Single and double contrast arthrography in lesions of the glenohumeral joint

International Nuclear Information System (INIS)

Ahovuo, J.

1984-01-01

One hundred and forty-five arthrograms from single and double contrast arthrography were compared with respect to their accuracy in revealing lesions of the glenohumeral joint. Total and partial rotator cuff tears were accurately delineated by both single and double contrast arthrography. The size of the tear did not correlate with surgical findings with either technique. The volume of the injected contrast medium was larger in full-thickness rotator cuff tears than in normal arthrograms (p 2 test). No difference in filling frequency of the sheath could be observed between single and double contrast arthrography. This study did not reveal any major advantages of double contrast arthrography over single contrast examinations in lesions of the rotator cuff and those of the tendon of the long head of the biceps brachii. (orig.)

The Impact of use of Double Set-up on Infection Rates in Revision Total Knee Replacement and Limb Salvage Procedures

Directory of Open Access Journals (Sweden)

Jennifer Waterman

2015-03-01

Full Text Available A retrospective analysis was performed to determine the impact of utilizing a double set-up procedure on reducing infection rates revision total knee and limb salvage procedures in patients with known joint infection.  Eighteen cases fit selection criteria.  The recurrence rate of infection was 5.5% which is less than reported recent literature review.   This suggests the use of a double set-up in combination with other infection reducing protocols may help further reduce recurrent infection.  Keywords: double set-up, infection, revision total knee arthroplasty, limb-salvage

A radiological study of the patella and the cartilage of patella by computed tomography following double-contrast arthrography

International Nuclear Information System (INIS)

Kim, Myung Joon; Yang, Seoung Oh

1987-01-01

Recurrent subluxation or dislocation of the patella is a painful condition that frequently leads to chondromalacia or arthrosis of the patellofemoral joint. A radiographic evaluation of the patella and patella cartilage is important in the diagnosis of chondromalacia and mal alignment. Authors performed the patellofemoral joint CT following the double contrast arthrography in 53 patients with knee joint pains who had visited to Capital Armed Forces General Hospital from July to December, 1986. Authors analysed the shape and position of patella and the shape of patella cartilage. The results were as follows; 1. shape of patella:The most common types are type II/III (14 cases) and type III (14 cases). type III → IV-9 cases, type I-5 cases, type IV-5 cases, other type-4 cases, type II-2 cases, no type V. 2. position of patella:Only 2 cases showed subluxation and external rotation of patella. 3. shape of patella cartilage:a)congruous cartilage-21 cases (39.6%) b)regular cartilage-22 cases (41.5%) c)irregular cartilage-10 cases (18.9%) irregular imbibition of contrast media-7 cases localized loss of cartilage or erosion-2 cases thinning of cartilage-1 case 4. Fissure and erosions of cartilages in 3 cases were confirmed by operation and knee arthroscopy

A radiological study of the patella and the cartilage of patella by computed tomography following double-contrast arthrography

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Kim, Myung Joon; Yang, Seoung Oh [Capital Armed Forces General Hospital, Seoul (Korea, Republic of)

1987-04-15

Recurrent subluxation or dislocation of the patella is a painful condition that frequently leads to chondromalacia or arthrosis of the patellofemoral joint. A radiographic evaluation of the patella and patella cartilage is important in the diagnosis of chondromalacia and mal alignment. Authors performed the patellofemoral joint CT following the double contrast arthrography in 53 patients with knee joint pains who had visited to Capital Armed Forces General Hospital from July to December, 1986. Authors analysed the shape and position of patella and the shape of patella cartilage. The results were as follows; 1. shape of patella:The most common types are type II/III (14 cases) and type III (14 cases). type III {yields} IV-9 cases, type I-5 cases, type IV-5 cases, other type-4 cases, type II-2 cases, no type V. 2. position of patella:Only 2 cases showed subluxation and external rotation of patella. 3. shape of patella cartilage:a)congruous cartilage-21 cases (39.6%) b)regular cartilage-22 cases (41.5%) c)irregular cartilage-10 cases (18.9%) irregular imbibition of contrast media-7 cases localized loss of cartilage or erosion-2 cases thinning of cartilage-1 case 4. Fissure and erosions of cartilages in 3 cases were confirmed by operation and knee arthroscopy.

Real-time feedback on knee abduction moment does not improve frontal-plane knee mechanics during jump landings.

Science.gov (United States)

Beaulieu, M L; Palmieri-Smith, R M

2014-08-01

Excessive knee abduction loading is a contributing factor to anterior cruciate ligament (ACL) injury risk. The purpose of this study was to determine whether a double-leg landing training program with real-time visual feedback improves frontal-plane mechanics during double- and single-leg landings. Knee abduction angles and moments and vertical ground reaction forces (GRF) of 21 recreationally active women were quantified for double- and single-leg landings before and after the training program. This program consisted of two sessions of double-leg jump landings with real-time visual feedback on knee abduction moments for the experimental group and without real-time feedback for the control group. No significant differences were found between training groups. In comparison with pre-training data, peak knee abduction moments decreased 12% post-training for both double- and single-leg landings; whereas peak vertical GRF decreased 8% post-training for double-leg landings only, irrespective of training group. Real-time feedback on knee abduction moments, therefore, did not significantly improve frontal-plane knee mechanics during landings. The effect of the training program on knee abduction moments, however, transferred from the double-leg landings (simple task) to single-leg landings (more complex task). Consequently, ACL injury prevention efforts may not need to focus on complex tasks during which injury occurs. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Apixaban versus enoxaparin for thromboprophylaxis after knee replacement (ADVANCE-2): a randomised double-blind trial

DEFF Research Database (Denmark)

Lassen, Michael Rud; Raskob, Gary E; Gallus, Alexander

2010-01-01

efficacy and safety of these drugs after elective total knee replacement. METHODS: In ADVANCE-2, a multicentre, randomised, double-blind phase 3 study, patients undergoing elective unilateral or bilateral total knee replacement were randomly allocated through an interactive central telephone system......BACKGROUND: Low-molecular-weight heparins such as enoxaparin are preferred for prevention of venous thromboembolism after major joint replacement. Apixaban, an orally active factor Xa inhibitor, might be as effective, have lower bleeding risk, and be easier to use than is enoxaparin. We assessed...

Prophylactic knee bracing alters lower-limb muscle forces during a double-leg drop landing.

Science.gov (United States)

Ewing, Katie A; Fernandez, Justin W; Begg, Rezaul K; Galea, Mary P; Lee, Peter V S

2016-10-03

Anterior cruciate ligament (ACL) injury can be a painful, debilitating and costly consequence of participating in sporting activities. Prophylactic knee bracing aims to reduce the number and severity of ACL injury, which commonly occurs during landing maneuvers and is more prevalent in female athletes, but a consensus on the effectiveness of prophylactic knee braces has not been established. The lower-limb muscles are believed to play an important role in stabilizing the knee joint. The purpose of this study was to investigate the changes in lower-limb muscle function with prophylactic knee bracing in male and female athletes during landing. Fifteen recreational athletes performed double-leg drop landing tasks from 0.30m and 0.60m with and without a prophylactic knee brace. Motion analysis data were used to create subject-specific musculoskeletal models in OpenSim. Static optimization was performed to calculate the lower-limb muscle forces. A linear mixed model determined that the hamstrings and vasti muscles produced significantly greater flexion and extension torques, respectively, and greater peak muscle forces with bracing. No differences in the timings of peak muscle forces were observed. These findings suggest that prophylactic knee bracing may help to provide stability to the knee joint by increasing the active stiffness of the hamstrings and vasti muscles later in the landing phase rather than by altering the timing of muscle forces. Further studies are necessary to quantify whether prophylactic knee bracing can reduce the load placed on the ACL during intense dynamic movements. Copyright © 2016 Elsevier Ltd. All rights reserved.

Liberal Versus Restrictive Fluid Management in Knee Arthroplasty: A Randomized, Double-Blind Study

DEFF Research Database (Denmark)

Holte, Kathrine; Kristensen, Billy Bjarne; Valentiner, Lotte

2007-01-01

BACKGROUND: There are few data describing the relationship between amount of perioperative fluid and organ function. In this study we investigated the effects of two levels of intravascular fluid administration ("liberal" versus "restrictive") in knee arthroplasty on physiological recovery...... with a standardized volume of colloid. All other aspects of perioperative management (including anesthesia, preoperative fluid status, and postoperative management) were standardized. Primary outcome variables included pulmonary function (spirometry), exercise capacity ("timed up and go" test), coagulation...... as the primary outcome variable. METHODS: In a double-blind study, 48 ASA I-III patients undergoing fast-track elective knee arthroplasty were randomized to restrictive or liberal perioperative intravascular fluid administration. Patients received a fixed rate infusion of Ringer's lactate solution...

On film quality in barium-air double contrast colon study

International Nuclear Information System (INIS)

Rhu, Sang Hyung; Rhee, Jae Ho; Kim, Hai Sung; Cheung, Hwan

1984-01-01

The colon double contrast study provides valuable diagnostic information by means of appropriate control of Kvp and mAa when making double contrast image by injecting air into the colon after coating the colon wall by appropriately diluted Barium solution. The following experiments were performed the results of which allowed to improve the quality of film in barium-air double contrast colon study: (1) Do the pictures have uniform density when measured with a densitometer from three measuring points established in the picture by changing Kvp and mAs depending on the thickness of the patient? (2) Is the quality of the picture improved by being compensated from the adjacent area when using a wedge filter in routine check lateral decubitus and erect view? (3) What is the optimum dilution of barium solution which gives the best result for colon wall coating? The above experiments revealed that as the patient's thickness increased, it should be considered to increase mAs as well as Kvp and a wedge filter could give diagnostically very informative pictures in routine-check lateral decubitus and erect view. And 70-80% solution of Barium-water mixture provided the best quality of double contrast image

A new double contrast barium enema

International Nuclear Information System (INIS)

Park, Jun Sang; Cho, Won Sik; Lee, Sung Woo; Lee, Mun Gyu; Jeon, Jeong Dong; Jaun, Woo Ki; Han, Chung Yul

1987-01-01

A new technic of the barium enema was proposed for the better colonic double contrast study with the average 204ml of 50w/v% barium, applied to 109 serial patients. The barium was introduced to sigmoid colon, and then pushed to a mid transverse colon by the air insufflation through an enema syringe, a new device. An advance to cecum is accomplished by the air insufflation and/or the position change of the patient. The barium transfer method was developed for the best spot film exposure, through colon, by the position change of the patient, the tilting of the x-ray table and the air insufflation with the enema syringe. The mean angle of the x-ray table tilted was -10 .deg. at the beginning the barium enema till the barium sent past the splenic flexure, -15 . deg. for the best lateral view of rectum and -18 .deg. for the bet prone PA view of rectosigmoid colon. This was a simple, better and economic double contrast barium enema for the cooperative patients

Treatment of knee osteoarthritis with pulsed electromagnetic fields: a randomized, double-blind, placebo-controlled study

DEFF Research Database (Denmark)

Thamsborg, G; Florescu, A; Oturai, P

2005-01-01

OBJECTIVE: The investigation aimed at determining the effectiveness of pulsed electromagnetic fields (PEMF) in the treatment of osteoarthritis (OA) of the knee by conducting a randomized, double-blind, placebo-controlled clinical trial. DESIGN: The trial consisted of 2h daily treatment 5 days per...

Advanced method of double contrast examination of the stomach

International Nuclear Information System (INIS)

Vlasov, P.V.; Yakimenko, V.F.

1981-01-01

An advanced method of double contrast examination of the stomach with the use of high concentrated barium suspension is described. It is shown that concentration of barium suspension must be not less than 200 mass/volume per cent to obtain the sharp image of the mucosal microrelief 6 standard position are recommended for the double contrast examination of all stomach walls. 200 patients with different digestive system diseases are examined with the help of developed methods. The sharp image of the mucosal microrelief is obtained in 70% cases [ru

Quantitative Assessment of Synovial Vascularity Using Contrast-Enhanced Power Doppler Ultrasonography: Correlation with Histologic Findings and MR Imaging Findings in Arthritic Rabbit Knee Model

International Nuclear Information System (INIS)

Lee, Sang Hoon; Shin, Myung Jin; Kim, Seong Moon; Kim, Namkug; Suh, Sang Hyun; Suh, Jin Suck

2008-01-01

To validate contrast-enhanced power Doppler ultrasonography (PD US) for the evaluation of synovial vascularity in an arthritic rabbit knee model in correlation with MR and histological findings. Power Doppler ultrasonography was performed for carrageenin-induced arthritic left knee and control right knee of 13 rabbits, first without and then with sonic contrast agent enhancement (Levovist, Schering, Berlin Germany), followed by gadolinium-enhanced MR imaging. Synovial vascularity was quantitatively assessed by calculating the color pixel area in power Doppler sonography using a computer-aided image analysis program and by grading the enhancement on MR images: grade 1, enhancement of knee joint is less than one-third of the area; grade 2, one-third to two-thirds enhancement; and grade 3, more than two-thirds enhancement. Microvessel density (MVD) was measured on slides stained immunohistochemically for CD31 antigen for histological assessment. The mean area of color pixels in PD US changed from 4.37 to 16.42 mm 2 in the arthritic knee after enhancement (p 2 in the control knee (p 0.05). Sonic contrast-enhanced PD US improves the visualization of synovial vascularity and allows quantitative measurement in experimentally induced rabbit arthritic knees

Choice and technique of negative contrast in double contrast roentgenography of the stomach

International Nuclear Information System (INIS)

Pomakov, P.; Tomov, A.; Popsavov, P.; Tirolska, M.

1993-01-01

A comparative study of 8 negative contrast media is performed in 720 patients undergoing double-contrast abdominal biomedical radiography. The following preparations and methods are compared: Unibarit (Roelm, Pharma), CO 2 granulate (Nicholas), Sandosten Calcium + Calcium gluconicum (Sandoz, Pharmachim), Kalinor (Nordmark), dust variation of p. Rivieri, conducted aerophagy, stomach-tube, 'Echo'-lemonade. The average size of the gas bubble of the fornix (cm 2 ), the average volume of the gas collection (ml) and the relationship between the area of the negative contrast image (cm 2 ) and the volume of the gas (ml) is given. Some possibilities for production of domestic negative contrast media are also discussed. 2 tabs., 18 refs. (orig.)

Post-double-contrast sigmoid flush: An adjuvant technique in imaging diverticular disease

International Nuclear Information System (INIS)

Lappas, J.C.; Maglinte, D.D.T.; Kopecky, K.K.; Cockerill, E.M.; Lehman, G.A.

1987-01-01

The sigmoid colon is the most difficult colonic segment to examine radiographically, especially when it is involved by diverticular disease. In a prospective study, infusion of a low-density contrast agent was evaluated as an adjuvant technique to high-density double-contrast sigmoid imaging. After a double-contrast barium enema, 52 consecutive patients with sigmoid diverticulosis received an additional 500-ml enema either with water or with a 1.5% CT barium suspension. Rectosigmoid films were compared and evaluated for luminal distention, visualization of the interhaustral space, definition of diverticula, and display of polypoid defects. Sigmoid flush, particularly with the 1.5% CT barium suspension, is a simple adjunct to the double-contrast examination that improves visualization of the diverticular sigmoid and increases diagnostic specificity

Double contrast investigation of the stomach in hypotonia

International Nuclear Information System (INIS)

Roggensack, H.O.

1980-01-01

After two years experience of routine investigation of the stomach in double contrast and hypotonia the advantages of this method and its main field of application are described pertaining to selected cases. (orig.) [de

Sensitivity of single and double contrast barium enema in the detection of colorectal carcinoma

International Nuclear Information System (INIS)

Myllylae, V.; Paeivansalo, M.; Laitinen, S.; Oulu Univ.

1984-01-01

The preoperative barium enema of the 188 colorectal carcinoma patients operated at the Oulu University Central Hospital (Finland) during 1977-1982 were examined retrospectively. Altogether 112 single contrast studies and 87 double contrast studies had been made on these patients. The single contrast barium enemas had resulted in a correct diagnosis of colorectal carcinoma in 93 cases (sensitivity 83%). The correct diagnosis in the double contrast studies numbered 71 (sensitivity 82%). Most of the overlooked carcinomas were located in the caecum, in the sigmoid or the rectum. Most of the errors made in the single contrast studies were due to detection errors and poor evacuation. The most common failures in double contrast enemas were detection errors and nonvisualisation of the sigmoid. The authors recommend use of the double contrast technique and suggest that the two methods of barium enema be used to complement each other. A false negative diagnosis delayed the operation of the colorectal carcinoma patients by 2.2 months (median). (orig.) [de

Double contrast examination of the colon. Die Doppelkontrastuntersuchung des Dickdarms

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Welin, S.; Welin, G.

1980-01-01

The double contrast method has been modified in order to get a more detailed picture of the mucous membrane of the colon. The method has been employed at Malmoe hospital since 1953. The method and its diagnostic application in cases of adenoids, villiferous tumours, diverticula, Crohn's disease, ulcerating colitis, and deformation of the rectum/sigma junction due to external endometriosis and peritoneal carcinosis are described. The diagnostic values of the double contrast method and colposcopy/biopsy of the colon are compared. The two methods are found to be complementary.

Treatment of pain associated to knee osteoarthritis in the elderly: a randomized double-blind clinical trial with lysine clonixinate

OpenAIRE

Santos,Fânia Cristina; Souza,Polianna Mara Rodrigues de; Toniolo Neto,João; Atallah,Álvaro Nagib

2011-01-01

BACKGROUND AND OBJECTIVES: Osteoarthritis (OA) is the most common arthropathy and one of the major causes of chronic pain in the elderly population, which may lead to major functional incapacity of these individuals. Aiming at treating pain of elderly patients with knee OA, we have used lysine clonixinate (LC) and have evaluated its effectiveness METHOD: Randomized, double-blind, placebo-controlled clinical trial with 109 elderly patients with knee OA-related pain. Participants were distribut...

Post double-contrast sigmoid flush: An adjuvant technique in imaging diverticular disease

International Nuclear Information System (INIS)

Lappas, J.C.; Maglinte, D.D.T.; Kopecky, K.K.; Cockerill, E.M.; Lehman, G.A.

1987-01-01

In a prospective study, the effect of a low-density contrast medium infusion was evaluated as an adjunct to high-density double-contrast medium sigmoid imaging. Following a double-contrast medium barium enema (DCBE), 52 consecutive patients with sigmoid diverticulosis received an additional 500-700-mL enema with either water or a 1.5%CT barium suspension. Rectosigmoid films were evaluated for luminal distention, visualization of the interhaustral space, definition of diverticula, and interpretation of polypoid defects. While double-contrast medium views were excellent in 21%, improvement in multiple factors by water or 1.5% barium flush resulted in improved sigmoid images in 65% and 73% of patients, respectively. Polyps may be confirmed and artifactual defects confidently excluded. Sigmoid flush, particularly with low-density barium, is a simple adjunct to DCBE that improves visualization of the diverticular sigmoid

Contrast-enhanced MRI of subchondral cysts in patients with or at risk for knee osteoarthritis: The MOST study

International Nuclear Information System (INIS)

Crema, M.D.; Roemer, F.W.; Marra, M.D.; Niu, J.; Lynch, J.A.; Felson, D.T.; Guermazi, A.

2010-01-01

Objective: The aim of the study was (1) to evaluate contrast enhancement patterns of subchondral cysts on magnetic resonance imaging and (2) to discuss possible radiological explanations of cyst enhancement based on existing theories of subchondral cyst formation in osteoarthritis. Materials and methods: The Multicenter Osteoarthritis Study (MOST) is a NIH-funded longitudinal observational study for individuals who have or are at high risk for knee osteoarthritis. All subjects with available non-enhanced and contrast-enhanced MRI were included. The tibiofemoral and patellofemoral joints were divided in 14 subregions. The presence and size of subchondral cysts and bone marrow edema-like lesions (BMLs) were scored semiquantitatively in each subregion on non-contrast-enhanced MRI from 0 to 3. Enhancement of subchondral cysts was evaluated on contrast-enhanced MRI as grade 0 (absent), grade 1 (partial enhancement), or grade 2 (full enhancement). The adjacent articular cartilage was scored in each subregion on non-enhanced MRI as grade 0 (intact), grade 1 (partial thickness loss), or grade 2 (full thickness loss). Results: Four hundred knees were included (1 knee per person, 5600 subregions). Subchondral cysts were detected in 260 subregions (4.6%). After intravenous contrast administration, 245 cysts (94.2%) showed full enhancement, 12 (4.6%) showed partial enhancement and 3 (1.2%) showed no enhancement. Enhancing BMLs were found in 237 (91.2%) subregions containing cysts, which were located adjacent or in the middle of BMLs. In 121 subregions (46.5%) having cysts, no adjacent full thickness cartilage loss was detected. Conclusion: Most subchondral cysts demonstrated full or partial contrast enhancement, and were located adjacent or in the midst of enhancing BMLs. As pure cystic lesions are not expected to enhance on MRI, the term 'subchondral cyst-like bone marrow lesion' might be appropriate to describe these lesions.

Contrast-enhanced MRI of subchondral cysts in patients with or at risk for knee osteoarthritis: The MOST study

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Crema, M.D., E-mail: michelcrema@gmail.co [Department of Radiology, Boston University School of Medicine, 820 Harrison Ave, FGH Building, 3rd Floor, Boston, MA 02118 (United States); Roemer, F.W., E-mail: frank.roemer@klinikum-augsburg.d [Department of Radiology, Boston University School of Medicine, 820 Harrison Ave, FGH Building, 3rd Floor, Boston, MA 02118 (United States); Department of Radiology, Klinikum Augsburg, Stenglinstrasse 2, Augsburg 86156 (Germany); Marra, M.D., E-mail: monicadiasmarra@gmail.co [Department of Radiology, Boston University School of Medicine, 820 Harrison Ave, FGH Building, 3rd Floor, Boston, MA 02118 (United States); Niu, J., E-mail: niujp@bu.ed [Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, 650 Albany Street, X Building, Suite 200, Boston, MA 02118 (United States); Lynch, J.A., E-mail: jlynch@psg.ucsf.ed [Department of Epidemiology and Biostatistics, University of California at San Francisco, 185 Berry Street, Lobby 5, Suite 5700, San Francisco, CA 94107 (United States); Felson, D.T., E-mail: dfelson@bu.ed [Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, 650 Albany Street, X Building, Suite 200, Boston, MA 02118 (United States); Guermazi, A., E-mail: ali.guermazi@bmc.or [Department of Radiology, Boston University School of Medicine, 820 Harrison Ave, FGH Building, 3rd Floor, Boston, MA 02118 (United States)

2010-07-15

Objective: The aim of the study was (1) to evaluate contrast enhancement patterns of subchondral cysts on magnetic resonance imaging and (2) to discuss possible radiological explanations of cyst enhancement based on existing theories of subchondral cyst formation in osteoarthritis. Materials and methods: The Multicenter Osteoarthritis Study (MOST) is a NIH-funded longitudinal observational study for individuals who have or are at high risk for knee osteoarthritis. All subjects with available non-enhanced and contrast-enhanced MRI were included. The tibiofemoral and patellofemoral joints were divided in 14 subregions. The presence and size of subchondral cysts and bone marrow edema-like lesions (BMLs) were scored semiquantitatively in each subregion on non-contrast-enhanced MRI from 0 to 3. Enhancement of subchondral cysts was evaluated on contrast-enhanced MRI as grade 0 (absent), grade 1 (partial enhancement), or grade 2 (full enhancement). The adjacent articular cartilage was scored in each subregion on non-enhanced MRI as grade 0 (intact), grade 1 (partial thickness loss), or grade 2 (full thickness loss). Results: Four hundred knees were included (1 knee per person, 5600 subregions). Subchondral cysts were detected in 260 subregions (4.6%). After intravenous contrast administration, 245 cysts (94.2%) showed full enhancement, 12 (4.6%) showed partial enhancement and 3 (1.2%) showed no enhancement. Enhancing BMLs were found in 237 (91.2%) subregions containing cysts, which were located adjacent or in the middle of BMLs. In 121 subregions (46.5%) having cysts, no adjacent full thickness cartilage loss was detected. Conclusion: Most subchondral cysts demonstrated full or partial contrast enhancement, and were located adjacent or in the midst of enhancing BMLs. As pure cystic lesions are not expected to enhance on MRI, the term 'subchondral cyst-like bone marrow lesion' might be appropriate to describe these lesions.

Prevention of crackle in double contrast examinations of the colon

International Nuclear Information System (INIS)

Carvalho, A. de; Madsen, B.

1981-01-01

Crackle of the barium contrast during double contrast examinations of the colon probably results from a drying effect due to resoption of water. The duration of the examination should therefore be kept as short as possible and the patient should be well hydrated. The tendency to crackle can be decreased by increasing the molality of the barium enema by suspending barium contrast in 0.4% saline. (Auth.)

Early colon cancer : findings on double contrast barium enema

International Nuclear Information System (INIS)

Kim, Seung Kwon; Lim, Jae Hoon; Lee, Soon Jin; Lim, Hyo Keun

1998-01-01

The purpose of this study is to describe the radiologic findings of early colon cancer on double-contrast barium enema. We retrospectively reviewed the double-contrast barium enemas of eight patients (M:F = 6:2; mean age : 67 yrs; range : 48-77 yrs) who were pathologically proven to be early colon cancer. The location, size and gross morphology of lesions was evaluated using double-contrast barium enema, while depth of invasion, degree of differentiation, precancerous lesions and lymph node metastasis were evaluated histopathologically. Early colon cancer was found in the rectum (n=4), sigmoid colon (n=3) and ascending colon (n=1). The size of mass ranged from 2.3 ∼ 8.3 (mean, 4.6) cm. And the polypoid type was most common (n=7); this was subdivided into sessile (Is, n=5), semipedunculated (Isp, n=1) and pedunculated type (Ip, n=1). Another mass was a sessile polypoid combined with a flat depressed lesion. In eight cases, four cancers were confined to the mucosa, while the remaining four had infiltrated the submucosa. Most cancers arose from villous and villotubular adenoma. All cases were well-differentiated adenocarcinoma and no metastasis to lymph nodes had occurred. In early colon cancer, lesions were mainly polypoid and large. Most arose from villous and villotubular adenoma. (author). 19 refs., 1 tab., 3 figs

Double contrast arthrography of the shoulder

International Nuclear Information System (INIS)

Gasparini, D.

1991-01-01

From 1980 to 1989 the author performed 481 double-contrast arthrographic examinations of the shoulder (DCSA). A hundred and forty-two complete and 46 partial rotator cuff tears were demonstrated; 68 of them underwent surgical exploration. Results confirmed DCSA capabilities in detecting both their location (100%) and size (95%). Moreover, thickness (89%) and erosions (94%) in tendon edges and surfaces were demonstrated - that is, all the qualitative information needed to depict degenerative processes. Such evidence may also affect treatment planning

Optimization of contrast of MR images in imaging of knee joint; Optymalizacja kontrastu obrazow MR na przykladzie obrazow stawu kolanowego

Energy Technology Data Exchange (ETDEWEB)

Szyblinski, K. [Institute of Nuclear Physics, Cracow (Poland); Bacic, G. [Dartmouth College, Hanover, NH (United States)

1994-12-31

The work describes the method of contrast optimization in magnetic resonance imaging. Computer program presented in the report allows analysis of contrast in selected tissues as a function of experiment parameters. Application to imaging of knee joint is presented. 2 refs, 4 figs.

Granulomatous colitis: findings on double contrast barium enema and follow-up studies

International Nuclear Information System (INIS)

Song, Jong Gi; Han, Joon Koo; Kim, Seung Hoon; Choo, Sung Wook; Kim, Seung Cheol; Choi, Byung Ihn

1995-01-01

To evaluate the radiologic findings of granulomatous colitis on double contrast barium enema and changes on follow-up studies. Serial double contrast barium enema of six patients with granulomatous colitis confirmed by endoscopic biopsy were reviewed. We analyzed the radiologic findings and their follow-up changes, including aphthous ulcers, lymphoid hyperplasia, deep ulcers, cobble stone appearance, geographic ulcers, asymmetric involvement of ulcers, skip lesions, sinus tract, fistula formation, pseudosacculation, focal stricture, and small bowel involvement. Pretreatment double contrast barium enema findings were aphthous ulcers in five patients, deep ulcer in six, cobble stone appearance in five, longitudinal geographic ulcers in two, fistulas in one, pseudosacculations in two, focal stricture in one, and pseudopolyps in six. Also, anal ulcers were observed in two patients, asymmetric involvement of ulcers in three, skip lesions in four, and small bowel involvement in five in five patients proved to have inactive disease after treatment, aphthous ulcers and deep ulcers disappeared. Geographic ulcers of two patients and anal ulcer of one patients decreased in size or depth. Pseudosacculation in one patient disappeared. Pseudopolyps decreased in two patients, increased in one, and decreased after increase in two. One patient whose disease remained active after treatment showed maintenance or increase of ulcers or fistula. And their pseudosacculation or focal stricture unchanged and pseudopolyps decreased. The major radiologic findings of chronic granulomatous colitis on double contrast barium enema are aphthous ulcer, deep ulcer, cobble stone appearance, discontinuity of the lesion and coexistence of ulcers and pseudopolyps. And, double contrast barium enema is good follow-up modality because its findings correlate with clinical course of the granulomatous colitis after treatment

Double contrast MR imaging with iron colloid and Gd-DTPA in cholangiocellular carcinoma

Energy Technology Data Exchange (ETDEWEB)

Suto, Y. [Dept. of Radiology, Tottori Univ. School of Medicine, Yonago (Japan); Shimatani, Y. [Dept. of Radiology, Tottori Univ. School of Medicine, Yonago (Japan); Kato, T. [Dept. of Radiology, Tottori Univ. School of Medicine, Yonago (Japan); Kamba, M. [Dept. of Radiology, Tottori Univ. School of Medicine, Yonago (Japan); Ohuchi, Y. [Dept. of Radiology, Tottori Univ. School of Medicine, Yonago (Japan); Kodama, F. [Dept. of Radiology, Tottori Univ. School of Medicine, Yonago (Japan); Kato, T.; Ohta, Y. [Dept. of Radiology, Tottori Univ. School of Medicine, Yonago (Japan)

1994-11-01

Double contrast MR imaging with combined use of chondroitin sulfate iron colloid (CSIC) and Gd-DTPA was attempted in 3 cases of cholangiocellular carcinoma (CCC). In all cases, nonenhanced spin echo T1- and T2-weighted images, and T1-weighted images after i.v. injection of Gd-DTPA were obtained. Within one week, the MR sequences were repeated one hour after i.v. injection of CSIC. Double contrast (CSIC/Gd-DTPA) T1-weighted imaging was evaluated and compared with the other sequences in terms of tumor detectability, tumor spreading and tumor characterization. Double contrast MR imaging was comparable in tumor detectability and superior as to the evaluation of spreading and characterization to the other MR imaging modalities. (orig.).

Effects of Prophylactic Knee Bracing on Lower Limb Kinematics, Kinetics, and Energetics During Double-Leg Drop Landing at 2 Heights.

Science.gov (United States)

Ewing, Katie A; Begg, Rezaul K; Galea, Mary P; Lee, Peter V S

2016-07-01

Anterior cruciate ligament (ACL) injuries commonly occur during landing maneuvers. Prophylactic knee braces were introduced to reduce the risk of ACL injuries, but their effectiveness is debated. We hypothesized that bracing would improve biomechanical factors previously related to the risk of ACL injuries, such as increased hip and knee flexion angles at initial contact and at peak vertical ground-reaction force (GRF), increased ankle plantar flexion angles at initial contact, decreased peak GRFs, and decreased peak knee extension moment. We also hypothesized that bracing would increase the negative power and work of the hip joint and would decrease the negative power and work of the knee and ankle joints. Controlled laboratory study. Three-dimensional motion and force plate data were collected from 8 female and 7 male recreational athletes performing double-leg drop landings from 0.30 m and 0.60 m with and without a prophylactic knee brace. GRFs, joint angles, moments, power, and work were calculated for each athlete with and without a knee brace. Prophylactic knee bracing increased the hip flexion angle at peak GRF by 5.56° (P knee flexion angle at peak GRF by 4.75° (P = .001), and peak hip extension moment by 0.44 N·m/kg (P knee and ankle. No differences in peak GRFs and peak knee extension moment were observed with bracing. The application of a prophylactic knee brace resulted in improvements in important biomechanical factors associated with the risk of ACL injuries. Prophylactic knee braces may help reduce the risk of noncontact knee injuries in recreational and professional athletes while playing sports. Further studies should investigate different types of prophylactic knee braces in conjunction with existing training interventions so that the sports medicine community can better assess the effectiveness of prophylactic knee bracing. © 2016 The Author(s).

Contrast-enhanced MRI of the knee in children unaffected by clinical arthritis compared to clinically active juvenile idiopathic arthritis patients

Energy Technology Data Exchange (ETDEWEB)

Nusman, Charlotte M.; Hemke, Robert [University of Amsterdam, Department of Radiology, Academic Medical Center, Amsterdam (Netherlands); University of Amsterdam, Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children' s Hospital AMC, Amsterdam (Netherlands); Benninga, Marc A.; Kindermann, Angelika [University of Amsterdam, Department of Pediatric Gastroenterology, Emma Children' s Hospital AMC, Amsterdam (Netherlands); Schonenberg-Meinema, Dieneke; Berg, J.M. van den; Kuijpers, Taco W. [University of Amsterdam, Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children' s Hospital AMC, Amsterdam (Netherlands); Rossum, Marion A.J. van [University of Amsterdam, Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children' s Hospital AMC, Amsterdam (Netherlands); Reade, Department of Pediatric Rheumatology, Amsterdam (Netherlands); Maas, Mario [University of Amsterdam, Department of Radiology, Academic Medical Center, Amsterdam (Netherlands)

2016-04-15

To evaluate enhancing synovial thickness upon contrast-enhanced magnetic resonance imaging (MRI) of the knee in children unaffected by clinical arthritis compared with clinically active juvenile idiopathic arthritis (JIA) patients. A secondary objective was optimization of the scoring method based on maximizing differences on MRI between these groups. Twenty-five children without history of joint complaints nor any clinical signs of joint inflammation were age/sex-matched with 25 clinically active JIA patients with arthritis of at least one knee. Two trained radiologists, blinded for clinical status, independently evaluated location and extent of enhancing synovial thickness with the validated Juvenile Arthritis MRI Scoring system (JAMRIS) on contrast-enhanced axial fat-saturated T1-weighted MRI of the knee. Enhancing synovium (≥2 mm) was present in 13 (52 %) unaffected children. Using the total JAMRIS score for synovial thickening, no significant difference was found between unaffected children and active JIA patients (p = 0.091). Additional weighting of synovial thickening at the JIA-specific locations enabled more sensitive discrimination (p = 0.011). Mild synovial thickening is commonly present in the knee of children unaffected by clinical arthritis. The infrapatellar and cruciate ligament synovial involvement were specific for JIA, which - in a revised JAMRIS - increases the ability to discriminate between JIA and unaffected children. (orig.)

Contrast-enhanced MRI of the knee in children unaffected by clinical arthritis compared to clinically active juvenile idiopathic arthritis patients

International Nuclear Information System (INIS)

Nusman, Charlotte M.; Hemke, Robert; Benninga, Marc A.; Kindermann, Angelika; Schonenberg-Meinema, Dieneke; Berg, J.M. van den; Kuijpers, Taco W.; Rossum, Marion A.J. van; Maas, Mario

2016-01-01

To evaluate enhancing synovial thickness upon contrast-enhanced magnetic resonance imaging (MRI) of the knee in children unaffected by clinical arthritis compared with clinically active juvenile idiopathic arthritis (JIA) patients. A secondary objective was optimization of the scoring method based on maximizing differences on MRI between these groups. Twenty-five children without history of joint complaints nor any clinical signs of joint inflammation were age/sex-matched with 25 clinically active JIA patients with arthritis of at least one knee. Two trained radiologists, blinded for clinical status, independently evaluated location and extent of enhancing synovial thickness with the validated Juvenile Arthritis MRI Scoring system (JAMRIS) on contrast-enhanced axial fat-saturated T1-weighted MRI of the knee. Enhancing synovium (≥2 mm) was present in 13 (52 %) unaffected children. Using the total JAMRIS score for synovial thickening, no significant difference was found between unaffected children and active JIA patients (p = 0.091). Additional weighting of synovial thickening at the JIA-specific locations enabled more sensitive discrimination (p = 0.011). Mild synovial thickening is commonly present in the knee of children unaffected by clinical arthritis. The infrapatellar and cruciate ligament synovial involvement were specific for JIA, which - in a revised JAMRIS - increases the ability to discriminate between JIA and unaffected children. (orig.)

Effect of knee joint icing on knee extension strength and knee pain early after total knee arthroplasty: a randomized cross-over study.

Science.gov (United States)

Holm, Bente; Husted, Henrik; Kehlet, Henrik; Bandholm, Thomas

2012-08-01

To investigate the acute effect of knee joint icing on knee extension strength and knee pain in patients shortly after total knee arthroplasty. A prospective, single-blinded, randomized, cross-over study. A fast-track orthopaedic arthroplasty unit at a university hospital. Twenty patients (mean age 66 years; 10 women) scheduled for primary unilateral total knee arthroplasty. The patients were treated on two days (day 7 and day 10) postoperatively. On one day they received 30 minutes of knee icing (active treatment) and on the other day they received 30 minutes of elbow icing (control treatment). The order of treatments was randomized. Maximal knee extension strength (primary outcome), knee pain at rest and knee pain during the maximal knee extensions were measured 2-5 minutes before and 2-5 minutes after both treatments by an assessor blinded for active or control treatment. The change in knee extension strength associated with knee icing was not significantly different from that of elbow icing (knee icing change (mean (1 SD)) -0.01 (0.07) Nm/kg, elbow icing change -0.02 (0.07) Nm/kg, P = 0.493). Likewise, the changes in knee pain at rest (P = 0.475), or knee pain during the knee extension strength measurements (P = 0.422) were not different between treatments. In contrast to observations in experimental knee effusion models and inflamed knee joints, knee joint icing for 30 minutes shortly after total knee arthroplasty had no acute effect on knee extension strength or knee pain.

T2 values of femoral cartilage of the knee joint: Comparison between pre-contrast and post-contrast images

International Nuclear Information System (INIS)

Yoon, Hyun Jung; Yoon, Young Cheol; Choe, Bong Keun

2014-01-01

To retrospectively evaluate the relationship between T2 values of pre- and post-contrast magnetic resonance (MR) images of femoral cartilage in patients with varying degrees of osteoarthritis. A total of 19 patients underwent delayed gadolinium-enhanced MRI of cartilage. Six regions of interest for T2 value measurement were obtained from pre- and post-contrast T2-weighted, sagittal, multi-slice, multi-echo, source images in each subject. Regions with modified Noyes classification grade 2B and 3 were excluded. Comparison of T2 values between pre- and post-contrast images and T2 values among regions with the grade 0, 1 and 2A groups were statistically analyzed. Of a total of 114 regions, 79 regions showing grade 0 (n = 46), 1 (n = 18), or 2A (n = 15) were analyzed. The overall and individual T2 values of post-contrast images were significantly lower than those of pre-contrast images (overall, 35.3 ± 9.2 [mean ± SD] vs. 29.9 ± 8.2, p < 0.01; range of individual, 28.9-37.6 vs. 27.1-36.4, p < 0.01). Pearson correlation coefficients showed a strong positive correlation between pre- and post-contrast images (rho-Pearson = 0.712-0.905). T2 values of pre- and post-contrast images of the grade 0 group were significantly lower than those of the grade 1/2A group (pre T2, p = 0.003; post T2, p = 0.006). T2 values of the femoral cartilage of the knee joint are significantly lower on post-contrast images than on pre-contrast images. Furthermore, these T2 values have a strong positive correlation between pre- and post-contrast images.

T2 values of femoral cartilage of the knee joint: Comparison between pre-contrast and post-contrast images

Energy Technology Data Exchange (ETDEWEB)

Yoon, Hyun Jung; Yoon, Young Cheol [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Choe, Bong Keun [Department of Preventive Medicine, Kyung Hee University School of Medicine, Seoul (Korea, Republic of)

2014-02-15

To retrospectively evaluate the relationship between T2 values of pre- and post-contrast magnetic resonance (MR) images of femoral cartilage in patients with varying degrees of osteoarthritis. A total of 19 patients underwent delayed gadolinium-enhanced MRI of cartilage. Six regions of interest for T2 value measurement were obtained from pre- and post-contrast T2-weighted, sagittal, multi-slice, multi-echo, source images in each subject. Regions with modified Noyes classification grade 2B and 3 were excluded. Comparison of T2 values between pre- and post-contrast images and T2 values among regions with the grade 0, 1 and 2A groups were statistically analyzed. Of a total of 114 regions, 79 regions showing grade 0 (n = 46), 1 (n = 18), or 2A (n = 15) were analyzed. The overall and individual T2 values of post-contrast images were significantly lower than those of pre-contrast images (overall, 35.3 ± 9.2 [mean ± SD] vs. 29.9 ± 8.2, p < 0.01; range of individual, 28.9-37.6 vs. 27.1-36.4, p < 0.01). Pearson correlation coefficients showed a strong positive correlation between pre- and post-contrast images (rho-Pearson = 0.712-0.905). T2 values of pre- and post-contrast images of the grade 0 group were significantly lower than those of the grade 1/2A group (pre T2, p = 0.003; post T2, p = 0.006). T2 values of the femoral cartilage of the knee joint are significantly lower on post-contrast images than on pre-contrast images. Furthermore, these T2 values have a strong positive correlation between pre- and post-contrast images.

Efficacy of kinesio taping on isokinetic quadriceps torque in knee osteoarthritis: a double blinded randomized controlled study.

Science.gov (United States)

Anandkumar, Sudarshan; Sudarshan, Shobhalakshmi; Nagpal, Pratima

2014-08-01

Double blind pre-test post-test control group design. To compare the isokinetic quadriceps torque, standardized stair-climbing task (SSCT) and pain during SSCT between subjects diagnosed with knee osteoarthritis pre and post kinesio tape (KT) application with and without tension. Strength of the quadriceps and torque producing capability is frequently found to be compromised in knee osteoarthritis. The efficacy of KT in improving isokinetic quadriceps torque in knee osteoarthritis is unknown, forming the basis for this study. Forty subjects were randomly allocated to either the experimental (therapeutic KT with tension) or control group (sham KT without tension) with the allocation being concealed. Pre and post test measurements of isokinetic quadriceps torque, SSCT and pain during SSCT were carried out by a blinded assessor. A large effect size with significant improvements in the peak quadriceps torque (concentric and eccentric at angular velocities of 90° per second and 120° per second), SSCT and pain were obtained in the experimental group when compared to the control group. Application of therapeutic KT is effective in improving isokinetic quadriceps torque, SSCT and reducing pain in knee osteoarthritis.

Glucosamine-containing supplement improves locomotor functions in subjects with knee pain: a randomized, double-blind, placebo-controlled study.

Science.gov (United States)

Kanzaki, Noriyuki; Ono, Yoshiko; Shibata, Hiroshi; Moritani, Toshio

2015-01-01

The aim of this study was to investigate the ability of a glucosamine-containing supplement to improve locomotor functions in subjects with knee pain. A randomized, double-blind, placebo-controlled, parallel-group comparative study was conducted for 16 weeks in 100 Japanese subjects (age, 51.8±0.8 years) with knee pain. Subjects were randomly assigned to one of the two supplements containing 1) 1,200 mg of glucosamine hydrochloride, 60 mg of chondroitin sulfate, 45 mg of type II collagen peptides, 90 mg of quercetin glycosides, 10 mg of imidazole peptides, and 5 μg of vitamin D per day (GCQID group, n=50) or 2) a placebo (placebo group, n=50). Japanese Knee Osteoarthritis Measure, visual analog scale score, normal walking speed, and knee-extensor strength were measured to evaluate the effects of the supplement on knee-joint functions and locomotor functions. In subjects eligible for efficacy assessment, there was no significant group × time interaction, and there were improvements in knee-joint functions and locomotor functions in both groups, but there was no significant difference between the groups. In subjects with mild-to-severe knee pain at baseline, knee-extensor strength at week 8 (104.6±5.0% body weight vs 92.3±5.5% body weight, P=0.030) and the change in normal walking speed at week 16 (0.11±0.03 m/s vs 0.05±0.02 m/s, P=0.038) were significantly greater in the GCQID group than in the placebo group. Further subgroup analysis based on Kellgren-Lawrence (K-L) grade showed that normal walking speed at week 16 (1.36±0.05 m/s vs 1.21±0.02 m/s, Pknee pain, GCQID supplementation was effective for relieving knee pain and improving locomotor functions.

Double contrast with technique of Insufflated Barium Meal in the radiological study of the esophagus

International Nuclear Information System (INIS)

Gallina, F.; Piga, V.; Gallina, M.S.

1985-01-01

The results are reported of the esophagus double contrast examination with Insufflated Barium Meal technique as first part of the routine upper digestive system radiological examination. This technique gives good double contrast without those artifacts using effervescent powders and without modifying the normal radiological alimentary tract examination established way. The double contrast is administered by a special container with a built-in mouthpiece which allows the simultaneous ingestion of barium suspension and air. The esophageal mucosa can be examined as far as the distal tract where frequently the barium contrast stops using different techniques. Good results in 90% of patients have been obtained. The early detection of inflammatory and tumoral lesions has taken particular advantage in patients sometimes asymptomatic

Double contrast with technique of Insufflated Barium Meal in the radiological study of the esophagus

Energy Technology Data Exchange (ETDEWEB)

Gallina, F; Piga, V; Gallina, M.S. and others

1985-01-01

The results are reported of the esophagus double contrast examination with Insufflated Barium Meal technique as first part of the routine upper digestive system radiological examination. This technique gives good double contrast without those artifacts using effervescent powders and without modifying the normal radiological alimentary tract examination established way. The double contrast is administered by a special container with a built-in mouthpiece which allows the simultaneous ingestion of barium suspension and air. The esophageal mucosa can be examined as far as the distal tract where frequently the barium contrast stops using different techniques. Good results in 90% of patients have been obtained. The early detection of inflammatory and tumoral lesions has taken particular advantage in patients sometimes asymptomatic.

Comparison between arthroscopy and 3 dimensional double echo steady state 3D-DESS sequences in magnetic resonance imaging of internal derangements of the knee

International Nuclear Information System (INIS)

Dongola, Nagwa A.; Gishen, Philip

2004-01-01

This study was performed with the aim of evaluating the usefulness of 3 dimensional double-echo steady state sequences in examining the internal derangements of the knee. Arthroscopy was used as a referral standard. The study was performed in the Radiology and Arthroscopy Departments of Kings College Hospital, London, United Kingdom, during a 6-month period from January 1997 to June 1997. All patients who had knee magnetic resonance imaging within 3 months of arthroscopy were retrospectively studied. Thirty-three patients fulfilled these criteria and were selected. Three dimensional double-echo steady state sequences produced sensitivity for detecting meniscal tears of 87.5% for medial menisci (MM) and 75% for lateral menisci (LM). Specificity was 76% for MM and 96% for LM; positive predictive value (PPV) was 46.1% for MM and 85.7% for LM and negative predictive value (NPV) of 95% for MM and 96% for LM. The sensitivity for the anterior cruciate ligament was 83.3%, specificity was 77.7%, PPV was 45.4% and NPV was 95.4%. Three dimensional double-echo steady state sequences are useful in evaluating internal derangement of the knee, especially in advanced cartilage lesions. (author)

Rectal water contrast transvaginal ultrasound versus double-contrast barium enema in the diagnosis of bowel endometriosis

OpenAIRE

Jiang, Jipeng; Liu, Ying; Wang, Kun; Wu, Xixiang; Tang, Ying

2017-01-01

Objectives The aim of study was to compare the accuracy between rectal water contrast transvaginal ultrasound (RWC-TVS) and double-contrast barium enema (DCBE) in evaluating the bowel endometriosis presence as well as its extent. Design and setting 198 patients at reproductive age with suspicious bowel endometriosis were included. Physicians in two groups specialised at endometriosis performed RWC-TVS as well as DCBE before laparoscopy and both groups were blinded to other groups’ results. Fi...

Examination of factors affecting gait properties in healthy older adults: focusing on knee extension strength, visual acuity, and knee joint pain.

Science.gov (United States)

Demura, Tomohiro; Demura, Shin-ichi; Uchiyama, Masanobu; Sugiura, Hiroki

2014-01-01

Gait properties change with age because of a decrease in lower limb strength and visual acuity or knee joint disorders. Gait changes commonly result from these combined factors. This study aimed to examine the effects of knee extension strength, visual acuity, and knee joint pain on gait properties of for 181 healthy female older adults (age: 76.1 (5.7) years). Walking speed, cadence, stance time, swing time, double support time, step length, step width, walking angle, and toe angle were selected as gait parameters. Knee extension strength was measured by isometric dynamometry; and decreased visual acuity and knee joint pain were evaluated by subjective judgment whether or not such factors created a hindrance during walking. Among older adults without vision problems and knee joint pain that affected walking, those with superior knee extension strength had significantly greater walking speed and step length than those with inferior knee extension strength (P pain in both knees showed slower walking speed and longer stance time and double support time. A decrease of knee extension strength and visual acuity and knee joint pain are factors affecting gait in the female older adults. Decreased knee extension strength and knee joint pain mainly affect respective distance and time parameters of the gait.

Opinions among Danish knee surgeons about indications to perform total knee replacement showed considerable variation

DEFF Research Database (Denmark)

Troelsen, Anders; Schrøder, Henrik; Husted, Henrik

2012-01-01

During the past decade, the incidence of primary total knee replacement (TKA) surgery in Denmark has approximately doubled. This increase could be due to weakened indications to perform TKA surgery. We aimed to investigate variation in opinions about indications to perform TKA among Danish knee...

Effects of Proprioceptive Neuromuscular Facilitation Stretching and Kinesiology Taping on Pelvic Compensation During Double-Knee Extension

Directory of Open Access Journals (Sweden)

Lee Seung-Woong

2015-12-01

Full Text Available Shortened hamstrings are likely to restrict the anterior pelvic tilt and induce a slumped posture due to the posterior pelvic tilt. This study was conducted to compare the effects of proprioceptive neuromuscular facilitation (PNF stretching and modified anterior pelvic tilt taping (APTT on hamstring shortness-associated pelvic compensation while executing seated double-knee extension. Male college students (28 healthy young adults; mean age: 21.4 ± 2.1 years with hamstring shortness were recruited as study subjects and randomly assigned to either the PNF stretching group (control group or the APTT group (experimental group. In all the subjects, changes in the movement distance of the centre of gluteal pressure (COGP as well as rectus abdominis (RA and semitendinosus (SEM muscle activities were measured during seated double-knee extension while the respective intervention method was applied. Both groups showed significant decreases in COGP distance and RA muscle activity compared with their respective baseline values (p < 0.05, however, no significant changes were observed in SEM muscle activity. We can infer that not only a direct intervention on the hamstring, such as PNF stretching, but also a modified APTT-mediated pelvic intervention may be used as a method for reducing pelvic compensation induced by hamstring shortness.

A Double-Blind, Active-Controlled Clinical Trial of Sodium Bicarbonate and Calcium Gluconate in the Treatment of Bilateral Osteoarthritis of the Knee

Directory of Open Access Journals (Sweden)

María del Carmen Caamaño

2017-02-01

Full Text Available Objective: To evaluate the effect of intra-articular injections of sodium bicarbonate with a single (SBCG1 or double dose (SBCG2 of calcium gluconate administered monthly compared with methylprednisolone (MP for treatment of knee osteoarthritis. Methods: A 3-month, randomized, double-blind clinical trial with patients diagnosed with knee osteoarthritis (OA. The outcome variables were the Western Ontario-McMaster University Osteoarthritis Index (WOMAC and the Lequesne functional index. Results: After 3 months, all treatments significantly improved in overall WOMAC and Lequesne scores. Mean changes (95% confidence interval in WOMAC total score and the Lequesne index, respectively, for SBCG1 (−12.5 [−14.3, −10.7]; −9.0 [−11.4, −6.7] and SBCG2 (−12.3 [−14.3, −10.4]; −8.9 [−10.4, −7.4] were significantly greater than for MP (−5.0 [−7.2, −2.8]; −3.2 [−4.9, −1.5] ( P  < .001. Conclusions: Intra-articular injections of sodium bicarbonate and calcium gluconate are useful for short-term relief of OA symptoms in patients with bilateral knee osteoarthritis. Both treatments are more effective than MP injections in the reduction of knee OA symptoms. Trial Registration: Clinicaltrials.gov NCT00977444

Intolerance reaction after application of glucagon during double contrast studies

International Nuclear Information System (INIS)

Kainberger, F.; Fruehwald, F.; Schwaighofer, B.; Lindemayr, H.

1986-01-01

Whereas intolerance reactions against contrast media are a well-known hazard during radiologic procedures, intolerance reactions to other preparations used in radiology are rare. Glucagon, frequently used to induce gastrointestinal hypotonia, is said to have almost no side-effects. A case of anaphylactic reaction during double-contrast upper gastrointestinal examination is reported. Pseudoallergic reaction to propylparaben, a preservative agent in glucagon, is suspected. IgE-antibodies to glucagon could not be detected by RAST. (orig.) [de

Limb symmetry during double-leg squats and single-leg squats on land and in water in adults with long-standing unilateral anterior knee pain; a cross sectional study.

Science.gov (United States)

Severin, Anna C; Burkett, Brendan J; McKean, Mark R; Wiegand, Aaron N; Sayers, Mark G L

2017-01-01

The presence of pain during movement typically results in changes in technique. However, the physical properties of water, such as flotation, means that water-based exercise may not only reduce compensatory movement patterns but also allow pain sufferers to complete exercises that they are unable to perform on land. The purpose of this study was to assess bilateral kinematics during double-leg squats and single-leg squats on land and in water in individuals with unilateral anterior knee pain. A secondary aim was to quantify bilateral asymmetry in both environments in affected and unaffected individuals using a symmetry index. Twenty individuals with unilateral knee pain and twenty healthy, matched controls performed body weight double- and single-leg squats in both environments while inertial sensors (100 Hz) recorded trunk and lower body kinematics. Repeated-measures statistics tested for environmental effects on movement depths and peak angles within the anterior knee pain group. Differences in their inter-limb symmetry in each environments was compared to the control group using analysis of variance tests. Water immersion allowed for greater movement depths during both exercises (double-leg squat: +7 cm, p  = 0.032, single-leg squat: +9 cm, p  = 0.002) for the knee pain group. The double-leg squat was symmetrical on land but water immersion revealed asymmetries in the lower body frontal plane movements. The single-leg squat revealed decreased hip flexion and frontal plane shank motions on the affected limb in both environments. Water immersion also affected the degree of lower limb asymmetry in both groups, with differences also showing between groups. Individuals with anterior knee pain achieved increased squat depth during both exercises whilst in water. Kinematic differences between the affected and unaffected limbs were often increased in water. Individuals with unilateral anterior knee pain appear to utilise different kinematics in the affected

Improve identification of details in double-contrast examination of the stomach by means of a new contrast medium mixture

International Nuclear Information System (INIS)

Tenner, R.

1984-01-01

In a contrast medium study, 100 patients were employed for a comparison between the contrast medium Mikropaque liquid and a mixture of Mikropaque HD and Mikropaque liquid in double-contrast examination of the stomach. The special feature of this method was that one and the same stomach was examined in each case with both contrast media. The new contrast media mixture with Mikropaque HD represents a step forward; the contrast could be enhanced in 80% of the cases, and the finely contoured relief became visible in two-thirds of the cases, compared with one-third of the examined patients before this method was introduced. (orig.) [de

Mobile ankle and knee perturbator.

Science.gov (United States)

Andersen, Jacob Buus; Sinkjaer, Thomas

2003-10-01

A mobile ankle and knee perturbator has been developed. It consists of a functional joint with an integrated clutch. Four Bowden wires connect the joint to a powerful motor and a double pneumatic cylinder. When needed during any time of the gait cycle, it is possible to impose an ankle rotation by engaging the clutch and rotating the ankle or knee joint with a predefined displacement. The system is designed to investigate electrophysiological and biomechanical features of the human ankle or knee joint during gait.

Arterial double-contrast dual-energy MDCT: in-vivo rabbit atherosclerosis with iodinated nanoparticles and gadolinium agents

Science.gov (United States)

Carmi, Raz; Kafri, Galit; Altman, Ami; Goshen, Liran; Planer, David; Sosna, Jacob

2010-03-01

An in-vivo feasibility study of potentially improved atherosclerosis CT imaging is presented. By administration of two different contrast agents to rabbits with induced atherosclerotic plaques we aim at identifying both soft plaque and vessel lumen simultaneously. Initial injection of iodinated nanoparticle (INP) contrast agent (N1177 - Nanoscan Imaging), two to four hours before scan, leads to its later accumulation in macrophage-rich soft plaque, while a second gadolinium contrast agent (Magnevist) injected immediately prior to the scan blends with the aortic blood. The distinction between the two agents in a single scan is achieved with a double-layer dual-energy MDCT (Philips Healthcare) following material separation analysis using the reconstructed images of the different x-ray spectra. A single contrast agent injection scan, where only INP was injected two hours prior to the scan, was compared to a double-contrast scan taken four hours after INP injection and immediately after gadolinium injection. On the single contrast agent scan we observed along the aorta walls, localized iodine accumulation which can point on INP uptake by atherosclerotic plaque. In the double-contrast scan the gadolinium contributes a clearer depiction of the vessel lumen in addition to the lasting INP presence. The material separation shows a good correlation to the pathologies inferred from the conventional CT images of the two different scans while performing only a single scan prevents miss-registration problems and reduces radiation dose. These results suggest that a double-contrast dual-energy CT may be used for advanced clinical diagnostic applications.

Effect of sodium bicarbonate pretreatment on barium coating of mucosa during double contrast barium meal

International Nuclear Information System (INIS)

Kinnunen, J.; Toetterman, S.; Kaila, R.; Pietilae, J.; Linden, H.; Tervahartiala, P.

1983-01-01

The radiographic pattern of the areae gastricae is produced by barium lying in the intersecting furrows of the gastric mucosal surface. However, if the mucus layer on the gastric mucosa is thick, it interferes with the barium coating of the areae gastricae during double contrast barium meal. As sodium bicarbonate decreases the viscosity of mucus and thus may make the gastric mucus layer thinner, it was evaluated as a pretreatment agent in a routine double contrast upper-gastrointestinal study to improve the visualization of the areae gastricae. In a single blind study, 53 of 106 patients took sodium bicarbonate water mixtures at bedtime the day before and on the morning of the examination. According to the results of the present study mucolysis induced by the used doses of sodium bicarbonate does not significantly affect micromucosal visualization during double-contrast barium meal. (orig.) [de

Effect of sodium bicarbonate pretreatment on barium coating of mucosa during double contrast barium meal

Energy Technology Data Exchange (ETDEWEB)

Kinnunen, J.; Toetterman, S.; Kaila, R.; Pietilae, J.; Linden, H.; Tervahartiala, P.

1983-08-01

The radiographic pattern of the areae gastricae is produced by barium lying in the intersecting furrows of the gastric mucosal surface. However, if the mucus layer on the gastric mucosa is thick, it interferes with the barium coating of the areae gastricae during double contrast barium meal. As sodium bicarbonate decreases the viscosity of mucus and thus may make the gastric mucus layer thinner, it was evaluated as a pretreatment agent in a routine double contrast upper-gastrointestinal study to improve the visualization of the areae gastricae. In a single blind study, 53 of 106 patients took sodium bicarbonate water mixtures at bedtime the day before and on the morning of the examination. According to the results of the present study mucolysis induced by the used doses of sodium bicarbonate does not significantly affect micromucosal visualization during double-contrast barium meal.

Comparative study of pneumocystography, positive contrast cystography and double contrast cystography in dogs; Estudio comparativo entre la neumocistografia, la cistografia de contraste positivo y la cistografia de doble contraste en perros

Energy Technology Data Exchange (ETDEWEB)

Thibaut, J.; Parada, E. [Universidad Austral de Chile, Valdivia (Chile); Vargas, L.; Deppe, R.; Born, R.

1997-07-01

In order to compare three radiographic techniques: pneumocystography, positive contrast cystography and double contrast cystography, three series of 24 radiographs each in lateral and ventrodorsal projections were made. Six healthy adult male dogs with weight ranging between 7 and 16 kg were used. Food was withheld for 24 hours and two enemas were made before the series of radiographs were taken. Dogs were anaesthetized with sodium thiopental (20 mg/kg i.v.). The contrast medium was introduced through a urethral catheter. Pneumocystography was performed in the first series introducing air (10 ml/kg) in the bladder. Positive contrast cystography was performed in the second series introducing Hypaque M-60% diluted, contributing 100 mg of iodine per ml (10 ml/kg). In the double contrast cystography Hypaque M-60% diluted (10 ml) was introduced, in concentration of 150 mg of iodine per ml. Then air was introduced (10 ml/kg) through a catheter. Plates were taken in both projections at 1 and 10 minutes for each technique. The radiographic plates of each series were analized comparing the characteristics of radiographic density, outline and size. In neumocystography, positive contrast and double contrast cystography, the radiographic density was predominantly low, high and intermediate, respectively. The radiographic outline was mainly regular for the three techniques. With respect to bladder size, there was a decrease of height and an increase of length and width at 10 minutes. Comparing these three radiographic techniques, it can be concluded that the one that best outlines the bladder mucosa is double contrast. Pneumocystography provides the best image for opaque structures and cystography best shows the position of the urinary bladder [Spanish] Se tomaron 3 series de 24 radiografias cada una, en proyeccion lateral y ventrodorsal. Se trabajo en cada serie con 6 perros machos clinicamente sanos 5 con un peso que vario entre los 7 y 16 kg. Previo a cada serie se efectuo

Effect of subjective knee-joint pain on the laterality of knee extension strength and gait in elderly women.

