Assessment of central aponeurosis curvature as an index of rectus femoris muscle overstrain in individuals with knee osteoarthritis

BACKGROUND: In medial knee osteoarthritis (knee OA), compensatory overstrain of the rectus femoris (RF) muscle leads to its hypertrophy. We hypothesize that besides hypertrophy of the RF, a prominent flattening of the central aponeurosis (CA) curvature is also indicative of RF. This study aims to evaluate the structural changes in the CA and clarify the conditions associated with RF overstrain in knee OA. OBJECTIVE: Twenty-three legs of 20 elderly without knee OA (elderly group) and 26 legs of 20 individuals with K-L grade II knee OA (knee OA group) with typical “comma”-shaped CA participated in this study. METHODS: The knee extension torque (Nm/kg) in the sitting position, the thickness of the RF and vastus intermedius (VI) muscles (VI), and change in CA curvature (%Curvature) were measured at the mid-thigh by ultrasonography. RESULTS: The knee extension torque was not significantly different between the two groups. Compared to the elderly group, the knee OA group had significantly thicker RF at rest, while the VI thickness during contraction was significantly smaller. The %Curvature was significantly higher in the knee OA group than in the elderly group. CONCLUSIONS: In the knee OA group, the RF was hypertrophic with a more pronounced CA flattening during muscle contraction, although the other quadriceps muscles were atrophic, suggesting an overstrained RF. Assessing thickness and CA curvature of the RF is, therefore, useful and simple for evaluating overstrain caused by RF compensation.

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Relationship Between Low Bone Mineral Density and Varus Deformity in Postmenopausal Women with Knee Osteoarthritis

The Journal of Rheumatology ◽

10.3899/jrheum.080699 ◽

2009 ◽

Vol 36 (3) ◽

pp. 592-597 ◽

Cited By ~ 9

Author(s):

YASUSHI AKAMATSU ◽

NAOTO MITSUGI ◽

NAOYA TAKI ◽

RYOHEI TAKEUCHI ◽

TOMOYUKI SAITO

Keyword(s):

Bone Mineral Density ◽

Lumbar Spine ◽

Knee Osteoarthritis ◽

Structural Changes ◽

Tibial Plateau ◽

Varus Deformity ◽

Varus Knee ◽

Mineral Density ◽

Femorotibial Angle ◽

Knee Oa

Objective.To assess the relationship between bone mineral density (BMD) and varus deformity arising from bone structural changes caused by knee osteoarthritis (OA) in postmenopausal women.Methods.This cross-sectional study involved 135 consecutive postmenopausal female patients who had varus knee OA and a Kellgren-Lawrence grade ≥ 2. Knee radiographs were obtained with the patient standing on one leg, and subjects were classified into 3 tertile groups according to femorotibial angle, which was taken as a measure of varus knee OA severity. We also measured the 3 subangles that make up the femorotibial angle, and focused on the varus inclination of the tibial plateau. BMD was measured in the lumbar spine, femoral neck, and medial and lateral tibial condyles using dual-energy X-ray absorptiometry. Differences between femorotibial angle tertile groups were assessed, and associations between femorotibial sub-angles and BMD values at various points were evaluated.Results.After adjustment for age and body mass index, there was no significant association between the varus inclination of the tibial plateau and lumbar spine BMD. A weak but statistically significant negative correlation existed between varus inclination of the tibial plateau and BMD at the ipsilateral proximal femur and lateral tibial condyle.Conclusion.Varus inclination of the tibial plateau was significantly more severe in the femorotibial angle tertile 3 group, and in patients with lower BMD in the ipsilateral lower limb. Varus knee OA may result not only from cartilage loss but also from structural changes of the bone.

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Comparison of Diagnostic Performance of Semi-Quantitative Knee Ultrasound and Knee Radiography with MRI: Oulu Knee Osteoarthritis Study

Scientific Reports ◽

10.1038/srep22365 ◽

2016 ◽

Vol 6 (1) ◽

Cited By ~ 31

Author(s):

Jana Podlipská ◽

Ali Guermazi ◽

Petri Lehenkari ◽

Jaakko Niinimäki ◽

Frank W. Roemer ◽

...

