Magnetic resonance evaluation of the knee in children and adolescents with achondroplasia

Akyol, Yakup; Averill, Lauren W.; Atanda, Alfred; Kecskemethy, Heidi H.; Bober, Michael B.; Mackenzie, William G.

doi:10.1007/s00247-014-3228-1

Cited by 12 publications

(12 citation statements)

References 26 publications

(28 reference statements)

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“…However, since these patients have characteristic anatomy, it may be difficult to differentiate between their ‘normal’ anatomy and intra-articular pathology at the time of arthroscopy. 6 …”

Section: Discussionmentioning

confidence: 99%

“…Knee MRI findings in children and young adults with achondroplasia 6 have been recently reported. Described deformities included increased knee flexion, patella baja, deep A-shaped intercondylar notch, increased anterior cruciate ligament (ACL)-Blumensaat line angle, a taut posterior cruciate ligament (PCL) and discoid lateral meniscus.…”

Section: Introductionmentioning

confidence: 99%

“…These radiographic findings include an inverted V-shaped distal femoral physis, prominent tibial tubercle, and distal femoral and proximal tibial angulation. 6 …”

Section: Introductionmentioning

confidence: 99%

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Arthroscopic knee anatomy in young achondroplasia patients

Orozco

Record

Rogers

et al. 2017

Journal of Children's Orthopaedics

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PurposeAchondroplasia is the most common form of skeletal dysplasia, affecting more than 250 000 individuals worldwide. In these patients, the developing knee undergoes multiple anatomical changes. The purpose of this study was to characterise the intra-articular knee anatomy in children with achondroplasia who underwent knee arthroscopy.MethodsRecords of achondroplasia patients who underwent knee arthroscopy between 2009 and 2014 were reviewed. Demographic data, operative reports, follow-up notes, MRI and arthroscopy images were reviewed. Bony, cartilaginous and ligamentous changes were noted. The trochlea sulcus angle was measured from intra-operative arthroscopic images.ResultsA total of 12 knee arthroscopies in nine patients were performed. The mean age at surgery was 16.9 years (12 to 22). In all patients, the indication for surgery was knee pain and/or mechanical symptoms that were refractory to non-operative treatment. Three anatomical variations involving the distal femur were found in all knees: a deep femoral trochlea; a high A-shaped intercondylar notch; and a vertically oriented anterior cruciate ligament. The average trochlea sulcus angle measured 123°. Pathology included: synovial plica (one knee); chondral lesions (three knees); discoid lateral meniscus (11 knees); and meniscal tears (six knees). All patients were pain-free and returned to normal activity at final follow-up.ConclusionChildren with achondroplasia have characteristic distal femur anatomy noted during knee arthroscopy. These variations should be considered normal during knee arthroscopy in these patients. Arthroscopic findings confirmed previous MRI findings within this specific population with the addition of a deep trochlear groove which was not previously reported.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Arthroscopic knee anatomy in young achondroplasia patients

Orozco

Record

Rogers

et al. 2017

Journal of Children's Orthopaedics

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“…However, the shorter femur observed in the Achondroplasic group compared to controls does not explain the Achondroplasic group's relatively longer patella tendon length. The Achondroplasic knee is more flexed when at rest (Akyol et al, 2015 ), and the more flexed knee may deform the patella tendon over time leading to a creep effect. However, no longitudinal measures of the Achondroplasic tendon has been made.…”

Section: Discussionmentioning

confidence: 99%

“…The Achondroplasic condition is synonymous with impaired bone growth and development, but given that the human tendon is predominantly made up of collagen fibrils (Wang, 2006 ), it is possible that the altered FGFR3 may impact intrinsic properties of the Achondroplasic tendon compared to age matched averaged statured individuals (controls). However, Achondroplasic tendon compliance (or joint laxity) have only been commented on but not quantified (Bober et al, 2008 ; Akyol et al, 2015 ).…”

Section: Introductionmentioning

confidence: 99%

Morphological and Mechanical Properties of the Human Patella Tendon in Adult Males With Achondroplasia

et al. 2018

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Achondroplasia is a genetic mutation of fibroblast growth factor receptor resulting in impaired growth plate development in long bones due to lower collagen turnover. Despite the characteristic shorter stature and lower strength in Achondroplasic groups, little is known of the tendon mechanical properties under loading. The aim of this study was therefore to conduct a between measure design of patella tendon (PT) mechanical properties (stress, strain, stiffness and Young's Modulus) in 10 men with Achondroplasia (22 ± 3 years) and 17 male controls (22 ± 2 years). PT mechanical properties were measured during isometric maximal voluntary contraction (iMVC) of the knee extensors using ultrasonography. The Achondroplasic group produced 54% less stress at iMVC than controls (29.4 ± 8.0 v 64.5 ± 14.0 MPa, P < 0.001, d = 3.12). Maximal excursion of the Achondroplasic PT was 22% less than controls at iMVC (7.4 ± 2.1 v 5.5 ± 1.7 mm, P < 0.001, d = 0.99), but there was no difference in strain between groups (13 ± 4 v 13 ± 3%, P > 0.05). Achondroplasic PT were 47% less stiff (748 ± 93 v 1418 ± 101 N·mm−1, P < 0.001, d = 6.89) and had a 51% lower Young's modulus (0.39 ± 0.09 v 0.77 ± 0.14 GPa, P < 0.001, d = 3.46) than controls at iMVC. Achondroplasic PT are indeed more compliant than controls which may contribute to lower relative force production. The causes of higher Achondroplasic PT compliance are unclear but are likely due to the collagen related genetic mutation which causes Achondroplasia.

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