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Sample records for lysholm knee scoring

  1. Questionário específico para sintomas do joelho "Lysholm Knee Scoring Scale": tradução e validação para a língua portuguesa Specific questionnaire for knee symptoms - the "Lysholm Knee Scoring Scale": translation and validation into Portuguese

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    Maria Stella Peccin

    2006-01-01

    Full Text Available As doenças do joelho apresentam conseqüências variadas para a função e a qualidade de vida do indivíduo. Para traduzir, validar e verificar as propriedades de medida do questionário específico para sintomas do joelho "Lysholm Knee Scoring Scale" para a língua portuguesa, selecionamos, por conveniência, 50 pacientes (29 homens e 21 mulheres, média de idade 38,7 anos com lesão de joelho (lesão meniscal, lesão do ligamento cruzado anterior, condromalácia ou artrose. A reprodutibilidade e a concordância ordinal inter e intra-entrevistador foram excelentes (alfa = 0,9. A concordância nominal inter-entrevistadores foi boa (Kappa = 0,7 e intra-entrevistador, excelente (Kappa = 0,8. No processo de validação, correlacionamos o questionário Lysholm com a escala numérica da dor (r=-0,6; p=0,001 e com o índice de Lequesne (r= -0,8; p=0,001. As correlações entre o Lysholm e a avaliação global da saúde pelo paciente e pelo terapeuta apresentaram-se fracas e não significantes. As correlações entre o questionário Lysholm e o SF-36 foram significantes nos aspectos físicos (r = 0,4; p = 0,04, de dor (r = 0,5; p = 0,001 e de capacidade funcional (r = 0,7; p = 0,0001. Concluímos que a tradução e adaptação cultural do "Lysholm knee scoring scale" para o nosso idioma apresentou reprodutibilidade e validade em pacientes com lesão meniscal, lesão do ligamento cruzado anterior, condromalácia ou artrose do joelho.Knee diseases present variable consequences for an individual’s function and quality of life. For the purposes of translating, validating and checking the measurement properties of the specific questionnaire for knee symptoms - the "Lysholm Knee Scoring Scale" - into Portuguese, we selected, for convenience, 50 patients (29 males and 21 females, mean age = 38.7 years with knee injuries (meniscal injury, anterior cruciate ligament injury, chondromalacia or arthrosis. Reproducibility and ordinal consistency inter- and

  2. Cross-cultural translation of the Lysholm knee score in Chinese and its validation in patients with anterior cruciate ligament injury.

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    Wang, W; Liu, L; Chang, X; Jia, Z Y; Zhao, J Z; Xu, W D

    2016-10-19

    The Lysholm Knee Score (LKS) is widely used and is one of the most effective questionnaires employed to assess knee injuries. Although LKS has been translated into multiple languages, there is no Chinese version even though China has the largest population of patients with knee-joint injuries. The objective of our study was to develop the Chinese version of LKS (C-LKS) and assess its reliability, validity and responsiveness in Chinese patients with anterior cruciate ligament (ACL) injuries. Study participants were mainly recruited among patients with ACL injuries scheduled for arthroscopic ACL reconstruction at our hospital. First, we developed the C-LKS in a five-step translation and cross-cultural adaptation procedure. Next, we calculated the Cronbach's alpha, intraclass correlation coefficient (ICC), Pearson's correlation coefficient (r), effect size (ES), and standardized response mean (SRM) to evaluate the reliability, validity, and responsiveness of C-LKS respectively. Overall, 126 patients with ACL injuries successfully completed the questionnaires. Acceptable internal consistency (Cronbach's alpha = 0.726) as well as excellent test-retest reliability (ICC = 0.935) was found for C-LKS. Good or moderate correlation (r = 0.514-0.837) was determined among C-LKS and International Knee Documentation Committee Subjective Knee Form (IKDC), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), physical subscales of SF-36; C-LKS also had fair or moderate correlation (r = 0.207-0.462) with the other subscales of SF-36, which adequately illustrated that good validity was included in C-LKS. In addition, good responsiveness was also observed in C-LKS (ES = 1.36,SRM = 1.26). We have shown that our developed C-LKS questionnaire is reliable, valid and responsible for the evaluation of Chinese-speaking patients with ACL injuries and it would be an effective instrument.

  3. Análise do protocolo funcional de Lysholm modificado em pacientes com joelhos normais Analysis on the modified Lysholm functional protocol among patients with normal knees

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    Rodrigo Pires e Albuquerque

    2011-01-01

    range was from 16 to 40 years, with an average of 28.8 years. Our study group consisted of 153 males and 147 females. In the modified Lysholm system, the maximum score is 100 points and this includes functional and objective criteria. Altogether, 50% of the total score is based on symptoms of pain and instability. RESULTS: The average score using the Lysholm protocol was 95 points in the knees that were considered normal. Males had higher scores than females. CONCLUSION: These patients with knees that were considered normal did not achieve the maximum score when evaluated using the modified Lysholm protocol. This study suggests that this line of research on functional evaluation systems for the knee is open for further evaluations. Moreover, creation and development of new forms of functional assessment for the knee should be investigated in order to achieve a worldwide consensus.

  4. An ultrasound score for knee osteoarthritis

    DEFF Research Database (Denmark)

    Riecke, B F; Christensen, R.; Torp-Pedersen, S

    2014-01-01

    OBJECTIVE: To develop standardized musculoskeletal ultrasound (MUS) procedures and scoring for detecting knee osteoarthritis (OA) and test the MUS score's ability to discern various degrees of knee OA, in comparison with plain radiography and the 'Knee injury and Osteoarthritis Outcome Score' (KOOS......) domains as comparators. METHOD: A cross-sectional study of MUS examinations in 45 patients with knee OA. Validity, reliability, and reproducibility were evaluated. RESULTS: MUS examination for knee OA consists of five separate domains assessing (1) predominantly morphological changes in the medial...... coefficients ranging from 0.75 to 0.97 for the five domains. Construct validity was confirmed with statistically significant correlation coefficients (0.47-0.81, P knee OA. In comparison with standing radiographs...

  5. Knee Injury and Osteoarthritis Outcome Score (KOOS)

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    Collins, N J; Prinsen, C A C; Christensen, R

    2016-01-01

    OBJECTIVE: To conduct a systematic review and meta-analysis to synthesize evidence regarding measurement properties of the Knee injury and Osteoarthritis Outcome Score (KOOS). DESIGN: A comprehensive literature search identified 37 eligible papers evaluating KOOS measurement properties in partici......OBJECTIVE: To conduct a systematic review and meta-analysis to synthesize evidence regarding measurement properties of the Knee injury and Osteoarthritis Outcome Score (KOOS). DESIGN: A comprehensive literature search identified 37 eligible papers evaluating KOOS measurement properties...... in participants with knee injuries and/or osteoarthritis (OA). Methodological quality was evaluated using the COSMIN checklist. Where possible, meta-analysis of extracted data was conducted for all studies and stratified by age and knee condition; otherwise narrative synthesis was performed. RESULTS: KOOS has...... adequate internal consistency, test-retest reliability and construct validity in young and old adults with knee injuries and/or OA. The ADL subscale has better content validity for older patients and Sport/Rec for younger patients with knee injuries, while the Pain subscale is more relevant for painful...

  6. Quadriceps strength and anterior knee pain following tibia ...

    African Journals Online (AJOL)

    The tension generated on extension of the knee against a resistance using tensiometer was measured in Newton. The ranges of motion of the knees were documented, as well as Lysholm score which measures activities and document the presence and limitation caused by anterior knee pain. Results: A total of 36 patients ...

  7. The Knee injury and Osteoarthritis Outcome Score (KOOS)

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    Roos, Ewa M.; Lohmander, L Stefan

    2003-01-01

    The Knee injury and Osteoarthritis Outcome Score (KOOS) was developed as an extension of the WOMAC Osteoarthritis Index with the purpose of evaluating short-term and long-term symptoms and function in subjects with knee injury and osteoarthritis. The KOOS holds five separately scored subscales...... be used for short-term and long-term follow-up of several types of knee injury including osteoarthritis. The measure is relatively new and further use of the instrument will add knowledge and suggest areas that need to be further explored and improved....

  8. Poor WOMAC scores in contralateral knee negatively impact TKA outcomes: data from the osteoarthritis initiative.

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    Kahn, Timothy L; Soheili, Aydin C; Schwarzkopf, Ran

    2014-08-01

    While total knee arthroplasty (TKA) has been shown to have excellent outcomes, a significant proportion of patients experience relatively poor post-operative function. In this study, we test the hypothesis that the level of osteoarthritic symptoms in the contralateral knee at the time of TKA is associated with poorer post-operative outcomes in the operated knee. Using longitudinal cohort data from the Osteoarthritis Initiative (OAI), we included 171 patients who received a unilateral TKA. We compared pre-operative Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores in the contralateral knee to post-operative WOMAC scores in the index knee. Pre-operative contralateral knee WOMAC scores were associated with post-operative index knee WOMAC Total scores, indicating that the health of the pre-operative contralateral knee is a significant factor in TKA outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Psychosocial and demographic factors influencing pain scores of patients with knee osteoarthritis.

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    Eberly, Lauren; Richter, Dustin; Comerci, George; Ocksrider, Justin; Mercer, Deana; Mlady, Gary; Wascher, Daniel; Schenck, Robert

    2018-01-01

    Pain levels in patients with osteoarthritis (OA) of the knee are commonly assessed by using a numeric scoring system, but results may be influenced by factors other than the patient's actual physical discomfort or disease severity, including psychosocial and demographic variables. We examined the possible relation between knee-pain scores and several psychosocial, sociodemographic, disease, and treatment variables in 355 patients with knee OA. The pain-evaluation instrument was a 0- to 10-point rating scale. Data obtained retrospectively from the patients' medical records were demographic characteristics, body mass index (BMI), concomitant disorders, illicit and prescription drug use, alcohol use, smoking, knee OA treatment, and severity of knee OA indicated by Kellgren-Lawrence (KL) radiographic grade. Univariate and multivariate analyses were performed to determine whether these variables correlated with reported pain scores. On univariate analysis, higher pain scores were significantly associated with Native American or Hispanic ethnicity; a higher BMI; current prescription for an opioid, antidepressant, or gabapentinoid medication; depression; diabetes mellitus; fibromyalgia; illicit drug use; lack of health insurance; smoking; previous knee injection; and recommendation by the clinician that the patient undergo knee surgery. Neither the patient's sex nor the KL grade showed a correlation. On multivariate analysis, depression, current opioid prescription, and Native American or Hispanic ethnicity retained a significant association with higher pain scores. Our results in a large, ethnically diverse group of patients with knee OA suggest that psychosocial and sociodemographic factors may be important determinants of pain levels reported by patients with knee OA.

  10. Negative emotions affect postoperative scores for evaluating functional knee recovery and quality of life after total knee replacement

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    A. Qi

    2016-01-01

    Full Text Available This study aimed to determine whether psychological factors affect health-related quality of life (HRQL and recovery of knee function in total knee replacement (TKR patients. A total of 119 TKR patients (male: 38; female: 81 completed the Beck Anxiety Inventory (BAI, Beck Depression Inventory (BDI, State Trait Anxiety Inventory (STAI, Eysenck Personality Questionnaire-revised (EPQR-S, Knee Society Score (KSS, and HRQL (SF-36. At 1 and 6 months after surgery, anxiety, depression, and KSS scores in TKR patients were significantly better compared with those preoperatively (P<0.05. SF-36 scores at the sixth month after surgery were significantly improved compared with preoperative scores (P<0.001. Preoperative Physical Component Summary Scale (PCS and Mental Component Summary Scale (MCS scores were negatively associated with extraversion (E score (B=-0.986 and -0.967, respectively, both P<0.05. Postoperative PCS and State Anxiety Inventory (SAI scores were negatively associated with neuroticism (N score; B=-0.137 and -0.991, respectively, both P<0.05. Postoperative MCS, SAI, Trait Anxiety Inventory (TAI, and BAI scores were also negatively associated with the N score (B=-0.367, -0.107, -0.281, and -0.851, respectively, all P<0.05. The KSS function score at the sixth month after surgery was negatively associated with TAI and N scores (B=-0.315 and -0.532, respectively, both P<0.05, but positively associated with the E score (B=0.215, P<0.05. The postoperative KSS joint score was positively associated with postoperative PCS (B=0.356, P<0.05. In conclusion, for TKR patients, the scores used for evaluating recovery of knee function and HRQL after 6 months are inversely associated with the presence of negative emotions.

  11. Crosscultural Adaptation and Validation of the Korean Version of the New Knee Society Knee Scoring System.

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    Kim, Seok Jin; Basur, Mohnish Singh; Park, Chang Kyu; Chong, Suri; Kang, Yeon Gwi; Kim, Moon Ju; Jeong, Jeong Seong; Kim, Tae Kyun

    2017-06-01

    The 2011 Knee Society Score © (2011 KS Score © ) is used to characterize the expectations, symptoms, physical activity, and satisfaction of patients who undergo TKA and is widely used to assess the outcome of TKA. However, it has not been adapted or validated for use in Korea. We developed a Korean version of the 2011 KS Score and evaluated the (1) test-retest reliability, (2) convergent validity, and (3) responsiveness of the Korean version. The Korean version of the 2011 KS Score was derived by using a well-established translational procedure based on international guidelines, which include translation, synthesis, back-translation, expert committee review, pretesting, and submission for appraisal. A total of 123 patients with knee osteoarthritis who were scheduled to undergo TKA were recruited for the study. Ninety percent of the patients (111 of 123) were women, which is an exact representation of the Korean population having TKAs. To evaluate reliability, the patients were evaluated twice during a 4-week interval using the questionnaire. Reliability was assessed by using intraclass correlation coefficients (ICCs) and internal consistency by using Cronbach's alpha to determine the validity of the Korean version of the 2011 KS Score. The patients were evaluated by using the validated Korean versions of the WOMAC and SF-36 questionnaires. Spearman's correlation coefficient was used for validation. Responsiveness was determined by calculating the standardized response mean from the preoperative and postoperative test scores in the Korean version of the 2011 KS Score. To address the gender disparity in our study we identified 53 males who underwent TKA for osteoarthritis after completion of this study and generated age-matched controlled groups to evaluate construct validity and responsiveness in Korean males. The reliability proved good to excellent with an ICC between 0.69 and 0.85, depending on the clinical properties tested, which included the following

  12. Translation and validation of the new version of the Knee Society Score - The 2011 KS Score - into Brazilian Portuguese.

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    Silva, Adriana Lucia Pastore E; Croci, Alberto Tesconi; Gobbi, Riccardo Gomes; Hinckel, Betina Bremer; Pecora, José Ricardo; Demange, Marco Kawamura

    2017-01-01

    Translation, cultural adaptation, and validation of the new version of the Knee Society Score - The 2011 KS Score - into Brazilian Portuguese and verification of its measurement properties, reproducibility, and validity. In 2012, the new version of the Knee Society Score was developed and validated. This scale comprises four separate subscales: (a) objective knee score (seven items: 100 points); (b) patient satisfaction score (five items: 40 points); (c) patient expectations score (three items: 15 points); and (d) functional activity score (19 items: 100 points). A total of 90 patients aged 55-85 years were evaluated in a clinical cross-sectional study. The pre-operative translated version was applied to patients with TKA referral, and the post-operative translated version was applied to patients who underwent TKA. Each patient answered the same questionnaire twice and was evaluated by two experts in orthopedic knee surgery. Evaluations were performed pre-operatively and three, six, or 12 months post-operatively. The reliability of the questionnaire was evaluated using the intraclass correlation coefficient (ICC) between the two applications. Internal consistency was evaluated using Cronbach's alpha. The ICC found no difference between the means of the pre-operative, three-month, and six-month post-operative evaluations between sub-scale items. The Brazilian Portuguese version of The 2011 KS Score is a valid and reliable instrument for objective and subjective evaluation of the functionality of Brazilian patients who undergo TKA and revision TKA.

  13. Knee injury and Osteoarthritis Outcome Score (KOOS – validation and comparison to the WOMAC in total knee replacement

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    Roos Ewa M

    2003-05-01

    Full Text Available Abstract Background The Knee injury and Osteoarthritis Outcome Score (KOOS is an extension of the Western Ontario and McMaster Universities Osteoarthrtis Index (WOMAC, the most commonly used outcome instrument for assessment of patient-relevant treatment effects in osteoarthritis. KOOS was developed for younger and/or more active patients with knee injury and knee osteoarthritis and has in previous studies on these groups been the more responsive instrument compared to the WOMAC. Some patients eligible for total knee replacement have expectations of more demanding physical functions than required for daily living. This encouraged us to study the use of the Knee injury and Osteoarthritis Outcome Score (KOOS to assess the outcome of total knee replacement. Methods We studied the test-retest reliability, validity and responsiveness of the Swedish version LK 1.0 of the KOOS when used to prospectively evaluate the outcome of 105 patients (mean age 71.3, 66 women after total knee replacement. The follow-up rates at 6 and 12 months were 92% and 86%, respectively. Results The intraclass correlation coefficients were over 0.75 for all subscales indicating sufficient test-retest reliability. Bland-Altman plots confirmed this finding. Over 90% of the patients regarded improvement in the subscales Pain, Symptoms, Activities of Daily Living, and knee-related Quality of Life to be extremely or very important when deciding to have their knee operated on indicating good content validity. The correlations found in comparison to the SF-36 indicated the KOOS measured expected constructs. The most responsive subscale was knee-related Quality of Life. The effect sizes of the five KOOS subscales at 12 months ranged from 1.08 to 3.54 and for the WOMAC from 1.65 to 2.56. Conclusion The Knee injury and Osteoarthritis Outcome Score (KOOS is a valid, reliable, and responsive outcome measure in total joint replacement. In comparison to the WOMAC, the KOOS improved validity

  14. Associations of anatomical measures from MRI with radiographically defined knee osteoarthritis score, pain, and physical functioning.

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    Sowers, Maryfran; Karvonen-Gutierrez, Carrie A; Jacobson, Jon A; Jiang, Yebin; Yosef, Matheos

    2011-02-02

    The prevalence of knee osteoarthritis is traditionally based on radiographic findings, but magnetic resonance imaging is now being used to provide better visualization of bone, cartilage, and soft tissues as well as the patellar compartment. The goal of this study was to estimate the prevalences of knee features defined on magnetic resonance imaging in a population and to relate these abnormalities to knee osteoarthritis severity scores based on radiographic findings, physical functioning, and reported knee pain in middle-aged women. Magnetic resonance images of the knee were evaluated for the location and severity of cartilage defects, bone marrow lesions, osteophytes, subchondral cysts, meniscal and/or ligamentous tears, effusion, and synovitis among 363 middle-aged women (724 knees) from the Michigan Study of Women's Health Across the Nation. These findings were related to Kellgren-Lawrence osteoarthritis severity scores from radiographs, self-reported knee pain, self-reported knee injury, perception of physical functioning, and physical performance measures to assess mobility. Radiographs, physical performance assessment, and interviews were undertaken at the 1996 study baseline and again (with the addition of magnetic resonance imaging assessment) at the follow-up visit during 2007 to 2008. The prevalence of moderate-to-severe knee osteoarthritis changed from 3.7% at the baseline assessment to 26.7% at the follow-up visit eleven years later. Full-thickness cartilage defects of the medial, lateral, and patellofemoral compartments were present in 14.5% (105 knees), 4.6% (thirty-three knees), and 26.2% (190 knees), respectively. Synovitis was identified in 24.7% (179) of the knees, and joint effusions were observed in 70% (507 knees); 21.7% (157) of the knees had complex or macerated meniscal tears. Large osteophytes, marked synovitis, macerated meniscal tears, and full-thickness tibial cartilage defects were associated with increased odds of knee pain and with

  15. [Multiple linear regression analysis of X-ray measurement and WOMAC scores of knee osteoarthritis].

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    Ma, Yu-Feng; Wang, Qing-Fu; Chen, Zhao-Jun; Du, Chun-Lin; Li, Jun-Hai; Huang, Hu; Shi, Zong-Ting; Yin, Yue-Shan; Zhang, Lei; A-Di, Li-Jiang; Dong, Shi-Yu; Wu, Ji

    2012-05-01

    To perform Multiple Linear Regression analysis of X-ray measurement and WOMAC scores of knee osteoarthritis, and to analyze their relationship with clinical and biomechanical concepts. From March 2011 to July 2011, 140 patients (250 knees) were reviewed, including 132 knees in the left and 118 knees in the right; ranging in age from 40 to 71 years, with an average of 54.68 years. The MB-RULER measurement software was applied to measure femoral angle, tibial angle, femorotibial angle, joint gap angle from antero-posterir and lateral position of X-rays. The WOMAC scores were also collected. Then multiple regression equations was applied for the linear regression analysis of correlation between the X-ray measurement and WOMAC scores. There was statistical significance in the regression equation of AP X-rays value and WOMAC scores (Pregression equation of lateral X-ray value and WOMAC scores (P>0.05). 1) X-ray measurement of knee joint can reflect the WOMAC scores to a certain extent. 2) It is necessary to measure the X-ray mechanical axis of knee, which is important for diagnosis and treatment of osteoarthritis. 3) The correlation between tibial angle,joint gap angle on antero-posterior X-ray and WOMAC scores is significant, which can be used to assess the functional recovery of patients before and after treatment.

  16. Oxford Knee Score: cross-cultural adaptation and validation of the Turkish version in patients with osteoarthritis of the knee.

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    Tuğay, Baki Umut; Tuğay, Nazan; Güney, Hande; Kınıklı, Gizem İrem; Yüksel, İnci; Atilla, Bülent

    2016-01-01

    The Oxford Knee Score (OKS) is a valid, short, self-administered, and site- specific outcome measure specifically developed for patients with knee arthroplasty. This study aimed to cross-culturally adapt and validate the OKS to be used in Turkish-speaking patients with osteoarthritis of the knee. The OKS was translated and culturally adapted according to the guidelines in the literature. Ninety-one patients (mean age: 55.89±7.85 years) with knee osteoarthritis participated in the study. Patients completed the Turkish version of the Oxford Knee Score (OKS-TR), Short-Form 36 Health Survey (SF-36), and Western Ontario and McMaster Universities Index (WOMAC) questionnaires. Internal consistency was tested using Cronbach's α coefficient. Patients completed the OKS-TR questionnaire twice in 7 days to determine the reproducibility. Correlation between the total results of both tests was determined by Spearman's correlation coefficient and intraclass correlation coefficients (ICC). Validity was assessed by calculating Spearman's correlation coefficient between the OKS, WOMAC, and SF-36 scores. Floor and ceiling effects were analyzed. Internal consistency was high (Cronbach's α: 0.90). The reproducibility tested by 2 different methods showed no significant difference (p>0.05). The construct validity analyses showed a significant correlation between the OKS and the other scores (p<0.05). There was no floor or ceiling effect in total OKS score. The OKS-TR is a reliable and valid measure for the self-assessment of pain and function in Turkish-speaking patients with osteoarthritis of the knee.

  17. Validation of a prediction model that allows direct comparison of the Oxford Knee Score and American Knee Society clinical rating system.

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    Maempel, J F; Clement, N D; Brenkel, I J; Walmsley, P J

    2015-04-01

    This study demonstrates a significant correlation between the American Knee Society (AKS) Clinical Rating System and the Oxford Knee Score (OKS) and provides a validated prediction tool to estimate score conversion. A total of 1022 patients were prospectively clinically assessed five years after TKR and completed AKS assessments and an OKS questionnaire. Multivariate regression analysis demonstrated significant correlations between OKS and the AKS knee and function scores but a stronger correlation (r = 0.68, p Society of Bone & Joint Surgery.

  18. Cross-Cultural Adaptation and Validation of the Persian Version of the Oxford Knee Score in Patients with Knee Osteoarthritis

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    Mohammad Hosein Ebrahimzadeh

    2014-11-01

    Full Text Available Background: The Oxford Knee Score (OKS is a short patient-reported outcome instrument that measures pain and physical activity related to knee osteoarthritis. The purpose of this study is to evaluate, construct validity and consistent reliability of the Persian version of the OKS. Methods: The case series consisted of 80 patients who were clinically diagnosed with having knee osteoarthritis. All patients were requested to fill-in the Persian OKS and Short-Form 36 Health Survey (SF-36. Correlation analysis between the Persian versions of these two instruments was then carried out. The scores of the Persian SF-36 were used to evaluate convergent and divergent validity of the 12-item Persian OKS. Results: From a total of 80 patients, 63 were female (79% and the remaining 17 were male (21% with a mean age of 52.2 years. In the present study, high Cronbach’s alpha of 0.95 confirms excellent internal consistency of the Persian OKS scale similar to previous investigations. The results confirm that the Persian version of this instrument is valid and reliable, similar to its English index and its subsequent translations in different languages. Conclusion: The Persian OKS is a reliable instrument to evaluate knee function in patients with knee osteoarthritis and is a useful tool for outcome measurement in clinical research.

  19. Cross-cultural adaptation and validation of the persian version of the oxford knee score in patients with knee osteoarthritis.

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    Ebrahimzadeh, Mohammad Hosein; Makhmalbaf, Hadi; Birjandinejad, Ali; Soltani-Moghaddas, Seyed Hosein

    2014-11-01

    The Oxford Knee Score (OKS) is a short patient-reported outcome instrument that measures pain and physical activity related to knee osteoarthritis. The purpose of this study is to evaluate, construct validity and consistent reliability of the Persian version of the OKS. The case series consisted of 80 patients who were clinically diagnosed with having knee osteoarthritis. All patients were requested to fill-in the Persian OKS and Short-Form 36 Health Survey (SF-36). Correlation analysis between the Persian versions of these two instruments was then carried out. The scores of the Persian SF-36 were used to evaluate convergent and divergent validity of the 12-item Persian OKS. From a total of 80 patients, 63 were female (79%) and the remaining 17 were male (21%) with a mean age of 52.2 years. In the present study, high Cronbach's alpha of 0.95 confirms excellent internal consistency of the Persian OKS scale similar to previous investigations. The results confirm that the Persian version of this instrument is valid and reliable, similar to its English index and its subsequent translations in different languages. The Persian OKS is a reliable instrument to evaluate knee function in patients with knee osteoarthritis and is a useful tool for outcome measurement in clinical research.

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

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

    2011-07-01

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

  1. Translation and Validation of the Korean Version of the International Knee Documentation Committee Subjective Knee Form

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    Kim, Jin Goo; Lee, Joong Yub; Seo, Seung Suk; Choi, Choong Hyeok; Lee, Myung Chul

    2013-01-01

    Purpose To perform a cross-cultural adaptation and to test the measurement properties of the Korean version of International Knee Documentation Committee (K-IKDC) Subjective Knee Form. Materials and Methods According to the guidelines for cross-cultural adaptation, translation and backward translation of the English version of the IKDC Subjective Knee Form were performed. After translation into the Korean version, 150 patients who had knee-related problems were asked to complete the K-IKDC, Lysholm score, and Short Form-36 (SF-36). Of these patients, 126 were retested 2 weeks later to evaluate test-retest reliability, and 104 were recruited 3 months later to evaluate responsiveness. Construct validity was analyzed by investigating the correlation with Lysholm score and SF-36; content validity was also evaluated. Standardized mean response was calculated for evaluating responsiveness. Results The test-retest reliability proved excellent with a high value for the intraclass correlation coefficient (r=0.94). The internal consistency was strong (Cronbach's α=0.91). Good content validity with absence of floor not ceiling effects and good convergent and divergent validity were observed. Moderate responsiveness was shown (standardized mean response=0.689). Conclusions The K-IKDC demonstrated good measurement properties. We suggest that this instrument is an excellent evaluation instrument that can be used for Korean patients with knee-related injuries. PMID:24032098

  2. Use of the KineSpring system in the treatment of medial knee osteoarthritis: preliminary results.

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    Madonna, Vincenzo; Condello, Vincenzo; Piovan, Gianluca; Screpis, Daniele; Zorzi, Claudio

    2015-01-01

    the purpose of this study was to analyze our preliminary results obtained with the KineSpring system in patients suffering from medial compartment knee osteoarthritis (OA). between September 2012 and May 2014, 53 patients underwent treatment with the KineSpring system. Patient self-assessment was performed pre-operatively and at 3, 6 and 12 months postoperatively, and included the KOOS, Tegner activity score, Lysholm functional knee score, VAS knee pain score, and IKDC score. Device- and procedure-related adverse events were recorded. mean KOOS subscales, except for the Sport/Recreation subscale at six months, improved over time. Mean WOMAC Pain and Function domains, Lysholm score, IKDC score and VAS knee pain score improved over the follow-up period and were significantly improved at 3, 6 and 12 months postoperatively compared to baseline. Mean Tegner score improved slightly over time. In 5 of the 53 (9.4%) patients re-operation was necessary. In 3 patients the device was removed due to infection (one case) or persistent knee pain (two cases). Surgical arthrolysis was performed in two patients. in our preliminary experience, the KineSpring system gave good short-term clinical results. Level IV, therapeutic case series.

  3. Intra- and inter-rater reliability of the Knee Society Knee Score when used by two physiotherapists in patients post total knee arthroplasty

    Directory of Open Access Journals (Sweden)

    S. Gopal

    2010-01-01

    Full Text Available Background and Purpose: It has yet to be shown whether routine physiotherapy plays a role in the rehabilitation of patients post totalknee arthroplasty (Rajan et al 2004. Physiotherapists should be using validoutcome measures to provide evidence of the benefit of their intervention. The aim of this study was to establish the intra and inter-rater reliability of the Knee Society Knee Score, a scoring system developed by Insall et al(1989. The Knee Society Knee Score can be used to assess the integrity of theknee joint of patients undergoing total knee arthroplasty. Since the scoreinvolves clinical testing, the intra-rater reliability of the clinician should be established prior to using the scores as datain clinical research. W here multiple clinicians are involved, inter-rater reliability should also be established.Design: This was a correlation study.Subjects: A  sample of thirty patients post total knee arthroplasty attending the arthroplasty clinic at Johannesburg Hospital between six weeks and twelve months postoperatively.M ethod: Recruited patients were evaluated twice with a time interval of one hour between each assessment. Statistical A nalysis: The intra- and inter-rater reliability were estimated using Intraclass Correlation Coefficient (ICC. R esults: The intra-rater reliability showed excellent reliability (h= 0.95 for Examiner A  and good reliability (h= 0.71for Examiner B. The inter-rater reliability showed moderate reliability (h= 0.67 during test one and h= 0.66 during test two.Conclusion: The KSKS has good intra-rater reliability when tested within a period of one hour. The KSKS demonstrated moderate agreement for inter rater reliability.

  4. Translation and validation of the Dutch new Knee Society Scoring System ©.

    Science.gov (United States)

    Van Der Straeten, Catherine; Witvrouw, Erik; Willems, Tine; Bellemans, Johan; Victor, Jan

    2013-11-01

    A new version of The Knee Society Knee Scoring System(©) (KSS) has recently been developed. Before this scale can be used in non-English-speaking populations, it has to be translated and validated for a particular population. We evaluated the construct and content validity, the test-retest reliability, and the internal consistency of the Dutch version of the New Knee Society KSS. A Dutch translation was performed using a forward-backward translation protocol. We tested the construct validity of the Dutch New KSS by comparing it with the Dutch versions of the WOMAC, Knee Injury and Osteoarthritis Outcome Score (KOOS), and SF-12 scores in 137 patients undergoing total knee arthroplasty (TKA). Content validity was assessed by comparing pre- and postoperative scores and by checking floor and ceiling effects. To evaluate test-retest reliability and consistency, 47 patients completed the questionnaire a second time with a mean of 8 days interval (range, 2-20 days) between tests. Construct validity was demonstrated because the Dutch New KSS correlated well with the Dutch WOMAC (r = -0.751; p Dutch KOOS (r = -0.723; p Dutch SF-12 (r = 0.569; p Dutch New KSS is an excellent instrument to evaluate TKA outcome in Dutch-speaking patients.

  5. Meaningful Change Scores in the Knee Injury and Osteoarthritis Outcome Score in Patients Undergoing Anterior Cruciate Ligament Reconstruction

    DEFF Research Database (Denmark)

    Ingelsrud, Lina Holm; Terwee, Caroline B; Terluin, Berend

    2018-01-01

    BACKGROUND: Meaningful change scores in the Knee injury and Osteoarthritis Outcome Score (KOOS) in patients undergoing anterior cruciate ligament (ACL) reconstruction have not yet been established. PURPOSE: To define the minimal important change (MIC) for the KOOS after ACL reconstruction. STUDY...... data for at least one of the KOOS subscales were obtained from 542 (45.3%) participants. Predictive modeling MIC values were 12.1 for the KOOS subscales of Sport and Recreational Function and 18.3 for Knee-Related Quality of Life. These values aid in interpreting within-group improvement over time...... and can be used as responder criteria when comparing groups. The corresponding and much lower values for the subscales of Pain (2.5), Symptoms (-1.2), and Activities of Daily Living (2.4) are the results from patients reporting, on average, only mild problems with these domains preoperatively. Although 4...

  6. Knee complaints vary with age and gender in the adult population. Population-based reference data for the Knee injury and Osteoarthritis Outcome Score (KOOS)

    DEFF Research Database (Denmark)

    Paradowski, Przemyslaw T; Bergman, Stefan; Sundén-Lundius, Anne

    2006-01-01

    Self-reported knee complaints may vary with age and gender. Reference data from the adult population would help to better interpret the outcome of interventions due to knee complaints. The objectives of the present study were to describe the variation of self-reported knee pain, function and qual......Self-reported knee complaints may vary with age and gender. Reference data from the adult population would help to better interpret the outcome of interventions due to knee complaints. The objectives of the present study were to describe the variation of self-reported knee pain, function...... and quality of life with age and gender in the adult population and to establish population-based reference data for the Knee injury and Osteoarthritis Outcome Score (KOOS)....

  7. The variability in Oxford hip and knee scores in the preoperative period: is there an ideal time to score?

    Science.gov (United States)

    Quah, C; Holmes, D; Khan, T; Cockshott, S; Lewis, J; Stephen, A

    2018-01-01

    Background All NHS-funded providers are required to collect and report patient-reported outcome measures for hip and knee arthroplasty. Although there are established guidelines for timing such measures following arthroplasty, there are no specific time-points for collection in the preoperative period. The primary aim of this study was to identify whether there was a significant amount of variability in the Oxford hip and knee scores prior to surgical intervention when completed in the outpatient clinic at the time of listing for arthroplasty or when completed at the preoperative assessment clinic. Methods A prospective cohort study of patients listed for primary hip or knee arthroplasty was conducted. Patients were asked to fill in a preoperative Oxford score in the outpatient clinic at the time of listing. They were then invited to fill in the official outcome measures questionnaire at the preoperative assessment clinic. The postoperative Oxford score was then completed when the patient was seen again at their postoperative follow up in clinic. Results Of the total of 109 patients included in this study period, there were 18 (17%) who had a worse score of 4 or more points difference and 43 (39.4%) who had an improvement of 4 or more points difference when the scores were compared between time of listing at the outpatient and at the preoperative assessment clinic. There was a statistically significant difference (P = 0.0054) in the mean Oxford scores. Conclusions The results of our study suggest that there should be standardisation of timing for completing the preoperative patient-reported outcome measures.

  8. MRI assessment of knee osteoarthritis: Knee Osteoarthritis Scoring System (KOSS) - inter-observer and intra-observer reproducibility of a compartment-based scoring system

    International Nuclear Information System (INIS)

    Kornaat, Peter R.; Ceulemans, Ruth Y.T.; Kroon, Herman M.; Bloem, Johan L.; Riyazi, Naghmeh; Kloppenburg, Margreet; Carter, Wayne O.; Woodworth, Thasia G.

    2005-01-01

    To develop a scoring system for quantifying osteoarthritic changes of the knee as identified by magnetic resonance (MR) imaging, and to determine its inter- and intra-observer reproducibility, in order to monitor medical therapy in research studies. Two independent observers evaluated 25 consecutive MR examinations of the knee in patients with previously defined clinical symptoms and radiological signs of osteoarthritis. We acquired on a 1.5 T system: coronal and sagittal proton density- and T2-weighted dual spin echo (SE) images, sagittal three-dimensional T1-weighted gradient echo (GE) images with fat suppression, and axial dual turbo SE images with fat suppression. Images were scored for the presence of cartilaginous lesions, osteophytes, subchondral cysts, bone marrow edema, and for meniscal abnormalities. Presence and size of effusion, synovitis and Baker's cyst were recorded. All parameters were ranked on a previously defined, semiquantitative scale, reflecting increasing severity of findings. Kappa, weighted kappa and intraclass correlation coefficient (ICC) were used to determine inter- and intra-observer variability. Inter-observer reproducibility was good (ICC value 0.77). Inter- and intra-observer reproducibility for individual parameters was good to very good (inter-observer ICC value 0.63-0.91; intra-observer ICC value 0.76-0.96). The presented comprehensive MR scoring system for osteoarthritic changes of the knee has a good to very good inter-observer and intra-observer reproducibility. Thus the score form with its definitions can be used for standardized assessment of osteoarthritic changes to monitor medical therapy in research studies. (orig.)

  9. Rasch analysis of the Knee injury and Osteoarthritis Outcome Score (KOOS): a statistical re-evaluation

    DEFF Research Database (Denmark)

    Comins, J; Brodersen, J; Krogsgaard, M

    2008-01-01

    The knee injury and Osteoarthritis Outcome Score (KOOS), based on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), is widely used to evaluate subjective outcome in anterior cruciate ligament (ACL) reconstructed patients. However, the validity of KOOS has not been assessed...

  10. The Knee injury and Osteoarthritis Outcome Score (KOOS: from joint injury to osteoarthritis

    Directory of Open Access Journals (Sweden)

    Roos Ewa M

    2003-11-01

    Full Text Available Abstract The Knee injury and Osteoarthritis Outcome Score (KOOS was developed as an extension of the WOMAC Osteoarthritis Index with the purpose of evaluating short-term and long-term symptoms and function in subjects with knee injury and osteoarthritis. The KOOS holds five separately scored subscales: Pain, other Symptoms, Function in daily living (ADL, Function in Sport and Recreation (Sport/Rec, and knee-related Quality of Life (QOL. The KOOS has been validated for several orthopaedic interventions such as anterior cruciate ligament reconstruction, meniscectomy and total knee replacement. In addition the instrument has been used to evaluate physical therapy, nutritional supplementation and glucosamine supplementation. The effect size is generally largest for the subscale QOL followed by the subscale Pain. The KOOS is a valid, reliable and responsive self-administered instrument that can be used for short-term and long-term follow-up of several types of knee injury including osteoarthritis. The measure is relatively new and further use of the instrument will add knowledge and suggest areas that need to be further explored and improved.

  11. Knee Injury and Osteoarthritis Outcome Score (KOOS): systematic review and meta-analysis of measurement properties.

    Science.gov (United States)

    Collins, N J; Prinsen, C A C; Christensen, R; Bartels, E M; Terwee, C B; Roos, E M

    2016-08-01

    To conduct a systematic review and meta-analysis to synthesize evidence regarding measurement properties of the Knee injury and Osteoarthritis Outcome Score (KOOS). A comprehensive literature search identified 37 eligible papers evaluating KOOS measurement properties in participants with knee injuries and/or osteoarthritis (OA). Methodological quality was evaluated using the COSMIN checklist. Where possible, meta-analysis of extracted data was conducted for all studies and stratified by age and knee condition; otherwise narrative synthesis was performed. KOOS has adequate internal consistency, test-retest reliability and construct validity in young and old adults with knee injuries and/or OA. The ADL subscale has better content validity for older patients and Sport/Rec for younger patients with knee injuries, while the Pain subscale is more relevant for painful knee conditions. The five-factor structure of the original KOOS is unclear. There is some evidence that the KOOS subscales demonstrate sufficient unidimensionality, but this requires confirmation. Although measurement error requires further evaluation, the minimal detectable change for KOOS subscales ranges from 14.3 to 19.6 for younger individuals, and ≥20 for older individuals. Evidence of responsiveness comes from larger effect sizes following surgical (especially total knee replacement) than non-surgical interventions. KOOS demonstrates adequate content validity, internal consistency, test-retest reliability, construct validity and responsiveness for age- and condition-relevant subscales. Structural validity, cross-cultural validity and measurement error require further evaluation, as well as construct validity of KOOS Physical function Short form. Suggested order of subscales for different knee conditions can be applied in hierarchical testing of endpoints in clinical trials. PROSPERO (CRD42011001603). Copyright © 2016 Osteoarthritis Research Society International. Published by Elsevier Ltd. All

  12. Simple Scoring System and Artificial Neural Network for Knee Osteoarthritis Risk Prediction: A Cross-Sectional Study

    Science.gov (United States)

    Yoo, Tae Keun; Kim, Deok Won; Choi, Soo Beom; Oh, Ein; Park, Jee Soo

    2016-01-01

    Background Knee osteoarthritis (OA) is the most common joint disease of adults worldwide. Since the treatments for advanced radiographic knee OA are limited, clinicians face a significant challenge of identifying patients who are at high risk of OA in a timely and appropriate way. Therefore, we developed a simple self-assessment scoring system and an improved artificial neural network (ANN) model for knee OA. Methods The Fifth Korea National Health and Nutrition Examination Surveys (KNHANES V-1) data were used to develop a scoring system and ANN for radiographic knee OA. A logistic regression analysis was used to determine the predictors of the scoring system. The ANN was constructed using 1777 participants and validated internally on 888 participants in the KNHANES V-1. The predictors of the scoring system were selected as the inputs of the ANN. External validation was performed using 4731 participants in the Osteoarthritis Initiative (OAI). Area under the curve (AUC) of the receiver operating characteristic was calculated to compare the prediction models. Results The scoring system and ANN were built using the independent predictors including sex, age, body mass index, educational status, hypertension, moderate physical activity, and knee pain. In the internal validation, both scoring system and ANN predicted radiographic knee OA (AUC 0.73 versus 0.81, p<0.001) and symptomatic knee OA (AUC 0.88 versus 0.94, p<0.001) with good discriminative ability. In the external validation, both scoring system and ANN showed lower discriminative ability in predicting radiographic knee OA (AUC 0.62 versus 0.67, p<0.001) and symptomatic knee OA (AUC 0.70 versus 0.76, p<0.001). Conclusions The self-assessment scoring system may be useful for identifying the adults at high risk for knee OA. The performance of the scoring system is improved significantly by the ANN. We provided an ANN calculator to simply predict the knee OA risk. PMID:26859664

  13. Knee Injury and Osteoarthritis Outcome Score (KOOS)--development of a self-administered outcome measure

    DEFF Research Database (Denmark)

    Roos, Ewa M.; Roos, H P; Lohmander, L S

    1998-01-01

    There is broad consensus that good outcome measures are needed to distinguish interventions that are effective from those that are not. This task requires standardized, patient-centered measures that can be administered at a low cost. We developed a questionnaire to assess short- and long......-term patient-relevant outcomes following knee injury, based on the WOMAC Osteoarthritis Index, a literature review, an expert panel, and a pilot study. The Knee injury and Osteoarthritis Outcome Score (KOOS) is self-administered and assesses five outcomes: pain, symptoms, activities of daily living, sport...

  14. Cross-cultural adaptation and validation of the Japanese version of the new Knee Society Scoring System for osteoarthritic knee with total knee arthroplasty.

    Science.gov (United States)

    Hamamoto, Yosuke; Ito, Hiromu; Furu, Moritoshi; Ishikawa, Masahiro; Azukizawa, Masayuki; Kuriyama, Shinichi; Nakamura, Shinichiro; Matsuda, Shuichi

    2015-09-01

    The purposes of this study were to translate the new Knee Society Score (KSS) into Japanese and to evaluate the construct and content validity, test-retest reliability, and internal consistency of the Japanese version of the new KSS. The Japanese version of the KSS was developed according to cross-cultural guidelines by using the "translation-back translation" method to ensure content validity. KSS data were then obtained from patients who had undergone total knee arthroplasty (TKA). The psychometric properties evaluated were as follows: for feasibility, response rate, and floor and ceiling effects; for construct validity, internal consistency using Cronbach's alpha, and correlations with quality of life. Construct validity was evaluated by using Spearman's correlation coefficient to quantify the correlation between the KSS and the Japanese version of the Oxford 12-item Knee Score or Short Form 36 Health Survey (SF-36) questionnaires. The Japanese version of the KSS was sent to 93 consecutive osteoarthritic patients who underwent primary TKA in our institution. Fifty-five patients completed the questionnaires and were included in this study. Neither a floor nor ceiling effect was observed. The reliability proved excellent in the majority of domains, with intraclass correlation coefficients of 0.65-0.88. Internal consistency, assessed by Cronbach's alpha, was good to excellent for all domains (0.78-0.94). All of the four domains of the KSS correlated significantly with the Oxford 12-item Knee Score. The activity and satisfaction domains of the KSS correlated significantly with all and the majority of subscales of the SF-36, respectively, whereas symptoms and expectation domains showed significant correlations only with bodily pain and vitality subscales and with the physical function, bodily pain, and vitality subscales, respectively. The Japanese version of the new KSS is a valid, reliable, and responsive instrument to capture subjective aspects of the functional

  15. Construct validity and reliability of the Finnish version of the Knee Injury and Osteoarthritis Outcome Score.

    Science.gov (United States)

    Multanen, Juhani; Honkanen, Mikko; Häkkinen, Arja; Kiviranta, Ilkka

    2018-05-22

    The Knee Injury and Osteoarthritis Outcome Score (KOOS) is a commonly used knee assessment and outcome tool in both clinical work and research. However, it has not been formally translated and validated in Finnish. The purpose of this study was to translate and culturally adapt the KOOS questionnaire into Finnish and to determine its validity and reliability among Finnish middle-aged patients with knee injuries. KOOS was translated and culturally adapted from English into Finnish. Subsequently, 59 patients with knee injuries completed the Finnish version of KOOS, Western Ontario and McMaster Osteoarthritis Index (WOMAC), Short-Form 36 Health Survey (SF-36) and Numeric Pain Rating Scale (Pain-NRS). The same KOOS questionnaire was re-administered 2 weeks later. Psychometric assessment of the Finnish KOOS was performed by testing its construct validity and reliability by using internal consistency, test-retest reliability and measurement error. The floor and ceiling effects were also examined. The cross-cultural adaptation revealed only minor cultural differences and was well received by the patients. For construct validity, high to moderate Spearman's Correlation Coefficients were found between the KOOS subscales and the WOMAC, SF-36, and Pain-NRS subscales. The Cronbach's alpha was from 0.79 to 0.96 for all subscales indicating acceptable internal consistency. The test-retest reliability was good to excellent, with Intraclass Correlation Coefficients ranging from 0.73 to 0.86 for all KOOS subscales. The minimal detectable change ranged from 17 to 34 on an individual level and from 2 to 4 on a group level. No floor or ceiling effects were observed. This study yielded an appropriately translated and culturally adapted Finnish version of KOOS which demonstrated good validity and reliability. Our data indicate that the Finnish version of KOOS is suitable for assessment of the knee status of Finnish patients with different knee complaints. Further studies are needed to

  16. [CLINICAL STUDIES ON EFFECT OF ARTHROSCOPIC INTERCONDYLAR FOSSA ANGIOPLASTY ON ABILITY OF NEUROMUSCULAR CONTROL IN ELDERLY PATIENTS WITH KNEE OSTEOARTHRITIS].

    Science.gov (United States)

    Huang, Jingmin; Wang, Haijiao; Wu, Jiang; Li, Dongchao; Li, Yuhong

    2015-08-01

    To study the effect of arthroscopic intercondylar fossa angioplasty on the ability of neuromuscular control of the knee joint in elderly patients with knee osteoarthritis (KOA). Between June 2012 and March 2013, 20 elderly patients with KOA and in accordance with inclusion and exclusion criteria underwent arthroscopic intercondylar fossa angioplasty (operation group), and 20 healthy elderly people served as control group. There was no significant difference in age, height, weight, and body mass index between 2 groups (P > 0.05). The proprioception capability (using passive regeneration test at measurement angles of 15, 30, and 60°) and quadriceps mobilization [including maximum voluntary contraction (MVC), central activation ratio (CAR), and activation deficit (AD)] were measured to avaluate the neuromuscular control of the knee; the Lysholm score was used to evaluate knee function. The above indexes were measured to assess the knee neuromuscular control and recovery of joint function in patients of operation group at 3, 6, and 9 months after operation. Compared with the control group, MVC, CAR, and Lysholm scores were significantly decreased, and the AD and passive knee angle difference were significantly increased in operation group (P 0.05). Arthroscopic intercondylar fossa angioplasty can relieve ACL pressure, abrasion, and impact, which will recover the ability of neuromuscular control, increase proprioception and quadriceps mobilization capacity, and improve the joint function.

  17. Cross-cultural adaptation and psychometric analysis of the Arabic version of the oxford knee score in adult male with knee osteoarthritis.

    Science.gov (United States)

    Alghadir, Ahmad H; Al-Eisa, Einas S; Anwer, Shahnawaz

    2017-05-15

    There are varieties of self-assessment questionnaire used for the evaluation of pain, functional disability, and health related quality of life in individuals with knee osteoarthritis (OA). The present study intended to adapt and translate the oxford knee score into the Arabic and investigated its psychometric properties in adult male with knee OA. Ninety-seven adult male (mean age 57.55 ± 11.49 years) with knee OA participated. Patients were requested to complete the adapted Arabic version of the Oxford knee score (OKS-Ar), reduced "Western Ontario and McMaster Universities Index (WOMAC)", and the Visual analogue scale (VAS). Patients were requested to complete 2 nd form of OKS-Ar at least 1 week apart to assess the reproducibility of the score. The OKS was adapted and translated into Arabic by two independent Arabic native speakers (one rehabilitation professional having experience of knee OA patients and another one a trained translator) according to the international guidelines. All the participants completed the 2 nd form of OKS-Ar (Response rate 100%). Reliability and internal consistency was high with an ICC of 0.97, and the Cronbach's alpha coefficient of 0.987, respectively. A significant relationship between the OKS-Ar and the WOMAC and VAS scores confirmed the construct validity (p < 0.001). The standard error of measurement (SEM) and the minimum detectable change (MDC) were 2.2 and 6.2, respectively. The adapted Arabic version of the OKS demonstrated acceptable psychometric properties, including reliability, internal consistency, and the validity. The present study indicates that the OKS-Ar is a suitable questionnaire to measure pain and physical function in the Arabic speaking adult male patients with knee OA.

  18. Different hip and knee priority score systems: are they good for the same thing?

    Science.gov (United States)

    Escobar, Antonio; Quintana, Jose Maria; Espallargues, Mireia; Allepuz, Alejandro; Ibañez, Berta

    2010-10-01

    The aim of the present study was to compare two priority tools used for joint replacement for patients on waiting lists, which use two different methods. Two prioritization tools developed and validated by different methodologies were used on the same cohort of patients. The first, an IRYSS hip and knee priority score (IHKPS) developed by RAND method, was applied while patients were on the waiting list. The other, a Catalonia hip-knee priority score (CHKPS) developed by conjoint analysis, was adapted and applied retrospectively. In addition, all patients fulfilled pre-intervention the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Correlation between them was studied by Pearson correlation coefficient (r). Agreement was analysed by means of intra-class correlation coefficient (ICC), Kendall coefficient and Cohern kappa. The relationship between IHKPS, CHKPS and baseline WOMAC scores by r coefficient was studied. The sample consisted of 774 consecutive patients. Pearson correlation coefficient between IHKPS and CHKPS was 0.79. The agreement study showed that ICC was 0.74, Kendall coefficient 0.86 and kappa 0.66. Finally, correlation between CHKPS and baseline WOMAC ranged from 0.43 to 0.64. The results according to the relationship between IHKPS and WOMAC ranged from 0.50 to 0.74. Results support the hypothesis that if the final objective of the prioritization tools is to organize and sort patients on the waiting list, although they use different methodologies, the results are similar. © 2010 Blackwell Publishing Ltd.

  19. Do Press Ganey Scores Correlate With Total Knee Arthroplasty-Specific Outcome Questionnaires in Postsurgical Patients?

    Science.gov (United States)

    Chughtai, Morad; Patel, Nirav K; Gwam, Chukwuweike U; Khlopas, Anton; Bonutti, Peter M; Delanois, Ronald E; Mont, Michael A

    2017-09-01

    The purpose of this study was to assess whether Center for Medicaid and Medicare services-implemented satisfaction (Press Ganey [PG]) survey results correlate with established total knee arthroplasty (TKA) assessment tools. Data from 736 patients who underwent TKA and received a PG survey between November 2009 and January 2015 were analyzed. The PG survey overall hospital rating scores were correlated with standardized validated outcome assessment tools for TKA (Short form-12 and 36 Health Survey; Knee Society Score; Western Ontario and McMaster Universities Arthritis Index; University of California, Los Angeles; and visual analog scale) at a mean follow-up of 1154 days post-TKA. There was no correlation between PG survey overall hospital rating score and the above-mentioned outcome assessment tools. Our study shows that there is no statistically significant relationship between established arthroplasty assessment tools and the PG overall hospital rating. Therefore, PG surveys may not be an appropriate tool to determine reimbursement for orthopedists performing TKAs. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Cross-cultural adaptation and validation of the French version of the Knee injury and Osteoarthritis Outcome Score (KOOS) in knee osteoarthritis patients

    DEFF Research Database (Denmark)

    Ornetti, P; Parratte, S; Gossec, L

    2008-01-01

    OBJECTIVE: To adapt the Knee injury and Osteoarthritis Outcome Score (KOOS) into French and to evaluate the psychometric properties of this new version. METHODS: The French version of the KOOS was developed according to cross-cultural guidelines by using the "translation-back translation" method...... to ensure content validity. KOOS data were then obtained in patients with symptomatic knee osteoarthritis (OA). The translated questionnaire was evaluated in two knee OA population groups, one with no indication for joint replacement (medicine), and the other waiting for joint replacement (surgery......). The psychometric properties evaluated were feasibility: percentage of responses, floor and ceiling effects; construct validity: internal consistency using Cronbach's alpha, correlations with osteoarthritis knee and hip quality of life domains using Spearman's rank test, and known group comparison between medicine...

  1. Association Between Plasma Beta-endorphin and WOMAC Score in Female Patients with Knee Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Hori Hariyanto

    2012-08-01

    Full Text Available BACKGROUND: β-endorphin plays a role in the descending pain control in the central nervous system. Central sensitization may be involved in the generating and maintenance of osteoarthritis (OA pain. However, the correlation between β-endorphin and pain severity in OA has shown conflicting results. The aim of this study was to investigate the association between plasma β-endorphin and the severity of the disease. METHODS: This study was an observational cross-sectional study carried out on 60 female subjects with knee OA who fulfilled the inclusion criteria. Plasma β-endorphin was measured by a commercial enzyme-linked immunosorbent assay (ELISA kit. Osteoarthritis knees were classified by the Kellegren-Lawrence (KL grading (1-4 criteria. The Western Ontario McMaster University Osteoarthritis (WOMAC scoring method was used to assess self-reported physical function, pain and stiffness. RESULTS: The mean of the participants' ages was 58 years old, ranging from 42 to 83 years. Overall, more than 70% of the participants were overweight with a mean of body mass index (BMI of 27.59. More than 54% of the participants were diagnosed of having KL grading 3 or 4. Plasma β-endorphin was correlated inversely with the WOMAC subscale of stiffness (r=-0.286, p=0.0311, but no correlation was noted with the WOMAC subscale of pain and physical activity. There was no significant difference of the mean of plasma β-endorphin among the KL gradings. CONCLUSIONS: Plasma β-endorphin is associated with better WOMAC total score and stiffness subscale, but not associated with KL grading of OA. KEYWORDS: knee osteoarthritis, female, β-endorphin, WOMAC, Kellgren-Lawrence.

  2. Cross-cultural adaptation, reliability and validity of the Turkish version of the Hospital for Special Surgery (HSS) Knee Score.

    Science.gov (United States)

    Narin, Selnur; Unver, Bayram; Bakırhan, Serkan; Bozan, Ozgür; Karatosun, Vasfi

    2014-01-01

    The purpose of this study was to adapt the English version of the Hospital for Special Surgery (HSS) knee score for use in a Turkish population and to evaluate its validity, reliability and cultural adaptation. Standard forward-back translation of the HSS knee score was performed and the Turkish version was applied in 73 patients. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Mini-Mental State Examination and sit-to-stand test were also performed and analyzed. Internal consistency reliability was tested using Cronbach's alpha. The intraclass correlation coefficient (ICC) was used to calculate the test-retest reliability at one-week intervals. Validity was assessed by calculating the Pearson correlation between the HSS, WOMAC and sit-to-stand test scores. The ICC ranged from 0.98 to 0.99 with high internal consistency (Cronbach's alpha: 0.87). The WOMAC score correlated with total HSS score (r: -0.80, p<0.001) and sit-to-stand score (r: 0.12, p: 0.312). The Turkish version of the HSS knee score is reliable and valid in evaluating the total knee arthroplasty in Turkish patients.

  3. Psychometric properties of the Knee injury and Osteoarthritis Outcome Score for Children (KOOS-Child) in children with knee disorders

    DEFF Research Database (Denmark)

    Ortqvist, Maria; Iversen, Maura D; Janarv, Per-Mats

    2014-01-01

    -Child was developed. This study aims to evaluate psychometric properties of the final KOOS-Child when used in children with knee disorders. METHODS: 115 children (boys/girls 51/64, 7-16 years) with knee disorders were recruited. All children (n=115) completed the KOOS-Child, the Child-Health Assessment Questionnaire...... better. CONCLUSIONS: The final KOOS-Child demonstrates good psychometric properties and supports the use of the KOOS-Child when evaluating children with knee disorders....

  4. Clinical outcomes after cell-seeded autologous chondrocyte implantation of the knee: when can success or failure be predicted?

