scholarly journals Is Indian osteoarthritis different? Emerging scenarios of disease pattern and implications for diagnosis and treatment of osteoarthritis in India

2020 ◽  
Vol 6 (3) ◽  
pp. 531
Author(s):  
Pavankumar Kohli ◽  
Hanumant Waybase ◽  
Poorv Patel ◽  
L. G. Naik ◽  
Rajiv Colaco ◽  
...  
Keyword(s):  
Femoral Condyle ◽  
Weight Bearing ◽  
Lateral Compartment ◽  
Joint Space ◽  
Cartilage Loss ◽  
Wear Loss ◽  
X Rays ◽  
Femoral Cartilage ◽  
Disease Pattern ◽  
Cartilage Wear

<p class="abstract"><strong>Background:</strong> There are many studies to show comparative cartilage wear of medial and lateral compartment of knee. However, there are no studies in Indians that compare relative cartilage loss between femur and tibia.</p><p class="abstract"><strong>Methods:</strong> 44 patients with osteoarthritic knee at our center were posted for operative intervention in the form of partial or total knee arthroplasty and included in this study. Each patient had an magnetic resonance imaging (MRI) (cartogram) and weight bearing X-rays of the same knee. Intraoperative qualitative cartilage loss both femoral and tibial surfaces was observed and confirmed with preop findings of cartilage loss on X-ray or MRI.<strong></strong></p><p class="abstract"><strong>Results:</strong> The wear/loss of cartilage in 44 patients in femur is approximately twice that of tibia.</p><p class="abstract"><strong>Conclusions:</strong> Femoral cartilage loss is significantly more than tibia in Indians. These findings carry significance of not waiting for bone on bone arthritis to consider active treatment for Indian osteoarthritis patients. Bone on bone arthritis has so far been considered the litmus test for any intervention for osteoarthritis, even in India. Specific attention should rather be given to the femoral condyle clinically and radiologically. The authors have already described “The Dervan RIM sign” for the same purpose. The wear pattern is different from Caucasians and focus cannot be on joint space narrowing which is only with equally prevalent tibial and femoral cartilage wear.</p><p class="abstract"> </p>

Postero-anterior radiogram of the knee in weight-bearing and semiflexion

1997 ◽  
Vol 38 (6) ◽  
pp. 1063-1070 ◽  
Author(s):  
T. Boegård ◽  
O. Rudling ◽  
I. F. Petersson ◽  
J. Sanfridsson ◽  
T. Saxne ◽  
...  
Keyword(s):  
Joint Space Narrowing ◽  
Spin Echo ◽  
Femoral Condyle ◽  
Weight Bearing ◽  
Joint Space ◽  
Cartilage Defects ◽  
Proton Density ◽  
Turbo Spin Echo ◽  
Chronic Knee Pain ◽  
Width Measurements

Purpose: the purpose was four-fold: to assess the reproducibility of p.a. weight-bearing radiograms of the knee and the minimal joint-space (MJS) width measurements in these radiograms; to compare the MJS with MR-detected cartilage defects; to evaluate the location of these cartilage defects; and to estimate the relation between meniscal abnormalities and joint-space narrowing Material and Methods: Fifty-nine individuals, aged 41–58 years (mean 50), with chronic knee pain were examined by means of p.a. weight-bearing radiograms in semi-flexion with fluoroscopic guidance of the knee joint. the MJS was measured with a standard ruler. on the same day MR imaging was performed with proton-density- and T2-weighted turbo spin-echo on a 1.0 T imager. Meniscal abnormalities and cartilage defects in the tibiofemoral joint (TFJ) were noted Results and Conclusion: the p.a. view of the knee and the MJS measurements were reproducible. MJS of 3 mm is a limit in diagnosing joint-space narrowing in knees with MR-detected cartilage defects. There was a high proportion <p<0.001) of meniscal abnormality within the narrowed compartments in comparison with those that were not narrowed. A larger number of the cartilage defects (p<0.05) was found in the medial femoral condyle than in any of the other condyles of the TFJ. the defects had a dorsal location <p<0.001) as shown in the weight-bearing radiograms of the knee in semiflexion

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 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 Comparison of radiographic hip joint space in weight bearing and supine X-rays in patients with hip pathology

2013 ◽  
Vol 21 ◽  
pp. S204
Author(s):  
M.J. Philippon ◽  
K.K. Briggs ◽  
P. Goljan ◽  
B.M. Devitt ◽  
L.P. Peixoto
Keyword(s):  
Hip Joint ◽  
Weight Bearing ◽  
Joint Space ◽  
X Rays

scholarly journals Proximal fibular osteotomy for pain relief and functional improvement in patients of osteoarthritis of knee

