Surgical Epicondylar Axis of the Knee and Its Relationship to the Axial Tibia Alignment in Knee Osteoarthritis: The Concept of Proximal Twist Tibia

2021 ◽  
Author(s):  
Luca Farinelli ◽  
Marco Baldini ◽  
Andrea Faragalli ◽  
Flavia Carle ◽  
Serena Ulisse ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Proximal Tibia ◽  
Area Under The Curve ◽  
Control Group ◽  
Trochlear Groove ◽  
Tibial Torsion ◽  
Knee Oa ◽  
Epicondylar Axis ◽  
Tibial Condyle ◽  
Posterior Condylar

AbstractThe proximal tibia and distal femur are intimately linked with the biomechanics of the knee and they are to be considered in total knee arthroplasty (TKA). The aim of the present study was to evaluate the proximal tibial torsion (PTT) in relation to surgical epicondylar axis (SEA) in a healthy cohort and a pathological cohort affected by knee osteoarthritis (OA). We retrospectively analyzed computed tomography of OA knee of 59 patients before they underwent TKA and nonarthritic knee of 39 patients as control. Posterior condylar angle (PCAn), femoral tibial torsion (SEA-proximal tibial condyle [PTC] and SEA-PTT), PTT (PTC-PTT and posterior condylar axes [PCAx]-PTC), and distance between tibial tuberosity and the trochlear groove (TT-TG) were measured. No differences were found for gender, age, TT-TG, and PCAn angles. Statistically significant differences were found for all the other angles considered. Significant correlation was found between tibial torsion and SEA-PTT angles, between PCAx-PTC and SEA-PTC, between SEA-PTT and SEA-PTC, and between PCAx-PTC and SEA-PTT. All measures, except TT-TG and PCAn angles, showed high validity (area under the curve [AUC] > 75%) in associating with OA, with SEA-PTT displaying the highest validity with an AUC of 94.38%. This is the first study to find significant differences in terms of proximal tibia geometry and anatomy between nonarthritic and OA knees. From our results, we reported that OA group was characterized by a greater internal rotation of tibia with respect to SEAs compared with control group. Since the design of the study cannot evaluate a cause–effect relationship, further studies need to be performed to assess the potential implications of these anatomic differences for knee OA and arthroplasty surgeries.

scholarly journals A Positive Association Between Foot Posture Index and Medial Compartment Knee Osteoarthritis in Moroccan People

2014 ◽  
Vol 8 (1) ◽  
pp. 96-99 ◽  
Author(s):  
Abourazzak F.E ◽  
Kadi N ◽  
Azzouzi H ◽  
Lazrak F ◽  
Najdi A ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Medial Compartment ◽  
Control Group ◽  
Flat Foot ◽  
Pes Cavus ◽  
Foot Posture Index ◽  
Posture Index ◽  
Knee Oa ◽  
Significant Difference ◽  
Foot Posture

Objectives : To compare foot posture in people with and without medial compartment knee osteoarthritis (OA), and to assess association between its abnormalities and medial compartment knee OA. Methods : We compared the foot posture of patients with clinically and radiographically-confirmed medial compartment knee OA and asymptomatic healthy controls using the foot posture index (FPI), navicular height, and the medial arch. Results : We included 100 patients and 80 asymptomatic controls. The mean age of patients was 59 ± 7 (44-76) years and 48 ± 9 (28-60) years in the control (p=0.06). Patients group have more pronated foot for FPI (1.50 ± 2.68 vs 0.72 ± 2.63; p=0.05), more flat foot (42% vs 22%; p=0.03), and less pes cavus than the control group (58% vs 77%; p=0.004). However, there was no significant difference between the groups in the navicular height (3.90 ± 0.85 cm vs 4.00 ± 0.76 cm; p=0.41). In multivariate statistical analysis, after adjusting for age and body mass index, pronated foot in FPI (OR=1.22, 95%IC= [1.06-1.40], p=0.005), and pes cavus (OR=0.32, 95%IC= [0.11-0.93], p=0.03) had a significant correlation with the knee osteoarthritis. Conclusion : Pronated foot posture and flat foot are significantly associated with medial compartment knee osteoarthritis.