    Science.gov (United States)

    Pestka, Jan M; Bode, Gerrit; Salzmann, Gian; Steinwachs, Mathias; Schmal, Hagen; Südkamp, Norbert P; Niemeyer, Philipp

    2014-01-01

    Autologous chondrocyte implantation (ACI) has been associated with satisfying results. Still, it remains unclear when success or failure after ACI can be estimated. To evaluate the clinical outcomes of cell-seeded collagen matrix-supported ACI (ACI-Cs) for the treatment of cartilage defects of the knee at 36 months and to determine a time point after ACI-Cs at which success or failure can be estimated. Cohort study; Level of evidence, 3. A total of 80 patients with isolated full-thickness cartilage defects of the knee joint treated with ACI-Cs were prospectively assessed before surgery as well as postoperatively by use of the International Knee Documentation Committee (IKDC) score and Lysholm knee score. Preoperative IKDC and Lysholm scores increased from 49.6 and 59.5, respectively, to 79.1 and 83.5, respectively, at 36 months. Only half the patients (46.6%) with poor IKDC scores (ie, <70) at 6 months postoperatively showed continued poor or fair scores at 36 months' follow-up. The probability of poor scores at 36 months after surgery further increased to 0.61 and 0.81, respectively, when scores were persistent at 12 and 24 months. All 3 patients (100%) with good IKDC scores (ie, 81-90) at 6 months after surgery showed constant or even improved scores at 36 months' follow-up. Ninety-one percent of patients with good and excellent scores at 12 months and 83% of patients with good and excellent scores at 24 months (a total of 23 and 37 patients, respectively) were able to maintain these scores at 36 months' follow-up. Similar results were obtained for the Lysholm score. With regard to the improvements in functional outcomes after ACI-Cs at 36 months after surgery, the technique described here appears to lead to satisfying and stable clinical results. This study helps the treating physician to predict the likeliness of further clinical improvements or constant unsatisfactory results after ACI. In patients with good/excellent scores shortly after surgery

  5. Can computer assistance improve the clinical and functional scores in total knee arthroplasty?

    Science.gov (United States)

    Hernández-Vaquero, Daniel; Suarez-Vazquez, Abelardo; Iglesias-Fernandez, Susana

    2011-12-01

    Surgical navigation in TKA facilitates better alignment; however, it is unclear whether improved alignment alters clinical evolution and midterm and long-term complication rates. We determined the alignment differences between patients with standard, manual, jig-based TKAs and patients with navigation-based TKAs, and whether any differences would modify function, implant survival, and/or complications. We retrospectively reviewed 97 patients (100 TKAs) undergoing TKAs for minimal preoperative deformities. Fifty TKAs were performed with an image-free surgical navigation system and the other 50 with a standard technique. We compared femoral angle (FA), tibial angle (TA), and femorotibial angle (FTA) and determined whether any differences altered clinical or functional scores, as measured by the Knee Society Score (KSS), or complications. Seventy-three patients (75 TKAs) had a minimum followup of 8 years (mean, 8.3 years; range, 8-9.1 years). All patients included in the surgical navigation group had a FTA between 177° and 182º. We found no differences in the KSS or implant survival between the two groups and no differences in complication rates, although more complications occurred in the standard technique group (seven compared with two in the surgical navigation group). In the midterm, we found no difference in functional and clinical scores or implant survival between TKAs performed with and without the assistance of a navigation system. Level II, therapeutic study. See the Guidelines online for a complete description of levels of evidence.

  6. 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.

  7. Satisfactory knee function after single-stage posterolateral corner reconstruction in the multi-ligament injured/dislocated knee using the anatomic single-graft technique.

    Science.gov (United States)

    Sanders, Thomas L; Johnson, Nick R; Pareek, Ayoosh; Krych, Aaron J; Marx, Robert G; Stuart, Michael J; Levy, Bruce A

    2018-04-01

    Increasing importance has been placed on the posterolateral corner (PLC) in maintaining varus and rotational stability of the knee. The goal of this study was to evaluate knee function and clinical stability following a single-graft PLC reconstruction technique and identify factors associated with poor knee function. This study identified patients with a multi-ligament knee injury between 2006 and 2013. Patients who received a single-graft fibular collateral ligament and PLC reconstruction with a single-stage surgery during the study period and had a minimum follow-up of 2 years after surgery were included. Functional outcomes were assessed using Lysholm and IKDC scores. Varus and rotational knee laxity and range of motion were assessed using physical examination. The final study cohort included 61 patients who underwent PLC reconstruction using a single-graft technique. The mean IKDC score was 74.1 (± 22.3) and the mean Lysholm score was 80.3 (± 21.8) at mean follow-up of 3.8 years (range 2-9 years). Mean range of motion at final follow-up measured from 0° to 126° [range flexion: 95-145, range extension: 0-5]. Fifty-eight patients (95%) had grade 0 varus laxity in full knee extension, and 54 patients (88.5%) had grade 0 varus laxity at 30° of knee flexion. Female gender was associated with a lower postoperative IKDC score (p = 0.04). Surgical treatment of the PLC using a single-graft technique can result in satisfactory knee function and stable physical examination findings at minimum 2 years after surgery. Female gender was predictive of poor knee function after PLC reconstruction. Surgical treatment of PLC injuries should be individualized based on the timing of surgery, specific injured knee structures, and physical examination findings. This study helps validate the use of a single-graft technique for PLC reconstruction and can be used to help counsel patients about expected knee function after surgical treatment of PLC injuries. Level of evidence

  8. Treatment of knee diffuse pigmented villonodular synovitis under the arthroscopy with radiotherapy

    International Nuclear Information System (INIS)

    Peng Wei; Huang Xunwu; Guan Changyong; Yu Fangyuan; Zhang Bo

    2011-01-01

    Objective: To evaluate arthroscopy plus radiotherapy in the treatment of diffuse pigmented villonodular synovitis of the knee. Methods: A total of 10 cases of diffuse pigmented villonodular synovitis of the knee were treated under the arthroscopy combined with postoperative radiotherapy. These patients were followed up for 12-36 months, and were evaluated as to the effect of treatment. Results: According to the Lysholm criteria, the score was (53.5 ± 11.6) and(85.7 ± 10.7) respectively before surgery and at the last followup. Conclusion: Arthroscopical synovectomy with a combined application of postoperative radiotherapy is an effective treatment for diffuse pigmented vilionoclular synovitis of the knee. (authors)

  9. The effect and safety of highly standardized Ginger (Zingiber officinale) and Echinacea (Echinacea angustifolia) extract supplementation on inflammation and chronic pain in NSAIDs poor responders. A pilot study in subjects with knee arthrosis.

    Science.gov (United States)

    Rondanelli, Mariangela; Riva, Antonella; Morazzoni, Paolo; Allegrini, Pietro; Faliva, Milena Anna; Naso, Maurizio; Miccono, Alessandra; Peroni, Gabriella; Degli Agosti, Irene; Perna, Simone

    2017-06-01

    The study aimed to evaluate the effect of Zingiber officinale and Echinacea angustifolia extract supplementation (25 mg of ginger and 5 mg of Echinacea) for 30 days on inflammation and chronic pain in knee osteoarthritis (OA). Consecutive nonsteroidal anti-inflammatory-drugs (NSAIDs) poor responders with chronic inflammation and pain due to knee arthrosis were assessed (15 subjects, age: 67.2 ± 7.9, body mass index: 30.6 ± 7.1, men/women:2/13). The primary endpoint was to determine pain improvement from baseline to Day 30 by Tegner Lysholm Knee Scoring. The secondary endpoints were the assessment of Visual Analog Scale for Pain, health-related quality of life, by the ShortForm36 (SF-36), anthropometric parameters, hydration. After supplementation, a significant improvement of 12.27 points was observed for Lysholm scale score (p < 0.05), SF-36 (p < 0.05), and a decrease in -0.52 cm in knee circumference (left) (p < 0.01). This pilot study provides feasibility and safety data for the use of highly standardised ginger and Echinacea extract supplementation in people with knee OA.

  10. Patients With Knee Osteoarthritis Who Score Highly on the PainDETECT Questionnaire Present With Multimodality Hyperalgesia, Increased Pain, and Impaired Physical Function

    OpenAIRE

    Moss, Penny; Benson, Heather A.E.; Will, Rob; Wright, Anthony

    2017-01-01

    Objectives: PainDETECT is a self-report questionnaire that can be used to identify features of neuropathic pain. A proportion of patients with knee osteoarthritis (OA) score highly on the PainDETECT questionnaire. This study aimed to determine whether those with a higher “positive neuropathic” score on the PainDETECT questionnaire also had greater pain, hypersensitivity, and reduced function compared with individuals with knee OA with lower PainDETECT scores. Materials and Methods: In total, ...

  11. MR appearance of autologous chondrocyte implantation in the knee: correlation with the knee features and clinical outcome

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, Tomoki [Department of Radiology and Institute of Orthopaedics, Oswestry, Shropshire (United Kingdom); Kumamoto University, Department of Orthopaedic and Neuro-Musculoskeletal Surgery, Kumamoto (Japan); Tins, Bernhard; McCall, Iain W.; Ashton, Karen [Department of Radiology and Institute of Orthopaedics, Oswestry, Shropshire (United Kingdom); Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Trust, Department of Diagnostic Imaging, Oswestry, Shropshire (United Kingdom); Richardson, James B. [Department of Radiology and Institute of Orthopaedics, Oswestry, Shropshire (United Kingdom); RJAH Orthopaedic Hospital, Institute of Orthopaedics, Oswestry, Shropshire (United Kingdom); Takagi, Katsumasa [Department of Radiology and Institute of Orthopaedics, Oswestry, Shropshire (United Kingdom); Kumamoto Aging Research Institute, Kumamoto (Japan)

    2006-01-01

    To relate the magnetic resonance imaging (MRI) appearance of autologous chondrocyte implantation (ACI) in the knee in the 1st postoperative year with other knee features on MRI and with clinical outcome. Forty-nine examinations were performed in 49 patients at 1 year after ACI in the knee. Forty-one preoperative magnetic resonance (MR) examinations were also available. The grafts were assessed for smoothness, thickness in comparison with that of adjacent cartilage, signal intensity, integration to underlying bone and adjacent cartilage, and congruity of subchondral bone. Presence of overgrowth and bone marrow appearance beneath the graft were also assessed. Presence of osteophyte formation, further cartilage defects, appearance of the cruciate ligaments and the menisci were also recorded. An overall graft score was constructed, using the graft appearances. This was correlated with the knee features and the Lysholm score, a clinical self-assessment score. The data were analysed by a Kruskal-Wallis H test followed by a Mann-Whitney U test with Bonferroni correction as post-hoc test. Of 49 grafts, 32 (65%) demonstrated complete defect filling 1 year postoperatively. General overgrowth was seen in eight grafts (16%), and partial overgrowth in 13 grafts (26%). Bone marrow change underneath the graft was seen; oedema was seen in 23 grafts (47%), cysts in six grafts (12%) and sclerosis in two grafts (4%). Mean graft score was 8.7 (of maximal 12) (95% CI 8.0-9.5). Knees without osteophyte formation or additional other cartilage defects (other than the graft site) had a significantly higher graft score than knees with multiple osteophytes (P=0.0057) or multiple further cartilage defects (P=0.014). At 1 year follow-up improvement in the clinical scores was not significantly different for any subgroup. (orig.)

  12. Predictive value of semi-quantitative MRI-based scoring systems for future knee replacement: data from the osteoarthritis initiative

    International Nuclear Information System (INIS)

    Hafezi-Nejad, Nima; Eng, John; Demehri, Shadpour; Zikria, Bashir; Carrino, John A.

    2015-01-01

    To evaluate, in a confirmatory fashion, whether baseline and change from baseline to 24-month follow-up in cartilage damage, bone marrow lesions and meniscal damage are predictors of knee replacement (KR) in subjects with a high risk of osteoarthritis (OA), independent of the level of physical activity, symptom severity and radiographic abnormalities. Data from the Osteoarthritis Initiative's (OAI) baseline and 24-month follow-up knee MRIs of 115 patients (age range: 45-78 years; 48 % female; BMI: 20.9-48.7) were analyzed. Cartilage, bone marrow and menisci were semi-quantitatively scored according to the Whole-Organ Magnetic Resonance Imaging Score (WORMS) and Boston-Leeds Osteoarthritis Knee Score (BLOKS) systems in all compartments. Baseline and 24-month interval changes in structural tissue damage assessed by BLOKS and WORMS were used as predictors of KR independent of clinical and radiographic parameters using Cox hazard analysis. Adjustments were performed for age, gender, BMI and physical activity (Physical Activity Scale for the Elderly: PASE), Western Ontario and McMaster Questionnaire (WOMAC) total score and radiographic Kellgren-Lawrence (KL) score. BLOKS and WORMS baseline cartilage scores were predictors of KR independent of the PASE, WOMAC and KL score. One score increase in the average baseline BLOKS full-thickness cartilage defect score was associated with a [hazard ratio (95 % CI)] 13.55 (3.61-50.89) times greater risk of KR independent of the PASE, WOMAC and KL score. Net reclassification improvements (NRIs) of the additional evaluation of 24-month follow-up MRI scores and assessment of changes were not significant for prediction of KR (NRI range: - 7.23 - 24.8 %). The BLOKS cartilage score for full-thickness cartilage defects had the highest hazard for KR. Follow-up MRI changes in structural tissue damage, detected by BLOKS and WORMS cartilage, bone marrow or meniscus scores (up to 24 months) had no significant predictive value in addition

  13. Predictive value of semi-quantitative MRI-based scoring systems for future knee replacement: data from the osteoarthritis initiative

    Energy Technology Data Exchange (ETDEWEB)

    Hafezi-Nejad, Nima; Eng, John; Demehri, Shadpour [Johns Hopkins University School of Medicine, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Zikria, Bashir [Johns Hopkins University, Department of Orthopedic Surgery, Baltimore, MD (United States); Carrino, John A. [Hospital for Special Surgery, Department of Radiology and Imaging, New York, NY (United States)

    2015-11-15

    To evaluate, in a confirmatory fashion, whether baseline and change from baseline to 24-month follow-up in cartilage damage, bone marrow lesions and meniscal damage are predictors of knee replacement (KR) in subjects with a high risk of osteoarthritis (OA), independent of the level of physical activity, symptom severity and radiographic abnormalities. Data from the Osteoarthritis Initiative's (OAI) baseline and 24-month follow-up knee MRIs of 115 patients (age range: 45-78 years; 48 % female; BMI: 20.9-48.7) were analyzed. Cartilage, bone marrow and menisci were semi-quantitatively scored according to the Whole-Organ Magnetic Resonance Imaging Score (WORMS) and Boston-Leeds Osteoarthritis Knee Score (BLOKS) systems in all compartments. Baseline and 24-month interval changes in structural tissue damage assessed by BLOKS and WORMS were used as predictors of KR independent of clinical and radiographic parameters using Cox hazard analysis. Adjustments were performed for age, gender, BMI and physical activity (Physical Activity Scale for the Elderly: PASE), Western Ontario and McMaster Questionnaire (WOMAC) total score and radiographic Kellgren-Lawrence (KL) score. BLOKS and WORMS baseline cartilage scores were predictors of KR independent of the PASE, WOMAC and KL score. One score increase in the average baseline BLOKS full-thickness cartilage defect score was associated with a [hazard ratio (95 % CI)] 13.55 (3.61-50.89) times greater risk of KR independent of the PASE, WOMAC and KL score. Net reclassification improvements (NRIs) of the additional evaluation of 24-month follow-up MRI scores and assessment of changes were not significant for prediction of KR (NRI range: - 7.23 - 24.8 %). The BLOKS cartilage score for full-thickness cartilage defects had the highest hazard for KR. Follow-up MRI changes in structural tissue damage, detected by BLOKS and WORMS cartilage, bone marrow or meniscus scores (up to 24 months) had no significant predictive value in addition

  14. Assessment of patients with diffuse pigmented Villonodular Synovitis of Knee before and after radio-synovectomy

    International Nuclear Information System (INIS)

    Koca, G.; Ozsoy, H.; Atilgan, H.I.; Baskin, A.; Koray, D.; Fakioglu, O.; Korkmaz, M.

    2015-01-01

    Full text of publication follows. Aim: the aim of this study was to evaluate subjective and objective findings of patients with diffuse pigmented villonodular synovitis (DPVNS) of knee before and after treatment with Yttrium-90 (Y-90) radio-synovectomy. Materials and methods: between years 2005 and 2013, 23 patients, 15 female and 8 male, who had adjuvant radio-synovectomy after arthroscopic surgery were included to our study. 5 mCi of Y-90 radiocolloid was administered under local anesthesia at least 6 weeks after arthroscopic surgery. The patients were reevaluated 6 months after radio-synovectomy. All the patients were assigned a Lysholm knee score prior to surgery, prior to radio-synovectomy and 6 months after radio-synovectomy. Lysholm score was calculated according to patients' pain, swelling, instability, locking, limping, support, climbing the stairs, squatting and the highest evaluation score was 100. In addition modified Marshall scoring system was calculated according to objective and subjective findings of the patients prior to surgery and six months after radio-synovectomy. The highest evaluation score was 30 in modified Marshall scoring system where 19 points were provided by objective findings and 11 points were provided by subjective findings. Scores higher than 26 were defined as very good, between 21-25 was good, between 16-20 was medium, and values less than 16 points are considered to be poor. The obtained points using scoring systems were evaluated statistically. Results: the mean age was (31.7 ± 13.2) years. The average time period between the operation and radio-synovectomy was (12.8 ± 8.14) weeks. The calculated Lysholm scores prior to surgery, prior to radio-synovectomy and 6 months after radio-synovectomy were (38.8 ± 4.1), (60.0 ± 4.4) and (82.9 ± 6.5), respectively (p <0.001). Modified Marshall scores prior to surgery, and 6 months after radio-synovectomy, was (12.4 ± 2.7) and (25.5 ± 3.1) respectively (p <0.001). Conclusion

  15. Cross-cultural translation and measurement properties of the Polish version of the Knee injury and Osteoarthritis Outcome Score (KOOS) following anterior cruciate ligament reconstruction

    DEFF Research Database (Denmark)

    Paradowski, Przemysław T; Witoński, Dariusz; Kęska, Rafał

    2013-01-01

    Knee Injury and Osteoarthritis Outcome Score (KOOS) is available in over 30 languages and a commonly used Patient-Reported Outcome (PRO) for assessment of treatment effects following knee surgery. The aim of the study was to report the linguistic translational process and evaluate the psychometri...... properties of the Polish version of the KOOS questionnaire....

  16. Psychometric Properties of the Malay Language Version of Knee Injury and Osteoarthritis Outcome Score (KOOS Questionnaire among Knee Osteoarthritis Patients: A Confirmatory Factor Analysis

    Directory of Open Access Journals (Sweden)

    Zulkifli MM

    2017-07-01

    Full Text Available INTRODUCTION: This study aimed to cross-culturally adapt a Malay version of Knee Injury and Osteoarthritis Outcome Score (KOOS and to evaluate its psychometric properties in patients with knee osteoarthritis (OA. MATERIALS AND METHODS: The English version KOOS was translated into a Malay version using forward and backward translation process, followed by face validity and content validity. Two hundred and twenty-six knee OA patients attending the Outpatient and Orthopaedic Clinics, Universiti Sains Malaysia Hospital, completed the Malay version KOOS. Construct validity using confirmatory factor analysis and internal reliability assessment were performed. RESULTS: The results showed that the original five-factor model with 42 items failed to achieve acceptable values of the goodness of fit indices, indicating poor model fit. A new five-factor model of 26 items demonstrated acceptable level of goodness of fit (comparative fit index= 0.929, incremental fit index= 0.930, Tucker Lewis fit index= 0.920, root mean square error of approximation= 0.073 and Chisquared/ degree of freedom= 2.183 indices to signify a model fit. The Cronbach’s alpha value for the new model ranged from 0.776 to 0.946. The composite reliability values of each construct ranged between 0.819 and 0.921, indicating satisfactory to high level of convergent validity. CONCLUSION: The five-factor model with 26 items in the Malay version of KOOS questionnaire demonstrated a good degree of goodness of fit and was found to be valid, reliable and simple as an assessment tool for symptoms, pain, activity of daily living, sports and recreational activity and quality of life for Malaysian adults suffering from knee osteoarthritis.

  17. Prosthetic alignment after total knee replacement is not associated with dissatisfaction or change in Oxford Knee Score: A multivariable regression analysis.

    Science.gov (United States)

    Huijbregts, Henricus J T A M; Khan, Riaz J K; Fick, Daniel P; Jarrett, Olivia M; Haebich, Samantha

    2016-06-01

    Approximately 18% of the patients are dissatisfied with the result of total knee replacement. However, the relation between dissatisfaction and prosthetic alignment has not been investigated before. We retrospectively analysed prospectively gathered data of all patients who had a primary TKR, preoperative and one-year postoperative Oxford Knee Scores (OKS) and postoperative computed tomography (CT). The CT protocol measures hip-knee-ankle (HKA) angle, and coronal, sagittal and axial component alignment. Satisfaction was defined using a five-item Likert scale. We dichotomised dissatisfaction by combining '(very) dissatisfied' and 'neutral/not sure'. Associations with dissatisfaction and change in OKS were calculated using multivariable logistic and linear regression models. 230 TKRs were implanted in 105 men and 106 women. At one year, 12% were (very) dissatisfied and 10% neutral. Coronal alignment of the femoral component was 0.5 degrees more accurate in patients who were satisfied at one year. The other alignment measurements were not different between satisfied and dissatisfied patients. All radiographic measurements had a P-value>0.10 on univariate analyses. At one year, dissatisfaction was associated with the three-months OKS. Change in OKS was associated with three-months OKS, preoperative physical SF-12, preoperative pain and cruciate retaining design. Neither mechanical axis, nor component alignment, is associated with dissatisfaction at one year following TKR. Patients get the best outcome when pain reduction and function improvement are optimal during the first three months and when the indication to embark on surgery is based on physical limitations rather than on a high pain score. 2. Copyright © 2016 Elsevier B.V. All rights reserved.

  18. Development of the Knee Injury and Osteoarthritis Outcome Score for Children (KOOS-Child) Comprehensibility and content validity

    DEFF Research Database (Denmark)

    Ortqvist, M.; Roos, E. M.; Brostrom, E. W.

    2012-01-01

    researcher conducted cognitive interviews with 34 Swedish children who had symptomatic knee injuries (either primary or repeated). They were 10-16 years of age, and were selected to allow for equal group representation of age and sex. All the interviews were recorded. 4 researchers analyzed the data...... of separate subscale scores as a profile. However, its applicability in children has not been established. In this study, we examined how well the KOOS could be understood in a cohort of children with knee injury, with a view to preparing a pediatric version (KOOS-Child). Material and methods A trained...... and modified the original KOOS questionnaire. Results Many children (n = 14) had difficulty in tracking items based on the time frame and an equivalent number of children had trouble in understanding several terms. Mapping errors resulted from misinterpretation of items and from design issues related...

  19. Bilateral cartilage T2 mapping 9 years after Mega-OATS implantation at the knee: a quantitative 3T MRI study.

    Science.gov (United States)

    Jungmann, P M; Brucker, P U; Baum, T; Link, T M; Foerschner, F; Minzlaff, P; Banke, I J; Saier, T; Imhoff, A B; Rummeny, E J; Bauer, J S

    2015-12-01

    To evaluate morphological and quantitative MR findings 9 years after autograft transfer of the posterior femoral condyle (Mega-OATS) and to correlate these findings with clinical outcomes. Quantitative MR measurements were also obtained of the contralateral knee and the utility as reference standard was investigated. Both knees of 20 patients with Mega-OATS osteochondral repair at the medial femoral condyle (MFC) were studied using 3T MRI 9 years after the procedure. MR-sequences included morphological sequences and a 2D multislice multiecho (MSME) spin echo (SE) sequence for quantitative cartilage T2 mapping. Cartilage segmentation was performed at the cartilage repair site and six additional knee compartments. Semi-quantitative MR observation of cartilage repair tissue (MOCART) scores and clinical Lysholm scores were obtained. Paired t-tests and Spearman correlations were used for statistical analysis. Global T2-values were significantly higher at ipsilateral knees compared to contralateral knees (42.1 ± 3.0 ms vs 40.4 ± 2.6 ms, P = 0.018). T2-values of the Mega-OATS site correlated significantly with MOCART scores (R = -0.64, P = 0.006). The correlations between MOCART and Lysholm scores and between absolute T2-values and Lysholm scores were not significant (P > 0.05). However, higher T2 side-to-side differences at the femoral condyles correlated significantly with more severe clinical symptoms (medial, R = -0.53, P = 0.030; lateral, R = -0.51, P = 0.038). Despite long-term survival, 9 years after Mega-OATS procedures, T2-values of the grafts were increased compared to contralateral knees. Clinical scores correlated best with T2 side-to-side differences of the femoral condyles, indicating that intraindividual adjustment may be beneficial for outcome evaluation. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  20. Good validity and reliability of the forgotten joint score in evaluating the outcome of total knee arthroplasty

    DEFF Research Database (Denmark)

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

    2016-01-01

    . We investigated the validity and reliability of the FJS. Patients and methods - A Danish version of the FJS questionnaire was created according to internationally accepted standards. 360 participants who underwent primary TKA were invited to participate in the study. Of these, 315 were included...... in a validity study and 150 in a reliability study. Correlation between the Oxford knee score (OKS) and the FJS was examined and test-retest evaluation was performed. A ceiling effect was defined as participants reaching a score within 15% of the maximum achievable score. Results - The validity study revealed...... of the FJS (ICC? 0.79). We found a high level of internal consistency (Cronbach's? = 0.96). The ceiling effect for the FJS was 16%, as compared to 37% for the OKS. Interpretation - The FJS showed good construct validity and test-retest reliability. It had a lower ceiling effect than the OKS. The FJS appears...

  1. Is peroneal nerve injury associated with worse function after knee dislocation?

    Science.gov (United States)

    Krych, Aaron J; Giuseffi, Steven A; Kuzma, Scott A; Stuart, Michael J; Levy, Bruce A

    2014-09-01

    Peroneal nerve palsy is a frequent and potentially disabling complication of multiligament knee dislocation, but little information exists on the degree to which patients recover motor or sensory function after this injury, and whether having this nerve injury--with or without complete recovery--is a predictor of inferior patient-reported outcome scores. The purposes of this study were to (1) report on motor and sensory recovery as well as patient-reported outcomes scores of patients with peroneal nerve injury from multiligament knee dislocation; (2) compare those endpoints between patients who had partial versus complete nerve injuries; and (3) compare patient-reported outcomes among patients who sustained peroneal nerve injuries after knee dislocation with a matched cohort of multiligament knee injuries without nerve injury. Thirty-two patients were identified, but five did not have 2-year followup and are excluded (16% lost to followup). Twenty-seven patients (24 male, three female) with peroneal nerve injury underwent multiligament knee reconstruction and were followed for 6.3 years (range, 2-18 years). Motor grades were assessed by examination and outcomes by International Knee Documentation Committee (IKDC) and Lysholm scores. Retrospectively, patients were divided into complete (n = 9) and partial nerve palsy (n = 18). Treatment for complete nerve palsy included an ankle-foot orthosis for all patients, nonoperative (one), neurolysis (two), tendon transfer (three), nerve transfer (one), and combined nerve/tendon transfer (one). Treatment for partial nerve palsy included nonoperative (12), neurolysis (four), nerve transfer (one), and combined nerve/tendon transfer (one). Furthermore, patients without nerve injury were matched by Schenck classification, age, and sex. Data were analyzed using univariate and multivariate models. Overall, 18 patients (69%) regained antigravity ankle dorsiflexion after treatment (three complete nerve palsy [38%] versus 15 partial

  2. Kinesio Taping does not improve the symptoms or function of older people with knee osteoarthritis: a randomised trial

    Directory of Open Access Journals (Sweden)

    Bruna Wageck

    2016-07-01

    Full Text Available Question: Does Kinesio Taping reduce pain and swelling, and increase muscle strength, function and knee-related health status in older people with knee osteoarthritis? Design: Randomised, controlled trial with concealed allocation, intention-to-treat analysis and blinded assessment. Participants: Seventy-six older people with knee osteoarthritis. Intervention: The experimental group received three simultaneous Kinesio Taping techniques to treat pain, strength and swelling. The control group received sham taping. All participants kept the taping on for 4 days. Outcome measures: The outcomes were: concentric muscle strength of knee extensors and flexors, measured by isokinetic dynamometry with an angular velocity of 60 deg/second normalised for body mass [(Nm/kg x 100 (%]; pressure pain threshold via digital pressure algometry (kgf/cm2; lower-limb swelling via volumetry (l and perimetry (cm; physical function via the Lysholm Knee Scoring Scale (0 = worst to 100 = best; and knee-related health status via the Western Ontario and McMaster (WOMAC osteoarthritis index (0 = best to 96 = worst. Outcomes were measured at Day 4 (end of the taping period and Day 19 (follow-up after the start of the treatment. Results: At Day 4, there were no significant between-group differences for knee extensor muscle strength (MD –1%, 95% CI –7 to 5, knee flexor muscle strength (MD 2%, 95% CI –3 to 7, the pressure pain threshold at any measured point, volumetry (MD 0.05 L, 95% CI –0.01 to 0.11, perimetry at any measured point, Lysholm score (MD –4 points, 95% CI –9 to 2, or WOMAC score (MD –2 points, 95% CI –8 to 4. The lack of significant between-group difference was also seen at the follow-up assessment on Day 19. Conclusion: The Kinesio Taping techniques investigated in this study provided no beneficial effects for older people with knee osteoarthritis on any of the assessed outcomes. Trial registration: Brazilian Registry of Clinical Trials, RBR

  3. Correlation between Family APGAR scores and health-related quality of life of Filipino elderly patients with knee osteoarthritis.

    Science.gov (United States)

    Lim, Anne T C; Manching, James; Penserga, Ester G

    2012-08-01

    This study aims to describe the clinical profile of Filipino patients with knee osteoarthritis (OA) and correlate their health-related quality of life (HrQoL) with perceived family support. This is a cross-sectional, analytical study of patients seen at the Philippine General Hospital Arthritis Clinic diagnosed with knee OA using the American College of Rheumatology classification criteria. Questionnaires for the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) v.3.1 and Family APGAR (Adaptation, Partnership, Growth, Affection and Resolve) were self-administered. Pearson's correlation, analysis of variance and Bonferroni tests were applied. Ninety patients with 3 : 1 female-to-male ratio, mean age of 70.14 years qualified for the study. Mean body mass index was 23.3. Mean duration of symptoms was 5.9 years. Fifty-three considered their family to be highly functional, 28 moderately dysfunctional and nine severely dysfunctional. Analysis showed that Family APGAR is moderately and inversely correlated with pain (r = -0.3373; P = 0.0002), stiffness (r = -0.3642; P = 0.0004), function (r = -0.3646; P = 0.0004) and total WOMAC scores (r = -0.3880; P = 0.0002). Likewise, there were significant differences of total WOMAC scores in the pain, stiffness and function subscales (P = 0.0076, P = 0.0032, P = 0.0165 and P = 0.0159, respectively) between patients in highly functional and severely dysfunctional families, and between highly and moderately functional families. As Family APGAR scores increased, there was significant decrease in all WOMAC subscales. We described the clinical profile of 90 elderly patients with knee OA and the relationship of HrQoL to Family APGAR scores. This paper concludes that higher Family APGAR scores in this population correlated with better HrQoL. © 2012 The Authors International Journal of Rheumatic Diseases © 2012 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  4. Anesthesia Technique and Mortality after Total Hip or Knee Arthroplasty: A Retrospective, Propensity Score-matched Cohort Study.

    Science.gov (United States)

    Perlas, Anahi; Chan, Vincent W S; Beattie, Scott

    2016-10-01

    This propensity score-matched cohort study evaluates the effect of anesthetic technique on a 30-day mortality after total hip or knee arthroplasty. All patients who had hip or knee arthroplasty between January 1, 2003, and December 31, 2014, were evaluated. The principal exposure was spinal versus general anesthesia. The primary outcome was 30-day mortality. Secondary outcomes were (1) perioperative myocardial infarction; (2) a composite of major adverse cardiac events that includes cardiac arrest, myocardial infarction, or newly diagnosed arrhythmia; (3) pulmonary embolism; (4) major blood loss; (5) hospital length of stay; and (6) operating room procedure time. A propensity score-matched-pair analysis was performed using a nonparsimonious logistic regression model of regional anesthetic use. We identified 10,868 patients, of whom 8,553 had spinal anesthesia and 2,315 had general anesthesia. Ninety-two percent (n = 2,135) of the patients who had general anesthesia were matched to similar patients who did not have general anesthesia. In the matched cohort, the 30-day mortality rate was 0.19% (n = 4) in the spinal anesthesia group and 0.8% (n = 17) in the general anesthesia group (risk ratio, 0.42; 95% CI, 0.21 to 0.83; P = 0.0045). Spinal anesthesia was also associated with a shorter hospital length of stay (5.7 vs. 6.6 days; P anesthesia and lower 30-day mortality, as well as a shorter hospital length of stay, after elective joint replacement surgery.

  5. Influence of knee flexion and atraumatic mobilisation of infrapatellar fat pad on incidence and severity of anterior knee pain after tibial nailing.

    Science.gov (United States)

    Jankovic, Andrija; Korac, Zelimir; Bozic, Nenad-Bozo; Stedul, Ivan

    2013-09-01

    We evaluated the incidence and aetiology of anterior knee pain (AKP) in a series of patients that underwent intramedullary nailing for stabilisation of tibial fractures. During the preparation of the entry site no excision of the infrapatellar fat was allowed and electrical haemostasis was kept at the lowest level. Medullary canal was reamed and the nails inserted in position of knee flexion over 100 degrees. All fractures were fixed using medial paratendinous approach. Functional outcome was measured using Lysholm knee score. The knee range of movement and return to previous level of activity were also documented and analysed. Mean follow up was 38.9 months (range 12-84 months). In total 60 patients with 62 tibial shaft fractures were analysed. The mean age at the time of final follow up was 49.4 years (range 20-87). In 22 (35.5%) a newly developed and persisting pain in the anterior region of the operated knee was reported. According to VAP scale, the pain was mild (VAS 1-3) in 12 cases (19.4%) and moderate (VAS 4-6) in 10 (16.1%). In 16 cases (73%) the pain was noticed 6-12 months after injury and subjectively related to return to full range of working and recreational activities. The mean Lysholm knee score in the group without AKP was 90.8. In the AKP group with mild pain it was 88.4 and in the group with moderate AKP it was 79.9. Complete return to previous professional and recreational activities occurred in 49/60 patients (81.7%). Content with the treatment regarding expectations in recovery dynamics and return to desired level of activity was present in 98.3% of patients; one patient was unsatisfied with the treatment. Our results indicate that respecting the physiological motion of Hoffa pad and menisci during knee flexion, accompanied with atraumatic mobilisation of retrotendinous fat, reduces incidence and severity of anterior knee pain following intramedullary fixation of tibial shaft fractures. Copyright © 2013 Elsevier Ltd. All rights reserved.

  6. Postural stability in patients with knee osteoarthritis: comparison with controls and evaluation of relationships between postural stability scores and International Classification of Functioning, Disability and Health components.

    Science.gov (United States)

    Hsieh, Ru-Lan; Lee, Wen-Chung; Lo, Min-Tzu; Liao, Wei-Cheng

    2013-02-01

    To assess the differences in postural stability between patients with knee osteoarthritis and controls without knee osteoarthritis, and to evaluate possible relations between postural stability scores and International Classification of Functioning, Disability and Health (ICF) components. An age-matched, case-controlled trial with a cross-sectional design. A teaching hospital. Patients with knee osteoarthritis (n=73) and age-matched controls (n=60). Data on patients' postural stability and additional health-related variables were collected using various instruments. These included the Hospital Anxiety and Depression Scale, the Multidimensional Fatigue Inventory, the World Health Organization Quality of Life Brief Version, the physical function test (chair-rising time), the Chinese version of the Western Ontario and McMaster Universities Osteoarthritis Index, the Chinese version of the Knee Injury and Osteoarthritis Outcome Score, and the Biodex Stability System. A comparison of postural stability in patients with knee osteoarthritis versus that of controls was performed. The relation between postural stability scores for patients with knee osteoarthritis and ICF components was evaluated. Pearson correlation tests were used to determine the variables that correlated with postural stability among these patients. Patients with knee osteoarthritis displayed lower overall postural stability than controls (scores of 0.7 vs. 0.5, P=.006) and scored lower on the environmental domain of the World Health Organization Quality of Life Brief Version (62.2 vs 66.8, P=.014). For patients with knee osteoarthritis, postural stability was weakly associated with the ICF components of body functions and structures, including pain (r=.33-.34, P=.004), physical fatigue (r=.28, P=.016), and reduced motivation (r=.30, P=.011). Weak to moderate associations between postural stability and the ICF components of activities and participation were found; the relevant ICF variables included

  7. Preoperative KOOS and SF-36 Scores Are Associated With the Development of Symptomatic Knee Osteoarthritis at 7 Years After Anterior Cruciate Ligament Reconstruction.

    Science.gov (United States)

    Ware, J Kristopher; Owens, Brett D; Akelman, Matthew R; Karamchedu, Naga Padmini; Fadale, Paul D; Hulstyn, Michael J; Shalvoy, Robert M; Badger, Gary J; Fleming, Braden C

    2018-03-01

    Anterior cruciate ligament (ACL) tears are associated with the development of knee osteoarthritis despite ACL reconstruction surgery. However, little evidence is available to determine which patients will develop symptomatic knee osteoarthritis. To determine if preoperative outcome measures-KOOS (Knee injury and Osteoarthritis Outcome Score) and SF-36 (36-item Short Form Health Survey)-were associated with the development of a symptomatic knee 7 years after ACL reconstruction. A secondary goal was to examine the relationship between imaging evidence of knee osteoarthritis and development of knee pain. Case-control study; Level of evidence, 3. Prospectively collected data from 72 patients were reviewed with 7-year follow-up after unilateral ACL reconstruction. Patients were divided into symptomatic and asymptomatic groups based on the previously defined KOOS pain ≤72. Demographic variables and preoperative KOOS and SF-36 scores were compared between groups. Radiographic and magnetic resonance imaging data were used to evaluate differences in joint space width, Osteoarthritis Research Society International radiographic score, and the Whole-Organ Magnetic Resonance Imaging Score between groups. Univariate and multivariate analyses were performed to identify potential predictors of pain at 7-year follow-up. Wilcoxon sum rank and t tests were used to compare imaging findings between the symptomatic and asymptomatic patients at 7 years. According to KOOS pain, 7 of the 72 patients available at 7-year follow-up formed the symptomatic group. No differences were found between groups in regard to demographic variables or intraoperative findings. In multivariate analysis, lower preoperative scores for KOOS sports/recreation ( P = .005) and SF-36 mental health ( P = .025) were associated with a painful knee at 7 years, with increased odds of 82% and 68% per 10-unit decrease, respectively. The Whole-Organ Magnetic Resonance Imaging Score at 7 years showed evidence of

  8. Patients With Knee Osteoarthritis Who Score Highly on the PainDETECT Questionnaire Present With Multimodality Hyperalgesia, Increased Pain, and Impaired Physical Function.

    Science.gov (United States)

    Moss, Penny; Benson, Heather A E; Will, Rob; Wright, Anthony

    2018-01-01

    PainDETECT is a self-report questionnaire that can be used to identify features of neuropathic pain. A proportion of patients with knee osteoarthritis (OA) score highly on the PainDETECT questionnaire. This study aimed to determine whether those with a higher "positive neuropathic" score on the PainDETECT questionnaire also had greater pain, hypersensitivity, and reduced function compared with individuals with knee OA with lower PainDETECT scores. In total, 130 participants with knee OA completed the PainDETECT, Western Ontario and McMaster Universities Arthritis Index (WOMAC), and Pain Quality Assessment Scale questionnaires. Quantitative sensory testing was carried out at 3 sites (both knees and elbow) using standard methods. Cold and heat pain thresholds were tested using a Peltier thermode and pressure pain thresholds using a digital algometer. Physical function was assessed using 3 timed locomotor function tests. In total, 22.3% of participants scored in the "positive neuropathic" category with a further 35.4% in the unclear category. Participants in the "positive neuropathic" category reported higher levels of pain and more impaired function based on the WOMAC questionnaire (Ppain thresholds at the OA knee. They were also slower to complete 2 of the locomotion tasks. This study identified a specific subgroup of people with knee OA who exhibited PainDETECT scores in the "positive neuropathic" category. These individuals experienced increased levels of pain, widespread, multimodality hyperalgesia, and greater functional impairment than the remaining cohort. Identification of OA patients with this pain phenotype may permit more targeted and effective pain management.

  9. Delayed gadolinium-enhanced MRI of cartilage and T2 mapping for evaluation of reparative cartilage-like tissue after autologous chondrocyte implantation associated with Atelocollagen-based scaffold in the knee

    Energy Technology Data Exchange (ETDEWEB)

    Tadenuma, Taku; Uchio, Yuji; Kumahashi, Nobuyuki; Iwasa, Junji [Shimane University School of Medicine, Department of Orthopaedic Surgery, Izumo-shi, Shimane-ken (Japan); Fukuba, Eiji; Kitagaki, Hajime [Shimane University School of Medicine, Department of Radiology, Izumo-shi, Shimane-ken (Japan); Ochi, Mitsuo [Hiroshima University, Department of Orthopaedic Surgery, Integrated Health Sciences, Institute of Biomedical and Health Sciences, Minami-ku, Hiroshima (Japan)

    2016-10-15

    To elucidate the quality of tissue-engineered cartilage after an autologous chondrocyte implantation (ACI) technique with Atelocollagen gel as a scaffold in the knee in the short- to midterm postoperatively, we assessed delayed gadolinium-enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC) and T2 mapping and clarified the relationship between T1 and T2 values and clinical results. In this cross-sectional study, T1 and T2 mapping were performed on 11 knees of 8 patients (mean age at ACI, 37.2 years) with a 3.0-T MRI scanner. T1{sub implant} and T2{sub implant} values were compared with those of the control cartilage region (T1{sub control} and T2{sub control}). Lysholm scores were also assessed for clinical evaluation. The relationships between the T1 and T2 values and the clinical Lysholm score were also assessed. There were no significant differences in the T1 values between the T1{sub implant} (386.64 ± 101.78 ms) and T1{sub control} (375.82 ± 62.89 ms) at the final follow-up. The implants showed significantly longer T2 values compared to the control cartilage (53.83 ± 13.89 vs. 38.21 ± 4.43 ms). The postoperative Lysholm scores were significantly higher than the preoperative scores. A significant correlation was observed between T1{sub implant} and clinical outcomes, but not between T2{sub implant} and clinical outcomes. Third-generation ACI implants might have obtained an almost equivalent glycosaminoglycan concentration compared to the normal cartilage, but they had lower collagen density at least 3 years after transplantation. The T1{sub implant} value, but not the T2 value, might be a predictor of clinical outcome after ACI. (orig.)

  10. Delayed gadolinium-enhanced MRI of cartilage and T2 mapping for evaluation of reparative cartilage-like tissue after autologous chondrocyte implantation associated with Atelocollagen-based scaffold in the knee

    International Nuclear Information System (INIS)

    Tadenuma, Taku; Uchio, Yuji; Kumahashi, Nobuyuki; Iwasa, Junji; Fukuba, Eiji; Kitagaki, Hajime; Ochi, Mitsuo

    2016-01-01

    To elucidate the quality of tissue-engineered cartilage after an autologous chondrocyte implantation (ACI) technique with Atelocollagen gel as a scaffold in the knee in the short- to midterm postoperatively, we assessed delayed gadolinium-enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC) and T2 mapping and clarified the relationship between T1 and T2 values and clinical results. In this cross-sectional study, T1 and T2 mapping were performed on 11 knees of 8 patients (mean age at ACI, 37.2 years) with a 3.0-T MRI scanner. T1 implant and T2 implant values were compared with those of the control cartilage region (T1 control and T2 control ). Lysholm scores were also assessed for clinical evaluation. The relationships between the T1 and T2 values and the clinical Lysholm score were also assessed. There were no significant differences in the T1 values between the T1 implant (386.64 ± 101.78 ms) and T1 control (375.82 ± 62.89 ms) at the final follow-up. The implants showed significantly longer T2 values compared to the control cartilage (53.83 ± 13.89 vs. 38.21 ± 4.43 ms). The postoperative Lysholm scores were significantly higher than the preoperative scores. A significant correlation was observed between T1 implant and clinical outcomes, but not between T2 implant and clinical outcomes. Third-generation ACI implants might have obtained an almost equivalent glycosaminoglycan concentration compared to the normal cartilage, but they had lower collagen density at least 3 years after transplantation. The T1 implant value, but not the T2 value, might be a predictor of clinical outcome after ACI. (orig.)

  11. Delayed gadolinium-enhanced MRI of cartilage and T2 mapping for evaluation of reparative cartilage-like tissue after autologous chondrocyte implantation associated with Atelocollagen-based scaffold in the knee.

    Science.gov (United States)

    Tadenuma, Taku; Uchio, Yuji; Kumahashi, Nobuyuki; Fukuba, Eiji; Kitagaki, Hajime; Iwasa, Junji; Ochi, Mitsuo

    2016-10-01

    To elucidate the quality of tissue-engineered cartilage after an autologous chondrocyte implantation (ACI) technique with Atelocollagen gel as a scaffold in the knee in the short- to midterm postoperatively, we assessed delayed gadolinium-enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC) and T2 mapping and clarified the relationship between T1 and T2 values and clinical results. In this cross-sectional study, T1 and T2 mapping were performed on 11 knees of 8 patients (mean age at ACI, 37.2 years) with a 3.0-T MRI scanner. T1implant and T2implant values were compared with those of the control cartilage region (T1control and T2control). Lysholm scores were also assessed for clinical evaluation. The relationships between the T1 and T2 values and the clinical Lysholm score were also assessed. There were no significant differences in the T1 values between the T1implant (386.64 ± 101.78 ms) and T1control (375.82 ± 62.89 ms) at the final follow-up. The implants showed significantly longer T2 values compared to the control cartilage (53.83 ± 13.89 vs. 38.21 ± 4.43 ms). The postoperative Lysholm scores were significantly higher than the preoperative scores. A significant correlation was observed between T1implant and clinical outcomes, but not between T2implant and clinical outcomes. Third-generation ACI implants might have obtained an almost equivalent glycosaminoglycan concentration compared to the normal cartilage, but they had lower collagen density at least 3 years after transplantation. The T1implant value, but not the T2 value, might be a predictor of clinical outcome after ACI.

  12. Effects on proprioception by Kinesio taping of the knee after anterior cruciate ligament rupture.

    Science.gov (United States)

    Bischoff, Lars; Babisch, Christian; Babisch, Jürgen; Layher, Frank; Sander, Klaus; Matziolis, Georg; Pietsch, Stefan; Röhner, Eric

    2018-03-10

    The use of Kinesio tape (KT) to improve proprioception is a matter of considerable debate. In comparison, the rupture of the anterior cruciate ligament is a sufficiently well-investigated injury with a proven compromise of proprioception. The objective of the present study was to assess a supportive effect on proprioception after KT application, taking the anterior cruciate ligament (ACL) rupture as an example. Forty-eight patients who had suffered an ACL rupture, confirmed clinically and by magnetic resonance imaging, and who were treated conservatively or were awaiting surgery were included in this study. In all patients, a gait analysis was performed on the affected leg before and after KT application. In addition, the IKDC score, the Lysholm score, stability using the Rolimeter, and the angle reproduction test were determined. Thirty-nine men and nine women who had had an ACL rupture for at least 3 weeks were included in the study. Significant improvements were achieved on the affected knee joint for the gait analysis parameters touchdown and unrolling, cadence, stability and stance phase as well as an extension of the hip joint. The Lysholm score improved from 79.3 to 85.8 (p < 0.001) and the IKDC score from 60.2 to 71.3 points (p < 0.001). Significant improvements were achieved in the Rolimeter and angle reproduction test. The use of KT has a positive effect on proprioception in patients with an anterior cruciate ligament rupture. Therefore, the application may improve gait pattern as well as the subjective function of the affected knee joint.

  13. Females, younger patients and patients with high BMI have the highest pre-operative knee awareness measured using the Forgotten Joint Score

    DEFF Research Database (Denmark)

    Li, Dana; Troelsen, A; Ingelsrud, L

    2018-01-01

    PURPOSE: The Forgotten Joint Score (FJS) is a novel measurement for patients' awareness of their knee in daily life. By identifying factors that could explain pre-operative FJS levels, the clinician could better prioritize and single out patients who would benefit most from TKA. The aim of this s...

  14. Assessment of the patellofemoral cartilage: Correlation of knee pain score with magnetic resonance cartilage grading and magnetization transfer ratio asymmetry of glycosaminoglycan chemical exchange saturation transfer.

    Science.gov (United States)

    Lee, Young Han; Yang, Jaemoon; Jeong, Ha-Kyu; Suh, Jin-Suck

    2017-01-01

    Biochemical imaging of glycosaminoglycan chemical exchange saturation transfer (gagCEST) could predict the depletion of glycosaminoglycans (GAG) in early osteoarthritis. The purpose of this study was to evaluate the relationship between the magnetization transfer ratio asymmetry (MTR asym ) of gagCEST images and visual analog scale (VAS) pain scores in the knee joint. This retrospective study was approved by the institutional review board. A phantom study was performed using hyaluronic acid to validate the MTR asym values of gagCEST images. Knee magnetic resonance (MR) images of 22 patients (male, 9; female, 13; mean age, 50.3years; age range; 25-79years) with knee pain were included in this study. The MR imaging (MRI) protocol involved standard knee MRI as well as gagCEST imaging, which allowed region-of-interest analyses of the patellar facet and femoral trochlea. The MTR asym at 1.0ppm was calculated at each region. The cartilages of the patellar facets and femoral trochlea were graded according to the Outerbridge classification system. Data regarding the VAS scores of knee pain were collected from the electronic medical records of the patients. Statistical analysis was performed using Spearman's correlation. The results of the phantom study revealed excellent correlation between the MTR asym values and the concentration of GAGs (r=0.961; p=0.003). The cartilage grades on the MR images showed significant negative correlation with the MTR asym values in the patellar facet and femoral trochlea (r=-0.460; p=0.031 and r=-0.543; p=0.009, respectively). The VAS pain scores showed significant negative correlation with the MTR asym values in the patellar facet and femoral trochlea (r=-0.435; p=0.043 and r=-0.671; p=0.001, respectively). The pain scores were associated with the morphological and biochemical changes in articular cartilages visualized on knee MR images. The biochemical changes, visualized in terms of the MTR asym values of the gagCEST images, exhibited

  15. Return to sport and knee functional scores after anterior cruciate ligament reconstruction: 2 to 10 years' follow-up

    Directory of Open Access Journals (Sweden)

    Sukrom Cheecharern

    2018-04-01

    , and worry about the possibility of re-injury. Overall, total IKDC scores of patients who returned to sport were significantly higher than those of subjects who did not. However, some points such as ability to kneel, ride and bend the knee were not different in the two groups. Bachelor degree education, monthly income lower than 10,000 Thai baht and IKDC score were the factors associated with returning to sport. Conclusions: The rates of return to sport after ACL reconstruction were low compared to those of other reports in the literature. Education, low income and IKDC score were predictive factors of sport re-participation. Further studies should be carried out to assess the impact on treatment indications and rehabilitation. Keywords: Anterior cruciate ligament, Return to sport, ACL outcomes, Knee function

  16. Reference Values for the Marx Activity Rating Scale in a Young Athletic Population: History of Knee Ligament Injury Is Associated With Higher Scores.

    Science.gov (United States)

    Cameron, Kenneth L; Peck, Karen Y; Thompson, Brandon S; Svoboda, Steven J; Owens, Brett D; Marshall, Stephen W

    2015-01-01

    Activity-related patient-reported outcome measures are an important component of assessment after knee ligament injury in young and physically active patients; however, normative data for most activity scales are limited. To present reference values by sex for the Marx Activity Rating Scale (MARS) within a young and physically active population while accounting for knee ligament injury history and sex. Cross-sectional study. Level 2. All incoming freshman entering a US Service Academy in June of 2011 were recruited to participate in this study. MARS was administered to 1169 incoming freshmen (203 women) who consented to participate within the first week of matriculation. All subjects were deemed healthy and medically fit for military service on admission. Subjects also completed a baseline questionnaire that asked for basic demographic information and injury history. We calculated means with standard deviations, medians with interquartile ranges, and percentiles for ordinal and continuous variables, and frequencies and proportions for dichotomous variables. We also compared median scores by sex and history of knee ligament injury using the Kruskal-Wallis test. MARS was the primary outcome of interest. The median MARS score was significantly higher for men when compared with women (χ(2) = 13.22, df = 1, P MARS scores between men and women (χ(2) = 0.47, df = 1, P = 0.493) who reported a history of injury. Overall, median MARS scores were significantly higher among those who reported a history of knee ligament injury when compared with those who did not (χ(2) = 9.06, df = 1, P = 0.003). Assessing activity as a patient-reported outcome after knee ligament injury is important, and reference values for these instruments need to account for the influence of prior injury and sex. © 2015 The Author(s).

  17. Does cruciate retention primary total knee arthroplasty affect proprioception, strength and clinical outcome?

    Science.gov (United States)

    Vandekerckhove, Pieter-Jan T K; Parys, Roel; Tampere, Thomas; Linden, Patrick; Van den Daelen, Luc; Verdonk, Peter C

    2015-06-01

    It remains unclear what the contribution of the PCL is in total knee arthroplasty (TKA). The goal of this study was to investigate the influence of the PCL in TKA in relationship to clinical outcome, strength and proprioception. Two arthroplasty designs were compared: a posterior cruciate-substituting (PS) and a posterior cruciate-retaining (CR) TKA. A retrospective analysis was performed of 27 CR and 18 PS implants with a minimum of 1 year in vivo. Both groups were compared in terms of clinical outcome (range of motion, visual analogue scale for pain, Hospital for Special Surgery Knee Scoring system, Lysholm score and Knee Injury and Osteoarthritis Outcome Score), strength (Biodex System 3 Dynamometer(®)) and proprioception (balance and postural control using the Balance Master system(®)). Each design was also compared to the non-operated contralateral side in terms of strength and proprioception. There were no significant differences between both designs in terms of clinical outcome and strength. In terms of proprioception, only the rhythmic weight test at slow and moderate speed shifting from left to right was significant in favour of the CR design. None of the unilateral stance tests showed any significant difference between both designs. There was no difference in terms of strength and proprioception between the operated side and the non-operated side. Retaining the PCL in TKA does not result in an improved performance in terms of clinical outcome and proprioception and does not show any difference in muscle strength. III.

  18. An empirical study using range of motion and pain score as determinants for continuous passive motion: outcomes following total knee replacement surgery in an adult population.

    Science.gov (United States)

    Tabor, Danielle

    2013-01-01

    The continuous passive motion (CPM) machine is one means by which to rehabilitate the knee after total knee replacement surgery. This study sought to determine which total knee replacement patients, if any, benefit from the use of the CPM machine. For the study period, most patients received active physical therapy. Patients were placed in the CPM machine if, on postoperative day 1, they had a range of motion less than or equal to 45° and/or pain score of 8 or greater on a numeric rating scale of 0-10, 0 being no pain and 10 being the worst pain. Both groups of patients healed at similar rates. The incidence of adverse events, length of stay, and functional outcomes was comparable between groups. Given the demonstrated lack of relative benefit to the patient and the cost of the CPM, this study supported discontinuing the routine use of the CPM.

  19. [Efficacy observation on knee osteoarthritis treated with electroacupuncture and its influence on articular cartilage with T2 mapping].

    Science.gov (United States)

    Bao, Fei; Zhang, Yan; Wu, Zhi-Hong; Wang, Yan; Sheng, Min; Hu, Na; Feng, Feng; Wang, Dao-Hai; Zhang, Yun-Xiang; Li, Tao; Sun, Hua

    2013-03-01

    To observe therapeutic efficacy of osteoarthritis treated by electroacupuncture, and explore its function of promoting cartilage restoration. According to random digital table, sixty cases of knee osteoarthritis (60 knees) were randomly divided into an electroacupuncture group and a physiotherapy group, 15 cases (30 knees) in each one. The electroacupuncture was applied at Neixiyan (EX-LE 4), Dubi (ST 35), Heding (EX-LE 2) and Xuehai (SP 10) in the electroacupuncture group, once every other day. The physiotherapy group was treated by medium-frequency therapeutic apparatus every day. For both groups, 4 weeks of treatment were required. The Lysholm knee scoring scale (LKSS) was used to evaluate and compare the knee joints function before and after treatment. At the same time, the GE Signa EXCITE Twin Speed HD 1.5T was used to take MRI examination of knee joints, and measure the T2 values in 10 sub-regions of the cartilage of tibiofemoral joints. Compared before treatment, the LKSS score of both groups were improved with significant differences except item demands for support (P electroacupuncture group was better than the physiotherapy group, but no significant difference on the other items (all P > 0.05). In the electroacupuncture group after treatment, T2 value in anterior lateral tibial sub-region (LTa) was significantly lowered (P 0.05). In the physiotherapy group, T2 value in any sub-region was not significantly different before and after treatment (all P > 0.05). Electroacupuncture could effectively improve the symptom, sign and knee joint's function of patients with knee osteoarthritis. Compared with physiotherapy, it has more superior effect and considered as a better non-operative treatment for osteoarthritis. Electroacupuncture also has positive influence on T2 value in cartilage, indicating that electroacupuncture may have the function of promoting cartilage restoration.

  20. Clinical and radiological outcomes after management of traumatic knee dislocation by open single stage complete reconstruction/repair

    Directory of Open Access Journals (Sweden)

    Lorez Lukas G

    2010-05-01

    Full Text Available Abstract Background The purpose of our study was to analyze the clinical and radiological long-term outcomes of surgically treated traumatic knee dislocations and determine prognostic factors for outcome. Methods Retrospective consecutive series of patients treated surgically for traumatic knee dislocation with reconstruction/refixation of the anterior (ACL and posterior cruciate ligaments (PCL and primary complete repair of collaterals and posteromedial and posteromedial corner structures. 68 patients were evaluated clinically (IKDC score, SF36 health survey, Lysholm score, Knee Society score, Tegner score, visual analogue scale - VAS pain and satisfaction, Cooper test and radiologically (weight bearing and stress radiographs with a mean follow up of 12 ± 8 years. Instrumented anterior-posterior translation was measured (Rolimeter, KT-1000. Pearson correlation and stepwise regression analysis was used. Results 82% of patients (n = 56 returned to their previous work. At final follow-up 6 patients (9% suffered from pain VAS > 3. The mean side-to-side difference of anterior/posterior translation (KT-1000, 134N was 1.6 ± 1.6 mm and 2.6 ± 1.4 mm. Valgus and varus stress testing in 30° flexion was 40 days were significantly associated with worse outcome (p Conclusions Early complete reconstruction can achieve good functional results and patient satisfaction with overall restoration of sports and working capacity. Negative predictive factors for outcome were injury pattern, type of surgical procedure and timing of surgery.

  1. Posterolateral Corner Reconstruction using the Anatomical Two-Tailed Graft Technique: Clinical Outcomes in the Multiligament Injured Knee.

    Science.gov (United States)

    Woodmass, Jarret M; Sanders, Thomas L; Johnson, Nick R; Wu, Isabella T; Krych, Aaron J; Stuart, Michael J; Levy, Bruce A

    2018-02-14

    Injury to the posterolateral corner (PLC) of the knee can lead to both varus and rotational instability. Multiple PLC reconstruction techniques have been described, including one-tailed graft (fibula-based constructs) or two-tailed graft (combined fibula- and tibia-based constructs). The purpose of our study was to evaluate the clinical outcomes of anatomical two-tailed graft reconstruction of the PLC in the setting of multiligament knee injuries (MKLIs) with grade III varus instability. Patients were identified through a prospective MLKI database between 2004 and 2013. Patients who received fibular collateral ligament and PLC reconstructions using a two-tailed graft and had a minimum follow-up of 2 years were included. Patients were assessed for clinical laxity grade, range of motion, and functional outcomes using Lysholm and International Knee Documentation Committee (IKDC) scores. Twenty patients (16 male, 4 female) with a mean age of 30.7 (range: 16-52) and a mean follow-up of 52.2 months (range: 24-93 months) were included. Knee dislocation (KD) grades included: 4 KD-1, 10 KD 3-L, 5 KD-4, and 1 KD-5. No patients had isolated PLC injuries. Mean IKDC and Lysholm score were 73.1 ± 25.8 and 78 ± 26, respectively. Mean range of motion was -1.1 to 122.8. In full extension, two patients (10%) had grade 1 laxity to varus stress. In 30 degrees of knee flexion, five (25%) patients had grade 1 laxity, and two (10%) had grade 2 laxity. Anatomical two-tailed PLC reconstruction can reliably restore varus stability when performed on patients with MLKIs and type C posterolateral instability with hyperextension external rotation recurvatum deformity. Satisfactory functional outcome scores were achieved in the majority of patients. This study supports the use of an anatomical two-tailed PLC reconstruction in the multiligament injured knee. The level of evidence is IV, case series. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  2. Balance index score as a predictive factor for lower sports results or anterior cruciate ligament knee injuries in Croatian female athletes--preliminary study.

