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Knee Exam

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1001. Is Rapid Recovery Hip and Knee Replacements Possible and Safe in the Octogenarian Patient? (Abstract)

reviewed 2482 patients undergoing primary and revision total hip and knee arthroplasties (THA and TKA) who all participated in a multifaceted rapid recovery program. The goals of this program were next day discharge to home without the use of home services or post-acute care admission. We examined the hospital LOS and the percentage of patients discharged home as well as 90-day readmission rates to determine efficacy and safety of this program in the patients aged 80 years and older.Octogenarians (...) Is Rapid Recovery Hip and Knee Replacements Possible and Safe in the Octogenarian Patient? Rapid recovery programs are now aimed to reduce costs of hip and knee arthroplasties by discharging patients directly home, shortening hospital length of stay (LOS), and reducing readmission rates. Although patients aged 80 years and older are included in the Medicare bundle, little work has been performed to determine if older patients can safely participate in rapid recovery programs.We retrospectively

2017 Journal of Arthroplasty

1002. Relationship of knee pain to time in moderate and light physical activities: Data from Osteoarthritis Initiative. Full Text available with Trip Pro

Relationship of knee pain to time in moderate and light physical activities: Data from Osteoarthritis Initiative. While OA literature indicates greater pain is related to less time being physically active, it is not known if time curtailment occurs primarily for moderate intensity activities or for light activities or in both. We examine the cross-sectional association of knee pain with physical activity using data from 1874 Osteoarthritis Initiative participants.Knee pain characteristics (...) of constant and intermittent pain were each scored by the Intermittent and Constant Osteoarthritis Pain instrument and categorized into four pain levels (no pain, intermittent pain below and above median level, and constant pain). The relationships between knee pain levels and objectively measured physical activity (average weekly moderate or light intensity minutes) were assessed by quantile regression adjusted for socio-demographics and health factors.Knee pain levels had a strong negative relationship

2017 Seminars in arthritis and rheumatism

1003. Kinematics of meniscal- and ACL-transected mouse knees during controlled tibial compressive loading captured using roentgen stereophotogrammetry. Full Text available with Trip Pro

Kinematics of meniscal- and ACL-transected mouse knees during controlled tibial compressive loading captured using roentgen stereophotogrammetry. Pre-clinical studies of post-traumatic OA have examined the pathways that lead to disease after injury by using surgical models such as the destabilization of the medial meniscus (DMM) and anterior cruciate ligament transection (ACLT). While the morphological, molecular, and genetic pathways leading to OA have been examined extensively; the effects (...) subjected to either a DMM or ACLT in their right knee joints, while the left limbs remained as intact controls. All limbs were labeled with fiducial markers, and the rigid body kinematics of the tibia and femur were examined using roentgen stereophotogrammetry (RSA) with application of compressive loads from 0 to 9 N. DMM and intact joints demonstrated similar kinematics under compressive loading, in contrast to ACLT joints, which dislocated even before load application. These results demonstrate

2017 Journal of Orthopaedic Research

1004. Twelve-Year Follow-Up of Navigated Computer-Assisted Versus Conventional Total Knee Arthroplasty: A Prospective Randomized Comparative Trial. (Abstract)

Twelve-Year Follow-Up of Navigated Computer-Assisted Versus Conventional Total Knee Arthroplasty: A Prospective Randomized Comparative Trial. Navigated computer-assisted total knee arthroplasty (TKA) was introduced to expedite long-term survival based on improved postoperative implantation accuracy. However, long-term outcome data after 10 years or more are rare, even available meta-analyses show controversial study results.In a prospective randomized trial, 100 conventional TKAs (group CONV (...) ) were compared with 100 computer-assisted TKAs (group NAV) after a mean follow-up of 12 years postoperatively. A long-leg weight-bearing X-ray was performed for measuring mechanical axis of the limb, lateral distal femoral angle, and medial proximal tibial angle. Tibial slope, patella alpha angle, and radiolucent lines were also observed. Clinical investigation included evaluation of 4 different scores: Insall Knee Score, Western Ontario and MacMaster University Index score, Hospital for Special

2017 Journal of Arthroplasty Controlled trial quality: uncertain

1005. Knee Osteoarthritis Treatment With Adipose-derived Stem Cells: Phase II Clinical Trial

Knee Osteoarthritis Treatment With Adipose-derived Stem Cells: Phase II Clinical Trial Knee Osteoarthritis Treatment With Adipose-derived Stem Cells: Phase II Clinical Trial - 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. Knee Osteoarthritis Treatment With Adipose-derived Stem Cells: Phase II Clinical Trial 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. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03308006 Recruitment Status : Not yet recruiting First Posted

