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Knee Exam

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201. Longitudinal Associations between Brain Volume and Knee Extension Peak Torque. Full Text available with Trip Pro

Longitudinal Associations between Brain Volume and Knee Extension Peak Torque. Muscle strength and brain volume decline with aging; changes in the brain manifested as change in volume may play a role in age-related strength loss, but this hypothesis has never been tested longitudinally. We examined longitudinal associations between brain volume changes and knee extension peak torque change in participants of the Baltimore Longitudinal Study of Aging.Brain volumes and isokinetic concentric knee (...) extension peak torque at 30 deg/sec were measured in 678 participants (55.2% women; baseline age, 50.1-97.2 years; median follow-up time in those who visited two or more times (n = 375), 4.0 [IQR, 2.3 - 5.0] years). Correlations between longitudinal changes in brain volumes and knee extension peak torque were examined using bivariate linear mixed-effects models, adjusted for baseline age, sex, race, education, and intracranial volume.Greater decline in muscle strength was associated with greater

2020 Biological Sciences and Medical Sciences

202. The Relationship between Polypharmacy and Physical Activity in Those with or at Risk of Knee Osteoarthritis. (Abstract)

The Relationship between Polypharmacy and Physical Activity in Those with or at Risk of Knee Osteoarthritis. Physical activity is associated with improved pain, functional status, and less disability in persons with knee osteoarthritis (KOA). Because polypharmacy is related to several adverse health outcomes in older persons, we hypothesized that it might also be associated with decreased physical activity in those with KOA. This study evaluates the relationship between the number (...) of prescription medications and weekly moderate to vigorous physical activity (MVPA).We used hierarchical median quantile regression analysis to examine the cross-sectional association between the number of prescription medications taken in the past 30 days and the median objectively measured MVPA minutes controlling for demographic and clinical variables.Four Osteoarthritis Initiative (OAI) recruitment centers in Providence, Rhode Island; Columbus, Ohio; Baltimore, Maryland; and Pittsburgh

2020 Journal of the American Geriatrics Society

203. Osgood-Schlatter disease: a 2020 update of a common knee condition in children. (Abstract)

-to-date account on contemporary prophylaxis as well as diagnostic and therapeutic approaches.Numerous studies have examined risk factors for OSD. These include body weight, muscle tightness, muscle weakness during knee extension and flexibility of hamstring muscles. In particular, shortening of the rectus femoris may substantially alter biomechanical functions of the knee. Conservative management remains successful in over 90% of patients. However, if disabling symptoms and pain persistent after (...) Osgood-Schlatter disease: a 2020 update of a common knee condition in children. Osgood-Schlatter disease (OSD) is one of the most common causes for anterior knee pain in children and adolescents resulting from a traction apophysitis of the tibial tubercle. While a peak in boys aged 12-15 years old was well documented, there seems to be no difference in sex distribution nowadays. This may result from increased participation of young females in high-impact sports. This review provides an up

2020 Current opinion in pediatrics

204. Risk of venous thromboembolism in knee, hip and hand osteoarthritis: a general population-based cohort study. Full Text available with Trip Pro

Risk of venous thromboembolism in knee, hip and hand osteoarthritis: a general population-based cohort study. Osteoarthritis is a leading cause of immobility and joint replacement, two strong risk factors for venous thromboembolism (VTE). We aimed to examine the relation of knee, hip and hand osteoarthritis to the risk of VTE and investigate joint replacement as a potential mediator.We conducted three cohort studies using data from The Health Improvement Network. Up to five individuals without (...) osteoarthritis were matched to each case of incident knee (n=20 696), hip (n=10 411) or hand (n=6329) osteoarthritis by age, sex, entry time and body mass index. We examined the relation of osteoarthritis to VTE (pulmonary embolism and deep vein thrombosis) using a multivariable Cox proportional hazard model.VTE developed in 327 individuals with knee osteoarthritis and 951 individuals without osteoarthritis (2.7 vs 2.0 per 1000 person-years), with multivariable-adjusted HR being 1.38 (95% CI 1.23 to 1.56

