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Sample records for subjective international knee

  1. 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...

  2. 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

  3. Translation and cross-cultural adaptation of the international knee documentation committee subjective knee form into Turkish.

    Science.gov (United States)

    Çelik, Derya; Coşkunsu, Dilber; KiliÇoğlu, Önder; Ergönül, Önder; Irrgang, James J

    2014-11-01

    Clinical measurement. To translate and culturally adapt the International Knee Documentation Committee (IKDC) Subjective Knee Form into Turkish and to determine selected psychometric properties of the translated version. The IKDC Subjective Knee Form is widely used to evaluate disability associated with knee injuries, but it has not yet been translated or culturally adapted for Turkish-speaking individuals. The IKDC Subjective Knee Form was translated into Turkish, consistent with published methodological guidelines. The process included 2 forward translations, followed by the synthesis of these translations, and 2 backward translations, followed by an analysis of the translations and creation of the final version. The measurement properties of the Turkish IKDC Subjective Knee Form (internal consistency, construct validity, and floor and ceiling effects) were tested in 103 patients (52 male; average ± SD age, 34.9 ± 11.9 years) with a variety of knee pathologies. Reproducibility was tested in 58 patients (28 male; age, 33.7 ± 10.6 years) over 3 to 14 days, and responsiveness was tested in 33 patients (23 male; age, 30.8 ± 8.0 years) with anterior cruciate ligament reconstruction. Cronbach alpha was used to assess internal consistency, and intraclass correlation coefficients were used to estimate the test-retest reliability. Construct validity was analyzed with the Turkish version of the Lysholm knee score, the Kujala Anterior Knee Pain Scale, and the Medical Outcomes Study 36-Item Short-Form Health Survey. The Turkish version of the IKDC Subjective Knee Form showed excellent internal consistency (Cronbach coefficient α = .89) and test-retest reliability (intraclass correlation coefficient = 0.91). The correlation coefficients between the IKDC Subjective Knee Form and the Lysholm knee score and Kujala Anterior Knee Pain Scale were 0.64 and 0.89, respectively (P<.001). The highest correlations between the IKDC Subjective Knee Form and the Medical Outcomes Study

  4. Cross-cultural adaptation and validation of the International Knee Documentation Committee Subjective Knee Form in Greek.

    Science.gov (United States)

    Koumantakis, George A; Tsoligkas, Konstantinos; Papoutsidakis, Antonios; Ververidis, Athanasios; Drosos, Georgios I

    2016-06-01

    Patient-reported outcomes require validation in a particular language and culture before administration for clinical use. A systematic translation of the IKDC Subjective Knee Form was initially tested in 30 patients with various knee pathologies to develop the first Greek version (IKDC/SKF-GR). It was then administered to another 80 patients. The test-retest reliability (n = 35) and internal consistency (n = 80) were examined. Construct validity was tested by correlating the IKDC/SKF-GR with the SF-36 subscales (n = 80) and content validity by measuring floor/ceiling effects. Responsiveness was measured in patients with meniscus pathology (n = 24). Patients filled the form without omissions/questions regarding the phrasing of items. Internal consistency was good (Cronbach's α = 0.87) and test-retest reliability very good (ICC2,1 = 0.95, SEM = 4.4 and SDC = 12.2). Correlations with the SF-36 subscales confirmed its construct validity. No floor/ceiling effects were recorded. The effect size was large (ES = 1.26). The IKDC/SKF-GR has comparable measurement properties to the original form. Level II.

  5. Are external knee load and EMG measures accurate indicators of internal knee contact forces during gait?

    Science.gov (United States)

    Meyer, Andrew J; D'Lima, Darryl D; Besier, Thor F; Lloyd, David G; Colwell, Clifford W; Fregly, Benjamin J

    2013-06-01

    Mechanical loading is believed to be a critical factor in the development and treatment of knee osteoarthritis. However, the contact forces to which the knee articular surfaces are subjected during daily activities cannot be measured clinically. Thus, the ability to predict internal knee contact forces accurately using external measures (i.e., external knee loads and muscle electromyographic [EMG] signals) would be clinically valuable. We quantified how well external knee load and EMG measures predict internal knee contact forces during gait. A single subject with a force-measuring tibial prosthesis and post-operative valgus alignment performed four gait patterns (normal, medial thrust, walking pole, and trunk sway) to induce a wide range of external and internal knee joint loads. Linear regression analyses were performed to assess how much of the variability in internal contact forces was accounted for by variability in the external measures. Though the different gait patterns successfully induced significant changes in the external and internal quantities, changes in external measures were generally weak indicators of changes in total, medial, and lateral contact force. Our results suggest that when total contact force may be changing, caution should be exercised when inferring changes in knee contact forces based on observed changes in external knee load and EMG measures. Advances in musculoskeletal modeling methods may be needed for accurate estimation of in vivo knee contact forces. Copyright © 2012 Orthopaedic Research Society.

  6. International Energy: Subject Thesaurus

    Energy Technology Data Exchange (ETDEWEB)

    Raridon, M.H. (ed.)

    1990-01-01

    The International Energy Subject Thesaurus contains the standard vocabulary to indexing terms (descriptors) developed and structured to build and maintain energy information databases. Involved in this cooperative task are (1) the technical staff of the USDOE Office of Scientific and Technical Information (OSTI) in cooperation with the member countries of the Energy Technology Data Exchange (ETDE) and (2) the International Nuclear Information System (INIS) staff representing the more than ninety countries and organizations recording and indexing information for the international nuclear information community. ETDE member countries are also members of the International Nuclear Information System (INIS). Nuclear information indexed and recorded for INIS by these ETDE member countries is also included in the ETDE Energy Data Base, and indexing terminology is therefore cooperatively standardized for use in both information systems. This structured vocabulary reflects the scope of international energy research, development, and technological programs and encompasses terminology derived not only from the basic sciences but also from the areas of energy resources, conservation, safety, environmental impact, and regulation.

  7. Reproducibility of the measurements of knee joint proprioception in patients with osteoarthritis of the knee and healthy subject

    NARCIS (Netherlands)

    Hurkmans, E.; van der Esch, M.; Ostelo, R.W.J.G.; Knol, D.L.; Dekker, J; Steultjens, M

    2007-01-01

    Objective. To estimate the inter- and intrarater reliability and agreement of instrumented knee joint proprioception measurement in subjects with knee osteoarthritis (OA) and healthy subjects; to assess the effect of variations in the measurement procedure on agreement parameters. Methods.

  8. Anterior cruciate ligament fatigue failures in knees subjected to repeated simulated pivot landings.

    Science.gov (United States)

    Lipps, David B; Wojtys, Edward M; Ashton-Miller, James A

    2013-05-01

    It is not known whether the human anterior cruciate ligament (ACL) is susceptible to fatigue failure as a result of repetitive loading or whether certain knee morphologic characteristics increase that risk. The number of knee loading cycles required to fail an ACL by fatigue failure is unaffected by the magnitude of the external load delivered to the knee joint. Furthermore, sex, ACL cross-sectional area, and lateral tibial slope will not affect the number of loading cycles to ACL failure. Controlled laboratory study. Knee pairs from 10 cadaveric donors (5 female) of similar age, height, and weight were imaged with 3-T magnetic resonance imaging to measure lateral tibial slope and ACL cross-sectional area. One knee from each pair was then subjected to repeated application of a load of 3 times body weight (3*BW), while the other knee was subjected to a 4*BW load, both involving impulsive compression force, knee flexion moment, and internal tibial torque combined with realistic trans-knee muscle forces. The resulting 3-dimensional tibiofemoral kinematics and kinetics were recorded, along with ACL relative strain and quadriceps, hamstring, and gastrocnemius muscle forces. The loading cycle was repeated until the ACL ruptured, a 3-mm increase in cumulative anterior tibial translation occurred, or a minimum of 50 trials was reached. Eight of 10 knees failed under the 4*BW load (mean ± SD cycles to failure, 21 ± 18), while 5 of 10 knees failed under the 3*BW load (mean ± SD cycles to failure, 52 ± 10). Four knees exhibited a 3-mm increase in anterior tibial translation, 7 knees developed partial or complete visible ACL tears, and 2 knees developed complete ACL tibial avulsions. A Cox regression showed that the number of cycles to ACL failure was influenced by the simulated landing force (P = .012) and ACL cross-sectional area (P = .022). Donor sex and lateral tibial slope did not influence the number of cycles to ACL failure. The human ACL is susceptible to fatigue

  9. 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.

  10. International energy: Subject thesaurus supplement

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-05-01

    This is a supplement to International Energy: Subject Thesaurus (ETDE/PUB--2(Rev.1)), which replaced DOE/TIC-7000--the EDB Subject Thesaurus. This supplement is provided periodically to keep International Energy: Subject Thesaurus recipients up-to-date on valid vocabulary terms (descriptors) used in building and maintaining several international energy information databases. Each issue contains all new terms added since the publication of the Thesaurus. Each supplement is a cumulative listing of the new terms, so that each issue replaces the previous one.

  11. Knee cartilage assessment with MRI (dGEMRIC) and subjective knee function in ACL injured copers: a cohort study with a 20 year follow-up.

    Science.gov (United States)

    Neuman, P; Owman, H; Müller, G; Englund, M; Tiderius, C J; Dahlberg, L E

    2014-01-01

    To assess knee cartilage quality and subjective knee function, 20 years after injury in anterior cruciate ligament (ACL) injured copers. We examined 32 knees using delayed gadolinium-enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC), 20 years after a complete ACL tear. Only subjects who had coped with the ACL injury without ACL reconstruction (ACLR), and who presented without radiographic signs of osteoarthritis (OA) at an earlier 16-year follow-up, were included in this study. The quality of the central weight-bearing parts of the medial and lateral femoral cartilage was estimated with dGEMRIC (T1Gd). These results were compared with corresponding results in 24 healthy individuals, and with the subjects' self-reported subjective knee function using the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire. The values of T1Gd in the medial and lateral femoral cartilage of the study group (mean (95% CI)), were 404 (385-423) and 427 (399-455) ms, not statistically different from those of the healthy reference group (P = 0.065 and 0.31). The subjective knee function 20 years after the injury, according to the five domains of the KOOS score, was good, with a mean score of 90 ± 11. Values of T1Gd for the medial femoral cartilage were correlated with the KOOS subgroup QOL (P = 0.021, Pearson correlation). Subjects who have managed to cope with their ACL injury for 20 years with sustained good subjective knee function also seem to have knee cartilage of good quality, with T1Gd values not very different from a healthy reference group. Copyright © 2013 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    Flaxman, Teresa E; Alkjær, Tine; Simonsen, Erik B; Krogsgaard, Michael R; Benoit, Daniel L

    2017-03-01

    Knee muscles are commonly labeled as flexors or extensors and aptly stabilize the knee against sagittal plane loads. However, how these muscles stabilize the knee against adduction-abduction and rotational loads remains unclear. Our study sought 1) to classify muscle roles as they relate to joint stability by quantifying the relationship between individual muscle activation patterns and internal net joint moments in all three loading planes and 2) to determine whether these roles change with increasing force levels. A standing isometric force matching protocol required subjects to modulate ground reaction forces to elicit various combinations and magnitudes of sagittal, frontal, and transverse internal joint moments. Surface EMG measured activities of 10 lower limb muscles. Partial least squares regressions determined which internal moment(s) were significantly related to the activation of individual muscles. Rectus femoris and tensor fasciae latae were classified as moment actuators for knee extension and hip flexion. Hamstrings were classified as moment actuators for hip extension and knee flexion. Gastrocnemius and hamstring muscles were classified as specific joint stabilizers for knee rotation. Vastii were classified as general joint stabilizers because activation was independent of moment generation. Muscle roles did not change with increasing effort levels. Our findings indicate muscle activation is not dependent on anatomical orientation but perhaps on its role in maintaining knee joint stability in the frontal and transverse loading planes. This is useful for delineating the roles of biarticular knee joint muscles and could have implications in robotics, musculoskeletal modeling, sports sciences, and rehabilitation.

  13. Relationships of Muscle Function and Subjective Knee Function in Patients After ACL Reconstruction.

    Science.gov (United States)

    Bodkin, Stephan; Goetschius, John; Hertel, Jay; Hart, Joe

    2017-07-01

    After anterior cruciate ligament reconstruction (ACLR), relationships between objective measures of muscle function and patient-reported outcomes may change over time. Examining these measures at different time frames after surgery may help develop individualized approaches to improve post-ALCR analysis. To examine the associations between subjective knee function and lower-extremity muscle function in individual patients at various time points after ACLR. Descriptive laboratory study. Fifty-one participants who underwent primary, unilateral ACLR (15 males, 36 females; mean age, 22.9 ± 4.5 years; mean height, 172.4 ± 10.1 cm; mean weight, 68.7 ± 13.1 kg) were separated into 3 groups depending on time since surgery (early, 5 years). Subjective knee function was quantified using the International Knee Documentation Committee (IKDC) subjective knee form and the Knee injury and Osteoarthritis Outcome Score (KOOS). Isometric knee extension and flexion strength were collected at 90 deg/s. Single-leg hop performance was measured using the single hop, triple hop, cross-over hop, and 6-m timed hop. Coefficient correlations were calculated between subjective knee function and objective measures of muscle function for each group. The early group demonstrated moderate correlations between the KOOS and unilateral measures of flexion peak torque (r = 0.514, P = .035) and flexion power (r = 0.54, P = .027). The middle group demonstrated the strongest correlations between the KOOS and symmetry measures of the single hop (r = 0.69, P = .002) and extension work (r = 0.71, P = .002) as well as unilateral measures of the triple hop (r = 0.52, P = .034) and extension work (r = 0.66, P = .004). The late group demonstrated strong correlations between the 6-m timed hop symmetry and the IKDC (r = 0.716, P = .001) and KOOS (r = 0.71, P = .001). Patients with a post-ACLR status of less than 2 years exhibited stronger relationships with unilateral strength measures to subjective function

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

    Science.gov (United States)

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

    2017-09-01

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

  15. Sports involvement following ACL reconstruction is related to lower extremity neuromuscular adaptations, subjective knee function and health locus of control.

    Science.gov (United States)

    Nyland, J; Mauser, N; Caborn, D N M

    2013-09-01

    This retrospective study compared the influence of perceived sports involvement on lower extremity neuromuscular adaptations during single-leg countermovement jumping (CMJ), perceived knee function and internal health locus of control (HLOC) scores at a minimum 2-year post-anterior cruciate ligament reconstruction. The hypothesis was that subjects with higher-level sports involvement would display significant differences compared to subjects with lower-level sports involvement. Uninvolved and involved lower extremity EMG amplitude (1,000 Hz), vertical ground reaction force (VGRF) (500 Hz) and kinematic (60 Hz) displacement differences were determined during single-leg CMJ. These data and International Knee Documentation Committee subjective knee survey scores, Multidimensional Health Locus of Control Survey internal HLOC subscale scores and sports activity characteristics were compared by sports involvement level. Subjects that regarded themselves as only sporting sometimes (Group 3, n = 26) had lower IKDC survey and internal HLOC scores, were more likely to decrease sports activities by two intensity levels than highly competitive (Group 1, n = 20) and well-trained/frequently sporting (Group 2, n = 24) subjects, and had greater peak landing VGRF differences suggesting decreased involved lower extremity loading compared to Group 2. During propulsion, Group 1 had greater gluteus maximus (GM) and gastrocnemius (G) EMG differences than Groups 2 and 3. Groups 1 and 2 had decreased vastus medialis (VM) EMG differences during propulsion than Group 3. During landing, Group 1 had greater GM and G EMG differences than Group 3. Subjects with higher-level sports involvement up-regulated involved lower extremity GM and G activation and down-regulated VM activation. This adaptation may enable continued higher-level sports participation while minimizing knee joint forces. Perceived higher-level sports involvement was related to neuromuscular adaptations, better subjective knee

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

    DEFF Research Database (Denmark)

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

    2017-01-01

    subjects to modulate ground reaction forces to elicit various combinations and magnitudes of sagittal, frontal, and transverse internal joint moments. Surface EMG measured activities of 10 lower limb muscles. Partial least squares regressions determined which internal moment(s) were significantly related......INTRODUCTION: Knee muscles are commonly labeled as flexors or extensors and aptly stabilize the knee against sagittal plane loads. However, how these muscles stabilize the knee against adduction-abduction and rotational loads remains unclear. Our study sought 1) to classify muscle roles...... as they relate to joint stability by quantifying the relationship between individual muscle activation patterns and internal net joint moments in all three loading planes and 2) to determine whether these roles change with increasing force levels. METHODS: A standing isometric force matching protocol required...

  17. 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

    osteoarthritis according to the ACR criteria. Three dimensional gait analysis was performed. Subjects walked barefoot at self-selected walking speed. The first peak magnitude KI from all three planes were calculated using inverse dynamics. Results Frontal plane kinematics contributed with 59.3% (SD 25.6) of KI...... while sagittal plane kinematics contributed with 40.5% (SD 26.1). A substantial inter-subject variation in the relative contribution of the flexion and extension moment components to KI was observed. Conclusion Our findings support the notion that the primary contributor to KI is the frontal plane...... 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...

  18. No Clinically Significant Difference Between Adult and Pediatric IKDC Subjective Knee Evaluation Scores in Adults.

    Science.gov (United States)

    Stegmeier, Nicole; Oak, Sameer R; O'Rourke, Colin; Strnad, Greg; Spindler, Kurt P; Jones, Morgan; Farrow, Lutul D; Andrish, Jack; Saluan, Paul

    Two versions of the International Knee Documentation Committee (IKDC) Subjective Knee Evaluation form currently exist: the original version (1999) and a recently modified pediatric-specific version (2011). Comparison of the pediatric IKDC with the adult version in the adult population may reveal that either version could be used longitudinally. We hypothesize that the scores for the adult IKDC and pediatric IKDC will not be clinically different among adult patients aged 18 to 50 years. Randomized crossover study design. Level 2. The study consisted of 100 participants, aged 18 to 50 years, who presented to orthopaedic outpatient clinics with knee problems. All participants completed both adult and pediatric versions of the IKDC in random order with a 10-minute break in between. We used a paired t test to test for a difference between the scores and a Welch's 2-sample t test to test for equivalence. A least-squares regression model was used to model adult scores as a function of pediatric scores, and vice versa. A paired t test revealed a statistically significant 1.6-point difference between the mean adult and pediatric scores. However, the 95% confidence interval (0.54-2.66) for this difference did not exceed our a priori threshold of 5 points, indicating that this difference was not clinically important. Equivalence testing with an equivalence region of 5 points further supported this finding. The adult and pediatric scores had a linear relationship and were highly correlated with an R2 of 92.6%. There is no clinically relevant difference between the scores of the adult and pediatric IKDC forms in adults, aged 18 to 50 years, with knee conditions. Either form, adult or pediatric, of the IKDC can be used in this population for longitudinal studies. If the pediatric version is administered in adolescence, it can be used for follow-up into adulthood.

  19. Subjective vs objective predictors of functional knee joint performance in anterior cruciate ligament-reconstructed patients

    DEFF Research Database (Denmark)

    Holsgaard-Larsen, Anders; Jensen, Carsten; Aagaard, Per

    2014-01-01

    BACKGROUND: Associations between objective and subjective measures of knee function may facilitate rehabilitation in ACL-patients. AIM: The aim of this study is to investigate if a test-battery of functional and/or muscle outcomes are associated with Knee osteoarthritis outcome score (KOOS) subsc...

  20. Principles of brain plasticity in improving sensorimotor function of the knee and leg in healthy subjects

    DEFF Research Database (Denmark)

    Ageberg, Eva; Bjorkman, Anders; Rosen, Birgitta

    2009-01-01

    and foot to improve sensorimotor function can be applied on the knee. We hypothesized that temporary anesthesia of the skin area above and below the knee would improve sensorimotor function of the ipsilateral knee and leg. METHODS: In this first double-blind exploratory study, 28 uninjured subjects (mean...... age 26 years, range 19-34, 50% women) were randomized to temporary local cutaneous application of anesthetic (EMLA) (n=14) or placebo cream (n=14). Fifty grams of EMLA, or placebo, was applied on the leg 10 cm above and 10 cm below the center of patella, leaving the area around the knee without cream...

  1. Varus/valgus and internal/external torsional knee joint stiffness differs between sexes.

    Science.gov (United States)

    Schmitz, Randy J; Ficklin, Travis K; Shimokochi, Yohei; Nguyen, Anh-Dung; Beynnon, Bruce D; Perrin, David H; Shultz, Sandra J

    2008-07-01

    Torsional joint stiffness is thought to play a role in the observed sex bias in noncontact anterior cruciate ligament injury rates. Women will exhibit lower torsional stiffness values of the knee in response to varus/valgus and internal/external rotations than will men. Controlled laboratory study. Knee kinematics of 20 university students (10 men, 27.3 +/- 3.4 years, 177.3 +/- 6.8 cm, 81.1 +/- 7.0 kg; 10 women, 22.9 +/- 1.5 years, 169.0 +/- 7.1 cm, 66.1 +/- 11.4 kg) were measured while 0 to 10 N . m of varus and valgus torques were applied with the subject nonweightbearing and while 0 to 5 N . m of internal and external torques were applied with the subject nonweightbearing and weightbearing with the use of a custom joint testing device. Joint stiffness values were calculated at 1-N . m increments. When low magnitudes of torque were applied to the knee, women had significantly lower stiffness values than did men. With the exception of applied external torque with the joint weightbearing and varus torque with the joint nonweightbearing, women demonstrated an increase in joint stiffness as the magnitude of torque increased from lower to higher magnitudes. In contrast, for the men, joint stiffness values remained unchanged as the magnitude of applied torque increased. Women exhibited lower knee stiffness in response to low magnitudes of applied torque compared to men and demonstrated an increase of joint stiffness as the magnitude of applied torque increased. The decreased stiffness behavior of the knee in response to low torques that was observed for women may have a role in detrimentally affecting knee biomechanics and resulting neuromuscular function, particularly when an individual transitions from nonweightbearing to weightbearing.

  2. Effects of knee bracing on the sensorimotor function of subjects with anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Wu, G K; Ng, G Y; Mak, A F

    2001-01-01

    The sensorimotor performance of the knee joint in 31 subjects who had undergone unilateral anterior cruciate ligament reconstruction at least 5 months previously was tested under three bracing conditions, 1) the DonJoy Legend brace, 2) a mechanical placebo brace, and 3) no brace, in random order. The accuracy of the subjects' ability to reproduce specified knee joint angles was tested as well as the isokinetic performance of their knee muscles at 60 and 180 deg/sec. The results showed that subjects with the brace or placebo brace performed similarly in reproducing the knee joint positions, but both groups performed better than the subjects without a brace. Isokinetic tests revealed no difference among the three groups in extensor and flexor peak torque production at 60 deg/sec or total work done by the extensors and flexors at 60 and 180 deg/sec. These results suggest that knee bracing can improve the static proprioception of the knee joint, but not the muscle contractile function, in subjects with anterior cruciate ligament reconstruction under isokinetic testing conditions. The finding of similar performances for joint angle reproduction in the brace and placebo brace groups suggests that the apparent improvement in proprioception with knee bracing was not due to the mechanical restraining action of the brace.

  3. MRI FINDINGS OF INTERNAL DERANGEMENT OF KNEE IN TRAUMA

    Directory of Open Access Journals (Sweden)

    Ravi Ningappa

    2015-02-01

    Full Text Available AIMS AND OBJECTIVES: 1. To evaluate ligament and meniscal injuries and secondary signs , using MRI . 2. To analyse the types and grades of the tears. MATERIALS AND METHODS : MR imaging studies of knee was performed in 200 patients, presenting to the department of radiodiagnosis, BMCRI from September - 2013 to September - 2014 with history of trauma and clinical suspicion of internal der angement of knee. Various sequences in coronal, sagittal and axial planes were obtained. RESULTS : Out of 200 patients evaluated , medial meniscus tear was the most common internal derangement. 94 patients showed medial meniscus tear and associated anterior cruciate ligament tear was found in 76 patients. Medial collateral ligament sprain was seen in 18 patients, lateral meniscus injury was seen in 26 patients, lateral collateral ligament injury was seen in 8 patients, posterior cruciate ligament injury was s een in 16 patients, 20 patients showed cartilage defect and 18 percent showed no internal derangement. Associated secondary signs such as bone contusions were seen in 60 individuals and minimal to moderate joint effusion was seen in 74 individuals. CONCLUS ION : MRI is an accurate, non - invasive modality in detecting ligament and meniscal injury of knee. It shows great capability in classifying them into types and grades. Special sequences are useful and should be included in the protocol.

  4. A biomechanical analysis of trunk and pelvis motion during gait in subjects with knee osteoarthritis compared to control subjects.

    Science.gov (United States)

    Linley, Heather S; Sled, Elizabeth A; Culham, Elsie G; Deluzio, Kevin J

    2010-12-01

    Trunk lean over the stance limb during gait has been linked to a reduction in the knee adduction moment, which is associated with joint loading. We examined differences in knee adduction moments and frontal plane trunk lean during gait between subjects with knee osteoarthritis and a control group of healthy adults. Gait analysis was performed on 80 subjects (40 osteoarthritis). To define lateral trunk lean two definitions were used. The line connecting the midpoint between two reference points on the pelvis and the midpoint between the acromion processes was projected onto the lab frontal plane and the pelvis frontal plane. Pelvic tilt was also measured in the frontal plane as the angle between the pelvic and lab coordinate systems. Angles were calculated across the stance phase of gait. We analyzed the data, (i) by extracting discrete parameters (mean and peak) waveform values, and (ii) using principal component analysis to extract shape and magnitude differences between the waveforms. Osteoarthritis subjects had a higher knee adduction moment than the control group (α=0.05). Although the discrete parameters for trunk lean did not show differences between groups, principal component analysis did detect characteristic waveform differences between the control and osteoarthritis groups. A thorough biomechanical analysis revealed small differences in the pattern of motion of the pelvis and the trunk between subjects with knee osteoarthritis and control subjects; however these differences were only detectable using principal component analysis. Copyright © 2010 Elsevier Ltd. All rights reserved.

  5. Single-subject analysis reveals variation in knee mechanics during step landing.

    Science.gov (United States)

    Scholes, Corey J; McDonald, Michael D; Parker, Anthony W

    2012-08-09

    Evidence concerning the alteration of knee function during landing suffers from a lack of consensus. This uncertainty can be attributed to methodological flaws, particularly in relation to the statistical analysis of variable human movement data. The aim of this study was to compare single-subject and group analyses in detecting changes in knee stiffness and coordination during step landing that occur independent of an experimental intervention. A group of healthy men (N=12) stepped-down from a knee-high platform for 60 consecutive trials, each trial separated by a 1-minute rest. The magnitude and within-participant variability of sagittal stiffness and coordination of the landing knee were evaluated with both group and single-subject analyses. The group analysis detected significant changes in knee coordination. However, the single-subject analyses detected changes in all dependent variables, which included increases in variability with task repetition. Between-individual variation was also present in the timing, size and direction of alterations. The results have important implications for the interpretation of existing information regarding the adaptation of knee mechanics to interventions such as fatigue, footwear or landing height. It is proposed that a participant's natural variation in knee mechanics should be analysed prior to an intervention in future experiments. Copyright © 2012 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2013-01-01

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

  7. Antagonist muscle moment is increased in ACL deficient subjects during maximal dynamic knee extension

    DEFF Research Database (Denmark)

    Alkjær, Tine; Simonsen, Erik B; Magnusson, S Peter

    2012-01-01

    INTRODUCTION: Coactivation of the hamstring muscles during dynamic knee extension may compensate for increased knee joint laxity in anterior cruciate ligament (ACL) deficient subjects. This study examined if antagonist muscle coactivation during maximal dynamic knee extension was elevated...... in subjects with anterior cruciate ligament (ACL) deficiency compared to age-matched healthy controls. METHODS: Electromyography (EMG) and net knee joint moments were recorded during maximal concentric quadriceps and eccentric hamstring contractions, performed in an isokinetic dynamometer (ROM: 90......-10°, angular speed: 30°/s). Hamstring antagonist EMG recorded during concentric quadriceps contraction was converted into antagonist moment based on the EMG-moment relationship observed during eccentric agonist contractions. RESULTS: The magnitude of antagonist hamstring EMG was 65.5% higher in ACL deficient...

  8. Prophylactic Ankle Braces and Knee Varus-Valgus and Internal-External Rotation Torque

    Science.gov (United States)

    Venesky, Kandy; Docherty, Carrie L; Dapena, Jesus; Schrader, John

    2006-01-01

    Context: Although prophylactic ankle bracing has been shown to be effective in reducing the incidence of ankle sprains, how these ankle braces might affect the other joints of the lower extremity is not clearly understood. Objective: To determine the effects of a prophylactic ankle brace on knee joint varus-valgus and internal-external rotation torque during a drop landing onto a slanted surface. Design: A repeated-measures design. Setting: Biomechanics research laboratory. Patients or Other Participants: Twenty-four physically active college students. Intervention(s): Participants were tested in a brace and no-brace condition. Main Outcome Measure(s): We measured 3 dependent variables: (1) peak ankle inversion-eversion torque, (2) peak knee varus-valgus torque, and (3) peak knee internal-external rotation torque. A forceplate was used to collect ground reaction force data, and 6 motion analysis cameras collected kinematic data during the unilateral drop landing. An adjustable bar was hung from the ceiling, and a slant board was positioned over the center of the forceplate, so that the ankle of the participant's dominant leg would invert upon landing. Peak torque was measured in both the brace and no-brace conditions. The average of the peak values in 3 trials for both conditions was used for the statistical analysis. Results: Ankle eversion torque was significantly greater in the brace condition (F1,23 = 19.75, P Knee external rotation torque was significantly greater in the brace condition (F1,23 = 4.33,P knee torque was smaller in the brace condition, but the difference was not statistically significant (F1,23 = 3.45,P = .08). Conclusions: This study provides an important first step in understanding the effects of prophylactic ankle bracing on other joints of the lower extremity. We found that prophylactic ankle bracing did have an effect on knee torque when the subject was landing on a slanted surface. Specifically, knee external rotation torque increased when

  9. Linguistic and cultural adaptation into Polish of the IKDC 2000 subjective knee evaluation form and the Lysholm scale.

    Science.gov (United States)

    Piontek, Tomasz; Ciemniewska-Gorzela, Kinga; Naczk, Jakub; Cichy, Kamil; Szulc, Andrzej

    2012-11-07

    The aim of the following paper was Polish cultural and linguistic adaptation including adaptation of particular questions, instructions and possible answers to 2000 IKDC knee form and Lysholm's scale. The cultural adaptation process of this questionnaire was made according to indicators of International Quality of Life Assessment (IQOLA) project, placed in Journal of Clinical Epidemiology. Testing version (pre-final test) was carried out on 30 patients suffering from instability of a knee. Patients underwent arthroscopic reconstruction of the anterior cruciate ligament. The period from operation to filling in the questionnaires took 2 years. The questionnaire was filled up twice, at intervals from 2 days to 2 weeks. We received cultural and linguistic adapted knee evaluation scales which are similar to the original version according to the psychometric proprieties such as accuracy of a single question and whole scales. We were able to develop a reliable, ISAKOS/ESSKA-compliant instrument for subjective knee function evaluation to be used in the population of Polish patients following arthroscopic reconstruction of anterior cruciate ligament. Polish version of IKDC 2000 questionnaire is more reliable--i.e. more useful in clinical evaluation of patients with ACL damage--than the Polish rendition of Lysholm scale.

  10. International Energy: Subject Thesaurus. Revision 2

    Energy Technology Data Exchange (ETDEWEB)

    Rutkowski, R.W. [ed.

    1997-12-31

    The Energy Technology Data Exchange (ETDE) is a consortium of member countries around the globe that share their energy research and technology information through ETDE`s database. The Exchange was established in 1987 under the auspices of the International Energy Agency (IEA) and serves all ETDE member countries. The Exchange also collaborates with other entities as appropriate.The International Energy:Subject Thesaurus [ETDE/PUB--2(Rev.2)] contains the standard vocabulary of indexing terms (descriptors) developed and structured to build and maintain energy information databases. Involved in this cooperative task are (1) the technical staff of the U.S. DOE Office of Scientific and technical Information (OSTI) in cooperation with the member countries of the International Energy Agency`s Energy Technology Data Exchange (ETDE) and (2) the International Atomic Energy Agency`s International Nuclear Information System (INIS) staff representing the more than 100 countries and organizations t hat record and index information for the international nuclear information community. Because all ETDE member countries are also members of INIS, the contents of INIS`s database are included in ETDE`s database. Indexing terminology is therefore cooperatively standardized for use in both information systems. This structured vocabulary reflects the scope of international energy research and technology programs. The terminology of this thesaurus aids in subject searching on commercial systems, such as the online products offered by Knight-Ridder Information Services and STN International and the CD-ROM products offered by Silver Platter and Knight-Ridder. This thesaurus can also be used with the in-house systems provided by some ETDE member countries. Descriptors are added to the thesaurus as needed (i.e., when a document contains a concept for which there is no adequate term or terms in the thesaurus). More than 28,000 entries appear in this document, which replaced International

  11. Muscle activity response to external moment during single-leg drop landing in young basketball players: the importance of biceps femoris in reducing internal rotation of knee during landing.

    Science.gov (United States)

    Fujii, Meguru; Sato, Haruhiko; Takahira, Naonobu

    2012-01-01

    Internal tibial rotation with the knee close to full extension combined with valgus collapse during drop landing generally results in non-contact anterior cruciate ligament (ACL) injury. The purpose of this study was to investigate the relationship between internal rotation of the knee and muscle activity from internal and external rotator muscles, and between the internal rotation of knee and externally applied loads on the knee during landing in collegiate basketball players. Our hypothesis was that the activity of biceps femoris muscle would be an important factor reducing internal knee rotation during landing. The subjects were 10 collegiate basketball students: 5 females and 5 males. The subjects performed a single-leg drop landing from a 25-cm height. Femoral and tibial kinematics were measured using a 3D optoelectronic tracking system during the drop landings, and then the knee angular motions were determined. Ground reaction forces and muscle activation patterns (lateral hamstring and medial hamstring) were simultaneously measured and computed. Results indicated that lower peak internal tibial rotation angle at the time of landing was associated with greater lateral hamstring activity (r = -0.623, p internal tibial rotation angle and the knee internal rotation moment. Control of muscle activity in the lateral to medial hamstring would be an important factor in generating sufficient force to inhibit excessive internal rotation during landing. Strengthening the biceps femoris might mitigate the higher incidence of non-contact ACL injury in female athletes. Key pointsLower activity of the external rotator muscle of the knee, which inhibits internal rotation of the knee, may be the reason why females tend to show a large internal rotation of the knee during drop landing.Externally applied internal rotation moment of the knee during landing would not be expected to explain why female athletes tend to show excessive internal knee rotation.Biceps femoris strength

  12. International Energy: Subject Thesaurus. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    1993-11-01

    The International Energy Agency: Subject Thesaurus contains the standard vocabulary of indexing terms (descriptors) developed and structured to build and maintain energy information databases. Involved in this cooperative task are (1) the technical staff of the USDOE Office of Scientific and Technical Information (OSTI) in cooperation with the member countries of the International Energy Agency`s Energy Technology Data Exchange (ETDE) and (2) the International Atomic Energy Agency`s International Nuclear Information System (INIS) staff representing the more than 100 countries and organizations that record and index information for the international nuclear information community. ETDE member countries are also members of INIS. Nuclear information prepared for INIS by ETDE member countries is included in the ETDE Energy Database, which contains the online equivalent of the printed INIS Atomindex. Indexing terminology is therefore cooperatively standardized for use in both information systems. This structured vocabulary reflects thscope of international energy research, development, and technological programs. The terminology of this thesaurus aids in subject searching on commercial systems, such as ``Energy Science & Technology`` by DIALOG Information Services, ``Energy`` by STN International and the ``ETDE Energy Database`` by SilverPlatter. It is also the thesaurus for the Integrated Technical Information System (ITIS) online databases of the US Department of Energy.

  13. Does wearing a functional knee brace affect hamstring reflex time in subjects with anterior cruciate ligament deficiency during muscle fatigue?

    Science.gov (United States)

    Lam, Rita Y; Ng, Gabriel Y; Chien, Eric P

    2002-07-01

    To evaluate the effects of wearing a functional knee brace and muscle fatigue on hamstring reflex time in subjects with anterior cruciate ligament (ACL) deficiency. Repeated-measures clinical trial. Outpatient physical therapy department. Sixteen subjects with ACL deficiency. Subjects tested with and without a functional knee brace before and after an exercise protocol designed to fatigue the knee muscles. Latency of hamstring reflex muscle activity after sudden perturbation of the knee. Wearing a knee brace shortened the hamstring reflex latency regardless of fatigue (F(1,15)=20.62, Pknee brace facilitated hamstring muscle reflex, but muscle fatigue lengthened the hamstring reflex latency. Subjects with ACL deficiency should not rely on the knee brace to facilitate hamstring reflex for joint protection during prolonged sporting activities when muscles are fatigued. Copyright 2002 by the American Congress of Rehabilitation Medicine and the American Academy of physical Medicine and Rehabilitation

  14. Subjects with Knee Osteoarthritis Exhibit Widespread Hyperalgesia to Pressure and Cold.

    Directory of Open Access Journals (Sweden)

    Penny Moss

    Full Text Available Hyperalgesia to mechanical and thermal stimuli are characteristics of a range of disorders such as tennis elbow, whiplash and fibromyalgia. This study evaluated the presence of local and widespread mechanical and thermal hyperalgesia in individuals with knee osteoarthritis, compared to healthy control subjects. Twenty-three subjects with knee osteoarthritis and 23 healthy controls, matched for age, gender and body mass index, were recruited for the study. Volunteers with any additional chronic pain conditions were excluded. Pain thresholds to pressure, cold and heat were tested at the knee, ipsilateral heel and ipsilateral elbow, in randomized order, using standardised methodology. Significant between-groups differences for pressure pain and cold pain thresholds were found with osteoarthritic subjects demonstrating significantly increased sensitivity to both pressure (p = .018 and cold (p = .003 stimuli, compared with controls. A similar pattern of results extended to the pain-free ipsilateral ankle and elbow indicating widespread pressure and cold hyperalgesia. No significant differences were found between groups for heat pain threshold, although correlations showed that subjects with greater sensitivity to pressure pain were also likely to be more sensitive to both cold pain and heat pain. This study found widespread elevated pain thresholds in subjects with painful knee osteoarthritis, suggesting that altered nociceptive system processing may play a role in ongoing arthritic pain for some patients.

  15. A subject-specific musculoskeletal modeling framework to predict in vivo mechanics of total knee arthroplasty

    NARCIS (Netherlands)

    Marra, M.A.; Vanheule, V.; Fluit, R.; Koopman, B.H.; Rasmussen, J.; Verdonschot, N.J.; Andersen, M.S.

    2015-01-01

    Musculoskeletal (MS) models should be able to integrate patient-specific MS architecture and undergo thorough validation prior to their introduction into clinical practice. We present a methodology to develop subject-specific models able to simultaneously predict muscle, ligament, and knee joint

  16. Subjective Crepitus as a Risk Factor for Incident Symptomatic Knee Osteoarthritis: Data From the Osteoarthritis Initiative.

    Science.gov (United States)

    Lo, Grace H; Strayhorn, Michael T; Driban, Jeffrey B; Price, Lori Lyn; Eaton, Charles B; Mcalindon, Timothy E

    2017-05-04

    Subjective crepitus is the reporting of hearing grating, cracking, or popping sounds in and/or around a joint. We aimed to evaluate whether there is an association between crepitus and incident symptomatic knee osteoarthritis (OA) in the Osteoarthritis Initiative (OAI), a multicenter longitudinal US cohort. Knees without baseline symptomatic OA were included. Crepitus frequency was assessed using a question from the Knee Injury and Osteoarthritis Outcome Score at baseline and at 12, 24, and 36 months. Frequent knee pain and radiographs were assessed at baseline and at annual visits up to 48 months. Radiographic OA was defined as a tibiofemoral Kellgren/Lawrence grade ≥2. Symptomatic OA was defined as a knee with both frequent symptoms and radiographic OA. We performed a repeated-measures analysis with a predictor of crepitus and outcome of incident symptomatic OA, adjusting for age, sex, and body mass index (BMI), with those never reporting crepitus as the referent group. There were a total of 3,495 participants (42.2% male), with mean ± SD age of 61.1 ± 9.2 years and a mean ± SD BMI of 28.2 ± 4.7 kg/m². The odds of incident symptomatic OA were higher with greater frequency of crepitus (never, rarely, sometimes, often, and always, with adjusted odds ratios of (referent), 1.5, 1.8, 2.2, and 3.0, respectively; P risk individuals, predictive modeling, and future research. © 2017, American College of Rheumatology.

  17. Serum cytokines are increased and circulating micronutrients are not altered in subjects with early compared to advanced knee osteoarthritis.

    Science.gov (United States)

    Barker, Tyler; Rogers, Victoria E; Henriksen, Vanessa T; Aguirre, Dale; Trawick, Roy H; Rasmussen, G Lynn; Momberger, Nathan G

    2014-08-01

    Knee osteoarthritis (OA) is a leading cause of physical disability. At the early stage of knee OA, the increase in synovial fluid cytokine concentrations could contribute to the pathogenesis of OA by degrading articular cartilage. It is unknown, however, if inflammatory cytokines increase systemically at the early or advanced stage of knee OA. The systemic increase of inflammatory cytokines could be detrimental to the endogenous status of micronutrients that protect against excessive inflammation and cytokine-mediated events. The purpose of this study was to test the hypothesis that an increase in serum cytokines associate with a decrease in circulating micronutrients in subjects with early compared to advanced knee OA. Advanced knee OA subjects (n=14) displayed radiographic, pain, and muscular weakness symptoms of knee OA. Early knee OA subjects (n=14) were matched (age, gender, and body mass index) to the advanced OA group and displayed one or two of the aforementioned symptoms of knee OA. Inflammatory cytokines, vitamins C (ascorbic acid), D (25-hydroxyvitamin D), and E (α- and γ-tocopherols), and β-carotene were measured in fasting blood samples. In the early OA group, serum tumor necrosis factor (TNF)-α, interleukin (IL)-5, IL-6, IL-12, and IL-13 concentrations were significantly (all pmicronutrients in subjects with early compared to advanced knee OA. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. The effect of proprioceptive knee bracing on knee stability during three different sport related movement tasks in healthy subjects and the implications to the management of Anterior Cruciate Ligament (ACL) injuries.

    Science.gov (United States)

    Hanzlíková, I; Richards, J; Tomsa, M; Chohan, A; May, K; Smékal, D; Selfe, J

    2016-07-01

    Proprioceptive knee braces have been shown to improve knee mechanics, however much of the work to date has focused on tasks such as slow step down tasks rather than more dynamic sporting tasks. This study aimed to explore if such improvements in stability may be seen during faster sports specific tasks as well as slower tasks. Twelve subjects performed a slow step down, single leg drop jump and pivot turn jump with and without a silicone web brace. 3D kinematics of the knee were collected using a ten camera Qualisys motion analysis system. Reflective markers were placed on the foot, shank, thigh and pelvis using the Calibrated Anatomical Systems Technique. A two way ANOVA with repeated measures was performed with post-hoc pairwise comparison to explore the differences between the two conditions and three tasks. Significant differences were seen in the knee joint angles and angular velocities in the sagittal, coronal and transverse planes between the tasks. The brace showed a reduction in knee valgum and internal rotation across all tasks, with the most notable effect during the single leg drop jump and pivot turn jump. The transverse plane also showed a significant reduction in the external rotation knee angular velocity when wearing the brace. The brace influenced the knee joint kinematics in coronal and transverse planes which confirms that such braces can have a significant effect on knee control during dynamic tasks. Further studies are required exploring the efficacy of proprioceptive braces in athletic patient cohort. Copyright © 2016 Elsevier B.V. All rights reserved.

  19. 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 before and the end of the intervention period for both groups. Results: at the end of the program, group A subjects showed significant improvements compared with group B subjects regarding MVIC and muscle architecture parameters (p<0.05. Also, there was significant improvement in post-test VAS and WOMAC scores in group A subjects compared to group B subjects (p<0.05. Conclusion: A 12-week quadriceps isometric training program improves knee pain and quadriceps muscle strength and architecture in obese subjects with knee OA. These results indicate that isometric training should be regarded as a proper exercise intervention for obese patients with knee OA.

  20. Energy expenditure during walking in subjects with tibial rotationplasty, above-knee amputation, or hip disarticulation.

    Science.gov (United States)

    van der Windt, D A; Pieterson, I; van der Eijken, J W; Hollander, A P; Dahmen, R; de Jong, B A

    1992-12-01

    The surgical treatment of osteosarcoma with a tibial rotationplasty seems to offer functional advantages in comparison with an above-knee amputation. It has not been established whether the functional advantages are accompanied by a lower rate of energy expenditure during walking. In children with a tibial rotationplasty (n = 15), an above-knee amputation (n = 6), or a hip disarticulation (n = 5), energy expenditure was measured during treadmill walking at various walking velocities. The subjects with a tibial rotationplasty were able to walk faster, but there were no differences between the groups in energy expenditure per unit time or per unit distance. Correction for confounding variables including age, sex, height, time since operation, level of activity, and support during walking in a multiple linear regression model did not reveal any significant differences in energy expenditure during walking between groups. 1992 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.

  1. Isokinetic knee function in healthy subjects with and without Kinesio taping.

    Science.gov (United States)

    Wong, Oscar M H; Cheung, Roy T H; Li, Raymond C T

    2012-11-01

    This study examined the difference in the isokinetic knee performance in healthy subjects with and without the Kinesio tape application onto the skin surface overlying the vastus medialis. A cross-sectional experimental study. Clinical setting. 30 healthy participants. Maximal concentric knee extension and flexion at three angular velocities (60, 120 and 180°/s) were measured with an isokinetic dynamometer. Normalized peak torque, normalized total work done and time to peak torque of knee extension and flexion were compared by repeated measures ANOVA. There was no significant main effect in ANOVA in normalized peak torque and normalized total work done between taping conditions and angular velocities. Conversely, participants demonstrated significant shorter time to peak extension torque with the tape condition (p = 0.03). Pair-wise comparisons indicated that such time reduction (36-101 ms) occurred at all three angular velocities (p Kinesio tape did not alter the muscle peak torque generation and total work done but shortened the time to generate peak torque. This finding may contribute to the rationale in injury prevention and rehabilitation in athletes with Kinesio taping. Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. [Influence of gait speed on plantar pressure in subjects with unilateral knee osteoarthritis].

    Science.gov (United States)

    Fernandes, Wagner Costa; Machado, Alvaro; Borella, Caio; Carpes, Felipe P

    2014-01-01

    Changing gait speed is a common strategy to manipulate exercise intensity during physical exercise, but may elicit higher impact forces and consequent joint loading. Here we analyzed the effects of increasing walking velocity on plantar pressure and asymmetries in elderly with knee osteoarthritis (OA). Our hypothesis was that the contralateral limb could receive higher loading compared to the OA limb in the different walking speeds tested. Twelve elderly with unilateral knee OA walked at different self-selected speeds along a 10 m pass way stepping on an instrumented mat for measurement of plantar pressure at preferred, slow and fast gait speeds. Five steps were recorded for each speed. Plantar pressure data were compared between the speeds and legs. speeds were significantly different between them (p<0.05). Mean and peak plantar pressure increased when speed changed from slow to fast (p<0.05). Velocity of the center of pressure increased and the single stance time decreased when walk speed was increased (p<0.05). Any asymmetries were observed. Increasing gait speed from slow to fast in subjects with unilateral knee OA significantly affected variables of plantar pressure, but asymmetries between committed and contralateral leg were not detected. Copyright © 2014 Elsevier Editora Ltda. All rights reserved.

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  4. Activation of biceps femoris long head reduces tibiofemoral anterior shear force and tibial internal rotation torque in healthy subjects.

    Science.gov (United States)

    Azmi, Nur Liyana; Ding, Ziyun; Xu, Rui; Bull, Anthony M J

    2018-01-01

    The anterior cruciate ligament (ACL) provides resistance to tibial internal rotation torque and anterior shear at the knee. ACL deficiency results in knee instability. Optimisation of muscle contraction through functional electrical stimulation (FES) offers the prospect of mitigating the destabilising effects of ACL deficiency. The hypothesis of this study is that activation of the biceps femoris long head (BFLH) reduces the tibial internal rotation torque and the anterior shear force at the knee. Gait data of twelve healthy subjects were measured with and without the application of FES and taken as inputs to a computational musculoskeletal model. The model was used to investigate the optimum levels of BFLH activation during FES gait in reducing the anterior shear force to zero. This study found that FES significantly reduced the tibial internal rotation torque at the knee during the stance phase of gait (p = 0.0322) and the computational musculoskeletal modelling revealed that a mean BFLH activation of 20.8% (±8.4%) could reduce the anterior shear force to zero. At the time frame when the anterior shear force was zero, the internal rotation torque was reduced by 0.023 ± 0.0167 Nm/BW, with a mean 188% reduction across subjects (p = 0.0002). In conclusion, activation of the BFLH is able to reduce the tibial internal rotation torque and the anterior shear force at the knee in healthy control subjects. This should be tested on ACL deficient subject to consider its effect in mitigating instability due to ligament deficiency. In future clinical practice, activating the BFLH may be used to protect ACL reconstructions during post-operative rehabilitation, assist with residual instabilities post reconstruction, and reduce the need for ACL reconstruction surgery in some cases.

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

    Directory of Open Access Journals (Sweden)

    Bomidi Sudha Rani

    2016-12-01

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

  6. Internal Fixation of Unstable Osteochondritis Dissecans in the Skeletally Mature Knee with Metal Screws.

    Science.gov (United States)

    Barrett, Ian; King, Alexander H; Riester, Scott; van Wijnen, Andre; Levy, Bruce A; Stuart, Michael J; Krych, Aaron J

    2016-04-01

    Several bioabsorbable and metal options are available for internal fixation of an unstable osteochondritis dissecans (OCD) lesion, but currently there are little data on outcomes with metal headless compression screws in the adult knee. The purpose of this study was to determine (1) the radiographic healing rates, (2) midterm clinical outcomes, and (3) comparison between healed and unhealed OCD fragments after use of headless metal compression screws for the treatment of unstable OCD lesions in the knees of skeletally mature patients. Retrospective chart review for all skeletally mature patients who presented with unstable femoral condyle OCD lesions of the knee was conducted. All patients underwent open or arthroscopic reduction and internal fixation using headless metal compression screws. Preoperative and postoperative radiographs were reviewed with healing defined as radiographic evidence of union of the OCD progeny fragment with the condyle. Clinical outcome data were collected retrospectively using 3 validated outcome scores: International Knee Documentation Committee (IKDC), Knee Injury and Osteoarthritis Outcome Score (KOOS), and Marx. Twenty-two knees in 22 patients with a mean age of 21 years (range= 14-37 years) were followed for an average of 8.7 years (range = 2-22 years). Metal, headless, cannulated compression screws were used in all 22 cases. At a mean of 31 months postoperatively (range = 2-262), fragment union was observed in 18 knees (82%). The remaining 4 knees (18%) required loose fragment excision and hardware removal at a mean of 9 months (range = 2-16 months) postoperatively. Mean postoperative Marx score was 7 (range = 0-16), the mean postoperative IKDC score was 85 (range = 62-100), and mean KOOS scores included KOOS Pain (93; range = 69-100), KOOS Symptoms (86; range = 71-100), KOOS ADL (98; range = 90-100), KOOS Sports (82; range = 50-100), and KOOS QOL (76; range = 50-100). Headless metal compression screws provide a satisfactory union

  7. Mechanisms of quadriceps muscle weakness in knee joint osteoarthritis: the effects of prolonged vibration on torque and muscle activation in osteoarthritic and healthy control subjects

    OpenAIRE

    Rice, David A; McNair, Peter J; Lewis, Gwyn N.

    2011-01-01

    Introduction A consequence of knee joint osteoarthritis (OA) is an inability to fully activate the quadriceps muscles, a problem termed arthrogenic muscle inhibition (AMI). AMI leads to marked quadriceps weakness that impairs physical function and may hasten disease progression. The purpose of the present study was to determine whether γ-loop dysfunction contributes to AMI in people with knee joint OA. Methods Fifteen subjects with knee joint OA and 15 controls with no history of knee joint p...

  8. Relationship between knee kinetic outcome measures in vertical counter movement jumps and self-reported function in ACL reconstructed subjects

    DEFF Research Database (Denmark)

    Brekke, Anders Falk

    2014-01-01

    and Traumatology, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark Introduction: Altered loading pattern of the medial aspect of the knee has been associated with the development of knee osteoarthritis (OA). Anterior cruciate ligament (ACL) injuries are associated......Relationship between knee kinetic outcome measures in counter movement jumps and self-reported function in ACL reconstructed subjects Brekke AF1,2, Nielsen DB2, Holsgaard-Larsen A2 1School of physiotherapy, University College Zealand, Denmark 2Orthopaedic Research Unit, Department of Orthopaedics...... with early-onset OA with associated pain, functional limitations, and decreased quality of life. However, specific knee loading pattern of the medial aspect has not been investigated during different jump-tasks in ACL-reconstructed patients. The purpose was to investigate potential kinetic differences...

  9. Diagnostic accuracy of low tesla MR imaging in the internal derangement of the knee

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Dae Ik; Ahn, Hyup; Kim, Jang Ho; Kim, Byung Young; Lee, Jong Gil [Fatima Hospital, Daegu (Korea, Republic of)

    1995-05-15

    This study is for the evaluation of low tesla(0.064T). MR imaging diagnostic accuracy in the internal derangement of the knee. We retrospectively analysed the MR images of 36 injured knees of 35 patients. The presence of tear was determined by arthroscopy or surgery in all cases. The specificity, accuracy, positive predictive value, negative predictive value of of low tesla MRI for the diagnosis of anterior cruciate ligament injury were 83%, 88%, 86%, 77%, 91%, for the posterior cruciate ligament 75%, 95%, 86%, 92%, 83%, for the medial collateral ligament 83%, 96%, 92%, 91%, 92%, for the lateral collateral ligament 67%, 97%, 94%, 67%, 97%, for the menisci 75%, 93%, 89%, 75%, 93%. The low tesla MRI is an accurate method in detection and evaluation of the internal derangement of the knee.

  10. Case definitions of knee osteoarthritis in 4,151 unselected subjects: relevance for epidemiological studies. The Copenhagen osteoarthritis study

    Energy Technology Data Exchange (ETDEWEB)

    Laxafoss, Erling; Jacobsen, Steffen; Gosvig, Kasper K.; Sonne-Holm, Stig [Copenhagen University Hospital of Hvidovre (Denmark). Department of Orthopaedic Surgery

    2010-09-15

    The aims of the present study were threefold: to examine the distribution of knee joint osteoarthritis in a large, standardized radiological study; to examine the relationships between self reported knee pain and radiological OA; and to examine the natural history of radio-morphological change over age in individuals without radiological features of OA. The Copenhagen Osteoarthritis Study - COS is a substudy of the Copenhagen City Heart Study, a longitudinal regional health survey. From the third inclusion of the CCHS (1992-1994) 4,151 subjects were selected for subsequent standardized radiography of the pelvis, the knees, the hands, the wrists, and the lumbar spine. Images were analyzed and knee joint osteoarthritis (OA) was classified according to the radiographic atlas of Kellgren and Lawrence. Joint space width (JSW) was measured at three sites within both the medial and the lateral compartment. For the entire cohort the prevalence of radiological knee joint OA of all grades was 38.7% for men and 44.2% for women. Age stratification documented increasing knee joint OA both in regard to prevalence and morphological severity. Knee pain was universally correlated to the Kellgren and Lawrence severity of OA. In a subgroup with no features of radiological OA, a significant and linear decline in JSW with increasing age was found. We found a clear relationship between self-reported knee pain and radiological osteoarthritis. Pain was proportionally related to the severity of change. We also demonstrated a significant diminishing of joint space width with increasing age in individuals without apparent radiological degeneration. (orig.)

  11. Incorporating Library School Interns on Academic Library Subject Teams

    Science.gov (United States)

    Sargent, Aloha R.; Becker, Bernd W.; Klingberg, Susan

    2011-01-01

    This case study analyzes the use of library school interns on subject-based teams for the social sciences, humanities, and sciences in the San Jose State University Library. Interns worked closely with team librarians on reference, collection development/management, and instruction activities. In a structured focus group, interns reported that the…

  12. Correlation between two-dimensional video analysis and subjective assessment in evaluating knee control among elite female team handball players

    DEFF Research Database (Denmark)

    Stensrud, Silje; Myklebust, Grethe; Kristianslund, Eirik

    2011-01-01

    . The present study investigated the correlation between a two-dimensional (2D) video analysis and subjective assessment performed by one physiotherapist in evaluating knee control. We also tested the correlation between three simple clinical tests using both methods. A cohort of 186 female elite team handball...

  13. Physical and psychosocial disability in elderly subjects in relation to pain in the hip and/or knee

    NARCIS (Netherlands)

    Hopman-Rock, M.; Odding, E.; Hofman, A.; Kraaimaat, F. W.; Bijlsma, J. W.

    1996-01-01

    To determine physical and psychosocial disability in subjects aged 55 to 74 years living in the community, in relation to pain in the hip and/or knee, and to explore the relationships between pain, physical and psychosocial disability, and selected background variables. A subsample from a community

  14. Physical and psychosocial disability in elderly subjects in relation to pain in the hip and/or knee

    NARCIS (Netherlands)

    Hopman-Rock, M.; Odding, E.; Hofman, A.; Kraaimaat, F.W.; Bijlsma, J.W.J.

    1996-01-01

    Objective. To determine physical and psychosocial disability in subjects aged 55 to 74 years living in the community, in relation to pain in the hip and/or knee, and to explore the relationships between pain, physical and psychosocial disability, and selected background variables. Methods. A

  15. Knee Medial Collateral Ligament and Posteromedial Corner Anatomic Repair With Internal Bracing

    Science.gov (United States)

    Lubowitz, James H.; MacKay, Gordon; Gilmer, Brian

    2014-01-01

    An internal brace is a ligament repair bridging concept using braided ultrahigh–molecular-weight polyethylene/polyester suture tape and knotless bone anchors to reinforce ligament strength as a secondary stabilizer after repair and return to sports, which may help resist injury recurrence. An internal brace may provide augmentation during knee medial and posteromedial corner anatomic repair. In patients with combined, chronic, symptomatic anterior cruciate ligament (ACL)–posteromedial corner laxity, combined ACL reconstruction with posteromedial corner reconstruction is indicated. Our ACL technique was previously published with video illustration in Arthroscopy and Arthroscopy Techniques. The purpose of this article is to describe, with video illustration, knee posteromedial corner reconstruction using anatomic repair with internal brace augmentation. PMID:25276610

  16. Case definitions of knee osteoarthritis in 4,151 unselected subjects: relevance for epidemiological studies : The Copenhagen Osteoarthritis Study

    DEFF Research Database (Denmark)

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

    2010-01-01

    -morphological change over age in individuals without radiological features of OA. MATERIALS AND METHODS: The Copenhagen Osteoarthritis Study - COS is a substudy of the Copenhagen City Heart Study, a longitudinal regional health survey. From the third inclusion of the CCHS (1992-1994) 4,151 subjects were selected......INTRODUCTION: The aims of the present study were threefold: to examine the distribution of knee joint osteoarthritis in a large, standardized radiological study; to examine the relationships between self reported knee pain and radiological OA; and to examine the natural history of radio...

  17. MUSCLE ACTIVITY RESPONSE TO EXTERNAL MOMENT DURING SINGLE-LEG DROP LANDING IN YOUNG BASKETBALL PLAYERS: THE IMPORTANCE OF BICEPS FEMORIS IN REDUCING INTERNAL ROTATION OF KNEE DURING LANDING

    Directory of Open Access Journals (Sweden)

    Meguru Fujii

    2012-06-01

    Full Text Available Internal tibial rotation with the knee close to full extension combined with valgus collapse during drop landing generally results in non-contact anterior cruciate ligament (ACL injury. The purpose of this study was to investigate the relationship between internal rotation of the knee and muscle activity from internal and external rotator muscles, and between the internal rotation of knee and externally applied loads on the knee during landing in collegiate basketball players. Our hypothesis was that the activity of biceps femoris muscle would be an important factor reducing internal knee rotation during landing. The subjects were 10 collegiate basketball students: 5 females and 5 males. The subjects performed a single-leg drop landing from a 25-cm height. Femoral and tibial kinematics were measured using a 3D optoelectronic tracking system during the drop landings, and then the knee angular motions were determined. Ground reaction forces and muscle activation patterns (lateral hamstring and medial hamstring were simultaneously measured and computed. Results indicated that lower peak internal tibial rotation angle at the time of landing was associated with greater lateral hamstring activity (r = -0.623, p < 0.001. When gender was considered, the statistically significant correlation remained only in females. There was no association between the peak internal tibial rotation angle and the knee internal rotation moment. Control of muscle activity in the lateral to medial hamstring would be an important factor in generating sufficient force to inhibit excessive internal rotation during landing. Strengthening the biceps femoris might mitigate the higher incidence of non-contact ACL injury in female athletes

  18. Functional knee brace use by non-injured subjects while performing an anaerobic capacity task: preliminary study.

    Science.gov (United States)

    Rishiraj, N; Taunton, J E; Lloyd-Smith, R; Niven, B; Regan, W; Woollard, R

    2010-12-01

    The objective of this paper was to investigate if performance was hindered in non-injured braced athletes during an anaerobic task. If performance was affected, could accommodation to wearing a knee brace occur and thus decreasing performance hindrance concern while using a functional knee brace (FKB). A 2x3 non-braced (NBr) and braced repeated measure factorial design. Five healthy athletes completed all testing. Subjects performed the Repeated High Intensity Shuttle Test (RHIST) over six days (three days NBr and three days braced). Running times were recorded each testing day to determine performance measures and percent fatigue levels while using a FKB and if accommodation to FKB use was possible. Non significant (F1,4=1.42, P=0.299) faster group mean performance time, was recorded for braced subjects relative to the non-braced condition. Although relatively faster performance levels were noted during the braced testing conditions during days 1 and 3 compared to the non-braced condition, these results were also not significant (F2,8=2.82, P=0.118). Lower percent fatigue level was recorded during all three braced days compared to non-braced days. Further, a tendency for accommodation to knee brace trend use was noted as the percentage performance difference between the two conditions had decreased by the last day of testing. Use of a knee brace did not hinder performance once accommodation to using the knee brace occurred and fatigue was not a factor while using a knee brace. Additional research, using a larger sample size and longer testing duration, is required to confirm the potential accommodation trend.

  19. Vitamin D deficiency associates with γ-tocopherol and quadriceps weakness but not inflammatory cytokines in subjects with knee osteoarthritis

    Directory of Open Access Journals (Sweden)

    Tyler Barker

    2014-01-01

    Full Text Available Knee osteoarthritis (OA is a degenerative joint condition and a leading cause of physical disability in the United States. Quadriceps weakness and inflammatory cytokines contribute to the pathogenesis of knee OA, and both of which, increase with vitamin D deficiency. Other micronutrients, such as vitamins C and E and β-carotene, modulate inflammatory cytokines and decrease during inflammation. The purpose of this study was to test the hypothesis that vitamin D deficiency associates with quadriceps weakness, an increase in serum cytokines, and a decrease in circulating micronutrients in subjects with knee OA. Subjects (age, 48±1 y; serum 25(OHD, 25.8±1.1 ng/mL with knee OA were categorized as vitamin D deficient (n=17; serum 25(OHD≤20 ng/mL, insufficient (n=21; serum 25(OHD 20–29 ng/mL, or sufficient (n=18; serum 25(OHD≥30 ng/mL. Single-leg strength (concentric knee extension–flexion contraction cycles at 60 °/s and blood cytokine, carotene (α and β, ascorbic acid, and tocopherol (α and γ concentrations were measured. Quadriceps peak torque, average power, total work, and deceleration were significantly (all p<0.05 impaired with vitamin D deficiency. Serum γ-tocopherol concentrations were significantly (p<0.05 increased with vitamin D deficiency. In the vitamin D sufficient group, γ-tocopherol inversely correlated (r=−0.47, p<0.05 with TNF-α, suggesting a pro-inflammatory increase with a γ-tocopherol decrease despite a sufficient serum 25(OHD concentration. We conclude that vitamin D deficiency is detrimental to quadriceps function, and in subjects with vitamin D sufficiency, γ-tocopherol could have an important anti-inflammatory role in a pathophysiological condition mediated by inflammation.

  20. Vitamin D deficiency associates with γ-tocopherol and quadriceps weakness but not inflammatory cytokines in subjects with knee osteoarthritis.

