Displaying publications 1 - 20 of 44 in total

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  1. Monro JK
    Matched MeSH terms: Knee Injuries
  2. George J, Saw KY, Ramlan AA, Packya N, Tan AH, Paul G
    Australas Radiol, 2000 Feb;44(1):19-22.
    PMID: 10761254
    In an arthroscopic-MRI correlation study of acute injuries to the knee it was found that anterolateral meniscocapsular separations of the lateral aspect of the knee were missed on MRI reporting. Eighty sports-related injuries of the knee were seen by experienced orthopaedic surgeons at the University of Malaya Medical Centre and at the National Sports Centre, Malaysia from January 1996 to July 1997. Fifty of the patients were suspected to have meniscal tears that were either lateral or medial on clinical examination and they were sent for MRI. Many of these patients were tertiary referrals. Magnetic resonance imaging examinations in 27 of the 50 patients were reported as not showing any intrasubstance or obvious meniscocapsular tears, but arthroscopy performed on them revealed anterolateral meniscocapsular tears of the lateral meniscus of varying degrees in nine of these patients. In retrospect the tears could be seen on MRI, and a pattern to the tears was noted and classified as follows. Type 0, normal; type 1, torn inferior or superior meniscocapsular attachment; type 2, both meniscofemoral and meniscotibial ligaments torn but with minimal separation of meniscus and capsule by fluid or synovitis; and type 3, marked separation of meniscus and capsule by fluid (> 3 mm). Ten patients who did not undergo arthroscopy for various personal and financial reasons underwent MRI which showed type 1 and type 2 tears, and were treated conservatively. These patients were all asymptomatic after 4-6 weeks with regard to clinical signs, suggesting a lateral meniscal tear. Magnetic resonance imaging therefore does reveal minor degrees of meniscocapsular tears anterolaterally when one understands the normal anatomy in this region.
    Matched MeSH terms: Knee Injuries/classification; Knee Injuries/diagnosis*
  3. Dhillon KS, Doraisamy S, Raveendran K
    Med J Malaysia, 1985 Mar;40(1):24-7.
    PMID: 3841686
    In a prospective study of 50 patients with suspected tear of the meniscus of the knee, the clinical diagnosis, arthrographic and arthroscopic findings were compared at arthro-tomy. The clinical diagnosis was correct in 85%, arthrographic in 54%, and arthroscopy in 91%of the patients.
    Matched MeSH terms: Knee Injuries/diagnosis*
  4. Pan KL, Ting F
    Med J Malaysia, 2000 Sep;55(3):368-70.
    PMID: 11200719
    A rare case of an isolated rupture of the biceps femoris tendon at its insertion to the femoral head is presented. Delayed surgical repair has not been previously reported. In this patient, a successful repair was carried out four months after the injury.
    Matched MeSH terms: Knee Injuries/surgery*
  5. Joseph CM, Rama-Prasad YS, Boopalan P, Jepegnanam TS
    Malays Orthop J, 2019 Jul;13(2):59-62.
    PMID: 31467656 DOI: 10.5704/MOJ.1907.013
    This is the first report of a long-term follow-up of an open bicondylar Hoffa with patella fracture. It is interesting to note the radiological changes of osteoarthritis 15 years after global intra-articular injury of the distal femur. The good clinical outcome is possibly due to the integrity of the knee ligaments and reconstruction of the extensor mechanism in addition to stable anatomical reduction and fixation.
    Matched MeSH terms: Knee Injuries
  6. K. Kadirgama, Z. Taha, A.R. Ismail, Azrul Hisham, A. Zulkifli, Nasrul Hadi, et al.
    Movement Health & Exercise, 2013;2(1):41-46.
    MyJurnal
    Wearing kneepads is the best defence against occupational knee injury. It has been reported that the use of knee pads can reduce injuries and increase performance. Knee pads provide protection by disbursing pressure on the knees and preventing puncture wounds. This study focuses on the effect of knee pads on muscle activity and gait analysis. As a case study, measurement of muscle activities whilst kicking a ball was conducted. The normalized mean of the EMG data shows that the vastus lateralis and vastus medialis muscles are highly active when wearing a knee pad. Gait analysis was conducted on six subjects with and without wearing knee pad. Results shows that wearing knee pads increases the force (950 '— 1150N) acting on the ground, compared with not wearing knee pads (800 —900 N).
    Matched MeSH terms: Knee Injuries
  7. Mortaza N, Abu Osman NA, Jamshidi AA, Razjouyan J
    PLoS One, 2013;8(5):e64308.
    PMID: 23717593 DOI: 10.1371/journal.pone.0064308
    Use of functional knee braces has been suggested to provide protection and to improve kinetic performance of the knee in Anterior cruciate ligament(ACL)-injured patients. However, many athletes might refrain from wearing the braces because of the fear of performance hindrance in the playing field. The aim of this study was to examine the effect of three functional knee brace/sleeves upon the isokinetic and functional performance of ACL-deficient and healthy subjects. Six anterior cruciate ligament deficient (29.0 ± 5.3 yrs., 175.2 ± 5.4 cm, and 73.0 ± 10.0 kg) and six healthy male subjects (27.2 ± 3.7 yrs., 176.4 ± 6.4 cm, and 70.3 ± 6.9 kg) were selected. The effect of a custom-made functional knee brace, and two neoprene knee sleeves, one with four metal supports and one without support were examined via the use of isokinetic and functional tests in four sets (non-braced,wearing functional knee brace,and wearing the sleeves). Cross-over hop and single leg vertical jump test were performed and jump height, and hop distance were recorded. Peak torque to body weight ratio and average power in two isokinetic velocities(60°.s(-1),180°.s(-1)) were recorded and the brace/sleeves effect was calculated as the changes in peak torque measured in the brace/sleeves conditions, expressed as a percentage of peak torque measured in non-braced condition. Frequency content of the isokinetic torque-time curves was also analyzed. Wilcoxon signed rank test was used to compare the measured values in four test conditions within each control and ACL-deficient group,and Mann-Whitney U test was used for the comparison between the two groups. No significant differences in peak torque, average power, torque-time curve frequency content, vertical-jump and hop measurements were found within the experimental and the non-braced conditions (p>0.05). Although the examined functional knee brace/sleeves had no significant effect on the knee muscle performance, there have been some enhancement regarding the extension peak torques and power generating capacity of the ACL-deficient subjects that could be helpful in reducing the bilateral asymmetry in these patients.
    Matched MeSH terms: Knee Injuries/physiopathology; Knee Injuries/therapy*
  8. Daneshjoo A, Mokhtar AH, Rahnama N, Yusof A
    PLoS One, 2012;7(12):e50979.
    PMID: 23226553 DOI: 10.1371/journal.pone.0050979
    PURPOSE: We aimed to investigate the effect of FIFA 11+ (11+) and HarmoKnee injury preventive warm-up programs on conventional strength ratio (CSR), dynamic control ratio (DCR) and fast/slow speed ratio (FSR) in young male professional soccer players. These ratios are related to the risk of injury to the knee in soccer players.

