scholarly journals Sonographic evaluation of the degree of medial meniscal extrusion during Thessaly test in healthy knees

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
John C. Cho ◽  
Lauren Tollefson ◽  
Kenneth Reckelhoff
Keyword(s):  
Knee Flexion ◽  
Medial Meniscus ◽  
Meniscus Tear ◽  
Data Sets ◽  
Meniscal Extrusion ◽  
Collateral Ligament ◽  
Convenience Sample ◽  
Knee Position ◽  
The Mean ◽  
The Difference

Abstract Objective The Thessaly test is a commonly used orthopedic test for meniscus tear evaluation. The study’s objective is to evaluate the degree of medial meniscal extrusion during different loading phases of the Thessaly test. Methods A convenience sample of 60 healthy knees (35 participants) was examined and the data sets were collected from October 8, 2018 through February 8, 2019. Sonographic measurement of the degree of physiologic extrusion of the medial meniscus deep to the medial collateral ligament was taken by two examiners at six different loading phases: supine, standing, 5° knee-flexion with internal (IR)/external (ER) rotation and 20° knee-flexion with IR/ER. The difference in meniscal extrusion by knee position was compared with ANOVA. Interexaminer reproducibility assessment was analyzed using limits of agreement. Results The mean meniscal extrusion for each position was—supine: 2.3 ± 0.5 mm, standing: 2.8 ± 0.8 mm, 5° IR: 2.3 ± 0.9 mm, 5° ER: 2.4 ± 0.7 mm, 20° IR: 1.9 ± 0.8 mm, and 20° ER: 2.3 ± 0.7 mm. Significant increase in extrusion was observed from supine to standing (p < 0.05) and from 20° IR to 20° ER (p = 0.015). Significant decreased measurement was observed from standing to 5° IR (p < 0.05), 5° ER (p < 0.05), 20° IR (p < 0.05) and 20° ER (p < 0.05). There is no significant change between 5° IR and 5° ER (p = 1.0). Agreement parameters revealed that the differences between examiner measurements were minimal; 75% of both examiners’ meniscal extrusion measurements were within 1.0 mm with 97% of measurements falling within 2.0 mm. Conclusion Our study’s novel findings showed various degrees of physiological extrusion of the medial meniscus in asymptomatic knees during the loading phases involved in the Thessaly test. Physiological MME does exist and should not be defaulted to pathologic meniscus as previously described. Agreement parameters suggest that measurement of meniscal extrusion during the Thessaly test is reproducible between different examiners.

scholarly journals Sonographic Evaluation of the Degree of Medial Meniscal Extrusion During Thessaly Test in Healthy Knees

2021 ◽  
Author(s):  
Chin-Suk Cho ◽  
Lauren Tollefson ◽  
Kenneth Reckelhoff
Keyword(s):  
Knee Flexion ◽  
Interrater Reliability ◽  
Medial Meniscus ◽  
Intraclass Correlation ◽  
Meniscus Tear ◽  
Meniscal Extrusion ◽  
Dynamic Changes ◽  
Convenience Sample ◽  
Knee Position ◽  
The Difference

Abstract ObjectiveThe Thessaly test is a commonly used orthopedic test for meniscus tear evaluation. The study’s objective is to evaluate the degree of medial meniscal extrusion during different loading phases of the Thessaly test. MethodsA convenience sample of 60 healthy knees (35 participants) was examined. Sonographic measurement of the degree of physiologic extrusion of the medial meniscus deep to the medial collateral ligament was taken by two examiners at six different loading phases: supine, standing, 5° knee-flexion with internal (IR)/external (ER) rotation and 20° knee-flexion with IR/ER. The difference in meniscal extrusion by knee position was compared with ANOVA. Interrater reliability assessment was analyzed using intraclass correlation coefficient. ResultsThe mean meniscal extrusion for each position was - supine: 2.3±0.5mm, standing: 2.8±0.8mm, 5° IR: 2.3±0.9mm, 5° ER: 2.4±0.7mm, 20° IR: 1.9±0.8mm, and 20° ER: 2.3±0.7mm. Significant increase in extrusion was observed from supine to standing (p<0.05) and from 20° IR to 20° ER (p=0.015). Significant decreased measurement was observed from standing to 5° IR (p<0.05), 5° ER (p<0.05), 20° IR (p<0.05) and 20° ER (p<0.05). There is no significant change between 5° IR and 5° ER (p=1.0). Interrater reliability of the measurements across the six positions was poor to moderate (0.35-0.57, p<0.05). ConclusionOur study’s novel findings showed clear dynamic changes during Thessaly test, which implies increase in compressive stress across the medial meniscus and a potential mechanism for pain generation during this test. Further testing is needed to address the poor-moderate reliability and confirm findings.