    Science.gov (United States)

    Barker, Tyler; Henriksen, Vanessa T; Rogers, Victoria E; Aguirre, Dale; Trawick, Roy H; Lynn Rasmussen, G; Momberger, Nathan G

    2014-01-01

    Knee osteoarthritis (OA) is a degenerative joint condition and a leading cause of physical disability in the United States. Quadriceps weakness and inflammatory cytokines contribute to the pathogenesis of knee OA, and both of which, increase with vitamin D deficiency. Other micronutrients, such as vitamins C and E and β-carotene, modulate inflammatory cytokines and decrease during inflammation. The purpose of this study was to test the hypothesis that vitamin D deficiency associates with quadriceps weakness, an increase in serum cytokines, and a decrease in circulating micronutrients in subjects with knee OA. Subjects (age, 48±1 y; serum 25(OH)D, 25.8±1.1 ng/mL) with knee OA were categorized as vitamin D deficient (n=17; serum 25(OH)D≤20 ng/mL), insufficient (n=21; serum 25(OH)D 20-29 ng/mL), or sufficient (n=18; serum 25(OH)D≥30 ng/mL). Single-leg strength (concentric knee extension-flexion contraction cycles at 60 °/s) and blood cytokine, carotene (α and β), ascorbic acid, and tocopherol (α and γ) concentrations were measured. Quadriceps peak torque, average power, total work, and deceleration were significantly (all p<0.05) impaired with vitamin D deficiency. Serum γ-tocopherol concentrations were significantly (p<0.05) increased with vitamin D deficiency. In the vitamin D sufficient group, γ-tocopherol inversely correlated (r=-0.47, p<0.05) with TNF-α, suggesting a pro-inflammatory increase with a γ-tocopherol decrease despite a sufficient serum 25(OH)D concentration. We conclude that vitamin D deficiency is detrimental to quadriceps function, and in subjects with vitamin D sufficiency, γ-tocopherol could have an important anti-inflammatory role in a pathophysiological condition mediated by inflammation.

  1. WOMAC Osteoarthritis Index--additional dimensions for use in subjects with post-traumatic osteoarthritis of the knee. Western Ontario and MacMaster Universities

    DEFF Research Database (Denmark)

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

    1999-01-01

    To compare the sensitivity of WOMAC and the two added dimensions Sport and Recreation Function and Knee Related Quality of Life in subjects with radiographic knee OA to that in controls. To study the influence of age on the reported outcomes....

  2. Prophylactic ankle braces and knee varus-valgus and internal-external rotation torque.

    Science.gov (United States)

    Venesky, Kandy; Docherty, Carrie L; Dapena, Jesus; Schrader, John

    2006-01-01

    Although prophylactic ankle bracing has been shown to be effective in reducing the incidence of ankle sprains,how these ankle braces might affect the other joints of the lower extremity is not clearly understood. To determine the effects of a prophylactic ankle brace on knee joint varus-valgus and internal-external rotation torque during a drop landing onto a slanted surface. A repeated-measures design. Biomechanics research laboratory. Twenty-four physically active college students. Participants were tested in a brace and no brace condition. We measured 3 dependent variables:(1) peak ankle inversion-eversion torque, (2) peak knee varus-valgus torque, and (3) peak knee internal-external rotation torque. A force plate was used to collect ground reaction force data, and 6 motion analysis cameras collected kinematic data during the unilateral drop landing. An adjustable bar was hung from the ceiling, and a slant board was positioned over the center of the force plate, so that the ankle of the participant's dominant leg would invert upon landing. Peak torque was measure din both the brace and no-brace conditions. The average of the peak values in 3 trials for both conditions was used for the statistical analysis. Ankle eversion torque was significantly greater in the brace condition (F1,23 19.75, P external rotation torque was significantly greater in the brace condition(F1,23 4.33, P external rotation torque increased when the ankle was braced.

  3. Effect of neuroscience education on subjects with chronic knee pain related to osteoarthritis: a randomized controlled trial

    OpenAIRE

    Lluch Girbés, Enrique Juan

    2017-01-01

    In this PhD study, the evidence for the role of central pain mechanisms in people with OA was investigated by means of a narrative and a systematic review of the existent literature. In addition, clinical criteria for recognizing central sensitization in subjects with knee OA are discussed as well as the rationale for a comprehensive integrative treatment program including pain neuroscience education and manual therapy for this population. Clinicians may find some practical problems when comb...

  4. Glucosamine-containing supplement improves locomotor functions in subjects with knee pain – a pilot study of gait analysis

    Directory of Open Access Journals (Sweden)

    Kanzaki N

    2016-06-01

    Full Text Available Noriyuki Kanzaki,1 Yuta Otsuka,1 Takayuki Izumo,1 Hiroshi Shibata,1 Hideyuki Nagao,2 Keita Ogawara,3 Hiroshi Yamada,3 Seiji Miyazaki,3 Yutaka Nakamura3 1Institute for Health Care Science, Suntory Wellness Ltd, Seika-cho, Soraku-gun, Kyoto, Japan; 2Research Institute of Sports Medical Science, Tokai University, Hiratsuka, Kanagawa, Japan; 3School of Physical Education, Tokai University, Hiratsuka, Kanagawa, Japan Background: Previously, we demonstrated that glucosamine-containing supplementation was effective for improving locomotor functions, especially walking speed. However, the biomechanical mechanism of efficacy has not been elucidated. This study aimed to address this challenge in subjects with knee pain, using a motion capture system. Methods: An open label study was conducted in 30 Japanese subjects with knee pain. The subjects were administered a daily supplement containing 1,200 mg of glucosamine hydrochloride, 60 mg of chondroitin sulfate, 45 mg of type II collagen peptides, 90 mg of quercetin glycosides, 10 mg of imidazole peptides, 1 mg of proteoglycan, and 5 µg of vitamin D (GCQID. The intervention continued for 16 weeks. Efficacy for locomotor functions involving the knee joint was evaluated mainly using the Japanese Knee Osteoarthritis Measure (JKOM and the 5-question Geriatric Locomotive Function Scale (GLFS-5. To examine the biomechanical mechanism of efficacy for locomotor functions, motions of subjects in a normal walking state were captured. Gait analysis was conducted and efficacy for gait parameters such as normal walking speed, stride length, cadence, and angle of soles was evaluated. Results: GCQID significantly improved total scores on the JKOM and GLFS-5. In gait analysis, normal walking speed, stride length, and angle of soles at the end of the stance phase were all significantly increased, but cadence did not change significantly during the intervention period. There were significant intercorrelations of changes in

  5. International comparative evaluation of knee replacement with fixed or mobile-bearing posterior-stabilized prostheses.

    Science.gov (United States)

    Graves, Stephen; Sedrakyan, Art; Baste, Valborg; Gioe, Terence J; Namba, Robert; Martínez Cruz, Olga; Stea, Susanna; Paxton, Elizabeth; Banerjee, Samprit; Isaacs, Abby J; Robertsson, Otto

    2014-12-17

    Posterior-stabilized total knee prostheses were introduced to address instability secondary to loss of posterior cruciate ligament function, and they have either fixed or mobile bearings. Mobile bearings were developed to improve the function and longevity of total knee prostheses. In this study, the International Consortium of Orthopaedic Registries used a distributed health data network to study a large cohort of posterior-stabilized prostheses to determine if the outcome of a posterior-stabilized total knee prosthesis differs depending on whether it has a fixed or mobile-bearing design. Aggregated registry data were collected with a distributed health data network that was developed by the International Consortium of Orthopaedic Registries to reduce barriers to participation (e.g., security, proprietary, legal, and privacy issues) that have the potential to occur with the alternate centralized data warehouse approach. A distributed health data network is a decentralized model that allows secure storage and analysis of data from different registries. Each registry provided data on mobile and fixed-bearing posterior-stabilized prostheses implanted between 2001 and 2010. Only prostheses associated with primary total knee arthroplasties performed for the treatment of osteoarthritis were included. Prostheses with all types of fixation were included except for those with the rarely used reverse hybrid (cementless tibial and cemented femoral components) fixation. The use of patellar resurfacing was reported. The outcome of interest was time to first revision (for any reason). Multivariate meta-analysis was performed with linear mixed models with survival probability as the unit of analysis. This study includes 137,616 posterior-stabilized knee prostheses; 62% were in female patients, and 17.6% had a mobile bearing. The results of the fixed-effects model indicate that in the first year the mobile-bearing posterior-stabilized prostheses had a significantly higher hazard

  6. Can pain influence the proprioception and the motor behavior in subjects with mild and moderate knee osteoarthritis?

    Science.gov (United States)

    de Oliveira, Daniela C Silveira; Barboza, Saulo Delfino; da Costa, Franciele Dias; Cabral, Monnique Ponciano; Silva, Vanessa Martins Pereira; Dionisio, Valdeci Carlos

    2014-09-27

    Osteoarthritis (OA) is a chronic disease, usually characterized by pain, which is associated with reduced muscle strength, disability and progressive loss of function. However, the pain influence over proprioception and motor behaviour remains unclear. Thus, the purpose of the study was to identify the levels of pain, the proprioceptive acuity and the pattern of muscle recruitment during stair ascent and descent in elderly patients with mild and moderate osteoarthritis (OA) compared to healthy subjects. The study participants included 11 healthy elderly subjects (7 women and 4 men) and 31 elderly patients with knee OA (19 women and 12 men). The functional capacity was assessed by the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index; the pain was evaluated by Wong-Baker faces pain rating scale (WBS) and pressure pain threshold (PPT); the proprioceptive acuity was based on the joint position sense evaluated by electrogoniometer; and the electromyographic (EMG) activity of the major muscles of the lower limb were evaluated during a task of stair ascent and descent of 15 cm. For statistical analysis it was used Statistic for Windows software (StatSoft Inc., version 5.0). Data from the WOMAC index, WBS, the proprioceptive acuity and IEMG (for each muscle in each phase) were analyzed using the Mann-Whitney U test and data from PPT was used Kruskal-Wallis test. Higher scores were found in the WOMAC index and WBS whereas lower scores were seen in PPT in patients with knee OA compared to healthy subjects. In contrast, there were no significant differences in the proprioceptive acuity and EMG results of most muscles analyzed between the groups. The presence of pain does not influence the proprioception and the motor behavior of the thigh muscles during stair ascent and descent in subjects with mild and moderate knee OA.

  7. The Effect of Knee Braces on Quadriceps Strength and Inhibition in Subjects With Patellofemoral Osteoarthritis.

    Science.gov (United States)

    Callaghan, Michael J; Parkes, Matthew J; Felson, David T

    2016-01-01

    Secondary analysis of a randomized controlled trial. The use of external supports has been questioned because they may lead to weakness in the surrounding muscles. To our knowledge, there is no investigation into the effect of knee supports or braces on quadriceps muscle strength and quadriceps inhibition in individuals with patellofemoral joint (PFJ) osteoarthritis (OA). To investigate the effects of a flexible knee support on quadriceps maximum voluntary contraction (MVC) and arthrogenous muscle inhibition (AMI) in patients with PFJ OA. The study included 108 participants who had at least 3 months of patellofemoral pain and a Kellgren-Lawrence score of 2 or 3 for PFJ OA. The participants were randomized to a group that wore a flexible knee support (brace) or a group that did not wear a support (no brace) in a 6-week randomized controlled trial, followed by an open-label trial, in which all participants wore the brace for a total of 12 weeks. Quadriceps MVC, measured isometrically, and quadriceps AMI, measured by twitch interpolation, were assessed at the 6-week and 12-week time points. After 6 weeks, MVC did not differ between the brace and no-brace groups (9.09 Nm; 95% confidence interval [CI]: -4.89, 23.07; P = .20). Arthrogenous muscle inhibition significantly decreased in the brace group (-8.62%; 95% CI: -13.90%, -3.33%; P = .002). After 12 weeks, in all of the participants who wore a flexible knee support, MVC increased by 7.98 Nm (95% CI: 2.52, 13.45; P = .004) and AMI decreased (-8.42%; 95% CI: -11.48%, -5.36%; Pknee support in participants with PFJ OA does not have an adverse effect on quadriceps MVC or AMI. Using a knee support should not be discouraged because of concerns about deleterious effects on quadriceps strength and inhibition. Therapy, level 1b.

  8. Effect of an ankle-foot orthosis on knee joint mechanics: a novel conservative treatment for knee osteoarthritis.

    Science.gov (United States)

    Fantini Pagani, Cynthia H; Willwacher, Steffen; Benker, Rita; Brüggemann, Gert-Peter

    2014-12-01

    Several conservative treatments for medial knee osteoarthritis such as knee orthosis and laterally wedged insoles have been shown to reduce the load in the medial knee compartment. However, those treatments also present limitations such as patient compliance and inconsistent results regarding the treatment success. To analyze the effect of an ankle-foot orthosis on the knee adduction moment and knee joint alignment in the frontal plane in subjects with knee varus alignment. Controlled laboratory study, repeated measurements. In total, 14 healthy subjects with knee varus alignment were analyzed in five different conditions: without orthotic, with laterally wedged insoles, and with an ankle-foot orthosis in three different adjustments. Three-dimensional kinetic and kinematic data were collected during gait analysis. Significant decreases in knee adduction moment, knee lever arm, and joint alignment in the frontal plane were observed with the ankle-foot orthosis in all three different adjustments. No significant differences could be found in any parameter while using the laterally wedged insoles. The ankle-foot orthosis was effective in reducing the knee adduction moment. The decreases in this parameter seem to be achieved by changing the knee joint alignment and thereby reducing the knee lever arm in the frontal plane. This study presents a novel approach for reducing the load in the medial knee compartment, which could be developed as a new treatment option for patients with medial knee osteoarthritis. © The International Society for Prosthetics and Orthotics 2013.

  9. E-wars, an increasing subject in international journalism

    OpenAIRE

    Caminos Marcet, José María; Armentia Vizuete, José Ignacio; Marín Murillo, Flora

    2013-01-01

    The aim of this article is to point out the main difficulties that journalists of international information have to discuss about the subject of the cyber wars (e-wars) or cyber attacks, difficulties who obviously are transferred to the audiences. Indeed, new technologies of information and communication have developed their own destructive capability in the form of cyber-attacks. These can be applied to other conflicts or establish their own strategies for foggy actors ranging from superpowe...

  10. Comparison of mobility and user satisfaction between a microprocessor knee and a standard prosthetic knee: a summary of seven single-subject trials.

    Science.gov (United States)

    Howard, Charla L; Wallace, Chris; Perry, Bonnie; Stokic, Dobrivoje S

    2018-03-01

    Insufficient evidence of the benefits provided by costlier microprocessor knees (MPKs) over nonmicroprocessor knees (NMPKs) often causes concern when considering MPK prescription. Thus, more studies are needed to demonstrate differences between MPKs and NMPKs and define sensitive outcomes to guide MPK prescription. The aim of this study was to evaluate the impact of switching from NMPK to MPK on measures of mobility and preference. Seven long-term NMPK users (all men, ages 50-84, 3-64 years postamputation) participated in this study, which use a single-subject design (ABA or BAB; A=NMPK, B=MPK). Mobility was assessed with the Amputee Mobility Predictor, Berg Balance Scale (BBS), L-Test, 6-Min Walk Test (6MWT) with Physiological Cost Index, and self-selected normal and very fast gait speeds. The preference between NMPK and MPK was evaluated by the Prosthesis Evaluation Questionnaire (PEQ) and the visual analog scale. Mobility improved with the MPK in six of seven participants, which was most often captured with BBS (median: +6 points) and 6MWT (median: +63 m). These improvements typically exceeded minimal clinically important difference or minimal detectable change thresholds. Most participants scored the MPK higher on the PEQ (median: +20 points) and six of seven expressed a global preference toward MPK. In the BAB group, the Amputee Mobility Predictor and BBS correlated with perception of change on several PEQ domains (Ρ≥0.59). In conclusion, MPKs may provide better outcomes and user satisfaction, particularly in those with lower mobility function. BBS and 6MWT were found to be the most sensitive measures to capture changes in mobility while using MPK for several weeks.

  11. Comparative effects of pulsed and continuous short wave diathermy on pain and selected physiological parameters among subjects with chronic knee osteoarthritis.

    Science.gov (United States)

    Teslim, Onigbinde Ayodele; Adebowale, Adenle Charles; Ojoawo, Adesola Ojo; Sunday, Odejide Akinwole; Bosede, Arilewola

    2013-01-01

    The purposes of this study were to compare the effects of pulsed and continuous short wave diathermy on pain, range of motion, pulse rate and skin temperature in subjects with chronic knee osteoarthritis. 24 Participants with grade 111 OA of the knee were randomly selected into CSWD and PSWD groups. Pre and post treatment parameters were recorded at onset and the end of 4th week. ANO VA, independent, paired t-test and chi-square were used to analyze the data. The pain experienced by participants in the CSWD group was significantly lower than that of the PSWD groups (P effective than PSWD in alleviating pain and in increasing knee flexion range of motion among subjects with chronic knee OA. Also, a mild elevation of skin temperature was able to elicit physiological effects that could exert therapeutic effects.

  12. The effect of valgus braces on medial compartment load of the knee joint - in vivo load measurements in three subjects.

    Science.gov (United States)

    Kutzner, Ines; Küther, Steffen; Heinlein, Bernd; Dymke, Jörn; Bender, Alwina; Halder, Andreas M; Bergmann, Georg

    2011-04-29

    Knee osteoarthritis occurs predominately at the medial compartment. To unload the affected compartment, valgus braces are used which induce an additional valgus moment in order to shift the load more laterally. Until now the biomechanical effect of braces was mainly evaluated by measuring changes in external knee adduction moments. The aim of this study was to investigate if and to which extent the medial compartment load is reduced in vivo when wearing valgus braces. Six components of joint contact load were measured in vivo in three subjects, using instrumented, telemeterized knee implants. From the forces and moments the medio-lateral force distribution was calculated. Two braces, MOS Genu (Bauerfeind AG) and Genu Arthro (Otto Bock) were investigated in neutral, 4° and 8° valgus adjustment during walking, stair ascending and descending. During walking with the MOS brace in 4°/8° valgus adjustment, medial forces were reduced by 24%/30% on average at terminal stance. During walking with the GA in the 8° valgus position, medial forces were reduced by only 7%. During stair ascending/descending significant reductions of 26%/24% were only observed with the MOS (8°). The load reducing ability of the two investigated valgus braces was confirmed in three subjects. However, the load reduction depends on the brace stiffness and its valgus adjustment and varies strongly inter-individually. Valgus adjustments of 8° might, especially with the MOS brace, not be tolerated by patients for a long time. Medial load reductions of more than 25% can therefore probably not be expected in clinical practise. Copyright © 2011 Elsevier Ltd. All rights reserved.

  13. Neither International nor Global: Rethinking the Problematic Subject of Security

    Directory of Open Access Journals (Sweden)

    David Chandler

    2010-09-01

    Full Text Available This paper argues that the problematic of the international and the global has been a barrier to understanding the transformation of security discourse over the last decade. Academic treatments of security within the discipline of international relations have been structured by the traditional liberal binaries, which conceive of political communities capable of constituting securing subjects at either the level of the state or the global. Today’s dominant framing of the security problematic seems to evade easy articulation within this structure and in some readings is seen to presage a transitory stage from the international to the global. An alternative reading is sketched out here, that of the post- liberal, which suggests that the apparent shift towards the global can not be captured from within the liberal problematic and highlights that rather than traditional disagreements over the nature of the subject of security – the constitution of the securing actor – we are witnessing the disappearance of securing agency itself.

  14. The effect of kinesiology tape on knee proprioception in healthy subjects.

    Science.gov (United States)

    Torres, Rui; Trindade, Raquel; Gonçalves, Rui Soles

    2016-10-01

    Kinesiology tape can improve athletic performance; however, due to cutaneous stimulation its application can have an influence on proprioception. To determine the effects of kinesiology tape on knee proprioception applied to quadriceps, namely in the joint position sense (JPS) and in the threshold to detect passive movement (TTDPM), both immediately after and 24 h after its application. Thirty young healthy participants were randomly divided into experimental and control group. In the experimental group, a kinesiology tape on the quadriceps muscle was applied. The JPS and the TTDPM of the knee was assessed before, immediately after and 24 h after the kinesiology tape intervention. No significant differences were found in the assessment made before intervention. The Friedman Test showed that kinesiology tape had no influence on JPS in either group over time (p > 0.05). However, the TTDPM decreased significantly immediately after and 24 h after its application (p < 0.05). Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. The relationship between pain catastrophizing, kinesiophobia and subjective knee function during rehabilitation following anterior cruciate ligament reconstruction and meniscectomy: A pilot study.

    Science.gov (United States)

    Tichonova, Ana; Rimdeikienė, Inesa; Petruševičienė, Daiva; Lendraitienė, Eglė

    2016-01-01

    Psychological responses to the initial injury and rehabilitation might be an important additional determinant of functional level outcomes after knee surgery. The objectives of this study were (1) to measure pain catastrophizing and kinesiophobia levels and (2) determine their association with self-reported subjective knee function during rehabilitation, following anterior cruciate ligament reconstruction (ACLR) and meniscectomy. The study involved 41 participants. The levels of catastrophizing (Pain Catastrophizing Scale [PCS]), kinesiophobia (Tampa Scale of Kinesiophobia [TSK-11]), pain (Numeric Pain Rating Scale [NRS]), and subjective knee function (the Knee Injury and Osteoarthritis Outcome Score [KOOS]) were assessed before and after completion of 14-session rehabilitation program. The mean level of catastrophizing changed from 5.8 (SD, 0.9) to 4.2 (SD, 0.5) during rehabilitation (Pkinesiophobia changed from 22.7 (SD, 0.7) to 18.4 (SD, 0.6) (Pkinesiophobia decreased during rehabilitation. A higher pain catastrophizing level correlated with a greater level of knee pain during activities, more difficulties experienced during daily activities before and after rehabilitation. A high level of kinesiophobia correlated with more difficulties experienced in daily activities and poorer knee-related quality of life before and after rehabilitation. Copyright © 2016 The Lithuanian University of Health Sciences. Production and hosting by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  16. Gait and balance of transfemoral amputees using passive mechanical and microprocessor-controlled prosthetic knees.

    Science.gov (United States)

    Kaufman, K R; Levine, J A; Brey, R H; Iverson, B K; McCrady, S K; Padgett, D J; Joyner, M J

    2007-10-01

    Microprocessor-controlled knee joints appeared on the market a decade ago. These joints are more sophisticated and more expensive than mechanical ones. The literature is contradictory regarding changes in gait and balance when using these sophisticated devices. This study employed a crossover design to assess the comparative performance of a passive mechanical knee prosthesis compared to a microprocessor-controlled knee joint in 15 subjects with an above-knee amputation. Objective measurements of gait and balance were obtained. Subjects demonstrated significantly improved gait characteristics after receiving the microprocessor-controlled prosthetic knee joint (pknee to a flexed knee during loading response which resulted in a change from an internal knee flexor moment to a knee extensor moment. The participants' balance also improved (pmicroprocessor-controlled knee have significant improvements in gait and balance.

  17. Comparison of Antagonist Muscle Activity During Walking Between Total Knee Replacement and Control Subjects Using Unnormalized Electromyography.

    Science.gov (United States)

    Lundberg, Hannah J; Rojas, Idubijes L; Foucher, Kharma C; Wimmer, Markus A

    2016-06-01

    Although satisfactory outcomes have been reported after total knee replacement (TKR), full recovery of muscle strength and physical function is rare. We developed a relative activation index (RAI) to compare leg muscle activity from unnormalized surface electromyography (sEMG) between TKR and control subjects. Nineteen TKR and 19 control subjects underwent gait analysis and sEMG. RAIs were calculated by dividing the average sEMG for 2 consecutive subphases of stance defined by the direction of the external sagittal plane moment (flexion or extension). RAIs and external moments indicate TKR subjects have less initial stance antagonist rectus femoris activity (P = .004), greater middle stance antagonist biceps femoris activity (P < .001), and less late stance agonist biceps femoris activity (P < .001) than control subjects. Individuals with TKR demonstrate increased flexor muscle activation during weight bearing, potentially contributing to altered gait patterns found during the stance phase of gait. The RAI helps detail whether decreased external moments correspond to less agonist or more antagonist muscle activity to determine true muscle activity differences between subject groups. Identifying the mechanisms underlying altered muscle function both before and after TKR is critical for developing rehabilitation strategies to address functional deficits and disability found in this patient population. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Weight loss is effective for symptomatic relief in obese subjects with knee osteoarthritis independently of joint damage severity assessed by high-field MRI and radiography.

    Science.gov (United States)

    Gudbergsen, H; Boesen, M; Lohmander, L S; Christensen, R; Henriksen, M; Bartels, E M; Christensen, P; Rindel, L; Aaboe, J; Danneskiold-Samsøe, B; Riecke, B F; Bliddal, H

    2012-06-01

    With an increasing prevalence of older and obese citizens, the problems of knee osteoarthritis (KOA) will escalate. Weight loss is recommended for obese KOA patients and in a majority of cases this leads to symptomatic relief. We hypothesized that pre-treatment structural status of the knee joint, assessed by radiographs, 1.5 T magnetic resonance imaging (MRI) and knee-joint alignment, may influence the symptomatic changes following a significant weight reduction. Patients were recruited from a Department of Rheumatology. Eligibility criteria were age above 50 years, body mass index ≥ 30 kg/m(2), primary KOA diagnosed according to the American College of Rheumatology (ACR) criteria and having verified structural damage. Patients underwent a 16 weeks dietary programme with formula products and counselling. MRI and radiographs of the most symptomatic knee were obtained at baseline and assessed for structural damage using the Boston-Leeds Osteoarthritis of the Knee Score, minimum joint space width and Kellgren-Lawrence score. Imaging variables, muscle strength and degree of alignment, were examined as predictors of changes in Knee Osteoarthritis Outcome Score (KOOS) and Outcome Measures in Rheumatoid Arthritis Clinical Trials (OMERACT) - Osteoarthritis Research Society International (OARSI) Responder Criterion. Structural damage at baseline assessed by imaging, muscle strength or knee-joint alignment showed no statistically significant association to changes in KOOS pain and function in daily living (r ≤ 0.13; P>0.05) or the OMERACT-OARSI Responder Criterion (OR 0.48-1.68; P-values ≥ 0.13). Presence of joint damage did not preclude symptomatic relief following a clinically relevant weight loss in older obese patients with KOA. Neither muscle strength nor knee-joint alignment was associated with the degree of symptomatic relief. Copyright © 2012 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  19. Interleukin-6 and tumor necrosis factor alpha in synovial fluid are associated with progression of radiographic knee osteoarthritis in subjects with previous meniscectomy.

    Science.gov (United States)

    Larsson, S; Englund, M; Struglics, A; Lohmander, L S

    2015-11-01

    To explore potential associations between proinflammatory cytokines in synovial fluid and progression of osteoarthritis (OA) in meniscectomized subjects. We studied 132 subjects on average 18 years after meniscectomy, with a second examination 4-10 years later. We measured concentrations of interleukin (IL)-6, -8 and tumor necrosis factor (TNF)-α by multiplex immunoassay, graded radiographic features of tibiofemoral and patellofemoral OA according to the Osteoarthritis Research Society International (OARSI) atlas, scored patient-reported outcomes using the Knee Injury and Osteoarthritis Outcome Score (KOOS), and used logistic regression (adjusted for age, gender, body mass index, and time between examinations) for assessment of associations. Higher first examination concentrations of IL-6 and TNF-α were associated with increased risk for subsequent osteophyte progression (odds ratios (OR); 95% confidence intervals 1.05; 1.00-1.09 and 1.35; 1.03-1.75). Higher second examination concentrations of TNF-α were associated with having progressed in loss of joint space (OR 1.70; 1.15-2.52) or having worsened in the activity of daily living subscale of KOOS (OR 1.50; 1.07-2.09) in the preceding years. Subjects with increasing concentrations of IL-6 or TNF-α between examinations were five times more likely to have progressed in joint space narrowing between the same examinations, as compared to those with stable or decreasing concentrations (OR 5.17; 1.54-17.32 and 5.01; 1.32-18.92). In subjects with previous meniscectomy, higher or over time increasing synovial fluid levels of IL-6 and TNF-α seems to be associated with increased risk for progression of radiographic OA. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  20. Monte Carlo modelling for in vivo measurements of americium in a knee voxel phantom: general criteria for an international comparison

    Energy Technology Data Exchange (ETDEWEB)

    Gomez-Ros, J.M.; Lis, M.; Lopez, M.A.; Moraleda, M. [CIEMAT, Avenida Complutense 22, E-28040 Madrid (Spain); Carlan, L. de [CEA DRT/LIST/DETECS/LNHB/LMD, Bat 534, F-91191 Gif sur Yvette Cedex (France); Franck, D. [IRSN DRPH/SDI/LEDI, BP6, F-92262 Fontenay-aux-Roses Cedex (France); Gualdrini, G. [ENEA ION-IRP, Via dei Colli 16, I-40136 Bologna (Italy); Zankl, M. [GSF - National Research Center for Environment and Health, D-85764 Neuherberg (Germany)

    2007-07-01

    The general criteria and the scientific approach adopted for an 'International comparison on Monte Carlo modelling for in vivo measurement of Americium in a knee phantom' that is being organised within the EU Coordination Action CONRAD (Coordinated Network for Radiation Dosimetry) are described her. Detection system and a knee voxel phantom based on a computerised axial tomography of the Spitz anthropometric knee phantom with a homogeneous distribution of {sup 241}Am in bone have been considered for the simulation of three specific situations: (a) a single Low Energy Germanium detector for a point {sup 241}Am source in air; (b) the calculation of photon fluence spectra in air around the voxel phantom; and (c) the calculation of the energy distribution of pulses and peak detection efficiency in the real detection system geometry. (authors)

  1. No differences in subjective knee function between surgical techniques of anterior cruciate ligament reconstruction at 2-year follow-up: a cohort study from the Swedish National Knee Ligament Register.

    Science.gov (United States)

    Hamrin Senorski, Eric; Sundemo, David; Murawski, Christopher D; Alentorn-Geli, Eduard; Musahl, Volker; Fu, Freddie; Desai, Neel; Stålman, Anders; Samuelsson, Kristian

    2017-12-01

    The purpose of this study was to investigate how different techniques of single-bundle anterior cruciate ligament (ACL) reconstruction affect subjective knee function via the Knee injury and Osteoarthritis Outcome Score (KOOS) evaluation 2 years after surgery. It was hypothesized that the surgical techniques of single-bundle ACL reconstruction would result in equivalent results with respect to subjective knee function 2 years after surgery. This cohort study was based on data from the Swedish National Knee Ligament Register during the 10-year period of 1 January 2005 through 31 December 2014. Patients who underwent primary single-bundle ACL reconstruction with hamstrings tendon autograft were included. Details on surgical technique were collected using a web-based questionnaire comprised of essential AARSC items, including utilization of accessory medial portal drilling, anatomic tunnel placement, and visualization of insertion sites and landmarks. A repeated measures ANOVA and an additional linear mixed model analysis were used to investigate the effect of surgical technique on the KOOS4 from the pre-operative period to 2-year follow-up. A total of 13,636 patients who had undergone single-bundle ACL reconstruction comprised the study group for this analysis. A repeated measures ANOVA determined that mean subjective knee function differed between the pre-operative time period and at 2-year follow-up (p technique or gender. Additionally, the linear mixed model adjusted for age at reconstruction, gender, and concomitant injuries showed no difference between surgical techniques in KOOS4 improvement from baseline to 2-year follow-up. However, KOOS4 improved significantly in patients for all surgical techniques of single-bundle ACL reconstruction (p techniques of primary single-bundle ACL reconstruction did not demonstrate differences in the improvement in baseline subjective knee function as measured with the KOOS4 during the first 2 years after surgery. However

  2. Internal derangement of the knee after ipsilateral femoral shaft fracture: MR imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Blacksin, M.F.; Zurlo, J.V. [Department of Radiology, University of Medicine and Dentistry of New Jersey, Newark, NJ (United States); Levy, A.S. [Department of Orthopedic Surgery, University of Medicine and Dentistry of New Jersey, University Hospital, Newark, NJ 07103-2426 (United States)

    1998-08-01

    Objective. This study uses magnetic resonance (MR) imaging to delineate the types and frequencies of injuries seen in the knee after ipsilateral femoral shaft fracture. We also compare the results of the orthopedic knee examination with the MR findings. Design and patients. MR imaging of the ipsilateral knee was performed on 34 patients with closed femoral shaft fractures. Indications for knee MR imaging included knee pain at the time of fracture, soft tissue swelling or an effusion of the knee, or a positive knee examination under anesthesia. The patients had a mean age of 27 years and all were stabilized with intramedullary nails. Imaging was performed a mean time of 2.5 days after surgery. All patients had knee examinations done under anesthesia, and the MR results were compiled and compared with the clinical examinations. Results. Ninety-seven percent of patients demonstrated knee effusions. Twenty-seven percent of patients demonstrated meniscal tears, with the posterior horn of the medial meniscus most frequently torn. The medial collateral ligament was the most frequent site of ligamentous injury (38%) followed by the posterior cruciate ligament (21%). Fifty percent of patients had injuries of the extensor mechanism. Bone bruises were noted in 32% of patients. Articular cartilage injuries were confined to the patella in four cases. One occult tibial plateau fracture and one meniscocapsular separation were seen. Conclusions. There is a common incidence of both ligamentous and meniscal injury to the knee after ipsilateral femoral shaft fracture. MR imaging can be useful in assessing the extent of injury, and may reveal findings unsuspected after clinical examination of the knee. (orig.) With 4 figs., 2 tabs., 13 refs.

  3. Evaluation of unipodal stance in knee osteoarthritis patients using knee accelerations and center of pressure.

    Science.gov (United States)

    Turcot, K; Hagemeister, N; de Guise, J A; Aissaoui, R

    2011-03-01

    This study aims to compare knee joint instability and postural impairments during the performance of a unipodal stance task between patients having knee osteoarthritis (OA) and healthy elderly subjects using knee accelerations and center of pressure (COP) measurements. Twenty patients with medial knee OA and nine healthy individuals participated in this study. Three-dimensional (3D) knee joint accelerations and COP were measured during unipodal stance. The range and the root mean square (RMS) were extracted from medial lateral (ML) and anterior-posterior (AP) knee accelerations, whereas sway area, velocity, and ML and AP ranges were measured from the COP. The average parameters of three trials for each subject were compared between groups. Results show that knee OA patients exhibited a significantly higher range of knee acceleration in both ML (0.22±0.08 g vs 0.15±0.05 g) and AP (0.17±0.06 g vs 0.06±0.01 g) directions and a lower COP velocity (136.6±22.3 mm/s vs 157.6±18.4 mm/s) than did the healthy age-matched group. Significant correlations between the COP and knee acceleration parameters were also obtained. This study confirmed that patients with knee OA displayed greater body sway than did able-bodied subjects. Moreover, using an accelerometric-based method, this study highlighted the higher knee joint instability in the frontal and sagittal planes in knee OA patients compared with able-bodied subjects during a unipodal standing task. Copyright © 2010 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  4. Assessment of Knee Proprioception in the Anterior Cruciate Ligament Injury Risk Position in Healthy Subjects: A Cross-sectional Study

    OpenAIRE

    Mir, Seyed Mohsen; Talebian, Saeed; Naseri, Nasrin; Hadian, Mohammad-Reza

    2014-01-01

    [Purpose] Knee joint proprioception combines sensory input from a variety of afferent receptors that encompasses the sensations of joint position and motion. Poor proprioception is one of the risk factors of anterior cruciate ligament injury. Most studies have favored testing knee joint position sense in the sagittal plane and non-weight-bearing position. One of the most common mechanisms of noncontact anterior cruciate ligament injury is dynamic knee valgus. No study has measured joint posit...

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

    Directory of Open Access Journals (Sweden)

    Kanzaki N

    2015-10-01

    Full Text Available Noriyuki Kanzaki,1 Yoshiko Ono,1 Hiroshi Shibata,1 Toshio Moritani2 1Institute for Health Care Science, Suntory Wellness Ltd, Seika-cho, Soraku-gun, 2Graduate School of Human and Environmental Studies, Kyoto University, Sakyo-ku, Kyoto, Japan Background: The aim of this study was to investigate the ability of a glucosamine-containing supplement to improve locomotor functions in subjects with knee pain.Methods: A randomized, double-blind, placebo-controlled, parallel-group comparative study was conducted for 16 weeks in 100 Japanese subjects (age, 51.8±0.8 years with knee pain. Subjects were randomly assigned to one of the two supplements containing 1 1,200 mg of glucosamine hydrochloride, 60 mg of chondroitin sulfate, 45 mg of type II collagen peptides, 90 mg of quercetin glycosides, 10 mg of imidazole peptides, and 5 µg of vitamin D per day (GCQID group, n=50 or 2 a placebo (placebo group, n=50. Japanese Knee Osteoarthritis Measure, visual analog scale score, normal walking speed, and knee-extensor strength were measured to evaluate the effects of the supplement on knee-joint functions and locomotor functions.Results: In subjects eligible for efficacy assessment, there was no significant group × time interaction, and there were improvements in knee-joint functions and locomotor functions in both groups, but there was no significant difference between the groups. In subjects with mild-to-severe knee pain at baseline, knee-extensor strength at week 8 (104.6±5.0% body weight vs 92.3±5.5% body weight, P=0.030 and the change in normal walking speed at week 16 (0.11±0.03 m/s vs 0.05±0.02 m/s, P=0.038 were significantly greater in the GCQID group than in the placebo group. Further subgroup analysis based on Kellgren–Lawrence (K–L grade showed that normal walking speed at week 16 (1.36±0.05 m/s vs 1.21±0.02 m/s, P<0.05 was significantly greater in the GCQID group than in the placebo group in subjects with K–L grade I. No

  6. The Effect of Upper Body Mass and Initial Knee Flexion on the Injury Outcome of Post Mortem Human Subject Pedestrian Isolated Legs.

    Science.gov (United States)

    Petit, Philippe; Trosseille, Xavier; Dufaure, Nicolas; Dubois, Denis; Potier, Pascal; Vallancien, Guy

    2014-11-01

    In the ECE 127 Regulation on pedestrian leg protection, as well as in the Euro NCAP test protocol, a legform impactor hits the vehicle at the speed of 40 kph. In these tests, the knee is fully extended and the leg is not coupled to the upper body. However, the typical configuration of a pedestrian impact differs since the knee is flexed during most of the gait cycle and the hip joint applies an unknown force to the femur. This study aimed at investigating the influence of the inertia of the upper body (modelled using an upper body mass fixed at the proximal end of the femur) and the initial knee flexion angle on the lower limb injury outcome. In total, 18 tests were conducted on 18 legs from 9 Post Mortem Human Subjects (PMHS). The principle of these tests was to impact the leg at 40 kph using a sled equipped with 3 crushing steel tubes, the stiffness of which were representative of the front face of a European sedan (bonnet leading edge, bumper and spoiler). The mass of the equipped sled was 74.5 kg. The test matrix was designed to perform 4 tests in 4 configurations combining two upper body masses (either 0 or 3 kg) and two knee angles (0 or 20 degrees) at 40 kph (11 m/s) plus 2 tests at 9 m/s. Autopsies were performed on the lower limbs and an injury assessment was established. The findings of this study were first that the increase of the upper body mass resulted in more severe injuries, second that an initial flexion of the knee, corresponding to its natural position during the gait cycle, decreased the severity of the injuries, and third that based on the injury outcome, a test conducted with no upper body mass and the knee fully extended was as severe as a test conducted with a 3 kg upper body mass and an initial knee flexion of 20°.

  7. Internal femoral component rotation adversely influences load transfer in total knee arthroplasty: a cadaveric navigated study using the Verasense device.

    Science.gov (United States)

    Manning, William A; Ghosh, Kanishka M; Blain, Alasdair; Longstaff, Lee; Rushton, Steven P; Deehan, David J

    2017-07-15

    Correct femoral component rotation at knee arthroplasty influences patellar tracking and may determine function at extremes of movement. Additionally, such malrotation may deleteriously influence flexion/extension gap geometry and soft tissue balancing kinematics. Little is known about the effect of subtle rotational change upon load transfer across the tibiofemoral articulation. Our null hypothesis was that femoral component rotation would not influence load across this joint in predictable manner. A cadaveric study was performed to examine load transfer using the orthosensor device, respecting laxity patterns in 6° of motion, to examine load across the medial and lateral compartments across a full arc of motion. Mixed-effect modelling allowed for quantification of the effect upon load with internal and external femoral component rotation in relation to a datum in a modern single-radius cruciate-retaining primary knee design. No significant change in maximal laxity was found between different femoral rotational states. Internal rotation of the femoral component resulted in significant increase in medial compartment load transfer for knee flexion including and beyond 60°. External rotation of the femoral component within the limits studied did not influence tibiofemoral load transfer. Internal rotation of the femoral component will adversely influence medial compartment load transfer and could lead to premature polyethylene wear on the medial side.

  8. Interleukin-6 and tumor necrosis factor alpha in synovial fluid are associated with progression of radiographic knee osteoarthritis in subjects with previous meniscectomy

    DEFF Research Database (Denmark)

    Larsson, S; Englund, M; Struglics, A

    2015-01-01

    concentrations of interleukin (IL)-6, -8 and tumor necrosis factor (TNF)-α by multiplex immunoassay, graded radiographic features of tibiofemoral and patellofemoral OA according to the Osteoarthritis Research Society International (OARSI) atlas, scored patient-reported outcomes using the Knee Injury...... (odds ratios (OR); 95% confidence intervals 1.05; 1.00-1.09 and 1.35; 1.03-1.75). Higher second examination concentrations of TNF-α were associated with having progressed in loss of joint space (OR 1.70; 1.15-2.52) or having worsened in the activity of daily living subscale of KOOS (OR 1.50; 1.......07-2.09) in the preceding years. Subjects with increasing concentrations of IL-6 or TNF-α between examinations were five times more likely to have progressed in joint space narrowing between the same examinations, as compared to those with stable or decreasing concentrations (OR 5.17; 1.54-17.32 and 5.01; 1...

  9. Case definitions of knee osteoarthritis in 4,151 unselected subjects: relevance for epidemiological studies : The Copenhagen Osteoarthritis Study

    DEFF Research Database (Denmark)

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

    2010-01-01

    INTRODUCTION: The aims of the present study were threefold: to examine the distribution of knee joint osteoarthritis in a large, standardized radiological study; to examine the relationships between self reported knee pain and radiological OA; and to examine the natural history of radio-morpholog...

  10. Defining an International Standard Set of Outcome Measures for Patients With Hip or Knee Osteoarthritis: Consensus of the International Consortium for Health Outcomes Measurement Hip and Knee Osteoarthritis Working Group

    Science.gov (United States)

    Wissig, Stephanie; van Maasakkers, Lisa; Stowell, Caleb; Ackerman, Ilana; Ayers, David; Barber, Thomas; Benzakour, Thami; Bozic, Kevin; Budhiparama, Nicolaas; Caillouette, James; Conaghan, Philip G.; Dahlberg, Leif; Dunn, Jennifer; Grady‐Benson, John; Ibrahim, Said A.; Lewis, Sally; Malchau, Henrik; Manzary, Mojieb; March, Lyn; Nassif, Nader; Nelissen, Rob; Smith, Noel; Franklin, Patricia D.

    2016-01-01

    Objective To define a minimum Standard Set of outcome measures and case‐mix factors for monitoring, comparing, and improving health care for patients with clinically diagnosed hip or knee osteoarthritis (OA), with a focus on defining the outcomes that matter most to patients. Methods An international working group of patients, arthroplasty register experts, orthopedic surgeons, primary care physicians, rheumatologists, and physiotherapists representing 10 countries was assembled to review existing literature and practices for assessing outcomes of pharmacologic and nonpharmacologic OA therapies, including surgery. A series of 8 teleconferences, incorporating a modified Delphi process, were held to reach consensus. Results The working group reached consensus on a concise set of outcome measures to evaluate patients’ joint pain, physical functioning, health‐related quality of life, work status, mortality, reoperations, readmissions, and overall satisfaction with treatment result. To support analysis of these outcome measures, pertinent baseline characteristics and risk factor metrics were defined. Annual outcome measurement is recommended for all patients. Conclusion We have defined a Standard Set of outcome measures for monitoring the care of people with clinically diagnosed hip or knee OA that is appropriate for use across all treatment and care settings. We believe this Standard Set provides meaningful, comparable, and easy to interpret measures ready to implement in clinics and/or registries globally. We view this set as an initial step that, when combined with cost data, will facilitate value‐based health care improvements in the treatment of hip and knee OA. PMID:26881821

  11. Vitamin D deficiency associates with γ-tocopherol and quadriceps weakness but not inflammatory cytokines in subjects with knee osteoarthritis

    OpenAIRE

    Barker, Tyler; Henriksen, Vanessa T; Victoria E. Rogers; Aguirre, Dale; Trawick, Roy H.; Lynn Rasmussen, G.; Momberger, Nathan G.

    2014-01-01

    Knee osteoarthritis (OA) is a degenerative joint condition and a leading cause of physical disability in the United States. Quadriceps weakness and inflammatory cytokines contribute to the pathogenesis of knee OA, and both of which, increase with vitamin D deficiency. Other micronutrients, such as vitamins C and E and β-carotene, modulate inflammatory cytokines and decrease during inflammation. The purpose of this study was to test the hypothesis that vitamin D deficiency associates with quad...

  12. 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...

  13. Obesity increases the prevalence and severity of focal knee abnormalities diagnosed using 3T MRI in middle-aged subjects - data from the osteoarthritis initiative

    Energy Technology Data Exchange (ETDEWEB)

    Laberge, Marc A.; Baum, Thomas; Virayavanich, Warapat; Nardo, Lorenzo; Link, Thomas M. [University of California San Francisco, Musculoskeletal and Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Nevitt, M.C.; Lynch, J.; McCulloch, C.E. [University of California San Francisco, Department of Epidemiology and Biostatistics, San Francisco, CA (United States)

    2012-06-15

    To study the effect of BMI on the prevalence, severity, and 36-month progression of early degenerative changes in the knee by using 3T MRI in middle-aged subjects without radiographic osteoarthritis (OA). We examined baseline and 36-month follow-up MR studies from 137 middle-aged individuals (45-55 years old) with risk factors for knee OA but no radiographic OA from the Osteoarthritis Initiative. Subjects were grouped into three categories: normal BMI (BMI < 25 kg/m{sup 2}, n = 38), overweight (BMI 25-29.9 kg/m{sup 2}, n = 37), and obese (BMI {>=} 30 kg/m{sup 2}, n = 62). Using 3T MRI, cartilage, meniscus, and bone marrow abnormalities were graded using the OA Whole-organ MR Imaging Score (WORMS). The statistical analysis was corrected as necessary for differences in age, sex, and OA risk factors other than BMI. The overall prevalence of lesions was 64% for meniscus and 79% for cartilage (including low grade lesions). At baseline, the prevalence and severity of knee lesions was positively associated with BMI, with a nearly fourfold increase in meniscal tears and more than twofold increase in high-grade cartilage defects in obese individuals relative to normal-weight subjects. Over the 36-month follow-up period, the number of new or worsening cartilage lesions of any grade was significantly higher in obese subjects (p = 0.039), while there was no significant difference in meniscal lesion progression. Obesity was associated with both higher prevalence and severity of early degenerative changes in the knee in middle-aged individuals without radiographic OA and with significantly increased cartilage lesion progression (of any grade) over 36 months. (orig.)

  14. Knee MRI

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Magnetic Resonance Imaging (MRI) - Knee Magnetic resonance imaging (MRI) of the knee ... of a knee MRI? What is a Knee MRI? MRI of the knee provides detailed images of ...

  15. Runner's Knee

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Runner's Knee KidsHealth / For Teens / Runner's Knee What's in this ... told he had runner's knee. What Is Runner's Knee? Runner's knee is the term doctors use for ...

  16. Validity and internal consistency of a Hausa version of the Ibadan knee/hip osteoarthritis outcome measure

    Directory of Open Access Journals (Sweden)

    Akinpelu Aderonke O

    2008-10-01

    Full Text Available Abstract Background The Ibadan Knee/Hip Osteoarthritis Outcome Measure (IKHOAM was developed for measuring end results of care in patients with knee or hip OA in Nigeria. The purpose of this study was to validate a Hausa translation of IKHOAM in order to promote its use among the Hausa populations of Nigeria and other West African countries. Methods Sixty-seven patients with knee OA, literate in Hausa and English, recruited consecutively from all government hospitals in Kano were assessed on both English and Hausa versions of IKHOAM. The order of assessment with the versions was randomized and separated by 24 hours. Participants also rated their pain intensity on the Visual Analogue Scale. Data was analyzed using the Spearman Rank Order correlation and Cronbach's alpha. Results The participants (17 males, 50 females were aged 55.7 ± 13.4 years. Participants' scores on the Hausa version correlated significantly with the original version (r = 0.67, p = 0.000 and with pain intensity scores on the Visual Analogue Scale (r = -0.24, p = 0.005. The Cronbach's alpha for correlation on the different parts of the Hausa version ranged between 0.28 and 0.95. Conclusion The Hausa version of IKHOAM meets the criteria for validity and internal consistency and may be used in the Hausa speaking parts of Nigeria and other West African countries.

  17. Radiographic evaluation of cervical spine of subjects with temporomandibular joint internal disorder

    OpenAIRE

    Wagner Cesar Munhoz; Amélia Pasqual Marques; José Tadeu Tesseroli de Siqueira

    2004-01-01

    Although the etiopathophysiology of internal temporomandibular joint internal disorders (TMJ ID) is still unknown, it has been suggested that head and body posture could be related to its initial onset, development and perpetuation. The purpose of the present study was to observe the relationship between cervical spine X-ray abnormalities and TMJ ID. This investigation evaluated 30 subjects with internal TMJ disorder symptoms (test group) and 20 healthy subjects (control group). Subjects were...

  18. Effects of Progressive Resistance Strength Training on Knee Biomechanics During Single Leg Step-up in Persons with Mild Knee Osteoarthritis

    Science.gov (United States)

    McQuade, Kevin James; de Oliveira, Anamaria Siriani

    2011-01-01

    Background The goal of this study was to determine if increasing strength in primary knee extensors and flexors would directly affect net knee joint moments during a common functional task in persons with knee osteoarthritis. Methods An exploratory single sample clinical trial with pre-post treatment measures was used to study volunteers with clinical diagnosis of mild knee OA in one knee. Subjects participated in an individually supervised training program 3 times a week for eight weeks consisting of progressive resistive exercises for knee extensors and knee flexors. Pre and post training outcome assessments included: 1. Net internal knee joint moments, 2. Electromyography of primary knee extensors and flexors, and 3. Self-report measures of knee pain and function. The distribution of lower extremity joint moments as a percent of the total support moment was also investigated. Findings Pain, symptoms, activities of daily life, quality of life, stiffness, and function scores showed significant improvement following strength training. Knee internal valgus and hip internal rotation moments showed increasing but non-statistically significant changes post-training. There were no significant differences in muscle co-contraction activation of the Quadriceps and Hamstrings. Interpretations While exercise continues to be an important element of OA management, the results of this study suggest improvements in function, pain, and other symptoms, as a result of strength training may not be causally related to specific biomechanical changes in net joint moments. PMID:21514018

  19. Mechanisms of quadriceps muscle weakness in knee joint osteoarthritis: the effects of prolonged vibration on torque and muscle activation in osteoarthritic and healthy control subjects.

    Science.gov (United States)

    Rice, David A; McNair, Peter J; Lewis, Gwyn N

    2011-01-01

    A consequence of knee joint osteoarthritis (OA) is an inability to fully activate the quadriceps muscles, a problem termed arthrogenic muscle inhibition (AMI). AMI leads to marked quadriceps weakness that impairs physical function and may hasten disease progression. The purpose of the present study was to determine whether γ-loop dysfunction contributes to AMI in people with knee joint OA. Fifteen subjects with knee joint OA and 15 controls with no history of knee joint pathology participated in this study. Quadriceps and hamstrings peak isometric torque (Nm) and electromyography (EMG) amplitude were collected before and after 20 minutes of 50 Hz vibration applied to the infrapatellar tendon. Between-group differences in pre-vibration torque were analysed using a one-way analysis of covariance, with age, gender and body mass (kg) as the covariates. If the γ-loop is intact, vibration should decrease torque and EMG levels in the target muscle; if dysfunctional, then torque and EMG levels should not change following vibration. One-sample t tests were thus undertaken to analyse whether percentage changes in torque and EMG differed from zero after vibration in each group. In addition, analyses of covariance were utilised to analyse between-group differences in the percentage changes in torque and EMG following vibration. Pre-vibration quadriceps torque was significantly lower in the OA group compared with the control group (P = 0.005). Following tendon vibration, quadriceps torque (P 0.299). Hamstrings torque and EMG amplitude were unchanged in both groups (all P > 0.204). The vibration-induced changes in quadriceps torque and EMG were significantly different between the OA and control groups (all P torque or EMG (all P > 0.554). γ-loop dysfunction may contribute to AMI in individuals with knee joint OA, partially explaining the marked quadriceps weakness and atrophy that is often observed in this population.

  20. Circulating interleukin-6 is not altered while γ-tocopherol is increased in subjects scheduled for knee surgery with low vitamin D.

    Science.gov (United States)

    Barker, Tyler; Henriksen, Vanessa T; Rogers, Victoria E; Momberger, Nathan G; Rasmussen, G Lynn; Trawick, Roy H

    2016-12-01

    The purpose of this study was to identify if circulating interleukin (IL)-6 and γ-tocopherol (γT) fluctuate with vitamin D status in subjects with an underlying knee joint injury or disease. We hypothesized that low vitamin D associates with an increase in plasma γT while serum IL-6 remains unchanged in subjects with an underlying knee joint trauma or disease. Fifty-four subjects scheduled to undergo primary, unilateral anterior cruciate ligament reconstructive surgery (ACL; n=27) or total knee arthroplasty (TKA; n=27) were studied. Circulating γT, α-tocopherol (αT), lipids (cholesterol and triglycerides), IL-6, and 25-hydroxyvitamin D (25(OH)D) were measured in fasting blood samples obtained prior to surgery. Subjects were classified as vitamin D deficient, insufficient, or sufficient if they had a serum 25(OH)D concentration 75nM, respectively. The majority (57%) of the subjects possessed a serum 25(OH)D less than 50nM. Circulating cholesterol, triglycerides, and IL-6 were not significantly (all p>0.05) different between vitamin D status groups. However, lipid corrected αT was significantly (p<0.05) decreased and both lipid- and non-lipid-corrected plasma γT concentrations were significantly (both p<0.05) increased with low serum 25(OH)D (i.e., <50nM). A significant (p<0.05) multi-variate analysis revealed that an increase in plasma γT per lipids was significantly (p<0.05) predicted by a decrease in serum 25(OH)D but not by a decrease in plasma αT per lipids. We conclude that low vitamin D associates with an increase in plasma γT but not IL-6 in subjects with an underlying joint injury or disease. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. History of knee injuries and knee osteoarthritis: a meta-analysis of observational studies.

    Science.gov (United States)

    Muthuri, S G; McWilliams, D F; Doherty, M; Zhang, W

    2011-11-01

    Although knee injury has been implicated as a risk factor for the development of knee osteoarthritis (OA), there is great disparity in the magnitude of quantifiable risk. Our aim was to systematically review the relationship between history of knee injuries and knee OA. Six electronic databases were searched between August and October 2010. Relative risk estimates or odds ratio (OR) and 95% confidence intervals (95% CI) were extracted or calculated from observational studies meeting the inclusion criteria. Publication bias was determined using funnel plot and the Egger's test. Heterogeneity was examined using Cochran Q test and I(2) statistic. Random effects model was used to pool the heterogeneous results and OR was used to present the results. Subgroup analyses were performed to examine potential causes of heterogeneity. Twenty-four observational studies (20,997 subjects) were included in the meta-analysis of which there were seven cohort, five cross-sectional and 12 case-control studies. The overall pooled OR was 4.20 (95% CI 3.11-5.66, I(2) = 81.0%). Association between history of knee injuries and knee OA was significantly different for specified injuries such as ligament or tendon injuries; meniscus damage or meniscectomy; and fracture of femur, knee or lower part of the leg (OR = 5.95, 95% 4.57-7.75), compared to unspecified injuries (OR = 3.12, 95% 2.17-4.50). History of knee injury is a major risk factor for the development of knee OA irrespective of study design and definition of knee injury. As one of the few modifiable/preventable risk factors, knee injury should be part of the future prevention programme in reducing the risk of knee OA. Copyright © 2011 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  2. An Evaluation of the Correlation between the Free Moments Applied on the Lower Extremity and the Knee Extensor Mechanism Force in Pronated Foot Subjects during the Stance Phase of Gait

    OpenAIRE

    Farzaneh Yazdani; Mohsen Razeghi; Samaneh Ebrahimi

    2016-01-01

    Background: Due to the rotatory nature of the excessive subtalar pronation and the possible impairment of the tibial rotation-knee flexion mechanism, changes of the free moment (FM) and changes of the extensor mechanism force are expected in hyper-pronated foot subjects. The purpose of this study was to evaluate the correlation between the FM applied on the lower extremity and the knee extensor mechanism force in subjects with flexible pronated feet. Methods: Fifteen asympto...

  3. Knee extensor muscle weakness is a risk factor for development of knee osteoarthritis. A systematic review and meta-analysis.

    Science.gov (United States)

    Øiestad, B E; Juhl, C B; Eitzen, I; Thorlund, J B

    2015-02-01

    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 intervals (CI) were estimated and combined using a random effects model. Twelve studies were eligible for inclusion in the meta-analysis after the initial searches. Five cohort studies with a follow-up time between 2.5 and 14 years, and a total number of 5707 participants (3553 males and 2154 females), were finally included. The meta-analysis showed an overall increased risk of developing symptomatic knee osteoarthritis in participants with knee extensor muscle weakness (OR 1.65 95% CI 1.23, 2.21; I(2) = 50.5%). This systematic review and meta-analysis showed that knee extensor muscle weakness was associated with an increased risk of developing knee osteoarthritis in both men and women. Copyright © 2014 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  4. EFFECTS OF KINESIOTAPING ALONG WITH QUADRICEPS STRENGTHENING EXERCISES ON PAIN, JOINT RANGE OF MOTION AND FUNCTIONAL ACTIVITIES OF KNEE IN SUBJECTS WITH PATELLOFEMORAL OSTEOARTHRITIS

    Directory of Open Access Journals (Sweden)

    M. Harshitha

    2014-08-01

    Full Text Available Background: Patello femoral Osteoarthritis is the most common degenerative disease in older age group, causing pain, physical disability, and decreased quality of life.As many treatment options available, kinesiotaping is an efficacious treatment for management of pain & disability in patellofemoral joint osteoarthritis. Previous studies have shown that kinesiotaping as well as quadriceps strengthening significantly yields functional benefits. But there is lack of evidence revealing combined effectiveness & effects of kinesiotaping along with quadriceps strengthening in subjects with patellofemoral joint osteoarthritis. Methods: 30 subjects with symptoms of patellofemoral osteoarthritis fulfilled the inclusion criteria were randomly assigned into 2 groups of 15 in each group. Taping along with quadriceps strengthening program is compared to the quadriceps strengthening program alone. Pain were measured by Visual Analogue Scale (VAS, knee ROM were measured by Goniometer, Functional status were measured by Western Ontario McMaster Universities index (WOMAC, score. Measurements were taken pre & post intervention. Results: The results indicated that kinesiotaping along with quadriceps strengthening exercises showed there was statistically significant improvement in pain (<0.05, knee ROM (<0.05 and functional activities (<0.05 after 6 weeks compared to quadriceps strengthening alone. Conclusion: Subjects with kinesiotaping along with quadriceps strengthening showed significant improvement in reducing pain, in improving ROM & functional activities at the end of 6th week treatment when compared to subjects with patellofemoral osteoarthritis underwent quadriceps strengthening exercises alone.

  5. Safety and Efficacy of NEXT-II®, a Novel Water-Soluble, Undenatured Type II Collagen inHealthy Human SubjectsSuffering from Occasional Knee Joint Pain

    Directory of Open Access Journals (Sweden)

    Orie Yoshinari

    2015-07-01

    Full Text Available Background: Oral administration of a novel water-soluble undenatured type II collagen (NEXT-II® has been demonstrated to ameliorate the signs and symptoms of rheumatoid arthritis (RA in animal models. In the present investigation, we conducted a pilot study to examine the efficacy and safety of NEXT-II® in borderline subjects defined as healthy and non-diseased state, but with potential risks in knee joint health. Method: We employed Western Ontario McMaster Index (WOMAC score and Visual Analog Scale (VAS scores to assess the extent of improvement in the knee joints in these volunteers following supplementation of 40 mg NEXT-II® (10 mg as undenatured type II collagen over a period of 12 weeks. Result: The results demonstrated that NEXT-II® treatment significantly reduced WOMAC and VAS scores compared to subjects at baseline. Specifically, in the evaluation using VAS, the borderline subjects at resting, walking, and going up and down the stairs revealed significant improvement when compared to the baseline. Conclusion: The results of the studies demonstrated that NEXT-II® might be an ingredient which is safe and effective in the application of dietary supplement in ameliorating joint pain and symptoms of the borderline subjects without any adverse events.

  6. Subjects and actors in international lawmaking: the paradigmatic divides in the cognition of international norm generating processes

    NARCIS (Netherlands)

    d' Aspremont, J.; Brölmann, C.; Radi, Y.

    2016-01-01

    With an emphasis on subjects and actors, this chapter seeks to shed some light on the choices made by scholars in modelling and cognizing international lawmaking processes. After a brief outline of the mainstream descriptive frameworks used to cognize and model normmaking processes in international

  7. 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 ...

  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. Short-term efficacy of calcium fructoborate on subjects with knee discomfort: a comparative, double-blind, placebo-controlled clinical study

    Directory of Open Access Journals (Sweden)

    Pietrzkowski Z

    2014-06-01

    Full Text Available Zbigniew Pietrzkowski,1 Michael J Phelan,2 Robert Keller,3 Cynthia Shu,1 Ruby Argumedo,1 Tania Reyes-Izquierdo11FutureCeuticals, Inc., Applied BioClinical Laboratory; 2Department of Statistics, School of Information and Computer Science, University of California at Irvine; 3NutraClinical Inc., Irvine, CA, USAAbstract: Calcium fructoborate (CFB at a dose of 110 mg twice per day was previously reported to improve knee discomfort during the first 14 days of treatment. In this study, 60 participants with self-reported knee discomfort were randomized into two groups receiving CFB or placebo. Initial levels of knee discomfort were evaluated by Western Ontario and McMaster Universities Arthritis Index (WOMAC and McGill Pain Questionnaire (MPQ scores at the beginning of the study and also at 7 and 14 days after treatment. Results showed that supplementation with CFB significantly improved knee discomfort in the study subjects; significant reductions of mean within-subject change in WOMAC and MPQ scores were observed for the CFB group compared to the placebo group at both 7 and 14 days after treatment. Estimated treatment differences for the MPQ score were -5.8 (P=0.0009 and -8.9 (P<0.0001 at Day 7 and 14, respectively. Estimated differences for the WOMAC score were -5.3 (P=0.06 and -13.73 (P<0.0001 at Day 7 and 14, respectively. Negative values indicate greater reductions in reported discomfort. On both Day 7 and Day 14, the trend was toward greater improvement in the CFB group. The placebo group did not exhibit any change in the WOMAC and MPQ scores. In conclusion, supplementation with 110 mg CFB twice per day was associated with improving knee discomfort during the 2 weeks of intake.Keywords: CFB, joint discomfort, WOMAC score, McGill pain score

  10. MR imaging of medial collateral ligament injury and associated internal knee joint injury

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Chae Ha; Lee, Sun Kyoung; Lim, Dong Hun; Kim, Young Sook; Byun, Ju Nam; Kim, Young Chul; Oh, Jae Hee [Chosun Univ. College of Medicine, GwangJu (Korea, Republic of)

    1996-11-01

    To assess the value of MR imaging in the diagnosis of medial collateral ligament injury of the knee, we used MR imaging to evaluate the characteristic findings in MCL tears and the frequency of associated knee joint injury. We retrospectively reviewed 26 patients within four weeks of MCL injury, analysed MR findings and correlated them with surgical findings. We evaluated discontinuity, heterogeneous signal intensity of MCL, thin band- like low signal intensity at MCL, facial edema, loss of clear demarcation of adjacent fat also combined bone injury, meniscus injury and other ligament injury. Complete MCL tears were present in 14 patients and partial tears in 12. Complete tears showed discontinuity of MCL, fascial edema and loss of clear demarcation from adjacent fat in 11 patients(79%);proximal MCL tears are more common than distal tears. Partial tears showed thin band-like low signal intensity within MCL, fascial edema and loss of clear demarcation from adjacent fat in seven patients (58%);all patient s with MCL injury showed fascial edema;in 12 patients there was loss of clear demarcation from adjacent fat. We could not, however, distinguish between complete tears and partial tears when MCL showed heterogeneous high signal intensity. Combined bone injury in MCL tears was found in eight patients(62%);the most common sites of this were the lateral femoral condyle and lateral tibial plateau. There was associated injury involving other ligaments(ACL:50%;PCL:27%). Combined meniscus injury in MCL tears was present in 17 patients and the most common meniscus site(50%) is the posterior horn of the medial meniscus. Complete MCL tears showed discontinuity of MCL and partial tears showed a thin band-like low signal intensity within MCL. All patients with MCL injury showed fascial edema, and loss of clear demarcation from adjacent fat. Various other injuries combine with MCL tears. MR imaging is therefore useful in the evaluation of medial collateral ligament injury and

  11. The effect of shoe design and lateral wedges on knee load and neuromuscular control in healthy subjects during walking

    DEFF Research Database (Denmark)

    Mølgaard, Carsten; Kersting, Uwe G.

