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Knee Exam

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13141. Intra-articular ropivacaine injection does not alleviate pain after day-case knee arthroscopy performed under spinal anaesthesia. (Abstract)

Intra-articular ropivacaine injection does not alleviate pain after day-case knee arthroscopy performed under spinal anaesthesia. To evaluate the effect of intra-articular ropivacaine injection on postoperative knee pain after day case arthroscopy.We studied one hundred outpatients in a prospective, randomized, double-blind fashion to examine the postoperative analgesic effect of intra-articular ropivacaine or saline injected into the knee joint after day-case knee arthroscopy performed under (...) spinal anaesthesia. Patients were interviewed postoperatively with a standardized questionnaire. The postoperative pain was measured using a 100-mm visual analogue scale (VAS).There were no statistically significant differences in the VAS scores of knee pain eight hours or more after the operation between the intra-articular ropivacaine and saline groups, and there was no significant difference in the need for postoperative pain killer.This study failed to demonstrate a decrease in postoperative VAS

2001 Annales chirurgiae et gynaecologiae Controlled trial quality: uncertain

13142. Flat vs. concave tibial joint surface in total knee arthroplasty: randomized evaluation of 39 cases using radiostereometry. (Abstract)

: constrained) polyethylene insert (20 in each group). Radiostereometric (RSA) examinations were done postoperatively and after 3,12 and 24 months. The median absolute rotations of the tibial inserts varied between 0.12 and 0.24 (range 0.00-1.54) degrees, with no differences between the 2 groups. The median maximum total-point motions (flat/concave = 0.41/0.42 mm), the maximum subsidence or lift-off did not differ. The Hospital for Special Surgery knee score and the patients' opinion about the operation (...) Flat vs. concave tibial joint surface in total knee arthroplasty: randomized evaluation of 39 cases using radiostereometry. 40 patients with non-inflammatory arthrosis and minor preoperative deformity (< or =5 degrees ) were operated on with an AMK type (DePuy, Johnson & Johnson) total knee arthroplasty (TKA). The posterior cruciate ligament was retained. The patients were divided into those with a flat (terminology of the manufacturer: standard) or a concave (terminology of the manufacturer

2001 Acta Orthopaedica Scandinavica Controlled trial quality: uncertain

13143. Reliability of the lateral pull test and tilt test to assess patellar alignment in subjects with symptomatic knees: student raters. (Abstract)

Reliability of the lateral pull test and tilt test to assess patellar alignment in subjects with symptomatic knees: student raters. Test-retest reliability with blinded testers.To determine the inter- and intra-rater reliability of the lateral pull test and patellar tilt test.If patellar malalignment can be detected by clinical examination, then condition-specific treatment interventions may be implemented in patients with patellofemoral pain syndrome. However, several clinical tests used (...) to assess patellar mobility have recently been shown to have poor to fair reliability. Because the lateral pull test and the patellar tilt test are widely used clinically as diagnostic tests for patellofemoral pain syndrome but have not been previously tested for reliability, we examined these tests.Fifty-two subjects (age range, 21-48 years) provided 95 knees (19 symptomatic and 76 asymptomatic) for assessment of the lateral pull test. Two testers, blinded to the presence or absence of symptoms

2001 The Journal of orthopaedic and sports physical therapy Controlled trial quality: uncertain

13144. A randomized, controlled trial comparing compression bandaging and cold therapy in postoperative total knee replacement surgery. (Abstract)

A randomized, controlled trial comparing compression bandaging and cold therapy in postoperative total knee replacement surgery. To examine the difference between compression bandaging and cold therapy after total knee arthroplasty.Eighty-four postoperative, unilateral, total knee replacement, surgical clients.Clients were randomized into two groups: those receiving compression bandaging, and those receiving cryo-pad technology. Subjects were assessed for total length of stay, blood loss, blood

2002 Orthopaedic nursing / National Association of Orthopaedic Nurses Controlled trial quality: uncertain

13145. High prevalence of jumper's knee and sonographic changes in Swedish elite junior volleyball players compared to matched controls. Full Text available with Trip Pro

