Displaying publications 61 - 80 of 200 in total

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  1. Fulltext Bedside continuous irrigation and drainage as an interim local treatment for septic arthritis of the knee in the medically unstable patient: a case report
    Khoo SS, Loi KW, Tan KT, Suhaeb AR, Simmrat S
    Malays Orthop J, 2015 Jul;9(2):57-59.
    PMID: 28435613 MyJurnal DOI: 10.5704/MOJ.1507.003
    Septic arthritis is a surgical emergency. Prompt diagnosis and immediate treatment reduce the destruction of articular cartilage and give better outcome. We describe a simple, minimally invasive closed tube irrigation system for the initial treatment of septic arthritis of the knee in a patient with complex medical problems who was unfit to undergo surgery.
    Matched MeSH terms: Knee Joint
  2. “‘Doc’ do I need an anterior cruciate ligament reconstruction? What happens if I do not reconstruct the cruciate ligament?”
    KS Dhillon
    Malays Orthop J, 2014;8(3):42-47.
    MyJurnal
    We are all aware that there has been a dramatic increase in the number of anterior cruciate ligament (ACL) reconstructions that are carried out here in Malaysia as well as around the world. The numbers of ACL injuries have undoubtedly increased over the years with greater participation of young adults in sporting activities. However it is not certain whether the increase in the numbers of reconstructions can be accounted for by the increasing numbers of ACL injuries. Without doubt commercial interests as well the influence of the biomedical companies have a role to play. In the past the rationale for surgical treatment of an ACL tear was that the ACL is vital for knee function and that in the long term ACL deficiency will lead to more injuries of the meniscus and more degeneration of the joint. This belief was prevalent because the natural history of an ACL deficient knee and the ultimate outcome of reconstruction of the ACL were both not known. However in recent years a substantial amount of research has been published, which has elucidated the natural history of ACL deficient knees as well as the long term outcome of reconstruction of the ACL.
    Matched MeSH terms: Knee Joint
  3. Fulltext Posterior Slope of the Tibia Plateau in Malaysian Patients Undergoing Total Knee Replacement
    Yoga, R., Sivapathasundaram, N., Suresh, C.
    Malays Orthop J, 2009;3(1):78-80.
    MyJurnal
    The posterior slope of the tibial plateau is an important feature to preserve during knee replacement. The correct slope aids in the amount of flexion and determines if the knee will be loose on flexion. This is a study on the posterior tibial plateau slope based on preoperative and postoperative radiographs of 100 consecutive patients who had total knee replacements. The average posterior slope of the tibia plateau was 10.1 degrees. There is a tendency for patients with higher pre-operative posterior tibial plateau slope to have higher post-operative posterior tibial plate slope.
    Matched MeSH terms: Knee Joint
  4. Fulltext Number of familiarisation sessions required for an Isokinetic Knee Strenght Assesment in Female varsity athletes
    Yin, Jerusha Chan Poe, Ashril Yusof, Victor Selvarajah Selvanayagam
    Jurnal Sains Sukan & Pendidikan Jasmani, 2016;5(2):1-8.
    MyJurnal
    Journal of Sports Science and Physical Education 5(2): 1-8, 2016 - The objective of this
    study was to determine the number of familiarisation sessions required for isokinetic knee
    extension and flexion in female varsity athletes. Thirty right footed dominance female varsity
    athletes (n=30; age: 21.73 ±0.22 years, body mass index (BMI): 22.58 ±0.52 kg/m2), with no
    history of knee injuries were recruited. The design started with either with the dominant or
    non-dominant limb, followed by the opposite limb. Four sets of isokinetic maximal voluntary
    contraction at 60 o/s were performed for each limb. The results showed that for knee
    extension regardless of which limb starts first is 2 sessions, however for knee flexion, 3
    sessions is required for dominant limb while 2 for non-dominant. In addition, the presence of
    cross-education effect is observed for knee flexion from non-dominant to dominant limb,
    where the number of session was reduced from three to two. In conclusion, we propose that
    two sessions of familiarisation are required for female varsity athletes and should begin with the non-dominant limb followed by dominant limb.
