WorldWideScience

Sample records for knee joint lesions

  1. Unusual lesions that distend the knee joint: pictorial essay

    Energy Technology Data Exchange (ETDEWEB)

    Lima, Luana T. Barros de, E-mail: luanatbl@hotmail.com [Universidade Federal de Alagoas (HUPAA/UFAL), Maceio (Brazil). Hospital Universitario; Albuquerque Filho, Eolo Santana de; Batista, Laecio Leitao [Universidade Federal de Pernambuco (UFPE), Recife (Brazil). Hospital das Clinicas; Moraes, Talita Peixoto de [Clinica Derbimagem, Recife, PE (Brazil); Pereira, Bruno Perez Guedes [Instituto de Medicina Integral Professor Fernando Figueira (IMIP), Recife, PE (Brazil)

    2016-09-15

    The high number of knee imaging exams at radiology clinics, together with the wide variety of knee disorders, calls for expanding the knowledge about the less common lesions seen in routine diagnostic practice. The purpose of this pictorial essay was to illustrate unusual lesions that distend the knee joint, selected by relevance and evaluated with multiple imaging modalities, including X-ray, computed tomography, and magnetic resonance imaging, as well as to perform a brief review of the literature. (author)

  2. Echoscanning of knee joints in norm and in rheumatic lesions

    International Nuclear Information System (INIS)

    Potsybina, V.V.; Sivachenko, T.P.; Fed'ko, A.A.; Zakharchenko, R.P.

    1991-01-01

    Methods were elaborated and clinical possibilities of echoscanning (sonography) of knee joints in comprehensive clinicoradiological examination of patients with rheumatic diseases of joints were studied. A total of 25 healthy persons and 52 patients with systemic diseases of connective tissue were investigated. All the patients were subjected to clinical, laboratory, functional and x-ray examinations, and so osteoscintigraphy with 99m Tc-phosphate complexes and ultrasonography. An advantage of ultrasonography in comparison with roentgenography was noted

  3. The impact of elbow and knee joint lesions on abnormal gait and posture of sows

    Directory of Open Access Journals (Sweden)

    Jørgensen Bente

    2008-02-01

    Full Text Available Abstract Background Joint lesions occur widespread in the Danish sow population and they are the most frequent cause for euthanasia. Clinically, it is generally impossible to differentiate between various types of non-inflammatory joint lesions. Consequently, it is often necessary to perform a post mortem examination in order to diagnose these lesions. A study was performed in order to examine the relation of abnormal gait and posture in sows with specific joint lesions, and thereby obtaining a clinical diagnostic tool, to be used by farmers and veterinarians for the evaluation of sows with joint problems. Methods The gait, posture and lesions in elbow- and knee joints of 60 randomly selected sows from one herd were scored clinically and pathologically. Associations between the scorings were estimated. Results The variables 'fore- and hind legs turned out' and 'stiff in front and rear' were associated with lesions in the elbow joint, and the variables 'hind legs turned out' and 'stiff in rear' were associated with lesions in the knee joint. Conclusion It was shown that specified gait and posture variables reflected certain joint lesions. However, further studies are needed to strengthen and optimize the diagnostic tool.

  4. MRI of articular cartilaginous lesions. MRI findings in osteoarthritis of the knee joint

    International Nuclear Information System (INIS)

    Nozaki, Hiroyuki; Takezawa, Yuuichi; Suguro, Tohru; Igata, Atsuomi; Kudo, Yukihiko; Motegi, Mitsuo.

    1995-01-01

    An investigation was carried out to assess the usefulness of magnetic resonance imaging for imaging of the knee joint, especially for detecting articular cartilaginous lesions associated with osteoarthritis of the knee. A total of 141 patients with osteoarthritis were examined (23 males, 118 females). Their age range was 40-93 (mean age 66.2). Using radiotherapy examinations, patients were classified according to Hokkaido University Classification Criteria; 22, 49, 46, 16, and 8 patients were classified as Type I, II, III, IV and V, respectively. Articular cartilage defects were examined using MRI, and the number of such defects increased as the X-ray stage progressed. The appearance of a low signal intensity area in the bone marrow was examined using MRI, and the number of patients observed to have such areas increased as the x-ray stages progressed. JOA OA scores were significantly low for patients with meniscal tears. Patients were classified and results reviewed using MRI examinations. Classification by MRI of articular cartilage lesions correlated with the JOA OA scores. Low signal intensity areas in the bone marrow were frequently observed in advanced osteoarthritis cases, and there was correlation between FTA and MRI classifications of these areas. MRI is extremely valuable in detecting articular cartilage lesions in the knee joint, showing those lesions which cannot be detected by conventional radiography examinations. Thus, MRI is judged to be a clinically useful method for diagnosis of osteoarthritis. (author)

  5. 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.

  6. A spectroscopic approach to imaging and quantification of cartilage lesions in human knee joints

    International Nuclear Information System (INIS)

    Johansson, A; Oeberg, P A; Sundqvist, T; Kuiper, J-H

    2011-01-01

    We have previously described a technology based on diffuse reflectance of broadband light for measuring joint articular cartilage thickness, utilizing that optical absorption is different in cartilage and subchondral bone. This study is the first evaluation of the technology in human material. We also investigated the prospects of cartilage lesion imaging, with the specific aim of arthroscopic integration. Cartilage thickness was studied ex vivo in a number of sites (n = 87) on human knee joint condyles, removed from nine patients during total knee replacement surgery. A reflectance spectrum was taken at each site and the cartilage thickness was estimated using the blue, green, red and near-infrared regions of the spectrum, respectively. Estimated values were compared with reference cartilage thickness values (taken after sample slicing) using an exponential model. Two-dimensional Monte Carlo simulations were performed in a theoretical analysis of the experimental results. The reference cartilage thickness of the investigated sites was 1.60 ± 1.30 mm (mean ± SD) in the range 0-4.2 mm. Highest correlation coefficients were seen for the calculations based on the near-infrared region after normalization to the red region (r = 0.86) and for the green region (r = 0.80).

  7. MR Imaging of Degenerative Cartilage Lesions of the Knee Joint in Floor Layers and Graphic Designers

    DEFF Research Database (Denmark)

    Rytter, Søren; Thomsen, Birthe Lykke; Christensen, Birgitte Schütt

    2016-01-01

    Introduction: Kneeling work leads to an additional risk of developing knee osteoarthritis (OA). Previous studies have primarily been based on radiography, but radiography is limited by its inability to visualize articular cartilage, in which the earliest signs of OA occur. The objective of this e......Introduction: Kneeling work leads to an additional risk of developing knee osteoarthritis (OA). Previous studies have primarily been based on radiography, but radiography is limited by its inability to visualize articular cartilage, in which the earliest signs of OA occur. The objective...... of this explorative study, based on available data, was to examine the prevalence of magnetic resonance imaging (MRI)-detected knee cartilage lesions in male floor layers exposed to kneeling work, as compared to non-exposed male graphic designers. Methods: MRI of the knees was conducted in 92 floor layers and 49...... tibiofemoral posterior area, the most strained area during kneeling and 2) the total knee. Presence of lesions was compared in floor layers and graphic designers after adjusting for age, BMI, seniority, knee injuries, and sports activity in logistic regression analyses for correlated data, and investigated...

  8. MRI of degenerative bone marrow lesions in experimental osteoarthritis of canine knee joints

    Energy Technology Data Exchange (ETDEWEB)

    Nolte-Ernsting, C.C.A. [Department of Diagnostic Radiology, University of Technology, Aachen, Pauwelsstrasse 30, D-52057 Aachen (Germany); Adam, G. [Department of Diagnostic Radiology, University of Technology, Aachen, Pauwelsstrasse 30, D-52057 Aachen (Germany); Buehne, M. [Department of Diagnostic Radiology, University of Technology, Aachen, Pauwelsstrasse 30, D-52057 Aachen (Germany); Prescher, A. [Department of Anatomy, University of Technology, Aachen (Germany); Guenther, R.W. [Department of Diagnostic Radiology, University of Technology, Aachen, Pauwelsstrasse 30, D-52057 Aachen (Germany)

    1996-07-01

    Objective. The objective of this study was to determine the value of MRI in the detection of degenerative bone marrow abnormalities in an animal osteoarthritis model. Design. In 10 dogs with experimentally induced unilateral osteoarthritis of the knee, MRI was performed using two-dimensional spin-echo (2D-SE) and three-dimensional gradient-echo (3D-GE) imaging. Contrast enhanced T1-weighted 2D-SE sequences were also obtained after injection of gadolinium-DTPA. The results were compared with the gross and histopathologic findings and with radiography. Results. Histopathologic specimens revealed 21 osteosclerotic lesions and 5 intraosseous cysts. On 2D-SE images, 24 of 26 lesions were detected, while 21 of 26 lesions were identified on 2D-GE sequences. Radiography, including conventional tomography, demonstrated 9 of 26 lesions. Regardless of the sequence weighting, all osteosclerotic lesions appeared hypointense on MRI. Signal loss in bone sclerosis resulted primarily from the reduction of intact fat marrow, the increased bone density being of secondary importance. Quantitative signal analysis allowed approximate estimation of the grade of sclerosis. On postcontrast images, sclerotic bone remained hypointense, although significant but non-specific enhancement relative to the normal fat marrow was observed. The extent of contrast enhancement did not correlate with the grade of osteosclerosis. All five cysts were readily diagnosed by MRI. Cysts displayed either central or marginal contrast enhancement within their cavities. Conclusions. MRI provides a sensitive method for the diagnosis of osteoarthritic bone abnormalities, allowing their differentiation from most non-degenerative subarticular lesions. (orig.). With 1 tab.

  9. Indian Hedgehog in Synovial Fluid Is a Novel Marker for Early Cartilage Lesions in Human Knee Joint

    Science.gov (United States)

    Zhang, Congming; Wei, Xiaochun; Chen, Chongwei; Cao, Kun; Li, Yongping; Jiao, Qiang; Ding, Juan; Zhou, Jingming; Fleming, Braden C.; Chen, Qian; Shang, Xianwen; Wei, Lei

    2014-01-01

    To determine whether there is a correlation between the concentration of Indian hedgehog (Ihh) in synovial fluid (SF) and the severity of cartilage damage in the human knee joints, the knee cartilages from patients were classified using the Outer-bridge scoring system and graded using the Modified Mankin score. Expression of Ihh in cartilage and SF samples were analyzed with immunohistochemistry (IHC), western blot, and enzyme-linked immunosorbent assay (ELISA). Furthermore, we detected and compared Ihh protein levels in rat and mice cartilages between normal control and surgery-induced osteoarthritis (OA) group by IHC and fluorescence molecular tomography in vivo respectively. Ihh expression was increased 5.2-fold in OA cartilage, 3.1-fold in relative normal OA cartilage, and 1.71-fold in OA SF compared to normal control samples. The concentrations of Ihh in cartilage and SF samples was significantly increased in early-stage OA samples when compared to normal samples (r = 0.556; p Ihh protein was also an early event in the surgery-induced OA models. Increased Ihh is associated with the severity of OA cartilage damage. Elevated Ihh content in human knee joint synovial fluid correlates with early cartilage lesions. PMID:24786088

  10. Indian Hedgehog in Synovial Fluid Is a Novel Marker for Early Cartilage Lesions in Human Knee Joint

    Directory of Open Access Journals (Sweden)

    Congming Zhang

    2014-04-01

    Full Text Available To determine whether there is a correlation between the concentration of Indian hedgehog (Ihh in synovial fluid (SF and the severity of cartilage damage in the human knee joints, the knee cartilages from patients were classified using the Outer-bridge scoring system and graded using the Modified Mankin score. Expression of Ihh in cartilage and SF samples were analyzed with immunohistochemistry (IHC, western blot, and enzyme-linked immunosorbent assay (ELISA. Furthermore, we detected and compared Ihh protein levels in rat and mice cartilages between normal control and surgery-induced osteoarthritis (OA group by IHC and fluorescence molecular tomography in vivo respectively. Ihh expression was increased 5.2-fold in OA cartilage, 3.1-fold in relative normal OA cartilage, and 1.71-fold in OA SF compared to normal control samples. The concentrations of Ihh in cartilage and SF samples was significantly increased in early-stage OA samples when compared to normal samples (r = 0.556; p < 0.001; however, there were no significant differences between normal samples and late-stage OA samples. Up-regulation of Ihh protein was also an early event in the surgery-induced OA models. Increased Ihh is associated with the severity of OA cartilage damage. Elevated Ihh content in human knee joint synovial fluid correlates with early cartilage lesions.

  11. The acutely ACL injured knee assessed by MRI: changes in joint fluid, bone marrow lesions, and cartilage during the first year

    DEFF Research Database (Denmark)

    Frobell, R B; Le Graverand, M-P; Buck, R

    2008-01-01

    OBJECTIVES: To investigate changes in the knee during the first year after acute rupture of the anterior cruciate ligament (ACL) of volumes of joint fluid (JF), bone marrow lesions (BMLs), and cartilage volume (VC), and cartilage thickness (ThCcAB) and cartilage surface area (AC). To identify fac...

  12. Knee joint replacement

    Science.gov (United States)

    ... to make everyday tasks easier. Practice using a cane, walker , crutches , or a wheelchair correctly. On the ... ask your doctor Knee joint replacement - discharge Preventing falls Preventing falls - what to ask your doctor Surgical ...

  13. Osteonecrosis in the knee joint

    International Nuclear Information System (INIS)

    Poeschl, M.

    1981-01-01

    The following forms are discussed: spontaneous osteonecrosis (Ahlbaeck's necrosis), which extends subchondrally into one of the femur condyles. It usually occurs in older patients, especially females. Blunt trauma may cause similar lesions. These often occur with cartilage and bone avulsions (flake fractures), which are often diagnosed much later (arthroscopy). Patellar chondropathy is increasing in frequency due to more intensive participation in sports. Pain localized at the apex of the patella (patellar apex syndrome) can develop from chondropathy, tendon lesions or primary juvenile necrosis of the patellar apex. Gas emboli occur near the knee joint during deep sea diving. Similar cartilage infarctions are seen in many hemoglobinopathies. The incidence of this is increasing due to the increased number of people immigrating from regions were these diseases are common. We have also observed vascular juvenile lesions of the epi- and metaphyses in Klippel-Trenaunay-Weber's syndrome. Their radiological appearance is similar to that of necroses. (orig.) [de

  14. Osteonecrosis in the knee joint

    Energy Technology Data Exchange (ETDEWEB)

    Poeschl, M

    1981-12-01

    The following forms are discussed: spontaneous osteonecrosis (Ahlbaeck's necrosis), which extends subchondrally into one of the femur condyles. It usually occurs in older patients, especially females. Blunt trauma may cause similar lesions. These often occur with cartilage and bone avulsions (flake fractures), which are often diagnosed much later (arthroscopy). Patellar chondropathy is increasing in frequency due to more intensive participation in sports. Pain localized at the apex of the patella (patellar apex syndrome) can develop from chondropathy, tendon lesions or primary juvenile necrosis of the patellar apex. Gas emboli occur near the knee joint during deep sea diving. Similar cartilage infarctions are seen in many hemoglobinopathies. The incidence of this is increasing due to the increased number of people immigrating from regions where these diseases are common. We have also observed vascular juvenile lesions of the epi- and metaphyses in Klippel-Trenaunay-Weber's syndrome. Their radiological appearance is similar to that of necroses.

  15. Recruitment of knee joint ligaments

    NARCIS (Netherlands)

    Blankevoort, L.; Huiskes, H.W.J.; Lange, de A.

    1991-01-01

    On the basis of earlier reported data on the in vitro kinematics of passive knee-joint motions of four knee specimens, the length changes of ligament fiber bundles were determined by using the points of insertion on the tibia and femur. The kinematic data and the insertions of the ligaments were

  16. Value of knee joint arthrography

    International Nuclear Information System (INIS)

    Luzsa, Gyoergy; Kiss Toth, Peter

    1985-01-01

    On the basis of the literature and the analysis of 204 examinations, the method and clinical application of knee joint arthrography are reviewed. 50 out of the 54 operated cases were perfectly diagnosed. The double contrast knee joint arthrography can be applied to detect meniscus changes, popliteal cysts, synovial disorders and chondral defects. The effectiveness of arthrography and arthroscopy was compared and the introduction of the former in each county seat is suggested. (author)

  17. Generalised joint hypermobility and knee joint hypermobility

    DEFF Research Database (Denmark)

    Junge, Tina; Henriksen, Peter; Hansen, Sebrina

    2018-01-01

    . Respondents with GJHk and KJH reported lower HRQoL. CONCLUSION: GJHk and KJH were frequently reported in the Danish adult population, mostly in women. Respondents with GJHk and KJH were two times more likely to report knee joint-related symptoms such as pain, reduced performance of usual activity and lower...

  18. Magnetic resonance in cartilaginous lesions of the knee joint with three-dimensional gradient-echo imaging

    International Nuclear Information System (INIS)

    Reiser, M.F.; Bongartz, G.; Erlemann, R.; Gaebert, K.; Stoeber, U.; Peters, P.E.; Strobel, M.; Pauly, T.

    1988-01-01

    Diagnosis of chondromalacia of the patellofemoral joint using three-dimensional gradient-echo sequences was investigated in 41 patients, with arthroscopic verification in 25 patients. In vitro examinations in human caderveric patellae were performed in order to determine optimal imaging parameters. FLASH (T R =40 ms, T E =10 ms, flip angle=30 0 ) and FISP (T R =40 ms, T E =10 ms, flip angle=40 0 ) were used in clinical studies. The therapeutically relevant differentiation of major and minor degrees of chondromalacia seems to be possible. 30 0 FLASH-images in the axial plane proved to be the most efficacious technique for the diagnosis of chondromalacia. (orig./GDG)

  19. Magnetic resonance in cartilaginous lesions of the knee joint with three-dimensional gradient-echo imaging

    Energy Technology Data Exchange (ETDEWEB)

    Reiser, M.F.; Bongartz, G.; Erlemann, R.; Gaebert, K.; Stoeber, U.; Peters, P.E.; Strobel, M.; Pauly, T.

    1988-10-01

    Diagnosis of chondromalacia of the patellofemoral joint using three-dimensional gradient-echo sequences was investigated in 41 patients, with arthroscopic verification in 25 patients. In vitro examinations in human caderveric patellae were performed in order to determine optimal imaging parameters. FLASH (T/sub R/=40 ms, T/sub E/=10 ms, flip angle=30/sup 0/) and FISP (T/sub R/=40 ms, T/sub E/=10 ms, flip angle=40/sup 0/) were used in clinical studies. The therapeutically relevant differentiation of major and minor degrees of chondromalacia seems to be possible. 30/sup 0/ FLASH-images in the axial plane proved to be the most efficacious technique for the diagnosis of chondromalacia. (orig./GDG).

  20. Automatic locking knee brace joint

    Science.gov (United States)

    Weddendorf, Bruce (Inventor)

    1995-01-01

    This invention is an apparatus for controlling the pivotal movement of a knee brace comprising a tang-and-clevis joint that has been uniquely modified. Both the tang and the clevis have a set of teeth that, when engaged, can lock the tang and the clevis together. In addition, the tang is biased away from the clevis. Consequently, when there is no axial force (i.e., body weight) on the tang, the tang is free to pivot within the clevis. However, when an axial force is exerted on the tang, the tang is pushed into the clevis, both sets of teeth engage, and the tang and the clevis lock together.

  1. THE METHOD OF KNEE JOINT ARTHRODESIS

    Directory of Open Access Journals (Sweden)

    V. G. Fedorov

    2011-01-01

    Full Text Available The usage of bone plastics by cylindrical autotransplant in cases of posttraumatic changes of knee joint is described. Knee joint arthrodesis is supposed to be used as alternate in term of replacement impossibility (for example, high-grade deformity, the age (osteoporosis, concomitant diseases that can lead to complicate operation.

  2. 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...

  3. 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...

  4. 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...

  5. 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.

  6. The volume of the human knee joint.

    Science.gov (United States)

    Matziolis, Georg; Roehner, Eric; Windisch, Christoph; Wagner, Andreas

    2015-10-01

    Despite its clinical relevance, particularly in septic knee surgery, the volume of the human knee joint has not been established to date. Therefore, the objective of this study was to determine knee joint volume and whether or not it is dependent on sex or body height. Sixty-one consecutive patients (joints) who were due to undergo endoprosthetic joint replacement were enrolled in this prospective study. During the operation, the joint volume was determined by injecting saline solution until a pressure of 200 mmHg was achieved in the joint. The average volume of all knee joints was 131 ± 53 (40-290) ml. The volume was not found to be dependent on sex, but it was dependent on the patients' height (R = 0.312, p = 0.014). This enabled an estimation of the joint volume according to V = 1.6 height - 135. The considerable inter-individual variance of the knee joint volume would suggest that it should be determined or at least estimated according to body height if the joint volume has consequences for the diagnostics or therapy of knee disorders.

  7. Conventional angiography in comparison with magnetic resonance tomography and arthroscopy for the diagnosis of knee joint lesion - specific indications?; Die konventionelle Arthrographie im Vergleich zu Magnetresonanztomographie und Arthroskopie bei Kniegelenkbinnenlaesionen: Verbleiben Indikationen?

    Energy Technology Data Exchange (ETDEWEB)

    Koenig, H. [Universitaetsklinikum Steglitz, Radiologische Klinik, Abt. fuer Roentgendiagnostik und Nuklearmedizin, FU Berlin (Germany); Andresen, R. [Universitaetsklinikum Steglitz, Radiologische Klinik, Abt. fuer Roentgendiagnostik und Nuklearmedizin, FU Berlin (Germany); Radmer, S. [Orthopaedisches Institut, Berlin (Germany); Schmidt, M. [Krankenhaus Moabit, Roentgenabteilung, Berlin (Germany); Wolf, K.J. [Universitaetsklinikum Steglitz, Radiologische Klinik, Abt. fuer Roentgendiagnostik und Nuklearmedizin, FU Berlin (Germany)

    1995-03-01

    Twenty-one patients with suspected internal knee joint lesions were examined prospectively. In all patients an MRI was carried out first and was followed within two weeks by an arthrography and an arthrocopy. Lesions of the menisci, cruciate ligaments, hyaline cartilage, and synovial tissues were evaluated. Arthroscopy findings were defined as the `gold standard`. MRI achieved an accuracy of 96.4%, a sensitivity of 93.6%, and a specifity of 92.5%, whereas arthrography achieved an accuracy of 67.8%, a sensitivity of 66.6%, and a specifity of 71.4%. These statistical data as well as the single findings revealed no special indications for arthrography in suspected knee joint lesions. (orig.) [Deutsch] In einer prospektiven Studie wurden insgesamt 21 Patienten mit suspekten Kniegelenksbinnenlaesionen untersucht. Bei allen Patienten erfolgte zunaechst eine Magnetresonanztomographie (MRT), anschliessend innerhalb von zwei Wochen eine Arthrographie und Arthroskopie des Kniegelenks. Beurteilt wurden Laesionen der Meniski, der Kreuzbaender, des hyalinen Gelenkknorpels und des Synovialgewebes. Bezogen auf den Arthroskopiebefund als `Gold-Standard` erreichte die MRT eine Treffsicherheit von 96,4%, eine Sensitivitaet von 93,6% und eine Spezifitaet von 92,5%; dagegen die Arthrographie eine Treffsicherheit von 67,8%, eine Sensitivitaet von 66,6% und eine Spezifitaet von 71,4%. Sowohl eine Uebersicht als auch die Auswertung der Einzelbefunde ergaben keine speziellen Indikationen zur Durchfuehrung einer Kniegelenksarthrographie bei suspekten Binnenlaesionen. (orig.)

  8. Knee joint vibroarthrographic signal processing and analysis

    CERN Document Server

    Wu, Yunfeng

    2015-01-01

    This book presents the cutting-edge technologies of knee joint vibroarthrographic signal analysis for the screening and detection of knee joint injuries. It describes a number of effective computer-aided methods for analysis of the nonlinear and nonstationary biomedical signals generated by complex physiological mechanics. This book also introduces several popular machine learning and pattern recognition algorithms for biomedical signal classifications. The book is well-suited for all researchers looking to better understand knee joint biomechanics and the advanced technology for vibration arthrometry. Dr. Yunfeng Wu is an Associate Professor at the School of Information Science and Technology, Xiamen University, Xiamen, Fujian, China.

  9. 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.

  10. The cyclops lesion after bicruciate-retaining total knee replacement

    Directory of Open Access Journals (Sweden)

    Mark A. Klaassen, MD, FACS

    2017-12-01

    Full Text Available The cyclops lesion is a localized anterior arthrofibrosis most commonly seen following anterior cruciate ligament reconstruction. The lesion forms at the anterior cruciate ligament insertion creating a painful extension block between femoral intercondylar notch and tibial plateau. We present 2 cases (3 knees in which cyclops lesions appeared atypically following bicruciate-retaining total knee replacement. Two lesions occurred in a single patient following bilateral knee replacement. One lesion occurred in an active sportswoman. All 3 resolved following arthroscopic debridement. We describe the presentation of this unusual complication and suggest keys to its diagnosis, treatment, and prevention. Keywords: Cyclops lesion, Bicruciate-retaining, Total knee arthroplasty, Extension deficit

  11. The cyclops lesion after bicruciate-retaining total knee replacement

    OpenAIRE

    Klaassen, Mark A.; Aikins, Jerry L.

    2017-01-01

    The cyclops lesion is a localized anterior arthrofibrosis most commonly seen following anterior cruciate ligament reconstruction. The lesion forms at the anterior cruciate ligament insertion creating a painful extension block between femoral intercondylar notch and tibial plateau. We present 2 cases (3 knees) in which cyclops lesions appeared atypically following bicruciate-retaining total knee replacement. Two lesions occurred in a single patient following bilateral knee replacement. One les...

  12. Comparison between two.magnetic resonance sequences (spin-echo and gradient-echo) in the analysis of lesions of the knee joint meniscus

    International Nuclear Information System (INIS)

    Marti-Bonati, L.; Casillas, C.

    1999-01-01

    To compare the diagnostic reliability, the proportion of common diagnoses and the degree of agreement between the results of two magnetic resonance (MR) sequences in the diagnosis of lesions of the meniscus of the knee. One hundred consecutive patients were studied prospectively by MR (1,5 Teslas). All of them underwent T1-weighted spin-echo and T1 and T2-weighted gradient-echo sequences. The final diagnosis was based on the combined results of four imaging sequences. The sensitivity, specificity, positive predictive value (PPV) and negative predictive (NPV) in terms of the final diagnosis were calculated for each meniscus and MR technique. The chi.squared test and kappa test were employed for the statistical analysis. There were discrepancies between the final diagnosis and the spin-echo sequence in 4 cases and between the final diagnosis and the gradient-echo sequences in 5 Both spin-echo and gradient-echo sequences showed the same diagnostic reliabilities: sensitivity of 0.98, specificity of 0.99, PPV of 0.98 and NPV of 0.99. The correlation between the two sequences was highly significant (chi-squared, p < 0.001) with a very high rate of agreement (kappa=0.84). The two sequences can be considered equally reliable in the study of meniscal lesions. (Author) 7 refs

  13. The MRI appearance of cystic lesions around the knee

    International Nuclear Information System (INIS)

    McCarthy, Catherine L.; McNally, Eugene G.

    2004-01-01

    This review presents a comprehensive illustrated overview of the wide variety of cystic lesions around the knee. The aetiology, clinical presentation, MRI appearances and differential diagnosis are discussed. Bursae include those related to the patella as well as pes anserine, tibial collateral ligament, semimembranosus-tibial collateral ligament, iliotibial and fibular collateral ligament-biceps femoris. The anatomical extension, imaging features and clinical significance of meniscal cysts are illustrated. Review of ganglia includes intra-articular, extra-articular, intraosseous and periosteal ganglia, highlighting imaging findings and differential diagnoses. The relationship between proximal tibiofibular joint cysts and intraneural peroneal nerve ganglia is discussed. Intraosseous cystic lesions, including insertional and degenerative cysts, as well as lesions mimicking cysts of the knee are described and illustrated. Knowledge of the location, characteristic appearance and distinguishing features of cystic masses around the knee as well as potential imaging pitfalls such as normal anatomical recesses and atypical cyst contents on MR imaging aids in allowing a specific diagnosis to be made. This will prevent unnecessary additional investigations and determine whether intra-articular surgery or conservative management is appropriate. (orig.)

  14. Regenerative strategies for the treatment of knee joint disabilities

    CERN Document Server

    Reis, Rui

    2017-01-01

    This book presents regenerative strategies for the treatment of knee joint disabilities. The book is composed of four main sections totaling 19 chapters which review the current knowledge on the clinical management and preclinical regenerative strategies. It examines the role of different natural-based biomaterials as scaffolds and implants for addressing different tissue lesions in the knee joint. Section one provides an updated and comprehensive discussion on articular cartilage tissue regeneration. Section two focuses on the important contributions for bone and osteochondral tissue engineering. Section three overview the recent advances on meniscus repair/regeneration strategies. Finally, section four further discusses the current strategies for treatment of ligament lesions. Each chapter is prepared by world know expert on their fields, so we do firmly believe that the proposed book will be a reference in the area of biomaterials for regenerative medicine.

  15. Computed tomography of the knee joint

    International Nuclear Information System (INIS)

    Jang, Byung Won; Kwon, Jung Hyeok; Park, Sung Hak; Kim, Tae Hun; Park, In Kyu; Kim, Yong Joo; Kang, Duk Sik; Kwon, Sae Hong

    1986-01-01

    Diagnosis of knee joint pathology has been mainly dependent on clinical manifestations and invasive procedures such as arthrography and arthroscopy etc. However, these procedures are invasive. Arthroscopy is performed under general anesthesia. Recently, with development of high resolution CT with thin slices and multiplanar reconstructions capability, CT could be used to verify the internal structures of knee joint in noninvasive or less invasive way. From June to December 1985, authors have experienced 19 cases of the knee joint CT. Among them, 13 cases were operated and confirmed. We concluded as follows. 1. The diagnostic accuracy of the knee CT was 100% in lateral meniscal tearing, 92.3% in medial mensical tearing, 92.3% in detachment of lateral collateral ligament, 92.3% in medial collateral ligament, 100% in tearing of cruciate ligaments. 2. CT could be considered as a primary diagnostic procedure in the knee pathology rather than more invasive arthroscopy or arthrography. 3. For the accurate diagnosis of knee joint pathology, CT, which can obtain thin slies, high resolution, multiplanar reconstructions, is indispensable.

  16. 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

  17. 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.

  18. Results of arthroscopic joint debridement in different stages of chondromalacia of the knee joint.

    Science.gov (United States)

    Krüger, T; Wohlrab, D; Birke, A; Hein, W

    2000-01-01

    A retrospective study was performed of 161 patients who had undergone arthroscopic operation for chondromalacia of the knee joint. After an average follow-up period of 40 (range 10-72) months, patients with severe articular cartilage lesions who had undergone articular lavage alone showed significantly poorer results (P chondromalacia and having undergone the same surgical procedure, younger patients showed better results than older patients. The more effective interruption of the circulus vitiosus during the development of degenerative joint diseases is the primary cause for better results achieved by mechanical debridement of the joint for patients suffering from grade 2 or higher. According to the literature, aggressive subchondral abrasion in severely degenerated knees does not show any benefits. Apparently, the success of the therapy depends to a great extent on the inferiority of the potential degenerative regenerate (lack of capacity of intrinsic regeneration of the hyaline cartilage) as well as on the grade and the progression of chondromalacia. Almost every second patient suffering from grade 4 chondromalacia complained of recurrent pain 1 year postoperatively. One of every 6 patients received a knee joint prosthesis within the 1st year. Therefore, the patients' preoperative expectations have to be clearly objectified. The surgical procedure as an operation with a low complication risk can also be justified as a temporary alternative to total knee arthroplasty in patients suffering from a high-grade degeneration of the joint.

  19. 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.

  20. Associations Between Knee Effusion-synovitis and Joint Structural Changes in Patients with Knee Osteoarthritis.

    Science.gov (United States)

    Wang, Xia; Jin, Xingzhong; Blizzard, Leigh; Antony, Benny; Han, Weiyu; Zhu, Zhaohua; Cicuttini, Flavia; Wluka, Anita E; Winzenberg, Tania; Jones, Graeme; Ding, Changhai

    2017-11-01

    To describe the associations between effusion-synovitis and joint structural abnormalities in patients with knee osteoarthritis (OA) over 24 months. A posthoc analysis using data from a randomized controlled trial in 413 patients with symptomatic OA (aged 63 ± 7 yrs, 208 women). Knee effusion-synovitis volume and score, cartilage defects, cartilage volume, and bone marrow lesions (BML) were assessed using magnetic resonance imaging. Joint space narrowing (JSN) and osteophytes were assessed using radiograph. Least significant change criterion was used to define change in effusion-synovitis volume. Knee symptoms were assessed by Western Ontario and McMaster University OA Index. Multivariable linear/logistic regression and multilevel generalized mixed-effects models were used in longitudinal analyses. Total effusion-synovitis volume increased modestly from baseline (8.0 ± 8.5 ml) to followup (9.0 ± 10.5 ml). Baseline BML, cartilage defect, JSN, and osteophyte scores were positively associated with change in effusion-synovitis volume (p effusion-synovitis score (p effusion-synovitis score nor volume consistently predicted change in the above structures except cartilage volume. In the mixed-effects models, knee effusion-synovitis was positively associated with BML (volume: β = 1.19 ml/grade; score: OR = 1.75/grade) and cartilage defects (volume: β = 1.87 ml/grade; score: OR = 2.22/grade), while negatively associated with cartilage volume loss. Change in effusion-synovitis volume was positively correlated with changes in knee pain and stiffness scores (p effusion-synovitis, but effusion-synovitis did not predict knee structural changes. These findings suggest that synovial inflammation is likely the result of joint structural abnormalities in established OA. ClinicalTrials.gov identifier: NCT01176344. Australian New Zealand Clinical Trials Registry: ACTRN12610000495022.

  1. Intra-articular lipoma with osteochondroid metaplasia in the knee joint

    Energy Technology Data Exchange (ETDEWEB)

    Lee, F.Y.I. [Dept. of Orthopaedic Surgery, College of Physicians and Surgeons of Columbia University, New York, NY (United States); Orthopaedic Oncology Unit and Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA (United States); Keel, S.B. [Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States); Gebhardt, M.C. [Orthopaedic Oncology Unit and Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA (United States); Rosenthal, D.I. [Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States)

    2001-04-01

    We describe a case of lipoma with osteochondroid metaplasia in the knee joint. Although the location of the lesion and radiographic findings were unusual, computed tomography and magnetic resonance imaging were useful in characterizing adipose, cartilaginous and osseous tissue components within the lesion. (orig.)

  2. Techniques for assessing knee joint pain in arthritis

    Directory of Open Access Journals (Sweden)

    Fu Yu

    2007-03-01

    Full Text Available Abstract The assessment of pain is of critical importance for mechanistic studies as well as for the validation of drug targets. This review will focus on knee joint pain associated with arthritis. Different animal models have been developed for the study of knee joint arthritis. Behavioral tests in animal models of knee joint arthritis typically measure knee joint pain rather indirectly. In recent years, however, progress has been made in the development of tests that actually evaluate the sensitivity of the knee joint in arthritis models. They include measurements of the knee extension angle struggle threshold, hind limb withdrawal reflex threshold of knee compression force, and vocalizations in response to stimulation of the knee. A discussion of pain assessment in humans with arthritis pain conditions concludes this review.

  3. A new approach to knee joint arthroplasty.

    Science.gov (United States)

    Zarychta, P

    2018-04-01

    The main aim of this new approach dedicated to knee arthroplasty is to provide an automated method for determining the cutting planes of both the head of femur and the head of tibia in knee replacement surgery. This paper shows a new approach differing from standard procedures associated with manual determination of the mechanical axis of the lower extremity (during surgery) and replacing them with a procedure based on the imprints (with selected cutting planes) of the two heads of bones. Both these imprints have been performed on the basis of the toposcan of the lower limb (before surgery). This methodology has been implemented in MATLAB and tested in clinical CT images of the lower limb in the coronal and transverse planes (61 studies) and in clinical MRI studies of the knee joint in coronal plane (107 studies). Correct results were obtained for about 90% cases. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Comparison between rheumatoid arthritis and osteoarthritis on knee joint MRI

    International Nuclear Information System (INIS)

    Wang Zhi; Meng Xianghong, Suo Yongmei; Wan Yeda

    2013-01-01

    Objective: To compare the MRI characteristics between the late stage rheumatoid arthritis (RA) and osteoarthritis (OA) in the knee joints. Materials and Methods: We collected knee joints MR data using 0.35 T MR from 40 patients with rheumatoid arthritis and 60 cases with osteoarthritis between July, 2010 and August, 2012. We compared the differences in the menisci, the articular cartilage, the subchondral bone, and synovial lesions between the two groups. We calculated the morbidity and analyzed the severity in each part in both groups, and compared the differences between the two groups. If P<0.05, the results had statistical significance. Results: The injury of all parts in the medial and lateral menisci in the RA group was more severe than in the OA group (P<0.05). The articular cartilage of lateral tibiofemoral joints in the RA group was more severe than in the OA group (Z values of the lateral femoral condyle and the lateral tibial plateau were 5.702 vs. 7.534, P<0.05). However, the injury did not significantly differ at the articular cartilage in the patellofemoral joints and in the medial tibiofemoral joints (P>0.05). The subchondral bone marrow lesions of both medial and lateral tibiofemoral joints in the RA group were more severe than in the OA group (the χ 2 values of the medial and lateral femoral condyle were 6.730 and 23.938, respectively; the χ 2 values of the medial and lateral tibial plateau were 12.033 and 41.017, respectively; P<0.05). However, there was no statistical significance in the subchondral bone marrow lesions in the patellofemoral joints (P>0.05). In the RA group, there were 97.5% (39/40) cases having diffuse synovial thickening, including 20 cases with bone destruction in the bare area. In the OA group, there were 21.7% (13/60) cases having synovial thickening with less extend compared to RA group, none of them had bone destruction in the bare area. Conclusions: There are diffuse synovial thickening, bare area destruction, diffuse

  5. 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.

  6. Imaging of the knee joint with emphasis on magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Reiser, M.F. [Radiologische Universitaetsklinik, Rheinische Friedrich-Wilhelms-Univ., Bonn (Germany); Vahlensieck, M. [Radiologische Universitaetsklinik, Rheinische Friedrich-Wilhelms-Univ., Bonn (Germany); Schueller, H. [Radiologische Universitaetsklinik, Rheinische Friedrich-Wilhelms-Univ., Bonn (Germany)

    1992-04-01

    The knee joint is frequently affected by trauma as well as degenerative and inflammatory disorders, involving the internal structures (i.e. ligaments, menisci, cartilage, synovial membrane) and the adjacent bones. Plain radiographs represent an indispensable basis for diagnosis. For further analysis magnetic resonance imaging (MRI) has become the method of choice, and has widely replaced computed tomography, arthrography and stress examinations. Extensive experience has been accumulated in MRI of the knee joint in recent years. In addition, advances in MRI technology have had a major impact on diagnostic accuracy. In this paper, diagnosis of various lesions of the knee joint, such as meniscal and ligamental injuries, aseptic necrosis, lesions of the hyaline cartilage, occult fractures and inflammatory lesions will be discussed. (orig.)

  7. [Ski shoe versus knee joint--3: Risk for falling backward].

    Science.gov (United States)

    Schaff, P; Hauser, W

    1990-12-01

    In contrast to the drop in the incidence of fractures of the lower leg that has been observed in recent years, the incidence of knee injuries has not decreased in skiing. There has even been a relative increase of severe knee lesions and isolated ACL ruptures, prompting us to conduct a comprehensive study of the causes of this phenomena. The goal of the study was to develop a new measuring device for alpine skiing research by combining motion analysis, pressure and force measurement, comprehensive examine the forward/backward movement in skiboots in the lab and by means of telemetry on the slope (Skiboot versus knee joint part 1/Sportverlerletzung. Sportschaden 3, 1989, pp. 149-161) and to come up with a proposal for a new safety concept to reduce the high number of knee injuries in alpine skiing in the future. The first study was devoted to the forward movement in skiboots (Skiboot versus knee joint part 2/Sportverletzung. Sportschaden 4, 1990, pp. 1-13). The results showed that a skiing style in backward lean position was adopted by skiers wearing boots with a stiff forward flexion and was supported by the fixed backward spoiler. In order to quantify the influence of the backward spoiler a special skiboot was constructed allowing the rear spoiler to give way at a variable, defined stiffness and register the angular displacement and horizontal force Fh. The results showed most clearly that even a medium rear spoiler resistance will sign, reduce the peak force values by a factor of 5.5. The acceleration at the knee joint level is significantly higher (factor 1.6, p less than 0.05) in case of a rigid spoiler. The lab tests could be confirmed on the slope (sign. reduction of max. force by factor 8). It also proved that normal skiing can be performed in such a boot without limitations. In consideration of our facts it is concluded that the principle of safety bindings must definitely apply in future in equal measure also to the ski boot. As a proposal for future

  8. Morel-Lavallee lesion in the knee: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Pitrez, Eduardo Hennemann, E-mail: epitrez@terra.com.b [Clinica Radiologica Osorio Lopes, Porto Alegre, RS (Brazil); Pellanda, Roberto Campos; Silva, Mariana Eltz; Holz, Gustavo Garcia; Hertz, Felipe Teixeira [Pontificia Univ. Catolica do Rio Grande do Sul (PUCRS), Porto Alegre, RS (Brazil). Hospital Sao Lucas; Hoefel Filho, Joao Rubiao [Pontificia Univ. Catolica do Rio Grande do Sul (PUCRS), Porto Alegre, RS (Brazil). Center of Imaging Diagnosis

    2010-09-15

    Morel-Lavallee lesion is a degloving injury of the interface between the subcutaneous fat and the underlying fascia. This lesion is characterized by the development of a fluid collection that, although originally described in the thigh, it has also been described in other anatomical sites. The authors report the case of a patient with Morel-Lavallee lesion in the knee after trauma and describe the main characteristics of the lesion. (author)

  9. Morel-Lavallee lesion in the knee: a case report

    International Nuclear Information System (INIS)

    Pitrez, Eduardo Hennemann; Pellanda, Roberto Campos; Silva, Mariana Eltz; Holz, Gustavo Garcia; Hertz, Felipe Teixeira; Hoefel Filho, Joao Rubiao

    2010-01-01

    Morel-Lavallee lesion is a degloving injury of the interface between the subcutaneous fat and the underlying fascia. This lesion is characterized by the development of a fluid collection that, although originally described in the thigh, it has also been described in other anatomical sites. The authors report the case of a patient with Morel-Lavallee lesion in the knee after trauma and describe the main characteristics of the lesion. (author)

  10. Who should have knee joint replacement surgery for osteoarthritis?

    DEFF Research Database (Denmark)

    Dieppe, Paul; Lim, Keith; Lohmander, Stefan

    2011-01-01

    Knee joint replacement is an effective and cost-effective intervention for severe symptomatic osteoarthritis of the knee joint. However, utilisation rates vary hugely, there are no indications, it is difficult to know when (in the course of arthritis) it is best to operate, and some 10-20% of peo......Knee joint replacement is an effective and cost-effective intervention for severe symptomatic osteoarthritis of the knee joint. However, utilisation rates vary hugely, there are no indications, it is difficult to know when (in the course of arthritis) it is best to operate, and some 10...

  11. 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 ...

  12. Degenerative joint disease on MRI and physical activity: a clinical study of the knee joint in 320 patients

    International Nuclear Information System (INIS)

    Bachmann, G.F.; Rauber, K.; Damian, M.S.; Rau, W.S.; Basad, E.

    1999-01-01

    We examined 320 patients with MRI and arthroscopy after an acute trauma to evaluate MRI in diagnosis of degenerative joint disease of the knee in relation to sports activity and clinical data. Lesions of cartilage and menisci on MRI were registered by two radiologists in consensus without knowledge of arthroscopy. Arthroscopy demonstrated grade-1 to grade-4 lesions of cartilage on 729 of 1920 joint surfaces of 320 knees, and MRI diagnosed 14 % of grade-1, 32 % of grade-2, 94 % of grade-3, and 100 % of grade-4 lesions. Arthroscopy explored 1280 meniscal areas and showed degenerations in 10 %, tears in 11.4 %, and complex lesions in 9.2 %. Magnetic resonance imaging was in agreement with arthroscopy in 81 % showing more degenerations but less tears of menisci than arthroscopy. Using a global system for grading the total damage of the knee joint into none, mild, moderate, or severe changes, agreement between arthroscopy and MRI was found in 82 %. Magnetic resonance imaging and arthroscopy showed coherently that degree of degenerative joint changes was significantly correlated to patient age or previous knee trauma. Patients over 40 years had moderate to severe changes on MRI in 45 % and patients under 30 years in only 22 %. Knee joints with a history of trauma without complete structural or functional reconstitution showed marked changes on MRI in 57 %, whereas stable joints without such alterations had degenerative changes in only 26 %. There was no correlation of degenerative disease to gender, weight, type, frequency, and intensity of sports activity. Therefore, MRI is an effective non-invasive imaging method for exact localization and quantification of chronic joint changes of cartilage and menisci that recommends MRI for monitoring in sports medicine. (orig.) (orig.)

  13. Experimental osteoarthritis in the rabbit knee joint

    International Nuclear Information System (INIS)

    Bohr, H.

    1976-01-01

    development of arthrotic-like changes following resection of the of the cruciate ligaments in the knee joint of rabbits has been studied at intervals from 2 weeks to 10 months in 35 animals. Signs of cartilage degeneration were followed by changes in the subchondral bone, where formation of osteophytes and condensation to took place. An increased vascular supply was demonstrated by microangiographic and scintigraphic investigations. The uptake of 18 F and 99 mTc-polyphosphate reached a maximal value about 2 months after the operation and then diminished despite further development of arthrotic changes. (author)

  14. Experience with Ultrasound of the Knee Joint at Mulago Hospital ...

    African Journals Online (AJOL)

    jen

    patients referred to the Radiology department with knee joint pathology were studied. ..... In Uganda, rugby and soccer sports are dominated by the elite .... Detection of Joint Effusions Academic Emergency Medicine Volume 8, Number 4 361- ...

  15. Bone marrow edema of the knee joint

    International Nuclear Information System (INIS)

    Breitenseher, M.J.; Mayerhoefer, M.E.; Hofmann, S.

    2006-01-01

    Bone marrow edema of the knee joint is a frequent clinical picture in MR diagnostics. It can be accompanied by symptoms and pain in the joint. Diseases that are associated with bone marrow edema can be classified into different groups. Group 1 includes vascular ischemic bone marrow edema with osteonecrosis (synonyms: SONK or Ahlbaeck's disease), osteochondrosis dissecans, and bone marrow edema syndrome. Group 2 comprises traumatic or mechanical bone marrow edema. Group 3 encompasses reactive bone marrow edemas such as those occurring in gonarthrosis, postoperative bone marrow edemas, and reactive edemas in tumors or tumorlike diseases. Evidence for bone marrow edema is effectively provided by MRI, but purely morphological MR information is often unspecific so that anamnestic and clinical details are necessary in most cases for definitive disease classification. (orig.) [de

  16. T2 black lesions on routine knee MRI: differential considerations

    International Nuclear Information System (INIS)

    Wadhwa, Vibhor; Cho, Gina; Moore, Daniel; Pezeshk, Parham; Coyner, Katherine; Chhabra, Avneesh

    2016-01-01

    The majority of abnormal findings or lesions on T2-weighted fast spin-echo (FSE) magnetic resonance imaging (MRI) are hyperintense due to increased perfusion or fluid content, such as infections, tumours or synovitis. Hypointense lesions on T2-weighted images (both fat-suppressed and non-fat-suppressed) are less common and can sometimes be overlooked. Such lesions have limited differential diagnostic possibilities, and include vacuum phenomenon, loose body, tenosynovial giant cell tumour, rheumatoid arthritis, haemochromatosis, gout, amyloid, chondrocalcinosis, hydroxyapetite deposition disease, lipoma arborescens, arthrofibrosis and iatrogenic lesions. These lesions often show characteristic appearances and predilections in the knee. In this article, the authors describe the MRI features of hypointense T2 lesions on routine knee MRI and outline a systematic diagnostic approach towards their evaluation. (orig.)

  17. Modeling knee joint endoprosthesis mode of deformation

    Science.gov (United States)

    Skeeba, V. Yu; Ivancivsky, V. V.

    2018-03-01

    The purpose of the work was to define the efficient design of the endoprosthesis, working in a multiple-cycle loading environment. Methodology and methods: triangulated surfaces of the base contact surfaces of endoprosthesis butt elements have been created using the PowerShape and SolidWorks software functional environment, and the assemblies of the possible combinations of the knee joint prosthetic designs have been prepared. The mode of deformation modeling took place in the multipurpose program complex ANSYS. Results and discussion: as a result of the numerical modeling, the following data were obtained for each of the developed knee joint versions: the distribution fields of absolute (total) and relative deformations; equivalent stress distribution fields; fatigue strength coefficient distribution fields. In the course of the studies, the following efficient design assembly has been established: 1) Ti-Al-V alloy composite femoral component with polymer inserts; 2) ceramic liners of the compound separator; 3) a Ti-Al-V alloy composite tibial component. The fatigue strength coefficient for the femoral component is 4.2; for the femoral component polymer inserts is 1.2; for the ceramic liners of the compound separator is 3.1; for the tibial component is 2.7. This promising endoprosthesis structure is recommended for further design and technological development.

  18. Prediction of cartilaginous tissue repair after knee joint distraction

    NARCIS (Netherlands)

    van der Woude, J A D; Welsing, P M; van Roermund, P M; Custers, R J H; Kuchuk, N O; Lafeber, F P J G G

    2016-01-01

    BACKGROUND: For young patients (<65years), knee joint distraction (KJD) may be a joint-saving treatment option for end-stage knee osteoarthritis. Distracting the femur from the tibia by five millimeters for six to eight weeks using an external fixation frame results in cartilaginous tissue repair,

  19. Pathological Knee Joint Motion Analysis By High Speed Cinephotography

    Science.gov (United States)

    Baumann, Jurg U.

    1985-02-01

    The use of cinephotography for evaluation of disturbed knee joint function was compared in three groups of patients. While a sampling rate of 50 images per second was adequate for patients with neuromuscular disorders, a higher frequency of around 300 i.p.s. is necessary in osteoarthritis and ligamentous knee joint injuries, but the task of digitizing is prohibitive unless automated.

  20. Wearable Vector Electrical Bioimpedance System to Assess Knee Joint Health.

    Science.gov (United States)

    Hersek, Sinan; Toreyin, Hakan; Teague, Caitlin N; Millard-Stafford, Mindy L; Jeong, Hyeon-Ki; Bavare, Miheer M; Wolkoff, Paul; Sawka, Michael N; Inan, Omer T

    2017-10-01

    We designed and validated a portable electrical bioimpedance (EBI) system to quantify knee joint health. Five separate experiments were performed to demonstrate the: 1) ability of the EBI system to assess knee injury and recovery; 2) interday variability of knee EBI measurements; 3) sensitivity of the system to small changes in interstitial fluid volume; 4) reducing the error of EBI measurements using acceleration signals; and 5) use of the system with dry electrodes integrated to a wearable knee wrap. 1) The absolute difference in resistance ( R) and reactance (X) from the left to the right knee was able to distinguish injured and healthy knees (p knee R was 2.5 Ω and for X was 1.2 Ω. 3) Local heating/cooling resulted in a significant decrease/increase in knee R (p knee R and X measured using the wet electrodes and the designed wearable knee wrap were highly correlated ( R 2 = 0.8 and 0.9, respectively). This study demonstrates the use of wearable EBI measurements in monitoring knee joint health. The proposed wearable system has the potential for assessing knee joint health outside the clinic/lab and help guide rehabilitation.

  1. Kinematic analysis of the knee joint by cine MRI

    International Nuclear Information System (INIS)

    Niitsu, Mamoru; Akisada, Masayoshi; Anno, Izumi; Matsumoto, Kunihiko; Kuno, Shin-ya; Miyakawa, Shunpei; Inouye, Tamon; Kose, Katsumi.

    1989-01-01

    In order to obtain the MR imaging of a moving knee joint, we developed a drive system of the knee. A reciprocating reversible motor with a rope and pulleys drove a knee brace with the knee bending and extending every two seconds. Using photo sensor probe for gating cine acquisition, we got 16-time frames/cycle MR images. Such as articular cartilage, ligaments and synovial fluid, the fine components of a moving knee joint were clearly seen. In a dynamic display, these cine images demonstrated 'actual' movement of the knee joint. Moving joint fluid and defect of anterior cruciate ligament were demonstrated in the case of knee injury. These findings were not seen on static images. Cine MR imaging was also helpful for evaluating the chronic joint disease and ligament reconstruction. Through the use of the present drive system and cine acquisition, dynamic MR imaging of a moving knee joint is clearly demonstrated and it may provide useful information in the kinematic analysis of the normal and pathologic knee. (author)

  2. 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.

  3. Incidence of chronic knee lesions in long-distance runners based on training level: Findings at MRI

    International Nuclear Information System (INIS)

    Schueller-Weidekamm, Claudia; Schueller, Gerd; Uffmann, Martin; Bader, Till

    2006-01-01

    Purpose: The purpose of this study was to evaluate the incidence of chronic knee changes in long-distance runners based on the training status, including distance, running frequency, training pace, and running experience. Methods: MRI of the knee was performed in 26 non-professional runners 5 days after their last training unit. Lesions of the menisci and cartilage (5-point scale), bone marrow and ligaments (3-point scale), and joint effusion were evaluated. A total score comprising all knee lesions in each runner was evaluated. The incidence of the knee changes was correlated with the training level, gender, and age of the runners. Results: Grade 1 lesions of the menisci were found in six runners with a high training level, and in only four runners with a low training level. Grade 1 cartilage lesions were found in three high-trained runners and in one low-trained runner, and grade 2 lesions were found in one high-trained runner and in two low-trained runners, respectively. Grade 1 anterior cruciate ligament lesions were seen in three runners with a high- and in two runners with a low-training level. Runners with a higher training level showed a statistically significant higher score for all chronic knee lesions than those with a lower training level (p < 0.05). Conclusions: MRI findings indicate that a higher training level in long-distance runners is a risk factor for chronic knee lesions

  4. Incidence of chronic knee lesions in long-distance runners based on training level: Findings at MRI

    Energy Technology Data Exchange (ETDEWEB)

    Schueller-Weidekamm, Claudia [Department of Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria)]. E-mail: claudia.schueller-weidekamm@meduniwien.ac.at; Schueller, Gerd [Department of Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Uffmann, Martin [Department of Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Bader, Till [Department of Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria)

    2006-05-15

    Purpose: The purpose of this study was to evaluate the incidence of chronic knee changes in long-distance runners based on the training status, including distance, running frequency, training pace, and running experience. Methods: MRI of the knee was performed in 26 non-professional runners 5 days after their last training unit. Lesions of the menisci and cartilage (5-point scale), bone marrow and ligaments (3-point scale), and joint effusion were evaluated. A total score comprising all knee lesions in each runner was evaluated. The incidence of the knee changes was correlated with the training level, gender, and age of the runners. Results: Grade 1 lesions of the menisci were found in six runners with a high training level, and in only four runners with a low training level. Grade 1 cartilage lesions were found in three high-trained runners and in one low-trained runner, and grade 2 lesions were found in one high-trained runner and in two low-trained runners, respectively. Grade 1 anterior cruciate ligament lesions were seen in three runners with a high- and in two runners with a low-training level. Runners with a higher training level showed a statistically significant higher score for all chronic knee lesions than those with a lower training level (p < 0.05). Conclusions: MRI findings indicate that a higher training level in long-distance runners is a risk factor for chronic knee lesions.

  5. Changes in bone marrow lesions in response to weight-loss in obese knee osteoarthritis patients

    DEFF Research Database (Denmark)

    Gudbergsen, Henrik; Boesen, Mikael; Christensen, Robin

    2013-01-01

    Patients are susceptible for knee osteoarthritis (KOA) with increasing age and obesity and KOA is expected to become a major disabling disease in the future. An important feature of KOA on magnetic resonance imaging (MRI) is changes in the subchondral bone, bone marrow lesions (BMLs), which...... are related to the future degeneration of the knee joint as well as prevalent clinical symptoms. The aim of this study was to investigate the changes in BMLs after a 16-week weight-loss period in obese subjects with KOA and relate changes in BMLs to the effects of weight-loss on clinical symptoms....

  6. 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.

  7. Increased joint loads during walking--a consequence of pain relief in knee osteoarthritis

    DEFF Research Database (Denmark)

    Henriksen, Marius; Simonsen, Erik B; Alkjaer, T

    2006-01-01

    Joint pain is a primary symptom in knee osteoarthritis (OA), but the effect of pain and pain relief on the knee joint mechanics of walking is not clear. In this study, the effects of local knee joint analgesia on knee joint loads during walking were studied in a group of knee osteoarthritis....... Although the patients walked with less compressive knee joint forces compared to the reference group, the effects of pain relief may accelerate the degenerative changes....

  8. Associations between serum ghrelin and knee symptoms, joint structures and cartilage or bone biomarkers in patients with knee osteoarthritis.

    Science.gov (United States)

    Wu, J; Wang, K; Xu, J; Ruan, G; Zhu, Q; Cai, J; Ren, J; Zheng, S; Zhu, Z; Otahal, P; Ding, C

    2017-09-01

    The roles of ghrelin in knee osteoarthritis (OA) are unclear. This study aimed to examine cross-sectional associations of ghrelin with knee symptoms, joint structures and cartilage or bone biomarkers in patients with knee OA. This study included 146 patients with symptomatic knee OA. Serum levels of ghrelin and cartilage or bone biomarkers including cartilage oligomeric matrix protein (COMP), cross linked C-telopeptide of type I collagen (CTXI), cross linked N-telopeptide of type I collagen (NTXI), N-terminal procollagen III propeptide (PIIINP), and matrix metalloproteinase (MMP)-3, 10, 13 were measured using Enzyme-linked immunosorbent assay (ELISA). Knee symptoms were assessed using the Western Ontario and McMaster Universities Arthritis Index (WOMAC). Infrapatellar fat pad (IPFP) volume, IPFP signal intensity alternation, cartilage defects, bone marrow lesions (BMLs) and effusion-synovitis were assessed using the (MRI). Osteophytes and joint space narrowing (JSN) were assessed using the Osteoarthritis Research Society International atlas. After adjustment for potential confounders, ghrelin quartiles were positively associated with knee symptoms including pain, stiffness, dysfunction and total score (quartile 4 vs 1: β 24.19, 95% CI 8.13-40.25). Ghrelin quartiles were also significantly associated with increased IPFP signal intensity alteration (quartile 4 vs 1: OR 3.57, 95% CI 1.55-8.25) and NTXI, PIIINP, MMP3 and MMP13. Ghrelin was not significantly associated with other joint structures and biomarkers. Serum levels of ghrelin were significantly associated with increased knee symptoms, IPFP signal intensity alteration and serum levels of MMP3, MMP13, NTXI and PIIINP, suggesting that ghrelin may have a role to play in knee OA. Copyright © 2017 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  9. A STUDY ON OSTEOARTHRITIS OF KNEE JOINT

    Directory of Open Access Journals (Sweden)

    Ayyappan Nair

    2016-09-01

    Full Text Available BACKGROUND Osteoarthritis is the most common type of arthritis. It is a degenerative disease where, load bearing synovial joints like hip and knee are affected. Usually bilateral, highest incidence is seen after 6th decade of life. It is also common in women post - menopausal age. Osteoarthritis of knee is more common in Asian population because of lifestyle habits like squatting and sitting cross legged. The aetiology of the disease can be multifactorial but usually it is an age associated disease due to wear and tear. The two types of osteoarthritis are, Primary osteoarthritis: It is more common. This occurs in old age due to wear and tear of the joints and Secondary osteoarthritis: In this there is an underlying primary joint disease which leads to degeneration. Any age group can be affected. Predisposing factors are, congenital malformation of joint, trauma, disease involving joints, malalignment, internal derangement and obesity. A sincere effort has been put in this study to understand the Osteoarthritis complications in the elderly population. This study is intended to help the practicing fellow orthopaedicians to understand and thus treat the patient more effectively. METHODS  The study was done in the Department of Orthopaedics, Travancore Medical College at Kollam.  The study was done from June 2014 to June 2016.  Three Hundred Twenty cases who attended in the Department of Orthopaedics were taken for the study.  Detailed History and Clinical Examination was conducted.  All the statistical analysis was done using the latest SPSS software 2015 (California. RESULTS In the present study, the mean age of the population was 62.67 years with a standard deviation of 11.739 years. Crepitus was present in eighty three cases; pain was the chief complaint and was present in two hundred and thirty eight cases. Stiffness was complained in two hundred and fourteen cases and in seventy one cases the patient complained of swelling. On

  10. 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.

  11. Tumor-like diseases of the knee joint; Tumoraehnliche Erkrankungen im Kniegelenk

    Energy Technology Data Exchange (ETDEWEB)

    Freyschmidt, J. [Klinikum Bremen-Mitte, Beratungsstelle und Referenzzentrum fuer Osteoradiologie, Bremen (Germany)

    2012-11-15

    Radiological diagnostics of tumor-like lesions of the knee joint. Magnetic resonance imaging (MRI), computed tomography (CT) and X-ray imaging. Up to now there have been no studies regarding sensitivity and specificity of the various diagnostic tools (MRI, CT, X-ray) for the visualization of soft tissue tumors of the knee. The method of first choice for detecting soft tissue tumors and tumor-like lesions in the knee joint is MRI. (orig.) [German] Radiologische Diagnostik tumoraehnlicher Laesionen im Kniegelenk. Eingesetzte Verfahren sind die MRT, CT und Projektionsradiographie. Da es sich um Weichteiltumoren handelt, ist die MRT bei der Diagnostik dominierend. Sensitivitaet und Spezifitaet sind unserer Kenntnis nach bisher nicht untersucht worden. In manchen Faellen werden jedoch noch zusaetzliche Roentgen- oder CT-Bilder benoetigt. Bei Verdacht auf einen Tumor im Kniegelenk wird als erste Untersuchung eine MRT empfohlen. (orig.)

  12. Dynamic MRI for the differentiation of inflammatory joint lesions

    International Nuclear Information System (INIS)

    Koenig, H.; Wolf, K.J.; Sieper, J.

