scholarly journals Biomechanical Changes in Gait Patterns of Patients with Grade II Medial Gonarthritis

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1242
Author(s):  
Dmitry Skvortsov ◽  
Sergey Kaurkin ◽  
Alexey Prizov ◽  
Aljona Altukhova ◽  
Alexander Troitskiy ◽  
...  
Keyword(s):  
Inertial Sensor ◽  
Varus Deformity ◽  
Functional Condition ◽  
Lower Limbs ◽  
Knee Oa ◽  
Affected Side ◽  
Hip Function ◽  
Healthy Control ◽  
Grade Ii ◽  
Single Support Phase

Deforming osteoarthritis (OA) of the knee is a progressive disease associated with pain and compromised function of the joint. Typical biomechanical modifications in the gait of subjects with medial knee OA are characterized by decreased gait speed and overload on the affected limb. The borderline stage for conservative versus surgical management is Grade II OA. The aim of this research was to study preoperatively the specific features of gait, knee, and hip function in patients with Grade II medial OA. We examined 26 patients with Grade II unilateral gonarthritis with varus deformity and 20 healthy adults. Biomechanical parameters of gait were recorded using an inertial sensor system. The gait cycle (GC) slightly increased both for the affected and for the intact limb. The hip joint movements showed significant symmetrical reduction in the first flexion amplitude, as well as a symmetrical delay in full hip extension at the end of the stance phase. In the knee, the first flexion amplitude was significantly reduced on the affected side compared to healthy control. The extension amplitude in the single support phase was significantly increased in both the affected and the intact lower limbs. The swing amplitude was significantly reduced on the affected side. On the affected side, the changes were more pronounced, both in incidence and in severity. The affected knee showed a syndrome of three reduced amplitudes. In patients, walking is characterized by several groups of symptoms: those of unloading of the affected limb, those of limiting the load on the affected joint and the musculoskeletal system as a whole, and those of gait harmonization. The symptoms of unloading the affected side and those of harmonization are the common symptoms of adaptation, typical for several pathological conditions with a relatively preserved function. The intensity of the observed symptoms can help assess changes in the subject’s functional condition over time and during the treatment.

Serum Calprotectin as a Blood-Based Biomarker for Monitoring Knee Osteoarthritis at Early but Not Late Stages

Cartilage ◽  
2020 ◽  
pp. 194760352096116
Author(s):  
Amin Safa ◽  
Abolfazl Bagherifard ◽  
Hamadalla Hadi Al-Baseesee ◽  
Azade Amini Kadijani ◽  
Hooman Yahyazadeh ◽  
...  
Keyword(s):  
Disease Duration ◽  
Early Stage ◽  
Enzyme Linked Immunosorbent Assay ◽  
Serum Samples ◽  
Knee Oa ◽  
Calprotectin Level ◽  
Healthy Control ◽  
Grade Ii ◽  
Late Stages

Objective The identification of early-stage osteoarthritis (OA) is crucial for the deceleration of its progression; however, no reliable biomarker is available for this purpose. The current study aimed to determine the role of serum calprotectin in the detection of early-stage knee OA. Design In a case-control study, serum samples were collected from 84 patients with primary bilateral knee OA and 52 healthy controls. The radiographic grading of knee OA was performed using the Kellgren-Lawrence classification system. Serum concentrations of calprotectin were measured using an enzyme-linked immunosorbent assay. Results The mean serum calprotectin level was 2908 ± 2516 ng/mL in OA patients and 901 ± 875 ng/mL in healthy control subjects ( P < 0.001). Mean serum calprotectin levels were significantly higher in the lower stages of OA: 3740 ± 2728 ng/mL in OA grade I, 3100 ± 2084 ng/mL in OA grade II, 2246 ± 1418 ng/mL in OA grade III, and 2035 ± 765 ng/mL in OA grade IV ( P = 0.047). Serum calprotectin levels were significantly higher in patients with a disease duration <42 months compared with those with a disease duration >42 months ( P = 0.043). Conclusion Serum calprotectin level increases significantly in the early stages of OA and shows a reverse association with disease severity. Therefore, it could be suggested as a promising blood-based marker for early-stage knee OA.

scholarly journals RADIOLOGICAL ASSESSMENT OF KNEE JOINT WIDTH DIFFERENCES IN OLDER ADULTS WITH SYMPTOMATIC MEDIAL KNEE OSTEOARTHRITIS

