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Joint Capsule (joint + capsule)
Selected AbstractsA cranial intercondylar arthroscopic approach to the caudal medial femorotibial joint of the horseEQUINE VETERINARY JOURNAL, Issue 1 2009T. Muurlink Summary Reason for performing study: Current noninvasive techniques for imaging the soft tissue structures of the stifle have limitations. Arthroscopy is commonly used for the investigation and treatment of stifle pain. Cranial and caudal arthroscopic approaches to the femorotibial joints are used. However, complete examination of the axial aspect of the medial femorotibial joint (MFTJ) is not possible currently. Objective: To develop a cranial approach to the caudal pouch of the MFTJ and to assess whether it would allow a more complete examination of the compartment and facilitate the caudomedial approach. Method: The regional anatomy was reviewed and the technique developed on cadavers. A series of nonrecovery surgeries were performed to evaluate the procedure, which was then used in 7 clinical cases. Advantages compared to existing techniques and complications encountered were recorded. Results: Successful entry into the caudal pouch of the MFTJ was achieved in 20 of 22 cadaver legs, 8 of 8 joints of nonrecovery surgery horses and 6 of 7 clinical cases operated. The caudal ligament of the medial meniscus could be visualised, along with other axial structures of the caudal joint pouch. The technique was used to facilitate a caudomedial approach and allowed better triangulation within the joint space. Complications were minor and included puncture of the caudal joint capsule and scoring of the axial medial femoral condyle. Conclusions and potential relevance: It is possible to access the caudal pouch of the MFTJ arthroscopically using a cranial intercondylar approach. The technique has advantages when compared to existing techniques and is associated with few significant complications. A cranial approach to the caudal pouch of the MFTJ could complement existing techniques and be useful clinically. [source] Rapidly destructive arthropathy of the hip in haemophiliaHAEMOPHILIA, Issue 1 2001N. Ishiguro The aetiology of rapidly destructive arthropathy is still being debated. We report a 48-year-old male haemophiliac who exhibited hip arthropathy that was similar to rapidly destructive arthropathy. The hip joint was destroyed 6 months after the onset of symptoms. Results of clinical and laboratory examinations did not show any features of neuropathic, inflammatory or septic arthropathy, except for coagulopathy. Magnetic resonance imaging revealed an expansive joint capsule with synovial proliferation in the affected hip joint. Total hip arthroplasty was carried out successfully with total resection of the synovial tissue and joint capsule. A histological examination revealed bone necrosis, nonspecific inflammation, haemosiderosis and synovial hypertrophy. The recurrent bleeding into the hip joint induced pronounced inflammation with synovial proliferation and acute destruction of bony tissue. [source] Single-stage Matriderm® and skin grafting as an alternative reconstruction in high-voltage injuriesINTERNATIONAL WOUND JOURNAL, Issue 5 2010Henning Ryssel This article presents a retrospective analysis of a series of nine patients requiring reconstruction of exposed bone, tendons or joint capsules as a result of acute high-voltage injuries in a single burn centre. As an alternative to free tissue transfer, the dermal substitute Matriderm® was used in a one-stage procedure in combination with split-thickness skin grafts (STSG) for reconstruction. Nine patients, in the period between 2005 and 2009 with extensive high-voltage injuries to one or more extremities which required coverage of exposed functional structures as bone, tendons or joint capsule, were included. A total of 11 skin graftings and 2 local flaps were performed. Data including regrafting rate, complications, hospital stays, length of rehabilitation and time until return to work were collected. Eleven STSG in combination with Matriderm® were performed on nine patients (success rate 89%). One patient died. One patient needed a free-flap coverage as a secondary procedure. The median follow-up was 30 months (range 6,48 months). The clinical results of these nine treated patients concerning skin-quality and coverage of exposed tendons or joint capsule were very good. In high-voltage injuries free-flap failure occurs between 10% and 30% if performed within the first 4,6 weeks after trauma. The use of single-stage Matriderm® and skin grafting for immediate coverage