    1990-01-01

    Eighteen patients with inflammatory lesions of the knee joints (ten with rheumatoid arthritis, eight with undiagnosed lesions) and two normal subjects were examined by MRI. In addition to spin-echo measurements, the signals from normal and pathological tissues were evaluated quantitatively by dynamic flash sequences following the injection of gadolinium DTPA. The latter method was able to distinguish active pannus from other proliferative synovial changes; the degree of activity could be related to synovial histology and relevant clinical features in eight patients. Areas of flat articular and subchondral pannus could be identified by the enhanced signal following the administration of gadolinium DTPA. Dynamic MRI is able to provide important information for the early diagnosis and follow-up of patients with rheumatoid arthritis. (orig.) [de

  13. Low Level Laser Therapy for chronic knee joint pain patients.

    Science.gov (United States)

    Nakamura, Takashi; Ebihara, Satoru; Ohkuni, Ikuko; Izukura, Hideaki; Harada, Takashi; Ushigome, Nobuyuki; Ohshiro, Toshio; Musha, Yoshiro; Takahashi, Hiroshi; Tsuchiya, Kazuaki; Kubota, Ayako

    2014-12-27

    Chronic knee joint pain is one of the most frequent complaints which is seen in the outpatient clinic in our medical institute. In previous studies we have reported the benefits of low level laser therapy (LLLT) for chronic pain in the shoulder joints, elbow, hand, finger and the lower back. The present study is a report on the effects of LLLT for chronic knee joint pain. Over the past 5 years, 35 subjects visited the outpatient clinic with complaints of chronic knee joint pain caused by the knee osteoarthritis-induced degenerative meniscal tear. They received low level laser therapy. A 1000 mW semi-conductor laser device was used to deliver 20.1 J/cm(2) per point in continuous wave at 830nm, and four points were irradiated per session (1 treatment) twice a week for 4 weeks. A visual analogue scale (VAS) was used to determine the effects of LLLT for the chronic pain and after the end of the treatment regimen a significant improvement was observed (pknee joint range of motion. Discussions with the patients revealed that it was important for them to learn how to avoid postures that would cause them knee pain in everyday life in order to have continuous benefits from the treatment. The present study demonstrated that 830 nm LLLT was an effective form of treatment for chronic knee pain caused by knee osteoarthritis. Patients were advised to undertake training involving gentle flexion and extension of the knee.

  14. 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.

  15. 21 CFR 888.3510 - Knee joint femorotibial metal/polymer constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Knee joint femorotibial metal/polymer constrained... Knee joint femorotibial metal/polymer constrained cemented prosthesis. (a) Identification. A knee joint... of a knee joint. The device limits translation or rotation in one or more planes and has components...

  16. 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)....

  17. Multi-joint postural behavior in patients with knee osteoarthritis.

    Science.gov (United States)

    Turcot, Katia; Sagawa, Yoshimasa; Hoffmeyer, Pierre; Suvà, Domizio; Armand, Stéphane

    2015-12-01

    Previous studies have demonstrated balance impairment in patients with knee osteoarthritis (OA). Although it is currently accepted that postural control depends on multi-joint coordination, no study has previously considered this postural strategy in patients suffering from knee OA. The objectives of this study were to investigate the multi-joint postural behavior in patients with knee OA and to evaluate the association with clinical outcomes. Eighty-seven patients with knee OA and twenty-five healthy elderly were recruited to the study. A motion analysis system and two force plates were used to investigate the joint kinematics (trunk and lower body segments), the lower body joint moments, the vertical ground reaction force ratio and the center of pressure (COP) during a quiet standing task. Pain, functional capacity and quality of life status were also recorded. Patients with symptomatic and severe knee OA adopt a more flexed posture at all joint levels in comparison with the control group. A significant difference in the mean ratio was found between groups, showing an asymmetric weight distribution in patients with knee OA. A significant decrease in the COP range in the anterior-posterior direction was also observed in the group of patients. Only small associations were observed between postural impairments and clinical outcomes. This study brings new insights regarding the postural behavior of patients with severe knee OA during a quiet standing task. The results confirm the multi-joint asymmetric posture adopted by this population. Copyright © 2014 Elsevier B.V. All rights reserved.

  18. 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...

  19. Accuracy of magnetic resonance in identifying traumatic intraarticular knee lesions

    International Nuclear Information System (INIS)

    Vaz, Carlos Eduardo Sanches; Camargo, Olavo Pires de; Santana, Paulo Jose de; Valezi, Antonio Carlos

    2005-01-01

    Purpose: To evaluate the diagnostic accuracy of magnetic resonance imaging of the knee in identifying traumatic intraarticular knee lesions. Method: 300 patients with a clinical diagnosis of traumatic intraarticular knee lesions underwent prearthoscopic magnetic resonance imaging. The sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio for a positive test, likelihood ratio for a negative test, and accuracy of magnetic resonance imaging were calculated relative to the findings during arthroscopy in the studied structures of the knee (medial meniscus, lateral meniscus, anterior cruciate ligament, posterior cruciate ligament, and articular cartilage). Results: Magnetic resonance imaging produced the following results regarding detection of lesions: medial meniscus: sensitivity 97.5%, specificity 92.9%, positive predictive value 93.9%, positive negative value 97%, likelihood positive ratio 13.7, likelihood negative ratio 0.02, and accuracy 95.3%; lateral meniscus: sensitivity 91.9%, specificity 93.6%, positive predictive value 92.7%, positive negative value 92.9%, likelihood positive ratio 14.3, likelihood negative ratio 0.08, and accuracy 93.6%; anterior cruciate ligament: sensitivity 99.0%, specificity 95.9%, positive predictive value 91.9%, positive negative value 99.5%, likelihood positive ratio 21.5, likelihood negative ratio 0.01, and accuracy 96.6%; posterior cruciate ligament: sensitivity 100%, specificity 99%, positive predictive value 80.0%, positive negative value 100%, likelihood positive ratio 100, likelihood negative ratio 0.01, and accuracy 99.6%; articular cartilage: sensitivity 76.1%, specificity 94.9%, positive predictive value 94.7%, positive negative value 76.9%, likelihood positive ratio 14.9, likelihood negative ratio 0.25, and accuracy 84.6%. Conclusion: Magnetic resonance imaging is a satisfactory diagnostic tool for evaluating meniscal and ligamentous lesions of the knee, but it is unable to clearly

  20. Accuracy of magnetic resonance in identifying traumatic intraarticular knee lesions

    Directory of Open Access Journals (Sweden)

    Vaz Carlos Eduardo Sanches

    2005-01-01

    Full Text Available PURPOSE: To evaluate the diagnostic accuracy of magnetic resonance imaging of the knee in identifying traumatic intraarticular knee lesions. METHOD: 300 patients with a clinical diagnosis of traumatic intraarticular knee lesions underwent prearthoscopic magnetic resonance imaging. The sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio for a positive test, likelihood ratio for a negative test, and accuracy of magnetic resonance imaging were calculated relative to the findings during arthroscopy in the studied structures of the knee (medial meniscus, lateral meniscus, anterior cruciate ligament, posterior cruciate ligament, and articular cartilage. RESULTS: Magnetic resonance imaging produced the following results regarding detection of lesions: medial meniscus: sensitivity 97.5%, specificity 92.9%, positive predictive value 93.9%, positive negative value 97%, likelihood positive ratio 13.7, likelihood negative ratio 0.02, and accuracy 95.3%; lateral meniscus: sensitivity 91.9%, specificity 93.6%, positive predictive value 92.7%, positive negative value 92.9%, likelihood positive ratio 14.3, likelihood negative ratio 0.08, and accuracy 93.6%; anterior cruciate ligament: sensitivity 99.0%, specificity 95.9%, positive predictive value 91.9%, positive negative value 99.5%, likelihood positive ratio 21.5, likelihood negative ratio 0.01, and accuracy 96.6%; posterior cruciate ligament: sensitivity 100%, specificity 99%, positive predictive value 80.0%, positive negative value 100%, likelihood positive ratio 100, likelihood negative ratio 0.01, and accuracy 99.6%; articular cartilage: sensitivity 76.1%, specificity 94.9%, positive predictive value 94.7%, positive negative value 76.9%, likelihood positive ratio 14.9, likelihood negative ratio 0.25, and accuracy 84.6%. CONCLUSION: Magnetic resonance imaging is a satisfactory diagnostic tool for evaluating meniscal and ligamentous lesions of the knee, but it is

  1. 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...

  2. Predicting the Functional Roles of Knee Joint Muscles from Internal Joint Moments

    DEFF Research Database (Denmark)

    Flaxman, Teresa E; Alkjær, Tine; Simonsen, Erik B

    2017-01-01

    INTRODUCTION: Knee muscles are commonly labeled as flexors or extensors and aptly stabilize the knee against sagittal plane loads. However, how these muscles stabilize the knee against adduction-abduction and rotational loads remains unclear. Our study sought 1) to classify muscle roles as they r...... on its role in maintaining knee joint stability in the frontal and transverse loading planes. This is useful for delineating the roles of biarticular knee joint muscles and could have implications in robotics, musculoskeletal modeling, sports sciences, and rehabilitation....

  3. 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

  4. 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

  5. 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.

  6. The study of subchondral lesions in osteoarthritis of the knee using magnetic resonance imaging

    International Nuclear Information System (INIS)

    Takagishi, Hiroshi

    2001-01-01

    In order to examine the significance of the signal abnormalities of subchondral bone in osteoarthritic knee with 0.5 T magnetic resonance imaging (MRI), especially in T2-low signal lesions which show a low signal intensity on both the T1- and T2-weighted images and T2-high signal lesions which show a low signal intensity on the T1-weighted image and a high signal intensity on the T2-weighted image, we examined 54 patients (representing 58 knees) with osteoarthritis (OA) of the knee on MRI as compared with the arthroscopic findings or operative findings and histologically evaluated them. In addition, in order to elucidate what becomes of those signal abnormalities in the subchondral bone after biomechanical treatment utilizing a high tibial osteotomy (HTO) which reduces the maldistributed load, we examined 30 patients (representing 34 knees) under HTO on MRI and compared these findings with the arthroscopic findings. The incidence of the presence of those signal abnormalities of subchondral bone on MRI tended to correlate with the severity of the articular cartilage damage, and also reflected the degree of damage to the articular cartilage well. In a histologically investigation, T2-high signal lesions showed granulation tissue with high vascularity, which seemed to be an active phase in OA. T2-low signal lesions of OA in a late stage showed subchondral sclerosis histologically. In addition, the signal changes of the subchondral bone on MRI seemed correlate with the changes in the load distribution in the knee joint because T2-high signal lesions before HTO were observed to either diminish or disappear after undergoing a successful osteotomy. The signal abnormalities of the subchondral bone on MRI on OA thus helped in determining the appropriate phase, therapeutic effects and prognosis of OA. (author)

  7. 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...

  8. MR imaging of the flexed knee: comparison to the extended knee in delineation of meniscal lesions

    International Nuclear Information System (INIS)

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

    2000-01-01

    The aim of this study was to obtain MR images in the flexed-knee position and to compare the diagnostic value to the extended position in delineation of the menisci. With a mobile knee brace and a flexible surface coil, the knee joint was either fully extended or bent to a semi-flexed position (average 45 of flexion) within a 1.5-T superconducting magnet. Sets of sagittal MR images were obtained for both the extended- and flexed-knee positions. Using the arthroscopic results as gold standards, 97 menisci were evaluated. Two observers interpreted each MR image of the extended and flexed positions independently without knowledge of the arthroscopic results. Flexed-knee MR images revealed 22 of the 27 arthroscopically proven torn menisci and 69 of the 70 intact menisci, for a sensitivity of 81.5 %, a specificity of 98.6 %, and an accuracy of 93.8 %. Extended-knee MR images indicated a sensitivity of 81.5 %, a specificity of 92.9 %, and an accuracy of 89.7 %. No statistically significant difference was found between the two positions. To enhance MR visualization of all the knee components, we recommend examining the knee in a flexed position within the magnet. (orig.)

  9. MR imaging of the flexed knee: comparison to the extended knee in delineation of meniscal lesions

    Energy Technology Data Exchange (ETDEWEB)

    Niitsu, M.; Itai, Y. [Dept. of Radiology, Institute of Clinical Medicine, University of Tsukuba Tennodai, Tsukuba, Ibaraki (Japan); Endo, H. [Tsukuba Medical Center Hospital, Ibaraki (Japan); Ikeda, K. [Dept. of Orthopedic Surgery, University of Tsukuba Tennodai, Tsukuba (Japan)

    2000-11-01

    The aim of this study was to obtain MR images in the flexed-knee position and to compare the diagnostic value to the extended position in delineation of the menisci. With a mobile knee brace and a flexible surface coil, the knee joint was either fully extended or bent to a semi-flexed position (average 45 of flexion) within a 1.5-T superconducting magnet. Sets of sagittal MR images were obtained for both the extended- and flexed-knee positions. Using the arthroscopic results as gold standards, 97 menisci were evaluated. Two observers interpreted each MR image of the extended and flexed positions independently without knowledge of the arthroscopic results. Flexed-knee MR images revealed 22 of the 27 arthroscopically proven torn menisci and 69 of the 70 intact menisci, for a sensitivity of 81.5 %, a specificity of 98.6 %, and an accuracy of 93.8 %. Extended-knee MR images indicated a sensitivity of 81.5 %, a specificity of 92.9 %, and an accuracy of 89.7 %. No statistically significant difference was found between the two positions. To enhance MR visualization of all the knee components, we recommend examining the knee in a flexed position within the magnet. (orig.)

  10. TREATMENT OF DEEP PERIPROSTHETIC INFECTION OF KNEE JOINT

    Directory of Open Access Journals (Sweden)

    Ivantsov V. A.

    2018-03-01

    Full Text Available In connection with the increase in arthroplasty of joints, the problem of infectious complications becomes topical. The aim of the study was to increase the effectiveness of purulent complications treatment after total knee arthroplasty. Material and methods. Treatment of patients with deep periprosthetic infection of the knee joint dealt with surgical debridement with the preservation of endoprosthesis, its removal and placement of a cement spacer or with the removal of endoprosthesis and arthrodesis of the knee joint. Surgical debridement was related to the radical excision of necrotic tissues and the remains of the synovial membrane. To prepare the cement spacer bone cement "CEMFIX" or "GENTAFIX" impregnated with antibiotic was used. For arthrodesis of the knee joint, Medbiotech core apparatus (the Republic of Belarus superimposed on the limb in the frontal and sagittal planes was applied. Results. The use of a differentiated and individual approach to the treatment of deep periprosthetic infection of the knee joint enabled to obtain positive results in 85.6% of cases. Conclusions. The two-stage method of treatment of deep periprosthetic infection of the knee joint is preferred, as compared to a one-stage method, which enables to obtain better results.

  11. Modelling of the Human Knee Joint Supported by Active Orthosis

    Science.gov (United States)

    Musalimov, V.; Monahov, Y.; Tamre, M.; Rõbak, D.; Sivitski, A.; Aryassov, G.; Penkov, I.

    2018-02-01

    The article discusses motion of a healthy knee joint in the sagittal plane and motion of an injured knee joint supported by an active orthosis. A kinematic scheme of a mechanism for the simulation of a knee joint motion is developed and motion of healthy and injured knee joints are modelled in Matlab. Angles between links, which simulate the femur and tibia are controlled by Simulink block of Model predictive control (MPC). The results of simulation have been compared with several samples of real motion of the human knee joint obtained from motion capture systems. On the basis of these analyses and also of the analysis of the forces in human lower limbs created at motion, an active smart orthosis is developed. The orthosis design was optimized to achieve an energy saving system with sufficient anatomy, necessary reliability, easy exploitation and low cost. With the orthosis it is possible to unload the knee joint, and also partially or fully compensate muscle forces required for the bending of the lower limb.

  12. Modelling of the Human Knee Joint Supported by Active Orthosis

    Directory of Open Access Journals (Sweden)

    Musalimov V.

    2018-02-01

    Full Text Available The article discusses motion of a healthy knee joint in the sagittal plane and motion of an injured knee joint supported by an active orthosis. A kinematic scheme of a mechanism for the simulation of a knee joint motion is developed and motion of healthy and injured knee joints are modelled in Matlab. Angles between links, which simulate the femur and tibia are controlled by Simulink block of Model predictive control (MPC. The results of simulation have been compared with several samples of real motion of the human knee joint obtained from motion capture systems. On the basis of these analyses and also of the analysis of the forces in human lower limbs created at motion, an active smart orthosis is developed. The orthosis design was optimized to achieve an energy saving system with sufficient anatomy, necessary reliability, easy exploitation and low cost. With the orthosis it is possible to unload the knee joint, and also partially or fully compensate muscle forces required for the bending of the lower limb.

  13. 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.

  14. Obesity-related juvenile form of cartilage lesions: a new affliction in the knees of morbidly obese children and adolescents

    Energy Technology Data Exchange (ETDEWEB)

    Widhalm, Harald K.; Marlovits, Stefan; Vecsei, Vilmos [Medical University of Vienna, Center for Joints and Cartilage, Department of Traumatology, Vienna (Austria); Welsch, Goetz H. [Medical University of Vienna, MR Center, Department of Radiology, Vienna (Austria); University Hospital of Erlangen, Department of Trauma Surgery, Erlangen (Germany); Dirisamer, Albert [Medical University of Vienna, Department of Radiology, Vienna (Austria); Neuhold, Andreas [Private Hospital Rudolfinerhaus, Department of Radiology, Vienna (Austria); Griensven, Martijn van [Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Vienna (Austria); Seemann, Rudolf [Medical University of Vienna, Department of Cranio-Maxillofacial and Oral Surgery, Vienna (Austria); Widhalm, Kurt [Medical University of Vienna, Division of Nutrition and Metabolism, Department of Pediatrics, Vienna (Austria)

    2012-03-15

    Overweight and obesity are afflictions that lead to an increased risk of health problems including joint problems. The aim of the study was to assess the condition of articular cartilage in obese adolescent patients suffering from knee pain. MRI of 24 knees of 20 morbidly obese patients, mean age 14.2 years, was performed in an open 1.0 Tesla MR system, where the cartilage, the quality and structure of the menisci, and the presence or absence of surrounding changes was examined. In all patients a cartilage lesion in at least one region of the knee could be detected. Retropatellar cartilage lesions have been found in 19 knees. Ten cartilage lesions grade I, and four lesions grade II have been described in the lateral compartment of the knee, whereas the medial compartment showed in eight cases a grade I, in 13 cases a grade II and in two cases a grade III cartilage lesion. Meniscal changes were assessed in most patients. Morbidly obese children and adolescents show major abnormalities in the articular cartilage of the knee. Whether obesity alone is the causal factor for the development of the pattern of these changes, remains to be seen. (orig.)

  15. Obesity-related juvenile form of cartilage lesions: a new affliction in the knees of morbidly obese children and adolescents

    International Nuclear Information System (INIS)

    Widhalm, Harald K.; Marlovits, Stefan; Vecsei, Vilmos; Welsch, Goetz H.; Dirisamer, Albert; Neuhold, Andreas; Griensven, Martijn van; Seemann, Rudolf; Widhalm, Kurt

    2012-01-01

    Overweight and obesity are afflictions that lead to an increased risk of health problems including joint problems. The aim of the study was to assess the condition of articular cartilage in obese adolescent patients suffering from knee pain. MRI of 24 knees of 20 morbidly obese patients, mean age 14.2 years, was performed in an open 1.0 Tesla MR system, where the cartilage, the quality and structure of the menisci, and the presence or absence of surrounding changes was examined. In all patients a cartilage lesion in at least one region of the knee could be detected. Retropatellar cartilage lesions have been found in 19 knees. Ten cartilage lesions grade I, and four lesions grade II have been described in the lateral compartment of the knee, whereas the medial compartment showed in eight cases a grade I, in 13 cases a grade II and in two cases a grade III cartilage lesion. Meniscal changes were assessed in most patients. Morbidly obese children and adolescents show major abnormalities in the articular cartilage of the knee. Whether obesity alone is the causal factor for the development of the pattern of these changes, remains to be seen. (orig.)

  16. 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.

  17. 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.

  18. Traumatology of the knee joint - radiological and accident surgery aspects. Pt. 1

    International Nuclear Information System (INIS)

    Schild, H.; Ahlers, J.; Mainz Univ.

    1987-01-01

    Lesions of the knee joint are relatively frequent and are on the increase due to the increasing number of sports and traffic accidents. Violent force exercised on the knee can lead basically to two different kinds of injury sequels. As a rule, injuries to the bone do not present diagnostic problems if there is a clear break in continuity. On the other hand, it is often very difficult to detect chondral or osteochondral lesions and also certain types of longitudinal patellar fractures and fractures of the head of the tibia. Their visualisation requires more far-reaching diagnostic measures. Fundamentally more difficult to identify: the second group of lesions, namely, those of the internal structures of the knee, unless there is a marked instability which is usually accessible to clinical examination. Relatively slight osseous tears or ruptures of a ligament often remain unnoticed on the plain X-ray film. Other diagnostic techniques are imperative in such cases. The first part deals specifically with the radiological aspects of knee injuries. The majority of injuries close to the knee region can be visualized by making use of all techniques of roentgenology. However, if the examination methods get too costly and complicated without ensuring an absolutely safe diagnosis other techniques must be employed. An example in this regard are the chondral or osteochondral lesions. It is here that arthroscopy often yields better results while offering at the same time a possibility to remove individual small fragments. (orig.) [de

  19. 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.

  20. 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

  1. Generalised joint hypermobility and knee joint hypermobility: prevalence, knee joint symptoms and health-related quality of life in a Danish adult population.

    Science.gov (United States)

    Junge, Tina; Henriksen, Peter; Hansen, Sebrina; Østengaard, Lasse; Golightly, Yvonne M; Juul-Kristensen, Birgit

    2017-10-27

    Several biomechanical factors, such as knee joint hypermobility (KJH), are suggested to play a role in the etiology of knee joint symptoms and knee osteoarthritis. Nevertheless, the prevalence or consequences of KJH solely or included in the classification of generalized joint hypermobility (GJHk) is unknown for a general population. Therefore, the objectives were to report the prevalence of self-reported GJHk and KJH, as well as the association of these conditions to knee joint symptoms, severity and duration of symptoms, and health-related quality of life (HRQoL) in a Danish adult population. This study is a cross-sectional population-based survey of 2056 Danish adults. Respondents received online questionnaires of GJHk and KJH, knee joint symptoms, the severity and duration of these, as well as HRQoL. Total response rate was 49% (n = 1006). The prevalence of self-reported GJHk and KJH was 13% and 23%, mostly representing women. More than half of the respondents with GJHk and KJH had knee joint symptoms. The odds for reporting knee joint symptoms, severity of knee joint symptoms and duration of knee joint symptoms were twice as high for respondents with GJHk and KJH. Respondents with GJHk and KJH reported lower HRQoL. GJHk and KJH were frequently reported in the Danish adult population, mostly in women. Respondents with GJHk and KJH were two times more likely to report knee joint-related symptoms such as pain, reduced performance of usual activity and lower HRQoL. The impact of these conditions on HRQoL is comparable with knee osteoarthritis. © 2017 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

  2. Self-reported knee joint instability is related to passive mechanical stiffness in medial knee osteoarthritis.

    Science.gov (United States)

    Creaby, Mark W; Wrigley, Tim V; Lim, Boon-Whatt; Hinman, Rana S; Bryant, Adam L; Bennell, Kim L

    2013-11-20

    Self-reported knee joint instability compromises function in individuals with medial knee osteoarthritis and may be related to impaired joint mechanics. The purpose of this study was to evaluate the relationship between self-reported instability and the passive varus-valgus mechanical behaviour of the medial osteoarthritis knee. Passive varus-valgus angular laxity and stiffness were assessed using a modified isokinetic dynamometer in 73 participants with medial tibiofemoral osteoarthritis. All participants self-reported the absence or presence of knee instability symptoms and the degree to which instability affected daily activity on a 6-point likert scale. Forward linear regression modelling identified a significant inverse relationship between passive mid-range knee stiffness and symptoms of knee instability (r = 0.27; P 0.05). Conceivably, a stiffer passive system may contribute toward greater joint stability during functional activities. Importantly however, net joint stiffness is influenced by both active and passive stiffness, and thus the active neuromuscular system may compensate for reduced passive stiffness in order to maintain joint stability. Future work is merited to examine the role of active stiffness in symptomatic joint stability.

  3. 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.

  4. 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

  5. Recent Advances in Computational Mechanics of the Human Knee Joint

    Science.gov (United States)

    Kazemi, M.; Dabiri, Y.; Li, L. P.

    2013-01-01

    Computational mechanics has been advanced in every area of orthopedic biomechanics. The objective of this paper is to provide a general review of the computational models used in the analysis of the mechanical function of the knee joint in different loading and pathological conditions. Major review articles published in related areas are summarized first. The constitutive models for soft tissues of the knee are briefly discussed to facilitate understanding the joint modeling. A detailed review of the tibiofemoral joint models is presented thereafter. The geometry reconstruction procedures as well as some critical issues in finite element modeling are also discussed. Computational modeling can be a reliable and effective method for the study of mechanical behavior of the knee joint, if the model is constructed correctly. Single-phase material models have been used to predict the instantaneous load response for the healthy knees and repaired joints, such as total and partial meniscectomies, ACL and PCL reconstructions, and joint replacements. Recently, poromechanical models accounting for fluid pressurization in soft tissues have been proposed to study the viscoelastic response of the healthy and impaired knee joints. While the constitutive modeling has been considerably advanced at the tissue level, many challenges still exist in applying a good material model to three-dimensional joint simulations. A complete model validation at the joint level seems impossible presently, because only simple data can be obtained experimentally. Therefore, model validation may be concentrated on the constitutive laws using multiple mechanical tests of the tissues. Extensive model verifications at the joint level are still crucial for the accuracy of the modeling. PMID:23509602

  6. Knee Joint Loads and Surrounding Muscle Forces during Stair Ascent in Patients with Total Knee Replacement.

    Directory of Open Access Journals (Sweden)

    Robert Rasnick

    Full Text Available Total knee replacement (TKR is commonly used to correct end-stage knee osteoarthritis. Unfortunately, difficulty with stair climbing often persists and prolongs the challenges of TKR patents. Complete understanding of loading at the knee is of great interest in order to aid patient populations, implant manufacturers, rehabilitation, and future healthcare research. Musculoskeletal modeling and simulation approximates joint loading and corresponding muscle forces during a movement. The purpose of this study was to determine if knee joint loadings following TKR are recovered to the level of healthy individuals, and determine the differences in muscle forces causing those loadings. Data from five healthy and five TKR patients were selected for musculoskeletal simulation. Variables of interest included knee joint reaction forces (JRF and the corresponding muscle forces. A paired samples t-test was used to detect differences between groups for each variable of interest (p<0.05. No differences were observed for peak joint compressive forces between groups. Some muscle force compensatory strategies appear to be present in both the loading and push-off phases. Evidence from knee extension moment and muscle forces during the loading response phase indicates the presence of deficits in TKR in quadriceps muscle force production during stair ascent. This result combined with greater flexor muscle forces resulted in similar compressive JRF during loading response between groups.

  7. Cystic lesion around the hip joint

    Science.gov (United States)

    Yukata, Kiminori; Nakai, Sho; Goto, Tomohiro; Ikeda, Yuichi; Shimaoka, Yasunori; Yamanaka, Issei; Sairyo, Koichi; Hamawaki, Jun-ichi

    2015-01-01

    This article presents a narrative review of cystic lesions around the hip and primarily consists of 5 sections: Radiological examination, prevalence, pathogenesis, symptoms, and treatment. Cystic lesions around the hip are usually asymptomatic but may be observed incidentally on imaging examinations, such as computed tomography and magnetic resonance imaging. Some cysts may enlarge because of various pathological factors, such as trauma, osteoarthritis, rheumatoid arthritis, or total hip arthroplasty (THA), and may become symptomatic because of compression of surrounding structures, including the femoral, obturator, or sciatic nerves, external iliac or common femoral artery, femoral or external iliac vein, sigmoid colon, cecum, small bowel, ureters, and bladder. Treatment for symptomatic cystic lesions around the hip joint includes rest, nonsteroidal anti-inflammatory drug administration, needle aspiration, and surgical excision. Furthermore, when these cysts are associated with osteoarthritis, rheumatoid arthritis, and THA, primary or revision THA surgery will be necessary concurrent with cyst excision. Knowledge of the characteristic clinical appearance of cystic masses around the hip will be useful for determining specific diagnoses and treatments. PMID:26495246

  8. Radionuclide joint imaging in osteoarthritis of the knee

    International Nuclear Information System (INIS)

    Peng Jingjing

    1988-01-01

    31 knee joints of 17 patients were studied with radinuclide joint imaging (RJI). The knees were afficted with primary osteoarthritis associated with various deformity. In comparison with the normal group, RJI of the group of osteoarthritiis showed increased radioactivity in medial compartment of the femorotibial articulation. The ratio of medial to lateral condyle activity was increased. The difference between the two groups was singificant (P < 0.01). In the 'hot patella' groups, the ratio of the activity of the patella to that of the femoral condyle was also increased. The difference between the group and the normals was significant (P < 0.01). Clinical evaluation of RJI was discussed

  9. Arthrography in sport injuries of the knee joint

    Energy Technology Data Exchange (ETDEWEB)

    Schaefer, H

    1983-09-01

    The arthrography is one of the most important diagnostic methods of sport injuries of the knee joint. The examination must give an exact information to the surgeon; a good technique and standard X-rays are an absolute postulate. The submitted examinations are based on 6687 arthrographies during a period of 5 years. The arthrography should not be carried out before the acute symptomatology has ceased, usually after an interval of 2-3 weeks. Most frequent are the meniscus injuries by rotary traumas of the knee-joint. Football as the most popular sport is responsible for more than 50% of the injuries, followed by skiing, handball and jogging.

  10. Arthrography in sport injuries of the knee joint

    International Nuclear Information System (INIS)

    Schaefer, H.

    1983-01-01

    The arthrography is one of the most important diagnostic methods of sport injuries of the knee joint. The examination must give an exact information to the surgeon; a good technique and standard X-rays are an absolute postulate. The submitted examinations are based on 6687 arthrographies during a period of 5 years. The arthrography should not be carried out before the acute symptomatology has ceased, usually after an interval of 2-3 weeks. Most frequently are the meniscus injuries by rotary traumas of the knee-joint. Football as the most popular sport is responsible for more than 50% of the injuries, followed by skiing, handball and jogging. (orig.)

  11. 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.

  12. Knee joint pain potentially due to bone alterations in a knee osteoarthritis patient.

    Science.gov (United States)

    Komatsu, Masatoshi; Nakamura, Yukio; Kamimura, Mikio; Uchiyama, Shigeharu; Mukaiyama, Keijiro; Ikegami, Shota; Kato, Hiroyuki

    2014-12-01

    Osteoarthritis (OA) is the leading cause of musculoskeletal pain and functional disability worldwide. However, the etiology of this condition is still largely unknown. We report the clinical course of an elderly man with knee OA. Plain radiographs and MRI examinations performed during follow-up suggested that the pathophysiology of the patient's knee OA and joint pain may have been primarily due to bone alterations.

  13. Experimental joint immobilization in guinea pigs. Effects on the knee joint

    Science.gov (United States)

    Marcondesdesouza, J. P.; Machado, F. F.; Sesso, A.; Valeri, V.

    1980-01-01

    In young and adult guinea pigs, the aftermath experimentally induced by the immobilization of the knee joint in hyperextended forced position was studied. Joint immobilization which varied from one to nine weeks was attained by plaster. Eighty knee joints were examined macro and microscopically. Findings included: (1) muscular hypotrophy and joint stiffness in all animals, directly proportional to the length of immobilization; (2) haemoarthrosis in the first week; (3) intra-articular fibrous tissue proliferation ending up with fibrous ankylosis; (4) hyaline articular cartilage erosions; (5) various degrees of destructive menisci changes. A tentative explanation of the fibrous tissue proliferation and of the cartilage changes is offered.

  14. 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.

  15. 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.

  16. A new solution in cartilage repair surgery of joint lesions

    Directory of Open Access Journals (Sweden)

    Patrascu JM¹,

    2016-12-01

    Full Text Available OBJECTIVES AND BACKGROUND The purpose of this study is to provide a simple, cost-effective, reproducible technology that is able to regenerate durable hyaline cartilage. Traumas and sports along with different diseases such as obesity or gradual degeneration over time of the joint surface determine cartilage defects resulting in pain and dysfunctionality. MATERIALS AND METHODS Since 2011 a number of 183 pacients were treated using Agili-C, out of which 40 pacients were operated in the IInd Clinic of Orthopaedics of the Timișoara Emergency County Hospital. The implant is a biphasic, porous, resorbable tissue regeneration scaffold used in the treatment of osteochondral defects. The surgical procedure is performed through minimal arthrotomy, with a good exposure of the cartilage defect. The implant is inserted so that the articular surface of the implant is parallel with the surrounding healthy cartilage. When in place, it facilitates vascularization thus allowing tissue formation to commence from the periphery towards the center of the defect. RESULTS Until now, results are promising, showing obvious improvements in pain and function in both degenerative and post-traumatic joint lesions in the knee, ankle and first MP joint. CONCLUSIONS Agili-C is a cell free, single stage, off the shelf implant that will hopefully meet market demands and become a reliable procedure in joint repair surgery in the future. Figure 1: Intra-operative aspect after the implant is in place. REFERENCES 1. Mehdi Kazemzadeh-Narbat et al. Biomaterials.2010. p.31. 2. Scaglione et al. Tissue engineering: Part A. 2009;15:1. FOOTNOTE Agili-C is a product of CartiHeal Company

  17. Magnetic resonance tomography of the knee joint

    Energy Technology Data Exchange (ETDEWEB)

    Puig, Stefan; Kuruvilla, Yojena Chittazhathu Kurian; Ebner, Lukas [University Hospital, University of Berne, Department of Interventional, Pediatric and Diagnostic Radiology Inselspital, Berne (Switzerland); Endel, Gottfried [Main Association of Austrian Social Insurance Institutions, Vienna (Austria)

    2015-10-15

    To compare the diagnostic performance of magnetic resonance imaging (MRI) in terms of sensitivity and specificity using a field strength of <1.0 T (T) versus ≥1.5 T for diagnosing or ruling out knee injuries or knee pathologies. The systematic literature research revealed more than 10,000 references, of which 1598 abstracts were reviewed and 87 full-text articles were retrieved. The further selection process resulted in the inclusion of four systematic reviews and six primary studies. No differences could be identified in the diagnostic performance of low- versus high-field MRI for the detection or exclusion of meniscal or cruciate ligament tears. Regarding the detection or grading of cartilage defects and osteoarthritis of the knee, the existing evidence suggests that high-field MRI is tolerably specific but not very sensitive, while there is literally no evidence for low-field MRI because only a few studies with small sample sizes and equivocal findings have been performed. We can recommend the use of low-field strength MRI systems in suspected meniscal or cruciate ligament injuries. This does, however, not apply to the diagnosis and grading of knee cartilage defects and osteoarthritis because of insufficient evidence. (orig.)

  18. Magnetic resonance tomography of the knee joint

    International Nuclear Information System (INIS)

    Puig, Stefan; Kuruvilla, Yojena Chittazhathu Kurian; Ebner, Lukas; Endel, Gottfried

    2015-01-01

    To compare the diagnostic performance of magnetic resonance imaging (MRI) in terms of sensitivity and specificity using a field strength of <1.0 T (T) versus ≥1.5 T for diagnosing or ruling out knee injuries or knee pathologies. The systematic literature research revealed more than 10,000 references, of which 1598 abstracts were reviewed and 87 full-text articles were retrieved. The further selection process resulted in the inclusion of four systematic reviews and six primary studies. No differences could be identified in the diagnostic performance of low- versus high-field MRI for the detection or exclusion of meniscal or cruciate ligament tears. Regarding the detection or grading of cartilage defects and osteoarthritis of the knee, the existing evidence suggests that high-field MRI is tolerably specific but not very sensitive, while there is literally no evidence for low-field MRI because only a few studies with small sample sizes and equivocal findings have been performed. We can recommend the use of low-field strength MRI systems in suspected meniscal or cruciate ligament injuries. This does, however, not apply to the diagnosis and grading of knee cartilage defects and osteoarthritis because of insufficient evidence. (orig.)

  19. 21 CFR 888.3565 - Knee joint patellofemorotibial metal/polymer porous-coated uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Knee joint patellofemorotibial metal/polymer... Devices § 888.3565 Knee joint patellofemorotibial metal/polymer porous-coated uncemented prosthesis. (a) Identification. A knee joint patellofemorotibial metal/polymer porous-coated uncemented prosthesis is a device...

  20. 21 CFR 888.3530 - Knee joint femorotibial metal/polymer semi-constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Knee joint femorotibial metal/polymer semi... § 888.3530 Knee joint femorotibial metal/polymer semi-constrained cemented prosthesis. (a) Identification. A knee joint femorotibial metal/polymer semi-constrained cemented prosthesis is a device intended...

  1. 21 CFR 888.3540 - Knee joint patellofemoral polymer/metal semi-constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Knee joint patellofemoral polymer/metal semi... § 888.3540 Knee joint patellofemoral polymer/metal semi-constrained cemented prosthesis. (a) Identification. A knee joint patellofemoral polymer/metal semi-constrained cemented prosthesis is a two-part...

  2. 21 CFR 888.3500 - Knee joint femorotibial metal/composite semi-constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Knee joint femorotibial metal/composite semi... § 888.3500 Knee joint femorotibial metal/composite semi-constrained cemented prosthesis. (a) Identification. A knee joint femorotibial metal/composite semi-constrained cemented prosthesis is a two-part...

  3. 21 CFR 888.3520 - Knee joint femorotibial metal/polymer non-constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Knee joint femorotibial metal/polymer non... § 888.3520 Knee joint femorotibial metal/polymer non-constrained cemented prosthesis. (a) Identification. A knee joint femorotibial metal/polymer non-constrained cemented prosthesis is a device intended to...

  4. 21 CFR 888.3550 - Knee joint patellofemorotibial polymer/metal/metal constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Knee joint patellofemorotibial polymer/metal/metal... § 888.3550 Knee joint patellofemorotibial polymer/metal/metal constrained cemented prosthesis. (a) Identification. A knee joint patellofemorotibial polymer/metal/metal constrained cemented prosthesis is a device...

  5. 21 CFR 888.3490 - Knee joint femorotibial metal/composite non-constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Knee joint femorotibial metal/composite non... § 888.3490 Knee joint femorotibial metal/composite non-constrained cemented prosthesis. (a) Identification. A knee joint femorotibial metal/composite non-constrained cemented prosthesis is a device...

  6. Neuromuscular knee joint control in adolescents with and without Generalised Joint Hypermobility during landing in the Single leg Hop for Distance test

    DEFF Research Database (Denmark)

    Junge, Tina; Juul-Kristensen, B; Thorlund, J B

    2014-01-01

    Severe knee injuries can occur due to biomechanical factors such as knee joint laxity. Generalised Joint Hypermobility (GJH) has been proposed as an intrinsic risk factor for knee injuries in adults and adolescents, as individuals with GJH often have knee joint hypermobility. Also, critical knee ...

  7. Neuromuscular knee joint control in adolescents with and without Generalised Joint Hypermobility during landing in the Single leg Hop for Distance test

    DEFF Research Database (Denmark)

    Junge, Tina; Juul-Kristensen, B; Thorlund, J B

    Severe knee injuries can occur due to biomechanical factors such as knee joint laxity. Generalised Joint Hypermobility (GJH) has been proposed as an intrinsic risk factor for knee injuries in adults and adolescents, as individuals with GJH often have knee joint hypermobility. Also, critical knee ...

  8. Localized tenosynovial giant cell tumor in both knee joints

    International Nuclear Information System (INIS)

    Kim, Hyun Su; Kwon, Jong Won; Ahn, Jin Hwan; Chang, Moon Jong; Cho, Eun Yoon

    2010-01-01

    Tenosynovial giant cell tumor, previously called pigmented villonodular synovitis (PVNS), is a rare benign neoplastic process that may involve the synovium of the joint. The disorder is usually monoarticular and only a few cases have been reported on polyarticular involvement. Herein, we present a case of localized intra-articular tenosynovial giant cell tumor in a 29-year-old man involving both knee joints with a description of the MR imaging and histological findings. (orig.)

  9. MRI diagnosis of knee joint injury: the clinical application with a report of 35 cases

    International Nuclear Information System (INIS)

    Zhao Quan; Tang Ni; Wu Xiaoyong; Zhao Ping; Guan Huanwen

    2006-01-01

    Objective: To study the MRI findings of knee joint injury and the pathalogical basis and clinical significance. Methods: MR images of the knee joint injury were investigated in 35 cases. Results: In 23 cases of meniscus damage, lesions were nodular, linear or radioactive fissure with hyperintense signal within the dark meniscus, extending to or beneath the articular cartilage surface. In 9 cases of cruciate ligament injury, the disorder was a hyperintense shadow which was hyperintense on T 1 WI and hypointense on T 2 WI within the stripe-like, hypointense ligament, accompanying with the alteration of the ligament, which was in a wave shape or discontinued. Dislocation of the tibia was also revealed. In 5 cases of the bilateral collateral ligament damage. The involved thickened ligament had increased signal and blurred edge. In 4 cases of obscure bone fracture, the lesion was located in the metaphysic, manifested a hypo-intense shadow on T 1 WI, diverse on T 2 WI. Conclusion: MRI plays an important role in the diagnosis of the injury of menicus, ligament, and the obscure fracture of knee joint, and provides detailed information for the clinical management. (authors)

  10. 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.

  11. Interlimb symmetry of dynamic knee joint stiffness and co-contraction is maintained in early stage knee osteoarthritis.

    Science.gov (United States)

    Collins, A T; Richardson, R T; Higginson, J S

    2014-08-01

    Individuals with knee OA often exhibit greater co-contraction of antagonistic muscle groups surrounding the affected joint which may lead to increases in dynamic joint stiffness. These detrimental changes in the symptomatic limb may also exist in the contralateral limb, thus contributing to its risk of developing knee osteoarthritis. The purpose of this study is to investigate the interlimb symmetry of dynamic knee joint stiffness and muscular co-contraction in knee osteoarthritis. Muscular co-contraction and dynamic knee joint stiffness were assessed in 17 subjects with mild to moderate unilateral medial compartment knee osteoarthritis and 17 healthy control subjects while walking at a controlled speed (1.0m/s). Paired and independent t-tests determined whether significant differences exist between groups (pknees compared to the healthy group (p=0.051). Subjects with mild to moderate knee osteoarthritis maintain symmetric control strategies during gait. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Temporal gene expression profiling of the rat knee joint capsule during immobilization-induced joint contractures.

    Science.gov (United States)

    Wong, Kayleigh; Sun, Fangui; Trudel, Guy; Sebastiani, Paola; Laneuville, Odette

    2015-05-26

    Contractures of the knee joint cause disability and handicap. Recovering range of motion is recognized by arthritic patients as their preference for improved health outcome secondary only to pain management. Clinical and experimental studies provide evidence that the posterior knee capsule prevents the knee from achieving full extension. This study was undertaken to investigate the dynamic changes of the joint capsule transcriptome during the progression of knee joint contractures induced by immobilization. We performed a microarray analysis of genes expressed in the posterior knee joint capsule following induction of a flexion contracture by rigidly immobilizing the rat knee joint over a time-course of 16 weeks. Fold changes of expression values were measured and co-expressed genes were identified by clustering based on time-series analysis. Genes associated with immobilization were further analyzed to reveal pathways and biological significance and validated by immunohistochemistry on sagittal sections of knee joints. Changes in expression with a minimum of 1.5 fold changes were dominated by a decrease in expression for 7732 probe sets occurring at week 8 while the expression of 2251 probe sets increased. Clusters of genes with similar profiles of expression included a total of 162 genes displaying at least a 2 fold change compared to week 1. Functional analysis revealed ontology categories corresponding to triglyceride metabolism, extracellular matrix and muscle contraction. The altered expression of selected genes involved in the triglyceride biosynthesis pathway; AGPAT-9, and of the genes P4HB and HSP47, both involved in collagen synthesis, was confirmed by immunohistochemistry. Gene expression in the knee joint capsule was sensitive to joint immobility and provided insights into molecular mechanisms relevant to the pathophysiology of knee flexion contractures. Capsule responses to immobilization was dynamic and characterized by modulation of at least three

  13. Experimental quadriceps muscle pain impairs knee joint control during walking

    DEFF Research Database (Denmark)

    Henriksen, Marius; Alkjaer, Tine; Lund, Hans

    2007-01-01

    Pain is a cardinal symptom in musculoskeletal diseases involving the knee joint, and aberrant movement patterns and motor control strategies are often present in these patients. However, the underlying neuromuscular mechanisms linking pain to movement and motor control are unclear. To investigate...... the functional significance of muscle pain on knee joint control during walking, three-dimensional gait analyses were performed before, during, and after experimentally induced muscle pain by means of intramuscular injections of hypertonic saline (5.8%) into vastus medialis (VM) muscle of 20 healthy subjects....... Isotonic saline (0.9%) was used as control. Surface electromyography (EMG) recordings of VM, vastus lateralis (VL), biceps femoris, and semitendinosus muscles were synchronized with the gait analyses. During experimental muscle pain, the loading response phase peak knee extensor moments were attenuated...

  14. Review: Modelling of meniscus of knee joint during soccer kicking

    Science.gov (United States)

    Azrul Hisham Mohd Adib, Mohd; Firdaus Jaafar, Mohd

    2013-12-01

    Knee is a part of the body that located between thigh and shank is one of the most complicated and largest joints in the human body. The common injuries that occur are ligaments, meniscus or bone fracture. During soccer games, the knee is the most critical part that will easily injure due to the shock from an external impact. Torn meniscus is one of the effects. This study will investigate the effect towards the meniscus within the knee joint during soccer ball kicking. We conduct a literary review of 14 journals that discuss the general view of meniscus and also soccer kicking. The selected topics for this review paper are meniscal function, meniscal movement, meniscal tears and also instep kick. As a finding, statistics show that most meniscal tears (73%) occurred in athletes who were soccer players, basketball players or skiers. The tear is frequently happening at the medial side rather than lateral side with a percentage of 70%.

  15. Ageing and Incidence of Osteoarthritis of the Knee Joint, Lumbar ...

    African Journals Online (AJOL)

    There was a significant difference in the distribution of osteoarthritis between gender and within the age groups (P=0.000). Osteoarthritis of the lumbar spine was the highest in males within the age groups of 61-65, followed by 45- 50, 56 - 60, and 51 - 55; whereas in the females, osteoarthritis of the knee joint was the ...

  16. Joint replacement in Zambia: A review of Hip & Knee Replacement ...

    African Journals Online (AJOL)

    Methods: Data captured by the different variables entered into the Joint Register covering the pre-op, intra-op and post-op period of all total hip and knee replacement surgery done at the ZIOH from 1998 to 2010 was entered into a spreadsheet after verification with individual patient medical records. This was then imported ...

  17. 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.

  18. The effects of transcutaneous electrical nerve stimulation on joint position sense in patients with knee joint osteoarthritis.

    Science.gov (United States)

    Shirazi, Zahra Rojhani; Shafaee, Razieh; Abbasi, Leila

    2014-10-01

    To study the effects of transcutaneous electrical nerve stimulation (TENS) on joint position sense (JPS) in knee osteoarthritis (OA) subjects. Thirty subjects with knee OA (40-60 years old) using non-random sampling participated in this study. In order to evaluate the absolute error of repositioning of the knee joint, Qualysis Track Manager system was used and sensory electrical stimulation was applied through the TENS device. The mean errors in repositioning of the joint, in two position of the knee joint with 20 and 60 degree angle, after applying the TENS was significantly decreased (p knee OA could improve JPS in these subjects.

  19. DINAMICS OF KNEE JOINT SPACE ASYMMETRY ON X-RAY AS A MARKER OF KNEE OSTEOARTHRITIS REHABILITATION EFFICACY.

    Science.gov (United States)

    Sheveleva, N; Minbayeva, L; Belyayeva, Y

    2017-03-01

    Reducing of articular cartilage functional volume in knee joint osteoarthritis occurs unevenly and accompanied with pathological changes of lower limb axis as a result of connective tissue and muscle structures dysfunction. Evaluation of X-ray knee joint space asymmetry seems to be informative to analyze the dynamics of lower extremities biomechanical imbalances characteristic for knee joint osteoarthritis. However, standardized method of X-ray joint space determining does not include its symmetry calculation. The purpose of the study was optimization of knee joint radiological examination by developing of X-ray knee joint space asymmetry index calculation method. The proposed method was used for comparative analysis of extracorporeal shock-wave therapy efficacy in 30 patients with knee joint osteoarthritis of 2-3 degrees (Kellgren-Lawrence, 1957). As a result of the conducted treatment statistically significant decrease of the X-ray knee joint space asymmetry index was observed (Me(Q1;Q3): Z=5.20, pknee joint space asymmetry index, calculated according to the proposed method, allows to evaluate dynamics of articular surfaces congruency changes and provide differentiated approach to the treatment of knee joint osteoarthritis.

  20. Proprioceptive acuity into knee hypermobile range in children with Joint Hypermobility Syndrome

    OpenAIRE

    Pacey, Verity; Adams, Roger D; Tofts, Louise; Munns, Craig F; Nicholson, Leslie L

    2014-01-01

    Background Children with Joint Hypermobility Syndrome (JHS) have reduced knee joint proprioceptive acuity compared to peers. Altered proprioception at end of range in individuals with JHS is hypothesised to contribute to recurrent joint injuries and instability. This study aims to provide the first objective comparison of functional knee joint proprioceptive acuity in hyperextension range compared to early flexion range in children with JHS. Methods Active, weight-bearing knee joint proprioce...

  1. Knee Joint Loads and Surrounding Muscle Forces during Stair Ascent in Patients with Total Knee Replacement

    Science.gov (United States)

    Rasnick, Robert; Standifird, Tyler; Reinbolt, Jeffrey A.; Cates, Harold E.

    2016-01-01

    Total knee replacement (TKR) is commonly used to correct end-stage knee osteoarthritis. Unfortunately, difficulty with stair climbing often persists and prolongs the challenges of TKR patents. Complete understanding of loading at the knee is of great interest in order to aid patient populations, implant manufacturers, rehabilitation, and future healthcare research. Musculoskeletal modeling and simulation approximates joint loading and corresponding muscle forces during a movement. The purpose of this study was to determine if knee joint loadings following TKR are recovered to the level of healthy individuals, and determine the differences in muscle forces causing those loadings. Data from five healthy and five TKR patients were selected for musculoskeletal simulation. Variables of interest included knee joint reaction forces (JRF) and the corresponding muscle forces. A paired samples t-test was used to detect differences between groups for each variable of interest (pknee extension moment and muscle forces during the loading response phase indicates the presence of deficits in TKR in quadriceps muscle force production during stair ascent. This result combined with greater flexor muscle forces resulted in similar compressive JRF during loading response between groups. PMID:27258086

  2. 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.

  3. Rotationplasty with vascular reconstruction for prosthetic knee joint infection.

    Science.gov (United States)

    Fujiki, Masahide; Miyamoto, Shimpei; Nakatani, Fumihiko; Kawai, Akira; Sakuraba, Minoru

    2015-01-01

    Rotationplasty is used most often as a function-preserving salvage procedure after resection of sarcomas of the lower extremity; however, it is also used after infection of prosthetic knee joints. Conventional vascular management during rotationplasty is to preserve and coil major vessels, but recently, transection and reanastomosis of the major vessels has been widely performed. However, there has been little discussion regarding the optimal vascular management of rotationplasty after infection of prosthetic knee joints because rotationplasty is rarely performed for this indication. We reviewed four patients who had undergone resection of osteosarcomas of the femur, placement of a prosthetic knee joint, and rotationplasty with vascular reconstruction from 2010 to 2013. The mean interval between prosthetic joint replacement and rotationplasty was 10.4 years and the mean interval between the diagnosis of prosthesis infection and rotationplasty was 7.9 years. Rotationplasty was successful in all patients; however, in one patient, arterial thrombosis developed and necessitated urgent surgical removal and arterial reconstruction. All patients were able to walk independently with a prosthetic limb after rehabilitation. Although there is no consensus regarding the most appropriate method of vascular management during rotationplasty for revision of infected prosthetic joints, vascular transection and reanastomosis is a useful option.

  4. Sex differences in proximal control of the knee joint.

    Science.gov (United States)

    Mendiguchia, Jurdan; Ford, Kevin R; Quatman, Carmen E; Alentorn-Geli, Eduard; Hewett, Timothy E

    2011-07-01

    Following the onset of maturation, female athletes have a significantly higher risk for anterior cruciate ligament (ACL) injury compared with male athletes. While multiple sex differences in lower-extremity neuromuscular control and biomechanics have been identified as potential risk factors for ACL injury in females, the majority of these studies have focused specifically on the knee joint. However, increasing evidence in the literature indicates that lumbo-pelvic (core) control may have a large effect on knee-joint control and injury risk. This review examines the published evidence on the contributions of the trunk and hip to knee-joint control. Specifically, the sex differences in potential proximal controllers of the knee as risk factors for ACL injury are identified and discussed. Sex differences in trunk and hip biomechanics have been identified in all planes of motion (sagittal, coronal and transverse). Essentially, female athletes show greater lateral trunk displacement, altered trunk and hip flexion angles, greater ranges of trunk motion, and increased hip adduction and internal rotation during sport manoeuvres, compared with their male counterparts. These differences may increase the risk of ACL injury among female athletes. Prevention programmes targeted towards trunk and hip neuromuscular control may decrease the risk for ACL injuries.

  5. Sex Differences in Proximal Control of the Knee Joint

    Science.gov (United States)

    Mendiguchia, Jurdan; Ford, Kevin R.; Quatman, Carmen E.; Alentorn-Geli, Eduard; Hewett, Timothy E.

    2014-01-01

    Following the onset of maturation, female athletes have a significantly higher risk for anterior cruciate ligament (ACL) injury compared with male athletes. While multiple sex differences in lower-extremity neuromuscular control and biomechanics have been identified as potential risk factors for ACL injury in females, the majority of these studies have focused specifically on the knee joint. However, increasing evidence in the literature indicates that lumbopelvic (core) control may have a large effect on knee-joint control and injury risk. This review examines the published evidence on the contributions of the trunk and hip to knee-joint control. Specifically, the sex differences in potential proximal controllers of the knee as risk factors for ACL injury are identified and discussed. Sex differences in trunk and hip biomechanics have been identified in all planes of motion (sagittal, coronal and transverse). Essentially, female athletes show greater lateral trunk displacement, altered trunk and hip flexion angles, greater ranges of trunk motion, and increased hip adduction and internal rotation during sport manoeuvres, compared with their male counterparts. These differences may increase the risk of ACL injury among female athletes. Prevention programmes targeted towards trunk and hip neuromuscular control may decrease the risk for ACL injuries. PMID:21688868

  6. 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.

  7. Intra-articular Nodular Fasciitis: An Unexpected Diagnosis for a Joint Lesion: A Case Report

    Directory of Open Access Journals (Sweden)

    MF Michelle Chan

    2014-07-01

    Full Text Available Pathological lesions in and around a joint can arise from underlying dermis, subcutis, deep muscle, bone or synovium. Clinical presentation can include joint pain, joint swelling, palpable masses and mechanical restriction. Whilst giant cell tumour of tendon sheath, pigmented villonodular synovitis, synovial chondromatosis, lipoma arborescens, juxta articular myxomas and inflammatory arthritis are the better-known conditions of the joint. Intra-articular nodular fasciitis, on the other hand, is less well recognized both clinically and radiologically. It is rarely seen in routine practice and is only described in case reports in the literature. Due to the non-specific clinical and radiological findings as well as the unfamiliarity with the entity, the diagnosis of intra-articular nodular fasciitis is usually clinched only after histological examination. We present a case of intra-articular nodular fasciitis arising in the knee joint which was not suspected clinically or radiologically.

  8. MRI STUDY OF TYPES AND INCIDENCE OF INTERNAL DERANGEMENTS OF TRAUMATIC KNEE JOINT

    Directory of Open Access Journals (Sweden)

    Bomidi Sudha Rani

    2016-12-01

    Full Text Available BACKGROUND MRI has been accepted as the best imaging modality for noninvasive evaluation of knee injuries and it has proved reliable, safe and offers advantages over diagnostic arthroscopy, which is currently regarded as the reference standard for the diagnosis of internal derangements of the knee. 1 METHODS AND MATERIALS A prospective study of fifty patients who underwent MRI for the diagnosis of internal derangement of knee was conducted between the period of January 2015 to January 2016 in Government General Hospital, Kakinada. All the patients with history of knee joint pain following trauma and clinically suspected to have meniscal and ligament tears are included in the study. Patients were evaluated using GE 1.5 T MRI machine with pulsar gradient system using a sensor extremity coil. RESULTS Commonest lesion detected in our study was ACL tear followed by medial meniscal tear and medial collateral ligament injury. The most common sign of cruciate ligament injury was hyperintensity in the ligament. Grade 3 was the most common grade of meniscal tear. CONCLUSION MRI is an excellent, noninvasive, radiation free imaging modality and is unique in its ability to evaluate the internal structure as well as soft tissue delineation. Many anatomical variants can mimic a tear on MRI. MRI is an excellent noninvasive modality for imaging the knee and helps in arriving at a correct anatomical diagnosis there by guiding further management of the patient.

  9. Kinetic analysis of the human knee joint

    Directory of Open Access Journals (Sweden)

    E Wiczkowski

    2008-03-01

    Full Text Available The pathology of the calcaneal (Achilles tendon constitutes a serious therapeutical and social problem. Indeed, this tendon is the strongest plantar flexor of the foot that plays an important role in the humangait. Although well known for a long time, no explicit description of the spontaneous subcutaneous rupture of the Achilles tendon can be found in medical or biomechanical literature. So far, neither pathomechanism nor the underlying causes of the tendon’s disruption have been fully elucidated. Many authors concentrate mostly on medical and biological aspects of the condition. The commonly held view is that it is the vascular supply to the tendon that plays a crucial role in pathogenesis of the tendon’s injuries. In fact, the vasculature a change with time and after the age of 30 is significantly reduced leading to the development of regressive alterations within as well as the decrement of the mechanical strength of the tendon. Obviously, interdisciplinary approach encompassing not only medical and biological but also the broadly taken mechanical viewpoint is needed to more comprehensively describe and explain this phenomenon. In the present paper, kinetic analysis of the knee was employed to define the trajectory of the point of initial insertion of the medial head of gastrocnemius, which was then used to determine the point’s route within the motor area extending from the flexion to the full extension of the knee. The obtained data on the trajectory are further utilized to present and define the pathomechanism of the spontaneous rupture of the calcaneal tendon.

  10. 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

  11. Comparison of arthroscopy and magnetic resonance imaging in investigation of the knee joint

    International Nuclear Information System (INIS)

    Zazyirnij, Yi.M.; Rogozhin, V.O.; Ternovij, M.K.

    2002-01-01

    MRI was done in 41 patients aged 18-56 who were treated for stage 1 and 2 osteoarthrosis of the knee joint. The analysis of accuracy, sensitivity, specificity suggests that MRI facilitates assessment of the state of the knee cartilage and menisci. High negative preliminary data of MRI allow to avoid unnecessary arthroscopy of the knee joint

  12. Shea Nut Oil Triterpene Concentrate Attenuates Knee Osteoarthritis Development in Rats: Evidence from Knee Joint Histology.

    Directory of Open Access Journals (Sweden)

    Jen-Hsin Kao

    Full Text Available Shea nut oil triterpene concentrate is considered to have anti-inflammatory and antioxidant properties. Traditionally, it has been used to treat arthritic conditions in humans. This study aimed to investigate the effect of attenuating osteoarthritis (OA-induced pain and joint destruction in rats by administering shea nut oil triterpene concentrate (SheaFlex75, which is more than 50% triterpenes.An anterior cruciate ligament transaction (ACLT with medial meniscectomy (MMx was used to induce OA in male Wistar rats. Different doses of SheaFlex75 (111.6 mg/kg, 223.2 mg/kg, and 446.4 mg/kg were then intragastrically administered daily for 12 weeks after surgery. Body weight and the width of the knee joint were measured weekly. Additionally, incapacitance tests were performed at weeks 2, 4, 6, 8, 10 and 12 to measure the weight bearing of the hind limbs, and the morphology and histopathology of the medial femoral condyles were examined and were evaluated using the Osteoarthritis Research Society International (OARSI scoring system.This study showed that SheaFlex75 reduced the swelling of the knee joint with OA and rectified its weight bearing after ACLT plus MMx surgery in rats. Treatment with SheaFlex75 also decreased ACLT plus MMx surgery-induced knee joint matrix loss and cartilage degeneration.SheaFlex75 relieves the symptoms of OA and protects cartilage from degeneration. SheaFlex75 thus has the potential to be an ideal nutraceutical supplement for joint protection, particularly for injured knee joints.

  13. Shea Nut Oil Triterpene Concentrate Attenuates Knee Osteoarthritis Development in Rats: Evidence from Knee Joint Histology.

    Science.gov (United States)

    Kao, Jen-Hsin; Lin, Sheng-Hsiung; Lai, Chun-Fu; Lin, Yu-Chieh; Kong, Zwe-Ling; Wong, Chih-Shung

    2016-01-01

    Shea nut oil triterpene concentrate is considered to have anti-inflammatory and antioxidant properties. Traditionally, it has been used to treat arthritic conditions in humans. This study aimed to investigate the effect of attenuating osteoarthritis (OA)-induced pain and joint destruction in rats by administering shea nut oil triterpene concentrate (SheaFlex75, which is more than 50% triterpenes). An anterior cruciate ligament transaction (ACLT) with medial meniscectomy (MMx) was used to induce OA in male Wistar rats. Different doses of SheaFlex75 (111.6 mg/kg, 223.2 mg/kg, and 446.4 mg/kg) were then intragastrically administered daily for 12 weeks after surgery. Body weight and the width of the knee joint were measured weekly. Additionally, incapacitance tests were performed at weeks 2, 4, 6, 8, 10 and 12 to measure the weight bearing of the hind limbs, and the morphology and histopathology of the medial femoral condyles were examined and were evaluated using the Osteoarthritis Research Society International (OARSI) scoring system. This study showed that SheaFlex75 reduced the swelling of the knee joint with OA and rectified its weight bearing after ACLT plus MMx surgery in rats. Treatment with SheaFlex75 also decreased ACLT plus MMx surgery-induced knee joint matrix loss and cartilage degeneration. SheaFlex75 relieves the symptoms of OA and protects cartilage from degeneration. SheaFlex75 thus has the potential to be an ideal nutraceutical supplement for joint protection, particularly for injured knee joints.

  14. Flexibility of Knee Joint Muscles in Women with Knee Osteoarthritis and Healthy Controls

    Directory of Open Access Journals (Sweden)

    Sara Abolahrari Shirazi

    2015-09-01

    Full Text Available Background: Osteoarthritis is one of the most common diseases in synovial joints. Due to high loading forces during weight-bearing activities, the knee joint is prone to degenerative processes. This study aimed to compare the flexibility of muscles around the knee joint in patients with knee osteoarthritis with those of healthy individuals. Methods: Twenty-three women with bilateral knee osteoarthritis and 23 healthy women matched with the patient group for age, height and weight participated in this study. Flexibility of the quadriceps, hamstring, iliotibial band, adductor and gastrocnemius muscles was evaluated with a goniometric device. Pain intensity was assessed with a visual analogue scale. The data were analyzed with independent t-tests to compare the two groups, and Pearson correlation coefficient was calculated to correlate muscle flexibility and pain intensity. Results: significant lower flexibility of the bilateral quadriceps muscles was found in patients compared to healthy women (P<0.05. No significant differences were detected between groups regarding other muscles. Quadriceps flexibility correlated significantly with pain intensity in patients (P<0.001. Conclusion: In patients with osteoarthritis, quadriceps flexibility may be decreased although other muscles may remain unaffected. Quadriceps stretching is thus a potentially important component of treatment, which may influence pain reduction in these patients.

