Supratrochlear Rim Is Correlated With Isolated Patellar Chondromalacia on Magnetic Resonance Imaging of the Knee

Purpose: To investigate the relationship between the supratrochlear rim and isolated patellar chondromalacia (PC) using magnetic resonance imaging (MRI) scans of the knee. Methods: Patients without patellofemoral pain (control group) and patients with patellofemoral pain and diagnosed with stage III or IV PC based on MRI (defect group) were retrospectively identified. Patients with a history of patellar subluxation were excluded. We used patient MRI scans to perform 20 anatomical measurements of the patellofemoral joint. We also performed 2 measurements of the anterior femoral curvature. A total of 30 patients (29 ± 8.7 years) were in the control group, and 20 patients were in the defect group (29.4 ± 9.7 years). Results: The maximum curvature (P < .001) and mean curvature (P < .001) of the anterior femoral condyle were found statistically significantly different between the groups. Patellotrochlear index (P = .03) and Insall-Salvati index (P < .001) were also found statistically significantly different between the 2 groups. Patella type III and trochlear dysplasia grade B were found more common in the defect group. Conclusions: We have shown through MRI knee measurements that the isolated patellar chondromalacia in patients without a history of patellar subluxation and dislocation is correlated with the increased anterior femoral curvature in combination with patella alta. Level of Evidence: Level III, progostic case-control

Technique for Arthroscopic-Assisted Primary Anterior Cruciate Ligament Reconstruction Using Doubled Tibialis Anterior Tendon

Advances in surgical technique and our knowledge of anterior cruciate ligament (ACL) anatomy have resulted in a marked increase in options for ACL reconstruction. Currently, patient age and activity level, surgeon preference and experience, and cost are factors influencing the type of reconstruction recommended to address knee instability. We present a simplified transtibial method of ACL reconstruction using a single-bundle, doubled tibialis anterior allograft. This method uses fixation with a suspensory device on the femur and a bio-composite interference screw on the tibia. We recommend this simplified technique for primary ACL reconstruction because it minimizes total steps, thus limiting variance, maximizing efficiency, and reducing potential technical error

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ABSTRACT Major Miocene central Andean (lat 22°-34°S) ore districts share common tectonic and magmatic features that point to a model for their formation over a shallowing subduction zone or during the initial steepening of a formerly flat subduction zone. A key ingredient for magmatism and ore formation is release of fluids linked to hydration of the mantle and lower crust above a progressively shallower and cooler subducting oceanic slab. Another is stress from South American-Nazca plate convergence that results in crustal thickening and shortening in association with magma accumulation in the crust. Fluids for mineralization are released as the crust thickens, and hydrous, lower crustal, amphibole-bearing mineral assemblages that were stable during earlier stages of crustal thickening break down to dryer, more garnet-bearing ones. Evidence for this process comes from trace-element signatures of pre-to postmineralization magmas that show a progression from equilibration with intermediate pressure amphibole-bearing residual mineral assemblages to higher pressure garnet-bearing ones. Mineralization over the shallowing subduction zone in central Chile (28°-33°S) is followed by cessation of arc volcanism or migration of the arc front away from the trench. Mineralization in the central Altiplano-Puna region (21°-24°S) formed above a formerly flat subduction zone as volcanism was reinitiating. Thus, hydration and crustal thickening associated with transitions in and out of flat-slab subduction conditions are fundamental controls on formation of these major ore deposits. INTRODUCTION S ome of the world&apos;s richest and largest copper and gold deposits are associated with Miocene magmatism in the central Andes. This paper reviews how the formation of major ore deposits between 22°and 34°S can be linked to the late Cenozoic magmatic and tectonic response of the mantle and lower crust to the formation and subsequent steepening of shallow subduction zone

Night eating syndrome in young adult women: Prevalence and correlates

Objective The current study examined the prevalence and clinical significance of night eating syndrome (NES) in a community cohort of Black and White women. Method We assessed 682 Black and 659 White women for NES, eating disorders, and psychiatric symptomatology. Results The prevalence was 1.6% (22 of 1,341; Blacks [n = 20]; Whites [n = 2]). Comparisons between identified Black women and the remaining Black participants revealed no significant differences in obesity, psychiatric comorbidity, or self-reported psychiatric distress. Comorbidity with eating disorders as outlined in the 4th ed. of the Diagnostic and Statistical Manual of Mental Disorders (Washington, DC: American Psychiatric Association) was low (n = 1 [4.5%]). Black NES women were significantly less likely than Black non-NES women to be overweight and significantly more likely to have two or more children. Discussion NES was rare in this sample of young women. Low comorbidity of NES with other eating disorders suggests that NES may be distinct from the DSM-IV recognized eating disorders. Longitudinal data are needed to determine the long-term health implications of this behavioral pattern. © 2005 by Wiley Periodicals, Inc

Health services use in women with a history of bulimia nervosa or binge eating disorder eating disorder

Objective The current study examined health services use during the past 12 months in a sample of young women with a history of an adolescent eating disorder (bulimia nervosa [BN] or binge eating disorder [BED]). Method A community sample of 1,582 young women (mean age = 21.5 years) was classified, based on a screening interview (and, for eating disorder diagnosis, confirmatory diagnostic interview), into one of three groups: BN or BED (n = 67), other psychiatric disorder (n = 443), and no adolescent psychiatric disorder (n = 1,072). Results A history of BN/BED in adolescence was associated with elevated health services use, but this was a general effect associated with having a psychiatric disorder, not an effect specific to the diagnosis of an eating disorder. Total service days, outpatient psychotherapy visits, and emergency department visits were elevated in the combined group of BN/BED and other psychiatric disorder participants relative to the healthy comparison group. The women with BN/BED did not differ significantly from the women with a non–eating-related psychiatric disorder in the use of these services. Discussion The similarity of health services use in young women with BN or BED and those with other psychiatric disorders underscores the clinical and economic impact of these eating disorders. © 2004 by Wiley Periodicals, Inc

Combined Anterior Cruciate Ligament Reconstruction and Lateral Extra-Articular Tenodesis

Anterolateral rotational instability may persist after anterior cruciate ligament (ACL) reconstruction for a variety of reasons including damage to lateral or posterolateral structures, injury to the meniscus, disruption of anterolateral soft tissue structures, or increased tibial slope. In the setting of revision or primary ACL reconstruction with persistent anterolateral laxity, despite repair or reconstruction of other injured structures or in the setting of increased tibial slope, a lateral extra-articular tenodesis procedure can be used to augment an ACL reconstruction to aid in restoring anterolateral rotational stability and to upload the ACL reconstruction graft. This article details our technique for performing a modified Lemaire lateral extra-articular tenodesis using iliotibial band autograft as an adjunct to ACL reconstruction

Combined Posterior Cruciate Ligament and Superficial Medial Collateral Ligament Knee Reconstruction: Avoiding Tunnel Convergence

Combined posterior cruciate ligament (PCL) and medial collateral ligament (MCL) injuries represent a complex pathology that requires a thorough clinical and radiographic examination to diagnose and identify all injured structures. Anatomic reconstruction of the injured ligaments is recommended, including double-bundle PCL reconstruction and superficial MCL augmentation. In the setting of this complex reconstruction, several technical aspects require consideration and preoperative planning, including the risk of femoral tunnel convergence on the medial aspect of the femoral condyle. This article details our technique for combined anatomic double-bundle PCL reconstruction and superficial MCL augmentation to avoid tunnel convergence. Level I (knee); level II (PCL)