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Knee Exam

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341. Stair climbing ability in patients with early knee osteoarthritis: Defining the clinical hallmarks of early disease. (Abstract)

the SCT is better than ascending stair time for the identification of these patients.This study was a secondary, cross-sectional analysis of baseline data from a randomized controlled trial. Adults with moderate to severe knee pain were enrolled (n = 57; mean age 58.9 years; 71.9% women). Each participant performed an 11-step SCT (11-SCT) while wearing shoes with a pressure sensor insole. A receiver operating characteristic analysis was used to examine the discriminative power of 11-SCT (...) Stair climbing ability in patients with early knee osteoarthritis: Defining the clinical hallmarks of early disease. A growing clinical interest has been shown towards identifying knee osteoarthritis (OA) patients at earlier stages. The early detection of knee OA may allow for more effective interventions.The aim of this study was to determine the discriminative ability of a stair-climb test (SCT) in identifying patients with early knee OA, and to determine if descending stair time during

2019 Gait & posture Controlled trial quality: uncertain

342. Gene expression analysis of vastus medialis cells after tourniquet-induced ischemia during total knee arthroplasty: a randomized clinical trial. (Abstract)

on gene expression within the human skeletal muscle cells are barely examined. The purpose of the present study was to analyze the gene expression within the skeletal muscle cells after tourniquet-induced ischemia to identify differential expressed genes (DEGs) and pathways.As part of a randomized, controlled, monocentric trial (Clinical-Trials.gov NCT02475603) 20 patients, scheduled to undergo primary total knee arthroplasty (TKA), were included. Written informed consent was received and the patients (...) Gene expression analysis of vastus medialis cells after tourniquet-induced ischemia during total knee arthroplasty: a randomized clinical trial. Postoperative quadriceps muscle strength was lowered after tourniquet application during total knee arthroplasty (TKA). Furthermore, tourniquet application results in higher proteolytic activity within vastus medialis cells, without influence on the amount and function of mitochondria. The effects of the commonly utilized intraoperative tourniquet

2019 European journal of trauma and emergency surgery : official publication of the European Trauma Society Controlled trial quality: uncertain

343. The Effect of Transcranial Direct Current Stimulation on Inflammation in Older Adults With Knee Osteoarthritis: A Bayesian Residual Change Analysis. Full Text available with Trip Pro

The Effect of Transcranial Direct Current Stimulation on Inflammation in Older Adults With Knee Osteoarthritis: A Bayesian Residual Change Analysis. Transcranial direct current stimulation (tDCS) has demonstrated effectiveness in reducing clinical and experimental measures of pain in patients with chronic pain; however, research examining the mechanisms of action for the effects of tDCS has been lacking. The present study investigated the effect of active tDCS on measures of inflammation (...) and stress. Older adults (aged 50-70 years) with knee osteoarthritis (OA) were randomly assigned to receive daily 20-min sessions of either tDCS (n = 20) or sham tDCS (n = 20) for 5 consecutive days. Participants provided blood samples at baseline and the end of treatment. The following measures of immune function and stress were collected: interleukin (IL)-6 and 10, tumor necrosis factor-α (TNF-α), C-reactive protein, cortisol, and β-endorphin. Generalized linear modeling evaluated each posttreatment

2019 Biological research for nursing Controlled trial quality: uncertain

344. Efficacy of combining home-based transcranial direct current stimulation with mindfulness-based meditation for pain in older adults with knee osteoarthritis: A randomized controlled pilot study. (Abstract)

and MBM in older adults with knee osteoarthritis (OA). Therefore, the aim of this study was to examine the feasibility and preliminary efficacy of home-based tDCS paired with MBM in older adults with knee OA. Thirty participants 50-85 years old with symptomatic knee OA were randomly assigned to receive 10 daily sessions of home-based 2 mA tDCS paired with active MBM for 20 min (n = 15) or sham tDCS paired with sham MBM (n = 15). We measured clinical pain and OA symptoms via a Numeric Rating Scale (...) Efficacy of combining home-based transcranial direct current stimulation with mindfulness-based meditation for pain in older adults with knee osteoarthritis: A randomized controlled pilot study. Transcranial direct current stimulation (tDCS) has been shown to be effective for reducing pain, and a growing body of literature shows the potential analgesic effects of mindfulness-based meditation (MBM). However, few studies have investigated the potential benefits associated with combining tDCS