2019 ◽  
Vol 6 (7) ◽  
pp. 2368 ◽  
Author(s):  
Anil Kumar Rai ◽  
Anand Saurabh ◽  
Shubhanshu Shekhar ◽  
Abhijeet Kunwar ◽  
Vishal Verma
Keyword(s):  
Pain Relief ◽  
Knee Joint ◽  
Lower Extremity ◽  
Weight Bearing ◽  
Lateral Compartment ◽  
Joint Space ◽  
Functional Improvement ◽  
Fibular Osteotomy ◽  
Short Term Study ◽  
Almost All

Background: The aim of this study was to evaluate the effect of proximal fibular osteotomy in relieving pain and functional improvement in patients of osteoarthritis knee.Methods: We selected 38 patients with KOA, out of which 30 patients gave written informed consent and underwent proximal fibular osteotomy. The median time of follow-up was 13.3 months. Preoperative and postoperative weight-bearing and whole lower extremity radiographs were obtained to analyse the alignment of the lower extremity (tibio-femoral angle) and ratio of the knee joint space (medial/lateral compartment). Assessment of knee pain was done using a visual analogue scale, and knee functional activities were evaluated using the American Knee Society score (KSS 1 and 2) preoperatively and postoperatively.Results: Pain relief was observed in almost all patients after proximal fibular osteotomy. Weight-bearing lower extremity radiographs showed significant change in tibio-femoral angle an average increase in the postoperative medial knee joint space. Additionally, obvious change in alignment was observed in the whole lower extremity radiographs in 24 out of 30 patients. In three patients tibio-femoral angle showed progressive more varus alignment after proximal fibulectomy.Conclusions: In short-term study, proximal fibular osteotomy provides pain relief and functional wellbeing to the patients of KOA.

Post-Run T2 Mapping Changes in Knees of Adolescent Basketball Players

Cartilage ◽  
2021 ◽  
pp. 194760352110218
Author(s):  
Yigal Chechik ◽  
Eran Beit Ner ◽  
Oleg Lysyy ◽  
Sigal Tal ◽  
Neta Stern ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
T2 Mapping ◽  
Femoral Condyle ◽  
Weight Bearing ◽  
Lateral Compartment ◽  
Medial Compartment ◽  
Cartilage Defects ◽  
Mri Scan ◽  
Basketball Players ◽  
Mean Values

Objective: While articular cartilage defects are common incidental findings among adult athletes, the effect of running on the cartilage of adolescent athletes have rarely been assessed. This study aims to assess the variations in the articular cartilage of the knees in healthy adolescent basketball players using quantitative T2 MRI (magnetic resonance imaging). Design: Fifteen adolescent basketball players were recruited (13.8 ± 0.5 years old). Girls were excluded to avoid potential gender-related confounding effects. Players underwent a pre-run MRI scan of both knees. All participants performed a 30-minute run on a treadmill. Within 15 minutes after completion of their run, players underwent a second, post-run MRI scan. Quantitative T2 maps were generated using the echo modulation curve (EMC) algorithm. Pre-run scans and post-run scans were compared using paired t test. Results: Participants finished their 30-minute run with a mean running distance of 5.77 ± 0.42 km. Pre-run scans analysis found statistically significant ( P < 0.05) changes in 3 regions of the knee lateral compartment representing the cartilaginous tissue. No differences were found in the knee medial compartment. Post-run analysis showed lower T2 values in the medial compartment compared to the pre-run scans in several weight-bearing regions: femoral condyle central (pre/post mean values of 33.9/32.2 ms, P = 0.020); femoral condyle posterior (38.1/36.8 ms, P = 0.038); and tibial plateau posterior (34.1/31.0 ms, P < 0.001). The lateral regions did not show any significant changes. Conclusions: Running leads to microstructural changes in the articular cartilage in several weight-bearing areas of the medial compartment, both in the femoral and the tibial cartilage.

Joint-space width in the weight-bearing radiogram of the tibiofemoral joint

1998 ◽  
Vol 39 (1) ◽  
pp. 32-35
Author(s):  
T. Boegård ◽  
O. Rudling ◽  
I. F. Petersson ◽  
K. Jonsson
Keyword(s):  
Knee Pain ◽  
Weight Bearing ◽  
Joint Space Width ◽  
Lateral Compartment ◽  
Joint Space ◽  
Equal Weight ◽  
Fluoroscopic Guidance ◽  
Tibiofemoral Joint ◽  
Chronic Knee Pain ◽  
Space Width