2020 Annals of the rheumatic diseases

205. Protocol for the process and feasibility evaluations of a new model of primary care service delivery for managing pain and function in patients with knee osteoarthritis (PARTNER) using a mixed methods approach. Full Text available with Trip Pro

Protocol for the process and feasibility evaluations of a new model of primary care service delivery for managing pain and function in patients with knee osteoarthritis (PARTNER) using a mixed methods approach. This protocol outlines the rationale, design and methods for the process and feasibility evaluations of the primary care management on knee pain and function in patients with knee osteoarthritis (PARTNER) study. PARTNER is a randomised controlled trial to evaluate a new model of service (...) delivery (the PARTNER model) against 'usual care'. PARTNER is designed to encourage greater uptake of key evidence-based non-surgical treatments for knee osteoarthritis (OA) in primary care. The intervention supports general practitioners (GPs) to gain an understanding of the best management options available through online professional development. Their patients receive telephone advice and support for OA management by a centralised, multidisciplinary 'Care Support Team'. We will conduct concurrent

2020 BMJ open

206. Distal Femoral Cortical Irregularity at Knee MRI: Increased Prevalence in Youth Competitive Alpine Skiers. (Abstract)

position were measured. Tendon attachment position and associated MRI findings (meniscus, cartilage, bone marrow edema, joint effusion, ligaments, tendons) were examined for an association with DFCI. Pearson χ2, Student t test, logistic regression, and κ statistics were applied. Results Unilateral knee MRI scans obtained in 105 skiers (mean age, 14.8 years ± 0.6 [standard deviation]; 66 boys) and in 105 control participants (mean age, 14.6 years ± 0.5; 59 boys) were evaluated. DFCIs were found in 61 (...) Distal Femoral Cortical Irregularity at Knee MRI: Increased Prevalence in Youth Competitive Alpine Skiers. Background Tumor-like cortical irregularities at the posterior distal femur are common incidental findings in adolescents, but the origin of these irregularities is debated. Purpose To compare the prevalence of distal femoral cortical irregularities (DFCIs) at different tendon attachment sites in youth competitive alpine skiers with that in young adults. Materials and Methods

2020 Radiology

207. Patient characteristics associated with a poor response to non-surgical multidisciplinary management of knee osteoarthritis: a multisite prospective longitudinal study in an advanced practice physiotherapist-led tertiary service. Full Text available with Trip Pro

+2 to+7)). Generalised linear models with binomial family and logit link were used to examine which patient characteristics yielded the strongest relationship with a poor response to management as estimated by the OR (95% CI).Overall, 114 out of 238 (47.9%) participants recorded a poor response. The odds of a poor response decreased with higher patient expectations of benefit (OR 0.74 (0.63 to 0.87) per 1/10 point score increase) and higher self-reported knee function (OR 0.67 (0.51 to 0.89) per (...) Patient characteristics associated with a poor response to non-surgical multidisciplinary management of knee osteoarthritis: a multisite prospective longitudinal study in an advanced practice physiotherapist-led tertiary service. To explore patient characteristics recorded at the initial consultation associated with a poor response to non-surgical multidisciplinary management of knee osteoarthritis (KOA) in tertiary care.Prospective multisite longitudinal study.Advanced practice physiotherapist

2020 BMJ open

208. The Association of Diabetes With Knee Pain Locations, Pain While Walking, and Walking Speed: Data From the Osteoarthritis Initiative. (Abstract)

with moderate to severe knee pain while walking and slower walking speed in people with knee OA.Clinicians may use knee pain map for examining knee pain locations for people with diabetes and knee OA. knee pain during walk and walking speed should be screened for people with knee OA and diabetes because of diabetes influence on theses parameters in this population.© The Author(s) 2020. Published by Oxford University Press on behalf of the American Physical Therapy Association. All rights reserved (...) The Association of Diabetes With Knee Pain Locations, Pain While Walking, and Walking Speed: Data From the Osteoarthritis Initiative. Osteoarthritis (OA) and diabetes mellitus (DM) often coexist and may result in negative outcomes. DM may affect pain and walking speed in people with knee OA; however, the impact of DM on OA is understudied. The purpose of this study was to investigate the association between diabetes and knee pain locations, pain severity while walking, and walking speed

