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901. Effect of low-intensity long-duration ultrasound on the symptomatic relief of knee osteoarthritis: a randomized, placebo-controlled double-blind study Full Text available with Trip Pro

Effect of low-intensity long-duration ultrasound on the symptomatic relief of knee osteoarthritis: a randomized, placebo-controlled double-blind study Wearable long-duration low-intensity ultrasound is an emerging non-invasive and non-narcotic therapy for the daily treatment of musculoskeletal pain. The aim of this randomized, double-blind, placebo-controlled study was to examine whether long-duration low-intensity ultrasound was effective in treating pain and improving function in patients (...) with knee osteoarthritis.Ninety patients with moderate to severe knee pain and radiographically confirmed knee osteoarthritis (Kellgren-Lawrence grade I/II) were randomized for treatment with active (n = 55) or placebo (n = 35) devices applied daily to the treated knee. Investigators and subjects were blinded to treatment groups. Ultrasound (3 MHz, 0.132 W/cm2, 1.3 W) was applied with a wearable device for 4 h daily for 6 weeks, delivering 18,720 J per treatment. The primary outcome was change in pain

2018 Journal of orthopaedic surgery and research Controlled trial quality: predicted high

902. Estimation of quadriceps femoris muscle dysfunction in the early period after surgery of the knee joint using shear-wave elastography Full Text available with Trip Pro

Estimation of quadriceps femoris muscle dysfunction in the early period after surgery of the knee joint using shear-wave elastography Orthopaedic surgery of the knee joint results in functional deterioration of the quadriceps femoris muscle. However, little is known about quadriceps femoris muscle dysfunction in the early postsurgical period. Therefore, we examined the stiffness of the quadriceps femoris muscle in the early postsurgical period.Seven patients and seven healthy controls performed

2018 BMJ Open Sport — Exercise Medicine

903. Knee pain as a predictor of structural progression over 4 years: data from the Osteoarthritis Initiative, a prospective cohort study Full Text available with Trip Pro

Knee pain as a predictor of structural progression over 4 years: data from the Osteoarthritis Initiative, a prospective cohort study There is evidence that knee pain not only is a consequence of structural deterioration in osteoarthritis (OA) but also contributes to structural progression. Clarifying this is important because targeting the factors related to knee pain may offer a clinical approach for slowing the progression of knee OA. The aim of this study was to examine whether knee pain (...) over 1 year predicted cartilage volume loss, incidence and progression of radiographic osteoarthritis (ROA) over 4 years.Osteoarthritis Initiative participants with no ROA (Kellgren-Lawrence grade ≤ 1) (n = 2120) and with ROA (Kellgren-Lawrence grade > 2) (n = 2249) were examined. Knee pain was assessed at baseline and 1 year using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Knee pain patterns were categorised as no pain (WOMAC pain < 5 at baseline and 1 year

2018 Arthritis research & therapy

904. Intra-articular administration of IκBα kinase inhibitor suppresses mouse knee osteoarthritis via downregulation of the NF-κB/HIF-2α axis Full Text available with Trip Pro

Intra-articular administration of IκBα kinase inhibitor suppresses mouse knee osteoarthritis via downregulation of the NF-κB/HIF-2α axis Activation of NF-κB signaling promotes osteoarthritis (OA) through the transcriptional induction of Hif-2α and catabolic enzymes. This study sought to examine whether inhibiting IκBα kinase (IKK) could suppress the development of surgically-induced OA of the knee in a mouse model. We employed BMS-345541 (4(2'-aminoethyl) amino-1, 8-dimethylimidazo (1,2 (...) -a) quinoxaline) as a selective inhibitor of the subunits of IKK. OA was created by resecting the medial collateral ligament and the medial meniscus in the knees of mice. The mice were then treated with an intra-articular injection of BMS-345541 (50 nM to 500 µM) or vehicle three times a week for 8 weeks. We found that the intra-articular administration of 500 nM and 5 µM BMS-345541 significantly suppressed OA development. In the BMS-345541-treated cartilage, there was a decrease in the phosphorylation

