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Knee Exam

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13081. MRI of the knee: value of short echo time fast spin-echo using high performance gradients versus conventional spin-echo imaging for the detection of meniscal tears. (Abstract)

, second-echo FSE sequence obtained using high-performance gradients and a CSE sequence with similar TR/TE for the detection of meniscal tears in the knee.One hundred consecutive MR examinations of the knee using FSE and CSE sequences at 1.5 T were evaluated. The FSE sequence used an effective TE of 20 ms (centered on the second echo at 2 times minimal interecho spacing) and an echo train length of 4. FSE and CSE parameters were otherwise similar. Four independent, masked readers reviewed randomized (...) MRI of the knee: value of short echo time fast spin-echo using high performance gradients versus conventional spin-echo imaging for the detection of meniscal tears. Fast spin-echo (FSE) sequences reduce imaging time compared with conventional spin-echo (CSE) sequences, but may result in blurring. High-performance gradients permit shorter interecho spacing and use of the second echo as the effective TE (20 ms); both improvements reduce blurring. This randomized observer study compared a short TE

2000 Skeletal radiology Controlled trial quality: uncertain

13082. Regional hemostatic status and blood requirements after total knee arthroplasty with and without tranexamic acid or aprotinin. (Abstract)

Regional hemostatic status and blood requirements after total knee arthroplasty with and without tranexamic acid or aprotinin. Antifibrinolytics seem to reduce postoperative blood loss after total knee arthroplasty. Few studies have shown the impact of these drugs on the mechanisms of coagulation. The purpose of this study was to examine coagulation/fibrinolysis variables as well as blood loss after total knee arthroplasty with and without antifibrinolytics in the operated limb on a regional (...) level. Thirty-six patients were randomized into one of three groups to receive aprotinin, tranexamic acid, or no medication. We took blood samples of the femoral vein before deflating the tourniquet and after 5, 10, 30, 60, 120 min and on the first postoperative day. The implantation of a knee prosthesis in artificial ischemia caused a significant activation of coagulation and fibrinolysis in the regional circulation. Tranexamic acid and aprotinin did not cause a significant modulation

2001 Anesthesia and analgesia Controlled trial quality: uncertain

13083. Efficacy and safety of eltenac gel in the treatment of knee osteoarthritis. Full Text available with Trip Pro

in the week preceding the examinatio ns, evaluated on a visual analog scale (VAS). Secondary criteria were Lequesne's score ISK, Jezek score, muscle strength and dolorimeter measurements, walking time, clinical examination results of the knee joint and patient's and investigator's overall efficacy estimates.The graphical depiction of VAS and ISK suggested a dose-related efficacy, but the pre-planned statistical analysis did not show significant differences between treatments. In the patient subgroup (...) with a higher degree of baseline severity of knee OA the ISK showed significant and relevant advantages of eltenac gel 1% to placebo at different examination times. Two patients each of the eltenac gel 1% group and the placebo group showed local intolerance reactions which subsided spontaneously.This study did not provide confirmatory proof of an efficacy of topical eltenac in patients with knee OA. Methodological pitfalls and possible responder subgroups are described. Despite the difficulties, dose

2001 Osteoarthritis and cartilage / OARS, Osteoarthritis Research Society Controlled trial quality: predicted high

13084. The effect of estrogen plus progestin on knee symptoms and related disability in postmenopausal women: The Heart and Estrogen/Progestin Replacement Study, a randomized, double-blind, placebo-controlled trial. (Abstract)

published regarding the relationship of hormone treatment to knee or hip symptoms. This study examined the association of hormone treatment with prevalent knee symptoms and disability related to knee pain as assessed at the final visit of the Heart and Estrogen/Progestin Replacement Study (HERS).The HERS was a 4-year randomized, double-blind, placebo-controlled trial of estrogen plus medroxy progesterone acetate for prevention of coronary heart disease in postmenopausal women with documented coronary (...) The effect of estrogen plus progestin on knee symptoms and related disability in postmenopausal women: The Heart and Estrogen/Progestin Replacement Study, a randomized, double-blind, placebo-controlled trial. Most observational studies suggest that postmenopausal women taking hormone replacement therapy have a reduced risk of radiographic knee and hip osteoarthritis (OA). There are no randomized trial data on the association of hormone treatment with knee or hip OA, and no studies have been

