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Knee Exam

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13041. Measurement of synovial lining volume by magnetic resonance imaging of the knee in chronic synovitis Full Text available with Trip Pro

Measurement of synovial lining volume by magnetic resonance imaging of the knee in chronic synovitis Current methods of monitoring chronic synovitis in a single joint rely on clinical examination derived indices, such as the detection of synovial thickening. This study aimed to develop a reproducible method for quantifying the volume of synovial lining in chronic synovitis using contrast enhanced magnetic resonance (MR) imaging.The knees of 18 patients with chronic synovitis were examined (34 (...) studies). A 2D T1 weighted FLASH sequence was used to evaluate the temporal enhancement of synovial structures after intravenous contrast. Synovial lining volume was calculated from subtraction of pre and post-enhancement 3D T1 weighted MP RAGE images with thresholding and pixel counting. Eleven patients were examined before and after intra-articular glucocorticoid (mean interval 14 weeks) and MR data compared with changes in clinical examination derived indices of disease activity.Synovial lining

1997 Annals of the Rheumatic Diseases

13042. Provider volume and other predictors of outcome after total knee arthroplasty: a population study in Ontario Full Text available with Trip Pro

Provider volume and other predictors of outcome after total knee arthroplasty: a population study in Ontario Because of rationing of the limited pool of health care resources, access to total knee arthroplasty (TKA) is limited, but investigation of variables that predict complications, length of hospital stay, cost and outcomes of TKA may allow us to optimize the available resources. The objective of this study was to examine the effect of various factors on complication rates after TKA

2003 Canadian Journal of Surgery

13043. Synovial fluid chondroitin and keratan sulphate epitopes, glycosaminoglycans, and hyaluronan in arthritic and normal knees Full Text available with Trip Pro

), nodal generalised OA (NGOA), and OA with calcium pyrophosphate crystal deposition (CPA). Clinical assessment of inflammation (0-6) was undertaken on OA and RA knees. Knee SF was examined by enzyme linked immunosorbent assay for: CS epitopes, using monoclonal antibodies 3-B-3 and 7-D-4; KS epitope using monoclonal antibody 5-D-4; and HA, using biotinylated HA binding region of cartilage proteoglycan. Total sulphated GAGs were measured by dye binding with 1:9 dimethylmethylene blue.Increased SF 3-B-3 (...) Synovial fluid chondroitin and keratan sulphate epitopes, glycosaminoglycans, and hyaluronan in arthritic and normal knees To determine concentrations of chondroitin sulphate (CS) and keratan sulphate (KS) epitopes, glycosaminoglycans (GAGs) and hyaluronan (HA) in knee synovial fluid (SF) from normal subjects and patients with osteoarthritis (OA) or rheumatoid arthritis (RA), to test whether these variables may be used as markers of the OA process.OA was subdivided into large joint OA (LJOA

1997 Annals of the Rheumatic Diseases

13044. The clinical effect of naproxen sodium after arthroscopy of the knee: a randomized, double-blind, prospective study. (Abstract)

The clinical effect of naproxen sodium after arthroscopy of the knee: a randomized, double-blind, prospective study. The aim of this study was to examine the clinical effect of naproxen sodium after knee arthroscopy. The design was randomized, prospective, and double-blind, with a placebo control group. Patients with preoperative synovial reaction were excluded. One hundred twenty consecutive arthroscopies were performed in 77 men and 43 women, median age 34 (range 18-65) years. General (...) anesthesia was used. Ninety-one arthroscopies were operative, whereas 29 were diagnostic. Postoperatively the patients received either 550 mg naproxen sodium twice daily or placebo for 10 days. Patients were given 500 mg acetaminophen to use if needed. Clinical examinations were performed 10 and 20 days postoperation. The results were analyzed using the Mann-Whitney test and chi 2 test. No operative complications were registered. All but two patients completed the study. Six patients had slight

1993 Arthroscopy Controlled trial quality: uncertain

13045. [What suction drainage is optimal for drainage of wound secretion? A clinico-experimental study exemplified by the knee joint]. (Abstract)

