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Latest & greatest articles for knee osteoarthritis
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-Lawrence grade (safety) in either group.Duloxetine reduced pain and improved function in patients with kneeosteoarthritis, without causing X-ray abnormalities or altered kneejoint mobility. Reduced pain was associated with improved HRQoL. Adverse events were consistent with duloxetine's known safety profile. (...) A randomized, double-blind, placebo-controlled Phase III trial of duloxetine in Japanese patients with knee pain due to osteoarthritis To examine the efficacy and safety of duloxetine in Japanese patients with knee pain due to osteoarthritis.Patients were randomized to receive duloxetine 60 mg/day or placebo for 14 weeks in a double-blind manner (ClinicalTrials.gov Identifier: NCT02248480). The primary efficacy endpoint was mean change in Brief Pain Inventory pain severity (BPI-Severity
Fluoroscopic Guided Radiofrequency of Genicular Nerves for Pain Alleviation in Chronic KneeOsteoarthritis: A Single-Blind Randomized Controlled Trial Nowadays, pain and disability due to chronic kneearthritis is a very common problem in middle aged people. A lot of modalities for management are available, including conservative analgesics and up to surgical interventions. Radiofrequency ablation of genicular nerves is assumed to be an effective less invasive and safe pain alleviation (...) pretreatment values with the values during the whole follow-up period with regard to the VAS and total WOMAC index in both groups.No diagnostic block was done prior to radiofrequency. We recommend the use of such a technique on a larger number of OA patients, with a longer follow-up period.RF can ameliorate pain and disability in chronic kneeosteoarthritis in a safe and effective manner.Chronic pain, radiofrequency (RF), kneeosteoarthritis.
Effectiveness of aquatic exercises compared to patient-education on health status in individuals with kneeosteoarthritis: a randomized controlled trial To compare the effectiveness of aquatic exercises with patient-education in individuals with knee osteoarthritis.Randomized controlled trial with blinded assessor and intention-to-treat analysis.Aquatic Physiotherapy Centre and Primary Health Care Unit.A total of 60 patients, aged 68.3 (SD = 4.8) with clinical symptoms and radiographic grading (...) (Kellgren-Lawrence 1-4) of kneeosteoarthritis were included.An eight-week treatment protocol of aquatic exercise ( n = 31) (16 individual sessions, twice a week) and an educational program (group sessions, once a week) ( n = 29).Before, after eight-week intervention, and a three-month follow-up with results for the following outcome measures: pain, function, quality of life, functional mobility, and depression.At the end of treatment, the WOMAC (Western Ontario and McMaster Universities Osteoarthritis
Exercise interventions and patient beliefs for people with hip, knee or hip and kneeosteoarthritis: a mixed methods review. Chronic peripheral joint pain due to osteoarthritis (OA) is extremely prevalent and a major cause of physical dysfunction and psychosocial distress. Exercise is recommended to reduce joint pain and improve physical function, but the effect of exercise on psychosocial function (health beliefs, depression, anxiety and quality of life) in this population is unknown.To (...) of land- or water-based exercise programmes compared with a control group consisting of no treatment or non-exercise intervention (such as medication, patient education) that measured either pain or function and at least one psychosocial outcome (self-efficacy, depression, anxiety, quality of life). Participants had to be aged 45 years or older, with a clinical diagnosis of OA (as defined by the study) or self-reported chronic hip or knee (or both) pain (defined as more than six months' duration
Osteoarthritis – A Randomized Clinical Trial April 6, 2018 6 min read By Rebecca Lazarus, MD Peer Reviewed Why does this matter? Osteoarthritis (OA) is a leading cause of disability in the United States and is the most common type of arthritis. The pathogenesis involves the progressive destruction of articular cartilage in a joint, which is accompanied by new bone formation and synovial proliferation. On a cellular level, this process is believed to involve mononuclear cells and pro-inflammatory mediators (...) age 45 years or older, and met kneeOA criteria as defined by the American College of Rheumatology. These criteria are based on a standardized questionnaire about knee pain, as well as tibiofemoral OA evident on radiographs. Eligibility criteria further included ultrasonographic evidence of effusion and synovitis. Participants were excluded if they had other disorders affecting the study joint, including systemic inflammatory jointdisease, prior sepsis, or osteonecrosis; chronic or recent use
