scholarly journals Unique myological changes associated with ossified fabellae: a femorofabellar ligament and systematic review of the double-headed popliteus

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e10028
Author(s):  
Michael A. Berthaume ◽  
Spencer Barnes ◽  
Kiron K. Athwal ◽  
Lukas Willinger
Keyword(s):  
Systematic Review ◽  
Soft Tissue ◽  
Lateral Collateral Ligament ◽  
Temporal Changes ◽  
Anatomical Models ◽  
Anatomical Variant ◽  
Knee Anatomy ◽  
Medial Side ◽  
Fresh Frozen ◽  
Functional Consequences

Introduction The fabella is a sesamoid bone embedded in the tendon of the lateral head of the gastrocnemius. It is the only bone in the human body to increase in prevalence in the last 100 years. As the fabella can serve as an origin/insertion for muscles, tendons, and/or ligaments (e.g., the oblique popliteal and fabellofibular ligaments), temporal changes in fabella prevalence could lead to temporal changes in “standard” knee anatomy. The aim of this study was to investigate unique myological changes to the posterolateral corner knee associated with ossified fabella presence and perform a systematic review to contextualize our results. Methods Thirty-three fresh frozen cadaveric knees were considered. As the knees were all used for previous experimentation, the knees were in variable levels of preservation. Those with adequate preservation were used to determine ossified fabella presence/absence. When ossified fabellae were present, unique myologies associated with the fabella were recorded. A systematic review was performed on the double-headed popliteus to investigate possible correlations between this anatomical variant and the fabella. Results Of the 33 knees, 30 preserved enough soft tissue to determine fabella presence/absence: 16/30 knees had fabellae (five cartilaginous and 11 ossified). Eight of the eleven knees with ossified fabellae retained enough soft tissue to investigate the posterolateral knee anatomy. Of these, 4/8 exhibited unique myological changes. One knee had a double-headed popliteus muscle where one head originated from the medial side of a large, bulbous fabella. A systematic review revealed double-headed popliteus muscles are rare, but individuals are 3.7 times more likely to have a fabella if they have a double-headed popliteus. Another knee had a large, thick ligament stretching from the lateral edge of the fabella to the inferoposterior edge of the lateral femoral epicondyle, deep to the lateral collateral ligament (LCL) and near the popliteal sulcus. We found no mention of such a ligament in the literature and refer to it here as the “femorofabellar ligament”. In all four knees, the plantaris and lateral gastrocnemius appeared to share a common tendinous origin, and the fabella was located at/near the junction of these muscles. In the case of the double-headed popliteus, the fabella clearly served as an origin for the plantaris. Conclusions Despite being found in an average of 36.80% of human knees, most standard anatomical models fail to account for the fabella and/or the unique myological changes associated with fabella presence. Although our sample is small, these data highlight aspects of human biological variability generally not considered when creating generalized anatomical models. Further work is needed to identify additional changes associated with ossified fabellae and the functional consequences of omitting these changes from models.

scholarly journals Redefining Knee Balance in a Medially Stabilized Prosthesis: An In-Vitro Study

2017 ◽  
Vol 11 (1) ◽  
pp. 1165-1172
Author(s):  
Philippe Van Overschelde ◽  
Vera Pinskerova ◽  
Peter P. Koch ◽  
Christophe Fornasieri ◽  
Sandro Fucentese
Keyword(s):  
Soft Tissue ◽  
Soft Tissues ◽  
In Vitro Study ◽  
Lateral Release ◽  
Soft Tissue Release ◽  
Iliotibial Band ◽  
Soft Tissue Envelope ◽  
Medial Side ◽  
Fresh Frozen

Background: To date, there is still no consensus on what soft tissues must be preserved and what structures can be safely released during total knee arthroplasty (TKA) with a medially stabilized implant. Objective: The aim of this study was to analyze the effect of a progressive selective release of the medial and lateral soft tissues in a knee implanted with a medially stabilized prosthesis. Method: Six cadaveric fresh-frozen full leg specimens were tested. In each case, kinematic pattern and mediolateral laxity were measured in three stages: firstly, prior to implantation; secondly, after the implantation of the trial components, but before any soft tissue release; and thirdly, progressively as soft tissue was released with the trial implant in place. The incremental impact of each selective release on knee balance was then analyzed. Results: In all cases sagittal stability was not affected by the progressive release of the lateral soft tissue envelope. It was possible to perform progressive lateral release provided the anterior one-third of the iliotibial band (ITB) remained intact. Progressive medial release could be performed on the medial side provided the anterior fibers of the superficial medial collateral ligament (sMCL) remained intact. Conclusion: The medially conforming implant remains stable provided the anterior fibers of sMCL and the anterior fibers of the ITB remain intact. The implant’s sagittal stability is mainly dependent on its medial ball-in-socket design.

