• Title/Summary/Keyword: Tibial rotation

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Simulation of Three Dimensional Motion of the Knee Joint in Total Knee Arthroplasty (인공 무릎 관절의 3차원 운동 시뮬레이션)

  • Kim, Ki-Bum;Son, Kwon;Moon, Byung-Young
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2003.06a
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    • pp.1310-1315
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    • 2003
  • Severe osteoarthrosis of the knee joint often requires total knee arthroplasty (TKA) to yield adequate knee function. The knee joint with TKA is expected ideally to restore the characteristics, however, this is not necessarily true in the clinical cases. In this study the motions of the intact joint and the joint after TKA were investigated numerically using computer simulation. For active knee extension from 90 degrees of flexion to full extension, the intact knee joint exhibited anterior tibial translation near the full extension while it showed only rotation for other flexion angles. Physiologic external rotation of the tibia near full extension was also noted in the analytical model. The analysis of the tibial insert of three different shapes (flat, semicurved, and curved types) demonstrated characteristic rotational and sliding motions as well as different contact forces.

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Simulation of Three Dimensional Motion of the Knee Joint in Total Knee Arthroplasty (인공 무릎 관절의 3차원 운동 시뮬레이션)

  • Moon, Byung-Young;Son, Kwon;Kim, Ki-Bum;Seo, Jung-Tak
    • Journal of the Korean Society for Precision Engineering
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    • v.21 no.9
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    • pp.188-195
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    • 2004
  • Severe osteoarthrosis of the knee joint often requires total knee arthroplasty(TKA) to yield adequate knee function. The knee joint with TKA is expected ideally to restore the characteristics, however, this is not necessarily 1.ue in the clinical cases. In this study the motion of the intact joint and the joint after. TKA were investigated numerically using computer simulation. For active knee extension from 90 degrees of flexion to full extension, the intact knee joint exhibited anterior tibial translation near the full extension and it showed only rotation at other flexion angles. Physiologic external rotation of the tibia near full extension known as screw home movement was also noted in the analytical model. The analysis of the tibial insert of three different shapes (flat, semicurved, and curved types) demonstrated characteristic rotational and sliding motion as well as different contact forces.

Comparison of Tibial Tuberosity Transposition and Anti-rotation Suture for Medial Patellar Luxation in 133 Small-breed Dogs

  • Son, Chansoo;Cheong, Jongtae;Lee, Joo Myoung
    • Journal of Veterinary Clinics
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    • v.35 no.5
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    • pp.200-205
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    • 2018
  • This retrospective study is designed to compare the clinical results of tibial tuberosity transposition (TTT) and anti-rotation suture (ARS) treatments for medial patellar luxation (MPL). Medical records of 133 dogs were reviewed that had undergone surgical correction of MPL between January 2013 and May 2017. MPL correction was performed on 182 stifles, with TTT and ARS being performed on 101 stifles and 81 stifles. The common dog breeds receiving surgical treatment for MPL were Maltese, Pomeranian, Chihuahua and Poodle. Mean age of dogs with MPL was 32.6 months, and their mean body weight was 4.26 kg. Seventy dogs (52.6%) were male and 63 (47.4%) were female. Of the 182 stifles with MPL, grade II, III and IV were 18.7%, 72.0% and 9.3%. Total complications after TTT and ARS were recorded in 16.8% and 29.6%. Major complications after TTT and ARS were recorded in 5.9% and 12.3%, minor complications after TTT and ARS were recorded in 10.9% and 17.3%. The risk of complication and reluxation rate after TTT were significantly lower than that for ARS (p < 0.05). However, the rate of reluxation among dogs treated by ARS (1.2%) for grade II MPL was significantly lower than that for dogs treated by ARS (8.6%) for grade III MPL (p < 0.05). The TTT group had a shorter recovery period after surgical intervention than that in the ARS group (p < 0.001). In conclusion, TTT had a significantly lower incidence of complication and a shorter recovery period than ARS. However, ARS for grade II MPL appears to be a good surgical option for reducing the rate of reluxation after surgery. These results of this study could be used to provide therapeutic guidelines for surgical MPL correction in small-breed dogs.

