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Latest & greatest articles for 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; Knee Joint; 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
Cross-species gene modules emerge from a systems biology approach to osteoarthritis Complexities in degenerative disorders, such as osteoarthritis, arise from multiscale biological, environmental, and temporal perturbations. Animal models serve to provide controlled representations of the natural history of degenerative disorders, but in themselves represent an additional layer of complexity. Comparing transcriptomic networks arising from gene co-expression data across species can facilitate (...) an understanding of the preservation of functional gene modules and establish associations with disease phenotypes. This study demonstrates the preservation of osteoarthritis-associated gene modules, described by immune system and system development processes, across human and rat studies. Class prediction analysis establishes a minimal gene signature, including the expression of the Rho GDP dissociation inhibitor ARHGDIB, which consistently defined healthy human cartilage from osteoarthritic cartilage
Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients With Knee Osteoarthritis: A Randomized Clinical Trial. Synovitis is common and is associated with progression of structural characteristics of knee osteoarthritis. 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 knee osteoarthritis 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 knee osteoarthritis, Kellgren-Lawrence
of the cartilage that lines the knee joints, 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 Knee Osteoarthritis: A Randomized, Controlled, Double-Blind Trial of Efficacy and Safety Viscosupplementation has been widely used for the treatment of knee osteoarthritis. Because we found no well-controlled trial comparing single-injection regimens of hyaluronan for knee osteoarthritis, 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 knee osteoarthritis (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
EULAR recommendations for the use of imaging in the clinical management of peripheral jointosteoarthritis The increased information provided by modern imaging has led to its more extensive use. Our aim was to develop evidence-based recommendations for the use of imaging in the clinical management of the most common arthropathy, osteoarthritis (OA). A task force (including rheumatologists, radiologists, methodologists, primary care doctors and patients) from nine countries defined 10 questions (...) on the role of imaging in OA to support a systematic literature review (SLR). Joints of interest were the knee, hip, hand and foot; imaging modalities included conventional radiography (CR), MRI, ultrasonography, CT and nuclear medicine. PubMed and EMBASE were searched. The evidence was presented to the task force who subsequently developed the recommendations. The strength of agreement for each recommendation was assessed. 17 011 references were identified from which 390 studies were included in the SLR
The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. 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 knee osteoarthritis. Hatha Yoga demonstrated significant improvement for pain relief (Grade B) and physical
glucocorticoid injections in patients with very early inflammatory polyarthritis: results of the STIVEA trial. In: Annals of the rheumatic diseases; 2010. p 503-9. Dorleijn DM, Luijsterburg PA, Reijman M, Kloppenburg M, Verhaar JA, Bindels PJ, et al. Intramuscular corticosteroid injection versus placebo effective in pain reduction in patients with hip osteoarthritis. Osteoarthritis and Cartilage 2016;24 SUPPL. 1:183-5. Eiser N, Phillips C, Wooler P, Partridge M. Comparison of oral and depot intra-muscular (...) Intermittent cortisone injection for treatment of osteoarthritis and chronic obstructive lung disease Upprepad intramuskulär injektion med kortison för att behandla artros och kroniskt obstruktiv lungsjukdom Vi använder cookies för att optimera webbplatsen på bästa sätt. Om du fortsätter innebär det att du accepterar att cookies används. Statens beredning för medicinsk och social utvärdering Upprepad intramuskulär injektion med kortison för att behandla artros och kroniskt obstruktiv
The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. 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 knee osteoarthritis management within a six-month period
The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. 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 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 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 knee osteoarthritis 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 knee osteoarthritis 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
