Immediate Effect of Ankle Mobilization on Range of Motion, Dynamic Knee Valgus, and Knee Pain in Women With Patellofemoral Pain and Ankle Dorsiflexion Restriction: A Randomized Controlled Trial With 48-Hour Follow-Up.

CONTEXT: Restriction in ankle dorsiflexion range of motion (ROM) has been previously associated with excessive dynamic knee valgus. This, in turn, has been correlated with knee pain in women with patellofemoral pain. OBJECTIVES: To investigate the immediate effect of 3 ankle mobilization techniques on dorsiflexion ROM, dynamic knee valgus, knee pain, and patient perceptions of improvement in women with patellofemoral pain and ankle dorsiflexion restriction. DESIGN: Randomized controlled trial with 3 arms. SETTING: Biomechanics laboratory. PARTICIPANTS: A total of 117 women with patellofemoral pain who display ankle dorsiflexion restriction were divided into 3 groups: ankle mobilization with anterior tibia glide (n = 39), ankle mobilization with posterior tibia glide (n = 39), and ankle mobilization with anterior and posterior tibia glide (n = 39). INTERVENTION(S): The participants received a single session of ankle mobilization with movement technique. MAIN OUTCOME MEASURES: Dorsiflexion ROM (weight-bearing lunge test), dynamic knee valgus (frontal plane projection angle), knee pain (numeric pain rating scale), and patient perceptions of improvement (global perceived effect scale). The outcome measures were collected at the baseline, immediate postintervention (immediate reassessment), and 48 hours postintervention (48 h reassessment). RESULTS: There were no significant differences between the 3 treatment groups regarding dorsiflexion ROM and patient perceptions of improvement. Compared with mobilization with anterior and posterior tibia glide, mobilization with anterior tibia glide promoted greater increase in dynamic knee valgus (P = .02) and greater knee pain reduction (P = .02) at immediate reassessment. Also compared with mobilization with anterior and posterior tibia glide, mobilization with posterior tibia glide promoted greater knee pain reduction (P < .01) at immediate reassessment. CONCLUSION: In our sample, the direction of the tibia glide in ankle mobilization accounted for significant changes only in dynamic knee valgus and knee pain in the immediate reassessment.

Does Kinesio taping correct exaggerated dynamic knee valgus? A randomized double blinded sham-controlled trial.

BACKGROUND: Deficiency in hip girdle neuromuscular control can cause exaggerated Dynamic Knee Valgus (DKV) which afflicts the knee joint and lead to knee injuries especially ACL injury in sports. Though Kinesio taping (KT) is known to improve function, stability and proprioception, the evidence is inconclusive on its effectiveness in athletes. We hypothesized that kinesio taping could enhance neuromuscular control of the hip girdle there by causing a reduction in DKV. AIM/OBJECTIVE: To determine whether KT on Gluteus medius can correct exaggerated dynamic knee valgus and improves hip abductor strength when compared to sham KT. METHOD: 40 collegiate level athletes, aged between 18 and 28 years, of both genders with presence of dynamic knee valgus (>8° for men and >13° for women) were recruited in the study. Athletes were excluded if they had history of lower back pain, history of any injury or surgery to the lower extremities during the past year. Subjects who met the inclusion criteria were randomized into kinesio taping (KT) group and sham taping (ST) group. The Drop Jump test and the Donnatelli Drop Leg Test (DDT) were performed before, and on the third day, immediately after the application of KT on them and documented. RESULTS: There was a significant reduction in DKV among male [4.0° (95% CI 3.5-4.5); p < 0.001] and female [4.3° (95% CI 3.5-5.2); p < 0.002] immediately after application of taping but not on the third day after application of KT. There was a significant rise in DDT immediately and on the third day after application of KT between KT group and SC group. CONCLUSION: There was a reduction in DKV immediately after the application of KT. However, there was no significant difference between KT group and SC group on the third day. Meanwhile, gluteus medius strength also showed significant improvement immediately after taping and it was maintained even on the third day.

Evaluación de resultados de la osteotomía en cuña cerrada de Coventry para corregir el genus valgum / Results of Coventry closing wedge osteotomy in the correction of genu valgum

