scholarly journals Preoperative and postoperative radiomorphological changes in the bones forming the knee joint of patients with tibial shortening and deformities of different etiology

2020 ◽  
Vol 98 (2) ◽  
pp. 142-148
Author(s):  
G. V. Diachkova ◽  
K. A. Diachkov ◽  
A. M. Aranovich ◽  
D. Alekberov ◽  
T. A. Larionova ◽  
...  
Keyword(s):  
Knee Joint ◽  
Deformity Correction ◽  
Rehabilitation Program ◽  
Normal Function ◽  
Morphological Process ◽  
Blount’S Disease ◽  
Tibial Lengthening ◽  
Postoperative Changes ◽  
Before And After ◽  
Limited Function

Introduction. Tibial lengthening is one of highly popular surgical procedures that can be associated with complications of the knee joint related to surgical intervention or baseline changes in the bones forming the knee. Objective. To explore preoperative and postoperative changes in the bones forming the knee joint of patients with tibial shortening of different etiology. Material and methods. Radiography and multislice computed tomography (MSCT) were performed for 48 achondroplasia patients, 15 subjects with subjectively low height, 25 patients with vitamin-D resistant rickets (MRI produced for 20 patients), 56 patients with Blount’s disease (MSCT produced for 10 cases) before and after tibial lengthening or deformity correction. Results. The findings showed that tibial lengthening was accompanied by limited function of the knee even in absence of evident articular changes. Good results could be ensured with adequately performed lengthening technique and proper control of muscle condition and rehabilitation program to be meticulously followed. Patients with baseline problems in the joints were shown to have progressive changes in the knee joints during tibial lengthening, however, they were not critical and could provide a normal function at a long-term follow-up. Conclusion. Tibial lengthening as a complicated biomechanical and morphological process is accompanied by changes in the knee joint and can be successfully accomplished with adequate technique applied and rehabilitation program performed. Chnages in the knee were more evident in patients with baseline disorders in the anatomy and architechtonics of the femoral and tibial condyles, however, improved biomechanical parameters of the limb allowed us to obtain positive outcomes and good function in almost all the cases.

Lateral Thoracolumbar Listhesis as an Independent Predictor of Disability in Adult Scoliosis Patients: Multivariable Assessment Before and After Surgical Realignment

Neurosurgery ◽  
2021 ◽  
Author(s):  
Alan H Daniels ◽  
Wesley M Durand ◽  
Renaud Lafage ◽  
Andrew S Zhang ◽  
David K Hamilton ◽  
...  
Keyword(s):  
Cobb Angle ◽  
Multivariable Analysis ◽  
Deformity Correction ◽  
Adult Scoliosis ◽  
Leg Pain ◽  
Minimally Clinically Important Difference ◽  
Before And After ◽  
Plane Deformity ◽  
Numeric Scale

Abstract BACKGROUND Lateral (ie, coronal) vertebral listhesis may contribute to disability in adult scoliosis patients. OBJECTIVE To assess for a correlation between lateral listhesis and disability among patients with adult scoliosis. METHODS This was a retrospective multi-center analysis of prospectively collected data. Patients eligible for a minimum of 2-yr follow-up and with coronal plane deformity (defined as maximum Cobb angle ≥20º) were included (n = 724). Outcome measures were Oswestry Disability Index (ODI) and leg pain numeric scale rating. Lateral thoracolumbar listhesis was measured as the maximum vertebral listhesis as a percent of the superior endplate across T1-L5 levels. Linear and logistic regression was utilized, as appropriate. Multivariable analyses adjusted for demographics, comorbidities, surgical invasiveness, maximum Cobb angle, and T1-PA. Minimally clinically important difference (MCID) in ODI was defined as 12.8. RESULTS In total, 724 adult patients were assessed. The mean baseline maximum lateral thoracolumbar listhesis was 18.3% (standard deviation 9.7%). The optimal statistical grouping for lateral listhesis was empirically determined to be none/mild (<6.7%), moderate (6.7-15.4%), and severe (≥15.4%). In multivariable analysis, listhesis of moderate and severe vs none/mild was associated with worse baseline ODI (none/mild = 33.7; moderate = 41.6; severe = 43.9; P < .001 for both comparisons) and leg pain NSR (none/mild = 2.9, moderate = 4.0, severe = 5.1, P < .05). Resolution of severe lateral listhesis to none/mild was independently associated with increased likelihood of reaching MCID in ODI at 2 yr postoperatively (odds ratio 2.1 95% confidence interval 1.2–3.7, P = .0097). CONCLUSION Lateral thoracolumbar listhesis is associated with worse baseline disability among adult scoliosis patients. Resolution of severe lateral listhesis following deformity correction was independently associated with increased likelihood of reaching MCID in ODI at 2-yr follow-up.

