A Comparative study of osteoarthritic knee patients between urban and rural areas in knee severity and quality of life.

Osteoarthritis Knee (OA) is the leading cause of pain and disability. This may affect the patient's quality of life (QoL) and lead to the onset of mental disorders. The aim of this study was 1) To find the correlation between the severity of OA, depression, and QoL. 2) To compare the severity of OA knee and QoL between urban and rural areas. 199 patients were diagnosed with OA. All patients had self-assessment with questionnaires in terms of 1) demographic data, 2) the knee severity by using Oxford Knee Score, 3) Depression screening by using Patient Health Questionnaire, and 4) World Health Organization Quality of Life Brief-Thai. The results revealed that OA knee patients had excellent (no abnormal symptoms) and good (mild symptoms) levels of severity were 34.2% and 32.2%, respectively. They also had a good level of QoL. The correlation between residential area and other variables were age group (p < 0.01), severity of osteoarthritis (p < 0.01), and depression (p < 0.05). The severity of OA knee and QoL in the mental health aspect was a significant difference in patients in each age group. (p < 0.01 and p < 0.05, respectively). Depression and QoL were not correlated. The conclusion was patients had less severity of osteoarthritis, good QoL, and no anxiety or depression. Residential areas had no impact on QoL but healthcare providers should explain the treatment plan. The next study should focus on the long term of the patient's QoL.

Real-Time Gait Phase Detection Using Wearable Sensors for Transtibial Prosthesis Based on a kNN Algorithm.

Those with disabilities who have lost their legs must use a prosthesis to walk. However, traditional prostheses have the disadvantage of being unable to move and support the human gait because there are no mechanisms or algorithms to control them. This makes it difficult for the wearer to walk. To overcome this problem, we developed an insole device with a wearable sensor for real-time gait phase detection based on the kNN (k-nearest neighbor) algorithm for prosthetic control. The kNN algorithm is used with the raw data obtained from the pressure sensors in the insole to predict seven walking phases, i.e., stand, heel strike, foot flat, midstance, heel off, toe-off, and swing. As a result, the predictive decision in each gait cycle to control the ankle movement of the transtibial prosthesis improves with each walk. The results in this study can provide 81.43% accuracy for gait phase detection, and can control the transtibial prosthetic effectively at the maximum walking speed of 6 km/h. Moreover, this insole device is small, lightweight and unaffected by the physical factors of the wearer.

Morphometric measurement of the proximal tibia to design the tibial component of total knee arthroplasty for the Thai population.

PURPOSE: This study evaluates the morphology of the Thai proximal tibia based on three-dimensional (3D) models to design the tibial component. METHODS: The 3D models of 480 tibias were created using reverse engineering techniques from computed tomography imaging data obtained from 240 volunteers (120 males, 120 females; range 20-50 years). Based on 3D measurements, a digital ruler was used to measure the distance between the triangular points of the models. The morphometric parameters consisted of mediolateral length (ML), anteroposterior width (AP), medial anteroposterior width (MAP), lateral anteroposterior width (LAP), central to a medial length (CM), central to a lateral length (CL), medial anterior radius (MAR), lateral anterior radius (LAR), and tibial aspect ratio (AR). An independent t-test was performed for gender differences, and K-means clustering was used to find the optimum sizes of the tibial component with a correlation between ML length and AP width in Thai people. RESULTS: The average morphometric parameters of Thai proximal tibia, namely ML, AP, MAP, LAP, CM, and CL, were as follows: 72.52 ± 5.94 mm, 46.36 ± 3.84 mm, 49.22 ± 3.62 mm, 43.59 ± 4.05 mm, 14.29 ± 2.72 mm, and 15.28 ± 2.99 mm, respectively. The average of MAR, LAR, and AR was 24.43 ± 2.11 mm, 21.52 ± 2.00 mm, and 1.57 ± 0.08, respectively. All morphometric parameters in males were significantly higher than those of females. There was a difference between the Thai proximal tibia and other nationalities and a mismatch between the size of the commercial tibial component and the Thai knee. Using K-means clustering analysis, the recommended number of ML and AP is seven sizes for the practical design of tibial components to cover the Thai anatomy. CONCLUSION: The design of the tibial component should be recommended to cover the anatomy of the Thai population. These data provide essential information for the specific design of Thai knee prostheses.

Randomized, double-blind, Placebo-Controlled Study to Compare the Efficacy of Combination of Lidocaine with ketorolac or triamcinolone versus Lidocaine Alone for Soft Tissue Injuries.

BACKGROUND: Corticosteroid and Ketorolac tromethamine is a pain reducing. OBJECTIVE: The primary objective was pain intensity scores (VAS) in 10, 30, 60 min, 2, 6 h, 1, and 7 days. METHOD: 120 patients were randomized. The placebo group (normal saline) and experimental groups (ketorolac 30 mg, 60 mg, triamcinolone 10 mg, 20 mg, and 40 mg, respectively) were compared. RESULT: VAS at 60 min, 2, 6 h, 1 and 7 days was significantly different (P < 0.05). Ketorolac 30 mg, 60 mg, and triamcinolone 10 mg shown non inferiority to triamcinolone 40 mg. CONCLUSIONS: ketorolac was considered equal to triamcinolone.

A home visit program versus a non-home visit program in total knee replacement patients: a randomized controlled trial.

BACKGROUND: The goals in total knee replacement (TKR) are pain relief, restore functions, and improve quality of life. Surgical outcomes were not related to patients' satisfaction. Low 1-year WOMAC especially in the first 6 weeks and painful TKR related to patient dissatisfied. To improve satisfaction, we created the home visit program (TKR-H) after hospital discharge. INHOMESSS was the rationale for home visit activities. METHODS: We recruited 52 TKRs. Four TKRs were excluded. We used simple randomization for 24 patients as a home visit (TKR-H) and 24 patients as a non-home visit (TKR). Patients were evaluated by general demographics, pain intensity scores (VAS), range of motion (ROM), WOMAC, knee scores, and functional scores as a primary objective. A duration for gait aid independent and patient's satisfaction score as secondary objective. The study was 6 weeks after surgery. RESULTS: TKR-H and TKR had significant differences in the mean of WOMAC score (88.29 ± 10.66 vs. 68.00 ± 12.47, respectively, P <  0.001), pain score (VAS) (6.25 ± 10.13 vs. 35.67 ± 22.05, respectively, P <  0.001), knee score (81.67 ± 10.08 vs. 68.38 ± 6.45, respectively, P <  0.001), functional score (77.83 ± 4.22 vs. 73.70 ± 7.48, respectively, P = 0.037), and range of motion (107.71 ± 8.47 vs. 98.17 ± 9.57, respectively, P = 0.001). The patient's satisfaction score in TKR-H group (4.71 ± 0.46) was significantly higher than the TKR group (4.13 ± 0.45) (P <  0.001) and time to gait aid independent (2.75 ± 0.99 vs. 3.71 ± 1.23, respectively, P = 0.005). CONCLUSION: Our TKR-H showed better clinical outcomes and satisfaction than non-home visit. The rationale in TKR-H improves satisfaction after total knee replacement. TRIAL REGISTRATION: TCTR20190514001.