Degenerative diseases significantly reduce the quality of human life.Non-invasive treatments are used in the initial stages of osteoarthritis(OA).Total knee arthroplasty is used in the late stages of osteoarthritis of...Degenerative diseases significantly reduce the quality of human life.Non-invasive treatments are used in the initial stages of osteoarthritis(OA).Total knee arthroplasty is used in the late stages of osteoarthritis of the knee joint.Non-invasive methods based on mechanical action are also used for the rehabilitation of a patient after arthroplasty.This paper presents numerical models of the knee joint with degenerative OA changes and arthroplasty.Using these models,a computational study was made of the influence of the intensity of shock-wave exposure on the conditioning for the regeneration of bone and cartilage tissues.Based on the modeling results,it was found that in the knee joint with degenerative OA changes,conditions for the regeneration of cartilage and meniscus tissues were fulfilled under medium and highintensity loading.Under high-intensity loading(up to 0.9 m J/mm^(2)),the stress level was significantly below the ultimate value required for fracture.At knee arthroplasty,the conditions for bone tissue regeneration around the tibia component are fulfilled only under high-intensity loading.展开更多
Objective:To determine the effect of rehabilitation education on pain,knee stiffness and performance difficulty in patients undergoing knee replacement surgery.Methods:This randomized clinical trial study was performe...Objective:To determine the effect of rehabilitation education on pain,knee stiffness and performance difficulty in patients undergoing knee replacement surgery.Methods:This randomized clinical trial study was performed on 96 patients undergoing knee replacement surgery,who were randomly divided into two groups:the control group and the intervention group,with 48 patients in each group.In the intervention group,the patients received educational intervention in four stages one day before surgery,24 h and 48 h later,upon discharge from the hospital.In the control group,only the routine of the hospital was performed.Questionnaires were completed before and 6 weeks after the intervention.Results:The mean scores of pain,knee stiffness and performance difficulty were significantly decreased in the intervention group(P=0.01).Compared to the control group,the intervention group had a better outcome of the illness,including pain,knee stiffness and performance difficulty(P=0.001).Conclusion:Rehabilitation education could be a suitable way to improve the surgical outcomes of patients undergoing total knee replacement.展开更多
Objective: The aim of this prospective study is <span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">to </span>...Objective: The aim of this prospective study is <span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">to </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">evaluate how much damage the patellar cartilage presents during a total knee replacement. Methods: The damage of the articular patellar surface was analysed by visual inspection and photographs in 354 primary total knee replacement</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">. The authors graded the degree of cartilage lesion in five groups. The cartilage status was analyzed and correlated with age, gender, side, body mass index (BMI), Kellgren-Lawrence radiographic scale and axial deviation. Results: After statistical analysis, we concluded: there was no evidence of an association between patellar arthrosis and age gender, side, weight and deformity. Conclusions: Articular cartilage was damaged in all 354 knees. Important subchondral bone exposure occurred in 274 knees (77</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">.</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">4%). Obese patients had more severe patellar osteoarthritis.</span></span></span>展开更多
