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Knee Exam

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961. Young athletes after ACL reconstruction with quadriceps strength asymmetry at the time of return-to-sport demonstrate decreased knee function 1 year later. (Abstract)

Young athletes after ACL reconstruction with quadriceps strength asymmetry at the time of return-to-sport demonstrate decreased knee function 1 year later. Quadriceps femoris (QF) strength deficits at return-to-sport (RTS) after ACL reconstruction (ACLR) contribute to decreased knee function at the same time point. However, the impact of QF strength at RTS on longitudinal function has not been examined. The purpose of this study was to test the hypothesis that young athletes after ACLR with QF (...) strength asymmetry at RTS would demonstrate decreased knee-related function and lower proportions of functional recovery at 1 year post-RTS compared to young athletes following ACLR with nearly symmetric QF strength at RTS.Participants included 76 young athletes (74% female; mean age at RTS = 17.3 years) after primary, unilateral ACLR, cleared to RTS, and followed for 1 year after RTS. At the time of RTS, QF strength was quantified on an isokinetic dynamometer and a Limb Symmetry Index (LSI

2017 Knee Surgery, Sports Traumatology, Arthroscopy

962. Periarticular Injection of Tranexamic Acid Reduces Blood Loss and the Necessity for Allogeneic Transfusion After Total Knee Arthroplasty Using Autologous Transfusion: A Retrospective Observational Study. (Abstract)

Periarticular Injection of Tranexamic Acid Reduces Blood Loss and the Necessity for Allogeneic Transfusion After Total Knee Arthroplasty Using Autologous Transfusion: A Retrospective Observational Study. This study aimed to examine the influence of a periarticular injection of tranexamic acid (TXA) on blood loss after a total knee arthroplasty (TKA) in patients who received an autologous blood transfusion.We retrospectively reviewed the medical charts of 82 patients (88 consecutive knees) who

2017 Journal of Arthroplasty

963. Effect of Vascular Injury on Functional Outcome in Knees with Multi-Ligament Injury: A Matched-Cohort Analysis. (Abstract)

injury. Functional outcomes were assessed with physical examination of range of motion and ligamentous stability as well as patient-reported outcome scores.The vascular cohort had a mean Lysholm score of 62.5 points (range, 16 to 100 points) and a mean International Knee Documentation Committee (IKDC) score of 59.7 points (range, 14.9 to 100 points) at a mean (and standard deviation) of 8.3 ± 5.0 years after surgery. The control cohort had a mean Lysholm score of 86.4 points (range, 51.0 to 100.0 (...) Effect of Vascular Injury on Functional Outcome in Knees with Multi-Ligament Injury: A Matched-Cohort Analysis. Multi-ligament knee injury (MLKI) associated with knee dislocation can result in vascular injury. The purpose of this study was to compare knee function after MLKI between patients with a vascular injury requiring popliteal artery bypass grafting and patients without vascular involvement. Additionally, factors associated with poor knee function in patients who had MLKI with vascular

2017 The Journal of Bone and Joint Surgery. American Volume

964. Current Total Knee Designs: Does Baseplate Roughness or Locking Mechanism Design Affect Polyethylene Backside Wear? Full Text available with Trip Pro

Current Total Knee Designs: Does Baseplate Roughness or Locking Mechanism Design Affect Polyethylene Backside Wear? Tibial baseplate roughness and polyethylene-insert micromotion resulting from locking-mechanism loosening can lead to polyethylene backside wear in TKAs. However, many retrieval studies examining these variables have evaluated only older TKA implant designs.We used implant-retrieval analysis to examine if there were differences in: (1) backside damage scores, (2) backside damage (...) modes, and (3) backside linear wear rates in five TKA implant designs owing to differing baseplate surface roughness and locking mechanisms. Additionally, we examined if (4) patient demographics influence backside damage and wear.Five TKA implant models (four modern and one historical design) were selected with different tibial baseplate and/or locking mechanism designs. Six tibial inserts retrieved at the time of revision from each TKA model were matched for time in vivo, age of the patient at TKA

