BackgroundIt has been suggested that the anterolateral ligament (ALL) of the knee may have importance in limiting rotational instability, and reconstruction may prevent a continued pivot-shift following anterior cruciate ligament surgery. However, the anatomy of this ligament has not been consistently reported in recent publications. We describe our experience of cadaveric dissection with reference to other published work.Materials and MethodsEleven fresh-frozen cadaveric knees were dissected using a standard technique. The ALL tissue was identified with internal rotation of the tibia and varus stress. Measurements were made using a digital caliper and details of the origin and insertion were recorded.ResultsThe ALL was identified in ten of the 11 cadavers. The only specimen in which it was not identified was found to also have an anterior cruciate ligament deficiency. The mean dimensions were: length 40.1 (± 5.53) mm, width 4.63 (± 1.39) mm, thickness 0.87 (± 0.18) mm. The femoral origin was posterior and proximal to the lateral collateral ligament attachment in six knees, anterior and distal in three knees, and at the same site in one knee. The tibial insertion was a mean 17.7 (± 2.95) mm from Gerdy’s tubercle (GT) and 12.3 (± 3.55) mm from the fibula head (FH). This was 59.5 (± 5.44) % from GT to FH.ConclusionsThis anatomical data adds to previous information about the ALL. Our results support the finding that the ALL is a capsular thickening with meniscal attachment. The findings will help to guide the further work required to define the indications for reconstruction and appropriate grafts.
ObjectiveThe aim of this study was to review the radiological alignment outcomes of patient Specific (PS) cutting blocks and Standard Instrumentation in Primary Total Knee Arthroplasty.MethodsWe hypothesized that the use of PS techniques would significantly improve sagittal, coronal and rotational alignment of the prosthesis on short term. We performed a systematic review and a meta-analysis including all the randomised controlled trials (RCT) using PS and standard (ST) total knee arthroplasty to date.ResultsA total of 538 PS TKA and 549 ST TKA were included in the study. Statistical analysis of the outliers for femoral component sagittal, coronal and rotational positioning, tibial component sagittal and coronal positioning and the overall mechanical axis were assessed. We found that there was no significant benefit from using PS instrumentation in primary knee arthroplasty to aid in the positioning of either the tibial or femoral components. Furthermore sagittal plane tibial component positioning was worse in the PS than the traditional ST group.ConclusionOur results suggest that at present PS instrumentation is not superior to ST instrumentation in primary total knee arthroplasty.Level of evidenceLevel 1, Systematic review of therapeutic studies.
Hemangiomas are lesions that are not present at birth. They manifest within first month of life, exhibit a rapid proliferative phase, and slowly involute to non-existent. Hemangiomas of the oral cavity are not common pathological entities, but the head and neck are common sites. Furthermore some time histologically lymphatic channels may be evident in hemangiomas, and then it will be categorized according predominant component, e.g.; hemangiolymphangiomas or lymphangiohemangiomas, vice versa is true for lymphangiomas. Most true hemangiomas involute with time, but 10-20% of true hemnagioma in completely involute and required post- adolescent ablative treatment. In the present article we are reporting a case of hemangiolypmangiomas of left buccal mucosa in an 18-year-old male patient. We have also reviewed various treatment modalities and their clinical implication.
Despite abundant biological, biomechanical, and clinical research, return to sport after anterior cruciate ligament (ACL) injury remains a significant challenge. Residual rotatory knee laxity has been identified as one of the factors responsible for poor functional outcome. To improve and standardize the assessment of knee instability, a variety of instability scoring systems is available. Recently, devices to objectively quantify static and dynamic clinical exams have been developed to complement traditional subjective grading systems. These devices enable an improved evaluation of knee instability and possible associated injuries. This additional information may promote the development of new treatment algorithms and allow for individualized treatment. In this review, the different subjective laxity scores as well as complementary objective measuring systems are discussed, along with an introduction of injury to an individualized treatment algorithm.
Two-dimensional (2D) transition-metal dichalcogenides (TMDCs) have shown promise for a variety of optoelectronic applications due to a wide range of optical, electrical, and mechanical properties. Large-area chemical vapor deposition (CVD)-grown TMDC flakes could be useful in such devices. However, the defects present in large-area TMDC flakes can significantly influence carrier dynamics and transport properties. Here, the ultrafast carrier dynamics of monolayer tungsten disulfide (WS 2 ) covering a large area of the substrate was explored using transient absorption spectroscopy. By monitoring the transient optical response, exciton trapping by oxygen-induced defects has been identified in monolayer WS 2 . We observe excitation-densitydependent exciton decay dynamics for both band-edge and above band-edge excitations due to exciton−exciton annihilation. Our results demonstrate the impact of defect states on carrier recombination in CVD-grown TMDCs, which could pave the way for utilizing such materials in optoelectronic device applications.
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