KNEE FLEXION EXTENSION AND STRENGTHENING (FELS) EXERCISE TO PAIN INTENSITY IN KNEE OSTEOARTHRITIS PATIENTS

2018 ◽  
Vol 2 (2) ◽  
pp. 274
Author(s):  
Marthalena Simamora ◽  
Galvani Volta Simanjuntak ◽  
Henny Syapitri
Keyword(s):  
Knee Osteoarthritis ◽  
Pain Intensity ◽  
Intervention Group ◽  
Control Group ◽  
Knee Oa ◽  
Randomized Design ◽  
Strengthening Exercise ◽  
Flexion Extension ◽  
Before And After ◽  
Quasi Experimental

Introduction. Osteoarthritis (OA) is a degenerative disease due to the thinning of the joint cartilage, mostly in the knee joint (89.91%) with the pain manifestation. If the pain is not managed, it could lead to the limitation of movement and disruption of daily activities. Having physical exercise regularly could reduce pain. The purpose of study was to determine the effect of knee fl exion extension and strengthening (FELS) exercise in reducing pain intensity. Methods. This was a quasi-experimental study with pretest-posttest control randomized design, where 70 respondents were recruited and consisted of 53 in intervention and 17 in control group. Result. The statistical analysis used ordinal regression revealed (1) FELS exercise was effective in reducing pain intensity (p = 0.013); (2) a signifi cant difference in pain intensity before and after FELS exercise (p = 0.000); (3) a signifi cant difference of pain intensity in the intervention group compared to the control group (p = 0.004); (4) effect of other activities in reducing pain intensity (p = 0.042). While the factors of age, gender, pain experience, anxiety and support system were not signifi cantly effective in reducing pain. Discussion. FELS exercise was helpful in reducing pain intensity in patients with knee osteoarthritis. It was then suggested to OA patients are requested to perform regular FELS exercise while the families are keep on giving support to the patient to do FELS exercise.Keywords: Knee fl exion extension, strengthening exercise, pain intensity, knee OA

Changes in postural control strategy during quiet standing in individuals with knee osteoarthritis

2021 ◽  
pp. 1-8
Author(s):  
Kento Sabashi ◽  
Satoshi Kasahara ◽  
Harukazu Tohyama ◽  
Takeshi Chiba ◽  
Yuta Koshino ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Angular Velocity ◽  
Postural Control ◽  
Knee Osteoarthritis ◽  
Lower Limb ◽  
Center Of Mass ◽  
Three Dimensional ◽  
Quiet Standing ◽  
Control Group ◽  
Knee Oa

BACKGROUND: Knee osteoarthritis (OA) impairs postural control and may be affected by how the lower limb joints are used. OBJECTIVE: To investigate how individuals with knee OA use lower limb joints for static postural control. METHODS: Ten patients with knee OA and thirteen healthy controls performed quiet standing for 30 s. The standard deviation of the center of mass (COM) and lower limb joint motions in the anterior-posterior (AP) and medial-lateral (ML) planes were calculated from three-dimensional marker trajectories. Pearson’s correlation analysis and independent t-tests were conducted to investigate the relationship between COM and lower limb joint motion and to compare group difference, respectively. RESULTS: The AP hip angular velocity alone in the knee OA group and the AP hip and knee angular velocity in the control group were significantly correlated with the AP COM velocity. The ML hip angular velocity was significantly correlated with the ML COM velocity in both groups. The knee OA group exhibited a significantly larger standard deviation of AP COM velocity than the control group. CONCLUSIONS: Individuals with knee OA depended solely on the contribution of the hip to the AP COM velocity, which could not be successfully controlled by the knee.

Fraxin prevents knee osteoarthritis through inhibiting chondrocyte apoptosis in an experimental rat osteoarthritis model

2021 ◽  
Vol 28 ◽  
Author(s):  
Zhigang Qian ◽  
Xuanliang Ru ◽  
Chun Liu ◽  
Xiaoqin Huang ◽  
Qicai Sun
Keyword(s):  
Knee Osteoarthritis ◽  
Histological Analysis ◽  
Cartilage Damage ◽  
Chondrocyte Apoptosis ◽  
Control Group ◽  
Potential Candidate ◽  
New Approach ◽  
Knee Oa ◽  
Protein Levels ◽  
Blue Stain

Background: Current treatments of osteoarthritis are unsatisfied, a new approach towards the treatment of osteoarthritis is urged considering the state at present. Objectives: The objective of this study is to investigate the effect of fraxin on knee OA in a rat model and probe into the possible molecular mechanism. Methods: Primary Murine Chondrocytes were isolated and cell apoptosis analyses were performed. Rat OA models were established using meniscectomy method and allocated into three groups. Knee joint specimens were collected for qRT-PCR, western blotting and histological analysis. Statistical analyses were processed by using a SPSS. Results: The apoptosis rate of fraxin group is significantly reduced compared with the OA group or the control group. Fraxin remarkably down-regulated the expression of cleaved-Caspase-3 while significantly up-regulated the expression of Bcl-2, both on mRNA and protein levels. Toluidine blue stain results show relatively lighter articular cartilage damage compared with OA group. Conclusion: Fraxin prevents knee osteoarthritis by inhibiting chondrocyte apoptosis, which makes it a potential candidate as an anti-OA drug for clinical use.

scholarly journals Investigation of Clinical Effects of High- and Low-Resistance Training for Patients With Knee Osteoarthritis: A Randomized Controlled Trial

