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Kow RY, Abdul Rani R, Mohamad Nazarallah MH, Leong JF, Hayyun MF, Low CL, Zulkifly AH, Mohamad Yahaya NH. Robotic-Assisted Hip and Knee Arthroplasty: A Bibliometric Analysis Using the Scopus Database. Cureus 2024; 16:e56617. [PMID: 38646377 PMCID: PMC11031712 DOI: 10.7759/cureus.56617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2024] [Indexed: 04/23/2024] Open
Abstract
Robotic-assisted hip and knee arthroplasty represents cutting-edge advancements in orthopedic surgery, harnessing robotic technology to enhance precision, improve clinical outcomes, and facilitate intra-operative procedures. In these robotic-assisted surgeries, the robotic systems assist surgeons in planning and executing joint replacement surgeries, thereby facilitating personalized implant positioning and optimizing the fit and alignment of hip and knee implants. Despite the increasing attention garnered by robotic-assisted hip and knee arthroplasty in recent years, a comprehensive bibliometric analysis using the Scopus database has yet to be conducted. This bibliometric analysis reviews the Scopus database from 1961 until 2022 to investigate the literature on the field of robotic-assisted hip and knee arthroplasty. A total of 577 articles that satisfied the selection criteria were included in this review. The majority of the articles focus more on total knee replacement, compared to total hip replacement and unicompartmental knee arthroplasty. The overwhelming majority of the articles were authored by researchers and clinicians from the United States of America (USA) and the United Kingdom (UK). Similarly, most of the articles with the highest number of citations were authored by researchers and clinicians from these regions. This comprehensive bibliometric analysis using Scopus in the domain of robotic-assisted hip and knee replacement has the potential to act as a roadmap for researchers, clinicians, and policymakers, facilitating informed decision-making, promoting collaborative initiatives, and guiding the development of future studies to further advance the field of robotic-assisted hip and knee arthroplasty.
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Affiliation(s)
- Ren Yi Kow
- Department of Orthopedics, Traumatology, and Rehabilitation, International Islamic University Malaysia, Kuantan, MYS
| | - Rizal Abdul Rani
- Department of Orthopedics and Traumatology, Universiti Kebangsaan Malaysia, Kuala Lumpur, MYS
| | | | - Juzaily F Leong
- Department of Orthopedics and Traumatology, Hospital Canselor Tuanku Muhriz, Kuala Lumpur, MYS
| | - Muhammad Fathi Hayyun
- Department of Orthopedics and Traumatology, Hospital Canselor Tuanku Muhriz, Kuala Lumpur, MYS
| | - Chooi Leng Low
- Department of Radiology, International Islamic University Malaysia, Kuantan, MYS
| | - Ahmad Hafiz Zulkifly
- Department of Orthopedics, Traumatology, and Rehabilitation, International Islamic University Malaysia, Kuantan, MYS
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Valtanen RS, Seligson M, Huddleston HG, Angibaud L, Huddleston JI. Improved Clinical Outcomes With Dynamic, Force-Controlled, Gap-Balancing in Posterior-Stabilized Total Knee Arthroplasty. J Arthroplasty 2024:S0883-5403(24)00121-9. [PMID: 38417556 DOI: 10.1016/j.arth.2024.02.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/12/2024] [Accepted: 02/07/2024] [Indexed: 03/01/2024] Open
Abstract
BACKGROUND Optimal soft-tissue management in total knee arthroplasty (TKA) may reduce symptomatic instability. We hypothesized that TKA outcomes using a computer-assisted dynamic ligament balancer that acquires medial and lateral gap sizes throughout the motion arc would show improved Knee Society Scores (KSS) compared to TKAs done with a traditional tensioner at 0 and 90°. We also sought to quantify the degree to which the planned femoral rotation chosen to optimize medio-lateral balance throughout the arc of motion deviated from the femoral rotation needed to achieve a rectangular flexion gap at 90° alone. METHODS Baseline demographics, clinical outcomes, KSSs, and femoral rotations were compared in 100 consecutive, computer-assisted TKAs done with the balancer (balancer group) to the immediately prior 100 consecutive computer-assisted TKAs done without the balancer (control group). Minimum follow-up was 13 months and all patients had osteoarthritis. Mean knee motion did not differ preoperatively (110.1 ± 13.6° balancer, 110.4 ± 12.5° control, P = .44) or postoperatively (119.1 ± 10.3° balancer, 118.8 ± 10.9° control, P = .42). Tourniquet times did not differ (93.1 ± 13.0 minutes balancer, 90.7 ± 13.0 minutes control, P = .13). Postoperative length of stay differed (40.2 ± 20.9 hours balancer, 49.0 ± 18.3 hours control, P = .0009). There were 14 readmissions (7 balancer, 7 control), 11 adverse events (4 balancer, 7 control), and 3 manipulations (1 balancer, 2 control). The cohorts were compared using Student's t-tests, Shapiro-Wilk normalities, Wilcoxon rank-sums, and multivariable logistic regression analyses. RESULTS Postoperative KSS improvements were higher in the balancer group (P < .0001). In multivariable regression analyses, the balancer group experienced 7 ± 2 point improvement in KSS Knee scores (P < .0001) and 4 ± 2 point improvement in KSS Function scores (P = .040) compared to the control group. CONCLUSIONS The statistically and clinically significant improvements in postoperative KSS demonstrated in the balancer cohort are likely driven by improved stability throughout the motion arc. Further study is warranted to evaluate replicability by non-design surgeons.
