Intercondylar Width Research Articles

Relationship between Intercondylar Width and Intermolar Distance – A Radiographic Study

Objectives To study the relationship between intercondylar width and intermolar distance in dentulous patients, the result of which may be applied to edentulous patients for teeth setting with maxillary first molar in focus. Material and Methods Sixty subjects consisting of 30 males and 30 females were selected, and maxillary impressions were made, followed by making study models; the intermolar distance was measured by marking the mesiobuccal cusp of maxillary molars and transferring the same for measurement. The subjects were then subjected to reverse Towne view (open mouth) and intercondylar width was measured between the exterior most points of both condyles on the X-ray film. The ratio between intercondylar width and intermolar distance was measured. The values were also subjected to statistical analysis. Results A high correlation existed between Intercondylar Width and intermolar distance in the dentulous patients. The intercondylar width, intermolar distance, and the ratio between intercondylar width and intermolar distance were higher in males than females. Conclusion Intercondylar width and intermolar distance were significantly correlated. Intercondylar width, intermolar distance, and the ratio between them were more in males than females.

Mandibular Gender Dimorphism: The Utility of Artificial Intelligence and Statistical Shape Modeling in Skeletal Facial Analysis.

In gender-affirming surgery, facial skeletal dimorphism is an important topic for every craniofacial surgeon. Few cephalometric studies have assessed this topic; however, they fall short to provide skeletal contour insights that direct surgical planning. Herein, we propose statistical shape modeling (SSM) as a novel tool for investigating mandibular dimorphism for young white individuals. A single-center, retrospective study was performed using computed tomography (CT) scans of white individuals, aged 20 to 39 years old. AI-assisted, three-dimensional (3D) mandibles were reconstructed in Materialise Mimics v25.0. We used SSM to generate average 3D models for both genders. Relevant manual anthropometric measurements were taken for the SSMs and individual mandibles. Contour disparities were then represented using 3D overlays and heatmaps. Statistical analyses were performed using unpaired student t testing or Wilcoxon signed rank testing with 95% confidence interval as deemed appropriate by population-level normality assessment. Ninety-eight patients (53 females, 45 males) were included. Male mandibles showed greater bigonial width, intercondylar width, ramus height, and body length [p<0.005]. There was no statistically significant difference in the gonial angle measurements [p=0.62]. All relevant manual individual measurements demonstrated excellent concordance to their SSM counterparts. The 3D overlays of SSMs revealed squarer male chins with more lateral but less anterior projection than their female counterparts. Also, the female mandibles showed smoother transition at the gonial angle. SSM provides a novel tool to objectively evaluate volumetric and contour dimorphisms between genders. Moreover, this method can be automated, allowing for expedited comparisons between populations of interest compared to manual assessment. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 . Bullet points about the importance of this work: Advancing Anthropometric Assessment: Statistical shape modeling (SSM) offers a cutting-edge approach to visualizing gender-specific skeletal anatomic differences for aesthetic and gender-affirming facial surgery. Expediting Comparative Analysis: The workflow established in this paper streamlines the evaluative process, enabling rapid morphologic comparisons between populations. Patient-Centered Care: This study establishes a foundation for the development of SSMs in individualized operative planning.

Three-dimensional magnetic resonance imaging-based statistical shape analysis and machine learning-based prediction of patellofemoral instability.

