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Objective:To observe any effect of tendon manipulation on the joint pain, joint motion and gait of persons with knee osteoarthritis (KOA).Methods:Sixty-one KOA patients were randomly divided into an observation group ( n=31) and a control group ( n=30). Both groups received ultrasonic physiotherapy and exercise trai-ning (including quadriceps femoris training and heel raising training), while the observation group was additionally provided with daily tendon manipulation, five times a week for 3 weeks. Before and after the treatment, knee pain (using a visual analog scale (VAS)), motor function (using the Western Ontario and McMaster University (WOMAC) osteoarthritis index scale), step length, gait speed and the double support phase ratio were evaluated in both groups using three-dimensional gait analysis equipment. Results:After the treatment the average VAS scores, as well as the joint pain, stiffness and dysfunction and the total WOMAC scores of both groups had decreased significantly. There was significant improvement in the average stride length, walking speed and the proportion of double support phase among the observation group, and the latter two measurements had also improved significantly in the control group. After the intervention, the average pain, WOMAC scores and gait descriptors of the observation group were significantly superior to the control group′s results.Conclusion:Tendon manipulation can usefully supplement routine rehabilitation in the treatment of KOA, improving walking efficiency and thus life quality.
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Objective:To compare the location and efficacy of femoral tunnel near-isometric reconstruction of anterior cruciate ligament (ACL) between the transtibial and assisted medial approaches.Methods:The clinical data of 47 patients were retrospectively analyzed who had been admitted by Department of Orthopaedics, The 904 Hospital of PLA for ACL rupture from January 2018 to December 2019. They were divided into 2 groups according to different surgical approaches. In groups A of 21 cases, there were 15 males and 6 females with an age of (29.5 ± 4.8) years and their ACL was reconstructed through the transtibial approach with adjustable Endobutton plate; in group B of 26 cases, there were 18 males and 8 females with an age of (31.2 ± 9.6) years and their ACL was reconstructed through the assisted medial approach with adjustable Endobutton plate. The 2 groups were compared in terms of location of femoral tunnel, Lysholm score and International Knee Documentation Committee (IKDC) score at the last follow-up, and anterior-posterior and rotational stability of the knee joint.Results:There was no significant difference in the preoperative general data between the 2 groups, showing comparability ( P>0.05). The 47 patients were followed up for 18 to 27 months (average, 22.3 months). As for the center of the inner opening of the femoral tunnel located by the four grid table method, the X-axis loci was 25.6% ± 2.5% and 26.7% ± 1.8% respectively in groups A and B, showing no statistically significant difference ( P>0.05) while the Y-axis loci 19.8% ± 2.0% and 30.6% ± 1.5% respectively in groups A and B, showing a statistically significant difference ( P<0.05). At the last follow-up, the lyholm scores were 90.9 ± 3.4 and 92.4 ± 3.9 and the IKDC scores 89.9 ± 3.5 and 90.2 ± 3.8 respectively in groups A and B, showing no significant difference between the 2 groups ( P>0.05). There was no significant difference either in the results of front drawer test, Lachman test or axial displacement test between the 2 groups ( P>0.05). Conclusion:In femoral tunnel near-isometric reconstruction of ACL, the transtibial approach can result in a tunnel location which is closer to the top of the condyle than the assisted medial approach, but both approaches can lead to satisfactory curative efficacy in the short postoperative period.
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SUMMARY: Accurate implant sizing is one of the major determinants in defining the success of total knee arthroplasty (TKA). Current TKA implants are based on Caucasian knee morphometry which is well documented to be larger than Asian knees. Even more, with regards to sizing, implant mismatch tends to be more evident in the female population. This study was designed to evaluate the distal femur dimensions of Malaysian female patients who underwent TKA in our institution and to compare them with the current prosthetic system in use. A total of 199 female patients (207 knees) who underwent TKA were enrolled in this study. Intraoperatively, the AP dimensions (medial and lateral condyles) and mediolateral (ML) width were measured. Known dimension of the femoral component of the prosthetic knee system currently in use were compared with the morphological data. The average femoral component overhang was 2.11 mm (SD 3.94 mm). There was significant difference between the mean ML width of the resected femur and the femoral component (p<0.01). Analysis also revealed a significant positive and weak relationship between both, AP (medial and lateral) and ML dimension. The aspect ratio (ML/AP) of the native femur was generally smaller than the implant aspect ratio which is likely to cause overhang in our population. In general, this study shows that the knees of our female sub-population are even narrower than the other Asian female knees from previous studies. Implants should be designed based on the morphological data of the local population. Implant manufactures should tailor them to accommodate a smaller change in ML width for an increment in the AP length and provide several ML widths for one AP length to obtain a better fitting prosthesis hence curbing the problem of ML overhang.
