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Knee Exam

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21. Validity evidence for two objective structured clinical examination stations to evaluate core skills of the shoulder and knee assessment (Full text)

Validity evidence for two objective structured clinical examination stations to evaluate core skills of the shoulder and knee assessment We developed two objective structured clinical examinations (OSCEs) to educate and evaluate trainees in the evaluation and management of shoulder and knee pain. Our objective was to examine the evidence for validity of these OSCEs.A multidisciplinary team of content experts developed checklists of exam maneuvers and criteria to guide rater observations (...) coefficient.A multi-disciplinary cohort of 69 examinees participated. Examinees correctly identified rotator cuff and meniscal disease 88% and 89% of the time, respectively. Inter-rater agreement was moderate for the knee (87%; k = 0.61) and near perfect for the shoulder (97%; k = 0.88). No correlation between stratified self-assessment and OSCE scores were found for either shoulder (0.02) or knee (-0.07).Validity evidence supports the continuing use of these OSCEs in educational programs addressing

2017 BMC medical education PubMed abstract

22. Surgeon's Preference in Total Knee Replacement: A Quantitative Examination of Attributes, Reasons for Alteration, and Barriers to Change. (Abstract)

Surgeon's Preference in Total Knee Replacement: A Quantitative Examination of Attributes, Reasons for Alteration, and Barriers to Change. The reasons why surgeons prefer a particular total knee replacement (TKR) to other viable options with lower cost or lower revision risk remain uncertain. This study examined the concept of surgeon's preference in TKR; including the self-assigned utility of their preferred prosthesis, reasons to alter usual preference and barriers to permanently changing

2017 Journal of Arthroplasty

23. Examining the Effects of Value-based Physician Payment Models

Examining the Effects of Value-based Physician Payment Models ` Rapid Synthesis Examining the Effects of Value-based Physician Payment Models 10 October 2017 McMaster Health Forum 1 Evidence >> Insight >> Action Rapid Synthesis: Examining the Effects of Value-based Physician Payment Models 30-day response 10 October 2017 Examining the Effects of Value-based Physician Payment Models 2 Evidence >> Insight >> Action McMaster Health Forum For concerned citizens and influential thinkers and doers (...) with identifying, reviewing and synthesizing literature. We are especially grateful to Gioia Buckley and Rick Glazier for their insightful comments and suggestions. Citation Mattison CA, Wilson MG. Rapid synthesis: Examining the effects of value-based physician payment models. Hamilton, Canada: McMaster Health Forum, 10 October 2017. Product registration numbers ISSN 2292-7999 (online) McMaster Health Forum 3 Evidence >> Insight >> Action KEY MESSAGES Questions • What value-based physician payment models have

2017 McMaster Health Forum

24. AIUM ACR SPR SRU Practice Parameter for the Performance of an Ultrasound Examination for Detection and Assessment of Developmental Dysplasia of the Hip

position, stability, and acetabular morphology. If position, stability, and/or morphology cannot be assessed when attempting to perform a complete examination, the report should note the portion not performed. It is acceptable to perform the examina- tion with the infant in a supine or in each lateral decubitus position separately. Morphology is assessed at rest. The stress maneuver (posterior push maneuver) is performed to evaluate for hip instability with the hip and knee 2 JUltrasound Med2018; 9999 (...) AIUM ACR SPR SRU Practice Parameter for the Performance of an Ultrasound Examination for Detection and Assessment of Developmental Dysplasia of the Hip PRACTICEGUIDELINES AIUM–ACR–SPR–SRU Practice Parameter for the Performance of an Ultrasound Examination for Detection and Assessment of Developmental Dysplasia of the Hip Preamble T heAmericanInstituteofUltrasoundinMedicine(AIUM)isa multidisciplinary association dedicated to advancing the safe and effective use of ultrasound in medicine through

