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Arnould B, Décarie P, Venne G. Anatomical variations of the liver and its suspensory system: a cadaver‐based study. FASEB J 2022. [DOI: 10.1096/fasebj.2022.36.s1.r3016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Beryl Arnould
- Department of Anatomy and Cell BiologyMcGill UniversityMontréalQC
| | - Pascale Décarie
- Institut de Génie BiomédicaleUniversité de MontréalMontréalQC
| | - Gabriel Venne
- Department of Anatomy and Cell BiologyMcGill UniversityMontréalQC
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Arnould B, Taylor H, Décarie P, Venne G. The Evolution of the Suspensory System of the Liver: A Narrative Review. FASEB J 2022. [DOI: 10.1096/fasebj.2022.36.s1.r4912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | - Pascale Décarie
- Institut de Génie BiomédicaleUniversité de MontréalMontréalQC
| | - Gabriel Venne
- Department of Anatomy and Cell BiologyMcGill UniversityMontréalQC
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Gentile A, MacKenzie L, Balta JY, Rockarts J, Palombella A, Venne G. Embalming Procedures and Laboratory Practices for Cadaver‐Based Learning. FASEB J 2022. [DOI: 10.1096/fasebj.2022.36.s1.r3255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Kondrup F, Gaudreault N, Venne G. The Deep Fascia and its Role in Chronic Pain & Pathological Conditions: A Review. Clin Anat 2022; 35:649-659. [PMID: 35417568 DOI: 10.1002/ca.23882] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 04/06/2022] [Accepted: 04/06/2022] [Indexed: 11/11/2022]
Abstract
INTRODUCTION The deep fascia is a three-dimensional continuum of connective tissue surrounding the bones, muscles, nerves and blood vessels throughout our body. Its importance in chronically debilitating conditions has recently been brought to light. This work investigates changes in these tissues in pathological settings. MATERIALS AND METHODS A state-of-the-art review was conducted in PubMed and Google Scholar following a two-stage process. A first search was performed to identify main types of deep fasciae. A second search was performed to identify studies considering a deep fascia, common pathologies of this deep fascia and the associated alterations in tissue anatomy. RESULTS We find that five main deep fasciae pathologies are chronic low back pain, chronic neck pain, Dupuytren's disease, plantar fasciitis and iliotibial band syndrome. The corresponding fasciae are respectively the thoracolumbar fascia, the cervical fascia, the palmar fascia, the plantar fascia and the iliotibial tract. Pathological fascia is characterized by increased tissue stiffness along with alterations in myofibroblast activity and the extra-cellular matrix, both in terms of collagen and Matrix Metalloproteases (MMP) levels. Innervation changes such as increased density and sensitization of nociceptive nerve fibers are observed. Additionally, markers of inflammation such as pro-inflammatory cytokines and immune cells are documented. Pain originating from the deep fascia likely results from a combination of increased nerve density, sensitization and chronic nociceptive stimulation, whether physical or chemical. CONCLUSIONS The pathological fascia is characterized by changes in innervation, immunology and tissue contracture. Further investigation is required to best benefit both research opportunities and patient care.
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Affiliation(s)
- Flemming Kondrup
- Department of Anatomy & Cell Biology, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
| | - Nathaly Gaudreault
- School of rehabilitation, Faculty of medicine and health sciences, University of Sherbrooke, Sherbrooke, Canada
| | - Gabriel Venne
- Department of Anatomy & Cell Biology, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada.,Institute of Health Science Education, Faculty of Medicine, McGill University, Montreal, Canada
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Balta JY, Venne G, Noël GPJC. 10 tips on working with human body donors in medical training and research. Anat Sci Int 2022; 97:307-312. [PMID: 35143025 PMCID: PMC9167808 DOI: 10.1007/s12565-022-00651-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 01/25/2022] [Indexed: 11/15/2022]
Abstract
Human body donors selflessly decided to make the ultimate gift to donate their bodies to education. Being on the receiving end, the health sciences education community owes it to the donors to ensure that they are being treated with utmost respect by promoting and developing high ethical standards and maximizing the benefits from this gift. Working with human body donors for research purposes has increased over the years, while regulations associated with these processes did not change. This article draws upon current literature and author’s experiences to offer practical tips for health educators and everyone working with body donors to achieve these goals. We offer 10 practical tips that help in starting the conversation about the best ways to work with body donors to maximize their contribution to health sciences education.
