BACKGROUND Unicompartmental knee arthroplasty(UKA)and high tibial osteotomy(HTO)are well-established operative interventions in the treatment of knee osteoarthritis.However,which intervention is more beneficial to pat...BACKGROUND Unicompartmental knee arthroplasty(UKA)and high tibial osteotomy(HTO)are well-established operative interventions in the treatment of knee osteoarthritis.However,which intervention is more beneficial to patients with knee osteoarthritis remains unknown and a topic of much debate.Simultaneously,there is a paucity of research assessing the relationship between radiographic parameters of knee joint alignment and patient-reported clinical outcomes,preoperatively and following HTO or UKA.AIM To compare UKAs and HTOs as interventions for medial-compartment knee osteoarthritis:Examining differences in clinical outcome and investigating the relationship of joint alignment with respect to this.METHODS This longitudinal observational study assessed a total of 42 patients that had undergone UKA(n=23)and HTO(n=19)to treat medial compartment knee osteoarthritis.Patient-reported outcome measures(PROMs)were collected to evaluate clinical outcome.These included two disease-specific(Knee Injury and Osteoarthritis Outcome Score,Oxford Knee Score)and two generic(EQ-5D-5L,Short Form-12)PROMs.The radiographic parameters of knee alignment assessed were the:Hip-knee-ankle angle,mechanical axis deviation and angle of Mikulicz line.RESULTS Statistical analyses demonstrated significant(P<0.001),preoperative to postoperative,improvements in the PROM scores of both groups.There were,however,no significant inter-group differences in the postoperative PROM scores of the UKA and HTO group.Several significant correlations associated a more distolaterally angled Mikulicz line with worse knee function and overall health preoperatively(P<0.05).Postoperatively,two clusters of significant correlations were observed between the disease-specific PROM scores and knee joint alignment parameters(hip-knee-ankle angle,mechanical axis deviation)within the HTO group;yet no such associations were observed within the UKA group.CONCLUSION UKAs and HTOs are both efficacious operations that provide a comparable degree of clinical benefit to patients with medial compartment knee osteoarthritis.Clinical outcome has a limited association with radiographic parameters of knee joint alignment postoperatively;however,a more distolaterally angled Mikulicz line appears associated with worse knee function/health-related quality of life preoperatively.展开更多
Objectives: We evaluated whether a valgus knee brace and an insole with subtalar strapping could reduce pain and improve functional scores over 12 months in patients with medial knee osteoarthritis (OA). Methods: OA w...Objectives: We evaluated whether a valgus knee brace and an insole with subtalar strapping could reduce pain and improve functional scores over 12 months in patients with medial knee osteoarthritis (OA). Methods: OA was confirmed by radiography in all patients, who were divided into three groups: exercise (n = 44), insole (n = 55), and brace (n = 19). Clinical knee functions and gait analyses were evaluated. Results: After 12 months, the clinical results for all groups had improved compared to pretreatment findings. Although the knee varus moment decreased and the gait speed increased when the insole was worn initially, the effects of the insole decreased at 6 and 12 months. In contrast, the knee varus moment decreased and the gait speed increased when the brace was initially fitted. The effects of the brace were maintained during the 12 months. Conclusions: The insole was effective for patients with Kellgren-Lawrence Grades II and III, and the knee brace was effective for patients with Grades III and IV conditions. Furthermore, the knee brace was more effective when worn for more than 6 months, while the effects of the insoles were not continuous.展开更多