[What suction drainage is optimal for drainage of wound secretion? A clinico-experimental study exemplified by the knee joint]. In a randomized clinical study on 40 intraarticular knee joint drainages the effect of a high vacuum, middle vacuum, low vacuum and suction free drainages were examined. The maximum of the volume that was drained had been in the group of the suction free drainages. Drains with a long period of suction had a minimum of evaluated ultrasonographic effusion in the knee

1992 Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen Controlled trial quality: uncertain

13046. Intra-articular sodium hyaluronate in osteoarthritis of the knee: a multicenter, double-blind study. (Abstract)

Intra-articular sodium hyaluronate in osteoarthritis of the knee: a multicenter, double-blind study. The efficacy and the safety of intra-articular injections of sodium hyaluronate were studied in patients with osteoarthritis of the knee in a randomized multicenter double-blind study. Two hundred and nine patients received five injections of either 25 mg hyaluronate/2.5 ml (verum, N = 102) or 0.25 mg hyaluronate/2.5 ml (control, N = 107) at weekly intervals. Seven patients in each group were (...) excluded from the protocol-correct efficacy analysis. The Lequesne Index, the first main criterion, showed a significant superiority of the verum-treated patients after the third injection up to the final follow-up examination 9 weeks after the last injection (MANOVA, P < 0.025). The consumption of paracetamol was defined as a complementary main criterion that did not reveal significant differences between the treatment groups. Most of the individual secondary endpoints demonstrated a much better

1993 Osteoarthritis and cartilage / OARS, Osteoarthritis Research Society Controlled trial quality: uncertain

13047. Scintimetry after total knee arthroplasty. Prospective 2-year study of 18 cases of arthrosis and 15 cases of rheumatoid arthritis. (Abstract)

Scintimetry after total knee arthroplasty. Prospective 2-year study of 18 cases of arthrosis and 15 cases of rheumatoid arthritis. 33 consecutive patients (18 arthrosis, 15 rheumatoid arthritis), operated on with total knee arthroplasty and randomized to cemented (18 knees) or cementless fixation (15 knees), were investigated with scintimetry 3, 6, 12, and 24 months postoperatively. Migration was evaluated with simultaneous roentgen stereophotogrammetric (RSA) examinations. The scintimetric (...) activity in the ipsilateral femoral diaphysis decreased and the activity in the tibial diaphysis increased during the observation period. Constant and low activity was recorded in front of the femoral component. This region was chosen as a reference. Three months after surgery, high activity was noted under the tibial component in knees with a preoperative varus deformity. After 2 years, the activity had decreased to the same level as in the patients with a valgus deformity. Diagnosis and mode

1992 Acta Orthopaedica Scandinavica Controlled trial quality: uncertain

13048. Obtaining reliable measurements of knee extensor torque produced during maximal voluntary contractions: an experimental investigation. (Abstract)

isokinetic contractions at velocities of 30 degrees, 90 degrees, 120 degrees, and 180 degrees/s; eccentric isokinetic contractions at velocities of 30 degrees, 90 degrees, 120 degrees, and 180 degrees/s; and isometric contractions at 40 and 60 degrees of knee flexion. The peak torques produced were examined to determine on which day and during which contraction subjects produced the greatest torques for each condition. This information was used to develop a practice protocol. Fifteen different subjects (...) Obtaining reliable measurements of knee extensor torque produced during maximal voluntary contractions: an experimental investigation. The purpose of this study was to develop and test a protocol that could be used to obtain reliable measurements of knee extensor torque produced during maximal voluntary contractions. On each of 3 days, 10 subjects performed six consecutive maximal voluntary contractions, in the same randomized order, for each of the following 10 conditions: concentric

1992 Physical therapy Controlled trial quality: uncertain

13049. Specific adaptations of neuromuscular control and knee joint stiffness following sensorimotor training. (Abstract)