2021 ◽  
Author(s):  
SAMWON YOON ◽  
YOUNGJOO CHA ◽  
HYUNSIK YOON ◽  
KYOUNGTAE KIM ◽  
ILBONG PARK ◽  
...  
Keyword(s):  
Older Adults ◽  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Joint Space Width ◽  
Lower Limbs ◽  
Unaffected Side ◽  
Medial Knee ◽  
Knee Oa ◽  
Affected Side ◽  
Significant Difference

Knee osteoarthritis (OA) is a degenerative articular disease. The knee joint space width (JSW) is used for grading the severity of knee OA. However, there is a lack of research on differences in the widths of knee joints between both lower limbs in unilateral OA. The purpose of this research was to examine the radiological difference in the affected knee joint and contralateral knee joint by analyzing unilateral older adults with medial knee OA using both knees’ JSW differences. Twenty-five subjects with unilateral medial knee OA participated. X-ray radiographs were used to assess knee JSW, and the paired [Formula: see text]-test was performed to assess the knee joint gap width between the affected side and the unaffected side in the respective medial and lateral sides. The independent [Formula: see text]-test compared the differences between the lateral and medial knee JSWs on the affected side and unaffected side. The paired [Formula: see text]-test did not show a significant difference in the medial and lateral knee JSW on the affected side compared to the unaffected side ([Formula: see text]; 0.11). Meanwhile, the independent [Formula: see text]-test revealed a significant difference between the affected and unaffected sides ([Formula: see text]). This study showed no significant changes in affected knee JSWs compared to unaffected sides, but the difference between the lateral and medial JSWs was significant between the knees affected and unaffected by OA in the older adults with medial knee OA.

scholarly journals Sydenham’s Chorea as Presentation of Rheumatic Heart Disease

2017 ◽  
Vol 13 (3) ◽  
pp. 271-273
Author(s):  
A. Joshi ◽  
R.P.B. Shrestha ◽  
P.S. Shrestha ◽  
S. Dangol ◽  
N.C. Shrestha ◽  
...  
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Lower Limbs ◽  
Moderate Degree ◽  
Sydenham’S Chorea ◽  
Streptolysin O ◽  
Grade Ii ◽  
Sydenham's Chorea ◽  
Penicillin Prophylaxis ◽  
Rheumatic Heart

Sydenham’s chorea is the most common type of acquired chorea in childhood which is a major neurological manifestation of rheumatic fever. We describe a 13 years old girl who presented with weakness and purposeless involuntary movements of upper and lower limbs. The symptoms slightly affected the child’s daily activities and had an unstable gait on walking which was aggravated during stress. Grade II ejection systolic murmur was noticed on cardiovascular examination. Echocardiography evaluation showed thickened aortic and mitral valve leaflets with mild to moderate degree of mitral regurgitation. Anti-streptolysin O titer was positive (≥200 IU/ml). CT scan of brain was normal. Subsequently child was diagnosed as Rheumatic heart disease with Sydenham’s chorea and kept on regular Benzathine penicillin prophylaxis. Symptoms subsided spontaneously after 3 months without any further complications. Although decreasing, early diagnosis and management of Sydenham’s chorea and Rheumatic heart disease are very crucial and should be considered with such presentation.

OPYT PRIMENENIYa KOMPOZITsIONNYKh BIOSOVMESTIMYKh IMPLANTATOV V KLINIKE DETSKOY I PODROSTKOVOY ORTOPEDII

2003 ◽  
Vol 10 (1) ◽  
pp. 78-83
Author(s):  
O A Malakhov ◽  
G A Krasnoyarov ◽  
S I Belykh ◽  
O V Kozhevnikov ◽  
A V Ivanov ◽  
...  
Keyword(s):  
Experimental Study ◽  
Medical Technology ◽  
Surgical Intervention ◽  
Hip Dislocation ◽  
Varus Deformity ◽  
Functional Results ◽  
Lower Limbs ◽  
Femur Head ◽  
Congenital Hip Dislocation

Specialists from Children Orthopedic Clinic (CITO) and Institute of Medical Technology elaborated therapeutically active implants on the base of N-vinilpirrolidone and methylmethacrylate with different additives. Those implants were successfully applied in clinical practice. Experimental study on rabbits showed the possibility of implants to stimulate osteogenesis. Various types and shapes of implants were elaborated using different combinations of additives. Minimum invasive surgical intervention and indications to implants' application were worked out. From 1987 to 2001 one hundred thirteen patients with various pathology (obstetrical paresis, clubfoot, juvenile femur head ephiphysiolysis, congenital hip dislocation, funnel-shaped deformity of thorax, dystrophic varus deformity of femur head, osteochondropathy of lower limbs) were treated surgically using new implants. At 3-5 years follow up good and excellent anatomic and functional results were noted in 89% of cases.

