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Okamura H, Ishikawa H, Ohno T, Fujita S, Yamamoto S, Yamakami S, Nagasaki K, Kudo Y. Medial Meniscus Posterior Root Reconstruction and Open-Wedge High-Tibial Osteotomy for Medial Meniscus Posterior Root Tear With Varus Knee Alignment: A Retrospective Study on Short-Term Outcomes. Cureus 2024; 16:e57170. [PMID: 38681336 PMCID: PMC11056034 DOI: 10.7759/cureus.57170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2024] [Indexed: 05/01/2024] Open
Abstract
PURPOSE We describe 13 cases of medial meniscus posterior root tear (MMPRT) with varus knee alignment treated with medial meniscus posterior root reconstruction (MMPR-R) and open-wedge high-tibial osteotomy (OWHTO) to identify an optimal MMPRT treatment. METHODS We retrospectively reviewed 13 patients (mean age: 66.3 ± 8.0 years) who underwent MMPR-R and OWHTO. The Knee Injury and Osteoarthritis Outcome Score (KOOS), femorotibial angle (FTA), percentage mechanical axis (%MA) on radiography, and medial meniscus extrusion (MME) on magnetic resonance imaging (MRI) between the preoperative period and last follow-up were compared. Moreover, meniscus healing status and the International Cartilage Repair Society (ICRS) classification of the medial femoral condyle and medial tibial plateau on arthroscopy between the initial surgery and second-look arthroscopy were compared. RESULTS The mean follow-up duration was 12.8 ± 2.2 months. At the last follow-up, the KOOS significantly improved (P < 0.01). Based on the FTA and %MA, the varus alignment was predominantly corrected at the last follow-up (P < 0.01). The MME was increased in nine (62.9%) patients, and the mean MME significantly increased at the last follow-up (P = 0.04). Second-look arthroscopy revealed improvements in the ICRS grade for the medial femoral condyle and medial tibial plateau in six (46.2%) patients. However, the results did not significantly differ. Regarding meniscus healing, four (30.8%) patients presented with complete healing, eight (57.1%) with partial healing, and one (7.7%) with failed healing. CONCLUSIONS The MMPRT with varus knee alignment significantly improved with MMPR-R and OWHTO. However, the MME and meniscus healing were unsatisfactory.
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Affiliation(s)
- Hiroki Okamura
- Department of Orthopaedic Surgery, Nihon Koukan Hospital, Kanagawa, JPN
| | - Hiroki Ishikawa
- Department of Orthopaedic Surgery, Nihon Koukan Hospital, Kanagawa, JPN
| | - Takuya Ohno
- Department of Orthopaedic Surgery, Nihon Koukan Hospital, Kanagawa, JPN
| | - Shogo Fujita
- Department of Orthopaedic Surgery, Nihon Koukan Hospital, Kanagawa, JPN
| | - Shota Yamamoto
- Department of Orthopaedic Surgery, Nihon Koukan Hospital, Kanagawa, JPN
| | - Shigeo Yamakami
- Department of Orthopaedic Surgery, Nihon Koukan Hospital, Kanagawa, JPN
| | - Kei Nagasaki
- Department of Orthopaedic Surgery, Showa University School of Medicine, Tokyo, JPN
| | - Yoshifumi Kudo
- Department of Orthopaedic Surgery, Showa University School of Medicine, Tokyo, JPN
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Zhang L, Liu G, Yan Y, Han B, Li H, Ma J, Wang X. A subject-specific musculoskeletal model to predict the tibiofemoral contact forces during daily living activities. Comput Methods Biomech Biomed Engin 2022; 26:972-985. [PMID: 35852103 DOI: 10.1080/10255842.2022.2101889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Accurate prediction of tibiofemoral contact force (TFCF) during daily living activities is significant for understanding the initiation, progression, and treatment of knee osteoarthritis (KOA). However, the diversity of target activities, prediction accuracy, and computational efficiency of the current musculoskeletal simulations need to be further improved. In this study, a subject-specific musculoskeletal model considered the tibiofemoral alignment, medial-lateral contact locations, secondary tibiofemoral and all patellofemoral motions, and knee ligaments was proposed to predict the TFCFs during the five daily activities (normal walking, sit-to-stand, stand-to-sit, stair ascent, and stair descent) in OpenSim software. The standing lower-limbs-full-length radiograph, local radiograph of knee joint, motion capture data, and force plate data of eighteen subjects were acquired as the input data of the musculoskeletal model. The results showed good agreements of TFCFs between the predictions based on our proposed musculoskeletal model and the in-vivo measurements based on instrumented knee implants during the five daily activities (RMSE: 0.16 ∼ 0.31 BW, R2: 0.88 ∼ 0.97, M: -0.11 ∼ -0.02, P: 0.03 ∼ 0.10, and C: 0.04 ∼ 0.14). Additionally, the order of the peak total and lateral TFCFs from low to high was normal walking, stair ascent and stand-to-sit, and stair descent and sit-to-stand (P < 0.05), and the peak medial TFCF was stand-to-sit, sit-to-stand, normal walking, stair ascent and stair descent (P < 0.05). The outcomes of this study are valuable for further understanding the knee biomechanics during daily living activities and providing theoretical guidance for the treatments of KOA.