Aim: In this study, the relationship between the change in the joint line and lateral knee pain was evaluated after primary total knee arthroplasty. Material and method: Between 2005 and 2012, patients who underwent p...Aim: In this study, the relationship between the change in the joint line and lateral knee pain was evaluated after primary total knee arthroplasty. Material and method: Between 2005 and 2012, patients who underwent primary total knee arthroplasty were included in the study. Patients having “cruciate retaining total knee arthroplasty” and with a change of the joint line ≥8 mm and patients having “posterior stabilized total knee arthroplasty” and with a change of the joint line ≥5 mm were selected as the study group (group 1, n = 32). A total of 47 patients having similar demographic characteristics with the study group and the joint line changing below the predetermined level or remaining unchanged were included as the control group (group 2). The 2 groups were compared according to the presence of knee pain, the localization and spread of the pain, iliotibial band, tension and pain in the patellar tendon and quadriceps tendon, front knee pain during squatting, VAS pain score, OBER test positivity, Knee Society knee and function score, and general patient satisfaction. Results: There were statistically significant more lateral knee pain (p < 0.001), OBER test positivity (p < 0.001) and iliotibial band tension (p < 0.001) in group 1 compared to group 2. However, there were no statistically significant differences between the 2 groups regarding rest pain (p = 0.855), pain during squatting (p = 0.761), exertional pain (p = 0.322), pain in the patellar tendon (p = 0.643) and quadriceps tendon (p = 0.873), Knee Society knee (p = 0.954) and function (p = 0.955) scores, and general satisfaction (p = 0.968). Conclusion: In total knee prosthesis operations, distal displacement of the joint line can result in lateral knee pain and iliotibial band tension. However, considering the results of total knee arthroplasty our findings have showed that this condition has no effect on knee functions and patient satisfaction.展开更多
目的:探讨经皮穴位电刺激联合厚朴三物汤对膝单髁关节置换术后胃肠功能障碍患者胃肠功能恢复的影响。方法:选择2020年1月-2022年12月我院收治的94例膝单髁关节置换术后胃肠功能障碍患者,采用随机数字表法将患者均分为两组,对照组(47例)...目的:探讨经皮穴位电刺激联合厚朴三物汤对膝单髁关节置换术后胃肠功能障碍患者胃肠功能恢复的影响。方法:选择2020年1月-2022年12月我院收治的94例膝单髁关节置换术后胃肠功能障碍患者,采用随机数字表法将患者均分为两组,对照组(47例)采用经皮穴位电刺激治疗,观察组(47例)采用经皮穴位电刺激联合厚朴三物汤治疗。观察两组疗效、中医症候积分、胃肠道恢复、腹痛和腹胀程度、血清胃肠激素水平和不良反应。结果:两组均无脱落病例。观察组治疗有效率高于对照组(95.74%vs 74.47%,P <0.05),观察组第1次肛门排气时间[(23.35±4.16)h vs (30.15±5.26] h)],第1次排便时间[(51.32±7.23)h vs (62.35±10.77) h],第1次肠鸣音恢复时间[(14.21±2.41)h vs (17.24±3.49) h],开始进食时间[(74.35±10.49)h vs (80.26±13.65) h]均短于对照组(P <0.05)。两组治疗后腹部胀满、大便不通、两胁疼痛、嗳气频频中医症候积分,腹痛和腹胀评分,血清生长抑素水平均较治疗前降低(P <0.05),且观察组治疗后腹部胀满,大便不通、两胁疼痛、嗳气频频中医症候积分,腹痛和腹胀评分,血清生长抑素水平低于对照组(P <0.05),两组治疗后血清胃动素、胃泌素均较治疗前降低(P <0.05),且观察组治疗后血清胃动素、胃泌素低于对照组(P <0.05)。结论:经皮穴位电刺激联合厚朴三物汤可增强胃肠动力,促使胃肠功能恢复,缓解腹痛腹胀症状,在膝单髁关节置换术后胃肠功能障碍治疗中优于单独经皮穴位电刺激治疗。展开更多
背景:有限元分析是一种先进的计算机工程技术,利用数学近似的方法对真实人体进行模拟,可以真实反映膝关节结构内部的生物力学特征,为理解膝关节疾病发病机制、优化手术方案以及开发新型植入材料提供了有效的工具。目的:对膝关节有限元...背景:有限元分析是一种先进的计算机工程技术,利用数学近似的方法对真实人体进行模拟,可以真实反映膝关节结构内部的生物力学特征,为理解膝关节疾病发病机制、优化手术方案以及开发新型植入材料提供了有效的工具。目的:对膝关节有限元模型的建立及其在膝关节疾病研究中的应用进行综述,并展望了未来的发展趋势。方法:第一作者于2024年4月以“Finite Element Analysis,FEA,knee joint,Finite Element Model,Knee Biomechanics,Knee Osteoarthritis,Knee Prosthesis,Knee Ligaments,Meniscus”为英文检索词在PubMed和EI数据库进行检索,以“有限元分析,有限元模型,膝关节,生物力学,骨关节炎,计算模型,膝关节假体,膝关节韧带,半月板”为中文检索词在中国知网和万方数据库进行检索,最终纳入75篇文献进行分析。结果与结论:①有限元分析法利用医学影像数据获得三维人体模型,将复杂的人体关节结构简化为有限且相互连接的单元,通过对模型施加外部载荷,直观地显示膝关节内部的应力分布。②研究者通过有限元分析深入研究膝关节在不同工况下的内部应力和应变分布,可发现膝关节内部载荷分配平衡改变时,关节软骨的过度载荷及部分区域的负荷下降,这种长期异常应力会引起软骨变形和磨损,最终缺失,对于理解生物力学因素如何引起膝关节退行性变至关重要。③有研究通过有限元分析评估膝骨关节炎患者采用太极拳、步态调整等物理治疗方法的效果,结果显示这些治疗方法减少了软骨的过度负荷,为临床治疗提供了科学理论依据。④临床医生通过有限元分析在手术前进行三维重建、数据测量和模拟手术,能够优化手术治疗策略;此外,还可以通过模拟不同假体的力学特征,改进假体的形状、材料和固定方式,减少患者的并发症,提高患者的治疗效果。⑤人工智能与有限元分析相结合使得有限元模型的构建更为精确和易于操作,极大提高了临床医生医疗实践的效率和患者的治疗效果。⑥有限元分析仅是数字化的模拟,与真实物理状态仍存在一定差异。展开更多
基金financial support of the Russian Foundation for Basic Research,grant No.20-08-00818(simulation results)the Government research assignment for ISPMS SB RAS,project FWRW-2021-009(in-house software development)。
文摘Degenerative diseases significantly reduce the quality of human life.Non-invasive treatments are used in the initial stages of osteoarthritis(OA).Total knee arthroplasty is used in the late stages of osteoarthritis of the knee joint.Non-invasive methods based on mechanical action are also used for the rehabilitation of a patient after arthroplasty.This paper presents numerical models of the knee joint with degenerative OA changes and arthroplasty.Using these models,a computational study was made of the influence of the intensity of shock-wave exposure on the conditioning for the regeneration of bone and cartilage tissues.Based on the modeling results,it was found that in the knee joint with degenerative OA changes,conditions for the regeneration of cartilage and meniscus tissues were fulfilled under medium and highintensity loading.Under high-intensity loading(up to 0.9 m J/mm^(2)),the stress level was significantly below the ultimate value required for fracture.At knee arthroplasty,the conditions for bone tissue regeneration around the tibia component are fulfilled only under high-intensity loading.