Science.gov (United States)

Sugiura, Hiroki; Demura, Shinichi

2012-01-01

This study aimed to examine the effect of subjective knee-joint pain on the laterality of knee extension strength and gait in elderly women. The subjects were 144 elderly women (62-94 years old; mean age 76.2±6.0 years; ±S.D.) who were divided into the following groups: 81 persons without knee-pain (no knee-pain group), 39 persons with the subjective pain in right or left knee (single knee-pain group), and 24 persons with the subjective pain in both knees (double knee-pain group). The subjects took a knee extension strength test and a 12 m maximum effort walk test. Knee extension strength, stance time, swing time, stride length, step length and swing speed were selected as parameters. A significant laterality was found in knee extension strength only in the one knee-pain group. The laterality of gait parameters was not found in all groups. In conclusion, elderly women who can perform daily living activity independently, even though having subjective pain in either knee or laterality in knee extension strength exertion show little laterality of gait during short distance walking. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

How does knee pain affect trunk and knee motion during badminton forehand lunges?

Science.gov (United States)

Huang, Ming-Tung; Lee, Hsing-Hsan; Lin, Cheng-Feng; Tsai, Yi-Ju; Liao, Jen-Chieh

2014-01-01

Badminton requires extensive lower extremity movement and a precise coordination of the upper extremity and trunk movements. Accordingly, this study investigated motions of the trunk and the knee, control of dynamic stability and muscle activation patterns of individuals with and without knee pain. Seventeen participants with chronic knee pain and 17 healthy participants participated in the study and performed forehand forward and backward diagonal lunges. This study showed that those with knee pain exhibited smaller knee motions in frontal and horizontal planes during forward lunge but greater knee motions in sagittal plane during backward lunge. By contrast, in both tasks, the injured group showed a smaller value on the activation level of the paraspinal muscles in pre-impact phase, hip-shoulder separation angle, trunk forward inclination range and peak centre of mass (COM) velocity. Badminton players with knee pain adopt a more conservative movement pattern of the knee to minimise recurrence of knee pain. The healthy group exhibit better weight-shifting ability due to a greater control of the trunk and knee muscles. Training programmes for badminton players with knee pain should be designed to improve both the neuromuscular control and muscle strength of the core muscles and the knee extensor with focus on the backward lunge motion.

Double contrast study of the operated stomach in lateroposition

International Nuclear Information System (INIS)

Volodina, G.I.; Novakovskij, A.R.

1986-01-01

Anastomosis was diagnosed in 34 patients, anastomosis ulcer in 3, cancer of the stump in 2, recurrence of stomach polyposis in 1 and cicatrical structure of the jejunum in 1. The great potentialities of a double contrast study of the operated stomach in lateroposition in the differential diagnosis of cancer of the stomach stump, deformities and other diseases were noted. The above method of examination of the operated stomach was recommended as an adjuvant to the commonly used method

Multiparameter double hole contrast detail phantom: Ability to detect image displacement due to off position anode stem

International Nuclear Information System (INIS)

Pauzi, Nur Farahana; Majid, Zafri Azran Abdul; Sapuan, Abdul Halim; Junet, Laila Kalidah; Azemin, Mohd Zulfaezal Che

2015-01-01

Contrast Detail phantom is a quality control tool to analyze the performance of imaging devices. Currently, its function is solely to evaluate the contrast detail characteristic of imaging system. It consists of drilled hole which gives effect to the penetration of x-ray beam divergence to pass through the base of each hole. This effect will lead to false appearance of image from its original location but it does not being visualized in the radiograph. In this study, a new design of Contrast Detail phantom’s hole which consists of double hole construction has been developed. It can detect the image displacement which is due to off position of anode stem from its original location. The double hole differs from previous milled hole, whereby it consists of combination of different hole diameters. Small hole diameter (3 mm) is positioned on top of larger hole diameter (10 mm). The thickness of double hole acrylic blocks is 13 mm. Result revealed that Multiparameter Double Hole Contrast Detail phantom can visualize the shifted flaw image quality produced by x-ray machine due to improper position of the anode stem which is attached to rotor and stator. The effective focal spot of x-ray beam also has been shifted from the center of collimator as a result of off-position anode stem. As a conclusion, the new design of double hole Contrast Detail phantom able to measure those parameters in a well manner

Multiparameter double hole contrast detail phantom: Ability to detect image displacement due to off position anode stem

Energy Technology Data Exchange (ETDEWEB)

Pauzi, Nur Farahana; Majid, Zafri Azran Abdul; Sapuan, Abdul Halim; Junet, Laila Kalidah [Department of Diagnostic Imaging and Radiotherapy, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia, Jalan Istana, 25200, Kuantan, Pahang (Malaysia); Azemin, Mohd Zulfaezal Che [Department of Optometry and Visual Science, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia, Jalan Istana, 25200, Kuantan, Pahang (Malaysia)

2015-04-24

Contrast Detail phantom is a quality control tool to analyze the performance of imaging devices. Currently, its function is solely to evaluate the contrast detail characteristic of imaging system. It consists of drilled hole which gives effect to the penetration of x-ray beam divergence to pass through the base of each hole. This effect will lead to false appearance of image from its original location but it does not being visualized in the radiograph. In this study, a new design of Contrast Detail phantom’s hole which consists of double hole construction has been developed. It can detect the image displacement which is due to off position of anode stem from its original location. The double hole differs from previous milled hole, whereby it consists of combination of different hole diameters. Small hole diameter (3 mm) is positioned on top of larger hole diameter (10 mm). The thickness of double hole acrylic blocks is 13 mm. Result revealed that Multiparameter Double Hole Contrast Detail phantom can visualize the shifted flaw image quality produced by x-ray machine due to improper position of the anode stem which is attached to rotor and stator. The effective focal spot of x-ray beam also has been shifted from the center of collimator as a result of off-position anode stem. As a conclusion, the new design of double hole Contrast Detail phantom able to measure those parameters in a well manner.

Routine filtration for decubitus radiography during double contrast barium enema examinations

International Nuclear Information System (INIS)

Camellini, V.; Abelli, P.; Marconi, G.

1987-01-01

A wedge-shaped plexiglass compensation filter for use in lateral decubitus radiographs of double contrast barium enema examinations has been designed. This filter, which has been used since February 1985, was compared with a second plexiglass filter, made by E-Z-EM. Voltage and amperage were kept contrast. Two different experiments were conducted in order to demonstrate the benefits of routine use of this compensation filter. First, the changes in skin dose were assessed using an ionization chamber on phantom. Secondly, three radiologists examined a series of 80 consecutive barium enemas without knowing which had been performed using the new filter. Out of the 70 examinations they considered excellent, as many as 45 had been performed with the new filter. Personal experience and the studies described show that the use of a compensation filter improves the accuracy and thus the diagnostic quality of the examinations as it enhances the detail of the anatomic structure of the colon; moreover the filter reduces skin exposure by up to 73.1% (EZ-E-EM filter 47.3%) and, at the same time, less radiographic films are needed. Routine use of a plexiglass compensation filter in lateral decubitus radiographs while performing a double contrast barium enema examination, is strongly recommended especially in obese patients

A radiologic evaluation of bladder tumors on barium air double contrast cystography and triple-fractionated cystography

International Nuclear Information System (INIS)

Hur, W. J.; Jang, H. Y.; Sol, C. H.; Kim, B. S.

1984-01-01

Clinically bladder tumors can be easily diagnosed on cystoscopic examination and biopsy in the patients with silent hematuria, terminal dribbling and dysuria. But for the evaluation of the extent of tumor invasion, the authors performed both barium-air double contrast and triple-fractionated cystography on 16 patients suspected to be bladder tumor on cystoscopic examination in the radiologic department of B.N.U.H. from September 1982 to August 1983. The obtained results were summarized as follows. 1. On barium-air double contrast cystography and triple-fractionated cystography, 13 cases were concluded as bladder tumor, and 3 cases were consistent with the findings of chronic inflammation out of the total 16 cases. 2. After operation of 15 cases, 12 cases were confirmed pathologically as transitional cell carcinoma, 1 case as prostatic hypertrophy, and 2 cases as chronic inflammation. Remaining one was biopsied on cystoscopic examination, and confirmed as chronic inflammation. 3. Among 9 cases of transitional cell carcinoma having the evidence of muscle invasion on triple- fractionated cystography, 8 cases were confirmed as more than stage B 1 on pathologic study, and the other as chronic inflammation. 4. In detecting multiplicity, presence of ulceration, and evaluation of nature of tumor surface, barium- air double contrast cystogrpahy was more excellent than cystoscopic results. 5. Cases presenting both ulceration and cauliflower appearance on barium- air double contrast cystography was more than grade III on microscopic evaluation. 6. In conclusion, the authors considers the barium-air double contrast and triple-fractionated cystography are easy to perform, reasonable in price and have relatively high accuracy in tumor detection, staging and grading.

Radiographer and radiologist perception error in reporting double contrast barium enemas: A pilot study

International Nuclear Information System (INIS)

Booth, Alison M.; Mannion, Richard A.J.

2005-01-01

Purpose: The practice of radiographers performing double contrast barium enemas (DCBE) is now widespread and in many centres the radiographer's opinion is, at least, contributing to a dual reporting system [Bewell J, Chapman AH. Radiographer performed barium enemas - results of a survey to assess progress. Radiography 1996;2:199-205; Leslie A, Virjee JP. Detection of colorectal carcinoma on double contrast barium enema when double reporting is routinely performed: an audit of current practice. Clin Radiol 2001;57:184-7; Culpan DG, Mitchell AJ, Hughes S, Nutman M, Chapman AH. Double contrast barium enema sensitivity: a comparison of studies by radiographers and radiologists. Clin Radiol 2002;57:604-7]. To ensure this change in practice does not lead to an increase in reporting errors, this study aimed to compare the perception abilities of radiographers with those of radiologists. Methods: Three gastro-intestinal (GI) radiographers and three consultant radiologists independently reported on a selection of 50 DCBE examinations, including the level of certainty in their comments for each examination. A blinded comparison of the results with an independent 'standard report' was recorded. Results: The results demonstrate there was no significant difference in perception error for any of the levels of certainty, for single reporting, for double reading by a radiographer/radiologist or by two radiologists. Conclusions: The study shows that radiographers can perceive abnormalities on DCBE at similar sensitivities and specificities as radiologists. While the participants in the study may be typical of a district general hospital, the nature of the study gives it limited external validity. As a pilot, the results demonstrate that, with slight modification, the methodology could be used for a larger study

Apixaban or enoxaparin for thromboprophylaxis after knee replacement

DEFF Research Database (Denmark)

Lassen, Michael Rud; Raskob, Gary E; Gallus, Alexander

2009-01-01

thromboprophylaxis with a low risk of bleeding and improved ease of use. METHODS: In a double-blind, double-dummy study, we randomly assigned patients undergoing total knee replacement to receive 2.5 mg of apixaban orally twice daily or 30 mg of enoxaparin subcutaneously every 12 hours. Both medications were started...... (P=0.03). CONCLUSIONS: As compared with enoxaparin for efficacy of thromboprophylaxis after knee replacement, apixaban did not meet the prespecified statistical criteria for noninferiority, but its use was associated with lower rates of clinically relevant bleeding and it had a similar adverse...

The efficacy and safety of S-flurbiprofen plaster in the treatment of knee osteoarthritis: a phase II, randomized, double-blind, placebo-controlled, dose-finding study

Directory of Open Access Journals (Sweden)

Yataba I

2017-04-01

Full Text Available Ikuko Yataba,1 Noboru Otsuka,1 Isao Matsushita,1 Hideo Matsumoto,2 Yuichi Hoshino3 1Taisho Pharmaceutical Co, Ltd, 2Institute for Integrated Sports Medicine, School of Medicine, Keio University, Tokyo, 3Department of Orthopedics Surgery, School of Medicine, Jichi Medical University, Tochigi, Japan Background: Nonsteroidal anti-inflammatory drug (NSAID patches are convenient for use and show much less gastrointestinal side effects than oral NSAIDs, whereas its percutaneous absorption is not sufficient for the expression of clinical efficacy at satisfactory level. S-flurbiprofen plaster (SFPP has shown dramatic improvement in percutaneous absorption results from animal and clinical studies. In this study, the efficacy and safety of SFPP were compared with placebo in patients with knee osteoarthritis (OA to determine its optimal dose. This was a multicenter, randomized, double-blind, parallel-group comparative study. Patients and methods: Enrolled 509 knee OA patients were treated with placebo or SFPP at 10, 20, or 40 mg applied on the affected site once daily for 2 weeks. The primary endpoint for efficacy was improvement in knee pain on rising from the chair assessed by visual analog scale (VAS. The other endpoints were clinical symptoms, pain on walking, and global assessment by both investigator and patient. Safety was evaluated by observing adverse events (AEs. Results: VAS change in knee pain from baseline to trial end was dose-dependent, least squares mean was 29.5, 31.5, 32.0, and 35.6 mm in placebo and SFPP 10, 20, and 40 mg, respectively. A significant difference was observed between placebo and SFPP 40 mg (P=0.001. In contrast, the effect of SFPP at a dose ≤20 mg was not significantly different from that of placebo. The proportion of the patients who achieved 50% pain relief was 72.4% in 40 mg and 51.2% in placebo (P<0.001. In all other endpoints, SFPP 40 mg showed significant improvement compared with placebo. The incidence of AEs was

Compensation filtration for decubitus radiography during double-contrast barium enema examinations

International Nuclear Information System (INIS)

Feczko, P.J.; Haggar, A.M.; Rauch, P.L.; Halpert, R.D.; Simms, S.M.

1983-01-01

Lateral decubitus images obtained during double-contrast barium enema examinations may be difficult to interpret because of the large difference in density between the various parts of the radiographs. Several types of filters are described which can be used to rectify this problem, thus improving the quality of the decubitus radiographs and achieving a slight reduction in radiation exposure

Traditional Chinese Herbal Patch for Short-Term Management of Knee Osteoarthritis: A Randomized, Double-Blind, Placebo-Controlled Trial

Directory of Open Access Journals (Sweden)

Xuezong Wang

2012-01-01

Full Text Available Objective. To assess the short-term efficacy and safety of two kinds of Traditional Chinese herbal patches, Fufang Nanxing Zhitong Gao (FNZG and Shangshi Jietong Gao (SJG, for painful knee osteoarthritis (OA. Methods. Patients were randomly enrolled in a double-blind, placebo-controlled study to receive FNZG (n=60, SJG (n=60, or placebo patch (n=30 for 7 days. Outcome measures included visual analogue scale (VAS, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC, and Traditional Chinese Medicine Syndrome Questionnaire (TCMSQ subscale. Results. Although there was no significant difference among, three groups in short-term pain management, patients receiving FNZG got significant improvement in symptom of fear of coldness as compared with placebo patch (P=0.029. The most common local adverse events of rash, itching, erythema, and slightly damaged skin were observed in 7% of participants. Conclusions. FNZG may be a useful treatment for symptom of knee OA and merits long-term study in broader populations.

Tunable Resonant-Cavity-Enhanced Photodetector with Double High-Index-Contrast Grating Mirrors

DEFF Research Database (Denmark)

Learkthanakhachon, Supannee; Yvind, Kresten; Chung, Il-Sug

2013-01-01

In this paper, we propose a broadband-tunable resonant-cavity-enhanced photodetector (RCE-PD) structure with double high-index-contrast grating (HCG) mirrors and numerically investigate its characteristics. The detector is designed to operate at 1550-nm wavelength. The detector structure consists....... Furthermore, the fact that it can be fabricated on a silicon platform offers us a possibility of integration with electronics.......In this paper, we propose a broadband-tunable resonant-cavity-enhanced photodetector (RCE-PD) structure with double high-index-contrast grating (HCG) mirrors and numerically investigate its characteristics. The detector is designed to operate at 1550-nm wavelength. The detector structure consists...... of a top InP HCG mirror, a p-i-n photodiode embedding multiple quantum wells, and a Si HCG mirror formed in the Si layer of a silicon-on-insulator wafer. The detection wavelength can be changed by moving the top InP HCG mirror suspended in the air. High reflectivity and small penetration length of HCGs...

Simultaneous double-contrast cystography and cystometry in dogs

International Nuclear Information System (INIS)

Mahaffey, M.B.; Barber, D.L.; Barsanti, J.A.; Crowell, W.A.

1984-01-01

Double-contrast cystograms and cystometrograms were performed simultaneously in each of six male and six female dogs with normal urinalyses. The dogs were sedated with oxymorphone and acepromazine. Detrusor reflex occurred in 11 of 12 dogs. After bladder infusion of 0.88 ml/kg of positive-contrast medium, there was mucosal irregularity in eight of 12 dogs and bladder shape distortion in 12 of 12 dogs. Bladder distortion decreased with progressive infusion of CO 2 , and mucosal irregularity was eliminated after infusion of 50–100 ml CO 2 . The bladder neck in all dogs was initially located within the pelvic canal. In ten of 12 dogs, the bladder neck was cranially displaced when the bladder was fully distended. Bladder wall thickness was approximately 1 mm circumferentially at all degrees of distention. There was no discernible difference between bladder shape prior to and at initiation of contraction. It was concluded that radiographic determination of a normal urinary bladder can be made without complete bladder distention and that cystograms and cystometrograms can be routinely performed simultaneously in dogs in which both procedures are required

Efficacy of physiotherapy management of knee joint osteoarthritis: a randomised, double blind, placebo controlled trial

Science.gov (United States)

Bennell, K; Hinman, R; Metcalf, B; Buchbinder, R; McConnell, J; McColl, G; Green, S; Crossley, K

2005-01-01

Objective: To determine whether a multimodal physiotherapy programme including taping, exercises, and massage is effective for knee osteoarthritis, and if benefits can be maintained with self management. Methods: Randomised, double blind, placebo controlled trial; 140 community volunteers with knee osteoarthritis participated and 119 completed the trial. Physiotherapy and placebo interventions were applied by 10 physiotherapists in private practices for 12 weeks. Physiotherapy included exercise, massage, taping, and mobilisation, followed by 12 weeks of self management. Placebo was sham ultrasound and light application of a non-therapeutic gel, followed by no treatment. Primary outcomes were pain measured by visual analogue scale and patient global change. Secondary measures included WOMAC, knee pain scale, SF-36, assessment of quality of life index, quadriceps strength, and balance test. Results: Using an intention to treat analysis, physiotherapy and placebo groups showed similar pain reductions at 12 weeks: –2.2 cm (95% CI, –2.6 to –1.7) and –2.0 cm (–2.5 to –1.5), respectively. At 24 weeks, pain remained reduced from baseline in both groups: –2.1 (–2.6 to –1.6) and –1.6 (–2.2 to –1.0), respectively. Global improvement was reported by 70% of physiotherapy participants (51/73) at 12 weeks and by 59% (43/73) at 24 weeks. Similarly, global improvement was reported by 72% of placebo participants (48/67) at 12 weeks and by 49% (33/67) at 24 weeks (all p>0.05). Conclusions: The physiotherapy programme tested in this trial was no more effective than regular contact with a therapist at reducing pain and disability. PMID:15897310

Intra-articular hyaluronan is without clinical effect in knee osteoarthritis: a multicentre, randomised, placebo-controlled, double-blind study of 337 patients followed for 1 year

DEFF Research Database (Denmark)

Jørgensen, Anette; Stengaard-Pedersen, Kristian; Simonsen, Ole

2010-01-01

OBJECTIVE: To examine the long-term efficacy and safety of five intra-articular injections with hyaluronan in knee osteoarthritis. METHODS: A multicentre, randomised, placebo-controlled double-blind study of 337 patients fulfilling the American College of Rheumatology (ACR) criteria for knee...... osteoarthritis (clinical and laboratory) and with a Lequesne algofunctional index score (LFI) of 10 or greater. Patients received a hyaluronan product (sodium hyaluronate; Hyalgan) (n=167) or saline (n=170) intra-articularly weekly for 5 weeks and were followed up to 1 year. Time to recurrence was the primary...... the ACR criteria for osteoarthritis of the knee with moderate to severe disease activity (LFI > or = 10), five intra-articular injections of hyaluronan did not improve pain, function, paracetamol consumption or other efficacy parameters 3, 6, 9 and 12 months after the treatment....

Patient radiation doses in upper GI examinations: a comparison between conventional and double-contrast techniques.

Science.gov (United States)

Bankvall, G; Owman, T

1982-01-01

A total of 60 patients, divided into 3 groups with 20 patients in each, were examined with 3 different techniques: group 1 -- conventional technique, exposure at 120 kV; group 2 -- double-contrast technique (hypotonic gastrography, HG), exposure at 80 kW; group 3 -- HG, exposure at 120 kV. All examinations were performed in the same examination room and by the same radiologist. Absorbed doses to skin, thyroid, breasts, and gonads as well as energy imparted were measured. The only significant dose enhancements found when using double-contrast instead of conventional technique were in the female breasts and then only if the voltage was in the lower range. With exposure at 120 kV there was little difference in absorbed dose, but a significant advantage with respect to energy was imparted when using a double-contrast technique instead of a conventional technique. The testes doses were very low in all 3 types of examinations, and it seems that use of a testes shield is hardly motivated. With regard to both diagnostic accuracy and patient radiation dose, there can be no reason to use a conventional technique for upper GI examinations.

Contrast-enhanced MRI findings of the knee in healthy children; establishing normal values

Energy Technology Data Exchange (ETDEWEB)

Hemke, Robert; Maas, Mario [University of Amsterdam, Department of Radiology and Nuclear Medicine, Academic Medical Center, Amsterdam (Netherlands); Berg, J.M. van den; Schonenberg-Meinema, Dieneke; Kuijpers, Taco W. [University of Amsterdam, Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Diseases, Emma Children' s Hospital AMC, Amsterdam (Netherlands); Nusman, Charlotte M. [University of Amsterdam, Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Diseases, Emma Children' s Hospital AMC, Amsterdam (Netherlands); Onze Lieve Vrouwe Gasthuis (OLVG), Department of Pediatrics, Amsterdam (Netherlands); Gulik, E.C. van; Barendregt, Anouk M. [University of Amsterdam, Department of Radiology and Nuclear Medicine, Academic Medical Center, Amsterdam (Netherlands); University of Amsterdam, Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Diseases, Emma Children' s Hospital AMC, Amsterdam (Netherlands); Dolman, Koert M. [Onze Lieve Vrouwe Gasthuis (OLVG), Department of Pediatrics, Amsterdam (Netherlands); Reade, Department of Pediatric Rheumatology, Amsterdam (Netherlands)

2018-03-15

To define normative standards for the knee in healthy children using contrast-enhanced MRI, focusing on normal synovial membrane thickness. Secondly, presence of joint fluid and bone marrow oedema was evaluated. For this study, children without disorders potentially resulting in (accompanying) arthritis were included. Patients underwent clinical assessments, followed by contrast-enhanced MRI. MRI features were evaluated in consensus using the Juvenile Arthritis MRI Scoring (JAMRIS) system. Additionally, the presence of joint fluid was evaluated. No cartilage lesions or bone abnormalities were observed. We included 57 healthy children. The overall mean thickness of the normal synovial membrane was 0.4 mm (min-max; 0.0-1.8mm). The synovium was thickest around the cruciate ligaments and retropatellar and suprapatellar regions. The mean overall diameter of the largest pocket of joint fluid was 2.8 mm (min-max; 0.9-8.0mm). Bone marrow changes were observed in three children (all in the apex patellae). The normal synovial membrane was maximally 1.8 mm thick, indicating that the JAMRIS cut-off value of 2 mm can be considered a valid measure for evaluating synovial hypertrophy. Some joint fluid and bone marrow changes suggestive of bone marrow oedema in the apex patellae can be seen in healthy children. (orig.)

Contrast-enhanced MRI findings of the knee in healthy children; establishing normal values

International Nuclear Information System (INIS)

Hemke, Robert; Maas, Mario; Berg, J.M. van den; Schonenberg-Meinema, Dieneke; Kuijpers, Taco W.; Nusman, Charlotte M.; Gulik, E.C. van; Barendregt, Anouk M.; Dolman, Koert M.

2018-01-01

To define normative standards for the knee in healthy children using contrast-enhanced MRI, focusing on normal synovial membrane thickness. Secondly, presence of joint fluid and bone marrow oedema was evaluated. For this study, children without disorders potentially resulting in (accompanying) arthritis were included. Patients underwent clinical assessments, followed by contrast-enhanced MRI. MRI features were evaluated in consensus using the Juvenile Arthritis MRI Scoring (JAMRIS) system. Additionally, the presence of joint fluid was evaluated. No cartilage lesions or bone abnormalities were observed. We included 57 healthy children. The overall mean thickness of the normal synovial membrane was 0.4 mm (min-max; 0.0-1.8mm). The synovium was thickest around the cruciate ligaments and retropatellar and suprapatellar regions. The mean overall diameter of the largest pocket of joint fluid was 2.8 mm (min-max; 0.9-8.0mm). Bone marrow changes were observed in three children (all in the apex patellae). The normal synovial membrane was maximally 1.8 mm thick, indicating that the JAMRIS cut-off value of 2 mm can be considered a valid measure for evaluating synovial hypertrophy. Some joint fluid and bone marrow changes suggestive of bone marrow oedema in the apex patellae can be seen in healthy children. (orig.)

Influence of delayed gadolinium enhanced MRI of cartilage (dGEMRIC) protocol on T2-mapping: is it possible to comprehensively assess knee cartilage composition in one post-contrast MR examination at 3 Tesla?

Science.gov (United States)

Verschueren, J; van Tiel, J; Reijman, M; Bron, E E; Klein, S; Verhaar, J A N; Bierma-Zeinstra, S M A; Krestin, G P; Wielopolski, P A; Oei, E H G

2017-09-01

To evaluate the possibility of assessing knee cartilage with T2-mapping and delayed gadolinium enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC) in one post-contrast MR examination at 3 Tesla (T). T2 mapping was performed in 10 healthy volunteers at baseline; directly after baseline; after 10 min of cycling; and after 90 min delay, and in 16 osteoarthritis patients before and after intravenous administration of a double dose gadolinium dimeglumine contrast agent, reflecting key dGEMRIC protocol elements. Differences in T2 relaxation times between each timepoint and baseline were calculated for 6 cartilage regions using paired t tests or Wilcoxon signed-rank tests and the smallest detectable change (SDC). After cycling, a significant change in T2 relaxation times was found in the lateral weight-bearing tibial plateau (+1.0 ms, P = 0.04). After 90 min delay, significant changes were found in the lateral weight-bearing femoral condyle (+1.2 ms, P = 0.03) and the lateral weight-bearing tibial plateau (+1.3 ms, P = 0.01). In these regions of interests (ROIs), absolute differences were small and lower than the corresponding SDCs. T2-mapping after contrast administration only showed statistically significantly lower T2 relaxation times in the medial posterior femoral condyle (-2.4 ms, P T2 relaxation times that were not consistent and lower than the SDC in the majority of regions, our results suggest that T2-mapping and dGEMRIC can be performed reliably in a single imaging session to assess cartilage biochemical composition in knee osteoarthritis (OA) at 3 T. Copyright © 2017 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Double contrast barium enema: technique, indications, results and limitations of a conventional imaging methodology in the MDCT virtual endoscopy era.

Science.gov (United States)

Rollandi, Gian Andrea; Biscaldi, Ennio; DeCicco, Enzo

2007-03-01

The double contrast barium enema of the colon continues to be a diffused conventional radiological technique and allows for the diagnosis of neoplastic and inflammatory pathology. After the '70s, a massive initiative is undertaken to simplify, perfect and encode the method of the double contrast barium enema: Altaras from Germany, Miller from USA and Cittadini from Italy are responsible for the perfection of this technique in the last 30 years. The tailored patient preparation, a perfect technique of execution and a precise radiological documentation are essentials steps to obtain a reliable examination. The main limit of double contrast enema is that it considers the pathology only from the mucosal surface. In neoplastic pathology evaluation the main limit is the "T" parameter staging, but more limited are the "N" and "M" parameters evaluation. Today the double contrast technique continues to be a refined, sensitive and specific diagnostic method, moreover, diagnostic results cannot compete with the new CT multislice techniques (CT-enteroclysis and virtual colonoscopy) which can examine both the lumen and the wall of the colon. The double contrast is a cheap and simple examination but in the next future is predictably a progressive substitution of conventional radiology from new multislice techniques, because the cross sectional imaging is more frequently able to detect causes of the symptoms whether resulting both from colonic or non colonic origin.

Double contrast barium enema: Technique, indications, results and limitations of a conventional imaging methodology in the MDCT virtual endoscopy era

International Nuclear Information System (INIS)

Rollandi, Gian Andrea; Biscaldi, Ennio; DeCicco, Enzo

2007-01-01

The double contrast barium enema of the colon continues to be a diffused conventional radiological technique and allows for the diagnosis of neoplastic and inflammatory pathology. After the '70s, a massive initiative is undertaken to simplify, perfect and encode the method of the double contrast barium enema: Altaras from Germany, Miller from USA and Cittadini from Italy are responsible for the perfection of this technique in the last 30 years. The tailored patient preparation, a perfect technique of execution and a precise radiological documentation are essentials steps to obtain a reliable examination. The main limit of double contrast enema is that it considers the pathology only from the mucosal surface. In neoplastic pathology evaluation the main limit is the 'T' parameter staging, but more limited are the 'N' and 'M' parameters evaluation. Today the double contrast technique continues to be a refined, sensitive and specific diagnostic method, moreover, diagnostic results cannot compete with the new CT multislice techniques (CT-enteroclysis and virtual colonoscopy) which can examine both the lumen and the wall of the colon. The double contrast is a cheap and simple examination but in the next future is predictably a progressive substitution of conventional radiology from new multislice techniques, because the cross sectional imaging is more frequently able to detect causes of the symptoms whether resulting both from colonic or non colonic origin

Knee arthrography today

International Nuclear Information System (INIS)

Otto, H.; Kallenberger, R.

1987-01-01

The role of knee arthrography today is demonstrated and technical problems are discussed. Among a lot of variants the position of the patient and the choice of contrast media play a great part concerning the result of the examination. Mild complications occur in 0.25% of the examinations, severe and live threatening complications are extremely rare. Diagnosis of meniscal lesions is most important for knee arthrography; arthroscopy and arthrography are complementary examinations and not mutually exclusive, they achieve combined an accuracy of 97-98%. In the same way arthrography is able to evaluate the condropathy of the femoro-tibial joint, whereas accuracy of arthroscopy in the diagnosis of patellar chondropathy is much higher. There is a great reliability of arthrography regarding the evaluation of lesions of the capsule, but accuracy in lesions of the cruciate ligaments is low. Arthrography is very suitable for evaluation of Baker-cysts, since indications for almost occuring internal derangement of the knee are even available. Knee arthrography is a complex and safe procedure with very less discomfort for the patient; it has a central position in the evaluation of lesions of the knee. (orig.) [de

A modified per os double contrast examination of the colon in the elderly

International Nuclear Information System (INIS)

Papadaki, P.J.; Vassiliou, P.M.; Zavras, G.M.; Kounis, N.G.; Hadjioannou, N.; Fezoulidis, I.B.; Manolakis, P.; Kelekis, D.

1993-01-01

A modified per os double contrast examination of the colon was used in 62 elderly patients in whom conventional barium enema had been unsuccessful. We created endogenous gas generation instead of air insufflation by per os administration of a special mixture containing barium sulftate, lactulose and gastrographin. Good quality double contrast images of the colon were obtained after 12 hours in 59 of the 62 patients. The sensitivity of the method was 100% in 6 patients suffering from carcinoma and in 15 patients suffering from diverticular disease. However, the method failed to demonstrate small solitary polyps in 5 patients and it was also negative in another 27 patients. 7 of these had negative endoscopy and in the remaining a definite diagnosis was not established by any other method. It seems that this method may become an alternative for investigation of suspected colonic pathology in the elderly patients with difficulty in retaining the barium enema. (orig.) [de

A modified per os double contrast examination of the colon in the elderly

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Papadaki, P J [Radiology Department, NIMTS General Hospital, Athens, and Radiology Department, Medical School, University of Patras (Greece); Vassiliou, P M [Radiology Department, NIMTS General Hospital, Athens, and Radiology Department, Medical School, University of Patras (Greece); Zavras, G M [Radiology Department, NIMTS General Hospital, Athens, and Radiology Department, Medical School, University of Patras (Greece); Kounis, N G [Radiology Department, NIMTS General Hospital, Athens, and Radiology Department, Medical School, University of Patras (Greece); Hadjioannou, N [Radiology Department, NIMTS General Hospital, Athens, and Radiology Department, Medical School, University of Patras (Greece); Fezoulidis, I B [Radiology Department, NIMTS General Hospital, Athens, and Radiology Department, Medical School, University of Patras (Greece); Manolakis, P [Radiology Department, NIMTS General Hospital, Athens, and Radiology Department, Medical School, University of Patra

1993-04-01

A modified per os double contrast examination of the colon was used in 62 elderly patients in whom conventional barium enema had been unsuccessful. We created endogenous gas generation instead of air insufflation by per os administration of a special mixture containing barium sulftate, lactulose and gastrographin. Good quality double contrast images of the colon were obtained after 12 hours in 59 of the 62 patients. The sensitivity of the method was 100% in 6 patients suffering from carcinoma and in 15 patients suffering from diverticular disease. However, the method failed to demonstrate small solitary polyps in 5 patients and it was also negative in another 27 patients. 7 of these had negative endoscopy and in the remaining a definite diagnosis was not established by any other method. It seems that this method may become an alternative for investigation of suspected colonic pathology in the elderly patients with difficulty in retaining the barium enema. (orig.)

Colorectal cancer: screening double-contrast barium enema examination in average-risk adults older than 50 years.

Science.gov (United States)

Kung, Justin W; Levine, Marc S; Glick, Seth N; Lakhani, Paras; Rubesin, Stephen E; Laufer, Igor

2006-09-01

To retrospectively determine the diagnostic yield of double-contrast barium enema examinations performed for colorectal cancer screening of neoplasms 1 cm or larger or advanced neoplastic lesions of any size in average-risk adults older than 50 years. The Institutional Review Board at the affiliated Veterans Affairs Medical Center approved this HIPAA-compliant study protocol and did not require informed consent from patients. Computerized databases revealed 276 double-contrast barium enema examinations performed for colorectal cancer screening in average-risk adults older than 50 years. Radiographic and pathologic reports were reviewed to determine the number of patients who had polypoid lesions 1 cm or larger, polyps smaller than 1 cm, or advanced neoplastic lesions of any size. Forty-five (16.3%) of the 276 patients underwent follow-up sigmoidoscopy or colonoscopy. Medical, endoscopic, and pathologic records were reviewed and compared with radiographic findings. The results of double-contrast barium enema examination revealed 74 (26.8%) of 276 patients with 104 polypoid lesions in the colon, including 32 patients (11.6%) with 41 polypoid lesions 1 cm or larger, 15 patients (5.4%) with 19 polyps 6-9 mm, and 27 patients (9.8%) with 44 polyps 5 mm or smaller. Endoscopy was performed in 24 (75%) of 32 patients, the results of which confirmed 23 (72%) of 32 radiographically diagnosed lesions 1 cm or larger in 16 (67%) of 24 patients. In two of these individuals, the polyps were hyperplastic. The remaining 14 patients had a total of 21 neoplastic lesions 1 cm or larger, including 11 tubular adenomas, seven tubulovillous adenomas, one villous adenoma with marked dysplasia, and two cancers. The diagnostic yield of screening double-contrast barium enema examination was 5.1% (14 of 276 patients) for neoplastic lesions 1 cm or larger and 6.2% (17 of 276 patients) for advanced neoplastic lesions of any size. Double-contrast barium enema examinations performed in average

Radiographical diagnosis of posttraumatic knee joints hemarthrosis and lipohemarthrosis

International Nuclear Information System (INIS)

Li Shuling; Liu Xulin; Ma Heng; Zhang Guanghui; Zhou Chengtao; Tang Xiaofeng; Li Wenle; Liu Zhongguang; Zhang Baozheng; Sun Qingju

2008-01-01

Objective: To explore the imaging findings and diagnostic values of X-ray, CT, MR, and ultrasonography in traumatic knee joints hemarthrosis and lipohemarthrosis. Methods: Traumatic knee joints hemarthrosis (12 knees) and lipohemarthrosis (18 knees) proved by operation (27 knees) or puncturation (3 knees) were included in the study. Horizontal-beam plain radiographs (16 knees), CT (30 knees), MRI (30 knees) and ultrasonography (24 knees) in supine position were investigated. Results (1)supine position horizontal-beam plain radiographs: Fat-liquid layer was found in 8 cases of lipohemarthrosis. Dense supragenual bursa was found in 1 case of lipohemarthrosis and 7 cases of hemarthrosis. Fracture (13 knees) was diagnosed correctly. (2) CT findings: double fluid-fluid layer was found in 11 of all 18 cases, and single fluid-fluid layer was found in 7 of 11 cases of lipohemarthrosis. Single fluid-fluid layer was found in 3 of 12 cases of hemarthrosis. Isodensity was detected in 9 cases, and high- density blood clot was found in 4 cases. Fracture (30 knees) was diagnosed correctly. (3) MRI findings: in 12 of 18 cases of lipohemarthrosis, double fluid-fluid layer was shown including supernatant layer as short T 1 , long T 2 signal and low signal after fat-suppression, middle layer as long T 1 , long T 2 signal and high signal after fat-suppression, and dependent layer as iso-T 1 , iso-T 2 and slight high signal after fat- suppression. Single fluid-fluid layer was seen in 6 cases, only had aforementioned upper and under layer. Only aforementioned supernatant layer and dependent layer were seen in 12 cases of hemarthrosis. 4 cases showed entire blood clot in fluid, T 1 WI showed middle signal or center iso-signal accompanied with peripheral high signal ring, and fat-suppression imaging showed high signal. T 2 WI and fat-suppression imaging showed middling or high signal accompanied with peripheral low signal ring. Fracture (30 knees) was diagnosed correctly. (4) Ultrasound

Combined nuclear and digital subtraction contrast arthrography in painful knee prosthesis

International Nuclear Information System (INIS)

Namasivayam, J.; Forrester, A.; Poon, F.W.; Cuthbert, G.F.; McKillop, J.H.; Bryan, A.S.

1992-01-01

The evaluation of a painful knee prosthesis remains a difficult problem for both orthopaedic surgeons and radiologists. We have compared digital subtraction arthrography with nuclear-arthrography in 7 patients with a painful knee prosthesis. Three patients showed a loose tibial component, demonstrated by both digital subtraction and nuclear arthrography. All 3 underwent revision of their prosthesis. One patient had an equivocal digital subtraction arthrogram and negative nuclear arthrogram, while both studies were negative in the 3 remaining patients. Nuclear arthrography is a simple procedure and can provide useful additional information when combined with digital subtraction arthrography. (orig.)

Use of radiographic projections of knee

International Nuclear Information System (INIS)

Cockshott, W.P.; Burrows, D.A.; Ferrier, M.

1985-01-01

A study to determine the routine radiography practice for the investigation of acute trauma cases and those with suspected arthritis of the knee was carried out by questionnaires sent to radiologists in 41 countries. The role of radiology in the investigation of chondromalacia patellae was also ascertained. Some of the reasons for the diversities of practice are discussed. The necessity for further views of the knee to supplement the two standard projections was assessed for various diagnostic entities. It became clear that if occult fractures were not to be missed, patients with knee effusions following acute trauma required additional views if a lesion was not shown by the anteroposterior (AP) and lateral views. In contrast, two views of the knee sufficed for examination of most entities affecting the knee. (orig.)

Use of radiographic projections of knee

Energy Technology Data Exchange (ETDEWEB)

Cockshott, W.P.; Burrows, D.A.; Ferrier, M.; Racoveanu, N.T.

1985-02-01

A study to determine the routine radiography practice for the investigation of acute trauma cases and those with suspected arthritis of the knee was carried out by questionnaires sent to radiologists in 41 countries. The role of radiology in the investigation of chondromalacia patellae was also ascertained. Some of the reasons for the diversities of practice are discussed. The necessity for further views of the knee to supplement the two standard projections was assessed for various diagnostic entities. It became clear that if occult fractures were not to be missed, patients with knee effusions following acute trauma required additional views if a lesion was not shown by the anteroposterior (AP) and lateral views. In contrast, two views of the knee sufficed for examination of most entities affecting the knee.

Double-contrast examination of the gastric antrum without Duodenal superposition

International Nuclear Information System (INIS)

Treugut, H.; Isper, J.

1980-01-01

By using a modified technique of double-contrast examination of the stomach it was possible in 75% to perform a study without superposition of the duodenum and jejunum on the distal stomach compared to 36% with the usual method. In this technique a small amount (50 ml) of Barium-suspension is given to the patient in left decubitus position by a straw or gastric tube after antiperistaltic medication. There was no difference in the quality of mucosa-coating compared to the technique using higher volumes of Barium. (orig.) [de

Efficacy and safety of strontium ranelate in the treatment of knee osteoarthritis: results of a double-blind, randomised placebo-controlled trial

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Jean-Yves Reginster

2013-01-01

Full Text Available Objective. Background Strontium ranelate is currently used for osteoporosis. The international, double-blind, randomised, placebo-controlled Strontium ranelate Efficacy in Knee OsteoarthrItis triAl evaluated its effect on radiological progression of knee osteoarthritis.Methods. Patients with knee osteoarthritis (Kellgren and Lawrence grade 2 or 3, and joint space width (JSW 2.5-5 mm were randomly allocated to strontium ranelate 1 g/day (n=558, 2 g/day (n=566 or placebo (n=559. The primary endpoint was radiographical change in JSW (medial tibiofemoral compartment over 3 years versus placebo. Secondary endpoints included radiological progression, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC score, and knee pain. The trial is registered (ISRCTN41323372.Results. The intention-to-treat population included 1371 patients. Treatment with strontium ranelate was associated with smaller degradations in JSW than placebo (1 g/day: -0.23 (SD 0.56 mm; 2 g/day: -0.27 (SD 0.63 mm; placebo:-0.37 (SD 0.59 mm; treatment-placebo differences were 0.14 (SE 0.04, 95% CI 0.05 to 0.23, p<0.001 for 1 g/day and 0.10 (SE 0.04, 95% CI 0.02 to 0.19, p=0.018 for 2 g/day. Fewer radiological progressors were observed withstrontium ranelate (p<0.001 and p=0.012 for 1 and 2 g/day. There were greater reductions in total WOMAC score (p=0.045, pain subscore (p=0.028, physical function subscore (p=0.099 and knee pain (p=0.065 with strontium ranelate 2 g/day. Strontium ranelate was well tolerated. Conclusions. Treatment with strontium ranelate 1 and 2 g/day is associated with a significant effect on structure in patients with knee osteoarthritis, and a beneficial effect on symptoms for strontium ranelate 2 g/day.Additional supplementary data are published online only. To view these files please visit the journal online (http://dx.doi. org/10.1136/annrheumdis-2012-202231

Intra-articular morphine versus bupivacaine for knee motion among patients with osteoarthritis: randomized double-blind clinical trial

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Miriam Bellini Gazi

Full Text Available CONTEXT AND OBJECTIVE: Osteoarthritis causes pain and disability in a high percentage of elderly people. The aim of the present study was to assess the efficacy of intra-articular morphine and bupivacaine on the joint flexion and extension angles of patients with knee osteoarthritis. DESIGN AND SETTING: A randomized double-blind study was performed at a pain clinic of Universidade Federal de São Paulo. METHODS: Thirty-nine patients with pain for more than three months, of intensity greater than three on a numerical scale (zero to 10, were included. G1 patients received 1 mg (1 ml of morphine diluted in 9 ml of saline, intra-articularly, and G2 patients received 25 mg (10 ml of 0.25% bupivacaine without epinephrine. Pain was assessed on a numerical scale and knee flexion and extension angles were measured after administration of the drugs at rest and during movement. The total amount of analgesic supplementation using 500 mg doses of paracetamol was also determined. RESULTS: No significant difference in pain intensity was observed between G1 and G2. Significant decreases in pain at rest and during movement and significant increases in mean flexion and extension angles were observed in both groups, with no significant difference between the two groups. The mean total amount of paracetamol used over a seven-day period was 3578 mg in G1 and 5333 mg in G2 (P = 0.2355; Mann-Whitney test. CONCLUSION: The analgesic effects of 1 mg of morphine and 25 mg of 0.25% bupivacaine were similar among patients with osteoarthritis of the knee.

Chondromalacia of the knee: evaluation with a fat-suppression three-dimensional SPGR imaging after intravenous contrast injection.

Science.gov (United States)

Suh, J S; Cho, J H; Shin, K H; Kim, S J

1996-01-01

Twenty-one MRI studies with a fat-suppression three-dimensional spoiled gradient-recalled echo in a steady state (3D SPGR) pulse sequence after intravenous contrast injection were evaluated to assess the accuracy in depicting chondromalacia of the knee. On the basis of MR images, chondromalacia and its grade were determined in each of five articular cartilage regions (total, 105 regions) and then the results were compared to arthroscopic findings. The sensitivity, specificity, and accuracy of MRI were 70%, 99%, and 93%, respectively. MR images depicted 7 of 11 lesions of arthroscopic grade 1 or 2 chondromalacia, and seven of nine lesions of arthroscopic grade 3 or 4 chondromalacia. The cartilage abnormalities in all cases appeared as focal lesions with high signal intensity. Intravenous contrast-injection, fat-suppression 3D SPGR imaging showed high specificity in excluding cartilage abnormalities and may be considered as an alternative to intra-articular MR arthrography when chondromalacia is suspected.

[The value of double contrast arthrotomography combined with cinematography in the diagnosis of functional and structural TMJ alterations].

Science.gov (United States)

Engelke, W; Grossniklaus, B; Sailer, H F

1991-01-01

Double contrast arthrotomography combined with cinematography as a diagnostic instrument establishing functional and structural TMJ alterations is evaluated for its diagnostic value and reliability within the chain of diagnostic measures applied. In 131 patients double-contrast arthrotomography was followed by a comprehensive history of joint problems, and verification of the clinical findings as well as the arthrographic diagnosis and the post-arthrographic TMJ alterations. Our interest was focussed, among others, on the question whether arthrography alone would have any therapeutic effect or produce an alteration in TMJ function.

Intra-Articular, Single-Shot Hylan G-F 20 Hyaluronic Acid Injection Compared with Corticosteroid in Knee Osteoarthritis: A Double-Blind, Randomized Controlled Trial.

Science.gov (United States)

Tammachote, Nattapol; Kanitnate, Supakit; Yakumpor, Thanasak; Panichkul, Phonthakorn

2016-06-01

The treatment of knee osteoarthritis with hyaluronic acid or corticosteroid injection has been widely used. The purpose of this study was to compare the efficacy of hyaluronic acid (hylan G-F 20) with triamcinolone acetonide as a single intra-articular injection for knee osteoarthritis. This study was a prospective, randomized, double-blind clinical trial. Participants with symptomatic knee osteoarthritis were recruited. They were randomized to receive a single-shot, intra-articular injection of either 6 mL of hylan G-F 20 or 6 mL of a solution comprising 1 mL of 40-mg triamcinolone acetonide and 5 mL of 1% lidocaine with epinephrine. The primary outcomes were knee pain severity, knee function, and range of motion at 6 months. Ninety-nine patients were assessed before injection and underwent a 6-month follow-up. Patients and evaluators were blinded. Multilevel regression models were used to estimate differences between the groups. At the 6-month follow-up, compared with patients who took hylan G-F 20, patients who took triamcinolone acetonide had similar improvement in knee pain, knee function, and range of motion. The difference in mean outcome scores between groups was, with regard to knee pain, a visual analog scale (VAS) score of 3 points (95% confidence interval [95% CI], -6 to 11 points); with regard to knee function, a modified Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score of 0 points (95% CI, -8 to 6 points); and, with regard to range of motion, flexion of -1° (95% CI, -5° to 2°) and extension of 0° (95% CI, -0.5° to 0.5°). However, patients who took triamcinolone acetonide had better pain improvement from 24 hours until 1 week after injection; the mean difference between groups with regard to the VAS score was 12 points (95% CI, 5 to 20 points; p = 0.002) at 24 hours and 9 points (95% CI, 1 to 15 points; p = 0.018) at 1 week. At 2 weeks after injection, patients who took triamcinolone acetonide also had better knee

Significance of demonstrating areae gastricae at hypotonic double contrast examination of the stomach

Energy Technology Data Exchange (ETDEWEB)

Rienmueller, R. (Muenchen Univ. (Germany, F.R.). Klinik und Poliklinik fuer Radiologie)

1980-05-01

150 patients were examined by the double contrast-technique in drug-induced hypotonia of the stomach. They were examined gastroscopically and at the same time biopsies were taken. Comparison of histological and radiological results was performed. There was found an agreement of 82% in the performance of areae gastricae and the histological diagnosis of chronic gastritis.

Efficacy of double inversion recovery magnetic resonance imaging for the evaluation of the synovium in the femoro-patellar joint without contrast enhancement

Energy Technology Data Exchange (ETDEWEB)

Son, Ye Na; Jin, Wook; Jahng, Geon-Ho; Park, Yong Sung; Park, So Young [Kyung Hee University School of Medicine, Department of Radiology, Kyung Hee University Hospital at Gangdong, Seoul (Korea, Republic of); Cha, Jang Gyu [Soonchunhyang University Bucheon Hospital, Department of Radiology, Bucheon-si, Gyeonggi-do (Korea, Republic of); Yun, Seong Jong [Kyung Hee University School of Medicine, Department of Radiology, Kyung Hee University Hospital at Gangdong, Seoul (Korea, Republic of); Department of Radiology, Aerospace Medical Center, Republic of Korea Air Force, Cheongwon-gun, Chungcheongbuk-do (Korea, Republic of); Park, Ji Seon; Ryu, Kyung Nam [Kyung Hee University Hospital, Department of Radiology, Seoul (Korea, Republic of)

2018-02-15

To investigate the efficacy of double inversion recovery (DIR) sequence for evaluating the synovium of the femoro-patellar joint without contrast enhancement (CE). Two radiologists independently evaluated the axial DIR and CE T1-weighted fat-saturated (CET1FS) images of 33 knees for agreement; the visualisation and distribution of the synovium were evaluated using a four-point visual scaling system at each of the five levels of the femoro-patellar joint and the location of the thickest synovium. The maximal synovial thickness at each sequence was measured by consensus. The interobserver agreement was good (κ = 0.736) for the four-point scale, and was excellent for the location of the thickest synovium on DIR and CET1FS (κ = 0.955 and 0.954). The intersequential agreement for the area with the thickest synovium was also excellent (κ = 0.845 and κ = 0.828). The synovial thickness on each sequence showed excellent correlation (r = 0.872). The DIR showed as good a correlation as CET1FS for the evaluation of the synovium at the femoro-patellar joint. DIR may be a useful MR technique for evaluating the synovium without CE. (orig.)

Use of mucolytic agents and guaran HEPART (HP-7000) for the detection of mucosal villi in double contrast barium studies of the small intestine

International Nuclear Information System (INIS)

Desaga, J.F.

1987-01-01

It was the aim of this study to enhance the visualisation of mucosal villi by double contrast barium studies of the small bowel. Prior to the radiological examination a 2-day pretreatment with the mucolytic agents acetylcysteine or carbocisteine was effected. Double contrast studies were performed with a high-molecular fraction of guaran HEPART (HP-7000), a hydrocolloidal isolated from the seed endosperm of C. tetragonolobus added into contrast-medium and distention medium. Compared to double contrast studies without mucolytic therapy, this procedure results in a better transparency and demonstration of the mucosal villi shown by a granular pattern in the radiographs. High quality visualisation of intestinal villi was achieved in all patients studied. A 2-day pretreatment with carbocisteine or acetylcysteine and the use of guaran in the double contrast barium study of the small bowel results in a greatly enhanced visualisation of mucosal villi. (orig.) [de

Ayurvedic medicine offers a good alternative to glucosamine and celecoxib in the treatment of symptomatic knee osteoarthritis: a randomized, double-blind, controlled equivalence drug trial.

Science.gov (United States)

Chopra, Arvind; Saluja, Manjit; Tillu, Girish; Sarmukkaddam, Sanjeev; Venugopalan, Anuradha; Narsimulu, Gumdal; Handa, Rohini; Sumantran, Venil; Raut, Ashwinikumar; Bichile, Lata; Joshi, Kalpana; Patwardhan, Bhushan

2013-08-01

To demonstrate clinical equivalence between two standardized Ayurveda (India) formulations (SGCG and SGC), glucosamine and celecoxib (NSAID). Ayurvedic formulations (extracts of Tinospora cordifolia, Zingiber officinale, Emblica officinalis, Boswellia serrata), glucosamine sulphate (2 g daily) and celecoxib (200 mg daily) were evaluated in a randomized, double-blind, parallel-efficacy, four-arm, multicentre equivalence drug trial of 24 weeks duration. A total of 440 eligible patients suffering from symptomatic knee OA were enrolled and monitored as per protocol. Primary efficacy variables were active body weight-bearing pain (visual analogue scale) and modified WOMAC pain and functional difficulty Likert score (for knee and hip); the corresponding a priori equivalence ranges were ±1.5 cm, ±2.5 and ±8.5. Differences between the intervention arms for mean changes in primary efficacy variables were within the equivalence range by intent-to-treat and per protocol analysis. Twenty-six patients showed asymptomatic increased serum glutamic pyruvic transaminase (SGPT) with otherwise normal liver function; seven patients (Ayurvedic intervention) were withdrawn and SGPT normalized after stopping the drug. Other adverse events were mild and did not differ by intervention. Overall, 28% of patients withdrew from the study. In this 6-month controlled study of knee OA, Ayurvedic formulations (especially SGCG) significantly reduced knee pain and improved knee function and were equivalent to glucosamine and celecoxib. The unexpected SGPT rise requires further safety assessment. Clinical Drug Trial Registry-India, www.ctri.nic.in, CTRI/2008/091/000063.

The failed postoperative shoulder: Role of double contrast CT arthrography

International Nuclear Information System (INIS)

Singson, R.D.; Feldman, F.; Bigliani, L.

1986-01-01

Various types of reparative and corrective operations on the shoulder joint are being increasingly undertaken. Defining residual, new, or acutely acquired pathology in the postoperative period is exceedingly difficult because of extensive surgical alterations. Since patients may be symptomatic or recurrently symptomatic postoperatively, judgments must be made regarding the failure of the initial repair, or new superimposed insults. CT double-contrast arthrography, performed in a series of symptomatic patients after shoulder arthroplasty for instability, successfully demonstrated responsible residual or recurrent pathologic processes, including persistent Bankart lesions, glenoid rim fractures, improper hardware placement, and migration of metallic hardware. These and other examples of pathology are illustrated and discussed

An improved contrast enhancement algorithm for infrared images based on adaptive double plateaus histogram equalization

Science.gov (United States)

Li, Shuo; Jin, Weiqi; Li, Li; Li, Yiyang

2018-05-01

Infrared thermal images can reflect the thermal-radiation distribution of a particular scene. However, the contrast of the infrared images is usually low. Hence, it is generally necessary to enhance the contrast of infrared images in advance to facilitate subsequent recognition and analysis. Based on the adaptive double plateaus histogram equalization, this paper presents an improved contrast enhancement algorithm for infrared thermal images. In the proposed algorithm, the normalized coefficient of variation of the histogram, which characterizes the level of contrast enhancement, is introduced as feedback information to adjust the upper and lower plateau thresholds. The experiments on actual infrared images show that compared to the three typical contrast-enhancement algorithms, the proposed algorithm has better scene adaptability and yields better contrast-enhancement results for infrared images with more dark areas or a higher dynamic range. Hence, it has high application value in contrast enhancement, dynamic range compression, and digital detail enhancement for infrared thermal images.

Development of an above-knee prosthesis equipped with a microcomputer-controlled knee joint: first test results.

Science.gov (United States)

Aeyels, B; Peeraer, L; Vander Sloten, J; Van der Perre, G

1992-05-01

The shortcomings of conventional above-knee prostheses are due to their lack of adaptive control. Implementation of a microcomputer controlling the knee joint in a passive way has been suggested to enhance the patient's gait comfort, safety and cosmesis. This approach was used in the design of a new prosthetic system for the above-knee amputee, and tested on one patient. The knee joint of a conventional, modular prosthesis was replaced by a knee joint mechanism, equipped with a controllable brake on the knee joint axis. Sensors and a microcomputer were added, keeping the system self-contained. The modularity of the design permits the use of an alternative, external, PC-based control unit, emulating the self-contained one, and offering extended data monitoring and storage facilities. For both units an operating environment was written, including sensor/actuator interfacing and the implementation of a real-time interrupt, executing the control algorithm. A double finite state approach was used in the design of the control algorithm. On a higher level, the mode identification algorithm reveals the patient's intent. Within a specific mode (lower level), the relevant mode control algorithm looks for the current phase within the gait cycle. Within a particular phase, a specific simple control action with the brake replaces normal knee muscle activity. Tests were carried out with one prosthetic patient using a basic control algorithm for level walking, allowing controlled knee flexion during stance phase. The technical feasibility of such a concept is illustrated by the test results, even though only flexion during early stance phase was controlled during the trials.(ABSTRACT TRUNCATED AT 250 WORDS)

Principles of brain plasticity in improving sensorimotor function of the knee and leg in patients with anterior cruciate ligament injury: a double-blind randomized exploratory trial

Directory of Open Access Journals (Sweden)

Ageberg Eva

2012-05-01

Full Text Available Abstract Background Severe traumatic knee injury, including injury to the anterior cruciate ligament (ACL, leads to impaired sensorimotor function. Although improvements are achieved by training, impairment often persists. Because good sensorimotor function is associated with better patient-reported function and a potential lower risk of future joint problems, more effective treatment is warranted. Temporary cutaneous anesthesia of adjacent body parts was successfully used on the hand and foot to improve sensorimotor function. The aim of this study was to test whether this principle of brain plasticity could be used on the knee. The hypothesis was that temporary anesthesia of the skin area above and below the knee would improve sensorimotor function of the ipsilateral knee and leg in subjects with ACL injury. Methods In this double-blind exploratory study, 39 subjects with ACL injury (mean age 24 years, SD 5.2, 49% women, mean 52 weeks after injury or reconstruction and self-reported functional limitations and lack of trust in the knee were randomized to temporary local cutaneous application of anesthetic (EMLA® (n = 20 or placebo cream (n = 19. Fifty grams of EMLA®, or placebo, was applied on the leg 10 cm above and 10 cm below the center of patella, leaving the area around the knee without cream. Measures of sensory function (perception of touch, vibration sense, knee kinesthesia and motor function (knee muscle strength, hop test were assessed before and after 90 minutes of treatment with EMLA® or placebo. The paired t-test was used for comparisons within groups and analysis of variance between groups, except for ordinal data where the Wilcoxon signed rank test, or Mann–Whitney test, was used. The number of subjects needed was determined by an a priori sample size calculation. Results No statistically significant or clinically relevant differences were seen over time (before vs. after in the measures of sensory or motor

Complications from radiographer-performed double contrast barium enemas

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Vora, P.; Chapman, A. E-mail: anthony.chapman@leedsth.nhs.uk

2004-04-01

AIM: To determine the types and rates of complications encountered by radiographers when performing double contrast barium enemas (DCBE). MATERIALS AND METHODS: Seven hundred and forty-one questionnaires were posted to radiographers who had in the last 5 years attended one of the biannual barium enema training courses. RESULTS: Of 741 questionnaires posted 407 (54.9%) were returned completed. Approximately 348,000 barium enema examinations had been performed. Fifty-nine radiographers reported 89 complications, including 13 intra-peritoneal and 11 extra-peritoneal perforations. There were five deaths (mortality 1 in 70,000). Deaths resulted from two of 24 (10%) perforations, two of 45 (5%) cardiac events and one cerebrovascular accident that occurred during an examination. CONCLUSIONS: Radiographers have been regularly performing DCBEs for almost a decade. The mortality for radiographer-performed DCBE is similar to that previously reported for radiologists, although a slightly higher rate of perforation is noted and so this is an area where radiographer training should be targeted.

Complications from radiographer-performed double contrast barium enemas

International Nuclear Information System (INIS)

Vora, P.; Chapman, A.

2004-01-01

AIM: To determine the types and rates of complications encountered by radiographers when performing double contrast barium enemas (DCBE). MATERIALS AND METHODS: Seven hundred and forty-one questionnaires were posted to radiographers who had in the last 5 years attended one of the biannual barium enema training courses. RESULTS: Of 741 questionnaires posted 407 (54.9%) were returned completed. Approximately 348,000 barium enema examinations had been performed. Fifty-nine radiographers reported 89 complications, including 13 intra-peritoneal and 11 extra-peritoneal perforations. There were five deaths (mortality 1 in 70,000). Deaths resulted from two of 24 (10%) perforations, two of 45 (5%) cardiac events and one cerebrovascular accident that occurred during an examination. CONCLUSIONS: Radiographers have been regularly performing DCBEs for almost a decade. The mortality for radiographer-performed DCBE is similar to that previously reported for radiologists, although a slightly higher rate of perforation is noted and so this is an area where radiographer training should be targeted

Early Results of Anatomic Double Bundle Anterior Cruciate Ligament Reconstruction

OpenAIRE

Demet Pepele

2014-01-01

Aim: The goal in anterior cruciate ligament reconstruction (ACLR) is to restore the normal anatomic structure and function of the knee. In the significant proportion of patients after the traditional single-bundle ACLR, complaints of instability still continue. Anatomic double bundle ACLR may provide normal kinematics in knees, much closer to the natural anatomy. The aim of this study is to clinically assess the early outcomes of our anatomical double bundle ACLR. Material and Method: In our ...

