Knee Pain Research Articles

Research on the biomechanical characteristics of basketball player injuries and their application in sports rehabilitation

Basketball is a dynamic sport, characterized by fast moves, powerful hops, and constant changes in direction, which contributes to its great intensity and excitement. However, these same features elevate athletes to a risk of various types, which include the most common ones such as ligament tears, knee problems, and ankle sprains. The knowledge of the risk factors associated with particular movement patterns and environmental conditions is made possible by knowledge of the biomechanical qualities of these injuries is crucial if one has to develop effective preventive and rehabilitation strategies. The purpose of the study is to establish the biomechanical characteristics of basketball player injuries and their application in sports rehabilitation. The study proposed a novel Tunicate Swarm Optimized Flexible Extreme Boosting (TSO-FXGBoost) to predict the injuries of basketball players and their sports rehabilitation. Player’s motion data capture sessions utilize cameras and sensors to record their biomechanics during basketball activities. A Gaussian filter was employed to process the data to eliminate the noise present in the biomechanical data. Principal component analysis (PCA) served as a dimensionality reduction approach to extract relevant features from the pre-processed data. The results demonstrate that certain biomechanical features have a strong correlation with the occurrence of injuries, which indicates great potential in the strategies of prevention of injuries. In a comparative analysis, the suggested approach performs various assessment metrics such as accuracy (98%), recall (96.2%), precision (98.49%), and F1 score (97.8%). The suggested approach and rehabilitation strategies can be customized to each player’s unique biomechanical profile, improving rehabilitation times and lowering the risk of re-injury.

Workplace-based prevention and management of knee pain: a systematic review.

Knee pain is highly prevalent and disabling among the general and working population. This systematic review explored the effectiveness of workplace-based interventions on knee pain among workers. A PICO-guided systematic search was performed in PubMed and Web of Science Core Collection for articles published from 2003 until January 2023. Eligible articles included randomized and non-randomized controlled trials assessing the effect of workplace-based interventions on knee pain among currently employed adult workers. The quality assessment and evidence synthesis adhered to the systematic review approach, which the Institute for Work & Health developed, and was focused on developing practical recommendations for stakeholders. Of the 13 identified studies, 11 medium- and high-quality studies were entered into the evidence synthesis. Importantly, none of the included studies specifically aimed at reducing of knee pain. Still, among the included studies, a strong level of evidence suggested no benefit of workplace-based physical exercise/activity intervention on knee pain. The level of evidence was deemed too uncertain to guide current policy/practices for ergonomic and multifaceted interventions. No intervention types were associated with negative effects on knee pain. The current evidence-base pertaining to workplace-based prevention and management of knee pain is insufficient to guide effective preventive workplace practice or policy development. Considering the global prevalence and health impact of knee pain, development and implementation of effective workplace interventions aimed at prevention and management of knee pain is needed.

Work-Related Muscluskeletal Disorders and Work Ability Among Hospital Employees in Southeast of Iran

Background: The Work Ability Index (WAI) evaluates how well workers cope with the physical and mental demands of their jobs. Objectives: This study aims to explore how demographic factors and work-related musculoskeletal disorders (WMSDs) influence work ability among employees at the largest specialized hospital in southeast Iran. Methods: This cross-sectional study was conducted at the largest specialized hospital in Zahedan. A sample of 194 clinical staff and support personnel, including nurses, nursing assistants, patient transporters, and cleaning staff, were randomly selected through a stratified random sampling method. Work ability and musculoskeletal discomfort were assessed using the Persian versions of the WAI and Cornell Questionnaires. Quantitative data were presented as mean ± SD, while qualitative data were expressed as numbers and percentages. Pearson correlation, Kruskal-Wallis, Mann-Whitney U, and one- and multi-factor General Linear Models were used for data analysis in SPSS version 19. Results: Work ability decreased with age (P < 0.001). Significant associations were found between work ability and age, job category, education, and Body Mass Index (BMI) (P < 0.05). After adjusting for age, job, education, and BMI, lower back pain (P = 0.002), thigh pain (P = 0.004), and knee pain (P = 0.026) were significantly linked to work ability. There was a notable negative correlation between work ability and discomfort score (r = -0.337, P < 0.001), with nursing assistants reporting higher discomfort scores compared to nurses, cleaning staff, and patient transporters (P < 0.05). Conclusions: Our findings suggest a potential link between musculoskeletal disorders (MSDs) and work ability. Therefore, it is recommended to implement a program focused on identifying and addressing the risk factors associated with MSDs.

