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Latest & greatest articles for knee osteoarthritis
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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
The Ottawa panel clinical practice guidelines for the management of kneeosteoarthritis. Part one: Introduction, and mind-body exercise programs To identify effective mind-body exercise programs and provide clinicians and patients with updated, high-quality recommendations concerning non-traditional land-based exercises for knee osteoarthritis.A systematic search and adapted selection criteria included comparative controlled trials with mind-body exercise programs for patients with knee (...) osteoarthritis. A panel of experts reached consensus on the recommendations using a Delphi survey. A hierarchical alphabetical grading system (A, B, C+, C, D, D+, D-) was used, based on statistical significance ( P < 0.5) and clinical importance (⩾15% improvement).The four high-quality studies identified demonstrated that various mind-body exercise programs are promising for improving the management of kneeosteoarthritis. Hatha Yoga demonstrated significant improvement for pain relief (Grade B) and physical
The Ottawa panel clinical practice guidelines for the management of kneeosteoarthritis. Part two: Strengthening exercise programs To identify effective strengthening exercise programs and provide rehabilitation teams and patients with updated, high-quality recommendations concerning traditional land-based exercises for knee osteoarthritis.A systematic search and adapted selection criteria included comparative controlled trials with strengthening exercise programs for patients with knee (...) osteoarthritis. A panel of experts reached consensus on the recommendations using a Delphi survey. A hierarchical alphabetical grading system (A, B, C+, C, D, D+ or D-) was based on statistical significance ( p < 0.5) and clinical importance (⩾15% improvement).The 26 high-quality studies identified demonstrated that various strengthening exercise programs with/without other types of therapeutic exercises are generally effective for improving kneeosteoarthritis management within a six-month period
The Ottawa panel clinical practice guidelines for the management of kneeosteoarthritis. Part three: Aerobic exercise programs To identify effective aerobic exercise programs and provide clinicians and patients with updated, high-quality recommendations concerning traditional land-based exercises for knee osteoarthritis.A systematic search and adapted selection criteria included comparative controlled trials with strengthening exercise programs for patients with kneeosteoarthritis. A panel (...) of experts reached consensus on the recommendations using a Delphi survey. A hierarchical alphabetical grading system (A, B, C+, C, D, D+, or D-) was used, based on statistical significance ( P < 0.5) and clinical importance (⩾15% improvement).The five high-quality studies included demonstrated that various aerobic training exercises are generally effective for improving kneeosteoarthritis within a 12-week period. An aerobic exercise program demonstrated significant improvement for pain relief (Grade B
averaged across levels of confounding variables: 1.70 (95% uncertainty interval 0.26 to 3.57) for SF-12 physical component summary (PCS); -10.69 (-13.39 to -8.01) for Western Ontario and McMaster Universities arthritis index (WOMAC); and 9.16 (6.35 to 12.49) for knee injury and osteoarthritis outcome score (KOOS) quality of life subscale. These improvements became larger with decreasing functional status at baseline. Provision of total knee replacement to patients with SF-12 PCS scores <35 (...) Impact of total knee replacement practice: cost effectiveness analysis of data from the Osteoarthritis Initiative. Objectives To evaluate the impact of total knee replacement on quality of life in people with kneeosteoarthritis and to estimate associated differences in lifetime costs and quality adjusted life years (QALYs) according to use by level of symptoms.Design Marginal structural modeling and cost effectiveness analysis based on lifetime predictions for total knee replacement and death
osteoarthritis residing in a parents' home in Sabzevar.This study is done as a crossover clinical trial. After obtaining written consent of elderly patients with osteoarthritis of the knee, they were randomly divided into two groups. In step 1, in group 1, 1 cc of Nigella sativa oil was applied on the kneejoint every 8 hours for 3 weeks; for the second group, every 8 hours for 3 weeks, patients were given 1 tablet of 325 mg acetaminophen. After a period of 1 month without medication to wash out each group (...) Effect of Topical Application of Nigella Sativa Oil and Oral Acetaminophen on Pain in Elderly with KneeOsteoarthritis: A Crossover Clinical Trial. Limited evidence supports Nigella sativa's role as an effective complementary and alternative medicine and the anti-inflammatory effects of Nigella sativa on patients with allergic rhinitis.The aim of this study was to investigate the effect of topical application of Nigella sativa oil and oral acetaminophen on pain in the elderly with knee
States Ann Intern Med 0372351 0003-4819 AIM IM Ann Intern Med. 2017 Apr 4;166(7):453-462 28241215 Humans Osteoarthritis, Knee 2017 2 28 6 0 2017 12 9 6 0 2017 2 28 6 0 ppublish 28241277 2605038 10.7326/M17-0330 PMC5868739 NIHMS951687 Am J Phys Med Rehabil. 2016 May;95(5):372-89 26945211 Arthritis Rheum. 2008 Sep 15;59(9):1207-13 18759314 Clin Ther. 2013 Nov;35(11):1690-702 24145044 Ann Intern Med. 2017 Apr 4;166(7):453-462 28241215 Arthritis Care Res (Hoboken). 2016 Dec;68(12 ):1743-1750 27014966 (...) Improving Symptoms in KneeOsteoarthritis: Can We Get There From Here? 28241277 2017 12 08 2018 12 02 1539-3704 166 7 2017 04 04 Annals of internal medicine Ann. Intern. Med. Improving Symptoms in KneeOsteoarthritis: Can We Get There From Here? 531-532 10.7326/M17-0330 Mandl Lisa A LA From Hospital for Special Surgery/Weill Cornell Medicine, New York, New York. eng K24 AG053462 AG NIA NIH HHS United States P30 AG022845 AG NIA NIH HHS United States Journal Article Comment 2017 02 21 United
