Knee Injury And Osteoarthritis Outcome Score Scale Research Articles

Patient response to osteotomy around the knee joint at one year post-operation-fulfilment of expectations and current health status.

The aim of this study was to investigate patient satisfaction and fulfilment of expectations after osteotomy around the knee at one year postoperatively, using patient-related outcome measures. From the initial sample of 264 patients, a total of 132 patients (age 48y ± 11) were enrolled in this prospective study (response rate 49.3%). Data were collected using the Hospital For Special Surgery-Knee Surgery Expectations Survey (HFSS-KSES), items for satisfaction and the Knee injury and Osteoarthritis Outcome Score (KOOS) measures. At one year postoperative follow-up, an individualized questionnaire asked whether the specific person-related expectations had been fulfilled. Satisfaction was high with 83.2% of all participants at one year after surgery. A total of 78% of patients stated they would decide to do the surgery again. This decision was significantly associated with satisfaction, younger age and better KOOS scores scales before surgery for pain, activity and sports. We found high correlations between satisfaction and fulfilment of expectations for the HFES-KSES. Fulfilment of expectations one year after surgery was significantly associated with significant improvements in KOOS scales at one year post-operation. Expectations (1) "to get the knee back to normal status", (2) "improve ability to squat", (3) "improve ability to run", (4) "improve ability to kneel" had been fulfilled worst. A multiple linear regression model for satisfaction had an R2 = 0.797 of the variance. The most influential was the variable fulfilment of "maintain health" that had 70.7% of variance. The fulfilled expectation concerning an improvement of the ability to maintain health was the most influential parameter for satisfaction at one year post-osteotomy. Patients with better health status of the knee and younger age rated the surgery to be more positive and were also more likely to do the surgery again. This provides an indication for an earlier intervention, before the knee and overall health status becomes more detrimental. Level II (Therapeutic study).

Efficacy of ultrasound guided dry needling as an adjunct to conventional physical therapy for patients with jumper's knee: A randomized controlled trial.

Jumper's knee is a degenerative condition among athletes, and it has been treated with conventional physical therapy (CPT). Ultrasound guided dry needling (USG-DN) is a relatively new technique to explore clinical outcomes in patients with tendinopathy. This parallel group, single-blinded randomized controlled trial was carried out involving 94 athletes with clinically diagnosed jumper's knee, divided into an intervention group (USG-DN + CPT, n = 47) and a control group (CPT, n = 47). Participants received a 4-week programme; the intervention group received ultrasound guided patellar tendon dry needling (DN) in conjunction with CPT. The control group received only CPT. The visual analog scale (VAS), Victorian institute of sports assessment-Patellar tendinopathy (VISA-P) questionnaire, Lysholm scale, Knee injury and osteoarthritis outcome score (KOOS) and ultrasonographic features of patellar tendinopathy were evaluated at baseline,1 week, 2 weeks, and 4 weeks. The data were analyzed through SPSS-26. The study found statistically significant differences (P < 0.05) regarding VAS, Lysholm, VISA-P, and KOOS scales at baseline, 1st, 2nd, and 4th week post-intervention. Within-group differences also showed statistically significant results after the intervention. There were significant results observed in ultrasonographic outcomes between both groups at 1 month post-intervention (all P < 0.05). The results of the current study suggest, ultrasound guided DN of patellar tendon in combination with CPT reduced pain, improved function, and showed a tendency to decrease tendon thickness in patients with patellar tendinopathy. (IRCT20210409050913N1). Dated: 17.04.2021. https://www.irct.ir/user/trial/55607/view.

