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Knee Exam

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13061. Optimal stimulation duration of tens in the management of osteoarthritic knee pain. (Abstract)

Optimal stimulation duration of tens in the management of osteoarthritic knee pain. This study examined the optimal stimulation duration of transcutaneous electrical nerve stimulation (TENS) for relieving osteoarthritic knee pain and the duration (as measured by half-life) of post-stimulation analgesia.Thirty-eight patients received either: (i) 20 minutes (TENS20); (ii) 40 minutes (TENS40); (iii) 60 minutes (TENS60) of TENS; or (iv) 60 minutes of placebo TENS (TENS(PL)) 5 days a week for 2 (...) for the TENS40 (256 minutes) and TENS60 (258 minutes) groups was more prolonged than in the other 2 groups (TENS20 = 168 minutes, TENS(PL) = 35 minutes) by Day10 (p < 0.000). However, the TENS40 group produced the longest pain relief period by the follow-up session.40 minutes is the optimal treatment duration of TENS, in terms of both the magnitude (VAS scores) of pain reduction and the duration of post-stimulation analgesia for knee osetoarthritis.

2003 Journal of rehabilitation medicine : official journal of the UEMS European Board of Physical and Rehabilitation Medicine Controlled trial quality: uncertain

13062. The effects of preoperative inflammation on the analgesic efficacy of intraarticular piroxicam for outpatient knee arthroscopy. (Abstract)

The effects of preoperative inflammation on the analgesic efficacy of intraarticular piroxicam for outpatient knee arthroscopy. We conducted a double-blinded study in 90 patients undergoing elective arthroscopic knee surgery to determine whether there is a role of inflammation in the analgesic efficacy of intraarticular piroxicam. Standardized general anesthetic techniques were used for all patients. At the end of the operation, after harvesting synovial biopsies, patients were randomized (...) into three intraarticular groups equally. Group 1 received 25 mL saline, Group 2 received 25 mL 0.25% bupivacaine, and Group 3 received 25 mL 0.25% bupivacaine and piroxicam 20 mg. After microscopic examination of the synovial materials, the patients were divided into two subgroups, inflammation positive (I+) and inflammation negative (I-). Preoperatively and postoperatively at 1, 2, 4, and 6 h, pain levels, analgesic duration, and postoperative analgesic consumption were recorded. Analgesic duration

2003 Anesthesia and analgesia Controlled trial quality: uncertain

13063. Physiotherapy, including quadriceps exercises and patellar taping, for knee osteoarthritis with predominant patello-femoral joint involvement: randomized controlled trial. (Abstract)

Physiotherapy, including quadriceps exercises and patellar taping, for knee osteoarthritis with predominant patello-femoral joint involvement: randomized controlled trial. To design and carry out a randomized controlled trial of a complex, physical therapy based intervention for patello-femoral joint (PFJ) osteoarthritis (OA) of the knee, examining medium to longterm outcomes.The participants, who had knee pain and predominant PFJ OA, were recruited from a large population based study (...) . The study design was a controlled trial using prerandomization and a blind observer, comparing the intervention package with standard nonphysiotherapy treatment. The physiotherapy intervention was delivered in local community health centers and clinics and comprised education, quadriceps and functional exercises, and patellar taping delivered by a single physiotherapist in nine 30-minute sessions over 10 weeks, with advice to continue thereafter. The outcome measures were pain in the worse knee by 100

2003 The Journal of rheumatology Controlled trial quality: predicted high

13064. [Reduced pain from osteoarthritis in hip joint or knee joint during treatment with calcium ascorbate. A randomized, placebo-controlled cross-over trial in general practice]. (Abstract)

[Reduced pain from osteoarthritis in hip joint or knee joint during treatment with calcium ascorbate. A randomized, placebo-controlled cross-over trial in general practice]. Although vitamin C is essential for the formation of collagen and proteoglycan and has been shown to minimise surgically induced arthritis in guinea pigs, no controlled trial has examined its effect on human osteoarthritis.The trial was a multicenter, double-blind, randomised, placebo-controlled, crossover-trial performed (...) by ten general practitioners. The Declaration of Helsinki and the European guidelines for good clinical practice were strictly followed. One hundred and thirty-three patients with radiographically verified symptomatic osteoarthritis of the hip joints and/or the knee joints were treated with one gram of calcium ascorbate or identically looking placebo tablets. The calcium ascorbate tablets and the placebo tablets should be swallowed daily for 14 +/- 3 days respectively, separated by 7 +/- 3 days wash

