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Latest & greatest articles for knee osteoarthritis
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Treatment of kneeosteoarthritis: platelet-derived growth factors vs. hyaluronic acid. A randomized controlled trial Aim of this trial was to compare efficacy of activated platelet-rich plasma against hyaluronic acid as intra-articular injections to people with osteoarthritis of the knee.Phase-2 randomized controlled trial, with blind patients and outcome assessors.Outpatient rehabilitation service; years 2011-2013.Patients with kneeosteoarthritis grades 2-3 at magnetic resonance imaging (MRI (...) Universities Osteoarthritis Index (WOMAC), Lysholm, Tegner, American Knee Society Score (AKSS), Lequesne, visual analogue scale (VAS) for pain).Overall, 30 patients were randomized to intervention and 28 to control group. For primary outcome, 28 patients (29 knees) in the intervention and 22 (25 knees) in the control group were available. Patients with at least 1 grade improvement at repeat MRI were 14 (48.3%) in the intervention and 2 (8%) in the control group ( P < 0.003). Improvement in symptoms
Autologous and micro-fragmented adipose tissue for the treatment of diffuse degenerativekneeosteoarthritis Chondral lesions of the knee represent a challenge for the orthopaedic surgeon. Several treatments have been proposed with variable success rate. Recently, new therapeutic approaches, such as the use of mesenchymal stem cells, have shown promising results. The adipose tissue is a good source of these naturally occurring regenerative cells, due to its abundance and easy access (...) . In addition, it can be used to provide cushioning and filling of structural defects. The 1-year safety and outcome of a single intra-articular injection of autologous and micro-fragmented adipose tissue in 30 patients affected by diffuse degenerative chondral lesions was evaluated.Micro-fragmented adipose tissue was obtained using a minimal manipulation technique in a closed system. The safety of the procedure was evaluated by recording type and incidence of any adverse event. The clinical outcomes were
A randomized controlled trial of a combined self-management and exercise intervention for elderly people with osteoarthritis of the knee: the PLE2NO program To assess the effectiveness of a 12-week self-management and exercise intervention (the PLE2NO program) in elderly individuals with knee osteoarthritis.Randomized controlled trial.Four different community settings.Eighty individuals aged 60 years or older with clinical and radiographic kneeosteoarthritis enrolled in the study.A combined (...) self-management and exercise intervention (treatment group) and an educational intervention (control group).The primary outcomes were pain and other kneeosteoarthritis symptoms (swelling, crackling, limitation on movement, and stiffness), self-management behaviors (communication with physician and cognitive symptom management), and functional lower limb strength. Secondary outcomes were kneeosteoarthritis-specific health-related quality of life, self-perceived health, aerobic capacity, lower
Effect of vitamin E on oxidative stress level in blood, synovial fluid, and synovial tissue in severe kneeosteoarthritis: a randomized controlled study This study was performed to evaluate the antioxidative and anti-inflammatory effects of vitamin E on oxidative stress in the plasma, synovial fluid, and synovial tissue of patients with knee osteoarthritis.Seventy-two patients with late-stage kneeosteoarthritis scheduled for total knee arthroplasty were randomized to take oral placebo (Group (...) A) or 400 IU of vitamin E (Group B) once a day for 2 months before undergoing surgery. The blood levels of endpoints indicating oxidative stress or antioxidant capacity, Knee Society Score (KSS), Western Ontario and McMaster Universities Osteoarthritis Index score (WOMAC), and adverse effects were compared before and after the intervention between the two groups. At surgery, these redox endpoints and histological findings were compared between the synovial fluid and synovial tissue.In blood samples
