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Knee Exam

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221. Occupational Risk in Knee Osteoarthritis: A Systematic Review and Meta-Analysis of Observational Studies. (Abstract)

Occupational Risk in Knee Osteoarthritis: A Systematic Review and Meta-Analysis of Observational Studies. To assess the association between occupational exposures and knee osteoarthritis (OA).We systematically searched for observational studies that examined the relationship between occupational exposures and knee OA and total knee replacement. Four databases were searched up to October 1, 2019. Two reviewers independently assessed study quality using the Newcastle-Ottawa Scale and evidence (...) = 16,824,492 total participants). A synthesis of 71 studies suggested increased odds of knee OA (OR 1.52 [95% CI 1.37-1.69]) by combining different physically demanding jobs and occupational activities as compared to sedentary occupations and/or low-exposure groups. Odds of knee OA were greater in males and in industry-based studies and studies assessing lifetime occupational exposures. There were 9 specific job titles that were associated with knee OA, including farmer, builder, metal worker, and floor

2020 Arthritis care & research

222. Access to hip and knee replacement surgery in patients with chronic diseases according to patient-reported pain and functional status. Full Text available with Trip Pro

Access to hip and knee replacement surgery in patients with chronic diseases according to patient-reported pain and functional status. An increasing number of patients undergoing hip or knee replacement have chronic diseases. It has been suggested that the presence of chronic diseases may affect access to this type of surgery in the English National Health Service (NHS). We examined the access to hip and knee replacement surgery in patients with and without chronic diseases according (...) to preoperative patient-reported pain, functional status and symptom duration.We analysed data of 640,832 patients who had hip or knee surgery between 2009 and 2016 in England. Multivariable regression was used to estimate the impact of 11 chronic diseases on severity of joint problems as measured on a scale from 0 to 48 by Oxford Hip (OHS) and Knee Scores (OKS) just before surgery and on likelihood of long-standing joint problems (> 5 years pre-operatively).Patients with chronic diseases reported more severe

2020 BMC health services research

223. Abortion is associated with knee osteoarthritis among older women in China: A STROBE-compliant article. Full Text available with Trip Pro

Abortion is associated with knee osteoarthritis among older women in China: A STROBE-compliant article. The current studies revealed inconsistent relationship between reproductive factors and osteoarthritis. Community-based research has not been conducted in China. The study was to examine the association of reproductive factors with the prevalence of knee osteoarthritis (OA).Through a multistage stratified random sampling method, 10 streets or villages from 5 cities in Hunan province were (...) randomly selected, a total 2746 eligible women aged 50 to 83 were recruited in this cross-sectional study. A structured questionnaire including demographic factors, socio-economic status, reproductive factors, and knee OA was used. According to the criteria of American College of Rheumatology, clinical knee OA was assessed by doctors in community or village health clinics for knee pain, age, morning stiffness, crepitus on active motion or for knee pain, morning stiffness, crepitus on active motion

2020 Medicine

224. Recommendation Rates for Physical Therapy, Lifestyle Counseling, and Pain Medications for Managing Knee Osteoarthritis in Ambulatory Care Settings: A Cross-Sectional Analysis of the National Ambulatory Care Survey (2007-2015). (Abstract)

recommendation.We conducted a cross-sectional analysis examining data between 2007 and 2015 from the National Ambulatory Medical Care Survey. Visits to orthopedists and primary care physicians for knee OA were identified and assessed for the following: PT referral, lifestyle counseling, nonsteroidal antiinflammatory drug (NSAID) prescriptions, and narcotics prescriptions. Triennial rates for each treatment were calculated. We examined associations between patient (e.g., race, insurance), physician, and practice (...) during the investigated timeframe. Variation in treatment choices were associated with nonclinical factors. Future research is necessary to examine ways to improve PT and lifestyle utilization and reduce variation in care for knee OA.© 2019, American College of Rheumatology.

2020 Arthritis care & research

225. Knee osteoarthritis, potential mediators, and risk of all-cause mortality: data from the Osteoarthritis Initiative. Full Text available with Trip Pro

) radiographic knee OA only; and (4) neither radiographic knee OA nor knee pain. We examined the relation of knee OA status to all-cause mortality using a multivariable Cox-proportional model and assessed the extent to which the association was mediated by disability, physical (PCS) and mental component summary scores (MCS) of quality of life (QoL), and oral pain-relief medications (i.e. nonsteroidal anti-inflammatory drugs and opioids) use.Among 4,796 participants, 282 died over the 96-month follow-up (...) Knee osteoarthritis, potential mediators, and risk of all-cause mortality: data from the Osteoarthritis Initiative. To assess the relation of symptomatic knee osteoarthritis (OA), knee pain, and radiographic knee OA to all-cause mortality and identify mediators in the causal pathway.Participants from the Osteoarthritis Initiative were divided into four groups: (1) symptomatic knee OA (i.e., both radiographic knee OA [Kellgren and Lawrence grade ≥2] and knee pain); (2) knee pain only; (3

