Intercondylar Distance Research Articles

Freehand Condyle-Positioning During Orthognathic Surgery: Postoperative Cone-Beam Computed Tomography Shows Only Minor Morphometric Alterations of the Temporomandibular Joint Position.

Purpose of this study was to evaluate changes in the temporomandibular joint (TMJ) position after bilateral sagittal split osteotomy (BSSO) of the mandible by the help of pre- and postoperative cone-beam computed tomography (CBCT) images. A collective of n = 78 patients was investigated between 2009 and 2011 before and after BSSO of the mandible in mono- or bimaxillary orthognathic surgery procedures. No intraoperative fixation of the condyles was administered. CBCT scans were performed in all patients before and immediately after surgery with the KaVo 3DeXam device in the position of terminal occlusion. Subsequently, all scans were analyzed by help of the eXam Vision program and the ImageJ image processing software. Alterations of the TMJs were quantified by determining pre- to postoperative differences of the intercondylar distance, the mandibular angle on both sides, and the condylar angles in the transversal plane. The difference between pre- and postoperatively ascertained values was minimal (means: lateral condylar distance -0.17 mm; distance of condylar centers -0.32 mm; medial condylar distance -0.49 mm; left mandibular angle +1.06°; right mandibular angle +2.06°; condylar angles in relation to a reference line: left -2.93, right -0.75; angle of cutting +3.42). There is no apparent tendency toward a positional change in any of the 3 examined planes. Between bi- and monomaxillarily operated patients there was no difference either, except for the osteotomy plane. A 3-dimensional analysis of CBCT data of the TMJ seems to be appropriate to determine the condylar position pre- and postoperatively. Performed by an experienced orthognathic surgeon, BSSO of the mandible does not effectuate any relevant changes of the TMJ-position, thus making an intraoperative condyle-fixation unnecessary.

탄성밴드운동과 스트레칭을 이용한 교정운동프로그램이 내반슬 대학생들의 무릎간 간격, Q-각 및 족압의 변화에 미치는 영향

본 연구는 탄성밴드운동과 스트레칭을 이용한 내반슬 교정운동프로그램이 내반슬 대학생의 무릎간 간격, Q-각, 족압 에 미치는 영향에 대해 알아보는데 그 목적이 있다. 총 30명의 내반슬 대학생을 대상으로 실험군과 대조군을 각각 15명씩 무작위 선정하여 실험군은 6주 동안 스트레칭과 탄성밴드를 이용한 교정 운동 프로그램을 실시하였고, 대조군은 일상생활을 유지하게 하였다. 중재 전 · 후 무릎사이 간격과 Q-각의 변화를 알아보기 위해서 computed radiography X-ray를, 족압 분포 변화를 확인하기 위해 RSscan을 사용하여 족압 분포를 측정하였다. 6주간의 교정운동프로그램 실시한 결과, 중재 전보다 중재 후 무릎간 간격이 유의하게 감소하였고, Q-각은 유의하게 증가하였다. 족압 분포는 중재 후에 2-5 지골과 1, 2, 3 중족골 족압이 증가하였으며, 4, 5 중족골 족압은 유의하게 감소하였다 (p<.05). 이러한 결과를 바탕으로 본 연구에서 실시한 내반슬 교정운동프로그램이 신체의 정렬과 족압 분포도의 배열을 맞추는데 효과가 있으며, 이를 통해 내반슬 변형자에게 긍정적인 효과가 있음을 확인하였다.

Intraoperative condyle positioning by sonographic monitoring in orthognathic surgery verified by MRI

