Knee Joint Pathology Research Articles

Multi-Scale Analysis of Knee Joint Acoustic Signals for Cartilage Degeneration Assessment

This study focuses on the diagnostic analysis of cartilage damage in the knee joint based on acoustic signals generated by the joint. The research utilizes a combination of advanced signal processing techniques, specifically empirical mode decomposition (EEMD) and detrended fluctuation analysis (DFA), alongside convolutional neural networks (CNNs) for classification and detection tasks. Acoustic signals, often reflecting the mechanical behavior of the joint during movement, serve as a non-invasive diagnostic tool for assessing the cartilage condition. EEMD is applied to decompose the signals into intrinsic mode functions (IMFs), which are then analyzed using DFA to quantify the scaling properties and detect irregularities indicative of cartilage damage. The separation of individual frequency components allows for multi-scale analysis of the signals, with each of the functions resulting from the analysis reflecting local variations in the amplitude and frequency over time and allowing for effective removal of noise present in the signal. The CNN model is trained on features extracted from these signals to accurately classify different stages of cartilage degeneration. The proposed method demonstrates the potential for early detection of knee joint pathology, providing a valuable tool for preventive healthcare and reducing the need for invasive diagnostic procedures. The results suggest that the combination of EEMD-DFA for feature extraction and CNN for classification offers a promising approach for the non-invasive assessment of cartilage damage.

PREOPERATIVE PLANNING OF ARTHROSCOPIC SYNOVECTOMY IN PATIENTS WITH KNEE INJURIES AND CONCOMITANT PATHOLOGY

Knee joint pathology poses a significant challenge in modern orthopaedics, driven by the rising incidence of traumatic injuries and their frequent association with comorbid conditions. Epidemiological data report an annual knee injury incidence of 5.3 per 1,000 population, with approximately 40% of cases progressing to synovitis. The presence of comorbidities significantly influences disease progression and treatment outcomes, underscoring their clinical importance. This study aimed to identify key factors affecting the quality of preoperative planning for arthroscopic synovectomy, with a focus on individual patient characteristics and the specific nature of concomitant pathologies. This study included 97 patients (2020–2024), categorized into two groups: traumatic pathology (n = 50) and degenerative pathology (n = 47). The assessment protocol comprised clinical evaluation using the Knee Injury and Osteoarthritis Outcome Score, magnetic resonance imaging analysis based on the Whole-Organ Magnetic Resonance Imaging Score and the Boston Knee Osteoarthritis Scoring System, inflammatory marker measurements, and comorbidity profiling. Statistical analysis revealed significant variations in synovitis severity and functional parameters correlating with comorbidity patterns. The concurrent presence of grade II- III hypertension and diabetes mellitus demonstrated the most adverse clinical profile, characterized by maximum synovitis scores (2.0 points by the Whole-Organ Magnetic Resonance Imaging Score) and severely compromised functional parameters (35.9±1.2 points by the Pain subscale of Knee Injury and Osteoarthritis Outcome Score). The study has established key risk factors for severe synovitis and developed a comprehensive risk stratification system, categorizing patients into low-, moderate-, and high-risk groups, facilitating the implementation of individualized preoperative management strategies tailored to their comorbidity profiles.

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.

Knee joint pathology and efferent pathway dysfunction: Mapping muscle inhibition from motor cortex to muscle force

