Effect evaluation of peroneal osteotomy combined with arthroscopic knee debridement in patients with knee osteoarthritis / 中国医师进修杂志

Objective:To evaluate the effects of peroneal osteotomy combined with arthroscopic knee debridement on perioperative indexes, X-ray indexes, Japanese Orthopaedic Association Assessment score (JOA score), American Hospital for Special Surgery knee score (HSS score) and complication rate of patients with knee osteoarthritis.Methods:A prospective research method was adopted. A total of 110 patients with knee osteoarthritis who were admitted to Chengde Central Hospital from April 2016 to April 2021 were selected as the research objects and divided into the control group (55 cases), the combined group (55 cases) by random number table method. The control group underwent arthroscopic debridement of the knee joint. On the basis of the control group, the combined group was combined with fibula osteotomy. The control group and the combined group were followed up for 6 months after operation. The perioperative indicators, score of JOA before and after 1 month of treatment, X-ray indicators, score of HSS before and after 6 months of treatment, and the incidence of complications during the follow-up period were compared between the control group and the combined group.Results:The operation time of the combined group was longer than that of the control group: (84.36 ± 14.64) min vs. (75.88 ± 12.86) min; compared with before operation, 1 month after operation, the scores of swelling, pain while up and down stairs, walking pain, joint range of motion were increased in the control group and the combined group, and the combined group was higher than the control group: (8.35 ± 0.73) points vs. (6.74 ± 0.67) points, (15.05 ± 1.74) points vs. (13.96±1.66) points, (21.75 ± 2.07) points vs. (18.58 ± 1.73) points, (27.59 ± 3.25) points vs. (25.74 ± 2.83) points; the femoral tibial angle and the range of motion of the knee joint in the control group and the combined group were increased, and the combined group was greater than the control group: (1.94 ± 0.60)° vs. (3.02 ± 0.67)°; the scores of stability, flexion deformity, muscle strength, range of motion, function, and pain in the control group and the combined group increased, and the combined group was higher than the control group: (8.62 ± 0.86) points vs. (6.89 ± 0.78) points, (7.86 ± 0.96) points vs. (6.27 ± 0.68) points, (7.79 ± 0.62) points vs. (6.95 ± 0.57) points, (14.95 ± 2.60) points vs. (12.48 ± 2.33) points, (17.46 ± 2.21) points vs. (14.59 ± 1.76) points, (24.83 ± 3.25) points vs. (18.59 ± 2.57) points, the difference was statistically significant ( P<0.05). During the following up period, there were no significant differences in the incidences of osteofascial compartment syndrome, neurovascular injury, intraarticular adhesion and incision infection between the two groups ( P>0.05). Conclusions:The operation time of fibular osteotomy combined with arthroscopic debridement of knee joint in patients with knee osteoarthritis was longer, but fibular osteotomy combined with arthroscopic debridement of the knee joint can reduce the valgus of the patient and improve the range of motion of the joint. It could effectively reduce the degree of pain and improve the function of knee joint, and the safety was good, with good therapeutic effect.

Knee Osteoarthritis Revisited; But Only After Kl Grading Is Tested: A Retrospective Analysis

Background: Osteoarthritis (OA) of knee is one of the major causes in musculoskeletal condition leading to func-tional loss in patients. Determining the progression of the disease is a useful tool which will help in planning of exer-cise programme to slow or halt the disease progression. Measuring the joint space width of the tibio-femoral joint is one of the best options for knowing the disease progression and helps in designing exercise programme. Aim:Retro-spective measurement of joint space width in patients with bilateral tibiofemoral osteoarthritis of knee joint. Method-ology: Data was retrieved from the picture archiving and communication system (PACS) from 1stof February to 22ndof June 2018. Radiographs that were showing OA knee features by using Kellegren Lawrence (KL) grading system were considered and the joint space between the tibial and femoral compartment were measured. Result: The joint space width showed more reduction in the medial compartment of the joint as compared to the lateral compartment. Conclusion: In rural population of Maharashtra the medial joint space is markedly decreased as compared to the lat-eral compartment of the tibiofemoral joint and as the KL grade increases the joint space width decreased.

