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Fulltext Outcome of longstanding dislocated elbows treated by open reduction and excision of collateral ligaments

Devnani AS

Singapore Med J, 2004 Jan;45(1):14-9.
PMID: 14976577

To study the long term result of open reduction of longstanding dislocated elbows with regard to stability, avascular necrosis of the distal humerus and degenerative changes of the joint.

Matched MeSH terms: Range of Motion, Articular/physiology
Fulltext Palm vitamin E and glucosamine sulphate in the treatment of osteoarthritis of the knee

Haflah NH, Jaarin K, Abdullah S, Omar M

Saudi Med J, 2009 Nov;30(11):1432-8.
PMID: 19882056

OBJECTIVE: To assess the efficacy of oral palm vitamin E in reducing symptoms of patients with osteoarthritis (OA) of the knee compared to oral glucosamine sulphate.
METHODS: This open study was carried out at the Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia between March 2006 and November 2007. Seventy-nine patients were recruited to receive either 1.5 g oral glucosamine sulphate or 400 mg oral palm vitamin E for 6 months. Symptoms were assessed using the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index and visual analogue scale (VAS).
RESULTS: Sixty-four patients completed the trial (vitamin E n=33, glucosamine sulfate n=31). After 6 months of treatment, both groups showed a significant improvement in WOMAC scale and significant reduction in the VAS score during standing and walking. There was no significant difference in WOMAC scale and VAS score between the 2 groups. Except for mild allergic reaction and abdominal discomfort in one patient, there were no other serious adverse effects reported. Serum malondialdehyde was significantly higher in the glucosamine group compared to palm vitamin E treated group at the end of the study. Serum of vitamin E was significantly higher in the palm vitamin E group compared to glucosamine.
CONCLUSION: The finding of this study suggests that oral palm vitamin E in a dose of 400 mg taken daily has a potential role in reducing symptoms of patients with OA of the knee. It may be just as effective as glucosamine sulphate in reducing the symptoms and free from serious side effects. Further study is required to ascertain the mechanism of action beside its antioxidant effect.

Matched MeSH terms: Range of Motion, Articular/physiology
Fulltext Preliminary analysis of knee stress in full extension landing

Makinejad MD, Abu Osman NA, Abu Bakar Wan Abas W, Bayat M

Clinics (Sao Paulo), 2013 Sep;68(9):1180-8.
PMID: 24141832 DOI: 10.6061/clinics/2013(09)02

This study provides an experimental and finite element analysis of knee-joint structure during extended-knee landing based on the extracted impact force, and it numerically identifies the contact pressure, stress distribution and possibility of bone-to-bone contact when a subject lands from a safe height.

Matched MeSH terms: Range of Motion, Articular/physiology
Fulltext Preoperative physiotherapy and short-term functional outcomes of primary total knee arthroplasty

Mat Eil Ismail MS, Sharifudin MA, Shokri AA, Ab Rahman S

Singapore Med J, 2016 Mar;57(3):138-43.
PMID: 26996450 DOI: 10.11622/smedj.2016055

INTRODUCTION: Physiotherapy is an important part of rehabilitation following arthroplasty, but the impact of preoperative physiotherapy on functional outcomes is still being studied. This randomised controlled trial evaluated the effect of preoperative physiotherapy on the short-term functional outcomes of primary total knee arthroplasty (TKA).
METHODS: 50 patients with primary knee osteoarthritis who underwent unilateral primary TKA were randomised into two groups: the physiotherapy group (n = 24), whose patients performed physical exercises for six weeks immediately prior to surgery, and the nonphysiotherapy group (n = 26). All patients went through a similar physiotherapy regime in the postoperative rehabilitation period. Functional outcome assessment using the algofunctional Knee Injury and Osteoarthritis Outcome Score (KOOS) scale and range of motion (ROM) evaluation was performed preoperatively, and postoperatively at six weeks and three months.
RESULTS: Both groups showed a significant difference in all algofunctional KOOS subscales (p < 0.001). The mean score difference at six weeks and three months was not significant in the sports and recreational activities subscale for both groups (p > 0.05). Significant differences were observed in the time-versus-treatment analysis between groups for the symptoms (p = 0.003) and activities of daily living (p = 0.025) subscales. No significant difference in ROM was found when comparing preoperative measurements and those at three months following surgery, as well as in time-versus-treatment analysis (p = 0.928).
CONCLUSION: Six-week preoperative physiotherapy showed no significant impact on short-term functional outcomes (KOOS subscales) and ROM of the knee following primary TKA.
KEYWORDS: algofunctional Knee Injury and Osteoarthritis Outcome Score; functional outcome; prehabilitation; preoperative physiotherapy; total knee arthroplasty

Matched MeSH terms: Range of Motion, Articular/physiology*
Racial variations in knee joint laxity: A comparative study of the Jordanian Arab and Malay populations

Bashaireh KM, Yabroudi MA, Nawasreh ZH, Al-Zyoud SM, Bashir NB, Aleshawi AJ, et al.

