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Objectives This study aimed to examine the relationships between kinesiophobia and injury severity, balance ability, knee pain intensity, self-efficacy, and functional status in patients with meniscus injuries and to identify key predictors of kinesiophobia. Design A single-center, prospective cross-sectional study. Methods A cross-sectional study involving 123 patients diagnosed with meniscus injuries at Fujian Provincial Hospital was conducted. The knee range of motion test was used to determine limitations in knee joint mobility, whereas magnetic resonance imaging (MRI) was used to assess the severity of meniscus damage. Several validated scales were administered: the Tampa Scale of Kinesiophobia (TSK-17) to measure kinesiophobia, the visual analog scale (VAS) to assess pain intensity, the general self-efficacy scale (GSES) to evaluate self-efficacy, and the Lysholm knee score (LKS) to assess knee functional status. Additionally, balance ability was assessed using the Huber 360 Neuromuscular Control Training and Assessment System (DJO, USA). Spearman’s correlation analysis was applied to explore factors associated with kinesiophobia, whereas simple linear regression analysis was used to identify its predictors. Results Among the 123 participants included in the study, 60.16% were identified as experiencing kinesiophobia. Among these participants, 69.10% had grade III meniscus injuries, and 33.3% exhibited limited joint movement. The key clinical characteristics were as follows: the median VAS score was 4 (IQR 2–6), the GSES score was 22 (IQR 20–29), and the LKS score was 45 (IQR 38–55). Kinesiophobia was significantly correlated with injury severity, limited joint movement, pain intensity, self-efficacy, and other functional parameters ( P  < 0.05). However, no significant correlation was detected between kinesiophobia and limits of stability. Simple linear regression analysis (R²=0.917) revealed several significant predictors of kinesiophobia, including injury severity (β = 2.08), pain intensity (β = 0.882), Romberg quotient (RQ) (β = 3.239), and limited joint movement (β = 0.868). In contrast, self-efficacy (β =-0.455) was negatively associated with kinesiophobia. Furthermore, Grade III injuries and RQ were found to be associated with markedly higher levels of kinesiophobia. Conclusion Kinesiophobia is strongly associated with knee injury severity, limited joint movement, RQ, pain intensity, and self-efficacy, which are key predictors. Clinical interventions should focus on these factors to enhance rehabilitation outcomes.

ObjectivesThere is a paucity of qualitative research exploring the patient experience of living with a meniscal tear, vital to effective patient management. The aim of this study was to explore the experiences and expectations of treatment of patients aged 18–55 years with a meniscal tear of the knee.DesignQualitative study involving semistructured interviews.SettingParticipants were selected from nine secondary care centres in England.Participants10 participants diagnosed with a meniscal tear were recruited from the Meniscal Tear Outcome cohort study using a purposive sampling strategy until data saturation was achieved. Semistructured interviews were conducted between April and May 2021 and thematic analysis was used to identify key patient experiences.ResultsThemes identified relate to the broad areas of symptoms, clinical consultation and experience of treatment. Meniscal tears have a profound impact on pain and many patients experience effects on their family and financial life in addition to physical symptoms. Participants expected most of their management to occur in secondary care and most thought surgery would be a definitive treatment, while they believed the effectiveness of physiotherapy could not be guaranteed as it would not fix the physical tear.ConclusionThis study is one of the first to explore patient experiences of a meniscal tear and their perceptions of treatment options. Patient experiences and perceptions are important for clinicians to understand in order to provide the best possible care. It is important to elicit these experiences, listen to the patient, discuss their perspectives and build these experiences and expectations into clinical care.Trial registration numberISRCTN11534691.

Background and Objectives: Meniscus injuries, particularly Grade I and II, are common knee injuries that can affect pain, joint function and quality of life, but the effectiveness of non-invasive treatments like Kinesiology taping (KT) in this population remains limited. This pilot randomized controlled trial aimed to explore the short-term effects of KT on pain, fear of movement, muscle strength, proprioceptive force sense, joint range of motion, joint position sense and quality of life in individuals with Grade I/II meniscus injuries. Materials and Methods: 26 participants diagnosed with Grade I-II meniscus injury were randomly assigned to two groups: the experimental group was applied ‘Y shaped’ kinesiology taping on quadriceps femoris muscle, based on facilitation technique with 25–50% tension. The control (placebo) group was applied a tape without tension, perpendicular to the quadriceps femoris muscle. Outcomes were evaluated before and 48–72 h after taping. Results: Between-group analysis demonstrated a significant improvement in joint position sense at 60° flexion with eyes closed in KT group compared with placebo (p = 0.002). Additionally, the KT group showed significantly greater improvements in the physical function (p = 0.006) and energy (p = 0.013) subdomains of the SF-36 quality of life scale. No significant between-group differences were observed for pain, fear of movement, muscle strength, proprioceptive force sense, or joint range of motion. Conclusions: In this pilot study, KT showed acute benefits in proprioception and quality of life in grade I-II meniscus injuries, but no advantage over placebo taping for pain, fear of movement, joint range of motion or muscle strength. Given the exploratory nature and limited sample size, these findings should be interpreted cautiously. Larger trials should confirm these results and determine the role of KT within multimodal rehabilitation programs.

