Investigating the Ability of Knee OA Patients to Maintain Targeted Knee Flexion Angles for Weight Bearing MRI

2011 ◽  
Author(s):  
Venkata Gade ◽  
Jerome Allen ◽  
Jeffrey L. Cole ◽  
Peter J. Barrance
Keyword(s):  
Knee Joint ◽  
Precise Measurement ◽  
Signal To Noise Ratio ◽  
Weight Bearing ◽  
Mr Images ◽  
Knee Oa ◽  
Symptomatic Knee ◽  
Measurement Tools ◽  
The Us ◽  
Common Clinical Presentation

Knee osteoarthritis (OA) is the most common clinical presentation of osteoarthritis, and has been estimated to affect 12–16% of the population older than 60 years in the US [1]. A biomechanical risk factor that has been linked to knee OA is the changes in the local loading and the contact area between the cartilage surfaces [2]. Investigation of such factors requires precise measurement tools to determine knee joint positioning and contact areas. Clinically, MR images of the knee are most frequently acquired in the supine position; such images are not representative of the loading conditions experienced functionally in the weight bearing knee joint. With the advent of vertically open MRI (e.g. Upright MRI, Fonar Corporation, Melville, NY), it is now possible to scan the knee in fully upright weight bearing conditions representing truly functional positions. To measure sensitive variables such as joint positioning and cartilage contact, it is important to minimize subject movement in order to obtain high quality images. In MRI, increased scan times allow for data of improved signal to noise ratio and resolution; however, long scanning durations without subject movement are not feasible, particularly in individuals with symptomatic knee OA.

scholarly journals One year change of knee cartilage morphology in the first release of participants from the Osteoarthritis Initiative progression subcohort: association with sex, body mass index, symptoms and radiographic osteoarthritis status

2008 ◽  
Vol 68 (5) ◽  
pp. 674-679 ◽  
Author(s):  
F Eckstein ◽  
S Maschek ◽  
W Wirth ◽  
M Hudelmaier ◽  
W Hitzl ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Body Mass ◽  
Statistical Significance ◽  
Weight Bearing ◽  
Rate Of Change ◽  
Cartilage Loss ◽  
Knee Oa ◽  
Symptomatic Knee ◽  
Osteoarthritis Initiative

Objective:The Osteoarthritis Initiative (OAI) is a multicentre study targeted at identifying biomarkers for evaluating the progression and risk factors of symptomatic knee OA. Here cartilage loss using 3 Tesla (3 T) MRI is analysed over 1 year in a subset of the OAI, together with its association with various risk factors.Methods:An age- and gender-stratified subsample of the OAI progression subcohort (79 women and 77 men, mean (SD) age 60.9 (9.9) years, body mass index (BMI) 30.3 (4.7)) with both frequent symptoms and radiographic OA in at least one knee was studied. Coronal FLASHwe (fast low angle shot with water excitation) MRIs of the right knee were acquired at 3 T. Seven readers segmented tibial and femoral cartilages blinded to order of acquisition. Segmentations were quality controlled by one expert.Results:The reduction in mean cartilage thickness (ThC) was greater (p = 0.004) in the medial than in the lateral compartment, greater (p = 0.001) in the medial femur (−1.9%) than in the medial tibia (−0.5%) and greater (p = 0.011) in the lateral tibia (−0.7%) than in the lateral femur (0.1%). Multifactorial analysis of variance did not reveal significant differences in the rate of change in ThC by sex, BMI, symptoms and radiographic knee OA status. Knees with Kellgren–Lawrence grade 2 or 3 and with a BMI >30 tended to display greater changes.Conclusions:In this sample of the OAI progression subcohort, the greatest, but overall very modest, rate of cartilage loss was observed in the weight-bearing medial femoral condyle. Knees with radiographic OA in obese participants showed trends towards higher rates of change than those of other participants, but these trends did not reach statistical significance.

scholarly journals Depression in patients with knee osteoarthritis: risk factors and associations with joint symptoms