    Matched MeSH terms: Knee Joint
  5. Fulltext Femoral deformity correction and lengthening on nail with monorail external fixator : a case report
    Mohd Bakrynizam Abu Bakar Siddiq, Kamarul Izham Kamarudin, Kamarul Al Haq, Suresh Chopr
    International e-Journal of Science, Medicine & Education, 2018;12(2):26-29.
    MyJurnal
    Limb length discrepancy (LLD) is quite common.
    Lower limb shortening is one of the causes of limb
    length discrepancy. The common treatment that is
    used is the llizarov technique for bone lengthening.
    The new technique uses an intramedullary nail with
    a monoplanar external fixator. Using this technique,
    bone lengthening duration in patients can be reduced
    and knee joint mobility can be improved without
    jeopardizing bone regeneration. We report a case of a
    27-year-old gentleman who had right femur shortening
    from childhood and was referred to us for corrective
    deformity. He underwent bone lengthening on the nail
    which lenghthens and equalizes the leg while avoiding
    stiffness and reduces joint mobility which leads to good
    patient satisfaction outcome. The use of the external
    fixator with intramedullary nailing to lengthen the
    femur is one method that can reduce patient burden
    mentally and physically. However although it has many
    advantages we must watch out for the complications
    during the regular visits to ensure good outcome.
    Matched MeSH terms: Knee Joint
  6. Fulltext Relationship between isokinetic leg strength and knee frontal plane projection angle during single leg squat among male junior athletes
    Mail, M.S.Z., Mohd Azhar, N., Affandi, N.F., Shaharudin, S., Agrawal, S., Chee, L.M.
    JUMMEC, 2019;22(2):43-48.
    MyJurnal
    Background: Those with increased dynamic knee valgus are vulnerable to increased risk of non-contact knee
    injuries. However, studies on the top down kinetic chain of lower limb mechanics during dynamic motions
    such as single leg squat (SLS) among trained males were scarce.

    Objective: The objective of the study was to evaluate the relationship between isokinetic hip and knee strength
    and frontal plane projection angle (FPPA) of the knee joint during SLS.

    Methods: Thirty-two male junior athletes (twelve cyclists, ten runners and ten squash players) were screened
    for excessive dynamic knee valgus (DKV) prior to participation. Only those within the normal value of DKV were
    included. Their hip and knee isokinetic strength in sagittal plane were evaluated at 60º/s of angular velocity
    for both legs using dynamometer. Two dimensional knee FPPA was evaluated during SLS at 60º of knee flexion.
    Pearson correlation was evaluated between knee FPPA during SLS and isokinetic leg strength.

    Results: Correlations between knee FPPA and hip and knee isokinetic strength were not statistically significant
    except between knee flexion peak torque/body weight (r = -0.35, p = 0.05) and hamstring to quadriceps ratio
    (r = -0.39, p = 0.03) of non-dominant leg.

    Conclusions: Isokinetic hip and knee strength and knee FPPA during SLS was correlated only for non-dominant
    leg during SLS among male junior athletes. DKV during SLS may be reduced through strengthening the muscles
    around hip and knee joints.
    Matched MeSH terms: Knee Joint
  7. Effects of simple knee sleeves on pain and knee adduction moment in early unilateral knee osteoarthritis
    Mohd Sharif NA, Usman J, Wan Safwani WKZ, Siew Li G, Abdul Karim S, Mohamed NA, et al.
    Proc Inst Mech Eng H, 2019 Nov;233(11):1132-1140.