2017 Clinical Trials

1006. Preemptive Tapentadol on Post-operative Analgesia Following Total Knee Arthroplasty

Preemptive Tapentadol on Post-operative Analgesia Following Total Knee Arthroplasty Preemptive Tapentadol on Post-operative Analgesia Following Total Knee Arthroplasty - 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. Preemptive Tapentadol on Post-operative Analgesia Following Total Knee Arthroplasty 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. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT03351517 Recruitment Status : Completed First Posted : November 24, 2017 Last Update Posted : September 10, 2018 Sponsor: All India Institute of Medical

2017 Clinical Trials

1007. What is the Ideal Degree of Extension After Primary Total Knee Arthroplasty? (Abstract)

What is the Ideal Degree of Extension After Primary Total Knee Arthroplasty? Few studies have examined flexion contracture at the time of primary total knee arthroplasty (TKA) or how flexion contracture changes over time. The purpose of this study was to assess the ideal degree of extension immediately after TKA and to document postoperative changes in extension and clinical outcomes over 5-year follow-up.This retrospective cohort study included 215 cases of primary TKA. Radiographic (...) evaluations were performed on sagittal radiographs with the patient in the supine position and the knee in gravity and in passive extension using a stress device. Clinical outcomes were also measured. Four groups were defined on the basis of the extension angle during radiological evaluation: group 1, -10° to 0°; group 2, >0° to +5°; group 3, >+5° to +10°; group 4, >+10° in gravity.There were statistically significant differences in passive extension and gravity extension angles in groups 1, 3, and 4

2017 Journal of Arthroplasty

1008. Varus femoral and tibial coronal alignments result in different kinematics and kinetics after total knee arthroplasty. (Abstract)

. Femoral and tibial alignment in the coronal plane was each varied from neutral to 5° of varus in 1° increments. Lift-off, defined as an intercomponent distance of >2 mm, and tibiofemoral contact forces were evaluated during gait up to 60° of knee flexion. Knee kinematics and contact stresses were also examined during squat, with up to 130° of knee flexion.During gait, lift-off occurred readily with more than 3° of varus tibial alignment and slight lateral joint laxity. In contrast, lift-off did (...) Varus femoral and tibial coronal alignments result in different kinematics and kinetics after total knee arthroplasty. Abnormal knee motion under various conditions has been described after total knee arthroplasty (TKA). However, differences in kinematics and kinetics of knees with varus femoral versus varus tibial alignment have not been evaluated. It was hypothesized that varus femoral and tibial alignments have the same impact on knee motion.A musculoskeletal computer simulation was used

2017 Knee Surgery, Sports Traumatology, Arthroscopy

1009. High tibial osteotomy in knee laxities: Concepts review and results Full Text available with Trip Pro

High tibial osteotomy in knee laxities: Concepts review and results Patients with unstable, malaligned knees often present a challenging management scenario, and careful attention must be paid to the clinical history and examination to determine the priorities of treatment.Isolated knee instability treated with ligament reconstruction and isolated knee malalignment treated with periarticular osteotomy have both been well studied in the past. More recently, the effects of high tibial osteotomy (...) on knee instability have been studied.Lateral closing-wedge high tibial osteotomy tends to reduce the posterior tibial slope, which has a stabilising effect on anterior tibial instability that occurs with ACL deficiency.Medial opening-wedge high tibial osteotomy tends to increase the posterior tibia slope, which has a stabilising effect in posterior tibial instability that occurs with PCL deficiency.Overall results from recent studies indicate that there is a role for combined ligament reconstruction

2016 EFORT open reviews

1010. Simultaneous anterior cruciate ligament reconstruction and dome-shaped high tibial osteotomy for severe medial compartment osteoarthritis of the knee Full Text available with Trip Pro

and apprehension with walking and playing soccer. Her preoperative range of motion was from 0° of extension to 135° of flexion. The anterior drawer sign (1+), Lachman test (1+), and pivot shift test (glide) were positive before surgery, as measured by the International Knee Documentation Committee knee examination form. The patient underwent simultaneous arthroscopic ACL single-socket and single-bundle reconstruction using hamstring tendons, dome-shaped high tibial osteotomy using the TomoFix fixation device (...) Simultaneous anterior cruciate ligament reconstruction and dome-shaped high tibial osteotomy for severe medial compartment osteoarthritis of the knee The optimal surgical procedure to address both anterior cruciate ligament (ACL) deficiency and medial compartment osteoarthritis (OA) has been controversial.A 49-year-old woman with a 30-year history of chronic anterior cruciate ligament (ACL) deficiency, medial compartment osteoarthritis, and varus deformity presented with medial knee pain

