Degree Of Knee Osteoarthritis Research Articles

The femoral anterior tangent line could serve as a reliable alternative reference axis for distal femoral rotational alignment in total knee arthroplasty: an MRI-based study.

This study aimed to evaluate the reference value of the femoral anterior tangent (FAT) line as a guidance of distal femoral rotation on magnetic resonance images (MRI). We retrospectively included 81 patients (106 knees) diagnosed as ailing from primary knee osteoarthritis. The indirect rotational axes including the FAT line, the perpendicular line to the anteroposterior axis (pAPA), and the posterior condylar axis (PCA) were identified on MRI, and their angles related to the clinical transepicondylar axis (cTEA) or surgical transepicondylar axis (sTEA) were measured. The patients were further divided into subgroups according to the Kellgren-Lawrence (K-L) grades, the joint-line convergence angle (JLCA), and the arithmetic hip-knee-ankle angle (aHKA) to assess the variance of different rotational reference axes. The FAT line was -11.8° ± 3.6° internally rotated to the cTEA and -7.5° ± 3.6° internally rotated to the sTEA. The FAT/cTEA angle and the FAT/sTEA angle shared a similar frequency distribution pattern but a little greater variance to the pAPA/cTEA angle and the PCA/cTEA angle. The PCA/cTEA angle in the JLCA |x| ≥ 6° subgroup was significantly smaller than in the two other JLCA subgroups. The pAPA/cTEA angle and the PCA/cTEA angle also presented statistical significance within the aHKA subgroups. While the FAT/cTEA angle and the FAT/sTEA angle demonstrated superior stability among the different K-L grades, JLCA subgroups, and aHKA subgroups. The FAT line was less affected by the degree of knee osteoarthritis and lower limb alignment, which could serve as a reliable alternative reference axis for the distal femoral rotational alignment in total knee arthroplasty.

Smoking Behaviour is a Protective Factor Against the Degree of Knee Osteoarthritis

Smoking Behaviour is a Protective Factor Against the Degree of Knee Osteoarthritis

Study on the relationship between severe knee osteoarthritis and bone marrow edema

To investigate the relationship between bone marrow edema and pathological changes, symptoms and signs of severe knee osteoarthritis. From January 2020 to March 2021, 160 patients with severe knee osteoarthritis who underwrent MRI of the knee at the Department of Bone and Joint, Wangjing Hospital, China Academy of Chinese Medical Sciences were included. Eighty patients with bone marrow edema were selected as the case group, including 12 males and 68 females, aged from 51 to 80 years old with an average of (66.58±8.10) years old, the duration of disease 5 to 40 months with an average of (15.61±9.25) months. Eighty patients without bone marrow edema were selected as the control group, including 15 males and 65 females, aged from 50 to 80 years old with an average of (67.82±8.05) years old, the duration of disease 6 to 37 months with an average of (15.75±8.18) months, BMI was (28.26±3.13) kg·m-2 ranged from 21.39 to 34.46 kg·m-2. The degree of bone marrow edema was evaluated by knee whole oragan magnetic resonance imaging score (WORMS). The degree of knee osteoarthritis was evaluated by Kellgren- Lawrence(K-L) grade and Western Ontario and McMaster University Osteoarthritis Index (WOMAC). The degree of joint pain was evaluated by visual analogue scale(VAS) and WOMAC pain score, the joint signs were evaluated by tenderness, percussion pain, joint swelling and joint range of motion. To explore the relationship between bone marrow edema and knee osteoarthritis, the prevalence of bone marrow edema and K-L grade were compared between the two groups. Furthermore the WORMS score and WOMAC index, pain-related score, and sign-related score correlation coefficient were analyzed to further explore the relationship between bone marrow edema and knee osteoarthritis index, joint pain symptoms and signs. There was 68.75% (55/80) of the patients in the case group were in K-L grade Ⅳ, and 52.5% (42/80) in the control group, indicating a higher proportion of patients with grade Ⅳ in the case group than the control group (χ2=4.425, P<0.05). In the case group, there was a strong correlation between bone marrow edema WORMS score and knee osteoarthritis WOMAC index. (r=0.873>0.8, P<0.001), a moderate correlation between WORMS score and VAS score and WOMAC pain score(r=0.752, 0.650>0.5, P<0.001), a moderate correlation between WORMS score and percussion pain score (r=0.784>0.5, P<0.001), and a weak correlation between WORMS score and VAS and tenderness score, joint swelling score and joint range of motion score (r=0.194, 0.259, 0.296<0.3, P<0.001). Our study suggests that severe knee osteoarthritis is associated with an increased risk of bone marrow edema. Bone marrow edema can also lead to knee osteoarthritis joint pain, with percussion pain being a positive sign, but tenderness, joint swelling and limitation of activity are not significantly related to bone marrow edema.