    METHODS: Thirty-six players were divided into 3 groups; FIFA 11+, HarmoKnee and control (n = 12 per group). These exercises were performed 3 times per week for 2 months (24 sessions). The CSR, DCR and FSR were measured before and after the intervention.

    RESULTS: After training, the CSR and DCR of knee muscles in both groups were found to be lower than the published normal values (0.61, 0.72, and 0.78 during 60°.s(-1), 180°.s(-1) and 300°.s(-1), respectively). The CSR (60°.s(-1)) increased by 8% and FSR in the quadriceps of the non-dominant leg by 8% in the 11+. Meanwhile, the DCR in the dominant and non-dominant legs were reduced by 40% and 30% respectively in the 11+. The CSR (60°.s(-1)) in the non-dominant leg showed significant differences between the 11+, HarmoKnee and control groups (p = 0.02). As for the DCR analysis between groups, there were significant differences in the non-dominant leg between both programs with the control group (p = 0.04). For FSR no significant changes were found between groups.

    CONCLUSIONS: It can be concluded that the 11+ improved CSR and FSR, but the HarmoKnee program did not demonstrate improvement. We suggest adding more training elements to the HarmoKnee program that aimed to enhance hamstring strength (CSR, DCR and FSR). Professional soccer players have higher predisposition of getting knee injuries because hamstring to quadriceps ratio were found to be lower than the average values. It seems that the 11+ have potentials to improve CSR and FSR as well as prevent knee injuries in soccer players.

