scholarly journals Varus alignment of the proximal tibia is associated with structural progression in early to moderate varus osteoarthritis of the knee

2020 ◽  
Vol 28 (10) ◽  
pp. 3279-3286 ◽  
Author(s):  
Jonathan S. Palmer ◽  
Luke D. Jones ◽  
A. Paul Monk ◽  
Michael Nevitt ◽  
John Lynch ◽  
...  
Keyword(s):  
Cohort Study ◽  
Lower Limb ◽  
Joint Space Narrowing ◽  
Proximal Tibia ◽  
Joint Space ◽  
Medial Compartment ◽  
Osteoarthritis Of The Knee ◽  
Varus Alignment ◽  
Medial Proximal Tibial Angle ◽  
Structural Progression

Abstract Purpose Lower limb malalignment is a strong predictor of progression in knee osteoarthritis. The purpose of this study is to identify the individual alignment variables that predict progression in early to moderate osteoarthritis of the knee. Method A longitudinal cohort study using data from the Osteoarthritis Initiative. In total, 955 individuals (1329 knees) with early to moderate osteoarthritis (Kellgren-Lawrence grade 1, 2 or 3) were identified. All subjects had full-limb radiographs analysed using the Osteotomy module within Medicad® Classic (Hectec GMBH) to give a series of individual alignment variables relevant to the coronal alignment of the lower limb. Logistic regression models, with generalised estimating equations were used to identify which of these individual alignment variables predict symptom worsening (WOMAC score > 9 points) and or structural progression (joint space narrowing progression in the medial compartment > 0.7mm) over 24 months. Results Individual alignment variable were associated with both valgus and varus alignment (mechanical Lateral Distal Femoral Angle, Medial Proximal Tibial Angle and mechanical Lateral Distal Tibial Angle). Only the Medial Proximal Tibial Angle was significantly associated with structural progression and none of the variables was associated with symptom progression. The odds of joint space narrowing progression in the medial compartment occurring at 24 months increased by 21% for every one degree decrease (more varus) in Medial Proximal Tibial Angle (p < 0.001) Conclusions Our results suggest that the risk of structural progression in the medial compartment is associated with greater varus alignment of the proximal tibia. Level of evidence Level III, retrospective cohort study.

scholarly journals Intra-Articular Pressure in Osteoarthritis of the Knee

2020 ◽  
Author(s):  
kai niu ◽  
le hai Pan
Keyword(s):  
Joint Space Narrowing ◽  
Normal Subjects ◽  
Joint Space ◽  
Positive Pressure ◽  
Osteoarthritis Of The Knee ◽  
Research Subjects ◽  
Pressure Profiles ◽  
Control Knee ◽  
Group 2 ◽  
The Relationship

Abstract Background: IAP （intra-articular pressure）of the knee has been extensively studied in the knee of rheumatoid arthritis1.3 . the relationship between IAP and osteoarthrosis of knee rarely mentioned in the literature. The purpose of the study was to discover the pressure profiles observed in OA(Osteoarthritis ）. The characteristics of osteoarthritis are multiple osteophytes, unstable chondral flaps ,joint-space narrowing，sclerosis. Whether these factors effect of osteoarthritis intra-articular pressure.Methods: Fifty three research subjects were studied. They were divided into two subgroups, group 1: Forty osteoarthritis (OA). group 2: Thirteen control knee of healthy volunteer. IAP was measured using the hand held portable water manometer. before operation of arthroscopic procedures in OAgroup . Research data were analyzed to identify IAP between the two groups. Results: The main findingwasthat Resting IAP was positive pressure in all Osteoarthritis joints, otherwise subatmospheric or weakly atmospheric in normal subjects. Conclusions: The IAP rising is a feature of all patients with OAgroup. Therefore, These observations we recognize that significantly increased resting IAP is major influences by multiple osteophytes, joint-space narrowing，sclerosis , loose bodies and definite deformity of bony ends.

scholarly journals Association of Acute Inflammatory Cytokines, Fracture Malreduction, and Functional Outcome 12 Months After Intra-articular Ankle Fracture – A Prospective Cohort Study of 46 Patients with Ankle Fractures