2020 Physical therapy

209. Six-year trends in postoperative prescribing and use of multimodal analgesics following total hip and knee arthroplasty: A single-site observational study of pain management. (Abstract)

Six-year trends in postoperative prescribing and use of multimodal analgesics following total hip and knee arthroplasty: A single-site observational study of pain management. Guidelines for acute postoperative pain management recommend administering analgesics in multimodal combination to facilitate synergistic benefit, reduce opioid requirements and decrease side-effects. However, limited observational research has examined the extent to which multimodal analgesics are prescribed (...) and administered postoperatively following joint replacement.In this longitudinal study, we used three-point prevalence surveys to observe the 6-year trends in prescribing and use of multimodal analgesics on the orthopaedic wards of a single Australian private hospital. We collected baseline postoperative data from total hip and knee arthroplasty patients in May/June 2010 (Time 1, n = 86), and follow-up data at 1 year (Time 2, n = 199) and 5 years (Time 3, n = 188). During the follow-up, data on prescribing

2020 European Journal of Pain

210. Effects of genotype on TENS effectiveness in controlling knee pain in persons with mild to moderate osteoarthritis. (Abstract)

Effects of genotype on TENS effectiveness in controlling knee pain in persons with mild to moderate osteoarthritis. This study examined the extent to which genetic variability modifies Transcutaneous Electrical Nerve Stimulation (TENS) effectiveness in osteoarthritic knee pain.Seventy-five participants with knee osteoarthritis were randomly assigned to either: (a) High-frequency TENS, (b) Low-frequency TENS or (c) Transient Placebo TENS. Pain measures were collected pre- and post-treatment (...) to the high-frequency TENS group (β = 28.37; p = .0004).EDNRA and COMT are implicated in osteoarthritic knee pain and provide a basis for tailoring TENS interventions according to individual characteristics.Findings from this study demonstrate that genetic variation within the COMT and EDNRA genes influences the effectiveness of TENS, a non-pharmacologic pain-reduction intervention, in the context of osteoarthritic knee pain. Evidence such as this may contribute to risk models that provide a clinically

2020 European Journal of Pain

211. Embolization for intractable spontaneous hemarthrosis of the knee joint in the elderly patient: Case report. Full Text available with Trip Pro

previously reported.An 82-year-old male presented to our outpatient department with acute left knee pain. He had no history of trauma. The patient had under gone several times of therapeutic arthrocentesis for treatment of left knee joint effusion at a local clinic.Arthroscopic examination was performed at the local clinic and was not able to reveal any focus of intra-articular bleeding. We consulted this case with the department of radiology to angiographically find out abnormalities of the genicular (...) Embolization for intractable spontaneous hemarthrosis of the knee joint in the elderly patient: Case report. Several case reports about the diagnostic and therapeutic approaches of hemarthrosis after total knee arthroplasty using angiogram have been reported, owing to the probability of bleeding caused by vascular injuries. However, there were only few cases of spontaneous hemarthrosis of the knee joint in the elderly patient that have not undergone total knee arthroplasty that have been

2020 Medicine

212. Interleukin 1 receptor antagonist (<i>IL1RN</i>) gene variants predict radiographic severity of knee osteoarthritis and risk of incident disease. Full Text available with Trip Pro

Interleukin 1 receptor antagonist (IL1RN) gene variants predict radiographic severity of knee osteoarthritis and risk of incident disease. In these studies, we examined the association of single nucleotide polymorphisms (SNPs) of the IL1RN gene with radiographic severity of symptomatic knee osteoarthritis (SKOA) and the risk of incident OA. We also explored these genetic polymorphisms in patients with new onset rheumatoid arthritis (RA).Over 1000 subjects who met American College (...) of the IL1RN TTG haplotype was associated with increased odds of more severe rOA compared with age-matched, sex-matched and body mass index-matched individuals. Examination of the osteoarthritis initiative Incidence Subcohort demonstrated that carriage of the TTG haplotype was associated with 4.1-fold (p=0.001) increased odds of incident rOA. Plasma IL-1Ra levels were lower in TTG carriers, while chondrocytes from TTG carriers exhibited decreased secretion of IL-1Ra. In patients with RA, the TTG haplotype

