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Latest & greatest articles for osteoarthritis
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on osteoarthritis or other clinical topics then use Trip today.
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Association of Tramadol With All-Cause Mortality Among Patients With Osteoarthritis. An American Academy of Orthopaedic Surgeons guideline recommends tramadol for patients with knee osteoarthritis, and an American College of Rheumatology guideline conditionally recommends tramadol as first-line therapy for patients with knee osteoarthritis, along with nonsteroidal anti-inflammatory drugs.To examine the association of tramadol prescription with all-cause mortality among patients (...) with osteoarthritis.Sequential, propensity score-matched cohort study at a general practice in the United Kingdom. Individuals aged at least 50 years with a diagnosis of osteoarthritis in the Health Improvement Network database from January 2000 to December 2015, with follow-up to December 2016.Initial prescription of tramadol (n = 44 451), naproxen (n = 12 397), diclofenac (n = 6512), celecoxib (n = 5674), etoricoxib (n = 2946), or codeine (n = 16 922).All-cause mortality within 1 year after initial tramadol prescription
Paracetamol versus placebo for knee and hip osteoarthritis. Paracetamol (acetaminophen) is vastly recommended as the first-line analgesic for osteoarthritis of the hip or knee. However, there has been controversy about this recommendation given recent studies have revealed small effects of paracetamol when compared with placebo. Nonetheless, past studies have not systematically reviewed and appraised the literature to investigate the effects of this drug on specific osteoarthritis sites (...) , that is, hip or knee, or on the dose used.To assess the benefits and harms of paracetamol compared with placebo in the treatment of osteoarthritis of the hip or knee.We searched the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, AMED, CINAHL, Web of Science, LILACS, and International Pharmaceutical Abstracts to 3 October 2017, and ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform (ICTRP) portal on 20 October 2017.We included randomised
Could Activity Modifications Indicate Physical Decline Among Adults With Symptomatic Knee Osteoarthritis? Mobility activity modifications indicate early functional losses that act as precursors to future declines among community-dwelling older adults. However, there is scarce evidence on whether activity modifications indicate poorer physical health among adults with symptomatic osteoarthritis, a major cause of disability. Our purpose was to investigate whether patient-reported mobility (...) with symptomatic knee osteoarthritis. If confirmed, patient-reported activity modifications may enhance symptom evaluation in osteoarthritis and enable a better understanding of the disablement process.
Effects of Platelet-Rich Plasma on Pain and Muscle Strength in Patients With Knee Osteoarthritis. No studies comparing the effects of platelet-rich plasma (PRP) injection and placebo injection in bilateral knee osteoarthritis in the same patient, or discussing muscle strength after PRP injection, have been published.Twenty patients with bilateral knee osteoarthritis were eligible, and 40 knees were randomized into two groups: PRP (knees [right or left by a coin toss] receiving a single intra (...) -articular PRP injection) and saline group (the contralateral knee of the same patient, into which single 4-mL intra-articular injection of normal saline was administered). The primary outcome measure was Western Ontario and McMaster's Universities Osteoarthritis Index and the secondary included isokinetic test results. The evaluation was at baseline and at 2 wks, 1, 3, and 6 mos after injection.The PRP group showed a significant reduction in the Western Ontario and McMaster's Universities Osteoarthritis
Platelet-rich plasma injections for knee osteoarthritis Platelet-rich plasma injections for knee Platelet-rich plasma injections for knee osteoarthritisosteoarthritis Interventional procedures guidance Published: 23 January 2019 nice.org.uk/guidance/ipg637 Y Y our responsibility our responsibility This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take (...) #notice-of-rights). Page 1 of 41 1 Recommendations Recommendations 1.1 Current evidence on platelet-rich plasma injections for knee osteoarthritis raises no major safety concerns. However, the evidence on efficacy is limited in quality. Therefore, this procedure should only be used with special arrangements for clinical governance, consent, and audit or research. 1.2 Clinicians wishing to give platelet-rich plasma injections for knee osteoarthritis should: Inform the clinical governance leads
Exercise for osteoarthritis of the knee and risk of subsequent osteoporotic vertebral fractures Exercise for osteoarthritis of the knee and subsequent vertebral fracture: An Evidence Snapshot 1 Exercise for osteoarthritis of the knee and risk of subsequent osteoporotic vertebral fractures Citation Garrubba M & Melder A. 2018. Exercise for Osteoarthritis of the knee and risk of subsequent osteoporotic vertebral fractures. Centre for Clinical Effectiveness, Monash Health, Victoria. Contact CCE (...) @monashhealth.org Background The evidence provided in this review aims to support decision-making for the clinical review panel currently investigating a related incident. The review provides evidence about low intensity rehabilitation exercise programs for patients with osteoarthritis of the knee and whether or not participating in exercise increases risk to patients with history of osteoporotic vertebral fractures. Question Does participation in a low intensity rehabilitation exercise program