Detection of gastritis by single- and double-contrast radiography

International Nuclear Information System (INIS)

Thoeni, R.F.; Goldberg, H.I.; Ominsky, S.; Cello, J.P.

1983-01-01

Sixty-eight patients with various types of gastritis, 23 patients with normal stomachs, and four patients with other gastric diseases were examined in a prospective study to assess the sensitivity and specificity of single-contrast (SC) and double-contrast (DC) upper gastrointestinal examinations in the evaluation of gastritis. All patients underwent endoscopy with biopsy followed first by DC and then by SC radiography. The respective sensitivities of SC and DC radiography were 58% and 72% for all examinations and 59% and 77% for adequate examinations only. The respective specificities were 59% and 55% based on all examinations. Useful radiographic features included polypoid defects and erosions detected by both methods, abnormal folds and flattened margins detected by the SC technique, and narrowed lumen and crenulated margins detected by the DC technique. In 93% of all cases, the correct diagnosis was based on two or more of these radiographic features. According to this study, the radiographic sensitivity in the detection of gastritis is reliable only in cases of moderate-to-severe disease and only when based on findings of the DC examination. Neither SC nor DC radiography should be used as the primary screening method for patients with suspected gastritis, and the radiographic diagnosis should be restricted to the terms ''erosive'' or ''nonerosive gastritis.''

Intra-articular hyaluronan is without clinical effect in knee osteoarthritis: a multicentre, randomised, placebo-controlled, double-blind study of 337 patients followed for 1 year

DEFF Research Database (Denmark)

Jørgensen, Anette; Stengaard-Pedersen, Kristian; Simonsen, Lars Ole

2010-01-01

Objective To examine the long-term efficacy and safety of five intra-articular injections with hyaluronan in knee osteoarthritis. Methods A multicentre, randomised, placebo-controlled double-blind study of 337 patients fulfilling the American College of Rheumatology (ACR) criteria for knee...... osteoarthritis (clinical and laboratory) and with a Lequesne algofunctional index score (LFI) of 10 or greater. Patients received a hyaluronan product (sodium hyaluronate; Hyalgan) (n= 167) or saline (n= 170) intra-articularly weekly for 5 weeks and were followed up to 1 year. Time to recurrence was the primary...... efficacy parameter. LFI, pain on walking 50 m based on visual analogue scale (VAS pain 50 m), paracetamol consumption, patients' global assessment, Nottingham health profile, joint effusion and number of responders were secondary efficacy parameters. The efficacy parameters were analysed by intention...

The significance of demonstrating areae gastricae at hypotonic double contrast examination of the stomach

International Nuclear Information System (INIS)

Rienmueller, R.

1980-01-01

150 patients were examined by the double contrast-technique in drug-induced hypotonia of the stomach. They were examined gastroscopically and at the same time biopsies were taken. Comparison of histological and radiological results was performed. There was found an agreement of 82% in the performance of areae gastricae and the histological diagnosis of chronic gastritis. (orig.) [de

Efficacy and short-term safety of topical Dwarf Elder (Sambucus ebulus L.) versus diclofenac for knee osteoarthritis: A randomized, double-blind, active-controlled trial.

Science.gov (United States)

Jabbari, Marzie; Hashempur, Mohammad Hashem; Razavi, Seyede Zahra Emami; Shahraki, Hadi Raeisi; Kamalinejad, Mohammad; Emtiazy, Majid

2016-07-21

Sambucus ebulus L. (S. ebulus) has had long-standing application in Traditional Persian Medicine for joint pain and for a variety of bone and joint disorders. According to traditional use of S. ebulus and its relevant pharmacologic properties, this study was designed to evaluate the efficacy and short-term safety of topical use of S. ebulus in patients with knee osteoarthritis (OA). Seventy nine patients with knee OA were randomly enrolled in 2 parallel arms of a pilot randomized, double-blind, active-controlled clinical trial. The patients were treated by topical S. ebulus gel or 1% diclofenac gel, three times a day, as much as a fingertip unit for 4 weeks. Patients were assessed prior to enrollment and, then, 2 and 4 weeks subsequent to the intervention, in terms of scores of visual analogue scale (VAS) for self-grading of their knee joint pain, and according to 3 different domains of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire. Any observed adverse effects were also scrutinized. The mean values of WOMAC pain score, total WOMAC score and VAS score for pain of the S. ebulus group were significantly lower compared with the diclofenac group (P=0.004, P=0.04, and P<0.001, respectively). In addition, no serious adverse effect was reported. This pilot study showed that topical treatment with S. ebulus gel can be recommended for alleviating symptoms of patients with knee OA. However, longer trials involving larger samples size, are needed for achieving a comprehensive understanding about the efficacy and safety of S. ebulus in knee OA. Copyright © 2016. Published by Elsevier Ireland Ltd.

Effects of laterally wedged insoles on symptoms and disease progression in medial knee osteoarthritis: a protocol for a randomised, double-blind, placebo controlled trial

Directory of Open Access Journals (Sweden)

Osborne Richard

2007-09-01

Full Text Available Abstract Background Whilst laterally wedged insoles, worn inside the shoes, are advocated as a simple, inexpensive, non-toxic self-administered intervention for knee osteoarthritis (OA, there is currently limited evidence to support their use. The aim of this randomised, double-blind controlled trial is to determine whether laterally wedges insoles lead to greater improvements in knee pain, physical function and health-related quality of life, and slower structural disease progression as well as being more cost-effective, than control flat insoles in people with medial knee OA. Methods/Design Two hundred participants with painful radiographic medial knee OA and varus malalignment will be recruited from the community and randomly allocated to lateral wedge or control insole groups using concealed allocation. Participants will be blinded as to which insole is considered therapeutic. Blinded follow up assessment will be conducted at 12 months after randomisation. The outcome measures are valid and reliable measures recommended for OA clinical trials. Questionnaires will assess changes in pain, physical function and health-related quality-of-life. Magnetic resonance imaging will measure changes in tibial cartilage volume. To evaluate cost-effectiveness, participants will record the use of all health-related treatments in a log-book returned to the assessor on a monthly basis. To test the effect of the intervention using an intention-to-treat analysis, linear regression modelling will be applied adjusting for baseline outcome values and other demographic characteristics. Discussion Results from this trial will contribute to the evidence regarding the effectiveness of laterally wedged insoles for the management of medial knee OA. Trial registration ACTR12605000503628; NCT00415259.

Design and Evaluation of a New Type of Knee Orthosis to Align the Mediolateral Angle of the Knee Joint with Osteoarthritis

Directory of Open Access Journals (Sweden)

Amir Esrafilian

2012-01-01

Full Text Available Background. Osteoarthritis (OA is a disease which influences the performance of the knee joint. Moreover, the force and moments applied on the joint increase in contrast to normal subjects. Various types of knee orthoses have been designed to solve the mentioned problems. However, there are other problems in terms of distal migration during walking and the alignment of the orthosis which cannot be changed following the use of brace. Therefore, the main aim of the research was to design an orthosis to solve the aforementioned problems. Method. A new type of knee orthosis was designed with a modular structure. Two patients with knee OA participated in this research project. The force applied on the foot, moment transmitted through the knee joint, and spatiotemporal gait parameters were measured by use of a motion analysis system. Results. The results of the research showed that the adduction moment applied on the knee joint decreased while subjects walked with the new knee orthosis (P-value < 0.05. Conclusion. The new design of the knee brace can be used as an effective treatment to decrease the loads applied on the knee joint and to improve the alignment whilst walking.

Meniscus tears of the knee: Postarthrogram high resolution CT

International Nuclear Information System (INIS)

Kim, Jae Hyoung; Do, Young Soo; You, Jin Jong; Gong, Jae Chul; Kim, Hyung Jin; Chung, Sung Hoon

1990-01-01

Thirty-eight knees with clinically suspected meniscal tears were examined with high resolution computed tomography(HRCT) immediately following double contrast arthrography. All subsequently underwent arthroscopy. The findings of postarthrogram HRCT and arthroscopy were compared to evaluated the usefulness of postarthrogram HRCT in diagnosis of the meniscal tears. The sensitivity, specificity and accuracy of HRCT were 96.2%. 83.3% and 92.1% respectively. The anatomic details of the meniscal tears were clearly visible on the HRCT scans. Sagittal and coronal reformation views well visualized the horizontal tears and the relationship of torn meniscal fragments, and well differential the peripheral tears from the synovial recess. Our result indicate that postarthrogram HRCT not only is a sensitive and effective method for the detection and characterization of the meniscal tears, but also provides arthroscopists with the appropriate surgical plans

Comparison of 2 surgical techniques for reconstructing posterolateral corner of the knee: a cadaveric study evaluated by navigation system.

Science.gov (United States)

Ho, Eric Po-Yan; Lam, Mak-Ham; Chung, Mandy Man-Ling; Fong, Daniel Tik-Pui; Law, Billy Kan-Yip; Yung, Patrick Shu-Hang; Chan, Wood-Yee; Chan, Kai-Ming

2011-01-01

This study aimed to evaluate the immediate effect on knee kinematics by 2 different techniques of posterolateral corner (PLC) reconstruction. Five intact formalin-preserved cadaveric knees were used in this study. A navigation system was used to measure knee kinematics (posterior translation, varus angulation, and external rotation) after application of a constant force and torque to the tibia. Four different conditions of the knee were evaluated during the biomechanical test: intact knee and PLC-sectioned knee and PLC-reconstructed knee by the double-femoral tunnel technique and single-femoral tunnel technique. Sectioning of the PLC structures resulted in significant increases in external rotation at 30° of flexion from 11.2° (SD, 2.6) to 24.6° (SD, 6.2), posterior translation at 30° of flexion from 3.4 mm (SD, 1.5) to 7.4 mm (SD, 3.8), and varus angulation at 0° of flexion from 2.3° (SD, 2.1) to 7.9° (SD, 5.1). Both reconstruction techniques significantly restored the varus stability. The external rotation and posterior translation at 30° of flexion after reconstruction with the double-femoral tunnel technique were 10.2° (SD, 1.3) and 3.4° (SD, 2.7), respectively, which were significantly better than those of the single-femoral tunnel technique. Both techniques of reconstruction showed improved stability compared with PLC-sectioned knees. The double-femoral tunnel technique in PLC reconstruction showed better rotational stability and resistance to posterior translation than the single-femoral tunnel technique without compromising varus stability. PLC reconstruction by a double-femoral tunnel technique achieves better rotational control and resistance to posterior translation. Copyright © 2011 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Muscle weakness, afferent sensory dysfunction and exercise in knee osteoarthritis

DEFF Research Database (Denmark)

Roos, Ewa M.; Herzog, Walter; Block, Joel A

2011-01-01

Lower-extremity muscle strength and afferent sensory dysfunction, such as reduced proprioceptive acuity, are potentially modifiable putative risk factors for knee osteoarthritis (OA). Findings from current studies suggest that muscle weakness is a predictor of knee OA onset, while there is confli...... with previous knee injuries) are easily identified, and may benefit from exercise interventions to prevent or delay OA onset....... there is conflicting evidence regarding the role of muscle weakness in OA progression. In contrast, the literature suggests a role for afferent sensory dysfunction in OA progression but not necessarily in OA onset. The few pilot exercise studies performed in patients who are at risk of incident OA indicate...... a possibility for achieving preventive structure or load modifications. In contrast, large randomized controlled trials of patients with established OA have failed to demonstrate beneficial effects of strengthening exercises. Subgroups of individuals who are at increased risk of knee OA (such as those...

The effect of contrast media on the synovial membrane

Energy Technology Data Exchange (ETDEWEB)

Papacharalampous, Xenophon [Department of Radiology, University of Athens, Vasilissis Sofias 76 Ave., GR-115 28 Athens (Greece)]. E-mail: medgraph@otenet.gr; Patsouris, Efstratios [Department of Pathology, University of Athens, Mikras Asias 75 str., GR-115 27 Athens (Greece); Mundinger, Alexander [Clinic of Radiology, Marienhospital Osnabrueck, Johannisfreiheit 2-4, D-49074 Osnabruek (Germany); Beck, Andreas [Clinic of Radiology, Konstanz, Luisenstrasse 7, D-78461 Konstanz (Germany); Kouloulias, Vasilios [Department of Radiotherapy, University of Athens, Vasilissis Sofias 76 Ave., GR-115 28 Athens (Greece); Primetis, Elias [Department of Radiology, University of Athens, Vasilissis Sofias 76 Ave., GR-115 28 Athens (Greece); Koureas, Andreas [Department of Radiology, University of Athens, Vasilissis Sofias 76 Ave., GR-115 28 Athens (Greece); Vlahos, Lambros [Department of Radiology, University of Athens, Vasilissis Sofias 76 Ave., GR-115 28 Athens (Greece)

2005-09-01

Objective: To examine the effect of intra-articular injection of contrast media, sorbitol and normal saline on the synovial membrane. Materials and methods: Sixty three rabbits (126 knees) were used in this study. We injected the knees with amidotrizoate, ioxaglate, iopamidol, iotrol and diluted gadolinium-DTPA (2 mmol/l). Normal saline and sorbitol 27.25% were used for comparison. A histological and histochemical examination of the knees was carried out 1, 2, 10, 20, 30, 40 and 60 days after the injection. Results: On histological examination, the knees injected with normal saline, ioxaglate and gadolinium-DTPA had a normal appearance. Intra-articular injection of amidotrizoate, iopamidol, iotrol and sorbitol caused early, mild and transient histological changes of the synovium (synovial hyperplasia, infiltration by leucocytes). Furthermore, the knees injected with amidotrizoate presented with late, extensive histological changes (severe synovial hyperplasia, moderate vascular dilatation, severe infiltration by leukocytes). Conclusion: The results suggest that the chemical structure and not the osmolality of the contrast media is the main cause for the histological changes of the synovium.

Initial study of magnetization transfer contrast MR imaging of the knee at 3 Tesla

Energy Technology Data Exchange (ETDEWEB)

Yoshioka, Hiroshi; Echigo, Junko; Niitsu, Mamoru; Anno, Izumi; Itai, Yuji [Tsukuba Univ., Ibaraki (Japan). Inst. of Clinical Medicine; Nakai, Toshiharu; Sato, Hiroshi; Tsukamoto, Tetsuji

1998-10-01

It has been reported that various image sequences, including magnetization transfer contrast (MTC) were effective in evaluating articular cartilage. It is difficult to identify cartilaginous structures, however, using conventional MR imaging because of low spatial resolution and low signal-to-noise (S/N) ratio. The purpose of the present study was to evaluate the optimal imaging sequences with MTC pulse at 3 T and to assess the feasibility of the clinical application thereof. Five porcine knees were studied using varying imaging parameters (frequency offset, flip angle (FA) and echo time (TE)) combined with off-resonance sinc radiation pulses. The effect of MTC was analyzed by dividing the signal intensity of MTC GRE images by that of conventional GRE images (Ms/Mo). MTC images were obtained with a low specific absorption rate (SAR). With an offset frequency of 1.5 kHz (repetition time/TE/FA=60 ms/8 ms/30 degrees), the mean Ms/Mo of articular cartilage and meniscus was 0.70 and 0.65, respectively. An FA of 20 to 30 degrees and a TE of 11 to 12 ms appear to be optimal parameters at 3 T with MTC pulse because of the higher S/N ratio of cartilage and higher contrast-to-noise ratio of cartilage relative to that of distilled water. These findings suggest that MTC at 3 T may be feasible and effective for assessment of cartilage and meniscus in clinical applications. (author)

The Effect of Ginger (Zingiber Officinale Powder Supplement on Pain in Patients with Knee Osteoarthritis: a Double-Blind Randomized Clinical Trial

Directory of Open Access Journals (Sweden)

A Nadjarzadeh

2013-01-01

Full Text Available Introduction: There is limited evidence that ginger (Zingiber Officinale powder consumption is effective to relieve the pain and inflammation due to special phytichemicals. The aim of this study was to investigate the effect of ginger powder supplementation in pain improvement in patients with knee osteoarthritis. Methods: This double-blind randomized clinical trial was conducted on 120 outpatients with knee osteoarthritis of moderate pain. Patients were randomly assigned to two groups: receiving ginger powder supplement and placebo. Ginger and placebo groups received two identical capsules per day for 12 weeks. Each capsule contained 500 mg ginger powder or starch. Pain severity was measured by VAS (Visual Analog Scale at first and after 3 months. A responder was defined as a reduction in pain of > 1.5 cm on a visual analog scale (VAS. Results: Before intervention, there was no significant difference between the two groups in severity of pain. However, after ginger supplementation, pain score decreased in ginger group. After 12 weeks, Pain reduction was more significant in ginger group than placebo. Response to intervention was 88% and 14% in ginger and placebo groups, respectively. There was statistically significant difference between both groups in response to intervention (p<0.001. Conclusion: The results of this study showed that ginger powder supplementation was effective in reducing pain in patients with knee osteoarthritis, therefore it is recommended as a safe supplement for these patients

Early manifestation of Yersinia colitis demonstrated by the double-contrast barium enema

Energy Technology Data Exchange (ETDEWEB)

Aspestrand, F.

1986-11-01

A 19-year old female with a bloody, diarrheal illness of acute onset where Crohn's disease primarly was suspected is presented. The double-contrast barium enema revealed multiple, diffusely scattered aphthous erosions of the colonic mucosa: the rectum was scarcely affected. Biopsies taken by endoscopy demonstrated nonspecific inflammatory changes of the mucous membrane. However, routinely taken stool cultures revealed an infectious colitis due to Yersinia enterocolitica. Our case demonstrates the necessity to consider Yersinia enterocolitis in the radiographic differential diagnosis when the diagnosis of Crohn's disease or ulcerative colitis seems obvious.

Influence of different iodinated contrast media on the induction of DNA double-strand breaks after in vitro X-ray irradiation.

Science.gov (United States)

Deinzer, Christoph K W; Danova, Daniela; Kleb, Beate; Klose, Klaus J; Heverhagen, Johannes T

2014-01-01

The objective of this work was to examine differences in DNA double-strand break induction in peripheral blood lymphocytes after in vitro X-ray irradiation between iodinated contrast agents. Four different iodinated X-ray contrast agents--three of them with two different iodine concentrations--and mannitol (negative control; concentration of 150 mg mannitol per ml blood) were pipetted into blood samples so that there was a concentration of 0, 7.5 or 15 mg of iodine per ml blood in the samples. Negative controls without contrast medium (0 mg of iodine per ml blood) were also processed for every irradiation dose. The tubes were exposed to 0, 20 or 500 mGy in vitro X-ray irradiation. After that, the lymphocytes were separated by using density-gradient centrifugation. Fluorescence microscopy was applied to determine the average number of γH2AX-foci per lymphocyte in the presence or absence of different contrast media or mannitol. Differences in the number of γH2AX-foci were statistically analysed by one-way ANOVA and post-hoc Tukey's honestly significant difference test. Iodinated contrast agents led to a statistically significant increase in DNA double-strand breaks after in vitro irradiation. This effect increased statistically significant with rising radiation dose and appeared independent of the contrast agent used (iopromid, iodixanol, iomeprol, iopamidol). A statistically significant difference in DNA damage between the different tested contrast agents was not found. Therefore, the increase in DNA double-strand breaks depends solely on the amount of iodine applied. For evaluation of clinical consequences, our findings could be tested in further animal studies. Copyright © 2014 John Wiley & Sons, Ltd.

Anatomic double-bundle anterior cruciate ligament reconstruction using hamstring tendons with minimally required initial tension.

Science.gov (United States)

Mae, Tatsuo; Shino, Konsei; Matsumoto, Norinao; Natsu-Ume, Takashi; Yoneda, Kenji; Yoshikawa, Hideki; Yoneda, Minoru

2010-10-01

Our purpose was to clarify the clinical outcomes at 2 years after anatomic double-bundle anterior cruciate ligament (ACL) reconstruction with 20 N of the initial tension, which was the minimally required initial tension to perform the reconstruction successfully according to our previous report about the pre-tension necessary to restore the laxity found in the opposite knee (7.3 N; range, 2.2 to 14 N). Of 64 patients who underwent anatomic double-bundle ACL reconstruction with autogenous semitendinosus tendon, 45 were periodically examined for 2 years. Two double-looped grafts were fixed with EndoButton CL devices (Smith & Nephew Endoscopy, Andover, MA) on the femoral side and Double Spike Plates (Smith & Nephew Endoscopy) on the tibial side, while a total of 20 N of initial tension (10 N to each graft) was applied at 20° of knee flexion. The International Knee Documentation Committee Knee Examination Form and Lysholm score were used for the subjective assessment, whereas range of motion and knee stability were evaluated as the objective assessment. Grafts were evaluated in 25 patients with second-look arthroscopy. According to the International Knee Documentation Committee subjective assessment, 62% of knees were graded as normal and 38% as nearly normal. The Lysholm score was 72 points in the preoperative period and improved to 99 points at 2 years' follow-up. A loss of knee extension of less than 3° was found in 2 patients. The pivot-shift test was evaluated as negative in all patients except for 5 as a glide. KT-2000 knee arthrometer side-to-side difference (MEDmetric, San Diego, CA) was 0.1 ± 0.9 mm at 2 years' follow-up. Of the subset of grafts evaluated by second-look arthroscopy, most were considered to have good synovial coverage and to be taut. The anatomic double-bundle ACL reconstruction with 20 N of low initial tension yielded good clinical outcomes at 2 years postoperatively, and second-look arthroscopic findings were excellent. Level IV

Primary double contrast study of the colon with citrate-sorbitol-barium suspension in the diagnosis of chronic colitis

International Nuclear Information System (INIS)

Sidorov, V.S.

1991-01-01

X-ray investigation of the colon was conducted in 292 patients with clinically diagnosed chronic colitis: standard 3-phase irrigoscopy-in 189 patients and a primary double contrast study of the colon with citrate-sorbitol-barium suspenzion - in 103. Basing on X-ray and morphological findings, the diagnosis was confirmed in 128 patients of the 1st group (68.2 %) and in 89 patients of the 2nd group (86 %). The primary double contrast study of the colon was found more effective as it permitted the detection of elements of the mucosal microcontours: transversal strips, not coinciding with haustration, focal granularity, diffuse granularity, small barium suspension depots or niches, nodular granularity. It permitted the recommendation of the method for a wide clinical use

Comparison of Glucosamine-Chondroitin Sulfate with and without Methylsulfonylmethane in Grade I-II Knee Osteoarthritis: A Double Blind Randomized Controlled Trial.

Science.gov (United States)

Lubis, Andri M T; Siagian, Carles; Wonggokusuma, Erick; Marsetyo, Aldo F; Setyohadi, Bambang

2017-04-01

Glucosamine, chondroitinsulfate are frequently used to prevent further joint degeneration in osteoarthritis (OA). Methylsulfonylmethane (MSM) is a supplement containing organic sulphur and also reported to slow anatomical joint progressivity in the knee OA. The MSM is often combined with glucosamine and chondroitin sulfate. However, there are controversies whether glucosamine-chondroitin sulfate or their combination with methylsulfonylmethane could effectively reduce pain in OA. This study is aimed to compare clinical outcome of glucosamine-chondroitin sulfate (GC), glucosamine-chondroitin sulfate-methylsulfonylmethane (GCM), and placeboin patients with knee osteoarthritis (OA) Kellgren-Lawrence grade I-II. a double blind, randomized controlled clinical trial was conducted on 147 patients with knee OA Kellgren-Lawrence grade I-II. Patients were allocated by permuted block randomization into three groups: GC (n=49), GCM (n=50), or placebo (n=48) groups. GC group received 1500 mg of glucosamine + 1200 mg of chondroitin sulfate + 500 mg of saccharumlactis; GCM group received 1500 mg of glucosamine + 1200 mg of chondroitin sulfate + 500 mg of MSM; while placebo group received three matching capsules of saccharumlactis. The drugs were administered once daily for 3 consecutive months VAS and WOMAC scores were measured before treatment, then at 4th, 8th and 12th week after treatment. on statistical analysis it was found that at the 12th week, there are significant difference between three treatment groups on the WOMAC score (p=0.03) and on the VAS score (p=0.004). When analyzed between weeks, GCM treatment group was found statistically significant on WOMAC score (p=0.01) and VAS score (p<0.001). Comparing the score difference between weeks, WOMAC score analysis showed significant difference between GC, GCM, and placebo in week 4 (p=0.049) and week 12 (p=0.01). In addition, VAS score also showed significant difference between groups in week 8 (p=0.006) and week 12 (p<0

Double-contrast imaging of the pharynx in case of dysphagia as the leading symptom

International Nuclear Information System (INIS)

Feyerabend, T.; Schmitt, R.; Richter, E.; Bohndorf, W.

1989-01-01

The article explains the value of double-contrast pharyngography in the gradual programme of diagnostic means for clarifying the symptom of dysphagia. The method is simple and quick and well suited as a first screening method before more complicated methods are used. It allows reliable assessment of postoperative or postradiogenic morphology in case of malignant oro- or hypopharynx tumors and thus also is suitable for tumor aftercare programmes. (orig./GDG) [de

Double-contrast arthrography in recurrent dislocation of the shoulder

International Nuclear Information System (INIS)

Faletti, C.; Vassoney, P.F.; Indemini, E.; Clerico, P.

1988-01-01

One hundred and ninety-three shoulder arthrographies were performed between 1979 and 1985 on patients affected by recurrent dislocations. The diagnostic doubt was cleared up in 162 cases (83%). Athrographic diagnosis was confirmed by pathological findings in 92% of the patients who underwent surgery. The double-contrast technique under local anaesthesia with anterior access is suggested, since it allows several arthrograms in different projections. Thus, an analytic study of the articular damage can be carried out. The patterns of each projection are briefly shown. Revision of case histories points out that: a) the use of arthrography should always be assessed on a clinical-radiological basis for each patients; b) there is no doubt as to the usefulness of this examination as a direct means of exploration, as far as the articular damage is concerned, not only as an aid to future surgery, but also in the follow-up of the results of the treatment in the long run

Efficacy and safety of diclofenac sodium 2% topical solution for osteoarthritis of the knee: a randomized, double-blind, vehicle-controlled, 4 week study.

Science.gov (United States)

Wadsworth, L Tyler; Kent, Jeffrey D; Holt, Robert J

2016-01-01

Nonsteroidal anti-inflammatory drugs (NSAIDs) are standard therapy for osteoarthritis (OA). Topically applied NSAIDs reduce systemic exposure compared with oral NSAIDS, and European guidelines recommend their use. The NSAID diclofenac is available in a range of topical formulations. Diclofenac 1% gel and 1.5% four times daily and 2% twice daily (BID) solutions are approved to reduce pain from OA of the knee(s). The objective of this study was to investigate the efficacy and safety of diclofenac sodium 2% topical solution BID versus vehicle control solution for treating pain associated with OA of the knee. A phase II, 4 week, randomized, double-blind, parallel-group, two-arm, vehicle-controlled study compared pain relief with diclofenac sodium 2% topical solution versus control (vehicle only) in patients aged 40 to 85 years with radiographically confirmed primary OA of the knee. ClinicalTrials.gov identifier NCT01119898. The primary efficacy outcome was change from baseline to the final visit in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale. Secondary outcomes included additional WOMAC subscales and patient global assessment of OA. Treatment-emergent adverse events (TEAEs), skin irritation, and vital signs were assessed and collected throughout the study. Of 260 patients randomized, 259 received ≥1 dose of study drug. Significantly greater reductions in least-squares mean (standard error) WOMAC pain scores were observed for diclofenac-treated (-4.4 [0.4]) versus vehicle-treated patients (-3.4 [0.4]) at the final visit (p = 0.040). The most commonly reported TEAEs were administration site conditions. The vehicle-treated group experienced slightly more TEAEs than the active treatment group (38.8% vs. 31.5%). No serious adverse events were reported. Administration of diclofenac sodium 2% topical solution BID resulted in significantly greater improvement in pain reduction in patients with OA of the knee versus vehicle

The trivector approach for minimally invasive total knee arthroplasty: a technical note.

Science.gov (United States)

Benazzo, Francesco; Rossi, Stefano Marco Paolo

2012-09-01

One of the main criticisms of minimally invasive approaches in total knee arthroplasty has been their poor adaptability in cases of major deformity or stiffness of the knee joint. When they are used in such cases, excessive soft-tissue tension is needed to provide appropriate joint exposure. Here, we describe the "mini trivector approach," which has become our standard approach for total knee replacement because it permits us to enlarge the indication for minimally or less invasive total knee replacement to many knees where quad sparing, a subvastus approach, or a mini quad or mini midvastus snip may not be sufficient to achieve correct exposure. It consists of a limited double snip of the VMO and the quadriceps tendon that reduces tension on the extensor mechanism and allows easier verticalization of the patella as well as good joint exposure.

Early Results of Anatomic Double Bundle Anterior Cruciate Ligament Reconstruction

Directory of Open Access Journals (Sweden)

Demet Pepele

2014-03-01

Full Text Available Aim: The goal in anterior cruciate ligament reconstruction (ACLR is to restore the normal anatomic structure and function of the knee. In the significant proportion of patients after the traditional single-bundle ACLR, complaints of instability still continue. Anatomic double bundle ACLR may provide normal kinematics in knees, much closer to the natural anatomy. The aim of this study is to clinically assess the early outcomes of our anatomical double bundle ACLR. Material and Method: In our clinic between June 2009 and March 2010, performed the anatomic double bundle ACLR with autogenous hamstring grafts 20 patients were evaluated prospectively with Cincinnati, IKDC and Lysholm scores and in clinically for muscle strength and with Cybex II dynamometer. Results: The mean follow-up is 17.8 months (13-21 months. Patients%u2019 scores of Cincinnati, IKDC and Lysholm were respectively, preoperative 18.1, 39.3 and 39.8, while the post-op increased to 27.2, 76.3 and 86.3. In their last check, 17 percent of the patients according to IKDC scores (85% A (excellent and B (good group and 3 patients took place as C (adequate group. The power measurements of quadriceps and hamstring muscle groups of patients who underwent surgery showed no significant difference compared with the intact knees. Discussion: Double-bundle ACL reconstruction is a satisfactory method. There is a need comparative, long-term studies in large numbers in order to determine improving clinical outcome, preventing degeneration and restoring the knee biomechanics better.

Comparison of robot surgery modular and total knee arthroplasty kinematics.

Science.gov (United States)

Yildirim, Gokce; Fernandez-Madrid, Ivan; Schwarzkopf, Ran; Walker, Peter S; Karia, Raj

2014-04-01

The kinematics of seven knee specimens were measured from 0 to 120 degrees flexion using an up-and-down crouching machine. Motion was characterized by the positions of the centers of the lateral and medial femoral condyles in the anterior-posterior direction relative to a fixed tibia. A modular unicompartmental knee, trochlea flange, and patella resurfacing (multicompartmental knee [MCK] system) were implanted using a surgeon-interactive robot system that provided accurate surface matching. The MCK was tested, followed by standard cruciate retaining (CR) and posterior stabilized (PS) knees. The motion of the MCK was close to anatomic, especially on the medial side, in contrast to the CR and PS knees that showed abnormal motion features. Such a modular knee system, accurately inserted, has the potential for close to normal function in clinical application. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Effect of intra-articular yttrium-90 on chronic pyrophosphate arthropathy of the knee

International Nuclear Information System (INIS)

Doherty, M.; Dieppe, P.A.

1981-01-01

Fifteen patients with bilateral, symmetrical chronic pyrophosphate arthropathy of the knee were given intra-articular injections of yttrium-90 (5 mCi) plus steroid (triamcinolone hexacetonide, 20 mg) into one knee, and saline plus steroid into the other (control) knee. Allocation of the 90 Y injection was random and double blind. After 6 months there was significantly less pain, inactivity stiffness, joint-line tenderness, and effusion in the 90 Y-injected knees than in the controls (p 90 Y-injected and control knees in the changes in range of movement (p 90 Y may be of benefit in chronic pyrophosphate arthropathy, a disease for which there is no treatment. The predilection of this condition to affect the knees of the elderly makes such treatment highly suitable because the joint lends itself readily to injection and the procedure carries very few actual or potential risks in this age group. (author)

Loss of knee-extension strength is related to knee swelling after total knee arthroplasty

DEFF Research Database (Denmark)

Holm, Bente; Kristensen, Morten T; Bencke, Jesper

2010-01-01

To examine whether changes in knee-extension strength and functional performance are related to knee swelling after total knee arthroplasty (TKA).......To examine whether changes in knee-extension strength and functional performance are related to knee swelling after total knee arthroplasty (TKA)....

Alterations in walking knee joint stiffness in individuals with knee osteoarthritis and self-reported knee instability.

Science.gov (United States)

Gustafson, Jonathan A; Gorman, Shannon; Fitzgerald, G Kelley; Farrokhi, Shawn

2016-01-01

Increased walking knee joint stiffness has been reported in patients with knee osteoarthritis (OA) as a compensatory strategy to improve knee joint stability. However, presence of episodic self-reported knee instability in a large subgroup of patients with knee OA may be a sign of inadequate walking knee joint stiffness. The objective of this work was to evaluate the differences in walking knee joint stiffness in patients with knee OA with and without self-reported instability and examine the relationship between walking knee joint stiffness with quadriceps strength, knee joint laxity, and varus knee malalignment. Overground biomechanical data at a self-selected gait velocity was collected for 35 individuals with knee OA without self-reported instability (stable group) and 17 individuals with knee OA and episodic self-reported instability (unstable group). Knee joint stiffness was calculated during the weight-acceptance phase of gait as the change in the external knee joint moment divided by the change in the knee flexion angle. The unstable group walked with lower knee joint stiffness (p=0.01), mainly due to smaller heel-contact knee flexion angles (pknee flexion excursions (pknee stable counterparts. No significant relationships were observed between walking knee joint stiffness and quadriceps strength, knee joint laxity or varus knee malalignment. Reduced walking knee joint stiffness appears to be associated with episodic knee instability and independent of quadriceps muscle weakness, knee joint laxity or varus malalignment. Further investigations of the temporal relationship between self-reported knee joint instability and walking knee joint stiffness are warranted. Copyright © 2015 Elsevier B.V. All rights reserved.

Efficacy of a comfrey root (Symphyti offic. radix) extract ointment in the treatment of patients with painful osteoarthritis of the knee: results of a double-blind, randomised, bicenter, placebo-controlled trial.

Science.gov (United States)

Grube, B; Grünwald, J; Krug, L; Staiger, C

2007-01-01

This randomised, double-blind, bicenter, placebo-controlled clinical trial investigated the effect of a daily application of 6g Kytta-Salbe f (3 x 2 g) over a 3 week period with patients suffering from painful osteoarthritis of the knee. The two hundred and twenty patients examined consisted of 153 women and 67 men of an average age of 57.9 years. On average, the complaints relating to osteoarthritis of the knee had persisted for 6.5 years. Two hundred and twenty patients were included in the Full Analysis Set (FAS) and safety collective, 186 (84.5%) in the Valid Case Analysis Set (VCAS) collective. In the course of the trial, the visual analog scale (VAS) total score (primary target value) in the verum group dropped by 51.6 mm (54.7%) and in the placebo group by 10.1 mm (10.7%). The average difference between the groups of 41.5 mm (95% confidence interval=34.8 to 48.2 mm) or 44.0% is significant (pcomfrey root extract ointment is well suited for the treatment of osteoarthritis of the knee. Pain is reduced, mobility of the knee improved and quality of life increased.

Perfusion of subchondral bone marrow in knee osteoarthritis: A dynamic contrast-enhanced magnetic resonance imaging preliminary study

Energy Technology Data Exchange (ETDEWEB)

Budzik, Jean-François, E-mail: Budzik.jean-francois@ghicl.net [Lille Catholic Hospitals, Imaging Department, Lille Catholic University, Lille (France); PMOI Physiopathology of Inflammatory Bone Diseases, EA 4490, Lille (France); Ding, Juliette, E-mail: Ding.juliette@gmail.com [Lille Catholic Hospitals, Imaging Department, Lille Catholic University, Lille (France); Norberciak, Laurène, E-mail: Norberciak.Laurene@ghicl.net [Lille Catholic Hospitals, Biostatistics Department, Lille Catholic University, Lille (France); Pascart, Tristan, E-mail: Pascart.tristan@ghicl.net [Lille Catholic Hospitals, Rheumatology Department, Lille Catholic University, Lille (France); Toumi, Hechmi, E-mail: hechmi.toumi@univ-orleans.fr [EA4708 I3MTO, Orleans Regional Hospital, University of Orleans, Orleans (France); Verclytte, Sébastien, E-mail: Verclytte.Sebastien@ghicl.net [Lille Catholic Hospitals, Imaging Department, Lille Catholic University, Lille (France); Coursier, Raphaël, E-mail: Coursier.Raphael@ghicl.net [Lille Catholic Hospitals, Orthopaedic Surgery Department, Lille Catholic University, Lille (France)

2017-03-15

The role of inflammation in the pathogenesis of osteoarthritis is being given major interest, and inflammation is closely linked with vascularization. It was recently demonstrated that dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) could identify the subchondral bone marrow vascularization changes occurring in osteoarthritis in animals. These changes appeared before cartilage lesions were visible and were correlated with osteoarthritis severity. Thus the opportunity to obtain an objective assessment of bone vascularization in non-invasive conditions in humans might help better understanding osteoarthritis pathophysiology and finding new biomarkers. We hypothesized that, as in animals, DCE-MRI has the ability to identify subchondral bone marrow vascularization changes in human osteoarthritis. We performed knee MRI in 19 patients with advanced knee osteoarthritis. We assessed subchondral bone marrow vascularization in medial and lateral femorotibial compartments with DCE-MRI and graded osteoarthritis lesions on MR images. Statistical analysis assessed intra- and inter-observer agreement, compared DCE-MRI values between the different subchondral zones, and sought for an influence of age, sex, body mass index, and osteoarthritis garde on these values. The intra- and inter-observer agreement for DCE-MRI values were excellent. These values were significantly higher in the femorotibial compartment the most affected by osteoarthritis, both in femur and tibia (p < 0.0001) and were significantly and positively correlated with cartilage lesions (p = 0.02) and bone marrow oedema grade (p < 0.0001) after adjustment. We concluded that, as in animals, subchondral bone marrow vascularization changes assessed with DCE-MRI were correlated with osteoarthritis severity in humans.

Perfusion of subchondral bone marrow in knee osteoarthritis: A dynamic contrast-enhanced magnetic resonance imaging preliminary study

International Nuclear Information System (INIS)

Budzik, Jean-François; Ding, Juliette; Norberciak, Laurène; Pascart, Tristan; Toumi, Hechmi; Verclytte, Sébastien; Coursier, Raphaël

2017-01-01

The role of inflammation in the pathogenesis of osteoarthritis is being given major interest, and inflammation is closely linked with vascularization. It was recently demonstrated that dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) could identify the subchondral bone marrow vascularization changes occurring in osteoarthritis in animals. These changes appeared before cartilage lesions were visible and were correlated with osteoarthritis severity. Thus the opportunity to obtain an objective assessment of bone vascularization in non-invasive conditions in humans might help better understanding osteoarthritis pathophysiology and finding new biomarkers. We hypothesized that, as in animals, DCE-MRI has the ability to identify subchondral bone marrow vascularization changes in human osteoarthritis. We performed knee MRI in 19 patients with advanced knee osteoarthritis. We assessed subchondral bone marrow vascularization in medial and lateral femorotibial compartments with DCE-MRI and graded osteoarthritis lesions on MR images. Statistical analysis assessed intra- and inter-observer agreement, compared DCE-MRI values between the different subchondral zones, and sought for an influence of age, sex, body mass index, and osteoarthritis garde on these values. The intra- and inter-observer agreement for DCE-MRI values were excellent. These values were significantly higher in the femorotibial compartment the most affected by osteoarthritis, both in femur and tibia (p < 0.0001) and were significantly and positively correlated with cartilage lesions (p = 0.02) and bone marrow oedema grade (p < 0.0001) after adjustment. We concluded that, as in animals, subchondral bone marrow vascularization changes assessed with DCE-MRI were correlated with osteoarthritis severity in humans.

The early manifestation of Yersinia colitis demonstrated by the double-contrast barium enema

International Nuclear Information System (INIS)

Aspestrand, F.

1986-01-01

A 19-year old female with a bloody, diarrheal illness of acute onset where Crohn's disease primarly was suspected is presented. The double-contrast barium enema revealed multiple, diffusely scattered aphthous erosions of the colonic mucosa: the rectum was scarcely affected. Biopsies taken by endoscopy demonstrated nonspecific inflammatory changes of the mucous membrane. However, routinely taken stool cultures revealed an infectious colitis due to Yersinia enterocolitica. Our case demonstrates the necessity to consider Yersinia enterocolitis in the radiographic differential diagnosis when the diagnosis of Crohn's disease or ulcerative colitis seems obvious. (orig.) [de

Double blind evaluation of the effects of various contrast media on extremity veins in the dog

International Nuclear Information System (INIS)

Laerum, F.; Dehner, L.P.; Rysavy, J.; Amplatz, K.; Minnesota Univ., Minneapolis

1987-01-01

Canine superficial extremity veins were examined grossly and microscopically in a double blind fashion for endothelial damage and phlebitis one hour and four days after the injection of ionic monomeric or dimeric, and non-ionic monomeric, 300 mg I/ml, contrast media. Superficial veins of all four extremities and the tail vein were injected with the same amounts of contrast medium after application of tourniquets for 20 minutes following the injections. Silver staining and prefixation of the veins were done in situ. The specimens were evaluated together with cross-sectioned, hematoxylin-eosin stained biopsies. On the basis of a randomized study of 77 dogs, endothelial damage or thrombosis caused by various contrast media as seen in man was not demonstrated. This may be due to species differences. It is postulated that canine endothelium may have a higher resistance to contrast medium injury than human endothelium. (orig.)

The relationship between pain and dynamic knee joint loading in knee osteoarthritis varies with radiographic disease severity. A cross sectional study.

Science.gov (United States)

Henriksen, Marius; Aaboe, Jens; Bliddal, Henning

2012-08-01

In a cross sectional study, we investigated the relationships between knee pain and mechanical loading across the knee, as indicated by the external knee adduction moment (KAM) during walking in patients with symptomatic knee OA who were distinguished by different radiographic disease severities. Data from 137 symptomatic medial knee OA patients were used. Based on Kellgren/Lawrence (K/L) grading, the patients were divided into radiographically less severe (K/L ≤ 2, n=68) or severe (K/L>2, n=69) medial knee OA. Overall knee pain was rated on a 10 cm visual analog scale, and peak KAM and KAM impulses were obtained from gait analyses. Mixed linear regression analyses were performed with KAM variables as the outcome, and pain and disease severity as independent variables, adjusting for age, gender, and walking speed. In adjusted analyses, less severe patients demonstrated negative relationships between pain intensities and dynamic loading. The severe patient group showed no relationship between pain intensity and peak KAM, and a positive relationship between pain intensity and KAM impulse. In radiographically less severe knee OA, the negative relationships between pain intensity and dynamic knee joint loading indicate a natural reaction to pain, which will limit the stress on the joint. In contrast, either absent or positive relationships between pain and dynamic loading in severe OA may lead to overuse and accelerated disease progression. These findings may have a large potential interest for strategies of treatment in knee OA. Copyright © 2011 Elsevier B.V. All rights reserved.

Double contrast barium enema combined with non-invasive imaging in peritoneal mesothelioma

International Nuclear Information System (INIS)

Cozzi, G.; Bellomi, M.; Frigerio, L.F.; Ostinelli, C.; Marchiano, A.; Petrillo, R.; Severini, A.; Milan Univ.

1989-01-01

Mesotheliomas are rare tumors arising from serosal linings of the major serous cavities. Five patients with peritoneal mesothelioma underwent a double contrast barium enema (DCBE) and ultrasonography (US) (2 patients), computed tomography (CT) (3 patients) and/or magnetic resonance imaging (MRI) (3 patients). The diagnosis was confirmed at laparotomy. The radiologic pattern at DCBE is unspecific and consists of compression and dislocation of bowel loops by extrinsic masses. Mesenteric retraction and segmental stenosis may be present. In one patient DCBE was normal. US, CT and MRI findings are also unspecific but when combined with information obtained from DCBE the site and abdominal extension of the disease are well defined. (orig.)

Intraoperative low-dose ketamine infusion reduces acute postoperative pain following total knee replacement surgery: a prospective, randomized double-blind placebo-controlled trial.

Science.gov (United States)

Cengiz, Pelin; Gokcinar, Derya; Karabeyoglu, Isil; Topcu, Hulya; Cicek, Gizem Selen; Gogus, Nermin

2014-05-01

To evaluate the effect of intraoperative low-dose ketamine with general anesthesia on postoperative pain after total knee replacement surgery. A randomized, double-blind comparative study. Ankara Numune Training and Research Hospital, Turkey, from January and June 2011. Sixty adults undergoing total knee arthroplasty were enrolled in this study. The patients were randomly allocated into two groups of equal size to receive either racemic ketamine infusion (6 μg/kg/minute) or the same volume of saline. A visual analogue scale (VAS) was used to measure each patient's level of pain at 1, 3, 6, 12, and 24 hours after surgery. Time to first analgesic request, postoperative morphine consumption and the incidence of side effects were also recorded. Low-dose ketamine infusion prolonged the time to first analgesic request. It also reduced postoperative cumulative morphine consumption at 1, 3, 6, 12, and 24 hours postsurgery (p < 0.001). Postoperative VAS scores were also significantly lower in the ketamine group than placebo, at all observation times. Incidences of side effects were similar in both study groups. Intraoperative continuous low-dose ketamine infusion reduced pain and postoperative analgesic consumption without affecting the incidence of side effects.

MRI EVALUATION OF INTERNAL DERANGEMENT OF KNEE

Directory of Open Access Journals (Sweden)

Ashok Srikar Chowdhary

2018-01-01

Full Text Available BACKGROUND Internal derangement of knee means loss of normal knee function due to ligament or meniscal injuries. MRI is a routinely utilised noninvasive modality for evaluation of various knee disorders including internal derangement. MRI provides excellent soft tissue contrast and multiplanar images when compared to other musculoskeletal imaging modalities. The aim of the study is to study the demographic profile of patients presenting with internal derangement of knee, identify the various ligament and meniscal injuries causing internal derangement of knee and describe the MRI features of the ligament and meniscal injuries. MATERIALS AND METHODS This study was undertaken from January 2016 to mid-December 2017 in the Department of Radiodiagnosis, MVJ Medical College and Research Hospital, Hoskote. The study population consisted of 108 patients with internal derangement of knee who underwent MRI of knee. All the MRI scans of the knee in this study were performed using Siemens Magnetom Essenza (A Tim+Dot system MR machine with a 1.5 tesla field strength magnet using a flex coil. RESULTS The study population consisted of 108 patients comprising of 90 males and 18 females. The age of the patients ranged from 16 to 67 years. Majority of the patients belonged to the age group of 21-30 years constituting about 41% of the total study population. Anterior cruciate ligament injury was the commonest followed by medial and lateral meniscus tears. Flap tear was the commonest type of meniscal tear. Posterior horn of the meniscus was the commonest tear site. CONCLUSION MRI is the investigation of choice in evaluating internal derangement of knee. MRI can accurately diagnose ligament and meniscal injuries and guide arthroscopy.

Anatomic Double-bundle ACL Reconstruction

NARCIS (Netherlands)

Schreiber, Verena M.; van Eck, Carola F.; Fu, Freddie H.

2010-01-01

Rupture of the anterior cruciate ligament (ACL) is one of the most frequent forms of knee trauma. The traditional surgical treatment for ACL rupture is single-bundle reconstruction. However, during the past few years there has been a shift in interest toward double-bundle reconstruction to closely

Posteromedial corner of the knee: MR imaging with gross anatomic correlation

Energy Technology Data Exchange (ETDEWEB)

Loredo, R. (Texas Univ., San Antonio, TX (United States). Dept. of Radiology); Hodler, J. (Department of Radiology, Univ. of Zurich (Switzerland)); Pedowitz, R. (Department of Orthopedic Surgery, Veterans Administration Medical Center (VAMC), San Diego, CA (United States)); Yeh, L.-R.; Trudell, D.; Resnick, D. (Department of Radiology, Veterans Administration Medical Center (VAMC), 3350 La Jolla Village Drive, San Diego, CA 92161 (United States))

1999-06-01

Objective. The objective of this study was to illustrate the magnetic resonance (MR) image appearance of the structures of the posteromedial ''corner'' of the knee with particular emphasis on the anatomy and differentiation between the medial collateral ligament and the posterior oblique ligament.Design. Six cadaveric knee specimens underwent MR imaging, before and following instillation of intra-articular contrast material. The knees were sectioned in the axial, coronal, and coronal oblique planes and the gross morphology of the posteromedial corner and surrounding structures was studied and correlated with the MR images.Patients. The human cadaveric specimens were from two female and four male patients (age at death, 72-86 years; average, 78 years).Results and conclusions. The contrast-enhanced sequences and the coronal oblique images allowed for improved visualization of the structures. (orig.) With 8 figs., 7 refs.

Indications for knee arthroplasty have remained consistent over time

DEFF Research Database (Denmark)

Thomsen, Morten Grove; Husted, Henrik; Otte, Kristian Stahl

2012-01-01

Between 2004 and 2009, the incidence of primary total knee arthroplasty (TKA) in Denmark has almost doubled. It has been speculated that this increase may be a result of patients being operated on weaker indications. The purpose of this study was to compare preoperative degrees of osteoarthritis...

A double-blind randomized placebo-controlled feasibility study evaluating individualized homeopathy in managing pain of knee osteoarthritis.

Science.gov (United States)

Koley, Munmun; Saha, Subhranil; Ghosh, Shubhamoy

2015-07-01

Few homeopathic complexes seemed to produce significant effects in osteoarthritis; still, individualized homeopathy remained untested. We evaluated the feasibility of conducting an efficacy trial of individualized homeopathy in osteoarthritis. A prospective, parallel-arm, double-blind, randomized, placebo-controlled pilot study was conducted from January to October 2014 involving 60 patients (homeopathy, n = 30; placebo, n = 30) who were suffering from acute painful episodes of knee osteoarthritis and visiting the outpatient clinic of Mahesh Bhattacharyya Homeopathic Medical College and Hospital, West Bengal, India. Statistically significant reduction was achieved in 3 visual analog scales (measuring pain, stiffness, and loss of function) and Osteoarthritis Research Society International scores in both groups over 2 weeks (P .05). Overall, homeopathy did not appear to be superior to placebo; still, further rigorous evaluation in this design involving a larger sample size seems feasible in future. Clinical Trials Registry, India (CTRI/2014/05/004589). © The Author(s) 2015.

Clinical practice guidelines for rest orthosis, knee sleeves, and unloading knee braces in knee osteoarthritis.

Science.gov (United States)

Beaudreuil, Johann; Bendaya, Samy; Faucher, Marc; Coudeyre, Emmanuel; Ribinik, Patricia; Revel, Michel; Rannou, François

2009-12-01

To develop clinical practice guidelines concerning the use of bracing--rest orthosis, knee sleeves and unloading knee braces--for knee osteoarthritis. The French Physical Medicine and Rehabilitation Society (SOFMER) methodology, associating a systematic literature review, collection of everyday clinical practice, and external review by multidisciplinary expert panel, was used. Few high-level studies of bracing for knee osteoarthritis were found. No evidence exists for the effectiveness of rest orthosis. Evidence for knee sleeves suggests that they decrease pain in knee osteoarthritis, and their use is associated with subjective improvement. These actions do not appear to depend on a local thermal effect. The effectiveness of knee sleeves for disability is not demonstrated for knee osteoarthritis. Short- and mid-term follow-up indicates that valgus knee bracing decreases pain and disability in medial knee osteoarthritis, appears to be more effective than knee sleeves, and improves quality of life, knee proprioception, quadriceps strength, and gait symmetry, and decreases compressive loads in the medial femoro-tibial compartment. However, results of response to valgus knee bracing remain inconsistent; discomfort and side effects can result. Thrombophlebitis of the lower limbs has been reported with the braces. Braces, whatever kind, are infrequently prescribed in clinical practice for osteoarthritis of the lower limbs. Modest evidence exists for the effectiveness of bracing--rest orthosis, knee sleeves and unloading knee braces--for knee osteoarthritis, with only low level recommendations for its use. Braces are prescribed infrequently in French clinical practice for osteoarthritis of the knee. Randomized clinical trials concerning bracing in knee osteoarthritis are still necessary.

Rectal water contrast transvaginal ultrasound versus double-contrast barium enema in the diagnosis of bowel endometriosis.

Science.gov (United States)

Jiang, Jipeng; Liu, Ying; Wang, Kun; Wu, Xixiang; Tang, Ying

2017-09-07

The aim of study was to compare the accuracy between rectal water contrast transvaginal ultrasound (RWC-TVS) and double-contrast barium enema (DCBE) in evaluating the bowel endometriosis presence as well as its extent. 198 patients at reproductive age with suspicious bowel endometriosis were included. Physicians in two groups specialised at endometriosis performed RWC-TVS as well as DCBE before laparoscopy and both groups were blinded to other groups' results. Findings from RWC-TVS or DCBE were compared with histological results. The severity of experienced pain severity through RWC-TVS or DCBE was assessed by an analogue scale of 10 cm. In total, 110 in 198 women were confirmed to have endometriosis nodules in the bowel by laparoscopy as well as histopathology. For bowel endometriosis diagnosis, DCBE and RWC-TVS demonstrated sensitivities of 96.4% and 88.2%, specificities of 100% and 97.3%, positive prediction values of 100% and 98.0%, negative prediction values of 98.0% and 88.0%, accuracies of 98.0% and 92.4%, respectively. DCBE was related to more tolerance than RWC-TVS. RWC-TVS and DCBE demonstrated similar accuracies in the bowel endometriosis diagnosis; however, patients showed more tolerance for RWC-TVS than those with DCBE. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Modified double contrast-enhanced examination of the stomach of adipose patients after vertical gastroplasty

International Nuclear Information System (INIS)

Raissaki, M.T.; Prassopoulos, P.; Hatjidakis, A.A.; Christodoulakis, M.; Melissas, J.; Gourtsoyiannis, N.C.

1995-01-01

The study reported covers 28 patients who were examined once by radiology before surgery, and twice after surgery. The first post-surgery examination was done on days 5-7, the second during the 4th until 6th month after surgery. For the first examination, water-soluble contrast agent was initially applied, then barium containing contrast agent. The second examination was done by modified double contrast technique. The most frequent, pre-surgery findings revealed gastro-esophageal reflux in 13 patients. The first post-surgery control detected a somastenosis in 2 patients, while the second control examination detected complications of various nature in 11 patients and gastro-esophageal reflux in 5 patients. In 6 patients, discrepancy between clinical and radiological findings was stated. The pouch size did not correlate with the frequency of complications, or with the body-to-mass index decrease. The examination method proposed in this article yields pre-surgery information on the anatomy of the stomach, more accurate dewscription of post-surgery complications, and better evaluation of the antireflux effect of the vertical gastroplasty. (orig.) [de

Synovial folds in the knee joint

International Nuclear Information System (INIS)

Schaefer, H.

1987-01-01

Stimulated by arthroscopic insight into central abnormalities of the knee joint and by the large number of unexplained case of 'anterior knee pain', we have studied the synovia in more than 2000 contrast examinations of the joint. Surprisingly, and contrary to the views expressed in the literature, the clinically significant plica parapatellaris medialis was seen as frequently during pneumo-arthrography as during more complex procedures. Abnormalities in the synovial fold emerged as a discreet disease identified as the 'medial shelf syndrome' and should be included in the differential diagnosis of causes of pain round the lower end of the femur and patella. (orig.) [de

Readout-segmented multi-shot diffusion-weighted MRI of the knee joint in patients with juvenile idiopathic arthritis.

Science.gov (United States)

Sauer, Alexander; Li, Mengxia; Holl-Wieden, Annette; Pabst, Thomas; Neubauer, Henning

2017-10-12

Diffusion-weighted MRI has been proposed as a new technique for imaging synovitis without intravenous contrast application. We investigated diagnostic utility of multi-shot readout-segmented diffusion-weighted MRI (multi-shot DWI) for synovial imaging of the knee joint in patients with juvenile idiopathic arthritis (JIA). Thirty-two consecutive patients with confirmed or suspected JIA (21 girls, median age 13 years) underwent routine 1.5 T MRI with contrast-enhanced T1w imaging (contrast-enhanced MRI) and with multi-shot DWI (RESOLVE, b-values 0-50 and 800 s/mm 2 ). Contrast-enhanced MRI, representing the diagnostic standard, and diffusion-weighted images at b = 800 s/mm 2 were separately rated by three independent blinded readers at different levels of expertise for the presence and the degree of synovitis on a modified 5-item Likert scale along with the level of subjective diagnostic confidence. Fourteen (44%) patients had active synovitis and joint effusion, nine (28%) patients showed mild synovial enhancement not qualifying for arthritis and another nine (28%) patients had no synovial signal alterations on contrast-enhanced imaging. Ratings by the 1st reader on contrast-enhanced MRI and on DWI showed substantial agreement (κ = 0.74). Inter-observer-agreement was high for diagnosing, or ruling out, active arthritis of the knee joint on contrast-enhanced MRI and on DWI, showing full agreement between 1st and 2nd reader and disagreement in one case (3%) between 1st and 3rd reader. In contrast, ratings in cases of absent vs. little synovial inflammation were markedly inconsistent on DWI. Diagnostic confidence was lower on DWI, compared to contrast-enhanced imaging. Multi-shot DWI of the knee joint is feasible in routine imaging and reliably diagnoses, or rules out, active arthritis of the knee joint in paediatric patients without the need of gadolinium-based i.v. contrast injection. Possibly due to "T2w shine-through" artifacts, DWI does not reliably

Low residual diet and hydration improving double contrast examination of the colon

International Nuclear Information System (INIS)

Virkki, R.; Maekelae, P.

1983-01-01

Light food diet and low residual diet with hydration, both combined with Proctosal and Bisacodyl cleansing, were compared in 268 patients in the preparation of the colon for double contrast examination. Low residual diet with hydration resulted in significantly less residual fecal material, no flocculation of the barium coating and significantly denser mucosal coating. The examination had to be repeated more often (8.6%) after light food diet than after low residual diet with hydration (1.7%), but there was no statistically significant difference in the diagnostic accuracy. The hydration is important in avoiding patient discomforts and flocculation of the barium coating. Despite the use of laxatives, a strict diet restriction is needed to obtain consistently clean colon. (orig.)

Elevated Z line: a new sign of Barrett's esophagus on double-contrast barium esophagograms.

Science.gov (United States)

Levine, Marc S; Ahmad, Nuzhat A; Rubesin, Stephen E

2015-01-01

We describe an elevated Z line as a new radiographic sign of Barrett's esophagus characterized by a transversely oriented, zigzagging, barium-etched line extending completely across the circumference of the midesophagus. An elevated Z line is rarely seen in other patients, so this finding should be highly suggestive of Barrett's esophagus on double-contrast barium esophagograms. If the patient is a potential candidate for surveillance, endoscopy and biopsy should be performed to confirm the presence of Barrett's esophagus. Copyright © 2015 Elsevier Inc. All rights reserved.

Effect of knee joint icing on knee extension strength and knee pain early after total knee arthroplasty: a randomized cross-over study

DEFF Research Database (Denmark)

Holm, Bente; Husted, Henrik; Kehlet, Henrik

2012-01-01

Objective: To investigate the acute effect of knee joint icing on knee extension strength and knee pain in patients shortly after total knee arthroplasty.Design: A prospective, single-blinded, randomized, cross-over study.Setting: A fast-track orthopaedic arthroplasty unit at a university hospital.......Participants: Twenty patients (mean age 66 years; 10 women) scheduled for primary unilateral total knee arthroplasty.Interventions: The patients were treated on two days (day 7 and day 10) postoperatively. On one day they received 30 minutes of knee icing (active treatment) and on the other day they received 30...... minutes of elbow icing (control treatment). The order of treatments was randomized.Main outcome measures: Maximal knee extension strength (primary outcome), knee pain at rest and knee pain during the maximal knee extensions were measured 2-5 minutes before and 2-5 minutes after both treatments...

Intraarticular Sprifermin (Recombinant Human Fibroblast Growth Factor 18) in Knee Osteoarthritis

DEFF Research Database (Denmark)

Lohmander, L. S.; Hellot, S.; Dreher, D.

2014-01-01

Objective. To evaluate the efficacy and safety of intraarticular sprifermin (recombinant human fibroblast growth factor 18) in the treatment of symptomatic knee osteoarthritis (OA). Methods. The study was a randomized, double-blind, placebo-controlled, proof-of-concept trial. Intraarticular sprif...

Randomised controlled trial of extraarticular gold bead implantation for treatment of knee osteoarthritis: a pilot study

DEFF Research Database (Denmark)

Nejrup, Kirsten; Olivarius, Niels de Fine; Jacobsen, Judith L.