BackgroundDysfunction in efferent pathways after knee pathology is tied to long-term impairments in quadriceps and hamstrings muscle performance, daily function, and health-related quality of life. Understanding the underlying etiology is crucial for effective treatment and prevention of poor outcomes, such as post-traumatic osteoarthritis or joint replacement. ObjectivesTo synthesize recent evidence of efferent pathway dysfunction (i.e., motor cortex, motor units) among individuals with knee pathology. DesignCommentary. MethodWe summarize the current literature investigating the motor cortex, corticospinal tract, and motoneuron pool in individuals with three common knee pathologies: anterior cruciate ligament (ACL) injury, anterior knee pain (AKP), and knee osteoarthritis (OA). To offer a complete perspective, we draw from studies applying a range of neuroimaging and neurophysiologic techniques. ResultsAdaptations within the motor cortices, corticospinal tract, and motoneuron pool are present in those with knee pathology and underline impairments in quadriceps and hamstrings muscle function. Each pathology has evidence of altered motor system excitability and reduced volitional muscle activation and force-generating capacity, but few impairments were common across ACL injury, AKP, and OA studies. These findings underscore the central role of the motor cortex and motor unit behavior in the long-term outcomes of individuals with knee pathology. ConclusionsAdaptations in the efferent pathways underlie persistent muscle dysfunction across three common knee pathologies. This review provides an overview of these changes and summarizes key findings from neurophysiology and neuroimaging studies, offering direction for future research and clinical application in the rehabilitation of joint injuries.

Effectiveness of Practical Skills Training on the Original Design Knee Joint Phantom

Background. Simulation training is a crucial aspect of intern training in Orthopedics surgery. Providing a practical and reproducible training environment, it helps interns avoid critical errors when working with future patients. Objective. The objective of our study was to design, manufacture, implement in education course and evaluate the effectiveness of a knee joint phantom for training knee joint puncture. Material and Methods. The knee joint phantom was created using Fusion 360 software and was printed using FDM technology on a Tevo Tarantula Pro printer with a Cura slicer with an insert container capable of repeated filling with various imitated liquids. To achieve a higher level of realism, the soft tissues were fully replicated. The phantom was fixed on two supports under the femoral and knee segments with a hinge, which provides the possibility of movements in the joint at different angles. 30 ordinators were involved in the study and divided into two groups: group I included 15 ordinators who conducted training on a knee model from the beginning of the 2nd year; group II consisted of 15 ordinators who conducted training from the beginning of the 1st year. The effectiveness of practical training was evaluated through statistical analysis of the results of OSCI, with a phantom being used. Results. The mean score was 3.9±2.7 and 4.8±2.8 in group I and group II, respectively, with the maximum possible result of 5.5, which indicates the effectiveness of simulation training with the help of a manufactured knee joint phantom. A small number of participants were included in the study, so no significant difference in learning outcomes between the comparison groups was established (p=0.09492). Conclusions. Simulation training with a knee phantom is an efficient method for educating orthopedic surgeons on how to perform manipulations on the knee joint. This training also aids in identifying those who have acquired the skill at a lower level. This approach can prevent potential errors when performing manipulations and minimize complications in the treatment of patients with knee joint pathology.

Tujia medicine Toddalia asiatica improves synovial pannus in rats with collagen-induced arthritis through the PI3K/Akt signaling pathway

To investigate the therapeutic mechanism of Tujia medicine Toddalia asiatica alcohol extract (TAAE) for synovial pannus formation in rats with college-induced arthritis (CIA). Sixty male SD rats were randomized into normal control group, CIA model group, TGT group, 3 TAAE treatment groups at low, medium and high doses (n=10). Except for those in the normal control group, all the rats were subjected to CIA modeling using a secondary immunization method and treatment with saline, TGT or TAAE by gavage once daily for 35 days. The severity of arthritis was assessed using arthritis index (AI) score, and knee joint synovium pathologies were examined with HE staining. Serum levels of TNF-α, IL-6, and IL-1β were detected with ELISA; the protein expressions of PI3K, Akt, p-PI3K, p-Akt, VEGF, endostatin, HIF-1α, MMP1, MMP3, and MMP9 in knee joint synovial tissues were determined using Western blotting, and the mRNA expressions of TNF‑α, IL-6, IL-1β, VEGF, HIF-1α, PI3K, and Akt were detected with RT-PCR. Treatment of CIA rat models with TAAE and TGT significantly alleviated paw swelling, lowered AI scores, and reduced knee joint pathology, neoangiogenesis, and serum levels of inflammatory factors. TAAE treatment obviously increased endostatin protein expression, downregulated p-PI3K, p-Akt, MMP1, MMP3, MMP9, VEGF, and HIF-1α proteins, and reduced TNF‑α, IL-6, IL-1β, PI3K, Akt, VEGF, and HIF-1α mRNA levels in the synovial tissues, and these changes were comparable between high-dose TAAE group and TGT group. TAAE can improve joint symptoms and inhibit synovial pannus formation in CIA rats by regulating the expressions of HIF-1α, VEGF, endostatin, MMP1, MMP3, and MMP9 via the PI3K/Akt signalling pathway.