Including people with or without: Mild to severe osteoarthritis Radiographic evidence of osteoarthritis i X-ray or MRI changes of arthritis Mechanical symptoms i Locking, clicking, catching Acute onset knee pain i Pain started suddenly or slowly Meniscal tears i Tear in knee cartilage People with degenerativekneedisease Choice of intervention or Arthroscopic surgery Conservative management Any conservative management strategy (exercise therapy, injections, drugs) Arthroscopic surgery with or without (...) ? Degenerativekneedisease is an inclusive term, which many consider synonymous with osteoarthritis. We use the term degenerativekneedisease to explicitly include patients with knee pain, particularly if they are >35 years old, with or without: Imaging evidence of osteoarthritis Meniscus tears Locking, clicking, or other mechanical symptoms except persistent objective locked knee Acute or subacute onset of symptoms Most people with degenerativearthritis have at least one of these characteristics
HAYES, Inc. Comparative effectiveness review of platelet-rich plasma for kneeosteoarthritis: a review of reviews. Lansdale: HAYES, Inc. Directory Publication. 2017 Authors' conclusions Health Problem: Osteoarthritis (OA) is a painful condition in which the cartilage between the bones degenerates, no longer providing a smooth, gliding surface for motion or adequate cushioning. Because OA damages the cartilage and may ultimately damage the bone, it disrupts how components work together, resulting (...) with PRP for kneeOA, and how do complications compare with sham injection and other IA treatments? Have definitive patient selection criteria been established for PRP for kneeOA? Final publication URL The report may be purchased from: Indexing Status Subject indexing assigned by CRD MeSH Humans; Osteoarthritis, Knee; Platelet-Rich Plasma Language Published English Country of organisation United States English summary An English language summary is available. Address for correspondence HAYES, Inc
. Comparative effectiveness review of hyaluronic acid for kneeosteoarthritis: a review of reviews. Lansdale: HAYES, Inc. Directory Publication. 2017 Authors' conclusions Health Problem: Osteoarthritis (OA) is a painful condition in which the cartilage between the bones degenerates, no longer providing a smooth, gliding surface for motion or adequate cushioning. Because OA damages the cartilage and may ultimately damage the bone, it disrupts how components work together, resulting in pain, swelling (...) , inflammation, muscle weakness, impaired quality of life (QOL), and reduced function. The knee is commonly afflicted by OA. Technology Description: Hyaluronic acid (HA) is a component of synovial fluid, which lubricates the joint and absorbs shock. HA production is generally reduced and may be of poorer quality in patients with OA, which may exacerbate inflammation. Intra-articular (IA) injection of HA (IA-HA) aims to replace depleted or poor-quality HA in the joint. Controversy: Despite a large evidence
A Prospective Randomized Trial of Prognostic Genicular Nerve Blocks to Determine the Predictive Value for the Outcome of Cooled Radiofrequency Ablation for Chronic Knee Pain Due to Osteoarthritis Genicular nerve radiofrequency ablation is an effective treatment for patients with chronic pain due to kneeosteoarthritis; however, little is known about factors that predict procedure success. The current study evaluated the utility of genicular nerve blocks to predict the outcome of genicular nerve (...) cooled radiofrequency ablation (cRFA) in patients with osteoarthritis.This randomized comparative trial included patients with chronic knee pain due to osteoarthritis. Participants were randomized to receive a genicular nerve block or no block prior to cRFA. Patients receiving a prognostic block that demonstrated ≥50% pain relief for six hours received cRFA. The primary outcome was the proportion of participants with ≥50% reduction in knee pain at six months.Twenty-nine participants (36 knees) had
Intra-articular Corticosteroids for Osteoarthritis of the Knee. Are intra-articular corticosteroids associated with improvement in pain and physical function compared with sham injection or no intervention in patients with kneeosteoarthritis?Intra-articular corticosteroids may be associated with moderate improvement in pain and a small improvement in physical function up to 6 weeks after injection. However, the quality of the evidence is low.
Predictive capacity of thigh muscle strength in symptomatic and/or radiographic kneeosteoarthritis progression â€“ data from the FNIH OA Biomarkers Consortium Thigh muscle weakness is a risk factor for incident radiographic and symptomatic kneeosteoarthritis (KOA). The role of thigh muscle weakness in radiographic and/or symptomatic KOA progression remains elusive. Five hundred twenty-seven knees of 527 Osteoarthritis Initiative participants with baseline Kellgren-Lawrence grades 1 to 3 were (...) included in this nested case-control study evaluating whether baseline muscle strength predicted symptomatic and/or radiographic KOA progression. Case knees (n = 173) displayed both medial tibiofemoral joint space loss (≥0.7 mm) and a persistent increase in Western Ontario McMasters Osteoarthritis Index pain (≥9 on a 0- to 100-point scale) over 24 to 48 months from baseline. Control knees (n = 354) included 174 with neither radiographic nor symptomatic progression, 91 with radiographic progression only
Hyaluronic acid injection therapy for osteoarthritis of the knee: concordant efficacy and conflicting serious adverse events in two systematic reviews. The prevalence of kneeosteoarthritis (OA)/degenerativejointdisease (DJD) is increasing in the USA. Systematic reviews of treatment efficacy and adverse events (AEs) of hyaluronic acid (HA) injections report conflicting evidence about the balance of benefits and harms. We review evidence on efficacy and AEs of intraarticular (...) viscosupplementation with HA in older individuals with kneeosteoarthritis and account for differences in these conclusions from another systematic review.We searched PubMed and eight other databases and gray literature sources from 1990 to December 12, 2014. Double-blind placebo-controlled randomized controlled trials (RCTs) reporting functional outcomes or quality-of-life; RCTs and observational studies on delay/avoidance of arthroplasty; RCTs, case reports, and large cohort studies and case series assessing