2008-01-01

The primary objective of this double-blind, randomised, controlled trial was to determine if implanting gold beads at five acupuncture points around the knee joint improves 1-year outcomes for patients with osteoarthritis (OA) of the knee. Participants were 43 adults aged 18-80 years with pain...... and stiffness from non-specific OA of the knee for over a year. The intervention was blinded implantation of gold beads at five acupuncture points around the affected knee through a hypodermic needle, or needle insertion alone. Primary outcome measures were knee pain, stiffness and function assessed...... acupuncture had greater relative improvements in self-assessed outcomes. The treatment was well tolerated. This 1-year pilot study indicates that extraarticular gold bead implantation is a promising treatment modality for patients with OA of the knee. The new treatment should be tested in a larger trial...

Does post-operative knee awareness differ between knees in bilateral simultaneous total knee arthroplasty? Predictors of high or low knee awareness

DEFF Research Database (Denmark)

Nielsen, Katrine Abildgaard; Thomsen, Morten Grove; Latifi, Roshan

2016-01-01

PURPOSE: To evaluate the difference in post-operative knee awareness between knees in patients undergoing bilateral simultaneous total knee arthroplasty (TKA) and to assess factors predicting high or low knee awareness. METHODS: This study was conducted on 99 bilateral simultaneous TKAs performed...... at our institution from 2008 to 2012. All patients received one set of questionnaires [Forgotten Joint Score (FJS) and Oxford Knee Score (OKS)] for each knee. Based on the FJS, the patients' knees were divided into two groups: "best" and "worst" knees. The median of the absolute difference in FJS and OKS...... within each patient was calculated. Multivariate linear regression was performed to identify factors affecting FJS. RESULTS: The difference between knees was 1 point (CI 0-5) for the FJS and 1 point (CI 0-2) for the OKS. The FJS for females increased (decreasing awareness) with increasing age. Males had...

Total knee arthroplasty for severe valgus knee deformity.

Science.gov (United States)

Zhou, Xinhua; Wang, Min; Liu, Chao; Zhang, Liang; Zhou, Yixin

2014-01-01

Primary total knee arthroplasty (TKA) in severe valgus knees may prove challenging, and choice of implant depends on the severity of the valgus deformity and the extent of soft-tissue release. The purpose of this study was to review 8 to 11 years (mean, 10 years) follow-up results of primary TKA for varient-III valgus knee deformity with use of different type implants. Between January 2002 and January 2005, 20 women and 12 men, aged 47 to 63 (mean, 57.19 ± 6.08) years old, with varient-III valgus knees underwent primary TKA. Of the 32 patients, 37 knees had varient-III deformities. Pie crusting was carefully performed with small, multiple inside-out incisions, bone resection balanced the knee in lieu of soft tissue releases that were not used in the series. Cruciate-retaining knees (Gemini MKII, Link Company, Germany) were used in 13 knees, Genesis II (Simth & Nephew Company, USA) in 14 knees, and hinged knee (Endo-Model Company, Germany) in 10 knees. In five patients with bilateral variant-III TKAs, three patients underwent 1-stage bilateral procedures, and two underwent 2-stage procedures. All implants were cemented and the patella was not resurfaced. The Hospital for Special Surgery (HSS) knee score was assessed. Patients were followed up from 8 to 11 years. The mean HSS knee score were improved from 50.33 ± 11.60 to 90.06 ± 3.07 (P managed with rivaroxaban and thrombo-embolic deterrent stockings. There was no incidence of pulmonary embolism. Post-operative patient satisfaction was 80.7 ± 10.4 points in the groups. Prosthetic survival rate was 100% at mean 10 years postoperative. Not only hinged implants can be successfully used in variant-III valgus knees. As our results show, if proper ligament balancing techniques are used and proper ligament balance is attained, the knee may not require the use of a more constrained components. Our results also present alternative implant choices for severe knee deformities.

Intraoperative Low-Dose Ketamine Infusion Reduces Acute Postoperative Pain Following Total Knee Replacement Surgery: A Prospective, Randomized Double-Blind Placebo-Controlled Trial

International Nuclear Information System (INIS)

Pelin Cengiz, P.; Gokcinar, D.; Karabeyoglu, I.; Topcu, H.; Cicek, G. S.; Gogus, N.

2014-01-01

Objective: To evaluate the effect of intraoperative low-dose ketamine with general anesthesia on postoperative pain after total knee replacement surgery. Study Design: A randomized, double-blind comparative study. Place and Duration of Study: Ankara Numune Training and Research Hospital, Turkey, from January and June 2011. Methodology: Sixty adults undergoing total knee arthroplasty were enrolled in this study. The patients were randomly allocated into two groups of equal size to receive either racemic ketamine infusion (6.25 g/kg/minute) or the same volume of saline. A visual analogue scale (VAS) was used to measure each patient's level of pain at 1, 3, 6, 12, and 24 hours after surgery. Time to first analgesic request, postoperative morphine consumption and the incidence of side effects were also recorded. Results: Low-dose ketamine infusion prolonged the time to first analgesic request. It also reduced postoperative cumulative morphine consumption at 1, 3, 6, 12, and 24 hours postsurgery (p < 0.001). Postoperative VAS scores were also significantly lower in the ketamine group than placebo, at all observation times. Incidences of side effects were similar in both study groups. Conclusion: Intraoperative continuous low-dose ketamine infusion reduced pain and postoperative analgesic consumption without affecting the incidence of side effects. (author)

The role of knee joint moments and knee impairments on self-reported knee pain during gait in patients with knee osteoarthritis.

Science.gov (United States)

O'Connell, Megan; Farrokhi, Shawn; Fitzgerald, G Kelley

2016-01-01

The association between high mechanical knee joint loading during gait with onset and progression of knee osteoarthritis has been extensively studied. However, less attention has been given to risk factors related to increased pain during gait. The purpose of this study was to evaluate knee joint moments and clinical characteristics that may be associated with gait-related knee pain in patients with knee osteoarthritis. Sixty-seven participants with knee osteoarthritis were stratified into three groups of no pain (n=18), mild pain (n=27), or moderate/severe pain (n=22) based on their self-reported symptoms during gait. All participants underwent three-dimensional gait analysis. Quadriceps strength, knee extension range of motion, radiographic knee alignment and self-reported measures of global pain and function were also quantified. The moderate/severe pain group demonstrated worse global pain (Pknee flexion moments during the midstance phase of gait compared to the no pain group (P=0.02). Additionally, the moderate/severe pain group demonstrated greater varus knee malalignment (P=0.009), which was associated with higher weight acceptance peak knee adduction moments (P=0.003) and worse global pain (P=0.003) and physical function scores (P=0.006). Greater knee flexion moment is present during the midstance phase of gait in patients with knee osteoarthritis and moderate/severe pain during gait. Additionally, greater varus malalignment may be a sign of increased global knee joint dysfunction that can influence many activities of daily living beyond gait. Copyright © 2015 Elsevier Ltd. All rights reserved.

Krill Oil Improves Mild Knee Joint Pain: A Randomized Control Trial.

Science.gov (United States)

Suzuki, Yoshio; Fukushima, Minoru; Sakuraba, Keishoku; Sawaki, Keisuke; Sekigawa, Kazuaki

2016-01-01

Krill oil is an edible oil extracted from krill, a small red-colored crustacean found in the Antarctic Ocean. The administration of krill oil is reported to mitigate inflammation in patients with cardiac disease, rheumatoid arthritis, or osteoarthritis. However, the effect of krill oil on mild knee pain has not yet been determined. To assess the effect of krill oil on mild knee pain. A randomized, double-blind, parallel-group, placebo-controlled trial of fifty adults (38-85 years old) with mild knee pain attending the Fukushima Orthopedic Clinic (Tochigi, Japan) between September 2014 and March 2015. Participants were randomized to receive 2 g per day of either krill oil or an identical placebo for 30 days. The primary outcome was improvement in subjective symptoms of knee pain as assessed by the Japanese Knee Osteoarthritis Measure (JKOM) and Japanese Orthopaedic Association score (JOA). Secondary outcomes included blood and urine biochemical parameters. Both the placebo and krill oil groups showed significant improvements in the questions in the JKOM and JOA questionnaires after administration. After the intervention, krill oil group showed more improvements than placebo group in two questions regarding the pain and stiffness in knees in JKOM. Controlling for age, sex, weight, and smoking and drinking habits, krill oil significantly mitigated knee pain in sleeping (P knees (both P = 0.011) compared to placebo. Krill oil administration raised plasma EPA (P = 0.048) and EPA/AA ratio (P = 0.003). This study indicates that krill oil administration (2 g/day, 30 days) improved the subjective symptoms of knee pain in adults with mild knee pain. UMIN-CTR; ID UMIN000014413.

RELATIONSHIP BETWEEN ISOKINETIC KNEE STRENGTH AND JUMP CHARACTERISTICS FOLLOWING ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION.

Science.gov (United States)

Laudner, Kevin; Evans, Daniel; Wong, Regan; Allen, Aaron; Kirsch, Tom; Long, Brian; Meister, Keith

2015-06-01

Clinicians are often challenged when making return-to-play decisions following anterior cruciate ligament reconstruction (ACL-R). Isokinetic strength and jump performance testing are common tools used to make this decision. Unfortunately, vertical jump performance standards have not been clearly established and many clinicians do not have access to isokinetic testing equipment. To establish normative jump and strength characteristics in ACL-R patients cleared by an orthopedic physician to return-to-play and to determine if relationships exist between knee isokinetic strength measurements and jump characteristics described using an electronic jump map system. Descriptive laboratory study. Thirty-three ACL-R patients who had been cleared to return to athletic competition participated in this study. Twenty-six of these ACL-R participants were also matched to 26 asymptomatic athletes based on sex, limb, height, and mass to determine isokinetic strength and jump characteristic differences between groups. Jump tests consisted of single leg vertical, double leg vertical, and a 4-jump single leg vertical jump assessed using an electronic jump mat system. Independent t-tests were used to determine differences between groups and multiple regression analyses were used to identify any relationships between jump performance and knee strength (pjump capabilities and some bilateral knee strength deficiencies compared to the matched control group. The ACL-R group also showed several moderate-to-strong positive relationships for both knee extension and flexion strength with several jump performance characteristics, such as single and double leg vertical jump height. The current results indicate that ACL-R patients present with several knee strength and vertical jump differences compared to a matched control group at the time of return-to-play. Also, ACL-R patient's performance on an electronic jump mat system is strongly related to isokinetic knee strength measures. 2b.

MR arthrography of the knee

International Nuclear Information System (INIS)

Kramer, J.; Engel, A. Jr.; Stiglbauer, R. Jr.; Prayer, L. Jr.; Hajek, P. Jr.; Imhof, H.

1991-01-01

This paper demonstrates the diagnostic value of MR arthrography in the assessment of cartilaginous lesions, including osteochondritis dissecans. One hundred thirty-two knees of 125 patients were examined with MR arthrography performed on a 1.5-T magnet with a knee resonator. T1-weighted spin-echo and T2*-weighted three-dimensional gradient-echo sequences were obtained after intraarticular administration of 40 mL of 2-mmol GD-DTPA solution. Seventy-five patients were also imaged without contrast agent. The description of the articular surface was classified into four types: I, normal cartilage surface and thickness; II, surface normal or slightly irregular; III, severe surface irregularities and cartilage defects; and IV, extensive cartilage defects, scar formation. MR findings were correlated with those of arthroscopy/arthrotomy (n = 75)

Analgesic and sedative effects of perioperative gabapentin in total knee arthroplasty A randomized, double-blind, placebo-controlled, dose-finding study

DEFF Research Database (Denmark)

Lunn, Troels Haxholdt; Husted, Henrik; Laursen, Mogens Berg

2015-01-01

(1:1:1) to either gabapentin 1300 mg/d (group A), gabapentin 900 mg/d (group B), or placebo (group C) daily from 2 hours preoperatively to postoperative day 6 in addition to a standardized multimodal analgesic regime. The primary outcome was pain upon ambulation 24 hours after surgery......Gabapentin has shown acute postoperative analgesic effects, but the optimal dose and procedure-specific benefits vs harm have not been clarified. In this randomized, double-blind, placebo-controlled dose-finding study, 300 opioid-naive patients scheduled for total knee arthroplasty were randomized......, and the secondary outcome was sedation 6 hours after surgery. Other outcomes were overall pain during well-defined mobilizations and at rest and sedation during the first 48 hours and from days 2-6, morphine use, anxiety, depression, sleep quality, and nausea, vomiting, dizziness, concentration difficulty, headache...

Knee Replacement

Science.gov (United States)

Knee replacement is surgery for people with severe knee damage. Knee replacement can relieve pain and allow you to ... Your doctor may recommend it if you have knee pain and medicine and other treatments are not ...

Double autologous lymph node transplantation (ALNT) at the level of the knee and inguinal region for advanced lymphoedema of the lower limb (elephantiasis).

Science.gov (United States)

Gómez Martín, C; Murillo, C; Maldonado, A A; Cristóbal, L; Fernández-Cañamaque, J L

2014-02-01

Primary lower-limb lymphoedema is a chronic, progressive and debilitating condition with a difficult management, especially in advanced cases (elephantiasis). Recently, autologous lymph node transplantation (ALNT) appears to be a promising treatment for extremity lymphoedema. A case of a double ALNT for an advanced primary lower-limb lymphoedema is here reported: a contralateral inguinal lymph node flap was transferred to the knee and, in a second surgery, a thoracic lymph node flap was transplanted to the inguinal region. Clinical outcomes at 5 months postoperatively are very satisfactory with reduction in limb circumferences and improvement in skin quality and social impairment. Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Knee Injuries

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... Staying Safe Videos for Educators Search English Español Knee Injuries KidsHealth / For Teens / Knee Injuries What's in ... can do to protect them. What's in a Knee? The knee is a joint , actually the largest ...

3D-imaging of the knee with an optimized 3D-FSE-sequence and a 15-channel knee-coil

Energy Technology Data Exchange (ETDEWEB)

Notohamiprodjo, Mike, E-mail: mike.notohamiprodjo@med.uni-muenchen.de [Department of Clinical Radiology, University Hospitals Munich, Marchioninistrasse 15, 81377 Munich (Germany); Department of Radiology, Langone Medical Center, Bernard and Irene Schwartz Center for Biomedical Imaging New York University, 660 First Avenue, 4th Floor, New York, NY 10016 (United States); Horng, Annie; Kuschel, Bernhard [Department of Clinical Radiology, University Hospitals Munich, Marchioninistrasse 15, 81377 Munich (Germany); Paul, Dominik [Siemens Healthcare, Erlangen, Henkestr. 127, 91054 Erlangen (Germany); Li, Guobin [Siemens Mindit Magnetic Resonance Ltd., Shenzhen, Guang Dong (China); Raya, Jose G. [Department of Radiology, Langone Medical Center, Bernard and Irene Schwartz Center for Biomedical Imaging New York University, 660 First Avenue, 4th Floor, New York, NY 10016 (United States); Reiser, Maximilian F. [Department of Clinical Radiology, University Hospitals Munich, Marchioninistrasse 15, 81377 Munich (Germany); Glaser, Christian [Department of Clinical Radiology, University Hospitals Munich, Marchioninistrasse 15, 81377 Munich (Germany); Department of Radiology, Langone Medical Center, Bernard and Irene Schwartz Center for Biomedical Imaging New York University, 660 First Avenue, 4th Floor, New York, NY 10016 (United States)

2012-11-15

Objectives: To evaluate the clinical usefulness of an optimized 3D-Fast-Spin-Echo-sequence (3D-SPACE) in combination with a 15-channel knee-coil for 3D-imaging of the knee at 3 T. Methods: 15 volunteers and 50 consecutive patients were examined at 3 T with fat-saturated moderately T2-weighted 3D-SPACE (Voxel-size (VS): 0.6 mm Multiplication-Sign 0.5 mm Multiplication-Sign 0.5 mm/acquisition-time (AT) 10:44 min) using a 15-channel knee-coil. Flip angle optimization and radial k-space reordering were applied. Signal- and contrast-to-noise-ratios (SNR, CNR) were compared to non-optimized 3D-SPACE (8-channel knee-coil) and conventional 2D-FSE (VS: 0.4 mm Multiplication-Sign 0.4 mm Multiplication-Sign 3 mm/total AT: 12 min). Two radiologists independently rated depiction of internal knee structures and assessed detection and depiction of cartilage and meniscus abnormalities compared to conventional 2D-FSE-sequences. Sensitivity and specificity were calculated for a subgroup with arthroscopy as reference standard. Statistical analysis was performed with paired t-tests, confidence intervals and weighted-{kappa}-coefficients. Results: SNR and CNR particularly of fluid/cartilage of optimized 3D-SPACE were significantly higher (p < 0.05) than of the non-optimized 3D-sequence and conventional 2D-sequence. Blurring and image inhomogeneity were reduced in the optimized sequence. The thin slice-thickness was beneficial for depiction of problematical anatomical structures such as meniscal roots. 3D-SPACE showed significantly higher diagnostic confidence (p < 0.05) for diagnosis of cartilage lesions of the femoral trochlea. Overall sensitivity and specificity of 3D-SPACE and 2D-FSE for cartilage lesions was 82.3%/80.2% and 79.4%/84.2% and 100%/86.4% and 92.3%/81.8% for meniscus lesions. Conclusions: Optimized 3D-SPACE provides significantly higher signal and contrast compared to conventional 2D-FSE, particularly for fluid and cartilage, leading to improved diagnostic confidence

Radiographic assessment of knee-ankle alignment after total knee arthroplasty for varus and valgus knee osteoarthritis.

Science.gov (United States)

Gao, Fuqiang; Ma, Jinhui; Sun, Wei; Guo, Wanshou; Li, Zirong; Wang, Weiguo

2017-01-01

There are unanswered questions about knee-ankle alignment after total knee arthroplasty (TKA) for varus and valgus osteoarthritis (OA) of the knee. The aim of this retrospective study was to assess knee-ankle alignment after TKA. The study consisted of 149 patients who had undergone TKA due to varus and valgus knee OA. The alignment and angles in the selected knees and ankles were measured on full-length standing anteroposterior radiographs, both pre-operatively and post-operatively. The paired t-test and Pearson's correlation tests were used for statistical analysis. The results showed that ankle alignment correlated with knee alignment both pre-operatively and postoperatively (Pknee was corrected (Pknee-ankle alignment on the non-operative side (P>0.05). These findings indicated that routine TKA could correct the varus or valgus deformity of a knee, and improve the tilt of the ankle. Ankle alignment correlated with knee alignment both pre-operatively and postoperatively. Both pre-operative knee and ankle malalignment can be simultaneously corrected following TKA. Level III. Copyright © 2016 Elsevier B.V. All rights reserved.

Retrospective Evaluation Of MRI Findings Of Knee Joint In 255 Patients

Directory of Open Access Journals (Sweden)

Ahmet Mete

2003-03-01

Full Text Available Retrospective evaluation of knee MRI obtained from 255 cases and to demonstrate most common knee joint pathologies in our region.In our study knee joints of 255 cases who admitted to different clinics of our hospital with various complains of knee between October 1996 and December 1998 were examined in wide spectrum with MRI. Via 1.0 Tesla MRI device and special knee coil in sagittal, coronal and axial plains MRI images were obtained. The number of male and female patients were 173 and 82 and their ages were ranged between 14 and 70, and the mean age was 3413.The most common knee pathologies were intra-articular fluid (%58.04, medial (%46,66 and lateral (%12.55 meniscal injuries, anterior cruciate ligament injury (%17.25 and osteoarthritis (%14.9. The other important lesions were degeneration of medial and lateral meniscus, Baker’s cyst, bursitis, posterior cruciate ligament injury , medial and lateral collateral ligament injuries, synovial hypertrophy, chondromalasia of patella, and contusion.In our images of knee the most common lesions were injuries of meniscus and ligament. Because of being noninvasive technique for knee joint pathologies, capacity of multiplanar imaging, high contrast resolution and chance of detailed anatomic evaluation MR imaging was found to be most appropriate imaging technique for knee joint pathologies.

Is a Double Contrast Barium Enema Necessary in Patients who Undergo a CT Colonography as a Preoperative Work-up?

International Nuclear Information System (INIS)

Lee, Ji Won; Lee, Soon Jin; Choi, Dong Il; Kim, Hee Jung; Chun, Ho Kyung; Yun, Seong Hyeon; Jeon, Yong Hwan; Park, Seung Bae; Kim, Min Ju

2009-01-01

To determine the efficiency of CT colonography (CTC), as compared with the double contrast barium enema (DCBE) for the preoperative work-up of colorectal neoplasms. A total of 39 patients underwent both a CTC and DCBE before surgery. Three abdominal radiologists and three colorectal surgeons retrospectively reviewed virtual double contrast (VDC) and DCBE images, regarding each examination for localization, conspicuity, extent and morphology of neoplasms. We reviewed the radiological reports of the CTC and DCBE for the polyps. In the case of both VDC and DCBE, 40 cancers were detected in 39 patients. According to abdominal radiologists, VDC showed the same ability to identify DCBE for localization of neoplasms (p 0.05). The performance of the CTC is comparable to the DCBE for the localization of main mass and polyps in patients with colorectal neoplasm. Barium enema don't seem to be necessary for patients who undergo a CTC as preoperative work-up

Correlation of double-contrast high-density barium enema, colonoscopy, and histology in children with special attention to disparities

International Nuclear Information System (INIS)

Stringer, D.A.; Sherman, P.M.; Jakowenko, N.

1986-01-01

Colonscopic and double-contrast high-density barium enema (DCBE) findings were correlated in 68 patients (39 boys and 29 girls) aged 6 months to 18 years (mean 11.6 years) evaluated over a 24-month period. There was excellent correlation in 53 patients (78.0%) and good correlation in another 3 (4.4%) who had identical diagnoses and only slightly differing extent of disease reported. In 2 of these, DCBE showed more extensive disease, confirmed histologically in 1. Distal colitis seen on colonoscopy as reddening and neovascularity was missed on DCBE in 6 patients. Colonoscopy and DEBE failed to show a polyp in 1 patient each. One patient who had a normal DCBE and colonoscopy demonstrated a histological abnormality, and 1 patient with an abnormality on histology and DCBE was normal on colonscopy. A disparity resulted from the time between procedures in 1 patient and observer error in another. This high correlation is far better than any previously reported in children, supporting the use of high-density barium sulfate and double-contrast barium enemas in pediatric patients. (orig.)

Self-reported previous knee injury and low knee function increase knee injury risk in adolescent female football.

Science.gov (United States)

Clausen, M B; Tang, L; Zebis, M K; Krustrup, P; Hölmich, P; Wedderkopp, N; Andersen, L L; Christensen, K B; Møller, M; Thorborg, K

2016-08-01

Knee injuries are common in adolescent female football. Self-reported previous knee injury and low Knee injury and Osteoarthritis Outcome Score (KOOS) are proposed to predict future knee injuries, but evidence regarding this in adolescent female football is scarce. The aim of this study was to investigate self-reported previous knee injury and low KOOS subscale score as risk factors for future knee injuries in adolescent female football. A sample of 326 adolescent female football players, aged 15-18, without knee injury at baseline, were included. Data on self-reported previous knee injury and KOOS questionnaires were collected at baseline. Time-loss knee injuries and football exposures were reported weekly by answers to standardized text-message questions, followed by injury telephone interviews. A priori, self-reported previous knee injury and low KOOS subscale scores (female football. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Radiological diagnostics of the early gastric carcinoma by means of the double-contrast technique

Energy Technology Data Exchange (ETDEWEB)

Faust, H

1981-05-01

Radiological efforts to detect early gastric cancer have been intensified by three facts: 1) the prognostic importance, 2) the world-wide accepted classification of early cancer, 3) by comparison with the findings of gastrocamera and endoscopy. Main factors in double-contrast barium meal are: distention of the stomach by at least 200 cc gas, gastric atony (Glucagon or anticholinergica), visualization of the total gastric mucosa by high density, low viscosity barium after washing out the mucus from the mucosal relief. Radiological symptoms of early cancer are demonstrated, the urgency of en-face documentation of gastric ulcers is stressed.

Gender differences in tibio-femoral kinematics and quadriceps muscle force during weight-bearing knee flexion in vitro.

Science.gov (United States)

Wünschel, Markus; Wülker, Nikolaus; Müller, Otto

2013-11-01

Females have a higher risk in terms of anterior cruciate ligament injuries during sports than males. Reasons for this fact may be different anatomy and muscle recruitment patterns leading to less protection for the cruciate- and collateral-ligaments. This in vitro study aims to evaluate gender differences in knee joint kinematics and muscle force during weight-bearing knee flexions. Thirty-four human knee specimens (17 females/17 males) were mounted on a dynamic knee simulator. Weight-bearing single-leg knee flexions were performed with different amounts of simulated body weight (BW). Gender-specific kinematics was measured with an ultrasonic motion capture system and different loading conditions were examined. Knee joint kinematics did not show significant differences regarding anteroposterior and medial-lateral movement as well as tibial varus-valgus and internal-external rotation. This applied to all simulated amounts of BW. Simulating 100 N BW in contrast to AF50 led to a significant higher quadriceps overall force in female knees from 45° to 85° of flexion in contrast to BW 50 N. In these female specimens, the quadriceps overall force was about 20 % higher than in male knees being constant in higher flexion angles. It is indicated by our results that in a squatting movement females compared with males produce higher muscle forces, suggesting an increased demand for muscular stabilization, whereas tibio-femoral kinematics was similar for both genders.

The effect of vision on knee biomechanics during functional activities - A systematic review.

Science.gov (United States)

Louw, Quinette; Gillion, Nadia; van Niekerk, Sjan-Mari; Morris, Linzette; Baumeister, Jochen

2015-07-01

The objective of this study was to assess the effect of occluded vision on lower limb kinematics and kinetics of the knee joint during functional tasks including drop landing (single or double leg), squatting (single or double leg), stepping down, cutting movement and hopping in healthy individuals, or individuals who had an ACL reconstruction or deficiency with no vision impairments. A systematic review was conducted. A systematic review was conducted and electronic databases were searched between March 2012 and April 2013 for eligible papers. Methodological quality of each study was assessed using the Downs and Black revised checklist. Six studies met the eligibility criteria and a wide variation in methodological approaches was reported. This small evidence base indicated equivocal evidence about the effect of vision on knee biomechanics in individuals with healthy and compromised somatosensory function post an ACL reconstruction or injury. Clinicians should consider innovative, individualised ACL rehabilitation strategies when prescribing exercises which involve visual occlusion. Further research to increase the relatively small evidence base for the effect of vision on knee biomechanics is warranted. Copyright © 2014 Sports Medicine Australia. All rights reserved.

Krill Oil Improves Mild Knee Joint Pain: A Randomized Control Trial.

Directory of Open Access Journals (Sweden)

Yoshio Suzuki

Full Text Available Krill oil is an edible oil extracted from krill, a small red-colored crustacean found in the Antarctic Ocean. The administration of krill oil is reported to mitigate inflammation in patients with cardiac disease, rheumatoid arthritis, or osteoarthritis. However, the effect of krill oil on mild knee pain has not yet been determined.To assess the effect of krill oil on mild knee pain.A randomized, double-blind, parallel-group, placebo-controlled trial of fifty adults (38-85 years old with mild knee pain attending the Fukushima Orthopedic Clinic (Tochigi, Japan between September 2014 and March 2015.Participants were randomized to receive 2 g per day of either krill oil or an identical placebo for 30 days.The primary outcome was improvement in subjective symptoms of knee pain as assessed by the Japanese Knee Osteoarthritis Measure (JKOM and Japanese Orthopaedic Association score (JOA. Secondary outcomes included blood and urine biochemical parameters.Both the placebo and krill oil groups showed significant improvements in the questions in the JKOM and JOA questionnaires after administration. After the intervention, krill oil group showed more improvements than placebo group in two questions regarding the pain and stiffness in knees in JKOM. Controlling for age, sex, weight, and smoking and drinking habits, krill oil significantly mitigated knee pain in sleeping (P < 0.001, standing (P < 0.001 and the range of motion of both right and left knees (both P = 0.011 compared to placebo. Krill oil administration raised plasma EPA (P = 0.048 and EPA/AA ratio (P = 0.003.This study indicates that krill oil administration (2 g/day, 30 days improved the subjective symptoms of knee pain in adults with mild knee pain.UMIN-CTR; ID UMIN000014413.

Colonic diverticulosis: evaluation with double contrast barium enema

International Nuclear Information System (INIS)

Ko, Jae Kook; Lee, Jong Koo; Yun, Eun Joo; Moon, Hee Jung; Shin, Hyun Ja

1997-01-01

To evaluate the pattern of colonic diverticulosis according to age and sex, and recent trend. The authors retrospectively reviewed 120 cases of colonic diverticulosis in 1,020 patients who had undergone a double contrast barium enema examination between January 1st, 1993, and December 31st, 1995, and analyzed the frequency, size, multiplicity and anatomical site, according to age and sex. Diverticulum size was classified into one of three groups : less than 5mm, 5-10mm, over 10mm in diameter. The overall incidence of colonic diverticulosis was 120 cases among 1,020 patients(11.8%) with an incidence 5.3 times higher in males than in females. Peak incidence was in the fifth decade, with 19 cases (15.8%) among males, and after the sixth decade, with four cases(3.3%) among females. Mean age was 57.7 years. Diverticulum size of 5-10mm in diameter was predominant (2% of cases); average diameter was 5-6mm. The incidence of colonic diverticulosis was 5.1 times more frequent in the right colon (101 cases) than in the left (20 cases). The overall incidence of colonic diverticulosis has continually increased; in addition it has also recently increased slightly in left-sided colon. This is thought to be due to various factors, both congenital and acquired, including longer life with good health care, constipation, irritable bowel syndrome, stress and the tendency of eating patterns to more closely resemble those of the west

Colonic diverticulosis: evaluation with double contrast barium enema

Energy Technology Data Exchange (ETDEWEB)

Ko, Jae Kook; Lee, Jong Koo; Yun, Eun Joo; Moon, Hee Jung; Shin, Hyun Ja [Korea Veterans Hospital, Seoul (Korea, Republic of)

1997-02-01

To evaluate the pattern of colonic diverticulosis according to age and sex, and recent trend. The authors retrospectively reviewed 120 cases of colonic diverticulosis in 1,020 patients who had undergone a double contrast barium enema examination between January 1st, 1993, and December 31st, 1995, and analyzed the frequency, size, multiplicity and anatomical site, according to age and sex. Diverticulum size was classified into one of three groups : less than 5mm, 5-10mm, over 10mm in diameter. The overall incidence of colonic diverticulosis was 120 cases among 1,020 patients(11.8%) with an incidence 5.3 times higher in males than in females. Peak incidence was in the fifth decade, with 19 cases (15.8%) among males, and after the sixth decade, with four cases(3.3%) among females. Mean age was 57.7 years. Diverticulum size of 5-10mm in diameter was predominant (2% of cases); average diameter was 5-6mm. The incidence of colonic diverticulosis was 5.1 times more frequent in the right colon (101 cases) than in the left (20 cases). The overall incidence of colonic diverticulosis has continually increased; in addition it has also recently increased slightly in left-sided colon. This is thought to be due to various factors, both congenital and acquired, including longer life with good health care, constipation, irritable bowel syndrome, stress and the tendency of eating patterns to more closely resemble those of the west.

Double-bundle depiction of the anterior cruciate ligament at 3 Tesla

Energy Technology Data Exchange (ETDEWEB)

Adriaensen, M.E.A.P.M. [Atrium Medical Center Parkstad, Department of Radiology, Heerlen (Netherlands); Hogan, B. [Sports Surgery Clinic, Department of Radiology, Dublin (Ireland); Al-Bulushi, H.I.J. [Armed Forces Hospital, Department of Radiology, Muscat (Oman); Kavanagh, E.C. [Mater Misericordiae Hospital, Department of Radiology, Dublin (Ireland)

2012-07-15

Magnetic resonance imaging on 3 Tesla (3T MRI) with arthroscopic correlation has proven to adequately identify the anteromedial bundle (AMB) and posterolateral bundle (PLB) in cadaver knees. The purpose of this study was to describe the depiction of ACL bundle anatomy on 3T MRI in daily practice. In a retrospective cohort study, we included 50 consecutive patients who underwent standard 3T MRI of the knee and had an intact ACL. Two musculoskeletal radiologists independently reviewed all scans for depiction of ACL bundle anatomy using standardized forms. Descriptive statistics were used. Twenty-three right knees (46%) and 27 left knees (54%) were included in the study. Mean age of the patients was 35 years (range 12 to 68 years); 37 patients were male (74%). ACL bundle anatomy was best depicted in the axial plane in 44 knees (88%) and in the coronal plane in six knees (12%). Two bundles were seen in 47 knees (94%). The AMB was completely seen in 45 knees (90%). The PLB was completely seen in 40 knees (80%). Both bundles were completely seen in 37 knees (76%). The double-bundle anatomy of the ACL is visualized in 94% of patients on 3T MRI. Because of potentially associated clinical benefits, we advocate to report separately on the anteromedial bundle and posterolateral bundle in case of anterior cruciate ligament injury of the knee. (orig.)

Limitations of combined flexible sigmoidoscopy and double contrast barium enema in patients with rectal bleeding

International Nuclear Information System (INIS)

Hixson, L.J.; Sampliner, R.E.; Chernin, M.; Amberg, J.; Kogan, F.; Veterans Administration Medical Center, Tucson, AZ

1989-01-01

Eighty-seven outpatients with non-massive rectal bleeding or asymptomatic positive fecal occult blood were evaluated with 35 cm flexible sigmoidoscopy, double contrast barium enema (DBCE) and colonoscopy. 82% had hemorrhoids and 35% harbored colorectal neoplasia. The combination of flexible sigmoidoscopy and DCBE missed none of 7 malignant lesions. However, 35% of benign polyps ≥ 1 cm and 60.5% of those < 1 cm were not detected by this combination. The presence of hemorrhoids should not prevent a search for colon neoplasia and colonoscopy is the preferred method. (orig.)

Accuracy of the double contrast technique in the detection of small lesions of the colon

Energy Technology Data Exchange (ETDEWEB)

Muzzio, P C; Pomerri, F; Feltrin, G P; Biondetti, P R; Di Maggio, C [Padua Univ. (Italy). Istituto di Radiologia e Fisioterapia

1979-02-01

Double contrast enema has become an indispensible aid in early lesions of the colon, in particular for small lesions. According to the authors' opinion, the method provides so much additional information that it ought to be applied at all rates in such cases. It is neither expensive nor time-consuming and can easily be carried out in any X-ray department, especially where a fibroscope is not available. The results are reliable if the technique is applied correctly, if the patient is well-prepared, and if the radiologist has enough technical and semiological experience.

Imaging assessment of the modified double contrast barium enema using carboxymethylcellulose on radiography and ultrasonography in dogs.

Science.gov (United States)

Choi, Mihyun; Lee, Namsoon; Kim, Junyoung; Yi, Kangjae; Jung, Joohyun; Yoon, Junghee; Choi, Mincheol

2011-01-01

A modified double contrast barium enema using carboxymethylcellulose was evaluated in beagle dogs and compared with dogs receiving a conventional barium enema. The experimental group was divided into three groups (1, 2, and 3) and given 30 ml/kg of different volume ratios of a barium vs. carboxymethylcellulose mixture. Each group underwent sonography following radiography. The volume ratio of one part barium to three parts carboxymethylcellulose was judged to be the optimal mixture, resulting in a general distribution of contrast and bowel radiolucency on radiographs and adequate postradiography sonography. The modified barium enema using carboxymethylcellulose is useful for assessing the general morphology and mucosal layers of the colon simultaneously on radiographs and ultrasonographs.

Assessment of DNA double-strand breaks induced by intravascular iodinated contrast media following in vitro irradiation and in vivo, during paediatric cardiac catheterization.

Science.gov (United States)

Gould, Richard; McFadden, Sonyia L; Horn, Simon; Prise, Kevin M; Doyle, Philip; Hughes, Ciara M

2016-01-01

Paediatric cardiac catheterizations may result in the administration of substantial amounts of iodinated contrast media and ionizing radiation. The aim of this work was to investigate the effect of iodinated contrast media in combination with in vitro and in vivo X-ray radiation on lymphocyte DNA. Six concentrations of iodine (15, 17.5, 30, 35, 45, and 52.5 mg of iodine per mL blood) represented volumes of iodinated contrast media used in the clinical setting. Blood obtained from healthy volunteers was mixed with iodinated contrast media and exposed to radiation doses commonly used in paediatric cardiac catheterizations (0 mGy, 70 mGy, 140 mGy, 250 mGy and 450 mGy). Control samples contained no iodine. For in vivo experimentation, pre and post blood samples were collected from children undergoing cardiac catheterization, receiving iodine concentrations of up to 51 mg of iodine per mL blood and radiation doses of up to 400 mGy. Fluorescence microscopy was performed to assess γH2AX-foci induction, which corresponded to the number of DNA double-strand breaks. The presence of iodine in vitro resulted in significant increases of DNA double-strand breaks beyond that induced by radiation for ≥ 17.5 mg/mL iodine to blood. The in vivo effects of contrast media on children undergoing cardiac catheterization resulted in a 19% increase in DNA double-strand breaks in children receiving an average concentration of 19 mg/mL iodine to blood. A larger investigation is required to provide further information of the potential benefit of lowering the amount of iodinated contrast media received during X-ray radiation investigations. Copyright © 2015 John Wiley & Sons, Ltd.

Computed tomography using contrast medium in disorders of the patello-femoral joint

Energy Technology Data Exchange (ETDEWEB)

Suzuki, Kenji; Chiba, Mitsuho; Morita, Hiromi; Kikuchi, Toshihiko; Shimada, Yoichi; Yamamoto, Masahiro; Tozawa, Kazuma

1985-01-01

The morphology and alignment of the articular cartilage of the patello-femoral joint were examined by computed tomography (CT) using a contrast medium in 15 patients with a chief complaint of patellar pain. CT was undertaken immediately after injecting a contrast medium and air into the knee joint. Retention and irregularity of the contrast medium in the joint estimated the expansion and depth of lesions in patients with osteomalacia of the auricular joint or osteoarthritis of the knee, and the thickness of the auricular cartilage. Considering the individual differences of the patella itself and specificity of the form of the auricular cartilage, the auricular joint should also be examined in terms of alignment of the cartilage surface. CT using a contrast medium is a simple, less invasive method for evaluating disorders of the patello-femoral joint.

Magnetic Resonance Imaging Comparison of Intra-Articular Cavernous Synovial Hemangioma and Cystic Synovial Hyperplasia of the Knee

International Nuclear Information System (INIS)

De Filippo, M.; Rovani, C.; Sudberry, J. J.; Rossi, F.; Pogliacomi, F.; Zompatori, M.

2006-01-01

Purpose: To identify and compare magnetic resonance imaging (MRI) characteristics, with and without intravenous contrast medium, of cavernous synovial hemangiomas and cystic synovial hyperplasia. Material and Methods: Four cases of cavernous synovial hemangioma and five of cystic synovial hyperplasia of the knee were studied retrospectively. The patients (5 F and 4 M; 15-25 years of age) all had long-standing knee pain. At clinical examination we observed elastic swelling and pain without significant joint effusion. The patients underwent conventional radiography and MRI without and following intravenous contrast medium before arthroscopic biopsy. Results: The radiographs were interpreted as negative in all patients. MRI examination without contrast medium revealed a similar multicystic appearance for both lesions. Following intravenous contrast agent administration, cavernous synovial hemangiomas demonstrated avid, rather homogenous enhancement, whereas cystic synovial hyperplasia demonstrated less intense, peripheral enhancement only. Arthroscopy with histological examination of the lesions confirmed the MRI diagnosis in every case. Conclusion: In our experience, cavernous synovial hemangioma and cystic synovial hyperplasia have a similar appearance on unenhanced MRI, but can be reliably differentiated on the basis of enhancement characteristics following intravenous contrast administration. Keywords: Cavernous synovial hemangioma; cystic synovial hyperplasia; knee; MRI

Partial knee replacement

Science.gov (United States)

... good range of motion in your knee. The ligaments in your knee are stable. However, most people with knee arthritis have a surgery called a total knee arthroplasty (TKA). Knee replacement is most often done in people age 60 ...

Role of the double-contrast barium enema in rectal stenosis due to suppositories containing paracetamol and acetylsalicylic acid

International Nuclear Information System (INIS)

Tannouri, F.; Lalmand, B.; Zalcman, M.; Gansbeke, D. van; Gevenois, P.A.; Struyven, J.; Peny, M.O.; Gossum, A. van

1998-01-01

Self-treatment of chronic headache with suppositories containing paracetamol and acetylsalaicylic acid may lead to serious complications. We report the radiological features of five cases of rectal stenosis following the use of such suppositories. The role of the double-contrast barium enema in suggesting the diagnosis of this complication of a chronic and often unrecognized self-treatment is emphasized. (orig.)

Swing Phase Control of Semi-Active Prosthetic Knee Using Neural Network Predictive Control With Particle Swarm Optimization.

Science.gov (United States)

Ekkachai, Kittipong; Nilkhamhang, Itthisek

2016-11-01

In recent years, intelligent prosthetic knees have been developed that enable amputees to walk as normally as possible when compared to healthy subjects. Although semi-active prosthetic knees utilizing magnetorheological (MR) dampers offer several advantages, they lack the ability to generate active force that is required during some states of a normal gait cycle. This prevents semi-active knees from achieving the same level of performance as active devices. In this work, a new control algorithm for a semi-active prosthetic knee during the swing phase is proposed to reduce this gap. The controller uses neural network predictive control and particle swarm optimization to calculate suitable command signals. Simulation results using a double pendulum model show that the generated knee trajectory of the proposed controller is more similar to the normal gait than previous open-loop controllers at various ambulation speeds. Moreover, the investigation shows that the algorithm can be calculated in real time by an embedded system, allowing for easy implementation on real prosthetic knees.

Quantitative Assessment of Degenerative Cartilage and Subchondral Bony Lesions in a Preserved Cadaveric Knee: Propagation-Based Phase-Contrast CT Versus Conventional MRI and CT.

Science.gov (United States)

Geith, Tobias; Brun, Emmanuel; Mittone, Alberto; Gasilov, Sergei; Weber, Loriane; Adam-Neumair, Silvia; Bravin, Alberto; Reiser, Maximilian; Coan, Paola; Horng, Annie

2018-04-09

The aim of this study was to quantitatively assess hyaline cartilage and subchondral bone conditions in a fully preserved cadaveric human knee joint using high-resolution x-ray propagation-based phase-contrast imaging (PBI) CT and to compare the performance of the new technique with conventional CT and MRI. A cadaveric human knee was examined using an x-ray beam of 60 keV, a detector with a 90-mm 2 FOV, and a pixel size of 46 × 46 μm 2 . PBI CT images were reconstructed with both the filtered back projection algorithm and the equally sloped tomography method. Conventional 3-T MRI and CT were also performed. Measurements of cartilage thickness, cartilage lesions, International Cartilage Repair Society scoring, and detection of subchondral bone changes were evaluated. Visual inspection of the specimen akin to arthroscopy was conducted and served as a standard of reference for lesion detection. Loss of cartilage height was visible on PBI CT and MRI. Quantification of cartilage thickness showed a strong correlation between the two modalities. Cartilage lesions appeared darker than the adjacent cartilage on PBI CT. PBI CT showed similar agreement to MRI for depicting cartilage substance defects or lesions compared with the visual inspection. The assessment of subchondral bone cysts showed moderate to strong agreement between PBI CT and CT. In contrast to the standard clinical methods of MRI and CT, PBI CT is able to simultaneously depict cartilage and bony changes at high resolution. Though still an experimental technique, PBI CT is a promising high-resolution imaging method to evaluate comprehensive changes of osteoarthritic disease in a clinical setting.

Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction With a Free Quadriceps Tendon Autograft.

Science.gov (United States)

Caterev, Sergiu; Nistor, Dan Viorel; Todor, Adrian

2016-10-01

Anatomic double-bundle anterior cruciate ligament (ACL) reconstruction aims to restore the 2 functional bundles of the ACL in an attempt to better reproduce the native biomechanics of the injured knee and promote long-term knee health. However, this concept is not fully accepted and is not performed on a standard basis. In addition, the superiority of this technique over the conventional single-bundle technique has been questioned, especially the long-term clinical results. One of the down sides of the double-bundle reconstruction is the complexity of the procedure, with increased risks, operative time, and costs compared with the single-bundle procedure. Also, the revision procedure, if necessary, is more challenging. We propose a technique that has some advantages over the traditional double-bundle procedure, using a single femoral tunnel, 2 tibial tunnels, and a free quadriceps tendon autograft.

Knee arthroscopy

Science.gov (United States)

... debridement; Meniscus repair; Lateral release; Knee surgery; Meniscus - arthroscopy; Collateral ligament - arthroscopy ... pain relief (anesthesia) may be used for knee arthroscopy surgery: Local anesthesia. Your knee may be numbed ...

Double-contrast gastrography and gastroscopy in the diagnosis of gastric polyps. Personal experience

Energy Technology Data Exchange (ETDEWEB)

Biscarini, R; Giorgi, G; Lazzari, G and others

1986-01-01

Gastric polyps are benign tumors which have been less uncommonly detected in recent years, due to the refinement of both radiologic and endoscopic investigations. From 1981 through 1985 gastric polyps were detected in 102 patients (1,9%) out of 5368 radiologic examination. In the same period, 98 cases (3,3%) were detected out of 2942 endoscopic examination. The comparison of data in these two series shows a superimposition. Despite an increased percentage of endoscopic findings (to some extent due to previous radiologic reports), the authors assert the diagnostic efficacy of double contrast radiologic investigation as a first approach to benign polypous lesions of the stomach. As far as histology is concerned, a clear prevalence is shown of hyperplastic versus adenomatous polyps (90 and 8 cases repectively).

Anterior knee pain

Science.gov (United States)

Patellofemoral syndrome; Chondromalacia patella; Runner's knee; Patellar tendinitis; Jumper's knee ... kneecap (patella) sits over the front of your knee joint. As you bend or straighten your knee, ...

Knee Arthrodesis After Failure of Knee Arthroplasty

DEFF Research Database (Denmark)

Gottfriedsen, Tinne B; Morville Schrøder, Henrik; Odgaard, Anders

2016-01-01

BACKGROUND: Arthrodesis is considered a salvage procedure after failure of a knee arthroplasty. Data on the use of this procedure are limited. The purpose of this study was to identify the incidence, causes, surgical techniques, and outcomes of arthrodesis after failed knee arthroplasty...... in a nationwide population. METHODS: Data were extracted from the Danish Civil Registration System, the Danish National Patient Register, and the Danish Knee Arthroplasty Register. A total of 92,785 primary knee arthroplasties performed in Denmark from 1997 to 2013 were identified by linking the data using....... Differences in cumulative incidence were compared with the Gray test. RESULTS: A total of 164 of the 165 arthrodeses were performed for causes related to failed knee arthroplasty. The 15-year cumulative incidence of arthrodesis was 0.26% (95% confidence interval, 0.21% to 0.31%). The 5-year cumulative...

[Knee disarticulation and through-knee amputation].

Science.gov (United States)

Baumgartner, R

2011-10-01

A knee disarticulation or a through-knee stump is superior compared to a transfemoral stump. The thigh muscles are all preserved, and the muscle balance remains undisturbed. The range of motion of the hip joint is not limited. The bulbous shape of the stump allows full weight bearing at the stump end and can easily be fitted with a prosthesis. An amputee with a bilateral knee disarticulation is able to walk "barefoot". A more distal amputation level, e.g., an ultra-short transtibial amputation, is not possible. Important alternative to transfemoral amputations. Possible for any etiology except for Buerger-Winiwarter's disease. New indications are infected and loosened total knee replacements. Preservation of the knee joint is possible. Knee disarticulation is a very atraumatic procedure, compared to transfemoral amputations. Neither bones nor muscles have to be severed, just skin, ligaments, vessels, and nerves. Even the meniscal cartilages may be left in place to act as axial shock absorbers. The cartilage of the femur is not resected, but only bevelled in case of osteoarthritis. There are no tendon attachments or myoplastic procedures necessary. The patella remains in place and is held in position only by the retinacula. Skin closure must be performed without the slightest tension, and if possible not in the weight-bearing area. Transcondylar amputations across the femoral condyles only are indicated when there are not sufficient soft tissues for wound closure of a knee disarticulation. Alternatives as the techniques of Gritti, Klaes, and Eigler, the shortening of the femur and the Sauerbruch's rotation plasty [14] are presented and discussed. The risk of decubital ulcers is rather high. Correct bandaging of the stump is, therefore, particularly important. Prosthetic fitting is possible 3-6 weeks after surgery. The type of prosthesis depends on the amputee's activity level. The superior performance of amputees with knee disarticulations in sports prove the

Evaluation of Single-Bundle versus Double-Bundle PCL Reconstructions with More Than 10-Year Follow-Up

Directory of Open Access Journals (Sweden)

Masataka Deie

2015-01-01

Full Text Available Background. Posterior cruciate ligament (PCL injuries are not rare in acute knee injuries, and several recent anatomical studies of the PCL and reconstructive surgical techniques have generated improved patient results. Now, we have evaluated PCL reconstructions performed by either the single-bundle or double-bundle technique in a patient group followed up retrospectively for more than 10 years. Methods. PCL reconstructions were conducted using the single-bundle (27 cases or double-bundle (13 cases method from 1999 to 2002. The mean age at surgery was 34 years in the single-bundle group and 32 years in the double-bundle group. The mean follow-up period was 12.5 years. Patients were evaluated by Lysholm scoring, the gravity sag view, and knee arthrometry. Results. The Lysholm score after surgery was 89.1±5.6 points for the single-bundle group and 91.9±4.5 points for the double-bundle group. There was no significant difference between the methods in the side-to-side differences by gravity sag view or knee arthrometer evaluation, although several cases in both groups showed a side-to-side difference exceeding 5 mm by the latter evaluation method. Conclusions. We found no significant difference between single- and double-bundle PCL reconstructions during more than 10 years of follow-up.

Does knee awareness differ between different knee arthroplasty prostheses?

DEFF Research Database (Denmark)

Thomsen, Morten G; Latifi, Roshan; Kallemose, Thomas

2016-01-01

BACKGROUND: Low knee awareness after Total Knee Arthroplasty (TKA) has become the ultimate goal in trying to achieve a natural feeling knee that meet patient expectations. To accommodate this manufacturers of TKAs have developed new prosthetic designs that potentially could give patients a more...... natural feeling knee during activities. The purpose af this study was to compare the Forgotten Joint Score (FJS) and Oxford Knee Score (OKS) of patients treated with a previous generation standard Cruciate Retaining (CR) TKA to the scores obtained by patients treated with a newer generation CR TKA...

Knee Arthroscopy Simulation: A Randomized Controlled Trial Evaluating the Effectiveness of the Imperial Knee Arthroscopy Cognitive Task Analysis (IKACTA) Tool.

Science.gov (United States)

Bhattacharyya, Rahul; Davidson, Donald J; Sugand, Kapil; Bartlett, Matthew J; Bhattacharya, Rajarshi; Gupte, Chinmay M

2017-10-04

Virtual-reality and cadaveric simulations are expensive and not readily accessible. Innovative and accessible training adjuncts are required to help to meet training needs. Cognitive task analysis has been used extensively to train pilots and in other surgical specialties. However, the use of cognitive task analyses within orthopaedics is in its infancy. The purpose of this study was to evaluate the effectiveness of a novel cognitive task analysis tool to train novice surgeons in diagnostic knee arthroscopy in high-fidelity, phantom-limb simulation. Three expert knee surgeons were interviewed independently to generate a list of technical steps, decision points, and errors for diagnostic knee arthroscopy. A modified Delphi technique was used to generate the final cognitive task analysis. A video and a voiceover were recorded for each phase of this procedure. These were combined to produce the Imperial Knee Arthroscopy Cognitive Task Analysis (IKACTA) tool that utilizes written and audiovisual stimuli to describe each phase of a diagnostic knee arthroscopy. In this double-blinded, randomized controlled trial, a power calculation was performed prior to recruitment. Sixteen novice orthopaedic trainees who performed ≤10 diagnostic knee arthroscopies were randomized into 2 equal groups. The intervention group (IKACTA group) was given the IKACTA tool and the control group had no additional learning material. They were assessed objectively (validated Arthroscopic Surgical Skill Evaluation Tool [ASSET] global rating scale) on a high-fidelity, phantom-knee simulator. All participants, using the Likert rating scale, subjectively rated the tool. The mean ASSET score (and standard deviation) was 19.5 ± 3.7 points in the IKACTA group and 10.6 ± 2.3 points in the control group, resulting in an improvement of 8.9 points (95% confidence interval, 7.6 to 10.1 points; p = 0.002); the score was determined as 51.3% (19.5 of 38) for the IKACTA group, 27.9% (10.6 of 38) for the

Civamide cream 0.075% in patients with osteoarthritis of the knee: a 12-week randomized controlled clinical trial with a longterm extension.

Science.gov (United States)

Schnitzer, Thomas J; Pelletier, Jean-Pierre; Haselwood, Doug M; Ellison, William T; Ervin, John E; Gordon, Richard D; Lisse, Jeffrey R; Archambault, W Tad; Sampson, Allan R; Fezatte, Heidi B; Phillips, Scott B; Bernstein, Joel E

2012-03-01

To evaluate the safety and efficacy of civamide cream 0.075% for the treatment of osteoarthritis (OA) of the knee. We conducted a 12-week, multicenter, randomized, double-blind study with a 52-week open-label extension. Patients with OA of the knee received either civamide cream 0.075% or a lower dose of civamide cream, 0.01%, as the control. The 3 co-primary endpoints in the double-blind study were the time-weighted average (TWA) of change from baseline to Day 84 in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale, the WOMAC physical function subscale, and the Subject Global Evaluation (SGE). In the 52-week open-label extension study, the Osteoarthritis Pain Score and SGE were assessed. A total of 695 patients were randomized to receive civamide cream 0.075% (n = 351) or civamide cream 0.01% (control; n = 344) in the double-blind study. Significance in favor of civamide cream 0.075% was achieved for the TWA for all 3 co-primary efficacy variables: WOMAC pain (p = 0.009), WOMAC physical function (p < 0.001), and SGE (p = 0.008); and at Day 84 for these 3 variables (p = 0.013, p < 0.001, and p = 0.049, respectively). These analyses accounted for significant baseline-by-treatment interactions. In the 52-week open-label extension, efficacy was maintained. Civamide cream 0.075% was well tolerated throughout the studies. These studies demonstrate the efficacy of civamide cream for up to 1 year of continuous use. Civamide cream, with its lack of systemic absorption, does not have the potential for serious systemic toxicity, in contrast to several other OA treatments.

21 CFR 888.3570 - Knee joint femoral (hemi-knee) metallic uncemented prosthesis.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Knee joint femoral (hemi-knee) metallic uncemented... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3570 Knee joint femoral (hemi-knee) metallic uncemented prosthesis. (a) Identification. A knee joint femoral (hemi-knee...

Combined intra-articular glucocorticoid, bupivacaine and morphine reduces pain and convalescence after diagnostic knee arthroscopy

DEFF Research Database (Denmark)

Rasmussen, Sten; Lorentzen, Jan S; Larsen, Allan S

2002-01-01

We studied the effect of intra-articullar saline vs. bupivacaine + morphine or bupivacaine morphine + methylprednisolone after diagnostic knee arthroscopy. In a double-blind randomized study, 60 patients undergoing diagnostic knee arthroscopy without a therapeutic procedure were allocated to groups...... receiving intra-articular saline, intra-articular bupivacaine 150 mg + morphine 4 mg or the same dose of bupivacaine + morphine + intra-articular methylprednisolone 40 mg at the end of arthroscopy during general anesthesia. All patients were instructed to resume normal activities immediately after...

Role of the double-contrast barium enema in rectal stenosis due to suppositories containing paracetamol and acetylsalicylic acid

Energy Technology Data Exchange (ETDEWEB)

Tannouri, F.; Lalmand, B.; Zalcman, M.; Gansbeke, D. van; Gevenois, P.A.; Struyven, J. [Department of Radiology, Hopital Erasme, University of Brussels (Belgium); Peny, M.O. [Department of Pathology, University of Brussels (Belgium); Gossum, A. van [Department of Gastroenterology, University of Brussels (Belgium)

1998-09-01

Self-treatment of chronic headache with suppositories containing paracetamol and acetylsalaicylic acid may lead to serious complications. We report the radiological features of five cases of rectal stenosis following the use of such suppositories. The role of the double-contrast barium enema in suggesting the diagnosis of this complication of a chronic and often unrecognized self-treatment is emphasized. (orig.) With 6 figs., 20 refs.

Self-reported previous knee injury and low knee function increase knee injury risk in adolescent female football

DEFF Research Database (Denmark)

Clausen, Mikkel Bek; Tang, L; Zebis, M K

2016-01-01

with low KOOS subscale scores (Sport/Recreational (RR: 2.2) and Quality of Life (RR: 3.0) (P time-loss knee...... questionnaires were collected at baseline. Time-loss knee injuries and football exposures were reported weekly by answers to standardized text-message questions, followed by injury telephone interviews. A priori, self-reported previous knee injury and low KOOS subscale scores (... as independent variables in the risk factor analyses. The study showed that self-reported previous knee injury significantly increased the risk of time-loss knee injury [relative risk (RR): 3.65, 95% confidence (CI) 1.73-7.68; P time-loss knee injury was also significantly increased in players...

Magnification bone scan of knees for knee pain evaluation

International Nuclear Information System (INIS)

Lee, Myoung Hoon; Park, Chan H.; Yoon, Seok Nam; Hwang, Kyung Hoon

2001-01-01

Knee pain is one of the common complaints of patients seen in our orthopedic clinic. Routine anterior and posterior views of whole body bone scan (WBBS) is often not sufficient in the evaluation of these patients. An ideal bone scan using pinhole collimator or single photon emission tomography (SPECT), however, is impractical and time consuming in busy nuclear medicine department with limited resources. Therefore, the aim of the study is to assess limited bone scan of knees with magnification (LNSKM) for knee pain evaluation. Technical aspect of LBSKM and diagnostic efficacy are discussed on this poster. Adult patients with knee pain were reffered for LBSKM from an orthopedic surgen specializing knees. Four hundred fifteen LBSKMs were performed since 1999. patients were given 740 MBq (20mCi) Tc-99m MDP intravenously and 3 hours later LBSKM was performed using a low energy high resolution parallel hole collimator and Siemens Orbitor camera. (Simens medical systems. Inc., Hoffman Estates, III., USA). Anterior view of the knees was taken for 5 min, without magnification and both lateral views of symptomatic knees were obtained with electronic magnification (1.25, upto 2.0) for 8 min each. Disease processes such as DJD, traumatic arthritis, P-F tendonitis, SONK, meniscus tear are detected and illustrated along with normal knee scan finding. We believe LBSKM may not be as good as SPECT or pinhole imaging of the knees in the evaluation of knee pain but superior to routine WBBS in the nuclear medicine department with limited resources of instrumentation and manpower

Association of knee confidence with pain, knee instability, muscle strength, and dynamic varus-valgus joint motion in knee osteoarthritis.

Science.gov (United States)

Skou, Søren T; Wrigley, Tim V; Metcalf, Ben R; Hinman, Rana S; Bennell, Kim L

2014-05-01

To investigate associations between self-reported knee confidence and pain, self-reported knee instability, muscle strength, and dynamic varus-valgus joint motion during walking. We performed a cross-sectional analysis of baseline data from 100 participants with symptomatic and radiographic medial tibiofemoral compartment osteoarthritis (OA) and varus malalignment recruited for a randomized controlled trial. The extent of knee confidence, assessed using a 5-point Likert scale item from the Knee Injury and Osteoarthritis Outcome Score, was set as the dependent variable in univariable and multivariable ordinal regression, with pain during walking, self-reported knee instability, quadriceps strength, and dynamic varus-valgus joint motion during walking as independent variables. One percent of the participants were not troubled with lack of knee confidence, 17% were mildly troubled, 50% were moderately troubled, 26% were severely troubled, and 6% were extremely troubled. Significant associations were found between worse knee confidence and higher pain intensity, worse self-reported knee instability, lower quadriceps strength, and greater dynamic varus-valgus joint motion. The multivariable model consisting of the same variables significantly accounted for 24% of the variance in knee confidence (P knee confidence is associated with higher pain, worse self-reported knee instability, lower quadriceps muscle strength, and greater dynamic varus-valgus joint motion during walking. Since previous research has shown that worse knee confidence is predictive of functional decline in knee OA, addressing lack of knee confidence by treating these modifiable impairments could represent a new therapeutic target. Copyright © 2014 by the American College of Rheumatology.