2018 American Institute of Ultrasound in Medicine

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

was the injection of 1 mL of triamcinolone 40 mg/mL; the control group received 1 mL of 0.9% normal saline. In both arms, synovial fluid (≤10 mL) was aspirated prior to the injection. Participants attended 9 visits over a 24-month period, which were scheduled at 3-month intervals. Each visit included a knee exam and assessments of pain and stiffness. Participants were also subject to radiographs, ultrasound, and magnetic resonance imaging (MRI) at standardized intervals. From the MRI, mean cartilage thickness (...) Gamechanger? The Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients with Knee Osteoarthritis ? A Randomized Clinical Trial Gamechanger? The Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients with Knee Osteoarthritis – A Randomized Clinical Trial – Clinical Correlations Search Gamechanger? The Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients with Knee

2018 Clinical Correlations

26. Does This Patient Have Hip Osteoarthritis?: The Rational Clinical Examination Systematic Review. (Abstract)

Does This Patient Have Hip Osteoarthritis?: The Rational Clinical Examination Systematic Review. Hip osteoarthritis (OA) is a common cause of pain and disability.To identify the clinical findings that are most strongly associated with hip OA.Systematic search of MEDLINE, PubMed, EMBASE, and CINAHL from inception until November 2019.Included studies (1) quantified the accuracy of clinical findings (history, physical examination, or simple tests) and (2) used plain radiographs as the reference (...) standard for diagnosing hip OA.Studies were assigned levels of evidence using the Rational Clinical Examination scale and assessed for risk of bias using the Quality Assessment of Diagnostic Accuracy Studies tool. Data were extracted using individual hips as the unit of analysis and only pooled when findings were reported in 3 or more studies.Sensitivity, specificity, and likelihood ratios (LRs).Six studies were included, with data from 1110 patients and 1324 hips, of which 509 (38%) showed

2020 JAMA

27. WITHDRAWN: Peripheral nerve blocks for postoperative pain after major knee surgery. (Abstract)

surgery requires the synthesis of evidence to evaluate its effectiveness and safety, when compared with systemic, local infiltration, epidural and spinal analgesia.To examine the efficacy and safety of peripheral nerve blocks for postoperative pain control following major knee surgery using methods that permit comparison with systemic, local infiltration, epidural and spinal analgesia.We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 1, 2014), MEDLINE and EMBASE, from (...) WITHDRAWN: Peripheral nerve blocks for postoperative pain after major knee surgery. Major knee surgery is a common operative procedure to help people with end-stage knee disease or trauma to regain mobility and have improved quality of life. Poorly controlled pain immediately after surgery is still a key issue for this procedure. Peripheral nerve blocks are localized and site-specific analgesic options for major knee surgery. The increasing use of peripheral nerve blocks following major knee

2019 Cochrane

28. How useful is the physical examination in suspected cauda equina syndrome?

of physical exam findings from [7,8]. Adapted from the Web Appendix of [11]. The Bottom Line The few studies conducted thus far are retrospective, small in sample size, and of lower tiers of evidence. Overall, there is poor evidence that any individual physical examination finding could be used to rule in or rule out CES. However, as suggested by Domen and his colleagues , a urinary retention of more than 500 mL alone (Sn 1.00, Sp 0.94, +LR 16) or in combination with two or more specific clinical (...) How useful is the physical examination in suspected cauda equina syndrome? How useful is the physical examination in suspected cauda equina syndrome? - CanadiEM How useful is the physical examination in suspected cauda equina syndrome? In , by Taft Micks August 8, 2017 Background Cauda equina syndrome (CES) is a syndrome consisting of one or more of the following: (1) bladder and/or bowel dysfunction, (2) reduced sensation in the saddle area (i.e. the perineum and inner thighs), and (3) sexual