scholarly journals Growth rate after limb deformity correction by the Ilizarov method with or without knee joint distraction

2009 ◽  
Vol 80 (3) ◽  
pp. 338-343 ◽  
Author(s):  
Hubert J Oostenbroek ◽  
Ronald Brand ◽  
Peter M van Roermund
Keyword(s):  
Growth Rate ◽  
Knee Joint ◽  
Deformity Correction ◽  
Ilizarov Method ◽  
Limb Deformity ◽  
Joint Distraction

scholarly journals Pengaruh Range of Motion (ROM) Aktif Terhadap Fleksibilitas Sendi Lutut Pada Lanjut Usia

2020 ◽  
Vol 1 (1) ◽  
pp. 13-16
Author(s):  
Tavip Indrayana ◽  
Warijan Warijan ◽  
Joni Siswanto
Keyword(s):  
Connective Tissue ◽  
Knee Joint ◽  
Muscle Fibers ◽  
Sampling Technique ◽  
The Elderly ◽  
Before And After ◽  
Post Test ◽  
Quasi Experimental ◽  
The Right ◽  
Average Angle

ABSTRACTBackground : Joint flexibility decreases in old age due to a degenerative process resulting in changes in joints, connective tissue and cartilage in the elderly. Decreasing flexibility is also due to reduced elasticity of muscle fibers, where connective tissue in muscle fibers increases (Mariyam, 2008).Objective : The aim of this study was to analyze the effect of active exercise (ROM) on the lower extremities on increasing the flexibility of the knee joint in the elderlyMethods : This study using a quasi-experimental approach with One group pre-test and post-test design. The sampling technique uses the Slovin method of 42 people, obtained a sample of 25 elderly. Exercise is done twice a day for 8 days. Measurements were made on day 1, day 4 and day 8 of the study using a Goniometer measuring instrument..Result : The results of measurement I average of the right knee joint 117.52o, measurement II = 122.24, measurement III = 126, 36o. From the analysis with Paired simple t-Test between the measurements I and II, it was found that the different test measurements I and II t count value was equal to -1.908 with 0.068. Because sig 0.05, it can be concluded that Ho is accepted, meaning that the average angle of ROM before and after training is the same (not different). In the different test measurements II and III the value of t count is equal to -2.152 with sig 0.042.Conclusion : Because sig 0.05, it can be concluded that Ho is rejected, meaning that there is a difference in ROM angle after training between days 4 to 8 with the first day to day 4. Thus it can be stated that active ROM exercises affect the angle of ROM of the knee joint elderly after exercise ROM between day 4 to day 8. Keywords: active ROM exercise, flexibility of knee joint, elderly.

