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Knee Ultrasound

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1. Short-term effects of neuromuscular electrical stimulation and ultrasound therapies on muscle architecture and functional capacity in knee osteoarthritis: a randomized study (Abstract)

Short-term effects of neuromuscular electrical stimulation and ultrasound therapies on muscle architecture and functional capacity in knee osteoarthritis: a randomized study To determine the effects of ultrasound therapy and neuromuscular electrical stimulation (NMES) application on the muscle architecture and functional capacity in patients with knee osteoarthritis.A randomized study.A total of 60 patients with knee osteoarthritis.Participants were randomized into one of the following two (...) intervention groups, five days a week, for three weeks: the combination of NMES application, hot pack, and exercise therapy was applied to the NMES group. The combination of therapeutic ultrasound, hot pack and exercise therapy was applied to the ultrasound therapy group.Subjects were evaluated for pain and functional capacity with the use of the visual analog pain scale (VAS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), and 15 meter walking test. The muscle architecture (muscle

2019 EvidenceUpdates

2. Effectiveness of Therapeutic Ultrasound on Clinical Parameters and Ultrasonographic Cartilage Thickness in Knee Osteoarthritis: A Double-Blind Trial. Full Text available with Trip Pro

Effectiveness of Therapeutic Ultrasound on Clinical Parameters and Ultrasonographic Cartilage Thickness in Knee Osteoarthritis: A Double-Blind Trial. A double-blind placebo-controlled randomized study was conducted to assess the effectiveness of therapeutic ultrasound (US) in knee OA.Thirty-three patients (mean age 54.7 ± 14.7) were randomized to receive either continuous US (n = 15) or sham US (n = 18) as a placebo. Continuous ultrasonic waves with 1 MHZ frequency and 1 watt/cm2 power were (...) applied for 5 min for 10 sessions. The primary outcome was pain on movement assessed by visual analog scale (VAS). The secondary outcomes were WOMAC scores and measurements of distal femoral cartilage thickness by imaging US.Both groups showed reduced knee pain on movement following intervention. The VAS measurements improved significantly both in the treatment and the placebo group patients (P < 0.05 and P < 0.05). WOMAC scores improved statistically significant in all domains (pain, stiffness

2019 Journal of medical ultrasound Controlled trial quality: predicted high

3. Ultrasound-Guided Motor-Sparing Knee Blocks for Postoperative Analgesia Following Total Knee Arthroplasty: A Randomized Blinded Study Full Text available with Trip Pro

Ultrasound-Guided Motor-Sparing Knee Blocks for Postoperative Analgesia Following Total Knee Arthroplasty: A Randomized Blinded Study Pain following total knee arthroplasty (TKA) is often severe and can inhibit rehabilitation. Motor-sparing analgesic techniques such as periarticular infiltrations and adductor canal blocks have been popularized for knee analgesia since they preserve motor strength and permit early mobilization. Our primary objective was to compare the duration of analgesia from (...) the ultrasound-guided adductor canal block by combining it with a lateral femoral cutaneous nerve block and posterior knee infiltration. The patients, surgeons, anesthetists administering the blocks, and outcome assessors all remained blinded to group allocation. Our primary outcome was duration of analgesia (time to first rescue analgesia). Secondary outcomes included quadriceps strength, function, side effects, satisfaction, and length of hospital stay.The duration of analgesia was significantly longer

2017 EvidenceUpdates

4. Ultrasound-Guided Genicular Nerve Block for Knee Osteoarthritis: A Double-Blind, Randomized Controlled Trial of Local Anesthetic Alone or in Combination with Corticosteroid (Abstract)

Ultrasound-Guided Genicular Nerve Block for Knee Osteoarthritis: A Double-Blind, Randomized Controlled Trial of Local Anesthetic Alone or in Combination with Corticosteroid Recently, several studies suggested that radiofrequency (RF) ablation of the genicular nerves is a safe and effective therapeutic procedure for intractable pain associated with chronic knee osteoarthritis (OA). Diagnostic genicular nerve block (GNB) with local anesthetic has been generally conducted before making decisions (...) regarding RF ablation. Although GNB has been recently performed together with corticosteroid, the analgesic effects of corticosteroids for treating chronic pain remain controversial.The current study aims to assess the effects of combining corticosteroids and local anesthesia during ultrasound-guided GNB in patients with chronic knee OA.A randomized, double-blinded institutional study.This study took place at Asan Medical Center in Seoul, Korea.Forty-eight patients with chronic knee OA were randomly