Conservatively treated knee injury is associated with knee cartilage matrix degeneration measured with MRI-based T2 relaxation times. Data from the osteoarthritis initiative

Energy Technology Data Exchange (ETDEWEB)

Hofmann, Felix C. [University of California San Francisco, Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Technical University of Munich, Department of Radiology, Munich (Germany); Neumann, Jan; Heilmeier, Ursula; Joseph, Gabby B.; Link, Thomas M. [University of California San Francisco, Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Nevitt, Michael C.; McCulloch, Charles E. [University of California San Francisco, Department of Epidemiology and Biostatistics, San Francisco, CA (United States)

2018-01-15

To investigate the association of cartilage degeneration with previous knee injuries not undergoing surgery, determined by morphologic and quantitative 3-T magnetic resonance imaging (MRI). We performed a nested cross-sectional study of right knee MRIs from participants in the Osteoarthritis Initiative (OAI) aged 45-79 with baseline Kellgren-Lawrence score of 0-2. Cases were 142 right knees of patients with self-reported history of injury limiting the ability to walk for at least 2 days. Controls were 426 right knees without history of injury, frequency-matched to cases on age, BMI, gender, KL scores and race (1:3 ratio). Cases and controls were compared using covariate-adjusted linear regression analysis, with the outcomes of region-specific T2 mean, laminar analysis and heterogeneity measured by texture analysis to investigate early cartilage matrix abnormalities and the Whole-Organ Magnetic Resonance Imaging Score (WORMS) to investigate morphologic knee lesions. Compared to control subjects, we found significantly higher mean T2 values in the injury [lateral tibia (28.10 ms vs. 29.11 ms, p = 0.001), medial tibia (29.70 ms vs. 30.40 ms, p = 0.014) and global knee cartilage (32.73 ms vs. 33.29 ms, p = 0.005)]. Injury subjects also had more heterogeneous cartilage as measured by GLCM texture contrast, variance and entropy (p < 0.05 in 14 out of 18 texture parameters). WORMS gradings were not significantly different between the two groups (p > 0.05). A history of knee injury not treated surgically is associated with higher and more heterogeneous T2 values, but not with morphologic knee abnormalities. Our findings suggest that significant, conservatively treated knee injuries are associated with permanent cartilage matrix abnormalities. (orig.)

Conservatively treated knee injury is associated with knee cartilage matrix degeneration measured with MRI-based T2 relaxation times. Data from the osteoarthritis initiative

International Nuclear Information System (INIS)

Hofmann, Felix C.; Neumann, Jan; Heilmeier, Ursula; Joseph, Gabby B.; Link, Thomas M.; Nevitt, Michael C.; McCulloch, Charles E.

2018-01-01

To investigate the association of cartilage degeneration with previous knee injuries not undergoing surgery, determined by morphologic and quantitative 3-T magnetic resonance imaging (MRI). We performed a nested cross-sectional study of right knee MRIs from participants in the Osteoarthritis Initiative (OAI) aged 45-79 with baseline Kellgren-Lawrence score of 0-2. Cases were 142 right knees of patients with self-reported history of injury limiting the ability to walk for at least 2 days. Controls were 426 right knees without history of injury, frequency-matched to cases on age, BMI, gender, KL scores and race (1:3 ratio). Cases and controls were compared using covariate-adjusted linear regression analysis, with the outcomes of region-specific T2 mean, laminar analysis and heterogeneity measured by texture analysis to investigate early cartilage matrix abnormalities and the Whole-Organ Magnetic Resonance Imaging Score (WORMS) to investigate morphologic knee lesions. Compared to control subjects, we found significantly higher mean T2 values in the injury [lateral tibia (28.10 ms vs. 29.11 ms, p = 0.001), medial tibia (29.70 ms vs. 30.40 ms, p = 0.014) and global knee cartilage (32.73 ms vs. 33.29 ms, p = 0.005)]. Injury subjects also had more heterogeneous cartilage as measured by GLCM texture contrast, variance and entropy (p < 0.05 in 14 out of 18 texture parameters). WORMS gradings were not significantly different between the two groups (p > 0.05). A history of knee injury not treated surgically is associated with higher and more heterogeneous T2 values, but not with morphologic knee abnormalities. Our findings suggest that significant, conservatively treated knee injuries are associated with permanent cartilage matrix abnormalities. (orig.)

MRI evaluation of the bucket handle tears of menisci of the knee

International Nuclear Information System (INIS)

Zheng Zhuozhao; Fan Jiadong; Xie Jingxia

2003-01-01

Objective: To determine the value of five MR imaging signs in diagnosing the bucket handle tears (BHT) of menisci of the knee. Methods: MR imaging of 139 knees with subsequent arthroscopy exams were retrospectively evaluated. Based on the results of arthroscopy, 19 knees had BHT of menisci. Two radiologists evaluated each MR exam independently, with discrepancies resolved by consensus. Each MR exam was analyzed for five signs: a double posterior cruciate ligament sign, a flipped meniscus sign, an absent bow tie sign, an internal displaced fragment sign, and an abnormal circumferential meniscus sign. Sensitivity, specificity, positive and negative predictive values, and accuracy for diagnosing BHT of menisci were calculated for the presence of each individual sign. Results: The sensitivities of these five signs ranged between 52.6% and 89.5%, and specificities ranged between 83.3% and 98.3%, respectively. Positive and negative predictive values ranged between 42.9% and 88.2%, and between 92.7% and 98.3%, respectively. The accuracy of these five signs ranged between 82.7% and 96.4%. Conclusion: BHT of menisci may have many signs on MR imaging. The diagnostic sensitivities of the internal displaced fragment sign and the abnormal circumferential meniscus sign are the highest. The double posterior cruciate ligament sign has the highest specificity and positive predictive value, while the internal displaced fragment sign has the highest negative predictive value and accuracy

Clinical Efficacy and Safety of Benjakul Remedy Extract for Treating Primary Osteoarthritis of Knee Compared with Diclofenac: Double Blind, Randomized Controlled Trial

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Patamaporn Rachawat

2017-01-01

Full Text Available Background. The purpose of this study was to investigate the clinical efficacy and safety of Benjakul (BJK extract for treating primary osteoarthritis (OA of the knee compared with diclofenac. Methods. A phase 2, double blind, randomized, and controlled study was conducted. The BJK group received 300 mg of BJK extract per day, while another group received 75 mg of diclofenac per day. All patients were followed up at 14 and 28 days. The changing of visual analogue scale (VAS for pain, 100-meter walking times, the modified Thai WOMAC index scores, and the global assessment were evaluated for efficacy. For safety issue, clinical signs and symptoms, complete physical examination, and renal and liver function were evaluated. Results. 39 and 38 patients for BJK extract group and diclofenac group were evaluated. For efficacy, all patients from both groups reported a decrease in the VAS pain score and 100-meter walking times but only the diclofenac group showed significant reduction of both measurements when compared with day 0. The modified Thai WOMAC scores of both groups were significantly reduced from baseline. However, all efficacy outcomes were not significantly different for both groups. For safety outcomes, the patients from both groups had no severe adverse events reported and only BJK had no toxicity in renal and liver functions. Conclusions. The BJK remedy extract showed equal clinical efficacy in relieving symptoms of OA knee when compared with diclofenac.

Multimodal imaging of the human knee down to the cellular level

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Schulz, G.; Götz, C.; Müller-Gerbl, M.; Zanette, I.; Zdora, M.-C.; Khimchenko, A.; Deyhle, H.; Thalmann, P.; Müller, B.

2017-06-01

Computed tomography reaches the best spatial resolution for the three-dimensional visualization of human tissues among the available nondestructive clinical imaging techniques. Nowadays, sub-millimeter voxel sizes are regularly obtained. Regarding investigations on true micrometer level, lab-based micro-CT (μCT) has become gold standard. The aim of the present study is firstly the hierarchical investigation of a human knee post mortem using hard X-ray μCT and secondly a multimodal imaging using absorption and phase contrast modes in order to investigate hard (bone) and soft (cartilage) tissues on the cellular level. After the visualization of the entire knee using a clinical CT, a hierarchical imaging study was performed using the lab-system nanotom® m. First, the entire knee was measured with a pixel length of 65 μm. The highest resolution with a pixel length of 3 μm could be achieved after extracting cylindrically shaped plugs from the femoral bones. For the visualization of the cartilage, grating-based phase contrast μCT (I13-2, Diamond Light Source) was performed. With an effective voxel size of 2.3 μm it was possible to visualize individual chondrocytes within the cartilage.

The effect of knee brace and knee sleeve on the proprioception of the knee in young non-professional healthy sportsmen.

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Bottoni, G; Herten, A; Kofler, P; Hasler, M; Nachbauer, W

2013-12-01

Proprioception has been defined as the capacity to feel the position of a joint in space as sensed by the central nervous system. Prophylactic knee braces are supposed to help in knee injury prevention not just with a mechanical support of the joint but also improving proprioception. The main aim of this study was to determine the effects of a knee brace and a knee sleeve on knee proprioception. The secondary aim was to determine if different starting angles of the knee and different movement directions influence knee proprioception. We tested a group of twenty healthy male sport students without knee injuries. They were tested with the brace, with the sleeve and without support. The threshold of detection of passive knee movement with a starting knee angle of 30° and 60°, both in flexion and extension was determined. We did not find any statistically significant change in the threshold of detection of passive knee movement wearing the brace or the sleeve compared to the unsupported condition (p=0.462, α=0.05). We found a significantly lower proprioceptive sensitivity starting at the more flexed knee angle (p=0.005, α=0.05) and moving in extension than in the other test situations (p=0.001, α=0.05). Movement direction and starting position appear to influence the threshold of detection of passive knee movement. The results of this study also suggest that knee supports do not influence either positively or negatively knee proprioception of uninjured active subjects. Copyright © 2013 Elsevier B.V. All rights reserved.

Intra-articular Autologous Conditioned Plasma Injections Provide Safe and Efficacious Treatment for Knee Osteoarthritis: An FDA-Sanctioned, Randomized, Double-blind, Placebo-controlled Clinical Trial.

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Smith, Patrick A

2016-04-01

Platelet-rich plasma (PRP) injections have become an intriguing treatment option for osteoarthritis (OA), particularly OA of the knee. Despite the plethora of PRP-related citations, there is a paucity of high-level evidence that is comparable, cohort specific, dose controlled, injection protocol controlled, and double-blinded. To determine the safety and efficacy of leukocyte-poor PRP autologous conditioned plasma (ACP) for knee OA treatment through a feasibility trial regulated by the US Food and Drug Administration (FDA). Randomized controlled trial; Level of evidence, 1. In accordance with FDA protocol, patient selection was based on strict inclusion/exclusion criteria; 114 patients were screened, and 30 were ultimately included in the study. These patients were randomized to receive either ACP (n = 15) or saline placebo (n = 15) for a series of 3 weekly injections. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores served as the primary efficacy outcome measure. Patients were followed for 1 year. No adverse events were reported for ACP administration. Furthermore, the results demonstrated no statistically significant difference in baseline WOMAC scores between the 2 groups. However, in the ACP group, WOMAC scores at 1 week were significantly decreased compared with baseline scores, and the scores for this group remained significantly lower throughout the study duration. At the study conclusion (12 months), subjects in the ACP group had improved their overall WOMAC scores by 78% from their baseline score, compared with 7% for the placebo group. ACP is safe and provides quantifiable benefits for pain relief and functional improvement with regard to knee OA. No adverse events were reported for ACP administration. After 1 year, WOMAC scores for the ACP subjects had improved by 78% from their baseline score, whereas scores for the placebo control group had improved by only 7%. Other joints affected with OA may also benefit from this

Influence of aspheric intraocular lens on frequency doubling technology and contrast sensitivity: a fellow eye study

Directory of Open Access Journals (Sweden)

Rodrigo França de Espíndola

2014-12-01

Full Text Available Purpose: To evaluate whether implantation of an aspheric intraocular lens (IOL results in reduced ocular aberrations and improved contrast sensitivity after cataract surgery and, therefore, changes on frequency-doubling technology (FDT testing. Methods: The present prospective clinical study enrolled 25 patients with bilateral cataract (50 eyes, who randomly received either an aspheric (Akreos AO or a spherical (Akreos Fit IOL in one eye and the other IOL in the second eye. Assessment 12 months postoperatively included photopic and mesopic contrast sensitivity testing. Higher-order aberrations (HOAs were computed. FDT testing was divided into four areas to evaluate the variation of the values at different points. The median values of the local pattern thresholds (median area contrast sensitivity [MACS] obtained with that division were calculated. Results: The Akreos AO group obtained statistically significantly lower values of HOAs and spherical aberration compared with the Akreos Fit group. There was a statistically significant between-group difference in contrast sensitivity under mesopic conditions at all spatial frequencies. No statistically significant differences were observed in mean deviation and pattern standard deviation. The aspheric IOL exhibited higher MACS in all areas, although a statistically significant difference was reached only in the 20-degree field area (P=0.043. Conclusion: Aspheric IOLs significantly reduced spherical aberration and HOAs, improving mesopic contrast sensitivity. Although there was a trend toward slightly improved FDT in the aspheric IOL group, it was not statistically significant.

Double-contrast imaging of the pharynx in case of dysphagia as the leading symptom. Methodology and diagnostic value

Energy Technology Data Exchange (ETDEWEB)

Feyerabend, T; Schmitt, R; Richter, E; Bohndorf, W

1989-01-01

The article explains the value of double-contrast pharyngography in the gradual programme of diagnostic means for clarifying the symptom of dysphagia. The method is simple and quick and well suited as a first screening method before more complicated methods are used. It allows reliable assessment of postoperative or postradiogenic morphology in case of malignant oro- or hypopharynx tumors and thus also is suitable for tumor aftercare programmes. (orig./GDG).

Bouncy knee in a semi-automatic knee lock prosthesis.

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Fisher, L D; Lord, M

1986-04-01

The Bouncy Knee concept has previously proved of value when fitted to stabilised knee units of active amputees. The stance phase flex-extend action afforded by a Bouncy Knee increased the symmetry of gait and also gave better tolerance to slopes and uneven ground. A bouncy function has now been incorporated into a knee of the semi-automatic knee lock design in a pilot laboratory trial involving six patients. These less active patients did not show consistent changes in symmetry of gait, but demonstrated an improved ability to walk on slopes and increased their walking range. Subjective response was positive, as noted in the previous trials.

Radiography, radionuclide imaging, and asthrography in the evaluation of total hip and knee replacement

International Nuclear Information System (INIS)

Gelman, M.I.; Coleman, R.E.; Stevens, P.M.; Davey, B.W.

1978-01-01

Twenty patients with 21 total joint replacements including 17 hips and 4 knees were studied by plain film radiography, radionuclide imaging, and subtraction arthrography to evaluate these procedures for assessing prosthetic complications. Surgery was performed in 14 patients and confirmed loosening of 8 femoral and 7 acetabular hip prosthesis components and 1 femoral and 4 tibial knee prosthesis components. Plain films suggested loosening of only 9 hip components and no knee components. In contrast, radionuclide imaging and subtraction arthrography were considerably more effective in demonstrating loosening as well as other causes of the painful total joint prosthesis

Knee pain (image)

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The location of knee pain can help identify the problem. Pain on the front of the knee can be due to bursitis, arthritis, or ... synovial fluid) that forms behind the knee. Overall knee pain can be due to bursitis, arthritis, tears in ...

Effect of 12 months treatment with chondroitin sulfate on cartilage volume in knee osteoarthritis patients: a randomized, double-blind, placebo-controlled pilot study using MRI.

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Railhac, J-J; Zaim, M; Saurel, A-S; Vial, J; Fournie, B

2012-09-01

This pilot study aimed to evaluate the correlation between clinical symptoms and cartilage volume through MRI in patients with knee osteoarthritis after 48 weeks of treatment with Structum®. Multicenter, double-blind, placebo-controlled, parallel-group study. Symptomatic knee osteoarthritis patients aged 50-75 years received either Structum® (500 mg twice daily; N = 22) or placebo (N = 21) during 48 weeks. Inclusion criteria were global pain in the target knee ≥30 mm (VAS 0-100) and radiological Kellgren-Lawrence grade 2 or 3. Clinical assessments included Lequesne index and VAS for pain on motion, at baseline, 24 and 48 weeks, and MRI at baseline and at 24 and 48 weeks. Global and compartments cartilage volume, joint cartilage abnormalities, meniscal lesions, ligaments abnormalities, synovitis, synovial effusion, osteophytes, subchondral cysts, popliteal cysts and subchondral oedema were quantified. The quantitative and qualitative reproducibility of MRI was tested by the Spearman correlation coefficient and kappa coefficients, respectively. Treatments were compared by an analysis of covariance with baseline value as covariate. Groups were comparable at baseline for demographics, disease characteristics, and cartilage volumes. A significant inter-readers correlation was seen for the assessment of cartilage volumes, number of cysts, and osteophytes (correlation coefficients from 0.951 to 0.980 within investigator and from 0.714 to 0.957). After 48 weeks, symptoms improved in both groups. The total cartilage volume increased in the Structum® group (+180 mm(3) + SD) which opposed to a loss in the placebo (-46 mm(3) + SD; NS). No statistically significant differences between groups were observed for the other MRI parameters. No correlations were evidenced between key MRI parameters changes and symptoms. The difference in the evolution of cartilage volume between the two groups could reflect a structure modifying effect of Structum

Knee effusion-synovitis volume measurement and effects of vitamin D supplementation in patients with knee osteoarthritis.

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Wang, X; Cicuttini, F; Jin, X; Wluka, A E; Han, W; Zhu, Z; Blizzard, L; Antony, B; Winzenberg, T; Jones, G; Ding, C

2017-08-01

To develop a measure of knee joint effusion-synovitis volume and to examine the effect of vitamin D supplementation on effusion-synovitis in people with knee osteoarthritis (OA) and low vitamin D levels over 24 months. Symptomatic knee OA patients with low 25-(OH)D levels (12.5-60 nmol/l) were recruited for a multi-centre, randomised, placebo-controlled and double-blind trial. Participants (age 63 ± 7 years, 208 females) were allocated to either 50,000 IU monthly vitamin D 3 (n = 209) or placebo (n = 204) for 24 months. Knee effusion-synovitis volume in suprapatellar and other regions was measured on magnetic resonance imaging (MRI) using OsiriX software. The intra-class correlation coefficients (ICCs) were used to test inter- and intra-rater reliabilities. The least significant change criterion was used to define the increase/decrease in effusion-synovitis volume. The reproducibilities of effusion-synovitis volume measurement were high with ICCs ranging from 0.93 to 0.99. Over 24 months, effusion-synovitis volume remained stable in the vitamin D group but increased in placebos with a significant between-group difference (-1.94 ml, 95% confidence interval (CI): -3.54, -0.33). This effect was evident in those with baseline effusion-synovitis and with suprapatellar effusion-synovitis. The proportion with an increase in effusion-synovitis volume was lower in the vitamin D group than placebo (risk ratio (RR): 0.87, 95% CI: 0.77, 0.97). This highly reproducible effusion-synovitis volume measurement could be a promising outcome measure in OA trials. Vitamin D supplementation could retard the progression of effusion-synovitis which can potentially benefit people with an inflammatory OA phenotype. Copyright © 2017 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Double-blind randomized controlled trial of isoxicam vs piroxicam in elderly patients with osteoarthritis of the hip and knee

Science.gov (United States)

Bellamy, N.; Buchanan, W. W.; Grace, E.

1986-01-01

1 Fifty-seven elderly patients with primary osteoarthritis of the hip and knee were entered into a double-blind, randomized, controlled parallel group trial to compare the efficacy and tolerability of isoxicam (maximum = 200 mg day-1) and piroxicam (maximum = 20 mg day-1). 2 Clinical assessments were made following a 1 week NSAID-free washout period and at biweekly intervals during the next 6 weeks of active treatment. 3 The majority of patients in both groups experienced a clinically important and statistically significant therapeutic response. 4 No statistically significant between-group differences were noted with respect to drug efficacy. 5 One patient was withdrawn from the piroxicam group because of lack of effect, but there were no such withdrawals from the isoxicam group. 6 Five patients were withdrawn from the piroxicam group because of adverse reactions compared to only one withdrawal from the isoxicam group. 7 This study indicates that isoxicam is an efficacious and well-tolerated once-daily NSAID for elderly patients with osteoarthritis. PMID:3620274

21 CFR 888.3590 - Knee joint tibial (hemi-knee) metallic resurfacing uncemented prosthesis.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Knee joint tibial (hemi-knee) metallic resurfacing... Knee joint tibial (hemi-knee) metallic resurfacing uncemented prosthesis. (a) Identification. A knee joint tibial (hemi-knee) metallic resurfacing uncemented prosthesis is a device intended to be implanted...

21 CFR 888.3580 - Knee joint patellar (hemi-knee) metallic resurfacing uncemented prosthesis.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Knee joint patellar (hemi-knee) metallic... § 888.3580 Knee joint patellar (hemi-knee) metallic resurfacing uncemented prosthesis. (a) Identification. A knee joint patellar (hemi-knee) metallic resurfacing uncemented prosthesis is a device made of...

An in vitro biomechanical comparison of anterior cruciate ligament reconstruction: single bundle versus anatomical double bundle techniques

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Sandra Umeda Sasaki

2008-01-01

Full Text Available INTRODUCTION: Anterior cruciate ligament ruptures are frequent, especially in sports. Surgical reconstruction with autologous grafts is widely employed in the international literature. Controversies remain with respect to technique variations as continuous research for improvement takes place. One of these variations is the anatomical double bundle technique, which is performed instead of the conventional single bundle technique. More recently, there has been a tendency towards positioning the two bundles through double bone tunnels in the femur and tibia (anatomical reconstruction. OBJECTIVES: To compare, through biomechanical tests, the practice of anatomical double bundle anterior cruciate ligament reconstruction with a patellar graft to conventional single bundle reconstruction with the same amount of patellar graft in a paired experimental cadaver study. METHODS: Nine pairs of male cadaver knees ranging in age from 44 to 63 years were randomized into two groups: group A (single bundle and group B (anatomical reconstruction. Each knee was biomechanically tested under three conditions: intact anterior cruciate ligament, reconstructed anterior cruciate ligament, and injured anterior cruciate ligament. Maximum anterior dislocation, rigidity, and passive internal tibia rotation were recorded with knees submitted to a 100 N horizontal anterior dislocation force applied to the tibia with the knees at 30, 60 and 90 degrees of flexion. RESULTS: There were no differences between the two techniques for any of the measurements by ANOVA tests. CONCLUSION: The technique of anatomical double bundle reconstruction of the anterior cruciate ligament with bone-patellar tendon-bone graft has a similar biomechanical behavior with regard to anterior tibial dislocation, rigidity, and passive internal tibial rotation.

Cross-Sectional Contrast Between Individuals With Foot/Ankle vs Knee Osteoarthritis for Obesity and Low Education on Health-Related Quality of Life.

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Perruccio, Anthony V; Gandhi, Rajiv; Lau, Johnny T C; Syed, Khalid A; Mahomed, Nizar N; Rampersaud, Y Raja

2016-01-01

Improving health-related quality of life (HRQoL) necessitates an understanding of the influence of patient characteristics on, and interrelationship among, HRQoL domains. In osteoarthritis (OA), these associations have predominantly been examined in hip/knee populations. We investigated whether there were differences in these associations between foot/ankle and knee OA samples. Individuals seeking orthopedic care for foot/ankle or knee OA completed a questionnaire pre-consultation, including HRQoL domains (bodily pain [BP], physical [PF] and social functioning [SF], and mental [MH] and general health [GH]), obesity, comorbidity, and sociodemographic characteristics. Associations were examined via stratified path analysis (foot/ankle vs knee). Foot/ankle: n = 180, mean age = 55 (range: 25 to 82), 52% female. Knee: n = 253, mean age = 62 (range: 26 to 92), 51% female. The interrelationship among HRQoL domains was generally similar between groups. However, the influence of patient characteristics differed. Low educational status was associated with worse scores for GH, MH, and SF in the foot/ankle group, whereas no significant effects were found in the knee group. Obesity was associated with worse scores for SF, BP, and GH in the foot/ankle compared to the knee group. Patient characteristics explained considerably more of the variation in domain scores in the foot/ankle group. There are significant differences in the impact of patient characteristics on HRQoL domains in foot/ankle versus knee OA patients. Therefore, a universal approach to patient education/intervention to improve HRQoL in lower-extremity OA is not likely to achieve optimal results. Based on these findings, we recommend joint-specific patient education, with a particular emphasis on patient characteristics among the foot/ankle OA population. Level III, retrospective comparative study. © The Author(s) 2015.

[Clinical effect of total knee arthroplasty on patients with knee osteoarthritis combined with mild to moderate valgus knee deformity].

Science.gov (United States)

Chen, Peng; Zeng, Min; Xie, Jie; Wang, Long; Su, Weiping; Hu, Yihe

2016-09-28

To investigate the clinical effect of total knee arthroplasty on patients with knee osteoarthritis combined with mild to moderate valgus knee deformity.
 A total of 15 patients received total knee arthroplasty for correcting mild (10°-15°) to moderate (15°-30°) valgus knee between January 2011 and February 2014 in Xiangya Hospital of Central South University. We adopted a stable prosthesis surgery through patellar medial approach, osteophytes cleaning, conventional osteotomy, a selective soft tissue release and balance technical correcting of knee valgus deformity. Then conventional anticoagulation and symptomatic rehabilitation was utilized. Preoperative and postoperative X-ray was conducted in patients with measuring femor-tibial angle (FTA) and inspecting the prosthesis position. FTA, visual analog scale (VAS) standard, and parallel knee scoring system (KSS) were used to evaluate the clinical effect.
 Fifteen patients were followed up for 14 to 36 (22.40±11.88) months. The hospitalization time was 7-13 (7.73±1.58) d; operative time was 58-110 (81.8±16.85) min, the dominant blood loss was 140-600 (337.30±143.65) mL. Two cases had knee extension hysteresis, and the knee activity recovered after exercise. Leg power lines were normal. Three postoperative cases suffered anterior knee pain. They were subjected to celecoxib analgesic treatment and the pain gradually eased after 3 months. One postoperative case showed incision discharge and swelling, which was healed after change of dressing. During follow-up, review of X-ray film does not show prosthesis loose, subsidence and other complications. The knee valgus angle (8.1±1.8)°, knee motion range (107.33±9.61)°, KSS knee score (74.7±14.5, 75.3±2.7) and pain score (2.5±0.9) were significantly better than the preoperative (Pclinical and function KSS scores showed that the improvement rate was 80%. 
 Total knee arthroplasty is an effective way to treat patients with knee osteoarthritis combined with

[Gluteal muscle contracture release for the treatment of gluteal muscle contracture induced knee osteoarthritis: a report of 52 cases].

Science.gov (United States)

Wang, Cheng-xiang; Gong, Yu-suo; Li, Sheng-hua; Liu, Hai-ping; Chai, Xi-ping

2011-07-01

To investigate clinical efficacy and significance of gluteal muscle contracture release for the treatment of gluteal muscle contracture induced knee osteoarthritis. From January 2008 to June 2010,52 patients with gluteal muscle contracture induced knee osteoarthritis were reviewed. Among the patients,15 patients were male and 37 patients were female, ranging in age from 15 to 45 years, with an average of 35 years. Eighteen patients had left knee osteoarthritis, 30 patients had right osteoarthritis, and 4 patients had double knee osteoarthritis. All the patients were treated with gluteal muscle contracture release. Lysholm knee score was used to evaluate therapeutic effects before and after operation. All the patients were followed up,and the duration ranged from 12 to 37 years,with a mean of 15 months. The Lysholm knee score improved from preoperative (68.12 +/- 0.78) points to postoperative (91.23 +/- 0.47) points at the last follow-up, the difference had statistical difference (t=31.269, Pmuscle contracture release is effective to relieve symptoms of gluteal muscles contracture and knee osteoarthritis. The patients with gluteal muscle contracture should be treated early so as to prevent effects of gluteal muscle contracture on knee joint, slow down degeneration of knee joint at early stage, and prevent occurrence of knee osteoarthritis.

Comparative analysis of double contrast study and endoscopy in early gastric cancer

International Nuclear Information System (INIS)

Choi, Young Jin; Chung, Tae Sub; Lee, Jong Tae; Yoo, Hyung Sik

1987-01-01

To assess the diagnostic accuracy of the double contrast upper gastrointestinal series (UGI), we have done a retrospective analysis of pathologically proven 92 cases of early gastric cancer (EGC) during the period between March 1981 and February 1986. The results were as follows: 1. The diagnostic accuracy of EGC was 66% on UGI and 62% on fiberscopy. 2. The radiological diagnosis (UGI) of 92 cases was EGC in 61 cases, advanced cancer in 15 cases, cancer invaded in the muscle layer in 7 cases (PM cancer), benign ulcer in 8 cases and polyp in 1 case. 3. The commonest type was type IIc (40%), and the second commonest type was IIc + III. As many EGC's present with ulceration, any ulcerating lesion should be carefully evaluated keeping the possibility of EGC in mind. 4. The rate of lymph node metastasis was 7%, and higher in EGC's with submucosal invasion, in depressed and large lesions

Comparative analysis of double contrast study and endoscopy in early gastric cancer

Energy Technology Data Exchange (ETDEWEB)

Choi, Young Jin; Chung, Tae Sub; Lee, Jong Tae; Yoo, Hyung Sik [College of Medicine, Yonsei University, Seoul (Korea, Republic of)

1987-10-15

To assess the diagnostic accuracy of the double contrast upper gastrointestinal series (UGI), we have done a retrospective analysis of pathologically proven 92 cases of early gastric cancer (EGC) during the period between March 1981 and February 1986. The results were as follows: 1. The diagnostic accuracy of EGC was 66% on UGI and 62% on fiberscopy. 2. The radiological diagnosis (UGI) of 92 cases was EGC in 61 cases, advanced cancer in 15 cases, cancer invaded in the muscle layer in 7 cases (PM cancer), benign ulcer in 8 cases and polyp in 1 case. 3. The commonest type was type IIc (40%), and the second commonest type was IIc + III. As many EGC's present with ulceration, any ulcerating lesion should be carefully evaluated keeping the possibility of EGC in mind. 4. The rate of lymph node metastasis was 7%, and higher in EGC's with submucosal invasion, in depressed and large lesions.

Knee joint loading in knee osteoarthritis: influence of abdominal and thigh fat.

Science.gov (United States)

Messier, Stephen P; Beavers, Daniel P; Loeser, Richard F; Carr, J Jeffery; Khajanchi, Shubham; Legault, Claudine; Nicklas, Barbara J; Hunter, David J; Devita, Paul

2014-09-01

Using three separate models that included total body mass, total lean and total fat mass, and abdominal and thigh fat as independent measures, we determined their association with knee joint loads in older overweight and obese adults with knee osteoarthritis (OA). Fat depots were quantified using computed tomography, and total lean and fat mass were determined with dual energy x-ray absorptiometry in 176 adults (age, 66.3 yr; body mass index, 33.5 kg·m) with radiographic knee OA. Knee moments and joint bone-on-bone forces were calculated using gait analysis and musculoskeletal modeling. Higher total body mass was significantly associated (P ≤ 0.0001) with greater knee compressive and shear forces, compressive and shear impulses (P knee extensor moments (P = 0.003). Regression analysis with total lean and total fat mass as independent variables revealed significant positive associations of total fat mass with knee compressive (P = 0.0001), shear (P knee extension moment (P = 0.008). Gastrocnemius and quadriceps forces were positively associated with total fat mass. Total lean mass was associated with knee compressive force (P = 0.002). A regression model that included total thigh and total abdominal fat found that both were significantly associated with knee compressive and shear forces (P ≤ 0.04). Thigh fat was associated with knee abduction (P = 0.03) and knee extension moment (P = 0.02). Thigh fat, consisting predominately of subcutaneous fat, had similar significant associations with knee joint forces as abdominal fat despite its much smaller volume and could be an important therapeutic target for people with knee OA.

Jumper's Knee (Patellar Tendonitis)

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... Safe Videos for Educators Search English Español Jumper's Knee KidsHealth / For Teens / Jumper's Knee What's in this ... continued damage to the knee. How Does the Knee Work? To understand how jumper's knee happens, it ...

Knee extensor muscle weakness is a risk factor for development of knee osteoarthritis

DEFF Research Database (Denmark)

Oiestad, B E; Juhl, C B; Eitzen, I

2015-01-01

The objective of this study was to perform a systematic review and meta-analysis on the association between knee extensor muscle weakness and the risk of developing knee osteoarthritis. A systematic review and meta-analysis was conducted with literature searches in Medline, SPORTDiscus, EMBASE......, CINAHL, and AMED. Eligible studies had to include participants with no radiographic or symptomatic knee osteoarthritis at baseline; have a follow-up time of a minimum of 2 years, and include a measure of knee extensor muscle strength. Hierarchies for extracting data on knee osteoarthritis and knee...... extensor muscle strength were defined prior to data extraction. Meta-analysis was applied on the basis of the odds ratios (ORs) of developing symptomatic knee osteoarthritis or radiographic knee osteoarthritis in subjects with knee extensor muscle weakness. ORs for knee osteoarthritis and 95% confidence...

ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION USING THE DOUBLE-BUNDLE TECHNIQUE - EVALUATION IN THE BIOMECHANICS LABORATORY.

Science.gov (United States)

D'Elia, Caio Oliveira; Bitar, Alexandre Carneiro; Castropil, Wagner; Garofo, Antônio Guilherme Padovani; Cantuária, Anita Lopes; Orselli, Maria Isabel Veras; Luques, Isabela Ugo; Duarte, Marcos

2011-01-01

The objective of this study was to describe the methodology of knee rotation analysis using biomechanics laboratory instruments and to present the preliminary results from a comparative study on patients who underwent anterior cruciate ligament (ACL) reconstruction using the double-bundle technique. The protocol currently used in our laboratory was described. Three-dimensional kinematic analysis was performed and knee rotation amplitude was measured on eight normal patients (control group) and 12 patients who were operated using the double-bundle technique, by means of three tasks in the biomechanics laboratory. No significant differences between operated and non-operated sides were shown in relation to the mean amplitudes of gait, gait with change in direction or gait with change in direction when going down stairs (p > 0.13). The preliminary results did not show any difference in the double-bundle ACL reconstruction technique in relation to the contralateral side and the control group.

KNEE-JOINT LOADING IN KNEE OSTEOARTHRITIS: INFLUENCE OF ABDOMINAL AND THIGH FAT

Science.gov (United States)

Messier, Stephen P.; Beavers, Daniel P.; Loeser, Richard F.; Carr, J. Jeffery; Khajanchi, Shubham; Legault, Claudine; Nicklas, Barbara J.; Hunter, David J.; DeVita, Paul

2014-01-01

Purpose Using three separate models that included total body mass, total lean and total fat mass, and abdominal and thigh fat as independent measures, we determined their association with knee-joint loads in older overweight and obese adults with knee osteoarthritis (OA). Methods Fat depots were quantified using computed tomography and total lean and fat mass determined with dual energy x-ray absorptiometry in 176 adults (age = 66.3 yr., BMI = 33.5 kg·m−2) with radiographic knee OA. Knee moments and joint bone-on-bone forces were calculated using gait analysis and musculoskeletal modeling. Results Higher total body mass was significantly associated (p ≤ 0.0001) with greater knee compressive and shear forces, compressive and shear impulses (p knee extensor moments (p = 0.003). Regression analysis with total lean and total fat mass as independent variables revealed significant positive associations of total fat mass with knee compressive (p = 0.0001), shear (p knee extension moment (p = 0.008). Gastrocnemius and quadriceps forces were positively associated with total fat mass. Total lean mass was associated with knee compressive force (p = 0.002). A regression model that included total thigh and total abdominal fat found both were significantly associated with knee compressive and shear forces (p ≤ 0.04). Thigh fat was associated with the knee abduction (p = 0.03) and knee extension moment (p = 0.02). Conclusions Thigh fat, consisting predominately of subcutaneous fat, had similar significant associations with knee joint forces as abdominal fat despite its much smaller volume and could be an important therapeutic target for people with knee OA. PMID:25133996

Composition of The Knee Index, a novel three-dimensional biomechanical index for knee joint load, in subjects with mild to moderate knee osteoarthritis

DEFF Research Database (Denmark)

Clausen, Brian; Andriacchi, Tom; Nielsen, Dennis Brandborg

Background Knee joint load is an important factor associated with progression of knee osteoarthritis. To provide an overall understanding of knee joint loading, the Knee Index (KI) has been developed to include moments from all three planes (frontal, sagittal and transversal). However, before KI...... index of joint load for the knee, in patients with mild to moderate knee osteoarthritis. Methods The contribution of frontal, sagittal and transversal plane knee moments to KI was investigated in 24 subjects (13 women, age: 58 ± 7.6 years, BMI: 27.1 ± 3.0) with clinically diagnosed mild to moderate knee...... kinematics (i.e. the knee adduction moment), and secondarily the sagittal plane kinematics (i.e. the knee flexion moment). This holds promise for using KI in clinical trials since both frontal and sagittal knee joint moments have been suggested to be associated with the knee osteoarthritis disease...

Dynamic Contrast Enhanced MRI Can Monitor the Very Early Inflammatory Treatment Response upon Intra-Articular Steroid Injection in the Knee Joint: A Case Report with Review of the Literature

DEFF Research Database (Denmark)

Boesen, Mikael; Kubassova, Olga; Cimmino, Marco A

2011-01-01

Dynamic contrast-enhanced MRI in inflammatory arthritis, especially in conjunction with computer-aided analysis using appropriate dedicated software, seems to be a highly sensitive tool for monitoring the early inflammatory treatment response in patients with rheumatoid arthritis. This paper give...... a review of the current knowledge of the emerging technique. The potential of the technique is demonstrated and discussed in the context of a case report following the early effect of an intra-articular steroid injection in a patient with rheumatoid arthritis flare in the knee....

Effectiveness of Bupivacaine Liposome Injectable Suspension for Postoperative Pain Control in Total Knee Arthroplasty: A Prospective, Randomized, Double Blind, Controlled Study.

Science.gov (United States)

DeClaire, Jeffrey H; Aiello, Paige M; Warritay, Olayinka K; Freeman, Dwight C

2017-09-01

We compared the effectiveness of liposomal bupivacaine to ropivacaine, each as part of multimodal pain management, in total knee arthroplasty (TKA) postoperative pain control. This prospective, double blind study randomized 96 TKA patients into a control group (periarticular injection of ropivacaine, ketorolac, morphine, and epinephrine in saline; 100cc) or an experimental group (periarticular injection of bupivacaine, ketorolac, morphine, and epinephrine in saline; 80cc plus 1.3% liposomal bupivacaine 20cc; total injection 100cc). The postoperative use of narcotics, visual analog pain scores, hours to ambulate 100 feet, and length of hospital stay were recorded. There was no significant difference between the two groups (control N = 49, experiment N = 47) in mean narcotic use per hour, total narcotic use during hospital stay, time to ambulate 100 feet, length of hospital stay, or visual analog score for pain postoperatively. There is no benefit in the use of liposomal bupivacaine compared with ropivacaine for postoperative pain control in TKA. Copyright © 2017 Elsevier Inc. All rights reserved.

Long-Acting Morphine Following Hip or Knee Replacement: A Randomized, Double-Blind, Placebo-Controlled Trial

Directory of Open Access Journals (Sweden)

Shirley L Musclow

2012-01-01

Full Text Available BACKGROUND: Patients undergoing total hip or knee replacement surgery experience unmanaged pain during postoperative physiotherapy sessions. It was theorized that a baseline opioid would improve pain management.

[Restricted motion after total knee arthroplasty].

Science.gov (United States)

Kucera, T; Urban, K; Karpas, K; Sponer, P

2007-10-01

patients. In these, the average value of knee flexion increased by 17 degrees only and, in the patients suffering from excessive adhesion production, this value remained almost unchanged. Revision TKA was carried out in four patients, in whom knee joint flexion increased on average by 35 degrees to achieve an average flexion of 83 degrees. Restricted motion after TKA has been reported to range from 1.3 % to 12.0 %, but consistent criteria have not been set up. In our study it was 4.14 %. In agreement with the literature data, one of the reasons was pre-operative restricted motion, which was recorded in 16 of 32 patients. Similarly, also in our patients, biological predisposition to excessive production of fibrocartilage associated with adhesions in all knee joint compartments was the major therapeutic problem. Intra-operative fractures, ligament tears requiring post-operative fixation and unremoved dorsal osteophytes lead to the restriction of knee joint motion. By inadequate resection of articular surface, the original joint line may be at a higher level; this results in an increased tension of the posterior cruciate ligament and patella infera development, both influencing knee flexion. In our study, three patients were affected. Knee joint stiffness can also develop in patients declining physical therapy or in whom this is not correctly performed, often for insufficient analgesia. In contrast to the data reported in the literature, 17 of 32 patients in this study had no need for surgical treatment of restricted knee joint motion. Redress under general anesthesia was not effective. For markedly restricted motion of the knee joint, reimplantation can be recommended or, in less severe cases, an intervention on adjacent soft tissues. Restricted motion of the knee joint after TKA is difficult to treat and, therefore, prevention is recommended. This should include thorough conservative treatment of gonarthrosis, early indication for surgery, prevention of elevation in the

Real-Time Tracking of Knee Adduction Moment in Patients with Knee Osteoarthritis

Science.gov (United States)

Kang, Sang Hoon; Lee, Song Joo; Zhang, Li-Qun

2014-01-01

Background The external knee adduction moment (EKAM) is closely associated with the presence, progression, and severity of knee osteoarthritis (OA). However, there is a lack of convenient and practical method to estimate and track in real-time the EKAM of patients with knee OA for clinical evaluation and gait training, especially outside of gait laboratories. New Method A real-time EKAM estimation method was developed and applied to track and investigate the EKAM and other knee moments during stepping on an elliptical trainer in both healthy subjects and a patient with knee OA. Results Substantial changes were observed in the EKAM and other knee moments during stepping in the patient with knee OA. Comparison with Existing Method(s) This is the first study to develop and test feasibility of real-time tracking method of the EKAM on patients with knee OA using 3-D inverse dynamics. Conclusions The study provides us an accurate and practical method to evaluate in real-time the critical EKAM associated with knee OA, which is expected to help us to diagnose and evaluate patients with knee OA and provide the patients with real-time EKAM feedback rehabilitation training. PMID:24361759

Knee Deformities in Children With Down Syndrome: A Focus on Knee Malalignment.

Science.gov (United States)

Duque Orozco, Maria Del Pilar; Abousamra, Oussama; Chen, Brian Po-Jung; Rogers, Kenneth J; Sees, Julieanne P; Miller, Freeman

Patellofemoral instability (PFI) has been the most reported knee abnormality in people with Down syndrome. Other reported knee abnormalities have been associated with PFI and different management approaches have been described with variable outcomes. The aim of this study was to describe the anatomic variations of the knee in children with Down syndrome. A comparison between knees with and without PFI was performed and our experience in treating knee abnormalities in Down syndrome was also reported. Records of all children with Down syndrome were reviewed. Two groups were identified (knees with and without PFI). Radiographic measurements included the mechanical and anatomic lateral distal femoral angles, medial proximal tibial angle, angle of depression of medial tibial plateau, lateral tibial translation, and distal femoral physis-joint angle. On the lateral view, Insall-Salvati and Blackburne-Peel ratios were measured. The sulcus angle was measured on the tangential view. Measurements were compared between the 2 groups (with and without PFI).Knees with PFI were divided into 3 subgroups based on their treatment (group A: surgical valgus correction, group B: surgical soft tissue procedures for PFI, and group C: conservative treatment). Preoperative radiographs were used for the surgical group and last available radiographs were used for the conservative group. Clinical and radiographic data were compared between the groups. For groups A and B, clinical and radiographic data were also compared between preoperative and last visits. Of the 581 children with Down syndrome, 5% (31 children: 22 females, 9 males) had PFI in 56 knees. Mean age at diagnosis was 11.5±3.5 years. Of the remaining 550 children, 75 children had radiographs for 130 knees. Knees with PFI had significantly more valgus and a larger distal femoral physis-joint angle. Depression of the medial tibial plateau and lateral tibial translation were noted in knees with PFI. Insall-Salvati ratio was higher

Development of a new high density (HD) barium meal (Falibaryt HD) for double contrast investigation of the stomach

International Nuclear Information System (INIS)

Dietze, R.

1986-01-01

During the development of a new double contrast barium meal barium sulfate preparations with various densities, additives and particle size distributions were tested. Phantoms made of leather, rubber and the opened stomachs of cows and pigs were used. A HD bariumsulfate suspension (200 - 250% W/V) of low viscosity and suitable grain size spectrum containing additives improving the adherence (e.g. natrium citrate) showed the best quality parameters for an optimal imaging of the fine mucosal relief. (author)

Traumatic knee extension deficit (the locked knee)

DEFF Research Database (Denmark)

Helmark, I C; Neergaard, K; Krogsgaard, M R

2007-01-01

In the present study we investigated the validity of magnetic resonance imaging (MRI) and arthroscopy in knees with acute, traumatic extension deficit (the "locked knee"), and evaluated whether arthroscopy of knees with no mechanical pathology could be avoided by MRI evaluation. The study consisted...... of 50 patients who had an acute, traumatic extension deficit of the knee. All patients were submitted to MRI prior to arthroscopy. Following MRI and surgery, standardized forms were filled out, attempting to objectify the findings. The orthopaedic surgeon was not aware of the MRI result prior to surgery....... Evaluating MRI, all grade-3 meniscal lesions were considered able to cause a mechanical block as well as acute partial or total anterior cruciate ligament (ACL)-ruptures. ACL-ruptures with an old appearance were not considered able to cause locking. Assuming that arthroscopy was the gold standard...

Can combined use of low-level lasers and hyaluronic acid injections prolong the longevity of degenerative knee joints?

Science.gov (United States)

Ip, David; Fu, Nga Yue

2015-01-01

This study evaluated whether half-yearly hyaluronic acid injection together with low-level laser therapy in addition to standard conventional physical therapy can successfully postpone the need for joint replacement surgery in elderly patients with bilateral symptomatic tricompartmental knee arthritis. In this prospective, double-blind, placebo-controlled study, 70 consecutive unselected elderly patients with bilateral tricompartmental knee arthritis were assigned at random to either one of two conservative treatment protocols to either one of the painful knees. Protocol A consisted of conventional physical therapy plus a sham light source plus saline injection, and protocol B consisted of protocol A with addition of half-yearly hyaluronic acid injection as well as low-level laser treatment instead of using saline and a sham light source. Treatment failure was defined as breakthrough pain necessitating joint replacement. Among the 140 painful knees treated with either protocol A or protocol B, only one of the 70 painful knees treated by protocol B required joint replacement, whereas 15 of the 70 painful knees treated by protocol A needed joint replacement surgery (Phyaluronic acid injections together with low-level laser therapy should be incorporated into the standard conservative treatment protocol for symptomatic knee arthritis, because it may prolong the longevity of the knee joint without the need for joint replacement.

Are the tolerabilities of nonionic contrast media identical? Outcome of a double-blind, randomized multicentre study with Iomeprol and lopromide

International Nuclear Information System (INIS)

Schmiedel, E.

1997-01-01

Since a larger number of nonionic contrast media is available for the radiologist, the question arises as to whether they differ in their clinical tolerability. A double-blind, randomized, two-group comparison of phase IV with Iomeprol and Iopromide was carried out at 6 hospitals involving a total of 1.200 patients with the indication for computed tomography. The contrast media doses and the flow in computed tomography of the skull, thorax, and abdomen were, depending on the centre, between 50 and 200 ml and 0.5 to 3.0 ml/s, respectively. The biostatistical evaluation of adverse events which were probably contrast medium-related produced a highly significant difference between the two contrast media in favor of Iomeprol (p=0.0005). The difference in the reactions of heat, nausea, and vomiting is of clinical relevance as such adverse events may negatively affect the examination procedure and the opacification in spiral computed tomography. (orig.) [de

RELIABILITY AND RESPONSIVENESS OF THE DANISH MODIFIED INTERNATIONAL KNEE DOCUMENTATION COMMITTEE SUBJECTIVE KNEE FORM FOR CHILDREN WITH KNEE DISORDERS

DEFF Research Database (Denmark)

Jacobsen, Julie Sandell; Knudsen, Pernille; Fynbo, Charlotte

2016-01-01

Introduction The modified international Knee Documentation Committee Subjective Knee Form (Pedi-IKDC) is a widely used patient-reported tool applicable for children with knee disorders ranging on a scale from 0-100. We aimed to translate the Pedi-IKDC Subjective Knee Form into Danish......, and furthermore to assess its reliability and responsiveness. Material and Methods The Pedi-IKDC Subjective Knee Form was translated to Danish according to international guidelines. Reliability was assessed with Bland Altman plots, standard error of measurement (SEM), Minimal Detectable Change (MDC) and the Intra....... Reliability and responsiveness were assessed in 50 children (median 15 years) referred to hospital due to different knee disorders. Results The SEM was 4.2 points and the MDC was 11.5 points. The ICC was 0.91 (0.9-1.0). The change score of the Pedi-IKDC Subjective Knee form was correlated to the external...

Gait changes in patients with knee osteoarthritis are replicated by experimental knee pain

DEFF Research Database (Denmark)

Henriksen, Marius; Nielsen, Thomas Graven; Aaboe, Jens

2010-01-01

Medial knee osteoarthritis (OA) is characterized by pain and associated with abnormal knee moments during walking. The relationship between knee OA pain and gait changes remains to be clarified, and a better understanding of this link could advance the treatment and prevention of disease...... progression. This study investigated changes in knee moments during walking following experimental knee pain in healthy volunteers, and whether these changes replicated the joint moments observed in medial knee OA patients....

How invasive is TMJ double-contrast arthrography in combination with cinematography? Patient discomfort versus known diagnostic gain.

Science.gov (United States)

Engelke, W; Mommaerts, M

1990-04-01

There is no doubt that double-contrast TMJ fluoroscopic tomography enables a differential diagnosis and treatment in internal derangement pathosis. Its indication is, apart from the expected diagnostic gain, also determined by the degree of its invasiveness, and other alternative diagnostics being available (nuclear magnetic resonance). Data on patient discomfort and complications were gathered in 63 arthrotomographies; pain sensations and mandibular mobility, during and after the procedure in particular, were studied. We consider, along with Westesson, the procedure to be less invasive than commonly considered, once the surgeon-radiologist has gained enough experience.

Knee arthroscopy - discharge

Science.gov (United States)

... page: //medlineplus.gov/ency/patientinstructions/000199.htm Knee arthroscopy - discharge To use the sharing features on this ... surgery to treat problems in your knee (knee arthroscopy). You may have been checked for: Torn meniscus. ...

Knee microfracture surgery

Science.gov (United States)

Cartilage regeneration - knee ... Three types of anesthesia may be used for knee arthroscopy surgery: Medicine to relax you, and shots of painkillers to numb the knee Spinal (regional) anesthesia General anesthesia (you will be ...

Preventing Knee Injuries

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... Our Newsletter Donate Blog Skip breadcrumb navigation Preventing Knee Injuries Knee injuries in children and adolescent athletes ... this PDF Share this page: WHAT ARE COMMON KNEE INJURIES? Pain Syndromes One of the most common ...

Hyperextension injuries of the knee. Do patterns of bone bruising predict soft tissue injury?

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Ali, A.M.; Gibbons, C.E.R. [Chelsea and Westminster Hospital, Department of Orthopaedic Surgery, London (United Kingdom); Pillai, J.K.; Roberton, B.J. [Chelsea and Westminster Hospital, Department of Radiology, London (United Kingdom); Gulati, V. [Homerton University Hospital, Department of Orthopaedic Surgery, London (United Kingdom)

2018-02-15

To establish whether patterns of soft tissue injury following knee hyperextension are associated with post-traumatic 'bone bruise' distribution. Patients with a knee MRI within one year of hyperextension injury were identified at our institution over a 7 year period. MRIs, plain radiographs and clinical details of these patients were reviewed. Twenty-five patients were identified (median time from injury to MRI = 24 days). The most common sites of bone bruising were the anteromedial tibial plateau (48%) and anterolateral tibial plateau (44%). There were high rates of injury to the posterior capsule (52%), ACL (40%) and PCL (40%) but lower rates of injury to the menisci (20%), medial and lateral collateral ligaments (16%) and posterolateral corner (16%). Anterior tibial plateau oedema and rupture of the posterior capsule predicted cruciate ligament injury [OR = 10.5 (p = 0.02) and 24.0 (p = 0.001) respectively]. Whilst anterolateral tibial plateau oedema strongly predicted PCL injury [OR = 26.0, p = 0.003], ACL injury was associated with a variable pattern of bone bruising. Meniscal injury was unrelated to the extent or pattern of bone bruising. 5 out of 8 patients with a 'double sulcus' on the lateral radiograph had ACL injury. The presence of a double sulcus showed significant association with anteromedial kissing contusions (OR = 7.8, p = 0.03). Following knee hyperextension, bone bruising patterns may be associated with cruciate ligament injury. Other structures are injured less frequently and have weaker associations with bone bruise distribution. The double sulcus sign is a radiographic marker that confers a high probability of ACL injury. (orig.)

Low contrast volume run-off CT angiography with optimized scan time based on double-level test bolus technique – feasibility study

International Nuclear Information System (INIS)

Baxa, Jan; Vendiš, Tomáš; Moláček, Jiří; Štěpánková, Lucie; Flohr, Thomas; Schmidt, Bernhard; Korporaal, Johannes G.; Ferda, Jiří

2014-01-01

Purpose: To verify the technical feasibility of low contrast volume (40 mL) run-off CT angiography (run-off CTA) with the individual scan time optimization based on double-level test bolus technique. Materials and methods: A prospective study of 92 consecutive patients who underwent run-off CTA performed with 40 mL of contrast medium (injection rate of 6 mL/s) and optimized scan times on a second generation of dual-source CT. Individual optimized scan times were calculated from aortopopliteal transit times obtained on the basis of double-level test bolus technique – the single injection of 10 mL test bolus and dynamic acquisitions in two levels (abdominal aorta and popliteal arteries). Intraluminal attenuation (HU) was measured in 6 levels (aorta, iliac, femoral and popliteal arteries, middle and distal lower-legs) and subjective quality (3-point score) was assessed. Relations of image quality, test bolus parameters and arterial circulation involvement were analyzed. Results: High mean attenuation (HU) values (468; 437; 442; 440; 342; 274) and quality score in all monitored levels was achieved. In 91 patients (0.99) the sufficient diagnostic quality (score 1–2) in aorta, iliac and femoral arteries was determined. A total of 6 patients (0.07) were not evaluable in distal lower-legs. Only the weak indirect correlation of image quality and test-bolus parameters was proved in iliac, femoral and popliteal levels (r values: −0.263, −0.298 and −0.254). The statistically significant difference of the test-bolus parameters and image quality was proved in patients with occlusive and aneurysmal disease. Conclusion: We proved the technical feasibility and sufficient quality of run-off CTA with low volume of contrast medium and optimized scan time according to aortopopliteal transit time calculated from double-level test bolus

ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION USING THE DOUBLE-BUNDLE TECHNIQUE – EVALUATION IN THE BIOMECHANICS LABORATORY

OpenAIRE

D'Elia, Caio Oliveira; Bitar, Alexandre Carneiro; Castropil, Wagner; Garofo, Antônio Guilherme Padovani; Cantuária, Anita Lopes; Orselli, Maria Isabel Veras; Luques, Isabela Ugo; Duarte, Marcos

2011-01-01

Objective: The objective of this study was to describe the methodology of knee rotation analysis using biomechanics laboratory instruments and to present the preliminary results from a comparative study on patients who underwent anterior cruciate ligament (ACL) reconstruction using the double-bundle technique. Methods: The protocol currently used in our laboratory was described. Three-dimensional kinematic analysis was performed and knee rotation amplitude was measured on eight normal patient...

The effect of timing of intravenous muscle relaxant on the quality of double-contrast barium enema

International Nuclear Information System (INIS)

Elson, E.M.; Elson, E.M.; Campbell, D.M.; Halligan, S.; Shaikh, I.; Davitt, S.; Bartram, C.I.

2000-01-01

AIM: To determine whether the timing of buscopan administration during double-contrast barium enema examination (DCBE) affects diagnostic quality. MATERIALS AND METHODS: In a prospective setting, 100 consecutive adult out-patients referred for DCBE received 20 mg buscopan (hyoscine-N-butylbromide) intravenously, either before infusion of barium suspension (Group A) or after barium infusion and gas insufflation (Group B). A subjective assessment of ease of contrast medium infusion was made at the time of examination and the films subsequently analysed by two radiologists unaware of the mode of relaxant administration, who noted the quality of mucosal coating and made subjective and objective measurements of segmental distension. RESULTS: There was no significant difference in screening times, infusion difficulty or colonic contrast medium coating between the two groups. Subjective assessment of distension of the caecum, ascending colon, transverse colon and rectum were not significantly different. Patients receiving intravenous relaxant after barium and gas infusion had less subjective descending (P = 0.05) and sigmoid (P = 0.04) colon distension, but there was no significant difference with respect to maximal bowel diameter in any of the segments measured. CONCLUSION: The timing of intravenous administration during DCBE is likely to have no significant effect on the diagnostic quality of the study. Elson, E.M. (2000)

Patients Unicondylar Knee Replacement vs. Total Knee Replacement

OpenAIRE

Hedra Eskander

2017-01-01

The aim of this review article is to analyse the clinical effectiveness of total knee replacement (TKR) compared to unicondylar knee replacement (UKR) on patients. In terms of survival rates, revision rates and postoperative complications. The keywords used were: knee arthroplasty. Nearly three thousand articles were found on 25 August 2016. Of those, only twenty-five were selected and reviewed because they were strictly focused on the topic of this article. Compared with those who have TKR, ...

Clinical Outcomes of Knee Osteoarthritis Treated With an Autologous Protein Solution Injection: A 1-Year Pilot Double-Blinded Randomized Controlled Trial.

Science.gov (United States)

Kon, Elizaveta; Engebretsen, Lars; Verdonk, Peter; Nehrer, Stefan; Filardo, Giuseppe

2018-01-01

Osteoarthritis (OA) is a debilitating disease resulting in substantial pain and functional limitations. A novel blood derivative has been developed to concentrate both growth factors and antagonists of inflammatory cytokines, with promising preliminary findings in terms of safety profile and clinical improvement. To investigate if one intra-articular injection of autologous protein solution (APS) can reduce pain and improve function in patients affected by knee OA in a multicenter, randomized, double-blind, saline-controlled study. Randomized controlled trial; Level of evidence, 2. Forty-six patients with unilateral knee OA (Kellgren-Lawrence 2 or 3) were randomized into the APS group (n = 31), which received a single ultrasound-guided injection of APS, and the saline (control) group (n = 15), which received a single saline injection. Patient-reported outcomes and adverse events were collected at 2 weeks and at 1, 3, 6, and 12 months through visual analog scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Knee injury and Osteoarthritis Outcome Score (KOOS), Short Form-36 (SF-36), Clinical Global Impression of Severity/Change (CGI-S/C), Patient Global Impression of Severity/Change (PGI-S/C), and Outcome Measures in Rheumatology-Osteoarthritis Research Society International (OMERACT-OARSI) responder rate. Imaging evaluation was also performed with radiograph and magnetic resonance imaging (MRI) before and after treatment (12 months and 3 and 12 months, respectively). The safety profile was positive, with no significant differences in frequency and severity of adverse events between groups. The improvement from baseline to 2 weeks and to 1, 3, and 6 months was similar between treatments. At 12 months, improvement in WOMAC pain score was 65% in the APS group and 41% in the saline group ( P = .02). There were no significant differences in VAS pain improvement between groups. At 12 months, APS group showed improved SF-36 Bodily Pain

Knee Confidence as it Relates to Self-Reported and Objective Correlates of Knee Osteoarthritis

DEFF Research Database (Denmark)

Skou, Søren T; Rasmussen, Sten; Simonsen, Ole

2015-01-01

osteoarthritis (OA). Background Lack of knee confidence is a frequent symptom in patients with knee OA, but little is known of associations between knee confidence and other common correlates of knee OA. Methods Baseline data from 220 patients with knee OA were applied in ordinal regression analyses, with knee...... confidence, assessed using item Q3 of the Knee injury and Osteoarthritis Outcome Score, as the dependent variable and self-reported (pain on walking, general health, fear of movement, self-efficacy, function, and previous serious injury) and objective measures (muscle strength, 20-m walk time.......21; 95% CI: 1.09, 1.34), and general health (OR = 0.024; 95% CI: 0.002, 0.259) explained 19% of the variance in knee confidence (Pcommon finding in individuals with knee OA. Pain on walking was confirmed as a correlate of knee confidence, whereas...

An 11-Year-Old Girl Presenting with Chronic Knee Pain: A Case Report with Diagnostic Dilemma

Directory of Open Access Journals (Sweden)

Muhammad Kamal Maj

2010-01-01

Full Text Available Discoid meniscus is the commonest anatomical aberration of the knee joint, among rare cases such as bilateral separated lateral meniscus, accessory lateral meniscus, partial deficiency of the lateral meniscus and double-layered lateral meniscus. An 11-year- old girl presented with history of chronic pain in her right knee for the last 6 months. The problem disturbed her involvement in the sport activities at school. Clinical examination revealed a clicking sensation on knee extension with lateral joint line tenderness. Magnetic resonance imaging (MRI of her right knee showed torn posterior horn of lateral meniscus. Arthroscopy examination revealed a discoid meniscus with absence posterior horn. Posterior horn deficient discoid meniscus is a rare form of a congenital meniscus anomaly. We as clinicians believe that the abnormal shaped meniscus may pose a diagnostic challenge clinically and radiologically. Presentation of this case may be beneficial for orthopaedicians in their daily clinical practice.

Prevention and management of knee osteoarthritis and knee cartilage injury in sports.

Science.gov (United States)

Takeda, Hideki; Nakagawa, Takumi; Nakamura, Kozo; Engebretsen, Lars

2011-04-01

Articular cartilage defects in the knee of young or active individuals remain a problem in orthopaedic practice. These defects have limited ability to heal and may progress to osteoarthritis. The prevalence of knee osteoarthritis among athletes is higher than in the non-athletic population. The clinical symptoms of osteoarthritis are joint pain, limitation of range of motion and joint stiffness. The diagnosis of osteoarthritis is confirmed by the symptoms and the radiological findings (narrowing joint space, osteophyte formation and subchondral sclerosis). There is no strong correlation between symptoms and radiographic findings. The aetiology of knee osteoarthritis is multifactorial. Excessive musculoskeletal loading (at work or in sports), high body mass index, previous knee injury, female gender and muscle weakness are well-known risk factors. The high-level athlete with a major knee injury has a high incidence of knee osteoarthritis. Cartilage injuries are frequently observed in young and middle-aged active athletes. Often this injury precedes osteoarthritis. Reducing risk factors can decrease the prevalence of knee osteoarthritis. The prevention of knee injury, especially anterior cruciate ligament and meniscus injury in sports, is important to avoid progression of knee osteoarthritis.