Thermal Oscillation Changes the Liquid-Form Autologous Platelet-Rich Plasma into Paste-Like Form.

Objectives The texture of the autologous platelet-rich plasma (PRP) that is used in treating degenerative joint diseases such as knee osteoarthritis (OA) is usually in liquid form. However, the turnover rate of protein metabolism in the knee synovial fluid (SF) is less than one hour. This study examined the feasibility of the thermal oscillation technique in converting the liquid-form PRP into an injectable viscous paste-like PRP that may delay the degradation of PRP and continuously release growth factors in the knee joint for a longer period of time. Methods This study was conducted in the rehabilitation department of a tertiary hospital. A total of 10 elderly patients with an average age of greater than 65 years and diagnosed with moderate degree of knee OA were recruited. The RegenPRP (RegenLab, Le Mont-sur-Lausanne, Switzerland) test tube chamber was used for PRP generation. A total of 60 milliliters (mL) of blood was drawn from each patient. 10 mL of blood was injected into each PRP test tube chamber. As a result, a total of 6 test tube chambers were obtained and each chamber was centrifuged for 15 minutes. Approximately 5 mL of PRP supernatant (the liquid-form end product) was aspirated and sent for thermal oscillation treatment. Five temperatures were tested: 55, 65, 75, 85, and 95 degrees Celsius. Oscillation was set at 200 revolutions per minute (rpm) for 15 minutes. The enzyme-linked immunosorbent assay (ELISA) was applied in measuring the concentration of platelet-derived growth factor (PDGF) in picogram/milliliter (pg/mL). Repeated measures ANOVA followed by the Bonferroni post hoc test was used to compare the PDGF concentrations between each testing condition. Results Under 75 degrees Celsius of heating, the resultant paste-like PRP end product had the highest concentration of PDGF in picograms per milliliter (pg/mL) as compared with other heating conditions (p < 0.05). The viscosity of the paste-like PRP was measured to be 70,000 centipoise (cP), which is similar to the viscosity of a toothpaste. The paste-like PRP end product was able to release PDGF continuously for about 14 days, with the highest concentration achieved on the 8th day with an average of 35646 ± 2499 pg/mL. In nonthermally treated liquid-form PRP sample, the highest number of PRP was observed on the 4th day with an average value of 8444 ± 831 pg/mL. Under the heating conditions of 55 and 95 degrees Celsius, the highest concentration of PDGF was observed on the 5th day (13346 ± 764 pg/mL and 3440 ± 303 pg/mL, respectively). Under the heating conditions of 65 and 85 degrees Celsius, the highest concentration of PDGF was observed on the 7th day (15468 ± 744 pg/mL and 20432 ± 1118 pg/mL, respectively). Conclusion Through thermal oscillation, liquid-form PRP can be converted to paste-like PRP end product with a viscosity similar to that of a toothpaste. The best heating condition was discovered to be 75 degrees Celsius. The paste-like PRP was able to release PDGF continuously for about 2 weeks, with the highest concentration obtained on the 8th day. The findings in this study suggested that paste-like PRP may be a viable option in treating degenerative knee joint diseases.

