Displaying publications 121 - 140 of 201 in total

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  1. Dhillon KS
    Malays Orthop J, 2015 Mar;9(1):47-52.
    PMID: 28435599 DOI: 10.5704/MOJ.1503.008
    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 rational 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 was not known although the ultimate outcome of reconstruction of the ACL was not known either. However in past few years a substantial amount 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
  2. Vanrenterghem, Jos, Zulezwan A. Malik, G. Burniston, Jatin
    MyJurnal
    Journal of Sports Science and Physical Education 5(2): 9-14, 2016 - Jump squat tests can be
    used to investigate the differences in the force - velocity (f-v) profile in movement that is
    more a sport-specific than isolated exercises such as open chain leg extension. However,
    squat jumps involve multi-joint movement, making it questionable which muscle is the main
    contributor for the movement. The main aim of this study is to develop a test of isolated knee
    extension that encompasses the entire range of human f-v relationship and to investigate the
    correlation between linear encoder and kinematic measurement of angular velocity using a
    camera system during unloaded kicking. One healthy male subject volunteered to participate
    in the study and performed 10 unloaded kicks (knee extension). A cuff was strapped around
    the lower leg, approximately 2 cm above the medial malleoli and connected to a linear
    velocity encoder (MuscleLab Ergotest version 4010, Norway). During the test sessions, threedimensional
    motion analysis was performed with an Oqus Motion Capture System (Qualisys,
    Sweden). Data were transferred to Windows-based data acquisition software (Qualisys Track
    Manager). There was a positive linear relationship (r = 0.94). The unloaded kicking test to
    determine maximum angular velocity at knee extension measured using the QTM showed
    that the mean angular velocity was 362˚.s-1, with the highest value being 528˚.s-1. This
    preliminary study suggests isokinetic dynamometry (IKD) can be used to investigate the
    entire range of velocities (i.e isometric – velocity maximum) of knee extension in normal
    human subjects. Further studies can examine the use of IKD in measuring higher velocities.
    Matched MeSH terms: Knee Joint
  3. Wam, B.L., Chee, E.K., Ewe, T.W.
    Malays Orthop J, 2010;4(3):11-15.
    MyJurnal
    The PROSTALAC (PROSThesis Antibiotic Loaded Acrylic Cement) functional spacer is made with antibiotic-loaded acrylic cement. We use it as an interim spacer in two-stage exchange arthroplasty in cases of infected total knee or total hip replacement. PROSTALAC allows continuous rehabilitation between stages as it maintains good alignment and stability of the joint with a reasonable range of movement. It also helps to maintain the soft-tissue planes, thereby facilitating the second-stage procedure. We report here early outcomes of the use of PROSTALAC in 5 patients - 3 in total knee replacements, 1 in a total hip replacement and 1 in a bipolar hemiarthroplasty.
    Matched MeSH terms: Knee Joint
  4. Suhail, A., Idham, H., Norhamdan, M.Y., Shahril, Y., Masbah, O.
    Malays Orthop J, 2009;3(2):33-35.
    MyJurnal
    Objective: To evaluate the early results of patients in a single institution who underwent total knee arthroplasty using an implant system. Methods: We retrospectively reviewed 76 total knee replacements using the Genesis II prosthesis (Smith and Nephew, Memphis) in 60 patients (16 were bilateral cases) performed between February 2005 andFebruary 2008. Patient related outcomes and clinical evaluations were done by an independent observer. Knee function and patient satisfaction were evaluated using the American Knee Society (ASK) score and the Western Ontario and Mac Master University Osteoarthritis Index (WOMAC). Results: The mean age of the patients at the time of operation was 63.5years. The mean follow up period was 1 year 5 months. At the final follow up, the mean Knee Society Knee Score was 87.9 with 77.3% (58 knees) rated excellent, 21.3% (16 knees) rated good and1.3% (1 knee) rated fair; none were rated poor. The mean Function Score was 87.1 with 64% (48 knees) rated excellent, 29.3% (22 knees) rated good, 6.7% (5 knees) rated fair, no knee was rated poor. The mean WOMAC Score was 94.4 (standard deviation 6.59). Conclusion: Most patients treated for knee osteoarthritis with total knee replacement showed high rates of excellence and good early functional outcomes.
    Matched MeSH terms: Knee Joint
  5. Yoga R, Mukaram M, Ramachandran
    Malays Orthop J, 2009;3(2):4-7.
    MyJurnal
    Intrarticular Hyaluronic Acid was administered to 45 patients with various grades of osteoarthritis in the knee. Following 3 fortnightly injections, these patients were reviewed at 6 weeks and 3 months with regard to their knee pain. We found the most patients (84.4%) has decreased knee pain following these injections. Patients who had severe grade osteoarthritis based on knee radiographs before the injections were less likely to have pain reduction compared to those with milder grade osteoarthritis. Only 4 (8.9%) patients showed no improvement and were subsequently considered for surgery. Many patients did not require any further treatment (24.4%) and the remaining were given analgesia (64.4%) to aid in their pain. One patient required another course of this injection. there were no complications recorded in this study. We concluded that Intrarticular Hyaluronic acid is an easy and safe method to treat osteoarthritis. The short-term outcome with regard to knee pain is good in patients with milder grades of osteoarthritis.
    Study site: Private orthopaedic clinic, Johor, Malaysia
    Matched MeSH terms: Knee Joint
  6. Narayanan SS, Suhail A, Harjeet S, Shahril Y, Masbah O
    Malays Orthop J, 2009;3(1):19-23.
    MyJurnal