2017 Clinical Orthopaedics and Related Research

965. Knee extensor power asymmetry is unrelated to functional mobility of older adults. Full Text available with Trip Pro

Knee extensor power asymmetry is unrelated to functional mobility of older adults. To determine whether knee extensor power asymmetry limits functional mobility of older adults who possess muscle weakness.Knee extensor power was measured in 36 older men and women (76.0±7.6yr), for each leg, on an isokinetic dynamometer at 60, 180, and 300degs-1 and power asymmetry was calculated as the percent difference in power between strong and weak legs, at each isokinetic velocity. 400-m walk, stair (...) ascent, and five-repetition chair rise tests were performed to assess functional mobility. Pearson correlations were used to examine the relationship between weak leg power, strong leg power, power asymmetry, and 400-m walk time, stair ascent time, and chair rise time. Participants were then stratified into low power-high asymmetry (LP-HA), low power-low asymmetry (LP-LA), high power-high asymmetry (HP-HA), and high power-low asymmetry (HP-LA) groups who were compared for functional mobility.Knee

2017 Experimental Gerontology

966. Preferences and motivation for weight loss among knee replacement patients: implications for a patient-centered weight loss intervention. Full Text available with Trip Pro

, or weight.This study provides a preliminary examination into the motives for weight loss, strategies utilized during past weight loss attempts, and preferences for future weight loss programs as described by knee replacement patients. These results will help guide the development and adaptation of future patient-centered weight loss programs as well as help clinicians recommend targeted weight programs based on the specific preferences of the knee replacement population. (...) Preferences and motivation for weight loss among knee replacement patients: implications for a patient-centered weight loss intervention. Most knee replacement patients are overweight/obese, yet are commonly excluded from evidence-based weight loss programs due to mobility limitations and barriers faced around the time of surgery. The purpose of this study was to identify knee replacement patient preferences for weight loss programs and qualitatively understand previous motives for weight loss

2017 BMC Musculoskeletal Disorders

967. Effects of Dietary Weight Loss with and without Exercise on Interstitial Matrix Turnover and Tissue Inflammation Biomarkers in Adults with Knee Osteoarthritis: The Intensive Diet and Exercise for Arthritis Trial (IDEA). Full Text available with Trip Pro

Effects of Dietary Weight Loss with and without Exercise on Interstitial Matrix Turnover and Tissue Inflammation Biomarkers in Adults with Knee Osteoarthritis: The Intensive Diet and Exercise for Arthritis Trial (IDEA). To examine the effects of dietary weight loss, with and without exercise, on selected soluble biomarkers in overweight and obese older adults with symptomatic knee osteoarthritis (OA).Blood samples were analyzed from 429 participants in the Intensive Diet and Exercise (...) progression. C3M (P = 0.008) and CRPM (P = 0.028) were positively associated with change in WOMAC function. Change in IL-6 was positively associated with change in C1M, C3M, and CRPM.Overweight and obese adults with knee OA who lost weight from diet and diet plus exercise reduced serum markers of interstitial matrix turnover and inflammation but not type II collagen degradation.Copyright © 2017 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

2017 Osteoarthritis and Cartilage Controlled trial quality: uncertain

968. Psychological interventions that target sleep reduce pain catastrophizing in knee osteoarthritis. Full Text available with Trip Pro

Psychological interventions that target sleep reduce pain catastrophizing in knee osteoarthritis. Pain catastrophizing is a significant risk factor for patients with knee osteoarthritis (KOA) and thus is a target for many psychological interventions for pain. This study examined if interventions targeting sleep found to be effective in improving sleep in KOA also reduce pain catastrophizing measured as a trait through the pain catastrophizing scale and measured as a daytime and nocturnal state

2017 Pain

969. The Longitudinal Relationship between Hand, Hip and Knee Osteoarthritis and Cardiovascular Events: A Population-Based Cohort Study. Full Text available with Trip Pro

