Reported Knee Pain Research Articles

Health-related quality of life, lifestyle habits and chronic pain in individuals with knee pain – a 2-year follow-up study

Introduction Knee pain increases the risk of developing chronic widespread pain (CWP) and knee osteoarthritis (KOA). The prevalence of CWP and KOA has increased, and there is a need for early prevention. Therefore, the aim was to examine the associations of health-related quality of life (HRQoL) and lifestyle habits with chronic pain at a two-year follow-up in individuals with knee pain. Methods A two-year longitudinal cohort study including 251 individuals aged 30–60 years reporting knee pain at baseline. HRQoL was measured via the Short-Form General Health Survey (SF-36), and lifestyle habits included questions on overweight, physical activity, diet, alcohol and tobacco use. Pain was assessed with a pain mannequin. Differences in health status and lifestyle habits over time in groups with unchanged no chronic pain (NCP), transitioned to less and more pain, and unchanged CWP were analysed using Wilcoxon’s, McNemar’s and Friedman’s tests. Multinominal regression analysis was performed to study associations with reporting chronic pain at follow-up. Results Reporting better HRQoL across various SF-36 concepts and normal weight at baseline was associated with reporting NCP after two years. A few changes were made regarding HRQoL and lifestyle habits over the course of two years, but an increase in general health was associated with transitioning to less pain. Conclusions During primary care visits for knee pain with a combination of overweight or lower HRQoL, individuals should receive comprehensive attention to prevent the development of CWP. Future studies should investigate the associations further.

Evaluation of knee articular cartilage through calcium-suppressed technique in dual-energy computed tomography

Objectives: The evaluation of knee articular cartilage is of paramount importance in diagnosing and managing musculoskeletal disorders. Accurate and non-invasive imaging techniques are essential for assessing cartilage health, guiding treatment decisions, and monitoring disease progression. The objective of this study is to assess the potential of a calcium-suppressed technique in dual-energy computed tomography (DECT) as a viable alternative to the gold standard magnetic resonance imaging (MRI) for the evaluation of knee articular cartilage. DECT is gaining momentum in musculoskeletal imaging due to its ability to differentiate tissues with high precision. By suppressing calcium signals in DECT, the cartilage can be visualized more effectively, providing valuable insights into its integrity and structural changes. This paper seeks to compare the diagnostic accuracy and overall performance of DECT with calcium suppression to conventional MRI. The findings of this research have the potential to revolutionize the way that we approach knee cartilage evaluation, making it more accessible and efficient for both clinicians and patients. This paper contributes to the ongoing efforts in advancing medical imaging and orthopedic diagnostics, ultimately improving patient outcomes and healthcare practices. Material and Methods: In this study, we included patients who had reported knee pain and were referred for both DECT and MRI examinations. To enhance cartilage visualization, calcium-suppressed images were generated through a specialized algorithm applied to spectral-based images and were then superimposed onto conventional computed tomography (CT) images for visual assessment. The structure and thickness of knee cartilage were meticulously examined, and measurements of articular cartilage thickness were taken from sagittal proton density-weighted images and calcium-suppressed images in at lateral femoral tibial, patella femoral, and medial femoral tibial region of knee. Results: The present study was done to compare the two diagnostic modalities (DECT and MRI) for assessment of cartilage thickness of patients with knee pain. Cartilage thickness was assessed at lateral femoral tibial, patella femoral, and medial femoral tibial region of knee. Cartilage thickness of only affected knee was assessed by DECT and MRI, which showed almost perfect agreement (differences non-significant) at all the regions: (Lateral femoral region 1.61 ± 0.55 mm vs. 1.62 ± 0.55; Patella femoral: 1.62 ± 0.70 vs. 1.65 ± 0.70 mm and Medial femoral tibial: 1.82 ± 0.78 vs. 1.86 ± 0.74 mm). Conclusion: This study showed that measurements of knee cartilage thickness by DECT were as reliable as that by MRI. This study compares DECT and MRI for assessing knee articular cartilage. The rationale for combining CT and MRI provides a comprehensive evaluation of bone and soft-tissue pathology, complex injuries, and pre-surgical planning. DECT excels in bone detail, while MRI excels in soft-tissue evaluation. Our findings suggest that DECT may replace MRI for cartilage thickness assessment and qualitative evaluation of knee abnormalities, offering a cost-effective alternative with improved accessibility and reduced contraindications. DECT benefits patients of knee pain with limited MRI access or with contraindications.