PARAMETERS OF THE INTERCONDYLAR FOSSA OF THE FEMUR IN CHILDRENIN NORMAL CONDITIONS AND WITH CONGENITAL MALFORMATIONS OF THE LOWER LIMBS

According to literature sources, radiography can indirectly visualize congenital insufficiency of the cruciate ligaments both in isolated form and in combination with other congenital malformations of the lower extremities. Objective. To study the parameters of the intercondylar fossa of the femur in children of different age groups with stable/unstable knee jo ints due to congenital malformations of the lower limbs using instrumental imaging methods. Methods. A prospective diagnostic study was conducted of 359 knee joints of 217 children who were treated at the pediatric orthopedics clinic from 2019to 2022 and with a retrospective control group (2010–2021). limbs, as well as with congenital malformations of the lower limbs. X-ray examinations were performed on the OPERA T90cex X-ray and fluoroscopic system. Results. 217 patients took part in the study, including 105 patients without knee jointpathology and 112 with congenital malformations of the lower limbs. Comparison of the accuracy of radiological diagnostic indicators was performed using the Studentʼs t-test with the results of computer and magnetic resonance imaging studies, which showed the absence of a statistically significant differencein the results research. A diagnostic study was also conducted to find the regularity of the development of the knee joints and to identify the parameters of the radiological norm of the development of the intercondylar fossa of the femur in children of different age categories. Conclusions. Using the resultsof instrumental studies, the parameters of the intercondylar fossa of the femur in children of different age categories with stable and unstable knee joints due to congenital malformations of the lower limbs were investigated. The results of the study should be taken into account for the diagnosis of congenital defects of the knee joint.

Two for One-Combined Morphologic and Quantitative Knee Joint MRI Using a Versatile Turbo Spin-Echo Platform.

Quantitative MRI techniques such as T2 and T1ρ mapping are beneficial in evaluating knee joint pathologies; however, long acquisition times limit their clinical adoption. MIXTURE (Multi-Interleaved X-prepared Turbo Spin-Echo with IntUitive RElaxometry) provides a versatile turbo spin-echo (TSE) platform for simultaneous morphologic and quantitative joint imaging. Two MIXTURE sequences were designed along clinical requirements: "MIX1", combining proton density (PD)-weighted fat-saturated (FS) images and T2 mapping (acquisition time: 4:59 min), and "MIX2", combining T1-weighted images and T1ρ mapping (6:38 min). MIXTURE sequences and their reference 2D and 3D TSE counterparts were acquired from ten human cadaveric knee joints at 3.0 T. Contrast, contrast-to-noise ratios, and coefficients of variation were comparatively evaluated using parametric tests. Clinical radiologists (n = 3) assessed diagnostic quality as a function of sequence and anatomic structure using five-point Likert scales and ordinal regression, with a significance level of α = 0.01. MIX1 and MIX2 had at least equal diagnostic quality compared to reference sequences of the same image weighting. Contrast, contrast-to-noise ratios, and coefficients of variation were largely similar for the PD-weighted FS and T1-weighted images. In clinically feasible scan times, MIXTURE sequences yield morphologic, TSE-based images of diagnostic quality and quantitative parameter maps with additional insights on soft tissue composition and ultrastructure.