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Affiliation(s)
- Joy Y Balta
- Division of Anatomy, College of Medicine, The Ohio State University, Columbus, OH, USA.
| | - Gabriel Venne
- Department of Anatomy and Cell Biology, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Geoffroy P J C Noël
- Department of Anatomy and Cell Biology, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada.,Division of Anatomy, School of Medicine, University of California, San Diego, CA, USA
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Gaudreault N, Lebel K, Bédard S, Daigle F, Venne G, Balg F. Using ultrasound imaging to assess novice physiotherapy students' ability to locate musculoskeletal structures with palpation. Physiotherapy 2021; 113:53-60. [PMID: 34563915 DOI: 10.1016/j.physio.2021.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Use ultrasound imaging to assess success rates of novice physiotherapy students attempting to locate two tendons and two joint spaces using palpation. DESIGN Cross-sectional study. SETTING Master of physiotherapy program at an academic institution. PARTICIPANTS Twenty-two end of first-year physiotherapy students. METHODS Participants were asked to palpate and locate the long head of the biceps (LHBT) and tibialis posterior (PTT) tendons as well as the acromioclavicular joint (ACJ) and medial tibiofemoral joint (TFJ) spaces on two human models. A truncated needle was taped onto the skin, parallel to the palpated structure. Ultrasound imaging was used to assess the position of the needle relative to the structures. MAIN OUTCOME MEASURES Success or failure was determined based on a judgment call on the needle position relative to the targeted structure on the ultrasound images. Inter-evaluator agreement for judgment criteria was investigated using Cohen's kappa tests and success rates subsequently calculated. RESULTS Kappa coefficients were 1.00 for all structures collectively, 1.00 for LHBT and PTT tendons, 1.006 for ACJ, and 0.79 for TFJ. Palpation success rates were: 9% for LHBT, 64% for PTT, 23% for ACJ, and 31% for medial TFJ. CONCLUSION These results highlight the fact that there is room for improvement in anatomy and palpation skill teaching methods and ultrasound imaging is valuable tool to assess this important skill.
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Affiliation(s)
- Nathaly Gaudreault
- School of Rehabilitation, Faculty of Medicine and Health Sciences, University of Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, J1H 5N4, Canada.
| | - Karina Lebel
- Department of Electrical and Computer Engineering, Faculty of Engineering, University of Sherbrooke, 2500 Boulevard de l'Université, Sherbrooke, QC J1K 2R1, Canada
| | - Sonia Bédard
- Orthopedic Surgery Division, Faculty of Medicine and Health Sciences, University of Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, J1H 5N4, Canada
| | - Frédériqu Daigle
- School of Rehabilitation, Faculty of Medicine and Health Sciences, University of Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, J1H 5N4, Canada
| | - Gabriel Venne
- Department of Anatomy and Cell Biology, Faculty of Medicine, McGill University, 845 Rue Sherbrooke Ouest, Montréal, H3A 0G4, Canada
| | - Frédéric Balg
- Orthopedic Surgery Division, Faculty of Medicine and Health Sciences, University of Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, J1H 5N4, Canada
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Noël GPJC, Dubé J, Venne G. The Unintentional Effects on Body Donation Programs of a Competency-Based Curriculum in Postgraduate Medical Education. Anat Sci Educ 2021; 14:675-681. [PMID: 33152170 DOI: 10.1002/ase.2033] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 10/05/2020] [Accepted: 11/02/2020] [Indexed: 06/11/2023]
Abstract
As medical programs place increasing importance on competency-based training and surgical simulations for residents, anatomy laboratories, and body donation programs find themselves in a position of adapting to changing demands. To better assess the demand for "life-like" cadaveric specimens and evaluate the possible impacts that competency-based medical education could have upon the body donation program of McGill University, Canada, the authors tracked, over the course of the last 10 years, the number of soft-embalmed specimens, along with the number of teaching sessions and the residents enrolled in competency-based programs that are using cadaveric material. The results reveal that the number of soft-embalmed specimens used within residency training increased from 5 in 2009 to 35 in 2019, representing an increase from 6% of bodies to 36.5% of the total number of body donors embalmed in this institution. Correspondingly, the number of annual teaching sessions for residents increased from 19 in 2012 to 116 in 2019. These increases in teaching are correlated with increasing number of residents enrolled in competency-based programs over the last 3 years (Pearson r ranging from 0.9705 to 0.9903, and R2 ranging from 0.9418 to 0.9808). Those results suggest that the new skill-centered curricula which require residents to perform specific tasks within realistic settings, exhibit a growing demand for "life-like" cadaveric specimens. Institutions' body donation programs must, therefore, adapt to those greater need for cadaveric specimens, which presents many challenges, ranging from the logistical to the ethical.