    This study was conducted to evaluate the efficacy of intra-articular injection of hyaluronic acid for the treatment of knee osteoarthritis. Patients with knee osteoarthritis were followed for a period of six months to assess the efficacy of intra-articular injection of hyaluronic acid given three times in three consecutive weeks. Fifty patients were reviewed at two, eight and 24 weeks post-injection. The average age was 60.9 years and female to male ratio was 3:1. Patients were assessed using the Lequesne Algofunctional Index for function, and the visual analogue score for pain and side effects. We found that the knee pain reduced and the function improved in most patients and these beneficial effects maintained for till the last follow up. The only side effect noted was one case of acute non-septic joint effusion after the 3rd injection. We concluded that intra-articular injection of hyaluronic acid can produce pain relief and functional improvement for up to 6 months.
    Matched MeSH terms: Knee Joint
  7. Ariff, M.S., Arshad, A.A.
    MyJurnal
    Introduction: Praying represents a fundamental activity of daily living in Muslim community. Muslims need to adopt several postures that require deep flexion of the knee and hip to perform this daily obligation. This is a preliminary report of the study on hip and knee range of motion conducted to obtain normative passive and functional range of flexion data during Muslim prayers in both weight-bearing joints of normal Muslim adults. Methods: A cohort of Malay men aged between 20 to 30 years was recruited in this cross-sectional study. Passive range of motion and flexion angles of the joints in various postures during prayer were measured using a standard goniometer. The difference against existing normative range of motion database available and the influence of various factors were analysed. Factors analysed include body mass index and other anthropometric measurements. Results: Sixty participants recruited for the preliminary phase of this study. The mean (SD) of passive hip and knee flexions were higher compared to other existing normative range of motion database. A unit increase in body mass index will have 0.782 units lower of knee range of motion. The hip and knee flexion arc were from 74.1° to 119.0° and from 3.3° to 119.7° respectively. Conclusion: The range of motion involved for prayers was more for the knee but less for the hip as compared to the measured passive range of motion. Body mass index has a significant linear negative relationship with the passive range of motion of the knee, but not the hip.
    Matched MeSH terms: Knee Joint
  8. Kamarul T, Razif A, Elina R, Azura M, Chan KY
    Malays Orthop J, 2007;1(2):11-16.
    MyJurnal
    A study to determine average knee laxity in the Malaysian population and how it affects daily living was conducted at the University Malaya Medical Centre between January and April 2004. Fifty two male and 76 female subjects were recruited for this study, all of whom were healthy volunteers with no ambulatory problems. Side to side knee laxity testing was performed using a KT-1000 arthrometer. Significant differences in knee laxity were noted among different races and between sexes. For instance, overall, Chinese and female study participants had higher knee laxity: (left knee, 2.17 mm (SD=1.30) and right knee was 2.88 mm (SD= 1.51)). On average, the difference between knees was 0.70 ± 1.26 mm (less than 1 mm) which is a smaller variation than reported in previous studies which suggested 3 mm. Despite finding knee laxity ranging from 0 to 8mm, no correlations were found between Lysholm, IKDC and Tegner knee outcome scores and the degree of knee laxity. No other predictors such as height, weight and age correlated with levels of knee laxity. We therefore conclude that knee laxity is a common occurrence in the normal population and is therefore not suitable as a sole predictor of knee function and should not be used as the only criteria for surgical intervention.
    Study site: Orthopedic clinic, Universiti Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Knee Joint
  9. Zaidi, M., Azuhairy, Chan, C.K.,
    Malays Orthop J, 2008;2(1):8-11.
    MyJurnal
    This study evaluates the outcome of anterior cruciate ligament (ACL) reconstruction with arthroscopy using the bone–patella tendon-bone method. We performed this procedure in 24 patients with the average age of 33.1 years (range: 17-51 years ) between 2004 and 2006. Sixteen of the 24 patients were available for evaluation using the Lysholm Knee Score and International Knee Documentation Committee (IKDC) system. Based on the Lysholm score, there was a statistically significant improvement in knee function when comparing pre- and post-surgical scores (p
    Matched MeSH terms: Knee Joint
  10. Mokhtar A.H., Kalimuthu, M.
    JUMMEC, 2017;20(1):1-5.
    MyJurnal
    The anterior cruciate ligament (ACL) deficient knee has been subjected to various research and many conclusions
    have been drawn to the loss of function in relation to it. ACL reconstruction is also very commonly done as
    this ligament damage is the most common injury in sports. Muscle strength and proprioception have been
    postulated to be affected alongside this injury. We conducted a cross sectional study in 19 patients who have
    ruptured their ACL. We measured their muscle strength, thigh muscle bulk and proprioception in comparison
    to their contralateral normal knee. The Biodex Isokinetic machine was used to measure the muscle strength
    and proprioception. The thigh circumference was measured manually using a measuring tape. There was
    significant reduction of muscle strength and thigh circumference in the ACL deficient limb as compared to the
    normal side, p
    Matched MeSH terms: Knee Joint
  11. Yusof MI, Shaharudin S, Sivalingarajah P
    Asian Spine J, 2018 Apr;12(2):349-355.
    PMID: 29713418 DOI: 10.4184/asj.2018.12.2.349
    Study Design: Comparative cross-sectional study.