Maintenance of the paraspinal muscles may protect against radiographic kneeosteoarthritisKneeosteoarthritis (OA) is an increasing health problem worldwide. So far, only obesity and quadriceps weakness are identified as modifiable risk factors for kneeOA. Core muscle strengthening is becoming increasingly popular among older adults because of its ability to enhance the activities of daily living during old age. This study investigated the associations of the size and quality of the abdominal (...) trunk muscles with radiographic kneeosteoarthritis (RKOA).From 2012 to 2016, data were collected from 146 males and 135 females (age 63.9±13.4 years, BMI 23.2±3.8 kg/m2) at annual musculoskeletal examinations, including knee radiographs and body composition analyses, by dual-energy X-ray absorptiometry. Cross-sectional areas of abdominal trunk muscles were measured using a single-slice computed tomography scan image obtained at the level of the umbilicus.The prevalence of RKOA was 21.2% in males
Effectiveness of three modes of kinetic-chain exercises on quadriceps muscle strength and thigh girth among individuals with kneeosteoarthritis The study was designed to evaluate and compare the effectiveness of 12-week open, closed and combined kinetic-chain exercises (OKCE, CKCE and CCE) on quadriceps muscle strength and thigh girth of patients with kneeosteoarthritis (OA).The randomized clinical trial involved ninety-six consecutive patients with kneeOA who were randomly assigned to one
Clinical significance of Matrilin-3 gene polymorphism in Egyptian patients with primary kneeosteoarthritisOsteoarthritis (OA) is a multifactorial, degenerative, and inflammatory disorder of joints causing damage of the articular cartilage, formation of osteophytes, and eburination of the subchondral bone. Matrilin-3 (MATN-3) is a non-collagenous oligomeric extracellular matrix protein (ECM), which is the smallest member of the matrilin family. This study was conducted to identify (...) the potential association and clinical significance of MATN-3 rs8176070 (SNP6) polymorphism in a series of Egyptian patients with primary knee OA.Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to determine genotypes of MATN-3 SNP6 for 50 primary kneeOA patients in addition to 50 healthy subjects of the same sex and age range. Full history was obtained from OA patients, followed by clinical examination, together with clinical assessment of the severity of kneeOA
Efficacy and safety of single injection of cross-linked sodium hyaluronate vs. three injections of high molecular weight sodium hyaluronate for osteoarthritis of the knee: a double-blind, randomized, multi-center, non-inferiority study This randomized, double-blind, multi-center, non-inferiority trial was conducted to assess the efficacy and safety of a cross-linked hyaluronate (XLHA, single injection form) compared with a linear high molecular hyaluronate (HMWHA, thrice injection form (...) ) in patients with symptomatic knee osteoarthritis.Two hundred eighty seven patients with osteoarthritis (Kellgren-Lawrence grade I to III) were randomized to each group. Three weekly injections were given in both groups but two times of saline injections preceded XLHA injection to maintain double-blindness. Primary endpoint was the change of weight-bearing pain (WBP) at 12 weeks after the last injection. Secondary endpoints included Western Ontario and McMaster Universities Osteoarthritis index; patient's
Periarticular dextrose prolotherapy instead of intra-articular injection for pain and functional improvement in kneeosteoarthritisOsteoarthritis (OA) is a degenerativedisease that can lead to painful and dysfunctional joints. Prolotherapy involves using injections to produce functional restoration of the soft tissues of the joint. Intra-articular injections are controversial because of the introduction of needles into the articular capsule.To compare the effect of periarticular versus intra (...) and were not signifi-cantly different in the peri- and intra-articular groups. Pain, joint locking, and limitation scores were all improved in both groups. Difficulty in walking on flat surfaces or climbing stairs, and sitting and standing pain, were all improved in both groups from 1 to 5 months after treatment.WOMAC scores are subjective and could be a limitation of the study.Periarticular prolotherapy has comparable effects on pain and disability due to kneeOA to intra-articular injections, while
