scholarly journals Comparison of the Asymmetries in Foot Posture and Properties of Gastrocnemius Muscle and Achilles Tendon Between Patients With Unilateral and Bilateral Knee Osteoarthritis Patients

2021 ◽  
Vol 9 ◽  
Author(s):  
Zehua Chen ◽  
Xiangling Ye ◽  
Zhen Shen ◽  
Yi Wang ◽  
Zugui Wu ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Achilles Tendon ◽  
Gastrocnemius Muscle ◽  
Asymmetry Index ◽  
Muscle Properties ◽  
Lateral Gastrocnemius ◽  
Bilateral Group ◽  
Foot Posture ◽  
The Difference ◽  
Unilateral Group

Background: Asymmetrical foot posture and properties alterations of the gastrocnemius muscle (GM) and Achilles tendon (AT) were observed in knee osteoarthritis (KOA). We aimed to investigate the inter-limbs asymmetries in foot posture and the properties of GM and AT and explore the association between them.Methods: A total of 62 subjects with unilateral or bilateral KOA were included in this study: 30 patients with unilateral pain and 32 patients with bilateral pain were assigned to the bilateral group (BG) and unilateral group (UG), respectively. The relatively serious leg (RSL) and relatively moderate leg (RML) were judged according to the severity of symptoms assessed by using visual analogue scale (VAS) motion. Foot posture and asymmetrical foot posture scores were assessed based on Foot Posture index (FPI-6). Subsequently, all the participants received an assessment for properties of GM and AT, including tone/tension (Hz), stiffness (N/m), and elasticity. We calculated the asymmetry index of AT (Asy-AT) in both legs and the difference of muscle properties between medial and lateral gastrocnemius (D-MLG) in the ipsilateral limb.Results: Asymmetry of foot posture was categorized into three types including normal, asymmetry, and severe asymmetry. The percentage of subjects classified as normal was higher in the BG (62.5%) than in the UG (36.67%), p < 0.05. Tension of AT and tone of lateral gastrocnemius (LG) in RSL were higher than those in RML (15.71 ± 0.91 vs. 15.23 ± 1.01; 25.31 ± 2.09 vs. 23.96 ± 2.08, p < 0.01 and p < 0.01, respectively), and stiffness of AT in the RSL was higher than that in RML (676.58 ± 111.45 vs. 625.66 ± 111.19, p < 0.01). Meanwhile, a positive relationship was found between ipsilateral FPI and tone of MG and LG in the left leg (0.246 per degree, 95% CI: −0.001, 0.129; p = 0.054 and 0.293 per degree, 95% CI: −0.014, 0.157; p = 0.021, respectively) and right leg (0.363 per degree, 95% CI: 0.033, 0.146; p = 0.004 and 0.272 per degree, 95% CI: 0.007, −0.144; p = 0.032, respectively). Moreover, a positive link was observed between asymmetrical FPI scores and K/L grade (0.291 per degree, 95% CI: 0.018, 0.216; p = 0.022). Furthermore, a significantly greater Asy-AT(tension) was detected in the UG than that in the BG (UG vs. UG: 8.20 ± 5.09% vs. 5.11 ± 4.72%, p < 0.01). Additionally, an increased asymmetrical FPI score (i.e., more severe asymmetry) was significantly associated with increases in Asy-AT(tension) and Asy-AT(stiffness) (0.42 per degree, 95% CI: 0.533, 1.881; p = 0.001 and 0.369 per degree, 95% CI: 0.596, 2.82; p = 0.003, respectively).Conclusions: The stiffness and tension of AT and the tone of LG in RSL were higher than those in RML in KOA patients, and inter-limbs foot posture and tension of AT were more asymmetrical in unilateral KOA patients compared to patients with bilateral KOA. Notably, foot posture, as an important biomechanical factor, was significantly associated with properties of GM, AT, and K/L grade in KOA patients.

