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Knee Exam

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861. Time Trends in Characteristics of Patients Undergoing Primary Total Hip and Knee Arthroplasty in California, 2007-2010. (Abstract)

Time Trends in Characteristics of Patients Undergoing Primary Total Hip and Knee Arthroplasty in California, 2007-2010. As the number of total hip and knee arthroplasty cases increases, it is important to understand the burden of factors that impact patient outcomes of these procedures. This article examined the time trends in key demographics, clinical characteristics, comorbidity burden (Deyo-Charlson Comorbidity Index [CCI]), and presence of depression in patients undergoing primary total (...) hip arthroplasty and total knee arthroplasty using population-based, all-payer inpatient database, California Healthcare Cost and Utilization Project, from 2007 to 2010.Chi-square tests and analysis of variance were used. Multivariate logistic regression analyses were also performed to compare the prevalence of depression in 2007 to later years.In the primary total hip arthroplasty cohort, the prevalence of depression significantly increased by 20%, mean age decreased by 0.4 years, mean length

2018 Journal of Arthroplasty

862. Physical therapy vs. internet-based exercise training for patients with knee osteoarthritis: Results of a randomized controlled trial. Full Text available with Trip Pro

, 2.08, P = 0.39). IBET was non-inferior to PT at both time points.Improvements in WOMAC score following IBET and PT did not differ significantly from the WL group. Additional research is needed to examine strategies for maximizing benefits of exercise-based interventions for patients with knee OA.NCT02312713.Published by Elsevier Ltd. (...) Physical therapy vs. internet-based exercise training for patients with knee osteoarthritis: Results of a randomized controlled trial. To compare the effectiveness of physical therapy (PT, evidence-based approach) and internet-based exercise training (IBET), each vs a wait list (WL) control, among individuals with knee osteoarthritis (OA).Randomized controlled trial of 350 participants with symptomatic knee OA, allocated to standard PT, IBET and WL control in a 2:2:1 ratio, respectively. The PT

2018 Osteoarthritis and Cartilage Controlled trial quality: predicted high

863. Safety and feasibility evaluation of tourniquets for total knee replacement (SAFE-TKR): study protocol. Full Text available with Trip Pro

Safety and feasibility evaluation of tourniquets for total knee replacement (SAFE-TKR): study protocol. This study is designed to determine whether a full randomised controlled trial (RCT) examining the clinical effectiveness and safety of total knee replacement surgery with or without a tourniquet is warranted and feasible.Single centre, patient-blinded and assessor-blinded RCT. A computer-generated randomisation service will allocate 50 participants into one of two trial treatments, surgery (...) with or without a tourniquet. The primary objective is to estimate recruitment, crossovers and follow-up of patients. All patients will have an MRI scan of their brain preoperatively and day 1 or 2 postoperatively to identify ischaemic cerebral emboli (primary clinical outcome). Oxford Cognitive Screen, Montreal Cognitive Assessment and Mini-Mental State Examination will be evaluated as outcome tools for measuring cognitive impairment at days 1, 2 and 7 postoperatively. Thigh pain, blood transfusion

2018 BMJ open

864. Arthroscopic Cartilage Lesion Preparation in the Human Cadaveric Knee Using a Curette Technique Demonstrates Clinically Relevant Histologic Variation. (Abstract)

Arthroscopic Cartilage Lesion Preparation in the Human Cadaveric Knee Using a Curette Technique Demonstrates Clinically Relevant Histologic Variation. To examine the quality of arthroscopic cartilage debridement using a curette technique by comparing regional and morphologic variations within cartilage lesions prepared in human cadaveric knee specimens for the purpose of cartilage repair procedures. A secondary aim was to compare the histologic properties of cartilage lesions prepared (...) by surgeons of varying experience.Standardized cartilage lesions (8 mm × 15 mm), located to the medial/lateral condyle and medial/lateral trochlea were created within 12 human cadaver knees by 40 orthopaedic surgeons. Participants were instructed to create full-thickness cartilage defects within the marked area, shouldered by uninjured vertical walls of cartilage, and to remove the calcified cartilage layer, without violating the subchondral plate. Histologic specimens were prepared to examine