2017 CandiEM

29. AIUM Practice Parameter for the Performance of a Musculoskeletal Ultrasound Examination

such as tendinosis or tears of the iliopsoas, gluteus medius, and gluteus minimus tendons. ? 20,21 To assess for a pseudotumor, the anterior, medial, lateral, and posterior hip structures should be evaluated for joint and extra-articular fluid collections and soft tissue masses. ? 22,23 F. Specifications for a Knee Examination A knee examination may be indicated to evaluate for a tendon or muscle rupture/tear or tendinosis, joint effusion, crystal deposition disease, periarticular cystic lesions, a meniscal tear (...) , bursitis, a ligamentous tear, or nerve pathology. The examination is divided into 4 regions. The examination may involve a complete assessment of 1 or more of the 4 regions of the knee described below or may be limited to a specific anatomic structure, depending on the clinical presentation. Color and power Doppler imaging may be useful in detecting hyperemia within the joint or surrounding structures. 1. Anterior—The patient is supine with the knee flexed to 30°. Longitudinal and transverse scans

2017 American Institute of Ultrasound in Medicine

30. American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee

in patients with first CMC joint OA. There are no published RCT s evaluating iontophoresis for OA in any anatomic location. Pulsed vibration therapy is conditionally recommended against in patients with knee OA. Few trials have addressed pulsed vibration therapy, and in the absence of adequate data, we conditionally recommend against its use. Transcutaneous electrical stimulation (TENS) is strongly recommended against in patients with knee and/or hip OA. Studies examining the use of TENS have been of low (...) in the hand lead to a conditional recommendation for use of topical NSAIDs in hand OA. In hip OA, the depth of the joint beneath the skin surface suggests that topical NSAIDs are unlikely to ACR/AF GUIDELINE FOR MANAGEMENT OF HAND, HIP, AND KNEE OA |??? 9 confer benefit, and thus, the Voting Panel did not examine use in hip OA. Topical capsaicin is conditionally recommended for patients with knee OA and conditionally recommended against in patients with hand OA. Topical capsaicin is conditionally

2020 American College of Rheumatology

31. Newer Interventions for Osteoarthritis of the Knee

Newer Interventions for Osteoarthritis of the Knee Health Evidence Review Commission (HERC) Coverage Guidance: Newer Interventions for Osteoarthritis of the Knee Approved 3/14/2019 HERC Coverage Guidance Whole body vibration Whole body vibration is not recommended for coverage (strong recommendation). TENS TENS is not recommended for coverage (strong recommendation). Glucosamine-chondroitin Glucosamine-chondroitin is not recommended for coverage (weak recommendation). Glucosamine alone (...) is not recommended for coverage (strong recommendation). Chondroitin alone is not recommended for coverage (weak recommendation). Platelet-rich plasma Platelet-rich plasma is not recommended for coverage (weak recommendation) Note: Definitions for strength of recommendation are in Appendix A. GRADE Table Element Descriptions. Rationales for each recommendation appear below in the GRADE table. 2 ¦ Newer Interventions for Osteoarthritis of the Knee Approved 3/14/2019 Table of Contents Coverage Guidance: Newer

2019 Oregon Health Evidence Review Commission

32. Knee Exam

Knee Exam Knee Exam Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Knee Exam Knee Exam Aka: Knee Exam , Knee Examination , Knee Joint (...) Finding , Knee Maneuver II. Exam: General (compare with less affected knee) Observation with obscured landmarks See See See Previous surgical scars resting position Quadriceps muscle atrophy Evaluate Vastus Medialis Obliquus specifically Atrophy often on side of Tenderness to Palpation Tibial tubercle r tendon Quadriceps tendon Joint line Pes Anserine Bursa Iliotibial Band Normal Range of Motion Flexion: 135 degrees Extension: 0 to -10 degrees (above horizontal plane) III. Exam: Patellofemoral (Q