Objective: To evaluate the early clinical effect of unicompartmental knee arthroplasty (UKA) for medial unicompartment osteoarthritis of knee in the old people, providing the evidence for the treatment of clinic. Meth...Objective: To evaluate the early clinical effect of unicompartmental knee arthroplasty (UKA) for medial unicompartment osteoarthritis of knee in the old people, providing the evidence for the treatment of clinic. Methods: From January of 2016 to January of 2017, 20 cases of knee osteoarthritis in medial unicompartment were treated by unicompartmental knee arthroplasty. The knee joint range of motion (ROM), visual analogue scale (VAS) and knee functional Hospital for Special Surgery (HSS) scores were preoperatively recorded. The loss of blood and time of operation were intraoperative recorded. The satisfaction of patient, knee joint range of motion (ROM) and knee functional special surgical hospital score (HSS score) were postoperatively recorded at one year. Results: All patients have been followed up at an average of twelve months. The operation time was 94 - 135 min, mean 105.6 min. The blood loss was 150 - 500 ml, mean 315 ml. The postoperative HSS and ROM were both reduced. The last follow-up, there were no meniscus subluxation, loose prosthesis, and lateral ventricular osteoarthritis or other complications. Conclusion: Unicompartmental knee arthroplasty has the advantages of small operation trauma, early postoperative effect and quick recovery.展开更多
The purpose of this study was to determine the associations between urinary estradiol (E2) metabolite concentration and medial knee loading with radiographic disease severity in middle aged women with initial stage kn...The purpose of this study was to determine the associations between urinary estradiol (E2) metabolite concentration and medial knee loading with radiographic disease severity in middle aged women with initial stage knee osteoarthritis (OA). Women presenting with knee pain were recruited into a cross-sectional correlation study (KOA, n = 9, age = 52 ± 4 yrs). Self report menstrual history, the Modified Baecke Questionnaire and the Knee Injury and Osteoarthritis Outcome Score (KOOS) subjective data were collected. A fasting blood sample (follicle stimulating hormone (FSH) and Tumor Necrosis Factor-α (TNF-α)), and urine catch (16α-hydroxyestrone and 2-hydroxyestrone) were collected. Gait analysis using an 8-camera motion analysis system assessed internal knee varus moment and foot progression angle. Pearson Product moments tested for associations between urinary 16α-hydroxyestrone and 2-hydroxyestrone, TNF-α, medial knee loading, and radiographic disease severity (Kellgren/Lawrence (K/L) radiographic score). Significant correlations were found within the hormonal biomarkers (r = 0.94, p p p = 0.31). No correlations were found for radiographic disease severity or TNF-α. The lack of association between hormonal and biomechanical variables could be due to large variability of the E2 metabolites seen in the menopause transition and the limited structural changes of initial staged knee OA.展开更多
Objective:To observe the clinical efficacy and advantages of 3D printed patient-specific instrumentation(PSI)assisted distal tibial tuberosity-high tibial osteotomy in the treatment of medial compartment knee osteoart...Objective:To observe the clinical efficacy and advantages of 3D printed patient-specific instrumentation(PSI)assisted distal tibial tuberosity-high tibial osteotomy in the treatment of medial compartment knee osteoarthritis.Methods:75 patients with medial compartment knee osteoarthritis were included in the study performed DTT-HTO in our hospital from August 2017 to August 2019.The patients were divided into the PSI group(n=39)and conventional group(n=36)According to whether PSI was used in surgery.The differences of lateral cortical fracture rate,time of intraoperative X-ray exposure,intraoperative blood loss,operative time,weight bearing line(WBL),Posterior tibial slope(PTS)and Caton-Deschamps index(CDI)were compared between the two groups.Visual analogue scale(VAS)scores and Hospital for Special Surgery(HSS)scores were recorded to evaluate knee pain and function before surgery and after surgery at 3 months and 12 months.Results:All 75 patients were followed up for more than 12 months,the ranged from 12-26(18.74±6.21)months.Three lateral cortical fractures in the conventional group and no fracture in PSI group.The lateral cortical fracture rate,time of intraoperative X-ray exposure,intraoperative blood loss,operative time in PSI group were lower than