  15. Morel-Lavallée Lesion of the Knee in a Recreational Frisbee Player

    Directory of Open Access Journals (Sweden)

    Alison Shmerling

    2016-01-01

    Full Text Available Traumatic swelling/effusion in the knee region is a relatively common presenting complaint among athletes and nonathletes. Due to its broad differential diagnosis, a comprehensive evaluation beginning with history and physical examination are recommended. Knee joint effusion can be differentiated from other types of swelling by careful physical examination. Imaging, including plain radiography, ultrasound, and magnetic resonance imaging (MRI, is preferred modality. Aspiration of a local fluctuating mass may help with the diagnosis and management of some of these conditions. We present a case of a 26-year-old gentleman with superomedial Morel-Lavallée lesion (MLL of the knee with history of a fall during a Frisbee game. His MLL was successfully treated with therapeutic aspiration and compression wrap without further sequelae. MLL is a rare condition consisting of a closed degloving injury caused by pressure and shear stress between the subcutaneous tissue and the superficial fascia or bone. Most commonly, MLL is found over the greater trochanter and sacrum but in rare cases can occur in other regions of the body. In most cases, concurrent severe injury mechanisms and concomitant fractures are present. MLL due to sports injuries are very rare. Therapeutic strategies may vary from compression wraps and aspiration to surgical evacuation.

  16. Knee joint anterior malalignment and patellofemoral osteoarthritis: an MRI study

    International Nuclear Information System (INIS)

    Tsavalas, Nikolaos; Karantanas, Apostolos H.; Katonis, Pavlos

    2012-01-01

    To evaluate patellofemoral congruency measurements on MRI and correlate the findings with severity of ipsilateral osteoarthritis. We retrospectively reviewed 650 consecutive knee MRI examinations from 622 patients divided into two age groups: ≤50 and >50 year-old. The femoral sulcus angle (SA) and depth (SD), lateral patellar displacement (LPD), lateral patellofemoral angle (LPFA), tibial tubercle-trochlear groove (TT-TG) distance and Insall-Salvati index as well as the grade of focal cartilage defects (ranging from I to IV) in the patellofemoral region were assessed in each subject on axial and sagittal fat-saturated intermediate-w MR images. A significant difference exists between normal and knees with patellofemoral joint osteoarthritis regarding SA (p = 0.0002 and 50 respectively). Significant correlation was found between grading of cartilage defects and SA (rho = 0.21, p = 0.0001 and 0.443, <0.0001), SD (rho = -0.198, p = 0.0003 and -0.418, <0.0001), LPD (rho = 0.176, p = 0.0013 and 0.251, 0.0002) and LPFA (rho = -0.204, p = 0.0002 and -0.239, 0.0005) in both age groups. Knee joint anterior malalignment is multivariably associated with patellofemoral osteoarthritis. circle MRI is an excellent method to evaluate knee alignment and articular cartilage damage. (orig.)

  17. Iron deposits in the knee joints of a thalassemic patient

    Directory of Open Access Journals (Sweden)

    Charalambos P Economides

    2013-02-01

    Full Text Available The overall prognosis for patients with ß-thalassemia has improved considerably during the past decades mainly due to regular blood transfusions, improvements in chelation therapy, and enhanced surveillance with imaging studies examining iron overload and other clinical complications. However, the prolonged survival of these patients leads to the development of other health problems including degenerative diseases such as arthropathies, which require further attention since they have a significant impact on the quality of life. In the current case report, we present a 45-year-old white man with ß-thalassemia complaining of non-traumatic pain and restriction in the range of motion of both knees. Magnetic resonance imaging (MRI revealed a tear in the medial meniscus of the left knee as well as iron deposits in both knees. Histological findings confirmed the presence of hemosiderin in both joints. To our knowledge, this is the first reported case of macroscopically documented iron deposits in the knee joints of a patient with ß-thalassemia using MRI.

  18. The extent and risk of knee injuries in children aged 9-14 with Generalised Joint Hypermobility and knee joint hypermobility

    DEFF Research Database (Denmark)

    Junge, Tina; Runge, Lisbeth; Juul-Kristensen, Birgit

    2015-01-01

    BACKGROUND: Generalised Joint Hypermobility (GJH) is suggested as an aetiological factor for knee injuries in adolescents and adults. It is presumed that GJH causes decreased joint stability, thereby increasing the risk of knee injuries during challenging situations like jumping and landing. The ...

  19. Knee joint changes in patients with neglected developmental hip dysplasia: a prospective case-control study.

    Science.gov (United States)

    Li, Qiwei; Kadhim, Muayad; Zhang, Lijun; Cheng, Xiangjun; Zhao, Qun; Li, Lianyong

    2014-12-01

    Few reports are available describing knee changes in neglected developmental dysplasia of the hip (DDH). The purpose of this study was to assess the radiographic morphology of knee joints in adults with neglected DDH. Thirty-seven patients (35 females and two males) with neglected DDH were prospectively recruited with an average age of 32.6 years. Twenty-three patients had unilateral and 14 patients had bilateral neglected DDH. Thirty-seven healthy individuals were recruited to form a matched control group. Three groups of knee joints were examined: affected knees (on the same side of the neglected DDH), unaffected knees (contralateral to the neglected DDH in patients with unilateral involvement), and control knees. A series of radiographic parameters of the knee joint were measured in the coronal and sagittal plane, and they were compared between patients and normal controls. In the coronal plane, the affected knees had increased valgus angulation related to increased height of the medial femoral condyle, decreased height of the lateral femoral condyle and decreased lateral distal femoral angle compared to control knees. In the sagittal plane, both distal femoral and proximal tibial joints of the affected knees developed a decrease in posterior angles. Additionally, the unaffected knees also developed radiographic changes compared to control knees. Patients with neglected DDH may develop changes in both knee joints. These changes should be considered during surgery to the hip, femur and knee to prevent potential complications. Level 2. Copyright © 2014 Elsevier B.V. All rights reserved.

  20. Sex Differences in Proximal Control of the Knee Joint

    OpenAIRE

    Mendiguchia, Jurdan; Ford, Kevin R.; Quatman, Carmen E.; Alentorn-Geli, Eduard; Hewett, Timothy E.

    2011-01-01

    Following the onset of maturation, female athletes have a significantly higher risk for anterior cruciate ligament (ACL) injury compared with male athletes. While multiple sex differences in lower-extremity neuromuscular control and biomechanics have been identified as potential risk factors for ACL injury in females, the majority of these studies have focused specifically on the knee joint. However, increasing evidence in the literature indicates that lumbopelvic (core) control may have a la...

  1. The reliability of knee joint position testing using electrogoniometry

    Directory of Open Access Journals (Sweden)

    Winter Adele

    2008-01-01

    Full Text Available Abstract Background The current investigation examined the inter- and intra-tester reliability of knee joint angle measurements using a flexible Penny and Giles Biometric® electrogoniometer. The clinical utility of electrogoniometry was also addressed. Methods The first study examined the inter- and intra-tester reliability of measurements of knee joint angles in supine, sitting and standing in 35 healthy adults. The second study evaluated inter-tester and intra-tester reliability of knee joint angle measurements in standing and after walking 10 metres in 20 healthy adults, using an enhanced measurement protocol with a more detailed electrogoniometer attachment procedure. Both inter-tester reliability studies involved two testers. Results In the first study, inter-tester reliability (ICC[2,10] ranged from 0.58–0.71 in supine, 0.68–0.79 in sitting and 0.57–0.80 in standing. The standard error of measurement between testers was less than 3.55° and the limits of agreement ranged from -12.51° to 12.21°. Reliability coefficients for intra-tester reliability (ICC[3,10] ranged from 0.75–0.76 in supine, 0.86–0.87 in sitting and 0.87–0.88 in standing. The standard error of measurement for repeated measures by the same tester was less than 1.7° and the limits of agreement ranged from -8.13° to 7.90°. The second study showed that using a more detailed electrogoniometer attachment protocol reduced the error of measurement between testers to 0.5°. Conclusion Using a standardised protocol, reliable measures of knee joint angles can be gained in standing, supine and sitting by using a flexible goniometer.

  2. No exacerbation of knee joint pain and effusion following preoperative progressive resistance training in patients scheduled for total knee arthroplasty

    DEFF Research Database (Denmark)

    Skoffer, Birgit; Dalgas, Ulrik; Maribo, Thomas

    2017-01-01

    BACKGROUND: Preoperative progressive resistance training (PRT) is controversial in patients scheduled for total knee arthroplasty (TKA), because of the concern that it may exacerbate knee joint pain and effusion. OBJECTIVE: To examine if preoperative PRT initiated 5 weeks prior to TKA would 1......) exacerbate pain and knee effusion, 2) allow a progressively increased training load throughout the training period that would subsequently increase muscle strength. DESIGN: Secondary analyses from a randomized controlled trial. SETTING: University Hospital and a Regional Hospital. PATIENTS: Thirty patients...... OUTCOME MEASURES: Before and after each training session, knee joint pain rated on an 11-point scale, effusion assessed by measuring the knee joint circumference, and training load were recorded. The first and last training session were initiated by 1RM testing of unilateral leg press, knee extension...

  3. 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

  4. 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.

  5. MRI demonstrates the extension of juxta-articular venous malformation of the knee and correlates with joint changes

    Energy Technology Data Exchange (ETDEWEB)

    Jans, L. [University of Melbourne, Royal Children' s Hospital, Department of Medical Imaging, Melbourne, Victoria (Australia); Ghent University Hospital, Department of Radiology and Medical Imaging, Gent (Belgium); Ditchfield, M.; Jaremko, J.L.; Stephens, N. [University of Melbourne, Royal Children' s Hospital, Department of Medical Imaging, Melbourne, Victoria (Australia); Verstraete, K. [Ghent University Hospital, Department of Radiology and Medical Imaging, Gent (Belgium)

    2010-07-15

    Juxta-articular venous malformations (VMs) are uncommon, but may cause early arthropathy of the knee in children and adolescents. We sought to describe the prevalence, extent and initial magnetic resonance imaging (MRI) features of knee arthropathy in children with VM adjacent to the knee joint. Thirty-five patients with VM adjacent to the knee who had MRI performed between 2000 and 2009 were identified through a keyword search of the radiology information system. VM extended to the joint in 17 of the 35 patients (5.4-21.5 years, mean 11.8 years). Most of these 17 patients had joint changes (15/17, 88%), most commonly haemosiderin deposition (14/17, 82%). Other findings included the presence of subchondral bone lesions (eight, 47%), cartilage loss (six, 35%), synovial thickening (six, 35%), marrow oedema (six, 35%), joint effusion (five, 29%), subchondral cysts (five, 29%) and one loose body (6%). VM location and size did not correlate with the degree of articular involvement. Joint changes were present in focal as well as non-discrete VM. We found that the frequency of arthropathy increased with extension of VM into the joint itself. This finding stresses the importance of early MRI evaluation of all juxta-articular VM. (orig.)

  6. An acoustic startle alters knee joint stiffness and neuromuscular control.

    Science.gov (United States)

    DeAngelis, A I; Needle, A R; Kaminski, T W; Royer, T R; Knight, C A; Swanik, C B

    2015-08-01

    Growing evidence suggests that the nervous system contributes to non-contact knee ligament injury, but limited evidence has measured the effect of extrinsic events on joint stability. Following unanticipated events, the startle reflex leads to universal stiffening of the limbs, but no studies have investigated how an acoustic startle influences knee stiffness and muscle activation during a dynamic knee perturbation. Thirty-six individuals were tested for knee stiffness and muscle activation of the quadriceps and hamstrings. Subjects were seated and instructed to resist a 40-degree knee flexion perturbation from a relaxed state. During some trials, an acoustic startle (50 ms, 1000 Hz, 100 dB) was applied 100 ms prior to the perturbation. Knee stiffness, muscle amplitude, and timing were quantified across time, muscle, and startle conditions. The acoustic startle increased short-range (no startle: 0.044 ± 0.011 N·m/deg/kg; average startle: 0.047 ± 0.01 N·m/deg/kg) and total knee stiffness (no startle: 0.036 ± 0.01 N·m/deg/kg; first startle 0.027 ± 0.02 N·m/deg/kg). Additionally, the startle contributed to decreased [vastus medialis (VM): 13.76 ± 33.6%; vastus lateralis (VL): 6.72 ± 37.4%] but earlier (VM: 0.133 ± 0.17 s; VL: 0.124 ± 0.17 s) activation of the quadriceps muscles. The results of this study indicate that the startle response can significantly disrupt knee stiffness regulation required to maintain joint stability. Further studies should explore the role of unanticipated events on unintentional injury. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Response of knee fibrocartilage to joint destabilization.

    Science.gov (United States)

    Dyment, N A; Hagiwara, Y; Jiang, X; Huang, J; Adams, D J; Rowe, D W

    2015-06-01

    A major challenge to understanding osteoarthritis (OA) pathology is identifying the cellular events that precede the onset of cartilage damage. The objective of this study is to determine the effect of joint destabilization on early changes to fibrocartilage in the joint. The anterior cruciate ligament was transected in collagen reporter mice (Col1CFP and ColXRFP). Mineralization labels were given every 2 weeks to measure new mineralized cartilage apposition. Novel fluorescent histology of mineralized tissue was used to characterize the changes in fibrocartilage at 2 and 4 weeks post-injury. Changes in fibrocartilaginous structures of the joint occur as early as 2 weeks after injury and are well developed by 4 weeks. The alterations are seen in multiple entheses and in the medial surface of the femoral and tibial condyles. In the responding entheses, mineral apposition towards the ligament midsubstance results in thickening of the mineralize fibrocartilage. These changes are associated with increases in ColX-RFP, Col1-CFP reporter activity and alkaline phosphatase enzyme activity. Mineral apposition also occurs in the fibrocartilage of the non-articular regions of the medial condyles by 2 weeks and develops into osteophytes by 4 weeks post-injury. An unexpected observation is punctate expression of tartrate resistant acid phosphatase activity in unmineralized fibrochondrocytes adjacent to active appositional mineralization. These observations suggest that fibrocartilage activates prior to degradation of the articular cartilage. Thus clinical and histological imaging of fibrocartilage may be an earlier indicator of disease initiation and may indicate a more appropriate time to start preventative treatment. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  8. Predicting dynamic knee joint load with clinical measures in people with medial knee osteoarthritis.

    Science.gov (United States)

    Hunt, Michael A; Bennell, Kim L

    2011-08-01

    Knee joint loading, as measured by the knee adduction moment (KAM), has been implicated in the pathogenesis of knee osteoarthritis (OA). Given that the KAM can only currently be accurately measured in the laboratory setting with sophisticated and expensive equipment, its utility in the clinical setting is limited. This study aimed to determine the ability of a combination of four clinical measures to predict KAM values. Three-dimensional motion analysis was used to calculate the peak KAM at a self-selected walking speed in 47 consecutive individuals with medial compartment knee OA and varus malalignment. Clinical predictors included: body mass; tibial angle measured using an inclinometer; walking speed; and visually observed trunk lean toward the affected limb during the stance phase of walking. Multiple linear regression was performed to predict KAM magnitudes using the four clinical measures. A regression model including body mass (41% explained variance), tibial angle (17% explained variance), and walking speed (9% explained variance) explained a total of 67% of variance in the peak KAM. Our study demonstrates that a set of measures easily obtained in the clinical setting (body mass, tibial alignment, and walking speed) can help predict the KAM in people with medial knee OA. Identifying those patients who are more likely to experience high medial knee loads could assist clinicians in deciding whether load-modifying interventions may be appropriate for patients, whilst repeated assessment of joint load could provide a mechanism to monitor disease progression or success of treatment. Copyright © 2010 Elsevier B.V. All rights reserved.

  9. Experimental knee joint pain during strength training and muscle strength gain in healthy subjects

    DEFF Research Database (Denmark)

    Sørensen, T J; Langberg, Henning; Hodges, P W

    2012-01-01

    Knee joint pain and reduced quadriceps strength are cardinal symptoms in many knee pathologies. In people with painful knee pathologies, quadriceps exercise reduces pain, improves physical function, and increases muscle strength. A general assumption is that pain compromises muscle function...... and thus may prevent effective rehabilitation. This study evaluated the effects of experimental knee joint pain during quadriceps strength training on muscle strength gain in healthy individuals....

  10. The alignment of the knee joint in relationship to age and osteoarthritis

    DEFF Research Database (Denmark)

    Laxafoss, Erling; Jacobsen, Steffen; Gosvig, Kasper K

    2012-01-01

    INTRODUCTION: The aim of the present study was to describe the changes in the axis of the knee joint in both radiologically osteoarthritic and non-osteoarthritic knees, on the basis of angles measurable in standardized clinical short knee radiographs, in a cross sectional study of an epidemiologi......INTRODUCTION: The aim of the present study was to describe the changes in the axis of the knee joint in both radiologically osteoarthritic and non-osteoarthritic knees, on the basis of angles measurable in standardized clinical short knee radiographs, in a cross sectional study...

  11. Estabilidade articular do joelho no quadro do "joelho-flutuante" Knee joint stability in a "floating knee" condition

    Directory of Open Access Journals (Sweden)

    Felipe Antônio de Marco

    2008-01-01

    examination of the knee. The joint instability was present in eight cases (47% followed by restricted movement in seven patients (41.2%. Anterior instability was diagnosed in five cases (29.4%, three of them associated with varus instability. Posterior instability was observed in two patients (11.8% and in both cases it was associated with varus instability. One patient presented with peripheral varus-valgus instability and an important knee movement restriction. Intra-articular and exposed fractures of the femur and tibia present a higher incidence of restricted arc movement. The results obtained in this study reinforce the need for the systemic assessment of knee joint stability in view of the fact that the "floating knee" condition is often associated with lesions of the knee joint capsule and ligament.

  12. Structural joint changes, malalignment, and laxity in osteoarthritis of the knee

    NARCIS (Netherlands)

    van der Esch, M.; Steultjens, M.; Wieringa, H.; Dinant, H.; Dekker, J.

    2005-01-01

    To assess the relationship between (i) structural joint changes (i.e. joint space narrowing and osteophyte formation) and laxity and (ii) joint malalignment and laxity in osteoarthritis (OA) of the knee. A cross-sectional study was carried out on 35 outpatients with osteoarthritis of the knee.

  13. The Effect of Foot Progression Angle on Knee Joint Compression Force during Walking

    DEFF Research Database (Denmark)

    Baldvinsson, Henrik Koblauch; Heilskov-Hansen, Thomas; Alkjær, Tine

    2013-01-01

    males walked at a fixed speed of 4.5 km/h under three conditions: Normal walking, internally rotated and externally rotated. All gait-trials were recorded by six infrared cameras. Net joint moments were calculated by 3D inverse dynamics. The results revealed that the medial knee joint compartment......It is unclear how rotations of the lower limb affect the knee joint compression forces during walking. Increases in the frontal plane knee moment have been reported when walking with internally rotated feet and a decrease when walking with externally rotated feet. The aim of this study...... was to investigate the knee joint compressive forces during walking with internal, external and normal foot rotation and to determine if the frontal plane knee joint moment is an adequate surrogate for the compression forces in the medial and lateral knee joint compartments under such gait modifications. Ten healthy...

  14. Mobility function of a prosthetic knee joint with an automatic stance phase lock.

    Science.gov (United States)

    Andrysek, Jan; Klejman, Susan; Torres-Moreno, Ricardo; Heim, Winfried; Steinnagel, Bryan; Glasford, Shane

    2011-06-01

    There is a need for a prosthetic knee joint design that is technologically and functionally appropriate for use in developing countries. To develop and clinically evaluate a new type of stance phase controlled prosthetic knee joint that provides stance phase stability without inhibiting swing phase flexion. A crossover repeated measures study design comparing the new knee joint to the participant's conventional low- or high-end prosthetic knee joint. The new knee joint was fitted to fourteen individuals aged 15 to 67 years with unilateral lower limb amputations. Walk tests were performed to measure walking speed. Energy expenditure was estimated using the physiological cost index (PCI). Walking speeds with the new knee joint were on average 0.14 m/s faster than conventional low-end knees (p < 0.0001), but 0.07 m/s slower than conventional high-end prosthetic knees (p = 0.008). The PCI was similar across all three knee joint technologies (p = 0.276). Mobility function with the new knee joint, in terms of walking speed, was more closely matched to high-end than low-end prosthetic knee joints. Therefore, given its relatively simple design, the new stance phase control mechanism may offer a functional and cost effective solution for active transfemoral amputees. This paper describes a new type of prosthetic knee joint mechanism that is intended to be cost-effective while providing high-level stance phase function to active individuals with a transfemoral amputation. Initial clinical testing suggests that the new knee joint may have some functional advantages over existing technologies in this category.

  15. MRI EVALUATION OF PAINFUL KNEE JOINT- THE CORRELATION OF MULTIPLE COEXISTING PATHOLOGIES, AGE AND SEX

    Directory of Open Access Journals (Sweden)

    Mukheswar Pame

    2017-03-01

    Full Text Available BACKGROUND 1. To evaluate the incidence and coexistence of multiple knee joint pathologies causing painful knee and their correlation to age and sex. 2. To evaluate the Magnetic Resonance Imaging (MRI features in various knee pathologies and to identify the common lesions. MATERIALS AND METHODS A retrospective study was performed using the clinical data of patients presenting with painful knee joint which were evaluated with MRI. Data from 200 patients examined between September 2015 and August 2016 were included into this study. The data was analysed statistically to evaluate the correlation between the MR pathological findings to age and sex of the patients. RESULTS The patient’s age ranged between 8 and 75 years (mean: 36 years. Anterior cruciate ligament (ACL tear was the commonest finding (60% followed by bursitis (55%, meniscal degeneration (54.6% and meniscal tear (52%. Primary signs of ACL tear were hyperintensity, discontinuity and nonvisualisation. Secondary signs like Posterior cruciate ligament (PCL buckling, PCL index of greater than 0.5, uncovered Lateral meniscus (LM and bone contusion assisted in diagnosis in indeterminate cases. Mid substance was the commonest site of ACL tear (64%. PCL tear accounted for only a small percentage (7%. Medial Meniscus (MM tear (35% was commoner than LM tear (17%. The posterior horn of meniscus was the commonest site of injury (86.5%. Age was significantly correlated with meniscal degeneration and tear, Medial collateral ligament (MCL degeneration, parameniscal cyst, and chondromalacia patellae. A significant correlation between male gender and ACL injury was noted. Meniscal injury was significantly correlated with bursitis, as well with MCL injury. Bone bruise was significantly correlated with ACL injury, MCL injury and Lateral collateral ligament (LCL injury. CONCLUSIONS MRI findings of certain pathologies in a painful knee can coexist and significantly correlate with each other, age and sex of

  16. Knee joint examinations by magnetic resonance imaging: The correlation of pathology, age, and sex

    OpenAIRE

    Serhat Avcu; Ersan Altun; Ihsan Akpinar; Mehmet Deniz Bulut; Kemal Eresov; Tugrul Biren

    2010-01-01

    Aims: The aim of our study was to investigate the incidence and coexistence of multiple knee joint pathologies and the distribution of knee joint pathologies according to age and sex. Patients and Methods: A retrospective analysis was performed using the clinical data of patients evaluated with magnetic resonance imaging (MRI) of the knee joint. Data from 308 patients examined between August 2002 and July 2003 were included into this study. A Pearson correlation analysis was performed to exam...

  17. Correlations between iron content in knee joint tissues and chosen indices of peripheral blood morphology.

    Science.gov (United States)

    Brodziak-Dopierała, Barbara; Roczniak, Wojciech; Jakóbik-Kolon, Agata; Kluczka, Joanna; Koczy, Bogdan; Kwapuliński, Jerzy; Babuśka-Roczniak, Magdalena

    2017-10-01

    Iron as a cofactor of enzymes takes part in the synthesis of the bone matrix. Severe deficiency of iron reduces the strength and mineral density of bones, whereas its excess may increase oxidative stress. In this context, it is essential to determine the iron content in knee joint tissues. The study objective was to determine the level of iron in the tissues of the knee joint, i.e., in the femoral bone, tibia and meniscus. Material for analysis was obtained during endoprosthetic surgery of the knee joint. Within the knee joint, the tibia, femur and meniscus were analyzed. Samples were collected from 50 patients, including 36 women and 14 men. The determination of iron content was performed with the ICP-AES method, using Varian 710-ES. The lowest iron content was in the tibia (27.04 μg/g), then in the meniscus (38.68 μg/g) and the highest in the femur (41.93 μg/g). Statistically significant differences were noted in the content of iron in knee joint tissues. In patients who underwent endoprosthesoplasty of the knee joint, statistically significant differences were found in the levels of iron in various components of the knee joint. The highest iron content was found in the femoral bone of the knee joint and then in the meniscus, the lowest in the tibia. The differences in iron content in the knee joint between women and men were not statistically significant.

  18. Knee joint stiffness in individuals with and without knee osteoarthritis: a preliminary study.

    Science.gov (United States)

    Oatis, Carol A; Wolff, Edward F; Lennon, Sandra K

    2006-12-01

    Descriptive, case-matched comparison. To compare the knee joint stiffness and damping coefficients of individuals with knee osteoarthritis (KOA) to those of age- and gender-matched individuals without KOA. A secondary purpose was to investigate relationships between these coefficients and complaints of stiffness in individuals with KOA. KOA is a leading cause of disability, and stiffness is a common complaint in individuals with KOA. Yet the most common method of assessing knee joint stiffness is through a self-report questionnaire. Stiffness and damping coefficients at the knee were calculated in 10 volunteers (mean age +/- SD, 64.1+/-15.5 years) with KOA and compared to coefficients from age-and gender-matched individuals without KOA, collected in a previous study (mean age +/- SD, 62.1+/-13.9 years). Stiffness and damping coefficients were calculated from the angular motion of the knee during a relaxed oscillation. Spearman correlation coefficients were calculated between stiffness and damping coefficients and WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) scores for subjects with KOA. Independent 2-tailed t tests revealed significantly larger damping coefficients (P = .035) among those with KOA (95% CI, 0.10-2.32 Nm s/rad). Spearman rank correlations revealed a significant positive relationship (r = .85, P = .003) between the damping coefficient and the stiffness subscore of the WOMAC. This study offers preliminary data demonstrating the feasibility of measuring stiffness and damping coefficients in individuals with KOA. Additionally, the damping coefficient is increased in people with KOA when compared to age- and gender-matched individuals without KOA. The damping coefficient appears to be associated with the complaints of stiffness reported by the WOMAC.

  19. Are the Kinematics of the Knee Joint Altered during the Loading Response Phase of Gait in Individuals with Concurrent Knee Osteoarthritis and Complaints of Joint Instability? A Dynamic Stereo X-ray Study

    Science.gov (United States)

    Farrokhi, Shawn; Tashman, Scott; Gil, Alexandra B.; Klatt, Brian A.; Fitzgerald, G. Kelley

    2011-01-01

    Background Joint instability has been suggested as a risk factor for knee osteoarthritis and a cause of significant functional declines in those with symptomatic disease. However, the relationship between altered knee joint mechanics and self-reports of instability in individuals with knee osteoarthritis remains unclear. Methods Fourteen subjects with knee osteoarthritis and complaints of joint instability and 12 control volunteers with no history of knee disease were recruited for this study. Dynamic stereo X-ray technology was used to assess the three-dimensional kinematics of the knee joint during the loading response phase of gait. Findings Individuals with concurrent knee osteoarthritis and joint instability demonstrated significantly reduced flexion and internal/external rotation knee motion excursions during the loading response phase of gait (P knee joint at initial contact was significantly different (P knee osteoarthritis and joint instability. However, the anteroposterior and mediolateral tibiofemoral joint positions at initial contact and the corresponding total joint translations were similar between groups during the loading phase of gait. Interpretations The rotational patterns of tibiofemoral joint motion and joint alignments reported for individuals with concurrent knee osteoarthritis and joint instability are consistent with those previously established for individuals with knee osteoarthritis. Furthermore, the findings of similar translatory tibiofemoral motion between groups suggest that self-reports of episodic joint instability in individuals with knee osteoarthritis may not necessarily be associated with adaptive alterations in joint arthrokinematics. PMID:22071429

  20. Relationship between quadriceps strength and patellofemoral joint chondral lesions after anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Wang, Hai-Jun; Ao, Ying-Fang; Jiang, Dong; Gong, Xi; Wang, Yong-Jian; Wang, Jian; Yu, Jia-Kuo

    2015-09-01

    The incidence of the patellofemoral joint chondral lesions after anterior cruciate ligament reconstruction (ACLR) is disturbingly high. Few studies have assessed the factors affecting patellofemoral joint chondral lesions postoperatively. The recovery of quadriceps strength after ACLR could be associated with patellofemoral joint cartilage damage. Cohort study; Level of evidence, 3. A total of 88 patients who underwent arthroscopic anatomic double-bundle ACLR with hamstring autografts received second-look arthroscopy at the time of metal staple removal at an average of 24.1 months (range, 12-51 months) postoperatively. All patients underwent standardized isokinetic strength testing for bilateral quadriceps and hamstrings 1 to 2 days before second-look arthroscopy. The patients were divided into 2 groups: Patients in group 1 had a ≥20% deficit on the peak torque measures for quadriceps compared with that of the contralateral knee, whereas those in group 2 had a patellofemoral joint and tibiofemoral joint were evaluated by second-look arthroscopy and the Outerbridge classification. Other assessments included the International Knee Documentation Committee (IKDC) score, Tegner and Lysholm scores, side-to-side difference on KT-2000 arthrometer, and range of motion. There were 42 patients included in group 1 and 46 patients in group 2. The mean postoperative quadriceps peak torque of the involved knee compared with the contralateral knee was 70% (range, 57%-80%) in group 1 and 95% (range, 81%-116%) in group 2. For all patients, a significant worsening was seen in the patellar and trochlear cartilage (P = .030 and <.001, respectively) but not at the medial or lateral tibiofemoral joint after ACLR. A significant worsening in the status of both patellar and trochlear cartilage was seen after ACLR in group 1 (P = .013 and =.011, respectively) and of trochlear cartilage in group 2 (P = .006). Significantly fewer severe chondral lesions of the patella were found in group 2

  1. Specific adaptations of neuromuscular control and knee joint stiffness following sensorimotor training.

    Science.gov (United States)

    Gruber, M; Bruhn, S; Gollhofer, A

    2006-08-01

    The aim of this study was to examine how fixations of the ankle joint during sensorimotor training (SMT) influence adaptations in mechanical stiffness and neuromuscular control of the knee joint. Sixty-three healthy subjects were randomly assigned to three training groups that differed in their degree of ankle joint fixation, which was either barefooted, with an ankle brace or with a ski boot. Mechanical knee joint stiffness and reflex control of m. vastus medialis, m. vastus lateralis, m. biceps femoris, and m. semitendinosus were tested during force controlled anterior tibial displacements. This force was applied as both a fast and a slow stimulus. After the training period the group that trained barefooted showed an increase in mechanical stiffness of the knee joint from 79 +/- 21 (Mean +/- SD) N/mm to 110 +/- 38 N/mm (p boots was able to improve knee joint stiffness from 67 +/- 26 N/mm to 96 +/- 47 N/mm (p knee joint injuries.

  2. Treatment of osteochondral lesions in the knee using a cell-free scaffold.

    Science.gov (United States)

    Verdonk, P; Dhollander, A; Almqvist, K F; Verdonk, R; Victor, J

    2015-03-01

    The treatment of osteochondral lesions is of great interest to orthopaedic surgeons because most lesions do not heal spontaneously. We present the short-term clinical outcome and MRI findings of a cell-free scaffold used for the treatment of these lesions in the knee. A total of 38 patients were prospectively evaluated clinically for two years following treatment with an osteochondral nanostructured biomimetic scaffold. There were 23 men and 15 women; the mean age of the patients was 30.5 years (15 to 64). Clinical outcome was assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS), the Tegner activity scale and a Visual Analgue scale for pain. MRI data were analysed based on the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) scoring system at three, 12 and 24 months post-operatively. There was a continuous significant clinical improvement after surgery. In two patients, the scaffold treatment failed (5.3%) There was a statistically significant improvement in the MOCART precentage scores. The repair tissue filled most of the defect sufficiently. We found subchondral laminar changes in all patients. Intralesional osteophytes were found in two patients (5.3%). We conclude that this one-step scaffold-based technique can be used for osteochondral repair. The surgical technique is straightforward, and the clinical results are promising. The MRI aspects of the repair tissue continue to evolve during the first two years after surgery. However, the subchondral laminar and bone changes are a concern. ©2015 The British Editorial Society of Bone & Joint Surgery.

  3. Knee joint anterior malalignment and patellofemoral osteoarthritis: an MRI study

    Energy Technology Data Exchange (ETDEWEB)

    Tsavalas, Nikolaos; Karantanas, Apostolos H. [University Hospital, University of Crete, Department of Medical Imaging, Heraklion, Crete (Greece); Katonis, Pavlos [University Hospital, University of Crete, Department of Orthopaedic Surgery, Heraklion, Crete (Greece)

    2012-02-15

    To evaluate patellofemoral congruency measurements on MRI and correlate the findings with severity of ipsilateral osteoarthritis. We retrospectively reviewed 650 consecutive knee MRI examinations from 622 patients divided into two age groups: {<=}50 and >50 year-old. The femoral sulcus angle (SA) and depth (SD), lateral patellar displacement (LPD), lateral patellofemoral angle (LPFA), tibial tubercle-trochlear groove (TT-TG) distance and Insall-Salvati index as well as the grade of focal cartilage defects (ranging from I to IV) in the patellofemoral region were assessed in each subject on axial and sagittal fat-saturated intermediate-w MR images. A significant difference exists between normal and knees with patellofemoral joint osteoarthritis regarding SA (p = 0.0002 and <0.0001), SD (p = 0.0004 and <0.0001), LPD (p = 0.0014 and 0.0009) and LPFA (p = 0.0002 and 0.0003) in both age groups ({<=}50 and >50 respectively). Significant correlation was found between grading of cartilage defects and SA (rho = 0.21, p = 0.0001 and 0.443, <0.0001), SD (rho = -0.198, p = 0.0003 and -0.418, <0.0001), LPD (rho = 0.176, p = 0.0013 and 0.251, 0.0002) and LPFA (rho = -0.204, p = 0.0002 and -0.239, 0.0005) in both age groups. Knee joint anterior malalignment is multivariably associated with patellofemoral osteoarthritis. circle MRI is an excellent method to evaluate knee alignment and articular cartilage damage. (orig.)

  4. The influence of continuous versus interval walking exercise on knee joint loading and pain in patients with knee osteoarthritis.

    Science.gov (United States)

    Farrokhi, Shawn; Jayabalan, Prakash; Gustafson, Jonathan A; Klatt, Brian A; Sowa, Gwendolyn A; Piva, Sara R

    2017-07-01

    To evaluate whether knee contact force and knee pain are different between continuous and interval walking exercise in patients with knee osteoarthritis (OA). Twenty seven patients with unilateral symptomatic knee OA completed two separate walking exercise sessions on a treadmill at 1.3m/s on two different days: 1) a continuous 45min walking exercise session, and 2) three 15min bouts of walking exercise separated by 1h rest periods for a total of 45min of exercise in an interval format. Estimated knee contact forces using the OpenSim software and knee pain were evaluated at baseline (1st minute of walking) and after every 15min between the continuous and interval walking conditions. A significant increase from baseline was observed in peak knee contact force during the weight-acceptance phase of gait after 30 and 45min of walking, irrespective of the walking exercise condition. Additionally, whereas continuous walking resulted in an increase in knee pain, interval walking did not lead to increased knee pain. Walking exercise durations of 30min or greater may lead to undesirable knee joint loading in patients with knee OA, while performing the same volume of exercise in multiple bouts as opposed to one continuous bout may be beneficial for limiting knee pain. Copyright © 2017. Published by Elsevier B.V.

  5. Relationships between the center of pressure and the movements of the ankle and knee joints during the stance phase in patients with severe medial knee osteoarthritis.

    Science.gov (United States)

    Fukaya, Takashi; Mutsuzaki, Hirotaka; Okubo, Tomoyuki; Mori, Koichi; Wadano, Yasuyoshi

    2016-08-01

    The knee joint movement during the stance phase is affected by altered ankle movement and the center of pressure (COP). However the relationships between changes in the center of pressure (COP) and the altered kinematics and kinetics of the ankle and knee joints in patients with osteoarthritis (OA) of the knee are not well understood. The purpose of this study was to determine the relationships between changes in the COP and the altered kinematic and kinetic variables in ankle and knee joints during the stance phase in patients with medial knee OA. Fourteen patients with knee OA (21 knees) and healthy subjects were assessed by gait analysis using an eight-camera motion analysis system to record forward and lateral shifts in the COP and the angle and net internal moments of the knee and ankle joint. Spearman rank-correlation coefficients were used to determine the relationship between these results. In knees with medial OA, lateral shifts in the COP were correlated with knee flexion angle. Lateral shifts in the COP were correlated with the second peak of the knee extensor moment and correlated with the knee abductor moment. In patients with medial knee OA, lateral shifts in the COP were negatively correlated with the kinematic and kinetic variables in the sagittal plane of the knee joints. Controlling such lateral shifts in the COP may thus be an effective intervention for mechanical loads on the knee during the stance phase in patients with knee OA. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. [Whiplash lesions and temporomandibular joint disorders].

    Science.gov (United States)

    Gola, R; Richard, O; Guyot, L; Cheynet, F

    2004-11-01

    Attributing dysfunction of the temporomandibular joint (TMJ) to whiplash injury is a difficult problem to solve. TMJ disorders do not seem to be secondary to direct articular trauma but rather caused by a postural disorder of the cervical spine. Occlusal disorders and stress further complicate the picture. Four clinical cases illustrate a new hypothetical approach.

  7. Increased expression of damage-associated molecular patterns (DAMPs) in osteoarthritis of human knee joint compared to hip joint.

    Science.gov (United States)

    Rosenberg, John H; Rai, Vikrant; Dilisio, Matthew F; Sekundiak, Todd D; Agrawal, Devendra K

    2017-12-01

    Osteoarthritis (OA) is a degenerative disease characterized by the destruction of cartilage. The greatest risk factors for the development of OA include age and obesity. Recent studies suggest the role of inflammation in the pathogenesis of OA. The two most common locations for OA to occur are in the knee and hip joints. The knee joint experiences more mechanical stress, cartilage degeneration, and inflammation than the hip joint. This could contribute to the increased incidence of OA in the knee joint. Damage-associated molecular patterns (DAMPs), including high-mobility group box-1, receptor for advanced glycation end products, and alarmins (S100A8 and S100A9), are released in the joint in response to stress-mediated chondrocyte and cartilage damage. This facilitates increased cartilage degradation and inflammation in the joint. Studies have documented the role of DAMPs in the pathogenesis of OA; however, the comparison of DAMPs and its influence on OA has not been discussed. In this study, we compared the DAMPs between OA knee and hip joints and found a significant difference in the levels of DAMPs expressed in the knee joint compared to the hip joint. The increased levels of DAMPs suggest a difference in the underlying pathogenesis of OA in the knee and the hip and highlights DAMPs as potential therapeutic targets for OA in the future.

  8. In vivo six-degree-of-freedom knee-joint kinematics in overground and treadmill walking following total knee arthroplasty.

    Science.gov (United States)

    Guan, Shanyuanye; Gray, Hans A; Schache, Anthony G; Feller, Julian; de Steiger, Richard; Pandy, Marcus G

    2017-08-01

    No data are available to describe six-degree-of-freedom (6-DOF) knee-joint kinematics for one complete cycle of overground walking following total knee arthroplasty (TKA). The aims of this study were firstly, to measure 6-DOF knee-joint kinematics and condylar motion for overground walking following TKA; and secondly, to determine whether such data differed between overground and treadmill gait when participants walked at the same speed during both tasks. A unique mobile biplane X-ray imaging system enabled accurate measurement of 6-DOF TKA knee kinematics during overground walking by simultaneously tracking and imaging the joint. The largest rotations occurred for flexion-extension and internal-external rotation whereas the largest translations were associated with joint distraction and anterior-posterior drawer. Strong associations were found between flexion-extension and adduction-abduction (R 2  = 0.92), joint distraction (R 2  = 1.00), and anterior-posterior translation (R 2  = 0.77), providing evidence of kinematic coupling in the TKA knee. Although the measured kinematic profiles for overground walking were grossly similar to those for treadmill walking, several statistically significant differences were observed between the two conditions with respect to temporo-spatial parameters, 6-DOF knee-joint kinematics, and condylar contact locations and sliding. Thus, caution is advised when making recommendations regarding knee implant performance based on treadmill-measured knee-joint kinematic data. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1634-1643, 2017. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  9. The Analysis of Knee Joint Movement During Golf Swing in Professional and Amateur Golfers

    OpenAIRE

    M.Somjarod; V. Tanawat; l. Weerawat

    2011-01-01

    The understanding of knee movement during swing importance for golf swing improving and preventing injury. Thirty male professional and amateur golfers were assigned to swing time by time for 3 times. Data from a vedio-based motion capture were used to compute knee joint movement variables. The results showed that professional and amateur golfers were significantly in left knee flexion angle at the impact point and mid follow through phase. Nevertheless, left knee externa...

  10. Modelling of subject specific based segmental dynamics of knee joint

    Science.gov (United States)

    Nasir, N. H. M.; Ibrahim, B. S. K. K.; Huq, M. S.; Ahmad, M. K. I.

    2017-09-01

    This study determines segmental dynamics parameters based on subject specific method. Five hemiplegic patients participated in the study, two men and three women. Their ages ranged from 50 to 60 years, weights from 60 to 70 kg and heights from 145 to 170 cm. Sample group included patients with different side of stroke. The parameters of the segmental dynamics resembling the knee joint functions measured via measurement of Winter and its model generated via the employment Kane's equation of motion. Inertial parameters in the form of the anthropometry can be identified and measured by employing Standard Human Dimension on the subjects who are in hemiplegia condition. The inertial parameters are the location of centre of mass (COM) at the length of the limb segment, inertia moment around the COM and masses of shank and foot to generate accurate motion equations. This investigation has also managed to dig out a few advantages of employing the table of anthropometry in movement biomechanics of Winter's and Kane's equation of motion. A general procedure is presented to yield accurate measurement of estimation for the inertial parameters for the joint of the knee of certain subjects with stroke history.

  11. Design and Evaluation of a Prosthetic Knee Joint Using the Geared Five-Bar Mechanism.

    Science.gov (United States)

    Sun, Yuanxi; Ge, Wenjie; Zheng, Jia; Dong, Dianbiao

    2015-11-01

    This paper presents the mechanical design, dynamics analysis and ankle trajectory analysis of a prosthetic knee joint using the geared five-bar mechanism. Compared with traditional four-bar or six-bar mechanisms, the geared five-bar mechanism is better at performing diverse movements and is easy to control. This prosthetic knee joint with the geared five-bar mechanism is capable of fine-tuning its relative instantaneous center of rotation and ankle trajectory. The centrode of this prosthetic knee joint, which is mechanically optimized according to the centrode of human knee joint, is better in the bionic performance than that of a prosthetic knee joint using the four-bar mechanism. Additionally, the stability control of this prosthetic knee joint during the swing and stance phase is achieved by a motor. By adjusting the gear ratio of this prosthetic knee joint, the ankle trajectories of both unilateral and bilateral amputees show less deviations from expected than that of the four-bar knee joint.

  12. Intraoperative joint gaps and mediolateral balance affect postoperative knee kinematics in posterior-stabilized total knee arthroplasty.

    Science.gov (United States)

    Watanabe, Toshifumi; Muneta, Takeshi; Sekiya, Ichiro; Banks, Scott A

    2015-12-01

    Adjusting joint gaps and establishing mediolateral (ML) soft tissue balance are considered essential interventions for better outcomes in total knee arthroplasty (TKA). However, the relationship between intraoperative laxity measurements and weightbearing knee kinematics has not been well explored. This study aimed to quantify the effect of intraoperative joint gaps and ML soft tissue balance on postoperative knee kinematics in posterior-stabilized (PS)-TKA. We investigated 44 knees in 34 patients who underwent primary PS-TKA by a single surgeon. The central joint gaps and ML tilting angles at 0°, 10°, 30°, 60°, 90°, 120° and 135° flexion were measured during surgery. At a minimum of two year follow-up, we analyzed in vivo kinematics of these knees and examined the influence of intraoperative measurements on postoperative kinematics. Gap difference of knee flexion at 135° minus 0° was correlated with the total posterior translation of lateral femoral condyle (r=0.336, p=0.042) and femoral external rotation (r=0.488, p=0.002) during squatting, anteroposterior position of lateral femoral condyle (r=-0.510, p=0.001) and maximum knee flexion (r=0.355, p=0.031) in kneeling. Similar correlations were observed between deep flexion gap differences with respect to the 90° reference and postoperative knee kinematics. Well-balanced knees showed less anterior translation of medial femoral condyle in mid- to deep flexion, consistent femoral external rotation, and the most neutral valgus/varus rotation compared with unbalanced knees. These findings indicate the importance of adequate intraoperative joint gaps in deep flexion and ML soft tissue balance throughout the range of motion. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. Are the kinematics of the knee joint altered during the loading response phase of gait in individuals with concurrent knee osteoarthritis and complaints of joint instability? A dynamic stereo X-ray study.

    Science.gov (United States)

    Farrokhi, Shawn; Tashman, Scott; Gil, Alexandra B; Klatt, Brian A; Fitzgerald, G Kelley

    2012-05-01

    Joint instability has been suggested as a risk factor for knee osteoarthritis and a cause of significant functional decline in those with symptomatic disease. However, the relationship between altered knee joint mechanics and self-reports of instability in individuals with knee osteoarthritis remains unclear. Fourteen subjects with knee osteoarthritis and complaints of joint instability and 12 control volunteers with no history of knee disease were recruited for this study. Dynamic stereo X-ray technology was used to assess the three-dimensional kinematics of the knee joint during the loading response phase of gait. Individuals with concurrent knee osteoarthritis and joint instability demonstrated significantly reduced flexion and internal/external rotation knee motion excursions during the loading response phase of gait (Pknee joint at initial contact was significantly different (Pknee osteoarthritis and joint instability. However, the anteroposterior and mediolateral tibiofemoral joint positions at initial contact and the corresponding total joint translations were similar between groups during the loading phase of gait. The rotational patterns of tibiofemoral joint motion and joint alignments reported for individuals with concurrent knee osteoarthritis and joint instability are consistent with those previously established for individuals with knee osteoarthritis. Furthermore, the findings of similar translatory tibiofemoral motion between groups suggest that self-reports of episodic joint instability in individuals with knee osteoarthritis may not necessarily be associated with adaptive alterations in joint arthrokinematics. Copyright © 2011 Elsevier Ltd. All rights reserved.

  14. Frequency and topography of lesions of the femoro-tibial cartilage at spiral CT arthrography of the knee: a study in patients with normal knee radiographs and without history of trauma

    International Nuclear Information System (INIS)

    Vande Berg, B.C.; Lecouvet, F.E.; Malghem, J.

    2002-01-01

    To determine the frequency and topography of cartilage lesions involving the femoro-tibial joints in patients with normal knee radiographs and without a remembered history of trauma.Design and patients. A radiologist retrospectively reviewed the dual-detector spiral CT knee arthrograms performed in 209 consecutive patients (mean age 37.6 years) with normal knee radiographs. Images were analyzed for the presence, grade (Noyes classification system) and location of cartilage lesions, the location being designated by dividing each articular surface into a grid of 16 parts.Results. Fifty-three percent of knees had cartilage lesions of grade 2A or higher that involved articular surfaces to a variable extent: lateral tibial plateau (31%), medial femoral condyle (27%), medial tibial plateau (14%) and lateral femoral condyle (5%). Areas of the posterior half of the lateral tibial plateau and of the inner half of the medial femoral condyle were statistically more frequently involved than their counterparts (P<0.0001). The bare area of the medial tibial plateau, but not that of the lateral tibial plateau, was more frequently involved than the corresponding meniscus-covered area (P<0.0001).Conclusion. Cartilage lesions of grade 2A or higher, detected at spiral CT arthrography in 53% of the knees, predominantly involved the posterior half of the lateral tibial plateau, the inner half of the medial femoral condyle and the bare area of the medial tibial plateau. (orig.)

  15. Efficiency assessment of phytocomplex phonophoresis in rehabilitation of patients with knee joint osteoarthrosis

    Directory of Open Access Journals (Sweden)

    Kotenko К.V.

    2013-12-01

    Full Text Available Objective: the comparative research of phytocomplex phonophoresis rehabilitation efficiency of patients with knee joint osteoarthrosis. Material and Methods, the study included 100 patients with knee joint osteoarthrosis; the effectiveness evaluation was made in terms of American Rheumatologic Association (ARA, the data of visual-analogue scale (VAS and goniometry, indexes WOMAC, Lekena and the index of activity SIA, criteria of life quality questionnaire HAQ. Results. The complex use of phyto- and ultrasonic therapy in conjunction with an medicamentous treatment of patients have a more pronounced positive effect on pain (by 26-28%, function of the knee joint (by 22-26% and the quality of life (by 24% compared to treatment with medicamentous only treatment or combined using ultrasonic and medicamentous therapy. Conclusion. The new method of phytocomplex phonophoresis leads to the expressed regress of clinical symptomatology at patients with knee joint osteoarthrosis, improves locomotor function of knee joints and quality of life.

  16. Intra-articular pressures and joint mechanics: should we pay attention to effusion in knee osteoarthritis?

    Science.gov (United States)

    Rutherford, Derek James

    2014-09-01

    What factors play a role to ensure a knee joint does what it should given the demands of moving through the physical environment? This paper aims to probe the hypothesis that intra-articular joint pressures, once a topic of interest, have been left aside in contemporary frameworks in which we now view knee joint function. The focus on ligamentous deficiencies and the chondrocentric view of osteoarthritis, while important, have left little attention to the consideration of other factors that can impair joint function across the lifespan. Dynamic knee stability is required during every step we take. While there is much known about the role that passive structures and muscular activation play in maintaining a healthy knee joint, this framework does not account for the role that intra-articular joint pressures may have in providing joint stability during motion and how these factors interact. Joint injuries invariably result in some form of intra-articular fluid accumulation. Ultimately, it may be how the knee mechanically responds to this fluid, of which pressure plays a significant role that provides the mechanisms for continued function. Do joint pressures provide an important foundation for maintaining knee function? This hypothesis is unique and argues that we are missing an important piece of the puzzle when attempting to understand implications that joint injury and disease have for joint function. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Apparent Skin Discoloration about the Knee Joint: A Rare Sequela of Metallosis after Total Knee Replacement

    Directory of Open Access Journals (Sweden)

    Narlaka Jayasekera

    2015-01-01

    Full Text Available Introduction. Metallosis is a phenomenon most commonly associated with hip replacement. However it can occur in any metallic implant subject to wear. Wear creates metal debris, which is deposited in the surrounding soft tissue. This leads to many local adverse reactions including, but not limited to, implant loosening/osteolysis, pain, and effusion. In the deeper joints, for example, the hip, metal deposits are mostly only seen intraoperatively. Case Study. A 74-year-old lady represented to orthopaedic outpatient clinic. Her principle complaint was skin discolouration, associated with pain and swelling over the left knee, on the background of a previous total knee replacement with a metal backed patella resurfacing six years. A plain radiograph revealed loosening of the patellar prosthesis. A diagnosis of metallosis was made; the patient underwent debridement of the stained soft tissue and primary revision of the prosthesis. She remained symptom-free five years after revision. Discussion. Metallosis results in metallic debris which causes tissue staining, often hidden within the soft tissue envelope of the hip, but more apparent in the knee. Metallosis may cause pain, effusion, and systemic symptoms because of raised levels of serum-metal ions. Surgical intervention with revision and debridement can have good functional results.

  18. Knee Kinematics Estimation Using Multi-Body Optimisation Embedding a Knee Joint Stiffness Matrix: A Feasibility Study.

    Directory of Open Access Journals (Sweden)

    Vincent Richard

    Full Text Available The use of multi-body optimisation (MBO to estimate joint kinematics from stereophotogrammetric data while compensating for soft tissue artefact is still open to debate. Presently used joint models embedded in MBO, such as mechanical linkages, constitute a considerable simplification of joint function, preventing a detailed understanding of it. The present study proposes a knee joint model where femur and tibia are represented as rigid bodies connected through an elastic element the behaviour of which is described by a single stiffness matrix. The deformation energy, computed from the stiffness matrix and joint angles and displacements, is minimised within the MBO. Implemented as a "soft" constraint using a penalty-based method, this elastic joint description challenges the strictness of "hard" constraints. In this study, estimates of knee kinematics obtained using MBO embedding four different knee joint models (i.e., no constraints, spherical joint, parallel mechanism, and elastic joint were compared against reference kinematics measured using bi-planar fluoroscopy on two healthy subjects ascending stairs. Bland-Altman analysis and sensitivity analysis investigating the influence of variations in the stiffness matrix terms on the estimated kinematics substantiate the conclusions. The difference between the reference knee joint angles and displacements and the corresponding estimates obtained using MBO embedding the stiffness matrix showed an average bias and standard deviation for kinematics of 0.9±3.2° and 1.6±2.3 mm. These values were lower than when no joint constraints (1.1±3.8°, 2.4±4.1 mm or a parallel mechanism (7.7±3.6°, 1.6±1.7 mm were used and were comparable to the values obtained with a spherical joint (1.0±3.2°, 1.3±1.9 mm. The study demonstrated the feasibility of substituting an elastic joint for more classic joint constraints in MBO.

  19. Knee Kinematics Estimation Using Multi-Body Optimisation Embedding a Knee Joint Stiffness Matrix: A Feasibility Study.

    Science.gov (United States)

    Richard, Vincent; Lamberto, Giuliano; Lu, Tung-Wu; Cappozzo, Aurelio; Dumas, Raphaël

    2016-01-01

    The use of multi-body optimisation (MBO) to estimate joint kinematics from stereophotogrammetric data while compensating for soft tissue artefact is still open to debate. Presently used joint models embedded in MBO, such as mechanical linkages, constitute a considerable simplification of joint function, preventing a detailed understanding of it. The present study proposes a knee joint model where femur and tibia are represented as rigid bodies connected through an elastic element the behaviour of which is described by a single stiffness matrix. The deformation energy, computed from the stiffness matrix and joint angles and displacements, is minimised within the MBO. Implemented as a "soft" constraint using a penalty-based method, this elastic joint description challenges the strictness of "hard" constraints. In this study, estimates of knee kinematics obtained using MBO embedding four different knee joint models (i.e., no constraints, spherical joint, parallel mechanism, and elastic joint) were compared against reference kinematics measured using bi-planar fluoroscopy on two healthy subjects ascending stairs. Bland-Altman analysis and sensitivity analysis investigating the influence of variations in the stiffness matrix terms on the estimated kinematics substantiate the conclusions. The difference between the reference knee joint angles and displacements and the corresponding estimates obtained using MBO embedding the stiffness matrix showed an average bias and standard deviation for kinematics of 0.9±3.2° and 1.6±2.3 mm. These values were lower than when no joint constraints (1.1±3.8°, 2.4±4.1 mm) or a parallel mechanism (7.7±3.6°, 1.6±1.7 mm) were used and were comparable to the values obtained with a spherical joint (1.0±3.2°, 1.3±1.9 mm). The study demonstrated the feasibility of substituting an elastic joint for more classic joint constraints in MBO.

  20. Intra-articular injection of dexketoprofen in rat knee joint: histopathologic assessment of cartilage & synovium.

    Science.gov (United States)

    Ekici, Aycan Guner; Akyol, Onat; Ekici, Murat; Sitilci, Tolga; Topacoglu, Hakan; Ozyuvaci, Emine

    2014-08-01

    Effective pain control following outpatient surgical procedures is an important aspect of patient discharge. This study was carried out with an aim to investigate the histopathological effects of intra-articular dexketoprofen trometamol injection in knee joint on synovium and cartilage in an experimental rat model. In each of 40 rats, the right knee was designated as the study group and the left knee as the control group (NS group). Under aseptic conditions, 35 rats received an injection of 0.25 ml (6.25 mg) dexketoprofen trometamol into the right knee joint and an injection of 0.25 ml 0.9 per cent normal saline solution into the left knee joint. On the 1st, 2nd, 7th, 14th, and 21st days after intra-articular injection, rats in specified groups were sacrificed by intraperitoneal injection of 120 mg/kg sodium thiopental. Knee joints were separated and sectioned for histopathological examination. Inflammatory changes in the joints were recorded according to a grade scale. No significant difference in terms of pathological changes both in synovium and cartilage was observed between the NS group and the study group on days 1, 2, 7, 14 and 21 after intra-articular injection of dexketoprofen or saline in the knee joint. The findings showed no evidence of significant histopathological damage to the cartilage and synovia for a period up to 21 days following intra-articular administration of dexketoprofen trometamol in the knee joints of rats.

  1. Effect of knee joint angle on neuromuscular activation of the vastus intermedius muscle during isometric contraction.

    Science.gov (United States)

    Watanabe, K; Akima, H

    2011-12-01

    The purpose of this study was to compare the relationship between surface electromyography (EMG) and knee joint angle of the vastus intermedius muscle (VI) with the synergistic muscles in the quadriceps femoris (QF) muscle group. Fourteen healthy men performed maximal voluntary contractions during isometric knee extension at four knee joint angles from 90°, 115°, 140°, and 165° (180° being full extension). During the contractions, surface EMG was recorded at four muscle components of the QF muscle group: the VI, vastus lateralis (VL), vastus medialis (VM), and rectus femoris (RF) muscles. The root mean square of the surface EMG at each knee joint angle was calculated and normalized by that at a knee joint angle of 90° for individual muscles. The normalized RMS of the VI muscle was significantly lower than those of the VL and RF muscles at the knee joint angles of 115° and 165° and those of the VL, VM, and RF muscles at the knee joint angle of 140° (Pneuromuscular activation of the VI muscle is regulated in a manner different from the alteration of the knee joint angle compared with other muscle components of the QF muscle group. © 2011 John Wiley & Sons A/S.

  2. 21 CFR 888.3535 - Knee joint femorotibial (uni-compartmental) metal/polymer porous-coated uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Knee joint femorotibial (uni-compartmental) metal... Devices § 888.3535 Knee joint femorotibial (uni-compartmental) metal/polymer porous-coated uncemented prosthesis. (a) Identification. A knee joint femorotibial (uni-compartmental) metal/polymer porous-coated...

  3. 21 CFR 888.3560 - Knee joint patellofemorotibial polymer/metal/polymer semi-constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Knee joint patellofemorotibial polymer/metal... Devices § 888.3560 Knee joint patellofemorotibial polymer/metal/polymer semi-constrained cemented prosthesis. (a) Identification. A knee joint patellofemorotibial polymer/metal/polymer semi-constrained...

  4. Modelling knee flexion effects on joint power absorption and adduction moment.

    Science.gov (United States)

    Nagano, Hanatsu; Tatsumi, Ichiroh; Sarashina, Eri; Sparrow, W A; Begg, Rezaul K

    2015-12-01

    Knee osteoarthritis is commonly associated with ageing and long-term walking. In this study the effects of flexing motions on knee kinetics during stance were simulated. Extended knees do not facilitate efficient loading. It was therefore, hypothesised that knee flexion would promote power absorption and negative work, while possibly reducing knee adduction moment. Three-dimensional (3D) position and ground reaction forces were collected from the right lower limb stance phase of one healthy young male subject. 3D position was sampled at 100 Hz using three Optotrak Certus (Northern Digital Inc.) motion analysis camera units, set up around an eight metre walkway. Force plates (AMTI) recorded ground reaction forces for inverse dynamics calculations. The Visual 3D (C-motion) 'Landmark' function was used to change knee joint positions to simulate three knee flexion angles during static standing. Effects of the flexion angles on joint kinetics during the stance phase were then modelled. The static modelling showed that each 2.7° increment in knee flexion angle produced 2.74°-2.76° increments in knee flexion during stance. Increased peak extension moment was 6.61 Nm per 2.7° of increased knee flexion. Knee flexion enhanced peak power absorption and negative work, while decreasing adduction moment. Excessive knee extension impairs quadriceps' power absorption and reduces eccentric muscle activity, potentially leading to knee osteoarthritis. A more flexed knee is accompanied by reduced adduction moment. Research is required to determine the optimum knee flexion to prevent further damage to knee-joint structures affected by osteoarthritis. Copyright © 2015 Elsevier B.V. All rights reserved.

  5. 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.

  6. Association of baseline knee sagittal dynamic joint stiffness during gait and 2-year patellofemoral cartilage damage worsening in knee osteoarthritis.

    Science.gov (United States)

    Chang, A H; Chmiel, J S; Almagor, O; Guermazi, A; Prasad, P V; Moisio, K C; Belisle, L; Zhang, Y; Hayes, K; Sharma, L

    2017-02-01

    Knee sagittal dynamic joint stiffness (DJS) describes the biomechanical interaction between change in external knee flexion moment and flexion angular excursion during gait. In theory, greater DJS may particularly stress the patellofemoral (PF) compartment and thereby contribute to PF osteoarthritis (OA) worsening. We hypothesized that greater baseline knee sagittal DJS is associated with PF cartilage damage worsening 2 years later. Participants all had OA in at least one knee. Knee kinematics and kinetics during gait were recorded using motion capture systems and force plates. Knee sagittal DJS was computed as the slope of the linear regression line for knee flexion moments vs angles during the loading response phase. Knee magnetic resonance imaging (MRI) scans were obtained at baseline and 2 years later. We assessed the association between baseline DJS and baseline-to-2-year PF cartilage damage worsening using logistic regression with generalized estimating equations (GEE). Our sample had 391 knees (204 persons): mean age 64.2 years (SD 10.0); body mass index (BMI) 28.4 kg/m 2 (5.7); 76.5% women. Baseline knee sagittal DJS was associated with baseline-to-2-year cartilage damage worsening in the lateral (OR = 5.35, 95% CI: 2.37-12.05) and any PF (OR = 2.99, 95% CI: 1.27-7.04) compartment. Individual components of baseline DJS (i.e., change in knee moment or angle) were not associated with subsequent PF disease worsening. Capturing the concomitant effect of knee kinetics and kinematics during gait, knee sagittal DJS is a potentially modifiable risk factor for PF disease worsening. Copyright © 2016 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  7. Knee joint laxity and passive stiffness in meniscectomized patients compared with healthy controls.

    Science.gov (United States)

    Thorlund, Jonas B; Creaby, Mark W; Wrigley, Tim V; Metcalf, Ben R; Bennell, Kim L

    2014-10-01

    Passive mechanical behavior of the knee in the frontal plane, measured as angular laxity and mechanical stiffness, may play an important role in the pathogenesis of knee osteoarthritis (OA). Little is known about knee laxity and stiffness prior to knee OA onset. We investigated knee joint angular laxity and passive stiffness in meniscectomized patients at high risk of knee OA compared with healthy controls. Sixty patients meniscectomized for a medial meniscal tear (52 men, 41.4 ± 5.5 years, 175.3 ± 7.9 cm, 83.6 ± 12.8 kg, mean ± SD) and 21 healthy controls (18 men, 42.0 ± 6.7 years, 176.8 ± 5.7 cm, 77.8 ± 13.4 kg) had their knee joint angular laxity and passive stiffness assessed twice ~2.3 years apart. Linear regression models including age, sex, height and body mass as covariates in the adjusted model were used to assess differences between groups. Greater knee joint varus (-10.1 vs. -7.3°, pknee joint angular laxity and reduced passive stiffness ~3 months post surgery compared with controls. In addition, the results indicated that knee joint laxity may increase over time in meniscectomized patients. Copyright © 2014 Elsevier B.V. All rights reserved.

  8. The association between knee joint biomechanics and neuromuscular control and moderate knee osteoarthritis radiographic and pain severity.