EFFECTIVENESS OF LATERAL WEDGE INSOLE ON KNEE OSTEOARTHRITIS OUTCOMES IN PAKISTANI POPULATION

Background: Osteoarthritis (OA) is a persistent joint disorder, which normally affects the weight bearing joints especially knee joint. Lateral wedge insole is one such approach suggested by professionals to manage the knee osteoarthritis. Objective: To determine the effectiveness of lateral wedge insoles on knee osteoarthritis outcomes in Pakistani population Design: A single-blinded, pretest-posttest comparison. Setting: District Headquarter (DHQ) Hospital, Bahawalnagar and National Institute of Rehabilitation Medicine (NIRM), for a time period of one month. Population: Patients with the age criteria of 40-70 years, and who had knee OA were included in the study. Methods: Participants were randomly divided in two groups; lateral wedge insoles (LWI) group (n=20), and conventional physical therapy (CPT) group (n=20). Pain, stiffness, activities of daily living, sports and recreational activities, and quality of life was assessed on Urdu version of Knee Injury and Osteoarthritis Outcome Score scale (KOOS) on every week till 4th week of intervention. Mixed ANOVA was used for interaction effect of between-subject factor (group) and within-subject factor (time) with-in group analysis and one way ANOVA for between group comparisons with their effect size (ɳp2). Results: Significant improvement with large effect size was observed in Symptoms and stiffness (p&lt;0.001, ɳp2=.329} , pain (p&lt;0.001, ɳp2=.559), functional activities (p&lt;0.001, ɳp2=.394), recreational activities (p&lt;0.001, ɳp2=.369) and quality of life (p&lt;0.001, ɳp2=.280). The CPT group showed more significant improvement (p&lt;0.001) in all domains of KOOS as compared to LWI group. Conclusion: Lateral wedge insoles (LWI) and conventional physical therapy (CPT) both have positive impact on knee osteoarthritis outcomes. But conventional physical therapy was more effective in improving functional independence. Clinical rehabilitation impact: This study provides the evidence on the use of LWI and CPT as alternative strategies to improving Knee OA outcome measures. Keywords: Knee osteoarthritis, functional independence, geriatric population, musculoskeletal physiotherapy, orthotics, quality of life, rehabilitation.

Assessment of the efficiency of arthroscopic laser dual-mode synovectomy in patients with chronic synovitis of the knee joint

BACKGROUND: Osteoarthritis (OA) of the knee joint is a common disease and a significant medical, social, and economic problem. Synovitis can be revealed at all stages of ОА, contributing to the progression of cartilage damage, increased pain, and impaired joint function. In patients with OA, the morphological pattern of the synovial membrane structure has characteristic features, such as hyperplasia, sublimating fibrosis, and stromal vascularization. Laser radiation is widely used in medicine. Exposure of two working wavelengths (0.97 m and 1.56 m) to the synovial membrane may lead to good results in the treatment of synovitis. AIM: This study aimed to improve treatment outcomes in patients with chronic synovitis of the knee joint by applying radiation of two different wavelengths. MATERIALS AND METHODS: Treatment outcomes of 50 patients with chronic synovitis of the knee joint, aged 23 to 67 years, with stages IIIV gonarthrosis according to the KellgrenLawrence classification, were prospectively analyzed. All patients underwent arthroscopic sanation and laser partial synovectomy using LSP-IRE-Polus apparatus (OOO NTO IRE-Polus, Russia), with a wavelength of 0.97 m (pulse 100 ms, pause 50 ms) in a pulsed-periodic mode and 1.56 m with a power of 5 W in a continuous mode. Surveys were conducted preoperatively and at 3, 6, and 12 months postoperatively using the following scales and questionnaires: Visual Analog Pain Scale (VAS), Lequesne index, Western Ontario and McMaster Universities Arthritis Index (WOMAC), and Knee Injury and Osteoarthritis Outcome Score (KOOS). RESULTS: The mean age (Ms) of the study subjects, body mass index, and the duration of synovitis were 45.3213.1, 28.634.72 kg/m2, and 2.261.91 years, respectively. Statistically significant improvements in the VAS, WOMAC, Lequesne, and KOOS scales were observed three months after surgery, whereas much more better results were obtained at six months and remained the same within 12 months after surgery (p 0.05). CONCLUSIONS: The results suggest that the proposed technique could be introduced into clinical practice.

Bone marrow aspirate concentrate versus platelet-rich plasma for treating knee osteoarthritis: a one-year non-randomized retrospective comparative study