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Affiliation(s)
- Li Zhang
- Innovation Center of Bioengineering, Shaanxi Engineering Laboratory for Transmissions and Controls, Northwestern Polytechnical University, Xi'an, P.R. China
| | - Geng Liu
- Innovation Center of Bioengineering, Shaanxi Engineering Laboratory for Transmissions and Controls, Northwestern Polytechnical University, Xi'an, P.R. China
| | - Yuzhou Yan
- Innovation Center of Bioengineering, Shaanxi Engineering Laboratory for Transmissions and Controls, Northwestern Polytechnical University, Xi'an, P.R. China
| | - Bing Han
- Innovation Center of Bioengineering, Shaanxi Engineering Laboratory for Transmissions and Controls, Northwestern Polytechnical University, Xi'an, P.R. China
| | - Hui Li
- Joint Surgery Department, Xi’an Hong-hui Hospital, Xi’an Jiaotong University College of Medicine, Xi’an, P.R. China
| | - Jianbing Ma
- Joint Surgery Department, Xi’an Hong-hui Hospital, Xi’an Jiaotong University College of Medicine, Xi’an, P.R. China
| | - Xupeng Wang
- Department of Industrial Design, School of Art and Design, Xi’an University of Technology, Xi’an, P.R. China
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Ramazanian T, Yan S, Rouzrokh P, Wyles CC, O Byrne TJ, Taunton MJ, Kremers HM. Distribution and Correlates of Hip-Knee-Ankle Angle in Early Osteoarthritis and Preoperative Total Knee Arthroplasty Patients. J Arthroplasty 2022; 37:S170-S175. [PMID: 35210147 PMCID: PMC9117418 DOI: 10.1016/j.arth.2021.12.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 11/30/2021] [Accepted: 12/09/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Several studies have investigated the distribution of hip-knee-ankle (HKA) angle in healthy populations; however, few have evaluated this metric in patients undergoing total knee arthroplasty (TKA). The purpose of this study is to compare HKA angle distribution in early and advanced knee osteoarthritis (OA) patients. METHODS Full limb radiographs were used to measure HKA angle for 983 subjects from the Osteoarthritis Initiative (OAI) cohort and 4,901 pre-TKA patients from an institutional cohort. Measurements were made using a previously validated deep learning algorithm. Linear regression models were used to determine the association of HKA alignment angle with patient characteristics. RESULTS The mean ± standard deviation HKA angle was -1.3° ± 3.2° in the OAI cohort and -4.1° ± 6.1° in the pre-TKA cohort. In the OAI cohort, normal alignment (64%) was the most common knee alignment followed by varus (29%), and valgus (7%). In pre-TKA patients, the most common alignment was varus (62%), followed by normal (27%) and valgus (11%). In pre-TKA patients, mean HKA angle in primary knee OA, post-traumatic knee OA, and rheumatoid arthritis patients were -4.3° ± 6.1°, -3.2° ± 6.4°, and -2.9° ± 6.1°, respectively. HKA angle was strongly associated (P < .001) with gender and body mass index. CONCLUSION TKA patients have a wider alignment distribution and more severe varus and valgus alignment than individuals "at risk" for knee OA from the OAI cohort. These epidemiologic findings improve our understanding of HKA angle distribution and its correlation with demographic characteristics in early and late-stage arthritis.