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Affiliation(s)
- Geoffroy P J C Noël
- Division of Anatomical Sciences, Department of Anatomy and Cell Biology, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Institute of Health Sciences Education, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Joseph Dubé
- Division of Anatomical Sciences, Department of Anatomy and Cell Biology, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Gabriel Venne
- Division of Anatomical Sciences, Department of Anatomy and Cell Biology, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Institute of Health Sciences Education, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
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Roch M, Gaudreault N, Cyr MP, Venne G, Bureau NJ, Morin M. The Female Pelvic Floor Fascia Anatomy: A Systematic Search and Review. Life (Basel) 2021; 11:life11090900. [PMID: 34575049 PMCID: PMC8467746 DOI: 10.3390/life11090900] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 08/20/2021] [Accepted: 08/26/2021] [Indexed: 12/20/2022] Open
Abstract
The female pelvis is a complex anatomical region comprising the pelvic organs, muscles, neurovascular supplies, and fasciae. The anatomy of the pelvic floor and its fascial components are currently poorly described and misunderstood. This systematic search and review aimed to explore and summarize the current state of knowledge on the fascial anatomy of the pelvic floor in women. Methods: A systematic search was performed using Medline and Scopus databases. A synthesis of the findings with a critical appraisal was subsequently carried out. The risk of bias was assessed with the Anatomical Quality Assurance Tool. Results: A total of 39 articles, involving 1192 women, were included in the review. Although the perineal membrane, tendinous arch of pelvic fascia, pubourethral ligaments, rectovaginal fascia, and perineal body were the most frequently described structures, uncertainties were identified in micro- and macro-anatomy. The risk of bias was scored as low in 16 studies (41%), unclear in 3 studies (8%), and high in 20 studies (51%). Conclusions: This review provides the best available evidence on the female anatomy of the pelvic floor fasciae. Future studies should be conducted to clarify the discrepancies highlighted and accurately describe the pelvic floor fasciae.
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Affiliation(s)
- Mélanie Roch
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Faculty of Medicine and Health Sciences, School of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada; (M.R.); (N.G.); (M.-P.C.)
| | - Nathaly Gaudreault
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Faculty of Medicine and Health Sciences, School of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada; (M.R.); (N.G.); (M.-P.C.)
| | - Marie-Pierre Cyr
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Faculty of Medicine and Health Sciences, School of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada; (M.R.); (N.G.); (M.-P.C.)
| | - Gabriel Venne
- Anatomy and Cell Biology, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC H3A 0C7, Canada;
| | - Nathalie J. Bureau
- Centre Hospitalier de l’Université de Montréal, Department of Radiology, Radio-Oncology, Nuclear Medicine, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1J4, Canada;
| | - Mélanie Morin
- Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Faculty of Medicine and Health Sciences, School of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada; (M.R.); (N.G.); (M.-P.C.)