2020 Arthritis care & research

226. Clinical osteoarthritis of the hip and knee and fall risk: The role of low physical functioning and pain medication. Full Text available with Trip Pro

Clinical osteoarthritis of the hip and knee and fall risk: The role of low physical functioning and pain medication. Several studies have found an increased fall risk in persons with osteoarthritis (OA). However, most prospective studies did not use a clinical definition of OA. In addition, it is not clear which factors explain this risk. Our objectives were: (1) to confirm the prospective association between clinical OA of the hip and knee and falls; (2) to examine the modifying effect of sex (...) ; and (3) to examine whether low physical performance, low physical activity and use of pain medication are mediating these relationships.Baseline and 1-year follow-up data from the European Project on OSteoArthritis (EPOSA) were used involving pre-harmonized data from five European population-based cohort studies (ages 65-85, n = 2535). Clinical OA was defined according to American College of Rheumatology (ACR) criteria. Falls were assessed using self-report.Over the follow-up period, 27.7

2020 Seminars in arthritis and rheumatism

227. Onset and maintenance of efficacy of subcutaneous tanezumab in patients with moderate to severe osteoarthritis of the knee or hip: A 16-week dose-titration study. Full Text available with Trip Pro

Onset and maintenance of efficacy of subcutaneous tanezumab in patients with moderate to severe osteoarthritis of the knee or hip: A 16-week dose-titration study. To examine the onset and maintenance of efficacy of subcutaneous tanezumab for pain relief and functional improvement in difficult-to-treat patients with moderate-to-severe osteoarthritis (OA) in a 16-week dose-titration study (NCT02697773).Patients were randomized to placebo (placebo group) or tanezumab 2.5 mg at baseline and week 8

2020 Seminars in arthritis and rheumatism

228. The Relationship Between Clinical and Quantitative Measures of Pain Sensitization in Knee Osteoarthritis. (Abstract)

The Relationship Between Clinical and Quantitative Measures of Pain Sensitization in Knee Osteoarthritis. Pain sensitization in knee osteoarthritis (OA) is associated with greater symptom severity and poorer clinical outcomes. Measures that identify pain sensitization and are accessible to use in clinical practice have been suggested to enable more targeted treatments. This merits further investigation. This study examines the relationship between quantitative sensory testing (QST) and clinical (...) measures of pain sensitization in people with knee OA.A secondary analysis of data from 134 participants with knee OA was performed. Clinical measures included: manual tender point count (MTPC), the Central Sensitization Inventory (CSI) to capture centrally mediated comorbidities, number of painful sites on a body chart, and neuropathic pain-like symptoms assessed using the modified PainDetect Questionnaire. Relationships between clinical measures and QST measures of pressure pain thresholds (PPTs

2020 Clinical Journal of Pain

229. Knee pain and future decline in higher-level functional competence in community-dwelling older Japanese: the Kurabuchi cohort study. (Abstract)

examinations. The frequency of knee pain, degree of pain and functional impairment resulting from the pain were asked at baseline (2005-2006) via a self-administered questionnaire in Japanese based on an English version of the Western Ontario and McMaster Universities Osteoarthritis Index. Information on HLFC at baseline and during home visits were collected annually until 2014 with the Tokyo Metropolitan Institute of Gerontology Index of Competence. The association between baseline knee pain and HLFC (...) Knee pain and future decline in higher-level functional competence in community-dwelling older Japanese: the Kurabuchi cohort study. The effect of knee osteoarthritis, which causes knee pain, on higher-level functional competence (HLFC) is not clear.To clarify the effect of knee pain on HLFC in older people.Community-based prospective cohort study.Kurabuchi town, Gumma prefecture, Japan.Community-dwelling individuals aged 65 and older.A total of 808 residents participated to the baseline

2020 Age and ageing

230. Ceramic Coating in Cemented Primary Total Knee Arthroplasty is Not Associated With Decreased Risk of Revision due to Early Prosthetic Joint Infection. Full Text available with Trip Pro

Ceramic Coating in Cemented Primary Total Knee Arthroplasty is Not Associated With Decreased Risk of Revision due to Early Prosthetic Joint Infection. Prosthetic joint infection (PJI) is one of the most frequent and devastating causes of short-term revision total knee arthroplasty (TKA). In vitro evidence suggests ceramic surfaces demonstrate resistance to biofilm, but the clinical effect of bearing surface modifications on the risk of PJI remains unclear. This premier registry-based study (...) examines the influence of ceramic bearing surface coatings on the outcome in cemented primary TKA.In total, 117,660 cemented primary TKAs in patients with primary osteoarthritis recorded in the German arthroplasty registry since 2012 were followed up for a maximum of 3 years. The primary endpoint was risk of revision for PJI on ceramic coated and uncoated cobalt-chromium-molybdenum femoral components. Propensity score matching for age, gender, obesity, diabetes mellitus, depression and Elixhauser