Keyword(s):

Articular Cartilage ◽

Knee Osteoarthritis ◽

Diagnostic Performance ◽

Structural Changes ◽

Morphological Changes ◽

Cost Effective ◽

Conventional Radiography ◽

Joint Space ◽

Meniscal Extrusion ◽

Knee Oa

Abstract Osteoarthritis (OA) is a common degenerative musculoskeletal disease highly prevalent in aging societies worldwide. Traditionally, knee OA is diagnosed using conventional radiography. However, structural changes of articular cartilage or menisci cannot be directly evaluated using this method. On the other hand, ultrasound is a promising tool able to provide direct information on soft tissue degeneration. The aim of our study was to systematically determine the site-specific diagnostic performance of semi-quantitative ultrasound grading of knee femoral articular cartilage, osteophytes and meniscal extrusion, and of radiographic assessment of joint space narrowing and osteophytes, using MRI as a reference standard. Eighty asymptomatic and 79 symptomatic subjects with mean age of 57.7 years were included in the study. Ultrasound performed best in the assessment of femoral medial and lateral osteophytes, and medial meniscal extrusion. In comparison to radiography, ultrasound performed better or at least equally well in identification of tibio-femoral osteophytes, medial meniscal extrusion and medial femoral cartilage morphological degeneration. Ultrasound provides relevant additional diagnostic information on tissue-specific morphological changes not depicted by conventional radiography. Consequently, the use of ultrasound as a complementary imaging tool along with radiography may enable more accurate and cost-effective diagnostics of knee osteoarthritis at the primary healthcare level.

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Intra-articular corticosteroid injection and genicular nerve block under ultrasound guidance in pain control of knee osteoarthritis

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-021-00577-z ◽

2021 ◽

Vol 52 (1) ◽

Author(s):

Abdel Rahman Ragab ◽

Sherif Hegab ◽

Rehab Elnemr ◽

Amr Abdel-Kerim

Keyword(s):

Knee Osteoarthritis ◽

Nerve Block ◽

Corticosteroid Injection ◽

Oxford Knee Score ◽

The Elderly ◽

Functional Improvement ◽

Ultrasound Guided ◽

Knee Oa ◽

Group 2

Abstract Background Chronic knee osteoarthritis (OA) is a frequent disease among the elderly. Intra-articular corticosteroid injection (IACSI) was commonly adopted to alleviate knee OA-related pains. Recently, Genicular nerve block (GNB) has emerged as a new alternative technique. The current study aimed to investigate the efficacy of those two approaches when guided with ultrasound and to determine which one offers better results. This study included 40 patients with painful chronic knee OA (Nine males and 31 females, age ranged from 44 to 65 years) and were randomly assigned to two equal groups. Groups 1 was managed with ultrasound-guided IACSI and group 2 with ultrasound-guided GNB using a mixture of lidocaine and Triamcinolone Acetonide. The baseline mean visual analogue scale (VAS) and Oxford knee score (OKS) for the group 1 were 87.10 and 51.3, while for group 2 were 87.75 and 53.25 respectively. Follow up values were obtained at 2, 4 and 8 weeks using VAS and OKS. Results The VAS score and OKS score were significantly lower in the GNB group and IACSI group at 2, and 4 weeks after the procedure (p < 0.001 for all), then returned near baseline values at 8 weeks. When the two groups were compared according to changes in VAS and OKS from baseline at 2, 4, and 8 weeks, GNB group showed significant alleviation of pain (mean reduction of 58.5, 53.3, and 9.25 points at 2, 4, and 8 weeks versus 44.9, 39.4, and 5.6 points at the IACSI groups, p < 0.001 at 2 and 4 weeks, p < 0.006 at 8 weeks). Similarly at the OKS, the GNB group showed significantly better results (33.50, 28.60, and 8.5 at GNB and 26.45, 20.10, 5.25 at IACSI. p < 0.001 at all periods). Conclusions Both GNB and IACSI are effective methods to relieve chronic knee osteoarthritis-related pains. When compared to each other, GNB showed more significant pain relief and functional improvement than IACSI.

