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Schmitt, Laura Clare. "Knee stabilization and medial knee osteoarthritis." Access to citation, abstract and download form provided by ProQuest Information and Learning Company; downloadable PDF file 0.80 Mb., 201 p, 2006. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqdiss&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:3220738.
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Soni, Anushka. "Pain characterisation in knee osteoarthritis." Thesis, University of Oxford, 2015. https://ora.ox.ac.uk/objects/uuid:4026d694-8e7b-47f5-9f05-9f5a7b2165a0.
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Osteoarthritis (OA) is the most common form of arthritis in the world, and it has been estimated that about one tenth of the world's population, aged over 60, have symptoms that can be attributed to OA. Despite the size of the global impact of OA, there is a significant unmet need for effective treatments. Knee replacement surgery is commonly used in patients with moderate to severe knee OA, in order to reduce pain. However, 10-34% of patients report an unfavourable long-term outcome with persistent pain after surgery. The neural mechanisms for the generation of pain in knee OA are not fully understood. Previous work has shown that around 20% of patients have features of neuropathic pain, and that the underlying mechanism for this may be through central sensitisation. This mechanism-based understanding of pain is important in order to aid targeted intervention, and it may be that this patient group is more likely to have an adverse outcome following surgery. This thesis uses a combination of methods to investigate the neural mechanisms underlying pain experienced by patients with knee OA, across the full spectrum of disease severity. Quantitative sensory testing (QST) was initially used in a community-based cohort to show that pain sensitisation can be detected in early disease, and also contributes to the observed discordance between radiographic structural and symptomatic disease. The clinical relevance of neuropathic pain was then investigated in patients with knee OA, who were awaiting knee replacement surgery. Prior to surgery patients with neuropathic pain had increased sensitivity to experimental pain, as well as higher symptom severity and psychological distress. Functional magnetic resonance imaging (fMRI) was then used to confirm that these features were also associated with central sensitisation in the form of increased descending facilitation as well as reduced descending inhibition prior to surgery. The presence of neuropathic pain prior to surgery was associated with statistically and clinically significantly worse outcome following surgery, compared to those with purely nociceptive pain in the absence of any significant structural differences between the two groups. Taken together, this mechanism-based understanding of the pain provides an opportunity for targeted therapy prior to surgery, which may enhance outcome following surgery.
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Metcalfe, Andrew John. "Knee osteoarthritis is a bilateral disease." Thesis, Cardiff University, 2014. http://orca.cf.ac.uk/67638/.
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Knee osteoarthritis (OA) is a common cause of pain and disability. Patients often complain that they overload the other limb when they walk, resulting in disease in the unaffected knee. However, it is unknown whether this happens or the mechanism by which it occurs. Data was analysed from an established longitudinal cohort study to examine the development of bilateral knee OA. One hundred and forty-three subjects were examined over a 12 year period with bilateral radiographs. Bilateral knee osteoarthritis was found to be very common over time, and the majority of individuals with unilateral knee OA eventually developed bilateral disease. A gait analysis study was performed on 20 subjects with unilateral knee OA awaiting arthroplasty surgery and 20 healthy age equivalent controls. Abnormal moments and muscle co-contractions were observed in the other knee and hips when they walked due a characteristic slow, cautious, stiff-legged gait pattern. Fifteen subjects re-attended 12 months following their surgery. Whilst moments returned to normal in most of the replaced knees, they remained elevated at the contra-lateral side and co-contraction failed to recover in either knee. A novel study design is presented to examine the effect of gait-derived loading waveforms on fresh human osteochondral plugs. By applying mechano-biology techniques and Finite Element Modelling to fresh human tissue, new observations vi can be made about the relationship between in-vivo loading and cartilage mechano-biology. A characteristic gait pattern was observed in knee OA which is not simply antalgic but tends towards symmetry, with an increase in joint loading bilaterally. The observed gait behaviour does not resolve, despite arthroplasty of the affected joint. This would be expected to contribute to the development of disease in an inherently vulnerable joint. Additional training may have a role to play in restoring normal biomechanics and protecting the other knee from disease.
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Smith, Stephanie L. "Neuromuscular control in knee osteoarthritis (NEKO)." Thesis, Glasgow Caledonian University, 2016. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.726764.
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Woods, Robert Jeffrey. "Biomechanics and osteoarthritis of the knee." Connect to resource, 1995. http://rave.ohiolink.edu/etdc/view.cgi?acc%5Fnum=osu1262616270.
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Krishnasamy, Priathashini. "The Role of Skeletal Muscle in the Incidence and Progression of Knee Osteoarthritis." Thesis, The University of Sydney, 2019. http://hdl.handle.net/2123/20699.
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Skeletal muscle quality may play a role in skeletal muscle health affecting its response to muscle strengthening exercises and susceptibility to osteoarthritis (OA). Chapter One of this thesis provides an introduction to the role of skeletal muscle in the incidence, progression and exercise management of knee OA. Chapter Two examines skeletal muscle quality (muscle attenuation and lean muscle volume), knee extensor strength and percentage whole-body fat as mediators in the symptomatic and functional improvements achieved in a diet and exercise (D+E) compared to D (diet) or E (exercise) interventions. Null mediation results were found for skeletal muscle quality and knee extensor strength. However, a reduction in the percentage of whole- body fat significantly partially mediated pain, function, 6-minute walk test and gait speed improvements achieved in the D+E compared to E groups. Chapter Three presents the relationship between a change in lower extremity lean mass (LM) and fat mass (FM) with radiographic knee OA (RKOA) incidence in women longitudinally and concurrently. A 2-year change in LM or FM measures did not predict subsequent RKOA incidence. A 5-year increase of LM percentage was associated with a 10% reduced odds of RKOA incidence (OR 0.90, 95% CI 0.82-0.98, P=0.016]. A 0.25 unit increase in LM:FM ratio over 5 years was associated with a 31% reduced odds of RKOA incidence [OR 0.69, 95% CI 0.49-0.97, P=0.032]. Thigh muscle quality and knee extensor strength did not mediate symptomatic and functional improvements, however, a reduction in percentage whole-body fat partially mediated symptomatic and functional improvements achieved in a D+E compared to E groups. Lower extremity LM and FM changes were significantly associated with RKOA incidence concurrently, but did not precede RKOA incidence longitudinally. Further understanding of skeletal muscle properties would enable a higher treatment effect size to be achieved from rehabilitation programmes in knee OA.
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McAlindon, Timothy Edward. "Knee joint failure." Thesis, University of Southampton, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.386627.
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Petterson, Stephanie Christine. "Knee osteoarthritis and total knee arthroplasty quadriceps weakness, rehabilitation, and recovery /." Access to citation, abstract and download form provided by ProQuest Information and Learning Company; downloadable PDF file 1.02 Mb., 222 p, 2006. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqdiss&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:3205435.
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Crenshaw, Jeremy. "Knee-joint loading variability during gait in subjects with knee osteoarthritis." Access to citation, abstract and download form provided by ProQuest Information and Learning Company; downloadable PDF file, 42 p, 2007. http://proquest.umi.com/pqdweb?did=1338917851&sid=5&Fmt=2&clientId=8331&RQT=309&VName=PQD.
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Parekh, Sanjay M. "The risk of knee pain and knee osteoarthritis in professional footballers." Thesis, University of Nottingham, 2017. http://eprints.nottingham.ac.uk/43010/.
