Online ISSN: 2515-8260

Keywords : knee


Retrospective Study Of Internal Derangements Of Knee Joints With MRI "

Dr. Saurabh Sachar, Dr. Sudhir Sachar

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 1, Pages 1621-1629

Background: Knee injury is the second most common problem in the musculoskeletal system for which patients consult their general physician or an orthopaedician. Since its introduction to musculoskeletal imaging in the early 1990`s and then onwards, MRI has revolutionized diagnostic imaging of the knee joints.  Magnetic resonance imaging has an advantage in diagnosis of menisci, ligaments and cartilages of the knee joints along with their pathologies and injuries, particularly in the early detection of grade I and grade II lesions. The ‘knee joint’, also known as the tibio-femoral joint, is one of the largest and a complex joint of the human body, and of one of the most frequently injured joints as the bony articular surface alone is inherently unstable. Therefore, it is imperative to study internal derangements in traumatic and degenerative knees

A hospital-based outcome assessment of Primary TKR in Severe fixed flexion deformity of knee compared with TKR in knees without fixed flexion deformity (FFD): A comparative study

Dr. Anurag Chandrakar; Dr. Shashimant Chavan; Dr. Rupesh Kumar Gupta

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 8, Pages 910-916

Aim: The aim of the present study was to know the functional outcome of Primary TKR in Severe fixed flexion deformity of knee compared with TKR in knees without fixed flexion deformity (FFD).
Methods: This was a prospective study of the Department of Orthopaedics, Shri Shankaracharya Institute of Medical Sciences, Bhilai, Chhattisgarh, India for the period of 1 year. Patients with and without severe flexion deformity of knees underwent primary TKR. Total of 120 knees were taken for the study with 90 with FFD of more than 30 degree and 30 were without FFD which were kept as a control. This study includes both inflammatory and non-inflammatory arthritis.
Results: In 100 patients, there were 30 bilateral cases and 90 unilateral cases with a total of 120 knees. 66 knees were inflammatory arthritis and 34 with non-inflammatory arthritis. There were 45 females and 55 male patients. Average age of the patients was 59.6 years (28-75 years). Average follow up was 1.5 years (1-3 years). In Primary TKR in FFD - Average FFD was 44 degree, Pre-operative average KSS-pain score was 27.5 and functional score was 15, post operatively KSS pain score was 82.7 and function score was 79.1. In Primary TKR in no FFD - Pre-operative average KSS-pain score was 31 and functional score was 24, post operatively KSS pain score was 85.3 and function score was 80.2.
Conclusion: There was no significant difference in postoperative KSS- pain and functional score, in patients with no FFD was comparable with patients with FFD. TKA is successful in correcting flexion deformity, although the amount of correction obtained depended on the degree of preoperative flexion deformity.

Study of correlation between MRI and arthroscopic findings in anterior cruciate ligament and meniscal injuries of the knee joint at a tertiary hospital

Bethi Anirudh Reddy, V Sahethya Mohan Rao, Vikram Goud, Sujitkumar Vakati R, Nayan Raj Puvvada, S. Venkatraman

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 7095-7100

Background: Complete evaluation of knee injury includes a detailed history, thorough clinical examination, radiological evaluation, and arthroscopic examination.  Present study was aimed to study correlation between MRI and arthroscopic findings in anterior cruciate ligament and meniscal injuries of the knee joint at a tertiary hospital.
Material and Methods: Present study was hospital based, prospective, comparative, observational study, conducted in ppatients admitted to the hospital with traumatic knee injury, underwent MRI knee followed by arthroscopy.
Results: During study period 60 patients of knee injury underwent MRI knee followed by arthroscopy considered for study. Majority were male (86.67 %), from 20-29 years age group (60 %), had injury dure to motor vehicle accident (43.33 %) & sports related activity (35 %). We compared injuries to ACL, PCL medial meniscus & lateral meniscus mentioned during MRI study with respect to knee arthroscopy using knee arthroscopy as diagnostic gold standard. In cases of ACL tear, MRI had sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) & accuracy values as 86.66 %, 73.33 %, 90.69 %, 64.70 % & 83.33 % respectively. In cases of PCL tear, MRI had sensitivity, specificity, PPV, NPV & accuracy values as 86.36 %, 89.47 %, 82.60 %, 91.89 % & 88.33 % respectively. In cases of Medial meniscus tear, MRI had sensitivity, specificity, PPV, NPV & accuracy values as 86.11 %, 87.5 %, 91.17 %, 80.76 % & 86.66 % respectively. In cases of lateral meniscus tear, MRI had sensitivity, specificity, PPV, NPV & accuracy values as 83.33 %, 88.09 % & 75 %, 92.5 % & 86.66 % respectively.
Conclusion: MRI is an excellent, non-invasive, radiation free imaging modality with multiplanar capabilities and excellent soft tissue delineation