    PMID: 31597554 DOI: 10.1177/0954411919874614
    Knee sleeves are often prescribed to alleviate pain in people with early knee osteoarthritis. However, the biomechanics underlying their pain-relieving effect are still not well understood. This pre-post study aims at evaluating and comparing the effects of two different types of knee sleeves on knee adduction moment. Patients with clinically diagnosed knee osteoarthritis were recruited from the University of Malaya Medical Centre and were randomly assigned to two test groups using (1) a simple knee sleeve and (2) a simple sleeve with patella cutout. Knee adduction moment was collected using the Vicon motion capture system with two Kistler force plates. Pain, stiffness and physical functions were recorded using the Western Ontario and McMaster Universities Osteoarthritis Index. All measurements were taken before, immediately after and at the completion of 6 weeks of application (primary time point). In total, 17 participants with early unilateral knee osteoarthritis (47.7 (9.7) years) completed the study. Overall results show significant reduction in pain, early stance and late stance knee adduction moment and increased walking speed after 6 weeks of both knee sleeves application. This study results suggest that knee sleeves can reduce knee adduction moments in early unilateral knee osteoarthritis by 14.0% and 12.1% using the simple sleeve and the sleeve with patella cutout, respectively, and can potentially delay disease progression. In addition, knee sleeve with patella cutout does not provide additional benefits when compared to the simple knee sleeve.
    Matched MeSH terms: Knee Joint
  8. Fulltext Arthroscopic All-Inside Repair of Tear of the Anterior Horn of Discoid Lateral Meniscus
    Muniandy M, Rajagopal S, Tahir SH
    Surg J (N Y), 2019 Jan;5(1):e35-e37.
    PMID: 31093532 DOI: 10.1055/s-0039-1688951
    The anterior horn of lateral meniscus tear is usually repaired using outside-in technique. Although easy to perform, it was associated with several complications which may alter the outcome of the surgery. Here, we present a case of an adolescent girl presented with incomplete discoid lateral meniscus accompanied by tear of anterior horn. The tear was repaired using all-inside technique without any implants. We described the surgical technique and discussed the rationale.
    Matched MeSH terms: Knee Joint
  9. Fulltext Synovial Cyst: A Culprit for Recalcitrant Iliotibial Band Syndrome: A Case Report
    Yeoh C, Lim G, Sathappan SS
    Malays Orthop J, 2015 Nov;9(3):68-70.
    PMID: 28611916 DOI: 10.5704/MOJ.1511.011
    We present the case of a 56-year old gentleman who presented with recalcitrant iliotibial band (ITB) friction syndrome which did not improve with various modalities of conservative treatment. Magnetic Resonance Imaging (MRI) of the affected knee did not show pathology typical of ITB friction syndrome. However, open exploration revealed a synovial cyst deep to the iliotibial band, abutting against the anterolateral capsule. The presence of distinctive clinical signs on physical examination should alert clinicians to consider knee synovial cyst as a differential diagnosis when dealing with recalcitrant ITB syndrome.
    Matched MeSH terms: Knee Joint
  10. Fulltext Management of valgus knee with irreducible patellar dislocation and MCL rupture: A case series
    Rhatomy S, Purnama H, Singh C, Setyawan R, Utomo DN
    Int J Surg Case Rep, 2019;60:175-182.
    PMID: 31229772 DOI: 10.1016/j.ijscr.2019.06.018
    INTRODUCTION: The high rate of recurrence in patellar dislocation treatment, requires a more comprehensive action, this is due to causes not only single but often multifactorial, including problems with static stability, dynamic stability or both.

    PRESENTATION OF CASE: 1st case: A-39-years-old male, complain of irreducible right patella dislocation with valgus knee and already done soft tissue procedure for patella dislocation. Long-leg radiographs of the right leg showed 18° valgus mechanical angle. 2nd case: A-26-years-old obese female, complain of dislocation of left patella and history of surgery for dislocation at 5 years old. Long-leg radiographs of the right leg showed 11° valgus mechanical angle.

    DISCUSSION: After knowing the cause of the patellar dislocation from history taking, physical and supporting examination, we performed lateral open wedge distal femoral osteotomy also MPFL and MCL reconstruction, and tibial tuberosity medialization osteotomy. There is improvement mean score in Tegner Lysholm Knee Scoring system and IKDC Scoring at 6 months after surgery.

    CONCLUSION: Lateral open wedge distal femur osteotomy combine with MPFL and MCL reconstruction and tibial tuberosity medialization realignment procedure can be successfully done for improve irreducible patellar dislocation in valgus knee, from clinical and radiological evaluation have good outcome after surgery.