Prevalence and Distribution of Musculoskeletal Symptoms in Cystic Fibrosis and Impacts on Daily Life.

Musculoskeletal problems are reported in the literature as a common problem for people with cystic fibrosis, with a range of aetiologies including an inflammatory arthritis. However, accurate data on the presentations and prevalence are lacking. The aim of this cohort study was to describe the scale and impact of musculoskeletal symptoms in CF. A collaboratively designed questionnaire was administered to adults attending two large UK CF centres. Data collected evaluated scale and impact of musculoskeletal symptoms. Results were obtained from 489 patients (response rate 59%). Of these, 49% reported that musculoskeletal symptoms impacted their activities of daily living in the previous year. Back pain was common, occurring in 44% of participants in the preceding week. The knee was the most commonly affected painful peripheral joint, with 26% of participants reporting knee pain within the last week rising to 50% within the last year. Early morning stiffness and joint swelling were markedly less common, suggesting that the majority of musculoskeletal pain in CF is not due to an inflammatory arthritis but is due to other factors. Musculoskeletal problems are common in CF and frequently affect activities of daily living. Symptoms of inflammatory arthritis occurred in only a small minority of individuals. A focused approach to characterising and clarifying the aetiology of musculoskeletal symptoms is needed to inform the management of these disabling symptoms.

Association of neighborhood-level disadvantage beyond individual sociodemographic factors in patients with or at risk of knee osteoarthritis

ObjectiveLower socioeconomic status (SES) is a risk factor for poorer pain-related outcomes. Further, the neighborhood environments of disadvantaged communities can create a milieu of increased stress and deprivation that adversely affects pain-related and other health outcomes. Socioenvironmental variables such as the Area Deprivation Index, which ranks neighborhoods based on socioeconomic factors could be used to capture environmental aspects associated with poor pain outcomes. However, it is unclear whether the ADI could be used as a risk assessment tool in addition to individual-level SES.MethodsThe current study investigated whether neighborhood-level disadvantage impacts knee pain-related outcomes above sociodemographic measures. Participants were 188 community-dwelling adults who self-identified as non-Hispanic Black or non-Hispanic White and reported knee pain. Area Deprivation Index (ADI; measure of neighborhood-level disadvantage) state deciles were derived for each participant. Participants reported educational attainment and annual household income as measures of SES, and completed several measures of pain and function: Short-form McGill Pain Questionnaire, Western Ontario and McMaster Universities Osteoarthritis Index, and Graded Chronic Pain Scale were completed, and movement-evoked pain was assessed following the Short Physical Performance Battery. Hierarchical linear regression analyses were used to assess whether environmental and sociodemographic measures (i.e., ADI 80/20 [80% least disadvantaged and 20% most disadvantaged]; education/income, race) were associated with pain-related clinical outcomes.ResultsLiving in the most deprived neighborhood was associated with poorer clinical knee pain-related outcomes compared to living in less deprived neighborhoods (ps < 0.05). Study site, age, BMI, education, and income explained 11.3–28.5% of the variance across all of the individual pain-related outcomes. However, the ADI accounted for 2.5–4.2% additional variance across multiple pain-related outcomes.ConclusionThe ADI accounted for a significant amount of variance in pain-related outcomes beyond the control variables including education and income. Further, the effect of ADI was similar to or higher than the effect of age and BMI. While the effect of neighborhood environment was modest, a neighborhood-level socioenvironmental variable like ADI might be used by clinicians and researchers to improve the characterization of patients’ risk profile for chronic pain outcomes.

What Characteristics Modify the Relation of Neighborhood Walkability and Walking Behavior in Older Adults?

