No description available.

No description available.

In clinical settings, the pectineal ligament forms a basic landmark for surgical approaches. However, to date, the detailed fascial topography of this ligament is not well understood. The aim of this study was to describe the morphology of the pectineal ligament including its fascial connections to surrounding structures. The spatial–topographical relations of 10 fresh and embalmed specimens were dissected, stained, slice plastinated, and analyzed macroscopically, and in three cases histological approaches were also used. The pectineal ligament is attached ventrally and superiorly to the pectineus muscle, connected to the inguinal ligament by the lacunar ligament and to the tendinous origin of rectus abdominis muscle and the iliopubic tract. It forms a site of origin for the internal obturator muscle, and throughout its curved course, the ligament attaches to both the fasciae of iliopsoas and the internal obturator muscle. However, dorsally, these fasciae pass free from the bone, while the pectineal ligament itself is adhered to it. The organ fasciae are seen apart from the pectineal ligament and its connections. The pectineal ligament seems to form a connective tissue junction between the anterior and medial compartment of the thigh. This ligament, however, is free to other compartments arisen from the embryonal gut and to the urogenital ridge. These features of the pectineal ligament are important to consider during orthopedic and trauma surgical approaches, in gynecology, hernia and incontinence surgery, and in operations for pelvic floor and neovaginal reconstructions

Introduktion: Skador på främre korsbandet är en av de vanligaste ortopediska skadorna hos hundar. Korsbandets huvudsakliga uppgift är att stabilisera knäleden. En främre korsbandsskada kan behandlas konservativt eller operativt, och i bägge fall är rehabilitering en viktig åtgärd. Syfte: Belysa studier kring postoperativ rehabilitering av främre korsbandsskada hos hund. Frågeställningar var; “Vilka postoperativa rehabiliteringsmetoder för främre korsbandsskada har studerats för hund?” och “Vilka effekter har de olika behandlingarna i studierna visat?” Metod: Denna systematiska litteraturstudie har följt Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) och granskningsmallar för originalstudier från Statens beredning för medicinsk utvärdering (SBU). Sökningen för litteratursammanställningen gjordes på PubMed och Scopus. Resultat: Tio artiklar kvalificerades för inkludering. Några rehabiliteringsmetoder som nämnts är bandage, köldterapi, ROM-träning, gång på vattenband, löpband, promenader, CCT och elektroterapi. Resultatet visar att extensionsvinkeln påverkas i högre grad än flexionsvinkeln. Vattenbandsträning och CCT ökar ledvinkeln postoperativt och ESWT ger snabbare belastning av det opererade benet. MET tillsammans med bandage, kall kompression och kall kompression tillsammans med bandage gav hade bäst effekt på svullnad. Konklusion: Resultatet visar att rehabilitering och fysioterapeutiska åtgärder är en viktig del för att återfå bästa möjliga funktion, minska smärta samt att förebygga försämrad funktion postoperativt efter en CrCL skada. Vidare forskning med fördjupning på rehabiliteringstyp och antal rehabiliteringstillfällen behövs för att kunna fastställa vilken rehabilitering som är mest gynnsam.

Twelve pairs of cadaveric pelvic limbs were harvested from skeletally mature dogs. Tibias were randomly assigned pairwise to two study groups: locking buttress screw fixation (LBS) and bone-screw-fastener fixation (BSF). A tibial plateau leveling osteotomy (TPLO) was performed. Each specimen was positioned in a servohydraulic testing machine to simulate physiological orientation and loading at the mid-point of the stance phase at the walk. Cyclic loading was performed for 30,000 cycles at 4Hz with a peak-load of 1000N. The cyclic test was then continued by stepwise increasing the peak-load at a rate of 75N per 500 cycles until failure of the construct. The findings of this current study suggest that stabilization of the TPLO with BSF in the proximal part of a locking TPLO plate provided similar biomechanical stability under cyclic axial loading conditions as the LBS. BSF may be an acceptable alternative to LBS for TPLO.