Knee varus alters three-dimensional ankle alignment in standing- a study with upright computed tomography

BackgroundFor knee osteoarthritis (OA) treatment, it is important to correct the lower limb alignment including the foot. However, in the upright position, lower limb alignment is generally assessed from the body surface or radiographs, and it is a challenge to capture the exact characteristics of three-dimensional lower limb alignment. The purpose of the study was to measure lower limb alignment in patients with knee OA using upright computed tomography (CT) and radiography, and to identify features of knee joint deformity.MethodsA total of 45 limbs in 25 patients with knee OA were enrolled. The subjects underwent both upright CT and radiography for the whole lower limb in the standing position. The joint angles were calculated on both images. The degree of knee OA was classified according to Kellgren-Lawrence (KL) grade by referring to radiography, which is mainly based on the degree of articular cartilage loss and severity of osteophytes, and the characteristics or correlation between knee and ankle joint in each group was investigated.ResultsIn KL-I, there was an association between varus of the knee joint and internal rotation of the talocrural joint (r = 0.76, P < 0.05). In KL-II, there was an association between varus of the knee joint and eversion of the subtalar joint (r = 0.63, P < 0.05) and talocrural joint (r = − 0.65, P < 0.05). In KL-III, there was an association between varus of the knee joint and internal rotation of the subtalar joint (r = − 0.62, P < 0.05), and in KL-IV, there was an association between varus of the knee joint and internal rotation of the subtalar joint (r = − 0.58, P < 0.05).ConclusionsThe lower limb alignment of patients with knee OA in the standing position was found that as knee OA worsened, it became apparent that compensatory knee joint alignment depended on the ankle joint rather than the subtalar joint. The results may help in the rehabilitation of patients with knee OA, since the ankle joint alignment has a significant impact on the knee joint during coarse movements involving load.

Severity of subchondral insufficiency knee fracture: is it associated with increasing age, femorotibial angle, and severity of meniscus extrusion?

Aim: To evaluate the relationship between severity of subchondral insufficiency fracture of the knee (SIFK) and age, gender, knee alingment, meniscus tear, type and location, severity of meniscus extrusion, and degree of knee osteoarthritis.&#x0D; Material and Method: This retrospective study included 308 patients with SIFK seen on MRI. SIFK lesions were categorized as grade 1 to 4, with distinction between low grade (1 and 2) and high grade (3 and 4). The relationships between SIFK grade and patients' age, body mass index (BMI), femorotibial angle (FTA), meniscus tear,type and location meniscusextrusiongrade and osteoarthritis (grade 0 to grade 4) evaluated.&#x0D; Results: According to the gender, 39.3% were men and 60.7% were women. The distrubutin of the SIFK grades were respectively 42.2% grade 1, 30.8% grade 2, 22.7% grade 3 and 4.2% grade 4. FTAwas positively correlated with SIFK grade (from grade 1 to grade 4, respectively; 4.42±2.57, 5.09±2.26, 5.74±2.78 and 5.95±2.54) (p=0.002). No statistically significant difference was observed between height, weight and BMI and the degree of SIFK.The mean FTA was 4.99±2.57° in SIFK. The FTA angles showed a stastistically significance between low (4.73±2.48°) and high (5.71±2.69°)grade SIFK (p:0.003). Roc analysis showed that the FTA above 3.1° and the age above 52 year old were at risk. The mean extent of meniscal extrusion was larger in high grade SIFK (p=0.001). Multivariable logistic regression analysis showed that compared with low grade SIFK, high grade SIFK was more closely associated with age, FTA, lateral meniscus extrusion and medial meniscus tear type.&#x0D; Conclusion: High-grade SIFK lesions are associated with higher FTA and older age. In particular, patients with acute knee pain, older than 52 years of ageanda higher FTA than 3.1°, we recommend to perform knee MRI if possible.

Preliminary Study on Grading Diagnosis of Early Knee Osteoarthritis by Shear Wave Elastography.