2018 Arthroscopy

865. Do Pain Coping and Pain Beliefs Associate With Outcome Measures Before Knee Arthroplasty in Patients Who Catastrophize About Pain? A Cross-sectional Analysis From a Randomized Clinical Trial. Full Text available with Trip Pro

performance measures in patients scheduled for knee arthroplasty have not been examined. Patients with moderate to high pain catastrophizing (a pain appraisal approach associated with an exaggerated focus on the threat value of pain) may represent an excellent study population in which to address this knowledge gap.We asked the following questions among patients with high levels of pain catastrophizing who were scheduled for TKA: (1) Do maladaptive pain responses correlate with worse self-reported pain (...) Do Pain Coping and Pain Beliefs Associate With Outcome Measures Before Knee Arthroplasty in Patients Who Catastrophize About Pain? A Cross-sectional Analysis From a Randomized Clinical Trial. Pain-coping strategies and appraisals are responses to the pain experience. They can influence patient-reported and physical performance outcome measures in a variety of disorders, but the associations between a comprehensive profile of pain-coping responses and preoperative pain/function and physical

2018 Clinical Orthopaedics and Related Research

866. Inflammation and glucose homeostasis are associated with specific structural features among adults without knee osteoarthritis: a cross-sectional study from the osteoarthritis initiative. Full Text available with Trip Pro

of inflammation and glucose homeostasis on structural features of early-stage OA may help identify therapeutic targets to delay or prevent the onset of OA among subsets of adults with these features. We examined if serum concentrations of glucose homeostasis (glucose, glycated serum protein [GSP]) or inflammation (C-reactive protein [CRP]) were associated with prevalent knee bone marrow lesions (BMLs) or effusion among adults without knee OA.We conducted a cross-sectional study using baseline data from (...) Inflammation and glucose homeostasis are associated with specific structural features among adults without knee osteoarthritis: a cross-sectional study from the osteoarthritis initiative. Greater age and body mass index are strong risk factors for osteoarthritis (OA). Older and overweight individuals may be more susceptible to OA because these factors alter tissue turnover in menisci, articular cartilage, and bone via altered glucose homeostasis and inflammation. Understanding the role

2018 BMC Musculoskeletal Disorders

867. Comparison of T2* mapping between regular echo time and ultrashort echo time with 3D cones at 3 tesla for knee meniscus. Full Text available with Trip Pro

magnetic resonance imaging (MRI) scans of 42 patients who presented with knee pain and underwent knee MRIs, with the 3D Cones of UTE sequence (minimum TEs: 32 μs) and a 3T MRI scanner (Discovery 750, GE Healthcare, Waukesha, WI), were analyzed. The enrolled patients were classified into 3 subgroups:normal meniscus on conventional MRI, with no positive meniscus-related physical examination in medical records;meniscal degeneration with signal changes on conventional MRI; andmeniscal tear.For (...) Comparison of T2* mapping between regular echo time and ultrashort echo time with 3D cones at 3 tesla for knee meniscus. The objectives of this study were to compare the ultrashort T2* relaxation time with the T2* relaxation time using the 3 dimensional (3D) cones sequence in 3 groups of patients with normal, degenerated, and torn knee menisci, and to demonstrate the additional effect of the ultrashort echo time (UTE) signal intensity.Following institutional review board approval, 42 knee

2018 Medicine

868. Medial Pivot in Total Knee Arthroplasty: Literature Review and Our First Experience Full Text available with Trip Pro

preliminary clinical improvement using the Medial Congruent (MC) insert as specific level of constraint.A total of 10 consecutive patients have been enrolled in this study and treated using an MC tibial polyethylene insert. The Oxford Knee Score (OKS) and the Knee Society Score (KSS) have been assessed preoperatively and at 3-month, 6-month, and 1-year follow-up (FU) and used as validated measurements to evaluate early clinical improvements. Postoperative radiological examination was reviewed looking (...) Medial Pivot in Total Knee Arthroplasty: Literature Review and Our First Experience Traditional total knee implants designs, usually, are not able to reproduce the physiological kinematics of the knee, leaving almost 20% of the patients, those who underwent a total knee arthroplasty (TKA), not fully satisfied. Modern inserts are nowadays designed with a fully congruent medial compartment to reproduce the normal medial pivoting biomechanics of the knee. The aim of this article was to evaluate

