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Cheng C, Wang J, Yang K, Wu X, Ren X, Liu T, Zhao Z, Zhang B, Ma B, Jiang L. Efficacy of hip abductors exercise training combined with repetitive transcranial magnetic stimulation on knee osteoarthritis: A randomized controlled trial. Technol Health Care 2024:THC240456. [PMID: 39093087 DOI: 10.3233/thc-240456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2024]
Abstract
BACKGROUND Knee osteoarthritis is a common degenerative joint disease where a single treatment method often fails to fully alleviate symptoms. Hence, finding effective non-invasive combined treatment approaches is particularly crucial. OBJECTIVE The efficacy of treating knee osteoarthritis with hip abductors exercise training combined with repetitive transcranial magnetic stimulation was assessed through functional scales and objective evaluation methods. METHODS In this four-week randomized clinical trial, 160 patients meeting inclusion criteria were randomly assigned 1:1 to group A to receive oral celecoxib and group B to receive a combination of hip abductors exercise training and repeated transcranial magnetic stimulation. The primary outcome was the western Ontario and McMaster universities osteoarthritis index. The secondary outcomes include Visual Analogue Scale, knee outcome survey activities of daily living scale, Active Range of Motion, and the Quadriceps Angle, the tibiofemoral angle, peak adductor moment, the integrated electromyography and root mean square of the surface electromyography of the lower extremity muscles. Paired sample t test was used for Within-Group comparison of outcome indicators, and independent sample t test was used for Between-Group comparison. RESULTS Of the 160 randomly assigned patients, 150 completed the study. After 4 weeks, the WOMAC index decreased from 61 ± 10.83 to 40.55 ± 7.58 in the combined treatment group and from 60.97 ± 10.18 to 47.7 ± 10.13 in the celecoxib group. The effect of the combined treatment group was significantly higher than that in the celecoxib group (P< 0.001). In the combined treatment group, the score of knee joint daily living scale increased (P< 0.001), the active range of motion increased (P< 0.001), the quadriceps angle decreased (P< 0.001), the tibiofemoral angle increased (P< 0.001), and the peak adduction moment decreased (P< 0.001), integrated electromyography and root mean square increased (P< 0.001), and the effect was better than that of celecoxib group (P< 0.001). The visual analog scale score in celecoxib group was lower (P< 0.001) and knee outcome survey activities of daily living scale was higher (P< 0.001). The incidence of treatment-related adverse events was 10% in the celecoxib group and 2.5% in the combined treatment group, all of which were mild. CONCLUSIONS Hip abductors exercise training combined with repetitive transcranial magnetic stimulation can enhance abduction muscle strength, improve mobility, reduce joint pain, and enhance quality of life. This combined approach shows superior clinical effectiveness compared to oral celecoxib.
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Affiliation(s)
- Changfeng Cheng
- Department of Rehabilitation, Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jiening Wang
- Department of Rehabilitation, Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Kun Yang
- Department of Rehabilitation, Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xubo Wu
- Department of Rehabilitation, Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xue Ren
- Department of Rehabilitation, Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Tiantian Liu
- Department of Rehabilitation, Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Zhongzhi Zhao
- Department of Rehabilitation, Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Beibei Zhang
- The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Anhui, China
| | - Bitao Ma
- Department of Traditional Chinese Medicine, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Liming Jiang
- Department of Rehabilitation, Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Kim JN, Park HJ, Park JH, Park SJ, Kim E, Lee YT, Shin H. Abnormalities of the pericruciate fat pad: Correlations with the location and severity of chondral lesions of the knee. Eur J Radiol 2023; 167:111028. [PMID: 37595398 DOI: 10.1016/j.ejrad.2023.111028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 07/10/2023] [Accepted: 08/05/2023] [Indexed: 08/20/2023]
Abstract
PURPOSE The aim of this study was to evaluate the relationship between the grade of signal change of the pericruciate fat pad (PCFP) and the location and severity of cartilage alterations in the knee on magnetic resonance imaging (MRI). MATERIALS AND METHODS This retrospective study included 234 patients (M:F = 96:138, mean: 51 years) who underwent knee MRI. Two experienced musculoskeletal radiologists assessed any PCFP alterations (as grades 0-3) and chondral lesions using the modified Outerbridge grade (as grades 0-4). Bone marrow lesions (BMLs), meniscal status, anterior cruciate ligament alterations, and effusion-synovitis were also evaluated on the MRI. The relationships between PCFP alteration and MR findings (including the grade of chondral lesion) were evaluated. RESULTS Signal changes in the PCFP were detected in 150 cases by Reader 1 (grade 0, 67 cases; grade 1, 53 cases; grade 2, 21 cases; grade 3, 9 cases) and in 154 cases by Reader 2 (grade 0, 59 cases; grade 1, 61 cases; grade 2, 24 cases; grade 3, 10 cases). The grade of PCFP signal change was statistically significantly correlated with the grade of the chondral lesion of the medial femoral condyle (MFC) (p = 0.029 and p = 0.003, respectively) and the medial tibial plateau (MTP) (p = 0.045, p = 0.002, Readers 1 and 2, respectively). The grade of PCFP signal change was significantly correlated with the grade of the BMLs of the MFC, MTP, and lateral femoral condyle (p < 0.05) for both readers. PCFP alteration was related to effusion-synovitis and tears of the medial meniscus. CONCLUSIONS The grade of PCFP signal change was correlated with the severity of the cartilage alteration in the medial compartment of the knee joint and was also correlated with BMLs in the medial compartment, medial meniscal tears, and synovitis. Therefore, signal change in the PFCP seen on MRI can be an additional clue of the presence of osteoarthritis in the knee, particularly in the medial compartment.
