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41. 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

42. 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

43. Association of intermittent and constant knee pain patterns with knee pain severity, radiographic knee osteoarthritis duration and severity. (Abstract)

Association of intermittent and constant knee pain patterns with knee pain severity, radiographic knee osteoarthritis duration and severity. To examine the relation of knee pain patterns to pain severity, and to radiographic osteoarthritis (OA) severity and duration.The Multicenter Osteoarthritis Study is a longitudinal cohort of older adults with or at risk of knee OA. Participants' Intermittent and Constant OA Pain (ICOAP) scores were characterized as 1) no intermittent or constant pain; 2 (...) ) intermittent pain only; 3) constant pain only; and 4) a combination of constant and intermittent pain. Knee pain severity was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale and the Visual Analog Scale (VAS). Radiographic knee OA (ROA) severity was defined as Kellgren Lawrence grade ≥ 2, and ROA duration was defined according to the clinic visit at which ROA was first noted. We assessed the relation of ICOAP pain patterns to knee pain severity, ROA

2020 Arthritis care & research

44. 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

45. Developmental rheumatology in children: Scenario: Knock knees in children

of the following are present: The child is aged less than 2 years or more than 5–6 years of age. Onset occurs in adolescence. They have: A feature. Severe deformity (more than 8 cm between ankle malleoli on examination). Unilateral or asymmetrical deformity. Knee pain. Leg length discrepancy. Progressive deformity. Short stature or significant deviation from the norm for height or weight. Limp; or recurrent trips or falls. Functional limitation. An abnormal joint examination. Features suggestive of juvenile (...) , the condition will self-resolve, reassurance is the only intervention needed, and that bracing and shoe inserts have no value [ ; ]. Referral The recommendation on when to consider referral is based on musculoskeletal triage guidance for children and young people [ ], an explanation of the pGALS (paediatric Gait, Arms, Legs, and Spine) examination [ ], and expert opinion in review articles [ ; ; ; ]. Experts suggest specialist referral for children with knock knees aged less than 2 years as investigations

2019 NICE Clinical Knowledge Summaries

46. Consensus statement for perioperative care in total hip replacement and total knee replacement surgery: Enhanced Recovery After Surgery (ERAS) Society recommendations Full Text available with Trip Pro

/00913847.2018.1403274. , , ). There is emerging work examining the addition of nutrition therapy and psychological preparation to exercise regimes, in a concept called prehabilitation. These programs have shown improvements to recovery in general surgical procedures (Carli and Scheede-Bergdahl Carli F , Scheede-Bergdahl C . Prehabilitation to enhance perioperative care . Anesthesiol Clin 2015 ; 33(1): 17 – 33 . , , ). However, procedure specific studies in hip and knee replacement are needed before recommendation (...) Consensus statement for perioperative care in total hip replacement and total knee replacement surgery: Enhanced Recovery After Surgery (ERAS) Society recommendations Consensus statement for perioperative care in total hip replacement and total knee replacement surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations: Acta Orthopaedica: Vol 0, No 0 | Search in: Journal 6,974 Views 0 CrossRef citations to date Altmetric Articles Consensus statement for perioperative care in total

2019 ERAS Society

47. Assessment of knee laxity using a robotic testing device: a comparison to the manual clinical knee examination. Full Text available with Trip Pro

Assessment of knee laxity using a robotic testing device: a comparison to the manual clinical knee examination. The purpose of this study was to collect knee laxity data using a robotic testing device. The data collected were then compared to the results obtained from manual clinical examination.Two human cadavers were studied. A medial collateral ligament (MCL) tear was simulated in the left knee of cadaver 1, and a posterolateral corner (PLC) injury was simulated in the right knee of cadaver (...) 2. Contralateral knees were left intact. Five blinded examiners carried out manual clinical examination on the knees. Laxity grades and a diagnosis were recorded. Using a robotic knee device which can measure knee laxity in three planes of motion: anterior-posterior, internal-external tibia rotation, and varus-valgus, quantitative data were obtained to document tibial motion relative to the femur.One of the five examiners correctly diagnosed the MCL injury. Robotic testing showed a 1.7° larger

2015 Knee Surgery, Sports Traumatology, Arthroscopy

48. 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

49. 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

50. Association between omega-3 fatty acids intake and muscle strength in older adults: A study from National Health and Nutrition Examination Survey (NHANES) 1999-2002. (Abstract)