CRPS Knee: How frequently encountered in differential diagnosis of Knee pain?

Science.gov (United States)

Aggarwal, Aakanksha; Agarwal, Anil

2018-04-13

We have read with great interest the paper by Catelijne M. van Bussel [1] recently published in Pain Practice. I wish to congratulate the authors for their valuable contributions. In the said article, 12 patients who had complex regional pain syndrome confined to the knee have been included. Though reports have been published involving primarily the knee after total knee arthroplasty [2,3] the incidence of CRPS knee following trauma or otherwise is not well appreciated. We would have appreciated if presence or absence of any inciting event for the development CRPS knee in these 12 patients could be mentioned, which could be helpful in a better diagnosis and management of the patients with CRPS knee. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

The efficacy and safety of a combination of glucosamine hydrochloride, chondroitin sulfate and bio-curcumin with exercise in the treatment of knee osteoarthritis: a randomized, double-blind, placebo-controlled study.

Science.gov (United States)

Sterzi, Silvia; Giordani, Laura; Morrone, Michelangelo; Lena, Emanuela; Magrone, Giovanni; Scarpini, Claudia; Milighetti, Stefano; Pellicciari, Leonardo; Bravi, Marco; Panni, Ilaria; Ljoka, Concetta; Bressi, Federica; Foti, Calogero

2016-06-01

Knee osteoarthritis (OA) conservative treatment aims to delay cartilage degeneration; chondroprotective agents are a valid approach in this sense. A commercially available dietary supplement, CartiJoint Forte, containing glucosamine hydrochloride (GH), chondroitin sulfate (CS) and Bio-Curcumin BCM-95®, was used in this trial. The aim of this study was to assess efficacy and safety of CartiJoint Forte combined with physical therapy in treating subjects with knee OA. A multicenter, prospective, randomized, double blind, placebo-controlled clinical trial. Outpatients referred to the Rehabilitation Departments of two University Hospitals. Fifty-three patients were randomly assigned to an experimental group (N=26) or a control group (N.=27). Experimental subjects received two tablets of CartiJoint Forte each day for 8 weeks, while those in the control group were provided with a placebo. Three subjects dropped out during the course of the study. The two groups both received 20 sessions of physical therapy during the course of the trial. Primary outcome was pain intensity, measured both at motion and at rest, using the Visual Analogue Scale (VAS). A secondary outcome was an assessment of knee function by Western Ontario and McMaster Universities Arthritis Index and Lequesne Index, knee ROM, and two inflammation markers (C-reactive protein and erythrocyte sedimentation rate). Each assessment was carried out at baseline (T0), at 8 weeks (T1) and at 12 weeks (T2). VAS at rest was found to be reduced between T0 and T1, as well as between T0 and T2 (F=13.712; P=0.0001), with no differences between groups (F=1.724; P=0.191). VAS at motion revealed a significant "group × time-check" interaction (F=2.491; P=0.032), with increasing effect of time on VAS reduction (F=17.748; P=0.0001). This was most pronounced in the experimental group at 8 weeks (F=3.437; P=0.045). The Lequesne Index showed reductions at T1 and T2 compared to T0 (F=9.535; P=0.0001), along with group effect

Effect of compression therapy on knee swelling and pain after total knee arthroplasty

DEFF Research Database (Denmark)

Munk, Stig; Jensen, Niels J. F.; Andersen, Ida Bøgh

2013-01-01

PURPOSE: Knee swelling after total knee arthroplasty may impair postoperative mobilisation and training, and as medical elastic compression stockings are well tolerated and effective to prevent oedema, haematoma and postoperative pain after venous surgery, we wanted to study whether this effect...... could be transferred to total knee arthroplasty surgery reducing postoperative swelling and pain and thereby facilitating mobilisation and improving patient-reported knee function. METHODS: In a randomised controlled study, 88 patients were randomised to use either a medical elastic compression stocking...... or no stocking from the first postoperative day and the following 4 weeks after total knee arthroplasty. Outcome measures were knee, calf and ankle swelling, knee flexion, pain and patient-reported knee function. RESULTS: Seventy per cent of the swelling had occurred before application of the stocking the day...

Knee Injuries and Disorders

Science.gov (United States)

Your knee joint is made up of bone, cartilage, ligaments and fluid. Muscles and tendons help the knee joint move. When any of these structures is hurt or diseased, you have knee problems. Knee problems can cause pain and difficulty ...

Association Between Pain at Sites Outside the Knee and Knee Cartilage Volume Loss in Elderly People Without Knee Osteoarthritis: A Prospective Study.

Science.gov (United States)

Pan, Feng; Laslett, Laura; Tian, Jing; Cicuttini, Flavia; Winzenberg, Tania; Ding, Changhai; Jones, Graeme

2017-05-01

Pain is common in the elderly. Knee pain may predict knee cartilage loss, but whether generalized pain is associated with knee cartilage loss is unclear. This study, therefore, aimed to determine whether pain at multiple sites predicts knee cartilage volume loss among community-dwelling older adults, and, if so, to explore potential mechanisms. Data from the prospective Tasmanian Older Adult Cohort study was utilized (n = 394, mean age 63 years, range 52-79 years). Experience of pain at multiple sites was assessed using a questionnaire at baseline. T1-weighted fat-saturated magnetic resonance imaging of the right knee was performed to assess the cartilage volume at baseline and after 2.6 years. Linear regression modeling was used with adjustment for potential confounders. The median number of painful sites was 3 (range 0-7). There was a dose-response relationship between the number of painful sites and knee cartilage volume loss in the lateral and total tibiofemoral compartments (lateral β = -0.28% per annum; total β = -0.25% per annum, both P for trend knee osteoarthritis (OA) (P pain medication, and knee structural abnormalities. The number of painful sites independently predicts knee cartilage volume loss, especially in people without knee OA, suggesting that widespread pain may be an early marker of more rapid knee cartilage loss in those without radiographic knee OA. The underlying mechanism is unclear, but it is independent of anthropometrics, physical activity, and knee structural abnormalities. © 2016, American College of Rheumatology.

Knee motion variability in patients with knee osteoarthritis: the effect of self-reported instability

Science.gov (United States)

Gustafson, Jonathan A.; Robinson, Megan E.; Fitzgerald, G. Kelley; Tashman, Scott; Farrokhi, Shawn

2015-01-01

Background Knee osteoarthritis has been previously associated with a stereotypical knee-stiffening gait pattern and reduced knee joint motion variability due to increased antagonist muscle co-contractions and smaller utilized arc of motion during gait. However, episodic self-reported instability may be a sign of excessive motion variability for a large subgroup of patients with knee osteoarthritis. The objective of this work was to evaluate the differences in knee joint motion variability during gait in patients with knee osteoarthritis with and without self-reported instability compared to a control group of older adults with asymptomatic knees. Methods Forty-three subjects, 8 with knee osteoarthritis but no reports of instability (stable), 11 with knee osteoarthritis and self-reported instability (unstable), and 24 without knee osteoarthritis or instability (control) underwent Dynamic Stereo X-ray analysis during a decline gait task on a treadmill. Knee motion variability was assessed using parametric phase plots during the loading response phase of decline gait. Findings The stable group demonstrated decreased sagittal-plane motion variability compared to the control group (p=0.04), while the unstable group demonstrated increased sagittal-plane motion variability compared to the control (p=0.003) and stable groups (pknee motion variability in patients with knee osteoarthritis without self-reported instability supports previous research. However, presence of self-reported instability is associated with increased knee motion variability in patients with knee osteoarthritis and warrants further investigation. PMID:25796536

Knee flexor strength recovery following hamstring tendon harvest for anterior cruciate ligament reconstruction: a systematic review

Directory of Open Access Journals (Sweden)

Clare Ardern

2009-07-01

Full Text Available The hamstring tendons are an increasingly popular graft choice for anterior cruciate ligament reconstruction due to preservation of quadriceps function and the absence of anterior knee pain post-operatively. Two commonly used hamstring grafts are a quadruple strand semitendinosus graft (4ST and a double strand semitendinosus-double strand gracilis graft (2ST-2G. It has been suggested that concurrent harvest of the semitendinsous and gracilis tendons may result in sub-optimal hamstring strength recovery as the gracilis may play a role in reinforcing the semitendinosus particularly in deep knee flexion angles. The objective of this systematic review was to synthesize the findings of available literature and determine whether semitendinosus and gracilis harvest lead to post-operative hamstring strength deficits when compared to semitendinosus harvest alone. Seven studies were identified which compared hamstring strength outcomes between the common hamstring graft types. The methodological quality of each paper was assessed, and where possible effect sizes were calculated to allow comparison of results across studies. No differences were reported between the groups in isokinetic hamstring strength. Deficits in hamstring strength were reported in the 2ST-2G groups when compared to the 4ST groups in isometric strength testing at knee flexion angles ≥70°, and in the standing knee flexion angle. Preliminary evidence exists to support the hypothesis that harvesting the semitendinosus tendon alone is preferable to harvesting in combination with the gracilis tendon for minimizing post-operative hamstring strength deficits at knee flexion angles greater than 70°. However, due to the paucity of research comparing strength outcomes between the common hamstring graft types, further investigation is warranted to fully elucidate the implications for graft harvest.

Knee osteoarthritis in traumatic knee symptoms in general practice: 6-year cohort study

NARCIS (Netherlands)

M. Kastelein (Marlous); P.A.J. Luijsterburg (Pim); I.M. Koster (Ingrid); J.A.N. Verhaar (Jan); D. Vroegindeweij (Dammis); S.M. Bierma-Zeinstra (Sita); E.H.G. Oei (Edwin)

2016-01-01

textabstractAim: To identify degenerative knee abnormalities using MRI and radiography 6 years after knee trauma, their relation with persistent knee symptoms and baseline prognostic factors. Methods: Adults (18–65 years) with incident traumatic knee symptoms visiting their

Three-dimensional dynamic analysis of knee joint during gait in medial knee osteoarthritis using loading axis of knee.

Science.gov (United States)

Nishino, Katsutoshi; Omori, Go; Koga, Yoshio; Kobayashi, Koichi; Sakamoto, Makoto; Tanabe, Yuji; Tanaka, Masaei; Arakawa, Masaaki

2015-07-01

We recently developed a new method for three-dimensional evaluation of mechanical factors affecting knee joint in order to help identify factors that contribute to the progression of knee osteoarthritis (KOA). This study aimed to verify the clinical validity of our method by evaluating knee joint dynamics during gait. Subjects were 41 individuals (14 normal knees; 8 mild KOAs; 19 severe KOAs). The positions of skin markers attached to the body were captured during gait, and bi-planar X-ray images of the lower extremities were obtained in standing position. The positional relationship between the markers and femorotibial bones was determined from the X-ray images. Combining this relationship with gait capture allowed for the estimation of relative movement between femorotibial bones. We also calculated the point of intersection of loading axis of knee on the tibial proximal surface (LAK point) to analyze knee joint dynamics. Knee flexion range in subjects with severe KOA during gait was significantly smaller than that in those with normal knees (p=0.011), and knee adduction in those with severe KOA was significantly larger than in those with mild KOA (p<0.000). LAK point was locally loaded on the medial compartment of the tibial surface as KOA progressed, with LAK point of subjects with severe KOA rapidly shifting medially during loading response. Local loading and medial shear force were applied to the tibial surface during stance phase as medial KOA progressed. Our findings suggest that our method is useful for the quantitative evaluation of mechanical factors that affect KOA progression. Copyright © 2015 Elsevier B.V. All rights reserved.

Features of time–intensity curve parameters of colorectal adenocarcinomas evaluated by double-contrast enhanced ultrasonography: Initial observation

International Nuclear Information System (INIS)

Zhuang Hua; Yang Zhigang; Wang Ziqiang; Wang Xiaodong; Chen Huijiao; Zhang Yuanchuan; Luo Yan

2012-01-01

Purpose: This study is to investigate the value of double contrast-enhanced ultrasonography (DCEU) in assessing microcirculation of colorectal adenocarcinomas and to describe the perfusion features of the tumours. Material and methods: DCEUS was performed in 42 patients with adenocarcinoma. The time–intensity curve parameters (arrival time (AT), time-to-peak (TTP), peak intensity (PI) and area under the curve (AUC)) within the tumours were extracted. The parameters were compared among the tumours with different CEUS features and stages. Results: The mean values of AT, TTP, PI and AUC of the colorectal adenocarcinomas were 13.68 ± 13.36 s, 32.61 ± 19.56 s, 19.82 ± 16.54 dB and 271.10 ± 159.19 dB s, respectively. In the adenocarcinomas with necrosis, the mean values of AUC was significantly lower than that of the adenocarcinomas without (231.10 ± 219.27 dB s, 278.10 ± 123.20 dB s, p = 0.004). In the adenocarcinomas with necrosis, the AUC and PI of the non-necrotic part were significantly higher than that of the necrotic part (p = 0.007, 0.0025, respectively). AUC increased progressively in the subgroups of T2, T3 and T4 and the difference of AUC between T2 and T4 subgroup was significant (p = 0.008). Conclusions: Double contrast-enhanced ultrasonography is a valuable technique for quantifying tumour vascularity of colorectal adenocarcinomas. AUC was significantly different in the subgroups of different T stage. AUC and PI could reflect the different perfusion status of tumours with or without necrosis.

ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION USING THE DOUBLE-BUNDLE TECHNIQUE – EVALUATION IN THE BIOMECHANICS LABORATORY

Science.gov (United States)

D'Elia, Caio Oliveira; Bitar, Alexandre Carneiro; Castropil, Wagner; Garofo, Antônio Guilherme Padovani; Cantuária, Anita Lopes; Orselli, Maria Isabel Veras; Luques, Isabela Ugo; Duarte, Marcos

2015-01-01

Objective: The objective of this study was to describe the methodology of knee rotation analysis using biomechanics laboratory instruments and to present the preliminary results from a comparative study on patients who underwent anterior cruciate ligament (ACL) reconstruction using the double-bundle technique. Methods: The protocol currently used in our laboratory was described. Three-dimensional kinematic analysis was performed and knee rotation amplitude was measured on eight normal patients (control group) and 12 patients who were operated using the double-bundle technique, by means of three tasks in the biomechanics laboratory. Results: No significant differences between operated and non-operated sides were shown in relation to the mean amplitudes of gait, gait with change in direction or gait with change in direction when going down stairs (p > 0.13). Conclusion: The preliminary results did not show any difference in the double-bundle ACL reconstruction technique in relation to the contralateral side and the control group. PMID:27027003

Association of Obesity, Parity, and History of Knee Injury with Knee Osteoarthritis in Female

Directory of Open Access Journals (Sweden)

Ade Triyadi

2015-12-01

Full Text Available Background: Osteoarthritis is the most joint disorder among elderly. There are a lot of risk factors of knee osteoarthritis. Obesity and high frequent of parity can increase the load on knee joint. Knee injury also decreases the stability of knee joint on bearing body load. This study was conducted to observe the association of obesity, parity ≥3 times and history of knee injury with the occurrence of knee osteoarthritis in female aged >50 years old. Methods: Case control design was chosen in this study. Female patients with age >50 years were recruited by consecutive sampling from rheumatology clinic at Dr. Hasan Sadikin General Hospital Bandung. Data were collected from August to September 2013. Minimal sample size was 60 samples calculated by rule of thumb formula. Obesity was measured by body mass index (BMI. Parity and history of knee injury were assessed by questionnaire. Those variables were analyzed by logistic regression method. Result: Obesity did not associate with knee osteoarthritis in this study, p=0.549 (odd ratio (OR 1.32, 95% confidence interval (CI 0.52–3.32. Parity was associated with knee osteoarthritis in this study p=0.001 (OR 4.7, 95% CI 1.89–11.68. History of knee injury was associated with knee osteoarthritis in this study, p=0.001 (OR 6.19, 95% CI 2.01–18.99. Conclusions: Parity ≥3 times and history of knee injury were associated with the occurrence of knee osteoarthritis. Obesity was not associated with the occurrence of knee osteoarthritis.

Biomechanical comparison of the double-push technique and the conventional skate skiing technique in cross-country sprint skiing.

Science.gov (United States)

Stöggl, Thomas; Müller, Erich; Lindinger, Stefan

2008-09-01

The aims of the study were to: (1) adapt the "double-push" technique from inline skating to cross-country skiing; (2) compare this new skiing technique with the conventional skate skiing cross-country technique; and (3) test the hypothesis that the double-push technique improves skiing speed in a short sprint. 13 elite skiers performed maximum-speed sprints over 100 m using the double-push skate skiing technique and using the conventional "V2" skate skiing technique. Pole and plantar forces, knee angle, cycle characteristics, and electromyography of nine lower body muscles were analysed. We found that the double-push technique could be successfully transferred to cross-country skiing, and that this new technique is faster than the conventional skate skiing technique. The double-push technique was 2.9 +/- 2.2% faster (P push technique had a longer cycle length and a lower cycle rate, and it was characterized by higher muscle activity, higher knee extension amplitudes and velocities, and higher peak foot forces, especially in the first phase of the push-off. Also, the foot was more loaded laterally in the double-push technique than in the conventional skate skiing technique.

Reconstrucción de rodilla con doble colgajo de gemelo Knee reconstruction with double gemelar muscular flap

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C. Márquez Zevallos

2011-06-01

Full Text Available Los traumatismos de miembros inferior representan un reto importante para el cirujano plástico en cuanto a su reconstrucción cuando no se dispone de técnicas microquirúrgicas. En el presente trabajo se presentan 2 casos de reconstrucción de rodilla con doble colgajo muscular de gemelo, en los que se demuestra que se pueden utilizar simultáneamente los dos gemelos sin dejar ninguna secuela estética importante ni funcional en la deambulación de los pacientes. Hasta donde podemos conocer, no existe en la literatura nacional ni internacional un reporte de casos con esta aplicación, ya que siempre se ha empelado un solo músculo precisamente por el temor a alterar la función de flexo-extensión del pie.Lower limb traumatism has always been a problem for plastic surgeon when in the moment of the surgical reconstruction we have not microsurgical techniques. In this paper, we present 2 cases of knee reconstruction using a double gemelar muscular flap, showing how is possible the simultaneous use of the two muscles without aesthetic or functional sequels. As we know, there is no national or international report of cases with this muscular reconstruction; it has been usual to use only one muscle, in order to avoid problems in the flexo-extension movements of the foot.

Knee arthrodesis – ultima ratio for the treatment of the infected knee

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Tiemann, Andreas H. H.

2013-04-01

Full Text Available The irretrievable destruction of the knee due to trauma, tumor or infection is the indication for knee arthrodesis. The main reason for knee arthrodesis in terms of infection ist the infected total knee arthroplasty. Central problem is the definition of the term “irretrievable”. It is based on the subjective opinion of the attending physician and depends on his expert knowledge of this specific entity. The preservation of a functioning extremity is the main goal.This article shows the typical indications and contraindications for knee arthrodesis following septic knee diseases. In addition it gives insight into the biomechanical and technical considerations to be kept in mind. Finally the postoperative care and outcome of different techniques are analysed.

Effects of Knee Alignments and Toe Clip on Frontal Plane Knee Biomechanics in Cycling

Science.gov (United States)

Shen, Guangping; Zhang, Songning; Bennett, Hunter J.; Martin, James C.; Crouter, Scott E.; Fitzhugh, Eugene C.

2018-01-01

Effects of knee alignment on the internal knee abduction moment (KAM) in walking have been widely studied. The KAM is closely associated with the development of medial knee osteoarthritis. Despite the importance of knee alignment, no studies have explored its effects on knee frontal plane biomechanics during stationary cycling. The purpose of this study was to examine the effects of knee alignment and use of a toe clip on the knee frontal plane biomechanics during stationary cycling. A total of 32 participants (11 varus, 11 neutral, and 10 valgus alignment) performed five trials in each of six cycling conditions: pedaling at 80 rpm and 0.5 kg (40 Watts), 1.0 kg (78 Watts), and 1.5 kg (117 Watts) with and without a toe clip. A motion analysis system and a customized instrumented pedal were used to collect 3D kinematic and kinetic data. A 3 × 2 × 3 (group × toe clip × workload) mixed design ANOVA was used for statistical analysis (p < 0.05). There were two different knee frontal plane loading patterns, internal abduction and adduction moment, which were affected by knee alignment type. The knee adduction angle was 12.2° greater in the varus group compared to the valgus group (p = 0.001), yet no difference was found for KAM among groups. Wearing a toe clip increased the knee adduction angle by 0.95º (p = 0.005). The findings of this study indicate that stationary cycling may be a safe exercise prescription for people with knee malalignments. In addition, using a toe clip may not have any negative effects on knee joints during stationary cycling. Key points Varus or valgus alignment did not cause increased frontal-plane knee joint loading, suggesting stationary cycling is a safe exercise. This study supports that using a toe clip did not lead to abnormal frontal-plane knee loading during stationary cycling. Two different knee frontal plane loading patterns, knee abduction and adduction moment, were observed during stationary cycling, which are likely affected by

Evaluation and management of knee pain in young athletes: overuse injuries of the knee

OpenAIRE

Patel, Dilip R.; Villalobos, Ana

2017-01-01

Recurrent or chronic activity related knee pain is common in young athletes. Numerous intrinsic conditions affecting the knee can cause such pain. In addition, knee pain can be referred pain from low back, hip or pelvic pathology. The most common cause of knee pain in young athletes is patellofemoral pain syndrome, or more appropriately termed idiopathic anterior knee pain. Although, numerous anatomical and biomechanical factors have been postulated to contribute the knee pain in young athlet...

Total knee arthroplasty

DEFF Research Database (Denmark)

Schrøder, Henrik M.; Petersen, Michael M.

2016-01-01

Total knee arthroplasty (TKA) is a successful treatment of the osteoarthritic knee, which has increased dramatically over the last 30 years. The indication is a painful osteoarthritic knee with relevant radiographic findings and failure of conservative measures like painkillers and exercise...... surgeon seems to positively influence the rate of surgical complications and implant survival. The painful TKA knee should be thoroughly evaluated, but not revised except if a relevant indication can be established. The most frequent indications for revision are: aseptic loosening, instability, infection...

Three-dimensional double-echo steady-state (3D-DESS) magnetic resonance imaging of the knee. Establishment of flip angles for evaluation of cartilage at 1.5 T and 3.0 T

International Nuclear Information System (INIS)

Moriya, Susumu; Miki, Yukio; Matsuno, Yukako; Okada, Masayo

2012-01-01

Background: The effect of flip angle (FA) on synovial fluid and cartilage signal and on image contrast using three-dimensional double-echo steady-state (3D-DESS) sequence have only been performed with 1.0-T but not with 1.5-T or 3.0-T scanners. Purpose: To identify the FA that gives the maximum synovial fluid and cartilage values, and to identify the FA at which maximum values of synovial fluid-cartilage contrast-to-noise ratio (CNR) in 3D-DESS sequences when 1.5-T and 3.0-T scanners are used. Material and Methods: Using 3D-DESS with water-excitation pulse, mid-sagittal plane images of the knees of 10 healthy volunteers (5 men, 5 women; age range, 21-42 years) were obtained with FA varying from 10 deg to 90 deg. Synovial fluid signals, cartilage signals, and background were measured at each FA, and the FA that gave the highest synovial fluid and cartilage values was obtained. Synovial fluid-cartilage CNR was also calculated, and the FA that gave the largest CNR was obtained. Results: At 1.5 T, the maximum synovial fluid signal was at FA 90 deg, and the maximum cartilage signal was at FA 30 deg. Synovial fluid-cartilage CNR was highest at FA 90 deg (P < 0.05). At 3.0 T, the maximum synovial fluid signal was at FA 90 deg, and the maximum cartilage signal was at FA 20 deg. Synovial fluid-cartilage CNR was highest at FA 90 deg (P < 0.05). Conclusion: In order to improve the visibility of cartilage itself, FA settings of 30 deg at 1.5 T and 20 deg at 3.0 T are apparently ideal. For observing the cartilage surface, the most effective FA setting is 90 deg for both 1.5 T and 3.0 T

Medical Image Visual Appearance Improvement Using Bihistogram Bezier Curve Contrast Enhancement: Data from the Osteoarthritis Initiative

Science.gov (United States)

Gan, Hong-Seng; Swee, Tan Tian; Abdul Karim, Ahmad Helmy; Sayuti, Khairil Amir; Abdul Kadir, Mohammed Rafiq; Tham, Weng-Kit; Wong, Liang-Xuan; Chaudhary, Kashif T.; Yupapin, Preecha P.

2014-01-01

Well-defined image can assist user to identify region of interest during segmentation. However, complex medical image is usually characterized by poor tissue contrast and low background luminance. The contrast improvement can lift image visual quality, but the fundamental contrast enhancement methods often overlook the sudden jump problem. In this work, the proposed bihistogram Bezier curve contrast enhancement introduces the concept of “adequate contrast enhancement” to overcome sudden jump problem in knee magnetic resonance image. Since every image produces its own intensity distribution, the adequate contrast enhancement checks on the image's maximum intensity distortion and uses intensity discrepancy reduction to generate Bezier transform curve. The proposed method improves tissue contrast and preserves pertinent knee features without compromising natural image appearance. Besides, statistical results from Fisher's Least Significant Difference test and the Duncan test have consistently indicated that the proposed method outperforms fundamental contrast enhancement methods to exalt image visual quality. As the study is limited to relatively small image database, future works will include a larger dataset with osteoarthritic images to assess the clinical effectiveness of the proposed method to facilitate the image inspection. PMID:24977191

Medical Image Visual Appearance Improvement Using Bihistogram Bezier Curve Contrast Enhancement: Data from the Osteoarthritis Initiative

Directory of Open Access Journals (Sweden)

Hong-Seng Gan

2014-01-01

Full Text Available Well-defined image can assist user to identify region of interest during segmentation. However, complex medical image is usually characterized by poor tissue contrast and low background luminance. The contrast improvement can lift image visual quality, but the fundamental contrast enhancement methods often overlook the sudden jump problem. In this work, the proposed bihistogram Bezier curve contrast enhancement introduces the concept of “adequate contrast enhancement” to overcome sudden jump problem in knee magnetic resonance image. Since every image produces its own intensity distribution, the adequate contrast enhancement checks on the image’s maximum intensity distortion and uses intensity discrepancy reduction to generate Bezier transform curve. The proposed method improves tissue contrast and preserves pertinent knee features without compromising natural image appearance. Besides, statistical results from Fisher’s Least Significant Difference test and the Duncan test have consistently indicated that the proposed method outperforms fundamental contrast enhancement methods to exalt image visual quality. As the study is limited to relatively small image database, future works will include a larger dataset with osteoarthritic images to assess the clinical effectiveness of the proposed method to facilitate the image inspection.

Runner's Knee

Science.gov (United States)

... require a lot of knee bending, such as biking, jumping, or skiing. Runner's knee happens when the ... is out of alignment, activities like running or biking can wear down the cartilage of the kneecap ( ...

Dose optimisation of double-contrast barium enema examinations.

Science.gov (United States)

Berner, K; Båth, M; Jonasson, P; Cappelen-Smith, J; Fogelstam, P; Söderberg, J

2010-01-01

The purpose of the present work was to optimise the filtration and dose setting for double-contrast barium enema examinations using a Philips MultiDiagnost Eleva FD system. A phantom study was performed prior to a patient study. A CDRAD phantom was used in a study where copper and aluminium filtration, different detector doses and tube potentials were examined. The image quality was evaluated using the software CDRAD Analyser and the phantom dose was determined using the Monte Carlo-based software PCXMC. The original setting [100 % detector dose (660 nGy air kerma) and a total filtration of 3.5 mm Al, at 81 kVp] and two other settings identified by the phantom study (100 % detector dose and additional filtration of 1 mm Al and 0.2 mm Cu as well as 80 % detector dose and added filtration of 1 mm Al and 0.2 mm Cu) were included in the patient study. The patient study included 60 patients and up to 8 images from each patient. Six radiologists performed a visual grading characteristics study to evaluate the image quality. A four-step scale was used to judge the fulfillment of three image quality criteria. No overall statistical significant difference in image quality was found between the three settings (P > 0.05). The decrease in the effective dose for the settings in the patient study was 15 % when filtration was added and 34 % when both filtrations was added and detector dose was reduced. The study indicates that additional filtration of 1 mm Al and 0.2 mm Cu and a decrease in detector dose by 20 % from the original setting can be used in colon examinations with Philips MultiDiagnost Eleva FD to reduce the patient dose by 30 % without significantly affecting the image quality. For 20 exposures, this corresponds to a decrease in the effective dose from 1.6 to 1.1 mSv.

Adductor canal block versus femoral nerve block for analgesia after total knee arthroplasty

DEFF Research Database (Denmark)

Jaeger, Pia; Zaric, Dusanka; Fomsgaard, Jonna Storm

2013-01-01

Femoral nerve block (FNB), a commonly used postoperative pain treatment after total knee arthroplasty (TKA), reduces quadriceps muscle strength essential for mobilization. In contrast, adductor canal block (ACB) is predominately a sensory nerve block. We hypothesized that ACB preserves quadriceps...

Musculoskeletal MR: knee

International Nuclear Information System (INIS)

Staebler, A.; Glaser, C.; Reiser, M.

2000-01-01

Magnetic resonance imaging is the most sensitive, specific, and accurate noninvasive method for diagnosing internal derangement of the knee. During the past 15 years knowledge of pathologic conditions of the knee had evolved significantly. Beyond the basic principles of imaging knee injuries great impact was made on the understanding of indirect or collateral findings, even in rare diseases. In this article the spectrum of disorders of the knee are reviewed and an overview of the current literature is given. This includes considerations about how to achieve a high-standard MR imaging study of the knee, and principles of imaging anterior cruciate ligament and meniscal tears. A focus is put on distinct diseases including intra-articular and intraosseous ganglion cysts, iliotibial band friction syndrome, transient osteoporosis, osteonecrosis, osteochondritis dissecans, and imaging of the articular cartilage. (orig.)

Prevalent knee pain and sport

DEFF Research Database (Denmark)

Hahn, Thomas; Foldspang, Anders

1998-01-01

STUDY OBJECTIVE: To estimate the prevalence of knee pain in active athletes and to investigate potential associations to type, amount and duration of sports participation. MEASUREMENTS: 339 athletes gave information about occupation, sports activity and different features of knee pain, based...... on a self-filled questionnaire. MAIN RESULTS: The prevalence of knee pain within the preceding 12 months, constant or recurrent knee pain, absence from sport and absence from work due to knee pain, was 54%, 34%, 19% and 4%, respectively. Knee pain was positively associated with years of jogging...... and with weekly hours of participation in competitive gymnastics but negatively with weekly hours of tennis. Constant or recurrent knee pain was positively associated with years of swimming. Absence from sport due to knee pain was positively associated with weekly hours of soccer participation. CONCLUSIONS: Knee...

Knitted outer gloves in primary hip and knee arthroplasty.

Science.gov (United States)

Tanner, J; Wraighte, P; Howard, P

2006-01-01

A randomised trial was carried out to determine the rate of perforation to inner gloves when comparing latex with knitted gloves during hip and knee arthroplasty. Members of the surgical team were randomised to wear either two pairs of latex gloves (standard double gloving) or a knitted glove on top of a latex glove. In addition, participants completed a visual analogue assessment of their overall satisfaction with the gloves. A total of 406 inner gloves were tested for perforations over a four-month period: 23% of inner gloves were perforated when latex outer gloves were used and 6% of inner gloves were perforated when knitted outer gloves were used. In total, there were 64 perforations to the inner gloves; only one of these perforations was detected by the glove wearer. Wearing knitted outer gloves during hip and knee arthroplasty statistically significantly reduces the risk of perforation to inner latex gloves (p<0.0001).

MR-cholangiography with a double contrast technique

International Nuclear Information System (INIS)

Hemmingsson, A.; Carlsten, J.; Ericsson, A.; Holtz, E.; Klaveness, J.; Loennemark, M.; Nyman, R.

1989-01-01

The combination of superparamagnetic particles (SPP) as a ''negative'' contrast agent for the liver parenchyma and Cr-HIDA as a ''positive'' one for the bile ducts was tested in dogs. The maximum effect of SPP was present about 30 minutes after injection with a reduction of the image intensity of the liver close to the background noise level at the highest dosages. This effect lasted for about 4 to 5 hours and it had disappeared after 24 hours. Before any contrast administration or after Cr-HIDA the bile ducts were not discernible, but a high signal in the gallbladder was present 15 to 30 minutes after injection of Cr-HIDA. After SPP the wider bile ducts were discernible because of the lowering of the signal intensity in the liver. When SPP were followed by Cr-HIDA, the bile had a higher signal intensity, and even tiny bile ducts were visible. After cholecystokinin visualization of the choledochus duct was achieved as well as contrast filling of the duodenum. The blood, urine and liver function tests were found normal during the experiments. The combination of superparamagnetic particles and Cr-HIDA seems to be a promising method for MR-cholangiography. An evaluation of the anatomic structures of the liver should be possible with this method in different pathologies. (orig.)

Unilateral Congenital Knee and Hip Dislocation with Bilateral Clubfoot – A rare Packaging disorder

Directory of Open Access Journals (Sweden)

Mukesh Tiwari

2013-04-01

Full Text Available ntroduction: Reduced intrauterine space gives rise to ‘packaging disorder’ which may involve joint dislocations or contractures. We present an unique case where mutiple joints were dislocated involving left congenital knee dislocation (CDK, bilateral congenital hip dislocation (CDH and congenital talipes equino varus (CTEVdeformities. Case Report: A preterm baby boy born to mother with diagnosed oligohydramios presented with left CDK bilateral DDH and CTEV. The knee dislocation was treated first with gradual streaching and weekly above knee cast. At 7th week good flexion was achieved at both knees and abduction splint for DDH (using double diaper with ponseti cast for CTEV was done. At one year follow up all joints were reduced and maintained well with baby able to stand with support. Conclusion: Packaging disorders may present with multiple dislocations and deformities. Early intervention with serial casting and manipulation minimises disability and prevents ambulatory problems. In our case there was a good response to manipulation and serial casting. This differs from cases with inherent pathology like arthrogryposis where response to treatment is not so good. Keywords: Congenital genu recurvatum, Develpmental dysplasia hip, CTEV, Clubfoot, serial manipulation, packaging disorders

Effects of Knee Alignments and Toe Clip on Frontal Plane Knee Biomechanics in Cycling.

Science.gov (United States)

Shen, Guangping; Zhang, Songning; Bennett, Hunter J; Martin, James C; Crouter, Scott E; Fitzhugh, Eugene C

2018-06-01

Effects of knee alignment on the internal knee abduction moment (KAM) in walking have been widely studied. The KAM is closely associated with the development of medial knee osteoarthritis. Despite the importance of knee alignment, no studies have explored its effects on knee frontal plane biomechanics during stationary cycling. The purpose of this study was to examine the effects of knee alignment and use of a toe clip on the knee frontal plane biomechanics during stationary cycling. A total of 32 participants (11 varus, 11 neutral, and 10 valgus alignment) performed five trials in each of six cycling conditions: pedaling at 80 rpm and 0.5 kg (40 Watts), 1.0 kg (78 Watts), and 1.5 kg (117 Watts) with and without a toe clip. A motion analysis system and a customized instrumented pedal were used to collect 3D kinematic and kinetic data. A 3 × 2 × 3 (group × toe clip × workload) mixed design ANOVA was used for statistical analysis (p < 0.05). There were two different knee frontal plane loading patterns, internal abduction and adduction moment, which were affected by knee alignment type. The knee adduction angle was 12.2° greater in the varus group compared to the valgus group (p = 0.001), yet no difference was found for KAM among groups. Wearing a toe clip increased the knee adduction angle by 0.95º (p = 0.005). The findings of this study indicate that stationary cycling may be a safe exercise prescription for people with knee malalignments. In addition, using a toe clip may not have any negative effects on knee joints during stationary cycling.

Association between knee alignment and knee pain in patients surgically treated for medial knee osteoarthritis by high tibial osteotomy. A one year follow-up study

DEFF Research Database (Denmark)

W-Dahl, Annette; Toksvig-Larsen, Sören; Roos, Ewa

2009-01-01

on for knee OA by high tibial osteotomy. METHODS: 182 patients (68% men) mean age 53 years (34 - 69) with varus alignment having tibial osteotomy by the hemicallotasis technique for medial knee OA were consecutively included. Knee alignment was assessed by the Hip-Knee-Ankle (HKA) angle from radiographs...... including the hip and ankle joints. Knee pain was measured by the subscale pain (0 - 100, worst to best scale) of the Knee injury and Osteoarthritis Outcome Score (KOOS) preoperatively and at one year follow-up. To estimate the association between knee alignment and knee pain multivariate regression...... with every degree of HKA angle, adjusted analysis 0.3 points (95% CI -1.3 - 0.6).The mean postoperative knee alignment was 184 degrees (171 - 185). The mean change in knee alignment was 13 degrees (0 - 30). The mean change in KOOS pain was 32 (-16 - 83). There was neither any association between change...

Body mass index affects knee joint mechanics during gait differently with and without moderate knee osteoarthritis.

Science.gov (United States)

Harding, Graeme T; Hubley-Kozey, Cheryl L; Dunbar, Michael J; Stanish, William D; Astephen Wilson, Janie L

2012-11-01

Obesity is a highly cited risk factor for knee osteoarthritis (OA), but its role in knee OA pathogenesis and progression is not as clear. Excess weight may contribute to an increased mechanical burden and altered dynamic movement and loading patterns at the knee. The objective of this study was to examine the interacting role of moderate knee OA disease presence and obesity on knee joint mechanics during gait. Gait analysis was performed on 104 asymptomatic and 140 individuals with moderate knee OA. Each subject group was divided into three body mass categories based on body mass index (BMI): healthy weight (BMI30). Three-dimensional knee joint angles and net external knee joint moments were calculated and waveform principal component analysis (PCA) was applied to extract major patterns of variability from each. PC scores for major patterns were compared between groups using a two-factor ANOVA. Significant BMI main effects were found in the pattern of the knee adduction moment, the knee flexion moment, and the knee rotation moment during gait. Two interaction effects between moderate OA disease presence and BMI were also found that described different changes in the knee flexion moment and the knee flexion angle with increased BMI with and without knee OA. Our results suggest that increased BMI is associated with different changes in biomechanical patterns of the knee joint during gait depending on the presence of moderate knee OA. Copyright © 2012 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Knee rotation influences the femoral tunnel angle measurement after anterior cruciate ligament reconstruction: a 3-dimensional computed tomography model study

Science.gov (United States)

Tang, Jing; Thorhauer, Eric; Marsh, Chelsea; Fu, Freddie H.

2013-01-01

Purpose Femoral tunnel angle (FTA) has been proposed as a metric for evaluating whether ACL reconstruction was performed anatomically. In clinic, radiographic images are typically acquired with an uncertain amount of internal/external knee rotation. The extent to which knee rotation will influence FTA measurement is unclear. Furthermore, differences in FTA measurement between the two common positions (0° and 45° knee flexion) have not been established. The purpose of this study was to investigate the influence of knee rotation on FTA measurement after ACL reconstruction. Methods Knee CT data from 16 subjects were segmented to produce 3D bone models. Central axes of tunnels were identified. The 0° and 45° flexion angles were simulated. Knee internal/external rotations were simulated in a range of ±20°. FTA was defined as the angle between the tunnel axis and femoral shaft axis, orthogonally projected into the coronal plane. Results Femoral tunnel angle was positively/negatively correlated with knee rotation angle at 0°/45° knee flexion. At 0° knee flexion, FTA for anterio-medial (AM) tunnels was significantly decreased at 20° of external knee rotation. At 45° knee flexion, more than 16° external or 19° internal rotation significantly altered FTA measurements for single-bundle tunnels; smaller rotations (±9° for AM, ±5° for PL) created significant errors in FTA measurements after double-bundle reconstruction. Conclusion Femoral tunnel angle measurements were correlated with knee rotation. Relatively small imaging malalignment introduced significant errors with knee flexed 45°. This study supports using the 0° flexion position for knee radiographs to reduce errors in FTA measurement due to knee internal/external rotation. Level of evidence Case–control study, Level III. PMID:23589127

The diagnostic value of double-contrast-technique cystography in the evaluation of benign and malignant lesions of the urinary bladder

International Nuclear Information System (INIS)

Beyer, D.; Koester, R.; Schuett, H.

1979-01-01

Cystography by double-contrast-technique as simple and quick method of evaluating benign and malignant lesions of the urinary bladder is being described. 301 examinations were reviewed and are being discussed in regard to diagnostic value, indication, complication and radiation exposure of this method. A few typical cases are being demonstrated to illustrate the value of this method in the spectrum of other diagnostic methods in the workup of urinary bladder lesions. (orig.) [de

Synovial hemangiomas of the knee: magnetic resonance findings in six cases

International Nuclear Information System (INIS)

Concepcion, L.; Marti-Bonmati, L. M.; Dosda, R.; Llauger, J.; Palmer, J.; Mellado, J. M.

1999-01-01

The synovial hemangioma is an uncommon benign vascular tumor that is difficult to diagnose on the basis of clinical signs Moreover, it has no characteristic radiographic features. The objective of the present report was to describe the MR findings associated with synovial hemangioma of the knee. We review the clinical and MR findings in six patients, with histologically confirmed synovial hemangioma of the Knee, studied with different MR systems and techniques. Synovial hemangiomas were isointense with respect to muscle in T1-weighted images, strongly hyperintense in T2-weighted sequences and presented wavy hypointense linear images. Gadolinium administration resulted in a marked enhancement, although it was heterogeneous in two of three cases analyzed. Although the findings are not pathognomonic, the presence of an intraarticular tumor of the knee that is isointense with respect to muscle in T1 and hyperintense in T2, and shows wavy hypointense images and a marked contrast uptake, may suggest the presence of synovial hemangioma. (Author) 11 refs

Associations of knee extensor strength and standing balance with physical function in knee osteoarthritis.

Science.gov (United States)

Pua, Yong-Hao; Liang, Zhiqi; Ong, Peck-Hoon; Bryant, Adam L; Lo, Ngai-Nung; Clark, Ross A

2011-12-01

Knee extensor strength is an important correlate of physical function in patients with knee osteoarthritis; however, it remains unclear whether standing balance is also a correlate. The purpose of this study was to evaluate the cross-sectional associations of knee extensor strength, standing balance, and their interaction with physical function. One hundred four older adults with end-stage knee osteoarthritis awaiting a total knee replacement (mean ± SD age 67 ± 8 years) participated. Isometric knee extensor strength was measured using an isokinetic dynamometer. Standing balance performance was measured by the center of pressure displacement during quiet standing on a balance board. Physical function was measured by the self-report Short Form 36 (SF-36) questionnaire and by the 10-meter fast-pace gait speed test. After adjustment for demographic and knee pain variables, we detected significant knee strength by standing balance interaction terms for both SF-36 physical function and fast-pace gait speed. Interrogation of the interaction revealed that standing balance in the anteroposterior plane was positively related to physical function among patients with lower knee extensor strength. Conversely, among patients with higher knee extensor strength, the standing balance-physical function associations were, or tended to be, negative. These findings suggest that although standing balance was related to physical function in patients with knee osteoarthritis, this relationship was complex and dependent on knee extensor strength level. These results are of importance in developing intervention strategies and refining theoretical models, but they call for further study. Copyright © 2011 by the American College of Rheumatology.

Local contrast-enhanced MR images via high dynamic range processing.

Science.gov (United States)

Chandra, Shekhar S; Engstrom, Craig; Fripp, Jurgen; Neubert, Ales; Jin, Jin; Walker, Duncan; Salvado, Olivier; Ho, Charles; Crozier, Stuart

2018-09-01

To develop a local contrast-enhancing and feature-preserving high dynamic range (HDR) image processing algorithm for multichannel and multisequence MR images of multiple body regions and tissues, and to evaluate its performance for structure visualization, bias field (correction) mitigation, and automated tissue segmentation. A multiscale-shape and detail-enhancement HDR-MRI algorithm is applied to data sets of multichannel and multisequence MR images of the brain, knee, breast, and hip. In multisequence 3T hip images, agreement between automatic cartilage segmentations and corresponding synthesized HDR-MRI series were computed for mean voxel overlap established from manual segmentations for a series of cases. Qualitative comparisons between the developed HDR-MRI and standard synthesis methods were performed on multichannel 7T brain and knee data, and multisequence 3T breast and knee data. The synthesized HDR-MRI series provided excellent enhancement of fine-scale structure from multiple scales and contrasts, while substantially reducing bias field effects in 7T brain gradient echo, T 1 and T 2 breast images and 7T knee multichannel images. Evaluation of the HDR-MRI approach on 3T hip multisequence images showed superior outcomes for automatic cartilage segmentations with respect to manual segmentation, particularly around regions with hyperintense synovial fluid, across a set of 3D sequences. The successful combination of multichannel/sequence MR images into a single-fused HDR-MR image format provided consolidated visualization of tissues within 1 omnibus image, enhanced definition of thin, complex anatomical structures in the presence of variable or hyperintense signals, and improved tissue (cartilage) segmentation outcomes. © 2018 International Society for Magnetic Resonance in Medicine.

MRI features of tuberculosis of the knee

Energy Technology Data Exchange (ETDEWEB)

Sanghvi, Darshana A.; Iyer, Veena R.; Deshmukh, Tejaswini; Hoskote, Sumedh S. [Seth GS Medical College and KEM Hospital, Department of Radiology, Mumbai (India)

2009-03-15

The objective of this study was to describe the magnetic resonance imaging (MRI) features of tuberculosis (TB) of the knee joint. The MRI features in 15 patients with TB of the knee, as confirmed by histology of the biopsied joint synovium, were reviewed retrospectively. The images were assessed for intra-articular and peri-articular abnormalities. All patients had florid synovial proliferation. The proliferating synovium showed intermediate to low T2 signal intensity. In the patients who were administered intravenous contrast, the hypertrophic synovium was intensely enhancing. Marrow edema (n = 9), osteomyelitis (n = 4), cortical erosions (n = 5), myositis (n = 6), cellulitis (n = 2), abscesses (n = 3), and skin ulceration/sinus formation (n = 2) were seen in the adjacent bone and soft tissue. Synovial proliferation associated with tuberculous arthritis is typically hypointense on T2-weighted images. This appearance, in conjunction with other peri-articular MRI features described, can help in distinguishing TB arthritis from other proliferating synovial arthropathies. (orig.)

Heat generated by knee prostheses.

Science.gov (United States)

Pritchett, James W

2006-01-01

Temperature sensors were placed in 50 knees in 25 patients who had one or both joints replaced. Temperature recordings were made before walking, after walking, and after cycling. The heat generated in healthy, arthritic, and replaced knees was measured. The knee replacements were done using eight different prostheses. A rotating hinge knee prosthesis generated a temperature increase of 7 degrees C in 20 minutes and 9 degrees C in 40 minutes. An unconstrained ceramic femoral prosthesis articulating with a polyethylene tibial prosthesis generated a temperature increase of 4 degrees C compared with a healthy resting knee. The other designs using a cobalt-chrome alloy and high-density polyethylene had temperature increases of 5 degrees-7 degrees C with exercise. Frictional heat generated in a prosthetic knee is not immediately dissipated and may result in wear, creep, and other degenerative processes in the high-density polyethylene. Extended periods of elevated temperature in joints may inhibit cell growth and perhaps contribute to adverse performance via bone resorption or component loosening. Prosthetic knees generate more heat with activity than healthy or arthritic knees. More-constrained knee prostheses generate more heat than less-constrained prostheses. A knee with a ceramic femoral component generates less heat than a knee with the same design using a cobalt-chromium alloy.

Analgesic efficacy of local anaesthetic wound administration in knee arthroplasty: volume vs concentration

DEFF Research Database (Denmark)

Andersen, L Ø; Gaarn-Larsen, L; Kristensen, B B

2010-01-01

was reduced in both groups with ropivacaine administration 24 h postoperatively (p time intervals. No reduction in pain scores was observed with ropivacaine injection 6 h postoperatively. The median (IQR [range]) dose of oxycodone administered......Wound administration of local anaesthetic may be effective for postoperative pain management in knee arthroplasty, but the analgesic efficacy of local anaesthetic in relation to volume vs concentration has not been determined. In a double-blinded trial, 48 patients scheduled for total knee...... arthroplasty were randomly assigned to receive either a high volume/low concentration solution of ropivacaine (20 ml, 0.5%) or a low volume/high concentration solution of ropivacaine (10 ml, 1%), 6 and 24 h postoperatively through an intracapsular catheter. Pain was assessed for 2 h after administration. Pain...

Knee Injuries Are Associated with Accelerated Knee Osteoarthritis Progression: Data from the Osteoarthritis Initiative

Science.gov (United States)

Driban, Jeffrey B.; Eaton, Charles B.; Lo, Grace H.; Ward, Robert J.; Lu, Bing; McAlindon, Timothy E.

2014-01-01

Objective We aimed to evaluate if a recent knee injury was associated with accelerated knee osteoarthritis (KOA) progression. Methods In the Osteoarthritis Initiative (OAI) we studied participants free of KOA on their baseline radiographs (Kellgren-Lawrence [KL]knee that progressed to end-stage KOA (KL Grade 3 or 4) within 48 months, 2) common KOA progression: at least one knee increased in radiographic scoring within 48 months (excluding those defined as accelerated KOA), and 3) no KOA: no change in KL grade in either knee. At baseline, participants were asked if their knees had ever been injured and at each annual visit they were asked about injuries during the prior 12 months. We used multinomial logistic regressions to determine if a new knee injury was associated with the outcome of accelerated KOA or common KOA progression after adjusting for age, sex, body mass index, static knee malalignment, and systolic blood pressure. Results A knee injury during the total observation period was associated with accelerated KOA progression (n=54, odds ratio [OR]=3.14) but not common KOA progression (n=187, OR=1.08). Furthermore, a more recent knee injury (within a year of the outcome) was associated with accelerated (OR=8.46) and common KOA progression (OR=3.12). Conclusion Recent knee injuries are associated with accelerated KOA. Most concerning is that certain injuries may be associated with a rapid cascade towards joint failure in less than one year. PMID:24782446

Influence of knee flexion angle and transverse drill angle on creation of femoral tunnels in double-bundle anterior cruciate ligament reconstruction using the transportal technique: Three-dimensional computed tomography simulation analysis.

Science.gov (United States)

Choi, Chong Hyuk; Kim, Sung-Jae; Chun, Yong-Min; Kim, Sung-Hwan; Lee, Su-Keon; Eom, Nam-Kyu; Jung, Min

2018-01-01

The purpose of this study was to find appropriate flexion angle and transverse drill angle for optimal femoral tunnels of anteromedial (AM) bundle and posterolateral (PL) bundle in double-bundle ACL reconstruction using transportal technique. Thirty three-dimensional knee models were reconstructed. Knee flexion angles were altered from 100° to 130° at intervals of 10°. Maximum transverse drill angle (MTA), MTA minus 10° and 20° were set up. Twelve different tunnels were determined by four flexion angles and three transverse drill angles for each bundle. Tunnel length, wall breakage, inter-tunnel communication and graft-bending angle were assessed. Mean tunnel length of AM bundle was >30mm at 120° and 130° of flexion in all transverse drill angles. Mean tunnel length of PL bundle was >30mm during every condition. There were ≥1 cases of wall breakage except at 120° and 130° of flexion with MTA for AM bundle. There was no case of wall breakage for PL bundle. Considering inter-tunnel gap of >2mm without communication and obtuse graft-bending angle, 120° of flexion and MTA could be recommended as optimal condition for femoral tunnels of AM and PL bundles. Flexion angle and transverse drill angle had combined effect on femoral tunnel in double-bundle ACL reconstruction using transportal technique. Achieving flexion angle of 120° and transverse drill angle close to the medial femoral condyle could be recommended as optimal condition for femoral tunnels of AM and PL bundles to avoid insufficient tunnel length, wall breakage, inter-tunnel communication and acute graft-bending angle. Copyright © 2017 Elsevier B.V. All rights reserved.

Anterior approach for knee arthrography

International Nuclear Information System (INIS)

Zurlo, J.V.; Towers, J.D.; Golla, S.

2001-01-01

Objective. To develop a new method of magnetic resonance arthrography (MRA) of the knee using an anterior approach analogous to the portals used for knee arthroscopy.Design. An anterior approach to the knee joint was devised mimicking anterior portals used for knee arthroscopy. Seven patients scheduled for routine knee MRA were placed in a decubitus position and under fluoroscopic guidance a needle was advanced from a position adjacent to the patellar tendon into the knee joint. After confirmation of the needle tip location, a dilute gadolinium solution was injected.Results and conclusion. All the arthrograms were technically successful. The anterior approach to knee MRA has greater technical ease than the traditional approach with little patient discomfort. (orig.)

Six degree-of-freedom knee joint kinematics in obese individuals with knee pain during gait.

Science.gov (United States)

Li, Jing-Sheng; Tsai, Tsung-Yuan; Felson, David T; Li, Guoan; Lewis, Cara L

2017-01-01

Knee joint pain is a common symptom in obese individuals and walking is often prescribed as part of management programs. Past studies in obese individuals have focused on standing alignment and kinematics in the sagittal and coronal planes. Investigation of 6 degree-of-freedom (6DOF) knee joint kinematics during standing and gait is important to thoroughly understand knee function in obese individuals with knee pain. This study aimed to investigate the 6DOF knee joint kinematics in standing and during gait in obese patients using a validated fluoroscopic imaging system. Ten individuals with obesity and knee pain were recruited. While standing, the knee was in 7.4±6.3°of hyperextension, 2.8±3.3° of abduction and 5.6±7.3° of external rotation. The femoral center was located 0.7±3.1mm anterior and 5.1±1.5mm medial to the tibial center. During treadmill gait, the sagittal plane motion, i.e., flexion/extension and anterior-posterior translation, showed a clear pattern. Specifically, obese individuals with knee pain maintained the knee in more flexion and more anterior tibial translation during most of the stance phase of the gait cycle and had a reduced total range of knee flexion when compared to a healthy non-obese group. In conclusion, obese individuals with knee pain used hyperextension knee posture while standing, but maintained the knee in more flexion during gait with reduced overall range of motion in the 6DOF analysis.

Prevalence of knee pain and knee OA in southern Sweden and the proportion that seeks medical care

DEFF Research Database (Denmark)

Turkiewicz, Aleksandra; Gerhardsson de Verdier, Maria; Engström, Gunnar

2015-01-01

OBJECTIVE: The aim of this study was to estimate the prevalence of frequent knee pain in radiographic, symptomatic and clinically defined knee OA in middle-aged and elderly patients and the proportion that seeks medical care. METHODS: In 2007 a random sample of 10 000 56- to 84-year-old residents...... of Malmö, Sweden, were questioned about knee pain. We classified subjects reporting knee pain with a duration of at least 4 weeks as having frequent knee pain. A random sample of 1300 individuals with frequent knee pain and 650 without were invited for assessment by the ACR clinical knee OA criteria...... and for bilateral weight-bearing knee radiography. We considered a Kellgren-Lawrence grade ≥2 as radiographic knee OA and that in combination with frequent knee pain as symptomatic knee OA. By linkage with the Skåne Healthcare Register, we determined the proportion of subjects that had consulted for knee OA or pain...

Clinical application of hysterosalpingography with a double-lumen catheter of a contrast media combination consisting iohexol and saline

International Nuclear Information System (INIS)

Xi Jiayuan; Jiang Yong; Cao Xinhua; Zhu Ying; Lv Liang; Zhao Xinxiang; Wei Dingying; Shao Jingxuan; Hua Jian

2005-01-01

Objective: To evaluate the clinical value of hysteosalpingographic diagnosis in infertile women. Methods: After a catheter with a double-lumen saccule was inserted into the uterine cavity, saline or air of 2.5-3.5 ml was injected to fill the saccule. The filled saccule was inserted at the isthmus of uterus for blocking the internal orifice. The contrast medium was injected through the catheter into the uterine cavity and fallopian tubes to undertake hysterosalpingography and fallopian tube reopening. In case of fallopian tube obstruction, the injection pressure could be increased to obtain recanalization. All operations and selective imagings were carried out under TV supervision. Results: 2698 cases including 806 primary infertile women and 1868 secondary infertile women were examined by this method. Technical success rate was 99.5% with 2198 cases (81.9%) having normal uterus, 249 (9.3%) congenital abnormal uterus and 238 (8.9%) uterus diseases. The number of obstructed fallopian tube was 3028 with 117 serious hydropsy (3.8%). Ninety-eight cases had been examined with lipiodol hysterosalpingography in other hospitals with 35 cases still having lipiodol accumulated within the uterine cavities and fallopian tubes. No serious complications or death occurred except slight pain. Conclusions: Double-lumen cather with a contrast media combination of iohexol and saline for hysterosal pinography is safe, easy and effective, outcoming with excellent quality images. More information can be gained with this method than traditional lipiodol hyterosalpinography, and furthermore could have compression during radiogrophy and avoid the long term stasis of lipiodol. (authors)

Double blind clinical trail comparing the safety and efficacy of ...

African Journals Online (AJOL)

Double blind clinical trail comparing the safety and efficacy of nimesulide (100g) and diclofenac in osteoarthrosis of the hip and knee joints. ... A significant proportion of the patients in the diclofenac group (50% vs 17.6%) had break through pain that warranted the use of at least two tablets of 500mg of paracetamol per week ...

Knee joint stabilization therapy in patients with osteoarthritis of the knee: a randomized, controlled trial.

Science.gov (United States)

Knoop, J; Dekker, J; van der Leeden, M; van der Esch, M; Thorstensson, C A; Gerritsen, M; Voorneman, R E; Peter, W F; de Rooij, M; Romviel, S; Lems, W F; Roorda, L D; Steultjens, M P M

2013-08-01

To investigate whether an exercise program, initially focusing on knee stabilization and subsequently on muscle strength and performance of daily activities is more effective than an exercise program focusing on muscle strength and performance of daily activities only, in reducing activity limitations in patients with knee osteoarthritis (OA) and instability of the knee joint. A single-blind, randomized, controlled trial involving 159 knee OA patients with self-reported and/or biomechanically assessed knee instability, randomly assigned to two treatment groups. Both groups received a supervised exercise program for 12 weeks, consisting of muscle strengthening exercises and training of daily activities, but only in the experimental group specific knee joint stabilization training was provided. Outcome measures included activity limitations (Western Ontario and McMaster Universities Osteoarthritis Index - WOMAC physical function, primary outcome), pain, global perceived effect and knee stability. Both treatment groups demonstrated large (∼20-40%) and clinically relevant reductions in activity limitations, pain and knee instability, which were sustained 6 months post-treatment. No differences in effectiveness between experimental and control treatment were found on WOMAC physical function (B (95% confidence interval - CI) = -0.01 (-2.58 to 2.57)) or secondary outcome measures, except for a higher global perceived effect in the experimental group (P = 0.04). Both exercise programs were highly effective in reducing activity limitations and pain and restoring knee stability in knee OA patients with instability of the knee. In knee OA patients suffering from knee instability, specific knee joint stabilization training, in addition to muscle strengthening and functional exercises, does not seem to have any additional value. Dutch Trial Register (NTR) registration number: NTR1475. Copyright © 2013 Osteoarthritis Research Society International. Published by Elsevier

Quantitative magnetic resonance imaging as marker of synovial membrane regeneration and recurrence of synovitis after arthroscopic knee joint synovectomy: a one year follow up study

DEFF Research Database (Denmark)

Østergaard, Mikkel; Ejbjerg, B; Stoltenberg, M

2001-01-01

OBJECTIVES: By repeated magnetic resonance imaging (MRI) to study synovial membrane regeneration and recurrence of synovitis after arthroscopic knee joint synovectomy in patients with rheumatoid arthritis (RA) and other (non-RA) causes of persistent knee joint synovitis. METHODS: Contrast enhanced...... at two months. No significant differences between volumes in RA and non-RA knees were seen. Synovial membrane volumes at two months were significantly inversely correlated with the duration of clinical remission, for all knees considered together (Spearman's correlation r(s)=-0.67; p

Experimental knee pain reduces muscle strength

DEFF Research Database (Denmark)

Henriksen, Marius; Mortensen, Sara Rosager; Aaboe, Jens

2011-01-01

Pain is the principal symptom in knee pathologies and reduced muscle strength is a common observation among knee patients. However, the relationship between knee joint pain and muscle strength remains to be clarified. This study aimed at investigating the changes in knee muscle strength following...... experimental knee pain in healthy volunteers, and if these changes were associated with the pain intensities. In a crossover study, 18 healthy subjects were tested on 2 different days. Using an isokinetic dynamometer, maximal muscle strength in knee extension and flexion was measured at angular velocities 0....... Knee pain reduced the muscle strength by 5 to 15% compared to the control conditions (P knee extension and flexion at all angular velocities. The reduction in muscle strength was positively correlated to the pain intensity. Experimental knee pain significantly reduced knee extension...

