Thesis (MSc (Physiotherapy))--University of Limpopo (Medunsa Campus), 2010. / The knee Injuries in Women Soccer Players in South Africa The Knee is a common site for injuries in soccer players. The reasons for the increased rates of knee injuries in women soccer players are not clear, but some theories suggested the reason to lie in the difference in anatomy. This research investigate the prevalence of knee injuries in women soccer players in South Africa and sought to find out whether three of the anatomical factors (Q-angle, pelvic width and Intercondylar notch width) have a role in increasing knee injuries in these individuals. The study design was case –control study. Methodology: Twenty four players of South Africa women soccer team (Under 23) participated in this study. X-rays of the hip were taken and the Q-angles were thereafter measured manually. Association between anatomical factors and knee injuries were determined. The result of this study showed that 17% of the players were having non contact knee injuries. Statistical analysis showed no significant relation between knee injuries among women soccer players and each of the anatomical factors. The P-values of both t-test and ANOVA test were larger than the 0.05 level of significance. The study found that the prevalence of knee injuries among the young women playing for the South African national team U-23 was relatively high. However, this study could not identify significant relationship between the anatomical risk factors and the incidences of knee injuries among the participants.

Thesis (MHSc--Health Science) -- AUT University, 2007. / Includes bibliographical references. Also held in print (viii, 247 leaves ; 30 cm.) in the Archive at the City Campus (T 617.582 COL)

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Medicine Johannesburg, 2018. / The knee is indispensable in everyday life and injuries to it can be debilitating with significant loss of earnings incurred. Clinical diagnosis may not always be made with certainty and Magnetic Resonance Imaging (MRI) helps further elucidate intra-articular injuries. MRI reporting has its shortcomings and may provide spurious results according to the interpretor’s level of experience. This study aims to test the diagnostic reliability of MRI done in a teaching hospital for the evaluation of anterior cruciate ligament and meniscal injuries using arthroscopy as the baseline for comparison. Due to the long waiting times to have surgery we also determined if there was a change in the reliability of an MRI result as time elapsed. A retrospective review of records of patients who had knee arthroscopies at Chris Hani Baragwanath Academic Hospital (Johannesburg, South Africa) from May 2009 to May 2015 was done. Adults (16 − 60 years) with one major episode of trauma to the knee and had MRI done prior to surgery at the above institution were included. Arthroscopy was performed by 2 senior surgeons or by residents under their direct supervision. Arthroscopic findings of anterior cruciate ligament (ACL) and medial (MM) or lateral meniscal (LM) injuries were compared to MRI findings. Data was analysed by STATA version 13.1 to determine injury demographics, sensitivity, specificity and diagnostic accuracy of MRI. The effect of time interval from MRI to surgery on the diagnostic accuracy was determined. A total of 72 patients (74 knees) qualified for review. The median age was 35 years (IQR 26 − 43) with a significant difference between males and females (28 vs 41 years, p = 0.0019). Leading causes of injury were traffic accidents (32.4%), falls (27.0%) and sports injuries (17.6%). Median interval from MRI to surgery was 71.5 days (IQR 29 − 143). The sensitivity of MRI for ACL, MM and LM injuries was (63.6%, 58.8% and 52.6%), specificity (92.7%, 86.0% and 80.0%) and diagnostic accuracy (79.7%, 79.7% and 73.0%) respectively. The patients were divided into subgroups of early (< 6 weeks), intermediate (6 − 16 weeks) and late intervention (> 16 weeks) post-MRI. There were marked differences in the diagnostic accuracy in the three groups for the ACL (70.8% vs 92.6% vs 73.9%) and LM (62.5% vs 81.5% vs 73.9%). This was unremarkable for the MM (75.0% vs 81.5% vs 82.6%). MRI findings correlate well with arthroscopic findings making it a reliable preoperative screening tool for ACL and meniscal injuries. However its diagnostic accuracy appears to change with time. It is apparent that the diagnostic accuracy is higher between 6 − 16 weeks post MRI. A bigger cohort would help determine an ideal waiting time interval without significant depreciation in diagnostic accuracy. / LG2018

by Raymond Che Tin Li. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1989. / Bibliography: leaves 149-168.