. We also aimed to evaluate whether an isocaloric substitution of dietary fatty acids types by ω-3 intake could be associated with muscle strength.This study included older adults aged from 50 to 85 y, from National Health and Nutrition Examination Survey (NHANES) 1999-2000 and 2001-2002. A total of 2141 individuals (1119 men and 1022 women) were evaluated and provided complete and reliable dietary intake and isokinetic strength of the knee extensors (peak force) data. Linear regression analysis (...) Association between omega-3 fatty acids intake and muscle strength in older adults: A study from National Health and Nutrition Examination Survey (NHANES) 1999-2002. Muscle strength is a predictor of mortality in older adults and some dietary components are associated with this variable; however, little is known about the association between omega-3 fatty acids (ω-3) intake and strength in older adults.To assess whether ω-3 intake is associated with muscle strength in individuals over 50 years

2020 Clinical nutrition (Edinburgh, Scotland)

51. Clinimetric properties of the one-leg sit-to-stand test in examining unilateral lower limb muscle strength among young adults. (Abstract)

was administered in two separate assessment sessions to examine test-retest reliability. Two-leg STS test was administered and the performance time was measured. The concentric peak strength of hip flexors/extensors, knee flexors/extensors and ankle dorsi-flexors/plantar-flexors were determined using an isokinetic dynamometer. An intraclass correlation coefficient (ICC) was used to examine the test-retest reliability of one-leg STS test. The criterion validity of the one-leg STS test was evaluated against (...) Clinimetric properties of the one-leg sit-to-stand test in examining unilateral lower limb muscle strength among young adults. One-leg sit-to-stand (one-leg STS) test is a new clinical test developed to measure the unilateral lower limb (LE) muscle strength among young adults. This study examined the test-retest reliability and the criterion-concurrent validity of the one-leg STS.Forty young adults (mean age ± SD, 28.07 ± 5.39 years) participated in the study. The one-leg STS test

2020 International journal of clinical practice

52. 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

53. 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

54. 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

55. 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

56. Knee pain - assessment: Traumatic causes

: The patella may be clearly dislocated (lying medial or lateral to the joint). There is usually acute swelling (haemarthrosis), and tenderness along the medial edge of the patella. 'Atraumatic' dislocation can occur in an anatomically abnormal knee without, or with a minimal, direct blow to the patella. Abnormalities will usually also be revealed on examination of the other knee. Recurrent dislocations and persistent anterior knee symptoms can occur following a first-time patellar dislocation. Quadriceps (...) Knee pain - assessment: Traumatic causes Traumatic causes | Diagnosis | Knee pain - assessment | CKS | NICE Search CKS… Menu Traumatic causes Knee pain - assessment: Traumatic causes Last revised in July 2017 Traumatic causes What are the signs and symptoms of serious pathology that may cause knee pain? Red flags (or alarm features) are symptoms, signs, or risk factors that may indicate more serious pathology and warrant urgent further investigation, or immediate or urgent referral. Fracture

2018 NICE Clinical Knowledge Summaries

57. Knee pain - assessment

(such as muscle strain and fractures), tumours, referred pain from the hip or lumbosacral spine, and bursitis. Risk factors for knee pain include increasing age, obesity, knee-straining work and participation in sport. A person presenting with knee pain should be: Asked about a history of trauma. Asked to describe the history of the pain and/or injury (including, type and duration of pain, aggravating and relieving factors, history of swelling). An examination of the knee should be carried out (...) Knee pain - assessment Knee pain - assessment | Topics A to Z | CKS | NICE Search CKS… Menu Knee pain - assessment Knee pain - assessment Last revised in July 2017 Knee pain is a common condition, particularly in older people.Possible causes include osteoarthritis of the knee, injuries Diagnosis Management Background information Knee pain - assessment: Summary Knee pain is a common condition, particularly in older people. Possible causes include osteoarthritis of the knee, injuries

2018 NICE Clinical Knowledge Summaries

58. Knee pain - assessment: Non-traumatic causes

. Acute rupture or dissection may present with pain and calf swelling. Signs: Posteromedial fullness and/or tenderness. Cyst is firm in knee extension and soft in flexion. Signs of rupture: Discolouration in the calf, beneath one of the malleoli or on the dorsum of the foot. Calf swelling. For further information, see the CKS topic on . If a ruptured Baker's cyst cannot be distinguished from a deep vein thrombosis on the basis of the history and examination, see the CKS topic on . Patellar tendonitis (...) ' dislocation can occur in an anatomically abnormal knee without, or with a minimal, direct blow to the patella. Abnormalities will usually also be revealed on examination of the other knee. For information on patellar dislocation, see . Iliotibial band syndrome Occurs most commonly in people who undertake activities involving repetitive knee flexion, such as running and cycling. Symptoms : Lateral knee pain. Usually aggravated by activity. An objective 'clicking' or 'clunking' sounds may be heard during

2018 NICE Clinical Knowledge Summaries

59. 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

60. 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

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