Knee Pain Research Articles

COVID-19 pandemic: Restrictions and functionality in the knees of physiotherapy students, preliminary study

Background: The COVID-19 pandemic declared by the WHO in 2020 led to restrictive measures that exerted an impact on physical activity, which can affect musculoskeletal health. Objective: The aim of the present study was to analyze the impact of the pandemic on knee pain and functioning among university students influenced by social isolation measures. Methods: An observational, cross-sectional study was conducted at the Evangelical University of Goiás (UniEVANGELICA) with 52 physiotherapy students. Data were collected with the aid of an online questionnaire addressing lifestyle habits, physical activity, knee pain, and functioning using the Lysholm knee score. Data analysis was performed with SPSS 21, using appropriate statistical tests. Results: The chi-square test revealed no significant association between COVID-19 and knee pain, but an apparent relationship was found between physical activity and pain. No significant association was found between COVID-19 and worse walking function, although a tendency was suggested. Discussion: Despite the apparent association between physical activity and pain, the lack of statistical significance indicates the need for more detailed analyses. The present results diverge from those of global studies, underscoring the complexity of the relationship between the pandemic and musculoskeletal health. Limitations of the study include the sample size and self-reporting. Conclusion: This study provides insights into the relationships between COVID-19, knee pain, physical activity, and walking function in university students. Although no significant association was found in some analyzes performed in this study, caution should be exercised when interpreting the results. Further research considering additional variables is recommended to gain a robust understanding of these relationships.

Validity and Reliability of an Arabic Version of the Survey Instrument for Natural History, Aetiology and Prevalence of Patellofemoral Pain Studies: A Cross-Sectional Study.

Knee pain, specifically patellofemoral pain (PFP), may lead to limitations in physical activity and social participation. Identifying knee pain that is attributed to PFP is not an easy job for healthcare professionals. To overcome this issue, The Survey Instrument for Natural History, Aetiology and Prevalence of Patellofemoral Pain (SNAPPS), which is a self-reporting questionnaire instrument, was designed to identify PFP in many languages. However, the Arabic version of the SNAPPS is not validated yet. This study was performed to assess the validity and reliability of the Arabic version of the SNAPPS (A-SNAPPS). A cross-sectional study was conducted to achieve the study goals. To assess reliability, 38 participants were asked to complete the A-SNAPPS two times on the same day with a 30 min break in between. Convergent validity of the A-SNAPPS was assessed by exploring the correlations of the SNAPPS total score with the visual analogue scale (VAS) scores, including VAS for usual pain, VAS for worst pain, and VAS for pain during activities such as jumping, running, ascending and descending stairs, and squatting. The validity test findings suggested that SNAPPS has a strong correlation with the VAS during ascending and descending stairs (r = 0.71) and moderate correlations during jumping (r = 0.54) and squatting (r = 0.57). The test-retest reliability ICC was 0.92, indicating a very strong test-retest reliability of the A-SNAPPS. The A-SNAPPS was cross-culturally adapted and validated, demonstrating very strong reliability.

Arthroplasty at Very High Altitude with Restricted Resources: Our Experience and Review of Literature.

Patients living in high altitudes are often deprived of total knee arthroplasty (TKA) due to logistic reasons, economic, and social challenges in performing surgical procedures for management of knee pain. Surgical procedures in high-altitude dwellers have associated risk of deep venous thrombosis/pulmonary embolism (DVT/PE). In patients undergoing these procedures at lower altitudes, return to high altitudes can cause high-altitude pulmonary edema (HAPE). We share our experience of performing TKA in high-altitude dwellers by setting up a surgical camp at 11,000 feet. A retrospective assessment of patients undergoing total knee arthroplasty at a camp set up at 11,000 feet between 2014 and 2020 was undertaken. Follow-up data of patients which included clinical assessment by the Knee Society Score (KSS) and complications like DVT, infection, residual deformity, etc. were included in the study. Radiographic evaluation to look for evidence of implant loosening was also inculcated. 132 patients (202 knee joints in 50 male and 82 female patients) underwent TKA during annual camps. The average follow-up of patients was 60months. Mean pre-operative KSS was 38, which was increased to 83 at 1-year follow-up post-surgery. There was no evidence of DVT or superficial or deep infection in any patient in the post-operative period. With this study, we want to highlight that total knee arthroplasty can be safely performed at high altitudes and remote areas with limited health facilities. We believe it is a safer and more convenient prospect for the residents of high-altitude regions. III.