- Correspondence:
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Vendries V, Ungi T, Harry J, Kunz M, Podlipská J, MacKenzie L, Venne G. Three-dimensional ultrasound for knee osteophyte depiction: a comparative study to computed tomography. Int J Comput Assist Radiol Surg 2021; 16:1749-1759. [PMID: 34313914 PMCID: PMC8580923 DOI: 10.1007/s11548-021-02456-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 07/06/2021] [Indexed: 11/29/2022]
Abstract
Purpose Osteophytes are common radiographic markers of osteoarthritis. However, they are not accurately depicted using conventional imaging, thus hampering surgical interventions that rely on pre-operative images. Studies have shown that ultrasound (US) is promising at detecting osteophytes and monitoring the progression of osteoarthritis. Furthermore, three-dimensional (3D) ultrasound reconstructions may offer a means to quantify osteophytes. The purpose of this study was to compare the accuracy of osteophyte depiction in the knee joint between 3D US and conventional computed tomography (CT). Methods Eleven human cadaveric knees were pre-screened for the presence of osteophytes. Three osteoarthritic knees were selected, and then, 3D US and CT images were obtained, segmented, and digitally reconstructed in 3D. After dissection, high-resolution structured light scanner (SLS) images of the joint surfaces were obtained. Surface matching and root mean square (RMS) error analyses of surface distances were performed to assess the accuracy of each modality in capturing osteophytes. The RMS errors were compared between 3D US, CT and SLS models. Results Average RMS error comparisons for 3D US versus SLS and CT versus SLS models were 0.87 mm ± 0.33 mm (average ± standard deviation) and 0.95 mm ± 0.32 mm, respectively. No statistical difference was found between 3D US and CT. Comparative observations of imaging modalities suggested that 3D US better depicted osteophytes with cartilage and fibrocartilage tissue characteristics compared to CT. Conclusion Using 3D US can improve the depiction of osteophytes with a cartilaginous portion compared to CT. It can also provide useful information about the presence and extent of osteophytes. Whilst algorithm improvements for automatic segmentation and registration of US are needed to provide a more robust investigation of osteophyte depiction accuracy, this investigation puts forward the potential application for 3D US in routine diagnostic evaluations and pre-operative planning of osteoarthritis.
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Affiliation(s)
- Valeria Vendries
- Anatomical Sciences Program and Department of Biomedical and Molecular Sciences, Queens University, Kingston, ON, K7L3 N6, Canada.
| | - Tamas Ungi
- School of Computing, Queen's University, Kingston, ON, K7L 3N6, Canada
| | - Jordan Harry
- Anatomical Sciences Program and Department of Biomedical and Molecular Sciences, Queens University, Kingston, ON, K7L3 N6, Canada
| | - Manuela Kunz
- School of Computing, Queen's University, Kingston, ON, K7L 3N6, Canada
| | - Jana Podlipská
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Les MacKenzie
- Anatomical Sciences Program and Department of Biomedical and Molecular Sciences, Queens University, Kingston, ON, K7L3 N6, Canada
| | - Gabriel Venne
- Department of Anatomy and Cell Biology, McGill University, Montreal, QC, H3A 0G4, Canada
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Venne G, Tse MY, Pang SC, Ellis RE. Mechanically-induced osteophyte in the rat knee. Osteoarthritis Cartilage 2020; 28:853-864. [PMID: 32147535 DOI: 10.1016/j.joca.2020.02.834] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 02/11/2020] [Accepted: 02/17/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Osteophytes are common anatomical signs of advanced osteoarthritis. It remains unclear whether they develop from physio-molecular, and/or mechanical stimuli. This study examined the effects of mechanical impact on the knee joint periosteum leading to osteophyte formation. DESIGN Eighteen mature rats received one single impact load of 53 N (30 MPa) to the periosteum of the experimental medial femoral condyles. Contralateral knees were used as controls. Animals were sacrificed at 24 h, 3, 6 and 9 weeks post-impact. Distal femurs were harvested and prepared for histology. Hematoxylin and Eosin, and Masson's trichrome stained slides were examined by light microscopy. Nuclear density was quantified to assess the tissue reaction. RESULTS 24 h: The synovium membrane, fibrous and cambium periosteum were damaged. Blood infiltration pooled in the impacted medial collateral ligament (MCL) region. Week 3: A cartilaginous tissue spur, chondrophyte, was found in every rat at the impacted site of the MCL. Chondrophytes were composed of fibrocartilage and cartilage matrix, with signs of cartilage mineralization and remodelling activity. Week 6: Chondrophytes presented signs of more advanced mineralisation, recognized as osteophytes. Week 9: Osteophytes appeared to be more mineralized with almost no cartilage tissue. CONCLUSIONS Osteophytes can be induced with a single mechanical impact applied to the periosteum in rat knees. These data indicate that a moderate trauma to the periosteal layer of the joint may play a role in osteophyte development.