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Affiliation(s)
- Taghi Ramazanian
- Department of Quantitative Sciences Research, 200 First St. SW, Rochester, MN 55905, USA
- Department of Orthopedic Surgery, 200 First St. SW, Rochester, MN 55905, USA
| | - Shi Yan
- Department of Quantitative Sciences Research, 200 First St. SW, Rochester, MN 55905, USA
| | - Pouria Rouzrokh
- Department of Radiology, Radiology Informatics Laboratory, 200 First St. SW, Rochester, MN 55905, USA
| | - Cody C. Wyles
- Department of Orthopedic Surgery, 200 First St. SW, Rochester, MN 55905, USA
- Department of Clinical Anatomy. 200 First St. SW, Rochester, MN 55905, USA
| | - Thomas J. O Byrne
- Department of Quantitative Sciences Research, 200 First St. SW, Rochester, MN 55905, USA
| | - Michael J. Taunton
- Department of Orthopedic Surgery, 200 First St. SW, Rochester, MN 55905, USA
| | - Hilal Maradit Kremers
- Department of Quantitative Sciences Research, 200 First St. SW, Rochester, MN 55905, USA
- Department of Orthopedic Surgery, 200 First St. SW, Rochester, MN 55905, USA
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Okamura H, Ishikawa H, Ohno T, Fujita S, Yamakami S, Akezuma H, Ishikawa K, Inagaki K. Potential of the non-weight-bearing tunnel view in diagnosing medial meniscus posterior root tear: a pilot study of X-ray characteristics. J Exp Orthop 2021; 8:99. [PMID: 34716847 PMCID: PMC8557219 DOI: 10.1186/s40634-021-00421-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 10/19/2021] [Indexed: 10/24/2022] Open
Abstract
PURPOSE Early detection of medial meniscus posterior root tear (MMPRT) is important in preventing the rapid onset and progression of degenerative knee disease. Diagnosis is facilitated by the availability of non-weight-bearing X-ray view, but information on the X-ray characteristics of MMPRT is scarce. Here, we conducted a pilot study of the X-ray characteristics of MMPRT on non-weight-bearing tunnel view. METHODS We retrospectively reviewed 43 consecutive patients treated in the outpatient department for medial knee pain or popliteal pain. Patients were divided into MMPRT (21 knees) and non-MMPRT groups (22 knees). We investigated X-ray characteristics and magnetic resonance imaging findings. Femorotibial angle, posterior tibial slope, medial tibial eminence (MTE)-medial femoral condyle (MFC) distance (contralateral and affected sides, and difference between the two), medial tibiofemoral joint (MTFJ) width (contralateral and affected sides, and difference between the two), and meniscus radial dislocation between the groups were evaluated using the Mann-Whitney U test. The association between X-ray characteristics and MMPRT was determined using univariate and multivariate logistic regression analyses. RESULTS A highly significant difference between the affected and contralateral sides was seen in MTFJ width and MTE-MFC distance on non-weight-bearing tunnel view between the MMPRT and non-MMPRT groups. Moreover, a difference in MTFJ width of <-0.575 mm and in MTE-MFC distance of >0.665 mm between the affected and contralateral sides was useful in predicting MMPRT. CONCLUSIONS The non-weight-bearing tunnel view is useful for the initial diagnosis of MMPRT. Prospective evaluation in a larger population is warranted.
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Affiliation(s)
- Hiroki Okamura
- Department of Orthopaedic Surgery, Nihon Koukan Hospital, 1-2-1 Koukandori, Kawasaki-ku, Kawasaki City, Kanagawa Prefecture, 210-0852, Japan.