This study performed three-dimensional (3D) magnetic resonance imaging (MRI)-based statistical shape analysis (SSA) by comparing patellofemoral instability (PFI) and normal femur models, and developed a machine learning (ML)-based prediction model. Twenty (19 patients) and 31 MRI scans (30 patients) of femurs with PFI and normal femurs, respectively, were used. Bone and cartilage segmentation of the distal femurs was performed and subsequently converted into 3D reconstructed models. The pointwise distance map showed anterior elevation of the trochlea, particularly at the central floor of the proximal trochlea, in the PFI models compared with the normal models. Principal component analysis examined shape variations in the PFI group, and several principal components exhibited shape variations in the trochlear floor and intercondylar width. Multivariate analysis showed that these shape components were significantly correlated with the PFI/non-PFI distinction after adjusting for age and sex. Our ML-based prediction model for PFI achieved a strong predictive performance with an accuracy of 0.909 ± 0.015, and an area under the curve of 0.939 ± 0.009 when using a support vector machine with a linear kernel. This study demonstrated that 3D MRI-based SSA can realistically visualize statistical results on surface models and may facilitate the understanding of complex shape features.

Morphometric analysis of distal femur through MRI in Turkish population and review of the literature

Measurements of the distal femur are highly variable among different subjects. To obtain the best stability and longevity of the knee implants, anthropometric data of the distal femur is required. The aim of this study was to investigate the anatomical structure of the distal femur according to age and gender and to determine the changes in the groups, of the patients with meniscopathy and controls. A total of 488 patients were included in the study according to age groups (0-15, 16-30, 31-45, 46-60, 61 and above). Intercondylar width, intercondylar anteroposterior distance, medial condylar width, lateral condylar width, bicondylar width, medial condyle anteroposterior distance, and lateral condyle anteroposterior distance were measured on axial Magnetic Resonance Imaging (MRI). Intercondylar width, medial condylar width, lateral condylar width and bicondylar width were significantly higher in men in all age groups compared to women (p &lt; 0.05). Intercondylar anteroposterior distance, medial condyle anteroposterior distance and lateral condyle anteroposterior distance were statistically significantly higher in males than in females except 0-15 age group (p &lt; 0.05). There was no significant difference in medial and lateral anteroposterior distance values in men (p &gt; 0.05), and found to be statistically significant (p &lt; 0.05) on the right and left side in women. Although personalized implant production is expensive compared to today’s conditions, we think that age and gender changes should be considered in the selection of prosthesis, since the dimensions of the distal femur will affect the stability and duration of use of knee implants.

Osteometric Dimension of Lower End of Femoral Bone among Bangladeshi Population

Introduction: The osteometric dimensions of the lower end of the femur have significant clinical implications, particularly in the context of total knee arthroplasty (TKA). Accurate measurements are crucial for the design of femoral components in TKA, which can influence surgical outcomes. This study aims to determine the measurements of different variables of the lower end of the femur, including femoral condylar width, intercondylar width and depth, and the depth of the medial and lateral condyles, in a Bangladeshi population. Methods: This cross-sectional study was conducted on 50 dried femurs collected from three medical colleges in Dhaka, Bangladesh. Measurements were obtained using digital sliding calipers and were rounded to two decimal places. Data analysis was performed using SPSS. Result: Statistical analysis revealed that 56% of the femurs were right-sided and 44% were left-sided. The mean femoral bicondylar width was 69.78 ± 5.38 mm, falling mostly in the "Above Average" range (30%). The mean intercondylar width was 23.77 ± 1.55 mm, with 50% falling in the "Medium" range. Other variables like femur medial condylar width had a mean of 31.05 ± 1.74 mm. Conclusion: Observationally, the study successfully delineates the osteometric dimensions of the lower end of the femur in a Bangladeshi cohort. The statistical results not only fulfill the study's initial aim but also provide a nuanced understanding of the osteometric variations. These findings are instrumental for clinicians in the design and customization of femoral components in TKA, thereby potentially enhancing surgical outcomes and patient satisfaction. The data also lay the groundwork for future research in this area.

Intermittent hypoxia in neonatal rodents affects facial bone growth.