Is device-measured physical activity associated with musculoskeletal disorders among young adult Finnish men?

Musculoskeletal (MSK) disorders represent a significant burden to society and can be unpleasant for the affected individuals. Physical activity (PA) can prevent MSK disorders while conferring other health benefits. The present study aimed to investigate associations between device-measured PA and perceived MSK disorders among young adult men. PA at different intensity levels, standing, and sedentary behavior were measured with a hip-worn accelerometer in a cohort of 422 young adult Finnish men aged 26 years on average. The incidences of three common MSK disorders (viz., knee pain, lumbar radicular pain, and lumbago pain) during the last month were inquired by a questionnaire. Binary logistic regression was used to examine the associations between the MSK outcomes and explanatory PA variables (PA times at different intensity levels, standing, and sedentary times). The models were controlled for age, education, smoking, BMI, and maximal oxygen uptake. PA, standing, and sedentary times were not significantly associated with the incidence of perceived MSK pain during the last month, except for lumbago pain. Lumbago pain was slightly more probable if the time spent in light PA increased, even after controlling for potential confounding factors, including moderate-to-vigorous PA, with an odds ratio (OR) of 1.07 (95% CI: 1.02-1.14). Sedentary time showed an opposite association, with an OR of 0.98 (95% CI: 0.96-1.00). There were neither positive nor negative clinically meaningful associations between PA and recent MSK disorders among young adult men. The result is surprising and requires further confirmation.

Correlation Between Coronal Position Sequence of Lumbar and WOMAC Score in Knee Osteoarthritis (KOA) in Standard Standing Position.

Sagittal sequences of the spine have been shown to correlate with knee osteoarthritis (KOA), but coronal sequences and KOA have never been studied before. The study required patients to use a standard standing posture and aimed to explore the relationship between coronal position of lumbar spine and WOMAC score in KOA. This is a cross-sectional observational study. Data on a total of 268 patients with KOA were collected. Patients were photographed in a standard standing position and lumbar-sacrum offset distance (L-SOD) and lumbar-knee offset distance (ΔL-KOD) were calculated. Patients were then divided into different groups according to different critical values and differences were compared. In the L-SOD of L1-3, WOMAC function (P = 0.021, P = 0.032, P = 0.001) and total score (P = 0.039, P = 0.034, P < 0.001) were different. In the L-SOD of L3-4, WOMAC pain score were different (P = 0.001, P = 0.032). At a cutoff of 13mm, ΔL-KOD of L1-2 showed significant differences in pain part (P = 0.025, P = 0.039) and total score (P = 0.036, P = 0.050). There were significant differences in pain (P = 0.023, P = 0.027, P = 0.022), function (P = 0.048, P = 0.038, P = 0.047), and total score (P = 0.030, P = 0.027, P = 0.029) of L3-5. In the 18-mm cutoff group, only L1 and L2have differences in the pain part (P = 0.050, P = 0.038). Coronal balance of the lumbar spine is associated with knee pain and function. The pelvis plays an important role in maintaining the coronal balance. Both the lumbar spine and the knee joint should be considered when developing the surgical strategy.

Observational Study of Growth-Related Knee Pain in Japanese Footballers Aged 12–15 Years: A Subsequent Series Following Children Aged 8–12 Years

This is a subsequent series of studies that examined the factors for growth-related injuries in children aged 8–12 years. We aimed to explore factors associated with growth-related knee pain (GRNP) in Japanese footballers aged 12–15 years. A total of 600 data (200 football players in 7–9th grades) were collected from their parents. Clinical characteristics (age, height, and weight), sports-specific variables (dominant leg, position, and surface), weekly training volume (total days and hours of football), and experience of GRKP (e.g., Osgood–Schlatter disease) within the past 1 year were assessed using a web-based questionnaire. Independent t-tests and chi-square tests were used to investigate the difference between groups with and without GRKP. Logistic regression analyses were also performed to explore risk factors for youth athletes. Additionally, a receiver operating characteristic curve was constructed for the variables used in the logistic regression model. Among junior high school footballers in Japan, 21.0% had experience with GRNP in the past 1 year. Weekly training hours were significantly and positively associated with GRNP (odds ratio, 1.047; 95% confidence interval, 1.016–1.079). The optimal cut-off value for training hours per week was 12.5 h, with low-to-moderate sensitivity (44.4%) and specificity (73.8%). However, clinical and sport-specific characteristics in Japanese footballers aged 12–15 years were not identified as risk factors for recent GRNP. To decrease the risk of GRNP in young Japanese footballers, controlling training volume, which combines adequate recovery or introducing multi-sports events, may be a key strategy for injury prevention.