2018 Scientific reports

905. Differential Gait Patterns by History of Falls and Knee Pain Status in Healthy Older Adults: Results From the Baltimore Longitudinal Study of Aging Full Text available with Trip Pro

Differential Gait Patterns by History of Falls and Knee Pain Status in Healthy Older Adults: Results From the Baltimore Longitudinal Study of Aging Consideration of knee pain can be crucial for identifying fall-related gait patterns. While walking, gait parameters at usual speed were examined in persons with different falls and knee pain status. A total of 439 adults aged 60-92 years participated in this study. Persons with a history of falls had a wider stride width (p = .036) and longer (...) double support time (p = .034) than nonfallers. In the absence of knee pain, fallers had longer double support time than nonfallers (p = .012), but no differences in double support time by history of falls were observed in participants with knee pain. With slower gait speed, fallers with knee pain have narrower stride width and larger hip range of motion (p = .027 and p = .001, respectively). Results suggest the importance of considering knee pain in fall studies for better understanding the fall

2018 Journal of aging and physical activity

906. Influence of Hip Fracture on Knee Pain During Postoperative Rehabilitation Full Text available with Trip Pro

as unstable fractures were more common in the group of intertrochanteric fracture patients with knee pain than in those without knee pain (74.1% vs. 36.4%, respectively; p=0.002).Intertrochanteric fracture affected knee pain after hip fracture surgery more than did femur neck fracture, particularly in unstable fractures. Furthermore, there was no difference in each fracture type according to the surgical procedure. Careful examination and management for knee pain is needed in patients with hip fracture (...) Influence of Hip Fracture on Knee Pain During Postoperative Rehabilitation To investigate whether fracture type, surgical procedure, or fracture grade affect knee pain during postoperative rehabilitation after a hip fracture.We conducted a retrospective case-controlled study of 139 patients during postoperative rehabilitation after surgery for hip fractures. Patients were divided into two groups: patients experiencing knee pain during the first week of postoperative rehabilitation, and patients

2018 Annals of rehabilitation medicine

907. Dual-energy CT and ceramic or titanium prostheses material reduce CT artifacts and provide superior image quality of total knee arthroplasty. Full Text available with Trip Pro

Dual-energy CT and ceramic or titanium prostheses material reduce CT artifacts and provide superior image quality of total knee arthroplasty. To evaluate the influence of different scan parameters for single-energy CT and dual-energy CT, as well as the impact of different material used in a TKA prosthesis on image quality and the extent of metal artifacts.Eight pairs of TKA prostheses from different vendors were examined in a phantom set-up. Each pair consisted of a conventional CoCr prosthesis (...) ). Qualitative image analysis was used to investigate the bone-prosthesis interface.The full titanium prosthesis and full ceramic knee showed significantly fewer blooming artifacts compared to the standard CoCr prosthesis (mean virtual growth 0.6-2.2 mm compared to 2.9-4.6 mm, p < 0.001). Dual-energy CT protocols showed less blooming (range 3.3-3.8 mm) compared to single-energy protocols (4.6-5.5 mm). The full titanium and full ceramic prostheses showed significantly fewer streak artifacts (mean standard

2018 Knee Surgery, Sports Traumatology, Arthroscopy

908. Declining Walking Speed Associates with Increasing Bone Marrow Lesion Volume and Effusion Volume in Individuals with Accelerated Knee Osteoarthritis. Full Text available with Trip Pro

who slowed their walking speed were approximately 3.4 times (95% CI 1.10-10.49) more likely to present with increased effusion volume. Walking speed change was not significantly associated with CDI change.A change in an easily assessable clinical examination (i.e., 20-meter walk test) was associated with concurrent worsening in BML and effusion volume in adults who developed accelerated knee OA.© 2018, American College of Rheumatology. (...) Declining Walking Speed Associates with Increasing Bone Marrow Lesion Volume and Effusion Volume in Individuals with Accelerated Knee Osteoarthritis. To determine whether a decline in walking speed during the year prior to disease onset is associated with concurrent changes in cartilage, bone marrow lesions (BMLs), or effusion in adults who develop common knee osteoarthritis (OA), accelerated knee OA, or no knee OA.We identified 3 groups from the Osteoarthritis Initiative based on annual