ObjectiveRepositioning of the jaw in orthognathic surgery must produce precise and stable long-term results; an effective and practical method of intraoperative condyle positioning is required to achieve this. Most traditional methods, such as manual positioning or positioning plates do not permit intraoperative monitoring of the temporomandibular joint (TMJ) position. This study evaluates the results of intraoperative, sonographically-monitored joint positioning, comparing preoperative and postoperative MRI scans. Patients and methodsOf the 97 patients who were originally assessed (53 female, average age 29 ± 10.93; and 44 male, average age 28 ± 9.25), 21 had incomplete data sets and were excluded, leaving 76 evaluable patients. MRIs were performed preoperatively between 2 days and 100 weeks (median 30.5 days), and postoperatively between 12 and 96 weeks (median 150 days). Condyle positioning, intercondylar distance, and disc degeneration and dislocation were compared in preoperative and postoperative MRIs, and differentiated by Angle class on horizontal, axial and sagittal scans.Condyle to fossa distances were measured on parasagittal images from 0° (the vertical sagittal plane), 45° anteriorly and 45° posteriorly. The intercondylar distances between the condylar head midpoints were measured on axial sections. Two-sided t-tests (α < 0.05) were used for comparisons within classes; the interclass correlation was performed using univariate ANOVA and linear correlation for paired sample correlation settings. ResultsIn 27 Angle class II cases, the anterior distance of both condyles increased on average 0.3 ± 1.0 mm, the posterior position decreased 0.1 ± 1.2 mm, and the vertical position decreased 0.2 ± 1.1 mm postoperatively. In 47 Angle class III cases the anterior distance of both condyles increased on average 0.3 ± 0.8 mm, the posterior 0.1 ± 0.8 mm and the vertical distance 0.1 ± 0.8 mm postoperatively. All alterations of the condyle-fossa relation were non-significant except for the anterior distance in Angle class ІІІ (p = 0.02). Alterations of the disc position and disc degeneration were non-significant in class II. In class ІІІ, the disc degeneration deteriorated slightly on the left side (p = 0.02). Intercondylar distance increased 1 ± 5.5 mm in class ІІ and decreased by 1 ± 5.5 mm in class ІІІ postoperatively, alterations were non-significant. ConclusionSonography is a non-invasive, comfortable, fast, economical and effective intraoperative method of condyle positioning. The results of the present study support this statement because the degree of disc degeneration and luxation remained unaltered and the condyle position did not change significantly. Prospective randomized comparison to manual positioning is in preparation and will be conducted in the near future.

Periprosthetic Supracondylar Femoral Fractures Above a Total Knee Replacement: Compatibility Guide for Fixation With a Retrograde Intramedullary Nail

The incidence of total knee arthroplasty (TKA) is increasing, as are periprosthetic supracondylar femoral fractures. Treatment is complex and may involve the use of a retrograde intramedullary femoral nail, and it is essential to know the nail will fit through the femoral prosthesis in line with the intramedullary canal. Knowledge of certain measurements is crucial i.e. minimal intercondylar distance and the position of the notch on the femoral component in relation to the intramedullary canal. A review of TKA prostheses dimensions and their compatibility with a retrograde nail was obtained directly from the manufacturers. A comprehensive data set lists manufacturer, model, size, minimal intercondylar notch distance and position. This will be of practical use when planning the operative management of periprosthetic supracondylar femoral fractures.

Evaluation of computer-assisted mandibular reconstruction with vascularized iliac crest bone graft compared to conventional surgery: a randomized prospective clinical trial

BackgroundComputer-assisted surgery plays an increasingly important role in mandibular reconstruction, ensuring the best possible masticatory function and aesthetic outcome.MethodsTwenty patients were randomly assigned to computer-assisted or conventional mandibular reconstruction with vascularized iliac crest bone graft in a prospective study design.Virtual surgical planning was based on preoperative CT-data using specific surgical planning software. A rapid prototyping guide transferred the virtual surgery plan to the operation site. During surgery the transplant ischemic time, reconstruction time, time for shaping the transplant and amount of bone removed were measured. Additionally, the difference in the intercondylar distance before and after surgery was calculated.ResultsComputer-assisted surgery shortened the time of transplant ischemia (P < 0.005) and defect reconstruction (P < 0.001) compared to conventional surgery. The time to saw and shape the transplant at the donor site was shorter using conventional surgery (P < 0.005); therefore, the overall time for surgery didn’t change (P = 0.527). In the computer-assisted group, the amount of bone harvested equaled the defect size, whereas the transplant size in the conventional group exceeded the defect site by 16.8 ± 5.6 mm (P < 0.001) on average. The intercondylar distance before compared to after surgery was less affected in the computer-assisted than in the conventional group (P < 0.001).ConclusionsThe presented study shows that computer-assisted surgery can help reduce the time for mandibular defect reconstruction and consequently the transplant ischemic time. In the computer-assisted group, the iliac crest donor site defect was downsized and the postoperative condyle position was less altered, reducing possible risks of postoperative complications and donor site morbidity.Trial RegistrationDRKS00005181.

