scholarly journals The Effect of Extensor Muscle Strength on Meniscus Progression in Subjects Without Radiologic Knee Osteoarthritis -- Data From the Osteoarthritis Initiative

2021 ◽  
Author(s):  
Mingyang Li ◽  
Yong Nie ◽  
Kang Li ◽  
Yi Zeng ◽  
Yuangang Wu ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Knee Osteoarthritis ◽  
Medial Meniscus ◽  
Lateral Meniscus ◽  
High Strength ◽  
Extensor Muscle ◽  
Strength Group ◽  
Structural Progression ◽  
Significant Difference ◽  
Osteoarthritis Initiative

Abstract BackgroundHigh extensor strength decreased knee osteoarthritis symptomatic progression in female was well demonstrated. However, few studies detected a significant association between extensor strength and structural progression when joint space narrowing or cartilage loss were the indicators. The pathological change in meniscus could come earlier than that in cartilage and JSN, but no studies have specifically investigated the association between extensor strength and meniscus progression. MethodsParticipants in Osteoarthritis Initiative with both muscle strength and meniscus assessment, KL grade ≤ 1, and BMI < 30, were enrolled. In separate-sex analysis, participants were divided into the high strength group and the low strength group referring to the median baseline maximum extensor muscle strength/weight. Overall and classified meniscus progression in MRI Osteoarthritis Knee Score was compared between the two groups, at 12 months (622 knees) and 24 months (548 knees). ResultsIn females, less overall medial meniscus progression (11.1% [17/153] VS 23.2% [32/138], P=0.04), less medial meniscal medially extrusion (5.2 % [8/155] VS 12.5 % [18/144], P =0.04), and less medial meniscal anteriorly extrusion progression (0 % [0/108] VS 5.3% [6/113], P=0.03), was presented in the high strength group over 24 months. No significant difference was detected in other comparisons (in males, or in lateral meniscus, or in 12 months). Conclusion High baseline extensor strength in females was associated with a decreased risk of 24- month medial meniscus progression. High extensor strength does not only correlate with less symptomatic progression of KOA, but also with lower risk of structural progression.

scholarly journals Meniscus position and size in knees with versus without structural knee osteoarthritis progression: data from the osteoarthritis initiative

2021 ◽  
Author(s):  
Kalpana Sharma ◽  
Felix Eckstein ◽  
Wolfgang Wirth ◽  
Katja Emmanuel
Keyword(s):  
Knee Osteoarthritis ◽  
Medial Meniscus ◽  
Lateral Meniscus ◽  
Cartilage Thickness ◽  
Cohen’S D ◽  
Structural Progression ◽  
Osteoarthritis Initiative ◽  
Cohen's D ◽  
Meniscus Extrusion ◽  
Central Slice

Abstract Objective To explore whether and which quantitative 3D measures of medial and/or lateral meniscus position and size are associated with subsequent medial femorotibial structural progression of knee osteoarthritis and to determine the correlation between central slice and total meniscus measures. Materials and Methods Knees with radiographic osteoarthritis from Osteoarthritis Initiative participants with longitudinal medial MRI-based cartilage thickness and radiographic joint space width (JSW) loss over 12 months were selected. These 37 structural progressor knees (64.7 ± 8.0y, 30.2 ± 4.6 kg/m2, 35% men) were matched 1:1 to 37 non-progressor knees (64.6 ± 9.8y, 30.2 ± 4.4 kg/m2, 35% men) without cartilage thickness or JSW loss. Quantitative measures of meniscus position and size were computed from manual segmentations of coronal baseline MRIs. Cohen’s D was used as measure of effect size. Results Maximum extrusion distance of the total medial meniscus and mean extrusion in the central 5 and in the central slice were greater for progressor than non-progressor knees (Cohen’s D 0.58–0.66). No significant differences were observed for medial tibial coverage or mean extrusion (entire meniscus). Among medial meniscus morphology measures, only mean height differed between progressor vs non-progressor knees (Cohen’s D 0.40). Among lateral meniscus measures, height and volume were greater in progressor vs. non-progressor knees (Cohen’s D 0.46–0.83). Mean extrusion measures were highly correlated between the entire meniscus and the central (r = 0.88) or the central 5 (r = 0.93) slices. Conclusions 3D maximum and central medial meniscus extrusion may serve as predictors for subsequent structural progression. Central meniscus extrusion measures could substitute 3D extrusion measurement across the entire meniscus.

