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Knee Pain
Published in Benjamin Apichai, Chinese Medicine for Lower Body Pain, 2021
Physical examination of the anterior cruciate ligament injury: Begin by obtaining the patient’s medical history: Sports activities that often involve sudden stops or changes in direction while running, including direct contact and noncontact injuries.Sports activities that cause direct contact injury, including a direct blow to the front side of the tibia.Sports that may cause noncontact injury include soccer, football, and basketball.An anterior cruciate ligament injury may also affect other knee structures such as the meniscus, patella cartilage, and fractures. A thorough physical examination should include the exams for other knee structures as well.Inspection: The knee is unstable with movement, and it is painful to bear weight.The knee may be easily bent backward.Swelling may occur within 4–12 hours after the initial injury.Palpation: Tenderness may be found along the joint line.Range of motion: The knee joint may lose full range of motion.Anterior Drawer Test: The patient is lying supine on the exam table, the knee flexes at 90 degrees, and the feet are placed flat on the bed to keep relaxed. The examiner pulls the tibia forward. If the tibia moves excessively forward (more than 5 mm), the test is positive, and it suggests a torn anterior cruciate ligament.Lachman Test: The patient is either supine or prone; the examiner stands next to the injured knee. The affected knee is bent at about 30 degrees. The examiner secures the femur with one hand and pulls the tibia forward with the other hand. If the tibia moves anteriorly significantly more than the unaffected leg, the test is positive, and it suggests a torn anterior cruciate ligament.
A THEORETICAL BASED PHYSIOTHERAPY GOAL SETTING MODEL FOR ANTERIOR CRUCIATE LIGAMENT REHABILITATION
Published in Physiotherapy Theory and Practice, 2022
Jenny Alexanders, John Perry, Caroline Douglas
From a global perspective, anterior cruciate ligament injury (ACL) incidences are continuing to rise, with Australia and the United States having one of the highest incidence rates within the athletic population (Culvenor et al., 2019). ACL data taken over the past two decades from the United Kingdom (UK) revealed that ACL injury rates have increased 12-fold (Abram, Price, Judge, and Beard, 2020). The annual cost of ACL surgery and rehabilitation varies internationally, with the USA costing approximately 7.4 billion dollars and Australia 142 million dollars (Zbrojkiewicz, Vertullo, and Grayson, 2018). Considering the population of the UK is less, the annual NHS costs are in excess of 63 million pounds (Davies et al., 2020). This is partly due to patients' elevated levels of worry and fear causing unnecessary costs associated with re-assessments and scans (Egloff, Huber, Wurm, and Pagernstert, 2019; Wu et al., 2018). While research surrounding sports-related ACL injuries dominate the literature, such injuries also occur in the workplace (Chen et al., 2013).
Emerging injectable therapies for osteoarthritis
Published in Expert Opinion on Emerging Drugs, 2022
IL-1 receptor antagonists have been studied in various knee pathologies. While there has been some promising effects of anakinra (a recombinant IL-1 receptor antagonist) in anterior cruciate ligament injury [44] and persistent knee joint effusion [45], this has not been translated to OA research. A phase II trial demonstrated that while it was well-tolerated, a single dose of intraarticular anakinra (50 or 150 mg) was not associated with significant improvement in patient-reported pain or function 12 weeks post injection, compared to placebo [46]. AMG 108 is a fully humanized monocloncal antibody to the IL-1 receptor and has also failed to demonstrate a significant response after subcutaneous or intravenous administration every 4 weeks for 12 weeks, compared to placebo [47].
Effects of vision and cognitive load on static postural control in subjects with and without patellofemoral pain syndrome
Published in Physiotherapy Theory and Practice, 2018
Afsaneh Zeinalzadeh, Saeed Talebian, Soofia Naghdi, Mahyar Salavati, Salman Nazary-Moghadam, Bahareh Zeynalzadeh Ghoochani
To our knowledge, no study has attempted to collate the available evidence on the effect of vision versus cognition in musculoskeletal disorders. Only a few studies have investigated the effect of vision during static postural control or selected functional activities in musculoskeletal disorders (e.g. anterior cruciate ligament injury, chronic ankle sprain, and low back pain). These articles concluded that vision appears to be important in compensating for the decreased role of proprioception in the symptomatic leg in patients with anterior cruciate ligament injury to have better postural control. (O’Connell et al., 1998; Okuda et al., 2005). Also, subjects with recurrent low back pain demonstrated less spine stability in eyes-closed condition as compared with open-eyes condition (Sung and Leininger, 2015). Mitchell et al. (2008) concluded that subjects with ankle instability had significantly greater medial and lateral postural sway in the absence of visual input.