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Affiliation(s)
- Rosa S Valtanen
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Redwood City, California
| | | | - Heather G Huddleston
- Department of Obstetrics and Gynecology, University of California, San Francisco School of Medicine, San Francisco, California
| | | | - James I Huddleston
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Redwood City, California
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Allegra F, Picchi A, Ratano M, Gumina S, Fidanza A, Logroscino G. Microfracture- and Xeno-Matrix-Induced Chondrogenesis for Treatment of Focal Traumatic Cartilage Defects of the Knee: Age-Based Mid-Term Results. Healthcare (Basel) 2023; 11:2995. [PMID: 37998487 PMCID: PMC10671418 DOI: 10.3390/healthcare11222995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/14/2023] [Accepted: 11/18/2023] [Indexed: 11/25/2023] Open
Abstract
The aim of this study was to investigate clinical and instrumental outcomes of the autologous matrix-induced chondrogenesis (AMIC) technique for the treatment of isolated traumatic condyle and femoropatellar cartilage lesions. A total of 25 patients (12 males, 13 females, mean age 47.3 years) treated between 2018 and 2021 were retrospectively reviewed and subdivided into two groups based on age (Group A, age < 45 years; Group B, age > 45 years). A clinical evaluation was performed using the International Knee Documentation Committee (IKDC), Lysholm score and Visual Analogue Score (VAS). Cartilage regeneration was evaluated via magnetic resonance (1.5 Tesla) and classified according to a Magnetic resonance Observation of CArtilage Repair Tissue (MOCART) scoring system. At a minimum follow-up of 2 years, Group A patients obtained greater instrumental results in comparison to group B: in fact, the MOCART score was statistically significantly correlated with IKDC (r = 0.223) (p < 0.001) exclusively in group A. Nevertheless, a significant improvement in clinical functionality was shown in Group B (p < 0.001), demonstrating that this technique is safe, reproducible and capable of offering satisfactory clinical results regardless of age.
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Affiliation(s)
| | - Aurelio Picchi
- Unit of Orthopaedics, Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy (G.L.)
| | - Marco Ratano
- Unit of Orthopaedics, Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy (G.L.)
| | - Stefano Gumina
- Department of Anatomy, Histology, Legal Medicine and Orthopaedics, Polo Pontino, Sapienza University of Rome, 00161 Rome, Italy
| | - Andrea Fidanza
- Unit of Orthopaedics, Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy (G.L.)
| | - Giandomenico Logroscino
- Unit of Orthopaedics, Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy (G.L.)
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Thöne P, Gruber MS, Kindermann H, Gussner W, Sadoghi P, Ortmaier R. Stem Design in Total Hip Arthroplasty Influences Ipsilateral Knee Valgus: A Retrospective Comparative Analysis of 2953 Cases. J Clin Med 2023; 12:6662. [PMID: 37892800 PMCID: PMC10607773 DOI: 10.3390/jcm12206662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 10/13/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Total hip arthroplasty (THA) affects the biomechanics of the hip and the patient gait. The stem design influences femoral lever ratios and tissue trauma. Biomechanical changes such as these have the potential to induce knee arthritis. A varus or valgus configuration of knee arthritis is formed by asymmetric loadings. The aim of this study was to evaluate the impact of stem design in THA on knee valgus by comparing a standard implant with an implant with a short stem. METHODS A total of 2953 patients who underwent primary total knee arthroplasty for end-stage osteoarthritis between 2015 and 2021 were included in this retrospective data analysis. Patients were divided into three groups, depending on hip status (straight stem, short stem, and native joint). Leg alignment was distinguished as varus or valgus, and the degree of axial deviation was measured. Descriptive and explorative statistical analyses were performed, with a p value < 0.05 set as significant. RESULTS Ipsilateral knee valgus occurred significantly more often in patients with straight stems (57.2%) than in those with short stems (29%) and native joints (25.8%) (p < 0.001). Additionally, mean valgus deviation was significantly increased in patients with straight stems (8.9°) compared to those with short stems (6.4°) or native hip joints (6.7°). Both findings were accentuated in women. CONCLUSIONS Previous ipsilateral straight-stem THA is associated with knee valgus deformity, especially in women. Short-stem THA seems to be better suited to restoring physiological biomechanics and preventing the development of valgus osteoarthritis of the ipsilateral knee.
