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The American Journal of Sports Medicine Dec 2012The adverse effects of smoking on various health conditions such as cancer, diabetes, and cardiovascular disease have been well documented. Many orthopaedic conditions,... (Review)
Review
BACKGROUND
The adverse effects of smoking on various health conditions such as cancer, diabetes, and cardiovascular disease have been well documented. Many orthopaedic conditions, such as fracture healing, wound repair, and bone mineral density, have been reported to be adversely affected by smoking. However, no known systematic reviews have investigated the effects of smoking on ligament and cartilage knee surgery.
PURPOSE
We hypothesized that smoking would have a negative influence from both a basic science and clinical outcome perspective on these types of knee surgeries.
STUDY DESIGN
Systematic review.
METHODS
A systematic review of multiple medical databases was performed evaluating clinical and basic science studies to determine the effects of smoking on ligament and cartilage knee surgery.
RESULTS
Fourteen studies were found for inclusion and analysis. Eight of these studies addressed the relationship between smoking and knee ligaments, and 6 investigated the relationship between smoking and articular cartilage. With the exception of 1, all of the basic science and clinical studies exploring the relationship between smoking and knee ligaments found a negative association of smoking, either molecularly, biomechanically, or clinically. One basic science and 3 clinical studies found a negative influence of smoking on articular cartilage of the knee. No studies were found that investigated the relationship of smoking and menisci.
CONCLUSION
The current literature reveals a negative influence of smoking on the results of knee ligament surgery, both from a basic science and clinical perspective, implying that smoking cessation would benefit patients undergoing these procedures. The association between smoking and knee articular cartilage was less clear, although the literature still suggests an overall negative influence and highlights the need for further investigation.
Topics: Cartilage, Articular; Humans; Knee Injuries; Ligaments, Articular; Smoking
PubMed: 22972849
DOI: 10.1177/0363546512458223 -
The Kurume Medical Journal Mar 2022This paper aimed to better describe the anatomy of the superficial anterior atlanto-occipital ligament of the craniocervical junction and discuss this ligament's... (Review)
Review
This paper aimed to better describe the anatomy of the superficial anterior atlanto-occipital ligament of the craniocervical junction and discuss this ligament's potential function and clinical implications. A broad literature review on the anatomical features and findings of the superficial anterior atlanto-occipital ligament was performed. The superficial anterior atlanto-occipital ligament is located anterior to the anterior atlanto-occipital membrane. However, the physiological role of the superficial anterior atlanto-occipital ligament is still unclear due to a lack of anatomical and biomechanical studies although one study has suggested that this ligament is a secondary stabilizer of the craniocervical junction. Further studies are needed to clarify the function and anatomy of the superficial anterior atlanto-occipital ligament.
Topics: Atlanto-Occipital Joint; Humans; Ligaments, Articular
PubMed: 35095017
DOI: 10.2739/kurumemedj.MS671005 -
Journal of Orthopaedic Research :... Sep 2021Unfavorable clinical outcomes after medial patellofemoral ligament (MPFL) reconstruction, such as early osteoarthritis of the patellofemoral joint, were considered to be...
Unfavorable clinical outcomes after medial patellofemoral ligament (MPFL) reconstruction, such as early osteoarthritis of the patellofemoral joint, were considered to be associate with tunnel malpositioning. Length change studies have found that small changes in the femoral position can cause great changes in elongation trends. Further studying the MPFL kinematics may help us to understand the consequences of tunnel malpositioning and optimize the reconstruction techniques. Fifteen healthy subjects were studied with a combined computed tomography and biplane fluoroscopic imaging technique during a lunge motion. Five femoral and three patellar attachments were used to simulate different MPFL bundles. Kinematics of MPFL was defined as elongation and orientation changes (i.e., deviation angle and elevation angle). The mean deviation angle was 28.7° (95% confidence interval, 28.0°-29.4°) at full extension and remained nearly unchanged up to 60° of flexion, and increased to 56.5° (54.1°-58.9°) at 110°. The elevation angle decreased linearly from 12.6° (9.3°-15.9°) at full extension to -86.2° (-92.7-79.7°) at 110° of flexion. The MPFL was most stretched anteriorly and laterally relative to femur from full extension to 30° of flexion and remained near isometric beyond 30°. The current study found that proximal and anterior femoral attachments caused excessive lateral stretching of the MPFL at deeper flexion angles. Such abnormal MPFL kinematics may subsequently cause overconstraint and increased cartilage pressures of the medial patellofemoral joint.
Topics: Cadaver; Femur; Humans; Knee Joint; Ligaments, Articular; Patella; Patellofemoral Joint; Range of Motion, Articular
PubMed: 33002242
DOI: 10.1002/jor.24872 -
Osteoarthritis and Cartilage Jan 1999In this review article, we discuss current data and concepts concerning the molecular biology and biomechanics of both normal and healing ligaments in a rabbit model. (Review)
Review
OBJECTIVE
In this review article, we discuss current data and concepts concerning the molecular biology and biomechanics of both normal and healing ligaments in a rabbit model.