High prevalence of jumper's knee and sonographic changes in Swedish elite junior volleyball players compared to matched controls. Jumper's knee is a common and troublesome condition among senior volleyball players, but its prevalence among elite junior players compared to matched non-sports active controls is not known.To clinically, and by sonography, examine the patellar tendons in elite junior volleyball players (15-19 years) at the Swedish National Centre for volleyball and in matched (...) controls.The patellar tendons in the 57 students at the Swedish National Centre for high school volleyball and in 55 age, height, and weight matched not regularly sports active controls were evaluated clinically and by grey scale ultrasonography (US) and power Doppler (PD) sonography.There were no significant differences in mean age, height, and weight between the volleyball players and the controls. In the volleyball group, jumper's knee was diagnosed clinically and by US in 12 patellar tendons (10 male

2005 British Journal of Sports Medicine

13146. Taiji training improves knee extensor strength and force control in older adults. (Abstract)

Taiji training improves knee extensor strength and force control in older adults. The purpose of this study was to examine the effects of Taiji training on knee extensor strength and force control in older individuals. Twenty-six healthy older adults (71.9 +/- 1.8 years) participated in the study. Sixteen of the older adults (70.2 +/- 1.8 years) underwent Taiji training for 20 weeks (experimental group), whereas the other 10 (74.6 +/- 1.2 years) served as the control group. For both groups (...) , strength and force control of the knee extensors was assessed twice with an isokinetic dynamometer. Strength was assessed with a maximum voluntary isometric contraction (MVC). Force control was measured as the standard deviation (SD) and coefficient of variation (CV) of force during a constant isometric knee extension task at 2%, 30%, 60%, and 90% MVC. For the experimental group, MVC significantly increased (19.5 +/- 4.9%) and the CV of force decreased (18.9 +/- 3.3%) following Taiji training

2003 Biological Sciences and Medical Sciences

13147. Older patients' perceptions of quality of chronic knee or hip pain: differences by ethnicity and relationship to clinical variables. (Abstract)

Older patients' perceptions of quality of chronic knee or hip pain: differences by ethnicity and relationship to clinical variables. There is marked ethnic or racial disparity in the utilization of joint replacement for osteoarthritis. The reasons are not known. Pain is the reason most patients with osteoarthritis seek care. Cultural and psychosocial factors influence how patients experience and express pain. We examined whether patient descriptions of chronic pain vary by ethnicity (...) and if they correlate with important clinical measures used in arthritis care.Sample consisted of 300 male veterans who were > or =50 years of age with moderate to severe symptomatic knee or hip osteoarthritis. Structured surveys were used to assess patient descriptions of pain and to collect important demographic, clinical, and psychosocial variables. Factor analysis was used to assess patterns of pain description in a comparison of African-American and Caucasian patients. Pearson correlations were used to examine

2003 Biological Sciences and Medical Sciences

13148. Baseline balance and functional decline in older adults with knee pain: the Observational Arthritis Study in Seniors. (Abstract)

Baseline balance and functional decline in older adults with knee pain: the Observational Arthritis Study in Seniors. To examine the cross-sectional and longitudinal effect of baseline balance, independent of multiple covariates (sociodemographic variables, comorbidities), on self-reported disability and several measures of functional performance.Observational Arthritis Study in Seniors was a community-based longitudinal study.Data collection was conducted at an exercise science research (...) laboratory.A cohort of 245 women and 235 men, aged 65 and older, with self-reported knee pain.Measurements of balance, self-reported disability, functional performance, strength, sociodemographic characteristics, disease burden (including radiographic knee osteoarthritis (OA)), and functional limitations were obtained on participants at baseline and 30 months. The four outcome measures (self-reported disability, stair climb time, car time, preferred walking speed) were also collected at 15 months.In cross

2003 Journal of the American Geriatrics Society

13149. Oxidative stress in bilateral total knee replacement, under ischaemic tourniquet. (Abstract)

Oxidative stress in bilateral total knee replacement, under ischaemic tourniquet. Free radicals, such as reactive oxygen species (ROS) which are released abruptly after deflation of an ischaemic tourniquet, cause reperfusion injuries. Ischaemic precondition (IPC), however, can reduce the injury. In clinical practice, the sequential application and release of tourniquets is often used in bilateral total knee replacement (TKR) to obtain a clearer operative field, but the effects on the production (...) of free radicals and lipid peroxidation have not been studied. In this study, we have observed the production of free radicals and the subsequent lipid peroxidation in bilateral TKR with sequential application of a tourniquet to examine the effect of IPC. Patients undergoing elective TKR under intrathecal anaesthesia were studied. Blood samples were obtained after spinal anaesthesia, one minute before and five and 20 minutes after release of each tourniquet. We used the lucigenin chemiluminescence