Methodology for Robotic In Vitro Testing of the Knee.

The knee joint plays a pivotal role in mobility and stability during ambulatory and standing activities of daily living. Increased incidence of knee joint pathologies and resulting surgeries has led to a growing need to understand the kinematics and kinetics of the knee. In vivo, in silico, and in vitro testing domains provide researchers different avenues to explore the effects of surgical interactions on the knee. Recent hardware and software advancements have increased the flexibility of in vitro testing, opening further opportunities to answer clinical questions. This paper describes best practices for conducting in vitro knee biomechanical testing by providing guidelines for future research. Prior to beginning an in vitro knee study, the clinical question must be identified by the research and clinical teams to determine if in vitro testing is necessary to answer the question and serve as the gold standard for problem resolution. After determining the clinical question, a series of questions (What surgical or experimental conditions should be varied to answer the clinical question, What measurements are needed for each surgical or experimental condition, What loading conditions will generate the desired measurements, Do the loading conditions require muscle actuation) must be discussed to help dictate the type of hardware and software necessary to adequately answer the clinical question. Hardware (type of robot, load cell, actuators, fixtures, motion capture, ancillary sensors) and software (type of coordinate systems used for kinematics and kinetics, type of control) can then be acquired to create a testing system tailored to the desired testing conditions. Study design and verification steps should be decided upon prior to testing to maintain the accuracy of the collected data. Collected data should be reported with any supplementary metrics (RMS error, dynamic statistics) that help illuminate the reported results. An example study comparing two different ACL reconstruction techniques is provided to demonstrate the application of these guidelines. Adoption of these guidelines may allow for better interlaboratory result comparison to improve clinical outcomes.

Anthropometric measures of obesity in patients with knee joint pathology: Body surface area versus body mass index.

Obesity is quantified using body mass index. Body surface area may provide a superior and more anthropometric method of quantifying obesity in patients with musculoskeletal knee disease. This study compares the effect of weight, height, age and gender on body mass index and body surface area in a population with orthopaedic knee disease. An observational cohort study was conducted of patients presenting with musculoskeletal knee disease. Associations between body mass index, body surface area, age, gender, height, weight and operative versus non-operative management were analysed. A total of 151 patients were included. Body surface area was more strongly correlated to weight than body mass index (r = 0.98, p < 0.001 versus r = 0.84, p < 0.001). Body surface area also reflects height which body mass index under presents (r = 0.65, p < 0.001 versus r = -0.08, p = 0.35). Body mass index and body surface area were correlated with one another (r = 0.70, p < 0.001). Age was inversely correlated with body surface area (r = -0.20, p = 0.013) but not body mass index (r = 0.05, p = 0.585). Body mass index did not differ between males and females (30.1 versus 30.9, p = 0.37); however, BSA scores were significantly higher in males than females (2.11 versus 1.91, p < 0.001). Neither body surface area nor body mass index scores influenced operative versus non-operative treatment. Body surface area could be a useful alternative to body mass index when considering obesity in patients with musculoskeletal knee pathology. Body surface area better reflects the effects of height, weight, age and gender than body mass index.

Evaluating the Anti-Osteoarthritis Potential of Standardized Boswellia serrata Gum Resin Extract in Alleviating Knee Joint Pathology and Inflammation in Osteoarthritis-Induced Models.

