Background: Ipsilateral fractures of tibia and femur or’ “floating KNEE”, commonly occur as a result of high energy trauma. It is, therefore, associated with high of KNEE injuries. This articles looks at the prevalence of intra-articular KNEE injury in “floating KNEE” when the fractures are extra-articular, both in tibia and femur. Methods: During a 3.5 year period of time (March 2002-Oct 2005), 61, out of total of 76 cases of “floating KNEEs” that had extra-articular femur and tibia fractures, had no history of prior KNEE problems, and the fractures of both segments had been internally fixed were studied. Each KNEE was examined for any possible ligamentous injury, following rigid fixation of the fractures, under the same anesthesia. The findings were documented and the patients were later followed for any new findings or complaints up to nine months after the incident. Results: The mean age in these 61 cases (57 males, 4 females) was 29.3 (18.46). Lachman and Pivot tests were positive in 5 and Posterior Drawer test in 3 cases. Valgus instability in 9 and varus instability in 6 other cases were detected. After the 9-months follow-up, KNEE pain was the chief complaint in 19 patients, while the MRI study which was done in 16 cases was positive for meniscal damage in 13 patients. Conclusions: Concomitant KNEE insults are fairly common in “floating KNEE” injuries. A thorough KNEE examination, following fixation of “floating KNEE” while the patient is still under anesthesia is essential. Further evaluation during the course of fracture treatment for any KNEE complaint is also recommended.

Arthritis of the KNEE is a common problem: 2% of United States population older than 17 years of age and 40% of Americans over 65 years age have clinically relevant arthritis of the KNEE. Degenerative arthritis is a progressive disease in active patients. Over loading the articular cartilage is harmful for cartilage nutrition.Maintaining the KNEE in a position without motion, like casting, for a long time deteriorates cartilage. The reduction of body mass and avoiding stair climbing and descending is a fundamental concept in prevention and treatment of KNEE arthritis.Analgesics without anti-inflammatory properties such as acetaminophen, are the initial medications used to treat degenerative arthritis of the KNEE.Nonsteroidal anti-inflammatory medications are the most commonly used drugs for treatment of degenerative arthritis of the KNEE joint. Cox I anti-inflammatory medications are less expensive and more effective, but has more, hepatic, GI and renal side effects.Cox 2 anti-inflammatory medications are more expensive, less effective and have less side effects. Cost-effective, risk-benefit matters should be considered in prescribing these medications.Nutritional supplement such as glucosamine and chondroitin sulfate have not shown any effect on cartilage regeneration in long term studies.Acute episodes of degenerative arthritis of the KNEE with pain and effusion can be treated by aspiration and intra articular steroid injections. However corticosteroid injections can increase the risk of damage to articular cartilage, should not repeat more than three to four times a year. Comparing intra-articular Hyaloronan injections with corticosteroids were found to be slower, more expensive and higher risk of local inflammatory response and overall no superiority.Quadriceps exercise, hamstring stretching and weight reduction has value in the treatment for arthritis of the KNEE joint.KNEE braces like unloaded KNEE braces, elastic bandages provide a feeling of increased support and pain relief in patients. Shoe inserts like wedges decrease the forces on involved side and decrease the pain of patients.

Background: ACL ligament tear is a common injury of KNEE, especially during traumatic sporting events. Clinical tests that are used to diagnose ACL tears are mostly subjective and an inexperienced examiner may miss the diagnosis. The goal is to evaluated ACL tensile strength with regard to the amount of displacement after imposing a constant force. Materials and Methods: In this study, 26 cases with ACL tear (20 cases with complete tear and 6 cases with partial tear) and 76 normal controls were evaluated. Results: In patients with complete tears, the difference of displacement was more than 2 mm in 80% of cases with 89 N forces. CID (compliance index difference) was more than 0.5 mm in 90% of patients with complete tear and less than 0.5 mm in 82% of normal people. In patients with incomplete tear, the difference between the two KNEEs was more than 3 mm in 50% of cases with 89 N force and CID was more than 0.5 in 50% of cases. Conclusion: In normal people, curves took a relatively similar course but in patients with complete tear a change was observed in shape or amount of displacement of injured KNEE curve. In patients with incomplete tear, the curve belongs to a spectrum of curves of patients with normal to completely tom ligament.

Background: KNEE dislocations are uncommon (<0. 5% of all dislocations); however, they may result in catastrophic outcomes secondary to their high‑ energy nature and neurovascular injuries. Objectives: The objective of this study was to evaluate the clinical outcome of KNEE dislocation management. Subjects and Methods: A total of 20 consecutive adult patients with KNEE dislocation were enrolled in this cross‑ sectional study between 2011 and 2014. A single KNEE surgeon examined all the patients for KNEE instability for subjective evaluation of KNEE function using the Lysholm KNEE Questionnaire, KNEE Society Score (KSS), and Short Form‑ 36 (SF‑ 36). Results: The average Lysholm KNEE Scores and KSS were 68 (range: 18– 100) and 65 (range: 15– 97), respectively. All domains of SF‑ 36 among the studied patients were lower than that of the normal population. We could not find any correlation between age, body mass index, and interval between initial trauma and operation with outcome variables (Lysholm KNEE Score, KSS, and SF‑ 36 Physical Component Score, and SF‑ 36 Mental Component Score). Conclusions: The KNEE function after proper management of dislocation is reasonable, but prolonged course of management and multiple operations may decrease the patients’ quality of life.

Background & Aims: KNEE instability has become a debilitating problem among patients with KNEE osteoarthritis which may have many causes and complications. In this study, researchers evaluated the KNEE Flexion Contracture (KFC), function, quality of life, and balance and its relationship with KNEE instability (KI). In this study, the researchers investigated the function, quality of life, KNEE Flexion Contracture (KFC), and balance of the patients with KNEE osteoarthritis and its relationship with KNEE joint instability. Materials & Methods: In this double-blinded case-control study, 60 females with KNEE osteoarthritis participated and divided into two groups (30 in each) of osteoarthritis (mean age: 52. 80) and without KNEE instability (mean age: 54. 43) based on the KNEE instability index scores. Pain was evaluated with a visual analog scale(VAS), KFC with a universal goniometer, performance with WOMAC, and physical performance of the patients with the time up and go (TUG) and and time of up and down stairs tests, quality of life with the SF36 questionnaire, and balance with the Single Leg Lift test. Data were analyzed by SPSS version 22 software and independent sample t-test at a significance level of 0. 05. Results: The mean scores of KFC showed significantly difference between the two groups with and without KI (right foot: P=0. 0001, left foot: P=0. 001). Also, the mean scores of pain, fall times, WOMAC, physical function, quality of life, and One-legged balance were significantly different between groups (P=0. 0001 in all variables). Regarding the time of up and down stairs, there was no significant difference between the two groups (P=0. 057), although the difference between them was significant in the descent time (P=0. 0001). Conclusion: According to the findings of this study, it was found that there was a significant difference between the two groups of osteoarthritis with and without KI in pain, function, KFC, quality of life, and One-legged balance, which paying attention to the causes and side effects of this problem makes it more clear.