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Articles by M Kozanek
Total Records ( 3 ) for M Kozanek
  J. M Alpert , M Kozanek , G Li , B. T Kelly and P. D. Asnis

Hip pain in patients with normal bony anatomy and anterior labral injury may be related to compression of the iliopsoas tendon across the anterior capsulolabral complex. No attempts to characterize the 3-dimensional anatomy of the iliopsoas tendon and its relationship to the acetabular labrum have been reported to date.


The iliopsoas tendon directly overlies the capsulolabral complex. Contribution of the muscle belly and tendon to the overall circumference at the level of the labrum is approximately the same.

Study Design

Descriptive laboratory study.

Materials and Methods

Eight hip joints were dissected and cross-sectional measurements of the iliopsoas muscle-tendon complex were performed using digital calipers and image analysis software.


The iliopsoas tendon in all specimens was located directly anterior to the anterosuperior capsulolabral complex at the 2 to 3 o’clock position. The overall length of the iliopsoas tendon from the lesser trochanter to the acetabular labrum was 75.4 ± 0.9 mm. The circumference of the iliopsoas tendon at the lesser trochanter was 25.5 ± 2.6 mm, the iliopsoas tendon at the level of the labrum was 28.4 ± 2.8 mm, and the iliopsoas tendon–muscle belly complex at the level of the labrum was 63.8 ± 7.4 mm. At the level of the labrum, the iliopsoas is composed of 44.5% tendon and 55.5% muscle belly.


The close anatomic relationship of the iliopsoas tendon to the anterior capsulolabral complex suggests that iliopsoas pathologic changes at this level may lead to labral injury. Additionally, these data suggest that at the level of the labrum, 45% of the tendon–muscle belly complex should be released to release the entire tendinous portion.

Clinical Relevance

Knowledge of the cross-sectional anatomy of the iliopsoas tendon and its relationship to the acetabular labrum will better assist surgeons in treating lesions associated with iliopsoas injury.

  J. K Seon , S. J Park , K. B Lee , H. R Gadikota , M Kozanek , L. S Oh , S Hariri and E. K. Song

Screw and suture fixations are the most commonly used methods of fixation in treatment of anterior cruciate ligament tibial avulsion fractures. Even though a few biomechanical studies have compared the stability of the 2 fixation techniques, a clinical comparison has not yet been reported.


The authors hypothesized that both fixations would be identical in all studied clinical outcome measures at a minimum 2-year follow-up.

Study Design

Cohort study; Level of evidence, 3.

Materials and Methods

Thirty-three patients treated with either screw fixation (16 patients) or suture fixation (17 patients) within 1 month of the anterior cruciate ligament tibial avulsion fracture (type II or III) without associated ligamentous injury were included. All patients were evaluated at a minimum 2-year follow-up in terms of Lysholm knee scores and return to preinjury activities. Knee stability was compared based on the Lachman test and stress radiography.


No significant differences were found between the 2 groups in terms of average Lysholm knee scores (91.7 in the screw group and 92.7 in the suture group, P = .413) at follow-up. All patients except 2 (1 in each group) returned to preinjury activity levels. However, flexion contractures (5° to 10°) were found in 3 patients in the screw group and 2 patients in the suture group without significant intergroup difference. Stabilities based on the Lachman test and instrumented stress radiography were also similar between the 2 groups at follow-up. However, 2 patients in the screw group and 1 in the suture group showed more than 5 mm laxity compared with the contralateral knee on stress radiographs.


Both the screw and suture fixation techniques for the anterior cruciate ligament tibial avulsion fracture produced relatively good results in terms of functional outcomes and stability without any significant differences. However, some patients in both groups showed residual laxity or flexion contractures.

  J. L Wu , A Hosseini , M Kozanek , H. R Gadikota , T. J Gill and G. Li

Background: The function of the anteromedial (AM) and posterolateral (PL) bundles of the anterior cruciate ligament (ACL) during gait has not been reported.

Hypothesis: The AM and PL bundles have distinct functional behavior during the stance phase of treadmill gait.

Study Design: Descriptive laboratory study.

Methods: Three-dimensional models of the knee were created by magnetic resonance images from 8 healthy subjects. The contour of the 2 bundle attachments were constructed on each model. Each bundle was represented by a straight line connecting its tibial and femoral attachment centroids. Next, the knee kinematics during the stance phase of gait was determined with a dual fluoroscopic imaging system. The relative elongation, sagittal plane elevation, coronal plane elevation, and transverse plane deviation of the 2 bundles were measured directly from heel strike to toe-off.

Results: At heel strike, the AM and PL bundles had first peak elongation of 9% ± 7% and 9% ± 13%, respectively. At 50% progress of the stance phase, both bundles were maximally elongated, 12% ± 7% for the AM bundle and 13% ± 15% for the PL bundle. No significant difference was found for each bundle between 40% and 60% of the stance phase (P > .05). With increasing knee flexion, the sagittal plane and coronal plane elevations of the 2 bundles decreased, whereas the deviation angles increased.

Conclusion: Both bundles are anisometric and function in a similar manner during the stance phase of gait. They were maximally elongated throughout the midstance where they were stretched maximally to resist anterior tibial translation.

Clinical relevance: This information can be useful for further improving anatomical ACL reconstructions to better reproduce the 2 bundle functions. It may also be useful for designing postoperative rehabilitation regimens to prevent overstretch of the grafts.

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