scholarly journals Non-union following bilateral simultaneos Ganz trochanteric osteotomy

2010 ◽  
Vol 1 (1) ◽  
pp. 1 ◽  
Author(s):  
Sean M. Dixon ◽  
Ravi P. Reddy ◽  
Dan Williams ◽  
E. Darren Fern ◽  
Mark R. Norton
Keyword(s):  
Weight Bearing ◽  
Deep Infection ◽  
Hip Resurfacing ◽  
Trochanteric Osteotomy ◽  
Exact Test ◽  
Non Union ◽  
Bilateral Group ◽  
Resurfacing Arthroplasty ◽  
The Difference ◽  
Unilateral Group

Between January 2003 and December 2004, 13 patients underwent bilateral resurfacing arthroplasty via a Ganz trochanteric osteotomy. This bilateral group was mobilised fully weight-bearing with crutches. During the same period 139 Ganz trochanteric osteoto-mies were performed for unilateral hip resurfacing. These patients were mobilised with crutches, weight-bearing up to 10 kg on the operated leg. Nine osteotomies (32%) in the bilateral group subsequently developed a symptomatic non-union requiring revision of fixation. This compares with 10 patients (7%) in the unilateral group. Applying the Fisher’s exact test, the difference reached significance (P=0.0004). In two patients a second revision was required to achieve union. In one patient, revision of trochanteric fixation precipitated a deep infection. Protected weight-bearing following a Ganz trochanteric osteotomy is important to the success of the procedure. Simultaneous bilateral hip arthroplasty through a Ganz approach should be avoided. If it is undertaken, we recommend that patients should be non weight-bearing for 6 weeks following surgery. Non-union following a Ganz trochanteric osteotomy for arthroplasty carries a significant morbidity.

Kinematic and Neuromuscular Changes of the Gait Pattern After Achilles Tendon Rupture

1997 ◽  
Vol 18 (6) ◽  
pp. 339-341 ◽  
Author(s):  
Daniela Neumann ◽  
Lutz Vogt ◽  
Winfried Banzer ◽  
Udo Schreiber
Keyword(s):  
Achilles Tendon ◽  
Gastrocnemius Muscle ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Gait Pattern ◽  
Control Group ◽  
Motor Patterns ◽  
Lateral Gastrocnemius ◽  
Functional Movement ◽  
Ankle Motion

After long immobilization periods in equinovalgus with operated Achilles tendon rupture, long-lasting changes of motor patterns in functional movement can be expected. In the present study, possible alterations in gait pattern have been analyzed based on kinematic and neuromuscular parameters. Ten patients 1 year after surgery and a healthy control group performed 10 gait cycles in natural walking cadence. Ankle motion, pressure distribution, and electromyographic data were recorded and analyzed in defined phases. Kinematic and neuromuscular changes are still evident 1 year after surgery with a temporal phase shift and a neuromuscular deficit of the lateral gastrocnemius muscle. The objective of rehabilitation should be the facilitation of the temporal innervation pattern of the lateral gastrocnemius muscle in the functional movement.

scholarly journals Functional outcomes of simultaneous bilateral versus unilateral total knee arthroplasty.

2020 ◽  
Vol 27 (11) ◽  
pp. 2326-2329
Author(s):  
Irfan Qadir ◽  
Saad Ilyas ◽  
Umair Nadeem ◽  
Ashfaq Ahmad ◽  
Shahzad Javed ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Osteoarthritis ◽  
Knee Arthroplasty ◽  
Functional Outcomes ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Bilateral Group ◽  
Bilateral Knee ◽  
Total Knee ◽  
Unilateral Group

