BACKGROUND The posterior cruciate ligament(PCL)is vital for regulating posterior tibial translation in relation to the femur,which is critical for knee stability.PCL tears are infrequently isolated in knee injuries;ho...BACKGROUND The posterior cruciate ligament(PCL)is vital for regulating posterior tibial translation in relation to the femur,which is critical for knee stability.PCL tears are infrequently isolated in knee injuries;however,the absence of the PCL results in abnormal knee kinematics,which may cause injuries to other ligaments.The ideal tendon source for PCL reconstruction is still a subject of debate.AIM To evaluate the results of employing the peroneus longus tendon(PLT)in PCL reconstruction.METHODS A comprehensive search was conducted to identify relevant randomized controlled trials and retrospective observational studies discussing the outcomes of using the PLT for PCL reconstruction.Studies published up to August 2024 were searched across multiple databases,including PubMed,EMBASE,Scopus,Web of Science,Cochrane Library,and Google Scholar.Full texts of the selected articles were retrieved,reviewed,and independently assessed by the investigators.Discrepancies were resolved by consensus,with any remaining disagreements being arbitrated by a third author.RESULTS This meta-analysis included five studies on PLT use for PCL reconstruction:(1)Four prospective studies with 104 patients;and(2)One retrospective study with 18 patients.Most studies followed up participants for 24 months,while one had a shorter follow-up of 18 months.Lysholm and modified cincinnati scores improved by pooled means of 32.2(95%CI:29.3-35.1,I2=0%)and 31.1(95%CI:27.98-34.22,I2=0%),respectively.Postoperative American Orthopaedic Foot and Ankle Society and Foot and Ankle Disability Index scores were 94.5(I2=61.5%)and 94.5(I2=80.09%),respectively.Single-hop and triple-hop test scores averaged 95.5(95%CI:94.5-96.5)and 92.4(95%CI:91.9-92.9)respectively.No significant differences were observed in thigh circumference at 10 cm and 20 cm between the injured and healthy sides.CONCLUSION Evidence supports PLT autografts for PCL reconstruction,improving knee function and patient outcomes.Larger randomized trials are needed to confirm efficacy and compare graft options.展开更多
[Objectives]To explore the effects of electroacupuncture combined with rehabilitation training on knee joint function,three-dimensional(3D)gait,and inflammatory markers in patients with knee osteoarthritis(KOA)of cold...[Objectives]To explore the effects of electroacupuncture combined with rehabilitation training on knee joint function,three-dimensional(3D)gait,and inflammatory markers in patients with knee osteoarthritis(KOA)of cold-dampness obstruction syndrome.[Methods]A total of 162 KOA patients admitted to Huadong Hospital Affiliated to Fudan University from January 2021 to May 2023 were enrolled and randomly divided into an electroacupuncture group and a control group,with 81 patients in each group.The control group received routine rehabilitation training,while the electroacupuncture group received electroacupuncture treatment in addition to the same rehabilitation training,both for 4 weeks.The efficacy,syndrome scores,Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC),Lysholm Knee Score(LKS),3D gait parameters,and levels of inflammatory markers were compared between the two groups.[Results]Following treatment,the total effective rate in the electroacupuncture group was 92.59%,which was significantly higher than 77.78%observed in the control group(P<0.05).Additionally,the electroacupuncture group exhibited lower TCM syndrome scores(P<0.05),reduced WOMAC scores,and elevated LKS scores compared to the control group(P<0.05).Gait parameters,including step frequency,step speed,stride length,initial ground contact flexion angle,maximum swing phase extension angle,and support phase extension angle,were all higher in the electroacupuncture group.Additionally,the sagittal plane maximum abduction moment was lower in the electroacupuncture group.Inflammatory markers showed that interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were lower in the electroacupuncture group,while transforming growth factor-β1(TGF-β1)was higher(P<0.05).[Conclusions]Electroacupuncture combined with rehabilitation training effectively enhances clinical efficacy,alleviates symptoms,improves knee joint mobility and walking ability,enhances knee function scores,and reduces inflammatory levels,contributing to the rapid recovery of knee joints in KOA patients.展开更多