Determination the Condyle Position and Measurement of Joint Space by CBCT in Patients with Disk Displacement Compared with Healthy Control Group

Introduction: Disc displacement is characterized by a change in the articular disc position (abnormal position) which is located between the mandibular fossa and the head of the condyle. Disc displacement can be classified as 8 positions (abnormal disc position); however, the most common types are anterior and anterolateral displacements. When the displacement of the disc occurs, the bilaminar zone is moved against the articular surfaces, gradually replacing the function of the disc itself. It has mechanical properties modifications in vascular diminishment and nerve supply which induces the condition. Aim of the Study: To study the radiographical assessment of temporomandibular joint in patients with disk displacement by using cone beam computed tomography and determination of condyle position anterior, centric or posterior depending on the joint space measurements (anterior, superior and posterior joint space). Materials and methods: The study sample consisted of 78 patients with disk displacement and 31 as control subjects. Patients with intra articular joint disorders were divided into 4 groups according to the diagnostic criteria for temporomandibular disorders (Group 1-disk displacement with reduction, Group 2-disk displacement with reduction with intermittent locking, Group 3-disk displacement without reduction with a limited opening, Group 4-disk displacement without reduction without limited opening). Results: The results show the position of the condyle in right and left side more anteriorly in control than in patients with disc displacement, while the position of the condyle in patients was more posterior and superior. There was a highly significant difference in condyle position between the control group and Group 2, Group 3 and Group 4. Conclusions: Disc displacement is one of the causes that change the condyle position in the glenoid fossa.

A Novel Four-Degree-of-Freedom Upper Limb Rehabilitation Robot / 中国康复理论与实践

Objective:A novel four-degree-of-freedom upper limb rehabilitation robot was designed to overcome the shortcomings of the structure of the most of serial robots. Methods:The shoulder and elbow joint drive system and the information detection system were placed in the base. The synchronous belt drive system and the spiral bevel gear transmission system were designed to transmit power from the base to the shoulder and elbow joint of the arm. The cubic polynomial trajectory planning method based on the joint space was selected to accomplish the trajectory planning of the recovery movements of taking objects and drawing quadrilaterals, and the single-degree-of-freedom motion control experiment and multi-degree-of-freedom trajectory planning experiment were designed to verify the rationality and feasibility of the design. Results:Each joint of the rehabilitation robot reached the designed range of motion at the designed speed, and well completed the planned rehabilitation training movements. Conclusion:This robot can effectively reduce the volume and mass of the mechanical arm, overcome the influence of motor noise and radiation on patients' rehabilitation training, and assist patients to complete a variety of rehabilitation exercises.

Variación del espacio articular externo de la rodilla posterior a la ostectomía del peroné / Change of the external intra joint space of posterior knee after fibular ostectomy

RESUMEN Introducción: en el diagnóstico y tratamiento del genu varo doloroso es importante el estudio radiográfico de la rodilla, se pueden visualizar los cambios estructurales que aparecen en las superficies articulares de la rodilla. Objetivo: demostrar desde el punto de vista radiológico la variación que ocurre posterior a la ostectomía del peroné en los pacientes operados de genus varos. Materiales y métodos: se realiza un estudio descriptivo, prospectivo y lineal en el Hospital Militar Dr. Mario Muñoz Monroy de Matanzas desde abril del 2016 -2017 donde se aplica la técnica de ostectomía del peroné, del Dr. Zhang Ying-Ze, se presentan los primeros 51 pacientes operados, un total de 57 rodillas, a los cuales se les realizó radiografía previa a la operación y posterior a ella al cabo de los 6 meses, donde se midió la altura del espacio articular externo. Resultados: el promedio de edad es de 67,2 años (50 años el menor y 84 años el mayor), de los cuales 23 eran hombres y 28 mujeres, previo al tratamiento quirúrgico el promedio de este espacio fue de 8,84 mm±1,01 mm (18 mm el mayor y el menor 2 mm) y al cabo de los 6 meses fue de 6,08 mm±0,9 mm(el mayor 10 mm y el menor 2 mm), en 6 pacientes no hubo variación de esta medida. Conclusiones: con la ostectomía proximal del peroné se logra disminuir el espacio articular externo modificando el eje mecánico y anatómico del miembro inferior, lo que se traduce por una disminución de la compresión interna articular (AU).