    2014-01-01

    design/type on the effectiveness of lateral wedging has not been investigated so far. The Purpose of the present study was to explore alterations in knee loading due to lateral foot wedges in three different shoes. Methods: Thirteen healthy participants with no history of knee pain were tested using...... wedging is effective regardless of shoe design. Differences between the three neutral walking conditions underline the importance of footwear choice in individuals. It is safe to apply lateral wedges without jeopardising muscular control during walking regardless of shoe type. Possible effects of altering...... three-dimensional gait analysis. Barefoot walking, walking in a running shoe, an Oxford-type leather shoe, and a rocker shoe were analysed. The shoes were tested both with and without a 10-degree full-length laterally wedged insole. Results: There were significant shoe wedge interactions on the first...

  12. Computer-assisted total knee arthroplasty using mini midvastus or medial parapatellar approach technique: A prospective, randomized, international multicentre trial.

    Science.gov (United States)

    Feczko, Peter; Engelmann, Lutz; Arts, Jacobus J; Campbell, David

    2016-01-13

    Despite the growing evidence in the literature there is still a lack of consensus regarding the use of minimally invasive surgical technique (MIS) in total knee arthroplasty (TKA). A prospective, randomized, international multicentre trial including 69 patients was performed to compare computer-assisted TKA (CAS-TKA) using either mini-midvastus (MIS group) or standard medial parapatellar approach (conventional group). Patients from 3 centers (Maastricht, Zwickau, Adelaide) with end-stage osteoarthritis of the knee were randomized to either an MIS group with dedicated instrumentation or a conventional group to receive cruciate retaining CAS-TKA without patella resurfacing. The primary outcome was to compare post operative pain and range of motion (ROM). The secondary outcome was to measure the duration of surgery, blood loss, chair rise test, quadriceps strength, anterior knee pain, Knee Society Score (KSS),WOMAC scores, mechanical leg axis and component alignment. Patients in the MIS group (3.97 ± 2.16) had significant more pain at 2 weeks than patients in the conventional group (2.77 ± 1.43) p = 0.003. There was no significant difference in any of the other primary outcome parameters. Surgery time was significantly longer (p loss (p = 0.002) in the MIS group as compared to the conventional group. The difference of the mean mechanical leg alignment between the groups was not statistically significant (-0.43° (95% CI -1.50-0.64); p = 0.43). There was no significant difference of component alignment between the two surgical groups with respect to flexion/extension (p = 0.269), varus/valgus (p = 0.653) or rotational alignment (p = 0.485) of the femur component and varus valgus alignment (p = 0.778) or posterior slope (p = 0.164) of the tibial component. There was no advantage of the MIS approach compared to a conventional approach CAS-TKA in any of the primary outcome measurements assessed, however the MIS approach was

  13. Energy Cost and Gait Efficiency of Below-Knee Amputee and Normal Subject with Similar Physical Parameters & Quality of Life: A Comparative Case Study

    Directory of Open Access Journals (Sweden)

    Durbadal Biswas

    2010-10-01

    Full Text Available The study focused on the comparative analysis of energy cost and gait efficiency between a below knee (BK amputee and a reference subject (without amputation. It also attempted to indicate the specific feature responsible for a controlled gait with optimum energy cost for BK amputees. Selection criteria of the subjects were similar physical parameters and quality of life studied with WHOQOL-100 quality of life assessment. A Cosmed® k4 b2 Respiratory Analyzer system was used for the measurement of Oxygen Uptake (VO2, Energy Expenditure per minute (EE and Heart Rate (HR. Gait efficiency (p < 0.0002 was found higher for BK amputee than normal subject. The therapeutic activities and mainly walking rhythm contributed to improve the mobility & balance. This ensures the optimum time & co-ordination of movements and hence improves the gait efficiency for the BK amputee. Comparison with control group was performed to validate the data.

  14. Risk Factors for Knee Injury in Golf: A Systematic Review.

    Science.gov (United States)

    Baker, Matthew L; Epari, Devakar R; Lorenzetti, Silvio; Sayers, Mark; Boutellier, Urs; Taylor, William R

    2017-12-01

    Golf is commonly considered a low-impact sport that carries little risk of injury to the knee and is generally allowed following total knee arthroplasty (TKA). Kinematic and kinetic studies of the golf swing have reported results relevant to the knee, but consensus as to the loads experienced during a swing and how the biomechanics of an individual's technique may expose the knee to risk of injury is lacking. Our objective was to establish (1) the prevalence of knee injury resulting from participation in golf and (2) the risk factors for knee injury from a biomechanical perspective, based on an improved understanding of the internal loading conditions and kinematics that occur in the knee from the time of addressing the ball to the end of the follow-through. A systematic literature search was conducted to determine the injury rate, kinematic patterns, loading, and muscle activity of the knee during golf. A knee injury prevalence of 3-18% was established among both professional and amateur players, with no clear dependence on skill level or sex; however, older players appear at greater risk of injury. Studies reporting kinematics indicate that the lead knee is exposed to a complex series of motions involving rapid extension and large magnitudes of tibial internal rotation, conditions that may pose risks to the structures of a natural knee or TKA. To date, the loads experienced by the lead knee during a golf swing have been reported inconsistently in the literature. Compressive loads ranging from 100 to 440% bodyweight have been calculated and measured using methods including inverse dynamics analysis and instrumented knee implants. Additionally, the magnitude of loading appears to be independent of the club used. This review is the first to highlight the lack of consensus regarding knee loading during the golf swing and the associated risks of injury. Results from the literature suggest the lead knee is subject to a higher magnitude of stress and more demanding

  15. Standing Stability in Knee Osteoarthritis Patients

    Directory of Open Access Journals (Sweden)

    M.T. Karimi

    2016-09-01

    Full Text Available Aims: Being prevalent in the more than 40 years old persons, the knee osteoarthritis is one of the main factors in the function system failure mainly affecting their life. There is a type of instability in the persons with knee osteoarthritis, which is an increase in the domain and frequency of body pressure center. The aim of the present study was to compare the standing stability parameters in persons with knee osteoarthritis and healthy persons. Instrument & Methods: In this case-control, 15 patients with knee osteoarthritis referred to the physiotherapy clinic of the rehabilitation center and Al-Zahra hospital were studied in the muscle-skeletal research center of Isfahan University of Medical Sciences in 2015. The subjects were selected via stratified sampling method. As control group, 15 healthy persons were also studied in Isfahan. Total path length and the domain and frequency of pressure center in different directions were measured to assess the stability. Data was analyzed by SPSS 19 software using descriptive statistics and paired T test. Findings: There were increases in the mean movement domain and the frequency of pressure center in the anterior-posterior and the internal-external directions, as well as in the total path proceeded by the pressure center in the internal-external direction, in the persons with knee osteoarthritis than the healthy persons (p0.05. Conclusion: Standing stability and balance in persons with knee osteoarthritis decreases compared to healthy persons.

  16. Return to running following knee osteochondral repair using an anti-gravity treadmill: A case report.

    Science.gov (United States)

    Hambly, Karen; Poomsalood, Somruthai; Mundy, Emma

    2017-07-01

    The purpose of this study was to assess the impact of an anti-gravity treadmill return to running programme on self-efficacy and subjective knee function following knee osteochondral surgery. A 39-year-old otherwise healthy female endurance runner with a left knee femoral cartilage grade 3-4 defect 3 cm2. The patient underwent single step arthroscopic microfracture with Bone Marrow Aspirate Concentrate. An AlterG® anti-gravity treadmill was used to manipulate loading during a graduated phased return to running over 8 weeks. Self-efficacy was evaluated using the Self-Efficacy for Rehabilitation outcomes scale (SER) and the Knee Self-Efficacy Scale (K-SES). Subjective knee function was evaluated using the Knee injury and Osteoarthritis Outcome Score (KOOS) and International Knee Documentation Committee Subjective Knee Form (IKDC). The programme resulted in improvements in SER (57%), K-SES present (89%) and K-SES future (65%) self-efficacy domains. The IKDC score demonstrated a clinically important improvement with an increase from 62.1 in week 1-86.2 in week 8 (39%). Only the KOOS Sport/Rec subscale showed a clinically important improvement from week 1 to week 8. The programme resulted in improved knee and rehabilitation self-efficacy and subjective knee function following osteochondral repair of the knee. This case report illustrates the importance of considering self-efficacy in rehabilitation after knee osteochondral surgery and highlights the potential role for anti-gravity treadmills in enhancing self-efficacy and subjective knee function in preparation for a return to sport. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  17. The 2- and 8-week effects of decompressive brace use in people with medial compartment knee osteoarthritis.

    Science.gov (United States)

    Lamberg, Eric M; Streb, Robert; Werner, Marc; Kremenic, Ian; Penna, James

    2016-08-01

    Knee osteoarthritis is a prevalent disease. Unloading the affected compartment using a brace is a treatment option. To determine whether a decompressive knee brace alters loading in medial knee osteoarthritis following 2 and 8 weeks of use. Within subjects; pre- and post-testing. A total of 15 individuals with medial knee osteoarthritis attended four sessions: baseline, fitting, 2 weeks after fitting (post), and 8 weeks after fitting (final). A gait analysis was performed at baseline (without knee brace), post and final. Knee adduction impulse, first and second peak knee adduction moment, knee motion, and walking velocity were calculated. Participants also recorded hours and steps taken while wearing the brace. On average, the brace was worn for more than 6 h/day. Through use of repeated-measures analysis of variance, it was determined that the knee adduction impulse and second peak knee adduction moment were reduced (p knee adduction impulse, 26% reduction in second peak knee adduction moment for post and final, respectively). Furthermore, participants walked faster with increased knee motion during stance. The studied decompressive brace was effective in reducing potentially detrimental forces at the knee-knee adduction impulse and second peak knee adduction moment during the stance phase of gait. The data from this study suggest that use of a medial unloading brace can reduce potentially detrimental adduction moments at the knee. Clinicians should use this evidence to advocate for use of this noninvasive treatment for people presenting with medial knee osteoarthritis. © The International Society for Prosthetics and Orthotics 2015.

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

    Science.gov (United States)

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

    2011-01-01

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

  19. Spatial and temporal changes of subchondral bone proceed to articular cartilage degeneration in rats subjected to knee immobilization.

    Science.gov (United States)

    Xu, Lei; Li, Zhe; Lei, Lei; Zhou, Yue-Zhu; Deng, Song-Yun; He, Yong-Bin; Ni, Guo-Xin

    2016-03-01

    This study was aimed to investigate the spatial and temporal changes of subchondral bone and its overlying articular cartilage in rats following knee immobilization. A total of 36 male Wistar rats (11-13 months old) were assigned randomly and evenly into 3 groups. For each group, knee joints in 6 rats were immobilized unilaterally for 1, 4, or 8 weeks, respectively, while the remaining rats were allowed free activity and served as external control groups. For each animal, femurs at both sides were dissected after sacrificed. The distal part of femur was examined by micro-CT. Subsequently, femoral condyles were collected for further histological observation and analysis. For articular cartilage, significant changes were observed only at 4 and 8 weeks of immobilization. The thickness of articular cartilage and chondrocytes numbers decreased with time. However, significant changes in subchondral bone were defined by micro-CT following immobilization in a time-dependent manner. Immobilization led to a thinner and more porous subchondral bone plate, as well as a reduction in trabecular thickness and separation with a more rod-like architecture. Changes in subchondral bone occurred earlier than in articular cartilage. More importantly, immobilization-induced changes in subchondral bone may contribute, at least partially, to changes in its overlying articular cartilage. © 2016 Wiley Periodicals, Inc.

  20. Heel-strike in walking: assessment of potential sources of intra- and inter-subject variability in the activation patterns of muscles stabilizing the knee joint.

    Science.gov (United States)

    Huber, Cora; Federolf, Peter; Nüesch, Corina; Cattin, Philippe C; Friederich, Niklaus F; Tscharner, Vinzenz von

    2013-04-26

    The electromyographic (EMG) signal is known to show large intra-subject and inter-subject variability. Adaptation to, and preparation for, the heel-strike event have been hypothesized to be major sources of EMG variability in walking. The aim of this study was to assess these hypotheses using a principal component analysis (PCA). Two waveform shapes with distinct characteristic features were proposed based on conceptual considerations of how the neuro-muscular system might prepare for, or adapt to, the heel-strike event. PCA waveforms obtained from knee muscle EMG signals were then compared with the predicted characteristic features of the two proposed waveforms. Surface EMG signals were recorded for ten healthy adult female subjects during level walking at a self-selected speed, for the following muscles; rectus femoris, vastus medialis, vastus lateralis, semitendinosus, and biceps femoris. For a period of 200 ms before and after heel-strike, EMG power was extracted using a wavelet transformation (19-395 Hz). The resultant EMG waveforms (18 per subject) were submitted to intra-subject and inter-subject PCA. In all analyzed muscles, the shapes of the first and second principal component (PC-) vectors agreed well with the predicted waveforms. These two PC-vectors accounted for 50-60% of the overall variability, in both inter-subject and intra-subject analyses. It was also found that the shape of the first PC-vector was consistent between subjects, while higher-order PC-vectors differed between subjects. These results support the hypothesis that adaptation to, and preparation for, a variable heel-strike event are both major sources of EMG variability in walking. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. Prothrombin time-international normalized ratio is a useful marker for edoxaban efficacy in preventing venous thromboembolism after total knee arthroplasty.

    Science.gov (United States)

    Kodato, Kazuki; Ishida, Kazunari; Shibanuma, Nao; Toda, Akihiko; Takayama, Koji; Oka, Shinya; Hayashi, Shinya; Hashimoto, Shingo; Kurosaka, Masahiro; Kuroda, Ryosuke; Matsumoto, Tomoyuki

    2017-08-01

    Deep vein thrombosis (DVT) is one of the main complications following total knee arthroplasty (TKA). In this study, oral administration of 15 mg edoxaban (a factor Xa inhibitor) once daily for 14 days efficiently prevented the incidence of DVT. Our hypothesis was that prothrombin time-international normalized ratio (PT-INR) on the third postoperative day could predict the incidence of DVT following TKA. In this study, 286 subjects were enrolled and divided into two groups according to the presence or absence of DVT. Several variables [age, body mass index, postoperative D-dimer level, PT-INR, and functional recovery findings (standing)] were analysed to determine the predictors of DVT, and for DVT diagnosis, ultrasonography was performed for seven days after surgery. The PT-INR levels were significantly higher in the group that did not develop DVT (p = 0.01). Further analysis with logistic regression analysis and receiver operating characteristic curve was performed. The PT-INR on the third postoperative day was an independent factor of the incidence of DVT (odds ratio 0.210; p = 0.035). The cut-off PT-INR was calculated to be 1.425. PT-INR level is a useful marker in determining whether 15 mg edoxaban administration can prevent DVT after TKA. It is suggested that increment of edoxaban to control PT-INR over the cut-off point might prevent the incidence of DVT.

  2. Subjectivity

    Directory of Open Access Journals (Sweden)

    Jesús Vega Encabo

    2015-11-01

    Full Text Available In this paper, I claim that subjectivity is a way of being that is constituted through a set of practices in which the self is subject to the dangers of fictionalizing and plotting her life and self-image. I examine some ways of becoming subject through narratives and through theatrical performance before others. Through these practices, a real and active subjectivity is revealed, capable of self-knowledge and self-transformation. 

  3. Correlation between dynamic postural stability and muscle strength, anterior instability, and knee scale in anterior cruciate ligament deficient knees.

    Science.gov (United States)

    Park, Won-Hah; Kim, Do-Kyung; Yoo, Jae Chul; Lee, Yong Seuk; Hwang, Ji-Hye; Chang, Moon Jong; Park, Yong Serk

    2010-08-01

    The purpose of this study was to assess the correlations between dynamic postural stability and muscle strength, anterior instability, and knee scores in anterior cruciate ligament (ACL) deficient knees. We examined 40 male patients with ACL injury prior to surgery. Maximal torques of flexors and extensors of the injured knee at 60 and 180 degrees /s were evaluated using an isokinetic testing device. Anterior translations of the tibia were measured using a KT-2000 arthrometer, and dynamic postural stabilities were measured during single-leg stance using the Biodex Stability System (BSS). Knee statuses were evaluated using Lysholm and International Knee Documentation Committee (IKDC) knee scores. Correlations between dynamic postural stability and muscle strength, anterior instability, and knee scores were determined. Significant correlations were found between maximal torques of the extensor of injured knees at 60 and 180 degrees /s (r = -0.52, p = 0.048 and r = -0.46, p = 0.019, respectively) and dynamic postural stability, and maximal torques of flexors of injured knees showed similar relations (r = -0.51, p = 0.0048 and r = -0.47, p = 0.016, respectively). Lysholm and IKDC knee scores were also found to be correlated with dynamic postural stability (r = -0.49, p = 0.001 and r = -0.52, p = 0.005, respectively). However, no correlation was found between grade of anterior translation measured using the KT-2000 arthrometer and dynamic postural stability (p = 1.0). Dynamic postural stability determined using the BSS appears to be influenced by muscle strength, as determined by isokinetic testing, but not with grade of anterior translation measured using a KT-2000 arthrometer. Subjective knee scores appear to improve in parallel with dynamic postural stability.

  4. Five times sit-to-stand test in subjects with total knee replacement: Reliability and relationship with functional mobility tests.

    Science.gov (United States)

    Medina-Mirapeix, Francesc; Vivo-Fernández, Iván; López-Cañizares, Juan; García-Vidal, José A; Benítez-Martínez, Josep Carles; Del Baño-Aledo, María Elena

    2018-01-01

    The objective was to determine the inter-observer and test/retest reliability of the "Five-repetition sit-to-stand" (5STS) test in patients with total knee replacement (TKR). To explore correlation between 5STS and two mobility tests. A reliability study was conducted among 24 (mean age 72.13, S.D. 10.67; 50% were women) outpatients with TKR. They were recruited from a traumatology unit of a public hospital via convenience sampling. A physiotherapist and trauma physician assessed each patient at the same time. The same physiotherapist realized a 5STS second measurement 45-60min after the first one. Reliability was assessed with intraclass correlation coefficients (ICCs) and Bland-Altman plots. Pearson coefficient was calculated to assess the correlation between 5STS, time up to go test (TUG) and four meters gait speed (4MGS). ICC for inter-observer and test-retest reliability of the 5STS were 0.998 (95% confidence interval [CI], 0.995-0.999) and 0.982 (95% CI, 0.959-0.992). Bland-Altman plot inter-observer showed limits between -0.82 and 1.06 with a mean of 0.11 and no heteroscedasticity within the data. Bland-Altman plot for test-retest showed the limits between 1.76 and 4.16, a mean of 1.20 and heteroscedasticity within the data. Pearson correlation coefficient revealed significant correlation between 5STS and TUG (r=0.7, ptest-retest reliability when it is used in people with TKR, and also significant correlation with other functional mobility tests. These findings support the use of 5STS as outcome measure in TKR population. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Return to Preinjury Sports Participation Following Anterior Cruciate Ligament Reconstruction: Contributions of Demographic, Knee Impairment, and Self-report Measures

    Science.gov (United States)

    Lentz, Trevor A.; Zeppieri, Giorgio; Tillman, Susan M.; Indelicato, Peter A.; Moser, Michael W.; George, Steven Z.; Chmielewski, Terese L.

    2013-01-01

    STUDY DESIGN Cross-sectional cohort. OBJECTIVES (1) To examine differences in clinical variables (demographics, knee impairments, and self-report measures) between those who return to preinjury level of sports participation and those who do not at 1 year following anterior cruciate ligament reconstruction, (2) to determine the factors most strongly associated with return-to-sport status in a multivariate model, and (3) to explore the discriminatory value of clinical variables associated with return to sport at 1 year postsurgery. BACKGROUND Demographic, physical impairment, and psychosocial factors individually prohibit return to preinjury levels of sports participation. However, it is unknown which combination of factors contributes to sports participation status. METHODS Ninety-four patients (60 men; mean age, 22.4 years) 1 year post–anterior cruciate ligament reconstruction were included. Clinical variables were collected and included demographics, knee impairment measures, and self-report questionnaire responses. Patients were divided into “yes return to sports” or “no return to sports” groups based on their answer to the question, “Have you returned to the same level of sports as before your injury?” Group differences in demographics, knee impairments, and self-report questionnaire responses were analyzed. Discriminant function analysis determined the strongest predictors of group classification. Receiver-operating-characteristic curves determined the discriminatory accuracy of the identified clinical variables. RESULTS Fifty-two of 94 patients (55%) reported yes return to sports. Patients reporting return to preinjury levels of sports participation were more likely to have had less knee joint effusion, fewer episodes of knee instability, lower knee pain intensity, higher quadriceps peak torque-body weight ratio, higher score on the International Knee Documentation Committee Subjective Knee Evaluation Form, and lower levels of kinesiophobia. Knee

  6. Safety, tolerability, pharmacokinetics, and efficacy of AMG 403, a human anti-nerve growth factor monoclonal antibody, in two phase I studies with healthy volunteers and knee osteoarthritis subjects.

    Science.gov (United States)

    Gow, Jason M; Tsuji, Wayne H; Williams, Gary J; Mytych, Daniel; Sciberras, David; Searle, Shawn L; Mant, Tim; Gibbs, John P

    2015-10-08

    Nerve growth factor plays a key role in the pathology of osteoarthritis (OA) related chronic pain. The aim of these studies was to evaluate the safety, tolerability, pharmacokinetics, and clinical response of AMG 403, a human anti-nerve growth factor monoclonal antibody, in healthy volunteers and subjects with knee OA. Two phase I, randomized, placebo-controlled, double-blind studies were conducted. The single-ascending dose study randomized healthy volunteers (n = 48) 3:1 to receive AMG 403 (1, 3, 10, or 30 mg intravenously; or 10 or 30 mg subcutaneously; n = 8 per group) or placebo. The multiple-ascending dose study randomized knee OA subjects (n = 18) 3:1 to receive AMG 403 (3, 10, or 20 mg subcutaneously once monthly for four doses) or placebo. Safety, tolerability, and pharmacokinetics (PK) were assessed for both studies. Patient's and physician's disease assessments and total WOMAC score were determined in knee OA subjects. AMG 403 appeared to be well-tolerated after single and multiple doses, except for subject-reported hyperesthesia, pain, and paresthesia (mild to moderate severity). These treatment-emergent neurosensory events showed evidence of reversibility and a possible dose-dependence. Three serious adverse events were reported in AMG 403 treated subjects, but were not considered treatment related. AMG 403 PK was linear with an estimated half-life of 19.6 to 25.8 days. After multiple doses, AMG 403 PK showed modest accumulation (≤2.4-fold increase) in systemic exposure. Knee OA diagnosis, body weight, and anti-drug antibody development did not appear to affect AMG 403 PK. Patient's and physician's disease assessments and total WOMAC score showed improvement in AMG 403 treated knee OA subjects compared with placebo. AMG 403 was generally safe and well-tolerated in both healthy volunteers and knee OA patients, and exhibited linear pharmacokinetics. Preliminary clinical efficacy was observed in knee OA subjects. ClinicalTrials.gov NCT02348879

  7. An Evaluation of the Correlation between the Free Moments Applied on the Lower Extremity and the Knee Extensor Mechanism Force in Pronated Foot Subjects during the Stance Phase of Gait

    Directory of Open Access Journals (Sweden)

    Farzaneh Yazdani

    2016-12-01

    Full Text Available Background: Due to the rotatory nature of the excessive subtalar pronation and the possible impairment of the tibial rotation-knee flexion mechanism, changes of the free moment (FM and changes of the extensor mechanism force are expected in hyper-pronated foot subjects. The purpose of this study was to evaluate the correlation between the FM applied on the lower extremity and the knee extensor mechanism force in subjects with flexible pronated feet. Methods: Fifteen asymptomatic female subjects (21.32±1.66 y, 56.30±6.08 kg, 159±6.3 cm participated in the study. Excessive subtalar pronation was determined by measuring the resting calcaneal stance position (RCSP in the frontal plane during weight bearing. A neutrally aligned foot was defined as having an RCSP between 2° of inversion and 2° of eversion. On the other hand, a flat foot had an RCSP of more than or equal to 4° of eversion. Both kinetic and kinematic data were collected using a six-camera motion analysis system and a single force plate. Three successful barefoot walking trials were recorded at selfselected speeds. The extensor mechanism force and the adductory component of the free moment (ADD FM were calculated. The correlation between the ADD FM and the knee extensor mechanism force was examined using the Pearson correlation test. Results: The Pearson correlation analysis showed a high positive correlation between the ADD FM and the extensor mechanism force (r=0.917, P<0.001. Conclusion: Excessive subtalar pronation, along with a possible impairment of the tibial rotation-knee flexion mechanism, may affect the extensor mechanism force at the knee joint. From a clinical perspective, the possible biomechanical linkage between the knee and the foot complex in the physical examination and treatment of patients should be considered.

  8. Comparison of reaction forces on the anterior cruciate and anterolateral ligaments during internal rotation and anterior drawer forces at different flexion angles of the knee joint.

    Science.gov (United States)

    Uğur, Levent

    2017-12-01

    Having a complicated anatomy, the knee joint has been further detailed and a new formation defined, the anterolateral ligament (ALL), in recent studies. While the importance of this ligament, which previously was associated with Segond fractures, was explained via clinical, radiologic and biomechanical studies, and basically, is thought to be a fixator structures for the tibia against internal rotation stress. Although in recent studies efficient surgical treatment was applied to patients who underwent anterior cruciate ligament (ACL) operation, some patients having a positive pivot test highlights the clinical importance of the ALL. The aim of this study is to evaluate reaction forces of different flexion angles on the tibia during internal rotation and anterior drawer tests on both the ALL and ACL, and to examine theimportance of this ligament in knee biomechanics by a finite element analysis method. In this study, normal anatomy knee joint was modelled using Computed Tomography images from lower extremity length in DICOM format. 0°, 15°,30°,45°,60°,75° and 90° angles of flexion were applied, respectively, to these models and reaction force vectors formed on both ligaments were examined separately and as total vector and size by applying internal rotation and anterior drawer forces on each model. Non-linear analysis was conducted using ANSYS (version 17) with the same limit conditions applied to all models. After all models were examined, in general when comparing reaction forces, those on the ACL were found to be higher. However, when vectoral directions were examined, forces on ALL increased with increased flexion ratio and internal rotation momentum. Beyond 30° flexion, the tensile force on the ALL is increased and compressive overload on the ACL occurs. The ALL plays an important role in stability, especially against internal rotation forces, and an increased knee joint flexion ratio increases the stability contribution ratio. In particular, at 30

  9. Musculoskeletal MR: knee

    Energy Technology Data Exchange (ETDEWEB)

    Staebler, A.; Glaser, C.; Reiser, M. [Dept. of Diagnostic Radiology, Klinikum Grosshadern, Ludwig-Maximilian Universitaet Muenchen (Germany)

    2000-02-01

    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.)

  10. Association between bone marrow lesions detected by magnetic resonance imaging and knee pain in community residents in Korea.

    Science.gov (United States)

    Kim, I J; Kim, D H; Jung, J Y; Song, Y W; Guermazi, A; Crema, M D; Hunter, D J; Kim, H A

    2013-09-01

    To describe the frequency of bone marrow lesions (BMLs) detected by magnetic resonance imaging (MRI), and to examine the association of BMLs with knee pain severity in community residents in Korea. Participants were randomly chosen from the population-based Hallym Aging Study, irrespective of whether they had knee osteoarthritis (OA) or pain. Demographic and knee pain data were obtained by questionnaire. Radiographic evaluations consisted of weight-bearing knee anteroposterior radiographs and 1.5-T MRI scans. MRI was performed in the dominant knees of subjects without knee pain and in the more symptomatic knees of subjects with knee pain. BMLs were graded according to the whole-organ MRI score. The mean age of the 358 study subjects was 71.8 years, and 34.5% of subjects had radiographically detected knee OA. The prevalences of BMLs and large BMLs in the tibiofemoral compartments were 80.3% and 40.4%, respectively. After adjusting for age, sex, and body mass index, total and medial compartment BML scores were significantly associated with the presence of knee pain, and the association was stronger as the summary score for BML increased. In proportional regression analysis, knee pain severity increased with BML severity in any compartment and in the medial compartment. BMLs detected by MRI were highly prevalent in this elderly Asian population. BMLs were significantly linked to knee pain, and BML severity correlated with knee pain severity. BMLs may be important surrogate targets for monitoring pain and structure modification in OA therapeutics. Copyright © 2013 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  11. Functional outcomes of uni-knee arthroplasty for medial compartment knee arthropathy in asian patients

    Directory of Open Access Journals (Sweden)

    To Wong

    2014-12-01

    Full Text Available Background: Uni-knee arthroplasty (UKA has shown better knee kinematics and motion that may better suit the activities of daily living in Eastern countries. The purpose of this study was to evaluate the functional outcomes of UKA for medial compartment knee arthropathy in Asian patients. Methods: The study cohort consisted of 48 patients with 51 UK A knees. Only one type of prosthesis was used and all components were cemented. Postoperative management included ambulation with weight bearing, range of motion, and muscle strengthening exercises as tolerated until full recovery. The average follow-up was 52.0 ± 24.0 (range 12-92 months. The evaluation included functional assessment, the Knee Society knee and functional scores, the International Knee Document Committee (IKDC subjective and objective scores, and radiographs of the knee. Results: The overall clinical outcomes of the knee showed the functional outcome of the knee to be normal in 51%, nearly normal in 37%, abnormal in 8%, and severely abnormal in 4%. The functional activities included stair climbing in 96%, squatting in 76%, jogging in 71% and kneeling in 47%. Three-quarters of the patients were able to kneel for daily activities. Approximately 98% of the patients were satisfied with the operation. The survivorship of the prosthesis was 98% with one revision pending. Radiographic evaluations revealed the components were centered in 82% and off-centered in 18%. Osteoarthritis was 22% preoperative and 27% postoperative for the patellofemoral compartment, and 0% before and 4% after surgery for the lateral compartment. The functional outcomes showed no difference between patients with and without patellofemoral arthritis. The complications included one component malposition and one knee pain of undetermined origin. Conclusions: UKA provides excellent pain relief and restoration of knee function including kneeling, squatting, and sit-to-stand activities that perfectly fit the oriental

  12. 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.

  13. Structural Stability of a Stiffened Aluminum Fuselage Panel Subjected to Combined Mechanical and Internal Pressure Loads

    Science.gov (United States)

    Rouse, Marshall; Young, Richard D.; Gehrki, Ralph R.

    2003-01-01

    Results from an experimental and analytical study of a curved stiffened aluminum panel subjected to combined mechanical and internal pressure loads are presented. The panel loading conditions were simulated using a D-box test fixture. Analytical buckling load results calculated from a finite element analysis are presented and compared to experimental results. Buckling results presented indicate that the buckling load of the fuselage panel is significantly influenced by internal pressure loading. The experimental results suggest that the stress distribution is uniform in the panel prior to buckling. Nonlinear finite element analysis results correlates well with experimental results up to buckling.

  14. The relationship between pain catastrophizing, kinesiophobia and subjective knee function during rehabilitation following anterior cruciate ligament reconstruction and meniscectomy: A pilot study

    Directory of Open Access Journals (Sweden)

    Ana Tichonova

    2016-01-01

    Conclusions: Pain catastrophizing and kinesiophobia decreased during rehabilitation. A higher pain catastrophizing level correlated with a greater level of knee pain during activities, more difficulties experienced during daily activities before and after rehabilitation. A high level of kinesiophobia correlated with more difficulties experienced in daily activities and poorer knee-related quality of life before and after rehabilitation.

  15. Weight loss is effective for symptomatic relief in obese subjects with knee osteoarthritis independently of joint damage severity assessed by high-field MRI and radiography

    DEFF Research Database (Denmark)

    Gudbergsen, H; Boesen, M; Lohmander, L S

    2012-01-01

    With an increasing prevalence of older and obese citizens, the problems of knee osteoarthritis (KOA) will escalate. Weight loss is recommended for obese KOA patients and in a majority of cases this leads to symptomatic relief. We hypothesized that pre-treatment structural status of the knee joint...

  16. Acute effects of lateral shoe wedges on joint biomechanics of patients with medial compartment knee osteoarthritis during stationary cycling.

    Science.gov (United States)

    Gardner, Jacob K; Klipple, Gary; Stewart, Candice; Asif, Irfan; Zhang, Songning

    2016-09-06

    Cycling is commonly prescribed for individuals with knee osteoarthritis (OA) but very little biomechanical research exists on the topic. Individuals with OA may be at greater risk of OA progression or other knee injuries because of their altered knee kinematics. This study investigated the effects of lateral wedges on knee joint biomechanics and pain in patients with medial compartment knee OA during stationary cycling. Thirteen participants with OA and 11 paired healthy participants volunteered for this study. A motion analysis system and a customized instrumented pedal were used to collect 5 pedal cycles of kinematics and kinetics, respectively, during 2 minutes of cycling in 1 neutral and 2 lateral wedge (5° and 10°) conditions. Participants pedaled at 60 RPM and an 80W workrate and rated their knee pain on a visual analog scale during each minute of each condition. There was a 22% decrease in the internal knee abduction moment with the 10° wedge. However, this finding was not accompanied by a decrease in knee adduction angle or subjective pain. Additionally, there was an increase in vertical and horizontal pedal reaction force which may negate the advantages of the decreased internal knee abduction moment. For people with medial knee OA, cycling with 10° lateral wedges may not be sufficient to slow the progression of OA beyond the neutral riding condition. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Further Study on Strain Growth in Spherical Containment Vessels Subjected to Internal Blast Loading

    OpenAIRE

    2009-01-01

    Abstract Strain growth is a phenomenon observed in the elastic response of containment vessels subjected to internal blast loading, which is featured by the increased vibration amplitude of the vessel in a later stage. Previous studies attributed the strain growth in spherical containment vessels to the beating between two close vibration modes, the interactions between the vessel vibration and the reflected shock waves and the structural perturbation. In this paper, it is shown th...

  18. Internalizing and externalizing personality and subjective effects in a sample of adolescent cannabis users.

    Science.gov (United States)

    García-Sánchez, Sara; Matalí, Josep Lluís; Martín-Fernández, María; Pardo, Marta; Lleras, Maria; Castellano-Tejedor, Carmina; Haro, Josep Maria

    2016-10-06

    Cannabis is the illicit substance most widely used by adolescents. Certain personality traits such as impulsivity and sensation seeking, and the subjective effects experienced after substance use (e.g. euphoria or relaxation) have been identified as some of the main etiological factors of consumption. This study aims to categorize a sample of adolescent cannabis users based on their most dominant personality traits (internalizing and externalizing profile). Then, to make a comparison of both profiles considering a set of variables related to consumption, clinical severity and subjective effects experienced. From a cross-sectional design, 173 adolescents (104 men and 69 women) aged 13 to 18 asking for treatment for cannabis use disorder in an Addictive Behavior Unit (UCAD) from the hospital were recruited. For the assessment, an ad hoc protocol was employed to register consumption, the Millon Adolescent Clinical Inventory (MACI) and the Addiction Research Center Inventory (ARCI) 49-item short form were also administered. Factor analysis suggested a two-profile solution: Introverted, Inhibited, Doleful, Dramatizing (-), Egotistic (-), Self-demeaning and Borderline tendency scales composed the internalizing profile, and Submissive (-), Unruly, Forceful, Conforming (-) and Oppositional scales composed the externalizing profile. The comparative analysis showed that the internalizing profile has higher levels of clinical severity and more subjective effects reported than the externalizing profile. These results suggest the need to design specific intervention strategies for each profile.

  19. 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...

  20. Knee arthroscopy

    Science.gov (United States)

    ... be able to walk without crutches or a knee brace for several weeks. Full recovery may take several months to a year. If you also have arthritis in your knee, you will still have arthritis symptoms after surgery ...

  1. Knee Bursitis

    Science.gov (United States)

    ... volleyball — can increase your risk of knee bursitis. Runners can develop pain and inflammation in the pes anserine bursa, situated on the inner side of your knee below the joint. Obesity and osteoarthritis. Pes anserine bursitis, affecting the inner ...

  2. The impact of simulated ankle plantarflexion contracture on the knee joint during stance phase of gait: a within-subject study.

    Science.gov (United States)

    Leung, Joan; Smith, Richard; Harvey, Lisa Anne; Moseley, Anne M; Chapparo, Joseph

    2014-04-01

    Ankle plantarflexion contractures are common in adults with neurological disorders and known to cause secondary gait deviations. However, their impact on the knee joint is not fully understood. The aims of this study are to describe the effect of simulated plantarflexion contractures on knee biomechanics during the stance phase and on the spatiotemporal characteristics of gait. Mild (10-degree plantarflexion) and severe (20-degree plantarflexion) ankle contractures were simulated in thirteen able-bodied adults using an ankle-foot-orthosis. A no contracture condition was compared with two simulated contracture conditions. There was an increase in knee extension, sometimes resulting in hyperextension, throughout stance for the two contracture conditions compared to the no contracture condition (mean increase in knee extension ranged from 5° to 9°; 95% CI 0° to 17°). At the same time, there were reductions in extension moment and power generation at the knee. Simulated plantarflexion contractures also reduced gait velocity, bilateral step length and cadence. All these changes were more pronounced in the severe contracture condition than mild contracture condition. While the majority of participants adopted a foot-flat pattern on landing and exhibited an increase in knee extension during stance, two participants used a toe-walking pattern and exhibited an increase in knee flexion. Ankle plantarflexion contractures are associated with an increase in knee extension during stance phase. However, some people with simulated ankle contractures may walk with an increase in knee flexion instead. Ankle plantarflexion contractures also adversely affect gait velocity, step length and cadence. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Ultrasound-guided saphenous nerve block is an effective technique for perioperative analgesia in ambulatory arthroscopic surgery of the internal knee compartment.

    Science.gov (United States)

    Bonet, A; Koo, M; Sabaté, A; Otero, I; Bocos, J; Pi, A

    2015-10-01

    Arthroscopic knee surgery is a minimally invasive technique with moderate pain during the first 24h. Our main objective was to evaluate the efficacy of ultrasound guided saphenous nerve block as a method of pain control intraoperatively and postoperatively for this surgery. A prospective and observational study. All patients received general anesthesia with laryngeal mask in the saphenous group, nerve block was performed with 10 ml ropivacaine 0.475%. Location of the surgery (external compartment group/internal compartment group), morphine consumption, VAS for pain at 5, 30, 60 and 120 min and 24 h after surgery, need for rescue medication, onset of nausea and vomiting, length of stay in PACU, delayed discharge and satisfaction were evaluated. The study included 73 patients. Of these, 46 received saphenous nerve block and 27 didn't receive it. Consumption of intraoperative, postoperative and total morphine was significantly lower in the saphenous group as well as VAS at 24h. In the subgroup of internal compartment surgery differences in VAS 24 h, morphine consume and lenght of stay in PACU were mantained. The ultrasound-guided block of saphenous nerve, particularly in the internal compartment arthroscopic knee surgery, decreases analgesic requirements, obtaining more effective pain control in the first 24 h postoperatively and without any known side effects. Copyright © 2014 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  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. Characterisation of Knee Brace Migration and Associated Skin Deformation During Flexion by Full-Field Measurements

    OpenAIRE

    Pierrat, Baptiste; Millot, Carine; Molimard, Jérôme; Navarro, Laurent; Calmels, Paul; Edouard, Pascal; Avril, Stéphane

    2015-01-01

    International audience; Fabric-based knee braces are widely used as orthotic devices to support and align the joint. Despite significant prescription, compliance with the treatment is often negatively affected by discomfort issues, in particular brace slippage and migration. Full-field measurements associated with digital image correlation were performed on 11 subjects to determine if the brace was able to follow skin deformation during knee flexion, which was suspected to be a primary slippa...

  6. Validity and internal consistency of a Yoruba version of the Ibadan knee/hip osteoathritis outcome measure (Yoruba IKHOAM).

    Science.gov (United States)

    Odole, A C; Akinpelu, A O; Bamgboye, E A

    2006-09-01

    The Ibadan Knee Hip osteoarthritis Outcome measure (IKHOAM) was developed for patients with Knee/Hip Osteoarthritis in the Nigerian and similar environments. The Yoruba Version was developed to encourage its use in the Southwestern region of Nigeria. The IKHOAM was translated into Yoruba in four separate processes of translation, back translation, committee review and pre-testing. It was administered to a cohort of 164 outpatients with symptomatic OA of the knee and or Hip who attended physiotherapy units in selected hospitals from Southwestern region of Nigeria. The IKHOAM (English Version) was correlated with the Yoruba version and Visual analogue scale (VAS). The Validity of the Yoruba IKHOAM was found to be satisfactory and comparable to the original version (r = 0.67, p = 0.005) for the criterion-related validity and r = -0.31 (p = 0.005) for construct validity. The items in the Yoruba IKHOAM correlated well with each other with Cronbach's alpha coefficient ranging between 0.69 and 0.99. The correlation on the different parts of the Yoruba IKHOAM was satisfactory (alpha = 0.52-0.87). The Yoruba IKHOAM like the original version is a reliable consistent and valid instrument that can be considered for use in the Nigeria environment for evidence based quality healthcare promotion in Knee/Hip OA patients.

  7. 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.

  8. The use of McConnell taping to correct abnormal biomechanics and muscle activation patterns in subjects with anterior knee pain: a systematic review

    Science.gov (United States)

    Leibbrandt, Dominique C; Louw, Quinette A

    2015-01-01

    [Purpose] The aim of this review was to present the available evidence for the effect of McConnell taping on knee biomechanics in individuals with anterior knee pain. [Methods] The PubMed, Medline, Cinahl, SPORTDiscus, PEDro and ScienceDirect electronic databases were searched from inception until September 2014. Experimental research on knee biomechanical or EMG outcomes of McConnell taping compared with no tape or placebo tape were included. Two reviewers completed the searches, selected the full text articles, and assessed the risk of bias of eligible studies. Authors were contacted for missing data. [Results] Eight heterogeneous studies with a total sample of 220 were included in this review. All of the studies had a moderate to low risk of bias. Pooling of data was possible for three outcomes: average knee extensor moment, average VMO/VL ratio and average VMO-VL onset timing. None of these outcomes revealed significant differences. [Conclusion] The evidence is currently insufficient to justify routine use of the McConnell taping technique in the treatment of anterior knee pain. There is a need for more evidence on the aetiological pathways of anterior knee pain, level one evidence, and studies investigating other potential mechanisms of McConnell taping. PMID:26311990

  9. The sleep, subjective fatigue, and sustained attention of commercial airline pilots during an international pattern.

    Science.gov (United States)

    Petrilli, Renée M; Roach, Gregory D; Dawson, Drew; Lamond, Nicole

    2006-01-01

    International commercial airline pilots may experience heightened fatigue due to irregular sleep schedules, long duty days, night flying, and multiple time zone changes. Importantly, current commercial airline flight and duty time regulations are based on work/rest factors and not sleep/wake factors. Consequently, the primary aim of the current study was to investigate pilots' amount of sleep, subjective fatigue, and sustained attention before and after international flights. A secondary aim was to determine whether prior sleep and/or duty history predicted pilots' subjective fatigue and sustained attention during the international flights. Nineteen pilots (ten captains, nine first officers; mean age: 47.42+/-7.52 years) participated. Pilots wore wrist activity monitors and completed sleep and duty diaries during a return pattern from Australia to Europe via Asia. The pattern included four flights: Australia-Asia, Asia-Europe, Europe-Asia, and Asia-Australia. Before and after each flight, pilots completed a 5 min PalmPilot-based psychomotor vigilance task (PVT) and self-rated their level of fatigue using the Samn-Perelli Fatigue Checklist. Separate repeated-measures ANOVAs were used to determine the impact of stage of flight and flight sector on the pilots' sleep in the prior 24 h, self-rated fatigue, and PVT mean response speed. Linear mixed model regression analyses were conducted to examine the impact of sleep in the prior 24 h, prior wake, duty length, and flight sector on pilots' self-rated fatigue and sustained attention before and after the international flights. A significant main effect of stage of flight was found for sleep in the prior 24 h, self-rated fatigue, and mean response speed (all p pilots should be taken into account in the development of flight and duty time regulations.

  10. The DAMASK trial protocol: a pragmatic randomised trial to evaluate whether GPs should have direct access to MRI for patients with suspected internal derangement of the knee

    Directory of Open Access Journals (Sweden)

    Orchard Jo

    2006-10-01

    Full Text Available Abstract Background Though new technologies like Magnetic Resonance Imaging (MRI may be accurate, they often diffuse into practice before thorough assessment of their value in diagnosis and management, and of their effects on patient outcome and costs. MRI of the knee is a common investigation despite concern that it is not always appropriate. There is wide variation in general practitioners (GPs access to, and use of MRI, and in the associated costs. The objective of this study was to resolve uncertainty whether GPs should refer patients with suspected internal derangement of the knee for MRI or to an orthopaedic specialist in secondary care. Methods/Design The design consisted of a pragmatic multi-centre randomised trial with two parallel groups and concomitant economic evaluation. Patients presenting in general practice with suspected internal derangement of the knee and for whom their GP was considering referral to an orthopaedic specialist in secondary care were eligible for inclusion. Within practices, GPs or practice nurses randomised eligible and consenting participants to the local radiology department for an MRI examination, or for consultation with an orthopaedic specialist. To ensure that the waiting time from GP consultation to orthopaedic appointment was similar for both trial arms, GPs made a provisional referral to orthopaedics when requesting the MRI examination. Thus we evaluated the more appropriate sequence of events independent of variations in waiting times. Follow up of participants was by postal questionnaires at six, twelve and 24 months after randomisation. This was to ensure that the evaluation covered all events up to and including arthroscopy. Discussion The DAMASK trial should make a major contribution to the development of evidence-based partnerships between primary and secondary care professionals and inform the debate when MRI should enter the diagnostic pathway.

  11. Prevalence of pathologic findings in asymptomatic knees of marathon runners before and after a competition in comparison with physically active subjects - a 3.0 T magnetic resonance imaging study

    Energy Technology Data Exchange (ETDEWEB)

    Stahl, Robert [University of California, San Francisco, Musculoskeletal and Quantitative Imaging Group, Department of Radiology, San Francisco, CA (United States); Ludwig Maximilians University of Munich, Department of Clinical Radiology, University Hospitals-Campus Grosshadern, Munich (Germany); Luke, Anthony [University of California, San Francisco, Department of Orthopedic Surgery, San Francisco, CA (United States); University of California, San Francisco, Department of Family and Community Medicine, San Francisco, CA (United States); Ma, C.B. [University of California, San Francisco, Department of Orthopedic Surgery, San Francisco, CA (United States); Krug, Roland; Steinbach, Lynne; Majumdar, Sharmila; Link, Thomas M. [University of California, San Francisco, Musculoskeletal and Quantitative Imaging Group, Department of Radiology, San Francisco, CA (United States)

    2008-07-15

    To determine the prevalence of pathologic findings in asymptomatic knees of marathon runners before and after a competition in comparison with physically active subjects. To compare the diagnostic performance of cartilage-dedicated magnetic resonance imaging (MRI) sequences at 3.0 T. Ten marathon runners underwent 3.0 T MRI 2-3 days before and after competition. Twelve physically active asymptomatic subjects not performing long-distance running were examined as controls. Pathologic condition was assessed with the whole-organ magnetic resonance imaging score (WORMS). Cartilage abnormalities and bone marrow edema pattern (BMEP) were quantified. Visualization of cartilage pathology was assessed with intermediate-weighted fast spin-echo (IM-w FSE), fast imaging employing steady-state acquisition (FIESTA) and T1-weighted three-dimensional (3D) high-spatial-resolution volumetric fat-suppressed spoiled gradient-echo (SPGR) MRI sequences. Eight of ten marathon runners and 7/12 controls showed knee abnormality. Slightly more and larger cartilage abnormalities, and BMEP, in marathon runners yielded higher but not significantly different WORMS (P > 0.05) than in controls. Running a single marathon did not alter MR findings substantially. Cartilage abnormalities were best visualized with IM-w FSE images (P < 0.05). A high prevalence of knee abnormalities was found in marathon runners and also in active subjects participating in other recreational sports. IM-w FSE sequences delineated more cartilage MR imaging abnormalities than did FIESTA and SPGR sequences. (orig.)

  12. ACTIVATION OF VASTUS MEDIALIS OBLIQUES AT DIFFERENT KNEE ANGLES IN CLOSED KINETIC CHAIN AND OPEN KINETIC CHAIN POSITION IN SUBJECTS WITH PATELLO FEMORAL PAIN SYNDROME

    Directory of Open Access Journals (Sweden)

    Ujwal Bhattacharya

    2015-06-01

    Full Text Available Background: Patello femoral pain syndrome is one of the most common musculoskeletal disorders and is reported to affect 15% - 33% of an active adult population and 21%-45% of adolescents thereby decreasing the work capacity of an individual. Patello femoral pain syndrome as implicated is due to inappropriate neural control of the quadriceps femoris muscle. Since Vastus medialis muscle is regarded as the dynamic medial stabilizer of patella so it’s important to understand the activation of Vastus Medialis Oblique’s in patients with patello femoral pain syndrome The purpose of this study is to assess the activation of Vastus Medialis Oblique’s at different knee angles between closed kinetic chain position and open kinetic chain position and the information thus gained can be used to design training program aimed at controlling patello femoral joint dysfunction. Methods: Thirty subjects with patello femoral pain syndrome (assessed through history and examination were assigned to two groups. Group A was made to perform open kinetic chain activity(i.e. sitting on high plinth and Group B was made to perform a closed kinetic chain activity(i.e. standing The outcome measure were amplitude and duration. Analyses were performed using independent t-Test. Results: Significant difference was found between the groups for amplitude and duration at varying angles. Amplitude: 0 degree (p=0.004, 60 degrees (p=0.015, 90 degrees (p=0.004. Duration: 0 degree (p=0.007, 60 degrees (p=0.008,90 degrees (p=0.002 Conclusion: Based on the outcome of the study it’s concluded that there is greater activation of Vastus Medialis Oblique’s muscle while performing close kinetic chain activity than in open kinetic chain.

  13. In vivo kinematics of the knee during weight bearing high flexion.

    Science.gov (United States)

    Qi, Wei; Hosseini, Ali; Tsai, Tsung-Yuan; Li, Jing-Sheng; Rubash, Harry E; Li, Guoan

    2013-05-31

    Achieving high flexion is an objective of contemporary total knee arthoplasty; however little is known on the knee biomechanics at high flexion under weight-bearing conditions. This study investigates the 6DOF kinematics and tibiofemoral cartilage contact biomechanics of the knee during weight-bearing flexion from full extension to maximal flexion. Eight knees from seven healthy subjects with no history of injuries or chronic pain were recruited. The knees were MRI scanned to create 3D models of the tibia and femur, including their articular cartilage surfaces. The subjects were then imaged using a dual fluoroscopic image system while performing a weight-bearing quasi-static single-legged lunge from full extension to maximal flexion. The 6DOF kinematics and the articular cartilage contact locations were measured along the flexion path of the knee. The result indicated that the internal tibial rotation increased sharply at low flexion angles (full extension to 30°), maintained a small variation in the middle range of flexion (30-120°, and then sharply increased again at high flexion angles (120° to maximal flexion). The contact point moved similarly in the medial and lateral compartments before 120° of flexion, but less on the medial compartment at high flexion angles. The results indicated that the knee motion could not be described using one character in the entire range of flexion, especially in high flexion. The knee kinematic data in the entire range of flexion of the knee could be instrumental for designing new knee prostheses to achieve physical high flexion and improving rehabilitation protocols after knee injuries. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. Effect of graft fixation sequence on knee joint biomechanics in double-bundle anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Shi, Dongliang; Zhou, Jingbin; Yapici, Can; Linde-Rosen, Monica; Smolinski, Patrick; Fu, Freddie H

    2015-03-01

    To investigate the effect of graft fixation sequence in double-bundle anterior cruciate ligament (ACL) reconstruction on knee biomechanics. Twelve mature porcine knees underwent double-bundle ACL reconstruction with a randomized fixation order of the two graft bundles. The knees were subjected to external loadings of (1) an 89 N anterior tibial load at 30°, 60° and 90° of knee flexion and (2) 4 N-m internal and external tibial torques at 30° and 60° of knee flexion for ACL intact, deficient and reconstructed states. Knee kinematics and in situ graft forces were measured under the applied loads. The anterior tibial translation of the two reconstructions was not different from each other but was significantly different from the intact ACL. There was no difference in internal and external rotations between the intact knees and the reconstructions. At lower flexion angles, the graft that was fixed last (whether anteromedial or posterolateral) tended to carry significantly higher in situ load under anterior tibial loading and tibial torques. While a difference in knee kinematics may not be observable with different graft fixation sequences, fixation sequence can alter the in situ forces that the grafts bear under knee loading.

  15. Contribution of regional 3D meniscus and cartilage morphometry by MRI to joint space width in fixed flexion knee radiography—A between-knee comparison in subjects with unilateral joint space narrowing

    Energy Technology Data Exchange (ETDEWEB)

    Bloecker, K., E-mail: katja.bloecker@pmu.ac.at [Institute of Anatomy and Musculoskeletal Research, Paracelsus Medical University, Strubergasse 21, 5020 Salzburg (Austria); Department of Traumatology and Sports Medicine, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg (Austria); Wirth, W., E-mail: wolfgang.wirth@pmu.ac.at [Institute of Anatomy and Musculoskeletal Research, Paracelsus Medical University, Strubergasse 21, 5020 Salzburg (Austria); Chondrometrics GmbH, Ulrichshöglerstrasse 23, 83404 Ainring (Germany); Hunter, D.J., E-mail: david.hunter@sydney.edu.au [Royal North Shore Hospital and Kolling Institute, University of Sydney, Pacific Highway, St Leonards, Sydney, NSW 2065 (Australia); Duryea, J., E-mail: jduryea@bwh.harvard.edu [Brigham and Women' s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA (United States); Guermazi, A., E-mail: Ali.Guermazi@bmc.org [Boston University School of Medicine, Department of Radiology, 820 Harrison Avenue, FGH Building 3rd Floor, Boston, MA (United States); Boston Imaging Core Lab (BICL), 601 Albany Street, Boston, MA (United States); Kwoh, C.K., E-mail: kwoh@pitt.edu [Division of Rheumatology and Clinical Immunology, University of Arizona, Tucson, AZ (United States); Division of Rheumatology and Clinical Immunology, University of Pittsburgh and VA, Pittsburgh Healthcare System, 3500 Terrace Street, Biomedical Science Tower South 702, Pittsburgh, PA 15261 (United States); Resch, H., E-mail: Herbert.resch@salk.at [Department of Traumatology and Sports Medicine, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg (Austria); Eckstein, F. [Institute of Anatomy and Musculoskeletal Research, Paracelsus Medical University, Strubergasse 21, 5020 Salzburg (Austria); Chondrometrics GmbH, Ulrichshöglerstrasse 23, 83404 Ainring (Germany)

    2013-12-01

    Background: Radiographic joint space width (JSW) is considered the reference standard for demonstrating structural therapeutic benefits in knee osteoarthritis. Our objective was to determine the proportion by which 3D (regional) meniscus and cartilage measures explain between-knee differences of JSW in the fixed flexion radiographs. Methods: Segmentation of the medial meniscus and tibial and femoral cartilage was performed in double echo steady state (DESS) images. Quantitative measures of meniscus size and position, femorotibial cartilage thickness, and radiographic JSW (minimum, and fixed locations) were compared between both knees of 60 participants of the Osteoarthritis Initiative, with strictly unilateral medial joint space narrowing (JSN). Statistical analyses (between-knee, within-person comparison) were performed using regression analysis. Results: A strong relationship with side-differences in minimum and a central fixed location JSW was observed for percent tibial plateau coverage by the meniscus (r = .59 and .47; p < .01) and central femoral cartilage thickness (r = .69 and .75; p < .01); other meniscus and cartilage measures displayed lower coefficients. The correlation of central femoral cartilage thickness with JSW (but not that of meniscus measures) was greater (r = .78 and .85; p < .01) when excluding knees with non-optimal alignment between the tibia and X-ray beam. Conclusion: 3D measures of meniscus and cartilage provide significant, independent information in explaining side-differences in radiographic JSW in fixed flexion radiographs. Tibial coverage by the meniscus and central femoral cartilage explained two thirds of the variability in minimum and fixed location JSW. JSW provides a better representation of (central) femorotibial cartilage thickness, when optimal positioning of the fixed flexion radiographs is achieved.

  16. 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

    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......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...

  17. The effect of knee braces on tibial rotation in anterior cruciate ligament-deficient knees during high-demand athletic activities.

    Science.gov (United States)

    Giotis, Dimitrios; Zampeli, Franceska; Pappas, Evangelos; Mitsionis, Grigoris; Papadopoulos, Pericles; Georgoulis, Anastasios D

    2013-07-01

    To examine if bracing can restrict tibial rotation in anterior cruciate ligament (ACL)-deficient patients during high loading activities. Repeated measures. Kinematic data were collected with an 8-camera Vicon system while each patient performed 2 tasks that are known to cause increased rotational and translational loads on the knee: (1) descending from a stair and subsequent pivoting, and (2) landing from a platform and subsequent pivoting. The tasks were repeated under 3 brace conditions for the ACL-deficient knee: (1) wearing a prophylactic brace (braced condition), (2) wearing a patellofemoral brace (sleeved condition), and (3) without brace (unbraced condition). Biomechanical laboratory study. Twenty-one male subjects with a confirmed unilateral ACL rupture were assessed in vivo. Tibial internal rotation. Two repeated measures ANOVAs tested for differences in tibial internal rotation among the 3 conditions of the ACL-deficient knee and the unbraced condition of the intact knee. In both tasks, tibial rotation was significantly lower in the intact knee compared with all 3 conditions of the ACL-deficient knee (P ≤ 0.031). Bracing the ACL-deficient knee resulted in lower rotation than the unbraced (P ≤ 0.001) and sleeved (P ≤ 0.033) conditions. The sleeved condition resulted in lower tibial rotation in the drop landing and pivoting task compared with the unbraced condition (P = 0.019) but not in the stair descending and pivoting task (P = 0.256). Bracing decreased the excessive tibial rotation in ACL-deficient patients during high-demand activities but failed to fully restore normative values. If knee braces can enhance rotational knee stability in ACL-deficient patients, then they could possibly play an important role in preventing further knee pathology in such patients.

  18. Reliability and measurement error of the Osteoarthritis Research Society International (OARSI) recommended performance-based tests of physical function in people with hip and knee osteoarthritis.

    Science.gov (United States)

    Dobson, F; Hinman, R S; Hall, M; Marshall, C J; Sayer, T; Anderson, C; Newcomb, N; Stratford, P W; Bennell, K L

    2017-11-01

    To estimate the reliability and measurement error of performance-based tests of physical function recommended by the Osteoarthritis Research Society International (OARSI) in people with hip and/or knee osteoarthritis (OA). Prospective repeated measures between independent raters within a session and within-rater over a week interval. Relative reliability was estimated for 51 people with hip and/or knee OA (mean age 64.5 years, standard deviation (SD) 6.21 years; 47% females; 36 (70%) primary knee OA) on the 30s Chair Stand Test (30sCST), 40m Fast-Paced Walk Test (40mFPWT), 11-Stair Climb Test (11-step SCT), Timed Up and Go (TUG), Six-Minute Walk Test (6MWT), 10m Fast-Paced Walk Test (10mFPWT) and 20s Stair Climb Test (20sSCT) using intra-class correlation coefficients (ICC). Absolute reliability was calculated using standard error of measurement (SEM) and minimal detectable change (MDC). Measurement error was acceptable (SEM tests. Between-rater reliability was: optimal (ICC > 0.9, lower 1-sided 95% CI > 0.7) for the 40mFPWT, 6MWT and 10mFPWT; sufficient (ICC >0.8, lower 1-sided 95% CI > 0.7) for 30sCST, 20sSCT; unacceptable (lower 1-side 95% CI reliability was optimal for 40mFPWT, and 6MWT; sufficient for 30sCST and 10mFPWT and unacceptable for 11-step SCT, TUG and 20sSCT. The 30sCST, 40mFPWT, 6MWT and 10mFPWT, demonstrated, at minimum, acceptable levels of both between and within-rater reliability and measurement error. All tests demonstrated sufficiently small measurement error indicating they are adequate for measuring change over time in individuals with knee/hip OA. Copyright © 2017 Osteoarthritis Research Society International. All rights reserved.

  19. Knee extension and flexion weakness in people with knee osteoarthritis: is antagonist cocontraction a factor?

    Science.gov (United States)

    Heiden, Tamika L; Lloyd, David G; Ackland, Timothy R

    2009-11-01

    Controlled laboratory study, cross-sectional data. To investigate isometric knee flexion and extension strength, failure of voluntary muscle activation, and antagonist cocontraction of subjects with knee osteoarthritis (OA) compared with age-matched asymptomatic control subjects. Quadriceps weakness is a common impairment in individuals with knee OA. Disuse atrophy, failure of voluntary muscle activation, and antagonist muscle cocontraction are thought to be possible mechanisms underlying this weakness; but antagonist cocontraction has not been examined during testing requiring maximum voluntary isometric contraction. Fifty-four subjects with knee OA (mean +/- SD age, 65.6 +/- 7.6 years) and 27 similarly aged control subjects (age, 64.2 +/- 5.1 years) were recruited for this study. Isometric knee flexion and extension strength were measured, and electromyographic data were recorded, from 7 muscles crossing the knee and used to calculate cocontraction ratios during maximal effort knee flexion and extension trials. The burst superimposition technique was used to measure failure of voluntary activation. Knee extension strength of subjects with knee OA (mean +/- SD, 115.9 +/- 6.7 Nm) was significantly lower than for those in the control group (152.3 +/- 9.6 Nm). No significant between-group difference was found for failure of voluntary muscle activation, or the cocontraction ratios during maximum effort knee flexion or extension. These results demonstrate that the reduction in isometric extension strength, measured with a 90 degrees knee flexion angle, in subjects with knee OA is not associated with increased antagonist cocontraction.

  20. Field testing the Unified Classification System for periprosthetic fractures of the femur, tibia and patella in association with knee replacement: an international collaboration.

    Science.gov (United States)

    Van der Merwe, J M; Haddad, F S; Duncan, C P

    2014-12-01

    The Unified Classification System (UCS) was introduced because of a growing need to have a standardised universal classification system of periprosthetic fractures. It combines and simplifies many existing classification systems, and can be applied to any fracture around any partial or total joint replacement occurring during or after operation. Our goal was to assess the inter- and intra-observer reliability of the UCS in association with knee replacement when classifying fractures affecting one or more of the femur, tibia or patella. We used an international panel of ten orthopaedic surgeons with subspecialty fellowship training and expertise in adult hip and knee reconstruction ('experts') and ten residents of orthopaedic surgery in the last two years of training ('pre-experts'). They each received 15 radiographs for evaluation. After six weeks they evaluated the same radiographs again but in a different order. The reliability was assessed using the Kappa and weighted Kappa values. The Kappa values for inter-observer reliability for the experts and the pre-experts were 0.741 (95% confidence interval (CI) 0.707 to 0.774) and 0.765 (95% CI 0.733 to 0.797), respectively. The weighted Kappa values for intra-observer reliability for the experts and pre-experts were 0.898 (95% CI 0.846 to 0.950) and 0.878 (95% CI 0.815 to 0.942) respectively. The UCS has substantial inter-observer reliability and 'near perfect' intra-observer reliability when used for periprosthetic fractures in association with knee replacement in the hands of experienced and inexperienced users. ©2014 The British Editorial Society of Bone & Joint Surgery.

  1. 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 ...

  2. High prevalence of knee osteoarthritis, pain, and functional limitations in female soccer players twelve years after anterior cruciate ligament injury.

    Science.gov (United States)

    Lohmander, L S; Ostenberg, A; Englund, M; Roos, H

    2004-10-01

    To determine the prevalence of radiographic knee osteoarthritis (OA) as well as knee-related symptoms and functional limitations in female soccer players 12 years after an anterior cruciate ligament (ACL) injury. Female soccer players who sustained an ACL injury 12 years earlier were examined with standardized weight-bearing knee radiography and 2 self-administered patient questionnaires, the Knee Injury and Osteoarthritis Outcome Score questionnaire and the Short Form 36-item health survey. Joint space narrowing and osteophytes were graded according to the radiographic atlas of the Osteoarthritis Research Society International. The cutoff value to define radiographic knee OA approximated a Kellgren/Lawrence grade of 2. Of the available cohort of 103 female soccer players, 84 (82%) answered the questionnaires and 67 (65%) consented to undergo knee radiography. The mean age at assessment was 31 years (range 26-40 years) and mean body mass index was 23 kg/m2 (range 18-40 kg/m2). Fifty-five women (82%) had radiographic changes in their index knee, and 34 (51%) fulfilled the criterion for radiographic knee OA. Of the subjects answering the questionnaires, 63 (75%) reported having symptoms affecting their knee-related quality of life, and 28 (42%) were considered to have symptomatic radiographic knee OA. Slightly more than 60% of the players had undergone reconstructive surgery of the ACL. Using multivariate analyses, surgical reconstruction was found to have no significant influence on knee symptoms. A very high prevalence of radiographic knee OA, pain, and functional limitations was observed in young women who sustained an ACL tear during soccer play 12 years earlier. These findings constitute a strong rationale to direct increased efforts toward prevention and better treatment of knee injury. Copyright 2004 American College of Rheumatology

  3. Bifurcation topology transfer in nonlinear nanocantilever arrays subject to parametric and internal resonances

    Directory of Open Access Journals (Sweden)

    Souayeh Saoussen

    2014-01-01

    Full Text Available The collective nonlinear dynamics of a coupled array of nanocantilevers is investigated while taking into account the main sources of nonlinearities. The amplitude and phase equations of this device, subject to parametric and internal resonances, are analytically derived by means of a multi-modal Galerkin discretization coupled with a multiscale analysis. Based on the steady-state solutions of these equations, the frequency responses are numerically computed for a two-beam array. The effects of different parameters are investigated and several dynamical aspects are confirmed by numerical simulations. Particularly, we have demonstrated that the bifurcation topology transfer is imposed by the first nanocantilever and it can be general to the collective nonlinear dynamics of the NEMS array.