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Affiliation(s)
- Paul Thöne
- Medical Faculty, Johannes Kepler University Linz, 4020 Linz, Austria
- Department of Orthopedic Surgery, Ordensklinikum Linz Barmherzige Schwestern, Vinzenzgruppe Center of Orthopedic Excellence, Teaching Hospital of the Paracelsus Medical University, 5020 Salzburg, Austria
| | - Michael Stephan Gruber
- Department of Orthopedic Surgery, Ordensklinikum Linz Barmherzige Schwestern, Vinzenzgruppe Center of Orthopedic Excellence, Teaching Hospital of the Paracelsus Medical University, 5020 Salzburg, Austria
| | - Harald Kindermann
- Department of Marketing and Electronic Business, University of Applied Sciences Upper Austria, 4400 Steyr, Austria;
| | - Walter Gussner
- Department of Orthopedic Surgery, Ordensklinikum Linz Barmherzige Schwestern, Vinzenzgruppe Center of Orthopedic Excellence, Teaching Hospital of the Paracelsus Medical University, 5020 Salzburg, Austria
| | - Patrick Sadoghi
- Department of Orthopedics and Trauma, Medical University of Graz, Austria Auenbruggerplatz 5, 8036 Graz, Austria
| | - Reinhold Ortmaier
- Department of Orthopedic Surgery, Ordensklinikum Linz Barmherzige Schwestern, Vinzenzgruppe Center of Orthopedic Excellence, Teaching Hospital of the Paracelsus Medical University, 5020 Salzburg, Austria
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Zhao AT, Caballero CJ, Nguyen LT, Vienne HC, Lee C, Kaye AD. A Comprehensive Update of Prolotherapy in the Management of Osteoarthritis of the Knee. Orthop Rev (Pavia) 2022; 14:33921. [PMID: 35769650 PMCID: PMC9235417 DOI: 10.52965/001c.33921] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 01/12/2022] [Indexed: 12/07/2023] Open
Abstract
This is a comprehensive review of the literature focusing on the use of prolotherapy in the treatment of osteoarthritis of the knee. It covers the background, efficacy, and advantages of prolotherapy in the management of osteoarthritis symptoms and then covers the existing evidence of the use of prolotherapy for this purpose. Current treatments for osteoarthritis of the knee are numerous, yet patients continue to endorse chronic pain and poor quality of life. Prolotherapy is a treatment that has been inadequately studied with poor sample sizes and lack of standardization between trials. However, in recent years the literature on prolotherapy in the treatment of knee osteoarthritis has grown. Although there is still a lack of homogeneity, trials have shown that dextrose prolotherapy, autologous conditioned serum, hyaluronic injections, and normal saline administered either intra- or peri-articularly are comparable in reducing pain scores to other primary treatment options. The mechanism of action for prolotherapy is still unclear, but researchers have found that prolotherapy plays some role in cartilage growth or chondrogenesis and has been shown to have improved radiographic outcomes. Prolotherapy appears to be a safe treatment alternative that has been shown to improve stiffness, pain, function, and quality of life in osteoarthritis of the knee. Knee osteoarthritis is remarkably prevalent in the United States and is one of the most common causes of disability in the elderly population. Although there are many treatment options, patients continue to live with chronic pain which can incur high costs for patients. A safe, long-term, and effective solution has not yet been identified. Prolotherapy has been shown to be a safe option for improving pain, function, and quality of life as effectively as other treatment options.
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Affiliation(s)
- Alex Tang Zhao
- Georgetown University School of Medicine, Washington, DC
| | | | - Linh T Nguyen
- Louisiana State University School of Medicine Shreveport, Shreveport, LA
| | - Hunter C Vienne
- Louisiana State University School of Medicine Shreveport, Shreveport, LA
| | - Christopher Lee
- Department of Internal Medicine, Creighton University School of Medicine-Phoenix Regional Campus, Phoenix, AZ
| | - Alan D Kaye
- Department of Anesthesiology, Louisiana State University Health Sciences Center, Shreveport, LA
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Wang C, Zhu Y, Liu Z, Long H, Ruan Z, Zhao S. Causal associations of obesity related anthropometric indicators and body compositions with knee and hip arthritis: A large-scale genetic correlation study. Front Endocrinol (Lausanne) 2022; 13:1011896. [PMID: 36246900 PMCID: PMC9556900 DOI: 10.3389/fendo.2022.1011896] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 09/20/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUNDS Epidemiological studies have repeatedly investigated the association between obesity related anthropometric indicators and body compositions and osteoarthritis (OA). However, the results have remained inconsistent. This work aimed to investigate the genetic correlation and causal associations of obesity related anthropometric indicators and body compositions with knee and hip OA. METHODS Single-nucleotide polymorphisms associated with the exposures were searched from the recent genome-wide association studies (GWAS) to obtain full statistics. Summary-level results of knee and hip OA were from the UK Biobank and arcOGEN. First, linkage disequilibrium score regression (LD score regression) was applied to detect the genetic correlation (rg). We further performed a series of sensitivity analyses as validation of primary mendelian randomization (MR) results and the specific evidence of potential causal effects was defined. RESULTS We found that genetic components in OA had significant correlation with obesity related traits, except waist-to-hip ratio. In the univariable MR analysis, with the exception of waist-to-hip ratio, obesity related anthropometric indicators were causally associated with increased risks of knee and hip OA. For obesity related body compositions, higher fat-free mass in arm, leg, and whole body increased the risk of knee OA but only fat-free mass in leg showed a significant association with hip OA. Meanwhile trunk fat mass and trunk fat percentage, were associated with knee but not with hip OA. Higher fat mass, and fat percentage in arm, leg, and whole body increased the risk of both knee and hip OA. After adjusting for BMI, the multivariable MR showed maintained results in knee OA. However, in hip OA, only fat mass and fat-free mass in arm, leg, trunk and whole body were significantly associated with the risk of hip OA. CONCLUSION The present study suggests genetic evidence for certain causal associations of obesity related anthropometric indicators and body compositions with knee and hip OA, which may provide important insights for the prevention and treatment on OA.