2020 ◽  
Author(s):  
That Minh Pham
Keyword(s):  
Cohort Study ◽  
Functional Outcome ◽  
Inflammatory Cytokines ◽  
Functional Outcomes ◽  
Joint Space Narrowing ◽  
Weight Bearing ◽  
Joint Space ◽  
X Rays ◽  
Ankle Surgery ◽  
Cytokine Levels

Abstract Background Several malreduction criteria have been proposed for ankle surgery, but the criteria of most importance for functional outcome remain undetermined. Furthermore, the acute inflammatory response in the ankle joint after fracture is hypothesized to result in osteoarthritis development, but no study has investigated the correlation between the levels of these inflammatory cytokines and post-surgical functional outcomes. We aimed to identify malreduction criteria and inflammatory cytokines associated with functional outcome after ankle surgery.MethodsDuring surgery, synovial fluid from the fractured and healthy contralateral ankles of 46 patients was collected for chemiluminescence analysis of 22 inflammatory cytokines and metabolic proteins. The quality of fracture reduction was based on 9 criteria on plain X-rays and 5 criteria on weight-bearing computed tomography (WBCT) scans. After 3 and 12 months, we recorded scores on American Orthopedic Foot and Ankle Society (AOFAS) scale, the Danish version of Foot Function Index (FFI-DK), EQ-5D-5L index score, the Kellgren Lawrence score, and joint space narrowing. ResultsTibiofibular (TF) overlap (p=0.02) and dime sign (p=0.008) correlated with FFI-DK. Tibiotalar tilt correlated positively with joint space narrowing at 3 months (p=0.01) and 12 months (p=0.03). TF widening correlated with FFI-DK (p=0.04), AOFAS (p=0.02), and EQ-5D-5L (p=0.02). No consistent correlations between synovial cytokine levels and functional outcomes were found at 12 months.ConclusionsMalreduction of TF overlap, TF widening, and tibiotalar tilt were the most important criteria for functional outcome after ankle surgery. Increased inflammatory cytokine levels after fracture did not affect functional outcome at 12 months.Trial registration: This cohort study is registered the 10th of December 2018 at ClinicalTrials.gov (NCT03769909, https://clinicaltrials.gov/ct2/show/NCT03769909), was approved by the local committee on health ethics (The Regional Committees on Health Research Ethics for Southern Denmark: J.No. S-20170139), and was reported to the National Danish Data Protection Agency (17/28505).

scholarly journals Relationship between arthroscopic evidence of cartilage damage and radiographic evidence of joint space narrowing in early osteoarthritis of the knee

1991 ◽  
Vol 34 (4) ◽  
pp. 377-382 ◽  
Author(s):  
Rose S. Fife ◽  
Kenneth D. Brandt ◽  
Ethan M. Braunstein ◽  
Barry P. Katz ◽  
K. Donald Shelbourne ◽  
...  
Keyword(s):  
Joint Space Narrowing ◽  
Cartilage Damage ◽  
Joint Space ◽  
Osteoarthritis Of The Knee ◽  
Early Osteoarthritis ◽  
Radiographic Evidence

scholarly journals Association of acute inflammatory cytokines, fracture malreduction, and functional outcome 12 months after intra-articular ankle fracture—a prospective cohort study of 46 patients with ankle fractures

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
That Minh Pham ◽  
Emil Bjoertomt Kristiansen ◽  
Lars Henrik Frich ◽  
Kate Lykke Lambertsen ◽  
Søren Overgaard ◽  
...  
Keyword(s):  
Cohort Study ◽  
Functional Outcome ◽  
Inflammatory Cytokines ◽  
Functional Outcomes ◽  
Joint Space Narrowing ◽  
Joint Space ◽  
X Rays ◽  
Link Type ◽  
Ankle Surgery ◽  
Cytokine Levels