2018 Clinical medicine insights. Arthritis and musculoskeletal disorders

869. The effects of injecting intra-articular platelet-rich plasma or prolotherapy on pain score and function in knee osteoarthritis Full Text available with Trip Pro

of platelet-rich plasma (PRP) injection and prolotherapy (PRL) were examined on the level of pain and function of the knee joint in patients with OA.After fulfilling the inclusion criteria and signing the informed consent form, 42 patients with knee OA were scheduled for intra-articular injection in the present randomized, double-blind, clinical trial. Following admission to the operating pain room, the condition of the patient's knee was evaluated first via the Western Ontario and McMaster Universities (...) The effects of injecting intra-articular platelet-rich plasma or prolotherapy on pain score and function in knee osteoarthritis Osteoarthritis (OA) is a chronic joint disease that usually occurs in older people and leads to pain and disabilities. OA treatment ranges from drug therapy to surgery. Drug and rehabilitation therapy are preferred over surgery, and, especially, there is a tendency toward compounds causing regenerative changes in the knee joint. In the present study, the effects

2018 Clinical interventions in aging Controlled trial quality: uncertain

870. Eccrine porocarcinoma arising from the knee Full Text available with Trip Pro

Eccrine porocarcinoma arising from the knee Enlarged eccrine porocarcinoma of the knee was encountered as a hemorrhagic bulky tumor. After controlling bleeding with Mohs' paste, local excision of the lesion was the mainstay of treatment. Pathological examination revealed poroid cells, cuticle cells, and prickle cells cancer components, suggesting that malignancy must be excluded by resection.

2018 Clinical Case Reports

871. The effect of intra-articular allogenic platelet rich plasma in Dunkin-Hartley guinea pig model of knee osteoarthritis Full Text available with Trip Pro

and synovium at the time of euthanasia.Mean synovial fluid COMP concentration was significantly lower in PRP treated knees (p<0.05) at three months. On histological examination mean synovitis scores and synovial vascularity were significantly lower in PRP treated knees as compared to controls at both three and six months (p < 0.05). Additionally mean articular cartilage degeneration was significantly lower in PRP treated knees in group 1 only (p<0.05).Our preliminary data from the study has shown some (...) The effect of intra-articular allogenic platelet rich plasma in Dunkin-Hartley guinea pig model of knee osteoarthritis To investigate the pathway for disease modifying effect of the PRP in osteoarthritis of knee.Two experimental models (group I and II) of Twelve Dunkin-Hartley guinea pigs each were enrolled as a part of a prospective controlled experimental study. One knee was enrolled for intervention and the other knee of the same animal used as control, the intervention being three intra

2018 Muscles, ligaments and tendons journal

872. Ultrasonographic assessment of the anterolateral ligament of the knee in healthy subjects Full Text available with Trip Pro

Ultrasonographic assessment of the anterolateral ligament of the knee in healthy subjects The aim of our study was to determine inter-observer agreement in the ultrasonographic identification of the anterolateral ligament (ALL) and in the evaluation of its length and thickness in healthy subjects.80 healthy volunteers (160 knees) (42 males and 38 females) were enrolled in the study. All subjects underwent ultrasound (US) examination of both knees, performed by two physicians with over ten years (...) of musculoskeletal US experience. In order to keep the ALL under optimal tension, the knee was flexed at approximately 30-35°, slightly internally rotated and length and thickness of the ligament were measured.ALL was identified in 93.8% (150 out of 160) and in 92.5% (148 out of 160) of the knees by Evaluator 1 and Evaluator 2, respectively. Interobserver agreement was substantial to almost perfect for the visualization of the ALL ( =0.90) and for measurements of its length (ICC = 0.83), and strong

2018 Muscles, ligaments and tendons journal

873. Integrating participatory ergonomic management in non-weight-bearing exercise and progressive resistance exercise on self-care and functional ability in aged farmers with knee osteoarthritis: a clustered randomized controlled trial Full Text available with Trip Pro

