-
The Journal of the American Osteopathic... Dec 2016
Topics: Adult; Female; Humans; Patella; Radiography
PubMed: 27893149
DOI: 10.7556/jaoa.2016.158 -
Journal of Exposure Science &... Feb 2021Lead is a ubiquitous toxicant following three compartment kinetics with the longest half-life found in bones. Patella and tibia lead levels-validated measures of...
BACKGROUND
Lead is a ubiquitous toxicant following three compartment kinetics with the longest half-life found in bones. Patella and tibia lead levels-validated measures of cumulative exposure-require specialized X-ray-fluorescence-spectroscopy available only in a few centers worldwide. We developed minimally invasive biomarkers reflecting individual cumulative lead exposure using blood DNA methylation profiles-obtainable via Illumina 450K or IlluminaEPIC bead-chip assays.
METHODS
We developed and tested two methylation-based biomarkers from 348 Normative Aging Study (NAS) elderly men. We selected methylation sites with strong associations with bone lead levels via robust regressions analysis and constructed the biomarkers using elastic nets. Results were validated in a NAS subset, reporting specificity, and sensitivity.
FINDINGS
Participants were 73 years old on average (standard deviation, SD = 6), with moderate lead levels of (mean ± SD patella: 27 ± 18 µg/g; tibia:21 ± 13 µg/g). Methylation-based biomarkers for lead in patella and tibia included 59 and 138 DNA methylation sites, respectively. Estimated lead levels were significantly correlated with actual measured values, (r = 0.62 patella, r = 0.59 tibia) and had low mean square error (MSE) (MSE = 0.68 patella, MSE = 0.53 tibia). Means and distributions of the estimated and actual lead levels were not significantly different across patella and tibia bones (p > 0.05). Methylation-based biomarkers discriminated participants highly exposed (>median) to lead with a specificity of 74 and 73% for patella and tibia lead levels, respectively, with 70% sensitivity.
INTERPRETATION
DNA methylation-based lead biomarkers are novel tools that can be used to reconstruct decades' worth of individual cumulative lead exposure using only blood DNA methylation profiles and may help identify the consequences of cumulative exposure.
Topics: Adult; Aged; Aging; DNA Methylation; Environmental Exposure; Humans; Lead; Male; Patella; Tibia
PubMed: 31636367
DOI: 10.1038/s41370-019-0183-9 -
Aging Dec 2020In this study, we investigated whether the measurement of patellar tracking can be used as a diagnostic parameter of patellofemoral joint disease. Patellar tracking is... (Review)
Review
In this study, we investigated whether the measurement of patellar tracking can be used as a diagnostic parameter of patellofemoral joint disease. Patellar tracking is defined as the movement of the patella in relation to the femorotibial joint within the full range of flexion and extension of the knee joint. The PubMed, EMBASE, Medline, PsychINFO, and AMED databases were used to find relevant articles. Analyzed were the patellar tracking coordinate system and the measurement objects, precision, methods used in those studies, as well as the results obtained. Origin points for coordinate systems varied across the studies. The research object and methods of patellar tracking varied in the studies. Most studies focused on a static description of the internal and external displacement and the internal and external inclination. The , noninvasive, and six degrees of freedom evaluation of patellar tracking reflect patellar motion more comprehensively, though each of these methods does so in different ways. Dynamic and quantitative evaluation of patellar tracking is still lacking in clinical work. Accurate and quantitative patellar tracking measurement could provide clinicians with a comprehensive evaluation of the stability of the knee joint.
Topics: Biomechanical Phenomena; Humans; Knee Joint; Patella; Patellofemoral Joint; Range of Motion, Articular
PubMed: 33260153
DOI: 10.18632/aging.202161 -
International Orthopaedics Dec 2012Recurrent patellofemoral instability is a disabling condition, attributed to a variety of anatomical aetiologies. Trochlear dysplasia, patella alta, an increased tibial... (Review)
Review
Recurrent patellofemoral instability is a disabling condition, attributed to a variety of anatomical aetiologies. Trochlear dysplasia, patella alta, an increased tibial tubercle trochlear groove distance of greater than 20 mm and soft tissue abnormalities such as a torn medial patellofemoral ligament and inadequate vastus medialis obliquus are all factors to be considered. Management of this condition remains difficult and controversial and knowledge of the functional anatomy and biomechanics of the patellofemoral joint, a detailed history and clinical examination, and an accurate patient assessment are all imperative to formulate an appropriate management plan. Surgical treatment is based on the underlying anatomical pathology with an aim to restore normal patellofemoral kinematics. We summarise aspects of assessment, treatment and outcome of patellofemoral instability and propose an algorithm of treatment.