Clinical diagnostic study of Ramp lesion of medial meniscus based on knee MRI at 90° flexed position

To evaluate the clinical diagnostic value of knee MRI at 90° flexed position for Ramp lesions of medial meniscus. A total of 228 patients with knee pain as the main complaint who were admitted between September 2021 and September 2023 was selected as the research subjects, of which 51 patients met the selection criteria and were enrolled in the study. There were 31 males and 20 females with an average age of 38.6 years (range, 15-67 years). Body mass index was 17.2-28.7 kg/m 2 (mean, 23.9 kg/m 2). There were 25 cases of left knee and 36 cases of right knee. The time from injury to admission was 0.1-14.3 weeks (mean, 2.1 weeks). Preoperative knee MRI at fully extended position (knee extension position) and 90° flexed position (knee flexion position) were performed to determine the presence of irregular signs at the posterior edge of the medial meniscus, and PHMM fluid high signal [i.e. complete fluid filling between the posterior horn of the medial meniscus (PHMM) and the capsule margin]. Findings obtained under arthroscopy served as the "gold standard" to analyze the sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of MRI at knee extension and flexion positions for the two specific signs of Ramp lesion. Twenty-one patients (41.2%) were diagnosed with Ramp lesions by using arthroscopy, including 1 case of Thaunat type Ⅰ, 2 cases of type Ⅱ, 6 cases of type Ⅲ, 7 cases of type Ⅳ, and 5 cases of type Ⅴ. The positive rates of irregular signs at the posterior edge of the medial meniscus on MRI at knee extension and flexion positions were significantly different from the diagnosis of Ramp injury under arthroscopy ( P<0.05). The sensitivity, specificity, accuracy, PPV, and NPV of MRI in the diagnosis of irregular signs were 76.1%, 60.0%, 66.7%, 57.1%, and 78.3% respectively at knee extension position, and 85.7%, 73.3%, 78.4%, 69.2%, and 88.0% respectively at knee flexion position. The positive rates of PHMM fluid high signal on MRI at knee extension and flexion positions were significantly different from the diagnosis of Ramp injury under arthroscopy ( P<0.05). The sensitivity, specificity, accuracy, PPV, and NPV of MRI in diagnosing PHMM fluid high signal were 38.1%, 100%, 74.5%, 100%, and 69.8% respectively at knee extension position, and 85.7%, 100%, 94.1%, 100%, and 90.9% respectively at knee flexion position. Knee MRI at 90° flexed position improves the diagnostic performance of the detection of medial meniscal Ramp lesions compared with MRI at fully extended position.

Prediction of the potentially suitable areas of Eucommia ulmoides Oliver in China under climate change based on optimized Biomod2 and MaxEnt models

Eucommia ulmoides Oliver is a medicinal plant of significant economic importance. Its cortex has been employed for centuries to alleviate various conditions such as lumbar pain, knee pain, and osteoporosis. Additionally, E. ulmoides possesses substantial industrial value. With the growing demand for this medicinal herb, ensuring its sustainable supply has become imperative. Climate change has caused habitat restrictions or migration of medicinal plants. Therefore, predicting the impact of climate change on the distribution of E. ulmoides is crucial for its conservation and sustainable use. This study evaluated the potential distribution of E. ulmoides across China under various climate change scenarios since the last interglacial period by modeling suitable areas based on 257 distribution records and 19 major environmental factors related to E. ulmoides. The model selection process initially identified the MaxEnt model as the most suitable. The optimized MaxEnt model, with RM = 2.0 and FC = LQHPT settings, generated the most precise predictions. Results indicate that the minimum temperature of the coldest month, annual mean temperature, and annual precipitation significantly affect the distribution of E. ulmoides. Under current environmental conditions, highly suitable areas for E. ulmoides are found in Southwest and Southeast China, with a total suitable habitat area of 23.12 × 104 km2. However, the range of suitable habitat has shifted due to global warming’s negative impact. Under different climate scenarios, suitable areas for E. ulmoides have either increased or decreased, with expansions primarily in high-latitude regions. Future climate scenarios predict shifts in the centroid of suitable E. ulmoides habitat towards Yichang City in Hubei Province. The findings of this study support the development, artificial cultivation, and conservation of E. ulmoides resources.