Purpose: The aim of this study was to compare the management approach of acute knee dislocations (AKDs) by orthopaedic surgeons from nations with different economic status. Methods: A survey sent to members of the Societe Internationale de Chirurgie Orthopedique et de Traumatologie (SICOT) compared different management strategies for acute multiligament knee injuries (aMLKIs). These were compared after categorising surgeons into developed economic nations (DEN) and emerging markets and developing nations (EMDN) based on the gross domestic product (GDP) per capita. Results: 138 orthopaedic surgeons from 47 countries participated in this study. DEN surgeons had more years of experience and were older (p <0.05). Surgeons from EMDN preferred conservative management and delayed reconstruction with autograft (p<0.05) if surgery was necessary. Surgeons from DEN favoured early, single stage arthroscopic ligament reconstruction. Significantly more EMDN surgeons preferred clinical examination (p<0.05) and duplex doppler scanning (p<0.05) compared to DEN surgeons. More surgeons from EMDN did not have access to a physiotherapist for their patients. Conclusions: Treatment of aMLKIs varied significantly based on the economic status of the country. In EMDN, aMLKIs are often treated conservatively, ligament surgery is often delayed and staged, alternative vascular assessment methods are more commonly used, and access to physiotherapy is challenging. This calls for adjusted guidelines when treating patients in areas of low resource setting.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 4 uppsatser.

Bakgrund: Knäskador är vanligt bland fotbollsspelande flickor och kan avsluta en karriär i förtid. Studier har gjorts där skadeförebyggande träning visat på god effekt, dock saknas studier som följer upp användningen av träningsprogrammen. Syfte: Beskriva och utvärdera användandet av det skadeförebyggande träningsprogrammet Knäglädje. Metod: En deskriptiv, komparativ design. Totalt 37 fotbollstränare till flicklag i åldrarna 13-19 år svarade på en webbaserad enkät. Resultat: viktigaste faktorerna för användandet av träningsprogrammet var : minskad skaderisk för spelarna, enkelt att lägga in i ordinarie träning och det var kostnadsfritt. De viktigaste faktorerna för att inte använda programmet var: tid försvann från ordinarie träning, tog tid att lära sig programmet samt följde ett annat skadeförebyggande program. Ingen signifikant skillnad sågs vad gäller användandet av träningsprogrammet i förhållande till tränarerfarenhet och tränarutbildning. Tränare som fått utbildning i träningsprogrammet använde det i högre utsträckning än de som inte fått någon utbildning. Skillnaden var signifikant. Konklusion: Viktiga faktorer för användandet av Knäglädje var den minskande skaderisken, att det var kostnadsfritt samt enkelt att lägga in i träningen. Programmet användes i större utsträckning av tränare som fått utbildning i det. Det framkom i studien att de flesta tränare visade en medvetenhet om vikten av skadeförebyggande träning för att minska risken för skador.