Topics: Algorithms; Biomechanical Phenomena; Disease Management; Humans; Joint Instability; Knee Joint; Osteotomy; Patella; Radiography; Treatment Outcome
PubMed: 23052278
DOI: 10.1007/s00264-012-1669-4 -
Journal of Anatomy May 2016The patella (kneecap) is the largest and best-known of the sesamoid bones, postulated to confer biomechanical advantages including increasing joint leverage and...
The patella (kneecap) is the largest and best-known of the sesamoid bones, postulated to confer biomechanical advantages including increasing joint leverage and reinforcing the tendon against compression. It has evolved several times independently in amniotes, but despite apparently widespread occurrence in lizards, the patella remains poorly characterised in this group and is, as yet, completely undescribed in their nearest extant relative Sphenodon (Rhynchocephalia). Through radiography, osteological and fossil studies we examined patellar presence in diverse lizard and lepidosauromorph taxa, and using computed tomography, dissection and histology we investigated in greater depth the anatomy and morphology of the patella in 16 lizard species and 19 Sphenodon specimens. We have found the first unambiguous evidence of a mineralised patella in Sphenodon, which appears similar to the patella of lizards and shares several gross and microscopic anatomical features. Although there may be a common mature morphology, the squamate patella exhibits a great deal of variability in development (whether from a cartilage anlage or not, and in the number of mineralised centres) and composition (bone, mineralised cartilage or fibrotendinous tissue). Unlike in mammals and birds, the patella in certain lizards and Sphenodon appears to be a polymorphic trait. We have also explored the evolution of the patella through ancestral state reconstruction, finding that the patella is ancestral for lizards and possibly Lepidosauria as a whole. Clear evidence of the patella in rhynchocephalian or stem lepidosaurian fossil taxa would clarify the evolutionary origin(s) of the patella, but due to the small size of this bone and the opportunity for degradation or loss we could not definitively conclude presence or absence in the fossils examined. The pattern of evolution in lepidosaurs is unclear but our data suggest that the emergence of this sesamoid may be related to the evolution of secondary ossification centres and/or changes in knee joint conformation, where enhancement of extensor muscle leverage would be more beneficial.
Topics: Animals; Biological Evolution; Fossils; Lizards; Patella; Phylogeny
PubMed: 26740056
DOI: 10.1111/joa.12435 -
Orthopaedics & Traumatology, Surgery &... Feb 2023Good patellar tracking is needed for functionally successful total knee arthroplasty (TKA), and depends on several factors. The aim of the present Instructional Lecture... (Review)
Review
Good patellar tracking is needed for functionally successful total knee arthroplasty (TKA), and depends on several factors. The aim of the present Instructional Lecture is to identify the main factors and how to control them so as to optimize patellar tracking: more or less "patella-friendly" prosthetic trochlea design, requiring precise assessment and choice of model; patellar component design; type of tibial implant; surgical approach and management of peripatellar structures, and any lateral release; distal and posterior femoral bone cuts, determining femorotibial alignment, femoral component rotation and patellar height; tibial implant rotation with respect to the anterior tibial tubercle; patellar cut characteristics in resurfacing. In case of instability or patellar maltracking despite correct implant positioning, there are 2 main surgical techniques: medial patellofemoral ligament reconstruction, and anterior tibial tubercle medialization. To obtain optimal patellar tracking, correction of other factors should be associated: trochlear component design, distal and posterior femoral bone cuts, tibial implant positioning, patellar component shape and positioning, etc.
Topics: Humans; Arthroplasty, Replacement, Knee; Patella; Knee Joint; Femur; Tibia
PubMed: 36302447
DOI: 10.1016/j.otsr.2022.103458 -
Computational and Mathematical Methods... 2022Memory alloy patella claws for treating patella fractures have been used for more than 30 years with many desirable features including fast healing, quick recovery, and...