Working conditions, health status, and musculoskeletal disorders among hospital cleaning workers: a cross-sectional study in Turkey.

Cleaning workers face many workplace risk factors and may experience many health problems. In this context, this study aimed to evaluate the musculoskeletal disorders, the health status of hospital cleaning workers, and the working conditions and risk factors affecting the workplace environment. This cross-sectional study was conducted in a university hospital of Turkey. All the cleaning workers who have been working for ≥1 year were participants. The participants' socio-demographic and occupational characteristics, health complaints, workplace risk factors, occupational accidents, and ergonomic nonconformities were observed and questioned. Four hundred thirty-eight cleaning employees participated in the study. In the past year, 19.6% of participants had an occupational accident. Of those, 24.4% did not report it, and 30.2% were absent from work. No pre-employment examination was reported by 36.8% of the participants, and periodic medical examinations were never undergone by 98.4%. Low back pain was experienced by 42.0% of the participants, while 29.5% reported shoulder pain and 28.8% knee pain. While working, 83.1% of the participants bent frequently, 82.2% repeated the same movement, and 73.2% stood for a long time. Chemical substances were the most common workplace risk factors. There were significant differences according to age and gender in almost all musculoskeletal disorders. Gender differences were observed also in various health outcomes and occupational complaints. Repeated bending and prolonged standing were associated with hip/leg and foot/ankle pains; heavy lifting with low back, back, wrist/hand, and ankle/foot pains; and failure to the breaks with shoulder, knee and hip/leg pains. This research investigated the health issues and occupational safety challenges faced by hospital cleaning personnel. Specifically, it examined musculoskeletal disorders and work-related accidents, emphasizing gaps in regular health screenings for these workers. The findings underscore gender variations in these challenges and propose strategies to mitigate ergonomic risks encountered by cleaning staff. Med Pr Work Health Saf. 2024;75(5).

Effect of experimental knee pain location on gait kinematics.

In this study, we investigated whether experimental knee pain alters lower limb kinematics and knee arthrokinematics during gait, and if this motor adaptation depends on the spatial characteristics of the painful stimulus. Twenty-one participants walked on a treadmill for 60-s trials, either without stimulation or while experiencing painful electrical stimulation in the medial, lateral or anterior region of the knee. Perceived pain location was analyzed using pain drawing. Gait spatiotemporal parameters, lower limb kinematics, and dispersion of the knee helical axes on the sagittal plane were quantified for each trial and compared between conditions using ANOVAs with repeated measures or Friedman tests. Pain perception was localized in the area the stimulation was applied to. Compared to walking without pain, participants demonstrated reduced knee extension (1.5 ± 1.5 degrees, p = 0.002) and reduced hip extension (0.8 ± 1.1 degrees, p = 0.037) when pain was induced in the anterior region, but not medially or laterally. Anterior knee pain increased the mean distance of the helical axes during late stance (0.7 [0.3, 1.4], p = 0.010), while medial pain increased both mean distance (0.3 [0.1, 0.5], p = 0.037) and mean angle (1.2 ± 1.4, p = 0.010) during early swing. Acute, experimental knee pain alters gait kinematics and increases the dispersion of the helical axis. These adaptations depend on the spatial characteristics of the painful stimulus. These adaptations may reflect an attempt of the central nervous system to protect the painful tissue while searching for a less painful movement strategy.