Neighborhood walkability can influence walking behaviors in older adults. However, its associations of walkability with walking may differ by demographic, socioeconomic, health, social, and residential characteristics due to factors such as increased vulnerability to environmental factors or increased resilience. In a sample of older adults (n = 493, median age = 82 [range 78-89], 56% female, 31% Black), a walkability index was derived from audits of Google Street View images of participants' immediate neighborhoods. Walking was self-reported in the past week. Effect modifiers by demographic (age, race, gender, marital status), socioeconomic (education, income), health (gait speed, falls, knee pain, depressive symptoms, cognitive status, perceived energy), social (driving status, social engagement), and residential/neighborhood (residence type, neighborhood socioeconomic status [SES], population density) characteristics were assessed by interaction terms in logistic regression models, adjusted for gender, race, gait speed, prior falls, high depressive symptoms, currently driving, and cognitive status. When effect modification was suggested (p for interaction <.1), adjusted analyses of walkability with walking stratified on the effect modifier were conducted. In this sample, 59% walked in the past week and greater walkability was associated with greater odds of walking (odds ratio [OR] = 1.16, 95% confidence interval [CI]: 1.01-1.34). This association (p for interaction range 0.002-0.07) was present for those who were not currently married (OR = 1.35, 95% CI: 1.17-1.56), who reported knee pain (OR = 1.40, 95% CI: 1.14-1.72) or high depressive symptoms (OR = 1.30, 95% CI: 1.06-1.60), or who had declining cognitive function (OR = 1.30, 95% CI: 1.09-1.55). High walkability may influence physical activity, particularly for those with vulnerabilities related to social, pain, and brain health characteristics. These results should inform neighborhood planning and targeted interventions for vulnerable older adults.

Impact of Remedial Exercise Training on Work-Related Musculoskeletal Morbidity Among Handloom Weavers in Kanchipuram District: A Quasi-experimental Study.

The handloom weaving industry is integral to developing countries, especially in South Asia, where traditional techniques are still widely practiced. In India, the handloom sector is a significant part of the informal economy, employing millions and preserving rich cultural heritage. Despite its economic and cultural importance, the sector faces severe challenges, including poor working conditions that lead to a high prevalence of work-related musculoskeletal disorders (WMSDs). This study focuses on assessing the prevalence of musculoskeletal morbidity and the effectiveness of physiotherapy interventions in reducing WMSDs among handloom weavers in Kanchipuram, Tamil Nadu. This quasi-experimental study utilized a pre- and post-test design conducted over 12 months. A total of 121 handloom weavers from four major cooperative societies in Kanchipuram were selected using multistage sampling. Inclusion criteria were adults over 18 years, full-time weavers with more than a year of experience, and those who consented to participate. The study involved initial data collection through interviews using a pre-tested semi-structured questionnaire and the Standardized Nordic Musculoskeletal Questionnaire to assess pain prevalence. The intervention phase included physiotherapy exercise training thrice a week for three months, followed by post-intervention data collection and analysis. Pre-intervention data indicated high prevalence rates of musculoskeletal pain, with 62% of participants reporting knee pain and 54.5% reporting ankle/foot pain over the past year. Post-intervention assessments showed significant reductions in pain across all body parts, with the most substantial decreases in knee and shoulder pain. For instance, knee pain scores decreased from 3.10 ± 2.61 to 1.81 ± 1.69. The overall mean pain rating significantly dropped from 1.72 ± 0.88 pre-intervention to 1.00 ± 0.50 post-intervention, demonstrating the effectiveness of the physiotherapy exercises. The study confirms the high prevalence of musculoskeletal disorders (MSDs) among handloom weavers and demonstrates the significant impact of physiotherapy interventions in alleviating pain. Implementing regular physiotherapy exercises can substantially improve the well-being and productivity of handloom weavers, ensuring the sustainability of this vital cultural and economic industry. The results advocate for policy changes and increased support for ergonomic and health interventions in the handloom sector.

Robotic Total Knee Arthroplasty: An Update.

Total knee arthroplasty (TKA) is a gold standard surgical procedure to improve pain and restore function in patients affected by moderate-to-severe severe gonarthrosis refractory to conservative treatments. Indeed, millions of these procedures are conducted yearly worldwide, with their number expected to increase in an ageing and more demanding population. Despite the progress that has been made in optimizing surgical techniques, prosthetic designs, and durability, up to 20% of patients are dissatisfied by the procedure or still report knee pain. From this perspective, the introduction of robotic TKA (R-TKA) in the late 1990s represented a valuable instrument in performing more accurate bone cuts and improving clinical outcomes. On the other hand, prolonged operative time, increased complications, and high costs of the devices slow down the diffusion of R-TKA. The advent of newer technological devices, including those using navigation systems, has made robotic surgery in the operatory room more common since the last decade. At present, many different robots are available, representing promising solutions to avoid persistent knee pain after TKA. We hereby describe their functionality, analyze potential benefits, and hint at future perspectives in this promising field.