BackgroundKnee osteoarthritis (OA) is a debilitating condition affecting human body biomechanics and quality of life. Current standard care for knee OA leads to trivial improvement and entails multiple adverse effects or complications. Recently, investigational cell therapies injected intra-articularly, such as bone marrow aspirate concentrate (BMAC) and platelet-rich plasma (PRP), have shown safety and therapeutic potency providing patients with pain relief. In the current retrospective comparative study, we investigated the differences in pain and functional improvements in patients with symptomatic knee OA receiving intra-articular injections of BMAC vs PRP.MethodsPain and functionality scores were measured at baseline and at different time points post-injection over 12 months, using 3 self-administered, clinically validated questionnaires: the visual analogue scale (VAS) for assessing pain intensity, the knee injury and osteoarthritis outcome score (KOOS) for evaluating functionality and knee-related quality of life, and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) for evaluating physical function. The repeated-measures general linear model with Sidak test for pairwise comparisons was used to investigate the influence of the treatment on the score evolution within groups (between baseline and each time point) and between groups (overall).ResultsThe BMAC group (n = 26 knees) significantly improved in VAS, KOOS, and WOMAC scores between baseline and 12 months (57.4, 75.88, and 73.95% mean score improvement, respectively). In contrast, the PRP group (n = 13 knees) witnessed nonsignificant improvement in all scores. BMAC, in comparison to PRP, induced significant improvement in outcomes by 29.38% on the VAS scale, 53.89% on the KOOS scale, and 51.71% on the WOMAC scale (P < .002, P < .01, P < .011, respectively).ConclusionsIntra-articular autologous BMAC injections are safe, effective in treating pain, and ameliorate functionality in patients with symptomatic knee OA to a greater extent than PRP injections.Graphical abstractIntra-articular autologous BMAC therapy is safe and provides more relief to patients with symptomatic knee osteoarthritis compared to PRP therapy.

Impact of Strengthening and Proprioceptive Exercises on Balance and Activities of Daily Living (ADLS) In Knee Osteoarthritis Patients from West Delhi, Indianpopulation

Background: Knee osteoarthritis (OA)is a chronic joint disease, primarily occurring in aged population. Rehabilitation of knee osteoarthritis aims to reduce pain and disability by strengthening, raising endurance, range of motion, proprioception and improving aerobic fitness. Aim and Objectives: This study aimed to analyse and compare the impact of strengthening and proprioceptive exercises on balance and activities of daily living in knee OAin population of west Delhi, India. Material &amp; Methods- Thirty OA patients were enrolled from Khetarpal hospital, Delhi, after taking ethical approval and informed consent. A study was explained to subjects and data was obtained as per proforma. Age of patients ranged from 50-80 years. Diagnosis was established based on radiological examination shown in the knee joint X-ray. Statistical analysis was performed by using SPSS software (Version 26). Results- Patients treated with the strengthening and proprioceptive exercises showed t-value on Berg balance scale(BBS)as -16.12 and 13.15 respectively, and the parameter of Knee Injury and Osteoarthritis Outcome Score (KOOS) showed -13.21 and 13.481 respectively, were statistically significant. Conclusion-The study groups showed, both the exercises helped reduce pain and improved the balance of daily-based activities. Furthermore, both the groups showed a significant improvement in BBS and KOOS scales.

Effect of Intra-articular Injection of Corticosteroid in the Patients with Osteoarthritis of the Knee - A Hospital-Based Cross-Sectional Study.

Background:Osteoarthritis (OA) of the peripheral joints is frequently related with physical disability and decline in health-related quality of life, deciphering into a significant burden on people and humankind. Although IA corticosteroid injections are being in clinical use, their long-term effects on knee OA are least studied and documented. Hence, the study was done with the aim of assessing the effect of intra-articular (IA) injection of corticosteroid in patients with OA of the knee.Methods:This prospective observational study was conducted over a period of 6 months between 40 years and 75 years with Grade I and II OA of the knee admitted under the Department of Orthopaedics, Tertiary Care Hospital, Belgaum. Patients' affected knee was injected with 80 mg of triamcinolone after the examination, and follow-ups had done at 2 weeks, 6 weeks, 3 months, and 6 months. The standard pro forma used were Visual Analog Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Knee Injury and Osteoarthritis Outcome Score (KOOS).Results:The mean age of the participants was 58.96 ± 9.58, ranging from 40 to 75 years, with a slightly higher proportion of females. The proportion of Grade 1 and Grade II OA was 24% and 76%, respectively, and 54.7% had right-sided involvement. The difference between pre Rx: Pre intervention VAS score VAS score and follow-up periods at 2 weeks, 6 weeks, 3 months, and 6 months was statistically significant with respect to VAS scale, KOOS scale, and WOMAC scale (P < 0.001).Conclusion:there was no major adverse effect of corticosteroid injections, and it showed significant improvement in patients. There is a need to conduct large-scale well-controlled clinical trials with an appropriate control group, to be able to document the relative efficacy and safety of IA steroid injection.