Effect of Opioid vs Nonopioid Medications on Pain-Related Function in Patients With Chronic Back Pain or Hip or KneeOsteoarthritis Pain: The SPACE Randomized Clinical Trial. Limited evidence is available regarding long-term outcomes of opioids compared with nonopioid medications for chronic pain.To compare opioid vs nonopioid medications over 12 months on pain-related function, pain intensity, and adverse effects.Pragmatic, 12-month, randomized trial with masked outcome assessment. Patients (...) were recruited from Veterans Affairs primary care clinics from June 2013 through December 2015; follow-up was completed December 2016. Eligible patients had moderate to severe chronic back pain or hip or kneeosteoarthritis pain despite analgesic use. Of 265 patients enrolled, 25 withdrew prior to randomization and 240 were randomized.Both interventions (opioid and nonopioid medication therapy) followed a treat-to-target strategy aiming for improved pain and function. Each intervention had its own
Ultrasound-Guided Genicular Nerve Block for KneeOsteoarthritis: A Double-Blind, Randomized Controlled Trial of Local Anesthetic Alone or in Combination with Corticosteroid Recently, several studies suggested that radiofrequency (RF) ablation of the genicular nerves is a safe and effective therapeutic procedure for intractable pain associated with chronic kneeosteoarthritis (OA). Diagnostic genicular nerve block (GNB) with local anesthetic has been generally conducted before making decisions (...) regarding RF ablation. Although GNB has been recently performed together with corticosteroid, the analgesic effects of corticosteroids for treating chronic pain remain controversial.The current study aims to assess the effects of combining corticosteroids and local anesthesia during ultrasound-guided GNB in patients with chronic knee OA.A randomized, double-blinded institutional study.This study took place at Asan Medical Center in Seoul, Korea.Forty-eight patients with chronic kneeOA were randomly
Intra-articular ozone or hyaluronic acid injection: Which one is superior in patients with kneeosteoarthritis? A 6-month randomized clinical trial Kneeosteoarthritis (OA) is a common disease, imposing a great burden through pain and decreased function. There are many therapeutic modalities including non-pharmacologic choices and oral, topical, and intra-articular medications. New studies have shown promising results for ozone application in kneeOA. Our aim was to compare the effects of ozone (...) therapy versus hyaluronic acid (HA) intra-articular injection in kneeOA patients.In this randomized clinical trial, a total of 174 patients with more than 3 months of chronic pain or swelling in the kneejoints along with consistent imaging findings were enrolled and randomly allocated into two groups of HA and ozone, which were planned to undergo 3 weekly injections of HA (Hyalgan®) and 10 mL of a 30 μg/mL ozone solution, respectively. Patients were evaluated at baseline and 6 months after the last
Growth Factors Levels Determine Efficacy of Platelets Rich Plasma Injection in KneeOsteoarthritis: A Randomized Double Blind Noninferiority Trial Compared With Viscosupplementation To assess the noninferiority of a single platelet-rich plasma (PRP) injection compared with hyaluronic acid (HA), to alleviate pain and enhance functional capacity in kneeosteoarthritis, and identify biological characteristics of PRP that may affect their efficacy.Fifty-four patients with symptomatic knee (...) osteoarthritis received a single injection of either PRP (26 patients) or HA (28 patients). They were assessed at baseline and at 1, 3, and 6 months. The primary endpoint was the change in Western Ontario and McMaster Universities Arthritis Index (WOMAC) score at 3 months, and secondary endpoints were responders' rate (improvement of at least 5 points or 40% of WOMAC total score at 3 months) of pain evaluation and patient's subjective satisfaction. Cell counts and the contents of vascular endothelial growth
Mucoid degeneration of the cruciate ligaments in osteoarthritis under primary total knee arthroplasty Mucoid degeneration of the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) with osteoarthritis is rarely reported. We experienced two knee osteoarthritic patients who had symptomatic mucoid degeneration of their ACL, and their PCL was also diagnosed as mucoid degeneration in histological evaluation. Preoperative radiological evaluation could not reveal precisely whether (...) the degeneration had extended to the PCL. We obtained good clinical results treating them with posterior-stabilized (PS) total knee arthroplasty (TKA) sacrificing both ligaments. In cases of osteoarthritis with mucoid degenerated ACL, PS TKA should be considered, sacrificing both cruciate ligaments, because mucoid degeneration might expand both cruciate ligaments.
