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Wilding, Christopher P., Martyn Snow, and Lee Jeys. "Which factors affect the ability to kneel following total knee arthroplasty? An outpatient study of 100 postoperative knee replacements." Journal of Orthopaedic Surgery 27, no. 3 (September 1, 2019): 230949901988551. http://dx.doi.org/10.1177/2309499019885510.
Background: Kneeling is an important activity of daily living, holding social, religious and occupational value. Following total knee replacement (TKR), many patients report they are unable to kneel or have been advised not to kneel. Methods: We observed 100 consecutive knee replacements in 79 patients attending outpatient clinic at a minimum 5 months post-TKR. The patients were asked to fill out a questionnaire detailing whether they were able to kneel prior to their knee replacement and whether they thought they were able to kneel since their knee replacement. The patients were then asked to kneel on a padded examination couch and then onto a pillow on the floor for 15 s. Degree of flexion achievable was also recorded. Results: Of the knees with patella resurfacing, 78.6% were able to kneel compared to only 45.6% knees with native patellae. Two-tailed Fisher’s exact test showed this difference to be statistically significant ( p = 0.001). The χ 2 analysis showed that those patients with an achievable flexion of angle of greater than 100° were significantly more likely to be able to kneel than those with a flexion angle of less than 100° ( p = 0.0148). Comparing posterior cruciate ligament (PCL) retaining against PCL sacrificing implants, there was no statistically significant difference in kneeling ability ( p = 0.541). Conclusion: Kneeling remains an important function in patients undergoing TKR, with patella resurfacing significantly improving the likelihood of a patient being able to kneel.
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Fahlman, Lissa, Emmeline Sangeorzan, Nimisha Chheda, and Daphne Lambright. "Older Adults without Radiographic Knee Osteoarthritis: Knee Alignment and Knee Range of Motion." Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders 7 (January 2014): CMAMD.S13009. http://dx.doi.org/10.4137/cmamd.s13009.
This study describes knee alignment and active knee range of motion (ROM) in a community-based group of 78-year old adults (n = 143) who did not have radiographic evidence of knee osteoarthritis in either knee (KL < 2). Although knee malalignment is a risk factor for knee osteoarthritis, most women and men had either valgus or varus alignments. Notably, no men were valgus in both knees. Women with both knees valgus had significantly greater body mass index ( P > 0.001) than women with varus or straight knees. Men and women with valgus or varus knee alignments had generally lower ROM than individuals with both knees straight. In summary, this study highlights the complex relationships among knee alignment, ROM, body mass index, and gender in elderly adults without radiographic knee osteoarthritis.
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Mohd Nizlan, Nasir, Fauzah Abd Ghani, and Rohaman Tasarib. "Acute Post-Traumatic Locked Knee - An Unmasking of a Rare Knee Disorder." Malaysian Journal of Medicine and Health Sciences 18, no. 5 (September 15, 2022): 215–17. http://dx.doi.org/10.47836/mjmhs.18.5.29.
Locked knees are commonly caused by meniscal tears, floating osteochondral bodies, ruptured anterior cruciate ligament (ACL) stump, or other mechanical origins in the knee. Some locked knees occur spontaneously, while in most cases, by a preceding knee trauma. Locked knees are rarely caused by a pathological growth in the knee. More unusually is the occurrence of locked knee caused by a pre-existing pathological entity after a traumatic event. We report a rare case of locking in the knee by a pre-existing knee condition presented only after trauma to the knee. This case emphasizes that locking in the knee can be caused by a pathology that may be asymptomatic until it is revealed by a traumatic event.
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Ismail, Shiek Abdullah, Milena Simic, Lucy J. Salmon, Justin P. Roe, Leo A. Pinczewski, Richard Smith, and Evangelos Pappas. "Side-to-Side Differences in Varus Thrust and Knee Abduction Moment in High-Functioning Individuals With Chronic Anterior Cruciate Ligament Deficiency." American Journal of Sports Medicine 47, no. 3 (December 10, 2018): 590–97. http://dx.doi.org/10.1177/0363546518812883.
Background: There is evidence that frontal plane knee joint motion plays a crucial role in the pathogenesis of knee osteoarthritis, yet investigation of individuals with chronic anterior cruciate ligament–deficient (ACLD) knees remains sparse. Purpose: To investigate (1) if individuals with chronic ACLD knees demonstrate higher biomechanical measures of medial knee load as compared with their anterior cruciate ligament–intact (ACLI) knees, (2) if differences in static knee alignment of the ACLD knee will demonstrate a difference in the magnitude of biomechanical measures of medial knee load when compared with the ACLI knee, and (3) the side-to-side concordance of varus thrust among individuals with chronic ACLD knees. Study Design: Descriptive laboratory study. Methods: Participants were sourced from a metropolitan orthopaedic surgeon group. Those who met the inclusion criteria and agreed to participate underwent a 3-dimensional gait analysis assessment to measure knee adduction moment (KAM), knee flexion moment (KFM), KAM peaks, KAM impulse, and varus thrust. Frontal plane knee static alignment was measured with a digital inclinometer fixed to medical calipers. The participants were divided according to their static knee alignment (neutral, varus, and valgus) for subgroup analysis. Peak knee angular velocity and frontal plane knee angle were used to establish if a participant was walking with a knee thrust. An individual was deemed to have knee thrust during gait if the largest frontal plane knee movement coincided with the peak knee angular velocity that occurred within the first 30% of stance phase. Results: Forty-five participants were recruited. The mean (SD) time from injury was 34.5 (55.6) months. ACLD knees did not demonstrate higher mean KAM and KFM ( P > .5) or early-stance peak KAM ( P = .3-.8) and KAM impulse ( P = .3-.9) as compared with ACLI knees as a whole group or when the varus, neutral, and valgus alignment subgroups were investigated separately. Twenty-three percent (n = 9) of the participants had a varus thrust at the ACLD or ACLI knee, 44% (n = 4) had a varus thrust at the ACLD knee, and 22% (n = 2) had varus thrust at both knees. Conclusion: There were no side-to-side differences in mean KAM and KFM and early-stance peak KAM and KAM impulse among high-functioning individuals with chronic unilateral ACLD knees. There was a low prevalence of varus thrust among high-functioning individuals with chronic unilateral ACLD knees.
