Knee Fat Pad Volumes in Patients with Hemophilia and Their Relationship with Osteoarthritis

Challenges facing community-dwelling adults with hemophilia: Implications for community-based adult education and nursing

Community-dwelling adults are members of society residing in community settings. Community-based adult education is designed for local residents and groups, to enable them to improve their quality of life within their community. Hemophilia is a bleeding disorder that can be inherited or acquired. World Hemophilia Day 2018 helped to raise awareness about the importance of sharing knowledge and the experience of hemophilia, as well as to improve access to care and treatment among people with this bleeding disorder. We used the documentary method of research, which has been adopted in recent review articles, to collect and analyze the findings of published literature on hemophilia. Our results showed that community-dwelling adults with hemophilia have concerns that merit the attention of government and non-governmental agencies. Some challenges faced by many community-dwelling adults with hemophilia include the cost of treatment and employment challenges. Herein, we discuss the implications for community-based health education and nursing with respect to patient care, adult education, nursing education, management, research, and policy. Finally, the authors note that sustainable efforts are needed in the provision of local, national and international leadership and educational resources to improve and sustain health care for community-dwelling adults with hemophilia.

Quantitative MRI analysis of infrapatellar and suprapatellar fat pads in normal controls, moderate and end-stage osteoarthritis

The aim of this study was to analyze the magnetic resonance imaging (MRI) volumetric and morphometric characteristics of the infrapatellar fat pad (IFP) and the suprapatellar fat pad (SFP) in normal controls, moderate and end-stage osteoarthritis (OA) patients. Forty-four MRI images of the three groups were collected: a) 17 patients undergoing meniscectomy with Outerbridge score 0 (control group); b) 15 patients undergoing meniscectomy with Outerbridge score 3/4 (moderate OA group); and c) 12 patients undergoing total knee replacement (end-stage OA group). Volume, depth, femoral and tibial arch lengths of IFP were quantified. The hypointense IFP signals were also scored. The SFP volume, oblique, antero-posterior and cranio-caudal lengths were determined. IFP and SFP characteristics were compared between groups. A decrease of IFP volume, depth, femoral, and tibial arch lengths in moderate and end-stage OA compared to controls were observed. A difference in IFP hypointense signal was found between groups. No differences were found in SFP characteristics between the groups. In controls and moderate OA patients, correlations were found among the different MRI characteristics of both IFP and SFP, while in the end-stage OA group correlations were found only in SFP. We evidenced differences of the IFP MRI morphometric characteristics between the groups analyzed, supporting an important role of IFP in OA pathology and progression. On the contrary, no differences were highlighted in SFP analysis suggesting that this fat pad is not clearly involved in OA, probably due to its peculiar localization and different function.