Purpose: the aim of the study was to compare the minimal joint-space (MJS) width of the tibiofemoral joint (TFJ) in weight-bearing radiograms with the patient in two different positions Material and Methods: from a study of 54 patients with chronic knee pain (aged 42–59 years, mean 52 years), we selected 21 consecutive patients for this study. in these 21 patients, both knees were examined by means of p.a. weight-bearing radiograms in semiflexion with fluoroscopic guidance. the patient stood with the weight: 1) almost entirely on the examined leg; and 2) equally distributed on both legs. the MJS was measured with a scale loupe in tenths of a millimeter in the medial and lateral compartments of the TFJ Results: with the patient standing on one leg, the MJS was 0.18 mm wider (p<0.006) in the medial compartment and 0.18 mm narrower (p<0.029) in the lateral compartment as compared to standing on both legs Conclusion: with the technique used, the assessment of the MJS width in the p.a. view of the TFJ in weight-bearing examinations should be performed with equal weight on both legs. Standing on only the examined leg might be an option in cases of suspected narrowing in the lateral compartment

Regional Cartilage Thinning Occurs First in the Walking Weight Bearing Regions of the Femur in Medial Compartment Knee Osteoarthritis

2008 ◽  
Author(s):  
Jennifer C. Erhart ◽  
Anne Mündermann ◽  
Seungbum Koo ◽  
Ben Merrick ◽  
Andrew Deagon ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Femoral Condyle ◽  
Weight Bearing ◽  
Lateral Compartment ◽  
Medial Compartment ◽  
Treatment Interventions ◽  
Knee Oa ◽  
Highest Weight ◽  
Kellgren And Lawrence ◽  
New Treatment

Osteoarthritis (OA) of the knee affects an estimated 20–40% of individuals over the age of 65 [1], and is nearly 10 times more common in the medial compartment than the lateral compartment [2]. Plain radiography measurements using the Kellgren and Lawrence (KL) scale have been the gold standard for diagnosis of knee osteoarthritis [3]. However, for new treatment interventions for medial compartment knee OA such as load modifying footwear, it would be important to know if the disease-related cartilage loss in the medial compartment occurs initially and predominantly in regions that are weight bearing during walking. Because walking results in highest weight bearing occurring in the anterior and middle regions of the femoral condyle and the anterior region of the tibial plateau, seeing a pattern of thinning in these areas would suggest that walking is an important activity for understanding both the cause and treatment of osteoarthritis.

scholarly journals The posterior-anterior-flexed view is essential for the evaluation of valgus osteoarthritis. A prospective study on 134 valgus knees

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Kilian Rueckl ◽  
Armin Runer ◽  
Ulrich Bechler ◽  
Martin Faschingbauer ◽  
Sebastian Philipp Boelch ◽  
...  
Keyword(s):  
Femoral Condyle ◽  
Joint Space Width ◽  
Lateral Compartment ◽  
Joint Space ◽  
Valgus Deformity ◽  
Initial Assessment ◽  
Posterior Aspect ◽  
Valgus Osteoarthritis ◽  
Grade 3 ◽  
Posterior Anterior

Abstract Background Radiographic imaging is an important tool to assess osteoarthritis (OA). Lateral compartment osteoarthritis (valgus OA) usually starts with cartilage degeneration along the posterior aspect of the lateral femoral condyle. There is evidence that the posterior-anterior (PA)-flexed view is more sensitive when diagnosing early stages of valgus OA compared to the anterior-posterior (AP) view. The current paper analyzes the value of the PA-flexed view for patients scheduled for total knee arthroplasty (TKA). Methods Radiographs of 134 valgus knees were assessed prior to TKA. The minimal joint space width (minJSW) was measured on AP and PA-flexed views. The extent of mechanical deformity was measured on hip to ankle standing films. Results 49 (36.6%) AP views showed Kellgren and Lawrence (K/L)-grade 4 osteoarthritis in the lateral compartment, 82 (63.4%) showed grade 3 or less. The PA-flexed view resulted in an increased K/L-grading to grade 4 for 53 knees (62.4%) that were considered grade 3 or less on standard AP-radiographs. There was a significant differences between lateral minJSW on AP and PA-flexed view for patients with up to 10 degrees of mechanical valgus deformity (p < 0.001), as well as 11 to 15 degrees of mechanical deformity (p = 0.021). Only knees with severe deformity of more than 15 degrees did not show a difference in minJSW between PA-flexed view and AP view (p = 0.345). Conclusions The PA-flexed view is superior to the standard AP view in quantifying the extent of valgus OA in patients with zero to fifteen degrees of valgus deformity. It is recommended for the initial assessment of patients with valgus osteoarthritis and better documents the extent of osteoarthritis prior to TKA.

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