Memory alloy patella claws for treating patella fractures have been used for more than 30 years with many desirable features including fast healing, quick recovery, and avoidance of top abrasion of Kirschner wires and other complications. However, there are many models and it is difficult to choose the accurate claw for the patient. In this study, a finite element model of the butterfly-shaped patellar claw made of shape memory alloy was established, its mechanical structure was analyzed, and its clinical application was monitored. We used Solidworks Simulation software for modeling and mainly analyzed the force of the compression ring of the butterfly-shaped patellar claw. Clinically, we chose a closed fresh patella fracture case. After finite element analysis, the maximum stress that the compression ring of the butterfly-shaped patellar claw can withstand is 568.1 MPa. In this range, it always has elastic deformation resistance. The butterfly-shaped patella claw is fixed on the patella and will not break when subjected to a maximum force of 150 N on the encircling arm, and at the same time, there will be no pressure failure due to plastic deformation. A total of 27 cases were clinically used for the assessment of the clinical efficacy of the newly designed butterfly-shaped patella claws. The average follow-up time was 15.5 months, and the average fracture healing time was 8-12 weeks. All patients can get out of bed with crutches within 2 to 3 days after surgery. Among them, there were 15 cases with excellent functional ratings, 10 cases with good ratings, 2 cases with acceptable ratings, and no cases with poor ratings. The designed butterfly-shaped patella claws can provide an effective method for the treatment of patella fractures.
Topics: Adolescent; Adult; Biomechanical Phenomena; Computational Biology; Computer Simulation; Computer-Aided Design; Elastic Modulus; Female; Finite Element Analysis; Fracture Fixation, Internal; Humans; Internal Fixators; Intra-Articular Fractures; Male; Middle Aged; Nickel; Patella; Prosthesis Design; Shape Memory Alloys; Software; Stress, Mechanical; Tensile Strength; Titanium; Treatment Outcome; Young Adult
PubMed: 35154357
DOI: 10.1155/2022/2008668 -
British Medical Journal (Clinical... Mar 1981
Topics: Adolescent; Cartilage Diseases; Diagnosis, Differential; Female; Humans; Osteoarthritis; Patella
PubMed: 6783225
DOI: No ID Found -
BMC Surgery Sep 2022Inferior pole fracture of the patella (IPFP) has small and comminuted fracture blocks that are hard to immobilize, and early mobilization may lead to loss of fracture...
BACKGROUND
Inferior pole fracture of the patella (IPFP) has small and comminuted fracture blocks that are hard to immobilize, and early mobilization may lead to loss of fracture reduction and immobilization failure. Therefore, a difficulty of treatment is to achieve rigid immobilization with early functional exercise. Here, a new treatment method of tension-free external immobilization is put forward.
METHODS
The clinical data of 11 IPFP patients treated with tension-free external immobilization from May 2016 to June 2019 were retrospectively analyzed. There were six males and five females aged 39.0 ± 12.8 years (range 18-53 years). IPFP was caused by traffic accidents in five cases and falls in six cases. All cases had unilateral closed injuries, including four in the left knee and seven in the right knee. The preoperative range of motion of the knee was 22.0 ± 7.5° (10-30°). The time from injury to operation was 4.5 ± 1.3 d (3-7 d). The operation-related indices were recorded, and the function of the affected knee was assessed by the Böstman score.
RESULTS
All operations were successful. The operation time was 56.4 ± 8.4 mi (45-70 min), the intraoperative blood loss was 54.1 ± 14.6 mL (40-80 mL), and the length of hospital stay was 7.5 ± 1.9 d (5-11 d). The mean follow-up time was 20.4 ± 7.6 months (12-36 months), the duration of fracture healing was 8.9 ± 1.5 weeks (7-12 weeks), and the removal time of the external immobilization device was 10.4 ± 0.9 weeks (9-12 weeks). At the last follow-up, the range of motion had no significant difference between the affected knee (129.7 ± 3.3°, range 125-135°) and the unaffected knee (130.8 ± 3.8°, range 126-137°) (t = 0.718, p < 0.05). The Böstman score of the knee was 29.2 ± 1.0 points (27-30 points), including 10 excellent cases (90.9%) and one good case (9.1%).
CONCLUSION
Tension-free external immobilization is a feasible treatment for IPFP. It can help with early functional exercise and achieve a satisfactory clinical effect.
Topics: Bone Wires; Female; Fracture Fixation, Internal; Fractures, Bone; Humans; Knee Injuries; Male; Patella; Retrospective Studies
PubMed: 36096769
DOI: 10.1186/s12893-022-01790-x -
Bulletin of the NYU Hospital For Joint... 2007
Review
Topics: Biomechanical Phenomena; Bone Malalignment; Femur; Humans; Joint Dislocations; Joint Instability; Knee Injuries; Knee Joint; Patella; Radiography
PubMed: 18081546
DOI: No ID Found