Increase in Tibial Internal Rotation Due to Weight-bearing is a Key Feature to Diagnose Early-stage Knee Osteoarthritis: A Study with Upright Computed Tomography

2021 ◽  
Author(s):  
Kazuya Kaneda ◽  
Kengo Harato ◽  
Satoshi Oki ◽  
Yoshitake Yamada ◽  
Masaya Nakamura ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Internal Rotation ◽  
Early Stage ◽  
Weight Bearing ◽  
Three Dimensional ◽  
Surface Registration ◽  
Lower Limbs ◽  
Clinical Issue ◽  
Osteoarthritic Change ◽  
Tibial Internal Rotation

Abstract Background The classification of knee osteoarthritis is an essential clinical issue, particularly in terms of diagnosing early knee osteoarthritis. However, the evaluation of three-dimensional limb alignment on two-dimensional radiographs is limited. This study evaluated the three-dimensional changes induced by weight-bearing in the alignments of lower limbs at various stages of knee osteoarthritis.Methods 45 knees of 25 patients (69.9 ± 8.9 years) with knee OA were examined in the study. CT images of the entire leg were obtained in the supine and standing positions using conventional CT and 320 low-detector upright CT, respectively. Next, the differences in the three-dimensional alignment of the entire leg in the supine and standing positions were obtained using 3D-3D surface registration technique, and those were compared for each Kellgren–Lawrence grade. Results Increased flexion, adduction, and tibial internal rotation were observed in the standing position, as opposed to the supine position. Kellgren–Lawrence grades 1 and 4 showed significant differences in flexion, adduction, and tibial internal rotation between two postures. Grades 2 and 4 showed significant differences in adduction, while grades 1 and 2, and 1 and 3 showed significant differences in tibial internal rotation between standing and supine positions.Conclusions Weight-bearing increased the three-dimensional deformities in knees with osteoarthritis. Particularly, increased tibial internal rotation was observed in patients with grades 2 and 3 compared to those with grade 1. The increase in tibial internal rotation due to weight-bearing is a key pathologic feature to detect early osteoarthritic change in knees undergoing osteoarthritis.

The role of rehabilitation exercises on weight, functional strength and exercise adherence in knee osteoarthritis patients

2021 ◽  
Vol 17 ◽  
Author(s):  
Muhammad Tariq Rafiq ◽  
Mohamad Shariff Abdul Hamid ◽  
Eliza Hafiz ◽  
Khalid Rashid ◽  
Farid Ahmad Chaudhary
Keyword(s):  
Knee Osteoarthritis ◽  
Weight Bearing ◽  
Exercise Adherence ◽  
Lower Limbs ◽  
Joint Disease ◽  
Control Group ◽  
Post Test ◽  
Rehabilitation Exercises ◽  
Normally Distributed

Introduction: Knee osteoarthritis (OA) is a weight-bearing joint disease and is more common in overweight and obese persons. The objective of this study was to determine the role of rehabilitation exercises (REs) of lower limbs on weight, functional strength, and exercise adherence in overweight and obese knee OA patients. Materials And Method: The patients were recruited from the Urban community of Lahore, Pakistan. The patients were divided into the rehabilitation group (RG) and control group (CG). The patients in the RG performed the REs of lower limbs and followed the instructions of daily care (IDC), while the patients in the CG only followed the IDC for 12 weeks. Outcome measures were assessed at pre-test before grouping and post-test after 12-weeks of interventions. The measures included: weight, functional strength, and exercise adherence. The Paired Samples t-test (for the normally distributed data) and the Wilcoxon Signed Ranked Test (for the data that was not normally distributed) were used to analyze the differences within groups from pre to post-test measurements. The analysis of variance 2 × 2 factors and the Mann-Whitney U-test were used to analyze the difference of weight and functional strength respectively between the groups. Results: The patients in the RG reported a statistically significant weight reduction (p < 0.001) and improvement in the functional strength (p < 0.001) within the group. Similarly, the patients in the CG also reported a significant improvement in the scores of functional strength (p = 0.004) within the group. The improvement in the scores of functional strength was greater in the patients of RG than the CG (p < 0.001. Similarly, the patients in the RG reported a statistically significant reduction in weight than the CG (p < 0.001). Conclusion: The REs could improve weight, functional strength and exercise adherence.

scholarly journals Effects of Unweighting on Gait Kinematics During Walking on a Lower-Body Positive Pressure Treadmill in Patients with Hip Osteoarthritis

2020 ◽  
Author(s):  
Yoshiaki Kataoka ◽  
Tomohiro Shimizu ◽  
Ryo Takeda ◽  
Shigeru Tadano ◽  
Yuki Saito ◽  
...  
Keyword(s):  
Rating Scale ◽  
Weight Bearing ◽  
Three Dimensional ◽  
Hip Osteoarthritis ◽  
Lower Limbs ◽  
Positive Pressure ◽  
Lower Body ◽  
Lower Body Positive Pressure ◽  
Gait Kinematics ◽  
Body Positive