| | - Hiroki Ishikawa
- Department of Orthopaedic Surgery, Nihon Koukan Hospital, 1-2-1 Koukandori, Kawasaki-ku, Kawasaki City, Kanagawa Prefecture, 210-0852, Japan
| | - Takuya Ohno
- Department of Orthopaedic Surgery, Nihon Koukan Hospital, 1-2-1 Koukandori, Kawasaki-ku, Kawasaki City, Kanagawa Prefecture, 210-0852, Japan
| | - Shogo Fujita
- Department of Orthopaedic Surgery, Nihon Koukan Hospital, 1-2-1 Koukandori, Kawasaki-ku, Kawasaki City, Kanagawa Prefecture, 210-0852, Japan
| | - Shigeo Yamakami
- Department of Orthopaedic Surgery, Nihon Koukan Hospital, 1-2-1 Koukandori, Kawasaki-ku, Kawasaki City, Kanagawa Prefecture, 210-0852, Japan
| | - Hirotaka Akezuma
- Department of Orthopaedic Surgery, Nihon Koukan Hospital, 1-2-1 Koukandori, Kawasaki-ku, Kawasaki City, Kanagawa Prefecture, 210-0852, Japan
| | - Koji Ishikawa
- Department of Orthopaedic Surgery, Showa University School of Medicine, Tokyo, 142-8555, Japan
| | - Katsunori Inagaki
- Department of Orthopaedic Surgery, Showa University School of Medicine, Tokyo, 142-8555, Japan
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Garriga C, Goff M, Paterson E, Hrusecka R, Hamid B, Alderson J, Leyland K, Honeyfield L, Greenshields L, Satchithananda K, Lim A, Arden NK, Judge A, Williams A, Vincent TL, Watt FE. Clinical and molecular associations with outcomes at 2 years after acute knee injury: a longitudinal study in the Knee Injury Cohort at the Kennedy (KICK). THE LANCET. RHEUMATOLOGY 2021; 3:e648-e658. [PMID: 34476411 PMCID: PMC8390381 DOI: 10.1016/s2665-9913(21)00116-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Joint injury is a major risk factor for osteoarthritis and provides an opportunity to prospectively examine early processes associated with osteoarthritis. We investigated whether predefined baseline demographic and clinical factors, and protein analytes in knee synovial fluid and in plasma or serum, were associated with clinically relevant outcomes at 2 years after knee injury. METHODS This longitudinal cohort study recruited individuals aged 16-50 years between Nov 1, 2010, and Nov 28, 2014, across six hospitals and clinics in London, UK. Participants were recruited within 8 weeks of having a clinically significant acute knee injury (effusion and structural injury on MRI), which was typically treated surgically. We measured several predefined clinical variables at baseline (eg, time from injury to sampling, extent and type of joint injury, synovial fluid blood staining, presence of effusion, self-reported sex, age, and BMI), and measured 12 synovial fluid and four plasma or serum biomarkers by immunoassay at baseline and 3 months. The primary outcome was Knee Injury and Osteoarthritis Outcome Score (KOOS4) at 2 years, adjusted for baseline score, assessed in all patients. Linear and logistic regression models adjusting for predefined covariates were used to assess associations between baseline variables and 2-year KOOS4. This study is registered with ClinicalTrials.gov, number NCT02667756. FINDINGS We enrolled 150 patients at a median of 17 days (range 1-59, IQR 9-26) after knee injury. 123 (82%) were male, with a median age of 25 years (range 16-50, IQR 21-30). 98 (65%) of 150 participants completed a KOOS4 at 2 (or 3) years after enrolment (50 participants were lost to follow-up and two were withdrawn due to adverse events unrelated to study participation); 77 (51%) participants had all necessary variables available and were included in the core variable adjusted analysis. In the 2-year dataset mean KOOS4 improved from 38 (SD 18) at baseline to 79 (18) at 2 years. Baseline KOOS4, medium-to-large knee effusion, and moderate-to-severe synovial blood staining and their interaction significantly predicted 2-year KOOS4 (n=77; coefficient -20·5, 95% CI -34·8 to -6·18; p=0·0060). The only predefined biomarkers that showed independent associations with 2-year KOOS4 were synovial fluid MCP-1 (n=77; -0·015, 0·027 to -0·004 per change in 1 pg/mL units; p=0·011) and IL-6 (n=77; -0·0005, -0·0009 to -0·0001 per change in 1 pg/mL units; p=0·017). These biomarkers, combined with the interaction of effusion and blood staining, accounted for 39% of outcome variability. Two adverse events occurred that were linked to study participation, both at the time of blood sampling (one presyncopal episode, one tenderness and pain at the site of venepuncture). INTERPRETATION The combination of effusion and haemarthrosis was significantly associated with symptomatic outcomes after acute knee injury. The synovial fluid molecular protein response to acute knee injury (best represented by MCP-1 and IL-6) was independently associated with symptomatic outcomes but not with structural outcomes, with the biomarkers overall playing a minor role relative to clinical predictors. The relationship between symptoms and structure after acute knee injury and their apparent dissociation early in this process need to be better understood to make clinical progress. FUNDING Versus Arthritis, Kennedy Trust for Rheumatology Research, and NIHR Oxford Biomedical Research Centre.
