Journal of Orthopaedic Case Reports最新文献

{"title":"Efficacy of Combined Intra-articular Steroids and Calcitonin Nasal Spray versus Intra-articular Steroids Alone in the Management of Early Frozen Shoulder: A Prospective Study.","authors":"Amit Kumar Salaria, Gaurav Kumar Sharma, Ramesh Negi, Sukhmin Singh","doi":"10.13107/jocr.2025.v15.i09.6126","DOIUrl":"10.13107/jocr.2025.v15.i09.6126","url":null,"abstract":"<p><strong>Introduction: </strong>Frozen shoulder is one of the commonest debilitating conditions with characteristic features of by pain and globally restricted range of motion of the shoulder. This study compares the efficacy of intra-articular steroids alone in comparison to the combined intra-articular steroids and calcitonin nasal spray in the management of early-stage frozen shoulder. We hypothesized that the combination therapy of intra-articular steroids and calcitonin nasal spray results in a better increase in shoulder function and superior pain relief. Along with decrease in disability in comparison to treatment with corticosteroids alone.</p><p><strong>Materials and methods: </strong>Less than 3 months was chosen as a critical period for defining early frozen shoulder. A prospective study was conducted on 434 patients diagnosed with early-stage frozen shoulder. Randomization of the patients was done in two treatment groups according to computer-generated tables after applying appropriate inclusion and exclusion criteria and taking written consent. Patients were randomly assigned to two groups: Group A received intra-articular corticosteroid injections alone, and Group B received a combination of intra-articular corticosteroid injections and calcitonin nasal spray. Post-intervention physiotherapy protocol was the same for both the groups. Paracetamol @ 15 mg/kg was used for pain management as and when required. To measure the outcomes, the Oxford Shoulder Score (OSS) was used at 12 weeks post-intervention.</p><p><strong>Results: </strong>There was improvement in OSS scores compared to baseline, which was found to be both clinically and statistically significant (P < 0.05). Patients who received combination therapy, i.e., Group B, exhibited superior clinical outcomes compared to patients who received intra-articular injections alone, i.e., Group A, at 12 weeks post-treatment. Group B demonstrated greater improvement in OSS scores (P < 0.001) as compared to Group A. Twenty-eight patients were lost to follow-up and 15 patients required analgesia like non-steroidal anti-inflammatory drugs other than paracetamol and hence excluded from the study.</p><p><strong>Conclusion: </strong>The combination therapy of intra-articular corticosteroids and calcitonin nasal spray was found to be more efficacious as compared to intra-articular corticosteroids alone in the treatment of early-stage frozen shoulder. This combination therapy of intra-articular steroids and calcitonin provides better pain relief and shoulder function. This decrease in disability suggests its potential as a promising treatment option in the management of patients with early frozen shoulder.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 9","pages":"361-366"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12422660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hip Abduction Strength Assessment and its Effect on Functional Outcome Following Hip Arthroplasty - Original Article.","authors":"B Vishnu Vardhan, P Pradeep, B Raghavendran, U Thiyagarajan, M Rayeez Ahmed","doi":"10.13107/jocr.2025.v15.i09.6114","DOIUrl":"10.13107/jocr.2025.v15.i09.6114","url":null,"abstract":"<p><strong>Aims and background: </strong>A subset of people has persistent functional impairment due to hip abductor muscle weakness post-hip arthroplasty. Hip abductor muscles collectively play a crucial role in maintaining pelvic stability, facilitating hip movements, and ensuring efficient gait mechanics. We aimed to prospectively evaluate the static abductor strength and lower extremity strength in patients undergoing hip arthroplasty and it's effect on functional outcome.</p><p><strong>Materials and methods: </strong>Twenty patients who underwent total hip arthroplasty (THA) or bipolar hemiarthroplasty were included in our study. Their static and dynamic hip abductor strength was prospectively assessed at 4 weeks, 3 months, and 6 months. Static abductor strength was measured using dynamometer and manual muscle testing, while dynamic abductor strength using 6 min walk test, stand and sit test, and timed up go test and its effect on functional outcome by Harris Hip Score (HHS).</p><p><strong>Results: </strong>Of 20 patients in our study, 16 underwent hemiarthroplasty and four underwent THA. Posterolateral approach was the most used approach. The median static abductor strength at 4 weeks was 0.37 kgf, 3 months was 0.59 kgf, and 6 months was 0.82 kgf (P < 0.001) which is statistically significant. Dynamic abductor strength was checked using 6- min walk test which showed improvement from 230 m at 4 weeks to 446 m at 6 months. Counts in sit and stand test increased from a median of 7 at 4 weeks to 14 at 6 months. Timed up and go test decreased from 32 s in 4 weeks to 15 s in 6 months. The functional outcome assessed by HHS showed 67. 