Preterm human infants often show periodic breathing (PB) or apnea of prematurity (AOP), breathing patterns which are accompanied by intermittent hypoxia (IH). We examined cause-effect relationships between transient IH and reduced facial bone growth using a rat model. Neonatal pups from 14 timed pregnant Sprague-Dawley rats were randomly assigned to an IH condition, with oxygen altering between 10% and 21% every 4 min for 1 h immediately after birth, or to a litter-matched control group. The IH pups were compared with their age- and sex-matched control groups in body weight (WT), size of facial bones and nor-epinephrine (NE) levels in blood at 3, 4, and 5-weeks. Markedly increased activity of osteoclasts in sub-condylar regions of 3-week-old IH-treated animals appeared, as well as increased numbers of sympathetic nerve endings in the same region of tissue sections. Male IH-pups showed significantly higher levels of NE levels in sera at 3, 4 as well as 5-week-old time points. NE levels in 4- and-5-week-old female pups did not differ significantly. Intercondylar Width, Mandible Length and Intermolar Width measures consistently declined after IH insults in 3- and 4-week-old male as well as female animals. Three-week-old male IH-pups only showed a significantly reduced (p < 0.05) body weight compared to those of 3-week controls. However, female IH-pups were heavier than age-matched controls at all 3 time-points. Trabecular bone configuration, size of facial bones, and metabolism are disturbed after an IH challenge 1 h immediately after birth. The findings raise the possibility that IH, introduced by breathing patterns such as PB or AOP, induce significantly impaired bone development and metabolic changes in human newborns. The enhanced NE outflow from IH exposure may serve a major role in deficient bone growth, and may affect bone and other tissue influenced by that elevation.

Correlation of intercondylar distance and occlusal vertical dimension in dentate individuals: A clinical study

Statement of problemDetermining the vertical dimension of occlusion for an edentulous patient depends on clinical judgment and the skill and experience of the dentist. Though many methods have been advocated, a universally accepted method of determining the vertical dimension of occlusion in edentulous patients is lacking. PurposeThis clinical study aimed to find a correlation between the intercondylar distance and occlusal vertical dimension in dentate individuals. Material and methodsThis study was conducted on 258 dentate individuals aged 18 to 30 years. The Denar posterior reference point was used to determine the center of the condyle. The posterior reference point was marked on either side of the face with this scale, and the intercondylar width between these 2 posterior reference points was measured with custom digital vernier calipers. A modified Willis gauge was used to measure the occlusal vertical dimension from the base of the nose to the lower border of the chin when the teeth were in maximum intercuspation. The relationship between the ICD and OVD was analyzed with the Pearson correlation test. Simple regression analysis was used to formulate a regression equation. ResultsThe mean intercondylar distance was 133.5 mm, and the mean occlusal vertical dimension was 55.4 mm. A statistically significant correlation (R=0.619) was found between the intercondylar distance and occlusal vertical dimension in the study population (P<.001). ConclusionsA significant correlation was found between the intercondylar distance and occlusal vertical dimension of the participants. Occlusal vertical dimension may be predicted from the intercondylar distance by using a regression model.

Anthropometric Analysis of Distal Femur Parameters in the Eastern Uttar-Pradesh Population.

Anthropometric measurements of the distal femoral fragment play a crucial role in prosthesis design during arthroplastic knee surgeries and offer valuable clues for stature estimation in forensic investigations. The present study is an attempt to assess various anthropometric parameters of the distal femur in this regard. A total of 96 intact dry femora were anthropometrically assessed using digital Vernier calipers. The femoral length was measured using an osteometric table. The torsion angle was calculated with an analog goniometer. The various parameters studied included: medial condyle length and thickness, lateral condyle length and thickness, bicondylar width, intercondylar width, intercondylar depth, torsional angle, and femoral length. The data obtained were statistically analyzed using SPSS software (IBM Corp., Armonk, NY, USA). Mean medial condyle length was 57.38±4.47mm and thickness was 24.53±2.27mm. Mean lateral condyle length and thickness were found to be 58.49±4.3mm and 25.33±3.15mm respectively. Mean bicondylar width was 71.96±6.73mm, mean intercondylar width 21.86±2.71mm, and the intercondylar depth 27.04±2.59mm respectively. The average femur length was 41.87±3.31mm and the average torsion angle was 20.19°±6.99°. Significant correlations were observed between distal femoral parameters. Lateral condyle length showed maximum correlation with other parameters. Femur length was found to correlate significantly with all parameters except medial condyle thickness. Torsion angle was significantly correlated with lateral condyle length and femur length only. The findings of this study show considerable variation from those of other studies done within India. This proves that distal femoral anthropometry has regional variations. These data can aid sports physicians and orthopedic surgeons with implant designing and forensic experts during investigations.