Objectives: There is currently no clear consensus on the benefits of performing simultaneous bilateral total knee arthroplasty (SBTKA) for patients with bilateral knee osteoarthritis. The purpose of this study was to analyze whether SBTKA provides equivalent reduction in pain and functional outcome as comparable with unilateral surger­ies (UTKA). Study Design: Cross sectional study. Setting: Ghurki Trust Teaching Hospital, Lahore, Pakistan. Period: January 2013 and July 2016. Material & Methods. 637 TKAs in 386 consecutive patients, who underwent total knee arthroplasty for bilateral knee osteoarthritis between Patients were split into 2 groups: those who underwent unilateral TKA (n=135) and those who underwent si­multaneous bilateral TKA (n=251). Knee range of motion, Knee Society Scores (KSS) and knee function scores were obtained pre­operatively and 2 or more years postop­eratively. Results: Mean±SD flexion was 111.6°± 8.6° for patients in the bilater­al group and 110.8°± 9.02° for patients in the unilateral group (p=0.34). Mean±SD KSS was 86.4 ± 9.3 in the bilateral group and 85.34 ± 10.5 in the unilateral group (p=0.236). Mean±SD function score was 83.4± 5.4 in the bilateral group and 80.90 ± 7.2 in the unilat­eral group (p<0.0001). Conclusion: In properly selected patients deemed fit for bilateral knee surgery, SBTKA provides significantly better functional outcomes compared to UTKA.

scholarly journals Sonographic evaluation of the immediate effects of eccentric heel drop exercise on Achilles tendon and gastrocnemius muscle stiffness using shear wave elastography

PeerJ ◽  
2017 ◽  
Vol 5 ◽  
pp. e3592 ◽  
Author(s):  
Wilson K.C. Leung ◽  
KL Chu ◽  
Christopher Lai
Keyword(s):  
Achilles Tendon ◽  
Shear Wave ◽  
Gastrocnemius Muscle ◽  
Shear Wave Elastography ◽  
Achilles Tendinopathy ◽  
Muscle Stiffness ◽  
Eccentric Load ◽  
Lateral Gastrocnemius ◽  
Acute Bout ◽  
Gastrocnemius Muscles

BackgroundMechanical loading is crucial for muscle and tendon tissue remodeling. Eccentric heel drop exercise has been proven to be effective in the management of Achilles tendinopathy, yet its induced change in the mechanical property (i.e., stiffness) of the Achilles tendon (AT), medial and lateral gastrocnemius muscles (MG and LG) was unknown. Given that shear wave elastography has emerged as a powerful tool in assessing soft tissue stiffness with promising intra- and inter-operator reliability, the objective of this study was hence to characterize the stiffness of the AT, MG and LG in response to an acute bout of eccentric heel drop exercise.MethodsForty-five healthy young adults (36 males and nine females) performed 10 sets of 15-repetition heel drop exercise on their dominant leg with fully-extended knee, during which the AT and gastrocnemius muscles, but not soleus, were highly stretched. Before and immediately after the heel drop exercise, elastic moduli of the AT, MG and LG were measured by shear wave elastography.ResultsAfter the heel drop exercise, the stiffness of AT increased significantly by 41.8 + 33.5% (P < 0.001), whereas the increases in the MG and LG stiffness were found to be more drastic by 75 + 47.7% (P < 0.001) and 71.7 + 51.8% (P < 0.001), respectively. Regarding the AT, MG and LG stiffness measurements, the inter-operator reliability was 0.940, 0.987 and 0.986, and the intra-operator reliability was 0.916 to 0.978, 0.801 to 0.961 and 0.889 to 0.985, respectively.DiscussionThe gastrocnemius muscles were shown to bear larger mechanical loads than the AT during an acute bout of eccentric heel drop exercise. The findings from this pilot study shed some light on how and to what extent the AT and gastrocnemius muscles mechanically responds to an isolated set of heel drop exercise. Taken together, appropriate eccentric load might potentially benefit mechanical adaptations of the AT and gastrocnemius muscles in the rehabilitation of patients with Achilles tendinopathy.

scholarly journals Difference in patient-reported outcomes of various patellar component designs in total knee arthroplasty: A randomized clinical study

