Abstract
Genu recurvatum in stroke patients with hemiplegia causes readily cumulative damage and degenerative changes in the knee cartilage. It is important to detect early cartilage lesions for appropriate treatment and rehabilitation. The purpose of this cross-sectional study was to provide a theoretical basis for the early rehabilitation of hemiplegia patients. We used a zero TE double-echo imaging sequence to analyse the water content in knee joint cartilage at 12 different sites of 39 stroke patients with genu recurvatum and 9 healthy volunteers using a metric similar to the porosity index. When comparing the hemiplegic limb vs. the nonhemiplegic limb in patients, the ratios of the deep/shallow free water content of the femur cartilages at the anterior horn (1.16 vs. 1.06) and posterior horn (1.13 vs. 1.25) of the lateral meniscus were significantly different. Genu recurvatum in stroke patients with hemiplegia can cause changes in the moisture content of knee cartilage, and the changes in knee cartilage are more obvious as the genu recurvatum increases. The "healthy limb" can no longer be considered truly healthy and should be considered simultaneously with the affected limb in the development of a rehabilitation treatment plan.
Highlights
Genu recurvatum in stroke patients with hemiplegia causes readily cumulative damage and degenerative changes in the knee cartilage
These changes induce an uneven distribution of the internal stress in the knee joint, cause knee pain and cartilage injury when walking in this way for a long time, and lead to cumulative damage and degenerative changes in knee c artilage[2]
A zero TE double-echo imaging sequence was used to analyse the water content in the knee joint cartilage of stroke patients with genu recurvatum using a metric similar to the porosity index, and the study focused on three questions: (1) is there any difference between the knee joint cartilage of the hemiplegia side and the nonhemiplegia side in stroke patients? (2) Are the changes in knee cartilage related to the degree of genu recurvatum? (3) Is there any difference between the knee cartilage of stroke patients and normal people? This study aims to provide a theoretical basis for the early rehabilitation of hemiplegia patients
Summary
Genu recurvatum in stroke patients with hemiplegia causes readily cumulative damage and degenerative changes in the knee cartilage. Many scholars have used these sequences to study articular cartilage, especially UTE T2* mapping and T1 rho mapping, which can quantitatively analyse early changes in endochondral injury[15–18]. These techniques are difficult to apply in clinical practice because of their complexity, long scanning time and the influence of the magic angle effect. Some scholars used the porosity index of the double-echo UTE sequence to evaluate the porosity of the bone cortex, calculated as the ratio of the image intensities of the second echo (indicating signals from pore water) and the first echo (indicating signals from all water), and found it to be highly consistent with the results measured by micro-CT19,20 This method is relatively simple and has potential for clinical use
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