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Alteration of Screw-home Movement in Patients With Knee Osteoarthritis: A Cross-sectional Study

10.21203/rs.3.rs-35701/v1 ◽

2020 ◽

Author(s):

Jeongwoo Jeon ◽

Dongyeop Lee ◽

Jaeho Yu ◽

Jinseop Kim ◽

Sang Hoon Lhee ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Knee Extension ◽

Cross Sectional Study ◽

Measurement Unit ◽

Tibial Rotation ◽

Sectional Study ◽

Control Groups ◽

Cross Sectional ◽

Knee Oa ◽

And Control

Abstract Background: Tibial rotation accompanying sagittal movement contains the phenomenon of screw-home movement of the knee, which plays an important role in knee stability during extension. This study aimed to investigate the alteration of screw-home movement in patients with knee osteoarthritis (OA).Methods: Participants (n =67) in this cross-sectional study were outpatients in the department of orthopedics of a general hospital and included patients with knee OA (n=31) and asymptomatic control subjects (n=36).Knee kinematic data were measured using an inertial measurement unit. The total tibial rotation was obtainedduring knee sagittal movement. The acquired angle of tibial rotation was divided into four periodseach extension and flexion. The total tibial rotation and the variation of each period were compared between the OA and control groups.Results: Significant differences arose between the OA and control groups in the total tibial rotation during knee extension and flexion(P< 0.001).The variation of tibial rotation was also significantly different between groups for all periods (P< 0.001; knee extensionat 70° to 45°,P = 0.014).Conclusions: We found a reduction in the total tibial rotation and loss of the screw-home movement in the unloaded OA knee. To normalize the screw-home movement, it is necessary to promote proper articular movement of the knee joint and suppress the hyperexcitability of the medial muscles.

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Intra-Articular Hyaluronic Acid as Treatment in Elderly and Middle-Aged Patients with Knee Osteoarthritis

The Open Rheumatology Journal ◽

10.2174/1874312901307010038 ◽

2013 ◽

Vol 7 (1) ◽

pp. 38-41 ◽

Cited By ~ 9

Author(s):

Demet Uçar ◽

Demirhan Dıraçoğlu ◽

Türker Süleyman ◽

Nalan Çapan

Keyword(s):

Hyaluronic Acid ◽

Knee Osteoarthritis ◽

The Elderly ◽

Elderly Group ◽

Middle Aged ◽

Old Patients ◽

Aged Group ◽

The Third ◽

Age Related ◽

One Year

Introduction: Osteoarthritis is the most common age-related degenerative joint disease. It affects all the joints containing hyaline cartilage. Knee osteoarthritis is the most cumbersome in terms of prevalence and disability. The aim of this study to evaluate the efficacy of intra-articular hyaluronic acid in patients with knee osteoarthritis with regard to joint pain and function, as well as patient satisfaction, assessed at one month and at one year, and by age group. Methods: In this prospective randomised study, 172 patients who were diagnosed knee OA and who received three consecutive intra-articular injections of HA weekly were included. Patients 65 years of age or older were accepted as the “elderly group”, and those under 65 were accepted as the “middle-aged group”. Clinical evaluations of efficacy and safety were conducted at the beginning of the study, one month after the third injection, and one year after the third injection. Results: In the two groups, the intragroup analysis revealed significant improvements following injection when compared with preinjection values. According to the last followup controls (after 12 months) in the middle-aged group, VAS activity pain, VAS rest pain, WOMAC physical function, and WOMAC pain values were found to be statistically lower when compared with pre-injection values. In the elderly group, no statistically significant differences were found between pre-injection and after 12 months. Conclusion: We can conclude that intra-articular joint HA injections are effective in both young and old patients with OA with regard to pain and functional status over a short-term period. Further, HA injections in patients younger than 65 years can be planned for a one-year period.