2016 Asia-Pacific journal of sports medicine, arthroscopy, rehabilitation and technology

1011. Influence of Knee Immobilization on Chondrocyte Apoptosis and Histological Features of the Anterior Cruciate Ligament Insertion and Articular Cartilage in Rabbits Full Text available with Trip Pro

Influence of Knee Immobilization on Chondrocyte Apoptosis and Histological Features of the Anterior Cruciate Ligament Insertion and Articular Cartilage in Rabbits This study examined the influence of immobilization on chondrocyte apoptosis and histological features of the anterior cruciate ligament (ACL) insertion and knee articular cartilage in rabbits. Forty-eight male Japanese white rabbits were assigned to an immobilization (n = 24) or sham (n = 24) group. Rabbits in the immobilization (...) group underwent complete unilateral surgical knee immobilization and rabbits in the sham group underwent a sham surgery. The average thickness of the glycosaminoglycan (GAG) stained red area by safranin O staining, the chondrocyte apoptosis rate and the chondrocyte proliferation rate in the cartilage layer in the ACL insertion and the articular cartilage of the medial tibial condyle were measured at one, two, four and eight weeks in six animals from each group. In the ACL insertion, the chondrocyte

2017 International journal of molecular sciences

1012. Effect of pre-emptive analgesia by continuous femoral nerve block on early postoperative cognitive function following total knee arthroplasty in elderly patients Full Text available with Trip Pro

function following total knee arthroplasty (TKA) surgery in elderly patients. CFNB was performed prior to TKA surgery in the pre-emptive analgesia group (n=30) and following TKA surgery in the control group (n=30). POCD was defined as a two-point reduction in the postoperative score compared with the preoperative score in the mini-mental state examination. The visual analog scale (VAS) was used to evaluate the intensity of pain at rest and during exercise. The intraoperative dose of remifentanil (...) Effect of pre-emptive analgesia by continuous femoral nerve block on early postoperative cognitive function following total knee arthroplasty in elderly patients To the best of our knowledge, the effect of pre-emptively blocking pain transmission on acute postoperative cognitive dysfunction (POCD) has not yet been assessed. Therefore, the present study aimed to investigate the effect of pre-emptive analgesia via a continuous femoral nerve block (CFNB) on postoperative pain and early cognitive

2017 Experimental and therapeutic medicine Controlled trial quality: uncertain

1013. Cost savings of outpatient versus standard inpatient total knee arthroplasty Full Text available with Trip Pro

Cost savings of outpatient versus standard inpatient total knee arthroplasty With diminishing reimbursement rates and strained public payer budgets, a high-volume inpatient procedure, such as total knee arthroplasty (TKA), is a common target for improving cost efficiencies.This prospective case-control study compared the cost-minimization of same day discharge (SDD) versus inpatient TKA. We examined if and where cost savings can be realized and the magnitude of savings that can be achieved

2017 Canadian Journal of Surgery

1014. Medial knee joint contact force in the intact limb during walking in recently ambulatory service members with unilateral limb loss: a cross-sectional study Full Text available with Trip Pro

loading experienced in daily life, they support a "mechanical overloading" hypothesis for the risk of developing knee OA in the intact limb of limb loss subjects. Examination of the evolution of gait mechanics, joint loading, and joint health over time, as well as interventions to reduce load or strengthen the ability of the joint to withstand loads, is warranted. (...) Medial knee joint contact force in the intact limb during walking in recently ambulatory service members with unilateral limb loss: a cross-sectional study Individuals with unilateral lower limb amputation have a high risk of developing knee osteoarthritis (OA) in their intact limb as they age. This risk may be related to joint loading experienced earlier in life. We hypothesized that loading during walking would be greater in the intact limb of young US military service members with limb loss

2017 PeerJ

1015. The Anatomic Relationship of the Tibial Nerve to the Common Peroneal Nerve in the Popliteal Fossa: Implications for Selective Tibial Nerve Block in Total Knee Arthroplasty Full Text available with Trip Pro

, after the ultrasound-guided dye injection the dissection revealed proximal spread of dye within the paraneural sheath. Consequentially, in the clinical study twenty patients scheduled for total knee arthroplasty received the ultrasound-guided selective tibial nerve block at the popliteal crease, which also resulted in proximal spread of local anesthetic. A sensorimotor exam was performed to monitor the effect on the peroneal nerve. Results. In the cadaver study, dye was observed to spread proximal (...) The Anatomic Relationship of the Tibial Nerve to the Common Peroneal Nerve in the Popliteal Fossa: Implications for Selective Tibial Nerve Block in Total Knee Arthroplasty Background. A recently described selective tibial nerve block at the popliteal crease presents a viable alternative to sciatic nerve block for patients undergoing total knee arthroplasty. In this two-part investigation, we describe the effects of a tibial nerve block at the popliteal crease. Methods. In embalmed cadavers