Knee osteoarthritis (KOA) is the most common chronic bone joint disease. The WHO points out that KOA has become the fourth most disabling disease in the world, and the main clinical treatment is prevention. At present, the clinical diagnosis of knee osteoarthritis with deformation is mainly made by X-ray and two-dimensional ultrasound, and the preventive treatment effect is not good. Shear wave elastography (SWE) has been widely used in clinical practice for its advantages of noninvasive, simple, rapid, and high accuracy in soft tissue hardness. This study investigates the feasibility of using SWE in the grading diagnosis of KOA and the detection of early skeletal muscle injury. 60 patients were enrolled with unilateral KOA who met the inclusion criteria. Routine scanning and SWE exploration were carried out and compared between the affected and healthy knee joints. The measurements included morphology, damage degree of cartilage, joint effusion, joint synovial thickness, the degree of meniscus convexity, and shear wave speed (SWS) in the tendon attachment area of the quadriceps femoris superior patella, and tendon thickness and SWS between and within groups. The affected was scored according to the ultrasonic characteristics. The correlation between them was analyzed to evaluate the feasibility of SWE in grading the diagnosis of KOA. 57 cases had knee cavity effusion (57/60, 95.0%), 58 cases had knee cartilage injury (58/60, 96.6%), and 35 cases had a lateral process of the medial meniscus (35/60, 53.3%); 30 cases had synovial hyperplasia (30/60, 50%), 21 cases had osteophyte formation (21/60, 35%), and no one had a popliteal cyst. There was no significant difference in tendon thickness between and within groups (p > 0.05), but a significant difference in SWS (p < 0.01); the SWS of the quadriceps femoris tendon is negatively correlated with ultrasound score (r = 0.955, p < 0.01). There is a strong negative correlation between SWS and the degree of KOA. It can be used in the grading diagnosis of KOA to help find more early strain points.

The Rosenberg view and coronal stress radiographs give similar measurements of articular cartilage height in knees with osteoarthritis.

Choosing the optimal radiographic methods to diagnose the cartilage height and degree of knee osteoarthritis is crucial to determine suitability for unicompartmental knee replacement. This study aims to evaluate and compare articular cartilage thickness measured using the Rosenberg view and coronal stress radiography. Intra- and interrater agreement and test-retest reliability of each method were determined. The hypothesis of the study was that the Rosenberg view and coronal stress radiographs provide similar assessments of articular cartilage height in the medial and lateral knee compartments of osteoarthritic knees. A prospective diagnostic study, including 73 patients was performed. Inclusion criteria were enrollment for either a medial unicompartmental or a total knee replacement. Radiographs were taken as the Rosenberg view, and coronal stress radiography using the Telos stress device. Repeated measurements were performed. Experienced knee surgeons performed measurements of cartilage height at a standardized location of joint space width (JSW), and a rater-perceived location of minimal joint space width (mJSW), thus allowing for reliability and agreement analysesusing weighted kappa. Coronal stress measurements were ultimately compared to the Rosenberg view using Spearman's rank correlation. A total of 12,264 measurements were performed. The radiographic methods proved substantial reliability. Intra- and interrater agreement showed substantial to almost perfect agreement. A very strong correlation was observed in the medial knee compartment (r = 0.91; CI = 0.84-0.95; p < 0.001), with a mean difference of 0.1mm and limits of agreement of - 1.5 to 1.7mm, when comparing JSW between the Rosenberg view and varus stress. Only a strong correlation was observed medially when using mJSW, and when using this measurementmore incidences of bone-on-bone were observed than when measuring with JSW. A Strong correlation was observed in the lateral knee compartment (r = 0.83; CI = 0.71-0.89; p < 0.001), with a mean difference of 0.62mm and limits of agreement of - 1.5 to 2.7mm, when comparing JSW between the Rosenberg view and valgus stress. The Rosenberg view is similar to 20° coronal valgus-varus stress radiography for determining articular cartilage thickness. Both techniques can be used in a clinical setting. Therefore, extra radiographs, equipment and expertise could be saved, when solely utilizing the Rosenberg view which is simple to perform. III.

Expression of VEGF-A Signaling Pathway in Cartilage of ACLT-induced Osteoarthritis Mouse Model