To Assess Various Histo-Pathological Changes in Knee Joint Cartilage in End Stage Osteo-Arthritis

Dr. Arpit Tiwari Dr. Sunil Barod Dr. Puneet Maheshwari Dr. Ankit Verma Dr. Ashok Nagla

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 9575-9577

The aim of this study is to assess various histo-pathological changes in knee joint cartilage in end stage osteo-arthritis. Of the various clinical scoring systems available, the Oxford Knee score is considered. The questionaire, specifically designed for patient undergoing total knee replacement, hence most appropriate for this study. It is a short, practical, reliable, valid and sensitive to clinically important changes over time and is now widely applied and accepted model.
Result: Mean score value of oxford knee is 25.69.
Conclusion: In recent years, our perception of OA has changed significantly. It is increasing obvious that it is difficult to distinguish between changes in the joints occasioned by age and those of true OA recalling that both are interrelated. Arguably, it is it is even difficult to know what OA actually is or how to diagnose it. The disease, if indeed, is one disease is no longer seen as wear and tear disorder or one in which cartilage failure and wear produce joint disruption.

Outcome of total knee replacement in osteoarthritis

Dr. Venugopal Palakurthi, Dr. Srimukthi Madhusudan, Dr. B Srinivas, Dr. V Krishna Kumar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 3147-3155

Background and Objectives: To investigate and assess the functional results of complete knee replacement surgery. To determine whether or not there has been an improvement in post-operative pain relief. The knee joint's degree of stability as well as its range of motion to investigate the risks and potential problems of total knee replacement surgery. The pre-operative Knee Clinical Score will be compared to the post-operative Knee Clinical Score. The pre-operative Knee Functional Score will be compared to the post-operative Knee Functional Score. In order to evaluate the radiological results of the total knee replacement procedure. Research will be conducted to investigate the connection between the Knee Clinical Score and the Knee Functional Score.
Methods: A total of 20 patients who had total knee replacements were included in this prospective analysis. Cases were selected based on certain criteria, both for inclusion and disqualification. At each patient's scheduled follow-up appointment, the Knee Society Score was applied to assess their condition. Within the participants of our study, there were a total of 20 female patients and 10 male patients. Indications were 15 cases of OA and 1 case of RA. The duration of the follow-up period was typically twenty weeks.
Results: In the course of our research, prior to surgery, every one of our patients experienced moderate to severe pain; but, following surgery, 16 of the patients only experienced mild discomfort. Following surgery, the patient's average flexion, which was 75 degrees preoperatively, increased to 94 degrees. Before surgery, each of the 15 knees received a knee score of less than 60, but after surgery, some of the knees received an exceptional score (80 to 100), while the other knees received a good score (72-79). Prior to surgery, 10 patients had a functional score that was below 60, and two patients had a functional score that was between 60 and 69. Postoperatively, 20 patients had a score that was considered to be outstanding (85-100), 10 patients had a score that was considered to be good (72-79), 6 patients had a score that was considered to be acceptable (61-69), and 2 patients had a score that was considered to be poor (60).
Conclusion: The surgical method known as total knee arthroplasty is now widely practiced and well-established. The functional outcome of the surgery is impressive, long-lasting, and gratifying, and patient acceptability is very high.

Assessment of knee joint pathologies using magnetic resonance imaging

Dr Eram Fatima, Dr Tarim Usmani

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 5823-5827

Background: MR examination, a non-invasive modality, is now routinely used to assess
a wide spectrum of internal knee derangements and articular disorders. The present
study was conducted to assessed the efficacy of MRI in evaluation of knee joint
pathologies.
Materials & Methods: 70 patients with painful knee joint of both gendersunderwent
MRI of knee joint with 1.5 Tesla high gradient MRI scanner. T1 and T2 weighted
sequences in sagittal planes, PD weighted sequences in axial, coronal and sagittal planes
and fat suppressed T2 or STIR sequences were recorded.
Results: Out of 70 patients, males were 45 and females were 25. Common knee
pathologies were anterior cruciate ligament tear in 12, posterior cruciate ligament tear
in 8, chondromalacia patellae in 5, rheumatoid arthritis in 7, medial collateral ligament
tears in 10, lateral collateral ligament tears in 8, medial meniscal tears in 5, lateral
meniscal tears in 5, osteochondritis dissecans in 6 and infection in 4 patients. The
difference was significant (P< 0.05).
Conclusion: MRI is an accurate and cost- effective radiographic aid useful in diagnosis
of painful knee. Common knee pathologies were anterior cruciate ligament tear,
posterior cruciate ligament tear, chondromalacia patellae, rheumatoid arthritis, medial
collateral ligament tears, lateral collateral ligament tears, medial meniscal tears, lateral
meniscal tears, osteochondritis dissecans and infection.