2018 Arthritis care & research

909. Biomechanics of the knee extensor mechanism and its relationship to patella tendinopathy: A review. Full Text available with Trip Pro

Biomechanics of the knee extensor mechanism and its relationship to patella tendinopathy: A review. The term jumpers knee for patella tendinitis, as coined by Dr. Martin Blazina, is now commonly referred to as tendinopathy. He believed it was associated with patella alta. Since then multiple studies have failed to reliably show an association between patella tendinopathy and associated intrinsic risk factors. There is, unfortunately, a well-established doctrine that the extensor mechanism (...) is simply a pulley. The goal of the review is to examine the biomechanics of the extensor mechanism and apply this to studies investigating intrinsic risk factors for patella tendinopathy. A better understanding of the biomechanics of the extensor mechanism may stimulate the discovery of intrinsic risk factors for developing patella tendinopathy, and subsequent surgical options to address them. Clinical significance: The aim of this review is to direct future research into biomechanical risk factors

2018 Journal of Orthopaedic Research

910. Trends in procedure type, patient characteristics, and outcomes among persons with knee osteoarthritis undergoing bariatric surgery, 2005-2014. Full Text available with Trip Pro

Trends in procedure type, patient characteristics, and outcomes among persons with knee osteoarthritis undergoing bariatric surgery, 2005-2014. To evaluate trends in the utilization, clinical characteristics, and inpatient outcomes among persons with knee osteoarthritis undergoing bariatric surgery.We used the National Inpatient Sample (NIS) to examine trends of bariatric surgeries performed on adults with clinically documented knee osteoarthritis between 2005 and 2014. We abstracted hospital (...) setting, procedure, demographic and clinical characteristics, and inpatient surgical outcomes from each discharge. We examined temporal trends using linear regression and Cochran-Armitage test for trend.The utilization of bariatric surgery among persons with knee osteoarthritis from 2005 to 2014 remained consistent, with an annual total of about 3,300 procedures performed nationally. The most common procedure type changed from laparoscopic Roux-en-Y (65%) in 2005-2006 to laparoscopic sleeve

2018 Osteoarthritis and Cartilage

911. A 9-Year Outcome Study Comparing Cancellous Titanium-Coated Cementless to Cemented Tibial Components of the Advance Medial-Pivot Knee Arthroplasty. Full Text available with Trip Pro

available for final follow-up evaluation at a mean of 8.6 ± 0.4 years. Survival analysis at 9 years showed a cumulative success rate of 100% in both groups with all end points. In neither group were implant-related, surgeon-related, or patient-related failures observed. When both groups were compared, in all time intervals, no differences were recorded on Knee Society system, Western Ontario and McMaster University Osteoarthritis Index, Short Form-12, and Oxford Knee Scores. On radiological examination (...) A 9-Year Outcome Study Comparing Cancellous Titanium-Coated Cementless to Cemented Tibial Components of the Advance Medial-Pivot Knee Arthroplasty. The cemented Advance Medial-Pivot total knee arthroplasty (TKA) was designed to reflect contemporary knee kinematics data and has shown satisfactory long-term outcomes.We retrospectively evaluated prospectively collected data from 2 groups of patients. Group A consisted of 54 patients (54 TKAs), 18 men and 36 women, and mean age at surgery was 63.2

2018 Journal of Arthroplasty

912. Tourniquetless Total Knee Arthroplasty With Modern Perioperative Protocols Decreases Pain and Opioid Consumption in Women. Full Text available with Trip Pro

Tourniquetless Total Knee Arthroplasty With Modern Perioperative Protocols Decreases Pain and Opioid Consumption in Women. This study examined whether a modern total knee arthroplasty (TKA) protocol without a tourniquet results in less patient-reported pain and in-hospital opioid consumption compared to TKA with a tourniquet.A retrospective study of 203 primary unilateral cemented TKAs consecutively performed with or without tourniquet was performed. Identical perioperative pain and blood loss