2003 The Journal of Bone and Joint Surgery British Volume

13150. Arthroscopically assisted combined anterior and posterior cruciate ligament reconstruction in the multiple ligament injured knee: 2- to 10-year follow-up. (Abstract)

cases), Achilles tendon allograft (6 cases), and autograft semitendinosus/gracilis (1 case). MCL injuries were treated with bracing or open reconstruction. Posterolateral instability was treated with biceps femoris tendon transfer, with or without primary repair, and posterolateral capsular shift procedures as indicated.Postoperative physical examination revealed normal posterior drawer/tibial step-off in 16 of 35 (46%) knees. Normal Lackman and pivot-shift test results were found in 33 of 35 (94 (...) , arthrometer testing, stress radiography, and physical examination. Postoperatively, these knees are not normal, but they are functionally stable. Continuing technical improvements will probably improve future results.

2002 Arthroscopy

13151. Sonographic imaging of the posterolateral structures of the knee: findings in human cadavers. (Abstract)

, the lateral collateral ligament, the popliteus tendon, the popliteofibular ligament, the arcuate ligament, and the fabellofibular ligament (when present) were identified. Following the soft tissue dissection, sonography was performed to characterize these structures. The technique was refined using this "open" examination method as anatomical and structural detail was noted. After adequate familiarization with this technique, researchers performed sonography on 2 pairs of thawed fresh-frozen cadaver knees (...) , 1 pair with a fabella and 1 pair without a fabella. After sonographic examination of all of the posterolateral structures, the knees were dissected and the structures previously identified by sonography were verified.In all 4 cadaver specimens, all posterolateral structures were identified based on their imaging characteristics and surrounding bony and soft tissue landmarks. We also present dissection photographs and sonographic images depicting our study findings.Sonographic imaging may provide

2002 Arthroscopy

13152. Echinococcal synovitis of the knee joint. (Abstract)

Echinococcal synovitis of the knee joint. Bone lesions are present in 1% to 2% of cases of hydatid disease. Hydatid synovitis can usually be identified due to secondary extension from the adjacent bone, or infrequently after hematogenous spread. We present an extremely rare case of hydatid synovitis without bony involvement. A 74-year-old man with diagnosed hydatid disease was admitted to our department because of left knee swelling. Neither physical examination nor laboratory studies revealed (...) any remarkable findings. Radiographic evaluation of the knee joint was noncontributory. The patient underwent an arthroscopically assisted synovectomy, and the biopsy revealed an echinococcus contamination. No complications occurred during the postoperative period.

2002 Arthroscopy

13153. Snapping knee caused by intra-articular tumors. (Abstract)

Snapping knee caused by intra-articular tumors. Locking of the knee can present with no history of antecedent injury. We identified impingement of intra-articular tumors in 2 cases. Intra-articular tumors are relatively rare. Mechanical symptoms were present in both cases. On physical examination, there was a palpable mass at the medial region of the patellofemoral joint. The interior had been replaced mainly by amorphous necrotic tissue. The definite diagnosis of a soft-tissue mass of the knee (...) could not be made on histologic examination.

2003 Arthroscopy

13154. Histological evaluation of chondral defects after autologous chondrocyte implantation of the knee. (Abstract)

Histological evaluation of chondral defects after autologous chondrocyte implantation of the knee. We have performed a prospective, single-surgeon study analysing the histological results of autologous chondrocyte implantation. Fourteen patients underwent autologous chondrocyte implantation of the knee and were evaluated at one year by clinical assessment and arthroscopy. Standard staining was used to examine the sections. In addition, in situ hybridisation was used to establish type-IIa

2003 The Journal of Bone and Joint Surgery British Volume

13155. Arthroscopic study of the knee joint in fetuses. (Abstract)

Arthroscopic study of the knee joint in fetuses. The purpose of this study was to macroscopically examine the fetal knee joint via arthroscopy. We have attempted to identify and describe the specific characteristics of the fetal knee joint, how it evolves during the last few weeks of intrauterine development, and any possible variations with regard to the adult knee.Observational anatomic case series.We used 20 frozen fetuses with a gestational age of 24 to 40 +/- 2 weeks, obtained from (...) spontaneous abortions. Examination was performed with standard arthroscopic surgical equipment, using a 2.7-mm optical lens. Whenever possible, we tried to use standard arthroscopic portals. Images were obtained for comparison with the adult knee.Suprapatellar and infrapatellar septa were an almost consistent finding. The suprapatellar septum always opened laterally and was intact in the developmentally younger specimens. We found 2 mediopatellar septa. The femoral attachment of the anterior cruciate