2020 Annals of the rheumatic diseases

213. The outcomes of post-traumatic arthritis vs osteoarthritis following primary total knee arthroplasty: A protocol of matched cohort study. Full Text available with Trip Pro

The outcomes of post-traumatic arthritis vs osteoarthritis following primary total knee arthroplasty: A protocol of matched cohort study. Total knee arthroplasty (TKA) for treatment of end-stage post-traumatic arthritis (PTA) has specific technical difficulties and complications. The aim of this study was to examine the outcome of TKA after PTA and to compare it with a cohort osteoarthritis (OA).A retrospective review of patients undergoing primary TKA at a single university hospital from 2013 (...) to 2016 was performed. A minimum follow-up of 4 years was required. Patients in the study group were matched 1:2 with patients in the cohort group based on the following criteria: age at time of TKA (±3 years), body mass index (±3 points), sex, and American Society of Anesthesiologists score (±1 point). Outcome measures included surgical time, intraoperative complications, Oxford Knee Score, range of motion, postoperative complications, and revision.This clinical trial is expected to determine whether

2020 Medicine

214. Is postoperative hyponatremia a real threat for total hip and knee arthroplasty surgery? Full Text available with Trip Pro

that underwent total hip arthroplasty and total knee arthroplasty performed between 2016 and 2017 were retrospectively examined. Serum electrolytes, hemoglobin, hematocrit, glucose, and creatinine were evaluated preoperatively and at day 0-I-II from surgery. Age, sex, body mass index, comorbidities, drugs, surgery data, transfusions, postoperative symptoms, and length of stay (LOS) were determined. All surgeries were performed by the same equipe. Patients had the same perioperative management, excluded those (...) Is postoperative hyponatremia a real threat for total hip and knee arthroplasty surgery? Postoperative hyponatremia (POH) is thought to be a fearsome complication of orthopedic surgery. Primary aim of this cohort study was to evaluate the incidence of POH and its clinical relevance in elective surgery, outlining differences between total knee arthroplasty (TKA) and total hip arthroplasty, looking for the presence of any risk factor commonly related to POH.Four hundred two patients

2020 Medicine

215. Correlation between radiographic knee osteoarthritis and lifetime cigarette smoking amount in a Korean population: A cross-sectional study. Full Text available with Trip Pro

population.This cross-sectional study used the Fifth and Sixth Korean National Health and Nutrition Examination Survey (2010-2013) data. Subjects included 11,638 community-dwelling adults aged ≥50 years. Knee ROA was defined as a Kellgren/Lawrence grade ≥2 on plain radiography. Lifetime cigarette smoking amount was calculated in terms of pack-year and further divided into quartile groups. Independent correlation between smoking and knee ROA was determined using odds ratios (OR) adjusted for age, sex, obesity (...) Correlation between radiographic knee osteoarthritis and lifetime cigarette smoking amount in a Korean population: A cross-sectional study. Although the inverse correlation between smoking and degenerative arthritis is controversial, quantitative analysis of the correlation between lifetime cigarette smoking amount and degenerative arthritis has not been performed. We investigated the correlation between knee radiographic osteoarthritis (ROA) and lifetime cigarette smoking amount in the general

2020 Medicine

216. The effect of short foot exercise using visual feedback on the balance and accuracy of knee joint movement in subjects with flexible flatfoot. Full Text available with Trip Pro

and after training.There was a significant difference in static balance pre- and post-exercise in the flatfoot group but not in the normal foot group. Moreover, in the flatfoot group, the accuracy of knee joint motions was significantly different between pre- and post-exercise in the closed chain but not in the open chain.This study examined the influence of SFE using visual feedback on the balance and accuracy of knee joint movements in subjects with flatfoot and demonstrated that this exercise, using (...) The effect of short foot exercise using visual feedback on the balance and accuracy of knee joint movement in subjects with flexible flatfoot. Flexible flatfoot is a condition characterized by the deformations of the foot where the calcaneus is pronated by weight support. Flat feet can affect balance and the entire chain of motion, causing indirect problems in adjacent joints. We investigated the effects of short foot exercise (SFE) using visual feedback on the static balance and function