described in this article is a reliable alternative to selected cases within this period. [source] The hip joint: the fibrillar collagens associated with development and ageing in the rabbitJOURNAL OF ANATOMY, Issue 1 2001YVETTE S. BLAND The fibrillar collagens associated with the articular cartilages, joint capsule and ligamentum teres of the rabbit hip joint were characterised from the 17 d fetus to the 2-y-old adult by immunohistochemical methods. Initially the putative articular cartilage contains types I, III and V collagens, but when cavitation is complete in the 25 d fetus, type II collagen appears. In the 17 d fetus, the cells of the chondrogenous layers express type I collagen mRNA, but not that of type II collagen. Types III and V collagens are present throughout life, particularly pericellularly. Type I collagen is lost. In all respects, the articular cartilage of the hip joint is similar to that of the knee. The joint capsule contains types I, III and V collagens. In the fetus the ligamentum teres contains types I and V collagens and the cells express type I collagen mRNA; type III collagen is confined mainly to its surface and insertions. After birth, the same distribution remains, but there is more type III collagen in the ligament, proper. The attachment to the cartilage of the head of the femur is marked only by fibres of type I collagen traversing the cartilage; the attachment cannot be distinguished in preparations localising types III and V collagens. The attachment to the bone at the lip of the acetabulum is via fibres of types I and V collagens and little type III is present. The ligament is covered by a sheath of types III and V collagens. Type II collagen was not located in any part of the ligamentum teres. The distribution of collagens in the ligamentum teres is similar to that in the collateral ligaments of the knee. Its insertions are unusual because no fibrocartilage was detected. [source] Magnetic resonance imaging of entheses using ultrashort TE (UTE) pulse sequencesJOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 2 2007Michael Benjamin PhD Abstract The attachment of tendons, ligaments, and joint capsule to bone (entheses) is reviewed and new options for visualizing key components of entheses provided by ultrashort TE (UTE) pulse sequences are described. Many features of entheses are adapted to the dispersion of stress at the boundary between tendons/ligaments and bone. Of particular interest is fibrocartilage, which has mechanical properties different from those of both "pure" tendon/ligament and bone. Features typical of entheses can also be seen at sites where tendons or ligaments are in contact with (but not attached to) bone, and the concept of a "functional enthesis" has been developed to emphasize the similarities. The enthesis concept has also been broadened to include the idea of an "enthesis organ" in which many tissues play a role in dissipating stress concentration. UTE pulse sequences can specifically identify the calcified and uncalcified fibrocartilage tissue components of entheses and differentiate these from fibrous connective tissue and bone. These tissues cannot be separately visualized at entheses with conventional pulse sequences. Entheses are involved in overuse syndromes and seronegative spondyloarthropathies (SpA) and there are important issues related to tissue repair and healing following surgery. J. Magn. Reson. Imaging 2007. © 2007 Wiley-Liss, Inc. [source] The proximal hip joint capsule and the zona orbicularis contribute to hip joint stability in distractionJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 8 2009Hiroshi Ito Abstract The structure and function of the proximal hip joint capsule and the zona orbicularis are poorly understood. We hypothesized that the zona orbicularis is an important contributor to hip stability in distraction. In seven cadaveric hip specimens from seven male donors we distracted the femur from the acetabulum in a direction parallel to the femoral shaft with the hip in the neutral position. Eight sequential conditions were assessed: (1) intact specimen (muscle and skin removed), (2) capsule vented, (3) incised iliofemoral ligament, (4) circumferentially incised capsule, (5) partially resected capsule (distal to the zona orbicularis), (6) completely resected capsule, (7) radially incised labrum, and (8) completely resected labrum. The reduction of the distraction load was greatest between the partially resected capsule phase and completely resected capsule phase at 1, 3, and 5 mm joint distraction (p,=,0.018). The proximal to middle part of the capsule, which