2019 Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia Controlled trial quality: uncertain

345. Single-use, patient-specific instrumentation technology in knee arthroplasty: a comparative study between standard instrumentation and PSI efficiency system. (Abstract)

instrumentation in malalignment risk and blood loss reduction. From April 2015 to September 2016, 40 patients for a total of 40 knees were included in the randomization process. Each patient underwent CT scan of the lower limb including hip, knee and ankle joint with the realization of the PSI system and the TKA with Medacta GMK Primary®. Patients were evaluated 1 month after surgery with X-ray and after 2 months with clinical examination and assessment by Knee Society Score (KSS). Blood loss was detected (...) Single-use, patient-specific instrumentation technology in knee arthroplasty: a comparative study between standard instrumentation and PSI efficiency system. Patient-specific instrumentation is a surgical technique that was created to improve the accuracy of implantation, surgical time and workflow in total knee arthroplasty. This study is a single-center, single-surgeon randomized clinical trial. The aim of this work was to evaluate clinical efficacy of PSI versus standard surgical

2019 Musculoskeletal surgery Controlled trial quality: uncertain

346. Dosing of intra-articular triamcinolone hexacetonide for knee synovitis in chronic polyarthritis: a randomized controlled study. Full Text available with Trip Pro

the relapse rate during 6 months. Methods: A total of 159 adult patients with rheumatoid arthritis (RA) or psoriatic arthritis (PsA) and active knee synovitis were randomized to IAGC injection with 20 mg or 40 mg THA. Participants were blinded to the treatment dose. The primary endpoint was relapse of arthritis. When symptoms from the treated joint recurred and signs of arthritis could be confirmed on a subsequent clinical examination, a relapse was recorded and the duration of response survival (...) Dosing of intra-articular triamcinolone hexacetonide for knee synovitis in chronic polyarthritis: a randomized controlled study. Objective: Intra-articular glucocorticoid (IAGC) injection treatment is an easy and effective way to treat the signs and symptoms of arthritis, but there is limited knowledge on the adequate dosing for different joints. The aim of this study was to compare the outcome between two common doses of intra-articular triamcinolone hexacetonide (THA) for knee synovitis using

2019 Scandinavian journal of rheumatology Controlled trial quality: uncertain

347. Foot and ankle characteristics and dynamic knee valgus in individuals with patellofemoral osteoarthritis. Full Text available with Trip Pro

Foot and ankle characteristics and dynamic knee valgus in individuals with patellofemoral osteoarthritis. Controlled laboratory study; cross-sectional design.Foot and ankle characteristics and dynamic knee valgus differ in people with and without patellofemoral (PF) pain. However, it is unknown if these characteristics are evident in people with PF osteoarthritis (OA), compared to pain-free older adults.To compare foot and ankle mobility, foot posture and dynamic knee valgus, measured (...) as the frontal plane projection angle (FPPA) during single-leg squatting, between individuals with and without PFOA.Fifty-one participants with PFOA (66% women, mean ± SD age 57 ± 10 years, body mass index (BMI) 27 ± 6 kg/m2), and 23 controls (56% women, age 56 ± 9 years, BMI 24 ± 4 kg/m2) had ankle dorsiflexion measured using the knee-to-wall test, foot mobility calculated as the difference in midfoot height or width between non-weightbearing and weightbearing, and static foot posture characterized

2019 Journal of foot and ankle research Controlled trial quality: uncertain

348. Comparative study of the effect of Thymus daenensis gel 5% and diclofenac in patients with knee osteoarthritis. Full Text available with Trip Pro

Comparative study of the effect of Thymus daenensis gel 5% and diclofenac in patients with knee osteoarthritis. Osteoarthritis is a syndrome characterized by joint pain and reduced performance and efficien- cy in patient. Thymus daenensis has been used since old times for the treatment of bone and joint deformities and pain in traditional medicine.This study was conducted to examine traditional usages and pharmacological features of T. daen- ensis with respect to the effect of the plant

2019 BioMedicine Controlled trial quality: uncertain

349. Intra-Articular Injection of Autologous Adipose Tissue-Derived Mesenchymal Stem Cells for the Treatment of Knee Osteoarthritis: A Phase IIb, Randomized, Placebo-Controlled Clinical Trial. Full Text available with Trip Pro

