The patellar ligament: A comprehensive review

The patellar ligament (PL) is an epiphyseal ligament and is part of the extensor complex of the knee. The ligament has gained attention due to its clinical relevance to autograft and tendinopathy. A variety of anatomical variations of the PL such as aplasia, numerical variations, and vascularity are being reported recently by clinicians and anatomists. The aim of this literature was to review the available literature to provide a consensus regarding anatomic variations of the PL, neurovasculature surrounding the PL, histology of the PL, and various aspects of PL measurements with relevance to the surgical considerations and sex and age-related differences. A narrative review of the patellar ligament was performed by conducting a detailed literature search and review of relevant articles. A total of 90 articles on the patellar ligament were included and were categorized into studies based on anatomical variations, neurovasculature, morphometrics, microanatomy, sex and age-related difference, and ACL reconstruction. The anatomical variations and morphometrics of the PL were found to correlate with the frequency of strain injuries, tendinopathy, and efficacy of the PL autograft in anterior cruciate ligament reconstruction. The sex differences in PL measurements and the effect of estrogen on collagen synthesis explained a higher incidence of patellar tendinopathy in women. An awareness of its variations enables careful selection of surgical incisions, thereby avoiding complications related to nerve injury. Accurate knowledge of the PL microanatomy assists in understanding the mechanism of ligament degeneration, rupture, autograft harvesting, and ligamentization results.     

Anatomical Variations in the Extra Hepatic Biliary Ductal System

The aim of the study was to study the various anatomical variations occurring in the extra hepatic biliary ductal tract. The study material consisted of 40 adult specimens of liver, gallbladder with duodenum collected enmass from the forensic department. Out of the 40 specimens dissected we came across accessory hepatic ducts all arising from the right lobe of liver. These accessory right hepatic ducts drained into the common hepatic duct at different levels. Knowledge of these accessory ducts confirmed by various intra operative cholangiographic procedures is necessary for avoiding any serious complications during surgery. Hence we conclude that this study will be a useful guideline for the operating Surgeons and Radiologist working in that area.     

Maximal power output during incremental exercise by resistance and endurance trained athletes

This study was aimed at comparing the maximal power output by resistance trained and endurance trained athletes during incremental exercise. Thirty male athletes who received resistance training (Group I) and thirty male athletes of similar age group who received endurance training (Group II) for a period of more than 1 year were chosen for the study. Physical parameters were measured and exercise stress testing was done on a cycle ergometer with a portable gas analyzing system. The maximal progressive incremental cycle ergometer power output at peak exercise and carbon dioxide production at VO2max were measured. Highly significant (P < 0.001) differences existed in values of maximal power output and carbon dioxide production at VO2max for group I and group II. The higher power displayed by group I when compared to group II could be due to variations in adaptations that happen in them due to different types of training. Similar studies could serveas a biofeedback and perk up the athlete's performance.