Effect of Lateral and Posterior Placement of Single-Bundle and Double-Bundle ACL Reconstructions on Tibial Internal Rotation During Single-Leg Landing (전방십자인대 한다발재건술의 후외측다발 재건 및 두다발재건술이 외발착지 동작 시에 경골내회전에 미치는 영향)

  • Shin, Choong-Soo
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.35 no.5
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    • pp.517-523
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    • 2011
  • Anterior cruciate ligament (ACL) injuries are treatedwith surgical reconstruction. Although ACL consists of two functional bundles, only the anteromedial bundle is surgically reconstructed, and the effect of the reconstruction of the posterolateral bundle is unknown. The purpose of this study is to investigate the role of the posterolateral bundle and the effect of double-bundle reconstruction during single-leg landing. A 3D dynamic knee with various ACL reconstructed models was created using MRI, and single-leg landing motion was simulated using in-vivo human experimental data. The results showed that the lateral shift of the tibial insertion of the anteromedial bundle and the posterolateral bundle of the ACL constrain the tibial internal rotation more efficiently than a single anteromedial bundle can. In addition, double-bundle ACL reconstruction is less sensitive to inaccuracies in the tibial tunnel placement.

Low Tibial Osteotomy (저위 경골 절골술)

  • Choi, Jun Young;Suh, Jin Soo
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.4
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    • pp.141-146
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    • 2014
  • Low tibial osteotomy is an extra-articular procedure that realigns the mechanical axis, restoring ankle function. It is also an alternative surgical procedure to manage early osteoarthritis of the ankle joint. This can mainly address ankle varus/valgus, as well as procurvatum/ recurvatum, internal/external rotation, equinus, calcaneus, and limb length discrepancy. The authors describe the history, mechanism, indications, and limitations of low tibial osteotomy focused on osteoarthritis of the ankle with varus malalignment reviewing several articles published thus far.

The influence of the genu varum and the genu valgum on malalignment of the lower limb (내반슬, 외반슬의 부정정렬이 하지에 미치는 영향)

  • Moon, Sung-Gi
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.6 no.2
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    • pp.31-38
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    • 2000
  • The influence of the genu varum and the genu valgum in two groups of twenty adult man with deformation on hip joint, knee joint, ankle joint is as follows. 1. Each and all, the statistics that measure tibiofemorial angle indicated the group of the genu varum 168 1.42 and the group of the genu valgum 193 2.21, that was more larger or smaller than normal angle 183 of tibiofemorial. The measure Q-Angle(patellofemorial) indicates the group of the genu varum 9 1.5, the genu valgum 19 2.3, that was larger or smaller than normal angle 13. 2. It showed that range of motion hip joint adduction in the group of the genu varum was more larger than normal range of motion hip joint abduction in the group of the genu valgum was more larger than normal range of motion, hip joint internal rotation in the group of the genu valgum was more larger than normal range of motion, hip joint external rotation in the group of the genu varum was more larger than normal range of motion. 3. range of motion knee joint flexion was simillar to two groups of the genu varum and the genu valgum. On tibial tortion of the leg, the group of the genu varum indicated medial tibial tortion, and the genu valgum indicated lateral tibial tortion. 4. Each groups of the genu varum and the genu valgum in plantarflexion and dorsiflexion of ankle joint. With peak angle, the group of the genu varum showed toe-in that was more smaller than normal angle, and the group of the genu valgum showed toe-out that was more larger than normal angle.

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Correlation between femoral rotation and clinical results after high tibial osteotomy in primary osteoarthritis patient (퇴행성 골관절염 환자에서 시행한 근위 경골 절골술 후 대퇴골의 회전과 임상결과의 상관관계)

  • Park, Sang Eun;Mun, Sang Won
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.10 no.2
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    • pp.100-104
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    • 2011
  • The purpose of this article is to examine correlation between femoral rotational angle and subjective satisfaction of high tibial osteotomy outcome of the range of motion of knee joint. The subjects were 15 patients (6 males, 9 females) with primary osteoarthritis undergoing high tibial osteotomy from June of 2004 to August of 2008. They were CT tested on the knee joint before and after high tibial osteotomy. TEA (Fig. 1) and Akagi's line (Fig. 2) are analyzed as percentages. The Kendall's and Spearman's nonparametric correlation coefficient were used for the statistical tests with 0.5 level of significance. The result reveals that femoral rotational angle correlates with not the range of motion of knee joint but subjective satisfaction of the patients. Therefore, this will enable patients and physicians to have better clinical outcome.

