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61. Spherox (spheroids of human autologous matrix-associated chondrocytes) - to repair defects to the cartilage in the knee

Spherox (spheroids of human autologous matrix-associated chondrocytes) - to repair defects to the cartilage in the knee 18 May 2017 EMA/349863/2017 Committee for Medicinal Products for Human Use (CHMP) CHMP assessment report Spherox Common name: spheroids of human autologous matrix-associated chondrocytes Procedure No. EMEA/H/C/002736/0000 30 Churchill Place ? Canary Wharf ? London E14 5EU ? United Kingdom An agency of the European Union Telephone +44 (0)20 3660 6000 Facsimile +44 (0)20 3660 (...) cartilage defects of the femoral condyle and the patella of the knee (International Cartilage Repair Society [ICRS] grade III or IV) with defect sizes up to 10 cm2 in adults. Pharmaceutical form: Implantation suspension Strength: 10–70 spheroids/cm² Route of administration: Intraarticular use Packaging: Applicator Pre-filled syringe Package sizes: 1 to10 sterile tubes with up to 2 applicators CHMP assessment report EMA/349863/2017 Page 2/125 each + 1 syringe per applicator and 1 to 10 sterile tubes

2017 European Medicines Agency - EPARs

62. Exam Series: Guide to the Knee Exam

Exam Series: Guide to the Knee Exam Exam Series: Guide to the Knee Exam - CanadiEM Exam Series: Guide to the Knee Exam In by Kathryn Chan June 5, 2018 A 22 year old female comes to emergency department unable to walk. She was in the middle of a rugby game when she caught the ball while pivoting quickly, and was tackled shortly thereafter. She immediately heard a “pop” and says that the swelling in her right leg has increased substantially over the last hour. Background: The knee is a complex (...) hinge joint and one of the most common sites of MSK injuries. Fortunately a diagnosis is usually possible with a good history and physical exam! Four ligaments – the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL) connect the femur to the tibial plateau, ensuring proper alignment and providing stability. Two menisci cushion the articulating surfaces while several bursa further reduce friction around the knee

2018 CandiEM

63. Chronic Knee Pain

Chronic Knee Pain Revised 2018 ACR Appropriateness Criteria ® 1 Chronic Knee Pain American College of Radiology ACR Appropriateness Criteria ® Chronic Knee Pain Variant 1: Adult or child greater than or equal to 5 years of age. Chronic knee pain. Initial imaging. Procedure Appropriateness Category Relative Radiation Level Radiography knee Usually Appropriate ? Aspiration knee Usually Not Appropriate Varies CT arthrography knee Usually Not Appropriate ? CT knee with IV contrast Usually (...) Not Appropriate ? CT knee without and with IV contrast Usually Not Appropriate ? CT knee without IV contrast Usually Not Appropriate ? MR arthrography knee Usually Not Appropriate O MRI knee without and with IV contrast Usually Not Appropriate O MRI knee without IV contrast Usually Not Appropriate O Tc-99m bone scan knee Usually Not Appropriate ??? US knee Usually Not Appropriate O Radiography hip ipsilateral Usually Not Appropriate ??? Variant 2: Adult or child greater than or equal to 5 years of age

2018 American College of Radiology

64. Patients With Total Knee Arthroplasty in the Acute Post-Operative Phase

Patients With Total Knee Arthroplasty in the Acute Post-Operative Phase Effect of Physical Therapy Interventions in the Acute Care S... : Journal of Acute Care Physical Therapy ')} You may be trying to access this site from a secured browser on the server. Please enable scripts and reload this page. Login No user account? Lippincott Journals Subscribers , use your username or email along with your password to log in. Remember me on this computer or Register for a free account Registered users (...) .0000000000000079 Original Studies Open Background: Despite seemingly routine use of physical therapy and its potential importance in reducing complications after total joint arthroplasty in the acute hospital setting, no agreed-upon approach to rehabilitation exists in this setting. In fact, rehabilitation practices and outcomes assessed are quite variable. Purpose: To determine the effects of physical therapy interventions in the acute care phase of total knee arthroplasty. Data Sources: Ovid Medline