2020 ◽  
Author(s):  
Shuang Zheng ◽  
Liudan Tu ◽  
Flavia Cicuttini ◽  
Zhaohua Zhu ◽  
Weiyu Han ◽  
...  
Keyword(s):  
Risk Factors ◽  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Controlled Trial ◽  
Womac Pain ◽  
Knee Oa ◽  
Symptomatic Knee Osteoarthritis ◽  
Symptomatic Knee ◽  
Joint Symptoms ◽  
Patient Health

Abstract Background:To describe demographic and clinical factors associated with the prevalence and incidence of depression and explore the temporal relationship between depression and joint symptoms in patients with symptomatic knee osteoarthritis (OA). Methods:413 participants were selected from a randomized controlled trial in people with symptomatic knee OA and vitamin D deficiency (age 63.2 ± 7.0 year, 50.4% female). Depression severity and knee joint symptoms were assessed using the patient health questionnaire (PHQ-9) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), respectively, at baseline and 24 months. Results: The prevalence and incidence of depression was 25.4% and 11.2%, respectively. At baseline, having younger age, a higher body mass index (BMI), greater scores of WOMAC pain (PR: 1.05, 95%CI:1.03, 1.07), dysfunction (PR: 1.02, 95%CI:1.01, 1.02) and stiffness (PR: 1.05, 95%CI: 1.02, 1.09), lower education level, having more than one comorbidity and having two or more painful body sites were significantly associated with a higher prevalence of depression. Over 24 months, being female, having a higher WOMAC pain (RR: 1.05, 95%CI: 1.02, 1.09) and dysfunction score (RR: 1.02, 95%CI: 1.01, 1.03) at baseline and having two or more painful sites were significantly associated with a higher incidence of depression. In contrast, baseline depression was not associated with changes in knee joint symptoms over 24 months. Conclusion: Knee OA risk factors and joint symptoms, along with co-existing multi-site pain are associated with the prevalence and development of depression. This suggests that managing common OA risk factors and joint symptoms may be important for prevention and treatment depression in patients with knee OA.Trial registration: ClinicalTrials.gov identifier: NCT01176344Anzctr.org.au identifier: ACTRN12610000495022

Estimation of In-Vivo Quadriceps Forces of the Knee: A Combined In-Vivo Patellofemoral Joint Kinematics Measurement and Finite Element Prediction

2011 ◽  
Author(s):  
Koichi Kobayashi ◽  
Guoan Li
Keyword(s):  
Knee Joint ◽  
Load Transfer ◽  
Weight Bearing ◽  
Knee Oa ◽  
Moment Arms ◽  
Joint Reaction Forces ◽  
Joint Contact ◽  
Reaction Forces ◽  
Knee Pathology

The load transfer mechanics across the patellofemoral (PF) joint during weight-bearing conditions is important for treatment of the knee pathology, such as knee OA, ACL deficiency as well as TKA. Many studies have characterized the PF joint reaction forces using equilibriums of the quadriceps and ground reaction forces at the knee joint [1,2,3]. However, this simplification does not consider other muscle function as well as 3D knee joint contact location when calculate moment arms of the involved forces.

scholarly journals Depression in patients with knee osteoarthritis: risk factors and associations with joint symptoms

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Shuang Zheng ◽  
Liudan Tu ◽  
Flavia Cicuttini ◽  
Zhaohua Zhu ◽  
Weiyu Han ◽  
...  
Keyword(s):  
Risk Factors ◽  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Trial Registration ◽  
Womac Pain ◽  
Knee Oa ◽  
Link Type ◽  
Symptomatic Knee Osteoarthritis ◽  
Symptomatic Knee ◽  
Joint Symptoms

