Background: The alignment of lower limbs change with growth and accurate knowledge of such a change in any particular geography is necessary to differentiate the pathologic conditions from normal variations. We are reporting the normal variations in TIBIOFEMORAL alignment in young people in a region of Iran.Methods: A cross-sectional study on 853 children (455 girls, 398 boys) of 3 to 16 years age was performed. TIBIOFEMORAL ANGLEs and intermalleolar distances were measured in standing position. Normal limits of TIBIOFEMORAL ANGLEs and intermalleolar distances were separately determined based on age and sex.Results: A valgus alignment was observed in all. The TIBIOFEMORAL ANGLEs in boys between ages 3 to 7 years were 7.1±0.35 and 4.97±0.36 between 8 to 16 years of age. The TIBIOFEMORAL ANGLE in girls aged 3 to 7 years were 7.1±0.38 and in girls of 8 to 16 years were 4.95±0.37 degrees. There was no significant difference between the TIBIOFEMORAL ANGLE in girls and boys. The intermalleolar distance in boys of 3 to 7 years old was 2.7±0.9 and in boys of 8 to 16 years were 1.4±0.86 centimeters. The intermalleolar distance was 2.6±0.88 centimeters in 3 to 7 year old girls and 2.29±0.93 centimeters in 8 to 16 year old girls.Pierson correlation coefficient showed a reverse relationship between TIBIOFEMORAL ANGLE and intermalleolar distance.Conclusion: The TIBIOFEMORAL alignment in Iranian children is similar to that of Europe, North America and Turkey but different from Chinese children.

Background: The alignment of lower limbs change with growth. Accurate knowledge of such a change in any particular geography is necessary to differentiate the pathologic conditions from normal variations. This was the reason for undertaking a study on limb alignment in schoolchildren of Qom. Method: Across- sectional study on 2263 children-1378 girls and 885 boys was stated in 1999. The inter malleolar (IM) and inter condylar (IC) distances and Tibiofibular ANGLE (TF) were measured. with children standing straight with knees in fun extension. Results: A valgus alignment was observed in all. The TF was 5.5±1.2 ranging from 3.1 to 8.3. This value was 5.7±1.3 in girls and 5.2±1.05 in boys. The IM-IC distance varied from -3.9 - 2.6 centimeters. There was a direct relation between T.F. ANGLE with IM or IC distances. The body mass index (BMI) also had a meaningful relation with T.F. ANGLE. A correlation between BMI and height was observed only in boys. Conclusions: The Tibiofemmoral alignment of school children of Qom is similar to that Europe and North America, but different from Chinese children. In order to verify in that the school children of Qom represent a good sample of Iranian children further studies in other part of the country is recommended.

Background and Objective: some studies shown that position of fetus in uterus could be some lower limb deformities. Up to now, no research has been done about relationship between type of delivery and TIBIOFEMORAL developing. We were investigated to consider of this relationship in people between 3-16 years old in Ahvaz city.Subjects and Methods: This cross-sectional study was carried out on 853 people (455 girls and 398 boys). TIBIOFEMORAL (TF) ANGLE, Intercondylar and intermalleolar distances were measured in standing position with knees and hip in full extension. Information about a kind of delivery (caesarian or vaginal) were taken by questionnaires in which was completed by their parents.Results: TF ANGLE in cesarean sections was more than in vaginal deliveries and the difference was statistically significant (p=0.02). Intercondylar and intermalleolar distances in cesarean sections were more than in vaginal deliveries but the differences were not statistically sign-ificant.Conclusion: There is significant relationship between TIBIOFEMORAL and type of delivery, but for the future work need to evaluate the effect of fetal position and adaptathions(mechanism of laber) in the development of TIBIOFEMORAL ANGLE after birth.

Background: Range of motion after total knee arthroplasty is an important factor measuring of the outcome and is crucial factor all of rating knee system. Our study was down to identify the most important factors that related with postoperative range of motion. Materials and Methods: We studied prospectively patients (68 knees) who had a primary total knee arthroplasty at the same center between 2000-2002. Ten preoperative factors (age, sex, extension lag, flexion contracture, flexion arc, TIBIOFEMORAL ANGLE, body mass index, cause of joint destruction, prosthesis type about PCL retention or substitution, history of high tibial osteotony) were used to predict postoperative range of motion. Results & Conclusion: We used correlation analysis tree to identify the preoperative factors predicting the postoperative range of motion. The significant factors were preoperative range of motion, preoperative tlexion contracture and body mass index.