2018 American Physical Therapy Association

65. Knee Pain and Mobility Impairments: Meniscal and Articular Cartilage Lesions Full Text available with Trip Pro

Knee Pain and Mobility Impairments: Meniscal and Articular Cartilage Lesions Knee Pain and Mobility Impairments: Meniscal and Articular Cartilage Lesions Revision 2018 | Journal of Orthopaedic & Sports Physical Therapy ADVERTISEMENT Journal of Orthopaedic & Sports Physical Therapy | | | | | > > > Knee Pain and Mobility Impairments: Meniscal and Articular Cartilage Lesions Revision 2018 Clinical Practice Guidelines Knee Pain and Mobility Impairments: Meniscal and Articular Cartilage Lesions (...) -Reported Measures 2018 Recommendation For knee-specific outcomes, clinicians should use the International Knee Documentation Committee 2000 Subjective Knee Evaluation Form (IKDC 2000) or Knee injury and Osteoarthritis Outcome Score (KOOS) (or a culturally appropriate version for patients whose primary language is not English) and may use the Lysholm scale (with removal of swelling item, and using unweighted scores). Clinicians may use the Tegner scale or Marx activity rating scale to assess activity

2018 American Physical Therapy Association

66. Viscosupplementation for Knee Osteoarthritis: A Review of Clinical and Cost-Effectiveness and Guidelines

Viscosupplementation for Knee Osteoarthritis: A Review of Clinical and Cost-Effectiveness and Guidelines Viscosupplementation for Knee Osteoarthritis: A Review of Clinical and Cost-Effectiveness and Guidelines | CADTH.ca Find the information you need Viscosupplementation for Knee Osteoarthritis: A Review of Clinical and Cost-Effectiveness and Guidelines Viscosupplementation for Knee Osteoarthritis: A Review of Clinical and Cost-Effectiveness and Guidelines Published on: June 22, 2017 Project (...) Number: RC0895-000 Product Line: Research Type: Devices and Systems Report Type: Summary with Critical Appraisal Result type: Report Question What is the clinical effectiveness of viscosupplementation for the treatment of adults with osteoarthritis of the knee? What is the cost-effectiveness of viscosupplementation for the treatment of adults with osteoarthritis of the knee? What are the evidence-based guidelines associated with viscosupplementation for the treatment of adults with osteoarthritis

2017 Canadian Agency for Drugs and Technologies in Health - Rapid Review

67. Microstructural scaffold (patch) insertion without autologous cell implantation for repairing symptomatic chondral knee defects

Microstructural scaffold (patch) insertion without autologous cell implantation for repairing symptomatic chondral knee defects Microstructur Microstructural scaffold (patch) insertion al scaffold (patch) insertion without autologous cell implantation for without autologous cell implantation for repairing symptomatic chondr repairing symptomatic chondral knee defects al knee defects Interventional procedures guidance Published: 22 June 2016 nice.org.uk/guidance/ipg560 Y Y our responsibility our (...) of implementing NICE recommendations wherever possible. 1 1 Recommendations Recommendations 1.1 The evidence on microstructural scaffold insertion without autologous cell implantation for repairing symptomatic chondral knee defects raises no major safety concerns; however, current evidence on its efficacy is inadequate in both © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 1 of 9quality and quantity. Therefore

2016 National Institute for Health and Clinical Excellence - Interventional Procedures

68. Correction: Six degree-of-freedom knee joint kinematics in obese individuals with knee pain during gait. Full Text available with Trip Pro

Correction: Six degree-of-freedom knee joint kinematics in obese individuals with knee pain during gait. [This corrects the article DOI: 10.1371/journal.pone.0174663.].