Managing of Post-traumatic Knee Arthritis by Total Knee Arthroplasty: Case Report and Literature Review

Introduction: Post-traumatic knee osteoarthritis (PTOA) develops rapidly after injuries from sports, accidents, or falls. Unlike primary osteoarthritis, PTOA escalates quickly, causing severe joint damage and impairments. Early intervention is crucial to alleviate pain, restore function, and prevent further deterioration. Delayed treatment worsens symptoms and increases the need for invasive procedures like total knee arthroplasty (TKA). Case Presentation: A 29-year-old patient with a year of left knee pain, swelling, and difficulty straightening had no history of rheumatic or autoimmune diseases. Examination showed osteophytes, indicating osteoarthritis. He underwent TKA with no complications, achieving a satisfactory outcome: good range of motion, improved quality of life, and an Oxford Knee Score of 42. Discussion: PTOA typically follows trauma to the joint surface, with severity often correlating with the impact intensity. In this case, the patient’s rapid development of osteoarthritis, despite his young age and lack of pre-existing conditions, may suggest a genetic predisposition. Knee arthroplasty was chosen to restore function, aligning with research showing comparable outcomes for post-traumatic and primary osteoarthritis patients, though post-trauma cases can have higher complication rates due to comorbidities. Conclusion: Effective management of PTOA is crucial due to its rapid progression and significant impact on joint function and quality of life. Early intervention is key to preventing severe damage and reducing the need for invasive treatments. While TKA can be effective, its success depends on the severity of the condition. Timely management and preventive strategies are vital to improving outcomes and maintaining joint health. Keywords: post traumatic osteoarthritis, total knee arthroplasty, quality of life, early intervention, case report

National Institute of Health and Care Excellence Clinical Criteria for the Diagnosis of Knee Osteoarthritis: A Prospective Diagnostic Accuracy Study in Individuals with Type 2 Diabetes.

The National Institute of Health and Care Excellence (NICE) criteria for osteoarthritis (OA) obviate the need for physical exam or imaging, and their use may improve timely diagnosis of OA. However, they have not been validated. Within a larger study of individuals with type 2 diabetes, participants with and without self-reported knee pain underwent assessment of the NICE criteria for knee OA by questionnaire (index test), and clinical evaluation for established or possible knee OA by a rheumatologist (reference standard). We calculated the sensitivity, specificity, likelihood ratio positive (LR+) and likelihood ratio negative (LR-) of the NICE criteria and modified NICE criteria without the stiffness criterion. Our study included 96 participants: mean age 65.4 (SD 8.3) years and 52% were women. Individuals who fulfilled NICE criteria for knee OA (55.2%) included a spectrum of pain severity on a 11-point pain numeric rating scale with a median score of 5 (range: 1-9). Rheumatologist assessment identified 56 (58.3%) participants with symptomatic knee OA. The sensitivity, specificity, LR+, and LR- of NICE criteria for symptomatic knee OA were 0.84 (95% CI 0.74, 0.94), 0.85 (95% CI 0.74, 0.96), 5.6 and 0.19, respectively. For modified NICE criteria, these were 0.89 (95% CI 0.82, 0.97), 0.85 (95% CI 0.74, 0.96), 5.93 and 0.13. The NICE criteria have high sensitivity and specificity for detecting symptomatic knee OA in a population with type 2 diabetes. We found that a modified version, omitting the stiffness criterion, performed similarly. These criteria should be validated in other settings and populations.

Extra-Axial Poorly Differentiated Chordoma Initially Misdiagnosed as Epithelioid Sarcoma.