scholarly journals Efficacy and safety of sprifermin injection for knee osteoarthritis treatment: a meta-analysis

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Ni Zeng ◽  
Xin-Yuan Chen ◽  
Zhi-Peng Yan ◽  
Jie-Ting Li ◽  
Tao Liao ◽  
...  
Keyword(s):  
Adverse Events ◽  
Knee Osteoarthritis ◽  
Meta Analysis ◽  
Placebo Treatment ◽  
Cartilage Volume ◽  
Cartilage Thickness ◽  
Random Effects Models ◽  
Structural Progression ◽  
Significant Difference ◽  
Mean Differences

Abstract Objective To perform a meta-analysis comparing the structural progression and clinical symptom outcomes as well as adverse events experienced from intra-articular injections of sprifermin compared to a placebo treatment for patients with knee osteoarthritis (KOA). Method We systematically searched the literature for studies that compared long-term outcomes between sprifermin and placebo injections for KOA treatment. Meta-analysis was performed with RevMan5.3 using an inverse variance approach with fixed or random effects models. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated. Results Eight studies were included. Overall, there was significantly less improvement of WOMAC total scores in patients receiving sprifermin, compared with the placebo (mean difference (MD) = 3.23, 95% CI 0.76–5.69; I2 = 0%; P = 0.01). Further, sprifermin injection patients gained more, and lost less, cartilage thickness and volume in total femorotibial joint (cartilage thickness: standardized mean differences (SMD) = 0.55, 95% CI 0.26–0.84; I2 = 78%; P = 0.0002; cartilage volume: SMD = 0.39, 95% CI 0.20–0.58; I2 = 49%; P < 0.0001). Changes in the cartilage surface morphology of the medial tibio-femoral joint (MD = −0.30, 95% CI −0.44 to −0.16; I2 = 0%; P < 0.0001) and patello-femoral joint (MD = −0.22; 95% CI −0.37 to −0.07; I2 = 0%; P = 0.004) showed a significant difference between the sprifermin and placebo injections. Moreover, there were no significant differences between sprifermin and the placebo in the risk of treatment-emergent adverse events (OR = 1.05; 95% CI 0.52–2.14; I2 = 48%; P = 0.89). Conclusion The data from the included studies provide strong evidence to determine the effect of intra-articular sprifermin on joint structure in individuals with KOA and show no specific adverse effects. Nevertheless, intra-articular sprifermin did not likely have any positive effect on symptom alleviation.

scholarly journals Poorer dynamic postural stability in patients with anterior cruciate ligament rupture combined with lateral meniscus tear than in those with medial meniscus tear

2020 ◽  
Vol 32 (1) ◽  
Author(s):  
Jin Hyuck Lee ◽  
Dae-Hee Lee ◽  
Jong-Hoon Park ◽  
Dong Won Suh ◽  
Eunseon Kim ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Postural Stability ◽  
Lateral Meniscus ◽  
Stability Index ◽  
Acl Rupture ◽  
Meniscus Tear ◽  
Significant Difference ◽  
Knee Muscle ◽  
Dynamic Postural Stability ◽  
Knee Muscle Strength