2019 PLoS ONE

69. Lumbar Epidural Corticosteroid Injection Reduces Subacute Pain and Improves Knee Function in the First Six Weeks After Total Knee Arthroplasty: A Double-Blinded Randomized Trial (Abstract)

Lumbar Epidural Corticosteroid Injection Reduces Subacute Pain and Improves Knee Function in the First Six Weeks After Total Knee Arthroplasty: A Double-Blinded Randomized Trial Pain control immediately following total knee arthroplasty (TKA) has been a focus for orthopaedists. However, control of subacute pain, which may persist up to 3 months, is usually not optimized. The efficacy of epidural corticosteroids in reducing pain after surgery is documented, but data on their efficacy (...) in controlling subacute pain after TKA are lacking. Our aim was to investigate the efficacy of an epidural corticosteroid in controlling pain in the first 3 months following TKA using a double-blinded randomized clinical trial.One hundred and eight patients with osteoarthritis of the knee who underwent TKA and received analgesic drugs through an epidural catheter for 48 hours were randomized to receive either 40 mg (1 mL) of triamcinolone acetonide plus 5 mL of 1% lidocaine, or 6 mL of 1% lidocaine alone

2018 EvidenceUpdates

70. Preoperative Pain Neuroscience Education Combined With Knee Joint Mobilization for Knee Osteoarthritis: A Randomized Controlled Trial Full Text available with Trip Pro

Preoperative Pain Neuroscience Education Combined With Knee Joint Mobilization for Knee Osteoarthritis: A Randomized Controlled Trial This study aimed to first compare the effects of a preoperative treatment combining pain neuroscience education (PNE) with knee joint mobilization versus biomedical education with knee joint mobilization on central sensitization (CS) in patients with knee osteoarthritis, both before and after surgery. Second, we wanted to compare the effects of both interventions (...) on knee pain, disability, and psychosocial variables.Forty-four patients with knee osteoarthritis were allocated to receive 4 sessions of either PNE combined with knee joint mobilization or biomedical education with knee joint mobilization before surgery. All participants completed self-administered questionnaires and quantitative sensory testing was performed at baseline, after treatment and at a 1 month follow-up (all before surgery), and at 3 months after surgery.Significant and clinically relevant

2018 EvidenceUpdates

71. Addition of Infiltration Between the Popliteal Artery and the Capsule of the Posterior Knee and Adductor Canal Block to Periarticular Injection Enhances Postoperative Pain Control in Total Knee Arthroplasty: A Randomized Controlled Trial (Abstract)

Addition of Infiltration Between the Popliteal Artery and the Capsule of the Posterior Knee and Adductor Canal Block to Periarticular Injection Enhances Postoperative Pain Control in Total Knee Arthroplasty: A Randomized Controlled Trial Periarticular injections (PAIs) are becoming a staple component of multimodal joint pathways. Motor-sparing peripheral nerve blocks, such as the infiltration between the popliteal artery and capsule of the posterior knee (IPACK) and the adductor canal block (...) (ACB), may augment PAI in multimodal analgesic pathways for knee arthroplasty, but supporting literature remains rare. We hypothesized that the addition of ACB and IPACK to PAI would lower pain on ambulation on postoperative day (POD) 1 compared to PAI alone.This triple-blinded randomized controlled trial included 86 patients undergoing unilateral total knee arthroplasty. Patients either received (1) a PAI (control group, n = 43) or (2) an IPACK with an ACB and modified PAI (intervention group, n

2018 EvidenceUpdates

72. The Effect of Adductor Canal Block on Knee Extensor Muscle Strength 6 Weeks After Total Knee Arthroplasty: A Randomized, Controlled Trial (Abstract)

The Effect of Adductor Canal Block on Knee Extensor Muscle Strength 6 Weeks After Total Knee Arthroplasty: A Randomized, Controlled Trial Total knee arthroplasty (TKA) reduces knee extensor muscle strength (KES) in the operated limb for several months after the surgery. Immediately after TKA, compared to either inguinal femoral nerve block or placebo, adductor canal block (ACB) better preserves KES. Whether this short-term increase in KES is maintained several weeks after surgery remains (...) ) and day 2 (POD2) KES, pain scores at rest and peak effort, and opioid consumption; variation at 6 weeks of Knee Osteoarthritis Outcome Score, patient satisfaction, and length of hospital stay.Sixty-three subjects were randomized and 58 completed the study. Patients in group ACB had less pain at rest during POD1 and during peak effort on POD1 and POD2, consumed less opioids on POD1 and POD2, and had higher median KES on POD1. There was no significant difference between groups for median KES on POD2

2018 EvidenceUpdates

73. Renal insufficiency plays a crucial association factor in severe knee osteoarthritis-induced pain in patients with total knee replacement: A retrospective study. Full Text available with Trip Pro