The objective of this study was to investigate the accuracy of eleven prediction equations and one prediction table when estimating isoinertial knee extension and leg press one repetition maximum (1-RM) performance in subjects with knee injuries and knee osteoarthritis. Study Design: A descriptive quantitative research study was undertaken utilizing a cross-sectional design. Background: Traumatic injuries and osteoarthritis are common musculoskeletal pathologies that can disrupt normal function of the knee joint. A frequent sequela of these pathologies is quadriceps femoris muscle weakness. Such weakness can contribute to disability and diminished levels of functional and recreational activity. Therefore, safe and accurate methods of measuring maximal strength are required to identify and quantify quadriceps strength deficits. One option proposed in the literature is the use of 1-RM prediction equations which estimate 1-RM performance from the number of repetitions completed with sub-maximal loads. These equations have been investigated previously using healthy populations and subjects with calf muscle injuries. However, to date, no known study has investigated their accuracy in individuals with joint pathologies. Method: Machine-weight seated knee extension and seated leg press exercises were investigated in this study. Twenty subjects with knee injuries and 12 subjects with knee OA completed the testing procedures for the knee extension exercise. Nineteen subjects with knee injuries and 18 subjects with knee OA completed the testing procedures for the leg press exercise. All subjects attended the testing venue on three occasions. At the first visit a familiarization session was carried out. At the second and third visits each subject was randomly assigned to perform either actual or predicted 1-RM testing for both of the exercises. Twelve different prediction methods were used to estimate 1-RM performance from the results. The estimates of 1-RM strength were then compared to actual 1-RM performance to assess the level of conformity between these measures. Statistical procedures including Bland and Altman analyses, intraclass correlation coefficients, typical error and total error of measurement were used in the analyses of the results. In addition, paired t-tests were performed to determine whether actual 1-RM values were significantly different across the control and affected limbs and whether there were any significant differences in predictive accuracy for each equation across the control and affected limbs. Finally, the number of subjects with predicted 1-RM values within 5% or less of their actual 1-RM values was determined for each equation. Results: When the knee injury group performed the knee extension exercise, the Brown, Brzycki, Epley, Lander, Mayhew et al., Poliquin and Wathen prediction methods demonstrated the greatest levels of predictive accuracy. When two atypical subjects were identified and excluded from the analyses, the accuracy of these equations improved further. Following the removal of these two subjects, no significant differences in predictive accuracy were found for any of the equations across the affected and control limbs (p > 0.05). Typical errors and total errors were low for the more accurate prediction methods ranging from 2.4-2.8% and from 2.4-3.5%, respectively. Overall, the Poliquin table appeared to be the most accurate prediction method for this sample (affected limbs: bias 0.3 kg, 95% limits of agreement (LOA) -5.8 to 6.4 kg, typical error as a coefficient of variation (COV) 2.4%, total error of measurement (total error) 2.4%; control limbs: bias -1.3 kg, 95% LOA -9.0 to 6.3 kg, typical error as a COV 2.7%, total error 2.8%). When the knee OA group performed the knee extension exercise, the Brown, Brzycki, Epley, Lander, Mayhew et al., Poliquin and Wathen prediction methods demonstrated the greatest levels of predictive accuracy. No significant differences in predictive accuracy were found for any of the equations across the affected and control limbs (p > 0.05). When an atypical subject was identified and excluded from the analyses, the accuracy of the equations improved further. Typical errors as COVs and total errors for the more accurate prediction methods ranged from 2.5-2.7% and from 2.4-2.9%, respectively. Overall, the Poliquin table appeared to be the most accurate prediction method for this sample (affected limbs: bias 0.9 kg, 95% LOA -4.5 to 6.3 kg, typical error as a COV 2.5%, total error 2.5%; control limbs: bias -0.1 kg, 95% LOA -6.0 to 5.9 kg, typical error as a COV 2.5%, total error 2.4%). When the knee injury group performed the leg press, the Adams, Berger, Lombardi and O’Connor equations demonstrated the greatest levels of predictive accuracy. No significant differences in predictive accuracy were found for any of the equations across the affected and control limbs (p > 0.05). Typical errors as COVs and total errors for the more accurate equations ranged from 2.8-3.2% and from 2.9-3.3%, respectively. Overall, the Berger (affected limbs: bias -0.4 kg, 95% LOA -7.2 to 6.3 kg, typical error as a COV 3.2%, total error 3.2%; control limbs: bias 0.1 kg, 95% LOA -6.6 to 6.7 kg, typical error as a COV 3.1%, total error 3.0%) and O’Connor equations (affected limbs: bias -0.6 kg, 95% LOA-6.8 to 5.7 kg, typical error as a COV 2.9%, total error 3.0%; control limbs: bias -0.2 kg, 95% LOA -6.9 to 6.4 kg, typical error as a COV 2.9%, total error 2.9%) appeared to be the most accurate prediction methods for this sample. When the knee OA group performed the leg press, the Adams, Berger, KLW, Lombardi and O’Connor equations demonstrated the greatest levels of predictive accuracy. No significant differences in predictive accuracy were found for any of the equations across the affected and control limbs (p > 0.05). The typical errors as COVs and the total error values for the more accurate prediction methods were the highest observed in this study, ranging from 5.8-6.0% and from 5.7-6.2%, respectively. Overall, the Adams, Berger, KLW and O’Connor equations appeared to be the most accurate prediction methods for this sample. However, it is possible that the predicted leg press 1-RM values produced by the knee OA group might not have matched actual 1-RM values closely enough to be clinically acceptable for some purposes. Conclusion: The findings of the current study suggested that the Poliquin table produced the most accurate estimates of knee extension 1-RM performance for both the knee injury and knee OA groups. In contrast, the Berger and O’Connor equations produced the most accurate estimates of leg press 1-RM performance for the knee injury group, while the Adams, Berger, KLW and O’Connor equations produced the most accurate results for the knee OA group. However, the higher error values observed for the knee OA group suggested that predicted leg press 1-RM performance might not be accurate enough for some clinical purposes. Finally, it can be concluded that no single prediction equation was able to accurately estimate both knee extension and leg press 1-RM performance in subjects with knee injuries and knee OA.

