Patellofemoral Alignment and Anterior Knee Pain After Closing- and Opening-Wedge Valgus High Tibial Osteotomy

2012 ◽  
Vol 28 (8) ◽  
pp. 1087-1093 ◽  
Author(s):  
Il-Hyeon Song ◽  
Eun-Kyoo Song ◽  
Hyoung-Yeon Seo ◽  
Keun-Bae Lee ◽  
Ji-Hyeon Yim ◽  
...  
Keyword(s):  
High Tibial Osteotomy ◽  
Knee Pain ◽  
Anterior Knee Pain ◽  
Tibial Osteotomy ◽  
Opening Wedge ◽  
Patellofemoral Alignment ◽  
Anterior Knee

scholarly journals Does arthroscopic patellar denervation with high tibial osteotomy improve anterior knee pain?

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Mohamed Kamel Mohamed Said ◽  
Hatem G. Said ◽  
Hesham Elkady ◽  
Mahmoud Kamel Mohamed Said ◽  
Islam Karam-Allah Ramadan ◽  
...  
Keyword(s):  
High Tibial Osteotomy ◽  
Knee Pain ◽  
Anterior Knee Pain ◽  
Tibial Osteotomy ◽  
Level Of Evidence ◽  
Kujala Score ◽  
Group A ◽  
Level I ◽  
Group B ◽  
Anterior Knee

Abstract Purpose Patellofemoral (PF) joint osteoarthritis (OA) is a major cause of anterior knee pain. Combined PF and medial tibiofemoral (TF) OA is common in older adults. We evaluated the effect of arthroscopic patellar denervation (PD) in patients with combined TF and PFOA after malalignment correction. Methods Forty-five patients [females/males, 27/18; age, 30–59 years (45.5 ± 8.50); mean body mass index, 25.15 ± 3.04 kg/m2] were treated in our department from March 2017 to March 2019. The patients were randomised into 2 groups: group A included 22 patients who underwent open-wedge high tibial osteotomy (OWHTO) and arthroscopic PD and group B included 23 patients who underwent OWHTO without denervation. The effect of denervation was statistically and clinically evaluated using the Knee injury and Osteoarthritis Outcome Score (KOOS) and Kujala (anterior knee pain score) score. Results After 24 months, 40 patients were available for the final follow-up. The final values of KOOS and the Kujala score were significantly different between the groups (p < 0.001). For group A, the average KOOS improved from 42.73 to 72.38 (p < 0.001) and the Kujala score improved from 42 to 74.1 (p < 0.001), whereas in group B, the average KOOS improved from 39.22 to 56.84 (p < 0.001) and the Kujala score improved from 39.7 to 56.4 (p < 0.001). Conclusion Adding arthroscopic PD to OWHTO relieves anterior knee pain in patients with combined TF and PFOA and improves knee joint function and quality of life. Level of evidence Level I prospective randomised control clinical trial.

Lower extremity rotational deformities and patellofemoral alignment parameters in patients with anterior knee pain

2015 ◽  
Vol 24 (9) ◽  
pp. 3011-3020 ◽  
Author(s):  
Omer Faruk Erkocak ◽  
Egemen Altan ◽  
Murat Altintas ◽  
Faik Turkmen ◽  
Bahattin Kerem Aydin ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Knee Pain ◽  
Anterior Knee Pain ◽  
Patellofemoral Alignment ◽  
Anterior Knee

Rotational Changes in the Tibia After High Tibial Valgus Osteotomy: A Comparative Study of Lateral Closing Versus Medial Opening Wedge Osteotomy

2020 ◽  
Vol 48 (14) ◽  
pp. 3549-3556
Author(s):  
Joong Il Kim ◽  
Bo Hyun Kim ◽  
Hyuk Soo Han ◽  
Myung Chul Lee
Keyword(s):  
Knee Pain ◽  
Anterior Knee Pain ◽  
External Rotation ◽  
Proximal Fragment ◽  
Tibial Torsion ◽  
Opening Wedge ◽  
High Tibial Valgus Osteotomy ◽  
Tibial Valgus ◽  
Anterior Knee

Background: After high tibial valgus osteotomy (HTO), rotational changes in the tibia may occur, which can affect the biomechanics of the patellofemoral joint and may lead to anterior knee pain. Purpose: To compare the rotational changes in the tibia between closing wedge HTO (CWHTO) and opening wedge HTO (OWHTO). Study Design: Cohort study; Level of evidence, 3. Methods: Among the patients who underwent HTO between May 2012 and August 2015, 53 (28 CWHTO and 25 OWHTO) who had computed tomography scans before and at 1 year after the HTO were included. The following parameters were compared between CWHTO and OWHTO: (1) tibial torsion angle, (2) knee rotation angle, and (3) tibial tuberosity–trochlear groove (TT-TG) distance. During the last follow-up, patients were asked to rate their anterior knee pain when climbing the stairs, using the visual analog scale. Results: The tibial torsion angle significantly decreased (internal rotation of the distal fragment) after CWHTO (mean ± SD, –2.1°± 4.1°; P = .019) and OWHTO (–1.8°± 3.3°; P = .029). The knee rotation angle significantly decreased (external rotation of the proximal fragment) after OWHTO (–1.8°± 3.4°; P = .039) but was not changed after CWHTO (0.1°± 3.1°; P = .859). The mean TT-TG distance significantly decreased after CWHTO (–3.1 ± 3.0 mm; P < .001) but increased after OWHTO (2.0 ± 4.3 mm; P = .012). At the final follow-up (minimum, 4 years), the visual analog scale pain score during stair climbing was significantly higher after OWHTO than after CWHTO (3.1 ± 1.4 vs 2.2 ± 1.3, P = .024). Conclusion: Internal rotation of the distal fragment occurred after both CWHTO and OWHTO. However, external rotation of the proximal fragment and increased TT-TG distance occurred after OWHTO. Because such rotational changes could affect anterior knee pain, further studies are warranted to investigate the definite relationship between tibial rotational changes and anterior knee pain after HTO.

120 Genicular Nerve Radio-Frequency Ablation in The Treatment of Anterior Knee Pain in Patients with Osteoarthritis of The Knee Joint: Systematic Review

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
M Farrugia ◽  
C Tinning
Keyword(s):  
Knee Pain ◽  
Anterior Knee Pain ◽  
Comparative Studies ◽  
Primary Outcome ◽  
Final Analysis ◽  
Primary Outcome Measure ◽  
Sensory Innervation ◽  
Osteoarthritis Of The Knee ◽  
Pain Scores ◽  
Anterior Knee

Abstract Anterior knee pain is one of the main symptoms in osteoarthritis, resulting from the rich sensory innervation of its capsule. Pain control can be difficult to achieve, with non-responders to conservative and medical therapy often requiring a total knee replacement. Radiofrequency ablation (RFA) is a novel technique that could be beneficial in managing anterior knee pain by targeting the genicular nerves around the knee; however, its routine use is not included in current guidelines. A literature search identified fifty-two results, which underwent screening using a study protocol and the final literature sources, of varying levels of evidence, underwent critical appraisal and analysis. The primary outcome included the significant improvement of pain scores from baseline, against their respective control treatments. The ten studies included in the final analysis consisted of seven comparative studies and three non-comparative studies. Literature showed significant improvement in their mean pain scores, all meeting the primary outcome measure. Most studies also showed significant improvement from the control treatments used. Current literature shows evidence that genicular nerve RFA is an effective and safe treatment modality in the management of anterior knee pain secondary to osteoarthritis. However, the literature available is limited and further comparative studies are required.

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