RESUMEN: El tamaño exacto del implante es uno de los principales determinantes para definir el éxito de la artroplastía total de rodilla (ATR). Los implantes de TKA se basan en la morfometría de rodilla caucásica, cuyo tamaño está reportado como mayor que las rodillas asiáticas. Más aún, en lo que respecta al tamaño, el desajuste de los implantes tiende a ser más evidente en la población femenina. Este estudio fue diseñado para evaluar las dimensiones del fémur distal de pacientes mujeres malasias que se sometieron a ATR en nuestra institución y compararlas con el sistema protésico actual. En este estudio se incluyeron un total de 199 pacientes (207 rodillas) que se sometieron a ATR. Intraoperatoriamente, se midieron las dimensiones AP (cóndilos medial y lateral) y el ancho mediolateral (ML). Se comparó la dimensión conocida del componente femoral del sistema protésico de rodilla actualmente en uso con los datos morfológicos. El voladizo o sobresaliencia del componente femoral fue de 2,11 mm (DE 3,94 mm). Hubo una diferencia significativa entre el ancho ML medio del fémur resecado y el componente femoral (p <0,01). El análisis también reveló una relación significativa positiva y débil entre las dimensiones AP (medial y lateral) y ML. La relación de aspecto (ML / AP) del fémur nativo fue más pequeña que la relación de aspecto del implante, lo que probablemente cause un voladizo en nuestra población. En general, este estudio muestra que las rodillas de nuestra subpoblación femenina son incluso más estrechas que otras rodillas de mujeres asiáticas reportadas en estudios anteriores. Los implantes deben ser diseñados en base a los datos morfológicos de la población local. Los fabricantes de implantes deben adaptarlos a un cambio más pequeño en el ancho de ML para un incremento en la longitud AP y proporcionar varios anchos ML para una longitud AP con el objetivo de obtener una prótesis de mejor ajuste y frenar el problema del voladizo ML.
Subject(s)
Humans , Female , Prostheses and Implants , Arthroplasty, Replacement, Knee , Femur/anatomy & histology , Knee/anatomy & histology , Cross-Sectional Studies , Intraoperative Period , MalaysiaABSTRACT
Objective:To explore the effect of radiofrequency heating on the morphology of articular cartilage in the knee and the expression of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) in the synovium using a rabbit model of knee osteoarthritis (OA).Methods:Fifty-four male rabbits had OA induced in their right hind limbs using the modified Hulth method. They were then randomly divided into a model group, a cervus and cucumis polypeptide (CCP) group and a radiofrequency thermotherapy (RT) group, each of 18. The CCP group was injected with deer melon peptide intramuscularly every day, while the RT group was given daily radiofrequency hyperthermia treatment at 36.5-38.5 ℃. The model group was not provided with any special treatment. On the 6th, 12th and 18th day of the treatment, 6 rabbits in each group were sacrificed to resect the right femur′s medial condyle cartilage. The morphological characteristics of the cartilage were evaluated using modified Mankins scoring, while the contents of lL-1B and TNF-a in the synovial membrane were detected using enzyme-linked immuno-sorbent assays.Results:The average Mankins scores and the levels of IL-1β and TNF-α decreased significantly at each time point, and significant differences were observed among the three groups. In the RT group the average Mankins score as well as the IL-1β and TNF-α levels decreased significantly with time throughout the experiment.Conclusions:Radiofrequency hyperthermia is superior to the injection of deer melon polypeptide in knee osteoarthritis, at least in rabbits. The therapeutic mechanism may be related to the control of IL-1β and TNF- α levels in the synovial membrane.