BACKGROUND Patients with knee arthroplasty often have problems such as slow recovery of knee function,which may cause negative emotions and affect their postoperative rehabilitation.The application of sensory and moto...BACKGROUND Patients with knee arthroplasty often have problems such as slow recovery of knee function,which may cause negative emotions and affect their postoperative rehabilitation.The application of sensory and motor training in the Acknowledge,Introduce,Duration,Evaluation,Thank You(AIDET)communication mode in patients after knee arthroplasty can provide reference for the selection of postoperative rehabilitation training measures.AIM To explore the sensory and motor training effects in AIDET communication mode on knee function recovery and resilience of patients after knee arthroplasty.METHODS One hundred patients who underwent knee arthroplasty at our hospital between January 2022 and January 2024 were randomly divided into two groups.The control group(n=50)received routine rehabilitation training.In the observation group(n=50),the AIDET communication mode was used to perform sensory and motor training,in addition to routine rehabilitation training.The rehabilitation training was administered for 8 weeks.After surgery,knee function,balance ability,walking ability,proprioception,and resilience were compared between the two groups.RESULTS The New York Hospital for Special Surgery knee scores of the observation group at the time of discharge and 8 weeks after intervention were(65.23±6.84,84.53±5.27),which was higher than those of the control group(61.03±7.15,74.92±6.52)(P<0.05).The balance ability of the observation group at the time of discharge and 8 weeks after the intervention was higher than that of the control group,the time of time up to go test was shorter than that of the control group,and proprioceptive function was higher than that of the control group(P<0.05).The resilience level in the observation group after the intervention was higher than that in the control group(P<0.05).CONCLUSION Sensory and motor training in AIDET communication mode promotes knee function recovery of patients after knee arthroplasty,improves their limb walking ability and balance function,and increases their resilience level.展开更多
AIM To establish minimum clinically important difference(MCID) for measurements in an orthopaedic patient population with joint disorders.METHODS Adult patients aged 18 years and older seeking care for joint condition...AIM To establish minimum clinically important difference(MCID) for measurements in an orthopaedic patient population with joint disorders.METHODS Adult patients aged 18 years and older seeking care for joint conditions at an orthopaedic clinic took the Patient-Reported Outcomes Measurement Information System Physical Function(PROMIS~? PF) computerized adaptive test(CAT), hip disability and osteoarthritis outcome score for joint reconstruction(HOOS JR), and the knee injury and osteoarthritis outcome score for joint reconstruction(KOOS JR) from February 2014 to April 2017. MCIDs were calculated using anchorbased and distribution-based methods. Patient reports of meaningful change in function since their first clinic encounter were used as an anchor.RESULTS There were 2226 patients who participated with a mean age of 61.16(SD = 12.84) years, 41.6% male, and 89.7% Caucasian. Mean change ranged from 7.29 to 8.41 for the PROMIS~? PF CAT, from 14.81 to 19.68 for the HOOS JR, and from 14.51 to 18.85 for the KOOS JR. ROC cut-offs ranged from 1.97-8.18 for the PF CAT, 6.33-43.36 for the HOOS JR, and 2.21-8.16 for the KOOS JR. Distribution-based methods estimated MCID values ranging from 2.45 to 21.55 for the PROMIS~? PF CAT; from 3.90 to 43.61 for the HOOS JR, and from 3.98 to 40.67 for the KOOS JR. The median MCID value in the range was similar to the mean change score for each measure and was 7.9 for the PF CAT, 18.0 for the HOOS JR, and 15.1 for the KOOS JR.CONCLUSION This is the first comprehensive study providing a wide range of MCIDs for the PROMIS? PF, HOOS JR, and KOOS JR in orthopaedic patients with joint ailments.展开更多
