Sonographic Diagnosis of the Knee Effusion

This paper presents the diagnosis of effusion of the knee by ultrasound. 140patients with pain and swelling of the knee were detected to have suprapatellar effusion by ultrasound. The antero-posterior distances of the suprapatellar effusion were 0. 2-3. 4 cm with a mean of 1. 2 cm. The effusion was revealed as an anechoic fluid-filled area in 121 cases (86. 4 %), as a hypoechoic area in 15 cases (10. 7 %), and as a mixed anechoic fluid-filled area and hypoechoic area in remaining 4 (2. 9 %). Of 140 cases of knee effusion, 126 cases were verified by aspiration or operation. The results obtaineddemonstrate that ultrasound can visualize not only the effusion of the knee, but also theabnormalities in the menisci, synovium, and the popliteal fossa ; This provides an important basis for diagnosis and treatment. Further more, ultrasound is painfree, noninvasive, inexpensive, readily acceptable by patients,and convenient for follow-up studles.

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.

Anatomical Risk Factors for Rupture of the Anterior Cruciate Ligament:Magnetic Resonance Imaging Based Knee Joint Assessment

Anterior cruciate ligament (ACL) rupture is one of the most frequently encountered traumatic ligamentous lesions of the knee. Several intrinsic and extrinsic factors are linked to this lesion. Anatomical factors increase the anterior translation of the knee and thus promote the stretching and rupture of the anterior cruciate ligament. Objectives: To determine the anatomical risk factors favouring ACL rupture by comparing morphometric parameters of patients with knee ACL rupture to patients without ACL rupture, as well as the intercondylar notch index and the tibial slopes of the two groups and describing the ruptured ACLs and associated signs. Materials and Methods: We conducted a case-control descriptive analytical study in imaging centres of the General Henri Mondor of Aurillac Hospital Centre in France (CHM) and the Jordan Medical Centre of Yaoundé in Cameroon (CMJ). MRI exam protocols included T1 SE, T2 SE, proton density and Fat Sat sequences, with slices in all three planes. Morphometry knee variables measured in our study were: intercondylar notch index and the tibial slopes. These measurements were obtained from images stored in DICOM format and post processing software OsiriX MD&reg;for CMJ patients and Explore&reg;for CHM patients. Results: The study included 92 individuals, 38 in the case group and 54 in the control group. The mean age was 36.6 years for both groups;35.5 years for the cases and 37.4 years for the controls. The sex ratio was 1.87 men for 1 woman in both groups;2.16 men for 1 woman for the case group. 53% of ACL ruptures are partial, with the predominant direct sign being morphologic and signal abnormalities of the ACL. The most significant indirect sign of ACL rupture was mirror-image bone contusion that was observed in 47.3% of cases. In the case group, the mean lateral tibial slope was 4.003&deg;, whereas it was 2.92&deg;in the control group. The comparison of means was estimated at approximately 0.039 (p Conclusion: The increase in the lateral tibial slope was a risk factor for anterior cruciate ligament rupture in our study population. Intercondylar notch index and medial tibial slope did not show any statistical significant difference.

Clinical efficacy of Xibitong recipe combined with platelet-rich plasma in the treatment of moderate knee osteoarthritis

Objective:To observe the clinical effect of knee-bitong prescription combined with platelet-rich plasma in the treatment of knee osteoarthritis in the middle stage.Methods:From May 2018 to January 2019,90 patients with moderate knee osteoarthritis(K-L classificationⅡandⅢ)with liver and kidney deficiency were admitted,and 45 patients were divided into experimental group and control group.The test group included 15 males and 30 females;aged 46 to 70(58.93±10.671)years;course of disease was 1 to 8 years(27.06±4.216)months;K-L classification:33 cases in gradeⅡand 12 cases in gradeⅢ.Jibitongfang Jianjian Granules is taken orally once a day,once in the morning and evening,14 days a course of treatment,and combined with platelet-rich plasma(2ml)articular cavity injection,once every 14 days,a total of two,14 days apart;control group male 12 There were 33 females aged 43-68(57.00±8.832)years old;the course of disease was 1-8 years(25.40±3.718)months;KL classification:36 cases of gradeⅡ,9 cases of gradeⅢ,and the control group were given platelet-rich plasma(2ml)Injection into the joint cavity,the treatment course and frequency are the same as the experimental group.Record and compare the VAS score,WOMAC score,matrix metalloproteinase-1 and interleukin-1βlevels of joint fluid before and after treatment for one month to evaluate the therapeutic effect.Results:All 90 cases were followed up without serious adverse reactions or other complications.The WOMAC scores of the experimental group and the control group before and after treatment were:106.40±47.962,116.13±41.151,55.13±22.022,62.67±26.232.The VAS scores of the two groups before and after treatment were:5.87±2.446,5.80±2.145,2.67±1.345,4.00±1.964.The levels of interleukin 1βin the test group and the control group before and after treatment were:78.33±7.227,76.60±7.069,25.73±3.239,31.13±5.743.The levels of matrix metalloproteinase-1 before and after treatment in the two groups were:2299.66±179.343,2206.66±194.235,1741.86±183.077,1762.46±192.097.Conclusion:The combination of platelet-rich plasma and knee-bitong decoction in the treatment of moderate knee osteoarthritis is better than platelet-rich plasma group in relieving knee pain,improving knee function and reducing the levels of interleukin-1βand matrix metalloproteinase-1 in joint fluid.And the side effects are small,it is worth clinical application.

Supermicrosurgical reconstruction of knee defect using superior medial genicular perforator as a recipient vessel

A 24-year-old male presented after being involved in a motorcycle accident and was found to have soft tissue defects of the knee with exposure of patella.Due to the severe injury from the popliteal fossa to the posterior aspects of the lower leg,repair with a free flap from anterolateral thigh perforator was planned instead of local calf muscle flap.Preoperative angiography was performed,and it showed that superior medial genicular perforator was patent compared with unreliable filling of the superior lateral genicular perforator.The soft tissue defect was repaired using the superior medial genicular perforator as the recipient vessel.This was performed by creating perforator to perforator anastomosis(supermicrosurgery).The flap survived successfully,and the patient was able to ambulate in a few weeks without serious complications.This case indicates that superior medial genicular perforator can be used as the recipient vessel for covering the soft tissue defects of the knee caused by blunt injury.