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Amin, Raj M., Vikram Vasan, and Julius K. Oni. "Kneeling after Total Knee Arthroplasty." Journal of Knee Surgery 33, no. 02 (January 2, 2019): 138–43. http://dx.doi.org/10.1055/s-0038-1676801.
AbstractThe ability to kneel is one of the many patient goals after total knee arthroplasty (TKA). Few studies have addressed patients' ability to kneel after TKA as a primary outcome. Given the altered biomechanics of the knee after TKA, the various implant designs, and multiple surgical approaches, there is a need to further understand the patient's kneeling ability after TKA. We evaluated the available literature on this topic to help to guide postoperative care recommendations. Biomechanical data show that the load borne by the patellofemoral joint is elevated significantly at all flexion angles, whereas tibiofemoral articulation pressures are elevated only at 90 to 120 degrees of flexion. However, these increased pressures are rarely borne by prosthetic knees because patients often avoid kneeling after TKA. In patients who do kneel after surgery, data show that increased range of motion promotes improved kneeling performance. Targeted interventions to encourage kneeling after TKA, including preoperative education, have not shown an ability to increase the frequency with which patients kneel after TKA. Reasons for patient avoidance of kneeling are multifaceted and complex. There is no biomechanical or clinical evidence contraindicating kneeling after TKA. There are insufficient data to recommend particular prosthetic designs or surgical approaches to maximize kneeling ability after surgery. Musculoskeletal health care providers should continue to promote kneeling to allow patients to achieve maximum clinical benefit after TKA.
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Agarwal, A., S. Miller, W. Hadden, L. Johnston, W. Wang, G. Arnold, and RJ Abboud. "Comparison of gait kinematics in total and unicondylar knee replacement surgery." Annals of The Royal College of Surgeons of England 101, no. 6 (July 2019): 391–98. http://dx.doi.org/10.1308/rcsann.2019.0016.
Introduction This study is aimed to compare kinematic gait data of patients who have undergone total and unicondylar knee replacement. Materials and methods This single-surgeon retrospective cohort study evaluated 13 patients with unilateral total knee arthroplasty (TKA) and 14 unicondylar knee arthroplasty (UKA). Gait analysis was carried out using a Vicon motion analysis system. The limits of knee flexion during stance phase, at heel strike and at loading response were measured. Results The total range of motion of the UKA knees was significantly greater than the TKA knees. UKA knees exhibited significantly greater knee extension during the stance phase than the TKA knees. Unlike TKA, UKA knees demonstrated improved knee flexion during the gait cycle when compared to the contralateral non-operated knee. The hips also demonstrated near normal hip flexion in UKA patients. Predictably, UKA knees had significantly greater varus compared with TKA in the coronal plane. Spatiotemporal variables demonstrated similar walking speed and step length to aid a fair comparison between knee replacement groups. Conclusions The UKA knees moved more physiologically in the sagittal plane with a greater range of motion during gait. Despite having a stiff gait pattern, the patients undergoing TKA demonstrated a more neutral alignment in the coronal plane. Neither type of knee arthroplasty restored knee kinematics to those of the non-operated side.
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Nagai, Kanto, Elmar Herbst, Tom Gale, Yasutaka Tashiro, James J. Irrgang, William Anderst, and Freddie H. Fu. "Patient-reported outcome measures following anterior cruciate ligament reconstruction are not related to dynamic knee extension angle." Journal of ISAKOS: Joint Disorders & Orthopaedic Sports Medicine 3, no. 1 (January 2018): 33–37. http://dx.doi.org/10.1136/jisakos-2017-000173.