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Affiliation(s)
- Cesar Garriga
- Centre for Osteoarthritis Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, NDORMS, University of Oxford, Oxford, UK
- Centre for Statistics in Medicine, NDORMS, University of Oxford, Oxford, UK
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Megan Goff
- Centre for Osteoarthritis Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, NDORMS, University of Oxford, Oxford, UK
| | - Erin Paterson
- Centre for Osteoarthritis Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, NDORMS, University of Oxford, Oxford, UK
| | - Renata Hrusecka
- Centre for Osteoarthritis Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, NDORMS, University of Oxford, Oxford, UK
| | - Benjamin Hamid
- Centre for Osteoarthritis Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, NDORMS, University of Oxford, Oxford, UK
| | - Jennifer Alderson
- Centre for Osteoarthritis Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, NDORMS, University of Oxford, Oxford, UK
| | - Kirsten Leyland
- NIHR Bristol BRC, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Lesley Honeyfield
- Department of Radiology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Liam Greenshields
- Department of Radiology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Keshthra Satchithananda
- Department of Radiology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
- Department of Radiology, King's College Hospital NHS Foundation Trust, London, UK
| | - Adrian Lim
- Department of Radiology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Nigel K Arden
- Centre for Osteoarthritis Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, NDORMS, University of Oxford, Oxford, UK
- Centre for Sports, Exercise and Osteoarthritis Research Versus Arthritis, NDORMS, University of Oxford, Oxford, UK
| | - Andrew Judge
- Centre for Statistics in Medicine, NDORMS, University of Oxford, Oxford, UK
- NIHR Bristol BRC, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
- Musculoskeletal Research Unit, University of Bristol, Bristol, UK
| | - Andrew Williams
- Centre for Osteoarthritis Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, NDORMS, University of Oxford, Oxford, UK
- Fortius Clinic, London, UK
| | - Tonia L Vincent
- Centre for Osteoarthritis Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, NDORMS, University of Oxford, Oxford, UK
- Department of Rheumatology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Fiona E Watt
- Centre for Osteoarthritis Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, NDORMS, University of Oxford, Oxford, UK
- Centre for Sports, Exercise and Osteoarthritis Research Versus Arthritis, NDORMS, University of Oxford, Oxford, UK
- Department of Rheumatology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
- Department of Immunology and Inflammation, Imperial College London, London, UK
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Wahyuningrum RT, Purnama IKE, Verkerke GJ, van Ooijen PMA, Purnomo MH. A novel method for determining the Femoral-Tibial Angle of Knee Osteoarthritis on X-ray radiographs: data from the Osteoarthritis Initiative. Heliyon 2020; 6:e04433. [PMID: 32775740 PMCID: PMC7404555 DOI: 10.1016/j.heliyon.2020.e04433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Revised: 05/26/2019] [Accepted: 07/09/2020] [Indexed: 11/01/2022] Open
Abstract
Femoral-tibial alignment is a prominent risk factor for Knee Osteoarthritis (KOA) incidence and progression. One way of assessing alignment is by determining the Femoral-Tibial Angle (FTA). Several studies have investigated FTA determination; however, methods of assessment of FTA still present challenges. This paper introduces a new method for semi-automatic measurement of FTA as part of KOA research. Our novel approach combines preprocessing of X-ray images and the use of Active Shape Model (ASM) as the femoral and tibial segmentation method, followed by a thinning process. The result of the thinning process is used to predict FTA automatically by measuring the angle between the intersection of the two vectors of branching points on the femoral and tibial areas. The proposed method is trained on 10 x-ray images and tested on 50 different x-ray images of the Osteoarthritis Initiative (OAI) dataset. The outcomes of this approach were compared with manually obtained FTA measurements from the OAI dataset as the ground truth. Based on experiments, the difference in measurement results between the FTA of the OAI and the FTA obtained using our method is quite small, i.e., below 0.81° for the right FTA and below 0.77° for the left FTA with minimal average errors. This result indicates that this method is clinically suitable for semi-automatic measurement of the FTA.