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Introduction: Knee osteoarthritis (KOA) is a common complex disorder. Although previously believed to be degenerative, KOA is in fact a regenerative condition, compensating against insults sustained at the joint. However, a failure of this compensatory repair process, especially in the presence of constitutional and local joint factors, increases the risk of KOA and inevitably leads to joint-failure (Dieppe and Lohmander, 2005, Arden and Nevitt, 2006, Sandell, 2012). Diagnosis of KOA may be made via clinical presentation, imaging, or using clinical algorithms, which may be a combination both in addition to biochemical diagnostic tests (Brandt et al., 2003). Knee pain (KP) is the most common symptom, and in the general population its prevalence is 25% (Peat et al., 2001a). Patients may also experience early morning stiffness of the joint and reduced function. Physician-observed signs include crepitus, restricted movement, and bony and soft tissue swellings (Abhishek and Doherty, 2013). Although considered the gold standard to diagnose KOA, plain film radiography is not without its limitations (Wick et al., 2012). Clinicians, however, favour radiography because it can easily discern two key features of the condition: joint space narrowing (JSN), a surrogate of cartilage loss, and the formation of osteophytes on the joint margin (Roemer et al., 2014). Assessment of radiographs is most commonly undertaken using Kellgren-Lawrence (KL) grade verbal descriptors (Altman et al., 1986a). The prevalence of radiographic KOA (RKOA) may be higher than KP, but there is a discordance between people reporting symptoms and those with structural change (RKOA) (Peat et al., 2001a, Bedson and Croft, 2008). A plethora of constitutional risk factors and joint-specific biomechanical factors increase the risk of KOA, including joint injury and occupation (Suri et al., 2012, Silverwood et al., 2015). One such occupation, which has a greater risk of injury are professional footballers (Drawer and Fuller, 2002) and knee injuries account for 17% of all footballing injuries (Ekstrand et al., 2011). Football is one of the most common team sports worldwide, with over 265 million people worldwide play the game (FIFA, 2007a), and of these, 110,000 are male professional footballers (FIFA, 2007b). Although perceived that that footballers are at great risk of long-term consequences such as KOA, due to their high risk of injury, the current evidence supporting this is limited (Kuijt et al., 2012, Tran et al., 2016). The previous studies observing KOA in footballers are difficult to generalise to the wider football population. This is for a number of reasons, including recruitment of inadequate sample, absence of inappropriate control groups, and differing case definitions, all resulting in a large variation in prevalence of KOA. Thus, there exists a need for a comprehensive study to determine the true prevalence and risk of KOA in retired professional footballers compared to the general population. Aims: (1) To determine the prevalence and risk of KOA (measured as KP, RKOA and requirement for total knee replacement (TKR)) in retired professional footballers compared to the general population; (2) To determine the specific factors (constitutional, biomechanical and football-specific) that are associated with an increased risk of each of these outcomes (KP, RKOA and TKR) within footballers. Methods: The Nottingham University Hospitals NHS Trust and the Nottingham Research Ethics Committee (Refs 14/EM/0045; 14/EM/0015) approved this study, which was registered on the clinicaltrials.gov portal (NCT02098044; NCT02098070). This study design involved carrying out two cross-sectional studies. The Football Study involved distributing 4775 postal questionnaire surveys to retired professional footballers via multiple sources, including football clubs, their former players’ associations and the Professional Footballers Association (PFA). The Knee Pain and Related Health in the Community Study (KPIC) involved distributing 40,500 postal questionnaires, via 12 general practice surgeries, to both men and women in the East Midlands general population. However, only men formed the control group for this study. The inclusion criteria for both the footballers and control participants was the same: men aged 40 and older. The questionnaires, developed based on previously literature, were similar to capture detailed information about KP, undergoing a TKR and putative risk factors for KOA, including knee injuries, surgery and alignment. The questionnaires also gathered information regarding demographics, medical and occupational history, general health and current medication. Following this, footballers and controls who consented had radiographic assessments of both their knees, including weight-bearing semi-flexed posterior-anterior (PA) view using the Rosen template (Rosenberg et al., 1988) and a seated 30° flexion skyline view. A single observer (GSF) scored all the radiographs as a single mixed batch using HIPAX Dicom software. In addition to the KL grades, the Nottingham Line Drawing Atlas (NLDA) was used (Nagaosa et al., 2000) (Wilkinson et al., 2005), which scored composite joint space narrowing (JSN), composite osteophyte, and a combined global score for each knee. Primary outcomes observed were current KP, RKOA (measured using the NLDA) and TKR. Secondary outcomes observed were ever having KP (chronic), physician-diagnosed KOA, RKOA (measured using KL grades) and radiographic CC. Power calculations determined the sample size for the questionnaire survey and the radiographic survey. Categorical variables presented as frequency and percent and compared using a chi-squared test. Continuous variables presented as mean and standard deviation and compared using a t-test. The risk of KOA (measured for each outcome independently) in footballers compared to the controls was determined using a generalised linear model (GLM) with a Poisson distribution, and adjusted for known risk factors (including age, body mass index (BMI) and previous knee injury). The specific risk factors within footballers associated with outcomes of KOA (namely KP, RKOA and TKR) were determined using multivariate logistic regression. Results: 1207 footballers (response rate of 25.3%) and 4085 control men responded to the Football and KPIC studies respectively, which was far lower than studies previously conducted in both populations. Following this, 470 footballers and 500 men consented to undergoing radiographic assessment of their knees. For participants who returned the questionnaire (footballers and controls), characteristics were compared between those who underwent a knee radiograph and those who did not. Age and sustaining a knee injury were the main factors significantly difference in both. Footballers were significantly older (3.9 years) than the controls, but were gender-matched (males-only) and had a similar BMI. Footballers had a significantly greater number of injuries (64.5% v. 23.3%) compared to the controls. They also had significantly more body pain (74.7% v. 69.8%) and therefore took more pain-relief medication (61.9% v. 28.5%). However, footballers suffered from far fewer comorbidities compared to the controls (29.4% v. 45.7%). Footballers had a far greater prevalence of both primary and secondary outcomes. The prevalence of KP was almost twice as great in footballers (52.2%) compared to the controls (26.9%) and this increased prevalence was regardless of age. The peak prevalence of KP also occurred at least ten years earlier in footballers compared to the controls. Although the prevalence of physician-diagnosed KOA was much lower than the prevalence of KP in footballers (28.3%), it was more than double that of the controls (12.2%). Additionally, footballers (11.1%) had almost three times greater prevalence of TKR compared to the controls. Risk factors significantly associated with footballers who had undergone a TKR, included age [OR 1.09, 95% CI 1.07-1.11], being obese [OR 1.77, 95% CI 1.00-3.12] and having gout [OR 3.11, 95% CI 1.96-4.70]. Sustaining a significant knee injury [OR 3.11, 95% CI 1.94-4.99] and receiving an intra-articular knee injection [OR 2.56, 95% CI 1.76-3.73] were also significant risk factors for footballers who underwent a TKR. However, those footballers with a longer duration of playing the game [OR 0.95, 95% CI 0.92-0.98] had a reduced risk of TKR.<br>Conclusion: These findings show footballers have a greater risk of KOA compared to the general population, reporting up to three times higher prevalence of various outcomes (KP, RKOA, physician-diagnosed KOA and TKR). The age-prevalence of all outcomes of KOA, are greater in footballers compared to the controls. The high prevalence of injuries significantly account the risk of KOA in footballers compared to the controls (even following adjustment of other risk factors). Within footballers, knee injuries, together with subsequent investigations (specifically exploratory and interventional arthroscopy) and management (specifically intra-articular knee injections), were strongly associated with risk of KOA (KP, RKOA and TKR independently). Football’s governing bodies need to set out and implement strategies to reduce or even prevent the risk of serious injury (thus reducing the risk of subsequent investigation). This will reduce the risk of long-term consequences, such as KOA. However, whether the Industrial Injuries Advisory Council considers the risk of KOA in footballers an industrial compensable disease remains a question.