those in conventional group(p敿0.05).WBL in two groups were significantly improved after surgery(p敿0.05),and PTS,CDI were no statistically improved after surgery(p>0.05).While there was no statistically significant difference with WBL,PTS and CDI between two groups(p>0.05).At 1 months,3 months and 12 months after surgery;VAS and HSS scores in both groups were significantly improved compared with that before surgery(p0.05),and were no statistically significant difference between two groups.Conclusion:3D printed patient-specific instrumentation assisted DTT-HTO has significant clinical efficacy,and effectively standardized surgical procedures,meanwhile reduced the time of intraoperative X-ray exposure,intraoperative blood loss and risk of lateral cortical fracture.展开更多
文摘BACKGROUND Unicompartmental knee arthroplasty(UKA)and high tibial osteotomy(HTO)are well-established operative interventions in the treatment of knee osteoarthritis.However,which intervention is more beneficial to patients with knee osteoarthritis remains unknown and a topic of much debate.Simultaneously,there is a paucity of research assessing the relationship between radiographic parameters of knee joint alignment and patient-reported clinical outcomes,preoperatively and following HTO or UKA.AIM To compare UKAs and HTOs as interventions for medial-compartment knee osteoarthritis:Examining differences in clinical outcome and investigating the relationship of joint alignment with respect to this.METHODS This longitudinal observational study assessed a total of 42 patients that had undergone UKA(n=23)and HTO(n=19)to treat medial compartment knee osteoarthritis.Patient-reported outcome measures(PROMs)were collected to evaluate clinical outcome.These included two disease-specific(Knee Injury and Osteoarthritis Outcome Score,Oxford Knee Score)and two generic(EQ-5D-5L,Short Form-12)PROMs.The radiographic parameters of knee alignment assessed were the:Hip-knee-ankle angle,mechanical axis deviation and angle of Mikulicz line.RESULTS Statistical analyses demonstrated significant(P<0.001),preoperative to postoperative,improvements in the PROM scores of both groups.There were,however,no significant inter-group differences in the postoperative PROM scores of the UKA and HTO group.Several significant correlations associated a more distolaterally angled Mikulicz line with worse knee function and overall health preoperatively(P<0.05).Postoperatively,two clusters of significant correlations were observed between the disease-specific PROM scores and knee joint alignment parameters(hip-knee-ankle angle,mechanical axis deviation)within the HTO group;yet no such associations were observed within the UKA group.CONCLUSION UKAs and HTOs are both efficacious operations that provide a comparable degree of clinical benefit to patients with medial compartment knee osteoarthritis.Clinical outcome has a limited association with radiographic parameters of knee joint alignment postoperatively;however,a more distolaterally angled Mikulicz line appears associated with worse knee function/health-related quality of life preoperatively.
文摘Objectives: We evaluated whether a valgus knee brace and an insole with subtalar strapping could reduce pain and improve functional scores over 12 months in patients with medial knee osteoarthritis (OA). Methods: OA was confirmed by radiography in all patients, who were divided into three groups: exercise (n = 44), insole (n = 55), and brace (n = 19). Clinical knee functions and gait analyses were evaluated. Results: After 12 months, the clinical results for all groups had improved compared to pretreatment findings. Although the knee varus moment decreased and the gait speed increased when the insole was worn initially, the effects of the insole decreased at 6 and 12 months. In contrast, the knee varus moment decreased and the gait speed increased when the brace was initially fitted. The effects of the brace were maintained during the 12 months. Conclusions: The insole was effective for patients with Kellgren-Lawrence Grades II and III, and the knee brace was effective for patients with Grades III and IV conditions. Furthermore, the knee brace was more effective when worn for more than 6 months, while the effects of the insoles were not continuous.