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Affiliation(s)
- Ji Na Kim
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hee Jin Park
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - Jai Hyung Park
- Department of Orthopaedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Se Jin Park
- Department of Orthopaedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Eugene Kim
- Department of Orthopaedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yong Taek Lee
- Department of Physical & Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hyunchul Shin
- Department of Neurosurgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Huang C, Chan PK, Chiu KY, Yan CH, Yeung SS, Lai CWK, Leung AKL, Fu SN. The association between tibial torsion, knee flexion excursion and foot progression during gait in people with knee osteoarthritis: a cross-sectional study. BMC Sports Sci Med Rehabil 2023; 15:110. [PMID: 37705057 PMCID: PMC10500835 DOI: 10.1186/s13102-023-00726-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 09/06/2023] [Indexed: 09/15/2023]
Abstract
BACKGROUND Lower limb malalignment is associated with gait kinematics, but there is limited information on the relationship between gait kinematics and tibial torsion in individuals with knee osteoarthritis (OA). This study aimed to investigate possible associations between tibial torsion and early stance kinematics during gait in people with mild and moderate medial knee OA. METHODS Forty-seven participants (age: 62.1 ± 6.0 years; female/male: 37/10) diagnosed with medial knee OA were recruited from a regional hospital. Thirty of them had mild and seventeen had moderate knee OA. Lower limb alignment including tibial torsion and valgus/varus alignment were assessed by an EOS biplaner X-ray system with participants in weight-bearing position. Lower limb kinematics during gait was captured using the Vicon motion analysis system. The associations were estimated by partial Pearson correlation coefficient test. RESULTS Our results indicated that external tibial torsion was related to early stance knee flexion excursion in participants with moderate knee OA (r = -0.58, p = 0.048), but not in participants with mild knee OA (r = 0.34, p = 0.102). External tibial torsion was associated with external foot progression angle (r = 0.48, p = 0.001), and knee varus/valgus alignment was associated with knee flexion excursion (r = -0.39, p = 0.010) in all participants. CONCLUSIONS Both horizontal and frontal lower limb alignments were associated with knee flexion excursion at early stance of gait cycle in participants with medial knee OA. The distal rotational profile of lower limb would likely affect knee motion in sagittal plane. It implies that people with moderate knee OA could possibly benefit from correction of rotational alignment of lower limb.
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Affiliation(s)
- Chen Huang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Ping-Keung Chan
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
| | - Kwong-Yuen Chiu
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
| | - Chun-Hoi Yan
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
| | - Shun-Shing Yeung
- Physiotherapy Department, MacLehose Medical Rehabilitation Centre, Hong Kong, China
| | | | - Aaron Kam-Lun Leung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Siu Ngor Fu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China.
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Yan Y, Liu G, Zhang L, Gong R, Fu P, Han B, Li H. Biomechanical Effect of Valgus Knee Braces on the Treatment of Medial Gonarthrosis: A Systematic Review. Appl Bionics Biomech 2022; 2022:4194472. [PMID: 35677195 PMCID: PMC9168205 DOI: 10.1155/2022/4194472] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/06/2022] [Accepted: 05/05/2022] [Indexed: 12/04/2022] Open
Abstract
Background Valgus braces are prescribed as a common conservative treatment option for patients with medial gonarthrosis to improve their quality of life. Many studies had reviewed the effects of the valgus braces on patients with medial gonarthrosis, while they mainly focused on the knee adduction moment (KAM), with less attention paid to other parameters such as spatiotemporal and morphological parameters. Objectives The purpose of this study was to review the effects of valgus braces on the spatiotemporal, kinematic/kinetic, morphological, and muscle parameters. Methods Based on the selected keywords, a survey of literatures was performed in Web of Science, PubMed, Scopus, and Google Scholar using the PRISMA methods, and the search period was established from January 2000 to March 2022. Results Thirty-four articles were included. According to the conclusion of these articles, the valgus brace can be used to relieve the symptoms of patients with medial gonarthrosis by decreasing the varus angle, decreasing the KAM, and redistributing the knee compartment loads. However, the effects of valgus braces on other biomechanical parameters (e.g., walking speed, cadence, joint angle, and joint space) had not reached a consensus. Conclusions The valgus knee brace can effectively relieve the symptoms of medial gonarthrosis through multiple mechanisms, while there is still some confusion about the effectiveness of the valgus brace on the other biomechanical parameters.
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Affiliation(s)
- Yuzhou Yan
- Innovation Center of Bioengineering, Shaanxi Engineering Laboratory for Transmissions and Controls, Northwestern Polytechnical University, Xi'an 710072, China
| | - Geng Liu
- Innovation Center of Bioengineering, Shaanxi Engineering Laboratory for Transmissions and Controls, Northwestern Polytechnical University, Xi'an 710072, China
| | - Li Zhang
- Innovation Center of Bioengineering, Shaanxi Engineering Laboratory for Transmissions and Controls, Northwestern Polytechnical University, Xi'an 710072, China
| | - Ruitao Gong
- Innovation Center of Bioengineering, Shaanxi Engineering Laboratory for Transmissions and Controls, Northwestern Polytechnical University, Xi'an 710072, China
| | - Pengge Fu
- Innovation Center of Bioengineering, Shaanxi Engineering Laboratory for Transmissions and Controls, Northwestern Polytechnical University, Xi'an 710072, China
| | - Bing Han
- Innovation Center of Bioengineering, Shaanxi Engineering Laboratory for Transmissions and Controls, Northwestern Polytechnical University, Xi'an 710072, China
| | - Hui Li
- Joint Surgery Department, Xi'an Hong-Hui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an 710054, China
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