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Macri, Erin Michelle. "Patellofemoral osteoarthritis : characterizing knee alignment and morphology." Thesis, University of British Columbia, 2017. http://hdl.handle.net/2429/63225.
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The full abstract for this thesis is available in the body of the thesis, and will be available when the embargo expires.<br>Medicine, Faculty of<br>Experimental Medicine, Division of<br>Medicine, Department of<br>Graduate
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Juntunen, M. (Mikael). "Diagnostic and quantitative imaging of knee osteoarthritis." Bachelor's thesis, University of Oulu, 2016. http://urn.fi/URN:NBN:fi:oulu-201606302589.
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Articular cartilage is a connective tissue, that provides virtually frictionless articulation between bones in a joint. Degenerative joint disease, osteoarthritis (OA), is the most common type of arthritis. During its development, cartilage is progressively lost, decreasing the functional capacity of the joint. Currently it is diagnosed with radiography, which might not show changes in cartilage tissue during the early stages of OA. In radiography, cartilage degeneration might be visible only when OA has progressed to advanced stage. The lack of effective treatment methods for advanced stage of OA has generated interest towards the development of biomarkers for the detection of early OA. Magnetic resonance imaging (MRI), especially relaxation time mapping, is able to provide accurate information on early changes in cartilage structure and is considered to be one of the best candidates for the detection of early OA. Morphological assessment of three-dimensional MRI, on the other hand, can be used as an indicator of the rate of cartilage loss. In this work, OA is reviewed and the current methods for diagnosing OA are studied. Relaxation time mapping and morphological assessment of articular cartilage are current research interests and these methods will also be discussed.
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Soul, Jamie. "A systems biology approach to knee osteoarthritis." Thesis, University of Manchester, 2017. https://www.research.manchester.ac.uk/portal/en/theses/a-systems-biology-approach-to-knee-osteoarthritis(0b229b46-7be4-4fdb-9a14-062c3dcfcf05).html.
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A hallmark of the joint disease osteoarthritis (OA) is the degradation of the articular cartilage in the affected joint, debilitating pain and decreased mobility. At present there are no disease modifying drugs for treatment of osteoarthritis. This represents a significant, unmet medical need as there is a large and increasing prevalence of OA. Using a systems biology approach, we aimed to better understand the pathogenic mechanisms of OA and ultimately aid development of therapeutics. This thesis focuses on the analysis of gene expression data from human OA cartilage obtained at total knee replacement (TKR). This transcriptomics approach gives a genome-wide overview of changes, but can be challenging to interpret. Network-based algorithms provide a framework for the fusion of knowledge so allowing effective interpretation. The PhenomeExpress algorithm was developed as part of this thesis to aid the interpretation of gene expression data. PhenomeExpress uses known disease gene associations to identify relevant dysregulated pathways in the data. PhenomeExpress was further developed into an 'app' for Cytoscape, the widely used network analysis and visualisation platform. To investigate the processes that occur during the degradation of cartilage we examined the gene expression of damaged and intact OA cartilage using RNA-Seq and identified key altered pathways with PhenomeExpress. A regulatory network driven by four transcription factors accounts for a significant proportion of the observed differential expression of damage-associated genes in the PhenomeExpress identified pathways. We further explored the role of the cytokines IL-1 and TNF that have been reported to β drive the progression of OA. Comparison of the expression response of in vitro cytokine-treated explants with the in vivo damage response revealed major differences, providing little evidence for any significant role of IL-1 and TNF as drivers of OA β damage in vivo. Finally, we examined the heterogeneity of OA through analysis of cartilage expression profiles at TKR. Through a network-based clustering method, we found two subgroups of patients on the basis of their gene expression profiles. These subgroups were found to have distinct OA expression perturbations and we identified TGF and S100A8/9 β signalling as potentially explaining the observed differential expression. We developeda RT-qPCR based classifier that allowed classification of new samples into these subgroups so allowing future assessment of the clinical significance of these subgroups. The work presented in this thesis includes a novel, widely-accessible tool for the analysis of disease gene expression data, which we used to give new insights into the pathogenesis of osteoarthritis. We have produced a rich dataset for future research and our analysis of this data has increased our understanding of cartilage damage processes and the heterogeneity of OA.
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Roos, Harald. "Exercise, knee injury and osteoarthrosis." Lund : Dept. of Orthopedics, University Hospital, 1994. http://books.google.com/books?id=c25sAAAAMAAJ.
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Brismar, Harald. "Morphological and molecular changes in developing guinea pig osteoarthritis /." Stockholm, 2003. http://diss.kib.ki.se/2003/91-7349-456-9/.
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Petersson, Ingemar F. "Developing knee joint osteoarthritis clinical, radiographical and biochemical features /." Lund : Dept. of Rheumatology, Lund University Hospital, 1997. http://catalog.hathitrust.org/api/volumes/oclc/39783203.html.
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Stevermer, Catherine Ann. "Functional movement assessment for individuals with knee osteoarthritis." [Ames, Iowa : Iowa State University], 2010. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3403838.
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Woolhead, Gillian Mary. "Patients' experience of osteoarthritis and total knee replacement." Thesis, University of Bristol, 2002. http://hdl.handle.net/1983/5fb81a12-786d-48ed-9cbe-9c2246d5ff5f.
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Wei, Wenbo. "Knee Osteoarthritis: gagCEST MR Imaging of Articular Cartilage." The Ohio State University, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=osu1365247669.
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Cammarata, F. P. "CLINICAL, GENETICAL AND BIOMOLECULAR FINDING IN KNEE OSTEOARTHRITIS." Doctoral thesis, Università degli Studi di Milano, 2015. http://hdl.handle.net/2434/336587.
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Osteoarthritis (OA) is a multifactorial, inflammatory and disabling degenerative joints disorder characterized by degeneration of articular cartilage, intra-articular inflammation with synovitis, and changes in peri-articular and subchondral bone. OA involves the synovial tissues and articular cartilage, resulting in symptoms that cause a decrease in the quality of life and disability. The non-modifiable risk factors include gender and age whereas the modifiable risk factors include body mass index (BMI), injury/trauma, among others.
Genetic studies have opened new opportunities in the definition and classification of OA etiopathogenesis describing a multifactorial disease that originates from both genetic and environmental factors. The main genes whose mutations are associated with the onset of OA encode proteins involved in some biological processes: bone morphogenesis, thyroid metabolism, apoptosis and mitochondrial damage, inflammation and the immune response and the Wnt signal cascade.
