• Title/Summary/Keyword: Patella position

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Graft Length of the Bone-patellar Tendon-bone for Reconstruction of ACL (골-슬개건-골을 이용한 전방십자인대 재건술에서 이식물의 길이)

  • Kim, Jung-Man
    • Journal of the Korean Arthroscopy Society
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    • v.1 no.1
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    • pp.55-62
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    • 1997
  • Various surgical techniques has been advocated for reconstruction of anterior cruciate ligament using the bone-patella tendon-bone graft. Recently endoscopic technique provides good clinical results, with minimal skin incision, accurate positioning of the graft to the femoral tunnel, and decreasing wear rate of the graft. But the graft-tunnel mismatch remains problematic in endoscopic technique. The purpose of this paper is to described causes of the graft-tunnel mismatch and to provide important steps to prevent or minimize the graft-runnel mismatch following anterior cruciate ligament while using the endoscopic technique. Our guideline for prevention of the graft-tunnel mismatch are as follows: (1) The tunnel should he positioned closely to isometric point as much as possible. (2) Anterior placement of the tunnel should be avoided. (3) The change of graft length should be within 2mm between flexion and extension position.

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Reliability and Validity of the Manual Measurement Method for Patellar Height (무릎뼈 높이에 대한 도수측정방법의 신뢰도와 타당도)

  • Kim, Moon-Hwan;Yun, Sung-Joon;Weon, Jong-Hyuck
    • Physical Therapy Korea
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    • v.20 no.3
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    • pp.54-61
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    • 2013
  • This study was to determine the reliability and validity of manual measurements of patellar height to standard radiographic measurements in 30 knees of 15 subjects. Patellar height was measured using manual and radiographic methods. The manual measurements were performed by two examiners using digital vernier calipers with the subject sitting and the knees in $30^{\circ}$ of flexion. The radiographic measurements were performed in the same position. The reliability of the manual measurements was assessed by means of intraclass correlation coefficients [ICC(3,1)], and the validity was investigated using the Pearson's product-moment correlation coefficient and an independent t-test. The intra- and inter-rater reliabilities of the manual measurement of patellar height were excellent (ICC=.86 and .88 respectively). The validity of patellar height measured manually compared to the radiographic method was good (Pearson's r=.69). In conclusion, the manual method is an objective, qualitative measurement of patella height.

Three-Dimensional Contact Dynamic Model of the Human Knee Joint During Walking

  • Mun, Joung-Hwan;Lee, Dae-Weon
    • Journal of Mechanical Science and Technology
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    • v.18 no.2
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    • pp.211-220
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    • 2004
  • It is well known that the geometry of the articular surface has a major role in determining the position of articular contact and the lines of action for the contact forces. The contact force calculation of the knee joint under the effect of sliding and rolling is one of the most challenging issues in this field. We present a 3-D human knee joint model including sliding and rolling motions and major ligaments to calculate the lateral and medial condyle contact forces from the recovered total internal reaction force using inverse dynamic contact modeling and the Least-Square method. As results, it is believed that the patella, muscles and tendon affect a lot for the internal reaction forces at the initial heel contact stage. With increasing flexion angles during gait, the decreasing contact area is progressively shifted to the posterior direction on the tibia plateau. In addition, the medial side contact force is larger than the lateral side contact force in the knee joint during normal human walking. The total internal forces of the knee joint are reasonable compared to previous studies.

Effects of Knee Malalignment on Static and Dynamic Postural Stability

  • Chae, Yun-Won;Park, Ji-Won;Park, Seol
    • The Journal of Korean Physical Therapy
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    • v.27 no.1
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    • pp.7-11
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    • 2015
  • Purpose: This study was conducted in order to determine the effects of knee malalignment including genu varum, valgum, and recurvatum on static and dynamic postural stability. Methods: A total of 80 subjects were enrolled in this study. Subjects who showed over 3 cm in the distance between the knees were classified as the genu varum group, and subjects who showed over 3 cm in the distance between the ankles were classified as the genu valgum group. Subjects who showed over 1 cm in the distance between the patella and a table in prone position were classified as the genu recurvatum group. Static and dynamic stability were measured as overall, anterioposterior, and mediolateral balance index using a Biodex Balance System. Results: This study showed that knee alignment affected static and dynamic postural stability. In particular, there were significant differences in the mediolateral stability index among genu varum, valgum group, and the other groups, but no differences in overall and anteriolateral stability index. Significant differences in the anterioposterior stability index were observed between genu recurvatum and the other groups, however, there were no differences in overall and mediolateral stability index. Conclusion: The findings were that knee malalignment affects postural stability toward a specific direction. Treatment to improve postural stability for treatment of knee malalignment or to prevent falling or injuries is needed and postural stability toward a specific direction according to the knee alignment conditions should be considered.