2018 Journal of Arthroplasty

913. The impact of hip and knee osteoarthritis on the subsequent risk of incident diabetes: a population-based cohort study. Full Text available with Trip Pro

The impact of hip and knee osteoarthritis on the subsequent risk of incident diabetes: a population-based cohort study. This study examined the relationship between hip/knee osteoarthritis and incident diabetes. We hypothesised that hip/knee osteoarthritis would be independently related to an increased risk of incident diabetes and that this relationship would be due, at least in part, to walking difficulty. We also hypothesised a stronger relationship with incident diabetes for knee than hip (...) -reported difficulty standing or walking in the last 3 months (yes/no). Using Cox regressions, we examined the relationship of baseline hip/knee osteoarthritis with incident diabetes as defined from health administrative data, controlling for age, sex, BMI, income, prior hypertension, cardiovascular disease and primary care exposure. We tested whether the observed effect was mediated through walking limitation.In total, 16,362 participants were included: median age 68 years and 61% female

2018 Diabetologia

914. Pain Severity as a Mediator of the Association between Depressive Symptoms and Physical Performance in Knee Osteoarthritis. Full Text available with Trip Pro

Pain Severity as a Mediator of the Association between Depressive Symptoms and Physical Performance in Knee Osteoarthritis. Depressive symptoms in knee osteoarthritis (OA) are associated with increased pain severity and declines in physical performance. This study examined whether pain severity mediates the association between depressive symptoms and physical performance in persons with radiographic knee OA.Three years of annual data from participants (n = 1,463) with radiographic knee OA (...) of the mediated, indirect effect, was never larger than 24%.Pain severity mediated approximately one-fifth of the association between depressive symptoms and physical performance in persons with radiographic knee OA, and the diminishing incremental effects may explain why unimodal treatment strategies with a single disease target are often ineffective in depressed OA patients.Published by Elsevier Ltd.

2018 Osteoarthritis and Cartilage

915. Contribution of central and peripheral risk factors to prevalence, incidence and progression of knee pain: a community-based cohort study. Full Text available with Trip Pro

Contribution of central and peripheral risk factors to prevalence, incidence and progression of knee pain: a community-based cohort study. To explore risk factors that may influence knee pain (KP) through central or peripheral mechanisms.A questionnaire-based prospective community cohort study with KP defined as pain in or around a knee on most days for at least a month. Baseline prevalence, and one year incidence and progression (KP worsening) were examined. Central (e.g., Pain Catastrophizing (...) Scale (PCS)) and peripheral (e.g., significant injury) risk factors were examined. Adjusted odds ratio (OR) and 95% confidence interval (CI) were calculated using logistic regression. Proportional risk contribution (PRC) was estimated using receiver-operator-characteristic (ROC) analysis.Of 9506 baseline participants, 4288 (45%) had KP (men 1826; women, 2462). KP incidence was 12% (men 11%, women 13%), and KP progression 19% (men 16%, women 21%) at one year. While both central and peripheral factors

2018 Osteoarthritis and Cartilage

916. Construction of an adherence rating scale for exercise therapy for patients with knee osteoarthritis. Full Text available with Trip Pro

Construction of an adherence rating scale for exercise therapy for patients with knee osteoarthritis. Knee osteoarthritis (KOA) is one of the most common chronic diseases in the elderly and is the primary cause of the loss of motor function and disability in this population. Exercise therapy is a core, basic and matureand treatment method of treating patients with KOA. Exercise therapy is "strongly recommended" or "recommended" in the diagnosis and treatment guidelines of osteoarthritis in many (...) countries, and most scholars advocate exercise therapy as the preferred rehabilitation method for KOA patients. However, poor long-term adherence is a serious problem affecting the therapeutic effect of this mature treatment. The objective of this study was to construct a concise and practical adherence rating scale (ARS) based on the exercise therapy adherence prediction model in patients with knee osteoarthritis.A binary logistic regression model was established, with the adherence of 218 cases of KOA

