Selected issues in the biomechanics of the knee joint

Aleksander Kabsch, Tadeusz Bober

Aleksander Kabsch, Tadeusz Bober – Selected issues in the biomechanics of the knee joint. Fizjoterapia Polska 2001; 1(2); 179-182

Abstract
This article presents of the biomechanics of the knee joint in terms suitable for application in diagnostics and kinesitherapy. For practical reasons the thematic range of the discussion is limited; a separate monograph would be required to deal with the subject fully, especially the biomechanical conditions underlying pathologies of this joint. The basic aspects of the biomechanics of the knee joint presented in this article include its motion and mobility, the role of muscle force momentum, and the value of the force of reaction in the context of the construction and function of the joint. The scope of the subject matter presented here covers the issues that in the authors’ opinion are most essential for the physiotherapist in terms of the biomechanics of the knee joint.

Key words:
Knee Joint, Biomechanics

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The application of a low-frequency impulse magnetic field in patients recovering from arthroscopic ablation of the medial meniscus

Piotr Wróbel, Rafał Trąbka

Piotr Wróbel, Rafał Trąbka – The application of a low-frequency impulse magnetic field in patients recovering from arthroscopic ablation of the medial meniscus. Fizjoterapia Polska 2003; 3(1); 31-37

Abstract
Background. The goal of the present study was to test the influence of a low-frequency impulse magnetic field on recovery from surgery by patients who have undergone surgical ablation of the medial meniscus. Material and methods. Our research involved 20 persons undergoing rehabilitation in a private physiotherapeutic practice. The clinical material was randomly divided into two numerically equal groups. The kinesitherapy program was identical in both groups, but the experimental group received magnetotherapy, while the control group did not. The rehabilitation program lasted for two 6-day cycles with a 1-day interval between. The patients in both groups were tested for range of movement in the knee, the strength of the femoral quadriceps, and the circumference of the affected limb, measured at the joint and 20 cm above the patella, before, during, and after rehabilitation. Results. In the experimental group the patients recovered normal range of movement somewhat faster. These patients also showed greater increases in limb circumference above the joint and greater reduction of edema in the joint itself. No significant differences were found in respect to muscle strength. Some patients from the control group showed a recurrence of edema, which did not take place in the experimental group. Conclusions. In view of the faster improvement in range of motion and the significant reduction of edema in the operated limb, the use of low-frequency impulse magnetic fields can be recommended for the rehabilitation of patients recovering from arthroscopic ablation of the medial meniscus.

Key words:
magnetic field intensity, magnetic field frequency, Knee Joint, range of movement

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Injuries and diseases of the knee joint – diagnostic evaluation

Jerzy Widuchowski, Wojciech Widuchowski

Jerzy Widuchowski, Wojciech Widuchowski – Injuries and diseases of the knee joint – diagnostic evaluation. Fizjoterapia Polska 2004; 4(4); 297-306

Abstract

In traumatic injuries and diseases of the knee joint establishing a correct diagnosis is a very important part of therapeutic management. In many cases it is not easy. The reason for this is the possibility of simultaneous injury of many different anatomical joint structures, and as a result the occurrence of clinical symptoms that vary in intensity and often overlap. In diagnostic procedures, the most important task is to establish which of the anatomical structures has been damaged as a result of acute or chronic trauma, and how extensive the loss of joint function actually is. Making a correct diagnosis in acute traumatic injuries of the knee should be done as quickly as possible. The present study contains an outline of diagnostic evaluation in traumatic injuries and diseases of the knee joint. Each part of this outline is fully discussed.

Key words:
knee joint, diagnosis, injury
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Changes in knee joint thermograms following local cryotherapy combined with various physiotherapy regimens

Magdalena Wilk, Rafał Trąbka, Zbigniew Śliwiński

Magdalena Wilk, Rafał Trąbka, Zbigniew Śliwiński – Changes in knee joint thermograms following local cryotherapy combined with various physiotherapy regimens. Fizjoterapia Polska 2008; 8(3); 267-271

Abstract
Background. The aim of the study was to evaluate the effectiveness of cryotherapy and physiotherapy regimens in patients with indications for use of these procedures in the knee joint region or knee joints. Material and methods. The study was performed in the Cracow Rehabilitation Centre in 2008. The study involved a group of 38 patients who underwent cryotherapy of the knee joint region. The patients were dMded into two groups. Group 1 included patients who performed lower limb exercises immediately after the cryotherapy procedure, and patients in group 2 performed exercises 30 minutes following the cryotherapy procedure. Changes in thermograms were recorded in all patients. Results. Mean temperature in the affected knee joint before treatment was x=30.19°C in group 1 and 31.46°C in group 2. The differences between the study groups revealed in examination 2 were also not statistically significant. Examination 3 showed signi-ficant differences. The mean value of the temperature range was x=28.54C in Group 1 and 23.38°C in Group 2. The last exami-nation, performed 30 minutes after the completion of the cryogenic therapy procedure, showed a mean temperature of the treated knee joint of x=28.99°C in Group 1 and x=29.43C in Group 2. Conclusions. Tissue temperature in the knee joint region increased at a slower rate in patients who did not undergo kinesi-therapy immediately after cryotherapy of that region.
Key words:
knee joint, cryotherapy, thermovision, physiotherapy
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Analysis of selected factors affecting rest pain in knee joint osteoarthritis