The effect of a preseason conditioning program of balance and jump landing training exercises was studied to evaluate its influence on static and dynamic balance and the occurrence of ankle and knee injuries in Basketball. Fifty-eight female representative Basketball players (aged 9 – 17 years) were studied over one season. Twenty-nine of these players participated in a six week training program implemented during the preseason. Pre and post tests measured balance and injuries documented over one season. The experimental group’s static and dynamic balance improved significantly as measured by a stork stand test and a multiple single-leg hop-stabilisation test In a post hoc analysis of dynamic balance, participants in the 12 – 13 years experimental group performed significantly better on dynamic balance, whereas the 12 – 13 years control group performed poorest compared with all other age cohorts. The lower limb injury rate for the 29 experimental group participants was .78 injuries per 1 000 hours, while the control group sustained no lower limb injuries in the 2001 season, based on the injury definition utilised in the study. This finding was statistically significant although three of the four injuries sustained were contact injuries. The study findings indicate that appropriately defined balance training can be beneficial for improving balance ability in female Basketball players. Evidence was found in the study for the existence of a critical age when balance training should be introduced to maximise the benefit for young female adolescent Basketball players. / Master of Education (Hons)

The objective of this study was to investigate the accuracy of eleven prediction equations and one prediction table when estimating isoinertial knee extension and leg press one repetition maximum (1-RM) performance in subjects with knee injuries and knee osteoarthritis. Study Design: A descriptive quantitative research study was undertaken utilizing a cross-sectional design. Background: Traumatic injuries and osteoarthritis are common musculoskeletal pathologies that can disrupt normal function of the knee joint. A frequent sequela of these pathologies is quadriceps femoris muscle weakness. Such weakness can contribute to disability and diminished levels of functional and recreational activity. Therefore, safe and accurate methods of measuring maximal strength are required to identify and quantify quadriceps strength deficits. One option proposed in the literature is the use of 1-RM prediction equations which estimate 1-RM performance from the number of repetitions completed with sub-maximal loads. These equations have been investigated previously using healthy populations and subjects with calf muscle injuries. However, to date, no known study has investigated their accuracy in individuals with joint pathologies. Method: Machine-weight seated knee extension and seated leg press exercises were investigated in this study. Twenty subjects with knee injuries and 12 subjects with knee OA completed the testing procedures for the knee extension exercise. Nineteen subjects with knee injuries and 18 subjects with knee OA completed the testing procedures for the leg press exercise. All subjects attended the testing venue on three occasions. At the first visit a familiarization session was carried out. At the second and third visits each subject was randomly assigned to perform either actual or predicted 1-RM testing for both of the exercises. Twelve different prediction methods were used to estimate 1-RM performance from the results. The estimates of 1-RM strength were then compared to actual 1-RM performance to assess the level of conformity between these measures. Statistical procedures including Bland and Altman analyses, intraclass correlation coefficients, typical error and total error of measurement were used in the analyses of the results. In addition, paired t-tests were performed to determine whether actual 1-RM values were significantly different across the control and affected limbs and whether there were any significant differences in predictive accuracy for each equation across the control and affected limbs. Finally, the number of subjects with predicted 1-RM values within 5% or less of their actual 1-RM values was determined for each equation. Results: When the knee injury group performed the knee extension exercise, the