Abstract Background Only limited data are available regarding postural stability between anterior cruciate ligament (ACL)-injured patients with medial meniscus (MM) tear and those with lateral meniscus (LM) tear. The purpose of this study was to compare preoperative postural stability for both involved and uninvolved knees in ACL rupture combined with MM and LM tears. It was hypothesized that there would be a significant difference in postural stability between these two groups. Methods Ninety-three ACL-injured patients (53 combined with MM tears vs. 40 combined with LM tears) were included. Static and dynamic postural stability were evaluated with the overall stability index (OSI), anterior–posterior stability index (APSI), and medial–lateral stability index (MLSI) using stabilometry. Knee muscle strength was evaluated using an isokinetic testing device. Results In the static postural stability test, none of the stability indices showed significant differences between the two groups for both knees (p > 0.05). In the dynamic postural stability test for involved side knees, the OSI and APSI were significantly higher in the LM tear group compared to the MM tear group (OSI: 2.0 ± 0.8 vs. 1.6 ± 0.5, p = 0.001; APSI: 1.5 ± 0.6 vs. 1.3 ± 0.5, p = 0.023), but not the MLSI (p > 0.05). In the static and dynamic postural stability tests in each group, there were no significant differences between the involved and uninvolved side knees (p > 0.05). There was no significant difference in the knee muscle strength between the two groups (p > 0.05). All postural stability showed no significant correlation with knee muscle strength (p > 0.05). Conclusion Dynamic postural stability was poorer in patients with ACL rupture combined with LM tear than in those with MM tear. Therefore, close monitoring for postural stability would be necessary during preoperative and postoperative rehabilitation, especially for patients with ACL rupture combined with LM tear. Level of evidence: Level III

scholarly journals Dynamics of the meniscus underweight-loading conditions: an investigation using upright magnetic resonance imaging

2020 ◽  
Vol 8 (7_suppl6) ◽  
pp. 2325967120S0045
Author(s):  
Junsuke Nakase ◽  
Kengo Shimozaki ◽  
Rikuto Yoshimizu ◽  
Hiroyuki Tsuchiya ◽  
Kazuki Asai
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Supine Position ◽  
Medial Meniscus ◽  
Lateral Meniscus ◽  
Loading Conditions ◽  
Resonance Imaging ◽  
Significant Difference ◽  
Posterior Shift ◽  
Weight Loading

Objectives: Meniscal morphology underweight-loading conditions remains unknown, because weight loading is rarely performed during magnetic resonance imaging (MRI). We focused on the weight-loading condition and developed an upright MRI. This study aimed to investigate the shift of the medial and lateral meniscus in healthy adults under both fully weight loaded and unloaded conditions, using both supine and upright MRI. Methods: Eighteen volunteers (13 men and 5 women) without previous knee complaints underwent an MRI of the right knee. The mean age of the subjects was 21.8±3.1 years. The examination was performed in three positions: supine, double-leg upright (DLU), and single-leg upright (SLU). The knees were fully extended in each position. For both the supine and upright examinations, we used a special MRI apparatus (Gravity MRI, Hitachi, Japan) that is capable of imaging in any position with a static magnetic field strength of 0.4 T (Figure). T1-weighted images were obtained in both coronal and sagittal planes with a slice thickness of 2 mm. The medial or lateral, anterior and posterior shifts of both the medial and lateral meniscus were measured, against the tibial wedge. The medial and lateral meniscal shift rates were measured as assessment items under each condition. The shift rate was defined as the proportion of the measured meniscal shift compared to the overall width of the medial and lateral meniscus. The MRI reference section on the sagittal plane was the midpoint of the medial or lateral femoral condyle. On the coronal plane, the reference point was the midpoint of the medial and lateral tibial condyle. The measurement items were compared in all three imaging positions using analysis of variance and multiple comparison tests, with statistical significance set at P < 0.05. Results: We show the results from the analysis of the dynamics of the medial and lateral meniscus in Table. The difference among the three conditions for the medial shift rate of the medial meniscus was significant. The medial shift rate was significantly greater in the DLU and SLU positions than in the supine position (supine: 7.3±5.8% vs. DLU: 20.0±8.8 % (P<0.01), supine vs. SLU: 21.5±7.6% (P<0.01), DLU vs. SLU (P=0.7)). No significant differences were observed for the anterior and posterior shift rates of the medial meniscus (anterior: P=0.6, posterior: P=0.4). In the lateral meniscus, the lateral shift rate was significantly greater in the SLU position than in the supine position, but no significant difference was observed in the DLU position (supine: -1.2±11.8% vs. DLU: 2.7±11.1 % (P=0.2), supine vs. SLU: 4.5±10.8% (P=0.04), DLU vs. SLU: P=0.7). Both anterior and posterior shift rates in the lateral meniscus were significantly greater in DLU and SLU positions than in the supine position (anterior/ supine: -20.6±14.3% vs. DLU: -14.7±12.2% (P<0.01), supine vs. SLU: -8.9±14.9% (P<0.01), DLU vs. SLU: P=0.3, posterior/ supine: -78.0±19.6% vs. DLU: -63.7±18.7 % (P<0.01), supine vs. SLU: -57.8±19.2% (P<0.01), DLU vs. SLU: P=0.4). Conclusions: Under upright weight-loading conditions, the medial meniscus showed only medial shift, whilst the lateral meniscus was seen to shift in lateral, anterior, and posterior directions. No significant difference was observed between the DLU and SLU shift rates in both the medial and lateral meniscus in healthy adults. We believe that this result will be useful when considering loading and rehabilitation following meniscal repair. [Table: see text]