文摘Objective: To evaluate the early clinical effect of unicompartmental knee arthroplasty (UKA) for medial unicompartment osteoarthritis of knee in the old people, providing the evidence for the treatment of clinic. Methods: From January of 2016 to January of 2017, 20 cases of knee osteoarthritis in medial unicompartment were treated by unicompartmental knee arthroplasty. The knee joint range of motion (ROM), visual analogue scale (VAS) and knee functional Hospital for Special Surgery (HSS) scores were preoperatively recorded. The loss of blood and time of operation were intraoperative recorded. The satisfaction of patient, knee joint range of motion (ROM) and knee functional special surgical hospital score (HSS score) were postoperatively recorded at one year. Results: All patients have been followed up at an average of twelve months. The operation time was 94 - 135 min, mean 105.6 min. The blood loss was 150 - 500 ml, mean 315 ml. The postoperative HSS and ROM were both reduced. The last follow-up, there were no meniscus subluxation, loose prosthesis, and lateral ventricular osteoarthritis or other complications. Conclusion: Unicompartmental knee arthroplasty has the advantages of small operation trauma, early postoperative effect and quick recovery.
文摘The purpose of this study was to determine the associations between urinary estradiol (E2) metabolite concentration and medial knee loading with radiographic disease severity in middle aged women with initial stage knee osteoarthritis (OA). Women presenting with knee pain were recruited into a cross-sectional correlation study (KOA, n = 9, age = 52 ± 4 yrs). Self report menstrual history, the Modified Baecke Questionnaire and the Knee Injury and Osteoarthritis Outcome Score (KOOS) subjective data were collected. A fasting blood sample (follicle stimulating hormone (FSH) and Tumor Necrosis Factor-α (TNF-α)), and urine catch (16α-hydroxyestrone and 2-hydroxyestrone) were collected. Gait analysis using an 8-camera motion analysis system assessed internal knee varus moment and foot progression angle. Pearson Product moments tested for associations between urinary 16α-hydroxyestrone and 2-hydroxyestrone, TNF-α, medial knee loading, and radiographic disease severity (Kellgren/Lawrence (K/L) radiographic score). Significant correlations were found within the hormonal biomarkers (r = 0.94, p p p = 0.31). No correlations were found for radiographic disease severity or TNF-α. The lack of association between hormonal and biomechanical variables could be due to large variability of the E2 metabolites seen in the menopause transition and the limited structural changes of initial staged knee OA.
基金Young Teacher Project of Basic Scientific Research in Beijing University of Chinese Medicine(No.2019-JYB-JS-178)。
文摘Objective:To observe the clinical efficacy and advantages of 3D printed patient-specific instrumentation(PSI)assisted distal tibial tuberosity-high tibial osteotomy in the treatment of medial compartment knee osteoarthritis.Methods:75 patients with medial compartment knee osteoarthritis were included in the study performed DTT-HTO in our hospital from August 2017 to August 2019.The patients were divided into the PSI group(n=39)and conventional group(n=36)According to whether PSI was used in surgery.The differences of lateral cortical fracture rate,time of intraoperative X-ray exposure,intraoperative blood loss,operative time,weight bearing line(WBL),Posterior tibial slope(PTS)and Caton-Deschamps index(CDI)were compared between the two groups.Visual analogue scale(VAS)scores and Hospital for Special Surgery(HSS)scores were recorded to evaluate knee pain and function before surgery and after surgery at 3 months and 12 months.Results:All 75 patients were followed up for more than 12 months,the ranged from 12-26(18.74±6.21)months.Three lateral cortical fractures in the conventional group and no fracture in PSI group.The lateral cortical fracture rate,time of intraoperative X-ray exposure,intraoperative blood loss,operative time in PSI group were lower than those in conventional group(p敿0.05).WBL in two groups were significantly improved after surgery(p敿0.05),and PTS,CDI were no statistically improved after surgery(p>0.05).While there was no statistically significant difference with WBL,PTS and CDI between two groups(p>0.05).At 1 months,3 months and 12 months after surgery;VAS and HSS scores in both groups were significantly improved compared with that before surgery(p0.05),and were no statistically significant difference between two groups.Conclusion:3D printed patient-specific instrumentation assisted DTT-HTO has significant clinical efficacy,and effectively standardized surgical procedures,meanwhile reduced the time of intraoperative X-ray exposure,intraoperative blood loss and risk of lateral cortical fracture.