Osteoarthritis is a widespread chronic degenerative disease marked by the deterioration of articular cartilage, modifications in subchondral bone, and a spectrum of symptoms, including pain, stiffness, and disability. Ultimately, this condition impairs the patient's quality of life. This study aimed to evaluate the therapeutic efficacy of standardized Boswellia serrata gum resin extract (BSRE) in a rat model of monosodium iodoacetate (MIA)-induced osteoarthritis. A total of 60 rats were allocated into six groups: normal control group (NC), osteoarthritis control (injected with MIA, OC), O + B50 (injected with MIA and treated with 50 mg/kg body weight (BW) BSRE), O + B75 (injected with MIA and treated with 75 mg/kg BW BSRE), O + B100 (injected with MIA and treated with 100 mg/kg BW BSRE), and O + M (injected with MIA and treated with 150 mg/kg BW methyl sulfonyl methane). Several parameters, including knee joint swelling, histopathological changes, and the expression of collagen type II alpha 1 (COL2A1) and aggrecan, were comprehensively assessed. Concurrently, the serum levels and mRNA expression of inflammatory mediators, cytokines, and matrix metalloproteinases (MMPs) were analyzed in both the serum and knee joint synovium. The results demonstrated that BSRE significantly mitigated knee joint swelling, cartilage destruction, and tissue deformation. Notably, BSRE administration markedly upregulated the expression of COL2A1 and aggrecan while concurrently reducing levels of nitric oxide, prostaglandin E2, leukotriene B4, interleukin (IL)-6, and tumor necrosis factor (TNF)-α. Furthermore, a substantial decrease was observed in the mRNA expression of inducible nitric oxide synthase, cyclooxygenase-2, 5-lipoxygenase, IL-6, TNF-α and MMP-3 and -13, thereby indicating promising therapeutic implications for osteoarthritis. In conclusion, BSRE exhibited anti-inflammatory properties and inhibited cartilage matrix degradation in a rat model of MIA-induced osteoarthritis, with the O + B100 group showing significant reductions in swelling and notable improvements in joint cartilage damage. These findings illuminate the preventive and therapeutic potential of BSRE for osteoarthritis treatment, emphasizing the criticality of exhaustive evaluation of novel compounds.

Automated personalization of biomechanical knee model.

Patient-specific biomechanical models of the knee joint can effectively aid in understanding the reasons for pathologies and improve diagnostic methods and treatment procedures. For deeper research of knee diseases, the development of biomechanical models with appropriate configurations is essential. In this study, we mainly focus on the development of a personalized biomechanical model for the investigation of knee joint pathologies related to patellar motion using automated methods. This study presents a biomechanical model created for patellar motion pathologies research and some techniques for automating the generation of the biomechanical model. To generate geometric models of bones, the U-Net neural network was adapted for 3D input datasets. The method uses the same neural network for segmentation of femur, tibia, patella and fibula. The total size of the train/validation (75/25%) dataset is 18,183 3D volumes of size voxels. The configuration of the biomechanical knee model proposed in the paper includes six degrees of freedom for the tibiofemoral and patellofemoral joints, lateral and medial contact surfaces for femur and tibia, and ligaments, representing, among other things, the medial and lateral stabilizers of the knee cap. The development of the personalized biomechanical model was carried out using the OpenSim software system. The automated model generation was implemented using OpenSim Python scripting commands. The neural network for bones segmentation achieves mean DICE 0.9838. A biomechanical model for realistic simulation of patellar movement within the trochlear groove was proposed. Generation of personalized biomechanical models was automated. In this paper, we have implemented a neural network for the segmentation of 3D CT scans of the knee joint to produce a biomechanical model for the study of knee cap motion pathologies. Most stages of the generation process have been automated and can be used to generate patient-specific models.

COMPARATIVE CASE ANALYSIS: THE IMPACT OF PHYSIOTHERAPY METHODS ON ENHANCING FUNCTION IN GRADE II PATELLAR CHONDROMALACI

Patellar chondromalacia represents a prevalent form of knee joint pathology, particularly among physically active young women (Smith et al., 2017). However, the scientific literature remains deficient in data regarding the comparative efficacy of diverse physiotherapy techniques. The principal objective of this investigation was to assess the differential effects of various physiotherapy methods on alterations in knee function in the context of Grade II patellar chondromalacia. Findings indicate that when contrasting physiotherapy and shockwave therapy against balance and muscle strength training conducted on a motorized HUBER 360 platform, physiotherapy, and shockwave therapy were notably superior in augmenting the strength of the thigh and gluteal muscles. Training on the motorized HUBER 360 platform exhibited greater efficacy in alleviating pain in the femur-patella joint and enhancing the range of motion in the knee joint. Nevertheless, both interventions had no discernible impact on the progression of femur-patella joint damage or alterations in the femur-patella Q angle.