Intra-Articular Injection of Autologous Adipose Tissue-Derived Mesenchymal Stem Cells for the Treatment of Knee Osteoarthritis: A Phase IIb, Randomized, Placebo-Controlled Clinical Trial. Mesenchymal stem cells (MSCs) have been the focus of an emerging treatment for osteoarthritis. However, few studies reported about outcomes of an intra-articular injection of autologous adipose-derived mesenchymal stem cells (AD-MSCs). This study aimed to assess the efficacy and safety of a single intra (...) -articular injection of AD-MSCs for patients with knee osteoarthritis. It was a prospective double-blinded, randomized controlled, phase IIb clinical trial. AD-MSCs were administered for 12 patients (MSC group), and the group was compared with 12 knees with injection of normal saline (control group) up to 6 months. All procedures were performed in the outpatient clinic. Primary outcome measure was the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) score. Secondary outcome measure

2019 Stem cells translational medicine Controlled trial quality: predicted high

350. Efficacy, Safety, and Tolerability of ONO-4474, an Orally Available Pan-Tropomyosin Receptor Kinase Inhibitor, in Japanese Patients With Moderate to Severe Osteoarthritis of the Knee: A Randomized, Placebo-Controlled, Double-Blind, Parallel-Group Comparat Full Text available with Trip Pro

Efficacy, Safety, and Tolerability of ONO-4474, an Orally Available Pan-Tropomyosin Receptor Kinase Inhibitor, in Japanese Patients With Moderate to Severe Osteoarthritis of the Knee: A Randomized, Placebo-Controlled, Double-Blind, Parallel-Group Comparat We examined the efficacy, safety, and tolerability of ONO-4474 in Japanese patients with osteoarthritis (OA) of the knee. In this multicenter, placebo-controlled, randomized, double-blind, parallel-group comparative study, patients (...) with moderate to severe OA who were refractory to nonsteroidal anti-inflammatory drugs were orally administered 100 mg of ONO-4474 twice daily for 28 days. The primary end point was knee pain during walking, assessed by visual analog scale over 24 hours (VAS24 ). Treatment-emergent adverse events (TEAEs) and adverse drug reactions were reported for safety. In total, 110 patients were randomized (1:1) to receive placebo or ONO-4474. The mean (standard deviation) change in VAS24 scores at week 4 was -26.9

2019 Journal of clinical pharmacology Controlled trial quality: predicted high

351. Densitometric changes of the patella in patients undergoing unilateral knee arthroplasty. (Abstract)

Densitometric changes of the patella in patients undergoing unilateral knee arthroplasty. Although the intervention of knee arthroplasty became routine, there is no standard reference on the densitometric characteristics of the patella before and after surgery. Scope of this work is the evaluation of patellar bone density before and after unilateral knee arthroplasty.BMD was assessed by DEXA examination in 146 individuals, who have been divided into three distinct groups. Group I: 68 subjects (...) with a mean age of 70.6 years, with an unilateral femoral-tibial knee prothesis. Group II: healthy subjects of similar age (average: 64) and without implants. Group III: healthy adults with a mean age of 26.6 years. The follow-up was performed at 6 months to a maximum of 2 years post surgery.The results were obtained from 68 subjects examined with the DEXA software dedicated to the forearm, which turned out to be the most appropriate for our purpose. The follow-up performed every 6 months after surgery

2019 Il Giornale di chirurgia Controlled trial quality: uncertain

352. Cellular and morphological changes with EAA supplementation before and after total knee arthroplasty. Full Text available with Trip Pro

Cellular and morphological changes with EAA supplementation before and after total knee arthroplasty. Investigate the underlying cellular basis of muscle atrophy (Placebo) and atrophy reduction (essential amino acid supplementation, EAAs) in total knee arthroplasty (TKA) patients by examining satellite cells and other key histological markers of inflammation, recovery, and fibrosis. Forty-one subjects (53-76 yr) scheduled for TKA were randomized into two groups, ingesting 20 g of EAAs (...) elevated postsurgery in both groups; however, TNF-α declined by 2 wk in the EAAs Group. EAAs starting 7 days before surgery increased satellite cells on the day of surgery and promoted a more favorable inflammatory environment postsurgery.NEW & NOTEWORTHY Clinical studies by our group indicate that the majority of muscle atrophy after total knee arthroplasty (TKA) in older adults occurs rapidly, within the first 2 wks. We have also shown that essential amino acid supplementation (EAAs) before and after