Assessing the relationship between the intercondylar distance and mandibular intercanine distance in orthopantomogram – A retrospective study

Background: In completely edentulous patients, it is necessary to replace the teeth with at most esthetics and comfort with less patient strain. Aim: The current retrospective study was done to find the relationship between the intercondylar distance and intercanine distance of the mandible by obtaining the ratio using an orthopantomogram (OPG) for lower anterior teeth selection in completely edentulous patients. Materials and Methods: The OPG of 500 subjects was selected randomly. The OPGs were taken using the Sirona Orthophos XG machine and exposed for 14.1 s at 64 kvp, 8 mA. Then, the intercondylar distance and mandibular intercanine distance were measured from the soft copy of the OPG using the software “Sidexis.” The required measurements were taken digitally from the OPG using the software “Sidexis” in millimeters (mm). The SPSS software version 22.0 was used for statistical analysis. Results: Pearson correlation coefficients (r) displayed a significant positive association between the intercondylar distance and intercanine distance of the mandible (r = 0.42; P = 0.0002). The correlation between intercondylar width and mandibular intercanine width was significant and positive for men (r = 0.26, P = 0.0003) but negative for women (r = −0.41, P = 0.0001). The ratio between the mean intercondylar width and the mean intercanine width was 1:4.90. Conclusion: The mandibular intercanine distance and the intercondylar distance have a positive and significant association. The ratio obtained in this study was 1:4.90 between the mandibular intercanine distance and the intercondylar distance that could be employed for the choice of mandibular anterior teeth.

Intercondylar width index of the tibia in the dogs: A morphological study

Morphological characteristics of the proximal tibia affect the orthopedic balance of the knee region. Such as the width of the condyles, tibial plateau angle, position of the patella; Intercondylar width is one of these features as well. The objectives of this study are to calculate the intercondylar width index of the tibia (ICWI) in dogs, to determine if there are gender-related differences in ICWI, and to compare the ICWI among the six breeds of dog. For these aims, the tibial bones of 84 dogs from 26 different breeds were used. The radiographs of tibias were taken, and the tibial plateau and intercondylar widths were measured. The intercondylar width index was calculated using the following formula: (intercondylar width/tibial plateau width) *100. The mean intercondylar width index of the dogs was 19.2±2.72. The index values of male and female dogs were 19.1±3.32 and 19.3±2.02, respectively. The significant differences in the index were not determined between male and female dogs, but the significant difference was determined among dogs’ breeds. The dogs in the high-risk breeds had significantly smaller eminence width index value than the dogs in the low-risk breeds related with the non-traumatic cranial cruciate ligament rupture. The results of this study suggested performing further clinical studies to evaluate whether the difference in intercondylar width index among breeds in dogs is associated with cranial cruciate ligament deficiency.