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

2009 ◽  
Vol 36 (3) ◽  
pp. 592-597 ◽  
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.

scholarly journals Inertial Sensor-Based Motion Analysis of Lower Limbs for Rehabilitation Treatments

2017 ◽  
Vol 2017 ◽  
pp. 1-11 ◽  
Author(s):  
Tongyang Sun ◽  
Hua Li ◽  
Quanquan Liu ◽  
Lihong Duan ◽  
Meng Li ◽  
...  
Keyword(s):  
Motion Analysis ◽  
Quantitative Evaluation ◽  
Degrees Of Freedom ◽  
Subjective Experience ◽  
Inertial Sensors ◽  
Inertial Sensor ◽  
Lower Limbs ◽  
Analysis Method ◽  
Practical Application ◽  
Input Signals

The hemiplegic rehabilitation state diagnosing performed by therapists can be biased due to their subjective experience, which may deteriorate the rehabilitation effect. In order to improve this situation, a quantitative evaluation is proposed. Though many motion analysis systems are available, they are too complicated for practical application by therapists. In this paper, a method for detecting the motion of human lower limbs including all degrees of freedom (DOFs) via the inertial sensors is proposed, which permits analyzing the patient’s motion ability. This method is applicable to arbitrary walking directions and tracks of persons under study, and its results are unbiased, as compared to therapist qualitative estimations. Using the simplified mathematical model of a human body, the rotation angles for each lower limb joint are calculated from the input signals acquired by the inertial sensors. Finally, the rotation angle versus joint displacement curves are constructed, and the estimated values of joint motion angle and motion ability are obtained. The experimental verification of the proposed motion detection and analysis method was performed, which proved that it can efficiently detect the differences between motion behaviors of disabled and healthy persons and provide a reliable quantitative evaluation of the rehabilitation state.

scholarly journals Treatment of Varus Deformities of the Lower Limbs in Patients with Achondroplasia and Hypochondroplasia

2013 ◽  
Vol 7 (1) ◽  
pp. 33-39 ◽  
Author(s):  
Ali Al Kaissi ◽  
Sebastian Farr ◽  
Rudolf Ganger ◽  
Jochen G Hofstaetter ◽  
Klaus Klaushofer ◽  
...  
Keyword(s):  
Limb Lengthening ◽  
Varus Deformity ◽  
Clinical Problem ◽  
Valgus Deformity ◽  
Lower Limbs ◽  
Phenotypic Characterization ◽  
Complex Patients ◽  
Limb Deformities ◽  
Common Clinical Problem ◽  
Angular Deformities

Angular deformities of the lower limbs are a common clinical problem encountered in pediatric orthopaedic practices particularly in patients with osteochondrodysplasias. The varus deformity is more common than the valgus deformity in achondroplasia and hypochondroplasia patients because of the unusual growth of the fibulae than that of the tibiae. We retrospectively reviewed six patients (four patients with achondroplasia and two patients with hypochondroplsia) with relevant limb deformities due to the above-mentioned entities. All patients manifested significant varus deformity of the lower limbs. Detailed phenotypic characterization, radiologic and genetic testing was carried out as baseline diagnostic tool. We described the re-alignment procedures, which have been applied accordingly. Therefore, bilateral multi-level procedures, multi-apical planning and limb lengthening have been successfully applied. While recognition of the underlying syndromic association in patients who are manifesting angular deformities is the baseline for proper orthopaedic management, this paper demonstrates how to evaluate and treat these complex patients.

scholarly journals Cell-free stem cell-derived extract formulation for treatment of knee osteoarthritis: study protocol for a preliminary non-randomized, open-label, multi-center feasibility and safety study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ashim Gupta ◽  
Nicola Maffulli ◽  
Hugo C. Rodriguez ◽  
R. Justin Mistovich ◽  
Kristin Delfino ◽  
...  
Keyword(s):  
Stem Cell ◽  
Magnetic Resonance ◽  
Prospective Study ◽  
Open Label ◽  
Safety And Efficacy ◽  
Knee Oa ◽  
Symptomatic Knee ◽  
Essential Components ◽  
Patient Reported ◽  
Grade Ii

