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41. Association of body mass index with incidence and progression of knee effusion on magnetic resonance imaging and on knee examination. Full Text available with Trip Pro

Association of body mass index with incidence and progression of knee effusion on magnetic resonance imaging and on knee examination. To determine the association of body mass index (BMI) with incidence and progression of knee effusion on magnetic resonance imaging (MRI) and physical examination (PE) in a longitudinal cohort with knee pain.A population-based cohort was assessed at baseline and 3 years (n = 163). BMI was categorized as normal (<25), overweight (25-29.9), and obese (≥30). Knee (...) ]). Overweight was associated with incident PEeff (HR 4.5 [95% CI 1.4-14.2]), while obesity was not statistically significant (HR 3.1 [95% CI 0.9-11.1]).Obesity was a risk factor for incident and progressive knee effusion in this population-based cohort. These findings highlight an important link between obesity and inflammation in knee osteoarthritis.© 2016, American College of Rheumatology.

2015 Arthritis care & research

42. Effect of ACL graft material on anterior knee force during simulated in vivo ovine motion applied to the porcine knee: An in vitro examination of force during 2000 cycles. (Abstract)

Effect of ACL graft material on anterior knee force during simulated in vivo ovine motion applied to the porcine knee: An in vitro examination of force during 2000 cycles. This study determined how anterior cruciate ligament (ACL) reconstruction affected the magnitude and temporal patterns of anterior knee force and internal knee moment during 2000 cycles of simulated gait. Porcine knees were tested using a six degree-of-freedom robot, examining three porcine allograft materials compared (...) with the native ACL. Reconstructions were performed using: (1) bone-patellar tendon-bone allograft (BPTB), (2) reconstructive porcine tissue matrix (RTM), or (3) an RTM-polymer hybrid construct (Hybrid). Forces and moments were measured over the entire gait cycle and contrasted at heel strike, mid stance, toe off, and peak flexion. The Hybrid construct performed the best, as magnitude and temporal changes in both anterior knee force and internal knee moment were not different from the native ACL knee

2015 Journal of Orthopaedic Research

43. Monoclonal Antibodies for Osteoarthritis of the Hip or Knee

parent studies of tanezumab for the treatment of hip or knee OA. Eligible patients were enrolled up to 12 weeks after their last dose of study medication in the parent study. TNZ IV 2.5 mg (n = 522) TNZ IV 5 mg (n = 832) TNZ IV 10 mg (n = 788) WOMAC pain WOMAC physical function PGA AEs Physical and neurological examinations Laboratory tests Schnitzer et. al., 2011 26 Open-label, multiple- dose extension study Phase II 56 weeks N = 281 Patients who previously participated in studies of tanezumab (...) for the treatment of knee OA (i.e., the phase II study by Lane et al.). 25b Patients who had received at least two doses of tanezumab in the parent study by Lane et al., and were followed for at least eight weeks. TNZ IV 50 mcg/kg (n = 281) on days 1 and 56, with subsequent dose administered at eight-week intervals, for up to a total of eight infusions All observed or volunteered AEs SAEs Laboratory test, vital signs, physical and neurological examinations Efficacy outcomes: overall knee pain WOMAC index

2018 CADTH - Issues in Emerging Health Technologies

44. Guideline for the management of knee and hip osteoarthritis

Guideline for the management of knee and hip osteoarthritis racgp.org.au Healthy Profession. Healthy Australia. Guideline for the management of knee and hip osteoarthritis Second editionGuideline for the management of knee and hip osteoarthritis. Second edition Disclaimer The information set out in this publication is current at the date of first publication and is intended for use as a guide of a general nature only and may or may not be relevant to particular patients or circumstances. Nor (...) . Whilst the text is directed to health professionals possessing appropriate qualifications and skills in ascertaining and discharging their professional (including legal) duties, it is not to be regarded as clinical advice and, in particular, is no substitute for a full examination and consideration of medical history in reaching a diagnosis and treatment based on accepted clinical practices. Accordingly, The Royal Australian College of General Practitioners Ltd (RACGP) and its employees and agents

2018 Clinical Practice Guidelines Portal

45. Spherox (spheroids of human autologous matrix-associated chondrocytes) - to repair defects to the cartilage in the knee