Gait Stability as a Predictor of Fall Risk in Knee Osteoarthritis: Insights from a Saudi Arabian Cross-sectional Study

Abstract Introduction: In the context of global health, knee osteoarthritis (OA) stands as a significant contributor to mobility impairments and quality of life deterioration. Particularly in Saudi Arabia, the incidence of knee OA is not only prevalent but also on the rise, posing major public health challenges. Previous studies have highlighted various aspects of OA, yet the specific relationship between gait stability parameters and the risk of falls in OA patients remains underexplored. This study aims to fill this gap by providing a comprehensive analysis of gait stability as a potential indicator of fall risk amongst Saudi Arabian patients with knee OA. It seeks to contribute to the existing literature by offering new insights into how OA affects mobility and balance, positioning its findings within the broader scope of knee OA management. Methods: This cross-sectional study was conducted in Saudi Arabia from July to October 2023. It involved 2304 patients diagnosed with knee OA from orthopaedic clinics across various hospitals and health care centres, primarily in the western and eastern regions of the country. The focus was on evaluating the relationship between gait stability parameters and the risk of falls. The methodologies included assessments of walking pace, balance and frequency of falls, alongside a detailed analysis of patient demographics. Results: The participant pool predominantly consisted of females (79.9%), primarily aged between 18 and 24 years (35.4%). A significant proportion (40.3%) reported knee pain related to OA. Notably, 27.8% of participants had experienced falls in the past year. Over half (52.8%) described their walking pace as moderate, whereas 67.4% occasionally experienced unsteadiness or balance loss. Crucially, a positive correlation was found between central nervous system involvement and increased fall risk. Conclusion: Knee OA’s impact extends beyond joint pain and stiffness; it crucially affects gait stability, thereby influencing fall risk. This study highlights gait instability as a key factor in fall susceptibility amongst Saudi Arabian knee OA patients. The findings underscore the potential of using gait stability parameters as predictive markers for fall risk, suggesting implications for clinical practices and rehabilitation strategies in Saudi Arabia. It is anticipated that these insights will enhance the overall management and quality of life for patients with knee OA.

56 Chronic Musculoskeletal Pain, Biobehavioral and Psychosocial Resilience Index, and Brain Age Gap

Objective:Chronic musculoskeletal pain is associated with neurobiological, physiological, and cellular measures. Importantly, we have previously demonstrated that a biobehavioral and psychosocial resilience index appears to have a protective relationship on the same biomarkers. Less is known regarding the relationships between chronic musculoskeletal pain, protective factors, and brain aging. This study investigates the relationships between clinical pain, a resilience index, and brain age. We hypothesized that higher reported chronic pain would correlate with older appearing brains, and the resilience index will attenuate the strength of the relationship between chronic pain and brain age.Participants and Methods:Participants were drawn from an ongoing observational multisite study and included adults with chronic pain who also reported knee pain (N = 135; age = 58.3 ± 8.1; 64% female; 49% non-Hispanic Black, 51% non-Hispanic White; education Mdn = some college; income level Mdn = $30,000 - $40,000; MoCA M = 24.27 ± 3.49). Measures included the Graded Chronic Pain Scale (GCPS), characteristic pain intensity (CPI) and disability, total pain body sites; and a cognitive screening (MoCA). The resilience index consisted of validated biobehavioral (e.g., smoking, waist/hip ratio, and active coping) and psychosocial measures (e.g., optimism, positive affect, negative affect, perceived stress, and social support). T1-weighted MRI data were obtained. Surface area metrics were calculated in FreeSurfer using the Human Connectome Project's multi-modal cortical parcellation scheme. We calculated brain age in R using previously validated and trained machine learning models. Chronological age was subtracted from predicted brain age to generate a brain age gap (BAG). With higher scores of BAG indicating predicated age is older than chronological age. Three parallel hierarchical regression models (each containing one of three pain measures) with three blocks were performed to assess the relationships between chronic pain and the resilience index in relation to BAG, adjusting for covariates. For each model, Block 1 entered the covariates, Block 2 entered a pain score, and Block 3 entered the resilience index.Results:GCPS CPI (R2 change = .033, p = .027) and GCPS disability (R2 change = 0.038, p = 0.017) significantly predicted BAG beyond the effects of the covariates, but total pain sites (p = 0.865) did not. The resilience index was negatively correlated and a significant predictor of BAG in all three models (p &lt; .05). With the resilience index added in Block 3, both GCPS CPI (p = .067) and GCPS disability (p = .066) measures were no longer significant in their respective models. Additionally, higher education/income (p = 0.016) and study site (p = 0.031) were also significant predictors of BAG.Conclusions:In this sample, higher reported chronic pain correlated with older appearing brains, and higher resilience attenuated this relationship. The biobehavioral and psychosocial resilience index was associated with younger appearing brains. While our data is cross-sectional, findings are encouraging that interventions targeting both chronic pain and biobehavioral and psychosocial factors (e.g., coping strategies, positive and negative affect, smoking, and social support) might buffer brain aging. Future directions include assessing if chronic pain and resilience factors can predict brain aging over time.

