Knee Diseases Research Articles

Patellar taping for patellofemoral pain syndrome in adults

Patellofemoral pain syndrome refers to the clinical presentation of knee pain related to changes in the patellofemoral joint. Patellofemoral pain syndrome usually has a gradual onset of pain with none of the features associated with other knee diseases or trauma. It is often treated by physiotherapists, who use a variety of techniques including patellar taping. This involves the application of adhesive sports medical tape applied directly to the skin over the patella on the front of the knee. Patients often report an instantaneous improvement in pain and function after the tape is applied, but its longer term effects are uncertain. The objective was to assess the effects, primarily on pain and function, of patellar taping for treating patellofemoral pain syndrome in adults. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, the Cochrane Central Register of Controlled Trials, MEDLINE, CINAHL, EMBASE, PEDro, SPORTDiscus, AMED, reference lists of articles, trial registers and conference proceedings. All were searched to August 2011. Randomised controlled trials and quasi-randomised controlled trials testing the effects of patellar taping on clinically relevant outcomes, pain and function, in adults with patellofemoral pain syndrome. We excluded studies testing only the immediate effects of tape application. Both review authors independently performed study selection, data extraction and assessment of risk of bias. Trialists were contacted for more information. Data were pooled where possible. Five small heterogeneous randomised controlled trials, all at high risk of performance bias and most at risk of at least one other type of bias, were included. These involved approximately 200 participants with a diagnosis of patellofemoral pain syndrome. All compared taping versus control (no or placebo taping) and all included one or more co-interventions given to both taping and control group participants; this was prescribed exercise in four trials. The intensity and length of treatment was very varied: for example, length of treatment ranged from one week in one trial to three months in another. A meta-analysis of the visual analogue scale (VAS) pain data (scale 0 to 10: worst pain), measured in different ways, from four trials (data from 161 knees), found no statistically or clinically significant difference between taping and non taping in pain at the end of the treatment programmes (mean difference (MD) -0.15; 95% confidence interval (CI) -1.15 to 0.85; random-effects model used given the significant heterogeneity (P < 0.0001)). Data for other outcomes measuring function and activities of daily living were from single trials only and gave contradictory results. The currently available evidence from trials reporting clinically relevant outcomes is low quality and insufficient to draw conclusions on the effects of taping, whether used on its own or as part of a treatment programme. Further research involving large, preferably multi-centre, good quality and well reported randomised controlled trials that measure clinically important outcomes and long-term results is warranted. Before this, consensus is required on the diagnosis of patellofemoral pain syndrome, the standardisation of outcome measurement and an acceptable approach for patellar taping.

The history of KSSTA

When in 1980–1981, ESKA was formed on my initiative and with economic help from the city of West Berlin, we also contacted the Springer Company in Heidelberg, Germany, about publishing the Proceedings of the First Congress in Berlin in 1984. It was also decided that we would publish the proceedings as a book. Even for our 2nd ESKA Congress in Basle, Switzerland, ESKA published a book with the meeting proceedings. A problem that soon became evident was that the often excellent manuscripts from the meetings were not referenced by PubMed, since they were published in a book. The only way they would be cited in PubMed was to publish them in a scientific journal. This is one of the major reasons why ESKA decided to start a scientific journal. The board of ESKA therefore negotiated with a number of publishing houses. After some tough economical discussions, the Springer Company accepted the terms of ESKA and promised to publish the journal. The journal was named Knee Surgery, Sports Traumatology and Arthroscopy (KSSTA). The idea was to cover all aspects of sports traumatology, with major focus on knee injuries and knee surgery. As the journal has grown manuscripts on basic science, degenerative knee diseases and knee replacements have increased in number. ESKA did not originally include sports traumatology in the name of the society. I was responsible for this delay of including sports trauma, since during the period 1980–1986, I was the president of the World Sports Medicine Federation (FIMS), and I wanted to avoid any collisions of interest between the new European society and FIMS. In 1988, however, ESKA included sports traumatology in its title and became ESSKA. KSSTA was originally published with four issues in 1993. I was the president of ESSKA and became the first Editor-in-Chief after I stepped down as ESSKA president. I held the position as Editor-in-Chief for 15 years, until 2008. My plan for KSSTA was to try to keep such a high scientific standard that a high impact factor would be possible. The first years of KSSTA were tough. The journal did not receive enough good manuscripts to fill the issues. Many ESSKA members were used to submit their scientific papers to American or British journals, and since we did not yet have an impact factor, it was difficult to compete with the established journals. After 3 years, the journal received its first impact factor and it was surprisingly good. This increased our members’ interest of publishing in KSSTA. While the journal was originally published as four relatively thin issues in 1993, it increased the number of issues gradually first to 6, then 8, and finally 12 issues per year. The issues also became thicker and thicker—often more than 100 pages. It meant a lot of work, especially for my secretary Louise von Essen, who was responsible for all administration of the journal during 16 years. She did all this work after hours and in weekends. One of the biggest problems for me in the beginning of KSSTA’s history was to find good reviewers who returned the manuscripts in time. I guess that this is a similar problem for my successors. It takes a lot of work to make a good review of a scientific paper and it takes time. The only ‘‘payment’’ the reviewers get is to be mentioned in the last issue of KSSTA each year. In the future, we need to find a better system for rewarding this important scientific work. I wish KSSTA a glorious future, and I am happy to have played a role when it was created. E. Eriksson (&) Lugnets Vag 11, 186 34 Vallentuna, Sweden e-mail: eriksson.werner@telia.com