Spherox (spheroids of human autologous matrix-associated chondrocytes) - to repair defects to the cartilage in the knee 18 May 2017 EMA/349863/2017 Committee for Medicinal Products for Human Use (CHMP) CHMP assessment report Spherox Common name: spheroids of human autologous matrix-associated chondrocytes Procedure No. EMEA/H/C/002736/0000 30 Churchill Place ? Canary Wharf ? London E14 5EU ? United Kingdom An agency of the European Union Telephone +44 (0)20 3660 6000 Facsimile +44 (0)20 3660 (...) cartilage defects of the femoral condyle and the patella of the knee (International Cartilage Repair Society [ICRS] grade III or IV) with defect sizes up to 10 cm2 in adults. Pharmaceutical form: Implantation suspension Strength: 10–70 spheroids/cm² Route of administration: Intraarticular use Packaging: Applicator Pre-filled syringe Package sizes: 1 to10 sterile tubes with up to 2 applicators CHMP assessment report EMA/349863/2017 Page 2/125 each + 1 syringe per applicator and 1 to 10 sterile tubes

2017 European Medicines Agency - EPARs

46. Chronic Knee Pain

radiographs are normal or demonstrate a joint effusion, MRI is usually considered the next imaging study. However, the use of MRI may be premature and unnecessary in some patients, as it is estimated that approximately 20% of patients with chronic knee pain have had an MRI performed without recent (within the prior year) radiographs [2]. This document discusses 5 variants for imaging chronic pain in a native knee in patients =5 years of age. The variants discussed include: (1) initial examination; (2 (...) or complete joint space loss on subsequent radiographs indicating disease progression and potentially indicating the need for arthroplasty [11-13]. Radiography Hip An ipsilateral hip radiograph is usually not indicated as a first imaging examination. CT Knee CT is usually not indicated as a first imaging examination. CT Arthrography Knee CT arthrography is usually not indicated as a first imaging examination. MRI Knee MRI is usually not indicated as a first imaging examination. To avoid unnecessary MRI

2018 American College of Radiology

47. Patients With Total Knee Arthroplasty in the Acute Post-Operative Phase

on ability to meet goals at discharge, discharge placement, or length of hospital stay. The study did not report adverse events. Two studies, 1 with low and 1 with moderate risk of bias examined the effect of 2 sessions per day of walking or other physical therapy intervention compared with 1 daily session. No differences were found for knee ROM, function, pain, or patient satisfaction. | “Early” or “Enhanced” Rehabilitation Five studies examined the effect of early or enhanced rehabilitation (...) not in either systematic review included a total of 182 participants. Demoulin et al with moderate risk of bias examined the effect of gaseous CO 2 over cold pack and Cryocuff (Aircast, Vista, California) for pain, swelling, and knee ROM for 88 participants. Thienpont had a high risk of bias and compared continuous computer-assisted cryotherapy with intermittent cold pack. The studies reported no effects on pain, knee ROM, walking, knee swelling, or length of stay. No adverse events were reported in either

2018 American Physical Therapy Association

48. Knee Pain and Mobility Impairments: Meniscal and Articular Cartilage Lesions Full Text available with Trip Pro

) may be used to assess knee-related quality of life. Examination — Physical Performance Measures 2018 Recommendation Clinicians may administer appropriate clinical or field tests, such as single-legged hop tests (eg, single hop for distance, cross-over hop for distance, triple hop for distance, and 6-m timed hop), that can identify a patient's baseline status relative to pain, function, and disability; detect side-to-side asymmetries; assess global knee function; determine a patient's readiness (...) . The authors of this guideline revision worked with the CPG Editors and medical librarians for methodological guidance. The research librarians were chosen for their expertise in systematic review rehabilitation literature search, and to perform systematic searches for concepts associated with meniscus and articular cartilage injuries of the knee in articles published from 2008 related to classification, examination, and intervention strategies consistent with previous guideline development methods related

2018 American Physical Therapy Association

49. Pain After Unilateral Total Knee Arthroplasty: A Prospective Randomized Controlled Trial Examining the Analgesic Effectiveness of a Combined Adductor Canal Peripheral Nerve Block with Periarticular Infiltration Versus Adductor Canal Nerve Block Alone Vers (Abstract)