The effectiveness of telehealth gait retraining in addition to standard physical therapy treatment for overuse knee injuries in soldiers: a protocol for a randomized clinical trial

IntroductionRunning is the most common cardiovascular exercise in the military. However, there is a high incidence of running-related overuse injuries that reduces military readiness. Gait retraining is a common intervention to treat running-related injuries, but the high cost of equipment and lack of clinician expertise and availability reduces utilization. Gait retraining intervention in a telehealth format might improve feasibility. The purpose of this randomized clinical trial is to determine the effectiveness of a telehealth gait retraining intervention on pain, self-reported function, and biomechanical risk factors for injury in service members who present to a Military Health System physical therapy clinic with an overuse knee injury.MethodsThis is a parallel, two-arm, single-blind randomized clinical trial. The two independent variables are intervention (2 levels: telehealth gait retraining intervention with standard of care or only standard of care) and time (3 levels: baseline, 10 weeks or post-intervention, 14 weeks). Participants between the ages of 18 to 60 years will be included if they report knee pain during and/or after running to be anywhere from a 3 to a 7 on the numerical pain rating scale and demonstrate a rearfoot strike pattern. The primary dependent variables are as follows: (1) pain (worst pain during and/or after running) and (2) foot strike pattern (conversion rate from rearfoot to non-rearfoot foot strike pattern during running). Secondary outcomes include patient self-reported function and running biomechanics.DiscussionThe effectiveness of a telehealth gait retraining intervention to reduce pain and modify foot strike pattern is not known. The results of this study may help determine the effectiveness and feasibility of a telehealth gait retraining intervention to reduce pain, change foot strike, improve function, and improve running gait biomechanics.Trial registrationClinicalTrials.gov, NCT04269473. Registered 05 February 2020.

Validity of the Brief Illness Perception Questionnaire in people with knee pain: a Rasch analysis

Objective The Brief Illness Perception Questionnaire (B-IPQ) is a frequently used measure of illness perception (IP). The aim of this study was to explore the psychometric properties of the questionnaire when used in elderly people with knee pain. Method Based on data from the Frederiksberg Cohort on elderly people reporting knee pain (N = 836), the psychometric properties of the eight B-IPQ items (1 ‘Consequences’, 2 ‘Timeline’, 3 ‘Personal control’, 4 ‘Treatment control’, 5 ‘Identity’, 6 ‘Concern’, 7 ‘Coherence’, and 8 ‘Emotions’) were analysed using Rasch analysis to establish whether the questionnaire provides reliable and valid measures of IP. Results Threshold disordering was found on the 1–10 rating scale in all items. When rescaling to a 0–2 rating scale, disordering was resolved in six items. Item goodness-of-fit analyses revealed that two items displayed underfit misfit and four items overfit misfit; hence, the B-IPQ does not present unidimensionality. The person separation index indicated that items separate respondents into only two IP levels. Finally, floor and ceiling effects were found, indicating that the B-IPQ may not fully describe the extent of IP in this population. Conclusion The 1–10 rating scale used in the Danish B-IPQ targeting knee pain is suboptimal, while a 0–2 scale improves the psychometric properties of the scale. The B-IPQ does not present unidimensionality and the use of a sum score is therefore not recommended when assessing IP. The B-IPQ may not cover the extent of IP in elderly people with knee pain.

