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Diagnostics
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Management of Knee Problems Based on the Proper Diagnostic Procedures
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Management of Knee Problems Based on the Proper Diagnostic Procedures

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (31 July 2022) | Viewed by 12551

Special Issue Editor

Prof. Dr. Yong-seuk Lee

E-Mail Website
Guest Editor
Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, Korea
Interests: osteoarthritis; malalignment; ligament injury; meniscal injury; cartilage injury

Special Issue Information

Dear Colleagues,

The wide array of knee problems, including meniscal injury, ligament injury, malalignment, osteoarthritis, and fracture, produce varying degrees of challenges to surgeons. Management of these problems should be based on proper diagnosis. Although the multidisciplinary team approach is essential for patients with such problems, orthopedic knee surgeons should be attuned to proper diagnosis and treatment for each problem.

For this Special Issue titled “Management of Knee Problems Based on the Proper Diagnostic Procedures”, we would like to invite authors to submit their original papers or review articles on specific and novel approaches for the diagnosis and management of knee problems. These can include all territories such as injury mechanism, diagnosis, conservative treatment, and surgical treatment. However, we are particularly interested in works based on proper diagnosis.

Prof. Dr. Yong-seuk Lee
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (5 papers)

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Research

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9 pages, 896 KiB  
Article
Predictive Variables for Interventional Angiography among Patients with Knee Hemarthrosis
by Sang-Hun Ko, Kwang-Hwan Jung, Jae-Ryong Cha and Ki-Bong Park
Diagnostics 2022, 12(4), 976; https://doi.org/10.3390/diagnostics12040976 - 13 Apr 2022
Viewed by 1489
Abstract
Studies regarding the variables that could predict the success of conservative treatment for knee hemarthrosis are lacking. This retrospective study evaluated the laboratory variables of patients who had unsatisfactory results from conservative treatment for knee hemarthrosis. Twenty-nine patients conservatively treated for knee hemarthrosis [...] Read more.
Studies regarding the variables that could predict the success of conservative treatment for knee hemarthrosis are lacking. This retrospective study evaluated the laboratory variables of patients who had unsatisfactory results from conservative treatment for knee hemarthrosis. Twenty-nine patients conservatively treated for knee hemarthrosis were included and divided into two groups: group A comprised 14 patients who underwent interventional angiography and selective embolization due to failed conservative treatment, and group B comprised 15 patients with successful results after conservative treatment. The results of the serological and synovial fluid tests were evaluated. The mean number of synovial red blood cells (RBCs) was 1,905,857 cells/µL and 7730 cells/µL in groups A and B, respectively (p = 0.01), while the mean number of RBCs per high-power field (HPF) was 68.9 and 3.2, respectively (p < 0.01). Patients who underwent interventional angiography and selective embolization after failed conservative treatment for knee hemarthrosis had higher synovial RBC counts and RBC counts per HPF than those with successful outcomes after conservative treatment. It is necessary to carefully interpret the results of the synovial fluid analysis in patients with knee hemarthrosis; if the synovial fluid analysis shows a synovial RBC count greater than 81,500 and RBC count per HPF greater than 16.3, we recommend immediate interventional angiography rather than continuing conservative treatment. Full article
(This article belongs to the Special Issue Management of Knee Problems Based on the Proper Diagnostic Procedures)
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11 pages, 2408 KiB  
Article
Preoperative Magnetic Resonance Imaging as a Diagnostic Aid for Hypermobile Lateral Meniscus
by Seikai Toyooka, Naoya Shimazaki, Hironari Masuda, Noriaki Arai, Wataru Miyamoto, Shuji Ando, Hirotaka Kawano and Takumi Nakagawa
Diagnostics 2021, 11(12), 2276; https://doi.org/10.3390/diagnostics11122276 - 05 Dec 2021
Cited by 4 | Viewed by 2209
Abstract
Background: Hypermobile lateral meniscus is difficult to diagnose with imaging due to its absence of tears or anomalies. We aimed to clarify the accuracy of the preoperative diagnosis using magnetic resonance imaging (MRI). Methods: The preoperative MRI status of the posterosuperior popliteomeniscal fascicle [...] Read more.