Background Randomized placebo-controlled trials represent the gold standard in evaluating healthcare interventions but are rarely performed within orthopedics. Ethical concerns or well-known challenges in recruiting patients for surgical trials in general have been expressed and adding a placebo component only adds to this complexity. The purpose of this study was to report the challenges of recruiting patients into an orthopedic placebo-controlled surgical trial, to determine the number of patients needed to be screened and allocated in order to include one participant into the trial, and to identify reasons associated with participation in a placebo-controlled randomized surgical trial. Methods Data were extracted from an ongoing placebo-controlled randomized controlled trial (RCT) on meniscectomy versus placebo surgery. We calculated the number of patients needed to be screened in order to include the required number of participants into the RCT. Participating patients were asked about their rationale for joining the study and which type of information was most useful for deciding upon participation. Results A total of 476 patients entered the screening group, of which 190 patients fulfilled the inclusion and exclusion criteria. 102 patients declined to participate in the study due to various reasons and 46 were later excluded (no meniscus lesion on the magnetic resonance imaging scan or withdrawn consent). A total of 40 patients were finally included in the RCT. To include one patient into the RCT, 11.9 individuals needed to be screened. A total of 69% of participating patients considered the oral information to be the most important and the most common reason for participating was the contribution to research (90%). Conclusions Patients are willing to participate in an orthopedic placebo-controlled surgical trial. Oral information given by the surgeon to the patient and the contribution to research are important aspects to enhance patient recruitment. Trial registration ClinicalTrials.gov NCT01264991 , registered 21 December 2010.

Objective: To compare the effectiveness of electromyographic biofeedback training and electrical stimulation therapy for rehabilitation following arthroscopic partial meniscectomy. Design: Randomized, prospective, controlled single-blind trial. Setting: Department of physical medicine and rehabilitation, university hospital. Subjects: Forty-five patients who had undergone surgery for arthroscopic partial meniscectomy were randomly divided into three groups with 15 patients in each group. Interventions: The control group had home exercise, the second and third groups received electromyographic biofeedback training or electrical stimulation therapy to quadriceps muscle in addition to home exercise. Main measures: The patients were evaluated for: visual analogue scale, gait velocity (m/s), time using a walking aid after surgery, Lysholm Knee Scoring Scale score, knee flexion–extension angle, maximum and average contraction powers of vastus medialis obliquus and vastus lateralis muscles on the day before the operation and two and six weeks after. Results: The time using a walking aid was 8.3 ± 8.0, 1.5 ± 2.5 and 4.5 ± 5.5 days, respectively, for the home exercise, electromyographic biofeedback training and electrical stimulation groups, and significantly shorter in the electromyographic biofeedback training than in the home exercise group (P < 0.017). While significant progress was detected in Lysholm Knee Scoring Scale score in the second and sixth postoperative weeks compared to the preoperative within-group evaluation for each of the three groups (P < 0.017), there was significant difference in Lysholm Knee Scoring Scale in the second postoperative week in favour of electromyographic biofeedback training compared to home exercise (P < 0.017). There were significant differences in vastus medialis obliquus average and vastus lateralis maximum and average contractions in favour of electromyographic biofeedback compared to home exercise and electrical stimulation in the second postoperative week (P < 0.017). Conclusions: The addition of electromyographic biofeedback training to a conventional exercise programme following arthroscopic partial meniscectomy helps to speed up the rehabilitation process.

Purpose The Western Ontario Meniscal Evaluation Tool (WOMET) is a questionnaire designed to evaluate quality of life related to the health (HRQOL) of patients with meniscus pathology. The purpose of this study was to translate and culturally adapt the WOMET into Turkish, and thereby to determine the reliability and validity of the translated version. Methods The WOMET was translated into Turkish in accordance with the stages recommended by Guillemin. Ninety-six patients [35 male, 61 female; mean age: 43.6 ± 11.7 (23–71) years] with meniscal pathology were included in the study. The WOMET was completed twice at 3–7-day intervals. The inter-rater correlation coefficient was used for reliability, and Cronbach’s α was used for internal consistency. Patients were asked to answer the Lysholm knee scale and the short form-36 (SF-36) for the validity of the estimation. The distribution of ceiling and floor effects was determined. Results Mean and s tandard deviation of the first and second evaluations of the total WOMET were 1,048.9 ± 271.6 and 1,000.4 ± 255.2 ( p  = 0.03), respectively. The test–retest reliability of the total score, physical function, sports/work/lifestyle and emotion domains were 0.88, 0.78, 0.80 and 0.85, respectively. Cronbach’s α was 0.89. WOMET was most strongly related to the physical function scale and the physical component score ( ρ 0.54, ρ 0.60, respectively; p  < 0.001). The weakest correlations between the WOMET and the SF-36 were for the mental component score and the emotional role functioning ( ρ 0.11, ρ 0.03, respectively). We observed no ceiling and floor effects of the overall WOMET score, but 36.5 % of the patients showed floor effect in the question of “numbness”, and 40.6 % of the patients showed ceiling effect in the question of “consciousness”. Conclusion The Turkish version of the WOMET is valid and reliable. It can therefore be used for HRQOL of patients with meniscal pathology. Level of evidence II.