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902199606
Author(s):  
Takeshi Mochizuki ◽  
Koichiro Yano ◽  
Katsunori Ikari ◽  
Ken Okazaki
Keyword(s):  
Knee Osteoarthritis ◽  
Clinical Effects ◽  
Patellar Component ◽  
American College Of Rheumatology ◽  
Randomized Clinical Study ◽  
Component Design ◽  
Patient Reported ◽  
Total Knee ◽  
The Difference ◽  
And Function

Purpose: This study investigated the clinical effects of different patellar components without being affected by the femoral component design in total knee arthritis (TKA) for patients with knee osteoarthritis (OA). Methods: In total, 48 patients with OA who met the criteria of the American College of Rheumatology for OA were enrolled and randomly assigned in a 1:1 ratio to two groups according to the usage of patellar component design for TKA (medialized dome type [dome group] or medialized anatomic type [anatomic group]). To evaluate the clinical outcomes for TKA, knee range of motion (ROM), pain intensity of 0–100 mm visual analog scale (pain VAS), and the Japanese Knee Osteoarthritis Measure (JKOM) score were obtained at baseline and year 1. Results: The difference in knee ROM, pain VAS, or total JKOM score at year 1 was not significant between the dome and anatomic groups ( p = 0.398, 0.733 and 0.536, respectively). Moreover, similar results were obtained for changes in knee ROM, pain VAS, or total JKOM scores from baseline. In both groups, the pain VAS and total JKOM scores were significantly improved at year 1. Conclusion: Both dome and anatomic groups in TKA are significantly effective for pain and function using the JKOM score. However, their efficacy did not differ, according to the JKOM score. Results of this study are rare information focusing on the patellar component design and provide one of the insights into the TKA clinical management.

scholarly journals Comparison of Short-Term Efficacy of Total Knee Arthroplasty Versus Arthroscopy in Chinese Patients with Knee Osteoarthritis

2020 ◽  
Author(s):  
Xiaolin Jia ◽  
San Cai ◽  
Wei Hu ◽  
Qiang Gan ◽  
Mingquan Zhou
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Osteoarthritis ◽  
Knee Arthroplasty ◽  
Scientific Basis ◽  
Knee Function ◽  
Chinese Patients ◽  
Control Group ◽  
Total Knee ◽  
The Difference ◽  
Experimental Group

Abstract Background: The purpose of this study was to compare the improvement of knee function in patients with knee osteoarthritis who underwent total knee arthroplasty and arthroscopy in China, and to provide a scientific basis for the application of clinical total knee arthroplasty in knee osteoarthritis.Methods: A total of 160 patients with knee osteoarthritis who were admitted to Chinese hospital from January 2017 to December 2018 were studied. They were divided into experimental group and control group according to their willingness of treatment. The control group was treated with arthroscopy and the experimental group was treated with total knee arthroplasty. All patients were followed for a period of 6 months. The knee joint function score (HSS), visual analog scale (VAS), and anxiety self-assessment scale (SAS) scores before and after surgery were compared between the two groups. Results: The proportion of "excellent or good" in the efficacy of the experimental group (91.25%) was higher than that of the control group (72.50%), and the difference was statistically significant (χ2=9.476, P<0.05). The HSS score of the experimental group was higher than that of the control group (P<0.05), while the VAS and SAS scores were lower than those of the control group (P<0.05). The scores of various SF-36 scales in the experimental group were higher than those in the control group after operation (P<0.05).Conclusions: Total knee arthroplasty was considered effective in treating patients with knee osteoarthritis that meet the indications, and is beneficial to improve knee function and reduce pain in patients. The surgical treatment also reduced the level of anxiety and effectively improve the quality of life of patients. Further investigation of its clinical application on treatment of knee osteoarthritis is warranted.