Background: Primary knee Osteoarthritis (OA) is the commonest articular disease in middle age and elderly people. Primary total knee replacement (TKR) is a known world-wide standard and definitive treatment of primary...Background: Primary knee Osteoarthritis (OA) is the commonest articular disease in middle age and elderly people. Primary total knee replacement (TKR) is a known world-wide standard and definitive treatment of primary knee OA following failed adequate non-operative management. It is of clinical importance to assess the clinical and functional outcome of TKR to prognosticate the severity of primary knee OA. The new (2011) knee society scoring system (nKSS) is both surgeons and patients’ assessment tool for the treatment outcome of TKR. Study Design: Prospective interventional analytical study. Aim and Objective: The aim of the study was to determine early clinical and functional outcome of primary total knee replacement in patients with primary knee osteoarthritis using nKSS. The objectives were: 1) To determine the pre-operative nKSS and post operative nKSS;2) To determine relationships between pre-operative nKSS and post operative nKSS at 6 weeks, 3, 6, 9 and 12 months;3) To determine the complication rates in patients undergoing primary TKR in the study centre. Methods: A prospective interventional study of 59 patients aged 51 to 70 years who had 67 Total Knee Replacements (TKRs) participated in the study between November 2015 to June 2018 at National Orthopaedics Hospital, Lagos, Nigeria. Patients’ sociodemographic data, pre-operative and post-operative nKSS system were recorded at 6 weeks, 3, 6, 9 and 12 months during follow up. The data were analyzed using Statistical Package for Social Science (SPSS). Results: There were 41 females and 18 males (M:F = 1:2.3). There were total of 67 TKRs with 31 right TKRs, 20 left TKRs and 8 staged bilateral TKRs. The participants’ age ranged from 51 to 70 years with the mean age of 59.5 (±8.5) years. Four patients did not complete the study due to various reasons. The remaining 55 participants completed the study period with progressive improvement of their post-operative nKSS at 6 weeks, 3, 6, 9 and 12 months post-operatively when compared with pre-operative nKSS (P value 0.5). Conclusion: This study revealed improved early clinical and functional outcome of primary total knee replacement in primary knee osteoarthritis using nKSS in all the studied patients. There is no significant negative effect of lower pre-operative nKSS (and its components) on the post-operative nKSS outcome.展开更多
目的观察培元养心法(背俞穴温针灸)治疗肾阳不足型膝关节退行性病变疗效。方法纳入肾阳不足型膝关节退行性病变患者80例,采取随机数字表法分为对照组40例与观察组40例,对照组接受膝关节置换术治疗,观察组在对照组治疗基础上结合培元养心...目的观察培元养心法(背俞穴温针灸)治疗肾阳不足型膝关节退行性病变疗效。方法纳入肾阳不足型膝关节退行性病变患者80例,采取随机数字表法分为对照组40例与观察组40例,对照组接受膝关节置换术治疗,观察组在对照组治疗基础上结合培元养心法(背俞穴温针灸)治疗,观察各组数据情况:疗效优良率、治疗前后中医证候积分变化、术后3 d及术后6 d、术后9 d患者的疼痛评分[视觉模拟疼痛评分法(Visual analogue scale,VAS)],治疗前后患者C反应蛋白(C-reactive protein,CRP)及肿瘤坏死因子α(Tumor necrosis factor-α,TNF-α)和白介素-6(Interleukin-6,IL-6)指标变化、治疗前后患者Lysholm膝关节量表评分变化、并发症发生率、治疗前、治疗2周及治疗4周身体健康评分(the MOS item short from health survey,SF-36)。结果观察组患者治疗效果优良率(95.00%,38/40)高于对照组(80.00%,32/40),差异有统计学意义(P<0.05);各组患者治疗后中医证候积分下降,炎症因子(CRP、TNF-α、IL-6)均显著下降,Lysholm膝关节量表总评分显著上升,观察组治疗后中医证候积分及炎症因子(CRP、TNF-α、IL-6)均低于对照组,Lysholm膝关节量表总评分高于对照组,差异有统计学意义(P<0.05);观察组患者术后3、6、9 d的VAS评分均比对照组更低,差异有统计学意义(P<0.05);对照组并发症率为20.00%(8/40),比观察组的5.00%(2/40)更低,差异有统计学意义(P<0.05);治疗2周及治疗4周后观察组患者的SF-36评分均高于对照组患者,差异有统计学意义(P<0.05)。结论培元养心法(背俞穴温针灸)治疗肾阳不足型膝关节退行性病变疗效良好,患者症状改善,膝关节功能改善,并发症少,治疗安全可靠,且患者治疗后身体健康好转,值得应用。展开更多