2018 EvidenceUpdates

5. Clinical and ultrasonographic features associated to response to intraarticular corticosteroid injection. A one year follow up prospective cohort study in knee osteoarthritis patient with joint effusion. Full Text available with Trip Pro

Clinical and ultrasonographic features associated to response to intraarticular corticosteroid injection. A one year follow up prospective cohort study in knee osteoarthritis patient with joint effusion. Intraarticular injection is used for pain relief in knee osteoarthritis (OA), but there is not a well defined profile of patient who could get more benefit from it. The purpose of this study was to evaluate the frequency of pain relief at one year after corticosteroids intraarticular injection (...) and to identify clinical factors associated to response in patients with knee osteoarthritis with joint effusion.One-year prospective cohort study of patients with knee OA with joint effusion confirmed by ultrasound. An intraarticular injection was performed following a clinical protocol. Anthropometric measurements, laboratory parameters, clinical severity, ultrasound parameters and radiological severity were collected. Response regarding pain and presence of synovial fluid on ultrasound at one month

2018 PLoS ONE

6. Efficacy of extracorporeal shockwave therapy and low-intensity pulsed ultrasound in a rat knee osteoarthritis model: A randomized controlled trial Full Text available with Trip Pro

Efficacy of extracorporeal shockwave therapy and low-intensity pulsed ultrasound in a rat knee osteoarthritis model: A randomized controlled trial This study aims to assess the efficacy of extracorporeal shockwave therapy (ESWT) and low-intensity pulsed ultrasound (LIPUS) on osteoarthritic rat knees.Twenty-four rats were divided into 3 groups: group 1-control (n=8), group 2-LIPUS (n=8) and group 3-ESWT (n=8). Cartilage degeneration was provided using mono-iodo-asetate (MIA). One milligram (...) of MIA was delivered to the right knees in group 1 and both knees in group 2 and 3. A 0.09% saline solution was delivered to the left knees in group 1 for control. Twenty-four hours after the delivery, ESWT was applied once on the right knees in the group 2 rats to the medial tibia plateu with a 1 Hz frequency and 800 impulses. LIPUS was applied to the right knees in the group 2 rats to the medial tibia plateu with a 3 mHz frequency and 40 mW/cm2 intensity for 20 minutes over a period of 15 days

2017 European journal of rheumatology Controlled trial quality: uncertain

7. Correlations between ultrasonographic findings, clinical scores, and depression in patients with knee osteoarthritis Full Text available with Trip Pro

Correlations between ultrasonographic findings, clinical scores, and depression in patients with knee osteoarthritis This study aimed to explore correlations between the presence of depression, clinical scores, and ultrasonographic (US) grading in osteoarthritis (OA) patients and to clarify if depressive symptoms might cause a discrepancy between US findings and clinical scores.Two hundred patients with primary knee OA and 100 healthy hospital volunteers of the same age and sex not complaining (...) of knee troubles participated in this study. We evaluated depressive symptoms in all participants using the Beck Depression Inventory (BDI) scale. Thorough clinical examination was performed, including assessment using the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) for disability. All patients underwent US examination of their affected knees.Depression was detected in 60 patients with knee OA (30%) and in 5 controls (5%). The mean of BDI score was 12.8±12.2 in OA patients

2017 European journal of rheumatology

8. Platelet-rich plasma injections for knee osteoarthritis

methods may affect the concentrations of platelets and the level of contamination with red and white blood cells. Different agents such as calcium chloride or thrombin may be added. 2.4 The platelet-rich plasma is injected into the joint space in the knee, usually under ultrasound guidance. Platelets contain growth factors that are thought to stimulate chondrocyte proliferation, leading to cartilage repair. The aim is to relieve symptoms, potentially delaying the need for joint replacement surgery (...) Platelet-rich plasma injections for knee osteoarthritis Platelet-rich plasma injections for knee Platelet-rich plasma injections for knee osteoarthritis osteoarthritis Interventional procedures guidance Published: 23 January 2019 nice.org.uk/guidance/ipg637 Y Y our responsibility our responsibility This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take