Spontaneous Osteomyelitis and Intraosseous Abscess: A Case Report.

Acute hematogenous osteomyelitis may have significant morbidity and mortality if undiagnosed. Because it is uncommon in developed countries and has variable presentations, the patient may undergo several healthcare visits prior to diagnosis. We report the case of a 9-year-old male who presented with hip and knee pain with associated fevers and was found to have osteomyelitis and intraosseous abscess in the diaphysis of the right femur. He had multiple emergency department and outpatient visits before the ultimate diagnosis was made. He was treated with irrigation and debridement in addition to intravenous antibiotics. Pediatric acute hematogenous osteomyelitis can have subtle presentations, and this case illustrates some of the difficulties in making the diagnosis. This condition should be considered in the workup of a child with undifferentiated fever, pain, or decrease in mobility.

Home-based circuit training improves blood lipid profile, liver function, musculoskeletal fitness, and health-related quality of life in overweight/obese older adult patients with knee osteoarthritis and type 2 diabetes: a randomized controlled trial during the COVID-19 pandemic

BackgroundThere is strong evidence showing the association between obesity, type 2 diabetes mellitus (T2DM), and knee pain resulting from osteoarthritis. Regular exercise has been reported as a foundational piece of the preventive therapy puzzle for knee osteoarthritis (KOA) patients. Nonetheless, evidence-based exercise protocols for people with comorbidities, such as obesity, T2DM, and KOA are limited. Therefore, the present trial aimed to assess the effectiveness of a 12-week home-based circuit training (HBCT) protocol on various indices related to cardiometabolic health, musculoskeletal fitness, and health-related quality of life (HRQoL) among overweight/obese older adult patients with KOA and T2DM during the COVID-19 lockdown.MethodsThis is a randomized controlled trial study registered at the National Medical Research Register (ID: RSCH ID-21-01180-KGTNMRR ID-21-02367-FUM) and obtained approval on December 9, 2021. Seventy overweight or obese patients with KOA and T2DM (62.2 ± 6.1 years; 56% female) were randomly assigned to the intervention group (n = 35, HBCT) or the no-exercise control group (n = 35, CON). HBCT performed a 12-week progressive protocol (seven exercises; 15–30 repetitions per exercise, 1 min passive rest between exercises; 2–4 rounds per session; 20–60 min total session duration). Blood samples were collected, and assays were performed to assess the lipid profile, liver function, and fasting blood glucose (FBG). In addition, the 30-s Chair Stand Test (30CST) was used to evaluate lower body muscular strength and endurance while the Timed Up and Go (TUG) test was used to evaluate lower limb function, mobility, and the risk of falls for all the participants. HRQoL was assessed using the Osteoarthritis Knee and Hip Quality of Life (OAKHQoL). All the assessments were conducted at pre-, mid-, and post-training stages during the application or practice of the exercise protocol, rather than during the training sessions themselves.ResultsHBCT significantly reduced total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), aminotransferase, alanine aminotransferase, FBG and knee pain (p < 0.05). Furthermore, HBCT induced meaningful increases in high-density lipoprotein (HDL-C), lower body muscular strength, endurance, function, mobility, and HRQoL in overweight/obese older adults with T2DM and KOA (p < 0.05).ConclusionThe present outcomes recommend that an injury-free HBCT program may improve various indicators related to cardiometabolic health, musculoskeletal fitness, and HRQoL in elderly with overweight/obesity, T2DM and KOA. These findings offer valuable insights for clinicians and practitioners seeking evidence-based exercise interventions tailored for patients managing substantial metabolic and musculoskeletal health challenges in clinical practice.