Condylar response to functional therapy with Twin-Block as shown by cone-beam computed tomography

To evaluate the condylar changes through cone-beam computed tomography (CBCT) images in patients treated with Twin-Block functional appliance. In this retrospective study, CBCT images of 30 patients who were treated with the Twin-Block appliance were used. Mandible was segmented and pretreatment and posttreatment (T0 and T1) condylar volume was compared. The angle between sella-nasion-Point A (SNA), angle between sella-nasion-Point B (SNB), angle between Point A-nasion-Point B (ANB), midfacial length (Co-A), mandibular length (Co-Gn), and the distances from right condylion to left condylion (CoR-CoL) were also measured on three-dimensional images. Differences were analyzed with Wilcoxon signed rank tests, and Mann-Whitney U-tests were used to compare the scores of male and female participants. Significance was set at P < .05. In this study, a decrease in SNA and ANB (P < .05 and P < .01, respectively) and an increase in SNB (P < .01) were found. Additionally, CoR-CoL, Co-Gn, and condylar volume increased at both the left and right sides (P < .01). However, increase at Co-A was not statistically significant (P > .05). Comparison of differences by sex was not statistically significant for all measurements (P > .05). Twin-Block appliance increases condylar volume, mandibular length, and intercondylar distance by stimulating growth of condyle in an upward and backward direction.

The Evaluation of the Knee Joint in Terms of Magnetic Resonance Imaging Measurements in Osteoarthritis Patients: A Comparative Study Comprising a Control Group

The aim of this study was to assess the knee joints of osteoarthritis patients in terms of clinical and magnetic resonance imaging (MRI) measurements and draw definitive conclusions from these quantimetric data. In order to achieve the above-mentioned goal, the knees of individuals from two distinct groups were examined by MRI. One group consisted of osteoarthritis patients while the other comprised the control individuals. All individuals from both groups underwent clinical and MRI measurements concerning their knees. These data were compared by using the statistical software from the Statistical Package for Social Sciences (SPSS) v.15 program. Statistically significant differences were found between the control and patients groups in terms of the measurements of the second (short) diameter of the medial femoral condyle, and the intercondylar distance (p < 0.05). In addition to these findings, the Receiver Operating Characteristics (ROC) curve analysis gave statistically significant results for both of these measurements. The cutoff values for these criteria were as follows in sequence order: a sensitivity of 75% and a specificity of 52% for the medial femoral condyle, and a sensitivity of 70% and a specificity of 70% for the intercondylar distance. The ROC curve data may not be a deterministic outcome alone for this study. But it may in fact have a significant meaning when it is evaluated together with other statistically significant data. The t-test for Equality of Means, for example, gave significant results, concerning the measurements of the short axis of the medial femoral condyle and the intercondylar distance. It is well known that it is the medial portion of the knee joint which deteriorates the most during the process of osteoarthritis of the knee (OAK), and this complies with the results of this study.

Anatomic study of the occipital condyle and its surgical implications in transcondylar approach.

Background:Craniovertebral surgeries require the anatomical knowledge of craniovertebral junction. The human occipital condyle (OC) is unique bony structure connecting the cranium and the vertebral column. A lateral approach like transcondylar approach (TA) requires understanding of the relationships between the OC, jugular tubercle, and hypoglossal canal. Hence, the aim of the present study was to analyze the morphological variations in OCs of dry adult human skull.Materials and Methods:The study was carried out on 142 OC of 71 adult human dry skulls (55 males and 16 females). Morphometric parameters such as length, width, thickness, intercondylar distances, and the distances from the OC to the foramen magnum, hypoglossal canal and jugular foramen were measured. In addition, the different locations of the hypoglossal canal orifices in relation to the OC and different shapes of the OC were also noted.Results:The average length, width and height of the OC were found to be 2.2, 1.1 and 0.9 cm. The anterior and posterior intercondylar distances were 2.1 and 3.9 cm, respectively. Maximum and minimum bicondylar distances were 4.5 and 2.6 cm, respectively. The intra-cranial orifice of the hypoglossal canal was found to be present in middle 1/3rd in all skulls (100%), and extra-cranial orifice of the hypoglossal canal was found to be in anterior 1/3rd (98%) in relation to OC. The oval shaped OC (22.5%) was the most predominant type of OC observed in these skulls.Conclusion:Occipital condyle is likely to have variations with respect to shape, length, width and its orientation. Therefore, knowledge of the variations in OC along with careful radiological analysis may help in safe TAs during skull base surgery.