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The effect of mobilization with movement on pain and function in patients with knee osteoarthritis: a randomized double-blind controlled trial

BMC Musculoskeletal Disorders ◽

10.1186/s12891-019-2841-4 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 9

Author(s):

Hani A. Alkhawajah ◽

Ali M. Alshami

Keyword(s):

Knee Osteoarthritis ◽

Knee Flexion ◽

Controlled Trial ◽

Pressure Pain Threshold ◽

Knee Extension ◽

Timed Up And Go ◽

Double Blind ◽

Knee Flexor ◽

Knee Oa ◽

Flexor Strength

Abstract Background Few studies have investigated the effects of mobilization with movement (MWM) in patients with knee osteoarthritis (OA) compared to other procedures. Sham procedures are generally more appropriate control than using no or usual treatments. Moreover, studies investigating the widespread hypoalgesic effects of MWM in patients with knee OA are lacking. The aim was to investigate the effect of MWM on function and pain in patients with knee OA compared to sham MWM. Methods This is a randomized double-blind (patients and assessor) controlled trial. Forty adult patients with knee OA of grade II and above were recruited to receive either MWM treatment or sham MWM for the knee. The outcome measures included the following: a visual analogue scale (VAS) for pain, the pressure pain threshold (PPT) test, the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index, the timed up and go (TUG) test, knee strength and knee range of motion (ROM). The measurements were taken at baseline, immediately after intervention and 2 days later. Results Compared with sham MWM, MWM resulted in greater immediate improvement in pain [mean difference (95% CI): − 2.2 (− 2.8, − 1.6)], PPT at both the knee [176 (97, 254)] and shoulder [212 (136, 288)], TUG time [− 1.6 (− 2.1, − 1.1)], knee flexor strength [2.0 (1.3, 2.7)] and extensor strength [5.7 (4.1, 7.2)] and knee flexion ROM [12.8 (9.6, 15.9)] (all, p < 0.001) but not knee extension ROM [− 0.8 (− 1.6, 0.1)] (p = 0.067). After 2 days of intervention, patients who received MWM also demonstrated a greater improvement in pain [− 1.0 (− 1.8, − 0.1)], PPT at the shoulder [107 (40, 175)], TUG time [− 0.9 (− 1.4, − 0.4)], knee flexor strength [0.9 (0.2, 1.7)] and extensor strength [2.9 (2.1, 3.9)] and knee flexion ROM [8.3 (4.7, 11.9)] (all, p ≤ 0.026). However, WOMAC scores and knee extension ROM showed no evidence of change at any stage after intervention (p ≥ 0.067). Conclusions MWM provided superior benefits over sham MWM in terms of local and widespread pain, physical function (walking), knee flexion and extension muscle strength and knee flexion ROM for at least 2 days in patients with knee OA. Trial registration ClinicalTrials.gov (NCT02865252), registered on August 12, 2016.

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Association Between Infrapatellar Fat Pad Volume and Knee Structural Changes in Patients with Knee Osteoarthritis

The Journal of Rheumatology ◽

10.3899/jrheum.150175 ◽

2015 ◽

Vol 42 (10) ◽

pp. 1878-1884 ◽

Cited By ~ 40

Author(s):

Jingyu Cai ◽

Jianhua Xu ◽

Kang Wang ◽

Shuang Zheng ◽

Fan He ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Structural Changes ◽

Spin Echo ◽

Cartilage Volume ◽

Infrapatellar Fat Pad ◽

Fast Spin Echo ◽

Cartilage Defects ◽

Fat Pad ◽

Cross Sectional ◽

Knee Oa

Objective.The function of the infrapatellar fat pad (IPFP) in knee osteoarthritis (OA) remains uncertain. This study aimed to examine cross-sectional associations between IPFP volume and knee structures in patients with knee OA.Methods.The study included 174 patients with clinical knee OA (mean age, 55.5 yrs). Fat-suppressed 3-D T1-weighted spoiled gradient recall magnetic resonance imaging (MRI) was used to measure the IPFP and cartilage volume. T2-weighted fast spin echo MRI was used to assess cartilage defects and bone marrow lesions (BML). Radiographic knee osteophytes and joint space narrowing (JSN) were assessed using the Osteoarthritis Research Society International atlas.Results.After adjustment for potential confounders, greater IPFP volume was associated with greater tibial and patellar cartilage volume (all p < 0.05), and fewer cartilage defects at all sites (OR 0.88–0.91, all p < 0.05). IPFP volume was associated with presence of BML at lateral tibial and medial femoral sites (OR 0.88–0.91, all p < 0.05) and osteophytes at lateral tibiofemoral compartment (OR 0.88, p < 0.05). IPFP volume was not significantly associated with JSN.Conclusion.Greater IPFP volume was associated with greater knee cartilage volume and fewer structural abnormalities, suggesting a protective role of IPFP size in knee OA.

