{"title":"Traumatic Anterior Dislocation of the Knee Without Any Neurovascular Complication-Case Report","authors":"Nitesh Gahlot, U. Saini, S. Aggarwal","doi":"10.4172/2167-7921.1000254","DOIUrl":"https://doi.org/10.4172/2167-7921.1000254","url":null,"abstract":"We are reporting a case of traumatic anterior dislocation of the left knee without any neurovascular complication. To our knowledge, such complete dislocation without involvement of popliteal artery and/or peroneal nerve has not been reported before however similar cases are reported after total knee replacement with and without neurovascular compromise. This injury was recognized and treated promptly with rehabilitation commencing early, resulting in a good functional outcome. We discuss the possible injury mechanism and management of this unusual case.","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":"6 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7921.1000254","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70836380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comparison of Outcome on Knee Related Function by 2 Different Mode of Progressive Resisted Exercises (PREx) Intervention in Patients with Knee Osteoarthritis","authors":"Swati Meshram, Sandhya Gupta, Medha Deo","doi":"10.4172/2167-7921.1000227","DOIUrl":"https://doi.org/10.4172/2167-7921.1000227","url":null,"abstract":"Background: Lower limb muscles strengthening are crucial in knee joint rehabilitation. Weight training as evolved by DeLorm is a more traditional robust form of Progressive resistive exercises (PREx) program in which muscles are exercised against constant resistance through the arc of motion. Use of Elastic bands is yet another tool used in strengthening exercise regimens. What popularly known as Theraband exercises, resistance varies through the arc and relies on various components such as modulus of elasticity. The characteristic differences of theses 2 modes of resisted exercise was assumed to result in different outcomes on measured knee related functions. Hence, this study has been undertaken to compare the short term effects PREx using weight cuffs versus Theraband resistance exercise in patients suffering from knee osteoarthritis. \u0000Methods: Eighty-nine participants completed this trial over the period of 14 months. Study participants were randomly allocated to 3 study groups which received PREx (DeLorm) (n=30), Theraband exercises (n=30) and conventional treatment (n=29) for 3 week period. \u0000Results: Interaction between time and function was significant when compared with control whereas both experimental groups improved equally (P>0.05) over the period of time. Post treatment Weight cuff (DeLorm) and Theraband PREx between group differences (median difference and probability of superiority (PS) is presented for 5 Knee injury and Osteoarthritis Outcome Score (KOOS) subscales and patient specific function are as follows. \u0000Pain: 6.5 (36%); symptoms 11(43%); ADL 5.5(45%), Sport and recreation 5(35%), QOL, PSFS 0.75(37%). \u0000Conclusion: Both the weight cuff PREx (DeLorm) and Theraband resistance exercises resulted in improvement of knee functions as measured on KOOS and patient specific functional scale in population suffering from knee osteoarthritis with better probability of superiority for weight cuff exercises.","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":"2016 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2016-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70836181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Åukasz Chojecki, Janusz PÅomiÅski, Artur PepÅoÅski
{"title":"Non-typical Localisation of Osteoid Osteoma in the Acromion","authors":"Åukasz Chojecki, Janusz PÅomiÅski, Artur PepÅoÅski","doi":"10.4172/2167-7921.1000226","DOIUrl":"https://doi.org/10.4172/2167-7921.1000226","url":null,"abstract":"The paper presents the clinical case of a 14-y.old female patient complaining on omalgia, in whom a focus of osteoid osteoma was diagnosed, localized in the acromion. The lesion was removed using the arthroscopic technique, achieving a complete disappearance of ailment.","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":"2016 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2016-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70836082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Non-surgical and Non-pharmacological Treatment of Knee Pain","authors":"D. Golding, P. Lee","doi":"10.4172/2167-7921.1000225","DOIUrl":"https://doi.org/10.4172/2167-7921.1000225","url":null,"abstract":"Knee pain is an increasingly common presentation to general practitioners both in the United Kingdom and worldwide and is thought to be caused by a combination of the obesity epidemic, the ageing population and continuing worldwide population growth. Two distinct aetiologies