    Matched MeSH terms: Knee Injuries/physiopathology*; Knee Injuries/prevention & control*
  9. Jin C, Zhao JY, Santoso A, Song EK, Chan CK, Jin QH, et al.
    Medicine (Baltimore), 2019 Sep;98(39):e17134.
    PMID: 31574814 DOI: 10.1097/MD.0000000000017134
    The aim of this study was to determine whether primary repair for intraoperative injury of the medial collateral ligament (MCL) can achieve satisfactory clinical results when compared to the clinical results of patients with no MCL injury. Simultaneously, we sought to determine the differences between 2 methods of primary repair (anchor suture and staple) in terms of their clinical outcomes.In our institute, 3897 total-knee arthroplasties (TKAs) were performed between 2003 and 2014. Sixty-five patients who suffered an MCL injury during the TKA procedure and in whom the injury was repaired with a suture anchor or staple (suture anchor: 36 vs staple: 29) were studied. A matched group of 65 patients without an MCL injury was selected to serve as the control group. Subjective feelings of instability and functional outcomes were assessed using the knee society (KS) score and the Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC). Objective stability was evaluated by the measurement of opening angles in extension and at 30° of knee flexion on valgus stress radiographs. The clinical outcomes and stability results were compared between the suture anchor and staple methods.The KS and WOMAC scores in patients who received primary repair of MCL injury during TKA improved from 50.6 ± 13.1 to 87.3 ± 7.3 (P 
    Matched MeSH terms: Knee Injuries/surgery*; Medial Collateral Ligament, Knee/injuries*
  10. Ismail AM, Balakrishnan R, Rajakumar MK
    J Bone Joint Surg Br, 1969 Aug;51(3):503-5.
    PMID: 5820795
    A case of disruption of patellar ligament is described. An association with previous steroid infiltration is present in this case.
    Matched MeSH terms: Knee Injuries/surgery; Knee Injuries/therapy
  11. Sulaiman AR, Halim AS, Azman WS, Eskandar H
    Singapore Med J, 2008 Aug;49(8):e205-7.
    PMID: 18756334
    Post-traumatic severe patella infera and intra-articular adhesion may lead to a severe knee stiffness. We report a 29-year-old man, a muslim prayer leader, who had a previous knee injury. He presented with knee movement from ten degrees to 30 degrees, patellar infera with a length of patella to length of patellar tendon ratio of 2:5, and severe knee arthrofibrosis. He underwent incision of the patella ligament and open arthrofibrosis release, leaving a tendon gap and skin defect of 5 cm. Reconstruction was successfully done using a free vascularised composite tensor fascia lata flap. He regained full range of knee motion with normal strength quadriceps mechanism at five months after surgery, and remained in full function at 18 months follow-up.
    Matched MeSH terms: Knee Injuries/diagnosis*; Knee Injuries/surgery*
  12. Nizlan MNM, Suhail A, Samsudin OC, Masbah O
    Med J Malaysia, 2004 Dec;59 Suppl F:65-8.
    PMID: 15941168
    A case of traumatic posterior cruciate ligament (PCL) avulsion fracture presenting with unusual radiographic findings is described. CT scan of the right knee showed features suggestive of combined ACL and PCL avulsion fractures. Arthroscopic findings showed that the injury was in fact a PCL avulsion fracture that was displaced anteriorly so as to mimic an ACL avulsion fracture on CT scan.
    Matched MeSH terms: Knee Injuries/etiology; Knee Injuries/radiography*; Knee Injuries/surgery
  13. Shekarchi B, Panahi A, Raeissadat SA, Maleki N, Nayebabbas S, Farhadi P
    Malays Orthop J, 2020 Jul;14(2):94-100.
    PMID: 32983383 DOI: 10.5704/MOJ.2007.018
    Introduction: Meniscus injuries are the most frequent problem of the knee. The aim of this study was to investigate the accuracy of the Thessaly test and comparing it with those of McMurray and Joint-line tenderness tests for diagnosing meniscal tears.Materials and methods: This study was designed as a prospective observational one done in an outpatient clinic at a university hospital. 106 patients with knee pain and 82 age-matched control were included during study period (from February 2014 to January 2015). Each patient was clinically examined with McMurray, Thessaly, and joint line tenderness tests. Then, the findings were matched by MRI and arthroscopic findings. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated as main outcomes.