50 at 4 weeks to 96 at 6 months.</p><p><strong>Conclusion: </strong>My study confirms that there is significant improvement in hip static and dynamic abductor strength and functional outcome within 6 months following hip arthroplasty. The lateral approach for hip arthroplasty has better static hip abductor strength than the posterolateral approach. There is no statistically significant difference in hip abductor strength recovery between THA and bipolar hemiarthroplasty.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 9","pages":"322-328"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12422680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Failure of the Femoral Neck System in a Young Patient: A Case Report.","authors":"Jude A Alawa, Christopher R Leland, Matthew A Pappas, Elyse J Berlinberg, John B Michaud, John J Wixted","doi":"10.13107/jocr.2025.v15.i09.6022","DOIUrl":"10.13107/jocr.2025.v15.i09.6022","url":null,"abstract":"<p><strong>Introduction: </strong>Femoral neck fractures in young adults are rare but carry a high risk of complications, including non-union and implant failure. The femoral neck system™ (FNS) is a newer fixation device designed to enhance mechanical stability while minimizing surgical morbidity. Limited reports exist on its failure modes. The purpose of this case report is to describe a unique failure of the FNS and the challenges encountered during revision surgery.</p><p><strong>Case report: </strong>A 21-year-old female sustained a basicervical femoral neck fracture and underwent fixation with the FNS and an additional headless screw at an outside institution. Seven months post-operatively, she developed progressive, atraumatic hip pain and was unable to bear weight. Imaging revealed non-union and implant failure at the aperture where the bolt and antirotation screw exit the plate barrel. Revision surgery included intertrochanteric valgus osteotomy and blade plate fixation. Removal of the broken FNS components was technically demanding and required trephination, leading to further compromise of the femoral head and neck bone stock.</p><p><strong>Conclusion: </strong>This case highlights a rare failure mode of the FNS involving simultaneous failure of the bolt and antirotation screw at the barrel aperture. Surgeons should be aware of this potential complication and the technical challenges it may pose during implant removal and revision surgery. These considerations may influence implant selection and pre-operative planning, particularly in young patients at risk for non-union.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 9","pages":"76-82"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12422654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term Comparison of Opening Wedge High Tibial Osteotomy and Double Level Osteotomy for Large Varus Knee Deformities: A Retrospective Cohort Study of Functional Outcomes, Complications, and Survival Rates.","authors":"Woon-Hwa Jung, Hari Kishore Potupureddy, Min-Seok Seo, Dong-Hyun Kim, Jong-Hyun Kim, Ryohei Takeuchi","doi":"10.13107/jocr.2025.v15.i09.6128","DOIUrl":"10.13107/jocr.2025.v15.i09.6128","url":null,"abstract":"<p><strong>Introduction: </strong>Opening wedge high tibial osteotomy (OWHTO) and double-level osteotomy (DLO) are commonly performed for correcting large varus knee deformities. This retrospective cohort study compares long-term functional outcomes, complication rates, and survival rates between these two techniques.</p><p><strong>Materials and methods: </strong>Sixty patients who underwent OWHTO (n = 32) or DLO (n = 28) for varus knee correction were evaluated. Outcome measures included the Knee Society Score (KSS) and KSS function score at 1, 5, and 10 years, with percentage improvements analyzed across intervals. Additional measures included hip-knee-ankle (HKA) alignment accuracy, complication rates, and survival rates. Trend analysis was based on 10-year data for OWHTO and 5-year data for DLO.</p><p><strong>Results: </strong>DLO demonstrated significantly higher HKA correction accuracy and fewer complications compared to OWHTO, including reduced incidence of joint line obliquity (JLO) (P = 0.001), posterior tibial slope (PTS) change (P = 0.013), and worsening patellofemoral arthritis (PFA) (P = 0.03). KSS improvements were observed in both groups at all intervals, with DLO showing superior KSS Function scores, suggesting higher functional stability. Percentage improvement trends favoured DLO for specific outcomes over the long term.