    Science.gov (United States)

    Astephen Wilson, J L; Deluzio, K J; Dunbar, M J; Caldwell, G E; Hubley-Kozey, C L

    2011-02-01

    The objective of this study was to determine the association between biomechanical and neuromuscular factors of clinically diagnosed mild to moderate knee osteoarthritis (OA) with radiographic severity and pain severity separately. Three-dimensional gait analysis and electromyography were performed on a group of 40 participants with clinically diagnosed mild to moderate medial knee OA. Associations between radiographic severity, defined using a visual analog radiographic score, and pain severity, defined with the pain subscale of the WOMAC osteoarthritis index, with knee joint kinematics and kinetics, electromyography patterns of periarticular knee muscles, BMI and gait speed were determined with correlation analyses. Multiple linear regression analyses of radiographic and pain severity were also explored. Statistically significant correlations between radiographic severity and the overall magnitude of the knee adduction moment during stance (r²=21.4%, P=0.003) and the magnitude of the knee flexion angle during the gait cycle (r²=11.4%, P=0.03) were found. Significant correlations between pain and gait speed (r²=28.2%, Pjoint biomechanical variables are associated with structural knee OA severity measured from radiographs in clinically diagnosed mild to moderate levels of disease, but that pain severity is only reflected in gait speed and neuromuscular activation patterns. A combination of the knee adduction moment and BMI better explained structural knee OA severity than any individual factor alone. Copyright © 2010 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  9. Magnetic resonance imaging of acute joint injuries of the knee

    International Nuclear Information System (INIS)

    Pinto, R.; Ragozzino, A.; Romano, L.; Del Vecchio, E.; Accarino, B.; Barile, V.

    1988-01-01

    Magnetic Resonance (MR) imaging was employed to evaluate muscoloskeletal pathoanathomy, and proved to be extremely useful in characterizing knee pathology. Between October 1986 and Novembre 1987, 24 patients with suspected traumatic ligament injuries were examined with high resolution MR imaging in the RMRC diagnostic center, Naples, with a 0.5T superconducting magnet ( 5000 Magniscan CGR) using a surface coil and a 500/28 (repetition time: TR: ms/echo time: TE-ms), 1200-1600/35-105 spin-echo pulse sequence. Nineteen patients with positive MR imaging exams underwent diagnostic and/or therapeutic arthroscopy. Arthroscopy confirmed MR diagnosis in the whole of cases. In 6 patients with negative MR findings no arthroscopy followed and the patients' successful outcome confirmed the accuracy of MR negative predictive value. Such results prove MR imaging to have a high diagnostic accuracy in the evaluation of acute joint injuries of the knee.Moreover, MR imaging-an uninvasive screening technique-appears to have high potentials for the evaluation of those cases where diagnostic arthroscopy is not required

  10. Migration of trochanteric cerclage cable debris to the knee joint

    Directory of Open Access Journals (Sweden)

    Kathleen M. Kollitz, BS

    2014-01-01

    Full Text Available Migrating orthopedic hardware has widely been reported in the literature. Most reported cases of migrating hardware involve smooth Kirschner wires or loosening/fracture of hardware involved with joint stabilization/fixation. It is unusual for hardware to migrate within the soft tissues. In some cases, smooth Kirschner wires have migrated within the thoracic cage—a proposed mechanism for this phenomenon is the negative intrathoracic pressure. While wires have also been reported to gain access to circulation, transporting them over larger distances, the majority of broken or retained wires remain local. We report a case of a 34-year-old man in whom numerous fragments of braided cable migrated from the hip to the knee.

  11. Pulsed Tm:YAG laser ablation of knee joint tissues

    Science.gov (United States)

    Shi, Wei-Qiang; Vari, Sandor G.; Duffy, J. T.; Miller, J. M.; Weiss, Andrew B.; Fishbein, Michael C.; Grundfest, Warren S.

    1992-06-01

    We investigated the effect of a free-running 2.01 micron pulsed Tm:YAG laser on bovine knee joint tissues. Ablation rates of fresh fibrocartilage, hyaline cartilage, and bone were measured in saline as a function of laser fluence (160 - 640 J/cm2) and fiber core size (400 and 600 microns). All tissues could be effectively ablated and the ablation rate increased linearly with the increasing fluence. Use of fibers of different core sizes, while maintaining constant energy fluence, did not result in significant difference in ablation rate. Histology analyses of the ablated tissue samples reveal average Tm:YAG radiation induced thermal damage (denatunalization) zones ranging between 130 and 540 microns, depending on the laser parameters and the tissue type.

  12. Altered Tibiofemoral Joint Contact Mechanics and Kinematics in Patients with Knee Osteoarthritis and Episodic Complaints of Joint Instability

    Science.gov (United States)

    Farrokhi, Shawn; Voycheck, Carrie A.; Klatt, Brian A.; Gustafson, Jonathan A.; Tashman, Scott; Fitzgerald, G. Kelley

    2014-01-01

    Background To evaluate knee joint contact mechanics and kinematics during the loading response phase of downhill gait in knee osteoarthritis patients with self-reported instability. Methods Forty-three subjects, 11 with medial compartment knee osteoarthritis and self-reported instability (unstable), 7 with medial compartment knee osteoarthritis but no reports of instability (stable), and 25 without knee osteoarthritis or instability (control) underwent Dynamic Stereo X-ray analysis during a downhill gait task on a treadmill. Findings The medial compartment contact point excursions were longer in the unstable group compared to the stable (p=0.046) and the control groups (p=0.016). The peak medial compartment contact point velocity was also greater for the unstable group compared to the stable (p=0.047) and control groups (p=0.022). Additionally, the unstable group demonstrated a coupled movement pattern of knee extension and external rotation after heel contact which was different than the coupled motion of knee flexion and internal rotation demonstrated by stable and control groups. Interpretation Our findings suggest that knee joint contact mechanics and kinematics are altered during the loading response phase of downhill gait in knee osteoarthritis patients with self-reported instability. The observed longer medial compartment contact point excursions and higher velocities represent objective signs of mechanical instability that may place the arthritic knee joint at increased risk for disease progression. Further research is indicated to explore the clinical relevance of altered contact mechanics and kinematics during other common daily activities and to assess the efficacy of rehabilitation programs to improve altered joint biomechanics in knee osteoarthritis patients with self-reported instability. PMID:24856791

  13. The effect on knee-joint load of instruction in analgesic use compared with neuromuscular exercise in patients with knee osteoarthritis

    DEFF Research Database (Denmark)

    Clausen, Brian; Holsgaard-Larsen, Anders; Søndergaard, Jens

    2014-01-01

    , compared with optimized analgesics and antiinflammatory drug use, on the measures of knee-joint load in people with mild to moderate medial tibiofemoral knee osteoarthritis. METHOD/DESIGN: One hundred men and women with mild to moderate medial knee osteoarthritis will be recruited from general medical...... during walking (the Knee Index, a composite score of the first external peak total reaction moment on the knee joint from all three planes based on 3D movement analysis) after 8 weeks of intervention. Secondary outcomes include changes in the external peak knee-adduction moment and impulse and functional...

  14. Knee joint biomechanics and neuromuscular control during gait before and after total knee arthroplasty are sex-specific.

    Science.gov (United States)

    Astephen Wilson, Janie L; Dunbar, Michael J; Hubley-Kozey, Cheryl L

    2015-01-01

    The future of total knee arthroplasty (TKA) surgery will involve planning that incorporates more patient-specific characteristics. Despite known biological, morphological, and functional differences between men and women, there has been little investigation into knee joint biomechanical and neuromuscular differences between men and women with osteoarthritis, and none that have examined sex-specific biomechanical and neuromuscular responses to TKA surgery. The objective of this study was to examine sex-associated differences in knee kinematics, kinetics and neuromuscular patterns during gait before and after TKA. Fifty-two patients with end-stage knee OA (28 women, 24 men) underwent gait and neuromuscular analysis within the week prior to and one year after surgery. A number of sex-specific differences were identified which suggest a different manifestation of end-stage knee OA between the sexes. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Designs and performance of three new microprocessor-controlled knee joints.

    Science.gov (United States)

    Thiele, Julius; Schöllig, Christina; Bellmann, Malte; Kraft, Marc

    2018-02-09

    A crossover design study with a small group of subjects was used to evaluate the performance of three microprocessor-controlled exoprosthetic knee joints (MPKs): C-Leg 4, Plié 3 and Rheo Knee 3. Given that the mechanical designs and control algorithms of the joints determine the user outcome, the influence of these inherent differences on the functional characteristics was investigated in this study. The knee joints were evaluated during level-ground walking at different velocities in a motion analysis laboratory. Additionally, technical analyses using patents, technical documentations and X-ray computed tomography (CT) for each knee joint were performed. The technical analyses showed that only C-Leg 4 and Rheo Knee 3 allow microprocessor-controlled adaptation of the joint resistances for different gait velocities. Furthermore, Plié 3 is not able to provide stance extension damping. The biomechanical results showed that only if a knee joint adapts flexion and extension resistances by the microprocessor all known advantages of MPKs can become apparent. But not all users may benefit from the examined functions: e.g. a good accommodation to fast walking speeds or comfortable stance phase flexion. Hence, a detailed comparison of user demands and performance of the designated knee joint is mandatory to ensure a maximum in user outcome.

  16. Joint awareness after total knee arthroplasty is affected by pain and quadriceps strength.

    Science.gov (United States)

    Hiyama, Y; Wada, O; Nakakita, S; Mizuno, K

    2016-06-01

    There is a growing interest in the use of patient-reported outcomes to provide a more patient-centered view on treatment. Forgetting the artificial joint can be regarded as the goal in joint arthroplasty. The goals of the study were to describe changes in joint awareness in the artificial joint after total knee arthroplasty (TKA), and to determine which factors among pain, knee range of motion (ROM), quadriceps strength, and functional ability affect joint awareness after TKA. Patients undergoing TKA demonstrate changes in joint awareness and joint awareness is associated with pain, knee ROM, quadriceps strength, and functional ability. This prospective cohort study comprised 63 individuals undergoing TKA, evaluated at 1, 6, and 12 months postoperatively. Outcomes included joint awareness assessed using the Forgotten Joint Score (FJS), pain score, knee ROM, quadriceps strength, and functional ability. Fifty-eight individuals completed all postoperative assessments. All measures except for knee extension ROM improved from 1 to 6 months. However, there were no differences in any measures from 6 to 12 months. FJS was affected most greatly by pain at 1 month and by quadriceps strength at 6 and 12 months. Patients following TKA demonstrate improvements in joint awareness and function within 6 months after surgery, but reach a plateau from 6 to 12 months. Quadriceps strength could contribute to this plateau of joint awareness. Prospective cohort study, IV. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  17. Tribology studies of the natural knee using an animal model in a new whole joint natural knee simulator.

    Science.gov (United States)

    Liu, Aiqin; Jennings, Louise M; Ingham, Eileen; Fisher, John

    2015-09-18

    The successful development of early-stage cartilage and meniscus repair interventions in the knee requires biomechanical and biotribological understanding of the design of the therapeutic interventions and their tribological function in the natural joint. The aim of this study was to develop and validate a porcine knee model using a whole joint knee simulator for investigation of the tribological function and biomechanical properties of the natural knee, which could then be used to pre-clinically assess the tribological performance of cartilage and meniscal repair interventions prior to in vivo studies. The tribological performance of standard artificial bearings in terms of anterior-posterior (A/P) shear force was determined in a newly developed six degrees of freedom tribological joint simulator. The porcine knee model was then developed and the tribological properties in terms of shear force measurements were determined for the first time for three levels of biomechanical constraints including A/P constrained, spring force semi-constrained and A/P unconstrained conditions. The shear force measurements showed higher values under the A/P constrained condition (predominantly sliding motion) compared to the A/P unconstrained condition (predominantly rolling motion). This indicated that the shear force simulation model was able to differentiate between tribological behaviours when the femoral and tibial bearing was constrained to slide or/and roll. Therefore, this porcine knee model showed the potential capability to investigate the effect of knee structural, biomechanical and kinematic changes, as well as different cartilage substitution therapies on the tribological function of natural knee joints. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  18. 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)

  19. Anatomy of the distal knee joint and pyarthrosis following external fixation.

    Science.gov (United States)

    Hyman, J; Moore, T

    1999-05-01

    To determine the limits of the distal synovial reflection of the human knee joint. Six paired knees studied by magnetic resonance imaging (MRI), fluoroscopic arthrography, and gross dissection. The right knees of five patients with chronic idiopathic knee effusions were studied by MRI. Cadaveric knees were injected with saline prior to MRI. The joint capsules were dissected to visualize local anatomy and check for capsular tears. In each modality (MRI, fluoroscopy, and dissection), the most distal extent of knee synovial fluid was measured. The right versus left agreement for paired specimens was generally two to three millimeters. Some specimens showed asymmetric capsular reflection. Medial fluid was identified at distances greater than forty-nine millimeters from the subchondral bone in seven knees and less than fifteen millimeters in four knees (range 0 to 70 millimeters, mean thirty-three millimeters). Laterally, the range was ten to thirty-five millimeters (mean twenty-three millimeters). In six of the twelve cadaveric specimens, there was evidence of a communication between the knee joint and the proximal tibiofibularjoint. In the knees of volunteers, joint fluid tracked medially to a range of ten to fifty millimeters and laterally to a range of six to fifteen millimeters, with means of twenty-six and eleven millimeters, respectively. The knees of the volunteers had no evidence of tibiofibular joint communication with the knee. Insertion of external fixation pins within sixty to seventy millimeters of the proximal articular surface of the tibia is associated with a high probability of synovial penetration and possibly provides a conduit for the introduction of bacteria, which may be etiologic in iatrogenic pyarthrosis.

  20. The alignment of the knee joint in relationship to age and osteoarthritis: the Copenhagen Osteoarthritis Study.

    Science.gov (United States)

    Laxafoss, Erling; Jacobsen, Steffen; Gosvig, Kasper K; Sonne-Holm, Stig

    2013-04-01

    The aim of the present study was to describe the changes in the axis of the knee joint in both radiologically osteoarthritic and non-osteoarthritic knees, on the basis of angles measurable in standardized clinical short knee radiographs, in a cross sectional study of an epidemiological cohort. From the third inclusion of the Copenhagen City Heart Study, 4,151 subjects were selected for standardized radiography of the knees. After censuring the inclusion, the resulting cohort was comprised of 3,488 individuals. Images were analyzed for radiological knee joint osteoarthritis (OA) and the anatomical femorotibial axis of the knee joint was measured. The prevalence of knee joint OA in males was 27.9% and 27.5%, for the left and right knees respectively. In females this was 32.8% and 36.4%. The mean knee joint angles were 4.11° in males; and 5.45° in females. A difference of 1.3° was found between the genders. In non-osteoarthritic knees the increase in valgus orientation in relationship to increasing age was found to be 0.03° and 0.04° per year, respectively, for males and females. Likewise, Kellgren and Lawrence found that OA was seen to influence a shift towards varus of 0.55°-0.76° per level of OA. Stratification in accordance with morphological severity of OA documented a clear tendency for the axis of the diseased knees to depart from the mean, primarily in the direction of varus. In knees exhibiting no signs of radiographic osteoarthritis we found a significant relationship between increasing age and a shift in the anatomical axis in the direction of valgus.

  1. Knee joint mobilization reduces secondary mechanical hyperalgesia induced by capsaicin injection into the ankle joint.

    Science.gov (United States)

    Sluka, K A; Wright, A

    2001-01-01

    Joint mobilization is a treatment approach commonly used by physical therapists for the management of a variety of painful conditions. However, the clinical effectiveness when compared to placebo and the neurophysiological mechanism of action are not known. The purpose of this study was to establish that application of a manual therapy technique will produce antihyperalgesia in an animal model of joint inflammation and that the antihyperalgesia produced by joint mobilization depends on the time of treatment application. Capsaicin (0.2%, 50 microl) was injected into the lateral aspect of the left ankle joint and mechanical withdrawal threshold assessed before and after capsaicin injection in Sprague-Dawley rats. Joint mobilization of the ipsilateral knee joint was performed 2 h after capsaicin injection for a total of 3 min, 9 min or 15 min under halothane anaesthesia. Control groups included animals that received halothane for the same time as the group that received joint mobilization and those whose limbs were held for the same duration as the mobilization (no halothane). Capsaicin resulted in a decreased mechanical withdrawal threshold by 2 h after injection that was maintained through 4 h. Both 9 and 15 min of mobilization, but not 3 min of mobilization, increased the withdrawal threshold to mechanical stimuli to baseline values when compared with control groups. The antihyperalgesic effect of joint mobilization lasted 30 min. Thus, joint mobilization (9 or 15 min duration) produces a significant reversal of secondary mechanical hyperalgesia induced by intra-articular injection of capsaicin. Copyright 2001 European Federation of Chapters of the International Association for the Study of Pain.

  2. Quasi-stiffness of the knee joint in flexion and extension during the golf swing.

    Science.gov (United States)

    Choi, Ahnryul; Sim, Taeyong; Mun, Joung Hwan

    2015-01-01

    Biomechanical understanding of the knee joint during a golf swing is essential to improve performance and prevent injury. In this study, we quantified the flexion/extension angle and moment as the primary knee movement, and evaluated quasi-stiffness represented by moment-angle coupling in the knee joint. Eighteen skilled and 23 unskilled golfers participated in this study. Six infrared cameras and two force platforms were used to record a swing motion. The anatomical angle and moment were calculated from kinematic and kinetic models, and quasi-stiffness of the knee joint was determined as an instantaneous slope of moment-angle curves. The lead knee of the skilled group had decreased resistance duration compared with the unskilled group (P golf swing and developing rehabilitation strategies following surgery.

  3. The KineSpring® Knee Implant System: an implantable joint-unloading prosthesis for treatment of medial knee osteoarthritis

    Directory of Open Access Journals (Sweden)

    Clifford AG

    2013-05-01

    Full Text Available Anton G Clifford,1 Stefan M Gabriel,1 Mary O’Connell,1 David Lowe,1 Larry E Miller,2,3 Jon E Block31Moximed, Inc, Hayward, CA, USA; 2Miller Scientific Consulting, Inc, Arden, NC, USA; 3The Jon Block Group, San Francisco, CA, USAAbstract: Symptomatic medial compartment knee osteoarthritis (OA is the leading cause of musculoskeletal pain and disability in adults. Therapies intended to unload the medial knee compartment have yielded unsatisfactory results due to low patient compliance with conservative treatments and high complication rates with surgical options. There is no widely available joint-unloading treatment for medial knee OA that offers clinically important symptom alleviation, low complication risk, and high patient acceptance. The KineSpring® Knee Implant System (Moximed, Inc, Hayward, CA, USA is a first-of-its-kind, implantable, extra-articular, extra-capsular prosthesis intended to alleviate knee OA-related symptoms by reducing medial knee compartment loading while overcoming the limitations of traditional joint-unloading therapies. Preclinical and clinical studies have demonstrated excellent prosthesis durability, substantial reductions in medial compartment and total joint loads, and clinically important improvements in OA-related pain and function. The purpose of this report is to describe the KineSpring System, including implant characteristics, principles of operation, indications for use, patient selection criteria, surgical technique, postoperative care, preclinical testing, and clinical experience. The KineSpring System has potential to bridge the gap between ineffective conservative treatments and irreversible surgical interventions for medial compartment knee OA.Keywords: KineSpring, knee, medial, osteoarthritis, prosthesis

  4. OSTEOARTHRITIS OF KNEE JOINT AND ITS RISK FACTOR IN POPULATION OF BIHAR

    Directory of Open Access Journals (Sweden)

    Mahesh

    2016-06-01

    Full Text Available BACKGROUND In study of Orthopaedic diseases, Osteoarthritis (OA is one of the most prevalent condition resulting to disability particularly in population of old age people and is a leading cause of chronic disability. The knee is the commonest of the large joints in the body to be affected by Osteoarthritis. Osteoarthritis is a very chronic joint disorder in which there is progressive softening and disintegration of articular cartilage accompanied by new growth of cartilage and bone at the joint margins (Osteophytes and the capsular fibrosis. METHODS A total of 100 cases and 100 controls were taken in the Bihari Population. For each case, an age matched control of same sex was taken, who had no complaints pertaining to knee. RESULTS In this study, old age, female sex, obesity, hypertension, family history of knee pain, Indian toilet habits, history of knee trauma/disease, sitting cross-legged for longer period, sitting before Computer for long hours, using cell phone with improper body posture and increased frequency of knee bending were found to be predisposing factors for knee Osteoarthritis. CONCLUSION Keeping weight under control, modifying daily habits such as sitting cross-legged and squatting along with using western toilet can significantly reduce the toll of knee osteoarthritis. Any trauma to knee should be dealt with utmost care, so as to maintain joint congruity and to prevent its progression to osteoarthritis in future is also strongly recommended.

  5. Nordic Walking does not reduce the loading of the knee joint

    DEFF Research Database (Denmark)

    Hansen, L; Henriksen, Michael; Larsen, P

    2008-01-01

    and the knee joint compressive forces were calculated. No differences in compression or shear forces between NW and NP were found. The peak knee flexion angles were larger during NW (-32.5+/-6.0 degrees) compared with NP (-28.2+/-4.2 degrees). The hip range of motion (ROM) was significantly increased during NW...

  6. Influence of Different Hip Joint Centre Locations on Hip and Knee Joint Kinetics and Kinematics During the Squat

    Directory of Open Access Journals (Sweden)

    Sinclair Jonathan

    2014-12-01

    Full Text Available Identification of the hip joint centre (HJC is important in the biomechanical examination of human movement. However, there is yet to be any published information regarding the influence of different HJC locations on hip and knee joint kinetics during functional tasks. This study aimed to examine the influence of four different HJC techniques on 3- D hip and knee joint kinetics/kinematics during the squat. Hip and knee joint kinetics/kinematics of the squat were obtained from fifteen male participants using an eight camera motion capture system. The 3-D kinetics/kinematics of the squat were quantified using four hip joint centre estimation techniques. Repeated measures ANOVAs were used to compare the discrete parameters as a function of each HJC location. The results show that significant differences in joint angles and moment parameters were evident at both the hip and knee joint in the coronal and transverse planes. These observations indicate that when calculating non-sagittal joint kinetics/kinematics during the squat, researchers should carefully consider their HJC method as it may significantly affect the interpretation of their data.

  7. Optimization of contrast of MR images in imaging of knee joint

    International Nuclear Information System (INIS)

    Szyblinski, K.; Bacic, G.

    1994-01-01

    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

  8. The Clinical Study on Bee Venom Acupuncture Treatment on Osteoarthritis of Knee Joint

    Directory of Open Access Journals (Sweden)

    Lim Jeong a

    2005-06-01

    Full Text Available Objective : This study is performed for the purpose of examining into the efficacy of the Bee Venom Acupuncture Treatment for Osteoarthritis of Knee Joint Methods : We investitigated 25 cases of patients with Osteoarthritis of Knee Joint from 1st June 2005 to 13th July 2005. The 25 patients were taken Bee Venom Acupuncture over three times irregularly. Treatment efficiency was monitored through VAS (Visual Analog Scale and improvement degree of the grade of clinical symptoms Conclusion : We brought to the conclusion that the Bee Venom Acupuncture has possibility to be efficient to cure the Osteoarthritis of Knee Joint patients. So we suggest the possibility to use this new remedy for the Osteoarthritis of Knee Joint

  9. Parameters Estimation For A Patellofemoral Joint Of A Human Knee Using A Vector Method

    Science.gov (United States)

    Ciszkiewicz, A.; Knapczyk, J.

    2015-08-01

    Position and displacement analysis of a spherical model of a human knee joint using the vector method was presented. Sensitivity analysis and parameter estimation were performed using the evolutionary algorithm method. Computer simulations for the mechanism with estimated parameters proved the effectiveness of the prepared software. The method itself can be useful when solving problems concerning the displacement and loads analysis in the knee joint.

  10. COMPARATIVE BIOMECHANICAL ANALYSES OF SQUAT JUMP WITHOUT AND WITH FLEXION IN KNEE JOINT

    Directory of Open Access Journals (Sweden)

    Saša Bubanj

    2009-11-01

    Full Text Available In sports hall of Faculty of sports and physical education in Niš, student demon- strated technique of squat jump – without and with flexion in knee joint. Elements of technique were recorded by using one digital video camera in sagital plane. By using comparative kinematics analyses, there were establish differences in values of kinema- tics parametres of different body segments. Bigger elevation of body centre of gravity was ascertain at bounce without flexion in knee joint.

  11. Collateral ligament strains during knee joint laxity evaluation before and after TKA.

    Science.gov (United States)

    Delport, Hendrik; Labey, Luc; De Corte, Ronny; Innocenti, Bernardo; Vander Sloten, Jos; Bellemans, Johan

    2013-08-01

    Passive knee stability is provided by the soft tissue envelope. There is consensus among orthopedic surgeons that good outcome in Total Knee Arthroplasty requires equal tension in the medial/lateral compartment of the knee joint, as well as equal tension in the flexion/extension gap. The purpose of this study was to quantify the ligament laxity in the normal non-arthritic knee before and after Posterior-Stabilized Total Knee Arthroplasty. We hypothesized that the Medial/Lateral Collateral Ligament shows minimal changes in length when measured directly by extensometers in the native human knee during varus/valgus laxity testing. We also hypothesized that due to differences in material properties and surface geometry, native laxity is difficult to reconstruct using a Posterior-Stabilized Total Knee. Six specimens were used to perform this in vitro cadaver test using extensometers to provide numerical values for laxity and varus-valgus tilting in the frontal plane. This study enabled a precise measurement of varus-valgus laxity as compared with the clinical assessment. The strains in both ligaments in the replaced knee were different from those in the native knee. Both ligaments were stretched in extension, in flexion the Medial Collateral Ligament tends to relax and the Lateral Collateral Ligament remains tight. As material properties and surface geometry of the replaced knee add stiffness to the joint, we recommend to avoid overstuffing the joint, when using this type of Posterior-Stabilized Total Knee Arthroplasty, in order to obtain varus/valgus laxity close to the native joint. Copyright © 2013 Elsevier Ltd. All rights reserved.

  12. Synovial haemangioma of the knee joint: an unusual cause of knee pain in a 14-month old girl.

    Science.gov (United States)

    Wen, D W; Tan, T J; Rasheed, S

    2016-06-01

    We report a histologically proven case of synovial haemangioma of the knee in a 14-month old girl who presented to the emergency department with an acute 1-day history of refusing to weight-bear on the right leg and a preceding 3-week history of a right knee lump. Physical examination revealed a non-tender, soft lump over the lateral infrapatellar region. Radiographs revealed a poorly defined soft tissue density over the infrapatellar fat pad and a suprapatellar joint effusion. Ultrasound was used to confirm the presence of a vascular soft tissue mass compatible with a synovial haemangioma within the infrapatellar fat pad which showed both intra-articular and extra-articular extension. There was good correlation of the ultrasound findings with magnetic resonance imaging (MRI), highlighting the potential clinical utility of ultrasound as an alternative imaging modality in establishing the pre-operative diagnosis and extent of a synovial haemangioma about the knee joint.

  13. Synovial haemangioma of the knee joint: an unusual cause of knee pain in a 14-month old girl

    Energy Technology Data Exchange (ETDEWEB)

    Wen, D.W.; Rasheed, S. [KK Women' s and Children' s Hospital, Department of Diagnostic and Interventional Imaging, Singapore (Singapore); Tan, T.J. [Changi General Hospital, Department of Radiology, Singapore (Singapore)

    2016-06-15

    We report a histologically proven case of synovial haemangioma of the knee in a 14-month old girl who presented to the emergency department with an acute 1-day history of refusing to weight-bear on the right leg and a preceding 3-week history of a right knee lump. Physical examination revealed a non-tender, soft lump over the lateral infrapatellar region. Radiographs revealed a poorly defined soft tissue density over the infrapatellar fat pad and a suprapatellar joint effusion. Ultrasound was used to confirm the presence of a vascular soft tissue mass compatible with a synovial haemangioma within the infrapatellar fat pad which showed both intra-articular and extra-articular extension. There was good correlation of the ultrasound findings with magnetic resonance imaging (MRI), highlighting the potential clinical utility of ultrasound as an alternative imaging modality in establishing the pre-operative diagnosis and extent of a synovial haemangioma about the knee joint. (orig.)

  14. Disruption of the proximal tibiofibular joint in the setting of multi-ligament knee injury

    Energy Technology Data Exchange (ETDEWEB)

    Porrino, Jack A. [University of Washington, Department of Radiology, 4245 Roosevelt Way NE, Box 354755, Seattle, WA (United States)

    2015-08-15

    Instability of the proximal tibiofibular joint is a relatively uncommon condition when in isolation; however, instability of the proximal tibiofibular joint is far more frequent in those presenting with a severe multi-ligament injury of the knee. If this joint is left unstable, repair of a co-existent injury of the posterolateral corner may fail, regardless of the proficiency of the technique. We present two patients with disruption of the proximal tibiofibular joint, including the MRI appearance, who initially presented to our hospital for management of significant polytrauma, as well as multi-ligament injury of the ipsilateral knee. (orig.)

  15. Disruption of the proximal tibiofibular joint in the setting of multi-ligament knee injury

    International Nuclear Information System (INIS)

    Porrino, Jack A.

    2015-01-01

    Instability of the proximal tibiofibular joint is a relatively uncommon condition when in isolation; however, instability of the proximal tibiofibular joint is far more frequent in those presenting with a severe multi-ligament injury of the knee. If this joint is left unstable, repair of a co-existent injury of the posterolateral corner may fail, regardless of the proficiency of the technique. We present two patients with disruption of the proximal tibiofibular joint, including the MRI appearance, who initially presented to our hospital for management of significant polytrauma, as well as multi-ligament injury of the ipsilateral knee. (orig.)

  16. Immediate effects of a new microprocessor-controlled prosthetic knee joint: a comparative biomechanical evaluation.

    Science.gov (United States)

    Bellmann, Malte; Schmalz, Thomas; Ludwigs, Eva; Blumentritt, Siegmar

    2012-03-01

    To investigate the immediate biomechanical effects after transition to a new microprocessor-controlled prosthetic knee joint. Intervention cross-over study with repeated measures. Only prosthetic knee joints were changed. Motion analysis laboratory. Men (N=11; mean age ± SD, 36.7±10.2y; Medicare functional classification level, 3-4) with unilateral transfemoral amputation. Two microprocessor-controlled prosthetic knee joints: C-Leg and a new prosthetic knee joint, Genium. Static prosthetic alignment, time-distance parameters, kinematic and kinetic parameters, and center of pressure. After a half-day training and an additional half-day accommodation, improved biomechanical outcomes were demonstrated by the Genium: lower ground reaction forces at weight acceptance during level walking at various velocities, increased swing phase flexion angles during walking on a ramp, and level walking with small steps. Maximum knee flexion angle during swing phase at various velocities was nearly equal for Genium. Step-over-step stair ascent with the Genium knee was more physiologic as demonstrated by a more equal load distribution between the prosthetic and contralateral sides and a more natural gait pattern. When descending stairs and ramps, knee flexion moments with the Genium tended to increase. During quiet stance on a decline, subjects using Genium accepted higher loading of the prosthetic side knee joint, thus reducing same side hip joint loading as well as postural sway. In comparision to the C-Leg, the Genium demonstrated immediate biomechanical advantages during various daily ambulatory activities, which may lead to an increase in range and diversity of activity of people with above-knee amputations. Results showed that use of the Genium facilitated more natural gait biomechanics and load distribution throughout the affected and sound musculoskeletal structure. This was observed during quiet stance on a decline, walking on level ground, and walking up and down ramps and

  17. Reliability of knee joint range of motion and circumference measurements after total knee arthroplasty: does tester experience matter?

    DEFF Research Database (Denmark)

    Jakobsen, Thomas Linding; Christensen, Malene; Christensen, Stine Sommer

    2010-01-01

    : The design was an intra-tester, inter-tester and intra-day reliability study. Nineteen outpatients (10 females) having received a TKA were examined by an inexperienced and an experienced physiotherapist. Following a standardized protocol, active and passive knee joint ROM and circumference measurements were...

  18. 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.

  19. Morel-Lavallée Lesions of the Knee: MRI Findings Compared With Cadaveric Study Findings.

    Science.gov (United States)

    Vassalou, Evangelia E; Zibis, Aristeidis H; Raoulis, Vasileios A; Tsifountoudis, Ioannis P; Karantanas, Apostolos H

    2018-05-01

    The purpose of this study is to describe the MRI findings and treatment decisions and outcome for Morel-Lavallée lesions (MLLs) of the knee and to investigate whether evidence exists to support an increased frequency of such lesions on the medial or lateral side by performing a cadaveric experiment. In a 4-year period, 24 MRI studies of 24 consecutive patients (16 male patients and eight female patients) with knee MLLs were retrospectively reviewed. Patient demographic characteristics, treatment decisions and outcome, and associated injuries were recorded. The location of the MLL was categorized as medial, lateral, or global. Lesions were categorized according to an established MRI classification. During the cadaveric experiment, the compartmental pressures of the medial or lateral aspect of the knee were monitored in 20 cadaveric knees. The chi-square test, t test, and Pearson correlation were used for statistical analysis. MLLs were located medially in 16 patients, laterally in two patients, and globally in six patients. The medial location was significantly more common than a lateral or global location (p < 0.05). MLLs were classified as type I in 14 patients, type II in eight patients, and type III in two patients. MRI type was correlated with the chronicity of injury (r 2 = 0.614; p = 0.0014). Fractures were the most common associated injuries, occurring in seven of 24 patients. In 17 patients, all of whom had conservatively treated type I or type II lesions, complete resolution of the MLL occurred. The maximum compartmental pressures were significantly higher on the lateral side than on the medial side (p < 0.0001). Knee MLLs have a predilection for the medial side, which may be attributed to the lower resistance in this location, and they have variable patterns on MRI, which correlate with chronicity. Conservative treatment of type I and II lesions seems effective.

  20. Intra-articular injection of dexketoprofen in rat knee joint : Histopathologic assessment of cartilage & synovium

    Directory of Open Access Journals (Sweden)

    Aycan Guner Ekici

    2014-01-01

    Full Text Available Background & objectives: Effective pain control following outpatient surgical procedures is an important aspect of patient discharge. This study was carried out with an aim to investigate the histopathological effects of intra-articular dexketoprofen trometamol injection in knee joint on synovium and cartilage in an experimental rat model. Methods: In each of 40 rats, the right knee was designated as the study group and the left knee as the control group (NS group. Under aseptic conditions, 35 rats received an injection of 0.25 ml (6.25 mg dexketoprofen trometamol into the right knee joint and an injection of 0.25 ml 0.9 per cent normal saline solution into the left knee joint. On the 1 st , 2 nd , 7 th , 14 th , and 21 st days after intra-articular injection, rats in specified groups were sacrificed by intraperitoneal injection of 120 mg/kg sodium thiopental. Knee joints were separated and sectioned for histopathological examination. Inflammatory changes in the joints were recorded according to a grade scale. Results: No significant difference in terms of pathological changes both in synovium and cartilage was observed between the NS group and the study group on days 1, 2, 7, 14 and 21 after intra-articular injection of dexketoprofen or saline in the knee joint. Interpretation & conclusions: The findings showed no evidence of significant histopathological damage to the cartilage and synovia for a period up to 21 days following intra-articular administration of dexketoprofen trometamol in the knee joints of rats.

  1. Effects of non-surgical joint distraction in the treatment of severe knee osteoarthritis.

    Science.gov (United States)

    Khademi-Kalantari, Khosro; Mahmoodi Aghdam, Somayeh; Akbarzadeh Baghban, Alireza; Rezayi, Mehdi; Rahimi, Abbas; Naimee, Sedighesadat

    2014-10-01

    The aim of this study was to evaluate the clinical results of non surgical knee distraction in patients with severe knee osteoarthritis. forty female patients with severe knee osteoarthritis were randomly divided in two groups. A standard physiotherapy treatment was applied to both groups and in one group it was accompanied with 20 min knee joint distraction. The patients were treated for 10 sessions. Clinical examination consisted of functional examination, completion of a quality of life questionnaire, pain scale, and assessment of joint mobility and joint edema. The standard physiotherapy treatment accompanied by knee distraction resulted in significantly higher improvement in pain (P = 0.004), functional ability (P = 0.02), quality of life (P = 0.002) and knee flexion range of motion (p = 0.02) compared to the standard physiotherapy treatment alone post treatment and after 1 month follow up. Adding knee distraction to standard physiotherapy treatment can result in further improvement in pain relief, increased functional ability and better quality of life in patients with severe knee osteoarthritis. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. Use of yttrium-90 hydroxyapatite radiosynovectomy as a primary modality of treatment in diffuse pigmented villonodular synovitis of the knee joint: A first case report

    International Nuclear Information System (INIS)

    Kamaleshwaran, Koramadai Karuppusamy; Rajan, David; Krishnan, Boopathi; Gounder, Thirumalaisamy Subbaih; Chakraborty, Sudipta; Kalarickal, Radhakrishnan; Mohanan, Vyshakh; Shinto, Ajit Sugunan

    2015-01-01

    Pigmented villonodular synovitis (PVNS) is a rare, relatively benign, intra-articular lesion characterized by a slowly progressive proliferation of synovial tissue. Knee is the most frequently involved joint. Localized and diffuse forms of synovial involvement were reported. In extensive diffuse cases, total synovectomy is needed, almost impossible to achieve. Hence, other treatment modalities such as intra-articular injection of yttrium-90 have been tried and shown to be effective in reducing the rate of local recurrence with “acceptable” joint damage. Radiosynovectomy is based on the irradiation of the joint synovium by the intra-articular administration of various β-emitting radiopharmaceuticals. We describe the first case report of use of yttrium-90 hydroxyapatite particulates in a 33-year-old male who presented with diffuse PVNS of knee joint as a primary modality of treatment

  3. Displacement of the medial meniscus within the passive motion characteristics of the human knee joint: an RSA study in human cadaver knees.

    NARCIS (Netherlands)

    Tienen, T. van; Buma, P.; Scholten, J.G.; Kampen, A. van; Veth, R.P.H.; Verdonschot, N.J.J.

    2005-01-01

    The objective of this study was to validate an in vitro human cadaver knee-joint model for the evaluation of the meniscal movement during knee-joint flexion. The question was whether our model showed comparable meniscal displacements to those found in earlier meniscal movement studies in vivo.

  4. Effects of changing speed on knee and ankle joint load during walking and running.

    Science.gov (United States)

    de David, Ana Cristina; Carpes, Felipe Pivetta; Stefanyshyn, Darren

    2015-01-01

    Joint moments can be used as an indicator of joint loading and have potential application for sports performance and injury prevention. The effects of changing walking and running speeds on joint moments for the different planes of motion still are debatable. Here, we compared knee and ankle moments during walking and running at different speeds. Data were collected from 11 recreational male runners to determine knee and ankle joint moments during different conditions. Conditions include walking at a comfortable speed (self-selected pacing), fast walking (fastest speed possible), slow running (speed corresponding to 30% slower than running) and running (at 4 m · s(-1) ± 10%). A different joint moment pattern was observed between walking and running. We observed a general increase in joint load for sagittal and frontal planes as speed increased, while the effects of speed were not clear in the transverse plane moments. Although differences tend to be more pronounced when gait changed from walking to running, the peak moments, in general, increased when speed increased from comfortable walking to fast walking and from slow running to running mainly in the sagittal and frontal planes. Knee flexion moment was higher in walking than in running due to larger knee extension. Results suggest caution when recommending walking over running in an attempt to reduce knee joint loading. The different effects of speed increments during walking and running should be considered with regard to the prevention of injuries and for rehabilitation purposes.

  5. Computed tomography of sternoclavicular joint lesions in spondylarthropathies

    International Nuclear Information System (INIS)

    Louvel, J.P.; Duvey, A.; Silva, F. da; Primard, E.; Mejjad, O.; Henry, J.; Le Loet, X.

    1997-01-01

    To evaluate the computed tomography (CT) findings of inflammatory lesions of the sternoclavicular joints (SCJ) in spondylarthropathies. Design and patients. CT scans of the SCJs were obtained in 23 patients (group 1) with inflammatory SCJ lesions in spondylarthropathies. These scans were reviewed by four readers and compared with the CT scans of 23 matched controls (group 2). Each reader had to complete a 27-item grid. Results and conclusion. In the 23 patients of group 1, the mean number of observed signs was 5.3±4.2 higher (P<0.01) than in the group of 23 matched controls (2.4±1.6). Four signs were more frequently observed (P<0.05) in group 1: surrounded subchondral clavicular erosions and cysts, surrounded subchondral sternal cysts and sternal bone sclerosis. A cyst and/or an erosion was associated with hyperostosis and/or bone sclerosis in 9 of 23 patients in group 1. This association was not observed in group 2; the difference was significant (P<0.001). A cyst and/or an erosive lesion was observed 18 times in group 1 versus 11 times in group 2; the difference was significant (P<0.05). Conversely, signs of degenerative lesions (osteophytes, subchondral sclerosis, unevenness of joint surface) were no more frequently observed in controls than in group 1. This study emphasizes the diagnostic value of CT, in particular in the identification of inflammatory lesions, even when pre-existing degenerative disease is present. (orig.). With 3 figs., 2 tabs

  6. Joint space narrowing, body mass index, and knee pain: the ROAD study (OAC1839R1).

    Science.gov (United States)

    Muraki, S; Akune, T; En-Yo, Y; Yoshida, M; Suzuki, T; Yoshida, H; Ishibashi, H; Tokimura, F; Yamamoto, S; Tanaka, S; Nakamura, K; Kawaguchi, H; Oka, H; Yoshimura, N

    2015-06-01

    The objective of the present study was to clarify the association of joint space narrowing with knee pain in Japanese men and women using a large-scale population-based cohort of the Research on Osteoarthritis/osteoporosis Against Disability (ROAD) study. This study examined the association between minimum joint space width (mJSW) in the medial compartment and pain at the knee. mJSW was measured in the medial and lateral compartments of the knee using a knee osteoarthritis (OA) computer-aided diagnosis system. From the 3040 participants in the ROAD study, the present study analyzed 2733 participants who completed the radiographic examinations and questionnaires regarding knee pain (975 men and 1758 women; mean age, 69.9 ± 11.2 years). Subjects with lateral knee OA were excluded. After adjustment for age and Body mass index (BMI), medial mJSW, as well as medial mJSW/lateral mJSW, was significantly associated with knee pain. Sex and BMI affected the association of medial mJSW with knee pain. The threshold of medial mJSW was approximately 3 mm in men and 2 mm in women, while that of medial mJSW/lateral mJSW was approximately 60% in both men and women. BMI was found to have a distinct effect on the association of mJSW with pain. The present cross-sectional study using a large-scale population from the ROAD study showed that joint space narrowing had a significant association with knee pain. The thresholds of joint space narrowing for knee pain were also established. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  7. Technical feasibility of personalized articulating knee joint distraction for treatment of tibiofemoral osteoarthritis.

    Science.gov (United States)

    Struik, T; Jaspers, J E N; Besselink, N J; van Roermund, P M; Plomp, S; Rudert, M J; Lafeber, F P J G; Mastbergen, S C

    2017-11-01

    Knee osteoarthritis is a highly prevalent degenerative joint disorder characterized by joint tissue damage and pain. Knee joint distraction has been introduced as a joint preserving surgical procedure to postpone knee arthroplasty. An often used standard externally fixation device for distraction poses a burden to patients due to the absence of joint flexion during the 6weeks treatment. Therefore, a personalized articulating distraction device was developed. The aim of this study was to test technical feasibility of this device. Based on an often applied rigid device, using equal bone pin positions and connectors, a hinge mechanism was developed consisting of a cam-following system for reproducing the complex joint-specific knee kinematics. In support, a device was developed for capturing the joint-specific sagittal plane articulation. The obtained kinematic data were translated into joint-specific cam shapes that were installed bilaterally in the hinge mechanism of the distraction device, as such providing personalized knee motion. Distraction of 5mm was performed within a range of motion of 30deg. joint flexion. Pre-clinical evaluation of the working principle was performed on human cadaveric legs and system stiffness characteristics were biomechanically evaluated. The desired range of motion was obtained and distraction was maintained under physiologically representative loading. Moreover, the joint-specific approach demonstrated tolerance of deviations from anatomical and alignment origin during initial placement of the developed distraction device. Articulation during knee distraction is considered technically feasible and has potential to decrease burden and improve acceptance of distraction therapy. Testing of clinical feasibility is warranted. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Whole-body vibration does not influence knee joint neuromuscular function or proprioception.

    Science.gov (United States)

    Hannah, R; Minshull, C; Folland, J P

    2013-02-01

    This study examined the acute effects of whole-body vibration (WBV) on knee joint position sense and indices of neuromuscular function, specifically strength, electromechanical delay and the rate of force development. Electromyography and electrically evoked contractions were used to investigate neural and contractile responses to WBV. Fourteen healthy males completed two treatment conditions on separate occasions: (1) 5 × 1 min of unilateral isometric squat exercise on a synchronous vibrating platform [30 Hz, 4 mm peak-to-peak amplitude] (WBV) and (2) a control condition (CON) of the same exercise without WBV. Knee joint position sense (joint angle replication task) and quadriceps neuromuscular function were assessed pre-, immediately-post and 1 h post-exercise. During maximum voluntary knee extensions, the peak force (PF(V)), electromechanical delay (EMD(V)), rate of force development (RFD(V)) and EMG of the quadriceps were measured. Twitch contractions of the knee extensors were electrically evoked to assess EMD(E) and RFD(E). The results showed no influence of WBV on knee joint position, EMD(V), PF(V) and RFD(V) during the initial 50, 100 or 150 ms of contraction. Similarly, electrically evoked neuromuscular function and neural activation remained unchanged following the vibration exercise. A single session of unilateral WBV did not influence any indices of thigh muscle neuromuscular performance or knee joint proprioception. © 2011 John Wiley & Sons A/S.

  9. Stair ascent with an innovative microprocessor-controlled exoprosthetic knee joint.

    Science.gov (United States)

    Bellmann, Malte; Schmalz, Thomas; Ludwigs, Eva; Blumentritt, Siegmar

    2012-12-01

    Climbing stairs can pose a major challenge for above-knee amputees as a result of compromised motor performance and limitations to prosthetic design. A new, innovative microprocessor-controlled prosthetic knee joint, the Genium, incorporates a function that allows an above-knee amputee to climb stairs step over step. To execute this function, a number of different sensors and complex switching algorithms were integrated into the prosthetic knee joint. The function is intuitive for the user. A biomechanical study was conducted to assess objective gait measurements and calculate joint kinematics and kinetics as subjects ascended stairs. Results demonstrated that climbing stairs step over step is more biomechanically efficient for an amputee using the Genium prosthetic knee than the previously possible conventional method where the extended prosthesis is trailed as the amputee executes one or two steps at a time. There is a natural amount of stress on the residual musculoskeletal system, and it has been shown that the healthy contralateral side supports the movements of the amputated side. The mechanical power that the healthy contralateral knee joint needs to generate during the extension phase is also reduced. Similarly, there is near normal loading of the hip joint on the amputated side.

  10. Knee joint angle affects EMG-force relationship in the vastus intermedius muscle.

    Science.gov (United States)

    Saito, Akira; Akima, Hiroshi

    2013-12-01

    It is not understood how the knee joint angle affects the relationship between electromyography (EMG) and force of four individual quadriceps femoris (QF) muscles. The purpose of this study was to examine the effect of the knee joint angle on the EMG-force relationship of the four individual QF muscles, particularly the vastus intermedius (VI), during isometric knee extensions. Eleven healthy men performed 20-100% of maximal voluntary contraction (MVC) at knee joint angles of 90°, 120° and 150°. Surface EMG of the four QF synergists was recorded and normalized by the root mean square during MVC. The normalized EMG of the four QF synergists at a knee joint angle of 150° was significantly lower than that at 90° and 120° (P knee joint angle of 150°. Furthermore, the neuromuscular activation of the VI was the most sensitive to change in muscle length among the four QF synergistic muscles. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. Analysing the Hydraulic Actuator-based Knee Unit Kinematics and Correlating the Numerical Results and Walking Human Knee Joint Behavior

    Directory of Open Access Journals (Sweden)

    K. A. Trukhanov

    2014-01-01

    Full Text Available State-of-the-art machinery development enables people with lost lower limb to continue their previous life despite a loss. International companies dealing with this area pursue a minimization of human behaviour problems because of amputation. Researches to create an optimal design of the artificial knee joint are under way.The work task was to define analytical relationships of changing kinematic parameters of the human walking on the flat surface such as an angle of the knee joint, knee point (moment, definition of reduced knee actuator (A load, as well as to compare obtained results with experimental data.As an A in created design, the article proposes to use a controlled shock absorber based on the hydraulic cylinder.A knee unit is a kinematic two-tier mechanism. One of the mechanism links performs rotational motion, and the other is rotation-translational to provide a rotation of the first one.When studying the hydraulic actuator device dynamics, as a generalized coordinate a coordinate of the piston x (or ρ position is chosen while in the study of link movements an angle β is preferable.Experimental data are obtained for a human with the body weight of 57.6 kg walking on the flat surface to estimate a value of the knee joint angle, speed, acceleration, torque, and capacity in the knee joint and are taken from the published works of foreign authors.A trigonometric approximation was used for fitting the experimental data. The resulting dependence of the reduced load on the stock of A is necessary to perform the synthesis of A. The criterion for linear mechanisms mentioned in the D.N. Popov’s work is advisable to use as a possible criterion for optimization of A.The results obtained are as follows:1. Kinematics linkage mechanism is described using relationships for dependencies of its geometrical parameters, namely a cylinder piston stroke x (or ρ and a links angle β.2. Obtained polynomials of kinematic relationships allow a synthesis of

  12. 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, ...

  13. Subject-specific knee joint geometry improves predictions of medial tibiofemoral contact forces

    Science.gov (United States)

    Gerus, Pauline; Sartori, Massimo; Besier, Thor F.; Fregly, Benjamin J.; Delp, Scott L.; Banks, Scott A.; Pandy, Marcus G.; D’Lima, Darryl D.; Lloyd, David G.

    2013-01-01

    Estimating tibiofemoral joint contact forces is important for understanding the initiation and progression of knee osteoarthritis. However, tibiofemoral contact force predictions are influenced by many factors including muscle forces and anatomical representations of the knee joint. This study aimed to investigate the influence of subject-specific geometry and knee joint kinematics on the prediction of tibiofemoral contact forces using a calibrated EMG-driven neuromusculoskeletal model of the knee. One participant fitted with an instrumented total knee replacement walked at a self-selected speed while medial and lateral tibiofemoral contact forces, ground reaction forces, whole-body kinematics, and lower-limb muscle activity were simultaneously measured. The combination of generic and subject-specific knee joint geometry and kinematics resulted in four different OpenSim models used to estimate muscle-tendon lengths and moment arms. The subject-specific geometric model was created from CT scans and the subject-specific knee joint kinematics representing the translation of the tibia relative to the femur was obtained from fluoroscopy. The EMG-driven model was calibrated using one walking trial, but with three different cost functions that tracked the knee flexion/extension moments with and without constraint over the estimated joint contact forces. The calibrated models then predicted the medial and lateral tibiofemoral contact forces for five other different walking trials. The use of subject-specific models with minimization of the peak tibiofemoral contact forces improved the accuracy of medial contact forces by 47% and lateral contact forces by 7%, respectively compared with the use of generic musculoskeletal model. PMID:24074941

  14. Using Cartilage MRI T2-Mapping to Analyze Early Cartilage Degeneration in the Knee Joint of Young Professional Soccer Players.

    Science.gov (United States)

    Waldenmeier, Leonie; Evers, Christoph; Uder, Michael; Janka, Rolf; Hennig, Frank Friedrich; Pachowsky, Milena Liese; Welsch, Götz Hannes

    2018-02-01

    Objective To evaluate and characterize the appearance of articular cartilage in the tibiofemoral joint of young professional soccer players using T2-relaxation time evaluation on magnetic resonance imaging (MRI). Design In this study, we included 57 male adolescents from the youth academy of a professional soccer team. The MRI scans were acquired of the knee joint of the supporting leg. An "early unloading" (minute 0) and "late unloading" (minute 28) T2-sequence was included in the set of images. Quantitative T2-analysis was performed in the femorotibial joint cartilage in 4 slices with each 10 regions of interest (ROIs). Statistical evaluation, using Wilcoxon signed-rank tests, was primarily performed to compare the T2 values of the "early unloading" and "late unloading." Results When comparing "early unloading" with "late unloading," our findings showed a significant increase of T2-relaxation times in the weightbearing femoral cartilage of the medial ( P cartilage of the medial compartment ( P cartilage were found with a maximum in the medial condyle where the biomechanical load of the knee joint is highest, as well as where most of the chronic cartilage lesions occur. To avoid chronic damage, special focus should be laid on this region.

  15. Knee Injuries

    Science.gov (United States)

    ... 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 ...

  16. Cartilage Health in Knees Treated with Metal Resurfacing Implants or Untreated Focal Cartilage Lesions: A Preclinical Study in Sheep.

    Science.gov (United States)

    Martinez-Carranza, Nicolas; Hultenby, Kjell; Lagerstedt, Anne Sofie; Schupbach, Peter; Berg, Hans E

    2017-07-01

    Background Full-depth cartilage lesions do not heal and the long-term clinical outcome is uncertain. In the symptomatic middle-aged (35-60 years) patient, treatment with metal implants has been proposed. However, the cartilage health surrounding these implants has not been thoroughly studied. Our objective was to evaluate the health of cartilage opposing and adjacent to metal resurfacing implants. Methods The medial femoral condyle was operated in 9 sheep bilaterally. A metallic resurfacing metallic implant was immediately inserted into an artificially created 7.5 mm defect while on the contralateral knee the defect was left untreated. Euthanasia was performed at 6 months. Six animals, of similar age and study duration, from a previous study were used for comparison in the evaluation of cartilage health adjacent to the implant. Cartilage damage to joint surfaces within the knee, cartilage repair of the defect, and cartilage adjacent to the implant was evaluated macroscopically and microscopically. Results Six animals available for evaluation of cartilage health within the knee showed a varying degree of cartilage damage with no statistical difference between defects treated with implants or left untreated ( P = 0.51; 95% CI -3.7 to 6.5). The cartilage adjacent to the implant (score 0-14; where 14 indicates no damage) remained healthy in these 6 animals showing promising results (averaged 10.5; range 9-11.5, SD 0.95). Cartilage defects did not heal in any case. Conclusion Treatment of a critical size focal lesion with a metal implant is a viable alternative treatment.

  17. Acute Ankle Sprain in a Mouse Model: Changes in Knee-Joint Space.

    Science.gov (United States)

    Hubbard-Turner, Tricia; Wikstrom, Erik A; Guderian, Sophie; Turner, Michael J

    2017-06-02

      Ankle sprains remain the most common orthopaedic injury. Conducting long-term studies in humans is difficult and costly, so the long-term consequences of an ankle sprain are not entirely known.   To measure knee-joint space after a single surgically induced ankle sprain in mice.   Randomized controlled trial.   University research laboratory.   Thirty male mice (CBA/2J) were randomly placed into 1 of 3 surgical groups: the transected calcaneofibular ligament (CFL) group, the transected anterior talofibular ligament/CFL group, or a sham treatment group. The right ankle was operated on in all mice.   Three days after surgery, all of the mice were individually housed in cages containing a solid-surface running wheel, and daily running-wheel measurements were recorded. Before surgery and every 6 weeks after surgery, a diagnostic ultrasound was used to measure medial and lateral knee-joint space in both hind limbs.   Right medial (P = .003), right lateral (P = .002), left medial (P = .03), and left lateral (P = .002) knee-joint spaces decreased across the life span. The mice in the anterior talofibular ligament/CFL group had decreased right medial (P = .004) joint space compared with the sham and CFL groups starting at 24 weeks of age and continuing throughout the life span. No differences occurred in contralateral knee-joint degeneration among any of the groups.   Based on current data, mice that sustained a surgically induced severe ankle sprain developed greater joint degeneration in the ipsilateral knee. Knee degeneration could result from accommodation to the laxity of the ankle or biomechanical alterations secondary to ankle instability. A single surgically induced ankle sprain could significantly affect knee-joint function.

  18. Estimation of Human Hip and Knee Multi-Joint Dynamics Using the LOPES Gait Trainer

    NARCIS (Netherlands)

    Koopman, Hubertus F.J.M.; van Asseldonk, Edwin H.F.; van der Kooij, Herman

    2016-01-01

    In this study, we present and evaluate a novel method to estimate multi-joint leg impedance, using a robotic gait training device. The method is based on multi-input–multi-output system identification techniques and is designed for continuous torque perturbations at the hip and knee joint

  19. Can stimulating massage improve joint repositioning error in patients with knee osteoarthritis?

    DEFF Research Database (Denmark)

    Lund, Hans; Henriksen, Marius; Bartels, Else M

    2009-01-01

    PURPOSE: The purpose of this study was to investigate the effect of massage applied to the thigh muscles on joint repositioning error (JRE) in patients suffering from osteoarthritis (OA).We hypothesized that stimulating massage of the muscles around an osteoarthritic knee joint, could improve the...

  20. [Correlation analysis of bone marrow edema degree and serum inflammatory factors change with knee joint pain symptoms in patients with bone contusion around the knee joint].

    Science.gov (United States)

    Li, Songiun; An, Rongze; Wang, Zhaojie; Kuang, Lipeng; Tan, Weiyuan; Fang, Cunxun

    2014-05-01

    To explore the correlation between the degree of bone marrow edema (BME) and the content change of tumor necrosis factor alpha (TNF-alpha) and matrix metalloproteinase 3 (MMP-3) and the knee pain symptoms in patients with bone contusion around the knee joint. Thirty patients (30 knees) of bone contusion around the knee joint were chosen as the trial group between October 2009 and April 2012. According to visual analogue scale (VAS), 30 patients were divided into mild group (10 cases), moderate group (10 cases), and severe group (10 cases); according to MRI morphological changes, the patients were divided into type I group (12 cases), type II group (11 cases), and type III group (7 cases). Ten patients (10 knees) with soft tissue injury of the knee were chosen as control group. No significant difference was found (P > 0.05) in gender, age, causes, side, and admission time after injury between 2 groups. The serum contents of MMP-3 and TNF-alpha were detected and statistically analysed between different degrees of pain groups and between different degrees of BME groups. Correlation was analysed between BME and inflammatory factor changes and VAS score. The MMP-3 and TNF-alpha contents in trial group [(29.580 +/- 6.870) (microg/L and (23.750 +/- 7.096) ng/L] were significantly higher than those in control group [(8.219 +/- 1.355) microg/L and (6.485 +/- 1.168) ng/L] (t = 9.686, P = 0.000; t = 7.596, P =0.000). The MMP-3 and TNF-alpha contents in patients with different degrees of pain and BME were significantly higher than those in patients of control group (P pain (P 0.05). Multiple linear regression analysis showed that TNF-alpha content was significantly correlated with VAS score (P = 0.000). Knee pain symptoms are not related to the degree of BME in patients with bone contusion around the knee joint. Inflammatory factor TNF-alpha content is the main influence factor of knee joint pain symptoms.

  1. Effect of Knee Joint Angle and Contraction Intensity on Hamstrings Coactivation.

    Science.gov (United States)

    Wu, Rui; Delahunt, Eamonn; Ditroilo, Massimiliano; Lowery, Madeleine M; DE Vito, Giuseppe

    2017-08-01

    This study investigated the effect of knee joint angle and contraction intensity on the coactivation of the hamstring muscles (when acting as antagonists to the quadriceps) in young and older individuals of both sexes. A total of 25 young (24 ± 2.6 yr) and 26 older (70 ± 2.5 yr) healthy men and women participated. Maximal voluntary isometric contraction of the knee extensors and flexors was assessed at two knee joint angles (90° and 60°, 0° = full extension). At each angle, participants performed submaximal contractions of the knee extensors (20%, 50%, and 80% maximal voluntary isometric contraction), whereas surface EMG was simultaneously acquired from the vastus lateralis and biceps femoris muscles to assess the level (EMG root-mean-square) of agonist activation and antagonist coactivation. Subcutaneous adipose tissue in the areas corresponding to surface EMG electrode placements was measured via ultrasonography. The contractions performed at 90° knee flexion demonstrated higher levels of antagonist coactivation (all P < 0.01) and agonist activation (all P < 0.01) as a function of contraction intensity compared with the 60° knee flexion. Furthermore, after controlling for subcutaneous adipose tissue, older participants exhibited a higher level of antagonist coactivation at 60° knee flexion compared with young participants (P < 0.05). The results of the present study suggest that 1) the antagonist coactivation is dependent on knee joint angle and contraction intensity and 2) subcutaneous adipose tissue may affect the measured coactivation level likely because of a cross-talk effect. Antagonist coactivation may play a protective role in stabilizing the knee joint and maintaining constant motor output.

  2. The structure and functioning of Dynastab DK - K fixator (knee joint) and its usefullness in clinical use.

    Science.gov (United States)

    Deszczyński, J; Karpiński, J; Deszczyńska, H

    1999-12-30

    The autor describes following stages of research on external fixator Dynastab DK - K (knee joint) with in - built artificial joint enabling physiological range of movement of the knee and the use of the device in functional treatment of articular fractures of the knee. The final clinical prototype of the device was developed according to the results of the experiments with anatomical preparations of knee joints in which the trajectory of the physiological movement of the knee was stated. These observations were used to construct mechanical joint with the range of movement adequate to this of the healthy knee. The positive and negative aspects in DK - K fixator are also described. The fixator was appled in 6 difficult cases of articular fractures of knee with good results.

  3. A rotary pneumatic actuator for the actuation of the exoskeleton knee joint

    Directory of Open Access Journals (Sweden)

    Jobin Varghese

    2017-07-01

    Full Text Available Rotary pneumatic actuators that are made out of linear one are always best suited for exoskeleton joint actuation due to its inherent power to weight ratio. This work is a modified version of knee actuation system that has already been developed and major modifications are made in order to make it more suitable for human wearing and also to reduce its bulkiness and complexity. The considered actuator system is a rotary actuator where a pulley converts the linear motion of the standard pneumatic piston into the rotary motion. To prove the capability of the actuator, its performance characteristics such as torque and power produced are compared to the required torque and power at the knee joint of the exoskeleton in swing phase and are found to be excellent. The two-way analysis of variance (ANOVA is performed to find the effect of the throat area valve on knee angle. The ANOVA shows the significant effect of the throat area variation on the knee angle flexion made by the proposed actuator. A relationship between the throat area of flow control valve, that is connected to the exit port of the direction control valve, and angular displacement of the knee joint has been formulated. This relationship can be used to design a control system to regulate the mass flow rate of air at the exit and hence the angular velocity of the knee joint can be controlled. Keywords: Driven pulley, Flow control valve, Rotary, Pneumatic cylinder

  4. Application of a semi-automatic cartilage segmentation method for biomechanical modeling of the knee joint.

    Science.gov (United States)

    Liukkonen, Mimmi K; Mononen, Mika E; Tanska, Petri; Saarakkala, Simo; Nieminen, Miika T; Korhonen, Rami K

    2017-10-01

    Manual segmentation of articular cartilage from knee joint 3D magnetic resonance images (MRI) is a time consuming and laborious task. Thus, automatic methods are needed for faster and reproducible segmentations. In the present study, we developed a semi-automatic segmentation method based on radial intensity profiles to generate 3D geometries of knee joint cartilage which were then used in computational biomechanical models of the knee joint. Six healthy volunteers were imaged with a 3T MRI device and their knee cartilages were segmented both manually and semi-automatically. The values of cartilage thicknesses and volumes produced by these two methods were compared. Furthermore, the influences of possible geometrical differences on cartilage stresses and strains in the knee were evaluated with finite element modeling. The semi-automatic segmentation and 3D geometry construction of one knee joint (menisci, femoral and tibial cartilages) was approximately two times faster than with manual segmentation. Differences in cartilage thicknesses, volumes, contact pressures, stresses, and strains between segmentation methods in femoral and tibial cartilage were mostly insignificant (p > 0.05) and random, i.e. there were no systematic differences between the methods. In conclusion, the devised semi-automatic segmentation method is a quick and accurate way to determine cartilage geometries; it may become a valuable tool for biomechanical modeling applications with large patient groups.