ObjectivesControversy still exists on whether knee hyperextension affects the outcome following anterior cruciate ligament reconstruction (ACL-R). Therefore, the purpose of the present study was to determine if maximum knee extension angle of ACL-R knees and contralateral uninjured knees during walking is related to the clinical outcome following ACL-R. It was hypothesised that maximum knee extension angle would not be significantly correlated with patient-reported outcome measures (PROMs) following ACL-R.MethodsForty-two patients (age at surgery: 23±9 years, 23 male and 19 female) underwent unilateral ACL-R. Twenty-four months after surgery, subjects performed level walking on a treadmill while biplane radiographs were acquired at 100 Hz. Three-dimensional tibiofemoral motion was determined using a validated model-based tracking process. Tibiofemoral rotations were calculated from foot strike through early stance. The primary kinematic outcome measure was maximum knee extension angle of ACL-R and contralateral uninjured knees during walking, with positive values indicating hyperextension. The side-to-side difference (SSD) in maximum knee extension angle was calculated by subtracting the angle of the contralateral uninjured knee from that of the ACL reconstructed knee. PROMs (International Knee Documentation Committee Subjective Knee Form, Knee Injury and Osteoarthritis Score and Marx Activity Rating Scale) were obtained at 24 months after surgery. Correlations between PROMs and maximum dynamic knee extension angle in ACL-R and contralateral knee were evaluated (P<0.05).ResultsMaximum knee extension angle during walking was 2.3±4.5° in ACL-R knees and 4.3±4.2° in contralateral uninjured knees at 24 months after surgery, indicating hyperextension during walking on average. SSD in maximum knee extension angle was −2.0±3.7°. No significant correlation was observed between maximum knee extension angle and the PROMs.ConclusionMaximum knee extension angle during walking was not significantly correlated with PROMs, suggesting that clinically, physiologic knee hyperextension can be restored after ACL-R and not adversely affect PROMs.Level of evidenceLevel III.
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WISE, BARTON L., DAVID T. FELSON, MARGARET CLANCY, JINGBO NIU, TUHINA NEOGI, NANCY E. LANE, JEAN HIETPAS, et al. "Consistency of Knee Pain and Risk of Knee Replacement: The Multicenter Osteoarthritis Study." Journal of Rheumatology 38, no. 7 (April 15, 2011): 1390–95. http://dx.doi.org/10.3899/jrheum.100743.
Objective.To examine whether the consistency or persistence of knee pain, in addition to its severity, predicts incident total knee replacement (TKR).Methods.The Multicenter Osteoarthritis Study (MOST) is a longitudinal study of persons aged 50 to 79 years with symptomatic knee osteoarthritis or at high risk of disease. Subjects were queried about the presence of knee pain on most days of the previous 30 days (i.e., frequent knee pain; FKP) at 2 timepoints: a telephone screen followed by a clinic visit (median separation 4 weeks). We defined a knee as having “consistent pain” if the subject answered positively to the FKP question at both timepoints, “inconsistent pain” if FKP was positive at only one timepoint, or as “no FKP” if negative at both. We examined the association between consistent FKP and risk of TKR using multiple binomial regression with generalized estimating equations.Results.In 3026 persons (mean age 63 yrs, mean body mass index 30.4), 2979 knees (50%) had no FKP at baseline, 1279 knees (21.5%) had inconsistent FKP, and 1696 knees (28.5%) had consistent FKP. Risk of TKR over 30 months was 0.8%, 2.6%, and 8.8% for knees with no, inconsistent, and consistent FKP, respectively. Relative risks of TKR over 30 months were 1.2 (95% CI 0.6–2.3) and 2.3 (95% CI 1.2–4.4) for knees with inconsistent and consistent FKP, compared with those without FKP. This association was consistent across each level of pain severity on the Western Ontario and McMaster Universities Osteoarthritis Index.Conclusion.Consistency of frequent knee pain is associated with an increased risk of TKR independently of knee pain severity.
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Blaisdell, Jay, and James Talmage. "Rating Knee Impairments." Guides Newsletter 23, no. 1 (January 1, 2018): 14–16. http://dx.doi.org/10.1001/amaguidesnewsletters.2018.janfeb04.
Abstract Workers who kneel for major portions of their workday (eg, floor and roof installers) may be prone to inflammation of the knee bursae and patellofemoral pain. In the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), range-of-motion (ROM) and diagnosis-based impairment (DBI) are the two possible stand-alone methods for rating knee impairment. The ROM method was widely used in previous editions of the AMA Guides, but at present DBI is the method of choice for calculating impairment. To rate knee impairment using the DBI method, the physician first chooses the appropriate diagnosis from the Knee Regional Grid in the AMA Guides, Sixth Edition. Next, the physician chooses the appropriate impairment class for the diagnosis and then selects the appropriate grade modifiers. The physician applies the net adjustment formula to determine lower extremity impairment and finally converts the final lower extremity impairment to whole person impairment. Two or more conditions often are found in the knees and require causation analysis in which the physician should choose the single causally related diagnosis that will yield the highest impairment rating. Modifiers should be chosen based on reliable findings that have not been used previously to assign either the diagnosis or impairment class. The ROM method can be used to select the physical examination grade modifier or as a stand-alone rating if the physician offers a rationale that is supported by the AMA Guides.
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Hiranaka, Takafumi, Yuichi Hida, Takaaki Fujishiro, Tomoyuki Kamenaga, Kenichi Kikuchi, Ryo Yoshikawa, Shotaro Tachibana, and Koji Okamoto. "Approximately 30% of Functioning Anterior Cruciate Ligaments Are Sacrificed for Knee Arthroplasty." Journal of Knee Surgery 33, no. 07 (March 25, 2019): 655–58. http://dx.doi.org/10.1055/s-0039-1683928.