Knee, 2020 Aug;27(4):1205-1211.
PMID: 32711883 DOI: 10.1016/j.knee.2020.05.003

BACKGROUND: A high incidence of joint laxity has been reported among Asians compared with Western populations, but clear differences between more specific ethnic populations have not been established. This study aimed to determine the average knee laxity in the Malaysian and Jordanian populations.
METHODS: Jordanian and Malaysian medical students from our institution were invited to participate in the study. General demographic data and factors affecting joint laxity were obtained from each participant using a printed questionnaire. Both knees were examined using the anterior drawer test while in 90° of flexion. Knee laxity was measured by three separate independent investigators through a knee laxity tester.
RESULTS: One hundred and eighty-six participants (95 females) were enrolled in the study. Among them, 108 Malaysians participated. The Jordanians had significantly higher knee laxity in both knees compared with the Malaysians. The mean average right knee laxity for Jordanians was 2.98 mm vs. 2.72 mm for Malaysians (P = 0.005). Similarly, the mean average left knee laxity for Jordanians was 2.95 mm, while for Malaysians, it was 2.62 mm (P = 0.0001). Furthermore, smokers had significantly more laxity in both knees. After performing a multivariate linear regression analysis for all factors, race was the only independent factor that affected knee laxity in both knees.
CONCLUSIONS: Race is directly associated with knee laxity. Jordanians tend to have more laxity in knee joints compared with Malaysians. Larger multi-center and genetic studies are recommended to establish the racial differences between different ethnic groups.

Matched MeSH terms: Range of Motion, Articular/physiology*
Revision of total hip arthroplasty using an anterior cortical window, extensive strut allografts, and an impaction graft: follow-up study

Arif M, Sivananthan S, Choon DS

J Orthop Surg (Hong Kong), 2004 Jun;12(1):25-30.
PMID: 15237118

To report the outcome of revised total hip arthroplasty procedures involving an anterior cortical window, extensive strut allografts, and an Exeter impaction graft.

Matched MeSH terms: Range of Motion, Articular/physiology
Satisfaction and problems experienced with wrist movements: comparison between a common body-powered prosthesis and a new biomechatronics prosthesis

Abd Razak NA, Abu Osman NA, Kamyab M, Wan Abas WA, Gholizadeh H

Am J Phys Med Rehabil, 2014 May;93(5):437-44.
PMID: 24429510 DOI: 10.1097/PHM.0b013e3182a51fc2

This report compares wrist supination and pronation and flexion and extension movements with the common body-powered prosthesis and a new biomechatronics prosthesis with regard to patient satisfaction and problems experienced with the prosthesis. Fifteen subjects with traumatic transradial amputation who used both prosthetic systems participated in this study. Each subject completed two questionnaires to evaluate their satisfaction and problems experienced with the two prosthetic systems. Satisfaction and problems with the prosthetic's wrist movements were analyzed in terms of the following: supination and pronation; flexion and extension; appearance; sweating; wounds; pain; irritation; pistoning; smell; sound; durability; and the abilities to open a door, hold a cup, and pick up or place objects. This study revealed that the respondents were more satisfied with the biomechatronics wrist prosthesis with regard to supination and pronation, flexion and extension, pain, and the ability to open a door. However, satisfaction with the prosthesis showed no significant differences in terms of sweating, wounds, irritation, pistoning, smell, sound, and durability. The abilities to hold a cup and pick up or place an object were significantly better with the body-powered prosthesis. The results of the survey suggest that satisfaction and problems with wrist movements in persons with transradial amputation can be improved with a biomechatronics wrist prosthesis compared with the common body-powered prosthesis.

Matched MeSH terms: Range of Motion, Articular/physiology*
Statistical factorial analysis approach for parameter calibration on material nonlinearity of intervertebral disc finite element model

Masni-Azian, Tanaka M

Comput Methods Biomech Biomed Engin, 2017 Aug;20(10):1066-1076.
PMID: 28532164 DOI: 10.1080/10255842.2017.1331345

In the biomechanics field, material parameters calibration is significant for finite element (FE) model to ensure a legit estimation of biomechanical response. Determining an appropriate combination of calibration factors is challenging as each constitutive component responds differently. This study proposes a statistical factorial analysis approach using L16(4(5)) orthogonal array to evaluate material nonlinearity and applicable calibration factor of the intervertebral disc FE model in pure moment. The calibrated model exhibits improved agreement to the experimental findings for all directions. Appropriate combination of calibration parameter reduces the estimation gap to the experimental findings, ensuring agreeable biomechanical responses.