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Affiliation(s)
- Chao Wang
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Yong Zhu
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Zhi Liu
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Haitao Long
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Zhe Ruan
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Shushan Zhao
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- *Correspondence: Shushan Zhao,
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Guo B, Qiao F, Liao Y, Song L, He J. Triptolide laden reduced graphene oxide transdermal hydrogel to manage knee arthritis: in vitro and in vivo studies. J Biomater Sci Polym Ed 2021; 32:1288-1300. [PMID: 33797338 DOI: 10.1080/09205063.2021.1912976] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Triptolide (extract of herb Tripterygium wilfordii) is widely used in rheumatoid arthritis due to its potent immunosuppressant effect. The marketed oral (tablet dosage forms) and parenteral injections have short duration of action (half-life = 38 min) and not limited to multiorgan toxicity, which restrict the use of triptolide in clinical practice. In this study, a triptolide-loaded Pluronic® F68-reduced graphene oxide transdermal (non-invasive) hydrogel was developed to achieve sustained release of triptolide. Fourier transform infrared spectroscopy, X-ray diffraction, and Raman spectroscopy confirmed the synthesis of Pluronic® F68-reduced graphene oxide. Transmission electron microscopy showed flat wrinkled-nanosheets. The developed hydrogel showed desirable viscosity (11,261-11,365 cps), adhesiveness (0.25 mJ), hardness (6.5 g), and cohesiveness (1.85) for transdermal application. The ex vivo release study demonstrated the ability of the Pluronic® F68-reduced graphene oxide hydrogel to prolong release up to 14 h (63.64-96.78%), owing to the strong π-π interactions between the graphene oxide and the triptolide. The in vivo pharmacokinetic parameters in the rat model confirmed the improvement in the relative bioavailability (3.3-fold) with Pluronic® F68-reduced graphene oxide hydrogel in comparison to the control hydrogel without reduced graphene oxide. The anti-rheumatoid efficacy model suggest the potential application of Pluronic® F68-reduced graphene oxide hydrogel to treat knee rheumatoid arthritis (70-75% resolution) to substitute tablets and parenteral injections.
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Affiliation(s)
- Binghua Guo
- Department of Orthopedics combined TCM with Western Medicine, Honghui Hospital, Xi'an Jiaotong University, No. 555 Youyi East Road, Beilin, Xi'an, Shaanxi, 710054, China
| | - Feng Qiao
- Department of Orthopedics combined TCM with Western Medicine, Honghui Hospital, Xi'an Jiaotong University, No. 555 Youyi East Road, Beilin, Xi'an, Shaanxi, 710054, China
| | - Yonghua Liao
- Department of Orthopedics combined TCM with Western Medicine, Honghui Hospital, Xi'an Jiaotong University, No. 555 Youyi East Road, Beilin, Xi'an, Shaanxi, 710054, China
| | - Lianjin Song
- Department of Traditional Chinese Medicine, High-Tech Hospital, Xi'an, Shaanxi, China
| | - Jinlong He
- Department of Orthopedics combined TCM with Western Medicine, Honghui Hospital, Xi'an Jiaotong University, No. 555 Youyi East Road, Beilin, Xi'an, Shaanxi, 710054, China
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Abstract
Background: Much of the world's population suffers from knee pain. Treatment options are too extreme (surgery), have side-effects (drugs), or take too long (physical therapy). Research has shown that acupuncture can provide modest relief of knee pain. This article presents ways to improve the effectiveness of acupuncture for treating knee pain. Using 3 composite "cases," the author offers specific modifications to acupuncture treatments-particularly palpatory techniques-that produce more-successful relief of patients' knee pain. Cases: Analyzing 3 composites of multiple similar typical cases, the author compares what made the treatments more successful than would be statistically anticipated. Composite case 1: Women, older than, 50 had knee osteoarthritis (OA), periodic pain, more at night and during weather changes. Composite case 2: Men and women, in their 40s and early 50s, had mild knee arthritis, and were given injections to relieve pain that was mild-to-moderate and worse at night. Composite case 3: Men between their late 20s and early 40s, experienced knee pain 1-4 times per week, with some patients reporting knee buckling after some activities. Results: Palpation of these patients' knees revealed the causes of their knee pain-spasms, adhesions, and/or fibrosis-and the patients were treated with individually selected points based on results of the Four Examinations. Most obtained relief lasting from 4 months to 2 years. Conclusions: Mainstream acupuncture treatments rarely involve using the Four Examinations of Traditional Chinese Medicine. Instead, these treatments involve common point selections for addressing knee pain or more-advanced approaches, such as Five Elements or Zang-Fu pattern diagnosis, often disregarding such basic but essential diagnostic techniques as visual inspection and particularly palpation. According to the Four Examinations, OA is not often the cause of knee pain; instead, adhesions and fibrosis of the soft tissues around the knee joint cause nerve entrapments, and knee pain is referred from those sources. While muscle fibrosis is well-known to cause pain, it is rarely addressed in detail in acupuncture literature. If palpation of the soft tissues around the knee joint evokes a patient's pain-thus, locating the nerve entrapment in each specific case precisely-this allows the clinician to insert acupuncture needles into the soft-tissue fibrosis. This needling could improve the clinical outcomes of acupuncture treatment of knee pain significantly, providing shorter- as well as longer-term relief.