Association of tibial acceleration during walking to pain and impact loading in adults with knee osteoarthritis

BackgroundHigher impact loading during walking is implicated in the pathogenesis of knee osteoarthritis. Accelerometry enables the measurement of peak tibial acceleration outside the laboratory. We characterized the relations of peak tibial acceleration to knee pain and impact loading during walking in adults with knee osteoarthritis. MethodsAdults with knee osteoarthritis reported knee pain then walked at a self-selected speed on an instrumented treadmill for 3 min with an ankle-worn inertial measurement unit. Ground reaction forces and tibial acceleration data were sampled for 1 min. Vertical impact peaks, and average and peak instantaneous load rates were determined and averaged across 10 steps. Peak tibial acceleration was extracted for all steps and averaged. Pearson's correlations and multiple linear regression analyses assessed the relation of peak tibial acceleration to pain and impact loading metrics, independently and after controlling for gait speed and pain. FindingsHigher peak tibial acceleration was associated with worse knee pain (r = 0.39; p = 0.01), and higher vertical average (r = 0.40; p = 0.01) and instantaneous (r = 0.46; p = 0.004) load rates. After adjusting for gait speed and pain, peak tibial acceleration was a significant predictor of vertical average (R2 = 0.33; p = 0.003) and instantaneous (R2 = 0.28; p = 0.02) load rates, but not strongly associated with vertical impact peak. InterpretationsPeak tibial acceleration during walking is associated with knee pain and vertical load rates in those with knee osteoarthritis. Clinicians can easily access measures of peak tibial acceleration with wearable sensors equipped with accelerometers. Future work should determine the feasibility of improving patient outcomes by using peak tibial acceleration to inform clinical management.

Prognostic value of illness perception on changes in knee pain among elderly individuals: Two-year results from the Frederiksberg Cohort study

ObjectiveTo investigate the prognostic value of illness perception (IP) on knee pain, quality of life (QoL) and functional level in elderly individuals reporting knee pain. DesignA prospective cohort study of 1552 elderly with knee pain comparing two previously established clusters based on the Brief Illness Perception questionnaire. Cluster 1 (“Concerned optimists” [hypothesized unfavorable profile]; n ​= ​642) perceived their knee pain as a greater threat to them than Cluster 2 (“Unconcerned confident” [hypothesized favorable profile]; n ​= ​910). Primary outcome was the change from baseline to year 2 in the KOOS Pain subscale. Secondary outcomes were changes from baseline in quality of life (EuroQol-5 Domain and EQ VAS) and in the KOOS subscales Symptom, Activities of Daily Living, Knee-related QoL and Sports and recreation. Analyses were done on the original Intention-To-Survey (ITS) population, using repeated measures mixed linear models. ResultsAmong the ITS population, 841 (54%) responded to the 2-year survey. There was a statistically significant but clinically irrelevant cluster difference in the 2-year change from baseline in KOOS pain (mean difference: 6.0 KOOS points [95% CI: 7.3 to −4.7]) explained by a minor improvement in Cluster 1: (6.2 points) and no changes in Cluster 2: (0.2 points). Comparable results were found across the secondary outcomes. Clinically irrelevant cluster changes in IP were seen. ConclusionIn a cohort of people with knee pain, IP phenotype (i.e., Clusters) were of no prognostic value for the 2-year changes in pain, function, and QoL. Targeting IP may not be relevant in this patient population. Trial registration number and date of registrationThe Frederiksberg Cohort study was pre-registered at clinicaltrials.gov (NCT03472300) on March 21, 2018.

Comparative fixation devices for preventing migration of the proximal tibiofibular joint during tibial lengthening: a tether versus screw fixation

BackgroundWhen lengthening the tibia segment using motorized internal lengthening nails (MILN), undesired distal migration of the proximal fibula segment is prevented by tibiofibular stabilization, traditionally using a screw. A tightened cortical suspensory fixation rope (tether) is an alternative option, but its appropriateness has never been studied. The primary outcome was comparing the amount of proximal fibular migration between patients who were stabilized with either a tether or a screw. The secondary outcome was to evaluate the effect of fibular migration on the clinical outcome between both groups.MethodsA retrospective study was conducted on patients who underwent tibial lengthening with MILN between April 2016 and June 2022. Two cohorts were compared: 18 limbs with tether fixation versus 29 limbs with screw fixation. Data on the patient's age, sex, etiologies, and clinical outcomes were collected. Radiographic measurements included the lengthening distance and the amount of proximal fibular migration.ResultsIn total, 47 limbs from 41 patients, with average age 35.01 ± 13.72 years old. There were 28 males (68.29%) and 13 females (31.71%). The tether group demonstrated a statistically significant greater distance of migration than the screw group (p < 0.001), with an average migration distance of 8.39 ± 5.09 mm and 2.59 ± 3.06 mm, respectively. No correlation was found between the amount of tibial lengthening and the distance of proximal fibular migration in both the tether group (p = 0.96) and the screw group (p = 0.32). There was no significant difference in the change of knee extension between both groups (p = 0.3), and no patients reported knee pain or tightness.ConclusionA screw provides better resistance to proximal tibiofibular joint migration during MILN lengthening, but the difference appears clinically inconsequential. Either option appears suitable.