AbstractThe anterior cruciate ligament (ACL) plays an important role in knee kinematics. Unicompartmental knee arthroplasty (UKA) preserves the ACL, an advantage over total knee arthroplasty (TKA), where it is sacrificed. This study aims to evaluate how often functional ACLs are sacrificed in arthroplasty. The type of arthroplasty (TKA or UKA) and condition of the ACL were studied in a total of 1,586 knees in 1,052 patients who underwent knee arthroplasties. Of 1,586 knees, TKA was performed on 653 knees (41%) and UKA on 933 knees (59%). The ACL was functioning in 77% of all knees. Of the TKA knees, the ACL was functioning in 357 knees (55%). Of these, around 30% of the functioning ACLs were sacrificed to perform TKA. To improve postoperative patient satisfaction after knee arthroplasty, further study regarding relationship between ACL preservation and clinical outcome will be required.
Schrader, Kate. "Knee Surgery: Total Knee Replacement or Partial Knee Replacement." University of Toledo Honors Theses / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=uthonors1305216135.
Zhang, Yin, and 張銀. "Validation of the new knee society knee scoring system for outcome assessment after total knew arthroplasty." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193564.
Introduction:
This retrospective comparative study was to define the validity and reliability of a translated, culturally adapted Chinese version questionnaire of the New Knee Society Knee Scoring System (NKSS).
This study is aim to investigate the validity and reliability of the translated Chinese version of the NKSS and assess its feasibility of measuring the scale on Chinese patients by performing its cross-cultural adaptation for patients after Total Knee Arthroplasty (TKA) in Hong Kong.
Methods:
A total of 104 knees from 64 Chinese patients performed TKA were included in the study using the translated, culturally adapted Chinese version of the NKSS. All Patients were operated on from October 2010 to May 2013 at Queen Mary Hospital. Patients who participated in this study have been clinically screened and established a set of including criteria. The outpatients were evaluated by completing the five questionnaires containing the NKSS, the Knee Society Clinical Rating System (KSS), Medial Outcomes Study 36+Item Short Form (SF-36), Bristol Knee Score and Oxford Knee Score.
Reliability was evaluated using the Split-half reliability, Chronbach's α coefficient and inter-item correlation. To assess validity, all patients filled in the same NKSS questionnaire, and previously validated Chinese version of the SF-36, Bristol Knee Score and Oxford Knee Score. The validity was determined with Content Validity and Contract Validity.
Results:
The NKSS showed ideal split-half reliability as evidenced by the high correlation coefficient (R>0.7, P<0.05). Chronbach's α coefficient for five major domains demographics, objective knee score, expectations, satisfaction and function was high (α>0.7. P<0.05). Also, the inter-item correlation was also excellent for all domains. For validity, the NKSS was found to have excellent correlation with Bristol Knee Score and Oxford Knee Score, good correlation with KSS and SF 36
Discussion:
The NKSS as a validated approach is adapted to the diverse health-related quality of lives and activities of contemporary patients with TKA. Orthopaedics surgeons are allowed to appreciate differences in the priorities of individual patients and the interplay among function, expectation, symptoms, and satisfaction after TKA using this assessment instrument.
Conclusion:
The results of this study show that the NKSS as a functional status questionnaire has been translated into Chinese without missing any psychometric properties of the original version. This culturally and linguistics adapted Chinese version of the NKSS outcome assessment has satisfactory internal consistency and good validity. It is an adequate and helpful instrument for the evaluation of Chinese speaking patients after TKA in clinical studies. published_or_final_version Medical Sciences Master Master of Medical Sciences
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Schmitt, Laura Clare. "Knee stabilization and medial knee osteoarthritis." Access to citation, abstract and download form provided by ProQuest Information and Learning Company; downloadable PDF file 0.80 Mb., 201 p, 2006. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqdiss&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:3220738.
As the number of total knee arthroplasty (TKA) procedures increases annually, the patient demographic is shifting to include younger patients with higher expectations for post-operative function. The aim of this study was to compare movement patterns during activities of daily living among TKA patients and a healthy, age-matched group using 3D motion analysis. Specifically, this analysis looked at walking on level and inclined surfaces, as well as sitting up and down from a chair. It was predicted that (1) TKA patients would exhibit reduced knee extension moments at the operated limb and increased adduction moments at the contralateral limb during gait, (2) walking downhill would result in greater differences between TKA and control groups, compared to level walking, and (3) TKA participants would have greater flexion angles, moments and power values at the hip, compared to controls, during the sit-stand tasks. Seventeen participants (age=62±6 years, BMI=30±3 kg/m2, time after surgery=11±5 months) were recruited from the Ottawa Hospital, having undergone unilateral TKA by the same surgeon. An age-matched control group was composed of 17 individuals (age=63±8 years, BMI=27±4 kg/m2) who were recruited from the local community. Three dimensional (3D) biomechanical assessment was conducted with all participants performing five trials of walking on level and inclined surfaces, stair ascent and descent as well as sit-stand tasks. Results from this study were focused on gait and sit-stand transitions, showing that TKA participants exhibited altered gait patterns on both walking surfaces, with significantly smaller knee flexion angles and moments, as well as reduced peak power at the knee. The TKA group also experienced reduced knee extension moments; however, this was only significant for downhill walking. Consistent with our hypothesis, downhill walking resulted in greater discrepancies between the groups compared to level walking. Contrary to our third hypothesis, TKA participants exhibited significantly smaller peak hip flexion angles and moments during the sit-stand task, along with reduced hip abduction angles and knee abduction moments. The reduced knee flexion kinematics and kinetics observed during gait tasks, combined with the differences in frontal plane mechanics observed during the sit-stand task suggest that altered loading patterns persist six to twelve months after surgery. This may be a result of continued pre-operative movement patterns as well as the surgery itself, and should be kept in mind when developing rehabilitation programs for this patient population.