POSTPARTUM AMENORRHOEA IN RURAL EASTERN UTTAR PRADESH, INDIA

1998 ◽  
Vol 30 (2) ◽  
pp. 227-243
Author(s):  
K. N. S. YADAVA ◽  
S. K. JAIN
Keyword(s):  
Higher Education ◽  
Uttar Pradesh ◽  
Current Status Data ◽  
North India ◽  
Current Status ◽  
Data Sets ◽  
Survival Status ◽  
The Mean ◽  
The Difference ◽  
Using Data

This paper calculates the mean duration of the postpartum amenorrhoea (PPA) and examines its demographic, and socioeconomic correlates in rural north India, using data collected through 'retrospective' (last but one child) as well as 'current status' (last child) reporting of the duration of PPA.The mean duration of PPA was higher in the current status than in the retrospective data;n the difference being statistically significant. However, for the same mothers who gave PPA information in both the data sets, the difference in mean duration of PPA was not statistically significant. The correlates were identical in both the data sets. The current status data were more complete in terms of the coverage, and perhaps less distorted by reporting errors caused by recall lapse.A positive relationship of the mean duration of PPA was found with longer breast-feeding, higher parity and age of mother at the birth of the child, and the survival status of the child. An inverse relationship was found with higher education of a woman, higher education of her husband and higher socioeconomic status of her household, these variables possibly acting as proxies for women's better nutritional status.

scholarly journals Association of 12-Month Contraceptive Supply Policy and Months of Oral Contraception Prescribed by Obstetrics and Gynecology Physicians: An Exploratory Cross-Sectional Study

2021 ◽  
Author(s):  
Megan Fuerst ◽  
Kaitlin Schrote ◽  
Bharti Garg ◽  
Maria Rodriguez
Keyword(s):  
The United States ◽  
Cross Sectional Study ◽  
Oral Contraception ◽  
Physician Education ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Supply Policy ◽  
The Mean ◽  
The Difference ◽  
United States Standard

Abstract Objective This study sought to determine if there was a difference in the months of oral contraception prescribed by physicians living in U.S. states with a 12-month supply policy compared to physicians in states without a policy. Methods We conducted an exploratory descriptive study using a convenience sample of Obstetrics & Gynecology resident physicians (n=275) in the United States. Standard bivariate analyses were used to compare the difference between groups. Results Few physicians in both groups (3.8% with a policy and 1.4% without a policy) routinely prescribed a 12-month supply of contraception. The mean coverage prescribed by providers in states with and without a policy was 2.81 and 2.07 months (p<0.05). Conclusions The majority of physicians were unaware of 12-month contraceptive supply policies and unable to correctly write a prescription for 12-months of contraception, regardless of whether they lived in a state with a 12-month contraceptive supply policy. Physician education may be needed to effectively implement 12-month contraceptive supply policies.

Preoperative Meniscal Extrusion Predicts Unsatisfactory Clinical Outcomes and Progression of Osteoarthritis after Isolated Partial Medial Meniscectomy: A 5-Year Follow-Up Study

2020 ◽  
Author(s):  
João V. Novaretti ◽  
Diego C. Astur ◽  
Elton L.B. Cavalcante ◽  
Camila C. Kaleka ◽  
Joicemar T. Amaro ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Medial Meniscus ◽  
International Knee Documentation Committee ◽  
Meniscal Extrusion ◽  
Optimal Cutoff ◽  
Medial Meniscectomy ◽  
The Mean ◽  
Medial Meniscus Extrusion ◽  
Meniscus Extrusion