2019 Journal of applied physiology (Bethesda, Md. : 1985) Controlled trial quality: uncertain

353. Short term outcomes of long duration versus short duration tourniquet in primary total knee arthroplasty: A randomized controlled trial. Full Text available with Trip Pro

of deep vein thrombosis and pulmonary embolism by causing venous stasis, endothelial damage and increased platelet adhesion secondary to distal limb ischemia.We conducted a randomized controlled trial (RCT) to examine the benefits and risks associated with the use of long duration over short duration tourniquets during TKA. The study was a prospective randomised control trial with a total of 80 knees (40 knees in each group) included in the study. The knees selected for surgery were randomly allocated (...) Short term outcomes of long duration versus short duration tourniquet in primary total knee arthroplasty: A randomized controlled trial. A tourniquet is used during the total knee replacement surgery to improve the visibility, to reduce the blood loss and for better cementation. Indirectly it decreases the duration of surgery and enhances the recovery of the patient. Their use however is controversial due to some side effects associated with the use of tourniquet. They may increase the risk

2019 Journal of clinical orthopaedics and trauma Controlled trial quality: uncertain

354. Comparison of a Patient-Centered Weight Loss Program starting before versus after knee replacement: A pilot study. Full Text available with Trip Pro

Comparison of a Patient-Centered Weight Loss Program starting before versus after knee replacement: A pilot study. Most patients risk gaining weight in the years after knee replacement, adding further concern to a population that is mostly overweight/obese prior to surgery.Via a randomised pilot study, we assessed changes in weight during a Patient Centered Weight Loss Program (PACE) initiated either before or after knee replacement, while simultaneously examining the feasibility of recruiting (...) and retaining participants over 26 weeks.Recruitment outreach was made to 133 patients scheduled for knee replacement. Sixteen participants were randomised to a 14-session weight loss program that started either ≤6 weeks before surgery (PACE) or at 12 weeks post-op (Delayed PACE). Repeated measures ANOVAs were used to examine preliminary changes in weight, function, patient-reported outcomes, and physical activity across time (baseline/pre-op, 12 and 26 weeks after surgery) and group.Retention was 75

2019 Obesity research & clinical practice Controlled trial quality: uncertain

355. Effectiveness of a weekend physiotherapy service on short-term outcomes following hip and knee joint replacement surgery: a quasi-experimental study. (Abstract)

Effectiveness of a weekend physiotherapy service on short-term outcomes following hip and knee joint replacement surgery: a quasi-experimental study. To investigate the effect of an acute weekend physiotherapy service compared to no physiotherapy service on short-term outcomes following lower limb joint replacement.Pre-post intervention (quasi-experimental) study nested within two stepped-wedge cluster randomized controlled trials.Public tertiary hospital in Melbourne, Australia.Consecutive (...) patients undergoing hip and knee replacement.This study analysed a subgroup of one cluster of the parent trials where acute weekend physiotherapy services were sequentially discontinued in random order from one cluster at a time. Intervention (at the ward level) included six months of existing acute weekend physiotherapy services (Phase 1; n = 130) followed by six months when these services were discontinued (Phase 2; n = 146).Acute hospital length of stay and other short-term patient and hospital

2019 Clinical rehabilitation Controlled trial quality: uncertain

356. Unilateral Knee and Ankle Joint Fatigue Induce Similar Impairment to Bipedal Balance in Judo Athletes. Full Text available with Trip Pro

contractions (force decreased to 50% of initial peak torque for three consecutive movements) of the knee flexors and extensors or ankle dorsiflexors and plantar flexors, respectively. Static bipedal postural control (French Posturology Association normative standards) with eyes open and eyes closed was examined before and immediately after the fatiguing task. Postural variables examined were the centre of pressure (CoP) sway in the medio-lateral and antero-posterior directions, total CoP area sway and CoP (...) Unilateral Knee and Ankle Joint Fatigue Induce Similar Impairment to Bipedal Balance in Judo Athletes. The purpose of this study was to compare the effects of unilateral ankle fatigue versus the knee muscles with and without vision on bipedal postural control. Elite judo athletes who competed at the national level with at least 10 years of training experience, were randomised into KNEE (n = 10; 20 ± 2 years) and ANKLE (n = 9; 20 ± 3 years) groups, who performed dynamic isokinetic fatiguing

