To the Editor:Anterior cruciate ligament(ACL)rupture is a frequent knee injury that modifies knee joint kinematics,including intra-articular motions and forces,leading to recurrent functional instability of the knee.W...To the Editor:Anterior cruciate ligament(ACL)rupture is a frequent knee injury that modifies knee joint kinematics,including intra-articular motions and forces,leading to recurrent functional instability of the knee.With an estimated 200,000 ACL ruptures annually in the United States,ACL ruptures are prevalent,especially in young,physically active individuals.[1]Restoring knee morphology,stability,and function is the aim of conventional therapy,which is ACL reconstruction(ACLR).[2]Previous studies have evaluated gait function at different time points before and after ACLR to quantify impairments in movement patterns and knee joint biomechanics.[3]These investigations have consistently revealed substantial alterations in gait patterns induced by ACLR,with recovery persisting for at least 6 months post-procedure.[4]Majewska et al[4]pointed out that most studies focus on short-term follow-up within 6 months after surgery,while time-dependent changes in long-term dynamic functional recovery remain poorly studied.Accordingly,we aimed to perform gait analysis both pre-ACLR and throughout the 12 months postoperatively,complemented by standard assessments of knee joint function.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
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
目的探讨火龙罐综合灸在肝肾亏虚型膝痹患者全膝关节置换术(TKA)后康复的临床疗效。方法选取114例单侧TKA的患者,采用随机数字表法分为两组,对照组(n=57)采用常规快速康复护理,干预组(n=57)在对照组的基础上加用火龙罐综合灸,比较两组...目的探讨火龙罐综合灸在肝肾亏虚型膝痹患者全膝关节置换术(TKA)后康复的临床疗效。方法选取114例单侧TKA的患者,采用随机数字表法分为两组,对照组(n=57)采用常规快速康复护理,干预组(n=57)在对照组的基础上加用火龙罐综合灸,比较两组患者术后疼痛视觉模拟评分(VAS)、汉密尔顿焦虑焦虑(HAMA)评分、美国特种外科医院膝关节功能评分(HSS)及术后血清炎症因子(C反应蛋白、中性粒细胞数、淋巴细胞计数)水平。结果干预组术后3 d及出院时VAS评分显著低于对照组(P<0.05),术前至术后3 d HAMA评分显著低于对照组(P<0.05),术后2周HSS评分(疼痛、功能、活动度、稳定性及总分)显著优于对照组(P<0.05),且炎症指标(C反应蛋白、中性粒细胞)改善更显著(P<0.05),淋巴细胞计数提升更明显(P<0.05)。结论火龙罐综合灸可有效缓解TKA后疼痛、改善术后关节功能、减轻术后焦虑及炎症反应,促进TKA后康复进程,是一种具有潜力的外治辅助疗法。展开更多
基金supported by the National Key Research and Development Program of China(Grant No.2024YFC2510400)Key Research and development projects of Shanxi province(202202150401019)the Central Government Guides Local Science and Technology Development Funds(Grant No.YDZJSX2022B011).
文摘To the Editor:Anterior cruciate ligament(ACL)rupture is a frequent knee injury that modifies knee joint kinematics,including intra-articular motions and forces,leading to recurrent functional instability of the knee.With an estimated 200,000 ACL ruptures annually in the United States,ACL ruptures are prevalent,especially in young,physically active individuals.[1]Restoring knee morphology,stability,and function is the aim of conventional therapy,which is ACL reconstruction(ACLR).[2]Previous studies have evaluated gait function at different time points before and after ACLR to quantify impairments in movement patterns and knee joint biomechanics.[3]These investigations have consistently revealed substantial alterations in gait patterns induced by ACLR,with recovery persisting for at least 6 months post-procedure.[4]Majewska et al[4]pointed out that most studies focus on short-term follow-up within 6 months after surgery,while time-dependent changes in long-term dynamic functional recovery remain poorly studied.Accordingly,we aimed to perform gait analysis both pre-ACLR and throughout the 12 months postoperatively,complemented by standard assessments of knee joint function.
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。
文摘目的探讨火龙罐综合灸在肝肾亏虚型膝痹患者全膝关节置换术(TKA)后康复的临床疗效。方法选取114例单侧TKA的患者,采用随机数字表法分为两组,对照组(n=57)采用常规快速康复护理,干预组(n=57)在对照组的基础上加用火龙罐综合灸,比较两组患者术后疼痛视觉模拟评分(VAS)、汉密尔顿焦虑焦虑(HAMA)评分、美国特种外科医院膝关节功能评分(HSS)及术后血清炎症因子(C反应蛋白、中性粒细胞数、淋巴细胞计数)水平。结果干预组术后3 d及出院时VAS评分显著低于对照组(P<0.05),术前至术后3 d HAMA评分显著低于对照组(P<0.05),术后2周HSS评分(疼痛、功能、活动度、稳定性及总分)显著优于对照组(P<0.05),且炎症指标(C反应蛋白、中性粒细胞)改善更显著(P<0.05),淋巴细胞计数提升更明显(P<0.05)。结论火龙罐综合灸可有效缓解TKA后疼痛、改善术后关节功能、减轻术后焦虑及炎症反应,促进TKA后康复进程,是一种具有潜力的外治辅助疗法。