Single-arm open-label study of Durolane (NASHA nonanimal hyaluronic acid) for the treatment of osteoarthritis of the thumb Osteoarthritis of the trapeziometacarpal (TMC) joint of the thumb - also known as rhizarthrosis - is painful and has a significant impact on quality of life. Intra-articular injection of hyaluronic acid may potentially meet the need for effective, minimally invasive intervention in patients not responding adequately to initial treatment. We aimed to confirm the safety (...) and effectiveness of viscosupplementation with Durolane (NASHA nonanimal hyaluronic acid) in rhizarthrosis.This was a prospective, single-arm, multicenter, open-label study with a 6-month follow-up period. Eligible patients had Eaton-Littler grade II-III rhizarthrosis in one TMC joint with pain and visual analog scale (VAS) pain score ≥4 (scale: 0-10). A single injection of NASHA was administered to the affected TMC joint. The primary effectiveness variable was change from baseline in VAS pain score.Thirty-five
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 knee joint 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 Knee Osteoarthritis: 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
Schisandrae Fructus ethanol extract ameliorates inflammatory responses and articular cartilage damage in monosodium iodoacetate-induced osteoarthritis in rats Schisandrae Fructus, the fruit of Schisandra chinensis (Turcz.) Baill., is widely used in traditional medicine for the treatment of a number of chronic diseases. Although, Schisandrae Fructus was recently reported to attenuate the interleukin (IL)-1β-induced inflammatory response in chondrocytes in vitro, its protective and therapeutic (...) potential against osteoarthritis (OA) in an animal model remains unclear. Therefore, we investigated the effects of the ethanol extract of Schisandrae Fructus (SF) on inflammatory responses and cartilage degradation in a monosodium iodoacetate (MIA)-induced OA rat model. Our results demonstrated that administration with SF had a tendency to attenuate MIA-induced damage of articular cartilage as determined by a histological grade of OA. SF significantly suppressed the production of pro-inflammatory
Generating Individual Patient Preferences for the Treatment of Osteoarthritis Using Adaptive Choice-Based Conjoint (ACBC) Analysis To explore how adaptive choice-based conjoint (ACBC) analysis could contribute to shared decision-making in the treatment of individual patients with osteoarthritis (OA).In-depth case study of three individuals randomly selected from patients with OA participating in an ACBC analysis exercise. Eleven members of a research users' group participated in developing (...) an ACBC task on medication preferences for OA. Individual medication priorities are illustrated by the detailed analysis of ACBC output from three randomly selected patients from the main sample.The case study analysis illustrates individual preferences. Participant 1's priority was avoidance of the four high-risk side effects of medication, which accounted for 90% of the importance of all attributes, while the remaining attributes (expected benefit; way of taking medication; frequency; availability
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 Knee Osteoarthritis: 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 Knee Osteoarthritis: 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
for osteoarthritis in a Department of Veterans Affairs medical center, this study found no statistically significant improvements in the osteoarthritis intervention groups compared with usual care.National Institute of Arthritis and Musculoskeletal and Skin Diseases. (...) Patient, Provider, and Combined Interventions for Managing Osteoarthritis in Primary Care: A Cluster Randomized Trial. A single-site study showed that a combined patient and provider intervention improved outcomes for patients with knee osteoarthritis, but it did not assess separate effects of the interventions.To examine whether patient-based, provider-based, and patient-provider interventions improve osteoarthritis outcomes.Cluster randomized trial with assignment to patient, provider
will benefit from specific treatment options. This guideline is not intended for use as a benefits determination document. PATIENT POPULATION This document addresses the management osteoarthritis of the hip in adult patients defined as those 18 years of age and older. It is not intended to address management of pediatric patients with osteoarthritis or patients with inflammatory arthritis or osteonecrosis of the hip. BURDEN OF DISEASE The burden of osteoarthritis (OA) of the hip is largely attributable (...) to the effects of disability, comorbid disease, and the expense of treatment. OA is the most frequent cause of disability among adults in the United States (US), and the burden is increasing both as the prevalence of OA increases and also as patient expectations for treatment rise. Twenty seven million adults (more than 10 percent) of the US adult population had clinical osteoarthritis (OA) in 2005, and in 2009 OA was the fourth most common cause of hospitalization (Murphy & Helmick, 2012). OA is the leading