2019 National Institute for Health and Clinical Excellence - Interventional Procedures

9. Ultrasound-Guided Continuous Femoral Nerve Block with Dexmedetomidine Combined with Low Concentrations of Ropivacaine for Postoperative Analgesia in Elderly Knee Arthroplasty. Full Text available with Trip Pro

Ultrasound-Guided Continuous Femoral Nerve Block with Dexmedetomidine Combined with Low Concentrations of Ropivacaine for Postoperative Analgesia in Elderly Knee Arthroplasty. This study aims to investigate the clinical effect of dexmedetomidine (DEX) combined with low concentrations of ropivacaine in ultrasound-guided continuous fem-oral nerve block for postoperative analgesia in elderly patients with total knee arthroplasty (TKA).Patients were divided into three groups: group C, group D1 (...) % ro-pivacaine in ultrasound-guided continuous femoral nerve block for postoperative analgesia in elderly patients with TKA provides a better analgesic effect than without DEX performance.X.-Y.Z. and E.-F.Z. have contributed equally to this research.© 2019 The Author(s) Published by S. Karger AG, Basel.

2019 Medical principles and practice : international journal of the Kuwait University, Health Science Centre Controlled trial quality: uncertain

10. Ultrasound-guided lumbar selective nerve root block plus T12 paravertebral and sacral plexus block for hip and knee arthroplasty: Three case reports. Full Text available with Trip Pro

Ultrasound-guided lumbar selective nerve root block plus T12 paravertebral and sacral plexus block for hip and knee arthroplasty: Three case reports. For hip or knee arthroplasty, it is essential to develop a satisfied peripheral nerve block method that will benefit elderly patients or patients who are contraindicated to neuraxial anesthesia.Patient in Case 1 suffered from the right intertrochanteric fracture, combined with chronic obstructive pulmonary disease; Patient in Case 2 suffered from (...) hip osteoarthritis; combined with ankylosing spondylitis; Patient in Case 3 suffered from rheumatoid arthritis, combined with ischemic encephalopathy.Case 1: Right intertrochanteric fracture, chronic obstructive pulmonary disease. Case 2: hip osteoarthritis. Case 3: rheumatoid arthritis.Ultrasound-guided lumbar selective nerve root block (SNRB) plus T12 paravertebral and sacral plexus block were performed in 2 patients who received hip arthroplasty and 1 patient who received knee arthroplasty.All

2019 Medicine

11. Effects of low-intensity pulsed ultrasound on recovery of physical impairments, functional performance and quality of life after total knee arthroplasty: Protocol for a quasi-experimental study. Full Text available with Trip Pro

Effects of low-intensity pulsed ultrasound on recovery of physical impairments, functional performance and quality of life after total knee arthroplasty: Protocol for a quasi-experimental study. The presence of significant pain and swelling during the acute stage following total knee arthroplasty (TKA) may limit the patients' ability to cooperate in intensive physiotherapy interventions. Low-intensity pulsed ultrasound is one of the modalities that can be used for acute pain and swelling (...) of interest are pain level, swelling, active range of knee motion, and quadriceps strength. The secondary outcomes are functional performance and quality of life.This study will fill the gaps in knowledge relating the benefits of including low-intensity pulsed ultrasound into conventional physiotherapy for patients with TKA.Australian New Zealand Clinical Trials Registry, ACTRN12618001226291.