ABSTRACT Background: the radiographic study of the knee is very important in the painful genu varum diagnosis and treatment: structural changes appearing in the knee joint surfaces may be observed. Objective: to show the changes taking place after fibular ostectomy in the patients surgically treated of genu varum from the radiological point of view. Material and methods: a lineal, prospective, descriptive study was carried out in the Military Hospital "Dr. Mario Muñoz Monroy" of Matanzas from April 2016 to April 2017, in 51 patients operated on applying Dr Zhang Ying-Ze's fibular ostectomy technique: a total of 57 knees. X-rays were taken before the surgery and six months after it, measuring the height of the external intra joint space. Results: the average age was 67.2 years (50 years the youngest and 84 the eldest patients); 23 were men and 28 women. Before the surgical treatment the average space was 8.84 mm±1.01 mm (18 mm the biggest and 2 mm the smallest); six months after surgery, it was 6.08 mm±0.9 mm (10 mm the biggest and 2 mm the smallest); six patients did not showed changes of the space. Conclusions: with the proximal fibular ostectomy we achieved the reduction of the external fibular space, modifying the anatomical and mechanical axis of the lower limb, what leads to a reduction of the internal joint compression (AU).

Clinical Study on Acupoint Iontophoresis with Sinomenine Hydrochloride in Treating Knee Osteoarthritis / 上海针灸杂志

Objective To observe the clinical efficacy of acupoint iontophoresis with Sinomenine hydrochloride in treating knee osteoarthritis (KOA).Method Sixty KOA patients were randomized into a treatment group and a control group, 30 cases each. The treatment group was intervened by iontophoresis with Sinomenine hydrochloride into specific acupoints via a direct current iontophoresis appliance; the control group was intervened by oral administration of Meloxicam tablets. The Lequesne index, Visual Analogue Scale (VAS) and knee joint space were observed before and after the intervention.Result The Lequesne and VAS scores were significantly changed after the treatment in the two groups (P<0.01,P<0.05). After the intervention, there was a significant difference in the Lequesne score between the two groups (P<0.01). After the treatment, the knee joint space didn't show significant intra-group or between- group differences (P>0.05).Conclusion Acupoint iontophoresis with Sinomenine hydrochloride is an effecttive method in treating KOA.

Morphological evaluation of temporo-mandibular joint in indian population / Avaliação morfológica da articulação temporo-mandibular em Indianos

The temporomandibular joint (TMJ) is one of the most complex joints in the body and its harmonious functioning is very important to maintain a normal masticatory system. The morphologic alterations and the asymmetrical position of the TMJ structures may lead the various clinicalsigns & symptoms. Morphology of the temporomandibular joint may be influenced by gender of patients, environmental factor and also food habits at various places. Objective: To evaluate the morphology of the temporomandibular joint using computed tomography, in order to determine the condyle shape, joint space and glenoid fossa roof thickness. Material and Methods: One hundred and six healthy patients (212 TMJs) who visited a private hospital (or the University's Hospital) for CT brain scan were included to this crosssectional study sample.The patients were aged between 20­50 years with an average age of 35.46 years. All the images were taken by positioning patients in supine position with 120kvp , 50ma,2.33minute exposure with 0.7mm thick slicesby computed topography machine in all three projection that is Axial, Coronal and Saggital view. Results: For all variables, the mean and standard deviation were calculated, based on gender, and TMJ sides. The Paired t-test was used and P <0.05 will be considered to be significant. Conclusion: Present study showed that thereis positive evidence of temporomandibular joint involvement in elderly patients. Change in morphology and position of condylar head with glenoid fossa and roof thickness are one of the most common cause of degenerative diseases (AU)

Objetivo: A articulação temporomandibular (ATM) é uma das articulações mais complexas do corpo e seu funcionamento harmonioso é muito importante para manter um sistema mastigatório. As alterações morfológicas e a posição assimétrica das estruturas da ATM podem levar os vários sinais e sintomas clínicos. A morfologia da articulação temporomandibular pode ser influenciada pelo gênero dos pacientes, fatores ambientais e também hábitos alimentares diversos. Objetivo: Avaliar a morfologia da articulação temporomandibular usando tomografia computadorizada, a fim de determinar a forma do côndilo, o espaço articular, e a espessura do teto da fossa glenóide. Material e Métodos: Cento e seis pacientes saudáveis (212 ATMs) que foram a um hospital privado (ou Hospital da Universidade) para tomografia computadorizada de cérebro foram incluídos na amostra deste estudo transversal. Os pacientes tinham entre 20 e 50 anos com uma idade média de 35,46 anos. Todas as imagens foram tiradas com os pacientes posicionados em decúbito dorsal com 120kvp, 50mA, 2,33minutos de exposição com espessura de 0.7mm nas três projeções: Axial, Coronal e Saggital. Resultados: Para todas as variáveis, a média e desvio padrão foram calculados, com base no sexo e nos lados da ATM. O teste t pareado foi usado e P <0,05 foi considerado significativo. Conclusão: O presente estudo mostrou que há evidências positivas de envolvimento da articulação temporomandibular nos pacientes mais velhos. Mudança na morfologia e posição da cabeça condilar com a espessura do teto da fossa glenóide é uma das causas mais comuns de doenças degenerativas (AU)