Specific adaptations of neuromuscular control and knee joint stiffness following sensorimotor training. The aim of this study was to examine how fixations of the ankle joint during sensorimotor training (SMT) influence adaptations in mechanical stiffness and neuromuscular control of the knee joint. Sixty-three healthy subjects were randomly assigned to three training groups that differed in their degree of ankle joint fixation, which was either barefooted, with an ankle brace or with a ski boot (...) . Mechanical knee joint stiffness and reflex control of m. vastus medialis, m. vastus lateralis, m. biceps femoris, and m. semitendinosus were tested during force controlled anterior tibial displacements. This force was applied as both a fast and a slow stimulus. After the training period the group that trained barefooted showed an increase in mechanical stiffness of the knee joint from 79 +/- 21 (Mean +/- SD) N/mm to 110 +/- 38 N/mm (p < 0.05) in the fast stimulus. The training group that trained with ski

2006 International Journal of Sports Medicine Controlled trial quality: uncertain

13050. Time dependence of iopamidol and iodixanol in arthrography of the knee. (Abstract)

Time dependence of iopamidol and iodixanol in arthrography of the knee. The safety and diagnostic efficacy of iodixanol (Visipaque) 270 mg I/ml was compared to that of iopamidol (Iopamiron) 300 mg I/ml in knee arthrography.This trial was a bi-center double-blind trial including 128 patients (iodixanol/iopamidol 64/64 patients). Efficacy was evaluated by blinded grading of the diagnostic quality of the p.a. images taken 0, 12 and 25 min after contrast administration by the examining radiologist (...) and later at a consensus evaluation by two experienced skeletal radiologists. Adverse events were recorded.No patient experienced any adverse event. The proportion of better images at both 12 and 25 min after injection was higher in the iodixanol group compared to the iopamidol group both by the examining radiologist and at the consensus evaluation.In the knee joint iodixanol is a safe contrast medium. The contrast effect of iodixanol lasted longer than that of iopamidol, which can be important when

1999 Acta radiologica (Stockholm, Sweden : 1987) Controlled trial quality: uncertain

13051. Intra-articular morphine and/or bupivacaine after total knee replacement. (Abstract)

Intra-articular morphine and/or bupivacaine after total knee replacement. The postoperative analgesic effects of intra-articular injections of bupivacaine and/or morphine were examined prospectively in 437 patients who had total knee replacement for osteoarthritis. They were divided randomly into four groups. Group I received 10 mg of morphine (1 ml) and 9 ml of saline, group II received 10 ml of bupivacaine (2.5 mg/ml), group III received 10 ml of saline, and group IV received 10 mg

1999 The Journal of Bone and Joint Surgery British Volume Controlled trial quality: uncertain

13052. Hyaluronic acid in the treatment of osteoarthritis of the knee. (Abstract)

Hyaluronic acid in the treatment of osteoarthritis of the knee. We examined the efficacy, safety and patient satisfaction of intra-articular hyaluronic acid (HA) in patients with osteoarthritis of the knee.One hundred patients with mild to moderate osteoarthritis of the knee entered a randomized blind-observer trial of 6 months HA vs placebo. Primary efficacy criteria were pain on walking, measured with a visual analogue scale, and the Lequesne Index.For pain on walking, a significant (...) of the knee with a symptomatic benefit which persisted for 6 months.

1999 Rheumatology (Oxford, England) Controlled trial quality: uncertain

13053. Effect of glucosamine hydrochloride in the treatment of pain of osteoarthritis of the knee. (Abstract)

Effect of glucosamine hydrochloride in the treatment of pain of osteoarthritis of the knee. Glucosamine products have been used extensively for the management of pain in osteoarthritis (OA). We investigated the efficacy of the hydrochloride salt of glucosamine on pain and disability in knee OA.At Week -2, subjects were examined, randomized, and instructed to take only prescribed acetaminophen for pain. At Week 0 patients were examined, prescribed acetaminophen, and either placebo or glucosamine (...) significant difference in WOMAC pain score between Week 0 and Week 8) was not met. However, positive trends were noted for the glucosamine group in 23 of 24 WOMAC questions. A significant difference was noted from Week 5 through Week 8 in the knee examination (p = 0.026) and in the response to a daily diary pain question (p = 0.018). However, responding to the question, "Are you better than at the start of the trial?", 40% of placebo and only 49% of glucosamine subjects answered in the affirmative (p