An MRI-based Study to Investigate If the Patella is Truly Centred between the Femoral Condyles in the Coronal Plane

BackgroundAn AP knee radiograph is considered adequate if the patella is centred between the femoral condyles. Our previous studies demonstrated a tendency for lateral patellar deviation on an AP view orthogonal to the posterior femoral condyles. However, findings were based on cadaveric samples limited by the lack of soft tissue effects on patellar positioning.Materials and methodsAfter excluding those with deformity or damage to osseous or ligamentous structures, 106 knee MRI scans were randomly selected. Patellar centring was calculated as a percentage of total distal femoral intercondylar width and represented how lateral the centre of the patella is located with respect to the midpoint of the femoral condyles. Multiple regression analysis was performed to determine the relationship between patellar centring and age, gender, anatomic lateral distal femoral angle (aLDFA), medial proximal tibial angle (MPTA) and tibial tuberosity to trochlear groove (TT-TG) distance.ResultsThere were 35 males and 71 females included in the study with a mean age of 29 ± 14 years. Mean patellar centring was 8 ± 4%. There was a statistically significant correlation between TT-TG distance and positive (lateral) patellar centring (standardised β = 0.36, p <0.01). There were no associations between aLDFA and MPTA with patellar centring.ConclusionThis study demonstrates that the patella is rarely perfectly centred and is usually positioned slightly laterally within the femoral condyles in an AP view orthogonal to the posterior aspect of the femoral condyles. The use of supine MRI scans makes this data relevant to a patient on the operating room table.How to cite this articleShah NS, Kyriakedes JC, Liu RW. An MRI-based Study to Investigate If the Patella is Truly Centred between the Femoral Condyles in the Coronal Plane. Strategies Trauma Limb Reconstr 2022;17(2):63–67.

Morphologic Risk Factor for ACL Rupture in Children Younger than Age 12: An Mri-Based Comparison

Background:There are findings in the adult and adolescent literature regarding anatomic variation that may lead to traumatic disruption of the anterior cruciate ligament (ACL). Previous studies have found an interaction between age and various morphologic risk factors but have been underpowered in assessing younger pediatric patients.Hypothesis/Purpose:The purpose of this study was to evaluate morphologic features of the knee in younger children to determine if any of these factors may contribute to risk of ACL injury in this age group.Methods:A retrospective review of knee MRIs was performed on pediatric patients evaluated at our facility for confirmed ACL rupture. Seven measures were performed and three ratios were calculated, which were compared to an age-matched control cohort previously used to establish and publish normative data of childhood knee MRIs. They were then grouped for statistical purposes by age: “child” aged 5 – 11 years, and “adolescents” aged 12 – 19 years. A generalized linear model was used to assess interaction between age and ACL status.Results:A total of 49 children age <12 years with ACL rupture were identified during the data collection period that met criteria for review. While intercondylar width and notch height index (NHI) were significant in the ACL-torn cohort at large (p=0.015 and p=0.001 respectively), this difference was not present in children. Conversely, tibial plateau to anterior tibial spine (ATS) height was different in ACL-torn children but not in adolescents (p=0.003). Notch Width Index (NWI) was significantly smaller in ACL torn children and adolescents (p<0.0001). When comparing age groups, NWI was the only variable that had minimal to no difference in the normal group, but a significant difference between children and adolescents in the ACL-torn group. No difference was found in Critical Notch Stenosis.Conclusion:Children and adolescents demonstrate the effect of multiple morphologic parameters on ACL tear risk. While there is overlap, there are risk factors specific to each age group. Uniquely, increased TP to ATS height was a risk factor for ACL tear in children. Despite the effect of age and ACL tear on NWI, there was no difference for Critical Notch Stenosis, suggesting that the current definition of critical notch stenosis should be adjusted. Given the difference between NWI in children and adolescents with ACL tear, it may be more appropriate to have age-based cutoffs for critical notch stenosis.