to make a recommendation for or against the use of HA for kneeOA, however two guidelines recommend against its use. Some guidelines recommend HA after failure of other treatments, or in older adults with a certain OA grade. Tags kneejoint, osteoarthritis, knee, viscosupplementation, medical devices, musculoskeletal, knee injection, knee injections, viscosupplement, viscosupplements, osteoarthritides, knee pain, osteoarthrosis, osteoarthroses, joint pain, kneearthritis, Knee Osteoarthritides Files (...) of the knee? Key Message There is a substantial body of evidence investigating viscosupplementation with hyaluronic acid (HA) in adults with kneeosteoarthritis (OA), but the evidence to support its efficacy is conflicting. Three meta-analyses rated by investigators as the best available evidence suggested that HA was superior to intra-articular (IA) placebo, corticosteroids (CS), and non-steroidal anti-inflammatory drugs (NSAIDs), in terms of improving knee pain and function, without increasing adverse
Correlations between ultrasonographic findings, clinical scores, and depression in patients with kneeosteoarthritis This study aimed to explore correlations between the presence of depression, clinical scores, and ultrasonographic (US) grading in osteoarthritis (OA) patients and to clarify if depressive symptoms might cause a discrepancy between US findings and clinical scores.Two hundred patients with primary kneeOA and 100 healthy hospital volunteers of the same age and sex not complaining (...) of knee troubles participated in this study. We evaluated depressive symptoms in all participants using the Beck Depression Inventory (BDI) scale. Thorough clinical examination was performed, including assessment using the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) for disability. All patients underwent US examination of their affected knees.Depression was detected in 60 patients with kneeOA (30%) and in 5 controls (5%). The mean of BDI score was 12.8±12.2 in OA patients
Efficacy of extracorporeal shockwave therapy and low-intensity pulsed ultrasound in a rat kneeosteoarthritis model: A randomized controlled trial This study aims to assess the efficacy of extracorporeal shockwave therapy (ESWT) and low-intensity pulsed ultrasound (LIPUS) on osteoarthritic rat knees.Twenty-four rats were divided into 3 groups: group 1-control (n=8), group 2-LIPUS (n=8) and group 3-ESWT (n=8). Cartilage degeneration was provided using mono-iodo-asetate (MIA). One milligram (...) . There was no difference among the pain scores of the right knees at day 14 (p<0.05).ESWT and LIPUS have systemic proliferative and regenerative effects on cartilage and tissue.
Decrease of serum biomarker of type II Collagen degradation (Coll2-1) by intra-articular injection of an autologous plasma-rich-platelet in patients with unilateral primary kneeosteoarthritis This study aimed to evaluate the effect of one dose of intra-articular injection of (PRP) in the kneejoint on a specific osteoarthritis (OA) serum biomarker of cartilage degeneration, Collagen 2-1 (Coll2-1), over a short period of 3 months. The aim extended to clarify the effect of PRP on the functional (...) status of the osteoarthritic knee joint.Sixty patients with primary unilateral kneeOA were enrolled in this study. They were subdivided according to Kellgren-Lawrence grading scale (KL) into (Group I): including patients with KL grade < 3 and (Group II): including patients with KL grade ≥3. Patients were asked to complete the Western Ontario and McMaster Universities Arthritis Index (WOMAC) Score. PRP was prepared and injected immediately into the affected knee. Serum Coll2-1 (S.Coll2-1
Genetic influence of growth and differentiation factor 5 gene polymorphism (+104T/C) on the development of kneeosteoarthritis and its association with disease severity The growth and differentiation factor 5 (GDF5) gene is recognized for its role in the development, repair, and maintenance of cartilage and bone. The present case-control study was conducted to detect the genetic association between GDF5 (+104T/C) single-nucleotide polymorphism (SNP) and primary kneeosteoarthritis (KOA (...) ), as well as the possible association of SNP with the severity of KOA.The study included 50 patients with primary KOA and 50 healthy control subjects. The severity of the disease was assessed by using the Kellgren-Laurence (K-L) grading system and aided by the Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC) score, visual analog scale (VAS) score, and tenderness score. The genetic association of the SNP with primary KOA was assessed by means of the TaqMan® allelic discrimination