includes the zona orbicularis, appears grossly and biomechanically to act as a locking ring wrapping around the neck of the femur and is a key structure for hip stability in distraction. © 2009 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 27: 989,995, 2009 [source] Joint capsule mast cells and neuropeptides are increased within four weeks of injury and remain elevated in chronic stages of posttraumatic contracturesJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 10 2008Kevin A. Hildebrand Abstract The purpose of this article was to determine mast cell and neuropeptide nerve fiber numbers in joint capsules in posttraumatic contractures, as elevated numbers have been implicated in other fibrotic and contracture conditions. Twelve skeletally mature rabbits had intraarticular cortical windows removed from the medial and lateral femoral condyles and the knee joint immobilized. The contralateral unoperated limb served as a control. Equal numbers of rabbits were sacrificed 4 weeks after surgery or 40 weeks after the first surgery that included 32 weeks of remobilization. Six patients with chronic posttraumatic elbow joint contractures and six age-matched organ donor controls free of elbow contractures were also studied. Joint capsule myofibroblast, mast cell, and neuropeptide containing nerve fiber numbers were assessed with immunohistochemistry. The numbers of myofibroblasts, mast cells, and neuropeptide containing nerve fibers expressed as a percentage of total cells were significantly greater in the contracture capsules when compared to the control capsules at all time points (p,<,0.0001). The range of percentages for the three components in the contracture capsules versus the controls were 41,48% versus 9,10%, 44,50% versus 11,13%, and 45,50% versus 10,12% for the acute and chronic stages of the rabbit model and the chronic stages in the human elbows, respectively. These data support the hypothesis that a myofibroblast,mast cell,neuropeptide fibrosis axis may underlie some of the pathologic changes in the joint capsule in posttraumatic contractures. Approaches designed to manipulate this axis, such as preventing degranulation of mast cells, warrant further investigation. © 2008 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 26:1313,1319, 2008 [source] The ligamentum olecrani of the Elbow Joint in Dogs and CatsANATOMIA, HISTOLOGIA, EMBRYOLOGIA, Issue 2005E. Engelke The olecranon ligament (ligamentum olecrani) is described as an elastic ligament of the elbow joint in carnivores that tenses the caudomedial part of the joint capsule. The aim of the study was to compare the course and the microscopic structure of the ligament in dogs and cats. The elbow regions of 25 dogs and 15 cats were dissected to examine the topography of the ligament in extension and flexion. Furthermore, the olecranon ligaments of five dogs and five cats were studied using routine histological methods. Additional sections were stained with Resorcin,Fuchsin and Orcein to detect elastic fibres. In both species the olecranon ligament originates at the lateral surface of the epicondylus medialis humeri and inserts at the cranial crest of the olecranon extending distally to the roof of the processus anconeus. Tension of the ligament only occurs when the elbow joint is flexed maximally. This tension is increased by a slight supination of the forearm, which takes place automatically in this joint position. In dogs the ligament is long (30,40 mm in medium sized breeds) and relatively slim (approx. 2,4 mm). In cats the ligament is short (10,12 mm) and relatively strong (5,8 mm). The histological examination of the olecranon ligament shows all signs of a tight collagenous ligament with a negligible amount of elastic fibres. The olecranon ligament helps to limit the maximal flexion of the elbow joint. In addition, it controls a slight lateral movement of the processus anconeus during the automatic supination of the antebrachial bones in extreme flexion of the elbow joint. [source] Soft tissue anatomy around the hip and its implications for choice of entry point in antegrade femoral nailingCLINICAL ANATOMY, Issue 6 2008C.M. Ansari Moein Abstract Antegrade intramedullary nailing is an accepted method of treatment for femoral shaft fractures. Entrance of the nail through the trochanteric fossa is currently recommended by some surgeons. This approach results in some cases, however, in loss of abduction strength and persistent pain. Nail insertion at the tip of the greater trochanter may be more favorable. In this study the anatomical relationships of the trochanteric fossa and of the tip