    Purpose: We measured the vertical ground reaction force (vGRF) of the hip, knee, and ankle joints during normal gait in normal patients, adolescent idiopathic scoliosis (AIS) patients with a Cobb angle <40° and in AIS patients with spinal fusion. We aimed to investigate whether vGRF in the aforementioned joints is altered in these three groups of patients.

    Overview of Literature: vGRF of the lower limb joints may be altered in these groups of patients. Although it is known that excessive force in the joints may induce early arthritis, there is limited relevant information in the literatures.

    Methods: We measured vGRF of the hip, knee, and ankle joints during heel strike, early stance, mid stance, and toe-off phases in normal subjects (group 1, n=14), AIS patients with Cobb angle <40° (group 2, n=14), and AIS patients with spinal fusion (group 3, n=13) using a gait analysis platform. Fifteen auto-reflective tracking markers were attached to standard anatomical landmarks in both the lower limbs. The captured motion images were used to define the orientations of the body segments and force exerted on the force plate using computer software. Statistical analysis was performed using independent t-test and analysis of variance to examine differences between the right and left sides as well as those among the different subject groups.

    Results: The measurements during the four gait phases in all the groups did not show any significant difference (p>0.05). In addition, no significant difference was found in the vGRF measurements of all the joints among the three groups (p>0.05).

    Conclusions: A Cobb angle <40° and spinal fusion did not significantly create imbalance or alter vGRF of the lower limb joints in AIS patients.