    Science.gov (United States)

    Vrbanić, Tea Schnurrer-Luke; Ravlić-Gulan, Jagoda; Gulan, Gordan; Matovinović, Damir

    2007-03-01

    Female athletes participating in high-risk sports suffer anterior cruciate ligament (ACL) knee injury at a 4- to 6-fold greater rate than do male athletes. ACL injuries result either from contact mechanisms or from certain unexplained non-contact mechanisms occurring during daily professional sports activities. The occurrence of non-contact injuries points to the existence of certain factors intrinsic to the knee that can lead to ACL rupture. When knee joint movement overcomes the static and the dynamic constraint systems, non-contact ACL injury may occur. Certain recent results suggest that balance and neuromuscular control play a central role in knee joint stability, protection and prevention of ACL injuries. The purpose of this study is to evaluate balance neuromuscular skills in healthy Croatian female athletes by measuring their balance index score, as well as to estimate a possible correlation between their balance index score and balance effectiveness. This study is conducted in an effort to reduce the risk of future injuries and thus prevent female athletes from withdrawing from sports prematurely. We analysed fifty-two female athletes in the high-risk sports of handball and volleyball, measuring for their static and dynamic balance index scores, using the Sport KAT 2000 testing system. This method may be used to monitor balance and coordination systems and may help to develop simpler measurements of neuromuscular control, which can be used to estimate risk predictors in athletes who withdraw from sports due to lower sports results or ruptured anterior cruciate ligament and to direct female athletes to more effective, targeted preventive interventions. The tested Croatian female athletes with lower sports results and ACL knee injury incurred after the testing were found to have a higher balance index score compared to healthy athletes. We therefore suggest that a higher balance index score can be used as an effective risk predictor for lower sports results

  3. Osteoarthritis in the Knee Joints of Göttingen Minipigs after Resection of the Anterior Cruciate Ligament? Missing Correlation of MRI, Gene and Protein Expression with Histological Scoring.

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    Gregor Reisig

    Full Text Available The Göttingen Minipig (GM is used as large animal model in articular cartilage research. The aim of the study was to introduce osteoarthritis (OA in the GM by resecting the anterior cruciate ligament (ACLR according to Pond and Nuki, verified by histological and magnetic resonance imaging (MRI scoring as well as analysis of gene and protein expression.The eight included skeletally mature female GM were assessed after ACLR in the left and a sham operation in the right knee, which served as control. 26 weeks after surgery the knee joints were scanned using a 3-Tesla high-field MR tomography unit with a 3 T CP Large Flex Coil. Standard proton-density weighted fat saturated sequences in coronal and sagittal direction with a slice thickness of 3 mm were used. The MRI scans were assessed by two radiologists according to a modified WORMS-score, the X-rays of the knee joints by two evaluators. Osteochondral plugs with a diameter of 4mm were taken for histological examination from either the main loading zone or the macroscopic most degenerated parts of the tibia plateau or condyle respectively. The histological sections were blinded and scored by three experts according to Little et al. Gene expression analysis was performed from surrounding cartilage. Expression of adamts4, adamts5, acan, col1A1, col2, il-1ß, mmp1, mmp3, mmp13, vegf was determined by qRT-PCR. Immunohistochemical staining (IH of Col I and II was performed. IH was scored using a 4 point grading (0-no staining; 3-intense staining.Similar signs of OA were evident both in ACLR and sham operated knee joints with the histological scoring result of the ACLR joints with 6.48 ± 5.67 points and the sham joints with 6.86 ± 5.84 points (p = 0.7953 The MRI scoring yielded 0.34 ± 0.89 points for the ACLR and 0.03 ± 0.17 for the sham knee joints. There was no correlation between the histological and MRI scores (r = 0.10021. The gene expression profiles as well as the immunohistochemical findings

  4. A practical MRI grading system for osteoarthritis of the knee: Association with Kellgren–Lawrence radiographic scores

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    Park, Hee-Jin, E-mail: parkhiji@gmail.com [Department of Radiology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, #108 Pyung-dong, Jongno-gu, Seoul 110-746 (Korea, Republic of); Department of Radiology, Kangwon National University School of Medicine, Baengnyeong-ro 156, Chuncheon-Si, Gangwon-Do Kangwon National University Hospital 200-722 (Korea, Republic of); Kim, Sam Soo, E-mail: samskim@kangwon.ac.kr [Department of Radiology, Kangwon National University School of Medicine, Baengnyeong-ro 156, Chuncheon-Si, Gangwon-Do Kangwon National University Hospital 200-722 (Korea, Republic of); Lee, So-Yeon, E-mail: parkhiji@kwandong.ac.kr [Department of Radiology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, #108 Pyung-dong, Jongno-gu, Seoul 110-746 (Korea, Republic of); Park, Noh-Hyuck, E-mail: nhpark904@kwandong.ac.kr [Department of Radiology, Myongji Hospital, Kwandong University, College of Medicine, 697-24 Hwajung-dong, Dukyang-ku, Koyang, Kyunggi 412-270 (Korea, Republic of); Park, Ji-Yeon, E-mail: zzzz3@hanmail.net [Department of Radiology, Myongji Hospital, Kwandong University, College of Medicine, 697-24 Hwajung-dong, Dukyang-ku, Koyang, Kyunggi 412-270 (Korea, Republic of); Choi, Yoon-Jung, E-mail: yoonchoi99@gmail.com [Department of Radiology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, #108 Pyung-dong, Jongno-gu, Seoul 110-746 (Korea, Republic of); Jeon, Hyun-Jun, E-mail: ostrich-13@hanmail.net [Department of Occupational Medicine, Dongsan Medical Center, Keimyung University School of Medicine, 194 Dongsan-Dong, Jung-ku, Taegu (Korea, Republic of)

    2013-01-15

    Purpose: To propose a reproducible and constant MR grading system for osteoarthritis of the knee joint that provides high interobserver and intraoberver agreement and that does not require complicated calculation procedures. Materials and methods: This retrospective study sample included 44 men and 65 women who underwent both MRI and plain radiography of the knee at our institution. All patients were older than 50 years of age (mean 57.7) and had clinically suspected osteoarthritis of the knee. The standard of 4 grades on the MR grade scale was based mainly on cartilage injury and additional findings. Kellgren–Lawrence grades were assessed for the same patient group. The relationship between the results was determined. Statistical analyses were performed including kappa statistics, categorical regression analysis and nonparametric correlation analysis. Results: The interobserver and intraoberver agreements between the two readers in the grading of osteoarthritis were found to be almost perfect. Interobserver and intraobserver agreements were slightly lower for the MR grading system than for the Kellgren–Lawrence grading scale. The correlation between the MR grade and Kellgren–Lawrence grade was very high and did not differ with patient age. The MR grades were highly correlated with the Kellgren–Lawrence grades and showed excellent interobserver and intraobserver agreements. Conclusion: This new MR grading system for osteoarthritis of the knee joint is reproducible and may be helpful for the grading of osteoarthritis of the knee without requiring reference to plain radiography.

  5. A practical MRI grading system for osteoarthritis of the knee: Association with Kellgren–Lawrence radiographic scores

    International Nuclear Information System (INIS)

    Park, Hee-Jin; Kim, Sam Soo; Lee, So-Yeon; Park, Noh-Hyuck; Park, Ji-Yeon; Choi, Yoon-Jung; Jeon, Hyun-Jun

    2013-01-01

    Purpose: To propose a reproducible and constant MR grading system for osteoarthritis of the knee joint that provides high interobserver and intraoberver agreement and that does not require complicated calculation procedures. Materials and methods: This retrospective study sample included 44 men and 65 women who underwent both MRI and plain radiography of the knee at our institution. All patients were older than 50 years of age (mean 57.7) and had clinically suspected osteoarthritis of the knee. The standard of 4 grades on the MR grade scale was based mainly on cartilage injury and additional findings. Kellgren–Lawrence grades were assessed for the same patient group. The relationship between the results was determined. Statistical analyses were performed including kappa statistics, categorical regression analysis and nonparametric correlation analysis. Results: The interobserver and intraoberver agreements between the two readers in the grading of osteoarthritis were found to be almost perfect. Interobserver and intraobserver agreements were slightly lower for the MR grading system than for the Kellgren–Lawrence grading scale. The correlation between the MR grade and Kellgren–Lawrence grade was very high and did not differ with patient age. The MR grades were highly correlated with the Kellgren–Lawrence grades and showed excellent interobserver and intraobserver agreements. Conclusion: This new MR grading system for osteoarthritis of the knee joint is reproducible and may be helpful for the grading of osteoarthritis of the knee without requiring reference to plain radiography

  6. Translation and Adaptation of Knee Injury and Osteoarthritis Outcome Score (KOOS in to Persian and Testing Persian Version Reliability Among Iranians with Osteoarthritis

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    Solaleh Saraei-Pour

    2007-04-01

    Full Text Available Objective: To achieve a reliable tool for measuring health related quality of life among Iranians with knee osteoarthritis, by translating and culturally adapting the Knee injury and Osteoarthritis Outcome Score(KOOS to Persian and testing the reliability and internal consistency of the Iranian version. Materials & Methods: It was a non experimental methodology study. KOOS was translated and adapted culturally to Persian language and culture in three phases with respect to IQOLA project. For examining test-retest reliability Iranians version of KOOS was corresponded twice with in at least two days or at most one week interval, by 30 Iranian people with knee OA whom were referred to Municipality and 110 physiotherapy clinics of Tehran with PT order by physicians. It was a non experimental methodological research and we used sample of convenience and non probability design for sampling. Psychometric evaluation: the collected data from the questionnaires was rated and analyzed with SPSS software from the aspects of test-retest reliability, absolute reliability, subscale and item internal consistency. Results: Internal consistency which was calculated by Cronbach '&alpha was high for all the subscales (at least 0.76, except for "symptom" subscale which was moderate, and showed that items of each subscale measured the same construct. Item internal consistency after correction for overlap, was higher than optimal value (0.4, except for the items of" symptom" subscale , which demonstrated good item internal consistency. SEM and ICC which were used for evaluating the absolute and test-retest reliability in respect showed that all the subscales had good test-retest reliability (0.7 and the absolute reliability was also very good in such away that the highest calculated SEM for Persian version was 7.44 which was less than Minimal Perceptible Clinical Improvement (MPCI that is estimated 8 to 10 for the KOOS questionnaire. Conclusion: With the Persian

  7. [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.

  8. Effectiveness and Safety of Manufactured Chinese Herbal Formula for Knee Osteoarthritis: Insights from a Systematic Review

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    Liguo Zhu

    2015-01-01

    Full Text Available Objective. To assess the current clinical evidence of manufactured Chinese herbal formulae (MCHF for knee osteoarthritis (KOA. Methods. Seven databases were searched from inception to May 2015. Eligible randomized controlled trials investigating the effectiveness of MCHF for KOA were included. Data extraction, methodological assessment, and meta-analyses were conducted according to the Cochrane standards. Results. A total of 17 kinds of MCHF were identified from the twenty-six included trials. Meta-analyses showed that MCHF significantly relieved the global pain of knee joints, either used alone or combined with routine treatments. Additionally, MCHF plus routine treatments significantly decreased the scores of WOMAC and Lequesne index. However, there were no statistical differences between MCHF group and routine treatment group in walk-related pain and WOMAC scores. No significant differences were found in Lysholm scores. There were twenty-one trials that mentioned adverse events. A pooled analysis showed that adverse events occurred more frequently in control group compared with MCHF group. Conclusions. Our results indicated that MCHF showed some potential benefits for KOA. However, we still cannot draw firm conclusions due to the poor methodological quality of included trials. More high-quality RCTs would help to confirm the evidence.

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

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    Felipe Antônio de Marco

    2008-01-01

    Full Text Available Neste trabalho, 22 pacientes com fraturas ipslaterais do fêmur e da tíbia ("joelho flutuante" tratados cirurgicamente foram convocados para reavaliação. Com seguimento mínimo de 4 meses, 17 pacientes compareceram e foram reavaliados através de exame físico, radiológico, escala de Lysholm e o escore de Kärlstron. As fraturas foram classificadas quanto ao grau de exposição (Gustillo e Andersen, cominuição (AO e o "joelho-flutuante" (Fraser. Doze pacientes (70,6% apresentaram alterações objetivas no exame físico do joelho. A instabilidade articular foi a alteração mais encontrada, presente em oito casos (47%, seguida da restrição de movimento em sete pacientes (41,2%. A instabilidade anterior foi diagnosticada em cinco casos (29,4%, sendo três associados à instabilidade em varo. A instabilidade posterior estava presente em dois pacientes (11,8%, ambos associados com instabilidade em varo. Um paciente apresentou instabilidade periférica em varo e valgo, associada à restrição importante da flexão do joelho. As presença de fraturas intra-articulares, fraturas expostas do fêmur cursaram com maior incidência de restrição do arco de movimento. Nesta casuística os resultados obtidos reforçam a necessidade da avaliação sistemática da estabilidade articular do joelho, visto que o quadro de "joelho flutuante" está freqüentemente associado à lesão cápsulo-ligamentar desta articulação.In this study, 22 patients who had undergone surgical treatment for ipsilateral fractures of the femur and tibia ("floating knee" were recalled for reassessment. Seventeen patients turned up after a follow-up period of four months and were reassessed by applying the physical and radiological exams, the Lysholm's knee scale and the Karlstron score. The fractures were classified according to degree of exposure, communication and "floating knee" condition. Twelve patients (70.6% presented with definite alterations during the physical

  10. Achieving Minimum Clinically Important Difference in Oxford Knee Score and Short Form-36 Physical Component Summary Is Less Likely with Single-Radius Compared with Multiradius Total Knee Arthroplasty in Asians.

    Science.gov (United States)

    Lee, Wu Chean; Bin Abd Razak, Hamid Rahmatullah; Allen, John Carson; Chong, Hwei Chi; Tan, Hwee Chye Andrew

    2018-04-10

    Single-radius (SR) and multiradius (MR) total knee arthroplasties (TKAs) have produced similar outcomes, albeit most studies originate from Western nations. There are known knee kinematic differences between Western and Asian patients after TKA. The aim of this study is to compare the short-term patient-reported outcome measures (PROMs) of SR-TKA versus MR-TKA in Asians. Registry data of 133 SR-TKA versus 363 MR-TKA by a single surgeon were analyzed. Preoperative and 2-year postoperative range of motion (ROM) and PROMs were compared with Student's t -test and Mann-Whitney U-test. Logistic regression model was used to evaluate the odds of SR-TKA or MR-TKA achieving the minimum clinically important difference (MCID) of studied outcomes. Patients in both groups had similar age (65.7 ± 7.6 vs. 65.8 ± 8.2 years; p  = 0.317), gender proportion (71% females vs. 79% females; p  = 0.119), and ethnic distribution (80% Chinese vs. 84% Chinese; p  = 0.258). Preoperatively, there were no statistically significant differences between both groups for ROM, Knee Society Score (KSS), Oxford Knee Score (OKS), and Short Form (SF)-36 scores. At 2 years, all outcomes were statistically similar or failed to achieve a difference of MCID. Controlling for all preoperative variables, SR-TKA has significantly lower odds of achieving MCID for OKS (odds ratio [OR]: 0.275, 95% confidence interval [CI]: 0.114-0.663; p  = 0.004) and SF-36 Physical Component Summary (PCS) (OR: 0.547; 95% CI: 0.316-0.946; p  = 0.031) compared with MR-TKA. In conclusion, there are no significant differences in the absolute PROMs between SR-TKA and MR-TKA at 2 years following TKA in Asians. However, SR-TKA has significantly lower odds of achieving the MCID for OKS and SF-36 PCS. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  11. Arthritis self-efficacy scale scores in knee osteoarthritis: a systematic review and meta-analysis comparing arthritis self-management education with or without exercise.

    Science.gov (United States)

    Brand, Emily; Nyland, John; Henzman, Cameron; McGinnis, Mark

    2013-12-01

    Systematic literature review and meta-analysis. To evaluate studies that used arthritis self-management education alone or with exercise to improve Arthritis Self-Efficacy Scale scores of patients with knee osteoarthritis. Increasing self-efficacy may improve patient knee osteoarthritis symptom management and function. MEDLINE (1946-March 2013), CINAHL (1981-March 2013), and PsycINFO (1967-March 2013) databases were searched. Twenty-four studies, including 3163 subjects (women, n = 2547 [80.5%]; mean ± SD age, 65.3 ± 6.5 years), met the inclusion criteria. A meta-analysis was performed to compare the standardized mean difference effect sizes (Cohen d) of randomized controlled studies that used the Arthritis Self-Efficacy Scale pain (13 studies, n = 1906), other symptoms (13 studies, n = 1957), and function (5 studies, n = 399) subscales. Cohen d effect sizes were also calculated for cohort studies that used the Arthritis Self-Efficacy Scale pain (10 studies, n = 1035), other symptoms (9 studies, n = 913), and function (3 studies, n = 141) subscales. Both randomized controlled studies and cohort studies were grouped by intervention type (intervention 1, arthritis self-management education alone; intervention 2, arthritis self-management education with exercise), and effect sizes were compared (Mann-Whitney U tests, Pmanagement education with exercise displayed higher methodological quality scale scores (76.8 ± 13.1 versus 61.6 ± 19.6, P = .03). Statistically significant standardized effect-size differences between intervention 1 and intervention 2 were not observed. Small to moderate effect sizes were observed regardless of whether the intervention included exercise. Exercise interventions used in conjunction with arthritis self-management education programs need to be developed to better enhance the self-efficacy of patients with knee osteoarthritis. Therapy, level 2b-.

  12. Arthroscopic Transplantation of Synovial Stem Cells Improves Clinical Outcomes in Knees With Cartilage Defects.

    Science.gov (United States)

    Sekiya, Ichiro; Muneta, Takeshi; Horie, Masafumi; Koga, Hideyuki

    2015-07-01

    Transplantation of mesenchymal stem cells (MSCs) is one possible strategy to achieve articular cartilage repair. We previously reported that synovial MSCs were highly proliferative and able to undergo chondrogenesis. We also found that placing a suspension of synovial MSCs on a cartilage defect for 10 minutes promoted cartilage repair in rabbit and pig models. However, the in vivo efficacy of this approach has not been tested clinically. We asked whether transplantation of synovial MSCs improves (1) MRI features, (2) histologic features, and (3) clinical evaluation scores in patients with cartilage defects in the knee? Patients with a symptomatic single cartilage lesion of the femoral condyle were indicated for inclusion in our study, and between April 2008 and April 2011, 10 patients were enrolled in this study. All patients completed followups of 3 years or more. The average followup period was 52 months (range, 37-80 months). Synovial MSCs were expanded with 10% autologous human serum for 14 days after digestion. For transplantation, the patient was positioned so that the cartilage defect was facing upward, and synovial MSC suspension was placed on the cartilage defect with a syringe under arthroscopic control. The defect with the applied suspension then was held in the upward position for 10 minutes. Five patients underwent concomitant ACL reconstructions, among whom two had meniscus suturing performed simultaneously. For MRI quantification, the cartilage defect was scored from 0 to 5. Second-look arthroscopy was performed for four patients and biopsy specimens were evaluated histologically. Clinical outcome was assessed using the Lysholm score and Tegner Activity Level Scale at final followup. Comparisons of MRI and Lysholm scores before and after treatment for each patient were analyzed using the Wilcoxon signed-rank test. MRI score (median ± 95% CI) was 1.0 ± 0.3 before and 5.0 ± 0.7 after, and increased after treatment in each patient (p = 0.005). Second

  13. Development of the Knee Quality of Life (KQoL-26 26-item questionnaire: data quality, reliability, validity and responsiveness

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    Atwell Chris

    2008-07-01

    Full Text Available Abstract Background This article describes the development and validation of a self-reported questionnaire, the KQoL-26, that is based on the views of patients with a suspected ligamentous or meniscal injury of the knee that assesses the impact of their knee problem on the quality of their lives. Methods Patient interviews and focus groups were used to derive questionnaire content. The instrument was assessed for data quality, reliability, validity, and responsiveness using data from a randomised trial and patient survey about general practitioners' use of Magnetic Resonance Imaging for patients with a suspected ligamentous or meniscal injury. Results Interview and focus group data produced a 40-item questionnaire designed for self-completion. 559 trial patients and 323 survey patients responded to the questionnaire. Following principal components analysis and Rasch analysis, 26 items were found to contribute to three scales of knee-related quality of life: physical functioning, activity limitations, and emotional functioning. Item-total correlations ranged from 0.60–0.82. Cronbach's alpha and test retest reliability estimates were 0.91–0.94 and 0.80–0.93 respectively. Hypothesised correlations with the Lysholm Knee Scale, EQ-5D, SF-36 and knee symptom questions were evidence for construct validity. The instrument produced highly significant change scores for 65 trial patients indicating that their knee was a little or somewhat better at six months. The new instrument had higher effect sizes (range 0.86–1.13 and responsiveness statistics (range 1.50–2.13 than the EQ-5D and SF-36. Conclusion The KQoL-26 has good evidence for internal reliability, test-retest reliability, validity and responsiveness, and is recommended for use in randomised trials and other evaluative studies of patients with a suspected ligamentous or meniscal injury.

  14. Development of the knee quality of life (KQoL-26) 26-item questionnaire: data quality, reliability, validity and responsiveness.

    Science.gov (United States)

    Garratt, Andrew M; Brealey, Stephen; Robling, Michael; Atwell, Chris; Russell, Ian; Gillespie, William; King, David

    2008-07-10

    This article describes the development and validation of a self-reported questionnaire, the KQoL-26, that is based on the views of patients with a suspected ligamentous or meniscal injury of the knee that assesses the impact of their knee problem on the quality of their lives. Patient interviews and focus groups were used to derive questionnaire content. The instrument was assessed for data quality, reliability, validity, and responsiveness using data from a randomised trial and patient survey about general practitioners' use of Magnetic Resonance Imaging for patients with a suspected ligamentous or meniscal injury. Interview and focus group data produced a 40-item questionnaire designed for self-completion. 559 trial patients and 323 survey patients responded to the questionnaire. Following principal components analysis and Rasch analysis, 26 items were found to contribute to three scales of knee-related quality of life: physical functioning, activity limitations, and emotional functioning. Item-total correlations ranged from 0.60-0.82. Cronbach's alpha and test retest reliability estimates were 0.91-0.94 and 0.80-0.93 respectively. Hypothesised correlations with the Lysholm Knee Scale, EQ-5D, SF-36 and knee symptom questions were evidence for construct validity. The instrument produced highly significant change scores for 65 trial patients indicating that their knee was a little or somewhat better at six months. The new instrument had higher effect sizes (range 0.86-1.13) and responsiveness statistics (range 1.50-2.13) than the EQ-5D and SF-36. The KQoL-26 has good evidence for internal reliability, test-retest reliability, validity and responsiveness, and is recommended for use in randomised trials and other evaluative studies of patients with a suspected ligamentous or meniscal injury.

  15. Associations between preoperative Oxford hip and knee scores and costs and quality of life of patients undergoing primary total joint replacement in the NHS England: an observational study.

    Science.gov (United States)

    Eibich, Peter; Dakin, Helen A; Price, Andrew James; Beard, David; Arden, Nigel K; Gray, Alastair M

    2018-04-10

    To assess how costs and quality of life (measured by EuroQoL-5 Dimensions (EQ-5D)) before and after total hip replacement (THR) and total knee replacement (TKR) vary with age, gender and preoperative Oxford hip score (OHS) and Oxford knee score (OKS). Regression analyses using prospectively collected data from clinical trials, cohort studies and administrative data bases. UK secondary care. Men and women undergoing primary THR or TKR. The Hospital Episode Statistics data linked to patient-reported outcome measures included 602 176 patients undergoing hip or knee replacement who were followed up for up to 6 years. The Knee Arthroplasty Trial included 2217 patients undergoing TKR who were followed up for 12 years. The Clinical Outcomes in Arthroplasty Study cohort included 806 patients undergoing THR and 484 patients undergoing TKR who were observed for 1 year. EQ-5D-3L quality of life before and after surgery, costs of primary arthroplasty, costs of revision arthroplasty and the costs of hospital readmissions and ambulatory costs in the year before and up to 12 years after joint replacement. Average postoperative utility for patients at the 5th percentile of the OHS/OKS distribution was 0.61/0.5 for THR/TKR and 0.89/0.85 for patients at the 95th percentile. The difference between postoperative and preoperative EQ-5D utility was highest for patients with preoperative OHS/OKS lower than 10. However, postoperative EQ-5D utility was higher than preoperative utility for all patients with OHS≤46 and those with OKS≤44. In contrast, costs were generally higher for patients with low preoperative OHS/OKS than those with high OHS/OKS. For example, costs of hospital readmissions within 12 months after primary THR/TKR were £740/£888 for patients at the 5th percentile compared with £314/£404 at the 95th percentile of the OHS/OKS distribution. Our findings suggest that costs and quality of life associated with total joint replacement vary systematically with

  16. Análise da correlação entre pico de torque, desempenho funcional e frouxidão ligamentar em indivíduos normais e com reconstrução do ligamento cruzado anterior Functional performance and knee laxity in normal individuals and in individuals submitted to anterior cruciate ligament reconstruction

    Directory of Open Access Journals (Sweden)

    Rodrigo Antunes de Vasconcelos

    2009-04-01

    Full Text Available OBJETIVO: Analisar a correlação entre os déficits musculares dos extensores e flexores do joelho através do pico de torque isocinético com os testes de salto monopodal, frouxidão ligamentar pós-operatória e questionário de função em indivíduos normais e indivíduos submetidos à reconstrução do LCA com enxerto autólogo do tendão patelar e dos tendões flexores. MÉTODOS: Foram recrutados 60 indivíduos, formando três grupos: 20 indivíduos sem lesões no joelho (grupo GC e dois grupos de 20 indivíduos submetidos à reconstrução do LCA com tendão patelar (grupo GTP ou tendões flexores (grupo GTF. RESULTADOS: Os resultados demonstraram correlação significativa entre déficits no pico de torque e testes funcionais no torque extensor nos grupos GTF e GC. Não foram observadas correlações significativas entre frouxidão ligamentar pós-operatória e questionário de Lysholm com os testes de salto e déficits no pico de torque. Em relação à diferença entre os grupos, foi observado que o grupo GTP demonstrou maior déficit do torque extensor, menor pontuação no questionário de Lysholm e maior percentagem dos indivíduos com índice de simetria entre membros (ISM OBJECTIVES: The aim of this study was to analyze the correlation between deficits in the isokinetic peak torque of the knee extensors and flexors with hop tests, postoperative knee laxity and functional scores in normal and ACL- reconstructed subjects with patellar tendon and hamstring tendon autografts. METHODS: Sixty male subjects were enrolled and subdivided into three groups: Twenty subjects without knee injuries (GC group and two groups of 20 subjects submitted to ACL reconstruction with patellar tendon (GTP group and hamstrings autograft (GTF group. RESULTS: The results showed significant correlation between knee extensors peak torque and performance in the hop tests for GTF and GC groups. There are no significantly correlations between post op knee laxity

  17. The importance of early diagnosis in spontaneous osteonecrosis of the knee - A case series with six year follow-up.

    Science.gov (United States)

    Jordan, Robert W; Aparajit, Prasad; Docker, Charles; Udeshi, Umesh; El-Shazly, Mohi

    2016-08-01

    Spontaneous osteonecrosis of the knee has an unknown aetiology. Management options include conservative, surgical and pharmacological interventions. The aim of this study was to report the experience of the authors in conservative management of SONK using non-operative measures by analysing the functional outcome and need for surgical intervention. All patients treated for SONK between 1st August 2001 and 1st April 2014 were retrospectively reviewed. Treatment consisted of touch-down weight bearing for around six weeks. MR imaging was evaluated for size of lesion, the condyles involved and the time taken for resolution. Tegner Activity Scale, VAS pain, Lysholm, WOMAC and IKDC scores were recorded at presentation and final follow-up (mean six years, range six months to 13years). Forty cases were included; the mean age of the group was 55.3years and 67.5% were male. The medial femoral condyle was the most commonly affected (52.5%). A statistically significant improvement was reported in all functional outcome measures (p<0.001). Only one patient required arthroscopic surgical intervention and no patients required arthroplasty during the follow-up period. Early stage spontaneous osteonecrosis of the knee can be managed successfully without surgery if diagnosed early. Thus early investigation of acute knee pain with MRI scanning is recommended. Copyright © 2016 Elsevier B.V. All rights reserved.

  18. Surgical treatment of subacute and chronic valgus instability in multiligament-injured knees with superficial medial collateral ligament reconstruction using Achilles allografts: a quantitative analysis with a minimum 2-year follow-up.

    Science.gov (United States)

    Liu, Xin; Feng, Hua; Zhang, Hui; Hong, Lei; Wang, Xue Song; Zhang, Jin; Shen, Jie Wei

    2013-05-01

    Symptomatic medial collateral ligament (MCL) instability is rare, and it is frequently associated with multiligament injuries. Most clinical investigations have failed to clearly define the specific objective outcome measures assessing the stability of the MCL quantitatively before and after the reconstruction procedure. To quantitatively evaluate the early clinical outcomes of patients with valgus instability of knee joints who had undergone superficial MCL reconstruction using Achilles tendon allografts. Case series; Level of evidence, 4. From August 2005 to December 2010, 19 consecutive patients with MCL injuries were included in this study. The inclusion criteria were (1) a subacute or chronic MCL injury, with a time from initial injury to surgery of longer than 3 weeks, and (2) valgus laxity graded C or D according to the International Knee Documentation Committee (IKDC). All patients underwent superficial MCL reconstruction using Achilles tendon allografts. To evaluate the laxity of the MCL preoperatively and postoperatively, valgus stress radiographs using a Telos device were used. Other assessments included the IKDC subjective functional evaluation and Lysholm score estimation. Sixteen of the 19 patients (12 men and 4 women) were available for final follow-up. The median age of the patients was 37 years (range, 19-53 years); mean body mass index (BMI) was 26.4 (range, 21.7-29.4). The mean time from injury to surgery was 15.9 months (range, 24 days to 84 months), and median follow-up period was 34 months (range, 24-67 months). The mean medial knee laxity (side-to-side difference) was 8.9 ± 3.2 mm (range, 6-15.9 mm) preoperatively and 1.1 ± 0.9 mm (range, -1.1 to 3.2 mm) postoperatively (P < .001). The preoperative mean IKDC subjective knee functional score was 49.8 ± 6.9 (range, 31-57.5), while the postoperative functional score was 84.3 ± 6.0 (range, 71.3-93.1) (P < .001). The mean Lysholm score was 69.3 ± 5.9 (range, 55-78) preoperatively and 88.6

  19. Anterior cruciate ligament reconstruction with 4-strand hamstring autograft and accelerated rehabilitation: a 10-year prospective study on clinical results, knee osteoarthritis and its predictors.

    Science.gov (United States)

    Janssen, Rob P A; du Mée, Arthur W F; van Valkenburg, Juliette; Sala, Harm A G M; Tseng, Carroll M

    2013-09-01

    Analysis of long-term clinical and radiological outcomes after anterior cruciate ligament (ACL) reconstruction with special attention to knee osteoarthritis and its predictors. A prospective, consecutive case series of 100 patients. Arthroscopic transtibial ACL reconstruction was performed using 4-strand hamstring tendon autografts with a standardized accelerated rehabilitation protocol. Analysis was performed preoperatively and 10 years postoperatively. Clinical examination included Lysholm and Tegner scores, IKDC, KT-1000 testing (MEDmetric Co., San Diego, CA, USA) and leg circumference measurements. Radiological evaluation included AP weight bearing, lateral knee, Rosenberg and sky view X-rays. Radiological classifications were according to Ahlbäck and Kellgren & Lawrence. Statistical analysis included univariate and multivariate logistic regressions. RESULTS CLINICAL OUTCOME: A significant improvement (p test, IKDC score and one-leg hop test. A pivot shift phenomenon (glide) was still present in 43 (50%) patients and correlated with lower levels of activity (p test. Transtibial ACL reconstruction with 4-strand hamstring autograft and accelerated rehabilitation restored anteroposterior knee stability. Clinical parameters and patient satisfaction improved significantly. At 10-year follow-up, radiological signs of OA were present in 53.5 % of the subjects. Risk factors for OA were meniscectomy prior to or at the time of ACL reconstruction and chondral lesions at the time of ACL reconstruction. II.

  20. Preoperative Short Form Health Survey Score Is Predictive of Return to Play and Minimal Clinically Important Difference at a Minimum 2-Year Follow-up After Anterior Cruciate Ligament Reconstruction.

    Science.gov (United States)

    Nwachukwu, Benedict U; Chang, Brenda; Voleti, Pramod B; Berkanish, Patricia; Cohn, Matthew R; Altchek, David W; Allen, Answorth A; Williams, Riley J

    2017-10-01

    There is increased interest in understanding the preoperative determinants of postoperative outcomes. Return to play (RTP) and the patient-reported minimal clinically important difference (MCID) are useful measures of postoperative outcomes after anterior cruciate ligament reconstruction (ACLR). To define the MCID after ACLR and to investigate the role of preoperative outcome scores for predicting the MCID and RTP after ACLR. Case-control study; Level of evidence, 3. There were 294 active athletes enrolled as part of an institutional ACL registry with a minimum 2-year follow-up who were eligible for inclusion. A questionnaire was administered to elicit factors associated with RTP. Patient demographic and clinical data as well as patient-reported outcome measures were captured as part of the registry. Outcome measures included the International Knee Documentation Committee (IKDC) subjective knee evaluation form, Lysholm scale, and 12-Item Short Form Health Survey (SF-12) physical component summary (PCS) and mental component summary (MCS). Preoperative outcome score thresholds predictive of RTP were determined using a receiver operating characteristic (ROC) with area under the curve (AUC) analysis. The MCID was calculated using a distribution-based method. Multivariable logistic models were fitted to identify predictors for achieving the MCID and RTP. At a mean (±SD) follow-up of 3.7 ± 0.7 years, 231 patients were included from a total 294 eligible patients. The mean age and body mass index were 26.7 ± 12.5 years and 23.7 ± 3.2 kg/m 2 , respectively. Of the 231 patients, 201 (87.0%) returned to play at a mean time of 10.1 months. Two-year postoperative scores on all measures were significantly increased from preoperative scores (IKDC: 50.1 ± 15.6 to 87.4 ± 10.7; Lysholm: 61.2 ± 18.1 to 89.5 ± 10.4; SF-12 PCS: 41.5 ± 9.0 to 54.7 ± 4.6; SF-12 MCS: 53.6 ± 8.1 to 55.7 ± 5.7; P predictive of RTP were the following: IKDC, 60.9; Lysholm, 57.0; SF-12 PCS, 42

  1. Traumatic posterior root tear of the medial meniscus in patients with severe medial instability of the knee.

    Science.gov (United States)

    Ra, Ho Jong; Ha, Jeong Ku; Jang, Ho Su; Kim, Jin Goo

    2015-10-01

    To examine the incidence and diagnostic rate of traumatic medial meniscus posterior root tear associated with severe medial instability and to evaluate the effectiveness of pullout repair. From 2007 to 2011, 51 patients who underwent operation due to multiple ligament injuries including medial collateral ligament rupture were reviewed retrospectively. The International Knee Documentation Committee (IKDC) subjective and Lysholm score were evaluated pre- and postoperatively. Postoperative magnetic resonance imaging (MRI) was performed, and if indicated, a second-look arthroscopic examination was conducted. Fourteen out of 51 patients were associated with severe medial instability. Seven patients were diagnosed with traumatic medial meniscus posterior root tear and underwent arthroscopic pullout repair. Five of them were missed at initial diagnosis using MRI. In seven patients, the mean Lysholm and IKDC subjective scores improved from 74.6 ± 10.3 and 47.6 ± 7.3 to 93.0 ± 3.7 and 91.6 ± 2.6, respectively. All showed complete healing of meniscus root on follow-up MRI and second-look arthroscopy. Medial meniscus posterior root tear may occur in severe medial instability from trauma. It is a common mistake that surgeons may not notice on the diagnosis of those injuries using MRI. Therefore, a high index of suspicion is required for the diagnosis of medial meniscus posterior root tear in this type of injuries. The traumatic medial meniscus posterior root tear could be healed successfully using arthroscopic pullout repair technique. The possibility of the medial meniscus posterior root tear should be considered in severe medial instability and arthroscopic pullout repair can be an effective option for treatment. Case series with no comparison group, Level IV.

  2. Evaluation of focal cartilage lesions of the knee using MRI T2 mapping and delayed Gadolinium Enhanced MRI of Cartilage (dGEMRIC).

    Science.gov (United States)

    Årøen, Asbjørn; Brøgger, Helga; Røtterud, Jan Harald; Sivertsen, Einar Andreas; Engebretsen, Lars; Risberg, May Arna

    2016-02-11

    Assessment of degenerative changes of the cartilage is important in knee cartilage repair surgery. Magnetic Resonance Imaging (MRI) T2 mapping and delayed Gadolinium Enhanced MRI of Cartilage (dGEMRIC) are able to detect early degenerative changes. The hypothesis of the study was that cartilage surrounding a focal cartilage lesion in the knee does not possess degenerative changes. Twenty-eight consecutive patients included in a randomized controlled trial on cartilage repair were evaluated using MRI T2 mapping and dGEMRIC before cartilage treatment was initiated. Inclusion was based on disabling knee problems (Lysholm score of ≤ 75) due to an arthroscopically verified focal femoral condyle cartilage lesion. Furthermore, no major malalignments or knee ligament injuries were accepted. Mean patient age was 33 ± 9.6 years, and the mean duration of knee symptoms was 49 ± 60 months. The MRI T2 mapping and the dGEMRIC measurements were performed at three standardized regions of interest (ROIs) at the medial and lateral femoral condyle, avoiding the cartilage lesion The MRI T2 mapping of the cartilage did not demonstrate significant differences between condyles with or without cartilage lesions. The dGEMRIC results did not show significantly lower values of the affected condyle compared with the opposite condyle and the contra-lateral knee in any of the ROIs. The intraclass correlation coefficient (ICC) of the dGEMRIC readings was 0.882. The MRI T2 mapping and the dGEMRIC confirmed the arthroscopic findings that normal articular cartilage surrounded the cartilage lesion, reflecting normal variation in articular cartilage quality. NCT00885729 , registered April 17 2009.

  3. Does knee awareness differ between different knee arthroplasty prostheses?

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  4. Prospective associations of C-reactive protein (CRP) levels and CRP genetic risk scores with risk of total knee and hip replacement for osteoarthritis in a diverse cohort.

    Science.gov (United States)

    Shadyab, A H; Terkeltaub, R; Kooperberg, C; Reiner, A; Eaton, C B; Jackson, R D; Krok-Schoen, J L; Salem, R M; LaCroix, A Z

    2018-05-22

    To examine associations of high-sensitivity C-reactive protein (CRP) levels and polygenic CRP genetic risk scores (GRS) with risk of end-stage hip or knee osteoarthritis (OA), defined as incident total hip (THR) or knee replacement (TKR) for OA. This study included a cohort of postmenopausal white, African American, and Hispanic women from the Women's Health Initiative. Women were followed from baseline to date of THR or TKR, death, or December 31, 2014. Medicare claims data identified THR and TKR. Hs-CRP and genotyping data were collected at baseline. Three CRP GRS were constructed: 1) a 4-SNP GRS comprised of genetic variants representing variation in the CRP gene among European populations; 2) a multilocus 18-SNP GRS of genetic variants significantly associated with CRP levels in a meta-analysis of genome-wide association studies; and 3) a 5-SNP GRS of genetic variants significantly associated with CRP levels among African American women. In analyses conducted separately among each race and ethnic group, there were no significant associations of ln hs-CRP with risk of THR or TKR, after adjusting for age, body mass index, lifestyle characteristics, chronic diseases, hormone therapy use, and non-steroidal anti-inflammatory drug use. CRP GRS were not associated with risk of THR or TKR in any ethnic group. Serum levels of ln hs-CRP and genetically-predicted CRP levels were not associated with risk of THR or TKR for OA among a diverse cohort of women. Copyright © 2018 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  5. Decreased synovial fluid ghrelin levels are linked with disease severity in primary knee osteoarthritis patients and are increased following laser therapy.

    Science.gov (United States)

    Zou, Yu-Cong; Deng, Hong-Yu; Mao, Zheng; Zhao, Chang; Huang, Ju; Liu, Gang

    2017-07-01

    Ghrelin has been proved to inhibit inflammation and promote cartilage growth. So far, its role in patients with primary knee osteoarthritis has not been investigated. The current study was performed to explore the serum and synovial ghrelin levels as well as the relationship between ghrelin levels and disease severity in primary knee OA patients. 52 primary knee OA patients were recruited in the study. 52 sex and age-matched patients visiting our hospital for regular body check were selected as controls. The serum and synovial fluid ghrelin levels were examined by enzyme linked immunosorbent assay (ELISA) before treatment, one week and four weeks after laser therapy, respectively. The inflammation markers IL-6 and TNF-α were also investigated. The radiographic progression was assessed by Kellgren-Lawrence (K-L) grade scale and the symptomatic severity was evaluated by visual analog scale (VAS), Lequesne index and Lysholm scores. The Receiver Operating Characteristic (ROC) analysis curve was conducted to test the diagnostic value of ghrelin, IL-6 and TNF-α for radiographic progression. No significant difference of serum ghrelin levels was found between knee OA patients and healthy controls. Synovial fluid ghrelin concentrations were significantly negatively correlated with K-L grading (r=-0.591, Pghrelin levels were also related to clinical severity determined by Lequesne index (r=-0.308, P=0.025),VAS scores (r=-0.591, Pghrelin levels were also negatively associated with TNF-α (r=-0.424, P=0.002) and IL-6 concentrations (r=-0.428, P=0.002). ROC curve analysis demonstrated that ghrelin exhibited more diagnostic value than IL-6 and TNF-α for assessing radiographic progression in medium-late stage. Decreased synovial fluid ghrelin levels are related to disease severity in patients with primary osteoarthritis and are increased following laser therapy. Local application of ghrelin may serve as an adjunctive therapy for knee OA. Copyright © 2017. Published by

  6. Biological knee reconstruction for combined malalignment, meniscal deficiency, and articular cartilage disease.

    Science.gov (United States)

    Harris, Joshua D; Hussey, Kristen; Wilson, Hillary; Pilz, Kyle; Gupta, Anil K; Gomoll, Andreas; Cole, Brian J

    2015-02-01

    The aim of this study was to analyze patient-reported outcomes in those undergoing the triad of simultaneous osteotomy, meniscal transplantation, and articular cartilage repair. Patients undergoing simultaneous meniscal transplantation, distal femoral or proximal tibial osteotomy, and articular cartilage surgery by a single surgeon (B.J.C.) were analyzed. Meniscal transplantation was performed using bone-in-slot techniques. Distal femoral and high tibial osteotomies were performed for valgus and varus malalignment, respectively. Microfracture, autologous chondrocyte implantation, and osteochondral autograft or allograft were performed for articular cartilage disease. Validated patient-reported and surgeon-measured outcomes were collected. Preoperative and postoperative outcomes and medial versus lateral disease were compared using Student t tests. Eighteen participants (mean age, 34 ± 7.8 years; symptomatic patients, 7.4 ± 5.6 years; 2.4 ± 1.0 surgical procedures before study enrollment; mean follow-up, 6.5 ± 3.2 years) were analyzed. Two thirds of participants had medial compartment pathologic conditions and one third had lateral compartment pathologic processes. At final follow-up, there were statistically significant clinically meaningful improvements in International Knee Documentation Committee (IKDC) subjective classification, Lysholm score, and 4 Knee Injury and Osteoarthritis Outcome Score (KOOS) subscores. Postoperative 12-item short form (SF-12) physical and mental component scores were not significantly different from preoperative scores. The Kellgren-Lawrence classification grade was 1.5 ± 1.1 at 2.5 ± 3.0 years after surgery. There was a significantly higher preoperative SF-12 physical composite score (PCS) in participants with lateral compartment pathologic conditions (v medial compartment conditions) (P = .011). Although there were 13 reoperations in 10 patients (55.5% reoperation rate), only one patient was converted to knee arthroplasty (5

  7. Determining utility values in patients with anterior cruciate ligament tears using clinical scoring systems

    Directory of Open Access Journals (Sweden)

    Szucs Thomas

    2011-08-01

    Full Text Available Abstract Background Several instruments and clinical scoring systems have been established to evaluate patients with ligamentous knee injuries. A comparison of individual articles in the literature is challenging, not only because of heterogeneity in methodology, but also due to the variety of the scoring systems used to document clinical outcomes. There is limited information about the correlation between used scores and quality of life with no information being available on the impact of each score on the utility values. The aim of this study was to compare the most commonly used scores for evaluating patients with anterior cruciate ligament (ACL injuries, and to establish corresponding utility values. These values will be used for the interpretation and comparison of outcome results in the currently available literature for different treatment options. Methods Four hypothetical vignettes were defined, based on different levels of activities after rupture of the ACL to simulate typical situations seen in daily practice. A questionnaire, including the Health Utility Index (HUI for utility values, the IKDC subjective score, the Lysholm and the Tegner score, was created and 25 orthopedic surgeons were asked to fill the questionnaire for each hypothetical patient as proxies for all patients they had treated and who would fit in that hypothetical vignette. Results The utility value as an indicator for quality of life increased with the level of activity. Having discomforts already during normal activities of daily living was rated with a mean utility value of 0.37 ± 0.19, half of that of a situation where mild sport activity was possible without discomfort (0.78 ± 0.11. All investigated scores were able to distinguish clearly (p Conclusions Here we report the correlation between the most commonly used scores for the assessment of patients with a ruptured ACL and utility values as an indicator of quality of life. Assumptions were based on expert

  8. 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 ...

  9. Knee Replacement

    Science.gov (United States)

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

  10. Continued Inpatient Care After Primary Total Knee Arthroplasty Increases 30-Day Post-Discharge Complications: A Propensity Score-Adjusted Analysis.

    Science.gov (United States)

    McLawhorn, Alexander S; Fu, Michael C; Schairer, William W; Sculco, Peter K; MacLean, Catherine H; Padgett, Douglas E

    2017-09-01

    Discharge destination, either home or skilled care facility, after total knee arthroplasty (TKA) may be associated with significant variation in postacute care outcomes. The purpose of this study was to characterize the 30-day postdischarge outcomes after primary TKA relative to discharge destination. All primary unilateral TKAs performed for osteoarthritis from 2011-2014 were identified in the National Surgical Quality Improvement Program database. Propensity scores based on predischarge characteristics were used to adjust for selection bias in discharge destination. Propensity-adjusted multivariable logistic regressions were used to examine associations between discharge destination and postdischarge complications. Among 101,256 primary TKAs identified, 70,628 were discharged home and 30,628 to skilled care facilities. Patients discharged to facilities were more frequently were female, older, higher body mass index class, higher Charlson comorbidity index and American Society of Anesthesiologists scores, had predischarge complications, received general anesthesia, and classified as nonindependent preoperatively. Propensity adjustment accounted for this selection bias. Patients discharged to skilled care facilities after TKA had higher odds of any major complication (odds ratio = 1.25; 95% confidence interval, 1.13-1.37) and readmission (odds ratio = 1.81; 95% confidence interval, 1.50-2.18). Skilled care was associated with increased odds for respiratory, septic, thromboembolic, and urinary complications. Associations with death, cardiac, and wound complications were not significant. After controlling for predischarge characteristics, discharge to skilled care facilities vs home after primary TKA is associated with higher odds of numerous complications and unplanned readmission. These results support coordination of care pathways to facilitate home discharge after hospitalization for TKA whenever possible. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2016-08-01

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

  12. MRI based volumetric assessment of knee cartilage after ACL-reconstruction, correlated with qualitative morphologic changes in the joint and with clinical outcome. Is there evidence for early posttraumatic degeneration?; MRT-basierte Knorpelvolumetrie nach Kreuzbandersatzplastik in Korrelation mit qualitativen Gelenkveraenderungen und dem klinischen Outcome. Gibt es Hinweise auf fruehzeitige posttraumatische degenerative Veraenderungen?

    Energy Technology Data Exchange (ETDEWEB)

    Arnoldi, A.P.; Weckbach, S.; Horng, A.; Reiser, M. [Ludwig-Maximilians-Univ. Muenchen (Germany). Dept. of Clinical Radiology; Nussbickel, C. [Klinikum Garmisch-Partenkirchen (Germany). Dept. of Internal Medicine; Noebauer, I. [Medizinische Universitaet Wien (Austria). Klinik fuer Radiodiagnostik; Zysk, S. [Orthopaedie Zentrum Groebenzell (Germany). Center of Orthopaedics; Glaser, C. [NYU Medical Center, New York, NY (United States). Dept. of Radiology

    2011-12-15

    Purpose: The purpose of this study was to analyze potential quantitative and qualitative changes of the knee cartilage and joint indicative of early posttraumatic OA 4 years after ACL-reconstruction and to correlate the MRI-findings with the clinical outcome (CO). Materials and Methods: 1.5 T MRI-scans were performed on 9 patients post-op and 4 years later. Using a high-resolution T 1-w-fs-FLASH-3D-sequence cartilage volume (cVol) and thickness (mTh) were quantified. Using standard PD-w fs and T 1-w sequences qualitative changes of the joint structures were analyzed based on the WORMS-score. CO was rated by an orthopaedic surgeon using Lysholm-score, OAK-score, Tegner-activity-score (TAS), and Arthrometer KT-1000 testing. Results: Mean changes of cVol were -1.8 % (range: -5.9 %; + 0.7 %) and of mTh -0.8 % (range: -3.0 %; + 1.1 %). No significant change (95 %-CI) could be identified for any compartment. Three patients developed new peripatellar ostheophytes, acute trauma related changes mostly decreased. Mean outcome of Lysholm-score and OAK-score were 90 pts and 86 pts, mean TAS was 4.3 pts. Average maximum tibial translation reached 5.2 mm comparing to 6.7 mm on the healthy contralateral side. Conclusion: Despite a tendency towards decreased cVol and mTh 4 years after ACL-reconstruction qMRI revealed no significant cartilage loss. Newly developing osteophytes did not match with the observed good CO. This small pilot study motivates future quantitative and qualitative-structural MRI-based assessment of articular cartilage and other joint structures in order to improve diagnostic tools for the detection of early OA. (orig.)

  13. Attenuated synovial fluid ghrelin levels are linked with cartilage damage, meniscus injury, and clinical symptoms in patients with knee anterior cruciate ligament deficiency.

    Science.gov (United States)

    Zou, Yu-Cong; Chen, Liang-Hua; Ye, Yong-Liang; Yang, Guang-Gang; Mao, Zheng; Liu, Dan-Dan; Chen, Jun-Qi; Chen, Jing-Jie; Liu, Gang

    2016-12-01

    The meniscus injury and post-traumatic knee osteoarthritis (PTOA) following anterior cruciate ligament (ACL) lesions often cause great burdens to patients. Ghrelin, a recently identified 28-amino-acid peptide, has been shown to inhibit inflammation and perform as a growth factor for chondrocyte. This study was aimed at investigating ghrelin concentration in synovial fluid and its association with the degree of meniscus injury, articular degeneration, and clinical severity in patients suffering from anterior cruciate ligament (ACL) deficiency. 61 ACL deficiency patients admitted to our hospital were drafted in the current study. The Noyes scale and Mankin scores were used to assess articular cartilage damage arthroscopically and histopathologically, respectively. The Lysholm scores and International Knee Documentation Committee (IKDC) subjective scores were utilized to evaluate the clinical severity. The radiological severity of meniscus injury was assessed by MR imaging. Serum and synovial fluid ghrelin levels were determined using enzyme linked immunosorbent assay (ELISA). The cartilage degradation markers collagen type II C-telopeptide (CTX-II) and cartilage oligomeric matrix protein (COMP) in addition to inflammatory markers interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) were also examined. Receiver operating characteristic (ROC) curve was performed and the area under curve (AUC) was calculated to assess the diagnostic value of ghrelin levels for the prediction of the MRI grading for meniscus injury by comparing with other biomarkers. SF ghrelin levels were positively related to Lysholm and IKDC scores. PTOA patients with grade 3 showed significantly decreased levels of ghrelin in SF compared with those with grade 2. The ghrelin levels in SF were negatively related to MRI signal grades for meniscus injury. SF ghrelin levels were also inversely associated with Noyes scale and Mankin scores, and levels of inflammation markers IL-6, TNF-α, and

  14. Evaluating the Use of a Negative D-Dimer and Modified Low Wells Score in Excluding above Knee Deep Venous Thrombosis in an Outpatient Population, Assessing Need for Diagnostic Ultrasound

    International Nuclear Information System (INIS)

    Rahiminejad, Maryam; Rastogi, Anshul; Prabhudesai, Shirish; Mcclinton, David; MacCallum, Peter; Platton, Sean; Friedman, Emma

    2014-01-01

    Aims. Colour doppler ultrasonography (CDUS) is widely used in the diagnosis of deep venous thrombosis (DVT); however, the number of scans positive for above knee DVT is low. The present study evaluates the reliability of the D-dimer test combined with a clinical probability score (Wells score) in ruling out an above knee DVT and identifying patients who do not need a CDUS. Materials and Method. This study is a retrospective audit and reaudit of a total of 816 outpatients presenting with suspected lower limb DVT from March 2009 to March 2010 and from September 2011 to February 2012. Following the initial audit, a revised clinical diagnostic pathway was implemented. Results. In our initial audit, seven patients (4.9%) with a negative D-dimer and a low Wells score had a DVT. On review, all seven had a risk factor identified that was not included in the Wells score. No patient with negative D-dimer and low Wells score with no extra clinical risk factor had a DVT on CDUS (negative predictive value 100%). A reaudit confirmed adherence to our revised clinical diagnostic pathway. Conclusions. A negative D-dimer together with a low Wells score and no risk factors effectively excludes a lower limb DVT and an ultrasound is unnecessary in these patients

  15. Knee arthroscopy

    Science.gov (United States)

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

  16. Osteoarthritis of the knee at 3.0 T: comparison of a quantitative and a semi-quantitative score for the assessment of the extent of cartilage lesion and bone marrow edema pattern in a 24-month longitudinal study

    Energy Technology Data Exchange (ETDEWEB)

    Stahl, Robert [University of California, San Francisco, Department of Radiology, San Francisco, CA (United States); Ludwig Maximilians University of Munich, Department of Clinical Radiology, University Hospitals, Campus Grosshadern, Munich (Germany); Jain, Sapna K.; Majumdar, Sharmila; Link, Thomas M. [University of California, San Francisco, Department of Radiology, San Francisco, CA (United States); Lutz, Juergen [Ludwig Maximilians University of Munich, Department of Neuroradiology, University Hospitals, Campus Grosshadern, Munich (Germany); Wyman, Bradley T.; Hellio Le Graverand-Gastineau, Marie-Pierre [Pfizer Inc., Groton, CT (United States); Vignon, Eric [Claude Bernard University Lyon I, Lyon (France)

    2011-10-15

    To compare a semi-quantitative and a quantitative morphological score for assessment of early osteoarthritis (OA) evolution. 3.0 T MRI of the knee was performed in 60 women, 30 with early OA (each 15 with Kellgren-Lawrence grade 2 and 3) and 30 age-matched controls at baseline and at 12 and 24 months. Pathological condition was assessed with the whole-organ magnetic resonance imaging score (WORMS). Cartilage abnormalities and bone marrow edema pattern (BMEP) were also quantified using a previously introduced morphological quantitative score. These data were correlated with changes in clinical parameters and joint space width using generalized estimation equations (GEE). At baseline, OA patients had significantly (p < 0.05) more and larger cartilage lesions and BMEP. During follow-up, cartilage lesions increased significantly (p < 0.05) in the patients compared with controls: WORMS showed progression only at the lateral patella, whereas the quantitative score revealed progression additionally at the trochlea and at the medial compartment. Both scores showed a significant (p < 0.05) increase in BMEP at the lateral femur in OA patients. In addition, quantitative scores of BMEP of the whole knee decreased significantly (p < 0.05) after 12 months and increased after 24 months in the patients, but showed an increase in controls at all follow-up examinations. Only weak correlations between structural imaging findings and clinical parameters were observed. Quantitative assessment of cartilage lesions and BMEP is more sensitive to changes during the course of the disease than semi-quantitative scoring. However, structural imaging findings do not correlate well with the clinical progression of OA. (orig.)

  17. Similar group mean scores, but large individual variations, in patient-relevant outcomes over 2 years in meniscectomized subjects with and without radiographic knee osteoarthritis

    DEFF Research Database (Denmark)

    Paradowski, Przemyslaw T; Englund, Martin; Roos, Ewa M.

    2004-01-01

    Epidemiological studies have, so far, identified factors associated with increased risk for incident or progressive OA, such as age, sex, heredity, obesity, and joint injury. There is, however, a paucity of long-term data that provide information on the nature of disease progression on either gro...... knee osteoarthritis (OA)....

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  19. Treatment of recurrent patellar dislocation via knee arthroscopy combined with C-arm fluoroscopy and reconstruction of the medial patellofemoral ligament.

    Science.gov (United States)

    Li, Li; Wang, Hongbo; He, Yun; Si, Yu; Zhou, Hongyu; Wang, Xin

    2018-06-01

    Recurrent patellar dislocations were treated via knee arthroscopy combined with C-arm fluoroscopy, and reconstruction of the medial patellofemoral ligaments. Between October 2013 and March 2017, 52 cases of recurrent patellar dislocation [27 males and 25 females; age, 16-47 years (mean, 21.90 years)] were treated. Arthroscopic exploration was performed and patellofemoral joint cartilage injuries were repaired. It was subsequently determined whether it was necessary to release the lateral patellofemoral support belt. Pre-operative measurements were used to decide whether tibial tubercle osteotomy was required. Medial patellofemoral ligaments were reconstructed using autologous semitendinosus tendons. Smith and Nephew model 3.5 line anchors were used to double-anchor the medial patellofemoral margin. On the femoral side, the medial patellofemoral ligament was fixed using 7-cm, absorbable, interfacial compression screws. All cases were followed for 1-40 months (average, 21 months). The Q angle, tibial tuberosity trochlear groove distance, Insall-Salvati index, patellofemoral angle, lateral patellofemoral angle and lateral shift were evaluated on X-Ray images using the picture archiving and communication system. Subjective International Knee Documentation Committee (IKDC) knee joint functional scores and Lysholm scores were recorded. Post-operative fear was absent, and no patellar re-dislocation or re-fracture was noted during follow-up. At the end of follow-up, the patellofemoral angle (0.22±4.23°), lateral patellofemoral angle (3.44±1.30°), and lateral shift (0.36+0.14°) differed significantly from the pre-operative values (all, Ppatellofemoral ligament was effective.