Pain After Unilateral Total Knee Arthroplasty: A Prospective Randomized Controlled Trial Examining the Analgesic Effectiveness of a Combined Adductor Canal Peripheral Nerve Block with Periarticular Infiltration Versus Adductor Canal Nerve Block Alone Vers Total knee arthroplasty is a painful surgery that requires early mobilization for successful joint function. Multimodal analgesia, including spinal analgesia, nerve blocks, periarticular infiltration (PI), opioids, and coanalgesics, has been (...) shown to effectively manage postoperative pain. Both adductor canal (AC) and PI have been shown to manage pain without significantly impairing motor function. However, it is unclear which technique is most effective. This 3-arm trial examined the effect of AC block with PI (AC + PI) versus AC block only (AC) versus PI only (PI). The primary outcome was pain on walking at postoperative day (POD) 1.One hundred fifty-one patients undergoing unilateral total knee arthroplasty were included. Patients

2016 Anesthesia and Analgesia Controlled trial quality: predicted high

50. Physical examination findings and their relationship with performance-based function in adults with knee osteoarthritis. Full Text available with Trip Pro

Physical examination findings and their relationship with performance-based function in adults with knee osteoarthritis. Many physical examination (PE) maneuvers exist to assess knee function, none of which are specific to knee osteoarthritis (KOA). The Osteoarthritis Research Society International also recommends the use of six functional performance measures to assess function in adults with KOA. While earlier studies have examined the relationship between PE findings and self-reported (...) function or PE findings and select performance tests in adults with knee pain and KOA, few have examined the all three types of measures. This cross-sectional study specifically examines the relationships between results of PE findings, functional performance tests and self-reported function in adults with symptomatic KOA.We used baseline PE data from a prospective randomized controlled trial in 87 participants aged ≥40 years with symptomatic and radiographic KOA. The PE performed by three experienced

2016 BMC Musculoskeletal Disorders

51. The Value of History, Physical Examination, and Radiographic Findings in the Diagnosis of Symptomatic Meniscal Tear among Middle-Age Subjects with Knee Pain. Full Text available with Trip Pro

The Value of History, Physical Examination, and Radiographic Findings in the Diagnosis of Symptomatic Meniscal Tear among Middle-Age Subjects with Knee Pain. To evaluate the utility of clinical history, radiographic findings, and physical examination findings in the diagnosis of symptomatic meniscal tear (SMT) in patients over age 45 years, in whom concomitant osteoarthritis is prevalent.In a cross-sectional study of patients from 2 orthopedic surgeons' clinics, we assessed clinical history (...) , physical examination findings, and radiographic findings in patients age >45 years with knee pain. The orthopedic surgeons rated their confidence that subjects' symptoms were due to meniscal tear; we defined the diagnosis of SMT as at least 70% confidence. We used logistic regression to identify factors independently associated with diagnosis of SMT, and we used the regression results to construct an index of the likelihood of SMT.In 174 participants, 6 findings were associated independently

2016 Arthritis care & research

52. Can Vascular Injury be Appropriately Assessed With Physical Examination After Knee Dislocation? Full Text available with Trip Pro

Can Vascular Injury be Appropriately Assessed With Physical Examination After Knee Dislocation? Knee dislocations are rare injuries with potentially devastating vascular complications. An expeditious and accurate diagnosis is necessary, as failing to diagnose vascular injury can result in amputation; however, the best diagnostic approach remains controversial.We asked: (1) What patient factors are predictors of vascular injury after knee dislocation? (2) What are the diagnostic utilities (...) , 1.008-1.155; p = 0.033) and open injuries (OR, 3.366; 95% CI, 1.008-11.420; p = 0.048) were associated with vascular injury. No single physical examination maneuver had a 100% sensitivity for ruling out vascular injury. A normal physical examination (palpable pulses and ABI ≥ 0.9) had 100% sensitivity for ruling out vascular injury.Increased BMI and the presence of open dislocation are associated with a greater risk for vascular injury after knee dislocation. The combination of a palpable dorsalis

2016 Clinical Orthopaedics and Related Research

53. Inter-rater reliability of the McKenzie System of Mechanical Diagnosis and Therapy in the examination of the knee Full Text available with Trip Pro