文摘BACKGROUND The posterior cruciate ligament(PCL)is vital for regulating posterior tibial translation in relation to the femur,which is critical for knee stability.PCL tears are infrequently isolated in knee injuries;however,the absence of the PCL results in abnormal knee kinematics,which may cause injuries to other ligaments.The ideal tendon source for PCL reconstruction is still a subject of debate.AIM To evaluate the results of employing the peroneus longus tendon(PLT)in PCL reconstruction.METHODS A comprehensive search was conducted to identify relevant randomized controlled trials and retrospective observational studies discussing the outcomes of using the PLT for PCL reconstruction.Studies published up to August 2024 were searched across multiple databases,including PubMed,EMBASE,Scopus,Web of Science,Cochrane Library,and Google Scholar.Full texts of the selected articles were retrieved,reviewed,and independently assessed by the investigators.Discrepancies were resolved by consensus,with any remaining disagreements being arbitrated by a third author.RESULTS This meta-analysis included five studies on PLT use for PCL reconstruction:(1)Four prospective studies with 104 patients;and(2)One retrospective study with 18 patients.Most studies followed up participants for 24 months,while one had a shorter follow-up of 18 months.Lysholm and modified cincinnati scores improved by pooled means of 32.2(95%CI:29.3-35.1,I2=0%)and 31.1(95%CI:27.98-34.22,I2=0%),respectively.Postoperative American Orthopaedic Foot and Ankle Society and Foot and Ankle Disability Index scores were 94.5(I2=61.5%)and 94.5(I2=80.09%),respectively.Single-hop and triple-hop test scores averaged 95.5(95%CI:94.5-96.5)and 92.4(95%CI:91.9-92.9)respectively.No significant differences were observed in thigh circumference at 10 cm and 20 cm between the injured and healthy sides.CONCLUSION Evidence supports PLT autografts for PCL reconstruction,improving knee function and patient outcomes.Larger randomized trials are needed to confirm efficacy and compare graft options.
基金Supported by General Program of the National Natural Science Foundation of China(81973883)Three-Year Action Plan Project for Enhancing Clinical Skills and Clinical Innovation Capabilities of Municipal Hospitals(SHDC2020CR1010A).
文摘[Objectives]To explore the effects of electroacupuncture combined with rehabilitation training on knee joint function,three-dimensional(3D)gait,and inflammatory markers in patients with knee osteoarthritis(KOA)of cold-dampness obstruction syndrome.[Methods]A total of 162 KOA patients admitted to Huadong Hospital Affiliated to Fudan University from January 2021 to May 2023 were enrolled and randomly divided into an electroacupuncture group and a control group,with 81 patients in each group.The control group received routine rehabilitation training,while the electroacupuncture group received electroacupuncture treatment in addition to the same rehabilitation training,both for 4 weeks.The efficacy,syndrome scores,Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC),Lysholm Knee Score(LKS),3D gait parameters,and levels of inflammatory markers were compared between the two groups.[Results]Following treatment,the total effective rate in the electroacupuncture group was 92.59%,which was significantly higher than 77.78%observed in the control group(P<0.05).Additionally,the electroacupuncture group exhibited lower TCM syndrome scores(P<0.05),reduced WOMAC scores,and elevated LKS scores compared to the control group(P<0.05).Gait parameters,including step frequency,step speed,stride length,initial ground contact flexion angle,maximum swing phase extension angle,and support phase extension angle,were all higher in the electroacupuncture group.Additionally,the sagittal plane maximum abduction moment was lower in the electroacupuncture group.Inflammatory markers showed that interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were lower in the electroacupuncture group,while transforming growth factor-β1(TGF-β1)was higher(P<0.05).[Conclusions]Electroacupuncture combined with rehabilitation training effectively enhances clinical efficacy,alleviates symptoms,improves knee joint mobility and walking ability,enhances knee function scores,and reduces inflammatory levels,contributing to the rapid recovery of knee joints in KOA patients.