  20. Runner's Knee

    Science.gov (United States)

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

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  2. 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.

  3. 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

  4. 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, ...

  5. Outcomes of Total Knee Arthroplasty in Patients With Poliomyelitis.

    Science.gov (United States)

    Gan, Zhi-Wei Jonathan; Pang, Hee Nee

    2016-11-01

    We report our experience with outcomes of poliomyelitis in the Asian population. Sixteen total knee replacements in 14 patients with polio-affected knees were followed up for at least 18 months. Follow-up assessment included scoring with the American Knee Society Score (AKSS), Oxford knee score, and Short Form 36 Health Survey scores. The mean AKSS improved from 25.59 preoperatively to 82.94 at 24 months, with greater improvement in the knee score. The mean Oxford knee score improved from 40.82 preoperatively to 20.53 at 24 months. The mean AKSS pain score rose from 2.35 to 47.66 at 24 months. The Short Form 36 Health Survey physical functioning and bodily pain scores improved for all patients. Primary total knee arthroplasty of poliomyelitis-affected limbs shows good outcomes, improving quality of life, and decreasing pain. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Can Competitive Athletes Return to High-Level Play After Osteochondral Allograft Transplantation of the Knee?

    Science.gov (United States)

    McCarthy, Mark A; Meyer, Maximilian A; Weber, Alexander E; Levy, David M; Tilton, Annemarie K; Yanke, Adam B; Cole, Brian J

    2017-09-01

    To investigate functional outcomes among competitive athletes undergoing osteochondral allograft (OCA) transplantation of the knee, including rates of return to play (RTP), and factors preventing RTP. A retrospective review identified all competitive athletes (high school, intercollegiate, professional) undergoing isolated femoral condyle OCA from 2004 to 2013. Patient-reported outcome (PRO) questionnaires (Lysholm, International Knee Documentation Committee [IKDC], Knee Injury and Osteoarthritis Outcome Score [KOOS], Western Ontario and McMasters Universities Arthritis Index [WOMAC], 12-Item Short Form Health Survey [SF-12], Tegner, and Marx) and custom RTP surveys were administered. All subsequent reoperations were documented. Thirteen athletes (4 intercollegiate, 9 high-school) were identified with an average follow-up of 5.9 ± 2.5 years. Seven athletes (54%) returned to competitive sport at an average of 7.9 ± 3.5 months, 5 of whom returned to preinjury functional levels. Of the 8 athletes who either did not return to competitive sport or failed to sustain their high level of play, the most common reasons cited were graduation from high school or college (4 patients, 50%) or fear of reinjury (3 patients, 38%). All 4 patients citing graduation as the primary factor preventing return to preinjury level of competitive sport resumed recreational sport without limitations, yielding an adjusted RTP rate of 10 patients (77%) who either returned to competitive play or believed they could return if they had not graduated. At final follow-up, athletes reported significant improvements in all PRO scores except for KOOS-Sport, WOMAC-Stiffness, and SF-12 Mental subscales. There were 3 reoperations at an average of 3.8 ± 3.3 years after the index OCA. There were no instances of graft failure. OCAs provide an adjusted RTP rate of 77% for high-level adolescent athletes. Social factors may be more likely than persistent pain to prevent return to sport. Level IV

  7. 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.

  8. Validation of a Knowledge Transfer Tool for the Knee Inflammation MRI Scoring System for Bone Marrow Lesions According to the OMERACT Filter

    DEFF Research Database (Denmark)

    Jaremko, Jacob L; Azmat, Omar; Lambert, Robert Gw

    2017-01-01

    grid within a Web-based interface to fit bones, then clicks or touches each region containing BML per slice, to score 1 if BML is present. Regional and total scores are automatically calculated. Outcomes include the interreader intraclass correlation coefficients (ICC) and the smallest detectable...

  9. Total knee arthroplasty for severe valgus knee deformity.

    Science.gov (United States)

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

    2014-01-01

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

  10. Trapezoidal osteochondral autologous plug singleblock graft for treating chondral lesions of the knee: clinical and functional medium-term results in an observational study

    Directory of Open Access Journals (Sweden)

    Cezar Teruyuki Kawano

    2012-10-01

    Full Text Available OBJECTIVE: To evaluate the clinical and functional results of autologous trapezoidal plug single-block grafts fixed with absorbable chondral darts in patients with osteochondral knee lesions of varying sizes. METHODS: Twenty-five patients underwent surgery from February 2000 to June 2008. Seventy-two percent of the patients were male, and the mean age was 29 years. RESULTS: The right side (56% and the medial condyle (92% were most affected. The lesions had an average area of 5.28 cm², and the mean follow-up was 59 months. All of the variables other than instability showed significant improvements (p<0.05, as shown by the increase in the mean Lysholm score from 55 points preoperatively to 92 points (p<0.001 postoperatively. There was no loosening or collapse of the osteochondral graft. All of the patients had patellofemoral crepitation and pain for an average of six months. CONCLUSION: Autologous trapezoidal plug single-block grafts are a therapeutic option for defects of varying sizes and provide good clinical results and low morbidity at the donor site in the medium term.

  11. Partial knee replacement

    Science.gov (United States)

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

  12. Jumper's Knee (Patellar Tendonitis)

    Science.gov (United States)

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

  13. Is cold therapy really efficient after knee arthroplasty?

    Directory of Open Access Journals (Sweden)

    Ersin Kuyucu

    2015-12-01

    Conclusion: After knee arthroplasty, the preoperative and postoperative use of cryotherapy is effective in terms of the pain control and functional knee scores without a significant change in surgical blood loss.

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

    DEFF Research Database (Denmark)

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

    2009-01-01

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

  15. Knee Replacement

    Science.gov (United States)

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

  16. Somatosensory abnormalities in knee OA.

    Science.gov (United States)

    Wylde, Vikki; Palmer, Shea; Learmonth, Ian D; Dieppe, Paul

    2012-03-01

    The aim of this study was to use quantitative sensory testing (QST) to explore the range and prevalence of somatosensory abnormalities demonstrated by patients with advanced knee OA. One hundred and seven knee OA patients and 50 age- and sex-matched healthy participants attended a 1-h QST session. Testing was performed on the medial side of the knee and the pain-free forearm. Light-touch thresholds were assessed using von Frey filaments, pressure pain thresholds using a digital pressure algometer, and thermal sensation and pain thresholds using a Thermotest MSA. Significant differences in median threshold values from knee OA patients and healthy participants were identified using Mann-Whitney U-tests. The z-score transformations were used to determine the prevalence of the different somatosensory abnormalities in knee OA patients. Testing identified 70% of knee OA patients as having at least one somatosensory abnormality. Comparison of median threshold values between knee OA patients and healthy participants revealed that patients had localized thermal and tactile hypoaesthesia and pressure hyperalgesia at the osteoarthritic knee. Tactile hypoaesthesia and pressure hyperalgesia were also present at the pain-free forearm. The most prevalent somatosensory abnormalities were tactile hypoaesthesia and pressure hyperalgesia, evident in between 20 and 34% of patients. This study found that OA patients demonstrate an array of somatosensory abnormalities, of which the most prevalent were tactile hypoaesthesia and pressure hyperalgesia. Further research is now needed to establish the clinical implications of these somatosensory abnormalities.

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  19. Knee pain

    Science.gov (United States)

    ... Fracture of the kneecap or other bones. Iliotibial band syndrome . Injury to the thick band that runs from your hip to the outside ... of your knee pain. When to Contact a Medical Professional Call your provider if: You cannot bear ...

  20. 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 ...

  1. Acute hematogenous septic arthritis of the knee in adults.

    Science.gov (United States)

    Sreenivas, T; Nataraj, A R; Menon, Jagdish

    2013-10-01

    To evaluate the factors associated with acute hematogenous septic arthritis of the knee in adults and to assess the outcome after open knee arthrotomy. We performed a prospective evaluation of 26 adult patients with acute nongonococcal septic arthritis of the knee presenting within 7 days. All patients underwent open knee arthrotomy, and final evaluation by means of Knee society score of the affected knee was compared with the contra lateral normal knee. The average duration of symptoms at the time of presentation was 3.9 days. Staphylococcus aureus was the commonest bacteria isolated in 17 (65.4 %) patients. The average duration of follow-up in our study was 18.5 months. In our study, Knee society score decreases as the age of the patient advances (P < 0.05) and also it was found to be low (P < 0.05) in the affected knee as compared to contra lateral normal knee. Our study shows that age of the patient at presentation is critical as it shows significant reduction in knee score. This explains that the septic arthritis may contribute to the progression of age-related degeneration of the knee joint. There appears to be no definite contributing factors or conditions associated with acute hematogenous septic arthritis of the knee in adults, although further study may be warranted regarding this matter.

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

    Science.gov (United States)

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

    2016-09-28

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

  3. 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.

  4. [Case-control study on Chinese medicine fumigation and massage therapy for the treatment of knee stability and func tional recovery after anterior cruciate ligament reconstruction operation].

    Science.gov (United States)

    Min, Zhong-han; Zhou, Ying; Jing, Lin; Zhang, Hong-mei; Wang, Sheng; Chen, Wei-heng; Chen, Ping-quan

    2016-05-01

    To study clinical outcomes of Chinese medidine fumigation and massage therapy for the treatment of knee stability and functional recovery after anterior cruciate ligament reconstruction operation,and to explore the effect on tendon-bone healing. Total 50 patients were divided into two groups: the control group (normal rehabilitation therapy group),the treatment group (Chinese medicine fumigation and manipulation group). There were 25 patients in the control group, including 16 males and 9 females, who were treated with isometric muscle training, with the gradually enlarging amplitude of flexion and progressive loading of bearing training for knee recovery. There were 25 patients in the treatment group, including 15 males and 10 females,who were treated with the conventional rehabilitation therapy combined with Chinese medicine fumigation and massage therapy. The Chinese herbs named as Haitongpi decoction was steamed by a special equipment to fumigate the knee after operation; Based on the biomechanical parameters of the ligament reconstruction, the massage therapy was designed to control the degree of the knee flexion and release the adhesion for early recovery of knee functions. The Lysholm knee function evaluation system was used, and MRI examination was performed to measure the change in width of ligament tunnel in femur and tibia to evaluate the safety and stability of the treatment. Lysholm system showed that two groups both had improving results from the 1st month after operation to the 3rd month (treatment group, F=36.54, P0.05), indicating that Chinese rehabilitation therapy was a safety treatment without the influence on the loosing of tendon. Chinese medicine fumigation and massage therapy can early improve the knee function after the anterior cruciate ligament reconstruction operation without the disturbance of the knee stability.

  5. The use of adaptive equipment following total knee replacement

    OpenAIRE

    McNaught, Jamie; Paul, Lorna

    2015-01-01

    Introduction: This study evaluates the need for adaptive equipment following total knee replacement. There are no recent studies to guide occupational therapists in the optimum time adaptive equipment is required following total knee replacement.\\ud \\ud Method: A non-experimental, concurrent mixed methods approach was used. The study population was patients attending for total knee replacement at a large general hospital. Outcome measures were the Oxford Knee Score, the United Kingdom Functio...

  6. Expectations in patients with total knee arthroplasty.

    Science.gov (United States)

    Tekin, Burcu; Unver, Bayram; Karatosun, Vasfi

    2012-01-01

    The primary objective of total knee arthroplasty (TKA) is to decrease pain and restore functional knee joint. Current hypotheses indicate higher knee flexion is required in terms of life style, culture and expectations in Eastern communities. Therefore, society-specific features related to life style and cultural habits are needed. The objective of this study was to investigate the expectations of patients undergoing TKA. The study included 131 patients (18 male, 113 female; mean age: 66.2 ± 8.3 years) who underwent cemented TKA due to knee osteoarthritis. All patients were operated by the same surgeon using the same implant and surgical technique. Patients were evaluated using the Hospital for Special Surgery (HSS) knee score, a 15-item clinical knee assessment questionnaire and the HSS knee arthroplasty expectation questionnaire. Mean HSS score for the right knee was 89.2 ± 10.5 and for the left knee was 89.6 ± 9.4. The two most expected outcomes were improvements in pain (99.2%) and gait (96.2%) and the two least expected outcomes were improvements in psychological well-being (22.9%) and communicative skills (35.1%). Expectations were not affected by education and working conditions. Patients' most expected outcomes were improvement in pain and restoration of function (gait, climbing stairs and no need of assistive devices), similar to Western and American communities.

  7. Analysis of the unicompartmental knee arthroplasty results

    Directory of Open Access Journals (Sweden)

    S. A. Firsov

    2015-01-01

    Full Text Available In 2012-2014 total 67 unicompartmental arthroplasty surgeries with use of Oxford knee meniscal bearing were performed. The surgeries were performed by a single surgeon. Minimally invasive approach was used. All patients were evaluated clinically, radiographically and with Oxford Knee score scale, Knee Society score scale and functional scale. Obtained data was processed with nonparametric Mann-Whitney-Wilcoxon test. Results were processed using the statistical analysis application package SPSS, version 10.07. Analysis of of mid-term results showed that the average for Oxford Knee score increased from 16.4 (95% CI 9-23 to 41.3 (95% CI 29-47. Average for Knee Society score scale increased from 42.7 (95% CI 31-55 to 88.6 (95% CI 73-100. No occurrence of early postoperative complications have been reported. Statistically significant improvements of knee function in patients after unicompartmental arthroplasty have been observed. Unicompartmental arthroplasty currently can be considered as an advanced treatment option for medial knee joint pathology. Meniscal bearing cemented prostheses such as Oxford III are preferable.

  8. 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.

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

    Science.gov (United States)

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

    2014-01-01

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

  10. Knee Luxation - Surgical treatment in acute cases

    International Nuclear Information System (INIS)

    De los Rios Giraldo, Adolfo

    2005-01-01

    Introduction: Traumatic luxation of the knee is an infrequent pathology with low number of reported cases. That implies a true challenge for the orthopedic surgeon due to its great of presentation. Objective: Establish a scheme of surgical management for this complex injury. Methodology: Observational study with different kinds of cases of patients from Universitario Del Valle Hospital and from the Imbanaco Medical Center. These surgeries occurred from December of 1999 to February of the 2003. Patients: 16. Age average: 31 years old. Age group: 13 to 64 years. Sex: 14 male and 2 female. Luxation Types: 15 closed and 1 exposed. Procedures: Correction of the extra-capsular structures and reintegration of the crossed ligaments in cases of avulsion using an acute management approach. In the two last patients, it was performed a simultaneous reconstruction of the crossed posterior and anterior with an auto-graft followed by patients monitoring from 12 to 50 months. The most common luxation type was KDIII L according to anatomical classification. A patient with vascular injury, two with external popliteo ciatic nerve injury and one broken patellar tendon, the results were evaluated according to the scale of Lysholm, IKDC and For Special Surgery. Conclusions: The acute management of the extra-articular structures gives the best results; therefore, if the surgeon does not have enough experience, this procedure should be to left for secondary reconstruction when the patient has normal arch of mobility

  11. Dynamic weight-bearing assessment of pain in knee osteoarthritis

    DEFF Research Database (Denmark)

    Klokker, Louise; Christensen, Robin; Osborne, Richard

    2015-01-01

    PURPOSE: To evaluate the reliability, agreement and smallest detectable change in a measurement instrument for pain and function in knee osteoarthritis; the Dynamic weight-bearing Assessment of Pain (DAP). METHODS: The sample size was set to 20 persons, recruited from the outpatient osteoarthritis...... for intra-rater test (1.95). The three knee bend scores all had ICC above 0.50, showing fair-to-good reliability. None of the knee bend scores showed acceptable SEM and SDC. CONCLUSIONS: The reproducibility of the DAP pain score meets the demands for use in clinical practice and research. The total knee...

  12. Reconstruction of the anterior cruciate ligament of the knee

    Directory of Open Access Journals (Sweden)

    Nikolić Dragan

    2006-01-01

    Full Text Available Background/Aim. Numerous papers on reconstruction of the anterior cruciate ligament of the knee (ACL contribute to the significance of this method. The aim of this study was to analyze the outcome of the use of this surgical treatment method regardless the type of surgical intervention, graft, and the choice of the material for fixing. Methods. The study included 324 patients treated within the period from April 1997 to April 2004. Arthroscopically assisted ACL reconstruction was typically performed using the central one-third of the patellar ligament, as a graft, with bone blocks. Fixing was performed using screws (spongy or interferential, Mitek type. In the cases who required revision of the surgery, we used a graft m. semitendinosus and m. gracilise (STG or a graft of the patellar ligament (B-Pt-B. Fixation in these cases was performed using absorptive wedges according to the Rigidfix technique or metallic implants. Results. The analysis included the results of the reconstruction of the anterior cruciate ligament of the knee (B-Pt-B or STG graft in 139 of the knees. Chronic injuries were revealed in 132 (94.9% of the knees. According to the anamnesis and clinical findings, the feeling of instability prevailed in 132 (94.9% of the knees, pain in 72 (51.7%, effluents in 24 (17.2%, and blockages in 13 (9.3%. Early and late postoperative complications were noticeable in 3.5% each. Hypotrophy of the upper knee musculature up to 2 cm was present in 53.9% of the operated knees, while minor contractions in 13.6% of them. The final result of the reconstruction graded begusing the Lysholm Scale was 85.2, simultaneous reconstructions of other ligaments 75.3, and revision surgery 68.0. First-grade degenerative postoperative changes according to the K/L Scale were found in 55.0% of the surgically treated knees, while the worst, four-grade one in 2.5%. Conclusion. On the basis of these findings, we can conclude that this method is the method of choice in

  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. Early recovery after fast-track Oxford unicompartmental knee arthroplasty

    DEFF Research Database (Denmark)

    Munk, Stig; Dalsgaard, Jesper; Bjerggaard, Karin

    2012-01-01

    trauma. We investigated changes in leg-extension power (LEP) in the first month after MIS Oxford UKA and its relation to pain, knee motion, functional performance, and knee function. Patients and methods In 35 consecutive Oxford UKA patients, LEP was measured 1 week before and 1 month after surgery...... together with knee motion, knee swelling, the 30-second chair-stand test, and Oxford knee score. Assessment of knee pain at rest and walking was done using a visual analog scale. Results 30 patients were discharged on the day after surgery, and 5 on the second day after surgery. LEP and functional...... performance reached the preoperative level after 1 month. Only slight postoperative knee swelling was observed with rapid restoration of knee flexion and function. A high level of pain during the first postoperative night and day fell considerably thereafter. None of the patients needed physiotherapy...

  15. Knee arthroscopy - discharge

    Science.gov (United States)

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

  16. Knee microfracture surgery

    Science.gov (United States)

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

  17. Preventing Knee Injuries

    Science.gov (United States)

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

  18. Forward lunge knee biomechanics before and after partial meniscectomy

    DEFF Research Database (Denmark)

    Hall, Michelle; Nielsen, Jonas Høberg; Holsgaard-Larsen, Anders

    2015-01-01

    partial meniscectomy (APM) on knee joint mechanics. The purpose of this study was to evaluate changes in knee joint biomechanics during a forward lunge in patients with a suspected degenerative meniscal tear from before to three months after APM. METHODS: Twenty-two patients (35-55years old......) with a suspected degenerative medial meniscal tear participated in this study. Three dimensional knee biomechanics were assessed on the injured and contralateral leg before and three months after APM. The visual analogue scale was used to assess knee pain and the Knee Injury Osteoarthritis Outcome Score was used...

  19. KNEE PROPRIOCEPTION FOLLOWING MENISCAL REPAIR

    Directory of Open Access Journals (Sweden)

    Brytsko A. A.

    2018-02-01

    Full Text Available Background. It is well known that meniscectomy leads to osteoarthritis of the knee and proprioception impairment. Objective. The aim of this study was to assess retrospectively the joint position sense after meniscal suture and partial medial meniscal resection and to estimate the patients’ satisfaction with knee function. Material and Methods. We evaluated the outcomes of 27 patients after meniscal repair and compared them to those of 24 patients after partial meniscal resection. We estimated the joint position sense at 30°, 45° and 60° of flexion using the Biodex system 4 Pro. All patients were assessed with the IKDC 2000 subjective knee score. Results. A statistically significant worsening in reproducing the injured joint position in comparison to the healthy limb in both groups was observed. These impairments were mostly expressed at 45° and 60° of knee flexion, and were worsening over time in the group of patients who had undergone medial meniscal resection. An average value by the IKDC 2000 scale after 24 months in the meniscorrhaphy group was 76.73 ± 11.17% and 68.93 ± 14.76% after partial medial meniscal resection. Сonclusion. The control over position of the knee is not impaired after meniscal repair. An overall satisfaction with joint function is higher in patients who undergo meniscal suture in comparison to the partial medial meniscal resection group.

  20. Neuromuscular Activity and Knee Kinematics in Adolescents with Patellofemoral Pain

    DEFF Research Database (Denmark)

    Rathleff, Michael Skovdal; Samani, Afshin; Olesen, Jens L

    2013-01-01

    This study aimed to investigate the neuromuscular control of the knee during stair descent among female adolescents with patellofemoral pain (PFP) and to report its association with self-reported clinical status assessed by the Knee Injury and Osteoarthritis Outcome Score (KOOS).......This study aimed to investigate the neuromuscular control of the knee during stair descent among female adolescents with patellofemoral pain (PFP) and to report its association with self-reported clinical status assessed by the Knee Injury and Osteoarthritis Outcome Score (KOOS)....

  1. Outcome of total knee arthroplasty with insall burstein-11 prosthesis

    International Nuclear Information System (INIS)

    Siddiq, M.Z.; Qayum, H.

    2006-01-01

    Patients with severe degenerative knee joint disease often require knee arthroplasty to reduce pain, improve stability and restore function. Insall Burstein II prosthesis is posteriorly stabilized condylar prosthesis, which provide posterior cruciate ligament substitution. It was designed to improve range of motion, stair climbing ability and to prevent posterior subluxation. Evaluate the functional outcome of total knee arthroplasty with IB II prosthesis and Evaluate the alignment of prosthetic components by radiological parameters and its correlation with functional outcome. Sixty knees of sixty patients were replaced by using Insall Burstein II prosthesis. Postoperative radiographs were evaluated for alignment of knee and prosthetic components by criteria selected from knee society roentogenographic evaluation system. Functional outcome was evaluated by rationale of knee society knee rating system. Prosthetic component was aligned in 93% and mal-alignment in 7% of the cases. There was significant improvement in functions core from mean score 33.83 +-15.5 to 59.5+-17.7 and knee score from 37 +- 12.5 to 76.4 +-2.2. Postoperative functional score was found correlated with alignment significantly. Conclusion: Total knee arthroplasty with I-B-II prosthesis is a safe durable and predictable procedure with proper surgical technique and expertise good alignment and satisfactory functional out come can be achieved. (author)

  2. Gait Parameters and Functional Outcomes After Total Knee Arthroplasty Using Persona Knee System With Cruciate Retaining and Ultracongruent Knee Inserts.

    Science.gov (United States)

    Rajgopal, Ashok; Aggarwal, Kalpana; Khurana, Anshika; Rao, Arun; Vasdev, Attique; Pandit, Hemant

    2017-01-01

    Total knee arthroplasty is a well-established treatment for managing end-stage symptomatic knee osteoarthritis. Currently, different designs of prostheses are available with majority ensuring similar clinical outcomes. Altered surface geometry is introduced to strive toward gaining superior outcomes. We aimed to investigate any differences in functional outcomes between 2 different polyethylene designs namely the Persona CR (cruciate retaining) and Persona UC (ultracongruent) tibial inserts (Zimmer-Biomet, Warsaw, IN). This prospective single blind, single-surgeon randomized controlled trial reports on 105 patients, (66 female and 39 male), who underwent simultaneous bilateral total knee arthroplasty using the Persona knee system (Zimmer-Biomet) UC inserts in one side and CR inserts in the contralateral side. By a blind assessor, at regular time intervals patients were assessed in terms of function and gait. The functional knee scoring scales used were the Western Ontario and McMaster Universities Osteoarthritis Index and Modified Knee Society Score. The gait parameters evaluated were foot pressure and step length. During the study period, no patient was lost to follow-up or underwent revision surgery for any cause. Western Ontario and McMaster Universities Osteoarthritis Index scores, Modified Knee Society Score, and knee range of motion of all 105 patients assessed preoperatively and postoperatively at 6 months, 1 year, and 2 years showed statistically better results (P < .05) for UC inserts. Gait analysis measuring foot pressures and step length, however, did not show any statistically significant differences at 2-year follow-up. Ultracongruent tibial inserts show significantly better functional outcomes as compared to CR inserts during a 2-year follow-up period. However, in this study these findings were not shown to be attributed to differences in gait parameters. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. The knee

    International Nuclear Information System (INIS)

    Rand, J.A.; Berquist, T.H.

    1985-01-01

    Evaluation of infection is difficult on the basis of radiographs. A clinical history suggestive of infection, such as excessive prolonged pain, drainage, fever, or a postoperative hematoma, is helpful in assessment. Radiographs may reveal periosteal new bone formation in long-standing cases of infection. Aspiration of the knee may or may not be helpful. Differential Tc-99m and gallium bone scans may be a useful adjunct in difficult cases. The gallium scan should show increased uptake relative to the Tc-99m scan to be considered positive. Bone scanning is not a useful criterion by itself for assessment of loosening

  4. Knee pain (image)

    Science.gov (United States)

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

  5. [Surgical technique and clinical results of total knee arthroplasty in treating endstage gonarthrosis combined with valgus knee deformity].

    Science.gov (United States)

    Wang, Xingshan; Weng, Xisheng; Lin, Jin; Jin, Jin; Qian, Wenwei

    2012-05-01

    To investigate the surgical technique and the clinical results of total knee arthroplasty (TKA) in treating end-stage gonarthrosis combined with valgus knee deformity. Between November 1998 and October 2010, 64 patients (72 knees) with end-stage gonarthrosis combined with valgus knee deformity underwent TKA by a medial parapatellar approach. Of the 64 patients, 18 were male and 46 were female with an average age of 62.5 years (range, 23-82 years), including 44 cases (49 knees) of osteoarthritis, 17 cases (20 knees) of rheumatoid arthritis, 2 cases (2 knees) of haemophilic arthritis, and 1 case (1 knee) of post-traumatic arthritis. Bilateral knees were involved in 8 cases, and single knee in 56 cases. The flexion and extension range of motion (ROM) of the knee joint was (82.2 +/- 28.7) degrees; the femur-tibia angle (FTA) was (18.0 +/- 5.8) degrees; according to Knee Society Score (KSS) criterion, the preoperative clinical score was 31.2 +/- 10.1 and functional score was 37.3 +/- 9.0. According to Krackow's classification, there were 65 knees of type I and 7 knees of type II. By medial parapatellar approach, conventional osteotomy and Ranawat soft tissue release were performed in all cases. Prosthesis of preserved posterior cruciate ligament were used in 7 cases (7 knees), posterior stabilize prosthesis in 54 cases (60 knees), constrained prosthesis in 4 cases (5 knees). Incisions healed by first intention in all cases. Peroneal nerve palsy occurred in 1 patient with haemophilic arthritis, severe valgus deformity (FTA was 41 degrees), and flexion contracture (20 degrees), which was cured after 1 year of conservative treatment. Revison surgery was performed in 1 case of deep infection at 2 years after surgery. All the patients were followed up 4.9 years on average (range, 1-13 years). At last follow-up, the FTA was (7.0 +/- 2.5) degrees, showing significant difference when compared with preoperative value (t = 15.502, P = 0.000). The KSS clinical score was 83.0 +/- 6

  6. Knee awareness and functionality after simultaneous bilateral vs unilateral total knee arthroplasty

    DEFF Research Database (Denmark)

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

    2016-01-01

    AIM: To investigate knee awareness and functional outcomes in patients treated with simultaneous bilateral vs unilateral total knee arthroplasty (TKA). METHODS: Through a database search, we identified 210 patients who had undergone unilateral TKA (UTKA) and 65 patients who had undergone......-surgical treatments were failed, thus preoperatively the patients had poor functionality. All patients were asked to complete Forgotten Joint Score (FJS) and Oxford Knee Score (OKS) questionnaires. The patients were matched according to age, gender, year of surgery, Kellgren-Lawrence score and pre- and postoperative...... overall knee alignment. The FJS and OKS questionnaire results of the two groups were then compared. RESULTS: A mixed-effects model was used to analyze differences between SBTKA and UTKA. OKS: The mean difference in the OKS between the patients who had undergone SBTKA and those who had undergone UTKA was 1...

  7. Patellar Skin Surface Temperature by Thermography Reflects Knee Osteoarthritis Severity

    Directory of Open Access Journals (Sweden)

    Anna E. Denoble

    2010-01-01

    Full Text Available Background Digital infrared thermal imaging is a means of measuring the heat radiated from the skin surface. Our goal was to develop and assess the reproducibility of serial infrared measurements of the knee and to assess the association of knee temperature by region of interest with radiographic severity of knee Osteoarthritis (rOA. Methods A total of 30 women (15 Cases with symptomatic knee OA and 15 age-matched Controls without knee pain or knee OA participated in this study. Infrared imaging was performed with a Meditherm Med2000™ Pro infrared camera. The reproducibility of infrared imaging of the knee was evaluated through determination of intraclass correlation coefficients (ICCs for temperature measurements from two images performed 6 months apart in Controls whose knee status was not expected to change. The average cutaneous temperature for each of five knee regions of interest was extracted using WinTes software. Knee x-rays were scored for severity of rOA based on the global Kellgren-Lawrence grading scale. Results The knee infrared thermal imaging procedure used here demonstrated long-term reproducibility with high ICCs (0.50–0.72 for the various regions of interest in Controls. Cutaneous temperature of the patella (knee cap yielded a significant correlation with severity of knee rOA (R = 0.594, P = 0.02. Conclusion The skin temperature of the patellar region correlated with x-ray severity of knee OA. This method of infrared knee imaging is reliable and as an objective measure of a sign of inflammation, temperature, indicates an interrelationship of inflammation and structural knee rOA damage.

  8. Patellar skin surface temperature by thermography reflects knee osteoarthritis severity.

    Science.gov (United States)

    Denoble, Anna E; Hall, Norine; Pieper, Carl F; Kraus, Virginia B

    2010-10-15

    Digital infrared thermal imaging is a means of measuring the heat radiated from the skin surface. Our goal was to develop and assess the reproducibility of serial infrared measurements of the knee and to assess the association of knee temperature by region of interest with radiographic severity of knee Osteoarthritis (rOA). A total of 30 women (15 Cases with symptomatic knee OA and 15 age-matched Controls without knee pain or knee OA) participated in this study. Infrared imaging was performed with a Meditherm Med2000™ Pro infrared camera. The reproducibility of infrared imaging of the knee was evaluated through determination of intraclass correlation coefficients (ICCs) for temperature measurements from two images performed 6 months apart in Controls whose knee status was not expected to change. The average cutaneous temperature for each of five knee regions of interest was extracted using WinTes software. Knee x-rays were scored for severity of rOA based on the global Kellgren-Lawrence grading scale. The knee infrared thermal imaging procedure used here demonstrated long-term reproducibility with high ICCs (0.50-0.72 for the various regions of interest) in Controls. Cutaneous temperature of the patella (knee cap) yielded a significant correlation with severity of knee rOA (R = 0.594, P = 0.02). The skin temperature of the patellar region correlated with x-ray severity of knee OA. This method of infrared knee imaging is reliable and as an objective measure of a sign of inflammation, temperature, indicates an interrelationship of inflammation and structural knee rOA damage.

  9. 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...

  10. Tibial slope correction combined with second revision ACL produces good knee stability and prevents graft rupture.

    Science.gov (United States)

    Dejour, David; Saffarini, Mo; Demey, Guillaume; Baverel, Laurent

    2015-10-01

    Revision ACL reconstruction requires careful analysis of failure causes particularly in cases of two previous graft ruptures. Intrinsic factors as excessive tibial slope or narrow femoral notch increase failure risks but are rarely addressed in revision surgery. The authors report outcomes, at minimum follow-up of 2 years, for second revision ACL reconstructions combined with tibial deflexion osteotomy for correction of excessive slope (>12°). Nine patients that underwent second revision ACL reconstruction combined with tibial deflexion osteotomy were retrospectively studied. The mean age was 30.3 ± 4.4 years (median 28; range 26-37), and mean follow-up was 4.0 ± 2.0 years (median 3.6; range 2.0-7.6). Autografts were harvested from the quadriceps tendon (n = 8) or hamstrings (n = 1), and tibial osteotomy was done by anterior closing wedge, without detachment of the patellar tendon, to obtain a slope of 3° to 5°. All patients had fused osteotomies, stable knees, and there were no intraoperative or postoperative complications. The mean posterior tibial slope decreased from 13.2° ± 2.6° (median 13°; range 12°-18°) preoperatively to 4.4° ± 2.3° (median 4°; range 2°-8°) postoperatively. The mean Lysholm score was 73.8 ± 5.8 (median 74; range 65-82), and the IKDC-SKF was 71.6 ± 6.1 (median 72.8; range 62.2-78.5). The satisfactory results of second revision ACL reconstruction combined with tibial deflexion osteotomy at minimum follow-up of 2 years suggest that tibia slope correction protects reconstructed ACL from fatigue failure in this study. The authors stress the importance of careful analysis failure causes prior to revision ACL reconstruction, and recommend correction of tibial slope if it exceeds 12°, to reduce the risks of graft retear. III.

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

    Science.gov (United States)

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

    2015-08-01

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

  12. Dynamic weight-bearing assessment of pain in knee osteoarthritis

    DEFF Research Database (Denmark)

    Klokker, Louise; Christensen, Robin; Wæhrens, Eva Elisabet Ejlersen

    2016-01-01

    -minute-walk-test (6MWT), and 6-min-walk-test with subsequent pain rating (6MWTpain), and once with a transition questionnaire (TRANS-Q) for the patient-reported change in pain after 12 weeks of exercise. Construct validity (baseline-scores) and responsiveness (change-scores) were estimated by Spearman Correlation...... a standing position). The purpose of this study is to evaluate the construct validity, responsiveness, and interpretability of the DAP for knee osteoarthritis (OA). METHODS: One-hundred participants with knee OA were tested twice each with the DAP, the Knee injury and Osteoarthritis Outcome Score (KOOS), six...

  13. Biochemical comparison of osteoarthritic knees with and without effusion

    Science.gov (United States)

    2011-01-01

    Background Several symptom-relieving interventions have been shown to be efficacious among osteoarthritis (OA) patients with knee effusion; however, not every symptomatic knee OA patient has clinical effusion. Results may be over-generalized since it is unclear if effused knees represent a unique pathological condition or subset compared to knees without effusion. The primary purpose of this study was to determine if biochemical differences existed between OA knees with and without effusion. Methods The present cross-sectional study consisted of 22 volunteers (11 with knee effusion, 11 without knee effusion) with confirmed late-stage radiographic knee OA (Kellgren-Lawrence score ≥ 3). Synovial fluid samples were collected and analyzed using a custom multiplex enzyme-linked immunosorbent assay to determine eight specific biomarker concentrations (e.g., catabolic, anabolic). Results Matrix metalloproteinase (MMP)-3, tissue inhibitor of MMPs (TIMP)-1, TIMP-2, and interleukin-10 were significantly higher in the knees with effusion than in the knees without effusion. Conclusions The biochemical differences that existed between knees with and without effusion provide support that OA subsets may exist, characterized by distinct biochemical characteristics and clinical findings (e.g., effusion). PMID:22122951

  14. Autograft reconstructions for bone defects in primary total knee replacement in severe varus knees

    Directory of Open Access Journals (Sweden)

    Yatinder Kharbanda

    2014-01-01

    Full Text Available Background: Large posteromedial defects encountered in severe varus knees during primary total knee arthroplasty can be treated by cementoplasty, structural bone grafts or metallic wedges. The option is selected depending upon the size of the defect. We studied the outcome of autograft (structural and impaction bone grafting reconstruction of medial tibial bone defects encountered during primary total knee replacement in severe varus knees. Materials and Methods: Out of 675 primary varus knees operated, bone defects in proximal tibia were encountered in 54 knees. Posteromedial defects involving 25-40% of the tibial condyle cut surface and measuring more than 5 mm in depth were grafted using a structural graft obtained from cut distal femur or proximal tibia in 48 knees. For larger, peripheral uncontained vertical defects in six cases, measuring >25 mm in depth and involving >40% cut surface of proximal tibial condyle, impaction bone grafting with a mesh support was used. Results: Bone grafts incorporated in 54 knees in 6 months. There was no graft collapse or stress fractures, loosening or nonunion. The average followup period was 7.8 years (range 5-10 years. We observed an average postoperative increase in the Knee Society Score from 40 to 90 points. There was improvement in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC scores in terms of pain, stiffness and physical function during activities of daily living. Conclusion: Bone grafting for defects in primary total knee is justified as it is biological, available then and is cost effective besides preserving bone stock for future revisions. Structural grafts should be used in defects >5 mm deep and involving 25-40% of the cut proximal tibial condyle surface. For larger peripheral vertical defects, impaction bone grafting contained in a mesh should be done.

  15. Bilateral Floating Hip and Floating Knee: a Rare Complex Injury ...

    African Journals Online (AJOL)

    We report a rare complex injury of a 45-year-old man who sustained a bilateral floating hip and floating knee and hospitalised in our service six days after a traffic accident. The floating knees were open type III and II of Cauchoix score in phase of suppuration. He also presented with a floating ankle on the right side.

  16. Partial knee replacement - slideshow

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/presentations/100225.htm Partial knee replacement - series—Normal anatomy To use the sharing ... A.M. Editorial team. Related MedlinePlus Health Topics Knee Replacement A.D.A.M., Inc. is accredited ...

  17. Knee braces - unloading

    Science.gov (United States)

    ... most people talk about the arthritis in their knees, they are referring to a type of arthritis ... is caused by wear and tear inside your knee joints. Cartilage, the firm, rubbery tissue that cushions ...

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

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  19. Total Knee Replacement: 12 Years Retrospective Review and Experience

    Directory of Open Access Journals (Sweden)

    Ahmad Hafiz Z

    2011-03-01

    Full Text Available This retrospective study was undertaken to evaluate the outcome of primary total knee arthroplasty (TKA performed from January 1986 to December 1997 at this institution. Case review included Knee Society scores and functional knee score. The records of 94 patients (128 knees were available for analysis with the sample comprised of 76 females (80.9% and 18 males (19.1% and a mean age was 61.4 years. TKA was performed for osteoarthritis (OA in 96 knees (75% and rheumatoid arthritis (RA in 32 knees (25%. Cemented TKAs were performed in all patients. The mean knee score improved from 38.8 preoperatively to 90.9 postoperatively. The mean functional score improved from 19.1 preoperatively to 62.5 postoperatively. Both scores showed significant improvement when comparing preoperative to post operative results (p< 0.005. Arthroplasty was designated failures if the prostheses used had been removed. Survivorship at 12 years was 89.5%.

  20. Knee osteoarthritis image registration: data from the Osteoarthritis Initiative

    Science.gov (United States)

    Galván-Tejada, Jorge I.; Celaya-Padilla, José M.; Treviño, Victor; Tamez-Peña, José G.

    2015-03-01

    Knee osteoarthritis is a very common disease, in early stages, changes in joint structures are shown, some of the most common symptoms are; formation of osteophytes, cartilage degradation and joint space reduction, among others. Based on a joint space reduction measurement, Kellgren-Lawrence grading scale, is a very extensive used tool to asses radiological OA knee x-ray images, based on information obtained from these assessments, the objective of this work is to correlate the Kellgren-Lawrence score to the bilateral asymmetry between knees. Using public data from the Osteoarthritis initiative (OAI), a set of images with different Kellgren-Lawrencescores were used to determine a relationship of Kellgren-Lawrence score and the bilateral asymmetry, in order to measure the asymmetry between the knees, the right knee was registered to match the left knee, then a series of similarity metrics, mutual information, correlation, and mean squared error where computed to correlate the deformation (mismatch) of the knees to the Kellgren-Lawrence score. Radiological information was evaluated and scored by OAI radiologist groups. The results of the study suggest an association between Radiological Kellgren-Lawrence score and image registration metrics, mutual information and correlation is higher in the early stages, and mean squared error is higher in advanced stages. This association can be helpful to develop a computer aided grading tool.

  1. Knee function and knee muscle strength in middle-aged patients with degenerative meniscal tears eligible for arthroscopic partial meniscectomy

    DEFF Research Database (Denmark)

    Stensrud, Silje; Risberg, May Arna; Roos, Ewa M.

    2014-01-01

    BACKGROUND: Functional limitations exist postmeniscectomy, but preoperative data are scarce. PURPOSE: To examine knee function, knee muscle strength and performance in middle-aged patients with degenerative meniscal tears, eligible for arthroscopic partial meniscectomy. STUDY DESIGN: Cross......-sectional study. METHODS: Eighty-two participants with MRI verified degenerative meniscal tear (35% women, mean age 49 years) answered the Knee injury and Osteoarthritis Outcome Score (KOOS) and were tested for isokinetic knee muscle strength and lower extremity performance (one-leg hop for distance, 6 m timed...

  2. 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.

  3. Osteochondrosis dissecans of the knee: Evaluation of the evolution of MR morphology during treatment

    International Nuclear Information System (INIS)

    Palczewski, P.; Golebiowski, M.; Strzelczyk, P.

    2008-01-01

    To assess the evolution of MR morphology of OCD lesions in response to treatment and feasibility of MRI as a control study in patients with treated OCD. 11 patients (6 women and 5 men, aged 11-24 years, average age 17 years) with lesions affecting 12 knee joints were followed for approximately 24.2 months with repeated clinical examination and MR imaging. All MR studies were performed on a 1.5 Tesla unit. MR arthrography was performed in 3 patients. The evolution of MR morphology of the lesions was assessed with a 5-point scale and correlated with the results of clinical assessment with a modified Lysholm scale. In 10 patients, a good clinical result was achieved. In 7 knee joints of patients from this group, the features of the healing of the OCD lesion were observed in MRI and in 4 knees the morphology of the OCD lesion was stable. In 5 MR examinations, a transient deterioration was observed, which in 4 cases preceded healing and in 1 case stabilization in MR morphology. Transient deterioration may be observed in MR studies prior to the healing of OCD lesions irrespective of the improvement in clinical examination. The follow up of patients with OCD should be based mainly on clinical examination, with MR studies reserved for late control or patients with clinical signs of deterioration. (author)

  4. Knee Arthrodesis After Failure of Knee Arthroplasty

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  5. 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.

  6. The Popularity of Outcome Measures for Hip and Knee Arthroplasties.

    Science.gov (United States)

    Lovelock, Thomas M; Broughton, Nigel S; Williams, Cylie M

    2018-01-01

    The optimal methods of determining outcomes following hip and knee arthroplasty remain controversial. The objectives of this study were to determine the most frequently used outcome measures in randomized controlled trials (RCT) and study protocols registered with clinical trials registries (CTR) on hip and knee arthroplasty. A systematic search strategy was undertaken to identify the outcome measures used in RCT and CTR following joint arthroplasty. Databases searched included Embase, Ovid MEDLINE (including In-Process), Cochrane Central Register of Controlled Trials, CINAHL Plus, clinicaltrials.gov, ISRCTN registry, and ANZCTR. Differences in the use of outcome measures between RCT and CTR were assessed using logistic regression. There were 291 RCT and 113 CTR on hip arthroplasty and 452 RCT and 184 CTR on knee arthroplasty that met the inclusion criteria. The most popular outcome measures were the Harris Hip Score and the Knee Society Score. Multiple outcome measures were used in greater than 50% of the included studies. The Oxford Hip Score, Oxford Knee Score, EuroQol-5D, and Knee Injury and Osteoarthritis Outcome Score (all P < .001) were used in significantly more CTR than RCT. There is a clear preference for the use of the Harris Hip Score and Knee Society Score, contrary to existing international guidelines and reviews on the topic. Both measures require clinician input, which potentially influences their validity and increases their overall administration cost. Some patient-reported outcome measures, such as the Oxford Hip and Knee Scores, EuroQol-5D, and KOOS, appear to be increasing in popularity. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Clinical Outcome of Medial Pivot Compared With Press-Fit Condylar Sigma Cruciate-Retaining Mobile-Bearing Total Knee Arthroplasty.

    Science.gov (United States)

    Kim, Young-Hoo; Park, Jang-Won; Kim, Jun-Shik

    2017-10-01

    The purpose of this study was to compare the long-term clinical results, radiographic results, range of knee motion, patient satisfaction, and the survival rate of Medial-Pivot posterior cruciate-substituting, knee prosthesis and a press-fit condylar (PFC) Sigma cruciate-retaining mobile-bearing knee prosthesis in the same patients. One hundred eighty-two patients received Medial-Pivot knee prosthesis in one knee and a PFC Sigma knee prosthesis in the contralateral knee. The minimum duration of follow-up was 11 years (range, 11-12.6 years). The knees with a Medial-Pivot knee prosthesis had significantly worse results than those with a PFC Sigma knee prosthesis at the final follow-up with regard to the mean postoperative Knee Society knee scores (90 compared with 95 points), Western Ontario and McMaster Universities Osteoarthritis Index score (25 compared with 18 points), and range of knee motion (117° compared with 128°). Patients were more satisfied with PFC Sigma knee prosthesis (93%) than with Medial-Pivot knee prosthesis (75%). Complication rates were significantly higher in the Medial-Pivot knee group (26%) than those in the PFC Sigma knee group (6.5%). Radiographic results and survival rates (99% compared with 99.5%) were similar between the 2 groups. Although the long-term fixation and survival rate of both Medial-Pivot and PFC Sigma prostheses were similar, we observed a worse knee score, worse range of knee motion, and patient satisfaction was less in the Medial-Pivot knee group than in the PFC Sigma knee group. Furthermore, complication rate was also higher in the Medial-Pivot knee group than the other group. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Knee effusion after total knee replacement.

    OpenAIRE

    Cameron, H. U.

    1993-01-01

    The various causes of effusions in artificial knees can be divided into four groups: implant related, technique related, interface problems, and infection. Diagnosis can be made from the patient's history and a clinical examination. Treatment is usually surgical revision.

  9. Traumatic knee extension deficit (the locked knee)

    DEFF Research Database (Denmark)

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

    2007-01-01

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

  10. Unilateral vs one stage bilateral total knee replacement in rheumatoid and osteoarthritis - A comparative study

    Directory of Open Access Journals (Sweden)

    Kiran E

    2005-01-01

    Full Text Available Background : A controversy exists regarding simultaneous or staged bilateral total knee replacement. Methods: Fifty patients undergoing simultaneous bilateral and 50 undergoing unilateral total knee arthroplasty were evaluated prospectively to compare the clinical, radiological results and complication rates. Eighty-four patients belonged to ASA category II or III preoperatively. The study included a high proportion of rheumatoid patients and osteoarthritis patients with severe deformities. Results: Bilateral group had greater blood loss and required more blood transfusion, but there was no difference in requirement of postoperative intensive care and the complication rates. Rheumatoid knees had lower pre and postoperative knee score and functional score as compared to osteoarthritic knees. Morbidity and mortality of one stage bilateral knee replacement was no greater than unilateral operation. Conclusion: Simultaneous bilateral knee replacement in younger patients with advanced rheumatoid arthritis is safe and effective

  11. Validation of the German version of the Kujala score in patients with patellofemoral instability: a prospective multi-centre study.

    Science.gov (United States)

    Dammerer, D; Liebensteiner, M C; Kujala, U M; Emmanuel, K; Kopf, S; Dirisamer, F; Giesinger, J M

    2018-04-01

    The Kujala score is the most frequently used questionnaire for patellofemoral disorders like pain, instability or osteoarthritis. Unfortunately, we are not aware of a validated German version of the Kujala score. The aim of our study was the translation and linguistic validation of the Kujala score in German-speaking patients with patella instability and the assessment of its measurement characteristics. The German Kujala score was developed in several steps of translation. In addition to healthy controls, the Kujala German was assessed in consecutive patients undergoing reconstruction of the medial patellofemoral ligament for recurrent patellar dislocations. Pre-op, 6 and 12 months postop the patients completed the Kujala German score, the KOOS, the Lysholm score, a VAS Pain, and the SF-12v2 scores. In addition, there was a Kujala German Score retest preop after a 1-week interval. We found high reliability in terms of internal consistency for the Kujala score (Cronbach's alpha = 0.87). Convergent validity with the KOOS (symptom r = 0.65, pain r = 0.78, ADL r = 0.74, sports/recreation r = 0.84, quality of life r = 0.70), the Lysholm score (r = 0.88) and the SF-12 physical component summary score (r = 0.79) and VAS pain (r = - 0.71) was also very high. Discriminant validity in terms of correlation with the SF-12 mental component summary Score was satisfactory (r = 0.14). In conclusion, the German version of the Kujala score proved to be a reliable and valid instrument in the setting of a typical patellofemoral disease treated with a standard patellofemoral procedure.

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

    Science.gov (United States)

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

    2015-01-01

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

  13. 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.

  14. The relationship of antiresorptive drug use to structural findings and symptoms of knee osteoarthritis.

    Science.gov (United States)

    Carbone, Laura D; Nevitt, Michael C; Wildy, Kathryn; Barrow, Karen D; Harris, Fran; Felson, David; Peterfy, Charles; Visser, Marjolein; Harris, Tamara B; Wang, Benjamin W E; Kritchevsky, Stephen B

    2004-11-01

    To examine the cross-sectional association between use of medications that have a bone antiresorptive effect (estrogen, raloxifene, and alendronate) and both the structural features of knee osteoarthritis (OA), assessed by magnetic resonance imaging (MRI) and radiography, and the symptoms of knee OA in elderly women. Women in the Health, Aging and Body Composition Study underwent MRI and radiography of the knee if they reported symptoms of knee OA, and women without significant knee symptoms were selected as controls. MR images of the knee were assessed for multiple features of OA using the Whole-Organ MRI scoring method, and radiographs were read for Kellgren and Lawrence grade and individual features of OA. Concurrent medication use and knee symptoms were assessed by interview, and knee pain severity was evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). There were 818 postmenopausal women from whom we obtained MR images of the knee and data on medication use. Among these women, 214 (26.2%) were receiving antiresorptive drugs. We found no significant association between overall use of antiresorptive drugs and the presence of knee pain and radiographic changes of OA of the knee. Use of alendronate, but not estrogen, was associated with less severity of knee pain as assessed by WOMAC scores. Both alendronate use and estrogen use were associated with significantly less subchondral bone attrition and bone marrow edema-like abnormalities in the knee as assessed by MRI, as compared with women who had not received these medications. Elderly women being treated with alendronate and estrogen had a significantly decreased prevalence of knee OA-related subchondral bone lesions compared with those reporting no use of these medications. Alendronate use was also associated with a reduction in knee pain according to the WOMAC scores.

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

    Science.gov (United States)

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

  16. The pediatric knee.

    Science.gov (United States)

    Orth, Robert C

    2013-03-01

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

  17. Imaging of knee arthroplasty

    International Nuclear Information System (INIS)

    Miller, Theodore T.

    2005-01-01

    Knee replacement surgery, either with unicompartmental or total systems, is common. The purpose of this manuscript is to review the appearance of normal knee arthroplasty and the appearances of complications such as infection, polyethylene wear, aseptic loosening and particle-induced osteolysis, patellofemoral abnormalities, axial instability, and periprosthetic and component fracture. Knowledge of the potential complications and their imaging appearances will help the radiologist in the diagnostic evaluation of the patient with a painful knee arthroplasty

  18. Imaging of knee arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Miller, Theodore T. [Department of Radiology, North Shore University Hospital, 825 Northern Blvd., Great Neck, NY 11021 (United States)]. E-mail: TMiller@NSHS.edu

    2005-05-01

    Knee replacement surgery, either with unicompartmental or total systems, is common. The purpose of this manuscript is to review the appearance of normal knee arthroplasty and the appearances of complications such as infection, polyethylene wear, aseptic loosening and particle-induced osteolysis, patellofemoral abnormalities, axial instability, and periprosthetic and component fracture. Knowledge of the potential complications and their imaging appearances will help the radiologist in the diagnostic evaluation of the patient with a painful knee arthroplasty.

  19. [CLINICAL APPLICATION OF OXFORD MOBILE-BEARING BIPOLAR PROSTHESIS UNICOMPARTMENTAL KNEE ARTHROPLASTY FOR SINGLE COMPARTMENTAL KNEE OSTEOARTHRITIS].

    Science.gov (United States)

    Wang, Shangzeng; Cheng, Shao; Wang, Yisheng

    2016-01-01

    To evaluate the effectiveness of Oxford mobile-bearing bipolar prosthesis unicompartmental knee arthroplasty (UKA) in the treatment of single compartmental knee osteoarthritis. Between June 2011 and July 2013, 22 cases of single compartmental knee osteoarthritis were treated by Oxford mobile-bearing bipolar prosthesis UKA. Of 22 cases, 8 were male and 14 were female with an average age of 65 years (range, 45-80 years); the left knee was involved in 12 cases, and the right knee in 10 cases, with a mean disease duration of 32.5 months (range, 8-90 months). The mean weight was 55.2 kg (range, 50-65 kg), and the mean body mass index was 20.8 kg/m2 (range, 17-25 kg/m2). Osteoarthritis involved in the single knee medial compartment in all patients. Knee society score (KSS) and range of motion (ROM) were measured to evaluate the knee joint function. Primary healing of incision was obtained in all patients, and there was no complication of infection, bedsore, or deep venous thrombosis. Postoperative follow-up was 2-4 years (mean, 3.2 years). The X-ray films showed good position of prosthesis, no prosthesis dislocation, or periprosthetic infection during follow-up. Knee ROM, KSS function score, and KSS clinical score were significantly improved at 1 week after operation and at last follow-up when compared with preoperative ones (P 0.05). Oxford mobile-bearing bipolar prosthesis UKA is an effective method to treat single compartmental knee osteoarthritis, with the advantages of less trauma, earlier rehabilitation exercise, near physiological state in joint function, and less risk of complications.

  20. 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.

  1. Knee-Extension Torque Variability and Subjective Knee Function in Patients with a History of Anterior Cruciate Ligament Reconstruction.

    Science.gov (United States)

    Goetschius, John; Hart, Joseph M

    2016-01-01

    When returning to physical activity, patients with a history of anterior cruciate ligament reconstruction (ACL-R) often experience limitations in knee-joint function that may be due to chronic impairments in quadriceps motor control. Assessment of knee-extension torque variability may demonstrate underlying impairments in quadriceps motor control in patients with a history of ACL-R. To identify differences in maximal isometric knee-extension torque variability between knees that have undergone ACL-R and healthy knees and to determine the relationship between knee-extension torque variability and self-reported knee function in patients with a history of ACL-R. Descriptive laboratory study. Laboratory. A total of 53 individuals with primary, unilateral ACL-R (age = 23.4 ± 4.9 years, height = 1.7 ± 0.1 m, mass = 74.6 ± 14.8 kg) and 50 individuals with no history of substantial lower extremity injury or surgery who served as controls (age = 23.3 ± 4.4 years, height = 1.7 ± 0.1 m, mass = 67.4 ± 13.2 kg). Torque variability, strength, and central activation ratio (CAR) were calculated from 3-second maximal knee-extension contraction trials (90° of flexion) with a superimposed electrical stimulus. All participants completed the International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, and we determined the number of months after surgery. Group differences were assessed using independent-samples t tests. Correlation coefficients were calculated among torque variability, strength, CAR, months after surgery, and IKDC scores. Torque variability, strength, CAR, and months after surgery were regressed on IKDC scores using stepwise, multiple linear regression. Torque variability was greater and strength, CAR, and IKDC scores were lower in the ACL-R group than in the control group (P Torque variability and strength were correlated with IKDC scores (P Torque variability, strength, and CAR were correlated with each other (P Torque variability alone

  2. Total knee arthroplasty

    DEFF Research Database (Denmark)

    Schrøder, Henrik M.; Petersen, Michael M.

    2016-01-01

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

  3. Total knee replacement and non-surgical treatment of knee osteoarthritis

    DEFF Research Database (Denmark)

    Skou, Søren T; Roos, Ewa M; Laursen, Mogens B

    2018-01-01

    OBJECTIVES: To compare 2-year outcomes of total knee replacement (TKR) followed by non-surgical treatment to that of non-surgical treatment alone and outcomes of the same non-surgical treatment to that of written advice. DESIGN: In two randomized trials, 200 (mean age 66) adults with moderate...... to severe knee osteoarthritis (OA), 100 eligible for TKR and 100 not eligible for TKR, were randomized to TKR followed by non-surgical treatment, non-surgical treatment alone, or written advice. Non-surgical treatment consisted of 12 weeks of supervised exercise, education, dietary advice, use of insoles......, and pain medication. The primary outcome was the mean score of the Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales, covering pain, symptoms, activities of daily living (ADL), and quality of life (QOL). RESULTS: Patients randomized to TKR had greater improvements than patients randomized...

  4. 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

  5. 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.

  6. [Knee disarticulation and through-knee amputation].

    Science.gov (United States)

    Baumgartner, R

    2011-10-01

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

  7. Translation and validation of the Dutch version of the International Knee Documentation Committee Subjective Knee Form

    NARCIS (Netherlands)

    Haverkamp, Daniël; Sierevelt, Inger N.; Breugem, Stefan J. M.; Lohuis, Kim; Blankevoort, Leendert; van Dijk, C. Niek

    2006-01-01

    BACKGROUND: For knee-related surgery, there is a great demand for internationally useable subjective scoring systems. Before such measurements can be used, they should be translated and validated for the population they are used on. For the Dutch population, only the Western Ontario and McMaster

  8. 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.

  9. Gait adaptations in patients with chronic posterior instability of the knee.

    Science.gov (United States)

    Hooper, D M; Morrissey, M C; Crookenden, R; Ireland, J; Beacon, J P

    2002-03-01

    A retrospective analysis was performed to assess gait in individuals with a long history of posterior knee instability. Descriptive study. There are few studies in the literature concerning evaluation of the biomechanics of the knee in patients with knee posterior instability. Nine individuals with posterior knee instability and a matched control group of uninjured subjects were tested in regards to knee kinematics and kinetics while walking and ascending and descending stairs. The mean follow up time for the individuals with posterior instability was 11.1 years. Individual satisfaction with the knee was measured by having participants complete the Flandry (also known as Hughston Clinic) self-assessment questionnaire. It was found that patients with knee posterior instability who indicated a higher level of satisfaction on the Flandry score walked in a manner that demonstrated greater peak knee extensor torque during stance phase, while less satisfied patients with knee posterior instability demonstrated lower peak knee extensor torque. There was a significant correlation between the self-assessment score and the peak knee extensor torque during level walking (P=0.003). During stair ascent and descent, patients with posterior instability averaged lower knee extensor torque and power than the control subjects, but those differences were only statistically significant in power while descending stairs (P=0.048). Individuals with chronic knee posterior instability modify their gait, and the adaptation can be predicted based upon the individuals self-assessment of their knee using the Flandry questionnaire. These data suggest that gait retraining may be a valuable addition to the traditional muscle strengthening programs, which are commonly used during conservative management of knee posterior instability.