  4. [Anatomic incidence of meniscochondrocalcinosis of the knee].

    Science.gov (United States)

    Mitrovic, D; Stankovic, A; Morin, J; Borda-Iriarte, O; Uzan, M; Quintero, M; Memin, Y; Bard, M; de Sèze, S; Richewaert, A

    1982-06-01

    The authors have studied the incidence of menisco-calcinosis (MC) and that of menisco-chondrocalcinosis (MCC) of knee joints of 108 non selected cadavera. The mean age of the subjects was 71.8 +/- 13.8 years. The study was performed by radiographic examination of the menisci and cartilagineous fragments of femoral condyles using high contrast films. The incidence of MC or MCC was found to be 18.5 per cent. It was slightly higher in females (21.5 p. cent) than in males (15.8 p. cent) subjects but this difference failed to reach the level of statistical significance. No positive case was detected before the age of 60 years. For the age groups of: 60-69, 70-79, 80-89 and over 90 years, its incidence was: 11.7; 26.9; 21.2 and 50 (4 subjects out of 8) per cent respectively. Approximately 40 per cent of all positive cases had meniscocalcinosis without associated chondrocalcinosis. No single case of chondrocalcinosis without meniscocalcinosis was observed. Six out of 8 cases with MC calcinosis and 2 out of 12 cases with MCC were unilateral. The external menisci were more frequently and more heavily affected than internal ones. Eighty per cent of the knees affected by either MC or MCC were at the same time associated to an osteoarthrotic lesion compared to 35 p. cent of the knees without MC or MCC matched for age: a result which appeared to be highly significant difference.

  5. 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

  6. A preliminary assessment of a novel pneumatic unloading knee brace on the gait mechanics of patients with knee osteoarthritis.

    Science.gov (United States)

    Della Croce, Ugo; Crapanzano, Fausto; Li, Ling; Kasi, Patrick K; Patritti, Benjamin L; Mancinelli, Chiara; Hunter, David J; Stamenović, Dimitrije; Harvey, William F; Bonato, Paolo

    2013-10-01

    To determine whether a knee brace incorporating inflatable air bladders can alter the net peak external knee adduction moment in persons with medial compartment knee osteoarthritis. Prospective cohort study. Motion analysis laboratory. Subjects (n = 18) diagnosed with knee osteoarthritis as defined by the Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Instrumented gait analysis was performed while subjects walked with and without the knee brace. When subjects wore the knee brace, the air bladders were either uninflated or inflated to 7 psi. The net external knee adduction moment was obtained by subtracting the abduction moment produced by the knee brace (estimated using a finite element analysis model) from the external knee adduction moment (estimated using a camera-based motion analysis system). The net external knee adduction moment was compared across all testing conditions. A 7.6% decrease in net peak external knee adduction moment was observed when subjects wore the knee brace uninflated compared with when they did not wear the brace. Inflation of the bladders to 7 psi led to a 26.0% decrease in net peak external knee adduction moment. The results of the study suggest that the effects of an unloading knee brace may be enhanced by incorporating inflatable air bladders into the design of the brace, thus leading to an improved correction of the excessive peak external knee adduction moment observed in patients with medial compartment knee osteoarthritis. Copyright © 2013. Published by Elsevier Inc.

  7. The role of internal and external factors on management students’ subject choices

    Directory of Open Access Journals (Sweden)

    David AL Coldwell

    2013-09-01

    Full Text Available The aim of the study is to investigate undergraduates’ perceptions of the comparative worth/utility of studying Business Science disciplines at a prominent South African University in terms of: (i internal factors comprising aptitudes, values and interests; and (ii external factors comprising job attractiveness (job prospects, earning potential, non-salary benefits and work-life balance, and (iii university and discipline academic reputations. The study utilises a specifically designed instrument to measure internal and external factors impinging on career choice. A purposive non-random sample, consisting of 130 second and third year students in Human Resource Management (HRM and Management, is used. Findings suggest that, while perceptions of aspects of careers, such as job and career prospects generally dominate the choice of major subjects, students studying HRM majors hold community orientated values that distinguish them from their peers. Many students are found to make choices primarily on the basis of their perceptions of ‘external factors’, rather than their interests. The findings are discussed in terms of extant theory and potential practical outcomes.

  8. The role of internal and external factors on management students’ subject choices

    Directory of Open Access Journals (Sweden)

    David AL Coldwell

    2013-09-01

    Full Text Available The aim of the study is to investigate undergraduates’ perceptions of the comparative worth/utility of studying Business Science disciplines at a prominent South African University in terms of: (i internal factors comprising  aptitudes, values and interests; and (ii external factors comprising job attractiveness (job prospects, earning potential, non-salary benefits and work-life balance, and (iii university and discipline academic reputations. The study utilises a specifically designed instrument to measure internal and external factors impinging on career choice. A purposive non-random sample, consisting of 130 second and third year students in Human Resource Management (HRM and Management, is used. Findings suggest that, while perceptions of aspects of careers, such as job and career prospects generally dominate the choice of major subjects, students studying HRM majors hold community orientated values that distinguish them from their peers. Many students are found to make choices primarily on the basis of their perceptions of ‘external factors’, rather than their interests. The findings are discussed in terms of extant theory and potential practical outcomes.

  9. Biomechanical effects of valgus knee bracing: a systematic review and meta-analysis.

    Science.gov (United States)

    Moyer, R F; Birmingham, T B; Bryant, D M; Giffin, J R; Marriott, K A; Leitch, K M

    2015-02-01

    To review and synthesize the biomechanical effects of valgus knee bracing for patients with medial knee osteoarthritis (OA). Electronic databases were searched from their inception to May 2014. Two reviewers independently determined study eligibility, rated study quality and extracted data. Where possible, data were combined into meta-analyses and pooled estimates with 95% confidence intervals (CI) for standardized mean differences (SMD) were calculated. Thirty studies were included with 478 subjects tested while using a valgus knee brace. Various biomechanical methods suggested valgus braces can decrease direct measures of medial knee compressive force, indirect measures representing the mediolateral distribution of load across the knee, quadriceps/hamstring and quadriceps/gastrocnemius co-contraction ratios, and increase medial joint space during gait. Meta-analysis from 17 studies suggested a statistically significant decrease in the external knee adduction moment (KAM) during walking, with a moderate-to-high effect size (SMD = 0.61; 95% CI: 0.39, 0.83; P brace use only (β, -0.01; 95% CI: -0.03, 0.0001; P = 0.06); with longer durations of brace use associated with smaller treatment effects. Minor complications were commonly reported during brace use and included slipping, discomfort and poor fit, blisters and skin irritation. Systematic review and meta-analysis suggests valgus knee braces can alter knee joint loads through a combination of mechanisms, with moderate-to-high effect sizes in biomechanical outcomes. Copyright © 2014 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  10. 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 group...... knee osteoarthritis (OA)....

  11. Systemic biochemical markers of joint metabolism and inflammation in relation to radiographic parameters and pain of the knee : Data from CHECK, a cohort of early-osteoarthritis subjects

    NARCIS (Netherlands)

    Van Spil, W. E.; Nair, S. C.; Kinds, M.B.; Emans, P. J.; Hilberdink, W. K H A; Welsing, P. M J; Lafeber, F. P J G

    2015-01-01

    Objective: To investigate associations of biochemical markers of joint metabolism and inflammation with minimum joint space width (JSW) and osteophyte area (OP area) of knees showing no or doubtful radiographic osteoarthritis (OA) and to investigate whether these differed between painful and

  12. ATTRIBUTION OF CONDUCT TO A STATE-THE SUBJECTIVE ELEMENT OF THE INTERNATIONAL RESPONSIBILITY OT THE STATE FOR INTERNATIONALLY WRONGFUL ACTS

    Directory of Open Access Journals (Sweden)

    FELICIA MAXIM

    2012-05-01

    Full Text Available In order to establish responsibility of states for internationally wrongful act, two elements are identified. First, the conduct in question must be attributable to the State under international law. Secondly, for responsibility to attach to the act of the State, the conduct must constitute a breach of an international legal obligation in force for that State at that time. For particular conduct to be characterized as an internationally wrongful act, it must first be attributable to the State. The State is a real organized entity, a legal person with full authority to act under international law. But to recognize this is not to deny the elementary fact that the State cannot act of itself. States can act only by and through their agents and representatives. In determining what constitutes an organ of a State for the purposes of responsibility, the internal law and practice of each State are of prime importance. The structure of the State and the functions of its organs are not, in general, governed by international law. It is a matter for each State to decide how its administration is to be structured and which functions are to be assumed by government. But while the State remains free to determine its internal structure and functions through its own law and practice, international law has a distinct role. Conduct is thereby attributed to the State as a subject of international law and not as a subject of internal law. The State as a subject of international law is held responsible for the conduct of all the organs, instrumentalities and officials which form part of its organization and act in that capacity, whether or not they have separate legal personality under its internal law.

  13. Some recent developments in the international guidelines on the ethics of research involving human subjects.

    Science.gov (United States)

    Levine, R J

    2000-11-01

    We are in a period of reconsideration and revision of international ethical guidelines for the conduct of biomedical research involving human subjects. The proximate cause of much of this activity is the recent controversy over the ethics of the use of a placebo control in the clinical trials of the short-duration regimen of zidovudine for prevention of perinatal transmission of HIV infection, trials that were carried out in several so-called technologically developing countries. Critics of these trials claimed that they were in violation of Article II.3 of the Declaration of Helsinki, which states: "In any medical study, every patient--including those of a control group, if any--should be assured of the best proven diagnostic and therapeutic method. This does not exclude the use of inert placebo in studies where no proven diagnostic or therapeutic method exists." The critics claimed that since the "best proven ... method" is the 076 regimen, this is what must be provided to members of the control groups. Failure to do so, they asserted, was a serious breach of ethics. In response to this allegation, several major international and national agencies convened multidisciplinary groups to consider the ethics of multinational clinical research. The first thing they realized was that Article II.3 was in error in that it did not reflect contemporary ethical thinking. Moreover, it was routinely violated in research conducted in developed as well as in developing countries. What replaces this standard? The 1993 CIOMS International Ethical Guidelines for Biomedical Research Involving Human Subjects include several criteria for justification of research carried out in developing countries. Most importantly, the research must be responsive to the health needs and priorities of the host country. They also require that any therapeutic products developed in such research must be made "reasonably available" to residents of the host country. A new standard is emerging for

  14. Adolescents' Cortisol Reactivity and Subjective Distress in Response to Family Conflict: The Moderating Role of Internalizing Symptoms

    National Research Council Canada - National Science Library

    Spies, Lauren A; Margolin, Gayla; Susman, Elizabeth J; Gordis, Elana B

    2011-01-01

    ... in the youths' daily activities [1,6] . The present study examines adolescents' HPA activity surrounding the social stress of conflictual parent–child discussions. We also examine adolescents' internalizing symptoms and subjective distress as putative influences on HPA activity. Because internalizing disorders include experiences of socia...

  15. Knee joint forces: prediction, measurement, and significance

    Science.gov (United States)

    D’Lima, Darryl D.; Fregly, Benjamin J.; Patil, Shantanu; Steklov, Nikolai; Colwell, Clifford W.

    2011-01-01

    Knee forces are highly significant in osteoarthritis and in the survival and function of knee arthroplasty. A large number of studies have attempted to estimate forces around the knee during various activities. Several approaches have been used to relate knee kinematics and external forces to internal joint contact forces, the most popular being inverse dynamics, forward dynamics, and static body analyses. Knee forces have also been measured in vivo after knee arthroplasty, which serves as valuable validation of computational predictions. This review summarizes the results of published studies that measured knee forces for various activities. The efficacy of various methods to alter knee force distribution, such as gait modification, orthotics, walking aids, and custom treadmills are analyzed. Current gaps in our knowledge are identified and directions for future research in this area are outlined. PMID:22468461

  16. Associations of knee muscle force, bone malalignment, and knee-joint laxity with osteoarthritis in elderly people

    Science.gov (United States)

    Nakagawa, Kazumasa; Maeda, Misako

    2017-01-01

    [Purpose] From the viewpoint of prevention of knee osteoarthritis, the aim of this study was to verify how muscle strength and joint laxity are related to knee osteoarthritis. [Subjects and Methods] The study subjects consisted of 90 community-dwelling elderly people aged more than 60 years (22 males, 68 females). Femorotibial angle alignment, knee joint laxity, knee extensors and flexor muscle strengths were measured in all subjects. In addition, the subjects were divided into four groups based on the presence of laxity and knee joint deformation, and the muscle strength values were compared. [Results] There was no significant difference in knee extensor muscle strength among the four groups. However, there was significant weakness of the knee flexor muscle in the group with deformation and laxity was compared with the group without deformation and laxity. [Conclusion] Decreased knee flexor muscle strengths may be involved in knee joint deformation. The importance of muscle strength balance was also considered. PMID:28356631

  17. Internal Lymphedema Correlates with Subjective and Objective Measures of Dysphagia in Head and Neck Cancer Patients.

    Science.gov (United States)

    Jackson, Leanne K; Ridner, Sheila H; Deng, Jie; Bartow, Carmin; Mannion, Kyle; Niermann, Ken; Gilbert, Jill; Dietrich, Mary S; Cmelak, Anthony J; Murphy, Barbara A

    2016-09-01

    Tumor/treatment-related internal lymphedema (IL) and/or external lymphedema (EL) are associated with functional deficits and increased symptom burden in head and neck cancer patients (HNCP). Previously, we noted association between EL/IL and patient-reported dysphagia using the Vanderbilt Head and Neck Symptom Survey (VHNSS) version 1.0. To determine the relationship between IL/EL and subjective and objective measures of swallowing function. Eighty-one HNCP completed: (1) VHNSS version 2.0, including 13 swallowing/nutrition-related questions grouped into three clusters: swallow solids (ss), swallow liquids (sl), and nutrition(nt); (2) physical assessment of EL using Foldi scale; (3) endoscopic assessment of IL using Patterson scale (n = 56); and (4) modified barium swallow study rated by dysphagia outcome and severity scale (DOSS) and in conjunction with a swallow evaluation by National Outcomes Measurement System (NOMS). Examinations were performed at varied time points to assess lymphedema spectrum, from baseline (n = 15, 18.1%) to 18 months post-therapy (n = 20, 24.1%). VHNSS swallow/nutrition items scores correlated with NOMS/DOSS ratings (p nutrition scores correlated with maximum grade of swelling for any single structure on Patterson scale: ss (0.43; p = 0.001); sl (0.38; p = 0.004); nt (0.41; p = 0.002). IL of aryepiglottic/pharyngoepiglottic folds, epiglottis, and pyriform sinus were most strongly correlated with VHNSS and NOMS ratings. NOMS/DOSS ratings correlated with EL (> = -0.34; p nutrition items and EL ( 0.20). IL correlated with subjective and objective measures of swallow dysfunction. Longitudinal analysis of trajectory and impact of IL/EL on dysphagia is ongoing.

  18. Muscle contributions to knee extension in the early stance phase in patients with knee osteoarthritis.

    Science.gov (United States)

    Ogaya, Shinya; Kubota, Ryo; Chujo, Yuta; Hirooka, Eiko; Kwang-Ho, Kim; Hase, Kimitaka

    2017-10-01

    The aim of this study was to analyze individual muscle contributions to knee angular acceleration using a musculoskeletal simulation analysis and evaluate knee extension mechanics in the early stance phase in patients with knee osteoarthritis (OA). The subjects comprised 15 patients with medial knee OA and 14 healthy elderly individuals. All participants underwent gait performance test using 8 infrared cameras and two force plates to measure the kinetic and kinematic data. The simulation was driven by 92 Hill-type muscle-tendon units of the lower extremities and a trunk with 23° of freedom. We analyzed each muscle contribution to knee angular acceleration in the 5%-15% and 15%-25% periods of the stance phase (% SP) using an induced acceleration analysis. We compared accelerations by individual muscles between the two groups using an analysis of covariance for controlling gait speed. Patients with knee OA had a significantly lesser knee extension acceleration by the vasti muscles and higher knee acceleration by hip adductors than those in controls in 5-15% SP. In addition, knee OA resulted in significantly lesser knee extension acceleration by the vasti muscles in 15-25% SP. These results indicate that patients with knee OA have decreased dependency on the vasti muscles to control knee movements during early stance phase. Hip adductor muscles, which mainly control mediolateral motion, partly compensate for the weak knee extension by the vasti muscles in patients with knee OA. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. 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

  20. Osteoarthritis of the knee after meniscal resection

    DEFF Research Database (Denmark)

    Paradowski, P T; Lohmander, L S; Englund, M

    2016-01-01

    OBJECTIVE: To determine prevalence, incidence and progression of radiographic knee osteoarthritis (OA) in a cohort of subjects with previous meniscectomy. METHODS: We assessed 221 subjects (177 men and 44 women) with weight bearing knee radiography twice (assessment A and B) with a follow-up time...... Kellgren and Lawrence grade 2 or worse. RESULTS: At assessment A, we found tibiofemoral radiographic OA in 107 subjects' index knee (48%) of which 41 subjects (38%) had bilateral tibiofemoral OA. At assessment B, the corresponding figures were 151 (68%) and 71 (32%). At assessment A, we found...... patellofemoral OA in 32 subjects' index knee (14%) of which 11 (34%) had bilateral patellofemoral OA. At assessment B, the corresponding figures were 51 (23%) and 19 (37%). There was an increase of the sum of joint space narrowing (JSN) and osteophyte grades in the tibiofemoral joint of 144 subjects' index knee...

  1. Effect of Loading on In Vivo Tibiofemoral and Patellofemoral Kinematics of Healthy and ACL-Reconstructed Knees.

    Science.gov (United States)

    Kaiser, Jarred M; Vignos, Michael F; Kijowski, Richard; Baer, Geoffrey; Thelen, Darryl G

    2017-12-01

    Although knees that have undergone anterior cruciate ligament reconstruction (ACLR) often exhibit normal laxity on clinical examination, abnormal kinematic patterns have been observed when the joint is dynamically loaded during whole body activity. This study investigated whether abnormal knee kinematics arise with loading under isolated dynamic movements. Tibiofemoral and patellofemoral kinematics of ACLR knees will be similar to those of the contralateral uninjured control knee during passive flexion-extension, with bilateral differences emerging when an inertial load is applied. Controlled laboratory study. The bilateral knees of 18 subjects who had undergone unilateral ACLR within the past 4 years were imaged by use of magnetic resonance imaging (MRI). Their knees were cyclically (0.5 Hz) flexed passively. Subjects then actively flexed and extended their knees against an inertial load that induced stretch-shortening quadriceps contractions, as seen during the load acceptance phase of gait. A dynamic, volumetric, MRI sequence was used to track tibiofemoral and patellofemoral kinematics through 6 degrees of freedom. A repeated-measures analysis of variance was used to compare secondary tibiofemoral and patellofemoral kinematics between ACLR and healthy contralateral knees during the passive and active extension phases of the cyclic motion. Relative to the passive motion, inertial loading induced significant shifts in anterior and superior tibial translation, internal tibial rotation, and all patellofemoral degrees of freedom. As hypothesized, tibiofemoral and patellofemoral kinematics were bilaterally symmetric during the passive condition. However, inertial loading induced bilateral differences, with the ACLR knees exhibiting a significant shift toward external tibial rotation. A trend toward greater medial and anterior tibial translation was seen in the ACLR knees. This study demonstrates that abnormal knee kinematic patterns in ACLR knees emerge during a

  2. Knee disarticulation

    Directory of Open Access Journals (Sweden)

    Antun Muljačić

    2009-08-01

    Full Text Available In this paper we presented three patients withknee disarticulation performed according toBaumgartner. The Baumgartner tehnique and theapplication of knee disarticulation prosthesis appearedto be superior in comparisson with othermethods.

  3. Association of single-nucleotide polymorphisms in HLA class II/III region with knee osteoarthritis.

    Science.gov (United States)

    Shi, D; Zheng, Q; Chen, D; Zhu, L; Qin, A; Fan, J; Liao, J; Xu, Z; Lin, Z; Norman, P; Xu, J; Nakamura, T; Dai, K; Zheng, M; Jiang, Q

    2010-11-01

    A genome-wide association study and a replication using Japanese, Spanish and Greek Caucasian populations have recently indicated two single-nucleotide polymorphisms (SNPs) (rs7775228 and rs10947262) associated with knee Osteoarthritis (OA) susceptibility. We have further evaluated the association in knee OA subjects from Han Chinese and Australian Caucasian origin. Two independent case-control association studies were performed using Han Chinese and Australian Caucasian populations. The two SNPs were genotyped in patients who had primary symptomatic knee OA with radiographic confirmation and/or received total knee replacement surgery as well as in matched controls. They were subjected to statistic analyses. A total of 991 OA patients and 1536 controls were genotyped. No significant difference was detected in genotype or allele frequencies of the two SNPs between knee OA and control groups in the two populations (all P>0.05). The association was also negative even after stratification by sex, body mass index (BMI) and Kellgren/Lawrence scores. The significant heterogeneity was detected between Chinese and Japanese (both P0.05). The result of meta-analysis showed significant association between knee OA and rs10947262 in total subjects [summary OR=1.26, 95%confidence intervals (CI)=1.07-1.27, P=3 × 10(-8)] and in Caucasian samples (summary OR=1.28, 95%CI=1.04-1.57, P=0.02). We demonstrated no association between the two SNPs in human leukocyte antigen (HLA) class II/III region and knee OA in Han Chinese population. A significant association was detected between SNP rs10947262 and knee OA in Caucasian subjects. Further replication studies are required to identify the impact of controversial association. Copyright © 2010 Osteoarthritis Research Society International. All rights reserved.

  4. Motion analysis of Chinese normal knees during gait based on a novel portable system.

    Science.gov (United States)

    Zhang, Yu; Yao, Zilong; Wang, Shaobai; Huang, Wenhan; Ma, Limin; Huang, Huayang; Xia, Hong

    2015-03-01

    Normative tibiofemoral data of Chinese or Asian subjects during gait is rarely reported. This study is aimed at investigating the six-degree-of-freedom (6DOF) knee kinematics of adult Chinese during gait, based on a novel portable system. Twenty-eight healthy Chinese subjects (56 knees) were studied during their treadmill gaits. A set of optical marker clusters were attached to the thighs and shanks of each subject, who was tracked by an optical joint kinematics measurement system. Knee landmarks were initially digitized with respect to the marker cluster sets to determine the local coordinate systems for calculation of 6DOF knee joint kinematics. The range of motion (ROM) in 6DOF and 5 kinematic parameters were calculated and compared between bilateral knees and genders. We discovered that knee rotations, as well as motion in proximodistal and mediolateral translations, showed similar patterns in flexion and extension. However, the anteroposterior translations did not show a clear pattern. The results of ROM in 6DOF obtained in this study are comparable with those reported in existing literature. No statistical difference was found between left and right knees either in the ROMs or in the 5 kinematic parameters. However, the ROM in the mediolateral direction during gait was found to be higher in men than women (P=0.014). In addition, the femurs of female subjects rotated more internally than the femurs of male during the stance phase (P=0.011). We concluded that normal Chinese knees exhibited distinct gait patterns, except for anteroposterior motion. Women and men exhibit different axial rotations and mediolateral translation patterns during their treadmill gait. Copyright © 2015 Elsevier B.V. All rights reserved.

  5. variability of the lateral ligamentous complex of the knee

    African Journals Online (AJOL)

    ligaments on the lateral aspect of the knee namely lateral collateral ligament, anterolateral and triradiate collateral ... lateral knee stability and prevention of excessive internal ... anterior cruciate ligaments were repaired. It therefore becomes ...

  6. 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 ...

  7. Effect of pulsed short-wave diathermy on pain and function of subjects with osteoarthritis of the knee: a placebo-controlled double-blind clinical trial.

    Science.gov (United States)

    Laufer, Y; Zilberman, R; Porat, R; Nahir, A M

    2005-05-01

    To examine the effects of pulsed short-wave diathermy (PSWD), delivered at an intensity sufficient to induce a thermal sensation and at an athermal intensity, in comparison with a placebo short-wave diathermy treatment, on reported pain, stiffness and functional ability and on mobility performance of patients with osteoarthritis of the knee. A placebo-controlled double-blind trial with sequential allocation of patients to different treatment groups. Outpatient physiotherapy department. One hundred and three consecutive patients, mean age 73.7 (+/-6.6) years with osteoarthritis of one or both knees for at least three months. All participants received three 20-min-long treatments per week for three weeks. One group received PSWD with mean power of 18 W (thermal effect), one group received PSWD with mean power of 1.8 W (athermal effect), and one group received sham short-wave diathermy treatment. Patients were assessed before the initial treatment, immediately following the last treatment, and at a three-month follow-up. Outcome measures included the WOMAC Osteoarthritis Index, which assessed reported pain, stiffness, and functional ability, and four measures of mobility performance: Timed Get Up and Go test (TGUG), stair-climbing, stair, descending and a 3-min walk. A difference across time was observed for the pain and stiffness categories of the WOMAC Osteoarthritis Index (p = 0.033 and p = 0.008, respectively), with no differences between groups. No other significant differences across time or between groups were observed in any of the other measures. The findings do not demonstrate pulsed short-wave diathermy, as it is utilized in clinical settings, to be effective in the treatment of osteoarthritis of the knee.

  8. The Nature of Age-Related Differences in Knee Function during Walking: Implication for the Development of Knee Osteoarthritis.

    Directory of Open Access Journals (Sweden)

    Katherine A Boyer

    Full Text Available Changes in knee kinematics have been identified in the early stages of osteoarthritis (OA. However, there is a paucity of information on the nature of kinematic change that occur with aging prior to the development of OA, This study applied a robust statistical method (Principal Component Analysis to test the hypothesis that coupling between primary (flexion and secondary (anterior-posterior translation, internal-external rotation joint motions in walking would differ for age groupings of healthy subjects.Seventy-four healthy participants divided into three groups with mean ages of 24 ± 2.3 years (younger, 48 ± 4.7years (middle-age and 64 ± 2.4 years (older were examined. Principal Component Analysis was used to characterize and statistically compare the patterns of knee joint movement and their relationships in walking.There were significant differences between the younger group and both the middle-age and older groups in the knee frontal plane angle and the coupling between knee flexion (PC1, p≤0.04 and the relative magnitudes of secondary plane motions in early and late stance (PC3, p<0.01. Two additional principal components (PC2, p = 0.03 and PC5, p<0.01 described differences in early stance knee flexion and relationship with secondary plane motion through-out stance for the older compared with middle-age group.It appears there are changes in knee kinematics that occur with aging. The kinematic differences were identified for middle-aged as well as older adults suggesting midlife changes in neuromuscular physiology or behavior may have important consequences. These kinematic measures offer the potential to identify early markers for the risk of developing knee OA with aging.

  9. Swollen Knee (Water on the Knee)

    Science.gov (United States)

    ... buildup in and around the knee joint include: Osteoarthritis Rheumatoid arthritis Infection Gout Pseudogout Bursitis Cysts Tumors Risk factors Age. Your likelihood of developing a swollen knee ...

  10. Learning with LinkedIn: Students' Perceptions of Incorporating Subject-Related Blogging in an International Marketing Course

    Science.gov (United States)

    Galan, Nataliya; Khodabandehloo, Akbar

    2016-01-01

    Purpose: This paper aims to report the results of implementation of blogging within a LinkedIn discussion group in an international marketing course for a multicultural group of students focusing on the students' perceptions of the subject-related blogging. Design/Methodology/ Approach: This study adopts a qualitative approach; data have been…

  11. 3D intersegmental knee loading in below-knee amputees across steady-state walking speeds.

    Science.gov (United States)

    Fey, Nicholas P; Neptune, Richard R

    2012-05-01

    Unilateral below-knee amputees often develop comorbidities that include knee joint disorders (e.g., intact leg knee osteoarthritis), with the mechanisms leading to these comorbidities being poorly understood. Mechanical knee loading of non-amputees has been associated with joint disorders and shown to be influenced by walking speed. However, the relationships between amputee knee loading and speed have not been identified. This study examined three-dimensional mechanical knee loading of amputees across a wide range of steady-state walking speeds. Fourteen amputees and 10 non-amputee control subjects were analyzed at four overground walking speeds. At each speed, intersegmental joint moment and force impulses (i.e., time-integrals over the stance phase) were compared between the control, intact and residual knees using repeated-measures ANOVAs. There were no differences in joint force impulses between the intact and control knees. The intact knee abduction moment impulse was lower than the non-amputees at 0.6 and 0.9 m/s. The intact knee flexion moment impulses at 0.6, 1.2 and 1.5m/s and knee external rotation moment impulses at all speeds were greater than the residual knee. The residual knee extension moment and posterior force impulses were insensitive to speed increases, while these quantities increased in intact and control knees. These results suggest the intact knees of asymptomatic and relatively new amputees are not overloaded during walking compared to non-amputees. Increased knee loads may develop in response to prolonged prosthesis usage or joint disorder onset. Further study is needed to determine if the identified bilateral loading asymmetries across speeds lead to diminished knee joint health. Copyright © 2011 Elsevier Ltd. All rights reserved.

  12. Cross-talk correction method for knee kinematics in gait analysis using principal component analysis (PCA: a new proposal.

    Directory of Open Access Journals (Sweden)

    Audrey Baudet

    Full Text Available In 3D gait analysis, the knee joint is usually described by the Eulerian way. It consists in breaking down the motion between the articulating bones of the knee into three rotations around three axes: flexion/extension, abduction/adduction and internal/external rotation. However, the definition of these axes is prone to error, such as the "cross-talk" effect, due to difficult positioning of anatomical landmarks. This paper proposes a correction method, principal component analysis (PCA, based on an objective kinematic criterion for standardization, in order to improve knee joint kinematic analysis.The method was applied to the 3D gait data of two different groups (twenty healthy subjects and four with knee osteoarthritis. Then, this method was evaluated with respect to three main criteria: (1 the deletion of knee joint angle cross-talk (2 the reduction of variance in the varus/valgus kinematic profile (3 the posture trial varus/valgus deformation matching the X-ray value for patients with knee osteoarthritis. The effect of the correction method was tested statistically on variabilities and cross-talk during gait.Cross-talk was lower (p<0.05 after correction (the correlation between the flexion-extension and varus-valgus kinematic profiles being annihilated. Additionally, the variance in the kinematic profile for knee varus/valgus and knee flexion/extension was found to be lower and higher (p<0.05, respectively, after correction for both the left and right side. Moreover, after correction, the posture trial varus/valgus angles were much closer to x-ray grading.The results show that the PCA correction applied to the knee joint eliminates the cross-talk effect, and does not alter the radiological varus/valgus deformation for patients with knee osteoarthritis. These findings suggest that the proposed correction method produces new rotational axes that better fit true knee motion.

  13. Functional knee brace effects during walking in patients with anterior cruciate ligament reconstruction.

    Science.gov (United States)

    DeVita, P; Lassiter, T; Hortobagyi, T; Torry, M

    1998-01-01

    The purpose of this study was to compare lower extremity joint kinematics and kinetics during walking with and without a functional knee brace in patients with recent anterior cruciate ligament reconstructions. Seven volunteers walked at 1.26 m/s with and without one of two functional knee braces 3 weeks after surgery. Eleven uninjured subjects were also tested as a control group. Video and ground-reaction data were collected and combined with inverse dynamics to estimate the joint positions, moments, and powers during the stance phase. Patients with ligament reconstructions were more erect with the brace, using 19% less knee flexion compared with walking without the brace. Areas under the internal extensor moment curve (angular impulse) and power curve (work) at the hip increased 40% and 44%, respectively, while walking with the brace. Extensor angular impulse decreased 41% at the knee while using the brace, and plantar flexor angular impulse and work increased 21% and 30%, respectively, at the ankle. While walking with the brace, the patients still had different kinematics, moments, and powers than the control subjects. The reduced extensor moment at the knee in the braced condition indicated that the load on the recently reconstructed ligament was reduced and that the brace protected the ligament during the stance phase of walking. We concluded that functional knee braces may be one means of developing neuromuscular adaptations during gait after anterior cruciate ligament reconstruction surgery.

  14. Risk of sick leave and disability pension in working-age women and men with knee osteoarthritis.

    Science.gov (United States)

    Hubertsson, Jenny; Petersson, Ingemar F; Thorstensson, Carina A; Englund, Martin

    2013-03-01

    To investigate sick leave and disability pension in working-age subjects with knee osteoarthritis (OA) compared with the general population. Population-based cohort study: individual-level inpatient and outpatient Skåne Health Care Register data were linked with data from the Swedish Social Insurance Agency. In 2009 all working-age (16-64 years) Skåne County residents who in 1998-2009 had been diagnosed with knee OA (International Classification of Diseases-10 code M17) were identified and their sick leave and disability pension in 2009 related to those of the general working-age population (n=789 366) standardised for age. 15 345 working-age residents (49.6% women) with knee OA were identified. Compared with the general population, the RR (95% CI) of having had one or more episodes of sick leave during the year was 1.82 (1.73 to 1.91) for women and 2.03 (1.92 to 2.14) for men with knee OA. The corresponding risk for disability pension was 1.54 (1.48 to 1.60) for women and 1.36 (1.28 to 1.43) for men with knee OA. The annual mean number of sick days was 87 for each patient with knee OA and 57 for the general population (age- and sex-standardised). Of all sick leave and disability pension in the entire population, 2.1% of days were attributable to knee OA or associated comorbidity in the patients with knee OA (3.1% for sick leave and 1.8% for disability pension). Subjects with doctor-diagnosed knee OA have an almost twofold increased risk of sick leave and about 40-50% increased risk of disability pension compared with the general population. About 2% of all sick days in society are attributable to knee OA.

  15. Internal and External Factors Shaping Educational Beliefs of High School Teachers of "Sacred" Subjects to Girls

    Science.gov (United States)

    Iluz, Shira; Rich, Yisrael

    2009-01-01

    This research investigated pedagogical beliefs of teachers of "sacred" school subjects, curricular topics that the school community deems culturally valued, unassailable and inviolate. Two hundred and fifty-five teachers of girls only who taught sacred or secular subjects in Jewish modern religious high schools responded to questionnaires focusing…

  16. Knee Pain in a Renal Transplant Patient

    Science.gov (United States)

    2017-04-26

    HUBBARD FROM: 59 MDW/SGVU SUBJECT: Professional Presentation Approval 25 APR 2017 1. Your paper, entitled Knee Pain In A Renal T ransplant Patient...MATERIAL TO BE PUBLISHED OR PRESENTED: Knee Pain in a Renal Transplant Patient 7. FUNDING RECEIVED FOR THIS STUDY? 0 YES IZJNO FUNDING SOURCE: 8. DO...41-108 PREVIOUS EDITIONS ARE OBSOLETE Page 3 of 3 Pages Title: Knee Pain in a Rena l Transplant Patient Authors: Matthew Hubbard, DO. Liem

  17. Nonlinear Response of Thin Cylindrical Shells with Longitudinal Cracks and Subjected to Internal Pressure and Axial compression Loads

    Science.gov (United States)

    Starnes, James H.; Rose, Cheryl A.

    1998-01-01

    The results of an analytical study of the nonlinear response of a thin unstiffened aluminum cylindrical shell with a longitudinal crack are presented. The shell is analyzed with a nonlinear shell analysis code that maintains the shell in a nonlinear equilibrium state while the crack is grown. The analysis accurately accounts for global and local structural response phenomena. Results are presented for internal pressure, axial compression, and combined internal pressure and axial compression loads. The effects of varying crack length on the nonlinear response of the shell subjected to internal pressure are described. The effects of varying crack length on the prebuckling, buckling and postbuckling responses of the shell subjected to axial compression, and subjected to combined internal pressure and axial compression are also described. The results indicate that the nonlinear interaction between the in-plane stress resultants and the out-of-plane displacements near a crack can significantly affect the structural response of the shell. The results also indicate that crack growth instabilities and shell buckling instabilities can both affect the response of the shell as the crack length is increased.

  18. Immediate effects of an elastic knee sleeve on frontal plane gait biomechanics in knee osteoarthritis.

    Directory of Open Access Journals (Sweden)

    Raphael Schween

    Full Text Available Osteoarthritis of the knee affects millions of people. Elastic knee sleeves aim at relieving symptoms. While symptomatic improvements have been demonstrated as a consequence of elastic knee sleeves, evidence for biomechanical alterations only exists for the sagittal plane. We therefore asked what effect an elastic knee sleeve would have on frontal plane gait biomechanics.18 subjects (8 women, 10 men with osteoarthritis of the medial tibiofemoral joint walked over ground with and without an elastic knee sleeve. Kinematics and forces were recorded and joint moments were calculated using an inverse dynamics approach. Conditions with sleeve and without sleeve were compared with paired t-Tests.With the sleeve, knee adduction angle at ground contact was reduced by 1.9 ± 2.1° (P = 0.006. Peak knee adduction was reduced by 1.5 ± 1.6° (P = 0.004. The first peak knee adduction moment and positive knee adduction impulse were decreased by 10.1% (0.74 ± 0.9 Nm • kg-1; P = 0.002 and 12.9% (0.28 ± 0.3 Nm • s • kg-1; P < 0.004, respectively.Our study provides evidence that wearing an elastic knee sleeve during walking can reduce knee adduction angles, moments and impulse in subjects with knee osteoarthritis. As a higher knee adduction moment has previously been identified as a risk factor for disease progression in patients with medial knee osteoarthritis, we speculate that wearing a knee sleeve may be beneficial for this specific subgroup.

  19. Correlation between hip function and knee kinematics evaluated by three-dimensional motion analysis during lateral and medial side-hopping.

    Science.gov (United States)

    Itoh, Hiromitsu; Takiguchi, Kohei; Shibata, Yohei; Okubo, Satoshi; Yoshiya, Shinichi; Kuroda, Ryosuke

    2016-09-01

    [Purpose] Kinematic and kinetic characteristics of the limb during side-hopping and hip/knee interaction during this motion have not been clarified. The purposes of this study were to examine the biomechanical parameters of the knee during side hop and analyze its relationship with clinical measurements of hip function. [Subjects and Methods] Eleven male college rugby players were included. A three-dimensional motion analysis system was used to assess motion characteristics of the knee during side hop. In addition, hip range of motion and muscle strength were evaluated. Subsequently, the relationship between knee motion and the clinical parameters of the hip was analyzed. [Results] In the lateral touchdown phase, the knee was positioned in an abducted and externally rotated position, and increasing abduction moment was applied to the knee. An analysis of the interaction between knee motion and hip function showed that range of motion for hip internal rotation was significantly correlated with external rotation angle and external rotation/abduction moments of the knee during the lateral touchdown phase. [Conclusion] Range of motion for hip internal rotation should be taken into consideration for identifying the biomechanical characteristics in the side hop test results.

  20. The effect of footwear and foot orthoses on transverse plane knee motion during running - A pilot study.

    Science.gov (United States)

    Hutchison, Laura; Scharfbillig, Rolf; Uden, Hayley; Bishop, Chris

    2015-11-01

    This study aimed to determine the immediate effects of footwear and foot orthoses on transverse plane rotation of the knee joint during the stance phase of jogging gait. An experimental, within subjects, repeated measures design. Three-dimensional knee kinematics were estimated in the transverse plane by surface-mounted markers as 14 asymptomatic participants ran in four randomised conditions; neutral shoe, neutral shoe with customised orthoses, neutral shoe with prefabricated orthoses, and a stability shoe. Peak internal/external rotation joint angles and ranges of motion (ROM) during loading response, midstance and propulsion were determined. Immediate subjective comfort was also recorded for each condition using a 100 mm visual analogue scale. Significant main effects of condition were observed for all outcomes except transverse plane knee ROM during loading response (p shoe and another condition, with less knee internal rotation in the stability shoe (mean differences ranged between 1.7° and 6.1°) (p shoe with prefabricated orthoses was reported as more uncomfortable than all other testing conditions. The stability shoe reduced peak knee internal rotation throughout stance phase of jogging more than any other condition. Importantly, it was subjectively as comfortable as the other conditions. These results identify the ability for footwear alone to induce immediate proximal kinematic effects. The use of the kinematic theory behind foot orthoses therapy is also questioned. Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  1. 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.

  2. Knee Problems

    Science.gov (United States)

    ... Nausea and Vomiting in Infants and Children Neck Pain Neck Swelling Shortness of Breath Shortness of Breath in Infants and Children Shoulder Problems Skin Rashes & Other Skin Problems Throat Problems Tooth Problems Urination Problems Back to Symptoms Step 2 Answering Questions Did your knee pain ...

  3. Risks of concomitant trauma to the knee in lower limb long bone shaft fractures: A retrospective analysis from a prospective study population

    Directory of Open Access Journals (Sweden)

    Brajesh Kumar

    2014-01-01

    Conclusion: One should have high index of suspicion about internal knee injuries and capsule-ligamentous injuries while dealing with femoral shaft fractures in particular. Arthroscopy of knee may safely enhance the diagnosis of simultaneous IDK. We propose that when MR imaging is not possible and when contraindication for arthroscopy does not exist, a careful clinical examination followed by arthroscopy of the knee may be considered a useful adjunct in femoral shaft fractures as it can readily confirm IDK by its ability to objectively look, probe, and distinguish fragile tissue from a normal one. Further study in larger number of subjects is needed to validate our findings.

  4. Effect of individualized distal femoral valgus resection angle in primary total knee arthroplasty: A systematic review and meta-analysis involving 1300 subjects.

    Science.gov (United States)

    Zhou, Kai; Ling, Tingxian; Xu, Yuan; Li, Jinglong; Yu, Haoda; Wang, Haoyang; Zhou, Zongke; Pei, Fuxing

    2018-02-01

    Proper limb alignment and implant positioning are important for successful total knee arthroplasty (TKA). Whether any differences exist in restoration of limb alignment for valgus knees between fixed and individual femoral valgus correction angle (VCA) for distal femoral resection remains unknown. The PubMed, Medline, Embase, and Wangfang databases were searched to identify studies comparing individualized VCA and fixed VCA in the distal femoral valgus resection. The primary outcomes were the mechanical femorotibial angle (MFT angle) and the proportion of postoperative alignment deviation within ±3°. The secondary outcomes were femoral valgus correction angle (VCA), component angle (α angle and β angle). Six studies with 1167 TKAs were analyzed quantitatively. The coronal limb alignments in individualized group were closer to neutral than fixed group with a mean 0.77° difference (95% CI, -1.43 to -0.11; P = .022; I 2  = 71.0%). Moreover, there were more patients' postoperative alignment deviation within neutral ±3° in the individualized group (RR, 1.23; 95% CI, 1.09 to 1.38; P = .00; I 2  = 36.4%). The α angle were closer to neutral in the individualized group, and there's 1.2° more deviation from neutral in the fixed group (95% CI, 0.99 to 1.41; P = .00; I 2  = 0%). No difference was found in the β angle between groups (WMD, 0.85; 95% CI, -0.09 to 1.78; P = .075; I 2  = 88.3%). This systematic review and meta-analysis demonstrated that the individualized VCA for distal femoral resection could enhance the accuracy of postoperative limb alignment and femoral component alignment in the coronal plane. However, further high-quality RCTs and well-designed trials are still needed. Copyright © 2018 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  5. Design rules for pipe systems subject to internal explosions, Pt. 2

    NARCIS (Netherlands)

    Smeulers, J.P.M.; Pape, G.

    2010-01-01

    In this part 2 various causes of dynamic stress amplification are discussed that are generated by internal explosion waves. The stress increase is expressed in an amplification factor that relates the increased stress to the hoop stress that would result if the detonation pressure is applied as a

  6. Efficacy of Glucosomine Iontophoresis in knee osteoarthritis ...

    African Journals Online (AJOL)

    The purpose of this study was to compare the relative efficacy of glucosamine iontophoresis with that of massage and a control group in managing osteoarthritic knee pain. Fifteen subjects with radiological evidence of knee osteoarthritis participated in this study. Participants were randomly assigned into three (3) groups; ...

  7. Effect of bidirectional internal flow on fluid–structure interaction dynamics of conveying marine riser model subject to shear current

    Directory of Open Access Journals (Sweden)

    Zheng-Shou Chen

    2012-03-01

    Full Text Available This article presents a numerical investigation concerning the effect of two kinds of axially progressing internal flows (namely, upward and downward on fluid–structure interaction (FSI dynamics about a marine riser model which is subject to external shear current. The CAE technology behind the current research is a proposed FSI solution, which combines structural analysis software with CFD technology together. Efficiency validation for the CFD software was carried out first. It has been proved that the result from numerical simulations agrees well with the observation from relating model test cases in which the fluidity of internal flow is ignorable. After verifying the numerical code accuracy, simulations are conducted to study the vibration response that attributes to the internal progressive flow. It is found that the existence of internal flow does play an important role in determining the vibration mode (/dominant frequency and the magnitude of instantaneous vibration amplitude. Since asymmetric curvature along the riser span emerges in the case of external shear current, the centrifugal and Coriolis accelerations owing to up- and downward internal progressive flows play different roles in determining the fluid–structure interaction response. The discrepancy between them becomes distinct, when the velocity ratio of internal flow against external shear current is relatively high.

  8. Large-scale international validation of the ADO index in subjects with COPD

    DEFF Research Database (Denmark)

    Puhan, Milo A; Hansel, Nadia N; Sobradillo, Patricia

    2012-01-01

    -year mortality and to update it in order to make prediction of mortality in COPD patients as generalisable as possible. DESIGN: Individual subject data analysis of 10 European and American cohorts (n=13 914). SETTING: Population-based, primary, secondary and tertiary care. PATIENTS: COPD GOLD stages I...

  9. An International Teacher Training Project: Integrating Subject Content, Communicative and Digital Competences in Didactic Materials

    Science.gov (United States)

    Sierra, Lina; Martin, Piedad

    2012-01-01

    The European intTT project "An Integral Teacher Training for Developing Digital and Communicative Competences and Subject Content Learning at Schools" deals with initial teacher training in primary and secondary School. The general objective of the project is to train future school teachers in order to improve the development of…

  10. Large-scale international validation of the ADO index in subjects with COPD: an individual subject data analysis of 10 cohorts

    Science.gov (United States)

    Puhan, Milo A; Hansel, Nadia N; Sobradillo, Patricia; Enright, Paul; Lange, Peter; Hickson, DeMarc; Menezes, Ana M; ter Riet, Gerben; Held, Ulrike; Domingo-Salvany, Antonia; Mosenifar, Zab; Antó, Josep M; Moons, Karel G M; Kessels, Alphons; Garcia-Aymerich, Judith

    2012-01-01

    Background Little evidence on the validity of simple and widely applicable tools to predict mortality in patients with chronic obstructive pulmonary disease (COPD) exists. Objective To conduct a large international study to validate the ADO index that uses age, dyspnoea and FEV1 to predict 3-year mortality and to update it in order to make prediction of mortality in COPD patients as generalisable as possible. Design Individual subject data analysis of 10 European and American cohorts (n=13 914). Setting Population-based, primary, secondary and tertiary care. Patients COPD GOLD stages I–IV. Measurements We validated the original ADO index. We then obtained an updated ADO index in half of our cohorts to improve its predictive accuracy, which in turn was validated comprehensively in the remaining cohorts using discrimination, calibration and decision curve analysis and a number of sensitivity analyses. Results 1350 (9.7%) of all subjects with COPD (60% male, mean age 61 years, mean FEV1 66% predicted) had died at 3 years. The original ADO index showed high discrimination but poor calibration (p<0.001 for difference between predicted and observed risk). The updated ADO index (scores from 0 to 14) preserved excellent discrimination (area under curve 0.81, 95% CI 0.80 to 0.82) but showed much improved calibration with predicted 3-year risks from 0.7% (95% CI 0.6% to 0.9%, score of 0) to 64.5% (61.2% to 67.7%, score of 14). The ADO index showed higher net benefit in subjects at low-to-moderate risk of 3-year mortality than FEV1 alone. Interpretation The updated 15-point ADO index accurately predicts 3-year mortality across the COPD severity spectrum and can be used to inform patients about their prognosis, clinical trial study design or benefit harm assessment of medical interventions. PMID:23242246

  11. Knee Function Assessment in Patients With Meniscus Injury

    Science.gov (United States)

    Naimark, Micah B.; Kegel, Gary; O’Donnell, Thomas; Lavigne, Stephanie; Heveran, Chelsea; Crawford, Dennis C.

    2014-01-01

    Background: Outcomes of meniscus surgery are typically assessed with patient questionnaires that help capture symptoms and functional limitations but may not provide an accurate representation of underlying joint health. There are currently no performance-based measures of knee function in patients with symptomatic meniscus injury. Purpose: To assess the reproducibility, response to partial meniscectomy, and correlation with patient-reported questionnaire outcomes of novel performance-based knee function tests. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: A battery of 9 tests for activities that require knee movements essential for everyday living was developed. Intra- and interrater reproducibility was assessed in 50 meniscus tear patients completing the battery at 2 preoperative assessments with either the same or different examiners. Response to arthroscopic partial meniscectomy was evaluated in 35 of these patients 6 weeks after surgery. Subjects also completed the Knee Injury and Osteoarthritis Outcome Score (KOOS) and International Knee Documentation Committee (IKDC) questionnaires pre- and postoperatively. Results: The intrarater intraclass correlation coefficients (ICCs) were excellent for all tests (ICC > 0.8). Interrater ICC > 0.8 was observed for step-down, stair descent, star lunges, and timed treadmill travel. Performance on all tests improved significantly with surgery (P < .05), with the greatest improvement in sit-to-stand and stair ascent and descent. A greater percentage response to surgery was seen on questionnaire outcomes (20%-65%) than on performance-based tests (3%-15%). Moderate to poor correlations existed between the KOOS activities of daily living subscale and the performance-based tests (all ICCs ≤ 0.4). Conclusion: Performance-based knee function tests demonstrated good reproducibility and responsiveness in patients undergoing partial meniscectomy. Clinical Relevance: As both patient perception and functional

  12. Male Asian international students' perceived racial discrimination, masculine identity, and subjective masculinity stress: a moderated mediation model.

    Science.gov (United States)

    Wong, Y Joel; Tsai, Pei-Chun; Liu, Tao; Zhu, Qingqing; Wei, Meifen

    2014-10-01

    This study examined male Asian international college students' perceptions of racial discrimination, subjective masculinity stress, centrality of masculine identity, and psychological distress by testing a moderated mediation model. Participants were 160 male Asian international college students from 2 large public universities. Participants' perceived racial discrimination was positively related to their subjective masculinity stress only at high (but not low) levels of masculine identity centrality. Additionally, subjective masculinity stress was positively related to psychological distress, although this association was stronger among those who reported high levels of masculine identity centrality. The authors also detected a moderated mediation effect in which subjective masculinity stress mediated the relationship between perceived racial discrimination and psychological distress only at high (but not low) levels of masculine identity centrality. These findings contribute to the counseling psychology literature by highlighting the connections between race- and gender-related stressors as well as the relevance of masculine identity to an understanding of men's mental health. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  13. Determination of representative dimension parameter values of Korean knee joints for knee joint implant design.

    Science.gov (United States)

    Kwak, Dai Soon; Tao, Quang Bang; Todo, Mitsugu; Jeon, Insu

    2012-05-01

    Knee joint implants developed by western companies have been imported to Korea and used for Korean patients. However, many clinical problems occur in knee joints of Korean patients after total knee joint replacement owing to the geometric mismatch between the western implants and Korean knee joint structures. To solve these problems, a method to determine the representative dimension parameter values of Korean knee joints is introduced to aid in the design of knee joint implants appropriate for Korean patients. Measurements of the dimension parameters of 88 male Korean knee joint subjects were carried out. The distribution of the subjects versus each measured parameter value was investigated. The measured dimension parameter values of each parameter were grouped by suitable intervals called the "size group," and average values of the size groups were calculated. The knee joint subjects were grouped as the "patient group" based on "size group numbers" of each parameter. From the iterative calculations to decrease the errors between the average dimension parameter values of each "patient group" and the dimension parameter values of the subjects, the average dimension parameter values that give less than the error criterion were determined to be the representative dimension parameter values for designing knee joint implants for Korean patients.

  14. The role of pain and functional impairment in the decision to recommend total joint replacement in hip and knee osteoarthritis: an international cross-sectional study of 1909 patients. Report of the OARSI-OMERACT Task Force on total joint replacement

    DEFF Research Database (Denmark)

    Gossec, L; Paternotte, S; Maillefert, J F

    2011-01-01

    OBJECTIVE: To assess the pain and functional disability levels corresponding to an indication for total joint replacement (TJR) in hip and knee osteoarthritis (OA). METHODS: Design: International cross-sectional study in 10 countries. Patients: Consecutive outpatients with definite hip or knee OA...... attending an orthopaedic outpatient clinic. Gold standard measure for recommendation for TJR: Surgeon's decision that TJR is justified. Outcome measures: Pain (ICOAP: intermittent and constant osteoarthritis pain, 0-100) and functional impairment (HOOS-PS/KOOS-PS: Hip/Knee injury and Osteoarthritis Outcome......: In all, 1909 patients were included (1130 knee/779 hip OA). Mean age was 66.4 [standard deviation (SD) 10.9] years, 58.1% were women; 628/1130 (55.6%) knee OA and 574/779 (73.7%) hip OA patients were recommended for TJR. Although patients recommended for TJR (yes vs no) had worse symptom levels [pain, 55...

  15. The immediate effect of a soft knee brace on pain, activity limitations, self-reported knee instability, and self-reported knee confidence in patients with knee osteoarthritis.

    Science.gov (United States)

    Cudejko, Tomasz; van der Esch, Martin; van der Leeden, Marike; van den Noort, Josien C; Roorda, Leo D; Lems, Willem; Twisk, Jos; Steultjens, Martijn; Woodburn, James; Harlaar, Jaap; Dekker, Joost

    2017-12-01

    We aimed to (i) evaluate the immediate effect of a soft knee brace on pain, activity limitations, self-reported knee instability, and self-reported knee confidence, and (ii) to assess the difference in effect between a non-tight and a tight soft brace in patients with knee osteoarthritis (OA). Forty-four patients with knee OA and self-reported knee instability participated in the single-session, laboratory, experimental study. A within-subject design was used, comparing a soft brace with no brace, and comparing a non-tight with a tight soft brace. The outcome measures were pain, self-reported knee instability and knee confidence during level and perturbed walking on the treadmill and activity limitations (10-m walk test and the get up and go (GUG) test). Linear mixed-effect model analysis for continuous outcomes and logistic generalized estimating equations for categorical outcomes were used to evaluate the effect of wearing a soft brace. Wearing a soft brace significantly reduced pain during level walking (B - 0.60, P = 0.001) and perturbed walking (B - 0.80, P self-reported knee instability during level walking (OR 0.41, P = 0.002) and perturbed walking (OR 0.36, P confidence in the knees during level walking (OR 0.45, P self-reported knee instability, and knee confidence in the immediate term in patients with knee OA. Further studies are needed evaluating the mode of action based on exerted pressure, and on the generalization to functioning in daily life. trialregister.nl, NTR6363 . Retrospectively registered on 15 May 2017.

  16. The evaluation of the role of medial collateral ligament maintaining knee stability by a finite element analysis.

    Science.gov (United States)

    Ren, Dong; Liu, Yueju; Zhang, Xianchao; Song, Zhaohui; Lu, Jian; Wang, Pengcheng

    2017-04-21

    A three-dimensional finite element model (FEM) of the knee joint was established to analyze the biomechanical functions of the superficial and deep medial collateral ligaments (MCLs) of knee joints and to investigate the treatment of the knee medial collateral ligament injury. The right knee joint of a healthy male volunteer was subjected to CT and MRI scans in the extended position. The scanned data were imported into MIMICS, Geomagic, and ANSYS software to establish a three-dimensional FEM of the human knee joint. The anterior-posterior translation, valgus-varus rotation, and internal-external rotation of knee joints were simulated to observe tibial displacement or valgus angle. In addition, the magnitude and distribution of valgus stress in the superficial and deep layers of the intact MCL as well as the superficial, deep, and overall deficiencies of the MCL were investigated. In the extended position, the superficial medial collateral ligament (SMCL) would withstand maximum stresses of 48.63, 16.08, 17.23, and 16.08 MPa in resisting the valgus of knee joints, tibial forward displacement, internal rotation, and external rotation, respectively. Meanwhile, the maximum stress tolerated by the SMCL in various ranges of motion mainly focused on the femoral end point, which was located at the anterior and posterior parts of the femur in resisting valgus motion and external rotation, respectively. However, the deep medial collateral ligament could tolerate only minimum stress, which was mainly focused at the femoral start and end points. This model can effectively analyze the biomechanical functions of the superficial and deep layers of the MCLs of knee joints. The results show that the knee MCL II° injury is the indication of surgical repair.

  17. Knee pain (image)

    Science.gov (United States)

    ... front of the knee can be due to bursitis, arthritis, or softening of the patella cartilage as ... knee. Overall knee pain can be due to bursitis, arthritis, tears in the ligaments, osteoarthritis of the ...

  18. Total Knee Replacement

    Science.gov (United States)

    ... activities following total knee replacement include unlimited walking, swimming, golf, driving, light hiking, biking, ballroom dancing, and ... Total Knee Replacement cont. Preparing for Surgery Medical Evaluation If you decide to have total knee replacement ...

  19. Water on the Knee

    Science.gov (United States)

    ... your knee joint. Some people call this condition "water on the knee." A swollen knee may be ... Choose low-impact exercise. Certain activities, such as water aerobics and swimming, don't place continuous weight- ...

  20. 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 ...

  1. 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 ...

  2. [Rivaroxaban versus standard of care in venous thromboembolism prevention following hip or knee arthroplasty in daily clinical practice (Spanish data from the international study XAMOS)].

    Science.gov (United States)

    Granero, J; Díaz de Rada, P; Lozano, L M; Martínez, J; Herrera, A

    2016-01-01

    To analyse the effectiveness and safety of rivaroxaban vs. standard treatment (ST) in the prevention of venous thromboembolism after hip or knee replacement in daily clinical practice in Spain. A sub-analysis of the Spanish data in the XAMOS international observational study that included patients>18 years who received 10mg o.d. rivaroxaban or ST. up to 3 months after surgery. incidence of symptomatic/asymptomatic thromboembolic events, bleeding, mortality, and other adverse events; use of health resources and satisfaction after hospital discharge. Of the total 801 patients included, 410 received rivaroxaban and 391 ST (64.7% heparin, 24.0% fondaparinux, 11% dabigatran). The incidence of symptomatic thromboembolic events and major bleeding was similar in both groups (0.2% vs. 0.8% wit ST and 0.7% vs. 1.3% with ST [EMA criteria]/0.0% vs. 0.3% with ST [RECORD criteria]). The adverse events incidence associated with the drug was significantly higher rivaroxaban (overall: 4.4% vs. 0.8% with ST, P=.001; serious: 1.5% vs. 0.0% with ST, P=.03). The rivaroxaban used less health resources after discharge, and the majority considered the tolerability as «very good« and the treatment as «very comfortable». Rivaroxaban is at least as effective as ST in the prevention of venous thromboembolism prevention in daily clinical practice, with a similar incidence of haemorrhages. It provides greater satisfaction/comfort, and less health resources after discharge. These results should be interpreted taking into account the limitations inherent in observational studies. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

  3. Is impaired knee confidence related to worse kinesiophobia, symptoms, and physical function in people with knee osteoarthritis after anterior cruciate ligament reconstruction?

    Science.gov (United States)

    Hart, Harvi F; Collins, Natalie J; Ackland, David C; Crossley, Kay M

    2015-09-01

    To compare knee confidence and kinesiophobia (fear of re-injury) in those with and without knee osteoarthritis following anterior cruciate ligament reconstruction, and determine whether poorer knee confidence is associated with greater kinesiophobia, worse knee-related symptoms, and functional impairments in those with knee osteoarthritis. Cross-sectional. Sixty-six individuals, 5-12 years following anterior cruciate ligament reconstruction, with (n=30) and without (n=36) knee osteoarthritis were included. Knee injury and Osteoarthritis Outcome Score quality-of-life question (Q3), assessed knee confidence and Tampa Scale of Kinesiophobia assessed kinesiophobia. In the osteoarthritis group, knee-related symptoms (International Knee Documentation Committee and Anterior Knee Pain Scale), self-reported function (Knee injury and Osteoarthritis Outcome Score activities daily living), sport/recreation (Knee injury and Osteoarthritis Outcome Score-sport and recreation), and performance-based function (hopping, one leg rise tasks) were assessed. Between-group differences in knee confidence and kinesiophobia were evaluated with the Chi square test and analysis of variance, respectively. In the osteoarthritis group, between-group differences (none, mild/moderate and severe/extreme problems with knee confidence) in kinesiophobia, symptoms and function were determined with analysis of variances: panterior cruciate ligament reconstruction, participants with knee osteoarthritis had significantly worse knee confidence (p=0.010) and greater kinesiophobia (p=0.006) than those without osteoarthritis. In those with knee osteoarthritis, poorer knee confidence was significantly associated with worse symptoms (Anterior Knee Pain Scale, p=0.001; International Knee Documentation Committee, panterior cruciate ligament reconstruction, compared to those without. Future studies should further investigate the psychological impairments associated with knee osteoarthritis after anterior cruciate

  4. Texture analysis of bone marrow in knee MRI for classification of subjects with bone marrow lesion - data from the Osteoarthritis Initiative.

    Science.gov (United States)

    Chuah, Tong Kuan; Van Reeth, Eric; Sheah, Kenneth; Poh, Chueh Loo

    2013-07-01

    Visualization of bone marrow lesion (BML) can improve the diagnosis of many bone disorders that are associated with it. A quantitative approach in detecting BML could increase the accuracy and efficiency of diagnosing those bone disorders. In this paper, we investigated the feasibility of using magnetic resonance imaging (MRI)-based texture to (a) identify slices and (b) classify subjects with and without BML. A total of 58 subjects were studied; 29 of them were affected by BML. The ages of subjects ranged from 45 to 74years with a mean age of 59. Texture parameters were calculated for the weight-bearing region of distal femur. The parameters were then analyzed using Mann-Whitney U test and individual feature selection methods to identify potentially discriminantive parameters. Forward feature selection was applied to select features subset for classification. Classification results from eight classifiers were studied. Results show that 98 of the 147 parameters studied are statistically significantly different between the normal and affected marrows: parameters based on co-occurrence matrix are ranked highest in their separability. The classification of subjects achieved an area under the receiver operating characteristic curve (AUC) of 0.914, and the classification of slices achieved an AUC of 0.780. The results show that MRI-texture-based classification can effectively classify subjects/slices with and without BML. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. Internalized mental illness stigma and subjective well-being: The mediating role of psychological well-being.

    Science.gov (United States)

    Pérez-Garín, Daniel; Molero, Fernando; Bos, Arjan E R

    2015-08-30

    This study examines the relationships between internalized stigma, psychological well-being, and subjective well-being in a sample of people with mental illness. We conducted a cross-sectional study with 213 outpatients from the Spanish public social care network. The results showed that (a) internalized stigma was significantly negatively correlated with psychological well-being and subjective well-being (affect balance and life satisfaction) (all correlations are significant with at least pstigma on affect balance and life satisfaction was mediated by psychological well-being. The component of internalized stigma most consistently associated with both types of well-being was alienation (life satisfaction: B=-0.35, p=0.001; affect balance: B=-0.38, p=0.001). These findings should be confirmed in future longitudinal or experimental research. On the basis of these results we recommend that interventions to combat self-stigma aim to reduce feelings of alienation and improve self-acceptance and other aspects of positive psychological functioning. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  6. 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

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

    Science.gov (United States)

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

    2013-08-01

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

  8. Temporal-spatial parameters of gait in transfemoral amputees: Comparison of bionic and mechanically passive knee joints.

    Science.gov (United States)

    Uchytil, Jaroslav; Jandacka, Daniel; Zahradnik, David; Farana, Roman; Janura, Miroslav

    2014-06-01

    A symmetrical gait affords the most efficient walking pattern. Bionic prostheses should provide better gait symmetry than mechanically passive prostheses with respect to a nonpathological gait. To compare the basic temporal-spatial parameters of gait in transfemoral amputees fitted with bionic or mechanically passive prosthetic knees with those of subjects with a nonpathological gait. Three-dimensional gait analysis using an optoelectronic device. Eight transfemoral amputees participated in the study. Subjects walked across two dynamometric platforms a total of 15 times. Movement kinematics were measured using optoelectronic stereophotogrammetry. The swing time of the affected limb in patients fitted with a mechanically passive knee joint was longer than that of the nonaffected limb by 0.055 s (effect size = 1.57). Compared with the control group, the swing time of the prosthetic limb in patients fitted with a mechanically passive knee was longer by 0.042 s (effect size = 2.1). Similarly, the stance time of the nonaffected limb was longer by 0.047 s (effect size = 1.07). Compared with a mechanically passive knee joint, a bionic knee joint evinced gait symmetry. Both the stance time and the swing time for amputees with a bionic knee were similar to those of nonamputees. Prosthetists aim to design prostheses that achieve a good symmetry between the healthy and affected limbs. The use of bionic technology achieves a level of symmetry approaching that observed in nonamputees. © The International Society for Prosthetics and Orthotics 2013.