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Rodrigues P, Antunes M, Raposo C, Marques P, Fonseca F, Barreto JP. Deep segmentation leverages geometric pose estimation in computer-aided total knee arthroplasty. Healthc Technol Lett 2019; 6:226-230. [PMID: 32038862 PMCID: PMC6952257 DOI: 10.1049/htl.2019.0078] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 10/02/2019] [Indexed: 12/03/2022] Open
Abstract
Knee arthritis is a common joint disease that usually requires a total knee arthroplasty. There are multiple surgical variables that have a direct impact on the correct positioning of the implants, and an optimal combination of all these variables is the most challenging aspect of the procedure. Usually, preoperative planning using a computed tomography scan or magnetic resonance imaging helps the surgeon in deciding the most suitable resections to be made. This work is a proof of concept for a navigation system that supports the surgeon in following a preoperative plan. Existing solutions require costly sensors and special markers, fixed to the bones using additional incisions, which can interfere with the normal surgical flow. In contrast, the authors propose a computer-aided system that uses consumer RGB and depth cameras and do not require additional markers or tools to be tracked. They combine a deep learning approach for segmenting the bone surface with a recent registration algorithm for computing the pose of the navigation sensor with respect to the preoperative 3D model. Experimental validation using ex-vivo data shows that the method enables contactless pose estimation of the navigation sensor with the preoperative model, providing valuable information for guiding the surgeon during the medical procedure.
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Affiliation(s)
- Pedro Rodrigues
- Institute of Systems and Robotics, University of Coimbra, Coimbra, Portugal
| | | | | | - Pedro Marques
- Faculty of Medicine, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - Fernando Fonseca
- Faculty of Medicine, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - Joao P Barreto
- Institute of Systems and Robotics, University of Coimbra, Coimbra, Portugal.,Perceive 3D, Coimbra, Portugal
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Abstract
BACKGROUND Benefits of yoga practice in patients with knee osteoarthritis and rheumatoid arthritis remains controversial. This study performs a meta-analysis to quantify the efficiency of yoga exercise for patients pain reduction, functional recovery, and general wellbeing. METHODS A computerized search of PubMed and Embase was performed to identify relevant studies. The outcome measures were pain, stiffness, and physical function. Two investigators identified eligible studies and extracted data independently. The quality of citations was measured using Jadad score. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated for pain, musculoskeletal impairment, quality of life, general wellbeing, and mental wellbeing. RESULTS A total of 13 clinical trials involving 1557 patients with knee osteoarthritis and rheumatoid arthritis were included in final meta-analysis with the average Jadad score 2.8. The SMD was -0.98 (95% CI -1.18, -0.78, P < .05) for pain, -1.83 (95% CI -2.09, -1.57, P < .05) for functional disability, was 0.80 (95% CI 0.59, 1.01, P < .05) for Short Form 36 Health Survey (SF-36) general health, 0.49 (95% CI 0.14, 0.82, P < .05) for SF-36 mental health, and HAQ was -0.55 (95% CI -0.83, -0.26, P < .05) for health associated questionnaire (HAQ). All the results favor yoga training group. CONCLUSIONS Regular yoga training is helpful in reducing knee arthritic symptoms, promoting physical function, and general wellbeing in arthritic patients.
