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Latest & greatest articles for knee osteoarthritis
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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
questions for hip OA 691 Guideline for the management of knee and hip osteoarthritis Second edition Summary: Plain language Osteoarthritis (OA) is a chronic disease and the most common form of chronic arthritis. It is characterised by joint pain, stiffness and swelling, and mainly affects the hands, knees and hips. OA most frequently occurs in people aged >55 years, although younger people can also be affected. Risk factors for OA include joint injury, being overweight or obese, and older age (...) management of hip and kneeosteoarthritis in 2009. Since then, there has been substantial progress in evaluating the effectiveness and safety of commonly used and new therapies for osteoarthritis (OA). The objective of this new guideline is to present the best available, current scientific evidence for OA interventions, covering all interventions other than joint replacement for the hip and knee. Target population and audience This guideline applies to all adults diagnosed with symptomatic OA of the hip
involvement and disease progression varies. Osteoarthritis is diagnosed at a median of 55 years of age, and patients may live approximately 30 years with the disease. Patients with OA may present to providers with minimal symptoms or have incidental findings on physical examination or radiologic testing. Patients with symptomatic OA typically present with joint pain, aching, stiffness, and limited walking ability. KneeOA is usually bilateral but one knee may be affected more severely; hip OA (...) annually in direct healthcare costs. The combination of direct and indirect costs for OA and related disorders is estimated to be $461 billion. Hip and kneejoint replacements represent a major portion of these costs. The indirect costs associated with OA greatly surpass healthcare costs and exert significant personal costs for people with OA due to work loss and premature retirement, leading to loss of income and subsequent reductions in personal savings. Osteoarthritis also causes
an evidence- based guideline for the comprehensive management of osteoarthritis (OA) as a collabora- tion between the American College of Rheumatology (ACR) and the Arthritis Foundation, updating the 2012 ACR recommenda- tions for the management of hand, hip, and kneeOA. Methods. We identified clinically relevant population, intervention, comparator, outcomes questions and critical outcomes in OA. A Literature Review T eam performed a systematic literature review to summarize evidence supporting (...) low and/ Figure 1. Recommended therapies for the management of osteoarthritis (OA). Strongly and conditionally recommended approaches to management of hand, knee, and/or hip OA are shown. No hierarchy within categories is implied in the figure, with the recognition that the various options may be used (and reused) at various times during the course of a particular patient’s disease. * = Exercise for knee and hip OA could include walking, strengthening, neuromuscular training, and aquatic exercise
Summary According to the Centers for Disease Control and Prevention (CDC), 13.9 percent of adults age 25 years and older and 33.6 percent of adults age 65 years and older are affected by osteoarthritis (OA). Arthritis appears to be a significant burden among Veterans of the United States (US) Armed Forces.  Research suggests that military service-related overuse and injuries may be a contributing factor for the increased risk of developing OA. One study examined the incidence of OA among active (...) of other joints outside the hip or knee expands the differential diagnosis beyond OA. A2. Plain Radiography Background Radiography can be useful in confirming a suspect diagnosis of OA and may eliminate other potential diagnoses from consideration. Recommendation 2. Clinicians may use plain radiography to confirm the clinical diagnosis of hip and kneeosteoarthritis. [C] Discussion In adults with non-traumatic knee pain, the consensus of the working group is to obtain a weight- bearing anterior
Osteoarthritis of the Knee TREATMENT OF OSTEOARTHRITIS OF THE KNEE EVIDENCE-BASED GUIDELINE 2 ND EDITION Adopted by the American Academy of Orthopaedic Surgeons Board of Directors May 18, 2013 i Disclaimer This clinical practice guideline was developed by an AAOS work group comprised of volunteer physicians and interdisciplinary clinicians as well as staff researchers with expertise in systematic reviews and statistical methods used to evaluate empirical evidence. It is an educational tool (...) Peer Review 26 Public Comment 27 The AAOS Guideline Approval Process 28 Revision Plans 28 Guideline Dissemination Plans 28 AAOS Clinical Guideline on Treating Osteoarthritis of the Knee 31 Guideline Recommendations 31 Recommendation 1 31 Rationale 31 Supporting Evidence 32 Quality 32 Applicability 34 Final Strength of Evidence 35 Results 46 Evidence Tables and Figures 61 Quality and Applicability 61 Findings 98 Recommendation 2 138 Rationale 138 Supporting Evidence 138 Quality 138 Applicability 139
) for hip OA 43 Chondroitin sulphate 43 Vitamin, herbal and other dietary therapies 44 Therapeutic ultrasound 45 Social support 45 FurtHEr InForMA tIon 46 rEFErEncES 47 APPEndIX A. ProcESS rEPort 52 APPEndIX B. rESourcES 60 APPEndIX c . MEMBErSHIP oF tHE rA cGP oStEo ArtHrItIS W orKInG GrouP 683 Guideline for the non-surgical management of hip and kneeosteoarthritis July 2009 INTrOduCTION Chronic disease is a major public health burden on Australian society. An increasing proportion of the population (...) of chronic arthritis, with radiological evidence of OA in more than 50% of people over 65 years of age. 8 Approximately 10% of men and 18% of women suffer symptomatic OA. 9 Osteoarthritis is characterised by joint pain and mobility impairment associated with the gradual wearing of cartilage. There is currently no cure for OA. Treatment is aimed primarily at symptom relief, improving joint mobility and function, and optimising consumer quality of life. 10 The treatment of OA of the hip and/ or knee