Correlation of transverse mandibular dimension with naso-pharyngeal and oro-pharyngeal airway using computed tomographic analysis – A retrospective observational study

Purpose: The aim of the study was to investigate changes in the naso-pharyngeal and oro-pharyngeal airway with varying degrees of mandibular flare. Methods: The investigators implemented a retrospective, observational study including CT data from patients fitting the inclusion criteria. Linear and angular measurements were used to assess the flare and transverse dimension of the mandible, while standard reference planes were used for assessment of airway dimensions. The primary outcome measures were to correlate and quantify the naso-pharyngeal and oro-pharyngeal volumes with mandibular flare. Secondary outcome measures were to study the intra-variable correlation. Significance level was fixed at 5% (α = 0.05). Results: The sample included CT data from 30 individuals with apparently normal craniofacial skeleton (53% males and 46.7% female with a mean age of 29.53 years). Both nasopharyngeal and oropharyngeal volumes demonstrated moderate positive correlations with inter-condylar width (p = 0.020 and p = 0.038) and inter-condylar angles (p = 0.041 and p = 0.005) respectively. Linear regression modelling demonstrated that for every millimetre increase of the Inter-condylar width, the naso-pharyngeal and oro-pharyngeal airway volume increased by 0.423 cm3 (p = 0.020) and 0.381 cm3 (p = 0.038) respectively, and every degree increase of inter-condylar angle produced an increase the nasopharyngeal and oropharyngeal volumes by 0.376cm3 (p = 0.041) and 0.496cm3 (p = 0.005) respectively. Conclusion: Parameters of mandibular flare demonstrate statistically significant correlation to pharyngeal airway volume, which may be a relevant predictor to evaluate airway in patients undergoing corrective skeletal surgery.

A Study to Determine the Correlation between the Intercondylar and Interdental Widths in South Indian Population: A Cross-sectional Study

Anatomical landmarks that remain fairly constant throughout an individual's life help determine the position of the artificial teeth closer to that of their predecessors. The aim of the present study was to evaluate whether there is a relationship between the intercondylar widths (ICWs) and the interdental widths (IDWs) in the maxillary and mandibular arches in dentate subjects. The study was conducted in two parts, with 80 dentate subjects in total. Initially, in the first 40 subjects, a mathematical index was obtained by dividing the mean ICWs by the mean IDWs. In the second part, the ICW was measured and was used along with the index obtained in the first part, to estimate the IDW. These estimated values were then verified with the real IDWs by direct intraoral measurements. An arbitrary earpiece facebow (ARTEX® Gesichtsbogen Facebow) was used to measure the ICW. Statistics was done using SPSS software version 18 using Karl Pearson's correlation test and paired t-test. The IDW was correlated to the ICW; the maximal correlation was found between ICW and lower 6-6 width (L6-6W) (p value 0.033) and the lowest correlation was found between ICW and upper 6-6 width (U6-6W) (p value 0.046). ICW can be used as an additional guide to position denture teeth. This method suggested would result in a better buccolingual positioning of the posterior teeth, which would help avoid encroaching on the tongue space, thereby improving phonetics and speech with dentures. ICW bears a relationship with the IDWs in the maxillary and mandibular arches. ICW being a fairly constant anatomical landmark can be used as an additional guide aid in positioning the artificial teeth.

Study of Morphometric Analysis of Distal End of Femur in the North Indian Population

Knee joint is one of the most important joint needed for locomotion but unfortunately it is commonly affected by degenerative diseases, which ultimately lead to joint replacement surgery. In such cases, measurements of lower end of femur has great importance in designing of implants. Prosthesis based on accurate morphometric data of components of knee; femur and tibia, plays a crucial role, which will ensure early mobility as well as fewer complications after arthroplasty. The present study was done to obtain certain morphometric data of femoral condyles by direct method and to determine differences on right and left side. It was carried out on 73 dried femurs of unknown sex in the department of Anatomy, regional Institute of Medical Sciences, Imphal. Measurements were taken by using the digital Vernier Caliper. Statistical analysis was done using SPSS software. The results obtained were, mean bicondylar width R:75.34±5.86,L:74.94±6.67; AP diameter of medial condyle, R:57.29±4.94,L:56.39±5.40;Lateral condyle, R:59.44±4.99, L:58.04±4.10; Transverse diameter of medial condyle, R:21.62±2.84, L:22.24±2.89; Lateral condyle, R:23.29±3.05, L:23.76±2.24; Intercondylar width, R:22.41±2.97,L:22.26±3.77. This morphometric data of the lower end of the femur can aid in the design of implants suitable for the North Indian population.