1999 The Journal of rheumatology Controlled trial quality: uncertain

13054. Use of tranexamic acid for an effective blood conservation strategy after total knee arthroplasty. (Abstract)

Use of tranexamic acid for an effective blood conservation strategy after total knee arthroplasty. We have investigated the effect of treatment with tranexamic acid, an inhibitor of fibrinolysis, on blood loss, blood transfusion requirements and blood coagulation in a randomized, double-blind, placebo-controlled study of 42 patients after total knee arthroplasty. Tranexamic acid 15 mg kg-1 (n = 21) or an equivalent volume of normal saline (n = 21) was given 30 min before surgery (...) and subsequently every 8 h for 3 days. Coagulation and fibrinolysis values, blood loss and blood units administered were measured before administration of tranexamic acid, 8 h after the end of surgery and at 24 and 72 h after operation. Coagulation profile was examined (bleeding time, platelet count, prothrombin time (PT), activated partial thromboplastin time (aPTT), plasminogen, beta-thromboglobulin and fibrinogen). Fibrinolysis was evaluated by measurement of concentrations of D-dimer and fibrinogen

1999 British Journal of Anaesthesia Controlled trial quality: uncertain

13055. Glucosamine, chondroitin, and manganese ascorbate for degenerative joint disease of the knee or low back: a randomized, double-blind, placebo-controlled pilot study. (Abstract)

community with chronic pain and radiographic DJD of the knee or low back were randomized. A summary disease score incorporated results of pain and functional questionnaires, physical examination scores, and running times. Changes were presented as a percentage of the patient's average score.Knee osteoarthritis symptoms were relieved as demonstrated by the summary disease score (-16.3%; p = 0.05), patient assessment of treatment effect (p = 0.02), visual analog scale for pain recorded at clinic visits (...) (-26.6%; p = 0.05) and in a diary (-28.6%; p = 0.02), and physical examination score (-43.3%; p = 0.01). Running times did not change. The study neither demonstrated, nor excluded, a benefit for spinal DJD. Side effect frequency was similar to that at baseline. There were no hematologic effects.The combination therapy relieves symptoms of knee osteoarthritis. A larger data set is needed to determine the value of this therapy for spinal DJD. Short-term combination therapy appears safe in this setting.

1999 Military medicine Controlled trial quality: uncertain

13056. Preoperative education for total hip and knee replacement patients. (Abstract)

Preoperative education for total hip and knee replacement patients. Psychoeducational preparation is known to improve postoperative outcome. We tested two common psychoeducational procedures in elderly orthopedic patients, examining how best to match interventions to patients by psychological type.Two hundred twenty-two elderly patients undergoing total hip or knee replacement were randomly assigned to 1) a slide-tape with information on the postoperative, in-hospital rehabilitation experience (...) , or 2) training in Benson's Relaxation Response with a bedside audiotape, in a 2 x 2 factorial design.The relaxation response did not influence postoperative outcomes. The educational intervention reduced length of stay and pain medication use for patients who exhibited most denial (tendency to avoid thinking about unpleasant events), and reduced postoperative anxiety and cognitive errors on the Mini-Mental State Exam for patients with most baseline anxiety. There was no effect on postoperative

1998 Arthritis care and research : the official journal of the Arthritis Health Professions Association Controlled trial quality: uncertain

13057. Intra-articular primatised anti-CD4: efficacy in resistant rheumatoid knees. A study of combined arthroscopy, magnetic resonance imaging, and histology. Full Text available with Trip Pro