Poorly differentiated chordoma is an exceedingly rare, aggressive subtype of chordoma. These tumors typically arise in the axial skeleton of young patients, most commonly the skull base, followed by the cervical spine. Herein, we present a 60-year-old patient with longstanding knee pain and nondiagnostic imaging, initially thought to be due to osteoarthritis. No discrete mass-forming lesion was identified by radiology. Synovial histology at the time of arthroplasty revealed a multinodular proliferation of epithelioid-to-histiocytoid cells with a moderate amount of eosinophilic-to-clear, vacuolated cytoplasm. Scattered cells with high-grade nuclear atypia were present. A diagnosis of metastatic carcinoma was considered due to immunohistochemical positivity for keratin and GATA3. However, a diagnosis of epithelioid sarcoma was rendered based on clinical context, morphology, and loss of immunohistochemical expression for SMARCB1 (INI1). However, upon re-review of the tumor, brachyury was retrospectively added to the immunohistochemistry panel and showed strong positivity, thus prompting amendment of the initial diagnosis of epithelioid sarcoma to extra-axial poorly differentiated chordoma. Given the rarity of this diagnosis, molecular testing was performed which revealed a unique SMARCB1 molecular profile with a single-nucleotide variant in addition to the commonly reported loss of chromosome 22q. This report of an ultra-rare sarcoma in an uncommon anatomic site highlights multiple potential pitfalls in the diagnosis of poorly differentiated chordoma, emphasizes the importance of brachyury immunohistochemistry in rendering a correct interpretation, and underscores an opportunity for further molecular analysis to better define the molecular profile of this entity.

MRI-guided neurolysis for the treatment of chronic refractory knee pain: a case report.

Chronic refractory pain poses a significant challenge in knee joint pathologies, especially after exhaustion of conservative, arthroscopic, and endoprosthetic therapy options. This case report illustrates an innovative approach using MRI-assisted chemical neurolysis of a genicular nerve to manage persistent knee pain after arthroscopy. A 62-year-old male patient with chronic refractory knee pain, primarily localized at the inferomedial part of the knee, underwent high-resolution MRI to visualize the genicular nerves. This allowed for targeted ethanol-based neurolysis of the inferomedial genicular nerve. Following the procedure, the patient experienced substantial pain reduction for the follow-up duration of 4months. The successful use of MRI-assisted chemical neurolysis offers a promising alternative treatment for patients with refractory knee pain, providing long-lasting pain relief without major side effects. This technique has the potential to improve the quality of life for patients suffering from chronic knee pain While these initial results are encouraging, it is important to note that further research, including both short-term and long-term studies, as well as randomized controlled trials, is warranted to establish the efficacy and safety of this treatment method in broader populations before it can be considered for routine incorporation into pain management practices.

A combined approach of design for Six Sigma, generic product development process and ergonomics-safety philosophy to reduce musculoskeletal disorder problems

Purpose The purpose of this paper is to decrease musculoskeletal disorder (MSD) problems using a combined approach including design for Six Sigma, generic product development process, and ergonomic-safety philosophies. Design/methodology/approach A total of 550 students voluntarily participated in this study. Kolmogorov–Smirnov and t-tests were used to analyze the collected anthropometry. A cause-and-effect diagram, Pareto’s chart, a brainstorming session, and a priority matrix were also used to extract the 22 design parameters of the product. Moreover, Cronbach’s alpha values were determined to verify the validity of qualitative and quantitative data. Findings Results showed that students are at a high risk of developing MSD issues. The most serious MSD problems among the students were neck pain (74%), back pain (73%), muscle and joint pain (67%), knee pain (57%), leg pain (54%), etc. Besides, all anthropometrics of males are higher than females except Hip Breadth. Among 12 anthropometries, two measurements and one measurement showed statistical significance at p &lt; 0.01 and p &lt; 0.05, respectively. Six design parameters of the mounted desktop (Seat Height, Desk Height, Seat to Desk Clearance, Seat Width, Seat Depth, and Backrest Height) are the most crucial design parameters to design and develop the product. Practical implications The proposed design of the mounted desktop can be used in different tertiary educational institutes to reduce MSDs among students. Originality/value To the best of the authors’ knowledge, this is the first attempt that introduces a combined approach to reduce MSD issues by applying Six Sigma, a generic product development process, and ergonomics-safety philosophy to design and measurement of 22 design parameters of mounted desktop for university students.

The analgesic effect of continuous adductor canal block combined with popliteal plexus block for total knee arthroplasty: a randomized controlled trial.