  10. Musculoskeletal MR: knee

    International Nuclear Information System (INIS)

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

    2000-01-01

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

  11. Anteroposterior glide versus rotating platform low contact stress (LCS knee arthroplasty: a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Wynn-Jones Charles

    2007-08-01

    Full Text Available Abstract Background Fifty thousand knee replacements are performed annually in the UK at an estimated cost of £150 million. Post-operative improvement depends on a number of factors including implant design and patient associated factors. To our knowledge there are no published study's comparing the results of AP glide and rotating platform designs of LCS knee arthroplasty. Therefore we feel that a study is required to investigate and compare the effects of two types of LCS total knee arthroplasty on joint proprioception and range of motion. Methods/Design Patients will be randomised to receive either a LCS AP glide or Rotating platform prosthesis. Clinical scores (Oxford knee score, American knee society score, EuroQol, range of motion and proprioception will be assessed prior to and at 3,6, 12 and 24 months after the operation. Proprioception will be assessed in terms of absolute error angle (mean difference between the target angle and the response angle. Knee angles will be measured in degrees using an electromagnetic tracking device, Polhemus 3Space Fastrak that detects positions of sensors placed on the test limb. Student's t-test will be used to compare the mean of two groups. Discussion Evidence is lacking concerning the best prosthesis to use for patients undergoing total knee replacement. This pragmatic randomised trial will test the null hypothesis that anteroposterior glide LCS knee arthroplasty does not result in better post operative knee motion and proprioception as compared to rotating platform LCS knee. Trial Registration ISRCTN52943804

  12. Knee Kinematic Improvement After Total Knee Replacement Using a Simplified Quantitative Gait Analysis Method

    Directory of Open Access Journals (Sweden)

    Hassan Sarailoo

    2013-10-01

    Full Text Available Objectives: The aim of this study was to extract suitable spatiotemporal and kinematic parameters to determine how Total Knee Replacement (TKR alters patients’ knee kinematics during gait, using a rapid and simplified quantitative two-dimensional gait analysis procedure. Methods: Two-dimensional kinematic gait pattern of 10 participants were collected before and after the TKR surgery, using a 60 Hz camcorder in sagittal plane. Then, the kinematic parameters were extracted using the gait data. A student t-test was used to compare the group-average of spatiotemporal and peak kinematic characteristics in the sagittal plane. The knee condition was also evaluated using the Oxford Knee Score (OKS Questionnaire to ensure thateach subject was placed in the right group. Results: The results showed a significant improvement in knee flexion during stance and swing phases after TKR surgery. The walking speed was increased as a result of stride length and cadence improvement, but this increment was not statistically significant. Both post-TKR and control groups showed an increment in spatiotemporal and peak kinematic characteristics between comfortable and fast walking speeds. Discussion: The objective kinematic parameters extracted from 2D gait data were able to show significant improvements of the knee joint after TKR surgery. The patients with TKR surgery were also able to improve their knee kinematics during fast walking speed equal to the control group. These results provide a good insight into the capabilities of the presented method to evaluate knee functionality before and after TKR surgery and to define a more effective rehabilitation program.

  13. Dextrose Prolotherapy for Knee Osteoarthritis: A Randomized Controlled Trial

    Science.gov (United States)

    Rabago, David; Patterson, Jeffrey J.; Mundt, Marlon; Kijowski, Richard; Grettie, Jessica; Segal, Neil A.; Zgierska, Aleksandra

    2013-01-01

    PURPOSE Knee osteoarthritis is a common, debilitating chronic disease. Prolotherapy is an injection therapy for chronic musculoskeletal pain. We conducted a 3-arm, blinded (injector, assessor, injection group participants), randomized controlled trial to assess the efficacy of prolotherapy for knee osteoarthritis. METHODS Ninety adults with at least 3 months of painful knee osteoarthritis were randomized to blinded injection (dextrose prolotherapy or saline) or at-home exercise. Extra- and intra-articular injections were done at 1, 5, and 9 weeks with as-needed additional treatments at weeks 13 and 17. Exercise participants received an exercise manual and in-person instruction. Outcome measures included a composite score on the Western Ontario McMaster University Osteoarthritis Index (WOMAC; 100 points); knee pain scale (KPS; individual knee), post-procedure opioid medication use, and participant satisfaction. Intention-to-treat analysis using analysis of variance was used. RESULTS No baseline differences existed between groups. All groups reported improved composite WOMAC scores compared with baseline status (P dextrose prolotherapy improved more (P <.05) at 52 weeks than did scores for patients receiving saline and exercise (score change: 15.3 ± 3.5 vs 7.6 ± 3.4, and 8.2 ± 3.3 points, respectively) and exceeded the WOMAC-based minimal clinically important difference. Individual knee pain scores also improved more in the prolotherapy group (P = .05). Use of prescribed postprocedure opioid medication resulted in rapid diminution of injection-related pain. Satisfaction with prolotherapy was high. There were no adverse events. CONCLUSIONS Prolotherapy resulted in clinically meaningful sustained improvement of pain, function, and stiffness scores for knee osteoarthritis compared with blinded saline injections and at-home exercises. PMID:23690322

  14. Psychosocial determinants of outcomes in knee replacement.

    Science.gov (United States)

    Lopez-Olivo, Maria A; Landon, Glenn C; Siff, Sherwin J; Edelstein, David; Pak, Chong; Kallen, Michael A; Stanley, Melinda; Zhang, Hong; Robinson, Kausha C; Suarez-Almazor, Maria E

    2011-10-01

    To identify potential psychosocial and educational barriers to clinical success following knee replacement. The authors evaluated 241 patients undergoing total knee replacement, preoperatively and 6 months after surgery. Outcomes included the Western Ontario McMaster (WOMAC) scale and the Knee Society rating system (KSRS). Independent variables included: the medical outcome study-social support scale; depression, anxiety and stress scale; brief COPE inventory; health locus of control; arthritis self-efficacy scale and the life orientation test-revised. Multiple regression models evaluated associations of baseline demographic and psychosocial variables with outcomes at 6 months, controlling for body mass index, comorbidities and baseline outcome scores. Patients' mean age was 65 ± 9 years; 65% were women. Most patients improved outcomes after surgery. Several psychosocial variables were associated with outcomes. Regression analyses indicated lower education, less tangible support, depression, less problem-solving coping, more dysfunctional coping, lower internal locus of control were associated with worse WOMAC scores (R(2) contribution of psychosocial variables for pain 0.07; for function, 0.14). Older age, lower education, depression and less problem-solving coping were associated with poorer total KSRS scores (R(2) contribution of psychosocial variables to total KSRS model 0.09). Psychosocial variables as a set contributed from 25% to 74% of total explained variance across the models tested. Patients' level of education, tangible support, depression, problem-solving coping, dysfunctional coping and internal locus of control were associated with pain and functional outcomes after knee replacement. The findings suggest that, in addition to medical management, perioperative psychosocial evaluation and intervention are crucial in enhancing knee replacement outcomes.

  15. Medium-term evaluation of total knee arthroplasty without patellar replacement

    Directory of Open Access Journals (Sweden)

    José Wanderley Vasconcelos

    2013-06-01

    Full Text Available OBJECTIVE: To mid-term evaluate patients who were submitted to total knee arthroplasty without patellar resurfacing. METHODS: It was realized a retrospective cross-sectional study of patients who were submitted to total knee arthroplasty without patellar resurfacing. In all patients clinical examination was done based on the protocol of the Knee Society Scoring System, which assessed pain, range of motion, stability, contraction, knee alignment and function, and radiological evaluation. RESULTS: A total of 36 patients were evaluated. Of these, 07 were operated only on left knee, 12 only on right knee and 17 were operated bilaterally, totaling 53 knees. Ages ranged from 26 to 84 years. Of the 53 knees evaluated, 33 (62.26% had no pain. The maximum flexion range of motion averaged 104.7°. No knee had difficulty in active extension. As to the alignment for anatomical axis twelve knees (22.64% showed deviation between 0° and 4° varus. Thirty-nine (75.49% knees showed pace without restriction and the femorotibial angle ranged between 3° varus and 13° valgus with an average of 5° valgus. The patellar index ranged from 0.2 to 1.1. CONCLUSION: Total knee arthroplasty whitout patellar resurfacing provides good results in mid-term evaluation.

  16. 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.

  17. Influence of Elastic Bandage and Neoprene Sleeve on Knee Position Sense and Pain in Subjects with Knee Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Basir Majdoleslami

    2003-12-01

    Full Text Available Objective: to investigate whether a neoprene sleeve and elastic bandage around the knee joint of subjects with knee osteoarthritis (OA would , in short term (a reduce pain (b improve knee joint position sense and comparison of their effect with each other if they have. Materials & Methods: In a semi-experimental study, 30 subjects (11 men, 19 women, age between 33-75 with unilateral knee OA. Subjects had to have at least 2cm from 10cm visual analogue scale (VAS of knee pain for study entry.All patients were randomly assigned to either an elastic bandage or a neoprene sleeve. One week later they were assigned to the opposite selection. Joint position sense was assessed in the sitting position using an electrogoniometer and pain by VAS where 0cm equals no pain and 10 cm equals worst pain. Knee pain and JPS were assessed for each selection one week apart. During each visit assessment were performed at baseline and after 20 min of bandage/neoprene sleeve application. Results: the mean of scores for knee variables JPS and VAS was taken and paired-t test and Wilcoxon signed rank test was employed to calculate the different between two trails. Neoprene sleeve had significant effect on knee JPS (P=0.037. But elastic bandage had no effect (P=0.631. Both of them had significantly reduced knee pain. (P=0.000 Conclusion: In subjects with both neoprene sleeve and elastic bandage reduced knee pain with more effect of neoprene sleeve. Only the neoprene sleeve had effect on knee JPS.

  18. A randomised, controlled trial of circumpatellar electrocautery in total knee replacement without patellar resurfacing.

    Science.gov (United States)

    van Jonbergen, H P W; Scholtes, V A B; van Kampen, A; Poolman, R W

    2011-08-01

    The efficacy of circumpatellar electrocautery in reducing the incidence of post-operative anterior knee pain is unknown. We conducted a single-centre, outcome-assessor and patient-blinded, parallel-group, randomised, controlled trial to compare circumpatellar electrocautery with no electrocautery in total knee replacement in the absence of patellar resurfacing. Patients requiring knee replacement for primary osteoarthritis were randomly assigned circumpatellar electrocautery (intervention group) or no electrocautery (control group). The primary outcome measure was the incidence of anterior knee pain. A secondary measure was the standardised clinical and patient-reported outcomes determined by the American Knee Society scores and the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index. A total of 131 knees received circumpatellar electrocautery and 131 had no electrocautery. The overall incidence of anterior knee pain at follow-up at one year was 26% (20% to 31%), with 19% (12% to 26%) in the intervention group and 32% (24% to 40%) in the control group (p = 0.02). The relative risk reduction from electrocautery was 40% (9% to 61%) and the number needed to treat was 7.7 (4.3 to 41.4). The intervention group had a better mean total WOMAC score at follow-up at one year compared with the control group (16.3 (0 to 77.7) versus 21.6 (0 to 76.7), p = 0.04). The mean post-operative American Knee Society knee scores and function scores were similar in the intervention and control groups (knee score: 92.4 (55 to 100) versus 90.4 (51 to 100), respectively (p = 0.14); function score: 86.5 (15 to 100) versus 84.5 (30 to 100), respectively (p = 0.49)). Our study suggests that in the absence of patellar resurfacing electrocautery around the margin of the patella improves the outcome of total knee replacement.

  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. Is there a causal link between knee loading and knee osteoarthritis progression?

    DEFF Research Database (Denmark)

    Henriksen, Marius; Creaby, Mark W; Lund, Hans

    2014-01-01

    OBJECTIVE: We performed a systematic review, meta-analysis and assessed the evidence supporting a causal link between knee joint loading during walking and structural knee osteoarthritis (OA) progression. DESIGN: Systematic review, meta-analysis and application of Bradford Hill's considerations...... was assessed from cohort studies using the Bradford Hill guidelines to derive a 0-4 causation score based on four criteria and examined for confirmation in RCTs. RESULTS: Of the 1078 potentially eligible articles, 5 prospective cohort studies were included. The studies included a total of 452 patients relating...

  1. Total Knee Arthroplasty for Knee Osteoarthritis: Support for a Foregone Conclusion?

    Science.gov (United States)

    Steinhaus, Michael E; Christ, Alexander B; Cross, Michael B

    2017-07-01

    Total knee arthroplasty (TKA) is generally accepted as the definitive treatment for advanced knee arthritis after patients fail nonoperative treatments; however, the safety and efficacy of TKA compared to continued nonoperative treatment has never been proven in high-quality, randomized controlled trials. Recently, a 2015 Danish study published a 12-month follow-up on a cohort of patients randomized to either a TKA or continued nonsurgical management for advanced knee osteoarthritis (OA). The authors reported significantly greater improvement in the TKA group in functional outcome scores such as the overall Knee Injury and Osteoarthritis Outcome Score (KOOS 4 score), the KOOS subscales, EQ-5D descriptive index, and timed get up-and-go and 20-m walk tests; however, patients in the TKA did suffer significantly more serious adverse events (SAE). The authors concluded that TKA combined with additional nonoperative care postoperatively is more efficacious than nonsurgical treatment alone in terms of improving pain, function, and quality of life at 12 months but is associated with more SAE. The purpose of this review is to identify the strengths and weaknesses of this trial, interpret its outcomes within the context of prior literature, and evaluate the validity of its conclusions.

  2. Ultrasonographic assessment of pes anserinus tendon and pes anserinus tendinitis bursitis syndrome in patients with knee osteoarthritis.

    Science.gov (United States)

    Toktas, Hasan; Dundar, Umit; Adar, Sevda; Solak, Ozlem; Ulasli, Alper Murat

    2015-01-01

    The aim of this study was to assess the ultrasonographic (US) findings of pes anserinus tendon and bursa in patients with knee osteoarthritis (OA) with or without clinical pes anserinus tendinitis bursitis syndrome (PATBS). A total of 157 female patients with the diagnosis of knee OA on both knees (314 knees), and 30 age, and body mass index- matched healthy female controls without knee pain (60 knees), were included in the study. PATBS was clinically diagnosed. US evaluation parameters were the measurement of the thickness of pes anserinus tendon insertion region (PA) and examination of the morphologic intratendinous PA tissue characteristics and pes anserinus bursitis (PAB). Radiographic knee osteoarthritis graded I-IV according to Kellgren and Lawrence (KL) for each knee was recorded. Pain and functional status were assessed by the Visual Analog Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). There were 183 PATBS (58.3%) clinical diagnoses among the 314 knees with OA. The mean thickness of PA in the patients with knee OA graded 1,2,3,4 with/without PATBS was significantly greater than the controls (p = 0.001). The mean thickness of PA in knees with OA KL graded 3 and 4 with/without PATBS, was greater than knees with OA KL graded 1 and 2 with/without PATBS (p < 0,05) (except knee OA KL graded 2 with PATBS versus knee OA KL graded 4 without PATBS).The knee OA KL graded 1,2,3,4 with PATBS had significantly more PAB and less loss of normal fibrillar echotexture of PA compared to controls and knees with OA KL graded 1,2,3,4 without PATBS (p < 0.05). The VAS scores of knees with OA KL graded 3, 4 with PATBS were significantly greater than those of knees with OA KL graded 3,4 without PATBS (p < 0.05). PA thickness was significantly associated with the KL grade (r: 0.336, p:0.001) and PATBS (r: 0.371, p < 0.001). It is concluded that the mean thickness of PA in knees with OA with/without PATBS was significantly greater than the

  3. Selective Denervation for Persistent Knee Pain After Total Knee Arthroplasty: A Report of 50 Cases.

    Science.gov (United States)

    Shi, Shao-Min; Meister, David W; Graner, Kelly C; Ninomiya, James T

    2017-03-01

    Despite the general success of total knee arthroplasty (TKA), up to 20% of patients report dissatisfaction following surgery. One potential cause of this dissatisfaction is residual pain secondary to neuroma formation in the sensory nerve branches that innervate the knee. We found, after performing a retrospective review, that up to 9.7% of patients following primary TKA and up to 21% of revision cases exhibited persistent knee pain attributable to neuroma formation. Despite the high incidence of this pathology, little is known about the effective diagnosis or treatment of neuroma formation following TKA. Between 2011 and 2014, 50 patients with persistent symptomatic neuroma pain following TKA underwent selective denervation. These patients had demonstrated the appropriate selection criteria and had failed conservative management. Patients were evaluated by the visual analog scale pain score and the Knee Society Score to determine the outcome of the described treatment. Thirty-two patients (64%) rated their outcome as excellent, 10 (20%) as good, 3 (6%) as fair, and 2 (4%) reported no change. The mean visual analog scale pain score was improved from 9.4 ± 0.8 to 1.1 ± 1.6 following surgery (P ≤ .001). The mean Knee Society Scores increased from 45.5 ± 14.3 to 94.1 ± 8.6 points (P ≤ .0001). Three patients (6%) required the second neurectomy due to recurrent pain and received excellent pain relief postoperatively. There were 2 complications of superficial skin peri-incisional hyperemia related to dressings. Average follow-up duration was 24 months (range, 16-38 months). Our study suggests that selective denervation provides an effective and long-lasting option for the management of this pathology. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. 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 ...

  5. Evaluation of 3D printed anatomically scalable transfemoral prosthetic knee.

    Science.gov (United States)

    Ramakrishnan, Tyagi; Schlafly, Millicent; Reed, Kyle B

    2017-07-01

    This case study compares a transfemoral amputee's gait while using the existing Ossur Total Knee 2000 and our novel 3D printed anatomically scalable transfemoral prosthetic knee. The anatomically scalable transfemoral prosthetic knee is 3D printed out of a carbon-fiber and nylon composite that has a gear-mesh coupling with a hard-stop weight-actuated locking mechanism aided by a cross-linked four-bar spring mechanism. This design can be scaled using anatomical dimensions of a human femur and tibia to have a unique fit for each user. The transfemoral amputee who was tested is high functioning and walked on the Computer Assisted Rehabilitation Environment (CAREN) at a self-selected pace. The motion capture and force data that was collected showed that there were distinct differences in the gait dynamics. The data was used to perform the Combined Gait Asymmetry Metric (CGAM), where the scores revealed that the overall asymmetry of the gait on the Ossur Total Knee was more asymmetric than the anatomically scalable transfemoral prosthetic knee. The anatomically scalable transfemoral prosthetic knee had higher peak knee flexion that caused a large step time asymmetry. This made walking on the anatomically scalable transfemoral prosthetic knee more strenuous due to the compensatory movements in adapting to the different dynamics. This can be overcome by tuning the cross-linked spring mechanism to emulate the dynamics of the subject better. The subject stated that the knee would be good for daily use and has the potential to be adapted as a running knee.

  6. Speed, not magnitude, of knee extensor torque production is associated with self-reported knee function early after anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Hsieh, Chao-Jung; Indelicato, Peter A; Moser, Michael W; Vandenborne, Krista; Chmielewski, Terese L

    2015-11-01

    To examine the magnitude and speed of knee extensor torque production at the initiation of advanced anterior cruciate ligament (ACL) reconstruction rehabilitation and the associations with self-reported knee function. Twenty-eight subjects who were 12 weeks post-ACL reconstruction and 28 age- and sex-matched physically active controls participated in this study. Knee extensor torque was assessed bilaterally with an isokinetic dynamometer at 60°/s. The variables of interest were peak torque, average rate of torque development, time to peak torque and quadriceps symmetry index. Knee function was assessed with the International Knee Documentation Committee Subjective Knee Form (IKDC-SKF). Peak torque and average rate of torque development were lower on the surgical side compared to the non-surgical side and controls. Quadriceps symmetry index was lower in subjects with ACL reconstruction compared to controls. On the surgical side, average rate of torque development was positively correlated with IKDC-SKF score (r = 0.379) while time to peak torque was negatively correlated with IKDC-SKF score (r = -0.407). At the initiation of advanced ACL reconstruction rehabilitation, the surgical side displayed deficits in peak torque and average rate of torque development. A higher rate of torque development and shorter time to peak torque were associated with better self-reported knee function. The results suggest that the rate of torque development should be addressed during advanced ACL reconstruction rehabilitation and faster knee extensor torque generation may lead to better knee function. III.

  7. Clinical Outcomes in Men and Women following Total Knee Arthroplasty with a High-Flex Knee: No Clinical Effect of Gender.

    Science.gov (United States)

    Nassif, Jeffrey M; Pietrzak, William S

    2015-01-01

    While it is generally recognized that anatomical differences exist between the male and female knee, the literature generally refutes the clinical need for gender-specific total knee prostheses. It has been found that standard, unisex knees perform as well, or better, in women than men. Recently, high-flex knees have become available that mechanically accommodate increased flexion yet no studies have directly compared the outcomes of these devices in men and women to see if gender-based differences exist. We retrospectively compared the performance of the high-flex Vanguard knee (Biomet, Warsaw, IN) in 716 male and 1,069 female knees. Kaplan-Meier survivorship was 98.5% at 5.6-5.7 years for both genders. After 2 years, mean improvements in Knee Society Knee and Function scores for men and women (50.9 versus 46.3; 26.5 versus 23.1) and corresponding SF-12 Mental and Physical scores (0.2 versus 2.2; 13.7 versus 12.2) were similar with differences not clinically relevant. Postoperative motion gains as a function of preoperative motion level were virtually identical in men and women. This further confirms the suitability of unisex total knee prostheses for both men and women.

  8. Clinical Outcomes in Men and Women following Total Knee Arthroplasty with a High-Flex Knee: No Clinical Effect of Gender

    Directory of Open Access Journals (Sweden)

    Jeffrey M. Nassif

    2015-01-01

    Full Text Available While it is generally recognized that anatomical differences exist between the male and female knee, the literature generally refutes the clinical need for gender-specific total knee prostheses. It has been found that standard, unisex knees perform as well, or better, in women than men. Recently, high-flex knees have become available that mechanically accommodate increased flexion yet no studies have directly compared the outcomes of these devices in men and women to see if gender-based differences exist. We retrospectively compared the performance of the high-flex Vanguard knee (Biomet, Warsaw, IN in 716 male and 1,069 female knees. Kaplan-Meier survivorship was 98.5% at 5.6–5.7 years for both genders. After 2 years, mean improvements in Knee Society Knee and Function scores for men and women (50.9 versus 46.3; 26.5 versus 23.1 and corresponding SF-12 Mental and Physical scores (0.2 versus 2.2; 13.7 versus 12.2 were similar with differences not clinically relevant. Postoperative motion gains as a function of preoperative motion level were virtually identical in men and women. This further confirms the suitability of unisex total knee prostheses for both men and women.

  9. The dynamics of the pain system is intact in patients with knee osteoarthritis: An exploratory experimental study.

    Science.gov (United States)

    Jørgensen, Tanja Schjødt; Henriksen, Marius; Rosager, Sara; Klokker, Louise; Ellegaard, Karen; Danneskiold-Samsøe, Bente; Bliddal, Henning; Graven-Nielsen, Thomas

    2017-12-29

    Background and aims Despite the high prevalence of knee osteoarthritis (OA) it remains one of the most frequent knee disorders without a cure. Pain and disability are prominent clinical features of knee OA. Knee OA pain is typically localized but can also be referred to the thigh or lower leg. Widespread hyperalgesia has been found in knee OA patients. In addition, patients with hyperalgesia in the OA knee joint show increased pain summation scores upon repetitive stimulation of the OA knee suggesting the involvement of facilitated central mechanisms in knee OA. The dynamics of the pain system (i.e., the adaptive responses to pain) has been widely studied, but mainly from experiments on healthy subjects, whereas less is known about the dynamics of the pain system in chronic pain patients, where the pain system has been activated for a long time. The aim of this study was to assess the dynamics of the nociceptive system quantitatively in knee osteoarthritis (OA) patients before and after induction of experimental knee pain. Methods Ten knee osteoarthritis (OA) patients participated in this randomized crossover trial. Each subject was tested on two days separated by 1 week. The most affected knee was exposed to experimental pain or control, in a randomized sequence, by injection of hypertonic saline into the infrapatellar fat pad and a control injection of isotonic saline. Pain areas were assessed by drawings on anatomical maps. Pressure pain thresholds (PPT) at the knee, thigh, lower leg, and arm were assessed before, during, and after the experimental pain and control conditions. Likewise, temporal summation of pressure pain on the knee, thigh and lower leg muscles was assessed. Results Experimental knee pain decreased the PPTs at the knee (P system in individuals with knee OA can be affected even after many years of nociceptive input. This study indicates that the adaptability in the pain system is intact in patients with knee OA, which opens for opportunities to

  10. CT of the knee

    International Nuclear Information System (INIS)

    Ghelman, B.

    1987-01-01

    CT can be combined with arthrography of the knee to study the following abnormalities: meniscal tears and cysts, synovial plicae, chondromalacia patellae, and osteochondritis dissecans. The CT-arthrogram images present abnormalities in a manner that resembles the ''in situ'' surgical findings, allowing management decisions to be made with greater confidence. The CT techniques for imaging the knee after arthrography are discussed, as is the use of plain CT

  11. Dashboard (in the) knee.

    Science.gov (United States)

    Patel, M S; Qureshi, A A; Green, T P

    2015-03-01

    We present the case of a 19-year-old individual presenting to an orthopaedic outpatient clinic several months following a dashboard knee injury during a road traffic accident with intermittent mechanical symptoms. Despite unremarkable examination findings and normal magnetic resonance imaging, the patient was identified subsequently as having an intra-articular plastic foreign body consistent with a piece of dashboard on arthroscopic knee assessment, the retrieval of which resulted in a complete resolution of symptoms.

  12. Prevalent knee pain and sport

    DEFF Research Database (Denmark)

    Hahn, Thomas; Foldspang, Anders

    1998-01-01

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

  13. Comparison of clinical outcomes between total knee arthroplasty and unicompartmental knee arthroplasty for osteoarthritis of the knee: a retrospective analysis of preoperative and postoperative results.

    Science.gov (United States)

    Horikawa, Akira; Miyakoshi, Naohisa; Shimada, Yoichi; Kodama, Hiroyuki

    2015-10-28

    Excellent results have recently been reported for both total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA), but there have been few reports about which has a better long-term outcome. The preoperative and postoperative results of TKA and UKA for osteoarthritis of the knee were thus compared. The results of 48 patients who underwent TKA and 25 patients who underwent UKA were evaluated based on clinical scores and survivorship in the middle long-term period. Preoperative, latest postoperative, and changes in the femoro-tibial angle (FTA), range of motion (ROM), Japanese Orthopedic Association score (JOA score), and Japanese Knee Osteoarthritis Measure (JKOM) were compared. The patients' mean age was 73 years. The mean follow-up period was 9 years (TKA: mean, 10.5 years; range, 7-12 years; UKA: mean, 9 years; range, 6-11 years). Preoperative FTA and ROM were significantly higher in the UKA group than in the TKA group. Total changes in all scores were similar among the two groups, as were changes in scores for all JOA and JKOM domains. The cumulative revision rate was higher for UKA than for TKA (7 versus 4%). Kaplan-Meier survivorship at 10 years was 84% for UKA and 92% for TKA. This clinical study found no significant differences between TKA and UKA, except in long-term survivorship.

  14. 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 ...

  15. Associations between MRI-defined structural pathology and generalized and localized knee pain - the Oulu Knee Osteoarthritis study.

    Science.gov (United States)

    Kaukinen, P; Podlipská, J; Guermazi, A; Niinimäki, J; Lehenkari, P; Roemer, F W; Nieminen, M T; Koski, J M; Arokoski, J P A; Saarakkala, S

    2016-09-01

    To determine the associations between multi-feature structural pathology assessed using magnetic resonance imaging (MRI) and the presence of knee pain, and to determine the associations between the locations of structural changes and different knee pain patterns. Eighty symptomatic subjects with knee pain and suspicion or diagnosis of knee OA and 63 asymptomatic subjects underwent knee MRI. Severity of structural changes was graded by MRI Osteoarthritis Knee Score (MOAKS) in separate knee locations. The associations between cartilage damage, bone marrow lesions (BMLs), osteophytes, Hoffa's synovitis, effusion-synovitis, meniscal damage and structural pathologies in ligaments, tendons and bursas and both the presence of pain and the knee pain patterns were assessed. The presence of Hoffa's synovitis (adjusted RR 1.6, 95% CI 1.2-1.3) and osteophytes in any region (2.07, 1.19-3.60) was significantly associated with the presence of pain. Any Hoffa's synovitis was associated with patellar pain (adjusted RR 4.70, 95% CI 1.19-3.60) and moderate-to-severe Hoffa's synovitis with diffuse pain (2.25, 1.13-4.50). Medial knee pain was associated with cartilage loss in the medial tibia (adjusted RR 2.66, 95% CI 1.22-5.80), osteophytes in the medial tibia (2.66, 1.17-6.07) and medial femur (2.55, 1.07-6.09), medial meniscal maceration (2.20, 1.01-4.79) and anterior meniscal extrusions (2.78, 1.14-6.75). Hoffa's synovitis and osteophytes were strongly associated with the presence of knee pain. Medial pain was associated most often with medially located structural pathologies. Copyright © 2016 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  16. Total knee replacement with tibial tubercle osteotomy in rheumatoid patients with stiff knee.

    Science.gov (United States)

    Eid, Ahmed Salem; Nassar, Wael Ahmed Mohamed; Fayyad, Tamer Abdelmeguid Mohamed

    2016-11-01

    Total knee arthroplasty (TKA) is a well-proven modality that can provide pain relief and restore mobility for rheumatoid arthritis (RA) patients with advanced joint destruction. Patellar ligament avulsion, especially in presence of poor bone quality and knee stiffness, is one of the special considerations that must be addressed in this unique population of patients. This study aimed to determine the functional results in a series of rheumatoid patients with stiff knee and end-stage joint destruction who underwent tibial tubercle osteotomy during TKA. Twenty-three knees in 20 patients (16 women; four men) at a mean age of 54 years with end-stage arthritis and knee stiffness due to RA were operated upon for TKA using tibial tubercle osteotomy as a step during the operation. Patients were reviewed clinically and radiographically with a minimum follow-up of two years. Complications were noted. Hospital for Special Surgery (HSS) score was recorded pre-operatively and at six and 12 months postoperatively. Union occurred at the osteotomy site in 21 of 23 cases. One case had deep venous thrombosis (DVT). There was no infection or periprosthetic fracture, and at last follow-up, no patient required revision. HSS score improved from 46 (15-60) pre-operatively to 85 (71-96) post-operatively. Tibial tubercle osteotomy during TKA in patients with RA and stiff knee is technically demanding yet proved to be effective in improving post-operative range of movement and minimising the complication of patellar ligament avulsion.

  17. A Survey On The Effects Of Iontophoresis Of Piroxicam Gel On Pain And Knee Muscles Strengthn Patients With Knee Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Asghar RezaSoltani

    2012-04-01

    Full Text Available Background and Aim: Knee osteoarthritis is the most common cause of disability in many societies. Therapeutic measures such as using anti-inflammation drugs and physiotherapy programs have been used to suppress knee pain and improve knee joint function in patients with knee osteoarthritis. The aim of this study was to compare the effects of iontophoresis of piroxicam gel, galvanic current with or without piroxicam gel on pain, functional ability and knee muscle strength in patients with knee osteoarthritis.Materials and Method: This study was a clinical trial conducted in Akhtar hospital. Forty two female patients (mean age 58.52 years old with knee osteoarthritis participated in this study. The protocol was performed in Physiotherapy Clinic of Mazandaran Medical University, Mazandaran, Iran. All patients were randomly assigned to three groups. Iontophoresis of piroxicam gel was applied for group 1 (n=14, proxicam gel for group 2 (n=14 and galvanic current for group 3 (n=14. The procedure was carried out for 20-minutes, three times a week and for two following weeks. Knee pain and functional ability were estimated by knee injury and osteoarthritis outcome score (KOOS questioner and the strength of knee extensor and flexor muscles by an isometric device just before the first treatment and immediately after the last treatment times.Results: A significant decrease in pain and a significant increase in functional ability and the strength of knee extensor muscles were resulted in all studied groups (P < 0.05. According to ANOVA test, the level of the percentage difference which was computed for KOOS and knee muscle strength before and after treatments was significantly higher in group 1 than the other two (P < 0.01.Conclusion: Pain and knee functional ability were significantly improved in patients in all three methods. But iontophoresis of piroxicam gel appeared to be more effective in relieving pain and improving knee functional abilities than the

  18. The effect of posterior tibial slope on knee flexion in posterior-stabilized total knee arthroplasty.

    Science.gov (United States)

    Shi, Xiaojun; Shen, Bin; Kang, Pengde; Yang, Jing; Zhou, Zongke; Pei, Fuxing

    2013-12-01

    To evaluate and quantify the effect of the tibial slope on the postoperative maximal knee flexion and stability in the posterior-stabilized total knee arthroplasty (TKA). Fifty-six patients (65 knees) who had undergone TKA with the posterior-stabilized prostheses were divided into the following 3 groups according to the measured tibial slopes: Group 1: ≤4°, Group 2: 4°-7° and Group 3: >7°. The preoperative range of the motion, the change in the posterior condylar offset, the elevation of the joint line, the postoperative tibiofemoral angle and the preoperative and postoperative Hospital for Special Surgery (HSS) scores were recorded. The tibial anteroposterior translation was measured using the Kneelax 3 Arthrometer at both the 30° and the 90° flexion angles. The mean values of the postoperative maximal knee flexion were 101° (SD 5), 106° (SD 5) and 113° (SD 9) in Groups 1, 2 and 3, respectively. A significant difference was found in the postoperative maximal flexion between the 3 groups (P slope resulted in a 1.8° flexion increment (r = 1.8, R (2) = 0.463, P slope can significantly increase the postoperative maximal knee flexion. The tibial slope with an appropriate flexion and extension gap balance during the operation does not affect the joint stability.

  19. [Comparison of external fixation with or without limited internal fixation for open knee fractures].

    Science.gov (United States)

    Li, K N; Lan, H; He, Z Y; Wang, X J; Yuan, J; Zhao, P; Mu, J S

    2018-03-01

    Objective: To explore the characteristics and methods of different fixation methods and prevention of open knee joint fracture. Methods: The data of 86 cases of open knee joint fracture admitted from January 2002 to December 2015 in Department of Orthopaedics, Affiliated Hospital of Chengdu University were analyzed retrospectively.There were 65 males and 21 females aged of 38.6 years. There were 38 cases treated with trans articular external fixation alone, 48 cases were in the trans articular external fixation plus auxiliary limited internal fixation group. All the patients were treated according to the same three stages except for different fixation methods. Observation of external fixation and fracture fixation, fracture healing, wound healing and treatment, treatment and related factors of infection control and knee function recovery. χ(2) test was used to analyze data. Results: Eleven patients had primary wound healing, accounting for 12.8%. Seventy-five patients had two wounds healed, accounting for 87.2%. Only 38 cases of trans articular external fixator group had 31 cases of articular surface reduction, accounting for 81.6%; Five cases of trans articular external fixator assisted limited internal fixation group had 5 cases of poor reduction, accounting for 10.4%; There was significant difference between the two groups (χ(2)=44.132, P external fixation group, a total of 23 cases of patients with infection, accounted for 60.5% of external fixation group; trans articular external fixation assisted limited internal fixation group there were 30 cases of patients with infection, accounting for the assistance of external fixator and limited internal fixation group 62.5%; There was significant difference between the two groups(χ(2)=0.035, P >0.05). Five cases of fracture nonunion cases of serious infection, patients voluntarily underwent amputation. The Lysholm Knee Scale: In the external fixation group, 23 cases were less than 50 points, accounting for 60

  20. Predictive value of MRI features for development of radiographic osteoarthritis in a cohort of participants with pre-radiographic knee osteoarthritis-the CHECK study

    NARCIS (Netherlands)

    van Oudenaarde, Kim; Jobke, Björn; Oostveen, Ans C M; Marijnissen, Annekarien C A; Wolterbeek, Ron; Wesseling, Janet; Bierma-Zeinstra, Sita M A; Bloem, Hans L; Reijnierse, Monique; Kloppenburg, Margreet

    OBJECTIVE: To determine whether MRI features are associated with development of radiographic knee OA and can be used as a predictive tool in early knee OA. METHODS: In 148 participants of the Cohort Hip and Cohort Knee study (mean age 56 years, 78% women), with a Kellgren Lawrence (KL) score ⩽1, we

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

    Science.gov (United States)

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

    2009-12-01

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

  2. The Effect of Patellar Denervation by Circumpatellar Electrocautery on Anterior Knee Pain Following Total Knee Replacement – An Experimental Study

    Directory of Open Access Journals (Sweden)

    Balaji Zacharia

    2017-07-01

    Full Text Available ABSTRACT OBJECTIVES Anterior knee pain is a common problem in patients who have undergone TKR which causes dissatisfaction among them. There are Various methods for prevention of anterior knee pain following TKR .The  objective of this study is to determine the  effect of circumpatellar electrocautery on anterior knee pain following TKR and to compare the results with that of those patients who have undergone TKR without circumpatellar denervation. METHODS This is a cohort study conducted in Dept. of Orthopedics, Govt. Medical College, Kozhikode,kerala, 2014. Total sample size was 90.out of which 2 patients died during the study period. We lost follow up of 7 patients.  Among the remaining 81 patients 42 had undergone TKR with circumpatellar denervation using electocautery and 39 without circumpatellar denervation. They were kept under follow up. Patients were followed up postoperatively at 1 month, 3 months, 6 months and at one year. At all postoperative visits, a clinical score was determined using the Knee Society score and the clinical anterior knee pain rating system described by Waters and Bentley RESULTS There is no statistically significant difference in AKP score between both groups.There is a statistically significant difference in the knee society score at 1st month(p value <.001.  But there is no difference on further follow up visits . CONCLUSION There is no statistically significant difference between final outcome of patients who underwent patella denervation using circumpatellar electrocauterisation and those without denervation  with respect to anterior knee pain among patients who have undergone TKR.

  3. Epinephrine inhanced double contrast knee arthrography

    International Nuclear Information System (INIS)

    Lee, Jae Mun; Choi, Byung Ihn

    1981-01-01

    It is well known that double contrast knee arthrography is useful in diagnosis of meniscal lesions and other knee pathology. But intra-articular structures become less well delineated shortly after injection into the knee joint with water soluble contrast media because of rapid absorption and dilution of the injected media. This limits the time when sharply detailed arthrograms are obtainable and precludes repeat delayed arthrogram without reinjection of contrast media. In order to overcome this major disadvantage, the authors used epinephrine which has vasoconstrictive effect and is expected to reduce fluid movement across the synovial membrane temporarily. The authors attempted to compare epinephrine inhanced double contrast arthrographic group, epinephrine(+) group, to the double contrast arthrographic group without epinephrine, epinephrine(-) group, by statistical evaluation. Each group consisted of 35 cases and 7 lateral films of knee joint were taken sequentially 2, 6, 10, 15, 20, 30, and 60 minutes after injection of contrast media, and were assessed by 5 certified radiologists. The results were as follows: 1. The difference of mean score of quality between epinephrine(+) group and epinephrine(-) group was statistically significant at every time interval (ρ value < 0.01 at 2 minutes, ρ < 0.001 at all other time intervals). Epinephrine(+) group was superior to the epinephrine(-) group in quality of film. 2. Numbers of cases above score of 2 which was considered to be of diagnostic quality in evaluating meniscal lesions were larger in epinephrine(+) group than epinephrine(-) group at every time interval. And the difference between two groups was highly significant statistically (ρ < 0.001). 3. Only 43% of cases was above score of 2 at 10 minutes in epinephrine(-) group, but 97% at 10 minutes and 80% at 20 minutes respectively in epinephrine(+) group. Therefore duration for adequate study of arthrogram is prolonged more than two times in epinephrine(+) group

  4. Correlations among measures of knee stiffness, gait performance and complaints in individuals with knee osteoarthritis.

    Science.gov (United States)

    Oatis, Carol A; Wolff, Edward F; Lockard, Margery A; Michener, Lori A; Robbins, Steven J

    2013-03-01

    Stiffness is a common complaint in individuals with knee osteoarthritis and is a component of the osteoarthritis diagnosis. Yet the relationship between stiffness and function is poorly understood and methods to quantify stiffness are limited. Using a cross-sectional observational design with 66 subjects with knee osteoarthritis, stiffness and damping coefficients were calculated from a relaxed knee oscillation procedure. Gait parameters were measured using an electronic walkway. Self-reported pain, stiffness, and function were measured with the Western Ontario and McMaster Osteoarthritis Index. Correlation and Alexander's normalized-t approximation analyses were used to assess associations among the variables. Subset analysis was performed on subjects with and without tibiofemoral joint crepitus. Slight to moderate correlations existed between stiffness and damping coefficients and most gait parameters ((| r |=0.30-0.56; PMcMaster Osteoarthritis Index scores and all gait parameters (| r |=0.35-0.62; Pcoefficient was only slightly associated with patient-rated Western Ontario and McMaster Osteoarthritis Index stiffness subscale scores. Subset analysis revealed significant correlations that differed between those with and without crepitus. These findings suggest that laboratory measured stiffness and damping coefficients, Western Ontario and McMaster Osteoarthritis Index scores and gait-related measurements assess different aspects related to movement in individuals with knee osteoarthritis. Stiffness and damping coefficients may offer the ability to explain gait changes in the knee that are independent of a person's perceptions particularly in the early stages of the disease. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. Early Experience with a Modern Generation Knee System: Average 2 Years’ Follow-up

    Directory of Open Access Journals (Sweden)

    Thomas Paszicsnyek

    2015-12-01

    Full Text Available Arthritis in the knee is a leading cause of pain and disability with total knee arthroplasty (TKA often the treatment of choice after failure of more conservative treatments. TKA has been demonstrated to be one of the most successful procedures performed.  However, despite the good long-term survivorship rates, patient satisfaction is still an issue post TKA with over 20% of patients exhibiting patient dissatisfaction most commonly due to anterior knee pain (over 18-28% patients and mediolateral or varus-valgus instability.  Recent studies have demonstrated that collateral ligament strains are altered post TKA which may lead to laxity and/or tightness of the ligaments resulting in patient discomfort, pain, stiffness and/or instability post TKA.  As a result, it may be beneficial to ensure ligamentous strains after TKA are similar or close to the native situation.  The purpose of this study was to evaluate the clinical and radiographic results of the Unity Knee™ Total Knee System (Corin Ltd, Cirencester, UK, a modern generation, single-radius total knee replacement (TKR and its accompanying instrumentation which is designed to help maintain proper ligament balance and restore the medial jointline.  A total of 89 knees (89 patients were implanted with the device in a single surgeon series.  All patients were assessed using the American Knee Society Score (AKSS, the Oxford Knee Score (OKS, and radiographs.  There was 1 revision due to infection and Kaplan-Meier survivorship was 98.9% at 2 years.  The mean AKSS knee score for the total cohort was 87.1 ± 7.98 and the mean Oxford Knee score was 45.89 + 3.69. Radiographic review found no signs of radiographic failure in any of the knees. This study demonstrates good survivorship, clinical, and radiographic results at 2 years for this TKR.

  6. Normalized knee-extension strength or leg-press power after fast-track total knee arthroplasty

    DEFF Research Database (Denmark)

    Aalund, Peter K; Larsen, Kristian; Hansen, Torben Bæk

    2013-01-01

    OBJECTIVE: (s): To investigate which of the two muscle-impairment measures for the operated leg, normalized knee extension strength or leg press power, is more closely associated to performance-based and self-reported measures of function shortly following total knee arthroplasty (TKA). DESIGN...... and dynamic leg presses to determine their body-mass normalized knee extension strength and leg press power, respectively. The 10-m fast speed walking and 30-s chair stand tests were used to determine performance-based function, while the Western Ontario McMaster University Osteoarthritis Index (WOMAC......) and Oxford Knee scores were used to determine self-reported function. RESULTS: Normalized leg press power was more closely associated to both performance-based (r=.82, P...

  7. Knee arthrography today

    International Nuclear Information System (INIS)

    Otto, H.; Kallenberger, R.

    1987-01-01

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

  8. Epidemiology of jumper's knee.

    Science.gov (United States)

    Ferretti, A

    1986-01-01

    Jumper's knee is a typical functional overload injury because it affects those athletes who submit their knee extensor mechanisms to intense and repeated stress, e.g. volleyball and basketball players, high and long jumpers. According to the classification of Perugia and colleagues, it is an insertional tendinopathy affecting, in order of frequency, the insertion of the patellar tendon into the patella (65% of cases), attachment of the quadriceps tendon to the patella (25%) and the attachment of the patellar tendon to the tibial tuberosity (10%). The frequent occurrence of this injury in athletes led to the study of factors that may contribute to its onset and aggravation. These factors are divided into extrinsic (i.e. kind of sport practised and training methods used) and intrinsic (i.e. connected with the somatic and morphological characteristics of the athletes). On the basis of our experience and after a review of the literature it appears, contrary to what has been repeatedly claimed in the past, the extrinsic factors are more important than the intrinsic in the aetiology of jumper's knee. The effect of traumatic incidents and use of elastic kneecap guards should also be considered negligible. The intrinsic causes of jumper's knee, can be sought in the mechanical properties of tendons (resistance, elasticity and extensibility) rather than in morphological or biomechanical abnormalities of the knee extensor mechanism.

  9. A Novel Association between Femoroacetabular Impingement and Anterior Knee Pain.

    Science.gov (United States)

    Sanchis-Alfonso, Vicente; Tey, Marc; Monllau, Joan Carles

    2015-01-01

    Background. For a long time it has been accepted that the main problem in the anterior knee pain (AKP) patient is in the patella. Currently, literature supports the link between abnormal hip function and AKP. Objective. Our objective is to investigate if Cam femoroacetabular impingement (FAI) resolution is related to the outcome in pain and disability in patients with chronic AKP recalcitrant to conservative treatment associated with Cam FAI. Material and Methods. A retrospective study on 7 patients with chronic AKP associated with FAI type Cam was performed. Knee and hip pain were measured with the visual analogue scale (VAS), knee disability with the Kujala scale, and hip disability with the Nonarthritic Hip Score (NAHS). Results. The VAS knee pain score and VAS hip pain score had a significant improvement postoperatively. At final follow-up, there was significant improvement in all functional scores (Kujala score and NAHS). Conclusion. Our finding supports the link between Cam FAI and AKP in some young patients. Assessment of Cam FAI should be considered as a part of the physical examination of patients with AKP, mainly in cases with pain recalcitrant to conservative treatment.

  10. A Novel Association between Femoroacetabular Impingement and Anterior Knee Pain

    Directory of Open Access Journals (Sweden)

    Vicente Sanchis-Alfonso

    2015-01-01

    Full Text Available Background. For a long time it has been accepted that the main problem in the anterior knee pain (AKP patient is in the patella. Currently, literature supports the link between abnormal hip function and AKP. Objective. Our objective is to investigate if Cam femoroacetabular impingement (FAI resolution is related to the outcome in pain and disability in patients with chronic AKP recalcitrant to conservative treatment associated with Cam FAI. Material and Methods. A retrospective study on 7 patients with chronic AKP associated with FAI type Cam was performed. Knee and hip pain were measured with the visual analogue scale (VAS, knee disability with the Kujala scale, and hip disability with the Nonarthritic Hip Score (NAHS. Results. The VAS knee pain score and VAS hip pain score had a significant improvement postoperatively. At final follow-up, there was significant improvement in all functional scores (Kujala score and NAHS. Conclusion. Our finding supports the link between Cam FAI and AKP in some young patients. Assessment of Cam FAI should be considered as a part of the physical examination of patients with AKP, mainly in cases with pain recalcitrant to conservative treatment.

  11. Self-reported activity level and knee function in amateur football players: the influence of age, gender, history of knee injury and level of competition.

    Science.gov (United States)

    Frobell, R B; Svensson, E; Göthrick, M; Roos, E M

    2008-07-01

    The aim of this study is to investigate if self-reported activity level or knee functions are influenced by subject characteristics, level of competition and history of knee injury. Cross-Sectional study using questionnaires distributed at a personal visit. One hundred and eighty-eight (65 women) amateur football players in 10 football clubs from each division below national level participated in the study. Self-reported Tegner Activity Scale, and the Knee injury and Osteoarthritis Outcome Score (KOOS) are the main outcome measures. Older age, female gender and lower level of competition (football division) were independently associated with lower self-reported Tegner Activity Scale (P history of knee injury had significantly worse KOOS scores (P football players, KOOS scores do not need adjustment for age and gender.

  12. Bouncy knee in a semi-automatic knee lock prosthesis.

    Science.gov (United States)

    Fisher, L D; Lord, M

    1986-04-01

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

  13. Excellent Survival and Good Outcomes at 15 Years Using the Press-Fit Condylar Sigma Total Knee Arthroplasty.

    Science.gov (United States)

    Oliver, William M; Arthur, Calum H C; Wood, Alexander M; Clayton, Robert A E; Brenkel, Ivan J; Walmsley, Philip

    2018-03-27

    We report 15-year survival, clinical, and radiographic follow-up data for the Press-Fit Condylar Sigma total knee arthroplasty. Between October 1998 and October 1999, 235 consecutive TKAs were performed in 203 patients. Patients were reviewed at a specialist nurse-led clinic before surgery and at 5, 8-10, and 15 years postoperatively. Clinical outcomes, including Knee Society Score, were recorded prospectively at each clinic visit, and radiographs were obtained. Of our initial cohort, 99 patients (118 knees) were alive at 15 years, and 31 patients (34 knees) were lost to follow-up. Thirteen knees (5.5%) were revised; 5 (2.1%) for infection, 7 (3%) for instability, and 1 (0.4%) for aseptic loosening. Cumulative survival with the end point of revision for any reason was 92.3% at 15 years and with revision for aseptic failure as the end point was 94.4%. The mean Knee Society Score knee score was 77.4 (33-99) at 15 years, compared with 31.7 (2-62) preoperatively. Of 71 surviving knees for which X-rays were available, 12 (16.9%) had radiolucent lines and 1 (1.4%) demonstrated clear radiographic evidence of loosening. The Press-Fit Condylar Sigma total knee arthroplasty represents a durable, effective option for patients undergoing knee arthroplasty, with excellent survival and good clinical and radiographic outcomes at 15 years. Copyright © 2018 Elsevier Inc. All rights reserved.

  14. Muscle strength, physical performance and physical activity as predictors of future knee replacement

    DEFF Research Database (Denmark)

    Skou, Søren T; Wise, Barton L; Lewis, Cora E

    2016-01-01

    Activity Scale for the Elderly score with incident KR between baseline and the 84-month follow-up. RESULTS: 1,252 (99.6%) participants (1,682 knees) completed the follow-up visits. 331 participants (394 knees) underwent a KR during the 84 months (229 women and 102 men). The crude analysis demonstrated......OBJECTIVE: To investigate associations between lower levels of muscle strength, physical performance and physical activity and the risk of knee replacement (KR) in older adults with frequent knee pain. METHOD: Participants from the Multicenter Osteoarthritis Study (MOST) with knee pain on most......% CI) 0.99 (0.99 to 1.00)), but not when adjusting for Kellgren-Lawrence grade (p = 0.97). CONCLUSION: Lower levels of chair stand performance and self-reported physical activity are not associated with an increased risk of KR within 7 years, while the independent effect of knee extensor strength...

  15. Bilateral custom-fit total knee arthroplasty in a patient with poliomyelitis.

    Science.gov (United States)

    Tardy, Nicolas; Chambat, Pierre; Murphy, Colin G; Fayard, Jean-Marie

    2014-09-01

    In limbs affected by poliomyelitis, total knee arthroplasty results in satisfactory pain relief. However, the risk of failure is high, especially if the preoperative quadriceps power is low. Therefore, treating osteoarthritis in the current patient represented a challenging procedure. A 66-year-old man presented with tricompartmental osteoarthritis of both knees, with valgus deformity of 14° on the left knee and 11° on the right knee. He walked with a bilateral knee recurvatum of 30° and a grade 1 quadriceps power. The authors treated both knees with cemented custom-fit hinged total knee arthroplasty with 30° of recurvatum in the tibial keel. Clinical scores showed good results 1 year postoperatively, especially on the subjective data of quality of life and function. At follow-up, radiographs showed good total knee arthroplasty positioning on the right side and a small mechanical loosening at the end of the tibial keel on the left side. Only 5 studies (Patterson and Insall; Moran; Giori and Lewallen; Jordan et al; and Tigani et al) have reported total knee arthroplasty results in patients with poliomyelitis. This study reports an original case of bilateral custom-fit hinged total knee arthroplasty in a patient with poliomyelitis. To the authors' knowledge, this is the first report of this type of procedure in the literature. The key point is the degree of recurvatum that is needed to allow walking, avoiding excessive constraints on the implants that can lead to early mechanical failure. Copyright 2014, SLACK Incorporated.

  16. Clinical and biomechanical assessment of patella resurfacing in total knee arthroplasty.

    Science.gov (United States)

    Berti, Lisa; Benedetti, Maria Grazia; Ensini, Andrea; Catani, Fabio; Giannini, Sandro

    2006-07-01

    Currently there is a limited understanding of the factors influencing range of motion by comparing patellar resurfacing vs non-resurfacing in total knee arthroplasty during activities of daily living. A recent meta-analysis of patellar replacement confirms better outcome with patella resurfacing; however, the result can be influenced by many other factors, such as: component design, surgeon experience, and technical aspects of the surgery. This study compares the biomechanics of the knee in patients after total knee arthroplasty with and without patellar resurfacing during stair climbing. Forty-seven patients with total knee arthroplasty were assessed at the mean follow-up of 24 months. In all of them a posterior stabilised fixed bearing prosthesis (Optetrak PS, Exactech) was implanted. Twenty-six patients were treated without patellar resurfacing and 21 with patellar resurfacing. Clinical evaluations were performed using the International Knee Society and the Hospital for Special Surgery scores. Ten patients with patellar resurfacing and 10 patients without patellar resurfacing were also studied with motion analysis during stair climbing; 10 healthy subjects were studied for statistical comparison. Clinical passive knee flexion, International Knee Society Function and Hospital for Special Surgery scores were significantly higher in the patellar resurfacing group. During stair climbing, active knee joint range of motion during the stance phase was greater in patients with patellar resurfacing. The maximum adduction moment was significantly higher in the group without patellar resurfacing. Patients with patellar resurfacing demonstrated better clinical scores, and kinematic and kinetic data while ascending stairs.

  17. An update on risk factors for cartilage loss in knee osteoarthritis assessed using MRI-based semiquantitative grading methods

    Energy Technology Data Exchange (ETDEWEB)

    Alizai, Hamza [Boston University School of Medicine, Quantitative Imaging Center, Department of Radiology, Boston, MA (United States); Aspetar Orthopaedic and Sports Medicine Hospital, Doha (Qatar); University of Texas Health Science Center at San Antonio, Department of Radiology, San Antonio, TX (United States); Roemer, Frank W. [Boston University School of Medicine, Quantitative Imaging Center, Department of Radiology, Boston, MA (United States); Aspetar Orthopaedic and Sports Medicine Hospital, Doha (Qatar); University of Erlangen-Nuremberg, Department of Radiology, Erlangen (Germany); Hayashi, Daichi [Boston University School of Medicine, Quantitative Imaging Center, Department of Radiology, Boston, MA (United States); Aspetar Orthopaedic and Sports Medicine Hospital, Doha (Qatar); Yale University School of Medicine, Department of Radiology, Bridgeport Hospital, Bridgeport, CT (United States); Crema, Michel D. [Boston University School of Medicine, Quantitative Imaging Center, Department of Radiology, Boston, MA (United States); Aspetar Orthopaedic and Sports Medicine Hospital, Doha (Qatar); Hospital do Coracao and Teleimagem, Department of Radiology, Sao Paulo (Brazil); Felson, David T. [Boston University School of Medicine, Clinical Epidemiology Research and Training Unit, Boston, MA (United States); Guermazi, Ali [Boston University School of Medicine, Quantitative Imaging Center, Department of Radiology, Boston, MA (United States); Aspetar Orthopaedic and Sports Medicine Hospital, Doha (Qatar); Boston Medical Center, Boston, MA (United States)

    2014-11-07

    Arthroscopy-based semiquantitative scoring systems such as Outerbridge and Noyes' scores were the first to be developed for the purpose of grading cartilage defects. As magnetic resonance imaging (MRI) became available faor evaluation of the osteoarthritic knee joint, these systems were adapted for use with MRI. Later on, grading methods such as the Whole Organ Magnetic Resonance Score, the Boston-Leeds Osteoarthritis Knee Score and the MRI Osteoarthritis Knee Score were designed specifically for performing whole-organ assessment of the knee joint structures, including cartilage. Cartilage grades on MRI obtained with these scoring systems represent optimal outcome measures for longitudinal studies, and are designed to enhance understanding of the knee osteoarthritis disease process. The purpose of this narrative review is to describe cartilage assessment in knee osteoarthritis using currently available MRI-based semiquantitative whole-organ scoring systems, and to provide an update on the risk factors for cartilage loss in knee osteoarthritis as assessed with these scoring systems. (orig.)

  18. An update on risk factors for cartilage loss in knee osteoarthritis assessed using MRI-based semiquantitative grading methods

    International Nuclear Information System (INIS)

    Alizai, Hamza; Roemer, Frank W.; Hayashi, Daichi; Crema, Michel D.; Felson, David T.; Guermazi, Ali

    2015-01-01

    Arthroscopy-based semiquantitative scoring systems such as Outerbridge and Noyes' scores were the first to be developed for the purpose of grading cartilage defects. As magnetic resonance imaging (MRI) became available faor evaluation of the osteoarthritic knee joint, these systems were adapted for use with MRI. Later on, grading methods such as the Whole Organ Magnetic Resonance Score, the Boston-Leeds Osteoarthritis Knee Score and the MRI Osteoarthritis Knee Score were designed specifically for performing whole-organ assessment of the knee joint structures, including cartilage. Cartilage grades on MRI obtained with these scoring systems represent optimal outcome measures for longitudinal studies, and are designed to enhance understanding of the knee osteoarthritis disease process. The purpose of this narrative review is to describe cartilage assessment in knee osteoarthritis using currently available MRI-based semiquantitative whole-organ scoring systems, and to provide an update on the risk factors for cartilage loss in knee osteoarthritis as assessed with these scoring systems. (orig.)

  19. 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.