2018 FP Notebook

33. Knee stability and movement coordination impairments: knee ligament sprain revision 2017.

, and Injury to multiple structures of knee, and the associated International Classification of Functioning, Disability and Health (ICF) impairment-based categories of knee instability (b7150 Stability of a single joint) and movement coordination impairments (b7601 Control of complex voluntary movements), using the following history and physical examination findings: mechanism of injury, passive knee laxity, joint pain, joint effusion, and movement coordination impairments. ( Grade of Recommendation (...) instructors, clinical instructors, students, interns, residents, and fellows regarding the best current practice of orthopaedic physical therapy Adult patients with knee stability and movement coordination impairments/knee ligament sprain Diagnosis Diagnosis and classification according to International Statistical Classification of Diseases and Related Health Problems (ICD) criteria and International Classification of Functioning, Disability, and Health (ICF) criteria Differential diagnosis Examination

2017 National Guideline Clearinghouse (partial archive)

34. American College of Rheumatology/American Association of Hip and Knee Surgeons Guideline for the Perioperative Management of Antirheumatic Medication in Patients with Rheumatic Diseases Undergoing Elective Total Hip or Total Knee Arthroplasty

American College of Rheumatology/American Association of Hip and Knee Surgeons Guideline for the Perioperative Management of Antirheumatic Medication in Patients with Rheumatic Diseases Undergoing Elective Total Hip or Total Knee Arthroplasty Arthritis Care & Research Vol. 69, No. 8, August 2017, pp 1111–1124 DOI 10.1002/acr.23274 V C 2017, American College of Rheumatology SPECIAL ARTICLE 2017 American College of Rheumatology/ American Association of Hip and Knee Surgeons Guideline (...) for the Perioperative Management of Antirheumatic Medication in Patients With Rheumatic Diseases Undergoing Elective Total Hip or Total Knee Arthroplasty SUSAN M. GOODMAN, 1 BRYAN SPRINGER, 2 GORDON GUYATT, 3 MATTHEW P. ABDEL, 4 VINOD DASA, 5 MICHAEL GEORGE, 6 ORA GEWURZ-SINGER, 7 JON T. GILES, 8 BEVERLY JOHNSON, 9 STEVE LEE, 10 LISA A. MANDL, 1 MICHAEL A. MONT, 11 PETER SCULCO, 1 SCOTT SPORER, 12 LOUIS STRYKER, 13 MARAT TURGUNBAEV, 14 BARRY BRAUSE, 1 ANTONIA F. CHEN, 15 JEREMY GILILLAND, 16 MARK GOODMAN, 17 ARLENE

2017 American College of Rheumatology

35. Knee Stability and Movement Coordination Impairments: Knee Ligament Sprain (Full text)

examination findings: mechanism of injury, passive knee laxity, joint pain, joint effusion, and movement coordination impairments. Differential Diagnosis The clinician should suspect diagnostic classifications associated with serious pathological conditions when the individual's reported activity limitations and impairments of body function and structure are not consistent with those presented in the Diagnosis/Classification section of this guideline, or when the individual's symptoms are not resolving (...) with intervention aimed at normalization of the individual's impairments of body function. Examination – Outcome Measures: Activity Limitations and Self-Reported Measures Clinicians should use the International Knee Documentation Committee 2000 Subjective Knee Evaluation Form (IKDC 2000) or Knee injury and Osteoarthritis Outcome Score (KOOS), and may use the Lysholm scale, as validated patient-reported outcome measures to assess knee symptoms and function, and should use the Tegner activity scale or Marx

2017 American Physical Therapy Association PubMed abstract

36. A Case of Fatal Colonic Perforation without Abdominal Exam Findings

examination revealed crepitus extending from the left groin to below the left knee despite an abdominal exam which continued to lack rigidity, tenderness, or guarding. Repeat CT imaging revealed subcutaneous and deep thigh soft tissue emphysema extending from the retroperitoneum likely originating from a colonic perforation. An emergent surgery consultation was made; however, the patient and family elected not to pursue surgical intervention, opting instead for comfort measures. The patient expired early (...) A Case of Fatal Colonic Perforation without Abdominal Exam Findings Spotlight: A Case of Fatal Colonic Perforation without Abdominal Exam Findings – Clinical Correlations Search Spotlight: A Case of Fatal Colonic Perforation without Abdominal Exam Findings June 14, 2018 6 min read By Christopher Sonne, MD Peer reviewed Learning Objectives: 1. Understand the pathophysiology of peritonitis secondary to bowel perforation. 2. Understand how classic findings of peritonitis can be absent in some

