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Knee Exam

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321. No impact of under-correction and joint line obliquity on clinical outcomes of total knee arthroplasty for the varus knee. (Abstract)

No impact of under-correction and joint line obliquity on clinical outcomes of total knee arthroplasty for the varus knee. It has been hypothesized that under-correction of a preoperative varus deformity may be more natural and improve outcomes after total knee arthroplasty (TKA). This study's purpose was to assess the impact of hip-knee-ankle (HKA) alignment and joint line obliquity on TKA outcomes for the varus knee.All patients with a preoperative varus deformity received both preoperative (...) patients (mean age 63.8 ± 9.0 years, BMI 33.0 ± 6.2 kg/m2, follow-up 1.3 ± 0.6 years) were included. There was no difference in the postoperative SF-12 physical component, mental component, Oxford knee, Forgotten Joint Score, or incremental improvement in scores based on the postoperative alignment category for either the HKA or mMPTA. There was no correlation between the magnitude of change in HKA (r = 0.03-0.1) and mMPTA (r = 0.02-0.1) from preoperatively to postoperatively with clinical outcomes.In

2017 Knee Surgery, Sports Traumatology, Arthroscopy

322. Association of frontal plane knee alignment with foot posture in patients with medial knee osteoarthritis. Full Text available with Trip Pro

Association of frontal plane knee alignment with foot posture in patients with medial knee osteoarthritis. To examine the association of radiographic frontal plane knee alignment with three-dimensional foot posture in patients with medial knee osteoarthritis (OA).Participants in orthopedic clinics with Kellgren/Lawrence (K/L) grade ≥1 (88 patients and 88 knees; age, 61-91 years; 65.9% female) were enrolled. An anteroposterior radiographic view was used to assess the anatomical axis angle (AAA (...)  = 0.005) adjusted for age, sex, and body mass index. The relationship between the corrected AAA and hallux valgus angle strengthened (regression coefficient: -0.60 per degree, 95% CI: -1.08, -0.13; P = 0.014) in varus-aligned knees examined separately (63 knees). The other foot postures (navicular height, navicular height/foot length, and rearfoot angle) were not significantly associated with corrected AAA.Radiographic frontal plane knee alignment was associated with hallux valgus angle and calcaneus

2017 BMC Musculoskeletal Disorders

323. Associations between serum ghrelin and knee symptoms, joint structures and cartilage or bone biomarkers in patients with knee osteoarthritis. Full Text available with Trip Pro

Associations between serum ghrelin and knee symptoms, joint structures and cartilage or bone biomarkers in patients with knee osteoarthritis. The roles of ghrelin in knee osteoarthritis (OA) are unclear. This study aimed to examine cross-sectional associations of ghrelin with knee symptoms, joint structures and cartilage or bone biomarkers in patients with knee OA.This study included 146 patients with symptomatic knee OA. Serum levels of ghrelin and cartilage or bone biomarkers including (...) cartilage oligomeric matrix protein (COMP), cross linked C-telopeptide of type I collagen (CTXI), cross linked N-telopeptide of type I collagen (NTXI), N-terminal procollagen III propeptide (PIIINP), and matrix metalloproteinase (MMP)-3, 10, 13 were measured using Enzyme-linked immunosorbent assay (ELISA). Knee symptoms were assessed using the Western Ontario and McMaster Universities Arthritis Index (WOMAC). Infrapatellar fat pad (IPFP) volume, IPFP signal intensity alternation, cartilage defects, bone

2017 Osteoarthritis and Cartilage

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

postoperative IKDC score (p = 0.04).Surgical treatment of the PLC using a single-graft technique can result in satisfactory knee function and stable physical examination findings at minimum 2 years after surgery. Female gender was predictive of poor knee function after PLC reconstruction. Surgical treatment of PLC injuries should be individualized based on the timing of surgery, specific injured knee structures, and physical examination findings. This study helps validate the use of a single-graft technique (...) Satisfactory knee function after single-stage posterolateral corner reconstruction in the multi-ligament injured/dislocated knee using the anatomic single-graft technique. Increasing importance has been placed on the posterolateral corner (PLC) in maintaining varus and rotational stability of the knee. The goal of this study was to evaluate knee function and clinical stability following a single-graft PLC reconstruction technique and identify factors associated with poor knee function.This