  20. Clinical results of Hi-tech Knee II total knee arthroplasty in patients with rheumatoid athritis: 5- to 12-year follow-up

    Directory of Open Access Journals (Sweden)

    Yamanaka Hajime

    2012-02-01

    Full Text Available Abstract Background Total knee arthroplasty (TKA is a common form of treatment to relieve pain and improve function in cases of rheumatoid arthritis (RA. Good clinical outcomes have been reported with a variety of TKA prostheses. The cementless Hi-Tech Knee II cruciate-retaining (CR-type prosthesis, which has 6 fins at the anterior of the femoral component, posterior cruciate ligament (PCL retention, flat-on-flat surface component geometry, all-polyethylene patella, strong initial fixation by the center screw of the tibial base plate, 10 layers of titanium alloy fiber mesh, and direct compression molded ultra high molecular weight polyethylene (UHMWPE, is appropriate for TKA in the Japanese knee. The present study was performed to evaluate the clinical results of primary TKA in RA using the cementless Hi-Tech Knee II CR-type prosthesis. Materials and methods We performed 32 consecutive primary TKAs using cementless Hi-Tech Knee II CR-type prosthesis in 31 RA patients. The average follow-up period was 8 years 3 months. Clinical evaluations were performed according to the American Knee Society (KS system, knee score, function score, radiographic evaluation, and complications. Results The mean postoperative maximum flexion angle was 115.6°, and the KS knee score and function score improved to 88 and 70 after surgery, respectively. Complications, such as infection, occurred in 1 patient and revision surgery was performed. There were no cases of loosening in this cohort, and prosthesis survival rate was 96.9% at 12 years postoperatively. Conclusion These results suggest that TKA using the cementless Hi-Tech Knee II CR-type prosthesis is a very effective form of treatment in RA patients at 5 to 12 years postoperatively. Further long-term follow-up studies are required to determine the ultimate utility of this type of prosthesis.

  1. Heat generated by knee prostheses.

    Science.gov (United States)

    Pritchett, James W

    2006-01-01

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

  2. Arthroscopic surgery for degenerative knee

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  3. Anterior approach for knee arthrography

    International Nuclear Information System (INIS)

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

    2001-01-01

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

  4. [Case-control study on the relationship between pain and knee function after the internal fixation of femoral fractures].

    Science.gov (United States)

    Dai, Ming-hai; Tang, Cheng-xuan; Yang, Guo-jing; Zhang, Li-cheng; Tang, Xiao-jun; Liu, Liang-le

    2011-09-01

    To investigate the relationship between pain and knee function after the internal fixation of femoral fractures. The clinical data of 73 patients after internal fixation on femoral fractures from June 2006 to December 2009 were retrospectively analyzed. All the patients were divided into two groups according to the degree of postoperative pain: low score group and high score group. Among the 39 patients in low score group (VAS 1 to 5 point), 25 patients were male and 14 patients were female, with a mean age of (37.5 +/- 5.3) years (ranged from 27 to 63 years ). Among 34 patients in high score group (VAS 6 to 10 point), 22 patients were male and 12 patients were female, with a mean age of (36.3 +/- 9.6) years (ranged from 29 to 62 years). The intra-articular pressure of knee and hospital for special surgery knee rating scale (HSS) were recorded and analyzed. All the patients were followed up for an average duration of 24.1 months. The intra-articular pressure of knee was rising for two groups, there were significant difference for the high score group compared with the low score group at 3 days after operation (t=15.67, P=0.000) and the end time of follow up (t=5.63, P=0.000). As to knee joint function, in low score group, 21 patients got an excellent result, 4 good, 7 poor and 2 bad; in high score group, 31 patients got an excellent result, 6 good, 2 poor and no bad. The knee function of low score group was better than that of high score group. The intra-articular pressure of knee is an important factor of the knee functional recovery, and its external symptoms of pain can be seen as an important index to forecast the prognosins of knee function in early time.

  5. 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

  6. Total knee replacement plus physical and medical therapy or treatment with physical and medical therapy alone

    DEFF Research Database (Denmark)

    Skou, Søren Thorgaard; Roos, Ewa M.; Laursen, Mogens Berg

    2012-01-01

    ABSTRACT: BACKGROUND: There is a lack of high quality evidence concerning the efficacy of total knee arthroplasty (TKA). According to international evidence-based guidelines, treatment of knee osteoarthritis (KOA) should include patient education, exercise and weight loss. Insoles....../or NSAIDs. Patients will be randomised to either receiving or not receiving a TKA in addition to the optimised non-surgical treatment. The primary outcome will be the change from baseline to 12 months on the Knee Injury and Osteoarthritis Outcome Score (KOOS)4 defined as the average score for the subscale...

  7. Midterm Outcomes of High-flexion Total Knee Arthroplasty on Japanese Lifestyle

    OpenAIRE

    Ohno, Hiroshi; Murata, Minoru; Ozu, Satoshi; Matsuoka, Nariyasu; Kawamura, Hiroshi; Iida, Hirokazu

    2018-01-01

    Objectives: To evaluate the clinical outcomes after total knee arthroplasty (TKA) using the Genesis II posterior stabilized prosthesis with a high-flex insert during the mid-term follow-up and to assess its effect on the Japanese lifestyle. Materials and Methods: Fifty-three consecutive patients (8 men and 45 women) underwent primary TKA. The mean follow-up duration was 76 months (5-9 years). We evaluated the Japanese Orthopedic Association osteoarthritis knee rating score (JOA knee score), r...

  8. Association of Exercise Therapy and Reduction of Pain Sensitivity in Patients With Knee Osteoarthritis

    DEFF Research Database (Denmark)

    Henriksen, Marius; Klokker, Louise; Graven-Nielsen, Thomas

    2014-01-01

    OBJECTIVE: Exercise has beneficial effects on pain in knee osteoarthritis (OA), yet the underlying mechanisms are unclear. The purpose of this study was to investigate the effects of exercise on pressure-pain sensitivity in patients with knee OA. METHODS: In a randomized controlled trial...... visual analog scale pain scores during constant pressure for 6 minutes at 125% of the PPT as a measure of temporal summation (TS) of pressure-pain. Secondary outcomes included self-reported pain using the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire. Analyses were based on the "per...

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

    NARCIS (Netherlands)

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

    2016-01-01

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

  10. Knees Lifted High

    Centers for Disease Control (CDC) Podcasts

    The Eagle Books are a series of four books that are brought to life by wise animal characters - Mr. Eagle, Miss Rabbit, and Coyote - who engage Rain That Dances and his young friends in the joy of physical activity, eating healthy foods, and learning from their elders about health and diabetes prevention. Knees Lifted High gives children fun ideas for active outdoor play.

  11. Knee injuries in football

    African Journals Online (AJOL)

    swimming and basketball.1 In 2001 it was reported to have injury rates of 1 000 times ... knee injury in football are the age of the player, a previous injury and the ligamentous .... football is possible, although the success rates may vary from ...

  12. Unicompartmental knee arthroplasty

    NARCIS (Netherlands)

    Kort, Nanne Pieter

    2007-01-01

    This thesis concerns technical aspects of unicompartmental knee arthroplasty. Recent years have witnessed a resurgence of interest in unicompartmental arthroplasty, particularly with the introduction of the minimally invasive technique. In the light of the excellent long-term results of the total

  13. 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.

  14. Does the grading of chondromalacia patellae influence anterior knee pain following total knee arthroplasty without patellar resurfacing?

    Science.gov (United States)

    Zha, Guo-Chun; Feng, Shuo; Chen, Xiang-Yang; Guo, Kai-Jin

    2018-03-01

    The influence of chondromalacia patellae (CMP) on post-operative anterior knee pain (AKP) following total knee arthroplasty (TKA) remains controversial, and few studies have focused on the relationship between them. The purpose of this study was to determine whether different CMP grades affect the incidence of AKP after TKA without patellar resurfacing. We performed a retrospective analysis of prospectively collected data on 290 TKAs with the use of the low contact stress mobile-bearing prosthesis, without patellar resurfacing in 290 patients from February 2009 to January 2013. Patients were assessed by the Outerbridge classification for CMP, visual analog scale for AKP, the Knee Society clinical scoring system of knee score (KS), function score (FS), the patellar score (PS) for clinical function, and patients' satisfaction. The intra-operative grading of CMP: grade I in 30 patients, grade II in 68 patients, grade III in 97 patients, and grade IV in 95 patients. The incidence of AKP at 36-month follow-up was 10.3% (30/290). No statistical difference was detected among the different CMP grades in terms of the incidence of AKP (p = 0.995), patients' satisfaction (p = 0.832), KS (p = 0.228), FS (p = 0.713), and PS (p = 0.119) at 36-month follow-up. The findings may suggest no relevant influence of CMP grading on the incidence of AKP after TKA without patellar resurfacing.

  15. Radiation dose reduction in digital plain radiography of the knee after total knee arthroplasty; Dosisreduktion in der digitalen Radiografie des Kniegelenkes nach endoprothetischem Gelenkersatz

    Energy Technology Data Exchange (ETDEWEB)

    Kloth, J.K.; Kauczor, H.U.; Weber, M.A. [University Hospital Heidelberg (Germany). Clinic for Diagnostic and Interventional Radiology; Tanner, M.; Ewerbeck, V. [University Hospital Heidelberg (Germany). Center of Orthopedics, Trauma and Spinal Cord Injury; Stiller, W. [German Cancer Research Center (DKFZ), Radiology (E010), Heidelberg (Germany); Burkholder, I. [Univ. of Applied Sciences of the Saarland, Dept. of Nursing and Health, Saarbruecken (Germany)

    2015-08-15

    To reduce radiation exposure of frequently performed radiographs of the knee in follow-up of total-knee arthroplasty ensuring accurate assessment by using objective quality control criteria. In this prospective randomized study 278 radiographs of the knee in follow-up of total-knee arthroplasty were performed with standard and 37 % reduced radiation dose. The evaluation of the plain-radiographs was conducted using the following criteria: bone-implant interface, implant-surface character, implant-implant discrimination and periarticular heterotopic ossification. Two radiologists evaluated these criteria using a score ranging from 1 (definitely assessable) to 4 (not assessable). If a single criterion had been evaluated with a score ≥ 3 or more than 2 criteria with ≥ 2 points, the radiograph was score das ''not assessable''. The study was designed as non-inferiority-trial. 100 % of examined radiographs were scored as assessable, hence no statistical inferiority between the examinations with standard and reduced dose could be observed. Singular assessment of the defined criteria was likewise dose-independent. Plain-radiography of the knee following total-knee arthroplasty can be performed with 63 % of standard dose without loss of diagnostic validity.

  16. Knee ultrasound from research to real practice: a systematic literature review of adult knee ultrasound assessment feasibility studies.

    Science.gov (United States)

    Peltea, Alexandra; Berghea, Florian; Gudu, Tania; Ionescu, Ruxandra

    2016-12-05

    To identify and analyse existing data regarding knee ultrasound (US) feasibility in clinical practice. Material and methods: A systematic literature review was performed using the terms: ("knee") AND ("ultrasound" OR "ultrasonography") AND ("feasibility" OR "pilot" OR "proof of concept"). Feasibility studies regarding knee US or US aided maneuver involving knee joint, published during 2005-2015, were selected and evaluated against a complex framework constructed around mandatory key areas for feasibility studies: acceptability, demand, implementation, practicality, adaptation, integration and expansion. One hundred and fifty-nine publications were identified, of which 9 were included in the final analysis: 6 dealt with the development and implementation of novel US scores, while the rest focused on implementing MSUS in clinical practice, evaluating the usefulness of articular cartilage US assessment and the feasibility of sonography for intra-articular knee injections, respectively. Six studies quantified feasibility as time spent for the evaluation, with only two addressing areassuch as acceptability, implementation and practicality, although none of these systematically assessed all feasibility domains. Knee US feasibility is still poorly addressed; the time required for US assessment is the main area addressed. This information gap should be properly addressed in future works, in order to ensure the right place for this technique.

  17. 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...

  18. 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...

  19. 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...

  20. Comparison of fixed-bearing and mobile-bearing total knee arthroplasty after high tibial osteotomy.

    Science.gov (United States)

    Hernigou, Philippe; Huys, Maxime; Pariat, Jacques; Roubineau, François; Flouzat Lachaniette, Charles Henri; Dubory, Arnaud

    2018-02-01

    There is no information comparing the results of fixed-bearing total knee replacement and mobile-bearing total knee replacement in the same patients previously treated by high tibial osteotomy. The purpose was therefore to compare fixed-bearing and mobile-bearing total knee replacements in patients treated with previous high tibial osteotomy. We compared the results of 57 patients with osteoarthritis who had received a fixed-bearing prosthesis after high tibial osteotomy with the results of 41 matched patients who had received a rotating platform after high tibial osteotomy. The match was made for length of follow-up period. The mean follow-up was 17 years (range, 15-20 years). The patients were assessed clinically and radiographically. The pre-operative knee scores had no statistically significant differences between the two groups. So was the case with the intra-operative releases, blood loss, thromboembolic complications and infection rates in either group. There was significant improvement in both groups of knees, and no significant difference was observed between the groups (i.e., fixed-bearing and mobile-bearing knees) for the mean Knee Society knee clinical score (95 and 92 points, respectively), or the Knee Society knee functional score (82 and 83 points, respectively) at the latest follow-up. However, the mean post-operative knee motion was higher for the fixed-bearing group (117° versus 110°). In the fixed-bearing group, one knee was revised because of periprosthetic fracture. In the rotating platform mobile-bearing group, one knee was revised because of aseptic loosening of the tibial component. The Kaplan-Meier survivorship for revision at ten years of follow-up was 95.2% for the fixed bearing prosthesis and 91.1% for the rotating platform mobile-bearing prosthesis. Although we did manage to detect significant differences mainly in clinical and radiographic results between the two groups, we found no superiority or inferiority of the mobile

  1. 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.

  2. Is there a causal link between knee loading and knee osteoarthritis progression? A systematic review and meta-analysis of cohort studies and randomised trials

    Science.gov (United States)

    Henriksen, Marius; Creaby, Mark W; Lund, Hans; Juhl, Carsten; Christensen, Robin

    2014-01-01

    Objective We performed a systematic review, meta-analysis and assessed the evidence supporting a causal link between knee joint loading during walking and structural knee osteoarthritis (OA) progression. Design Systematic review, meta-analysis and application of Bradford Hill's considerations on causation. Data sources We searched MEDLINE, Scopus, AMED, CINAHL and SportsDiscus for prospective cohort studies and randomised controlled trials (RCTs) from 1950 through October 2013. Study eligibility criteria We selected cohort studies and RCTs in which estimates of knee joint loading during walking were used to predict structural knee OA progression assessed by X-ray or MRI. Data analyses Meta-analysis was performed to estimate the combined OR for structural disease progression with higher baseline loading. The likelihood of a causal link between knee joint loading and OA progression was assessed from cohort studies using the Bradford Hill guidelines to derive a 0–4 causation score based on four criteria and examined for confirmation in RCTs. Results Of the 1078 potentially eligible articles, 5 prospective cohort studies were included. The studies included a total of 452 patients relating joint loading to disease progression over 12–72 months. There were very serious limitations associated with the methodological quality of the included studies. The combined OR for disease progression was 1.90 (95% CI 0.85 to 4.25; I2=77%) for each one-unit increment in baseline knee loading. The combined causation score was 0, indicating no causal association between knee loading and knee OA progression. No RCTs were found to confirm or refute the findings from the cohort studies. Conclusions There is very limited and low-quality evidence to support for a causal link between knee joint loading during walking and structural progression of knee OA. Trial registration number CRD42012003253 PMID:25031196

  3. 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.

  4. Backside wear in modern total knee designs.

    Science.gov (United States)

    Jayabalan, Prakash; Furman, Bridgette D; Cottrell, Jocelyn M; Wright, Timothy M

    2007-02-01

    Although modularity affords various options to the orthopedic surgeon, these benefits come at a price. The unintended bearing surface between the back surface of the tibial insert and the metallic tray results in micromotion leading to polyethylene wear debris. The objective of this study was to examine the backside wear of tibial inserts from three modern total knee designs with very different locking mechanisms: Insall-Burstein II (IB II), Optetrak, and Advance. A random sample of 71 inserts were obtained from our institution's retrieval collection and examined to assess the extent of wear, depth of wear, and wear damage modes. Patient records were also obtained to determine patient age, body mass index, length of implantation, and reason for revision. Modes of wear damage (abrasion, burnishing, scratching, delamination, third body debris, surface deformation, and pitting) were then scored in each zone from 0 to 3 (0 = 0%, 1 = 0-10%, 2 = 10-50%, and 3 = >50%). The depth of wear was subjectively identified as removal of manufacturing identification markings stamped onto the inferior surface of the polyethylene. Both Advance and IB II polyethylene inserts showed significantly higher scores for backside wear than the Optetrak inserts. All IB II and Advance implants showed evidence of backside wear, whereas 17% (5 out of 30) of the retrieved Optetrak implants had no observable wear. There were no significant differences when comparing the depth of wear score between designs. The locking mechanism greatly affects the propensity for wear and should be considered when choosing a knee implant system.

  5. Patients Unicondylar Knee Replacement vs. Total Knee Replacement

    OpenAIRE

    Hedra Eskander

    2017-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2018-01-15

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

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

    International Nuclear Information System (INIS)

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

    2018-01-01

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

  8. Prevalence of Jumper's knee among nonelite athletes from different sports: a cross-sectional survey.

    Science.gov (United States)

    Zwerver, Johannes; Bredeweg, Steven W; van den Akker-Scheek, Inge

    2011-09-01

    The prevalence of jumper's knee among nonelite athletes from different sports is unknown. This study was undertaken to determine the prevalence of jumper's knee in nonelite athletes from different sports and to determine potential risk factors for jumper's knee. Cohort study (prevalence); Level of evidence, 2. The authors interviewed 891 male and female nonelite athletes from 7 popular sports in The Netherlands: basketball, volleyball, handball, korfball, soccer, field hockey, and track and field. Using a specially developed questionnaire, information was obtained about individual characteristics (age, height, and weight), training background, previous and actual knee problems, and the VISA-P (Victorian Institute of Sport Assessment-Patella) score. The overall prevalence of current jumper's knee was 8.5% (78 of 891 athletes), showing a significant difference between sports with different loading characteristics. Prevalence was highest among volleyball players (14.4%) and lowest among soccer players (2.5%); it was significantly higher among male athletes (51 of 502 [10.2%]) than female athletes (25 of 389 [6.4%]) (χ(2) = 3.91, P = .048). The mean duration of symptoms was 18.9 months (standard deviation [SD], 21.6; median value, 12.0; range, 2.0-59.8). The mean VISA-P score of the athletes with jumper's knee was 71.4 (SD, 13.8). Athletes with jumper's knee were significantly younger, taller, and heavier than those without jumper's knee. Prevalence of jumper's knee is high among nonelite athletes and varies between 14.4% and 2.5% for different sports. Jumper's knee is almost twice as common among male nonelite athletes compared with female athletes. Different sport-specific loading characteristics of the knee extensor apparatus, a younger age, a taller body stature, and higher body weight seem to be risk factors associated with patellar tendinopathy.

  9. [Application of tibial mechanical axis locator in tibial extra-articular deformity in total knee arthroplasty].

    Science.gov (United States)

    Li, Guoliang; Han, Guangpu; Zhang, Jinxiu; Ma, Shiqiang; Guo, Donghui; Yuan, Fulu; Qi, Bingbing; Shen, Runbin

    2013-07-01

    To explore the application value of self-made tibial mechanical axis locator in tibial extra-articular deformity in total knee arthroplasty (TKA) for improving the lower extremity force line. Between January and August 2012, 13 cases (21 knees) of osteoarthritis with tibial extra-articular deformity were treated, including 5 males (8 knees) and 8 females (13 knees) with an average age of 66.5 years (range, 58-78 years). The disease duration was 2-5 years (mean, 3.5 years). The knee society score (KSS) was 45.5 +/- 15.5. Extra-articular deformities included 1 case of knee valgus (2 knees) and 12 cases of knee varus (19 knees). Preoperative full-length X-ray films of lower extremities showed 10-21 degrees valgus or varus deformity of tibial extra joint. Self-made tibial mechanical axis locator was used to determine and mark coronal tibial mechanical axis under X-ray before TKA, and then osteotomy was performed with extramedullary positioning device according to the mechanical axis marker.' All incisions healed by first intention, without related complications of infection and joint instability. All patients were followed up 5-12 months (mean, 8.3 months). The X-ray examination showed case of 2.9 degrees knee deviation angle at 3 days after operation, and the accurate rate was 95.2%. No loosening or instability of prosthesis occurred during follow-up. KSS score was 85.5 +/- 15.0 at last follow-up, showing significant difference when compared with preoperative score (t=12.82, P=0.00). The seft-made tibial mechanical axis locator can improve the accurate rate of the lower extremity force line in TKA for tibia extra-articular deformity.

  10. The Impact of Knee Injury History on Health-Related Quality of Life in Adolescent Athletes.

    Science.gov (United States)

    Lam, Kenneth C; Markbreiter, Jessica G

    2017-10-16

    Current evidence suggests that, despite returning to full participation, physically active adults with a previous knee injury experience lower health-related quality of life (HRQOL) than those with no knee injury history. It is unknown if this relationship is present in adolescent athletes. To determine the impact of knee injury history on HRQOL in adolescent athletes who were medically cleared for full participation. Cross-sectional. Athletic training clinics. A convenience sample of 183 adolescent athletes, who were medically cleared for full participation, were grouped by self-report of a previous knee injury: positive knee injury history [HIS] (n=36, age=15.7+1.35 years, height=168.0+11.9 cm; weight=71.8+11.9 kg) and no knee injury history [NO-HIS] (n=147, age=15.5+1.4 years, height=166.0+10.5 cm, weight=67.6+14.6 kg). Participants completed the pediatric version of the International Knee Documentation Committee form (Pedi-IKDC) and Pediatric Quality of Life Inventory (PedsQL) during their preparticipation examination. Generalized linear models were used to compare group differences for the total and subscale scores of the Pedi-IKDC and PedsQL. Main effects of injury group indicated that the HIS group reported significantly lower scores than the NO-HIS group for the Pedi-IKDC total score (p.05). Our findings suggest that, despite returning to full sport participation, adolescent athletes with a previous knee injury generally experience lower HRQOL than their peers with no knee injury history, specifically for knee-specific HRQOL, physical functioning, school functioning and social functioning. Our results are similar to previous findings reported in collegiate athletes and military cadets.

  11. Patellar resurfacing versus nonresurfacing in total knee arthroplasty for osteoarthritis: experience at a tertiary care institution in Pakistan

    Directory of Open Access Journals (Sweden)

    Lakdawala RH

    2012-02-01

    Full Text Available Akil Fazal1, Riaz H Lakdawala21Clinical Fellow, NYU Hospital for Joint Disease, New York, US; 2Associate Professor and Chief, Section of Orthopedics, Department of Surgery, The Aga Khan University Hospital, Karachi, PakistanObjective: To determine the effect of patellar resurfacing in patients offered total knee arthroplasty for osteoarthritis.Design: Randomized control study.Place and duration of study: The Aga Khan University Hospital, Karachi, Pakistan from January 3, 2005 to January 9, 2010.Patients and methods: Patients undergoing primary total knee arthroplasty for osteoarthritis were assigned to either the patellar resurfacing or nonresurfacing arm using systematic sampling. This consisted of patients undergoing unilateral and bilateral knee arthroplasty. Preoperatively, Knee Society Knee and Function Scores were calculated. After a minimum of 3 years postoperatively Knee Society Knee and Function Scores as well as the Clinical Anterior Knee Pain Rating were calculated and analysis done to check for differences.Results: Seventy-five patients were recruited in each arm; 135 patients had bilateral and 15 had unilateral knee arthroplasty. The mean preoperative knee score was 40.4 for the resurfacing group and 40.60 for the nonresurfacing group (P = 0.45. This improved postoperatively to 93.67 and 94.23 respectively, with no difference between the two groups (P = 0.67. The mean preoperative function score was 45.50 for resurfaced patellae and 45.83 for nonresurfaced. This improved to 89.67 and 90.50, respectively, again with no difference (P = 0.51. Postoperative Clinical Anterior Knee Pain Rating was a mean of 0.1 for resurfaced and 0.13 for nonresurfaced patellas, with no difference on analysis (P = 0.06. However, patients who had bilateral knee arthroplasty had a slightly higher Clinical Anterior Knee Pain Rating than those who had single knee surgery (P = 0.046 irrespective of whether the patellar was resurfaced or not.Conclusion: In

  12. Arthroscopic debridement for grade III and IV chondromalacia of the knee in patients older than 60 years.

    Science.gov (United States)

    van den Bekerom, Michel P J; Patt, Thomas W; Rutten, Sjoerd; Raven, Eric E J; van de Vis, Harm M V; Albers, G H Rob

    2007-10-01

    Arthroscopic debridement has been used to treat patients with degenerative knee osteoarthritis, although there is sometimes conflicting evidence documenting its efficacy. This study evaluates the success of arthroscopic debridement in elderly patients with grade III and IV chondromalacia of the knee as measured by patient satisfaction and the need for additional surgery. From December 1998 to August 2001, a total of 102 consecutive cases of knee arthroscopy in 99 patients > 60 years were performed. Average follow-up was 34 months (range: 7-104 months). Patients were asked about their satisfaction using a visual analog scale, and the presence of meniscal lesions during arthroscopy and the treatment for these lesions were evaluated. Knees also were assessed for articular surface degeneration using Outerbridge's classification for chondromalacia. The need for and type of additional surgery was evaluated. During arthroscopy, meniscal lesions requiring a partial meniscectomy were found in 95 knees. Chondromalacia was found in 92 knees; 53 knees had grade I or II chondromalacia and 39 knees had grade III or IV chondromalacia. Additional surgery was performed in 17 knees. Mean patient satisfaction score was 73 (range: 50-100) in the 39 knees with grade III or IV chondromalacia after arthroscopic debridement was performed. These findings suggest arthroscopic debridement in elderly patients has a place in the treatment algorithm for grade III or IV chondromalacia of the knee.

  13. Asymptomatic population reference values for three knee patient-reported outcomes measures: evaluation of an electronic data collection system and implications for future international, multi-centre cohort studies.

    Science.gov (United States)

    McLean, James M; Brumby-Rendell, Oscar; Lisle, Ryan; Brazier, Jacob; Dunn, Kieran; Gill, Tiffany; Hill, Catherine L; Mandziak, Daniel; Leith, Jordan

    2018-05-01

    The aim was to assess whether the Knee Society Score, Oxford Knee Score (OKS) and Knee Injury and Osteoarthritis Outcome Score (KOOS) were comparable in asymptomatic, healthy, individuals of different age, gender and ethnicity, across two remote continents. The purpose of this study was to establish normal population values for these scores using an electronic data collection system. There is no difference in clinical knee scores in an asymptomatic population when comparing age, gender and ethnicity, across two remote continents. 312 Australian and 314 Canadian citizens, aged 18-94 years, with no active knee pain, injury or pathology in the ipsilateral knee corresponding to their dominant arm, were evaluated. A knee examination was performed and participants completed an electronically administered questionnaire covering the subjective components of the knee scores. The cohorts were age- and gender-matched. Chi-square tests, Fisher's exact test and Poisson regression models were used where appropriate, to investigate the association between knee scores, age, gender, ethnicity and nationality. There was a significant inverse relationship between age and all assessment tools. OKS recorded a significant difference between gender with females scoring on average 1% lower score. There was no significant difference between international cohorts when comparing all assessment tools. An electronic, multi-centre data collection system can be effectively utilized to assess remote international cohorts. Differences in gender, age, ethnicity and nationality should be taken into consideration when using knee scores to compare to pathological patient scores. This study has established an electronic, normal control group for future studies using the Knee society, Oxford, and KOOS knee scores. Diagnostic Level II.

  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. Dimensionality of the Knee Numeric-Entity Evaluation Score (KNEES-ACL)

    DEFF Research Database (Denmark)

    Comins, J D; Krogsgaard, M R; Kreiner, Svend

    2013-01-01

    The benefit of anterior cruciate ligament (ACL) reconstruction has been questioned based on patient-reported outcome measures (PROMs). Valid interpretation of such results requires confirmation of the psychometric properties of the PROM. Rasch analysis is the gold standard for validation of PROMs...

  16. Development of the Knee Numeric-Entity Evaluation Score (KNEES – ACL)

    DEFF Research Database (Denmark)

    Comins, J D; Krogsgaard, M R; Brodersen, J

    2013-01-01

    Patient-related outcome measures (PROMs) are commonly used to gauge treatment effects in patients with anterior cruciate ligament (ACL) deficiency. Valid measures of specific conditions depend on relevant item content. While item content can be derived either from clinicians (face validity) or fr...

  17. Kinematic and kinetic analysis of the knee joint before and after a PCL retaining total knee replacement during gait and single step ascent.

    Science.gov (United States)

    Apostolopoulos, Alexandros; Lallos, Stergios; Mastrokalos, Dimitrios; Michos, Ioannis; Darras, Nikolaos; Tzomaki, Magda; Efstathopoulos, Nikolaos

    2011-01-01

    The objective of this study was to capture and analyze the kinetics and kinematics and determine the functional performance of the osteoarthritic knee after a posterior cruciate ligament (PCL) retaining total knee arthroplasty. Kinematic and kinetic gait analysis of level walking was performed in 20 subjects (12 female and 8 male) with knee ostoarthritis. These patients were free of any neurological diseases that could affect their normal gait. Mean age was 69.6 ± 6.6 years; mean height was 157.6 cm ± 7.6 cm; and mean weight was 77.2 ± 12.1 kg. Full body gait analyses were performed using the BIOKIN 3D motion analysis system before and 9 months after total knee arthroplasty procedures. Single-step ascending kinetic analyses and plantar pressure distribution analyses were also performed for all subjects. International Knee Society Scores (IKSSs) were also assessed pre- and postoperatively. Significant increases were noted postoperatively in average cadence (preoperative mean = 99.26, postoperative mean = 110.5; p knee adduction moment were also reported postoperatively. All patients showed a significant improvement of knee kinetics and kinematics after a PCL retaining total knee arthroplasty. Significant differences were found in the cadence, step length, stride length, and walk velocity postoperatively. IKSSs also significantly improved. Further research is warranted to determine the clinical relevance of these findings.

  18. Knee strength retention and analgesia with continuous perineural fentanyl infusion after total knee replacement: randomized controlled trial.

    Science.gov (United States)

    Mangar, Devanand; Karlnoski, Rachel A; Sprenker, Collin J; Downes, Katheryne L; Taffe, Narrene; Wainwright, Robert; Gustke, Kenneth; Bernasek, Thomas L; Camporesi, Enrico

    2014-04-01

    Despite providing adequate pain relief, a femoral nerve block can induce postoperative muscle weakness after total knee arthoplasty (TKA). Fentanyl has been shown to have peripheral effects but has not been used as a perineural infusate alone after TKA. Sixty patients scheduled for TKA were randomized to one of three blinded groups: a continuous 24 h infusion of either fentanyl 3 μg/ml, ropivacaine 0.1%, or 0.9% normal saline through a femoral nerve sheath catheter at 10 ml/h. The main outcome was maximum voluntary isometric contraction (MVIC) in the quadriceps femoris (knee extension), measured by a handheld dynamometer (Nm/kg). Other variables assessed were preoperative and postoperative visual analog scale (VAS) scores, hamstrings MVIC (knee flexion), active range of motion of the operative knee, distance ambulated, incidence of knee buckling, supplemental morphine usage, postoperative side effects, and serum fentanyl levels. Quadriceps MVIC values were significantly greater in the fentanyl group compared to the group that received ropivacaine (median values, 0.08 vs. 0.03 Nm/kg; p = 0.028). The incidence of postoperative knee buckling upon ambulation was higher in the ropivacaine group compared to the fentanyl group, although not statistically significant (40% vs. 15 %, respectively; p = 0.077). VAS scores while ambulating were not significantly different between the fentanyl group and the ropivacaine group (p = 0.270). Postoperative morphine consumption, nausea and vomiting, and resting VAS scores were similar among the three groups. A continuous perineural infusion of fentanyl produced greater strength retention than ropivacaine post-TKA.

  19. Total Knee Arthroplasty Designed to Accommodate the Presence or Absence of the Posterior Cruciate Ligament

    Directory of Open Access Journals (Sweden)

    Melinda K. Harman

    2014-01-01

    Full Text Available Evidence for selecting the same total knee arthroplasty prosthesis whether the posterior cruciate ligament (PCL is retained or resected is rarely documented. This study reports prospective midterm clinical, radiographic, and functional outcomes of a fixed-bearing design implanted using two different surgical techniques. The PCL was completely retained in 116 knees and completely resected in 43 knees. For the entire cohort, clinical knee (96±7 and function (92±13 scores and radiographic outcomes were good to excellent for 84% of patients after 5–10 years in vivo. Range of motion averaged 124˚±9˚, with 126 knees exhibiting ≥120° flexion. Small differences in average knee flexion and function scores were noted, with the PCL-resected group exhibiting an average of 5° more flexion but an average function score that was 7 points lower compared to the PCL-retained group. Fluoroscopic analysis of 33 knees revealed stable tibiofemoral translations. This study demonstrates that a TKA articular design with progressive congruency in the lateral compartment can provide for femoral condyle rollback in maximal flexion activities and achieve good clinical and functional performance in patients with PCL-retained and PCL-resected TKA. This TKA design proved suitable for use with either surgical technique, providing surgeons with the choice of maintaining or sacrificing the PCL.

  20. Arthroscopic cartilage debridement by excimer laser in chondromalacia of the knee joint. A prospective randomized clinical study.

    Science.gov (United States)

    Raunest, J; Löhnert, J

    1990-01-01

    A new operative technique in arthroscopic treatment of chondromalacia using ultraviolet laser systems is introduced. The postoperative results are evaluated in a prospective and randomized clinical trial. One hundred and forty patients stage II or III chondromalacia according to Outerbridge were randomly assigned to arthroscopic operation using either laser or mechanical instruments. After a 6-month follow-up period the clinical results were compared, guided by a specially designed modification of the Lysholm scoring scale. In the short-term follow-up laser surgery gave superior results in regard to reducing pain (P less than 0.05) and leading to a lower incidence of reactive synovitis (P less than 0.01). No difference was found in respect of disability and functional impairment. Our results lead to the conclusion that arthroscopic laser application seems to be a successful procedure in the treatment of degenerative cartilage disorders, providing precise ablation of tissue without significant thermal damage to the remaining cartilage.

  1. Do we need a gender-specific total knee replacement?

    DEFF Research Database (Denmark)

    Thomsen, M G; Husted, H; Bencke, J

    2012-01-01

    The purpose of this study was to investigate whether a gender-specific high-flexion posterior-stabilised (PS) total knee replacement (TKR) would offer advantages over a high-flex PS TKR regarding range of movement (ROM), 'feel' of the knee, pain and satisfaction, as well as during activity. A total......, satisfaction and daily 'feel' of each knee. Patients underwent gait analysis pre-operatively and at one year, which yielded kinematic, kinetic and temporospatial parameters indicative of knee function during gait. At final follow-up we found no statistically significant differences in ROM (p = 0.......82). The median pain score was 0 (0 to 8) in both groups (p = 0.95). The median satisfaction score was 9 (4 to 10) in the high-flex group and 8 (0 to 10) in the gender-specific group (p = 0.98). The median 'feel' score was 9 (3 to 10) in the high-flex group and 8 (0 to 10) in the gender-specific group (p = 0...

  2. Evaluation of outcome measures for use in clinical practice for adults with musculoskeletal conditions of the knee: a systematic review.

    Science.gov (United States)

    Howe, Tracey E; Dawson, Lesley J; Syme, Grant; Duncan, Louise; Reid, Judith

    2012-04-01

    This systematic review reported on the clinimetric properties of outcome measures for use in clinical practice for adults with musculoskeletal conditions of the knee. A systematic search was performed in Medline, EMBASE, Cinahl and AMED to identify studies examining the clinimetric properties of outcome measures for adults undergoing conservative treatment of ligament injuries, meniscal lesions, patellofemoral pain and osteoarthritis of the knee. Outcomes measures taking less than 20 min to administer and requiring minimal equipment and space were included. Pairs of authors used a checklist to record the characteristics of the outcome measures, their reported clinimetric properties and the demographics of the study populations. The OMERACT filters of 'truth' and 'discrimination' were applied to the data for each outcome measure by an expert panel. Forty-seven studies were included evaluating 37 outcome measures. Ten outcome measures had adequate supporting evidence for 'truth' and 'discrimination': AAOS, AKPS, goniometer measurement, IKDC, KOOS, LEFS, Lysholm, Tegner, WOMAC and WOMET. However none of the outcome measures had been comprehensively tested across all clinimetric properties. Despite the widespread use of some outcome measures in clinical practice and primary research, data on the clinimetric properties were available for only 37 and of these only 10 had adequate supporting evidence for use in this population. However, before a core set of outcome measures can be recommended use in clinical practice, for adults with musculoskeletal conditions of the knee, consensus should be obtained on 'feasibility' in terms of burden on the clinician and the participant. Copyright © 2011 Elsevier Ltd. All rights reserved.

  3. Muscle area of knee O.A

    International Nuclear Information System (INIS)

    Suzuki, Nobuharu; Onozawa, Toshihiro; Shibata, Minoru; Yamasita, Izumi; Kitsunai, Isamu; Asano, Akira

    1983-01-01

    The cross sectional area of the thigh muscles were studied by means of C.T. scan. Twelve normal knees, twelve primary knee O.A. knees, and six R.A. knees were examined. The cross sectional area of the Quadriceps femoris decreased significantly in the patient of the knee O.A. although flexors did not decrease. We discussed the etiology of the knee O.A. from this result. (author)

  4. Mid- term results of stryker® scorpio plus mobile bearing total knee arthroplasty

    Directory of Open Access Journals (Sweden)

    Kobayashi Hideo

    2012-10-01

    Full Text Available Abstract Background The mobile bearing knee system was introduced to lessen contact stress on the articular bearing surface and reduce polyethylene wear. The purpose of the current study was to investigate the mid-term results of patients undergoing total knee arthroplasties (TKAs using Scorpio Plus Mobile Bearing Knee System (Stryker, Mahwah, NJ, and compare the outcomes between patients with osteoarthritis and osteonecrosis (OA·ON group and patients with rheumatoid arthritis (RA group. Methods Eight males and 58 females were followed up for a period of 4.4- 7.6 years from June 1, 2003 to December 31, 2005. There were 53 knees with osteoarthritis, 17 knees with rheumatoid arthritis, and 6 knees with osteonecrosis. Clinical and radiographic follow- up was done using The Japanese Orthopedic Association knee rating score (JOA score and Knee Society Total Knee Arthroplasty Roentgenographic Evaluation and Scoring System. Results With regard to the JOA score, there was significant improvement in both groups. The postoperative range of motion was between 0.8°and 116.8° in OA·ON group, and between 0.0° and 113.7° in RA group. There were no significant differences with the radiographic evaluation between two groups. Spontaneous dislocation of a polyethylene insert occurred in one patient, and deep infection was occurred in one patient. Conclusion There was significant improvement with regard to the clinical and radiographic results of patients undergoing TKAs using the model. The risk of polyethylene insert dislocation related to the mobile bearing TKA is a cause for concern.

  5. The floating knee

    DEFF Research Database (Denmark)

    Muñoz Vives, Josep; Bel, Jean-Christophe; Capel Agundez, Arantxa

    2016-01-01

    In 1975, Blake and McBryde established the concept of 'floating knee' to describe ipsilateral fractures of the femur and tibia.1This combination is much more than a bone lesion; the mechanism is usually a high-energy trauma in a patient with multiple injuries and a myriad of other lesions...... fixation when both fractures (femoral and tibial) are extra-articular.Plates are the 'standard of care' in cases with articular fractures.A combination of implants are required by 40% of floating knees.Associated ligamentous and meniscal lesions are common, but may be irrelevant in the case of an intra......-articular fracture which gives the worst prognosis for this type of lesion. Cite this article: Muñoz Vives K, Bel J-C, Capel Agundez A, Chana Rodríguez F, Palomo Traver J, Schultz-Larsen M, Tosounidis, T. The floating knee.EFORT Open Rev2016;1:375-382. DOI: 10.1302/2058-5241.1.000042....

  6. 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.

  7. Unicompartmental knee arthroplasty for spontaneous osteonecrosis of the knee: A meta-analysis.

    Science.gov (United States)

    Jauregui, Julio J; Blum, Christopher L; Sardesai, Neil; Bennett, Craig; Henn, R Frank; Adib, Farshad

    2018-01-01

    Spontaneous osteonecrosis of the knee (SONK) is a poorly understood but debilitating disease entity. Total knee arthroplasty (TKA) is the standard of care for those patients who fail conservative management, but considering SONK's predilection for affecting a single knee compartment, unicompartmental knee arthroplasty (UKA) appears to be a more tailored option. Unfortunately, conflicting data exist on the utility of UKA in SONK. Thus, the purpose of this study was to evaluate functional outcomes and revision rates of UKA in the setting of SONK. A systematic literature search was performed to evaluate all studies examining patients who underwent UKA for SONK. Screening of the articles was performed using multiple Boolean search strings, methodological index for non-randomized studies criteria, and other selected exclusion criteria. Seven studies were included, with a total of 276 knees (273 patients). The mean age was 68 years (64-74 years), with a mean body mass index of 26 kg/m 2 (25-29 kg/m 2 ). The final range of motion was 125° (124-126°). Standardized mean difference (SMD) of clinical improvement pre- and post-outcome was 3.39 ( p < 0.001). The improvement in the visual analog score was 57.03 points, with an SMD of 4.57 ( p < 0.001). Revision rates were determined to be 5.51% (95% confidence interval of 1.96-10.69%). Our meta-analysis demonstrated that in properly selected patients, UKA could be an excellent alternative to TKA for patients with SONK. These data show that UKA has few complications, significant improvements on functional outcomes, and good survivorship at a mean follow-up of 6 years.

  8. Influences of continuous femoral nerve block on knee function and quality of life in patients following total knee arthroplasty.

    Science.gov (United States)

    Wang, Fen; Zhou, Yingjie; Sun, Jiajun; Yang, Chunxi

    2015-01-01

    Continuous femoral nerve block (CFNB), guided by ultrasound combined nerve stimulations, offers advantages for both sides and provides effective postoperative analgesia after total knee arthroplasty (TKA). The objective of this study was to evaluate the medium-term impact of continuous femoral nerve block on knee function and quality of life in patients following TKA. This was a follow-up study. Total 168 adult patients scheduled for elective TKA were randomly allocated to receive postoperative continuous femoral nerve block guided by ultrasound combined nerve stimulator (group CFNB, n = 82) or patient-controlled epidural analgesia (group PCEA, n = 86). Quality of life, knee function, patient satisfaction, pain medication and associated adverse effects were compared at 1, 3, 6, and 12 months postoperatively. Quality of life was assessed using the Medical Outcomes Study Short Form-36 Health Survey (MOS SF-36), and clinical results were assessed using the Hospital for Special Surgery (HSS) Knee Scoring System. Patient satisfaction scores were divided into four categories. A total of 162 patients completed the 12-month follow-up. The CFNB group patients had significantly improved SF-36 scores and physical function at 1 month postoperatively (P quality of life in patients at one month postoperatively. Continuous femoral nerve block is a good choice for postoperative analgesia after TKA.

  9. The role of the posterior cruciate ligament in total knee replacement

    Science.gov (United States)

    Ritter, M. A.; Davis, K. E.; Meding, J. B.; Farris, A.

    2012-01-01

    Objectives The purpose of this study was to examine the effect of posterior cruciate ligament (PCL) retention, PCL recession, and PCL excision during cruciate-retaining total knee replacement. Methods A total of 3018 anatomic graduated component total knee replacements were examined; 1846 of these retained the PCL, 455 PCLs were partially recessed, and in 717 the PCL was completely excised from the back of the tibia. Results Clinical scores between PCL groups favored excision for flexion (p knees, 98.2% for recessed knees, and 96.4% for excised knees (p = 0.0934, Wilcoxon; p = 0.0202, log-rank). Conclusions Despite some trade off in clinical performance, if the PCL is detached at the time of operation, conversion to a posterior-stabilised prosthesis may not be necessarily required as long as stability in the anteroposterior and coronal planes is achieved. PMID:23610673

  10. [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.

  11. Assessment of quality of life of patients who underwent anterior cruciate ligament reconstruction and a rehabilitation program

    Directory of Open Access Journals (Sweden)

    Moises Cohen

    2004-12-01

    Full Text Available Introduction: Quality of life can be defined as the expression of aconceptual model that tries to represent patient’s perspectivesand his/her level of satisfaction expressed by numbers. Theobjective of this study is to evaluate the parameters of quality oflife of 23 patients who underwent surgery for anterior cruciateligament reconstruction. Methods: We adopted SF-36, a generichealth-related evaluation questionnaire, to obtain informationregarding several aspects of patients’ health conditions, and theLysholm questionnaire, specific to evaluate the symptoms andfunction of the knee. The questionnaires were applied at two stagesof the treatment: pre- and postoperatively (after the rehabilitationprogram. Results: Before surgery, the Lysholm questionnairepresented the following results: excellent in 4% of the cases, goodin 22%, fair in 22%, and poor in 52%. After surgery (Lysholm e SF-36 the correlation level was approximately 44% (p = 0.041.Discussion: The correlation between the Lysholm and the SF-36questionnaires showed the following: the lower the level of pain,the higher the Lysholm score. The high scores presented by theLysholm questionnaire are directly proportional to physical andemotional aspects, and to functional capacity. Conclusion:Analysis of both questionnaires, as well as of their correlation,showed some improvement in patients´ quality of life. We werealso able to demonstrate the importance and usefulness of applyingthe two questionnaires at three different moments: before, duringand after physiotherapeutic intervention.

  12. Histopathological subgroups in knee osteoarthritis.

    Science.gov (United States)

    Wyatt, L A; Moreton, B J; Mapp, P I; Wilson, D; Hill, R; Ferguson, E; Scammell, B E; Walsh, D A

    2017-01-01

    Osteoarthritis (OA) is a heterogeneous, multi-tissue disease. We hypothesised that different histopathological features characterise different stages during knee OA progression, and that discrete subgroups can be defined based on validated measures of OA histopathological features. Medial tibial plateaux and synovium were from 343 post-mortem (PM) and 143 OA arthroplasty donations. A 'chondropathy/osteophyte' group (n = 217) was classified as PM cases with osteophytes or macroscopic medial tibiofemoral chondropathy lesions ≥grade 3 to represent pre-surgical (early) OA. 'Non-arthritic' controls (n = 48) were identified from the remaining PM cases. Mankin histopathological scores were subjected to Rasch analysis and supplemented with histopathological scores for subchondral bone marrow replacement and synovitis. Item weightings were derived by principle components analysis (PCA). Histopathological subgroups were sought using latent class analysis (LCA). Chondropathy, synovitis and osteochondral pathology were each associated with OA at arthroplasty, but each was also identified in some 'non-arthritic' controls. Tidemark breaching in the chondropathy/osteophyte group was greater than in non-arthritic controls. Three histopathological subgroups were identified, characterised as 'mild OA', or 'severe OA' with mild or moderate/severe synovitis. Presence and severity of synovitis helps define distinct histopathological OA subgroups. The absence of a discrete 'normal' subgroup indicates a pathological continuum between normality and OA status. Identifying specific pathological processes and their clinical correlates in OA subgroups has potential to accelerate the development of more effective therapies. Copyright © 2016 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  13. Magnification bone scan of knees for knee pain evaluation

    International Nuclear Information System (INIS)

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

    2001-01-01

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

  14. 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.

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

    Science.gov (United States)

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

    2017-10-04

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

  16. Automatic locking orthotic knee device

    Science.gov (United States)

    Weddendorf, Bruce C. (Inventor)

    1993-01-01

    An articulated tang in clevis joint for incorporation in newly manufactured conventional strap-on orthotic knee devices or for replacing such joints in conventional strap-on orthotic knee devices is discussed. The instant tang in clevis joint allows the user the freedom to extend and bend the knee normally when no load (weight) is applied to the knee and to automatically lock the knee when the user transfers weight to the knee, thus preventing a damaged knee from bending uncontrollably when weight is applied to the knee. The tang in clevis joint of the present invention includes first and second clevis plates, a tang assembly and a spacer plate secured between the clevis plates. Each clevis plate includes a bevelled serrated upper section. A bevelled shoe is secured to the tank in close proximity to the bevelled serrated upper section of the clevis plates. A coiled spring mounted within an oblong bore of the tang normally urges the shoes secured to the tang out of engagement with the serrated upper section of each clevic plate to allow rotation of the tang relative to the clevis plate. When weight is applied to the joint, the load compresses the coiled spring, the serrations on each clevis plate dig into the bevelled shoes secured to the tang to prevent relative movement between the tang and clevis plates. A shoulder is provided on the tang and the spacer plate to prevent overextension of the joint.

  17. 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

  18. 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.

  19. Self-Reported Knee Symptoms Assessed by KOOS Questionnaire in Downhill Runners (Skyrunners.

    Directory of Open Access Journals (Sweden)

    Giulio Sergio Roi

    Full Text Available The knee is the weight-bearing joint most commonly associated with sports injuries, and therefore is most at risk of developing degenerative changes, including osteoarthritis. Skyrunners can be considered to be at risk of developing symptoms of post-traumatic osteoarthritis due to downhill running.The aim of this study was to analyze the health of the knee joints of a large group of these athletes via a specific self-report questionnaire.This study was carried out by asking the participants of seven official Skyraces (22.4±3.1 km length; 1596±393 m elevation to fill out a questionnaire. Information regarding age, sex, downhill elevation (m during training and competitions over the last month, and history of previous knee injury was also collected before the participants filled out the Knee injury and Osteoarthritis Outcome Score (KOOS, which is a reliable and validated instrument designed to assess patients' opinions about their knees and associated problems that can result in post-traumatic osteoarthritis. Athletes were divided into six age groups (from 17 to 70 years and 12 groups based on the downhill gradient they had covered over the last month (from 1,000 to 40,000 m.Six hundred twenty-one questionnaires were collected from 45% of the participants in the seven races. Multivariate analysis revealed that self-reported KOOS scores were unrelated to age, sex and monthly downhill gradient. Only 74 (12% of the participants reported previous knee injuries. Significant differences in the five subscales of the KOOS were found between skyrunners with and without previous knee injuries (P<0.01.In the studied population, regular training for downhill running and participation in Skyraces could not be considered risk factors for subjective knee symptoms. Skyrunners with self-reported histories of knee injuries scored worse on all five subscales of the KOOS.

  20. Overuse Knee Injuries in Athletes

    Directory of Open Access Journals (Sweden)

    Miroslav Kezunović

    2013-03-01

    Full Text Available According to many statistics over 55% of all sports-related injuries are incurred in the knee joint (active sportsmen and recreationists. The statistics definitely differ, depending on type of sport and specific movements habitually performed in a particular sport. Therefore, in addition to acute knee injuries overuse syndromes are common in the knee area also due to specificities of patellofemoral joint just because specific diseases like „jumper's knee“ and „runner's knee“ are related to certain sport activities. Generally speaking, these syndromes occur due to poor orientation of the knee extensor mechanism, i.e. friction of iliotibial band and patellofemoral chondromalacia. It is believed that about 45% of all overuse syndromes in the knee area occur as a result of running.

  1. MR findings in knee osteoarthritis

    International Nuclear Information System (INIS)

    Guermazi, Ali; Taouli, Bachir; Genant, Harry K.; Zaim, Souhil; Miaux, Yves; Peterfy, Charles G.

    2003-01-01

    Knee osteoarthritis (OA) is a leading cause of disability. Recent advances in drug discovery techniques and improvements in understanding the pathophysiology of osteoarthritic disorders have resulted in an unprecedented number of new therapeutic agents. Of all imaging modalities, radiography has been the most widely used for the diagnosis and management of the progression of knee OA. Magnetic resonance imaging is a relatively recent technique and its applications to osteoarthritis have been limited. Compared with conventional radiography, MR imaging offers unparalleled discrimination among articular soft tissues by directly visualizing all components of the knee joint simultaneously and therefore allowing the knee joint to be evaluated as a whole organ. In this article we present the MR findings in knee OA including cartilage abnormalities, osteophytes, bone edema, subarticular cysts, bone attrition, meniscal tears, ligament abnormalities, synovial thickening, joint effusion, intra-articular loose bodies, and periarticular cysts. (orig.)

  2. Patella position is not a determinant for anterior knee pain 10 years after balanced gap total knee arthroplasty.

    Science.gov (United States)

    van Houten, Albert H; Heesterbeek, Petra J C; Wymenga, Ate B

    2016-08-01

    Incidence of anterior knee pain after total knee arthroplasty (TKA) is reported to be between 4 and 49 %. The incidence of AKP at long-term follow-up and possible determinants after cruciate cruciate-retaining TKA were investigated. A 10-year follow-up of a cohort of 55 patients (63 TKAs), who received the balanSys™ cruciate-retaining total knee system (Mathys Ltd, Bettlach, Switzerland) between 1999 and 2002, was performed. Patients had undergone the balanced gap technique, with either a fixed bearing or an AP-glide bearing. Standardised diagnostic questions regarding AKP were collected and categorised into two groups: those with and without AKP. The lateral patellar tilt, patellar displacement measurement and modified Insall-Salvati ratio were used for patella position evaluation on skyline radiographs. The Knee Society Score (KSS), the Knee Osteoarthritis Outcome Score (KOOS) and Numerical Rating Scales (NRS) for pain and satisfaction were obtained at follow-up. Sixteen patients in the study population experienced AKP. Incidence of AKP (fixed bearing 13/44; AP-glide bearing baring 3/17) was not dependent on type of insert (n.s.). There were no statistical differences in patella position and tibiofemoral contact point between the AKP group and the no AKP group (n.s.). KSS, KOOS, NRS-pain and NRS-satisfaction were significantly lower for the patients with AKP (all p years after balanced gap TKA. Postoperative patella positioning was not found to be a determinant for anterior knee pain after TKA. However, patellar displacement does not seem completely favourable. Moreover, type of bearing was not found a determinant for AKP at long-term follow-up. Lower quality prospective cohort study (<80 % follow-up, patients enrolled at different time points in disease), Level II.

  3. Anterior knee pain

    International Nuclear Information System (INIS)

    LLopis, Eva; Padron, Mario

    2007-01-01

    Anterior knee pain is a common complain in all ages athletes. It may be caused by a large variety of injuries. There is a continuum of diagnoses and most of the disorders are closely related. Repeated minor trauma and overuse play an important role for the development of lesions in Hoffa's pad, extensor mechanism, lateral and medial restrain structures or cartilage surface, however usually an increase or change of activity is referred. Although the direct relation of cartilage lesions, especially chondral, and pain is a subject of debate these lesions may be responsible of early osteoarthrosis and can determine athlete's prognosis. The anatomy and biomechanics of patellofemoral joint is complex and symptoms are often unspecific. Transient patellar dislocation has MR distinct features that provide evidence of prior dislocation and rules our complication. However, anterior knee pain more often is related to overuse and repeated minor trauma. Patella and quadriceps tendon have been also implicated in anterior knee pain, as well as lateral or medial restraint structures and Hoffa's pad. US and MR are excellent tools for the diagnosis of superficial tendons, the advantage of MR is that permits to rule out other sources of intraarticular derangements. Due to the complex anatomy and biomechanic of patellofemoral joint maltracking is not fully understood; plain films and CT allow the study of malalignment, new CT and MR kinematic studies have promising results but further studies are needed. Our purpose here is to describe how imaging techniques can be helpful in precisely defining the origin of the patient's complaint and thus improve understanding and management of these injuries

  4. Anterior knee pain

    Energy Technology Data Exchange (ETDEWEB)

    LLopis, Eva [Hospital de la Ribera, Alzira, Valencia (Spain) and Carretera de Corbera km 1, 46600 Alzira Valencia (Spain)]. E-mail: ellopis@hospital-ribera.com; Padron, Mario [Clinica Cemtro, Ventisquero de la Condesa no. 42, 28035 Madrid (Spain)]. E-mail: mario.padron@clinicacemtro.com

    2007-04-15

    Anterior knee pain is a common complain in all ages athletes. It may be caused by a large variety of injuries. There is a continuum of diagnoses and most of the disorders are closely related. Repeated minor trauma and overuse play an important role for the development of lesions in Hoffa's pad, extensor mechanism, lateral and medial restrain structures or cartilage surface, however usually an increase or change of activity is referred. Although the direct relation of cartilage lesions, especially chondral, and pain is a subject of debate these lesions may be responsible of early osteoarthrosis and can determine athlete's prognosis. The anatomy and biomechanics of patellofemoral joint is complex and symptoms are often unspecific. Transient patellar dislocation has MR distinct features that provide evidence of prior dislocation and rules our complication. However, anterior knee pain more often is related to overuse and repeated minor trauma. Patella and quadriceps tendon have been also implicated in anterior knee pain, as well as lateral or medial restraint structures and Hoffa's pad. US and MR are excellent tools for the diagnosis of superficial tendons, the advantage of MR is that permits to rule out other sources of intraarticular derangements. Due to the complex anatomy and biomechanic of patellofemoral joint maltracking is not fully understood; plain films and CT allow the study of malalignment, new CT and MR kinematic studies have promising results but further studies are needed. Our purpose here is to describe how imaging techniques can be helpful in precisely defining the origin of the patient's complaint and thus improve understanding and management of these injuries.

  5. Minimally invasive unicompartmental knee replacement: Midterm clinical outcome.

    Science.gov (United States)

    Tian, Shaoqi; Liu, Jiangjun; Yuan, Wanqing; Wang, Yuanhe; Ha, Chengzhi; Liu, Lun; Li, Qicai; Yang, Xu; Sun, Kang

    2017-01-01

    The purpose of this study was to explore the midterm clinical outcomes of unicompartmental knee replacement (UKR) for medial knee arthropathy through a minimally invasive approach (MIA). From January 2006 to June 2010, 442 consecutive patients (485 knees) were included in the study. All patients underwent MIA-UKR with the mobile bearing Oxford phrase III prosthesis. The incision was made starting 1 cm medial to the medial pole of the patella and extending distally to the tibial tubercle. Radiographic evaluations include femorotibial angle (FTA) from coronal x-rays and rectified varus deformity angle, while clinical evaluations included Knee Society Score (KSS, clinical score and function score), the Western Ontario and McMaster Universities Arthritis Index (WOMAC) osteoarthritis index and visual analog scale (VAS) for pain. Patients followed-up at 1, 3, 6, 12 months after surgery and each year thereafter. Four hundreds and two patients completed the entire follow-up, 40 patients (45 knees) were lost to follow-up. The average follow-up time was 73.0 ± 1.9 months. The mean length of the incisions was 5.0 ± 0.2 cm. The average FTA decreased from 183.6° ± 5.1° preoperatively to 174.3° ± 4.2° postoperatively, and the mean rectified varus deformity angle was 9.3° ± 1.2°. The KSS clinical score improved from 42.4 ± 2.9 to 92.9 ± 3.8, and the function score improved from 53.5 ± 3.8 to 93.5 ± 4.0. The WOMAC score improved from 47.5 ± 3.1 preoperatively to 12.3 ± 1.5 at the last evaluation. The VAS dropped from 7.8 ± 1.9 preoperatively to 1.6 ± 0.2 postoperatively. All clinical evaluations (KSS, WOMAC, VAS) were significantly different (p clinical outcomes of MIA-UKR are satisfactory in a Chinese patient population, which is a good surgical option for patients with medial arthropathy of the knee. However, longer-term follow-up studies should be performed in these patients.