Monoclonal Antibodies for Osteoarthritis of the Hip or Knee Monoclonal Antibodies for Osteoarthritis of the Hip or Knee | CADTH.ca CADTH Document Viewer Monoclonal Antibodies for Osteoarthritis of the Hip or Knee Table of Contents Search this document Monoclonal Antibodies for Osteoarthritis of the Hip or Knee July 2018 Summary Osteoarthritis (OA) is a common and chronic disease of the synovial joints caused by biomechanical factors, inflammation, and joint tissue damage. The current (...) therapeutic options include non-pharmacologic therapy and topical analgesics, followed by oral analgesics and injectable agents, followed by surgery for end-stage disease. OA typically affects the knees, hips, hands, spine, and feet. Treatment with anti-nerve growth factors monoclonal antibodies (anti-NGFs) may improve joint pain and physical function, as nerve growth factor is associated with chronic pain conditions, and is elevated in the joints of patients with osteoarthritis. Within the indication
Exercise, Manual Therapy, and Booster Sessions in KneeOsteoarthritis: Cost-Effectiveness Analysis From a Multicenter Randomized Controlled Trial 29088393 2019 04 19 2019 04 19 1538-6724 98 1 2018 01 01 Physical therapy Phys Ther Exercise, Manual Therapy, and Booster Sessions in KneeOsteoarthritis: Cost-Effectiveness Analysis From a Multicenter Randomized Controlled Trial. 16-27 10.1093/ptj/pzx104 Bove Allyn M AM Department of Physical Therapy, School of Health and Rehabilitation Sciences (...) States P30 AG024827 AG NIA NIH HHS United States Journal Article Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S. United States Phys Ther 0022623 0031-9023 AIM IM Aged Combined Modality Therapy Cost-Benefit Analysis Exercise Therapy economics methods Female Follow-Up Studies Health Care Costs statistics & numerical data Humans Male Middle Aged Musculoskeletal Manipulations economics methods Osteoarthritis, Knee economics
Cost-Utility Analysis of High Molecular Weight Hyaluronic Acid for KneeOsteoarthritis in Everyday Clinical Care in Patients at a Working Age: An Economic Evaluation of a Randomized Clinical Trial Kneeosteoarthritis (OA) is associated with high medical costs and especially with high productivity costs, in particular in patients in their working years. High molecular weight (HMW) hyaluronic acid (HA) is an alternative treatment for nonsteroidal antiinflammatory drugs, which are known (...) for their serious side-effects. The cost-utility of intraarticular HMW-HA treatment in these patients is unknown, however, and was assessed in this study.Secondary care patients ages 18-65 years with kneeOA were randomized to usual care plus HMW-HA (intervention group) or to usual care only (control group). A cost-utility analysis over 52 weeks from the societal and health care perspective was performed. Uncertainty for costs, effects, and cost-utility ratio was analyzed by nonparametric bootstrapping
Internet Cognitive-Behavioral Therapy for Depression in Older Adults With KneeOsteoarthritis: A Randomized Controlled Trial To determine the efficacy of an internet-based cognitive-behavioral therapy (iCBT) program for depression in older adults with osteoarthritis (OA) of the knee and comorbid major depressive disorder (MDD).We conducted a randomized controlled trial in 69 adults (ages ≥50 years) meeting criteria for MDD and OA of the knee with 1-week postintervention (week 11) and 3-month (...) followup (week 24) end points. Patients were allocated to either a 10-week iCBT program for depression added to treatment as usual (TAU) or to a TAU control group. Primary outcomes were depression symptoms (9-Item Patient Health Questionnaire [PHQ-9]) and psychological distress (Kessler-10 [K-10]). Secondary outcomes included arthritis self-efficacy (Arthritis Self-Efficacy Scale [ASES]), OA pain, stiffness, physical function (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC
Prospective, Multicenter, Randomized, Crossover Clinical Trial Comparing the Safety and Effectiveness of Cooled Radiofrequency Ablation With Corticosteroid Injection in the Management of Knee Pain From OsteoarthritisOsteoarthritis (OA) of the knee affects the aging population and has an associated influence on the health care system. Rigorous studies evaluating radiofrequency ablation for OA-related knee pain are lacking. This study compared long-term clinical safety and effectiveness (...) of cooled radiofrequency ablation (CRFA) with intra-articular steroid (IAS) injection in managing OA-related knee pain.This is a prospective, multicenter, randomized trial with 151 subjects with chronic (≥6 months) knee pain that was unresponsive to conservative modalities. Knee pain (Numeric Rating Scale [NRS]), Oxford Knee Score, overall treatment effect (Global Perceived Effect), analgesic drug use, and adverse events were compared between CRFA and IAS cohorts at 1, 3, and 6 months after