scholarly journals Predictors of upper leg muscle strength over 2 and 4 years in subjects with knee osteoarthritis: data from the osteoarthritis initiative

2018 ◽  
Vol 26 ◽  
pp. S219
Author(s):  
A.H. de Zwart ◽  
M. van der Leeden ◽  
L.D. Roorda ◽  
M. van der Esch ◽  
J.W. Twisk ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Knee Osteoarthritis ◽  
Osteoarthritis Initiative ◽  
Leg Muscle

scholarly journals Effect of Electroacupuncture versus Sham Electroacupuncture in Patients with Knee Osteoarthritis: A Pilot Randomized Controlled Trial

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Qi Wang ◽  
Hui Lv ◽  
Zhao-Tian Sun ◽  
Jian-Feng Tu ◽  
Yong-Wei Feng ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Muscle Strength ◽  
Knee Osteoarthritis ◽  
Range Of Motion ◽  
Controlled Trial ◽  
Dropout Rate ◽  
Flexor Muscle ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Pilot Randomized Controlled Trial

Objective. To explore the feasibility of evaluating the effectiveness and safety of electroacupuncture versus sham electroacupuncture for patients with knee osteoarthritis (KOA). Method. A pilot randomized controlled trial was conducted at a teaching hospital in Beijing. A total of 30 patients with KOA (Kellgren grade II or III) were randomly allocated to an eight-week treatment of either electroacupuncture or sham electroacupuncture. Patients and outcome assessors were blinded to group allocation. The primary outcome was the proportion of responders achieving at least 1.14 seconds decrease in the Timed Up and Go Test (TUG) at week eight compared with baseline. The secondary outcomes included the knee range of motion, the knee extensor and flexor muscle strength, Lequesne index, 9-step stair-climb test (9-SCT), and TUG. Results. Of 30 patients allocated to two groups, 27 (90%) completed the study. The proportion of responders was 53.3% (8 of 15) for electroacupuncture group and 26.7% (4 of 15) for sham electroacupuncture group by the intention-to-treat analysis (P=0.264). There was no statistically significant difference in TUG between the two groups at eight weeks (P=0.856). The compliance rate measured according to patients who conformed to the protocol and had received treatments ≥20 times was 93.3% (28 of 30). The dropout rate was 20% (3 of 15). Adverse effects were not reported in the study. Conclusion. Our research demonstrated that further evaluation of the effectiveness of electroacupuncture versus sham electroacupuncture was feasible and safe for patients with KOA. Whether or not the electroacupuncture can improve the physical functions of knee joint, expand the knee range of motion, and increase the extensor and flexor muscle strength more significantly than sham electroacupuncture, future studies can be designed with larger sample size, randomization design and less biases. This trial is registered with NCT03366363.