  6. Minimally invasive unicompartmental knee replacement: Midterm clinical outcome.

    Directory of Open Access Journals (Sweden)

    Shaoqi Tian

    Full Text Available The purpose of this study was to explore the midterm clinical outcomes of unicompartmental knee replacement (UKR for medial knee arthropathy through a minimally invasive approach (MIA.From January 2006 to June 2010, 442 consecutive patients (485 knees were included in the study. All patients underwent MIA-UKR with the mobile bearing Oxford phrase III prosthesis. The incision was made starting 1 cm medial to the medial pole of the patella and extending distally to the tibial tubercle. Radiographic evaluations include femorotibial angle (FTA from coronal x-rays and rectified varus deformity angle, while clinical evaluations included Knee Society Score (KSS, clinical score and function score, the Western Ontario and McMaster Universities Arthritis Index (WOMAC osteoarthritis index and visual analog scale (VAS for pain. Patients followed-up at 1, 3, 6, 12 months after surgery and each year thereafter.Four hundreds and two patients completed the entire follow-up, 40 patients (45 knees were lost to follow-up. The average follow-up time was 73.0 ± 1.9 months. The mean length of the incisions was 5.0 ± 0.2 cm. The average FTA decreased from 183.6° ± 5.1° preoperatively to 174.3° ± 4.2° postoperatively, and the mean rectified varus deformity angle was 9.3° ± 1.2°. The KSS clinical score improved from 42.4 ± 2.9 to 92.9 ± 3.8, and the function score improved from 53.5 ± 3.8 to 93.5 ± 4.0. The WOMAC score improved from 47.5 ± 3.1 preoperatively to 12.3 ± 1.5 at the last evaluation. The VAS dropped from 7.8 ± 1.9 preoperatively to 1.6 ± 0.2 postoperatively. All clinical evaluations (KSS, WOMAC, VAS were significantly different (p < 0.05 from pre and post-operative evaluations. The survival rate was 99.1% at 73 months, and the revision rate was 0.9%.The midterm clinical outcomes of MIA-UKR are satisfactory in a Chinese patient population, which is a good surgical option for patients with medial arthropathy of the knee. However, longer

  7. Knees Lifted High

    Centers for Disease Control (CDC) Podcasts

    2008-08-04

    The Eagle Books are a series of four books that are brought to life by wise animal characters - Mr. Eagle, Miss Rabbit, and Coyote - who engage Rain That Dances and his young friends in the joy of physical activity, eating healthy foods, and learning from their elders about health and diabetes prevention. Knees Lifted High gives children fun ideas for active outdoor play.  Created: 8/4/2008 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 8/5/2008.

  8. Knee kinematics and kinetics in former soccer players with a 16-year-old ACL injury – the effects of twelve weeks of knee-specific training

    Directory of Open Access Journals (Sweden)

    Holmström Eva

    2007-04-01

    Full Text Available Abstract Background Training of neuromuscular control has become increasingly important and plays a major role in rehabilitation of subjects with an injury to the anterior cruciate ligament (ACL. Little is known, however, of the influence of this training on knee stiffness during loading. Increased knee stiffness occurs as a loading strategy of ACL-injured subjects and is associated with increased joint contact forces. Increased or altered joint loads contribute to the development of osteoarthritis. The aim of the study was to determine if knee stiffness, defined by changes in knee kinetics and kinematics of gait, step activity and cross-over hop could be reduced through a knee-specific 12-week training programme. Methods A 3-dimensional motion analysis system (VICON and a force plate (AMTI were used to calculate knee kinetics and kinematics before and after 12 weeks of knee-specific training in 12 males recruited from a cohort with ACL injury 16 years earlier. Twelve uninjured males matched for age, sex, BMI and activity level served as a reference group. Self-reported patient-relevant data were obtained by the KOOS questionnaire. Results There were no significant changes in knee stiffness during gait and step activity after training. For the cross-over hop, increased peak knee flexion during landing (from 44 to 48 degrees, p = 0.031 and increased internal knee extensor moment (1.28 to 1.55 Nm/kg, p = 0.017 were seen after training, indicating reduced knee stiffness. The KOOS sport and recreation score improved from 70 to 77 (p = 0.005 and was significantly correlated with the changes in knee flexion during landing for the cross-over hop (r = 0.6, p = 0.039. Conclusion Knee-specific training improved lower extremity kinetics and kinematics, indicating reduced knee stiffness during demanding hop activity. Self-reported sport and recreational function correlated positively with the biomechanical changes supporting a clinical importance of the

  9. Weighted cumulative exposure models helped identify an association between early knee-pain consultations and future knee OA diagnosis.

    Science.gov (United States)

    Yu, Dahai; Peat, George; Bedson, John; Edwards, John J; Turkiewicz, Aleksandra; Jordan, Kelvin P

    2016-08-01

    To establish the association between prior knee-pain consultations and early diagnosis of knee osteoarthritis (OA) by weighted cumulative exposure (WCE) models. Data were from an electronic health care record (EHR) database (Consultations in Primary Care Archive). WCE functions for modeling the cumulative effect of time-varying knee-pain consultations weighted by recency were derived as a predictive tool in a population-based case-control sample and validated in a prospective cohort sample. Two WCE functions ([i] weighting of the importance of past consultations determined a priori; [ii] flexible spline-based estimation) were comprehensively compared with two simpler models ([iii] time since most recent consultation; total number of past consultations) on model goodness of fit, discrimination, and calibration both in derivation and validation phases. People with the most recent and most frequent knee-pain consultations were more likely to have high WCE scores that were associated with increased risk of knee OA diagnosis both in derivation and validation phases. Better model goodness of fit, discrimination, and calibration were observed for flexible spline-based WCE models. WCE functions can be used to model prediagnostic symptoms within routine EHR data and provide novel low-cost predictive tools contributing to early diagnosis. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  10. Anterior Cruciate Ligament Reconstruction using Bone Patellar Tendon Bone autograft in ACL deficient Knee

    Directory of Open Access Journals (Sweden)

    Navin Kumar Karn

    2015-12-01

    Full Text Available Background & Objectives: Injury to Anterior Cruciate Ligament (ACL reconstruction has increased because of increased interest in sports. There are various grafts used for reconstruction of ACL, for example, Bone Patellar Tendon Bone, Hamstring etc. The study was conducted to evaluate the results of Bone Patellar Tendon Bone graft used for reconstruction of Anterior Cruciate Ligament.Materials & Methods: 40 patients with chronic ACL deficient knee presenting to Neuro Hospital from July 2011 to June 2013 were included in the study. The patients with intraarticular fracture of knee, severe OA knee, local active or suspected infection and systemic disease that might influence the study results were excluded from the study. Bone patellar tendon bone graft was harvested from ipsilateral knee in all the cases. The patient was followed till 2 year with specified programme of rehabilitation. The pain was assessed using VAS and the function of the knee was assessed using Modified WOMAC knee index.Results: The long term satisfactory results in terms of functional stability, symptom relief and return to preinjury level of activity was seen in 32 cases (80%. Two knees got infected out of which one required arthroscopic debridement. Mean visual analogue scale was 8 and modified WOMAC knee score was 3 at 2 year follow up.Conclusion: Bone patellar tendon bone graft is useful in high demand patients and cost effective option with high patient satisfaction rate for reconstruction of ACL.JCMS Nepal. 2015;11(3:12-15.

  11. Effect of a physiotherapy rehabilitation program on knee osteoarthritis in patients with different pain intensities.

    Science.gov (United States)

    Abdel-Aziem, Amr Almaz; Soliman, Elsadat Saad; Mosaad, Dalia Mohammed; Draz, Amira Hussin

    2018-02-01

    [Purpose] To examine the effect of physiotherapy rehabilitation program on moderate knee osteoarthritis in patients with different pain intensities. [Subjects and Methods] Sixty subjects (37 men and 23 women) with moderate knee osteoarthritis participated in the current study. Randomization software was used to select the participating subjects' numbers from the clinic records. They were classified into three groups according to pain intensity: mild, moderate, and severe pain groups. All groups underwent a standard set of pulsed electromagnetic field, ultrasound, stretching exercises, and strengthening exercises. Pain intensity, knee range of motion, knee function, and isometric quadriceps strength were evaluated using the visual analogue scale, universal goniometer, Western Ontario and McMaster Universities osteoarthritis index, and Jamar hydraulic dynamometer, respectively. The evaluation was performed before and after a 4-week rehabilitation program. [Results] All groups showed significant differences in pain intensity, knee range of motion, isometric quadriceps strength, and knee function. The score change in moderate pain group was significantly greater than those in mild and severe pain groups. [Conclusion] Pain intensity is one of the prominent factors that are responsible for the improvement of knee osteoarthritis. Consequently, pain intensity should be considered during rehabilitation of knee osteoarthritis.

  12. MR Imaging-based Semi-quantitative Methods for Knee Osteoarthritis

    Science.gov (United States)

    JARRAYA, Mohamed; HAYASHI, Daichi; ROEMER, Frank Wolfgang; GUERMAZI, Ali

    2016-01-01

    Magnetic resonance imaging (MRI)-based semi-quantitative (SQ) methods applied to knee osteoarthritis (OA) have been introduced during the last decade and have fundamentally changed our understanding of knee OA pathology since then. Several epidemiological studies and clinical trials have used MRI-based SQ methods to evaluate different outcome measures. Interest in MRI-based SQ scoring system has led to continuous update and refinement. This article reviews the different SQ approaches for MRI-based whole organ assessment of knee OA and also discuss practical aspects of whole joint assessment. PMID:26632537

  13. The efficacy of 12 weeks non-surgical treatment for patients not eligible for total knee replacement

    DEFF Research Database (Denmark)

    Skou, Søren Thorgaard; Rasmussen, Sten; Laursen, Mogens Berg

    2015-01-01

    OBJECTIVE: To compare the efficacy of a 12-week non-surgical treatment program with usual care in patients with knee osteoarthritis (OA) not eligible for total knee replacement (TKR). METHOD: This two-arm parallel group assessor-blinded randomized controlled trial (RCT) included 100 adults from...... secondary care with knee OA, confirmed by radiography (Kellgren-Lawrence grade ≥1), but not eligible for a TKR. The 12-week non-surgical treatment program consisted of individualized progressed neuromuscular exercise, patient education, insoles, dietary advice and prescription of pain medication...... if indicated, while usual care comprised two leaflets with information and advice on knee OA and recommended treatments. The primary outcome was the change from baseline to 12 months in the Knee injury and Osteoarthritis Outcome Score (KOOS)4 defined as the average score for the KOOS subscales of pain...

  14. Courses of change in knee adduction moment and lateral thrust differ up to 1 year after TKA.

    Science.gov (United States)

    Shimada, Noboru; Deie, Masataka; Hirata, Kazuhiko; Hiate, Yasuhiko; Orita, Naoya; Iwaki, Daisuke; Ito, Yoshihiro; Kimura, Hiroaki; Pappas, Evangelos; Ochi, Mitsuo

    2016-08-01

    In total knee arthroplasty (TKA), dynamic knee loading may loosen the artificial joint and bone or cause polyethylene wear after prolonged use. TKA decreases knee adduction moment at 6 months, but this effect is lost by 1 year post-operatively. However, lateral thrust after TKA has not been clarified. We hypothesized that like knee adduction moment, lateral thrust would return to baseline levels by 1 year post-operatively. Participants were 15 patients who underwent TKA for medial knee OA. Japanese Orthopaedic Association (JOA) score, numeric rating scale, and gait analysis (measurement of peak knee adduction moment, knee varus angle at peak knee adduction moment, lateral thrust, and gait speed) were performed preoperatively (baseline) and 3 weeks, 3 and 6 months, and 1 year post-operatively. JOA score improved from 55 ± 9.8 to 78 ± 12.1 at 1 year post-operatively, and pain decreased significantly from baseline at each follow-up (p < 0.001). Significant increases in gait speed were observed at 6 months and 1 year (p < 0.001). Peak knee adduction moment during stance phase was significantly lower at 3 weeks, 3 months, and 6 months compared to baseline (p < 0.05), but no significant changes were seen at 1 year. Knee varus at peak knee adduction moment did not differ significantly between any measurement points, while lateral thrust was decreased at 6 months and 1 year compared to baseline (p < 0.05). Temporal courses of changes up to 1 year after TKA differed between knee adduction moment and lateral thrust, so our hypothesis was rejected. IV.

  15. Total knee arthroplasty in a pseudoachondroplastic dwarfism patient with bilateral patellar dislocation.

    Science.gov (United States)

    Oh, Kwang-Jun; Yoon, Jung-Ro; Yang, Jae-Hyuk

    2013-01-01

    Late presentation of congenital patellar dislocation with advanced osteoarthritis is rare. This article presents a case of a 59-year-old man with underlying pseudoachondroplastic dwarfism. Advanced osteoarthritis due to bilateral neglected congenital patellar dislocation was treated with total knee arthroplasty without patella relocation surgery. Two years later, the patient had an improvement in Knee Society scores, painless function, and stability. Copyright © 2012 Elsevier B.V. All rights reserved.

  16. 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 ...

  17. The iDuo Bi-compartmental Knee Replacement: Our Early Experience.

    Directory of Open Access Journals (Sweden)

    Peter Jemmett

    2016-12-01

    Our early results suggest that the iDuo knee is a good option for those with isolated bi-compartmental disease and outcome scores are comparable with those reported for the BKA. This bi-compartmental design may bridge the gap between the uni-compartmental and total knee replacement. The choice between monolithic or modular designs remains in debate. We will continue to use this prosthesis for a carefully selected group of patients.

  18. [Periprosthetic knee fractures].

    Science.gov (United States)

    Mittlmeier, T; Beck, M; Bosch, U; Wichelhaus, A

    2016-01-01

    The cumulative incidence of periprosthetic fractures around the knee is increasing further because of an extended indication for knee replacement, previous revision arthroplasty, rising life expectancy and comorbidities. The relevance of local parameters such as malalignment, osseous defects, neighbouring implants, aseptic loosening and low-grade infections may sometimes be hidden behind the manifestation of a traumatic fracture. A differentiated diagnostic approach before the treatment of a periprosthetic fracture is of paramount importance, while the physician in-charge should also have particular expertise in fracture treatment and in advanced techniques of revision endoprosthetics. The following work gives an overview of this topic. Valid classifications are available for categorising periprosthetic fractures of the femur, the tibia and the patella respectively, which are helpful for the selection of treatment. With the wide-ranging modern treatment portfolio bearing in mind the substantial rate of complications and the heterogeneous functional outcome, the adequate analysis of fracture aetiology and the corresponding transformation into an individualised treatment concept offer the chance of an acceptable functional restoration of the patient at early full weight-bearing and prolonged implant survival. The management of complications is crucial to the final outcome.

  19. 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...

  20. Experimental knee pain reduces muscle strength

    DEFF Research Database (Denmark)

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

    2011-01-01

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

  1. Auricular Acupressure for Managing Postoperative Pain and Knee Motion in Patients with Total Knee Replacement: A Randomized Sham Control Study

    Directory of Open Access Journals (Sweden)

    Ling-hua Chang

    2012-01-01

    Full Text Available Background. Postoperative pain management remains a significant challenge for all healthcare providers. A randomized controlled trial was conducted to examine the adjuvant effects of auricular acupressure on relieving postoperative pain and improving the passive range of motion in patients with total knee replacement (TKR. Method. Sixty-two patients who had undergone a TKR were randomly assigned to the acupressure group and the sham control group. The intervention was delivered three times a day for 3 days. A visual analog scale (VAS and the Short-Form McGill Pain Questionnaire were used to assess pain intensity. Pain medication consumption was recorded, and the knee motion was measured using a goniometer. Results. The patients experienced a moderately severe level of pain postoperatively (VAS 58.66 ± 20.35 while being on the routine PCA. No differences were found in pain scores between the groups at all points. However, analgesic drug usage in the acupressure group patients was significantly lower than in the sham control group (<0.05, controlling for BMI, age, and pain score. On the 3rd day after surgery, the passive knee motion in the acupressure group patients was significantly better than in the sham control group patients (<0.05, controlling for BMI. Conclusion. The application of auricular acupressure at specific therapeutic points significantly reduces the opioid analgesia requirement and improves the knee motion in patients with TKR.

  2. Mobile bearing medial unicompartmental knee arthroplasty in patients whose lifestyles involve high degrees of knee flexion: A 10-14year follow-up study.

    Science.gov (United States)

    Choy, Won Sik; Lee, Kwang Won; Kim, Ha Yong; Kim, Kap Jung; Chun, Young Sub; Yang, Dae Suk

    2017-08-01

    Because Asian populations have different lifestyles, such as squatting and sitting on the floor, from those of Western populations, it is possible that the clinical results and survival rate of unicompartmental knee arthroplasty (UKA) for Asian patients may be different. This study described outcomes of mobile bearing medial UKA for Korean patients. A total of the 164 knees treated with mobile bearing UKAs in 147 patients (14 males and 133 females) were reviewed. The mean follow-up period was 12.1years (range 10.1-14). The clinical outcomes, such as the Hospital for Special Surgery Knee score, the Oxford Knee Score and the Knee Society rating system, showed statistically significant improvement from pre-operative to final follow-up (Pbearing dislocation. The 95% confidence interval of survival rate at 12years was 84.1%, with revision for any reason as the end point. Minimally invasive mobile bearing UKA in Asian patients who required high degrees of knee flexion showed rapid recovery and good clinical outcome. However, they also showed relatively high rates of bearing dislocation and aseptic loosening. Therefore, mobile bearing UKA should only be performed in patients whose lifestyle involves high flexions after carefully considering these risks and benefits. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Clinical And Radiological Assessment Of Deferiprone Related Knee Arthropathy In Children With P-Thalassemia Major

    International Nuclear Information System (INIS)

    Mokhtar, G.M.; Tantawy, A.A.; Abdelmaksoud, A.A.; Shams, M.A.; Tantawy, W.; Sakr, H.; Nassar, N.

    2013-01-01

    Objectives: To evaluate deferiprone related knee arthropathy in patients with fi-thalassemia major undergoing chelation therapy with deferiprone (LI). Materials and Methods. This study included 40 patients with β- thalassemia major on deferiprone; their ages ranged from 8 to 18 years with a mean age of 12.6 ± 3 years. Forty age and sex matched patients on desferal served as controls. Patients were subjected to clinical knee joint examination using the modified hemophilia joint health score (JHS), bilateral knee joint X-ray and bilateral knee joint ultrasound. Twenty patients of the deferiprone group with positive knee joint ultrasound findings were subjected to knee MRI. Data collected included age, sex, transfusion index, chelation history (dose, duration, and adverse effects), history of splenectomy and symptoms of knee or other joints arthropathy. Weight, height, BMI and Tanner staging of the patients were recorded. Laboratory investigations included CBC, ALT, serum ferritin, viral hepatitis markers (B,C) and echocardiography. Results: Among deferiprone group; 25 patients (62.5%) had knee symptoms while; 93.3% of the asymptomatic patients had evidence of knee joint affection by JHS compared to 17 symptomatic patients (42.5%) among desferal group (ρ> 0.05). Among deferiprone group 7 patients (17.5%) had symptoms of other joints arthropathy. Knee symptoms were more prevalent with longer duration of deferiprone therapy (ρ<0.05), knee joint effusion in US (ρ< 0.05) and Higher platelet count (ρ<0.05), while in desferal group it was related to poor compliance (ρ< 0.01) and higher serum ferritin levels (ρ=<0.01). JHS ranged from 0-33 with 39 (97.5%) affected patients. JHS was positively correlated to age, weight, height, BMI, Tanner staging and platelet count (ρ<0.01), and negatively correlated to transfusion index (ρ<0.01) with no significant correlation to ultrasound or MRI findings. JHS was higher among splenectomized patients in both groups (ρ<0.01). No

  4. Hyaluronic Acid Injections in Medicare Knee Osteoarthritis Patients Are Associated With Longer Time to Knee Arthroplasty.

    Science.gov (United States)

    Ong, Kevin L; Anderson, Allen F; Niazi, Faizan; Fierlinger, Anke L; Kurtz, Steven M; Altman, Roy D

    2016-08-01

    Few nonoperative treatment options for knee osteoarthritis (OA) are available, but there is ongoing debate about the effectiveness of intra-articular (IA) hyaluronic acid (HA) injections. We investigated whether the formulation of IA HA, or its combined use with IA corticosteroid (CS), may be contributing to some of the reported variation in clinical outcomes. The 5% Part B Medicare data (2005-2012) were used to identify knee OA patients who underwent knee arthroplasty (KA). The time from diagnosis of OA to KA was compared between patients with (HA) and without (no HA) IA HA use, using quantile regression with propensity score adjustment. These were further stratified by type of IA HA. Patient factors associated with time to KA were also assessed using Cox regression. The "HA" cohort was associated with a longer time to KA of 8.7 months (95% confidence interval: 8.3-9.1 months; P injection use. Patients with both IA HA and IA CS had an additional 6.3 months (95% confidence interval: 5.5-7.0 months; P < .001) to KA over those with only IA HA. In a large cohort of elderly patients undergoing KA, there was a significant longer time from diagnosis of OA to KA in those receiving IA HA. It is unclear if the extended time may lead to less KA utilization. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. New Generation Lockable Knee Brace

    Science.gov (United States)

    2000-01-01

    A knee brace that uses Space Shuttle propulsion technology has moved a step closer to being available to help knee injury and stroke patients and may possibly benefit patients with birth defects, spinal cord injuries, and post-polio conditions. After years of hard work, inventors at NASA's Marshall Space Flight Center (MSFC) in Huntsville, Alabama, have turned over the final design and prototype to industry partners at Horton's Orthotic Lab in Little Rock, Arkansas for further clinical testing. The device, called the Selectively Lockable Knee Brace, may mean faster, less painful rehabilitation for patients by allowing the knee to move when weight is not on the heel. Devices currently on the market lock the knee in a rigid, straight-leg position, or allow continuous free motion. The knee brace is just one example of how space technology is being used to improve the lives of people on Earth. NASA's MSFC inventors Michael Shadoan and Neill Myers are space propulsion engineers who use the same mechanisms and materials to build systems for rockets that they used to design and develop the knee brace.

  6. Physiotherapy management of knee osteoarthritis.

    Science.gov (United States)

    Page, Carolyn J; Hinman, Rana S; Bennell, Kim L

    2011-05-01

    Knee osteoarthritis (OA) is a prevalent chronic joint disease causing pain and disability. Physiotherapy, which encompasses a number of modalities, is a non-invasive treatment option in the management of OA. This review summarizes the evidence for commonly used physiotherapy interventions. There is strong evidence to show short-term beneficial effects of exercise on pain and function, although the type of exercise does not seem to influence treatment outcome. Delivery modes, including individual, group or home exercise are all effective, although therapist contact may improve benefits. Attention to improving adherence to exercise is needed to maximize outcomes in the longer-term. Knee taping applied with the aim of realigning the patella and unloading soft tissues can reduce pain. There is also evidence to support the use of knee braces in people with knee OA. Biomechanical studies show that lateral wedge shoe insoles reduce knee load but clinical trials do not support symptomatic benefits. Recent studies suggest individual shoe characteristics also affect knee load and there is current interest in the effect of modified shoe designs. Manual therapy, while not to be used as a stand-alone treatment, may be beneficial. In summary, although the research is not equivocal, there is sufficient evidence to indicate that physiotherapy interventions can reduce pain and improve function in those with knee OA. © 2011 The Authors. International Journal of Rheumatic Diseases © 2011 Asia Pacific League of Associations for Rheumatology and Blackwell Publishing Asia Pty Ltd.

  7. 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

  8. Mobile ankle and knee perturbator.

    Science.gov (United States)

    Andersen, Jacob Buus; Sinkjaer, Thomas

    2003-10-01

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

  9. Granuloma debridement and the use of an injectable calcium phosphate bone cement in the treatment of osteolysis in an uncemented total knee replacement

    Directory of Open Access Journals (Sweden)

    Ranawat Vijai S

    2010-04-01

    Full Text Available Abstract Polyethylene particulate debris-induced periprosthetic osteolysis is a known complication of knee arthroplasty surgery, and may result in the need for revision surgery. The management of these bony defects can be surgically challenging, and full revisions of well-fixed total knee components can lead to substantial bone loss. We present the case of a 71 year old man who developed knee pain and osteolysis around an uncemented total knee replacement. Due to significant medical comorbidies he was treated by percutaneous cyst granuloma debridement and grafting using an injectable calcium phosphate bone substitute. There were no wound complications, and the patient was allowed to fully weight-bear post-operatively. Histopathology and microbiology of the cyst material confirmed polyethylene granulomata without any evidence of infection. At 6 weeks post-operatively the patient's previous knee pain had resolved, he was able to comfortably fully weight-bear. Preoperative scores (Knee Society Score (KSS 41, WOMAC score 46.2, and Oxford Knee Score 39 had all improved at the 12-month post-operative review KSS 76, WOMAC 81.7 and Oxford Knee score 21. This is a safe and effective technique with minimal morbidity and may be an appropriate treatment modality when more extensive revision surgery is not possible. The case is discussed with reference to the literature.

  10. 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.

  11. 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.

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

    OpenAIRE

    Patel, Dilip R.; Villalobos, Ana

    2017-01-01

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

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

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  14. Allegheny County Walk Scores

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Walk Score measures the walkability of any address using a patented system developed by the Walk Score company. For each 2010 Census Tract centroid, Walk Score...

  15. Arthroscopic treatment of patients with moderate arthrofibrosis after total knee replacement.

    Science.gov (United States)

    Jerosch, Joerg; Aldawoudy, Akram M

    2007-01-01

    The purpose of this study was to document the effect of arthroscopic management in patients with knee stiffness after total knee replacement. We present a case series study, in which 32 patients have been treated for moderate arthrofibrosis of the knee after total knee replacement, with the same regimen. We have excluded all cases of stiffness, because of infection, mechanical mal-alignment, loosening of the implants and other obvious reasons of stiffness of the knee, rather than pure arthrofibrosis. All patients first underwent a trial of conservative treatment before going for arthroscopic management. A pain catheter for femoral nerve block was inserted just before anesthesia for post-operative pain management. Arthroscopic arthrolysis of the intra-articular pathology was performed in a standardized technique with release of all fibrous bands in the suprapatellar pouch, reestablishing the medial and lateral gutter, release of the patella, resection of the remaining meniscal tissue or an anterior cyclops, if needed. Intensive physiotherapy and continuous passive motion were to start immediately post-operatively. All the patients were available for the follow up and they were evaluated using the knee society rating system. A total of 25 of the 32 procedures resulted in an improvement of the patients knee score. All the knees operated upon had intra-articular fibrous bands, hypertrophic synovitis and peri-patellar adhesions. A total of eight patients suffered from an anterior cyclops lesion and six patients showed pseudomenicus. In 19 cases a medial and lateral relapse of the patella was performed; only 5 patients got an isolated lateral release. The mean knee flexion was 119 degrees (100-130) at the end of arthroscopy and was 97 degrees (75-115) at the last follow up. The eight patients with extension lags decreased from 27 degrees (10 degrees-35 degrees) pre-operatively to 4 degrees (0-10) at time of follow up. The average knee society ratings increased from 70

  16. Total knee reconstruction without posterior stabilization in rheumatoid arthritis patients

    Directory of Open Access Journals (Sweden)

    Radu Prejbeanu

    2010-12-01

    Full Text Available Objectives: to present the results with posterior cruciate ligament-retaining total knee arthroplasty in rheumatoid arthritis (RA patients. Background: Total knee replacement in RA patients has many particularities. One of them is the difficulty of obtaining a proper ligamentous balance.Methods: 24 RA patients were followed for a 5-year period after posterior cruciate ligament-retaining total knee arthroplasty. Clinical assessments analyzed general health status by using Hospital for Special Surgery Knee Evaluation Form (HSSKEF and mediolateral and anteroposterior ligament stability by using varus-valgus and posterior drawer tests. Radiological assessments evaluated axial alignment, size and position of components, radiolucent lines in anteroposterior and lateral standard views, integrity of the posterior cruciate ligament on lateral view X-ray at 45 degrees of flexion.Results: the mean HSSKEF score increased from 32 to 84 points at the end of follow-up. Preoperative mean range of motion was 60 degrees; postoperative mean range of motion was of 105 degrees, with significant statistical difference (p<0.05. The mean femoral component axial deviation was 6 degrees. The tibial component had a mean axial deviation of 1 degree of varus. There were no radioluscency lines of more than 1mm. 21 patients had excellent results. None of the knees was unstable. Conclusion: posterior cruciate ligament-retaining total knee arthroplasty can be used in RA patients without excessive valgus deformity (over 15 degrees, providing thus sufficient stabilization. The outcomes re similar to those patients who followed a posterior stabilized endoprosthesis.

  17. Percutaneous radiofrequency treatment for refractory anteromedial pain of osteoarthritic knees.

    Science.gov (United States)

    Ikeuchi, Masahiko; Ushida, Takahiro; Izumi, Masashi; Tani, Toshikazu

    2011-04-01

    Although severe knee osteoarthritis with refractory pain is commonly treated surgically, this is often not an option for patients with poor health status or unwillingness to undergo major surgery. We examined the efficacy of radiofrequency application to sensory nerves as a novel alternative treatment for refractory knee pain. This study was an open-label, nonrandomized, and controlled study. Patients complaining of refractory anteromedial knee pain associated with radiological osteoarthritis (moderate or severe) were included. They were assigned to one of two groups: those receiving radiofrequency thermocoagulation (N = 18) or those receiving nerve block (N = 17), depending on the time period that they were referred to the clinic. Radiofrequency current or local anesthetics was applied to the medial retinacular nerve and the infrapatellar branch of the saphenous nerve. Western Ontario McMaster Universities osteoarthritis index score, pain visual analog scale (VAS), and patient's global assessment were assessed with a minimum follow-up of 6 months.   Radiofrequency treatment significantly decreased knee pain as measured by VAS for 12 weeks compared with the control group. In terms of responders, more patients in the RF group responded to the treatment than in the control group. The differences were statistically significant at 4 weeks, 8 weeks, and 12 weeks in pain VAS. Eight patients (44%) treated with radiofrequency rated excellent or good but only three (18%) in the control group rated good, although the difference was not statistically significant. Some patients were able to benefit substantially from radiofrequency treatment. Even if its effective period is limited, radiofrequency application is a promising treatment to alleviate refractory anteromedial knee pain with osteoarthritis. Further experience and technical improvements are needed to establish its role in the management of knee osteoarthritis. Wiley Periodicals, Inc.

  18. [Quality of life in patients with knee and hip osteoarthritis].

    Science.gov (United States)

    Bernad-Pineda, M; de Las Heras-Sotos, J; Garcés-Puentes, M V

    2014-01-01

    To evaluate the quality of life in patients with knee and hip osteoarthritis through self-assessment and those made by the physician. An observational and cross-sectional multicenter study in which 628 traumatologists or rheumatologists evaluated 1,849 patients with knee and/or hip osteoarthritis, aged ≥ 50 years old, and representative of 49 Spanish provinces. Each researcher evaluated three patients and also completed the SF-12v2 health questionnaire. The patients completed the WOMAC and SF-12v2 questionnaires. The patients were 68.5 ± 9.5 years old, 61.5% had knee osteoarthritis, 19% had hip osteoarthritis, and 19.5% in both locations. Older patients and those who had both knee and hip osteoarthritis had a poorer quality of life, according to patients and researchers. Physical health perceived by the researchers was better than patients reported (36.74 ± 8.6 and 35.21 ± 8.53; respectively, p<0.001), and the mental health score was similar between physicians and patients. Kellgren/Lawrence scale and test Timed Up & Go predict better the quality of life, assessed by WOMAC and SF-12v2 questionnaires. This is the Spanish study on quality of life in osteoarthritis of the knee and hip of larger amplitude and number of patients. These results could be considered as reference values of Spanish population aged ≥ 50 years with knee or hip osteoarthritis. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

  19. Persistent below-knee great saphenous vein reflux after above-knee endovenous laser ablation with 1470-nm laser: a prospective study

    Directory of Open Access Journals (Sweden)

    Walter Junior Boim de Araujo

    2016-01-01

    Full Text Available Abstract Background In endovenous laser ablation (EVLA, the great saphenous vein (GSV is usually ablated from the knee to the groin, with no treatment of the below-knee segment regardless of its reflux status. However, persistent below-knee GSV reflux appears to be responsible for residual varicosities and symptoms of venous disease. Objectives To evaluate clinical and duplex ultrasound (DUS outcomes of the below-knee segment of the GSV after above-knee EVLA associated with conventional surgical treatment of varicosities and incompetent perforating veins. Methods Thirty-six patients (59 GSVs were distributed into 2 groups, a control group (26 GSVs with normal below-knee flow on DUS and a test group (33 GSVs with below-knee reflux. Above-knee EVLA was performed with a 1470-nm bare-fiber diode laser and supplemented with phlebectomies of varicose tributaries and insufficient perforating-communicating veins through mini-incisions. Follow-up DUS, clinical evaluation using the venous clinical severity score (VCSS, and evaluation of complications were performed at 3-5 days after the procedure and at 1, 6, and 12 months. Results Mean patient age was 45 years, and 31 patients were women (86.12%. VCSS improved in both groups. Most patients in the test group exhibited normalization of reflux, with normal flow at the beginning of follow-up (88.33% of GSVs at 3-5 days and 70% at 1 month. However, in many of these patients reflux eventually returned (56.67% of GSVs at 6 months and 70% at 1 year. Conclusions These data suggest that reflux in the below-knee segment of the GSV was not influenced by the treatment performed.

  20. [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

  1. Anterior Knee Pain (Chondromalacia Patellae).

    Science.gov (United States)

    Garrick, James G.

    1989-01-01

    This article presents a pragmatic approach to the definition, diagnosis, and management of anterior knee pain. Symptoms and treatment are described. Emphasis is on active involvement of the patient in the rehabilitation exercise program. (IAH)

  2. Unusual Cause of Knee Locking

    Directory of Open Access Journals (Sweden)

    Gazi Huri

    2013-01-01

    Full Text Available We report a case of partial intrasubstance tear of popliteus tendon as an unusual cause of pseudolocking of the knee. A 13-year-old semiprofessional soccer player applied to our clinic with a locked right knee in spite of the therapy applied (cold pack, NSAID, and immobilization in another institution 20 days after the injury. Significant extension loss was observed in his right knee with 30∘–90∘ ROM. Magnetic resonance imaging (MRI and arthroscopy confirmed the intrasubstance tear of popliteus tendon and synovitis. The ruptured part of the tendon was debrided, and the inflammatory tissue around the tendon, which may lead to pseudolocking, was gently removed with a shaver in order to regain the normal ROM. The patient was discharged with full ROM and weight bearing first day after the surgery. To our knowledge, this is the first case demonstrating intrasubstance tear of popliteus tendon causing pseudolocking of the knee.

  3. Bowlegs and Knock-Knees

    Science.gov (United States)

    ... Español Text Size Email Print Share Bowlegs and Knock-Knees Page Content Article Body Toddlers’ legs often ... about two years old, then they’ll look knock-kneed until they are about six years of ...

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Yoshio Suzuki

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

  6. An appraisal of the Functional Movement Screen™ grading criteria--Is the composite score sensitive to risky movement behavior?

    Science.gov (United States)

    Frost, David M; Beach, Tyson A C; Campbell, Troy L; Callaghan, Jack P; McGill, Stuart M

    2015-11-01

    To examine the relationship between the composite Functional Movement Screen (FMS) score and performers' spine and frontal plane knee motion. Examined the spine and frontal plane knee motion exhibited by performers who received high (>14) and low (0.8) were noted between the high- and low-scoring groups when performing the FMS tasks; high-scorers employed less spine and frontal plane knee motion. Substantial variation was also observed amongst participants. Participants with high composite FMS scores exhibited less spine and frontal plane knee motion while performing the FMS in comparison to their low-scoring counterparts. However, because substantial variation was observed amongst performers, the FMS may not provide the specificity needed for individualized injury risk assessment and exercise prescription. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. CIFKAS A Measurer of Functional Disability Status in Knee Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Vijay K Singh

    2012-01-01

    Full Text Available Knee osteoarthritis (OA results in structural and functional abnormalities and reduced functional performance abilities. In developing countries majority of population lives in rural areas having limited resources and socio-cultural biodiversity. Their personal, socio-cultural and occupational habits vary and need to be addressed. So a culturally relevant and contextually appropriate, Composite Indian Functional Knee Assessment Scale (CIFKAS for measuring the functional status in knee osteoarthritis was formulated. 128 participants from various geographical regions of India of age range 40 to 60 years using convenient sampling were included and informed consent signed by the participants. Each participant was assigned to one of the two groups. 39 participants in group A reported no episode of knee pain while 89 participants in group B reported at least one episode of knee pain in the last two months. Each participant was assessed on Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC and CIFKAS and statistical analysis was done. The Pearson correlation coefficient calculated for all 128 subjects for pain, physical functional abilities and total functional disability score were 0.878, 0.925 and 0.945 respectively. Between group analysis was done using Independent t test and p value was found to be not significant for pain (<.178, highly significant for physical functional abilities (p<.0001 and very significant for total functional disability status score (p<.004. The results indicate that both WOMAC and CIFKAS are highly correlated and there is no difference between the two for measuring pain, but for functional ability and overall functional disability status within their functional context, CIFKAS is a better tool than WOMAC.

  8. 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)

  9. Development and initial validation of the ibadan knee/hip osteoarthritis outcome measure

    Directory of Open Access Journals (Sweden)

    A. O. Akinpelu

    2007-01-01

    was developed from other measures found in literature, as well as complaints of attending patients. Forty nine patients with pain from knee and/or hip osteoarthritis, the OA group (OAG and 49 individuals without knee or hip pain, the pain-free group (PFG were assessed, using the IKHOAM. The OAG was assessed on IKHOAM and the Visual Analogue Scale (VAS before and after a 6-week physiotherapy programme. Results: Significant differences between IKHOAM scores of the OAG and PFG and between IKHOAM scores of OAG pre and post 6-week physiotherapy programme, as well as the significant negative correlations between changes in IKHOAM and VAS scores of OAG before and after the 6-week physiotherapy programme were demonstrated. Conclusion: IKHOAM demonstrated initial criteria towards validity and responsiveness and may be used in a Nigerian population of OA knee/hip individuals and similar environments.

  10. 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.

  11. The effect on knee-joint load of instruction in analgesic use compared with neuromuscular exercise in patients with knee osteoarthritis: study protocol for a randomized, single-blind, controlled trial (the EXERPHARMA trial).

    Science.gov (United States)

    Clausen, Brian; Holsgaard-Larsen, Anders; Søndergaard, Jens; Christensen, Robin; Andriacchi, Thomas P; Roos, Ewa M

    2014-11-15

    Knee osteoarthritis (OA) is a mechanically driven disease, and it is suggested that medial tibiofemoral knee-joint load increases with pharmacologic pain relief, indicating that pharmacologic pain relief may be positively associated with disease progression. Treatment modalities that can both relieve pain and reduce knee-joint load would be preferable. The knee-joint load is influenced by functional alignment of the trunk, pelvis, and lower-limb segments with respect to the knee, as well as the ground-reaction force generated during movement. Neuromuscular exercise can influence knee load and decrease knee pain. It includes exercises to improve balance, muscle activation, functional alignment, and functional knee stability. The primary objective of this randomized controlled trial (RCT) is to investigate the efficacy of a NEuroMuscular EXercise (NEMEX) therapy program, 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. One hundred men and women with mild to moderate medial knee osteoarthritis will be recruited from general medical practices and randomly allocated (1:1) to one of two 8-week treatments, either (a) NEMEX therapy twice a week or (b) information on the recommended use of analgesics and antiinflammatory drugs (acetaminophen and oral NSAIDs) via a pamphlet and video materials. The primary outcome is change in knee load 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 performance measures, in addition to changes in self-reported pain, function, health status, and quality of life. These findings will help determine whether 8 weeks of neuromuscular exercise is superior to optimized use

  12. Randomized trial investigating the efficacy of manual lymphatic drainage to improve early outcome after total knee arthroplasty.

    Science.gov (United States)

    Ebert, Jay R; Joss, Brendan; Jardine, Berit; Wood, David J

    2013-11-01

    To investigate the efficacy of manual lymphatic drainage (MLD) in the early postoperative period after total knee arthroplasty (TKA) to reduce edema and pain and improve knee range of motion. Prospective randomized controlled trial. Private hospital and functional rehabilitation clinic. Consecutive sample of patients (N=43; 53 knees) scheduled for TKA. MLD (vs no MLD) on days 2, 3, and 4 postoperatively. Both groups underwent conventional, concomitant physical therapy. Clinical assessment was undertaken pre- and postoperatively prior to and after the designated postoperative MLD sessions (days 2, 3, and 4) and at 6 weeks postsurgery. This included active knee flexion and extension range of motion, lower limb girths (ankle, midpatella, thigh, and calf), and knee pain using a numeric rating scale and the Knee Injury and Osteoarthritis Outcome Score. A significant group effect was observed for active knee flexion, with post hoc tests demonstrating a significantly greater active knee flexion in the MLD group when compared with the control (no MLD) group at the final measure prior to hospital discharge (day 4 postsurgery) and at 6 weeks postsurgery. There were no further group effects observed for the remaining patient-reported and functional outcomes. MLD in the early postoperative stages after TKA appears to improve active knee flexion up to 6 weeks postsurgery, in addition to conventional care. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  13. 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.

  14. Self-reported activity level and knee function in amateur football players

    DEFF Research Database (Denmark)

    Frobell, R B; Svensson, E; Göthrick, M

    2008-01-01

    ) amateur football players in 10 football clubs from each division below national level participated in the study. Self-reported Tegner Activity Scale, and the Knee injury and Osteoarthritis Outcome Score (KOOS) are the main outcome measures. Older age, female gender and lower level of competition (football...... is recommended. We suggest that self-reported Tegner Activity Scale scores should be adjusted for age, gender and level of competition. In amateur football players, KOOS scores do not need adjustment for age and gender....

  15. One year effectiveness of neuromuscular exercise compared with instruction in analgesic use on knee function in patients with early knee osteoarthritis

    DEFF Research Database (Denmark)

    Holsgaard-Larsen, A; Christensen, R; Clausen, B

    2018-01-01

    of California Activity Score (UCLA) and the European Quality of Life-5 Dimensions. RESULTS: Ninety-three patients (57% women, 58 ± 8 years, body mass index 27 ± 4 kg/m(2)) were randomized to NEMEX (n = 47) or PHARMA group (n = 46) with data from 85% being available at 12-months follow-up. Good compliance......OBJECTIVE: To test long-term effectiveness of neuromuscular exercise (NEMEX) with instructions in optimized pharmacological treatment (PHARMA) on activities of daily living (ADL) in patients with early knee osteoarthritis. DESIGN: 12-months follow-up from a randomized controlled trial. Participants...... with mild-to-moderate medial tibiofemoral knee osteoarthritis were randomly allocated to 8 weeks NEMEX or PHARMA. The primary outcome measure was the ADL-subscale of the Knee Injury and Osteoarthritis Outcome Score (KOOS). Secondary outcome measures included the other four KOOS-subscales, the University...

  16. Serum periostin is associated with prevalent knee osteoarthritis and disease incidence/progression in women: the OFELY study.

    Science.gov (United States)

    Rousseau, J C; Sornay-Rendu, E; Bertholon, C; Garnero, P; Chapurlat, R

    2015-10-01

    Our aim was to investigate the relationships between serum periostin (POSTN) and both prevalence and incidence/progression of knee osteoarthritis (OA) in women. We investigated 594 women (62.7 ± 11.2 yr) from the OFELY cohort. Knee radiographs were scored according to the Kellgren & Lawrence (KL) grading system at baseline and 4 years later. Spine, hip and hand OA were assessed at baseline. Prevalent knee OA was defined by a KL score higher or equal in 2. Progression of KL was defined as an increase of the KL score ≥1 during the 4 years follow-up. Serum POSTN was measured at baseline by ELISA. By non-parametric tests, POSTN was significantly lower in 83 women with a KL score ≥2 at baseline, compared to those with a KL score women. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  17. A systematic review to evaluate exercise for anterior cruciate ligament injuries: does this approach reduce the incidence of knee osteoarthritis?

    Directory of Open Access Journals (Sweden)

    Duncan KJ

    2016-01-01

    Full Text Available Koji J Duncan, Jaclyn N Chopp-Hurley, Monica R Maly School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada Purpose: Among a variety of conservative and surgical options to treat anterior cruciate ligament (ACL injuries, we do not understand which options could potentially prevent knee osteoarthritis (OA. The aim of this systematic review was to examine the evidence pertaining to exercise treatment of ACL injuries in the context of knee OA. Methods: Medline, Embase, CINAHL, PubMed, and PEDro (Physiotherapy Evidence Database databases were systematically searched using keywords encompassed within four primary key terms: knee, osteoarthritis, anterior cruciate ligament, and exercise. Clinical studies evaluating the effect of an exercise treatment for ACL injuries on the development of knee OA in adult humans were included. The PEDro scale was used to critically assess the studies included in the review. Results: Eighteen studies were included in this review, with a median PEDro score of 6/11 (range, 2/11–9/11. Three studies provided statistical evidence that exercise following ACL injury lowered the risk for knee OA development. Nine studies demonstrated no benefit of exercise in preventing knee OA incidence relative to either operative treatment or the contralateral, unaffected knee. However, exercise resulted in higher knee instability. Nonetheless, there were no significant differences in subjective or objective knee outcomes for early versus late ACL reconstruction. Limitations: This review was not registered through PROSPERO. Conclusion: The relationship between a rehabilitative exercise for ACL injuries and long-term knee OA prevalence is inconclusive. However, research suggests initial conservative treatment with optional late ACL reconstruction because this treatment strategy may reduce the risk of knee OA. More research, ideally randomized controlled trials or comparable designs, is required prior to establishing

  18. Existence of a neuropathic pain component in patients with osteoarthritis of the knee.

    Science.gov (United States)

    Ohtori, Seiji; Orita, Sumihisa; Yamashita, Masaomi; Ishikawa, Tetsuhiro; Ito, Toshinori; Shigemura, Tomonori; Nishiyama, Hideki; Konno, Shin; Ohta, Hideyuki; Takaso, Masashi; Inoue, Gen; Eguchi, Yawara; Ochiai, Nobuyasu; Kishida, Shunji; Kuniyoshi, Kazuki; Aoki, Yasuchika; Arai, Gen; Miyagi, Masayuki; Kamoda, Hiroto; Suzkuki, Miyako; Nakamura, Junichi; Furuya, Takeo; Kubota, Gou; Sakuma, Yoshihiro; Oikawa, Yasuhiro; Suzuki, Masahiko; Sasho, Takahisa; Nakagawa, Koichi; Toyone, Tomoaki; Takahashi, Kazuhisa

    2012-07-01

    Pain from osteoarthritis (OA) is generally classified as nociceptive (inflammatory). Animal models of knee OA have shown that sensory nerve fibers innervating the knee are significantly damaged with destruction of subchondral bone junction, and induce neuropathic pain (NP). Our objective was to examine NP in the knees of OA patients using painDETECT (an NP questionnaire) and to evaluate the relationship between NP, pain intensity, and stage of OA. Ninety-two knee OA patients were evaluated in this study. Pain scores using Visual Analogue Scales (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), painDETECT, duration of symptoms, severity of OA using the Kellgren-Lawrence (KL) system, and amount of joint fluid were evaluated and compared using a Spearman's correlation coefficient by rank test. Our study identified at least 5.4% of our knee OA patients as likely to have NP and 15.2% as possibly having NP. The painDETECT score was significantly correlated with the VAS and WOMAC pain severity. Compared with the painDETECT score, there was a tendency for positive correlation with the KL grade, and tendency for negative correlation with the existence and amount of joint fluid, but these correlations were not significant. PainDETECT scores classified 5.4% of pain from knee OA as NP. NP tended to be seen in patients with less joint fluid and increased KL grade, both of which corresponded to late stages of OA. It is important to consider the existence of NP in the treatment of knee OA pain.

  19. Treatment choice for osteoarthritis of the knee joint according to semi-automatic MRI based assessment of disease severity

    International Nuclear Information System (INIS)

    Sasho, Takahisa; Suzuki, Masahiko; Nakagawa, Koichi; Ochiai, Nobuyasu; Matsuki, Megumi; Takahashi, Kazuhisa; Moriya, Hideshige

    2008-01-01

    Objective assessment of disease severity of osteoarthritis of the knee joint (OA knee) is fundamental to establish adequate treatment system. Regrettably, there is no such a reliable system. Grading system based upon X-ray findings or measurement of joint space narrowing is widely used method for this purpose but they are still far from satisfaction. Our previous study elucidated that measuring irregularity of the contour of the femoral condyle on MRI (irregularity index) using newly developed software enabled us to assess disease severity of OA objectively. Advantages of this system are expressing severity by metric variable and semi-automatic character. In the present study, we examined relationship between treatment selection and irregularity index. Sixty-one medial type OA knees that received total knee arthroplasty (TKA), arthroscopic surgery (AS), and conservative treatment (CT) were involved. Their x-ray grading, irregularity index were recorded at the time of corresponding treatment. Irregularity index of each group were compared. As for AS group, pre- and post-operative knee score employing JOA score were also examined to study relationship between irregularity index and improvement of knee score. All the four parameters that represent irregularity of femoral condyle were significantly higher in TKA group than in AS group, whereas no significant difference was observed between AS group and CT group. Negative correlation was observed between irregularity index and improvement of knee score after arthroscopic surgery. Although treatment selection was determined by skillful knee surgeon in this series, irregularity index could indicate adequate timing of TKA. It also served as an indicator to predict outcome of arthroscopic surgery, and could be used as to show limitation of arthroscopic surgery. Our new system to assess disease severity of OA knee can serve as an index to determine treatment options. (author)

  20. Level and determinants of knowledge of symptomatic knee osteoarthritis among railway workers in Malaysia.

    Science.gov (United States)

    Ganasegeran, Kurubaran; Menke, J Michael; Challakere Ramaswamy, Vasudeva Murthy; Abdul Manaf, Rizal; Alabsi, Aied M; Al-Dubai, Sami Abdo Radman

    2014-01-01

    Symptomatic knee osteoarthritis, an ancient malady greatly impairing modern population quality of life, has stimulated global attention to find effective modes of prevention and intervention. This study aimed to assess factors affecting knowledge of symptomatic knee osteoarthritis (knee OA) among Malaysian railway workers. A cross-sectional study was conducted among 513 railway workers involving eight major states within Peninsular Malaysia using population-based sampling. The assessment instrument was a face-validated, prepiloted, self-administered instrument with sociodemographics and knowledge items on knee OA. Mean (± SD) age of the respondents was 41.4 (± 10.7), with the majority aged 50 years or older (34.9%). Of the total respondents, 53.6% had low levels of knowledge of knee OA disease. Multivariate analysis found that four demographic predictors, age ≥ 50 years, family history of knee OA, self-awareness, and clinical diagnosis of the disease entity, were significantly associated with knowledge scores. The finding of a low level knee OA knowledge among Malaysian railway workers points to an urgent need for massive information to be disseminated among the workers at risk to foster primary prevention and self-care.

  1. Quality of life after total knee arthroplasty.

    Science.gov (United States)

    Canovas, F; Dagneaux, L

    2018-02-01

    Total knee arthroplasty (TKA) results in a high degree of patient satisfaction, as it provides patients with considerable medium- and long-term benefits in terms of quality of life, pain relief and function. Nevertheless, the literature reports that up to 30% of patients are dissatisfied. This dissatisfaction is directly related to the patients' quality of life, which they deem insufficient. Their quality of life depends on many physical, behavioural, social and psychological factors that are not taken into account by functional outcome scores. After describing the principles of quality of life evaluation after TKA, we will assess the effects of patient-related factors, the surgical technique and postoperative program through an exhaustive review of the literature. Patient expectations after TKA will then be outlined, particularly return to work and return to sports. Copyright © 2017. Published by Elsevier Masson SAS.

  2. Radiofrequency Procedures to Relieve Chronic Knee Pain: An Evidence-Based Narrative Review.

    Science.gov (United States)

    Bhatia, Anuj; Peng, Philip; Cohen, Steven P

    2016-01-01

    Chronic knee pain from osteoarthritis or following arthroplasty is a common problem. A number of publications have reported analgesic success of radiofrequency (RF) procedures on nerves innervating the knee, but interpretation is hampered by lack of clarity regarding indications, clinical protocols, targets, and longevity of benefit from RF procedures. We reviewed the following medical literature databases for publications on RF procedures on the knee joint for chronic pain: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Google Scholar up to August 9, 2015. Data on scores for pain, validated scores for measuring physical disability, and adverse effects measured at any timepoint after 1 month following the interventions were collected, analyzed, and reported in this narrative review. Thirteen publications on ablative or pulsed RF treatments of innervation of the knee joint were identified. A high success rate of these procedures in relieving chronic pain of the knee joint was reported at 1 to 12 months after the procedures, but only 2 of the publications were randomized controlled trials. There was evidence for improvement in function and a lack of serious adverse events of RF treatments. Radiofrequency treatments on the knee joint (major or periarticular nerve supply or intra-articular branches) have the potential to reduce pain from osteoarthritis or persistent postarthroplasty pain. Ongoing concerns regarding the quality, procedural aspects, and monitoring of outcomes in publications on this topic remain. Randomized controlled trials of high methodological quality are required to further elaborate role of these interventions in this population.

  3. 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...

  4. 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...

  5. Risks of hip and knee replacement

    Science.gov (United States)

    ... is normal to lose blood during and after hip or knee replacement surgery. Some people need a ... clot form are higher during and soon after hip or knee replacement surgery. Sitting or lying down ...

  6. Patient satisfaction after total knee arthroplasty: an Asian perspective.

    Science.gov (United States)

    Thambiah, Matthew Dhanaraj; Nathan, Sahaya; Seow, Branden Z X; Liang, Shen; Lingaraj, Krishna

    2015-05-01

    Total knee arthroplasty (TKA) is an effective method for alleviating pain and restoring knee function in patients with severe osteoarthritis. However, despite the improvements in surgical technique and postoperative care, it has been reported that up to 19% of patients are dissatisfied after their operations. The aim of this study was to evaluate patient satisfaction levels after TKA in an Asian cohort, as well as assess the correlation between patient satisfaction levels and the results of traditional physician-based scoring systems. The medical data of 103 Asian patients who underwent 110 TKAs between December 2008 and June 2009 were obtained from our hospital's Joint Replacement Registry. The minimum follow-up period was one year and patient expectations were assessed before TKA. Patient satisfaction was assessed postoperatively using a 5-point Likert scale. Reasons for patient dissatisfaction were recorded. Standardised instruments (e.g. the Knee Society Score, the Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC] and the generic Short Form-36 health survey) were used to assess the patient's functional status and the severity of symptoms pre- and postoperatively. Among the 110 TKAs performed, 92.8% resulted in patient satisfaction. Patient satisfaction correlated with postoperative WOMAC function scores (p = 0.028), postoperative WOMAC final scores (p = 0.040) and expectations being met (p = 0.033). Although there was a high level of patient satisfaction following TKA in our cohort of Asian patients, a significant minority was dissatisfied. Patient satisfaction is an important outcome measure and should be assessed in addition to traditional outcome scores.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1998-02-01

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

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

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

    International Nuclear Information System (INIS)

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

    1998-01-01

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

  10. The Knee: Theory and Experiment

    International Nuclear Information System (INIS)

    Yodh, Gaurang B

    2006-01-01

    A review of current status of theoretical paradigm and results of direct and indirect experiments to study cosmic rays through the knee region are presented and discussed. There is general agreement that the knee is around a PeV and that it reflects a rigidity cutoff. The composition of cosmic rays in the knee region is mixed and changing with energy. The two direct experiments, JACEE and RUNJOB with measurements in the 100 TeV per particle to 1000 TeV per particle and with similar exposures do not agree. While JACEE indicates a increase in (lnA) from its low energy value of 1.5 to a value closer to 3 , the RUNJOB experiment sees no change in the composition albeit with large uncertainty. Of the indirect experiments, KASKADE, SPASEAMANDA, HEGRA-Airobic, CACTI, TUNKA and Tibet favor ''Heavy'' composition above the knee and beyond. The KASKADE energy range extends to 100 PeV where their analysis indicates iron dominance. KASKADE does not see a proton rigidity cutoff until about 3 PeV, while Tibet measures a steepening of the proton slope at a few hundred TeV. BLANCA and DICE favor little composition change or a change towards a proton dominated composition around 10 PeV. We need experiments with much better mass resolution in the energy range of the knee and a more quantitative understanding of the hadron production in the forward region at these energies to make definitive progress

  11. TOTAL KNEE REPLACEMENT IN PATIENTS WITH BELOW-KNEE AMPUTATION

    Science.gov (United States)

    Karam, Matthew D; Willey, Michael; Shurr, Donald G

    2010-01-01

    Total knee replacement (TKR) is reserved for patients with severe and disabling arthritis that is non-responsive to conservative measures. Based on existing data, total knee replacement is a safe and cost-effective treatment for alleviating pain and improving physical function in patients who do not respond to conservative therapy. Despite the large variation in health status of patients and types of prosthesis implanted, total knee replacement has proven to be a relatively low risk and successful operation. Each year in the United States surgeons perform approximately 300,000 TKR.1 Likewise, lower extremity amputation is commonly performed in the United States with an annual incidence of 110,000 per year.2 Nearly 70% of all lower extremity amputations are performed as the result of chronic vascular disease, followed by trauma (22%), congenital etiology and tumor (4% each).3 Approximately 50% of all lower extremity amputations are performed secondary to complications from Diabetes Mellitus. Norvell et al. demonstrated that patients who have previously undergone transtibial amputation and ambulate with a prosthesis are more likely to develop degenerative joint disease in the con-tralateral extremity than the ipsilateral extremity.4 Further, radiographic changes consistent with osteoporosis have been demonstrated in up to 88% of limbs that have undergone transtibial amputation.8 To our knowledge, there have been only three reported cases of total knee replacement in patients with ipsilateral transtibial amputation.5,7 The purpose of the present study is to review the existing data on total knee replacement in patients who have undergone transtibial amputation. Further we present a patient with a transtibial amputation who underwent contralateral total knee replacement. PMID:21045987

  12. Investigation of the Relationship between Anterior Knee Pain and Chondromalacia Patellae and Patellofemoral Malalignment.

    Science.gov (United States)

    Aysin, Idil Kurut; Askin, Ayhan; Mete, Berna Dirim; Guvendi, Ece; Aysin, Murat; Kocyigit, Hikmet

    2018-02-01

    The study aimed to investigate whether there is any association of anterior knee pain and knee function with chondromalacia stage and patellofemoral alignment in patients with anterior knee pain for over a month and with chondromalacia patellae (CMP) detected by magnetic resonance imaging (MRI). We reviewed the medical records of 38 patients who underwent a knee MRI examination and were diagnosed with chondromalacia based on the MRI. Knee MRI images were evaluated by a radiologist for chondromalacia staging. Patients were divided into two groups as early stage (stage 1-2) and advanced stage (stage 3-4) chondromalacia. Patients' demographical data (age, sex, and occupation), clinical features, physical examination findings and patellofemoral pain severity scale, kujala patellofemoral scoring system, and functional index questionnaire scores were obtained from their medical records. Trochlear sulcus angle, sulcus depth, lateral patellofemoral angle, patellar translation, and Insall-Salvati index were measured using the MRI images. The mean patient age was higher in the advanced stage CMP group compared to the early stage CMP group (p=0.038). There was no statistically significant difference regarding other demographical data (p>0.05). MRI measurement parameters did not show difference between the groups (p>0.05). Patients in the advanced stage CMP group had higher patellofemoral pain severity score, lower kujala patellofemoral score, and lower functional index questionnaire score compared to the early stage CMP group. The differences were statistically significant (p=0.008, p=0.012, and p=0.026, respectively). As chondromalacia stage advances, the symptom severity worsens and knee functions decline; however, MRI measurements do not show difference between early and advanced stage CMP patients.