Preoperative Pain Neuroscience Education Combined With KneeJoint Mobilization for KneeOsteoarthritis: A Randomized Controlled Trial This study aimed to first compare the effects of a preoperative treatment combining pain neuroscience education (PNE) with kneejoint mobilization versus biomedical education with kneejoint mobilization on central sensitization (CS) in patients with kneeosteoarthritis, both before and after surgery. Second, we wanted to compare the effects of both interventions (...) on knee pain, disability, and psychosocial variables.Forty-four patients with kneeosteoarthritis were allocated to receive 4 sessions of either PNE combined with kneejoint mobilization or biomedical education with kneejoint mobilization before surgery. All participants completed self-administered questionnaires and quantitative sensory testing was performed at baseline, after treatment and at a 1 month follow-up (all before surgery), and at 3 months after surgery.Significant and clinically relevant
Comparative effectiveness of intra-articular prolotherapy versus peri-articular prolotherapy on pain reduction and improving function in patients with kneeosteoarthritis: A randomized clinical trial Osteoarthritis is a common degenerativedisease. Prolotherapy is an alternative therapy used in multiple musculoskeletal disorders.To compare the effectiveness of intra-articular dextrose injection versus peri-articular prolotherapy in patients with kneeosteoarthritis (KOA).Fifty-two adults (...) with painful primary kneeosteoarthritis for at least three months were randomized to intra- and peri-articular injection groups. Prolotherapy was done twice with two week intervals. The outcome measures included the Oxford Knee Scale (OKS), Western Ontario McMaster University Osteoarthritis Index (WOMAC), and Visual Analogue Scale (VAS), which were obtained from patients before the first injection at the base line and after the second injection at the fourth and eighth weeks.There were no statistically
Clinical Outcomes of KneeOsteoarthritis Treated With an Autologous Protein Solution Injection: A 1-Year Pilot Double-Blinded Randomized Controlled Trial Osteoarthritis (OA) is a debilitating disease resulting in substantial pain and functional limitations. A novel blood derivative has been developed to concentrate both growth factors and antagonists of inflammatory cytokines, with promising preliminary findings in terms of safety profile and clinical improvement.To investigate if one intra (...) -articular injection of autologous protein solution (APS) can reduce pain and improve function in patients affected by kneeOA in a multicenter, randomized, double-blind, saline-controlled study.Randomized controlled trial; Level of evidence, 2.Forty-six patients with unilateral kneeOA (Kellgren-Lawrence 2 or 3) were randomized into the APS group (n = 31), which received a single ultrasound-guided injection of APS, and the saline (control) group (n = 15), which received a single saline injection
The effect of self-administered superficial local hot and cold application methods on pain, functional status and quality of life in primary kneeosteoarthritis patients To investigate the effect of the self-administered superficial local hot and cold applications on pain, and the functional status and the quality of life in primary kneeosteoarthritis patients.Superficial local hot and cold application is used as a nonpharmacological method for the treatment of kneeosteoarthritis. However (...) , various guidelines for the management of kneeosteoarthritis have conflicting recommendation for hot and cold therapy.A randomised clinical trial design.The sample consisted of patients (n = 96) who were diagnosed with primary kneeosteoarthritis. During the application stage, patients were designated to the hot and cold application groups and administered hot and cold application twice a day for 3 weeks together with standard osteoarthritis treatment. The control group only used standard