Impact of knee flexion on patella length in osteoarthritic patients undergoing total knee arthroplasty.

PURPOSE: This study used magnetic resonance imaging (MRI) to evaluate in vivo preoperative changes in the length of the patellar tendon (LPT) in patients undergoing total knee arthroplasty (TKA). We sought to answer two questions: first, does the LPT change with flexion? Second, does the LPT show a gender-specific pattern? METHODS: Eighty-five knees in 76 consecutive osteoarthritic patients were evaluated. The age range was 56-90 years (mean 70). The study included 62 females and 14 males. MRI was performed at full extension and at 30°, 60°, 90°, and full flexion. RESULTS: There were significantly different patterns between genders (p < 0.001). The main shortenings occurred earlier, at 30°, in females and later, at 60°, in males. In females, LPT values in full extension were significantly longer than those measured at other flexion angles. In male subjects, significant differences in LPT values were found between full extension versus 90° (p < 0.001) and full flexion (p < 0.001), and between 60° versus 90°(p = 0.030) and full flexion (p = 0.030). CONCLUSION: These differences might influence the gender-specific complications related to the extensor mechanism after TKA. These data provide useful information for surgeons attempting to achieve a satisfactory balance between joint gaps in the patellar reduced position intraoperatively.

Changes in the medial and lateral posterior condylar offset in total knee arthroplasty.

The purpose of this study was to clarify the changes between preoperation and postoperation in each posterior condylar offset (PCO) using computed tomography (CT) and to compare them to conventional radiographic (x-ray) evaluation in total knee arthroplasty. One hundred nine knees in 97 patients were evaluated. The medial PCO was significantly larger before surgery. The lateral PCO was significantly larger after surgery. Changes in the PCO on x-ray showed no significant correlation with the changes observed in the CT-evaluated medial (R = 0.028) and lateral PCO (R = 0.190). Changes in PCO observed by x-ray did not reflect those of the medial or lateral condyles on CT. We recommend CT-based evaluation of PCO by condyle when assessing the influence of PCO on range of motion following total knee arthroplasty.

Anandamide inhibits the DOI-induced head-twitch response in mice.

RATIONALE: Recently, Delta(9)-tetrahydrocannabinol (THC), the major psychoactive component of marijuana, and synthetic cannabinoid receptor agonists reportedly reduced the head-twitches induced by the 5-HT(2A/2C) receptor agonist 1-(2,5-dimethoxy 4-iodophenyl)-2-amino propane (DOI) in mice, which is mediated via the activation of 5-HT(2A) receptor. However, the effect of endogenous cannabinoid anandamide on the head-twitch response has not been studied. OBJECTIVES: In this study, we investigated the effect of anandamide on the DOI-induced head-twitch response in mice. METHODS: Five minutes after the injection of DOI (5 mg/kg IP), the number of head-twitches was counted for a 5-min period. THC or anandamide was injected IP 60 min or 10 min before the number of head-twitches was counted, respectively. RESULTS: THC and anandamide each reduced the DOI-induced head-twitch response. The inhibition of the DOI-induced head-twitch response by THC was reversed by SR141716A (N-piperidino-5-(4-chlorophenyl)-1-(2,4-dichlorophenyl)-4-methyl-3-pyrazole-carboxamide), a CB(1) receptor antagonist, while the effect of anandamide was not blocked by SR141716A. Cyclooxygenase (COX) inhibitors such as aspirin and indomethacin reversed the inhibition of the DOI-induced head-twitch response by anandamide. On the other hand, COX inhibitors did not affect the inhibition of the DOI-induced head-twitch response by THC. CONCLUSIONS: Taken together, these findings suggest that the endocannabinoid anandamide may inhibit 5-HT(2A) receptor-mediated function via the arachidonic acid cascade, but not via a direct interaction with the CB(1) cannabinoid receptor, and that the mechanism of its action is clearly different from that of THC.