Abstract Background: Hip osteoarthritis (OA) is a musculoskeletal condition that makes walking difficult due to pain induced by weight-bearing activity. Treadmills that support body weight reduce the load on the lower limbs, and those equipped with a lower-body positive pressure (LBPP) device, developed as a new method for unweighting, significantly reduce pain in patients with knee OA. However, the effects of unweighting on gait kinematics remain unclear in patients with hip OA. Therefore, we investigated the effects of unweighting on kinematics in patients with hip OA during walking on a treadmill equipped with an LBPP device.Methods: Fifteen women with hip OA and fifteen age-matched female controls wore a three-dimensional motion analysis system and walked at a self-selected speed on the LBPP treadmill. Data regarding hip pain using a numeric rating scale under three different unweighting conditions (100%, 75%, and 50% bodyweight) were collected. Three-dimensional peak joint angles during gait under each condition were calculated and compared.Results: In the hip OA group, numerical rating scores at the unweighted conditions were significantly decreased compared to the 100% bodyweight condition, and peak hip extension angle decreased compared to the healthy controls. In both groups, unweighting significantly decreased the peak hip and knee flexion angle and increased the peak ankle plantarflexion angle during walking.Conclusions: Although unweighting by LBPP decreased pain in the hip OA group, gait kinematics did not alter despite less load on the hip joint. Therefore, clinicians should consider the benefits of pain reduction, rather than the alternation of gait kinematics, when considering LBPP treadmill for patients with hip OA.

Weight-bearing CT Technology in Musculoskeletal Pathologies of the Lower Limbs: Techniques, Initial Applications, and Preliminary Combinations with Gait-Analysis Measurements at the Istituto Ortopedico Rizzoli

2019 ◽  
Vol 23 (06) ◽  
pp. 643-656 ◽  
Author(s):  
Alberto Leardini ◽  
Stefano Durante ◽  
Claudio Belvedere ◽  
Paolo Caravaggi ◽  
Claudio Carrara ◽  
...  
Keyword(s):  
Weight Bearing ◽  
Three Dimensional ◽  
3D Models ◽  
Two Dimensions ◽  
Lower Limbs ◽  
Flat Foot ◽  
Musculoskeletal Radiology ◽  
Foot Bones ◽  
Patellofemoral Alignment ◽  
3D Scans

AbstractMusculoskeletal radiology has been mostly limited by the option between imaging under load but in two dimensions (i.e., radiographs) and three-dimensional (3D) scans but in unloaded conditions (i.e., computed tomography [CT] and magnetic resonance imaging in a supine position). Cone-beam technology is now also a way to image the extremities with 3D and weight-bearing CT. This article discusses the initial experience over a few studies in progress at an orthopaedic center. The custom design of total ankle replacements, the patellofemoral alignment after medial ligament reconstruction, the overall architecture of the foot bones in the diabetic foot, and the radiographic assessment of the rearfoot after subtalar fusion for correction of severe flat foot have all taken advantage of the 3D and weight-bearing feature of relevant CT scans. To further support these novel assessments, techniques have been developed to obtain 3D models of the bones from the scans and to merge these with state-of-the-art gait analyses.

scholarly journals A Comparison of Dynamic and Static Hip-Knee-Ankle Angle during Gait in Knee Osteoarthritis Patients and Healthy Individuals

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Li Zhang ◽  
Geng Liu ◽  
Bing Han ◽  
Yuzhou Yan ◽  
Junhua Fei ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Healthy Subjects ◽  
Gait Cycle ◽  
Three Dimensional ◽  
Lower Limbs ◽  
Ankle Angle ◽  
The Mean ◽  
The Relationship ◽  
Hip Knee Ankle Angle ◽  
Healthy Participants

Malalignment of the lower limbs is the main biomechanical factor for knee osteoarthritis (KOA). The static hip-knee-ankle angle (S-HKAA) measured from radiograph is regarded as the “gold standard” of the malalignment. However, many evidences showed that the S-HKAA has no significant correlation with the knee dynamic-load distribution, unlike the dynamic HKAA (D-HKAA). The purpose of this study was to quantitatively analyze the D-HKAA and investigate the relationship between D-HKAA and S-HKAA for both KOA and healthy participants. In this paper, twenty-five healthy subjects and twenty-five medial compartment KOA (M-KOA) patients were recruited. Three-dimensional motion analysis and standing lower-limbs-full-length radiograph were utilized to obtain the D-HKAA and S-HKAA, respectively. The results showed that the mean D-HKAA was more varus than the S-HKAA ( p < 0.05 ). For the mean D-HKAA, larger varus angle was observed in swing phase than stance phase ( p < 0.05 ). Compared with healthy subjects, the M-KOA patients had remarkably smaller S-HKAA and D-HKAA during gait cycle ( p < 0.01 ). For the relationship between the S-HKAA and mean D-HKAA, no significant correlation was found for both healthy subjects and M-KOA patients ( r < 0.357 , n = 25 , p > 0.05 , Spearman correlation analysis). In conclusion, the S-HKAA was limited to predict the D-HKAA for both M-KOA patients and healthy subjects. The D-HKAA should be given more attention to the orthopedist and the designer of knee brace and orthotics.