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Objective To compare the efficacy of intra-articular injection of autologous platelet-rich plasma (PRP) with that of sodium hyaluronate for patients with knee osteoarthritis (KOA). Methods Fifty KOA patients were randomly divided into a PRP group ( n=25) and a sodium hyaluronate group ( n=25) . Those in the PRP group were injected intra-articularly with 5 ml of autologous PRP every 2 weeks for 6 consecutive weeks, while the sodium hyaluronate group was given intra-articular injections of 2 ml of sodium hyaluronate once a week for 6 weeks. Both groups performed isokinetic strength training three times a week for 6 weeks. Before as well as 6 weeks, 3 months, 6 months and 12 months after the treatment, both groups were followed and evaluated using the Western Ontario and McMaster University osteoarthritis index ( WOMAC) . A Biodex System 4 isometric muscle strength testing system was used to evaluate the knees' peak torque (PT) in flexion and extension, total power (TW), and average power (AP). Results Before the treatment there were no significant differences in pain, stiffness or average WOMAC score be-tween the two groups. Afterward significant improvement was observed in the pain, stiffness and WOMAC scores of both groups. Compared with the sodium hyaluronate group, significantly greater decreases in the average WOMAC pain score were observed in the PRP group after the different intervals. That was also true of the average stiffness scores and the overall average WOMAC scores after 6 and 12 months. The flexor and extensor PT, TW and AP at the angular velocities of 60°/s and 90°/s also improved significantly in both groups after 6 weeks and 12 months, with the improvement of the PRP group significantly greater than that in the control group at the same time points. Conclu-sion Intra-articular injection of either autologous PRP or sodium hyaluronate can effectively alleviate the clinical symptoms of KOA when combined with isokinetic strength training. However, PRP is the more effective. Its use is worthy of clinical application and promotion.
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Objective@#To compare the efficacy of intra-articular injection of autologous platelet-rich plasma (PRP) with that of sodium hyaluronate for patients with knee osteoarthritis (KOA).@*Methods@#Fifty KOA patients were randomly divided into a PRP group (n=25) and a sodium hyaluronate group (n=25). Those in the PRP group were injected intra-articularly with 5 ml of autologous PRP every 2 weeks for 6 consecutive weeks, while the sodium hyaluronate group was given intra-articular injections of 2 ml of sodium hyaluronate once a week for 6 weeks. Both groups performed isokinetic strength training three times a week for 6 weeks. Before as well as 6 weeks, 3 months, 6 months and 12 months after the treatment, both groups were followed and evaluated using the Western Ontario and McMaster University osteoarthritis index (WOMAC). A Biodex System 4 isometric muscle strength testing system was used to evaluate the knees′ peak torque (PT) in flexion and extension, total power (TW), and average power (AP).@*Results@#Before the treatment there were no significant differences in pain, stiffness or average WOMAC score between the two groups. Afterward significant improvement was observed in the pain, stiffness and WOMAC scores of both groups. Compared with the sodium hyaluronate group, significantly greater decreases in the average WOMAC pain score were observed in the PRP group after the different intervals. That was also true of the average stiffness scores and the overall average WOMAC scores after 6 and 12 months. The flexor and extensor PT, TW and AP at the angular velocities of 60°/s and 90°/s also improved significantly in both groups after 6 weeks and 12 months, with the improvement of the PRP group significantly greater than that in the control group at the same time points.@*Conclusion@#Intra-articular injection of either autologous PRP or sodium hyaluronate can effectively alleviate the clinical symptoms of KOA when combined with isokinetic strength training. However, PRP is the more effective. Its use is worthy of clinical application and promotion.