Relationship of inter-condylar distance with inter-dental distance of maxillary arch and occlusal vertical dimension: a clinical anthropometric study.

To find out the anthropometric relationship of Inter-condylar distance to Inter-canine and Inter-molar distance of maxillary arch and occlusal vertical dimension in dentate individuals of South Indian population. A total number of 120 dentate individuals were randomly equally divided into Group A and Group B. According to the face form, each Group was again subdivided into four subgroups. Subgroup A1 and B1 contained Square face form, Subgroup A2 and B2 Tapered, Subgroup A3 and B3 Square tapered and Subgroup A4 and B4 Ovoid face form. The ratio of ICD to U3, U6 and OVD of Group A individuals were applied to the Group B individuals with similar face forms and the clinical significance of the ratios were evaluated. No significant difference (p-value=0.841) was observed in the ratio of U6 to ICD (U6/ICD) in all the face forms. A significant difference (p-value = 0.010) in the mean value was observed when the ratio of OVD to ICD (OVD/ICD) was compared between the squared tapered face form of Group A (0.60 ± 0.01) and Group B (0.06±0.03). A significant difference (p value = 0.007) was observed between the measured (62.47 ±2.77) and calculated (64.99±2.61) values of OVD in square taper face form. In south Indian population, ICD can be used as a reliable guide line to determine the bucco-palatal position of maxillary first molar irrespective of the face forms.

Remodelling pattern of the ramus on submentovertex cephalographs after intraoral vertical ramus osteotomy

The aim of this study was to evaluate postoperative changes in proximal segments and condyles on the transverse plane after intraoral vertical ramus osteotomy. This is a retrospective study that included 200 subjects operated on, from 2003 to 2010, from whom we compared preoperative and postoperative (7 days, and 1, 3, 6, and 12 months) submentovertex radiographs. Postoperative positional changes in the condyles showed a mean (SD) of 15.05 (8.97)° lateral rotation, which slowly returned towards the original position. However, 4.53 (6.03)° lateral rotation remained on the postoperative radiographs at 1 year. There were no remarkable differences in intercondylar distance at any given time interval, which showed pure rotation of condyles without any bodily shift. The length of horizontal overlapping was also increased after operation, and was later decreased by 48% on postoperative radiographs at 1 year through the remodelling process. Condyles had rotated laterally without a lateral shifting movement only after intraoral vertical ramus osteotomy. Further studies to evaluate the physiological effects of rotational movement of the condyles after the operation in patients with symptoms in the temporomandibular joint are indicated.

A morphometric anatomical and comparative study of the foramen magnum region in a Greek population

The foramen magnum (FM), a complex area in craniocervical surgery, poses a challenge for neurosurgeons. The knowledge of the detailed anatomy of the FM, occipital condyles (OC) and variations of the region is crucial for the safety of vital structures. This study focuses on the FM and OC morphometry, highlights anatomical variability and investigates correlations between the parameters studied. One hundred and forty-three Greek adult dry skulls were examined using a digital sliding calliper (accuracy, 0.01mm). Mean FM width and length were found 30.31±2.79 and 35.53±3.06mm, respectively. The commonest FM shape was two semicircles (25.9%), whereas the most unusual was irregular (0.7%). The OC minimum width, maximum width and length were 5.71±1.61, 13.09±1.99 and 25.60±2.91mm on the right, and 6.25±1.76, 13.01±1.98 and 25.60±2.70mm on the left side. The commonest OC shape was S-like and the most unusual was ring, bilaterally. The mean anterior and posterior intercondylar distances were 19.30±3.25 and 51.61±5.01mm, respectively. The OC protruded into the FM in 86.7% of the skulls. Variations such as a third OC existed in 5.6% and basilar processes in 2.8%. Posterior condylar foramina were present in 75.5%. The gender was correlated with FM width and length, OC length, bilaterally, anterior intercondylar distance (AID) and posterior intercondylar distance (PID). The OC protrusion and existence of posterior condylar foramina were correlated. Bilateral asymmetry for OC shape was statistically significant. Our results provide useful information that will enable effective and reliable surgical intervention in the FM region with the maximum safety and widest possible exposure.