The Longitudinal Relationship between Hand, Hip and Knee Osteoarthritis and Cardiovascular Events: A Population-Based Cohort Study. In this population-based cohort study, we examined the association between the presence of symptomatic osteoarthritis (OA) and risk for cardiovascular (CV) events.A cohort aged ≥55 years recruited from 1996 to 98 was followed through provincial health administrative data to 2014. Demographics, joint complaints and functional limitations were collected. Hip, knee (...) % knee, 16.0% hand), 16.3% self-reported limitation in grip and 25.4% in walking. Over a median 13.4 years, 31.9% experienced a CV event. Controlling for all but walking limitation, a dose-response relationship was observed between number of joints affected by knee/hip OA and CV risk (HR 2 hips/knees vs none: 1.13, 95% CI 1.03-1.23; 3+ hips/knees: 1.22, 95% CI 1.09-1.36). This relationship became non-significant additionally controlling for difficulty walking. Self-reported difficulty walking

2017 Osteoarthritis and Cartilage

970. Intraoperative validation of quantitative T2 mapping in patients with articular cartilage lesions of the knee. Full Text available with Trip Pro

Intraoperative validation of quantitative T2 mapping in patients with articular cartilage lesions of the knee. The aim of this study was to compare T2 relaxation times of knee cartilage with intraoperative results for the assessment of early osteoarthritis (OA) and to define T2 values for the differentiation between healthy and degenerated cartilage.Twenty-one patients with cartilage lesions or moderate OA were examined using 3T magnetic resonance imaging (MRI). In this prospective study (...) , a total of 882 regions of interest (ROIs) were examined by a sagittal, multi-echo, spin-echo T2 sequence and a morphological high-resolution three-dimensional, fat-saturated proton-density space sequence. Cartilage lesions were identified arthroscopically, graded by the International Cartilage Repair Society (ICRS) score in 42 defined ROIs per patient and consecutively compared with mean T2 values using analysis of variance and Spearman's rank correlation test. Receiver operating characteristics (ROC

2017 Osteoarthritis and Cartilage

971. The impact of preoperative bacteriuria on the risk of periprosthetic joint infection after primary knee or hip replacement: a retrospective study with a one-year follow-up. Full Text available with Trip Pro

The impact of preoperative bacteriuria on the risk of periprosthetic joint infection after primary knee or hip replacement: a retrospective study with a one-year follow-up. Patients who undergo elective joint replacement are traditionally screened and treated for preoperative bacteriuria to prevent periprosthetic joint infection (PJI). More recently, this practice has been questioned. The purpose of this study was to determine whether preoperative bacteriuria is associated with an increased (...) risk of PJI.Patients who had undergone a primary hip or knee replacement in a tertiary care hospital between September 2002 and December 2013 were identified from the hospital database (23 171 joint replacements, 10 200 hips, and 12 971 knees). The results of urine cultures taken within 90 days before the operation were obtained. Patients with subsequent PJI or superficial wound infection in a 1-year follow-up period were identified based on prospective infection surveillance. The association

2017 Clinical Microbiology and Infection

972. Physical performance and movement-evoked pain profiles in community-dwelling individuals at risk for knee osteoarthritis. Full Text available with Trip Pro

Physical performance and movement-evoked pain profiles in community-dwelling individuals at risk for knee osteoarthritis. Knee pain associated with osteoarthritis is a significant contributor to decreased physical function. Recent evidence supports the inter-individual heterogeneity associated with knee pain presentation, but whether there is similar heterogeneity in physical performance among these individuals has not been previously examined. The aim of the present study was to characterize (...) measures.Our results support the hypothesis that among persons with knee OA pain, three different physical performance profiles exist with varying degrees of movement-evoked pain. Even as all three groups experienced moderate to severe levels of spontaneous knee pain, those individuals with the most severe movement-evoked pain and lowest physical functional performance also had the least favorable psychological characteristics along with increased mechanical pain sensitivity and temporal summation.Our