AbstractThe objective of this study was to examine the association between preoperative meniscal extrusion of patients undergoing partial medial meniscectomy with clinical outcomes and progression of osteoarthritis and to determine the extent of meniscal extrusion associated with unsatisfactory clinical outcomes and progression of osteoarthritis. Ninety-five patients who underwent partial medial meniscectomy with a minimum follow-up of 5 years were retrospectively reviewed. Preoperative meniscal extrusion was evaluated with magnetic resonance imaging. Patients were assessed preoperatively and postoperatively with Lysholm and International Knee Documentation Committee (IKDC) subjective scores for clinical outcomes and with IKDC radiographic scale for osteoarthritis. An ANOVA (Analysis of Variance) was used to analyze the variations in meniscal extrusion and the clinical and radiological outcomes. A regression analysis was performed to identify factors that affect preoperative medial meniscus extrusion and that influence results after partial meniscectomy. An optimal cutoff value for meniscal extrusion associated with unsatisfactory clinical outcomes and progression of osteoarthritis was established. Significance was set at p < 0.05. The mean ± SD preoperative and postoperative Lysholm scores were 59.6 ± 15.5 versus 83.8 ± 13.1 (p < 0.001) and the mean preoperative and postoperative IKDC subjective scores were 59.4 ± 16.8 versus 82.0 ± 15.8 (p < 0.001). Meniscal extrusion greater than 2.2 mm (sensitivity, 84%; specificity, 81%) and 2.8 mm (sensitivity, 73%; specificity, 85%) was associated with unsatisfactory (poor/fair) Lysholm and IKDC subjective scores, respectively. The progression of osteoarthritis, characterized as a change of at least one category on the IKDC radiographic scale, occurred when meniscal extrusion was greater than 2.2 mm (sensitivity, 63%; specificity, 75%). Patients with higher body mass index (BMI) had significantly greater meniscal extrusion that patients with normal BMI (p < 0.001). The medial meniscus was more extruded in patients with horizontal and root tears. In conclusion, patients with preoperative meniscal extrusion of 2.2 mm or greater had unsatisfactory clinical outcomes and progression of osteoarthritis after partial medial meniscectomy at a minimum of 5 years follow-up. Higher BMI and horizontal and root tears were associated with greater preoperative meniscal extrusion.

scholarly journals Tropospheric CO vertical profiles deduced from total columns using data assimilation: methodology and validation

2014 ◽  
Vol 7 (9) ◽  
pp. 3035-3057 ◽  
Author(s):  
L. El Amraoui ◽  
J.-L. Attié ◽  
P. Ricaud ◽  
W. A. Lahoz ◽  
A. Piacentini ◽  
...  
Keyword(s):  
Data Assimilation ◽  
Data Sets ◽  
Vertical Profiles ◽  
Night Time ◽  
Chi Square ◽  
Independent Observations ◽  
The Mean ◽  
The Difference ◽  
Using Data ◽  
Total Column

Abstract. This paper presents a validation of a method to derive the vertical profile of carbon monoxide (CO) from its total column using data assimilation. We choose version 3 of MOPITT CO total columns to validate the proposed method. MOPITT products have the advantage of providing both the vertical profiles and the total columns of CO. Furthermore, this version has been extensively validated by comparison with many independent data sets, and has been used in many scientific studies. The first step of the paper consists in the specification of the observation errors based on the chi-square (χ2) test. The observations have been binned according to three types: over land during daytime, over land during night-time, and over sea. Their respective errors using the χ2 metric have been found to be 8, 11 and 7%. In the second step, the CO total columns, with their specified errors, are used within the assimilation system to estimate the vertical profiles. These are compared to the retrieved profiles of MOPITT V3 at global and regional scales. Generally, the two data sets show similar patterns and good agreement at both scales. Nevertheless, total column analyses slightly overestimate CO concentrations compared to MOPITT observations. The mean bias between both data sets is +15 and +12% at 700 and 250 hPa, respectively. In the third step, the assimilation of total column has been compared to the assimilation of MOPITT vertical profiles. The differences between both analyses are very small. In terms longitude–latitude maps, the mean bias between the two data sets is +6 and +8% at the pressure levels 700 and 200 hPa, respectively. In terms of zonal means, the CO distribution is similar for both analyses, with a mean bias which does not exceed 12%. Finally, the two analyses have been validated using independent observations from the aircraft-based MOZAIC program in terms of vertical profiles over eight airports. Over most airports, both analyses agree well with aircraft profiles. For more than 50% of recorded measurements, the difference between the analyses and MOZAIC does not exceed 5 ppbv (parts per billion by volume).

scholarly journals Is it possible to use stress radiographs as a tool to diagnose medial meniscus posterior root tears?