  9. Internal Fat and Cardiometabolic Risk Factors Following a Meal-Replacement Regimen vs. Comprehensive Lifestyle Changes in Obese Subjects

    Directory of Open Access Journals (Sweden)

    Daniel König

    2015-12-01

    Full Text Available The aim of the present study was to investigate the effect of a meal-replacement regimen vs. comprehensive lifestyle changes in overweight or obese subjects on intra-abdominal fat stores (Magnetic Resonance Imaging (MRI measurements and cardiometabolic risk factors. Forty-two obese men (n = 18 and women (n = 24 (age 49 ± 8 years; weight 96.3 ± 12.1 kg; BMI 32.7 ± 2.3 kg/m2 were selected for this randomized parallel-group design investigation. Subjects in the lifestyle group (LS-G; n = 22 received dietary counselling sessions and instructions how to increase physical activity. In the meal replacement group (MR-G; n = 20 meals were replaced by a low-calorie drink high in soy protein. After six months, subjects in the LS-G lost 8.88 ± 6.24 kg and subjects in the MR-G lost 7.1 ± 2.33 kg; p < 0.01 for changes within groups; no significant differences were found between the groups. Lean body mass remained constant in both intervention groups. MRI analyses showed that internal fat was significantly reduced in both groups to a comparable amount; the higher fat loss in the LS-G in the abdominal area was due to a higher reduction in subcutaneous fat. Both interventions significantly reduced components of the cardiometabolic risk profile and leptin levels. The decrease in the adipokines fetuin A and resistin was more pronounced in the MR-G. In conclusion, both interventions significantly reduced body weight, total fat mass and internal abdominal fat while preserving lean body mass. The reduction in the adipokines fetuin A and resistin was more pronounced in the meal replacement group suggesting an additional effect of soy protein components.

  10. Effects of off-axis elliptical training on reducing pain and improving knee function in individuals with patellofemoral pain

    Science.gov (United States)

    Tsai, Liang-Ching; Lee, Song Joo; Yang, Aaron J.; Ren, Yupeng; Press, Joel M.; Zhang, Li-Qun

    2014-01-01

    Objective To examine whether an off-axis elliptical training program reduces pain and improves knee function in individuals with patellofemoral pain (PFP). Design Controlled laboratory study, pre-test-post-test. Setting University rehabilitation center. Participants Twelve adult subjects with PFP. Interventions Subjects with PFP completed an exercise program consisting of 18 sessions of lower extremity off-axis training using a custom-made elliptical trainer that allows frontal-plane sliding and transverse-plane pivoting of the footplates. Main Outcome Measures Changes in knee pain and function post-training and 6 weeks following training were evaluated using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and International Knee Documentation Committee (IKDC) scores. Lower extremity off-axis control was assessed by pivoting and sliding instability, calculated as the root mean square (RMS) of the footplate pivoting angle and sliding distance during elliptical exercise. Subjects’ single-leg hop distance and proprioception in detecting lower extremity pivoting motion were also evaluated. Results Subjects reported significantly greater KOOS and IKDC scores (increased by 12–18 points) and hop distance (increased by 0.2 m) following training. A significant decrease in the pivoting and sliding RMS was also observed following training. Additionally, subjects with PFP demonstrated improved pivoting proprioception when tested under a minimum-weight-bearing position. Conclusions An off-axis elliptical training program was effective in enhancing lower extremity neuromuscular control on the frontal and transverse planes, reducing pain and improving knee function in persons with PFP. PMID:25591131

  11. Efeito da posição relativa do joelho sobre a carga mecânica interna durante o agachamento Effect of relative knee position on internal mechanical loading while squatting

    Directory of Open Access Journals (Sweden)

    RP Hirata

    2007-04-01

    healthy individuals during free squatting exercises using weights performed in two different ways: a knee not going beyond a vertical line going through the toes; b knee going beyond this vertical line. METHOD: Three-dimensional analysis using video cameras and a force platform was performed on squatting movements performed by ten healthy young adults. Fifteen repetitions of each of the two squatting conditions were performed by each subject on the force plate. The forces and joint torque at the ankle, knee and hip were calculated using an inverse dynamic procedure. RESULTS: The results obtained showed that the mean peak torque on the knee was around 38 ± 31% greater, and the mean patellofemoral force was around 28 ± 27% greater, when the knee went beyond the tip of the foot, than when it did not. CONCLUSIONS: These results demonstrate that, when the knee does not go beyond the line of the foot, the patellofemoral compression force is less, which leads to lower mechanical demand on this joint.

  12. RAPID KNEE-EXTENSIONS TO INCREASE QUADRICEPS MUSCLE ACTIVITY IN PATIENTS WITH TOTAL KNEE ARTHROPLASTY

    DEFF Research Database (Denmark)

    Husted, Rasmus Skov; Wilquin, Lousia; Jakobsen, Thomas Linding

    2017-01-01

    BACKGROUND: Inhibition of the quadriceps muscle and reduced knee-extension strength is common shortly following total knee arthroplasty (weeks to months), due to reduced voluntary activation of the quadriceps muscle. In healthy subjects, strength training with heavy loads is known to increase ago...

  13. Rapid knee-extensions to increase quadriceps muscle activity in patients with total knee arthroplasty

    DEFF Research Database (Denmark)

    Husted, Rasmus Skov; Wilquin, Lousia; Jakobsen, Thomas Linding

    2017-01-01

    BACKGROUND: Inhibition of the quadriceps muscle and reduced knee-extension strength is common shortly following total knee arthroplasty (weeks to months), due to reduced voluntary activation of the quadriceps muscle. In healthy subjects, strength training with heavy loads is known to increase ago...

  14. The effect of knee orthoses on gait parameters in medial knee compartment osteoarthritis: A literature review.

    Science.gov (United States)

    Maleki, Maryam; Arazpour, Mokhtar; Joghtaei, Mahmoud; Hutchins, Stephen W; Aboutorabi, Atefeh; Pouyan, Ali

    2016-04-01

    Knee osteoarthritis is a musculoskeletal condition which is most prevalent in the medial compartment. This injury causes considerable pain, disability, and negative changes in kinetic and kinematic parameters. The efficiency of unloader valgus brace as a conservative treatment for medial knee osteoarthritis is not well documented. The aim of this study was to review the previous research regarding the biomechanical effects of knee valgus braces on walking in medial compartment knee osteoarthritis patients. Literature review According to the population intervention comparison outcome measure methods and based on selected keywords, 12 studies were chosen according to (met) the inclusion criteria. The results indicated that treatment with knee braces was effective in decreasing pain, improving function, ameliorating improvement in range of motion, and increasing speed of walking and step length in conjunction with a reduction in the adduction moment applied to the knee. Osteoarthritis knee braces may be considered for improvement of walking and treatment of medial compartment knee osteoarthritis. Knee braces are an orthotic intervention that could potentially be significant in assisting in improving the walking parameters and treatment of medial compartment knee osteoarthritis. © The International Society for Prosthetics and Orthotics 2014.

  15. Efficacy of knee braces and foot orthoses in conservative management of knee osteoarthritis: a systematic review.

    Science.gov (United States)

    Raja, Kavitha; Dewan, Neha

    2011-03-01

    A systematic analysis was conducted on the effectiveness of knee braces and foot orthoses in conservative management of knee osteoarthritis. The methodologic quality of the randomized clinical trials, controlled clinical trials, and observational studies were systematically reviewed using the Structured Effectiveness Quality Evaluation Scale. Twenty-five studies met the inclusion criteria. The orthoses used in the studies included Generation II osteoarthritis knee brace, valgus knee braces, functional off-loading knee braces, knee sleeves, lateral-wedged insoles with subtalar strapping, medial-wedged insoles, and specialized footwear. Results suggest that knee braces and foot orthoses are effective in decreasing pain, joint stiffness, and drug dosage. They also improve proprioception, balance, Kellgren/Lawrence grading, and physical function scores in subjects with varus and valgus knee osteoarthritis. Knee braces and foot orthoses could be cautiously considered as conservative management for relief of pain and stiffness and improving physical function for persons with knee osteoarthritis. The conclusions of this review are limited by methodologic considerations like poor quality of trials and heterogeneity of interventions.

  16. THE PROFILE OF THE ACCOUNTING RESEARCH ABOUT IFRS: A BIBLIOMETRIC REVIEW OF INTERNATIONAL ARTICLES ON THE SUBJECT

    Directory of Open Access Journals (Sweden)

    Andressa Iovine Martins

    2012-12-01

    Full Text Available The main objective of this article is to identify what is currently being researched in the area of International Financial Reporting Standards (IFRS around the world; who is carrying on such researches; which researches has caused stronger impact; which journals shows more articles about this issue and the ones that cause more impacts; the time frames and places this subject is more often produced. The applied methodology was based on the metrics precepts, using as data base platform the Web of Science (WoS of Citation Indexes from the Institute for Scientific Information – ISI – Citation Indexes. It was found 150 articles for the research lookout of “International Financial Reporting Standards” and 147 for “IFRS” found in the four main categories of WoS related to that subject. According to the two used terms for research, the result was quite conflicting. It was observed that the more productive writers are not necessarily the most influential ones, which also occurred in regard to periodic publications. The large majority of the production occurred from 2006 on, and the countries that stood out more, in quantity terms, were the United States of America, Germany, Australia and England.

  17. Knee extensor strength and risk of structural, symptomatic and functional decline in knee osteoarthritis

    DEFF Research Database (Denmark)

    Culvenor, Adam G; Ruhdorfer, Anja; Juhl, Carsten

    2017-01-01

    OBJECTIVE: To perform a systematic review and meta-analysis on the association between knee extensor strength and the risk of structural, symptomatic, or functional deterioration in individuals with or at risk of knee osteoarthritis (KOA). METHODS: We systematically identified and methodologically....... CONCLUSION: Meta-analysis showed that lower knee extensor strength is associated with an increased risk of symptomatic and functional deterioration, but not tibiofemoral JSN. The risk of patellofemoral deterioration in the presence of knee extensor strength deficits is inconclusive. This article is protected...... appraised all longitudinal studies (≥1-year follow-up) reporting an association between knee extensor strength and structural (tibiofemoral, patellofemoral), symptomatic (self-reported, knee replacement), or functional (subjective, objective) decline in individuals with or at risk of radiographic...

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

    Directory of Open Access Journals (Sweden)

    Tiemann, Andreas H. H.

    2013-04-01

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

  19. Total Knee Replacement

    Science.gov (United States)

    2005-01-01

    the knee prosthesis. The most common risks and complications associated with TKR are deep venous thrombosis, infection, stiffness, loosening, and osteolysis. To prevent deep venous thrombosis, patients are treated with heparin prophylactically and/or given support stockings to wear. Patients are also given antibiotics for 24 hours after surgery to minimize the risk of infection. Stiffness is another associated complication. In most patients, it can be avoided by keeping the knee moving in the days and weeks following surgery. The National Institutes of Health in the United States concluded that the indications for TKR should include the following: radiological evidence of joint damage, moderate to severe persistent pain that is not adequately relieved by nonsurgical management, and clinically significant functional limitation resulting in diminished quality of life. Review Strategy In March 2005, the following databases were searched: Cochrane Library International Agency for Health Technology Assessment (first quarter 2005), Cochrane Database of Systematic Reviews (first quarter 2005), Cochrane Central Register of Controlled Trials (first quarter 2005), MEDLINE (1966 to March 2005), MEDLINE In-Process and Other Non-indexed Citations (1966 to March 14, 2005), and EMBASE (1980 to 2005 week 9). The Medical Advisory Secretariat also searched Medscape on the Internet for recent reports on trials that were unpublished but that were presented at international conferences. In addition, the Web site Current Controlled Trials (www.controlled-trials.com) was searched for ongoing trials investigating TKR or unicompartmental knee replacement. No studies were identified that compared TKR to an alternative treatment. Several studies have been reported that compare preoperative measurement scores on targeted measures of functioning and pain to postoperative measurement scores in patients undergoing various TKR procedures. In order for the Medical Advisory Secretariat to measure the

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

    DEFF Research Database (Denmark)

    Klokker, Louise; Christensen, Robin; Wæhrens, Eva E

    2016-01-01

    BACKGROUND: The Osteoarthritis Research Society International (OARSI) has suggested to asses pain after specific activities consistently in clinical trials on knee OA. The Dynamic weight-bearing Assessment of Pain (DAP) assesses pain during activity (30 s of performing repeated deep knee-bends from...... 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...

  1. In Vivo Kinematics of the Knee during Weight Bearing in High Flexion

    OpenAIRE

    Qi, Wei; Hosseini, Ali; Tsai, Tsung-Yuan; Li, Jing-Sheng; Rubash, Harry E.; Li, Guoan

    2013-01-01

    Achieving high flexion is an objective of contemporary total knee arthoplasty, however little is known on the knee biomechanics at high flexion under weight-bearing conditions. This study is to investigate the 6DOF kinematics and tibiofemoral cartilage contact biomechanics of the knee during weight-bearing flexion from full extension to maximal flexion. Eight knees from seven healthy subjects with no history of injuries or chronic pain were recruited. The knees were MRI scanned to create 3D m...

  2. Comparison of kinematics of ACL-deficient and healthy knees during passive flexion and isometric leg press.

    Science.gov (United States)

    Esfandiarpour, Fateme; Shakourirad, Ali; Talebian Moghaddam, Saeed; Olyaei, Gholamreza; Eslami, Abouzar; Farahmand, Farzam

    2013-12-01

    Studying the kinematics of the ACL deficient (ACLD) knees, during different physiological activities and muscle contraction patterns, can improve our understanding of the joint's altered biomechanics due to ACL deficiency as well as the efficacy and safety of the rehabilitations exercises. Twenty-five male volunteers, including 11 normal and 14 unilateral ACLD subjects, participated in this study. The kinematics of the injured knees of the ACLD subjects was compared with their intact knees and the healthy group during passive flexion and isometric leg press with the knees flexed from full extension to 45° flexion, with 15° intervals. An accurate registration algorithm was used to obtain the three dimensional kinematical parameters, from magnetic resonance images. The ACL deficiency mainly altered the tibial anterior translation, and to some extent its internal rotation, with the change in other parameters not significant. During leg press, the anterior translation of the ACLD knees was significantly larger than that of the normal knees at 30° flexion, but not at 45°. Comparison of the anterior translations of the ACLD knees during leg press with that of the passive flexion revealed improved consistency (CVs changed from 1.2 and 4.0 to 0.6 and 0.6, at 30° and 45° flexion, respectively), but considerable larger translations (means increased by 6.2 and 4.9mm, at 30° and 45° flexion, respectively). The simultaneous contraction of the quadriceps and hamstrings during leg press, although reduces the knee laxity, cannot compensate for the loss of the ACL to restore the normal kinematics of the joint, at least during early flexion. Copyright © 2012 Elsevier B.V. All rights reserved.

  3. A MECHANICAL HYPOTHESIS FOR THE EFFECTIVENESS OF KNEE BRACING FOR MEDIAL COMPARTMENT KNEE OSTEOARTHRITIS

    Science.gov (United States)

    Ramsey, Dan K; Briem, Kristin; Axe, Michael J; Snyder-Mackler, Lynn

    2011-01-01

    Background Evidence that knee braces used for the treatment of osteoarthritis mediate pain relief and improve function by unloading the joint (increased joint separation) remains inconclusive. Alternatively, valgus braces may mediate pain relief by mechanically stabilizing the joint and reducing muscle co-contractions and joint compression. This study therefore sought to examine the degree to which unloader knee braces control knee instability and influence muscle co-contractions during gait. Methods Sixteen subjects with radiographic evidence of medial compartment knee osteoarthritis and malalignment were recruited and fitted with a custom Generation II Unloader Brace. Gait analysis was performed with the knee unbraced and with the brace in neutral alignment and 4° valgus. A two week washout period separated brace conditions. Muscle co-contraction indices were derived for agonist and antagonist muscle pairings. Pain, instability and functional status were assessed using self-report questionnaires. Repeated-measures ANOVA’s, correlations and regression analysis were used for statistical analysis. Results The scores for pain, function and stability were worst when the knee was unsupported (baseline and washout). At baseline, 9 of 16 subjects reported knee instability, of which 5 complained it affected activities of daily living. Poor knee stability was significantly correlated with decreased activities of daily living, quality of life, global knee function and higher pain and symptoms. Knee function and stability scored highest with the neutral brace compared to the valgus brace. Vastus lateralis-lateral hamstring and vastus medialis-medial hamstring muscle co-contractions were significantly reduced as a result of bracing. Subjects with greater varus alignment exhibited greater decreases in vastus lateralis-lateral hamstrings co-contraction. Conclusion Neutral alignment performed as well or better than valgus alignment, in reducing pain, disability, muscle co

  4. A Porcine Knee Model Is Valid for Use in the Evaluation of Arthroscopic Skills: A Pilot Study.

    Science.gov (United States)

    Martin, R Kyle; Gillis, Danny; Leiter, Jeff; Shantz, Jesse Slade; MacDonald, Peter

    2016-04-01

    Previously validated knee arthroscopy evaluation tools have used human cadaveric knees. This is unsustainable because of the cost and scarcity of these specimens. Porcine (pig) knees are anatomically similar, affordable, and easily obtainable; however, whether porcine knees represent a suitable alternative to human specimens has not been evaluated. The purpose of this study was to determine whether porcine knees are similar to human cadaveric knees for the assessment of knee arthroscopy skills by evaluating (1) the validity of the porcine model (whether trainees of the same level of ability scored similarly when using the two models) and (2) the reliability of the porcine model (whether surgeons with experience achieved higher scores than surgeons with less experience in the porcine model). Eleven orthopaedic surgery residents (five junior residents and six senior residents), one orthopaedic sports medicine fellow, and three attending orthopaedic surgeons were enrolled. Participants were provided instructions for a proper arthroscopic examination of the knee and asked to identify, and then probe, the listed anatomic structures on both the human and porcine knee specimens. Each participant was asked to demonstrate the following skills: joint manipulation, instrument control and triangulation, fluid management, maintenance of field of view, economy of movement, and efficiency. The Objective Assessment of Arthroscopic Skills (OAAS) and checklist for diagnostic arthroscopy of the knee were used for skills assessment by one observer. Internal consistency, a measure of how well the assessment tool measures the skills being studied, was determined by Cronbach's α and group differences investigated by paired t-test and Wilcoxon signed-rank tests where appropriate. Based on a sample size calculation, a total of 37 subjects would be required for the full-scale research study to achieve a power of 0.80, with α set at 0.05, to detect a difference in OAAS score of 4.73 (25

  5. Experimental Research on the Influence of Vibration on Knee Mobility

    Directory of Open Access Journals (Sweden)

    Radu Panaitescu-Liess

    2013-09-01

    Full Text Available Besides hand - arm system, the vibration can enter in the human body through the feet, too. In these case - when the subject was in a standing position and the vibrations have a vertical component - longer exposures may cause disease of joints, lower extremity and serious disorders of the cerebral blood vessels, internal organs and circulatory system. This paper focused on the influence of vibration on knee mobility. We used a MediTouch system which consists of a motion capture device (an ergonomic leg brace and a dedicated software.

  6. Can a knee brace reduce the strain in the anterior cruciate ligament? A study using combined in vivo/in vitro method.

    Science.gov (United States)

    Hangalur, Gajendra; Brenneman, Elora; Nicholls, Micah; Bakker, Ryan; Laing, Andrew; Chandrashekar, Naveen

    2016-06-01

    It is unknown whether prophylactic knee braces can reduce the strain in the anterior cruciate ligament during dynamic activities. An athlete, who had characteristics of high anterior cruciate ligament injury risk, was chosen. A motion capture system (Optotrak Certus; Northern Digital, Waterloo, ON, Canada) was used to record dynamic trials during drop-landing activity of this subject with and without the knee brace being worn. A musculoskeletal model was used to estimate the muscle forces during this activity. A dynamic knee simulator then applied kinematics and muscle forces on a cadaver knee with and without the brace mounted on it. The anterior cruciate ligament strain was measured. The peak strain in the anterior cruciate ligament was substantially lower for the braced (7%) versus unbraced (20%) conditions. Functional knee braces could decrease the strain in the anterior cruciate ligament during dynamic activities in a high-risk subject. However, the reduction seems to be a result of altered muscle firing pattern due to the brace. Prophylactic knee brace could reduce the strain in the anterior cruciate ligament of high-risk subjects during drop-landing through altered muscle firing pattern associated with brace wear. This could help reduce the anterior cruciate ligament injury risk. © The International Society for Prosthetics and Orthotics 2015.

  7. Observer-Based Human Knee Stiffness Estimation.

    Science.gov (United States)

    Misgeld, Berno J E; Luken, Markus; Riener, Robert; Leonhardt, Steffen

    2017-05-01

    We consider the problem of stiffness estimation for the human knee joint during motion in the sagittal plane. The new stiffness estimator uses a nonlinear reduced-order biomechanical model and a body sensor network (BSN). The developed model is based on a two-dimensional knee kinematics approach to calculate the angle-dependent lever arms and the torques of the muscle-tendon-complex. To minimize errors in the knee stiffness estimation procedure that result from model uncertainties, a nonlinear observer is developed. The observer uses the electromyogram (EMG) of involved muscles as input signals and the segmental orientation as the output signal to correct the observer-internal states. Because of dominating model nonlinearities and nonsmoothness of the corresponding nonlinear functions, an unscented Kalman filter is designed to compute and update the observer feedback (Kalman) gain matrix. The observer-based stiffness estimation algorithm is subsequently evaluated in simulations and in a test bench, specifically designed to provide robotic movement support for the human knee joint. In silico and experimental validation underline the good performance of the knee stiffness estimation even in the cases of a knee stiffening due to antagonistic coactivation. We have shown the principle function of an observer-based approach to knee stiffness estimation that employs EMG signals and segmental orientation provided by our own IPANEMA BSN. The presented approach makes realtime, model-based estimation of knee stiffness with minimal instrumentation possible.

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

    Science.gov (United States)

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

    2013-12-01

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

  9. Effect of Material Parameters on Steady State Creep in a Thick Composite Cylinder Subjected to Internal Pressure

    Directory of Open Access Journals (Sweden)

    Tejeet Singh

    2009-12-01

    Full Text Available The steady state creep in Al- SiCP composite cylinder subjected to internal pressure was investigated. The creep behavior of the material were described by threshold stress based creep law by assuming a stress exponent of 5. The effect of size and content of the reinforcement (SiCP , and operating temperature on the stresses and strain rates in the composite cylinder were investigated. The stresses in the cylinder did not have significant variation with varying size and content of the reinforcement, and operating temperature. However, the tangential as well as radial strain rates in the cylinder could be reduced to a significant extent by decreasing size of SiCP, increasing the content of SiCP and decreasing operating temperature.

  10. Biomechanical and functional efficacy of knee sleeves: A literature review.

    Science.gov (United States)

    Mohd Sharif, Nahdatul Aishah; Goh, Siew-Li; Usman, Juliana; Wan Safwani, Wan Kamarul Zaman

    2017-11-01

    Knee sleeves are widely used for the symptomatic relief and subjective improvements of knee problems. To date, however, their biomechanical effects have not been well understood. To determine whether knee sleeves can significantly improve the biomechanical variables for knee problems. Systematic literature search was conducted on four online databases - PubMed, Web of Science, ScienceDirect and Springer Link - to find peer-reviewed and relevant scientific papers on knee sleeves published from January 2005 to January 2015. Study quality was assessed using the Structured Effectiveness Quality Evaluation Scale (SEQES). Twenty studies on knee sleeves usage identified from the search were included in the review because of their heterogeneous scope of coverage. Twelve studies found significant improvement in gait parameters (3) and functional parameters (9), while eight studies did not find any significant effects of knee sleeves usage. Most improvements were observed in: proprioception for healthy knees, gait and balance for osteoarthritic knees, and functional improvement of injured knees. This review suggests that knee sleeves can effect functional improvements to knee problems. However, further work is needed to confirm this hypothesis, due to the lack of homogeneity and rigor of existing studies. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Análise biomecânica das articulações do quadril e joelho durante a marcha em participantes idosos Biomechanical analysis of hip and knee joints during gait in elderly subjects

    Directory of Open Access Journals (Sweden)

    Renata Noce Kirkwood

    2007-01-01

    Full Text Available O objetivo desse estudo foi determinar a amplitude de movimento, o momento de força, a potência e o trabalho das articulações do quadril e joelho durante a marcha em um grupo de participantes entre 55 e 75 anos de idade. O andar é uma atividade diária comum e normalmente prescrita como exercício terapêutico na reabilitação de pessoas idosas. Dados cinemáticos e cinéticos das articulações do quadril e joelho foram obtidos usando o sistema Optotrak, associado a uma plataforma de força, raio-X padronizado para determinar com acurácia o centro de rotação das articulações do joelho e quadril e dados antropométricos. A articulação do quadril gerou mais trabalho que o joelho durante a marcha. O quadril gerou um total de 0.40J/kg, sendo que 22% ocorreram no plano frontal, 76% no sagital e 2% no plano transverso. A articulação do joelho gerou um trabalho total de 0,30J/kg durante a marcha, sendo 7% no plano frontal, 90% no sagital e 3% no transverso. O estudo biomecânico das articulações durante diferentes atividades leva a uma maior compreensão do papel de cada articulação durante o movimento, contribuindo assim para a elaboração de melhores programas físicos de reabilitação, prevenção e treinamento de performance.The objective of this study was to quantify the range of motion, force momentum, power and the mechanical work performed by hip and knee joints during gait in a group of subjects aged between 55 and 75 years. As a common activity of daily life, walking is often prescribed as a therapeutic exercise in elderly adults' rehabilitation. Kinematic and kinetic analyses during gait were obtained from optical tracking, force plate, standardized x-ray imaging and anthropometric data. The total effort generated by the hip joint during gait was greater than the one of the knee joint. The hip joint generated a total effort of 0.40J/kg, with 22% on the frontal plane, 76% on sagittal plane, and 2% on transverse plane

  12. Risk factors of knee osteoarthritis, WHO-ILAR-COPCORD study

    Directory of Open Access Journals (Sweden)

    Barghamdi M

    2009-01-01

    Full Text Available "nBackground: To evaluate the association between age, sex, BMI, waist/hip ratio, smoking, religion, ethnicity, education and knee osteoarthritis. "nMethods: Eligible subjects were randomly included from participants of Tehran COPCORD study, of whom 480 subjects with knee osteoarthritis were compared to 490 subjects without (case-control study. Using a questionnaire developed by COPCORD group (Asia & Oceania, we enquired about the risk factors of knee osteoarthritis i.e. age, sex, BMI, Waist/Hip ratio, religion, ethnicity, education and smoking. Knee osteoarthritis was defined using ACR criteria. Each knee was unit of analysis using GEE technique to evaluate these associations. "nResults: Age (OR; 1.096; CI95%: 1.091-1.1; P: 0.00 and sex (OR; 2.85; CI95%: 2.49-3.28; P: 0.00 showed significant association with knee osteoarthritis. Overweight (OR; 1.81; CI95%: 1.28-2.55; P: 0.00 and obesity (OR; 3.3; CI95%: 2.34-4.66; P: 0.00 both showed higher risk for knee osteoarthritis. The association between waist/hip ratio and knee osteoarthritis showed an OR of 5.28, CI95%: 0.89-31.44; P: 0.07. However, this association was only borderline significant. People with different religion or ethnicity and smokers had no extra risks for knee osteoarthritis. Higher education is a protective factor for knee osteoarthritis as people who had university education compared to people with no/primary education showed a lower risk for knee osteoarthritis (OR; 0.54; CI95%: 0.38-0.78; P: 0.00. "nConclusions: Our study confirmed that elderly, females, overweight and obese people are at higher risk to develop knee osteoarthritis as found in western societies. Higher education is a protective factor against knee osteoarthritis. Ethnicity, religion and smoking showed no extra risk of knee osteoarthritis.

  13. Is Lifelong Knee Joint Force from Work, Home, and Sport Related to Knee Osteoarthritis?

    Directory of Open Access Journals (Sweden)

    Charles R. Ratzlaff

    2012-01-01

    Full Text Available Purpose. To investigate the association of cumulative lifetime knee joint force on the risk of self-reported medically-diagnosed knee osteoarthritis (OA. Methods. Exposure data on lifetime physical activity type (occupational, household, sport/recreation and dose (frequency, intensity, duration were collected from 4,269 Canadian men and women as part of the Physical Activity and Joint Heath cohort study. Subjects were ranked in terms of the “cumulative peak force index”, a measure of lifetime mechanical knee force. Multivariable logistic regression was conducted to obtain adjusted effects for mean lifetime knee force on the risk of knee OA. Results. High levels of total lifetime, occupational and household-related force were associated with an increased in risk of OA, with odds ratio’s ranging from approximately 1.3 to 2. Joint injury, high BMI and older age were related to risk of knee OA, consistent with previous studies. Conclusions. A newly developed measure of lifetime mechanical knee force from physical activity was employed to estimate the risk of self-reported, medically-diagnosed knee OA. While there are limitations, this paper suggests that high levels of total lifetime force (all domains combined, and occupational force in men and household force in women were risk factors for knee OA.

  14. Modelling and Analysis on Biomechanical Dynamic Characteristics of Knee Flexion Movement under Squatting

    Directory of Open Access Journals (Sweden)

    Jianping Wang

    2014-01-01

    Full Text Available The model of three-dimensional (3D geometric knee was built, which included femoral-tibial, patellofemoral articulations and the bone and soft tissues. Dynamic finite element (FE model of knee was developed to simulate both the kinematics and the internal stresses during knee flexion. The biomechanical experimental system of knee was built to simulate knee squatting using cadaver knees. The flexion motion and dynamic contact characteristics of knee were analyzed, and verified by comparing with the data from in vitro experiment. The results showed that the established dynamic FE models of knee are capable of predicting kinematics and the contact stresses during flexion, and could be an efficient tool for the analysis of total knee replacement (TKR and knee prosthesis design.

  15. The potential role of prophylactic/functional knee bracing in preventing knee ligament injury.

    Science.gov (United States)

    Rishiraj, Neetu; Taunton, Jack E; Lloyd-Smith, Robert; Woollard, Robert; Regan, William; Clement, D B

    2009-01-01

    It is estimated that knee injuries account for up to 60% of all sport injuries, with the anterior cruciate ligament (ACL) accounting for almost half of these knee injuries. These knee injuries can result in high healthcare costs, as an ACL injury is often associated with surgery, long and costly rehabilitation, differing degrees of impairment and potential long-term consequences such as osteoarthritis. The interest in ACL injury prevention has been extensive for the past decade. Over this period, many ACL (intrinsic and extrinsic) injury risk factors have been identified and investigated by numerous researchers. Although prevention programmes have shown potential in decreasing knee ligament injuries, several researchers have suggested that no conclusive evidence has been presented in reducing the rate and/or severity of ACL injuries during sporting competition. Knee braces have been available for the last 30 years and have been used to assist individuals with ACL-deficient and ACL-reconstructed knees. However, research is limited on the use of knee braces (prophylactic and functional) to potentially prevent knee ligament injury in the non-injured population. One possible explanation for the limited research could be that the use of these devices has raised concerns of decreased or impaired athletic performance. In summary, the review of subjective and some objective publications suggests that a functional knee brace may offer stability to an ACL-deficient knee joint; however, research is limited on the use of a knee brace for prophylactic use in non-injured athletes. The limited research could be a result of fear of performance hindrance that has led to poor knee brace compliance.

  16. Anterior knee pain.

    Science.gov (United States)

    LLopis, Eva; Padrón, Mario

    2007-04-01

    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.

  17. 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.

  18. Kinematic analysis of anterior cruciate ligament reconstruction in total knee arthroplasty.

    Science.gov (United States)

    Liu, Hua-Wei; Ni, Ming; Zhang, Guo-Qiang; Li, Xiang; Chen, Hui; Zhang, Qiang; Chai, Wei; Zhou, Yong-Gang; Chen, Ji-Ying; Liu, Yu-Liang; Cheng, Cheng-Kung; Wang, Yan

    2016-01-01

    This study aims to retain normal knee kinematics after knee replacement surgeries by reconstructing anterior cruciate ligament during total knee arthroplasty. We use computational simulation tools to establish four dynamic knee models, including normal knee model, posterior cruciate ligament retaining knee model, posterior cruciate ligament substituting knee model, and anterior cruciate ligament reconstructing knee model. Our proposed method utilizes magnetic resonance images to reconstruct solid bones and attachments of ligaments, and assemble femoral and tibial components according representative literatures and operational specifications. Dynamic data of axial tibial rotation and femoral translation from full-extension to 135 were measured for analyzing the motion of knee models. The computational simulation results show that comparing with the posterior cruciate ligament retained knee model and the posterior cruciate ligament substituted knee model, reconstructing anterior cruciate ligament improves the posterior movement of the lateral condyle, medial condyle and tibial internal rotation through a full range of flexion. The maximum posterior translations of the lateral condyle, medial condyle and tibial internal rotation of the anterior cruciate ligament reconstructed knee are 15.3 mm, 4.6 mm and 20.6 at 135 of flexion. Reconstructing anterior cruciate ligament in total knee arthroplasty has been approved to be an more efficient way of maintaining normal knee kinematics comparing to posterior cruciate ligament retained and posterior cruciate ligament substituted total knee arthroplasty.

  19. Thigh-calf contact: Does it affect the loading of the knee in the high-flexion range?

    NARCIS (Netherlands)

    Zelle, J.; Barink, M.; De Waal Malefijt, M.; Verdonschot, Nicolaas Jacobus Joseph

    2009-01-01

    Recently, high-flexion knee implants have been developed to provide for a large range of motion (ROM>120°) after total knee arthroplasty (TKA). Since knee forces typically increase with larger flexion angles, it is commonly assumed that high-flexion knee implants are subjected to larger loads than

  20. A censervative programme for treatment of anterior knee pain in ...

    African Journals Online (AJOL)

    week conservative rehabilitation programme in addressing anterior knee pain in adolescents. Design. Subjects were randomly allocated to a control group (N=12) and an experimental group (N=18). The experimental group was subjected to a ...

  1. Effects of proprioceptive circuit exercise on knee joint pain and muscle function in patients with knee osteoarthritis

    Science.gov (United States)

    Ju, Sung-Bum; Park, Gi Duck; Kim, Sang-Soo

    2015-01-01

    [Purpose] This study applied proprioceptive circuit exercise to patients with degenerative knee osteoarthritis and examined its effects on knee joint muscle function and the level of pain. [Subjects] In this study, 14 patients with knee osteoarthritis in two groups, a proprioceptive circuit exercise group (n = 7) and control group (n = 7), were examined. [Methods] IsoMed 2000 (D&R Ferstl GmbH, Hemau, Germany) was used to assess knee joint muscle function, and a Visual Analog Scale was used to measure pain level. [Results] In the proprioceptive circuit exercise group, knee joint muscle function and pain levels improved significantly, whereas in the control group, no significant improvement was observed. [Conclusion] A proprioceptive circuit exercise may be an effective way to strengthen knee joint muscle function and reduce pain in patients with knee osteoarthritis. PMID:26357422

  2. Primary total knee arthroplasty for acute fracture around the knee.

    Science.gov (United States)

    Parratte, S; Ollivier, M; Argenson, J-N

    2018-02-01

    Relatively poor results have been reported with open reduction and internal fixation of complex fractures around the knee in elderly osteoporotic patients, and primary total knee arthroplasty (TKA) has been proposed as an alternative solution. While limiting the number of procedures, it meets two prerequisites: (1) to save the patient's life, thanks to early weight-bearing, to limit decubitus complications; and (2) to save knee function and patient autonomy, thanks to early knee mobilization. There are 3 main indications: complex articular fractures in elderly patients with symptomatic osteoarthritis prior to fracture; complex articular fractures of the tibial plateau in elderly patients whose bone quality makes internal fixation hazardous; and major destruction of the distal femur in younger patients. Although admitted in emergency, these patients require adequate preoperative management, including a multidisciplinary approach to manage comorbidities, control of anemia and pain, and assessment and management of vascular and cutaneous conditions. Preoperative planning is crucial, to order appropriate implants and materials that may be needed intraoperatively. Surgical technique is based on the basic principles of revision surgery as regards choice of implant, steps of reconstruction, bone defect management and implant fixation. For complex fractures of the distal femur, primary temporary reduction is a useful "trick", to determine the level of the joint line and femoral rotation. Complementary internal fixation may be required in case of diaphyseal extension of the fracture and to prevent inter-prosthetic fractures. In the literature, the results of primary TKA for fracture are encouraging and better than for secondary TKA after failure of non-operative treatment or internal fixation, with lower rates of revision and complications, earlier full weight-bearing and better functional results. Loss of autonomy is, however, frequent, and 1-year mortality is high

  3. The Consumer Quality Index Hip Knee Questionnaire measuring patients' experience with quality of care after a total hip or knee arthroplasty.

    NARCIS (Netherlands)

    Stubbe, J.H.; Gelsema, T.; Delnoij, D.M.J.

    2007-01-01

    Background: The Dutch Consumer Quality Index Hip Knee Questionnaire (CQI Hip Knee) was used to assess patients' experiences with and evaluations of quality of care after a total hip (THA) or total knee arthroplasty (TKA). The aim of this study is to evaluate the construct validity and internal

  4. Return to preinjury status after routine knee arthroscopy in military population.

    Science.gov (United States)

    Joshi, A; Kayastha, N; Maharjan, R; Chand, P; K C, B R

    2014-01-01

    Knee arthroscopy is frequently advised procedure for knee-related problems in serving soldiers. The scanty published literatures have documented wide range of recovery duration ranging from nine days to four weeks even for routine uncomplicated arthroscopy. However, neither of these studies evaluated military population, where arthroscopic procedures are frequent and physical demands are different. The aim of this study was to ascertain the time required to return to unrestricted physical activities in serving military population. This was a prospective descriptive study enrolling 51 patients who underwent two portal arthroscopic procedures like diagnostic arthroscopy, meniscectomy, loose body removal and excision of plica or combination of these. A uniform home based physiotherapy protocol was used for everyone. All of them were followed up at 2nd, 4th, 6th, 8th and 12th postoperative weeks. At each follow up, 2000 International Knee Documentation Committee subjective knee evaluation form was filled and submitted for analysis. Although all of our patients were able to walk around without any support at two weeks follow up, 88% had restriction to activities of daily living because of knee related problems. The mean International Knee Documentation Committee score was 41 at 1st follow up, which gradually improved to 64, 86, 94, 94 at 4th, 6th, 8th and 12th week follow up respectively. At 6 weeks 91% resumed their preinjury status which reached 94% in eight weeks. Most of the soldiers return to unrestricted activities within six to eight weeks after diagnostic arthroscopy, meniscectomy, loose body removal and excision of plica or combination of these procedures.

  5. Knee joint replacement - slideshow

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/presentations/100088.htm Knee joint replacement - series—Normal anatomy To use the ... to slide 4 out of 4 Overview The knee is a complex joint. It contains the distal ...

  6. Knee arthroscopy - slideshow

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/presentations/100117.htm Knee arthroscopy - series—Normal anatomy To use the sharing ... to slide 5 out of 5 Overview The knee is a complex joint made up of the ...

  7. 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 ...

  8. 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 ...

  9. Surgical technique: medial collateral ligament reconstruction using Achilles allograft for combined knee ligament injury.

    Science.gov (United States)

    Marx, Robert G; Hetsroni, Iftach

    2012-03-01

    Previous approaches for medial collateral ligament (MCL) reconstruction have been associated with extensive exposure, risk of donor site morbidity with autografts, loss of motion, nonanatomic graft placement, and technical complexity with double-bundle constructs. Therefore, we implemented a technique that uses Achilles allograft, small incisions, and anatomic insertions to reconstruct the MCL. The MCL femoral insertion was identified, and a socket reamed over a guide pin. The Achilles bone plug was fixed in the socket and the tendon passed distally under the skin and fixed on the tibia, creating isometric reconstruction. We evaluated 14 patients who had this MCL reconstruction. We determined range of knee motion, knee ligament laxity, functional outcome scores (International Knee Documentation Committee [IKDC]-subjective, Lysholm, Knee injury and Osteoarthritis Outcome Score [KOOS]), and activity level scores (Tegner, Marx). Followup range was 24 to 61 months. Knee motion was maintained in 12 cases. Grade 0-1 + valgus stability was obtained in all 14 cases. In cases of MCL with primary ACL reconstruction, IKDC-subjective, Lysholm, and KOOS-sports scores were 91 ± 6, 92 ± 6, and 93 ± 12, respectively, and return to preinjury activity levels was achieved. In cases of MCL with revision ACL reconstruction, function was inferior, and patients did not return to their preinjury activity levels. This technique uses allograft that provides bone-to-bone healing on the femur, requires small incisions, and creates isometric reconstruction. When performed with a cruciate reconstruction, knee stability can be restored at 2 to 5 years followup. In patients with MCL with primary ACL reconstruction, return to preinjury activity level in recreational athletes can be achieved.

  10. 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)....

  11. Modificações biomecânicas na marcha de indivíduos com osteoartrite medial do joelho Biomechanical changes in gait of subjects with medial knee osteoarthritis

    Directory of Open Access Journals (Sweden)

    Hésojy Gley Pereira Vital da Silva

    2012-01-01

    Full Text Available OBJETIVO: Demonstrar a presença e magnitude de determinadas variáveis biomecânicas na marcha de pacientes com osteoartrite (OA medial de joelho e suas relações com o carregamento deste. MÉTODOS: Vinte e um indivíduos diagnosticados com OA do compartimento medial do joelho foram submetidos à avaliação da marcha e comparados com grupo controle. RESULTADOS: O grupo com OA em relação ao grupo controle apresentou: menor velocidade da marcha (0,8±0,1 vs. 1,1±0,1m/s, maior pico precoce do momento adutor (2,6±1,2 vs. 0,3±1,4 Nm/kg, maior pico tardio do momento adutor (1,8±0,7 vs. 0,9±0,2 Nm/kg, maior pico do momento flexor (1,6±0,9 vs. 0,6±0,4 Nm/kg, elevado pico de varo dinâmico (11,5º±8,3 vs. 3º±3,9, maior pico de flexão (15,6º±8 vs. 9,3º±4,1, com tendência ao flexo (5,5º±8,5 na fase de apoio, menor pico de flexão (58,7º±13,3 vs. 67,5º±4,8 no balanço e elevados picos de rotação externa (25,5º±12,7 vs. 0,5º±12,4. Os picos de ângulos e de momentos ocorreram nas mesmas fases da marcha nos dois grupos. CONCLUSÃO: Pacientes com OA do compartimento medial do joelho apresentam modificações na marcha com aumento rotação externa, redução da velocidade, aumento do momento flexor e flexão no apoio, insuficientes para uma redução considerável do carregamento. Nível de Evidência III, Estudo caso-controle.OBJETIVE: Demonstrate the presence and magnitude of biomechanical variables during gait in patients with medial knee osteoarthritis (OA and the relationship with the knee loading. METHODS: Gait of 21 subjects diagnosed with medial knee OA was evaluated and compared to the control group. RESULTS: The group with OA showed: Lower gait speed (0.8 ± 0.1 vs. 1.1 ± 0.1m/s, higher peak early (2.6 ± 1.2 vs. 0.3 ± 1.4 Nm/Kg and late peak of the adduction moment (1.8 ± 0.7 vs. 0.9 ± 0.2 Nm/Kg, higher peak flexor moment (1.6 ± 0.9 vs. 0.6 ± 0.4 Nm/Kg , high dynamic peak varus (11.5 ± 8.3 vs. 3o ± 3.9, higher

  12. Internal Marketing and Reflective Subjects Formation Marketing Interno e a Formação de Sujeitos Reflexivos

    Directory of Open Access Journals (Sweden)

    Sérgio Carvalho Benício de Mello

    2011-03-01

    Full Text Available Internal marketing perspective has gaining primordial space. It happens through an interdisciplinary process with human management discipline and is based on the assumption that a significant part of the organizational success depends on the attitudes, commitment and performance of people in an organization, above all the ones that interact with the customers. Assuming the premise that such procedure depends on the relationship between the contact employees and the customers of an organization, we revise in this essay fundamental notions of interpresonel relationships to discuss the role of the internal marketing in the formation of employees that becomes reflexive subjects. We understand such premise as a fundamental characteristic for those to carry out his/her role in a conscious way. Our conclusion is a theoretical proposal of how this can be developed.A perspectiva do marketing interno tem ganho espaço primordial. Isto ocorre por meio de um processo interdisciplinar com a gestão de pessoas, por se compreender que parte do êxito organizacional dependa das atitudes, do comprometimento e do desempenho de todos os envolvidos numa organização, sobretudo os que interagem com os clientes. Assumindo a premissa de que tal procedimento dependa do relacionamento entre o funcionário de contato e os clientes de uma organização, neste ensaio teórico revisamos noções fundamentais do conhecimento acerca das relações interpessoais para discutir o papel do marketing interno na formação de funcionários que se tornem sujeitos reflexivos. Tal premissa é por nos compreendida como característica fundamental para que estes desempenhem seu papel de forma consciente. Nossa chegada é uma proposta teórica de como isto possa ser desenvolvido.

  13. Knee flexion after total knee arthroplasty reduces blood loss.

    Science.gov (United States)

    Panni, Alfredo Schiavone; Cerciello, Simone; Vasso, Michele; Del Regno, Chiara

    2014-08-01

    Extensive blood loss after total knee arthroplasty (TKA) may be a potential problem since it leads to anaemia, increased need for transfusion and prolonged hospitalization. Aim of this study was to investigate the effects of postoperative knee flexion after TKA on blood loss and the need for transfusion. One hundred consecutive patients undergoing primary TKA from 2012 to 2013 were randomizely divided into two groups. In one group, the knee was extended for the first 6 h after surgery, whereas in the other was flexed at 90° for the same time. Two doses of endovenous tranexamic acid were administered in all subjects. Patients were homogeneous for all the possible confounding factors. Calculated blood loss was 846 ± 197 (ml) in the flexion group and 1,242 ± 228 (ml) in the extension group (p extension group (p extension group. Knee flexion at 90° after TKA, associated with the intraoperative use of tranexamic, acid is an effective method to reduce blood loss and the need for blood transfusion. The routine use of the present protocol is effective in reducing social costs and length of hospitalization of TKA procedures.

  14. Subjective Cognitive Decline in Older Adults: An Overview of Self-Report Measures Used Across 19 International Research Studies

    Science.gov (United States)

    Rabin, Laura A.; Smart, Colette M.; Crane, Paul K.; Amariglio, Rebecca E.; Berman, Lorin M.; Boada, Mercè; Buckley, Rachel F.; Chételat, Gaël; Dubois, Bruno; Ellis, Kathryn A.; Gifford, Katherine A.; Jefferson, Angela L.; Jessen, Frank; Katz, Mindy J.; Lipton, Richard B.; Luck, Tobias; Maruff, Paul; Mielke, Michelle M.; Molinuevo, José Luis; Naeem, Farnia; Perrotin, Audrey; Petersen, Ronald C.; Rami, Lorena; Reisberg, Barry; Rentz, Dorene M.; Riedel-Heller, Steffi G.; Risacher, Shannon L.; Rodriguez, Octavio; Sachdev, Perminder S.; Saykin, Andrew J.; Slavin, Melissa J.; Snitz, Beth E.; Sperling, Reisa A.; Tandetnik, Caroline; van der Flier, Wiesje M.; Wagner, Michael; Wolfsgruber, Steffen; Sikkes, Sietske A.M.

    2015-01-01

    Research increasingly suggests that subjective cognitive decline (SCD) in older adults, in the absence of objective cognitive dysfunction or depression, may be a harbinger of non-normative cognitive decline and eventual progression to dementia. Little is known, however, about the key features of self-report measures currently used to assess SCD. The Subjective Cognitive Decline Initiative (SCD-I) Working Group is an international consortium established to develop a conceptual framework and research criteria for SCD (Jessen et al., 2014, Alzheimers Dement 10, 844–852). In the current study we systematically compared cognitive self-report items used by 19 SCD-I Working Group studies, representing 8 countries and 5 languages. We identified 34 self-report measures comprising 640 cognitive self-report items. There was little overlap among measures—approximately 75% of measures were used by only one study. Wide variation existed in response options and item content. Items pertaining to the memory domain predominated, accounting for about 60% of items surveyed, followed by executive function and attention, with 16% and 11% of the items, respectively. Items relating to memory for the names of people and the placement of common objects were represented on the greatest percentage of measures (56% each). Working group members reported that instrument selection decisions were often based on practical considerations beyond the study of SCD specifically, such as availability and brevity of measures. Results document the heterogeneity of approaches across studies to the emerging construct of SCD. We offer preliminary recommendations for instrument selection and future research directions including identifying items and measure formats associated with important clinical outcomes. PMID:26402085

  15. Influence of advanced prosthetic knee joints on perceived performance and everyday life activity level of low-functional persons with a transfemoral amputation or knee disarticulation

    NARCIS (Netherlands)

    Theeven, P.J.; Hemmen, B.; Geers, R.P.; Smeets, R.J.P.; Brink, P.R.; Seelen, H.A.M.

    2012-01-01

    OBJECTIVE: To assess the effects of two types of microprocessor-controlled prosthetic knee joints (MPKs) on perceived performance and everyday life activity level. DESIGN: Randomized cross-over trial. SUBJECTS: Thirty persons with a unilateral above-knee amputation or knee disarticulation classified

  16. Importance of Patella, Quadriceps Forces, and Depthwise Cartilage Structure on Knee Joint Motion and Cartilage Response During Gait.

    Science.gov (United States)

    Halonen, K S; Mononen, M E; Jurvelin, J S; Töyräs, J; Klodowski, A; Kulmala, J-P; Korhonen, R K

    2016-07-01

    In finite-element (FE) models of the knee joint, patella is often omitted. We investigated the importance of patella and quadriceps forces on the knee joint motion by creating an FE model of the subject's knee. In addition, depthwise strains and stresses in patellar cartilage with different tissue properties were determined. An FE model was created from subject's magnetic resonance images. Knee rotations, moments, and translational forces during gait were recorded in a motion laboratory and used as an input for the model. Three material models were implemented into the patellar cartilage: (1) homogeneous model, (2) inhomogeneous (arcadelike fibrils), and (3) random fibrils at the superficial zone, mimicking early stages of osteoarthritis (OA). Implementation of patella and quadriceps forces into the model substantially reduced the internal-external femoral rotations (versus without patella). The simulated rotations in the model with the patella matched the measured rotations at its best. In the inhomogeneous model, maximum principal stresses increased substantially in the middle zone of the cartilage. The early OA model showed increased compressive strains in the superficial and middle zones of the cartilage and decreased stresses and fibril strains especially in the middle zone. The results suggest that patella and quadriceps forces should be included in moment- and force-driven FE knee joint models. The results indicate that the middle zone has a major role in resisting shear forces in the patellar cartilage. Also, early degenerative changes in the collagen network substantially affect the cartilage depthwise response in the patella during walking.

  17. Large-scale international validation of the ADO index in subjects with COPD: an individual subject data analysis of 10 cohorts

    DEFF Research Database (Denmark)

    Puhan, Milo A; Hansel, Nadia N; Sobradillo, Patricia

    2012-01-01

    Background: Little evidence on the validity of simple and widely applicable tools to predict mortality in patients with chronic obstructive pulmonary disease (COPD) exists.Objective: To conduct a large international study to validate the ADO index that uses age, dyspnoea and FEV1 to predict 3-yea...

  18. What Are Knee Problems?

    Science.gov (United States)

    ... Health Topics English Español 한국어 繁體中文 tiếng Việt Knee Problems Basics In-Depth Download Download EPUB Download PDF What are they? Points To Remember About Knee Problems Knee problems may be caused by injury, ...

  19. Prediction of in-vivo kinematics and contact track of total knee arthroplasty during walking

    Directory of Open Access Journals (Sweden)

    Zhenxian Chen

    2016-09-01

    Full Text Available In vivo kinematics of total knee arthroplasty (TKA are essential to investigate the articular surface wear of the knee implant. However, the prediction of in vivo knee kinematics and contact track during walking remains challenged. In this study, a previously developed subject-specific musculoskeletal multibody dynamics model was utilized to predict the in vivo kinematics of TKA during the straight gait and right-turn cycles, and the contact position as described by the center of pressure (COP. The predicted in vivo knee motions of the straight gait cycle were found with similar kinematic patterns and ranges of motion to clinical studies. The main internal-external rotations of the femoral component relative to the tibial insert occurred at the stance phase of the straight gait cycle with a lateral rotational pivot point; while the remaining changes in the contact positon mainly exhibited the anterior or posterior translation. For the right-turn cycle, the major changes in the contact positon were the internal-external rotations, and the rotational pivot points were mostly located at the medial compartment. These predictions further demonstrate that in vivo kinematics and contact track are gait pattern-dependent and are important considerations to further investigate the in vivo wear mechanisms of TKA bearings.

  20. Gender differences in gait kinematics for patients with knee osteoarthritis

    OpenAIRE

    Phinyomark, Angkoon; Sean T Osis; Blayne A Hettinga; Kobsar, Dylan; Ferber, Reed

    2016-01-01

    Background Females have a two-fold risk of developing knee osteoarthritis (OA) as compared to their male counterparts and atypical walking gait biomechanics are also considered a factor in the aetiology of knee OA. However, few studies have investigated sex-related differences in walking mechanics for patients with knee OA and of those, conflicting results have been reported. Therefore, this study was designed to examine the differences in gait kinematics (1) between male and female subjects ...

  1. Improving data availability for brain image biobanking in healthy subjects: Practice-based suggestions from an international multidisciplinary working group.

    Science.gov (United States)

    Shenkin, Susan D; Pernet, Cyril; Nichols, Thomas E; Poline, Jean-Baptiste; Matthews, Paul M; van der Lugt, Aad; Mackay, Clare; Lanyon, Linda; Mazoyer, Bernard; Boardman, James P; Thompson, Paul M; Fox, Nick; Marcus, Daniel S; Sheikh, Aziz; Cox, Simon R; Anblagan, Devasuda; Job, Dominic E; Dickie, David Alexander; Rodriguez, David; Wardlaw, Joanna M

    2017-06-01

    Brain imaging is now ubiquitous in clinical practice and research. The case for bringing together large amounts of image data from well-characterised healthy subjects and those with a range of common brain diseases across the life course is now compelling. This report follows a meeting of international experts from multiple disciplines, all interested in brain image biobanking. The meeting included neuroimaging experts (clinical and non-clinical), computer scientists, epidemiologists, clinicians, ethicists, and lawyers involved in creating brain image banks. The meeting followed a structured format to discuss current and emerging brain image banks; applications such as atlases; conceptual and statistical problems (e.g. defining 'normality'); legal, ethical and technological issues (e.g. consents, potential for data linkage, data security, harmonisation, data storage and enabling of research data sharing). We summarise the lessons learned from the experiences of a wide range of individual image banks, and provide practical recommendations to enhance creation, use and reuse of neuroimaging data. Our aim is to maximise the benefit of the image data, provided voluntarily by research participants and funded by many organisations, for human health. Our ultimate vision is of a federated network of brain image biobanks accessible for large studies of brain structure and function. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. The evaluation of the elasto-plastic behavior in case of the honed steel pipes subjected to variable internal pressure

    Science.gov (United States)

    Steigmann, R.; Stanciu, M. D.; Szasz, M.; Curtu, I.; Sturzu, T.; Savin, A.

    2016-08-01

    The paper analyses the elasto-plastic behavior of ten samples of E355 steel pipe of the same inner diameter, but with wall thickness ranging between 1.100 and 2.500 mm and length about 100 mm. The samples were subjected to variable internal pressure which was increased from 0 to 600-800 bar (up to the breaking of the pipe), being used the hydraulic oil, type HM46. The outer diameter of the tested pipes was measured successive for each increase of pressure with 100 bars, thus being determined the flow curve of the pipe material characterized by the elasto-plastic behavior and a tenacious failure. It was found that thin pipes, with the ratio between the inner and outer diameter less than 1.1, shows a different flow curve compare to pipes with thick walls, having the ratio between the inner and outer diameter greater than 1.1, the deformations being about two times higher. The rheological models of each type of pipes were identified.

  3. Immediate effects of a knee brace with a constraint to knee extension on knee kinematics and ground reaction forces in a stop-jump task.

    Science.gov (United States)

    Yu, Bing; Herman, Daniel; Preston, Jennifer; Lu, William; Kirkendall, Donald T; Garrett, William E

    2004-01-01

    A small knee flexion angle in landing tasks was identified as a possible risk factor for noncontact anterior cruciate ligament injuries that are common in sports. A specially designed knee brace with a constraint to knee extension would significantly increase the knee flexion angle at the landing of athletic tasks preceded with horizontal movement components, such as stop-jump tasks. Repeated measure design for brace effects. Three-dimensional videographic and force plate data were collected for 10 male and 10 female recreational athletes performing a stop-jump task with and without the specially designed brace. Knee flexion angle at landing, maximum knee flexion angle, and peak ground reaction forces during the stance phase of the stop-jump task were determined for each subject with and without the knee brace. The knee brace decreased the knee flexion angle at the landing by 5 degrees for both genders but did not significantly affect the peak ground reaction forces during the landing. The specially designed knee brace may be a useful device in the prevention and rehabilitation of noncontact anterior cruciate ligament injuries in sports. Copyright 2004 American Orthopaedic Society for Sports Medicine

  4. 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......, the following results were calculated for the overall appearance of a lesion able to cause locking: Positive predictive value = 0.85, negative predictive value = 0.77, sensitivity = 0.95, specificity = 0.53. Two knees were erroneously evaluated with no mechanical locking at MRI (one bucket-handle lesion and one...

  5. 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...

  6. Reliability of knee biomechanics during a vertical drop jump in elite female athletes.

    Science.gov (United States)

    Mok, Kam-Ming; Petushek, Erich; Krosshaug, Tron

    2016-05-01

    The purpose of the study was to assess the within-session and between-session reliability of knee kinematics and kinetics in a vertical drop jump task among elite female handball and football athletes. Specifically, we aimed to quantify the within-session waveform consistency and between-session consistency of the subject ranking for a variety of knee kinematics and kinetics. Forty-one elite female handball and football (soccer) athletes were tested in two sessions. The reliability of three-dimensional knee biomechanical measurements was quantified by the intra-class correlation, Spearman's rank correlation, and typical error. All the selected discrete variables achieved excellent within-session reliability (ICC>0.87). The typical error of valgus angles, internal rotation angles, and internal rotation moment was constant throughout the whole stance phase. For between-session reliability, the selected discrete variables achieved good to excellent reliability (ICC>0.69), except peak internal rotation moment (ICC=0.40). All between-session rank correlation coefficients ranged from 0.56 to 0.90. Most of the discrete variables achieved good to excellent reliability in both within-session and between-session analysis. Moreover, moderate to strong between-session consistency of subject rankings was found, implying that the measurements assessed during the vertical drop jump demonstrate sufficient reliability to be used in both single-session and multiple-session studies. Copyright © 2016 Elsevier B.V. All rights reserved.

  7. Does the Q - H index show a stronger relationship than the H:Q ratio in regard to knee pain during daily activities in patients with knee osteoarthritis?

    Science.gov (United States)

    Fujita, Remi; Matsui, Yasumoto; Harada, Atsushi; Takemura, Marie; Kondo, Izumi; Nemoto, Tetsuya; Sakai, Tadahiro; Hiraiwa, Hideki; Ota, Susumu

    2016-12-01

    [Purpose] The purpose of this study was to elucidate the relationship between knee muscle strength and knee pain in activities of daily living, based on consideration of the difference between extension and flexion strength (Q - H) and the hamstring:quadriceps (H:Q) ratio in patients with knee osteoarthritis. [Subjects and Methods] The participants were 78 females with knee osteoarthritis, and a total of 133 knees that had not been treated surgically were the targets of this research. The legs were divided according to dominance. Isometric knee extension and flexion muscle strength and knee pain during activities of daily living were measured. The H:Q ratio (flexion/extension muscle strength) and the difference between extension and flexion strength, (extension muscle strength/weight) minus (flexion muscle strength/weight), that is, Q - H, were calculated. The correlation between these indices and the knee pain score during activities of daily living was investigated. [Results] Greater knee pain during activities of daily living was related to lower knee extension muscle strength and Q - H in both the dominant and nondominant legs. Knee flexion muscle strength and the H:Q ratio were not significantly correlated with knee pain during any activities of daily living. [Conclusion] Knee extension muscle strength and Q - H were found to be significantly correlated with knee pain during activities of daily living, whereas the H:Q ratio was not.

  8. Kinematic Analysis of a Posterior-stabilized Knee Prosthesis

    Directory of Open Access Journals (Sweden)

    Zhi-Xin Zhao

    2015-01-01

    Full Text Available Background: The goal of total knee arthroplasty (TKA is to restore knee kinematics. Knee prosthesis design plays a very important role in successful restoration. Here, kinematics models of normal and prosthetic knees were created and validated using previously published data. Methods: Computed tomography and magnetic resonance imaging scans of a healthy, anticorrosive female cadaver were used to establish a model of the entire lower limbs, including the femur, tibia, patella, fibula, distal femur cartilage, and medial and lateral menisci, as well as the anterior cruciate, posterior cruciate, medial collateral, and lateral collateral ligaments. The data from the three-dimensional models of the normal knee joint and a posterior-stabilized (PS knee prosthesis were imported into finite element analysis software to create the final kinematic model of the TKA prosthesis, which was then validated by comparison with a previous study. The displacement of the medial/lateral femur and the internal rotation angle of the tibia were analyzed during 0-135° flexion. Results: Both the output data trends and the measured values derived from the normal knee′s kinematics model were very close to the results reported in a previous in vivo study, suggesting that this model can be used for further analyses. The PS knee prosthesis underwent an abnormal forward displacement compared with the normal knee and has insufficient, or insufficiently aggressive, "rollback" compared with the lateral femur of the normal knee. In addition, a certain degree of reverse rotation occurs during flexion of the PS knee prosthesis. Conclusions: There were still several differences between the kinematics of the PS knee prosthesis and a normal knee, suggesting room for improving the design of the PS knee prosthesis. The abnormal kinematics during early flexion shows that the design of the articular surface played a vital role in improving the kinematics of the PS knee prosthesis.

  9. Effects of an unloader knee brace on knee-related symptoms and function in people with post-traumatic knee osteoarthritis after anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Hart, Harvi F; Crossley, Kay M; Ackland, David C; Cowan, Sallie M; Collins, Natalie J

    2016-01-01

    This pilot study evaluated the immediate and four-week effects of an unloader knee brace on knee-related symptoms and performance-based function in people with knee osteoarthritis (OA) after anterior cruciate ligament reconstruction (ACLR). Individuals with knee OA, five to 20years post-ACLR, were recruited for two within-subject randomized studies: immediate effects (n=18) and four-week effects (n=11). Patient-reported knee-related symptoms (knee pain, perceived task difficulty, confidence, stability) were assessed during hop for distance and step-down tests, while performance-based function was assessed with hopping distance under three conditions: i) no brace; ii) unadjusted brace (sagittal plane support); and iii) adjusted brace (sagittal plane support with varus/valgus readjustment). Participants in the four-week brace effect study were randomized to wear the unadjusted or adjusted brace for four weeks after baseline (no brace) testing, and repeated tests in their allocated brace at four-week follow-up. Friedman tests evaluated differences between the three brace conditions for each variable for the immediate brace effect study (pbrace and allocated brace for the four-week study (pbraces produced immediate improvements in knee confidence during hop for distance, and knee pain during step-down. Following the four-week brace intervention, the allocated brace improved knee confidence, perceived task difficulty and stability during hop for distance; and knee pain, perceived task difficulty, confidence, and stability during step-down. The unloader knee brace, adjusted or unadjusted, has the potential to improve knee-related symptoms associated with knee OA after ACLR. Copyright © 2015 Elsevier B.V. All rights reserved.

  10. Valgus-varus motion of the knee in normal level walking and stair climbing.

    Science.gov (United States)

    Yu, B; Stuart, M J; Kienbacher, T; Growney, E S; An, K-N

    1997-07-01

    OBJECTIVE: The knee valgus-varus moment and the knee angles were compared between normal level walking and stair climbing. DESIGN: Ten healthy subjects were tested for ascent, descent, and level walking. BACKGROUND: An understanding of the normal valgus-varus motion of the knee during stair climbing is needed to apply biomechanical analysis of stair climbing as a evaluation tool for knee osteoarthritis patients. METHODS: A motion analysis system, three force plates, and a flight of stairs were used to collect kinematic and kinetic data. The knee angles and moments were calculated from the collected kinematic and kinetic data. RESULTS: The knee varus angle for the maximum knee valgus moments in stair climbing was significantly greater than that in level walking. The knee valgus moment was significantly correlated to ground reaction forces and knee valgus-varus angle during stair climbing and level walking. CONCLUSIONS: There is a coupling between the knee valgus-varus motion and flexion-extension motion. Ground reaction forces are the major contributors to the within-subject variation in the knee valgus-varus moment during stair climbing and level walking. The knee valgus-varus angle is a major contributor to the between-subject variation in the knee valgus moment during stair climbing and level walking.