scholarly journals Increase in medial meniscal extrusion in the weight-bearing position observed on ultrasonography correlates with lateral thrust in early-stage knee osteoarthritis

2020 ◽  
Vol 25 (4) ◽  
pp. 640-646 ◽  
Author(s):  
Yosuke Ishii ◽  
Masakazu Ishikawa ◽  
Hiroshi Kurumadani ◽  
Seiju Hayashi ◽  
Atsuo Nakamae ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Early Stage ◽  
Weight Bearing ◽  
Lateral Thrust ◽  
Meniscal Extrusion

Varying degrees of running incline: Implications for chronic injury aetiology and rehabilitation

2014 ◽  
Vol 10 (4) ◽  
pp. 207-214 ◽  
Author(s):  
J. Sinclair ◽  
A. Greenhalgh ◽  
P.J. Taylor ◽  
I. Bentley
Keyword(s):  
Lower Extremity ◽  
Internal Rotation ◽  
Repeated Measures ◽  
Three Dimensional ◽  
Treadmill Running ◽  
Clinical Perspective ◽  
Chronic Injury ◽  
Combined Analysis ◽  
Tibial Internal Rotation ◽  
Tibial Acceleration

There has yet to be a combined analysis of the kinetics and three-dimensional kinematics of running at various degrees of inclination. The aim of the current study was to investigate the influence of treadmill running at various inclines (flat, 5, 10 and 15 degrees) on three-dimensional kinematics of the lower extremities and accelerations measured at the tibia. Ten male participants ran at 4.0 m/s at the four different inclinations. Three-dimensional lower extremity kinematics and tibial accelerations were quantified and contrasted using repeated measures ANOVA's. Tibial acceleration parameters were reduced significantly as a function of running incline, whilst tibial internal rotation was significant greater at 15° compared to flat. This study confirms that differences in both kinetics and kinematics are mediated through alterations in running inclination. From a clinical perspective, those who are susceptible/ recovering from injury may wish to utilise an incline in their training.

Immediate effects of leg-press exercises with tibial internal rotation on individuals with medial knee osteoarthritis

2018 ◽  
Vol 23 (4) ◽  
pp. e1725 ◽  
Author(s):  
Kenji Hanada ◽  
Michiya Hara ◽  
Yoshiyuki Hirakawa ◽  
Kenji Hoshi ◽  
Kazuya Ito ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Internal Rotation ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis ◽  
Leg Press ◽  
Tibial Internal Rotation

The Three-Dimensional Kinematics and Flexibility Characteristics of the Human Ankle and Subtalar Joints—Part I: Kinematics

1988 ◽  
Vol 110 (4) ◽  
pp. 364-373 ◽  
Author(s):  
Sorin Siegler ◽  
Jie Chen ◽  
C. D. Schneck
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
Ankle Joint ◽  
Subtalar Joint ◽  
External Rotation ◽  
Three Dimensional ◽  
Lower Limbs ◽  
Helical Axis ◽  
Kinematic Coupling ◽  
Human Ankle

The in-vitro, three dimensional kinematic characteristics of the human ankle and subtalar joint were investigated in this study. The main goals of this investigation were: 1) To determine the range of motion of the foot-shank complex and the associated range of motion of the ankle and subtalar joints; 2) To determine the kinematic coupling characteristics of the foot-shank complex, and 3) To identify the relationship between movements at the ankle and subtalar joints and the resulting motion produced between the foot and the shank. The tests were conducted on fifteen fresh amputated lower limbs and consisted of incrementally displacing the foot with respect to the shank while the motion of the articulating bones was measured through a three dimensional position data acquisition system. The kinematic analysis was based on the helical axis parameters describing the incremental displacements between any two of the three articulating bones and on a joint coordinate system used to describe the relative position between the bones. From the results of this investigation it was concluded that: 1) The range of motion of the foot-shank complex in any direction (dorsiflexion/plantarflexion, inversion/eversion and internal rotation/external rotation) is larger than that of either the ankle joint or the subtalar joint.; 2) Large kinematic coupling values are present at the foot-shank complex in inversion/eversion and in internal rotation/external rotation. However, only a slight amount of coupling was observed to occur in dorsiflexion/plantarflexion.; 3) Neither the ankle joint nor the subtalar joint are acting as ideal hinge joints with a fixed axis of rotation.; 4) Motion of the foot-shank complex in any direction is the result of rotations at both the ankle and the subtalar joints. However, the contribution of the ankle joint to dorsiflexion/plantarflexion of the foot-shank complex is larger than that of the subtalar joint and the contribution of the subtalar joint to inversion/eversion is larger than that of the ankle joint.; 5) The ankle and the subtalar joints have an approximately equal contribution to internal rotation/external rotation movements of the foot-shank complex.

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