METHOD
Data is presented from light microscopy, transmission electron microscopy, molecular biology (RT-PCR), and biomechanical measurements (laxity, stress at failure, modulus, and static creep) or normal, pregnant and healing rabbit medial collateral ligaments.
RESULTS
'Flaws' in scar matrix, smaller-than-normal diameter collagen fibrils, and failure of collagen cross-link maturation may be particularly important deficiencies which appear to be related to ligament scar weakness and perhaps to scar creep. The mechanical behaviours of both normal and healing ligaments are altered by relative states of joint motion and normal ligaments are affected by systemic hormones (particularly during pregnancy).
DISCUSSION
Molecular analysis of ligaments and ligament scars, combined with ongoing morphological and biomechanical studies of ligament structure and function, will ultimately reveal which factors can be manipulated clinically to optimize the restoration of normal ligament properties after ligament injuries. Further studies on the mechanisms of ligament healing, genetic markers of repair, and gender-specific differences in ligament repair responses are required.
Topics: Animals; Biomechanical Phenomena; Female; Ligaments, Articular; Male; Rabbits; Sex Factors; Wound Healing
PubMed: 10367021
DOI: 10.1053/joca.1998.0168 -
Journal of Orthopaedic Research :... Dec 2022An adequate soft tissue balance is important in total hip arthroplasty (THA). This study assessed the contribution of the iliofemoral ligament, ischiofemoral ligament,...
An adequate soft tissue balance is important in total hip arthroplasty (THA). This study assessed the contribution of the iliofemoral ligament, ischiofemoral ligament, and conjoined tendon to the range of hip rotation after THA and hip stability in response to axial traction. THA was performed in eight fresh-frozen cadaveric specimens via an anterolateral approach using a navigation system. The ischiofemoral ligament, the medial arm of the iliofemoral ligament, and the conjoined tendon were resected in that order. The ranges of external and internal rotation and the amount of movement of the femoral head in response to axial traction were measured with the hip in 10° of extension, the neutral position, and in 10°, 30°, and 60° of flexion. Resection of the medial arm of the iliofemoral ligament significantly increased the range of external rotation in 10° of extension, the neutral position, and in 10°, 30°, and 60° of flexion. The conjoined tendon was the most important inhibitor of internal rotation from 10° of extension to 30° of flexion. Although each single element had a minor role in stabilizing the hip when axial traction was applied, resection of two or more elements significantly affected joint stability. The iliofemoral ligament and conjoined tendon are the main inhibitors of external rotation and internal rotation, respectively, when THA is performed using an anterior or anterolateral approach. Resection of two or more elements could greatly affect hip stability when axial traction is applied.
Topics: Humans; Arthroplasty, Replacement, Hip; Biomechanical Phenomena; Cadaver; Ligaments, Articular; Range of Motion, Articular; Tendons
PubMed: 35266582
DOI: 10.1002/jor.25320 -
Journal of Ultrasound in Medicine :... Feb 2019Ultrasonography (US) has been increasingly used in the evaluation of ankle ligamentous injuries given its advantages as a dynamic, efficient, noninvasive, and... (Review)
Review
Ultrasonography (US) has been increasingly used in the evaluation of ankle ligamentous injuries given its advantages as a dynamic, efficient, noninvasive, and cost-effective imaging method. Understanding the anatomy of the ankle ligaments is critical for correct diagnosis and treatment. This pictorial essay describes and illustrates the US scanning technique and potential pitfalls in evaluating the ankle ligaments and also provides an overview of the US appearance of normal and injured ankle ligaments with magnetic resonance imaging correlation. Highlighted structures include the lateral complex, medial/deltoid complex, spring (calcaneonavicular) ligament complex, and syndesmosis.
Topics: Ankle Injuries; Ankle Joint; Humans; Ligaments, Articular; Magnetic Resonance Imaging; Ultrasonography
PubMed: 30099744
DOI: 10.1002/jum.14716 -
Journal of Digital Imaging Dec 2022Several studies have investigated the relationship between the thickness of the posterior meniscofemoral ligament (pMFL) and the presence of a discoid meniscus. We...
Several studies have investigated the relationship between the thickness of the posterior meniscofemoral ligament (pMFL) and the presence of a discoid meniscus. We investigated the correlation between meniscal pathology and anatomic features of pMFL such as attachment type, thickness, and volume. We retrospectively evaluated 191 patients who underwent knee MRI. MR images were reviewed to assess the attachment type of the pMFL on the medial femoral condyle (high vs. low), the thickness of the pMFL, and the presence of a meniscal tear or a discoid meniscus. The pMFL volume was quantified by using three-dimensional (3D) segmentation software. The relationship between the frequency of medial or lateral meniscal tear and anatomic features of pMFL were analyzed using Chi-square, Fisher's exact, or Mann-Whitney U test. High type pMFLs had significantly greater thickness and volume than low type pMFLs (p < 0.001). Patients with degenerative lateral meniscal tear had significantly higher thickness and volume of the pMFL than patients with intact lateral meniscus (p < 0.05). The pMFL thickness and volume were not significantly related to traumatic lateral meniscal tear, medial meniscal tear, and discoid meniscus. High type pMFLs tended to be thicker and larger than low type pMFLs and higher thickness and volume of the pMFL was significantly related to the degenerative lateral meniscal tear. However, the attachment type of the pMFL itself was not significantly related to the lateral meniscal tear as well as the medial meniscal tear.