Short-term Outcomes after High Tibial Osteotomy Aimed at Neutral Alignment Combined with Arthroscopic Centralization of Medial Meniscus in Osteoarthritis Patients

2020 ◽  
Author(s):  
Hiroki Katagiri ◽  
Yusuke Nakagawa ◽  
Kazumasa Miyatake ◽  
Koji Otabe ◽  
Toshiyuki Ohara ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
High Tibial Osteotomy ◽  
Medial Meniscus ◽  
Control Group ◽  
Tibial Osteotomy ◽  
Short Term ◽  
Subjective Satisfaction ◽  
Significant Difference ◽  
Neutral Alignment

Abstract Purpose To improve long-term outcomes of open-wedge high tibial osteotomy (OWHTO), procedures combining OWHTO aimed at neutral alignment and arthroscopic centralization for meniscal extrusion have been introduced. The purpose of the present study was to compare short-term clinical and radiological outcomes of medial joint space width (JSW) after the OWHTO aimed at neutral alignment with and without arthroscopic centralization for an extruded medial meniscus. Methods A retrospective review of 50 primary OWHTO patients was conducted. Thirty-five patients included for analysis after exclusion criteria was applied. Twenty-one knee osteoarthritis patients, who underwent the OWHTO with arthroscopic meniscal centralization, were included in the centralization group. Fourteen patients, who underwent solely OWHTO, were included in the control group. Lysholm knee scale, International Knee Documentation Committee (IKDC) subjective score, Knee Osteoarthritis Outcome Score (KOOS), and patient subjective satisfaction scores were recorded at the final follow-up. Radiographic changes of JSW and joint line congruence angle (JLCA) were measured 2 years postoperatively. Patient demographic data were also reviewed. Results IKDC subjective scores, KOOS subgroup scores, patient subjective satisfaction scores, and Lysholm score did not show significant differences between the two groups at the final follow-up. Change of the JSW in the centralization group was significantly greater than that in the control group 2 years postoperatively (Control group: -0.1 mm, Centralization group: 0.8 mm P =0.03). Conclusion Change of JSW after OWHTO aimed at neutral alignment with arthroscopic centralization for extruded medial meniscus was greater than solely OWHTO, and there was no significant difference in the short-term clinical outcomes between the 2 procedures at the final follow-up.

Evaluation of Shoulder Muscle Improvement in Patients Following Free Latissimus Dorsi Muscle Pedicle Flap Transfer

2021 ◽  
pp. 229255032110485
Author(s):  
Erman Ak ◽  
Ömer Ayik ◽  
Ömer Berköz ◽  
Erol Kozanoğlu ◽  
Bora Edim Akalin ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Latissimus Dorsi ◽  
Peak Torque ◽  
Extensor Muscle ◽  
Total Work ◽  
Pedicle Flap ◽  
Flap Transfer ◽  
Shoulder Range Of Motion ◽  
Shoulder Muscle ◽  
Significant Difference

Aim: This study aimed to evaluate the clinical outcomes, shoulder muscle strength, and donor site morbidity following the free latissimus dorsi (LD) muscle pedicle flap transfer. Materials: Patients with free LD muscle pedicle flap reconstructions and with asymptomatic shoulders (affected and contralateral side) were included. The follow-up duration was 12 months. The combined shoulder range of motion (ROM), Constant–Murley shoulder (CMS), and quick disabilities of the arm, shoulder, and hand (QuickDASH) scores were measured preoperatively and at 1 year postoperatively. The ratio of the isokinetic muscle strength and total work was measured with an isokinetic dynamometer (Cybex 350®) both preoperatively and at sixth month postoperatively. Results: Twenty patients with a mean age of 37.06 ± 9.74 years and a mean body mass index of 23.49 ± 8.6 kg/m2 were included. The difference in shoulder ROM and CMS and increase in QuickDASH were not significant at the first postoperative year. The peak torque and total work performed decreased by 13%–16% for the adductor and extensor functions at the six month postoperatively, and these differences were significant. Although the adductor peak torque was significantly lower in the postoperative test of the operated side, no significant difference was found between the operated and unaffected shoulder peak torque values. Moreover, no significant difference was noted between the operated and unaffected shoulders in all isokinetic tests pre- and postoperatively. Conclusion: The free LD muscle pedicle flap harvest did not decrease function and ROM at the first postoperative year. The muscle strength and total work of shoulders after the LD muscle transfer returned to the preoperative condition at the sixth month, except adductor and extensor muscle strengths. However, adductor and extensor muscle strengths of the operated shoulders were not significantly different postoperatively. Level of Evidence: Level IV, Diagnostic study

Sign in / Sign up

Export Citation Format

Share Document