To date, OA is incurable and most treatments, which include physiotherapy, life-style modifications, pharmacotherapy and surgery, aim to provide symptomatic relief rather than targeting the disease processes themselves.
This work represents a multidisciplinary and translational medicine approach to study OA where clinical, radiographic, genetic and biochemical evaluation could contribute to better define the disease grading and progression for the development of new therapies.
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Al-Sobayel, Hana I. "Construction and validation of the Saudi Knee Function Scale, a knee osteoarthritis index." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp04/mq22264.pdf.
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Goulston, Lyndsey. "The epidemiology and interaction of knee alignment and body mass on knee osteoarthritis." Thesis, University of Southampton, 2015. https://eprints.soton.ac.uk/397326/.
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The growing prevalence of knee osteoarthritis (KOA) is fuelled by the rising obesity epidemic and an ageing population. The lack of a KOA cure drives the need to identify prevention strategies with alternative treatments to surgery a priority. This requires careful investigation of risk factors and their interaction. Knee mal-alignment and excess body mass are KOA risk factors but their combined effect is less understood. These five studies examine knee alignment and body mass as separate risk factors, describing their natural history and their association with prevalence and incidence of symptomatic radiographic knee osteoarthritis (SRKOA), radiographic knee osteoarthritis (RKOA) and knee pain outcomes in a long-standing female cohort. The cross-sectional interaction of these risk factors and outcomes is examined. One-point (1P) versus two-point (2P) anatomic axis (AA) knee alignment measurements, and body mass index (BMI) versus waist circumference (WC) measurements are also compared. Differences between 1P and 2P measurements indicate method specific alignment categories are required. Improvements are identified in AA angle measurement that require further validation to establish a gold standard AA alignment method. Changes in AA alignment over 10 years were small, but limited by identification of rotated knees. Over 19 years the tripling amount of obese women, was associated with increased prevalence and incidence of SKROA, RKOA and knee pain. WC measurement offers no advantage over BMI in predicting SRKOA, but it could be substituted where height or weight measurement is difficult. Results suggest a cross-sectional interaction between BMI and alignment with SRKOA and RKOA but not with knee pain, indicating that it may be driven by structure. This is important for targeting timely treatment of these risk factors. This new knowledge should assist in identification of individuals who would benefit from early intervention and treatment, to reduce pain, suffering and high future costs of KOA.
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Khoja, Latif. "Hip and knee frontal plane biomechanics in people with medial compartment knee osteoarthritis." Thesis, Kingston, Ont. : [s.n.], 2008. http://hdl.handle.net/1974/1054.
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Riordan, Edward A. "Imaging markers for osteoarthritis progression." Thesis, The University of Sydney, 2018. http://hdl.handle.net/2123/20347.
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Joint damage in osteoarthritis (OA) involves characteristic changes in multiple joint tissue types, with alterations in the shape of subchondral bone and composition of synovial fluid occurring concomitantly with cartilage damage. Systemic risk factors such as obesity and local biomechanical processes that determine joint loading have long been shown to predispose to the disease, and more recent evidence suggests that specific genetic loci and inflammatory processes may make contributions, but the exact mechanisms driving the initiation and progression of the disease are yet to be elucidated. Advances in imaging that allow visualisation of minute changes in structures such as cartilage composition and subchondral bone shape have enabled longitudinal tracking of early disease development. It is hoped that the identification of early imaging biomarkers for later disease will not only assist in clarifying disease pathogenesis, but facilitate the development of disease-modifying interventions by shortening the lead time for assessing their effectiveness. This thesis aimed to clarify the current information on the utility of imaging biomarkers in research into the pathogenesis and treatment of osteoarthritis, and investigate potential imaging markers in the two regions that contribute the most to the disease burden of osteoarthritis; the knee and the hand. It utilises data from three clinical studies; a cross-sectional survey on quality of life indices in patients with arthritis, and the ongoing KANON (Knee Anterior Cruciate Ligament Non-operative vs. Operative Treatment) and COMBO (Combined Conservative Therapies on Clinical Outcomes in Thumb Base Osteoarthritis) trials. The chapters are presented in mixed manuscript form and journal format owing to differing stages of publication, and are designed to be read independently. Chapter one presents an introduction to the current understanding of the pathogenesis of OA and the role of imaging in clinical research. Chapter two presents published data from a cross-sectional survey that included 1039 participants via an online platform and utilised the validated ICOAP (Measure of Intermittent and Constant Osteoarthritis Pain) and EQ5D scores. The data identified the knees and hands as the regions in which pain was the most common, and in which arthropathy was the most detrimental to activities of daily living. This regional distribution differed slightly from studies in which participants were drawn from clinician referral, rather than from a convenience sample, raising points on the potential advantages of online platforms, and framing the subsequent focus on research into imaging biomarkers for OA of the knees and hands. Chapter three provides a further introduction to magnetic resonance imaging (MRI) to provide a background for the subsequent two chapters, and consists of a published book chapter that focuses on MRI as an imaging modality that enables direct visualisation of changes in both structure and composition in different joint tissues through the modification of contrast and sequences. In chapter four, post-traumatic osteoarthritis is discussed in two published manuscripts in terms of its value in investigating disease pathogenesis through imaging. Traumatic joint injury, and anterior cruciate ligament (ACL) rupture in particular, is strongly linked to the subsequent development of osteoarthritis, so provides an opportunity to track pathological changes from a defined starting point, and therefore potentially identify early imaging markers for subsequent disease. Chapter five presents data from serial MRIs in the KANON trial, which included 121 individuals who had sustained an acute anterior cruciate ligament (ACL) rupture to a previously uninjured knee. In the trial, 62 participants were randomised to undergo early ACL reconstruction and structured rehabilitation, and 59 were allocated to undergo structured rehabilitation alone, with an optional delayed ACL reconstruction. MRIs of the knee were obtained for all participants at baseline, two years, and five years, and for a subgroup of 63 participants, additional MRIs were performed at 3, 6, and 12 months. The serial MR imaging has enabled the effects of concomitant injuries such as osteochondral fractures and meniscal tears to be tracked, as well as providing longitudinal measurements of changes in cartilage and subchondral bone that can then be correlated with clinical outcomes. Data on the regional changes in the area of bone covered by cartilage (cAB) as a potential biomarker for disease, and the effects of baseline injuries to other joint structures, are presented. In chapter six, data on radiographic markers in trapeziometacarpal (base of thumb) osteoarthritis are presented from the COMBO trial. It includes two manuscripts – one published and one in the process of review – that present data from the first 100 participants included in the COMBO trial. Radiographic markers have traditionally had a poor correlation with symptomatic and functional outcomes, so generalised estimating equations are used for bilateral data to minimize the influence of interpersonal confounding factors and account for the fact that within-person measurements are not independent. The radial subluxation ratio is investigated in the manuscripts as a marker for structural and functional osteoarthritis progression, and radiographic markers of disease severity are analysed in relation to pain and functional outcomes in symptomatic disease. In summary, magnetic resonance imaging and radiographic markers are investigated in relation to their utility as indicators of osteoarthritis progression, and in acting as outcomes for the assessment of potential interventions in clinical trials.
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Duong, Vicky. "Adherence to core treatments in osteoarthritis." Thesis, The University of Sydney, 2022. https://hdl.handle.net/2123/29618.