The Main Cause of Death Following Primary Total Hip and Knee Replacement for Osteoarthritis: A Cohort Study of 26,766 Deaths Following 332,734 Hip Replacements and 29,802 Deaths Following 384,291 Knee Replacements Patients undergoing primary total joint replacement are selected for surgery and thus (other than having a transiently increased mortality rate postoperatively) have a lower mortality rate than age and sex-matched individuals do. Understanding the causes of death following joint (...) (29%  of the deaths in patients with primary hip replacement and 31%  of the deaths in patients with primary knee replacement). There was an elevated risk of death from circulatory, respiratory, and (most markedly) digestive system-related causes within 90 days postoperatively compared with 91 days to 1 year postoperatively.Ischemic heart disease is the leading cause of death in the 90 days following total joint replacement, and there is an increase in postoperative deaths associated
J, SooHoo NF, Booth M, Marks J, Motala A, Apaydin E, Chen C, Raaen L, Shanman R, Shekelle PG.. Treatment of osteoarthritis of the knee: an update review. Rockville: Agency for Healthcare Research and Quality (AHRQ). Comparative Effectiveness Review No. 190. 2017 Authors' objectives To assess the evidence for the efficacy of the following interventions for improving clinical outcomes in adults with osteoarthritis (OA) of the knee: cell-based therapies; glucosamine, chondroitin, or glucosamine (...) effective for which patients. Final publication URL Indexing Status Subject indexing assigned by CRD MeSH Humans; KneeJoint; Osteoarthritis Language Published English Country of organisation United States English summary An English language summary is available. Address for correspondence AHRQ, Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA Email: AHRQTAP@ahrq.hhs.gov AccessionNumber 32017000249 Date abstract record published 09/05/2017 Health
Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients With KneeOsteoarthritis: A Randomized Clinical Trial. Synovitis is common and is associated with progression of structural characteristics of kneeosteoarthritis. Intra-articular corticosteroids could reduce cartilage damage associated with synovitis but might have adverse effects on cartilage and periarticular bone.To determine the effects of intra-articular injection of 40 mg of triamcinolone (...) acetonide every 3 months on progression of cartilage loss and knee pain.Two-year, randomized, placebo-controlled, double-blind trial of intra-articular triamcinolone vs saline for symptomatic kneeosteoarthritis with ultrasonic features of synovitis in 140 patients. Mixed-effects regression models with a random intercept were used to analyze the longitudinal repeated outcome measures. Patients fulfilling the American College of Rheumatology criteria for symptomatic kneeosteoarthritis, Kellgren-Lawrence
of the cartilage that lines the kneejoints, the subchondral bone surfaces, and synovium, accompanied by pain, immobility, muscle weakness, and reduction in function and the ability to complete activities of daily living (ADLs). Two types of OA of the knee are recognized: the more prevalent primary OA of the knee is the result of the progressive joint cartilage destruction over time, whereas secondary OA of the knee can be caused by trauma, inactivity, overweight, or a disease process such as rheumatoid (...) arthritis. No evidence suggests that the two types are treated differently or respond differently to treatments. 1 Therefore, the remainder of this report treats the two conditions as one entity. The clinical diagnosis of OA of the knee is typically based on presentation, including insidious onset of weight-bearing knee pain that is exacerbated by use of the joint and relieved by rest, and that tends to worsen over the course of the day. Radiographic evidence of OA may precede symptomatic OA but may
Comparison of Single Intra-Articular Injection of Novel Hyaluronan (HYA-JOINT Plus) with Synvisc-One for KneeOsteoarthritis: A Randomized, Controlled, Double-Blind Trial of Efficacy and Safety Viscosupplementation has been widely used for the treatment of kneeosteoarthritis. Because we found no well-controlled trial comparing single-injection regimens of hyaluronan for kneeosteoarthritis, we compared the efficacy and safety of a single intra-articular injection of a novel cross-linked (...) hyaluronan (HYA-JOINT Plus) with a single injection of Synvisc-One in patients with knee osteoarthritis.In a prospective, randomized, controlled, double-blind trial with a 6-month follow-up, 132 patients with kneeosteoarthritis (Kellgren-Lawrence grade 2 or 3) were randomized to receive 1 intra-articular injection of 3 mL of HYA-JOINT Plus (20 mg/mL) (n = 66) or 6 mL of Synvisc-One (8 mg/mL) (n = 66). The primary outcome was the change from baseline in the visual analog scale (VAS) (0 to 100 mm) pain