Can preoperative quantitative sensory testing predict persistent post-operative knee pain following total knee replacement?: A systematic review

OBJECTIVE: To investigate whether pre-operative Quantitative Sensory Testing (QST) can identify patients who experience persistent post-operative knee pain following Total Knee Replacement (TKR). DATA SOURCES: PubMed, EMBASE, CINAHL, EBSCO and grey literature. STUDY SELECTION: 1056 studies were retrieved. The title and abstracts were screened by two independent reviewers, of which 45 were retrieved for full text analysis and 16 studies were included. Studies of any design were included if they recruited adults who underwent TKR; completed any component of the German Research Network on Neuropathic Pain QST or conditioned pain modulation testing preoperatively and assessed post-surgical joint pain using a self-reported outcome measure at a minimum of three months post TKR. DATA EXTRACTION: Data was independently extracted by two researchers. Disagreements were resolved through consensus. The extracted data was recorded in a predefined spreadsheet. Domains included demographic data, type and site of QST, pain outcome measure, follow up duration, statistical methods and associative data. Two independent reviewers assessed the quality of studies using Quality in Prognosis risk of bias tool and the certainty of evidence using the GRADE framework. DATA SYNTHESIS: Sixteen cohort studies met the eligibility criteria (n = 2051 patients). Data was analysed narratively because of the heterogeneity across the QST procedures (mechanical and thermal detection and pain thresholds, conditioned pain modulation and temporal summation of pain), measures of reporting pain (Western Ontario and McMaster Universities Osteoarthritis Index, visual analogue scale and numeric pain rating score) and follow up time points (3 to 18 months). CONCLUSIONS: Due to the heterogeneity and low-moderate quality studies included, it remains unclear whether QST can identify patients who are likely to experience persistent postoperative joint pain following TKR.

Patient Self-Management Scale After Total Knee Arthroplasty (PSMS-TKA): Instrument Development and Cross-Sectional Validation Study

BackgroundEffective self-management after total knee arthroplasty (TKA) not only improves patients’ knee pain and physical function but also improves quality of life. However, there is no assessment tool that can be targeted to evaluate the self-management level of patients after TKA. This study aimed to develop and validate a scale to specifically assess the level of self-management in patients after TKA. MethodsThe study was conducted in 2 steps: (1) instrument development and (2) psychological tests (n = 428). For the instrument development portion, scale items were generated through a literature review and semi-structured interviews, then reviewed and revised by a panel of experts, and assessed for content validity and pilot testing. For the psychometric tests component, items were analyzed using corrected item-total scale correlations, the critical ratio method, and Cronbach’s α. Construct validity was evaluated using exploratory factor analysis and validation factor analysis. Criterion correlation validity was checked by calculating Pearson’s correlation coefficient using the Arthritis Self-Efficacy Scale-8 and the scale developed in this study. Internal consistency reliability was evaluated using Cronbach’s α and fold-half reliability, and retest reliability was assessed using intragroup correlation coefficients. ResultsThe Patient Self-Management Scale after Total Knee Arthroplasty (PSMS-TKA) comprises 4 factors and 23 items that assess daily behavior management, disease information management, psychosocial management, and exercise rehabilitation management. Exploratory factor analysis and validation factor analysis yielded a stable 4-factor model for the 23 items. The PSMS-TKA demonstrated good criterion-related validity when using the Arthritis Self-Efficacy-8 as a criterion. The Cronbach’s α of the PSMS-TKA was 0.903, the split-half reliability was 0.934, and the test-retest reliability correlation coefficient was 0.887 (P < .01); thus, the reliability of the scale is good. ConclusionsThe PSMS-TKA developed in this study has good validity and reliability and can be used to assess the level of self-management in patients after TKA. The scale helps healthcare professionals understand the level of self-management of patients undergoing TKA.

Tuina on knee pain and functional decline of lower limbs for patients with mild-to-moderate knee osteoarthritis in Shanghai: protocol for a multicentre, assessor-blinded, randomised controlled trial

IntroductionKnee osteoarthritis (KOA) is one of the most common osteoarthritis, imposing substantial economic and medical burdens on both individuals and society. In China, Tuina has been selected as a complementary...

Reliability and concurrent validity of 30-s and 5-time sit-to-stand tests in older adults with knee osteoarthritis.