  13. Gel-type autologous chondrocyte (Chondron™ implantation for treatment of articular cartilage defects of the knee

    Directory of Open Access Journals (Sweden)

    Chun Chung-Woo

    2010-05-01

    Full Text Available Abstract Background Gel-type autologous chondrocyte (Chondron™ implantations have been used for several years without using periosteum or membrane. This study involves evaluations of the clinical results of Chondron™ at many clinical centers at various time points during the postoperative patient follow-up. Methods Data from 98 patients with articular cartilage injury of the knee joint and who underwent Chondron™ implantation at ten Korean hospitals between January 2005 and November 2008, were included and were divided into two groups based on the patient follow-up period, i.e. 13~24-month follow-up and greater than 25-month follow-up. The telephone Knee Society Score obtained during telephone interviews with patients, was used as the evaluation tool. Results On the tKSS-A (telephone Knee Society Score-A, the score improved from 43.52 ± 20.20 to 89.71 ± 13.69 (P Conclusion Gel-type autologous chondrocyte implantation for chondral knee defects appears to be a safe and effective method for both decreasing pain and improving knee function.

  14. Correlations between commonly used clinical outcome scales and patient satisfaction after total knee arthroplasty.

    Science.gov (United States)

    Kwon, Sae Kwang; Kang, Yeon Gwi; Kim, Sung Ju; Chang, Chong Bum; Seong, Sang Cheol; Kim, Tae Kyun

    2010-10-01

    Patient satisfaction is becoming increasingly important as a crucial outcome measure for total knee arthroplasty. We aimed to determine how well commonly used clinical outcome scales correlate with patient satisfaction after total knee arthroplasty. In particular, we sought to determine whether patient satisfaction correlates better with absolute postoperative scores or preoperative to 12-month postoperative changes. Patient satisfaction was evaluated using 4 grades (enthusiastic, satisfied, noncommittal, and disappointed) for 438 replaced knees that were followed for longer than 1 year. Outcomes scales used the American Knee Society, Western Ontario McMaster University Osteoarthritis Index scales, and Short Form-36 scores. Correlation analyses were performed to investigate the relation between patient satisfaction and the 2 different aspects of the outcome scales: postoperative scores evaluated at latest follow-ups and preoperative to postoperative changes. The Western Ontario McMaster University Osteoarthritis Index scales function score was most strongly correlated with satisfaction (correlation coefficient=0.45). Absolute postoperative scores were better correlated with satisfaction than the preoperative to postoperative changes for all scales. Level IV (retrospective case series). Copyright © 2010 Elsevier Inc. All rights reserved.

  15. Comparison of suprapatellar and infrapatellar intramedullary nailing for tibial shaft fractures: a systematic review and meta-analysis.

    Science.gov (United States)

    Yang, Liqing; Sun, Yuefeng; Li, Ge

    2018-06-14

    Optimal surgical approach for tibial shaft fractures remains controversial. We perform a meta-analysis from randomized controlled trials (RCTs) to compare the clinical efficacy and prognosis between infrapatellar and suprapatellar intramedullary nail in the treatment of tibial shaft fractures. PubMed, OVID, Embase, ScienceDirect, and Web of Science were searched up to December 2017 for comparative RCTs involving infrapatellar and suprapatellar intramedullary nail in the treatment of tibial shaft fractures. Primary outcomes were blood loss, visual analog scale (VAS) score, range of motion, Lysholm knee scores, and fluoroscopy times. Secondary outcomes were length of hospital stay and postoperative complications. We assessed statistical heterogeneity for each outcome with the use of a standard χ 2 test and the I 2 statistic. The meta-analysis was undertaken using Stata 14.0. Four RCTs involving 293 participants were included in our study. The present meta-analysis indicated that there were significant differences between infrapatellar and suprapatellar intramedullary nail regarding the total blood loss, VAS scores, Lysholm knee scores, and fluoroscopy times. Suprapatellar intramedullary nailing could significantly reduce total blood loss, postoperative knee pain, and fluoroscopy times compared to infrapatellar approach. Additionally, it was associated with an improved Lysholm knee scores. High-quality RCTs were still required for further investigation.

  16. Symptomatic knee disorders in floor layers and graphic designers. A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Jensen Lilli

    2012-09-01

    Full Text Available Abstract Background Previous studies have described an increased risk of developing tibio-femoral osteoarthritis (TF OA, meniscal tears and bursitis among those with a trade as floor layers. The purpose of this study was to analyse symptomatic knee disorders among floor layers that were highly exposed to kneeling work tasks compared to graphic designers without knee-demanding work tasks. Methods Data on the Knee injury and Osteoarthritis Outcome Score (KOOS were collected by questionnaires. In total 134 floor layers and 120 graphic designers had a bilateral radiographic knee examination to detect TF OA and patella-femoral (PF OA. A random sample of 92 floor layers and 49 graphic designers had Magnetic Resonance Imaging (MRI of both knees to examine meniscal tears. Means of the subscales of KOOS were compared by analysis of variance. The risk ratio of symptomatic knee disorders defined as a combination of radiological detected knee OA or MRI-detected meniscal tears combined with a low KOOS score was estimated by logistic regression in floor layers with 95% confidence interval (CI and adjusted for age, body mass index, traumas, and knee-straining sports activities. Symptomatic knee OA or meniscal tears were defined as a combination of low KOOS-scores and radiographic or MRI pathology. Results Symptomatic TF and medial meniscal tears were found in floor layers compared to graphic designers with odds ratios 2.6 (95%CI 0.99-6.9 and 2.04 (95% CI 0.77-5.5, respectively. There were no differences in PF OA. Floor layers scored significantly lower on all KOOS subscales compared to graphic designers. Significantly lower scores on the KOOS subscales were also found for radiographic TF and PF OA regardless of trade but not for meniscal tears. Conclusions The study showed an overall increased risk of developing symptomatic TF OA in a group of floor layers with a substantial amount of kneeling work positions. Prevention would be appropriate to reduce the

  17. Proprioception in knee osteoarthritis: a narrative review

    NARCIS (Netherlands)

    Knoop, J.; Steultjens, M.P.M.; van der Leeden, M.; van der Esch, M.; Thorstensson, C.A.; Roorda, L.D.; Lems, W.F.; Dekker, J.

    2011-01-01

    Objective: To give an overview of the literature on knee proprioception in knee osteoarthritis (OA) patients. Method: A literature search was performed and reviewed using the narrative approach. Results: (1) Three presumed functions of knee proprioception have been described in the literature:

  18. The Zhongshan Score

    Science.gov (United States)

    Zhou, Lin; Guo, Jianming; Wang, Hang; Wang, Guomin

    2015-01-01

    Abstract In the zero ischemia era of nephron-sparing surgery (NSS), a new anatomic classification system (ACS) is needed to adjust to these new surgical techniques. We devised a novel and simple ACS, and compared it with the RENAL and PADUA scores to predict the risk of NSS outcomes. We retrospectively evaluated 789 patients who underwent NSS with available imaging between January 2007 and July 2014. Demographic and clinical data were assessed. The Zhongshan (ZS) score consisted of three parameters. RENAL, PADUA, and ZS scores are divided into three groups, that is, high, moderate, and low scores. For operative time (OT), significant differences were seen between any two groups of ZS score and PADUA score (all P RENAL showed no significant difference between moderate and high complexity in OT, WIT, estimated blood loss, and increase in SCr. Compared with patients with a low score of ZS, those with a high or moderate score had 8.1-fold or 3.3-fold higher risk of surgical complications, respectively (all P RENAL score, patients with a high or moderate score had 5.7-fold or 1.9-fold higher risk of surgical complications, respectively (all P RENAL and PADUA scores. ZS score could be used to reflect the surgical complexity and predict the risk of surgical complications in patients undergoing NSS. PMID:25654399

  19. Preoperative hypoalgesia after cold pressor test and aerobic exercise is associated with pain relief six months after total knee replacement

    DEFF Research Database (Denmark)

    Vaegter, Henrik Bjarke; Handberg, Gitte; Emmeluth, Claus

    2017-01-01

    OBJECTIVES: Chronic pain after total knee replacement (TKR) is not uncommon. Preoperative impaired conditioning pain modulation (CPM) has been used to predict chronic postoperative pain. Interestingly, exercises reduce pain sensitivity in patients with knee osteoarthritis. This pilot study...... investigated the association between exercise-induced hypoalgesia (EIH) and CPM on post-TKR pain relief. METHODS: Before and six months post-TKR, 14 patients with chronic knee osteoarthritis performed the cold pressor test on the non-affected leg and two exercise conditions (bicycling and isometric knee...... at the affected leg improved post-TKR compared with pre-TKR (PCPM and bicycling EIH assessed by the increase in cPTT correlated with reduction in NRS pain scores post-TKR (PCPM and EIH responses after TKR were significantly correlated with reduction in NRS pain scores...

  20. How well do radiographic, clinical and self-reported diagnoses of knee osteoarthritis agree? Findings from the Hertfordshire cohort study.

    Science.gov (United States)

    Parsons, Camille; Clynes, Michael; Syddall, Holly; Jagannath, Darshan; Litwic, Anna; van der Pas, Suzan; Cooper, Cyrus; Dennison, Elaine M; Edwards, Mark H

    2015-01-01

    Epidemiological studies of knee osteoarthritis (OA) have often used a radiographic definition. However, the clinical syndrome of OA is influenced by a broad range of factors in addition to the structural changes required for radiographic OA. Hence more recently several studies have adopted a clinical or self-reported approach to OA diagnosis rather than a radiographic approach. The aim of this study was to investigate agreement between radiographic OA and the clinical and self-reported diagnoses of OA. Data were available for 199 men and 196 women in the Hertfordshire Cohort Study (HCS), UK. Participants completed a questionnaire detailing self-reported OA. Clinical OA was defined based on American College of Rheumatology (ACR) criteria. Knee radiographs were taken and graded for overall Kellgren and Lawrence (K&L) score. The mean (standard deviation (SD)) age of study participants was 75.2 (2.6) years and almost identical proportions of men and women. The prevalence of knee OA differed depending on the method employed for diagnosis; 21% of the study participants self-reported knee OA, 18% of the participants had clinical knee OA and 42% of the participants had radiographic OA. Of those 72 study participants with a self-reported diagnosis of knee OA 52 (72%) had a radiographic diagnosis of knee OA, while 66% (39 out of 59) of study participants with clinical knee OA had a diagnosis of radiographic knee OA. However 58% of those participants diagnosed with radiographic OA did not have either self-reported knee OA or a diagnosis of clinical OA. Therefore in comparison with the radiographic definition of OA, both the clinical and self-report definitions had high specificity (91.5% & 91.5% respectively) and low sensitivity (24.5% and 32.7% respectively). There is modest agreement between the radiographic, clinical and self-report methods of diagnosis of knee OA.

  1. MR imaging of the knee

    International Nuclear Information System (INIS)

    Mink, J.H.

    1987-01-01

    There is increasing evidence that MR imaging of the knee can accurately evaluate the menisci and the cruciate and collateral ligaments with an accuracy equal to that of conventional anthrography. MR imaging can, as a simple test, definitively assess a wide spectrum of the causes of knee pain, including osteonecrosis/osteochondritis dissecans, chondral and bony fractures, abnormal plicae, and chondromalacia. The presentation focuses on the optimal imaging parameters that will ensure accuracy and maximize patient throughput. The etiology and significance of meniscal signal is discussed, and the criteria for an MR imaging-based diagnosis of meniscal tears, cruciate and collateral ligament and extensor mechanism abnormalities, osteonecrosis, and stress fractures are presented

  2. Total knee arthroplasty in ochronosis

    Directory of Open Access Journals (Sweden)

    Vaibhav G. Patel, MBBS

    2015-09-01

    Full Text Available Alkaptonuria is disorder of tyrosine metabolism due to deficiency of homogentisic oxidase characterized by excretion of homogentisic acid in urine, deposition of oxidized homogensitate pigments in connective tissues and articular cartilages (ochronosis. The result is dark pigmentation and weakening of the tissues resulting in chronic inflammation and osteoarthritis. Management of alkaptonuric ochronic osteoarthritis is usually symptomatic and replacements have comparable outcomes to osteoarthritis in patients without ochronosis. I report a case of a patient with ochronosis of knee treated with total knee replacement and report operative pearls for surgery in this rare disorder.

  3. Bicruciate-retaining Total Knee Replacement Provides Satisfactory Function and Implant Survivorship at 23 Years.

    Science.gov (United States)

    Pritchett, James W

    2015-07-01

    One of the goals of a TKA is to approximate the function of a normal knee. Preserving the natural ligaments might provide a method of restoring close to normal function. Sacrifice of the ACL is common and practical during a TKA. However, this ligament is functional in more than 60% of patients undergoing a TKA and kinematic studies support the concept of bicruciate-retaining (that is, ACL-preserving) TKA; however, relatively few studies have evaluated patients treated with bicruciate-retaining TKA implants. I asked: (1) what is the long-term (minimum 20-year) survivorship, (2) what are the functional results, and (3) what are the reasons for revision of bicruciate-retaining knee arthroplasty prostheses? From January 1989 to September 1992, I performed 639 total knee replacements in 537 patients. Of these, 489 were performed in 390 patients using a bicruciate-retaining, minimally constrained device. During the period in question, this knee prosthesis was used for all patients observed intraoperatively to have an intact, functional ACL with between 15° varus and 15° valgus joint deformity. There were 234 women and 156 men with a mean age at surgery of 65 years (range, 42-84 years) and a primary diagnosis of osteoarthritis in 89%. The patella was resurfaced in all knees. The mean followup was 23 years (range, 20-24 years). At the time of this review, 199 (51%) patients had died and 31 (8%) patients were lost to followup, leaving 160 (41%) patients (214 knees) available for review. Component survivorship was determined by competing-risks analysis and Kaplan Meier survivorship analysis with revision for any reason as the primary endpoint. Patients were evaluated every 2 years to assess ROM, joint laxity, knee stability, and to determine American Knee Society scores. The Kaplan-Meier survivorship was 89% (95% CI, 82%-93%) at 23 years with revision for any reason as the endpoint. Competing-risks survivorship was 94% (95% CI, 91%%-96 %) at 23 years. At followup, the mean

  4. Immediate Efficacy of Neuromuscular Exercise in Patients with Severe Osteoarthritis of the Hip or Knee

    DEFF Research Database (Denmark)

    Villadsen, Allan; Overgaard, Søren; Holsgaard-Larsen, Anders

    2014-01-01

    and Osteoarthritis Outcome Score (HOOS) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire. The secondary outcomes were the HOOS/KOOS subscales Pain, Symptoms, Sport and Recreation, and Joint-related Quality of Life. Exploratory outcomes were functional performance measures and lower limb...... muscle power. RESULTS: Included were 165 patients, 56% female, average age 67 years (SD ± 8), and a body mass index of 30 (SD ± 5), who were scheduled for primary hip or knee replacement. The postintervention difference between mean changes in ADL was 7.2 points (95% CI 3.5 to 10.9, p = 0.0002) in favor...... and objective performance were improved and pain reduced immediately following 8 weeks of neuromuscular exercise. While the effects were moderate in hip OA, they were only small in knee OA. ClinicalTrials.gov Identifier: NCT01003756....

  5. A 5 year prospective study of patient-relevant outcomes after total knee replacement

    DEFF Research Database (Denmark)

    Nilsdotter, A-K; Toksvig-Larsen, S; Roos, E M

    2008-01-01

    men, mean age 71 (51-86) assigned for TKR at the Department of Orthopaedics at Lund University Hospital were included in the study. The self-administered questionnaires Knee injury and Osteoarthritis Outcome Score (KOOS) and SF-36 were mailed preoperatively and 6 months, 12 months and at 5 years......OBJECTIVE: To prospectively describe self-reported outcomes up to 5 years after total knee replacement (TKR) in Osteoarthritis (OA) and to study which patient-relevant factors may predict outcomes for pain and physical function (PF). METHODS: 102 consecutive patients with knee OA, 63 women and 39...... postoperatively. RESULTS: Response rate at 5 years was 86%. At 6 months significant improvement was seen in all KOOS and SF-36 scores (P

  6. Kinetics features changes before and after intra-articular hyaluronic acid injections in patients with knee osteoarthritis.

    Science.gov (United States)

    Tang, Alice Chu-Wen; Tang, Simon Fuk-Tan; Hong, Wei-Hsien; Chen, Hsieh-Ching

    2015-02-01

    To examine the kinetic features in patients with knee osteoarthritis (OA) after intra-articular hyaluronic acid (IAHA) injections in different time periods. A single group repeated measures study. Gait laboratory in a tertiary hospital. Twenty-five subjects with bilateral symptomatic knee OA and 15 healthy control subjects. Gait analyses were performed in both control and OA groups before (baseline), and after the completion of IAHA injections (1 week, 3 months, and 6 months). Knee pain and functional indices were assessed using a visual analogue scale (VAS) and the Lequesne function Index (LI). Joint kinetic changes were analyzed in the frontal and sagittal planes with 6-camera motion analysis system and two AMTI force plates. VAS and LI scores were both improved in OA group after IAHA injections (pinjections (pinjections can provide significant pain relief and improvement in activity of daily living function for patients with knee OA. However, the reduction in pain and the increase in knee adduction moment may last up to 6 months. This may cause excessive loading on the knee joints, which may further accelerate the rate of knee degeneration. As a result, longer study time is needed to determine whether the observed kinetic findings in this study are associated with detrimental outcomes on the knee joints. © 2015 Elsevier B.V. All rights reserved.

  7. Magnetic Resonance Imaging of Asymptomatic Knees in Collegiate Basketball Players: The Effect of One Season of Play.

    Science.gov (United States)

    Pappas, George P; Vogelsong, Melissa A; Staroswiecki, Ernesto; Gold, Garry E; Safran, Marc R

    2016-11-01

    To determine the prevalence of abnormal structural findings using 3.0-T magnetic resonance imaging (MRI) in the asymptomatic knees of male and female collegiate basketball players before and after a season of high-intensity basketball. Institutional review board-approved prospective case series. Asymptomatic knees of 24 NCAA Division I collegiate basketball players (12 male, 12 female) were imaged using a 3.0-T MRI scanner before and after the end of the competitive season. Three subjects did not undergo scanning after the season. Images were evaluated for prepatellar bursitis, fat pad edema, patellar and quadriceps tendinopathy, bone marrow edema, and articular cartilage and meniscal injury. Every knee imaged had at least 1 structural abnormality both preseason and postseason. A high preseason and postseason prevalence of fat pad edema (75% and 81%), patellar tendinopathy (83% and 90%), and quadriceps tendinopathy (75% and 90%) was seen. Intrameniscal signal change was observed in 50% preseason knees and 62% of postseason knees, but no discrete tears were found. Bone marrow edema was seen in 75% and 86% of knees in the preseason and postseason, respectively. Cartilage findings were observed in 71% and 81% of knees in the preseason and postseason, respectively. The cartilage injury score increased significantly in the postseason compared with the preseason (P = 0.0009). A high prevalence of abnormal knee MRI findings was observed in a population of asymptomatic young elite athletes. These preliminary data suggest that high-intensity basketball may have potentially deleterious effects on articular cartilage.

  8. 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.

  9. Evaluation of psychometric properties of Tinetti performance-oriented mobility assessment scale in subjects with knee osteoarthritis

    OpenAIRE

    Parveen, Huma; Noohu, Majumi M.

    2017-01-01

    Objective: The objective of this study was to determine the psychometric properties of the Tinetti Performance-Oriented Mobility Assessment (POMA) scale to measure balance and gait impairments in individuals with knee osteoarthritis (OA). Methods: A convenient sample of 25 individuals with bilateral OA knee were recruited. The convergent validity was determined by correlation analysis between scores of Berg Balance Scale (BBS) with balance subscale (POMA-B) and the Timed Up and Go Test (TU...

  10. Patterns of functional improvement after revision knee arthroplasty.

    Science.gov (United States)

    Ghomrawi, Hassan M K; Kane, Robert L; Eberly, Lynn E; Bershadsky, Boris; Saleh, Khaled J

    2009-12-01

    Despite the increase in the number of total knee arthroplasty revisions, outcomes of such surgery and their correlates are poorly understood. The aim of this study was to characterize patterns of functional improvement after revision total knee arthroplasty over a two-year period and to investigate factors that affect such improvement patterns. Three hundred and eight patients in need of revision surgery were enrolled into the study, conducted at seventeen centers, and 221 (71.8%) were followed for two years. Short Form-36 (SF-36), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Lower-Extremity Activity Scale (LEAS) scores were collected at baseline and every six months for two years postoperatively. A piecewise general linear mixed model, which models correlation between repeated measures and estimates separate slopes for different follow-up time periods, was employed to examine functional improvement patterns. Separate regression slopes were estimated for the zero to twelve-month and the twelve to twenty-four-month periods. The slopes for zero to twelve months showed significant improvement in all measures in the first year. The slopes for twelve to twenty-four months showed deterioration in the scores of the WOMAC pain subscale (slope = 0.67 +/- 0.21, p coefficient = -5.46 +/- 1.91, p coefficient = 5.41 +/- 2.35, p coefficient = 1.42 +/- 0.69, p < 0.05]). Factors related to the surgical technique did not predict outcomes. The onset of worsening pain and knee-specific function in the second year following revision total knee arthroplasty indicates the need to closely monitor patients, irrespective of the mode of failure of the primary procedure or the surgical technique for the revision. This information may be especially important for patients with multiple comorbidities.

  11. [Application of radiofrequency vaporization in arthroscopic treatment of patellofemoral joint disorders].

    Science.gov (United States)

    Xuan, Tao; Xu, Bin; Xu, Honggang; Wang, Hao

    2009-01-01

    To explore the treatment of patellofemoral joint disorders with radiofrequency vaporization under arthroscopy. From June 2004 to June 2007, 86 cases of patellofemoral joint disorder (98 knees) were treated by lateral retinacular release or medial retinacular tighten added, and combined with bipolar radiofrequency chondroplasty under arthroscopy. There were 30 males (34 knees) and 56 females (64 knees), aging 15-68 years (mean 40 years). The locations were left in 42 cases, right in 32 cases, both sides in 12 cases. The disease course was 3 months to 6 years (mean 30.5 months). In 98 knees, there were 28 knees of static patellar tilt, 10 knees of static patellar subluxation, 45 knees of dynamic patellar tilt and 15 knees of dynamic patellar subluxation. The Lysholm knee score preoperatively was 57.72 +/- 8.86. The patellofemoral cartilage abnormality were classified according to the Outerbridge grade (18 knees of grade I, 36 knees of grade II, 32 knees of grade III and 12 knees of grade IV). The incisions healed by first intention without complications such as infection or hemarthrosis. Seventy-five cases (82 knees) were followed up 8-37 months (mean 20.6 months). One month after operation, the patellofemoral joint pain was relieved remarkably, the knee joint activity was good and the radiological outcomes was also satisfactory. Six months after operation, the Lysholm knee score was improved significantly in patients of grades I, II and III (P 0.05). The postoperative score was 69.95 +/- 5.42 (P joint disorders.

  12. Knee Pain and Low Back Pain Additively Disturb Sleep in the General Population: A Cross-Sectional Analysis of the Nagahama Study.

    Directory of Open Access Journals (Sweden)

    Kimihiko Murase

    Full Text Available Association of knee and low back pain with sleep disturbance is poorly understood. We aimed to clarify the independent and combined effects of these orthopedic symptoms on sleep in a large-scale general population.Cross-sectional data about sleep and knee/low back pain were collected for 9,611 community residents (53±14 years old by a structured questionnaire. Sleep duration less than 6 h/d was defined as short sleep. Sleep quality and the presence of knee and low back pain were evaluated by dichotomous questions. Subjects who complained about knee or low back pains were graded by tertiles of a numerical response scale (NRS score and a Roland-Morris disability questionnaire (RDQ score respectively. Multivariate regression analyses were performed to determine the correlates of short sleep duration and poor sleep quality.Frequency of participants who complained of the orthopedic symptoms was as follows; knee pain, 29.0%; low back pain, 42.0% and both knee and low back pain 17.6%. Both knee and low back pain were significantly and independently associated with short sleep duration (knee pain: odds ratio (OR = 1.19, p<0.01; low back pain: OR = 1.13, p = 0.01 and poor sleep quality (knee pain: OR = 1.22, p<0.01; low back pain; OR = 1.57, p<0.01. The group in the highest tertile of the NRS or RDQ score had the highest risk for short sleep duration and poor sleep quality except for the relationship between the highest tertile of the RDQ score and short sleep duration.(the highest tertile of the NRS: OR for short sleep duration = 1.31, p<0.01; OR for poor sleep quality = 1.47, p<0.01; the highest tertile of the RDQ: OR for short sleep duration = 1.11, p = 0.12; OR for poor sleep quality = 1.81, p<0.01 Further, coincident knee and low back pain raised the odds ratios for short sleep duration (either of knee or low back pain: OR = 1.10, p = 0.06; both knee and low back pain: OR = 1.40, p<0.01 and poor sleep quality (either of knee or low back pain: OR

  13. Knee extension torque variability after exercise in ACL reconstructed knees.

    Science.gov (United States)

    Goetschius, John; Kuenze, Christopher M; Hart, Joseph M

    2015-08-01

    The purpose of this study was to compare knee extension torque variability in patients with ACL reconstructed knees before and after exercise. Thirty two patients with an ACL reconstructed knee (ACL-R group) and 32 healthy controls (control group) completed measures of maximal isometric knee extension torque (90° flexion) at baseline and following a 30-min exercise protocol (post-exercise). Exercise included 30-min of repeated cycles of inclined treadmill walking and hopping tasks. Dependent variables were the coefficient of variation (CV) and raw-change in CV (ΔCV): CV = (torque standard deviation/torque mean x 100), ΔCV = (post-exercise - baseline). There was a group-by-time interaction (p = 0.03) on CV. The ACL-R group demonstrated greater CV than the control group at baseline (ACL-R = 1.07 ± 0.55, control = 0.79 ± 0.42, p = 0.03) and post-exercise (ACL-R = 1.60 ± 0.91, control = 0.94 ± 0.41, p = 0.001). ΔCV was greater (p = 0.03) in the ACL-R group (0.52 ± 0.82) than control group (0.15 ± 0.46). CV significantly increased from baseline to post-exercise (p = 0.001) in the ACL-R group, while the control group did not (p = 0.06). The ACL-R group demonstrated greater knee extension torque variability than the control group. Exercise increased torque variability more in the ACL-R group than control group. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  14. Reliability and concurrent validity of the Dutch hip and knee replacement expectations surveys.

    Science.gov (United States)

    van den Akker-Scheek, Inge; van Raay, Jos J A M; Reininga, Inge H F; Bulstra, Sjoerd K; Zijlstra, Wiebren; Stevens, Martin

    2010-10-19

    Preoperative expectations of outcome of total hip and knee arthroplasty are important determinants of patients' satisfaction and functional outcome. Aims of the study were (1) to translate the Hospital for Special Surgery Hip Replacement Expectations Survey and Knee Replacement Expectations Survey into Dutch and (2) to study test-retest reliability and concurrent validity. Patients scheduled for total hip (N = 112) or knee replacement (N = 101) were sent the Dutch Expectations Surveys twice with a 2 week interval to determine test-retest reliability. To determine concurrent validity, the Expectation WOMAC was sent. The results for the Dutch Hip Replacement Expectations Survey revealed good test-retest reliability (ICC 0.87), no bias and good internal consistency (alpha 0.86) (N = 72). The correlation between the Hip Expectations Score and the Expectation WOMAC score was 0.59 (N = 86). The results for the Dutch Knee Replacement Expectations Survey revealed good test-retest reliability (ICC 0.79), no bias and good internal consistency (alpha 0.91) (N = 46). The correlation with the Expectation WOMAC score was 0.52 (N = 57). Both Dutch Expectations Surveys are reliable instruments to determine patients' expectations before total hip or knee arthroplasty. As for concurrent validity, the correlation between both surveys and the Expectation WOMAC was moderate confirming that the same construct was determined. However, patients scored systematically lower on the Expectation WOMAC compared to the Dutch Expectation Surveys. Research on patients' expectations before total hip and knee replacement has only been performed in a limited amount of countries. With the Dutch Expectations Surveys it is now possible to determine patients' expectations in another culture and healthcare setting.

  15. [Overuse injury syndromes of the knee].

    Science.gov (United States)

    Pećina, M; Bojanić, I; Haspl, M

    2001-12-01

    Overuse injuries are frequent in the knee joint. The reason for this is that the knee joint is engaged in all sports activities. Furthermore, the joint area has numerous attachment points for muscles and tendons and numerous bursae. Another reason is that the specific joint between the patella and femur (patellofemoral joint) constitutes a part of the knee joint. Speaking in general terms, all overuse injuries in the knee joint can be divided in four groups according to the aspect: anterior aspect--patellofemoral pain syndrome, patellar tendinitis (jumper's knee), Osgood-Schlatter disease, Sinding Larson Johanson disease, stress fracture of the patella, fat pad syndrome; medial aspect--plica syndrome, semimembranosus tendinitis, pes anserinus tendinitis (bursitis), breaststroker's knee, medial retinaculitis; lateral aspect--Iliotibial band friction syndrome (runner's knee), Popliteal Tendinitis, Bicipital tendinitis; posterior aspect--fabellitis, medial gastrocnemius strain. There are numerous possible reasons for pain caused by overuse injuries around the knee joint, but two are the most frequent: patellar tendinitis (jumper's knee) and Iliotibial band friction syndrome (runner's knee). This paper gives a brief overview of overuse injuries of the knee joint including their definition, anatomy, aetiology, clinical symptoms and signs, and non-operative and surgical treatment.

  16. 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...

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

    Science.gov (United States)

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

    2015-01-01

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

  18. Early rehabilitation after elective total knee arthroplasty.

    Science.gov (United States)

    Lisi, Claudio; Caspani, Patrick; Bruggi, Marco; Carlisi, Ettore; Scolè, Donatella; Benazzo, Francesco; Dalla Toffola, Elena

    2017-10-18

    Outcomes after TKA surgery are supposed to be related to the intensity and type of post-operative rehabilitation. Aim of this paper is to describe our early rehabilitation protocol following TKA with mini-invasive surgery in the immediate post-operative period and analyze functional recovery and changes in pain scores in these patients. in this observational study, data were collected on 215 total knee arthroplasty patients referred to Orthopedics and Traumatology inpatient ward from July 2012 to January 2014, treated with the same early start rehabilitation protocol. We recorded times to reach functional goals (sitting, standing and assisted ambulation) and pain after the treatment. length of hospital stay in TKA was 4.6±1.8 days, with a rehabilitation treatment lenght of 3.3±1.3 days. The mean time needed to achieve the sitting position was 2.3±0.7 days, to reach the standing position was 2.6±1.0 days to reach the walking functional goal was 2.9±1.0 days.  Pain NRS scores remained below 4 in the first and second post-operative day and below 3 from the third post-operative day. Our study confirms that rehabilitation started as soon as 24 hours after surgery with mini-invasive approach, enables early verticalization of patients and early recovery of walking with a good control of pain.

  19. Evaluation of the relationship between anteroposterior translation of a posterior cruciate ligament-retaining total knee replacement and functional outcome.

    Science.gov (United States)

    Seah, R B; Pang, H N; Lo, N N; Chong, H C; Chin, P L; Chia, S L; Yeo, S J

    2012-10-01

    The success of total knee replacement (TKR) depends on optimal soft-tissue balancing, among many other factors. The objective of this study is to correlate post-operative anteroposterior (AP) translation of a posterior cruciate ligament-retaining TKR with clinical outcome at two years. In total 100 patients were divided into three groups based on their AP translation as measured by the KT-1000 arthrometer. Group 1 patients had AP translation  10 mm. Outcome assessment included range of movement of the knee, the presence of flexion contractures, hyperextension, knee mechanical axes and functional outcome using the Knee Society score, Oxford knee score and the Short-Form 36 questionnaire. At two years, patients in Group 2 reported significantly better Oxford knee scores than the other groups (p = 0.045). A positive correlation between range of movement and AP translation was noted, with patients in group 3 having the greatest range of movement (mean flexion: 117.9° (106° to 130°)) (p 10° (p = 0.01). In this study, the best outcome for cruciate-ligament retaining TKR was achieved in patients with an AP translation of 5 mm to 10 mm.

  20. Phaeohyphomycosis infection in the knee

    Directory of Open Access Journals (Sweden)

    David Sadigursky

    2016-04-01

    Full Text Available Phaeohyphomycosis is caused by cutaneous fungi and rarely affects large joints. This is a case report on phaeohyphomycosis in the left knee of an elderly individual without immunosuppression. It was accompanied by pain and swelling the anterior knee. The case was first suspected to be suprapatellar bursitis, and was treated with nonsteroidal anti-inflammatory drugs, without remission of symptoms. Surgical treatment was performed, with resection of the suprapatellar bursa and anterior region of the quadriceps tendon. The material was sent for anatomopathological examination and culturing. The pathological examination showed phaeohyphomycosis. The treatment instituted consisted of itraconazole, 200 mg/day for six weeks, and complete remission of symptoms was achieved. The physical examination remained normal after one year of follow-up. This is the first published case of phaeohyphomycosis infection in the suprapatellar region of the knee. Although almost all the cases reported have been associated with immunosuppressed patients, this was an exception. It is important to suspect phaeohyphomycosis in cases of knee infection, in the area of the suprapatellar bursa, when the symptoms do not resolve after clinical treatment.

  1. Preoperative psychosocial risk factors for poor outcomes at 1 and 5 years after total knee replacement.

    Science.gov (United States)

    Wylde, Vikki; Trela-Larsen, Lea; Whitehouse, Michael R; Blom, Ashley W

    2017-10-01

    Background and purpose - Psychosocial factors are important risk factors for poor outcomes in the first year after total knee replacement (TKR), however their impact on long-term outcomes is unclear. We aimed to identify preoperative psychosocial risk factors for poor outcomes at 1 year and 5 years after TKR. Patients and methods - 266 patients were recruited prior to TKR surgery. Knee pain and function were assessed preoperatively and at 1 and 5 years postoperative using the WOMAC Pain score, WOMAC Function score and American Knee Society Score (AKSS) Knee score. Preoperative depression, anxiety, catastrophizing, pain self-efficacy and social support were assessed. Statistical analyses involved multiple linear regression and mixed effect linear regression. Results - Higher anxiety was a risk factor for worse pain at 1 year postoperative. No psychosocial factors were associated with any outcomes at 5 years postoperative. Analysis of change over time found that patients with higher pain self-efficacy had lower preoperative pain and experienced less improvement in pain up to 1 year postoperative. Higher pain self-efficacy was associated with less improvement in the AKSS up to 1 year postoperative but more improvement between 1 and 5 years postoperative. Interpretation - Preoperative anxiety was found to influence pain at 1 year after TKR. However, none of the psychosocial variables were risk factors for a poor outcome at 5 years post-operative, suggesting that the negative effects of anxiety on outcome do not persist in the longer-term.

  2. Effectiveness of preemptive intra-articular levobupivacaine on pain relief after arthroscopic knee surgery

    Directory of Open Access Journals (Sweden)

    Seher Altinel

    2017-06-01

    Conclusion: Preemptive analgesia using intraarticular levobupivacaine 5 mg/ml (20 ml total volume provides better pain control-evaluated through VAS scoring, time to first analgesic request and opioid consumption - compared to saline in patients undergoing arthroscopic knee surgery. [Arch Clin Exp Surg 2017; 6(2.000: 91-95

  3. Thermographic and microscopic evaluation of LARS knee ligament tearing.

    Science.gov (United States)

    Pătraşcu, Jenel Marian; Amarandei, Mihaela; Kun, Karla Noemy; Borugă, Ovidiu; Totorean, Alina; Andor, Bogdan; Florescu, Sorin

    2014-01-01

    Damage to knee articular ligaments causes important functional problems and adversely affects particularly the stability of the knee joint. Several methods were developed in order to repair damage to the anterior cruciate ligament (ACL), which employ autografts, allografts, as well as synthetic ligaments. One such synthetic scaffold, the ligament advanced reinforcement system (LARS) synthetic ligament is made of non-absorbing polyethylene terephthalate fibers whose structure allow tissue ingrowths in the intra-articular part, improving the stability of the joint. The LARS ligament is nowadays widely used in modern knee surgery in the Europe, Canada, China or Japan. This paper evaluates LARS ligament from two perspectives. The first regards a study done by the Orthopedics Clinic II, Timisoara, Romania, which compared results obtained by employing two techniques of ACL repair - the Bone-Tendon-Bone (BTB) or LARS arthroscopic, intra-articular techniques. This study found that patients treated with the BTB technique presented with an IKDC score of 45.82±1.14 units preoperative, with increasing values in the first nine months after each implant post-surgical ligament restoration, reaching an average value of 75.92 ± 2.88 units postoperative. Patients treated with the LARS technique presented with an IKDC score of 43.64 ± 1.11 units preoperative, and a score of 77.32 ± 2.71 units postoperative. The second perspective describes the thermographic and microscopic analysis of an artificial knee ligament tearing or loosening. The objective of the study was to obtain information regarding the design of artificial ligaments in order to expand their lifespan and avoid complications such as recurring synovitis, osteoarthritis and trauma of the knee joint. Thermographic data has shown that tearing begins from the inside out, thus improving the inner design of the ligament would probably enhance its durability. An optical microscope was employed to obtain images of structural

  4. 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.

  5. Adipose Derived Stromal Cell (ADSC) Injections for Pain Management of Osteoarthritis in the Human Knee Joint.

    Science.gov (United States)

    Fodor, Peter B; Paulseth, Stephen G

    2016-02-01

    This safety and feasibility study used autologous adipose-derived stromal vascular cells (the stromal vascular fraction [SVF] of adipose tissue), to treat 8 osteoarthritic knees in 6 patients of grade I to III (K-L scale) with initial pain of 4 or greater on a 10-point Visual Analog Scale (VAS). The primary objective of the study was evaluation of the safety of intra-articular injection of SVF. The secondary objective was to assess initial feasibility for reduction of pain in osteoarthritic knees. Adipose-derived SVF cells were obtained through enzymatic disaggregation of lipoaspirate, resuspension in 3 mL of Lactated Ringer's Solution, and injection directly into the intra-articular space of the knee, with a mean of 14.1 million viable, nucleated SVF cells per knee. Metrics included monitoring of adverse events and preoperative to postoperative changes in the Western Ontario and McMaster Universities Arthritis Index (WOMAC), the VAS pain scale, range of motion (ROM), timed up-and-go (TUG), and MRI. No infections, acute pain flares, or other adverse events were reported. At 3-months postoperative, there was a statistically significant improvement in WOMAC and VAS scores (P knee pain. Autologous SVF was shown to be safe and to present a new potential therapy for reduction of pain for osteoarthritis of the knee. LEVEL OF EVIDENCE 4: Therapeutic. © 2015 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

  6. Balance and risk of fall in individuals with bilateral mild and moderate knee osteoarthritis.

    Science.gov (United States)

    Khalaj, Nafiseh; Abu Osman, Noor Azuan; Mokhtar, Abdul Halim; Mehdikhani, Mahboobeh; Wan Abas, Wan Abu Bakar

    2014-01-01

    Balance is essential for mobility and performing activities of daily living. People with knee osteoarthritis display impairment in knee joint proprioception. Thus, the aim of this study was to evaluate balance and risk of fall in individuals with bilateral mild and moderate knee osteoarthritis. Sixty subjects aged between 50 and 70 years volunteered in this study. They were categorized into three groups which were healthy (n = 20), mild (n = 20) and moderate (n = 20) bilateral knee osteoarthritis groups. Dynamic and static balance and risk of fall were assessed using Biodex Stability System. In addition, Timed Up and Go test was used as a clinical test for balance. Results of this study illustrated that there were significant differences in balance (dynamic and static) and risk of fall between three groups. In addition, the main (most significant) difference was found to be between healthy group and moderate group. Furthermore, on clinical scoring of balance, the "Timed Up and Go" test, all three groups showed significant difference. In conclusion, bilateral knee osteoarthritis impaired the balance and increased the risk of fall, particularly in people with moderate knee osteoarthritis.

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

    Science.gov (United States)

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

    2017-01-01

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

  8. Knee injury and obesity in patients undergoing total knee replacement: a retrospective study in 115 patients

    DEFF Research Database (Denmark)

    Jensen, Claus Hjorth; Rofail, S

    1999-01-01

    The prevalence of obesity and previous knee injury was assessed in a retrospective study of 115 patients under-going total knee replacement due to osteoarthritis. Obesity was considered a contributing factor in the development of osteoarthritis in 37% of the patients, and 33% of the patients had...... had an injury to the knee in question. Unilateral osteoarthritis was significantly more frequent than bilateral osteoarthritis among patients with a history of previous knee injury. The association of previous injury to the knee and unilateral osteoarthritis was stronger in men than women. Aggressive...... treatment of patients with knee injuries seems warranted....

  9. [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.

  10. 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.

  11. Our Patients with Knee Osteoarthritis Risk Factors and Relationship with Osteoarhritis-Osteoporosis

    Directory of Open Access Journals (Sweden)

    Nadide Torlak Koca

    2015-04-01

    Full Text Available Aim: Osteoarthritis (OA is a degenerative disease, that developes as a result of the impairment of formation and destruction processes in cartilage and sinovial tissues, with the effect of various traumatic, biomechanic, inflammatory and genetic factors. Material and Methods: In this study, risk factors and relation between OA and OP (osteoporosis is evaluated in 127 patients with knee OA. Age, gender, obesity, menopause, ligamentous laxity, DM, injury of joint, genetic predisposition and proprioceptive defects are the risk factors in knee OA. Results: No relation was observed between radiographic knee OA and scores of tests which evaluate pain and disability such as WOMAC and Lequesne; but there was a significant relation between obesity and WOMAC and Lequesne scores. Thus, obesity is a disability determinant in knee OA. We think that smoking has protective effects on OA, but this claim has to be proven with studies containing large control groups. In accordance with literature, we determined a significant concurrence between hand and knee OA. This relation gets stronger as severity of radiographic disease increases. In our patients with knee OA depriving clinical inflammation signs, CRP values were higher than control group and this was statistically significant. Therefore, we may not deny a chronic inflammatory response in OA. No significant relation observed between serum cholesterol values, lipid values, blood pressure and OA. However, presence of DM accelerates the radiographic progression of OA. Serum uric acid levels were significantly higher in our OA patients than in controls. The literature data, that high serum uric acid levels play role especially in generalised OA’s multifactorial etiology, is also supported by our results. Conclusion: Age, gender, menopause and genetic predisposition seemed to have more effects on the incidence of knee OA; while obesity, period of menopause, ligamantous laxity and DM seemed to have more effects

  12. Medial abrasion syndrome: a neglected cause of knee pain in middle and old age.

    Science.gov (United States)

    Lyu, Shaw-Ruey; Lee, Ching-Chih; Hsu, Chia-Chen

    2015-04-01

    Knee pain is a prevailing health problem of middle and old age. Medial plica-related medial abrasion syndrome (MAS), although a well-known cause of knee pain in younger individuals, has rarely been investigated in older individuals. This prospective study was conducted to investigate the prevalence and clinical manifestations of this syndrome as a cause of knee pain in middle and old age. The outcomes of arthroscopic treatment for this syndrome were also evaluated.A total of 232 knees of 169 patients >40 years of age (41-82, median: 63 years old) suffering from chronic knee pain were analyzed. The clinical diagnosis, predisposing factors, presenting symptoms, and physical signs were investigated. The sensitivity and specificity of each parameter of the clinical presentation for the diagnosis of MAS were evaluated after confirmation by arthroscopy. For patients with MAS, the roentgenographic and arthroscopic manifestations were investigated, and arthroscopic medial release (AMR) was performed. The outcomes were evaluated by the changes in the pain domain of the Knee Society scoring system and by patient satisfaction. The prevalence of medial plica was 95%, and osteoarthritis (OA) was the most common clinical diagnosis. Symptoms of pain and crepitus in motion and local tenderness during physical examination were the most sensitive parameters for the diagnosis. A history of a single knee injury combined with local tenderness and a palpable band found during physical examination were the most specific parameters for the diagnosis. The majority of patients suffering from this syndrome were successfully treated using AMR, yielding a satisfaction rate of 85.5% after a minimum of 3 years.MAS is a common cause of knee pain in middle and old age and can be effectively treated by AMR. Its concomitance with OA warrants further investigation.

  13. Short Operative Duration and Surgical Site Infection Risk in Hip and Knee Arthroplasty Procedures.

    Science.gov (United States)

    Dicks, Kristen V; Baker, Arthur W; Durkin, Michael J; Anderson, Deverick J; Moehring, Rebekah W; Chen, Luke F; Sexton, Daniel J; Weber, David J; Lewis, Sarah S

    2015-12-01

    To determine the association (1) between shorter operative duration and surgical site infection (SSI) and (2) between surgeon median operative duration and SSI risk among first-time hip and knee arthroplasties. Retrospective cohort study A total of 43 community hospitals located in the southeastern United States. Adults who developed SSIs according to National Healthcare Safety Network criteria within 365 days of first-time knee or hip arthroplasties performed between January 1, 2008 and December 31, 2012. Log-binomial regression models estimated the association (1) between operative duration and SSI outcome and (2) between surgeon median operative duration and SSI outcome. Hip and knee arthroplasties were evaluated in separate models. Each model was adjusted for American Society of Anesthesiology score and patient age. A total of 25,531 hip arthroplasties and 42,187 knee arthroplasties were included in the study. The risk of SSI in knee arthroplasties with an operative duration shorter than the 25th percentile was 0.40 times the risk of SSI in knee arthroplasties with an operative duration between the 25th and 75th percentile (risk ratio [RR], 0.40; 95% confidence interval [CI], 0.38-0.56; Poperative duration did not demonstrate significant association with SSI for hip arthroplasties (RR, 1.04; 95% CI, 0.79-1.37; P=.36). Knee arthroplasty surgeons with shorter median operative durations had a lower risk of SSI than surgeons with typical median operative durations (RR, 0.52; 95% CI, 0.43-0.64; Poperative durations were not associated with a higher SSI risk for knee or hip arthroplasty procedures in our analysis.

  14. The effect of exercise therapy on knee osteoarthritis: a randomized clinical trial

    Science.gov (United States)

    Nejati, Parisa; Farzinmehr, Azizeh; Moradi-Lakeh, Maziar

    2015-01-01

    Background: Knee osteoarthritis (OA) is the most common musculoskeletal disease among old individuals which affects ability for sitting on the chair, standing, walking and climbing stairs. Our objective was to investigate the short and long-term effects of the most simple and the least expensive exercise protocols in combination to conventional conservative therapy for knee OA. Methods: It was a single blind RCT study with a 12-months follow-up. Totally, 56 patients with knee OA were assigned into 2 random groups. The patients in exercise group received exercise for knee muscles in combination with non-steroid anti-inflammatory drugs (NSAIDs) and 10 sessions acupuncture and physiotherapy modalities. Non-exercise group received similar treatments except exercise program. The changes in patients’ pain and functional status were evaluated by visual analog scale (VAS), knee and osteoarthritis outcome score (KOOS) questionnaire and functional tests (4 steps, 5 sit up, and 6 min walk test) before and after treatment (1 and 3 months after intervention), and 1 year later at the follow-up. Results: The results showed that the patients with knee OA in exercise group had significant improvement in pain, disability, walking, stair climbing, and sit up speed after treatment at first and second follow-up when compared with their initial status and when compared with non-exercise group. At third follow up (1 year later) there was significant difference between groups in VAS and in three items of KOOS questionnaire in functional status. Conclusion: Non aerobic exercises for muscles around knee can augment the effect of other therapeutic interventions like medical therapy, acupuncture, and modalities for knee OA. PMID:26034739

  15. Knee function among elite handball and football players 1-6 years after anterior cruciate ligament injury.

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    Myklebust, G; Bahr, R; Nilstad, A; Steffen, K

    2017-05-01

    The aim of the study was to describe objective and self-reported knee function for athletes who have returned to elite handball and football play after an ACL injury, comparing these to non-injured players at the same level. A total of 414 handball and 444 football players completed baseline tests from 2007 through 2014, examining lower extremity strength, dynamic balance, knee laxity, and knee function (KOOS questionnaire). Measures were compared between injured and non-injured legs and between injured legs and legs of controls. Eighty (9.3%) of the 858 players reported a previous ACL injury, 1-6 years post-injury (3.5±2.5 years), 49 handball (61.3%) and 31 football players (38.7%). We found no difference in strength or dynamic balance between previously ACL-injured (N=80) and non-injured players legs (N=1556). However, lower quadriceps (6.3%, 95% CI: 3.2-9.2) and hamstrings muscle strength (6.1%, 95% CI: 3.3-8.1) were observed in previously ACL-injured legs compared to the non-injured contralateral side (N=80). ACL-injured knees displayed greater joint laxity than the contralateral knee (N=80, 17%, 95% CI: 8-26) and healthy knees (N=1556, 23%, 95% CI: 14-33). KOOS scores were significantly lower for injured knees compared to knees of non-injured players. ACL-injured players who have successfully returned to elite sport have comparable strength and balance measures as their non-injured teammates. Subjective perception of knee function is strongly affected by injury history, with clinically relevant lower scores for the KOOS subscores Pain, Function, Sport, and Quality Of Life. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Validity and inter-rater reliability of medio-lateral knee motion observed during a single-limb mini squat

    Directory of Open Access Journals (Sweden)

    Simic Milena

    2010-11-01

    Full Text Available Abstract Background Muscle function may influence the risk of knee injury and outcomes following injury. Clinical tests, such as a single-limb mini squat, resemble conditions of daily life and are easy to administer. Fewer squats per 30 seconds indicate poorer function. However, the quality of movement, such as the medio-lateral knee motion may also be important. The aim was to validate an observational clinical test of assessing the medio-lateral knee motion, using a three-dimensional (3-D motion analysis system. In addition, the inter-rater reliability was evaluated. Methods Twenty-five (17 women non-injured participants (mean age 25.6 years, range 18-37 were included. Visual analysis of the medio-lateral knee motion, scored as knee-over-foot or knee-medial-to-foot by two raters, and 3-D kinematic data were collected simultaneously during a single-limb mini squat. Frontal plane 2-D peak tibial, thigh, and knee varus-valgus angles, and 3-D peak hip internal-external rotation, and knee varus-valgus angles were calculated. Results Ten subjects were scored as having a knee-medial-to-foot position and 15 subjects a knee-over-foot position assessed by visual inspection. In 2-D, the peak tibial angle (mean 89.0 (SE 0.7 vs mean 86.3 (SE 0.4 degrees, p = 0.001 and peak thigh angle (mean 77.4 (SE 1.0 vs mean 81.2 (SE 0.5 degrees, p = 0.001 with respect to the horizontal, indicated that the knee was more medially placed than the ankle and thigh, respectively. Thus, the knee was in more valgus (mean 11.6 (SE 1.5 vs 5.0 (SE 0.8 degrees, p 0.90 and 96 between raters. Conclusions Medio-lateral motion of the knee can reliably be assessed during a single-leg mini-squat. The test is valid in 2-D, while the actual movement, in 3-D, is mainly exhibited as increased internal hip rotation. The single-limb mini squat is feasible and easy to administer in the clinical setting and in research to address lower extremity movement quality.

  17. 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.

  18. Evaluation of microfracture of traumatic chondral injuries to the knee in professional football and rugby players

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    Rolf Christer

    2009-05-01

    Full Text Available Abstract Background Traumatic chondral lesions of the knee are common in football and rugby players. The diagnosis is often confirmed by arthroscopy which can be therapeutic by performing microfracture. Prospective information about the clinical results after microfracture is still limited. Aim To evaluate the short-term outcome of microfractured lesions in professional football ad rugby players in terms of healing and ability to return to play. Methods Twenty-four consecutive professional male players with isolated full-thickness articular cartilage defects on weight-bearing surface of femoral condyles were treated with microfracture. Clinical assessment of healing was done at three, six, 12 and at 18 months by using modified Cincinnati subjective and objective functional scoring. All 24 subjects were periodically scanned by 3-Tesla MRI on the day of the clinical evaluations and scored by the Henderson MRI classification for cartilage healing. A second look arthroscopy was carried out in 10 players five to seven months after surgery to evaluate lesion healing by using ICRS scoring system. This was done due to presence of discrepancy between a "normal" MRI and persistent clinical symptoms. Results This study showed that 83.3% of players' resume full training between five to seven months (mean: 6.2 after microfracture of full-thickness chondral lesions of weight-bearing surface of the knee. Function and MRI knee scores of the 24 subjects gradually improved over 18 months, and showed good correlation in assessing healing after microfracture at six, 12 and 18 months (r2 = 0.993, 0.986 and 0.993, respectively however, the second look arthroscopy score proved to have stronger strength of association with function score than MRI score. Conclusion We confirmed that microfracture is a safe and effective procedure in treating isolated traumatic chondral lesions of the load-bearing areas of the knee. Healing as defined by subjective symptoms and evaluated

  19. Evaluation of microfracture of traumatic chondral injuries to the knee in professional football and rugby players.

    Science.gov (United States)

    Riyami, Masoud; Rolf, Christer

    2009-05-07

    Traumatic chondral lesions of the knee are common in football and rugby players. The diagnosis is often confirmed by arthroscopy which can be therapeutic by performing microfracture. Prospective information about the clinical results after microfracture is still limited. To evaluate the short-term outcome of microfractured lesions in professional football ad rugby players in terms of healing and ability to return to play. Twenty-four consecutive professional male players with isolated full-thickness articular cartilage defects on weight-bearing surface of femoral condyles were treated with microfracture. Clinical assessment of healing was done at three, six, 12 and at 18 months by using modified Cincinnati subjective and objective functional scoring. All 24 subjects were periodically scanned by 3-Tesla MRI on the day of the clinical evaluations and scored by the Henderson MRI classification for cartilage healing. A second look arthroscopy was carried out in 10 players five to seven months after surgery to evaluate lesion healing by using ICRS scoring system. This was done due to presence of discrepancy between a "normal" MRI and persistent clinical symptoms. This study showed that 83.3% of players' resume full training between five to seven months (mean: 6.2) after microfracture of full-thickness chondral lesions of weight-bearing surface of the knee. Function and MRI knee scores of the 24 subjects gradually improved over 18 months, and showed good correlation in assessing healing after microfracture at six, 12 and 18 months (r2 = 0.993, 0.986 and 0.993, respectively) however, the second look arthroscopy score proved to have stronger strength of association with function score than MRI score. We confirmed that microfracture is a safe and effective procedure in treating isolated traumatic chondral lesions of the load-bearing areas of the knee. Healing as defined by subjective symptoms and evaluated by MRI and a modified knee function score occurred between 5 to 7

  20. Arthroscopic knee anatomy in young achondroplasia patients

    Science.gov (United States)

    del Pilar Duque Orozco, M.; Record, N. C.; Rogers, K. J; Bober, M. B.; Mackenzie, W. G.; Atanda, A.

    2017-01-01

    Abstract Purpose Achondroplasia is the most common form of skeletal dysplasia, affecting more than 250 000 individuals worldwide. In these patients, the developing knee undergoes multiple anatomical changes. The purpose of this study was to characterise the intra-articular knee anatomy in children with achondroplasia who underwent knee arthroscopy. Methods Records of achondroplasia patients who underwent knee arthroscopy between 2009 and 2014 were reviewed. Demographic data, operative reports, follow-up notes, MRI and arthroscopy images were reviewed. Bony, cartilaginous and ligamentous changes were noted. The trochlea sulcus angle was measured from intra-operative arthroscopic images. Results A total of 12 knee arthroscopies in nine patients were performed. The mean age at surgery was 16.9 years (12 to 22). In all patients, the indication for surgery was knee pain and/or mechanical symptoms that were refractory to non-operative treatment. Three anatomical variations involving the distal femur were found in all knees: a deep femoral trochlea; a high A-shaped intercondylar notch; and a vertically oriented anterior cruciate ligament. The average trochlea sulcus angle measured 123°. Pathology included: synovial plica (one knee); chondral lesions (three knees); discoid lateral meniscus (11 knees); and meniscal tears (six knees). All patients were pain-free and returned to normal activity at final follow-up. Conclusion Children with achondroplasia have characteristic distal femur anatomy noted during knee arthroscopy. These variations should be considered normal during knee arthroscopy in these patients. Arthroscopic findings confirmed previous MRI findings within this specific population with the addition of a deep trochlear groove which was not previously reported. PMID:28828058

  1. How to score questionnaires

    NARCIS (Netherlands)

    Hofstee, W.K.B.; Ten Berge, J.M.F.; Hendriks, A.A.J.

    The standard practice in scoring questionnaires consists of adding item scores and standardizing these sums. We present a set of alternative procedures, consisting of (a) correcting for the acquiescence variance that disturbs the structure of the questionnaire; (b) establishing item weights through

  2. SCORE - A DESCRIPTION.

    Science.gov (United States)

    SLACK, CHARLES W.

    REINFORCEMENT AND ROLE-REVERSAL TECHNIQUES ARE USED IN THE SCORE PROJECT, A LOW-COST PROGRAM OF DELINQUENCY PREVENTION FOR HARD-CORE TEENAGE STREET CORNER BOYS. COMMITTED TO THE BELIEF THAT THE BOYS HAVE THE POTENTIAL FOR ETHICAL BEHAVIOR, THE SCORE WORKER FOLLOWS B.F. SKINNER'S THEORY OF OPERANT CONDITIONING AND REINFORCES THE DELINQUENT'S GOOD…

  3. Influence of Isometric Exercise Training on Quadriceps Muscle Architecture and Strength in Obese Subjects with Knee Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Waleed S Mahmoud

    2017-03-01

    Full Text Available Obese individuals have reduced quadriceps muscle strength relative to body mass that may increase the rate of progression of knee osteoarthritis (OA. The purpose of this study was to evaluate the effects of isometric exercise training on quadriceps muscle architecture and strength in obese subjects with knee osteoarthritis. Methods: Fortyfour obese male subjects aged 40–65 years diagnosed with knee osteoarthritis were randomly assigned into group A (n=32 and group B (n=12. Group A subjects performed a 12-week isometric exercise program. Group B subjects did not participate in any exercise program and maintained their ordinary activities for the same period. Both groups received the same conventional physical therapy program including hot packs and therapeutic ultrasonic. Muscle thickness, pennation angles and fascicle length of the vastus lateralis (VL muscle of the affected knee were measured at rest by B-mode ultrasonography. Maximal voluntary isometric knee extension torque (MVIC of the affected knee was measured using an isokinetic dynamometer. Knee pain and function were evaluated using visual analogue pain scale (VAS and Western Ontario and McMaster Universities Arthritis Index (WOMAC. All variables were evaluated