of the greater trochanter were explored. Dissection was carried out in 10 fresh human cadaver femurs. The risks and safety of the two entry points with respect to the adjacent soft tissues were assessed. Abductor muscles and tendons, branches of the medial circumflex femoral artery and the hip joint capsule were at risk during nail insertion through the trochanteric fossa. These structures were not endangered during insertion through the trochanteric tip. The reported clinical morbidity after nailing through the trochanteric fossa may result from direct soft tissue injury and may be reduced by choosing the route through the greater trochanter. Clin. Anat. 21:568,574, 2008. © 2008 Wiley-Liss, Inc. [source] Gross anatomy of the interphalangeal joint of the great toe: Implications for excision of plantar capsular accessory ossiclesCLINICAL ANATOMY, Issue 4 2005M.B. Davies Abstract Bony or cartilaginous ossicles occur at the plantar aspect of the interphalangeal joint of the great toe. The variation in pattern, prevalence, and anatomic relationships of these structures is not clearly established in the literature, especially in a Caucasian population. Without this knowledge, pathology at this joint may be underestimated and surgical approaches may be poorly planned particularly as radiographs underestimate the incidence of ossicles at this joint. The aims of this study were to determine the incidence and pattern of ossicles at this joint and to establish their anatomic relationships to aid planning the approach for their excision. The interphalangeal joint of the left hallux was dissected in 40 British Caucasian cadavers and the pattern of nodules and their anatomic relationships were established. In 27.5% of subjects, there was no identifiable ossicle and, in these specimens, the tendon of flexor hallucis longus was adherent to the joint capsule. In the remaining specimens (72.5%), a bursa separated the tendon of flexor hallucis longus from the plantar joint capsule and nodules were found embedded within the joint capsule. More than half (52.5%) of the specimens had a single nodule located centrally within the plantar capsule and the remaining 20% had two nodules lying within the capsule. This study shows that a large proportion of the population have either one or two bony or cartilaginous ossicles at this joint. It has also shown that, when present, these structures do not lie within the tendon of flexor hallucis longus and may be most safely excised from a medial approach. Clin. Anat. 18:239,244, 2005. © 2005 Wiley-Liss, Inc. [source] Single-stage Matriderm® and skin grafting as an alternative reconstruction in high-voltage injuriesINTERNATIONAL WOUND JOURNAL, Issue 5 2010Henning Ryssel This article presents a retrospective analysis of a series of nine patients requiring reconstruction of exposed bone, tendons or joint capsules as a result of acute high-voltage injuries in a single burn centre. As an alternative to free tissue transfer, the dermal substitute Matriderm® was used in a one-stage procedure in combination with split-thickness skin grafts (STSG) for reconstruction. Nine patients, in the period between 2005 and 2009 with extensive high-voltage injuries to one or more extremities which required coverage of exposed functional structures as bone, tendons or joint capsule, were included. A total of 11 skin graftings and 2 local flaps were performed. Data including regrafting rate, complications, hospital stays, length of rehabilitation and time until return to work were collected. Eleven STSG in combination with Matriderm® were performed on nine patients (success rate 89%). One patient died. One patient needed a free-flap coverage as a secondary procedure. The median follow-up was 30 months (range 6,48 months). The clinical results of these nine treated patients concerning skin-quality and coverage of exposed tendons or joint capsule were very good. In high-voltage injuries free-flap failure occurs between 10% and 30% if performed within the first 4,6 weeks after trauma. The use of single-stage Matriderm® and skin grafting for immediate coverage described in this article is a reliable alternative to selected cases within this period. [source] Joint capsule mast cells and neuropeptides are increased within four weeks of injury and remain elevated in chronic stages of posttraumatic contracturesJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 10 2008Kevin A. Hildebrand Abstract The purpose of this article was to determine mast cell and neuropeptide nerve fiber numbers in joint capsules in posttraumatic contractures, as elevated numbers have been