Sit-to-stand (STS) movement is fundamental in daily life. STS tasks have been used to assess lower limb muscle strength, balance control, and functional abilities in various populations, but limited information is available on their use in older individuals with knee osteoarthritis. We here examined the intra-rater, inter-rater, and test-retest reliability of the 30-s and 5-time STS tests, and calculated the standard error of measurement (SEM) and minimal detectable change (MDC). Moreover, we explored the concurrent validity of these tests by analysing their correlation with knee muscle strength, pain, stiffness, and physical function in older adults with knee osteoarthritis. This cross-sectional study included 60 older participants diagnosed with knee osteoarthritis. Baseline demographic information and data on pain, stiffness, and physical function using the modified Western Ontario and McMaster Universities Osteoarthritis (WOMAC) were obtained. Participants performed the 30-s and 5-time STS tests as well as knee muscle strength assessment using a hand-held dynamometer. After 1week, 30 participants were reassessed to evaluate test-retest reliability. The 30-s and 5-time STS tests had excellent intra-, inter-, and test-retest reliability (intraclass correlation coefficients: 0.990-1.000, 0.996-0.999, and 0.841-0.853, respectively) with a large SEM and MDC. Both STS tests significantly correlated with knee extensor and flexor strength and all modified WOMAC domains (Pearson's correlation coefficients: 0.28-0.61, p < 0.05). The 30-s and 5-time STS tests are reliable assessment tools and correlate with knee muscle strength, pain, stiffness, and physical function in older adults with knee osteoarthritis. Key Points • The 30-s and 5-time STS test can serve as surrogate measures in various aspects of knee health, including muscle strength, pain levels, stiffness, and overall physical function, in older adults with knee osteoarthritis. • Both these STS tests are dependable tools, accessible for both experienced and inexperienced assessors to administer effectively.

Cartilage oligomeric matrix protein as a potential biomarker for knee osteoarthritis.

This study aimed to determine the expression and clinical significance of a cartilage protein, cartilage oligomeric matrix protein (COMP), in knee osteoarthritis (OA) patients. A total of 270 knee OA patients and 93 healthy controls were recruited. COMP messenger RNA (mRNA) and protein levels in serum, synovial fluid, synovial tissue, and fibroblast-like synoviocytes (FLSs) of knee OA patients were determined using enzyme-linked immunosorbent assay, real-time polymerase chain reaction, and immunohistochemistry. COMP protein levels were significantly elevated in serum and synovial fluid of knee OA patients, especially those in the advanced stages of the disease. Serum COMP was significantly correlated with radiological severity as well as measures of body composition, physical performance, knee pain, and disability. Receiver operating characteristic curve analysis unveiled a diagnostic value of serum COMP as a biomarker of knee OA (41.64 ng/ml, area under the curve (AUC) = 1.00), with a sensitivity of 99.6% and a specificity of 100.0%. Further analysis uncovered that COMP mRNA expression was markedly upregulated in the inflamed synovium of knee OA, consistent with immunohistochemical staining revealing localization of COMP protein in the lining and sub-lining layers of knee OA inflamed synovium. Most notably, relative COMP mRNA expression in knee OA synovium was positively associated with its protein levels in serum and synovial fluid of knee OA patients. In human knee OA FLSs activated with tumour necrosis factor-alpha, COMP mRNA expression was considerably up-regulated in a time-dependent manner. All results indicate that COMP might serve as a supportive diagnostic marker for knee OA in conjunction with the standard diagnostic methods.

A domain-oriented approach to characterizing movement-evoked pain.