Effects of Treadmill Walking Speed on Lateral Gastrocnemius Muscle Firing

2004 ◽  
Vol 83 (7) ◽  
pp. 507-514 ◽  
Author(s):  
Edward A. Clancy ◽  
Kevin D. Cairns ◽  
Patrick O. Riley ◽  
Melvin Meister ◽  
D. Casey Kerrigan
Keyword(s):  
Gastrocnemius Muscle ◽  
Walking Speed ◽  
Treadmill Walking ◽  
Lateral Gastrocnemius

Arthroscopic Debridement Combined with Rehabilitation Training in the Treatment of Knee Osteoarthritis

2021 ◽  
Vol 7 (5) ◽  
pp. 3384-3388
Author(s):  
Wei Sun ◽  
Wenjie Yu ◽  
Yanhua Wang ◽  
Guangliang Hu
Keyword(s):  
Knee Osteoarthritis ◽  
Total Effective Rate ◽  
Effective Rate ◽  
Control Group ◽  
Observation Group ◽  
Arthroscopic Debridement ◽  
Rehabilitation Training ◽  
The Difference ◽  
Score Result ◽  
Better Than

Objective: The clinical effect of arthroscopic debridement combined with rehabilitation training in the treatment of knee arthritis was studied and analyzed. Methods: A total of 90 patients with knee osteoarthritis treated in our hospital from August 2017 to August 2018 were selected as the research objects. All patients were divided into the observation group and the control group by using the random number method. The control group was treated by arthroscopic cleaning operation, and the observation group was treated by combined rehabilitation training on the basis of the treatment in the control group. The total effective rate and simple McGill pain of the two groups were compared Score and lyshoim score. Result: The total effective rate of the observation group was significantly higher than that of the control group (P < 0.05), the difference was statistically significant; after treatment, the simple McGill pain score of the observation group was significantly lower than that of the control group (P < 0.05), the difference was statistically significant, the lyshoim score of the observation group was significantly better than that of the control group (P < 0.05), the difference was statistically significant. Conclusion: In the treatment of knee osteoarthritis, arthroscopic debridement combined with rehabilitation training has a significant effect, which can significantly reduce the pain and improve the prognosis of patients. It is worth popularizing in clinical treatment.

scholarly journals A Positive Association Between Foot Posture Index and Medial Compartment Knee Osteoarthritis in Moroccan People

2014 ◽  
Vol 8 (1) ◽  
pp. 96-99 ◽  
Author(s):  
Abourazzak F.E ◽  
Kadi N ◽  
Azzouzi H ◽  
Lazrak F ◽  
Najdi A ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Medial Compartment ◽  
Control Group ◽  
Flat Foot ◽  
Pes Cavus ◽  
Foot Posture Index ◽  
Posture Index ◽  
Knee Oa ◽  
Significant Difference ◽  
Foot Posture

Objectives : To compare foot posture in people with and without medial compartment knee osteoarthritis (OA), and to assess association between its abnormalities and medial compartment knee OA. Methods : We compared the foot posture of patients with clinically and radiographically-confirmed medial compartment knee OA and asymptomatic healthy controls using the foot posture index (FPI), navicular height, and the medial arch. Results : We included 100 patients and 80 asymptomatic controls. The mean age of patients was 59 ± 7 (44-76) years and 48 ± 9 (28-60) years in the control (p=0.06). Patients group have more pronated foot for FPI (1.50 ± 2.68 vs 0.72 ± 2.63; p=0.05), more flat foot (42% vs 22%; p=0.03), and less pes cavus than the control group (58% vs 77%; p=0.004). However, there was no significant difference between the groups in the navicular height (3.90 ± 0.85 cm vs 4.00 ± 0.76 cm; p=0.41). In multivariate statistical analysis, after adjusting for age and body mass index, pronated foot in FPI (OR=1.22, 95%IC= [1.06-1.40], p=0.005), and pes cavus (OR=0.32, 95%IC= [0.11-0.93], p=0.03) had a significant correlation with the knee osteoarthritis. Conclusion : Pronated foot posture and flat foot are significantly associated with medial compartment knee osteoarthritis.

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