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Lane, Judith. "Knee joint stiffness and function following total knee arthroplasty." Thesis, University of Edinburgh, 2010. http://hdl.handle.net/1842/4790.
Introduction: Studies show that Total Knee Arthroplasty (TKA) is successful for the majority of patients however some continue to experience some functional limitations and anecdotal evidence indicates that stiffness is a common complaint. Some studies have suggested an association between stiffness and functional limitations however there has been no previous work which has attempted to objectively quantify knee joint stiffness following TKA. The purpose of this study was to pilot and evaluate a method for the quantitative evaluation in joint stiffness in replaced knees, OA knees and healthy controls and to explore whether there is an association between stiffness and functional limitations post-TKA surgery. Methods: The first part of the study created a biomechanical model of knee stiffness and built a system from which stiffness could be calculated. A torque transducer was used to measure the resistance as the knee was flexed and extended passively and an electrogoniometer concurrently measured the angular displacement. Stiffness was calculated from the slope of the line relating the passive resistive torque and displacement. The torque and joint angle at which stiffness was seen to increase greatly was also noted. The system was bench tested and found to be reliable and valid. Further tests on 6 volunteers found stiffness calculations to have acceptable intra-day reliability. The second part was conducted on three groups: those with end-stage knee OA (n = 8); those who were 1 year post-TKA (n = 15) and age matched healthy controls (n = 12). Knee range of motion was recorded and participants then completed the WOMAC, the SF-12 and a Visual Analogue Score for stiffness as well as indicating words to describe their stiffness. Four performance based tests – the Timed Up and Go (TUG), the stair ascent/descent, the 13m walk and a quadriceps strength test were also undertaken. Finally, passive stiffness at the affected knee was measured. Results: 100% of OA, 80% of TKA and 58% of controls reported some stiffness at the knee. The OA group reported significantly higher stiffness than the OA or TKA groups. There was no difference in self-reported stiffness between the TKA and control groups. Of the total number of words used to describe stiffness, 52% related to difficulty with movement, 35% were pain related and 13% related to sensations. No significantly differences were found between groups in the objective stiffness measures. Significant differences were found however in threshold flexion stiffness angles between groups. When this angle was normalised, differences between groups were not significant. No significant differences were found between groups in the threshold stiffness torque. Greater self-reported stiffness was found to be associated with worse self-reported function. A higher flexion stiffness threshold angle was associated with slower timed tests of function but also with better quadriceps muscle strength. Conclusions: The results support anecdotal reports that perceived stiffness is a common complaint following TKA but there was no evidence to show that patients with TKA have greater stiffness than a control group. There was however evidence to show that patients’ were unable to distinguish between sensations of stiffness and other factors such as pain. Self-perceived increased stiffness was associated with worse functional performance. Greater stiffness however was not necessarily negative. Stiffness increases earlier in flexion range were associated with better functional performance. These results suggest that an ideal threshold range for stiffness may exist; above which negative perceptions of the knee result in worse function but below which, knee laxity and instability may also result in worse function.
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Garrett, Benjamin R. "Knee pain, swelling and stiffness after total knee replacement : a survey of South African knee surgeons." Master's thesis, University of Cape Town, 2011. http://hdl.handle.net/11427/2841.
Molloy, Martin-Patrick. "The biomechanics of the knee of total knee replacement golfers." Thesis, Ulster University, 2014. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.625503.
Total knee arthroplasty (TKA) - the replacement of the articulating surfaces of the knee joint - is an increasingly used intervention for osteoarthritis. Younger, more active patients are undergoing TKA due to the clinical success of the implants. Surgeons must make recommendations on the suitability of post-surgery sporting activities; a balance must be struck between the health-promoting nature of the activity and the risk involved to the implant. Golf has been identified as a sport with a large number of participants that is recommended by the majority of knee surgeons. Despite golf being considered a low risk activity, there is limited scientific evidence that the loading applied to the knee-joint may be larger than assumed. Thus, the main aim of this thesis was to provide objective biomechanical data to contribute to our scientific knowledge base and to provide meaningful clinical data to enable medical practitioners to make informed decisions regarding the appropriateness of golf as an activity for post -TKA individuals. Three studies are presented in this thesis. The first investigated the suitability of a standard six-degrees-of-freedom (6DoF) marker model and tested the performance of an alternative model that included an 'optimised', modified cluster design placed on a site of low soft tissue artefact. Whilst statistically significant differences were identified between knee angles derived from each cluster design, the magnitude of the differences were small. Thus, both of the marker models were considered to provide knee-angle measurements that would be considered equivalent in a clinical setting.