Backgraund and Objective: In evaluation of genu varum and genu valgum which are common in growth period of children, TIBIOFEMORAL (TF), intercondylar (IC) and intermaleolar (IM) distances are commonly measured. Normally, the legs of most newborns are slightly curved or have moderate curves medially when they are in standing position. During their growth, the extension of the lower limb changes. The aim of this study was to determine the relationship between normal intercondylar and intermaleoar distances and physiolgical factors among these subject groups.Subjects and Methods: In this cross-sectional study a group of 850 children (452 females, 398 males) aged between 3 to 16 years old were studied. The samples were collected randomly from kindergartens, preschool care centers and schools in all 4 districts of Ahvaz, plus a few patients in Shafa hospital. The intercondylar and intermaleolar distance were examined in standing position, while the knee and hip joints were fully extended and the two medial maleolus or two medial condye of knees were in contact.In this study, descriptive statistics as well as t- and ANOVA tests were used for comparison.Pearson correlation for the survey were used data analysis by SPSS version 15.Results: The mean of intercondylar distance among studied groups was 1.65±0.86: 1.5 in boys and 1.71 cm in girls respectively. The mean of intermaleolar distances was 2.31cm: in males 2.05cm and in females 2.53cm, the difference was significant (P<0.05).Conclusion: There was a direct ralationship between intermaleolar distance and weight, height and length of leg, but relationship between Intercondylar distance and these factors is in reverse order.

Introduction: Partial fibulectomy has been suggested for patients who encounter with severe varus/valgus or ununited fractures of the tibia. This study develops a finite element (FE) model of partial fibulectomy to study stress distribution in the TIBIOFEMORAL joint. Materials and Methods: A 3D magnetic resonance imaging (MRI)-based of TIBIOFEMORAL joint and FE model was developed for study from a man volunteer with the normal left knee. Components consisted of the exact geometry of femur, tibia, fibula, meniscus, and articular cartilages. Firstly, geometries were constructed in Mimics and then exported to Rapid Forming XOR2 and finally, the Computer-aided design (CAD) model was analyzed in ABAQUS 6. 10. Mechanical properties of the model for soft tissues were considered to be linear elastic, isotropic and homogenous and for bony parts were considered to be rigid. Results: Model predictions were compared with normal one and used to derive stress distribution under physiological loading for standing in quasi-static condition. The results showed load transferring toward lateral condyle due to partial fibulectomy. The variation of stress distribution would increase the risk of osteoarthritis. Conclusion: Our results have been predicted that partial fibulectomy could be an unknown risk factor for osteoarthritis and the model could be used for extended similar studies.

Purpose: The purpose of this study is to examine the differences of kinetic and kinematic variables in middle-aged women with genu varum and normal knee ANGLE during walking and running.Methods: Eight middle-aged women with genu varum (age: 45.12 ±12.74 y, height: 160.62 ± 5.26 cm, weight: 71.75 ± 16.38 kg, right TIBIOFEMORAL ANGLE: -4 ± 3.9, left TIBIOFEMORAL ANGLE: -5.1 ± 4.6) and 7 with normal knee (age: 40.71 ± 11.32 y, height: 157.85 ± 5.01 cm, weight: 71.71 ± 14.00 kg, right TIBIOFEMORAL ANGLE: 7.2 ± 2.1, left TIBIOFEMORAL ANGLE: 7.8 ± 1.8) volunteered to participate in this study. We measured knee ANGLE in frontal plane based on anatomical axis of femur and tibia by goniometer. This factor was labeled as TIBIOFEMORAL ANGLE.Results: Participants walked a 7-m pathway 6 times with self-selected speed, then they ran the same route 3 times. Independent t tests were used to determine statistical differences. Significance level was P<0.05. The results showed that there was no significant difference between the groups in walking with self-selected speed regarding knee normalized ground reaction force, in medial-lateral and vertical plane, but this variable was significantly greater in anterior-posterior plane among normal knee group (P<0.05). There was also no significant difference in medial lateral plane in normalized ground reaction force between the groups while they ran. However, this variable in both vertical and anterior-posterior planes was significantly greater in normal knee group (P<0.05).Conclusion: The results did not show any difference between the groups in angular velocity of knee joint in sagittal plane during swing phase under two situations. According to the findings, the genu varum in dynamic activities such as walking and running is more related to kinetic variables like ground reaction force. These effects are not limited to the frontal plane, however, this variable in vertical and anterior-posterior planes is significantly lower in genu varum knee ANGLE group.

Congenital anterior tibiofernoral subluxation is an extremely rare disorder. All reported cases accompanied by other abnormalities and syndromes. A 16-year-old high school girl referred us with bilateral anterior TIBIOFEMORAL subluxation as the knees were extended and reduced at more than 30 degrees flexion. Deformities were due to tightness of the iliotibial band and biceps femuris muscles and corrected by surgical release. Associated disorders included: bilateral shoulders dislocation, short metacarpals, metatarsals, and right calcaneuvalgus deformity.