Medial Knee Endoscopy

2021 ◽  
pp. 183-191
Author(s):  
Keith Hay-Man Wan ◽  
Tun Hing Lui ◽  
Tianlong Huang
Keyword(s):  
Medial Knee

scholarly journals A comparison between laterally wedged insoles and ankle-foot orthoses for the treatment of medial osteoarthritis of the knee: A randomized cross-over trial

2021 ◽  
pp. 026921552199363
Author(s):  
Martin Schwarze ◽  
Leonie P Bartsch ◽  
Julia Block ◽  
Merkur Alimusaj ◽  
Ayham Jaber ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Controlled Trial ◽  
Oxford Knee Score ◽  
Knee Adduction Moment ◽  
Osteoarthritis Of The Knee ◽  
Knee Score ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis ◽  
Patient Reported ◽  
Angular Impulse

Objective: To compare biomechanical and clinical outcome of laterally wedged insoles (LWI) and an ankle-foot orthosis (AFO) in patients with medial knee osteoarthritis. Design: Single-centre, block-randomized, cross-over controlled trial. Setting: Outpatient clinic. Subjects: About 39 patients with symptomatic medial knee osteoarthritis. Interventions: Patients started with either LWI or AFO, determined randomly, and six weeks later changed to the alternative. Main measures: Change in the 1st maximum of external knee adduction moment (eKAM) was assessed with gait analysis. Additional outcomes were other kinetic and kinematic changes and the patient-reported outcomes EQ-5D-5L, Oxford Knee Score (OKS), American Knee Society Clinical Rating System (AKSS), Hannover Functional Ability Questionnaire – Osteoarthritis and knee pain. Results: Mean age (SD) of the study population was 58 (8) years, mean BMI 30 (5). Both aids significantly improved OKS (LWI P = 0.003, AFO P = 0.001), AKSS Knee Score (LWI P = 0.01, AFO P = 0.004) and EQ-5D-5L Index (LWI P = 0.001, AFO P = 0.002). AFO reduced the 1st maximum of eKAM by 18% ( P < 0.001). The LWI reduced both maxima by 6% ( P = 0.02, P = 0.03). Both AFO and LWI reduced the knee adduction angular impulse (KAAI) by 11% ( P < 0.001) and 5% ( P = 0.05) respectively. The eKAM (1st maximum) and KAAI reduction was significantly larger with AFO than with LWI ( P = 0.001, P = 0.004). Conclusions: AFO reduces medial knee load more than LWI. Nevertheless, no clinical superiority of either of the two aids could be shown.

scholarly journals Predictors of single-leg standing balance in individuals with medial knee osteoarthritis

2010 ◽  
Vol 62 (4) ◽  
pp. 496-500 ◽  
Author(s):  
Michael A. Hunt ◽  
Fiona J. McManus ◽  
Rana S. Hinman ◽  
Kim L. Bennell
Keyword(s):  
Knee Osteoarthritis ◽  
Standing Balance ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis

scholarly journals Lower Failure Rates and Improved Patient Outcome Due to Reconstruction of the MCL and Revision ACL Reconstruction in Chronic Medial Knee Instability

2021 ◽  
Vol 9 (3) ◽  
pp. 232596712198931
Author(s):  
Lena Alm ◽  
Tobias Claus Drenck ◽  
Jannik Frings ◽  
Matthias Krause ◽  
Alexander Korthaus ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Lysholm Score ◽  
Knee Instability ◽  
Failure Rates ◽  
Medial Knee ◽  
Revision Acl Reconstruction ◽  
Risk Of Failure ◽  
Significant Difference ◽  
Patient Reported ◽  
Reconstruction Group

Background: Concomitant lesion of the medial collateral ligament (MCL) is associated with a greater risk of anterior cruciate ligament (ACL) graft failure. Purpose: The aim of this study was to compare two medial stabilization techniques in patients with revision ACL reconstruction (ACLR) and concomitant chronic medial knee instability. Study Design: Cohort study; Level of evidence, 3. Methods: In a retrospective study, we included 53 patients with revision ACLR and chronic grade 2 medial knee instability to compare medial surgical techniques (MCL reconstruction [n = 17] vs repair [n = 36]). Postoperative failure of the revision ACLR (primary aim) was defined as side-to-side difference in Rolimeter testing ≥5 mm or pivot-shift grade ≥2. Clinical parameters and postoperative functional scores (secondary aim) were evaluated with a mean ± SD follow-up of 28.8 ± 9 months (range, 24-69 months). Results: Revision ACLR was performed in 53 patients with additional grade 2 medial instability (men, n = 33; women, n = 20; mean age, 31.3 ± 12 years). Failure occurred in 5.9% (n = 1) in the MCL reconstruction group, whereas 36.1% (n = 13) of patients with MCL repair showed a failed revision ACLR ( P = .02). In the postoperative assessment, the anterior side-to-side difference in Rolimeter testing was significantly reduced (1.5 ± 1.9 mm vs 2.9 ± 2.3 mm; P = .037), and medial knee instability occurred significantly less (18% vs 50%; P = .025) in the MCL reconstruction group than in the MCL repair group. In the logistic regression, patients showed a 9-times elevated risk of failure when an MCL repair was performed ( P = .043). Patient-reported outcomes were increased in the MCL reconstruction group as compared with MCL repair, but only the Lysholm score showed a significant difference (Tegner, 5.6 ± 1.9 vs 5.3 ± 1.6; International Knee Documentation Committee, 80.3 ± 16.6 vs 73.6 ± 16.4; Lysholm, 82.9 ± 13.6 vs 75.1 ± 21.1 [ P = .047]). Conclusion: MCL reconstruction led to lower failure rates in patients with combined revision ACLR and chronic medial instability as compared with MCL repair. MCL reconstruction was superior to MCL repair, as lower postoperative anterior instability, an increased Lysholm score, and less medial instability were present after revision ACLR. MCL repair was associated with a 9-times greater risk of failure.