2020 Journal of Arthroplasty

231. The Relationship Between Psychological Aspects and Trajectories of Symptoms in Total Knee Arthroplasty and Total Hip Arthroplasty. Full Text available with Trip Pro

The Relationship Between Psychological Aspects and Trajectories of Symptoms in Total Knee Arthroplasty and Total Hip Arthroplasty. This study aimed to examine different trajectories of physical symptoms in hip and knee arthroplasty patients from presurgery to 1 year postsurgery and relate this to preoperative anxiety and depressive symptoms.Patients (N = 345) completed the Hip injury and Osteoarthritis Outcome Score or the Knee injury and Osteoarthritis Outcome Score to examine (...) . Knee patients belonged mainly to classes with least improvement. Least improvement in pain was characterized by a combination of high levels of both anxiety and depressive symptoms. Anxiety and depressive symptoms were independently related to less reduction in stiffness while little improvement in function was characterized by higher depressive symptoms.The results of this study indicate that anxiety and depressive symptoms were significantly, but differently, related to the distinct physical

2020 Journal of Arthroplasty

232. Reduced strength, poor balance and concern about falls mediate the relationship between knee pain and fall risk in older people. Full Text available with Trip Pro

Reduced strength, poor balance and concern about falls mediate the relationship between knee pain and fall risk in older people. Pain is an independent risk factor for falling. One in two older community-dwelling people with musculoskeletal pain fall each year. This study examined physical, psychological and medical factors as potential mediators to explain the relationship between knee pain and falls.Three hundred and thirty-three community-dwelling people aged 70+ years (52% women (...) ) participated in this cohort study with a 1-year follow-up for falls. Participants completed questionnaires (medical history, general health and concern about falls) and underwent physical performance tests. Participants were classified into 'pain' and 'no pain' groups based on self-reported knee pain. Poisson Regression models were computed to determine the Relative Risk (RR) of having multiple falls and potential mediators for increased fall risk.One hundred and eighteen (36%) participants were

2020 BMC Geriatrics

233. A 49-Year-Old Man With Cough and Hand, Wrist, and Knee Pain. (Abstract)

weight loss: 50 pounds over 12 months. He was a never smoker. The examination was notable for bilateral knee effusions. Radiographs of his wrists, hands, and knee were obtained, along with a chest radiograph. He was then referred to a pulmonologist for further workup.Copyright © 2019 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved. (...) A 49-Year-Old Man With Cough and Hand, Wrist, and Knee Pain. A 49-year-old man was sent by his primary care physician to the rheumatology clinic with complaints of several months of bilateral lower extremity swelling. The swelling migrated from both ankles up to his knees. Presenting symptoms consisted of bilateral knee pain as well as bilateral wrist and hand pain with swelling. Pulmonary symptoms consisted of a nagging productive cough of several months. He also complained of significant

2020 Chest

234. Cerebrospinal fluid cholinergic biomarkers are associated with postoperative delirium in elderly patients undergoing Total hip/knee replacement: a prospective cohort study. Full Text available with Trip Pro

expression levels of cholinergic biomarkers in cerebrospinal fluid (CSF) and the occurrence and development of POD in elderly patients.Four hundred and ninety-two elderly patients aged 65 years old or older with elective total hip/knee replacement received combined spinal-epidural anesthesia. Preoperative baseline cognitive function was assessed using the Mini-Mental State Examination (MMSE) before surgery. Each patient was interviewed in post-anesthesia care unit (PACU) and on the first, second, third (...) Cerebrospinal fluid cholinergic biomarkers are associated with postoperative delirium in elderly patients undergoing Total hip/knee replacement: a prospective cohort study. Postoperative delirium (POD) is a frequent complication after surgery and its occurrence is associated with poor outcomes. The neuropathology of this complication is unclear, but it is important to evaluate relevant biomarkers for postoperative status. The purpose of this study is to explore the relationship between

2020 BMC Anesthesiology

235. Perioperative Opioid Prescribing Patterns and Readmissions After Total Knee Arthroplasty in a National Cohort of Veterans Health Administration Patients. (Abstract)