2017 Knee Surgery, Sports Traumatology, Arthroscopy

325. RAPID KNEE-EXTENSIONS TO INCREASE QUADRICEPS MUSCLE ACTIVITY IN PATIENTS WITH TOTAL KNEE ARTHROPLASTY: A RANDOMIZED CROSS-OVER STUDY. Full Text available with Trip Pro

contractions.The purpose of this study was to examine if patients with total knee arthroplasty could perform rapid knee-extensions using a 10 RM load four to eight weeks after surgery, and the degree to which rapid knee-extensions were associated with greater voluntary quadriceps muscle activity during an experimental strength training session, compared to that elicited using slow knee-extensions.A randomized cross-over study.Twenty-four patients (age 66.5) 4-8 weeks post total knee arthroplasty randomly (...) RAPID KNEE-EXTENSIONS TO INCREASE QUADRICEPS MUSCLE ACTIVITY IN PATIENTS WITH TOTAL KNEE ARTHROPLASTY: A RANDOMIZED CROSS-OVER STUDY. 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 agonist muscle activity, especially if the exercise is conducted using rapid muscle

2017 International journal of sports physical therapy Controlled trial quality: uncertain

326. Poly-traumatic multi-ligament knee injuries: is the knee the limiting factor? (Abstract)

dislocation grade. Functional outcomes and knee physical examination were assessed at a 2-year follow-up. New Injury Severity Score (NISS) was calculated based on the poly-traumatic injury pattern. Risk factors for worse outcomes in the poly-trauma cohort were analyzed.The mean IKDC, Lysholm, and NISS scores in the polytrauma cohort were 57.2 ± 21.9, 62 ± 22, and 40.9 ± 20.4, respectively, at a mean of 67 months (range 24-220). The isolated knee injury group was followed for a mean of 74 months (range 24 (...) -266) with mean IKDC and Lysholm scores of 71.1 ± 26.5 and 78 ± 23, respectively. Patients in the control cohort had significantly higher IKDC (p = 0.01) and Lysholm scores, (p = 0.003). There were no major differences between the two groups in regards physical examination findings at final follow-up. None of the analyzed risk factors was predictive of poor outcome.When comparing knees with similar multi-ligament and neurovascular injury patterns, patients who sustained their injury as a result

2017 Knee Surgery, Sports Traumatology, Arthroscopy

327. Fixed-flexion view X-ray of the knee superior in detection and follow-up of knee osteoarthritis. Full Text available with Trip Pro

with knee OA. The 81 patients (157 knees) followed up for ≥24 months were selected as study subjects. Medial joint space widths (MJSW), Kellgren-Lawrence (KL) grades, and reductions in MJSW on SEV (ΔSEV) and FFV (ΔFFV) were compared in knees evaluated by SEV and FFV.At both time-points, mean MJSW was significantly lower by FFV than by SEV. Mean MJSW was significantly lower at follow-up than at first examination by both SEV and FFV. At both time-points, the KL grade was higher by FFV than by SEV group (...) Fixed-flexion view X-ray of the knee superior in detection and follow-up of knee osteoarthritis. A fixed flexion view (FFV) is useful for evaluating joint space when assessing the severity of osteoarthritis (OA) of the knee. We analyzed changes in joint space revealed by standing extended view (SEV) and FFV over a mean 4 years, to compare both views on their capacity to measure joint space width accurately at particular time points during follow-up.SEV and FFV images were acquired in patients

2017 Medicine

328. The medial tibial joint line elevation over 5 mm restrained the improvement of knee extension angle in unicompartmental knee arthroplasty. (Abstract)