Abstract Background Musculoskeletal conditions are highly prevalent, and knee OA is most common. Current treatment modalities have limitations and either fail to solve the underlying pathophysiology or are highly invasive. To address these limitations, attention has focused on the use of biologics. The efficacy of these devices is attributed to presence of growth factors (GFs), cytokines (CKs), and extracellular vesicles (EVs). With this in mind, we formulated a novel cell-free stem cell-derived extract (CCM) from human progenitor endothelial stem cells (hPESCs). A preliminary study demonstrated the presence of essential components of regenerative medicine, namely GFs, CKs, and EVs, including exosomes, in CCM. The proposed study aims to evaluate the safety and efficacy of intraarticular injection of the novel cell-free stem cell-derived extract (CCM) for the treatment of knee OA. Methods and analysis This is a non-randomized, open-label, multi-center, prospective study in which the safety and efficacy of intraarticular CCM in patients suffering from grade II/III knee OA will be evaluated. Up to 20 patients with grade II/III OA who meet the inclusion and exclusion criteria will be consented and screened to recruit 12 patients to receive treatment. The study will be conducted at up to 2 sites within the USA, and the 12 participants will be followed for 24 months. The study participants will be monitored for adverse reactions and assessed using Numeric Pain Rating Scale (NPRS), Patient-Reported Outcomes Measurement Information System (PROMIS) Score, Knee Injury and Osteoarthritis Outcome Score Jr. (KOOS Jr.), 36-ietm short form survey (SF-36), Single Assessment Numeric Evaluation (SANE), physical exams, plain radiography, and magnetic resonance imaging (MRI) with Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score for improvements in pain, function, satisfaction, and cartilage regeneration. Discussion This prospective study will provide valuable information into the safety and efficacy of intraarticular administration of cell-free stem cell-derived extract (CCM) in patients suffering with grade II/III knee OA. The outcomes from this initial study of novel CCM will lay the foundation for a larger randomized, placebo-controlled, multi-center clinical trial of intraarticular CCM for symptomatic knee OA. Trial registration Registered on July 21, 2021. ClinicalTrials.gov NCT04971798

scholarly journals Hyperacute tetraparesis with fasciculations as an initial manifestation of secondary hyperkalemic paralysis: a case report

2021 ◽  
Author(s):  
Tulio Marcos Coimbra ◽  
Sara Terrim ◽  
Guilherme Diogo Silva
Keyword(s):  
Case Report ◽  
Lupus Erythematosus ◽  
Lower Limbs ◽  
Cervical Region ◽  
Upper Limbs ◽  
Limb Weakness ◽  
Initial Manifestation ◽  
Complete Reversal ◽  
Grade Ii

Context: Acute flaccid paralysis (AFP) is characterized by progressive weakness with signs of impairment of the lower motoneuron. Secondary hyperkalemic paralysis is a cause of AFP that must be quickly recognized to prevent cardiac and neurological deterioration. Case report: We present a 69-years-old man admitted to the emergency department due to hyperacute weakness. The patient walked normally to the hospital’s laboratory, where he sat down to wait for the collection of laboratory exams for the investigation of a thrombocytopenia. He was unable to get up from his chair when he was asked to collect the exams. The neurological examination showed symmetrical tetraparesis. Weakness was proximal grade II and distal grade III in the lower limbs. Upper limb weakness was grade IV. Reflexes were abolished in lower limbs and hypoactive in upper limbs. The sensitivity and cranial pairs were normal. Our patient denied bladder or bowel complaints. He also presented intense fasciculations in the cervical region and in the proximal muscles of the upper limbs. Initial laboratory showed potassium of 9.3 mEq/dL. The correction of hyperkalemia led to a complete reversal of weakness and fasciculations. During hospitalization, the patient was diagnosed with systemic lupus erythematosus. Renal impairment led to hyperkalemia. Conclusions: Characterization of the motor examination, sensitivity and of reflexes allow the topographic diagnosis in AFPs. Secondary hyperkalemic paralysis manifests as symmetrical tetraparesis with a proximal predominance with hypoactive and abolished reflexes. Sensory examination is normal. The hyperacute manifestation and the presence of fasciculations reinforce this diagnosis as the cause of AFP.

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