Abstract Background To describe demographic and clinical factors associated with the presence and incidence of depression and explore the temporal relationship between depression and joint symptoms in patients with symptomatic knee osteoarthritis (OA). Methods Three hundred ninety-seven participants were selected from a randomized controlled trial in people with symptomatic knee OA and vitamin D deficiency (age 63.3 ± 7.1 year, 48.6% female). Depression severity and knee joint symptoms were assessed using the patient health questionnaire (PHQ-9) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), respectively, at baseline and 24 months. Results The presence and incidence of depression was 25.4 and 11.2%, respectively. At baseline, having younger age, a higher body mass index (BMI), greater scores of WOMAC pain (PR: 1.05, 95%CI:1.03, 1.07), dysfunction (PR: 1.02, 95%CI:1.01, 1.02) and stiffness (PR: 1.05, 95%CI: 1.02, 1.09), lower education level, having more than one comorbidity and having two or more painful body sites were significantly associated with a higher presence of depression. Over 24 months, being female, having a higher WOMAC pain (RR: 1.05, 95%CI: 1.02, 1.09) and dysfunction score (RR: 1.02, 95%CI: 1.01, 1.03) at baseline and having two or more painful sites were significantly associated with a higher incidence of depression. In contrast, baseline depression was not associated with changes in knee joint symptoms over 24 months. Conclusion Knee OA risk factors and joint symptoms, along with co-existing multi-site pain are associated with the presence and development of depression. This suggests that managing common OA risk factors and joint symptoms may be important for prevention and treatment depression in patients with knee OA. Trial registration ClinicalTrials.gov identifier: NCT01176344. Anzctr.org.au identifier: ACTRN12610000495022.

scholarly journals Tibial Condyle Valgus Osteotomy for Ipsilateral Knee Osteoarthritis after Hip Arthrodesis

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Daisuke Fukuhara ◽  
Hiroaki Inoue ◽  
Shuji Nakagawa ◽  
Yuji Arai ◽  
Kenji Takahashi
Keyword(s):  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Mechanical Load ◽  
Weight Bearing ◽  
Valgus Osteotomy ◽  
Hip Arthrodesis ◽  
Knee Oa ◽  
Early Loosening ◽  
Tibial Condyle ◽  
End Stage

We report a case of tibial condylar valgus osteotomy (TCVO) for ipsilateral knee osteoarthritis (OA) after hip arthrodesis. A 58-year-old woman developed right purulent hip arthritis at one month of age and underwent right hip fusion at 16 years old. She visited our department at the age of 57 because her right knee joint pain worsened. The range of motion for her right knee was 80° and -5° of flexion and extension, respectively, and she experienced medial weight-bearing pain. A plain X-ray image showed that the right knee joint had end-stage knee OA with a bone defect inside the tibia, and the tibial plateau shape was the pagoda type. There was a marked instability in her right knee with a valgus of 9° and varus of 7° on stress photography. She underwent TCVO on her right knee and was allowed full load four weeks after surgery. Computed tomography imaging showed bone union nine months after surgery. Two years after the operation, there was no correction loss, and she could walk independently without pain. In general, total knee arthroplasty (TKA) is indicated for end-stage knee OA; however, there are problems, such as early loosening due to the increased mechanical load on the knee after hip OA. In this case, since a good course was obtained, TCVO is considered a treatment option for terminal knee OA after hip arthrodesis.

scholarly journals EVALUATING THE EFFECTIVENESS OF PHONOPHORESIS BY PIROXICAM AND DIMETHYL SULFOXIDE FOR WOMEN’S WITH OSTEOARTHRITIS KNEE JOINT

2018 ◽  
Vol 11 (6) ◽  
pp. 329
Author(s):  
Monisha R ◽  
Manikumar M ◽  
Aparna Krishnakumar
Keyword(s):  
Articular Cartilage ◽  
Chronic Disease ◽  
Pain Relief ◽  
Knee Joint ◽  
Dimethyl Sulfoxide ◽  
Moderate Degree ◽  
Knee Oa ◽  
Osteoarthritis Knee ◽  
Symptomatic Knee ◽  
Inflammatory Drugs

Objective: Osteoarthritis (OA) is a progressive chronic disease with the loss of articular cartilage. In managing osteoarthritis, inadequate pain relief often occurs, particularly with a single non-steroidal anti-inflammatory drugs therapy.Methods: A total of 50 participants were randomly allocated into three groups, received phonophoresis with piroxicam, dimethyl sulfoxide (DMSO), and ultrasound (US) therapy with aquasonic gel.Results: On comparing, the baseline phonophoresis group with piroxicam showed significantly more pain reduction than the DMSO and US therapy. Enrolled patients in three groups have completed the study without any drawbacks.Conclusion: This study showed that phonophoresis was superior to conventional US therapy in reducing pain in patients with symptomatic knee OA of a mild to moderate degree.