2017 ◽  
Vol 5 (2_suppl2) ◽  
pp. 2325967117S0007
Author(s):  
Ali Engin Daştan ◽  
Elcil Kaya Biçer ◽  
Hüseyin Kaya ◽  
Emin Taşkıran
Keyword(s):  
Medial Meniscus ◽  
Weight Bearing ◽  
Joint Space Width ◽  
Joint Space ◽  
X Rays ◽  
Meniscal Extrusion ◽  
Valgus Stress ◽  
Varus Stress ◽  
The Difference ◽  
Space Width

Aim: Medial meniscus posterior root tear (MMPRT) causes meniscal extrusion, loss of meniscus function, arthritic changes. Clinical history, physical examination and magnetic resonance imaging (MRI) findings are useful for the diagnosis of MMPRT. The aim of this study is to evaluate the utility of stress X-rays in the diagnosis of MMPRT. Methods: Twenty patients who had undergone high tibial osteotomy between March 2015 and May 2016 and whose preoperative bilateral varus and valgus stress x-rays (Telos device) along with weight bearing x-rays were available were included. These patients were grouped into two according to integrity of posterior roots of their medial menisci; there were ten patients both in the study and control groups. Lateral joint space width (LJW) on varus stress x-rays, medial joint space width (MJW) on valgus stress x-rays as well as LJW and MJW on weight bearing x-rays were measured bilaterally. Intragroup comparisons of joint space widths between index and opposite knees were performed. Differences of MJW and LJW between index and opposite knees were calculated. Differences of joint space widths between stress x-rays and weight bearing x-rays were also calculated. The changes in joint space widths between the two groups were compared. Statistical analyses were performed utilizing SPSS 18.0. Significance level was set at 0.05. Results: In MMPRT group, opening of LJ space of index knees under varus stress was greater than that of opposite knees (Index: (mean±SD) 10,27±1,17 mm, opposite: 8,61±1,37 mm; p<0,0001). In the control group the difference was not significant (Index: 9,29±2,55 mm, opposite: 9,68±1,44 mm; p=0,566). The difference in the opening of LJW (under varus stress) between index and opposite knees was significantly greater in the study group (p=0,013). The difference between LJW under weight-bearing and varus stress conditions was significantly greater in the study group. (Study: 3,64±0.217 mm, control:2,28±0,182 mm, p=0.018). Conclusions: The findings of this study showed that in patients who had MMPRTs, an increased opening in the LJW was observed under varus stress conditions. This may be relevant with the fact that when varus stress is applied, meniscal extrusion is increased in case of a MMPRT. Stress x-rays could be a useful tool in the diagnosis of MMPRTs. Further studies are needed to determine the sensitivity and specificity of this diagnostic tool.

scholarly journals Usefulness of ultrasonography for dynamic evaluation of medial meniscus hoop function in early knee osteoarthritis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kengo Shimozaki ◽  
Junsuke Nakase ◽  
Kazuki Asai ◽  
Rikuto Yoshimizu ◽  
Mitsuhiro Kimura ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Medial Meniscus ◽  
Knee Extension ◽  
Meniscus Tear ◽  
Meniscal Tears ◽  
Meniscal Extrusion ◽  
Mri Findings ◽  
Characteristic Finding ◽  
Flexion Extension ◽  
Group D