    Matched MeSH terms: Knee Joint
  12. Arifaizad Abdullah, Mohd Hezery Harun, Hariati Jamil, Ezamin Abdul Rahim
    MyJurnal
    Traumatic rupture of the popliteus tendon is a rare type of knee injury. Most reported cases had occurred in athletes or following high impact trauma. We report a case of a 23-year-old male with an isolated complete popliteus tendon rupture that was diagnosed arthroscopically. The patient worked as a general labourer in a sawmill. He fell at his workplace and presented with acute painful fixed flexion of the right knee. Initially he was suspected to have a meniscus tear. Diagnostic arthroscopy of the knee was carried out; and diagnosis of popliteal tendon rupture was established. The patient was subsequently managed conservatively by arthroscopic debridement. He was allowed to mobilize the knee as tolerated after the surgery. He was well with a full knee range of movement and was able to walk normally at six weeks after surgery. This article highlights the possibility of complete popliteus tendon rupture following a minor occupational injury in a previously normal knee.
    Matched MeSH terms: Knee Joint
  13. Nor Azlin M, Lyn SK
    Sains Malaysiana, 2011;40(12):1461-1465.
    A controlled, single blinded experimental study was conducted to determine the effects of passive joint mobilization on pain and stairs ascending-descending time in subjects with knee osteoarthritis (OA knee). A total of 22 subjects aged 40 and above with mild and moderate OA knee were assigned to either passive knee mobilization plus conventional physiotherapy (experimental group) or conventional physiotherapy alone (control group). Both groups received 2 therapy sessions per week, for 4 weeks. A blinded assessor measured pain with Visual analogue scale and stairs ascending-descending time with Aggregated Locomotor Function test, at baseline and at week 4. There was a significant reduction in pain among subjects in the experimental group (18.07 mm, t = 3.48, p = 0.01) compared to the control group (6.66 mm, t = 0.44, p = 0.67). Non-significant clinical difference was found in stairs ascending-descending time between the two groups (i.e. 6.25s in the experimental group versus 6.78 s in the control group, F(1,10) = 0.70, p = 0.42). No significant correlation was found between pain score and stairs ascending-descending time, r = 0.34, p = 0.16. The addition of passive joint mobilization to conventional physiotherapy reduced pain but not stairs ascending-descending time among subjects with knee osteoarthritis.
    Matched MeSH terms: Knee Joint
  14. Kamudin NAF, Rani RA, Yahaya NHM
    J Clin Orthop Trauma, 2018 11 20;11(1):171-174.
    PMID: 32002008 DOI: 10.1016/j.jcot.2018.11.007
    Pes anserine syndrome is a cause of inferomedial knee pain. It occurs in patients with diabetes mellitus, osteoarthritis, rheumatoid arthritis and in overweight patients. It is a challenge to identify the causes of knee pain following knee replacement surgery. We present a case report of pes anserine syndrome in a 79-year-old female who had undergone knee arthroplasty 13 years prior. She was pain free until one year ago when her knee pain resurfaced without any symptoms of infection or history of trauma. She was successfully treated with a combination of stretching exercise and steroid local steroid injection. We want to highlight that such common condition as pes anserine syndrome, could occur in total knee arthroplasty, and should be considered as one of the possible diagnosis.
    Matched MeSH terms: Knee Joint
  15. Vipin M, Sujendra DM, Imthiaz VK, Hitesh-Shah
    Malays Orthop J, 2016 Nov;10(3):46-48.
    PMID: 28553449 DOI: 10.5704/MOJ.1611.006
    An adolescent boy with spastic diplegic cerebral palsy presented with crouch gait. He had bilateral severe flexion deformities of knees and hips. He was treated with single event multilevel surgery for the correction of deformities. Surgical procedures included bilateral adductor release, iliopsoas lengthening, bilateral femoral shortening and patella plication. Persistent hypertension was noted in the post-operative period. All causes of secondary hypertension were ruled out. Having persistent hypertension following the femoral shortening procedure is unusual. Antihypertensive medication controlled his blood pressure 15 months after surgery. Hypertension following correction of knee flexion deformity and limb lengthening is well known. Hypertension has not been described with the shortening osteotomy of the femur. Hypertension is a rare complication following the corrective surgery for the treatment of crouch gait. Blood pressure should be monitored during the post-operative period to detect such a rare complication.
    Matched MeSH terms: Knee Joint
  16. Tan T, Ho W
    Malays Orthop J, 2015 Nov;9(3):65-67.
    PMID: 28611915 DOI: 10.5704/MOJ.1511.010
    Stress fractures of the proximal tibia metaphysis are rare in the elderly. We present a case of a 65-year old male who developed sequential proximal tibia stress fractures associated with prolonged usage of methotrexate and prednisolone within a span of 18 months. Magnetic Resonance Imaging revealed an incomplete stress fracture involving the medial proximal tibial region. The patient was treated with stemmed total knee arthroplasty (TKA) bilaterally. Stress fractures should be considered in patients with atypical knee pain who have a history of methotrexate and prednisolone usage. TKA is an effective treatment in stress fractures of the proximal tibia.