The medial tibial joint line elevation over 5 mm restrained the improvement of knee extension angle in unicompartmental knee arthroplasty. The purpose of this study was to examine the relationship between medial tibial joint line elevation and the improvement of range of motion (ROM) in unicompartmental knee arthroplasty (UKA). The hypothesis was that limited elevation of tibial joint line will improve knee range of motion in UKA.Forty-six consecutive medial UKAs were enrolled in this study (...) . Medial tibial joint line elevation was defined as the polyethylene insert and tibial tray thickness minus the tibial osteotomy and sawblade thickness. Positive values indicated an elevation of the tibial joint line. A component gap between the femoral trial prosthesis and the medial tibial osteotomy surface was also examined. Joint loosening was also calculated based on the joint component gap minus insert and tibial tray thickness. The correlation of the medial tibial joint line elevation with joint

2017 Knee Surgery, Sports Traumatology, Arthroscopy

329. Lower Extremity Arterial Calcification on Preoperative Knee Radiographs as a Predictor of Postoperative Cardiovascular Events After Primary Total Knee Arthroplasty. (Abstract)

Lower Extremity Arterial Calcification on Preoperative Knee Radiographs as a Predictor of Postoperative Cardiovascular Events After Primary Total Knee Arthroplasty. A cross-sectional study of total knee arthroplasty (TKA) patients was conducted to determine the association of lower-extremity arterial calcification (LEAC) with acute perioperative cardiovascular events (CVEs).Regression modeling was used to examine the association of radiographic presence of LEAC and acute myocardial infarction (...) -day mortality, and few 1-year mortality events, computing OR for these was not possible. Likewise, because of small number of events (n = 3), estimates for the odds of LEAC cases having an acute MI are less reliable, yielding extremely large random errors (OR 11.37; 95% CI 0.09-597.93) and must be interpreted with caution. The OR for 1-year mortality was 1.88 (95% CI 0.17-13.20), but again with large random errors.Our study shows that LEAC around the knee is associated with an increased risk

2017 Journal of Arthroplasty

330. Editorial Commentary: Ultrasound Barely Beats Magnetic Resonance Imaging in Knee Anterolateral Ligament Evaluation…But Does This Change the Treatment of the Anterior Cruciate Ligament-Deficient Knee? Full Text available with Trip Pro

Editorial Commentary: Ultrasound Barely Beats Magnetic Resonance Imaging in Knee Anterolateral Ligament Evaluation…But Does This Change the Treatment of the Anterior Cruciate Ligament-Deficient Knee? Ultrasound (US) examination of the anterolateral ligament (ALL) in the anterior cruciate ligament-deficient knee betters magnetic resonance imaging analysis with slightly higher identification rate of the entire ALL presumably due to the ability to test in a functional pivot shift configuration (...) . The ALL was injured in 63% of the anterior cruciate ligament-deficient knees and the injury occurred at the tibial insertion in all cases. Although the authors propose US to be the new "gold standard" for diagnosing ALL injuries, there still remains a question of whether there is any necessity for an US diagnosis of ALL injury when the pivot shift test may provide the necessary information, and the consensus for ALL reconstruction or lateral extra-articular tenodesis has yet to be reached.Copyright ©

2017 Arthroscopy

331. Knee Symptoms among Adults at Risk for Accelerated Knee Osteoarthritis: Data from the Osteoarthritis Initiative Full Text available with Trip Pro

Knee Symptoms among Adults at Risk for Accelerated Knee Osteoarthritis: Data from the Osteoarthritis Initiative The purpose of this study was to examine if adults who develop accelerated knee osteoarthritis (KOA) have greater knee symptoms with certain activities than those with or without incident common KOA. We conducted a case-control study using data from baseline and the first four annual visits of the Osteoarthritis Initiative. Participants had no radiographic KOA at baseline (Kellgren (...) , or no KOA. To examine group difference in knee symptoms, we used ordinal logistic regression models for each symptom. Results are reported as odds ratios (OR) and 95% confidence intervals (CI). Individuals who developed accelerated KOA were more likely to report greater difficulty with lying down (OR = 2.10, 95% CI = 1.04 to 4.25), pain with straightening the knee fully (OR = 2.04, 95% CI = 1.08, 3.85), and pain walking (OR = 2.49, 95% CI = 1.38, 4.84) than adults who developed common KOA. Individuals