of knee pain have been described: a bony-type which is usually degenerative in nature; and a ligamentous-type which usually occurs as a result of acute injury but then predisposes to the development of bony-type in later life. There are a wide variety of treatment options available to the clinician: ranging from conservative to major surgery. Total Knee Replacement (TKR) is often the end-point of many causes of knee pain and is used with increasingly frequency. However, there are a wide variety of problems associated with TKR including ongoing pain, patient dissatisfaction and the need for revision surgery. This review aims to demonstrate that TKR should be avoided unless absolutely necessary and also provides the clinician with an overview of the various evidence-based conservative options available to be utilised to improve patient pain and functional knee capabilities.","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":"5 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2016-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7921.1000225","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70836032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
O. Benacka, J. Beňačka, P. Blažíček, M. Belansky, J. Payer, Z. Killinger, J. Lietava
{"title":"Speckle-tracking Echocardiography is More Sensitive in Detecting Subclinical Myocardial Dysfunction in Patients with Rheumatoid Arthritis","authors":"O. Benacka, J. Beňačka, P. Blažíček, M. Belansky, J. Payer, Z. Killinger, J. Lietava","doi":"10.4172/2167-7921.1000224","DOIUrl":"https://doi.org/10.4172/2167-7921.1000224","url":null,"abstract":"Introduction: Patients with rheumatoid arthritis (RA) have shorter life expectancy and their risk of cardiovascular death is more than 50% higher than the rest of the population. Early myocardial dysfunction may be detectable more precisely and sooner using speckle tracking echocardiography. Method: Cross-sectional study enrolled 55 patients with RA (mean age 44.1 years) without known cardiovascular disease and 31 healthy controls, matched for age, sex, blood pressure, BMI and smoking habit. All subjects underwent a standard echocardiographic and Doppler examination (isovolumic contraction and relaxation times (IVCT and IVRT), mitral valve inflow curve (E/A), septal mitral annular motion (e'), and E/e' ratio) as well as the speckle tracking assessment of left ventricle strains and strain rates. Results: In standard echocardiographic examination RA patients exhibited higher indexed left ventricle mass (96.4 ± 20.9 g/m2 vs. 95.8 ± 21.9 g/m2; p=0.013), lower ejection fraction (64 ± 4% vs. 67 ± 4%; p=0.011) and prolonged IVCT (61.5 ± 9.3 ms vs. 53.7 ± 8.95 ms; p=0.001). Diastolic dysfunction was demonstrasted by prolonged IVRT (81.6 ± 9.6 ms vs. 74.6 ± 12.0 ms; p=0.007) as well as by higher E/e’ ratio (8.2 ± 1.8 vs. 7.2 ± 1.5; p=0.009). Speckle tracking method detected decreased global longitudinal epicardial strain (-19.5% vs. -21.5%; p=0.049). Global longitudinal epicardial strain (GLES) correlated with IVCT and IVRT, disease duration and with marker of myocardial damage NTproBNP. RA pts exhibited higher prevalence of markers of myocardial damage (defined as presence NT-proBNP ≥ 125 ng/l or IVRT ≥ 74 ms or IVCT ≥ 57 ms or GLES ≥ -20.0%) 2.2 ± 1.0 vs. 1.3 ± 1.0 (p=0.001), RR 1.97 (95% CI: 1.24–3.15; p=0.004) in comparison with controls. Conclusions: RA patients without known cardiovascular disease exhibited almost two times higher risk for detection of myocardial damage defined as impaired systolic or diastolic function or myocardial contraction deformity parameters or NT-pro-BNP as compared to matched controls. Speckle-tracking echocardiography significantly revealed incipient myocardial dysfunction, which correlates with clinical RA characteristics and other markers of cardiac damage.","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":"121 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2016-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70836015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Tony, H. Mohammed, N. Fathi, Abeer A. Tony, O. Afifi, M. Abdou, R. Gamal, E. Saad, A. Fehr