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Affiliation(s)
- Yiguo Wang
- School of Medicine, Nankai University, Tianjin
- Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma & War Injuries, PLA Institute of Orthopedics, Chinese PLA General Hospital, Beijing
| | - Shibi Lu
- Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma & War Injuries, PLA Institute of Orthopedics, Chinese PLA General Hospital, Beijing
| | - Ruomei Wang
- Department of Endocrinology, The Fourth Affiliated Hospital of Anhui Medical University. Hefei
| | - Peng Jiang
- Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma & War Injuries, PLA Institute of Orthopedics, Chinese PLA General Hospital, Beijing
| | - Feng Rao
- Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma & War Injuries, PLA Institute of Orthopedics, Chinese PLA General Hospital, Beijing
- Department of Trauma and Orthopedics, Peking University People's Hospital, 11th Xizhimen South Street, Beijing
| | - Bo Wang
- Department of Trauma and Orthopedics, Peking University People's Hospital, 11th Xizhimen South Street, Beijing
| | - Yong Zhu
- Department of Trauma and Orthopedics, Peking University People's Hospital, 11th Xizhimen South Street, Beijing
| | - Yihe Hu
- Department of Trauma and Orthopedics, Peking University People's Hospital, 11th Xizhimen South Street, Beijing
| | - Jianxi Zhu
- Department of Trauma and Orthopedics, Peking University People's Hospital, 11th Xizhimen South Street, Beijing
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
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Lynall RC, Pietrosimone B, Kerr ZY, Mauntel TC, Mihalik JP, Guskiewicz KM. Osteoarthritis Prevalence in Retired National Football League Players With a History of Concussion and Lower Extremity Injury. J Athl Train 2018; 52:518-525. [PMID: 28653870 DOI: 10.4085/1062-6050-52.2.03] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
CONTEXT Dynamic balance deficits have been described postconcussion, even after athletes return to play. Lower extremity (LE) musculoskeletal injury rates increase for up to 1 year after concussion, but the long-term musculoskeletal implications of concussion are unclear. OBJECTIVE To (1) examine the association of concussion and LE injury histories with osteoarthritis (OA) prevalence in retired National Football League players and (2) examine the association of concussion and LE injury histories with OA prevalence in those ≤55 years of age. DESIGN Case-control study. SETTING Survey. PATIENTS OR OTHER PARTICIPANTS We administered the Health Survey of Retired National Football League Players, which collects information about demographics, OA, LE injury, and concussion history. MAIN OUTCOME MEASURE(S) Twelve discrete categories were created based on concussion and LE injury history, ranging from 0 concussions and 0 LE injuries (referent group) to 3+ concussions and 2+ LE injuries. Binomial regression analysis modeled lifetime OA prevalence. Covariates were body mass index, age at the time of the survey, and total years playing professional football. RESULTS Complete data were available for 2696 participants. Lifetime OA prevalence was smallest in the referent group (21.1%) and largest in the 3+ concussion and 2+ LE group (50.6%; 2.5 times the referent; 95% confidence interval [CI] = 2.1, 3.1). Participants in all concussion groups (1, 2, 3+) who reported a history of 0 LE injuries had a greater OA prevalence than the referent group. When participants were stratified by age, the ≤55 years of age, 3+ concussions, and 2+ LE injuries group prevalence ratio (3.6; 95% CI = 2.7, 5.2) was larger than that of the >55 years of age, 3+ concussions, and 2+ LE injuries group (1.8; 95% CI = 1.3, 2.4) compared with the respective referent groups. CONCLUSIONS Concussion with or without a history of LE injury may be an important moderator of OA. Future researchers should seek to better understand the mechanisms that influence the association among concussion, LE injury, and OA.
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Affiliation(s)
- Robert C Lynall
- Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center.,Curriculum in Human Movement Science, Department of Allied Health Sciences, University of North Carolina at Chapel Hill. Dr Lynall is now at the Concussion Research Laboratory, Department of Kinesiology, The University of Georgia, Athens. Dr Mauntel is now at Walter Reed National Military Medical Center, Department of Orthopaedics, Bethesda, MD
| | - Brian Pietrosimone
- Neuromuscular Research Laboratory.,Sports Medicine Research Laboratory.,Curriculum in Human Movement Science, Department of Allied Health Sciences, University of North Carolina at Chapel Hill. Dr Lynall is now at the Concussion Research Laboratory, Department of Kinesiology, The University of Georgia, Athens. Dr Mauntel is now at Walter Reed National Military Medical Center, Department of Orthopaedics, Bethesda, MD
| | | | - Timothy C Mauntel
- Sports Medicine Research Laboratory.,Curriculum in Human Movement Science, Department of Allied Health Sciences, University of North Carolina at Chapel Hill. Dr Lynall is now at the Concussion Research Laboratory, Department of Kinesiology, The University of Georgia, Athens. Dr Mauntel is now at Walter Reed National Military Medical Center, Department of Orthopaedics, Bethesda, MD