Integrating participatory ergonomic management in non-weight-bearing exercise and progressive resistance exercise on self-care and functional ability in aged farmers with knee osteoarthritis: a clustered randomized controlled trial Ergonomic hazards are the most important cause of knee osteoarthritis (OA) in aged para rubber farmers. Ergonomic management comprising improvement of working conditions and muscle-strengthening exercise has been well documented in terms of workers' health benefit (...) . However, those interventions were not adequate to sustain the advantage. Few studies have demonstrated the effect of integrating participatory ergonomic management (PEM) in non-weight-bearing exercise (NWE) and progressive resistance exercise (PRE), and none has focused on aged para rubber farmers with knee OA.This study investigated the effect of PEM-NWE, PEM-PRE, and standard treatment (ST) on self-care and functional ability in the aged population.A single-blinded, clustered randomized controlled

2018 Clinical interventions in aging Controlled trial quality: uncertain

874. Comparison of the effects of exercise with chondroitin sulfate on knee osteoarthritis in rabbits Full Text available with Trip Pro

Comparison of the effects of exercise with chondroitin sulfate on knee osteoarthritis in rabbits The aim of the study is to compare the effects of exercise therapy with chondroitin sulfate (CS) therapy in an experimental model of osteoarthritis (OA).Twenty-one New Zealand rabbits were randomly divided into four groups: normal group (N group, n = 3); OA control group (C group, n = 6); OA plus medication group (CS group, n = 6); and OA plus exercise group (E group, n = 6). Four weeks after (...) modeling, the rabbits were subjected to exercise (artificial, 30 min/time, 4 times/week) or medicated with CS (2% CS, 0.3 ml/time, once/week) for 4 weeks. Histopathological changes in treated joints were examined after staining. X-ray and scanning electron microscopy was used to evaluate the different therapies by examining the surfaces and joint spaces of the articular cartilage. RT-qPCR was used to assess chondrogenic gene expression including Col2, Col10, mmp-13, il-1β, adamats-5, and acan

2018 Journal of orthopaedic surgery and research

875. Prospective Study of Central versus Peripheral Obesity in Total Knee Arthroplasty Full Text available with Trip Pro

Prospective Study of Central versus Peripheral Obesity in Total Knee Arthroplasty Body mass index (BMI) is often used to predict surgical difficulty in patients receiving total knee arthroplasty (TKA); however, BMI neglects variation in the central versus peripheral distribution of adipose tissue. We sought to examine whether anthropometric factors, rather than BMI alone, may serve as a more effective indication of surgical difficulty in TKA.We prospectively enrolled 67 patients undergoing (...) primary TKA. Correlation coefficients were used to evaluate the associations of tourniquet time, a surrogate of surgical difficulty, with BMI, pre- and intraoperative anthropometric measurements, and radiographic knee alignment. Similarly, Knee Injury and Osteoarthritis Outcome Score (KOOS) was compared to BMI.Tourniquet time was significantly associated with preoperative inferior knee circumference (p=0.025) and ankle circumference (p=0.003) as well as the intraoperative depth of incision

2018 Knee surgery & related research

876. Reduced tibial strain-shielding with extraosseous total knee arthroplasty revision system Full Text available with Trip Pro

Reduced tibial strain-shielding with extraosseous total knee arthroplasty revision system Revision total knee arthroplasty (RTKA) has poorer results than primary total knee arthroplasty (TKA), and the prostheses are invasive and cause strain-shielding of the bones near the knee. This paper describes an RTKA system with extracortical fixation. It was hypothesised that this would reduce strain-shielding compared with intramedullary fixation.Twelve replica tibiae were prepared for full-field (...) , extracortical fixation reduced surface strain-shielding by half versus intramedullary fixation. For all load cases and bone regions examined, the extracortical implant shielded 8-27% of bone strain, whereas the intramedullary component shielded 37-56%.The new fixation design, which offers less bone destruction than conventional RTKA, also reduced strain-shielding. Clinically, this design may allow greater rebuilding of bone loss, and should increase long-term fixation.Copyright © 2018 The Authors. Published