Differential expressed proteins of knee osteoarthritic chondrocytes

To investigate the molecular mechanism of osteoarthritis (OA) through the differential expressed proteins of advanced osteoarthritic chondrocytes. Normal articular cartilage (NAC, n = 22) were obtained from knee cartilage of donors without knee diseases and osteoarthritic cartilage (OAC, n = 17) from OA patients undergoing knee arthroplasty. Total protein was extracted from chondrocytes and loaded directly for two-dimensional gel electrophoresis (2-DE). Gel images were analyzed with the software Imagemaster 2-D platinum3.0 to screen the differential expression protein spots. Target spots were excised and digested and the resulting peptides submitted for mass spectrometry analysis. Identities of differential expressed proteins were recognized through matching the peptide mass finger printing of each spot with NCBI protein database by MASCOT. About 1000 protein spots were presented in the 2-DE gels for each group. Thirty-five NAC spots and 31 OAC spots were confirmed to be differential expression protein spots. Among these spots, 19 proteins were identified by MASCOT, including type VI collagen, enzymes involved in collagen synthesis, shock related proteins and some novel proteins with unknown functions. The differential expressed proteins isolated and identified by the present study provide valuable information on various aspects of OA pathology. It may help us to gain new insights into the molecular mechanism of OA.

Force-Velocity Parameters of Knee Flexors and Extensors in 10-12-Year-Old Children with Spinal and Knee Diseases

Force-Velocity Parameters of Knee Flexors and Extensors in 10-12-Year-Old Children with Spinal and Knee Diseases

Results and influencing factors of high tibial osteotomy for medial-type knee diseases

Results and influencing factors of high tibial osteotomy for medial-type knee diseases

Ultrasound's value in the diagnostic of some knee diseases

Ultrasound's value in the diagnostic of some knee diseases

Questionário específico para sintomas do joelho "Lysholm Knee Scoring Scale": tradução e validação para a língua portuguesa

As doenças do joelho apresentam conseqüências variadas para a função e a qualidade de vida do indivíduo. Para traduzir, validar e verificar as propriedades de medida do questionário específico para sintomas do joelho "Lysholm Knee Scoring Scale" para a língua portuguesa, selecionamos, por conveniência, 50 pacientes (29 homens e 21 mulheres, média de idade 38,7 anos) com lesão de joelho (lesão meniscal, lesão do ligamento cruzado anterior, condromalácia ou artrose). A reprodutibilidade e a concordância ordinal inter e intra-entrevistador foram excelentes (alfa = 0,9). A concordância nominal inter-entrevistadores foi boa (Kappa = 0,7) e intra-entrevistador, excelente (Kappa = 0,8). No processo de validação, correlacionamos o questionário Lysholm com a escala numérica da dor (r=-0,6; p=0,001) e com o índice de Lequesne (r= -0,8; p=0,001). As correlações entre o Lysholm e a avaliação global da saúde pelo paciente e pelo terapeuta apresentaram-se fracas e não significantes. As correlações entre o questionário Lysholm e o SF-36 foram significantes nos aspectos físicos (r = 0,4; p = 0,04), de dor (r = 0,5; p = 0,001) e de capacidade funcional (r = 0,7; p = 0,0001). Concluímos que a tradução e adaptação cultural do "Lysholm knee scoring scale" para o nosso idioma apresentou reprodutibilidade e validade em pacientes com lesão meniscal, lesão do ligamento cruzado anterior, condromalácia ou artrose do joelho.

