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Is Flexion Gap Rectangular in Native Indian Knees? Results of an MRI Study

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Abstract

Background

The purpose of this study was to evaluate the flexion-gap of the native knees in the normal population and to assess any gender-specific variations in the flexion gap of the knees.

Methods

A total of 50 normal asymptomatic volunteers with normal knee radiographs were selected for MRI of the knee. The left knee was scanned in an open MRI using a T1-weighted sequence. Imaging was performed in neutral, passive varus and valgus stress at 90° of knee flexion by placing custom-made blocks on a special board consecutively below the distal part of the leg.

Results

The study population consisted of 26 males and 24 females with a mean age of 25.77 years. Under varus stress, the mean lateral flexion gap increased to 9.28 ± 1.53 mm and under valgus stress, the mean medial flexion gap increased to 2.75 ± 1.22 mm from neutral. The increase in the flexion gap on the lateral side was 5.28 ± 1.79 mm, which was significantly higher compared to that on the medial side. In gender-specific analysis, the mean lateral flexion gap was 10.21 mm in females and 8.46 mm in males under varus stress.

Conclusion

The findings of the study indicate that the lateral soft tissues are more lax compared to the medial soft tissue structures and this laxity is higher in females as compared to males. The study provides evidence of the existing physiological variations of these soft tissue structures resulting in a trapezoidal flexion gap in the native knees rather than the recommended rectangular gap.

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Data availability

The manuscript data can be made available on request.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Orthopaedics, Maharishi Markandeshwar Institute of Medical Sciences and Research, M M Deemed to be University, Mullana, India

    Subodh Kumar Pathak, Praveen Thivari, Rakesh Kumar Gautam, Jasneet Chawla & Aryan Sharma

  2. Department of Orthopaedics, Phull Neuro Hospital, Patiala, India

    Manish Sethi

  3. Department of Surgical Oncology, GCRI, Ahmedabad, Gujarat, India

    Abhijeet Ashok Salunke

  4. Department of Orthopaedics, ASCOMS & Hospital, Jammu, India

    Rashid Anjum

Authors
  1. Subodh Kumar Pathak
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  2. Manish Sethi
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  3. Abhijeet Ashok Salunke
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  4. Praveen Thivari
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  5. Rakesh Kumar Gautam
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  7. Jasneet Chawla
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  8. Aryan Sharma
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Contributions

SKP: manuscript preparation, manuscript editing; MS: data collection, subject allocation, manuscript preparation; AAS: supervision, manuscript editing, statistical analysis; PT: manuscript editing, statistical analysis, data collection; RKG: manuscript editing, data collection; RA: data collection and analysis. JC: manuscript editing, statistical analysis. AS: data collection, manuscript editing. All authors read and approved the final manuscript.

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Correspondence to Subodh Kumar Pathak.

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Pathak, S.K., Sethi, M., Salunke, A.A. et al. Is Flexion Gap Rectangular in Native Indian Knees? Results of an MRI Study. JOIO 55, 1127–1134 (2021). https://doi.org/10.1007/s43465-021-00418-1

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  • DOI: https://doi.org/10.1007/s43465-021-00418-1

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