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ABSTRACT: The aim of this study was to investigate the influence of fur length in the evaluation of knees temperature in healthy dogs, using infrared thermography. This is a non-invasive diagnosis that is able to assess the microcirculation of the internal skin. Changes in temperature reflect from inflammatory reactions and vascular infarction to neurological disorders. Knees of 30 healthy dogs were analyzed, with up to 11 pounds of weight, screened by clinical examination and radiographic examination. Group A, consisting of 13 dogs with short fur, with 26 knees evaluated in total. Group B included animals with long fur, consisting of 17 animals, with 29 knees evaluated in total. The average temperatures of the cranial, lateral, caudal and medial sides of knees were analyzed. A significant difference between the groups was observed, with group A temperature being greater than the group B in all four analyzed faces. Comparing the temperatures of the faces in the contralateral limb, in both groups, the statistical analysis revealed no significant difference. In group A it was observed that temperatures in the cranial and lateral sides were similar, but different from the others. In group B, the statistical analysis showed the cranial lateral and caudal faces was similar, but differed from the medial side. The thermographic examination proved to be sensitive in the evaluation of temperature of small dogs' knees;however, the length of the fur influenced the result.
RESUMO: O objetivo desse estudo foi verificar a influência do comprimento do pelo na avaliação da temperatura de joelhos de cães saudáveis, por meio do uso da termografia infravermelha. Trata-se de um exame de diagnóstico por imagem, não invasivo, capaz de avaliar a microcirculação da pele. Foram analisados os joelhos de 30 cães saudáveis, com até 11 quilos de peso, triados por meio de exame clínico e exame radiográfico. O grupo A, formado por 13 cães de pelo curto, totalizou 26 joelhos avaliados. O grupo B foi formado por animais de pelo longo, totalizando 17 animais, contando com 29 joelhos avaliados. Foram analisadas as temperaturas médias nas faces cranial, lateral, caudal e medial dos joelhos. Observou-se diferença significativa entre os grupos, a temperatura do grupo A foi maior que a de B nas quatro faces analisadas. Comparando as temperaturas das faces no membro contralateral, nos dois grupos, não foi observado diferença significativa. No grupo A observou-se que as temperaturas nas faces cranial e lateral foram semelhantes, mas diferiram das demais, sendo a medial mais quente e a caudal mais fria. No grupo B a análise estatística mostrou as faces cranial, lateral e caudal semelhantes, entretanto diferiram da face medial, que apresentou a temperatura mais elevada. O exame termográfico mostrou ser sensível na avaliação da temperatura do joelho de cães de pequeno porte, entretanto o comprimento dos pelos influi no resultado da avaliação.
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Objective To explore any effect of proprioceptive neuromuscular facilitation (PNF) on the proprioception and balance of patients with knee osteoarthritis (KOA).Methods Forty patients with KOA were randomly divided into an experimental group (EG) and a control group (CG),each of 20.The PNF techniques of isotonic combined contraction,and rhythmic stable and dynamic reversal were applied in the EG,while the CG received quadriceps muscle strength training.Knee proprioception was evaluated using knee angle reconstruction experiments,and balance ability was measured using the one leg standing test (OLS) and the five times sit to stand test (FTSST).Results The errors in active and passive knee angle reconstruction at 30°,60° and 110° all improved significantly in the EG,but not in the CG.After the treatment,the OLS and FTSST results improved significantly in the EG,but only the OLS results improved significantly in the CG,not the FTSST times.Even so,the average OLS time in the EG was significantly longer than that of the CG after the training.Conclusion Proprioceptive neuromuscular facilitation can improve the proprioception and balance of persons with knee osteoarthritis.