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Joint Position Effects on Biceps Femoris and Peroneal Muscle Activation and Ankle Evertor Strength

  • Do-eun Lee;Jun-hee Kim;Seung-yoon Han;Oh-yun Kwon
    • Physical Therapy Korea
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    • v.31 no.2
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    • pp.114-122
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    • 2024
  • Background: The peroneus longus (PL) and peroneus brevis (PB) function as the primary muscles of eversion, a movement closely associated with tibial external rotation for ankle mortise stability. Ankle motion and tibial rotation vary based on different ankle and knee positions. Objects: This study aimed to investigate the PL, PB, and biceps femoris (BF) muscle activation and eversion strength during side-lying isometric eversion exercise based on different ankle positions (neutral [N] and plantarflexion [PF]) and knee positions (90° flexion [KF] and extension [KE]). Methods: Thirty healthy adults with an Ankle Joint Functional Assessment Tool score of ≥ 22 were recruited (mean age = 24.8 ± 3.1 years). Maximal isometric eversion strength and submaximal muscle activation of the PL, PB and BF were measured during isometric eversion exercise in side-lying. A 2 × 2 repeated measures analysis of variance was performed to investigate differences in muscle activation and strength. Results: The PL and PB muscle activation showed significant main effects with the knee and ankle positions (p < 0.05); activation was greater in the KE and PF positions than in the KF and N positions. The BF muscle activation showed a significant interaction effect with knee and ankle positions, which was greater in knee extension and ankle plantarflexed (KEPF) position than in knee flexion and ankle plantarflexed (KFPF) position (p < 0.05). Eversion strength showed a significant main effect only in ankle position (p < 0.05) and was greater in the N position than in the PF position. Conclusion: The results of this study indicate that the KEPF position can be recommended to facilitate contraction of the PL and PB during side-lying eversion exercise. Furthermore, the effects of the knee-ankle positions should be considered for measuring ankle eversion strength and implementing the isometric submaximal side-lying eversion exercise.

Perforator-Based Propeller Flap for Lower Extremity Reconstruction (천공지기저 프로펠러 피판술을 이용한 하지 재건)

  • Huh, Sung-Woo;Bae, Jae-Ho;Song, Joo-Hyoun;Lee, Joo-Yup
    • Archives of Reconstructive Microsurgery
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    • v.21 no.2
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    • pp.111-117
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    • 2012
  • Purpose: To report the clinical results of the perforated-based propeller flap for lower extremity soft tissue reconstruction. Materials and Methods: Between January 2010 and June 2012, a total of 16 defects in the lower extremities were covered with perforator-based propeller flaps. Retrospective data for location and size of the defect, flap dimension, pedicle artery, pedicle rotation, complications were obtained. Results: Peroneal artery-based perforator flap were used in eleven cases, posterior tibial artery-based perforator flap in two cases, anterior tibial artery-based perforator flap in one case and medial plantar artery-based perforator flap in two cases. The average size of the flaps was $63cm^2$. The marginal skin necrosis of the flaps as a complication was developed in two cases, one of which was covered with split-thickness skin graft. There were no functional deficits from the donor site. Conclusion: For the reconstruction of lower extremities, the perforator-based propeller flap could be a reasonable alternative as it is a simple, safe and versatile technique.

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Restoring blood flow to the lateral plantar artery after elevation of an instep flap or medialis pedis flap

  • Velazquez-Mujica, Jonathan;Amendola, Francesco;Spadoni, Davide;Chen, Hung-Chi
    • Archives of Plastic Surgery
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    • v.49 no.1
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    • pp.80-85
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    • 2022
  • The instep flap and medialis pedis flap are both originate based on the medial plantar artery. The medialis pedis flap is based from the deep branch and the instep flap is based from the superficial branch. To increase the axial rotation, it is acceptable to ligate the lateral plantar artery. However, this can partially affect the blood supply of the plantar metatarsal arch. We restored the blood flow with a vein graft between the posterior tibial artery and the ligated stump. From 2012 to 2020, 12 cases of heel reconstruction, including seven instep flaps and five medialis pedis flaps, were performed with ligation of the lateral plantar artery. The stump of the lateral plantar artery was restored with a vein graft and between the posterior tibial artery and the ligated stump. Patients were followed for 18 months. Long-term results showed the vascular restoration of the lateral plantar artery remained patent demonstrated by doppler ultrasonography. Restoring blood flow to the lateral plantar artery maintains good blood supply to the toes. If the patient in the future develops a chronic degenerative disease, with microvascular complications, bypass surgery can still be performed because of the patency of both branches.