2018 Medical engineering & physics

877. Tranexamic acid use and risk of thrombosis in regular users ofantithrombotics undergoing primary total knee arthroplasty: a prospectivecohort study Full Text available with Trip Pro

Tranexamic acid use and risk of thrombosis in regular users ofantithrombotics undergoing primary total knee arthroplasty: a prospectivecohort study The effect of tranexamic acid has not been examined in patients who are regular users of antithrombotics before undergoing total knee arthroplasty. The aim of this study was to determine the impact of tranexamic acid on bleeding and the risk of transfusion and thrombosis in patients taking an antithrombotic treatment before primary unilateral total (...) knee arthroplasty.A prospective observational study was conducted in a series of 385 consecutive primary total knee arthroplasties performed with and without the administration of tranexamic acid. We compared post-operative bleeding, as determined by a bleeding index, and postoperative haemoglobin and haematocrit between patients taking an antithrombotic treatment before the operation (ATT+ group) and those naïve or non-regular users of antithrombotics (ATT- group). Post-operatively, rivaroxaban

2018 Blood Transfusion

878. MAXIMAL HIP AND KNEE MUSCLE STRENGTH ARE NOT RELATED TO NEUROMUSCULAR PRE-ACTIVITY DURING SIDECUTTING MANEUVER: A CROSS-SECTIONAL STUDY Full Text available with Trip Pro

obtained during an isometric contraction, however, whether these two measures are related when muscle activity is obtained during a movement associated with a high risk of non-contact ACL injury is not known. Absence or presence of such a relationship may have implications for which training modalities to choose in the prevention of ACL injuries.The purpose of this study was to examine the relationship between maximal muscle strength of the hip extensors, hip abductors and knee flexors and the pre (...) MAXIMAL HIP AND KNEE MUSCLE STRENGTH ARE NOT RELATED TO NEUROMUSCULAR PRE-ACTIVITY DURING SIDECUTTING MANEUVER: A CROSS-SECTIONAL STUDY Reduced lower extremity muscle strength as well as reduced lower extremity muscle pre-activity (defined as muscular activity just prior to initial ground contact) during high-risk movements are factors related to increased risk of non-contact ACL injury in adolescent female athletes. A strong relationship exists between muscle strength and muscle activity

2018 International journal of sports physical therapy

879. Rheumatoid Arthritis Patients Achieve Better Satisfaction but Lower Functional Activities as Compared to Osteoarthritis Patients After Total Knee Arthroplasty. (Abstract)

Rheumatoid Arthritis Patients Achieve Better Satisfaction but Lower Functional Activities as Compared to Osteoarthritis Patients After Total Knee Arthroplasty. Recently, poor patient satisfaction after total knee arthroplasty (TKA) has gained attention mainly in osteoarthritis (OA) patients; however, satisfaction after TKA remains to be understood in rheumatoid arthritis (RA) patients. This study aimed to examine satisfaction and function after RA TKA using patient-reported outcome measures (...) and to compare the results with those of OA-TKA.This study enrolled 534 TKAs of 501 patients consisting of 75 TKAs of 70 RA patients and 459 TKAs of 431 OA patients. Data of patient-reported outcome measures such as new Knee Society Score 2011, Pain Catastrophizing Scale, and Pain DETECT Score were collected at 2 years. Multiple regression analysis was performed with Knee Society Score satisfaction score set as a dependent variable in order to clarify factors affecting patient satisfaction. Principle

2018 Journal of Arthroplasty

880. Does Supplementing of Quadriceps Strength With Exoskeleton After Total Knee Arthroplasty in High Risk Population Reduce Transfer to Extended Care Facility (ECF)

Does Supplementing of Quadriceps Strength With Exoskeleton After Total Knee Arthroplasty in High Risk Population Reduce Transfer to Extended Care Facility (ECF) Does Supplementing of Quadriceps Strength With Exoskeleton After Total Knee Arthroplasty in High Risk Population Reduce Transfer to Extended Care Facility (ECF) - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study (...) Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Does Supplementing of Quadriceps Strength With Exoskeleton After Total Knee Arthroplasty in High Risk Population Reduce Transfer to Extended Care Facility (ECF) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S

2018 Clinical Trials

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