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Osteoarthritis (OA) is a prevalent and disabling joint condition. Despite numerous treatments for OA, the clinical benefits of core treatments such as exercise remain modest. Adherence (the extent to which treatments have been completed as prescribed) is an important factor influencing outcomes in OA. However, understanding of adherence remains poor.
This thesis aims to investigate adherence to core treatments for OA. Chapter One provides a background of OA and presents a narrative review of adherence. Chapter Two presents a systematic review of adherence measures of core treatments in knee OA. Chapter Three investigates the relationship between adherence, pain, and function in thumb base OA participants. Those with higher baseline pain were more likely to be adherent to a home management program. Chapter Four investigates predictors of adherence to a step count intervention following total knee replacement (TKR). Younger age, higher patient activation, and higher technology self-efficacy were associated with higher adherence. Chapter Five investigates the correlation between self-reported and objective adherence measurements of step count following TKR. One-third of participants underestimated their step count adherence when comparing self-reported to objective measures. Chapter Six examined the presence of different trajectories of step count adherence following TKR using latent class analyses. Three distinct trajectories were identified. Baseline BMI and pain levels differed between groups.
Taken together, the findings of this thesis provide greater insight into adherence in OA. The results of this work may be used to 1) make recommendations for reporting adherence in clinical practice and research; 2) identify those at risk of low adherence; 3) support the use of objective measures of adherence, and the need for valid and reliable tools of adherence measurement; 4) better understand how adherence varies between individuals and how to best support them.
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Palmer, Jonathan. "The role of surgery in early osteoarthritis of the knee." Thesis, University of Oxford, 2017. https://ora.ox.ac.uk/objects/uuid:9a7413a4-f5ca-4378-a3c7-b6eca59373bb.
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Early knee osteoarthritis (EKOA) is common, hard to treat and can be debilitating for symptomatic individuals. Whilst end-stage osteoarthritis is treated reliably with knee replacement surgery, such surgery is not routinely offered to those with less severe OA as it is associated with a poorer outcome. These patients are said to be in a 'treatment gap' and they are the primary focus of this thesis. A series of large epidemiological studies were designed to clarify the natural history of symptomatic EKOA. A prospective cohort study including 1,634 symptomatic knees with EKOA found that malalignment was the most potent risk factor for structural progression. A subsequent study, which included a detailed assessment of lower limb alignment, established that this structural progression was driven by the alignment of the proximal tibia. Using semi-quantitive MRI analysis it was found that the increased structural progression seen in subjects with proximal tibia vara, was due to more full thickness cartilage loss in the central medial tibia. These are novel observations which have implications for future research as the alignment of the proximal tibia can be corrected with surgery. Following this epidemiological description of EKOA, attention was turned to intervention and treatment. A systematic review of the literature identified moderate to very low quality evidence to support the role of surgery in treating symptomatic EKOA. A single-centre prospective cohort study for patients undergoing a novel neutralising high tibial osteotomy was established and excellent early (1yr) and mid-term (3-5 years) clinical outcomes are reported. A retrospective study was designed to investigate whether full thickness cartilage loss on magnetic resonance imaging, but not on plain film radiographs, is sufficient to warrant proceeding to unicompartmental knee arthroplasty (UKA). Outcomes for this cohort of patients were excellent, highlighting the usefulness of MR for the early identification of patients suitable for UKA. In summary, this thesis has reported the natural history of symptomatic EKOA and identified proximal tibia vara as a potent risk factor for structural progression. The paucity of trials investigating subjects with this disease has been highlighted and surgical interventions which are safe and clinically effective have been identified. The direction of future research in this area has been proposed.
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Reid, Duncan A. "The effects of acute and periodic stretching interventions on knee extension range of motion and hamstring muscle extensibility in individuals with osteoarthritis of the knee a thesis submitted in partial fulfilment for the degree of Doctor of Health Science, Auckland University of Technology, November 2008." Click here to access this resource online, 2008. http://hdl.handle.net/10292/647.
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Murray, Amanda Megan. "The Effects of High-Velocity Power Training on Knee Joint Mechanics in Knee Osteoarthritis." University of Toledo / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1404391903.
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Austin, Gretchen E. "Diet quality in older, overweight, and obese adults with knee osteoarthritis." Electronic thesis, 2002. http://dspace.zsr.wfu.edu/jspui/handle/10339/171.
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Mason, Kayleigh. "Central and peripheral mechanisms of pain in clinical knee osteoarthritis." Thesis, University of Manchester, 2015. https://www.research.manchester.ac.uk/portal/en/theses/central-and-peripheral-mechanisms-of-pain-in-clinical-knee-osteoarthritis(4167874f-85ee-4f92-86c9-409bb91b6763).html.
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Background: Knee pain is a common musculoskeletal complaint with an estimated annual population prevalence of 25% in people aged over 55 years. There are many causes of knee pain though osteoarthritis (OA) is one of the most frequent. Not all people with OA, however, have knee pain. There is discordance between pain intensity and disease severity, the reason for which is unknown. Variation in pain sensitivity may be one possible explanation. Quantitative sensory testing (QST) is a non-invasive technique using non-painful and painful stimuli to assess altered sensitivities in the skin and muscle. Little is known, however, about pain sensitivity in people with knee pain and the role of psychosocial factors in relation to pain sensitivity and pain intensity. Intra-articular steroids are a widely used and effective therapy for knee OA though response to treatment varies in both magnitude and duration of response. Pain sensitivity and/or psychosocial factors may explain some of the variation observed in response to treatment. Aims: To determine whether (i) greater sensitivity to stimuli is associated with higher levels of pain intensity in a population-based sample with knee pain, and whether those associations are mediated by psychosocial factors, (ii) there are changes in QST following intra-articular steroid injections in patients with symptomatic knee OA, and (iii) whether psychosocial factors and sensitivity to stimuli at baseline predict change in pain following intervention. Methods: 72 men and women with knee pain were recruited from a population-based cohort. All had QST assessments and completed a range of questionnaire instruments addressing pain intensity and psychosocial factors. QST assessments (including thermal, mechanical, vibration and pressure) were made at the most affected knee and contralateral forearm. Assessments of tender point count, wind-up ratio and diffuse noxious inhibitory control were also performed. Structural equation modelling was used to determine whether associations between QST measures and pain intensity were mediated by a latent psychosocial factor. In a separate open label trial of intra-articular steroid injections, 32 men and women with symptomatic knee OA underwent QST assessments and also completed questionnaires. The assessments were performed at both knees at the baseline visit (prior to injection) and at a post-injection visit 5-15 days later. Changes in QST were assessed using Wilcoxon matched pairs signed-rank with linear regression used to determine baseline QST predictors of change in pain. Results: In the observational study, mechanical hyperalgesia (tender point count, mechanical pain sensitivity, and allodynia), illness perceptions, catastrophizing and disability scores were positively associated with higher levels of pain intensity. Mediation analyses revealed stronger associations for the indirect effect including a latent psychosocial mediator between measures of mechanical hyperalgesia and global pain, and stronger associations for the direct effect between measures of mechanical hyperalgesia and knee pain. In the intervention study no changes in QST were observed between visits. However, lower baseline mechanical pain thresholds at the injected knee and illness perceptions predicted response to treatment. Conclusion: Illness perceptions and mechanical hyperalgesia can be used to identify subjects experiencing higher levels of global and knee pain intensity, and those who were more likely to respond to intra-articular steroid therapy. Changes in knee pain following intervention with steroid injection are not explained by changes in pain sensitivity.