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Objective To compare the effects of combination of maternal hydration and hands and knees posture with simple hands and knees posture on correction of breech pregnancy. Methods One hundred patients who were diagnosed breech pregnancy from November 2015 to November 2016 were assigned to experimental group and control group with 50 cases each according to individual willingness. The patients in experimental group received the combination of maternal hydration and hands and knees posture;while the patients in control group received simple hands and knees posture. Results Amniotic fluid index was (18.94±2.44)cm in experimental group and (15.97±2.33)cm in control group, the difference had statistic significance (t=6.239, P<0.05). The effective transfer rate and successfully used time was 92%(46/50) , (2.10 ± 0.75) weeks in experimental group and 64%(32/50), (4.27 ± 0.98) weeks in control group, the difference had statistic significance (χ2=11.422, P<0.05; t=-12.463, P<0.05). For primipara and multipara, the effective transfer rate was 90.91%(30/33), 16/17 in experimental group, and 68.75%(22/32), 10/18 in control group, the difference had statistic significance (χ2=4.986, 6.806, all P<0.05). The rate of vaginal and cesarean section deliveries was 86%(43/50), 14%(7/50) in experimental group, and 56%(28/50), 44%(22/50) in control group, the difference had statistic significance(χ2=10.928, P=0.001). Patients who had fetal movement or who didn′t have time to do correction or missed was 17.10%(46/269), 1.49%(4/269) in experimental group, and 12.55% (22/255), 7.06% (18/255) in control group. Conclusions @Therapic effects of combination of maternal hydration and hands and knees posture is much better than that of the simple hands and knees posture therapy on correction of breech pregnancy, which is worthy of popularization and application in clinic.
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Introduction: Osteoarthritis is a degenerative joint disease. Fear of fall and balance impairment in people with osteoarthritis of knee joint is a major cause of loss of independence, which has an effect on the physical function in them. The aim of the study was to correlate fear of fall with balance scores and with physical function in people with osteoarthritis of knee joint. Material and methods: A correlational study was conducted at college of physiotherapy where fear of fall, balance impairment and physical function were assessed in 30 subjects, both males and females, diagnosed having osteoarthritis of knee joint. Exclusion criteria were subjects with history of neurological diseases, fracture or total joint replacement within the previous 6 month or acute illness or injury on the day of the functional assessment. Outcome measure includded Fear of fall measured using falls efficacy scale-international (English) (FES), balance was measured using Berg balance scale (BBS) and physical function was assessed using modified WOMAC index (CRD pune version). Level of significance was kept at 5%. Spearman correlation was applied to find the correlation between FES and BBS and between FES and WOMAC. All the data were analyzed using SPSS16. Results: A moderate negative correlation was found between FES and BBS (r=0.520, p=0.002) and a positive moderate correlation between FES and WOMAC (r=0.666, p<0.001) which were significant. Conclusion: The study concluded that there is a correlation between fear of fall and balance and physical function in subjects with osteoarthritis of knee.
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Objective To compare the clinical effects of extensive or limited arthroscopic debridement in varying degrees of knees osteo-arthritis. Methods 32 cases with knees osteoarthritis who underwent extensive debridement under arthroscopy were selected as the observa-tion group, and 30 cases with knees osteoarthritis who underwent limited debridement were selected as the control group. The excellent rate of joint function, Lysholm and VAS scores were compared between the two groups. Results The excellent rate of joint function were 90. 0%and 91. 4% in observation group and control group respectively, without significant difference (P>0. 05). Lysholm scores of patients with grade Ⅱ osteoarthritis was much higher in observation group than that in control group after operation (P0. 05). No statistically significant difference of VAS scores on 1 year after operation were found (P>0. 05). Conclusion Extensive debridement and limited debridement under arthroscopy have similar effects for knees osteoarthritis. Extensive arthroscopic debridement is an ideal treatment method for Ⅱ grade of knees osteoarthritis.
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Objective To observe any therapeutic effect of proprioception training and intra-articular injection of sodium hyaluronate on knee osteoarthritis (KOA) in the elderly.Methods Forty-five patients with KOA were randomly divided into a treatment group (23 cases) and a control group (22 cases).The arthritic knees of both groups were treated with sodium hyaluronate injections,but the patients in the treatment group also received proprioception training.Before treatment,and after 5 weeks and 3 months of treatment,knee function was assessed against Lysholm's assessment standard.Results There was no significant difference in the average Lysholm scores of the two groups before treatment.After 5 weeks and 3 months the patients in each group scored significantly higher than before treatment.After 3 months the average score of the treatment group was significantly higher than that of the control group.Conclusion Proprioception training and sodium hyaluronate injections together constitute a useful method to treat KOA in elderly patients.