scholarly journals Accuracy of Percutaneous Lateral Release for Hallux Valgus: An Anatomic Study

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0010
Author(s):  
Lara C. Atwater ◽  
Matthew R. McDonald ◽  
Patrick J. Maloney ◽  
Rebecca A. Cerrato
Keyword(s):  
Soft Tissue ◽  
Minimally Invasive ◽  
Proximal Phalanx ◽  
Lateral Collateral Ligament ◽  
Cutaneous Nerve ◽  
Lateral Release ◽  
Soft Tissue Release ◽  
Percutaneous Technique ◽  
Fresh Frozen ◽  
Bunion Correction

Category: Bunion; Other Introduction/Purpose: Minimally Invasive Chevron and Akin (MICA) surgery is growing in popularity. There are now multiple studies comparing minimally invasive bunion correction to traditional open techniques. Many of these studies include percutaneous lateral soft tissue release using a specific blade, while others use an open technique. To our knowledge, there is no prior study confirming the accuracy of soft tissue release via percutaneous technique. Our objective was to evaluate the precision of the percutaneous release, both the structures released and percent release. Additionally, we identified adjacent nerves potentially at risk with a lateral soft tissue release, measuring their proximity to the incision and if they were damaged. Methods: Sixteen fresh frozen cadaveric foot specimens (8 paired limbs) underwent percutaneous lateral release utilizing a beaver blade under fluoroscopic guidance by two Foot and Ankle Fellowship Faculty who regularly perform the procedure. As described in early MICA technique papers by Redfern and Vernois, the blade was inserted into the plantar plate between the lateral sesamoid and the proximal phalanx. Then the blade was rotated laterally while the hallux was directed into varus. The goal was to release the lateral head of the Flexor Hallucis Brevis (FHB) without violating the Lateral Collateral Ligament (LCL). During our experiment the sesamoids were able to be successfully reduced after each release. The specimens were then dissected to reveal the extent of release of the FHB and LCL. Distance was measured between the blade path and the dorsal digital branch of the deep peroneal nerve, as well as the plantar digital nerve. Results: The FHB was at least partially released in 15/16 specimens. It was completely released in two specimens. 5/16 specimens had greater than 50% but less than 100% release and 8/16 specimens had <50% release. The LCL was completely intact in 8/16 specimens. It was partially released in 8/16 specimens (5 less than 50% released and 3 greater than 50% released). There was no correlation between percent of FHB release and the likelihood of LCL release. The dorsal cutaneous nerve was consistently near the path of the beaver blade, with a median distance of 2mm (range 1-8mm). However, the nerve was never found to be incised or transected. Likewise, the plantar nerve was never injured. Conclusion: This study sought to verify the effectiveness of percutaneous lateral release. We found the FHB to be at least partially released in all but one case, resulting in adequate clinical correction of sesamoid position. Full FHB release may not be necessary to achieve the clinical objective of sesamoid reduction. There was no correlation between percent of FHB release and concomitant release of the LCL, which demonstrates the challenge of an isolated FHB release. The dorsal cutaneous nerve was consistently near the blade path but was never injured, suggesting patients should be counseled regarding the risk. [Table: see text]

scholarly journals A systematic review of criteria used to report complications in soft tissue and oncologic surgical clinical research studies in dogs and cats

2019 ◽  
Vol 49 (1) ◽  
pp. 61-69 ◽  
Author(s):  
Christelle M. Follette ◽  
Michelle A. Giuffrida ◽  
Ingrid M. Balsa ◽  
William T. N. Culp ◽  
Philipp D. Mayhew ◽  
...  
Keyword(s):  
Systematic Review ◽  
Soft Tissue ◽  
Clinical Research ◽  
Research Studies

Cell-based therapy in soft tissue sports injuries of the knee: a systematic review

2021 ◽  
Author(s):  
Nardeen Kader ◽  
Vipin Asopa ◽  
Kwaku Baryeh ◽  
David Sochart ◽  
Nicola Maffulli ◽  
...  
Keyword(s):  
Systematic Review ◽  
Soft Tissue ◽  
Sports Injuries ◽  
Cell Based Therapy