This study aimed to confirm the hypothesis that continuous ACB (CACB) combined with a popliteal plexus block (PPB) can improve posterior knee pain, reduce nalbuphine consumption, and shorten the length of hospital stay. Patients who underwent TKA were allocated to the CACB + sham block (SHAM) or CACB + PPB groups. The primary outcome was the maximum pain score originating from the posterior knee within 4h after TKA. Secondary outcomes included the maximum pain score originating from the posterior and anterior knees within 72h after TKA, range of motion on postoperative day (POD) 1-3, postoperative nalbuphine consumption within 72h of surgery, length of hospital stay, and complications. The maximum pain score of the posterior knee was lower in the CACB + PPB group than in the CACB + SHAM group within 0-12h after surgery. Nalbuphine consumption within 24h after surgery was lower in the CACB + PPB group than in the CACB + SHAM group. The range of motion was better in the CACB + PPB group than in the CACB + SHAM group on POD1 and 2. The length of hospital stay was shorter in the CACB + PPB group than in the CACB + SHAM group. The incidence of clinical significant nausea and vomiting was lower in the CACB + PPB group than in the CACB + SHAM group. This study found that PPB combined with CACB could relieve pain in the posterior knee within at least 12h after TKA, reduce nalbuphine consumption within 24h after TKA, improve the range of motion on POD1 and 2, and shorten the length of hospital stay for patients who underwent TKA.

Advanced Non-Operative Interventions for Anterior Knee Pain.

This review presents evidence for advanced non-operative interventions, including extracorporeal shockwave therapy (ESWT), prolotherapy, platelet-rich plasma (PRP), adipose tissue-derived cells, bone marrow aspirate concentrate, various additional non-corticosteroid injectates, and needle-based interventions for common causes of anterior knee pain in the adult population. These etiologies include osteoarthritis of the knee, patellofemoral pain syndrome, chondromalacia patella, Hoffa fat pad impingement syndrome, patellar/quadriceps tendinopathy, and prepatellar bursitis. This review discusses patient care options using a case-based understanding of interventions by condition while recognizing strength of evidence. ESWT and PRP are the most robustly studied and have greatest evidence for treating tibiofemoral osteoarthritis and for long-term benefit in treating patellar tendinopathy. PRP may have evidence for treatment of chondromalacia and prolotherapy for management of tibiofemoral arthritis; both have limited evidence. Botulinum neurotoxin type A has strong evidence to support use in treating patellofemoral pain syndrome. There is limited evidence to support the use of viscosupplementation, percutaneous needle tenotomy, and medicinal signaling cell-based therapies beyond platelet-rich plasma for anterior knee pain. There is limited research on the management of quadriceps tendinopathy, prepatellar bursitis, patellofemoral osteoarthritis, and Hoffa's fat pad impingement syndrome. Further research and standardization of protocols are necessary to fully assess these treatments' efficacy. ESWT, cell-based, and needle-based interventions, may serve as effective treatment options for patients with anterior knee pain. Selection of each intervention requires understanding the evidence, level of risk, and appropriate application based on a patient's level of activity to enable clinicians to enhance patient outcomes and quality of life.

Morphometric evaluation of the proximal tibiofibular joint among patients with knee joint pain: A pilot study and literature review

Objectives: The proximal tibiofibular joint (PTFJ) serves as a crucial stabilizing component of the entire knee joint complex. Morphometric analysis of the PTFJ can lead to clinically significant conclusions for orthopedic specialists and physiotherapists. The aim of the study was to assess the values of the inclination angle of the PTFJ in the sagittal and coronal planes using magnetic resonance imaging in patients with knee pain. Material and Methods: Measurements of the inclination angle were conducted on 48 patients divided into three groups: Those with damaged medial meniscus (M), those with knee joint cartilage damage (Ca), and the control group (C), in which no deviations from normality were observed in the analyzed imaging study. Results: The mean values of the tibiofibular joint inclination angle in the frontal plane were as follows: (C) 16.927° ± 1.778; (Ca) 16.822° ± 2.537; (M) 14.958° ± 1.760. In the sagittal plane, the corresponding values were: (C) 38.155° ± 1.524; (Ca) 39.392° ± 1.927; (M) 37.471° ± 1.165. Although the mean tibiofibular joint inclination angle was lowest in the group with medial meniscus injury when compared to the control group, these differences did not reach statistical significance. Conclusion: Measuring and observing the variety of PTFJ inclination angles among patients are conducive to better understanding its influence on knee pain. The differences in the PTFJ inclination angle between groups in our pilot study were not statistically significant. Consequently, the study necessitates replication within a substantial population cohort.