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Lower Extremity Muscle Strength and Risk of Self-Reported Hip or Knee Osteoarthritis

Journal of Physical Activity and Health ◽

10.1123/jpah.1.4.321 ◽

2004 ◽

Vol 1 (4) ◽

pp. 321-330 ◽

Cited By ~ 45

Author(s):

Jennifer M. Hootman ◽

Shannon FitzGerald ◽

Carol A. Macera ◽

Steven N. Blair

Keyword(s):

Lower Extremity ◽

Knee Osteoarthritis ◽

Knee Extension ◽

Quadriceps Strength ◽

Community Dwelling ◽

Leg Press ◽

Knee Oa ◽

Lower Extremity Muscle ◽

Longitudinal Association

Purpose:The purpose of this study was to investigate the gender-specific longitudinal association between quadriceps strength and self-reported, physician-diagnosed hip or knee osteoarthritis (OA).Methods:Subjects were 3081 community-dwelling adults who were free of OA, joint symptoms and injuries, completed a maximum treadmill exercise test, had isokinetic knee extension and flexion and isotonic leg press strength measurements taken at baseline and returned at least one written follow-up survey. Multivariate logistic regression was used to estimate odds ratios and 95% confidence intervals.Results:Women with moderate or high isokinetic quadriceps strength had a significantly reduced risk (55% to 64%) of hip or knee OA. A similar, nonsignificant trend was noted among men. Moderate isotonic leg press strength was protective for hip or knee osteoarthritis among men only.Conclusions:These results suggest that quadriceps weakness is an independent and modifiable risk factor for lower extremity OA, particularly among women.

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Serum Metabolites as Potential Biomarkers for Diagnosis of Knee Osteoarthritis

Disease Markers ◽

10.1155/2015/684794 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 13

Author(s):

Qingmeng Zhang ◽

Heng Li ◽

Zhendong Zhang ◽

Fan Yang ◽

Jiying Chen

Keyword(s):

Knee Osteoarthritis ◽

Metabolic Profile ◽

Elderly Population ◽

The Elderly ◽

Ultra Performance Liquid Chromatography ◽

Degenerative Joint Disease ◽

Joint Disease ◽

Healthy Controls ◽

Knee Oa ◽

Potential Biomarkers

Knee osteoarthritis (OA) is a highly prevalent chronic degenerative joint disease that mainly affects the elderly population. The aim of this study was to investigate serum signature metabolites as potential biomarkers for early diagnosis of knee OA. Global serum metabolic profiles of 40 patients with knee OA and 20 healthy controls (HC) were analyzed by ultra-performance liquid chromatography coupled to mass spectrometry. An OA-specific metabolic profile was established that can clearly discriminate patients with OA from HCs. Fourteen metabolites that are involved in the metabolism of amino acids, purine, energy, glycolysis, fatty acids, and lipids were significantly altered in patients with OA compared to HCs. These metabolites could be potentially used as biomarkers for the diagnosis of knee OA.

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The manifestation of middle ear pathology in an elderly group

South African Journal of Communication Disorders ◽

10.4102/sajcd.v35i1.304 ◽

1988 ◽

Vol 35 (1) ◽

Author(s):

N. J. Cilliers ◽

A. Van der Merwe ◽

M. Hurter ◽

O. Nel

Keyword(s):

Middle Ear ◽

Structural Changes ◽

The Elderly ◽

Test Battery ◽

Elderly Group ◽

Abnormal Results

There is a lack of clarity in the literature regarding the manifestation of the structural changes due to aging in the middle ear and the pathology which occurs in the elderly. In order to determine the incidence and manifestation of middle ear problems in an elderly group, acoustic immittance measurements and otoscopy were carried out on 94 subjects over the age of 65 years. Thirty eight percent of all the subjects tested had abnormal tympanometric results in one or both ears. These abnormal results were due to either pathologies which were medically diagnosed, or other unidentified factors such as possible structural changes in the middle ear as a result of increased age. Otoscopy and acoustic immittance measures should always be carried out as part of the test battery for the elderly.

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