THE IMPACT OF DIFFERENT PHYSIOTHERAPY METHODS ON IMPROVING FUNCTION IN GRADE II PATELLAR CHONDROMALACIA: A COMPARATIVE CASE ANALYSIS

Patellar chondromalacia represents a prevalent form of knee joint pathology, particularly among physically active young women (Smith et al., 2017). However, the scientific literature remains deficient in data regarding the comparative efficacy of diverse physiotherapy techniques. The principal objective of this investigation was to assess the differential effects of various physiotherapy methods on alterations in knee function in the context of Grade II patellar chondromalacia. Findings indicate that when contrasting physiotherapy and shockwave therapy against balance and muscle strength training conducted on a motorized HUBER 360 platform, physiotherapy, and shockwave therapy were notably superior in augmenting the strength of the thigh and gluteal muscles. Training on the motorized HUBER 360 platform exhibited greater efficacy in alleviating pain in the femur-patella joint and enhancing the range of motion in the knee joint. Nevertheless, both interventions had no discernible impact on the progression of femur-patella joint damage or alterations in the femur-patella Q angle

COMPARATIVE CASE ANALYSIS: THE IMPACT OF PHYSIOTHERAPY METHODS ON ENHANCING FUNCTION IN GRADE II PATELLAR CHONDROMALACI

Patellar chondromalacia represents a prevalent form of knee joint pathology, particularly among physically active young women (Smith et al., 2017). However, the scientific literature remains deficient in data regarding the comparative efficacy of diverse physiotherapy techniques. The principal objective of this investigation was to assess the differential effects of various physiotherapy methods on alterations in knee function in the context of Grade II patellar chondromalacia. Findings indicate that when contrasting physiotherapy and shockwave therapy against balance and muscle strength training conducted on a motorized HUBER 360 platform, physiotherapy, and shockwave therapy were notably superior in augmenting the strength of the thigh and gluteal muscles. Training on the motorized HUBER 360 platform exhibited greater efficacy in alleviating pain in the femur-patella joint and enhancing the range of motion in the knee joint. Nevertheless, both interventions had no discernible impact on the progression of femur-patella joint damage or alterations in the femur-patella Q angle.

COMPARATIVE CASE ANALYSIS: THE IMPACT OF PHYSIOTHERAPY METHODS ON ENHANCING FUNCTION IN GRADE II PATELLAR CHONDROMALACI

Patellar chondromalacia represents a prevalent form of knee joint pathology, particularly among physically active young women (Smith et al., 2017). However, the scientific literature remains deficient in data regarding the comparative efficacy of diverse physiotherapy techniques. The principal objective of this investigation was to assess the differential effects of various physiotherapy methods on alterations in knee function in the context of Grade II patellar chondromalacia. Findings indicate that when contrasting physiotherapy and shockwave therapy against balance and muscle strength training conducted on a motorized HUBER 360 platform, physiotherapy, and shockwave therapy were notably superior in augmenting the strength of the thigh and gluteal muscles. Training on the motorized HUBER 360 platform exhibited greater efficacy in alleviating pain in the femur-patella joint and enhancing the range of motion in the knee joint. Nevertheless, both interventions had no discernible impact on the progression of femur-patella joint damage or alterations in the femur-patella Q angle.

The relationship of proximal lateral collateral ligament hyperintensity with knee joint ligament and meniscus pathologies.