BackgroundAnterior cruciate ligament transection surgery (ACLT)-induced OA model was often used to investigate the molecular mechanism of knee osteoarthritis (KOA). Researches have shown that vascular endothelial growth factor (VEGF) played an important role in OA. The present study aimed to investigate the pathological changes after ACLT surgery and reveal the expression characteristics of the VEGF-A/VEGFR2 signaling pathway in this model.MethodsModerate KOA model was established by ACLT, and 1, 2, 4, 8, and 12 weeks after surgery, hematoxylin-eosin (HE) and Safranin-O(S-O) staining were used to detect the pathological changes in mouse knee cartilage, and the matrix biomarkers A Disintegrin and Metalloproteinase with Thrombospondin Motifs 5(ADAMTS5), Collagen II (COL-II) were detected using immunohistochemistry (IHC), CD31 was detected by immunofluorescence (IF) to show the vascular invasion in cartilage, and proteins expression of VEGF-A pathway were detected by Western blot (WB). Meanwhile, the inflammatory biomarkers cyclooxygenase-2 (COX-2) and inducible nitric oxide synthase (iNOS) in cartilage were detected by WB.ResultsACLT surgery can lead to degeneration of cartilage in mice, and the characteristics of the lesion were time-dependent. The ADAMTS5-positive cells increased while COL-II decreased in OA cartilage with time, and new blood vessels labeled by CD31 can be seen from 1 week in OA cartilage, and increased in 8 and 12 weeks. The expression of VEGF-A, VEGFR2, COX-2, and iNOS were higher than control groups, which were basically consistent with the degree of osteoarthritis.ConclusionsThe degenerative degree of articular cartilage was time-dependent; angiogenesis and inflammation were important pathological changes of cartilage in KOA. The expression of the VEGF-A/VEGFR2 signaling pathway was basically correlated with the degree of KOA.

The correlation between Erα gene polymorphism and the distribution pattern of fascia syndrome in women with knee osteoarthritis

Objective To study the correlation between Erα gene polymorphism and the distribution pattern of TCM meridian syndrome in women with knee osteoarthritis. Methods A total of 120 Knee osteoarthritis (KOA) female patients admitted to our hospital between January 2018 and December 2018 were selected as the observation group, and 120 healthy female subjects accepted physical examination at our hospital over the same period were selected as the control group. The Erα gene distribution of estrogen receptor was compared between the two groups to identify the differences between KOA women and healthy women. The TCM syndromes and meridians types of the patients in the observation group were defined to evaluate the degree of KOA. The correlation among KOA status, Erαgenotypes, TCM syndromes and meridians was analyzed. Results The distribution of Erα gene XbaI was significantly different between the observation group and the control group (χ2=35.339, P<0.001). There was a statistical difference in the distribution of XbaI genotypes between mild to moderate and severe patients in the observation group (χ2=29.088, P<0.001). There was a moderate correlation between the Lequesne score and the fascia type in KOA women, and a high correlation between the Lequesne score and the TCM syndrome differentiation type, and a moderate correlation between the Lequesne score and the Erα gene and the XbaI genotype (P<0.05). The Erα gene polymorphisms, meridians and syndrome differentiation were moderately correlated (P<0.05). Conclusions In female patients with knee osteoarthritis, the conditions are more serious in patients with complex type of tendons, deficiency of liver and kidney, phlegm and blood stasis, Erα gene xx genotype, and there is a clear correlation between the TCM type of tendons and ER gene polymorphism. Key words: Osteoarthritis, knee; Female; Estrogen receptor alpha; Genotype; Syndrome differentiation classification; Syndrome type

Phonopheresis Associated with Nanoparticle Gel from Phyllanthus amarus Relieves Pain by Reducing Oxidative Stress and Proinflammatory Markers in Adults with Knee Osteoarthritis.

To determine the changes in serum levels of inflammatory biomarkers and antioxidant levels among the knee osteoarthritis (OA) patients after treatment with Phyllanthus amarus (PP) by nanoparticle gel phonophoresis. This study was a randomized, double-blind, placebo-control, parallel-group, clinical trial involving 30 subjects with mild-to-moderate degree of knee OA. The patients were allocated to two groups using a computer-generated random numbers, and received conventional ultrasound therapy (control group, 15 cases) and PP (treatment group, 15 cases) once daily for 10 sessions. The pain was evaluated by visual analogue scale (VAS). Serum levels of tumor necrosis factor-α (TNF-α) were determined by enzyme-linked immunosorbnent assay (ELISA). Nitric oxide (NO) was determined by modified Griess reagent. The antioxidant effects, including superoxide dismutase (SOD) and total antioxidant capacity (TAC), were also measured by ELISA assay. The VAS score was significantly decreased in the treatment group compared with the control group after treatment (P<0.01). The serum concentrations of TNF-α and NO were significantly reduced in the treatment group compared with the control group (P<0.01) after treatment. However, the serum concentrations of SOD and TAC in the treatment group were significantly higher after treatment compared with the control group (P<0.01). PP could alleviate knee pain and significantly reduce systemic anti-inflammatory effects in knee OA patients.