Topics: Humans; Tibial Meniscus Injuries; Retrospective Studies; Menisci, Tibial; Ligaments, Articular; Knee Joint; Magnetic Resonance Imaging
PubMed: 35668218
DOI: 10.1007/s10278-022-00651-6 -
Canadian Association of Radiologists... Feb 2016
Review
Topics: Adult; Ankle Joint; Athletic Injuries; Collateral Ligaments; Female; Humans; Ligaments, Articular; Magnetic Resonance Imaging
PubMed: 26800620
DOI: 10.1016/j.carj.2015.09.002 -
Archives of Orthopaedic and Trauma... Feb 2021Reconstruction of the scapho-lunate (SL) ligament is still challenging. Many different techniques, such as capsulodesis, tendon graft and bone-ligament-bone graft have...
INTRODUCTION
Reconstruction of the scapho-lunate (SL) ligament is still challenging. Many different techniques, such as capsulodesis, tendon graft and bone-ligament-bone graft have been described to stabilize reducible SL dissociation. If primary ligament repair alone is not possible, an additional stabilizer is needed to achieve scapho-lunate stability. A new local bone-ligament transfer using half of the radio-luno-triquetral ligament is performed. The direction of traction of the transposed ligament is very similar to the original ligament. Ideal tension can be attained by fixation of the bone block at the dorsal ridge of the scaphoid. The biomechanical stability of this bone-ligament transfer shall be examined biomechanically.
MATERIAL AND METHODS
Computed tomography imaging was performed using eight cadaveric forearms with a defined position of the wrist. Axial load was accomplished with tension springs attached to the extensor and flexor tendons. Three series ([a] native, [b] divided SL ligament and [c]) after reconstruction with bone-ligament transfer] were reconstructed three-dimensionally to determine the angles between radius, scaphoid and lunate. The radial distal part including a bone fragment of the radio-luno-triquetral ligament was transferred from its insertion at the distal edge of the radius to be attached to the dorsal ridge of the scaphoid.
RESULTS
SL gap was widened after its transection. Average SL distance was 6.6 ± 1.6 mm. After ligament reconstruction, the gap could be narrowed significantly to 4.2 mm (± 0.7 mm). The movement of the scaphoid and lunate showed significant changes, especially in wrist flexion, fist closure and radial deviation. These deviations could be corrected by the bone ligament transfer.
CONCLUSION
Reconstruction of a transected SL ligament with a bone-ligament transfer from the radio-luno-triquetral ligament reduces SL dissociation under axial load. The described surgical technique causes low donor-side morbidity and can be considered in addition to improve stability if SL ligament suture alone does not appear sufficient.
LEVEL OF EVIDENCE
Level II, therapeutic investigating experimental study.
Topics: Humans; Joint Instability; Ligaments, Articular; Lunate Bone; Orthopedic Procedures; Plastic Surgery Procedures; Scaphoid Bone; Tomography, X-Ray Computed
PubMed: 33251560
DOI: 10.1007/s00402-020-03690-2 -
Journal of Orthopaedic Research :... Mar 2009The first purpose of this study was to develop a noninvasive clinical tool that could predict whether the scapholunate interosseous ligament and other secondary...
The first purpose of this study was to develop a noninvasive clinical tool that could predict whether the scapholunate interosseous ligament and other secondary stabilizing ligaments are injured in the presence of suspected scapholunate instability. The second purpose of this study was to determine which of those ligaments or ligament groups have been injured. Kinematic and three-dimensional (3D) meaurements from 62 cadaver wrists moved in a wrist joint motion simulator were used to develop various neural network predictive models. One group of models was based on angular changes in scaphoid and lunate motion before and after ligament sectioning (representing scapholunate instability). A second group of models was based on changes in the minimum distance between the scaphoid and lunate as well as other 3D gap measurements. The models, based on the scaphoid and lunate angular data, could predict with a 93% accuracy rate whether the wrist ligaments were intact. These models could also predict whether it was the dorsal ligaments or the volar ligaments that were sectioned 84% of the time. The models worked best using data with the wrist in 10 to 30 degrees of wrist flexion. The viability of a CT-based predictive model has been demonstrated by obtaining high prediction rates, sensitivity, specificity, and kappa statistic values.
Topics: Cadaver; Humans; Joint Instability; Ligaments, Articular; Models, Biological; Wrist Injuries
PubMed: 18853432
DOI: 10.1002/jor.20749