Correlation of notch width index in knees with mucoid degeneration of anterior cruciate ligament to normal knees

Background: Notch width index (NWI) is a most widely used two dimensional measurement of Intercondylar notch volume of the knee. ACL with mucoid degeneration if often underdiagnosed or overlooked cause of nonspecific knee pain and mild restriction of knee movements. ACL in this condition appears bulky and characteristically shows mucinous material along its fibers. We aim to find any correlation of Notch width index in knees with mucoid degeneration of ACL to knees of age matched controls. Methods: In this study, 32 patients diagnosed with Mucoid degeneration of ACL based on Magnetic Resonance studies were included. Notch width Index i, e width of the intercondylar notch divided by intercondylar width at 2/3 notch depth was measured on a coronal section on MRI. This data was compared with age matched controls using Pearson’s correlation Co efficient. Results: 22 patients in study group were females and 10 were males with age ranging from 25-73 years (Median age 45.5 years) The NWI in Mucoid degeneration of ACL when compared to normal knees showed a significant decrease (NWI -0.222±0.03 Mean in Mucoid ACL group; NWI- 0.311±0.03 in controls) in Intercondylar notch width viz Notch stenosis. Female patients compared to male had decreased NWI with 0.222 Mean. Conclusions: Mucoid degeneration of ACL leading to bulky ACL causing stenosis of the notch is evident in this study. However larger sampling size and volumetric analysis by other methods are needed to better manage this poorly understood condition.

Association between time from anterior cruciate ligament injury to reconstruction and morphological changes of the intercondylar notch using MRI and arthroscopy

BackgroundFew studies have measured the dimensions of intercondylar notch under direct arthroscopic visualization. The purpose of our study was to analyse the association between time from anterior cruciate ligament (ACL) injury to reconstruction and the morphological changes of intercondylar notch using magnetic resonance imaging (MRI) and arthroscopy. MethodsData was collected for patients who received knee arthroscopic surgery during 2014–2015. According to the time from ACL injury to reconstruction, these patients were divided into five groupsACL non-injured group (NI), acute rupture group (AR, <3 months), chronic rupture group 1 (CR1, 3–12 months), 2 (CR2, 1–5 years) and 3 (CR3, >5 years). MRI measurements of femoral condylar width (FCW) and intercondylar width (ICW) were undertaken before surgery. The widths at the base, middle and top of the intercondylar notch (ICWb, ICWm, ICWt, respectively) and the intercondylar notch height (ICH) were measured during arthroscopy. Intercondylar notch width index (NWI) and notch shape index (NSI) were then calculated and analysed among groups. ResultsA total of 272 patients were allocated to groups NI (n = 89), AR (n = 84), CR1 (n = 51), CR2 (n = 30) or CR3 (n = 18). Statistical analysis showed significant differences in ICW, ICWb, ICH, NWI and NSI between groups NI and AR. Among the groups with ACL-injury, ICWb and ICWt and NWI in group CR3 were statistically smaller than the other three groups (P = 0.004, 0.016, and 0.005, respectively). ConclusionsThe width of intercondylar notch had a negative correlation with time from ACL injury to reconstruction. Significant secondary notch stenosis was observed over 5 years after ACL rupture.