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Imboden, Madeleine Alora-Ivy. "Design and Evaluation of an Offloading Orthosis for Medial Knee Osteoarthritis." Thesis, Université d'Ottawa / University of Ottawa, 2021. http://hdl.handle.net/10393/42538.
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Knee osteoarthritis is an incurable degenerative joint disease that affects millions of people in Canada. Characterized by stiffness and knee pain in the early stages, it can cause loss of function and mobility. Most treatment options are either not sustainable, such as pain medications and steroid injections, or invasive, such as knee replacement surgery. While therapeutic options, such as physiotherapy, have been shown to have a positive effect on pain and activity levels over time, minimal immediate relief has been observed. Moreover, these treatments or combinations of treatments can be costly.
Alternatively, offloading knee orthoses are a cost-effective option that provides immediate pain relief when worn. Offloading knee orthoses, however, have low patient compliance rates. To improve patient compliance and optimize patient benefit, current orthosis designs must be enhanced to improve comfort, increase the perceived effect and be adjustable to the patient.
Consequently, this thesis presents the design, fabrication and testing of an offloading knee orthosis joint designed to enhance comfort and perceived effect. This improvement is achieved by developing a novel modular orthosis that features an offloading mechanism intended to relieve the load on the joint through an offloading moment solely during stance phase and reduce the moment during swing phase when offloading is not needed. The evaluation of the proposed orthosis design was achieved by fabricating an experimental prototype and performing mechanical testing. Three-point bending tests demonstrated a generated offloading moment of 3.36 Nm, creating a noticeable offloading effect during stance, and reduced the moment to less than 0.5 Nm after 35° of knee flexion, thus, increasing comfort during swing phase and sitting when offloading forces are not needed.
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Innes, John Francis. "Osteoarthritis of the canine stifle joint." Thesis, University of Bristol, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.361105.
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Jayadev, Chethan. "A synovial fluid fingerprint for end-stage knee osteoarthritis." Thesis, University of Oxford, 2014. http://ora.ox.ac.uk/objects/uuid:b3f41800-5ede-437d-a2fc-df7cbb54c081.
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Morgan, Tanya G. "Biochemical and mobility markers in osteoarthritis of the knee." Thesis, University of Sunderland, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.269194.
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Donoghue, Claire. "Analysis of MRI for knee osteoarthritis using machine learning." Thesis, Imperial College London, 2013. http://hdl.handle.net/10044/1/24684.
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Approximately 8.5 million people in the UK (13.5% of the population) have osteoarthritis (OA) in one or both knees, with more than 6 million people in the UK suffering with painful osteoarthritis of the knee. In addition, an ageing population implies that an estimated 17 million people (twice as many as in 2012) are likely to be living with OA by 2030. Despite this, there exists no disease modifying drugs for OA and structural OA in MRI is poorly characterised. This motivates research to develop biomarkers and tools to aid osteoarthritis diagnosis from MRI of the knee. Previously many solutions for learning biomarkers have relied upon hand-crafted features to characterise and diagnose osteoarthritis from MRI. The methods proposed in this thesis are scalable and use machine learning to characterise large populations of the OAI dataset, with one experiment applying an algorithm to over 10,000 images. Studies of this size enable subtle characteristics of the dataset to be learnt and model many variations within a population. We present data-driven algorithms to learn features to predict OA from the appearance of the articular cartilage. An unsupervised manifold learning algorithm is used to compute a low dimensional representation of knee MR data which we propose as an imaging marker of OA. Previous metrics introduced for OA diagnosis are loosely based on the research communities intuition of the structural causes of OA progression, including morphological measures of the articular cartilage such as the thickness and volume. We demonstrate that there is a strong correlation between traditional morphological measures of the articular cartilage and the biomarkers identified using the manifold learning algorithm that we propose (R 2 = 0.75). The algorithm is extended to create biomarkers for different regions and sequences. A combination of these markers is proposed to yield a diagnostic imaging biomarker with superior performance. The diagnostic biomarkers presented are shown to improve upon hand-crafted morphological measure of disease status presented in the literature, a linear discriminant analysis (LDA) classification for early stage diagnosis of knee osteoarthritis results with an AUC of 0.9. From the biomarker discovery experiments we identified that intensity based affine registration of knee MRIs is not sufficiently robust for large scale image analysis, approximately 5% of these registrations fail. We have developed fast algorithms to compute robust affine transformations of knee MRI, which enables accurate pairwise registrations in large datasets. We model the population of images as a non-linear manifold, a registration is defined by the shortest geodesic path over the manifold representation. We identify sources of error in our manifold representation and propose fast mitigation strategies by checking for consistency across the manifold and by utilising multiple paths. These mitigation strategies are shown to improve registration accuracy and can be computed in less than 2 seconds with current architecture.
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Zalіavska, O. V. "I Liq Chuan is effective in treating knee osteoarthritis." Thesis, БДМУ, 2022. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/19633.
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Metzger, K., J. Ham, A. Schafer, and Jodi Polaha. "Resident Training in Primary Care Management of Knee Osteoarthritis." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/6559.
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Cromer, Megan. "Evaluating Structural Disease Progression in Knee Osteoarthritis with MRI." Thesis, The University of Sydney, 2013. http://hdl.handle.net/2123/9923.
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Evaluating Structural Disease Progression in Knee Osteoarthritis with MRI Knee osteoarthritis (OA) is highly prevalent in the ageing population. OA is a slowly progressive debilitating disease which impacts negatively on quality of life. Economically, there is a substantial cost to the community through the loss of productive work hours and cost of health care, including joint replacement surgery (Huskisson, 2008). As there is no known cure for knee OA, treatment strategies are two-fold and are aimed at improving joint functionality whilst providing symptomatic relief (Harvey & Hunter, 2010). The marketplace is saturated with dietary supplements purporting to support cartilage health and provide a measure of symptomatic relief. Many people with OA use the commonly available dietary supplements glucosamine sulfate and chondroitin sulfate hoping to avail themselves of the perceived therapeutic benefits. Previous trials evaluating glucosamine sulfate and chondroitin sulfate supplements have provided no definitive evidence of their beneficial use in terms of structural disease modification. The majority of trials have mostly used radiographically-based primary outcome measures; however, due to the increased availability and proven diagnostic performance of Magnetic Resonance Imaging (MRI) in OA, its use in providing an evaluation of these supplements appears warranted. This research had three main areas of focus. An experiment was undertaken to validate the use of an unspoiled fat-suppressed gradient echo sequence for use in clinical trials to provide accurate cartilage volume measurements. Following on from this, an evaluation of analysis techniques using quantitative MRI data was performed. This evaluation included the application of ordered values of cartilage thickness changes and a subsequent comparison of the sensitivity of quantitative MRI (qMRI) techniques in detecting disease progression relative to the traditional standard measures from conventional radiography. Lastly, a randomised trial was undertaken in order to evaluate the possible effects of glucosamine sulfate and chondroitin sulfate compared to a placebo on the rate of structural disease progression in OA. The primary outcome measures were based on MRI-derived data of disease progression, including cartilage volume and thickness changes, along with cartilage T2 mapping to provide quantitative measures (T2 relaxation rates) of the extracellular matrix integrity. This work described the first application of T2 mapping in an evaluation of the dietary supplements glucosamine sulfate and chondroitin sulfate. This work validated the use of an unspoiled gradient echo sequence applicable for use in providing datasets for cartilage volume measurements, with very high interscan reproducibility for cartilage quantification. MRI combined with an ordered value analysis was found to be a more sensitive analysis technique in detecting disease progression in OA than the standard measure of joint space narrowing from radiographs. These findings support the future application of ordered values in the analysis of qMRI data. The preliminary results from the randomised trial showed there were no statistically significant definitive benefits from the use of glucosamine sulfate or chondroitin sulfate supplements in slowing structural disease progression in OA, as assessed by MRI-derived cartilage volume and thickness changes and cartilage T2 relaxation rates over a two year period.