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Newman, Simon David Standen. "Improving outcomes in knee arthroplasty : the lateral unicompartmental knee replacement." Thesis, Imperial College London, 2016. http://hdl.handle.net/10044/1/39290.
Total knee replacement (TKR) continues to increase in popularity, but satisfying patients who remain active for longer is a major challenge. Outcomes from TKR remain suboptimal, with as many as 20% gaining little benefit. An alternative approach to TKR is the use of partial or unicompartmental knee replacements (UKR). These are smaller and safer operations, but are arguably more difficult to perform and have been associated with a higher rate of revision surgery. Whilst a great deal is understood about medial UKR, relatively little is known about lateral UKR and this procedure forms the basis of this thesis. Outcomes of a lateral UKR implant, the Oxford Domed Lateral Partial Knee were assessed through upto 10 year follow-up of the largest independent series of this implant and demonstrated similar rates of revision and Oxford Knee Scores to previously published medial UKR series. Further assessment of the gait of patients with the same implant however failed to show a significant improvement over demographically matched patients with TKR. Accuracy of implant positioning is important for achieving optimal outcomes. One technology that may assist in delivering expert level skill is patient specific instrumentation (PSI). For the first time, the effect of changes in PSI guide design were explored, demonstrating the importance of achieving multiplanar bone contact. The use of PSI guides compared to traditional instruments was associated with superior femoral implant positioning and a trend for superior tibial implant positioning when used by inexperienced surgeons on a training course. The effect of tibial implant malpositioning on tibial strain was demonstrated using digital image correlation. Excessive posterior slope and tibial resection should be avoided to prevent higher tibial strains that may result in fracture. A pre-requisite for successful arthroplasty, including lateral UKR, is the establishment of osseomechanical integration. Enhanced osseomechanical integration may be better achieved with strontium-substituted bioactive glass (SrBG) than a hydroxyapatite (HA) coating as demonstrated in a lapine model. The data presented in this thesis demonstrates that lateral UKR is a challenging but effective operation, though further development is required to facilitate normal gait. Further improvements in function and outcomes may be achievable through the use of PSI and enhanced implant fixation with SrBG coatings.
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McAlindon, Timothy Edward. "Knee joint failure." Thesis, University of Southampton, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.386627.
Petterson, Stephanie Christine. "Knee osteoarthritis and total knee arthroplasty quadriceps weakness, rehabilitation, and recovery /." Access to citation, abstract and download form provided by ProQuest Information and Learning Company; downloadable PDF file 1.02 Mb., 222 p, 2006. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqdiss&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:3205435.
Courage, Olivier, Simon Bertiaux, Pierre-Emmanuel Papin, and Anthony Kamel. Knee Arthroscopy. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-82830-1.
Hanschen, Marc, Peter Biberthaler, and James P. Waddell, eds. Knee Fractures. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-81776-3.
Richmond, John C., James V. Bono, and Brian P. McKeon, eds. Knee Arthroscopy. New York, NY: Springer US, 2009. http://dx.doi.org/10.1007/978-0-387-89504-8.
Dreher, Geoffrey M., Utsav Hanspal, David M. Baxter, and Morteza Khodaee. "Knee." In Sports-related Fractures, Dislocations and Trauma, 375–420. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-36790-9_24.
Miller*, C., K. Johnson*, S. Mohan*, and R. Botchu**. "Knee." In Measurements in Musculoskeletal Radiology, 517–51. Berlin, Heidelberg: Springer Berlin Heidelberg, 2019. http://dx.doi.org/10.1007/978-3-540-68897-6_13.
Egan, Matthew, and David Spinner. "Knee." In Atlas of Handheld Ultrasound, 21–24. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-73855-0_5.
Visser, Jan Douwes. "Knee." In Pediatric Orthopedics, 171–236. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-40178-2_10.
Szendrői, M., G. Skaliczki, and L. Bartha. "Knee." In Color Atlas of Clinical Orthopedics, 403–37. Berlin, Heidelberg: Springer Berlin Heidelberg, 2009. http://dx.doi.org/10.1007/978-3-540-85561-3_19.
Yang, Aaron Jay, and Nitin B. Jain. "Knee." In Pain Medicine, 65–67. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-43133-8_17.
Bullock, James M., Scott Kling, Justin Arner, Joseph Labrum, Freddie Fu, and Dharmesh Vyas. "Knee." In Passport for the Orthopedic Boards and FRCS Examination, 991–1040. Paris: Springer Paris, 2015. http://dx.doi.org/10.1007/978-2-8178-0475-0_45.
Mohiaddin, Raad H., and Donald B. Longmore. "Knee." In MRI Atlas of Normal Anatomy, 155–81. Dordrecht: Springer Netherlands, 1992. http://dx.doi.org/10.1007/978-94-011-2990-9_9.