  5. 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.

  6. No Exacerbation of Knee Joint Pain and Effusion Following Preoperative Progressive Resistance Training in Patients Scheduled for Total Knee Arthroplasty: Secondary Analyses From a Randomized Controlled Trial.

    Science.gov (United States)

    Skoffer, Birgit; Dalgas, Ulrik; Maribo, Thomas; Søballe, Kjeld; Mechlenburg, Inger

    2017-11-09

    Preoperative progressive resistance training (PRT) is controversial in patients scheduled for total knee arthroplasty (TKA), because of the concern that it may exacerbate knee joint pain and effusion. To examine whether preoperative PRT initiated 5 weeks prior to TKA would exacerbate pain and knee effusion, and would allow a progressively increased training load throughout the training period that would subsequently increase muscle strength. Secondary analyses from a randomized controlled trial. University Hospital and a Regional Hospital. A total of 30 patients who were scheduled for TKA due to osteoarthritis and assigned as the intervention group. Patients underwent unilateral PRT (3 sessions per week). Exercise loading was 12 repetitions maximum (RM) with progression toward 8 RM. The training program consisted of 6 exercises performed unilaterally. Before and after each training session, knee joint pain was rated on an 11-point scale, effusion was assessed by measuring the knee joint circumference, and training load was recorded. The first and last training sessions were initiated by 1 RM testing of unilateral leg press, unilateral knee extension, and unilateral knee flexion. The median pain change score from before to after each training session was 0 at all training sessions. The average increase in knee joint effusion across the 12 training sessions was a mean 0.16 cm ± 0.23 cm. No consistent increase in knee joint effusion after training sessions during the training period was found (P = .21). Training load generally increased, and maximal muscle strength improved as follows: unilateral leg press: 18% ± 30% (P = .03); unilateral knee extension: 81% ± 156% (P knee flexion: 53% ± 57% (P knee joint pain and effusion, despite a substantial progression in loading and increased muscle strength. Concerns for side effects such as pain and effusion after PRT seem unfounded. To be determined. Copyright © 2017. Published by Elsevier Inc.

  7. Imaging osteoarthritis in the knee joints using x-ray guided diffuse optical tomography

    Science.gov (United States)

    Zhang, Qizhi; Yuan, Zhen; Sobel, Eric S.; Jiang, Huabei

    2010-02-01

    In our previous studies, near-infrared (NIR) diffuse optical tomography (DOT) had been successfully applied to imaging osteoarthritis (OA) in the finger joints where significant difference in optical properties of the joint tissues was evident between healthy and OA finger joints. Here we report for the first time that large joints such as the knee can also be optically imaged especially when DOT is combined with x-ray tomosynthesis where the 3D image of the bones from x-ray is incorporated into the DOT reconstruction as spatial a priori structural information. This study demonstrates that NIR light can image large joints such as the knee in addition to finger joints, which will drastically broaden the clinical utility of our x-ray guided DOT technique for OA diagnosis.

  8. Anatomical study of the articular branches innervated the hip and knee joint with reference to mechanism of referral pain in hip joint disease patients.

    Science.gov (United States)

    Sakamoto, Junya; Manabe, Yoshitaka; Oyamada, Joichi; Kataoka, Hideki; Nakano, Jiro; Saiki, Kazunobu; Okamoto, Keishi; Tsurumoto, Toshiyuki; Okita, Minoru

    2018-03-25

    Referred pain in the anterior knee joint is the most common symptom in hip disease patients. The development of referred pain is considered to be related to dichotomizing peripheral sensory fibers. However, no gross anatomical findings identify any dichotomizing fibers innervating both the hip and knee joints. We dissected the femoral and obturator nerves in human cadavers to investigate the distribution of the articular branches in the hip and knee joints. Fourteen embalmed left lower limbs from 14 Japanese adult cadavers (five from females, nine from males, average age 73.8 ± 14.1 years) were observed macroscopically. The articular branches of the femoral and obturator nerves were dissected at the anterior margin of the groin toward the thigh region. After dissections of the articular nerves of the hip joints, the femoral and obturator nerves were exposed from proximally to distally to identify the articular nerves of the knee joints. The branching pattern of the articular branches in the hip and knee joints was recorded. In six of 14 limbs (42.9%), the femoral nerve supplied articular branches to the anteromedial aspect of both the hip and knee joints. These articular branches were derived from the same bundle of femoral nerve. These gross anatomical findings suggested that dichotomizing peripheral sensory fibers innervate the hip and knee joints and these could relate to the referred pain confirmed in the anterior knee joints of patients with hip disease. Clin. Anat., 2018. © 2018 Wiley Periodicals, Inc. © 2018 Wiley Periodicals, Inc.

  9. Knee joint contact mechanics during downhill gait and its relationship with varus/valgus motion and muscle strength in patients with knee osteoarthritis.

    Science.gov (United States)

    Farrokhi, Shawn; Voycheck, Carrie A; Gustafson, Jonathan A; Fitzgerald, G Kelley; Tashman, Scott

    2016-01-01

    The objective of this exploratory study was to evaluate tibiofemoral joint contact point excursions and velocities during downhill gait and assess the relationship between tibiofemoral joint contact mechanics with frontal-plane knee joint motion and lower extremity muscle weakness in patients with knee osteoarthritis (OA). Dynamic stereo X-ray was used to quantify tibiofemoral joint contact mechanics and frontal-plane motion during the loading response phase of downhill gait in 11 patients with knee OA and 11 control volunteers. Quantitative testing of the quadriceps and the hip abductor muscles was also performed. Patients with knee OA demonstrated larger medial/lateral joint contact point excursions (p knee OA compared to their control counterparts (p = 0.02). Additionally, patients with knee OA demonstrated significantly increased frontal-plane varus motion excursions (p knee OA were linearly associated with greater frontal-plane varus motion excursions (p knee OA may be related to compromised frontal-plane joint stability but not with deficits in muscle strength.

  10. The combined use of pelotherapy and phytocomplex in rehabilitation of patients with knee joint osteoarthrosis

    Directory of Open Access Journals (Sweden)

    Kotenko К.V.

    2013-12-01

    Full Text Available Aim: to study the effect features of combined use of pelotherapy and phytocomplex on main clinical symptoms regress and quality of life in patients with knee joint osteoarthrosis. Material and Methods. The study included 96 patients with knee joint osteoarthrosis; the effectiveness evaluation was estimated in terms of American Rheumatologic Association (ARA, the data of visual-analogue scale (VAS, goniometry and laser Doppler flowmetry, indexes WOMAC, Lekena and the index of activity SIA, criteria of life quality questionnaire HAQ. Results. The complex use of pelotherapy and phytocomplex in conjunction with a drug treatment of patients have a more pronounced positive effect on pain (by 35-36%, function of the knee joint (by 26-28%, microcirculation (1.5-2 times and the quality of life (by 22-25% compared to treatment with only drug treatment or combined using of ultrasound and drug therapy. Conclusion. The new method of combined use of pelotherapy and phytocomplex leads to the evident regress of clinical symptomatology at patients with knee joint osteoarthrosis, improves locomotor function, microcirculation of knee joints and quality of life.

  11. Rapidly growing non-tuberculous mycobacteria infection of prosthetic knee joints: A report of two cases.

    Science.gov (United States)

    Kim, Manyoung; Ha, Chul-Won; Jang, Jae Won; Park, Yong-Beom

    2017-08-01

    Non-tuberculous mycobacteria (NTM) cause prosthetic knee joint infections in rare cases. Infections with rapidly growing non-tuberculous mycobacteria (RGNTM) are difficult to treat due to their aggressive clinical behavior and resistance to antibiotics. Infections of a prosthetic knee joint by RGNTM have rarely been reported. A standard of treatment has not yet been established because of the rarity of the condition. In previous reports, diagnoses of RGNTM infections in prosthetic knee joints took a long time to reach because the condition was not suspected, due to its rarity. In addition, it is difficult to identify RGNTM in the lab because special identification tests are needed. In previous reports, after treatment for RGNTM prosthetic infections, knee prostheses could not be re-implanted in all cases but one, resulting in arthrodesis or resection arthroplasty; this was most likely due to the aggressiveness of these organisms. In the present report, two cases of prosthetic knee joint infection caused by RGNTM (Mycobacterium abscessus) are described that were successfully treated, and in which prosthetic joints were finally reimplanted in two-stage revision surgery. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. The effect of instruction in analgesic use compared with neuromuscular exercise on knee-joint load in patients with knee osteoarthritis

    DEFF Research Database (Denmark)

    Holsgaard-Larsen, A; Clausen, B; Søndergaard, J

    2017-01-01

    OBJECTIVE: To investigate the effect of a NEuro-Muscular EXercise (NEMEX) therapy program compared with instructions in optimized analgesics and anti-inflammatory drug use (PHARMA), on measures of knee-joint load in people with mild to moderate knee osteoarthritis. We hypothesized that knee joint...... loading during walking would be reduced by NEMEX and potentially increased by PHARMA. DESIGN: Single-blind, RCT comparing NEMEX therapy twice a week with PHARMA. Participants with mild-to-moderate medial tibiofemoral knee osteoarthritis were randomly allocated (1:1) to one of two 8-week treatments...

  13. Alterations in knee joint laxity during the menstrual cycle in healthy women leads to increases in joint loads during selected athletic movements.

    Science.gov (United States)

    Park, Sang-Kyoon; Stefanyshyn, Darren J; Ramage, Barbara; Hart, David A; Ronsky, Janet L

    2009-06-01

    It has been speculated that the hormonal cycle may be correlated with higher incidence of ACL injury in female athletes, but results have been very contradictory. Knee joint loads are influenced by knee joint laxity (KJL) during the menstrual cycle. Controlled laboratory study. Serum samples and KJL were assessed at the follicular, ovulation, and luteal phases in 26 women. Knee joint mechanics (angle, moment, and impulse) were measured and compared at the same intervals. Each of the 26 subjects had a value for knee laxity at each of the 3 phases of their cycle, and these were ordered and designated low, medium, and high for that subject. Knee joint mechanics were then compared between low, medium, and high laxity. No significant differences in knee joint mechanics were found across the menstrual cycle (no phase effect). However, an increase in KJL was associated with higher knee joint loads during movement (laxity effect). A 1.3-mm increase in KJL resulted in an increase of approximately 30% in adduction impulse in a cutting maneuver, an increase of approximately 20% in knee adduction moment, and a 20% to 45% increase in external rotation loads during a jumping and stopping task (P knee joint loading during movements. Clinical Relevance Our findings will be beneficial for researchers in the development of more effective ACL injury prevention programs.

  14. Value of radiographic examination of the knee joint for the orthopedic surgeon

    International Nuclear Information System (INIS)

    Pietsch, M.; Hofmann, S.

    2006-01-01

    Extended radiographic examinations offer excellent options for diagnosis and strategy for treatment of the knee joint. The whole-leg radiograph is indispensable in measuring alignment for osteotomy or total knee arthroplasty (TKA). Fluoroscopically assisted varus-valgus stress radiographs provide the possibility for verifying mechanical function of the implanted knee prosthesis. Ultrasound examinations have been widely replaced by magnetic resonance imaging (MRI). MRI is the golden standard to examine intra-articular structures of the knee (meniscus, ligaments, cartilage) and surrounding soft tissue. For evaluating femoral and tibial torsion and determining axial rotation of TKA, computed tomography (CT) is best qualified. Imaging of the patellofemoral joint (patella instability) is difficult; CT scans in combination with true lateral radiographs seem to be helpful. (orig.) [de

  15. The effect of age and knee osteoarthritis on muscle activation patterns and knee joint biomechanics during dual belt treadmill gait.

    Science.gov (United States)

    Rutherford, Derek; Baker, Matthew; Wong, Ivan; Stanish, William

    2017-06-01

    To compare a group of individuals with moderate medial compartment knee osteoarthritis (OA) to both an age-matched asymptomatic group of older adults and younger adults to determine whether differences in knee joint muscle activation patterns and joint biomechanics exist during gait between these three groups. 20 young adults, 20 older adults, and 40 individuals with moderate knee OA were recruited. Using standardized procedures, surface electromyograms were recorded from the vastus lateralis and medialis, rectus femoris and the medial and lateral hamstrings. All individuals walked on a dual belt instrumented treadmill while segment motions and ground reaction forces were recorded. Sagittal plane motion and net external sagittal and frontal plane moments were calculated. Discrete measures and principal component analyses extracted amplitude and temporal waveform features. Analysis of Variance models using Bonferroni corrections determined between and within group differences in these gait features (α=0.05). Individuals with knee OA have distinct biomechanics and muscle activation patterns when compared to age-matched asymptomatic adults and younger adults whereas differences between the young and older adults were few and included only measures of muscle activation amplitude. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. [Influence of patellofemoral joint degeneration on outcome of medial unicompartmental knee arthroplasty].

    Science.gov (United States)

    Xu, B Y; Ji, B C; Guo, W T; Mu, W B; Cao, L

    2017-06-01

    Objective: To evaluate the influence of patellofemoral joint degeneration and pre-operative pain location on the outcome of medial Oxford unicompartmental knee arthroplasty (UKA). Methods: A total of 58 patients (58 knees) with medial Oxford UKA had been performed for medial osteoarthritis from March 2013 to July 2014 in Department of Orthopaedic Surgery at First Teaching Hospital of Xinjiang Medical University were retrospective reviewed. There were 24 males and 34 females, the age from 43 to 87 years with the mean age was 68.5 years. The mean body mass index was 25.2 kg/m(2) ranging from 19.7 to 31.5 kg/m(2). Patients were divided into anterior-medial pain group (35 knees), anterior knee pain group (17 knees) and general knee pain group (6 knees) according to pre-operative pain location. Pre-operative radiological statuses of the patellefemoral joint were defined by Ahlback system and divided into patellofemoral joint degeneration group (16 knees) and normal group (42 knees). Patients were also divided into medial patellofemoral degeneration group (20 knees), lateral patellofemoral degeneration group (12 knees) and normal group (26 knees) according to Altman scoring system. Outerbridge system was used intraoperatively and the patients were divided into patellofemoral joint degeneration group (21 knees) and normal group (37 knees). Pre- and post-operative outcomes were evaluated with Oxford Knee Score (OKS), Western Ontario and MacMaster (WOMAC) and patellofemoral score system of Lonner. T test and ANOVA were used to analyze the data. Results: The average duration of follow-up was 33 months (from 26 to 42 months). There were no patients had complications of infection, deep vein thrombosis, dislocation or loosing at the last follow-up. Compared to pre-operation, OKS (18.9±3.5 vs . 38.9±4.7, 19.3±4.2 vs . 39.6±4.6, 18.1±3.2 vs . 38.1±3.7)( t =5.64 to 7.08, all P patellofemoral joint degeneration group and normal group, the outcomes were the same according to

  17. Muscle area and muscle density of osteoarthritis of the knee joint studied by computerized tomography

    International Nuclear Information System (INIS)

    Suzuki, Nobuharu; Onosawa, Toshihiro; Shibata, Minoru; Yamashita, Izumi; Yoshimura, Shinichiro; Muraoka, Shunichi; Asano, Akira

    1985-01-01

    In order to investigate the etiology and pathology of osteoarthritis of the knee joints (OA), the areas and density of the muscle 10 cm above the knee were compared using computerized tomography (CT) in 26 knees from 19 normal persons, 30 knees from 17 patients with OA, and 14 knees from 7 patients with rheumatoid arthritis. The areas of the quadriceps musculi of thigh were remarkably decreased and the areas of the flexor musculi were comparatively maintained in the patients with OA. Muscle density was markedly lowered in the musculi semimembranosus and biceps femoris long head. Fatty tissues were seen in the whole area of the venter on CT in some of the patients with OA. These findings are considered to be of major importance when studying the etiology of OA. (Namekawa, K.)

  18. Selective peripheral nerve resection for treatment of persistent pain around the knee joint after total knee arthroplasty.

    Science.gov (United States)

    Zhong, Guangjun; Liang, Zhu; Kan, Jiang; Muheremu, Aikeremujiang

    2018-01-01

    Objective This study was performed to determine the efficacy of selective peripheral nerve resection for treatment of persistent neuropathic pain after total knee arthroplasty (TKA). Methods Patients who underwent TKA in our department from January 2013 to July 2016 and experienced persistent pain around the knee joint after TKA were retrospectively included in the current study. Sixty patients were divided into experimental and control groups according the treatment they received. The treatment effect was evaluated by the Hospital for Special Surgery (HSS) knee score and visual analog scale (VAS) pain score preoperatively and at 1, 2, 3, 6, and 12 months postoperatively. Results The HSS knee scores were higher in both groups after than before the treatment, and HSS knee scores were significantly higher in the experimental group than in the control group. The VAS pain scores were lower in both groups after than before the treatment, and VAS pain scores were significantly lower in the experimental group than in the control group. Conclusions Selective peripheral nerve resection is an effective treatment method for persistent neuropathic pain after TKA.

  19. RADIOLOGICAL ASSESSMENT OF AGE FROM EPIPHYSEAL FUSION AT THE KNEE JOINT

    OpenAIRE

    Ebeye, Oladunni Abimbola; Eboh, Dennis Erhisenebe; Onyia, Nwabueze Stephen

    2016-01-01

    Objectives: Age determination is needed in administration of justice, employment, marriage, forensic investigation and identification. This cross-sectional study aimed to investigate the relationship between stages of epiphyseal union at the knee joint and chronological age.Methods: Anterior posterior and lateral knee radiographs of 100 males and 110 females aged 9–19 years were examined. Epiphyseal union was divided into five specific stages in the femur, tibia and fibula. Fusion was scored ...

  20. Reductions in knee joint forces with weight loss are attenuated by gait adaptations in class III obesity

    NARCIS (Netherlands)

    DeVita, Paul; Rider, Patrick; Hortobagyi, Tibor

    A consensus exists that high knee joint forces are a precursor to knee osteoarthritis and weight loss reduces these forces. Because large weight loss also leads to increased step length and walking velocity, knee contact forces may be reduced less than predicted by the magnitude of weight loss. The

  1. Linear signal hyperintensity adjacent to the subchondral bone plate at the knee on T2-weighted fat-saturated sequences: imaging aspects and association with structural lesions

    Energy Technology Data Exchange (ETDEWEB)

    Gondim Teixeira, Pedro Augusto; Balaj, Clemence [CHU Hopital Central, Service D' Imagerie Guilloz, Nancy (France); Universite de Lorraine, IADI, UMR S 947, Nancy (France); Marie, Beatrice [CHU Hopital Central, Service d' Anatomo-Pathologie, Nancy (France); Lecocq, Sophie; Louis, Matthias; Blum, Alain [CHU Hopital Central, Service D' Imagerie Guilloz, Nancy (France); Braun, Marc [CHU Hopital Central, Service de Neuroradiologie, Nancy (France)

    2014-11-15

    To describe the association between linear T2 signal abnormalities in the subchondral bone and structural knee lesions. MR studies of patients referred for the evaluation of knee pain were retrospectively evaluated and 133 of these patients presented bone marrow edema pattern (BMEP) (study group) and while 61 did not (control group). The presence of linear anomalies of the subchondral bone on T2-weighted fat-saturated sequences was evaluated. The findings were correlated to the presence of structural knee lesions and to the duration of the patient's symptoms. Histologic analysis of a cadaveric specimen was used for anatomic correlation. Linear T2 hyperintensities at the subchondral bone were present in 41 % of patients with BMEP. None of the patients in the control group presented this sign. When a subchondral linear hyperintensity was present, the prevalence of radial or root tears was high and that of horizontal tears was low (71.4 and 4.8 %, respectively). Sixty-nine percent of the patients with a subchondral insufficiency fracture presented a subchondral linear hyperintensity. It was significantly more prevalent in patients with acute or sub-acute symptoms (p < 0.0001). The studied linear T2 hyperintensity is located at the subchondral spongiosa and can be secondary to local or distant joint injuries. Its presence should evoke acute and sub-acute knee injuries. This sign is closely related to subchondral insufficiency fractures and meniscal tears with a compromise in meniscal function. (orig.)

  2. Gait adaptations with aging in healthy participants and people with knee-joint osteoarthritis.

    Science.gov (United States)

    Duffell, Lynsey D; Jordan, Stevan J; Cobb, Justin P; McGregor, Alison H

    2017-09-01

    The relationship between age and gait characteristics in people with and without medial compartment osteoarthritis (OA) remains unclear. We aimed to characterize this relationship and to relate biomechanical and structural parameters in a subset of OA patients. Twenty five participants with diagnosed unilateral medial knee OA and 84 healthy participants, with no known knee pathology were recruited. 3D motion capture was used to analyse sagittal and coronal plane gait parameters while participants walked at a comfortable speed. Participants were categorized according to age (18-30, 31-59 and 60+ years), and those with and without OA were compared between and within age groups. In a subset of OA patients, clinically available Computed Tomography images were used to assess joint structure. Differences in coronal plane kinematics at the hip and knee were noted in participants with OA particularly those who were older compared with our healthy controls, as well as increased knee moments. Knee adduction moment correlated with structural parameters in the subset of OA patients. Increased knee moments and altered kinematics were observed in older participants presenting with OA only, which seem to be related to morphological changes in the joint due to OA, as opposed to being related to the initial cause of medial knee OA. Copyright © 2017. Published by Elsevier B.V.

  3. Dual-joint modeling for estimation of total knee replacement contact forces during locomotion.

    Science.gov (United States)

    Hast, Michael W; Piazza, Stephen J

    2013-02-01

    Model-based estimation of in vivo contact forces arising between components of a total knee replacement is challenging because such forces depend upon accurate modeling of muscles, tendons, ligaments, contact, and multibody dynamics. Here we describe an approach to solving this problem with results that are tested by comparison to knee loads measured in vivo for a single subject and made available through the Grand Challenge Competition to Predict in vivo Tibiofemoral Loads. The approach makes use of a "dual-joint" paradigm in which the knee joint is alternately represented by (1) a ball-joint knee for inverse dynamic computation of required muscle controls and (2) a 12 degree-of-freedom (DOF) knee with elastic foundation contact at the tibiofemoral and patellofemoral articulations for forward dynamic integration. Measured external forces and kinematics were applied as a feedback controller and static optimization attempted to track measured knee flexion angles and electromyographic (EMG) activity. The resulting simulations showed excellent tracking of knee flexion (average RMS error of 2.53 deg) and EMG (muscle activations within ±10% envelopes of normalized measured EMG signals). Simulated tibiofemoral contact forces agreed qualitatively with measured contact forces, but their RMS errors were approximately 25% of the peak measured values. These results demonstrate the potential of a dual-joint modeling approach to predict joint contact forces from kinesiological data measured in the motion laboratory. It is anticipated that errors in the estimation of contact force will be reduced as more accurate subject-specific models of muscles and other soft tissues are developed.

  4. Effects of changes in skiing posture on the kinetics of the knee joint.

    Science.gov (United States)

    Koyanagi, Maki; Shino, Konsei; Yoshimoto, Yoji; Inoue, Satoru; Sato, Mutsumi; Nakata, Ken

    2006-01-01

    This study was performed to investigate the effects of changes in the skiing posture on mechanical stress across the knee joint. The aim of the present study was to establish a safer form of skiing for the prevention of injury to the anterior cruciate ligament of the knee (ACL). Ten healthy volunteers were placed on a force plate on an artificial slope, and assumed forward and backward bending postures with a single leg by changing their centre of gravity. The knee flexion angles were limited to approximately 30 degrees by orthotics in each posture. Joint moments of the lower extremity were analyzed using a motion analysis system, and the muscle activities of the lower extremity were recorded by EMG and digitised to integrated EMG in each posture. In addition, extrusion of the lower leg by the boot was measured using a force sensor sheet inserted behind the calf. We found that the extension moment of the hip and ankle joints, and muscular activity of the hamstrings were increased in forward bending, whereas the extension moment of the knee and muscular activity of the quadriceps were decreased. Conversely, the muscular activity of the quadriceps, the flexion moment of the hip, extension moment of the knee joint, and pressure of the boot were increased in backward bending, whereas muscular activity of the hamstrings was decreased. The dependency on the hamstrings increased in forward bending in a skiing posture on a slope with slight knee flexion. Therefore, forward bending seemed to be an advantageous posture for the prevention of ACL injury. Conversely, in a backward bending skiing posture, the extension moment of the knee joint produced by muscle contraction of the quadriceps also increased imbalance in the hamstrings. The results of this study suggest that the internal force exerted by the quadriceps, in addition to the passive factor of extrusion of the lower leg by the boot, may contribute to non-contact ACL injury in a backward bending posture while skiing.

  5. A COMPARATIVE STUDY BETWEEN JOINT MOBILIZATION AND CONVENTIONAL PHYSIOTHERAPY IN KNEE OSTEOARTHRITIS

    Directory of Open Access Journals (Sweden)

    Aftab Ahmad

    2016-04-01

    Full Text Available Background: Osteoarthritis (O.A. is an active disease process involving articular cartilage destruction, subchondral bone thickening and new bone formation. Worldwide osteoarthritis is estimated to be the fourth leading cause of disability, in which 10% are males and 13% are females. Studies from china, Bangladesh and Pakistan have shown high prevalence of knee osteoarthritis. Pharmacological interventions, surgical procedures and Physiotherapy management play important role in knee Osteoarthritis. In Physiotherapy management of osteoarthritis, manual therapy along with thermotherapy and/or electrotherapy is used. Current study was to evaluate the effectiveness of joint mobilization in knee osteo-arthritis. Methods: Comparative study was undertaken on 50 patients with osteoarthritis of the knee who were randomly assigned to one of two groups that received Joint mobilization alone (n = 25; mean age, 53 years or Conventional Physiotherapy (n = 25; mean age, 50 years.Both groups were received their programs for 8 weeks; two sessions per week. Analysis of data within group and between groups of the pre and post treatment values of the function and pain was done using pair t test and independent t test. Results: Both groups showed significant improvement in ISOA score and VAS. There was statistical significant difference between the two groups (Group A and B i.e. p < 0.005. Conclusion: Manual joint mobilization improves the effectiveness of the treatment program in treating symptoms of knee OA and improves function in elderly people with knee OA.

  6. On the problem of knee joint articular space in the X-ray film

    International Nuclear Information System (INIS)

    Saure, D.; Emminger, A.; Freyschmidt, J.

    1980-01-01

    Measurements of the width of the intraarticular space were performed in X-ray films of 64 human knee joints (32 patients), taken laterally, and in standing position after 24 hours of rest in bed or after exposure to load for one hour. In more than half of the knee joints, the width of the intraarticular space increased after load. However, the distance between the articular surfaces rarely changed in the same patient in the same sense in the right and left knee joint, respectively medially and laterally. Hence, this method of indirect measurement of the cartilaginous layer is unsuitable, and the question raised in literature regarding the cartilaginous changes under load can be explained as being due to influx of fluid or as an expression of the viso-elastic properties of the articular cartilage. (orig.) 891 MG/orig. 892 MB [de

  7. Joint laxity and the relationship between muscle strength and functional ability in patients with osteoarthritis of the knee.

    Science.gov (United States)

    van der Esch, M; Steultjens, M; Knol, D L; Dinant, H; Dekker, J

    2006-12-15

    To establish the impact of knee joint laxity on the relationship between muscle strength and functional ability in osteoarthritis (OA) of the knee. A cross-sectional study of 86 patients with OA of the knee was conducted. Tests were performed to determine varus-valgus laxity, muscle strength, and functional ability. Laxity was assessed using a device that measures the angular deviation of the knee in the frontal plane. Muscle strength was measured using a computer-driven isokinetic dynamometer. Functional ability was assessed by observation (100-meter walking test) and self report (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]). Regression analyses were performed to assess the impact of joint laxity on the relationship between muscle strength and functional ability. In regression analyses, the interaction between muscle strength and joint laxity contributed to the variance in both walking time (P = 0.002) and WOMAC score (P = 0.080). The slope of the regression lines indicated that the relationship between muscle strength and functional ability (walking time, WOMAC) was stronger in patients with high knee joint laxity. Patients with knee OA and high knee joint laxity show a stronger relationship between muscle strength and functional ability than patients with OA and low knee joint laxity. Patients with OA, high knee joint laxity, and low muscle strength are most at risk of being disabled.

  8. Bone signal abnormality, as seen on knee joint MRI : relationship between its location and associated injury

    International Nuclear Information System (INIS)

    Kim, Young Nam; Kim, Baek Hyun; Jung, Hoe Seok; Na, Eui Sung; Seol, Hye Young; Cha, In Ho; Lim, Hong Chul

    1998-01-01

    The purpose of the study was to evaluate the relationship between the location of bone signal abnormality and associated injury, as seen on MR, in patients with acute knee joint injury. Materials and Methods: Thirty-six patients with acute knee injury and bone signal abnormalities on MR were included in this study. The femur and tibia were each divided into six compartments, namely the anteromedial, medial, posteromedial,anterolateral, lateral, and posterolateral ; these were obtained in each knee joint. We evaluated the location of bone signal abnormality and the corresponding arthroscopic or operative findings of injury to ligaments and menisci. Cases with signal abnormalities involving more than three compartments were excluded. Results : Bone signal abnormalities were demonstrated in 51 compartments. Most(84%, 43/51) were noted in the lateral half of the knee joint, the most common location being the tibio- posterolateral compartment(13/51). The femoro-lateral(11/51) and tibio- anterolateral compartment(8/51) were the next most common locations. All cases(13/13)with bone signal abnormality in the tibio- posterolateral compartment had tears at the anterior cruciate ligament,while 9 of 11 cases(81%) with abnormality in the femoro- lateral compartment had tears at the anterior cruciate ligament. Six of eight cases(75%) with signal abnormality in the tibio- anterolateral compartment had tears at the posterior cruciate ligament ; 31 of 43 cases (72%) with abnormality in the lateral half of the knee joint had tears at the medial collateral ligament. Six of eight cases(75%) with signal abnormality in the medial half of the knee joint had tears at the medial meniscus, but no lateral meniscal tear was found. Among patients with signal abnormality in the lateral half of the knee joint, the tear was lateral meniscal in nine of 43 cases(21%) and medial meniscal in six of 43(14%). Conclusion : The location of bone signal abnormality, as seen on knee MR, inpatients with

  9. Knee joint passive stiffness and moment in sagittal and frontal planes markedly increase with compression.

    Science.gov (United States)

    Marouane, H; Shirazi-Adl, A; Adouni, M

    2015-01-01

    Knee joints are subject to large compression forces in daily activities. Due to artefact moments and instability under large compression loads, biomechanical studies impose additional constraints to circumvent the compression position-dependency in response. To quantify the effect of compression on passive knee moment resistance and stiffness, two validated finite element models of the tibiofemoral (TF) joint, one refined with depth-dependent fibril-reinforced cartilage and the other less refined with homogeneous isotropic cartilage, are used. The unconstrained TF joint response in sagittal and frontal planes is investigated at different flexion angles (0°, 15°, 30° and 45°) up to 1800 N compression preloads. The compression is applied at a novel joint mechanical balance point (MBP) identified as a point at which the compression does not cause any coupled rotations in sagittal and frontal planes. The MBP of the unconstrained joint is located at the lateral plateau in small compressions and shifts medially towards the inter-compartmental area at larger compression forces. The compression force substantially increases the joint moment-bearing capacities and instantaneous angular rigidities in both frontal and sagittal planes. The varus-valgus laxities diminish with compression preloads despite concomitant substantial reductions in collateral ligament forces. While the angular rigidity would enhance the joint stability, the augmented passive moment resistance under compression preloads plays a role in supporting external moments and should as such be considered in the knee joint musculoskeletal models.

  10. A Combined Experimental and Computational Approach to Subject-Specific Analysis of Knee Joint Laxity

    Science.gov (United States)

    Harris, Michael D.; Cyr, Adam J.; Ali, Azhar A.; Fitzpatrick, Clare K.; Rullkoetter, Paul J.; Maletsky, Lorin P.; Shelburne, Kevin B.

    2016-01-01

    Modeling complex knee biomechanics is a continual challenge, which has resulted in many models of varying levels of quality, complexity, and validation. Beyond modeling healthy knees, accurately mimicking pathologic knee mechanics, such as after cruciate rupture or meniscectomy, is difficult. Experimental tests of knee laxity can provide important information about ligament engagement and overall contributions to knee stability for development of subject-specific models to accurately simulate knee motion and loading. Our objective was to provide combined experimental tests and finite-element (FE) models of natural knee laxity that are subject-specific, have one-to-one experiment to model calibration, simulate ligament engagement in agreement with literature, and are adaptable for a variety of biomechanical investigations (e.g., cartilage contact, ligament strain, in vivo kinematics). Calibration involved perturbing ligament stiffness, initial ligament strain, and attachment location until model-predicted kinematics and ligament engagement matched experimental reports. Errors between model-predicted and experimental kinematics averaged ligaments agreed with literature descriptions. These results demonstrate the ability of our constraint models to be customized for multiple individuals and simultaneously call attention to the need to verify that ligament engagement is in good general agreement with literature. To facilitate further investigations of subject-specific or population based knee joint biomechanics, data collected during the experimental and modeling phases of this study are available for download by the research community. PMID:27306137

  11. Managing Knee Osteoarthritis: The Effects of Body Weight Supported Physical Activity on Joint Pain, Function, and Thigh Muscle Strength.

    Science.gov (United States)

    Peeler, Jason; Christian, Mathew; Cooper, Juliette; Leiter, Jeffrey; MacDonald, Peter

    2015-11-01

    To determine the effect of a 12-week lower body positive pressure (LBPP)-supported low-load treadmill walking program on knee joint pain, function, and thigh muscle strength in overweight patients with knee osteoarthritis (OA). Prospective, observational, repeated measures investigation. Community-based, multidisciplinary sports medicine clinic. Thirty-one patients aged between 55 and 75 years, with a body mass index ≥25 kg/m and mild-to-moderate knee OA. Twelve-week LBPP-supported low-load treadmill walking regimen. Acute knee joint pain (visual analog scale) during full weight bearing treadmill walking, chronic knee pain, and joint function [Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire] during normal activities of daily living, and thigh muscle strength (isokinetic testing). Appropriate methods of statistical analysis were used to compare data from baseline and follow-up evaluation. Participants reported significant improvements in knee joint pain and function and demonstrated significant increases in thigh muscle strength about the degenerative knee. Participants also experienced significant reductions in acute knee pain during full weight bearing treadmill walking and required dramatically less LBPP support to walk pain free on the treadmill. Data suggest that an LBPP-supported low-load exercise regimen can be used to significantly diminish knee pain, enhance joint function, and increase thigh muscle strength, while safely promoting pain-free walking exercise in overweight patients with knee OA. These findings have important implications for the development of nonoperative treatment strategies that can be used in the management of joint symptoms associated with progressive knee OA in at-risk patient populations. This research suggests that LBPP-supported low-load walking is a safe user-friendly mode of exercise that can be successfully used in the management of day-to-day joint symptoms associated with knee OA, helping to improve the

  12. Radio-synoviorthesis with yttrium 90 in the knee-joint in rheumatoid arthritis

    International Nuclear Information System (INIS)

    Hagena, F.W.; Muenchen Univ.

    1982-01-01

    The radio-synoviorthesis with yttrium 90 in the knee-joint in rheumatoid arthritis was performed and controlled in 106 knees of patients with rheumatoid arthritis over a span of time between 6 and 49 months. The results are similar to those of other authors. As compared to synovectomy radio-synoviorthesis seems less successful as far as long-term results are concerned. As local treatment radio-synoviorthesis seems a good supplementory element in the therapeutic plan of rheumatoid arthritis. The indication to alternative procedures has been considered carefully for each individual case and joint. (orig.) [de

  13. 1. 5 MRT of the hyaline articular cartilage of the knee joint

    Energy Technology Data Exchange (ETDEWEB)

    Adam, G.; Bohndorf, K.; Krasny, R.; Guenther, R.W.; Prescher, A.

    1988-06-01

    MRI is a new method for imaging the knee joint. There is still some uncertainty regarding the extent and the signal from hyaline articular cartilage. MRI images were therefore compared with anatomical and histological preparations of the knee joint and the difference between MRI and the anatomical sections have been determined. It was shown that demonstration of hyaline cartilage was obscured by an artifact. Further investigations are required to determine the cause of this artifact and to achieve accurate imaging of hyaline cartilage by MRI.

  14. Pain sensation in human osteoarthritic knee joints is strongly enhanced by diabetes mellitus.

    Science.gov (United States)

    Eitner, Annett; Pester, Julia; Vogel, Franziska; Marintschev, Ivan; Lehmann, Thomas; Hofmann, Gunther O; Schaible, Hans-Georg

    2017-09-01

    The major burden of knee joint osteoarthritis (OA) is pain. Since in elder patients diabetes mellitus is an important comorbidity of OA, we explored whether the presence of diabetes mellitus has a significant influence on pain intensity at the end stage of knee OA, and we aimed to identify factors possibly related to changes of pain intensity in diabetic patients. In 23 diabetic and 47 nondiabetic patients with OA undergoing total knee arthroplasty, we assessed the pain intensity before the operation using the "Knee Injury and Osteoarthritis Outcome Score". Furthermore, synovial tissue, synovial fluid (SF), cartilage, and blood were obtained. We determined the synovitis score, the concentrations of prostaglandin E2 and interleukin-6 (IL-6) in the SF and serum, and of C-reactive protein and HbA1c and other metabolic parameters in the serum. We performed multivariate regression analyses to study the association of pain with several parameters. Diabetic patients had on average a higher Knee Injury and Osteoarthritis Outcome Score pain score than nondiabetic patients (P Knee joints from diabetic patients exhibited on average higher synovitis scores (P = 0.024) and higher concentrations of IL-6 in the SF (P = 0.003) than knee joints from nondiabetic patients. Multivariate regression analysis showed that patients with higher synovitis scores had more intense pain independent of all investigated confounders, and that the positive association between pain intensities and IL-6 levels was dependent on diabetes mellitus and/or synovitis. These data suggest that diabetes mellitus significantly increases pain intensity of knee OA, and that in diabetic patients higher pain intensities were determined by stronger synovitis.

  15. Arthroscopic-assisted Arthrodesis of the Knee Joint With the Ilizarov Technique: A Case Report and Literature Review.

    Science.gov (United States)

    Waszczykowski, Michal; Niedzielski, Kryspin; Radek, Maciej; Fabis, Jaroslaw

    2016-01-01

    Arthrodesis of the knee joint is a mainly a salvage surgical procedure performed in cases of infected total knee arthroplasty, tumor, failed knee arthroplasty or posttraumatic complication.The authors report the case of 18-year-old male with posttraumatic complication of left knee because of motorbike accident 1 year before. He was treated immediately after the injury in the local Department of Orthopaedics and Traumatology. The examination in the day of admission to our department revealed deformation of the left knee, massive scar tissue adhesions to the proximal tibial bone and multidirectional instability of the knee. The plain radiographs showed complete lack of lateral compartment of the knee joint and patella. The patient complained of severe instability and pain of the knee and a consecutive loss of supporting function of his left limb. The authors decided to perform an arthroscopic-assisted fusion of the knee with Ilizarov external fixator because of massive scar tissue in the knee region and the prior knee infection.In the final follow-up after 54 months a complete bone fusion, good functional and clinical outcome were obtained.This case provides a significant contribution to the development and application of low-invasive techniques in large and extensive surgical procedures in orthopedics and traumatology. Moreover, in this case fixation of knee joint was crucial for providing good conditions for the regeneration of damaged peroneal nerve.

  16. Total hip and knee joint replacement: perioperative clinical aspects

    Directory of Open Access Journals (Sweden)

    Luciana Pereira Almeida de Piano

    2010-09-01

    Full Text Available Objective: To understand the profile of patients undergoing hip and knee replacement during two years, and to compare the data obtained with the literature. Methods: A total of 323 medical records were reviewed to analyze the perioperative data of patients submitted to hip and knee replacement. Results: Osteoarthritis was the main indication for both procedures and male patients were heavier than females (p < 0.05. Hypertension was the prevalent disease among patients. Blood loss was more frequent in knee surgery than in the hip. Conclusions: The profile of patients undergoing total arthroplasty improved substantially over the past decade due to shorter hospital stay, lower risk of thromboembolic events and no infection as compared to previous reports.

  17. In vitro method for assessing the biomechanics of the patellofemoral joint following total knee arthroplasty.

    Science.gov (United States)

    Coles, L G; Gheduzzi, S; Miles, A W

    2014-12-01

    The patellofemoral joint is a common site of pain and failure following total knee arthroplasty. A contributory factor may be adverse patellofemoral biomechanics. Cadaveric investigations are commonly used to assess the biomechanics of the joint, but are associated with high inter-specimen variability and often cannot be carried out at physiological levels of loading. This study aimed to evaluate the suitability of a novel knee simulator for investigating patellofemoral joint biomechanics. This simulator specifically facilitated the extended assessment of patellofemoral joint biomechanics under physiological levels of loading. The simulator allowed the knee to move in 6 degrees of freedom under quadriceps actuation and included a simulation of the action of the hamstrings. Prostheses were implanted on synthetic bones and key soft tissues were modelled with a synthetic analogue. In order to evaluate the physiological relevance and repeatability of the simulator, measurements were made of the quadriceps force and the force, contact area and pressure within the patellofemoral joint using load cells, pressure-sensitive film, and a flexible pressure sensor. The results were in agreement with those previously reported in the literature, confirming that the simulator is able to provide a realistic physiological loading situation. Under physiological loading, average standard deviations of force and area measurements were substantially lower and comparable to those reported in previous cadaveric studies, respectively. The simulator replicates the physiological environment and has been demonstrated to allow the initial investigation of factors affecting patellofemoral biomechanics following total knee arthroplasty. © IMechE 2014.

  18. The effect of constitutive representations and structural constituents of ligaments on knee joint mechanics.

    Science.gov (United States)

    Orozco, Gustavo A; Tanska, Petri; Mononen, Mika E; Halonen, Kimmo S; Korhonen, Rami K

    2018-02-02

    Ligaments provide stability to the human knee joint and play an essential role in restraining motion during daily activities. Compression-tension nonlinearity is a well-known characteristic of ligaments. Moreover, simpler material representations without this feature might give reasonable results because ligaments are primarily in tension during loading. However, the biomechanical role of different constitutive representations and their fibril-reinforced poroelastic properties is unknown. A numerical knee model which considers geometric and material nonlinearities of meniscus and cartilages was applied. Five different constitutive models for the ligaments (spring, elastic, hyperelastic, porohyperelastic, and fibril-reinforced porohyperelastic (FRPHE)) were implemented. Knee joint forces for the models with elastic, hyperelastic and porohyperelastic properties showed similar behavior throughout the stance, while the model with FRPHE properties exhibited lower joint forces during the last 50% of the stance phase. The model with ligaments as springs produced the lowest joint forces at this same stance phase. The results also showed that the fibril network contributed substantially to the knee joint forces, while the nonfibrillar matrix and fluid had small effects. Our results indicate that simpler material models of ligaments with similar properties in compression and tension can be used when the loading is directed primarily along the ligament axis in tension.

  19. Relationships between in vivo dynamic knee joint loading, static alignment and tibial subchondral bone microarchitecture in end-stage knee osteoarthritis.

    Science.gov (United States)

    Roberts, B C; Solomon, L B; Mercer, G; Reynolds, K J; Thewlis, D; Perilli, E

    2018-04-01

    To study, in end-stage knee osteoarthritis (OA) patients, relationships between indices of in vivo dynamic knee joint loads obtained pre-operatively using gait analysis, static knee alignment, and the subchondral trabecular bone (STB) microarchitecture of their excised tibial plateau quantified with 3D micro-CT. Twenty-five knee OA patients scheduled for total knee arthroplasty underwent pre-operative gait analysis. Mechanical axis deviation (MAD) was determined radiographically. Following surgery, excised tibial plateaus were micro-CT-scanned and STB microarchitecture analysed in four subregions (anteromedial, posteromedial, anterolateral, posterolateral). Regional differences in STB microarchitecture and relationships between joint loading and microarchitecture were examined. STB microarchitecture differed among subregions (P knee adduction moment (KAM) and internal rotation moment (|r|-range: 0.54-0.74). When controlling for walking speed, KAM and MAD, the ERM explained additional 11-30% of the variations in anteromedial BV/TV and medial-to-lateral BV/TV ratio (R 2  = 0.59, R 2  = 0.69, P knee joint loading indices in end-stage knee OA patients. Particularly, anteromedial BV/TV correlates strongest with ERM, whereas medial-to-lateral BV/TV ratio correlates strongest with indicators of medial-to-lateral joint loading (MAD, KAM) and rotational moments. However, associations with ERM should be interpreted with caution. Copyright © 2018 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  20. Pseudogout at the knee joint will frequently occur after hip fracture and lead to the knee pain in the early postoperative period.

    Science.gov (United States)

    Harato, Kengo; Yoshida, Hiroki

    2015-01-14

    Symptomatic knee joint effusion is frequently observed after hip fracture, which may lead to postoperative knee pain during rehabilitation after hip fracture surgery. However, unfortunately, very little has been reported on this phenomenon in the literature. The purpose of the current study was to investigate the relationship between symptomatic knee effusion and postoperative knee pain and to clarify the reason of the effusion accompanied by hip fracture. A total of 100 patients over 65 years of age with an acute hip fracture after fall were prospectively followed up. Knee effusion was assessed on admission and at the operating room before the surgery. If knee effusion was observed at the time of the surgery, synovial fluid was collected into syringes to investigate the cause of the effusion using a compensated polarized light microscope. Furthermore, for each patient, we evaluated age, sex, radiographic knee osteoarthritis (OA), type of the fracture, laterality, severity of the fracture, and postoperative knee pain during rehabilitation. These factors were compared between patients with and without knee effusion at the time of the surgery. As a statistical analysis, we used Mann-Whitney U-test for patients' age and categorical variables were analyzed by chi-square test or Fisher's exact test. A total of 30 patients presented symptomatic knee effusion at the time of the surgery. In patients with knee effusion, numbers of intertrochanteric fracture, radiographic knee OA, and postoperative knee pain were significantly large compared to those without effusion. In terms of synovial fluid analysis, calcium pyrophosphate dihydrate crystals were observed in 80% of patients with knee effusion. From our study, approximately 63% of patients with knee effusion at the time of the surgery had postoperative knee pain. In addition, this effusion was basically related to pseudogout.

  1. 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.

  2. [Correlations Between Joint Proprioception, Muscle Strength, and Functional Ability in Patients with Knee Osteoarthritis].

    Science.gov (United States)

    Chen, Yoa; Yu, Yong; He, Cheng-qi

    2015-11-01

    To establish correlations between joint proprioception, muscle flexion and extension peak torque, and functional ability in patients with knee osteoarthritis (OA). Fifty-six patients with symptomatic knee OA were recruited in this study. Both proprioceptive acuity and muscle strength were measured using the isomed-2000 isokinetic dynamometer. Proprioceptive acuity was evaluated by establishing the joint motion detection threshold (JMDT). Muscle strength was evaluated by Max torque (Nm) and Max torque/weight (Nm/ kg). Functional ability was assessed by the Western Ontario and McMaster Universities Osteoarthritis Index physical function (WOMAC-PF) questionnaire. Correlational analyses were performed between proprioception, muscle strength, and functional ability. A multiple stepwise regression model was established, with WOMAC-PF as dependent variable and patient age, body mass index (BMI), visual analogue scale (VAS)-score, mean grade for Kellgren-Lawrance of both knees, mean strength for quadriceps and hamstring muscles of both knees, and mean JMDT of both knees as independent variables. Poor proprioception (high JMDT) was negatively correlated with muscle strength (Pcoefficient (B) = 0.385, P<0.50 and high VAS-scale score (B=0.347, P<0.05) were significant predictors of WOMAC-PF score. Patients with poor proprioception is associated with poor muscle strength and limitation in functional ability. Patients with symptomatic OA of knees commonly endure with moderate to considerable dysfunction, which is associated with poor proprioception (high JMDT) and high VAS-scale score.

  3. Effect of Sri Lankan traditional medicine and Ayurveda on Sandhigata Vata (osteoarthritis of knee joint)

    Science.gov (United States)

    Perera, Pathirage Kamal; Perera, Manaram; Kumarasinghe, Nishantha

    2014-01-01

    Reported case was a 63-year-old female with end-stage osteoarthritis (OA) (Sandhigata Vata) of the left knee joint accompanied by exostoses. Radiology (X-ray) report confirmed it as a Kellgren-Lawrence grade III or less with exostoses. At the beginning, the Knee Society Rating System scores of pain, movement and stability were poor, and function score was fair. Srilankan traditional and Ayurveda medicine treatment was given in three regimens for 70 days. After 70 days, external treatment of oleation and 2 capsules of Shallaki (Boswellia serrata Triana and Planch) and two tablets of Jeewya (comprised of Emblica officinalis Gaertn., Tinospora cordifolia [Willd.] Millers. and Terminalia chebula Retz.), twice daily were continued over 5 months. Visual analogue scale for pain, knee scores in the Knee Society online rating system and a Ayurveda clinical assessment criteria was used to evaluate the effects of treatments in weekly basis. After treatment for 70 days, the Knee Society Rating System scores of pain, movement and stability were also improved up to good level and function score was improved up to excellent level. During the follow-up period, joint symptoms and signs and the knee scores were unchanged. In conclusion, this OA patient's quality of life was improved by the combined treatment of Sri Lankan traditional medicine and Ayurveda. PMID:26195904

  4. The association between antagonist hamstring coactivation and episodes of knee joint shifting and buckling.

    Science.gov (United States)

    Segal, N A; Nevitt, M C; Welborn, R D; Nguyen, U-S D T; Niu, J; Lewis, C E; Felson, D T; Frey-Law, L

    2015-07-01

    Hamstring coactivation during quadriceps activation is necessary to counteract the quadriceps pull on the tibia, but coactivation can be elevated with symptomatic knee osteoarthritis (OA). To guide rehabilitation to attenuate risk for mobility limitations and falls, this study evaluated whether higher antagonistic open kinetic chain hamstring coactivation is associated with knee joint buckling (sudden loss of support) and shifting (a sensation that the knee might give way). At baseline, median hamstring coactivation was assessed during maximal isokinetic knee extensor strength testing and at baseline and 24-month follow-up, knee buckling and shifting was self-reported. Associations between tertiles of co-activation and knee (1) buckling, (2) shifting and (3) either buckling or shifting were assessed using logistic regression, adjusted for age, sex, knee OA and pain. 1826 participants (1089 women) were included. Mean ± SD age was 61.7 ± 7.7 years, BMI was 30.3 ± 5.5 kg/m(2) and 38.2% of knees had OA. There were no consistent statistically significant associations between hamstring coactivation and ipsilateral prevalent or incident buckling or the combination of buckling and shifting. The odds ratios for incident shifting in the highest in comparison with the lowest tertile of coactivation had similar magnitudes in the combined and medial hamstrings, but only reached statistical significance for lateral hamstring coactivation, OR(95%CI) 1.53 (0.99, 2.36). Hamstring coactivation during an open kinetic chain quadriceps exercise was not consistently associated with prevalent or incident self-reported knee buckling or shifting in older adults with or at risk for knee OA. Copyright © 2015. Published by Elsevier Ltd.

  5. Joint angles of the ankle, knee, and hip and loading conditions during split squats.

    Science.gov (United States)

    Schütz, Pascal; List, Renate; Zemp, Roland; Schellenberg, Florian; Taylor, William R; Lorenzetti, Silvio

    2014-06-01

    The aim of this study was to quantify how step length and the front tibia angle influence joint angles and loading conditions during the split squat exercise. Eleven subjects performed split squats with an additional load of 25% body weight applied using a barbell. Each subject's movements were recorded using a motion capture system, and the ground reaction force was measured under each foot. The joint angles and loading conditions were calculated using a cluster-based kinematic approach and inverse dynamics modeling respectively. Increases in the tibia angle resulted in a smaller range of motion (ROM) of the front knee and a larger ROM of the rear knee and hip. The external flexion moment in the front knee/hip and the external extension moment in the rear hip decreased as the tibia angle increased. The flexion moment in the rear knee increased as the tibia angle increased. The load distribution between the legs changed squat execution was varied. Our results describing the changes in joint angles and the resulting differences in the moments of the knee and hip will allow coaches and therapists to adapt the split squat exercise to the individual motion and load demands of athletes.

  6. Helical axes of skeletal knee joint motion during running.

    Science.gov (United States)

    van den Bogert, A J; Reinschmidt, C; Lundberg, A

    2008-01-01

    The purpose of this study was to determine the changes in the axis of rotation of the knee that occur during the stance phase of running. Using intracortical pins, the three-dimensional skeletal kinematics of three subjects were measured during the stance phase of five running trials. The stance phase was divided into equal motion increments for which the position and orientation of the finite helical axes (FHA) were calculated relative to a tibial reference frame. Results were consistent within and between subjects. At the beginning of stance, the FHA was located at the midepicondylar point and during the flexion phase moved 20mm posteriorly and 10mm distally. At the time of peak flexion, the FHA shifted rapidly by about 10-20mm in proximal and posterior direction. The angle between the FHA and the tibial transverse plane increased gradually during flexion, to about 15 degrees of medial inclination, and then returned to zero at the start of the extension phase. These changes in position and orientation of FHA in the knee should be considered in analyses of muscle function during human movement, which require moment arms to be defined relative to a functional rotation axis. The finding that substantial changes in axis of rotation occurred independent of flexion angle suggests that musculoskeletal models must have more than one kinematic degree-of-freedom at the knee. The same applies to the design of knee prostheses, if the goal is to restore normal muscle function.

  7. MR imaging before arthroscopy in knee joint disorders?

    International Nuclear Information System (INIS)

    Rappeport, E.D.; Mehta, S.; Wieslander, S.B.; Schwarz Lausten, G.; Thomsen, H.S.

    1996-01-01

    Purpose: To review the current literature examining the relative merits of arthroscopy and MR imaging of the knee. Material and Methods: All papers comparing MR imaging with arthroscopy published within the last 10 years according to Medline were collected and read. Results: Technology has improved considerably during recent years allowing detailed non-invasive visualization of the knee. In particular, the development of cheaper whole-body and dedicated low-field MR units has opened up for non-invasive inspection of the knee at reasonable cost. Meniscal tears can be detected with accuracy rates of around 90% and rupture of the anterior cruciate ligament with accuracy rates of around 93% compared to arthroscopy. However, arthroscopy is not the ideal gold standard, since it has weak points, e.g. peripheral meniscal tears or osteochondritis without apparent damage to the cartilage. Conclusion: Based on the overwhelming literature it seems safe to conclude that MR examinations of the knee should be performed before arthroscopy is undertaken. (orig.)

  8. Cyclooxygenase-2 inhibitor celecoxib attenuates joint contracture following immobilization in rat knees.

    Science.gov (United States)

    Ozawa, Junya; Kaneguchi, Akinori; Tanaka, Ryo; Kito, Nobuhiro; Moriyama, Hideki

    2016-10-24

    The aim of this study is to clarify the following two points: First, whether a cyclooxygenase-2 mediated pathway is involved in the formation of immobilization-induced joint contracture and, second, the effectiveness of oral administration of non-steroidal anti-inflammatory drug celecoxib (CBX) for the prevention of myogenic and arthrogenic contracture following immobilization in a rat model. Thirty male rats were randomly divided into three groups: immobilization (Im), Im + CBX, and control (n = 10 each). External fixation immobilized the right knee joint of Im and Im + CBX groups in flexion for 3 weeks. 50 mg/kg of CBX was administrated daily to the Im + CBX group during this period. The passive range of motion (ROM) of knee joints was measured before and after transection of knee flexor muscles and myogenic and arthrogenic ROM restrictions were calculated. The semitendinosus muscles and knee joints were investigated histologically to elucidate factors responsible for contracture. Myogenic ROM restrictions were exhibited both in Im and Im + CBX groups (44 ± 5 and 36 ± 8 °, respectively), but restrictions significantly decreased in the Im + CBX group compared to the Im group. Significant reductions of the muscle length ratios (Rt/Lt) and sarcomere number ratios (Rt/Lt) in knee flexor semitendinosus muscle, which are responsible for myogenic contracture, were also seen both in Im group (92 ± 5 and 92 ± 4 %, respectively) and Im + CBX group (97 ± 3 and 97 ± 3 %, respectively), but were inhibited by CBX administration (P muscle shortening following immobilization. These results imply that inflammation and nociception are involved in myogenic contracture formation independently of joint immobilization, and that CBX is effective in preventing joint contracture following immobilization in rats.

  9. Structural knee joint pathology in patients aged 40 years or older with meniscal tears

    DEFF Research Database (Denmark)

    Pihl, Kenneth; Englund, Martin; Lohmander, L S

    2017-01-01

    Purpose: Recent studies have challenged the tenet that mechanical symptoms of the knee (i.e. the sensation of catching or locking) are caused by degenerative meniscal tears per se and relieved by surgery. We explored the potential associations between meniscal and other knee joint pathologies...... identified at meniscal surgery with the presence of patient-reported mechanical symptoms. Methods: This study included patients aged 40 years or older undergoing surgery for a meniscal tear from the Knee Arthroscopy Cohort Southern Denmark (KACS). Patients were consecutively recruited from February 2013...... score (KOOS), together with information on previous meniscal surgery. At arthroscopy, the operating surgeon recorded information about specific meniscal pathology (tear location, depth, type, length, meniscal tissue quality and circumferential and radial location) and other structural knee pathologies...

  10. Effect of generalized joint hypermobility on knee function and muscle activation in children and adults

    DEFF Research Database (Denmark)

    Jensen, Bente Rona; Olesen, Annesofie T.; Pedersen, Mogens Theisen

    2013-01-01

    Introduction: We investigated muscle activation strategy and performance of knee extensor and flexor muscles in children and adults with generalized joint hypermobility (GJH) and compared them with controls. Methods: Muscle activation, torque steadiness, electromechanical delay, and muscle strength...... were evaluated in 39 children and 36 adults during isometric knee extension and flexion. Subjects performed isometric maximum contractions, submaximal contractions at 25% maximum voluntary contraction (MVC), and explosive contractions. Results: Agonist activation was reduced, and coactivation ratio...... was greater in GJH during knee flexion compared with controls. Torque steadiness was impaired in adults with GJH during knee flexion. No effect of GJH was found on muscle strength or electromechanical delay. Correlation analysis revealed an association between GJH severity and function in adults. Conclusions...

  11. Experimental knee joint pain during strength training and muscle strength gain in healthy subjects: a randomized controlled trial.

    Science.gov (United States)

    Sørensen, T J; Langberg, H; Hodges, P W; Bliddal, H; Henriksen, M

    2012-01-01

    Knee joint pain and reduced quadriceps strength are cardinal symptoms in many knee pathologies. In people with painful knee pathologies, quadriceps exercise reduces pain, improves physical function, and increases muscle strength. A general assumption is that pain compromises muscle function and thus may prevent effective rehabilitation. This study evaluated the effects of experimental knee joint pain during quadriceps strength training on muscle strength gain in healthy individuals. Twenty-seven healthy untrained volunteers participated in a randomized controlled trial of quadriceps strengthening (3 times per week for 8 weeks). Participants were randomized to perform resistance training either during pain induced by injections of painful hypertonic saline (pain group, n = 13) or during a nonpainful control condition with injection of isotonic saline (control group, n = 14) into the infrapatellar fat pad. The primary outcome measure was change in maximal isokinetic muscle strength in knee extension/flexion (60, 120, and 180 degrees/second). The group who exercised with pain had a significantly larger improvement in isokinetic muscle strength at all angular velocities of knee extension compared to the control group. In knee flexion there were improvements in isokinetic muscle strength in both groups with no between-group differences. Experimental knee joint pain improved the training-induced gain in muscle strength following 8 weeks of quadriceps training. It remains to be studied whether knee joint pain has a positive effect on strength gain in patients with knee pathology. Copyright © 2012 by the American College of Rheumatology.

  12. ECHOGRAPHY POTENTIAL IN DIAGNOSTICS OF THE KNEE JOINT IMPAIRMENT IN THE EVENT OF THE JUVENILE ARTHRITIDES

    Directory of Open Access Journals (Sweden)

    N.V. Osipova

    2008-01-01

    Full Text Available The juvenile rheumatoid arthritis (JRA is one of the most widely spread rheumatic diseases among children, which is characterized by the steady progressive run, rapidly leading to the disability. Among numerous JRA manifestations, one of the leading is the joint syndrome with children mostly suffering from the knee joint impairment. With JRA, the initial changes in the joints affect the joint tissues and articular cartilage, while the bone changes evolve at the late stages of the disease. As a result, the echography plays an important role in the early arthritides diagnostics if compared to the x ray study and computerized tomography. To identify the typical features of the knee joint impairment, 97 children with JRA and 16 children with the juvenile spondyl arthritis (JSA underwent the high pitched linear transducer assisted echography. The overwhelming majority of patients showed the changes in the hyaline cartilage. The hyperechoic enlargements in the depth of the cartilage were typical of JRA, while the cartilage thinning was typical of JSA. About a half of the patients showed the effusion. Over a third of the patients showed the changes in the cortical layer of the articular bone surface.Key words: juvenile rheumatoid arthritis, juvenile spondyl arthritis, diagnostics, knee joint echography, children.

  13. Numerical Modelling of the Weight-Bearing Total Knee Joint Replacement and Usage in Practice

    Czech Academy of Sciences Publication Activity Database

    Daněk, Josef; Nedoma, Jiří; Hlaváček, Ivan; Vavřík, P.; Denk, F.

    2007-01-01

    Roč. 76, č. 1-3 (2007), s. 49-56 ISSN 0378-4754 R&D Projects: GA MPO FT-TA/087 Institutional research plan: CEZ:AV0Z10300504 Keywords : total knee joint replacement * contact problem * non-overlapping domain decomposition method Subject RIV: BA - General Mathematics Impact factor: 0.738, year: 2007

  14. /sup 133/Xe clearance of the knee joint of patients suffering from arthritis and osteoarthrosis

    Energy Technology Data Exchange (ETDEWEB)

    Balint, G.; Reviczky, L.A.; Lendvay, J.; Boehm, U.; Kucsera, K.; Genti, Gy. (Orszagos Reuma es Fizioterapias Intezet, Budapest (Hungary))

    1982-01-01

    65 inflammed and 13 non-inflammed knee joints of patients suffering from osteoarthrosis were examined by the Xe/sup 133/ clearance method. The control group consisted of 27 patients with exsudative arthritis of the knee. The counts of 80 ..mu..C /sup 133/Xe given intraarticcularly were measured above the knee joint by NK 350 energy selective counter. The time needed to halve the count rate measured in the 4th minute after administration (biological half life (T1/2)) was significantly different in the three groups. It was the longest in the non-inflammed arthrosis, the shortest in the exsudative arthritis group. Significant differences were apparent regarding joint pain and tenderness in all the three groups. Though the synovial protein level and the C/sub 3/ complement level were significantly different, in the three groups no relationship was found between the T1/2 and synovial/serum protein ratio or between the synovial/serum C/sub 3/ ratio. The authors concluded that /sup 133/Xe clearance, which measures the perfusion of the synovial membrane, can be used for measuring the inflammatory activity of knee joint synovitis.