Knee pain improvement after genicular artery embolization for the management of knee osteoarthritis: an updated systematic review and meta-analysis of 21 studies.

Knee osteoarthritis is aprogressive inflammatory musculoskeletal disease with aprevalence of approximately 15-23% and limited treatment options. In recent years, transcatheter genicular artery embolization (GAE) has been proposed due to promising results concerning symptomatic knee pain relief and mobility. This systematic review and meta-analysis aimed to evaluate the aggregated data on the safety and efficacy of GAE for pain reduction in the treatment of knee osteoarthritis. Asystematic search of the three major databases (MEDLINE, Embase, and CENTRAL) from inception to 27February 2024 was conducted according to the PRISMA guidelines. Studies reporting pain reduction according to the Visual Analogue Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)-Total, WOMAC-Pain, and Knee Injury and Osteoarthritis Outcome Score (KOOS)-Pain scales and adverse event rates were included. Meta-analysis was performed by estimating the mean differences and by fitting random-effect models. Overall, 21studies were included, comprising of 633 patients and 758 knees treated. The combined data analysis showed that patients who underwent GAE demonstrated mean declines in the VAS score of -38.5 points (95% confidence interval [CI]: -44.9, -32.0) at 1month, -36.2 points (95%CI -43.0, -29.5) at 3months, -40.3 points (95%CI: -49.0, -31.7) at 6months, and -40.5 points (95%CI: -54.5, -26.6) at 12months. Similarly, significant differences at all time points were also found for the WOMAC-Total, WOMAC-Pain, and KOOS-Pain scores. No difference between permanent and non-permanent embolic material was found in the subgroup analysis for all time points. Genicular artery embolization is safe and effective for the treatment of painful knee osteoarthritis. This result was not affected by the type of embolic material used (permanent vs. non-permanent).

Psychometric properties of the Thai version of the Simple Knee Value in patients with patellofemoral pain

Purpose This study aimed to translate the Simple Knee Value (SKV) into Thai and evaluate its psychometric properties as a single-question assessment tool. Methods The SKV was translated into Thai according to international guidelines. Psychometric properties were assessed in adults aged 18–50 years with patellofemoral pain. Participants completed questionnaires at baseline, 2 weeks, and 2 months. Results Seventy-six patients with patellofemoral pain (mean age 36.8 ± 8.3 years, 56.6% female) participated in this prospective cohort study. SKV scores were moderately correlated with those of the Knee Injury and Osteoarthritis Outcome Score–Patellofemoral Subscale (KOOS-PF) and the Anterior Knee Pain Scale (AKPS). The test-retest reliability was high, with an intraclass correlation coefficient of 0.79 (95% confidence interval: 0.65–0.88). The SKV change scores effectively differentiated between improved and unimproved patients, with a minimal important change of 12.5 points. Conclusions The SKV demonstrated acceptable psychometric properties for assessing patellofemoral pain in young to middle-aged adults. This single-question patient-reported outcome measure is simple and easy to use in daily clinical practice and can serve as an adjunctive assessment tool in patellofemoral pain research.

Association of Flat Feet with Knee Moments and Western Ontario and McMaster Universities Arthritis Index in Knee Osteoarthritis