| | - Jason P Mihalik
- Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center.,Curriculum in Human Movement Science, Department of Allied Health Sciences, University of North Carolina at Chapel Hill. Dr Lynall is now at the Concussion Research Laboratory, Department of Kinesiology, The University of Georgia, Athens. Dr Mauntel is now at Walter Reed National Military Medical Center, Department of Orthopaedics, Bethesda, MD
| | - Kevin M Guskiewicz
- Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center.,Curriculum in Human Movement Science, Department of Allied Health Sciences, University of North Carolina at Chapel Hill. Dr Lynall is now at the Concussion Research Laboratory, Department of Kinesiology, The University of Georgia, Athens. Dr Mauntel is now at Walter Reed National Military Medical Center, Department of Orthopaedics, Bethesda, MD
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Camp CL, Martin JR, Krych AJ, Taunton MJ, Spencer-Gardner L, Trousdale RT. Resection Technique Does Affect Resection Symmetry and Thickness of the Patella During Total Knee Arthroplasty: A Prospective Randomized Trial. J Arthroplasty 2015; 30:2110-5. [PMID: 26115983 DOI: 10.1016/j.arth.2015.05.038] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 05/14/2015] [Accepted: 05/21/2015] [Indexed: 02/01/2023] Open
Abstract
The purpose of this study was to evaluate the accuracy and efficiency of three patellar resection techniques: cutting guide, free hand with haptic feedback, and a novel technique utilizing four quadrant measurements. Ninety patients undergoing TKA were randomized to receive patellar resurfacing by one of the three study techniques. The novel four quadrant technique resulted in least post-resection asymmetry (0.85 mm, P = 0.001). The most accurate methods for obtaining desired thickness were haptic feedback (0.66 mm mean discrepancy [MD]) and novel four quadrant technique (0.66 mm MD) followed by the patellar cutting guide (1.40 mm MD) (P < 0.001). Use of a patellar cutting guide resulted in increased patellar asymmetry and decreased accuracy in obtaining desired patellar thickness in this prospective trial.
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Affiliation(s)
- Christopher L Camp
- Department of Orthopedic Surgery, Mayo Clinic and Mayo Foundation, Rochester, Minnesota
| | - John R Martin
- Department of Orthopedic Surgery, Mayo Clinic and Mayo Foundation, Rochester, Minnesota
| | - Aaron J Krych
- Department of Orthopedic Surgery, Mayo Clinic and Mayo Foundation, Rochester, Minnesota
| | - Michael J Taunton
- Department of Orthopedic Surgery, Mayo Clinic and Mayo Foundation, Rochester, Minnesota
| | - Luke Spencer-Gardner
- Department of Orthopedic Surgery, Mayo Clinic and Mayo Foundation, Rochester, Minnesota
| | - Robert T Trousdale
- Department of Orthopedic Surgery, Mayo Clinic and Mayo Foundation, Rochester, Minnesota
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13
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Hernandez HJ, McIntosh V, Leland A, Harris-Love MO. Progressive Resistance Exercise with Eccentric Loading for the Management of Knee Osteoarthritis. Front Med (Lausanne) 2015; 2:45. [PMID: 26217665 PMCID: PMC4497310 DOI: 10.3389/fmed.2015.00045] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 06/26/2015] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION The patient was a 58-year-old African-American male with radiographic evidence of bilateral knee osteoarthritis (OA). He participated in a standardized 12-week eccentric strengthening program within a Veterans Affairs (VA) medical center. BACKGROUND The use of an eccentric training paradigm may prove to be beneficial for older adults with knee OA since eccentric muscle actions are involved in the energy absorption at the knee joint during gait and controlled movement during stair descent. Furthermore, in comparison to standard muscle actions, eccentric muscle actions result in higher torque generation and a lower rate of oxygen consumption at a given level of perceived exertion. Therefore, this mode of progressive resistance exercise may be ideal for older adults. DISCUSSION The patient completed an eccentric strengthening regimen for the knee flexors and extensors twice per week without an exacerbation of knee pain. Muscle morphology measures of the rectus femoris were measured using diagnostic ultrasound. Isokinetic measures of muscle peak torque were obtained at 60°/s and 180°/s. Functional performance was assessed using a physical performance battery and stair-step performance was assessed from the linear displacement of the center of gravity trajectories obtained with a force plate. Visual analog scale pain ratings and self-reported global disease status were also documented. Post-exercise assessments revealed improvements in sonographic muscle size and tissue composition estimates, peak knee extensor torque (ranging from 60 to 253%), functional performance, and global disease status. CONCLUDING REMARKS The patient exhibited improvements in muscle morphology, muscle strength, functional performance, pain, and global disease status after 12 weeks of an eccentric strengthening regimen. The intervention and outcomes featured in this case were feasible to implement within a VA medical center and merit further investigation.