Guess, Trent M., Mohammad Kia, Katherine Weimer, Kevin Dodd, and Lorin Maletsky. "Validation of Computational Knee Models Using a Dynamic Knee Simulator." In ASME 2008 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2008. http://dx.doi.org/10.1115/sbc2008-192490.
Computational models of the knee provide valuable information on knee biomechanics, but validation of these models is challenging as in-vivo parameters such as muscle forces and tissue loading cannot be measured. Machines that simulate the dynamic loading and motion of physiological activities on cadaver knees can provide a means for validating computational knee models and modeling methods. In this approach, all forces applied to cadaver knees are known and can be replicated in computational simulations. The resulting experimental and computational kinematics can then be compared. Presented here is the development and use of a modeling platform comprised of a multi-body computational model of a cadaver knee and dynamic knee simulator and experimental measurements from the cadaver knee loaded in the machine. This modeling platform has been used to study: 1) patient specific reference lengths versus literature obtained reference lengths [1], 2) inclusion of ligament and tendon wrapping [2] and, 3) the development of a multi-body model of the meniscus [3].
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Caruntu, Dumitru I. "3-D Knee Biomechanics." In ASME 2008 International Mechanical Engineering Congress and Exposition. ASMEDC, 2008. http://dx.doi.org/10.1115/imece2008-67633.
This is a survey on 3-D dynamic and quasi-static human knee joint modeling. Anatomical surface representation, contact modeling, ligament structure, and solution algorithm are reviewed. Understanding knee joint biomechanics is important for total knee replacement and rehabilitation exercise design, ligament reconstruction, and cartilage damage. Knee models were proposed mostly in the last two decades. They aimed normal activities and rehabilitation exercises, and sought muscle, ligament, and joint contact forces. Consisting of two joints, tibio-femoral (TF) and patello-femoral (PF), the human knee 3-D models were PF, TF [1–3], and both TF and PF [4–7]. Models were static, quasi-static, and dynamic, including the entire, partial, or none of the ligament structure. Contact models of the knee were rigid or deformable. Both natural knees and replacement models were reported. Different groups of muscles were considered.
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Muñoz, David, Andy Pruett, and Graceline Williams. "Knee." In CHI '14: CHI Conference on Human Factors in Computing Systems. New York, NY, USA: ACM, 2014. http://dx.doi.org/10.1145/2559206.2580932.
Edd, Shannon N., Nathan A. Netravali, Julien Favre, Nicholas J. Giori, and Thomas P. Andriacchi. "Meniscectomized Knees Regain Normal Walking Flexion Range of Motion With Time Past Surgery." In ASME 2013 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2013. http://dx.doi.org/10.1115/sbc2013-14746.
Meniscal tears are one of the most common knee injuries with an incidence rate of 60–70 per 100,000 person-years [1]. Although arthroscopic partial meniscectomy, the leading treatment for meniscal tears, decreases pain, the risk of knee osteoarthritis (OA) is four times higher for a meniscectomized knee compared to an uninjured knee [2]. Prior research has shown that meniscectomized knees have reduced sagittal-plane range of motion in the early period following surgery (6 to 18 months) [3–5]. These observations suggest a mechanical pathway to knee OA, in which alteration in ambulatory knee function causes shifts in tibiofemoral cartilage location to unprepared cartilage regions, thus causing damage to the maladapted tissue [6]. While such a mechanical pathway is well documented for knees with reconstruction of the anterior cruciate ligament [7], the paucity of information regarding the walking mechanics of meniscectomized knees at longer term post-operation limits our understanding of the pathway to OA in this population. Particularly, it is unknown whether meniscectomized knees regain normal dynamic range of motion (ROM) in knee flexion with time past surgery. Because regaining ROM alters the mechanical function in the meniscectomized knee, understanding the changes in this gait variable over time may help elucidate the various pathways to OA development in meniscectomized knees.
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Maletsky, Lorin P., and Ben M. Hillberry. "Loading Evaluation of Knee Joint During Walking Using the Next Generation Knee Simulator." In ASME 2000 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 2000. http://dx.doi.org/10.1115/imece2000-2530.
Abstract Even with the advances in material selection, processing, and articular geometry for knee prostheses, there is still a need for in vitro evaluation of these components. The high occurrence of revision surgeries for failed prosthetics suggests that the component designs can still be improved. While historically the typical total knee recipient was an elderly woman, components are being implanted in younger patients who wish to lead more active lives with their new artificial knees. Therefore, the testing of new prostheses must be more rigorous and demanding than done previously. For these reasons a new five-axis electro-hydraulic knee simulator was constructed.
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Tiulpin, Aleksei, Iaroslav Melekhov, and Simo Saarakkala. "KNEEL: Knee Anatomical Landmark Localization Using Hourglass Networks." In 2019 IEEE/CVF International Conference on Computer Vision Workshop (ICCVW). IEEE, 2019. http://dx.doi.org/10.1109/iccvw.2019.00046.
Bloemker, Katherine H., and Trent M. Guess. "Effects of ACL Reconstruction Techniques on the Kinematics of the Knee in a Computational Knee Model." In ASME 2011 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2011. http://dx.doi.org/10.1115/sbc2011-53276.