Background: Hypermobile lateral meniscus is difficult to diagnose with imaging due to its absence of tears or anomalies. We aimed to clarify the accuracy of the preoperative diagnosis using magnetic resonance imaging (MRI). Methods: The preoperative MRI status of the posterosuperior popliteomeniscal fascicle (sPMF), anteroinferior popliteomeniscal fascicle (iPMF), and popliteal hiatus were examined retrospectively on sagittal images in the hypermobile lateral meniscus group (n = 22) and an age- and gender-matched control group (n = 44). These statuses were evaluated by a logistic regression analysis to assess their degree of diagnostic accuracy. Results: The area under the curve (AUC) of the sPMF, iPMF, popliteal hiatus, and all three criteria combined was 0.66, 0.74, 0.64, and 0.77, respectively (low, moderate, low, and moderate accuracy, respectively). The odds ratios of the most severe type 3 forms of the sPMF, iPMF, and popliteal hiatus for hypermobile lateral meniscus were significantly high (5.50, 12.20, and 5.00, respectively). Although the diagnostic accuracy was not high enough, the significantly higher odds ratio for type 3 may indicate a hypermobile lateral meniscus. Conclusion: a definitive diagnosis of hypermobile lateral meniscus is difficult with MRI findings alone; however, MRI evaluations of the iPMF, sPMF, and the widening of popliteal hiatus can be used as an adjunct to diagnosis. Full article
(This article belongs to the Special Issue Management of Knee Problems Based on the Proper Diagnostic Procedures)
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10 pages, 2095 KiB  
Article
Magnetic Resonance Imaging of Patellofemoral Morphometry Reveals Age and Gender Variations in the Knees of Children and Adolescents
by Wonchul Choi, Sang-June Lee, Jongbeom Oh, Hongseok Baek, Jinhyuk Yang, Jaeyeon Shin, Bosung Jung and Soonchul Lee
Diagnostics 2021, 11(11), 1985; https://doi.org/10.3390/diagnostics11111985 - 26 Oct 2021
Cited by 7 | Viewed by 1596
Abstract
Background: The morphology and alignment of the patellofemoral joint are crucial risk factors for patellar instability, and the incidence of acute primary patellar dislocation is the highest in women in their second decade of life. The purpose of the study was to analyze [...] Read more.
Background: The morphology and alignment of the patellofemoral joint are crucial risk factors for patellar instability, and the incidence of acute primary patellar dislocation is the highest in women in their second decade of life. The purpose of the study was to analyze age and gender variations of the patellofemoral joint using magnetic resonance imaging (MRI). Methods: A total of 852 patients aged between 4 and 18 years with a history of knee MRI examinations were screened for eligibility and 663 patients (470 males, 193 females) were included. Patients were divided into groups according to age and sex. The age group was divided into five groups (Group 1, 4–6 years; Group 2, 7–9 years; Group 3, 10–12 years; Group 4, 13–15 years; and Group 5, 16–18 years). Three orthopaedic surgeons measured MRI parameters reflecting the patellofemoral morphology (sulcus angle, lateral trochlear inclination, trochlear facet symmetry, and femoral depth) and alignment (tibial tuberosity–trochlear groove distance, percent sulcus location, and percent tibia tuberosity location). Results: Parameters including tibial tuberosity–trochlear groove distance, sulcus angle, percent tibial tuberosity location, trochlear facet symmetry, and femoral depth showed significant differences between the age groups (p < 0.05). The sulcus angle decreased fin Group 2, and the femoral depth showed an increasing trend with aging in male patients. However, the sulcus angle in females decreased first and then increased in Group 3 as the inflection point. The femoral depth showed an opposite pattern. Conclusions: Patellofemoral morphometry showed age and gender variation. Notably, the sulcus angle and femoral depth were significantly different between males and females and changed according to the development. These findings may reflect the sex difference and peak incidence of the patellar instability risk. Understanding the morphological changes and differences of the patellofemoral joint may facilitate the diagnosis of patellofemoral pathologies. Full article
(This article belongs to the Special Issue Management of Knee Problems Based on the Proper Diagnostic Procedures)
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Review

