DESIGN: MEDLINE, EMBASE, CINAHL were systematically searched (1990-April 2020) for studies describing the prevalence of NP and PS in knee and hip osteoarthritis using self-report questionnaires. Random-effects meta-analysis was performed. Statistical heterogeneity between studies and sub-groups (affected joint and population source as a proxy for disease severity) was assessed (I2 statistic and the Chi-squared test).
RESULTS: From 2,706 non-duplicated references, 39 studies were included (2011-2020). Thirty-six studies reported on knee pain and six on hip pain. For knee osteoarthritis, the pooled prevalence of NP was: using PainDETECT, possible NP(score ≥13) 40% (95%CI 32-48%); probable NP(score >18) 20% (95%CI 15-24%); using Self-Report Leeds Assessment of Neuropathic Symptoms and Signs, 32% (95%CI 26-38%); using Douleur Neuropathique (DN4) 41% (95% CI 24-59%). The prevalence of PS using Central Sensitization Inventory (CSI) was 36% (95% CI 12-59%). For hip osteoarthritis, the pooled prevalence of NP was: using PainDETECT, possible NP 29% (95%CI 22-37%%); probable NP 9% (95%CI 6-13%); using DN4 22% (95%CI 12-31%) in one study. The prevalence of possible NP pain was higher at the knee (40%) than the hip (29%) (difference 11% (95% CI 0-22%), P = 0.05).
CONCLUSIONS: Using self-report questionnaire tools, NP was more prevalent in knee than hip osteoarthritis. The prevalence of NP in knee and hip osteoarthritis were similar for each joint regardless of study population source or tool used. Whether defining NP using self-report questionnaires enables more effective targeted therapy in osteoarthritis requires investigation.
METHODS: Eighteen male healthy subjects volunteered to participate in the experiment. Walking gait analysis was conducted with eight different levels of insole to simulate the LLD, starting from 0 cm until 4.0 cm with 0.5 cm increment. Qualisys Track Manager System and C-motion Visual 3D biomechanical tools were used to analyse the results. Four joints (ankle, knee, hip, and pelvis) of lower limb of two legs were investigated. The increment of insoles was placed on the right leg to represent the long leg.
RESULTS: The results suggest that the mean contact forces for all joints in the short leg were increased as the increment level increased. On the contrary, the mean contact forces in the long leg decreased when the LLD level increased. Among these four joints, JCF in hip shows a positive increment based on the ASI value. Means that hip shows the most affected joint as the LLD level increase.
CONCLUSIONS: The result obtained in this study might help clinicians treat patients with a structural LLD for treatment plan including surgical intervention.
METHODS: Nine full-text articles in English that reported the clinical and radiological outcomes of KA TKA were included. Five studies had a control group of patients who underwent MA TKA. Data on patient demographics, clinical scores, and radiological results were extracted. There were two level I, one level II, three level III, and three level IV studies. Six of the nine studies used patient-specific instrumentation, one study used computer navigation, and two studies used manual instrumentation.
RESULTS: The clinical outcomes of KA TKA were comparable or superior to those of MA TKA with a minimum 2-year follow-up. Limb and knee alignment in KA TKA was similar to those in MA TKA, and component alignment showed slightly more varus in the tibial component and slightly more valgus in the femoral component. The JLOA in KA TKA was relatively parallel to the floor compared to that in the native knee and not oblique (medial side up and lateral side down) compared to that in MA TKA. The implant survivorship and complication rate of the KA TKA were similar to those of the MA TKA.
CONCLUSION: Similar or better clinical outcomes were produced by using a KA TKA at early-term follow-up and the component alignment differed from that of MA TKA. KA TKA seemed to restore function without catastrophic failure regardless of the alignment category up to midterm follow-up. The JLOA in KA TKA was relatively parallel to the floor similar to the native knee compared to that in MA TKA. The present review of nine published studies suggests that relatively new kinematic alignment is an acceptable and alternative alignment to mechanical alignment, which is better understood. Further validation of these findings requires more randomized clinical trials with longer follow-up.
LEVEL OF EVIDENCE: Level II.
OBJECTIVE: To determine whether knee sleeves can significantly improve the biomechanical variables for knee problems.
METHOD: Systematic literature search was conducted on four online databases - PubMed, Web of Science, ScienceDirect and Springer Link - to find peer-reviewed and relevant scientific papers on knee sleeves published from January 2005 to January 2015. Study quality was assessed using the Structured Effectiveness Quality Evaluation Scale (SEQES).
RESULTS: Twenty studies on knee sleeves usage identified from the search were included in the review because of their heterogeneous scope of coverage. Twelve studies found significant improvement in gait parameters (3) and functional parameters (9), while eight studies did not find any significant effects of knee sleeves usage.
CONCLUSION: Most improvements were observed in: proprioception for healthy knees, gait and balance for osteoarthritic knees, and functional improvement of injured knees. This review suggests that knee sleeves can effect functional improvements to knee problems. However, further work is needed to confirm this hypothesis, due to the lack of homogeneity and rigor of existing studies.
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.
RESULTS: Participants in the RPG and CG reported a statistically significant reduction in knee pain and stiffness (p ≤ 0.05) within the group. The reduction in the scores of knee pain was higher in participants in the RPG than that in participants in the CG (p=0.001). Additionally, participants in the RPG reported greater satisfaction (p=0.001) and higher self-reported exercise adherence (p=0.010) and coordinator-reported exercise adherence (p=0.046) than the participants in the CG.
CONCLUSION: Short-term effects of the LLRP appear to reduce knee pain and stiffness only, but not physical function and BMI.
METHODS: Osteoarthritis was induced at the right knee of sheep by complete resection of ACL and medial meniscus. Stem cells from sheep were induced to chondrogenic lineage. Test sheep received 5 mls single doses of 2 × 107 autologous PKH26-labelled ADSCs or BMSCs, while controls received basal medium. Functional recovery of the knees was evaluated via electromyography.
RESULTS: Induced ADSCs had 625, 255, 393, 908, 409, 157 and 1062 folds increases of collagen I, collagen II, aggrecan, SOX9, cartilage oligomeric protein, chondroadherin and fibromodullin compare to uninduced cells, while BMSCs had 702, 657, 321, 276, 337, 233 and 1163 respectively; p = .001. Immunocytochemistry was positive for these chondrogenic markers. 12 months post-treatment, controls scored 4 in most regions using ICRS, while the treated had 8; P = .001. Regenerated cartilages were positive to PKH26 and demonstrated the presence of condensing cartilages on haematoxylin and eosin; and Safranin O. OA degenerations caused significant amplitude shift from right to left hind limb. After treatments, controls persisted with significant decreases; while treated samples regained balance.
CONCLUSIONS: Both ADSCs and BMSCs had increased chondrogenic gene expressions using TGF-β3 and BMP-6. The treated knees had improved cartilage scores; PKH26 can provide elongated tracking, while EMG results revealed improved joint recoveries. These could be suitable therapies for osteoarthritis.