</p><p><strong>Conclusion: </strong>DLO provides more accurate HKA alignment with lower complication rates in JLO, PFA, and PTS changes, while both procedures yield comparable overall KSS scores. The enhanced KSS Function outcomes with DLO indicate a potential clinical advantage in maintaining higher functional activity and patient satisfaction over time. These findings support the use of DLO for patients requiring precise correction of significant varus deformities with sustained functional benefits.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 9","pages":"367-375"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12422676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Silent Shoulder of Plentiful Pathology: An Uncommon Presentation of Acromioclavicular Ganglion Cyst.","authors":"Steve Fernandes, Santosh Jeevannavar, Keshav Shenoy, Prasanna Baindoor","doi":"10.13107/jocr.2025.v15.i09.6036","DOIUrl":"10.13107/jocr.2025.v15.i09.6036","url":null,"abstract":"<p><strong>Introduction: </strong>The acromioclavicular (AC) ganglion cyst first described by a shoulder arthrogram by Craig in 1984, still remains an uncommon presentation of a shoulder pathology. Classified as a type one cyst by Hiller in the presence of a rotator cuff pathology, the management of these lesions is governed by ill-defined guidelines. Literature shows the variability of surgical management ranges from simple cyst excision and lateral end clavicular excision to reverse shoulder arthroplasty. Type two cysts are usually benign ganglion cysts, filled with mucinous putty material, and arise from the AC joint as a result of constant pressure of the synovial fluid passing in sequence, from the glenohumeral joint to the subacromial bursa and then reaching the AC joint. They are painless, gradually enlarging masses that appear just at the tip of the shoulder and, unless large, do not limit shoulder movements.</p><p><strong>Case report: </strong>We present to you a 77-year-old male patient with hypertension and diabetes, who came with a painless swelling over the right shoulder, gradually increasing in size for the first 6 months. He gave a prior history of pain in the shoulder associated with stiffness, depicting a frozen shoulder 5 years ago. On examination, the swelling was soft, cystic, non-reducible, fluctuant, measuring 3 × 3 cm centred over the AC joint. The range of motion was near normal, comparable to the opposite side, associated with crepitus, although pain free. Clinical special tests revealed intact but weak cuff muscles. Imaging was performed that revealed superior migration of the humeral head and near complete chronic supraspinatus tear with glenohumeral arthritis on radiograph. Magnetic resonance imaging showed synovial thickening with a cystic homogenous swelling above the AC joint, a cutoff geyser sign with no communication to the AC joint or subacromial bursa. Complete excision of the cyst in toto was performed with no additional procedure. The histopathological examination revealed a ganglion cyst.</p><p><strong>Conclusion: </strong>The AC joint cyst is a rare clinical diagnosis, requiring further insight into the spectrum of management of these lesions. In our case, the lack of clinical findings makes the management more challenging and thus, individualised.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 9","pages":"116-120"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12422636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Asymmetrical Bilateral Complex Dislocations of the Hips: A Rare Case Report.","authors":"Papa Kwabena Offeh Kyei, Tamsanqa Joseph Mazibuko, Collen Sandile Nkosi","doi":"10.13107/jocr.2025.v15.i09.6088","DOIUrl":"10.13107/jocr.2025.v15.i09.6088","url":null,"abstract":"<p><strong>Introduction: </strong>Asymmetrical hip dislocations are rare injuries. The native hip joint is inherently stable, so both joints will dislocate in a high-energy setting. Therefore, it is imperative to exclude other associated injuries and fractures and ensure both hips are reduced timeously.</p><p><strong>Case report: </strong>We present a rare case of a 46-year-old male patient who presented with asymmetrical complex hip dislocations following a pedestrian-vehicle accident. Both hips were reduced; however, the left acetabulum posterior wall needed open reduction and internal fixation.</p><p><strong>Conclusion: </strong>Early diagnosis and treatment are crucial in hip dislocations to mitigate the long-term complications. Patients who sustain asymmetrical complex dislocations should be evaluated for other injuries, as these are generally associated with poorer outcomes.