Risk Factors for Postoperative Opioid Use in Arthroscopic Meniscal Surgery

(1) To evaluate the influence of preoperative opioid use on postoperative consumption after arthroscopic meniscal surgery and (2) to determine preoperative patient factors associated with increased opioid use after meniscal surgery. We performed a retrospective review of all patients with a primary diagnosis of a meniscal tear at a single institution between August 2013 and February 2017. Patients were classified as opioid nonusers if they had not received any opioid medications in the 3months before meniscal surgery, as acute users if they received at least 1 opioid prescription within 1month preceding meniscal surgery, or as chronic users if they received at least 1 opioid prescription within 3months preceding meniscal surgery. Clinical records were reviewed for postoperative opioid use within a year after surgery. We also recorded patient demographic characteristics and the degree of knee osteoarthritis at the time of surgery using the Outerbridge classification. A total of 735 patients were included. The average age was 46.7years (range, 12-79years), and the average body mass index was 30.2 ± 6.2 (range, 13.3-55.4). Patients who were acute or chronic opioid users preoperatively were more likely to continue to use opioids beyond 1month postoperatively (P < .001). A higher percentage of patients with advanced osteoarthritis (Outerbridge grade 3 or 4) were found to continue to use opioids at all time points beyond the first postoperative month (P < .05). Pair-wise comparisons showed that the number of total opioid prescriptions filled was significantly higher in the group with Outerbridge grade 1 or 2 and the group with Outerbridge grade 3 or 4 than the group with Outerbridge grade 0 (P= .023 and P= .014, respectively). No significant difference in postoperative opioid use was noted when we compared meniscal repair versus resection, primary procedure versus revision, different tear types, or concomitant procedures. In patients undergoing arthroscopic meniscal surgery, the chronicity of preoperative opioid intake and degree of knee osteoarthritis were found to have a significant effect on postoperative opioid use. Level III, retrospective comparative study.

Correlation Study of Functional Performance between Diabetic and Non-Diabetic Patients with Knee Osteoarthritis

Osteoarthritis is recently considered a part of metabolic syndrome which shifts the traditional concept that believed on, osteoarthritis is a degenerative joint disease based on continuous mechanical overload to a metabolic pathogenesis. The aim of our study designed to investigate the correlation between type two diabetes and knee osteoarthritis with the impact on functional performance. One hundred women with knee osteoarthritis enrolled in the study with mean age 50.5±3.11 years and mean BMI 26.23±2.48 Kg/m2. All patients were subjected to radiological assessment to detect the degree of knee osteoarthritis, laboratory investigations to measure glycemic control, Western Ontario and Mc Master Universities Index (WOMAC) scale to evaluate functional performance. All patients assigned into two groups, group A (50 women) as a type two diabetic group and group B (50 women) as a non-diabetic group. Results showed a non-significant correlation between glycemic level and limitations in functional performance in mild knee osteoarthritis. However, there were significant differences among diabetic and non-diabetic groups regarding functional performance. Then our conclusion demonstrated non-significant correlation between type two diabetes and functional performance. Meanwhile, there were significant differences among diabetic and non-diabetic patients regarding functional performance.