Matched MeSH terms: Range of Motion, Articular/physiology
Fulltext The assessment of immediate post-operative scoliosis correction using pedicle screw system by utilising the fulcrum bending technique

Chan CY, Kwan MK, Saravanan S, Saw LB, Deepak AS

Med J Malaysia, 2007 Mar;62(1):33-5.
PMID: 17682567 MyJurnal

Assessment of the curve flexibility is a crucial step in a surgeon's pre-operative planning for scoliosis surgery. Many techniques have been described. These include traction films, supine side bending films, push prone techniques, traction under general anaesthesia as well as fulcrum bending film. In this study, we studied the pre- and immediate post-operative radiographs of twenty eight adolescent idiopathic scoliosis (AIS) patients who were corrected using pedicle screw systems between January 2004 and August 2006. There were twenty two females and six male patients. The mean age of the patients were 17.5 years with a range of 12 to 38 years. Skeletal maturity of the patients was assessed by Risser's score. The majority was Risser 4 (15 cases, 53.6%). Based on King and Moe's classification, the most common curve was type 3 curve (15 cases, 53.6%). Among the twenty eight patients, twenty three patients underwent only posterior correction, while 5 patients underwent additional anterior release surgery. The mean pre-operative Cobb's angle for the posterior surgery group was 65.5 +/- 13.9 degrees and the mean post-operative Cobb's angle was 32.9 +/- 12.6 degrees. There was no difference between the mean correction estimated by fulcrum bending films (Fulcrum Flexibility) and the post- operative Correction Rate figures (44.2% vs. 49.9%). The mean Fulcrum Bending Correction Index (FBCI) in this group of patients is 112.8%. In the group of patients who underwent additional anterior release, their curves were noted to be larger and less flexible with the mean pre-operative Cobb's angle and Fulcrum Flexibility of 90.4 degrees +/- 9.3 degrees and 23.4% respectively. The Fulcrum Bending Correction Index (FBCI) for this group of patients was significantly higher than the posterior surgery group: i.e. 164.0% vs 112.8%. Thus, anterior release does help to improve the correction significantly. The fulcrum bending films give good pre-operative estimation of the amount of correction to be expected post-operatively. The fulcrum bending films can help to identify the curve types which might require anterior release in order to improve the scoliosis correction. Using the Fulcrum Bending Correction Index (FBCI) will also enable surgeons to quantify more accurately the amount of correction achieved by taking into account the inherent flexibility of the spine.

Matched MeSH terms: Range of Motion, Articular/physiology*
The influence of foot orthoses on foot mobility magnitude and arch height index in adults with flexible flat feet

Sheykhi-Dolagh R, Saeedi H, Farahmand B, Kamyab M, Kamali M, Gholizadeh H, et al.

Prosthet Orthot Int, 2015 Jun;39(3):190-6.
PMID: 24604086 DOI: 10.1177/0309364614521652

BACKGROUND: Flexible flat foot is described as a reduction in the height of the medial longitudinal arch and may occur from abnormal foot pronation. A foot orthosis is thought to modify and control excessive pronation and improve arch height.
OBJECTIVE: To compare the immediate effect of three types of orthoses on foot mobility and the arch height index in subjects with flexible flat feet.
STUDY DESIGN: A quasi-experimental study.
METHOD: The dorsal arch height, midfoot width, foot mobility and arch height index were assessed in 20 participants with flexible flat feet (mean age = 23.2 ± 3 years) for three different foot orthosis conditions: soft, semi-rigid and rigid University of California Biomechanics Laboratory (UCBL).
RESULTS: Maximum midfoot width at 90% with arch mobility in the coronal plane was shown in the semi-rigid orthosis condition. The semi-rigid orthosis resulted in the highest mean foot mobility in 90% of weight bearing, and the rigid orthosis (UCBL) had the lowest mean foot mobility. The soft orthosis resulted in foot mobility between that of the rigid and the semi-rigid orthosis. UCBL orthosis showed the highest arch height index, and the semi-rigid orthosis showed the lowest mean arch height index.
CONCLUSION: Due to its rigid structure and long medial-lateral walls, the UCBL orthosis appears to limit foot mobility. Therefore, it is necessary to make an orthosis that facilitates foot mobility in the normal range of the foot arch. Future studies should address the dynamic mobility of the foot with using various types of foot orthoses.
CLINICAL RELEVANCE: Although there are many studies focussed on flat foot and the use of foot orthoses, the mechanism of action is still unclear. This study explored foot mobility and the influence of foot orthoses and showed that a more rigid foot orthosis should be selected based on foot mobility.
KEYWORDS: Foot orthosis; arch height index; foot mobility magnitude

Matched MeSH terms: Range of Motion, Articular/physiology*
Fulltext Treatment for flexion contracture of the knee during Ilizarov reconstruction of tibia with passive knee extension splint

Kwan MK, Penafort R, Saw A

Med J Malaysia, 2004 Dec;59 Suppl F:39-41.
PMID: 15941159

Joint stiffness is one of the complications of limb procedure. It developes as a result of failure of knee flexors to lengthen in tandem with the bone, especially when there is inadequate physical therapy to provide active and passive mobilization of the affected joint. We are reporting four patients who developed fixed flexion contracture of their knees during bone lengthening procedure for the tibia with Ilizarov external fixator. Three of them were treated for congenital pseudoarthrosis and one was for fibular hemimelia. None of them were able to visit the physiotherapist even on a weekly basis. A splint was constructed from components of Ilizarov external fixator and applied on to the existing frame to passively extend the affected knee. Patients and their family members were taught to perform this exercise regularly and eventually near complete correction were achieved. With this result, we would like to recommend the use of this "Passive Knee Extension Splint" to avoid knee flexion Contracture during limb lengthening procedures with Ilizarov external fixators.

Matched MeSH terms: Range of Motion, Articular/physiology

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