  11. Knee Pain and Patellofemoral Symptoms in Patients With Cerebral Palsy.

    Science.gov (United States)

    Rethlefsen, Susan A; Nguyen, Danny T; Wren, Tishya A L; Milewski, Matthew D; Kay, Robert M

    2015-01-01

    Knee pain in cerebral palsy (CP) is associated with increased patellofemoral forces present when walking with flexed knees. In typically developing children, knee pain and patellofemoral dysfunction are associated with obesity, genu valgum, femoral anteversion, and external tibial torsion. These problems are also common in CP, and may contribute to knee problems in this population. The purposes of this study were to define the prevalence of knee pain and patellofemoral dysfunction in children with CP, and to identify physical and gait characteristics (using 3-dimensional gait analysis data) that predispose them to such problems. Retrospective review of 121 children with CP, Gross Motor Function Classification System level I to IV, who underwent computerized gait analysis testing. Demographics, range of motion, body mass index and hip, knee, and ankle kinematics were compared between subjects with and without knee pain. Twenty-five of 121 subjects (21%) reported knee pain at the time of testing. Three of 121 subjects (2%) had a history of patellar subluxation/dislocation. Age and sex were significantly related to presence of knee pain. The likelihood of knee pain was almost 5 times higher in females (odds ratio=4.9, [95% confidence interval, 1.8-13.3], P=0.002), with a prevalence of 40% (17/42) in females versus 10% (8/79) in males. The likelihood of knee pain increased with age by approximately 13% per year (odds ratio=1.13, [95% confidence interval, 1.00-1.28], P=0.058). Malignant malalignment syndrome showed a potential relationship to more severe knee pain (P=0.05), which warrants further investigation. Body mass index, pes valgus, and degree of stance knee flexion showed no statistically significant relationships to knee pain (P>0.16). The prevalence of knee pain in ambulatory patients with CP is approximately 21%. Patellar subluxation (2%) and dislocation are rare in these patients. Knee pain is not always related to crouch, femoral anteversion, external

  12. 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...... of 34 patients (21%) underwent repeat arthrodesis, and 23 patients (14%) eventually underwent transfemoral amputation. CONCLUSIONS: The cumulative incidence of arthrodesis within 15 years after primary knee arthroplasty was 0.26%. There was a significant decrease in the 5-year cumulative incidence...

  13. Gait variability and motor control in people with knee osteoarthritis

    DEFF Research Database (Denmark)

    Alkjaer, Tine; Raffalt, Peter C; Dalsgaard, Helle

    2015-01-01

    stereotypic pattern in people with knee OA compared with healthy age-matched subjects. To assess the gait variability the temporal structure of the ankle and knee joint kinematics was quantified by the largest Lyapunov exponent and the stride time fluctuations were quantified by sample entropy and detrended...

  14. Isotonic quadriceps-hamstring strength ratios of patients with knee ...

    African Journals Online (AJOL)

    (Q/H) ratios of patients with knee osteoarthritis (OA) and apparently healthy control subjects. The relationships between Q/H ratio and each of height, total body weight, age and Quetelet index of both groups were also investigated. Participants in the study were twenty patients with knee OA (13 females and 7 males) and 20 ...

  15. The influence of footwear on knee joint loading during walking--in vivo load measurements with instrumented knee implants.

    Science.gov (United States)

    Kutzner, Ines; Stephan, Daniel; Dymke, Jörn; Bender, Alwina; Graichen, Friedmar; Bergmann, Georg

    2013-02-22

    Since footwear is commonly used every day, its influence on knee joint loading and thereby on the development and progression of osteoarthritis may be crucial. So far the influence of footwear has been examined only indirectly. The aim of this study was to directly measure the effect of footwear on tibiofemoral contact loads during walking. Instrumented knee implants with telemetric data transmission were used to measure the tibiofemoral contact forces and moments in six subjects. The loads during walking with four different shoes (basic running shoes, advanced running shoes, classical dress shoes and shoes with a soft rounded sole in the sagittal plane (MBT)) were compared to those during barefoot walking. Peak values of all six load components were analyzed. In general, footwear tended to increase knee joint loading slightly, with the dress shoe being the most unfavorable type of footwear. At the early stance phase all load components were increased by all shoe types. The resultant force rose by 2-5%, the internal adduction moment by 7-12% and the forces on the medial compartment by 3-5%. Significant reductions of the resultant force were solely observed for the advanced running shoe (-6%) and the MBT (-9%) shoe at late stance. Also the medial compartment force was slightly yet non-significantly reduced by 2-5% with the two shoes. It is questionable whether such small load changes have an influence on the progression of gonarthrosis. Future research is necessary to examine which factors regarding the shoe design, such as heel height, arch support or flexibility are most decisive for a reduction of knee joint loading. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. Prospective Study of the Relation between Landing Biomechanics and Jumper's Knee

    NARCIS (Netherlands)

    der Worp, H van; van der Does, H T D; Brink, M.S.; Zwerver, J.; Hijmans, J.M.

    The literature on the relation between jump biomechanics and jumper's knee indicates that a jump with horizontal displacement poses a threat for developing jumper's knee. Subjects with jumper's knee have been shown to display a stiff landing pattern characterized by a small range of motion. However,

  17. No differences between fixed- and mobile-bearing total knee arthroplasty.

    NARCIS (Netherlands)

    Fransen, B.L.; van Duijvenbode, D.C.; Hoozemans, M.J.M.; Burger, B.J.

    2017-01-01

    Purpose: For years, numerous studies have been performed to determine whether mobile-bearing total knee arthroplasty (MB-TKA) or fixed-bearing total knee arthroplasty (FB-TKA) is the preferential design in total knee arthroplasty. Reviews and meta-analyses on this subject have focused on a

  18. [Postero-internal menisco-capsular disinsertions associated with chronic instabilities of the knee caused by rupture of the anterior cruciate ligament].

    Science.gov (United States)

    Lemaire, M; Combelles, F; Miremad, C; Van Vooren, P

    1984-01-01

    Posterior menisco-capsular tears of the medial compartment of the knee can be considered as a complication of rupture of the anterior cruciate ligament and the consequent medial instability. The lesion is more a capsular lesion than a true meniscal one and it is related to an excessive stress on the oblique fibres of the ligament of Hughston attached to the meniscus. The diagnosis is based on arthrography made with meticulous technique. The lesion must be differentiated from true meniscal tears because it can be sutured. One hundred and twenty five such lesions have been operated on and reviewed after a follow-up of an average of two years. The technique must be very precise to prevent any secondary lesion due to surgery and to avoid any plaster cast immobilisation. The results have been satisfactory in 69 p. 100. They should be improved with more accurate surgical technique and with more precise indications.

  19. Evaluation of Internal Echogenic Pattern of Masseter in Subjects with Myofascial Pain/ Myositis, Oral Submucous Fibrosis, Chewers, Bruxers and Healthy Individuals- A Preliminary Ultrasonographic Study.

    Science.gov (United States)

    Raghunandan Iyengar, Asha; Patil, Seema; Guddannanavar Karibasappa, Ganga; Beloor Vasudev, Subash; Kumar Joshi, Revan

    2016-12-01

    The masseter is generally involved in myofascial pain, myositis, oral submucous fibrosis (OSMF), bruxism, and in subjects with habitual tobacco/arecanut chewing. In all the above conditions, changes in the internal echogenic pattern on ultrasonography of the muscle may be observed. The present study aimed at evaluating the internal echogenic pattern of masseter by ultrasonography in subjects with various conditions affecting masster muscle. The study subjects were categorized into 5 groups consisting of 20 subjects each with the following conditions; Group 1: myofascial pain or myositis, Group 2: oral submucous fibrosis (OSMF), Group 3: habitual chewing of tobacco/arecanut without OSMF, Group 4: bruxism. Group 5 consisted of 20 healthy subjects. An ultrasonographic examination of masseter was performed in all subjects and the echogenic pattern was classified into Types I, II and III. The images were examined by two observers and inter-observer variability was assessed. Differences in internal echogenic pattern between study groups and control group was evaluated using Chi- square test. A good inter observer agreement was noted (k value= 0.8). An equal distribution of Types II and III echogenic pattern was noted in myofascial pain/myositis group. Type II was predominant in subjects with OSMF, habitual tobacco/arecanut chewing and bruxism. Type I was predominant in controls. The echogenic pattern differed significantly from controls in subjects with myofascial pain/myositis and OSMF (p=0.00001*, 0.0237* respectively), whereas in subjects with habitual tobacco/ arecanut chewing and bruxism, it did not differ significantly from controls (p=0.2482, 0.1223 respectively). Ultrasonographic examination of the echogenic pattern may help in understanding the nature of the disease process affecting the masseter muscle in various conditions.

  20. UCI knee replacement.

    Science.gov (United States)

    Evanski, P M; Waugh, T R; Orofino, C F; Anzel, S H

    1976-10-01

    Between March 9, 1972 and December 31, 1973, a total of 103 UCI knee replacements were performed. Follow-up data are available on 83 knees with an average follow-up of 33 months. Patient evaluation of the end results indicates that 78.3 per cent were better, 9.6 per cent unchanged, and 12.1 per cent worse. Patient evaluation of their own knee function averaged 55 per cent preoperatively and 79 per cent postoperatively. Patients were also evaluated on a 100 point Modified Larson Analysis Form. The average preoperative score was 46, and the average postoperative score was 70. There were six (5.8%) biological complications in the 103 knee replacement. Biological complications included infections, wound healing problems and unexplained pain. Mechanical complications were seen in 18 (17.4%) knees, and included knee instability, tibial component loosening or deformation, and patellar problems. Additional surgery was required in 18 (17.4%) knees. Failure of the procedure eventually requiring removal of the prosthesis and fusion or amputation occurred in 4 (3.9%) knees. The intermediate-term results of UCI knee replacement have been clinically satisfactory. We currently recommend consideration of this procedure for patients with disabling arthritis of the knee.

  1. Effect of a natural extract of chicken combs with a high content of hyaluronic acid (Hyal-Joint® on pain relief and quality of life in subjects with knee osteoarthritis: a pilot randomized double-blind placebo-controlled trial

    Directory of Open Access Journals (Sweden)

    Schwartz Howard

    2008-01-01

    Full Text Available Abstract Background Intra-articular hyaluronic acid represents a substantive addition to the therapeutic armamentarium in knee osteoarthritis. We examined the effect of dietary supplementation with a natural extract of chicken combs with a high content of hyaluronic acid (60% (Hyal-Joint® (active test product, AP on pain and quality of life in subjects with osteoarthritis of the knee. Methods Twenty subjects aged ≥40 years with knee osteoarthritis (pain for at least 15 days in the previous month, symptoms present for ≥6 months, Kellgren/Lawrence score ≥2 participated in a randomized double-blind controlled trial. Ten subjects received AP (80 mg/day and 10 placebo for 8 weeks. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC and quality of life by the Short Form-36 (SF-36v2 were administered at baseline and after 4 and 8 weeks of treatment. Results WOMAC pain (primary efficacy variable was similar in both study groups (mean [SD] with 6.6 (4.0 points in the AP group and 6.4 (2.7 in the placebo group (P = 0.943. As compared with baseline, subjects in both groups showed statistically significant improvements in WOMAC pain, stiffness, physical function subscales, and in the aggregate score, but the magnitude of changes was higher in the AP group for WOMAC physical function (-13.1 [12.0] vs. -10.1 [8.6], P = 0.575 and total symptoms (-18.6 [16.8] vs. -15.8 [11.4], P = 0.694. At 4 weeks, statistically significant mean changes compared with baseline were observed in the SF-36v2 scales of role-physical, bodily pain, social functioning and role-emotional among subjects in the AP group, and in physical functioning, bodily pain, and social functioning in the placebo group. At 8 weeks, changes were significant for role-physical, bodily pain, and physical component summary in the AP group, and for physical functioning and role-emotional in the placebo arm. Changes in bodily pain and social functioning were of greater magnitude

  2. Electromyographic analysis of anterior cruciate deficient knees with and without functional bracing during lunge exercise.

    Science.gov (United States)

    Jalali, Maryam; Farahmand, Farzam; Rezaeian, Tahmineh; Ramsey, Daniel K; Mousavi, Seyed Mohammad Ebrahim

    2016-04-01

    The use of functional knee braces for returning to sports or during demanding activities following anterior cruciate ligament rupture is common; yet despite being commonly prescribed, its mechanism of action remains unknown. To examine the effect of functional knee braces on mean muscle activity when performing lunge exercises. Pre-/post-test (within-subject research design). A total of 10 male participants with unilateral isolated anterior cruciate ligament deficiency participated. Electromyographic activities of six muscles around the knee were recorded during lunge exercises, with and without wearing a custom functional knee brace. The lunge cycle movement was subdivided into three phases: eccentric, isometric, and concentric. The quadriceps and hamstrings were no different in the braced and unbraced conditions. When braced, the mean amplitude of the medial gastrocnemius was significantly lower throughout the whole movement (p = 0.01) and during the concentric (p = 0.006) and eccentric (p = 0.028) phases, but not within the isometric phase. The lateral gastrocnemius was found to have lower mean amplitude in the isometric phase (p = 0.044). With its origin on the medial femoral condyle, perhaps reduced medial gastrocnemius activity may better guide knee rotation and assist the joint achieving a healthier kinematic pattern. Lower medial gastrocnemius activity may facilitate lower medial compartment contact pressure, for which greater loading is known to increase the risk of osteoarthritis in anterior cruciate ligament-deficient (ACLD) knees. However, further research is needed. © The International Society for Prosthetics and Orthotics 2014.

  3. Loading of the medial meniscus in the ACL deficient knee: A multibody computational study.

    Science.gov (United States)

    Guess, Trent M; Razu, Swithin

    2017-03-01

    The menisci of the knee reduce tibiofemoral contact pressures and aid in knee lubrication and nourishment. Meniscal injury occurs in half of knees sustaining anterior cruciate ligament injury and the vast majority of tears in the medial meniscus transpire in the posterior horn region. In this study, computational multibody models of the knee were derived from medical images and passive leg motion for two female subjects. The models were validated against experimental measures available in the literature and then used to evaluate medial meniscus contact force and internal hoop tension. The models predicted that the loss of anterior cruciate ligament (ACL) constraint increased contact and hoop forces in the medial menisci by a factor of 4 when a 100N anterior tibial force was applied. Contact forces were concentrated in the posterior horn and hoop forces were also greater in this region. No differences were found in contact or hoop tension between the intact and ACL deficient (ACLd) knees when only a 5Nm external tibial torque was applied about the long axis of the tibia. Combining a 100N anterior tibial force and a 5Nm external tibial torque increased posterior horn contact and hoop forces, even in the intact knee. The results of this study show that the posterior horn region of the medial meniscus experiences higher contact forces and hoop tension, making this region more susceptible to injury, especially with the loss of anterior tibia motion constraint provided by the ACL. The contribution of the dMCL in constraining posterior medial meniscus motion, at the cost of higher posterior horn hoop tension, is also demonstrated. Copyright © 2016 IPEM. Published by Elsevier Ltd. All rights reserved.

  4. The effect of personal and group discrimination on the subjective well-being of people with mental illness: the role of internalized stigma and collective action intention.

    Science.gov (United States)

    Pérez-Garín, Daniel; Molero, Fernando; Bos, Arjan E R

    2017-04-01

    The goal of this study is to test a model in which personal discrimination predicts internalized stigma, while group discrimination predicts a greater willingness to engage in collective action. Internalized stigma and collective action, in turn, are associated to positive and negative affect. A cross-sectional study with 213 people with mental illness was conducted. The model was tested using path analysis. Although the data supported the model, its fit was not sufficiently good. A respecified model, in which a direct path from collective action to internalized stigma was added, showed a good fit. Personal and group discrimination appear to impact subjective well-being through two different paths: the internalization of stigma and collective action intentions, respectively. These two paths, however, are not completely independent, as collective action predicts a lower internalization of stigma. Thus, collective action appears as an important tool to reduce internalized stigma and improve subjective well-being. Future interventions to reduce the impact of stigma should fight the internalization of stigma and promote collective action are suggested.

  5. Nocturnal knee pain increases with the severity of knee osteoarthritis, disturbing patient sleep quality.

    Science.gov (United States)

    Sasaki, Eiji; Tsuda, Eiichi; Yamamoto, Yuji; Maeda, Shugo; Inoue, Ryo; Chiba, Daisuke; Okubo, Noriyuki; Takahashi, Ippei; Nakaji, Shigeyuki; Ishibashi, Yasuyuki

    2014-07-01

    Sleep disturbances frequently accompany chronic pain from osteoarthritis (OA). Effective management of sleep disturbances may require successful treatment of chronic pain, a key factor in the clinical evaluation of knee OA. However, the relationship between the severity of knee OA and sleep quality is unclear. Our purpose was to correlate the prevalence of nocturnal knee pain with different OA severity levels and to determine its influence on sleep quality. Subjects included 1,214 local volunteers with mean ± SD age 58.1 ± 13.0 years. The existence and severity of knee OA were determined by the Kellgren/Lawrence (K/L) grade, and joint space widths were measured. The presence of nocturnal knee pain and Knee Injury and Osteoarthritis Outcome Scores (KOOS) were assessed by self-completed questionnaires. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index. Knee-related factors affecting sleep quality were detected using statistical methods. The prevalence of nocturnal knee pain was 3.6%, 6.9%, 19.4%, 32.7%, and 75.0% in K/L grades 0, 1, 2, 3, and 4, respectively. Also, prevalence significantly increased with OA severity (P Sleep problems also increased with K/L grade (P = 0.038), and KOOS quality of life (QOL) was significantly lower in those with OA and sleep problems. Logistic regression showed that sleep problems were related to joint space narrowing (P = 0.016) and nocturnal knee pain (P = 0.039). Severe OA also disturbed onset and maintenance of sleep. The prevalence of nocturnal knee pain and sleep problems increased with the severity of OA, impacting QOL. These results suggest the necessity of appropriate nocturnal pain control. Copyright © 2014 by the American College of Rheumatology.

  6. Older Adults without Radiographic Knee Osteoarthritis: Knee Alignment and Knee Range of Motion

    Directory of Open Access Journals (Sweden)

    Lissa Fahlman

    2014-01-01

    Full Text Available This study describes knee alignment and active knee range of motion (ROM in a community-based group of 78-year old adults (n = 143 who did not have radiographic evidence of knee osteoarthritis in either knee (KL 0.001 than women with varus or straight knees. Men and women with valgus or varus knee alignments had generally lower ROM than individuals with both knees straight. In summary, this study highlights the complex relationships among knee alignment, ROM, body mass index, and gender in elderly adults without radiographic knee osteoarthritis.

  7. Orthopedic management of spina bifida. Part I: hip, knee, and rotational deformities

    OpenAIRE

    Swaroop, Vineeta T.; Dias, Luciano

    2009-01-01

    Children with spina bifida develop a wide variety of congenital and acquired orthopedic deformities. Among these are hip deformities such as contracture, subluxation, or dislocation. Patients may also have problems with the knee joint, such as knee flexion or extension contracture, knee valgus deformity, or late knee instability and pain. In addition, rotational deformities of the lower extremities, either internal or external torsion, are common as well. This paper will review both the overa...

  8. FRACTURE MECHANICS UNCERTAINTY ANALYSIS IN THE RELIABILITY ASSESSMENT OF THE REACTOR PRESSURE VESSEL: (2D SUBJECTED TO INTERNAL PRESSURE

    Directory of Open Access Journals (Sweden)

    Entin Hartini

    2016-06-01

    Full Text Available ABSTRACT FRACTURE MECHANICS UNCERTAINTY ANALYSIS IN THE RELIABILITY ASSESSMENT OF THE REACTOR PRESSURE VESSEL: (2D SUBJECTED TO INTERNAL PRESSURE. The reactor pressure vessel (RPV is a pressure boundary in the PWR type reactor which serves to confine radioactive material during chain reaction process. The integrity of the RPV must be guaranteed either  in a normal operation or accident conditions. In analyzing the integrity of RPV, especially related to the crack behavior which can introduce break to the reactor pressure vessel, a fracture mechanic approach should be taken for this assessment. The uncertainty of input used in the assessment, such as mechanical properties and physical environment, becomes a reason that the assessment is not sufficient if it is perfomed only by deterministic approach. Therefore, the uncertainty approach should be applied. The aim of this study is to analize the uncertainty of fracture mechanics calculations in evaluating the reliability of PWR`s reactor pressure vessel. Random character of input quantity was generated using probabilistic principles and theories. Fracture mechanics analysis is solved by Finite Element Method (FEM with  MSC MARC software, while uncertainty input analysis is done based on probability density function with Latin Hypercube Sampling (LHS using python script. The output of MSC MARC is a J-integral value, which is converted into stress intensity factor for evaluating the reliability of RPV’s 2D. From the result of the calculation, it can be concluded that the SIF from  probabilistic method, reached the limit value of  fracture toughness earlier than SIF from  deterministic method.  The SIF generated by the probabilistic method is 105.240 MPa m0.5. Meanwhile, the SIF generated by deterministic method is 100.876 MPa m0.5. Keywords: Uncertainty analysis, fracture mechanics, LHS, FEM, reactor pressure vessels   ABSTRAK ANALISIS KETIDAKPASTIAN FRACTURE MECHANIC PADA EVALUASI KEANDALAN

  9. Is obesity a risk factor for progressive radiographic knee osteoarthritis?

    Science.gov (United States)

    Niu, J; Zhang, Y Q; Torner, J; Nevitt, M; Lewis, C E; Aliabadi, P; Sack, B; Clancy, M; Sharma, L; Felson, D T

    2009-03-15

    To examine whether obesity increases the risk of progression of knee osteoarthritis (OA). We used data from the Multicenter Osteoarthritis Study, a longitudinal study of persons with or at high risk of knee OA. OA was characterized at baseline and 30 months using posteroanterior fixed-flexion radiographs and Kellgren/Lawrence (K/L) grading, with alignment assessed on full-extremity films. In knees with OA at baseline (K/L grade 2 or 3), progression was defined as tibiofemoral joint space narrowing on the 30-month radiograph. In knees without OA at baseline (K/L grade 0 or 1), incident OA was defined as the development of radiographic OA at 30 months. Body mass index (BMI) at baseline was classified as normal (or=35 kg/m(2)). The risk of progression was tested in all knees and in subgroups categorized according to alignment. Analyses were adjusted for age, sex, knee injury, and bone density. Among the 2,623 subjects (5,159 knees), 60% were women, and the mean +/- SD age was 62.4 +/- 8.0 years. More than 80% of subjects were overweight or obese. At baseline, 36.4% of knees had tibiofemoral OA, and of those, only one-third were neutrally aligned. Compared with subjects with a normal BMI, those who were obese or very obese were at an increased risk of incident OA (relative risk 2.4 and 3.2, respectively [P for trend risk extended to knees from all alignment groups. Among knees with OA at baseline, there was no overall association between a high BMI and the risk of OA progression; however, an increased risk of progression was observed among knees with neutral but not varus alignment. The effect of obesity was intermediate in those with valgus alignment. Although obesity was a risk factor for incident knee OA, we observed no overall relationship between obesity and the progression of knee OA. Obesity was not associated with OA progression in knees with varus alignment; however, it did increase the risk of progression in knees with neutral or valgus alignment. Therefore

  10. Knee Injury and Osteoarthritis Outcome Score (KOOS)

    DEFF Research Database (Denmark)

    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...

  11. Proprioception, Laxity, Muscle Strength and Activity Limitations in Early Symptomatic Knee Osteoarthritis: Results from the Check Cohort

    NARCIS (Netherlands)

    Holla, J.F.M.; van der Leeden, M.; Peter, W.F.H.; Roorda, L.D.; van der Esch, M.; Lems, W.F.; Gerritsen, M.; Voorneman, R.E.; Steultjens, M.P.; Dekker, J.

    2012-01-01

    Objective: To establish whether proprioception and varusvalgus laxity moderate the association between muscle strength and activity limitations in patients with early symptomatic knee osteoarthritis. Design: A cross-sectional study. Subjects: A sample of 151 participants with early symptomatic knee

  12. The effect of foot progression angle on knee joint compression force during walking

    DEFF Research Database (Denmark)

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

    2013-01-01

    males walked at a fixed speed of 4.5 km/h under three conditions: Normal walking, internally rotated and externally rotated. All gait trials were recorded by six infrared cameras. Net joint moments were calculated by 3D inverse dynamics. The results revealed that the medial knee joint compartment...... was to investigate the knee joint compressive forces during walking with internal, external and normal foot rotation and to determine if the frontal plane knee joint moment is an adequate surrogate for the compression forces in the medial and lateral knee joint compartments under such gait modifications. Ten healthy...... compression force increased during external foot rotation and the lateral knee joint compartment compression force increased during internal foot rotation. The increases in joint loads may be a result of increased knee flexion angles. Further, these data suggest that the frontal plane knee joint moment...

  13. 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 ...

  14. Thompson′s quadricepsplasty for stiff knee

    Directory of Open Access Journals (Sweden)

    Kundu Z

    2007-01-01

    Full Text Available Background : Stiffness of the knee after trauma and/or surgery for femoral fractures is one of the most common complications and is difficult to treat. Stiffness in extension is more common and can be reduced by vigorous physiotherapy. If it does not improve then quadricepsplasty is indicated. The present study was undertaken to evaluate the results of Thompsons quadricepsplasty. Materials and Methods : 22 male patients (age range 20-45 years with posttraumatic knee stiffness following distal femoral fractures underwent Thompson′s quadricepsplasty where knee flexion range was less than 45°. The index injury in these patients was treated with plaster cast (n=5, plates (n=3, intramedullary nailing (n=3 and external fixator for open fractures (n=9. Thompson′s quadricepsplasty was performed in all the patients using anterior approach, with incision extending from upper thigh to tibial tubercle. Release of rectus femoris from underlying vastus intermedius and release of intraarticular adhesions were performed. After surgery the patients needed parentral analgesia for three days and then oral analgesics for three weeks. Active assisted knee mobilization exercises were started on the first post-operative day. Continous passive motion machine was used from the same day. Supervised physiotherapy was continued in hospital for six weeks followed by intensive knee flexion and extension exercise including cycling at home for atleast another six months. Results : Out of 22 patients, 20 had excellent to good results and two patients had poor results using criteria devised by Judet. One poor result was due to peroperative fracture of patella which was then internally fixed and hence the flexion of knee could not be started immediately. There was peroperative avulsion of tibial tuberosity in another patient who finally gained less than 50° knee flexion and hence a poor result. Conclusion : Thompsons quadricepsplasty followed by a strict and rigourous

  15. Wear in human knees

    Directory of Open Access Journals (Sweden)

    M.L. Wang

    2015-06-01

    Full Text Available Wear occurs in natural knee joints and plays a pivotal factor in causing articular cartilage degradation in osteoarthritis (OA processes. Wear particles are produced in the wear process and get involved in inflammation of human knees. This review presents progresses in the mechanical and surface morphological studies of articular cartilages, wear particles analysis techniques for wear studies and investigations of human knee synovial fluid in wear of human knees. Future work is also included for further understanding of OA symptoms and their relations which may shed light on OA causes.

  16. 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...

  17. The Role of the Peripheral Passive Rotation Stabilizers of the Knee With Intact Collateral and Cruciate Ligaments: A Biomechanical Study

    Science.gov (United States)

    Vap, Alexander R.; Schon, Jason M.; Moatshe, Gilbert; Cruz, Raphael S.; Brady, Alex W.; Dornan, Grant J.; Turnbull, Travis Lee; LaPrade, Robert F.

    2017-01-01

    Background: A subset of patients have clinical internal and/or external knee rotational instability despite no apparent injury to the cruciate or collateral ligaments. Purpose/Hypothesis: The purpose of this study was to assess the effect of sequentially cutting the posterolateral, anterolateral, posteromedial, and anteromedial structures of the knee on rotational stability in the setting of intact cruciate and collateral ligaments. It was hypothesized that cutting of the iliotibial band (ITB), anterolateral ligament and lateral capsule (ALL/LC), posterior oblique ligament (POL), and posteromedial capsule (PMC) would significantly increase internal rotation, while sectioning of the anteromedial capsule (AMC) and the popliteus tendon and popliteofibular ligament (PLT/PFL) would lead to a significant increase in external knee rotation. Study Design: Controlled laboratory study. Methods: Ten pairs (N = 20) of cadaveric knees were assigned to 2 sequential cutting groups (group 1: posterolateral-to-posteromedial [PL → PM] and group 2: posteromedial-to-posterolateral [PM → PL]). Specimens were subjected to applied 5-N·m internal and external rotation torques at knee flexion angles of 0°, 30°, 60°, and 90° while intact and after each cut state. Rotational changes were measured and compared with the intact and previous cut states. Results: Sectioning of the ITB significantly increased internal rotation at 60° and 90° by 5.4° and 6.2° in group 1 (PL → PM) and 3.5° and 3.8° in group 2 (PM → PL). PLT/PFL complex sectioning significantly increased external rotation at 60° and 90° by 2.7° and 2.9° in group 1 (PL → PM). At 60° and 90° in group 2 (PM → PL), ALL/LC sectioning produced significant increases in internal rotation of 3.1° and 3.5°, respectively. In group 2 (PM → PL), POL sectioning produced a significant increase in internal rotation of 2.0° at 0°. AMC sectioning significantly increased external rotation at 30° to 90° of flexion

  18. MRI EVALUATION OF SPORTS RELATED KNEE INJURIES

    Directory of Open Access Journals (Sweden)

    Aniruddha Basu

    2016-07-01

    Full Text Available PURPOSE To investigate the accuracy of MRI in evaluation of sports related knee injuries. MATERIALS AND METHODS From June 2015 to 1 st week of July 2016. Thirty patients referred for sports related knee pain have been included in this study. Patients were subjected to a dedicated MR knee study (GE HD XT 1.5T MR System and correlated knee arthroscopy and surgery. RESULTS The study included Thirty patients complaining of sports related knee pain, only 5 patients (16.67 % were with normal MRI findings and 25 patients (83.33% were with abnormal MRI findings. Among the 25 patients who had injuries of their knees, 15 patients (60% had ACL injuries, 6 patients (24% had PCL injuries, 10 patients (40% had meniscal injuries, 8 patients (32% had collateral ligament injuries, 5 patients (20% had bone injuries and 2 patients (8% had muscular injuries. Only 5 patients (20% were represented with isolated injury and 20 patients (80% were represented with combined injuries. In correlation with arthroscopies and surgeries, morphological analysis was true-positive in 23 (92% patients of the 25 injured patients, and true-negative in 1 (60% patient of the 2 normal patients. Morphological analysis revealed overall 92% sensitivity and 60% specificity. Regarding the 15 patients who had ACL injuries, 13 patients (86.6% were true-positive and 8 patients (80% of the 10 patients who had meniscal injuries were true-positive. CONCLUSION MRI represents the optimal imaging modalities in the evaluation of the sports related knee injuries, which has been shown to be an accurate and non-invasive method of diagnosing ligament, meniscal, cartilage and muscular knee injuries.

  19. Lateral trunk lean and medializing the knee as gait strategies for knee osteoarthritis.

    Science.gov (United States)

    Gerbrands, T A; Pisters, M F; Theeven, P J R; Verschueren, S; Vanwanseele, B

    2017-01-01

    To determine (1) if Medial Thrust or Trunk Lean reduces the knee adduction moment (EKAM) the most during gait in patients with medial knee osteoarthritis, (2) if the best overall strategy is the most effective for each patient and (3) if these strategies affect ankle and hip kinetics. Thirty patients with symptomatic medial knee osteoarthritis underwent 3-dimensional gait analysis. Participants received verbal instructions on two gait strategies (Trunk Lean and Medial Thrust) in randomized order after comfortable walking was recorded. The peaks and impulse of the EKAM and strategy-specific kinematic and kinetic variables were calculated for all conditions. Early stance EKAM peak was significantly reduced during Medial Thrust (-29%). During Trunk Lean, early and late stance EKAM peak and EKAM impulse reduced significantly (38%, 21% and -25%, respectively). In 79% of the subjects, the Trunk Lean condition was significantly more effective in reducing EKAM peak than Medial Thrust. Peak ankle dorsi and plantar flexion, knee flexion and hip extension and adduction moments were not significantly increased. Medial Thrust and Trunk Lean reduced the EKAM during gait in patients with knee osteoarthritis. Individual selection of the most effective gait modification strategy seems vital to optimally reduce dynamic knee loading during gait. No detrimental effects on external ankle and hip moments or knee flexion moments were found for these conditions. Copyright © 2016 Elsevier B.V. All rights reserved.

  20. Abnormal loading of the major joints in knee osteoarthritis and the response to knee replacement.

    Science.gov (United States)

    Metcalfe, Andrew; Stewart, Caroline; Postans, Neil; Barlow, David; Dodds, Alexander; Holt, Cathy; Whatling, Gemma; Roberts, Andrew

    2013-01-01

    Knee osteoarthritis is common and patients frequently complain that they are 'overloading' the joints of the opposite leg when they walk. However, it is unknown whether moments or co-contractions are abnormal in the unaffected joints of patients with single joint knee osteoarthritis, or how they change following treatment of the affected knee. Twenty patients with single joint medial compartment knee osteoarthritis were compared to 20 asymptomatic control subjects. Gait analysis was performed for normal level gait and surface EMG recordings of the medial and lateral quadriceps and hamstrings were used to investigate co-contraction. Patients were followed up 12 months post-operatively and the analysis was repeated. Results are presented for the first 14 patients who have attended follow-up. Pre-operatively, adduction moment impulses were elevated at both knees and the contra-lateral hip compared to controls. Co-contraction of hamstrings and quadriceps was elevated bilaterally. Post-operatively, moment waveforms returned to near-normal levels at the affected knee and co-contraction fell in the majority of patients. However, abnormalities persisted in the contra-lateral limb with partial or no recovery of both moment waveforms and co-contraction in the majority. Patients with knee osteoarthritis do experience abnormal loads of their major weight bearing joints bilaterally, and abnormalities persist despite treatment of the affected limb. Further treatment may be required if we are to protect the other major joints following joint arthroplasty. Copyright © 2012 Elsevier B.V. All rights reserved.

  1. Dynamic knee alignment and collateral knee laxity and its variations in normal humans

    Directory of Open Access Journals (Sweden)

    Kamal eDeep

    2015-11-01

    Full Text Available Alignment of normal, arthritic and replaced human knees is a much debated subject as is the collateral ligamentous laxity. Traditional quantitative values have been challenged. Methods used to measure these are also not without flaws. Authors review the recent literature and a novel method of measurement of these values has been included. This method includes use of computer navigation technique in clinic setting for assessment of the normal or affected knee before the surgery. Computer navigation has been known for achievement of alignment accuracy during knee surgery. Now its use in clinic setting has added to the inventory of measurement methods. Authors dispel the common myth of straight mechanical axis in normal knees and also look at quantification of amount of collateral knee laxity. Based on the scientific studies it has been shown that the mean alignment is in varus in normal knees. It changes from lying non weight bearing position to standing weight bearing position in both coronal and the sagittal planes. It also varies with gender and race. The collateral laxity is also different for males and females. Further studies are needed to define the ideal alignment and collateral laxity which the surgeon should aim for individual knees.

  2. Dynamic knee stability and ballistic knee movement after ACL reconstruction: an application on instep soccer kick.

    Science.gov (United States)

    Cordeiro, Nuno; Cortes, Nelson; Fernandes, Orlando; Diniz, Ana; Pezarat-Correia, Pedro

    2015-04-01

    The instep soccer kick is a pre-programmed ballistic movement with a typical agonist-antagonist coordination pattern. The coordination pattern of the kick can provide insight into deficient neuromuscular control. The purpose of this study was to investigate knee kinematics and hamstrings/quadriceps coordination pattern during the knee ballistic extension phase of the instep kick in soccer players after anterior cruciate ligament reconstruction (ACL reconstruction). Seventeen players from the Portuguese Soccer League participated in this study. Eight ACL-reconstructed athletes (experimental group) and 9 healthy individuals (control group) performed three instep kicks. Knee kinematics (flexion and extension angles at football contact and maximum velocity instants) were calculated during the kicks. Rectus femoris (RF), vastus lateralis, vastus medialis, biceps femoralis, and semitendinosus muscle activations were quantified during the knee extension phase. The ACL-reconstructed group had significantly lower knee extension angle (-1.2 ± 1.6, p angle and RF muscle activation while performing an instep kick. These findings are in accordance with the knee stability recovery process after ACL reconstruction. No differences were observed in the ballistic control movement pattern between normal and ACL-reconstructed subjects. Performing open kinetic chain exercises using ballistic movements can be beneficial when recovering from ACL reconstruction. The exercises should focus on achieving multi-joint coordination and full knee extension (range of motion). III.

  3. The Consumer Quality Index Hip Knee Questionnaire measuring patients' experiences with quality of care after a total hip or knee arthroplasty

    Directory of Open Access Journals (Sweden)

    Delnoij Diana MJ

    2007-04-01

    Full Text Available Abstract Background The Dutch Consumer Quality Index Hip Knee Questionnaire (CQI Hip Knee was used to assess patients' experiences with and evaluations of quality of care after a total hip (THA or total knee arthroplasty (TKA. The aim of this study is to evaluate the construct validity and internal consistency reliability of this new instrument and to assess its ability to measure differences in quality of care between hospitals. Methods Survey data of 1,675 subjects who underwent a THA or TKA were used to evaluate the psychometric properties. Exploratory factor analyses were performed and item-total correlations and inter-factor correlations were calculated to assess the construct validity of the instrument. Reliability analyses included tests of internal consistency (Cronbach's alpha coefficients. Finally, multilevel analyses were performed to assess the ability of the instrument to discriminate between hospitals in quality of care. Results Exploratory factor analyses indicated that the survey consisted of 21 items measuring five aspects of care (i.e. communication with nurses, communication with doctors, communication with general practitioner, communication about new medication, and pain control. Cronbach's alpha coefficients ranged from 0.76 to 0.90 indicating good internal consistency. The survey's ability to discriminate between hospitals was partly supported by multilevel analysis. Two scales (i.e. communication with nurses and communication with doctors were able to measure differences between hospitals with respect to patients' experiences with quality of care. Logistic multilevel analyses indicated that hospitals explained part of the variation between patients in receiving information. Conclusion These findings suggest that the CQI Hip Knee is reliable and valid for use in Dutch health care. Health care providers or health plans can use this survey to measure patients' experiences with hospital care and to identify variations in care

  4. The acutely ACL injured knee assessed by MRI

    DEFF Research Database (Denmark)

    Frobell, R B; Roos, H P; Roos, E M

    2008-01-01

    depression fractures, meniscal injuries and patient characteristics. METHODS: One hundred and twenty-one subjects (26% women, mean age 26 years) with an ACL rupture to a previously un-injured knee were studied using a 1.5T MR imager within 3 weeks from trauma. Meniscal injuries and fractures were classified...... by type, size and location. BML location and volume were quantified using a multi-spectral image data set analyzed by computer software, edited by an expert radiologist. RESULTS: Fractures were found in 73 (60%) knees. In 67 (92%) of these knees at least one cortical depression fracture was found. Uni......-compartmental meniscal tears were found in 44 (36%) subjects and bi-compartmental in 24 (20%). One hundred and nineteen (98%) knees had at least one BML, all but four (97%) located in the lateral compartment. Knees with a cortical depression fracture had larger BML volumes (P

  5. Interpolation function for approximating knee joint behavior in human gait

    Science.gov (United States)

    Toth-Taşcǎu, Mirela; Pater, Flavius; Stoia, Dan Ioan

    2013-10-01

    Starting from the importance of analyzing the kinematic data of the lower limb in gait movement, especially the angular variation of the knee joint, the paper propose an approximation function that can be used for processing the correlation among a multitude of knee cycles. The approximation of the raw knee data was done by Lagrange polynomial interpolation on a signal acquired using Zebris Gait Analysis System. The signal used in approximation belongs to a typical subject extracted from a lot of ten investigated subjects, but the function domain of definition belongs to the entire group. The study of the knee joint kinematics plays an important role in understanding the kinematics of the gait, this articulation having the largest range of motion in whole joints, in gait. The study does not propose to find an approximation function for the adduction-abduction movement of the knee, this being considered a residual movement comparing to the flexion-extension.

  6. Posteromedial knee friction syndrome: an entity with medial knee pain and edema between the femoral condyle, sartorius and gracilis

    Energy Technology Data Exchange (ETDEWEB)

    Simeone, F.J.; Huang, Ambrose J.; Chang, Connie Y.; Smith, Maximilian; Bredella, Miriam A.; Torriani, Martin [Massachusetts General Hospital and Harvard Medical School, Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Boston, MA (United States); Gill, Thomas J. [Boston Sports Medicine and Research Institute, Boston, MA (United States)

    2014-12-20

    To describe MRI features of an entity consisting of medial knee pain and edema between the posteromedial femoral condyle (PMFC), sartorius and/or gracilis tendons and determine whether reduced tendon-bone distances may account for these findings. We retrospectively identified MRI cases of edema between the PMFC, sartorius and/or gracilis tendons (25 subjects, 26 knees). Two musculoskeletal radiologists independently graded edema and measured the sartorius- and gracilis-PMFC distances and knee flexion angle. Age- and gender-matched subjects with normal knee MRIs (27 subjects, 27 knees) served as controls for measurements. Statistical analyses compared abnormal to control subjects. Sartorius-PMFC and gracilis-PMFC spaces were narrower in abnormal compared to control subjects (1.6 ± 1.0 vs. 2.1 ± 1.2 mm, P = 0.04; 2.3 ± 2.0 vs. 4.6 ± 3.0 mm, P = 0.002, respectively). The knee flexion angle was similar between groups (P > 0.05). In subjects with clinical information, medial knee pain was the main complaint in 58 % (15/26) of abnormal subjects, with 42 % (11/26) having clinical suspicion of medial meniscal tear. Edema between the PMFC, sartorius and/or gracilis was mild in 54 % (14/26), moderate in 35 % (9/26) and severe in 12 % (3/26), and it was most frequent deep to both the sartorius and gracilis (50 %, 13/26). Edema between the PMFC, sartorius and/or gracilis tendons identified on knee MRI may be associated with medial knee pain and may represent a friction syndrome. (orig.)

  7. Cyclic variations in multiplanar knee laxity influence landing biomechanics

    National Research Council Canada - National Science Library

    Shultz, Sandra J; Schmitz, Randy J; Kong, Yanfang; Dudley, William N; Beynnon, Bruce D; Nguyen, Anh-Dung; Kim, Hyunsoo; Montgomery, Melissa M

    2012-01-01

    ...), and internal-external (IER) rotation knee laxity across the menstrual cycle. We then compared changes in landing biomechanics from days of minimum to maximum laxity between female clusters and a group of males...

  8. Limited hip and knee flexion during landing is associated with increased frontal plane knee motion and moments.

    Science.gov (United States)

    Pollard, Christine D; Sigward, Susan M; Powers, Christopher M

    2010-02-01

    It has been proposed that female athletes who limit knee and hip flexion during athletic tasks rely more on the passive restraints in the frontal plane to deceleration their body center of mass. This biomechanical pattern is thought to increase the risk for anterior cruciate ligament injury. To date, the relationship between sagittal plane kinematics and frontal plane knee motion and moments has not been explored. Subjects consisted of 58 female club soccer players (age range: 11-20 years) with no history of knee injury. Kinematics, ground reaction forces, and surface electromyography were collected while each subject performed a drop landing task. Subjects were divided into two groups based on combined sagittal plane knee and hip flexion angles during the deceleration phase of landing (high flexion and low flexion). Subjects in the low flexion group demonstrated increased knee valgus angles (P=0.02, effect size 0.27), increased knee adductor moments (P=0.03, effect size 0.24), decreased energy absorption at the knee and hip (P=0.02, effect size 0.25; and P<0.001, effect size 0.59), and increased vastus lateralis EMG when compared to subjects in the high flexion group (P=0.005, effect size 0.35). Female athletes with limited sagittal plane motion during landing exhibit a biomechanical profile that may put these individuals at greater risk for anterior cruciate ligament injury. Copyright (c) 2009 Elsevier Ltd. All rights reserved.

  9. Treatment of knee cartilage defect in 2010.

    Science.gov (United States)

    Versier, G; Dubrana, F

    2011-12-01

    Treatment of knee cartilage defect, a true challenge, should not only reconstruct hyaline cartilage on a long-term basis, but also be able to prevent osteoarthritis. Osteochondral knee lesions occur in either traumatic lesions or in osteochondritis dissecans (OCD). These lesions can involve all the articular surfaces of the knee in its three compartments. In principle, this review article covers symptomatic ICRS grade C or D lesions, depth III and IV, excluding management of superficial lesions, asymptomatic lesions that are often discovered unexpectedly, and kissing lesions, which arise prior to or during osteoarthritis. For clarity sake, the international classifications used are reviewed, for both functional assessment (ICRS and functional IKDC for osteochondral fractures, Hughston for osteochondritis) and morphological lesion evaluations (the ICRS macroscopic evaluation for fractures, the Bedouelle or SOFCOT for osteochondritis, and MOCART for MRI). The therapeutic armamentarium to treat these lesions is vast, but accessibility varies greatly depending on the country and the legislation in effect. Many comparative studies have been conducted, but they are rarely of high scientific quality; the center effect is nearly constant because patients are often referred to certain centers for an expert opinion. The indications defined herein use algorithms that take into account the size of the cartilage defect and the patient's functional needs for cases of fracture and the vitality, stability, and size of the fragment for cases of osteochondritis dissecans. Fractures measuring less than 2 cm(2) are treated with either microfracturing or mosaic osteochondral grafting, between 2 and 4 cm(2) with microfractures covered with a membrane or a culture of second- or third-generation chondrocytes, and beyond this size, giant lesions are subject to an exceptional allografting procedure, harvesting from the posterior condyle, or chondrocyte culture on a 3D matrix to restore

  10. Arabic translation, cultural adaptation, and validation study of Knee Outcome Survey: Activities of Daily Living Scale (KOS-ADLS).

    Science.gov (United States)

    Algarni, Abdulrahman D; Alrabai, Hamza M; Al-Ahaideb, Abdulaziz; Kachanathu, Shaji John; AlShammari, Sulaiman A

    2017-09-01

    Knee complaints and their accompanying functional impairments are frequent problems encountered by healthcare practitioners worldwide. Plenty of functional scoring systems were developed and validated to give a relative estimation about the knee function. Despite the wide geographic distribution of Arabic language in the Middle East and North Africa, it is rare to find a validated knee function scale in Arabic. The present study is aimed to translate, validate, and culturally adjust the Knee Outcome Survey: Activities of Daily Living Scale (KOS-ADLS) into Arabic language for future use among Arabic-speaking patients. Permission for translation was obtained from the copyrights holder. Two different teams of high-level clinical and linguistic expertise conducted translation process blindly. Forward-backward translation technique was implemented to ensure preservation of the main conceptual content. Main study consisted of 280 subjects. Reliability was examined by test-retest pilot study. Visual Analogue Scale (VAS), Get Up and Go (GUG) Test, Ascending/Descending Stairs (A/D Stairs), and Subjective Assessment of Function (SAF) were conducted concurrently to show the validity of Arabic KOS-ADLS statistically in relation to these scales. Final translated version showed no significant discrepancies. Minor adaptive adjustment was required to fit Arabian cultural background. Internal consistency was favourable (Cronbach's alpha 0.90). Patients' scoring on Arabic KOS-ADLS appeared relatively consistent with their scoring on VAS, GUG, A/D Stairs, and SAF. A significant linear relationship was demonstrated between SAF and total KOS-ADLS scores on regression analysis (adj. R 2 = 0.548). Arabic KOS-ADLS, as its English counterpart, was found to be a simple, valid, and useful instrument for knee function evaluation. Arabic version of KOS-ADLS represents a promising candidate for unconditional use among Arabic-speaking patients with knee complaints.

  11. Socioeconomic inequalities in knee pain, knee osteoarthritis, and health-related quality of life

    DEFF Research Database (Denmark)

    Kiadaliri, A. A.; Gerhardsson de Verdier, Maria; Turkiewicz, Aleksandra

    2017-01-01

    Objectives: To determine socioeconomic inequalities in frequent knee pain (FKP), knee osteoarthritis (OA), and associated health-related quality of life (HRQoL) in Sweden. Method: In 2007 a postal questionnaire about knee pain was sent to a random sample of 10 000 residents of Malmö, Sweden (7402...... individuals responded). Subjects reporting pain with duration ≥ 4 weeks in one or both knees in the past 12 months were classified as having FKP. A random sample of 1527 subjects with and without FKP attended a clinical and radiographic knee examination and responded to generic and disease-specific HRQo...... bias that might arise from non-responses in the study. Results: With education, the RIIs for FKP and knee OA were 0.71 [95% confidence interval (CI) 0.61–0.84] and 0.56 (95% CI 0.34–0.93), respectively. With occupation, the corresponding figures were 0.70 (95% CI 0.60–0.82) and 0.59 (95% CI 0...

  12. Estimation of stature in Turkish adults using knee height.

    Science.gov (United States)

    Ozer, Başak Koca; Gültekin, Timur; Sağir, Mehmet

    2007-06-01

    Body height is an important clinical indicator to derive body mass index (BMI), which is a useful screening tool for both excess adiposity and malnutrition. Height measurement in the elderly may impose some difficulties and the reliability is doubtful. Stature estimation from knee height is one of the commonly used methods; nevertheless no study has been carried out so far on the Turkish population. A cross sectional anthropometric study was conducted to develop body height estimation equations by using knee height measurement for Turkish people. Measurements of height and knee height were taken according to the International Biological Programme procedures from 1422 adults (610 males, 812 females) aged 18-90 years from Ankara, the capital city of Turkey. Samples were randomly split into two sub-samples, training and validation (control group) sub-samples. Height estimation equations were developed from the knee height measurements by linear regression analysis according to age groups and sexes. Males were significantly taller and have higher knee height values than females in all age groups. Height and the knee height variables showed a gradual decrease (P 50) with aging in females and males. Evaluated knee height equations for stature estimation were tested through the validation sample and the results showed high accuracy. The study presents sex and age specific regression equations for height estimation by using the knee height measurement for Turkish adults and suggests facilitating the accurate usage of knee height.

  13. Pneumatic osteoarthritis knee brace.

    Science.gov (United States)

    Stamenović, Dimitrije; Kojić, Milos; Stojanović, Boban; Hunter, David

    2009-04-01

    Knee osteoarthritis is a chronic disease that necessitates long term therapeutic intervention. Biomechanical studies have demonstrated an improvement in the external adduction moment with application of a valgus knee brace. Despite being both efficacious and safe, due to their rigid frame and bulkiness, current designs of knee braces create discomfort and difficulties to patients during prolonged periods of application. Here we propose a novel design of a light osteoarthritis knee brace, which is made of soft conforming materials. Our design relies on a pneumatic leverage system, which, when pressurized, reduces the excessive loads predominantly affecting the medial compartment of the knee and eventually reverses the malalignment. Using a finite-element analysis, we show that with a moderate level of applied pressure, this pneumatic brace can, in theory, counterbalance a greater fraction of external adduction moment than the currently existing braces.

  14. Biomechanical Analysis of the Effects of Bilateral Hinged Knee Bracing

    Science.gov (United States)

    Lee, Hangil; Ha, Dokyeong; Kang, Yeoun-Seung; Park, Hyung-Soon

    2016-01-01

    This research analyzed the effect of bilateral hinged knee braces on a healthy knee from a biomechanical frame in vivo. This was accomplished by fitting a knee brace with two customized wireless force/torque (F/T) sensors that could readily record force and torque during live motion, while the kinetics at the knee were computed using the inverse dynamics of the motion capture and force plate data. Four tasks to test the brace’s effects were drop vertical jumping, pivoting, stop vertical jumping, and cutting. The results showed that the hinges in the knee brace can absorb up to 18% of the force and 2.7% of the torque at the knee during various athletic motions. Thus, the hinges demonstrated minimal effect in reducing the mechanical load on the knee. There were limitations concerning the consistency of the motions performed by the subjects during the trials and the influence of the other portions of the brace to evaluate the overall effectiveness of the brace as a whole. Future works may incorporate a fatigue protocol and injured subjects to better determine the effects of the brace. There is still a need for more research on the biomechanical influence of knee braces to develop safer and more effective products. PMID:27379233

  15. The effects of a prophylactic knee brace and two neoprene knee sleeves on the performance of healthy athletes: a crossover randomized controlled trial.

    Science.gov (United States)

    Mortaza, Niyousha; Ebrahimi, Ismail; Jamshidi, Ali Ashraf; Abdollah, Vahid; Kamali, Mohammad; Abas, Wan Abu Bakar Wan; Osman, Noor Azuan Abu

    2012-01-01

    Knee injury is one of the major problems in sports medicine, and the use of prophylactic knee braces is an attempt to reduce the occurrence and/or severity of injuries to the knee joint ligament(s) without inhibiting knee mobility. The aim of the present study was to examine the effect of one recently designed prophylactic knee brace and two neoprene knee sleeves upon performance of healthy athletes. Thirty-one healthy male athletes (age = 21.2 ± 1.5) volunteered as participants to examine the effect of prophylactic knee brace/sleeves on performance using isokinetic and functional tests. All subjects were tested in four conditions in a random order: 1. nonbraced (control) 2. using a neoprene knee sleeve 3. using a knee sleeve with four bilateral metal supports and 4. using a prophylactic knee brace. The study design was a crossover, randomized, controlled trial. Subjects completed single leg vertical jump, cross-over hop, and the isokinetic knee flexion and extension (at 60, 180, 300°/sec). Data were collected from the above tests and analyzed for jump height, cross-over hop distance, peak torque to body weight ratio and average power, respectively. Comparisons of these variables in the four testing conditions revealed no statistically significant difference (p>0.05). The selected prophylactic brace/sleeves did not significantly inhibit athletic performance which might verify that their structure and design have caused no complication in the normal function of the knee joint. Moreover, it could be speculated that, if the brace or the sleeves had any limiting effect, our young healthy athletic subjects were well able to generate a mean peak torque large enough to overcome this possible restriction. Further studies are suggested to investigate the long term effect of these prophylactic knee brace and sleeves as well as their possible effect on the adjacent joints to the knee.

  16. The effects of a prophylactic knee brace and two neoprene knee sleeves on the performance of healthy athletes: a crossover randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Niyousha Mortaza

    Full Text Available Knee injury is one of the major problems in sports medicine, and the use of prophylactic knee braces is an attempt to reduce the occurrence and/or severity of injuries to the knee joint ligament(s without inhibiting knee mobility. The aim of the present study was to examine the effect of one recently designed prophylactic knee brace and two neoprene knee sleeves upon performance of healthy athletes. Thirty-one healthy male athletes (age = 21.2 ± 1.5 volunteered as participants to examine the effect of prophylactic knee brace/sleeves on performance using isokinetic and functional tests. All subjects were tested in four conditions in a random order: 1. nonbraced (control 2. using a neoprene knee sleeve 3. using a knee sleeve with four bilateral metal supports and 4. using a prophylactic knee brace. The study design was a crossover, randomized, controlled trial. Subjects completed single leg vertical jump, cross-over hop, and the isokinetic knee flexion and extension (at 60, 180, 300°/sec. Data were collected from the above tests and analyzed for jump height, cross-over hop distance, peak torque to body weight ratio and average power, respectively. Comparisons of these variables in the four testing conditions revealed no statistically significant difference (p>0.05. The selected prophylactic brace/sleeves did not significantly inhibit athletic performance which might verify that their structure and design have caused no complication in the normal function of the knee joint. Moreover, it could be speculated that, if the brace or the sleeves had any limiting effect, our young healthy athletic subjects were well able to generate a mean peak torque large enough to overcome this possible restriction. Further studies are suggested to investigate the long term effect of these prophylactic knee brace and sleeves as well as their possible effect on the adjacent joints to the knee.

  17. Effects of toe-in angles on knee biomechanics in cycling of patients with medial knee osteoarthritis.

    Science.gov (United States)

    Gardner, Jacob K; Zhang, Songning; Liu, Hairui; Klipple, Gary; Stewart, Candice; Milner, Clare E; Asif, Irfan M

    2015-03-01

    Cycling is commonly prescribed for knee osteoarthritis, but previous literature on biomechanics during cycling and the effects of acute intervention on osteoarthritis patients does not exist. Due to their altered knee kinematics, osteoarthritis patients may be at greater risk of osteoarthritis progression or other knee injuries during cycling. This study investigated the effects of reduced foot progression (toe-in) angles on knee joint biomechanics in subjects with medial compartment knee osteoarthritis. Thirteen osteoarthritis and 11 healthy subjects participated in this study. A motion analysis system and custom instrumented pedal was used to collect 5 pedal cycles of kinematic and kinetic data in 1 neutral and 2 toe-in conditions (5° and 10°) at 60 RPM and 80W. For peak knee adduction angle, there was a 61% (2.7°) and a 73% (3.2°) decrease in the 5° and 10° toe-in conditions compared to neutral in the osteoarthritis group and a 77% (1.7°) and 109% (2.4°) decrease in the healthy group for the 5° and 10° conditions, respectively. This finding was not accompanied by a decrease in pain or peak knee abduction moment. A simple linear regression showed a positive correlation between Kelgren-Lawrence score and both peak knee adduction angle and abduction moment. For individuals who cycle with increased knee adduction angles, decreasing the foot progression angle may be beneficial for reducing the risk of overuse knee injuries during cycling by resulting in a frontal plane knee alignment closer to a neutral position. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Fun During Knee Rehabilitation: Feasibility and Acceptability Testing of a New Android-Based Training Device.

    Science.gov (United States)

    Weber-Spickschen, Thomas Sanjay; Colcuc, Christian; Hanke, Alexander; Clausen, Jan-Dierk; James, Paul Abraham; Horstmann, Hauke

    2017-01-01

    The initial goals of rehabilitation after knee injuries and operations are to achieve full knee extension and to activate quadriceps muscle. In addition to regular physiotherapy, an android-based knee training device is designed to help patients achieve these goals and improve compliance in the early rehabilitation period. This knee training device combines fun in a computer game with muscular training or rehabilitation. Our aim was to test the feasibility and acceptability of this new device. 50 volunteered subjects enrolled to test out the computer game aided device. The first game was the high-striker game, which recorded maximum knee extension power. The second game involved controlling quadriceps muscular power to simulate flying an aeroplane in order to record accuracy of muscle activation. The subjects evaluated this game by completing a simple questionnaire. No technical problem was encountered during the usage of this device. No subjects complained of any discomfort after using this device. Measurements including maximum knee extension power, knee muscle activation and control were recorded successfully. Subjects rated their experience with the device as either excellent or very good and agreed that the device can motivate and monitor the progress of knee rehabilitation training. To the best of our knowledge, this is the first android-based tool available to fast track knee rehabilitation training. All subjects gave very positive feedback to this computer game aided knee device.

  19. Does Migration Make You Happy? A Longitudinal Study of Internal Migration and Subjective Well-Being (discussion paper)

    NARCIS (Netherlands)

    Nowok, B.; Van Ham, M.; Findlay, A.; Gayle, V.

    2011-01-01

    The majority of modelling studies on consequences of internal migration focus almost exclusively on the labour market outcomes and the material well-being of migrants. We investigate whether individuals who migrate within the UK become happier after the move than they were before it and whether the

  20. Study on prestressed concrete reactor vessel structures. II-5: Crack analysis by three dimensional finite elements method of 1/20 multicavity type PCRV subjected to internal pressure

    Science.gov (United States)

    1978-01-01

    A three-dimensional finite elements analysis is reported of the nonlinear behavior of PCRV subjected to internal pressure by comparing calculated results with test results. As the first stage, an analysis considering the nonlinearity of cracking in concrete was attempted. As a result, it is found possible to make an analysis up to three times the design pressure (50 kg/sqcm), and calculated results agree well with test results.

  1. An investigation to examine the inter-tester and intra-tester reliability of the Rolimeter knee tester, and its sensitivity in identifying knee joint laxity.

    Science.gov (United States)

    Hatcher, Julian; Hatcher, Alison; Arbuthnot, Jamie; McNicholas, Mike

    2005-11-01

    The purpose of this study is to evaluate the Rolimeter knee tester (Aircast, Europe) as reliable and clinically sensitive tool for identifying and quantifying knee joint laxity utilising a sample of both known ACLD and normal knees. Thirty matched subjects (15 known ACLD and 15 normal subjects) were tested for knee joint laxity using the Rolimeter. Each subject was measured at both 90 degrees and 30 degrees of knee flexion, by each of the six investigators. This was then repeated again by all six investigators so that inter-tester and intra-tester reliability could be examined. Results showed that there was good reliability between testers, and intra-tester reliability was good for both left and right knees in both 90 degrees and 30 degrees of flexion. Results also demonstrated a high level of sensitivity for determining knee joint laxity in ACLD compared to normal knees. The Rolimeter knee tester is a reliable device for quantifying knee joint laxity, and is sensitive enough to identify anterior cruciate ligament deficiency.

  2. The relationship between knee joint angle and knee flexor and extensor muscle strength.

    Science.gov (United States)

    Ha, Misook; Han, Dongwook

    2017-04-01

    [Purpose] The aim of this study was to determine a relationship between joint angle and muscular strength. In particular, this research investigated the differences in maximum muscular strength and average muscular strength at the knee-joint posture. [Subjects and Methods] The study subjects comprised eight female students in their 20s attending S University in Busan. None of the subjects had functional disabilities or had experienced damage to the lower extremities in terms of measurement of muscular strength. A BIODEX system III model (Biodex medical system, USA) was used to measure joint angles and muscular strength. The axis of the dynamometer was consistent with the axis of motion, and measurements were made at 25° and 67° to examine differences in maximum muscular strength according to joint angle. [Results] The maximum muscular strength both knee-joint extension value, at 67° and flexion value, at 25° the value was larger. The average muscular strength both knee-joint extension value, at 67° and flexion value, at 25° the value was larger. [Conclusion] The results of this study reveal that muscular strength does not reach maximum at particular range angles, such as the knee-joint resting posture angle or the knee-joint middle range angle. Rather, a stretched muscle is stronger than a contracted muscle. Therefore, it is considered that it will be necessary to study the effects of the joint change ratio on muscular strength on the basis of the maximum stretched muscle.

  3. Association Between Overweight and Obesity and Risk of Clinically Diagnosed Knee, Hip, and Hand Osteoarthritis: A Population-Based Cohort Study.

    Science.gov (United States)

    Reyes, Carlen; Leyland, Kirsten M; Peat, George; Cooper, Cyrus; Arden, Nigel K; Prieto-Alhambra, Daniel

    2016-08-01

    Studies of previous cohorts have demonstrated an association between a status of overweight/obesity and the presence of knee and hand osteoarthritis (OA). However, no data on the effect of these factors on the OA burden are available. The aim of the present study was to analyze the effect of being overweight or obese on the incidence of routinely diagnosed knee, hip, and hand OA. The study was conducted in a population-based cohort using primary care records from the Sistema d'Informació per al Desenvolupament de l'Investigació en Atenció Primària database (>5.5 million subjects, covering >80% of the population of Catalonia, Spain). Participants were subjects ages ≥40 years who were without a diagnosis of OA on January 1, 2006 and had available body mass index (BMI) data. All subjects were followed up from January 1, 2006 to December 31, 2010 or to the time of loss to follow-up or death. Measures included the World Health Organization categories of BMI (exposure), and incident clinical diagnoses of knee, hip, or hand OA according to International Classification of Diseases, Tenth Revision codes. In total, 1,764,061 subjects were observed for a median follow-up period of 4.45 years (interquartile range 4.19-4.98 years). Incidence rates (per 1,000 person-years at risk) of knee, hip, and hand OA were 3.7 (99% confidence interval [99% CI] 3.6-3.8), 1.7 (99% CI 1.7-1.8), and 2.6 (99% CI 2.5-2.7), respectively, among subjects in the normal weight category, and 19.5 (99% CI 19.1-19.9), 3.8 (99% CI 3.7-4.0), and 4.0 (99% CI 3.9-4.2), respectively, in those with a classification of grade II obesity. Compared to subjects with normal weight, being overweight or obese increased the risk of OA at all 3 joint sites, especially at the knee. A status of overweight, grade I obesity, and grade II obesity increased the risk of knee OA by a factor of 2-fold, 3.1-fold, and 4.7-fold, respectively. Being overweight or obese increases the risk of hand, hip, and knee OA, with the

  4. Heterotopic Ossification around the Knee after Internal Fixation of a Complex Tibial Plateau Fracture Combined with the Use of Demineralized Bone Matrix (DBM): A Case Report

    NARCIS (Netherlands)

    Nota, Sjoerd P. F. T.; Kloen, Peter

    2014-01-01

    Demineralized bone matrix has been successfully commercialized as an alternative bone graft material that not only can function as filler but also as an osteoinductive graft. Numerous studies have confirmed its beneficial use in clinical practice. Heterotopic ossification after internal fixation

  5. Commercial Law Reform in territories subject to International Administration. Kosovo & Iraq. Different standards of legitimacy and accountability?

    Directory of Open Access Journals (Sweden)

    Alejandro Carballo Leyda

    2008-01-01

    Full Text Available The paper will address questions of legality and accountability of the legislative functions exerted by international territorial administrations1 in the field of commercial law in two recent scenarios that are theoretically different: a UN-authorized mission under Chapter VII of the UN Chart and that of a strictly Occupying Power. No attempt will be made to study other important and interrelated issues, such as the problematic privatizations carried out in Kosovo and Iraq, which do not seem to be compatible with the obligation of administration of public assets (Art. 55 of the 1907 Hague Regulations.This paper will first provide a brief overview of the deep economic legislative reformation that took place in Iraq and Kosovo during the very early stages. Most of the scholar literature focused on criminal law and human rights aspects, leaving aside commercial law reforms; yet, those profound commercial reforms have resulted in a drastic economic transformation from a planned, centrally controlled, socialist system into a liberal, marketoriented, capitalist economy. The radical nature of those changes raises the question of their conformity with relevant international law and the need for public accountability.Part III will then explore the sources of legality invoked so far (namely UN Mandates, International Humanitarian Law, and authority invested by local intervention by the academic world, experts and intervening actors as basis for the commercial reformation in Kosovo and Iraq, and whether the actual results comply with the discretion vested in the temporal administrations by those sources. Finally, in Part IV problems of judicial review and public accountability in relation to the law-making function of those international administrations in Iraq and Kosovo will be considered.