Hyperintensity in the proximal lateral collateral ligament (LCL) is often confusing. This appearance may be alone or accompany other pathologies. To investigate the relationship between the signal intensity (SI) change in the proximal LCL and the knee joint pathologies. The knee MRI scans taken between 2020 and 2022 were queried retrospectively. Patients with acute trauma, instability, knee surgery, or high-grade osteoarthritis were excluded. Included patients were divided into two groups as normal SI and increased SI according to proximal LCL. The difference in ligamentous and meniscal pathologies between the two groups was analyzed using a chi-square test. Inter-observer agreement analysis was performed on 50 randomly selected patients. A total of 351 patients (139 men [39.6%], 212 women [60.4%]; median age = 37 years; interquartile range = 67 years) were included. There were 114 (32.5%) LCLs with normal SI and 237 (67.5%) LCLs with increased SI. Normal SI and increased SI groups had a significant difference in terms of joint side, median age, patellar tendon SI, anterior cruciate ligament SI, and medial collateral ligament SI (P = 0.004, P = 0.004, P = 0.001, P = 0.011, P = 0.004, respectively). A significant difference between the results of two separate LCL examinations in coronal + axial and coronal-only planes (P <0.001). Inter-observer agreement was found to be good to excellent. Hyperintensity in the proximal LCL was more common on the right joint side, in older patients, and patients with hyperintensity in the proximal patellar tendon, anterior cruciate ligament, and medial collateral ligament. Evaluating the LCL only in the coronal plane overestimates the hyperintensity.

Возможности лучевых методов диагностики связочно-суставного аппарата коленного сустава в современных условиях

Relevance. This article is devoted to a review of current radiation methods for visualizing pathologies of the structures of the knee joint, which represent a topical problem in modern clinical practice and require close attention and in-depth study. The range of medical treatment depends entirely on the rational and necessary use of radiation imaging methods and the competence of diagnostic specialists. Objective of the review. Based on an analysis of the literature, to assess the current state of the problem and the effectiveness of the used radiation methods for diagnosing damage to the ligamentous-articular structure of the knee. Material and methods. The search was conducted in the open electronic scientific databases PubMed of the US National Electronic Medical Library and the databases of the Russian scientific electronic library e-library using keywords and phrases: radiodiagnosis, knee joint injury, standard radiography, computed tomography, magnetic resonance imaging, arthrography . Review results. In order to make an early diagnosis through radiation methods and provide the necessary assistance, standard radiography, computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound are used. Contrast x-ray arthrography, computed tomographic arthrography (CT arthrography) and magnetic resonance arthrography (MR arthrography) are also relevant methods for detecting knee joint injuries. One of the most commonly used primary methods of radiological imaging of pathologies of large joints is standard radiography in two projections. However, it is not possible to assess damage within the anatomical structures of the soft tissues and ligaments of the knee joint due to the low sensitivity of this method. The use of computed tomography in most cases is an additional way to clarify the correctness of the intended diagnosis and is of a secondary nature. Magnetic resonance imaging is the method of choice for pathologies of both intra-articular and extra-articular structures of the knee. The advantages of magnetic resonance imaging include the safety and non-invasiveness of the study, the absence of ionizing radiation and high diagnostic value. The most promising and informative invasive radiation techniques for diagnosing knee joint pathologies using paramagnetic contrast agents in clinical practice are CT arthrography and MR arthrography. Conclusion. Each radiation imaging method has its own advantages and it is important to individually determine the need for the use of diagnostic tools for certain clinical cases. Also, in order to early identify pathological conditions of the knee joint structures and carry out the necessary surgical or therapeutic manipulations, it is necessary to use an integrated approach to diagnostic measures

Effects of smartphone use while walking on external knee abduction moment peak: A crossover randomized trial on an instrumented treadmill