Atgalinio žingsniavimo poveikis kelio sąnario osteoartrozei

Šiuo tyrimu siekta įverinti atgalinio žingsniavimo poveikį osteoartroze sergančių pacientų pažeisto kelio sąnario funkcijai. 30 pacientų, kuriems diagnozuota II° - IV° kelio sąnario osteoartrozė, atsitiktinės atrankos būdu suskirstyti į tiriamąją ir kontrolinę grupes vykdė 10 užsiėmimų kineziterapijos pratimų programą, papildytą įprastu ir atgaliniu žingsniavimu. Pacientų funkcinė būklė testuota prieš ir po kineziterapijos programų taikymo: įvertintas skausmo pojūtis, šlaunies lenkėjų ir tiesėjų, kelio lenkėjų ir tiesėjų, čiurnos lenkėjų ir tiesėjų raumenų izometrinė jėga, apatinių galūnių funkcinė būklė. Duomenų analizė atlikta naudojant statistinės analizės „SPSS Windows 20.0“ ir Excel 2010 programas. Nustatyta, kad atgaliniu ir įprastu žingsniavimu papildytos kineziterapijos programos statistiškai patikimai gerina funkcinę būklę, mažina skausmo pojūtį kelio sąnario lenkimo metu, didina šlaunies lenkėjų, šlaunies tiesėjų, kelio lenkėjų, kelio tiesėjų, čiurnos lenkėjų ir čiurnos tiesėjų raumenų grupių izometrinę jėgą. Atgalinio žingsniavimo metodas mažina skausmo pojūtį kelio sąnario tiesimo metu, reikšmingiau nei įprastas ėjimas didina šlaunies tiesėjų ir čiurnos lenkėjų raumenų izometrinę jėgą.

Serum leptin and osteoporosis in postmenopausal women with primary knee osteoarthritis

Aim of the workThe purpose of this study was to evaluate the relationship of serum leptin level and osteoporosis in postmenopausal women with knee osteoarthritis (KOA). Patients and methodsThe study included 40 postmenopausal women with primary KOA and 37 age-matched postmenopausal healthy controls. Plain X-ray knees were performed and assessed using the Kellgren–Lawrence (KL) grading scale. Bone mineral density (BMD) was assessed using dual-energy X-ray absorptiometry (DXA) in lumbar spine, hip and forearm regions. As a bone turn-over marker serum osteocalcin was measured. Serum leptin level was assessed in patients and control. ResultsThe mean age of the KOA patients was 58.05±5.7years. Osteoporosis was detected among 15% of the KOA patients and 35.1% of the control. The BMD was significantly increased at the spine and wrist in the patients than in the control (p=0.011 and p=0.015 respectively). The serum osteocalcin was comparable between patients (19.74±8.05ng/ml) and control (21.2±8.36ng/ml) (p=0.5). Serum leptin was significantly higher in the patient (58.7±27.17ng/ml) compared to the control (48.75±13.19ng/ml) (p=0.048), and significantly correlated with the degree of KOA (p=0.017). No significant correlation was found between serum osteocalcin level or the BMD and the degree of KOA. There was a significant negative correlation between serum osteocalcin level and forearm BMD in KOA patients (r=−0.33, p=0.038). ConclusionsAlthough postmenopausal women with KOA had significantly higher BMD, both diseases can coexist. It seemed that osteoarthritis does not prevent the occurrence of osteoporosis. Our study suggested a promising role of leptin as a biomarker of KOA.

Effect of body mass index and osteoarthritis on outcomes following arthroscopic meniscectomy: A prospective nationwide study

BackgroundCurrent evidence suggests limiting arthroscopic meniscectomy to those patients with no or early arthritis however outcomes of arthroscopic meniscectomy with patients of a higher body mass index (BMI) are not as widely available. The aim of this study was to determine if patient reported outcome scores for arthroscopic meniscectomy are adversely affected by the degree of knee osteoarthritis or patient BMI. MethodsAll patients who underwent arthroscopic meniscectomy within the NHS in Scotland between the 6th of February and 29th of April 2012 were audited as part of the Scottish Government Musculoskeletal Audit and were eligible for inclusion within this study. A total of 270 patients returned both their pre-operative and post-operative EuroQol 5Q5D5L descriptive questionnaire and Knee injury and Osteoarthritis Outcomes Scores. Patients were stratified according to BMI, degree of osteoarthritis, history of injury, and duration of knee symptoms. ResultsPre-operative to post-operative EuroQol index scores [0.642±0.253 to 0.735±0.277, median±SD] and Knee injury and Osteoarthrtis Outcome Scores [44.63±18.78 to 62.28±24.94, median±SD] improved across all patients (p<0.0001). This was irrespective of degree of BMI, history of injury, or duration of symptoms. There was no such improvement in patients with moderate to severe osteoarthritis. Those patients with a BMI >35kg/m2 had lower post-operative scores than the pre-operative scores of those of BMI <30kg/m2. ConclusionsArthroscopic meniscectomy is beneficial regardless of patient BMI, duration of symptoms, history of injury, or in the presence of early osteoarthritis.