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Affiliation(s)
- Haniel J. Hernandez
- Human Performance Research Unit, Muscle Morphology, Mechanics and Performance Laboratory, Clinical Research Center, Veterans Affairs Medical Center, Washington, DC, USA
- Physical Medicine and Rehabilitation Service, Veterans Affairs Medical Center, Washington, DC, USA
| | - Valerie McIntosh
- Human Performance Research Unit, Muscle Morphology, Mechanics and Performance Laboratory, Clinical Research Center, Veterans Affairs Medical Center, Washington, DC, USA
| | - Azadeh Leland
- Physical Medicine and Rehabilitation Service, Veterans Affairs Medical Center, Washington, DC, USA
| | - Michael O. Harris-Love
- Human Performance Research Unit, Muscle Morphology, Mechanics and Performance Laboratory, Clinical Research Center, Veterans Affairs Medical Center, Washington, DC, USA
- Department of Exercise and Nutritional Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
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Marczak D, Synder M, Sibiński M, Okoń T, Kowalczewski J. One-stage total knee arthroplasty with pre-existing fracture deformity: post-fracture total knee arthroplasty. J Arthroplasty 2014; 29:2104-8. [PMID: 25092561 DOI: 10.1016/j.arth.2014.07.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Revised: 06/23/2014] [Accepted: 07/05/2014] [Indexed: 02/01/2023] Open
Abstract
The aim of the study was to assess the results of treating knee osteoarthrosis with total knee arthroplasty (TKA) after previous tibia and/or femur fractures resulting in axial limb deformities. Thirty-six knees (34 patients) were operated on. At the most recent follow-up, 4.8 years after surgery, all but one patient demonstrated an improvement in both clinical and functional KSS. This male patient required revision after 2 years. Improved range of motion was generally noted, especially extension, however, two patients with both tibia and femur fractures had worse results. TKA is an effective method of treatment for patients with arthrosis after a previous femur or tibia fractures. When deformity is severe semi-constrained or constrained, implants with extensions may be necessary.
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Affiliation(s)
- Dariusz Marczak
- Postgraduated Medical Education Center Orthopeadic Department Otwock, Poland
| | - Marek Synder
- Clinic of Orthopedics and Pediatric Orthopedics Medical University of Lodz, Poland
| | - Marcin Sibiński
- Clinic of Orthopedics and Pediatric Orthopedics Medical University of Lodz, Poland
| | - Tomasz Okoń
- Postgraduated Medical Education Center Orthopeadic Department Otwock, Poland
| | - Jacek Kowalczewski
- Postgraduated Medical Education Center Orthopeadic Department Otwock, Poland
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Munigangaiah S, O'Sullivan TA, Lenehan B. Simultaneous bilateral septic arthritis of the knee after intraarticular steroid injection: A clinical report. J Nat Sci Biol Med 2014; 5:485-7. [PMID: 25097444 PMCID: PMC4121944 DOI: 10.4103/0976-9668.136278] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Osteoarthritis of knee is one of the common problems in elderly population. Intraarticular corticosteroid injection is a conservative management modality in osteoarthritis of knee. Septic arthritis is an infective complication of intraarticular corticosteroid injection. Septic arthritis in rheumatoid arthritis patients have worse prognosis because of delay in diagnosis. A higher rate of infectious complications following intraarticular injection is expected in immunocompromised and rheumatoid patients. We would like to report an extremely rare case of simultaneous bilateral knee septic arthritis after bilateral knee intraarticular steroid injection in a rheumatoid arthritis patient. Patient was treated successfully with multiple bilateral knee arthroscopic washouts and long-term intravenous antibiotics. This case report emphasizes the increased risk of infection in rheumatoid arthritis patients and a risk benefit assessment on individual basis before carrying out intraarticular steroid injection. Patient should be aware of this increased risk of infection.
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Affiliation(s)
| | - Theresa A O'Sullivan
- Department of Trauma & Orthopaedic Surgery, Midwestern Regional Hospital Limerick, Dooradoyle, Co Limerick, Ireland
| | - Brian Lenehan
- Department of Trauma & Orthopaedic Surgery, Midwestern Regional Hospital Limerick, Dooradoyle, Co Limerick, Ireland
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Kowalczewski J, Marczak D, Synder M, Sibiński M. Primary rotating-hinge total knee arthroplasty: good outcomes at mid-term follow-up. J Arthroplasty 2014; 29:1202-6. [PMID: 24418767 DOI: 10.1016/j.arth.2013.12.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2013] [Revised: 11/12/2013] [Accepted: 12/07/2013] [Indexed: 02/01/2023] Open
Abstract
We evaluated the clinical and radiologic outcomes of primary knee replacements using a rotating-hinge knee prosthesis in 12 knees with a minimum follow-up of 10 years. Indications for the operation included gross joint destruction, significant axial deformities and contracture with a dysfunctional medial collateral ligament in all cases. The patients' WOMAC and Knee Society scores improved, and the use of mobility aids decreased. No loosening of implants was observed. Nonprogressive radiolucent lines were identified around three tibial components. Three patients required marginal wound excision with resuturing and thereafter healed uneventfully. With significant improvement in function, pain and range of motion, the rotating-hinge knee prosthesis can be used as a salvage device in patients with medial collateral ligament deficiency, contracture, and gross joint destruction.
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