Renal insufficiency plays a crucial association factor in severe knee osteoarthritis-induced pain in patients with total knee replacement: A retrospective study. Pain, the main symptom of osteoarthritis (OA), can lead to functional disability in patients with knee OA. Understanding the association factors related to knee pain is important since preventing OA-induced disabilities can be achieved by modifying these pain-associated issues. Therefore, this study was aimed to investigate (...) the association factors for OA-induced knee pain in Taiwanese patients who received total knee replacements (TKR).In this retrospective study, 357 subjects who had undergone TKR at the Taipei Municipal Wan-Fang Hospital were recruited. The distribution of pain severity among patients with knee OA was evaluated. Demographic data and clinical parameters were analyzed to determine relationships between these variables and the severity of knee OA pain.Of the 357 patients studied, 54% and 33% had moderate

2020 Medicine

74. Prior knee arthroscopy effects on subsequent total knee arthroplasty: A protocol of match-controlled study. Full Text available with Trip Pro

Prior knee arthroscopy effects on subsequent total knee arthroplasty: A protocol of match-controlled study. Currently, there exists a paucity of literature about the impact of prior knee arthroscopy on subsequent total knee arthroplasty (TKA). The purpose of this study was to compare outcomes of patients undergoing TKA after prior knee arthroscopy with a matched cohort of control subjects with primary osteoarthritis and no history of arthroscopy.We reviewed patients who underwent primary TKA (...) at our academic center from January 2011 to December 2017. Of these, we included 68 patients (70 knees) that were performed TKA following knee arthroscopy. The groups were split by sex, age to within 6 years, and body mass index within 5 kg/m. A 1:2 matching algorithm was applied. Outcome measures included surgical time, intraoperative estimated blood loss, Oxford Knee Score, range of movement, complications, and revision rate.This study had limited inclusion and exclusion criteria and a well

2020 Medicine

75. A Decline in Walking Speed is Associated with Incident Knee Replacement in Adults with and at Risk for Knee Osteoarthritis. (Abstract)

A Decline in Walking Speed is Associated with Incident Knee Replacement in Adults with and at Risk for Knee Osteoarthritis. To determine if a one-year change in walking speed is associated with receiving an incident knee replacement during the following year in adults with and at risk for knee osteoarthritis (OA).Using data from the Osteoarthritis Initiative, we determined a one-year change in 20- meter walk speed from three observation periods (i.e., 0-12, 12-24, and 24-36 month). We (...) operationally defined one-year change in walking speed as either: 1) decline: < -0.1 m/s change, 2) no change: between -0.1 and 0.1 m/s change, 3) increase: > 0.1 m/s change. Incident knee replacement was defined using each subsequent one-year period (i.e., 12-24, 24- 36, and 36-48 month). Combining data from the three observation periods, we performed a Poisson regression with robust error variance to determine the relative risk between a change in walking speed (exposure) and incident knee replacement

2020 Journal of Rheumatology

76. Joint distraction for knee osteoarthritis without alignment correction

Joint distraction for knee osteoarthritis without alignment correction Joint distr Joint distraction for knee osteoarthritis without action for knee osteoarthritis without alignment correction alignment correction Interventional procedures guidance Published: 23 July 2015 nice.org.uk/guidance/ipg529 Y Y our responsibility our responsibility This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare (...) for knee osteoarthritis without alignment correction is inadequate in quantity and quality. Therefore, this procedure should only be used in the context of research. © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 1 of 71.2 Further research into joint distraction for knee osteoarthritis without alignment correction should include comparative studies against existing forms of management. Studies should record patient

2015 National Institute for Health and Clinical Excellence - Interventional Procedures

77. Predicting individual knee range of motion, knee pain, and walking limitation outcomes following total knee arthroplasty. Full Text available with Trip Pro

