Change of Knee Cartilage Components in Stroke Patients with Genu Recurvatum Analyzed by Zero TE MR Imaging

Abstract

-BACKGROUND: Genu recurvatum in stroke patient hemiplegia causes readily cumulative damage and degenerative changes of knee cartilage. It is important to detect early lesions of cartilage for appropriate treatment and rehabilitation.-PURPOSE: The purpose is to provide theoretical basis for early rehabilitation of hemiplegia patients. -STUDY TYPE: Cross-sectional study. -POPULATION: 39 Stroke patients with genu recurvatum and 9 healthy volunteers. -SEQUENCE: We used zero TE double echo imaging sequence. -ASSESSMENT: Analyze the water content in knee joint cartilage at 12 different sites of stroke patients with genu recurvatum using a method similar to porosity index. -STATISTICAL TESTS: Statistical analysis was performed using SPSS 17.0 statistical software. The mean ± standard deviation was used to represent the mean. The independent sample t test was used for all mean comparisons. When the data did not conform to the normal distribution or variance heterogeneity, the non-parametric test was used. P< 0.05 was considered statistically significant.-RESULTS: When compared hemiplegia limb vs. non-hemiplegia limb in patients, the ratio of deep/shallow free water content of the cartilages at the junction of the femur and anterior horn (1.16 vs. 1.06) and posterior horn (1.13 vs. 1.25) of lateral meniscus were significant differences (P<0.05). -DATA CONCLUSION: Conclusion is that Genu recurvatum in stroke patients with hemiplegia can cause changes in moisture content of knee cartilage, and the changes of knee cartilage are more obvious with the increase of genu recurvatum. The so-called "healthy limb" is no longer the real meaning of healthy limb, and should be considered simultaneously with the affected limb in the development of rehabilitation treatment plan.

Methods and Tools for Measurement of Genu Recurvatum in Patients with Stroke: A Systematic Review

“…[9,11] Different authors have provided different causes of Genu Recurvatum. [10,12] There are different views on causes but almost all the studies have mentioned that, irrespective of cause GR increases with weight bearing. [9,15] Though occurrence of GR is very common in patients with Stroke, there is limited evidence that provides detailed information about it.…”

“…Studies have shown that the peak amplitude of knee hyperextension (PKH) can range as high as 22 o in Stroke patients. [12] The biomechanical trend of the lower extremity is altered by long-term hyperextension of the knee, and because of the inadequacy of the load-bearing reaction in knee joint, there is leaning of body in forward direction as the stability of the standing phase is reduced. [13] Walking like this for an extended period of time, leads to knee discomfort and cartilage injury, these alterations generate an unequal distribution of internal stress in the knee join and cause cumulative damage and degenerative changes in knee cartilage.…”

“…[13] Walking like this for an extended period of time, leads to knee discomfort and cartilage injury, these alterations generate an unequal distribution of internal stress in the knee join and cause cumulative damage and degenerative changes in knee cartilage. [12] Genu recurvatum has also been found associated with proprioception deficits and a predisposition to knee ligament injury. It can alter weight bearing symmetry and gait in patients with stroke and can affect their functional recovery.…”