Inter-rater reliability of the McKenzie System of Mechanical Diagnosis and Therapy in the examination of the knee The McKenzie System of Mechanical Diagnosis and Therapy (MDT) is a widely used method of classification and management of musculoskeletal problems. Although MDT has been investigated for its reliability and efficacy in the management of spinal pain, few studies have evaluated the system when applying it to musculoskeletal problems in the extremities, in particular the knee (...) . The purpose of this study was to investigate the inter-rater reliability of MDT when classifying clinical vignettes describing patients with musculoskeletal knee pain.This study was divided into two phases. First, 10 clinicians experienced in the use of MDT were recruited to write a total of 60 clinical vignettes based upon the initial assessment of their past patients with knee pain. Second, six different MDT raters were recruited to rate 53 selected vignettes and reliability was determined using Fleiss

2016 The Journal of manual & manipulative therapy

54. Assessment of the Relationship between the Shape of the Lateral Meniscus and the Risk of Extrusion Based on MRI Examination of the Knee Joint Full Text available with Trip Pro

Assessment of the Relationship between the Shape of the Lateral Meniscus and the Risk of Extrusion Based on MRI Examination of the Knee Joint Meniscus extrusion is a serious and relatively frequent clinical problem. For this reason the role of different risk factors for this pathology is still the subject of debate. The goal of this study was to verify the results of previous theoretical work, based on the mathematical models, regarding a relationship between the cross-section shape (...) of the meniscus and the risk of its extrusion.Knee MRI examination was performed in 77 subjects (43 men and 34 women), mean age 34.99 years (range: 18-49 years), complaining of knee pain. Patients with osteoarthritic changes (grade 3 and 4 to Kellgren classification), varus or valgus deformity and past injuries of the knee were excluded from the study. A 3-Tesla MR device was used to study the relationship between the shape of the lateral meniscus (using slope angle, meniscus-cartilage height and meniscus

2016 PloS one

55. Examining Ankle-Joint Laxity Using 2 Knee Positions and With Simulated Muscle Guarding Full Text available with Trip Pro

Examining Ankle-Joint Laxity Using 2 Knee Positions and With Simulated Muscle Guarding Several factors affect the reliability of the anterior drawer and talar tilt tests, including the individual clinician's experience and skill, ankle and knee positioning, and muscle guarding.To compare gastrocnemius activity during the measurement of ankle-complex motion at different knee positions, and secondarily, to compare ankle-complex motion during a simulated trial of muscle guarding.Cross-sectional (...) ).In a relaxed state, the gastrocnemius muscle did not appear to affect anterior ankle laxity at the 2 most common knee positions for anterior drawer testing; however, talar tilt testing may be best performed with the knee in 0° of knee flexion. Finally, our outcomes from the simulated muscle-guarding condition suggest that clinicians should use caution and be aware of reduced perceived laxity when performing these clinical examination techniques immediately postinjury.

2016 Journal of athletic training

56. CORR Insights®: Can Vascular Injury be Appropriately Assessed With Physical Examination After Knee Dislocation? Full Text available with Trip Pro

CORR Insights®: Can Vascular Injury be Appropriately Assessed With Physical Examination After Knee Dislocation? 26979319 2017 04 24 2018 12 02 1528-1132 474 6 2016 06 Clinical orthopaedics and related research Clin. Orthop. Relat. Res. CORR Insights(®): Can Vascular Injury be Appropriately Assessed With Physical Examination After Knee Dislocation? 1459-60 10.1007/s11999-016-4789-0 Beksaç Burak B Acıbadem University School of Medicine, Acıbadem Maslak Hospital, 40 Buyukdere Cad., Istanbul (...) , Sarıyer, 34457, Turkey. bbeksac@gmail.com. eng Journal Article Comment 2016 03 15 United States Clin Orthop Relat Res 0075674 0009-921X AIM IM Clin Orthop Relat Res. 2016 Jun;474(6):1453-8 26847454 Humans Knee Dislocation diagnosis Physical Examination Vascular System Injuries diagnosis 2016 02 26 2016 03 08 2016 3 17 6 0 2016 3 17 6 0 2017 4 25 6 0 ppublish 26979319 10.1007/s11999-016-4789-0 10.1007/s11999-016-4789-0 PMC4868148 J Vasc Surg. 2013 May;57(5):1196-203 23384491 Clin Orthop Relat Res. 2014