文摘Objective:To determine the effect of rehabilitation education on pain,knee stiffness and performance difficulty in patients undergoing knee replacement surgery.Methods:This randomized clinical trial study was performed on 96 patients undergoing knee replacement surgery,who were randomly divided into two groups:the control group and the intervention group,with 48 patients in each group.In the intervention group,the patients received educational intervention in four stages one day before surgery,24 h and 48 h later,upon discharge from the hospital.In the control group,only the routine of the hospital was performed.Questionnaires were completed before and 6 weeks after the intervention.Results:The mean scores of pain,knee stiffness and performance difficulty were significantly decreased in the intervention group(P=0.01).Compared to the control group,the intervention group had a better outcome of the illness,including pain,knee stiffness and performance difficulty(P=0.001).Conclusion:Rehabilitation education could be a suitable way to improve the surgical outcomes of patients undergoing total knee replacement.
文摘Objective: The aim of this prospective study is <span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">to </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">evaluate how much damage the patellar cartilage presents during a total knee replacement. Methods: The damage of the articular patellar surface was analysed by visual inspection and photographs in 354 primary total knee replacement</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">. The authors graded the degree of cartilage lesion in five groups. The cartilage status was analyzed and correlated with age, gender, side, body mass index (BMI), Kellgren-Lawrence radiographic scale and axial deviation. Results: After statistical analysis, we concluded: there was no evidence of an association between patellar arthrosis and age gender, side, weight and deformity. Conclusions: Articular cartilage was damaged in all 354 knees. Important subchondral bone exposure occurred in 274 knees (77</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">.</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">4%). Obese patients had more severe patellar osteoarthritis.</span></span></span>
文摘Aim: In this study, the relationship between the change in the joint line and lateral knee pain was evaluated after primary total knee arthroplasty. Material and method: Between 2005 and 2012, patients who underwent primary total knee arthroplasty were included in the study. Patients having “cruciate retaining total knee arthroplasty” and with a change of the joint line ≥8 mm and patients having “posterior stabilized total knee arthroplasty” and with a change of the joint line ≥5 mm were selected as the study group (group 1, n = 32). A total of 47 patients having similar demographic characteristics with the study group and the joint line changing below the predetermined level or remaining unchanged were included as the control group (group 2). The 2 groups were compared according to the presence of knee pain, the localization and spread of the pain, iliotibial band, tension and pain in the patellar tendon and quadriceps tendon, front knee pain during squatting, VAS pain score, OBER test positivity, Knee Society knee and function score, and general patient satisfaction. Results: There were statistically significant more lateral knee pain (p < 0.001), OBER test positivity (p < 0.001) and iliotibial band tension (p < 0.001) in group 1 compared to group 2. However, there were no statistically significant differences between the 2 groups regarding rest pain (p = 0.855), pain during squatting (p = 0.761), exertional pain (p = 0.322), pain in the patellar tendon (p = 0.643) and quadriceps tendon (p = 0.873), Knee Society knee (p = 0.954) and function (p = 0.955) scores, and general satisfaction (p = 0.968). Conclusion: In total knee prosthesis operations, distal displacement of the joint line can result in lateral knee pain and iliotibial band tension. However, considering the results of total knee arthroplasty our findings have showed that this condition has no effect on knee functions and patient satisfaction.