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 9","pages":"250-254"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12422669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atypical Idiopathic Inferior Functional Shoulder Instability in a 15-year-old Female: A Case Report and Review of Literature.","authors":"Shrirang R Godbole, Devendra N Vartak, Renuka S Indurkar, Gayatri R Godbole","doi":"10.13107/jocr.2025.v15.i09.6020","DOIUrl":"10.13107/jocr.2025.v15.i09.6020","url":null,"abstract":"<p><strong>Introduction: </strong>The glenohumeral joint, while offering a high degree of mobility due to its ball-and-socket design, is inherently unstable. Shoulder instability is particularly challenging in pediatric and adolescent populations, where presentations are often atypical and non-traumatic. Functional shoulder instability (FSI), especially when idiopathic and inferior in direction, is exceedingly rare and underrepresented in literature.</p><p><strong>Case report: </strong>We report a unique case of a 15-year-old female who presented with chronic, atraumatic left shoulder subluxation, persisting over 18 months. The patient experienced pain and limited range of motion but reported no history of injury. Multiple prior consultations yielded temporary relief with analgesics, and no definitive diagnosis was established. Clinical evaluation revealed limited active abduction and external rotation with no signs of ligamentous laxity or neurological involvement. Radiographic assessment demonstrated gross inferior subluxation of the humeral head. Magnetic resonance imaging and computed tomography imaging confirmed intact soft tissue structures with mild joint effusion, anterior glenoid flattening, and a 6% glenoid bone loss. A diagnosis of inferior, non-positional, controllable idiopathic FSI was made, likely due to deltoid atony.</p><p><strong>Treatment and outcome: </strong>Management included temporary immobilization and physiotherapy using the Watson multidirectional instability protocol focused on scapular motor control retraining. After 10 weeks, the patient showed marked improvement with restoration of overhead abduction and full external rotation. Radiographs confirmed proper joint alignment, and the patient resumed normal activities symptom-free.</p><p><strong>Conclusion: </strong>This case highlights a rare presentation of inferior idiopathic FSI in an adolescent. Early recognition and structured rehabilitation can lead to excellent outcomes, avoiding unnecessary interventions. Increased awareness of such atypical presentations is essential for prompt diagnosis and effective non-operative management.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 9","pages":"71-75"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12422637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Forearm Compartment Syndrome in a Toddler Caused by Hematoma without Fracture: A Case Report.","authors":"Yasushi Naganuma, Hiroshi Satake, Norio Fukuda, Michiaki Takagi","doi":"10.13107/jocr.2025.v15.i09.6038","DOIUrl":"10.13107/jocr.2025.v15.i09.6038","url":null,"abstract":"<p><strong>Introduction: </strong>Acute forearm compartment syndrome (AFCS) is rare in pediatric patients. Diagnosis of AFCS in pediatric patients is often difficult based on their presentation variability and immature verbal. We present a case of AFCS in a toddler who showed specific congestion from the distal forearm to the hand that resulted in a hematoma without fracture.</p><p><strong>Case report: </strong>A 2-year-old boy had right upper extremity pain and paralysis after falling from a chair. He had no family history of congenital hemorrhagic diseases or anticoagulant medications. His right distal forearm to hand was congested with a clear borderline to the proximal forearm. It was unable to detect any fractures in the X-rays. We diagnosed him with AFCS and performed a fasciotomy that showed a developing hematoma around the carpal tunnel. Two years after surgery, he had no signs of neurological defect in the upper extremity.</p><p><strong>Conclusion: </strong>The toddler was injured by a low-energy fall, which was atypical enough to suggest the onset of ACFS. Congestion beyond the wrist, with a clear border to the proximal area, indicating peripheral circulatory disturbance, was the most notable physical finding in this case.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 9","pages":"121-124"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12422649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unusual Case of Failure of Tibial Polyethylene Insert Locking Mechanism in a Design of Cruciate Retaining Total Knee Arthroplasty - A Case Report.","authors":"Chandan Mehta, Mohan Madhav Desai, Kushagra Jain, Urvil Shah","doi":"10.13107/jocr.2025.v15.i09.6106","DOIUrl":"10.13107/jocr.2025.v15.i09.6106","url":null,"abstract":"<p><strong>Introduction: </strong>Bilateral total knee arthroplasty (TKA) with a cruciate-retaining (CR) design is a widely performed procedure, but complications involving the prosthesis's locking mechanism are rare. We present a case of locking clip dislodgement in a Zimmer Biomet Vanguard prosthesis, highlighting a rare cause of post-operative swelling and hardware impingement.