    Matched MeSH terms: Knee Joint
  11. Reconstruction for chronic grade-II posterior cruciate ligament deficiency in Malaysian military personnel
    Ahmad S, Mahidon R, Shukur MH, Hamdan A, Kasmin M
    J Orthop Surg (Hong Kong), 2014 Dec;22(3):325-8.
    PMID: 25550011
    To evaluate the outcome of reconstruction for chronic grade-II posterior cruciate ligament (PCL) deficiency in Malaysian military personnel.
    Matched MeSH terms: Knee Joint/surgery*
  12. Biomechanical analysis of knee laxity with isolated anteromedial or posterolateral bundle-deficient anterior cruciate ligament
    Kondo E, Merican AM, Yasuda K, Amis AA
    Arthroscopy, 2014 Mar;30(3):335-43.
    PMID: 24581258 DOI: 10.1016/j.arthro.2013.12.003
    The purpose of this study was to clarify the changes in the kinematics of the knee that result from isolated deficiency of the anteromedial (AM) or posterolateral (PL) bundle.
    Matched MeSH terms: Knee Joint/physiopathology*
  13. Non-invasive and in vivo assessment of osteoarthritic articular cartilage: a review on MRI investigations
    Hani AF, Kumar D, Malik AS, Ahmad RM, Razak R, Kiflie A
    Rheumatol Int, 2015 Jan;35(1):1-16.
    PMID: 24879325 DOI: 10.1007/s00296-014-3052-9
    Early detection of knee osteoarthritis (OA) is of great interest to orthopaedic surgeons, rheumatologists, radiologists, and researchers because it would allow physicians to provide patients with treatments and advice to slow the onset or progression of the disease. Early detection can be achieved by identifying early changes in selected features of degenerative articular cartilage (AC) using non-invasive imaging modalities. Magnetic resonance imaging (MRI) is becoming the standard for assessment of OA. The aim of this paper was to review the influence of MRI on the selection, detection, and measurement of AC features associated with early OA. Our review of the literature indicates that the changes associated with early OA are in cartilage thickness, cartilage volume, cartilage water content, and proteoglycan content that can be accurately, consistently, and non-invasively measured using MRI. Choosing an MR pulse sequence that provides the capability to assess cartilage physiology and morphology in a single acquisition and advanced multi-nuclei MRI is desirable. The results of the review indicate that using an ultra-high magnetic strength, MR imager does not affect early OA detection. In conclusion, MRI is currently the most suitable modality for early detection of knee OA, and future research should focus on the quantitative evaluation of early OA features using advances in MR hardware, software, and data processing with sophisticated image/pattern recognition techniques.
    Matched MeSH terms: Knee Joint/pathology
  14. Fulltext Histology, glycosaminoglycan level and cartilage stiffness in monoiodoacetate-induced osteoarthritis: comparative analysis with anterior cruciate ligament transection in rat model and human osteoarthritis
    Naveen SV, Ahmad RE, Hui WJ, Suhaeb AM, Murali MR, Shanmugam R, et al.
    Int J Med Sci, 2014;11(1):97-105.
    PMID: 24396291 DOI: 10.7150/ijms.6964
    Monosodium -iodoacetate (MIA)-induced animal model of osteoarthritis (OA) is under-utilised despite having many inherent advantages. At present, there is lack of studies that directly compare the degenerative changes induced by MIA with the surgical osteoarthritis induction method and human osteoarthritis, which would further verify a greater use of this model. Therefore, we compared the histological, biochemical and biomechanical characteristics in rat model using MIA against the anterior cruciate ligament transection (ACLT) and human cartilage with clinically established osteoarthritis. The right knees of Sprague-Dawley rats were subjected to either MIA or ACLT (n=18 in each group). Six rats were used as controls. Human cartilage samples were collected and compared from patients clinically diagnosed with (n=7) and without osteoarthritis (n=3). Histological, biochemical (Glycosaminoglycans/total protein) and biomechanical (cartilage stiffness) evaluations were performed at the end of the 1(st) and 2(nd) week after OA induction. For human samples, evaluations were performed at the time of sampling. Histopathological changes in the MIA group were comparable to that observed in the ACLT group and human OA. The Mankin scores of the 3 groups were comparable (MIA: 11.5 ± 1.0; ACLT: 10.1 ± 1.1; human OA: 13.2 ± 0.8). Comparable reduction in Glycosaminoglycan/total protein content in the intervention groups were observed (MIA: 7 ± 0.6; ACLT: 6.6 ± 0.5; human OA: 3.1 ± 0.7). Cartilage stiffness score were 24.2 ± 15.3 Mpa for MIA, 25.3 ± 4.8 for ACLT and 0.5 ± 0.0 Mpa for human OA. The MIA model produces comparable degenerative changes to ACLT and human OA with the advantage of being rapid, minimally invasive and reproducible. Therefore, wider utilisation of MIA as animal translational OA model should perhaps be advocated.