2003 Ugeskrift for laeger Controlled trial quality: predicted high

13065. The effect of exercise regimens on reflex response time of the vasti muscles in patients with anterior knee pain: a prospective randomized intervention study. (Abstract)

tonification exercises (group I) (n = 30), or only closed kinetic chain tonification exercises (group II) (n = 30). Assessment of an aspect of neuromotor control was obtained by measuring the reflex response times of VMO and VL at the time of initial clinical examination, at the end of the exercise period (five weeks), and three months after the completion of the exercise period. At these evaluation occasions, the intensity and the number of times that the patients experienced anterior knee pain during (...) The effect of exercise regimens on reflex response time of the vasti muscles in patients with anterior knee pain: a prospective randomized intervention study. The purpose of this prospective randomized intervention study was to evaluate the effect of two exercise protocols on reflex response time of vastus medialis obliquus (VMO), vastus lateralis (VL), in patients with anterior knee pain. Sixty patients were randomized into a 5-week treatment program, which consisted of only open kinetic chain

2003 Scandinavian journal of medicine & science in sports Controlled trial quality: uncertain

13066. Sensory stimulation (acupuncture) for the treatment of idiopathic anterior knee pain. (Abstract)

Sensory stimulation (acupuncture) for the treatment of idiopathic anterior knee pain. A randomized controlled study was conducted to evaluate the effect of acupuncture treatment in idiopathic anterior knee pain, a pain syndrome without known aetiology. Fifty-eight patients, clinically and radiologically examined, were randomly assigned to either deep or minimal superficial acupuncture treatment. The patients were treated twice weekly for a total of 15 treatments. The main outcome measurements (...) decreased after sensory stimulation, neither the ability to jump on one leg, the functional score nor the skin temperature changed. This study shows that patients with idiopathic anterior knee pain benefit from both electroacupuncture treatment and subcutaneous needling. The pain-relieving effect remains for at least 6 months. Central pain inhibition, caused by either afferent stimulation or by non-specific therapeutic (placebo) effects, is a plausible explanation behind the treatment effects.

2002 Journal of rehabilitation medicine : official journal of the UEMS European Board of Physical and Rehabilitation Medicine Controlled trial quality: uncertain

13067. Obese, older adults with knee osteoarthritis: weight loss, exercise, and quality of life. (Abstract)

Obese, older adults with knee osteoarthritis: weight loss, exercise, and quality of life. This study examined the effects of dietary weight loss and exercise on the health-related quality of life (HRQL) of overweight and obese, older adults with knee osteoarthritis. A total of 316 older men and women with documented evidence of knee osteoarthritis were randomly assigned to 1 of 4 18-month interventions: dietary weight loss, exercise, dietary weight loss and exercise, or healthy lifestyle

2002 Health psychology : official journal of the Division of Health Psychology, American Psychological Association Controlled trial quality: uncertain

13068. Electromyographic and biomechanic analysis of anterior cruciate ligament deficiency and functional knee bracing. (Abstract)

Electromyographic and biomechanic analysis of anterior cruciate ligament deficiency and functional knee bracing. Examine the neuromuscular response to functional knee bracing relative to anterior tibial translations in vivo.During randomised brace conditions, electromyographic data with simultaneous skeletal tibiofemoral kinematics were recorded from four anterior cruciate ligament deficient subjects to investigate the effect of the DonJoy Legend functional brace during activity.Knee braces do (...) not increase knee stability but may influence afferent inputs from proprioception and therefore one might expect changes in muscle firing patterns, amplitude and timing.Hoffman bone pins affixed with markers were implanted into the tibia and femur for kinematic measurement. The EMG data from the rectus femoris, semitendinosus, biceps femoris, and lateral head of the gastrocnemius were integrated for each subject in three separate time periods: 250 ms preceding footstrike and two consecutive 125 ms time