2018 BMC Musculoskeletal Disorders Controlled trial quality: uncertain

917. The impact of sarcopenic obesity on knee and hip osteoarthritis: a scoping review. Full Text available with Trip Pro

treatment practices may inadvertently be influencing its development.A scoping review was used to examine the extent of evidence of sarcopenic obesity in adults with hip or knee osteoarthritis. Medline, CINAHL, Web of Science and EMBASE were systematically searched from inception to December 2017 with keywords and subject headings related to obesity, sarcopenia and osteoarthritis.Eleven studies met inclusion criteria, with indications that muscle weakness, low skeletal muscle mass or sarcopenia (...) The impact of sarcopenic obesity on knee and hip osteoarthritis: a scoping review. The progressive, debilitating nature of knee and hip osteoarthritis can result in severe, persistent pain and disability, potentially leading to a need for total joint arthroplasty (TJA) in end-stage osteoarthritis. TJA in adults with obesity is associated with increased surgical risk and prolonged recovery, yet classifying obesity only using body mass index (BMI) precludes distinction of obesity phenotypes

2018 BMC Musculoskeletal Disorders

918. Optimism and Psychological Resilience are Beneficially associated with Measures of Clinical and Experimental Pain in Adults with or at Risk for Knee Osteoarthritis. Full Text available with Trip Pro

Optimism and Psychological Resilience are Beneficially associated with Measures of Clinical and Experimental Pain in Adults with or at Risk for Knee Osteoarthritis. This cross-sectional study examined the associations among optimism, psychological resilience, endogenous pain inhibition, and clinical knee pain severity. Two hypotheses were tested. First, we hypothesized that experimentally tested endogenous pain inhibition would mediate the relationship between optimism and clinical knee pain (...) severity, respectively. Endogenous pain inhibition was examined experimentally using a conditioned pain modulation (CPM) protocol with algometry (test stimulus) and a cold pressor task (conditioning stimulus).As hypothesized, results showed that increased CPM significantly mediated the association between higher optimism and lower clinical knee pain severity. Further, optimism moderated the association between psychological resilience and CPM. However, contrary to our hypothesis, greater psychological

2018 Clinical Journal of Pain

919. Association of Physical Activity with Late-life Mobility Limitation among Women with Total Joint Replacement for Knee or Hip Osteoarthritis. Full Text available with Trip Pro

Association of Physical Activity with Late-life Mobility Limitation among Women with Total Joint Replacement for Knee or Hip Osteoarthritis. To examine the association between leisure-time physical activity (PA) and survival to age 85 with mobility limitation or death before age 85 after total knee (TKR) or total hip replacement (THR) for osteoarthritis (OA).This was a prospective study among participants from the Women's Health Initiative (WHI), recruited 1993-1998 (baseline age 65-79 yrs (...) of lower PA levels with increased risk of late-life mobility limitation and death.Women with lower PA levels before TJR were more likely to experience mobility limitation in late life following TJR for hip or knee OA.

2018 Journal of Rheumatology

920. Level and Downhill Walking to Assess Implant Functionality in Bicruciate- and Posterior Cruciate-Retaining Total Knee Arthroplasty. (Abstract)

Level and Downhill Walking to Assess Implant Functionality in Bicruciate- and Posterior Cruciate-Retaining Total Knee Arthroplasty. The goal of this study is to set up a functional motion analysis test to examine effects of the anterior cruciate ligament in total knee arthroplasty (TKA) patients by comparing knee kinematics, kinetics, and muscle activation patterns during level and downhill walking for patients with posterior cruciate-retaining (PCR) and bicruciate-retaining (BiCR) TKAs.Motion (...) and electromyography (EMG) data were collected for 12 subjects (4/8 male/female, 64 ± 11 years, 31.3 ± 7.3 body mass index, 6/6 right/left) with BiCR TKAs and 15 subjects (6/9 male/female, 67 ± 7 years, 30.5 ± 5.1 body mass index, 4/11 right/left) with PCR TKAs during level and downhill walking using the point cluster marker set and surface electrodes placed on the vastus medialis obliquus, rectus femoris, biceps femoris, and semitendinosus muscles.Level walking exhibited no significant differences in knee

2018 Journal of Arthroplasty

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