2001 Arthritis and rheumatism Controlled trial quality: predicted high

13085. Synovial fluid chondroitin sulphate epitopes 3B3 and 7D4, and glycosaminoglycan in human knee osteoarthritis after exercise. Full Text available with Trip Pro

Synovial fluid chondroitin sulphate epitopes 3B3 and 7D4, and glycosaminoglycan in human knee osteoarthritis after exercise. Walking exercise alleviates some symptoms, such as pain, in patients with mild to moderate knee osteoarthritis (OA). However, a major concern is that weightbearing exercise on osteoarthritic joints may exacerbate articular cartilage degradation. Loading of proteoglycan depleted articular cartilage in vitro increased expression of the chondroitin sulphate epitope 3B3 (...) , suggesting that loading may influence metabolism of osteoarthritic cartilage. This study aimed at evaluating the effects of walking exercise on articular cartilage metabolism in patients with knee OA, as reflected by changes in concentrations of synovial fluid markers.Thirty elderly patients with knee OA (Kellgren-Lawrence grades II to IV) were randomly allocated to control (n = 15) and 12 week exercise (n = 15) groups. Synovial fluid obtained from 21 of the patients at time zero and after 12 weeks

2000 Annals of the rheumatic diseases Controlled trial quality: uncertain

13086. Morphological analysis of knee synovial membrane biopsies from a randomized controlled clinical study comparing the effects of sodium hyaluronate (Hyalgan) and methylprednisolone acetate (Depomedrol) in osteoarthritis. (Abstract)

acetate (Depomedrol) (MP).Synovial membranes from patients with OA of the knee, primary or secondary to a traumatic event and classified according to the American College of Rheumatology criteria, were examined by arthroscopy and by light and electron microscopy before and 6 months after local injection of HY (2 ml of 500-730 000 MW hyaluronan, 10 mg/ml in saline, one injection per week for 5 weeks) or MP (1 ml of methylprednisolone acetate, 40 mg/ml, one injection per week for 3 weeks).Arthroscopy (...) Morphological analysis of knee synovial membrane biopsies from a randomized controlled clinical study comparing the effects of sodium hyaluronate (Hyalgan) and methylprednisolone acetate (Depomedrol) in osteoarthritis. The study was part of a randomized open-label clinical trial designed to evaluate the effects of intra-articular injections of hyaluronan (Hyalgan) (HY) in osteoarthritis (OA) of the human knee. Data were compared with those obtained after treatment with methylprednisolone

2001 Rheumatology (Oxford, England) Controlled trial quality: uncertain

13087. Is a knee brace advantageous after anterior cruciate ligament surgery? A prospective, randomised study with a two-year follow-up. (Abstract)

of a brace. Pre-operatively, the groups were comparable in terms of age, sex, activity level, knee laxity and muscle strength. The follow-up examination was performed by one independent observer. All the patients were followed up for a minimum of two years. At the follow-up, there were no significant differences between the study groups in terms of the Tegner activity level, Lysholm score, IKDC evaluation system, one-leg-hop quotient, KT-1000 measurements and isokinetic torque. Using the visual analogue (...) Is a knee brace advantageous after anterior cruciate ligament surgery? A prospective, randomised study with a two-year follow-up. The aim of this study was to evaluate the use of a knee brace after arthroscopic anterior cruciate ligament reconstruction using central third patellar tendon autografts. Fifty patients were randomly allocated to two groups. The patients in Group A wore a brace for three weeks postoperatively, while the patients in Group B were rehabilitated without the use

2001 Scandinavian journal of medicine & science in sports Controlled trial quality: uncertain

13088. Comparison of three catheter sets for continuous spinal anesthesia in patients undergoing total hip or knee arthroplasty. (Abstract)

