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Rehabilitation after Trauma
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
Trans-tibial amputation preserves the anatomical knee joint, permitting a more comfortable prosthesis, greater aesthetic mobility and a cosmetically acceptable limb replacement. Through-knee amputation provides a potentially strong stump which can potentially bear weight for walking. However, this creates a leg-length discrepancy most apparent when seated. Ideally the knee joint should be preserved, however through knee disarticulations often walk earlier after surgery.
Evaluation of the Spine in a Child
Published in Nirmal Raj Gopinathan, Clinical Orthopedic Examination of a Child, 2021
Ashish Dagar, Sarvdeep Singh Dhatt, Deepak Neradi, Vijay G Goni
Do a PSLR test and stop when it becomes positive. At this point, flex the knee joint, which will relieve pain. Now, using your hand, firmly press in the popliteal fossa. If symptoms are reproduced, the test is said to be positive.
Animal Models of Meniscal Repair
Published in Yuehuei H. An, Richard J. Friedman, Animal Models in Orthopaedic Research, 2020
Jan Klompmaker, René P. H. Veth
The same authors also studied the effect of a meniscal prosthesis in an unstable knee after resection of the anterior cruciate ligament.53 It appeared that no protective effect of a prosthesis is present in an unstable knee. Therefore, just as applies for meniscal repair, a stable knee joint seems to be a prerequisite for success. A combination of an artificial prosthesis of Teflon combined with a biological periosteal implant in rabbits did not improve results.61 All grafts had changed in shape and were extruded towards the periphery of the joint. The cartilage no longer was covered and protected. Fibrocartilage was not formed and the meniscus failed to carry out meniscal function.
How prosthetic design influences knee kinematics: a narrative review of tibiofemoral kinematics of healthy and joint-replaced knees
Published in Expert Review of Medical Devices, 2019
Fanhe Meng, Sebastian Jaeger, Robert Sonntag, Stefan Schroeder, Sydney Smith-Romanski, J. Philippe Kretzer
At the initial stage of stationary activities, the tibia is located at the neutral (physiologic) position regarding the femur. During activities, the knee joint is mainly driven by the surrounding anatomical structure and the flexor-extensor mechanism. Conversely, during ambulatory motions, at the initial point of stance (heel strike), the tibia is dislocated anteriorly from the natural position by the contraction of quadriceps. Afterward, the inertia of the upper body drives the femur anteriorly while the foot is planted on the ground, leading to completely different kinematics compared to stationary activities [82–84]. While walking upstairs and downstairs are both ambulatory motions, the kinematics of these motions seem to be quite different from the kinematics of gait. According to some studies, this could be explained by the limited experimental methods [47,63]. For example, during the walking upstairs, the observed leg is planted on the first step and changes from flexion to extension when the second leg steps up. The subject makes a step-like motion but stops when the observed leg is fully extended. If the second leg would proceed, it would cross the image generated by the fluoroscope. Keeping the observed leg planted on the step during the experiment leaves out a crucial phase of stepping kinematics. It is the swing phase. Considering this problem in the test setup, the kinematics observed may not accurately represent continuous stair-stepping. A standardized method for performing and measuring the continuous stepping activity would be of great benefit to the research community for future applications.
Do functional hamstring to quadriceps ratio differ between men and women with and without stroke?
Published in Topics in Stroke Rehabilitation, 2018
Rodrigo Rodrigues Gomes Costa, Jefferson Rosa Cardoso, Clarice Bacelar Rezende, Gustavo Christofoletti, Rodrigo Luiz Carregaro
The non-paretic side presented FH/Q ratios below one (1.0), thus indicating a knee imbalance. This could be interpreted as a risk of future injury, as a previous study demonstrated a relative risk as high as 17 when the FH/Q ratio is below 0.6.44 This is a relevant finding that raises practical concerns, mostly during gait. For instance, the lower limbs weight transfer is affected by an asymmetrical weight bearing, which is one of the most common findings after stroke.45 Therefore, both the paretic and the non-paretic limbs weakness and the dynamic imbalance on the non-paretic side found in our study demonstrates that the deleterious impacts of asymmetrical weight bearing might be increased. Future studies are warranted in order to elucidate if the FH/Q ratio are related to gait asymmetries. Additionally, our findings suggest that knee joint muscle strengthening exercises could be of importance to this population and should be included within intervention protocols.
Comparative effectiveness of oral pharmacologic interventions for knee osteoarthritis: A network meta-analysis
Published in Modern Rheumatology, 2018
Sun-Young Jung, Eun Jin Jang, Seoung Wan Nam, Hyuk Hee Kwon, Seul Gi Im, Dam Kim, Soo-Kyung Cho, Dalho Kim, Yoon-Kyoung Sung
The knee joint is the main large joint affected by osteoarthritis (OA), and knee OA is a leading cause of disability globally [1]. Oral pharmacologic interventions are the mainstay treatment options in the non-surgical management of knee OA pain, and clinical practice guidelines recommend a stepped approach taking into account evidence on the efficacy of pain relief and the risk of gastrointestinal or other adverse effects [2,3]. However, clinicians face difficulties in decision-making because the current recommendations on use of acetaminophen (AAP), cyclooxygenase-2 (COX-2) inhibitors, non-steroidal anti-inflammatory drugs (NSAIDs), and opioids differ between clinical practice guidelines. For instance, the recommendation on the use of AAP is inconclusive in the American Academy of Orthopedic Surgeons (AAOS) guidelines [4] whereas AAP is conditionally recommended by the OA Research Society International (OARSI) [3], American College of Rheumatology (ACR) [2], and the European League Against Rheumatism (EULAR) [5]. The recommendations on use of NSAIDs and tramadol also differ between guidelines [2–5].