Biologic Therapies for the Treatment of Knee Osteoarthritis The use of biologic therapies for the management of knee osteoarthritis has increased, despite insufficient evidence of efficacy. Our aim was to complete a systematic review and analysis of reports utilizing the highest level-of-evidence evaluating: (1) platelet-rich plasma injections (PRPs); (2) bone marrow-derived mesenchymal stem cells (BMSCs); (3) adipose-derived mesenchymal stem cells (ADSCs); and (4) amnion-derived mesenchymal (...) stem cells (AMSCs).PubMed, Embase, and Cochrane Library databases were queried for studies evaluating PRP injections, BMSCs, ADSCs, and AMSCs in patients with knee osteoarthritis. Of 1009 studies identified within the last 5 years, 123 met inclusion criteria. A comprehensive analysis of all levels-of-evidence was performed, as well as separate analysis on level-of-evidence I studies. Level-of-evidence was determined by the American Academy of Orthopedic Surgeons classification system.Although
Intra-articular Injection of Platelet-Rich Plasma Is Superior to Hyaluronic Acid or Saline Solution in the Treatment of Mild to Moderate Knee Osteoarthritis: A Randomized, Double-Blind, Triple-Parallel, Placebo-Controlled Clinical Trial To prospectively compare the efficacy of intra-articular injections of platelet-rich plasma (PRP) and hyaluronic acid (HA) with a sham control group (normal saline solution [NS]) for knee osteoarthritis in a randomized, dose-controlled, placebo-controlled (...) , double-blind, triple-parallel clinical trial.A total of 87 osteoarthritic knees (53 patients) were randomly assigned to 1 of 3 groups receiving 3 weekly injections of either leukocyte-poor PRP (31 knees), HA (29 knees), or NS (27 knees). The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score and International Knee Documentation Committee (IKDC) subjective score were collected at baseline and at 1, 2, 6, and 12 months after treatment. Data were analyzed using generalized
Diclofenac or etoricoxib, but not paracetamol, is effective for treating osteoarthritis Diclofenac or etoricoxib, but not paracetamol, is effective for treating osteoarthritis Discover Portal Discover Portal Diclofenac or etoricoxib, but not paracetamol, is effective for treating osteoarthritis Published on 26 May 2016 doi: This review aimed to identify the most effective drugs for pain relief in hip or knee osteoarthritis. High dose diclofenac or etoricoxib were the most effective non (...) missed trials and a duplicate publication. This has not changed the overall message. Share your views on the research. Why was this study needed? Osteoarthritis is the most common type of arthritis in the UK and the leading cause of pain in older adults. The severity of pain and functional disability can vary from person to person, from mild symptoms that come and go to more continuous and severe problems. Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used to treat symptoms
People with osteoarthritis can benefit from exercise but may harbour myths about safety People with osteoarthritis can benefit from exercise but may harbour myths about safety Discover Portal Discover Portal People with osteoarthritis can benefit from exercise but may harbour myths about safety Published on 21 August 2018 doi: Programmes that show people with osteoarthritis how to exercise safely may slightly improve pain scores, self-belief and social function, but participants also report (...) the myth that discomfort while exercising indicates on-going harm. The review combines evidence from 21 randomised controlled trials evaluating exercise in hip or knee osteoarthritis with 12 studies where people receiving the intervention were interviewed about the impact of exercise on their disease. Participants were men and women aged older than 45 years. Analysis of the randomised trials provides moderate- to low-quality evidence that exercise slightly improved pain and function and gave small
Short-term effects of neuromuscular electrical stimulation and ultrasound therapies on muscle architecture and functional capacity in knee osteoarthritis: a randomized study To determine the effects of ultrasound therapy and neuromuscular electrical stimulation (NMES) application on the muscle architecture and functional capacity in patients with knee osteoarthritis.A randomized study.A total of 60 patients with knee osteoarthritis.Participants were randomized into one of the following two
The efficacy of electromyographic biofeedback on pain, function, and maximal thickness of vastus medialis oblique muscle in patients with knee osteoarthritis: a randomized clinical trial The aim of this survey was to examine the effect of adding electromyographic biofeedback (EMGBF) to isometric exercise, on pain, function, thickness, and maximal electrical activity in isometric contraction of the vastus medialis oblique (VMO) muscle in patients with knee osteoarthritis (OA).In this clinical (...) trial, 46 patients with a diagnosis of knee OA were recruited and assigned to two groups. The case group consisted of 23 patients with EMGBF-associated exercise, and the control group was made up of 23 patients with only isometric exercise. Data were gathered via visual analog scale (VAS) score, the Persian version of the Western Ontario and McMaster Universities Osteoarthritis Index and Lequesne questionnaires, ultrasonography of the VMO, and surface electromyography of this muscle at baseline