Результаты хирургического лечения переломов надколенника

Introduction Patella fractures account for one percent of all fractures. Arthritis, non-union and other complications which affect the function of the lower limb may develop in the long term. The aim was to develop the most optimal osteosynthesis techniques for patella fractures. Methods We analyzed longterm treatment results of 78 patients with patella fractures treated from 2017 to 2018 using the KOOS (The Knee Injury and Osteoarthritis Outcome Score) scale, clinical examinations and knee joint X-rays. Based on the methods of surgical treatment for patella fractures, we divided the patients into 5 groups: Weber tension band wiring for two-fragment fractures; cross-like osteosynthesis and other methods of patella osteosynthesis using K-wires and wire loops for multifragmental fractures of the patella; combined osteosynthesis (tension band wiring with an additional screw or cerclage around patella); partial patellectomy and the inferior pole osteosynthesis. Results A comparative analysis of patients’ groups after surgical treatment of patella fractures using the KOOS scale showed the best results after Weber tension band wiring for transversal fractures (72 %). The results of patients with multifragmental fractures of the patella using K-wires and wire loops were positive in 64 %; after the restoration of the inferior pole in 68 %, after partial patellectomy in 57 %. Conclusion For transversal fractures of the patella, tension band wiring is the method of choice. With multifragmental patella fractures, good results are achieved by cross-like osteosynthesis and other methods using K-wires and wire bands. The use of patellectomy followed by wire loop locking should be avoided for all types of patella fractures. In fractures of the inferior pole of the patella, it is preferable to fix it to the main patella fragment.

Comparison of intra-articular steroid injection and hyaluronic acid in mono-articular synovitis knee

Introduction: Mono articular presentation of rheumatoid arthritis is infrequent and has been previously reported to involve the hip and knee joints. Rheumatoid arthritis is a common symmetrical chronic inflammatory arthritis with the prevalence of 1% worldwide. Mono- articular rheumatoid arthritis is a rare entity reported to initially affect large joints such as hips and knees, progressing to a poly articular presentation within 3 to 5 years. Synovitis is an important component of rheumatoid arthritis, so we conducted a study to include all the recurrent effusion of knee cases, and we have compared the functional outcome of intra-articular steroid injection and hyaluronic acid in the treatment of such cases. Material and Methods: 40 cases of recurrent effusion of knee joint attending the OPD or emergency services at Government Medical College and Rajindra hospital, Patiala between July 2016 to July 2019 were evaluated with the clinical examination, haematological investigations and radiological investigations. In all the cases, the joint was aspirated with a 16 G Needle and aspirated fluid was sent for pus cultural sensitivity in a microbiology Department of our hospital and was sent for CBNAAT to chest and TB hospital of our hospital. In Group 1, following the aspiration, injection of local corticosteroid (methylprednisolone acetate 80 mg) was given and in group 2, injection of hyaluronic acid was given, followed by a short course of antibiotics for 5 days and short course of non-steroidal anti-inflammatory drugs was given for 10 days and a crêpe bandage was applied for 2 days. The results were assessed by VAS for pain and KOOS (Knee Injury and Osteoarthritis Outcome Score) scores. Results: In all 40 patients, the pus cultural sensitivity was negative for any microorganism and CBNAAT was negative in all the 40 patients. By comparing the results obtained in KOOS scale it was seen that symptoms improved after six months in both steroid (P = 0.017) and HA groups (P = 0.004). Besides, daily activity improved in both steroid (P = 0.027) and HA groups (P = 0.047). On the contrary, pain did not decrease 6 months after intervention in both steroid (P = 0.096) and HA groups (P = 0.17) Conclusion: Mono articular synovitis in an otherwise seronegative patient is due to recurrent inflammatory response due to recurrent stress or any other intra articular pathology. Patients are advised rest, and a short course of steroidal anti-inflammatory drugs, which also helped to relieve the inflammation. This was markedly improved by intra-articular HA injection as shown by the recovery in intra-articular HA injection group as compared to the steroid group.