{"title":"Serum and Urinary Biomarkers Endothelin-1, Beta-2 Microglobulin, Cystatin C, Galectin-3 and Alpha-1-acid Glycoprotein; Can they Surrogate Clinical and Histological Staging in Lupus Nephritis Patients?","authors":"E. Tony, H. Mohammed, N. Fathi, Abeer A. Tony, O. Afifi, M. Abdou, R. Gamal, E. Saad, A. Fehr","doi":"10.4172/2167-7921.1000223","DOIUrl":"https://doi.org/10.4172/2167-7921.1000223","url":null,"abstract":"Background: Lupus nephritis (LN) affects up to 50% of patients with Systemic lupus erythematosus (SLE) and is a major cause of morbidity. It is thus essential to identify biomarkers as indices with substantial predictive power to reduce the serious sequelae. However, criteria for disease remission have not been clearly established for these indices, except for the SLE Disease Activity Index (SLEDAI). \u0000Objectives: To investigate the relationship of non-invasively renal protein biomarkers and established measures of renal function to histologic findings in LN, and to test whether certain combinations of the above mentioned laboratory measures are diagnostic for specific histologic features of LN and to evaluate their relations to SLEDAI and chronicity. \u0000Methods: The study was conducted on 40 SLE female patients, recruited from renal unit of Internal Medicine department and Rheumatology and Rehabilitation department, and Neurology department, Assuit and Aswan University Hospitals, Egypt from May 2011 to January 2014, Renal biopsies were evaluated using the International Society of Nephrology/Renal Pathology Society classification (ISN/RPS), and scored for Activity Index and Chronicity Index; Clinical responders (CR) were required to have ≥50% reduction in proteinuria, normal or improved renal function, and inactive urinary sediment. Histopathological responders (HR) were required to have ≥50% improvement in Activity Index In addition, 40 age and sex matched healthy persons as a control group were enrolled in the study. The GFR was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Novel serum biomarkers; Endothelin-1 (ET-1), cystatin C, beta-2 microglobulin (B2M), galectin-3 (Gal-3) and alpha-1-acid glycoprotein (AAG) were collected. Urine samples from patients were collected within 2 months of kidney biopsy and assayed for the urinary biomarkers Endothelin-1 (ET-1), α1-acid glycoprotein (AAG), Cystatin C (CysC) and beta-2 microglobulin (B2M). Renal disease activity was estimated using the British Isles Lupus Assessment Group (BILAG) index. \u0000Results: The urinary and plasma biomarkers; ET-1, AAG, Cys C and B2M and GAL-3 were statistically significantly higher in patients with LN compared to controls that is reflective of specific histologic features seen in active LN. The combination of ET-1, AAG and CRP levels plus protein: creatinine ratio was excellent in predicting LN activity. The urinary B2M together with ET-1 and AAG plus creatinine clearance was an excellent diagnostic test for LN chronicity. However, plasma and urinary Cys C showed insignificant correlation with chronicity indices with lowest sensitivity and specificity. The statistically significantly high levels of serum and urinary ET-1 and AAG were related to specific histologic findings in LN with significant positive correlations with SLEDAI and chronicity indices in renal biopsy and highest sensitivity and specificity. Notably, these plasma biom","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":"23 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2016-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7921.1000223","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70836344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Khaled M Alsubiaee, Khalid Alkhathlan, A. Omair, Farhan M Alenezi
{"title":"The Effects of Vitamin D Supplementation in Patients with Knee Osteoarthritis:Uncontrolled Open Label Clinical Trial","authors":"Khaled M Alsubiaee, Khalid Alkhathlan, A. Omair, Farhan M Alenezi","doi":"10.4172/2167-7921.1000222","DOIUrl":"https://doi.org/10.4172/2167-7921.1000222","url":null,"abstract":"Background: Osteoarthritis (OA) is a degenerative disease that affects joints. The current relationship between low vitamin D levels, functions, and symptoms of osteoarthritis is controversial. Objective: The aim of this study is to investigate the relationship between knee osteoarthritis and serum levels of vitamin D. \u0000Method: An uncontrolled open label clinical trial conducted on patients with low vitamin D levels using the Western Ontario and McMaster Universities Arthritis Index (WOMAC criteria). The WOMAC criteria used objectively to assess knee-joint function and symptoms before and after vitamin D3 supplementation. The study conducted from March 2013 to October 2015 at King Abdulaziz Medical City. Riyadh, Saudi Arabia. All participants with knee osteoarthritis and low vitamin D levels (≤75 nmol/L) were given 45,000 IU of vitamin D3 orally, once per week for three months, followed by 45,000 IU of vitamin D3 once every two weeks. \u0000Results: Of the 100 participants recruited to the study, 58 patients completed the clinical trial and included in the analysis. Nineteen participants excluded due to severe knee OA, vitamin D use, or history of knee surgery, while 23 patients were lost during the follow-up period. Among the 58 patients completing the trial, 39 were females and 19 were males, with an average age of 45.7 ± 4.5 years. The WOMAC scores did not change significantly (P=0.920) post-treatment with vitamin D3, despite the