Another neglected symptom among the overweight young: an analysis of the self-reported anterior knee pain scores of the secondary school children

Objective: Knee pain is the most common joint complaint among the young and is linked with excessive weight by the World Health Organization. The study aimed to define the prevalence of anterior knee pain in secondary school children and search its’ relations to weight and academic performance. Method: The cross-sectional and descriptive study was conducted in Adana, between Sept 15 and Oct 15, 2020. Middle school students aged between 10 and 18 years were included. Anterior knee pain was assessed using the Anterior Knee Pain Scale short form (AKPS-SF), and the numerical rating scale (NRS) was used for pain intensity. Data were collected by questionnaires sent by e-mail. Results: There were 709 replies eligible for analysis. The NRS mean score was 0.78±1.47 for 249 (35.12 %) participants who reported knee pain. The number of students with an AKPS-SF score of ≤40 in the study group was 46 (6.40%). AKPS-SF scores showed weak negative linear associations with weight and the school year (r=-0.346/p=0.019, and r=-0.292/p=0.049, respectively), and no correlations were found with academic performance. Conclusion: The study has shown that more than a third of the students reported various levels of knee pain. The inverse correlation of AKPS-SF with weight and the weak link with the school year might attract the attention of healthcare givers to pay more attention to knee examination and help avoid future impairments in the knee joints of school age children.

Occupation-related musculoskeletal pain in school teachers: A cross-sectional survey

Background: Teaching profession demands the high level of physical and psychological involvement. Musculoskeletal pain is common among different professionals. The study is aimed to find out the occurrence of musculoskeletal pain among teachers and its correlation with occupation. Methods: One hundred and nine government school teachers participated in the study. The presence of musculoskeletal pain was assessed by using nordic musculoskeletal questionnaire and job-related stress was assessed by new brief job stress questionnaire. Pearson's correlation was used to correlate the musculoskeletal disorder and job-related stress. Results: The study reports that participants experienced musculoskeletal pain at various joints in last 12 months; 62.39% reported neck pain, 41.28% reported shoulder pain, 40.37% reported upper back pain, 9.7% reported elbow pain, 23.85% reported wrist pain, 31.20% reported lower back pain, 10.09% reported hip pain, 34.86% reported knee pain, and 29.36% reported ankle pain. A strong positive correlation was found between job-related stress and neck pain (r = 0.19, P = 0.04) and job-related stress and lower back pain (r = 0.37, P = 0.00). Conclusion: From the study, it can be concluded that school teachers increased job-related stress has direct impact on the occurrence of the musculoskeletal pain.

Knee Pain After Retrograde Intramedullary Nailing with Surgical Implant Generation Network of Femur Shaft Fractures at Public Hospitals in Bahir Dar City, Ethiopia: Analysis of 6-Months Follow-Up Results.

The incidence of femur fractures in young and elderly people has increased, particularly in countries with limited resources like Ethiopia. Intra-medullary nailing (IM) has been an effective and cost-effective method of treating long bone shaft fractures, but it can lead to complications such as knee pain. This study aimed to evaluate knee pain and its associated factors following retrograde intramedullary nailing for femur fractures. The study followed 110 patients diagnosed with femur fractures and treated with retrograde SIGN Standard Nail or Fin Nail from January 2020 to December 2022 at two hospitals in Ethiopia. The patients were followed up for at least 6 months, and data were collected from medical charts, patient interviews, and phone calls to patients who did not attend the follow-up appointment. Binary logistic regression analysis was used to identify factors associated with knee pain. The study showed that 40 patients reported knee pain at 6-months follow-up, making a prevalence of 36.4%. Factors significantly associated with knee pain were a time of injury to nailing (AOR=4.23, 95% CI: 1.28-13.92), use of a screw to the medial cortex (AOR=9.30, 95% CI: 2.90-12.74), and fracture site (AOR= 2.67, 95% CI: 14.01-7.03). Specifically, the longer the time from injury to nailing, the higher the risk of knee pain. The use of a longer screw to the medial cortex and a fracture site were also positively associated with knee pain. This study concludes that although retrograde intramedullary nail fixation is an effective method for femur fractures, it often results in knee pain. Approximately 4 of 10 patients suffered from knee pain in this study. Avoiding delayed surgical management and minimizing the use of prominent metalwork may reduce knee pain.

