Modalities for knee pain

This systematic review aims to assess the management of knee osteoarthritis through proximal fibular osteotomy (PFO) in the Indian population by synthesizing data from various prospective cohort and interventional studies. We seek to provide an overview of the effectiveness and safety of PFO as a treatment modality and offer insights into its potential implications for clinical practice in India. A systematic search strategy was employed, targeting multiple medical databases to identify relevant studies published from 2018 to 2023...

BACKGROUND: Dysplasia epiphysealis hemimelica is a rare non-inherited condition characterized by the unilateral predominance of osteochondromas in one or more epiphyses, with ankles and knees being the most affected joints. Treatment approaches vary based on the localization of the disease, encompassing both conservative and surgical options. Due to its rarity, there is a lack of definitive surgical guidelines or specific treatment modalities. Therefore, the objective of this systematic review was to thoroughly investigate dysplasia epiphysealis hemimelica to provide evidence-based guidance for managing this condition, specifically focusing on the foot and ankle...

BACKGROUND AND PURPOSE: There is a high frequency of frailty in patients with musculoskeletal pain. Pain from osteoarthritis and lower back pain may be associated with frailty. However, the future risk of frailty among older adults with pain remains unclear. Thus, the primary objective of this study was to examine the association between musculoskeletal pain and the risk of becoming prefrail and frail in older adults. PARTICIPANTS AND METHODS: A secondary analysis was performed using data from baseline and 1-, 2-, 3-, 4-, 6-, and 8-year follow-ups of the Osteoarthritis Initiative (OAI)...

BACKGROUND AND PURPOSE: Post-hip-fracture knee pain (PHFKP) occurs in ∼28%-37% of patients and contributes to a prolonged length of hospital stay (LOS). Analyses of LOS prolongation due to PHFKP have been limited to univariate analyses that do not consider important confounding factors. After adjusting for important confounding factors, we investigated whether the presence or absence of PHFKP makes a difference in LOS in patients with hip fractures. METHODS: We conducted a retrospective review of the medical records of patients who had undergone postoperative rehabilitation after surgery for a hip fracture...

The knees are the most frequently affected weight-bearing joints in osteoarthritis (OA), impacting millions of people globally. With increasing life spans and obesity rates, the prevalence of knee OA will further mount, leading to a significant increase in the economic burden. The usual treatment modalities utilized to manage knee OA have shortcomings. Over the last decade, the field of regenerative medicine involving the use of biologics, such as autologous peripheral blood-derived orthobiologics, including hyperacute serum (HS), has evolved and shown potential for managing knee OA...

Tibial plateau fractures (TPFs) are orthopedic challenges with multiple injury modalities and clinical presentations. TPFs are often classified using the Schatzker classification system, which can dictate management. In our case, a 37-year-old male presented at an orthopedic specialty hospital with right knee pain after a fall from a truck ramp. X-rays and CT imaging demonstrated a comminuted bicondylar TPF in the emergency room with metaphyseal dissociation. The patient was placed in a knee immobilizer, made non-weight bearing, and scheduled for outpatient follow-up with a local orthopedic surgeon...

OBJECTIVE: To compare the effect of early meniscal surgery versus exercise and education with the option of later surgery on pain, function, and quality of life in young patients with a meniscal tear, taking symptom onset into account. DESIGN AND METHODS: In a randomized controlled trial (the DREAM-trial), 121 patients aged 18-40 years with MRI-verified meniscal tear were randomized to surgery or 12-weeks supervised exercise and patient education. For this exploratory study, the analyses were stratified by symptom onset (traumatic/non-traumatic)...

BACKGROUND: In 2013, physical therapy students demonstrated low guideline-adherent recommendations regarding chronic low back pain (CLBP) for spinal pathology, activity, and work. OBJECTIVES: To assess the differences in physical therapy students' attitudes, beliefs, and adherence to guideline recommendations regarding CLBP and knee osteoarthritis between 2013 and 2020. METHODS: In 2013 and 2020, second and fourth-year physical therapy students were recruited from 6 Belgian and 2 Dutch institutions...

INTRODUCTION: Robotic-assisted total knee arthroplasty (RA-TKA) is increasingly used in revision TKA (rTKA), with imageless systems recently receiving Food and Drug Administration (FDA) approval. However, there remains a paucity of literature on the use of robotic assistance in revision TKA. This paper describes the imageless surgical technique for robotic revision TKA using a second-generation robotic system and details both intraoperative and 90-day outcomes. METHODS: This was a retrospective review of 115 robotic revision TKAs from March 2021 to May 2023 at three tertiary academic centers...

BACKGROUND: Among the risk factors studied for persistent pain after total knee arthroplasty (TKA), pain catastrophizing stands out above the others. In this regard, preoperative interventions based on pain neuroscience education or multimodal physiotherapy have been shown to be effective in reducing pain catastrophizing. OBJECTIVES: The present qualitative study aims to explore the perioperative experiences of high pain catastrophizing participants undergoing total knee arthroplasty surgery...