Error analysis of a CAD/CAM method for unidirectional mandibular distraction osteogenesis in the treatment of hemifacial microsomia

Our aim was to investigate the errors in a computer-aided design and manufacture (CAD/CAM) method of unidirectional mandibular distraction osteogenesis. Six patients with hemifacial microsomia were selected, and studied on computed tomographic (CT) scans taken at 3 time intervals: preoperatively, at the end of the latent period, and at the end of consolidation. The plan for mandibular distraction osteogeneisis was designed using CT-based 3-dimensional visible software. The osteotomy line and site of the drill were transferred to a rapid prototyping surgical guide. The osteotomy of the mandible and implantation of the distraction device were completed under guidance. The accuracy of the transferred surgical plan was confirmed by fusion of images after the latency period. The 3-dimensional superimposition of the preoperative simulation, and the postoperative actual models at the end of consolidation, showed that the mean (SD) error between the actual and the predicted height of the ramus was 0.6 (0.6)mm. The error between the actual and predicted intercondylar distance was 8.1 (2.1)mm. There was a significant difference in intercondylar distance between the simulated and actual groups (p=0.00024). The 3-dimensional CT-based planning system described in this paper was transferred precisely from the virtual plan to the real-time operation. The planning system also gave a precise prediction of the height of the ramus after mandibular distraction osteogenesis. However, because of the pull of the lateral pterygoid muscle and pseudarthrosis, the intercondylar distance decreased compared with the predicted value. These influencing factors should be considered when the planning system is refined.

Proximal segment positioning with high oblique sagittal split osteotomy: indications and limits of intraoperative mobile cone-beam computerized tomography

The purpose of this study was to evaluate the indications and limits for intraoperative proximal segment positioning control by mobile cone-beam computerized tomography (CBCT). For mandible osteotomy in orthognathic surgery, the high oblique sagittal split osteotomy (HSSO) is our standard procedure. In 22 patients, positioning control of the proximal segment was performed during and after surgery to check this alternative osteotomy technique. The mean intercondylar distance increased 0.31 mm in all patients. No significant change of the condyle positions was found in the axial and coronal planes. In the sagittal plane a significant change was found. In 1 case, revision was required because of a lateral shifting of the condyles. Intraoperative positioning control with CBCT is an effective and reliable method to avoid condyle malpositions. Only minor position changes occur when using HSSO in orthognathic surgery, without compromising temporomandibular joint function postoperatively.

Intercondylar distance before and after mandible resection

Purpose One of the goals of mandible resection and reconstruction is achieving optimal occlusion. Therefore, the aim of the present study was to evaluate the pre- and post-operative condyle distances. Patients and methods All computed tomography (CT) scans of 32 patients with a partial mandible resection who were treated between 2006 and 2011 were evaluated retrospectively. The distances between the condyle centres were measured before and after mandible resection. Results The preoperative intercondylar distance of the 32 patients was between 85.8 and 109.5 mm (median = 100.5 mm), and the post-operative distance was between 87.0 and 110.5 mm (median = 100.6 mm). There was no significant difference between pre- and postoperative distances. Conclusion Reconstruction plates and bony reconstructions do not significantly change the intercondylar distance.

Bilateral genu varus (bowlegs) at early childhood in Mosul

Background: Genu varus deformity (bowlegs) is deviation of leg distal to knee toward midline, it is very common in early childhood. No data is available in apparently healthy Iraqi children. Objective: To identify the common causes of genu varus, and to evaluate its correction. Patients and methods: it is case series study; two hundred and thirteen children with bilateral genu varus deformities were included from Orthopedic Outpatient Clinic, Aljumhoori Teaching Hospital. The intercondylar distance was measured every 6 months during the period of follow-up which ranged between 2- 6 years. Results: Physiological genu varus was the commonest cause, 153 children (71.8%), their mean intercondylar distance was 3.42 ± 0.93, corrected spontaneously within two years. Nutritional rickets was the second cause in 58 patients (27.2%), their mean intercondylar distance was 4.22 ± 0.92 corrected spontaneously with medical treatment within 4 years. Two patients had vitamin D resistant rickets (hypophosphataemia), their deformities increased with growth. Conclusion: The most common cause of bilateral genu varus was physiological, usually corrected spontaneously within two years. Nutritional rickets was the second cause which leads to more severe genu varus, and delay its correction.