文摘BACKGROUND Patients with knee arthroplasty often have problems such as slow recovery of knee function,which may cause negative emotions and affect their postoperative rehabilitation.The application of sensory and motor training in the Acknowledge,Introduce,Duration,Evaluation,Thank You(AIDET)communication mode in patients after knee arthroplasty can provide reference for the selection of postoperative rehabilitation training measures.AIM To explore the sensory and motor training effects in AIDET communication mode on knee function recovery and resilience of patients after knee arthroplasty.METHODS One hundred patients who underwent knee arthroplasty at our hospital between January 2022 and January 2024 were randomly divided into two groups.The control group(n=50)received routine rehabilitation training.In the observation group(n=50),the AIDET communication mode was used to perform sensory and motor training,in addition to routine rehabilitation training.The rehabilitation training was administered for 8 weeks.After surgery,knee function,balance ability,walking ability,proprioception,and resilience were compared between the two groups.RESULTS The New York Hospital for Special Surgery knee scores of the observation group at the time of discharge and 8 weeks after intervention were(65.23±6.84,84.53±5.27),which was higher than those of the control group(61.03±7.15,74.92±6.52)(P<0.05).The balance ability of the observation group at the time of discharge and 8 weeks after the intervention was higher than that of the control group,the time of time up to go test was shorter than that of the control group,and proprioceptive function was higher than that of the control group(P<0.05).The resilience level in the observation group after the intervention was higher than that in the control group(P<0.05).CONCLUSION Sensory and motor training in AIDET communication mode promotes knee function recovery of patients after knee arthroplasty,improves their limb walking ability and balance function,and increases their resilience level.
基金National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health,No.U01AR067138.
文摘AIM To establish minimum clinically important difference(MCID) for measurements in an orthopaedic patient population with joint disorders.METHODS Adult patients aged 18 years and older seeking care for joint conditions at an orthopaedic clinic took the Patient-Reported Outcomes Measurement Information System Physical Function(PROMIS~? PF) computerized adaptive test(CAT), hip disability and osteoarthritis outcome score for joint reconstruction(HOOS JR), and the knee injury and osteoarthritis outcome score for joint reconstruction(KOOS JR) from February 2014 to April 2017. MCIDs were calculated using anchorbased and distribution-based methods. Patient reports of meaningful change in function since their first clinic encounter were used as an anchor.RESULTS There were 2226 patients who participated with a mean age of 61.16(SD = 12.84) years, 41.6% male, and 89.7% Caucasian. Mean change ranged from 7.29 to 8.41 for the PROMIS~? PF CAT, from 14.81 to 19.68 for the HOOS JR, and from 14.51 to 18.85 for the KOOS JR. ROC cut-offs ranged from 1.97-8.18 for the PF CAT, 6.33-43.36 for the HOOS JR, and 2.21-8.16 for the KOOS JR. Distribution-based methods estimated MCID values ranging from 2.45 to 21.55 for the PROMIS~? PF CAT; from 3.90 to 43.61 for the HOOS JR, and from 3.98 to 40.67 for the KOOS JR. The median MCID value in the range was similar to the mean change score for each measure and was 7.9 for the PF CAT, 18.0 for the HOOS JR, and 15.1 for the KOOS JR.CONCLUSION This is the first comprehensive study providing a wide range of MCIDs for the PROMIS? PF, HOOS JR, and KOOS JR in orthopaedic patients with joint ailments.