High tibial osteotomy to neutral alignment improves medial knee articular cartilage composition

2021 ◽  
Author(s):  
Hayden F. Atkinson ◽  
Trevor B. Birmingham ◽  
Jenna M. Schulz ◽  
Codie A. Primeau ◽  
Kristyn M. Leitch ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
High Tibial Osteotomy ◽  
Tibial Osteotomy ◽  
Medial Knee ◽  
Neutral Alignment

scholarly journals Three‐month efficacy of three knee braces in the treatment of medial knee osteoarthritis in a randomized crossover trial

2020 ◽  
Vol 38 (10) ◽  
pp. 2262-2271
Author(s):  
Xavier Robert‐Lachaine ◽  
Yoann Dessery ◽  
Étienne L. Belzile ◽  
Sylvie Turmel ◽  
Philippe Corbeil
Keyword(s):  
Knee Osteoarthritis ◽  
Crossover Trial ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis ◽  
Randomized Crossover Trial ◽  
Knee Braces

scholarly journals Medial knee joint contact force in the intact limb during walking in recently ambulatory service members with unilateral limb loss: a cross-sectional study

PeerJ ◽  
2017 ◽  
Vol 5 ◽  
pp. e2960 ◽  
Author(s):  
Ross H. Miller ◽  
Rebecca L. Krupenevich ◽  
Alison L. Pruziner ◽  
Erik J. Wolf ◽  
Barri L. Schnall
Keyword(s):  
Knee Joint ◽  
Limb Loss ◽  
Service Members ◽  
Model Parameters ◽  
Joint Loading ◽  
Cross Sectional ◽  
Medial Knee ◽  
Knee Oa ◽  
Joint Contact ◽  
Intact Limb

BackgroundIndividuals with unilateral lower limb amputation have a high risk of developing knee osteoarthritis (OA) in their intact limb as they age. This risk may be related to joint loading experienced earlier in life. We hypothesized that loading during walking would be greater in the intact limb of young US military service members with limb loss than in controls with no limb loss.MethodsCross-sectional instrumented gait analysis at self-selected walking speeds with a limb loss group (N = 10, age 27 ± 5 years, 170 ± 36 days since last surgery) including five service members with transtibial limb loss and five with transfemoral limb loss, all walking independently with their first prosthesis for approximately two months. Controls (N = 10, age 30 ± 4 years) were service members with no overt demographical risk factors for knee OA. 3D inverse dynamics modeling was performed to calculate joint moments and medial knee joint contact forces (JCF) were calculated using a reduction-based musculoskeletal modeling method and expressed relative to body weight (BW).ResultsPeak JCF and maximum JCF loading rate were significantly greater in limb loss (184% BW, 2,469% BW/s) vs. controls (157% BW, 1,985% BW/s), with large effect sizes. Results were robust to probabilistic perturbations to the knee model parameters.DiscussionAssuming these data are reflective of joint loading experienced in daily life, they support a “mechanical overloading” hypothesis for the risk of developing knee OA in the intact limb of limb loss subjects. Examination of the evolution of gait mechanics, joint loading, and joint health over time, as well as interventions to reduce load or strengthen the ability of the joint to withstand loads, is warranted.

scholarly journals Association of Varus Thrust With Pain and Stiffness and Activities of Daily Living in Patients With Medial Knee Osteoarthritis

2016 ◽  
Vol 96 (2) ◽  
pp. 167-175 ◽  
Author(s):  
Naoto Fukutani ◽  
Hirotaka Iijima ◽  
Takahiko Fukumoto ◽  
Daisuke Uritani ◽  
Eishi Kaneda ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Predictor Variable ◽  
Cross Sectional Study ◽  
Sensitivity Analyses ◽  
Varus Alignment ◽  
Cross Sectional ◽  
Medial Knee ◽  
Knee Oa

Background Increasing evidence highlights potential associations between varus thrust and health domains associated with knee osteoarthritis (OA). Objective The aim of this study was to investigate the association between varus thrust and 2 subcategories—“pain and stiffness” and “activities of daily living (ADL)”—of the Japanese Knee Osteoarthritis Measure (JKOM). Design This was a cross-sectional study. Methods In total, 296 outpatients with knee OA visiting orthopedic clinics were enrolled. The inclusion criteria were age ≥50 years, medial knee OA and Kellgren-Lawrence (K/L) grade ≥1 in one or both knees, and the ability to walk independently. Standard posterior-anterior knee radiographs were measured for varus alignment. Participants were video recorded while walking and were evaluated for the presence or absence of varus thrust. Pain and stiffness of the knee joint and ADL were evaluated using the JKOM. Multivariate regressions (outcomes: pain and stiffness and ADL; predictor variable: varus thrust) were performed. Results Varus thrust was present in 46 (16.2%) of 284 patients. Multivariate regression analyses demonstrated that varus thrust is independently associated with pain and stiffness, adjusted for age, sex, body mass index, K/L grade, and varus alignment (β=.17, P=.005). However, the association between varus thrust and ADL was not significant (β=.11, P=.058). Based on sensitivity analyses, including participants of K/L grade 1 had little influence on this analysis. Limitations Only 16.2% of participants had a varus thrust. Moreover, a cause-effect relationship between varus thrust and pain and stiffness remains unknown due to the cross-sectional design of this study. Conclusions Varus thrust was associated with pain and stiffness in patients with medial knee OA. However, the association between varus thrust and ADL did not reach significance.

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