Dataset Information

Orientation of Transverse Acetabular Ligament With Reference to Anterior Pelvic Plane.

ABSTRACT:

Background

Transverse acetabular ligament (TAL) is a 3-dimensional structure which cannot be defined by a single plane. Therefore, we aimed at describing the orientation of different parts of TAL with respect to anterior pelvic plane (APP) and correlate it with gender, body mass index (BMI), and Lewinnek's safe zone.

Methods

A total of 109 consecutive patients undergoing imageless navigated THA were prospectively studied. Computer navigation was used as the measurement tool. APP was registered for navigation. After excision of osteophytes, a trial component matching the size of unreamed acetabular cavity was aligned with acetabular rim, outer and inner margins, and middle of TAL to record cup orientation with computer tracker.

Results

Ninety-nine patients (41 males and 58 females, mean BMI of 28.8kg/m²) were studied after applying exclusion criteria. Mean acetabular inclination was 55.15°, 53.00°, 47.70°, and 42.60° respectively, for acetabular rim, outer, middle, and inner margins of the TAL. Corresponding mean acetabular anteversion was 6.63°, 7.41°, 11.23° and 14.90°respectively. Overall, 17.17%, 28.28%, 47.47% and 71.71% of cup orientation corresponding to acetabular rim, outer, middle, and inner margin of TAL respectively, were within Lewinnek's safe zone. No association was established between BMI and acetabular orientation. Males had overall lesser anteversion than females.

Conclusion

We describe orientation of outer, middle, and inner margins of TAL, as reference planes for TAL, in relation to APP. The anteversion differs significantly with gender. A knowledge about these will assist surgeon in component placement during THA, with inner margin of TAL providing the best chance of orientation out of the studied landmarks.

SUBMITTER: Deep K

PROVIDER: S-EPMC7818603 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Publications

Orientation of Transverse Acetabular Ligament With Reference to Anterior Pelvic Plane.

Deep Kamal K Prabhakara Anjan A Mohan Diwakar D Mahajan Vivek V Sameer Mohamed M

Arthroplasty today 20201221

<h4>Background</h4>Transverse acetabular ligament (TAL) is a 3-dimensional structure which cannot be defined by a single plane. Therefore, we aimed at describing the orientation of different parts of TAL with respect to anterior pelvic plane (APP) and correlate it with gender, body mass index (BMI), and Lewinnek's safe zone.<h4>Methods</h4>A total of 109 consecutive patients undergoing imageless navigated THA were prospectively studied. Computer navigation was used as the measurement tool. APP w ...[more]

PMID: 33521189

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Project description:BACKGROUND:Both the anterior cruciate ligament (ACL) and the medial collateral ligament (MCL) bear load during athletic tasks of landing, cutting, pivoting, and twisting. As dynamic knee valgus is a purported mechanism for ACL injury, the MCL should bear significant strain load with valgus force. HYPOTHESIS:The intact MCL will demonstrate a significant increase in strain upon failure of the ACL at 25° of knee flexion. STUDY DESIGN:Controlled laboratory study. METHODS:In vivo kinetics/kinematics of 44 healthy athletic participants were measured to determine stratification of injury risk (ie, low, medium, and high) in 3 degrees of knee forces/moments (knee abduction moment, anterior tibial shear, and internal tibial rotation). These stratified kinetic values were input into a cadaveric impact simulator to assess ligamentous strain during a simulated landing task. Uniaxial and multiaxial load cells and differential variable reluctance transducer strain sensors were utilized to collect mechanical data for analysis. Conditions of external loads applied to the cadaveric limbs were varied and randomized. RESULTS:ACL strain increased with increased dynamic knee abduction moment (?2[5] = 14.123, P = .0148). The most extreme dynamic knee abduction moment condition demonstrated significantly higher ACL strain compared with lower loaded trials (P? .0203). Similarly, MCL strain increased with dynamic knee abduction moment (?2[5] = 36.578, P < .0001). Matched-pairs analysis compared ACL strain with MCL strain (maximum ACL strain - maximum MCL strain) and demonstrated high strain for the ACL versus the MCL (S177 = 6223.5, P < .0001). CONCLUSION:Although significant, MCL strain had minimal increase with increased dynamic knee abduction moment, and the event of ACL failure did not significantly increase MCL strain when compared with high dynamic knee abduction moment conditions in the cadaveric model. The ACL bears more strain than the MCL at increasing amounts of dynamic knee abduction moment at 25° of knee flexion, which may explain the limited concomitant MCL injury rate that can occur during a dynamic valgus collapse of the knee. CLINICAL RELEVANCE:These characteristics of ACL and MCL strain are important to understand the mechanisms that drive these injuries at the knee and will improve rehabilitation and injury prevention techniques.

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Dataset Information

Orientation of Transverse Acetabular Ligament With Reference to Anterior Pelvic Plane.

Background

Methods

Results

Conclusion

Publications

Orientation of Transverse Acetabular Ligament With Reference to Anterior Pelvic Plane.

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