Introduction: Flat feet are prevalent among individuals with medial compartment knee osteoarthritis (KOA), showing a correlation with elevated knee pain and cartilage degeneration. This study investigates the relationship between calcaneal eversion angle (CEA) and medial longitudinal arch angle (MLAA) with knee kinetics and pain. Materials and Methods: This analytical observational study included 30 volunteers with moderate KOA. The Vicon motion analysis system and two synchronized force plates were employed to capture level walking and the static standing position to measure CEA and MLAA. The study assessed the first and second peaks of the knee adduction moment, knee adduction moment impulse, peak knee flexion moment, and the peak knee flexion angle at heel strike (PKFA-HS). The Western Ontario and McMaster Universities arthritis index (WOMAC) pain and physical function were evaluated. Results: A significant positive correlation was found between CEA and the knee pain sub-score (Pearson correlation [PC]=0.446, P=0.011) and WOMAC total score (PC=0.363, P=0.049). Additionally, a significant negative correlation was observed between CEA and peak knee flexion moment/PKFA-HS (PC=-0.418, P=0.022, and PC=-0.479, P=0.001, respectively). The results also indicated a negative significant correlation between MLAA and WOMAC pain sub-score (PC=-0.389, P=0.034). Conclusion: Increased CEA and decreased MLAA are associated with elevated WOMAC pain sub-score and decreased PKFA-HS in individuals with moderate KOA. Addressing flat feet should be considered in KOA management to enhance pain relief and functional outcomes

Investigating the Correlations between Patient Demographics and Complications Following Total Knee Arthroplasty: A Cross-Sectional Study

Introduction: This study investigates the relationship between patient age, gender, and various complications, such as pain, restricted range of motion (ROM), and hemorrhage following total knee arthroplasty. Materials and Methods: This cross-sectional study included 62 patients (Mean±SD age= 65.9±7.38 years; female participants=74.2%) who underwent total knee arthroplasty at Atieh Hospital in Tehran, Iran, between 2020 and 2021. Pain levels were assessed using the numerical pain rating score. Meanwhile, knee joint ROM was evaluated using a reliable mobile application. Hemorrhage was measured through knee joint drainage. Statistical analyses were performed to analyze the data. Results: Women reported higher pain levels and more restricted ROM in passive knee extension and active/passive knee flexion compared to men (P&lt;0.05). However, no significant differences were observed between genders in active knee extension and hemorrhage. A significant inverse correlation was found between pain and ROM in passive knee extension (rho=-0.41, P≤0.001), as well as in active (rho=-0.5, P≤0.001) and passive knee flexion (rho= -0.59, P≤0.001). However, no significant relationship was observed between pain and active knee extension or hemorrhage. Age showed no statistically significant correlation with the other variables. Conclusion: This study highlights the association between higher pain levels and greater ROM restrictions in passive knee extension and active/passive knee flexion following total knee arthroplasty; however, patient age and gender were not found to be associated with postoperative hemorrhage. These findings underscore the importance of closely monitoring pain and ROM, particularly in women undergoing total knee arthroplasty.

THE RELATIONSHIP OF POSTERIOR TIBIAL SLOPE WITH CRUCIATE LIGAMENTS AND MENISCAL INJURIES BASED ON MRI– A PROSPECTIVE OBSERVATIONAL STUDY

Purpose: Various studies show that the disparities in the posterior tibial slope can make native cruciate ligaments and the menisci susceptible to tears. This study is to determine the relationship between posterior tibial slope with the anterior cruciate ligament, posterior cruciate ligament and meniscal injuries. Methods: A total of 72 subjects between 18 and 60 years having a history of traumatic knee pain were included in the study. All subjects were clinically examined, radiologically investigated, and the posterior tibial slope of the patients was calculated. Incidences of cruciate ligaments and menisci injury were identified. Results: In our study, the mean medial compartment posterior tibial slope and lateral compartment posterior tibial slope in all the Anterior Cruciate Ligament injured patients are 7.82 ± 2.56 and 10.53 ± 3.46. But in controls, it is 5.91 ± 4.49 and 6.24 ± 5.15, respectively. The differences are statistically significant ([Formula: see text]10). In cases with increased lateral Posterior Tibial Slope, more degeneration was seen in the lateral meniscus. Less Posterior Tibial Slope is associated with Posterior Cruciate Ligament tears. Conclusion: Anterior cruciate ligament is more prone to tears with a steeper posterior tibial slope. Lateral Meniscus tear is frequently associated with acute Anterior Cruciate Ligament injury and Medial Meniscus tear is predominantly associated with a chronic Anterior Cruciate Ligament injury. A decreased posterior tibial slope is more often associated with patients with a posterior cruciate ligament injury and is considered a risk factor for native Posterior Cruciate Ligament.