Is High-Impact Sports Participation Associated with Bowlegs in Adolescent Boys?

The purpose of this study was to investigate whether the participation in load bearing sports is associated with significant knee alignment adaptations in adolescent boys, which might cause a higher risk for the development of knee osteoarthritis in later life. Five hundred twenty-one healthy boys (from 7 to 18 yr), selected from local primary and secondary schools, participated in the study. Two hundred sixty-five of them practiced competitive sports (track and field, field hockey, basketball, volleyball, tennis, badminton, and squash) for at least 3 h·wk(-1). The other remaining 256 boys did not practice any kind of sports. Genu varum/valgum was determined by measuring the intercondylar (IC) and intermalleolar (IM) distance with the subjects in a relaxed erect standing position. The IC and/or IM distance was measured using a caliper. Both measurements were combined to one parameter: the IC-IM distance. A one-way ANOVA was performed to analyze differences between the different age groups within the sporting and nonsporting boys separately. For each age group, the IC-IM distances of the sporting and nonsporting boys were compared by ANOVA with post hoc Bonferroni corrections. A comparison between the sporting and nonsporting boys showed that the sporting boys had a significantly higher degree of genu varum from 13 to 15 yr or older (P = 0.01). From the results of this study, it can be concluded that practicing load bearing sports in general is associated with the same knee varus alignment in adolescent boys as previously has been indicated in intense soccer-playing adolescents.

Motor Branch of Extensor Carpi Radialis Longus: Anatomic Localization

Genet F, Autret K, Schnitzler A, Lautridou C, Bernuz B, Denormandie P, Allieu Y, Parratte B. Motor branch of extensor carpi radialis longus: anatomic localization. ObjectiveTo identify extensor carpi radialis longus (ECRL) motor nerve coordinates in relation to anatomic surface landmarks. DesignDescriptive study. SettingAnatomy institute of a school of medicine in Paris, France. CadaversFresh adult cadaver upper limbs (N=20). InterventionAnatomic dissection of upper limbs. Main Outcome MeasuresThree measurements (mm) were taken of the position of the ECRL motor branch: the distance between the lateral epicondyle and the emergence of the ECRL branch along the forearm axis, the branch depth, and the ratio between the distance corresponding to the nerve depth and the intercondylar distance. ResultsThe radial nerves of 4 men and 6 women (age range 59–80y) were identified between the brachioradialis and the ECRL and traced proximally to the lateral epicondyle. The injection point was between the lateral epicondyle posteriorly and the wrist extensor group anteriorly. Direction was perpendicular to the axis of the forearm. Mean depth was 35.6mm (minimal value: 24.0; maximal value: 58.0; SD=9mm). Ratio between nerve depth and intercondylar distance was .46 (.37; .53±.05). ConclusionsThe ECRL motor nerve branch is easy to reach using specified landmarks. Selective motor nerve block of the ECRL branch should be considered in the clinical assessment to test the capacity of the extensor carpi radialis brevis to extend the wrist alone and to assess the command and overactivity of antagonists before surgery.