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13 pages, 707 KiB  
Review
Diagnosis of Central Sensitization and Its Effects on Postoperative Outcomes following Total Knee Arthroplasty: A Systematic Review and Meta-Analysis
by Man Soo Kim, Jae Jung Kim, Ki Ho Kang, Min Jun Kim and Yong In
Diagnostics 2022, 12(5), 1248; https://doi.org/10.3390/diagnostics12051248 - 17 May 2022
Cited by 11 | Viewed by 2184
Abstract
Central sensitization (CS) has been extensively researched as a cause of persistent pain after total knee arthroplasty (TKA). This systematic review study sought to investigate the diagnosis of CS in patients who underwent TKA for knee osteoarthritis (OA) and the effect of CS [...] Read more.
Central sensitization (CS) has been extensively researched as a cause of persistent pain after total knee arthroplasty (TKA). This systematic review study sought to investigate the diagnosis of CS in patients who underwent TKA for knee osteoarthritis (OA) and the effect of CS on clinical outcomes after TKA. Three comprehensive databases, including MEDLINE, EMBASE, and the Cochrane Library, were searched for studies that evaluated the outcomes of TKA in knee OA patients with CS. Data extraction, risk of bias assessment, and (where appropriate) meta-analysis were performed. The standardized mean difference (SMD) with a 95% confidence interval was used to assess the different scales of pain. A total of eight studies were selected, including two retrospective studies and five prospective observational studies. One study used additional randomized controlled trial data. Five studies were finally included in the meta-analysis. All studies had a minimum follow-up period of 3 months. The Central Sensitization Inventory (CSI), whole-body pain diagram, and quantitative sensory testing (QST) were used for measuring CS. The pooled analysis showed that patients with CS had more severe postoperative pain after TKA (SMD, 0.65; 95% CI, 0.40–0.90; p < 0.01) with moderate heterogeneity (I2 = 60%). In patients who underwent TKA with knee OA, CSI is most often used for the diagnosis of CS, and the QST and whole-body pain diagram are also used. CS is closely associated with more severe and persistent pain after TKA. Full article
(This article belongs to the Special Issue Management of Knee Problems Based on the Proper Diagnostic Procedures)
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21 pages, 2072 KiB  
Review
Knee Injury Detection Using Deep Learning on MRI Studies: A Systematic Review
by Athanasios Siouras, Serafeim Moustakidis, Archontis Giannakidis, Georgios Chalatsis, Ioannis Liampas, Marianna Vlychou, Michael Hantes, Sotiris Tasoulis and Dimitrios Tsaopoulos
Diagnostics 2022, 12(2), 537; https://doi.org/10.3390/diagnostics12020537 - 19 Feb 2022
Cited by 18 | Viewed by 4340
Abstract
The improved treatment of knee injuries critically relies on having an accurate and cost-effective detection. In recent years, deep-learning-based approaches have monopolized knee injury detection in MRI studies. The aim of this paper is to present the findings of a systematic literature review [...] Read more.
The improved treatment of knee injuries critically relies on having an accurate and cost-effective detection. In recent years, deep-learning-based approaches have monopolized knee injury detection in MRI studies. The aim of this paper is to present the findings of a systematic literature review of knee (anterior cruciate ligament, meniscus, and cartilage) injury detection papers using deep learning. The systematic review was carried out following the PRISMA guidelines on several databases, including PubMed, Cochrane Library, EMBASE, and Google Scholar. Appropriate metrics were chosen to interpret the results. The prediction accuracy of the deep-learning models for the identification of knee injuries ranged from 72.5–100%. Deep learning has the potential to act at par with human-level performance in decision-making tasks related to the MRI-based diagnosis of knee injuries. The limitations of the present deep-learning approaches include data imbalance, model generalizability across different centers, verification bias, lack of related classification studies with more than two classes, and ground-truth subjectivity. There are several possible avenues of further exploration of deep learning for improving MRI-based knee injury diagnosis. Explainability and lightweightness of the deployed deep-learning systems are expected to become crucial enablers for their widespread use in clinical practice. Full article
(This article belongs to the Special Issue Management of Knee Problems Based on the Proper Diagnostic Procedures)
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