文摘目的:探讨经皮穴位电刺激联合厚朴三物汤对膝单髁关节置换术后胃肠功能障碍患者胃肠功能恢复的影响。方法:选择2020年1月-2022年12月我院收治的94例膝单髁关节置换术后胃肠功能障碍患者,采用随机数字表法将患者均分为两组,对照组(47例)采用经皮穴位电刺激治疗,观察组(47例)采用经皮穴位电刺激联合厚朴三物汤治疗。观察两组疗效、中医症候积分、胃肠道恢复、腹痛和腹胀程度、血清胃肠激素水平和不良反应。结果:两组均无脱落病例。观察组治疗有效率高于对照组(95.74%vs 74.47%,P <0.05),观察组第1次肛门排气时间[(23.35±4.16)h vs (30.15±5.26] h)],第1次排便时间[(51.32±7.23)h vs (62.35±10.77) h],第1次肠鸣音恢复时间[(14.21±2.41)h vs (17.24±3.49) h],开始进食时间[(74.35±10.49)h vs (80.26±13.65) h]均短于对照组(P <0.05)。两组治疗后腹部胀满、大便不通、两胁疼痛、嗳气频频中医症候积分,腹痛和腹胀评分,血清生长抑素水平均较治疗前降低(P <0.05),且观察组治疗后腹部胀满,大便不通、两胁疼痛、嗳气频频中医症候积分,腹痛和腹胀评分,血清生长抑素水平低于对照组(P <0.05),两组治疗后血清胃动素、胃泌素均较治疗前降低(P <0.05),且观察组治疗后血清胃动素、胃泌素低于对照组(P <0.05)。结论:经皮穴位电刺激联合厚朴三物汤可增强胃肠动力,促使胃肠功能恢复,缓解腹痛腹胀症状,在膝单髁关节置换术后胃肠功能障碍治疗中优于单独经皮穴位电刺激治疗。
文摘背景:有限元分析是一种先进的计算机工程技术,利用数学近似的方法对真实人体进行模拟,可以真实反映膝关节结构内部的生物力学特征,为理解膝关节疾病发病机制、优化手术方案以及开发新型植入材料提供了有效的工具。目的:对膝关节有限元模型的建立及其在膝关节疾病研究中的应用进行综述,并展望了未来的发展趋势。方法:第一作者于2024年4月以“Finite Element Analysis,FEA,knee joint,Finite Element Model,Knee Biomechanics,Knee Osteoarthritis,Knee Prosthesis,Knee Ligaments,Meniscus”为英文检索词在PubMed和EI数据库进行检索,以“有限元分析,有限元模型,膝关节,生物力学,骨关节炎,计算模型,膝关节假体,膝关节韧带,半月板”为中文检索词在中国知网和万方数据库进行检索,最终纳入75篇文献进行分析。结果与结论:①有限元分析法利用医学影像数据获得三维人体模型,将复杂的人体关节结构简化为有限且相互连接的单元,通过对模型施加外部载荷,直观地显示膝关节内部的应力分布。②研究者通过有限元分析深入研究膝关节在不同工况下的内部应力和应变分布,可发现膝关节内部载荷分配平衡改变时,关节软骨的过度载荷及部分区域的负荷下降,这种长期异常应力会引起软骨变形和磨损,最终缺失,对于理解生物力学因素如何引起膝关节退行性变至关重要。③有研究通过有限元分析评估膝骨关节炎患者采用太极拳、步态调整等物理治疗方法的效果,结果显示这些治疗方法减少了软骨的过度负荷,为临床治疗提供了科学理论依据。④临床医生通过有限元分析在手术前进行三维重建、数据测量和模拟手术,能够优化手术治疗策略;此外,还可以通过模拟不同假体的力学特征,改进假体的形状、材料和固定方式,减少患者的并发症,提高患者的治疗效果。⑤人工智能与有限元分析相结合使得有限元模型的构建更为精确和易于操作,极大提高了临床医生医疗实践的效率和患者的治疗效果。⑥有限元分析仅是数字化的模拟,与真实物理状态仍存在一定差异。