2003 Clinical biomechanics (Bristol, Avon) Controlled trial quality: uncertain

13069. Autologous chondrocyte implantation and osteochondral cylinder transplantation in cartilage repair of the knee joint. A prospective, comparative trial. (Abstract)

Autologous chondrocyte implantation and osteochondral cylinder transplantation in cartilage repair of the knee joint. A prospective, comparative trial. Current methods used to restore the joint surface in patients with localized articular cartilage defects include transplantation of an autologous osteochondral cylinder and implantation of autologous chondrocytes. The purpose of this study was to evaluate the clinical and histological outcomes of these two techniques.We performed a prospective (...) in all patients. The tissue consisted mainly of fibrocartilage, while localized areas of hyaline-like regenerative cartilage could be detected close to the subchondral bone. Although a gap remained at the site of the transplantation in all five biopsy specimens examined as long as two years after osteochondral cylinder transplantation, histomorphological analysis and scanning electron microscopy revealed no differences between the osteochondral transplants and the surrounding original cartilage.Both

2003 The Journal of Bone and Joint Surgery. American Volume Controlled trial quality: uncertain

13070. Patellar resurfacing in total knee arthroplasty. A prospective, randomized study. (Abstract)

patient-satisfaction score. The assessment was performed without the examiner knowing whether the patella had been resurfaced. At the time of follow-up, there were 474 knees. Thirty-five patients who had a bilateral knee replacement underwent resurfacing on one side only.The overall prevalence of anterior knee pain was 25.1% (fifty-eight of 231 knees) in the nonresurfacing group, compared with 5.3% (thirteen of 243 knees) in the resurfacing group (p < 0.0001). There was one case of component loosening (...) Patellar resurfacing in total knee arthroplasty. A prospective, randomized study. Anterior knee pain following total knee arthroplasty is a common complaint and typically is attributed to the patellofemoral joint. The purpose of the present study was to compare the outcome of resurfacing and nonresurfacing of the patella, particularly with regard to anterior knee pain, and to clarify the indications for patellar resurfacing at the time of total knee arthroplasty.We performed a prospective

2003 The Journal of Bone and Joint Surgery. American Volume Controlled trial quality: uncertain

13071. Peroral tramadol premedication increases postoperative nausea and delays home-readiness in day-case knee arthroscopy patients. (Abstract)

Peroral tramadol premedication increases postoperative nausea and delays home-readiness in day-case knee arthroscopy patients. To evaluate the effect of preoperative oral tramadol on postoperative pain and its effect on the patient's home-readiness after diagnostic day-case knee arthroscopy performed under spinal anaesthesia.We studied 156 outpatients in a prospective, randomized, double-blind fashion to examine the postoperative analgesic effect of preoperative oral slow-release tramadol (...) although the tramadol patients required less intravenous midazolam for sedation.Preoperatively given slow-release tramadol is ineffective for reduction of postoperative pain after day-case arthroscopy of the knee. Additionally, preoperative tramadol is associated with higher incidence of PONV and it seems to cause delay in the patient's home-readiness.

2002 Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society Controlled trial quality: uncertain

13072. The effectiveness of a pain wrap compared to a standard dressing on the reduction of postoperative morbidity following routine knee arthroscopy: a prospective randomized single-blind study. (Abstract)

The effectiveness of a pain wrap compared to a standard dressing on the reduction of postoperative morbidity following routine knee arthroscopy: a prospective randomized single-blind study. A pain wrap dressing in patients undergoing routine knee arthroscopy was evaluated to determine its ability to decrease postoperative pain and swelling. Bilateral knee examinations were performed pre- and postoperatively. Patients recorded narcotic usage and pain levels for 10 postoperative days. Twenty-four

