This study aimed to investigate the effect of high tibial osteotomy (HTO) on medial meniscus extrusion (MME) and the association between the changes in limb alignment and MME under weight-bearing (WB) conditions after HTO. We included 17 patients with knee osteoarthritis (OA) who underwent HTO. MME was evaluated using ultrasonography in supine and unipedal standing positions. Knee alignment was evaluated radiographically using WB, whole-leg radiographs with the hip-knee-ankle angle (HKAA), percentage of the mechanical axis (%MA), medial proximal tibial angle (MPTA), and joint line convergence angle (JLCA). All measurements were performed serially at four time points: preoperative and 3, 6, and 12 months postoperative. Clinical outcomes were assessed by knee injury and osteoarthrosis outcome score (KOOS) and visual analogue scale (VAS) value for pain. Mean MME in the WB position was significantly greater than that in the supine position in the preoperative condition; however, MME in both supine and WB positions was significantly lowered postoperatively. The ΔMME, difference of MME between supine and WB positions, was significantly lowered postoperatively and maintained for up to 1 year. MME change in the WB position between preop and postoperative conditions was significantly correlated with change in HKAA and %MA at 1 year postoperative. KOOS and VAS score were significantly improved after HTO. HTO correcting varus alignment can decrease MME in WB position and minimise the change in MME between supine and WB positions. The changes in MME after HTO were correlated with changes in the mechanical alignments.

A medial meniscus extrusion (MME) gradually expands during activities of daily living according to the mechanical stress on the medial compartment of the knee. Increase in MME occurs during the stance phase of the gait cycle, which is key for its expand. The knee adduction moment (KAM) represents the mechanical stress on the medial compartment; however, the relationship between the increase in MME and KAM is still unknown. Therefore, the present study aimed to investigate the relationship between MME during gait and KAM. Twenty-one patients with medial knee osteoarthritis and 11 healthy middle-aged adults were recruited. Three-dimensional motion analysis system and ultrasonography were used to measure the KAM and MME in the stance phase. The increase in MME was identified as the difference in MME between the maximum and minimum (ΔMME). Patients with knee osteoarthritis performed two conditions as normal and toe-out gait. The difference in KAM and ΔMME between conditions were evaluated. ΔMME was correlated with the KAM second peak in normal gait of knee osteoarthritis patients (r = 0.51, p < 0.05). Toe-out gait reduced the KAM second peak and the ΔMME, and these reductions were correlated (r = 0.50, p < 0.05). Toe-out gait immediately inhibited the expansion of MME associated with the KAM second peak.

Objective To assess the relationships between phase angle and muscle mass, strength, and physical function in patients with heart failure.Methods This study used a cross-sectional design. The analysis included 51 patients with heart failure. The Short Physical Performance Battery, one-leg standing time, handgrip strength, phase angle, and skeletal muscle index were measured. To identify explanatory variables of phase angle, hierarchical multiple regression analysis was performed.Results Handgrip strength was found to be an explanatory variable of phase angle independent of age, sex, and body mass index. This model was able to explain 30.4% of the model variance for phase angle.Conclusion In patients with heart failure, improving muscle strength rather than muscle mass or physical function might be more important for improving phase angle. Handgrip strength is an important outcome for improving prognosis in patients with heart failure.