2017 Experimental Gerontology

973. Teriparatide Administration Increases Periprosthetic Bone Mineral Density After Total Knee Arthroplasty: A Prospective Study. (Abstract)

sides of the joints together has never been examined. We investigated the efficacy of teriparatide to inhibit BMD loss in the femoral and tibial side and considered complications such as migration and periprosthetic fractures after TKA.Twenty-two knees in 17 patients were included in this study, and a control group of patients who underwent TKA was identified according to their medical records. Dual-energy X-ray absorptiometry was performed for different locations (knee, hip, and lumbar spine (...) Teriparatide Administration Increases Periprosthetic Bone Mineral Density After Total Knee Arthroplasty: A Prospective Study. Teriparatide is a currently available therapeutic agent for osteoporosis. Previous studies have reported that teriparatide affects periprosthetic bone mineral density (BMD) after total knee arthroplasty (TKA). However, little agreement has been reached concerning the treatment of periprosthetic BMD after TKA with teriparatide. Moreover, BMD in the femoral and tibial

2017 Journal of Arthroplasty

974. Longitudinal Postoperative Course of Pain and Dysfunction Following Total Knee Arthroplasty. Full Text available with Trip Pro

Longitudinal Postoperative Course of Pain and Dysfunction Following Total Knee Arthroplasty. Although the majority of patients undergoing total knee arthroplasty (TKA) report substantial improvement in pain and function, a significant subset experience persistent postsurgical pain and dysfunction. Better understanding of the longitudinal postoperative course is needed, including the association between patient status following physical rehabilitation at 6-weeks post-TKA, to 6-months outcomes (...) . This study aims to described the postoperative course of TKA and examine variables associated with change in pain and functioning between 6-weeks and 6-months post-TKA.In this longitudinal study of 223 participants, assessments of analgesic intake, depression, anxiety, pain catastrophizing, dysfunction, resting and range of motion pain, and pain sensitivity were completed at 6-weeks post-TKA. Analgesic intake, pain ratings, and dysfunction data were also collected at 6-months post-TKA. Pain

2017 Clinical Journal of Pain

975. Accumulation of advanced-glycation end products (AGEs) accelerates arthrogenic joint contracture in immobilized rat knee. Full Text available with Trip Pro

-joint tissues. After serial injections, rats were subjected to unilateral knee-joint immobilization in a flexion position for various periods. At day 21, the passive knee ranges of motions (ROMs) were measured. Knee joint histopathology were assessed, and the expression of fibrotic genes in the posterior joint capsules was examined using real-time PCR. Ribose injection induced a 7.0-fold increase in pentosidine levels relative to saline injection. Joint immobilization resulted in equal myogenic ROM (...) Accumulation of advanced-glycation end products (AGEs) accelerates arthrogenic joint contracture in immobilized rat knee. Joint mobility decreases in the elderly and in diabetics, this process is thought to be caused by accumulation of advanced-glycation end products (AGEs). Here, we aimed to elucidate the role of AGEs in joint contracture formation in rat knees. Rats were injected with ribose or saline into the knees twice weekly for 8 weeks. Pentosidine (AGE) levels were measured in the knee

2017 Journal of Orthopaedic Research

976. Reductions in Perceived Injustice are Associated with Reductions in Disability and Depressive Symptoms after Total Knee Arthroplasty. Full Text available with Trip Pro

Reductions in Perceived Injustice are Associated with Reductions in Disability and Depressive Symptoms after Total Knee Arthroplasty. Perceptions of injustice have been associated with problematic recovery outcomes in individuals with a wide range of debilitating pain conditions. It has been suggested that, in patients with chronic pain, perceptions of injustice might arise in response to experiences characterized by illness-related pain severity, depressive symptoms, and disability (...) . If symptoms severity and disability are important contributors to perceived injustice (PI), it follows that interventions that yield reductions in symptom severity and disability should also contribute to reductions in perceptions of injustice. The present study examined the relative contributions of postsurgical reductions in pain severity, depressive symptoms, and disability to the prediction of reductions in perceptions of injustice.The study sample consisted of 110 individuals (69 women and 41 men

2017 Clinical Journal of Pain

977. Internal femoral component rotation adversely influences load transfer in total knee arthroplasty: a cadaveric navigated study using the Verasense device. Full Text available with Trip Pro

