Alterations of kinematics in knees after single versus multiple radius femoral prostheses total knee arthroplasty: a retrospective study

Biomechanically based Fu's subcutaneous needling treatment for senile knee osteoarthritis: protocol for a randomized controlled trial

INTRODUCTION

Fu's subcutaneous needling (FSN) is a new type of acupuncture that uses subcutaneous tissue to oscillate from side to side to improve muscle pathology status and can be effective in treating Knee osteoarthritis. Nonetheless, whether the clinical effect is similar to that of most commonly used drugs is unclear. Thus, this study aims to determine the pain-relieving effect and improvement in the joint function of the FSN therapy by comparing it with that of a positive control drug (celecoxib). Furthermore, this clinical trial also aims to evaluate the effect of FSN on gait and lower limb muscle flexibility, which can further explore the scientific mechanisms of the FSN therapy.

METHODS AND ANALYSIS

This study is a randomized, parallel-controlled, single-center prospective clinical study that includes 60 participants, with an FSN group (n = 30) and a drug group (n = 30). The Fu's subcutaneous needling (FSN) group undergo the FSN therapy 3 times a week for 2 weeks, while the drug group receives 0.2 g/day oral celecoxib for 2 weeks, with a follow-up period of 4 weeks after the completion of treatment. The primary outcome is the difference in the visual analog scale score after 2 weeks of treatment compared with baseline. The Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index, joint active range of motion test, three-dimensional gait analysis, and shear wave elastic imaging technology analysis in lower limb muscles are also performed to demonstrate clinical efficacy.

ETHICS AND DISSEMINATION

The trial is performed following the Declaration of Helsinki. The study protocol and consent form have been approved by the Ethics Committee of Guangdong Provincial Hospital of Chinese Medicine. All patients will give informed consent before participation and the trial is initiated after approval. The results of this trial will be disseminated through publication in peer-reviewed journals.

TRIAL REGISTRATION NUMBER

NCT06328153.

Kinematic study of the overall unloading brace for the knee

Objective

Traditional knee braces unloading forces primarily from a single compartment are insufficient for patients with knee injuries or knee osteoarthritis (KOA) involving multiple compartments. We investigated how knee kinematics were altered by an overall unloading brace (OUB) designed to unload both the medial and lateral tibiofemoral (TF) compartments simultaneously during dynamic movement.

Methods

Gait analysis was performed on 32 adults with normal knee alignment and no history of knee disease. Three-dimensional (3D) knee kinematic data collected during treadmill walking (3 km/h) and jogging (5 km/h) with an optical motion capture system were compared with versus without the OUB.

Results

In the stance phase, wearing the OUB, versus not wearing it, increased the proximal-distal translational range of motion (ROM) of the knee by 4.04 mm (Effect size, ES = 0.97) during walking and by 3.43 mm (ES = 0.97) during jogging, decreased abduction-adduction rotational ROM by 3.09°(ES = 1.05) during walking and by 2.88°(ES = 1.50) during jogging, and decreased internal-external rotation by 2.14°(ES = 0.81) during walking and by 4.66°(ES = 1.61) during jogging. In the swing phase, the OUB increased proximal-distal translational ROM by 12.64 mm (ES = 1.31) during walking and by 9.23 mm (ES = 0.92) during jogging, decreased abduction-adduction rotational ROM by 2.83°(ES = 0.54) during walking and by 3.37°(ES = 0.67) during jogging, and decreased internal-external rotational ROM by 2.71°(ES = 0.68) during jogging.

Conclusions

OUB use increased proximal-distal translation while reducing abduction-adduction rotation. This effect may increase the joint gap of the tibiofemoral joint, thereby reducing joint stress, and may contribute to disease rehabilitation in the knee of clinical orthopedics, rehabilitation, and sports medicine fields. However, additional studies are needed to assess the range of possible clinical and prophylactic benefits of OUB.

Similar kinematic patterns between revision total stabilized (TS) and primary posterior stabilized (PS) knee prostheses: a prospective case-controlled study with gait assessment

PURPOSE

There are increased surgical considerations when revising total knee arthroplasty (TKA) in active patients. Few studies have assessed if a semi-constrained [Total Stabilized (TS)] prostheses has similar knee biomechanics to a primary posterior stabilized (PS) prosthesis. The aim was to compare the gait parameters in patients with PS or TS TKA and normal controls.

METHODS

32 patients with TKA were prospectively included with either a primary PS (n = 15) or a revision TS (n = 17) prosthesis. Gait analysis was performed at 6 months postoperatively for each patient, with an optoelectronic knee assessment device (KneeKG®) assessing the displacement of the tibia relative to the femur during the different gait phases (flexion/extension, anterior/posterior translation, adduction/abduction, internal/external rotation). A control group (n = 12) of healthy knees was compared with the TKA groups.

RESULTS

There were no significant kinematic differences between PS and TS groups. The maximum knee flexion during gait was 53° ± 8.1° in the PS group vs 52° ± 8.7° in the TS group. The antero-posterior translation was similar in both group (2.3 ± 0.5 mm vs 2.6 ± 0.9 mm, respectively). Peak varus angle during loading and swing phase was slightly higher in the TS group (2.7° ± 0.7° and 5.2° ± 0.9°) than in the PS group (2.9° ± 0.6° and 5.6° ± 1.2°), without significant difference. The ranges in internal/external rotation were similar between PS and TS TKA (3.7° ± 0.5° vs 3.3° ± 0.6°, respectively). Both designs approached closely the normal gait patterns of the control group except in the frontal plane.

CONCLUSION

Single radius TS TKA has gait parameters similar to single radius PS TKA. Use of a single radius TS TKA in revision TKA is not detrimental to a patient's gait pattern. Both designs approached closely the normal gait patterns of the control group.

LEVEL OF EVIDENCE

Prospective, case-control study; Level III.