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Objective To observe and compare the functional outcomes of early rehabilitation of persons who received primary bilateral or unilateral total knee arthroplasty (TKA).Methods Sixty-eight subjects were divided into a unilateral TKA group (36 cases) and a bilateral TKA group (32cases).All received the same professional rehabilitation program during an average postoperative hospital stay of (15.00 ± 3.71 ) days.At discharge,a visual analogue scale (VAS) was used to rate pain.Active range of motion (AROM) of the involved knee,knee injury and an osteoarthritis outcome score (KOOS) were also assessed.The KOOS and knee society score (KSS) were evaluated at follow-up about 11 months later.Results There was no significant difference between the two groups in any assessment at discharge,nor in the KOOS and KSS-Ⅰ assessments at follow-up.The KOOS of both groups at follow-up had improved significantly compared with that at discharge.The KSS-Ⅱ results in the bilateral group were slightly better than those in the unilateral group at follow-up,and that difference was significant.Conclusions Bilateral TKA patients and unilateral TKA patients had the same clinical outcomes after early postoperative rehabilitation,but the functional outcomes of bilateral TKA patients were better than those of unilateral TKA patients a year later.
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The objective of this study was to evaluate the morphometric variations in human beings meniscus. For this,40 menisci from 20 knees, previously dissected and preserved with Formaldehyde and/or glycerin solution,were utilized. In each meniscus, the following aspects were evaluated to check the width and thicknessvariations: outer circumference length and distance between posterior and anterior horns in three points(anterior, medium, and posterior part). With regard to the outer circumference length, there was no significantstatistic difference between the medial and lateral meniscus. The distance between the anterior and posteriorhorns in the medial meniscus was significantly higher than that of the lateral meniscus. The lateral meniscusshowed no significant difference regarding to the length between the anterior, medium, and posterior part,whereas the posterior part was wider in the medial meniscus. With regard to the medial meniscus length, theposterior part was thicker than the anterior and medium part. In the lateral meniscus, the medium part wasthe thickest followed by the posterior and anterior part, respectively. The meniscus morphometric findings arein accordance with studies on meniscus injuries.
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Humans , Knee/anatomy & histology , Menisci, Tibial , Menisci, Tibial/anatomy & histology , Menisci, Tibial/physiology , Brazil , Dissection , FormaldehydeABSTRACT
Objetivo: Verificar se há diferença entre as medidas da fenda articular do joelho nas incidências radiográficas em ântero-posterior (AP), com carga e o joelho totalmente estendido, e a vista póstero-anterior do túnel (VPAT), com carga e joelho flexionado cerca de 30 graus. Materiais e métodos: Foram avaliados radiologicamente 50 pacientes do sexo feminino, acima de 40 anos, com sintomas clínicos e sinais radiológicos de osteoartrose (OA) nos joelhos, enquadradas nos graus II e III, de acordo com a classificação de Kellgren e Lawrence. As medidas foram feitas por dois ortopedistas cegos entre si que utilizaram um paquímetro digital. Os pontos da fenda articular determinados para medida foram a 10 mm da borda e no ponto médio dos compartimentos medial e lateral. As medidas em ambas as técnicas foram comparadas segundo teste t Student. Resultados: O método AP com carga apresentou médias maiores para as medidas realizadas nos pontos médios do compartimento lateral em ambos os lados. Para todos os demais pontos de medidas, as médias foram inferiores às observadas na incidência vista póstero-anterior do túnel. Conclusões: Não houve diferença estatística nas medições do espaço articular do joelho nas duas incidências, AP e VPAT.
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Humans , Female , Middle Aged , Osteoarthritis, Knee/diagnosis , Osteoarthritis, Knee/physiopathology , Osteoarthritis, Knee , Osteoarthritis/diagnosis , Osteoarthritis/pathology , Osteoarthritis , Cohort Studies , Knee/pathology , KneeABSTRACT
Current available implants for total knee replacement are based on the mormphometry of the Caucasian knee. We believe there are significant morphometric differences in the Asian knee that will be relevant in future implant designs. Sixty nine consecutive patients (80 knees) underwent computer navigated primary total knee arthroplasty. The anterior posterior (AP) length, and the medial lateral (ML) width of the distal femur, were analyzed, with respect to the final sizing details of four implants (femoral component) commonly used locally. The mean AP length was 59.9 (SD 4.8) mm, and the mean ML width was 65.0 (SD 5.0) mm. The overall mean aspect ratio (ML/AP) was 1.09 (SD 0.07). The mean aspect ratio for females was 1.08 (SD 0.07). Both were smaller than the aspect ratio of the implants which ranged from 1.11 to 1.13. All four implants tend to overhang at the medial lateral width of the distal femur. This is more obvious in females. Future implant designs should provide more ML wdth sizes for a given AP length, in addition to gender differences, for ths population.