    Results: Based on MRI, Thessaly was the most sensitive for medial meniscus tears (56.2%), while McMurray and joint-line tenderness were more specific (89.1% and 88.0%, respectively). For lateral meniscus tears, McMurray was the most sensitive (56.2%) and all were specific (McMurray 89.6%, Thessaly 88.4%, joint-line tenderness 90.2%). With arthroscopy, Thessaly was the most sensitive for medial meniscus (76.6%), while McMurray and joint-line tenderness were more specific (81.0%, and 81.0%). Agreement with arthroscopy was the highest with McMurray (for medial meniscus kappa=0.40, p<0.001, and for lateral meniscus kappa=0.38, p=0.002).

    Conclusion: The Thessaly can be used to screen for medial meniscus tears. McMurray and joint-line tenderness should be used for suspected medial meniscus tears. For lateral meniscus, McMurray is appropriate for screening and all the tests are useful in clinic.

    Matched MeSH terms: Knee Injuries
  14. Soni A, Kansay R, Gupta S, Malhotra A
    Malays Orthop J, 2019 Mar;13(1):57-59.
    PMID: 31001387 DOI: 10.5704/MOJ.1903.014
    Femoral condyle fracture in coronal plane, also known as Hoffa fracture, is a rare fracture. Non-union of Hoffa fracture is even rarer. We present a case of fibrous nonunion of a Hoffa fracture in which the fractured fragment, though not freely movable, led to painful walking. Since the fragment was un-displaced and non-movable we fixed the fractured fragment in situ. Patient regained full range of motion of the knee and was asymptomatic on follow-up.
    Matched MeSH terms: Knee Injuries
  15. KS Dhillon
    Malays Orthop J, 2014;8(3):42-47.
    MyJurnal
    We are all aware that there has been a dramatic increase in the number of anterior cruciate ligament (ACL) reconstructions that are carried out here in Malaysia as well as around the world. The numbers of ACL injuries have undoubtedly increased over the years with greater participation of young adults in sporting activities. However it is not certain whether the increase in the numbers of reconstructions can be accounted for by the increasing numbers of ACL injuries. Without doubt commercial interests as well the influence of the biomedical companies have a role to play. In the past the rationale for surgical treatment of an ACL tear was that the ACL is vital for knee function and that in the long term ACL deficiency will lead to more injuries of the meniscus and more degeneration of the joint. This belief was prevalent because the natural history of an ACL deficient knee and the ultimate outcome of reconstruction of the ACL were both not known. However in recent years a substantial amount of research has been published, which has elucidated the natural history of ACL deficient knees as well as the long term outcome of reconstruction of the ACL.
    Matched MeSH terms: Knee Injuries
  16. Yin, Jerusha Chan Poe, Ashril Yusof, Victor Selvarajah Selvanayagam
    MyJurnal
    Journal of Sports Science and Physical Education 5(2): 1-8, 2016 - The objective of this
    study was to determine the number of familiarisation sessions required for isokinetic knee
    extension and flexion in female varsity athletes. Thirty right footed dominance female varsity
    athletes (n=30; age: 21.73 ±0.22 years, body mass index (BMI): 22.58 ±0.52 kg/m2), with no
    history of knee injuries were recruited. The design started with either with the dominant or
    non-dominant limb, followed by the opposite limb. Four sets of isokinetic maximal voluntary
    contraction at 60 o/s were performed for each limb. The results showed that for knee
    extension regardless of which limb starts first is 2 sessions, however for knee flexion, 3
    sessions is required for dominant limb while 2 for non-dominant. In addition, the presence of
    cross-education effect is observed for knee flexion from non-dominant to dominant limb,
    where the number of session was reduced from three to two. In conclusion, we propose that
    two sessions of familiarisation are required for female varsity athletes and should begin with the non-dominant limb followed by dominant limb.
    Matched MeSH terms: Knee Injuries
  17. Dehghan F, Muniandy S, Yusof A, Salleh N
    Int J Med Sci, 2014;11(2):180-91.
    PMID: 24465164 DOI: 10.7150/ijms.6283
    The incidence of non-contact knee injury was found higher in female than in male and is related to the phases of the menstrual cycle. This raised the possibility that female sex-steroids are involved in the mechanism underlying this injury via affecting the expression of the receptors for relaxin, a peptide hormone known to modulate ligament laxity. Therefore, this study aims to investigate the effect of sex-steroids on relaxin receptor isoforms (RXFP1 & RXFP2) expression in the ligaments and tendons of the knee.