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Stockman, Tyler Joseph. "Early targeting of knee osteoarthritis : validation of computational methods." Thesis, University of Iowa, 2014. https://ir.uiowa.edu/etd/2149.
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Osteoarthritis (OA) is the most common type of arthritis, a disease in which inflammation and stiffness of the joints occur. This debilitating disease of the joints currently reigns as the most prevalent among the world's populations. Of particular interest to our group is the study of the biomechanical factors relating to knee OA. Studies have shown that knee OA is related to multiple biomechanical factors, all of which are complexly interrelated. These factors have been seen to produce varied effects on the structures of the knee. This work examines validation of a computational model implementing discrete element analysis, and discusses the potential for large-scale, subject-specific modeling of the knee. In particular, contact stress can be estimated using this technique, and these estimates can potentially be related to OA onset in subjects.
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Agaliotis, Maria. "Chronic Knee Pain And Worker Productivity." Thesis, The University of Sydney, 2015. http://hdl.handle.net/2123/13675.
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AIM: The aim of this thesis was to examine worker productivity among people with chronic knee pain due to osteoarthritis within the Australian context. METHOD: The three main measures of reduced worker productivity were: absenteeism, presenteeism and work transitions. Contextual factors were included to determine whether these factors modify worker productivity. This research utilised a large prospective cohort, followed by a cross-sectional survey and focus groups. RESULTS A small proportion of study participants in paid employment reported being absent from work due to knee problems. Around 80% reported presenteeism due to their knee problems over a 12-month follow-up period. Almost a quarter (24%) of the participants reported one or more work transitions due to knee problems within the last six months. The only significant risk factors for absenteeism were reporting a low mental health-related quality of life. Significant risk factors for presenteeism included reporting marked activity limitations or knee pain, working in semi-manual or manual occupations, reporting problems with one or more other joints, while reporting job instability decrease the risk. Knee pain, co-morbidity and low co-worker support were associated with work transitions, while having an occupation requiring sitting for more than 30% in a typical working day reduced the likelihood. Insights gained from the focus groups included: the extent of physical limitations due to chronic knee pain, the lack of workplace ergonomic policies, the types of work transitions utilized to accommodate knee pain, the complexity of disease disclosure and social support at work and the effect of the unpredictability of future arthritis progression. CONCLUSION Overall this research provides important insights and initiatives to develop a healthy ageing workforce by reducing the burden and risk factors associated with reduced worker productivity among people with chronic knee pain.
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Dandees, Husam. "Evidence-based physiotherapeutic management for knee osteoarthritis: A knowledge translation study." Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/20161.
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Thesis (MScPhysio)--Stellenbosch University, 2012.<br>Background: Evidence for the effectiveness of physiotherapeutic interventions in the management of knee osteoarthritis (OA) is synthesised in the current clinical guidelines (CGs), providing clinicians with readily accessible and interpretable practice guidelines. However, CGs are often not specific to the local context of the target users, therefore hindering successful implementation of evidence into clinical practice. Formulating succinct and composite recommendations by synthesising the current CGs reporting on the evidence-based (EB) management of knee OA may assure contextual relevance and facilitate implementation of evidence into clinical practice. In addition, multifaceted interventions, such as evidence-based practice (EBP) workshops, are also postulated to promote the implementation of guideline recommendations, thereby enhancing clinical outcomes.
Objectives: The primary objectives of this study were to: 1) describe the range of EB physiotherapeutic interventions in the management of knee OA as documented in the current CGs; and 2) develop composite clinical recommendations for a specific group of users working in Jerusalem. A secondary study objective was to ascertain the effect of translating the knowledge through a specifically-designed EBP workshop on the uptake of knowledge and implementation of EBP into clinical practice by physiotherapists working in Jerusalem. The EBP workshop was aimed at educating physiotherapists about the EB physiotherapeutic techniques for knee OA management.
Study design: Two studies were conducted. A systematic review (SR) into EB clinical guidelines was conducted to describe and synthesise the available evidence and formulate composite recommendations for knee OA. The results of the SR were used to design an EBP workshop aimed at educating physiotherapists about EB physiotherapeutic techniques for treating knee OA patients. A pre-post quasi-experimental design was then conducted to assess the effect of this EBP workshop on the uptake and implementation of EBP into clinical practice amongst public sector physiotherapists working in Jerusalem.
Methodology for quasi experimental study: Physiotherapists who regularly treat knee OA patients were recruited from a list of members registered with the Palestinian Physiotherapy Association Jerusalem. A three-month retrospective audit (initial audit) of knee OA patients’ physiotherapy records kept by the participating physiotherapists was conducted to establish current management patterns. EB strategies for knee OA was presented to the participating physiotherapists during a one-day workshop. A second audit of physiotherapy records was conducted three months after the EBP workshop to establish changes in the selection of physiotherapeutic management techniques for knee OA.
Results: The initial audit revealed that the participating physiotherapists utilized one high EB modality namely, exercises, as a core management strategy in knee OA, but did not frequently implement other high EB modalities such as self-management and weight-loss programs. Following the EBP workshop, a statistically significant increase (p=0.008) in the implementation of weight-loss and self-management strategies in the management of knee OA was noted. Conversely, a statistically significant decrease was noticed in using patellar taping (low EB modality) in the management of knee OA (p=0.04). No significant changes were noticed in the utilization of other physiotherapy modalities supported by weak or modest EB recommendations.
Conclusion: The study concluded that physiotherapists inherently prescribed exercise as a core management strategy for knee OA. Modalities supported by modest levels of evidence were used as adjunct treatments. The EBP workshop facilitated the increased application of high EB modalities such as weight-loss and self-management programs. The results of this study illustrate that an EBP workshop may be effective in promoting the implementation of EB physiotherapeutic modalities in the management of knee OA. However, larger studies with longer follow-up periods are required.<br>No Afrikaans abstract available
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Wei, Lei. "Guinea pig osteoarthrosis : morphological and biochemical studies /." Stockholm, 1999. http://diss.kib.ki.se/1999/91-628-3361-8/.
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Molloy, John. "A comparison of surface EMG temporal and spectral parameters from the vastus medialis of subjects with and without knee joint osteoarthritis during a sustained, fatiguing submaximal isometric contraction this thesis is submitted to the Auckland University of Technology in partial fulfilment of the degree of Master of Health Science, March 2005." Full thesis. Abstract, 2005. http://puka2.aut.ac.nz/ait/theses/MolloyJ.pdf.