Safety and efficacy of curcumin versus diclofenac in knee osteoarthritis: a randomized open-label parallel-arm study

BackgroundThe purpose of this study was to compare the efficacy and safety of curcumin with those of diclofenac in the treatment of knee osteoarthritis (OA).MethodsIn this randomized, open-label, parallel, active controlled clinical study, 139 patients with knee OA were randomly assigned to receive either a curcumin 500-mg (BCM-95®) capsule three times daily or a diclofenac 50-mg tablet two times daily for 28 days. Patients underwent assessment at baseline and days 7, 14, and 28. The main outcome measure was severity of pain using visual analogue scale score at days 14 and 28. Knee Injury and Osteoarthritis Outcome Score (KOOS) (at days 14 and 28), anti-flatulent effect (at day 7), anti-ulcer effect, weight-lowering effect, and patient’s and physician’s global assessment of therapy at day 28 were included as secondary outcome measures. Safety after treatment was evaluated by recording adverse events and laboratory investigation.ResultsAt days 14 and 28, patients receiving curcumin showed similar improvement in severity of pain and KOOS scale when compared with diclofenac, and the difference was not statistically significant. At day 7, the patients who received curcumin experienced a significantly greater reduction in the number of episodes of flatulence compared with diclofenac (P <0.01). At day 28, a weight-lowering effect (P <0.01) and anti-ulcer effect (P <0.01) of curcumin were observed. None of the patients required H2 blockers in the curcumin group, and 19 patients required H2 blockers in the diclofenac group (0% versus 28%, respectively; P <0.01). Adverse effects were significantly less in the curcumin group (13% versus 38% in the diclofenac group; P <0.01). Patient’s and physician’s global assessment of therapy was similar in the two treatment groups.ConclusionCurcumin has similar efficacy to diclofenac but demonstrated better tolerance among patients with knee OA. Curcumin can be an alternative treatment option in the patients with knee OA who are intolerant to the side effects of non-steroidal anti-inflammatory drugs.Trial registrationISRCTN, ISRCTN10074826. Registered 21 November 2017 - Retrospectively registered.

МЕТОД РАННЕЙ РЕАБИЛИТАЦИИ И ДИНАМИКА СОДЕРЖАНИЯ С-РЕАКТИВНОГО БЕЛКА В СЫВОРОТКЕ КРОВИ У ПАЦИЕНТОВ ПОСЛЕ ЭНДОПРОТЕЗИРОВАНИЯ КОЛЕННОГО СУСТАВА

The purpose of this study is to study the effect of the implementation of the method of early surgical rehabilitation on the dynamics of the content of C-reactive protein in the serum of patients after knee arthroplasty. Material and methods. The study included: patients’ questioning, analysis of inpatient medical records, postoperative treatment. Fifty patients with stage 3 gonarthrosis were examined according to N.S. Kosinskaya. Patients were subjected to a study that included an examination of an orthopedic traumatologist with a clinical assessment of the patient's condition on the KOOS (The Knee injury and Osteoarthritis Outcome Score) scale. The control of the content of C-reactive protein in serum was performed by immunoturbidimetric analysis at 5 stages of the study. Results. At stage 1, the content of C-reactive protein in the serum of patients in the groups was 1.54 (0.61; 3.65), 14.9 (8.17; 26.3) mg /l, respectively (p> 0.05). At stage 2 of the study, the content of C-reactive protein in groups was 39.58 (19.8; 64.5), 34.55 (23.1; 69.47) mg/l, respectively (p <0.05). At the 3rd stage of the study, the content of C-reactive protein in the groups was 48.06 (27.05, 75.78), 46.2 (21.5; 70.6) mg/l, respectively (p <0.05). At the 4th stage, the C-reactive protein content in the groups was 14.38 (12.8; 19.09), 18.9 (16.5; 34.25) mg/l, respectively (p <0.05). At stage 5, the content of C-reactive protein in the groups was 11.12 (8.05; 21.6), 12.6 (9.6; 19.87) mg/l, respectively (p <0.05). Conclusions. The content of C-reactive protein in the blood serum of patients after total knee arthroplasty reflects the invasiveness of the surgical intervention and the degree of inflammation reduction in the first 10 days after surgery. A decrease in the C-reactive content of up to 40 mg / l 2 days after the operation is the basis for initiating active early rehabilitation activities in the Department of Traumatology and Orthopedics. A prerequisite for the start and implementation of the program of early rehabilitation of patients is the relief of pain; quantification of pain perception can be effectively carried out using the KOOS scale.

Zoledronic acid reduces knee pain and bone marrow lesions over 1 year: a randomised controlled trial

ObjectivesTo compare the effect of a single infusion of zoledronic acid (ZA) with placebo on knee pain and bone marrow lesions (BMLs).MethodsAdults aged 50–80 years (n=59) with clinical knee osteoarthritis...