Brown, Brzycki, Epley, Lander, Mayhew et al., Poliquin and Wathen prediction methods demonstrated the greatest levels of predictive accuracy. When two atypical subjects were identified and excluded from the analyses, the accuracy of these equations improved further. Following the removal of these two subjects, no significant differences in predictive accuracy were found for any of the equations across the affected and control limbs (p > 0.05). Typical errors and total errors were low for the more accurate prediction methods ranging from 2.4-2.8% and from 2.4-3.5%, respectively. Overall, the Poliquin table appeared to be the most accurate prediction method for this sample (affected limbs: bias 0.3 kg, 95% limits of agreement (LOA) -5.8 to 6.4 kg, typical error as a coefficient of variation (COV) 2.4%, total error of measurement (total error) 2.4%; control limbs: bias -1.3 kg, 95% LOA -9.0 to 6.3 kg, typical error as a COV 2.7%, total error 2.8%). When the knee OA group performed the knee extension exercise, the Brown, Brzycki, Epley, Lander, Mayhew et al., Poliquin and Wathen prediction methods demonstrated the greatest levels of predictive accuracy. No significant differences in predictive accuracy were found for any of the equations across the affected and control limbs (p > 0.05). When an atypical subject was identified and excluded from the analyses, the accuracy of the equations improved further. Typical errors as COVs and total errors for the more accurate prediction methods ranged from 2.5-2.7% and from 2.4-2.9%, respectively. Overall, the Poliquin table appeared to be the most accurate prediction method for this sample (affected limbs: bias 0.9 kg, 95% LOA -4.5 to 6.3 kg, typical error as a COV 2.5%, total error 2.5%; control limbs: bias -0.1 kg, 95% LOA -6.0 to 5.9 kg, typical error as a COV 2.5%, total error 2.4%). When the knee injury group performed the leg press, the Adams, Berger, Lombardi and O’Connor equations demonstrated the greatest levels of predictive accuracy. No significant differences in predictive accuracy were found for any of the equations across the affected and control limbs (p > 0.05). Typical errors as COVs and total errors for the more accurate equations ranged from 2.8-3.2% and from 2.9-3.3%, respectively. Overall, the Berger (affected limbs: bias -0.4 kg, 95% LOA -7.2 to 6.3 kg, typical error as a COV 3.2%, total error 3.2%; control limbs: bias 0.1 kg, 95% LOA -6.6 to 6.7 kg, typical error as a COV 3.1%, total error 3.0%) and O’Connor equations (affected limbs: bias -0.6 kg, 95% LOA-6.8 to 5.7 kg, typical error as a COV 2.9%, total error 3.0%; control limbs: bias -0.2 kg, 95% LOA -6.9 to 6.4 kg, typical error as a COV 2.9%, total error 2.9%) appeared to be the most accurate prediction methods for this sample. When the knee OA group performed the leg press, the Adams, Berger, KLW, Lombardi and O’Connor equations demonstrated the greatest levels of predictive accuracy. No significant differences in predictive accuracy were found for any of the equations across the affected and control limbs (p > 0.05). The typical errors as COVs and the total error values for the more accurate prediction methods were the highest observed in this study, ranging from 5.8-6.0% and from 5.7-6.2%, respectively. Overall, the Adams, Berger, KLW and O’Connor equations appeared to be the most accurate prediction methods for this sample. However, it is possible that the predicted leg press 1-RM values produced by the knee OA group might not have matched actual 1-RM values closely enough to be clinically acceptable for some purposes. Conclusion: The findings of the current study suggested that the Poliquin table produced the most accurate estimates of knee extension 1-RM performance for both the knee injury and knee OA groups. In contrast, the Berger and O’Connor equations produced the most accurate estimates of leg press 1-RM performance for the knee injury group, while the Adams, Berger, KLW and O’Connor equations produced the most accurate results for the knee OA group. However, the higher error values observed for the knee OA group suggested that predicted leg press 1-RM performance might not be accurate enough for some clinical purposes. Finally, it can be concluded that no single prediction equation was able to accurately estimate both knee extension and leg press 1-RM performance in subjects with knee injuries and knee OA.