Fixed-flexion knee radiography using a new positioning device produced highly repeatable measurements of joint space width: ELSA-Brasil Musculoskeletal Study (ELSA-Brasil MSK) / A radiografia do joelho em flexão fixa utilizando um novo posicionador produziu medidas da largura do espaço articular com alta repetibilidade: estudo ELSA-Brasil Musculoesquelético (ELSA-Brasil ME)

Abstract Objective: To describe the performance of a non-fluoroscopic fixed-flexion PA radiographic protocol with a new positioning device, developed for the assessment of knee osteoarthritis (OA) in Brazilian Longitudinal Study of Adult Health Musculoskeletal Study (ELSA-Brasil MSK). Material and methods: A test–retest design including 19 adults (38 knee images) was conducted. Feasibility of the radiographic protocol was assessed by image quality parameters and presence of radioanatomic alignment according to intermargin distance (IMD) values. Repeatability was assessed for IMD and joint space width (JSW) measured at three different locations. Results: Approximately 90% of knee images presented excellent quality. Frequencies of nearly perfect radioanatomic alignment (IMD ≤1 mm) ranged from 29% to 50%, and satisfactory alignment was found in up to 71% and 76% of the images (IMD ≤1.5 mm and ≤1.7 mm, respectively). Repeatability analyses yielded the following results: IMD [SD of mean difference = 1.08; coefficient of variation (%CV) = 54.68%; intraclass correlation coefficient (ICC) (95%CI) = 0.59 (0.34–0.77)]; JSW [SD of mean difference = 0.34–0.61; %CV = 4.48%–9.80%; ICC (95%CI) = 0.74 (0.55–0.85)–0.94 (0.87–0.97)]. Adequately reproducible measurements of IMD and JSW were found in 68% and 87% of the images, respectively. Conclusions: Despite the difficulty in achieving consistent radioanatomic alignment between subsequent radiographs in terms of IMD, the protocol produced highly repeatable JSW measurements when these were taken at midpoint and 10 mm from the medial extremity of the medial tibial plateau. Therefore, measurements of JSW at these locations can be considered adequate for the assessment of knee OA in ELSA-Brasil MSK.

Resumo Objetivo: Descrever o desempenho de um protocolo radiográfico em flexão fixa sem fluoroscopia em incidência PA com um novo posicionador, desenvolvido para a avaliação da osteoartrite de joelho (OA) no estudo ELSA-Brasil ME. Material e métodos: Fez-se um estudo de teste e reteste que incluiu 19 adultos (38 imagens de joelho). A viabilidade do protocolo radiográfico foi avaliada por meio de parâmetros de qualidade da imagem e presença de alinhamento radioanatômico de acordo com as medidas da distância intermarginal (DIM). Avaliaram-se a repetibilidade dos valores de DIM e do espaço articular (EA) em três locais diferentes. Resultados: Aproximadamente 90% das imagens de joelho apresentaram uma qualidade excelente. As frequências de imagens com alinhamento radioanatômico quase perfeito (DIM<1mm) variaram de 29% a 50%, e de alinhamento satisfatório (DIM<1,5mm e <1,7mm) de 71% a 76%, respectivamente. As análises de repetibilidade produziram os seguintes resultados: DIM [DP da média das diferenças = 1,08; coeficiente de variação (% CV) = 54,68%; coeficiente de correlação intraclasse (CCI) (IC 95%) = 0,59 (0,34 a 0,77)]; EA [DP da média das diferenças = 0,34 a 0,61; % CV = 4,48% a 9,80%; CCI (IC 95%) = 0,74 (0,55 a 0,85) a 0,94 (0,87 a 0,97]. Encontraram-se medidas adequadamente reprodutíveis de DIM e EA em 68% e 87% das imagens, respectivamente. Conclusões: Apesar da dificuldade de obter um alinhamento radioanatômico consistente entre radiografias repetidas em termos de DIM, o protocolo produziu medições de EA altamente repetíveis quando essas foram tomadas no ponto médio e a 10 mm da extremidade medial do platô tibial medial. Portanto, as medidas de EA nesses locais podem ser consideradas adequadas para a avaliação da OA de joelho no estudo ELSA-Brasil ME.

