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Displaying publications 21 - 26 of 26 in total

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Distal Femoral Rotation Correlates With Proximal Tibial Joint Line Obliquity: A Consideration for Kinematic Total Knee Arthroplasty

Ng CK, Chen JY, Yeh JZY, Ho JPY, Merican AM, Yeo SJ

J Arthroplasty, 2018 06;33(6):1936-1944.
PMID: 29395720 DOI: 10.1016/j.arth.2017.12.025

BACKGROUND: We hypothesized that there is a correlation between the distal femoral rotation and proximal tibial joint line obliquity in nonarthritic knees. This has significance for kinematic knee arthroplasty, in which the target knee alignment desired approximates the knee before disease.
METHODS: Fifty computed tomography scans of nonarthritic knees were evaluated using three-dimensional image processing software. Four distal femoral rotational axes were determined in the axial plane: the transepicondylar axis (TEA), transcondylar axis (TCA), posterior condylar axis (PCA), and a line perpendicular to Whiteside's anterior-posterior axis. Then, angles were measured relative to the TEA. Tibial joint line obliquity was measured as the angle between the proximal tibial plane and a line perpendicular to the axis of the tibia.
RESULTS: There was a strong positive correlation between PCA-TEA and tibial joint line obliquity (r = 0.68, P < .001) as well as TCA-TEA and tibial joint line obliquity (r = 0.69, P < .001). In addition, the tibial joint line obliquity and TCA-TEA angles were similar, 3.7° ± 2.2° (mean ± standard deviation) and 3.5° ± 1.7°, respectively (mean difference, 0.2° ± 0.2°; P = .369).
CONCLUSION: Both PCA-TEA and TCA-TEA strongly correlated with proximal tibial joint line obliquity indicating a relationship between distal femoral rotational geometry and proximal tibial inclination. These findings could imply that the native knee in flexion attempts to balance the collateral ligaments toward a rectangular flexion space. A higher tibial varus inclination is matched with a more internally rotated distal femur relative to the TEA.

Matched MeSH terms: Femur/surgery*
Fulltext Design process of cementless femoral stem using a nonlinear three dimensional finite element analysis

Baharuddin MY, Salleh ShH, Zulkifly AH, Lee MH, Noor AM, A Harris AR, et al.

BMC Musculoskelet Disord, 2014;15:30.
PMID: 24484753 DOI: 10.1186/1471-2474-15-30

Minimal available information concerning hip morphology is the motivation for several researchers to study the difference between Asian and Western populations. Current use of a universal hip stem of variable size is not the best option for all femur types. This present study proposed a new design process of the cementless femoral stem using a three dimensional model which provided more information and accurate analysis compared to conventional methods.

Matched MeSH terms: Femur/surgery*
Bilateral atypical femoral diaphyseal fractures in a patient treated with alendronate sodium

Lee JK

Int J Rheum Dis, 2009 Jul;12(2):149-54.
PMID: 20374333 DOI: 10.1111/j.1756-185X.2009.01396.x

Antiresorptive agents have been used as primary or first-line therapy in managing patients with osteoporosis. Bisphosphonates in particular are used widely to reduce bone resorption, increase bone mineral density, improve bone quality and therefore reduce fracture risk. However, prolonged use of bisphosphonates may cause over-suppression of bone resorption, leading on to accumulation of micro-damage in bone. This in turn might lead on to atypical femoral fractures. A patient treated with alendronate sodium for 8 years, and presenting with bilateral atypical femoral diaphyseal fractures is reported. X-rays of both femurs showed typical horizontal fracture line involving the thick lateral cortex with short oblique fracture pattern over the medial cortex. This fracture pattern was further confirmed with intra-operative examination of the fracture ends. Histopathological examination of the endocortical fragment removed from the proximal fracture end showed absence of osteoclasts and osteoblasts. Bone mineral density with dual energy X-ray absorptiometry (DXA) scan showed osteopenia over the femoral neck. Blood investigations did not show significant abnormalities. Bone turnover marker levels were not reliable, as presence of fracture might have altered the marker levels. Both femoral fractures united well. The patient reported here had complete pictures on X-ray examination, intra-operative findings, histopathological examination, DXA, as well as blood test results. Complete data should be collected from patients treated with alendronate sodium presenting with atypical femoral fractures to show any link between the use of alendronate sodium with atypical fracture of femur.

Matched MeSH terms: Femur/surgery
Fulltext Early complication following long bone reconstruction using vascularised fibula graft

Imran Y, Zulmi W, Halim AS

Med J Malaysia, 2004 Dec;59 Suppl F:35-8.
PMID: 15941158

Long bone reconstruction using vascularized fibula graft is becoming more popular despite the difficulties and its post-operative complications. We reviewed our early experience dealing with vascularized fibula graft for the management of massive long bone defect. Thirteen patients had undergone long bone reconstruction using vascularized fibula graft. Early complications that had been encountered include superficial wound infection (23%), transient common peroneal nerve palsy (23%), stage 1 bed sore (7.7%), anastomotic venous thrombosis (30.8%), DIVC (15.4%), flap loss and amputation (7.7%), and reactive psychiatric problem (7.7%). The early complications following this procedure are comparable with other major orthopaedic surgery and most of them are minor and treatable. The complication rates are also comparable with similar surgery done elsewhere.

Matched MeSH terms: Femur/surgery
Fulltext Metastatic disease of the proximal femur

Faisham WI, Zulmi W, Biswal BM

Med J Malaysia, 2003 Mar;58(1):120-4.
PMID: 14556337

Since January 1999, ten patients had undergone surgical treatment for metastatic bony lesions of proximal femur at this centre. Seven of these patients were treated for complete pathological fractures, one for impending fracture and one for revision of internal fixation and loosening of hemiarthroplasty. Primary malignancies were located in breast in four cases, prostate in three and one in lung, thyroid and neurofibrosarcoma. Two patients had died within six months after surgery, four after 1 year while the remaining four were still alive. The mean duration of survival was eleven months. Nine patients had been ambulating pain free and there were no failure of reconstruction.

Matched MeSH terms: Femur/surgery
Comparable clinical and radiological outcomes between anatomical and high femoral tunnels in posterior cruciate ligament reconstruction

Yoon KH, Kim JS, Park JY, Park SY, Kiat RYD, Kim SG

Knee Surg Sports Traumatol Arthrosc, 2021 Jun;29(6):1936-1943.
PMID: 32914218 DOI: 10.1007/s00167-020-06266-0

PURPOSE: To compare clinical and radiological outcomes and failure rates between anatomical and high femoral tunnels in remnant-preserving single-bundle posterior cruciate ligament (PCL) reconstruction.
METHODS: 63 patients who underwent remnant-preserving single-bundle PCL reconstruction between 2011 and 2018 with a minimum 2-year follow-up were retrospectively reviewed. Patients were divided into two groups according to the femoral tunnel position: group A (33 patients with anatomical femoral tunnel) and group H (30 patients with high femoral tunnels). The femoral tunnel was positioned at the center (group A) or upper margin (group H) of the remnant anterolateral bundle. The position of the femoral tunnel was evaluated using the grid method on three-dimensional computed tomography. Clinical and radiological outcomes and failure rates were compared between the groups at the 2-year follow-up.
RESULTS: The position of the femoral tunnel was significantly high in group H than in group A (87.4% ± 4.2% versus 76.1% ± 3.7%, p

Matched MeSH terms: Femur/surgery*