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Affiliation(s)
- Rima Tri Wahyuningrum
- Department of Electrical Engineering, Institut Teknologi Sepuluh Nopember, Surabaya, Indonesia.,Department of Informatics, Universitas Trunojoyo Madura, Bangkalan, Indonesia
| | - I Ketut Eddy Purnama
- Department of Electrical Engineering, Institut Teknologi Sepuluh Nopember, Surabaya, Indonesia.,Department of Computer Engineering, Institut Teknologi Sepuluh Nopember, Surabaya, Indonesia
| | - Gijsbertus Jacob Verkerke
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, the Netherlands.,Department of Biomechanical Engineering, University of Twente, the Netherlands
| | - Peter M A van Ooijen
- Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, the Netherlands
| | - Mauridhi Hery Purnomo
- Department of Electrical Engineering, Institut Teknologi Sepuluh Nopember, Surabaya, Indonesia.,Department of Computer Engineering, Institut Teknologi Sepuluh Nopember, Surabaya, Indonesia.,The Science and Technology Center of Artificial Intelligence for Healthcare and Society (PUI AI HeS), Indonesia
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7
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Zhang L, Liu G, Han B, Wang Z, Yan Y, Ma J, Wei P. Knee Joint Biomechanics in Physiological Conditions and How Pathologies Can Affect It: A Systematic Review. Appl Bionics Biomech 2020; 2020:7451683. [PMID: 32322301 PMCID: PMC7160724 DOI: 10.1155/2020/7451683] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 02/01/2020] [Indexed: 01/17/2023] Open
Abstract
The knee joint, as the main lower limb motor joint, is the most vulnerable and susceptible joint. The knee injuries considerably impact the normal living ability and mental health of patients. Understanding the biomechanics of a normal and diseased knee joint is in urgent need for designing knee assistive devices and optimizing a rehabilitation exercise program. In this paper, we systematically searched electronic databases (from 2000 to November 2019) including ScienceDirect, Web of Science, PubMed, Google Scholar, and IEEE/IET Electronic Library for potentially relevant articles. After duplicates were removed and inclusion criteria applied to the titles, abstracts, and full text, 138 articles remained for review. The selected articles were divided into two groups to be analyzed. Firstly, the real movement of a normal knee joint and the normal knee biomechanics of four kinds of daily motions in the sagittal and coronal planes, which include normal walking, running, stair climbing, and sit-to-stand, were discussed and analyzed. Secondly, an overview of the current knowledge on the movement biomechanical effects of common knee musculoskeletal disorders and knee neurological disorders were provided. Finally, a discussion of the existing problems in the current studies and some recommendation for future research were presented. In general, this review reveals that there is no clear assessment about the biomechanics of normal and diseased knee joints at the current state of the art. The biomechanics properties could be significantly affected by knee musculoskeletal or neurological disorders. Deeper understanding of the biomechanics of the normal and diseased knee joint will still be an urgent need in the future.