Variations in radiographic appearance of articular cartilage of knee joints in persons of 35 to 65 years of age.

Background: Osteoarthritis is a slowly progressive degenerative disease characterized by gradual loss of articular cartilage. Osteoarthritis is not a normal process of ageing processes. Age related changes are distinct from osteoarthritic changes but when coupled with certain precipitating factors like obesity, muscle weakness and neurological dysfunction may play an important role in the causation of osteoarthritis. Osteoarthritis occurrence appears to increase with patient’s age in a non-linear fashion. The prevalence of disease increases dramatically after the age of 50 years, likely because of age related alterations in collagen and proteoglycan synthesis coupled with diminished nutrient supply to the cartilage. Methods: In this paper presenting the naked eye assessment of radiographic appearance of articular cartilage of knee joints of 100 persons (both men and women) of 35 to 65 years of age with symptoms like pain and stiffness of the joint. Results: Parameters like changes in the joint space width, the presence or absence of osteophytes and subchondral sclerosis and cysts were noted. The correlation between the patient’s age, sex, symptoms and radiological appearance were observed. Conclusion: Osteoarthritis has a higher prevalence and more often generalized in women than in men. Before the age of 50 years, the incidence of osteoarthritis is low and men have a slightly higher prevalence than women, but after the age of 50 years, the disease becomes more frequent and women have a much higher prevalence with a female to male ration of about 12:1. The reason for this is sex difference in cartilage volume.

Evaluación de la posición condilary del espacio articular en atm de individuos chilenos con trastornos temporomandibulares / Assessment of tmj condylar position and joint space in chilean individuals with temporomandibular disorders

La importancia de la relación cóndilo-fosa en la articulación temporomandibular (ATM) aún no es clara, sin embargo algunos autores asocian la posición no céntrica del cóndilo de la mandíbula en la fosa mandibular con trastorno temporomandibular (TTM). Además, otros autores sugieren que la evaluación del espacio articular es una herramienta diagnóstica para la evaluación de las alteraciones de ATM. El objetivo de este estudio fue evaluar la posición condilar y el espacio articular de ATM en individuos chilenos con TTM utilizando tomografía computarizada cone-beam. Fueron seleccionados 19 pacientes de la Unidad de Trastornos Cráneo Cervico Mandibulares-Universidad de Talca, con diagnóstico de TTM según el Research Diagnostic Criteria for Temporomandibular Disorders. Para la evaluación de la posición condilar se utilizó la técnica de Pullinger & Hollender y para la evaluación de los espacios articulares anterior (EAA), superior (EAS) y posterior (EAP) se utilizó la técnica de Ikeda & Kawamura. Un 39,47% de los cóndilos se presentaron en posición posterior, 34,21% en posición central y un 26,31% en posición anterior. Para cóndilos en posición central encontramos: EAA=1,57 mm; EAS=2,20 mm; EAP= 1,54 mm. Para cóndilos en posición posterior encontramos: EAA= 2,18 mm; EAS= 2,02 mm; EAP= 0,98 mm. Para cóndilos en posición anterior encontramos: EAA= 1,00 mm; EAS= 1,89 mm y EAP= 2,07 mm. Concluimos que individuos con diagnóstico de TTM presentan las regiones anatómicas predisponientes a las alteraciones articulares con espacios articulares disminuidos cuando comparados con sujetos asintomáticos. La posición posterior fue la más común en individuos con TTM, sin embargo hubo gran variabilidad en la posición condilar, por ello sugerimos que una posición no centralizada del cóndilo no está necesariamente asociada con la presencia de TTM. Concluimos además que en individuos con TTM los cóndilos ubicados en posición central y posterior presentan EAP disminuido en comparación con individuos sanos.