2003 Orthopedics Controlled trial quality: uncertain

13073. X-ray technologists' reproducibility from automated measurements of the medial tibiofemoral joint space width in knee osteoarthritis for a multicenter, multinational clinical trial. (Abstract)

trial.Technologists from 12 NA and 12 EU clinical radiology units received identical training, at one site on each continent, in performing the fluoroscopically assisted semiflexed knee examination and in quality control criteria (QCC) for film acceptance. Subjects recruited were 129 in NA and 70 in EU, with both knees radiographed for some subjects. Each technologist radiographed 5 OA knees and repeated the process on the same knees 2 to 7 days later. Minimum medial JSW was measured at a single center (...) X-ray technologists' reproducibility from automated measurements of the medial tibiofemoral joint space width in knee osteoarthritis for a multicenter, multinational clinical trial. To determine the reproducibility of x-ray technologists, 26 in North America (NA), 24 in Europe (EU), in reliably repositioning patient's osteoarthritic (OA) knees, from computerized measurements of minimum joint space width (JSW) and reproducibility in joint repositioning, during their training for the clinical

2003 The Journal of rheumatology Controlled trial quality: uncertain

13074. [Prophylaxis for deep vein thrombosis with low molecular weight heparin following hip and knee surgery]. (Abstract)

[Prophylaxis for deep vein thrombosis with low molecular weight heparin following hip and knee surgery]. To evaluate the efficacy and safety of low molecular weight heparin(LMWH) in prophylaxis of postoperative deep vein thrombosis (DVT) following hip and knee surgery.From April 1997 to October 1998, 46 patients undergoing hip and knee orthopedic procedures were randomized into 2 groups for studying. The following eligibility criteria were applied: age over 40 years old, no recently history (...) of venous thromboembolism (over 3 months), normal result of preoperative hemostasis test and normal result of Doppler examination of the lower extremities. One group was control group and the other group received subcutaneously a low molecular weight heparin(Fraxiparine) with anti-factor X, activity of 41 IU/kg.day for three days, then 62 IU/kg.day from the 4th day to 10th day. All patients had venegraphy performed in the operated leg at 4 to 7 days after surgery.eight patients(34.8%) developed DVT

2001 Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery Controlled trial quality: uncertain

13075. Knee extensor torque and quadriceps femoris EMG during perceptually-guided isometric contractions. (Abstract)

Knee extensor torque and quadriceps femoris EMG during perceptually-guided isometric contractions. The aim of this study was to examine superficial quadriceps femoris (QF) EMG and torque at perceived voluntary contraction efforts. Thirty subjects (15 males, 15 females) performed 9, 5 s, sub-maximal contractions at prescribed levels of perceived voluntary effort at points 1-9 on an 11-point scale (0-10), in a random order. Surface electromyograms (EMG) of the vastus medialis (VM), vastus (...) values at contraction levels 6-9. The AT was found to be lower than the expected percent value at perceived effort levels 2-9. Torque C.V. was not found to be different across the range of perceived effort. The major findings of this study suggested that humans over-estimate voluntary QF muscle torque when guided by perceptual sensations. It is also suggested that the produced EMG signals revealed a reliance on the VL muscle for knee extensor torque generation at sub-maximal levels.

2003 Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology Controlled trial quality: uncertain

13076. Balance in single-limb stance in patients with anterior cruciate ligament injury: relation to knee laxity, proprioception, muscle strength, and subjective function. (Abstract)

strength on balance in single-limb stance and to study the correlation between balance in single-limb stance and subjective estimation of extremity function.Cross-sectional study; Level of evidence, 3.A total of 36 patients with a unilateral, nonoperated, nonacute anterior cruciate ligament injury were examined with regard to anterior knee laxity, proprioception, muscle strength, and stabilometry (amplitude and average speed of the center of pressure movements). Subjective estimation of extremity (...) Balance in single-limb stance in patients with anterior cruciate ligament injury: relation to knee laxity, proprioception, muscle strength, and subjective function. It has been shown previously that an anterior cruciate ligament injury may affect postural control, measured by balance in single-limb stance. To our knowledge, no studies have reported the influence of measures of impairment on postural control after such an injury.To assess the influence of knee laxity, proprioception, and muscle