Functional Arthralgies of Knee Joint as a Complex Problem in the Modern Rehabilitation System

2021 ◽  
Vol 6 (5) ◽  
pp. 56-62
Author(s):  
T. G. Turitska ◽  
◽  
A. A. Vinnyk ◽  
O. S. Snisar
Keyword(s):  
Knee Joint ◽  
Knee Pain ◽  
Local Level ◽  
Pain Syndrome ◽  
Rehabilitation Program ◽  
Google Scholar ◽  
Sources Of Information ◽  
Surgical Interventions ◽  
Muscle Imbalance ◽  
The Impact

The purpose of the study was to search for and analyze data from modern sources of information on the features of the occurrence and manifestations of pain in the knee joint and approaches to treatment. Materials and methods. The paper presents an analysis and generalization of modern scientific and methodological literature of domestic and foreign authors according to the Internet and Google Scholar service on the peculiarities of arthralgia of the knee joint and concomitant manifestations of this disorder (back pain, posture, etc.). Results and discussion. The article analyzed modern views on the occurrence and development of the process of pain syndrome in the knee joint. Sources on request in the Google Scholar service were analyzed, where the overwhelming majority of publications are described by pain slander and approaches to its treatment after the occurrence of anatomical changes in the structures of bone and soft-wound structures or after surgical interventions. Thus, the prevailing approach is the purpose of non-steroidal anti-inflammatory drugs in combination with chondroprotectors. According to the authors of the article, this approach to the treatment of pain in the area of the knee joint does not take into account one of the main components of the occurrence of arthralgia – muscle imbalance, both at the local level of the lower extremities and muscular-fascial chains. According to the theory of muscular chains, the dislocation of bones forming the knee joint leads to uneven loading of the femoral and tibial bones to the metaphizar deposits, which leads to a circulatory disorder and further leads to degenerative-dystrophic diseases. Understanding this component of pathogenesis can give a specialist in physical therapy and ergotherapy a more informed approach to the development of balanced treatment tactics aimed at eliminating the primary causes of pain syndrome. Conclusion. Pain in the knee joint can be caused not only by degenerative-dystrophic changes in the bones, but also can be associated with muscle imbalance of the posterior surface line. The development of a rehabilitation program for knee pain should include not only the use of local remedies, but also take into account the impact on the relevant reflex areas in the spine. Emerging degenerative-dystrophic processes in the bones that are part of the structure of the knee joint can be caused by their dislocation due to muscle imbalance. Uncontrolled and unauthorized use of analgesics by patients with knee pain can smooth the clinical picture and reduce the effectiveness of rehabilitation measures

scholarly journals Effects of a Rehabilitation Programme with a Nasal Inspiratory Restriction Device on Exercise Capacity and Quality of Life in COPD

2020 ◽  
Vol 17 (10) ◽  
pp. 3669 ◽  
Author(s):  
Aurelio Arnedillo ◽  
Jose L. Gonzalez-Montesinos ◽  
Jorge R. Fernandez-Santos ◽  
Carmen Vaz-Pardal ◽  
Carolina España-Domínguez ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Muscle Strength ◽  
Exercise Capacity ◽  
Rehabilitation Program ◽  
Inspiratory Muscle ◽  
Control Group ◽  
6Mwt Distance ◽  
Before And After ◽  
Inspiratory Muscle Strength

Objective: The objective was to assess the effects of a nasal restriction device for inspiratory muscle training, called Feelbreathe®, added to a rehabilitation program (RP) on exercise capacity, quality of life, dyspnea and inspiratory muscle strength in patients with stable COPD. Methods: Patients were randomized into three groups, one performed a supervised RP using the Feelbreathe® device (FB group), the second group developed the same RP with oronasal breathing without FB (ONB group) and the third was the control group (CG). We evaluated inspiratory muscle strength (PImax), dyspnea (mMRC), quality of life (CAT) and exercise capacity (6MWT) before and after 8-week of RP. Results: A total of 16 patients completed the study, seven in FB group, five in ONB group and four in the CG. After the RP, the FB group showed a significant increase in PImax (93.3 ± 19.1 vs. 123.0 ± 15.8 mmHg) and in the 6MWT distance (462.9 ± 71.8 m vs. 529.1 ± 50.1 m) and a decrease in the CAT score (9.7 ± 6.5 vs. 5.9 ± 6.0) and in the mMRC dyspnea score. FB provides greater improvement in PImax, dyspnea, quality of life and 6MWT than ONB. Conclusions: The Feelbreathe® device provides greater improvements in quality of life, dyspnea, exercise capacity and inspiratory muscle strength compared to patients that did not use it.

