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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The assessment of gait deviations in patients with knee arthritis using the ground reaction forces analysis

Grzegorz Konieczny, Katarzyna Leżoń, Zdzisława Wrzosek, Michał Sokołowski

Grzegorz Konieczny, Katarzyna Leżoń, Zdzisława Wrzosek, Michał Sokołowski – The assessment of gait deviations in patients with knee arthritis using the ground reaction forces analysis. Fizjoterapia Polska 2006; 6(4); 317-321

Abstract
Background. The purpose of this study is to analyze the objective gait parameters for the subjects with knee arthritis using ground reaction forces analysis. Material and methods. The gait analysis was performed on 31 subjects with unilateral knee arthritis with use of Pressure Distribution Measurement System (PDM-S) force-plate. The first peak force, the second peak force, the loading rate, the push-off rate, the stance time, and the distribution of pressure across the foot were analyzed. The VAS score was also obtained. Results. The obtained results were compared with outcomes of gait analysis of healthy population presented by J. L. McCrory. The first and the second peak force were lower for the limb with arthritic knee. The stance time for the limb with arthritic knee was lower. The pressure measured at the heel, and rate of loading were also lower for the limb with arthritic knee. Conclusion. The osteoarthritis of knee leads to substantial alterations in gait. Gait deviations contribute mainly to pain associated with osteoarthritis of knee joint. The gait analysis with use of ground reaction force-plates is valuable method in functional assessment of knee arthritis.

Key words:
gait analysis, arthritis, knee

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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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The efficacy of ultrasound and electrophonophoresis as adjuncts to the treatment of degenerative knee joint disease

Marta Szlachta, Anna Polak, Beata Błaszczyk, Agnieszka Kluszczyńska-Galas, Janusz Kubacki, Piotr Król

Marta Szlachta, Anna Polak, Beata Błaszczyk, Agnieszka Kluszczyńska-Galas, Janusz Kubacki, Piotr Król – The efficacy of ultrasound and electrophonophoresis as adjuncts to the treatment of degenerative knee joint disease. Fizjoterapia Polska 2009; 9(3); 211-222

Abstract
Background. The study aimed to evaluate the efficacy of ultrasound and Ketonal (ketoprofen) electrophonophoresis as adjuncts to the treatment of degenerative knee joint disease. Materiał and methods. Forty-six persons randomly assigned to two groups were investigated. Group A consisted of 23 per-sons aged 53-72 years. Group B comprised 23 patients whose age ranged from 54 to 60 years. The knee joint rangę of motion and muscle strength were assessed in all patients immediately before treatment and on completion ofa course of physical thera-py Group A was treated with ultrasound (1 MHz; 0.5-1.0 W/cm2; 20%; 1-3 min/cm2), while Group B was subjected to electropho-nophoretic treatment (0.1 mA/cm2; 1 MHz; 0.5-1.0 W/cm2; 20%; 1-3 min/cm2; 2% Ketonal). A total of 10 procedures were admini-stered to each patient over two weeks. Results. The knee-joint rangę of motion and strength ofthe knee flexors and extensors improved significantly in both groups after treatment in comparison to baseline values. There was no statistically significant inerease in the muscle strength ofthe knee rotators. An inter-group comparison of treatment effects showed that the ranges of the passive and active flexion, passive and active extension and strength of the flexor and extensor muscles of the knee joint had inereased morę significantly in group B than in group A. Conclusions. The treatment applied in both comparative groups was effective. Electrophonophoresis led to slightly better treatment outeomes than ultrasound.
Key words:
degenerative disease, ultrasound, electrophonophoresis, knee joint
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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 pre and post operative physiotherapy using the Lysholm scale on functional Outcomes in Patients undergoing Anterior Cruciate Ligament Reconstruction

Sebastian Zduński, Witold Rongies

S. Zduński, W. Rongies – Evaluation of pre and post operative physiotherapy using the Lysholm scale on functional Outcomes in Patients undergoing Anterior Cruciate Ligament Reconstruction. Fizjoterapia Polska 2020; 20(1); 130-143

Abstract
Background. Most anterior cruciate ligament (ACL) injuries require surgery and physiotherapy. One important factor that determines physiotherapeutic success is achieving optimal function already before an ACL reconstruction surgery.
Material and methods. A total of 72 randomly enrolled patients, who had been diagnosed with a complete ACL tear and qualified for surgical reconstruction, were included in this study. The experimental group comprised 37 patients aged from 18 to 60 years (mean age 37 ± 10.3 years). All patients from this group underwent a physiotherapy regimen based on established rehabilitation practices over a period of 4 weeks preceding the surgery. The control group comprised 35 patients aged from 18 to 60 years (mean age 34 ± 10.0 years) who did not undergo any preoperative physiotherapy regimen.
Results. At the second time point, both the experimental and control groups exhibited significant improvement in Lysholm scores in comparison with baseline scores (p < 0.05). The Lysholm-Gillquist score in the experimental group was better in the experimental group. There was a significant difference in Lysholm functional knee scores in experimental and control subjects at postsurgical week 6 and 12 (p < 0.05).
Conclusions. 1. Physiotherapy in patients with a complete ACL tear is an important and beneficial factor improving knee function prior to ACL reconstruction.
2. Functional knee scores (assessed with the Lysholm scale) obtained in both groups after the reconstruction surgery confirmed the effectiveness of surgical procedures and physiotherapeutic protocols.

Key words:
knee joint, anterior cruciate ligament, Lysholm-Gillquist scale

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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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