scholarly journals Design Evaluation of a Novel Multicompartment Unloader Knee Brace

2019 ◽  
Vol 142 (1) ◽  
Author(s):  
Aleksandra R. Budarick ◽  
Bradley E. MacKeil ◽  
Stephen Fitzgerald ◽  
Christopher D. Cowper-Smith
Keyword(s):  
Weight Loss ◽  
Knee Joint ◽  
Weight Bearing ◽  
Knee Extension ◽  
Force Output ◽  
Knee Brace ◽  
Knee Oa ◽  
Joint Forces ◽  
Knee Joint Surgery ◽  
Knee Braces

Abstract Knee osteoarthritis (OA) is a significant problem in the aging population, causing pain, impaired mobility, and decreased quality of life. Conservative treatment methods are necessary to reduce rapidly increasing rates of knee joint surgery. Recommended strategies include weight loss and knee bracing to unload knee joint forces. Although weight loss can be beneficial for joint unloading, knee OA patients often find it difficult to lose weight or begin exercise due to knee pain, and not all patients are overweight. Unicompartment offloader knee braces can redistribute joint forces away from one tibiofemoral (TF) compartment; however, <5% of patients have unicompartmental tibiofemoral osteoarthritis (TFOA), while patients with isolated patellofemoral or multicompartmental OA are much more common. By absorbing body weight (BW) and assisting the knee extension moment using a spring-loaded hinge, sufficiently powerful knee-extension-assist (KEA) braces could be useful for unloading the whole knee. This paper (1) describes the design of a spring-loaded tricompartment unloader (TCU) knee brace intended to provide unloading in all three compartments of the knee while weight-bearing, (2) measures and compares the force output of the TCU against the only published and commercially available KEA brace, and (3) calculates the static unloading capacity of each device. The TCU and KEA braces delivered maximum assistive moments equivalent to reducing BW by approximately 45 and 6 lbs, respectively. The paper concludes that sufficiently powerful spring-loaded knee braces show promise in a new class of multicompartment unloader knee orthoses, capable of providing a clinically meaningful unloading effect across all three knee compartments.

scholarly journals Depression in patients with knee osteoarthritis: risk factors and associations with joint symptoms

2020 ◽  
Author(s):  
Shuang Zheng ◽  
Liudan Tu ◽  
Flavia Cicuttini ◽  
Zhaohua Zhu ◽  
Weiyu Han ◽  
...  
Keyword(s):  
Risk Factors ◽  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Controlled Trial ◽  
Womac Pain ◽  
Knee Oa ◽  
Symptomatic Knee Osteoarthritis ◽  
Symptomatic Knee ◽  
Joint Symptoms ◽  
Patient Health

Abstract Background To describe demographic and clinical factors associated with the prevalence and incidence of depression and explore the temporal relationship between depression and joint symptoms in patients with symptomatic knee osteoarthritis (OA). Methods 413 participants were selected from a randomized controlled trial in people with symptomatic knee OA and vitamin D deficiency (age 63.2 ± 7.0 year, 50.4% female). Depression severity and knee joint symptoms were assessed using the patient health questionnaire (PHQ-9) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), respectively, at baseline and 24 months. Results The prevalence and incidence of depression was 25.4% and 11.2%, respectively. At baseline, having a higher body mass index (BMI), greater scores of WOMAC pain (PR: 1.05, 95%CI:1.03, 1.07), dysfunction (PR: 1.02, 95%CI:1.01, 1.02) and stiffness (PR: 1.05, 95%CI: 1.02, 1.09), lower education level, having more than one comorbidity and having two or more painful body sites were significantly associated with a higher prevalence of depression. Over 24 months, being female, having a higher WOMAC pain (RR: 1.04, 95%CI: 1.00, 1.08) and dysfunction score (RR: 1.01, 95%CI: 1.00, 1.02) at baseline and having two or more painful sites were significantly associated with a higher incidence of depression. In contrast, baseline depression was not associated with changes in knee joint symptoms over 24 months. Conclusion Knee OA risk factors and joint symptoms, along with co-existing multi-site pain are associated with the prevalence and development of depression. This suggests that managing common OA risk factors and joint symptoms could be important for prevention and treatment depression in patients with knee OA.