Clinical experience of osteoarticular MRI using a dedicated system

Magnetic resonance imaging (MRI) has a significative impact on diagnosis of musculoskeletal diseases. At present, joint diseases are evaluated with total-body systems, this fact representing an obstacle to MR diffusion in the osteoarticular field. The last technological advances have allowed the development of a cost-effective, compact and easy-to-install MR system. The system is constituted by a 0.2-T permanent unit, weighing 800 kg. The unit is used only for limb examination. To verify the diagnostic accuracy of the new system a study based on 1902 lower limb examinations was carried out between October 1992 and February 1994. Of these patients, 301 underwent surgery during which the MR findings were verified. Quite satisfying overall results were obtained, particularly in case of knee trauma, comparable to those provided by total body units with higher magnetic field. It must be noted, however, that in 3% of the investigated knee diseases, the examinations could not be performed due to technical limitations related to the magnet size. The authors believe that the limited field of view (11 cm) does not allows accurate staging of the malignant lesions concerning soft tissue and bone, which require a wider loco-regional staging. They also believe that the particular structure of the magnet allows for a comfortable management of pediatric, elderly, and acute patients.

Microarthroscopic study of the morphologic features of normal and pathological synovial membrane

The complex symptoms occurring in several internal knee diseases are usually related to changes in the synovial membrane, causing diagnostic and therapeutic problems. The conventional arthroscope, useful in establishing the diagnosis of internal derangement, is of questionable value in the differential diagnosis and evaluation of the stages of arthritis. With magnifying arthroscopy, it is possible to better show various forms of synovitis. Between 1983 and 1989, 3,000 knee joints were studied with conventional arthroscopy. In 400 of these joints, magnifying arthroscopic examination (microarthroscopy) was performed: 34 were normal, 57 had meniscal and ligamentous lesion, 220 had osteoarthritis, and 89 had inflammatory synovitis. We used two types of arthroscopes, Hamou-Storz and Microview-Wolf, adapted from a microhysteroscope, which provided a × 150 magnification of the conventional field. Referring to established microarthroscopic aspects of the synovial membrane in normal and pathological conditions, we have suggested microarthroscopic criteria for the differential diagnosis of synovitis in various pathological disorders. We believe that there are new applications for microarthroscopy because the instruments appear to have great potential value for both research and diagnosis.

Joint disorders and walking disability in Sweden by the year 2000

The prevalence of joint complaints with walking disability, as well as clinically diagnosed hip and knee diseases, in Sweden in the year 2000 was calculated from data from a population survey that we made in a Swedish community (Atvidaberg) in 1986. The population was representative of that of the whole country. Among all 5,259 persons aged 45 years and older, 35 percent reported long-lasting joint complaints. The prevalence of clinically diagnosed degenerative joint disease was 14 percent, that of extraarticular disease 12 percent, inflammatory joint disease 2.4 percent, arthralgia 1.4 percent, and collagenoses 0.5 percent. From the official estimations of the Swedish 8.5 million population as to age classes and sex by the year 2000, joint complaints can be foreseen in 1.2 million inhabitants, representing a total increase of 0.16 million persons. The number of patients with destructive rheumatoid arthritis can be estimated at 58,000 in the year 2000.

O'Connor's Textbook of Arthroscopic Surgery

ABSTRACT This is an updated multiauthored version of O'Connor's original text, Arthroscopy. After Dr O'Connor's untimely death, Dr Heshmat Shahriaree assumed the duties of editor.The initial chapters present an excellent historical review of the development of arthroscopy, discuss the anatomy and clinical examination of the knee, and describe general equipment needed by the arthroscopist. This last section is not as complete as it could be and tends to favor Wolfe instrumentation. There is also a chapter at the end of this text that deals with arthroscopy of joints other than the knee.However, most of the book is devoted to a general review of knee pathology in which the use of the arthroscope may be beneficial and includes torn menisci, symptomatic plica, osteochondritis dissecans, loose bodies, degenerative arthritis, tibial compression fractures, the acutely injured knee, the unstable knee, intra-articular adhesions, and synovial diseases. The discussion of each of these entities

Diseases of the Knee

Diseases of the Knee