  15. Estimation of the forces acting on the tibiofemoral joint during knee extension exercises

    Directory of Open Access Journals (Sweden)

    Rodrigo Rico Bini

    2008-02-01

    Full Text Available http://dx.doi.org/10.5007/1980-0037.2008v10n1p35 The objectives of this study were to: (1 evaluate the resistive torque of an open kinetic chain strength-training machine for performing knee extensions, and (2 perform an analysis estimating internal forces in the tibiofemoral joint. During a fi rst phase of the study, measurements were taken of the machine under analysis (external forces, and then calculations were performed to estimate forces on the lower limb (internal forces. Equations were defi ned to calculate human force (HF, and the moment of muscular force (MMF. Perpendicular muscular force (MFp and joint force (JFp, axial muscular force (MF” and joint force (JF”, and total muscular force (MF and joint force (JF were all calculated. Five knee angles were analyzed (zero, 30, 45, 60, and 90 degrees. A reduction was observed in HF at higher knee angles, while MF and JF also increased at the same time. HF was always lower than the load selected on the machine, which indicates a reduced overload imposed by the machine. The reduction observed in MFp and JFp at higher knee angles indicates a lower tendency to shear the tibia in relation to the femur. At the same time, there was an increase in JF” due to higher MF”. The biomechanical model proposed in this study has shown itself adequate for the day-to-day needs of professionals who supervise orient strength training.

  16. Menopause is associated with articular cartilage degeneration: a clinical study of knee joint in 860 women.

    Science.gov (United States)

    Lou, Chao; Xiang, Guangheng; Weng, Qiaoyou; Chen, Zhaojie; Chen, Deheng; Wang, Qingqing; Zhang, Di; Zhou, Bin; He, Dengwei; Chen, Hongliang

    2016-11-01

    The purpose of this study was to investigate the association between menopause and severity of knee joint cartilage degeneration using a magnetic resonance imaging-based six-level grading system, with six cartilage surfaces, the medial and lateral femoral condyle, the femoral trochlea, the medial and lateral tibia plateau, and the patella. The study cohort comprised 860 healthy women (age 36-83 y), and 5,160 cartilage surfaces were analyzed. Age, weight, height, age at natural menopause, and years since menopause (YSM) were obtained. Cartilage degeneration was assessed using a magnetic resonance imaging-based six-level grading system. After removing the age, height, and weight effects, postmenopausal women had more severe cartilage degeneration than pre- and perimenopausal women (P  0.05). No significant difference was observed in lateral tibia plateau and lateral femoral condyle in postmenopausal women. Menopause is associated with cartilage degeneration of knee joint. After menopause, cartilage showed progressive severe degeneration that occurred in the first 25 YSM, suggesting estrogen deficiency might be a risk factor of cartilage degeneration of the knee joint. Further studies are needed to investigate whether age or menopause plays a more important role in the progression of cartilage degeneration in the knee joint.

  17. Porous polymers for repair and replacement of the knee joint meniscus and articular cartilage

    NARCIS (Netherlands)

    Klompmaker, Jan

    1992-01-01

    The studies presented here were initiated to answer a variety of questions concerning firstly the repair and replacement of the knee joint meniscus and, secondly, the repair of full-thickness defects of articular cartilage. AIMS OF THE STUDIES I To assess the effect of implantation of a porous

  18. Characteristic complications after autologous chondrocyte implantation for cartilage defects of the knee joint

    DEFF Research Database (Denmark)

    Niemeyer, Philipp; Pestka, Jan M; Kreuz, Peter C

    2008-01-01

    BACKGROUND: Although autologous chondrocyte implantation (ACI) is a well-established therapy for the treatment of isolated cartilage defects of the knee joint, little is known about typical complications and their treatment after ACI. HYPOTHESIS: Unsatisfactory outcome after ACI is associated...

  19. No associations between self-reported knee joint instability and radiographic features in knee osteoarthritis patients prior to Total Knee Arthroplasty: A cross-sectional analysis of the Longitudinal Leiden Orthopaedics Outcomes of Osteo-Arthritis study (LOAS) data.

    Science.gov (United States)

    Leichtenberg, Claudia S; Meesters, Jorit J L; Kroon, Herman M; Verdegaal, Suzan H M; Tilbury, Claire; Dekker, Joost; Nelissen, Rob G H H; Vliet Vlieland, Thea P M; van der Esch, Martin

    2017-08-01

    To describe the prevalence of self-reported knee joint instability in patients with pre-surgery knee osteoarthritis (OA) and to explore the associations between self-reported knee joint instability and radiological features. A cross-sectional study including patients scheduled for primary Total Knee Arthroplasty (TKA). Self-reported knee instability was examined by questionnaire. Radiological features consisted of osteophyte formation and joint space narrowing (JSN), both scored on a 0 to three scale. Scores >1 are defined as substantial JSN or osteophyte formation. Regression analyses were provided to identify associations of radiological features with self-reported knee joint instability. Two hundred and sixty-five patients (mean age 69years and 170 females) were included. Knee instability was reported by 192 patients (72%). Substantial osteophyte formation was present in 78 patients (41%) reporting and 33 patients (46%) not reporting knee joint instability. Substantial JSN was present in 137 (71%) and 53 patients (73%), respectively. Self-reported knee instability was not associated with JSN (relative to score 0, odds ratios (95% CI) of score 1, 2 and 3 were 0.87 (0.30-2.54), 0.98 (0.38-2.52), 0.68 (0.25-1.86), respectively) or osteophyte formation (relative to score 0, odds ratios (95% CI) of score 1, 2 and 3 were 0.77 (0.36-1.64), 0.69 (0.23-1.45), 0.89 (0.16-4.93), respectively). Stratified analysis for pain, age and BMI showed no associations between self-reported knee joint instability and radiological features. Self-reported knee joint instability is not associated with JSN or osteophyte formation. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. The Immediate Effects of Conventional Physical Therapy on the Knee Joint Load in Subjects with Moderate Knee Osteoarthritis; A Preliminary Single Blinded Randomized Control Trial

    Directory of Open Access Journals (Sweden)

    Leila Fattahi

    2015-12-01

    Full Text Available Background: Subjects with knee osteoarthritis typically have higher knee adduction moment. Current research efforts are mainly focused on therapeutic procedures that potentially may modify disease progression. This preliminary study was designed as a single blind (examiner randomized control trial to investigate the impact of conventional physical therapy on pain, and knee joint load in subjects with moderate knee osteoarthritis. Methods: Twelve participants diagnosed with moderate knee OA were randomly assigned into control and intervention groups. Three-dimensional knee kinematic and kinetic data were recorded during the gait before and after 10 sessions of conventional physical therapy. In addition, pain intensity was evaluated by visual analog scale and pain subscale of KOOS questionnaire. The control group did not receive any intervention during the same period. Gait parameters were analyzed within and between groups using nonparametric tests. Results: There was a significant difference between groups in baseline KOOS-pain Score and ML knee force (P=0.048 and P=0.01. Immediately after ten sessions of physical therapy the initial (first peak of knee adduction moment was significantly (P=0.03 lower than that of the control group while the first and second peak of knee AP velocity were significantly (P=0.02, P=0.01 respectively higher. In the intervention group, the second peaks of vertical and anteroposterior (AP knee forces were strongly correlated with the pretest KOOS-pain Score (r=0.99 and r=0.98, P<0.001. Therefore a multivariate general linear model was adopted with adjustment to baseline KOOS-pain. By this adjustment, 51% alleviation of VAS pain score and 81% decrement of first peak of knee adduction moment in comparison to control group was statistically significant (P=0.02, P=0.03 respectively. Conclusion: It seems that ten sessions of conventional physical therapy may modify knee joint load in subjects with moderate knee

  1. EFFECT OF ISOMETRIC QUADRICEPS STRENGTHENING EXERCISE AT MULTIPLE ANGLES IN KNEE JOINT AMONG NORMAL ADULTS

    Directory of Open Access Journals (Sweden)

    JibiPaul

    2014-04-01

    Full Text Available Introduction: Strengthening exercises have been routinely used in persons with orthopaedic problems and athletes to increase force production or minimize muscle imbalance and joint injuries.Many studies have reported that isometric contractions can rapidly increases strength in quadriceps muscle. Objective: Objective of the study was to find out the effect of isometric strengthening exercise on strength of quadriceps at 45 and 90 degree of knee joint and also to compare the effect of strengthening exercise on strength of quadriceps at multiple angles of knee joint among control and experimental group. Methodology: This was a ccomparative experimental study with forty female healthy subjects from physiotherapy department of KPJ Healthcare University College, Malaysia. Convenient sampling method used to select the samples. The subjects were selected by inclusion criteria and randomly divided equally in to two with 20 subjects in each group. Isometric strengthening exercise and squatting exercise were given as intervention program for eight weeks respectively for experimental and control group. Pre and post data of quadriceps muscle strength measured were collected separately at 45 and 90 degree of knee joint using goniometry during resisted extension of knee in multi gym. Result: In experimental group Pre –Post statistical analysis found significant effect in increase of quadriceps strength at 45 and 90 degree with P<0.0001.****In control group quadriceps pre-post statistical analysis found no significant effect in increase of quadriceps strength at 45 and 90 degree with P<0.083NS and P<0.055 NS respectively. Comparative study between experimental and control groups for quadriceps strength at 90 degree of knee joint found significant effect in increase of quadriceps strength with P< 0.001.*** Comparative study between experimental and control groups for quadriceps strength at 45 degree of knee joint found significant effect in increase of

  2. Evaluation of the gait performance of above-knee amputees while walking with 3R20 and 3R15 knee joints

    Directory of Open Access Journals (Sweden)

    AliReza Taheri

    2012-01-01

    Full Text Available Background: The performance of the subjects with above-knee amputation is noticeably poorer than normal subjects. Various types of components have been designed to compensate their performance. Among various prosthetic components, the knee joint has great influence on the function. Two types of knee joints (3R15, 3R20 have been used broadly for above-knee prostheses. However, there is not enough research to highlight the influence of these joints on the gait performance of the subjects. Therefore, an aim of this research was to investigate the performance of the above-knee amputees while walking with 3R15 and 3R20 knee joints. Materials and Methods: 7 above-knee amputees were recruited in this research study. They were asked to walk with a comfortable speed to investigate the gait function of the subjects with 3 cameras 3D motion analysis system (Kinematrix system. The difference between the performances of the subjects with these joints was compared by use of paired t-test. Results: The results of this study showed that, the performances of the subjects with 3R20 were better than that with 3R15. The walking speed of the subjects with 3R20 was 66.7 m/min compared to 30.4 m/min (P-value = 0.045. Moreover; the symmetry of walking with 3R20 was more than that with 3R15, based on the spatio- temporal gait parameters values (P-value <0.05. Conclusion: The difference between the performances of the subjects with 3R20 and 3R15 knee joints was related to the walking speed, which improved while walking with 3R20 joint.

  3. Estimating the Mechanical Behavior of the Knee Joint during Crouch Gait: Implications for Real-Time Motor Control of Robotic Knee Orthoses

    Science.gov (United States)

    Damiano, Diane L.; Bulea, Thomas C.

    2016-01-01

    Individuals with cerebral palsy frequently exhibit crouch gait, a pathological walking pattern characterized by excessive knee flexion. Knowledge of the knee joint moment during crouch gait is necessary for the design and control of assistive devices used for treatment. Our goal was to 1) develop statistical models to estimate knee joint moment extrema and dynamic stiffness during crouch gait, and 2) use the models to estimate the instantaneous joint moment during weight-acceptance. We retrospectively computed knee moments from 10 children with crouch gait and used stepwise linear regression to develop statistical models describing the knee moment features. The models explained at least 90% of the response value variability: peak moment in early (99%) and late (90%) stance, and dynamic stiffness of weight-acceptance flexion (94%) and extension (98%). We estimated knee extensor moment profiles from the predicted dynamic stiffness and instantaneous knee angle. This approach captured the timing and shape of the computed moment (root-mean-squared error: 2.64 Nm); including the predicted early-stance peak moment as a correction factor improved model performance (root-mean-squared error: 1.37 Nm). Our strategy provides a practical, accurate method to estimate the knee moment during crouch gait, and could be used for real-time, adaptive control of robotic orthoses. PMID:27101612

  4. 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.

  5. The Effectiveness of a Functional Knee Brace on Joint-Position Sense in Anterior Cruciate Ligament-Reconstructed Individuals.

    Science.gov (United States)

    Sugimoto, Dai; LeBlanc, Jessica C; Wooley, Sarah E; Micheli, Lyle J; Kramer, Dennis E

    2016-05-01

    It is estimated that approximately 350,000 individuals undergo anterior cruciate ligament (ACL) reconstruction surgery in each year in the US. Although ACL-reconstruction surgery and postoperative rehabilitation are successfully completed, deficits in postural control remain prevalent in ACL-reconstructed individuals. In order to assist the lack of balance ability and reduce the risk of retear of the reconstructed ACL, physicians often provide a functional knee brace on the patients' return to physical activity. However, it is not known whether use of the functional knee brace enhances knee-joint position sense in individuals with ACL reconstruction. Thus, the effect of a functional knee brace on knee-joint position sense in an ACL-reconstructed population needs be critically appraised. After systematically review of previously published literature, 3 studies that investigated the effect of a functional knee brace in ACL-reconstructed individuals using joint-position-sense measures were found. They were rated as level 2b evidence in the Centre of Evidence Based Medicine Level of Evidence chart. Synthesis of the reviewed studies indicated inconsistent evidence of a functional knee brace on joint-position improvement after ACL reconstruction. More research is needed to provide sufficient evidence on the effect of a functional knee brace on joint-position sense after ACL reconstruction. Future studies need to measure joint-position sense in closed-kinetic-chain fashion since ACL injury usually occurs under weight-bearing conditions.

  6. Total knee replacement influences both knee and hip joint kinematics during stair climbing

    OpenAIRE

    Saari, Tuuli; Tranberg, Roy; Zügner, Roland; Uvehammer, Johan; Kärrholm, Johan

    2004-01-01

    A gait analysis system was used to evaluate the kinematics of the hip and knee during stair ascending and descending after operation with total knee replacement. Patients with 5° varus/valgus alignment or less were selected randomly to receive either a flat or a concave tibial component with retention of the posterior cruciate ligament. Patients who had more than 5° varus/valgus alignment and/or an extension defect of 10° or more were selected randomly to receive the concave or posterior-stab...

  7. Mechanical and physiological factors in knee joint contact mechanics

    DEFF Research Database (Denmark)

    Mølgaard, Carsten

    conservative treatment modalities also increases. The aim of this thesis was to 1) identify relationships between footwear and laterally wedged insoles in a healthy group, 2) to evaluate the mechanical and physiological factors of experimental pain when introducing a laterally wedged insoles to otherwise...... not to the level of healthy matched controls. In conclusion, although similar reductions can be achieved by choice of shoe design the difference between a neutral running shoe and Oxford leather shoes are similar in magnitude compared to the effect of lateral wedges in any type of shoe. Experimental pain does...... not seem to change the effect of lateral wedges independently. The knee adduction moment in patients 3-5 years after a medial arthroscopic partial meniscectomy was at a similar level to what is observed with advanced knee osteoarthritis. Therefore, laterally wedged insoles should be considered part...

  8. Knee Joint Distraction. Intrinsic Cartilage Repair and Sustained Clinical Benefit

    NARCIS (Netherlands)

    Wiegant, K.

    2015-01-01

    Loading is important in the maintenance of joint homeostasis, in which biochemical processes are continuously balancing between a catabolic (breakdown) and an anabolic (synthesis and repair) metabolism. For maintenance of specific joint morphology and -function, load is essential. At the other side

  9. Measurement of dose received in knee joint x-ray examination

    International Nuclear Information System (INIS)

    Abashar, Basamat Musa Hajo

    2014-11-01

    Diagnostic x-rays examinations play an important role in the health care of the population. These examinations may involve significant irradiation of the patient and probably represent the largest man-made source of radiation exposure for the population. This study was performed in Khartoum Teaching Hospital in period of January to June 2014. This study performed to assess the effective dose (ED) received in knee joint radiographic examination and to analyze dose (ed) received in knee joint radiographic examination and to analyze effective dose distribution among radiological departments under study. The study was performed in Khartoum Teaching Hospital, covering two x-ray units and a sample of 50 patients. The following parameters were recorded age, weight, height, body mass ines (BMI) derived from weight (Kg) and (Height (M)) and (height (m)) and exposure factors. The dose was measured for knee joint x-rays examination. For effective dose calculation, the entrance surface dose (ESD) values were estimated from the x-ray tube output parameters for knee joint Ap and lateral examinations. The ED values were then calculated from the obtained ESD values using IAEA calculation methods. Effective doses were then calculated from energy imparted using ED conversion factors proposed by IAEA. The results of ED values calculated showed that patient exposure were within the normal range of exposure. The mean ED values calculated were( 2.49 + 0.03) and (5.60 + 0.22) milli Grey for knee joint AP and lateral examinations, respectively, Further studies are recommended with more number of patients and using more two modalities for comparison.(Author)

  10. Comparing Knee Joint Position Sense in Patellofemoral Pain and Healthy Futsal Women

    Directory of Open Access Journals (Sweden)

    Negar Kooroshfar

    2017-03-01

    Full Text Available Background: Proprioception, or joint position sense, probably plays an important role in joint function. A number of studies have shown that proper joint position sense can decrease the risk of injuries in sports. It is not very clear how patellofemoral pain syndrome (PFPS can affect athletes joint position sense (JPS. Regarding the importance of proper joint position sense for movement performance and injury prevention in athletes, the aim of this study was to evaluate knee JPS in athletes with PFPS and compare it with asymptomatic individuals under non-weight bearing (sitting conditions. Methods: The study design was comparative in which 15 patients and 15 healthy athletes participated. JPS was evaluated by active and passive replication of knee angles for 30, 45 and 60° of knee flexion target angle while visual cues were eliminated. Each test was repeated three times. By subtracting the test angle from the replicated angle, the absolute error was calculated as a dependent variable. T-statistical test was used to compare data between two groups and P value of 0.05 was considered as the level of statistical significance. Results: No significant difference (P<0.05 in active (A and passive (P knee JPS was found between two groups for three (30°, p-value (A =0.79, P=0.68, 45°, P value (A=0.12, P=0.54 and 60°, P value (A=0.74, P=0.71 target angles. Conclusion: According to results, both groups had the same JPS ability, it seems PFPS does not affect the knee JPS at least in athlete cases. It would be possible that deficiency of JPS compensated for the physical activity or on the other hand, maybe pain intensity was not high enough to interfere with JPS accuracy. According to our results, PFPS doesn’t reduce IPS but further investigation is needed to disclose if other factors such as skill

  11. Role of magnetic resonance imaging in the evaluation of articular cartilage in painful knee joint

    Directory of Open Access Journals (Sweden)

    Digish Shah

    2014-01-01

    Full Text Available Aim: The aim of this study was to determine the role of the magnetic resonance imaging (MRI in patients with atraumatic knee pain. Background and Objectives: Knee pain is one of the most common problems faced by people from time immemorial. There is a wide range of disease ranging from traumatic to degenerative causing knee pain in which articular cartilage is involved. Over the past 15 years, MRI has become the premier, first-line imaging study that should be performed in the evaluation of the painful knee in particular in tears of menisci, cruciate and collateral ligaments, osteochondral abnormalities (chondromalacia, osteoarthritis and osteochondral defects, synovial cysts and bone bruises. MRI, by virtue of its superior soft-tissue contrast, lack of ionizing radiation and multiplanar capabilities, is superior to more conventional techniques for the evaluation of articular cartilage. Materials and Methods: A prospective study was carried out on 150 patients in the Department of Radio-diagnosis, Padmashree Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune over a period of 2 years from June 2011 to May 2013. Patients having fracture or dislocations of the knee joint were also excluded from the study. Detailed clinical history, physical and systemic examination findings of all patients were noted in addition to the laboratory investigations. All patients were subjected to radiograph of knee anterior-posterior and lateral view. MRI was performed with Siemens 1.5 Tesla MAGNETOM Avanto machine. Results: In our study of 150 patients with knee pain, articular cartilage defect was found in 90 patients (60%. Out of 90 patients with articular cartilage defect, 30 patients (20% had full thickness cartilage defects. Subchondral marrow edema was seen beneath 30 patients (20% with articular cartilage defects. 32 patients (21.1% had a complex or macerated meniscal tear. Complete anterior cruciate ligament tear was found in seven

  12. Dual-energy CT for detection of traumatic bone bruises in the knee joint

    International Nuclear Information System (INIS)

    Seo, Sang Hyun; Sohn, Young Jun; Lee, Chong Ho; Park, Seong Hoon; Kim, Hye Won; Juhng, Seon Kwan

    2013-01-01

    To evaluate the diagnostic performance of dual-energy computed tomography (DECT) in detecting traumatic bone marrow lesions in patients with acute knee injury. Between August 2011 and June 2012, 22 patients presenting with an acute knee injury, including 4 patients who were referred for bilateral knee trauma, underwent DECT (80 kVp and 140 kVp) and MR imaging. DECT data were postprocessed using a three-dimensional, color-coded, virtual non-calcium technique (VNC). DECT data were graded by 2 blinded independent readers using a four-point system (1 = distinct bone marrow lesion, 2 = less distinct bone marrow lesion, 3 = equivocal, 4 = none) for 6 femoral and tibial regions and 2 patellar regions. Routine MR knee imaging served as the reference standard. MR images showed bone bruises in 81 of 364 regions. The overall sensitivity, specificity, positive predictive value, and negative predictive value of DECT for bone bruises were 65.4%, 98.2%, 91.4%, and 90.8%, respectively, for Reader 1 and 70.3%, 93.6%, 76.0%, and 91.7%, respectively, for Reader 2. In particular, tibial bone bruises could be found more easily with better sensitivity (80.2%). The color-coded VNC technique with reconstructions from the DECT maybe helpful in detecting traumatic bone bruises with moderate sensitivity and excellent specificity compared to MR imaging.

  13. Dual-energy CT for detection of traumatic bone bruises in the knee joint

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Sang Hyun; Sohn, Young Jun; Lee, Chong Ho; Park, Seong Hoon; Kim, Hye Won; Juhng, Seon Kwan [Dept. of Radiology, Wonkwang University Hospital, Iksan (Korea, Republic of)

    2013-12-15

    To evaluate the diagnostic performance of dual-energy computed tomography (DECT) in detecting traumatic bone marrow lesions in patients with acute knee injury. Between August 2011 and June 2012, 22 patients presenting with an acute knee injury, including 4 patients who were referred for bilateral knee trauma, underwent DECT (80 kVp and 140 kVp) and MR imaging. DECT data were postprocessed using a three-dimensional, color-coded, virtual non-calcium technique (VNC). DECT data were graded by 2 blinded independent readers using a four-point system (1 = distinct bone marrow lesion, 2 = less distinct bone marrow lesion, 3 = equivocal, 4 = none) for 6 femoral and tibial regions and 2 patellar regions. Routine MR knee imaging served as the reference standard. MR images showed bone bruises in 81 of 364 regions. The overall sensitivity, specificity, positive predictive value, and negative predictive value of DECT for bone bruises were 65.4%, 98.2%, 91.4%, and 90.8%, respectively, for Reader 1 and 70.3%, 93.6%, 76.0%, and 91.7%, respectively, for Reader 2. In particular, tibial bone bruises could be found more easily with better sensitivity (80.2%). The color-coded VNC technique with reconstructions from the DECT maybe helpful in detecting traumatic bone bruises with moderate sensitivity and excellent specificity compared to MR imaging.

  14. 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 ...

  15. The association between reduced knee joint proprioception and medial meniscal abnormalities using MRI in knee osteoarthritis: results from the Amsterdam osteoarthritis cohort.

    Science.gov (United States)

    van der Esch, M; Knoop, J; Hunter, D J; Klein, J-P; van der Leeden, M; Knol, D L; Reiding, D; Voorneman, R E; Gerritsen, M; Roorda, L D; Lems, W F; Dekker, J

    2013-05-01

    Osteoarthritis (OA) of the knee is characterized by pain and activity limitations. In knee OA, proprioceptive accuracy is reduced and might be associated with pain and activity limitations. Although causes of reduced proprioceptive accuracy are divergent, medial meniscal abnormalities, which are highly prevalent in knee OA, have been suggested to play an important role. No study has focussed on the association between proprioceptive accuracy and meniscal abnormalities in knee OA. To explore the association between reduced proprioceptive accuracy and medial meniscal abnormalities in a clinical sample of knee OA subjects. Cross-sectional study in 105 subjects with knee OA. Knee proprioceptive accuracy was assessed by determining the joint motion detection threshold in the knee extension direction. The knee was imaged with a 3.0 T magnetic resonance (MR) scanner. Number of regions with medial meniscal abnormalities and the extent of abnormality in the anterior and posterior horn and body were scored according to the Boston-Leeds Osteoarthritis Knee Score (BLOKS) method. Multiple regression analyzes were used to examine whether reduced proprioceptive accuracy was associated with medial meniscal abnormalities in knee OA subjects. Mean proprioceptive accuracy was 2.9° ± 1.9°. Magnetic resonance imaging (MRI)-detected medial meniscal abnormalities were found in the anterior horn (78%), body (80%) and posterior horn (90%). Reduced proprioceptive accuracy was associated with both the number of regions with meniscal abnormalities (P knee complaints. This is the first study showing that reduced proprioceptive accuracy is associated with medial meniscal abnormalities in knee OA. The study highlights the importance of meniscal abnormalities in understanding reduced proprioceptive accuracy in persons with knee OA. Copyright © 2013 Osteoarthritis Research Society International. All rights reserved.

  16. MR imaging evaluation of plica synoviallis mediopatellaris of the knee joint

    Energy Technology Data Exchange (ETDEWEB)

    Nakanishi, Katsuyuki; Inoue, Masahiro; Murakami, Takamichi (Osaka Univ. (Japan). Faculty of Medicine) (and others)

    1992-12-01

    To evaluate the diagnostic ability of MR imaging for plica synoviallis mediopatellaris (PSM), we retrospectively reviewed the MR imaging findings of patellofemoral space in 20 knee joints of 11 patients. In all 20 knee joints, arthroscopy and MR imaging were available. MR imaging was performed with a 1.5 Tesla Magnetom (Siemens) using a round surface coil. Pulse sequences were SE (TR 600 ms/TE 26 ms), SE (TR 200 ms/TE 26,70 ms) and FLASH (TR 450 ms/TE 15 ms/FA 90deg). In six of the 20 knees with PSM proved by arthroscopy, a low intensity band was shown above the medial condyle of the femur on both T1- and T2-weighted MR images, and on FLASH images this band was shown as intermediate intensity. In the other 14 knees with no PSM observed by arthroscopy, the low intensity band was not shown on MR imaging. In all 20 knees, a similar low intensity band was shown about 1 cm cranial to the medial condyle of the femur. This should not be diagnosed as PSM. The low intensity band seen on T1- and T2-weighted MR images and its anatomical relation to the medial condyle are important in diagnosing PSM. (author).

  17. Wear Distribution Detection of Knee Joint Prostheses by Means of 3D Optical Scanners

    Directory of Open Access Journals (Sweden)

    Saverio Affatato

    2017-03-01

    Full Text Available The objective of this study was to examine total knee polyethylene inserts from in vitro simulation to evaluate and display—using a 3D optical scanner—wear patterns and wear rates of inserts exposed to wear by means of simulators. Various sets of tibial inserts have been reconstructed by using optical scanners. With this in mind, the wear behavior of fixed and mobile bearing polyethylene knee configurations was investigated using a knee wear joint simulator. After the completion of the wear test, the polyethylene menisci were analyzed by an innovative 3D optical scanners in order to evaluate the 3D wear distribution on the prosthesis surface. This study implemented a new procedure for evaluating polyethylene bearings of joint prostheses obtained after in vitro wear tests and the proposed new approach allowed quantification of the contact zone on the geometry of total knee prostheses. The results of the present study showed that mobile TKPs (total knee prosthesis have lower wear resistance with respect to fixed TKPs.

  18. MR imaging evaluation of plica synoviallis mediopatellaris of the knee joint

    International Nuclear Information System (INIS)

    Nakanishi, Katsuyuki; Inoue, Masahiro; Murakami, Takamichi

    1992-01-01

    To evaluate the diagnostic ability of MR imaging for plica synoviallis mediopatellaris (PSM), we retrospectively reviewed the MR imaging findings of patellofemoral space in 20 knee joints of 11 patients. In all 20 knee joints, arthroscopy and MR imaging were available. MR imaging was performed with a 1.5 Tesla Magnetom (Siemens) using a round surface coil. Pulse sequences were SE (TR 600 ms/TE 26 ms), SE (TR 200 ms/TE 26,70 ms) and FLASH (TR 450 ms/TE 15 ms/FA 90deg). In six of the 20 knees with PSM proved by arthroscopy, a low intensity band was shown above the medial condyle of the femur on both T1- and T2-weighted MR images, and on FLASH images this band was shown as intermediate intensity. In the other 14 knees with no PSM observed by arthroscopy, the low intensity band was not shown on MR imaging. In all 20 knees, a similar low intensity band was shown about 1 cm cranial to the medial condyle of the femur. This should not be diagnosed as PSM. The low intensity band seen on T1- and T2-weighted MR images and its anatomical relation to the medial condyle are important in diagnosing PSM. (author)

  19. Compression-rate-dependent nonlinear mechanics of normal and impaired porcine knee joints.

    Science.gov (United States)

    Rodriguez, Marcel Leonardo; Li, LePing

    2017-11-14

    The knee joint performs mechanical functions with various loading and unloading processes. Past studies have focused on the kinematics and elastic response of the joint with less understanding of the rate-dependent load response associated with viscoelastic and poromechanical behaviors. Forty-five fresh porcine knee joints were used in the present study to determine the loading-rate-dependent force-compression relationship, creep and relaxation of normal, dehydrated and meniscectomized joints. The mechanical tests of all normal intact joints showed similar strong compression-rate-dependent behavior: for a given compression-magnitude up to 1.2 mm, the reaction force varied 6 times over compression rates. While the static response was essentially linear, the nonlinear behavior was boosted with the increased compression rate to approach the asymptote or limit at approximately 2 mm/s. On the other hand, the joint stiffness varied approximately 3 times over different joints, when accounting for the maturity and breed of the animals. Both a loss of joint hydration and a total meniscectomy greatly compromised the load support in the joint, resulting in a reduction of load support as much as 60% from the corresponding intact joint. However, the former only weakened the transient load support, but the latter also greatly weakened the equilibrium load support. A total meniscectomy did not diminish the compression-rate-dependence of the joint though. These findings are consistent with the fluid-pressurization loading mechanism, which may have a significant implication in the joint mechanical function and cartilage mechanobiology.

  20. Long-term clinical evaluation of the automatic stance-phase lock-controlled prosthetic knee joint in young adults with unilateral above-knee amputation.

    Science.gov (United States)

    Andrysek, Jan; Wright, F Virginia; Rotter, Karin; Garcia, Daniela; Valdebenito, Rebeca; Mitchell, Carlos Alvarez; Rozbaczylo, Claudio; Cubillos, Rafael

    2017-05-01

    The purpose of this study was to clinically evaluate the automatic stance-phase lock (ASPL) knee mechanism against participants' existing weight-activated braking (WAB) prosthetic knee joint. This prospective crossover study involved 10 young adults with an above-knee amputation. Primary measurements consisted of tests of walking speeds and capacity. Heart rate was measured during the six-minute walk test and the Physiological Cost Index (PCI) which was calculated from heart rate estimated energy expenditure. Activity was measured with a pedometer. User function and quality of life were assessed using the Lower Limb Function Questionnaire (LLFQ) and Prosthetic Evaluation Questionnaire (PEQ). Long-term follow-up over 12 months were completed. Walking speeds were the same for WAB and APSL knees. Energy expenditure (PCI) was lower for the ASPL knees (p = 0.007). Step counts were the same for both knees, and questionnaires indicated ASPL knee preference attributed primarily to knee stability and improved walking, while limitations included terminal impact noise. Nine of 10 participants chose to keep using the ASPL knee as part of the long-term follow-up. Potential benefits of the ASPL knee were identified in this study by functional measures, questionnaires and user feedback, but not changes in activity or the PEQ.

  1. Evaluation of an intact, an ACL-deficient, and a reconstructed human knee joint finite element model.

    Science.gov (United States)

    Vairis, Achilles; Stefanoudakis, George; Petousis, Markos; Vidakis, Nectarios; Tsainis, Andreas-Marios; Kandyla, Betina

    2016-02-01

    The human knee joint has a three-dimensional geometry with multiple body articulations that produce complex mechanical responses under loads that occur in everyday life and sports activities. Understanding the complex mechanical interactions of these load-bearing structures is of use when the treatment of relevant diseases is evaluated and assisting devices are designed. The anterior cruciate ligament (ACL) in the knee is one of four main ligaments that connects the femur to the tibia and is often torn during sudden twisting motions, resulting in knee instability. The objective of this work is to study the mechanical behavior of the human knee joint and evaluate the differences in its response for three different states, i.e., intact, ACL-deficient, and surgically treated (reconstructed) knee. The finite element models corresponding to these states were developed. For the reconstructed model, a novel repair device was developed and patented by the author in previous work. Static load cases were applied, as have already been presented in a previous work, in order to compare the calculated results produced by the two models the ACL-deficient and the surgically reconstructed knee joint, under the exact same loading conditions. Displacements were calculated in different directions for the load cases studied and were found to be very close to those from previous modeling work and were in good agreement with experimental data presented in literature. The developed finite element model for both the intact and the ACL-deficient human knee joint is a reliable tool to study the kinematics of the human knee, as results of this study show. In addition, the reconstructed human knee joint model had kinematic behavior similar to the intact knee joint, showing that such reconstruction devices can restore human knee stability to an adequate extent.

  2. Is increased joint loading detrimental to obese patients with knee osteoarthritis? A secondary data analysis from a randomized trial.

    Science.gov (United States)

    Henriksen, M; Hunter, D J; Dam, E B; Messier, S P; Andriacchi, T P; Lohmander, L S; Aaboe, J; Boesen, M; Gudbergsen, H; Bliddal, H; Christensen, R

    2013-12-01

    To investigate whether increased knee joint loading due to improved ambulatory function and walking speed following weight loss achieved over 16 weeks accelerates symptomatic and structural disease progression over a subsequent 1 year weight maintenance period in an obese population with knee osteoarthritis (OA). Data from a prospective study of weight loss in obese patients with knee OA (the CARtilage in obese knee OsteoarThritis (CAROT) study) were used to determine changes in knee joint compressive loadings (model estimated) during walking after a successful 16 week weight loss intervention. The participants were divided into 'Unloaders' (participants that reduced joint loads) and 'Loaders' (participants that increased joint loads). The primary symptomatic outcome was changes in knee symptoms, measured with the Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire, during a subsequent 52 weeks weight maintenance period. The primary structural outcome was changes in tibiofemoral cartilage loss assessed semi-quantitatively (Boston Leeds Knee Osteoarthritis Score (BLOKS) from MRI after the 52 weight maintenance period. 157 participants (82% of the CAROT cohort) with medial and/or lateral knee OA were classified as Unloaders (n = 100) or Loaders (n = 57). The groups showed similar significant changes in symptoms (group difference: -2.4 KOOS points [95% CI -6.8:1.9]) and cartilage loss (group difference: -0.06 BLOKS points [95% CI -0.22:0.11) after 1 year, with no statistically significant differences between Loaders and Unloaders. For obese patients undergoing a significant weight loss, increased knee joint loading for 1 year was not associated with accelerated symptomatic and structural disease progression compared to a similar weight loss group that had reduced ambulatory compressive knee joint loads. NCT00655941. Copyright © 2013 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  3. Topographic variation in redifferentiation capacity of chondrocytes in the adult human knee joint.

    Science.gov (United States)

    Stenhamre, H; Slynarski, K; Petrén, C; Tallheden, T; Lindahl, A

    2008-11-01

    The aim of this study was to investigate the topographic variation in matrix production and cell density in the adult human knee joint. Additionally, we have examined the redifferentiation potential of chondrocytes expanded in vitro from the different locations. Full thickness cartilage-bone biopsies were harvested from seven separate anatomical locations of healthy knee joints from deceased adult human donors. Chondrocytes were isolated, expanded in vitro and redifferentiated in a pellet mass culture. Biochemical analysis of total collagen, proteoglycans and cellular content as well as histology and immunohistochemistry were performed on biopsies and pellets. In the biochemical analysis of the biopsies, we found lower proteoglycan to collagen (GAG/HP) ratio in the non-weight bearing (NWB) areas compared to the weight bearing (WB) areas. The chondrocytes harvested from different locations in femur showed a significantly better attachment and proliferation ability as well as good post-expansion chondrogenic capacity in pellet mass culture compared with the cells harvested from tibia. These results demonstrate that there are differences in extra cellular content within the adult human knee in respect to GAG/HP ratio. Additionally, the data show that clear differences between chondrocytes harvested from femur and tibia from healthy human knee joints exist and that the differences are not completely abolished during the process of de- and redifferentiation. These findings emphasize the importance of the understanding of topographic variation in articular cartilage biology when approaching new cartilage repair strategies.

  4. Preoperative diagnostic for periprosthetic joint infection prior to total knee revision arthroplasty

    Directory of Open Access Journals (Sweden)

    Leif Claassen

    2014-08-01

    Full Text Available Periprosthetic joint infection (PJI after total knee arthroplasty remains a challenging problem. The aim of this study was to evaluate the accuracy of diagnostic knee aspiration and serum inflammatory markers in diagnostic of a PJI after total knee arthroplasty. Within 2011 and 2012, 46 patients received a one- or two-stage revision arthroplasty of the knee joint. These patients received a total number of 77 operations. A preoperative aspiration was performed in each case. We analyzed the microbiological and histological examinations of the samples from the aspiration and from the revision operation and additionally estimated serum inflammatory markers. The diagnostic aspiration had a specificity of 0.87, a sensitivity of 0.39, a positive predictive value of 0.67 and a negative predictive value of 0.68. For C-reactive protein the specificity was 0.61 and the sensitivity was 0.48, the serum white blood cell count had a specificity of 0.98 and a sensitivity of 0.23. Our data queries whether diagnostic joint aspiration or serum inflammatory markers are sufficient to verify or exclude a PJI.

  5. Effects of taping on knee joint position sense of female athletes across the menstrual cycle

    Directory of Open Access Journals (Sweden)

    Rose fouladi

    2013-06-01

    Full Text Available Introduction: The rate of anterior cruciate ligament (ACL tearing is more common in female athletes and one of thereasons is the effect of sex hormones. It was illustrated that knee joint position sense (JPS isaltered across the menstrual cycle and its lowest level is at menses. Therefore, it’s important to find a method to reduce injury risk at menses. Thus, the purpose of this study was to evaluate the effect of taping as a stimulator of skin, on the knee JPS in healthy female athletes across the menstrual cycle with different levels of estrogen and progesterone. Materials and Methods: In this semi-experimental study, 16 healthy female athletes with regular menstrual cycle voluntarily participated. Knee JPS was measured at 3 menstrual cycle phases, before and after patellataping. JPS was evaluated by reproduction of the target angle (30° flexion in standing position, from full extension. Serum estrogen and progesterone levels were collected in these 3 phases. Knee angles were measured by using a system comprised of skin markers, digital photography, and autoCAD software. Absolute error was considered as a dependent variable.Results: There was a significant difference between the knee JPS in 3 phases of measurement before taping (P=0.025, while no significant difference was found between knee JPS in 3 phases after taping (P=0.965. Conclusion: Findings of this study suggest that healthy female athletes have different levels of knee JPS across a menstrual cycle and its accuracy decreasesat menses. This differencecan be reduced by skin stimulatingmethods, such as taping. Therefore, kinesio taping would improve the knee JPSdeficiency at menses.

  6. Modelling and Simulation of the Knee Joint with a Depth Sensor Camera for Prosthetics and Movement Rehabilitation

    Science.gov (United States)

    Risto, S.; Kallergi, M.

    2015-09-01

    The purpose of this project was to model and simulate the knee joint. A computer model of the knee joint was first created, which was controlled by Microsoft's Kinect for Windows. Kinect created a depth map of the knee and lower leg motion independent of lighting conditions through an infrared sensor. A combination of open source software such as Blender, Python, Kinect SDK and NI_Mate were implemented for the creation and control of the simulated knee based on movements of a live physical model. A physical size model of the knee and lower leg was also created, the movement of which was controlled remotely by the computer model and Kinect. The real time communication of the model and the robotic knee was achieved through programming in Python and Arduino language. The result of this study showed that Kinect in the modelling of human kinematics and can play a significant role in the development of prosthetics and other assistive technologies.

  7. The effect of instruction in analgesic use compared with neuromuscular exercise on knee-joint load in patients with knee osteoarthritis: a randomized, single-blind, controlled trial.

    Science.gov (United States)

    Holsgaard-Larsen, A; Clausen, B; Søndergaard, J; Christensen, R; Andriacchi, T P; Roos, E M

    2017-04-01

    To investigate the effect of a neuro-muscular exercise (NEMEX) therapy program compared with instructions in optimized analgesics and anti-inflammatory drug use (PHARMA), on measures of knee-joint load in people with mild to moderate knee osteoarthritis (OA). We hypothesized that knee joint loading during walking would be reduced by NEMEX and potentially increased by PHARMA. Single-blind, randomized controlled trial (RCT) comparing NEMEX therapy twice a week with PHARMA. Participants with mild-to-moderate medial tibiofemoral knee OA were randomly allocated (1:1) to one of two 8-week treatments. Primary outcome was change in knee load during walking (Knee Index, a composite score from all three planes based on 3D movement analysis) after 8 weeks of intervention. Secondary outcomes were frontal plane peak knee adduction moment (KAM), Knee Injury and Osteoarthritis Outcome Scores (KOOS) and functional performance tests. Ninety three participants (57% women, 58 ± 8 years with a body mass index [BMI] of 27 ± 4 kg/m 2 (mean ± standard deviation [SD])) were randomized to NEMEX group (n = 47) or PHARMA (n = 46); data from 44 (94%) and 41 (89%) participants respectively, were available at follow-up. 49% of the participants in NEMEX and only 7% in PHARMA demonstrated good compliance. We found no difference in the primary outcome as evaluated by the Knee Index -0.07 [-0.17; 0.04] Nm/%BW HT. Secondary outcomes largely supported this finding. We found no difference in the primary outcome; knee joint load change during walking from a NEMEX program vs information on the recommended use of analgesics and anti-inflammatory drugs. ClinicalTrials.gov Identifier: NCT01638962 (July 3, 2012). Ethical Committee: S-20110153. Copyright © 2016 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  8. Dissecting the contribution of knee joint NGF to spinal nociceptive sensitization in a model of OA pain in the rat.

    Science.gov (United States)

    Sagar, D R; Nwosu, L; Walsh, D A; Chapman, V

    2015-06-01

    Although analgesic approaches targeting nerve growth factor (NGF) for the treatment of osteoarthritis (OA) pain remain of clinical interest, neurophysiological mechanisms by which NGF contribute to OA pain remain unclear. We investigated the impact of local elevation of knee joint NGF on knee joint, vs remote (hindpaw), evoked responses of spinal neurones in a rodent model of OA pain. In vivo spinal electrophysiology was carried out in anaesthetised rats with established pain behaviour and joint pathology following intra-articular injection of monosodium iodoacetate (MIA), vs injection of saline. Neuronal responses to knee joint extension and flexion, mechanical punctate stimulation of the peripheral receptive fields over the knee and at a remote site (ipsilateral hind paw) were studied before, and following, intra-articular injection of NGF (10 μg/50 μl) or saline. MIA-injected rats exhibited significant local (knee joint) and remote (lowered hindpaw withdrawal thresholds) changes in pain behaviour, and joint pathology. Intra-articular injection of NGF significantly (P knee extension-evoked firing of spinal neurones and the size of the peripheral receptive fields of spinal neurones (100% increase) over the knee joint in MIA rats, compared to controls. Intra-articular NGF injection did not significantly alter responses of spinal neurones following noxious stimulation of the ipsilateral hind paw in MIA-injected rats. The facilitatory effects of intra-articular injection of NGF on spinal neurones receiving input from the knee joint provide a mechanistic basis for NGF mediated augmentation of OA knee pain, however additional mechanisms may contribute to the spread of pain to remote sites. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  9. Prospective comparison of 3D FIESTA versus fat-suppressed 3D SPGR MRI in evaluating knee cartilage lesions

    Energy Technology Data Exchange (ETDEWEB)

    Li, X.; Yu, C. [Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030 (China); Wu, H. [Department of Orthopaedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030 (China)], E-mail: lilyboston2002@163.com; Daniel, K. [Department of Radiology, Brigham and Women' s Hospital, Harvard Medical School, Boston, MA 02115 (United States); Hu, D.; Xia, L.; Pan, C.; Xu, A.; Hu, J.; Wang, L.; Peng, W. [Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030 (China); Li, F. [Department of Orthopaedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030 (China)

    2009-10-15

    Aim: To prospectively compare the accuracy of three-dimensional fast imaging employing steady-state acquisition (3D FIESTA) sequences with that of fat-suppressed three-dimensional spoiled gradient-recalled (3D SPGR) in the diagnosis of knee articular cartilage lesions, using arthroscopy as the reference standard. Materials and methods: Fifty-eight knees in 54 patients (age range 21-82 years; mean 36 years) were prospectively evaluated by using sagittal 3D FIESTA and sagittal fat-suppressed 3D SPGR sequences. Articular cartilage lesions were graded on MRI and during arthroscopy with a modified Noyes scoring system. Sensitivity, specificity, and accuracy were assessed. Interobserver agreement was determined with {kappa} statistics. Results: The performance of 3D FIESTA sequences (sensitivity, specificity, and accuracy were 80, 94, and 92%, respectively, for reader 1 and 76, 94, and 90%, respectively, for reader 2) was similar to that of fat-suppressed 3D SPGR sequences (sensitivity, specificity, and accuracy were 82, 92, and 90%, respectively, for reader 1 and 82, 90, and 88%, respectively, for reader 2) in the detection of knee articular cartilage lesions. The interobserver agreement varied from fair to good to excellent (kappa values from 0.43-0.83). Conclusion: 3D FIESTA has good diagnostic performance, comparable with fat-suppressed 3D SPGR in evaluating knee cartilage lesions, and it can be incorporated into routine knee MRI protocols due to the short acquisition time.

  10. Prospective comparison of 3D FIESTA versus fat-suppressed 3D SPGR MRI in evaluating knee cartilage lesions

    International Nuclear Information System (INIS)

    Li, X.; Yu, C.; Wu, H.; Daniel, K.; Hu, D.; Xia, L.; Pan, C.; Xu, A.; Hu, J.; Wang, L.; Peng, W.; Li, F.

    2009-01-01

    Aim: To prospectively compare the accuracy of three-dimensional fast imaging employing steady-state acquisition (3D FIESTA) sequences with that of fat-suppressed three-dimensional spoiled gradient-recalled (3D SPGR) in the diagnosis of knee articular cartilage lesions, using arthroscopy as the reference standard. Materials and methods: Fifty-eight knees in 54 patients (age range 21-82 years; mean 36 years) were prospectively evaluated by using sagittal 3D FIESTA and sagittal fat-suppressed 3D SPGR sequences. Articular cartilage lesions were graded on MRI and during arthroscopy with a modified Noyes scoring system. Sensitivity, specificity, and accuracy were assessed. Interobserver agreement was determined with κ statistics. Results: The performance of 3D FIESTA sequences (sensitivity, specificity, and accuracy were 80, 94, and 92%, respectively, for reader 1 and 76, 94, and 90%, respectively, for reader 2) was similar to that of fat-suppressed 3D SPGR sequences (sensitivity, specificity, and accuracy were 82, 92, and 90%, respectively, for reader 1 and 82, 90, and 88%, respectively, for reader 2) in the detection of knee articular cartilage lesions. The interobserver agreement varied from fair to good to excellent (kappa values from 0.43-0.83). Conclusion: 3D FIESTA has good diagnostic performance, comparable with fat-suppressed 3D SPGR in evaluating knee cartilage lesions, and it can be incorporated into routine knee MRI protocols due to the short acquisition time.

  11. Prediction of medial and lateral contact force of the knee joint during normal and turning gait after total knee replacement.

    Science.gov (United States)

    Purevsuren, Tserenchimed; Dorj, Ariunzaya; Kim, Kyungsoo; Kim, Yoon Hyuk

    2016-04-01

    The computational modeling approach has commonly been used to predict knee joint contact forces, muscle forces, and ligament loads during activities of daily living. Knowledge of these forces has several potential applications, for example, within design of equipment to protect the knee joint from injury and to plan adequate rehabilitation protocols, although clinical applications of computational models are still evolving and one of the limiting factors is model validation. The objective of this study was to extend previous modeling technique and to improve the validity of the model prediction using publicly available data set of the fifth "Grand Challenge Competition to Predict In Vivo Knee Loads." A two-stage modeling approach, which combines conventional inverse dynamic analysis (the first stage) with a multi-body subject-specific lower limb model (the second stage), was used to calculate medial and lateral compartment contact forces. The validation was performed by direct comparison of model predictions and experimental measurement of medial and lateral compartment contact forces during normal and turning gait. The model predictions of both medial and lateral contact forces showed strong correlations with experimental measurements in normal gait (r = 0.75 and 0.71) and in turning gait trials (r = 0.86 and 0.72), even though the current technique over-estimated medial compartment contact forces in swing phase. The correlation coefficient, Sprague and Geers metrics, and root mean squared error indicated that the lateral contact forces were predicted better than medial contact forces in comparison with the experimental measurements during both normal and turning gait trials. © IMechE 2016.

  12. Meniscectomy versus meniscal repair: 10 years radiological and clinical results in vertical lesions in stable knee.

    Science.gov (United States)

    Lutz, C; Dalmay, F; Ehkirch, F P; Cucurulo, T; Laporte, C; Le Henaff, G; Potel, J F; Pujol, N; Rochcongar, G; Salledechou, E; Seil, R; Gunepin, F-X; Sonnery-Cottet, B

    2015-12-01

    Surgical management of meniscal lesion consists of either a meniscectomy or meniscal repair. Although repair offers immediate recovery after surgery, it is also associated with higher rates of revision. A meniscectomy, on the other hand is known to be associated with an early onset of osteoarthritis. The present study compared clinical and radiological results at 10 years between meniscectomy and meniscal repair in isolated vertical lesion in an otherwise stable knee. The hypothesis was that repair shows functional and radiological benefit over meniscectomy. A multi-centric retrospective comparative study of 32 patients (24 male, 8 female). Mean follow-up was 10.6 years (range, 10-13 years). There were 10 meniscal repairs (group R) and 22 meniscectomies (group M), in 17 right and 15 left knees. Mean age at surgery was 33.45±12.3 years (range, 9-47 years). There were 28 medial and 4 lateral meniscal lesions; 26 were in the red-red zone and 6 in red-white zone. Functional score: KOOS score was significantly higher in group R than M on almost all parameters: 98±4.69 versus 77.38±21.97 for symptoms (P=0.0043), 96.89±7.20 versus 78.57±18.9 for pain (P=0.0052), 99.89±0.33 versus 80.88±19.6 for daily life activities (P=0.0002), 96.11±9.83 versus 54.05±32.85 for sport and leisure (P=0.0005), but 91±16.87 versus 68.15±37.7 for quality of life (P=0.1048). Radiology score: in group R, 7 patients had no features of osteoarthritis, and 2 had grade 1 osteoarthritis. In group M, 5 patients had grade 1 osteoarthritis, 10 grade 2, 3 grade 3 and 3 grade 4. Mean quantitative score was 0 (mean, 0.22±0.44) in-group R and 2 (mean, 2.19±0.98) in group M (P<0.0001). At more than 10year's follow-up, functional scores were significantly better with meniscal repair than meniscectomy on all parameters of the KOOS scale except quality of life. Functional and radiological scores correlated closely. These results show that meniscal repair for vertical lesions in stable knees

  13. Effects of neuromuscular training on knee joint stability after anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Shim, Jae-Kwang; Choi, Ho-Suk; Shin, Jun-Ho

    2015-12-01

    [Purpose] This study examined the effects of neuromuscular training on knee joint stability after anterior cruciate ligament reconstruction. [Subjects and Methods] The subjects were 16 adults who underwent arthroscopic anterior cruciate reconstruction and neuromuscular training. The Lysholm scale was used to assess functional disorders on the affected knee joint. A KT-2000 arthrometer was used to measure anterior displacement of the tibia against the femur. Surface electromyography was used to detect the muscle activation of the vastus medialis oblique, vastus lateralis, biceps femoris, and semitendinosus before and after neuromuscular training. [Results] There was significant relaxation in tibial anterior displacement of the affected and sound sides in the supine position before neuromuscular training. Furthermore, the difference in the tibial anterior displacement of the affected knee joints in the standing position was reduced after neuromuscular training. Moreover, the variation of the muscle activation evoked higher muscle activation of the vastus medialis oblique, vastus lateralis, biceps femoris, and semitendinosus. [Conclusion] Neuromuscular training may improve functional joint stability in patients with orthopedic musculoskeletal injuries in the postoperative period.

  14. Reliability of a smartphone-based goniometer for knee joint goniometry.

    Science.gov (United States)

    Ferriero, Giorgio; Vercelli, Stefano; Sartorio, Francesco; Muñoz Lasa, Susana; Ilieva, Elena; Brigatti, Elisa; Ruella, Carolina; Foti, Calogero

    2013-06-01

    The aim of this study was to assess the reliability of a smartphone-based application developed for photographic-based goniometry, DrGoniometer (DrG), by comparing its measurement of the knee joint angle with that made by a universal goniometer (UG). Joint goniometry is a common mode of clinical assessment used in many disciplines, in particular in rehabilitation. One validated method is photographic-based goniometry, but the procedure is usually complex: the image has to be downloaded from the camera to a computer and then edited using dedicated software. This disadvantage may be overcome by the new generation of mobile phones (smartphones) that have computer-like functionality and an integrated digital camera. This validation study was carried out under two different controlled conditions: (i) with the participant to measure in a fixed position and (ii) with a battery of pictures to assess. In the first part, four raters performed repeated measurements with DrG and UG at different knee joint angles. Then, 10 other raters measured the knee at different flexion angles ranging 20-145° on a battery of 35 pictures taken in a clinical setting. The results showed that inter-rater and intra-rater correlations were always more than 0.958. Agreement with the UG showed a width of 18.2° [95% limits of agreement (LoA)=-7.5/+10.7°] and 14.1° (LoA=-6.6/+7.5°). In conclusion, DrG seems to be a reliable method for measuring knee joint angle. This mHealth application can be an alternative/additional method of goniometry, easier to use than other photographic-based goniometric assessments. Further studies are required to assess its reliability for the measurement of other joints.

  15. Modeling and simulating the neuromuscular mechanisms regulating ankle and knee joint stiffness during human locomotion.

    Science.gov (United States)

    Sartori, Massimo; Maculan, Marco; Pizzolato, Claudio; Reggiani, Monica; Farina, Dario

    2015-10-01

    This work presents an electrophysiologically and dynamically consistent musculoskeletal model to predict stiffness in the human ankle and knee joints as derived from the joints constituent biological tissues (i.e., the spanning musculotendon units). The modeling method we propose uses electromyography (EMG) recordings from 13 muscle groups to drive forward dynamic simulations of the human leg in five healthy subjects during overground walking and running. The EMG-driven musculoskeletal model estimates musculotendon and resulting joint stiffness that is consistent with experimental EMG data as well as with the experimental joint moments. This provides a framework that allows for the first time observing 1) the elastic interplay between the knee and ankle joints, 2) the individual muscle contribution to joint stiffness, and 3) the underlying co-contraction strategies. It provides a theoretical description of how stiffness modulates as a function of muscle activation, fiber contraction, and interacting tendon dynamics. Furthermore, it describes how this differs from currently available stiffness definitions, including quasi-stiffness and short-range stiffness. This work offers a theoretical and computational basis for describing and investigating the neuromuscular mechanisms underlying human locomotion. Copyright © 2015 the American Physiological Society.

  16. Is increased joint loading detrimental to obese patients with knee osteoarthritis? A secondary data analysis from a randomized trial

    DEFF Research Database (Denmark)

    Henriksen, Marius; Hunter, D J; Dam, E B

    2013-01-01

    To investigate whether increased knee joint loading due to improved ambulatory function and walking speed following weight loss achieved over 16 weeks accelerates symptomatic and structural disease progression over a subsequent 1 year weight maintenance period in an obese population with knee ost...

  17. Experience with Ultrasound of the Knee Joint at Mulago Hospital ...

    African Journals Online (AJOL)

    jen

    as anaechoic area bounded by the joint capsule. A simple effusion was anaechoic. Diffuse increase in echogenicity suggested infection or haemoarthrosis. Simple bursitis was depicted as anechoic fluid, with or without septa (fig 1A). In chronic bursitis, there was bursal thickening seen as a band of moderate echogenicity.

  18. The value of emission computer tomography (ECT) for chronic abnormalities of the knee joint

    International Nuclear Information System (INIS)

    Koenig, H.; Geiger, A.; Feine, U.; Tuebingen Univ.

    1987-01-01

    Twenty-eight patients with chronic abnormalities of the knee were examined by 3-phase scintigraphy and ECT. The unobscured images produced by ECT provide additional information for evaluating the localisation, extent and activity of the lesions. The diagnosis of meniscus abnormalities in particular revealed pathognomonic patterns. The indications and value of ECT was compared with other diagnostic measures and particularly with invasive techniques (arthroscopy and arthrotomy). (orig.) [de

  19. Hand joint space narrowing and osteophytes are associated with magnetic resonance imaging-defined knee cartilage thickness and radiographic knee osteoarthritis: data from the Osteoarthritis Initiative.

    Science.gov (United States)

    Haugen, Ida K; Cotofana, Sebastian; Englund, Martin; Kvien, Tore K; Dreher, Donatus; Nevitt, Michael; Lane, Nancy E; Eckstein, Felix

    2012-01-01

    To evaluate whether features of radiographic hand osteoarthritis (OA) are associated with quantitative magnetic resonance imaging (MRI)-defined knee cartilage thickness, radiographic knee OA, and 1-year structural progression. A total of 765 participants in Osteoarthritis Initiative (OAI; 455 women, mean age 62.5 yrs, SD 9.4) obtained hand radiographs (at baseline), knee radiographs (baseline and Year 1), and knee MRI (baseline and Year 1). Hand radiographs were scored for presence of osteophytes and joint space narrowing (JSN). Knee radiographs were scored according to the Kellgren-Lawrence (KL) scale. Cartilage thickness in the medial and lateral femorotibial compartments was measured quantitatively from coronal FLASHwe images. We examined the cross-sectional and longitudinal associations between features of hand OA (total osteophyte and JSN scores) and knee cartilage thickness, 1-year knee cartilage thinning (above smallest detectable change), presence of knee OA (KL grade ≥ 3), and progression of knee OA (KL change ≥ 1) by linear and logistic regression. Both hand OA features were included in a multivariate model (if p ≤ 0.25) adjusted for age, sex, and body mass index (BMI). Hand JSN was associated with reduced knee cartilage thickness (ß = -0.02, 95% CI -0.03, -0.01) in the medial femorotibial compartment, while hand osteophytes were associated with the presence of radiographic knee OA (OR 1.10, 95% CI 1.03-1.18; multivariate models) with both hand OA features as independent variables adjusted for age, sex, and BMI). Radiographic features of hand OA were not associated with 1-year cartilage thinning or radiographic knee OA progression. Our results support a systemic OA susceptibility and possibly different mechanisms for osteophyte formation and cartilage thinning.

  20. Congruence and joint space width alterations of the medial compartment following lateral unicompartmental knee arthroplasty.

    Science.gov (United States)

    Zuiderbaan, H A; Khamaisy, S; Thein, R; Nawabi, D H; Pearle, A D

    2015-01-01

    Progressive degenerative changes in the medial compartment of the knee following lateral unicompartmental arthroplasty (UKA) remains a leading indication for revision surgery. The purpose of this study is to evaluate changes in the congruence and joint space width (JSW) of the medial compartment following lateral UKA. The congruence of the medial compartment of 53 knees (24 men, 23 women, mean age 13.1 years; sd 62.1) following lateral UKA was evaluated pre-operatively and six weeks post-operatively, and compared with 41 normal knees (26 men, 15 women, mean age 33.7 years; sd 6.4), using an Interactive closest point algorithm which calculated the congruence index (CI) by performing a rigid transformation that best aligns the digitised tibial and femoral surfaces. Inner, middle and outer JSWs were measured by sub-dividing the medial compartment into four quarters on pre- and post-operative, weight bearing tunnel view radiographs. The mean CI of knees following lateral UKA significantly improved from 0.92 (sd 0.06) pre-operatively to 0.96 (sd 0.02) (p congruence and normalise the JSW of the medial compartment, potentially preventing progression of degenerative change. ©2015 The British Editorial Society of Bone & Joint Surgery.

  1. [Application of pie-crusting the medial collateral ligament release in arthroscopic surgery for posterior horn of 
medial meniscus in knee joint].

    Science.gov (United States)

    Zhu, Weihong; Tang, Qi; Liao, Lele; Li, Ding; Yang, Yang; Chen, You

    2017-09-28

    To explore the effectiveness and safety of pie-crusting the medial collateral ligament release (MCL) in treating posterior horn of medial meniscus (PHMM) tear in tight medial tibiofemoral compartment of knee joint.
 Methods: Thirty-two consecutive patients with PHMM tear in tight medial tibiofemoral compartment of knee joint were admitted to our department from January, 2013 to December, 2014. All patients were performed pie-crusting the MCL release at its tibial insertion with 18-gauge intravenous needle. All patients were evaluated by valgus stress test and bilateral valgus stress radiograph at postoperative 1st day, 4th week and 12th week. Visual Analogue Scales (VAS), Lysholm scores, Tegner scores and International Knee Documentation Committee (IKDC) scores were recorded at the 1st, 3th, 6th month follow-up, then follow-up every 6 months.
 Results: The mean follow-up was 28 (24-36) months. All cases were negative in valgus stress test. MCL rupture, femoral fracture, articular cartilage lesion and neurovascular injury were not found at the last follow-up. The median medial joint space width of affected side and unaffected side for valgus stress radiographs were 6.8 mm and 4.3 mm (P0.05) at the 12th week, respectively. VAS scores was changed from 4.5±1.5 preoperatively to 1.7±1.0 at the final follow-up (t=16.561, Pjoint.