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Affiliation(s)
- G Venne
- Department of Anatomy and Cell Biology, McGill University, Montreal, QC, Canada; 3640, Rue University, Montréal, QC, H3A 0C7, Canada.
| | - M Y Tse
- Department Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
| | - S C Pang
- Department Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
| | - R E Ellis
- Department Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada; Human Mobility Research Center, Kingston General Hospital, 76 Stuart Street, Kingston, ON, K7L 2V7, Canada; Department of Surgery, Queen's University, Kingston, ON, Canada; Kingston General Hospital, Kingston, ON, Canada; Department of Mechanical and Materials Engineering, Queen's University, Kingston, ON, Canada; School of Computing, Queen's University, Kingston, ON, Canada
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Venne G, Zec ML, Welte L, Noel GPJC. Qualitative and quantitative comparison of Thiel and phenol-based soft-embalmed cadavers for surgery training. Anat Histol Embryol 2020; 49:372-381. [PMID: 32059261 DOI: 10.1111/ahe.12539] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 01/03/2020] [Accepted: 01/14/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Surgical skills training has traditionally been limited to formalin embalming that does not provide a realistic model. The aim of this study was to qualitatively and quantitatively compare Thiel and phenol-based soft-embalming techniques: qualitatively in a surgical training setup, and quantitatively by comparing the mechanical and histomorphometric properties of skin specimens embalmed using each method. MATERIALS AND METHODS Thirty-four participants were involved in surgical workshops comparing Thiel and phenol-based embalmed bodies. Participants were asked to evaluate the utility of the different models for surgical skills training. In parallel, tensile elasticity evaluation was performed on skin flaps from six fresh-frozen cadavers. Flaps were divided into three groups for each specimen: fresh-frozen, Thiel, and phenol-based embalmed and compared together at 1 month or 1 year after embalming. A histological investigation of the skin structural properties was performed for each embalming type using haematoxylin and eosin and Masson's trichrome. RESULTS All participants rated the phenol-based specimens consistently better or equivalent to Thiel for the evaluated parameters. Quantitatively, there were statistically significant differences for the tensile elasticity between the embalming techniques (p < .05). There were no significant differences for the tensile elasticity between phenol-based embalmed skin and fresh state (p = .30), and no significant difference between embalming time was reported (p = .47). Histologically, the integrity of the skin was better preserved with the phenol-based technique. CONCLUSION Phenol-based embalming provides as realistic or better of a model as Thiel embalming for surgical training skills and was generally preferred over Thiel model. The phenol-based embalming better preserved the integrity of the skin.