The importance of the condyle-fossa relationship in the temporomandibular joint (TMJ) is not yet fully clear, however, some authors associate the non-central position of the head of the mandible in the mandibular fossa with temporomandibular disorder (TMD). Furthermore, other authors suggest that assessment of joint space is a diagnostic tool for assessing the TMJ alterations. The aim of this study was to evaluate the TMJ condylar position and joint space in Chilean individuals with TMD using cone-beam computed tomography. We selected 19 patients of "Unidad de Trastornos Cráneo Cervico Mandibulares (UCRACEM) - Universidad de Talca, Chile", who had a diagnosis of TMD according to the Research Diagnostic Criteria for Temporomandibular Disorders. The assessment of condylar position was performed using Pullinger & Hollender technique and to evaluate the anterior joint space (AJS), superior joint space (SJS) and posterior joint space (PJS) was used Ikeda & Kawamura technique. Posterior condylar position was found in 39.47% of condyles, central condylar position in 34.21% and anterior condylar position in 26.31%. To condyles in central position we found: AJS = 1.57 mm; SJS = 2.20 mm; PJS = 1.54 mm. To condyles in posterior position we found: AJS = 2.18 mm; SJS = 2.02 mm; PJS = 0.98 mm. To condyles in anterior position we found: AJS = 1.00 mm; SJS = 1.89 mm and PJS = 2.07 mm. We conclude that individuals diagnosed with TMD present anatomical regions predisposing to joint disorders with joint spaces diminished when compared with asymptomatic subjects. Furthermore, the posterior condylar position was the most common in individuals with TMD, however there was great variability in condylar position, therefore we suggest that a non-centralized position of the condyle is not necessarily associated with the presence of TMD. We further conclude that in individuals with TMD the condyles located in central and posterior position present EAP decreased compared with healthy individuals.

A Study of Joint Space Narrowing and Erosion in Rheumatoid Arthritis / 대한의료정보학회지

OBJECTIVE: This study was conducted to measure radiographic joint space width and to estimate erosion in the hands of patients with rheumatoid arthritis. It showed that joint space width, homogeneity, and invariant moments are parameters to discriminate between the normal and the rheumatoid joint. METHODS: In order to measure the joint space width and to estimate erosion in the finger joint, 32 radiographic images were used - 16 images for training and 16 images for testing. The joint space width was measured in order to quantify the joint space narrowing. Also, homogeneity and invariant moments was computed in order to quantify erosion. Finally, artificial neural networks were constructed and tested as a classifier distinguishing between the normal and the rheumatoid joint. RESULTS: The joint space width of normal was 1.04+/-0.15 mm and the width of patients with rheumatoid arthritis was 0.94+/-0.15 mm. The Homogeneity of normal was 16568.83+/-2669.83 and invariant moments were 6843.45+/-2937.55. They were statistically difference (p<.05). Using these characteristics, artificial neural networks showed that they discriminate between normal and rheumatoid arthritis (AUC=0.91). CONCLUSION: Measuring joint space width, estimating homogeneity, and invariant moments provide the capability to distinguish between a normal joint and a rheumatoid joint.

Evaluación radiográfica del daño anatómico en la artritis reumatoide / Radiographic evaluation of anatomical damage in rheumatoid arthritis

En este artículo revisamos los diferentes métodos de evaluación radiográfica del daño anatómico producido por la artritis reumatoide; sus ventajas y limitaciones, así como las principales características.

In this article we reviewed the different radiologic methods of evaluation of the anatomical damage produced by rheumatoid arthritis; its advantages and limitations, as well as the main characteristics.

Forty-five-degree posteroanterior flexion weight-bearing radiograph of the knee while standing on the homolateral foot and the weight-bearing anteroposterior radiograph with both knees in full extention to detect knee osteoarthritis:a prospective controll / 中国矫形外科杂志

[Objective] Posteroanterior weight-bearing radiographs,made with the knee in 45 degrees of flexion while the patient was standing on the homolateral foot,were compared with the weight-bearing anteroposterior radiographs with both knees in full extention,in order to find a more sensitive method to detect knee osteoarthritis.[Methods]Seventeen osteoarthritis knees were radiographed in the weight-bearing anteroposterior view with both knees in full extention and in the weight-bearing posteroanterior view with the knee in 45 degrees of flexion while standing on the homolateral foot.The minimum joint space width of all the radiograph were measured.The data were analysed statistically with SPSS 11.5.[Results]The mean minimum joint space width of the medial compart in extended knee view and standing on the homolateral foot were 4.65 mm?1.44 mm and 2.52 mm?1.69 mm,respectively(P

Glucosamine sulfate: the first clinical proven disease modifying drug for osteoarthritis / 中国新药与临床杂志

The publish summarized three latest systemic reviews and given details of the landmark trail on glucosamine sulfate introduce the yesterday, today and a good future of disease modifying drug for osteoarthritis (DMOAD) on a view. It will helpful to promote the clinical, the assessment and the developing of DMOAD in China.