  2. Changes in knee joint load indices from before to 12 months after arthroscopic partial meniscectomy

    DEFF Research Database (Denmark)

    Thorlund, Jonas Bloch; Holsgaard-Larsen, Anders; Creaby, M W

    2016-01-01

    with the contra-lateral leg. METHODS: We estimated indices of knee joint loading (external peak knee adduction moment (KAM), KAM impulse and peak knee flexion moment (KFM)) normalized to body size (i.e., body mass (BM) and height (HT)) using 3D gait analysis in 23 patients (17 men, mean (SD) 46.2 (6.4) years, BMI...... 25.8 (3.4) kg/m(2)) without radiographic knee OA before and 12 months after medial APM. Static alignment was assessed by radiography and self-reported outcomes by Knee injury and Osteoarthritis Outcome Score (KOOS). RESULTS: Peak KAM and KAM impulse increased in the APM leg compared to the contra......-lateral leg from before to 12 months after surgery (change difference: 0.38 Nm/BM*HT% 95% CI 0.01 to 0.76 (P = 0.049) and 0.20 Nm*s/BM*HT% 95% CI 0.10 to 0.30 (P

  3. Fixed-flexion radiography of the knee provides reproducible joint space width measurements in osteoarthritis

    International Nuclear Information System (INIS)

    Kothari, Manish; Sieffert, Martine; Block, Jon E.; Peterfy, Charles G.; Guermazi, Ali; Ingersleben, Gabriele von; Miaux, Yves; Stevens, Randall

    2004-01-01

    The validity of a non-fluoroscopic fixed-flexion radiographic acquisition and analysis protocol for measurement of joint space width (JSW) in knee osteoarthritis is determined. A cross-sectional study of 165 patients with documented knee osteoarthritis participating in a multicenter, prospective study of chondroprotective agents was performed. All patients had posteroanterior, weight-bearing, fixed-flexion radiography with 10 caudal beam angulation. A specially designed frame (SynaFlexer) was used to standardize the positioning. Minimum medial and lateral JSW were measured manually and twice by an automated analysis system to determine inter-technique and intra-reader concordance and reliability. A random subsample of 30 patients had repeat knee radiographs 2 weeks apart to estimate short-term reproducibility using automated analysis. Concordance between manual and automated medial JSW measurements was high (ICC=0.90); lateral compartment measurements showed somewhat less concordance (ICC=0.72). There was excellent concordance between repeated automated JSW measurements performed 6 months apart for the medial (ICC=0.94) and lateral (ICC=0.86) compartments. Short-term reproducibility for the subsample of 30 cases with repeat acquisitions demonstrated an average SD of 0.14 mm for medial JSW (CV=4.3%) and 0.23 mm for lateral JSW (CV=4.0%). Fixed-flexion radiography of the knee using a positioning device provides consistent, reliable and reproducible measurement of minimum JSW in knee osteoarthritis without the need for concurrent fluoroscopic guidance. (orig.)

  4. Effect of joint traction on functional improvement and quality of life in patients with severe knee osteoarthritis

    OpenAIRE

    Sedigheh Sadat Naeimee; Abbas Rahimi; Mehdi Rezaee; Alireza Akbarzadeh Baghban; Khosro Khademi Kalantari; ُSomayeh Mahmoudi Aghdam

    2012-01-01

    Background and aim: Osteoarthritis (OA) is the most prevalent joint disease in adults around the world and its incidence rises with age. Patients with severe knee osteoarthritis often complain of pain and severe functional disability. Most of conservative treatments used in this group of patients induce poor improvements. This study evaluated the effect of joint traction on quality of life of patients with severe knee osteoarthritis.Materials and Methods: In this clinical trial study, forty f...

  5. Rates of hip and knee joint replacement amongst different ethnic groups in England: an analysis of National Joint Registry data.

    Science.gov (United States)

    Smith, M C; Ben-Shlomo, Y; Dieppe, P; Beswick, A D; Adebajo, A O; Wilkinson, J M; Blom, A W

    2017-04-01

    Despite a health care system that is free at the point of delivery, ethnic minorities may not always get care equitable to that of White patients in England. We examined whether ethnic differences exist in joint replacement rates and surgical practice in England. 373,613 hip and 428,936 knee National Joint Registry (NJR) primary replacement patients had coded ethnicity in Hospital Episode Statistics (HES). Age and gender adjusted observed/expected ratios of hip and knee replacements amongst ethnic groups were compared using indirect standardisation. Associations between ethnic group and type of procedure were explored and effects of demographic, clinical and hospital-related factors examined using multivariable logistic regression. Adjusted standardised observed/expected ratios were substantially lower in Blacks and Asians than Whites for hip replacement (Blacks 0.33 [95% CI, 0.31-0.35], Asians 0.20 [CI, 0.19-0.21]) and knee replacement (Blacks 0.64 [CI, 0.61-0.67], Asians 0.86 % [CI, 0.84-0.88]). Blacks were more likely to receive uncemented hip replacements (Blacks 52%, Whites 37%, Asians 44%; P replacements than Whites (men 10% vs 15%, P = 0.001; women 6% vs 14%, P replacement (OR 1.43 [CI, 1.11-1.84]). In England, hip and knee replacement rates and prosthesis type given differ amongst ethnic groups. Whether these reflect differences in clinical need or differential access to treatment requires urgent investigation. Copyright © 2017. Published by Elsevier Ltd.

  6. Priority of surgical treatment techniques of full cartilage defects of knee joint

    Directory of Open Access Journals (Sweden)

    Андрій Вікторович Літовченко

    2015-10-01

    Full Text Available Aim. Surgical treatment of chondromalacia of knee joint cartilage is an actual problem of the modern orthopedics because the means of conservative therapy can be realized at an initial stage only and almost exhausted at the further ones. Imperfections of palliative surgical techniques are the short-term clinical effect and pathogenetic baselessness because surgical procedure is not directed on reparation of cartilaginous tissue. For today there are a lot of transplantation techniques that are used for biological renewal of articular surface with formation of hyaline or at least hyaline-like cartilage. The deep forage of cartilage defect bottom to the medullary canal is a perspective and priority technique.Methods. The results of treatment of 61 patients with chondromalacia of knee joint of 3-4 degree according to R. Outerbridge are the base of the work. 20 patients of every group underwent microfracturization of cartilage defect bottom and subchondral forage of defect zone. 21 patients underwent the deep forage of defect zone of knee joint according to an offered technique.Result. The results of treatment with microfracturization, subchondral forage and deep forage of defect zone indicate the more strong clinical effect especially in the last clinical group where good and satisfactory results ratios in the term of observation 18 and 24 month remain stable.Conclusions. Deep forage of cartilage defects zone is the most adequate reparative technique of the surgical treatment of local knee joint cartilage defects. Owing to this procedure the number of cells of reparative chondrogenesis predecessors is realized

  7. The development and validation of a custom built device for assessing frontal knee joint laxity.

    Science.gov (United States)

    Ismail, Shiek Abdullah; Simic, Milena; Clarke, Jillian L; Lopes, Thiago Jambo Alves; Pappas, Evangelos

    2017-12-01

    This study reports the development and validation of a quantitative technique of assessing frontal knee joint laxity through a custom built device named KLICP. The objectives of this study were to determine: (i) the intra- and inter-rater reliability and (ii) the validity of the device when compared to real time ultrasound. Twenty-five participants had their frontal knee joint laxity assessed by the KLICP, by manual varus/valgus tests and by ultrasound. Two raters independently assessed laxity manually by three repeated measurements, repeated at least 48h later. Results were validated by comparing them to the medial and lateral joint space opening measured by the ultrasound. Intraclass correlation coefficients and standard error of measurement reliability were calculated. Pearson's correlation coefficients were calculated to determine the correlation between the KLICP and the joint space. Intra-rater reliability (intra-session) for each rater was good on both sessions (0.91-0.98), intra-rater reliability (inter-sessions) was moderate to good (0.62-0.87), and inter-rater reliability (intra-session) was good (0.75-0.80). There is low agreement for intra-rater (inter-session) and for inter-rater (intra-session) reliability. The KLICP measurement has a significant positive fair to moderate correlation to the ultrasound measurement at the left (r: 0.61, p: 0.01) and right (r: 0.48, p: 0.02) knee in the valgus direction and at the left (r: 0.51, p: 0.01) and right (r: 0.39, p: 0.05) knee in the varus direction. There is low agreement between the KLICP and the RTU. Reliability and agreement was good only when measured for intra-rater, within session. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. The frequency of cartilage lesions in non-injured knees with symptomatic meniscus tears: results from an arthroscopic and NIR- (near-infrared) spectroscopic investigation.

    Science.gov (United States)

    Spahn, Gunter; Plettenberg, Holger; Hoffmann, Martin; Klemm, Holm-Torsten; Brochhausen-Delius, Christoph; Hofmann, Gunther O

    2017-06-01

    Are symptomatic tear injuries to the menisci of the knee frequently or always associated with cartilage damage to the corresponding articular surfaces and other joint surfaces, respectively? A total of 137 patients (medial n = 127; lateral n = 10) underwent a meniscus resection. These patients showed no signs of a clear radiographic arthrosis and no MRI-detectable cartilage lesions > grade II. Traumatic injury was ruled out with a thorough medical history. The indication for operation was made exclusively on the basis of distinct, clinically apparent meniscus signs. In addition to the ICRS classification, all articular surfaces were examined spectroscopically (NIRS, near-infrared spectroscopy). In 76.6% (n = 105) of all knees examined, clear cartilage damage (ICRS-grade III/IV) was found. For 43.8%, these were in the area of the patella, while for 34.3% they were in the area of the medial femur, and for 17.5%, in the area of the medial tibial plateau. More rarely, this damage was localized to the area of the trochlea (8.8%) or the lateral joint compartment (femoral 2.2%, tibial 15.3%). There were no significant differences between patients with medial or lateral meniscus lesions with respect to the distribution pattern of the joint injuries. During spectroscopic examination, pathological values were demonstrated (objective evidence of cartilage degeneration) in at least one of the examined articular surfaces (media n = 6, range 1-6). Through our investigations, a high, if not complete, concomitance of degenerative cartilage lesions and degenerative meniscus damage was demonstrated. From this it can be concluded that the entity of "isolated degenerative meniscus damage" clearly does not exist in practice. It is therefore highly probable that degenerative meniscus lesions, as a part of general joint degeneration, are to be interpreted in the context of the development of arthrosis. The practical consequences still are unclear. Patients after partial

  9. Knee joint laxity does not moderate the relationship between quadriceps strength and physical function in knee osteoarthritis patients: A cross-sectional study.

    Science.gov (United States)

    Altubasi, Ibrahim M

    2018-06-07

    Knee osteoarthritis is a common and a disabling musculoskeletal disorder. Patients with knee osteoarthritis have activity limitations which are linked to the strength of the quadriceps muscle. Previous research reported that the relationship between quadriceps muscle strength and physical function is moderated by the level of knee joint frontal plane laxity. The purpose of the current study is to reexamine the moderation effect of the knee joint laxity as measured by stress radiographs on the relationship between quadriceps muscle strength and physical function. One-hundred and sixty osteoarthritis patients participated in this cross-sectional study. Isometric quadriceps muscle strength was measured using an isokinetic dynamometer. Self-rated and performance-based physical function were measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function subscale and Get Up and Go test, respectively. Stress radiographs which were taken while applying varus and valgus loads to knee using the TELOS device. Knee joint laxity was determined by measuring the distance between joint surfaces on the medial and lateral sides. Hierarchical multiple regression models were constructed to study the moderation effect of laxity on the strength function relationship. Two regression models were constructed for self-rated and performance-based function. After controlling for demographics, strength contributed significantly in the models. The addition of laxity and laxity-strength interaction did not add significant contributions in the regression models. Frontal plane knee joint laxity measured by stress radiographs does not moderate the relationship between quadriceps muscle strength and physical function in patients with osteoarthritis. Copyright © 2018 Elsevier B.V. All rights reserved.

  10. Quadriceps Function and Knee Joint Ultrasonography after ACL Reconstruction.

    Science.gov (United States)

    Pamukoff, Derek N; Montgomery, Melissa M; Moffit, Tyler J; Vakula, Michael N

    2018-02-01

    Individuals with anterior cruciate ligament reconstruction (ACLR) are at greater risk for knee osteoarthritis, partially because of chronic quadriceps dysfunction. Articular cartilage is commonly assessed using magnetic resonance imaging and radiography, but these methods are expensive and lack portability. Ultrasound imaging may provide a cost-effective and portable alternative for imaging the femoral cartilage. The purpose of this study was to compare ultrasonography of the femoral cartilage between the injured and uninjured limbs of individuals with unilateral ACLR, and to examine the association between quadriceps function and ultrasonographic measures of femoral cartilage. Bilateral femoral cartilage thickness and quadriceps function were assessed in 44 individuals with unilateral ACLR. Quadriceps function was assessed using peak isometric strength, and early (RTD100) and late (RTD200) rate of torque development. Cartilage thickness at the medial femoral condyle (P accounting for time since ACLR, quadriceps peak isometric strength was associated with cartilage thickness at the medial femoral condyle (r = 0.35, P = 0.02) and femoral cartilage cross-sectional area (r = 0.28, P = 0.04). RTD100 and RTD200 were not associated with femoral cartilage thickness or cross-sectional area. Individuals with ACLR have thinner cartilage in their injured limb compared with uninjured limb, and cartilage thickness is associated with quadriceps function. These results indicate that ultrasonography may be useful for monitoring cartilage health and osteoarthritis progression after ACLR.

  11. Correlation between bone contusion and ligament, menisci injury of knee joint

    International Nuclear Information System (INIS)

    Zhang Lijuan; Li Pei; Tu Changzhuo; Wu Guangren; Qi Yuliang; Yan Xiaoqun

    2004-01-01

    Objective: To evaluate the correlation between bone contusion and ligament, meniscus injury of knee joint with MR imaging. Methods: Thirty-five patients with acute trauma of knee joint were studied retrospectively. All eases showed negative on X-ray and bone cont, -sion on MR imaging. Results: in all patients, ligament and meniscus injury were seen in 25 cases (71%), incorporate anterior cruciate ligament injury in 12 cases, posterior cruciate ligament in 6, tibial collateral ligament in 8 cases, fibular collateral ligament in 6 cases, medial meniscus tear in 4 cases, lateral meniscus tear in 5 cases, and hydrops in 29 cases. There were only 3 patients with ligament or meniscus injury but no bone contusion during the same period. Conclusion: It is necessary to check by MR for the patients with acute trauma of knee joint, who have clinical symptom such as ache, swelling, move un-freely showing bone contusion on MR Imaging but without any abnormality on X-ray in order to avoid failure in diagnosing injury of ligament and meniscus. (authors)

  12. Synovial deposition of wild-type transthyretin-derived amyloid in knee joint osteoarthritis patients.

    Science.gov (United States)

    Takanashi, Tetsuo; Matsuda, Masayuki; Yazaki, Masahide; Yamazaki, Hideshi; Nawata, Masashi; Katagiri, Yoshiki; Ikeda, Shu-Ichi

    2013-09-01

    To investigate histological features of deposited amyloid in the synovial tissue and its clinical significance in knee joint osteoarthritis (OA) patients. We prospectively enrolled 232 consecutive patients who underwent arthroplasty or total replacement of the knee joint for treatment of OA. Congo red staining and immunohistochemistry were performed in the synovial tissue obtained at surgery. When transthyretin (TTR)-derived amyloid was positive, we analyzed all 4 exons of the TTR gene using the direct DNA sequencing method in order to detect mutations. We analyzed 322 specimens in this study. Twenty-six specimens (8.1%) obtained from 21 patients (5 men and 16 women; mean, 79.0 ± 4.6 years) showed deposition of amyloid, which was positively stained with the anti-TTR antibody. Eighteen patients showed inhomogeneous accumulations of amyloid in the loose connective tissue under the synovial epithelia sometimes with nodule formation, while in the remaining three, small vessels in the adipose tissue were involved. Medical records of these patients revealed nothing remarkable in the clinical course, laboratory data or macroscopic intraarticular findings at surgery. No mutations were detectable in the TTR gene analysis. Wild-type TTR-derived amyloid may affect the synovial tissue as a result of long-term mechanical stress or as a part of senile systemic amyloidosis in approximately 8% of knee joint OA patients. No obvious clinical significance was found in synovial deposition of amyloid.

  13. MRI follow-up of conservatively treated meniscal knee lesions in general practice

    Energy Technology Data Exchange (ETDEWEB)

    Oei, Edwin H.G.; Hunink, M.G.M. [University Medical Center Rotterdam, Program for the Assessment of Radiological Technology (ART Program), Erasmus MC, Rotterdam (Netherlands); University Medical Center Rotterdam, Department of Radiology, Erasmus MC, Rotterdam (Netherlands); University Medical Center Rotterdam, Department of Epidemiology, Erasmus MC, Rotterdam (Netherlands); Koster, Ingrid M. [University Medical Center Rotterdam, Department of Radiology, Erasmus MC, Rotterdam (Netherlands); Maasstad Ziekenhuis, Department of Radiology, Rotterdam (Netherlands); Hensen, Jan-Hein J.; Vroegindeweij, Dammis [Maasstad Ziekenhuis, Department of Radiology, Rotterdam (Netherlands); Boks, Simone S. [University Medical Center Rotterdam, Department of General Practice, Erasmus MC, Rotterdam (Netherlands); Maasstad Ziekenhuis, Department of Radiology, Rotterdam (Netherlands); Diaconessenhuis Meppel, Department of Radiology, Meppel (Netherlands); Wagemakers, Harry P.A.; Koes, Bart W.; Bierma-Zeinstra, Sita M.A. [University Medical Center Rotterdam, Department of General Practice, Erasmus MC, Rotterdam (Netherlands)

    2010-05-15

    To evaluate meniscal status change on follow-up MRI after 1 year, prognostic factors and association with clinical outcome in patients with conservatively treated knee injury. We analysed 403 meniscal horns in 101 conservatively treated patients (59 male; mean age 40 years) in general practice who underwent initial knee MRI within 5 weeks of trauma. We performed ordinal logistic regression analysis to analyse prognostic factors for meniscal change on follow-up MRI after 1 year, and we assessed the association with clinical outcome. On follow-up MRI 49 meniscal horns had deteriorated and 18 had improved. Age (odds ratio [OR] 1.3/decade), body weight (OR 1.2/10 kg), total anterior cruciate ligament (ACL) rupture on initial MRI (OR 2.4), location in the posterior horn of the medial meniscus (OR 3.0) and an initial meniscal lesion (OR 0.3) were statistically significant predictors of meniscal MRI appearance change after 1 year, which was not associated with clinical outcome. In conservatively treated patients, meniscal deterioration on follow-up MRI 1 year after trauma is predicted by higher age and body weight, initial total ACL rupture, and location in the medial posterior horn. Change in MRI appearance is not associated with clinical outcome. (orig.)

  14. Diagnostic accuracy of history taking and physical examination for assessing anterior cruciate ligament lesions of the knee in primary care

    NARCIS (Netherlands)

    Wagemakers, H.P.; Luijsterburg, P.A.; Boks, S.S.; Heintjes, E.M.; Berger, M.Y.; Verhaar, J.A.; Koes, B.W.; Bierma-Zeinstra, S.M.

    2010-01-01

    Wagemakers HP, Luijsterburg PA, Boks SS, Heintjes EM, Berger MY, Verhaar JA, Koes BK, Bierma-Zeinstra SM. Diagnostic accuracy of history taking and physical examination for assessing anterior cruciate ligament lesions of the knee in primary care. Arch Phys Med Rehabil 2010;91:1452-9. Objective: To

  15. Incidence of symptomatic osteochondritis dissecans lesions of the knee : A population-based study in Olmsted County

    NARCIS (Netherlands)

    Pareek, A.; Sanders, T. L.; Wu, I. T.; Larson, D. R.; Saris, D. B.F.; Krych, A.J.

    2017-01-01

    Objective: To (1) define population-based incidence of knee Osteochondritis dissecans (OCD) lesions using the population of Olmsted County, (2) examine trends over time, and (3) evaluate rate of surgical management over time. Method: Study population included 302 individuals who were diagnosed with

  16. Hip and knee joint loading during vertical jumping and push jerking.

    Science.gov (United States)

    Cleather, Daniel J; Goodwin, Jon E; Bull, Anthony M J

    2013-01-01

    The internal joint contact forces experienced at the lower limb have been frequently studied in activities of daily living and rehabilitation activities. In contrast, the forces experienced during more dynamic activities are not well understood, and those studies that do exist suggest very high degrees of joint loading. In this study a biomechanical model of the right lower limb was used to calculate the internal joint forces experienced by the lower limb during vertical jumping, landing and push jerking (an explosive exercise derived from the sport of Olympic weightlifting), with a particular emphasis on the forces experienced by the knee. The knee experienced mean peak loadings of 2.4-4.6×body weight at the patellofemoral joint, 6.9-9.0×body weight at the tibiofemoral joint, 0.3-1.4×body weight anterior tibial shear and 1.0-3.1×body weight posterior tibial shear. The hip experienced a mean peak loading of 5.5-8.4×body weight and the ankle 8.9-10.0×body weight. The magnitudes of the total (resultant) joint contact forces at the patellofemoral joint, tibiofemoral joint and hip are greater than those reported in activities of daily living and less dynamic rehabilitation exercises. The information in this study is of importance for medical professionals, coaches and biomedical researchers in improving the understanding of acute and chronic injuries, understanding the performance of prosthetic implants and materials, evaluating the appropriateness of jumping and weightlifting for patient populations and informing the training programmes of healthy populations. Copyright © 2012 Elsevier Ltd. All rights reserved.

  17. Does aquatic exercise reduce hip and knee joint loading? In vivo load measurements with instrumented implants.

    Directory of Open Access Journals (Sweden)

    Ines Kutzner

    Full Text Available Aquatic exercises are widely used for rehabilitation or preventive therapies in order to enable mobilization and muscle strengthening while minimizing joint loading of the lower limb. The load reducing effect of water due to buoyancy is a main advantage compared to exercises on land. However, also drag forces have to be considered that act opposite to the relative motion of the body segments and require higher muscle activity. Due to these opposing effects on joint loading, the load-reducing effect during aquatic exercises remains unknown. The aim of this study was to quantify the joint loads during various aquatic exercises and to determine the load reducing effect of water. Instrumented knee and hip implants with telemetric data transfer were used to measure the resultant joint contact forces in 12 elderly subjects (6x hip, 6x knee in vivo. Different dynamic, weight-bearing and non-weight-bearing activities were performed by the subjects on land and in chest-high water. Non-weight-bearing hip and knee flexion/extension was performed at different velocities and with additional Aquafins. Joint forces during aquatic exercises ranged between 32 and 396% body weight (BW. Highest forces occurred during dynamic activities, followed by weight-bearing and slow non-weight-bearing activities. Compared to the same activities on land, joint forces were reduced by 36-55% in water with absolute reductions being greater than 100%BW during weight-bearing and dynamic activities. During non-weight-bearing activities, high movement velocities and additional Aquafins increased the joint forces by up to 59% and resulted in joint forces of up to 301%BW. This study confirms the load reducing effect of water during weight-bearing and dynamic exercises. Nevertheless, high drag forces result in increased joint contact forces and indicate greater muscle activity. By the choice of activity, movement velocity and additional resistive devices joint forces can be modulated

  18. Correlation between knee and hindfoot alignment in patients with rheumatoid arthritis: The effects of subtalar joint destruction.

    Science.gov (United States)

    Nakada, Izumi; Nakamura, Ichiro; Juji, Takuo; Ito, Katsumi; Matsumoto, Takumi

    2015-09-01

    Compensatory hindfoot alignment for deformities at the knee level has been demonstrated in patients with knee osteoarthritis. However, this phenomenon has not been elucidated in patients with rheumatoid arthritis (RA). The aim of this study is to investigate the relationship between knee deformity and hindfoot alignment and the effect of subtalar joint destruction in patients with RA. We retrospectively investigated RA patients (110 patients, 205 limbs) using radiographs in the standing anteroposterior knee, standing lateral foot, and hindfoot alignment views. The grade of destruction at the knee and subtalar joints was assigned using Larsen's grading system. The correlation between the femorotibial and tibiocalcaneal angles and the effect of joint destruction on this correlation were analyzed using Pearson's correlation coefficients. There was moderate correlation between the femorotibial and tibiocalcaneal angles in a group of knees with a Larsen grade of ≥ 4 (r = 0.544, p = 0.0239). This correlation was stronger in a group with less damaged subtalar joints with a Larsen grade of ≤ 3 (r = 0.705, p = 0.0049). These findings emphasized the importance of examining foot and ankles in patients with RA who undergo total knee arthroplasty.

  19. Interposition of the posterior cruciate ligament into the medial compartment of the knee joint on coronal magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Su; Yoon, Young Cheol; Park, Ki Jeong; Wang, Joon Ho [Dept. of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Choe, Bong Keun [Dept. of Preventive Medicine, Kyung Hee University School of Medicine, Seoul (Korea, Republic of)

    2016-04-15

    The purpose of our study was to evaluate the overall prevalence and clinical significance of interposition of the posterior cruciate ligament (PCL) into the medial compartment of the knee joint in coronal magnetic resonance imaging (MRI). We retrospectively reviewed 317 consecutive patients referred for knee MRI at our institution between October 2009 and December 2009. Interposition of the PCL into the medial compartment of the knee joint on proton coronal MRI was evaluated dichotomously (i.e., present or absent). We analyzed the interposition according to its prevalence as well as its relationship with right-left sidedness, gender, age, and disease categories (osteoarthritis, anterior cruciate ligament tear, and medial meniscus tear). Prevalence of interposition of PCL into the medial compartment of the knee joint was 47.0% (149/317). There was no right (50.0%, 83/166) to left (43.7%, 66/151) or male (50.3%, 87/173) to female (43.1%, 62/144) differences in the prevalence. There was no significant association between the prevalence and age, or the disease categories. Interposition of the PCL into the medial compartment of the knee joint is observed in almost half of patients on proton coronal MRI of the knee. Its presence is not associated with any particular factors including knee pathology and may be regarded as a normal MR finding.

  20. MRT of the knee joint of juvenile footballers. Are there early changes in the knee due to competitive sport?

    International Nuclear Information System (INIS)

    Wacker, F.; Koenig, H.; Felsenberg, D.; Wolf, K.J.

    1994-01-01

    In a prospective study, the right knee of 21 symptom free juvenile footballers was examined by MRT (group I) and the results were compared with 12 juveniles of similar age but who did not take part in any special sorting activities (group II). A 1.5 Tesla Magnetome with an extremity coil was used. There were no abnormal changes in either group in the cruciate ligaments. The hyaline cartilage medially was about 10% thicker than laterally in both groups but in group I it was, on average, 24.8% thicker than in group II. Increased signals in the centre of the menisci were observed in 8 members of group I and two in group II. 5 on the 8 in group I, but none in group II, also showed an increase in the joint fluid. (orig.) [de

  1. The Influence of Radiographic Severity on the Relationship between Muscle Strength and Joint Loading in Obese Knee Osteoarthritis Patients

    Directory of Open Access Journals (Sweden)

    Jens Aaboe

    2011-01-01

    Full Text Available Objective. To investigate the relationship between knee muscle strength and the external knee adduction moment during walking in obese knee osteoarthritis patients and whether disease severity influences this relationship. Methods. This cross-sectional study included 136 elderly obese (BMI>30 adults with predominant medial knee osteoarthritis. Muscle strength, standing radiographic severity as measured by the Kellgren and Lawrence scale, and the peak external knee adduction moment were measured at self-selected walking speed. Results. According to radiographic severity, patients were classified as “less severe” (KL 1-2, N=73 or “severe” (KL 3-4, N=63. A significant positive association was demonstrated between the peak knee adduction moment and hamstring muscle strength in the whole cohort (P=.047. However, disease severity did not influence the relationship between muscle strength and dynamic medial knee joint loading. Severe patients had higher peak knee adduction moment and more varus malalignment (P<.001. Conclusion. Higher hamstring muscle strength relates to higher estimates of dynamic knee joint loading in the medial compartment. No such relationship existed for quadriceps muscle strength. Although cross sectional, the results suggest that hamstrings function should receive increased attention in future studies and treatments that aim at halting disease progression.

  2. Arthroscopic evaluation of patellofemoral congruence with rotation of the knee joint and electrical stimulation of the quadriceps.

    Science.gov (United States)

    Suganuma, Jun; Mochizuki, Ryuta; Inoue, Yutaka; Kitamura, Kazuya; Honda, Akio

    2014-02-01

    The aim of this study was to investigate the pathoanatomic features of patellar instability by arthroscopically comparing patellofemoral congruence with rotation of the knee joint and/or electrical stimulation of the quadriceps (ESQ) between knees with and without patellar instability. We retrospectively examined 83 knee joints in 83 patients. The joints were classified into 2 groups: group 1 comprised those without a history of patellar dislocation and included 59 patients (25 male and 34 female patients), and group 2 comprised those with a history of patellar dislocation and included 24 patients (9 male and 15 female patients). Evaluation of patellofemoral congruence at 30° of flexion of the knee joint was conducted based on an axial radiograph and arthroscopic findings. The congruence angle was measured on the radiograph. The position of the patellar central ridge (PPCR) on the trochlear groove during arthroscopy was measured using still video frames of knee joints with rotational stress and/or ESQ. Statistical differences in the measurements between the 2 groups were assessed with the unpaired t test and the area under the receiver operating characteristic curve of each measurement. There were significant differences (P congruence angle on radiographs and PPCR in knee joints with rotational stress and/or ESQ on arthroscopy. External and internal rotation of the knee joint caused lateral and medial patellar shift, respectively, in both groups, but the shift was significantly larger in group 2. ESQ in addition to rotation caused further patellar shift in group 2 but reduced patellar shift in group 1. Measurement of PPCR with external rotation of the knee and ESQ was the only method to show an area under the receiver operating characteristic curve of 1. There were significant differences in the effects of rotation of the knee joint and/or ESQ on patellofemoral congruence at 30° of flexion of the knee joint on arthroscopy between knees with and without patellar

  3. Accurate joint space quantification in knee osteoarthritis: a digital x-ray tomosynthesis phantom study

    Science.gov (United States)

    Sewell, Tanzania S.; Piacsek, Kelly L.; Heckel, Beth A.; Sabol, John M.

    2011-03-01

    The current imaging standard for diagnosis and monitoring of knee osteoarthritis (OA) is projection radiography. However radiographs may be insensitive to markers of early disease such as osteophytes and joint space narrowing (JSN). Relative to standard radiography, digital X-ray tomosynthesis (DTS) may provide improved visualization of the markers of knee OA without the interference of superimposed anatomy. DTS utilizes a series of low-dose projection images over an arc of +/-20 degrees to reconstruct tomographic images parallel to the detector. We propose that DTS can increase accuracy and precision in JSN quantification. The geometric accuracy of DTS was characterized by quantifying joint space width (JSW) as a function of knee flexion and position using physical and anthropomorphic phantoms. Using a commercially available digital X-ray system, projection and DTS images were acquired for a Lucite rod phantom with known gaps at various source-object-distances, and angles of flexion. Gap width, representative of JSW, was measured using a validated algorithm. Over an object-to-detector-distance range of 5-21cm, a 3.0mm gap width was reproducibly measured in the DTS images, independent of magnification. A simulated 0.50mm (+/-0.13) JSN was quantified accurately (95% CI 0.44-0.56mm) in the DTS images. Angling the rods to represent knee flexion, the minimum gap could be precisely determined from the DTS images and was independent of flexion angle. JSN quantification using DTS was insensitive to distance from patient barrier and flexion angle. Potential exists for the optimization of DTS for accurate radiographic quantification of knee OA independent of patient positioning.

  4. Reductions in knee joint forces with weight loss are attenuated by gait adaptations in class III obesity.

    Science.gov (United States)

    DeVita, Paul; Rider, Patrick; Hortobágyi, Tibor

    2016-03-01

    A consensus exists that high knee joint forces are a precursor to knee osteoarthritis and weight loss reduces these forces. Because large weight loss also leads to increased step length and walking velocity, knee contact forces may be reduced less than predicted by the magnitude of weight loss. The purpose was to determine the effects of weight loss on knee muscle and joint loads during walking in Class III obese adults. We determined through motion capture, force platform measures and biomechanical modeling the effects of weight loss produced by gastric bypass surgery over one year on knee muscle and joint loads during walking at a standard, controlled velocity and at self-selected walking velocities. Weight loss equaling 412 N or 34% of initial body weight reduced maximum knee compressive force by 824 N or 67% of initial body weight when walking at the controlled velocity. These changes represent a 2:1 reduction in knee force relative to weight loss when walking velocity is constrained to the baseline value. However, behavioral adaptations including increased stride length and walking velocity in the self-selected velocity condition attenuated this effect by ∼50% leading to a 392 N or 32% initial body weight reduction in compressive force in the knee joint. Thus, unconstrained walking elicited approximately 1:1 ratio of reduction in knee force relative to weight loss and is more indicative of walking behavior than the standard velocity condition. In conclusion, massive weight loss produces dramatic reductions in knee forces during walking but when patients stride out and walk faster, these favorable reductions become substantially attenuated. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. On the role of the patella, ACL and joint contact forces in the extension of the knee.

    Directory of Open Access Journals (Sweden)

    Daniel J Cleather

    Full Text Available Traditional descriptions of the knee suggest that the function of the patella is to facilitate knee extension by increasing the moment arm of the quadriceps muscles. Through modelling and evidence from the literature it is shown in this paper that the presence of the patella makes the ability of the quadriceps to rotate the thigh greater than their ability to rotate the tibia. Furthermore, this difference increases as the knee is flexed, thus demonstrating a pattern that is consistent with many human movements. This paper also shows that the anterior cruciate ligament plays a previously unheralded role in extending the shank and that translation at the tibiofemoral and patellofemoral joints is important in improving the capacity for thigh rotation when the knee is flexed. This study provides new insights as to how the structure of the knee is adapted to its purpose and illustrates how the functional anatomy of the knee contributes to its extension function.

  6. Effects of joint immobilization on changes in myofibroblasts and collagen in the rat knee contracture model.

    Science.gov (United States)

    Sasabe, Ryo; Sakamoto, Junya; Goto, Kyo; Honda, Yuichiro; Kataoka, Hideki; Nakano, Jiro; Origuchi, Tomoki; Endo, Daisuke; Koji, Takehiko; Okita, Minoru

    2017-09-01

    The purpose of this study was to examine the time-dependent changes in the development of joint capsule fibrosis and in the number of myofibroblasts in the joint capsule after immobilization, using a rat knee contracture model. Both knee joints were fixed in full flexion for 1, 2, and 4 weeks (immobilization group). Untreated rats were bred for each immobilization period (control group). Histological analysis was performed to evaluate changes in the amount and density of collagen in the joint capsule. The changes in type I and III collagen mRNA were examined by in situ hybridization. The number of myofibroblasts in the joint capsule was assessed by immunohistochemical methods. In the immobilization group, the amount of collagen increased within 1 week and the density of collagen increased within 2 weeks, as compared with that in the control group. Type I collagen mRNA-positive cell numbers in the immobilization group increased at all time points. However, type III collagen mRNA-positive cell numbers did not increase. Myofibroblasts in the immobilization group significantly increased compared with those in the control group at all time points, and they increased significantly with the period of immobilization. These results suggest that joint capsule fibrosis with overexpression of type I collagen occurs and progresses within 1 week after immobilization, and an increase in myofibroblasts is related to the mechanism of joint capsule fibrosis. The findings suggest the need for a treatment targeting accumulation of type I collagen associated with an increase in myofibroblasts. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1998-2006, 2017. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  7. Walking velocity and step length adjustments affect knee joint contact forces in healthy weight and obese adults.

    Science.gov (United States)

    Milner, Clare E; Meardon, Stacey A; Hawkins, Jillian L; Willson, John D

    2018-04-28

    Knee osteoarthritis is a major public health problem and adults with obesity are particularly at risk. One approach to alleviating this problem is to reduce the mechanical load at the joint during daily activity. Adjusting temporospatial parameters of walking could mitigate cumulative knee joint mechanical loads. The purpose of this study was to determine how adjustments to velocity and step length affects knee joint loading in healthy weight adults and adults with obesity. We collected three-dimensional gait analysis data on 10 adults with a normal body mass index and 10 adults with obesity during over ground walking in nine different conditions. In addition to preferred velocity and step length, we also conducted combinations of 15% increased and decreased velocity and step length. Peak tibiofemoral joint impulse and knee adduction angular impulse were reduced in the decreased step length conditions in both healthy weight adults (main effect) and those with obesity (interaction effect). Peak knee joint adduction moment was also reduced with decreased step length, and with decreased velocity in both groups. We conclude from these results that adopting shorter step lengths during daily activity and when walking for exercise can reduce mechanical stimuli associated with articular cartilage degenerative processes in adults with and without obesity. Thus, walking with reduced step length may benefit adults at risk for disability due to knee osteoarthritis. Adopting a shorter step length during daily walking activity may reduce knee joint loading and thus benefit those at risk for knee cartilage degeneration. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 9999:XX-XX, 2018. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  8. Hip joint biomechanics in those with and without post-traumatic knee osteoarthritis after anterior cruciate ligament injury.

    Science.gov (United States)

    Wellsandt, E; Zeni, J A; Axe, M J; Snyder-Mackler, L

    2017-12-01

    Anterior cruciate ligament injury results in altered kinematics and kinetics in the knee and hip joints that persist despite surgical reconstruction and rehabilitation. Abnormal movement patterns and a history of osteoarthritis are risk factors for articular cartilage degeneration in additional joints. The purpose of this study was to determine if hip joint biomechanics early after anterior cruciate ligament injury and reconstruction differ between patients with and without post-traumatic knee osteoarthritis 5years after reconstruction. The study's rationale was that individuals who develop knee osteoarthritis after anterior cruciate ligament injury may also demonstrate large alterations in hip joint biomechanics. Nineteen athletes with anterior cruciate ligament injury completed standard gait analysis before (baseline) and after (post-training) extended pre-operative rehabilitation and at 6months, 1year, and 2years after reconstruction. Weightbearing knee radiographs were completed 5years after reconstruction to identify medial compartment osteoarthritis. Five of 19 patients had knee osteoarthritis at 5years after anterior cruciate ligament reconstruction. Patients with knee osteoarthritis at 5years walked with smaller sagittal plane hip angles (P: 0.043) and lower sagittal (P: 0.021) and frontal plane (P: 0.042) external hip moments in the injured limb before and after reconstruction compared to those without knee osteoarthritis. The current findings suggest hip joint biomechanics may be altered in patients who develop post-traumatic knee osteoarthritis. Further study is needed to confirm whether the risk of non-traumatic hip pathology is increased after anterior cruciate ligament injury and if hip joint biomechanics influence its development. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Does joint alignment affect the T2 values of cartilage in patients with knee osteoarthritis?

    International Nuclear Information System (INIS)

    Friedrich, Klaus M.; Shepard, Timothy; Chang, Gregory; Wang, Ligong; Babb, James S.; Regatte, Ravinder; Schweitzer, Mark

    2010-01-01

    To assess the relationship between T2 values of femorotibial cartilage and knee alignment in patients with clinical symptoms of medial osteoarthritis (OA). Twenty-four patients (mean age ± standard deviation, 62.5 ± 9.9 years) with clinical symptoms of medial knee OA, 12 with varus and 12 with valgus alignment of the femorotibial joint, were investigated on 3T MR using a 2D multi-echo spin echo (MESE) sequence for T2 mapping. Analysis of covariance, Spearman correlation coefficients, exact Mann-Whitney tests, and Fisher's exact tests were used for statistical analysis. Overall the T2 values of cartilage in the medial compartment (median ± interquartile-range, 49.44 ± 6.58) were significantly higher (P = 0.0043) than those in the lateral compartment (47.15 ± 6.87). Patients with varus alignment (50.83 ± 6.30 ms) had significantly higher T2 values of cartilage (P < 0.0001) than patients with valgus alignment (46.20 ± 6.00 ms). No statistically significant association between the T2 values of cartilage (in either location) and the Kellgren Lawrence score was found in the varus or in the valgus group. T2 measurements were increased in medial knee OA patients with varus alignment, adding support to the theory of an association of OA and joint alignment. (orig.)

  10. Does joint alignment affect the T2 values of cartilage in patients with knee osteoarthritis?

    Energy Technology Data Exchange (ETDEWEB)

    Friedrich, Klaus M. [Medical University of Vienna, Department of Radiology, Vienna (Austria); Shepard, Timothy; Chang, Gregory; Wang, Ligong; Babb, James S.; Regatte, Ravinder [New York University Langone Medical Center, Department of Radiology, New York, NY (United States); Schweitzer, Mark [Ottawa Hospital, Diagnostic Imaging, Ottawa, ON (Canada)

    2010-06-15

    To assess the relationship between T2 values of femorotibial cartilage and knee alignment in patients with clinical symptoms of medial osteoarthritis (OA). Twenty-four patients (mean age {+-} standard deviation, 62.5 {+-} 9.9 years) with clinical symptoms of medial knee OA, 12 with varus and 12 with valgus alignment of the femorotibial joint, were investigated on 3T MR using a 2D multi-echo spin echo (MESE) sequence for T2 mapping. Analysis of covariance, Spearman correlation coefficients, exact Mann-Whitney tests, and Fisher's exact tests were used for statistical analysis. Overall the T2 values of cartilage in the medial compartment (median {+-} interquartile-range, 49.44 {+-} 6.58) were significantly higher (P = 0.0043) than those in the lateral compartment (47.15 {+-} 6.87). Patients with varus alignment (50.83 {+-} 6.30 ms) had significantly higher T2 values of cartilage (P < 0.0001) than patients with valgus alignment (46.20 {+-} 6.00 ms). No statistically significant association between the T2 values of cartilage (in either location) and the Kellgren Lawrence score was found in the varus or in the valgus group. T2 measurements were increased in medial knee OA patients with varus alignment, adding support to the theory of an association of OA and joint alignment. (orig.)

  11. Redistribution of Mechanical Work at the Knee and Ankle Joints During Fast Running in Minimalist Shoes.

    Science.gov (United States)

    Fuller, Joel T; Buckley, Jonathan D; Tsiros, Margarita D; Brown, Nicholas A T; Thewlis, Dominic

    2016-10-01

    Minimalist shoes have been suggested as a way to alter running biomechanics to improve running performance and reduce injuries. However, to date, researchers have only considered the effect of minimalist shoes at slow running speeds. To determine if runners change foot-strike pattern and alter the distribution of mechanical work at the knee and ankle joints when running at a fast speed in minimalist shoes compared with conventional running shoes. Crossover study. Research laboratory. Twenty-six trained runners (age = 30.0 ± 7.9 years [age range, 18-40 years], height = 1.79 ± 0.06 m, mass = 75.3 ± 8.2 kg, weekly training distance = 27 ± 15 km) who ran with a habitual rearfoot foot-strike pattern and had no experience running in minimalist shoes. Participants completed overground running trials at 18 km/h in minimalist and conventional shoes. Sagittal-plane kinematics and joint work at the knee and ankle joints were computed using 3-dimensional kinematic and ground reaction force data. Foot-strike pattern was classified as rearfoot, midfoot, or forefoot strike based on strike index and ankle angle at initial contact. We observed no difference in foot-strike classification between shoes (χ 2 1 = 2.29, P = .13). Ankle angle at initial contact was less (2.46° versus 7.43°; t 25 = 3.34, P = .003) and strike index was greater (35.97% versus 29.04%; t 25 = 2.38, P = .03) when running in minimalist shoes compared with conventional shoes. We observed greater negative (52.87 J versus 42.46 J; t 24 = 2.29, P = .03) and positive work (68.91 J versus 59.08 J; t 24 = 2.65, P = .01) at the ankle but less negative (59.01 J versus 67.02 J; t 24 = 2.25, P = .03) and positive work (40.37 J versus 47.09 J; t 24 = 2.11, P = .046) at the knee with minimalist shoes compared with conventional shoes. Running in minimalist shoes at a fast speed caused a redistribution of work from the knee to the ankle joint. This finding suggests that runners changing from conventional to minimalist

  12. The main approaches to the knee joint stabilization in patients with cerebral palsy

    Directory of Open Access Journals (Sweden)

    V. V. Umnov

    2013-01-01

    Full Text Available Objective: to improve the results of surgical correction of flexion contracture of knee joint in patients with cerebral palsy. Material and methods. 196 patients with cerebral palsy aged from 2.5 to 18 years old were examined. In 131 patients aged from 8 to 18 years old we performed lengthening of tibia flexors with posterior capsulotomy and without it, in 4 patients aged from 11 to 16 years old the contracture was corrected after preliminary reduction of muscle tone using lumbar dorsal selective rhizotomy (LDSR. Among 246 operated segments a slight contracture in 23 cases was eliminated only with lengthening of tibia flexors, in the remaining 223 cases in addition after lengthening of tibia flexors the residual contracture was corrected by the method of pre-dosed correction in plaster cast. In 16 segments if there was a severe contracture we performed a posterior capsulotomy of knee joint. Besides, we investigated the dependence of contraction degree from phase-tonic activity of tibia flexors, as well as the influence of LDSR on the possibility to correct flexion contracture in 65 knee joints of patients aged from 2.5 to 16 years old. Results. The high degree of dependence of knee flexion contracture (KFC from tone increase of tibia muscle flexors (correlation coefficient r p<=0,01 in patients aged from 2.5 to 7 years old is 0,942, 8-16 years old - 0,712. Probably that is why in 65 investigated joints using LDSR the contracture was corrected in the younger age group in 50 %, in elder age group - in 46 % cases after reduction of muscle tone - tibia flexors by 59% and 37%. Taking into consideration the data we worked out the indications for different variants of surgical correction of KFC depending on the degree of its intensity and with account of muscle hypertonia. As a result of the appliance of differentiated approach the contracture was corrected in 91,6 cases. Conclusion. The main causes of knee flexion contracture in patients with cerebral

  13. Computational stability of human knee joint at early stance in Gait: Effects of muscle coactivity and anterior cruciate ligament deficiency.

    Science.gov (United States)

    Sharifi, M; Shirazi-Adl, A; Marouane, H

    2017-10-03

    As one of the most complex and vulnerable structures of body, the human knee joint should maintain dynamic equilibrium and stability in occupational and recreational activities. The evaluation of its stability and factors affecting it is vital in performance evaluation/enhancement, injury prevention and treatment managements. Knee stability often manifests itself by pain, hypermobility and giving-way sensations and is usually assessed by the passive joint laxity tests. Mechanical stability of both the human knee joint and the lower extremity at early stance periods of gait (0% and 5%) were quantified here for the first time using a hybrid musculoskeletal model of the lower extremity. The roles of muscle coactivity, simulated by setting minimum muscle activation at 0-10% levels and ACL deficiency, simulated by reducing ACL resistance by up to 85%, on the stability margin as well as joint biomechanics (contact/muscle/ligament forces) were investigated. Dynamic stability was analyzed using both linear buckling and perturbation approaches at the final deformed configurations in gait. The knee joint was much more stable at 0% stance than at 5% due to smaller ground reaction and contact forces. Muscle coactivity, when at lower intensities (knee joint at the heel strike. It also markedly diminishes forces in lateral hamstrings (by up to 39%) and contact forces on the lateral plateau (by up to 17%). Current work emphasizes the need for quantification of the lower extremity stability margin in gait. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Knee joint position sense of roller hockey players: a comparative study.

    Science.gov (United States)

    Venâncio, João; Lopes, Diogo; Lourenço, Joaquim; Ribeiro, Fernando

    2016-06-01

    This study aimed to compare knee joint position sense of roller hockey players with an age-matched group of non-athletes. Forty-three male participants voluntarily participated in this cross-sectional study: 21 roller hockey players (mean age: 23.2 ± 4.2 years old, mean weight: 81.8 ± 9.8 kg, mean height: 180.5 ± 4.1 cm) and 22 age-matched non-athletes (mean age: 23.7 ± 3.9 years old, mean weight: 85.0 ± 6.2 kg, mean height: 181.5 ± 5.0 cm). Knee joint position sense of the dominant limb was evaluated using a technique of open-kinetic chain and active knee positioning. Joint position sense was reported using absolute, relative and variable angular errors. The main results indicated that the group of roller hockey players showed significantly lower absolute (2.4 ± 1.2º vs. 6.5 ± 3.2º, p ≤ 0.001) and relative (1.7 ± 2.1º vs. 5.8 ± 4.4º, p ≤ 0.001) angular errors in comparison with the non-athletes group. In conclusion, the results from this present study suggest that proprioceptive acuity, assessed by measuring joint position sense, is increased in roller hockey players. The enhanced proprioception of the roller hockey players could contribute to injury prevention and improved performance during sporting activities.

  15. Neuromuscular adaptations associated with knee joint angle-specific force change.

    Science.gov (United States)

    Noorkõiv, Marika; Nosaka, Kazunori; Blazevich, Anthony J

    2014-08-01

    Neuromuscular adaptations to joint angle-specific force increases after isometric training have not yet been fully elucidated. This study examined angle-specific neuromuscular adaptations in response to isometric knee extension training at short (SL, joint angle 38.1° ± 3.7°) versus long (LL, 87.5° ± 6.0°) muscle lengths. Sixteen men trained three times a week for 6 wk either at SL (n = 8) or LL (n = 8). Voluntary maximal isometric knee extensor (MVC) force, doublet twitch force, EMG amplitudes (EMG/Mmax), and voluntary activation during MVC force (VA%) were measured at eight knee joint angles (30°-100°) at weeks 0, 3, and 6. Muscle volume and cross-sectional area (CSA) were measured from magnetic resonance imaging scans, and fascicle length (Lf) was assessed using ultrasonography before and after training. Clear joint angle specificity of force increase was seen in SL but not in LL. The 13.4% ± 9.7% (P = 0.01) force increase around the training angle in SL was related to changes in vastus lateralis and vastus medialis EMG/Mmax around the training angle (r = 0.84-0.88, P < 0.05), without changes in the doublet twitch force-angle relation or muscle size. In LL, muscle volume and CSA increased and the changes in CSA at specific muscle regions were correlated with changes in MVC force. A 5.4% ± 4.9% (P = 0.001) increase in Lf found in both groups was not associated with angle-specific force changes. There were no angle-specific changes in VA%. The EMG/Mmax, although not VA%, results suggest that neural adaptations underpinned training-related changes at short quadriceps lengths, but hypertrophic changes predominated after training at long lengths. The findings of this study should contribute to the development of more effective and evidence-based rehabilitation and strength training protocols.

  16. The Effects of Cryotherapy on Knee Joint Position Sense and Force Production Sense in Healthy Individuals

    Directory of Open Access Journals (Sweden)

    Furmanek Mariusz P.

    2018-03-01

    Full Text Available The proprioceptive information received from mechanoreceptors is potentially responsible for controlling the joint position and force differentiation. However, it is unknown whether cryotherapy influences this complex mechanism. Previously reported results are not universally conclusive and sometimes even contradictory. The main objective of this study was to investigate the impact of local cryotherapy on knee joint position sense (JPS and force production sense (FPS. The study group consisted of 55 healthy participants (age: 21 ± 2 years, body height: 171.2 ± 9 cm, body mass: 63.3 ± 12 kg, BMI: 21.5 ± 2.6. Local cooling was achieved with the use of gel-packs cooled to -2 ± 2.5°C and applied simultaneously over the knee joint and the quadriceps femoris muscle for 20 minutes. JPS and FPS were evaluated using the Biodex System 4 Pro apparatus. Repeated measures analysis of variance (ANOVA did not show any statistically significant changes of the JPS and FPS under application of cryotherapy for all analyzed variables: the JPS’s absolute error (p = 0.976, its relative error (p = 0.295, and its variable error (p = 0.489; the FPS’s absolute error (p = 0.688, its relative error (p = 0.193, and its variable error (p = 0.123. The results indicate that local cooling does not affect proprioceptive acuity of the healthy knee joint. They also suggest that local limited cooling before physical activity at low velocity did not present health or injury risk in this particular study group.

  17. Clinical efficacy and safety of Gubitong Recipe () in treating osteoarthritis of knee joint.

    Science.gov (United States)

    Tao, Qing-wen; Xu, Yuan; Jin, Di-er; Yan, Xiao-ping

    2009-12-01

    To observe the therapeutic efficacy and safety of Gubitong Recipe (, GBT) in treating osteoarthritis (OA) of knee joint. Ninety patients with knee osteoarthritis were equally assigned, according to a randomizing digital table, to the treatment group and the control group. The treatment group was treated with GBT Decoction one dose every day and the control group with glucosamine sulfate 500 mg thrice a day, respectively, for eight successive weeks. Besides, diclofenac sodium could be given as supplementary dugs with the dosage used recorded if necessary. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC, an index reflecting the degree of joint pain, stiffness, and dysfunction) in patients was assessed before and after treatment, and the patients' symptoms were evaluated by visual analogue scale (VAS) as well. Moreover, erythrocyte sedimentation rate (ESR), blood C-reactive protein (CRP), blood and urinary routine tests, liver and kidney function examination, and the adverse reaction that occurred during the treatment period were observed. WOMAC index and integral VAS value were lowered in both groups after treatment, showing significant statistical difference as compared with before treatment (P<0.05), but the decrement of WOMAC index in the treatment group was more significant than that in the control group (P<0.05). ESR and CRP levels remained unchanged in all patients, and the proportion and mean dosage of diclofenac sodium used were similar in the two groups. No evident adverse reaction occurred during the treatment period. GBT is an effective and safe recipe for the treatment of osteoarthritis of knee joint, which could alleviate the joint pain, stiffness, and dysfunction.

  18. The Effects of Cryotherapy on Knee Joint Position Sense and Force Production Sense in Healthy Individuals

    Science.gov (United States)

    Furmanek, Mariusz P.; Słomka, Kajetan J.; Sobiesiak, Andrzej; Rzepko, Marian; Juras, Grzegorz

    2018-01-01

    Abstract The proprioceptive information received from mechanoreceptors is potentially responsible for controlling the joint position and force differentiation. However, it is unknown whether cryotherapy influences this complex mechanism. Previously reported results are not universally conclusive and sometimes even contradictory. The main objective of this study was to investigate the impact of local cryotherapy on knee joint position sense (JPS) and force production sense (FPS). The study group consisted of 55 healthy participants (age: 21 ± 2 years, body height: 171.2 ± 9 cm, body mass: 63.3 ± 12 kg, BMI: 21.5 ± 2.6). Local cooling was achieved with the use of gel-packs cooled to -2 ± 2.5°C and applied simultaneously over the knee joint and the quadriceps femoris muscle for 20 minutes. JPS and FPS were evaluated using the Biodex System 4 Pro apparatus. Repeated measures analysis of variance (ANOVA) did not show any statistically significant changes of the JPS and FPS under application of cryotherapy for all analyzed variables: the JPS’s absolute error (p = 0.976), its relative error (p = 0.295), and its variable error (p = 0.489); the FPS’s absolute error (p = 0.688), its relative error (p = 0.193), and its variable error (p = 0.123). The results indicate that local cooling does not affect proprioceptive acuity of the healthy knee joint. They also suggest that local limited cooling before physical activity at low velocity did not present health or injury risk in this particular study group. PMID:29599858

  19. Negative pressure wound therapy for the treatment of infected wounds with exposed knee joint after patellar fracture.

    Science.gov (United States)

    Lee, Sang Yang; Niikura, Takahiro; Miwa, Masahiko; Sakai, Yoshitada; Oe, Keisuke; Fukazawa, Takahiro; Kawakami, Yohei; Kurosaka, Masahiro

    2011-06-14

    Treatment of soft tissue defects with exposed bones and joints, resulting from trauma, infection, and surgical complications, represents a major challenge. The introduction of negative pressure wound therapy has changed many wound management practices. Negative pressure wound therapy has recently been used in the orthopedic field for management of traumatic or open wounds with exposed bone, nerve, tendon, and orthopedic implants. This article describes a case of a patient with a large soft tissue defect and exposed knee joint, in which negative pressure wound therapy markedly improved wound healing. A 50-year-old man presented with an ulceration of his left knee with exposed joint, caused by severe wound infections after open reduction and internal fixation of a patellar fracture. After 20 days of negative pressure wound therapy, a granulated wound bed covered the exposed bones and joint.To our knowledge, this is the first report of negative pressure wound therapy used in a patient with a large soft tissue defect with exposed knee joint. Despite the chronic wound secondary to infection, healing was achieved through the use of the negative pressure wound therapy, thus promoting granulation tissue formation and closing the joint. We suggest negative pressure wound therapy as an alternative option for patients with lower limb wounds containing exposed bones and joints when free flap transfer is contraindicated. Our result added to the growing evidence that negative pressure wound therapy is a useful adjunctive treatment for open wounds around the knee joint. Copyright 2011, SLACK Incorporated.

  20. Experimental muscle pain during a forward lunge--the effects on knee joint dynamics and electromyographic activity

    DEFF Research Database (Denmark)

    Henriksen, Marius; Alkjaer, T; Simonsen, Erik Bruun

    2009-01-01

    . Isotonic saline (0.9%) was used as control. MAIN OUTCOME MEASUREMENTS: Three-dimensional movement analyses were performed and inverse dynamics were used to calculate joint kinematics and kinetics for ankle, knee and hip joints. Electromyographic (EMG) signals of the hamstrings and quadriceps muscles were...

  1. 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.

  2. GIANT CELL-RICH LESIONS OF BONE AND JOINTS: A ONE YEAR PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Sri Nithisa H

    2016-07-01

    Full Text Available BACKGROUND Giant cell-rich lesions constitute a group of biologically and morphologically diverse bone and joint tumours. The common feature is presence of numerous multinucleated osteoclast-like giant cells. However, they differ from each other by in terms of clinical and radiographic features and in many cases by their distinct morphological features. METHODS All the bone and joint specimens with giant cell-rich lesions received in the period of one year were studied along with clinical and radiological data available. Gross and microscopic findings were noted. RESULTS In a period of one year, 10 cases of giant cell-rich lesions of bone and joints have been studied, which were and correlated with clinical and radiological findings. Five were lesions from bone and two were from joints, which are chondroblastoma, chondromyxoid fibroma, osteoclastoma, aneurysmal bone cyst, pigmented villonodular synovitis, giant cell lesion of tendon sheath, and tendinous xanthoma. CONCLUSION In the present study, variety of giant cell lesions of bone and joints are studied. Of which, the mean age in young patients being 20 years and in elderly patients being 50 years. The common site being lower end of femur.

  3. Do Changes in Patellofemoral Joint Offset Lead to Adverse Outcomes in Total Knee Arthroplasty With Patellar Resurfacing? A Radiographic Review.

    Science.gov (United States)

    Matz, Jacob; Howard, James L; Morden, David J; MacDonald, Steven J; Teeter, Matthew G; Lanting, Brent A

    2017-03-01

    Patellofemoral joint biomechanics contribute to anterior knee pain, instability, and dysfunction following total knee arthroplasty (TKA). Information about specific factors leading to anterior knee pain and dysfunction is currently limited. Changes in patellofemoral joint offset (PFO) refers to a mismatch between the preoperative and postoperative anteroposterior geometry of the patellofemoral joint. It remains unclear whether these changes lead to adverse outcomes in TKA. A retrospective radiographic review of 970 knees pre-TKA and post-TKA was completed to correlate the radiographic and clinical outcomes of changing the PFO using a posterior-stabilized single knee design with patellar resurfacing. A total of 970 patients were reviewed. Postoperatively, the anterior femoral offset, anteroposterior femoral size, and anterior patellar offset were changed in 40%, 60%, and 71% of knees, respectively, compared to preoperative values. The Western Ontario and McMasters Osteoarthritis Index total score as well as subscale scores for pain and function were not significantly affected by an increase or decrease in PFO. Similarly, Knee Society Scores and range of motion were not significantly affected. Increased anterior patellar offset was, however, associated with increased postoperative patellar tilt. Postoperative patellar tilt was not correlated with adverse patient satisfaction scores or loss of range of motion. Changes in PFO (decreased, maintained, or increased) are common post-TKA and are not associated with a difference in clinical outcomes. Increases in anterior patellar offset led to increased patellar tilt, which was not associated with adverse patient satisfaction scores. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Effect of joint traction on functional improvement and quality of life in patients with severe knee osteoarthritis

    Directory of Open Access Journals (Sweden)

    Sedigheh Sadat Naeimee

    2012-07-01

    Full Text Available Background and aim: Osteoarthritis (OA is the most prevalent joint disease in adults around the world and its incidence rises with age. Patients with severe knee osteoarthritis often complain of pain and severe functional disability. Most of conservative treatments used in this group of patients induce poor improvements. This study evaluated the effect of joint traction on quality of life of patients with severe knee osteoarthritis.Materials and Methods: In this clinical trial study, forty female patients with severe knee OA were randomly assigned to two following groups; common physiotherapy treatment and common physiotherapy treatment accompanied by knee distraction. Quality of life was evaluated pre- and post-treatment and also one month follow-up using the Knee injury and Osteoarthritis Outcome Score (KOOS questionnaire.Results: Common physiotherapy treatment accompanied by knee distraction resulted in significantly better quality of life post-treatment and at 1month follow-up, compared to common physiotherapy treatment alone (P<0.01.Conclusion: Common physiotherapy treatment accompanied by knee distraction induces significant improvement in quality of life in patients with severe knee osteoarthritis compared to common physiotherapy treatment alone.

  5. Radiologic manifestations of degenerative-dystrophic lesion of false joints of the limbs

    International Nuclear Information System (INIS)

    Novikov, V.P.

    1980-01-01

    There have been examined 752 patients with false joints and defects of articular ends of the long tubular bones. Various forms of degenerative-dystrophic lesion of the false joints and neoarthrosis which developed after resection of the articular end, as well as of other sections of bones and joints preconditioned by the long-term overload, have been studied in that group. Degenerative-dystrophic damage has been established to be one of the main causes of secondary sub-and decompensation that manifests by cystic transformation, aseptic necrosis and, in extremely rare cases, deforming arthrosis of the former lesion area. Similar alterations in the adjacent and distant overloaded sections of bones and joints are also thought to belong to causative factors. The importance of the timely multiple X-ray examination has been shown, particularly in detecting early manifestations of degenerative-dystrophic lesion in clinical and preclinical phases

  6. Subchondroplasty for treating bone marrow lesions in the knee - initial experience

    Directory of Open Access Journals (Sweden)

    Marcelo Batista Bonadio

    Full Text Available ABSTRACT OBJECTIVE: To evaluate the use of subchondroplasty in the treatment of bone marrow lesions in an initial series of five cases. METHODS: The study included patients aged between 40 and 75 years old, with pain in the knee for at least six months, associated with high-signal MRI lesion on T2 sequences, on the tibia or femur. Patients were assessed using the visual analog pain scale and the KOOS score, one week before surgery and one, three, six, 12, and 24 weeks after the procedure. Subchondroplasty was performed with a technique developed for filling the area of the bone marrow lesion with a calcium phosphate bone substitute. RESULTS: The filling was performed on the medial femoral condyle in four patients and medial tibial plateau in one case. The assessment by the KOOS score presented a preoperative average of 38.44 points and 62.7, 58.08, 57.92, 63.34, and 71.26 points with one, three, six, 12, and 24 weeks after surgery, respectively. In the evaluation by the VAS, the average was 7.8 points preoperatively and 2.8, 3, 2.8, 1.8, and 0.6 points over the same periods. All patients were able to ambulate without additional support, on the first day after the procedure. One patient had a minimal graft dislocation to the soft tissue, with local pain, which resolved completely after a week. CONCLUSION: The subchondroplasty technique provided significant improvements in the parameters of pain and functional capacity in the short-term assessment.