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Affiliation(s)
- Li Zhang
- Shaanxi Engineering Laboratory for Transmissions and Controls, Northwestern Polytechnical University, Xi'an 710072, China
| | - Geng Liu
- Shaanxi Engineering Laboratory for Transmissions and Controls, Northwestern Polytechnical University, Xi'an 710072, China
| | - Bing Han
- Shaanxi Engineering Laboratory for Transmissions and Controls, Northwestern Polytechnical University, Xi'an 710072, China
| | - Zhe Wang
- Shaanxi Engineering Laboratory for Transmissions and Controls, Northwestern Polytechnical University, Xi'an 710072, China
| | - Yuzhou Yan
- Shaanxi Engineering Laboratory for Transmissions and Controls, Northwestern Polytechnical University, Xi'an 710072, China
| | - Jianbing Ma
- Hong-Hui hospital, Xi'an Jiaotong University College of Medicine, Xi'an 710054, China
| | - Pingping Wei
- State Key Laboratory for Manufacturing Systems Engineering, Xi'an Jiaotong University, Xi'an 710054, China
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8
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Ismail SA, Simic M, Salmon LJ, Roe JP, Pinczewski LA, Smith R, Pappas E. Side-to-Side Differences in Varus Thrust and Knee Abduction Moment in High-Functioning Individuals With Chronic Anterior Cruciate Ligament Deficiency. Am J Sports Med 2019; 47:590-597. [PMID: 30525874 DOI: 10.1177/0363546518812883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND There is evidence that frontal plane knee joint motion plays a crucial role in the pathogenesis of knee osteoarthritis, yet investigation of individuals with chronic anterior cruciate ligament-deficient (ACLD) knees remains sparse. PURPOSE To investigate (1) if individuals with chronic ACLD knees demonstrate higher biomechanical measures of medial knee load as compared with their anterior cruciate ligament-intact (ACLI) knees, (2) if differences in static knee alignment of the ACLD knee will demonstrate a difference in the magnitude of biomechanical measures of medial knee load when compared with the ACLI knee, and (3) the side-to-side concordance of varus thrust among individuals with chronic ACLD knees. STUDY DESIGN Descriptive laboratory study. METHODS Participants were sourced from a metropolitan orthopaedic surgeon group. Those who met the inclusion criteria and agreed to participate underwent a 3-dimensional gait analysis assessment to measure knee adduction moment (KAM), knee flexion moment (KFM), KAM peaks, KAM impulse, and varus thrust. Frontal plane knee static alignment was measured with a digital inclinometer fixed to medical calipers. The participants were divided according to their static knee alignment (neutral, varus, and valgus) for subgroup analysis. Peak knee angular velocity and frontal plane knee angle were used to establish if a participant was walking with a knee thrust. An individual was deemed to have knee thrust during gait if the largest frontal plane knee movement coincided with the peak knee angular velocity that occurred within the first 30% of stance phase. RESULTS Forty-five participants were recruited. The mean (SD) time from injury was 34.5 (55.6) months. ACLD knees did not demonstrate higher mean KAM and KFM ( P > .5) or early-stance peak KAM ( P = .3-.8) and KAM impulse ( P = .3-.9) as compared with ACLI knees as a whole group or when the varus, neutral, and valgus alignment subgroups were investigated separately. Twenty-three percent (n = 9) of the participants had a varus thrust at the ACLD or ACLI knee, 44% (n = 4) had a varus thrust at the ACLD knee, and 22% (n = 2) had varus thrust at both knees. CONCLUSION There were no side-to-side differences in mean KAM and KFM and early-stance peak KAM and KAM impulse among high-functioning individuals with chronic unilateral ACLD knees. There was a low prevalence of varus thrust among high-functioning individuals with chronic unilateral ACLD knees.
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Affiliation(s)
| | - Milena Simic
- The University of Sydney, Faculty of Health Sciences, Lidcombe, Australia
| | - Lucy J Salmon
- North Sydney Orthopaedic and Sports Medicine Centre, Sydney, Australia
| | - Justin P Roe
- North Sydney Orthopaedic and Sports Medicine Centre, Sydney, Australia
| | - Leo A Pinczewski
- North Sydney Orthopaedic and Sports Medicine Centre, Sydney, Australia
- University of Notre Dame, Medical School, Sydney, Australia
| | - Richard Smith
- The University of Sydney, Faculty of Health Sciences, Lidcombe, Australia
| | - Evangelos Pappas
- The University of Sydney, Faculty of Health Sciences, Lidcombe, Australia
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Becker R, Hirschmann M. The pertinent question in treatment of unicompartmental osteoarthritis of the knee: high tibial osteotomy or unicondylar knee arthroplasty or total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2017; 25:637-638. [PMID: 28251284 DOI: 10.1007/s00167-017-4466-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Roland Becker
- Department of Orthopeadic Surgery and Traumatology, Hospital Brandenburg, Brandenburg Medical School, Hochstrasse 26, 14770, Brandenburg/havel, Germany.
| | - Michael Hirschmann
- Department of Orthopaedic Surgery and Traumatology, Kantonsspital Baselland (Bruderholz, Liestal, Laufen), Bruderholz, Switzerland
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