The positional change of condylar head after orthognathic surgery using simplified condyle positioning device

Investigation of temporomandibular joint space of healthy adults by using cone beam computed tomography / 北京大学学报(医学版)

0.05).Conclusion:All the results of the five measurement methods showed that the condyle was located in the center of the fossa with a variation in the healthy adults in intercuspal position.The CBCT image of the sagittal middle layer of the joint could show the joint space accurately and has an important value in the research related to the changes of TMJ space.

Restoration of Joint Space of the Knee After High Tibial Osteotomy

PURPOSE: The purpose of this study was to evaluate whether the medial joint space could be restored by HTO in osteoarthritic knee associated with varus deformity and to evaluate its clinical results. MATERIALS AND METHODS: HTO for medial gonarthrosis was performed in 65 knee joints of 59 patient. The median follow-up period was 36 months. The femoro-tibial angle(FTA) and joint space distance of medial and lateral compartment of the knee was measured on the weight-bearing antero-posterior plain radiogram. And the clinical results were evaluated by HSS knee score composed of pain, function, range of motion, muscle strength, flexion deformity and instability. RESULTS: Medial joint space distance was restored to 2.9 mm in average at postoperative 3 years from 1.8 mm in average preoperatively. Also the lateral joint space distance was maintained without decrease. FTA was corrected from varus 6.3 degree in average preoperatively to valgus 7.3 degree in average at three years postoperatively. HSS score was improved from 69.1 point in average preoperatively to 95 points in average at three years postoperatively. The group of increased joint space distance showed more improved HSS score and more corrected FTA than the unchanged group(p<0.05). When the change of HSS score was compared according to the postoperative FTA, the group, FTA was corrected 7 degree or more had more improved clinical results and more increased joint space distance(p<0.05). Complications were pain or tenderness on the fibular osteotomy site in seven knees, nonunion of fibular osteotomy in seven knee, transient peroneal paresis in four knees and delayed union of tibial osteotomy in one knee. CONCLUSION: At three years follow up after HTO, there was restoration of joint space of the medial compartment of the knee. Also we found the fact that the joint space widening was correlated with clinical improvement. These results suggest that the correction angle of valgus 7 degree or more may have better clinical outcomes.

Change of Joint Space according to Sideways Disc Displacement of TMJ

OBJECTIVE: Disc displacement may affect the joint space narrowing between condyle head and glenoid fossa. This study was designed to evaluate the correlation between the joint space change and the directions of disc displacement. STUDY DESIGN: Two hundreds temporomandibular joints MR images of TMD patients (170 joints) and asymptomatic volunteers (30 joints) were evaluated for this purpose. Anterior disc displacement was divided into 3 stages (normal, little to mild, and moderate to severe displacement) based on sagittal images. And sideways displacement was classified as 3 categories (center, medial and lateral displacement) based on coronal images, then joint spaces were measured at medial, central and lateral parts of condyle head on coronal MR images, respectively. The joint spaces of 7 groups divided according to the severity and the direction of disc displacement were compared. RESULTS: The reduction of the joint space was affected by sideways disc displacement at the opposite side of the condyle head, except the cases accompanied with severe anteriorly and laterally displaced disc. CONCLUSION: The sideways disc displacement affected on the opposite side temporomandibular joint space width.

Indirect Measurement of Joint Space Distance using Ladmarks in TKRA

PURPOSE: We invented an indirect method to check the changes in the joint space in each steps of the operation procedure such as medial release, bone osteotomy and after total knee replacement. MATERIALS AND METHODS: We have measured ILD in 43 eases of osteoartluitic patients who receive total knee replacement. After knee exposure, two drill holes were made on the anterior surface of distal femur and proximal tibia about 100 mm apart from each other. The length between the two holes was designated as inter-landmark distance(ILD). ILD-I means the original distance between the two holes before any procedure were done. After media3 release, femur and tibia were realigned along the mechanical axis. ILD-II was measured in this aligned situation. ILD-III was measured after femoral and tibial osteotomy. ILD-IV was measured after replacements were done. RESULT: The length difference between ILD-IV and ILB-II was 2. 1+/-2.0mm(Mean+/-2 S.D.). CONCLUSION: We could evaluate the fittness of the total knee replacements numerically by taking an indirect joint space measuring technique using landmarks on the femur and tibia.