  7. Osteochondral lesions in distal tarsal joints of Icelandic horses reveal strong associations between hyaline and calcified cartilage abnormalities

    Directory of Open Access Journals (Sweden)

    CJ Ley

    2014-03-01

    Full Text Available Osteochondral lesions in the joints of the distal tarsal region of young Icelandic horses provide a natural model for the early stages of osteoarthritis (OA in low-motion joints. We describe and characterise mineralised and non-mineralised osteochondral lesions in left distal tarsal region joint specimens from twenty-two 30 ±1 month-old Icelandic horses. Combinations of confocal scanning light microscopy, backscattered electron scanning electron microscopy (including, importantly, iodine staining and three-dimensional microcomputed tomography were used on specimens obtained with guidance from clinical imaging. Lesion-types were described and classified into groups according to morphological features. Their locations in the hyaline articular cartilage (HAC, articular calcified cartilage (ACC, subchondral bone (SCB and the joint margin tissues were identified and their frequency in the joints recorded. Associations and correlations between lesion-types were investigated for centrodistal joints only. In centrodistal joints the lesion-types HAC chondrocyte loss, HAC fibrillation, HAC central chondrocyte clusters, ACC arrest and ACC advance had significant associations and strong correlations. These lesion-types had moderate to high frequency in centrodistal joints but low frequencies in tarsometatarsal and talocalcaneal-centroquartal joints. Joint margin lesion-types had no significant associations with other lesion-types in the centrodistal joints but high frequency in both the centrodistal and tarsometatarsal joints. The frequency of SCB lesion-types in all joints was low. Hypermineralised infill phase lesion-types were detected. Our results emphasise close associations between HAC and ACC lesions in equine centrodistal joints and the importance of ACC lesions in the development of OA in low-motion compression-loaded equine joints.

  8. Osteochondral lesions in distal tarsal joints of Icelandic horses reveal strong associations between hyaline and calcified cartilage abnormalities.

    Science.gov (United States)

    Ley, C J; Ekman, S; Hansson, K; Björnsdóttir, S; Boyde, A

    2014-03-25

    Osteochondral lesions in the joints of the distal tarsal region of young Icelandic horses provide a natural model for the early stages of osteoarthritis (OA) in low-motion joints. We describe and characterise mineralised and non-mineralised osteochondral lesions in left distal tarsal region joint specimens from twenty-two 30 ±1 month-old Icelandic horses. Combinations of confocal scanning light microscopy, backscattered electron scanning electron microscopy (including, importantly, iodine staining) and three-dimensional microcomputed tomography were used on specimens obtained with guidance from clinical imaging. Lesion-types were described and classified into groups according to morphological features. Their locations in the hyaline articular cartilage (HAC), articular calcified cartilage (ACC), subchondral bone (SCB) and the joint margin tissues were identified and their frequency in the joints recorded. Associations and correlations between lesion-types were investigated for centrodistal joints only. In centrodistal joints the lesion-types HAC chondrocyte loss, HAC fibrillation, HAC central chondrocyte clusters, ACC arrest and ACC advance had significant associations and strong correlations. These lesion-types had moderate to high frequency in centrodistal joints but low frequencies in tarsometatarsal and talocalcaneal-centroquartal joints. Joint margin lesion-types had no significant associations with other lesion-types in the centrodistal joints but high frequency in both the centrodistal and tarsometatarsal joints. The frequency of SCB lesion-types in all joints was low. Hypermineralised infill phase lesion-types were detected. Our results emphasise close associations between HAC and ACC lesions in equine centrodistal joints and the importance of ACC lesions in the development of OA in low-motion compression-loaded equine joints.

  9. Neuromechanical evidence of improved neuromuscular control around knee joint in volleyball players.

    Science.gov (United States)

    Masci, Ilaria; Vannozzi, Giuseppe; Gizzi, Leonardo; Bellotti, Pasquale; Felici, Francesco

    2010-02-01

    The aim of the present work was to verify that skilled volleyball players present specific adaptations in both neuromuscular control and movement biomechanics, showing an improved neuromuscular control around the knee joint than in non-jumper athletes. Seven male volleyball players and seven male non-jumper athletes were recruited for this study. The following tests were performed in a random order: single countermovement jump (CMJ), single squat jump. At the end of the series, subjects performed a repetitive CMJ test. Electromyographic signals were recorded from vastus lateralis and biceps femoris muscles on both sides. Ground reaction forces and moments were measured with a force plate. Volleyball athletes performed better in all tests and were more resistant to fatigue than non-jumper athletes. Furthermore, volleyball athletes showed a reduced co-activation of knee flexor/extensor muscles. The present results seem to stand for a neural adaptation of the motor control scheme to training.

  10. Automatic 3D MR image registration and its evaluation for precise monitoring of knee joint disease

    International Nuclear Information System (INIS)

    Cheng Yuanzhi; Jin Quan; Guo Changyong; Ding Xiaohua; Tanaka, Hisashi; Tamura, Shinichi

    2011-01-01

    We describe a technique for the registration of three dimensional (3D) knee femur surface points from MR image data sets; it is a technique that can track local cartilage thickness changes over time. In the first coarse registration step, we use the direction vectors of the volume given by the cloud of points of the MR image to correct for different knee joint positions and orientations in the MR scanner. In the second fine registration step, we propose a global search algorithm that simultaneously determines the optimal transformation parameters and point correspondences through searching a six dimensional space of Euclidean motion vectors (translation and rotation). The present algorithm is grounded on a mathematical theory- Lipschitz optimization. Compared with the other three registration approaches (iterative closest point (ICP), EM-ICP, and genetic algorithms), the proposed method achieved the highest registration accuracy on both animal and clinical data. (author)

  11. Dynamic simulation of knee-joint loading during gait using force-feedback control and surrogate contact modelling.

    Science.gov (United States)

    Walter, Jonathan P; Pandy, Marcus G

    2017-10-01

    The aim of this study was to perform multi-body, muscle-driven, forward-dynamics simulations of human gait using a 6-degree-of-freedom (6-DOF) model of the knee in tandem with a surrogate model of articular contact and force control. A forward-dynamics simulation incorporating position, velocity and contact force-feedback control (FFC) was used to track full-body motion capture data recorded for multiple trials of level walking and stair descent performed by two individuals with instrumented knee implants. Tibiofemoral contact force errors for FFC were compared against those obtained from a standard computed muscle control algorithm (CMC) with a 6-DOF knee contact model (CMC6); CMC with a 1-DOF translating hinge-knee model (CMC1); and static optimization with a 1-DOF translating hinge-knee model (SO). Tibiofemoral joint loads predicted by FFC and CMC6 were comparable for level walking, however FFC produced more accurate results for stair descent. SO yielded reasonable predictions of joint contact loading for level walking but significant differences between model and experiment were observed for stair descent. CMC1 produced the least accurate predictions of tibiofemoral contact loads for both tasks. Our findings suggest that reliable estimates of knee-joint loading may be obtained by incorporating position, velocity and force-feedback control with a multi-DOF model of joint contact in a forward-dynamics simulation of gait. Copyright © 2017 IPEM. Published by Elsevier Ltd. All rights reserved.

  12. Proximal fibular osteotomy: a new surgery for pain relief and improvement of joint function in patients with knee osteoarthritis.

    Science.gov (United States)

    Wang, Xiaohu; Wei, Lei; Lv, Zhi; Zhao, Bin; Duan, Zhiqing; Wu, Wenjin; Zhang, Bin; Wei, Xiaochun

    2017-02-01

    Objective To explore the effects of proximal fibular osteotomy as a new surgery for pain relief and improvement of medial joint space and function in patients with knee osteoarthritis. Methods From January 2015 to May 2015, 47 patients who underwent proximal fibular osteotomy for medial compartment osteoarthritis were retrospectively followed up. Preoperative and postoperative weight-bearing and whole lower extremity radiographs were obtained to analyse the alignment of the lower extremity and ratio of the knee joint space (medial/lateral compartment). Knee pain was assessed using a visual analogue scale, and knee ambulation activities were evaluated using the American Knee Society score preoperatively and postoperatively. Results Medial pain relief was observed in almost all patients after proximal fibular osteotomy. Most patients exhibited improved walking postoperatively. Weight-bearing lower extremity radiographs showed an average increase in the postoperative medial knee joint space. Additionally, obvious correction of alignment was observed in the whole lower extremity radiographs in 8 of 47 patients. Conclusions The present study demonstrates that proximal fibular osteotomy effectively relieves pain and improves joint function in patients with medial compartment osteoarthritis at a mean of 13.38 months postoperatively.

  13. Patient-Specific Instruments Based on Knee Joint Computed Tomography and Full-Length Lower Extremity Radiography in Total Knee Replacement

    Directory of Open Access Journals (Sweden)

    Hua Tian

    2018-01-01

    Conclusions: The use of PSIs based on knee joint CT and standing full-length lower extremity radiography in TKR resulted in acceptable alignment compared with the use of conventional instruments, although the marginal advantage was not statistically different. Surgical time and clinical results were also similar between the two groups. However, the PSI group had less postoperative drainage.

  14. Depression and the Overall Burden of Painful Joints: An Examination among Individuals Undergoing Hip and Knee Replacement for Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Rajiv Gandhi

    2015-01-01

    Full Text Available The majority of patients with hip or knee osteoarthritis (OA report one or more symptomatic joints apart from the one targeted for surgical care. Therefore, the purpose of the present study was to investigate the association between the burden of multiple symptomatic joints and self-reported depression in patients awaiting joint replacement for OA. Four hundred and seventy-five patients at a single centre were evaluated. Patients self-reported joints that were painful and/or symptomatic most days of the previous month on a homunculus, with nearly one-third of the sample reporting 6 or more painful joints. The prevalence of depression was 12.2% (58/475. When adjusted for age, sex, education level, hip or knee OA, body mass index, chronic condition count, and joint-specific WOMAC scores, each additional symptomatic joint was associated with a 19% increased odds (odds ratio: 1.19 (95% CI: 1.08, 1.31, P<0.01 of self-reported depression. Individuals reporting 6 or more painful joints had 2.5-fold or greater odds of depression when compared to those patients whose symptoms were limited to the surgical joint. A focus on the surgical joint alone is likely to miss a potentially important determinant of postsurgical patient-reported outcomes in patients undergoing hip or knee replacement.

  15. Study of MR sequence in detecting hyaline cartilage defects of the knee joint

    International Nuclear Information System (INIS)

    Li Songbai; He Cuiju; Sun Wenge; Li Chunkui; Qi Xixun; Li Yanliang; Xu Ke; Bai Xizhuang; Wu Zhenhua

    2003-01-01

    Objective: To evaluate the value of various MR imaging sequences for detecting hyaline cartilage defects. Methods: Ten animal models of cartilage defect were established in 5 pig knees. 5 knees were examined with nine different MR sequences. The signal noise ratio of cartilage and contrast noise ratio were calculated and compared between cartilage and adjacent tissue. Measurement of the defect depth and width on the imaging was correlated with the actual measurement before imaging. 23 patients with hyaline cartilage defects of the knee were evaluated with MR imaging. All these patients underwent subsequent arthroscopy. MR imaging protocol included the selected sequences in the experimental study. Results: The cartilage SNR was better in FSE PD, FS 3D FSPGR, and FS FSE PD sequences. CNR between cartilage and subcartilaginous bone was best in FS 3D FSPGR and FS FSE PD sequences. CNR between cartilage and joint fluid was best in FS 3D FSPGR and FS FSE T 2 WI sequences. CNR between cartilage and meniscus and ligament was best in FS 3D FSPGR, FS FSE PD, SE T 1 WI, and IR TI700 sequences. CNR between cartilage and fat was best in FS 3D FSPGR and SE T 1 WI sequences. The width and depth correlation was best in IR TI700 sequence, which showed the statistical significance (P 2 WI sequence, 68%, 99%, and 0.74, respectively with IR TI700 sequence. Conclusion: The sensitivity of FS 3D FSPGR sequence in detecting hyaline cartilage defect is the highest. T 1 WI of spin echo sequence and T 2 WI/PDWI of fast spin-echo with fat saturation should be the standard sequence in the examination of knee joint. T 1 WI of IR sequence has potential clinical value for cartilage examination

  16. Inverse Modeling of Human Knee Joint Based on Geometry and Vision Systems for Exoskeleton Applications

    Directory of Open Access Journals (Sweden)

    Eduardo Piña-Martínez

    2015-01-01

    Full Text Available Current trends in Robotics aim to close the gap that separates technology and humans, bringing novel robotic devices in order to improve human performance. Although robotic exoskeletons represent a breakthrough in mobility enhancement, there are design challenges related to the forces exerted to the users’ joints that result in severe injuries. This occurs due to the fact that most of the current developments consider the joints as noninvariant rotational axes. This paper proposes the use of commercial vision systems in order to perform biomimetic joint design for robotic exoskeletons. This work proposes a kinematic model based on irregular shaped cams as the joint mechanism that emulates the bone-to-bone joints in the human body. The paper follows a geometric approach for determining the location of the instantaneous center of rotation in order to design the cam contours. Furthermore, the use of a commercial vision system is proposed as the main measurement tool due to its noninvasive feature and for allowing subjects under measurement to move freely. The application of this method resulted in relevant information about the displacements of the instantaneous center of rotation at the human knee joint.

  17. Posterior Tibial Slope Angle Correlates With Peak Sagittal and Frontal Plane Knee Joint Loading During Robotic Simulations of Athletic Tasks

    Science.gov (United States)

    Bates, Nathaniel A.; Nesbitt, Rebecca J.; Shearn, Jason T.; Myer, Gregory D.; Hewett, Timothy E.

    2017-01-01

    Background Tibial slope angle is a nonmodifiable risk factor for anterior cruciate ligament (ACL) injury. However, the mechanical role of varying tibial slopes during athletic tasks has yet to be clinically quantified. Purpose To examine the influence of posterior tibial slope on knee joint loading during controlled, in vitro simulation of the knee joint articulations during athletic tasks. Study Design Descriptive laboratory study. Methods A 6 degree of freedom robotic manipulator positionally maneuvered cadaveric knee joints from 12 unique specimens with varying tibial slopes (range, −7.7° to 7.7°) through drop vertical jump and sidestep cutting tasks that were derived from 3-dimensional in vivo motion recordings. Internal knee joint torques and forces were recorded throughout simulation and were linearly correlated with tibial slope. Results The mean (6SD) posterior tibial slope angle was 2.2° ± 4.3° in the lateral compartment and 2.3° ± 3.3° in the medial compartment. For simulated drop vertical jumps, lateral compartment tibial slope angle expressed moderate, direct correlations with peak internally generated knee adduction (r = 0.60–0.65), flexion (r = 0.64–0.66), lateral (r = 0.57–0.69), and external rotation torques (r = 0.47–0.72) as well as inverse correlations with peak abduction (r = −0.42 to −0.61) and internal rotation torques (r = −0.39 to −0.79). Only frontal plane torques were correlated during sidestep cutting simulations. For simulated drop vertical jumps, medial compartment tibial slope angle expressed moderate, direct correlations with peak internally generated knee flexion torque (r = 0.64–0.69) and lateral knee force (r = 0.55–0.74) as well as inverse correlations with peak external torque (r = −0.34 to 20.67) and medial knee force (r = −0.58 to −0.59). These moderate correlations were also present during simulated sidestep cutting. Conclusion The investigation supported the theory that increased posterior

  18. Supramolecular Organization of Collagen Fibrils in Healthy and Osteoarthritic Human Knee and Hip Joint Cartilage.

    Directory of Open Access Journals (Sweden)

    Riccardo Gottardi

    Full Text Available Cartilage matrix is a composite of discrete, but interacting suprastructures, i.e. cartilage fibers with microfibrillar or network-like aggregates and penetrating extrafibrillar proteoglycan matrix. The biomechanical function of the proteoglycan matrix and the collagen fibers are to absorb compressive and tensional loads, respectively. Here, we are focusing on the suprastructural organization of collagen fibrils and the degradation process of their hierarchical organized fiber architecture studied at high resolution at the authentic location within cartilage. We present electron micrographs of the collagenous cores of such fibers obtained by an improved protocol for scanning electron microscopy (SEM. Articular cartilages are permeated by small prototypic fibrils with a homogeneous diameter of 18 ± 5 nm that can align in their D-periodic pattern and merge into larger fibers by lateral association. Interestingly, these fibers have tissue-specific organizations in cartilage. They are twisted ropes in superficial regions of knee joints or assemble into parallel aligned cable-like structures in deeper regions of knee joint- or throughout hip joints articular cartilage. These novel observations contribute to an improved understanding of collagen fiber biogenesis, function, and homeostasis in hyaline cartilage.

  19. Evaluation of the articular cartilage of the knee joint: value of adding a T2 mapping sequence to a routine MR imaging protocol.

    Science.gov (United States)

    Kijowski, Richard; Blankenbaker, Donna G; Munoz Del Rio, Alejandro; Baer, Geoffrey S; Graf, Ben K

    2013-05-01

    To determine whether the addition of a T2 mapping sequence to a routine magnetic resonance (MR) imaging protocol could improve diagnostic performance in the detection of surgically confirmed cartilage lesions within the knee joint at 3.0 T. This prospective study was approved by the institutional review board, and the requirement to obtain informed consent was waived. The study group consisted of 150 patients (76 male and 74 female patients with an average age of 41.2 and 41.5 years, respectively) who underwent MR imaging and arthroscopy of the knee joint. MR imaging was performed at 3.0 T by using a routine protocol with the addition of a sagittal T2 mapping sequence. Images from all MR examinations were reviewed in consensus by two radiologists before surgery to determine the presence or absence of cartilage lesions on each articular surface, first by using the routine MR protocol alone and then by using the routine MR protocol with T2 maps. Each articular surface was then evaluated at arthroscopy. Generalized estimating equation models were used to compare the sensitivity and specificity of the routine MR imaging protocol with and without T2 maps in the detection of surgically confirmed cartilage lesions. The sensitivity and specificity in the detection of 351 cartilage lesions were 74.6% and 97.8%, respectively, for the routine MR protocol alone and 88.9% and 93.1% for the routine MR protocol with T2 maps. Differences in sensitivity and specificity were statistically significant (P T2 maps to the routine MR imaging protocol significantly improved the sensitivity in the detection of 24 areas of cartilage softening (from 4.2% to 62%, P T2 mapping sequence to a routine MR protocol at 3.0 T improved sensitivity in the detection of cartilage lesions within the knee joint from 74.6% to 88.9%, with only a small reduction in specificity. The greatest improvement in sensitivity with use of the T2 maps was in the identification of early cartilage degeneration. © RSNA

  20. Changes on magnetic resonance tomography in the knee joints of marathon runners: a 10-year longitudinal study

    International Nuclear Information System (INIS)

    Krampla, Wolfgang W.; Newrkla, Stephan P.; Hruby, Walter F.; Kroener, Andreas H.

    2008-01-01

    The aim of the study was to evaluate long-term damage in the internal structures of the knee joints of recreational long-distance runners. Ten years after their participation in a baseline study concerning their knee joints, seven long-distance runners and one who had given up long-distance running were invited to participate in a repeat magnetic resonance imaging (MRI) investigation. The same evaluation criteria and the same technical equipment were used, and the results of the two investigations were compared. No adverse long-term consequences were observed in six of the seven active runners, regardless of pre-existing damage at the baseline investigation. In one case the arthrotic changes were progressive in nature. The person who had given up running presented with severe deterioration of the internal structures of the knee joint. Non-physiological maximal loads secondary to the marathon race do not cause any permanent damage in the internal structures of the knee joint in individuals without significant pre-existing damage. A disposition for premature arthrosis was not registered in the population investigated. A protective value of long distance running on the internal structures of the knee joint is discussed. (orig.)

  1. Changes on magnetic resonance tomography in the knee joints of marathon runners: a 10-year longitudinal study

    Energy Technology Data Exchange (ETDEWEB)

    Krampla, Wolfgang W.; Newrkla, Stephan P.; Hruby, Walter F. [Danube Hospital, Radiology Department, Vienna (Austria); Kroener, Andreas H. [Danube Hospital, Department of Orthopedic Surgery, Vienna (Austria)

    2008-07-15

    The aim of the study was to evaluate long-term damage in the internal structures of the knee joints of recreational long-distance runners. Ten years after their participation in a baseline study concerning their knee joints, seven long-distance runners and one who had given up long-distance running were invited to participate in a repeat magnetic resonance imaging (MRI) investigation. The same evaluation criteria and the same technical equipment were used, and the results of the two investigations were compared. No adverse long-term consequences were observed in six of the seven active runners, regardless of pre-existing damage at the baseline investigation. In one case the arthrotic changes were progressive in nature. The person who had given up running presented with severe deterioration of the internal structures of the knee joint. Non-physiological maximal loads secondary to the marathon race do not cause any permanent damage in the internal structures of the knee joint in individuals without significant pre-existing damage. A disposition for premature arthrosis was not registered in the population investigated. A protective value of long distance running on the internal structures of the knee joint is discussed. (orig.)

  2. [Antero-medial incision of knee joint for the treatment of intercondylar fracture of femur].

    Science.gov (United States)

    Yin, Zi-Fei; Sun, Bin-Feng; Yang, Xiao-Hai; Wang, Qing; Qian, Ping-Kang; Wu, Xiao-Feng; Xu, Feng

    2017-12-25

    To explore the clinical effect of antero-medial incision of knee joint in treating intercondylar fracture of femur. From September 2012 to March 2015, 24 patients with intercondylar fracture of femur were selected, including 17 males and 7 females, aged from 20 to 65 years old with an average of(38.3±9.5) years old. Among them, 12 cases were caused by traffic accident, 8 cases were caused by falling injury and 4 cases were caused by falling down. All patients were closed fractures. The time from injury to hospital was from 30 min to 8 h with an average of(2.2±0.3) h. According to AO classification, 4 cases were type B1, 3 type B2, 2 type B3, 5 type C1, 6 type C2 and 4 type C3. All patients were treated with antero-medial incision of knee joint. Operative time, blood loss and postoperative complications were observed and recovery of keen function was evaluated by Kolmert scoring. All patients were followed-up from 6 to 12 months with average of (9.0±1.7) months. Operative time ranged from 50 to 90 min with an average of (70.0±8.2) min; blood loss ranged from 90 to 400 ml with an average of (180±36) ml; negative pressure flow was from 30 to 90 ml, with an average of (50.0±7.1) ml. All fracture were healed at stage I without loosening of internal fixator, fracture nonunion, and deep vein thrombosis. According to Kolmert scoring, 16 patients got excellent result, 5 patients good and 3 fair. Antero-medial incision of knee joint in treating intercondylar fracture of femur, which has advantages of good fracture reduction, less injury of soft tissue and simple operation, could obtain good clinical results.

  3. Semiautomated digital analysis of knee joint space width using MR images

    International Nuclear Information System (INIS)

    Agnesi, Filippo; Amrami, Kimberly K.; Frigo, Carlo A.; Kaufman, Kenton R.

    2007-01-01

    The goal of this study was to (a) develop a semiautomated computer algorithm to measure knee joint space width (JSW) from magnetic resonance (MR) images using standard imaging techniques and (b) evaluate the reproducibility of the algorithm. Using a standard clinical imaging protocol, bilateral knee MR images were obtained twice within a 2-week period from 17 asymptomatic research participants. Images were analyzed to determine the variability of the measurements performed by the program compared with the variability of manual measurements. Measurement variability of the computer algorithm was considerably smaller than the variability of manual measurements. The average difference between two measurements of the same slice performed with the computer algorithm by the same user was 0.004 ± 0.07 mm for the tibiofemoral joint (TF) and 0.009 ± 0.11 mm for the patellofemoral joint (PF) compared with an average of 0.12 ± 0.22 mm TF and 0.13 ± 0.29 mm PF, respectively, for the manual method. Interuser variability of the computer algorithm was also considerably smaller, with an average difference of 0.004 ± 0.1 mm TF and 0.0006 ± 0.1 mm PF compared with 0.38 ± 0.59 mm TF and 0.31 ± 0.66 mm PF obtained using a manual method. The between-day reproducibility was larger but still within acceptable limits at 0.09 ± 0.39 mm TF and 0.09 ± 0.51 mm PF. This technique has proven consistently reproducible on a same slice base,while the reproducibility comparing different acquisitions of the same subject was larger. Longitudinal reproducibility improvement needs to be addressed through acquisition protocol improvements. A semiautomated method for measuring knee JSW from MR images has been successfully developed. (orig.)

  4. Semiautomated digital analysis of knee joint space width using MR images

    Energy Technology Data Exchange (ETDEWEB)

    Agnesi, Filippo [Mayo Clinic, Motion Analysis Laboratory, Division of Orthopedic Research, Rochester, MN (United States); Polytechnic of Milan, Department of Bioengineering, Milan (Italy); Amrami, Kimberly K. [Mayo Clinic, Department of Radiology, Rochester, MN (United States); Frigo, Carlo A. [Polytechnic of Milan, Department of Bioengineering, Milan (Italy); Kaufman, Kenton R. [Mayo Clinic, Motion Analysis Laboratory, Division of Orthopedic Research, Rochester, MN (United States); Mayo Clinic, Mayo Foundation, Motion Analysis Laboratory, Department of Orthopedic Surgery, Rochester, MN (United States)

    2007-05-15

    The goal of this study was to (a) develop a semiautomated computer algorithm to measure knee joint space width (JSW) from magnetic resonance (MR) images using standard imaging techniques and (b) evaluate the reproducibility of the algorithm. Using a standard clinical imaging protocol, bilateral knee MR images were obtained twice within a 2-week period from 17 asymptomatic research participants. Images were analyzed to determine the variability of the measurements performed by the program compared with the variability of manual measurements. Measurement variability of the computer algorithm was considerably smaller than the variability of manual measurements. The average difference between two measurements of the same slice performed with the computer algorithm by the same user was 0.004 {+-} 0.07 mm for the tibiofemoral joint (TF) and 0.009 {+-} 0.11 mm for the patellofemoral joint (PF) compared with an average of 0.12 {+-} 0.22 mm TF and 0.13 {+-} 0.29 mm PF, respectively, for the manual method. Interuser variability of the computer algorithm was also considerably smaller, with an average difference of 0.004 {+-} 0.1 mm TF and 0.0006 {+-} 0.1 mm PF compared with 0.38 {+-} 0.59 mm TF and 0.31 {+-} 0.66 mm PF obtained using a manual method. The between-day reproducibility was larger but still within acceptable limits at 0.09 {+-} 0.39 mm TF and 0.09 {+-} 0.51 mm PF. This technique has proven consistently reproducible on a same slice base,while the reproducibility comparing different acquisitions of the same subject was larger. Longitudinal reproducibility improvement needs to be addressed through acquisition protocol improvements. A semiautomated method for measuring knee JSW from MR images has been successfully developed. (orig.)

  5. The Relationship Between Early-Stage Knee Osteoarthritis and Lower-Extremity Alignment, Joint Laxity, and Subjective Scores of Pain, Stiffness, and Function.

    Science.gov (United States)

    Hicks-Little, Charlie A; Peindl, Richard D; Hubbard-Turner, Tricia J; Cordova, Mitchell L

    2016-08-01

    Knee osteoarthritis (OA) is a debilitating disease that affects an estimated 27 million Americans. Changes in lower-extremity alignment and joint laxity have been found to redistribute the medial and/or lateral loads at the joint. However, the effect that changes in anteroposterior knee-joint laxity have on lower-extremity alignment and function in individuals with knee OA remains unclear. To examine anteroposterior knee-joint laxity, lower-extremity alignment, and subjective pain, stiffness, and function scores in individuals with early-stage knee OA and matched controls and to determine if a relationship exists among these measures. Case control. Sports-medicine research laboratory. 18 participants with knee OA and 18 healthy matched controls. Participants completed the Western Ontario McMaster (WOMAC) osteoarthritis questionnaire and were tested for total anteroposterior knee-joint laxity (A-P) and knee-joint alignment (ALIGN). WOMAC scores, A-P (mm), and ALIGN (°). A significant multivariate main effect for group (Wilks' Λ = 0.30, F7,26 = 8.58, P Knee-OA participants differed in WOMAC scores (P knee OA had worse pain, stiffness, and functional outcome scores than the matched controls; however, ALIGN and A-P were no different. There was no association identified among participants' subjective scores, ALIGN, or A-P measures in this study.

  6. First Case Report of a Late Onset Knee Periprosthetic Joint Infection Caused by Lactococcus garvieae

    Directory of Open Access Journals (Sweden)

    V.-I. Neagoe

    2016-01-01

    Full Text Available Lactococcus garvieae is known as a Gram-positive, catalase-negative, and facultatively anaerobic fish pathogen. The association between Lactococcus spp. and human infectious diseases is described as being mainly associated with lumbar osteomyelitis, hepatic abscess, and infective endocarditis. In the literature of orthopedic post-prosthetic infections, L. garvieae was associated with a case of hip prosthetic infection in a fishmonger woman. We present the case of a 79-year-old male patient with multiple comorbidities, who is admitted to our center with a 5-day history of pain, swelling, and motility disorder of the right knee by the presence of a bicondylar knee replacement surgery, which was performed due to gonarthrosis 17 years ago. The radiographies of the right knee revealed no signs of displacement or loosening of the prothesis. After multiple radical debridements including VAC therapy and targeted antibiotic therapy we have managed to defeat the infection without exchange arthroplasty. Although we could not demonstrate the source of infection, we can only presume that in our case the source of infection was represented by the ingestion of possibly contaminated food. The patient had a habit of eating Nile perch fish (Lates niloticus every 4 weeks. We illustrated once more the possibility of a late onset L. garvieae related orthopedic periprosthetic joint infection by multiple comorbidities.

  7. TKA patients with unsatisfying knee function show changes in neuromotor synergy pattern but not joint biomechanics.

    Science.gov (United States)

    Ardestani, Marzieh M; Malloy, Philip; Nam, Denis; Rosenberg, Aaron G; Wimmer, Markus A

    2017-12-01

    Nearly 20% of patients who have undergone total knee arthroplasty (TKA) report persistent poor knee function. This study explores the idea that, despite similar knee joint biomechanics, the neuro-motor synergies may be different between high-functional and low-functional TKA patients. We hypothesized that (1) high-functional TKA recruit a more complex neuro-motor synergy pattern compared to low-functional TKA and (2) high-functional TKA patients demonstrate more stride-to-stride variability (flexibility) in their synergies. Gait and electromyography (EMG) data were collected during level walking for three groups of participants: (i) high-functional TKA patients (n=13); (ii) low-functional TKA patients (n=13) and (iii) non-operative controls (n=18). Synergies were extracted from EMG data using non-negative matrix factorization. Analysis of variance and Spearman correlation analyses were used to investigate between-group differences in gait and neuro-motor synergies. Results showed that synergy patterns were different among the three groups. Control subjects used 5-6 independent neural commands to execute a gait cycle. High functional TKA patients used 4-5 independent neural commands while low-functional TKA patients relied on only 2-3 independent neural commands to execute a gait cycle. Furthermore, stride-to-stride variability of muscles' response to the neural commands was reduced up to 15% in low-functional TKAs compared to the other two groups. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Medial unicompartmental knee arthroplasty improves congruence and restores joint space width of the lateral compartment.

    Science.gov (United States)

    Khamaisy, Saker; Zuiderbaan, Hendrik A; van der List, Jelle P; Nam, Denis; Pearle, Andrew D

    2016-06-01

    Osteoarthritic progression of the lateral compartment remains a leading indication for medial unicompartmental knee arthroplasty (UKA) revision. Therefore, the purpose of this study was to evaluate the alterations of the lateral compartment congruence and joint space width (JSW) following medial UKA. Retrospectively, lateral compartment congruence and JSW were evaluated in 174 knees (74 females, 85 males, mean age 65.5years; SD±10.1) preoperatively and six weeks postoperatively, and compared to 41 healthy knees (26 men, 15 women, mean age 33.7years; SD±6.4). Congruence (CI) was calculated using validated software that evaluates the geometric relationship between surfaces and calculates a congruence index (CI). JSW was measured on three sides (inner, middle, outer) by subdividing the lateral compartment into four quarters. The CI of the control group was 0.98 (SD±0.01). The preoperative CI was 0.88 (SD±0.01), which improved significantly to 0.93 (SD±0.03) postoperatively (pcongruence and restores the JSW of the lateral compartment. Copyright © 2016 Elsevier B.V. All rights reserved.

  9. A comparison of muscle stiffness and musculoarticular stiffness of the knee joint in young athletic males and females.

    Science.gov (United States)

    Wang, Dan; De Vito, Giuseppe; Ditroilo, Massimiliano; Fong, Daniel T P; Delahunt, Eamonn

    2015-06-01

    The objective of this study was to investigate the gender-specific differences in peak torque (PT), muscle stiffness (MS) and musculoarticular stiffness (MAS) of the knee joints in a young active population. Twenty-two male and twenty-two female recreational athletes participated. PT of the knee joint extensor musculature was assessed on an isokinetic dynamometer, MS of the vastus lateralis (VL) muscle was measured in both relaxed and contracted conditions, and knee joint MAS was quantified using the free oscillation technique. Significant gender differences were observed for all dependent variables. Females demonstrated less normalized PT (mean difference (MD)=0.4Nm/kg, p=0.005, η(2)=0.17), relaxed MS (MD=94.2N/m, pjoint injury incidence and prevalence in females when compared to males. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Radiofrequency energy in the arthroscopic treatment of knee chondral lesions: a systematic review.

    Science.gov (United States)

    Rocco, Papalia; Lorenzo, Diaz Balzani; Guglielmo, Torre; Michele, Paciotti; Nicola, Maffulli; Vincenzo, Denaro

    2016-03-01

    Cartilage debridement is one of the recommended procedures for the management of chondral defects. Radiofrequency probes allow to debride the cartilage, but may induce subchondral bone necrosis. Medline, Cochrane and Google Scholar were searched to identify studies on arthroscopic debridement of the articular cartilage of the knee using radiofrequency chondroplasty. The methodological quality of the studies was assessed using the Coleman methodology score (CMS). Monopolar and bipolar radiofrequency devices provide significantly better clinical outcomes, especially for patients with high-grade chondral lesions, compared with mechanical shaver only. Despite the original concerns regarding subchondral bone necrosis, low complication rates are reported. Heterogeneity in terms of type of device does not allow sound comparison of the published results. There is lack of evidence on the long-term effects of radiofrequency chondroplasty. Study methodology should be improved: the average Coleman methodology score was 56.2 out of 100. More comparative, well-designed and larger cohort trials are needed to ascertain whether radiofrequency chondroplasty offers long-term benefits over other simpler and more economical alternatives. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Joint line tenderness and McMurray tests for the detection of meniscal lesions: what is their real diagnostic value?

    Science.gov (United States)

    Galli, Marco; Ciriello, Vincenzo; Menghi, Amerigo; Aulisa, Angelo G; Rabini, Alessia; Marzetti, Emanuele

    2013-06-01

    To assess the interobserver concordance of the joint line tenderness (JLT) and McMurray tests, and to determine their diagnostic efficiency for the detection of meniscal lesions. Prospective observational study. Orthopedics outpatient clinic, university hospital. Patients (N=60) with suspected nonacute meniscal lesions who underwent knee arthroscopy. Not applicable. Patients were examined by 3 independent observers with graded levels of experience (>10y, 3y, and 4mo of practice). The interobserver concordance was assessed by Cohen-Fleiss κ statistics. Accuracy, negative and positive predictive values for prevalence 10% to 90%, positive (LR+) and negative (LR-) likelihood ratios, and the Bayesian posttest probability with a positive or negative result were also determined. The diagnostic value of the 2 tests combined was assessed by logistic regression. Arthroscopy was used as the reference test. No interobserver concordance was determined for the JLT. The McMurray test showed higher interobserver concordance, which improved when judgments by the less experienced examiner were discarded. The whole series studied by the "best" examiner (experienced orthopedist) provided the following values: (1) JLT: sensitivity, 62.9%; specificity, 50%; LR+, 1.26; LR-, .74; (2) McMurray: sensitivity, 34.3%; specificity, 86.4%; LR+, 2.52; LR-, .76. The combination of the 2 tests did not offer advantages over the McMurray alone. The JLT alone is of little clinical usefulness. A negative McMurray test does not modify the pretest probability of a meniscal lesion, while a positive result has a fair predictive value. Hence, in a patient with a suspected meniscal lesion, a positive McMurray test indicates that arthroscopy should be performed. In case of a negative result, further examinations, including imaging, are needed. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  12. The role of adipocytokines in the pathogenesis of knee joint osteoarthritis.

    Science.gov (United States)

    Richter, Magdalena; Trzeciak, Tomasz; Owecki, Maciej; Pucher, Andrzej; Kaczmarczyk, Jacek

    2015-06-01

    Osteoarthritis (OA) is one of the most common causes of musculoskeletal disability in the world. Traditionally, it has been thought that obesity contributes to the development and progression of OA by increased mechanical load of the joint structures. Nevertheless, studies have shown that adipose tissue-derived cytokines (adipocytokines) are a possible link between obesity and OA. Furthermore, according to recent findings, not only articular cartilage may be the main target of these cytokines but also the synovial membrane, subchondral bone and infrapatellar fat pad may be encompassed in the process of degradation. This review presents the most recent reports on the contribution of adipocytokines to the knee joint cartilage degradation, osteophyte formation, infrapatellar fat pad alterations and synovitis.

  13. MR imaging reflects cartilage proteoglycan degradation in the rabbit knee joint

    International Nuclear Information System (INIS)

    Paul, P.K.; O'Byrne, E.M.; Blancuzzi, V.; Wilson, D.; Douglas, F.L.; Mezrich, R.S.

    1989-01-01

    Depletion of proteoglycan (PG) from articular cartilage is an early feature of osteoarthritis (OA). Noninvasive assessment of joint morphology corresponding to changes in cartilage PG is crucial for early diagnosis of OA and for demonstration of efficacy of drugs for OA. Intraarticular injection of papain causes a reversible loss of cartilage PG in intact joints. Both knees of NZW rabbits were scanned with a 1.5-T Signa MR imager with a 3-inch surface coil. A spin-echo technique was used, and coronal and sagittal MR images were obtained at 0, 24, 48, and 72 hours after injection of 5 U papain. An 8-cm field of view, a 3-mm section thickness, and a 128 x 256 matrix was used to obtain T1-, proton density-, and T2-weighted images. Cartilage was dissected from the femur for measurement of PG with 1,9-dimethylmethylene blue. Results are presented

  14. A CLINICAL STUDY OF ARTHROSCOPIC MANAGEMENT OF ANTERIOR C RUCIATE LIGAMENT INJURIES OF KNEE JOINT

    Directory of Open Access Journals (Sweden)

    Paragjyoti

    2015-09-01

    Full Text Available BACKGROUND : Anterior C ruciate L igament (ACL tear is a common sports injury of the knee. There are a lot of controversies related to the management of this injury and more than 2000 papers have been published on the various aspects of the topic. Arthroscopic reconstruction of the ACL with autogenous graft material is widely used nowadays. The two most commonly used grafts are the central one - third of the patellar ligament (bone - tendon - bone, BTB and the hamstring tendon ( S emitendinosus - gracilis, STG construct but the former graft leads to increased donor site morbidity & hurdles in postoperative rehab & pain. The aim of the study is to study the Arthroscopic management of anterior cruciate ligament injury of knee joint using quadrupled hamstring graft. METHOD: The study was carried out on 30 cases of anterior cruciate ligament injury of knee joint attending the OPD and emergency of department of Orthopaedics, Silchar Medical College & Hospital who met the inclusion criteria. An informed consent was obtained from each patient prior to participation in the study. All the patients were examined in detail and worked up to obtain pre - anaesthetic clearance. X - rays and MRI were done routinely in all the cases. Clinical and radiological parameters were recorded. Arthroscopic anterior cruciate ligament reconstruction with quadrupled hamstring graft was done in all the patients. Concomitant meniscal inju ries were treated according to the merit of the injury. Patients were followed up at regular intervals and outcome variables were assessed and recorded. RESULTS: Results of our study clearly showed that arthroscopic ACL reconstruction using quadrupled hamstring graft is a safe, effective and reproducible procedure in restoring knee function with minimal donor site morbidity. At follow up evaluation, all patients had good outcomes in terms of clinical stability, range of motion and general symptoms. CONCLUSION: From the results in this study

  15. Classification of Knee Joint Vibration Signals Using Bivariate Feature Distribution Estimation and Maximal Posterior Probability Decision Criterion

    Directory of Open Access Journals (Sweden)

    Fang Zheng

    2013-04-01

    Full Text Available Analysis of knee joint vibration or vibroarthrographic (VAG signals using signal processing and machine learning algorithms possesses high potential for the noninvasive detection of articular cartilage degeneration, which may reduce unnecessary exploratory surgery. Feature representation of knee joint VAG signals helps characterize the pathological condition of degenerative articular cartilages in the knee. This paper used the kernel-based probability density estimation method to model the distributions of the VAG signals recorded from healthy subjects and patients with knee joint disorders. The estimated densities of the VAG signals showed explicit distributions of the normal and abnormal signal groups, along with the corresponding contours in the bivariate feature space. The signal classifications were performed by using the Fisher’s linear discriminant analysis, support vector machine with polynomial kernels, and the maximal posterior probability decision criterion. The maximal posterior probability decision criterion was able to provide the total classification accuracy of 86.67% and the area (Az of 0.9096 under the receiver operating characteristics curve, which were superior to the results obtained by either the Fisher’s linear discriminant analysis (accuracy: 81.33%, Az: 0.8564 or the support vector machine with polynomial kernels (accuracy: 81.33%, Az: 0.8533. Such results demonstrated the merits of the bivariate feature distribution estimation and the superiority of the maximal posterior probability decision criterion for analysis of knee joint VAG signals.

  16. Repositioning the knee joint in human body FE models using a graphics-based technique.

    Science.gov (United States)

    Jani, Dhaval; Chawla, Anoop; Mukherjee, Sudipto; Goyal, Rahul; Vusirikala, Nataraju; Jayaraman, Suresh

    2012-01-01

    Human body finite element models (FE-HBMs) are available in standard occupant or pedestrian postures. There is a need to have FE-HBMs in the same posture as a crash victim or to be configured in varying postures. Developing FE models for all possible positions is not practically viable. The current work aims at obtaining a posture-specific human lower extremity model by reconfiguring an existing one. A graphics-based technique was developed to reposition the lower extremity of an FE-HBM by specifying the flexion-extension angle. Elements of the model were segregated into rigid (bones) and deformable components (soft tissues). The bones were rotated about the flexion-extension axis followed by rotation about the longitudinal axis to capture the twisting of the tibia. The desired knee joint movement was thus achieved. Geometric heuristics were then used to reposition the skin. A mapping defined over the space between bones and the skin was used to regenerate the soft tissues. Mesh smoothing was then done to augment mesh quality. The developed method permits control over the kinematics of the joint and maintains the initial mesh quality of the model. For some critical areas (in the joint vicinity) where element distortion is large, mesh smoothing is done to improve mesh quality. A method to reposition the knee joint of a human body FE model was developed. Repositions of a model from 9 degrees of flexion to 90 degrees of flexion in just a few seconds without subjective interventions was demonstrated. Because the mesh quality of the repositioned model was maintained to a predefined level (typically to the level of a well-made model in the initial configuration), the model was suitable for subsequent simulations.

  17. Intravoxel incoherent motion magnetic resonance imaging of the knee joint in children with juvenile idiopathic arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Hilbert, Fabian; Sauer, Alexander; Koestler, Herbert [University Hospital Wuerzburg, Department of Diagnostic and Interventional Radiology, Wuerzburg (Germany); Holl-Wieden, Annette [University Hospital Wuerzburg, Department of Paediatrics, Wuerzburg (Germany); Neubauer, Henning [University Hospital Wuerzburg, Department of Diagnostic and Interventional Radiology, Wuerzburg (Germany); University Hospital Ulm, Department of Diagnostic and Interventional Radiology, Ulm (Germany)

    2017-05-15

    MRI of synovitis relies on use of a gadolinium-based contrast agent. Diffusion-weighted MRI (DWI) visualises thickened synovium but is of limited use in the presence of joint effusion. To investigate the feasibility and diagnostic accuracy of diffusion-weighted MRI with intravoxel incoherent motion (IVIM) for diagnosing synovitis in the knee joint of children with juvenile idiopathic arthritis. Twelve consecutive children with confirmed or suspected juvenile idiopathic arthritis (10 girls, median age 11 years) underwent MRI with contrast-enhanced T1-weighted imaging and DWI at 1.5 T. Read-out segmented multi-shot DWI was acquired at b values of 0 s/mm{sup 2}, 200 s/mm{sup 2}, 400 s/mm{sup 2} and 800 s/mm{sup 2}. We calculated the IVIM parameters perfusion fraction (f) and tissue diffusion coefficient (D). Diffusion-weighted images at b=800 s/mm{sup 2}, f parameter maps and post-contrast T1-weighted images were retrospectively assessed by two independent readers for synovitis using the Juvenile Arthritis MRI Scoring system. Seven (58%) children showed synovial hypertrophy on contrast-enhanced imaging. Diagnostic ratings for synovitis on DWI and on f maps were fully consistent with contrast-enhanced imaging, the diagnostic reference. Two children had equivocal low-confidence assessments on DWI. Median f was 6.7±2.0% for synovitis, 2.1±1.2% for effusion, 5.0±1.0% for muscle and 10.6±5.7% for popliteal lymph nodes. Diagnostic confidence was higher based on f maps in three (25%) children and lower in one child (8%), as compared to DWI. DWI with IVIM reliably visualises synovitis of the knee joint. Perfusion fraction maps differentiate thickened synovium from joint effusion and hence increase diagnostic confidence. (orig.)

  18. Environmental Disruption of Circadian Rhythm Predisposes Mice to Osteoarthritis-Like Changes in Knee Joint

    Science.gov (United States)

    Voigt, Robin M; Ellman, Michael B; Summa, Keith C; Vitaterna, Martha Hotz; Keshavarizian, Ali; Turek, Fred W; Meng, Qing-Jun; Stein, Gary S.; van Wijnen, Andre J.; Chen, Di; Forsyth, Christopher B; Im, Hee-Jeong

    2015-01-01

    Circadian rhythm dysfunction is linked to many diseases, yet pathophysiological roles in articular cartilage homeostasis and degenerative joint disease including osteoarthritis (OA) remains to be investigated in vivo. Here, we tested whether environmental or genetic disruption of circadian homeostasis predisposes to OA-like pathological changes. Male mice were examined for circadian locomotor activity upon changes in the light:dark (LD) cycle or genetic disruption of circadian rhythms. Wild-type (WT) mice were maintained on a constant 12 hour:12 hour LD cycle (12:12 LD) or exposed to weekly 12 hour phase shifts. Alternatively, male circadian mutant mice (ClockΔ19 or Csnk1etau mutants) were compared with age-matched WT littermates that were maintained on a constant 12:12 LD cycle. Disruption of circadian rhythms promoted osteoarthritic changes by suppressing proteoglycan accumulation, upregulating matrix-degrading enzymes and downregulating anabolic mediators in the mouse knee joint. Mechanistically, these effects involved activation of the PKCδ-ERK-RUNX2/NFκB and β-catenin signaling pathways, stimulation of MMP-13 and ADAMTS-5, as well as suppression of the anabolic mediators SOX9 and TIMP-3 in articular chondrocytes of phase-shifted mice. Genetic disruption of circadian homeostasis does not predispose to OA-like pathological changes in joints. Our results, for the first time, provide compelling in vivo evidence that environmental disruption of circadian rhythms is a risk factor for the development of OA-like pathological changes in the mouse knee joint. PMID:25655021

  19. Quadriceps Activation Failure After Anterior Cruciate Ligament Rupture Is Not Mediated by Knee Joint Effusion

    Science.gov (United States)

    LYNCH, ANDREW D.; LOGERSTEDT, DAVID S.; AXE, MICHAEL J.; SNYDER-MACKLER, LYNN

    2013-01-01

    STUDY DESIGN Descriptive prospective cohort study. OBJECTIVES To investigate the relationships between knee joint effusion, quadriceps activation, and quadriceps strength. These relationships may help clinicians better identify impaired quadriceps activation. BACKGROUND After anterior cruciate ligament (ACL) injury, the involved quadriceps may demonstrate weakness. Experimental data have shown that quadriceps activation and strength may be directly mediated by intracapsular joint pressure created by saline injection. An inverse relationship between quadriceps activation and the amount of saline injected has been reported. This association has not been demonstrated for traumatic effusion. We hypothesized that traumatic joint effusion due to ACL rupture and postinjury quadriceps strength would correlate well with quadriceps activation, allowing clinicians to use effusion and strength measurement as a surrogate for electrophysiological assessment of quadriceps activation. METHODS Prospective data were collected on 188 patients within 100 days of ACL injury (average, 27 days) referred from a single surgeon. A complete clinical evaluation of the knee was performed, including ligamentous assessment and assessment of range of motion and effusion. Quadriceps function was electrophysiologically assessed using maximal volitional isometric contraction and burst superimposition techniques to quantify both strength and activation. RESULTS Effusion grade did not correlate with quadriceps central activation ratio (CAR) (zero effusion: mean ± SD CAR, 93.5% ± 5.8%; trace effusion: CAR, 93.8% ± 9.5%; 1+ effusion: CAR, 94.0% ± 7.5%; 2+/3+ effusion: CAR, 90.6% ± 11.1%). These values are lower than normative data from healthy subjects (CAR, 98% ± 3%). CONCLUSION Joint effusion after ACL injury does not directly mediate quadriceps activation failure seen after injury. Therefore, it should not be used as a clinical substitute for electrophysiological assessment of quadriceps

  20. Altered knee joint neuromuscular control during landing from a jump in 10-15year old children with Generalised Joint Hypermobility. A substudy of the CHAMPS-study Denmark

    DEFF Research Database (Denmark)

    Junge, Tina; Wedderkopp, Niels; Thorlund, Jonas Bloch

    2015-01-01

    Generalised Joint Hypermobility (GJH) is considered an intrinsic risk factor for knee injuries. Knee neuromuscular control during landing may be altered in GJH due to reduced passive stability. The aim was to identify differences in knee neuromuscular control during landing of the Single-Leg-Hop-...

  1. The effects of neuromuscular exercise on medial knee joint load post-arthroscopic partial medial meniscectomy: 'SCOPEX', a randomised control trial protocol

    DEFF Research Database (Denmark)

    Hall, Michelle; Hinman, Rana S; Wrigley, Tim V

    2012-01-01

    Meniscectomy is a risk factor for knee osteoarthritis, with increased medial joint loading a likely contributor to the development and progression of knee osteoarthritis in this group. Therefore, post-surgical rehabilitation or interventions that reduce medial knee joint loading have the potential...... to reduce the risk of developing or progressing osteoarthritis. The primary purpose of this randomised, assessor-blind controlled trial is to determine the effects of a home-based, physiotherapist-supervised neuromuscular exercise program on medial knee joint load during functional tasks in people who have...

  2. Knee and Hip Joint Kinematics Predict Quadriceps and Hamstrings Neuromuscular Activation Patterns in Drop Jump Landings.

    Directory of Open Access Journals (Sweden)

    Bart Malfait

    Full Text Available The purpose was to assess if variation in sagittal plane landing kinematics is associated with variation in neuromuscular activation patterns of the quadriceps-hamstrings muscle groups during drop vertical jumps (DVJ.Fifty female athletes performed three DVJ. The relationship between peak knee and hip flexion angles and the amplitude of four EMG vectors was investigated with trajectory-level canonical correlation analyses over the entire time period of the landing phase. EMG vectors consisted of the {vastus medialis(VM,vastus lateralis(VL}, {vastus medialis(VM,hamstring medialis(HM}, {hamstring medialis(HM,hamstring lateralis(HL} and the {vastus lateralis(VL,hamstring lateralis(HL}. To estimate the contribution of each individual muscle, linear regressions were also conducted using one-dimensional statistical parametric mapping.The peak knee flexion angle was significantly positively associated with the amplitudes of the {VM,HM} and {HM,HL} during the preparatory and initial contact phase and with the {VL,HL} vector during the peak loading phase (p<0.05. Small peak knee flexion angles were significantly associated with higher HM amplitudes during the preparatory and initial contact phase (p<0.001. The amplitudes of the {VM,VL} and {VL,HL} were significantly positively associated with the peak hip flexion angle during the peak loading phase (p<0.05. Small peak hip flexion angles were significantly associated with higher VL amplitudes during the peak loading phase (p = 0.001. Higher external knee abduction and flexion moments were found in participants landing with less flexed knee and hip joints (p<0.001.This study demonstrated clear associations between neuromuscular activation patterns and landing kinematics in the sagittal plane during specific parts of the landing. These findings have indicated that an erect landing pattern, characterized by less hip and knee flexion, was significantly associated with an increased medial and posterior

  3. A comprehensive joint replacement program for total knee arthroplasty: a descriptive study

    Directory of Open Access Journals (Sweden)

    Prefontaine Paul

    2008-11-01

    Full Text Available Abstract Background Total knee arthroplasty (TKA is a commonly performed surgical procedure in the US. It is important to have a comprehensive inpatient TKA program which maximizes outcomes while minimizing adverse events. The purpose of this study was to describe a TKA program – the Joint Replacement Program (JRP – and report post-surgical outcomes. Methods 74 candidates for a primary TKA were enrolled in the JRP. The JRP was designed to minimize complications and optimize patient-centered outcomes using a team approach including the patient, patient's family, and a multidisciplinary team of health professionals. The JRP consisted of a pre-operative class, standard pathways for medical care, comprehensive peri-operative pain management, aggressive physical therapy (PT, and proactive discharge planning. Measures included functional tests, knee range of motion (ROM, and medical record abstraction of patient demographics, length of stay, discharge disposition, and complications over a 6-month follow-up period. Results All patients achieved medical criteria for hospital discharge. The patients achieved the knee flexion ROM goal of 90° (91.7 ± 5.4°, but did not achieve the knee extension ROM goal of 0° (2.4 ± 2.6°. The length of hospital stay was two days for 53% of the patients, with 39% and 7% discharged in three and four days, respectively. All but three patients were discharged home with functional independence. 68% of these received outpatient physical therapy compared with 32% who received home physical therapy immediately after discharge. Two patients ( Conclusion The comprehensive JRP for TKA was associated with satisfactory clinical outcomes, short lengths of stay, a high percentage of patients discharged home with outpatient PT, and minimal complications. This JRP may represent an efficient, effective and safe protocol for providing care after a TKA.

  4. CT and MR imaging of the knee joint in the ''plica syndrome''

    International Nuclear Information System (INIS)

    Passariello, R.; Trecco, F.; De Paulis, F.; Masciocchi, C.; Zobel, B.B.; Buoni, C.

    1986-01-01

    ''Synovial plicae'' are present in 60% of adult knees and can be the cause of a nonspecific clinical picture known as the plica syndrome. Direct high-resolution CT and MR imaging were performed on 30 patients with serious clinical signs of plica syndrome. All patients underwent anthroscopy. Twelve infrapetallar, eight suprapatellar, and 22 medical synovial plicae were shown (in 12 cases two different plicae were present). In seven cases there were other associated lesions: one case of patellar tendinitis, three medial meniscus lesions, one lateral diskoid meniscus, and two patellar subluxations. The diagnostic accuracy of both CT and MR imaging were compared with arthroscopy. CT always showed the plicae and defined their types, locations, and associations with other lesions. MR imaging was superior to CT in characterizing the morphology of the plica (related with symptomatology) and in showing the femoral and patellar chondromalacia secondary to the plica itself. MR imaging was equally accurate in revealing the tendinitis and the patellar subluxations, but CT was superior in displaying the meniscal lesions and the diskoid meniscus

  5. Magnetic resonance tomography (MRT) of the knee joint: Meniscus, cruciate ligaments and hyaline cartilage. Magnetresonanztomographie (MRT) des Kniegelenks: Meniskus, Kreuzbaender und hyaliner Gelenkknorpel

    Energy Technology Data Exchange (ETDEWEB)

    Hodler, J. (Radiologie, Universitaetsspital, Zurich (Switzerland) Orthopaedische Universitaetsklinik Balgrist, Zurich (Switzerland). Radiologische Abt.); Buess, E. (Orthopaedische Universitaetsklinik Balgrist, Zurich (Switzerland)); Rodriguez, M. (Orthopaedische Universitaetsklinik Balgrist, Zurich (Switzerland)); Imhoff, A. (Orthopaedische Universitaetsklinik Balgrist, Zurich (Switzerland))

    1993-08-01

    The use of MRT for diagnosing injury to the meniscus, the cruciate ligaments and hyaline cartilage was evaluated retrospectively in 82 knee joints without any knowledge of operative findings. In 49 cases the results were verified by arthroscopy and in 33 cases by arthrotomy. Sensitivity, specificity and diagnostic accuracy of MRT for meniscus lesions was 73.9%, 96.9%, and 94.6%. Corresponding values for lesions of the anterior cruciate ligament were 88.9%, 96.6%, and 94.7%, and for lesions of the hyaline cartilage 62.6%, 96.1%, and 87.9%, respectively. In addition to its high specificity, MRT proved accurate in excluding lesions of the meniscus (97.1%) of the anterior cruciate ligament (96.6%) and of hyaline cartilage (88.8%). A negative finding on MRT therefore makes the presence of a lesion of the meniscus, cruciate ligaments of cartilage unlikely. In such cases one is justified in delaying the use of arthroscopy or arthrotomy. (orig.)

  6. Magnetostrictive energy generator for harvesting the rotation of human knee joint

    Directory of Open Access Journals (Sweden)

    Baiping Yan

    2018-05-01

    Full Text Available This paper presents the design and fabrication of a rotary-impact magnetostrictive energy generator, used to harvest the rotation of human knee joint. The harvester consists of twelve movable Terfenol-D rods, surrounded by the picked up coils respectively, and alternate permanent magnet (PM array sandwiched in each part of the shell. Rotational electromagnetic power generating effect and impacted magnetostrictive power generating effect are designed in the harvester. Modeling and simulation are used to validate the concept. Then, magnetic field and leakage of the harvester are analyzed, electromagnetic force in the harvester is simulated. A prototype of harvester is fabricated, and subjected to the experimental characterization. It can be concluded that huge induced voltage generated in the short-time impact situation and that induced voltage in the harvester can reach up to 60-80 volts at 0.91Hz low frequency rotation. Also, the presented harvester has good harvesting effects at low frequency human walking and periodic swing crus situation, which are suitable to be used for future researches of wearable knee joint applications.

  7. Biomechanical effects of robot assisted walking on knee joint kinematics and muscle activation pattern.

    Science.gov (United States)

    Thangavel, Pavithra; Vidhya, S; Li, Junhua; Chew, Effie; Bezerianos, Anastasios; Yu, Haoyong

    2017-07-01

    Since manual rehabilitation therapy can be taxing for both the patient and the physiotherapist, a gait rehabilitation robot has been built to reduce the physical strain and increase the efficacy of the rehabilitation therapy. The prototype of the gait rehabilitation robot is designed to provide assistance while walking for patients with abnormal gait pattern and it can also be used for rehabilitation therapy to restore an individual's normal gait pattern by aiding motor recovery. The Gait Rehabilitation Robot uses gait event based synchronization, which enables the exoskeleton to provide synchronous assistance during walking that aims to reduce the lower-limb muscle activation. This study emphasizes on the biomechanical effects of assisted walking on the lower limb by analyzing the EMG signal, knee joint kinematics data that was collected from the right leg during the various experimental conditions. The analysis of the measured data shows an improved knee joint trajectory and reduction in muscle activity with assistance. The result of this study does not only assess the functionality of the exoskeleton but also provides a profound understanding of the human-robot interaction by studying the effects of assistance on the lower limb.

  8. Biotribology of Cartilage Wear in Knee and Hip Joints Review of Recent Developments

    Science.gov (United States)

    Gulsen, Akdogan; Merve, Goncu; Meltem, Parlak

    2018-01-01

    Nowadays, the problem of wear in the knee and hip joints is an important issue that concerns many people and still requires new solutions. In recent years, researchers dealing with knee and hip articular cartilage erosion continue to investigate the subject in terms of biotribology. In this study, recent developments and studies in this relevant area are been examined. By using the basic principles of tribology, useful new methods that can be used in the field of biotribology can be produced. Artificial joints designed using various materials such as metals, ceramics, polymers and composites are still being studied. New studies in this area will affect the development of implant technology. Different alloys or composites are currently being tested for new implant designs. Moving implants with a risk of wear are tested in laboratory conditions in simulator devices before they are used in the human body. Major topics such as nanotechnology, tissue engineering, orthopedics, tribology, biotribology, lubrication, organ transplantation and artificial organs, which are still important today, will be useful in the search for finding suitable solutions in the future in biotribological studies. This review article aims to provide an overview of in-vitro studies at the theoretical and laboratory conditions that must be performed prior to clinical investigation.

  9. Magnetostrictive energy generator for harvesting the rotation of human knee joint

    Science.gov (United States)

    Yan, Baiping; Zhang, Chengming; Li, Liyi

    2018-05-01

    This paper presents the design and fabrication of a rotary-impact magnetostrictive energy generator, used to harvest the rotation of human knee joint. The harvester consists of twelve movable Terfenol-D rods, surrounded by the picked up coils respectively, and alternate permanent magnet (PM) array sandwiched in each part of the shell. Rotational electromagnetic power generating effect and impacted magnetostrictive power generating effect are designed in the harvester. Modeling and simulation are used to validate the concept. Then, magnetic field and leakage of the harvester are analyzed, electromagnetic force in the harvester is simulated. A prototype of harvester is fabricated, and subjected to the experimental characterization. It can be concluded that huge induced voltage generated in the short-time impact situation and that induced voltage in the harvester can reach up to 60-80 volts at 0.91Hz low frequency rotation. Also, the presented harvester has good harvesting effects at low frequency human walking and periodic swing crus situation, which are suitable to be used for future researches of wearable knee joint applications.

  10. Effects of pulsed mid-IR lasers on bovine knee joint tissues

    Science.gov (United States)

    Vari, Sandor G.; Shi, Wei-Qiang; Pergadia, Vani R.; Duffy, J. T.; Miller, J. M.; van der Veen, Maurits J.; Weiss, Andrew B.; Fishbein, Michael C.; Grundfest, Warren S.

    1993-07-01

    We investigated the effect of varying Tm:YAG (2.014 micrometers ) and Ho:YAG (2.130 micrometers ) laser parameters on ablation rate and consequent thermal damage. Mid-infrared wavelengths are strongly absorbed by most biological tissues due to the tissue's high water content. The ablation rate of fresh bovine knee joint tissues (fibrous cartilage, hyaline cartilage, and bone) in saline was assessed as a function of radiant exposure (160 - 950 J/cm2), at pulse widths of 200 microsecond(s) ec for Tm:YAG and 250 microsecond(s) ec for Ho:YAG and a repetition rate of 2 Hz. All tissues used in this study could be efficiently ablated using two micron lasers. The mechanism of action is likely related to the formation and collapse of cavitation bubbles, associated with mid-infrared lasers. We concluded that the Tm:YAG and Ho:YAG lasers are capable of effective knee joint tissue ablation.

  11. Precision analysis of a multi-slice ultrasound sensor for non-invasive 3D kinematic analysis of knee joints.

    Science.gov (United States)

    Masum, Md Abdullah; Lambert, Andrew J; Pickering, Mark R; Scarvell, J M; Smith, P N

    2012-01-01

    Currently the standard clinical practice for measuring the motion of bones in a knee joint with sufficient precision involves implanting tantalum beads into the bones to act as fiducial markers prior to imaging using X-ray equipment. This procedure is invasive in nature and exposure to ionizing radiation imposes a cancer risk and the patient's movements are confined to a narrow field of view. In this paper, an ultrasound based system for non-invasive kinematic evaluation of knee joints is proposed. The results of an initial analysis show that this system can provide the precision required for non-invasive motion analysis while the patient performs normal physical activities.

  12. Tears of anterior cruciate ligament and associated injury in the knee joint: MR imaging

    International Nuclear Information System (INIS)

    Kim, Eui Jong; Ryu, Kyung Nam; Ahn, Jin Whan; Yoon, Yup

    1994-01-01

    The objective of the study was to evaluate the characteristic findings in tears of the anterior cruciate ligament(ACL) and associated injury at MR imaging. We reviewed the findings of MR images and the corresponding arthroscopic results of 32 patients with ACL tears. We evaluat