2016 Clinical Orthopaedics and Related Research

57. A New Physical Examination Technique for Evaluating Valgus Knee Deformity: Swing Test Full Text available with Trip Pro

A New Physical Examination Technique for Evaluating Valgus Knee Deformity: Swing Test 27958235 2017 03 13 2018 11 13 2542-5641 129 24 2016 12 20 Chinese medical journal Chin. Med. J. A New Physical Examination Technique for Evaluating Valgus Knee Deformity: Swing Test. 3004-3006 10.4103/0366-6999.195465 Zhou Yi-Xin YX Department of Adult Joint Reconstructive Surgery, Beijing Jishuitan Hospital, 4th Medical College of Peking University, Jishuitan Orthopaedic College of Tsinghua University (...) -6999 IM Adult Aged Arthroplasty, Replacement, Knee Female Humans Joint Deformities, Acquired physiopathology surgery Knee Joint Male Middle Aged Physical Examination methods Prospective Studies Young Adult There are no conflicts of interest. 2016 12 14 6 0 2016 12 14 6 0 2017 3 14 6 0 ppublish 27958235 ChinMedJ_2016_129_24_3004_195465 10.4103/0366-6999.195465 PMC5198538 Clin Orthop Relat Res. 1992 Jul;(280):48-64 1611764 J Bone Joint Surg Am. 2005 Sep;87 Suppl 1(Pt 2):271-84 16140800 Chin Med J

2016 Chinese medical journal

58. Clinical diagnosis of partial or complete anterior cruciate ligament tears using patients' history elements and physical examination tests. Full Text available with Trip Pro

Clinical diagnosis of partial or complete anterior cruciate ligament tears using patients' history elements and physical examination tests. To assess the diagnostic validity of clusters combining history elements and physical examination tests to diagnose partial or complete anterior cruciate ligament (ACL) tears.Prospective diagnostic study.Orthopaedic clinics (n = 2), family medicine clinics (n = 2) and community-dwelling.Consecutive patients with a knee complaint (n = 279) and consulting one (...) or complete ACL tears (LR-: 0.08; 95%CI: 0.03-0.24).Diagnostic clusters combining history elements and physical examination tests can support the differential diagnosis of ACL tears compared to various knee disorders.

2018 PLoS ONE

59. AIUM Practice Parameter for the Performance of an Ultrasound Examination of the Neonatal and Infant Spine

has been developed to assist practitioners in the performance of neonatal and infant spine sonography. In some cases, an additional or specialized examination may be necessary. While it is not possible to detect every abnormality, following this practice parameter will maximize the detection of abnormalities of the infant spine. Sonographic exam- ination of the pediatric spinal canal is accomplished by scanning through the normally incom- pletely ossified posterior elements. Therefore, it is most (...) better delineation of the cauda equina. A small bolster may be placed under the lower abdomen/pelvis to mildly flex the back, which may improve imaging. The knees may be flexed to the abdomen to allow adequate separation of the spinous processes and visualization of the spinal canal contents. Avoid overzealous and excessive flexing that could impede respi- ration. 15 An infant who has recently been fed will generally lie quietly during the examination. If preprocedural feeding is not possible

2016 American Institute of Ultrasound in Medicine

60. Body Composition is More Closely Related to the Development of Knee Osteoarthritis in Women than Men: A Cross-sectional Study Using the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V-1, 2). Full Text available with Trip Pro

Body Composition is More Closely Related to the Development of Knee Osteoarthritis in Women than Men: A Cross-sectional Study Using the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V-1, 2). To evaluate the association between knee osteoarthritis (OA) and body composition parameters, and to analyze the correlations of both obesity and lower extremity muscle mass with radiographic knee OA in relation to sex.This was a cross-sectional study using data on body composition (...) parameters measured using dual energy X-ray absorptiometry in 4246 participants in the Fifth Korea National Health and Nutrition Examination Survey. The relationships between knee OA and body composition parameters were evaluated. The associations between knee OA and the four subgroups corresponding to obesity and muscle mass percentage in both lower extremities were analyzed separately for each sex.The lower extremity muscle mass showed a decreasing trend, while fat parameters showed an increasing

2015 Osteoarthritis and Cartilage

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