Slightly flexed knee position within a standard knee coil: MR delineation of the anterior cruciate ligament

Energy Technology Data Exchange (ETDEWEB)

Niitsu, M.; Itai, Y. [Department of Radiology, Institute of Clinical Medicine, University of Tsukuba, Tennodai, Tsukuba, Ibaraki 305 (Japan); Ikeda, K. [Department of Orthopedic Surgery, Institute of Clinical Medicine, University of Tsukuba, Tennodai, Tsukuba, Ibaraki 305 (Japan)

1998-02-01

The purpose of this study was to assess the value of positioning the knee slightly flexed within a standard MR knee coil in delineation of the anterior cruciate ligament (ACL). Within the confined space of a commercially available knee coil, knee could bend as much as 30 , average 17 of flexion. Sets of oblique sagittal MR images were obtained at both fully extended and slightly flexed positions. Twenty-two normal knees and 18 knees with ACL tears were examined and paired MR images were evaluated by two observers. Compared with knee extension, the MR images for knee flexion provided better clarity in 57 % of reviews of full length of the ACL and 53 % of the femoral attachment. In the extended position the anterior margin of the ligament was obscured due to partial averaging with the intercondylar roof. We recommend examining the knee in an achievable flexed position within the standard knee coil. (orig.) With 3 figs., 1 tab., 6 refs.

Slightly flexed knee position within a standard knee coil: MR delineation of the anterior cruciate ligament

International Nuclear Information System (INIS)

Niitsu, M.; Itai, Y.; Ikeda, K.

1998-01-01

The purpose of this study was to assess the value of positioning the knee slightly flexed within a standard MR knee coil in delineation of the anterior cruciate ligament (ACL). Within the confined space of a commercially available knee coil, knee could bend as much as 30 , average 17 of flexion. Sets of oblique sagittal MR images were obtained at both fully extended and slightly flexed positions. Twenty-two normal knees and 18 knees with ACL tears were examined and paired MR images were evaluated by two observers. Compared with knee extension, the MR images for knee flexion provided better clarity in 57 % of reviews of full length of the ACL and 53 % of the femoral attachment. In the extended position the anterior margin of the ligament was obscured due to partial averaging with the intercondylar roof. We recommend examining the knee in an achievable flexed position within the standard knee coil. (orig.)

Multi-Axis Prosthetic Knee Resembles Alpine Skiing Movements of an Intact Leg

Directory of Open Access Journals (Sweden)

Ivan Demšar, Jože Duhovnik, Blaž Lešnik, Matej Supej

2015-12-01

Full Text Available The purpose of the study was to analyse the flexion angles of the ski boot, ankle and knee joints of an above-knee prosthesis and to compare them with an intact leg and a control group of skiers. One subject with an above-knee amputation of the right leg and eight healthy subjects simulated the movement of a skiing turn by performing two-leg squats in laboratory conditions. By adding additional loads in proportion to body weight (BW; +1/3 BW, +2/3 BW, +3/3 BW, various skiing regimes were simulated. Change of Flexion Angle (CoFA and Range of Motion (RoM in the ski boot, ankle and knee joints were calculated and compared. An average RoM in the skiing boot on the side of prosthesis (4.4 ± 1.1° was significantly lower compared to an intact leg (5.9 ± 1.8° and the control group (6.5 ± 2.3°. In the ankle joint, the average RoM was determined to be 13.2±2.9° in the prosthesis, 12.7 ± 2.8° in an intact leg and 14.8±3.6 in the control group. However, the RoM of the knee joint in the prosthesis (42.2 ± 4.2° was significantly larger than that of the intact leg (34.7 ± 4.4°. The average RoM of the knee joint in the control group was 47.8 ± 5.4°. The influences of additional loads on the kinematics of the lower extremities were different on the side of the prosthesis and on the intact leg. In contrast, additional loads did not produce any significant differences in the control group. Although different CoFAs in the ski boot, ankle and knee joints were used, an above-knee prosthesis with a built-in multi-axis prosthetic knee enables comparable leg kinematics in simulated alpine skiing.

The standard biphasic-contrast examination of the stomach and duodenum

International Nuclear Information System (INIS)

Op den Orth, J.O.

1979-01-01

A standard examination has been developed, called biphasic, because it combines the advantages of positive-contrast and double-contrast techniques. The theoretical background and technique of this examination are described and the basic interpretation of double-contrast studies stated. General remarks on the results and on the complementary role of radiological examination and endoscopy are included. A quantitative study of standard biphasic-contrast examinations in patients over a period of 3 years is presented. Finally a radiological atlas of common lesions of the stomach and duodenum is given. (C.F.)

Position controlled Knee Rehabilitation Orthotic Device for Patients after Total Knee Replacement Arthroplasty

Science.gov (United States)

Wannaphan, Patsiri; Chanthasopeephan, Teeranoot

2016-11-01

Knee rehabilitation after total knee replacement arthroplasty is essential for patients during their post-surgery recovery period. This study is about designing one degree of freedom knee rehabilitation equipment to assist patients for their post-surgery exercise. The equipment is designed to be used in sitting position with flexion/extension of knee in sagittal plane. The range of knee joint motion is starting from 0 to 90 degrees angle for knee rehabilitation motion. The feature includes adjustable link for different human proportions and the torque feedback control at knee joint during rehabilitation and the control of flexion/extension speed. The motion of the rehabilitation equipment was set to move at low speed (18 degrees/sec) for knee rehabilitation. The rehabilitation link without additional load took one second to move from vertical hanging up to 90° while the corresponding torque increased from 0 Nm to 2 Nm at 90°. When extra load is added, the link took 1.5 seconds to move to 90° The torque is then increased from 0 Nm to 4 Nm. After a period of time, the speed of the motion can be varied. User can adjust the motion to 40 degrees/sec during recovery activity of the knee and users can increase the level of exercise or motion up to 60 degrees/sec to strengthen the muscles during throughout their rehabilitation program depends on each patient. Torque control is included to prevent injury. Patients can use the equipment for home exercise to help reduce the number of hospital visit while the patients can receive an appropriate therapy for their knee recovery program.

Knee Replacement

Science.gov (United States)

... days. Medications prescribed by your doctor should help control pain. During the hospital stay, you'll be encouraged to move your ... exercise your new knee. After you leave the hospital, you'll continue physical ... mobility and a better quality of life. And most knee replacements can be ...

Jumper's Knee (Patellar Tendonitis) (For Parents)

Science.gov (United States)

... Safe Videos for Educators Search English Español Jumper's Knee (Patellar Tendonitis) KidsHealth / For Parents / Jumper's Knee (Patellar ... prevent continued damage to the knee. How the Knee Works To understand how jumper's knee happens, it ...

Influence of Bundle Diameter and Attachment Point on Kinematic Behavior in Double Bundle Anterior Cruciate Ligament Reconstruction Using Computational Model

Directory of Open Access Journals (Sweden)

Oh Soo Kwon

2014-01-01

Full Text Available A protocol to choose the graft diameter attachment point of each bundle has not yet been determined since they are usually dependent on a surgeon’s preference. Therefore, the influence of bundle diameters and attachment points on the kinematics of the knee joint needs to be quantitatively analyzed. A three-dimensional knee model was reconstructed with computed tomography images of a 26-year-old man. Based on the model, models of double bundle anterior cruciate ligament (ACL reconstruction were developed. The anterior tibial translations for the anterior drawer test and the internal tibial rotation for the pivot shift test were investigated according to variation of bundle diameters and attachment points. For the model in this study, the knee kinematics after the double bundle ACL reconstruction were dependent on the attachment point and not much influenced by the bundle diameter although larger sized anterior-medial bundles provided increased stability in the knee joint. Therefore, in the clinical setting, the bundle attachment point needs to be considered prior to the bundle diameter, and the current selection method of graft diameters for both bundles appears justified.

An oral modified-release nifedipine tablet (Adalat LA) and its appearance on double contrast barium enema

International Nuclear Information System (INIS)

Bleehen, Robert E.

2000-01-01

Adalat LA 30 mg and 60 mg tablets are widely prescribed oral modified release nifedipine preparations with a porous, non-digestible plastic tablet coating which is required in order to effect the osmotically driven slow release mechanism. These tablets may therefore be seen anywhere along the gastrointestinal tract and are passed apparently whole in the faeces. An example of the appearance within the rectum of Adalat LA 30 (Bayer) on double contrast barium enema is shown and the main features described. A review of the literature is given. Recognition of the appearances during the barium enema examination will prompt those performing the procedure to question the drug history where relevant and will reduce the incidence of false-positive reporting. Bleehen, R.E. (2000)

The pediatric knee.

Science.gov (United States)

Orth, Robert C

2013-03-01

Knee pain is a common problem in children and adolescents, and MRI of the knee is the most commonly performed pediatric cross-sectional musculoskeletal imaging exam. The purpose of this pictorial review is to highlight differences between adult and pediatric knee imaging with an emphasis on normal developmental variants, injury and disease patterns unique to children and adolescents, and differences in response and presentation to conditions affecting both adults and children.

Differences in injury pattern and prevalence of cartilage lesions in knee and ankle joints: a retrospective cohort study

Directory of Open Access Journals (Sweden)

Matthias Aurich

2014-12-01

Full Text Available Osteoarthritis (OA is more common in the knee compared to the ankle joint. This can not be explained exclusively by anatomical and biomechanical differences. The aim of this study is to analyze and compare the injury pattern (clinically and the cartilage lesions (arthroscopically of knee and ankle joints in a cohort of patients from the same catchment area. A retrospective study of the clinical data of 3122 patients (2139 outpatients and 983 inpatients was performed, who were treated due to an injury of the knee and ankle joint. Statistical analysis was performed using SigmaStat 3.0 (SPSS Inc, Chicago, USA. There is a higher prevalence of injuries in the ankle as compared to the knee joint in this population from the same catchment area. In contrast, high-grade cartilage lesions are more prevalent in the knee, whereas low grade cartilage lesions are equally distributed between knee and ankle. From this data it can be concluded that the frequency of injuries and the injury pattern of knee versus ankle joints do not correlate with the severity of cartilage lesions and may therefore have no direct influence on the differential incidence of OA in those two joints.

Importance of timing of post-contrast MRI in rheumatoid arthritis: what happens during the first 60 minutes after IV gadolinium-DTPA?

DEFF Research Database (Denmark)

Østergaard, Mikkel; Klarlund, Mette

2001-01-01

compromises the differentiation of synovium from joint fluid. OBJECTIVE: To determine the time period after IV MRI contrast (gadolinium-DTPA (Gd)) injection in which synovial membrane volume determination is reliable. METHODS: MRI of five RA knees with clinical synovitis was carried out, with axial, T(1...... threshold. Thereafter, the measured volumes remained practically unchanged. CONCLUSION: This study suggests that MR image acquisition in arthritic knee joints should be performed within the initial approximately 10 minutes after gadolinium contrast injection to achieve the most accurate distinction between...

Barium sulphate preparations for use in double contrast examination of the upper gastrointestinal tract

International Nuclear Information System (INIS)

Anderson, W.; Harthill, J.E.; James, W.B.; Montgomery, D.

1980-01-01

Physical properties relevant to upper gastrointestinal radiology have been compared for five barium sulphate preparations and related to radiographic results. Evaluation of particles (size and stability) and whole suspension (dispersibility and fluidity) resulted in ranking of the preparations generally in accord with that based on radiological experience in double contrast examinations of the stomach. Experiments with extirpated pig stomach revealed a tendency for large particles in a low viscosity barium sulphate suspension to settle in mucosal grooves. This is believed to contribute to good radiographic definition of both the areae gastricae and small lesions. Particle size is therefore important and susceptibility to flocculation, a possible cause of random change in size during use, was assessed by measuring particle electrophoretic mobility under varying conditions; quantitative differences in suspension flow and dispersibility were also demonstrated. Fluidity and dispersibility together with rapid sedimentation of suitably sized particles resistant to flocculation underlie the successful use of low viscosity high density barium sulphate suspensions. (U.K.)

Radiography, radionuclide imaging, and asthrography in the evaluation of total hip and knee replacement. [/sup 99m/Tc-phosphate

Energy Technology Data Exchange (ETDEWEB)

Gelman, M.I.; Coleman, R.E.; Stevens, P.M.; Davey, B.W.

1978-09-01

Twenty patients with 21 total joint replacements including 17 hips and 4 knees were studied by plain film radiography, radionuclide imaging, and subtraction arthrography to evaluate these procedures for assessing prosthetic complications. Surgery was performed in 14 patients and confirmed loosening of 8 femoral and 7 acetabular hip prosthesis components and 1 femoral and 4 tibial knee prosthesis components. Plain films suggested loosening of only 9 hip components and no knee components. In contrast, radionuclide imaging and subtraction arthrography were considerably more effective in demonstrating loosening as well as other causes of the painful total joint prosthesis.

Immediate effect of Masai Barefoot Technology shoes on knee joint moments in women with knee osteoarthritis.

Science.gov (United States)

Tateuchi, Hiroshige; Taniguchi, Masashi; Takagi, Yui; Goto, Yusuke; Otsuka, Naoki; Koyama, Yumiko; Kobayashi, Masashi; Ichihashi, Noriaki

2014-01-01

Footwear modification can beneficially alter knee loading in patients with knee osteoarthritis. This study evaluated the effect of Masai Barefoot Technology shoes on reductions in external knee moments in patients with knee osteoarthritis. Three-dimensional motion analysis was used to examine the effect of Masai Barefoot Technology versus control shoes on the knee adduction and flexion moments in 17 women (mean age, 63.6 years) with radiographically confirmed knee osteoarthritis. The lateral and anterior trunk lean values, knee flexion and adduction angles, and ground reaction force were also evaluated. The influence of the original walking pattern on the changes in knee moments with Masai Barefoot Technology shoes was evaluated. The knee flexion moment in early stance was significantly reduced while walking with the Masai Barefoot Technology shoes (0.25±0.14Nm/kgm) as compared with walking with control shoes (0.30±0.19 Nm/kgm); whereas the knee adduction moment showed no changes. Masai Barefoot Technology shoes did not increase compensatory lateral and anterior trunk lean. The degree of knee flexion moment in the original walking pattern with control shoes was correlated directly with its reduction when wearing Masai Barefoot Technology shoes by multiple linear regression analysis (adjusted R2=0.44, Pknee flexion moment during walking without increasing the compensatory trunk lean and may therefore reduce external knee loading in women with knee osteoarthritis. Copyright © 2014 Elsevier B.V. All rights reserved.

The effects of knee direction, physical activity and age on knee joint position sense.

Science.gov (United States)

Relph, Nicola; Herrington, Lee

2016-06-01

Previous research has suggested a decline in knee proprioception with age. Furthermore, regular participation in physical activity may improve proprioceptive ability. However, there is no large scale data on uninjured populations to confirm these theories. The aim of this study was to provide normative knee joint position data (JPS) from healthy participants aged 18-82years to evaluate the effects of age, physical activity and knee direction. A sample of 116 participants across five age groups was used. The main outcome measures were knee JPS absolute error scores into flexion and extension, Tegner activity levels and General Practitioner Physical Activity Questionnaire results. Absolute error scores in to knee flexion were 3.6°, 3.9°, 3.5°, 3.7° and 3.1° and knee extension were 2.7°, 2.5°, 2.9°, 3.4° and 3.9° for ages 15-29, 30-44, 45-59, 60-74 and 75 years old respectively. Knee extension and flexion absolute error scores were significantly different when age group data were pooled. There was a significant effect of age and activity level on joint position sense into knee extension. Age and lower Tegner scores were also negatively correlated to joint position sense into knee extension. The results provide some evidence for a decline in knee joint position sense with age. Further, active populations may have heightened static proprioception compared to inactive groups. Normative knee joint position sense data is provided and may be used by practitioners to identify patients with reduced proprioceptive ability. Copyright © 2016 Elsevier B.V. All rights reserved.

Arthroscopic surgery for degenerative knee

DEFF Research Database (Denmark)

Thorlund, J B; Juhl, C B; Roos, E M

2015-01-01

OBJECTIVE: To determine benefits and harms of arthroscopic knee surgery involving partial meniscectomy, debridement, or both for middle aged or older patients with knee pain and degenerative knee disease. DESIGN: Systematic review and meta-analysis. MAIN OUTCOME MEASURES: Pain and physical function....... RESULTS: The search identified nine trials assessing the benefits of knee arthroscopic surgery in middle aged and older patients with knee pain and degenerative knee disease. The main analysis, combining the primary endpoints of the individual trials from three to 24 months postoperatively, showed a small...... included symptomatic deep venous thrombosis (4.13 (95% confidence interval 1.78 to 9.60) events per 1000 procedures), pulmonary embolism, infection, and death. CONCLUSIONS: The small inconsequential benefit seen from interventions that include arthroscopy for the degenerative knee is limited in time...

Noninjured Knees of Patients With Noncontact ACL Injuries Display Higher Average Anterior and Internal Rotational Knee Laxity Compared With Healthy Knees of a Noninjured Population.

Science.gov (United States)

Mouton, Caroline; Theisen, Daniel; Meyer, Tim; Agostinis, Hélène; Nührenbörger, Christian; Pape, Dietrich; Seil, Romain

2015-08-01

Excessive physiological anterior and rotational knee laxity is thought to be a risk factor for noncontact anterior cruciate ligament (ACL) injuries and inferior reconstruction outcomes, but no thresholds have been established to identify patients with increased laxity. (1) To determine if the healthy contralateral knees of ACL-injured patients have greater anterior and rotational knee laxity, leading to different laxity profiles (combination of laxities), compared with healthy control knees and (2) to set a threshold to help discriminate anterior and rotational knee laxity between these groups. Case-sectional study; Level of evidence, 3. A total of 171 healthy contralateral knees of noncontact ACL-injured patients (ACL-H group) and 104 healthy knees of control participants (CTL group) were tested for anterior and rotational laxity. Laxity scores (measurements corrected for sex and body mass) were used to classify knees as hypolax (score 1). Proportions of patients in each group were compared using χ(2) tests. Receiver operating characteristic curves were computed to discriminate laxity between the groups. Odds ratios were calculated to determine the probability of being in the ACL-H group. The ACL-H group displayed greater laxity scores for anterior displacement and internal rotation in their uninjured knee compared with the CTL group (P knees of patients with noncontact ACL injuries display different laxity values both for internal rotation and anterior displacement compared with healthy control knees. The identification of knee laxity profiles may be of relevance for primary and secondary prevention programs of noncontact ACL injuries. © 2015 The Author(s).

The influence of knee pain location on symptoms, functional status and knee-related quality of life in older adults with chronic knee pain: data from the Osteoarthritis Initiative

Science.gov (United States)

Farrokhi, Shawn; Chen, Yi-Fan; Piva, Sara R.; Fitzgerald, G. Kelley; Jeong, Jong-Hyeon; Kwoh, C. Kent

2015-01-01

Objective To evaluate whether knee pain location can influence symptoms, functional status and knee-related quality of life in older adults with chronic knee pain. Methods A total of 2959 painful knees from the Osteoarthritis Initiative database were analyzed. Trained interviewers recorded patient-reported location of knee pain. Painful knees were divided into three groups of patellofemoral only pain, tibiofemoral only pain, and combined pain. Self-reported knee-specific symptoms, functional status and knee-related quality of life were assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS). Results The most common knee pain pattern was tibiofemoral only pain (62%), followed by patellofemoral only pain (23%) and combined pain (15%). The combined pain pattern was associated with greater odds of reporting pain, symptoms, sports or recreational activity limitations and lower knee-related quality of life compared to either isolated knee pain patterns, after adjusting for demographics and radiographic disease severity. Individual item analysis further revealed that patients with combined pain had greater odds of reporting difficulty with daily weightbearing activities that required knee bending compared to tibiofemoral or patellofemoral only pain patterns. Furthermore, symptoms, functional status, and knee-related quality of life were comparable between patients with patellofemoral and tibiofemoral only pain patterns, after adjusting for demographics and radiographic disease severity. Discussion Combined patellofemoral and tibiofemoral pain is associated with poorer clinical presentation compared to isolated knee pain from either location. Additionally, patellofemoral pain in isolation may be as important as tibiofemoral pain in causing symptoms and functional limitation in older adults with chronic knee pain. PMID:26308705

Focal knee lesions in knee pairs of asymptomatic and symptomatic subjects with OA risk factors—Data from the Osteoarthritis Initiative

Energy Technology Data Exchange (ETDEWEB)

Chundru, Renu, E-mail: renu.chundru@ucsf.edu [Musculoskeletal and Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, San Francisco, CA 94107 (United States); Baum, Thomas, E-mail: thbaum@gmx.de [Musculoskeletal and Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, San Francisco, CA 94107 (United States); Nardo, Lorenzo, E-mail: lorenzo.nardo@ucsf.edu [Musculoskeletal and Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, San Francisco, CA 94107 (United States); Nevitt, Michael C., E-mail: MNevitt@psg.ucsf.edu [Department of Epidemiology and Biostatistics, University of California San Francisco, 185 Berry Street, Suite 5700, San Francisco, CA 94107 (United States); Lynch, John, E-mail: JLynch@psg.ucsf.edu [Department of Epidemiology and Biostatistics, University of California San Francisco, 185 Berry Street, Suite 5700, San Francisco, CA 94107 (United States); McCulloch, Charles E., E-mail: CMcCulloch@epi.ucsf.edu [Department of Epidemiology and Biostatistics, University of California San Francisco, 185 Berry Street, Suite 5700, San Francisco, CA 94107 (United States); Link, Thomas M., E-mail: tmlink@radiology.ucsf.edu [Musculoskeletal and Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, San Francisco, CA 94107 (United States)

2013-08-15

Objective: To better understand the relationship between knee pain and bilateral knee lesions, we compared focal knee lesions in knee pairs of subjects with no, unilateral, and bilateral knee pain, and risk factors for knee osteoarthritis (OA), but no radiographic knee OA. Materials and methods: We examined both knees of 120 subjects from the Osteoarthritis Initiative database. We randomly selected 60 subjects aged 45–55 years with OA risk factors, no knee pain (WOMAC pain score = 0) and no radiographic OA (KL-score ≤1) in both knees. We also selected two comparison groups with OA risk factors and no radiographic OA in both knees, but with knee pain (WOMAC pain score ≥5): 30 subjects with right only knee pain and 30 subjects with bilateral knee pain. All subjects underwent 3T MRI of both knees and focal knee lesions were assessed. Results: Statistically significant associations between prevalence of focal lesions in the right and left knee with odds ratios up to 13.5 were found in all three subject groups. Focal knee lesions were generally not associated with pain in analyses comparing knee pairs of subjects with unilateral knee pain (p > 0.05). The prevalence and severity of focal knee lesions were not significantly different in knee pairs of subjects with no knee pain and those with bilateral knee pain (p > 0.05). Conclusion: Focal knee lesions in the right and left knee of subjects with OA risk factors were positively associated with each other independent of knee pain status, and were not statistically significant different between knees in subjects with unilateral knee pain.

Focal knee lesions in knee pairs of asymptomatic and symptomatic subjects with OA risk factors—Data from the Osteoarthritis Initiative

International Nuclear Information System (INIS)

Chundru, Renu; Baum, Thomas; Nardo, Lorenzo; Nevitt, Michael C.; Lynch, John; McCulloch, Charles E.; Link, Thomas M.

2013-01-01

Objective: To better understand the relationship between knee pain and bilateral knee lesions, we compared focal knee lesions in knee pairs of subjects with no, unilateral, and bilateral knee pain, and risk factors for knee osteoarthritis (OA), but no radiographic knee OA. Materials and methods: We examined both knees of 120 subjects from the Osteoarthritis Initiative database. We randomly selected 60 subjects aged 45–55 years with OA risk factors, no knee pain (WOMAC pain score = 0) and no radiographic OA (KL-score ≤1) in both knees. We also selected two comparison groups with OA risk factors and no radiographic OA in both knees, but with knee pain (WOMAC pain score ≥5): 30 subjects with right only knee pain and 30 subjects with bilateral knee pain. All subjects underwent 3T MRI of both knees and focal knee lesions were assessed. Results: Statistically significant associations between prevalence of focal lesions in the right and left knee with odds ratios up to 13.5 were found in all three subject groups. Focal knee lesions were generally not associated with pain in analyses comparing knee pairs of subjects with unilateral knee pain (p > 0.05). The prevalence and severity of focal knee lesions were not significantly different in knee pairs of subjects with no knee pain and those with bilateral knee pain (p > 0.05). Conclusion: Focal knee lesions in the right and left knee of subjects with OA risk factors were positively associated with each other independent of knee pain status, and were not statistically significant different between knees in subjects with unilateral knee pain

Multiple Nonspecific Sites of Joint Pain Outside the Knees Develop in Persons With Knee Pain.

Science.gov (United States)

Felson, David T; Niu, Jingbo; Quinn, Emily K; Neogi, Tuhina; Lewis, Cara L; Lewis, Cora E; Frey Law, Laura; McCulloch, Chuck; Nevitt, Michael; LaValley, Michael

2017-02-01

Many persons with knee pain have joint pain outside the knee, but despite the impact and high frequency of this pain, its distribution and causes have not been studied. We undertook this study to test the hypothesis of those studying gait abnormalities who have suggested that knee pain causes pain in adjacent joints but that pain adaptation strategies are highly individualized. We studied persons ages 50-79 years with or at high risk of knee osteoarthritis who were recruited from 2 community-based cohorts, the Multicenter Osteoarthritis Study and the Osteoarthritis Initiative, and we followed them up for 5-7 years. We excluded those with knee pain at baseline and compared those who had developed knee pain at the first follow-up examination (the index visit) with those who had not. We examined pain on most days at joint regions outside the knee in examinations after the index visit. Logistic regression analyses examined the risk of joint-specific pain adjusted for age, sex, body mass index, and symptoms of depression, and we performed sensitivity analyses excluding those with widespread pain. In the combined cohorts, 693 persons had knee pain at the index visit and 2,793 did not. A total of 79.6% of those with bilateral knee pain and 63.8% of those with unilateral knee pain had pain during follow-up in a joint region outside the knee, compared with 49.9% of those without knee pain. There was an increased risk of pain at most extremity joint sites, without a predilection for specific sites. Results were unchanged when those with widespread pain were excluded. Persons with chronic knee pain are at increased risk of pain in multiple joints in no specific pattern. © 2016, American College of Rheumatology.

In-Plane Ultrasound-Guided Knee Injection Through a Lateral Suprapatellar Approach: A Safe Technique.

Science.gov (United States)

Chagas-Neto, Francisco A; Taneja, Atul K; Gregio-Junior, Everaldo; Nogueira-Barbosa, Marcello H

2017-06-01

This study aims to describe a technique for in-plane ultrasound-guided knee arthrography through a lateral suprapatellar approach, reporting its accuracy and related complications. A retrospective search was performed for computed tomography and magnetic resonance reports from June 2013 through June 2015. Imaging studies, puncture descriptions, and guided-procedure images were reviewed along with clinical and surgical history. A fellowship-trained musculoskeletal radiologist performed all procedures under sterile technique and ultrasound guidance with the probe in oblique position on the lateral suprapatellar recess after local anesthesia with the patient on dorsal decubitus, hip in neutral rotation, and 30 to 45 degrees of knee flexion. A total of 86 consecutive subjects were evaluated (mean, 55 years). All subjects underwent intra-articular injection of contrast, which was successfully reached in the first attempt in 94.2% of the procedures (81/86), and in the second attempt in 5.8% (5/86) after needle repositioning without a second puncture. There were no postprocedural reports of regional complications at the puncture site, such as significant pain, bleeding, or vascular lesions. Our study demonstrates that in-plane ultrasound-guided injection of the knee in semiflexion approaching the lateral suprapatellar recess is a safe and useful technique to administer intra-articular contrast solution, as an alternative method without radiation exposure.

Association of knee pain and different definitions of knee osteoarthritis with health-related quality of life

DEFF Research Database (Denmark)

Kiadaliri, A. A.; Lamm, C.J.; Gerhardsson de Verdier, Maria

2016-01-01

Background: While the impact of knee pain and knee osteoarthritis (OA) on health-related quality of life (HRQoL) has been investigated in the literature, there is a lack of knowledge on the impact of different definitions of OA on HRQoL. The main aim of this study was to measure and compare...... among references (neither knee pain nor OA) was 42 %. The participants with knee pain and OA had all HRQoL measures lower compared to those with knee pain but no OA. The ACR clinical definition of knee OA was associated with lower HRQoL than the definition based on radiographic knee OA (adjusted...

The associations between quadriceps muscle strength, power, and knee joint mechanics in knee osteoarthritis: A cross-sectional study.

Science.gov (United States)

Murray, Amanda M; Thomas, Abbey C; Armstrong, Charles W; Pietrosimone, Brian G; Tevald, Michael A

2015-12-01

Abnormal knee joint mechanics have been implicated in the pathogenesis and progression of knee osteoarthritis. Deficits in muscle function (i.e., strength and power) may contribute to abnormal knee joint loading. The associations between quadriceps strength, power and knee joint mechanics remain unclear in knee osteoarthritis. Three-dimensional motion analysis was used to collect peak knee joint angles and moments during the first 50% of stance phase of gait in 33 participants with knee osteoarthritis. Quadriceps strength and power were assessed using a knee extension machine. Strength was quantified as the one repetition maximum. Power was quantified as the peak power produced at 40-90% of the one repetition maximum. Quadriceps strength accounted for 15% of the variance in peak knee flexion angle (P=0.016). Quadriceps power accounted for 20-29% of the variance in peak knee flexion angle (Pknee adduction moment (P=0.05). These data suggest that quadriceps power explains more variance in knee flexion angle and knee adduction moment during gait in knee osteoarthritis than quadriceps strength. Additionally, quadriceps power at multiple loads is associated with knee joint mechanics and therefore should be assessed at a variety of loads. Taken together, these results indicate that quadriceps power may be a potential target for interventions aimed at changing knee joint mechanics in knee osteoarthritis. Copyright © 2015 Elsevier Ltd. All rights reserved.

Experimental studies on the development of Falibaryt HD, a new high density barium meal for double contrast examination of the stomach

International Nuclear Information System (INIS)

Dietze, R.

1985-01-01

During the development of a new double contrast barium meal barium sulfate preparations with different densities, additives and particle size distributions were tested. Phantoms made of leather, rubber and dissected stomachs of cows and pigs. High density bariumsulfat suspension (200 - 250 % weight/volume) of low viscosity and suitable particle size spectrum containing additives improving the adherence (e.g. natrium citrate) displayed the best quality parameters for optimal imaging of the fine mucosal relief. (author)

Gait changes in patients with knee osteoarthritis are replicated by experimental knee pain

DEFF Research Database (Denmark)

Henriksen, Marius; Graven-Nielsen, Thomas; Aaboe, Jens

2010-01-01

Medial knee osteoarthritis (OA) is characterized by pain and associated with abnormal knee moments during walking. The relationship between knee OA pain and gait changes remains to be clarified, and a better understanding of this link could advance the treatment and prevention of disease...

The influence of below-knee compression garments on knee-joint proprioception.

Science.gov (United States)

Ghai, Shashank; Driller, Matthew W; Masters, Rich S W

2018-02-01

The purpose of the study was to assess the influence of below-knee compression garments on proprioception accuracy under, information processing constraints designed to cause high or low conscious attention to the task. In a counterbalanced, single-blinded, crossover trial, 44 healthy participants (26 male/18 female) with a mean age of 22.7±6.9 years performed an active joint repositioning task using their nondominant and their dominant leg, with and without below-knee compression and with and without conducting a secondary task. Analysis of variance revealed no main effect of leg dominance and no interactions (p's>0.05). However, a main effect was evident for both compression (F 1, 43 =84.23, pknee proprioception under differential information processing constraints. We conclude that proprioception accuracy of the knee joint is significantly enhanced post application of below-knee compression garments and when a secondary task is conducted concurrently with active joint repositioning. The findings suggest that below-knee compression garments may improve proprioception of the knee, regardless of leg dominance, and that secondary tasks that direct attention away from proprioceptive judgments may also improve proprioception, regardless of the presence of compression. Clinical implications are discussed with respect to proprioception in modern.sports and rehabilitation settings. Copyright © 2016 Elsevier B.V. All rights reserved.

Muscle area of knee O.A

International Nuclear Information System (INIS)

Suzuki, Nobuharu; Onozawa, Toshihiro; Shibata, Minoru; Yamasita, Izumi; Kitsunai, Isamu; Asano, Akira

1983-01-01

The cross sectional area of the thigh muscles were studied by means of C.T. scan. Twelve normal knees, twelve primary knee O.A. knees, and six R.A. knees were examined. The cross sectional area of the Quadriceps femoris decreased significantly in the patient of the knee O.A. although flexors did not decrease. We discussed the etiology of the knee O.A. from this result. (author)

Preoperative Pain Neuroscience Education Combined With Knee Joint Mobilization for Knee Osteoarthritis: A Randomized Controlled Trial.

Science.gov (United States)

Lluch, Enrique; Dueñas, Lirios; Falla, Deborah; Baert, Isabel; Meeus, Mira; Sánchez-Frutos, José; Nijs, Jo

2018-01-01

This study aimed to first compare the effects of a preoperative treatment combining pain neuroscience education (PNE) with knee joint mobilization versus biomedical education with knee joint mobilization on central sensitization (CS) in patients with knee osteoarthritis, both before and after surgery. Second, we wanted to compare the effects of both interventions on knee pain, disability, and psychosocial variables. Forty-four patients with knee osteoarthritis were allocated to receive 4 sessions of either PNE combined with knee joint mobilization or biomedical education with knee joint mobilization before surgery. All participants completed self-administered questionnaires and quantitative sensory testing was performed at baseline, after treatment and at a 1 month follow-up (all before surgery), and at 3 months after surgery. Significant and clinically relevant differences before and after surgery were found after treatments for both knee pain and disability, and some measures of CS (ie, widespread hyperalgesia, CS inventory), with no significant between-group differences. Other indicators of CS (ie, conditioned pain modulation, temporal summation) did not change over time following either treatment, and in some occasions the observed changes were not in the expected direction. Patients receiving PNE with knee joint mobilization achieved greater improvements in psychosocial variables (pain catastrophizing, kinesiophobia) both before and after surgery. Preoperative PNE combined with knee joint mobilization did not produce any additional benefits over time for knee pain and disability, and CS measures compared with biomedical education with knee joint mobilization. Superior effects in the PNE with knee joint mobilization group were only observed for psychosocial variables related to pain catastrophizing and kinesiophobia.

TOTAL KNEE REPLACEMENT IN PATIENTS WITH BELOW-KNEE AMPUTATION

Science.gov (United States)

Karam, Matthew D; Willey, Michael; Shurr, Donald G

2010-01-01

Total knee replacement (TKR) is reserved for patients with severe and disabling arthritis that is non-responsive to conservative measures. Based on existing data, total knee replacement is a safe and cost-effective treatment for alleviating pain and improving physical function in patients who do not respond to conservative therapy. Despite the large variation in health status of patients and types of prosthesis implanted, total knee replacement has proven to be a relatively low risk and successful operation. Each year in the United States surgeons perform approximately 300,000 TKR.1 Likewise, lower extremity amputation is commonly performed in the United States with an annual incidence of 110,000 per year.2 Nearly 70% of all lower extremity amputations are performed as the result of chronic vascular disease, followed by trauma (22%), congenital etiology and tumor (4% each).3 Approximately 50% of all lower extremity amputations are performed secondary to complications from Diabetes Mellitus. Norvell et al. demonstrated that patients who have previously undergone transtibial amputation and ambulate with a prosthesis are more likely to develop degenerative joint disease in the con-tralateral extremity than the ipsilateral extremity.4 Further, radiographic changes consistent with osteoporosis have been demonstrated in up to 88% of limbs that have undergone transtibial amputation.8 To our knowledge, there have been only three reported cases of total knee replacement in patients with ipsilateral transtibial amputation.5,7 The purpose of the present study is to review the existing data on total knee replacement in patients who have undergone transtibial amputation. Further we present a patient with a transtibial amputation who underwent contralateral total knee replacement. PMID:21045987

Injury risk curves for the skeletal knee-thigh-hip complex for knee-impact loading.

Science.gov (United States)

Rupp, Jonathan D; Flannagan, Carol A C; Kuppa, Shashi M

2010-01-01

Injury risk curves for the skeletal knee-thigh-hip (KTH) relate peak force applied to the anterior aspect of the flexed knee, the primary source of KTH injury in frontal motor-vehicle crashes, to the probability of skeletal KTH injury. Previous KTH injury risk curves have been developed from analyses of peak knee-impact force data from studies where knees of whole cadavers were impacted. However, these risk curves either neglect the effects of occupant gender, stature, and mass on KTH fracture force, or account for them using scaling factors derived from dimensional analysis without empirical support. A large amount of experimental data on the knee-impact forces associated with KTH fracture are now available, making it possible to estimate the effects of subject characteristics on skeletal KTH injury risk by statistically analyzing empirical data. Eleven studies were identified in the biomechanical literature in which the flexed knees of whole cadavers were impacted. From these, peak knee-impact force data and the associated subject characteristics were reanalyzed using survival analysis with a lognormal distribution. Results of this analysis indicate that the relationship between peak knee-impact force and the probability of KTH fracture is a function of age, total body mass, and whether the surface that loads the knee is rigid. Comparisons between injury risk curves for the midsize adult male and small adult female crash test dummies defined in previous studies and new risk curves for these sizes of occupants developed in this study suggest that previous injury risk curves generally overestimate the likelihood of KTH fracture at a given peak knee-impact force. Future work should focus on defining the relationships between impact force at the human knee and peak axial compressive forces measured by load cells in the crash test dummy KTH complex so that these new risk curves can be used with ATDs.

Effect of an ankle-foot orthosis on knee joint mechanics: a novel conservative treatment for knee osteoarthritis.

Science.gov (United States)

Fantini Pagani, Cynthia H; Willwacher, Steffen; Benker, Rita; Brüggemann, Gert-Peter

2014-12-01

Several conservative treatments for medial knee osteoarthritis such as knee orthosis and laterally wedged insoles have been shown to reduce the load in the medial knee compartment. However, those treatments also present limitations such as patient compliance and inconsistent results regarding the treatment success. To analyze the effect of an ankle-foot orthosis on the knee adduction moment and knee joint alignment in the frontal plane in subjects with knee varus alignment. Controlled laboratory study, repeated measurements. In total, 14 healthy subjects with knee varus alignment were analyzed in five different conditions: without orthotic, with laterally wedged insoles, and with an ankle-foot orthosis in three different adjustments. Three-dimensional kinetic and kinematic data were collected during gait analysis. Significant decreases in knee adduction moment, knee lever arm, and joint alignment in the frontal plane were observed with the ankle-foot orthosis in all three different adjustments. No significant differences could be found in any parameter while using the laterally wedged insoles. The ankle-foot orthosis was effective in reducing the knee adduction moment. The decreases in this parameter seem to be achieved by changing the knee joint alignment and thereby reducing the knee lever arm in the frontal plane. This study presents a novel approach for reducing the load in the medial knee compartment, which could be developed as a new treatment option for patients with medial knee osteoarthritis. © The International Society for Prosthetics and Orthotics 2013.

Short-term efficacy of calcium fructoborate on subjects with knee discomfort: a comparative, double-blind, placebo-controlled clinical study

Directory of Open Access Journals (Sweden)

Pietrzkowski Z

2014-06-01

Full Text Available Zbigniew Pietrzkowski,1 Michael J Phelan,2 Robert Keller,3 Cynthia Shu,1 Ruby Argumedo,1 Tania Reyes-Izquierdo11FutureCeuticals, Inc., Applied BioClinical Laboratory; 2Department of Statistics, School of Information and Computer Science, University of California at Irvine; 3NutraClinical Inc., Irvine, CA, USAAbstract: Calcium fructoborate (CFB at a dose of 110 mg twice per day was previously reported to improve knee discomfort during the first 14 days of treatment. In this study, 60 participants with self-reported knee discomfort were randomized into two groups receiving CFB or placebo. Initial levels of knee discomfort were evaluated by Western Ontario and McMaster Universities Arthritis Index (WOMAC and McGill Pain Questionnaire (MPQ scores at the beginning of the study and also at 7 and 14 days after treatment. Results showed that supplementation with CFB significantly improved knee discomfort in the study subjects; significant reductions of mean within-subject change in WOMAC and MPQ scores were observed for the CFB group compared to the placebo group at both 7 and 14 days after treatment. Estimated treatment differences for the MPQ score were -5.8 (P=0.0009 and -8.9 (P<0.0001 at Day 7 and 14, respectively. Estimated differences for the WOMAC score were -5.3 (P=0.06 and -13.73 (P<0.0001 at Day 7 and 14, respectively. Negative values indicate greater reductions in reported discomfort. On both Day 7 and Day 14, the trend was toward greater improvement in the CFB group. The placebo group did not exhibit any change in the WOMAC and MPQ scores. In conclusion, supplementation with 110 mg CFB twice per day was associated with improving knee discomfort during the 2 weeks of intake.Keywords: CFB, joint discomfort, WOMAC score, McGill pain score

The effect of knee extensor open kinetic chain resistance training in the ACL-injured knee.

Science.gov (United States)

Barcellona, Massimo G; Morrissey, Matthew C; Milligan, Peter; Clinton, Melissa; Amis, Andrew A

2015-11-01

To investigate the effect of different loads of knee extensor open kinetic chain resistance training on anterior knee laxity and function in the ACL-injured (ACLI) knee. Fifty-eight ACLI subjects were randomised to one of three (12-week duration) training groups. The STAND group trained according to a standardised rehabilitation protocol. Subjects in the LOW and HIGH group trained as did the STAND group but with the addition of seated knee extensor open kinetic chain resistance training at loads of 2 sets of 20 repetition maximum (RM) and 20 sets of 2RM, respectively. Anterior knee laxity and measurements of physical and subjective function were performed at baseline, 6 and 12 weeks. Thirty-six subjects were tested at both baseline and 12 weeks (STAND n = 13, LOW n = 11, HIGH n = 12). The LOW group demonstrated a reduction in 133 N anterior knee laxity between baseline and 12 weeks testing when compared to the HIGH and the STAND groups (p = 0.009). Specifically, the trained-untrained knee laxity decreased an average of approximately 5 mm in the LOW group while remaining the same in the other two groups. Twelve weeks of knee extensor open kinetic chain resistance training at loads of 2 sets of 20RM led to a reduction in anterior knee laxity in the ACLI knee. This reduction in laxity does not appear to offer any significant short-term functional advantages when compared to a standard rehabilitation protocol. These results indicate that knee laxity can be decreased with resistance training of the thigh muscles. Randomised controlled trial, Level II.

[Overuse injury syndromes of the knee].

Science.gov (United States)

Pećina, M; Bojanić, I; Haspl, M

2001-12-01

Overuse injuries are frequent in the knee joint. The reason for this is that the knee joint is engaged in all sports activities. Furthermore, the joint area has numerous attachment points for muscles and tendons and numerous bursae. Another reason is that the specific joint between the patella and femur (patellofemoral joint) constitutes a part of the knee joint. Speaking in general terms, all overuse injuries in the knee joint can be divided in four groups according to the aspect: anterior aspect--patellofemoral pain syndrome, patellar tendinitis (jumper's knee), Osgood-Schlatter disease, Sinding Larson Johanson disease, stress fracture of the patella, fat pad syndrome; medial aspect--plica syndrome, semimembranosus tendinitis, pes anserinus tendinitis (bursitis), breaststroker's knee, medial retinaculitis; lateral aspect--Iliotibial band friction syndrome (runner's knee), Popliteal Tendinitis, Bicipital tendinitis; posterior aspect--fabellitis, medial gastrocnemius strain. There are numerous possible reasons for pain caused by overuse injuries around the knee joint, but two are the most frequent: patellar tendinitis (jumper's knee) and Iliotibial band friction syndrome (runner's knee). This paper gives a brief overview of overuse injuries of the knee joint including their definition, anatomy, aetiology, clinical symptoms and signs, and non-operative and surgical treatment.

Aspirin or Rivaroxaban for VTE Prophylaxis after Hip or Knee Arthroplasty.

Science.gov (United States)

Anderson, David R; Dunbar, Michael; Murnaghan, John; Kahn, Susan R; Gross, Peter; Forsythe, Michael; Pelet, Stephane; Fisher, William; Belzile, Etienne; Dolan, Sean; Crowther, Mark; Bohm, Eric; MacDonald, Steven J; Gofton, Wade; Kim, Paul; Zukor, David; Pleasance, Susan; Andreou, Pantelis; Doucette, Steve; Theriault, Chris; Abianui, Abongnwen; Carrier, Marc; Kovacs, Michael J; Rodger, Marc A; Coyle, Doug; Wells, Philip S; Vendittoli, Pascal-Andre

2018-02-22

Clinical trials and meta-analyses have suggested that aspirin may be effective for the prevention of venous thromboembolism (proximal deep-vein thrombosis or pulmonary embolism) after total hip or total knee arthroplasty, but comparisons with direct oral anticoagulants are lacking for prophylaxis beyond hospital discharge. We performed a multicenter, double-blind, randomized, controlled trial involving patients who were undergoing total hip or knee arthroplasty. All the patients received once-daily oral rivaroxaban (10 mg) until postoperative day 5 and then were randomly assigned to continue rivaroxaban or switch to aspirin (81 mg daily) for an additional 9 days after total knee arthroplasty or for 30 days after total hip arthroplasty. Patients were followed for 90 days for symptomatic venous thromboembolism (the primary effectiveness outcome) and bleeding complications, including major or clinically relevant nonmajor bleeding (the primary safety outcome). A total of 3424 patients (1804 undergoing total hip arthroplasty and 1620 undergoing total knee arthroplasty) were enrolled in the trial. Venous thromboembolism occurred in 11 of 1707 patients (0.64%) in the aspirin group and in 12 of 1717 patients (0.70%) in the rivaroxaban group (difference, 0.06 percentage points; 95% confidence interval [CI], -0.55 to 0.66; Paspirin group and in 5 (0.29%) in the rivaroxaban group (difference, 0.18 percentage points; 95% CI, -0.65 to 0.29; P=0.42). Clinically important bleeding occurred in 22 patients (1.29%) in the aspirin group and in 17 (0.99%) in the rivaroxaban group (difference, 0.30 percentage points; 95% CI, -1.07 to 0.47; P=0.43). Among patients who received 5 days of rivaroxaban prophylaxis after total hip or total knee arthroplasty, extended prophylaxis with aspirin was not significantly different from rivaroxaban in the prevention of symptomatic venous thromboembolism. (Funded by the Canadian Institutes of Health Research; ClinicalTrials.gov number, NCT01720108 .).

Effects of prophylactic knee bracing on knee joint kinetics and kinematics during netball specific movements.

Science.gov (United States)

Sinclair, Jonathan K; Vincent, Hayley; Richards, Jim D

2017-01-01

To investigate the effects of a prophylactic knee brace on knee joint kinetics and kinematics during netball specific movements. Repeated measures. Laboratory. Twenty university first team level female netball players. Participants performed three movements, run, cut and vertical jump under two conditions (brace and no-brace). 3-D knee joint kinetics and kinematics were measured using an eight-camera motion analysis system. Knee joint kinetics and kinematics were examined using 2 × 3 repeated measures ANOVA whilst the subjective ratings of comfort and stability were investigated using chi-squared tests. The results showed no differences (p > 0.05) in knee joint kinetics. However the internal/external rotation range of motion was significantly (p < 0.05) reduced when wearing the brace in all movements. The subjective ratings of stability revealed that netballers felt that the knee brace improved knee stability in all movements. Further study is required to determine whether reductions in transverse plane knee range of motion serve to attenuate the risk from injury in netballers. Copyright © 2016 Elsevier Ltd. All rights reserved.

Knee braces - unloading

Science.gov (United States)

... most people talk about the arthritis in their knees, they are referring to a type of arthritis ... is caused by wear and tear inside your knee joints. Cartilage, the firm, rubbery tissue that cushions ...

MR imaging of the knee: Improvement of signal and contrast efficiency of T1-weighted turbo spin echo sequences by applying a driven equilibrium (DRIVE) pulse

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Radlbauer, Rudolf, E-mail: rudolf.radlbauer@stpoelten.lknoe.a [MR Physics Group, Department of Radiology, Landesklinikum St. Poelten, Propst Fuehrer Strasse 4, 3100 St. Poelten (Austria); Lomoschitz, Friedrich, E-mail: friedrich.lomoschitz@stpoelten.lknoe.a [MR Physics Group, Department of Radiology, Landesklinikum St. Poelten, Propst Fuehrer Strasse 4, 3100 St. Poelten (Austria); Salomonowitz, Erich, E-mail: erich.salomonowitz@stpoelten.lknoe.a [MR Physics Group, Department of Radiology, Landesklinikum St. Poelten, Propst Fuehrer Strasse 4, 3100 St. Poelten (Austria); Eberhardt, Knut E., E-mail: info@mrt-kompetenzzentrum.d [MRT Competence Center Schloss Werneck, Balthasar-Neumann-Platz 2, 97440 Werneck (Germany); Stadlbauer, Andreas, E-mail: andi@nmr.a [MR Physics Group, Department of Radiology, Landesklinikum St. Poelten, Propst Fuehrer Strasse 4, 3100 St. Poelten (Austria); Department of Neurosurgery, University of Erlangen-Nuremberg, Schwabachanlage 6, 91054 Erlangen (Germany)

2010-08-15

The purpose of this study was to assess the effect of a driven equilibrium (DRIVE) pulse incorporated in a standard T1-weighted turbo spin echo (TSE) sequence as used in our routine MRI protocol for examination of pathologies of the knee. Sixteen consecutive patients with knee disorders were examined using the routine MRI protocol, including T1-weighted TSE-sequences with and without a DRIVE pulse. Signal-to-noise ratios (SNRs) and contrast-to-noise ratio (CNR) of anatomical structures and pathologies were calculated and compared for both sequences. The differences in diagnostic value of the T1-weighted images with and without DRIVE pulse were assessed. SNR was significantly higher on images acquired with DRIVE pulse for fluid, effusion, cartilage and bone. Differences in the SNR of meniscus and muscle between the two sequences were not statistically significant. CNR was significantly increased between muscle and effusion, fluid and cartilage, fluid and meniscus, cartilage and meniscus, bone and cartilage on images acquired using the DRIVE pulse. Diagnostic value of the T1-weighted images was found to be improved for delineation of anatomic structures and for diagnosing a variety of pathologies when a DRIVE pulse is incorporated in the sequence. Incorporation of a DRIVE pulse into a standard T1-weighted TSE-sequence leads to significant increase of SNR and CNR of both, anatomical structures and pathologies, and consequently to an increase in diagnostic value within the same acquisition time.

MR imaging of the knee: Improvement of signal and contrast efficiency of T1-weighted turbo spin echo sequences by applying a driven equilibrium (DRIVE) pulse

International Nuclear Information System (INIS)

Radlbauer, Rudolf; Lomoschitz, Friedrich; Salomonowitz, Erich; Eberhardt, Knut E.; Stadlbauer, Andreas

2010-01-01

The purpose of this study was to assess the effect of a driven equilibrium (DRIVE) pulse incorporated in a standard T1-weighted turbo spin echo (TSE) sequence as used in our routine MRI protocol for examination of pathologies of the knee. Sixteen consecutive patients with knee disorders were examined using the routine MRI protocol, including T1-weighted TSE-sequences with and without a DRIVE pulse. Signal-to-noise ratios (SNRs) and contrast-to-noise ratio (CNR) of anatomical structures and pathologies were calculated and compared for both sequences. The differences in diagnostic value of the T1-weighted images with and without DRIVE pulse were assessed. SNR was significantly higher on images acquired with DRIVE pulse for fluid, effusion, cartilage and bone. Differences in the SNR of meniscus and muscle between the two sequences were not statistically significant. CNR was significantly increased between muscle and effusion, fluid and cartilage, fluid and meniscus, cartilage and meniscus, bone and cartilage on images acquired using the DRIVE pulse. Diagnostic value of the T1-weighted images was found to be improved for delineation of anatomic structures and for diagnosing a variety of pathologies when a DRIVE pulse is incorporated in the sequence. Incorporation of a DRIVE pulse into a standard T1-weighted TSE-sequence leads to significant increase of SNR and CNR of both, anatomical structures and pathologies, and consequently to an increase in diagnostic value within the same acquisition time.

Can combined use of low-level lasers and hyaluronic acid injections prolong the longevity of degenerative knee joints?

Directory of Open Access Journals (Sweden)

Ip D

2015-08-01

Full Text Available David Ip, Nga Yue FuAsia Medical Pain Centre, Grand Plaza, Mong Kok, Hong KongBackground: This study evaluated whether half-yearly hyaluronic acid injection together with low-level laser therapy in addition to standard conventional physical therapy can successfully postpone the need for joint replacement surgery in elderly patients with bilateral symptomatic tricompartmental knee arthritis.Methods: In this prospective, double-blind, placebo-controlled study, 70 consecutive unselected elderly patients with bilateral tricompartmental knee arthritis were assigned at random to either one of two conservative treatment protocols to either one of the painful knees. Protocol A consisted of conventional physical therapy plus a sham light source plus saline injection, and protocol B consisted of protocol A with addition of half-yearly hyaluronic acid injection as well as low-level laser treatment instead of using saline and a sham light source. Treatment failure was defined as breakthrough pain necessitating joint replacement.Results: Among the 140 painful knees treated with either protocol A or protocol B, only one of the 70 painful knees treated by protocol B required joint replacement, whereas 15 of the 70 painful knees treated by protocol A needed joint replacement surgery (P<0.05.Conclusion: We conclude that half-yearly hyaluronic acid injections together with low-level laser therapy should be incorporated into the standard conservative treatment protocol for symptomatic knee arthritis, because it may prolong the longevity of the knee joint without the need for joint replacement.Keywords: knee osteoarthritis, hyaluronic acid injection, low-level laser, outcome

RAPID KNEE-EXTENSIONS TO INCREASE QUADRICEPS MUSCLE ACTIVITY IN PATIENTS WITH TOTAL KNEE ARTHROPLASTY

DEFF Research Database (Denmark)

Husted, Rasmus Skov; Wilquin, Lousia; Jakobsen, Thomas Linding

2017-01-01

rapid knee-extensions were associated with greater voluntary quadriceps muscle activity during an experimental strength training session, compared to that elicited using slow knee-extensions. STUDY DESIGN: A randomized cross-over study. METHODS: Twenty-four patients (age 66.5) 4-8 weeks post total knee...... agonist muscle activity, especially if the exercise is conducted using rapid muscle contractions. PURPOSE: The purpose of this study was to examine if patients with total knee arthroplasty could perform rapid knee-extensions using a 10 RM load four to eight weeks after surgery, and the degree to which...... arthroplasty randomly performed one set of five rapid, and one set of five slow knee-extensions with the operated leg, using a load of their 10 repetition maximum, while surface electromyography recordings were obtained from the vastus medialis and lateralis of the quadriceps muscle. RESULTS: Data from 23...

Rapid knee-extensions to increase quadriceps muscle activity in patients with total knee arthroplasty

DEFF Research Database (Denmark)

Husted, Rasmus Skov; Wilquin, Lousia; Jakobsen, Thomas Linding

2017-01-01

rapid knee-extensions were associated with greater voluntary quadriceps muscle activity during an experimental strength training session, compared to that elicited using slow knee-extensions. STUDY DESIGN: A randomized cross-over study. METHODS: Twenty-four patients (age 66.5) 4-8 weeks post total knee...... agonist muscle activity, especially if the exercise is conducted using rapid muscle contractions. PURPOSE: The purpose of this study was to examine if patients with total knee arthroplasty could perform rapid knee-extensions using a 10 RM load four to eight weeks after surgery, and the degree to which...... arthroplasty randomly performed one set of five rapid, and one set of five slow knee-extensions with the operated leg, using a load of their 10 repetition maximum, while surface electromyography recordings were obtained from the vastus medialis and lateralis of the quadriceps muscle. RESULTS: Data from 23...

Prospective comparison of double contrast barium enema plus flexible sigmoidoscopy v colonoscopy in rectal bleeding: barium enema v colonoscopy in rectal bleeding.

OpenAIRE

Irvine, E J; O'Connor, J; Frost, R A; Shorvon, P; Somers, S; Stevenson, G W; Hunt, R H

1988-01-01

Rectal bleeding often heralds serious colonic disease. The literature suggests that colonoscopy is superior to barium enema plus sigmoidoscopy, although no good comparative studies exist. Seventy one patients with overt rectal bleeding had prospectively flexible sigmoidoscopy, double contrast barium enema and colonoscopy completed independently. Against the gold standard, the sensitivity and specificity of colonoscopy were 0.69 and 0.78 respectively for a spectrum of colonic lesions, while fo...

Gait Parameters and Functional Outcomes After Total Knee Arthroplasty Using Persona Knee System With Cruciate Retaining and Ultracongruent Knee Inserts.

Science.gov (United States)

Rajgopal, Ashok; Aggarwal, Kalpana; Khurana, Anshika; Rao, Arun; Vasdev, Attique; Pandit, Hemant

2017-01-01

Total knee arthroplasty is a well-established treatment for managing end-stage symptomatic knee osteoarthritis. Currently, different designs of prostheses are available with majority ensuring similar clinical outcomes. Altered surface geometry is introduced to strive toward gaining superior outcomes. We aimed to investigate any differences in functional outcomes between 2 different polyethylene designs namely the Persona CR (cruciate retaining) and Persona UC (ultracongruent) tibial inserts (Zimmer-Biomet, Warsaw, IN). This prospective single blind, single-surgeon randomized controlled trial reports on 105 patients, (66 female and 39 male), who underwent simultaneous bilateral total knee arthroplasty using the Persona knee system (Zimmer-Biomet) UC inserts in one side and CR inserts in the contralateral side. By a blind assessor, at regular time intervals patients were assessed in terms of function and gait. The functional knee scoring scales used were the Western Ontario and McMaster Universities Osteoarthritis Index and Modified Knee Society Score. The gait parameters evaluated were foot pressure and step length. During the study period, no patient was lost to follow-up or underwent revision surgery for any cause. Western Ontario and McMaster Universities Osteoarthritis Index scores, Modified Knee Society Score, and knee range of motion of all 105 patients assessed preoperatively and postoperatively at 6 months, 1 year, and 2 years showed statistically better results (P < .05) for UC inserts. Gait analysis measuring foot pressures and step length, however, did not show any statistically significant differences at 2-year follow-up. Ultracongruent tibial inserts show significantly better functional outcomes as compared to CR inserts during a 2-year follow-up period. However, in this study these findings were not shown to be attributed to differences in gait parameters. Copyright © 2016 Elsevier Inc. All rights reserved.

Effectiveness of Moxibustion Treatment in Quality of Life in Patients with Knee Osteoarthritis: A Randomized, Double-Blinded, Placebo-Controlled Trial

Directory of Open Access Journals (Sweden)

Xiumei Ren

2015-01-01

Full Text Available Objective. To observe the effects of traditional Chinese moxibustion, compared with sham moxibustion, on the quality of life (QOL in patients with chronic knee osteoarthritis (KOA. Methods. This is a randomized double-blinded, placebo-controlled trial. 150 patients with KOA were randomly allocated to either a true moxibustion treatment (n = 77 or a sham moxibustion treatment (n = 73 three times a week for six weeks. The QOL of patients was evaluated with SF-36 at baseline and 3, 6, and 12 weeks after baseline. Results. 136 patients were available for analysis. Participants in the true moxibustion group experienced statistically significantly greater improvement in GH (general health scores than the sham group at week 6 (P = 0.015 and week 12 (P = 0.029. Participants in the true moxibustion group experienced statistically significantly greater improvement in VT (vitality scores than the sham group at week 12 (P = 0.042. No significant adverse effects were found during the trial. Conclusion. A 6-week moxibustion treatment seems to improve general health and vitality, which are associated with physical and mental quality of life, in patients with KOA up to 12 weeks, relative to credible sham moxibustion. This trial is registered with Clinicaltrials.gov ISRCTN68475405.

Dynamic knee alignment and collateral knee laxity and its variations in normal humans

Directory of Open Access Journals (Sweden)

Kamal eDeep

2015-11-01

Full Text Available Alignment of normal, arthritic and replaced human knees is a much debated subject as is the collateral ligamentous laxity. Traditional quantitative values have been challenged. Methods used to measure these are also not without flaws. Authors review the recent literature and a novel method of measurement of these values has been included. This method includes use of computer navigation technique in clinic setting for assessment of the normal or affected knee before the surgery. Computer navigation has been known for achievement of alignment accuracy during knee surgery. Now its use in clinic setting has added to the inventory of measurement methods. Authors dispel the common myth of straight mechanical axis in normal knees and also look at quantification of amount of collateral knee laxity. Based on the scientific studies it has been shown that the mean alignment is in varus in normal knees. It changes from lying non weight bearing position to standing weight bearing position in both coronal and the sagittal planes. It also varies with gender and race. The collateral laxity is also different for males and females. Further studies are needed to define the ideal alignment and collateral laxity which the surgeon should aim for individual knees.

Assessment of knee laxity using a robotic testing device: a comparison to the manual clinical knee examination.