scholarly journals Platelet-Rich Plasma and Osteoarthritis of the Knee: A Literature Review

2019 ◽  
Vol 7 (11_suppl6) ◽  
pp. 2325967119S0047
Author(s):  
Monica Elizabeth Tanod Rosandi
Keyword(s):  
Platelet Rich Plasma ◽  
Weight Bearing ◽  
Osteoarthritis Of The Knee ◽  
Short Term ◽  
Residual Symptoms ◽  
Knee Oa ◽  
Post Surgery ◽  
Osteoarthritic Chondrocytes ◽  
Symptomatic Knee

Osteoarthritis (OA) is a debilitating disease affecting people worldwide that affects weight-bearing joints, including the knee. Pharmacological options should be attempted before surgical therapy, especially for the younger population where there is a likelihood of residual symptoms and risk of revision post-surgery. There are several injection therapies available to treat symptoms and slow degenerative process. One option is platelet-rich plasma (PRP). The study aims to answer the following questions: What effect does PRP have on osteoarthritic chondrocytes? What are the current results on the clinical outcomes of PRP on knee OA? A search was conducted on Google Scholar and PubMed to find studies from the past five years on “knee osteoarthritis” and ”platelet-rich plasma”. Results from current findings demonstrate that PRP induces chondroprotection in vitro. Clinically, PRP improves short-term outcomes of symptomatic knee OA. Although the results look promising; unfortunately, a standardized PRP protocol has not been established and several studies are biased, thus the efficacy of PRP is still inconclusive.

scholarly journals Depression in patients with knee osteoarthritis: risk factors and associations with joint symptoms

2020 ◽  
Author(s):  
Shuang Zheng ◽  
Liudan Tu ◽  
Flavia Cicuttini ◽  
Zhaohua Zhu ◽  
Weiyu Han ◽  
...  
Keyword(s):  
Risk Factors ◽  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Controlled Trial ◽  
Womac Pain ◽  
Knee Oa ◽  
Symptomatic Knee Osteoarthritis ◽  
Symptomatic Knee ◽  
Joint Symptoms ◽  
Patient Health

Abstract Background: To describe demographic and clinical factors associated with the presence and incidence of depression and explore the temporal relationship between depression and joint symptoms in patients with symptomatic knee osteoarthritis (OA). Methods: 397 participants were selected from a randomized controlled trial in people with symptomatic knee OA and vitamin D deficiency (age 63.3 ± 7.1 year, 48.6% female). Depression severity and knee joint symptoms were assessed using the patient health questionnaire (PHQ-9) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), respectively, at baseline and 24 months. Results: The presence and incidence of depression was 25.4% and 11.2%, respectively. At baseline, having younger age, a higher body mass index (BMI), greater scores of WOMAC pain (PR: 1.05, 95%CI:1.03, 1.07), dysfunction (PR: 1.02, 95%CI:1.01, 1.02) and stiffness (PR: 1.05, 95%CI: 1.02, 1.09), lower education level, having more than one comorbidity and having two or more painful body sites were significantly associated with a higher presence of depression. Over 24 months, being female, having a higher WOMAC pain (RR: 1.05, 95%CI: 1.02, 1.09) and dysfunction score (RR: 1.02, 95%CI: 1.01, 1.03) at baseline and having two or more painful sites were significantly associated with a higher incidence of depression. In contrast, baseline depression was not associated with changes in knee joint symptoms over 24 months. Conclusion: Knee OA risk factors and joint symptoms, along with co-existing multi-site pain are associated with the presence and development of depression. This suggests that managing common OA risk factors and joint symptoms may be important for prevention and treatment depression in patients with knee OA.Trial registration: ClinicalTrials.gov identifier: NCT01176344Anzctr.org.au identifier: ACTRN12610000495022

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