Background: Evidence indicates that an external focus (EF) of attention on the intended effect of one’s movement results in better motor performance and motor control than an internal focus (IF) on one’s own body. Despite this, an IF is predominantly encouraged through instructions and feedback provided by clinicians during sports and rehabilitation from injuries such as anterior cruciate ligament (ACL) injury. Aim: The aim of this pilot study was to investigate the influence of EF and IF on motor control and performance on a bilateral leg extension and flexion task. The secondary aim was to investigate potential differences in the outcomes between a control group and a group with ACL reconstruction (ACLR). Method: Fourteen controls and four individuals with ACLR performed a bilateral leg extension and flexion task with instructions that encouraged either an IF, EF or neutral focus (NF) of attention. The instructions encouraged participants to either keep the individual tubes located on the footplates under the soles of the feet (EF) or the feet themselves (IF) level with each other. A three-dimensional motion capture system was used to record kinematics. Motor control was assessed based on the movement smoothness according to the knee angular velocity profile and performance was assessed based on the absolute mean deviation of the tubes/footplates from parallel. Results: For the control group, IF instructions resulted in significantly better motor control than EF instructions for left knee movement smoothness (p=0.02) and NF instructions resulted in significantly better motor control than EF on a majority of dependent variables. Conclusion: For our task, EF instructions did not result in better outcomes compared to IF instructions which might be explained because the task was proprioceptive demanding with less involvement of the vision. The reason for better motor control with NF instructions compared to EF instructions might be because of differences in angular velocity and instructions between conditions.

No description available.

Spinal ligaments may be a significant source of chronic back pain, yet they are often disregarded by the clinical community due to a lack of information with regards to their material response, and innervation characteristics. The purpose of this dissertation was to characterize the material response of spinal ligaments and to review their innervation characteristics. Review of relevant literature revealed that all of the major spinal ligaments are innervated. They cause painful sensations when irritated and provide reflexive control of the deep spinal musculature. As such, including the neurologic implications of iatrogenic ligament damage in the evaluation of surgical procedures aimed at relieving back pain will likely result in more effective long-term solutions. The material response of spinal ligaments has not previously been fully quantified due to limitations associated with standard soft tissue testing techniques. The present work presents and validates a novel testing methodology capable of overcoming these limitations. In particular, the anisotropic, inhomogeneous material constitutive properties of the human supraspinous ligament are quantified and methods for determining the response of the other spinal ligaments are presented. In addition, a method for determining the anisotropic, inhomogeneous pre-strain distribution of the spinal ligaments is presented. The multi-axial pre-strain distributions of the human anterior longitudinal ligament, ligamentum flavum and supraspinous ligament were determined using this methodology. Results from this work clearly demonstrate that spinal ligaments are not uniaxial structures, and that finite element models which account for pre-strain and incorporate ligament’s complex material properties may provide increased fidelity to the in vivo condition.

The purpose of this work was to determine the possible effects of isolated spinal ligament transection on the biomechanics of the lumbar spine. A finite element model of a lumbar spine was developed and validated against experimental data. The model was tested in the primary modes of spinal motion in the intact condition, followed by comparative analysis of isolated removal of each spinal ligament. Results showed that stress increased in the remaining ligaments once a ligament was removed, potentially leading to ligament damage. Results also showed changes in bone remodeling "stimulus" which could lead to changes in bone density. Isolated ligament transection had little effect on intervertebral disc pressures. All major biomechanical changes occurred at the same spinal level as the transected ligament, with minor changes at adjacent levels. The results of this work demonstrate that iatrogenic damage of spinal ligaments disturbs the load sharing within spinal-ligament complex and may induce significant clinical changes in the spinal motion segment.

The purpose of this work was to analyze the biomechanics of degeneration, damage, and failure in biological soft tissues both experimentally and computationally to provide insight into tendon or ligament tearing, tendo-achilles lengthening and lumbar spine dysfunction. For soft tissue tearing, experimental studies for calculating fracture toughness were performed and determined that tendons and ligaments are able to completely resist tear propagation. For tendo-achilles lengthening, a damage model was developed to mimic the behavior of the lengthening that occurs as a result of the percutaneous triple hemisection technique. The model provided insight for predicting the amount of lengthening that occurs during the procedure. For lumbar spine dysfunction, a finite element model was validated against experimental testing and simulated using boundary conditions representing physiological loading. The model was able to predict how biomechanical changes can lead to pain and how the prevalence of Schmorl's nodes can be predicted. For each of the situations, the best verification and validation methods were selected and are presented throughout the research to demonstrate the predictive capabilities and limitations of the work. Results of these studies are presented along with how those results influence the clinical endeavors associated with the degeneration, damage and failure of soft tissues.