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Affiliation(s)
- Gabriel Venne
- Department of Anatomy and Cell Biology, Division of Anatomical Sciences, Faculty of Medicine, McGill University, Montreal, QC, Canada.,Institute of Health Sciences Education, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Michelle L Zec
- Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Lauren Welte
- Department of Mechanical and Materials Engineering, Queen's University, Kingston, ON, Canada
| | - Geoffroy P J C Noel
- Department of Anatomy and Cell Biology, Division of Anatomical Sciences, Faculty of Medicine, McGill University, Montreal, QC, Canada.,Institute of Health Sciences Education, Faculty of Medicine, McGill University, Montreal, QC, Canada
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Venne G, Pickell M, Ellis RE, Bicknell RT. Reliability of a novel 3-dimensional computed tomography method for reverse shoulder arthroplasty postoperative evaluation. JSES Open Access 2019; 3:168-173. [PMID: 31709357 PMCID: PMC6835033 DOI: 10.1016/j.jses.2019.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background Long-term function and survival of reverse shoulder arthroplasties (RSAs) are reliant on component positioning and fixation. Conventional postoperative analysis is performed using plain radiographs or 2-dimensional (2D) computed tomography (CT) images. Although 3-dimensional (3D) CT would be preferred, its use is limited by metal artifacts. This study proposes a new 3D CT method for postoperative RSA evaluation and compares its interobserver reliability with conventional methods. Materials and methods Preoperative and postoperative CT scans, as well as postoperative radiographs, were obtained from 18 patients who underwent RSA implantation; the scapula, implant, and screws were reconstructed as 3D CT models. The postoperative 3D scapula and implant were imported into preoperative coordinates and matched to the preoperative scapula. Standardized scapula coordinates were defined, in which the glenoid baseplate version and inclination angle were measured. The percentage of screw volume in bone was measured from a Boolean intersection operation between the preoperative scapula and screw models. Four independent reviewers performed the measurements using 3D CT and conventional 2D methods. Intraclass correlation coefficients (ICCs) were used to compare the reliability of the methods. Results The 3D CT method showed excellent reliability (ICC > 0.75) in baseplate inclination (ICC = 0.92), version (ICC = 0.97), and screw volume in bone (ICC = 0.99). Conventional 2D methods demonstrated poor reliability (ICC < 0.4). For radiographs, inclination showed poor reliability (ICC = 0.09) and the screw percentage in bone showed fair reliability (ICC = 0.54). Version was not measured with plain radiographs. For 2D CT slice measurements, inclination showed poor reliability (ICC = 0.02), version showed excellent reliability (ICC = 0.81), and the screw percentage in bone showed poor reliability (ICC = 0.28). Conclusion The new 3D CT-based method for evaluating RSA glenoid implant positioning and screw volume in bone showed excellent reliability and overcame the metal-artifact limitation of postoperative CT and 3D CT reconstruction.
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Affiliation(s)
- Gabriel Venne
- Department of Anatomy and Cell Biology, McGill University, Montréal, QC, Canada
- Corresponding author: Gabriel Venne, DO, PhD, Department of Anatomy and Cell Biology, McGill University, 3640 Rue University, Montréal, QC H3A 0C7, Canada. gabriel.venne.@mcgill.ca
| | - Michael Pickell
- Department of Surgery, Queen’s University, Kingston, ON, Canada
- Kinston General Hospital, Kingston, ON, Canada
| | - Randy E. Ellis
- Department of Surgery, Queen’s University, Kingston, ON, Canada
- Kinston General Hospital, Kingston, ON, Canada
- Department of Biomedical and Molecular Sciences, Queen’s University, Kingston, ON, Canada
- Department of Mechanical and Materials Engineering, Queen’s University, Kingston, ON, Canada
- School of Computing, Queen’s University, Kingston, ON, Canada
| | - Ryan T. Bicknell
- Department of Surgery, Queen’s University, Kingston, ON, Canada
- Kinston General Hospital, Kingston, ON, Canada
- Department of Mechanical and Materials Engineering, Queen’s University, Kingston, ON, Canada
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Venne G, Medvedev R. Limited access to museum and prosection models: how 3D scanning and 3D printing can help. FASEB J 2019. [DOI: 10.1096/fasebj.2019.33.1_supplement.444.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Gabriel Venne
- Anatomy and Cell BiologyMcGill UniversityMontrealQCCanada
| | - Rachel Medvedev
- School of Physical and Occupational TherapyMcGill UniversityMontrealQCCanada