2020 Medicine

217. Radiosynoviorthesis in the treatment of posttraumatic joint bleedings of hemophilic patients (concerning hip, knee and ankle joints)-Hungarian experience. Full Text available with Trip Pro

Radiosynoviorthesis in the treatment of posttraumatic joint bleedings of hemophilic patients (concerning hip, knee and ankle joints)-Hungarian experience. The surgical, arthroscopic synovectomy and radiosynovectomy (radiosynoviorthesis, RSO) all have great practical importance, since they can eliminate the posttraumatic joint bleedings and prevent the further joint destructions in hemophilic patients. The aim of this study was to examine the role of RSO in the prevention of joint bleedings

2020 Injury

218. What is an important difference in gait speed in adults with knee osteoarthritis? (Abstract)

What is an important difference in gait speed in adults with knee osteoarthritis? Little is known regarding what difference in functional performance measures are significant in individuals with chronic medical disease. We examined the important differences in gait speed in adults with radiographic knee osteoarthritis.Functional performance was measured by gait speed using 20-meter and 400-meter walk tests performed at self-selected usual pace among adults with radiographic knee osteoarthritis (...) participating in the Osteoarthritis Initiative at baseline and two years later. Both distribution-based methods and anchor-based methods used to calculate the important differences in gait speed. Anchor-based methods used chair stand rate and self-reported function to estimate gait speed differences related to physical function.We included 2527 participants with radiographic knee osteoarthritis. Distribution-based important difference estimates for 20-meter walk ranged from 4.1 to 6.4 meters/minute and 400

2020 Arthritis care & research

219. Development and Underlying Structure of a Second-Generation Appropriateness Classification System for Total Knee Arthroplasty. (Abstract)

Development and Underlying Structure of a Second-Generation Appropriateness Classification System for Total Knee Arthroplasty. Evidence supports the validity of total knee arthroplasty (TKA) appropriateness classification based on the RAND Corporation and University of California Los Angeles system developed by Escobar and colleagues. The system, however, is approximately two decades old and the science and clinical application of TKA has changed dramatically. The purposes of our study (...) was to: 1) describe the methods used to develop a second-generation system, and 2) examine the structure of the system to determine the extent to which each of the indication criteria informed appropriateness.The development process is summarized. Multivariable multinomial regression analyses determined the extent to which each of eight individually analyzed indication criteria informed appropriateness judgements. Classification tree analysis illustrate how the indication criteria, in combination, led

2020 Arthritis care & research

220. The Association of Pain Sensitization and Conditioned Pain Modulation to Pain Patterns in Knee Osteoarthritis. (Abstract)

The Association of Pain Sensitization and Conditioned Pain Modulation to Pain Patterns in Knee Osteoarthritis. To examine the cross-sectional association of ascending pain mechanisms (APM), implicated in pain sensitization (PS), and descending pain modulation with pain patterns and unpredictability of pain.The Multicenter Osteoarthritis (OA) Study is a longitudinal cohort of older adults with or at risk of knee OA. Peripheral and central APM were assessed using quantitative sensory tests (QST (...) ); pressure pain thresholds (PPTs) using a handheld pressure algometer (knee/peripheral and wrist/central), temporal summation (TS) using weighted probes (wrist/central). Descending modulation was assessed by conditioned pain modulation (CPM) using PPTs and a forearm ischemia test. Pain patterns were characterized based on responses to the Intermittent and Constant OA Pain (ICOAP) questionnaire: 1) no intermittent or constant pain; 2) intermittent pain only; 3) constant pain only; and 4) combined constant

2020 Arthritis care & research

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