2019 Medicine

12. Ultrasound and anatomical study of accessing the nerves in the knee by fascial planes. (Abstract)

Ultrasound and anatomical study of accessing the nerves in the knee by fascial planes. The fascia is an undifferentiated mesenchymal tissue related to the peripheral nerves. Both can be identified by ultrasound, which is useful to perform peripheral nerve blocks. However, there is no unanimity about the approaching point of each nerve nor is there a consensus on how to name the appropriate infiltration zone, although the paraneural zone is frequently mentioned. The aims of this study (...) is to determine if ultrasound is accurate to identify the fascial planes and the paraneural space of the nerves in the knee, infiltrate them and achieve a correct anatomical diffusion, as well as establish access routes to avoid intraneural infiltration. The study was performed in 16 cryopreserved lower extremities of the dissection room of the Faculty of Medicine and Health Sciences. Nerves of the knee were injected with colourant guided by ultrasound after they were visualized. Correct location

2019 Pain Practice

13. Does adding transcutaneous electrical nerve stimulation to therapeutic ultrasound affect pain or function in people with osteoarthritis of the knee? A randomized controlled trial. (Abstract)

Does adding transcutaneous electrical nerve stimulation to therapeutic ultrasound affect pain or function in people with osteoarthritis of the knee? A randomized controlled trial. To compare the efficacy of therapeutic ultrasound combined with transcutaneous electrical nerve stimulation versus therapeutic ultrasound alone for pain relief and functional improvement in patients with symptomatic knee osteoarthritis.Randomized controlled trial (blinded assessor).Outpatient.A total of 148 ambulatory (...) knee osteoarthritis patients (pain score ⩾ 5/10) were recruited as study participants.Ultrasound combined with transcutaneous electrical nerve stimulation (study group) or ultrasound (control group). Both groups received treatment in the supine position for 10 minutes per session, for 10 sessions within two weeks.Pain score and gait speed were measured after random allocation and on day 10. Adverse events, global assessment, and patient satisfaction were recorded after treatment.All baseline data

2019 Clinical rehabilitation Controlled trial quality: predicted high

14. Postoperative analgesia with ropivacaine and dexmedetomidine for ultrasound-guided fascia iliaca compartment block after arthroscopic knee surgery. (Abstract)

Postoperative analgesia with ropivacaine and dexmedetomidine for ultrasound-guided fascia iliaca compartment block after arthroscopic knee surgery. The objective of this study is to evaluate the postoperative analgesic effect of a combination of ropivacaine and dexmedetomidine for ultrasound-guided fascia iliaca compartment block (FICB) after knee arthroscopy.Forty patients scheduled for knee arthroscopy were randomized to receive either 30 ml of 0.25% ropivacaine alone (Group A, n = 20 (...) with lower postoperative analgesic requirement after arthroscopic knee surgery. No adverse reactions or complications were noted except for lower heart rate in Group B patients.

2019 Saudi journal of anaesthesia Controlled trial quality: uncertain

15. A Prospective Randomized Comparison of the Efficacy of Ultrasound- vs Fluoroscopy-Guided Genicular Nerve Block for Chronic Knee Osteoarthritis. (Abstract)

A Prospective Randomized Comparison of the Efficacy of Ultrasound- vs Fluoroscopy-Guided Genicular Nerve Block for Chronic Knee Osteoarthritis. Recently, genicular nerve block and radiofrequency ablation were introduced to alleviate knee pain in patients with chronic knee osteoarthritis. Both ultrasound- and fluoroscopy-guided genicular nerve blocks have been used. However, whether one is superior to the other remains unknown.The present study compares the efficacy of ultrasound- vs fluoroscopy (...) period. GPES and complication rates were also similar between both groups.We were unable to perform double-blind randomization and did not evaluate patients' baseline emotional states.Pain relief, functional improvement, and safety were similar between groups receiving ultrasound- and fluoroscopy-guided genicular nerve blocks. Therefore, either of the 2 imaging devices may be utilized during a genicular nerve block for chronic knee pain relief. However, considering radiation exposure, ultrasound

2019 Pain physician Controlled trial quality: predicted high

16. The Prolonged Analgesic Efficacy of an Ultrasound-Guided Single-Shot Adductor Canal Block in Patients Undergoing Total Knee Arthroplasty. (Abstract)

The Prolonged Analgesic Efficacy of an Ultrasound-Guided Single-Shot Adductor Canal Block in Patients Undergoing Total Knee Arthroplasty. In this prospective, randomized, placebo-controlled study, the authors compared the analgesic efficacy of the single-shot adductor canal block (SS-ACB) vs the continuous adductor canal block (C-ACB) with intermittent boluses during the 72-hour postoperative period. Seventy-five patients randomly received the following: a single shot of 20 mL of 0.5 (...) satisfaction with their pain-relief treatment. Given the similar analgesic effect but better quadriceps muscle strength, easier execution, and higher patient satisfaction, the SS-ACB may be more suitable for total knee arthroplasty patients than the C-ACB. [Orthopedics. 2018; 41(5):e607-e614.].Copyright 2018, SLACK Incorporated.