, examining its mode of action using a combined imaging approach of arthroscopy, magnetic resonance imaging (MRI), and histology.Thirteen RA patients with active, resistant knee synovitis, were randomised to intra-articular injection of placebo (n=3), 0.4 mg (n=3) or 40 mg (n=7) of anti-CD4 after sequential dynamic gadolinium enhanced MRI, followed by same day arthroscopy and synovial membrane biopsy. Imaging and arthroscopic synovial membrane sampling were repeated at six weeks. This study used a unique (...) Intra-articular primatised anti-CD4: efficacy in resistant rheumatoid knees. A study of combined arthroscopy, magnetic resonance imaging, and histology. CD4+ T cells sustain the chronic synovial inflammatory response in rheumatoid arthritis (RA). SB-210396/CE 9.1 is an anti-CD4 monoclonal antibody that has documented efficacy in RA when given intravenously. This study aimed to establish the safety and efficacy of the intra-articular administration of SB-210396/CE 9.1 compared with placebo

1999 Annals of the rheumatic diseases Controlled trial quality: uncertain

13058. Effects of perioperative analgesic technique on the surgical outcome and duration of rehabilitation after major knee surgery. (Abstract)

postoperative maximal amplitude of knee flexion was measured during continuous passive motion at 24 h and 48 h and compared with the target levels prescribed by the surgeon. To evaluate functional outcome, the maximal amplitudes were measured again on postoperative day 5, at hospital discharge (day 7), and at 1- and 3-month follow-up examinations. When the patients left the surgical ward, they were admitted to a rehabilitation center, where their length of stay depended on prospectively determined discharge (...) Effects of perioperative analgesic technique on the surgical outcome and duration of rehabilitation after major knee surgery. Continuous passive motion after major knee surgery optimizes the functional prognosis but causes severe pain. The authors tested the hypothesis that postoperative analgesic techniques influence surgical outcome and the duration of convalescence.Before standardized general anesthesia, 56 adult scheduled for major knee surgery were randomly assigned to one of three groups

1999 Anesthesiology Controlled trial quality: uncertain

13059. Knee flexor torque and perceived exertion: a gender and reliability analysis. (Abstract)

Knee flexor torque and perceived exertion: a gender and reliability analysis. The objectives of the present study were to examine gender differences and between-day variability of isometric hamstring muscle peak torque and perceived exertion.Subjects included 20 healthy, college-aged male (N = 10) and female (N = 10) volunteers. Each subject completed five maximal voluntary isometric hamstring muscle contractions (MVC), in a prone position, with their knee at 30 degrees flexion. Subjects (...) then completed, in random order, isometric contractions at 10, 20, 30, 40, 50, 60, 70, 80, and 90% of their three highest averaged MVC. Perceived exertion was measured with a modified Borg CR-10 scale after each contraction. Ten randomly chosen subjects were asked to return approximately 1 wk after the initial evaluation to repeat the same procedure. Peak hamstring muscle torque was examined in absolute (N.m), relative (N.m.kg-1), and allometric-scaled (N.m.kg-n) units. Perceived exertion across

2003 Medicine and science in sports and exercise Controlled trial quality: uncertain

13060. Perceived exertion and maximal quadriceps femoris muscle strength during dynamic knee extension exercise in young adult males and females. (Abstract)

Perceived exertion and maximal quadriceps femoris muscle strength during dynamic knee extension exercise in young adult males and females. The objectives of the present study were to: (1) examine perceived exertion across different target voluntary-contraction intensities; (2) compare perceived exertion ratings with actual target intensities, and (3) compare perceived exertion ratings between males and females. Subjects for this study included 30 healthy, college-aged male (n=15) and female (n (...) =15) volunteers. All subjects were free of orthopedic, cardiopulmonary, systemic and neurological disease. Subjects were evaluated for their one-repetition maximum (1-RM) during inertial knee extension exercise. All subjects then completed, in a random order, two sub-maximal inertial contractions at 20%, 30%, 40%, 50%, 60%, 70%, 80%, and 90% of their 1-RM. Perceived exertion was measured by asking subjects to provide a number that corresponded to the feelings in their quadriceps after completion

2003 European journal of applied physiology Controlled trial quality: uncertain

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