Radiographic knee osteoarthritis in ex-elite table tennis players

BackgroundTable tennis involves adoption of the semi-flexed knee and asymmetrical torsional trunk movements creating rotational torques on the knee joint which may predispose players to osteoarthritis (OA) of the knee. This study aims to compare radiographic signs of knee OA and associated functional levels in ex-elite male table tennis players and control subjects.MethodsStudy participants were 22 ex-elite male table tennis players (mean age 56.64 ± 5.17 years) with 10 years of involvement at the professional level and 22 non-athletic males (mean age 55.63 ± 4.08 years) recruited from the general population. A set of three radiographs taken from each knee were evaluated by an experienced radiologist using the Kellgren and Lawrence (KL) scale (0-4) to determine radiographic levels of OA severity. The intercondylar distance was taken as a measure of lower limb angulation. Participants also completed the pain, stiffness, and physical function categories of the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) 3.1 questionnaire.ResultsThe results showed 78.3% of the ex-elite table tennis players and 36.3% of controls had varying signs of radiographic knee OA with a significant difference in the prevalence levels of definite radiographic OA (KL scale > 2) found between the two groups (P ≤ 0.001). Based on the WOMAC scores, 68.2% of the ex-elite table tennis players reported symptoms of knee pain compared with 27.3% of the controls (p = 0.02) though no significant differences were identified in the mean physical function or stiffness scores between the two groups. In terms of knee alignment, 73.7% of the ex-elite athletes and 32% of the control group had signs of altered lower limb alignment (genu varum) (p = 0.01). Statistical differences were found in subjects categorized as having radiographic signs of OA and altered lower limb alignment (p = 0.03).ConclusionsEx-elite table tennis players were found to have increased levels of radiological signs of OA in the knee joint though this did not transpire through to altered levels of physical disability or knee stiffness in these players when compared with subjects from the general population suggesting that function in these players is not severely impacted upon.

Do Patients Treated With Bimaxillary Surgery Have More Stable Condylar Positions Than Those Who Have Undergone Single-Jaw Surgery?

Because condylar positioning after sagittal split ramus osteotomy of the mandible has been known to affect postoperative skeletal stability, accurate positional assessment of the temporomandibular joint after orthognathic surgery is vital to maximize stability of the surgery. The purpose of this study was to evaluate condylar changes after single-jaw and double-jaw surgeries in mandibular prognathism patients by comparing 3-dimensional angular and positional changes of the condylar heads in groups of patients receiving combined maxillary posterior impaction and mandibular setback and those undergoing only mandibular setback surgeries. We assessed condylar changes of patients who have been diagnosed with mandibular prognathism and underwent either bimaxillary surgery or isolated mandibular surgery at Kangdong Sacred Heart Hospital and SmileFuture Orthodontic Clinic, Seoul, South Korea, from August 2008 to February 2011. Condylar angulation, intercondylar distance, and amount of condylar displacement were examined based on the 3-dimensional reconstructed images. Preoperative and postoperative changes within each group were assessed by paired t test. Differences between the groups were determined by independent t test. A total of 43 skeletal Class III patients were included in this retrospective, multicenter study. After single-jaw surgery, condylar angulations in all dimensions did not change. In contrast, those who received double-jaw surgery showed forward rotation of 1.93° (P = .027) and medial rotation of 1.48° (P = .032) in the sagittal and axial planes, respectively. The mean distances of condylar displacements were 0.28 ± 0.44 mm in the single-jaw group and 0.31 ± 0.51 mm in the double-jaw group, but there was no statistically significant difference. Condylar angulations are more stable after sagittal split ramus osteotomy of the mandible as an isolated procedure than in combination with the posterior maxillary impaction in treatment of skeletal Class III malocclusion patients. Condylar displacements in both the single-jaw and double-jaw groups are clinically insignificant.

Geometry of the femoral condyles in dogs

The stifle joint is one of the most important joints in dogs from the orthopaedic point of view. The aim of this study was to document the morphometric values of femoral condyles, given the close relationship between the shape and function of an anatomic structure. The left femora of 16 mid-sized dogs were used, and diameter and nine radii as well as cranial and caudal bow lengths from each condyle were measured. The photographs were taken of the distal femora from both sides. All measurements were obtained from these images by using software. Additionally, the rotation angle was calculated from the intercondylar distance and the difference between lateral and medial bow lengths. In addition to the rotation angle, the difference of diameter and nine radii between the lateral and medial condyles was determined. All radii except getting at 90° were significantly different between the medial and lateral condyles. The greatest values were determined in the caudal part of the medial condyle. This results the smaller contact area and a greater pressure on the underlying surface, and therefore the meniscus and articular cartilage of the caudal part of the medial side suggests the possibility of a risk of injury as the stifle joint flexes. The mean rotational angle of the femur was also calculated to be 2.18° laterally and 1.02° medially in the caudal and cranial parts of condyles, respectively. The result of this study showed that the lateral and medial condyles had different shapes in canine femur.