2008 ◽  
Vol 88 (4) ◽  
pp. 427-436 ◽  
Author(s):  
Mei-Hwa Jan ◽  
Jiu-Jeng Lin ◽  
Jiann-Jong Liau ◽  
Yeong-Fwu Lin ◽  
Da-Hon Lin
Keyword(s):  
Knee Osteoarthritis ◽  
Resistance Exercise ◽  
Strength Training ◽  
High Resistance ◽  
Elderly Subjects ◽  
Control Group ◽  
Clinical Effects ◽  
Low Resistance ◽  
Knee Oa ◽  
Significant Difference

Background and PurposeMuscle strength training is important for people with knee osteoarthritis (OA). High-resistance exercise has been demonstrated to be more beneficial than low-resistance exercise for young subjects. The purpose of this study was to compare the effects of high- and low-resistance strength training in elderly subjects with knee OA.Subjects and MethodsOne hundred two subjects were randomly assigned to groups that received 8 weeks of high-resistance exercise (HR group), 8 weeks of low-resistance exercise (LR group), or no exercise (control group). Pain, function, walking time, and muscle torque were examined before and after intervention.ResultsSignificant improvement for all measures was observed in both exercise groups. There was no significant difference in any measures between HR and LR groups. However, based on effect size between exercise and control groups, the HR group improved more than the LR group.Discussion and ConclusionBoth high- and low-resistance strength training significantly improved clinical effects in this study. The effects of high-resistance strength training appear to be larger than those of low-resistance strength training for people with mild to moderate knee OA, although the differences between the HR and LR groups were not statistically significant.

scholarly journals Evaluating the efficacy of Internet-Based Exercise programme Aimed at Treating knee Osteoarthritis (iBEAT-OA) in the community: a study protocol for a randomised controlled trial

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e030564
Author(s):  
Sameer Akram Gohir ◽  
Paul Greenhaff ◽  
Abhishek Abhishek ◽  
Ana M. Valdes
Keyword(s):  
Randomised Controlled Trial ◽  
Knee Osteoarthritis ◽  
Rating Scale ◽  
Controlled Trial ◽  
Maximum Voluntary Contraction ◽  
Intervention Group ◽  
Exercise Programme ◽  
Control Group ◽  
Knee Oa ◽  
Randomised Controlled

IntroductionKnee osteoarthritis (OA) is the most common joint disease worldwide. As of today, there are no disease-modifying drugs, but there is evidence that muscle strengthening exercises can substantially reduce pain and improve function in this disorder, and one very well tested physiotherapy protocol is the ‘Better Management of Patients with Osteoarthritis’ developed in Sweden. Given the high prevalence of knee OA, a potentially cost-effective, digitally delivered approach to treat knee OA should be trialled. This study aims to explore the benefits of iBEAT-OA (Internet-Based Exercise programme Aimed at Treating knee Osteoarthritis) in modulating pain, function and other health-related outcomes in individuals with knee OA.Methods and analysisA randomised controlled trial was designed to evaluate the efficacy of a web-based exercise programme in a population with knee OA compared with standard community care provided by general practitioners (GPs) in the UK. We anticipate recruiting participants into equal groups. The intervention group (n=67) will exercise for 20–30 min daily for six consecutive weeks, whereas the control group (n=67) will follow GP-recommended routine care. The participants will be assessed using a Numerical Rating Scale, the Western Ontario and McMaster Universities Osteoarthritis Index, the Arthritis Research UK Musculoskeletal Health Questionnaire, the Pittsburgh Sleep Quality Index, 30 s sit to stand test, timed up and go test, quantitative sensory testing, musculoskeletal ultrasound scan, muscle thickness assessment of the vastus lateralis, and quadriceps muscles force generation during an isokinetic maximum voluntary contraction (MVC). Samples of urine, blood, faeces and synovial fluid will be collected to establish biomarkers associated with changes in pain and sleep patterns in individuals affected with knee OA. Standard parametric regression methods will be used for statistical analysis.Ethics and disseminationEthical approval was obtained from the Research Ethics Committee (ref: 18/EM/0154) and the Health Research Authority (protocol no: 18021). The study was registered in June 2018. The results of the trial will be submitted for publication in a peer-reviewed journal.Trial registration numberNCT03545048

scholarly journals Lower extremity venous diseases in primary knee osteoarthritis

2017 ◽  
Vol 89 (5) ◽  
pp. 53-59 ◽  
Author(s):  
O M Lesnyak ◽  
E V Zubareva ◽  
M G Goncharova ◽  
D M Maksimov
Keyword(s):  
Lower Extremity ◽  
Knee Osteoarthritis ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Group Versus ◽  
Duplex Scanning ◽  
Control Group ◽  
Old Patients ◽  
Knee Oa ◽  
Venous Diseases