AbstractThis study aimed to evaluate the dynamics of the medial meniscus during knee flexion–extension by ultrasonography and compare them with MRI findings to confirm the usefulness of ultrasonography for evaluating early knee osteoarthritis (KOA). In total, 100 patients were diagnosed with early KOA using clinical and radiographical findings. Dynamic ultrasonographic evaluation and MRI were performed in all patients. Medial meniscal extrusion (MME) and medial meniscal tears were evaluated via ultrasonography and MRI. Abnormal MME was defined as MME > 2 mm on ultrasonography during knee extension. Patients with abnormal MME were divided into two groups: a decrease group (group D) and a non-decrease group (group N). Age, sex, absence or type of meniscus tear, and MME were compared between the two groups. Of the 100 patients, 75 demonstrated MME > 2 mm at knee extension. MME at all assessment positions using ultrasonography and MRI were significantly greater in group N (n = 34) than that in group D (n = 41). Medial meniscus posterior root tears or radial tears were observed in most cases in group N. A lack of decrease in MME from 0° to 90° of flexion on ultrasonography was a characteristic finding in patients with a loss of meniscal hoop function.

Developmental and growth patterns in Xiphinema parasimile and X. simile (Nematoda: Dorylaimida), members of the X. americanum-group

Nematology ◽  
2009 ◽  
Vol 11 (2) ◽  
pp. 267-273
Author(s):  
László Barsi
Keyword(s):  
Body Length ◽  
Growth Pattern ◽  
Developmental Stages ◽  
Growth Patterns ◽  
Body Volume ◽  
Data Sets ◽  
Embryonic Growth ◽  
Juvenile Stages ◽  
The Mean ◽  
The Difference

AbstractXiphinema parasimile and X. simile are morphologically and morphometrically very similar, yet molecularly different, species with different developmental and growth patterns, a different number of juvenile developmental stages (four vs three) and a different post-embryonic growth pattern. Body length, body volume and odontostyle and replacement odontostyle lengths served for comparison of the post-embryonic growth patterns in these species. A percentage method was used to make the data sets comparable between one population of X. parasimile and three populations of X. simile. The mean body lengths of the first, second and pre-adult stages in X. simile showed similarity with those of the second, third and pre-adult stages in X. parasimile. In X. simile there was no unique growth pattern of body length and body volume from stage to stage applicable for all populations, just a similar trend with more or less similar values. The difference between replacement odontostyle and functional odontostyle lengths in all juvenile stages was higher in X. simile and lower in X. parasimile, despite the very similar mean odontostyle length in the female stage of both species.

scholarly journals High Posterior Tibial Slope Influence Medial Meniscus Injuries in ACL Deficient Knees

2018 ◽  
Vol 69 (11) ◽  
pp. 3295-3298
Author(s):  
Iulian Marcu ◽  
Ana Maria Oproiu ◽  
Nicolae Mihailide
Keyword(s):  
Medial Meniscus ◽  
Cruciate Ligament ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Meniscus Tear ◽  
Meniscus Lesion ◽  
Posterior Tibial ◽  
Meniscus Lesions ◽  
The Mean ◽  
Meniscus Injuries

The purpose of the current study was to evaluate the correlation between the tibial slope and medial meniscus injury in anterior cruciate ligament deficient knees. A total of 223 patients with primary ACL injury admitted to Foisor Orthopedic Hospital between 2015-2016 were included in this study. The posterior tibial slope was evaluated on a lateral x-ray view of the knee and was defined as the angle between the line joining the tibial plateau and the line perpendicular to the longitudinal axis (the proximal tibial anatomical axis). Patients were divided into two groups depending on the posterior tibial slope ([9.9 and �10), and a Chi square test was used to evaluate if there is any correlation between this and internal meniscus injuries, and Fisher�s exact test was used to verify this. Overall medial meniscus lesions were found in 43.5% of the patients. The mean value of the posterior tibial slope was 11.19+/-2,685. After grouping patients in low and high group ([9.9 and �10), there were 66.8% in the high tibial slope group and 33.2% in the low group. In the high PTS group there were 93 patients with medial meniscus lesion (62.4%), and 56 (37.6%) without medial meniscus lesion. The mean posterior tibial slope was higher in the medial meniscus tear group (11.78 degrees), than mean PTS in the group without medial meniscus lesion (10.42 degrees). There was a strong correlation between high tibial slope and medial meniscus lesions (p=0.015). The main finding of the current study is that there is a statistically significant correlation between posterior tibial slope higher than 10 degrees and internal meniscus tears.

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