implicated in other fibrotic and contracture conditions. Twelve skeletally mature rabbits had intraarticular cortical windows removed from the medial and lateral femoral condyles and the knee joint immobilized. The contralateral unoperated limb served as a control. Equal numbers of rabbits were sacrificed 4 weeks after surgery or 40 weeks after the first surgery that included 32 weeks of remobilization. Six patients with chronic posttraumatic elbow joint contractures and six age-matched organ donor controls free of elbow contractures were also studied. Joint capsule myofibroblast, mast cell, and neuropeptide containing nerve fiber numbers were assessed with immunohistochemistry. The numbers of myofibroblasts, mast cells, and neuropeptide containing nerve fibers expressed as a percentage of total cells were significantly greater in the contracture capsules when compared to the control capsules at all time points (p,<,0.0001). The range of percentages for the three components in the contracture capsules versus the controls were 41,48% versus 9,10%, 44,50% versus 11,13%, and 45,50% versus 10,12% for the acute and chronic stages of the rabbit model and the chronic stages in the human elbows, respectively. These data support the hypothesis that a myofibroblast,mast cell,neuropeptide fibrosis axis may underlie some of the pathologic changes in the joint capsule in posttraumatic contractures. Approaches designed to manipulate this axis, such as preventing degranulation of mast cells, warrant further investigation. © 2008 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 26:1313,1319, 2008 [source] Neurophysiological and biomechanical characterization of goat cervical facet joint capsulesJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 4 2005Ying Lu Abstract Cervical facet joints have been implicated as a major source of pain after whiplash injury. We sought to identify facet joint capsule receptors in the cervical spine and quantify their responses to capsular deformation. The response of mechanosensitive afferents in C5,C6 facet joint capsules to craniocaudal stretch (0.5 mm/s) was examined in anaesthetized adult goats. Capsular afferents were characterized into Group III and IV based on their conduction velocity. Two-dimensional strains across the capsules during stretch were obtained by a stereoimaging technique and finite element modeling. 17 (53%) Group III and 14 (56%) Group IV afferents were identified with low strain thresholds of 0.107 ± 0.033 and 0.100 ± 0.046. A subpopulation of low-strain-threshold afferents had discharge rate saturation at the strains of 0.388 ± 0.121 (n = 9, Group III) and 0.341 ± 0.159 (n = 9, Group IV). Two (8%) Group IV units responded only to high strains (0.460 ± 0.170). 15 (47%) Group III and 9 (36%) Group IV units could not be excited even by noxious capsular stretch. Simple linear regressions were conducted with capsular load and principal strain as independent variables and neural response of low-strain-threshold afferents as the dependent variable. Correlation coefficients (R2) were 0.73 ± 0.11 with load, and 0.82 ± 0.12 with principal strain. The stiffness of the C5,C6 capsules was 16.8 ± 11.4 N/mm. Our results indicate that sensory receptors in cervical facet joint capsules are not only capable of signaling a graded physiological mechanical stimulus, but may also elieit pain sensation under excessive deformation. © 2005 Orthopaedic Research Society. Published by Elsevier Ltd. All rights reserved. [source] Cranial cruciate stabilitv in the rottweiler and racing greyhound: an in vitro studyJOURNAL OF SMALL ANIMAL PRACTICE, Issue 5 2000C. Wingfield An in vitro biomechanical study of cadaver stifles from rottweilers and racing greyhounds was undertaken to evaluate the contribution of the cranial cruciate ligament to stifle joint stability. This was performed at differing stifle joint angles, first with the joint capsules and ligaments intact and then with all structures removed except for the cranial cruciate ligament. Craniocaudal laxity increased in both breeds as stifle flexion increased. The rottweiler stifle showed greater craniocaudal joint laxity than the racing greyhound at all joint angles between 150° and 110°, but the actual increases in joint laxity between these joint angles were similar for both breeds. Tibial rotation during craniocaudal loading of the stifle increased craniocaudal laxity in both breeds during joint flexion. The relative contribution of the cranial cruciate ligament to cranial stability of the stifle joint increased as the joint flexed and was similar in both breeds. [source] | |||||||||||||