Movement-evoked pain (MEP) impacts a substantial proportion of US adults living with chronic pain. Evidence suggests that MEP is influenced by numerous biopsychosocial factors and mediated by mechanisms differing from those of spontaneous pain. However, both characteristic and mechanistic knowledge of MEP remain limited, hindering effective diagnosis and treatment. We asked (1) can chronic pain, functional, psychosocial, and behavioral measures be grouped into descriptive domains that characterize MEP? and (2) what relationships exist between biopsychosocial factors across multiple domains of MEP? We formed 6 characteristic domains from 46 MEP-related variables in a secondary analysis of data from 178 individuals (aged 45-85 years) with knee pain. Ratings of pain during 3 functional activities (ie, Balance, Walking, Chair Stand) were used as primary MEP variables. Pearson correlations were calculated to show linear relationships between all individual domain variables. Relationships between variables were further investigated through weighted correlation network analysis. We observed a unique combination of pain characteristics associated with MEP apart from general pain. Notably, minutes doing physical activity were inversely associated with multiple variables within 4 of the 6 domains. Weighted correlation network analysis largely supported our classification of MEP domains. Additional interdomain relationships were observed, with the strongest existing between MEP, Mechanical Pain, and Multiple Pain Characteristics and Symptoms. Additional relationships were observed both within and between other domains of the network. Our analyses bolster fundamental understanding of MEP by identifying relevant mechanistic domains and elucidating biopsychosocial and interdomain relationships.

Individuals with musculoskeletal conditions awaiting orthopaedic surgery consultation: an untapped opportunity for patient health management?

To describe the health characteristics, condition-specific measures, chronic disease risk factors, and healthcare and medication use over time of individuals with musculoskeletal conditions awaiting orthopaedic surgical consultation. Study importance: Musculoskeletal conditions are highly prevalent in the general population and often coexist with chronic diseases. However, little is documented about the overall health of this group. This study describes the health of these individuals, with particular emphasis on modifiable risk factors of chronic disease. A repeated measures longitudinal cohort study of individuals referred for orthopaedic consultation across three time points (2014, 2015 and 2016). This study was undertaken in the orthopaedic outpatient service of a public tertiary referral hospital in New South Wales, Australia. Participants were aged 18 years and older and were referred for and awaiting orthopaedic surgical consultation for a musculoskeletal condition (back, neck, hand or wrist pain, or hip or knee osteoarthritis). Measures included patient demographics, condition-specific indicators (e.g. pain, disability, quality of life [QoL]) and chronic disease risk factors (e.g., excess weight, smoking). The mean age of participants was 57.7 years, and 7.3% identified as Aboriginal and/or Torres Strait Islander. Back (43.1%) and knee (35.0%) pain were the most prevalent conditions. At baseline (N = 1052), participants reported moderate pain (mean numerical pain rating scale score of 6.4, standard deviation [SD] 2.4) and QoL (Physical Component Score of 32.7, SD 10.7; Mental Component Score of 46.6, SD 13.3). Chronic disease risk factors were highly prevalent, with 74.6% of participants having three or more. For most measures, there were only small changes over time. Individuals with musculoskeletal conditions who are awaiting orthopaedic surgical consultation have a complex clinical picture and numerous chronic disease risk factors. Given the modifiable nature of many of these risk factors, identifying and addressing them before or while awaiting consultation may improve the health of these individuals.

Comparing Knee Kinetics and Kinematics in Healthy Individuals and Those With Knee Osteoarthritis, With and Without Flat Feet.

Individuals with knee osteoarthritis (KOA) and flat feet are more likely to experience increased pain and cartilage damage. This study aimed to investigate the knee kinetics, kinematics, pain, and physical function in individuals with moderate symptomatic KOA, in comparison to asymptomatic control participants. Thirty volunteers with moderate KOA (with flat feet n = 15, with normal feet n = 15) and 30 asymptomatic people (with flat feet n = 15, with normal feet n = 15) were evaluated. The knee adduction angular impulse, knee flexion moment, knee flexion angular impulse, and knee flexion angle were measured during level walking. The pain was assessed in patients with KOA. The study found that individuals with KOA had a significant increase in the knee adduction angular impulse compared with the asymptomatic people (P < .05). The KOA with flat feet group had significantly lower knee flexion moment, knee flexion angular impulse, and knee flexion angle values than the KOA with normal feet group (P < .05). Furthermore, the KOA with flat feet group had a higher pain score than the KOA with normal feet group. Individuals with osteoarthritis and flat feet had lower knee flexion moments which may indicate reduced knee force exerted through compensatory mechanisms. Despite this reduction, they reported significantly higher levels of pain compared with those without flat feet, a finding that warrants further investigation in future studies.