    Matched MeSH terms: Knee Joint
  17. Kapil Mani KC, Dirgha Raj RC, Parimal A, Ram PB
    Malays Orthop J, 2016 Nov;10(3):56-57.
    PMID: 28553452 DOI: 10.5704/MOJ.1611.011
    Old neglected dislocation of knee joint is a rare injury. Any orthopaedic surgeon would have faced only a few cases of unreduced neglected dislocation in his life time practice. We report the case of a 30-year old male patient with one month old unreduced knee dislocation which was managed with open reduction and stabilization with two intra-articular crossed Steinman pins for six weeks, followed by removal of the pins and gradual weight bearing in hinged knee brace. At the end of one year, range of movement of knee joint was 0 to 50 degree with minimal knee pain on walking.
    Matched MeSH terms: Knee Joint
  18. Kamsan SS, Singh DKA, Tan MP, Kumar S
    PLoS One, 2020;15(3):e0230318.
    PMID: 32226047 DOI: 10.1371/journal.pone.0230318
    Knee osteoarthritis (KOA) is closely related with ageing, physical disability and functional dependency. The course of KOA is considered progressive and irreversible. Engagement with self-management may, however, minimize the impact of KOA. To be fully engaged with self-management activities, knowledge about KOA is a prerequisite. There is limited empirical data on older adults' understanding on KOA and their information needs about KOA. Therefore, the aims of this study were to explore older adults' knowledge about KOA and their perspectives on the information required to enable self-management. Three focus groups were conducted with 16 older adults with KOA. The sample consisted of three men and thirteen women with the mean age 73.2 years (range from 61 to 89). Thematic content analysis revealed two themes which were understanding about KOA and information needed about KOA. Participants' knowledge about KOA varied between individuals with many expressing that they needed more information about KOA. A targeted strategy is needed to educate older adults about KOA in order to support and prepare them for self-management.
    Matched MeSH terms: Knee Joint
  19. Swarna Nantha Y, Yeoh MH, Sharif SM
    Malays Fam Physician, 2019;14(3):60-64.
    PMID: 32175042
    Langerhans cell histiocytosis (LCH) in adults is rare and regarded as an 'orphan disease.' The systemic symptoms of LCH can mimic many other undifferentiated diseases seen at the primary care level. Failure to diagnose and delays in referral are common pitfalls in the management of this disease. We present a case of a 34-year-old woman with referred knee pain who was eventually diagnosed with multi-system LCH 4 years after the initial presentation. The mean age of presentation of LCH symptoms in adults is 33. Bone lesions are the frequent presentation of LCH in this age group. Endocrine involvement in LCH is seen in the form of diabetes insipidus (DI), which remains the most common extraskeletal presentation of LCH in adults. In the case discussed here, a definitive diagnosis of LCH was established through tissue biopsy. The spectrum of undifferentiated symptoms underscores the difficulty and delay in making a diagnosis associated with the condition. Most GPs not only face the predicament of initial recognition but also fail to merge presenting symptoms to form a purposeful referral of this elusive disease to a tertiary care unit.
    Matched MeSH terms: Knee Joint
  20. Boo HC, Yeo SJ, Chong HC
    Malays Orthop J, 2020 Mar;14(1):55-60.
    PMID: 32296483 DOI: 10.5704/MOJ.2003.009
    Introduction: Stiffness after Total Knee Arthroplasty (TKA) is a complication that decreases patient satisfaction. Patients in an Asian population have potentially different requirements of knee range of motion. The authors have encountered patients who complain of subjective stiffness post TKA who do not have a severely restricting range of motion (ROM). Some patients have persistent subjective stiffness and undergone Manipulation Under Anaesthesia (MUA). We look at their functional outcomes post MUA.

    Materials and Methods: This is a retrospective study, including 48 patients from a single institution who underwent MUA for stiffness, separated into objective and subjective knee stiffness. Patients with subjective knee stiffness who underwent MUA had failed conservative management. ROM, Oxford Knee Scores (OKS), Knee Society Scores (KSS) and Short Form 36 (SF36) scores were compared at two years post MUA.

    Results: The demographics of the two patient groups were similar. The time interval between index TKA and MUA was higher in the subjective knee stiffness group. Pre-MUA OKS, KS Function Score, KSS and SF36 scores were similar in both patient subgroups. There was no significant difference in the OKS, KSS or SF36 at two year follow-up. The proportion of patients in each group who achieved the Minimum Clinically Important Difference (MCID) improvement in the scores was also similar.

    Conclusions: Patients with subjective knee stiffness can achieve similar functional outcome improvements in Oxford and Knee Society Scores with MUA at two years follow-up.

    Matched MeSH terms: Knee Joint
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