IntroductionIn addition to its effects on cognitive awareness, smartphone use while walking may reduce the speed, regularity, and symmetry of walking. Although its effects on spatiotemporal gait parameters, such as walking speed and step width, have already been studied, little is currently known about the impact of smartphone dual tasking on lower limb kinetics. Research questionDoes smartphone use during walking alter gait patterns (i.e., walking speed and step width) and consequently external knee moments? MethodsIn a four-period crossover trial, external knee moment peaks, walking speed, and step width were assessed in 27 healthy adults during matched-speed walking, self-paced walking, self-paced walking with spoken calculation tasks, and self-paced walking with smartphone-entered calculation tasks. Differences between the smartphone use condition and all other conditions were determined using repeated measures ANOVA with predefined contrasts. ResultsDecreased walking speed and increased step width were observed during smartphone use. The mean external knee abduction moment peak (Nm/kg) differed significantly (p < 0.01) across the intervention condition, namely walking with smartphone-entered calculations (0.15; 95 % CI: 0.12, 0.18), and the control conditions, namely matched-speed walking (0.11; 95 % CI: 0.08, 0.13), self-paced walking (0.11; 95 % CI: 0.09, 0.14), and walking with spoken calculations (0.14; 95 % CI: 0.12, 0.16). After confounder adjustment for walking speed, step width, gender, and age, this primary outcome was significantly different between using the smartphone and self-paced walking (p < 0.01, r = 0.51). This effect size was reduced when comparing smartphone use with spoken calculations (p = 0.04, r = 0.32). ConclusionWhen using a smartphone while walking, walking speed is slowed down, step width is increased, and knee moments are adversely altered compared to walking without dual tasking. These altered knee moments are partially, but not entirely, attributable to the cognitive calculation task. These effects are age-independent, but women are more affected than men. Nevertheless, it remains unclear whether sustained walking while using a smartphone adversely affects the development of knee joint pathologies.

Effects of low-intensity exercise on spontaneously developed knee osteoarthritis in male senescence-accelerated mouse prone 8

BackgroundOsteoarthritis (OA) is a degenerative joint disease associated with aging, which often leads to joint stiffness and disability. Exercise is one of the most important non-pharmacological treatments and is prescribed as an indispensable treatment for OA. However, whether physical exercise is beneficial for preventing the progression of OA symptoms with age is poorly understood. We investigated the effects of exercise on spontaneously developed knee OA using male senescence-accelerated mouse prone 8 (SAMP8).MethodsTo examine age-related changes in the knee joints of SAMP8, knee articular cartilage changes, synovitis, knee joint flexion and extension angles, swelling, walking ability, and quadriceps muscle atrophy were analyzed at 3, 5, 7, and 9 months. SAMP8 were required to run at a speed of 10 m/min for 15 min/day from 7 to 9 months of age. The knee joint pathologies and symptoms of exercising and non-exercising mice were compared by histological, immunohistochemical, and morphometrical analyses.ResultsThe mice presented with various histological changes, including cartilage destruction, osteocyte formation, synovitis, declined joint angles, and swelling. Notably, medial and posterior cartilage destruction was more severe than that of the lateral and anterior cartilage. Knee joint angles were significantly correlated with the histological scores (modified Mankin and OARSI, osteophyte formation and synovial lining cell layer). Exercise did not attenuate cartilage degeneration in the medial and posterior tibial plateau, although the articular cartilage of the anterior and lateral tibial plateau and its histological scores was remained and significantly improved, respectively, by exercise. Exercise suppressed the age-related decline of collagen type II-positive areas in the remaining articular cartilage and improved the OA symptoms. Exercise reduced the expression of monocyte chemoattractant protein (MCP)-1 and tumor necrosis factor (TNF)-α positive macrophages in the synovium.ConclusionThis study revealed that SAMP8 developed spontaneous knee OA with age, which resembled the disease symptoms in humans. Low-intensity exercise temporarily alleviated degeneration of the remaining cartilage, synovitis, and age-related decreases in knee flexion angle, stride length, and muscle atrophy in SAMP8. However, exercise during OA progression with age may cause mechanical stress that could be both beneficial and detrimental to joint health.