    METHODS: Ovariectomized adult female WKY rats were treated with different doses of estrogen (0.2, 2, 20 μg/kg), progesterone (4mg) and testosterone (125 & 250μg/kg) for three consecutive days. At the end of the treatment, the animals were sacrificed and the patellar tendon and lateral collateral ligament were harvested for mRNA and protein expression analyses by Real Time PCR and Western blotting respectively.

    RESULTS: RXFP1, the main isoform expressed in these knee structures and RXFP2 showed a dose-dependent increase in expression with estrogen. Progesterone treatment resulted in an increase while testosterone caused a dose-dependent decrease in the mRNA and protein expression of both relaxin receptor isoforms.

    DISCUSSION: Progesterone and high dose estrogen up-regulate while testosterone down-regulates RXFP1 and RXFP2 expression in the patellar tendon and lateral collateral ligament of rat's knee.

    CONCLUSION: Relaxin receptor isoforms up-regulation by progesterone and high dose estrogen could provide the basis for the reported increase in knee laxity while down-regulation of these receptor isoforms by testosterone could explain low incidence of non-contact knee injury in male.

    Matched MeSH terms: Knee Injuries/drug therapy*; Knee Injuries/genetics; Knee Injuries/pathology
  18. Keays SL, Bullock-Saxton JE, Newcombe P, Bullock MI
    Physiother Res Int, 2006 Dec;11(4):204-18.
    PMID: 17236528
    BACKGROUND AND PURPOSE: Little evidence supports the prescription of pre-operative rehabilitation in the treatment of chronic anterior cruciate ligament-deficient (ACLD) subjects. The aim of the present study was to assess the effectiveness of a specific six-week pre-operative exercise programme on ACLD knees.

    METHOD: A single, masked, controlled study was designed. This comprised two matched groups of 12 chronically ACLD patients awaiting reconstruction and a group of 12 matched uninjured control subjects. Only one ACLD group received a home-based exercise and educational programme. Assessment before and after the exercise intervention included: knee joint stability (clinical and KT1000 evaluation); muscle strength (Cybex II); standing balance and functional performance (agility, [corrected] and subjective tests).

    RESULTS: At the time of initial assessment there were no statistically significant differences in any measures for the two ACLD groups but both ACLD groups were significantly different from the uninjured control group as regards quadriceps strength and function. Measures taken after six weeks showed no significant improvement in the untreated ACLD group or in the uninjured control group. The treated ACLD group showed significant improvement in the following measures: quadriceps strength measured at 60 degrees and 120 degrees per second (p < 0.001); single leg standing balance with eyes closed (p < 0.001); instrumented passive stability at 20 lb (89 N) force (p = 0.003); agility and subjective performance (p < 0.001). The incidence of unstable episodes had decreased in the treated ACLD group, reducing further damage to the joint.

    CONCLUSION: This study leaves little doubt that pre-operative physiotherapy had a positive effect on motor function in ACLD subjects and should be prescribed routinely to maximize muscle stabilizing potential prior to reconstruction. Patients report improved stability and, in certain cases, may avoid surgery. The finding that exercise increased the passive stability of the joint was unexpected and requires further investigation.

    Matched MeSH terms: Knee Injuries/physiopathology; Knee Injuries/rehabilitation*; Knee Injuries/surgery
  19. Ahmad S, Mahidon R, Shukur MH, Hamdan A, Kasmin M
    J Orthop Surg (Hong Kong), 2014 Dec;22(3):325-8.
    PMID: 25550011
    To evaluate the outcome of reconstruction for chronic grade-II posterior cruciate ligament (PCL) deficiency in Malaysian military personnel.
    Matched MeSH terms: Knee Injuries/surgery*
  20. Tan HK, Bakri MM, Peh WC
    Semin Musculoskelet Radiol, 2014 Feb;18(1):45-53.
    PMID: 24515881 DOI: 10.1055/s-0034-1365834
    MR imaging is an established tool for the detection and diagnosis of various injuries and internal derangements of the knee, enabling excellent anatomical visualization and producing good soft tissue contrast and characterization. However, numerous normal variants and potential pitfalls may lead to diagnostic errors. Understanding the basic MR imaging principles, applying the correct technique, knowing the normal anatomy and variants, recognizing artifacts, and assuring good clinical and radiographic correlation helps avoid these potential pitfalls.
    Matched MeSH terms: Knee Injuries/diagnosis*
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