Assessment of Inflammation of Infrapatellar Fat Pad and its Contribution to Anterior Knee Pain Severity and Severity of Knee Osteoarthritis
Notice bibliographique
Résumé
Abstract Background Osteoarthritis is the most common arthritic disease worldwide leading to debilitating pain (which is the hallmark symptom of the disease) and destruction of joint tissues. The exact etiopathogenesis of Knee osteoarthritis pain is unclear, but clinical, imaging and biochemical observations indicate that inflammation may contribute to both structural disease progression and pain (consequently disability). Early diagnosis and treatment of the inflammation and its cause may contribute to improve the outcome of the disease. Aim of the Work The aim of the study was to assess inflammation of infrapatellar fat pad by musculoskeletal Doppler Ultrasound in knee osteoarthritis patients and its contribution to anterior knee pain severity, and relation to different lines of treatment. Patients and Methods This case-control study was conducted on 30 knee osteoarthritis (OA) patients and 30 patients with anterior knee pain without OA. Diagnosis of knee OA is based on American College of Rheumatology clinical and radiographic classification criteria for knee osteoarthritis. Each group of patients was divided into 2 subgroups: Fifteen patients were subjected to weight reduction, NSAID for 2 weeks, and physiotherapy in the form of ultra sound diathermy (US), Trans cutaneous electrical nerve stimulation (TENS), and strengthening exercises for quadriceps muscles. Fifteen patients were subjected to US guided local steroid and anesthetic injection in the infrapatellar fat pad under sterile conditions. The injectate was 40 mg methylprednisolone acetate every 4 weeks for a maximum 3 injections. Results Flexion ROM and extension ROM before treatment were insignificantly different between group 1B and group 1A and between group 2B and group 2A while were significantly higher in group 2 (A and B) than group 1(A and B) (p < 0.05). Flexion ROM and extension ROM after treatment were insignificantly different between group 1B and group 1A and between group 2B and group 2A while were significantly higher in group 2B than 1B and in group 1B than group 2A and in group 2A than group 1A (p < 0.05). The lateral recess effusion before treatment was significantly different between the studied groups (p = 0.008) and after treatment was insignificantly different among the studied groups (p = 0.295). Medial femorotibial joint osteophytes before and after treatment was insignificantly different among the studied groups. Femoral cartilage assessment before and after treatment was insignificantly different among the studied groups. Echogenicity before and after treatment was significantly different among the studied groups (p = 0.002 and <0.001 respectively). Hoffa fat pad width before treatment was insignificantly different among the studied groups. Hoffa fat pad width after treatment was significantly different among the studied groups. The Hoffa fat pad width after treatment was significantly lower in group 2B than 1B and in group 1B than group 2A and in group 2A than group 1A (p < 0.05). Largest fat lobule width before treatment was insignificantly different among the studied groups. Largest fat lobule width after treatment was significantly different among the studied groups. Largest fat lobule was significantly higher in group 2B than 1B and in group 1B than group 2A and in group 2A than group 1A (p < 0.05). The Western Ontario and McMaster universities (WOMAC) index before treatment was insignificantly different between group 1A and group 2A, and in group 1B and group 2B while was significantly lower in group 2B and group 1B than group 1A and in group 1B and 2B than group 2A (p < 0.05). The WOMAC index after treatment was significantly different among the studied groups. WOMAC index was significantly lower in group 2B than 1B and in group 1B than 2A and in group 2A than group 1A (p < 0.05). VAS scale before treatment was insignificantly different among the studied groups. VAS scale after treatment was significantly lower in group 2B than 1B and in group 1B than group 2A (p < 0.05). Conclusion Inflammation of infrapatellar fat pad is evident clinically in patients with knee osteoarthritis and musculoskeletal US has great role in its diagnosis and treatment by US guided injection. Favorable outcomes were observed by US findings and WOMAC index in patients with no osteoarthritis and taking corticosteroid injections compared to patients with osteoarthritis and taking corticosteroid injections. However, patients with osteoarthritis and taking corticosteroid injections had favorable outcomes compared to osteoarthritis or no osteoarthritis but taking the conventional therapy. Recommendations Further largescale clinical studies are needed with multicenter cooperation, and long-term follow-up period to monitor structural changes in both groups is recommended. Relying on musculoskeletal US for early detection of inflammation in Hoffa fat pad, and early treatment by musculoskeletal Us guided local corticosteroid injection may decrease the progression and subsequently the disability of knee OA.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».