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@#Objective To observe the effect of meridian-thumbing therapy on flexion deformity on knees of children with cerebral palsy(CP).Methods The therapy of thumbing the points from Chengfu to Chengshan of the meridian of Foot Taiyang Bladder was used for 40 CP children with flexion deformity on knees.Results After three months treatment,the positive flexion of knee joint in 40 children improved significantly than before(P<0.001).Conclusion The therapy of meridian-thumbing has obvious effect on flexion deformity on knees of CP children.
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PURPOSE: This study is to compare the size distribution of current total knee prostheses with a measurements of Korean knees. MATERIALS AND METHODS: 566 consecutive osteoarthritic knees were measured, intraoperatively, for anteroposterior(AP) dimension of medial and lateral condyle, and mediolateral(ML) dimension of distal femur and proximal tibia. The size distribution of 5 total knee arthroplasty(TKA) systems were compared with these measurements. RESULTS: Regarding femoral component, the numbers of available lateral AP sizes within +/-1SD of Korean knees were two in Genesis II, PFC-RPF, Scorpio and one in Advance MPK, LPS-Flex. Those of available ML sizes for +/-1SD range were two in all systems. Regarding tibial component, the numbers of available lateral AP sizes for +/-1SD range were four in Scorpio, three in LPS-Flex, PFC-RPF and two in Advance MPK, Genesis II. Those of available ML sizes for +/-1SD range were two in Advance MPK, Scorpio and one in the others. CONCLUSION: Korean-friendly total knee prostheses should incorporate the size distribution as well as the dimension of the Korean knees.
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Femur , Knee Prosthesis , Knee , TibiaABSTRACT
[Objective] To compare the effect and safety between Tripterygium Wilfordii Film (TNF) and Compound Tripterygium Wilfordii Film (CTWF) for osteoarthritis of knees. The latter was mainly composed of Radix Folium seu Flos Tripterygii Wilfordii, Rhizoma Chuanxiong, Olibanum, Myrrha, etc. [Methods] Sixty cases of osteoarthritis of knees were randomized to two groups: group A (30 cases) treated with CTWF and group B (30 cases) with TWF. Both of the two groups were given oral use of herbal medicine on the basis of syndrome differentiation. Pain and stiffness of the knees and knee function were observed before and after treatment and their side reactions were also observed. [Results] Pain and stiffness of the knees and the impaired function were relieved in both groups ( P
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Septic artiritis is a disease that causes a rapid joint destruction by various kinds of bacteria such as Staphylococcus aureus. It affects more frequently the patients with rheumatoid arthritis, diabetes, immunocompromised patients, and chronic steroid users. In patients with rheumatoid arthritis, 1 to 12% of patients are affected by septic arthritis. In these patients, it is very difficult to distinguish between an acute exacerbation of rheumatoid arthritis and a development of septic arthritis if the latter affects more than one joint. Septic arthritis usually affects single joint, especially the knee joint. If the diagnosis and treatment are delayed, it would cause sepsis resulting in high mortality and morbidity. Thus early diagnosis by arthrocentesis, prompt drainage, and antibiotics therapy are essential. We experienced a 46 years-old woman with rheumatoid arthritis who abused the steroids for 10 years and complaining recent aggravation of bilateral knee joint swelling, warmth, and tenderness. Large amount of pus from both knees showed Gram positive cocci. The immediate open surgical drainage of both knees was done. The patient recovered from septic arthritis after 6 weeks of antibiotics therapy. The synovial fluid microbiology study should be done in all joints of the patients with the risk factors of joint infection.