2017 Clinical rheumatology

332. The effects of kinematically aligned total knee arthroplasty on stress at the medial tibia: A case study for varus knee Full Text available with Trip Pro

The effects of kinematically aligned total knee arthroplasty on stress at the medial tibia: A case study for varus knee Little biomechanical information is available about kinematically aligned (KA) total knee arthroplasty (TKA). The purpose of this study was to simulate the kinematics and kinetics after KA TKA and mechanically aligned (MA) TKA with four different limb alignments.Bone models were constructed from one volunteer (normal) and three patients with three different knee deformities (...) (slight, moderate and severe varus). A dynamic musculoskeletal modelling system was used to analyse the kinematics and the tibiofemoral contact force. The contact stress on the tibial insert, and the stress to the resection surface and medial tibial cortex were examined by using finite element analysis.In all bone models, posterior translation on the lateral side and external rotation in the KA TKA models were greater than in the MA TKA models. The tibiofemoral force at the medial side was increased

2017 Bone & joint research

333. MULTIPLE NONSPECIFIC SITES OF JOINT PAIN OUTSIDE THE KNEES DEVELOP IN PERSONS WITH KNEE PAIN Full Text available with Trip Pro

-79 years with or at high risk of knee osteoarthritis who were recruited from 2 community-based cohorts, the Multicenter Osteoarthritis Study and the Osteoarthritis Initiative, and we followed them up for 5-7 years. We excluded those with knee pain at baseline and compared those who had developed knee pain at the first follow-up examination (the index visit) with those who had not. We examined pain on most days at joint regions outside the knee in examinations after the index visit. Logistic (...) regression analyses examined the risk of joint-specific pain adjusted for age, sex, body mass index, and symptoms of depression, and we performed sensitivity analyses excluding those with widespread pain.In the combined cohorts, 693 persons had knee pain at the index visit and 2,793 did not. A total of 79.6% of those with bilateral knee pain and 63.8% of those with unilateral knee pain had pain during follow-up in a joint region outside the knee, compared with 49.9% of those without knee pain

2017 Arthritis & rheumatology (Hoboken, N.J.)

334. Advanced Knee Structure Analysis (AKSA): a comparison of bone mineral density and trabecular texture measurements using computed tomography and high-resolution peripheral quantitative computed tomography of human knee cadavers Full Text available with Trip Pro

between high-resolution peripheral quantitative CT (HR-pQCT) and CT using human cadaveric knees. The secondary goal was the verification of the spatial resolution dependence of texture parameters observed in the earlier simulations, two important prerequisites for the interpretation of in vivo measurements in OA patients.The applicability of texture analysis to characterize bone architecture in clinical CT examinations was investigated and compared to results obtained from HR-pQCT. Fifty-seven human (...) knee cadavers (OA status unknown) were examined with both imaging modalities. Three-dimensional (3D) segmentation and registration processes, together with automatic positioning of 3D analysis volumes of interest (VOIs), ensured the measurement of BMD and texture parameters at the same anatomical locations in CT and HR-pQCT datasets.According to the calculation of dice ratios (>0.978), the accuracy of VOI locations between methods was excellent. Entropy, anisotropy, and global inhomogeneity showed

2017 Arthritis research & therapy

335. Strain measurements of the tibial insert of a knee prosthesis using a knee motion simulator Full Text available with Trip Pro

on a parallel-link six degrees-of-freedom actuator and the principal strain and pressure distribution of the tibial insert were measured. In particular, the early stance phase obtained from in vivo X-ray images was examined because the knee is applied to the largest load during extension/flexion movement. The knee varus-valgus angles were 0° (neutral alignment), 3°, and 5° malalignment.Under a neutral orientation, the pressure was higher at the middle and posterior condyles. The first and second principal (...) Strain measurements of the tibial insert of a knee prosthesis using a knee motion simulator The longevity of a knee prosthesis is influenced by the wear of the tibial insert due to its posture and movement. In this study, we assumed that the strain on the tibial insert is one of the main reasons for its wear and investigated the influence of the knee varus-valgus angles on the mechanical stress of the tibial insert.Knee prosthesis motion was simulated using a knee motion simulator based

