Effect of Knee Valgus Angle during Single Leg Squat and Horizontal Hop for Distance in Patients with Patellofemoral Pain and Controls

Background: Patellofemoral pain (PFP) is considered one of the most common dysfunctions of the lower extremities. Faulty lower limb mechanics and increased of knee valgus on loaded tasks are believed to play an important role in the development of PFP. Objective: To figure out if male PFP patients during single leg horizontal hop for distance and squat with greater knee valgus than controls, and if the nature of the task changes the angles of knee valgus. Methods: Twenty males with unilateral PFP formed the patient group and forty-five asymptomatic males formed the control group. Two dimensional (2-D) frontal plane projection angle (FPPA) was used during single leg squatting and horizontal hop for distance tasks. Results: For the single leg squat, the mean of 6.96°, 9.80°, 15.04° was reported in the control, PFP asymptomatic knee, and PFP symptomatic knee, respectively. For the single leg horizontal hop for distance, the mean of 11.63°, 13.72°, 19.17° was reported in the control, PFP asymptomatic knee, and PFP symptomatic knee, respectively. These differences were significant (p < 0.002) for both tasks. Conclusions: Patients with PFP represented with greater knee valgus angle than what was found in either their asymptomatic limb or in the control group.

Total knee arthroplasty in Ranawat Ⅱ valgus deformity with enlarged femoral valgus cut angle:A new technique to achieve balanced gap

BACKGROUND Nearly 10%of patients undergoing primary total knee arthroplasty(TKA)have valgus deformity(VD)of the knee.For severe VD of the knee,a more lateral structural release is needed to achieve balance between medial and lateral space and neutral femorotibial mechanical axis(FTMA),which is challenging and technical.AIM To introduce a new surgical technique of resection,soft tissue release,and FTMA for Ranawat type-Ⅱ VD with a 5-year follow-up.METHODS A retrospective study was conducted on patients who underwent TKA from December 2011 to December 2014.Hip-knee-ankle(HKA),range of motion(ROM),Oxford knee score(OKS),and knee society score(KSS)were used to assess the joint activity of patients in the new theory TKA group(NT-TKA)and were compared with those of the conventional TKA group(C-TKA).RESULTS A total of 103 people(103 knees)were included in this study,including 42 patients with an average follow-up period of 83 mo in the C-TKA group and 61 patients with an average follow-up period of 76 mo in the NT-TKA group.Six patients had constrained prosthesis,one had common peroneal nerve injury,and two had joint instability in the C-TKA group,but none of these occurred in the NT-TKA group.There were significant statistical differences in constrained prosthesis usage and complications between the groups(P=0.002 and P=0.034,respectively).The KSS at 1 mo post-operation for the C-TKA and NT-TKA groups were 11.2±3.8 and 13.3±2.9,respectively,with a significant difference(P=0.007).However,the data of HKA,ROM,OKS KSS,and prosthesis survival rate were insignificant(P>0.05)in both the preoperative and follow-up periods.CONCLUSION Adopting 5°-7°valgus cut angle for VD and sacrificing 2°neutral FTMA for severe VD which cannot be completely corrected during TKA can reduce the need for soft tissue release,maintain early joint stability,reduce the use of constrained prostheses,and minimize postoperative complications.

Clinical Study on the Acupotomy for Iliotibial Band Release in the Treatment of Valgus Knee Osteoarthritis

[Objectives]To observe the clinical effect of acupotomy for iliotibial band release in the treatment of valgus knee osteoarthritis.[Methods]Sixty patients with mild valgus knee osteoarthritis who met the inclusion criteria were randomly divided into control group(n=30)and treatment group(n=30).The control group was treated with celecoxib capsule,and the treatment group was treated with acupotomy.The visual analogue score(VAS),modified American knee society score(KSS)and anatomic valgus angulation(AVA)were observed and compared between the two groups before and after treatment to evaluate the curative effect.[Results]Compared with those before treatment,there were significant differences in VAS and KSS between the two groups after treatment(P<0.05).There was no significant difference in AVA between the two groups before and after treatment.There were significant differences in the above-mentioned indexes between the two groups(P<0.05).The comprehensive curative effect of the treatment group was better than that of the control group(P<0.05),and there was significant difference between the two groups one month after treatment(P<0.05).[Conclusions]The acupotomy for iliotibial band release was effective in the treatment of valgus knee osteoarthritis,and it was found to delay the progression of knee valgus deformity through long-term observation.

The impact of individualized care after artificial knee replacement surgery for patients with valgus deformity of the knee

Objective:To evaluate the perioperative nursing of total knee arthroplasty for patients with valgus deformity of the knee.Methods:Seventy-six patients who underwent surgical treatment were enrolled in the study from March 2014 to March 2018.The patients in the control group were treated with routine nursing.The experimental group was treated not only with routine nursing but also with health education,psychological care,family social support,and other nursing intervention.Hospital for special surgery and Pittsburgh sleep quality index were used to evaluate the effect of nursing intervention on patients after operation.Results:All the index scores of the experimental group were lower than those of the control group(P<0.05),indicating that the function of the diseased limb and the patient's sleep status improved significantly after the intervention.Conclusions:Individualized nursing can improve the recovery of limb function and improve the patients'quality of life.It is very effective for nurses to implement individualized nursing measures for patients after surgery.

A New Physical Examination Technique for Evaluating Valgus Knee Deformity： Swing Test

INTRODUCTIONRestoring mechanical alignment and soft tissue balance in total knee arthroplasty （TKA） for valgus knees depend on the origin of deformity and soft tissue status. Valgus deformity can exist during knee flexion besides extension, which could lead to patellofemoral joint instability and soft tissue imbalance in the flexion gap, and thus complicate the surgical procedures.

Concurrent validity of evaluating knee kinematics using Kinect system during rehabilitation exercise

Squats,ascending and descending stairs,and lunges are three functional movements popularly used in clinical rehabilitation.This study aimed to analyze the validity of the Kinect v2 for assessing the kinematics of three functional knee movements.An intelligent program was developed for real-time kinematic evaluation of the knee joint using the Kinect v2 system.Based on image recognition technology,images from the Kinect v2 depth camera were used to develop a kinematic evaluation program for knee joint movements.The kinematics of 30 healthy volunteers during stair ascent and descent,squatting,and lunging movements were collected synchronously with both VICON and Kinect systems.The peak knee angles in the sagittal and coronal planes were extracted and analyzed.A paired samples t-test and the relative coefficient within the groups were used for statistical analysis of the validity of the Kinect compared to the VICON.There was no significant difference(p>0.05)in bilateral knee flexion angle when lunging.No significant difference(p>0.05)was found in left knee flexion during squatting exercises.Although the Kinect generally underestimated knee flexion and valgus,it displayed excellent consistency and good to excellent agreement with the VICON motion analysis system.The results demonstrated that the Kinect based measurement tool for analyzing knee kinematics has the potential to be an effective clinical training device for maintaining knee alignment during exercise.