(1) To determine the accuracy of computed tomography (CT) in the evaluation of ligament tear and avulsion in patients with tibial plateau fracture. (2) To evaluate whether the presence or severity of fracture gap and articular depression can predict meniscal injury. A fellowship-trained musculoskeletal radiologist retrospectively reviewed knee CT and MRI examinations of 41 consecutive patients presenting to a level 1 trauma center with tibial plateau fractures. Fracture gap, articular depression, ligament tear and footprint avulsions were assessed on CT examinations. The MRI studies were examined for osseous and soft tissue injuries, including meniscal tear, meniscal displacement, ligament tear, and ligament avulsion. CT demonstrated torn ligaments with 80% sensitivity and 98% specificity. Only 2% of ligaments deemed intact on careful CT evaluation had partial or complete tears on MRI. Although the degree of fracture gap and articular depression was significantly greater in patients with meniscal injury compared with those without meniscal injury, ROC analysis demonstrated no clear threshold for gap or depression that yielded a combination of high sensitivity and specificity. In the acute setting, CT offers high sensitivity and specificity for depicting osseous avulsions, as well as high negative predictive value for excluding ligament injury. However, MRI remains necessary for the preoperative detection of meniscal injury.

ObjectiveMeniscal tears occur frequently in the population and the most common surgical treatment, arthroscopic partial meniscectomy, is performed in approximately two million cases worldwide each year. The purpose of this systematic review is to summarise and critically appraise the evidence for the use of patient-reported outcome measures (PROMs) in patients with meniscal tears.DesignA systematic review was undertaken. Data on reported measurement properties were extracted and the quality of the studies appraised according to Consensus-based Standards for the Selection of Health Measurement Instruments.Data sourcesA search of MEDLINE, Embase, AMED and PsycINFO, unlimited by language or publication date (last search 20 February 2017).Eligibility criteria for selecting studiesDevelopment and validation studies reporting the measurement properties of PROMs in patients with meniscal tears were included.Results11 studies and 10 PROMs were included. The overall quality of studies was poor. For measurement of symptoms and functional status, there is only very limited evidence supporting the selection of either the Lysholm Knee Scale, International Knee Documentation Committee Subjective Knee Form or the Dutch version of the Knee injury and Osteoarthritis Outcome Score. For measuring health-related quality of life, only limited evidence supports the selection of the Western Ontario Meniscal Evaluation Tool (WOMET). Of all the PROMs evaluated, WOMET has the strongest evidence for content validity.ConclusionFor patients with meniscal tears, there is poor quality and incomplete evidence regarding the validity of the currently available PROMs. Further research is required to ensure these PROMs truly reflect the symptoms, function and quality of life of patients with meniscal tears.PROSPERO registration numberCRD42017056847.

This study examined the forces during motion across human meniscal tears. Longitudinal cuts were created in 6 human cadaveric knees at the red-white junction of the medial and lateral menisci into which a pressure transducer was placed. Pressure data were gathered with the knees at neutral, internal rotation, and external rotation and matched to knee flexion. The meniscal cuts were compressed throughout the range of motion. No distraction pressures were observed. Therefore, meniscal tear displacement does not occur with knee motion and a meniscal repair device load-to-failure strength may be less important than the device's ability to accurately reduce a meniscal tear and avoid shear stress.

Surgery is a stressful experience. Many minor interventions have been shown to cause considerable anxiety in patients, but whether arthroscopy leads to such anxiety is not well-known. Methods for lowering perioperative anxiety have been sought and listening to music or watching a movie have been recommended. The method of permitting patients to watch their own endoscopy has been studied infrequently. Our aim in this study was to find out the effect of watching simultaneous arthroscopic views on postoperative anxiety. A total of 63 patients were randomly divided into two groups: those watching their own arthroscopy formed group W, while patients that were only verbally informed formed group NW. The mean age of patients in both groups were 33 and 34, respectively. Meniscal surgery was the most commonly performed procedure (49/63 patients). The patients filled in state scale of State-trait anxiety inventory (STAI) forms and the study questionnaire (SQ) prepared for this study, just before and after the arthroscopy. Group W had significantly lower postoperative scores of STAI-S, whole questionnaire ( Q -score) and all but one of individual statements in SQ. Having a previous operation history did not affect STAI scores. Age and level of education was not correlated with any of the studied parameters either. The ratio of patients that were pleased with the arthroscopy experience in group W and NW were 94 and 63%, respectively. Watching live arthroscopic views has led to a significant decrease in postoperative anxiety and worries about the surgery and the postoperative period, while increasing overall understanding and satisfaction of the patient.