  6. [Osteoarthritis of the knee: lose weight first?].

    Science.gov (United States)

    Poolman, Rudolf W; van Wagensveld, Bart A

    2013-01-01

    Being heavy and having knee pain often co-exists. To date, the optimal treatment for patients with osteoarthritis of the knee and obesity remains the subject of debate, since patients with a high BMI (> 30 kg/m2) have a higher risk of complications following total knee arthroplasty (TKA). Kerkhoffs and colleagues suggest that these patients should first be submitted to a weight-loss programme prior to their TKA to reduce the risk of complications. This commentary addresses various questions arising from the Dutch meta-analysis by Kerkhoffs. For instance, should patients who fail to lose weight still undergo TKA or have bariatric surgery, or are there other options? Finally, suggestions are made for future research that might shed light upon this critical issue.

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

    DEFF Research Database (Denmark)

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

    2006-01-01

    Joint pain is a primary symptom in knee osteoarthritis (OA), but the effect of pain and pain relief on the knee joint mechanics of walking is not clear. In this study, the effects of local knee joint analgesia on knee joint loads during walking were studied in a group of knee osteoarthritis...... patients. A group of healthy subjects was included as a reference group. The joint loads were calculated from standard gait analysis data obtained with standardised walking speed (4 km/h). The gait analyses were performed before and after pain relief by intra-articular injections of 10 mL lidocaine (1...

  8. Medial plica syndrome of the knee: diagnosis with dynamic sonography.

    Science.gov (United States)

    Paczesny, Lukasz; Kruczynski, Jacek

    2009-05-01

    To perform a feasibility study of dynamic sonography for the diagnosis of medial plica syndrome of the knee. The study design was approved by the university bioethics board, and all the participants gave informed consent. Inclusion criteria were a palpable medial band, history of painful aching, and giving way or locking, which limited the subject's activity for at least 6 months. Exclusion criteria were a history of trauma with hemarthrosis, previous knee surgery, and arthrosis detectable on radiographs. A prospective evaluation in 88 subjects (56 female subjects, 32 male subjects; mean age, 20 years; range, 7-47 years) who were suspected of having a medial plica and 91 knees was performed. Three sonographic criteria were assessed during patellar movement by using a 12-MHz 38-mm linear transducer: (a) continuous echo sliding over the medial femoral condyle during medial and lateral movement of the patella, (b) entry of the echo under the patella during medial movement of the patella, and (c) pain or discomfort during dynamic sonography. Arthroscopy was the reference standard. An asymptomatic control group consisting of 32 volunteers (mean age, 28 years; range, 10-52 years) and 60 knees was also assessed. Arthroscopy revealed 68 plicae with pathologic findings, 61 of which met all three sonographic criteria. Medial plicae with pathologic findings were absent in 23 knees; 19 plicae were correctly diagnosed by using sonography. Diagnostic accuracy was 88%, sensitivity was 90%, and specificity was 83%. In the asymptomatic control group, there were 37 knees without a plica echo, 16 knees with a plica echo that met one criterion, and seven knees that met two criteria. Dynamic sonography allows detection of abnormalities of medial plicae in the knee, with good sensitivity and specificity.

  9. Functional outcome of patients with rotationplasty about the knee.

    Science.gov (United States)

    Fuchs, Bruno; Kotajarvi, Brian R; Kaufman, Kenton R; Sim, Franklin H

    2003-10-01

    Rotationplasty is a surgical procedure designed to achieve a durable reconstruction after the resection of tumors about the knee. However, because of the recent advances with expandable prostheses, rotationplasty has been less popular in the skeletally immature patient, particularly in the United States. We assessed the functional outcome of patients who had rotationplasty to allow better comparison with other operative techniques in this patient population. Seven patients, who were operated on at our institution at an average age of 9.4 years (range, 5-14 years), had a followup of at least 4 years and were evaluated in the Motion Analysis Laboratory. The gait analysis included kinetic, kinematic and temporal-distance parameters to evaluate the patient's functional performance. The data also were compared with measurements of a population of 25 able-bodied subjects and with four subjects with distal above-knee amputation. All patients had the ability to weightbear fully. All patients ambulated without assistive devices. Gait analysis of patients with rotationplasty revealed only slight asymmetry regarding stride duration, stride length, cadence, velocity and stance-swing ratio compared with healthy subjects. Although the gait was similar to subjects with distal above-knee amputation, knee motion was superior in patients who had rotationplasty. Rotationplasty offers a durable reconstruction. Rotationplasty allows the patient to actively control the knee, which results in a coordinated gait pattern, which is similar to the gait of the able-bodied population, and better than in subjects with distal-knee amputation.

  10. 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......, and - at least in the younger patients - more cementless implants. Trends related to organization are implementation of the fast track concept, which has reduced morbidity and length of stay, and concentration in larger units, which will also decrease morbidity and mortality. An annual volume of >25 TKAs per...

  11. Dating and intimate relationships of women with below-knee amputation: an exploratory study.

    Science.gov (United States)

    Mathias, Zoë; Harcourt, Diana

    2014-01-01

    This study investigates experiences of dating and intimate relationships amongst women who use a below-knee prosthesis. Four women took part in semi-structured online interviews. Transcripts were subject to interpretative phenomenological analysis (IPA). Five themes were identified: Revealing and Exposing: Disclosing the Amputation and Prosthesis; Judging and Judged: Internal Fears and Self-Doubt; Trusting and Accepting: Good Guy/Bad Guy Elimination; Taking it Further: The Need for Depth; and Realisation: Accepting and Feeling Accepted. Participants described how, despite negative feelings towards their appearance and body image, they chose not to conceal their prosthesis when dating. Rather, it was used as a means of screening potential partners in their search for deep and meaningful relationships. Realising that others were not prejudiced towards people who use a prosthetic had helped them become more comfortable with their own prosthesis. These findings suggest that facilitating contact with other below-knee amputees and, in some cases specialist support, could help those who are struggling with the challenges they face regarding dating and intimate relationships. They also highlight the need for researchers and clinicians to give more attention to these important aspects of amputees' lives. Implications for Rehabilitation Amputation can have a significant psychosocial impact for those affected. The relative invisibility of below-knee amputation and prostheses can present particular challenges for amputees looking to establish romantic and intimate relationships, particularly around when and how to disclose the limb loss to potential partners. Developing a sense of resilience to the reactions of other people can help those who have undergone below-knee amputation. Support for people affected by below-knee amputation should routinely consider their needs and concerns in relation to new and established relationships, offer specialist psychosocial input when

  12. Kinematics of a bicruciate-retaining total knee arthroplasty.

    Science.gov (United States)

    Heyse, Thomas J; Slane, Joshua; Peersman, Geert; Dirckx, Margo; van de Vyver, Arne; Dworschak, Philipp; Fuchs-Winkelmann, Susanne; Scheys, Lennart

    2017-06-01

    The recently reintroduced bicruciate-retaining Total Knee Arthroplasty (BCR TKA) is an interesting approach in the quest for close replication of knee joint biomechanics and kinematics closer to the native knee. Therefore, this study aimed at providing a detailed biomechanical view on the functional resemblance of BCR TKA to the native knee joint. Seven fresh-frozen full leg cadaver specimens (76 ± 10 year) were mounted in a 6 degrees-of-freedom kinematic rig that applied a dynamic squatting motion knee flexion. Two motion patterns were performed pre- and post-implantation of a fixed bearing BCR TKA: passive flexion-extension and squatting while an infrared camera system tracked the location of reflective markers attached to the tibia and femur. Additionally, specimen laxity was assessed using Lachman tests and varus/valgus stress tests in triplicate. Overall, differences in tibiofemoral kinematics between native knee and BCR TKA were small. Some minor differences appeared under the load of a squat: less internal tibial rotation and some minor paradoxical anterior translation of the medial femoral condyle during mid-flexion. BCR TKA may slightly elevate the joint line. Knee laxity as measured by the Lachman and varus/valgus tests was not significantly influenced by BCR TKA implantation. As both cruciate ligaments are preserved with BCR TKA the unloaded knee closely resembles native knee kinematics including preserving the rollback mechanism. The loss of the conforming anatomy of menisci and tibial cartilage and replacement via a relatively flat polyethylene inlay may account for the loss of tibial internal rotation and the slight paradoxical AP motion of the medial femoral condyle with BCR TKA. This phenomenon reproduces findings made earlier with fixed bearing unicondylar knee arthroplasty.

  13. A multiple regression normalization approach to evaluation of gait in total knee arthroplasty patients.

    Science.gov (United States)

    Wahid, Ferdous; Begg, Rezaul; McClelland, Jodie A; Webster, Kate E; Halgamuge, Saman; Ackland, David C

    2016-02-01

    Gait features characteristic of a cohort may be difficult to evaluate due to differences in subjects' demographic factors and walking speed. The aim of this study was to employ a multiple regression normalization method that accounts for subject age, height, body mass, gender, and self-selected walking speed in the evaluation of gait in unilateral total knee arthroplasty patients. Three-dimensional gait analysis was performed on 45 total knee arthroplasty patients and 31 aged-matched controls walking at their self-selected speed. Gait data peaks including joint angles, ground reaction forces, net joint moments, and net joint powers were normalized using subject body mass, standard dimensionless equations, and a multiple regression approach that modeled subject age, height, body mass, gender, and self-selected walking speed. Normalizing gait data using subject body mass, dimensionless equations, and multiple regression approach resulted in a significantly lower knee adduction moment and knee extensor power in total knee arthroplasty patients compared to controls (pmultiple regression normalization greatly reduced variance in gait data by minimizing correlations with subject demographic factors and walking speed, resulting in significantly higher peak hip extension angles and peak hip flexion powers in total knee arthroplasty patients (p<0.05). Total knee arthroplasty patients generate greater hip extension angles and hip flexor power and have a lower knee adduction moment than healthy controls. This gait pattern may be a strategy to reduce muscle and joint loading at the knee. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. 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.

  15. Muscle strength and exercise intensity adaptation to resistance training in older women with knee osteoarthritis and total knee arthroplasty

    Directory of Open Access Journals (Sweden)

    Emmanuel Gomes Ciolac

    2011-01-01

    Full Text Available OBJECTIVES: To analyze muscle strength and exercise intensity adaptation to resistance training in older women with knee osteoarthritis and total knee arthroplasty. METHODS: Twenty-three community-dwelling women were divided into the following groups: older, with knee osteoarthritis and total knee arthroplasty in the contralateral limb (OKG; N= 7; older, without symptomatic osteoarthritis (OG; N= 8; and young and healthy (YG; N= 8. Muscle strength (1-repetition maximum strength test and exercise intensity progression (workload increases of 5%-10% were made whenever adaptation occurred were compared before and after 13 weeks of a twice-weekly progressive resistance-training program. RESULTS: At baseline, OKG subjects displayed lower muscle strength than those in both the OG and YG. Among OKG subjects, baseline muscle strength was lower in the osteoarthritic leg than in the total arthroplasty leg. Muscle strength improved significantly during follow-up in all groups; however, greater increases were observed in the osteoarthritic leg than in the total knee arthroplasty leg in OKG subjects. Greater increases were also seen in the osteoarthritic leg of OKG than in OG and YG. The greater muscle strength increase in the osteoarthritic leg reduced the interleg difference in muscle strength in OKG subjects, and resulted in similar posttraining muscle strength between OKG and OG in two of the three exercises analyzed. Greater exercise intensity progression was also observed in OKG subjects than in both OG and YG subjects. CONCLUSIONS: OKG subjects displayed greater relative muscle strength increases (osteoarthritic leg than subjects in the YG, and greater relative exercise intensity progression than subjects in both OG and YG. These results suggest that resistance training is an effective method to counteract the lower-extremity strength deficits reported in older women with knee osteoarthritis and total knee arthroplasty.

  16. The association of BMI and knee pain among persons with radiographic knee osteoarthritis: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Wilder Frances V

    2008-12-01

    Full Text Available Abstract Background Many people with radiographic knee osteoarthritis (RKOA do not present with pain. It is suspected that such persons tend toward lower body mass index (BMI. The purpose of the study was to explore the relationship between BMI and knee pain among persons with RKOA. Methods Subjects in the Clearwater Osteoarthritis Study with RKOA (N = 576 were classified as reporting knee pain (Pain or no knee pain (No Pain. WHO-classified BMI categories were compared by pain status. Odds ratios were calculated for the four elevated BMI groups, with the normal BMI group as the reference group. Elevated BMI was the risk factor, and knee pain status was the outcome factor. Results Pain subjects presented with a higher mean BMI (30.4 kg/m2 compared with No Pain subjects (27.5 kg/m2 (p Conclusion Among subjects with RKOA, those presenting with an elevated BMI had a greater likelihood of knee pain compared to subjects with a normal BMI, and this chance rose with each successive elevated BMI category. As BMI is a modifiable risk factor, longitudinal research is needed to confirm these findings and elucidate the mechanisms underlying this relationship.

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

    Science.gov (United States)

    Holm, Bente; Kristensen, Morten T; Bencke, Jesper; Husted, Henrik; Kehlet, Henrik; Bandholm, Thomas

    2010-11-01

    To examine whether changes in knee-extension strength and functional performance are related to knee swelling after total knee arthroplasty (TKA). Prospective, descriptive, hypothesis-generating study. A fast-track orthopedic arthroplasty unit at a university hospital. Patients (N=24; mean age, 66y; 13 women) scheduled for primary unilateral TKA were investigated 1 week before surgery and on the day of hospital discharge 2.4 days postsurgery. Not applicable. We assessed all patients for knee-joint circumference, knee-extension strength, and functional performance using the Timed Up & Go, 30-second Chair Stand, and 10-m fast speed walking tests, together with knee pain during all active test procedures. All investigated variables changed significantly from pre- to postsurgery independent of knee pain. Importantly, knee circumference increased (knee swelling) and correlated significantly with the decrease in knee-extension strength (r=-.51; P=.01). Reduced fast-speed walking correlated significantly with decreased knee-extension strength (r=.59; P=.003) and decreased knee flexion (r=.52; P=.011). Multiple linear regression showed that knee swelling (P=.023), adjusted for age and sex, could explain 27% of the decrease in knee-extension strength. Another model showed that changes in knee-extension strength (P=.009) and knee flexion (P=.018) were associated independently with decreased performance in fast-speed walking, explaining 57% of the variation in fast-speed walking. Our results indicate that the well-known finding of decreased knee-extension strength, which decreases functional performance shortly after TKA, is caused in part by postoperative knee swelling. Future studies may look at specific interventions aimed at decreasing knee swelling postsurgery to preserve knee-extension strength and facilitate physical rehabilitation after TKA. Copyright © 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  18. Wear Behavior of an Unstable Knee: Stabilization via Implant Design?

    Directory of Open Access Journals (Sweden)

    Jörn Reinders

    2014-01-01

    Full Text Available Background. Wear-related failures and instabilities are frequent failure mechanisms of total knee replacements. High-conforming designs may provide additional stability for the joint. This study analyzes the effects of a ligamentous insufficiency on the stability and the wear behavior of a high-conforming knee design. Methods. Two simulator wear tests were performed on a high-conforming total knee replacement design. In the first, a ligamentous-stable knee replacement with a sacrificed anterior cruciate ligament was simulated. In the second, a ligamentous-unstable knee with additionally insufficient posterior cruciate ligament and medial collateral ligament was simulated. Wear was determined gravimetrically and wear particles were analyzed. Implant kinematics was recorded during simulation. Results. Significantly higher wear rates (P≤0.001 were observed for the unstable knee (14.58±0.56 mg/106 cycles compared to the stable knee (7.97 ± 0.87 mg/106 cycles. A higher number of wear particles with only small differences in wear particle characteristics were observed. Under unstable knee conditions, kinematics increased significantly for translations and rotations (P≤0.01. This increase was mainly attributed to higher tibial posterior translation and internal rotations. Conclusion. Higher kinematics under unstable test conditions is a result of insufficient stabilization via implant design. Due to the higher kinematics, increased wear was observed in this study.

  19. Subjective Reactions to International Research Participation: An Illustration of Ethical Considerations With Women Heading Households in Sri Lanka.

    Science.gov (United States)

    Lambert, Jessica E; Banford Witting, Alyssa; Ponnamperuma, Lakmal; Wickrama, Thulitha

    2017-06-19

    here are unique ethical considerations in conducting international research with war and disaster-affected populations that are important for ensuring adequate protection of participants. Of particular importance is the distress that participants may experience as a result of being asked about traumatic stressors, psychological symptoms, and life problems. In this study, trauma-affected Tamil women in Eastern Sri Lanka were asked to report on their research-participation experience after taking part in a larger study on risk and resiliency. Results indicated that most participants experienced emotional upset as a result of taking part in the study. However, the degree of distress was generally not more than they anticipated, and most participants reported they would have participated had they known in advance how they would feel. Most participants perceived some benefit as a result of participating and agreed that items were personally relevant. Emotional distress from participation positively correlated with culturally specific symptoms of anxiety and depression. Contextual stressors and social support were not associated with participation-related distress. We discuss these findings as well as general issues that might arise in international research with trauma-affected populations. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  20. Importance to include the term superficial musculoaponeurotic system in medical subject headings and in the international anatomical nomenclature.

    Science.gov (United States)

    Ferreira, Lydia Massako; Locali, Rafael Fagionato; Lapin, Guilherme Abbud Franco; Hochman, Bernardo

    2011-06-01

    To investigate the relevance of the term superficial musculoaponeurotic system (SMAS) and demonstrate that this term is important enough to be added to the MeSH database and listed in International Anatomical Nomenclature. Terms related to SMAS were selected from original articles retrieved from the ISI Web of Science and MEDLINE (PubMed) databases. Groups of terms were created to define a search strategy with high-sensitivity and restricted to scientific periodicals devoted to plastic surgery. This study included articles between January 1996 and May 2009, whose titles, abstracts, and keywords were searched for SMAS-related terms and all occurrences were recorded. A total of 126 original articles were retrieved from the main periodicals related to plastic surgery in the referred databases. Of these articles, 51.6% had SMAS-related terms in the abstract only, and 25.4% had SMAS-related terms in both the title and abstract. The term 'superficial musculoaponeurotic system' was present as a keyword in 19.8% of the articles. The most frequent terms were 'SMAS' (71.4%) and superficial musculoaponeurotic system (62.7%). The term SMAS refers to a structure relevant enough to start a discussion about indexing it as a keyword and as an official term in Terminologia Anatomica: International Anatomical Terminology.

  1. Ultrasonographic Findings in Hemiplegic Knees of Stroke Patients

    Directory of Open Access Journals (Sweden)

    Chao-Pin Yang

    2005-02-01

    Full Text Available Clinical and radiologic asymmetric arthritic differences between paralyzed and nonparalyzed limbs of stroke patients have been reported. Arthritic pathology aggravates motor dysfunction and compromises rehabilitation. Musculoskeletal ultrasonography plays an important role in showing soft tissue and the articular cartilage of the knee. Fifty-nine patients with either ischemic or hemorrhagic stroke-induced right or left hemiplegia were recruited to evaluate soft-tissue and intra-articular cartilage changes in hemiplegic knees of stroke patients using ultrasonography. An additional 15 subjects (30 knees without knee disease or a history of knee trauma or surgery were used as controls. There were significant differences in suprapatellar effusion and patellar tendinitis between hemiplegic and nonhemiplegic knees. Suprapatellar effusion and pes anserinus tendinitis were correlated with Brunnstrom stage. The length of time since stroke onset was not significantly correlated with positive ultrasonographic findings in hemiplegic knees. In conclusion, ultrasonography is useful for detecting periarticular soft-tissue changes and intra-articular lesions in hemiplegic knees of stroke patients.

  2. Runners knee (image)

    Science.gov (United States)

    ... forces on the knee, such as a misaligned patella. Chondromalacia is treated with rest or immobilization and nonsteroidal anti-inflammatory drugs for pain. Physical therapy, especially ... alignment of the patella that cannot be corrected with therapy.

  3. Knee MRI scan

    Science.gov (United States)

    ... pain that does not get better with treatment Instability of the knee You may also have this ... Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, ...

  4. Knee arthroscopy - discharge

    Science.gov (United States)

    ... your leg propped up on 1 or 2 pillows. Place the pillows under your foot or calf muscle. This helps ... Getting your home ready - knee or hip surgery Surgical wound care - open Review Date 11/27/2016 ...

  5. Resultant lower extremity joint moments in below-knee amputees during running stance.

    Science.gov (United States)

    Miller, D I

    1987-01-01

    Resultant flexion/extension lower extremity joint moments of four below-knee amputees running between 2.5 and 5.7 m s-1 were computed during stance on their intact and prosthetic limbs. All subjects wore patellar tendon-bearing prostheses with either a SACH or Greissinger foot component. During stance on the prosthesis, the resultant hip extensor moment on the amputated side was greater in magnitude and duration than its counterpart on the intact limb during its corresponding stance period. Since the artificial foot was planted on the ground, such a moment may help control knee flexion and promote knee extension of the residual limb. For the three subjects whose knees continued to flex at the beginning of stance, there was a dominant extensor moment about the knee joint during stance on the prosthesis. By contrast, for the fourth subject whose knee remained straight or hyperextended throughout stance on the prosthesis, a flexor moment was dominant.

  6. How accurate are lockable orthotic knee braces? An objective gait analysis study.

    Science.gov (United States)

    Khan, W S; Jones, R K; Nokes, L; Johnson, D S

    2007-12-01

    There has been an increasing use of orthotic knee braces in the management of knee injuries but, to our knowledge, there is no gait analysis study assessing the accuracy of these braces. Eight healthy male subjects were studied to determine the accuracy of immobilisation or splintage provided by a lockable orthotic knee brace using gait analysis. Six types of immobilisation were studied: locked at 0, 10, 20, 30 degrees and unlocked in an orthotic knee brace, and without a brace. The knee flexion angles measured using the kinematic instruments at 0 and 10 degrees were significantly greater than those set at the knee brace. The knee flexion angle measured using the unlocked knee brace was significantly greater than that measured in the absence of a brace. This study highlights inaccuracies in a knee brace at low knee flexion angles. The higher actual angles alter the biomechanics of the knee joint and result in greater forces across the knee joint and especially the extensor mechanism.

  7. Biomechanical and neuromuscular adaptations during the landing phase of a stepping-down task in patients with early or established knee osteoarthritis

    NARCIS (Netherlands)

    Sanchez-Ramirez, Diana C.; Malfait, Bart; Baert, Isabel; van der Leeden, Marike; van Dieën, Jaap; Lems, Willem F.; Dekker, Joost; Luyten, Frank P.; Verschueren, Sabine

    Background: To compare the knee joint kinematics, kinetics and EMG activity patterns during a stepping-down task in patients with knee osteoarthritis (OA) with control subjects. Methods: 33 women with knee OA (early OA, n = 14; established OA n = 19) and 14 female control subjects performed a

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

    Science.gov (United States)

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

    2015-12-01

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

  9. 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...

  10. Influence of advanced prosthetic knee joints on perceived performance and everyday life activity level of low-functional persons with a transfemoral amputation or knee disarticulation

    OpenAIRE

    Theeven, P.J.; Hemmen, B.; Geers, R.P.; Smeets, R.J.P.; Brink, P.R.; Seelen, H.A.

    2012-01-01

    OBJECTIVE: To assess the effects of two types of microprocessor-controlled prosthetic knee joints (MPKs) on perceived performance and everyday life activity level. DESIGN: Randomized cross-over trial. SUBJECTS: Thirty persons with a unilateral above-knee amputation or knee disarticulation classified as Medicare Functional Classification Level-2. METHODS: Participants were measured in 3 conditions, i.e. using a mechanically controlled prosthesis, an MPK featuring a microprocessor-controlled st...

  11. Translation and cross-cultural adaptation of the lower extremity functional scale into a Brazilian Portuguese version and validation on patients with knee injuries.

    Science.gov (United States)

    Metsavaht, Leonardo; Leporace, Gustavo; Riberto, Marcelo; Sposito, Maria Matilde M; Del Castillo, Letícia N C; Oliveira, Liszt P; Batista, Luiz Alberto

    2012-11-01

    Clinical measurement. To translate and culturally adapt the Lower Extremity Functional Scale (LEFS) into a Brazilian Portuguese version, and to test the construct and content validity and reliability of this version in patients with knee injuries. There is no Brazilian Portuguese version of an instrument to assess the function of the lower extremity after orthopaedic injury. The translation of the original English version of the LEFS into a Brazilian Portuguese version was accomplished using standard guidelines and tested in 31 patients with knee injuries. Subsequently, 87 patients with a variety of knee disorders completed the Brazilian Portuguese LEFS, the Medical Outcomes Study 36-Item Short-Form Health Survey, the Western Ontario and McMaster Universities Osteoarthritis Index, and the International Knee Documentation Committee Subjective Knee Evaluation Form and a visual analog scale for pain. All patients were retested within 2 days to determine reliability of these measures. Validation was assessed by determining the level of association between the Brazilian Portuguese LEFS and the other outcome measures. Reliability was documented by calculating internal consistency, test-retest reliability, and standard error of measurement. The Brazilian Portuguese LEFS had a high level of association with the physical component of the Medical Outcomes Study 36-Item Short-Form Health Survey (r = 0.82), the Western Ontario and McMaster Universities Osteoarthritis Index (r = 0.87), the International Knee Documentation Committee Subjective Knee Evaluation Form (r = 0.82), and the pain visual analog scale (r = -0.60) (all, PPortuguese LEFS had a low level of association with the mental component of the Medical Outcomes Study 36-Item Short-Form Health Survey (r = 0.38, PPortuguese version of the LEFS were high. The standard error of measurement was low (3.6) and the agreement was considered high, demonstrated by the small differences between test and retest and the narrow

  12. Knee Pain during Strength Training Shortly following Fast-Track Total Knee Arthroplasty

    DEFF Research Database (Denmark)

    Bandholm, Thomas; Thorborg, Kristian; Lunn, Troels Haxholdt

    2014-01-01

    BACKGROUND: Loading and contraction failure (muscular exhaustion) are strength training variables known to influence neural activation of the exercising muscle in healthy subjects, which may help reduce neural inhibition of the quadriceps muscle following total knee arthroplasty (TKA). It is unkn......BACKGROUND: Loading and contraction failure (muscular exhaustion) are strength training variables known to influence neural activation of the exercising muscle in healthy subjects, which may help reduce neural inhibition of the quadriceps muscle following total knee arthroplasty (TKA......). It is unknown how these exercise variables influence knee pain after TKA. OBJECTIVE: To investigate the effect of loading and contraction failure on knee pain during strength training, shortly following TKA. DESIGN: Cross-sectional study. SETTING: Consecutive sample of patients from the Copenhagen area, Denmark......, receiving a TKA, between November 2012 and April 2013. PARTICIPANTS: Seventeen patients, no more than 3 weeks after their TKA. MAIN OUTCOME MEASURES: In a randomized order, the patients performed 1 set of 4 standardized knee extensions, using relative loads of 8, 14, and 20 repetition maximum (RM...

  13. Italy-Japan international project-based learning for developing human resources using design of welfare equipment as a subject.

    Science.gov (United States)

    Hanafusa, A; Komeda, T; Ito, K; Zobel, P Beomonte

    2015-08-01

    Project-based learning (PBL) is effective for developing human resources of young students. The design of welfare equipment, such as wheelchairs and gait assistive devices, is taken as the subject in this study because these devices must be fit to their environment, users, and method of use; students must consider the circumstances of each country concerned. The program commenced in 2012 at L'Aquila, Italy, and the Shibaura Institute of Technology, Japan and has been continuing for three years. Students were divided into four groups and discussions were held on how to adapt the equipment to the user and environment. After discussion, they designed and simulated a model of the equipment using CAD. Finally, they presented their designs to each other. Through the program, students had fruitful discussions, exchanged ideas from different cultures, and learned from each other. Furthermore, friendships among the students were nurtured. It is believed that the objective of the program was satisfactorily accomplished.

  14. A Phase IIIb, Multicentre, Randomised, Parallel-Group, Placebo-Controlled, Double-Blind Study to Investigate the Efficacy and Safety of OROS Hydromorphone in Subjects with Moderate-to-Severe Chronic Pain Induced by Osteoarthritis of the Hip or the Knee

    Directory of Open Access Journals (Sweden)

    Jozef Vojtaššák

    2011-01-01

    Full Text Available Background. Opioid analgesics are included in treatment guidelines for the symptomatic management of osteoarthritis (OA. Starting with a low dose of opioid and slowly titrating to a higher dose may help avoid intolerable side effects. Methods. Subjects aged ≥40 years, with moderate to severe pain induced by OA of the hip or knee not adequately controlled by previous non-steroidal anti-inflammatory drugs (NSAIDs or paracetamol treatment, were enrolled. Subjects received OROS hydromorphone 4 mg or placebo once-daily. The dose was titrated every 3-4 days in case of unsatisfactory pain control during the 4-week titration phase. A 12 week maintenance phase followed. The primary efficacy endpoint was the change in “pain on average” measured on the Brief Pain Inventory (BPI scale from baseline to the end of the maintenance phase. Results. 139 subjects received OROS hydromorphone and 149 subjects received placebo. All efficacy endpoints showed similar improvements from baseline to end of study in the 2 groups. The safety results were consistent with the safety profile of OROS hydromorphone. Conclusion.The study did not meet the primary endpoint; although many subjects' pain was not adequately controlled at inclusion, their pain may have improved with continued paracetamol or NSAID treatment.

  15. The effect of electromagnetic navigation in total knee arthroplasty on knee kinematics during functional activities using flexible electrogoniometry.

    Science.gov (United States)

    Smith, Julie R; Rowe, Philip J; Blyth, Mark; Jones, Bryn

    2013-01-01

    Navigated total knee arthroplasty has been shown to increase accuracy in post operative implant alignment. By contrast navigated total knee arthroplasty has not shown significant functional improvements to date, when compared with conventional surgery using subjective clinical questionnaire scores. The aim of this study was to compare the knee joint kinematics measured during functional activities using electrogoniometry 12 months after total knee arthroplasty in randomised navigated and conventional total knee arthroplasty groups. The study design was a double blinded, randomised, prospective, controlled trial. The patients were randomised into 2 surgical groups (n=102 navigated group, n=98 conventional group; mean age navigated=67, conventional=67). Flexible electrogoniometry was used to measure patient's knee kinematics with respect to time during 12 functional activities. No significant difference was found in terms of the maximum, minimum and excursion knee joint angle during any of the functional activities. However there was a statistically significant improvement in the level and slope gait cycle at the pre swing phase in the navigated group. There were minimal functional improvements in the navigated total knee arthroplasty group 12 months after surgery. However, these are unlikely to have a significant effect on daily activity for the navigated group. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. 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 ...

  17. The effects of knee extensor eccentric training on functional tests in healthy subjects Os efeitos do treino isocinético excêntrico dos extensores do joelho nos testes funcionais em sujeitos saudáveis

    Directory of Open Access Journals (Sweden)

    Heleodório H. Santos

    2010-08-01

    Full Text Available BACKGROUND: It is well known that eccentric training increases muscle strength and promotes greater neural activation, and therefore has been used in the recovery of knee extensors. The hypothesis of this study was that there would be a strong correlation between knee extensor torque and functional tests. OBJECTIVES: To investigate the relationship between knee extensor peak torque and functional tests of agility (runs and propulsion (hop for distance after short-term isokinetic eccentric training. METHODS: Twenty healthy and active male undergraduate students (age 22.5±2.1 years; height 1.72±0.10 m; weight 67.8±9.5 kg; body mass index: 22.5±2.0 kg/m², with no abnormalities or history of injury of the limbs, performed an isokinetic assessment of the knee extensors and flexors and also functional tests before and after isokinetic training, which consisted of 3 sets of 10 MVECs at 30º/s, with 3 minutes of rest between sets, twice a week for 6 weeks. RESULTS: The eccentric training increased the extensor peak torque (16, 27 and 17%; PCONTEXTUALIZAÇÃO: Sabe-se que o treino excêntrico aumenta a força muscular, promovendo uma maior ativação neural e, portanto, tem sido usado na recuperação do torque extensor. A hipótese deste estudo foi a de que possa existir uma forte correlação entre o torque extensor do joelho e os testes funcionais. OBJETIVOS: Correlacionar o torque extensor do joelho com os testes funcionais de agilidade (corridas e impulsão (saltos em distância após o treino isocinético excêntrico de curta duração. MÉTODOS: Vinte homens universitários, ativos e saudáveis (22,5±2,1 anos; 1,72±0,10 m; 67,8±9,5 kg; IMC 22,5±2,0 kg/m², sem reportar anormalidades ou história de lesão no membro inferior, realizaram avaliação isocinética do torque extensor e flexor do joelho e testes funcionais antes e depois do treino isocinético que consistiu em três séries de 10 CEVM a 30º/s, com 3 minutos de repouso entre as

  18. Effects of fatigue on knee proprioception.

    Science.gov (United States)

    Lattanzio, P J; Petrella, R J; Sproule, J R; Fowler, P J

    1997-01-01

    To investigate the effects of muscular fatigue on knee joint proprioception. Prospective study. Exercise physiology laboratory. Sixteen (eight men and eight women) healthy volunteers ages 19-27 years, with no history of neuromuscular disorders, vestibular disorders, or lower limb injuries (e.g., ligament/meniscus tear). Three separate fatigue protocols [ramp test (RT), continuous test (CT), and interval test (IT)] were performed. All tests consisted of lower limb cycling on a computer-driven cycle ergometer (Lode). The RT was used to calculate the maximal aerobic power (VO2max) and determine the work rates for the CT and IT. Work rate for the RT increased 20/25 W/min to maximal exhaustion. The CT consisted of cycling at 80% VO2max until maximal exhaustion. The IT consisted of cycling alternately at 120% VO2max and at 40% VO2max for 30 s each to the point of maximal exhaustion. In the standing position, subjects were instructed to perform a two-legged squat to specific knee flexion angles. The absolute angular error (AAE) was measured for each test angle using an electrogoniometer (Penny & Giles, Blackwood, Gwent, U.K.) placed laterally across the dominant knee joint. AAE was defined as the absolute difference between test angle and subject perceived angle of knee flexion. A statistically significant increase in AAE after the RT (1.0 +/- 0.66 degree, p 0.5) after the RT protocol. These findings suggest that exercising to fatigue may produce a change in subjects' reproduction ability of knee joint angles. This may represent a decline in proprioceptive function after heavy exercise bouts. Whether this suggested proprioceptive decline is at the clinical significance level (e.g., significantly altering joint stability and motion) cannot be determined from the present findings.

  19. Knee pain in competitive swimming.

    Science.gov (United States)

    Rodeo, S A

    1999-04-01

    The high volume of training in competitive swimming results in cumulative overload injuries. Knee pain ranks second to shoulder pain as a common complaint in competitive swimmers. Most knee pain occurs on the medial side of the knee and, most commonly, in breaststroke swimmers; however, knee pain may accompany all strokes. This article reviews the incidence of knee pain, the biomechanic and anatomic factors predisposing to injury, specific injury patterns, injury diagnosis, and the treatment and prevention of injury to the knee in swimmers.

  20. Improvement in knee loading after use of specialized footwear for knee osteoarthritis: results of a six-month pilot investigation.

    Science.gov (United States)

    Shakoor, Najia; Lidtke, Roy H; Wimmer, Markus A; Mikolaitis, Rachel A; Foucher, Kharma C; Thorp, Laura E; Fogg, Louis F; Block, Joel A

    2013-05-01

    Biomechanical interventions for knee osteoarthritis (OA) aim to improve pain and retard disease progression by decreasing knee loading. This study was undertaken to evaluate the effects of 6 months of use of flat, flexible footwear (the mobility shoe) on knee loading in OA. Subjects with knee OA underwent baseline gait analyses under conditions of walking in their own shoes, walking in mobility shoes, and walking barefoot. Thereafter, subjects wore the mobility shoes at least 6 hours per day for 6 days per week. Gait evaluations were repeated at 6, 12, and 24 weeks. An intent-to-treat analysis was performed to assess the longitudinal effects on knee loading with the shoe intervention. Compared to knee loading at baseline with the participants' own shoes, there was an 18% reduction in the knee adduction moment (KAM) by 24 weeks with the mobility shoes (P shoe and barefoot walking (P = 0.192). Over the 6 months of followup, participants also experienced an 11% reduction in the KAM when walking in their own shoes (P = 0.002) and a 10% reduction in the KAM when walking barefoot (P = 0.002 for the whole followup), as compared to these values at baseline under the same conditions. This study suggests that use of flat, flexible footwear results in significant reductions in knee loading in subjects with OA. By 24 weeks, there is evidence of a gait adaptation with sustained load reduction even when the mobility shoes are removed, suggesting that footwear may serve as a biomechanical training device to achieve beneficial alterations in gait mechanics for knee OA. Copyright © 2013 by the American College of Rheumatology.

  1. Is quadriceps muscle weakness a risk factor for incident or progressive knee osteoarthritis?

    Science.gov (United States)

    Segal, Neil A; Glass, Natalie A

    2011-11-01

    The role of the quadriceps muscle in mediating risk for knee osteoarthritis (OA) is a common subject of investigation. The quadriceps muscle is a principal contributor to knee joint stability and provides shock absorption for the knee during ambulation. Clinically, weakness of the quadriceps muscle is consistently found in patients with knee OA. Research has shown that higher quadriceps muscle strength is associated with a reduced risk for incident symptomatic knee OA. However, there is limited evidence to suggest that quadriceps muscle plays a significant role in the incidence of radiographic knee OA. In addition, greater quadriceps muscle strength is associated with a lower risk for progression of tibiofemoral joint space narrowing and cartilage loss in women. This article summarizes knowledge of the relationship between quadriceps muscle strength and risk for knee OA.

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

    Directory of Open Access Journals (Sweden)

    Adriana Lucia Pastore e Silva

    Full Text Available ABSTRACT OBJECTIVE: 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. METHOD: 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. RESULTS: The ICC found no difference between the means of the pre-operative, three-month, and six-month post-operative evaluations between sub-scale items. CONCLUSION: 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.

  3. Adductor canal blockade for moderate to severe pain after arthroscopic knee surgery

    DEFF Research Database (Denmark)

    Espelund, M; Grevstad, U; Jaeger, P

    2014-01-01

    BACKGROUND: The analgesic effect of the adductor canal block (ACB) after knee surgery has been evaluated in a number of trials. We hypothesized that the ACB would provide substantial pain relief to patients responding with moderate to severe pain after arthroscopic knee surgery. METHODS: Fifty...... subjects with moderate to severe pain after arthroscopic knee surgery were enrolled in this placebo-controlled, blinded trial. All subjects received two ACBs; an initial ACB with either 30 ml ropivacaine 7.5 mg/ml (n = 25) (R group) or saline (n = 25) (C group) and after 45 min a second ACB...... arthroscopic knee surgery....

  4. Introduction of total knee arthroplasty in Lithuania

    Science.gov (United States)

    Stucinskas, Justinas; Robertsson, Otto; Wingstrand, Hans

    2009-01-01

    Background and purpose We have previously reported that the first 10 years of hip arthroplasty in Lithuania resulted in a higher cumulative revision rate than that observed in Sweden. We thus compared the corresponding results after introduaction of total knee replacement in Lithuania. Methods The 10-year revision rate for the first 595 primary ScanKnee arthroplasties inserted in Klaipeda, Lithuania, was compared to that for the first 1,280 ScanKnee primary arthroplasties inserted in Sweden. As in the hip replacement study, only patients with osteoarthritis (OA) were included. Primary knee arthroplasties without patellar resurfacing were included, and the endpoint was revision for any reason other than addition of a patellar component. Results We found that the cumulative revision rate was not statistically significantly different between the groups. The revision pattern was different, however, and we observed 24 isolated patellar component additions in Sweden, but none in Klaipeda. Interpretation Contrary to the results of our previous hip arthroplasty study, the cumulative revision rate after total knee arthroplasty was similar in the two groups. This suggests that compared to hip arthroplasty, the outcome of total knee arthroplasty was less dependent on surgical experience. The large difference regarding isolated patellar component additions may be explained by long-term accumulation of severe OA cases in Lithuania. To patients subject to a newly introduced surgical treatment offering great improvement in quality of life, patellofemoral pain may be a minor problem. Furthermore, patellar problems may not have seemed particularly relevant for the surgeons, considering the disability of other patients waiting to be treated. PMID:19297790

  5. Non-driving intersegmental knee moments in cycling computed using a model that includes three-dimensional kinematics of the shank/foot and the effect of simplifying assumptions.

    Science.gov (United States)

    Gregersen, Colin S; Hull, M L

    2003-06-01

    Assessing the importance of non-driving intersegmental knee moments (i.e. varus/valgus and internal/external axial moments) on over-use knee injuries in cycling requires the use of a three-dimensional (3-D) model to compute these loads. The objectives of this study were: (1) to develop a complete, 3-D model of the lower limb to calculate the 3-D knee loads during pedaling for a sample of the competitive cycling population, and (2) to examine the effects of simplifying assumptions on the calculations of the non-driving knee moments. The non-driving knee moments were computed using a complete 3-D model that allowed three rotational degrees of freedom at the knee joint, included the 3-D inertial loads of the shank/foot, and computed knee loads in a shank-fixed coordinate system. All input data, which included the 3-D segment kinematics and the six pedal load components, were collected from the right limb of 15 competitive cyclists while pedaling at 225 W and 90 rpm. On average, the peak varus and internal axial moments of 7.8 and 1.5 N m respectively occurred during the power stroke whereas the peak valgus and external axial moments of 8.1 and 2.5 N m respectively occurred during the recovery stroke. However, the non-driving knee moments were highly variable between subjects; the coefficients of variability in the peak values ranged from 38.7% to 72.6%. When it was assumed that the inertial loads of the shank/foot for motion out of the sagittal plane were zero, the root-mean-squared difference (RMSD) in the non-driving knee moments relative to those for the complete model was 12% of the peak varus/valgus moment and 25% of the peak axial moment. When it was also assumed that the knee joint was revolute with the flexion/extension axis perpendicular to the sagittal plane, the RMSD increased to 24% of the peak varus/valgus moment and 204% of the peak axial moment. Thus, the 3-D orientation of the shank segment has a major affect on the computation of the non-driving knee

  6. Design, construction, and evaluation of "sensor lock": an electromechanical stance control knee joint.

    Science.gov (United States)

    Arazpour, Mokhtar; Ahmadi Bani, Monireh; Baniasad, Mina; Samadian, Mohammad; Golchin, Navid

    2017-03-28

    Most currently-available stance control knee ankle foot orthoses (SCKAFOs) still need full knee extension to lock the knee joint, and they are still noisy, bulky, and heavy. Therefore, the aim of this study was to design, construct, and evaluate an original electromechanical SCKAFO knee joint that could feasibly solve these problems, and thus address the problems of current stance control knee joints with regards to their structure, function, cosmesis, and cost. Ten able-bodied (AB) participants and two (knee ankle foot orthosis) KAFO users were recruited to participate in the study. A custom SCKAFO with the same set of components was constructed for each participant. Lower limb kinematics were captured using a 6-camera, video-based motion analysis system. For AB participants, significant differences were found between normal walking and walking with the SCKAFO for temporal-spatial parameters and between orthoses with two modes of knee joints in the healthy subjects. Walking with stance control mode produced greater walking speed and step length, greater knee flexion during swing, and less pelvic obliquity than walking with a locked knee, for both AB and KAFO users. The feasibility of this new knee joint with AB people was demonstrated. Implications for rehabilitation Stance control knee ankle foot orthoses (SCKAFOs) are designed to stop knee flexion in stance phase and provide free knee movement during swing phase of walking. Due to their high cost, size, excessive weight, and poor performance, few SCKAFO were optimal clinically and commercially. The feasibility of the new knee joint with able-bodied people and poliomyelitis subjects was demonstrated.

  7. Nonsurgical or Surgical Treatment of ACL Injuries: Knee Function, Sports Participation, and Knee Reinjury

    Science.gov (United States)

    Grindem, Hege; Eitzen, Ingrid; Engebretsen, Lars; Snyder-Mackler, Lynn; Risberg, May Arna

    2014-01-01

    Background: While there are many opinions about the expected knee function, sports participation, and risk of knee reinjury following nonsurgical treatment of injuries of the anterior cruciate ligament (ACL), there is a lack of knowledge about the clinical course following nonsurgical treatment compared with that after surgical treatment. Methods: This prospective cohort study included 143 patients with an ACL injury. Isokinetic knee extension and flexion strength and patient-reported knee function as recorded on the International Knee Documentation Committee (IKDC) 2000 form were collected at baseline, six weeks, and two years. Sports participation was reported monthly for two years with use of an online activity survey. Knee reinjuries were reported at the follow-up evaluations and in a monthly online survey. Repeated analysis of variance (ANOVA), generalized estimating equation (GEE) models, and Cox regression analysis were used to analyze group differences in functional outcomes, sports participation, and knee reinjuries, respectively. Results: The surgically treated patients (n = 100) were significantly younger, more likely to participate in level-I sports, and less likely to participate in level-II sports prior to injury than the nonsurgically treated patients (n = 43). There were no significant group-by-time effects on functional outcome. The crude analysis showed that surgically treated patients were more likely to sustain a knee reinjury and to participate in level-I sports in the second year of the follow-up period. After propensity score adjustment, these differences were nonsignificant; however, the nonsurgically treated patients were significantly more likely to participate in level-II sports during the first year of the follow-up period and in level-III sports over the two years. After two years, 30% of all patients had an extensor strength deficit, 31% had a flexor strength deficit, 20% had patient-reported knee function below the normal range, and

  8. Obesity, knee osteoarthritis and knee arthroplasty: a review

    OpenAIRE

    Salih, Saif; Sutton, Paul

    2013-01-01

    The incidence of obesity is rising worldwide. Obesity is a risk factor for developing osteoarthritis in the knee. Obesity and knee osteoarthritis are independently disabling conditions and in combination pose difficult therapeutic challenges. This review will discuss obesity, osteoarthritis, and the problems associated with knee osteoarthritis in an obese population. Treatment options including surgery and its success will be discussed.

  9. How to quantify knee function after total knee arthroplasty?

    NARCIS (Netherlands)

    Boonstra, M.C.; Waal Malefijt, M.C. de; Verdonschot, N.J.J.

    2008-01-01

    Total knee arthroplasty (TKA) is being undertaken in a younger population than before and as a result the functional demands on the knee are likely to be increasing. As a consequence, it is important to define quantitative functional knee tests that can monitor any increase. A valuable functional

  10. Outdoor dynamic subject-specific evaluation of internal stresses in the residual limb: hydraulic energy-stored prosthetic foot compared to conventional energy-stored prosthetic feet.

    Science.gov (United States)

    Portnoy, Sigal; Kristal, Anat; Gefen, Amit; Siev-Ner, Itzhak

    2012-01-01

    The prosthetic foot plays an important role in propelling, breaking, balancing and supporting body loads while the amputee ambulates on different grounds. It is therefore important to quantify the effect of the prosthetic foot mechanism on biomechanical parameters, in order to prevent pressure ulcers and deep tissue injury. Our aim was to monitor the internal stresses in the residuum of transtibial amputation (TTA) prosthetic-users ambulating on different terrains, which the amputees encounter during their daily activities, i.e. paved floor, grass, ascending and descending stairs and slope. We specifically aimed to compare between the internal stresses in the TTA residuum of amputees ambulating with a novel hydraulic prosthetic foot compared to conventional energy storage and return (ESR) prosthetic feet. Monitoring of internal stresses was accomplished using a portable subject-specific real-time internal stress monitor. We found significant decrease (phydraulic foot, compared to walking with ESR feet. The loading rate calculated while ambulating with the hydraulic foot was at least three times lower than the loading rate calculated while ambulating with the ESR foot. Although the average decrease in internal stresses was ≈ 2-fold larger when replacing single-toe ESR feet with the hydraulic foot than when replacing split-toed ESR feet with the hydraulic foot, the differences were statistically insignificant. Our findings suggest that using a hydraulic prosthetic foot may protect the distal tibial end of the TTA residuum from high stresses, therefore preventing pressure-related injury and pain. Copyright © 2011 Elsevier B.V. All rights reserved.

  11. Image based weighted center of proximity versus directly measured knee contact location during simulated gait.

    Science.gov (United States)

    Wang, Hongsheng; Chen, Tony; Koff, Matthew F; Hutchinson, Ian D; Gilbert, Susannah; Choi, Dan; Warren, Russell F; Rodeo, Scott A; Maher, Suzanne A

    2014-07-18

    To understand the mechanical consequences of knee injury requires a detailed analysis of the effect of that injury on joint contact mechanics during activities of daily living. Three-dimensional (3D) knee joint geometric models have been combined with knee joint kinematics to dynamically estimate the location of joint contact during physiological activities-using a weighted center of proximity (WCoP) method. However, the relationship between the estimated WCoP and the actual location of contact has not been defined. The objective of this study was to assess the relationship between knee joint contact location as estimated using the image-based WCoP method, and a directly measured weighted center of contact (WCoC) method during simulated walking. To achieve this goal, we created knee specific models of six human cadaveric knees from magnetic resonance imaging. All knees were then subjected to physiological loads on a knee simulator intended to mimic gait. Knee joint motion was captured using a motion capture system. Knee joint contact stresses were synchronously recorded using a thin electronic sensor throughout gait, and used to compute WCoC for the medial and lateral plateaus of each knee. WCoP was calculated by combining knee kinematics with the MRI-based knee specific model. Both metrics were compared throughout gait using linear regression. The anteroposterior (AP) location of WCoP was significantly correlated with that of WCoC on both tibial plateaus in all specimens (p0), but the correlation was not significant in the mediolateral (ML) direction for 4/6 knees (p>0.05). Our study demonstrates that while the location of joint contact obtained from 3D knee joint contact model, using the WCoP method, is significantly correlated with the location of actual contact stresses in the AP direction, that relationship is less certain in the ML direction. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Gait analysis of patients with an off-the-shelf total knee replacement versus customized bi-compartmental knee replacement.

    Science.gov (United States)

    Wang, Henry; Foster, Jonathan; Franksen, Natasha; Estes, Jill; Rolston, Lindsey

    2017-09-04

    Newer TKR designs have been introduced to the market with the aim of overcoming common sizing problems with older TKR designs. Furthermore, since a sizable percentage of patients with OA present with disease limited to the medial/lateral knee compartment in addition to the patellofemoral joint, for whom, a customized bi-compartmental knee replacement (BKR) is available as a treatment option. To date, there is very little information regarding knee strength and mechanics during gait for patients implanted with these modern TKR and BKR designs. The purpose of the study was to evaluate knee strength and mechanics during walking for patients with either a modern off the shelf TKR or a customized BKR and compare these findings to a cohort of healthy controls. Twelve healthy controls, eight BKR, and nine TKR patients participated in the study. Maximal isometric knee strength was evaluated. 3D kinematic and kinetic analyses were conducted for level walking. The TKR knee exhibited less peak extensor torque when compared to, both the BKR and control limbs (p < 0.05). The TKR knee had less extensor moment at stance than both the BKR and control knees (p < 0.05). Both the BKR and control knees displayed larger internal rotation at stance than that of the TKR knee (p < 0.05). This study suggests that, for patients that exhibit isolated OA of the tibiofemoral joint, using a customized BKR implant is a viable treatment option and may contribute to superior mechanical advantages.

  13. Defining the Relationship of Student Achievement Between STEM Subjects Through Canonical Correlation Analysis of 2011 Trends in International Mathematics and Science Study (TIMSS) Data

    Science.gov (United States)

    O'Neal, Melissa Jean

    Canonical correlation analysis was used to analyze data from Trends in International Mathematics and Science Study (TIMSS) 2011 achievement databases encompassing information from fourth/eighth grades. Student achievement in life science/biology was correlated with achievement in mathematics and other sciences across three analytical areas: mathematics and science student performance, achievement in cognitive domains, and achievement in content domains. Strong correlations between student achievement in life science/biology with achievement in mathematics and overall science occurred for both high- and low-performing education systems. Hence, partial emphases on the inter-subject connections did not always lead to a better student learning outcome in STEM education. In addition, student achievement in life science/biology was positively correlated with achievement in mathematics and science cognitive domains; these patterns held true for correlations of life science/biology with mathematics as well as other sciences. The importance of linking student learning experiences between and within STEM domains to support high performance on TIMSS assessments was indicated by correlations of moderate strength (57 TIMSS assessments was indicated by correlations of moderate strength (57 complexity upon firm foundations were prepared for successful learning throughout their educational careers. The results from this investigation promote a holistic design of school learning opportunities to improve student achievement in life science/biology and other science, technology, engineering, and mathematics (STEM) subjects at the elementary and middle school levels. While the curriculum can vary from combined STEM subjects to separated mathematics or science courses, both professional learning communities (PLC) for teachers and problem-based learning (PBL) for learners can be strengthened through new knowledge construction beyond the traditional boundaries of each subject. It is the

  14. Functional electrical stimulation of gluteus medius reduces the medial joint reaction force of the knee during level walking.

    Science.gov (United States)

    Rane, Lance; Bull, Anthony Michael James

    2016-11-03

    By altering muscular activation patterns, internal forces acting on the human body during dynamic activity may be manipulated. The magnitude of one of these forces, the medial knee joint reaction force (JRF), is associated with disease progression in patients with early osteoarthritis (OA), suggesting utility in its targeted reduction. Increased activation of gluteus medius has been suggested as a means to achieve this. Motion capture equipment and force plate transducers were used to obtain kinematic and kinetic data for 15 healthy subjects during level walking, with and without the application of functional electrical stimulation (FES) to gluteus medius. Musculoskeletal modelling was employed to determine the medial knee JRF during stance phase for each trial. A further computer simulation of increased gluteus medius activation was performed using data from normal walking trials by a manipulation of modelling parameters. Relationships between changes in the medial knee JRF, kinematics and ground reaction force were evaluated. In simulations of increased gluteus medius activity, the total impulse of the medial knee JRF was reduced by 4.2 % (p = 0.003) compared to control. With real-world application of FES to the muscle, the magnitude of this reduction increased to 12.5 % (p < 0.001), with significant inter-subject variation. Across subjects, the magnitude of reduction correlated strongly with kinematic (p < 0.001) and kinetic (p < 0.001) correlates of gluteus medius activity. The results support a major role for gluteus medius in the protection of the knee for patients with OA, establishing the muscle's central importance to effective therapeutic regimes. FES may be used to achieve increased activation in order to mitigate distal internal loads, and much of the benefit of this increase can be attributed to resulting changes in kinematic parameters and the ground reaction force. The utility of interventions targeting gluteus medius can be assessed

  15. Effects of kinesiology taping on repositioning error of the knee joint after quadriceps muscle fatigue.

    Science.gov (United States)

    Han, Jin Tae; Lee, Jung-Hoon

    2014-06-01

    [Purpose] The purpose of this study was to identify the effects of kinesiology taping on repositioning error of the knee joint after quadriceps muscle fatigue. [Subjects] Thirty healthy adults with no orthopaedic or neurological problems participated in this study. [Methods] The repositioning error of the knee joint was measured using a digital goniometer when the subjects extended their dominant-side knee to a random target angle (30°, 45°, or 60°) with their eyes closed, before and after a quadriceps muscle fatigue protocol, and after application of kinesiology tape. [Results] We found that repositioning errors of the dominant-side knee joint increased after quadriceps fatigue compared with no-fatigue conditions. However, kinesiology taping of the quadriceps muscle and patella after quadriceps fatigue significantly decreased repositioning errors of the knee joint. [Conclusion] These results suggest that quadriceps fatigue increases the repositioning error of the knee joint, whereas application of kinesiology tape decreases fatigue-induced joint repositioning error.

  16. Type II collagen C2C epitope in human synovial fluid and serum after knee injury

    DEFF Research Database (Denmark)

    Kumahashi, N; Swärd, P; Larsson, S

    2015-01-01

    ). Serum was collected from 71 of the knee injured patients. Synovial fluid from 8 knee-healthy subjects was used as reference. C2C was quantified by immunoassay and structural injury was determined from magnetic resonance images (MRI) of the injured knee acquired 1-38 days after injury (n = 98......). Additional joint injury biomarker results were from earlier investigations of the same samples. RESULTS: Synovial fluid C2C concentrations were higher in injured knees than in knees of reference subjects from 1 day up to 7 years after injury. C2C concentrations in synovial fluid and serum were correlated (r......PURPOSE: Investigate in a cross-sectional study time-dependent changes of synovial fluid type II collagen epitope C2C concentrations after knee injury and correlate to other joint injury biomarkers. METHODS: Synovial fluid samples were aspirated between 0 days and 7 years after injury (n = 235...

  17. USE OF TECHNOLOGIES OF PLASTIC AND RECONSTRUCTIVE MICROSURGERY IN TREATMENT OF PATIENTS WITH PATHOLOGY OF KNEE

    Directory of Open Access Journals (Sweden)

    L. A. Rodomanova

    2012-01-01

    Full Text Available Analysis of the results of surgical treatment of 63 patients with knee-joint pathology who were treated in Vreden’s Scientific-research Institute of traumatology and orthopaedics (Saint-Petersburg, Russia within the period from 2000 to 2011. All the patients had pedicled flap transfer or free tissue transfer. 53 patients (84,1% had additionally various orthopedic operations on the knee joint: 42 patients had primary or revision total knee arthroplasty, 6 patients had resections of bony tumors and total knee arthroplasty, 4 - knee arthrodesis, 1 - open reduction and internal fixation of patella. The results of treatment were estimated according to WOMAC knee score. 4 patients had total necrosis of flap what demanded repeated reconstructive microsurgical operation. 6 patients had knee arthroplasty surgical site infection, 1 patient had recidive of osteoblastic sarcoma and he was made leg amputation. 65,7% of patients had good results according to WOMAC knee score, 28,6% patients had satisfactory results. Microsurgical operations in patients with pathology of knee-joint mainly aim to correct various pathological changes of tissues located in this particular area. In cases of scarry deformations and defects of tissues located in the area of knee-joint microsurgical technologies increase the opportunities for fulfilling total knee arthroplasty and improve its results as well as results of other orthopedical operations. At the same time microsurgical technologies may be used as preparative operations, single-step maneuvers and operations fulfilled in case of development of local infectious complications.

  18. Knee joint distraction compared with total knee arthroplasty: a randomised controlled trial.

    Science.gov (United States)

    van der Woude, J A D; Wiegant, K; van Heerwaarden, R J; Spruijt, S; Emans, P J; Mastbergen, S C; Lafeber, F P J G

    2017-01-01

    Knee joint distraction (KJD) is a relatively new, knee-joint preserving procedure with the goal of delaying total knee arthroplasty (TKA) in young and middle-aged patients. We present a randomised controlled trial comparing the two. The 60 patients ≤ 65 years with end-stage knee osteoarthritis were randomised to either KJD (n = 20) or TKA (n = 40). Outcomes were assessed at baseline, three, six, nine, and 12 months. In the KJD group, the joint space width (JSW) was radiologically assessed, representing a surrogate marker of cartilage thickness. In total 56 patients completed their allocated treatment (TKA = 36, KJD = 20). All patient reported outcome measures improved significantly over one year (p Osteoarthritis Research Society International clinical response was 83% after TKA and 80% after KJD. A total of 12 patients (60%) in the KJD group sustained pin track infections. In the KJD group both mean minimum (0.9 mm, standard deviation (sd) 1.1) and mean JSW (1.2 mm, sd 1.1) increased significantly (p = 0.004 and p = 0.0003). In relatively young patients with end-stage knee osteoarthritis, KJD did not demonstrate inferiority of outcomes at one year when compared with TKA. However, there is a high incidence of pin track infection associated with KJD. Cite this article: Bone Joint J 2017;99-B:51-8. ©2017 The British Editorial Society of Bone & Joint Surgery.

  19. Integrative Approach in Haemophillic Arthropathy of The Knee: a Case Report

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    Andri Maruli T Lubis

    2016-05-01

    Full Text Available Haemophilic arthropathy is the most prevalent joint disorder in haemophilia. This disorder is characterized by chronic synovitis and progressive destruction of joint cartilage. We report a case of arthroscopic synovectomy to reduce bleeding frequency in haemophilic arthropathy of the knee. Patient was a 15 years old male with haemophilic arthropathy of the left knee. We performed an arthroscopic synovectomy under tightly regulated factor VIII replacement therapy. There were villous synovial hypertrophy at all part of the joint, multiple bone and cartilage defect, and also anterior cruciate ligament (ACL and posterior cruciate ligament (PCL deficiency found intraoperatively. After 6 month follow up, subjective complain and bleeding frequency decreased significantly. The visual analog scale improved from 5-6 to 1-2, and the International Knee Documentation Committee Score increased from 49 to 66. Bleeding frequency decreased from 4-8 times per month to less than 1 time per month. Arthroscopic synovectomy performed in this case could reduce the pain, decrease the frequency of bleeding, and improve patient’s functional outcome. Key words: arthroscopic synovectomy, haemophilic arthropathy, haemophilia, anterior cruciate ligament, posterior cruciate ligament.

  20. Detection of Prosthetic Knee Movement Phases via In-Socket Sensors: A Feasibility Study

    Directory of Open Access Journals (Sweden)

    Amr M. El-Sayed

    2015-01-01

    Full Text Available This paper presents an approach of identifying prosthetic knee movements through pattern recognition of mechanical responses at the internal socket’s wall. A quadrilateral double socket was custom made and instrumented with two force sensing resistors (FSR attached to specific anterior and posterior sites of the socket’s wall. A second setup was established by attaching three piezoelectric sensors at the anterior distal, anterior proximal, and posterior sites. Gait cycle and locomotion movements such as stair ascent and sit to stand were adopted to characterize the validity of the technique. FSR and piezoelectric outputs were measured with reference to the knee angle during each phase. Piezoelectric sensors could identify the movement of midswing and terminal swing, pre-full standing, pull-up at gait, sit to stand, and stair ascent. In contrast, FSR could estimate the gait cycle stance and swing phases and identify the pre-full standing at sit to stand. FSR showed less variation during sit to stand and stair ascent to sensitively represent the different movement states. The study highlighted the capacity of using in-socket sensors for knee movement identification. In addition, it validated the efficacy of the system and warrants further investigation with more amputee subjects and different sockets types.

  1. Joint kinetics in unilateral below-knee amputee patients during running.

    Science.gov (United States)

    Sanderson, D J; Martin, P E

    1996-12-01

    To explore the nature of the accommodations in running gait that persons with below-knee amputations make in response to the limb segment loss. Two groups of volunteer subjects (n = 6 in each group). Individuals in one group had below-knee amputations; the second group had intact lower limbs. Individuals ran at two nominal speeds, 2.7 m/sec and 3.5 m/sec, over a flush-mounted force platform. Ground reaction force data were combined with simultaneously recorded and subsequently digitized video data of coordinate motion to calculate joint and segment motion and net joint moment data. The degree of left-to-right asymmetry for the amputee group was dependent on the variable of interest. There was symmetry in stride frequency and support moment and a marked asymmetry in ankle, knee, and hip moments. In response to increased running speed, both groups increased the amplitude of each joint moment. The nonamputee group appeared to increase the gain uniformly across the three joints, whereas the intact and prosthetic limbs were not uniformly increased. The temporal sequencing of the components for the intact and prosthetic limbs did not appear to differ from the nonamputee limb. This similarity in timing was unaffected by speed increases. There was no need to develop completely new patterns of joint moments; rather, it was sufficient to retune the current moment patterns to account for new segmental properties and thus retain the internal timing characteristics.

  2. Well-being, problematic alcohol consumption and acute subjective drug effects in past-year ayahuasca users: a large, international, self-selecting online survey.

    Science.gov (United States)

    Lawn, Will; Hallak, Jaime E; Crippa, Jose A; Dos Santos, Rafael; Porffy, Lilla; Barratt, Monica J; Ferris, Jason A; Winstock, Adam R; Morgan, Celia J A

    2017-11-09

    Ayahuasca is a natural psychedelic brew, which contains dimethyltryptamine (DMT). Its potential as a psychiatric medicine has recently been demonstrated and its non-medical use around the world appears to be growing. We aimed to investigate well-being and problematic alcohol use in ayahuasca users, and ayahuasca's subjective effects. An online, self-selecting, global survey examining patterns of drug use was conducted in 2015 and 2016 (n = 96,901). Questions were asked about: use of ayahuasca, lysergic acid diethylamide (LSD) and magic mushrooms; demographics, current well-being and past-year problematic alcohol use of past-year ayahuasca users and comparison drug users; and subjective effects of ayahuasca and comparison drugs. Ayahuasca users (n = 527) reported greater well-being than both classic psychedelic users (n = 18,138) and non-psychedelic drug-using respondents (n = 78,236). Ayahuasca users reported less problematic drinking than classic psychedelic users, although both groups reported greater problematic drinking than the other respondents. Ayahuasca's acute subjective effects usually lasted for six hours and were most strongly felt one hour after consumption. Within our online, self-selecting survey, ayahuasca users reported better well-being than comparison groups and less problematic drinking than classic psychedelic users. Future longitudinal studies of international samples and randomised controlled trials are needed to dissect the effects of ayahuasca on these outcomes.