Re-excision after unplanned excision of soft tissue sarcoma: A systematic review and metanalysis. The rationale of systematic re-excision

2021 ◽  
Author(s):  
Federico Sacchetti ◽  
Andac Celasun Alsina ◽  
Riccardo Morganti ◽  
Matteo Innocenti ◽  
Lorenzo Andreani ◽  
...  
Keyword(s):  
Systematic Review ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Unplanned Excision

scholarly journals Systematic Review: Adipose-Derived Mesenchymal Stem Cells, Platelet-Rich Plasma and Biomaterials as New Regenerative Strategies in Chronic Skin Wounds and Soft Tissue Defects

2021 ◽  
Vol 22 (4) ◽  
pp. 1538 ◽  
Author(s):  
Pietro Gentile ◽  
Simone Garcovich
Keyword(s):  
Systematic Review ◽  
Stem Cells ◽  
Wound Healing ◽  
Soft Tissue ◽  
Chronic Wounds ◽  
Platelet Rich Plasma ◽  
Skin Wounds ◽  
Soft Tissue Defects ◽  
Chronic Skin ◽  
Tissue Defects

The number of clinical trials evaluating adipose-derived mesenchymal stem cells (AD-MSCs), platelet-rich plasma (PRP), and biomaterials efficacy in regenerative plastic surgery has exponentially increased during the last ten years. AD-MSCs are easily accessible from various fat depots and show intrinsic plasticity in giving rise to cell types involved in wound healing and angiogenesis. AD-MSCs have been used in the treatment of soft tissue defects and chronic wounds, employed in conjunction with a fat grafting technique or with dermal substitute scaffolds and platelet-rich plasma. In this systematic review, an overview of the current knowledge on this topic has been provided, based on existing studies and the authors’ experience. A multistep search of the PubMed, MEDLINE, Embase, PreMEDLINE, Ebase, CINAHL, PsycINFO, Clinicaltrials.gov, Scopus database, and Cochrane databases has been performed to identify papers on AD-MSCs, PRP, and biomaterials used in soft tissue defects and chronic wounds. Of the 2136 articles initially identified, 422 articles focusing on regenerative strategies in wound healing were selected and, consequently, only 278 articles apparently related to AD-MSC, PRP, and biomaterials were initially assessed for eligibility. Of these, 85 articles were excluded as pre-clinical, experimental, and in vitro studies. For the above-mentioned reasons, 193 articles were selected; of this amount, 121 letters, expert opinions, commentary, and editorials were removed. The remaining 72 articles, strictly regarding the use of AD-MSCs, PRP, and biomaterials in chronic skin wounds and soft tissue defects, were analyzed. The studies included had to match predetermined criteria according to the patients, intervention, comparator, outcomes, and study design (PICOS) approach. The information analyzed highlights the safety and efficacy of AD-MSCs, PRP, and biomaterials on soft tissue defects and chronic wounds, without major side effects.

scholarly journals Accuracy and Reliability of Soft Tissue Landmarks Using Three-Dimensional Imaging in Comparison With Two-Dimensional Cephalometrics: A Systematic Review

2020 ◽  
Vol 54 (4) ◽  
pp. 289-296
Author(s):  
Adeeba Ali ◽  
Anil K. Chandna ◽  
Anshul Munjal
Keyword(s):  
Systematic Review ◽  
Soft Tissue ◽  
3D Imaging ◽  
Soft Tissues ◽  
Three Dimensional ◽  
Database Search ◽  
Cochrane Library ◽  
Two Dimensional ◽  
Imaging Tool ◽  
Electronic Database Search

Background: Concerns about the accuracy and reliability of soft tissue landmarks using two-dimensional (2D) and three-dimensional (3D) imaging. Objective: The aim of the systematic review is to estimate accuracy and reliability of soft tissue landmarks with 2D imaging and 3D imaging for orthodontic diagnosis planning and treatment planning purposes. Data Sources: Electronic database search was performed in MEDLINE via PubMed, Embase via embase.com, and the Cochrane library website. Selection Criteria: The data were extracted according to two protocols based on Centre for Evidence-Based Medicine (CEBM) critical appraisal tools. Next, levels of evidence were categorized into three groups: low, medium, and high. Data Synthesis: Fifty-five publications were found through database search strategies. A total of nine publications were included in this review. Conclusion According to the available literature, 3D imaging modalities were more accurate and reliable as compared to 2D modalities. Cone beam computed tomography (CBCT) was considered the most reliable imaging tool for soft tissues.

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