Beata Olesiak, Agnieszka Przedborska

Beata Olesiak, Agnieszka Przedborska – Analysis of selected factors affecting rest pain in knee joint osteoarthritis. Fizjoterapia Polska 2021; 21(2); 206-214

Abstract
Introduction. Knee pain is a clinical sign of osteoarthritis and an ongoing inflammatory process in the joint. Aim of the thesis. The purpose of this study was to evaluate the effect of BMI and degradative changes in patellofemoral joint cartilage on the level of knee pain at rest. Material and methods. The study group consisted of 150 patients with patellofemoral joint cartilage lesions. The classification of cartilage degradation according to Outerdridge was done by ultrasound. The level of pain at rest was assessed according to the VAS scale. The data was collected with usage of a self-made study protocol. Results. There was no statistically significant correlation between BMI and VAS pain complaints (rho = 0.099, p = 0.228). There was also no statistically significant correlation between degradative changes in the cartilage of the patellofemoral joint and the level of pain on the VAS scale (rho = 0.076, p = 0.353). Conclusions. BMI does not affect the severity of knee joint pain at rest. The extent of cartilage wear in the patellofemoral joint does not correlate with knee pain during physical inactivity.
Key words:
rest pain, femoropatellar joint, gonarthrosis, knee joint, Body Masse Index (BMI)
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Evaluation of physiotherapy results after anterior cruciate ligament reconstruction using the Knee and Osteoarthrosis Outcome Score (KOOS) questionnaire

Sebastian Zduński, Witold Rongies, Marcin Ziółkowski, Tomasz Kozieł, Janusz Sierdziński

S. Zduński, W. Rongies, M. Ziółkowski, T. Kozieł, J. Sierdziński – Evaluation of physiotherapy results after anterior cruciate ligament reconstruction using the Knee and Osteoarthrosis Outcome Score (KOOS) questionnaire. FP 2017; 17(2); 60-70

Abstract

Introduction. In recent years, there has been an increase in the number of knee injuries with subsequent total anteriur ligament injury (ACL). ACL lesions in most cases require specialized surgical and physiotherapeutic treatment. The main goal of rehabilitation is to restore the full function of the knee joint and the entire lower limb. Interest in methods of assessing the outcome of ACL reconstruction procedures has increased recently. A number of questionnaires and scales were developed to assess the outcome of treatment. An example is the Knee and Osteoarthrosis Outcome Score (KOOS).
The aim of the study. Assessment of near and distant outcomes of post-arthroscopic anterior cruciate ligament reconstruction in the selected model of Knee and Osteoarthrosis Outcome Score (KOOS).
Material and methodology. Randomized study included 72 patients with a complete rupture of the ACL identified for operative reconstruction. The study group included 37 patients aged 18 to 60 years (mean 37 ±10.3 years). All subjects in this group were subjected to a physiotherapy for 4 weeks prior to reconstructive surgery. In total, 10 to 12 therapeutic sessions were conducted. The control group included 35 patients aged 18 to 60 years (mean 34 ±10.0 years) who did not perform the preoperative physiotherapy program. The postoperative physiotherapy program was the same in all subjects studied.
Results. There was a statistically significant improvement in the functional assessment of the knee joint after reconstruction of the ACL using the KOOS questionnaire in the Study and Control groups at subsequent measurement points (p < 0.05). Better results in the Study Group were found in almost all subgroups of KOOS (symptoms, stiffness, daily activities, activity, quality of life) 6 and 12 weeks after ACL reconstruction. However, there was no statistically significant difference between the Study and Controlled Group (p > 0.05). There was a statistically significant difference in the “stiffness” of the KOOS scale after 12 weeks (p < 0.05). There was also a statistically significant difference in the SP3 (skipping ability) of the KOOS scale after 12 weeks (p < 0.05).
Conclusions. 1. Obtained results in both examined groups, in terms of functional capabilities evaluated by the KOOS questionnaire after reconstruction, confirm the good quality of performed surgical procedures and physiotherapeutic activities.  2. A better KOOS score in the Study Group indicates the high therapeutic value of preoperative rehabilitation.