2017 Journal of orthopaedics

336. Simultaneous ipsilateral knee arthroscopy and unicondylar knee arthroplasty is effective for bicompartmental symptoms Full Text available with Trip Pro

Simultaneous ipsilateral knee arthroscopy and unicondylar knee arthroplasty is effective for bicompartmental symptoms Patients with unicompartmental radiographic arthritis but bicompartmental symptoms pose a clinical challenge. Some surgeons may perceive it as a contraindication for unicondylar knee arthroplasty (UKA). We investigated patient outcomes 2 years after simultaneous ipsilateral arthroscopy and UKA as compared to a similar group of patients who had total knee replacement (TKA (...) and simultaneous arthroscopy. Further, TKA for isolated compartment radiographic disease in this limited series had poorer outcomes. We obtain MRI selectively when physical exam and radiographic findings suggest isolated arthritic disease in patients with bicompartmental symptoms.

2017 Journal of orthopaedics

337. Test-retest reliability of repeated knee laxity measurements in the acute phase following a knee trauma using a Rolimeter Full Text available with Trip Pro

Test-retest reliability of repeated knee laxity measurements in the acute phase following a knee trauma using a Rolimeter The purpose was to examine the test-retest reliability of the Rolimeter measurement procedure in the acute time phase, following a substantial knee trauma. In total, 15 participants with acute knee trauma were examined by one single observer at three different time-points with the Rolimeter using a maximum force. The selected time-points were: baseline (0-7 days after (...) the trauma), midpoint (3-4 weeks after the trauma), and endpoint (3-4 weeks after the trauma). The anterior-posterior displacement was recorded where the endpoint evaluation was used as the reference value. The mean anterior laxity scores remained constant over the measurement time-points for both knees, with an anterior laxity that was 2.7 mm higher (on average) in the injured than the noninjured knee (9.5 mm vs. 6.8 mm). The mean difference (i.e., bias) between laxity scores, for the injured knee

2017 Journal of exercise rehabilitation

338. Total Knee Arthroplasty in Severe Unstable Knee: Case-Report and Literature Review Full Text available with Trip Pro

female patient with CMT and MG complaining of progressive pain, swelling, and crepitation of the knee joints who had been undergone total knee arthroplasty (TKA) with rotating hinge prosthesis. She had an acute myasthenia crisis soon after operation with prolonged intubation and intensive care unit admission. Radiographies and physical examination revealed bilateral severe unstable arthritic knee joints and left knee posterior dislocation. Short-term postoperative follow-up revealed improved knee (...) Total Knee Arthroplasty in Severe Unstable Knee: Case-Report and Literature Review Multiplanar or global laxity in arthritic knee is rare, most of this patients have neuromuscular disorder (post poliomyelitis, spinal dystrophy) or history of knee trauma. Ligament insufficiency and severe bone loss is significant in this patient. The estimated prevalence for the concurrence of charcot marie-tooth (CMT) with myasthenia gravis (MG) suggests an extremely rare event. We have presented a 54-year-old

2017 Archives of bone and joint surgery

339. Synovial Plica Syndrome of the Knee: A Commonly Overlooked Cause of Anterior Knee Pain Full Text available with Trip Pro

Synovial Plica Syndrome of the Knee: A Commonly Overlooked Cause of Anterior Knee Pain Synovial plica syndrome (SPS) occurs in the knee, when an otherwise normal structure becomes a source of pain due to injury or overuse. Patients may present to general practitioners, physiotherapists, or surgeons with anterior knee pain with or without mechanical symptoms, and the diagnosis can sometimes be difficult. Several studies have examined the epidemiology, diagnosis, and treatment of SPS. We review (...) these resources to provide an evidence-based guide to the diagnosis and treatment of SPS of the knee.

2017 The Surgery Journal

340. The relationship between knee joint angle and knee flexor and extensor muscle strength Full Text available with Trip Pro

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 (...) The relationship between knee joint angle and knee flexor and extensor muscle strength [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

2017 Journal of physical therapy science

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