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 (...) or knee (or both) pain (defined as more than six months' duration).To be included in the qualitative synthesis, studies had to have reported people's opinions (...) in a randomized, double-blind, placebo-controlled clinical trial in patients with kneeosteoarthritis . 27477804 2016 08 26 2016 12 28 2326-5205 69 1 2017 Jan Arthritis & rheumatology (Hoboken, N.J.) Combined Treatment With Chondroitin Sulfate and Glucosamine Sulfate Shows No Superiority Over Placebo for Reduction of Joint Pain and Functional Impairment in Patients With KneeOsteoarthritis : A Six-Month Multicenter (...) , Randomized, Double-Blind, Placebo-Controlled Clinical Trial. 77-85 10.1002/art.39819
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
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
and Quality (AHRQ); 2016 Jun. [cited YYYY Mon DD]. Available: http://www.guideline.gov. A direct comparison of recommendations presented in the above guidelines for nonsurgical management of osteoarthritis (OA) of the knee is provided. The AAOS guideline provides recommendations for surgical interventions that are less invasive than knee replacement, which are beyond the scope of this synthesis. The VA/DoD guideline addresses OA of the hip, which is also beyond the scope of this synthesis (recommendations (...) AAOS and VA/DoD agree that overweight or obese patients (defined by a BMI >25 kg/m 2 [VA/DoD] or ≥25 kg/m 2 [AAOS]) with symptomatic OA of the knee should attempt weight loss. Ideally, patients should lose a minimum of five percent body weight and maintain this new level of weight, specifies VA/DoD. Complementary and Alternative Medicine The developers recommend against the use of chondroitin sulfate and/or glucosamine to treat joint pain or improve function in patients with symptomatic OA
Newer Interventions for Osteoarthritis of the Knee Health Evidence Review Commission (HERC) Coverage Guidance: Newer Interventions for Osteoarthritis of the Knee Approved 3/14/2019 HERC Coverage Guidance Whole body vibration Whole body vibration is not recommended for coverage (strong recommendation). TENS TENS is not recommended for coverage (strong recommendation). Glucosamine-chondroitin Glucosamine-chondroitin is not recommended for coverage (weak recommendation). Glucosamine alone (...) is not recommended for coverage (strong recommendation). Chondroitin alone is not recommended for coverage (weak recommendation). Platelet-rich plasma Platelet-rich plasma is not recommended for coverage (weak recommendation) Note: Definitions for strength of recommendation are in Appendix A. GRADE Table Element Descriptions. Rationales for each recommendation appear below in the GRADE table. 2 ¦ Newer Interventions for Osteoarthritis of the Knee Approved 3/14/2019 Table of Contents Coverage Guidance: Newer
in Osteoarthritis of the Knee: A Review of Clinical Effectiveness and Safety Last updated: June 24, 2019 Project Number: RC1136-000 Product Line: Research Type: Devices and Systems Report Type: Summary with Critical Appraisal Result type: Report Question What is the clinical effectiveness and safety of intra-articular hyaluronic acid for patients with osteoarthritis of the kneejoint? Key Message Evidence suggests that there may be differences in the efficacy of intraarticular hyaluronic acid for treatment (...) of kneeosteoarthritis with respect to hyaluronic acid products, numbers of injection regimen, and disease severity. Intraarticular hyaluronic acid was found to be more effective with high molecular weight and biological fermented products, with 2-to-4 injection regimens, and in patients with low-to-moderate osteoarthritis. However, studies with direct head-to-head comparison are needed to confirm these findings. Between intraarticular hyaluronic acid and intraarticular corticosteroid, evidence
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
for the initial pharmaco- logic management of kneeosteoarthritis (OA). For patients who have an inadequate response to initial pharmacologic management, please see the Results for alternative strategies. NSAIDs non- steroidal antiin?ammatory drugs. 470 Hochberg et alper GI problems, or chronic kidney disease presents to her primary care provider for treatment. As few trials have been performed in patients with symptomatic hip OA, the TEP considered that patients with hip OA should be treated in a similar (...) of Rheumatology Subcommittee on Osteo- arthritis Guidelines. Recommendations for the medical man- agement of osteoarthritis of the hip and knee. 2005. URL: http://www.rheumatology.org/practice/clinical/guidelines/ oa-mgmt.asp. 4. Jordan KM, Arden NK, Doherty M, Bannwarth B, Bijlsma JW, Dieppe P, et al. EULAR recommendations 2003: an evidence based approach to the management of kneeosteoarthritis: report of a Task Force of the EULAR Standing Committee for International Clinical Studies Including Therapeutic
. 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
Randomised controlled trial of magnetic bracelets for relieving pain in osteoarthritis of the hip and knee. To determine the effectiveness of commercially available magnetic bracelets for pain control in osteoarthritis of the hip and knee.Randomised, placebo controlled trial with three parallel groups.Five rural general practices.194 men and women aged 45-80 years with osteoarthritis of the hip or knee.Wearing a standard strength static bipolar magnetic bracelet, a weak magnetic bracelet (...) blinding status did not affect the results. The scores for secondary outcome measures were consistent with the WOMAC A scores.Pain from osteoarthritis of the hip and knee decreases when wearing magnetic bracelets. It is uncertain whether this response is due to specific or non-specific (placebo) effects.
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