Internal femoral component rotation adversely influences load transfer in total knee arthroplasty: a cadaveric navigated study using the Verasense device. Correct femoral component rotation at knee arthroplasty influences patellar tracking and may determine function at extremes of movement. Additionally, such malrotation may deleteriously influence flexion/extension gap geometry and soft tissue balancing kinematics. Little is known about the effect of subtle rotational change upon load transfer (...) across the tibiofemoral articulation. Our null hypothesis was that femoral component rotation would not influence load across this joint in predictable manner.A cadaveric study was performed to examine load transfer using the orthosensor device, respecting laxity patterns in 6° of motion, to examine load across the medial and lateral compartments across a full arc of motion. Mixed-effect modelling allowed for quantification of the effect upon load with internal and external femoral component rotation

2017 Knee Surgery, Sports Traumatology, Arthroscopy

978. Incidence of Symptomatic Osteochondritis Dissecans Lesions of the Knee: A Population-Based Study in Olmsted County. Full Text available with Trip Pro

Incidence of Symptomatic Osteochondritis Dissecans Lesions of the Knee: A Population-Based Study in Olmsted County. To (1) define population-based incidence of knee Osteochondritis dissecans (OCD) lesions using the population of Olmsted County, (2) examine trends over time, and (3) evaluate rate of surgical management over time.Study population included 302 individuals who were diagnosed with knee OCD lesions between January 1, 1976 and December 31, 2014. Complete medical records were reviewed (...) to extract injury and treatment details. Age- and gender-specific incidence rates were calculated and adjusted to the 2010 US population. Poisson regression analyses were performed to examine incidence and surgery trends by age, gender, and calendar period.Overall age- and gender-adjusted incidence annual incidence of knee OCD lesions was 6.09 per 100,000 person-years. The incidence was significantly higher (P < 0.001) in males (8.82, 95% CI 7.63 to 10.00 per 100,000) compared to females (3.32, 95% CI

2017 Osteoarthritis and Cartilage

979. Reductions in Readmission Rates Are Associated With Modest Improvements in Patient-reported Health Gains Following Hip and Knee Replacement in England. Full Text available with Trip Pro

Reductions in Readmission Rates Are Associated With Modest Improvements in Patient-reported Health Gains Following Hip and Knee Replacement in England. Although many hospital readmission reduction initiatives have been introduced globally, health care systems ultimately aim to improve patients' health and well-being. We examined whether the hospitals that report greater success in reducing readmissions also see greater improvements in patient-reported outcomes.We examined hospital groups (...) (Trusts) that provided hip replacement or knee replacement surgery in England between April 2010 and February 2013. For each Trust, we calculated risk-adjusted 30-day readmission rates from administrative datasets. We also obtained changes in patient-reported health between presurgical assessment and 6-month follow-up, using general health EuroQuol five dimensions questionaire (EQ-5D) and EuroQuol visual analogue scales (EQ-VAS) and procedure-specific (Oxford Hip and Knee Scores) measures. Panel

2017 Medical Care

980. Quantitative Regional and Sub-Regional Analysis of Femoral and Tibial Subchondral Bone Mineral Density Using Computed Tomography: Comparison of Non-Osteoarthritic and Severe Osteoarthritic Knees. Full Text available with Trip Pro

Quantitative Regional and Sub-Regional Analysis of Femoral and Tibial Subchondral Bone Mineral Density Using Computed Tomography: Comparison of Non-Osteoarthritic and Severe Osteoarthritic Knees. This study aimed to compare subchondral bone mineral density (sBMD) between non-radiographic osteoarthritic (OA) and medial femorotibial OA knees, using computed tomography (CT).CT exams from 16 non-radiographic OA (KL grade < 2) and 16 severe medial OA (KL grade ≥ 3) knees (average age of 61.7 ± 3 (...) and 62.2 ± 5 years old respectively, 50% male in each group), were retrospectively analyzed. CT exams were segmented and 3D maps of sBMD based on the CT number in the most superficial 3 mm of femoral and tibial subchondral bone were computed. Average sBMD and medial-to-lateral sBMD ratios were calculated for total load-bearing regions and for sub-regions of interest in the femur and tibia.The analysis of total load-bearing regions did not reveal any significant difference between groups, except

2017 Osteoarthritis and Cartilage

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