scholarly journals Limb lengthening in the treatment of posteromedial bowing of the tibia

2020 ◽  
Vol 14 (5) ◽  
pp. 480-487
Author(s):  
J. Eric Gordon ◽  
Perry L. Schoenecker ◽  
Thomas R. Lewis ◽  
Mark L. Miller
Keyword(s):  
Skeletal Maturity ◽  
Deformity Correction ◽  
Limb Lengthening ◽  
Limb Length Discrepancy ◽  
Single Institution ◽  
Level Of Evidence ◽  
Tibial Lengthening ◽  
The Mean ◽  
Ankle Valgus

Purpose Posteromedial bowing of the tibia is an uncommon but recognized congenital lower extremity deformity in children that can lead to limb length discrepancy (LLD) and residual angulatory deformity. The purpose of this study is to report a series of children at a single institution with posteromedial bowing treated by lengthening. Methods A retrospective review was carried out at our institution identifying 16 patients who were treated with limb lengthening for posteromedial bowing of the tibia and followed to skeletal maturity. Projected LLD was a mean of 7.7 cm (range 5.0 cm to 14.2 cm). Three patients were treated in a staged fashion with lengthening and deformity correction at age three to four years and subsequent definitive tibial lengthening. The remaining 13 patients were treated with limb lengthening approaching adolescence using circular external fixation. Results All patients were pain free and ambulated without a limp at final follow-up. The mean final LLD was 0.3 cm short. In spite of correction of distal tibial shaft valgus in 11 of the 16 patients, eight of the 16 (50%) required later correction of persistent, symptomatic ankle valgus by either hemiepiphyseodesis (seven patients) or osteotomy (one patient). Conclusions Children with posteromedial bowing of the tibial with projected LLD over 5cm can be effectively treated with lengthening. Patients with severe valgus of more than 30° of shaft valgus and difficulty ambulating at age three years can be successfully treated with a two-stage lengthening procedure. Attention should be paid in patients with posteromedial bowing to ankle valgus. Level of Evidence IV

Gadolinium-Dtpa-Enhanced MR Imaging in Asymptomatic Knees

1996 ◽  
Vol 37 (3P2) ◽  
pp. 877-882 ◽  
Author(s):  
T. Boegård ◽  
Å. Johansson ◽  
O. Rudling ◽  
I. Petersson ◽  
K. Forslind ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Knee Joint ◽  
Healthy Subjects ◽  
Knee Joints ◽  
Age Group ◽  
Healthy Individuals ◽  
Middle Aged ◽  
Gadolinium Dtpa ◽  
Contrast Enhanced ◽  
Before And After

Purpose: To evaluate the occurrence and extent of Gd-DTPA-enhanced synovial structures in asymptomatic knee joints of middle-aged healthy individuals. Material and Methods: MR imaging of the knee joint was performed in 10 healthy subjects aged 40–61 years. The study included a sagittal T1-weighted SE sequence before and after i.v. injection of 0.1 mmol Gd-DTPA/kg b.w. Results: Contrast-enhanced synovial structures were found in all knees. The extent of the synovial structures was usually not uniform within the examined joint. In the intercondylar fossa, the thickness of synovial structures was more often pronounced. In the suprapatellar recess, synovial thickness was constant and minimal. Conclusion: The presence and the varying extent and thickness of synovial structures in asymptomatic knees in middle-aged individuals must be considered in the evaluation of early and mild synovitis of the knee joint with Gd-enhanced MR imaging in this age group.

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