Key words:
anteriur cruciate ligament, knee joint, physiotherapy, KOOS questionnaire

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Analysis goniometric of selected classes of traffic knee

Jędrzej Płocki, Joanna Banaś,  Dominik Pikuła,
Andrzej Kotela, Ireneusz Kotela

J. Płocki, J. Banaś,  D. Pikuła, A. Kotela, I. Kotela – Analysis goniometric of selected classes of traffic knee. FP 2014; 14(2); 52-59

Abstract

Normal range of motion of joint is an important factor of physical fitness. It’s measurement makes up the basis of evaluation of the skeletal joint system. Analysing the changes in ranges of motion in the function of the time with the use of electrogoniometer provides valuable and meaningful data. The aim of the study was an attempt to determine the dynamics of change and the range of motion of the knee healthy population during going up the step of the dominant limb.
Material and Methods.
75 students of the Department of Medical University of Rzeszow, aged 18-26 were examined. The research was carried out with the use of Noraxon 1400 L system as well as compatible biaxial electrogoniometer. The preliminary process was performed in MS Excel. The statistical analysis was carried out in the Statistica 10.0 program.
Results.
Established normative value for the maximum angle of knee bends during going up the step – 85,12˚ with confidence interval 80,27-88,25˚.
Conclusions.
There is a need for research on a larger, representative sample in order to determine the standards for the maximum angle of knee flexion during the entry level in the studied age group.

Key words:
Electrogoniometer, normative value, knee joint

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The therapeutic effect of local cryotherapy operation on the knee, joint depending on the type of diagnosis of osteoarthritis

Łukasz Kopacz,  Anna Lubkowska, Iwona Bryczkowska,
Danuta Lietz-Kijak, Zbigniew Śliwiński

Ł. Kopacz,  A. Lubkowska, I. Bryczkowska, D. Lietz-Kijak, Z. Śliwiński – The therapeutic effect of local cryotherapy operation on the knee, joint depending on the type of diagnosis of osteoarthritis. FP 2015; 15(1); 6-14

Abstract

Introduction. The aim of the study was to evaluate the effect of local cryotherapy treatment for range of motion in the knee joint in patients with osteoarthritis. In addition, analyzed potential changes in symptoms of pain patients.
Material and method. The study group consisted of 50 of the patients. The study involved 39 women and 11 men. Patients were subjected to 10 daily treatments local cryotherapy on the area of the knee. Before treatment was collected interview regarding comorbidities and examined pain according to VAS. In all patients performed to measure of range of motion in the knee joint using a goniometer. It was made before and after treatment.
Results. Considering the range of flexion in the knee joint in both groups, both diagnosed with osteoarthritis of the knee and polyarticular osteoarthritis, after a series of local cryotherapy treatments became significant improvement, while the range of motion in the knee extension improved more in the group diagnosed with polyarticular osteoarthritis.
In assessing the two groups studied, both in the group with a diagnosis of osteoarthritis of the knee, as well as polyarticular osteoarthritis, and made a series of treatments local cryotherapy declared value level of pain on the VAS decreased. Considering the improvement by gender, it can be concluded that in women with a diagnosis of osteoarthritis of the knee improvement was much greater.
Conclusion. Local cryotherapy is a beneficial effect on the range of motion in the knee joint and reduction of pain in patients with gonarthrosis.

Key words:
cryotherapy, gonarthrosis, knee joint

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Characteristic of the anterolateral ligament of the knee and its correlation with trauma of the anterior cruciate ligament in athletes

Patrycja Szkutnik, Marcin Domżalski

P. Szkutnik, M. Domżalski: Characteristic of the anterolateral ligament of the knee and its correlation with trauma of the anterior cruciate ligament in athletes. FP 2015;15(4);74-81

Abstract

Traumas of the anterior cruciate ligament (ACL) are the most common injuries of a knee joint in athletes. We diagnose them by specific clinical tests – Lachman test, anterior drawer test, pivot-shift test and additional imaging studies. Form of the treatment is to reconstruct the ligament with a graft taken muscle. After treatment, there is still a problem with the rotational instability. Only 60% of the athletes returned to pre-injury form. This is due to anterolateral ligament (ALL) of knee. It is a ligament that occurs in approximately 95% of the population. It’s located on the anterolateral side of the knee joint which connects the femur with the tibia bone, it is responsible for rotational stability of the knee, especially when bent knee (30-90 deg) and it`s supports the function of the ACL. ALL trauma that may be asymptomatic, they can imply subsequently breaking of the ACL. However, when ACL is ruptured, almost always the ALL is damaged too. Ruptures and damages of ALL have a connection with Segond fractures. Undetected damage of ALL causes treatment failure of the anterior cruciate ligament injuries. It should be taken into consideration that with concomitant ACL and ALL injuries conservative treatment of damaged ALL is enough for treatment and rehabilitation success or if reconstruction of the ALL also necessary. The aim of the study is to highlight the widespread problem of knee injuries in athletes and how they should be treated so it will lead to full recovery of the competitor and his/her faster return to the game.

Key words:
knee joint, anterolateral ligament of the knee, anterior cruciate ligament, characteristic, trauma

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