2003 Arthroscopy

13156. Knee rating scales. (Abstract)

Knee rating scales. In the past 2 decades, outcome assessment following knee surgery has focused increasingly on the patient's perspective. While traditional measures of outcome, including physical examination, imaging studies, and measures of knee laxity are complementary, questionnaires have become more important in determining the value of a procedure. Reliability, validity, and responsiveness are all important measurement qualities for health-related quality of life instruments (...) . There are several questionnaires available, both for active patients with disorders of the knee, as well as for older patients with degenerative conditions. Activity level is also an important prognostic variable for patients with disorders of the knee. Clinical researchers should also use a validated activity rating scale to evaluate what patients are doing, in addition to how they are doing.

2003 Arthroscopy

13157. Result of arthroscopic treatment of pigmented villonodular synovitis of the knee. (Abstract)

Result of arthroscopic treatment of pigmented villonodular synovitis of the knee. We report 10 years' experience in arthroscopic treatment of pigmented villonodular synovitis (PVNS) of the knee in a series of patients affected by the localized or diffuse form of the disease. The purpose of the study is to critically examine the results of arthroscopic synovectomy in the knee affected by PVNS, to determine the safety and effectiveness of the procedure.Retrospective case analysis.The study (...) population consists of 19 patients, with an average follow-up of 60 months (minimum, 12; maximum, 128). All patients underwent knee arthroscopy. The 3 standard portals were used; posteromedial and posterolateral portals were added if required. Four patients were affected by localized PVNS and were subject to partial synovectomy with excision of the pathologic tissue. The remaining 15 patients presented a diffuse form of PVNS; 7 of them underwent extended arthroscopic synovectomy and 8 underwent partial

2003 Arthroscopy

13158. Synovial hemangioma of the knee. (Abstract)

Synovial hemangioma of the knee. Synovial hemangioma of a knee joint has been reported as a rare cause of pain, hemarthrosis, and intermittent locking. This case report describes our experience in excising intra-articular hemangioma of the knee joint. Complete resection, after arthroscopic examination, was performed in a 59-year-old man. Six months after the surgery, no evidence of recurrence was seen.

2003 Arthroscopy

13159. Juxta-articular myxoma: a rare cause of painful restricted motion of the knee. (Abstract)

and orthopaedic evaluations of the knee, including a magnetic resonance imaging (MRI), had been performed at a geographically distant (but affiliated) institution. The resulting presumptive diagnosis was a "wear and tear" degenerative articular disorder of the knee. A program of anti-inflammatory medication and physical therapy was begun for several months but produced no therapeutic benefit by the time the patient presented at our institution. After examination confirmed marked losses of both flexion (...) Juxta-articular myxoma: a rare cause of painful restricted motion of the knee. A 68-year-old athletic woman presented to our institution in January 2002 with a several-month history of progressing complaints of pain, swelling, and loss of motion in the right knee. These manifestations had begun the previous July during a game of tennis. She experienced persisting pain and recurring effusions. Because the patient had been residing in another state between July and January, rheumatologic

2003 Arthroscopy

13160. Coronary ligament rupture as a cause of medial knee pain. (Abstract)

examination of the knees. These patients were found to have coronary ligament ruptures. All the patients were treated conservatively. The pain resolved in all cases over a few months. No patient required a second arthroscopy. The patients were followed up for 9 months in 2 cases and 2 years in 1 case. By final follow-up examination, all patients were symptom free. Meniscal cartilage tear is the most common injury to the knee requiring surgery. Standard practice is to diagnose meniscal tear based (...) Coronary ligament rupture as a cause of medial knee pain. Three cases of a meniscal injury variant are presented, the signs and symptoms of which imitate meniscal tear, but that required no definitive intervention and resolved with conservative management. We include a review of the literature on these injuries. Three patients attended clinic giving a history and exhibiting symptoms suggestive of medial meniscal injury. Symptoms were severe and of long enough duration to warrant arthroscopic

2003 Arthroscopy

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