文摘Background: Primary knee Osteoarthritis (OA) is the commonest articular disease in middle age and elderly people. Primary total knee replacement (TKR) is a known world-wide standard and definitive treatment of primary knee OA following failed adequate non-operative management. It is of clinical importance to assess the clinical and functional outcome of TKR to prognosticate the severity of primary knee OA. The new (2011) knee society scoring system (nKSS) is both surgeons and patients’ assessment tool for the treatment outcome of TKR. Study Design: Prospective interventional analytical study. Aim and Objective: The aim of the study was to determine early clinical and functional outcome of primary total knee replacement in patients with primary knee osteoarthritis using nKSS. The objectives were: 1) To determine the pre-operative nKSS and post operative nKSS;2) To determine relationships between pre-operative nKSS and post operative nKSS at 6 weeks, 3, 6, 9 and 12 months;3) To determine the complication rates in patients undergoing primary TKR in the study centre. Methods: A prospective interventional study of 59 patients aged 51 to 70 years who had 67 Total Knee Replacements (TKRs) participated in the study between November 2015 to June 2018 at National Orthopaedics Hospital, Lagos, Nigeria. Patients’ sociodemographic data, pre-operative and post-operative nKSS system were recorded at 6 weeks, 3, 6, 9 and 12 months during follow up. The data were analyzed using Statistical Package for Social Science (SPSS). Results: There were 41 females and 18 males (M:F = 1:2.3). There were total of 67 TKRs with 31 right TKRs, 20 left TKRs and 8 staged bilateral TKRs. The participants’ age ranged from 51 to 70 years with the mean age of 59.5 (±8.5) years. Four patients did not complete the study due to various reasons. The remaining 55 participants completed the study period with progressive improvement of their post-operative nKSS at 6 weeks, 3, 6, 9 and 12 months post-operatively when compared with pre-operative nKSS (P value 0.5). Conclusion: This study revealed improved early clinical and functional outcome of primary total knee replacement in primary knee osteoarthritis using nKSS in all the studied patients. There is no significant negative effect of lower pre-operative nKSS (and its components) on the post-operative nKSS outcome.
文摘目的观察培元养心法(背俞穴温针灸)治疗肾阳不足型膝关节退行性病变疗效。方法纳入肾阳不足型膝关节退行性病变患者80例,采取随机数字表法分为对照组40例与观察组40例,对照组接受膝关节置换术治疗,观察组在对照组治疗基础上结合培元养心法(背俞穴温针灸)治疗,观察各组数据情况:疗效优良率、治疗前后中医证候积分变化、术后3 d及术后6 d、术后9 d患者的疼痛评分[视觉模拟疼痛评分法(Visual analogue scale,VAS)],治疗前后患者C反应蛋白(C-reactive protein,CRP)及肿瘤坏死因子α(Tumor necrosis factor-α,TNF-α)和白介素-6(Interleukin-6,IL-6)指标变化、治疗前后患者Lysholm膝关节量表评分变化、并发症发生率、治疗前、治疗2周及治疗4周身体健康评分(the MOS item short from health survey,SF-36)。结果观察组患者治疗效果优良率(95.00%,38/40)高于对照组(80.00%,32/40),差异有统计学意义(P<0.05);各组患者治疗后中医证候积分下降,炎症因子(CRP、TNF-α、IL-6)均显著下降,Lysholm膝关节量表总评分显著上升,观察组治疗后中医证候积分及炎症因子(CRP、TNF-α、IL-6)均低于对照组,Lysholm膝关节量表总评分高于对照组,差异有统计学意义(P<0.05);观察组患者术后3、6、9 d的VAS评分均比对照组更低,差异有统计学意义(P<0.05);对照组并发症率为20.00%(8/40),比观察组的5.00%(2/40)更低,差异有统计学意义(P<0.05);治疗2周及治疗4周后观察组患者的SF-36评分均高于对照组患者,差异有统计学意义(P<0.05)。结论培元养心法(背俞穴温针灸)治疗肾阳不足型膝关节退行性病变疗效良好,患者症状改善,膝关节功能改善,并发症少,治疗安全可靠,且患者治疗后身体健康好转,值得应用。