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Vendries V, Ungi T, Kunz M, MacKenzie LW, Venne G. Comparison of 3D Ultrasound Imaging to Computed Tomography in Knee Osteophyte Depiction. FASEB J 2018. [DOI: 10.1096/fasebj.2018.32.1_supplement.641.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Valeria Vendries
- Department of Biomedical and Molecular SciencesQueen's UniversityKingstonONCanada
| | - Tamas Ungi
- School of ComputingQueen's UniversityKingstonONCanada
| | - Manuela Kunz
- School of ComputingQueen's UniversityKingstonONCanada
| | - Leslie W. MacKenzie
- Department of Biomedical and Molecular SciencesQueen's UniversityKingstonONCanada
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Venne G, Welte L, Noel G. Quantitative and Qualitative Comparison of Thiel and Phenol‐Based Soft‐Embalmed skin for Surgical Training. FASEB J 2018. [DOI: 10.1096/fasebj.2018.32.1_supplement.632.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Lauren Welte
- Department of Mechanical and Materials EngineeringQueen's UniversityKingstonONCanada
| | - Geoffroy Noel
- Department of Anatomy and Cell BiologyMcGill UniversityMontrealQCCanada
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Venne G, Rasquinha BJ, Pichora D, Ellis RE, Bicknell R. Comparing conventional and computer-assisted surgery baseplate and screw placement in reverse shoulder arthroplasty. J Shoulder Elbow Surg 2015; 24:1112-9. [PMID: 25556807 DOI: 10.1016/j.jse.2014.10.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Revised: 10/06/2014] [Accepted: 10/19/2014] [Indexed: 02/01/2023]
Abstract
BACKGROUND Preoperative planning and intraoperative navigation technologies have each been shown separately to be beneficial for optimizing screw and baseplate positioning in reverse shoulder arthroplasty (RSA) but to date have not been combined. This study describes development of a system for performing computer-assisted RSA glenoid baseplate and screw placement, including preoperative planning, intraoperative navigation, and postoperative evaluation, and compares this system with a conventional approach. MATERIALS AND METHODS We used a custom-designed system allowing computed tomography (CT)-based preoperative planning, intraoperative navigation, and postoperative evaluation. Five orthopedic surgeons defined common preoperative plans on 3-dimensional CT reconstructed cadaveric shoulders. Each surgeon performed 3 computer-assisted and 3 conventional simulated procedures. The 3-dimensional CT reconstructed postoperative units were digitally matched to the preoperative model for evaluation of entry points, end points, and angulations of screws and baseplate. Values were used to find accuracy and precision of the 2 groups with respect to the defined placement. Statistical analysis was performed by t tests (α = .05). RESULTS Comparison of the groups revealed no difference in accuracy or precision of screws or baseplate entry points (P > .05). Accuracy and precision were improved with use of navigation for end points and angulations of 3 screws (P < .05). Accuracy of the inferior screw showed a trend of improvement with navigation (P > .05). Navigated baseplate end point precision was improved (P < .05), with a trend toward improved accuracy (P > .05). CONCLUSION We conclude that CT-based preoperative planning and intraoperative navigation allow improved accuracy and precision for screw placement and precision for baseplate positioning with respect to a predefined placement compared with conventional techniques in RSA.
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Affiliation(s)
- Gabriel Venne
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada.
| | - Brian J Rasquinha
- Department of Mechanical and Materials Engineering, Queen's University, Kingston, ON, Canada
| | - David Pichora
- Department of Mechanical and Materials Engineering, Queen's University, Kingston, ON, Canada; Department of Surgery, Queen's University, Kingston, ON, Canada; Kingston General Hospital, Kingston, ON, Canada
| | - Randy E Ellis
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada; Department of Mechanical and Materials Engineering, Queen's University, Kingston, ON, Canada; Department of Surgery, Queen's University, Kingston, ON, Canada; Kingston General Hospital, Kingston, ON, Canada; School of Computing, Queen's University, Kingston, ON, Canada
| | - Ryan Bicknell
- Department of Surgery, Queen's University, Kingston, ON, Canada; Kingston General Hospital, Kingston, ON, Canada
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Affiliation(s)
| | - G Venne
- DBMS Queen's UniversityKingstonONCanada
| | - R Easteal
- DBMS Queen's UniversityKingstonONCanada
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Venne G, Reifel C, Pang S, Ellis R. Rectus capitis posterior minor and its relationship to the spinal dura mater: a histological investigation (913.3). FASEB J 2014. [DOI: 10.1096/fasebj.28.1_supplement.913.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Gabriel Venne