Prevalence of Patellofemoral Pain and Knee Pain in the General Population of Saudi Arabia.

Background Patellofemoral pain (PFP) is a common cause of knee pain. This condition can restrict daily activities by trying to avoid activities that aggravate their pain. This study aimed to determine the prevalence of PFP and knee pain and its associated factors among Saudi young adults. Methods A descriptive cross-sectional study was conducted in Saudi Arabia. A validated translated Arabic questionnaire was used. Data was collected through an online self-administered questionnaire. Saudi young adults of both genders aged between (18 to 40 years) were included. The mean ±SD was described for continuous variables, whereas categorical variables were reported using frequencies and percentages. The chi-square test was used for descriptive analysis. Results A total of 1558 subjects were enrolled in the current study. About 663 (42.6%) were males and 895 (57.4%) were females. Of the total participants, 718 (46%) were within the age group of 18 to 25.The overall prevalence of PFP among the current study participant was found to be 30.3%. The prevalence of PFP among males was found to be 31.4% and the prevalence of PFP among females was found to be 29.5%. The overall prevalence of knee pain among study participants was found to be 13.2% as 205 of the participants reported knee pain. The prevalence of knee pain among males was found to be 14% and the prevalence of knee pain among females was found to be 12.3%. The multivariate analysis included the following variables: age, gender, and marital status. The following factors predicted higher rate of PFP: being 18 to 25 years old (p-value < 0.001, odds ratio = 1), being 26 to 35 years old (p-value = 0.001, odds ratio = 1.689). Conclusion The prevalence of PFP and knee pains was found to be relatively high in Saudi Arabia. Age less than 40 years old was found to be associated with a higher prevalence of PFP and knee pain when compared to other age groups.

Is There a Correlation Between Reported Knee Pain and Fluid at the Distal Insertion of the Iliotibial Band in Runners?

ObjectiveTo determine whether there is a correlation between pain and the amount of fluid present at the distal insertion of the iliotibial band (ITB) in runners, as measured by USG.MethodOur retrospective cross-sectional study evaluated 100 male and female runners prior to the start of a race. A valid and reliable questionnaire collected demographic, pain, and training data. If a runner reported knee pain, a numeric pain rating scale was used to record the degree of pain. Participants then underwent USG on both knees to determine the presence or absence of fluid at the distal insertion of the ITB.ResultWe found no statistically significant correlations of fluid measurements with pain score, running experience in years, or age. In addition, we found no other differences in fluid measurements between those with and without knee pain or between the sexes.ConclusionsOur findings indicate that the presence or absence of fluid at the distal insertion of the ITB does not correlate with knee pain in runners, regardless of age, running experience, or sex.

Running footstrike pattern effect on lower extremity work in an individual with transtibial amputation.

Asymmetrical loading favoring the intact limb during running has been associated with increased prevalence of reported knee pain and potential risk factors of knee osteoarthritis in that limb for patients with amputation. Footstrike pattern alterations have been suggested to help alleviate some overloading of the knee, but little is known about how it affects the rest of the limb. The purpose of this case study was to evaluate the effect of footstrike pattern on the distribution of loading throughout the lower extremities during submaximal running of an individual with transtibial amputation (TTA). This study compared loading distribution among the lower extremity joints in a male patient who sustained a TTA and ran using both a rearfoot (RFS) and forefoot strike (FFS) pattern. The results of this case demonstrated that altering footstrike pattern minimally alters the total mechanical work being done by the lower extremities but more so affects the relative amount of work contributed by the individual joints. In the intact limb, the ankle contributes the most to power absorption using a FFS pattern while the knee has a larger role using a RFS pattern. This case suggests that the footstrike pattern affects lower extremity loading distribution at the joint level, and adopting a FFS pattern may alleviate overloading the knee, whereas a RFS pattern may reduce loading at the ankle in individuals with TTA.