2019 Orthopedics Controlled trial quality: uncertain

17. Ultrasound measurement of knee synovial fluid during external pneumatic compression. (Abstract)

Ultrasound measurement of knee synovial fluid during external pneumatic compression. Synovial fluid based biomarker research has been limited by the small volumes of synovial fluid from the knees of some patients. We used ultrasound (US) to determine if synovial fluid could be displaced into an access port during pneumatic compression to 100 mmHg. Forty knees from 37 consecutive arthritis patients with rheumatoid arthritis -25, osteoarthritis -8, psoriatic arthritis -2, and 1 each with systemic (...) lupus erythematosus and gout were evaluated. This group of 28 females and 9 males with a median age of 59 years and an average body mass index of 26.9 kg/m2 had previously undergone a diagnostic arthrocentesis and or a therapeutic knee injection using this pneumatic compression device. Blinded digital image analysis of the anechoic region on ultrasound demonstrated an increase in fluid within the 9 cm × 6 cm access port (anterolateral or anteromedial joint) during inflation in all patients

2019 Journal of Orthopaedic Research

18. Feasibility of point-of-care knee ultrasonography for diagnosing anterior cruciate and posterior cruciate ligament tears in the ED. (Abstract)

Feasibility of point-of-care knee ultrasonography for diagnosing anterior cruciate and posterior cruciate ligament tears in the ED. To evaluate the feasibility of point-of-care knee ultrasonography (POCUS) compared with knee magnetic resonance imaging (MRI) for diagnosing anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) tears in patients with acute knee trauma.A prospective study was conducted in a tertiary hospital emergency department; acute (within 1-week) knee trauma (...) patients with suspected ACL or PCL tear were recruited. Two POCUS performers (a board-certified emergency physician and a musculoskeletal radiologist) independently evaluated the ACL and PCL using POCUS. Findings were classified as normal appearance or ligament tear. Final radiology reports of knee MRI were used as the reference standard. We calculated the diagnostic values (sensitivity, specificity, and accuracy) for POCUS obtained by both POCUS performers. Kappa values (k) were calculated for inter

2019 American Journal of Emergency Medicine

19. Diagnostic value of ultrasound in calcium pyrophosphate deposition disease of the knee joint. (Abstract)

Diagnostic value of ultrasound in calcium pyrophosphate deposition disease of the knee joint. To assess the diagnostic performance of ultrasound (US) for calcium pyrophosphate deposition (CPPD) at the level of menisci, hyaline cartilage (HC), tendons, and synovial fluid (SF) of the knee, and to examine inter- and intra-observer reliability.We consecutively included patients with knee effusion over a 2-year period (43 patients with CPPD and 131 controls). All patients underwent SF analysis

2019 Osteoarthritis and Cartilage

20. Gamechanger? The Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients with Knee Osteoarthritis ? A Randomized Clinical Trial

age 45 years or older, and met knee OA criteria as defined by the American College of Rheumatology. These criteria are based on a standardized questionnaire about knee pain, as well as tibiofemoral OA evident on radiographs. Eligibility criteria further included ultrasonographic evidence of effusion and synovitis. Participants were excluded if they had other disorders affecting the study joint, including systemic inflammatory joint disease, prior sepsis, or osteonecrosis; chronic or recent use (...) was the injection of 1 mL of triamcinolone 40 mg/mL; the control group received 1 mL of 0.9% normal saline. In both arms, synovial fluid (≤10 mL) was aspirated prior to the injection. Participants attended 9 visits over a 24-month period, which were scheduled at 3-month intervals. Each visit included a knee exam and assessments of pain and stiffness. Participants were also subject to radiographs, ultrasound, and magnetic resonance imaging (MRI) at standardized intervals. From the MRI, mean cartilage thickness

2018 Clinical Correlations

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