Science.gov (United States)

Branch, T P; Stinton, S K; Siebold, R; Freedberg, H I; Jacobs, C A; Hutton, W C

2017-08-01

The purpose of this study was to collect knee laxity data using a robotic testing device. The data collected were then compared to the results obtained from manual clinical examination. Two human cadavers were studied. A medial collateral ligament (MCL) tear was simulated in the left knee of cadaver 1, and a posterolateral corner (PLC) injury was simulated in the right knee of cadaver 2. Contralateral knees were left intact. Five blinded examiners carried out manual clinical examination on the knees. Laxity grades and a diagnosis were recorded. Using a robotic knee device which can measure knee laxity in three planes of motion: anterior-posterior, internal-external tibia rotation, and varus-valgus, quantitative data were obtained to document tibial motion relative to the femur. One of the five examiners correctly diagnosed the MCL injury. Robotic testing showed a 1.7° larger valgus angle, 3° greater tibial internal rotation, and lower endpoint stiffness (11.1 vs. 24.6 Nm/°) in the MCL-injured knee during varus-valgus testing when compared to the intact knee and 4.9 mm greater medial tibial translation during rotational testing. Two of the five examiners correctly diagnosed the PLC injury, while the other examiners diagnosed an MCL tear. The PLC-injured knee demonstrated 4.1 mm more lateral tibial translation and 2.2 mm more posterior tibial translation during varus-valgus testing when compared to the intact knee. The robotic testing device was able to provide objective numerical data that reflected differences between the injured knees and the uninjured knees in both cadavers. The examiners that performed the manual clinical examination on the cadaver knees proved to be poor at diagnosing the injuries. Robotic testing could act as an adjunct to the manual clinical examination by supplying numbers that could improve diagnosis of knee injury. Level II.

Knee injury and obesity in patients undergoing total knee replacement: a retrospective study in 115 patients

DEFF Research Database (Denmark)

Jensen, Claus Hjorth; Rofail, S

1999-01-01

The prevalence of obesity and previous knee injury was assessed in a retrospective study of 115 patients under-going total knee replacement due to osteoarthritis. Obesity was considered a contributing factor in the development of osteoarthritis in 37% of the patients, and 33% of the patients had...... had an injury to the knee in question. Unilateral osteoarthritis was significantly more frequent than bilateral osteoarthritis among patients with a history of previous knee injury. The association of previous injury to the knee and unilateral osteoarthritis was stronger in men than women. Aggressive...... treatment of patients with knee injuries seems warranted....

Effects of whole body cryotherapy and cold water immersion on knee skin temperature

OpenAIRE

Costello, J. T.; Donnelly, A. E.; Karki, A.; Selfe, J.

2014-01-01

This study sought to a) compare and contrast the effect of 2 commonly used cryotherapy treatments, 4 min of −110°C whole body cryotherapy and 8°C cold water immersion, on knee skin temperature and b) establish whether either protocol was capable of achieving a skin temperature (

Decreased Knee Joint Loading Associated With Early Knee Osteoarthritis After Anterior Cruciate Ligament Injury.

Science.gov (United States)

Wellsandt, Elizabeth; Gardinier, Emily S; Manal, Kurt; Axe, Michael J; Buchanan, Thomas S; Snyder-Mackler, Lynn

2016-01-01

Anterior cruciate ligament (ACL) injury predisposes individuals to early-onset knee joint osteoarthritis (OA). Abnormal joint loading is apparent after ACL injury and reconstruction. The relationship between altered joint biomechanics and the development of knee OA is unknown. Altered knee joint kinetics and medial compartment contact forces initially after injury and reconstruction are associated with radiographic knee OA 5 years after reconstruction. Case-control study; Level of evidence, 3. Individuals with acute, unilateral ACL injury completed gait analysis before (baseline) and after (posttraining) preoperative rehabilitation and at 6 months, 1 year, and 2 years after reconstruction. Surface electromyographic and knee biomechanical data served as inputs to an electromyographically driven musculoskeletal model to estimate knee joint contact forces. Patients completed radiographic testing 5 years after reconstruction. Differences in knee joint kinetics and contact forces were compared between patients with and those without radiographic knee OA. Patients with OA walked with greater frontal plane interlimb differences than those without OA (nonOA) at baseline (peak knee adduction moment difference: 0.00 ± 0.08 N·m/kg·m [nonOA] vs -0.15 ± 0.09 N·m/kg·m [OA], P = .014; peak knee adduction moment impulse difference: -0.001 ± 0.032 N·m·s/kg·m [nonOA] vs -0.048 ± 0.031 N·m·s/kg·m [OA], P = .042). The involved limb knee adduction moment impulse of the group with osteoarthritis was also lower than that of the group without osteoarthritis at baseline (0.087 ± 0.023 N·m·s/kg·m [nonOA] vs 0.049 ± 0.018 N·m·s/kg·m [OA], P = .023). Significant group differences were absent at posttraining but reemerged 6 months after reconstruction (peak knee adduction moment difference: 0.02 ± 0.04 N·m/kg·m [nonOA] vs -0.06 ± 0.11 N·m/kg·m [OA], P = .043). In addition, the OA group walked with lower peak medial compartment contact forces of the involved limb

Autograft reconstructions for bone defects in primary total knee replacement in severe varus knees

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Yatinder Kharbanda

2014-01-01

Full Text Available Background: Large posteromedial defects encountered in severe varus knees during primary total knee arthroplasty can be treated by cementoplasty, structural bone grafts or metallic wedges. The option is selected depending upon the size of the defect. We studied the outcome of autograft (structural and impaction bone grafting reconstruction of medial tibial bone defects encountered during primary total knee replacement in severe varus knees. Materials and Methods: Out of 675 primary varus knees operated, bone defects in proximal tibia were encountered in 54 knees. Posteromedial defects involving 25-40% of the tibial condyle cut surface and measuring more than 5 mm in depth were grafted using a structural graft obtained from cut distal femur or proximal tibia in 48 knees. For larger, peripheral uncontained vertical defects in six cases, measuring >25 mm in depth and involving >40% cut surface of proximal tibial condyle, impaction bone grafting with a mesh support was used. Results: Bone grafts incorporated in 54 knees in 6 months. There was no graft collapse or stress fractures, loosening or nonunion. The average followup period was 7.8 years (range 5-10 years. We observed an average postoperative increase in the Knee Society Score from 40 to 90 points. There was improvement in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC scores in terms of pain, stiffness and physical function during activities of daily living. Conclusion: Bone grafting for defects in primary total knee is justified as it is biological, available then and is cost effective besides preserving bone stock for future revisions. Structural grafts should be used in defects >5 mm deep and involving 25-40% of the cut proximal tibial condyle surface. For larger peripheral vertical defects, impaction bone grafting contained in a mesh should be done.

Gadolinium-enhanced magnetic resonance imaging of the knee: an experimental approach

International Nuclear Information System (INIS)

Liu, Sirun; Shen, Si; Zhu, Tianyuan; Liang, Wenbin; Huang, Li; Chen, Hanfang; Wu, Hejia

2010-01-01

The purpose of this study was to examine gadolinium-enhanced magnetic resonance imaging (MRI) for monitoring cartilage degeneration. This is a proof-of-concept study in an animal model. Adult New Zealand rabbits were randomly stratified into five groups. Papain was injected intra-articularly in the right knee in four groups to establish the stages of cartilage degeneration. The left knee and group 5 served as controls. Bilateral MRI was performed 24 h after the initial injection of papain, and 1 week, 1 month, and 3 months following three papain injections. Injection of the contrast agent was followed by bilateral MRI examination immediately upon injection, and at 2 and 4 h post-injection. Signal intensities of articular cartilage and peripheral soft tissues were obtained before animals were sacrificed. Post-mortem bilateral cartilage specimens were studied histologically. Histopathology results verified the staged degeneration of papain-treated articular cartilage. Differences in cartilage signal intensity were significant for the staged model using a special three-dimensional MRI method (P 0.05). Contrast-enhanced MRI examination may be a viable tool for early diagnosis of osteoarticular disease. Prospective studies are warranted to evaluate the potential for clinical application. (orig.)

Knee extensor strength and body weight in adolescent men and the risk of knee osteoarthritis by middle age.

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Turkiewicz, Aleksandra; Timpka, Simon; Thorlund, Jonas Bloch; Ageberg, Eva; Englund, Martin

2017-10-01

To assess the extent to which knee extensor strength and weight in adolescence are associated with knee osteoarthritis (OA) by middle age. We studied a cohort of 40 121 men who at age 18 years in 1969/1970 underwent mandatory conscription in Sweden. We retrieved data on isometric knee extensor strength, weight, height, smoking, alcohol consumption, parental education and adult occupation from Swedish registries. We identified participants diagnosed with knee OA or knee injury from 1987 to 2010 through the National Patient Register. We estimated the HR of knee OA using multivariable-adjusted Cox proportional regression model. To assess the influence of adult knee injury and occupation, we performed a formal mediation analysis. The mean (SD) knee extensor strength was 234 (47) Nm, the mean (SD) weight was 66 (9.3) kg. During 24 years (median) of follow-up starting at the age of 35 years, 2049 persons were diagnosed with knee OA. The adjusted HR (95% CI) of incident knee OA was 1.12 (1.06 to 1.18) for each SD of knee extensor strength and 1.18 (1.15 to 1.21) per 5 kg of body weight. Fifteen per cent of the increase in OA risk due to higher knee extensor strength could be attributed to knee injury and adult occupation. Higher knee extensor strength in adolescent men was associated with increased risk of knee OA by middle age, challenging the current tenet of low muscle strength being a risk factor for OA. We confirmed higher weight to be a strong risk factor for knee OA. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

A low-fat yoghurt supplemented with a rooster comb extract on muscle joint function in adults with mild knee pain: a randomized, double blind, parallel, placebo-controlled, clinical trial of efficacy.

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Solà, Rosa; Valls, Rosa-Maria; Martorell, Isabel; Giralt, Montserrat; Pedret, Anna; Taltavull, Núria; Romeu, Marta; Rodríguez, Àurea; Moriña, David; Lopez de Frutos, Victor; Montero, Manuel; Casajuana, Maria-Carmen; Pérez, Laura; Faba, Jenny; Bernal, Gloria; Astilleros, Anna; González, Roser; Puiggrós, Francesc; Arola, Lluís; Chetrit, Carlos; Martinez-Puig, Daniel

2015-11-01

Preliminary results suggested that oral-administration of rooster comb extract (RCE) rich in hyaluronic acid (HA) was associated with improved muscle strength. Following these promising results, the objective of the present study was to evaluate the effect of low-fat yoghurt supplemented with RCE rich in HA on muscle function in adults with mild knee pain; a symptom of early osteoarthritis. Participants (n = 40) received low-fat yoghurt (125 mL d(-1)) supplemented with 80 mg d(-1) of RCE and the placebo group (n = 40) consumed the same yoghurt without the RCE, in a randomized, controlled, double-blind, parallel trial over 12 weeks. Using an isokinetic dynamometer (Biodex System 4), RCE consumption, compared to control, increased the affected knee peak torque, total work and mean power at 180° s(-1), at least 11% in men (p < 0.05) with no differences in women. No dietary differences were noted. These results suggest that long-term consumption of low-fat yoghurt supplemented with RCE could be a dietary tool to improve muscle strength in men, associated with possible clinical significance. However, further studies are needed to elucidate reasons for these sex difference responses observed, and may provide further insight into muscle function.

The minimal effective dose of cis-9-cetylmyristoleate (CMO) in persons presenting with knee joint pain: A double-blind, randomized, placebo-controlled trial.

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Lee, Sang Chul; Jin, Hyun Seung; Joo, Young; Kim, Yong Chul; Moon, Jee Youn

2017-03-01

Nutraceuticals containing cis-9-cetylmyristoleate (CMO) are used to improve knee pain despite the lack of placebo-controlled studies in humans. The aim of the study was to explore the minimal effective dose of CMO for relieving knee joint pain. Twenty-eight subjects with mild degree arthritic knee joint pain were randomized into 4 groups; groups A, B, and C that contained 100%, 80%, and 62.4% of fatty acid component with 12.5% of CMO, and control group D (starch 100%). The pain intensity, functional disability, and the Patient Global Impression of Change (PGIC) were assessed for a 12-week ingestion period. Compared to group D (n = 6), there were significant differences in pain score in group A (n = 7, P = 0.005) and group C (n = 7, P = 0.012), but not significant in group B (n = 6, P = 0.180). Western Ontario and McMaster Universities Arthritis (WOMAC) score decreased significantly in groups A and C. The PGIC was positive in the majority (>50%) in groups A, B, and C, whereas negative in 83.3% in group D (control). CMO is effective in alleviating knee pain in persons with mild degree arthritis of the knee joint, at an effective dose of 62.4%.

Multi-Axis Prosthetic Knee Resembles Alpine Skiing Movements of an Intact Leg

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Demšar, Ivan; Duhovnik, Jože; Lešnik, Blaž; Supej, Matej

2015-01-01

The purpose of the study was to analyse the flexion angles of the ski boot, ankle and knee joints of an above-knee prosthesis and to compare them with an intact leg and a control group of skiers. One subject with an above-knee amputation of the right leg and eight healthy subjects simulated the movement of a skiing turn by performing two-leg squats in laboratory conditions. By adding additional loads in proportion to body weight (BW; +1/3 BW, +2/3 BW, +3/3 BW), various skiing regimes were simulated. Change of Flexion Angle (CoFA) and Range of Motion (RoM) in the ski boot, ankle and knee joints were calculated and compared. An average RoM in the skiing boot on the side of prosthesis (4.4 ± 1.1°) was significantly lower compared to an intact leg (5.9 ± 1.8°) and the control group (6.5 ± 2.3°). In the ankle joint, the average RoM was determined to be 13.2±2.9° in the prosthesis, 12.7 ± 2.8° in an intact leg and 14.8±3.6 in the control group. However, the RoM of the knee joint in the prosthesis (42.2 ± 4.2°) was significantly larger than that of the intact leg (34.7 ± 4.4°). The average RoM of the knee joint in the control group was 47.8 ± 5.4°. The influences of additional loads on the kinematics of the lower extremities were different on the side of the prosthesis and on the intact leg. In contrast, additional loads did not produce any significant differences in the control group. Although different CoFAs in the ski boot, ankle and knee joints were used, an above-knee prosthesis with a built-in multi-axis prosthetic knee enables comparable leg kinematics in simulated alpine skiing. Key points The RoM in the ski boot on the side of the prosthetic leg was smaller than the RoM of the intact leg and the control group of healthy subjects. The RoM in the ankle joint of prosthetic leg was comparable to that of the intact leg and the control group of healthy subjects. The RoM in the prosthetic knee joint was greater than the RoM in the knee joint of the

New Generation Lockable Knee Brace

Science.gov (United States)

2000-01-01

A knee brace that uses Space Shuttle propulsion technology has moved a step closer to being available to help knee injury and stroke patients and may possibly benefit patients with birth defects, spinal cord injuries, and post-polio conditions. After years of hard work, inventors at NASA's Marshall Space Flight Center (MSFC) in Huntsville, Alabama, have turned over the final design and prototype to industry partners at Horton's Orthotic Lab in Little Rock, Arkansas for further clinical testing. The device, called the Selectively Lockable Knee Brace, may mean faster, less painful rehabilitation for patients by allowing the knee to move when weight is not on the heel. Devices currently on the market lock the knee in a rigid, straight-leg position, or allow continuous free motion. The knee brace is just one example of how space technology is being used to improve the lives of people on Earth. NASA's MSFC inventors Michael Shadoan and Neill Myers are space propulsion engineers who use the same mechanisms and materials to build systems for rockets that they used to design and develop the knee brace.

A double-blind study comparing ibuprofen 1800 mg or 2400 mg daily and placebo in sports injuries.

Science.gov (United States)

Hutson, M A

1986-01-01

In a double-blind, placebo-controlled study of forty-six patients with acute ligamentous damage of the knee, ibuprofen in dosages 1800 mg and 2400 mg produced significant improvements in joint mobility, weight bearing ability and match fitness. Joint effusion, pain on stress and pain severity was significantly improved by all three treatments. Only two patients reported side-effects (one while taking placebo and one taking ibuprofen 2400 mg). The study confirmed the efficacy and excellent tolerance to ibuprofen in patients with sports injuries to the knee.

The X-ray and MRI diagnosis of osteochondritis dissecans in the knee joint

International Nuclear Information System (INIS)

Ge Xihong; Wang Bin; Sun Xihe; Chang Guanghui

2002-01-01

Objective: To investigate the X-ray and MRI manifestations of osteochondritis dissecans (OCD) and to compare the sensitivity of detection among different sequences. Methods: Thirty-six OCD cases (thirty-eight knees) with complete data were selected and analyzed. The sagittal and coronal images were acquired on T 1 WI, T 2 WI, PDWI and FLASH T 2 WI. MRI manifestations were analyzed retrospectively with double blind contrast method. The radiography were obtained on the same day. The sensitivity of detection among different sequences was also compared. Results: (1) The medial femoral condyle was the most commonly affected location in the knee (63.2%). The proportion of classical type, expanded type, and infero-central type was 55.3%, 15.8% and 28.9%, respectively. (2) On radiographs, the lesions typically appeared as a well circumscribed area of sclerotic subchondral bone separated from the remainder of the epiphysis by a radiolucent line. (3) Subchondral bone lesion was displayed as small and crescent-shaped (n = 38) on the sagittal image and as wedge (14) or short bar (24) shape on coronal image. The signal of the lesion was hypointense or isointense on T 1 WI, surrounded by a hypointense or hyperintense (FLASH T 2 WI, T 2 WI) line. The subchondral plate disappeared or became thinner. Interruption or disappearance of the hyaline cartilage could be seen sometimes. (4) The detection rate on T 1 WI was higher than that of PDWI, T 2 WI and FLASH T 2 WI. Conclusion: (1) Osteochondritis dissecans has specific X-ray and MRI manifestations. The abnormality of the hyaline cartilage and the subchondral bone can be displayed by MRI. Thus a proper diagnosis can be made. (2) The detection rate on T 1 WI is higher than that of PDWI, T 2 WI and FLASH T 2 WI

[Surgical technique and clinical results of total knee arthroplasty in treating endstage gonarthrosis combined with valgus knee deformity].

Science.gov (United States)

Wang, Xingshan; Weng, Xisheng; Lin, Jin; Jin, Jin; Qian, Wenwei

2012-05-01

To investigate the surgical technique and the clinical results of total knee arthroplasty (TKA) in treating end-stage gonarthrosis combined with valgus knee deformity. Between November 1998 and October 2010, 64 patients (72 knees) with end-stage gonarthrosis combined with valgus knee deformity underwent TKA by a medial parapatellar approach. Of the 64 patients, 18 were male and 46 were female with an average age of 62.5 years (range, 23-82 years), including 44 cases (49 knees) of osteoarthritis, 17 cases (20 knees) of rheumatoid arthritis, 2 cases (2 knees) of haemophilic arthritis, and 1 case (1 knee) of post-traumatic arthritis. Bilateral knees were involved in 8 cases, and single knee in 56 cases. The flexion and extension range of motion (ROM) of the knee joint was (82.2 +/- 28.7) degrees; the femur-tibia angle (FTA) was (18.0 +/- 5.8) degrees; according to Knee Society Score (KSS) criterion, the preoperative clinical score was 31.2 +/- 10.1 and functional score was 37.3 +/- 9.0. According to Krackow's classification, there were 65 knees of type I and 7 knees of type II. By medial parapatellar approach, conventional osteotomy and Ranawat soft tissue release were performed in all cases. Prosthesis of preserved posterior cruciate ligament were used in 7 cases (7 knees), posterior stabilize prosthesis in 54 cases (60 knees), constrained prosthesis in 4 cases (5 knees). Incisions healed by first intention in all cases. Peroneal nerve palsy occurred in 1 patient with haemophilic arthritis, severe valgus deformity (FTA was 41 degrees), and flexion contracture (20 degrees), which was cured after 1 year of conservative treatment. Revison surgery was performed in 1 case of deep infection at 2 years after surgery. All the patients were followed up 4.9 years on average (range, 1-13 years). At last follow-up, the FTA was (7.0 +/- 2.5) degrees, showing significant difference when compared with preoperative value (t = 15.502, P = 0.000). The KSS clinical score was 83.0 +/- 6

Effect of biomagnetic therapy versus physiotherapy for treatment of knee osteoarthritis: a randomized controlled trial.

Science.gov (United States)

Gremion, Gerald; Gaillard, David; Leyvraz, Pierre-Francois; Jolles, Brigitte M

2009-11-01

To assess the effectiveness of pulsed signal therapy in the treatment of knee osteoarthritis (Kellgren II or III). A randomized, double-blind controlled clinical trial. The first 95 patients sent to the clinic with knee osteo-arthritis were selected and randomized into treatment with pulsed signal therapy or conventional physiotherapy. Assessment included recording of usual demographic data, pertinent history, baseline medication and radiographs. Clinical evaluation was made at baseline, 6 weeks and 6 months after the end of treatment by the same blinded doctor. At each follow-up time, the patient was asked to complete a visual analogue pain scale and a Lequesne score. The doctor recorded the degree of pain on motion and the ability to move the affected knee. Both treatments resulted in significant improvements in pain and physical function. A statistical difference was observed only for activities of daily living, where the physiotherapy was more efficient (pphysiotherapy. Like physiotherapy, pulsed signal therapy has improved the clinical state of treated patients but with no significant statistical difference. Pulsed signal therapy is, however, more expensive.

The Use of Hyaluronic Acid and Corticosteroid Injections Among Medicare Patients With Knee Osteoarthritis.

Science.gov (United States)

Koenig, Karl M; Ong, Kevin L; Lau, Edmund C; Vail, Thomas P; Berry, Daniel J; Rubash, Harry E; Kurtz, Steven; Bozic, Kevin J

2016-02-01

Hyaluronic acid (HA) and corticosteroid (CS) injections are frequently used in the management of osteoarthritis (OA) of the knee, despite a lack of strong evidence supporting their efficacy in the literature. The purpose of this study is to evaluate trends in HA and CS usage in Medicare patients over the past 15 years. The Medicare 5% national sample database was used to identify 581,022 patients (representing an estimated 11.6 million) with a diagnosis of knee OA between 1999 and 2013. The percentage of newly diagnosed knee OA patients who received any injection trended from 39% in 1999 to 47% in 2006 and then declined to 37.5% in 2013. However, the mean number of injections per newly diagnosed OA patient nearly doubled from 0.27 to 0.45 for CS and from 0.18 to 0.36 for HA. Among those having both HA and CS injections, 69% had CS as first-line treatment, whereas 31% had HA first. The percentage of newly diagnosed knee OA patients receiving injections peaked in 2007 and then decreased steadily through 2013, as did the proportion of patients receiving HA injections as first-line therapy. However, the number of injections per patient has increased significantly over the past 15 years in both groups. Copyright © 2016 Elsevier Inc. All rights reserved.

Soft tissue artifact compensation in knee kinematics by multi-body optimization: Performance of subject-specific knee joint models.

Science.gov (United States)

Clément, Julien; Dumas, Raphaël; Hagemeister, Nicola; de Guise, Jaques A

2015-11-05

Soft tissue artifact (STA) distort marker-based knee kinematics measures and make them difficult to use in clinical practice. None of the current methods designed to compensate for STA is suitable, but multi-body optimization (MBO) has demonstrated encouraging results and can be improved. The goal of this study was to develop and validate the performance of knee joint models, with anatomical and subject-specific kinematic constraints, used in MBO to reduce STA errors. Twenty subjects were recruited: 10 healthy and 10 osteoarthritis (OA) subjects. Subject-specific knee joint models were evaluated by comparing dynamic knee kinematics recorded by a motion capture system (KneeKG™) and optimized with MBO to quasi-static knee kinematics measured by a low-dose, upright, biplanar radiographic imaging system (EOS(®)). Errors due to STA ranged from 1.6° to 22.4° for knee rotations and from 0.8 mm to 14.9 mm for knee displacements in healthy and OA subjects. Subject-specific knee joint models were most effective in compensating for STA in terms of abduction-adduction, inter-external rotation and antero-posterior displacement. Root mean square errors with subject-specific knee joint models ranged from 2.2±1.2° to 6.0±3.9° for knee rotations and from 2.4±1.1 mm to 4.3±2.4 mm for knee displacements in healthy and OA subjects, respectively. Our study shows that MBO can be improved with subject-specific knee joint models, and that the quality of the motion capture calibration is critical. Future investigations should focus on more refined knee joint models to reproduce specific OA knee geometry and physiology. Copyright © 2015 Elsevier Ltd. All rights reserved.

Effect of Knee Extensor Strength on Incident Radiographic and Symptomatic Knee Osteoarthritis in Individuals with Meniscal Pathology

DEFF Research Database (Denmark)

Thorlund, Jonas B; Felson, David T; Segal, Neil A

2016-01-01

months. Separate binomial regression analyses with robust standard errors adjusted for age, history of knee surgery, physical activity level and clinic site were conducted for men and women. RESULTS: High knee extensor strength (normalized by allometric scaling) was associated with a reduced risk...... of radiographic knee OA in women (relative risk: 0.52; 95% CI: 0.29 to 0.94) but not in men (0.56; 0.27 to 1.16). High knee extensor strength did not protect against the development of symptomatic knee OA, either in women or in men. CONCLUSION: The results only partly confirm the hypothesis that high knee...

Double agents and secret agents: the emerging fields of exogenous chemical exchange saturation transfer and T2-exchange magnetic resonance imaging contrast agents for molecular imaging.

Science.gov (United States)

Daryaei, Iman; Pagel, Mark D

2015-01-01

Two relatively new types of exogenous magnetic resonance imaging contrast agents may provide greater impact for molecular imaging by providing greater specificity for detecting molecular imaging biomarkers. Exogenous chemical exchange saturation transfer (CEST) agents rely on the selective saturation of the magnetization of a proton on an agent, followed by chemical exchange of a proton from the agent to water. The selective detection of a biomarker-responsive CEST signal and an unresponsive CEST signal, followed by the ratiometric comparison of these signals, can improve biomarker specificity. We refer to this improvement as a "double-agent" approach to molecular imaging. Exogenous T 2 -exchange agents also rely on chemical exchange of protons between the agent and water, especially with an intermediate rate that lies between the slow exchange rates of CEST agents and the fast exchange rates of traditional T 1 and T 2 agents. Because of this intermediate exchange rate, these agents have been relatively unknown and have acted as "secret agents" in the contrast agent research field. This review exposes these secret agents and describes the merits of double agents through examples of exogenous agents that detect enzyme activity, nucleic acids and gene expression, metabolites, ions, redox state, temperature, and pH. Future directions are also provided for improving both types of contrast agents for improved molecular imaging and clinical translation. Therefore, this review provides an overview of two new types of exogenous contrast agents that are becoming useful tools within the armamentarium of molecular imaging.

Contribution of regional 3D meniscus and cartilage morphometry by MRI to joint space width in fixed flexion knee radiography—A between-knee comparison in subjects with unilateral joint space narrowing

International Nuclear Information System (INIS)

Bloecker, K.; Wirth, W.; Hunter, D.J.; Duryea, J.; Guermazi, A.; Kwoh, C.K.; Resch, H.; Eckstein, F.

2013-01-01

Background: Radiographic joint space width (JSW) is considered the reference standard for demonstrating structural therapeutic benefits in knee osteoarthritis. Our objective was to determine the proportion by which 3D (regional) meniscus and cartilage measures explain between-knee differences of JSW in the fixed flexion radiographs. Methods: Segmentation of the medial meniscus and tibial and femoral cartilage was performed in double echo steady state (DESS) images. Quantitative measures of meniscus size and position, femorotibial cartilage thickness, and radiographic JSW (minimum, and fixed locations) were compared between both knees of 60 participants of the Osteoarthritis Initiative, with strictly unilateral medial joint space narrowing (JSN). Statistical analyses (between-knee, within-person comparison) were performed using regression analysis. Results: A strong relationship with side-differences in minimum and a central fixed location JSW was observed for percent tibial plateau coverage by the meniscus (r = .59 and .47; p < .01) and central femoral cartilage thickness (r = .69 and .75; p < .01); other meniscus and cartilage measures displayed lower coefficients. The correlation of central femoral cartilage thickness with JSW (but not that of meniscus measures) was greater (r = .78 and .85; p < .01) when excluding knees with non-optimal alignment between the tibia and X-ray beam. Conclusion: 3D measures of meniscus and cartilage provide significant, independent information in explaining side-differences in radiographic JSW in fixed flexion radiographs. Tibial coverage by the meniscus and central femoral cartilage explained two thirds of the variability in minimum and fixed location JSW. JSW provides a better representation of (central) femorotibial cartilage thickness, when optimal positioning of the fixed flexion radiographs is achieved

Contribution of regional 3D meniscus and cartilage morphometry by MRI to joint space width in fixed flexion knee radiography—A between-knee comparison in subjects with unilateral joint space narrowing

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Bloecker, K., E-mail: katja.bloecker@pmu.ac.at [Institute of Anatomy and Musculoskeletal Research, Paracelsus Medical University, Strubergasse 21, 5020 Salzburg (Austria); Department of Traumatology and Sports Medicine, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg (Austria); Wirth, W., E-mail: wolfgang.wirth@pmu.ac.at [Institute of Anatomy and Musculoskeletal Research, Paracelsus Medical University, Strubergasse 21, 5020 Salzburg (Austria); Chondrometrics GmbH, Ulrichshöglerstrasse 23, 83404 Ainring (Germany); Hunter, D.J., E-mail: david.hunter@sydney.edu.au [Royal North Shore Hospital and Kolling Institute, University of Sydney, Pacific Highway, St Leonards, Sydney, NSW 2065 (Australia); Duryea, J., E-mail: jduryea@bwh.harvard.edu [Brigham and Women' s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA (United States); Guermazi, A., E-mail: Ali.Guermazi@bmc.org [Boston University School of Medicine, Department of Radiology, 820 Harrison Avenue, FGH Building 3rd Floor, Boston, MA (United States); Boston Imaging Core Lab (BICL), 601 Albany Street, Boston, MA (United States); Kwoh, C.K., E-mail: kwoh@pitt.edu [Division of Rheumatology and Clinical Immunology, University of Arizona, Tucson, AZ (United States); Division of Rheumatology and Clinical Immunology, University of Pittsburgh and VA, Pittsburgh Healthcare System, 3500 Terrace Street, Biomedical Science Tower South 702, Pittsburgh, PA 15261 (United States); Resch, H., E-mail: Herbert.resch@salk.at [Department of Traumatology and Sports Medicine, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg (Austria); Eckstein, F. [Institute of Anatomy and Musculoskeletal Research, Paracelsus Medical University, Strubergasse 21, 5020 Salzburg (Austria); Chondrometrics GmbH, Ulrichshöglerstrasse 23, 83404 Ainring (Germany)

2013-12-01

Background: Radiographic joint space width (JSW) is considered the reference standard for demonstrating structural therapeutic benefits in knee osteoarthritis. Our objective was to determine the proportion by which 3D (regional) meniscus and cartilage measures explain between-knee differences of JSW in the fixed flexion radiographs. Methods: Segmentation of the medial meniscus and tibial and femoral cartilage was performed in double echo steady state (DESS) images. Quantitative measures of meniscus size and position, femorotibial cartilage thickness, and radiographic JSW (minimum, and fixed locations) were compared between both knees of 60 participants of the Osteoarthritis Initiative, with strictly unilateral medial joint space narrowing (JSN). Statistical analyses (between-knee, within-person comparison) were performed using regression analysis. Results: A strong relationship with side-differences in minimum and a central fixed location JSW was observed for percent tibial plateau coverage by the meniscus (r = .59 and .47; p < .01) and central femoral cartilage thickness (r = .69 and .75; p < .01); other meniscus and cartilage measures displayed lower coefficients. The correlation of central femoral cartilage thickness with JSW (but not that of meniscus measures) was greater (r = .78 and .85; p < .01) when excluding knees with non-optimal alignment between the tibia and X-ray beam. Conclusion: 3D measures of meniscus and cartilage provide significant, independent information in explaining side-differences in radiographic JSW in fixed flexion radiographs. Tibial coverage by the meniscus and central femoral cartilage explained two thirds of the variability in minimum and fixed location JSW. JSW provides a better representation of (central) femorotibial cartilage thickness, when optimal positioning of the fixed flexion radiographs is achieved.

Effects of an intensive weight loss program on knee joint loading in obese adults with knee osteoarthritis

DEFF Research Database (Denmark)

Aaboe, J; Bliddal, H; Messier, S P

2011-01-01

To determine the effect of an intensive weight loss program on knee joint loads during walking in obese patients with knee osteoarthritis (OA).......To determine the effect of an intensive weight loss program on knee joint loads during walking in obese patients with knee osteoarthritis (OA)....

Effects of proprioceptive circuit exercise on knee joint pain and muscle function in patients with knee osteoarthritis.

Science.gov (United States)

Ju, Sung-Bum; Park, Gi Duck; Kim, Sang-Soo

2015-08-01

[Purpose] This study applied proprioceptive circuit exercise to patients with degenerative knee osteoarthritis and examined its effects on knee joint muscle function and the level of pain. [Subjects] In this study, 14 patients with knee osteoarthritis in two groups, a proprioceptive circuit exercise group (n = 7) and control group (n = 7), were examined. [Methods] IsoMed 2000 (D&R Ferstl GmbH, Hemau, Germany) was used to assess knee joint muscle function, and a Visual Analog Scale was used to measure pain level. [Results] In the proprioceptive circuit exercise group, knee joint muscle function and pain levels improved significantly, whereas in the control group, no significant improvement was observed. [Conclusion] A proprioceptive circuit exercise may be an effective way to strengthen knee joint muscle function and reduce pain in patients with knee osteoarthritis.

Active knee joint flexibility and sports activity

DEFF Research Database (Denmark)

Hahn, Thomas; Foldspang, Anders; Vestergaard, E

1999-01-01

was significantly higher in women than in men and significantly positively associated with weekly hours of swimming and weekly hours of competitive gymnastics. Active knee flexion was significantly positively associated with participation in basketball, and significantly negatively associated with age and weekly......The aim of the study was to estimate active knee flexion and active knee extension in athletes and to investigate the potential association of each to different types of sports activity. Active knee extension and active knee flexion was measured in 339 athletes. Active knee extension...... hours of soccer, European team handball and swimming. The results point to sport-specific adaptation of active knee flexion and active knee extension. Udgivelsesdato: 1999-Apr...

Effect of rocker-soled shoes on parameters of knee joint load in knee osteoarthritis.

Science.gov (United States)

Madden, Elizabeth G; Kean, Crystal O; Wrigley, Tim V; Bennell, Kim L; Hinman, Rana S

2015-01-01

This study evaluated the immediate effects of rocker-soled shoes on parameters of the knee adduction moment (KAM) and pain in individuals with knee osteoarthritis (OA). Three-dimensional gait analysis was performed on 30 individuals (mean (SD): age, 61 (7) yr; 15 (50%) male) with radiographic and symptomatic knee OA under three walking conditions in a randomized order: i) wearing rocker-soled shoes (Skechers Shape-ups), ii) wearing non-rocker-soled shoes (ASICS walking shoes), and iii) barefoot. Peak KAM and KAM angular impulse were measured as primary indicators of knee load distribution. Secondary measures included the knee flexion moment (KFM) and knee pain during walking. Peak KAM was significantly lower when wearing the rocker-soled shoes compared with that when wearing the non-rocker-soled shoes (mean difference (95% confidence interval), -0.27 (-0.42 to -0.12) N·m/BW × Ht%; P < 0.001). Post hoc tests revealed no significant difference in KAM impulse between rocker-soled and non-rocker-soled shoe conditions (P = 0.13). Both peak KAM and KAM impulse were significantly higher during both shoe conditions compared with those during the barefoot condition (P < 0.001). There were no significant differences in KFM (P = 0.36) or knee pain (P = 0.89) between conditions. Rocker-soled shoes significantly reduced peak KAM when compared with non-rocker-soled shoes, without a concomitant change in KFM, and thus may potentially reduce medial knee joint loading. However, KAM parameters in the rocker-soled shoes remained significantly higher than those during barefoot walking. Wearing rocker-soled shoes did not have a significant immediate effect on walking pain. Further research is required to evaluate whether rocker-soled shoes can influence symptoms and progression of knee OA with prolonged wear.

Improvements in knee biomechanics during walking are associated with increased physical activity after total knee arthroplasty.

Science.gov (United States)

Arnold, John B; Mackintosh, Shylie; Olds, Timothy S; Jones, Sara; Thewlis, Dominic

2015-12-01

Total knee arthroplasty (TKA) in people with knee osteoarthritis increases knee-specific and general physical function, but it has not been established if there is a relationship between changes in these elements of functional ability. This study investigated changes and relationships between knee biomechanics during walking, physical activity, and use of time after TKA. Fifteen people awaiting TKA underwent 3D gait analysis before and six months after surgery. Physical activity and use of time were determined in free-living conditions from a high resolution 24-h activity recall. After surgery, participants displayed significant improvements in sagittal plane knee biomechanics and improved their physical activity profiles, standing for 105 more minutes (p=0.001) and performing 64 min more inside chores on average per day (p=0.008). Changes in sagittal plane knee range of motion (ROM) and peak knee flexion positively correlated with changes in total daily energy expenditure, time spent undertaking moderate to vigorous physical activity, inside chores and passive transport (r=0.52-0.66, p=0.005-0.047). Restoration of knee function occurs in parallel and is associated with improvements in physical activity and use of time after TKA. Increased functional knee ROM is required to support improvements in total and context specific physical activity. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

MRI evaluation of osteonecrosis in knee joints after intravenous administration of corticosteroids in patients with severe acute respiratory syndrome

International Nuclear Information System (INIS)

Gao Yong'an; Liu Hualiang; Dong Yanqing; Liu Ying; Li Kuncheng; Wang Zhongwei; Li Ping

2005-01-01

Objective: To evaluate MRI features of osteonecrosis in knee joints after intravenous administration of exogenous corticosteroids in patients with severe acute respiratory syndrome (SARS). Methods: MRI was done in 18 patients (medical staff from 4 hospitals) suffered from SARS and treated with intravenous use of exogenous corticosteroids in hip joints and knee joints to indicate the findings and characteristics of osteonecrosis as well as their relation with hormone amount. Results: Eleven patients showed lesions of osteonecrosis in knee joints with bilateral in 7 and unilateral in 4, and 3 patients were complicated with avascular necrosis in bilateral femoral heads. Among the 38 lesions in knee joints, 34 lesions were located in medial condylu, lateral condylus and shaft of femur, and 4 in medial condylus or lateral condylus of tibia. Large-middle lesions showed geographic focus of typically heterogeneous signal (low or intermediate signal intensity on T 1 WI and high or intermediate signal intensity T 2 WI) within the marrow that was surrounded by characteristic low signal intensity, serpentine border on T 1 , T 2 WI. This border showed a classic double-line sign on T 2 WI in 4 lesions. Small lesions showed low signal intensity on T 1 and low or high signal intensity on T 2 WI. Subchondral avascular necrosis in middle-upper femoral heads showed intermediate signal intensity on T 1 weighted images and high or complicated signal intensity on T 2 WI encircled with characteristic low signal intensity, serpentine border on T 1 and T 2 WI. This border showed a classic double-line sign on T 2 weighted images in avascular necrosis of bilateral femoral heads in 1 case. Conclusion: In these cases, osteonecrosis in knee joints was more than in femoral heads in patients with SARS after intravenous use of exogenous corticosteroids, mostly located in medial condylus, lateral condylus and shaft of femur as well as in medial condylus or lateral condylus of tibia. So, MRI should

Taking care of your new knee joint

Science.gov (United States)

Knee arthroplasty - precautions; Knee replacement - precautions ... After you have knee replacement surgery , you will need to be careful about how you move your knee, especially for the first few ...

Cross-sectional and Longitudinal Associations between Knee Joint Effusion Synovitis and Knee Pain in Older Adults.

Science.gov (United States)

Wang, Xia; Jin, Xingzhong; Han, Weiyu; Cao, Yuelong; Halliday, Andrew; Blizzard, Leigh; Pan, Faming; Antony, Benny; Cicuttini, Flavia; Jones, Graeme; Ding, Changhai

2016-01-01

To describe the cross-sectional and longitudinal associations between knee regional effusion synovitis and knee pain in older adults. Data from a population-based random sample (n = 880, mean age 62 yrs, 50% women) were used. Baseline knee joint effusion synovitis was graded (0-3) using T2-weighted magnetic resonance imaging (MRI) in the suprapatellar pouch, central portion, posterior femoral recess, and subpopliteal recess. Effusion synovitis of the whole joint was defined as a score of ≥ 2 in any subregion. Other knee structural (including cartilage, bone marrow, and menisci) lesions were assessed by MRI at baseline. Knee pain was assessed by the Western Ontario and McMaster Universities Osteoarthritis Index questionnaire at baseline and 2.6 years later. Multivariable analyses were performed after adjustment for age, sex, body mass index, and other structural lesions. The prevalence of effusion synovitis was 67%. Suprapatellar pouch effusion synovitis was significantly and independently associated with increased total and nonweight-bearing knee pain in both cross-sectional and longitudinal analyses (for an increase in total knee pain of ≥ 5, RR 1.26 per grade, 95% CI 1.04-1.52), and increased weight-bearing knee pain in longitudinal analysis only. Effusion synovitis in posterior femoral recess and central portion were independently associated with increases in nonweight-bearing pain (RR 1.63 per grade, 95% CI 1.32-2.01 and RR 1.29 per grade, 95% CI 1.01-1.65, respectively) in longitudinal analyses only. Knee joint effusion synovitis has independent associations with knee pain in older adults. Suprapatellar pouch effusion synovitis is associated with nonweight-bearing and weight-bearing knee pain, while posterior femoral recess and central portion effusion synovitis are only associated with nonweight-bearing pain.

Imaging of knee arthroplasty

International Nuclear Information System (INIS)

Miller, Theodore T.

2005-01-01

Knee replacement surgery, either with unicompartmental or total systems, is common. The purpose of this manuscript is to review the appearance of normal knee arthroplasty and the appearances of complications such as infection, polyethylene wear, aseptic loosening and particle-induced osteolysis, patellofemoral abnormalities, axial instability, and periprosthetic and component fracture. Knowledge of the potential complications and their imaging appearances will help the radiologist in the diagnostic evaluation of the patient with a painful knee arthroplasty

Imaging of knee arthroplasty

Energy Technology Data Exchange (ETDEWEB)

Miller, Theodore T. [Department of Radiology, North Shore University Hospital, 825 Northern Blvd., Great Neck, NY 11021 (United States)]. E-mail: TMiller@NSHS.edu

2005-05-01

Knee replacement surgery, either with unicompartmental or total systems, is common. The purpose of this manuscript is to review the appearance of normal knee arthroplasty and the appearances of complications such as infection, polyethylene wear, aseptic loosening and particle-induced osteolysis, patellofemoral abnormalities, axial instability, and periprosthetic and component fracture. Knowledge of the potential complications and their imaging appearances will help the radiologist in the diagnostic evaluation of the patient with a painful knee arthroplasty.

Knee Kinematic Improvement After Total Knee Replacement Using a Simplified Quantitative Gait Analysis Method

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Hassan Sarailoo

2013-10-01

Full Text Available Objectives: The aim of this study was to extract suitable spatiotemporal and kinematic parameters to determine how Total Knee Replacement (TKR alters patients’ knee kinematics during gait, using a rapid and simplified quantitative two-dimensional gait analysis procedure. Methods: Two-dimensional kinematic gait pattern of 10 participants were collected before and after the TKR surgery, using a 60 Hz camcorder in sagittal plane. Then, the kinematic parameters were extracted using the gait data. A student t-test was used to compare the group-average of spatiotemporal and peak kinematic characteristics in the sagittal plane. The knee condition was also evaluated using the Oxford Knee Score (OKS Questionnaire to ensure thateach subject was placed in the right group. Results: The results showed a significant improvement in knee flexion during stance and swing phases after TKR surgery. The walking speed was increased as a result of stride length and cadence improvement, but this increment was not statistically significant. Both post-TKR and control groups showed an increment in spatiotemporal and peak kinematic characteristics between comfortable and fast walking speeds. Discussion: The objective kinematic parameters extracted from 2D gait data were able to show significant improvements of the knee joint after TKR surgery. The patients with TKR surgery were also able to improve their knee kinematics during fast walking speed equal to the control group. These results provide a good insight into the capabilities of the presented method to evaluate knee functionality before and after TKR surgery and to define a more effective rehabilitation program.

Knee functions and a return to sports activity in competitive athletes following anterior cruciate ligament reconstruction.

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Nakayama, Y; Shirai, Y; Narita, T; Mori, A; Kobayashi, K

2000-06-01

We investigated knee functions and a return to sports in 50 competitive athlete patients treated with arthroscopic anterior cruciate ligament reconstruction using double-looped STG augmented by woven polyester at a 1-year follow-up. There were 25 males and 25 females with a mean age of 24.3 years (range: 19-39 years). The majority of preinjury sports were basketball, volleyball and soccer. Athletic rehabilitation including agility training and sports-specific training was started at 12 weeks. Fourty patients (80%) was rated as normal or nearly normal on the assessment of International Knee Documentation Commitee postoperatively. Fourty-eight patients (96%) obtained full range of motion, and the mean quadriceps muscle strength of the injured side was 91.3%of that of the uninjured side. As for a return to sports, 46 patients (92%) were able to do fully competitive sports at a mean of 8.1 postoperative months. These results suggest that arthroscopic reconstruction using augmented double-looped STG allows early athletic rehabilitation, and lead satisfactory outcome as well as a reliable and early return to preinjury level of sport activity for the majority of the competitive athlete patients.

An ultrasound score for knee osteoarthritis

DEFF Research Database (Denmark)

Riecke, B F; Christensen, R.; Torp-Pedersen, S

2014-01-01

OBJECTIVE: To develop standardized musculoskeletal ultrasound (MUS) procedures and scoring for detecting knee osteoarthritis (OA) and test the MUS score's ability to discern various degrees of knee OA, in comparison with plain radiography and the 'Knee injury and Osteoarthritis Outcome Score' (KOOS......) domains as comparators. METHOD: A cross-sectional study of MUS examinations in 45 patients with knee OA. Validity, reliability, and reproducibility were evaluated. RESULTS: MUS examination for knee OA consists of five separate domains assessing (1) predominantly morphological changes in the medial...... coefficients ranging from 0.75 to 0.97 for the five domains. Construct validity was confirmed with statistically significant correlation coefficients (0.47-0.81, P knee OA. In comparison with standing radiographs...

The effect of different decline angles on the biomechanics of double limb squats and the implications to clinical and training practice.

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Richards, Jim; Selfe, James; Sinclair, Jonathan; May, Karen; Thomas, Gavin

2016-09-01

Bilateral decline squatting has been well documented as a rehabilitation exercise, however, little information exists on the optimum angle of decline. The aim of this study was to determine the ankle and knee angle, moments, the patellofemoral joint load, patellar tendon load and associated muscle activity while performing a double limb squat at different decline angles and the implications to rehabilitation. Eighteen healthy subjects performed double limb squats at 6 angles of declination: 0, 5, 10, 15, 20 and 25 degrees. The range of motion of the knee and ankle joints, external moments, the patellofemoral/patellar tendon load and integrated EMG of gastrocnemius, tibialis anterior, rectus femoris and biceps femoris were evaluated. As the decline angle increased up to 20 degrees, the range of motion possible at the ankle and knee increased. The joint moments showed a decrease at the ankle up to 15 degrees and an increase at the knee up to 25 degrees, indicating a progressive reduction in loading around the ankle with a corresponding increase of the load in the patellar tendon and patellofemoral joint. These trends were supported by a decrease in tibialis anterior activity and an increase in the rectus femoris activity up to 15 degrees declination. However, gastrocnemius and biceps femoris activity increased as the decline angle increased above 15 degrees. The action of gastrocnemius and biceps femoris stabilises the knee against an anterior displacement of the femur on the tibia. These findings would suggest that there is little benefit in using a decline angle greater than 15-20 degrees unless the purpose is to offer an additional stability challenge to the knee joint.

The effect of different decline angles on the biomechanics of double limb squats and the implications to clinical and training practice

Directory of Open Access Journals (Sweden)

Richards Jim

2016-09-01

Full Text Available Bilateral decline squatting has been well documented as a rehabilitation exercise, however, little information exists on the optimum angle of decline. The aim of this study was to determine the ankle and knee angle, moments, the patellofemoral joint load, patellar tendon load and associated muscle activity while performing a double limb squat at different decline angles and the implications to rehabilitation. Eighteen healthy subjects performed double limb squats at 6 angles of declination: 0, 5, 10, 15, 20 and 25 degrees. The range of motion of the knee and ankle joints, external moments, the patellofemoral/patellar tendon load and integrated EMG of gastrocnemius, tibialis anterior, rectus femoris and biceps femoris were evaluated. As the decline angle increased up to 20 degrees, the range of motion possible at the ankle and knee increased. The joint moments showed a decrease at the ankle up to 15 degrees and an increase at the knee up to 25 degrees, indicating a progressive reduction in loading around the ankle with a corresponding increase of the load in the patellar tendon and patellofemoral joint. These trends were supported by a decrease in tibialis anterior activity and an increase in the rectus femoris activity up to 15 degrees declination. However, gastrocnemius and biceps femoris activity increased as the decline angle increased above 15 degrees. The action of gastrocnemius and biceps femoris stabilises the knee against an anterior displacement of the femur on the tibia. These findings would suggest that there is little benefit in using a decline angle greater than 15-20 degrees unless the purpose is to offer an additional stability challenge to the knee joint.

Is the body-coil at 3 Tesla feasible for the MRI evaluation of the painful knee? A comparative study

International Nuclear Information System (INIS)

Lutterbey, G.; Behrends, K.; Falkenhausen, M.V.; Wattjes, M.P.; Morakkabati, N.; Schild, H.; Gieseke, J.

2007-01-01

The purpose of this study was to compare the in-built body coil of the 3.0-Tesla (T) scanner with a dedicated surface coil of a 1.5 T system regarding knee imaging. We performed an intraindividual prospective clinical trial on 17 patients with knee pain using magnetic resonance imaging (MRI) at 1.5 and 3.0 T systems equipped with identical gradient systems. Proton-density-weighted turbo spin echo sequences with the same spatial resolution and comparable contrast parameters were used. A quantitative measurement of signal to noise ratio (SNR), relative contrast (RC) and contrast to noise ratio (CNR) between muscle and bone marrow was performed, followed by a qualitative assessment of anatomic/pathologic structures and the extent of artefacts. At 3.0 T, 30 lesions (91%) compared to 33 lesions at 1.5 T were detected. The SNR/CNR/RC were moderately reduced at 3.0 T versus 1.5 T (muscle 42 vs 47 and bone 83 vs 112/46 vs 69/0.33 vs 0.43). Motion artefacts from the pulsating popliteal artery were significantly increased at 3.0 T. A visible and measurable signal loss occurred at 3.0 T using the built-in body coil compared with the dedicated 1.5 T knee coil, but nearly all clinically important information could be obtained. (orig.)

Is the body-coil at 3 Tesla feasible for the MRI evaluation of the painful knee? A comparative study.

Science.gov (United States)

Lutterbey, G; Behrends, K; Falkenhausen, M V; Wattjes, M P; Morakkabati, N; Gieseke, J; Schild, H

2007-02-01

The purpose of this study was to compare the in-built body coil of the 3.0-Tesla (T) scanner with a dedicated surface coil of a 1.5 T system regarding knee imaging. We performed an intraindividual prospective clinical trial on 17 patients with knee pain using magnetic resonance imaging (MRI) at 1.5 and 3.0 T systems equipped with identical gradient systems. Proton-density-weighted turbo spin echo sequences with the same spatial resolution and comparable contrast parameters were used. A quantitative measurement of signal to noise ratio (SNR), relative contrast (RC) and contrast to noise ratio (CNR) between muscle and bone marrow was performed, followed by a qualitative assessment of anatomic/pathologic structures and the extent of artefacts. At 3.0 T, 30 lesions (91%) compared to 33 lesions at 1.5 T were detected. The SNR/CNR/RC were moderately reduced at 3.0 T versus 1.5 T (muscle 42 vs 47 and bone 83 vs 112/46 vs 69/0.33 vs 0.43). Motion artefacts from the pulsating popliteal artery were significantly increased at 3.0 T. A visible and measurable signal loss occurred at 3.0 T using the built-in body coil compared with the dedicated 1.5 T knee coil, but nearly all clinically important information could be obtained.

Overuse Knee Injuries in Athletes

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Miroslav Kezunović

2013-03-01

Full Text Available According to many statistics over 55% of all sports-related injuries are incurred in the knee joint (active sportsmen and recreationists. The statistics definitely differ, depending on type of sport and specific movements habitually performed in a particular sport. Therefore, in addition to acute knee injuries overuse syndromes are common in the knee area also due to specificities of patellofemoral joint just because specific diseases like „jumper's knee“ and „runner's knee“ are related to certain sport activities. Generally speaking, these syndromes occur due to poor orientation of the knee extensor mechanism, i.e. friction of iliotibial band and patellofemoral chondromalacia. It is believed that about 45% of all overuse syndromes in the knee area occur as a result of running.

Cryotherapy impairs knee joint position sense.

Science.gov (United States)

Oliveira, R; Ribeiro, F; Oliveira, J

2010-03-01

The effects of cryotherapy on joint position sense are not clearly established; however it is paramount to understand its impact on peripheral feedback to ascertain the safety of using ice therapy before resuming exercise on sports or rehabilitation settings. Thus, the aim of the present study was to determine the effects of cryotherapy, when applied over the quadriceps and over the knee joint, on knee position sense. This within-subjects repeated-measures study encompassed fifteen subjects. Knee position sense was measured by open kinetic chain technique and active positioning at baseline and after cryotherapy application. Knee angles were determined by computer analysis of the videotape images. Twenty-minute ice bag application was applied randomly, in two sessions 48 h apart, over the quadriceps and the knee joint. The main effect for cryotherapy application was significant (F (1.14)=7.7, p=0.015) indicating an increase in both absolute and relative angular errors after the application. There was no significant main effect for the location of cryotherapy application, indicating no differences between the application over the quadriceps and the knee joint. In conclusion, cryotherapy impairs knee joint position sense in normal knees. This deleterious effect is similar when cryotherapy is applied over the quadriceps or the knee joint. Georg Thieme Verlag KG Stuttgart.New York.

Efficacy of individualized Chinese herbal medication in osteoarthrosis of hip and knee: a double-blind, randomized-controlled clinical study.

Science.gov (United States)

Lechner, Matthias; Steirer, Iva; Brinkhaus, Benno; Chen, Yun; Krist-Dungl, Claudia; Koschier, Alexandra; Gantschacher, Martina; Neumann, Kurt; Zauner-Dungl, Andrea

2011-06-01

The objective of this study was to determine the efficacy of individually designed herbal formulas according to the rules of Traditional Chinese Medicine (TCM) in patients with osteoarthritis of the hip and knee. This was a randomized, controlled, double-blind study with two parallel groups. This study was conducted at the University-centre in Gars am Kamp/Austria and was organized by the Institute of TCM and Complementary Medicine of the Danube University Krems /Austria. The study comprised female and male patients with osteoarthritis of hip or knee aged between 45 and 75 years. Patients were randomized into a treatment with individualized, water-based herbal decoctions prepared in a standardized cooking process (Verum group) or to a treatment with nonspecific presumably ineffective, water-based herbal decoctions (Control group). The primary outcome was the comparison of change between the intervention groups in the Western Ontario and McMaster Universities lower limb global index questionnaire (WOMAC global index) between baseline and week 20. Secondary outcomes included subscales of WOMAC for pain (A), stiffness (B), and functional impairment (C) and general quality of life in the form of the SF-36 questionnaire. Altogether, 102 patients were randomized in this trial. The demographic and medical baseline characteristics were comparable in the 2 groups. The change of the WOMAC global index and all three subscales was significant in both groups between week 20 and baseline (verum group, global WOMAC: at baseline 47 [SD ± 11.8] and at week 20: 24 (SD ± 18.3); change of mean 23; p > 0.001; control group; global WOMAC: at baseline: 48 (SD ± 14.7) and at week 20: 25 (SD ± 18.3); change of mean 23; p > 0.001). However, there was no significant difference (p = 0.783) between the treatment groups. There were significant changes in the subscales "physical functioning," "bodily pain," "vitality," "social-functioning," and "role-physical" of

Knee extensor strength and risk of structural, symptomatic and functional decline in knee osteoarthritis

DEFF Research Database (Denmark)

Culvenor, Adam G; Ruhdorfer, Anja; Juhl, Carsten

2017-01-01

OBJECTIVE: To perform a systematic review and meta-analysis on the association between knee extensor strength and the risk of structural, symptomatic, or functional deterioration in individuals with or at risk of knee osteoarthritis (KOA). METHODS: We systematically identified and methodologically...... appraised all longitudinal studies (≥1-year follow-up) reporting an association between knee extensor strength and structural (tibiofemoral, patellofemoral), symptomatic (self-reported, knee replacement), or functional (subjective, objective) decline in individuals with or at risk of radiographic......-analysis revealed that lower knee extensor strength was associated with an increased risk of symptomatic (WOMAC-Pain: odds ratio [OR] 1.35, 95% confidence interval [CI] 1.10, 1.67) and functional decline (WOMAC-Function: OR 1.38, 95%CI 1.00, 1.89; chair-stand task: OR 1.03, 95%CI 1.03, 1.04), but not increased risk...

Automatic locking orthotic knee device

Science.gov (United States)

Weddendorf, Bruce C. (Inventor)

1993-01-01

An articulated tang in clevis joint for incorporation in newly manufactured conventional strap-on orthotic knee devices or for replacing such joints in conventional strap-on orthotic knee devices is discussed. The instant tang in clevis joint allows the user the freedom to extend and bend the knee normally when no load (weight) is applied to the knee and to automatically lock the knee when the user transfers weight to the knee, thus preventing a damaged knee from bending uncontrollably when weight is applied to the knee. The tang in clevis joint of the present invention includes first and second clevis plates, a tang assembly and a spacer plate secured between the clevis plates. Each clevis plate includes a bevelled serrated upper section. A bevelled shoe is secured to the tank in close proximity to the bevelled serrated upper section of the clevis plates. A coiled spring mounted within an oblong bore of the tang normally urges the shoes secured to the tang out of engagement with the serrated upper section of each clevic plate to allow rotation of the tang relative to the clevis plate. When weight is applied to the joint, the load compresses the coiled spring, the serrations on each clevis plate dig into the bevelled shoes secured to the tang to prevent relative movement between the tang and clevis plates. A shoulder is provided on the tang and the spacer plate to prevent overextension of the joint.

Somatosensory abnormalities in knee OA.

Science.gov (United States)

Wylde, Vikki; Palmer, Shea; Learmonth, Ian D; Dieppe, Paul

2012-03-01

The aim of this study was to use quantitative sensory testing (QST) to explore the range and prevalence of somatosensory abnormalities demonstrated by patients with advanced knee OA. One hundred and seven knee OA patients and 50 age- and sex-matched healthy participants attended a 1-h QST session. Testing was performed on the medial side of the knee and the pain-free forearm. Light-touch thresholds were assessed using von Frey filaments, pressure pain thresholds using a digital pressure algometer, and thermal sensation and pain thresholds using a Thermotest MSA. Significant differences in median threshold values from knee OA patients and healthy participants were identified using Mann-Whitney U-tests. The z-score transformations were used to determine the prevalence of the different somatosensory abnormalities in knee OA patients. Testing identified 70% of knee OA patients as having at least one somatosensory abnormality. Comparison of median threshold values between knee OA patients and healthy participants revealed that patients had localized thermal and tactile hypoaesthesia and pressure hyperalgesia at the osteoarthritic knee. Tactile hypoaesthesia and pressure hyperalgesia were also present at the pain-free forearm. The most prevalent somatosensory abnormalities were tactile hypoaesthesia and pressure hyperalgesia, evident in between 20 and 34% of patients. This study found that OA patients demonstrate an array of somatosensory abnormalities, of which the most prevalent were tactile hypoaesthesia and pressure hyperalgesia. Further research is now needed to establish the clinical implications of these somatosensory abnormalities.

Contrast Enhancement Method Based on Gray and Its Distance Double-Weighting Histogram Equalization for 3D CT Images of PCBs

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Lei Zeng

2016-01-01

Full Text Available Cone beam computed tomography (CBCT is a new detection method for 3D nondestructive testing of printed circuit boards (PCBs. However, the obtained 3D image of PCBs exhibits low contrast because of several factors, such as the occurrence of metal artifacts and beam hardening, during the process of CBCT imaging. Histogram equalization (HE algorithms cannot effectively extend the gray difference between a substrate and a metal in 3D CT images of PCBs, and the reinforcing effects are insignificant. To address this shortcoming, this study proposes an image enhancement algorithm based on gray and its distance double-weighting HE. Considering the characteristics of 3D CT images of PCBs, the proposed algorithm uses gray and its distance double-weighting strategy to change the form of the original image histogram distribution, suppresses the grayscale of a nonmetallic substrate, and expands the grayscale of wires and other metals. The proposed algorithm also enhances the gray difference between a substrate and a metal and highlights metallic materials. The proposed algorithm can enhance the gray value of wires and other metals in 3D CT images of PCBs. It applies enhancement strategies of changing gray and its distance double-weighting mechanism to adapt to this particular purpose. The flexibility and advantages of the proposed algorithm are confirmed by analyses and experimental results.

Efficacy of pre-operative quadriceps strength training on knee-extensor strength before and shortly following total knee arthroplasty

DEFF Research Database (Denmark)

Husted, Rasmus Skov; Troelsen, Anders; Thorborg, Kristian

2018-01-01

BACKGROUND: Patients with knee osteoarthritis (OA) report knee pain, limitation in physical activities and low quality of life. The two primary treatments for knee OA are non-surgical treatment (e.g., exercise) and surgery (total knee arthroplasty (TKA)); however, national guidelines recommend non...

A randomized prospective triaI comparing oral sodium phosphate with magnesium citrate in preparing of patients for double contrast barium enema

International Nuclear Information System (INIS)