2019 Journal of human kinetics Controlled trial quality: uncertain

357. The Effect of Medical Exercise Therapy on Pressure Sensitivity in Patients with Knee Osteoarthritis: A Cohort Pilot Study. Full Text available with Trip Pro

The Effect of Medical Exercise Therapy on Pressure Sensitivity in Patients with Knee Osteoarthritis: A Cohort Pilot Study. While continued research into pain and exercise may address the underlying mechanisms, the mechanisms through which exercise may act are still poorly understood. The purpose of this study was to examine the effects of medical exercise therapy on pressure sensitivity in knee osteoarthritis patients, and to assess whether the decreased pain perception after medical exercise (...) therapy can be explained by changes in pressure sensitivity.We adopted acohort design in which 16 patients with long term pain were tested before and after 3 months of medical exercise therapy intervention. Pain was detected by visual analogue scale (VAS) and a digital pressure algometer, which also assessed pressure sensitivity. Function (Knee Osteoarthritis Outcome Score, KOOS), anxiety and depression (HAD) and kinesiophobia (Tampa Scale of Kinesiophobia, TSK) were also measured.The VAS showed

2019 Pain and therapy Controlled trial quality: uncertain

358. Effect of Vitamin D supplementation on synovial tissue volume and subchondral bone marrow lesion volume in symptomatic knee osteoarthritis. Full Text available with Trip Pro

Effect of Vitamin D supplementation on synovial tissue volume and subchondral bone marrow lesion volume in symptomatic knee osteoarthritis. Data from a recent clinical trial of vitamin D therapy in knee OA suggests that, compared to placebo, vitamin D therapy may be associated with a reduction in effusion-synovitis. Our aim was, using contrast-enhanced (CE) magnetic resonance imaging (MRI), to examine the effect of vitamin D therapy on synovial tissue volume (STV) and also subchondral bone (...) marrow lesion (BML) volume in men and women with symptomatic knee OA.Data was acquired from participants who took part in a randomised placebo-controlled trial (UK VIDEO) investigating the effect of vitamin D therapy (800 IU cholecalciferol daily) on radiographic joint space narrowing. A subsample had serial CE MRI scans acquired during the trial. Subjects with serial images were assessed (N = 50) for STV and subchondral BML volume. The difference in the mean change from baseline in these structural

2019 BMC Musculoskeletal Disorders Controlled trial quality: predicted high

359. Diagnostic value of ultrasound in calcium pyrophosphate deposition disease of the knee joint. Full Text available with Trip Pro

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 (...) , conventional radiography (CR), and US examination using the Outcome Measures in Rheumatology (OMERACT) definition of the US characteristics of CPPD. Two independent operators performed the US, and inter-observer agreement was calculated. Intra-observer agreement was examined with static images obtained for all enrolled patients.US revealed calcium pyrophosphate (CPP) deposits in menisci, HC, and tendon more frequently in patients with CPPD than in control patients. The presence of US CPP deposits in SF

2019 Osteoarthritis and Cartilage

360. MRI-determined anterolateral capsule injury did not affect the pivot-shift in anterior cruciate ligament-injured knees. (Abstract)

the reliability of the MRI, the difference in the pivot-shift between two groups was assessed.Because of the poor agreement between examiners with respect to the ALC evaluations (κ coefficient of 0.25 and 58.5% concordance), the result from each examiner was analyzed separately. Examiner 1 found ALC injury in 42/82 knees (51%). The two groups had similar clinical grading (glide/clunk/gross: ALC+ group 21/18/3cases vs. ALC- group 21/16/3cases) (n.s.). Tibial acceleration during pivot-shift was also similar (...) in the ALC+ (1.4 ± 1.2 m/s2) and ALC- (1.7 ± 1.3 m/s2) groups (n.s.). Examiner 2 found ALC injury in 28/82 knees (34%). Differences in clinical grading were not observed (glide/clunk/gross: ALC+ group 16/9/3 vs. ALC- group 26/25/3) (n.s.). However, the tibial acceleration in the ALC+ group (1.2 ± 0.8 m/s2) was significantly lower than that in the ALC- group (1.7 ± 1.3 m/s2, p = 0.03).Concomitant ALC injury in knees with ACL injury was not consistently detected on MRI and did not affect rotatory knee

2019 Knee Surgery, Sports Traumatology, Arthroscopy

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