Perioperative Opioid Prescribing Patterns and Readmissions After Total Knee Arthroplasty in a National Cohort of Veterans Health Administration Patients. Among Veterans Health Administration (VHA) patients who undergo total knee arthroplasty (TKA) nationally, what are the underlying readmission rates and associations with perioperative opioid use, and are there associations with other factors such as preoperative health care utilization?We retrospectively examined the records of 5,514 TKA

2020 Pain Medicine

236. Changes in Experimental Pain Sensitivity from Using Home-Based Remotely Supervised Transcranial Direct Current Stimulation in Older Adults with Knee Osteoarthritis. (Abstract)

Changes in Experimental Pain Sensitivity from Using Home-Based Remotely Supervised Transcranial Direct Current Stimulation in Older Adults with Knee Osteoarthritis. The present study examined the effects of home-based remotely supervised transcranial direct current stimulation on quantitative sensory testing measurements in older adults with knee osteoarthritis. Participants were hypothesized to experience improved pain measurements over time.Open-label, single-arm trial.Southeast Texas between (...) March and November 2018 at a nursing school and participant homes.Older adults (aged 50-85 years) with self-reported unilateral or bilateral knee osteoarthritis pain who met eligibility criteria set by the American College of Rheumatology.The intervention was applied with a constant current intensity for 20 minutes every weekday for two weeks (10 total sessions). Quantitative measures of pain were collected three times over 10 days (days 1, 5, and 10) and included heat threshold and tolerance

2020 Pain Medicine

237. Time Trends and Risk Factors for 30-Day Adverse Events in Black Patients Undergoing Primary Total Knee Arthroplasty. (Abstract)

Time Trends and Risk Factors for 30-Day Adverse Events in Black Patients Undergoing Primary Total Knee Arthroplasty. Increased adverse events (AEs) have been reported among black patients undergoing joint arthroplasty, but little is known about their persistence and risk factors. The purpose of this study is (1) to examine recent annual trends in 30-day outcomes after total knee arthroplasty (TKA) and (2) to develop a preoperative risk stratification model in this racial minority.The American

2020 Journal of Arthroplasty

238. Reporting Outcomes of Treatment for Periprosthetic Joint Infection of the Knee and Hip Together With a Minimum 1-Year Follow-Up is Reliable. (Abstract)

. A multivariate Cox proportional hazards regression and a sensitivity analysis using propensity matching were performed. A two-piecewise linear regression model was used to examine the threshold effect of time after treatment on survival rates.There were no significant differences between hip and knee PJIs in overall survivorship (P = .71), or when stratified by irrigation and debridement (P = .39), or two-stage exchange arthroplasty (P = .59). There was also no difference by joint in the multivariate (...) Reporting Outcomes of Treatment for Periprosthetic Joint Infection of the Knee and Hip Together With a Minimum 1-Year Follow-Up is Reliable. Although there is an increasing trend toward reporting the outcome of hip and knee arthroplasty separately, it remains unknown whether joint-specific reporting is necessary for periprosthetic joint infection (PJI) as sample sizes are already low, given its relatively rare occurrence. The aim of this study is to compare treatment outcomes of PJI occurring

2020 Journal of Arthroplasty

239. Association of Pain on Hospital Discharge with the Risk of 30-Day Readmission in Patients with Total Hip and Knee Replacement. (Abstract)

Association of Pain on Hospital Discharge with the Risk of 30-Day Readmission in Patients with Total Hip and Knee Replacement. It is not clear if there is a risk of 30-day readmissions following total hip and knee arthroplasty in patients reporting high levels of pain at hospital discharge. We examined the relationship between post-surgical pain on the day of discharge and 30-day readmission in patients who received total knee and hip arthroplasty.Retrospective cohort study was conducted (...) of patients who received total knee (n = 155,284) or hip arthroplasty (n = 89,283) from 2011 to 2018 using electronic health records from the Optum database. Four categories of pain at discharge were created, from none to severe. Multivariate logistic regression models to predict 30-day all-cause readmission were adjusted for patient and clinical characteristics and built separately for knee and hip arthroplasty patients.Mean ages for hip and knee patients were 64.4 (standard deviation 11.3) and 65.7

2020 Journal of Arthroplasty

240. Postoperative Intravenous Iron Supplementation Does Not Improve Hemoglobin Level and Transfusion Rate Following Staged Bilateral Total Knee Arthroplasty. (Abstract)

Postoperative Intravenous Iron Supplementation Does Not Improve Hemoglobin Level and Transfusion Rate Following Staged Bilateral Total Knee Arthroplasty. We determined whether postoperative intravenous (IV) iron supplementation could reduce transfusion rate in patients undergoing staged bilateral total knee arthroplasty (TKA). Furthermore, we examined whether hemoglobin (Hb) levels and iron profile differed between patients with and without postoperative IV iron supplementation.This

2020 Journal of Arthroplasty

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