Comparison of three catheter sets for continuous spinal anesthesia in patients undergoing total hip or knee arthroplasty. Continuous spinal anesthesia (CSA) with microcatheters may be complicated because of technical problems. In elderly patients, some of the problems may be solved by using thicker catheters. A recent invention, involving a catheter-over-needle system, may prevent leakage of cerebrospinal fluid (CSF) and may also improve the prediction of the intrathecal position (...) of the catheter tip.This study included 90 patients undergoing primary hip or knee replacement, randomly allocated into 3 groups, with 30 patients in each group: Group EC, a 24-gauge epidural catheter through a 19-gauge Tuohy needle; group MC, a 28-gauge microcatheter through a 22-gauge spinal needle; group SC, a 22-gauge spinal catheter over a 27-gauge spinal needle through an epidurally placed 18-gauge Crawford needle. All subarachnoid catheterizations were performed with the patient in the lateral position

2001 Regional Anesthesia and Pain Medicine Controlled trial quality: uncertain

13089. Why don't patients do their exercises? Understanding non-compliance with physiotherapy in patients with osteoarthritis of the knee. Full Text available with Trip Pro

Why don't patients do their exercises? Understanding non-compliance with physiotherapy in patients with osteoarthritis of the knee. To understand reasons for compliance and non-compliance with a home based exercise regimen by patients with osteoarthritis of the knee.A qualitative study, nested within a randomised controlled trial, examining the effectiveness of physiotherapy in reducing pain and increasing mobility in knee osteoarthritis. In the intervention arm, participants undertook a series

2001 Journal of epidemiology and community health Controlled trial quality: uncertain

13090. MRI-demonstrated outcome of subchondral stress fractures of the knee after treatment with iloprost or tramadol: observations in 14 patients. (Abstract)

MRI-demonstrated outcome of subchondral stress fractures of the knee after treatment with iloprost or tramadol: observations in 14 patients. To investigate the outcome of subchondral stress fractures (SSF) of the knee after treatment with the prostacyclin analogue Iloprost or the opioid analgesic Tramadol.Case series/retrospective review.Tertiary care center.Fourteen patients with at least a single subchondral stress fracture of the knee, surrounded by bone marrow edema, visible on T1-weighted (...) and short tau inversion recovery magnetic resonance images.Nine patients had been treated with oral Iloprost (group 1; 11 SSF) and 5 patients with Tramadol (group 2; 5 SSF) for 4 weeks in the course of a double-blind, randomized clinical trial. MR images were obtained at baseline (1 day before the start of treatment), after 3 months, and after 1 year.SSF volumes and their rates of change between baseline and follow-up examinations, as determined on T1-weighted images by computer-assisted

2008 Clinical Journal of Sport Medicine Controlled trial quality: uncertain

13091. Adolescent flexibility, endurance strength, and physical activity as predictors of adult tension neck, low back pain, and knee injury: a 25 year follow up study. Full Text available with Trip Pro

Adolescent flexibility, endurance strength, and physical activity as predictors of adult tension neck, low back pain, and knee injury: a 25 year follow up study. To examine whether adolescent flexibility, endurance strength, and physical activity can predict the later occurrence of recurrent low back pain, tension neck, or knee injury.In 1976, 520 men and 605 women participated in a sit and reach test (flexibility) and a 30 second sit up test (endurance strength). In 1976 and 2001 (aged 37 (...) and 42 years) they completed a questionnaire. Lifetime occurrence and risk of self reported low back pain and self reported, physician diagnosed tension neck and knee injury were calculated for subjects divided into tertiles by baseline results of strength and flexibility tests.Men from the highest baseline flexibility tertile were at lower risk of tension neck than those from the lowest tertile (odds ratio (OR) 0.51, 95% confidence interval (CI) 0.28 to 0.93). Women from the highest baseline

2006 British Journal of Sports Medicine

13092. Effect of lower limb massage on electromyography and force production of the knee extensors. Full Text available with Trip Pro