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Kobayashi, Sarah. "The prevalence, clinical features and trajectory of patellofemoral osteoarthritis." Thesis, The University of Sydney, 2018. http://hdl.handle.net/2123/20472.
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Osteoarthritis (OA) is the most common form of arthritis, and affects approximately 1.8 million people in Australia, with prevalence rates expected to increase due to our ageing population and obesity crisis. The knee joint is most commonly affected by OA of all the weight-bearing joint. Studies involving people with knee OA have focused on the tibiofemoral joint, with little acknowledgement on the patellofemoral joint. The aim of this thesis was to investigate the prevalence, clinical features, treatment strategies and prognosis of patellofemoral OA. Five studies were conducted in order to explore this aim. Firstly, a systematic review and meta-analysis determined the prevalence of patellofemoral osteoarthritis, by pooling data from published studies that reported radiographically confirmed compartmental patterns of knee osteoarthritis. Following, a reliability and validity study validated an assessment tool for patellofemoral OA using magnetic resonance imaging (MRI). Prior to this thesis, there were no tools to specifically assess OA features in the patellofemoral joint. Using the assessment tools assessed in this study, a cross-sectional study using the data from the Long-Term Evaluation of Glucosamine Supplements (LEGS) evaluated whether pain, activity limitations and quality of life differ between people with different compartmental distributions of MRI-based OA structural features in the knee. People with MRI-defined patellofemoral OA were identified, and used to investigate the effectiveness of glucosamine and chondroitin supplements on MRI-based OA features in the patellofemoral joint in a randomised placebo-controlled study design. Finally, this cohort was followed up two years after the study period for a fifth study that investigated the prognosis of MRI-based patellofemoral osteoarthritis using this cohort of people with baseline knee pain. The results from this thesis provided new insights to the literature on patellofemoral OA as well as knee OA.
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Robertson, William Brett. "Functional and radiological evaluation of autologous chondrocyte implantation using a type I/III collagen membrane : from single defect treatment to early osteoarthritis /." Connect to this title, 2006. http://theses.library.uwa.edu.au/adt-WU2007.0172.
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Li, Tsz-shan, and 李芷珊. "Systematic review of the effectiveness of glucosamine for knee osteoarthritis." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B48424250.
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Objective: To investigate the effectiveness of glucosamine for knee osteoarthritis (KOA) through the examination of symptomatic and structural effectiveness of the compound, and to increase public awareness, especially in Hong Kong, about its potential benefits contingent upon the quality of the existing research.
Methods, Results: All studies published between 1965 and 2011 in MEDLINE, and from 1980 to 2012 in EMBASE, which evaluated the effectiveness of glucosamine for KOA, were searched and identified using specific keywords. A total of 9 randomized controlled trials out of 672 articles from MEDLINE and 1712 articles from EMBASE were included in this systematic review. The included studies used different outcome measures to compare the effects of glucosamine with other remedies for treating KOA. Similar demographic and clinical characteristics of the subjects between the intervention and the control groups were recorded. The studies were from eight countries. The average age of the subjects in the nine studies were 55 years and they were generally overweight. Though there were discrepancies among the results generated in the included studies, the potential benefits of glucosamine could not be dismissed.
Discussion: Factors about compliance, possible drug-to-drug interaction, unknown placebo, subject characteristics (disease progress and severity, age, gender, and occupation), as well as the dosage of glucosamine could have greatly affected the results of the included studies. Limitations on finding articles about the effectiveness of glucosamine for OA of different sites, the cost-effectiveness of the compound, the assumption of the language restriction, and the risks of biases were raised. More clinical trials with comprehensive considerations of all possible factors affecting the results, are necessary.
Conclusion: Based on this systematic review, the potential effects of glucosamine for KOA remain unclear. More research of different ethnic groups, especially of people in Hong Kong, is needed to raise public awareness about the effectiveness of glucosamine for OA other than the knee globally as well as in Hong Kong.<br>published_or_final_version<br>Public Health<br>Master<br>Master of Public Health
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Balamoody, Sharon Dr. "MR Imaging at 3.0T in the Assessment of Knee Osteoarthritis." Thesis, University of Manchester, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.493422.
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The National Institute of Health Osteoarthritis Initiative (NIH OAI) is a large cohort study which has enrolled over 5,000 subjects either at-risk of developing osteoarthritis (OA) or with evidence of early OA. Their aims are to discover potential imaging, biochemical and genetic biomarkers signifying OA onset or progression. All the subjects are being scanned on Siemens Trio 3.0 Tesla MR scanners. In the UK, the 3.0 Tesla scanners in use are manufactured by three principal companies: Philips Medical Systems, GE Healthcare and Siemens. In order to perform and interpret future research on Philips and GE scanners in relation to the future results of the NIH OAI, a comparison study is required.
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Brouwer, Reinoud Willem. "Unicompartmental osteoarthritis of the knee diagnosis and treatment of malignment /." [S.l.] : Rotterdam : [The Author] ; Erasmus University [Host], 2006. http://hdl.handle.net/1765/7731.
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Sweeney, Mary Kathleen. "Outcomes evaluation in knee arthroplasty for the treatment of osteoarthritis." Thesis, University of British Columbia, 2010. http://hdl.handle.net/2429/29403.
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Objectives: The primary objective was to evaluate differences in outcome between unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) with respect to total WOMAC and OKS scores. In order to properly evaluate outcomes following both UKA and TKA valid and responsive instruments are needed. Therefore the second objective was to assess the construct validity and responsiveness of the SF-6D and the WOMAC derived HUI3 in patients undergoing either UKA or TKA. Lastly, the third objective was to evaluate any differences in the effect of socioeconomic status in outcomes following UKA compared to TKA.
Methods: A retrospective analysis was conducted to evaluate outcomes following knee arthroplasty on data collected between July 2000 and December 2008 on all patients requiring either UKA or TKA. Patients completed the WOMAC, OKS and SF-12 preoperatively and then subsequently at 3 and 6 months post-surgery. The Pearson correlation coefficient and intraclass correlation coefficient (ICC) were used to measure the correlation between the OKS, WOMAC, SF-6D and HUI3. Responsiveness was evaluated using a distribution based evaluation and an anchor-based method. A three level hierarchical linear model was used to model the total WOMAC scores and OKS as a function of group (UKA or TKA) and time. A similar model was used to investigate whether differences in total WOMAC or OKS between UKA and TKA occur across socioeconomic groups.
Results: The WOMAC derived HUI3 and SF-6D appear to be valid measures of HRQL in this patient sample. The SF-6D was not as responsive as the HUI3 but demonstrated a good ability to identify patients who had improved. There were no significant differences in HRQL between UKA and TKA and socioeconomic status did not have a significant effect on HRQL following knee arthroplasty.
Conclusions: Both the HUI3 and SF-6D appeared to be valid and responsive measures in this patient sample. However, further study looking at the interchangeability of the WOMAC derived HUI3 with the HUI3 itself is needed. No differences in HRQL between UKA and TKA were noted and there were no differences in outcome between UKA and TKA across SES groups.
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Donell, Simon Thomas. "Mechanical factors in the management of osteoarthritis of the knee." Thesis, University of East Anglia, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.368174.
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