significant improvement of vitamin D levels (P=0.001). \u0000Conclusion: This study did not find a relationship between vitamin D levels, knee symptoms and functions in patients with OA.","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":"2016 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2016-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70835991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Crystal Induced Arthropathies: A Pictorial Review","authors":"S. Dhanda, S. Quek","doi":"10.4172/2167-7921.1000I102","DOIUrl":"https://doi.org/10.4172/2167-7921.1000I102","url":null,"abstract":"Crystal induced arthropathies are disorders involving crystal deposition in the articular and peri articular soft tissues with resultant inflammation. Gout (Figures 1 and 2) and calcium pyrophosphate dihydrate (CPPD) crystal deposition disease (Figures 3 and 4) are the two most common types of crystaldeposition arthritis [1]. The diagnosis is primarily based on clinical and laboratory findings, especially synovial fluid analysis [2]. Radiographs can further aid clinicians in establishing the correct diagnosis.","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":"5 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2016-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70837535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Towards Consensus on the Reporting of Core Outcome Domains in Total Joint Replacement Clinical Trials: The Derivation of the Preliminary Core Outcome Domain Set","authors":"J. Singh, M. Dohm","doi":"10.4172/2167-7921.1000221","DOIUrl":"https://doi.org/10.4172/2167-7921.1000221","url":null,"abstract":"Background: There is no consensus on how to report total joint replacement (TJR) trials. To our knowledge, core outcome domains for TJR clinical trials have not been defined. Our objective was to develop data-driven, consensus-based, preliminary recommendations for core outcome domains for TJR clinical trials. \u0000Method: We surveyed two groups of experts/stakeholders, who rated potential core outcome domains (mapped to Outcome Measures in Rheumatology Trials (OMERACT) filter 2.0 framework) for their relevance to TJR clinical trials during the 2014 American Academy of Orthopaedic Surgeons [AAOS] and Outcome Research Interest Group of the Orthopaedic Research Society (ORS) annual meeting and the 2014 OMERACT meeting. Ratings were on a 1-9 scale, 1-3 indicating domain of limited importance, 4-6 being important domain, and 7-9 being critically important domain. \u0000Results: Seventeen participants at the AAOS/ORS Outcomes Research Interest Group and 19 at OMERACT meeting completed the survey. At the two meetings, 73% and 36% were arthroplasty researcher/surgeons, 0% and 10% were patients and 58% and 31% were above 54 years, respectively. The following domains were rated as core outcome domains by both groups, with a median score of 7 and above (median score from AAOS/ORS vs. OMERACT): Joint pain (9 vs. 9), functional ability (8 vs. 9), joint-specific quality of life (8 vs. 7), patient satisfaction (7 vs. 8), revision surgery (8 vs. 7), adverse events (9 vs. 8), death (9 vs. 7.5), serious adverse events (8.5 vs. 8), reoperation (8 vs. 8), and cost (7 vs. 7). \u0000Conclusion: Stakeholders achieved consensus on preliminary core outcome domain set for TJR clinical trials. This set will be further vetted with multi-stakeholder input to achieve a fully endorsed TJR core outcome domain set.","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":"5 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2016-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7921.1000221","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70835831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Modern British Cemented Total Hip Replacement","authors":"P. Lee, James P. Brock","doi":"10.4172/2167-7921.1000E114","DOIUrl":"https://doi.org/10.4172/2167-7921.1000E114","url":null,"abstract":"Total Hip Replacement (THR) is the most successful operation in medical history, and this editorial would like to take a look at the history of its development and how the contributions of great British orthopaedic surgeons made it possible. Britain continues to produce notable orthopaedic surgeons and special mention will go to the founding father of modern THR, Sir John Charnley. Further, the most popular stem in the world of 2015, the Exeter Stem V40, was developed in Britain with over 1 million being implanted in the last 46 years. The THR procedure gives people with disabling pain a chance to regain hold on their life, get out and walk freely again.","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":"5 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2016-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70837241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}