Patellar Tendinitis in the adult Volleyball Players (성인 배구 선수에서 발생하는 슬개건염)

  • Moon Young Lae;Kim Keun Ho
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.1
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    • pp.44-49
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    • 2003
  • Purpose: To estimate the prevalence and incidence of patellar tendinitis, to discover the patellar tendinitis in top level male volley ball players. Materials and Methods: Thirteen members of the male adult volleyball players were included in this study. From history and physical examination, 3 of the 13 players had patellar tendon pain associated with activity and were diagnosed as patellar tendinitis at the time of the study. Investigators were blinded about the injury status of the players. For all players, data such as age, volleyball experience, amount of training and competition hours were recorded. Results: Of the thirteen cases, two spikers complained pain on the lower pole of the patella, one setter on the upper pole. Conclusion: This findings suggest that patellar tendinitis in the volleyball players are influenced by the amount of the practice and their position. In most cases, the supervised control of the practice will reduce the overuse injuries in the volleyball players.

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A Study on the Optimal Angle as Modified Tangential Projection of Knee Bones (무릎뼈의 변형된 접선방향 검사 시 최적의 입사각에 관한 연구)

  • Oh, Wang-Kyun;Kim, Sang-Hyun
    • Journal of the Korean Society of Radiology
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    • v.15 no.6
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    • pp.919-926
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    • 2021
  • In this study, we wanted to find out the optimal angle as a modified tangential projection of the patella. In the experiment, we used Kyoto Kagaku's PBU-50 phantom. In the supine position, the F-T angle was set to 95°, 105°, 115°, 125°, 135°, 145°, and Patella tangential projection images were obtained by varying the X-ray tube angle by 5° so that the angle between the X-ray centerline and tibia at each angle was 5~20°. Image J was used for image analysis and the congruence angle, lateral patellofemoral angle, patellofemoral index and contrast to noise ratio(CNR) were also measured. SPSS 22 was used for statistical analysis, and the mean values of congruence angle, patellofemoral angle, patellofemoral index, and CNR were compared with Merchant method through one-way batch analysis and corresponding sample t-test. As a result of the study, in the case of congruence angle, the angle of incidence of the knee-angle X-ray centerline was 105°-72.5° (20° tangential irradiation), 115°-72.5°, 77.5° (15, 20° tangential irradiation), 125°-82.5° (20° tangential irradiation), lateral patellofemoral angle is 115°-72.5°, 77.5° (15, 20° tangential irradiation), 125°-72.5° (10° tangential irradiation), patellofemoral index is 115°-72.5° (15° tangential irradiation) and 125°-72.5° (10° tangential irradiation) were not significantly different from Merchant method (p> .05). In case of CNR, it is not different from Merchant method at 105°-67.5°, 72.5° (15, 20° tangential irradiation), 115°-67.5°, 72.5°, 77.5° (10, 15, 20° tangential irradiation). (P> .05). Based on the results of this study, high diagnostic value images can be obtained by setting the knee angle and the angle of incidence of the X-ray tube to 115°-72.5° (15° tangential irradiation) during the modified tangential examination of the knee bone. It was confirmed.

The Regional Anatomy of Perforating artery and Pedicle for the Anterolateral Thigh Free Flap in the Korean (한국사람의 앞가쪽넙다리유리피판술에서의 관통동맥과 피판줄기에 대한 국소 해부)

  • Song, Hyun Suk;Park, Myong Chul
    • Archives of Plastic Surgery
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    • v.35 no.1
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    • pp.20-27
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    • 2008
  • Purpose: The anterolateral thigh flap has many advantages over other conventional free flaps. But the anterolateral thigh flap has yet to enter widespread use because perforating arteries exhibit a wide range of anatomic variations and are difficult to dissect when small. The aim of this study is to identify the vascular variability of perforating arteries and pedicle in the anterolateral thigh free flap. Methods: We studied 12 cadavers and dissected 23 thighs. An anterolateral thigh flap ($12{\times}12cm$) was designed and centered at the midpoint of the line drawn from anterior superior iliac spine to the superolateral border of the patella. After we identifed the perforating arteries we dissected up to their origin from lateral circumflex femoral artery along descending branch of lateral circumflex femoral artery. We then investigated the number and the position of perforating arteries, length and diameter of vascular pedicle and pattern of lateral circumflex femoral arterial system. Results: On average $2.3{\pm}1.1$ perforating arteries per thigh were identified. The musculocutaneous perforators were 63.1%. In those perforators five perforators were arose from transverse branch of lateral circumflex femoral artery and two were arose from rectus femoral artery. Most of the perforators were near the intermuscular septum between rectus femoris muscle and vastus lateralis muscle. The length and diameter of pedicle were $11.9{\pm}3.5cm$ and $3.1{\pm}0.8mm$ on average. Conclusion: This study will be helpful for the success in anterolateral thigh free flap.