This study examines the effects of different Anterior Cruciate Ligament (ACL) reconstruction techniques on computational multibody knee models. The knee models were derived from two cadaver knees that underwent simulated walk cycles while the kinematics of the knee geometries were collected in a dynamic knee simulator. Once the computational models performed well compared to experimental data, multiple simulated ACL reconstruction surgeries were done on each model. For each simulated reconstruction technique, overall knee kinematics was compared to the experimental cadaver results and anterior-posterior movement of the tibia relative to the femur was compared to the original, intact computational model. The factors examined were ACL reconstruction method, adding preload to the reconstruction element, and reconstruction element type.
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Gao, Fei, Xinyu Wu, and Wei-Hsin Liao. "Smart Prosthetic Knee for Above-Knee Amputees." In 2022 IEEE International Conference on Mechatronics and Automation (ICMA). IEEE, 2022. http://dx.doi.org/10.1109/icma54519.2022.9856182.
Celebi, Besir, Mustafa Yalcin, and Volkan Patoglu. "AssistOn-Knee: A self-aligning knee exoskeleton." In 2013 IEEE/RSJ International Conference on Intelligent Robots and Systems (IROS 2013). IEEE, 2013. http://dx.doi.org/10.1109/iros.2013.6696472.
Martinez-Villalpando, Ernesto C., Jeff Weber, Grant Elliott, and Hugh Herr. "Biomimetic Prosthetic Knee Using Antagonistic Muscle-Like Activation." In ASME 2008 International Mechanical Engineering Congress and Exposition. ASMEDC, 2008. http://dx.doi.org/10.1115/imece2008-67705.
The majority of commercial prosthetic knees are passive in nature and therefore cannot replicate the positive mechanical work exhibited by the natural human knee in early and late stance. In contrast to traditional purely dissipative prosthetic knees, we propose a biomimetic active agonist-antagonist structure designed to reproduce both positive and negative work phases of the natural joint while using series elasticity to minimize net energy consumption. We present the design and implementation of the active knee prosthesis prototype.
Reports on the topic "Knee":
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Pritchard, Joy, H. R. Whay, and A. Brown. Knee lesions. Brooke, 2011. http://dx.doi.org/10.46746/gaw.2020.abi.les.knee.
Xu, Zhiteng, and Renbin Li. A systematic review and meta-analysis of outcomes following unicompartmental knee arthroplasty versus total knee arthroplasty for unicondylar knee osteoarthritis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, March 2023. http://dx.doi.org/10.37766/inplasy2023.3.0003.
Review question / Objective: To conduct a systematic review and meta-analysis of randomized controlled trials comparing outcomes following unicompartmental knee arthroplasty versus total knee arthroplasty for patients with unicondylar knee osteoarthritis. Condition being studied: Knee osteoarthritis is a common disease in elderly population and its treatment strategies consist of non-operative treatment and surgery. Arthroplasty is a main surgery for this condition, while the optimal selection between unicompartmental knee arthroplasty and total knee arthroplasty remains debatable. We aim to collect RCTs comparing these two techniques in treatment of knee osteoarthritis and make a meta-analysis in order to provide high level of evidence for future decision-making for this issue.
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Berend, Keith R., and David Murray. Oxford Knee Replacement. Touch Surgery Simulations, 2018. http://dx.doi.org/10.18556/touchsurgery/2018.s0130.
Hollerbach, K., and A. Hollister. Prosthetic knee design by simulation. Office of Scientific and Technical Information (OSTI), July 1999. http://dx.doi.org/10.2172/15002379.
Hao, Dongsheng, Junjie Wang, and Liyun Zuo. Comparing the efficacy and safety of bicompartmental knee arthroplasty and total knee arthroplasty in the management of bicompartmental knee osteoarthritis: a meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, November 2022. http://dx.doi.org/10.37766/inplasy2022.11.0016.
Review question / Objective: At present, many clinical studies have been reported on the treatment of KOA by injecting sinomenine hydrochloride into the knee cavity. However, no systematic evaluation has been published on this issue, and it is not clear whether sinomenine hydrochloride injection is effective and safe in the treatment of KOA.Therefore, it is important to conduct systematic evaluation to obtain relatively convincing conclusions as to whether sinomenine hydrochloride injection can be a good choice as a complementary and alternative drug (CAM) for KOA. Condition being studied: The RCTs are eligible, whether or not the blind method is specifically described. There are no restrictions on languages. Moreover, systemic evaluation, review literature and the full article cannot be obtained will be excluded.
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Li, Jia, Yuan Liu, Jing Zhang, and Mingxing Yuan. Neuroimaging studies of acupuncture on knee osteoarthritis: a systematic review. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, April 2022. http://dx.doi.org/10.37766/inplasy2022.4.0110.
Review question / Objective: This study was conducted in order to investigate the study design and main outcomes of acupuncture neuroimaging studies on knee osteoarthritis (KOA),and reveal the potential mechanism of the pain-relieving effect of acupuncture on knee osteoarthritis. Condition being studied: Knee osteoarthritis is a very common disease that seriously affects people's quality of life. Acupuncture, as an effective treatment option, can achieve pain relief and treat the disease, but the mechanism of acupuncture analgesia is still unclear to us. Therefore, we set certain criteria to include eligible clinical trials to reveal its principles.