- Department of Biomedical and Molecular Sciences (DBMS) Queen's UniversityKingstonONCanada
| | - Conrad Reifel
- Department of Biomedical and Molecular Sciences (DBMS) Queen's UniversityKingstonONCanada
| | - Stephen Pang
- Department of Biomedical and Molecular Sciences (DBMS) Queen's UniversityKingstonONCanada
| | - Randy Ellis
- Department of Surgery Queen's UniveristyKingstonONCanada
- School of Computing Queen's UniveristyKingstonONCanada
- Department of Biomedical and Molecular Sciences (DBMS) Queen's UniversityKingstonONCanada
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Smith EJ, Anstey JA, Venne G, Ellis RE. Using additive manufacturing in accuracy evaluation of reconstructions from computed tomography. Proc Inst Mech Eng H 2013; 227:551-9. [DOI: 10.1177/0954411912474612] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Bone models derived from patient imaging and fabricated using additive manufacturing technology have many potential uses including surgical planning, training, and research. This study evaluated the accuracy of bone surface reconstruction of two diarthrodial joints, the hip and shoulder, from computed tomography. Image segmentation of the tomographic series was used to develop a three-dimensional virtual model, which was fabricated using fused deposition modelling. Laser scanning was used to compare cadaver bones, printed models, and intermediate segmentations. The overall bone reconstruction process had a reproducibility of 0.3 ± 0.4 mm. Production of the model had an accuracy of 0.1 ± 0.1 mm, while the segmentation had an accuracy of 0.3 ± 0.4 mm, indicating that segmentation accuracy was the key factor in reconstruction. Generally, the shape of the articular surfaces was reproduced accurately, with poorer accuracy near the periphery of the articular surfaces, particularly in regions with periosteum covering and where osteophytes were apparent.
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Affiliation(s)
- Erin J Smith
- Department of Mechanical and Materials Engineering, Queen’s University, Kingston, ON, Canada
| | - Joseph A Anstey
- Department of Biomedical and Molecular Sciences, Queen’s University, Kingston, ON, Canada
| | - Gabriel Venne
- Department of Biomedical and Molecular Sciences, Queen’s University, Kingston, ON, Canada
| | - Randy E Ellis
- School of Computing, Queen’s University, Kingston, ON, Canada
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Zakani S, Venne G, Smith EJ, Bicknell R, Ellis RE. Analyzing shoulder translation with navigation technology. Int J Comput Assist Radiol Surg 2012; 7:853-60. [PMID: 22855410 DOI: 10.1007/s11548-012-0782-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2012] [Accepted: 07/03/2012] [Indexed: 11/30/2022]
Abstract
PURPOSE Asymmetric stress imposed on the shoulder can lead to anterior shoulder instability in young athletes who perform repetitive overhead motions. A common treatment, surgical anterior capsule tightening, assumes that the instability is caused by abnormal anterior laxity. This study investigated the possibility that one element of overall imbalance, posterior capsular tightness, could be an underlying reason for shoulder instability. Surgical navigation technology, which is more accurate than whole-body motion-capture systems, was used to study anterior translational motions. METHOD The study was used four cadaver shoulders, with the scapula and rotator cuff muscles intact. Opto-electronic surgical navigation localization devices were mounted on the scapula and humerus to accurately capture positions and orientations. The shoulders were passively moved through 7 motions, 5 of simple angulation and 2 combinations of clinical interest. Each motion was repeated in 4 different soft-tissue states: rotator cuff intact, capsule intact, and surgically induced capsular tightnesses of 5 and 10mm. RESULTS The shoulders had significantly greater anterior translation when the posterior capsule was artificially tightened (p < 0.05); this was particularly in movements that combined abduction with internal or external rotation, which are typical overhead sports motions. Overall translation was indifferent to whether the shoulders were intact or dissected down to the capsule, as was translation during flexion was indifferent to dissection state (p > 0.95). CONCLUSION Surgical navigation technology can easily be used to analyze cadaveric shoulder motion, with opportunities for adaptation to anesthetized patients. Results suggest that the inverse of artificial tightening, such as surgical release of the posterior capsule, may be an effective minimally invasive treatment of chronic shoulder dislocation subsequent to sports motions.
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Affiliation(s)
- S Zakani
- Department of Mechanical and Materials Engineering, Queen's University, Kingston, ON, Canada.
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