2005 American Journal of Sports Medicine Controlled trial quality: uncertain

13077. No effect of eccentric training on jumper's knee in volleyball players during the competitive season: a randomized clinical trial. (Abstract)

No effect of eccentric training on jumper's knee in volleyball players during the competitive season: a randomized clinical trial. The effect of surgery on patellar tendinopathy (jumper's knee) is questionable, and conservative treatment protocols have not been properly documented.: The aim of this study was to investigate the effect of a newly developed eccentric training program for patellar tendinopathy in volleyball players during the competitive season.Randomized clinical trial.Patients (...) were recruited from male and female elite volleyball teams in Norway, and the diagnosis was based on clinical examination alone. Of 51 players diagnosed with patellar tendinopathy, 29 could be included in the study. The training group (n = 13) performed squats on a 25 degrees decline board as a home exercise program (3 x 15 repetitions twice daily) for a 12-week intervention period during the final half of the competitive season. The eccentric (downward) component was done on the affected leg

2005 Clinical Journal of Sport Medicine Controlled trial quality: uncertain

13078. Radiological changes five years after unicompartmental knee replacement. (Abstract)

Radiological changes five years after unicompartmental knee replacement. Failure of a unicompartmental knee replacement (UKR) may be caused by progressive osteoarthritis of the knee and/or failure of the prosthesis. Limb alignment can influence both of these factors. We have examined the fate of the other compartments and measured changes in leg alignment after UKR. A total of 50 UKRs was carried out on 45 carefully selected patients between 1989 and 1992. At operation, deliberate attempts were (...) made to avoid overcorrection of the deformity. Four patients died, one patient was lost to follow-up and two knees were revised before review which was at a minimum of five years. Standard long-leg weight-bearing anteroposterior views of the knee and skyline views of the patellofemoral joint were taken before and at eight months and five years after operation. The radiographs of the remaining 43 knees were reviewed twice by blind and randomised assessment to measure the progression

2000 The Journal of Bone and Joint Surgery British Volume Controlled trial quality: uncertain

13079. Does metal backing improve fixation of tibial component in unicondylar knee arthroplasty? A randomized radiostereometric analysis. (Abstract)

component fixation. A total of 45 knees (42 patients; 23 metal-backed components and 22 all-polyethylene components) were examined. We used radiostereometric analysis to measure micromotion of the tibial component over a period of 2 years after surgery. Hospital for Special Surgery score was used for clinical evaluation. We found no statistically significant differences in clinical results or migration of the tibial component over a 2-year follow-up period. These findings do not support better fixation (...) Does metal backing improve fixation of tibial component in unicondylar knee arthroplasty? A randomized radiostereometric analysis. In a prospective, randomized study, patients with medial gonarthrosis stage I to III according to Ahlbäck were allocated to a unicondylar knee arthroplasty (Miller-Galante, Zimmer, Inc., Warsaw, IN) with an all-polyethylene tibial component or metal-backed tibial component of the same design. The purpose of the study was to evaluate if metal backing enhanced tibial

2001 Journal of Arthroplasty Controlled trial quality: uncertain

13080. Exercise combined with continuous passive motion or slider board therapy compared with exercise only: a randomized controlled trial of patients following total knee arthroplasty. (Abstract)

alone-achieved the maximum degree of knee ROM in the fIrst 6 months following primary total knee arthroplasty (TKA). The secondary purpose was to compare health-related quality of life among these 3 groups.The subjects were 120 patients (n=40/group) who received a TEA at a teaching hospital between June 1997 and July 1998 and who agreed to participate in the study.Subjects were examined preoperatively, at discharge, and at 3 and 6 months after surgery. The examination consisted of measurement (...) Exercise combined with continuous passive motion or slider board therapy compared with exercise only: a randomized controlled trial of patients following total knee arthroplasty. The primary purpose of this randomized controlled trial was to determine which method of mobilization - (1) standardized exercises (SE) and continuous passive motion (CPM), (2) SE and slider board (SB) therapy, using an inexpensive, nontechnical device that requires minimal knee active range of motion (ROM), or (3) SE

2001 Physical therapy Controlled trial quality: uncertain

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