Association between Intercondylar Notch Dimensions and Morphometry of Anterior Cruciate Ligament – A Cadaveric Study

Introduction: Injuries to the anterior cruciate ligament (ACL) are commonly encountered in day-to-day practice. The morphology of the intercondylar notch (ICN), in particular, the width, and shape of the notch are of anatomic interest predisposing to ligament injuries. The previous literature points to contradicting views on the association between ICN dimensions and cruciate ligament injuries. Aim of the study: This study aims to study the morphometry of the ACL and ICN in 32 prosected lower limbs and to see if any association exists between the two. Objectives The objectives of the study were to estimate the dimensions of ACL (maximum length and width) in 32 prosected lower limbs, estimate the dimensions of ICN (ICN width and depth) along with intercondylar (IC) width in 32 prosected lower limbs, and test the strength of association between the dimensions of ICN with the dimensions of ACL. Materials and Methods: The study was done in the Department of Anatomy of MVJ Medical College and Research Hospital, Bengaluru. Thirty-two prosected lower limbs from the department of anatomy were used for the study. Results: It was observed that IC width correlated positively with ACL length as well as ACL width. A strong positive correlation was also observed between IC width with ICN width. Femoral notch width index also correlated positively with ACL width. Conclusions: The above study provides valuable data on the morphometry of ACL and its association with all dimensions of IC fossa unlike previous studies which have correlated the dimensions of IC fossa only with the thickness of ACL.

Does posterior configuration have similar strength as parallel configuration for treating comminuted distal humerus fractures? A cadaveric biomechanical study

BackgroundThe posterior plating technique could be used as a clinical alternative to parallel plating for treating comminuted distal humerus fractures (DHFs) successfully with good clinical results. However, the biomechanical characteristics for posterior fixation are still unclear. The purpose of this study is to evaluate the biomechanical properties of the posterior fixation and to make comparisons between the parallel and the posterior fixation systems.Materials and methodsWe performed a cadaveric biomechanical testing with two posterior plating systems (a posterior two plating and a single posterior pre-contoured Y plating system) and one parallel two plating system to treat AO/OTA type-C2.3 DHFs. Among three groups, we compared construct stiffness, failure strength, and intercondylar width changes after 5000-cycle fatigue loading and failure loads and failure modes after destructive tests in both the axial compression and (sagittal) posterior bending directions. The correlations between construct failure loads and bone marrow density (BMD) were also compared.ResultsIn axial direction, there were no significant differences in the stiffness and failure load between the posterior and the parallel constructs. However, in sagittal direction, the two-plate groups (posterior two plating and parallel plating group) had significant higher stiffness and failure loads than the one-plate group (single posterior Y plating). There was no fixation failure after 5000-cyclic loading in both directions for all groups. Positive correlation was noted between BMD and failure loads on parallel fixation.ConclusionsWe found that when using two plates for treating comminuted DHFs, there were no significant differences in terms of most biomechanical measurements between posterior and parallel fixation. However, the single pre-contoured posterior Y plate construct was biomechanically weaker in the sagittal plane than the parallel and the posterior two-plate constructs, although there was no fixation failure after the fatigue test for all groups regardless of the fixation methods.Level of evidenceBiomechanical study

An osteological study of distal end of femur in adult south Indian population

Background: Need for the study: Anthropometric studies across different population groups have exhibited significant difference between races. Hence the usage of implant for total knee arthroplasty has to be gender specific and race specific. This study was undertaken to analyse the morphometry of distal end of femur in South Indian population. Aims and objectives: To analyse the morphometry of distal end of femur and to study the anteroposterior dimensions of condyles of femur, bicondylar width, intercondylar notch width. Materials and Methods: The study was conducted on 150 femur (80 right and 70 left) obtained from Department of Anatomy of a private medical college. Measurements of anteroposterior dimensions of condyles of femur, bicondylar width, intercondylar notch width were taken using a sliding calipers. Conclusions: In the present study, mean Bicondylar width noted in the present study is 72.63 ±4.13 mm on the right side and 71.25±3.14mm on the left side The mean intercondylar width observed is 21.27±4.18mm on the right side and 20.35±2.14mm on the left side. There was no statistically significant differences observed in the values of anteroposterior length of medial and lateral condyles, bicondylar width, intercondylar width between right and left sides. The results of the study has application in the field of biomedical engineering to design knee implants specific for South Indian population.