</p><p><strong>Case report: </strong>A patient, 1 year after undergoing bilateral TKA, presented with a four-month history of medially prominent knee swelling. Clinical examination and radiographs revealed impinging hardware and confirmed the failure of the locking mechanism, with the locking clip visible as a dislodged entity. Following a negative work-up for infection, the patient was taken for revision surgery. The locking clip was found in the subcutaneous tissue, having buttonholed through the retinaculum. To facilitate access, the posterior cruciate ligament was released, a quadriceps snip was performed, and the anterior superficial medial collateral ligament was subperiosteally released. The original polyethylene liner was replaced with a new anterior stabilized (AS) polyethylene liner of the same thickness and secured with a new locking clip. Intraoperative cultures were negative. The post-operative course was uneventful, with the patient achieving full range of motion within 1 week.</p><p><strong>Conclusion: </strong>This case report underscores that locking mechanism failure should be considered in the differential diagnosis of post-TKA knee swelling and pain. The use of an AS polyethylene liner with a new locking clip proved to be a successful revision strategy, leading to a favorable functional outcome.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 9","pages":"299-304"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12422656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Muscle Energy Technique, Strengthening, and Patellar Mobilization in the Physiotherapeutic Management of Patellofemoral Osteoarthritis.","authors":"Namrata Srivastava, Nitesh Kumar Meena, Ajit Modi, Ajit Saharan, Shruti Mahajan, Kartik Chhonker","doi":"10.13107/jocr.2025.v15.i09.6130","DOIUrl":"10.13107/jocr.2025.v15.i09.6130","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Patellofemoral osteoarthritis (PFOA) is a prevalent degenerative joint disorder characterized by anterior knee pain, stiffness, reduced functional mobility, and impaired quality of life, particularly in older adults. Due to its multifactorial etiology-including muscle imbalance, altered patellar tracking, and joint degeneration-conservative physiotherapy approaches are often prioritized over surgical interventions. This study aimed to evaluate the clinical effectiveness of an integrated physiotherapeutic regimen comprising muscle energy technique (MET), targeted strengthening exercises, and patellar mobilization in the management of PFOA. These findings support the inclusion of multimodal manual therapy and targeted exercise interventions as first-line conservative management strategies for patellofemoral joint degeneration. However, due to the small sample size, further large-scale studies are warranted to enhance generalizability and confirm these results.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;A single-group pre- and post-interventional design was implemented involving 30 participants (aged 45-65 years) clinically and radiologically diagnosed with PFOA. The 6-week intervention protocol included MET applied to the quadriceps and hamstring muscle groups, progressive resistance strengthening exercises focusing primarily on the vastus medialis obliquus (VMO), and patellar mobilization techniques aimed at improving patellar tracking and joint mobility. Each participant received three supervised sessions per week. Outcome measures were assessed at baseline and post-intervention using the Visual Analog Scale (VAS) for pain intensity, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for pain, stiffness, and functional limitation, and the Kujala Anterior Knee Pain Scale for patellofemoral joint function.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Statistical analysis revealed significant improvements across all outcome parameters post-intervention. Mean VAS scores decreased from 6.9 ± 1.2 to 3.1 ± 1.0 (P&lt; 0.001), indicating substantial pain relief. WOMAC scores showed a marked reduction from 58.6 ± 5.4 to 34.2 ± 4.9 (p&lt;0.001), reflecting improved joint function and reduced stiffness. The Kujala Score improved significantly from 45.7 ± 6.1 to 71.8± 5.6 (P&lt;0.001), denoting enhanced patellofemoral mechanics and functional mobility.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The study demonstrates that a physiotherapy program integrating MET, quadriceps strengthening (with VMO emphasis), and patellar mobilization is effective in significantly reducing pain and improving functional outcomes in individuals with PFOA. These findings support the inclusion of multimodal manual therapy and targeted exercise interventions as first-line conservative management strategies for patellofemoral joint degeneration. However, due to the small sample size, further large-scale studies are warranted to enhance generalizability ","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 9","pages":"376-381"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12422686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}