2018 Clinical Correlations

37. Knee replacement

, Ivanovic N, Mahale A Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary (...) of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology The study examined two strategies of rehabilitation after total hip replacement (THR) or total knee replacement (TKR). The strategies were conventional (...) Knee replacement Top results for knee replacement - Trip Database or use your Google+ account Turning Research Into Practice ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1

2018 Trip Latest and Greatest

38. Knee osteoarthritis

reserved.1 Guideline for the non-surgical management of hip and knee osteoarthritis July 2009 CONTENTS IntroductIon 3 The role of general practitioners 4 Endorsement and expiry date for the recommendations 4 Acknowledgments 5 2009 5. Long-term effects of glucosamine/chondroitin sulfate on the progression of structural changes in knee osteoarthritis : 6-year follow-up data from the osteoarthritis initiative. OBJECTIVE: To examine the long-term (6-year) effect of combined glucosamine (Glu (...) To determine whether available evidence demonstrates IAHA provides clinically meaningful improvement in pain and function compared with placebo in patients with knee OA ; to examine the potential harms of IAHA; and to assess whether net health outcomes are improved. Authors' conclusions A large body of evidence obtained from randomized controlled trials has examined the effect of IAHA on pain 2015 14. Comparative effectiveness review of hyaluronic acid for knee osteoarthritis : a review of reviews

2018 Trip Latest and Greatest

39. Examining the Minimal Important Difference of Patient-reported Outcome Measures for Individuals with Knee Osteoarthritis: A Model Using the Knee Injury and Osteoarthritis Outcome Score. (Abstract)

Examining the Minimal Important Difference of Patient-reported Outcome Measures for Individuals with Knee Osteoarthritis: A Model Using the Knee Injury and Osteoarthritis Outcome Score. To examine the influence of different analytical methods, baseline covariates, followup periods, and anchor questions when establishing a minimal important difference (MID) for individuals with knee osteoarthritis (OA). Second, to propose MID for improving and worsening on the Knee injury and Osteoarthritis (...) Outcome Score (KOOS).Retrospective analysis of prospectively collected data from 272 patients with knee OA undergoing a multidisciplinary nonsurgical management strategy. The magnitude and rate of change as well as the influence of baseline covariates were examined for 5 KOOS subscales over 52 weeks. The MID for improving and worsening were investigated using 4 anchor-based methods.Waitlisted for joint replacement and exhibiting unilateral/bilateral symptoms influenced change in KOOS over time

2016 Journal of Rheumatology

40. Custom-made or customisable 3D printed implants and cutting guides versus non-3D printed standard implants and cutting guides for improving outcome in patients undergoing knee, maxillofacial, or cranial surgery

Custom-made or customisable 3D printed implants and cutting guides versus non-3D printed standard implants and cutting guides for improving outcome in patients undergoing knee, maxillofacial, or cranial surgery Dec2015 © EUnetHTA, 2015. Reproduction is authorised provided EUnetHTA is explicitly acknowledged 1 EUnetHTA Joint Action 3 WP4 Version 1.4, 17 th April 2019 This report is part of the project / joint action ‘724130 / EUnetHTA JA3’ which has received funding from the European Union’s (...) Health Programme (2014-2020) Rapid assessment of other technologies using the HTA Core Model ® for Rapid Relative Effectiveness Assessment Custom-made or customisable 3D printed implants and cutting guides versus non- 3D printed standard implants and cutting guides for improving outcome in patients undergoing knee, maxillofacial, or cranial surgery PROJECT ID: OTCA11 Custom-made 3D printed implants and cutting guides in knee, maxillofacial, or cranial surgery EUnetHTA Joint Action 3 WP4 2 DOCUMENT

2019 EUnetHTA

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