Aim. To establish a possible association between knee osteoarthritis (OA) and lower extremity venous diseases ((LEVDs) on the basis of thorough clinical and instrumental studies. Subjects and methods. A case-control study recruiting 40-60-year-old women was conducted. A study group included 85 women with knee OA; a control group consisted of 50 women without this condition. The patients of both groups underwent assessment of complaints and goal-directed objective examination to identify joint diseases and chronic LEVDs, knee X-ray study, and duplex scanning of the lower extremity veins. Results. The patients with knee OA were more frequently diagnosed with lower extremity varicose vein disease (VVD) (43% vs 22%; p=0.015) and had signs of chronic venous insufficiency (28% vs 12%; p=0.03). Duplex scanning of the lower extremities showed that knee OA was characterized by generalized LEVD (bilateral valve lesions of the great and small saphenous veins and severe valvular incompetence in the veins) that was detected in 53% of the patients in this group versus 20% of the women in the control group (p = 0.0004). After adjustment for body mass index, the differences in the incidence of VVD between the groups remained clinically and statistically significant (odds ratio (OR), 2.7; 95% confidence interval, 1.1—6.7; p=0.036). Conclusion. The 40—60-year-old patients with knee OA more commonly develop symptoms of chronic venous insufficiency than their healthy peers. Although obesity is a risk factor for both diseases, there is an independent association between knee OA and lower extremity VVD.

scholarly journals Tibial Condyle Valgus Osteotomy for Ipsilateral Knee Osteoarthritis after Hip Arthrodesis

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Daisuke Fukuhara ◽  
Hiroaki Inoue ◽  
Shuji Nakagawa ◽  
Yuji Arai ◽  
Kenji Takahashi
Keyword(s):  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Mechanical Load ◽  
Weight Bearing ◽  
Valgus Osteotomy ◽  
Hip Arthrodesis ◽  
Knee Oa ◽  
Early Loosening ◽  
Tibial Condyle ◽  
End Stage

We report a case of tibial condylar valgus osteotomy (TCVO) for ipsilateral knee osteoarthritis (OA) after hip arthrodesis. A 58-year-old woman developed right purulent hip arthritis at one month of age and underwent right hip fusion at 16 years old. She visited our department at the age of 57 because her right knee joint pain worsened. The range of motion for her right knee was 80° and -5° of flexion and extension, respectively, and she experienced medial weight-bearing pain. A plain X-ray image showed that the right knee joint had end-stage knee OA with a bone defect inside the tibia, and the tibial plateau shape was the pagoda type. There was a marked instability in her right knee with a valgus of 9° and varus of 7° on stress photography. She underwent TCVO on her right knee and was allowed full load four weeks after surgery. Computed tomography imaging showed bone union nine months after surgery. Two years after the operation, there was no correction loss, and she could walk independently without pain. In general, total knee arthroplasty (TKA) is indicated for end-stage knee OA; however, there are problems, such as early loosening due to the increased mechanical load on the knee after hip OA. In this case, since a good course was obtained, TCVO is considered a treatment option for terminal knee OA after hip arthrodesis.

scholarly journals Effect of the Herbal Drug Guilu Erxian Jiao on Muscle Strength, Articular Pain, and Disability in Elderly Men with Knee Osteoarthritis

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Chen-Chen Tsai ◽  
Yin-Yi Chou ◽  
Yi-Ming Chen ◽  
Yih-Jing Tang ◽  
Hui-Ching Ho ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Knee Osteoarthritis ◽  
Treated Group ◽  
Lower Limbs ◽  
Control Group ◽  
Herbal Drug ◽  
Elderly Men ◽  
Knee Oa ◽  
Lequesne Index ◽  
Articular Pain

Background. Guilu Erxian Jiao (GEJ) is a widely used Chinese herbal remedy for knee osteoarthritis, but its clinical efficacy is unknown.Methods. We enrolled 42 elderly male patients with knee OA, including 21 patients who received the herbal drug GEJ as the case group and 21 patients who did not receive GEJ as the control group. The effects of 12 weeks of GEJ treatment on muscle strength of lower limbs were measured by a Biodex dynamometer, with disability evaluated on the Lequesne index and articular pain measured on the visual analog scale (VAS) between the two groups on the baseline and after treatment.Results. There were significant increases in the levels of muscle strength of TQ/BW-ext-dominant and TQ/BW-flex-dominant between the two groups after treatment (P<0.05). There were also significant increases in muscle strength of knee extensor muscles in the GEJ-treated group (n=21) self-controlled before and after 12 weeks of treatment (allP<0.01). There were significant decreases in articular pain (P<0.01) and Lequesne index scores (P<0.01) in the GEJ-treated group when compared to the non-GEJ-treated group.Conclusions. Our results showed that GEJ is effective and is tolerated well in elderly men with knee OA.

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