  3. Measurement of strength and loading variables on the knee during Alpine skiing.

    Science.gov (United States)

    Maxwell, S M; Hull, M L

    1989-01-01

    The study focusses on the prevention of knee injuries during snow skiing. In order to develop a technology of knee injury prevention, both the strength and loading on the knee during skiing activity must be known. This paper reports measurements of variables influencing both knee strength and loading of the joint. The strength variables measured included the degree of activity in six muscles crossing the knee, the knee flexion angle, and the axial load (i.e. weight bearing) transmitted to the knee. Transducers included surface electrodes to monitor electromyogram signals indicating the degree of muscle activity and a goniometer to measure both hip and knee flexion angles. The complete loading on the knee was derived from a dynamometer which measured the six load components at the boot-dynamometer interface. The transducer data were acquired and stored by a compact, battery powered digital data acquisition-controller system. Three male subjects of similar physical size (nominal was 1.8 m and 75 kg) and skiing ability (advanced intermediate to expert) were tested under similar conditions. Each subject skied a total of four slalom runs--one snowplow and three parallel. The total time of each test was 21 s. Example data plots from different types of runs are presented and discussed. Based on observations from the data, necessary performance features for ski bindings offering improved protection from knee ligamentous injuries are defined.

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

    Science.gov (United States)

    Esrafilian, Amir; Karimi, Mohammad Taghi; Eshraghi, Arezoo

    2012-01-01

    Background. Osteoarthritis (OA) is a disease which influences the performance of the knee joint. Moreover, the force and moments applied on the joint increase in contrast to normal subjects. Various types of knee orthoses have been designed to solve the mentioned problems. However, there are other problems in terms of distal migration during walking and the alignment of the orthosis which cannot be changed following the use of brace. Therefore, the main aim of the research was to design an orthosis to solve the aforementioned problems. Method. A new type of knee orthosis was designed with a modular structure. Two patients with knee OA participated in this research project. The force applied on the foot, moment transmitted through the knee joint, and spatiotemporal gait parameters were measured by use of a motion analysis system. Results. The results of the research showed that the adduction moment applied on the knee joint decreased while subjects walked with the new knee orthosis (P-value knee brace can be used as an effective treatment to decrease the loads applied on the knee joint and to improve the alignment whilst walking. PMID:22577565

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

    Directory of Open Access Journals (Sweden)

    Amir Esrafilian

    2012-01-01

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

  6. An algorithm recommendation for the management of knee osteoarthritis in Europe and internationally: a report from a task force of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO).

    Science.gov (United States)

    Bruyère, Olivier; Cooper, Cyrus; Pelletier, Jean-Pierre; Branco, Jaime; Luisa Brandi, Maria; Guillemin, Francis; Hochberg, Marc C; Kanis, John A; Kvien, Tore K; Martel-Pelletier, Johanne; Rizzoli, René; Silverman, Stuart; Reginster, Jean-Yves

    2014-12-01

    Existing practice guidelines for osteoarthritis (OA) analyze the evidence behind each proposed treatment but do not prioritize the interventions in a given sequence. The objective was to develop a treatment algorithm recommendation that is easier to interpret for the prescribing physician based on the available evidence and that is applicable in Europe and internationally. The knee was used as the model OA joint. ESCEO assembled a task force of 13 international experts (rheumatologists, clinical epidemiologists, and clinical scientists). Existing guidelines were reviewed; all interventions listed and recent evidence were retrieved using established databases. A first schematic flow chart with treatment prioritization was discussed in a 1-day meeting and shaped to the treatment algorithm. Fine-tuning occurred by electronic communication and three consultation rounds until consensus. Basic principles consist of the need for a combined pharmacological and non-pharmacological treatment with a core set of initial measures, including information access/education, weight loss if overweight, and an appropriate exercise program. Four multimodal steps are then established. Step 1 consists of background therapy, either non-pharmacological (referral to a physical therapist for re-alignment treatment if needed and sequential introduction of further physical interventions initially and at any time thereafter) or pharmacological. The latter consists of chronic Symptomatic Slow-Acting Drugs for OA (e.g., prescription glucosamine sulfate and/or chondroitin sulfate) with paracetamol at-need; topical NSAIDs are added in the still symptomatic patient. Step 2 consists of the advanced pharmacological management in the persistent symptomatic patient and is centered on the use of oral COX-2 selective or non-selective NSAIDs, chosen based on concomitant risk factors, with intra-articular corticosteroids or hyaluronate for further symptom relief if insufficient. In Step 3, the last

  7. Proprioception in Above-the-Knee Amputees with Artificial Limbs

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    E. P. Latanioti

    2013-01-01

    Full Text Available Purpose. To evaluate the lower limb proprioceptive sensation in patients with femoral amputation who received an artificial joint. Materials and Methods. 22 patients (18 men, 4 women, 24–65 years old (mean: 42, who had undergone above-the-knee joint amputation and underwent evaluation of proprioception using joint reposition in a predetermined angle of 15° knee flexion. The measurements were applied using a conventional goniometer to both amputated and healthy knees. The last ones were used as internal control. All patients performed an active knee flexion from hyperextension to 15° in a closed kinetic chain in order to evaluate proprioceptive sensation of the knee joint using the joint position sense (JPS method during specific controllable circumstances very close to normal gait. Results. JPS at 15° flexion for the amputated knee was calculated to be equal to 13.91 (SD = ±4.74, and for the healthy side it was equal to 14.15 (SD = ±2.61. No statistically significant differences were detected between the amputated and the healthy limb (. Conclusions. The proprioceptive information of the stumps did not appear to be affected significantly after thigh amputation and application of artificial prosthesis when JPS at 15° was evaluated. It seems that these patients compensate the loss of the knee sensory receptors via alternative mechanisms.

  8. Periprosthetic Fractures Following Total Knee Arthroplasty

    Science.gov (United States)

    Kim, Nam Ki

    2015-01-01

    Periprosthetic fractures after total knee arthroplasty may occur in any part of the femur, tibia and patella, and the most common pattern involves the supracondylar area of the distal femur. Supracondylar periprosthetic fractures frequently occur above a well-fixed prosthesis, and risk factors include anterior femoral cortical notching and use of the rotational constrained implant. Periprosthetic tibial fractures are frequently associated with loose components and malalignment or malposition of implants. Fractures of the patella are much less common and associated with rheumatoid arthritis, use of steroid, osteonecrosis and malalignment of implants. Most patients with periprosthetic fractures around the knee are the elderly with poor bone quality. There are many difficulties and increased risk of nonunion after treatment because reduction and internal fixation is interfered with by preexisting prosthesis and bone cement. Additionally, previous soft tissue injury is another disadvantageous condition for bone healing. Many authors reported good clinical outcomes after non-operative treatment of undisplaced or minimally displaced periprosthetic fractures; however, open reduction or revision arthroplasty was required in displaced fractures or fractures with unstable prosthesis. Periprosthetic fractures around the knee should be prevented by appropriate technique during total knee arthroplasty. Nevertheless, if a periprosthetic fracture occurs, an appropriate treatment method should be selected considering the stability of the prosthesis, displacement of fracture and bone quality. PMID:25750888

  9. The Danish Knee Ligament Reconstruction Registry

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    Rahr-Wagner L

    2016-10-01

    Full Text Available Lene Rahr-Wagner, Martin Lind Department of Orthopaedic Surgery, Division of Sports Surgery, Aarhus University Hospital, Aarhus, Denmark Abstract: The Danish Knee Ligament Reconstruction Registry was established in 2005 as a web-based nationwide clinical database with the purpose of improving the monitoring and quality of both primary and revision knee ligament reconstructions in Denmark. All primary and revision anterior and posterior cruciate ligament reconstructions as well as collateral ligament and multiligament reconstructions are recorded. Main variables include sex, age, cause of injury, objective ligament instability, and surgical data, such as affected ligament, graft- and implant choice, operation technique among other things. The operating surgeon prospectively collects the data. Hence, detailed preoperative, intraoperative, and 1-year follow-up data are recorded by the operating surgeon using a standardized form and a secured Internet portal. The number of procedures registered in the database each year is ~2,500 and the first 9 years, in total, 22,775 procedures have been registered. Since the beginning of the database multiple papers have been published in international peer-reviewed journals, improving the knowledge of patients treated with knee ligament reconstruction surgery. This paper reviews the content, organization, and published research from the Danish Knee Ligament Reconstruction Registry. Keywords: ligament reconstruction, anterior cruciate ligament, operation technique, database, graft choice, femoral tunnel drilling, patient-reported outcome measure

  10. Knee Osteoarthritis Affects the Distribution of Joint Moments During Gait

    Science.gov (United States)

    Zeni, Joseph A; Higginson, Jill S.

    2010-01-01

    Alterations in lower extremity kinetics have been shown to exist in persons with knee osteoarthritis (OA), however few investigations have examined how the intersegmental coordination of the lower extremity kinetic chain varies in the presence of knee joint pathology. The objective of this study was to evaluate the how knee OA and walking speed affect total support moment and individual joint contributions to the total support moment. Fifteen healthy subjects and 30 persons with knee OA participated in 3D walking analysis at constrained (1.0 m/s), self-selected and fastest tolerable walking speeds. Individual joint contributions to total support moment were analyzed using separate ANOVAs with one repeated measure (walking speed). Linear regression analysis was used to evaluate the relationship between walking speed and joint contribution. Persons with knee OA reduced the contribution of the knee joint when walking at constrained (p=0.04) and self-selected walking speeds (p=0.009). There was a significant increase in the ankle contribution and a significant decrease in the hip contribution when walking speed was increased (Pknee OA is not responsible for the reduction in knee joint moments, rather this change is likely due to alterations in the neuromuscular strategy of the lower extremity kinetic chain in response to joint pain or muscle weakness. PMID:20510618

  11. Rehabilitation after ACL Injury: A Fluoroscopic Study on the Effects of Type of Exercise on the Knee Sagittal Plane Arthrokinematics

    Directory of Open Access Journals (Sweden)

    Sadegh Norouzi

    2013-01-01

    Full Text Available A safe rehabilitation exercise for anterior cruciate ligament (ACL injuries needs to be compatible with the normal knee arthrokinematics to avoid abnormal loading on the joint structures. The objective of this study was to measure the amount of the anterior tibial translation (ATT of the ACL-deficient knees during selective open and closed kinetic chain exercises. The intact and injured knees of fourteen male subjects with unilateral ACL injury were imaged using uniplanar fluoroscopy, while the subjects performed forward lunge and unloaded/loaded open kinetic knee extension exercises. The ATTs were measured from fluoroscopic images, as the distance between the tibial and femoral reference points, at seven knee flexion angles, from 0° to 90°. No significant differences were found between the ATTs of the ACL-deficient and intact knees at all flexion angles during forward lunge and unloaded open kinetic knee extension (. During loaded open kinetic knee extension, however, the ATTs of the ACL deficient knees were significantly larger than those of the intact knees at 0° (. It was suggested that the forward lunge, as a weight-bearing closed kinetic chain exercise, provides a safer approach for developing muscle strength and functional stability in rehabilitation program of ACL-deficient knees, in comparison with open kinetic knee extension exercise.

  12. Rehabilitation after ACL Injury: A Fluoroscopic Study on the Effects of Type of Exercise on the Knee Sagittal Plane Arthrokinematics

    Science.gov (United States)

    Norouzi, Sadegh; Esfandiarpour, Fateme; Shakourirad, Ali; Salehi, Reza; Akbar, Mohammad; Farahmand, Farzam

    2013-01-01

    A safe rehabilitation exercise for anterior cruciate ligament (ACL) injuries needs to be compatible with the normal knee arthrokinematics to avoid abnormal loading on the joint structures. The objective of this study was to measure the amount of the anterior tibial translation (ATT) of the ACL-deficient knees during selective open and closed kinetic chain exercises. The intact and injured knees of fourteen male subjects with unilateral ACL injury were imaged using uniplanar fluoroscopy, while the subjects performed forward lunge and unloaded/loaded open kinetic knee extension exercises. The ATTs were measured from fluoroscopic images, as the distance between the tibial and femoral reference points, at seven knee flexion angles, from 0° to 90°. No significant differences were found between the ATTs of the ACL-deficient and intact knees at all flexion angles during forward lunge and unloaded open kinetic knee extension (P < 0.05). During loaded open kinetic knee extension, however, the ATTs of the ACL deficient knees were significantly larger than those of the intact knees at 0° (P = 0.002) and 15° (P = 0.012). It was suggested that the forward lunge, as a weight-bearing closed kinetic chain exercise, provides a safer approach for developing muscle strength and functional stability in rehabilitation program of ACL-deficient knees, in comparison with open kinetic knee extension exercise. PMID:24066288

  13. Peak torque and knee kinematics during gait after eccentric isokinetic training of quadriceps in healthy subjects O pico de torque e a cinemática do joelho durante a marcha após treino isocinético excêntrico do quadríceps em sujeitos saudáveis

    Directory of Open Access Journals (Sweden)

    PR Poletto

    2008-08-01

    Full Text Available OBJECTIVE: To evaluate the effects of eccentric isokinetic training on knee range of motion (ROM of healthy subjects. METHODS: The knee extensor and flexor isokinetic peak torques and ROM of flexion/extension and varus/valgus knee movements during gait of 18 healthy men (21.7±2.2 years; 1.73±0.10m; 68.7±9.4kg; body mass index: 22.6±2kg/m² were analyzed, before and after six weeks of bilateral eccentric isokinetic training of the knee extensors at 30º/s. RESULTS: The knee extensor torque increased in both limbs (right, from 229±54 to 304±53Nm; pOBJETIVO: Avaliar os efeitos do treino isocinético excêntrico sobre a amplitude de movimento (ADM do joelho em sujeitos saudáveis. MÉTODOS: Foram analisados os picos de torque isocinético dos extensores e flexores do joelho e a ADM de flexo/extensão e valgo/varo, durante a marcha, de 18 homens saudáveis (21,7±2,2 anos; 1,73±0,10m; 68,7±9,4kg; índice de massa corpórea: 22,6±2kg/m² antes e após seis semanas de treino isocinético excêntrico bilateral dos extensores do joelho a 30º/s. RESULTADOS: O torque extensor do joelho aumentou em ambos os membros, direito (de 229±54 para 304±53Nm; p<0,01 e esquerdo (de 228±59 para 311±63Nm; p<0,01 sem diferença de ganho de torque entre eles. O pico de torque flexor aumentou (de 114±30 para 123±22Nm; p<0,05, mas a razão isquiotibiais/quadríceps (I/Q diminuiu (de 0,5±0,08 para 0,39±0,07; p<0,01 após o treino. Não houve diferença para os movimentos de flexo/extensão e valgo/varo após o treino, exceto uma pequena mudança (4° no valgo para o joelho esquerdo. CONCLUSÕES: O treino isocinético excêntrico dos extensores do joelho aumentou o torque extensor e diminuiu a razão I/Q, entretanto o efeito sobre o padrão da marcha parece desprezível em sujeitos saudáveis. Um treino associado dos flexores, complementar ao treino dos extensores parece ser necessário para o equilíbrio entre agonistas e antagonistas do joelho.

  14. Assessment of functional knee bracing: an in vivo three-dimensional kinematic analysis of the anterior cruciate deficient knee.

    Science.gov (United States)

    Ramsey, D K; Lamontagne, M; Wretenberg, P F; Valentin, A; Engström, B; Németh, G

    2001-01-01

    To describe three-dimensional tibial and femoral movements in vivo and examine the effect of a brace on knee kinematics during moderate to intense activity. Skeletal kinematics of anterior cruciate ligament deficient knees was measured with and without braces during moderate to intense activity. Invasive markers implanted into the tibia and femur are the most accurate means to directly measure skeletal motion and may provide a more sensitive measure of the differences between brace conditions. Steinmann traction pins were implanted into the femur and tibia of four subjects having a partial or complete anterior cruciate ligament rupture. Non-braced and braced conditions were randomly assigned and subjects jumped for maximal horizontal distance to sufficiently stress the anterior cruciate ligament. Intra-subject peak vertical force and posterior shear force were generally consistent between conditions. Intra-subject kinematics was repeatable but linear displacements between brace conditions were small. Differences in angular and linear skeletal motion were observed across subjects. Bracing the anterior cruciate ligament deficient knee resulted in only minor kinematic changes in tibiofemoral joint motion. In this study, no consistent reductions in anterior tibial translations were observed as a function of the knee brace tested. Relevance. Investigations have reported that knee braces fail when high loads are encountered or when load is applied in an unpredictable manner. Questions remain regarding tibiofemoral joint motion, in particular linear displacements. The pin technique is a means for direct skeletal measurement and may provide a more sensitive measure of the differences between brace conditions.

  15. Pain perception in knees with circumscribed cartilage lesions is associated with intra-articular IGF-1 expression.

    Science.gov (United States)

    Schmal, Hagen; Niemeyer, Philipp; Südkamp, Norbert P; Gerlach, Ulrike; Dovi-Akue, David; Mehlhorn, Alexander T

    2011-09-01

    Circumscribed cartilage defects are considered as prearthritic lesions and lead to differential intra-articular cytokine expression. Mechanisms of associated pain development and influence of smoking behavior are not yet fully understood in humans. This study aimed to reveal relations between synovial cytokine levels in knees with circumscribed cartilage defects and pain sensation. Descriptive laboratory study. In a clinical trial, knee lavage fluids of 42 patients with circumscribed cartilage lesions treated by either microfracturing (n = 19) or by autologous chondrocyte implantation (n = 23) and fluids of 5 healthy control individuals were prospectively collected. Preoperative knee pain was evaluated according to frequency and strength; subjective knee function was assessed using a visual analog scale and the International Knee Documentation Committee (IKDC) score. Synovial concentrations of aggrecan, insulin-like growth factor (IGF)-I, basic fibroblast growth factor (bFGF), interleukin (IL)-1β, bone morphogenetic protein (BMP)-2, and BMP-7 were determined by enzyme-linked immunosorbent assay. Pain strength showed a highly significant association with intra-articular IGF-1 levels (ρ = .48, P < .01), but no correlation with synovial concentrations of aggrecan, bFGF, IL-1β, BMP-2, and BMP-7. Although pain strength and frequency demonstrated a statistically significant relationship, no substantial association between pain frequency and any of the examined cytokine levels was found. Intra-articular IGF-1 concentrations significantly correlated with the area of cartilage damage (ρ = .35, P < .02); the other investigated cytokines failed to show this association. Neither of the determined intra-articular mediators demonstrated statistically significant correlations with subjective knee function or IKDC score. Only intra-articular concentrations of IGF-1 and BMP-2 statistically significantly correlated with age; total protein content was negatively associated with

  16. CURBSIDE CONSULTATION IN KNEE ARTHROPLASTY: 49 CLINICAL QUESTIONS

    Directory of Open Access Journals (Sweden)

    Craig J. Della Vale

    2008-12-01

    Full Text Available A user- friendly reference for decision making in complicated cases of knee arthroplasty desingned in a question and answers format composed of articles containing current concepts and preferences of experts in total knee replacement surgery, enhanced by several images, diagrams and references and written in the form of a casual advice by Craig J. Della Vale, MD. and his collaborators. PURPOSE By this practical reference of knee arthroplasty, the editor and the contributors have aimed providing straightforward and brief answers, evidence-based advices, their preference and opinions containing current concepts for unanswered questions about complicated cases in total knee replacement surgery which are often controversial and not addressed clearly in traditional knee arthroplasty references. FEATURES There are 49 subjects each written by a different expert designed in 4 sections in a question and answers format including several images and diagrams and also essential references at the end of each article. In the first section preoperative questions is subjected including indications, unicompartmental osteoarthritis of the knee, patient with vascular problems, donating blood, bilateral arthroplasty, patellar resurfacing, range of motion, bearing surface, contraindications, teaching class for patients prior surgery. The second section is about intraoperative questions including skin incision, patella femoral maltracking, femoral component rotation, tibial component rotation, lateral release, femoral component sizing, flexion instability, varus deformity, and valgus deformity, tightness in extension, iatrogenic MCL injury, antibiotic-loaded cement, and perioperative pain. The third section subjects postoperative questions including wound drainage, preventing tromboembolic events, vascular complications, foot drop, manipulation under anesthesia, patella fractures, supracondylar femur fractures, acute extensor mechanism disruptions. In the fourth

  17. The effect of medial meniscal horn injury on knee stability.

    Science.gov (United States)

    Chen, Lianxu; Linde-Rosen, Monica; Hwang, Sun Chul; Zhou, Jingbin; Xie, Qiang; Smolinski, Patrick; Fu, Freddie H

    2015-01-01

    This study investigated the effect of damage of the posterior and anterior horns of the medial meniscus on knee stability. Twenty fresh-frozen porcine knees were divided into two groups (anterior horn and posterior horn injury). Each group was tested in three states: intact medial meniscus, posterior or anterior horn of medial meniscus resection and total medial meniscectomy. A robotic testing system was used to test anterior tibial translation (ATT) at 30° (full extension), 60° and 90° of knee flexion with an external anterior tibial load of 89 N, internal rotation (IR) and external rotation (ER) at 30° and 60° of knee flexion under a 4 N m tibial rotation torque. In response to an IR torque, there was a significant difference between the state of intact medial meniscus and anterior and posterior horn damage, except for anterior horn resection at 60° of knee flexion. In response to an ER torque, there were no significant differences between the state of intact meniscus and horn damage except for anterior horn resection at 30° of knee flexion. Meniscal damage had no significant effect on ATT. The results indicated that the posterior horn was more important in controlling the IR stability than the anterior horn with knee flexion, and the anterior horn was more important in controlling the ER stability than the posterior horn at full knee extension in the anterior cruciate ligament-intact knee. These findings further the understanding of the mechanisms, the prevention of injuries and rehabilitation of meniscal horn injury in clinical practice.

  18. Arthroscopic surgery for degenerative knee

    DEFF Research Database (Denmark)

    Thorlund, Jonas Bloch; 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...

  19. Bioinspired Knee Joint for a Power-Assist Suit

    Directory of Open Access Journals (Sweden)

    Takehito Kikuchi

    2016-01-01

    Full Text Available Movement of the knee joint of a human includes rolling and sliding. There also exist rotations in the frontal and horizontal planes. To assist the standing movement of a human, we developed a bioinspired knee joint and torque adjustment mechanism. We evaluated the motion, torque characteristics, and stress of the developed mechanism. This joint allows deep flexion of the knee with small resistance for both the user and the device. In addition, in spite of 33% error in deep flexion, the measured torque over less than 120 degrees fits the designed torque curve. We conducted evaluation tests for a human subject. The electromyogram (EMG of musculus rectus femoris was measured during standing with or without the assistance. The result shows 30% and 63% reduction with the assistance from 100-degree and 80-degree knee angles, respectively. In addition, the proposed device reduced up to 80% of stress in the frontal plane during standing.

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

    Science.gov (United States)

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

    2014-12-27

    Chronic knee joint pain is one of the most frequent complaints which is seen in the outpatient clinic in our medical institute. In previous studies we have reported the benefits of low level laser therapy (LLLT) for chronic pain in the shoulder joints, elbow, hand, finger and the lower back. The present study is a report on the effects of LLLT for chronic knee joint pain. Over the past 5 years, 35 subjects visited the outpatient clinic with complaints of chronic knee joint pain caused by the knee osteoarthritis-induced degenerative meniscal tear. They received low level laser therapy. A 1000 mW semi-conductor laser device was used to deliver 20.1 J/cm(2) per point in continuous wave at 830nm, and four points were irradiated per session (1 treatment) twice a week for 4 weeks. A visual analogue scale (VAS) was used to determine the effects of LLLT for the chronic pain and after the end of the treatment regimen a significant improvement was observed (p<0.001). After treatment, no significant differences were observed in the knee joint range of motion. Discussions with the patients revealed that it was important for them to learn how to avoid postures that would cause them knee pain in everyday life in order to have continuous benefits from the treatment. The present study demonstrated that 830 nm LLLT was an effective form of treatment for chronic knee pain caused by knee osteoarthritis. Patients were advised to undertake training involving gentle flexion and extension of the knee.

  1. [Clinical and gait analytical investigation of valgus knee bracing in therapy for medial degenerative joint disease of the knee].

    Science.gov (United States)

    Müller-Rath, R; Cho, H Y; Siebert, C H; Miltner, O

    2011-04-01

    pathological in all subjects. Clinically, in 4 of 5 subjective and objective scores (Insall score, Lequesne score, Tegner score, WOMAC, and VAS for pain) a statistically significant improvement of the symptoms, joint function and activity level thanks to the application of the corrective valgus knee brace was documented after 16 weeks. The knee bandage also led to an improvement, but only in 2 scores (Insall score, Tegner score). No changes were documented for the control group. The gait analysis of the orthosis group revealed an improvement in the extension and flexion angles (sagittal plane) and the knee rotation angles (horizontal plane) when compared to a control group. The correction obtained by this knee orthosis, which places a valgus stress on the medially osteoarthritic knee, is an effective addition to the conservative treatment protocols and is superior to the isolated use of an elastic knee bandage. Further research is warranted to evaluate the longevity of such treatment and to further improve the technique of gait analysis by the development of quantitative parameters. © Georg Thieme Verlag KG Stuttgart · New York.

  2. Osteoarthritis of the Knee

    Directory of Open Access Journals (Sweden)

    Jun Iwamoto

    2011-01-01

    Full Text Available The objective of the present study was to identify factors correlated with the serum leptin concentration in women with knee OA. Fifty postmenopausal Japanese women with knee OA (age: 50–88 years were recruited in our outpatient clinic. Plain radiographs of the knee were taken, and urine and blood samples were collected. Dual-energy X-ray absorptiometry (DXA scanning was performed for the whole body and lumbar spine, and factors correlated with the serum leptin concentration were identified. A simple linear regression analysis showed that body weight, body mass index, whole-body bone mineral density (BMD, total fat mass, and total fat percentage, but not age, height, lumbar spine BMD, lean body mass, serum and urinary bone turnover markers, or the radiographic grade of knee OA, were significantly correlated with the serum leptin concentration. A multiple regression analysis showed that among these factors, only body weight and total fat mass exhibited a significant positive correlation with the serum leptin concentration. These results suggest that the serum leptin concentration might be related to increases in body weight and total fat mass, but not to BMD or bone turnover markers, in postmenopausal women with OA.

  3. Knee Osteoarthritis: A Primer

    Science.gov (United States)

    Lespasio, Michelle J; Piuzzi, Nicolas S; Husni, M Elaine; Muschler, George F; Guarino, AJ; Mont, Michael A

    2017-01-01

    The purpose of this article is to provide a synopsis of the current medical understanding of knee osteoarthritis. We describe the prevalence, causes and associated risk factors, symptoms, diagnosis and classification, and treatment options. A quiz serves to assist readers in their understanding of the presented material. PMID:29035179

  4. Knee CT scan

    Science.gov (United States)

    ... be used to detect: Abscess or infection Broken bone Examine fractures and pattern of fractures The cause of pain or other problems in the knee joint (usually when MRI can't be done) Masses and tumors, including cancer Healing problems or scar tissue following ...

  5. Analysis of biomechanical effectiveness of valgus-inducing knee brace for osteoarthritis of knee.

    Science.gov (United States)

    Schmalz, Thomas; Knopf, Elmar; Drewitz, Heiko; Blumentritt, Siegmar

    2010-01-01

    The biomechanical effectiveness of a valgus-inducing knee brace was investigated for 16 patients with knee osteoarthritis (mean +/- standard deviation age 56 +/- 10 yr, height 172 +/- 9 cm, mass 83 +/- 7 kg, body mass index 27.6 +/- 4.5 kg/m(2)). At the time of investigation, all subjects had been wearing the brace for at least 4 weeks. In addition to conducting standard gait analysis, we calculated the valgus moment generated by the brace by using a novel system that measured the actual deformation of the brace during stance phase and determined the reaction force created by the brace on the leg. The mean maximum value of the orthotic valgus moment was 0.053 Nm/kg, which represents approximately 10% of the external genu varus moment without the brace. This finding may explain the pain relief reported by patients using such braces in clinical studies. Use of the tested brace also decreased the magnitude of gait asymmetry between the braced and contralateral legs during walking (horizontal ground reaction force, external knee flexion moment), presumably because the subjects' need to walk abnormally to shield the knee from pain was reduced.

  6. 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.

  7. Vitamin K deficiency is associated with incident knee osteoarthritis.

    Science.gov (United States)

    Misra, Devyani; Booth, Sarah L; Tolstykh, Irina; Felson, David T; Nevitt, Michael C; Lewis, Cora E; Torner, James; Neogi, Tuhina

    2013-03-01

    Osteoarthritis is the most common form of arthritis, with knee osteoarthritis being the leading cause of lower extremity disability among older adults in the US. There are no treatments available to prevent the structural pathology of osteoarthritis. Because of vitamin K's role in regulating skeletal mineralization, it has potential to be a preventative option for osteoarthritis. We therefore examined the relation of vitamin K to new-onset radiographic knee osteoarthritis and early osteoarthritis changes on magnetic resonance imaging (MRI). Subjects from the Multicenter Osteoarthritis (MOST) Study had knee radiographs and MRI scans obtained at baseline and 30 months later, and plasma phylloquinone (vitamin K) measured at baseline. We examined the relationship of subclinical vitamin K deficiency to incident radiographic knee osteoarthritis and MRI-based cartilage lesions and osteophytes, respectively, using log binomial regression with generalized estimating equations, adjusting for potential confounders. Among 1180 participants (62% women, mean age 62±8 years, mean body mass index 30.1±5.1 kg/m(2)), subclinical vitamin K deficiency was associated with incident radiographic knee osteoarthritis (risk ratio [RR] 1.56; 95% confidence interval [CI], 1.08-2.25) and cartilage lesions (RR 2.39; 95% CI, 1.05-5.40) compared with no deficiency, but not with osteophytes (RR 2.35; 95% CI, 0.54-10.13). Subclinically vitamin K-deficient subjects were more likely to develop osteoarthritis in one or both knees than neither knee (RR 1.33; 95% CI, 1.01-1.75 and RR 2.12; 95% CI, 1.06-4.24, respectively). In the first such longitudinal study, subclinical vitamin K deficiency was associated with increased risk of developing radiographic knee osteoarthritis and MRI-based cartilage lesions. Further study of vitamin K is warranted given its therapeutic/prophylactic potential for osteoarthritis. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. 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 and pharmacolog...

  9. THE COMBINED EFFECTIVENESS OF GLENOHUMERAL END-RANGE MOBILIZATION AND CONTRACT-RELAX TECHNIQUE FOR GLENOHUMERAL INTERNAL ROTATORS IN SUBJECTS WITH ADHESIVE CAPSULITIS

    Directory of Open Access Journals (Sweden)

    Abhijit Kalita

    2015-10-01

    Full Text Available Background: Frozen shoulder is an insidious condition that begins with pain and gradual restriction of movement in the shoulder region. There are various methods of treating frozen shoulder (both surgical and non-surgical.Among the non-surgical methods there is no specific method accepted universally. Purpose of this study is to determine the combined effectiveness of Glenohumeral End-Range Mobilization and Contract-Relax technique for glenohumeral internal rotators in patients with adhesive capsulitis. Methods: 60 frozen shoulder patients randomized 30 subjects into each experimental and control group. Group A (experimental group received Glenohumeral End-Range Mobilization, Contract-Relax Technique for glenohumeral internal rotators and Shoulder Pendular Exercises 2 times a week for a period of 4 weeks (8 sessions.Group B (control group received Shoulder Pendular exercises 2 times a week for a period of 4 weeks (8 sessions. Outcome measures included are VAS, SPADI and goniometry for assessing pain, functional ability and ROM for the shoulder joint. Results: The average improvement of VAS for Group A and Group B were 4.5 and 3 respectively using median. The U-value was 176, which is statistically highly significant (p value = 0.000.The average improvement of Shoulder Pain and Disability Index for Group A and group B were 56.9333 and 10.3667 respectively using mean and Standard Deviation. The t-value was 35.91181, which is statistically highly significant (p value = 0.000. Conclusion: The results indicated that both Group A and Group B had significant improvement in the scores of VAS, SPADI and GONIOMETRY scores at the 4th week when compared to base line values, but when comparing the end results of group A and group B it has been found out that group A intervention is more effective then Group B in treating the internal rotators of patients with adhesive capsulitis

  10. Radial artery pulse pressure variation correlates with brachial artery peak velocity variation in ventilated subjects when measured by internal medicine residents using hand-carried ultrasound devices.

    Science.gov (United States)

    Brennan, J Matthew; Blair, John E A; Hampole, Chetan; Goonewardena, Sascha; Vasaiwala, Samip; Shah, Dipak; Spencer, Kirk T; Schmidt, Gregory A

    2007-05-01

    Rapid prediction of the effect of volume expansion is crucial in unstable patients receiving mechanical ventilation. Both radial artery pulse pressure variation (DeltaPP) and change of aortic blood flow peak velocity are accurate predictors but may be impractical point-of-care tools. We sought to determine whether respiratory changes in the brachial artery blood flow velocity (DeltaVpeak-BA) as measured by internal medicine residents using a hand-carried ultrasound (HCU) device could provide an accurate corollary to DeltaPP in patients receiving mechanical ventilation. Thirty patients passively receiving volume-control ventilation with preexisting radial artery catheters were enrolled. The brachial artery Doppler signal was recorded and analyzed by blinded internal medicine residents using a HCU device. Simultaneous radial artery pulse wave and central venous pressure recordings (when available) were analyzed by a blinded critical care physician. A Doppler signal was obtained in all 30 subjects. The DeltaVpeak-BA correlated well with DeltaPP (r = 0.84) with excellent agreement (weighted kappa, 0.82) and limited intraobserver variability (2.8 +/- 2.8%) [mean +/- SD]. A DeltaVpeak-BA cutoff of 16% was highly predictive of DeltaPP > or = 13% (sensitivity, 91%; specificity, 95%). A poor correlation existed between the CVP and both DeltaVpeak-BA (r = - 0.21) and DeltaPP (r = - 0.16). The HCU Doppler assessment of the DeltaVpeak-BA as performed by internal medicine residents is a rapid, noninvasive bedside correlate to DeltaPP, and a DeltaVpeak-BA cutoff of 16% may prove useful as a point-of-care tool for the prediction of volume responsiveness in patients receiving mechanical ventilation.

  11. Muscle power is an independent determinant of pain and quality of life in knee osteoarthritis

    Science.gov (United States)

    OBJECTIVE: This study examined the relationships between leg muscle strength, power, and perceived disease severity in subjects with knee osteoarthritis (OA) in order to determine whether dynamic leg extensor muscle power would be associated with pain and quality of life in knee OA. METHODS: Baseli...

  12. 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...

  13. 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...

  14. 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...

  15. Quadriceps rate of force development affects gait and function in people with knee osteoarthritis.

    Science.gov (United States)

    Winters, Joshua D; Rudolph, Katherine S

    2014-02-01

    Quadriceps weakness exists in people with knee osteoarthritis (OA), but other muscle factors like rate of force development (RFD) may also be affected by knee OA. The purpose of this study was to determine if people with knee OA have deficits in quadriceps RFD, determine if quadriceps RFD would improve predicting knee joint power absorption and generation during free and fast walking, and determine if RFD would improve predicting functional outcomes. 26 subjects with knee OA and 23 healthy control subjects performed maximal voluntary isometric strength (MVIC) and RFD measures of the quadriceps. Subjects also underwent a 3-D motion analysis of both self-selected free and self-selected fast walking speeds. Joint kinetics were calculated from inverse dynamics. RFD was not different by group (p = 0.763), however, the OA subjects generated the highest peak RFD at a lower % MVIC (p = 0.008). Controls walked significantly faster at both free and fast walking speeds (p = 0.001, p = 0.029). Knee angles at heel strike and peak knee extension were lower (p = 0.004, p = 0.027) in the OA group. During fast walking knee power generation was higher in controls (p = 0.028). MVIC and force of highest peak RFD predicted KOOS-ADL score in the OA subjects, but only MVIC predicted stair climbing time. The submaximal force at which peak RFD occurs plays a significant role in knee joint power as well as functional measures in the OA subjects, providing further evidence that factors other than maximal strength are also important in people with knee OA.

  16. Gait and neuromuscular adaptations after using a feedback-based gait monitoring knee brace.

    Science.gov (United States)

    Riskowski, Jody L

    2010-06-01

    The purpose of this study was to evaluate the gait and neuromuscular effects of a feedback-based gait monitoring knee brace. The aim of this paper was to explore how training with this knee brace affected the gait pattern utilized, rate of loading (ROL), and proprioceptive acuity. Fifteen healthy women wore this knee brace that provided audible feedback on gait kinematics for a 30-min training period. We performed pre- and post-gait analyses and proprioceptive acuity assessments to determine gait learning and adaptation with this training. Post-training significant changes were seen in the knee angle prior to and at initial contact and peak knee extensor, flexor, and adductor moments, which ultimately led to a reduced ROL experienced. Subjects also had improved proprioceptive acuity post-training. Our results indicate that using a feedback-based gait monitoring knee brace can change the gait pattern by increasing the knee flexion angle during the swing to stance transition. Though there was an approximate 25% decrease in the ROL experienced, there was also an increase in the knee adductor moment. Future long-term studies are needed to further explore the positive and negative effects of feedback-based gait monitoring knee brace on individuals with a compromised knee joint, such as those post-anterior cruciate ligament injury. Copyright 2010 Elsevier B.V. All rights reserved.

  17. The Relationship between Knee Joint Loading Rate During Walking and Degenerative Changes on Magnetic Resonance Imaging

    Science.gov (United States)

    Morgenroth, David C.; Medverd, Jonathan R.; Seyedali, Mahyo; Czerniecki, Joseph M.

    2014-01-01

    Background While animal study and cadaveric study have demonstrated an association between knee joint loading rate and joint degeneration, the relationship between knee joint loading rate during walking and osteoarthritis has not yet been sufficiently studied in humans. Methods Twenty-eight participants (14 transfemoral amputees and 14 age and body mass matched controls) underwent knee MRI with subsequent assessment using the semiquantitative Whole-Organ Magnetic Resonance Image Score. Each subject also underwent gait analysis in order to determine knee adduction moment loading rate, peak, and impulse and an exploratory measure, knee adduction moment rate*magnitude. Findings Significant correlations were found between medial tibiofemoral joint degeneration and knee adduction moment peak (slope = 0.42 [SE 0.20]; P=.037), loading rate (slope = 12.3 [SE 3.2]; P=.0004), and rate*magnitude (slope = 437 [SE 100]; Pknee semiquantitative MRI score and knee adduction moment loading rate and rate*magnitude continued to be significant even after adjusting for peak moment (Pknee semiquantitative MRI score and peak moment was no longer significant after adjusting for either loading rate or rate*magnitude (P>.2 in both cases). Interpretation This study suggests an independent relationship between knee adduction moment loading rate and medial tibiofemoral joint degeneration. Our results support the hypothesis that rate of loading, represented by the knee adduction moment loading rate, is strongly associated with medial tibiofemoral joint degeneration independent of knee adduction moment peak and impulse. PMID:24820134

  18. A long term clinical outcome of the Medial Pivot Knee Arthroplasty System.

    Science.gov (United States)

    Macheras, George A; Galanakos, Spyridon P; Lepetsos, Panagiotis; Anastasopoulos, Panagiotis P; Papadakis, Stamatios A

    2017-03-01

    The ideal total knee arthroplasty (TKA) should provide maximum range of motion and functional stability for all desired daily activities and, if possible, to replicate normal knee kinematics and function. The ADVANCE® Medial Pivot (AMP) Knee System was designed with a highly congruent medial compartment and a less conforming lateral compartment to more closely mimic the kinematics of the normal knee and to offer more stability through out of range of motion (ROM). The purpose of this study was to evaluate the long-term clinical and radiographic outcomes of this TKA system. Three hundred and twenty-five (325) patients (347 knees) with knee osteoarthritis underwent a TKA using the AMP prosthesis in our Department. For evaluation, objective and subjective clinical rating systems along with radiograph series were used. The average follow-up was 15.2years. All patients showed a statistically significant improvement (p<0.0005) in the Knee Society clinical rating system, Western Ontario and McMaster Universities Osteoarthritis Index questionnaire, SF-12® questionnaire, and Oxford knee score. The majority of patients (94%) were able to perform age-appropriate activities with a mean knee flexion of 120° (range, 105°-135°) at final follow-up. Survival analysis showed a cumulative success rate of 98.8% at 17years. The obtained results demonstrate excellent long-term clinical outcome for this knee design. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  19. Differences between measured and resultant joint moments during voluntary and artificially elicited isometric knee extension contractions.

    Science.gov (United States)

    Arampatzis, Adamantios; Karamanidis, Kiros; De Monte, Gianpiero; Stafilidis, Savvas; Morey-Klapsing, Gaspar; Brüggemann, Gert-Peter

    2004-03-01

    Examine two hypotheses: (a) during isometric knee extension contractions the moment measured at the dynamometer is different from the resultant moment in the same plane around the knee joint and (b) during isometric contractions, at the same given resultant moment the knee angle while loading is different from the knee angle while unloading. Comparative study in which the geometrical and the kinetic differences between joint and dynamometer were determined. It is usually assumed that the moment measured by the dynamometer is equivalent to the resultant joint moment. The non-rigidity of the dynamometer-leg system can influence the equivalence of these two moments. Twenty seven subjects performed isometric maximal knee extension contractions and contractions induced by electrostimulation on a dynamometer. The kinematics of the leg were recorded using 8 cameras (120 Hz). The resultant moment at the knee joint and the moment measured by the dynamometer are different. During a knee extension effort the knee angle changes significantly. At identical resultant knee joint moments the knee angles are different when comparing the loading and the unloading phases. The differences between the measured and the resultant joint moments might influence the estimation of parameters as: muscle forces, moment-angle relationship and strain and hysteresis of tendons and aponeuroses. Torque dynamometers have been often used to estimate muscle forces, to examine neuromuscular processes and to determine the mechanical properties of tendons and aponeuroses.

  20. [Effect of Chinese massage (Tui Na) on isokinetic muscle strength in patients with knee osteoarthritis].

    Science.gov (United States)

    Zhu, Qingguang; Li, Jianhua; Fang, Min; Gong, Li; Sun, Wuquan; Zhou, Nan

    2016-06-01

    Chinese massage (Tui Na) is one of the most popular Traditional Chinese Medicine remedies for knee osteoarthritis (OA). Several studies have subjectively evaluated the effect of Chinese massage on knee OA through self-assessment questionnaires; however, very few studies have objectively assessed the effect by measuring knee muscle strength. The purpose of this study was to assess the efficacy of Chinese massage in improving knee extensor and flexor muscle strength in patients with knee OA. Thirty patients with knee OA received Chinese massage therapy three times per week for 2 weeks. Patients completed pre- and post-treatment Visual Analogue Scale (VAS) pain questionnaires, and pre- and post-treatment knee muscle strength was evaluated using the Biodex Multi-Joint System 3. Isokinetic muscle strength measurements were performed at 60 degrees/s and 180 degrees/s. The peak torque (PT), peak torque/body weight(PT/BW), total work (TW), average power (AP), hamstring/quadriceps (H/Q), and range of motion (ROM) values were recorded separately for flexors and extensors. Chinese massage therapy significantly improved knee pain as assessed by the VAS in patients with knee OA (P massage therapy decreased pain and may improve extensor muscle strength in patients with knee OA, but does not appear to improve ROM.

  1. Balance control and knee osteoarthritis severity.

    Science.gov (United States)

    Kim, Hee-Sang; Yun, Dong Hwan; Yoo, Seung Don; Kim, Dong Hwan; Jeong, Yong Seol; Yun, Jee-Sang; Hwang, Dae Gyu; Jung, Pil Kyo; Choi, Seong He

    2011-10-01

    To investigate balance control according to the severity of knee osteoarthritis (OA) using clinical tests and Tetra-ataxiometric posturography (Tetrax®). A total 80 patients with primary knee OA classified according to American College of Rheumatology criteria, and 40 age-matched controls were enrolled in this study. Of those with OA, 39 patients had mild OA (Kellgren-Lawrence [KL] grade 1, 2) and the other 41 had moderate to severe OA (KL grade 3, 4). The postural control capabilities of the subjects were assessed using the timed up and go test (TUG), Berg balance scale (BBS), and Tetrax®, which utilizes two paired force plates to measure vertical pressure fluctuations over both heels and forefeet. The subjects were checked for their stability index (ST), Fourier index, weight distribution index (WDI), and synchronization index (SI) in eight positions using Tetrax®. Patients with moderate to severe OA exhibited significantly higher stability indices in all positions than patients with mild OA. The Fourier index was also higher in patients with moderate to severe OA than in patients with mild OA. However, the weight distribution index and synchronization of both heels and forefeet were not significantly different in the three groups. These findings suggest that patients with moderate to severe OA have more deficits in balance control than those with mild disease. Therefore, evaluation of balance control and education aimed at preventing falls would be useful to patients with knee OA.

  2. Effects of the abdominal drawing-in maneuver on muscle activity, pelvic motions, and knee flexion during active prone knee flexion in patients with lumbar extension rotation syndrome.

    Science.gov (United States)

    Park, Kyue-Nam; Cynn, Heon-Seock; Kwon, Oh-Yun; Lee, Won-Hwee; Ha, Sung-Min; Kim, Su-Jung; Weon, Jong-Hyuck

    2011-09-01

    To investigate the effects of performing an abdominal drawing-in maneuver (ADIM) during active prone knee flexion on the hamstrings and erector spinae muscle activity, the amounts of pelvic motion and knee flexion, and onset of pelvic movements. Comparative, repeated-measures study. University research laboratory. Men patients (N=18) with lumbar extension rotation syndrome. Subjects performed prone knee flexion in 2 conditions. To measure muscle activity, surface electromyogram (EMG) of both erector spinae and the medial and lateral hamstrings was performed. Kinematic data on the pelvic motion and knee flexion were measured using a 3-dimensional motion analysis system. Repeated 1-way analysis of variance was used for the statistical analysis. Significantly decreased electromyographic activity in the right and left erector spinae and significantly increased electromyographic activity in the medial and lateral hamstrings activity were shown during prone knee flexion in ADIM condition using the pressure biofeedback unit. In addition, the amounts of anterior pelvic tilt, pelvic rotation, knee flexion, and perceived pain decreased significantly during prone knee flexion in the ADIM condition compared with the same maneuver in the non-ADIM condition. The onset of anterior pelvic tilt and pelvic rotation occurred significantly earlier in the non-ADIM condition, compared with the ADIM condition. ADIM effectively increased activation of knee flexors, decreased activation of back extensors, and reduced the pelvic motions and low back pain during prone knee flexion in patients with lumbar extension rotation syndrome. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  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...... and pre- and postoperative knee alignment. Patients were asked to complete the FJS and OKS questionnaires. Of the 316 patients completing the survey 64 standard CR TKAs to 35 new generation CR TKAs and 121 standard CR TKAs to 68 mobile bearing TKAs were matched. The FJS and OKS scores of the three TKA...

  4. Is it possible to reduce the knee joint compression force during level walking with hiking poles?

    DEFF Research Database (Denmark)

    Jensen, S B; Henriksen, M; Aaboe, J

    2010-01-01

    estimated by using a biomechanical knee joint model. The results showed that the subjects were able to increase the pole force by 2.4 times the normal pole force. However, this did not lead to a reduction in the knee joint compressive force and we rejected our hypothesis. In conclusion, the use of poles......Walking with hiking poles has become a popular way of exercising. Walking with poles is advocated as a physical activity that significantly reduces the loading of the hip, knee and ankle joints. We have previously observed that pole walking does not lead to a reduction of the load on the knee joint....... However, it is unclear whether an increased force transmitted through the poles can reduce the load on the knee joint. Thus, the purpose of the present study was to investigate if an increased load transmitted through the arms to the poles could reduce the knee joint compression force during level walking...

  5. Gait characteristics and lower limb muscle strength in women with early and established knee osteoarthritis.

    Science.gov (United States)

    Baert, Isabel A C; Jonkers, Ilse; Staes, Filip; Luyten, Frank P; Truijen, Steven; Verschueren, Sabine M P

    2013-01-01

    Based on novel classification criteria using magnetic resonance imaging, a subpopulation of "early knee osteoarthritis patients" was clearly defined recently. This study assessed whether these early osteoarthritis patients already exhibit gait adaptations (knee joint loading in particular) and changes in muscle strength compared to control subjects and established knee osteoarthritis patients. Fourteen female patients with early knee joint degeneration, defined by magnetic resonance imaging (early osteoarthritis), 12 female patients with established osteoarthritis and 14 female control subjects participated. Specific gait parameters and lower limb muscle strength were analyzed and compared between groups. Within the osteoarthritis groups, association between muscle strength and dynamic knee joint loading was also evaluated. Early osteoarthritis patients presented no altered gait pattern, no significant increase in knee joint loading and no significant decrease in hamstring muscle strength compared to controls, while established osteoarthritis patients did. In contrast, early osteoarthritis patients experienced significant quadriceps weakness, comparable to established osteoarthritis patients. Within the osteoarthritis groups, muscle strength was not correlated with knee joint loading during gait. The results suggest that gait changes reflect mechanical overload and are most likely the consequence of structural degeneration in knee osteoarthritis. Quadriceps weakness might however contribute to the onset and progression of the disease. This study supports the relevance of classification of early osteoarthritis patients and assists in identifying their functional characteristics. This helps to understand the trajectory of disease onset and progression and further develop more targeted strategies for prevention and treatment of knee osteoarthritis. Copyright © 2012 Elsevier Ltd. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    AliReza Taheri

    2012-01-01

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

  7. Measurement of fatigue in knee flexor and extensor muscles.

    Science.gov (United States)

    Kawabata, Y; Senda, M; Oka, T; Yagata, Y; Takahara, Y; Nagashima, H; Inoue, H

    2000-04-01

    In order to examine fatigue of the knee flexor and extensor muscles and to investigate the characteristics of muscular fatigue in different sports, a Cybex machine was used to measure muscle fatigue and recovery during isokinetic knee flexion and extension. Eighteen baseball players, 12 soccer players and 13 marathon runners were studied. Each subject was tested in the sitting position and made to perform 50 consecutive right knee bends and stretches at maximum strength. This was done 3 times with an interval of 10 min between each series. The peak torque to body weight ratio and the fatigue rate were determined in each case. In all subjects, the peak torque to body weight ratio was higher for extensors than flexors. Over the 3 trials, the fatigue rate of extensors showed little change, while that of flexors had a tendency to increase. In each subject, knee extensors showed a high fatigue rate but a quick recovery, while knee flexors showed a low fatigue rate but a slow recovery. As the marathon runners had the smallest fatigue rates for both flexors and extensors, we concluded that marathon runners had more stamina than baseball players and soccer players.

  8. Changes in fatigue, multiplanar knee laxity, and landing biomechanics during intermittent exercise.

    Science.gov (United States)

    Shultz, Sandra J; Schmitz, Randy J; Cone, John R; Henson, Robert A; Montgomery, Melissa M; Pye, Michele L; Tritsch, Amanda J

    2015-05-01

    Knee laxity increases during exercise. However, no one, to our knowledge, has examined whether these increases contribute to higher-risk landing biomechanics during prolonged, fatiguing exercise. To examine associations between changes in fatigue (measured as sprint time [SPTIME]), multiplanar knee laxity (anterior-posterior [APLAX], varus-valgus [VVLAX] knee laxity, and internal-external rotation [IERLAX]) knee laxity and landing biomechanics during prolonged, intermittent exercise. Descriptive laboratory study. Laboratory and gymnasium. A total of 30 male (age = 20.3 ± 2.0 years, height = 1.79 ± 0.05 m, mass = 75.2 ± 7.2 kg) and 29 female (age = 20.5 ± 2.3 years, height = 1.67 ± 0.08 m, mass = 61.8 ± 9.0 kg) competitive athletes. A 90-minute intermittent exercise protocol (IEP) designed to simulate the physiologic and biomechanical demands of a soccer match. We measured SPTIME, APLAX, and landing biomechanics before and after warm-up, every 15 minutes during the IEP, and every 15 minutes for 1 hour after the IEP. We measured VVLAX and IERLAX before and after the warm-up, at 45 and 90 minutes during the IEP, and at 30 minutes after the IEP. We used hierarchical linear modeling to examine associations between exercise-related changes in SPTIME and knee laxity with exercise-related changes in landing biomechanics while controlling for initial (before warm-up) knee laxity. We found that SPTIME had a more global effect on landing biomechanics in women than in men, resulting in a more upright landing and a reduction in landing forces and out-of-plane motions about the knee. As APLAX increased with exercise, women increased their knee internal-rotation motion (P = .02), and men increased their hip-flexion motion and energy-absorption (P = .006) and knee-extensor loads (P = .04). As VVLAX and IERLAX increased, women went through greater knee-valgus motion and dorsiflexion and absorbed more energy at the knee (P ≤ .05), whereas men were positioned in greater hip

  9. Vitamin D supplementation in the management of knee osteoarthritis: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Cao Yuelong

    2012-08-01

    Full Text Available Abstract Background Osteoarthritis (OA is a common health issue worldwide in the aging population who are also commonly deficient in vitamin D. Our previous study suggested that higher serum 25-(OHD levels were associated with reduced knee cartilage loss, implying that vitamin D supplementation may prevent the progression of knee OA. The aim of the VItamin D Effects on OA (VIDEO study is to compare, over a 2- year period, the effects of vitamin D supplementation versus placebo on knee structural changes, knee pain, and lower limb muscle strength in patients with symptomatic knee OA. Methods/design Randomised, placebo-controlled, and double-blind clinical trial aiming to recruit 400 subjects (200 from Tasmania and 200 from Victoria with both symptomatic knee OA and vitamin D deficiency (serum [25-(OHD] level of >12.5 nmol/liter and 3 capsule monthly or identical inert placebo group for 2 years. The primary endpoint is loss of knee cartilage volume measured by magnetic resonance imaging (MRI and Western Ontario and McMaster Universities Index of OA (WOMAC knee pain score. The secondary endpoints will be other knee structural changes, and lower limb muscle strength. Several other outcome measures including core muscle images and central blood pressure will be recorded. Linear and logistic regression will be used to compare changes between groups using univariable and multivariable modeling analyses. Both intention to treat and per protocol analyses will be utilized. Discussion The trial is designed to test if vitamin D supplementation will reduce loss of knee cartilage volume, prevent the progression of other knee structural abnormalities, reduce knee pain and strengthen lower limb muscle strength, thus modify disease progression in knee OA. Trial registration ClinicalTrials.gov identifier: NCT01176344; Australian New Zealand Clinical Trials Registry: ACTRN12610000495022

  10. Vitamin D supplementation in the management of knee osteoarthritis: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Cao, Yuelong; Jones, Graeme; Cicuttini, Flavia; Winzenberg, Tania; Wluka, Anita; Sharman, James; Nguo, Kay; Ding, Changhai

    2012-08-06

    Osteoarthritis (OA) is a common health issue worldwide in the aging population who are also commonly deficient in vitamin D. Our previous study suggested that higher serum 25-(OH)D levels were associated with reduced knee cartilage loss, implying that vitamin D supplementation may prevent the progression of knee OA. The aim of the VItamin D Effects on OA (VIDEO) study is to compare, over a 2- year period, the effects of vitamin D supplementation versus placebo on knee structural changes, knee pain, and lower limb muscle strength in patients with symptomatic knee OA. Randomised, placebo-controlled, and double-blind clinical trial aiming to recruit 400 subjects (200 from Tasmania and 200 from Victoria) with both symptomatic knee OA and vitamin D deficiency (serum [25-(OH)D] level of >12.5 nmol/liter and vitamin D supplementation (50,000 IU compounded vitamin D3 capsule monthly) or identical inert placebo group for 2 years. The primary endpoint is loss of knee cartilage volume measured by magnetic resonance imaging (MRI) and Western Ontario and McMaster Universities Index of OA (WOMAC) knee pain score. The secondary endpoints will be other knee structural changes, and lower limb muscle strength. Several other outcome measures including core muscle images and central blood pressure will be recorded. Linear and logistic regression will be used to compare changes between groups using univariable and multivariable modeling analyses. Both intention to treat and per protocol analyses will be utilized. The trial is designed to test if vitamin D supplementation will reduce loss of knee cartilage volume, prevent the progression of other knee structural abnormalities, reduce knee pain and strengthen lower limb muscle strength, thus modify disease progression in knee OA. ClinicalTrials.gov identifier: NCT01176344; Australian New Zealand Clinical Trials Registry: ACTRN12610000495022.

  11. Combining valgus knee brace and lateral foot wedges reduces external forces and moments in osteoarthritis patients.

    Science.gov (United States)

    Jafarnezhadgero, Amir Ali; Oliveira, Anderson S; Mousavi, Seyed Hamed; Madadi-Shad, Morteza

    2018-01-01

    Osteoarthritis progression can be related to the external knee adduction and flexion moments during walking. Lateral foot wedges and knee braces have been used as treatment for osteoarthritis, but little is known about their influence on knee joint moments generated in the sagittal and frontal planes. Therefore, the aim of the present study was determine the effects of the isolated and combined use of valgus knee brace and lateral wedge foot orthotic on peak forces and moments during gait in knee osteoarthritis patients. Twenty four males (age: 62.1±2.0years) with varus alignment, symptomatic medial compartment knee osteoarthritis participated in this study. Subjects walked over ground at preferred speed in four conditions: (1) no assistive device (control); (2) using lateral wedges, (3) using knee braces, and (4) using both lateral wedges and knee braces. Ground reaction forces (GRF) and moments, as well as lower limb kinematics were recorded. Peak GRF, vertical loading rate, free moment, external knee adduction and flexion moments were compared across conditions. The concurrent use of lateral wedge and knee brace reduced the first peak GRF in the vertical (6%, p=0.002), anterior-posterior (30%, p=0.028) and medial-lateral directions (44%, p=0.029). Moreover, the use of these devices reduced the peak external knee adduction moment (25%, p=0.019), but not the external flexion moment and free moment (p>0.05). The combined use of lateral wedges and knee braces can reduce medial-lateral knee joint loading, but despite reduced peak forces in the sagittal plane, these device do not reduce joint moments. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Synovitis and the risk of knee osteoarthritis: the MOST Study.

    Science.gov (United States)

    Felson, D T; Niu, J; Neogi, T; Goggins, J; Nevitt, M C; Roemer, F; Torner, J; Lewis, C E; Guermazi, A

    2016-03-01

    To identify the independent relation of synovitis with incident radiographic knee osteoarthritis (OA) after adjusting for other structural factors known to cause synovitis. We examined MRIs from knees that developed incident radiographic OA from the Multicenter Osteoarthritis Study (MOST) and compared these case knees with controls that did not develop OA. We examined baseline MRIs for knees developing OA at any time up to 84 months follow-up. We scored lesions in cartilage, meniscus, bone marrow and synovitis. Synovitis scores were summed (0-9) across three regions, suprapatellar, infrapatellar and intercondylar region, each of which was scored 0-3. After bivariate analyses examining each factor's association with incidence, we carried out multivariable regression analyses adjusting for age, sex, BMI, alignment and cartilage and meniscal damage. We studied 239 case and 731 control knees. In bivariate analyses, cartilage lesions, meniscal damage, synovitis and bone marrow lesions were all risk factors for OA. After multivariable analyses, synovitis was associated with incident OA. A higher synovitis score increased the risk of incident OA (adjusted OR per unit increase 1.1; (95% CI 1.0, 1.2, P = .02)), but increased risk was associated only with synovitis scores of ≥3 (adjusted OR 1.6; 95% CI 1.2, 2.1, P = .003). Synovitis, especially when there is a substantial volume within the knee, is an independent cause of OA. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  13. Hyperextended Knee: Cause of Serious Injury?

    Science.gov (United States)

    ... Cause of serious injury? My daughter hyperextended her knee yesterday at school. Can this injury be serious? ... from Edward R. Laskowski, M.D. A hyperextended knee occurs when the knee is bent backward, often ...

  14. Geographic variations of the International Diabetes Federation and the National Cholesterol Education Program-Adult Treatment Panel III definitions of the metabolic syndrome in nondiabetic subjects.

    Science.gov (United States)

    Lorenzo, Carlos; Serrano-Ríos, Manuel; Martínez-Larrad, María T; González-Sánchez, José L; Seclén, Segundo; Villena, Arturo; Gonzalez-Villalpando, Clicerio; Williams, Ken; Haffner, Steven M

    2006-03-01

    We have carried out international comparisons of the metabolic syndrome using the International Diabetes Federation (IDF) and National Cholesterol Education Program-Adult Treatment Panel III (ATP III) definitions. This analysis could help to discern the applicability of these definitions across populations. Nondiabetic subjects aged 35-64 years were eligible for analysis in population-based studies from San Antonio (Mexican Americans and non-Hispanic whites, n = 2,473), Mexico City (n = 1,990), Spain (n = 2,540), and Peru (n = 346). Kappa statistics examined the agreement between metabolic syndrome definitions. Because of the lower cutoff points for elevated waist circumference, the IDF definition of the metabolic syndrome generated greater prevalence estimates than the ATP III definition. Prevalence difference between definitions was more significant in Mexican-origin and Peruvian men than in Europid men from San Antonio and Spain because the IDF definition required ethnic group-specific cutoff points for elevated waist circumference. ATP III and IDF definitions disagreed in the classification of 13-29% of men and 3-7% of women. In men, agreement between these definitions was 0.54 in Peru, 0.43 in Mexico City, 0.62 in San Antonio Mexican Americans, 0.69 in San Antonio non-Hispanic whites, and 0.64 in Spain. In women, agreement between definitions was 0.87, 0.89, 0.86, 0.87, and 0.93, respectively. The IDF definition of the metabolic syndrome generates greater prevalence estimates than the ATP III definition. Agreement between ATP III and IDF definitions was lower for men than for women in all populations and was relatively poor in men from Mexico City.

  15. In vivo study of acute effects of hip and knee positions on blood flow in canine sciatic nerve

    OpenAIRE

    Koga, Kei; Naito, Masatoshi; Akiyoshi, Yuichiro; Asayama, Isao; Shiramizu, Kei; Abe, Tatunobu; Kanbe, Taichi

    2002-01-01

    We studied blood flow in the canine sciatic nerve using a laser Doppler flowmeter. Blood flow was measured in 20 hind limbs of ten adult dogs at varying angles of hip flexion, hip rotation and knee flexion. Blood flow decreased as flexion and internal rotation of the hip increased and also with only slight flexion of the knee. With 90° knee flexion, the mean blood flow did not change significantly when the hip was internally rotated from 0° to 30°. When the knee was straight, the blood flow c...

  16. Reconstrução do L.C.P. do joelho: técnica de fixação no leito tibial ("INLAY". Avaliação objetiva e subjetiva de 30 casos Knee P.C.L. reconstruction: a tibial bed fixation ("INLAY" technique. Objective and subjective evaluation of a 30-cases series

    Directory of Open Access Journals (Sweden)

    Sérgio Rocha Piedade

    2006-01-01

    Full Text Available A reconstrução cirúrgica do ligamento cruzado posterior (L.C.P. do joelho ainda permanece como um grande desafio terapêutico. Neste trabalho avaliamos 30 pacientes submetidos à reconstrução cirúrgica do L.C.P. com a técnica de fixação do enxerto tendíneo no leito tibial por abordagem direta ("INLAY". 28 pacientes eram do sexo masculino e 2 do feminino, com idade média de 31,10 anos. O tempo médio de lesão foi de 34,24 meses Em 67% dos casos a lesão foi secundária a acidente motociclístico. As lesões condrais e do ligamento cruzado anterior (L.C.A. do joelho estavam presentes em 67% e 33% dos casos, respectivamente. Os pacientes foram avaliados objetivamente (teste de gaveta posterior e subjetivamente (Escala de Lysholm. O seguimento pós-operatório médio foi de 21,7 meses. Cerca de 66% dos casos foram classificados como bom e excelente na avaliação subjetiva e objetiva. A análise estatística apresentou comportamento semelhante para as duas avaliações.Os resultados clínicos pós-operatórios obtidos neste trabalho têm nos encorajado a seguir com esta técnica cirúrgica.Surgical reconstruction of the knee posterior cruciate ligament (P.C.L. still remains as a major therapeutic challenge. In this paper, we assessed 30 patients submitted to surgical reconstruction of the P.C.L. with a technique of tendinous graft fixation on tibial bed by direct approach ("INLAY". Twentyeight male patients and 2 female patients, with mean age of 31.10 years, participated on the study. The average injury time was 34.24 months. In 67% of the cases, injury was secondary to motorcycle accidents. Chondral injuries and knee anterior cruciate ligament (ACL injuries were present in 67% and 33% of the cases, respectively. Patients were assessed objectively (posterior drawer test and subjectively (Lysholm's Scale. Mean post-operative follow-up time was 21.7 months. About 66% of the cases were rated as good and excellent at the subjective and

  17. Treatment of knee osteoarthritis.

    Science.gov (United States)

    Ringdahl, Erika; Pandit, Sandesh

    2011-06-01

    Knee osteoarthritis is a common disabling condition that affects more than one-third of persons older than 65 years. Exercise, weight loss, physical therapy, intra-articular corticosteroid injections, and the use of nonsteroidal anti-inflammatory drugs and braces or heel wedges decrease pai