    Matched MeSH terms: Knee Joint/physiopathology
  15. Fulltext Influence of functional knee bracing on the isokinetic and functional tests of anterior cruciate ligament deficient patients
    Mortaza N, Abu Osman NA, Jamshidi AA, Razjouyan J
    PLoS One, 2013;8(5):e64308.
    PMID: 23717593 DOI: 10.1371/journal.pone.0064308
    Use of functional knee braces has been suggested to provide protection and to improve kinetic performance of the knee in Anterior cruciate ligament(ACL)-injured patients. However, many athletes might refrain from wearing the braces because of the fear of performance hindrance in the playing field. The aim of this study was to examine the effect of three functional knee brace/sleeves upon the isokinetic and functional performance of ACL-deficient and healthy subjects. Six anterior cruciate ligament deficient (29.0 ± 5.3 yrs., 175.2 ± 5.4 cm, and 73.0 ± 10.0 kg) and six healthy male subjects (27.2 ± 3.7 yrs., 176.4 ± 6.4 cm, and 70.3 ± 6.9 kg) were selected. The effect of a custom-made functional knee brace, and two neoprene knee sleeves, one with four metal supports and one without support were examined via the use of isokinetic and functional tests in four sets (non-braced,wearing functional knee brace,and wearing the sleeves). Cross-over hop and single leg vertical jump test were performed and jump height, and hop distance were recorded. Peak torque to body weight ratio and average power in two isokinetic velocities(60°.s(-1),180°.s(-1)) were recorded and the brace/sleeves effect was calculated as the changes in peak torque measured in the brace/sleeves conditions, expressed as a percentage of peak torque measured in non-braced condition. Frequency content of the isokinetic torque-time curves was also analyzed. Wilcoxon signed rank test was used to compare the measured values in four test conditions within each control and ACL-deficient group,and Mann-Whitney U test was used for the comparison between the two groups. No significant differences in peak torque, average power, torque-time curve frequency content, vertical-jump and hop measurements were found within the experimental and the non-braced conditions (p>0.05). Although the examined functional knee brace/sleeves had no significant effect on the knee muscle performance, there have been some enhancement regarding the extension peak torques and power generating capacity of the ACL-deficient subjects that could be helpful in reducing the bilateral asymmetry in these patients.
    Matched MeSH terms: Knee Joint/physiopathology
  16. Finite element analysis of Puddu and Tomofix plate fixation for open wedge high tibial osteotomy
    Raja Izaham RM, Abdul Kadir MR, Abdul Rashid AH, Hossain MG, Kamarul T
    Injury, 2012 Jun;43(6):898-902.
    PMID: 22204773 DOI: 10.1016/j.injury.2011.12.006
    The use of open wedge high tibial osteotomy (HTO) to correct varus deformity of the knee is well established. However, the stability of the various implants used in this procedure has not been previously demonstrated. In this study, the two most common types of plates were analysed (1) the Puddu plates that use the dynamic compression plate (DCP) concept, and (2) the Tomofix plate that uses the locking compression plate (LCP) concept. Three dimensional model of the tibia was reconstructed from computed tomography images obtained from the Medical Implant Technology Group datasets. Osteotomy and fixation models were simulated through computational processing. Simulated loading was applied at 60:40 ratios on the medial:lateral aspect during single limb stance. The model was fixed distally in all degrees of freedom. Simulated data generated from the micromotions, displacement and, implant stress were captured. At the prescribed loads, a higher displacement of 3.25 mm was observed for the Puddu plate model (p<0.001). Coincidentally the amount of stresses subjected to this plate, 24.7 MPa, was also significantly lower (p<0.001). There was significant negative correlation (p<0.001) between implant stresses to that of the amount of fracture displacement which signifies a less stable fixation using Puddu plates. In conclusion, this study demonstrates that the Tomofix plate produces superior stability for bony fixation in HTO procedures.