OBJECTIVE: To report the treatment effects of early use kinesiotaping on pain, range of motion, mobility, and edema outcomes following total knee arthroplasty. DATA SOURCES: Cochrane Central Register of Controlled Trials, PubMED, SPORTDiscus, Biosis Citation Index, and the Cumulative Index to Nursing and Allied Health Literature were searched for potential randomized control trials from inception to 8 January 2024. REVIEW METHODS: Randomized control trials evaluating the effect of kinesiotaping published in English were included...

Surgeons performing hip arthroscopy (HA) continue to look for solutions to address immediate postoperative pain and achieve a safe and efficient same-day discharge. Multiple studies have looked at modalities to achieve this, and we have learned that some methods are successful whereas others have a high-risk profile and should be avoided. The pericapsular nerve group (PENG) block is at the forefront of the literature. The PENG block is an easy-to-perform pericapsular nerve block that has been shown in prospective and retrospective studies to decrease acute postoperative pain...

Corticosteroid injections are a frequently used modality for addressing shoulder pain. The widespread utilization of corticosteroid injections is supported by clinical practice guidelines and consensus statements including the 2019 American Academy for Orthopaedic Surgeons (AAOS) guidelines for the management of rotator cuff injuries. However, steroids may be detrimental to healing potential following cuff repair and increase the risk of re-tear. In addition, corticosteroid injections administered within 4 weeks prior to shoulder arthroscopy are associated with an increased risk of infection...

OBJECTIVE: The purpose of this study was to describe the relationship between behavioral and psychological traits with indicators of central sensitization in female runners with patellofemoral pain (PFP), and to determine if behavioral and psychological traits improve with strength training. DESIGN: Cross-sectional study. SETTING: University laboratory. PARTICIPANTS: Twenty-eight active females (mean age 32 ± 8...

OBJECTIVE: To (i) compare activity-related psychological factors between individuals with and without knee conditions, and (ii) assess associations between these factors and objective measures of function in individuals with knee conditions. DESIGN: A-priori registered systematic review with meta-analysis LITERATURE SEARCH: MEDLINE-Ovid, EMBASE-Ovid, Scopus-Elsevier, CINAHL-EBSCO, SPORTDiscus-EBSCO, and Cochrane Library were searched to May 27th , 2022. STUDY SELECTION CRITERIA: We included peer-reviewed primary data studies (observational and experimental) of human participants with and without knee conditions reporting knee confidence, fear of movement/avoidance beliefs, and/or psychological readiness to return to sport (RTS) or reporting correlations between these factors and objective measures of function in knee conditions...

Physical Medicine and Rehabilitation (PM&R) is a rapidly expanding field. Physicians who practice PM&R are known as physiatrists and provide care primarily for patients who have disabilities or physical impairments affecting the musculoskeletal system, brain, and spinal cord. Physiatrists may work in an inpatient or outpatient setting, with outpatient physiatrists being an invaluable resource in treating patients experiencing pain. It is worthwhile to refer patients experiencing hip, knee, or back pain to a PM&R specialist because of their skill in making specific and accurate diagnoses, as well as providing a wide range of modalities to treat pain and augment function such as management of pain medications, osteopathic manipulative therapy, trigger point injections, intra-articular steroid injections, orthobiologic therapy, and interventional spinal procedures...

BACKGROUND: Rehabilitation following anterior cruciate ligament (ACL) reconstruction surgery is essential to regain functionality and return to previous activity level. Electromyographic biofeedback may be an effective intervention for rehabilitation of patients following ACL surgery. OBJECTIVE: To synthesize the available evidence on the effect of electromyographic biofeedback in the treatment of quadriceps strength following ACL surgery. DESIGN: Systematic review with meta-analysis...

OBJECTIVE: To determine which temperature settings on a new continuous cold-flow cryocompression device effectively reduce knee skin temperature to 10-15 °C, where pain and swelling are expected to be attenuated. DESIGN: Randomised controlled crossover trial. SETTING: University laboratory. PARTICIPANTS: 32 healthy adult participants recruited (1 dropout) with no contraindications to cryocompressive therapy...

OBJECTIVE: This study aimed to synthesize the evidence from randomized clinical trials (RCTs) in people with nontraumatic degenerative meniscal pathology, comparing physical therapist interventions versus or combined with arthroscopic partial meniscectomy (APM). METHODS: Seven electronic databases were searched. Methodological quality was evaluated using the Physiotherapy Evidence Database scale. Data synthesis was performed with random-effects network meta-analysis, and results were summarized using the standardized mean differences...

BACKGROUND: The primary management modalities for the patella in TKA include patellar resurfacing, patellar non-resurfacing, patellar resurfacing with denervation, and patellar non-resurfacing with denervation. Traditionally, meta-analyses have predominantly focused on examining comparisons between two management modalities. However, this study performed a network meta-analysis to compare all four patellar management interventions to identify the most optimal approach for patellar management in TKA...