Fundamento: los pacientes con deformidad en genus valgum asociada o no a osteoartritis unicompartimental lateral, son candidatos para una osteotomía varizante del fémur distal.Objetivo: evaluar los resultados con la osteotomía en cuña cerrada del fémur distal para el genus valgum.Métodos: se realizó un estudio descriptivo prospectivo a un grupo de pacientes con el diagnóstico de genus valgum, operados con la osteotomía de Coventry MB en el Hospital Militar Universitario Octavio de la Concepción y de la Pedraja de Camagüey, desde enero de 2009 hasta diciembre de 2013 y el tiempo promedio de seguimiento de los pacientes fue de 26 meses. El universo lo conformaron 39 pacientes con el diagnóstico de genus valgum operados con la técnica de Coventry MB. La muestra no probabilística la conformaron 36 pacientes. Las variables de estudio fueron edad, sexo, tiempo de consolidación, las complicaciones, el ángulo femorotibial y la evaluación según escala evaluativa para la rodilla.Resultados: predominó el grupo de edades entre 51 y 60 años para un 50 por ciento; el sexo más afectado fue el femenino con un 58,3 por ciento; el tiempo de consolidación fue de 14 a 24 semanas en el 66,6 por ciento; al finalizar el trabajo se logró un ángulo tibiofemoral promedio de 4,5 grados de valgo y la escala para la rodilla mejoró 33 puntos; los resultados de la osteotomía en cuña cerrada fueron excelentes en el 97,2 por ciento del total de pacientes operados.Conclusiones: la osteotomía de Coventry MB demostró ser excelente para corregir el genus valgum(AU)

Background: patients with genu valgum associated or not to lateral unicompartmental osteoarthritis are candidates for distal femoral varus osteotomy.Objective: to evaluate the results of distal femoral Coventry closing wedge osteotomy in the correction of genu valgum.Methods: a descriptive, prospective study was conducted in a group of patients with the diagnosis of genu valgum who underwent a Coventry osteotomy in Octavio de la Concepción y de la Pedraja Teaching Military Hospital, Camagüey from January 2009 to December 2013. The average time of monitoring of the patients was 26 months. The universe was composed of 39 patients with the diagnosis of genu valgum who underwent a Coventry osteotomy. The sample consisted of 36 patients. The variables of the study were the following: age, sex, knitting time, complications, femorotibial angle and the evaluation according to the evaluative scale for the knee.Results: the age group 51-60 years old predominated for a 50 percent. Female was the most affected sex for a 58, 3 percent. The knitting time was from 14 to 24 weeks in the 66, 6 percent of the patients. At the end of the treatment, an average femorotibial angle of 4, 5 degrees was achieved and the scale for the knee improved on 33 points. The results of closing wedge osteotomy were excellent in the 97, 2 percent of the patients who underwent the operation(AU)

Mi hijo no crece, ¿y dice usted que esto es normal? / My child doesn’t grow, and you say this is normal?

El genu varum es un proceso fisiológico en los dos primeros años de vida, evolucionando en ocasiones hacia genu valgum. No obstante, su diagnóstico diferencial abarca patologías importantes que deben ser descartadas para decidir el tratamiento. En los niños con genu varum se debe tranquilizar a la familia y adoptar una actitud expectante, dado que no reviste gravedad y es un proceso autolimitado. Presentamos el caso de dos hermanos con genu varum extremo, llegando incluso a producir un estacionamiento de la talla en uno de ellos. Ambos han evolucionado a la normalidad sin intervención médica (AU)

Genu varum is a physiologic finding in children p to 2 years old that sometimes becomes genu valgum. However, it may present accompanying systemic conditions that must be ruled out in order to treat them or not. The relatives of children with genu varum should be reassured and doctors should assume an expectant management due to its favourable natural history. We show the case of two brothers with a pronounced genu varum, one of them with a temporary stop in growth. Both evolved in a right way without treatment (AU)

Kinetic and kinematic changes with the use of valgus knee brace and lateral wedge insoles in patients with medial knee osteoarthritis.

The effect of a valgus knee brace and a lateral wedged insole on knee and ankle kinematics and kinetics was evaluated in ten patients with medial knee osteoarthritis (OA). The knee orthosis was tested in two valgus adjustments (4° and 8°), and the laterally wedged insole was fabricated with an inclination of 4°. A motion capture system and force platforms were used for data collection and joint moments were calculated using inverse dynamics. The valgus moment applied by the orthosis was also measured using a strain gauge implemented in the orthosis' rotational axis. For the second peak knee adduction moment, decreases of 18%, 21%, and 7% were observed between baseline and test conditions for the orthosis in 4° valgus, in 8° valgus, and insole, respectively. Similar decreases were observed for knee lever arm in the frontal plane. Knee adduction angular impulse decreased 14%, 18%, and 7% from baseline to conditions for the orthosis in 4° valgus, in 8° valgus, and insole, respectively. Knee angle in the frontal plane reached a more valgus position during gait using the valgus knee brace. The valgus moment applied by the orthosis with 8° valgus adjustment was 30% higher than with 4° valgus adjustment. The valgus knee orthosis was more effective than the laterally wedged insole in reducing knee adduction moment in patients with medial knee OA.