Adaptation of the Oslo Sports Injury and Health Problems Questionnaire to the Bahasa Version and Its Application for Athletes Surveillance

The Oslo Sports Trauma Research Center (OSTRC) questionnaire on injuries and health problems is one of the recommended methods for monitoring athletes’ health problems, but until now it has not been available and validated in a Bahasa version. This study aims to develop the OSTRC Questionnaire into Bahasa and assess its application in adolescent athlete surveillance. The research process is divided into two stages; The adaptation and validity assessment according to ISPOR rules involving 42 adolescent athletes for 2 weeks and the second stage is 8 weeks of surveillance involving 46 adolescent athletes. Results of the analysis found that the Bahasa version of the OSLO Questionnaire for shoulder, knee, ankle, and health problems has good validity and reliability with Cronbach-α 0.905, 0.940, 0.933, and 0.840 respectively. The intraclass correlation coefficient for health problems was 0.905, the shoulder region was 0.94, the knee region was 0.933 and the ankle region was 0.840, with all p-values &lt;0.001. The sensitivity of the health problems questionnaire reached 97.6% and specificity 99.4%, while the sensitivity of the injury questionnaire reached 100% and specificity reached 99.4%. The Bahasa version of OSLO Sports Trauma Research Center Injury and Health Problems is valid and reliable and shows high sensitivity and specificity to detect and separate athletes with injuries or health problems.

CSP2023: 145 - Case report: Digital Musculoskeletal triage and rehabilitation tools enhance accessibility, user experience and outcomes in mechanical knee pain

CSP2023: 145 - Case report: Digital Musculoskeletal triage and rehabilitation tools enhance accessibility, user experience and outcomes in mechanical knee pain

Diminished vibration perception and greater pressure pain sensitivity are associated with worse knee osteoarthritis outcomes across sex and race

ObjectiveTo examine associations of vibration sensitivity and pressure pain sensitivity with knee osteoarthritis (OA) outcomes across sex and race, which may relate to known sex and race disparities in clinical outcomes. DesignData were from the 2013-2015 visit of the Johnston County Osteoarthritis Project. Exposures were vibration perception threshold (VPT) measured at the bilateral medial femoral condyle (MFC) and first metatarsophalangeal joint (MTP), and pressure pain threshold (PPT) measured at the bilateral upper trapezius. Outcomes were knee pain severity and presence of knee symptoms, radiographic knee OA, and symptomatic knee OA in each knee. Cross-sectional associations of the exposures with the outcomes were examined using logistic regression models, overall and separately by sex and race. ResultsIn the VPT and PPT analyses, 851 and 862 participants (mean age 71 years, 68% female, 33% Black, body mass index 31 kg/m2) and 1585 and 1660 knees were included, respectively. Higher VPT (lower vibration sensitivity) at the MFC and first MTP joint was associated with all outcomes. Lower PPT (greater pressure pain sensitivity) was associated with greater knee pain severity. Associations of VPT and PPT with all outcomes were similar among females and males and Black and White individuals. ConclusionsDiminished vibration perception and greater pressure pain sensitivity were cross-sectionally associated with worse knee OA outcomes. Despite differences in VPT and PPT among females and males and Black and White adults, associations with knee OA outcomes did not differ by sex or race, suggesting neurophysiological differences do not relate to established disparities.

Acute patellar dislocation during isokinetic knee strength testing: A case report

Key Clinical MessageIsokinetic testing is a maximal muscle strength test which requires adequate patient's preparation and observer's care. While the available data suggests that isokinetic devices are safe, their use may rarely cause severe injuries. The screening of predisposing anatomical factors could help preventing injuries before testing.AbstractA 29‐year‐old athletic man presented an acute patellar dislocation on a healthy right knee during isokinetic muscle strength testing, which was conducted in the setting of an intensive physical rehabilitation program, for persistent left knee pain after arthroscopic surgery for meniscal tear. This is the first case to occur in an adult male without clear risk factors such as patellar dysplasia. Predisposing factors may include slightly elevated patellar tilt and lateral shift compared to the contralateral knee (researched from subsequent review of pre‐injury X‐rays), and an elevated quadricipital strength in the context of recreational bodybuilding. The dislocation occurred during eccentric extension phase of testing. Medial patellofemoral ligament reconstruction was conducted 6 months later. Isokinetic muscle strength testing is generally considered as a safe method, despite limited data on the devices' safety. Since severe injuries might rarely occur, adequate patient preparation is needed, as well as the screening of predisposing factors.