2017 Pain research & management

1016. Impact of remote ischaemic preconditioning on cerebral oxygenation during total knee arthroplasty Full Text available with Trip Pro

Impact of remote ischaemic preconditioning on cerebral oxygenation during total knee arthroplasty Background: Ischaemic reperfusion injury (IRI) after tourniquet release during total knee arthroplasty (TKR) is related to postoperative cerebral complications. Remote ischaemic preconditioning (RIPC) is known to minimise IRI in previous studies. Thus, we evaluated the effect of RIPC on regional cerebral oxygenation after tourniquet release during TKR. Methods: Patients undergoing TKR were randomly (...) allocated to not receive RIPC (control group) and to receive RIPC (RIPC group). Regional cerebral oxygenation and pulmonary oxygenation were assessed up to 24 h postoperatively. The changes in serum cytokine and lactate dehydrogenase (LDH) levels were assessed and arterial blood gas analysis was performed. Total transfusion amounts and postoperative bleeding were also examined. Results: In total, 72 patients were included in the final analysis. Regional cerebral oxygenation (P < 0.001 in the left side

2017 International journal of medical sciences Controlled trial quality: uncertain

1017. Stress Fracture of the Lateral Femoral Condyle after Total Knee Arthroplasty Full Text available with Trip Pro

Stress Fracture of the Lateral Femoral Condyle after Total Knee Arthroplasty This is to assess one of the rare complications after total knee replacement and to assess risk factors of failure.11 patients with varus knee and an average age of 67 years underwent TKA between 2005 and 2013. All patients returned with a sudden sharp knee pain, disability to walk and significant decrease in ROM about 4 to 8 weeks after surgery. Radiographic examination revealed a lateral femoral condylar stress

2017 Archives of bone and joint surgery

1018. Is Home-Based, High-Intensity Interval Training Cycling Feasible and Safe for Patients With Knee Osteoarthritis?: Study Protocol for a Randomized Pilot Study Full Text available with Trip Pro

quality of life. While moderate-intensity continuous training (MICT) cycling is often recommended, little is known about the feasibility, safety, and benefits of high-intensity interval training (HIIT) cycling for this population, even though the feasibility, safety, and benefits of HIIT have been demonstrated in other chronic disease groups.The primary objective of this pilot study was to examine the feasibility and safety of home-based HIIT and MICT cycling in middle-aged and older adults with knee (...) Is Home-Based, High-Intensity Interval Training Cycling Feasible and Safe for Patients With Knee Osteoarthritis?: Study Protocol for a Randomized Pilot Study Osteoarthritis (OA) is a degenerative joint disease affecting the knee joint of many middle-aged and older adults. As OA symptoms typically involve knee pain and stiffness, individuals with knee OA are often insufficiently physically active, have low levels of physical function, and are at increased risk of other comorbidities and reduced

2017 Orthopaedic journal of sports medicine Controlled trial quality: uncertain

1019. Severity and distribution of cartilage damage and bone marrow edema in the patellofemoral and tibiofemoral joints in knee osteoarthritis determined by MRI Full Text available with Trip Pro

Severity and distribution of cartilage damage and bone marrow edema in the patellofemoral and tibiofemoral joints in knee osteoarthritis determined by MRI The aim of the present study was to analyze the distribution and severity of cartilage damage (CD) and bone marrow edema (BME) of the patellofemoral and tibiofemoral joints (PFJ and TFJ, respectively) in patients with knee osteoarthritis (OA), and to determine whether a correlation exists between BME and CD in knee OA, using magnetic (...) resonance imaging (MRI). Forty-five patients diagnosed with knee OA (KOA group) and 20 healthy individuals (control group) underwent sagittal multi-echo recalled gradient echo sequence scans, in addition to four conventional MR sequence scans. Knee joints were divided into 15 subregions by the whole-organ MRI scoring method. MRIs of each subregion were analyzed for the presence of CD, CD score and BME score. The knee joint activity functional score was determined using the Western Ontario and McMaster

2017 Experimental and therapeutic medicine

1020. Morning Self-Efficacy Predicts Physical Activity Throughout the Day in Knee Osteoarthritis Full Text available with Trip Pro

Morning Self-Efficacy Predicts Physical Activity Throughout the Day in Knee Osteoarthritis The purpose of this study was to examine the within-day and cross-day prospective effects of knee osteoarthritis (OA) patients' self-efficacy to engage in physical activity despite the pain on their subsequent physical activity assessed objectively in their natural environment.Over 22 days, 135 older adults with knee OA reported their morning self-efficacy for being physically active throughout the day

2017 Health psychology : official journal of the Division of Health Psychology, American Psychological Association

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