    Matched MeSH terms: Knee Joint/surgery*
  17. Autologous chondrocyte transplantation in the repair of full-thickness focal cartilage damage in rabbits
    Kamarul T, Selvaratnam L, Masjuddin T, Ab-Rahim S, Ng C, Chan KY, et al.
    J Orthop Surg (Hong Kong), 2008 Aug;16(2):230-6.
    PMID: 18725678
    To compare the efficacy of autologous chondrocyte transplantation (ACT) versus non-operative measures for cartilage repair in rabbits.
    Matched MeSH terms: Knee Joint/surgery*
  18. Fulltext Chronic rupture of the extensor apparatus of the knee joint
    Poonnoose PM, Korula RJ, Oommen AT
    Med J Malaysia, 2005 Oct;60(4):511-3.
    PMID: 16570720
    Chronic ruptures of the extensor mechanism of the knee are uncommon injuries, and previously reported literature assumes the presence of an intact patella for repair. We present a case of chronic rupture following patellectomy done twelve years previously. The defect in the extensor apparatus was extensive (18cm), and this was bridged using a large fascia lata graft from the opposite thigh, with reasonably successful results.
    Matched MeSH terms: Knee Joint/physiopathology*
  19. Fulltext Resection arthrodesis for primary bone tumour about the knee
    Kwan MK, Ng ES, Penafort R, Saw A, Sengupta S
    Med J Malaysia, 2005 Jul;60 Suppl C:66-71.
    PMID: 16381287 MyJurnal
    Bone defect following en bloc resection of primary bone tumor around the knee can be reconstructed by allograft or prothesis or combination of both. Resection-arthrodesis is an alternative option for young vigorous patients facing circumstances of financial constrain or limited supply of allograft. This study was undertaken to determine the outcome and complications associated with resection-arthrodesis of 22 primary bone tumors (13 giant cell tumors and 9 osteosarcomas) around the knee treated between 1990 and 2003 at the University Malaya Medical Center. The mean follow-up was 6 years (range 1-13 years). hree patients with osteosarcoma died of lung metastasis, 3 required above knee amputation and 2 defaulted follow-up. Local complications of the procedure include infection in 8 cases (36.4%), non-union 7 (31.8%) and mal-union. Of 14 patients who returned for final evaluation, 79.8% had satisfactory outcomes according to the Musculoskeletal Tumor Society grading system. In conclusion, resection-arthrodesis of the knee is a viable treatment option for selected patients with primary bone tumor around the knee, and good functional outcome can be expected in the presence of short-term local complications.
    Matched MeSH terms: Knee Joint/surgery*
  20. Fulltext The incidence of deep venous thrombosis following arthroscopic knee surgery
    Ng WM, Chan KY, Lim ABK, Gan EC
    Med J Malaysia, 2005 Jul;60 Suppl C:14-6.
    PMID: 16381276
    A prospective cohort study was undertaken at two centers to look for the incidence of deep vein thrombosis (DVT) following knee arthroscopic surgery. Eighty-four patients who had 90 arthroscopic procedures were reviewed. The relevant risk factors: past or family history of DVT, smoking, oral contraceptives, body weight, haemoglobin level, platelet count, tourniquet time and type of anaesthesia were documented. All patients were subjected to preoperative and post-operative duplex ultrasound. Only one patient (1.2 %) was noted to have DVT involving the peroneal vein. We concluded that the incidence of DVT after knee arthroscopy was very low in this study population.
    Matched MeSH terms: Knee Joint/surgery*
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