Effect of lower limb massage on electromyography and force production of the knee extensors. To evaluate the effect of massage on force production and neuromuscular recruitment.Ten healthy male subjects performed isokinetic concentric contractions on the knee extensors at speeds of 60, 120, 180, and 240 degrees /s. These contractions were performed before and after a 30 minute intervention of either rest in the supine position or lower limb massage. Electromyography (EMG) and force data were (...) fibre conduction velocity are not responsible for the observed reductions in force. Although experimental confirmation is necessary, a possible explanation is that massage induced force loss by influencing "muscle architecture". However, it is possible that the differences were only found at 60 degrees /s because it was the first contraction after massage. Therefore muscle tension and architecture after massage and the duration of any massage effect need to be examined.

2006 British Journal of Sports Medicine

13093. Intraobserver and interobserver reliability of the kneeling technique of stress radiography for the evaluation of posterior knee laxity. Full Text available with Trip Pro

Intraobserver and interobserver reliability of the kneeling technique of stress radiography for the evaluation of posterior knee laxity. Stress radiography provides an objective tool to measure posterior knee instability. Intraobserver and interobserver reliability has been reported for the Telos device, but it has not been studied using the kneeling technique.This study was conducted to evaluate the intraobserver and interobserver reliability of measurements made using kneeling stress (...) radiography to quantify posterior knee instability.Case series (diagnosis); Level of evidence, 4.One hundred thirty-two stress radiographs in 44 patients with suspected posterior knee instability were prospectively taken using the kneeling technique. The amount of posterior displacement on the radiographs was then measured independently by 3 blinded testers (an orthopaedic sports medicine faculty member, an orthopaedic chief resident, and a medical student) on 2 separate occasions. Changes in mean

2008 American Journal of Sports Medicine

13094. Arthroscopic release for symptomatic scarring of the anterior interval of the knee. (Abstract)

interval, confirmed with both magnetic resonance imaging (MRI) and arthroscopic examination, were included. All 25 patients had refractory anterior knee pain that was unimproved after a minimum of 6 months of physical therapy and nonsteroidal anti-inflammatory medications and pain during knee extension. All patients had a minimum of 2 previous surgical procedures, and 11 (44%) of the patients had a previous anterior cruciate ligament (ACL) reconstruction. All 25 (100%) patients had an apparent decrease (...) Arthroscopic release for symptomatic scarring of the anterior interval of the knee. Patients with a history of knee trauma or previous surgery may exhibit pain in the infrapatellar region that is refractory to conservative care. This may be due to subtle scarring of the anterior interval.Arthroscopic release of a scarred anterior interval will lead to improvement in anterior knee pain.Case series; Level of evidence, 4.Twenty-five consecutive patients with isolated scarring of the anterior

2008 American Journal of Sports Medicine

13095. Color Doppler ultrasound findings in patellar tendinopathy (jumper's knee). Full Text available with Trip Pro

Color Doppler ultrasound findings in patellar tendinopathy (jumper's knee). Recent studies have revealed structural changes with neovessels in patients with jumper's knee and Achilles tendinopathy, and treatment with sclerosing injections has shown promising clinical results.To study the prevalence of neovascularization and structural tendon changes on color Doppler ultrasound examination in elite athletes with clinical symptoms of jumper's knee and to examine the ultrasound characteristics (...) of the tendon after sclerosing injection treatment with polidocanol.Cohort study; Level of evidence, 3.The authors recruited patients among elite athletes with a clinical diagnosis of jumper's knee who participated in a previous randomized clinical trial. The patients recorded knee function using the Victorian Institute of Sport Assessment score. Patients were examined by color Doppler ultrasound at baseline and, for patients with structural changes and neovascularization who received sclerosing treatment