Abstract Background Several malreduction criteria have been proposed for ankle surgery, but the criteria of most importance for functional outcome remain undetermined. Furthermore, the acute inflammatory response in the ankle joint after fracture is hypothesized to result in osteoarthritis development, but no study has investigated the correlation between the levels of these inflammatory cytokines and post-surgical functional outcomes. We aimed to identify malreduction criteria and inflammatory cytokines associated with functional outcome after ankle surgery. Methods During surgery, synovial fluid from the fractured and healthy contralateral ankles of 46 patients was collected for chemiluminescence analysis of 22 inflammatory cytokines and metabolic proteins. The quality of fracture reduction was based on 9 criteria on plain X-rays and 5 criteria on weight-bearing computed tomography (WBCT) scans. After 3 and 12 months, we recorded scores on American Orthopedic Foot and Ankle Society (AOFAS) scale, the Danish version of Foot Function Index (FFI-DK), EQ-5D-5L index score, the Kellgren-Lawrence score, and joint space narrowing. Results Tibiofibular (TF) overlap (p = 0.02) and dime sign (p = 0.008) correlated with FFI-DK. Tibiotalar tilt correlated positively with joint space narrowing at 3 months (p = 0.01) and 12 months (p = 0.03). TF widening correlated with FFI-DK (p = 0.04), AOFAS (p = 0.02), and EQ-5D-5L (p = 0.02). No consistent correlations between synovial cytokine levels and functional outcomes were found at 12 months. Conclusions Malreduction of TF overlap, TF widening, and tibiotalar tilt were the most important criteria for functional outcome after ankle surgery. Increased inflammatory cytokine levels after fracture did not affect functional outcome at 12 months. Trial registration This cohort study is registered the 10th of December 2018 at ClinicalTrials.gov (NCT03769909), was approved by the local committee on health ethics (The Regional Committees on Health Research Ethics for Southern Denmark: J.No. S-20170139), and was reported to the National Danish Data Protection Agency (17/28505).

Reduction of Medial Compartment Loads with Valgus Bracing of the Osteoarthritic Knee

2002 ◽  
Vol 30 (3) ◽  
pp. 414-421 ◽  
Author(s):  
Fabian E. Pollo ◽  
James C. Otis ◽  
Sherry I. Backus ◽  
Russell F. Warren ◽  
Thomas L. Wickiewicz
Keyword(s):  
Cohort Study ◽  
Pain Relief ◽  
Three Dimensional ◽  
Compressive Load ◽  
Activity Level ◽  
Medial Compartment ◽  
Osteoarthritis Of The Knee ◽  
Activity Levels ◽  
Medial Compartment Osteoarthritis ◽  
Valgus Alignment

Background Patients with medial compartment osteoarthritis of the knee may be treated nonoperatively with adjustable valgus bracing. Hypothesis Valgus bracing reduces load on the medial compartment through the application of an external valgus moment about the knee, resulting in pain relief. Study Design Prospective cohort study. Methods Eleven patients were tested using an instrumented brace and three-dimensional gait analysis. We measured the valgus moment applied by the adjustable valgus brace and determined the compressive load in the medial compartment. We also documented the effects of increased valgus alignment of the brace and increased strap tension on load sharing. Pain and activity levels were also recorded. Results Pain and activity level improved in all subjects with valgus bracing. During gait, valgus bracing reduced the net varus moment about the knee by an average of 13% (7.1 N•m) and the medial compartment load at the knee by an average of 11% (114 N) in the calibrated 4° valgus brace setting. Increasing valgus alignment with the adjustable brace had a greater effect on the medial compartment load than did increasing strap tension. Conclusion Adjustable valgus bracing was effective in reducing medial compartment load and subsequent pain while also improving knee function in a group of patients with osteoarthritis.

scholarly journals Do MRI features at baseline predict radiographic joint space narrowing in the medial compartment of the osteoarthritic knee 2 years later?

2008 ◽  
Vol 37 (9) ◽  
pp. 805-811 ◽  
Author(s):  
Ruby Madan-Sharma ◽  
Margreet Kloppenburg ◽  
Peter R. Kornaat ◽  
Stella A. Botha-Scheepers ◽  
Marie-Pierre Hellio Le Graverand ◽  
...  
Keyword(s):  
Joint Space Narrowing ◽  
Joint Space ◽  
Medial Compartment ◽  
Osteoarthritic Knee ◽  
Mri Features
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