Predicting individual knee range of motion, knee pain, and walking limitation outcomes following total knee arthroplasty. Background and purpose - Up to 20% of patients are dissatisfied after total knee arthroplasty (TKA), mainly because of pain and restricted physical function. We developed a prediction model for 6-month knee range of motion, knee pain, and walking limitations in patients undergoing TKA surgery. Patients and methods - We performed a prospective cohort study of 4,026 patients (...) who underwent elective, primary TKA between July 2013 and July 2017. Candidate predictors included demographic, clinical, psychosocial, and preoperative outcome measures. The outcomes of interest were (i) knee extension and flexion range of motion, (ii) knee pain rated on a 5-point ordinal scale, and (iii) self-reported maximum walk time at 6 months post TKA. For each outcome, we fitted a multivariable proportional odds regression model with bootstrap internal validation. Results - At 6 months

2019 Acta Orthopaedica

78. Adequate protection rather than knee flexion prevents popliteal vascular injury during high tibial osteotomy: analysis of three-dimensional knee models in relation to knee flexion and osteotomy techniques. (Abstract)

Adequate protection rather than knee flexion prevents popliteal vascular injury during high tibial osteotomy: analysis of three-dimensional knee models in relation to knee flexion and osteotomy techniques. (1) To analyse popliteal artery (PA) movement in a three-dimensional (3D) coordinate system in relation to knee flexion and high tibial osteotomy (HTO) techniques (lateral closed wedge HTO [LCHTO], uniplane medial open wedge HTO [UP-MOHTO], biplane medial open wedge HTO [BP-MOHTO]) and (2 (...) ) to identify safe zones of the PA in each osteotomy plane.Sixteen knees of patients who underwent magnetic resonance imaging with extension and 90° flexion were used to develop subject-specific 3D knee flexion models. Displacement of the PA during knee flexion was measured along the X- and Y-axis, as was the distance between the posterior tibial cortex and PA parallel to the Y-axis (d-PCA). Frontal plane safety index (FPSI) and maximal axial safe angles (MASA) of osteotomy, which represented safe zones

2019 Knee Surgery, Sports Traumatology, Arthroscopy

79. Knee Replacement Bandaging Study (KReBS) evaluating the effect of a two-layer compression bandage system on knee function following total knee arthroplasty: study protocol for a randomised controlled trial. Full Text available with Trip Pro

Knee Replacement Bandaging Study (KReBS) evaluating the effect of a two-layer compression bandage system on knee function following total knee arthroplasty: study protocol for a randomised controlled trial. Data from a feasibility study suggest that the use of an inelastic, short-stretch compression bandage following total knee arthroplasty is a safe technique that may improve patient-reported health outcomes, and that it is feasible to recruit to a full-scale study.We will conduct a randomised (...) controlled trial (RCT) of 2600 adult patients, which has 80% power to detect a 1 point difference in the Oxford Knee Score (a patient self-reported assessment of knee pain and function) at 52 weeks. Short stretch compression bandaging will be compared with standard wool and crepe bandaging following total knee arthroplasty. Recruitment will take place in orthopaedic units across the United Kingdom. Secondary outcomes include the EuroQol 5 Dimensions (EQ-5D)-5 L and EQ-5D-3 L scores, pain, length

2019 Trials Controlled trial quality: uncertain

80. Revision Risk for Total Knee Arthroplasty Converted from Medial Unicompartmental Knee Arthroplasty: Comparison with Primary and Revision Arthroplasties, Based on Mid-Term Results from the Danish Knee Arthroplasty Registry. (Abstract)

Revision Risk for Total Knee Arthroplasty Converted from Medial Unicompartmental Knee Arthroplasty: Comparison with Primary and Revision Arthroplasties, Based on Mid-Term Results from the Danish Knee Arthroplasty Registry. Medial unicompartmental knee arthroplasties (UKAs) have good clinical outcomes but implant survival is inferior to that of total knee arthroplasties (TKAs). Conversion to a TKA is a reliable option when UKA fails. However, there is controversy regarding these conversions (...) . The aim of this study was to analyze the survival of TKAs converted from UKAs when compared with both primary and revision TKAs.On the basis of registrations in the Danish Knee Arthroplasty Registry from 1997 to 2017, 1,012 TKAs converted from UKAs were compared with 73,819 primary TKAs and 2,572 revision TKAs. The primary outcome was the risk of revision. Secondarily, the study analyzed the influence of different implants, the indication for the UKA conversion, and surgical volume on the survival

2019 The Journal of Bone and Joint Surgery. American Volume

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