2008 American Journal of Sports Medicine

13096. A synovial ganglion of the knee: two cases in athletes. (Abstract)

A synovial ganglion of the knee: two cases in athletes. The objective of the study is to describe two cases of proximal tibiofibular ganglion cysts in high level athletes. In May 2003 and March 2005 two athletes (one tennis player in the top eighty of the Italian national ranking and a gymnast belonging to the Italian rhythmic gymnastics national team) were referred to our institution complaining of postero-lateral knee discomfort and the presence of localized swelling over the fibular head (...) and the antero-lateral aspect of the leg, with a clinically suspected diagnosis of ganglion cyst of the proximal tibiofibular joint. Ultrasonography clearly detected the fluid-filled structures while magnetic resonance imaging confirmed the diagnosis, also showing precisely the anatomic relationship between the ganglions and the surrounding structures. Both athletes underwent surgical excision and the histological examination was compatible with a proximal tibiofibular joint ganglion cyst; as yet they have

2008 International Journal of Sports Medicine

13097. Relationship between hip strength and frontal plane posture of the knee during a forward lunge. Full Text available with Trip Pro

complaints.Muscle strength of six hip muscle groups was measured using a handheld dynamometer. Subjects were videotaped during a forward lunge and peak knee valgus or varus angles were determined using a digital video analysis software program.A correlation was examined between hip muscle strength and the amount of frontal plane movement of the knee during a forward lunge.There were no significant differences in hip muscle strength between the valgus group and the varus group during the forward lunge movement (...) Relationship between hip strength and frontal plane posture of the knee during a forward lunge. Excessive frontal plane knee movement during forward lunge movements might be associated with the occurrence of knee injuries in tennis. Here, we attempt to determine whether hip muscle strength is related to the frontal plane motion of the knee during a functional lunge movement.A correlational study.A total of 84 healthy subjects (76 men, 8 women), with no history of knee or lower leg

2007 British Journal of Sports Medicine

13098. Effect of tibial positioning on the diagnosis of posterolateral rotatory instability in the posterior cruciate ligament-deficient knee. Full Text available with Trip Pro

with the patient in the prone position increases the ability of an examiner to detect a concomitant PLC injury in the setting of a PCL-deficient knee. (...) Effect of tibial positioning on the diagnosis of posterolateral rotatory instability in the posterior cruciate ligament-deficient knee. To determine whether positioning of the tibia affects the degree of tibial external rotation seen during a dial test in the posterior cruciate ligament (PCL)-posterolateral corner (PLC)-deficient knee.Laboratory investigation.Biomechanics laboratory.An anterior force applied to the tibia in the combined PCL-PLC-deficient knee will yield increased tibial

2007 British Journal of Sports Medicine

13099. Stress fractures around the knee. (Abstract)

Stress fractures around the knee. Stress fractures of the lower extremities are common, especially in the younger athletic population. The current literature consists mainly a variety of case reports but is devoid of any sizeable series of knee stress fracture investigations. Diagnosing a stress fracture around the knee can be a challenge. The proximity of the stress fracture to the knee joint may lead the clinician to investigate intra-articular or other periarticular pathology (...) . The differential diagnosis can be large, including bursitis, tendonitis, mechanical causes, insufficiency fracture, and tumor. A high index of suspicion is necessary to confirm the underlying diagnosis. A patient's medical history combined with a physical examination and imaging modalities will aid the physician in arriving at the diagnosis of stress fracture.

2006 Clinics in Sports Medicine

13100. Prevalence of jumper's knee among elite athletes from different sports: a cross-sectional study. Full Text available with Trip Pro

Prevalence of jumper's knee among elite athletes from different sports: a cross-sectional study. The prevalence of jumper's knee across different sports has not been examined, and it is not known if there is a gender difference. Data from surgical case series indicate that there may be a high prevalence in sports with high speed and power demands.The aim of this study was to estimate the prevalence of jumper's knee in different sports among female and male athletes and to correlate (...) ), team handball (male and female athletes), and wrestling (male athletes). The examination included an interview on individual characteristics (weight, age, height, and training background), a clinical examination, and self-recorded Victorian Institute of Sport Assessment score from 0 (worst) to 100 (best).The overall prevalence of current jumper's knee was 14.2% (87 of 613 athletes), with a significant difference between sports with different performance characteristics (range, 0%-45%). In addition

2005 American Journal of Sports Medicine

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