Effects of a finger exercise program on hand function in automobile workers with hand osteoarthritis: A randomized controlled trial. Hand osteoarthritis reduces a person's ability to perform work activities and return to their occupation. We investigated the effects of a finger exercise program on hand grip strength, pain, physical function, and stiffness in automobile manufacturing workers with hand osteoarthritis. This randomized controlled trial was conducted on 29 subjects. Fifteen (...) experimental subjects received a finger exercise program with paraffin baths, while 14 control subjects received only paraffin baths. Hand grip strength, pain, physical function, and stiffness were assessed at baseline and 8 weeks later. In the experimental group, hand grip strength (P < 0.001) and Australian/Canadian osteoarthritis hand index (AUSCAN) scores (pain, P < 0.001; stiffness, P < 0.001; physical function, P < 0.001) were significantly improved by 3.52 ± 2.03, 21.6 ± 8.3 (pain), 16.8 ± 10.21
Platelet-Rich Plasma Versus Hyaluronic Acid Injections for the Treatment of Knee Osteoarthritis: Results at 5 Years of a Double-Blind, Randomized Controlled Trial Platelet-rich plasma (PRP) injections have been proposed as a new conservative option for knee degeneration to provide symptomatic relief and delay surgical intervention. Although the current literature provides some evidence on the benefits of this technique compared with viscosupplementation, no studies have been performed (...) to compare their long-term effects.To compare the long-term clinical outcomes provided by intra-articular injections of either PRP or hyaluronic acid (HA) to treat knee degenerative disease.Randomized controlled trial; Level of evidence, 1.Patients with a history of chronic symptomatic knee degenerative changes and osteoarthritis (Kellgren-Lawrence grade 0-3) were enrolled: 192 patients were randomized to undergo 3 blinded weekly intra-articular injections of either PRP or HA. Patients were prospectively
Efficacy and Safety of Massage for Osteoarthritis of the Knee: a Randomized Clinical Trial Current treatment options for knee osteoarthritis have limited effectiveness and potentially adverse side effects. Massage may offer a safe and effective complement to the management of knee osteoarthritis.Examine effects of whole-body massage on knee osteoarthritis, compared to active control (light-touch) and usual care.Multisite RCT assessing the efficacy of massage compared to light-touch and usual (...) care in adults with knee osteoarthritis, with assessments at baseline and weeks 8, 16, 24, 36, and 52. Subjects in massage or light-touch groups received eight weekly treatments, then were randomized to biweekly intervention or usual care to week 52. The original usual care group continued to week 24. Analysis was performed on an intention-to-treat basis.Five hundred fifty-one screened for eligibility, 222 adults with knee osteoarthritis enrolled, 200 completed 8-week assessments, and 175 completed
Association of Pharmacological Treatments With Long-term Pain Control in Patients With Knee Osteoarthritis: A Systematic Review and Meta-analysis. Even though osteoarthritis is a chronic and progressive disease, pharmacological agents are mainly studied over short-term periods, resulting in unclear recommendations for long-term disease management.To search, review, and analyze long-term (≥12 months) outcomes (symptoms, joint structure) from randomized clinical trials (RCTs) of medications (...) for knee osteoarthritis.The databases of MEDLINE, Scopus, EMBASE, Web of Science, and the Cochrane Central Register of Controlled Trials were searched until June 30, 2018 (MEDLINE alerts through August 31, 2018) for RCTs of patients with knee osteoarthritis that had treatment and follow-up lasting 1 year or longer.Data at baseline and at the longest available treatment and follow-up of 12 months' duration or longer (or the change from baseline) were extracted. A Bayesian random-effects network meta
Comparison of high, medium and low mobilization forces for increasing range of motion in patients with hip osteoarthritis: A randomized controlled trial. Manual therapy has been shown to increase range of motion (ROM) in hip osteoarthritis (OA). However, the optimal intensity of force during joint mobilization is not known.To compare the effectiveness of high, medium and low mobilization forces for increasing range of motion (ROM) in patients with hip OA and to analyze the effect size
Topical Capsaicin for Neuropathic and Osteoarthritis Pain: Maybe not so hot? Tools for Practice is proudly sponsored by the Alberta College of Family Physicians (ACFP). ACFP is a provincial, professional voluntary organization, representing more than 4,800 family physicians, family medicine residents, and medical students in Alberta. Established over sixty years ago, the ACFP strives for excellence in family practice through advocacy, continuing medical education and primary care research (...) . www.acfp.ca December 10, 2018 Topical Capsaicin for Neuropathic and Osteoarthritis Pain: Maybe not so hot? Clinical Question: What are the benefits and harms of topical capsaicin for neuropathic or osteoarthritis pain? Bottom Line: Evidence for topical capsaicin in neuropathic pain and hand osteoarthritis is highly inconsistent, with some studies showing clinical benefit (variably defined) for one in 4-7 patients while other studies show no benefit. There is no benefit in knee osteoarthritis. Local
Periosteal Electrical Dry Needling as an Adjunct to Exercise and Manual Therapy for Knee Osteoarthritis: A Multicenter Randomized Clinical Trial To compare the effects of adding electrical dry needling into a manual therapy (MT) and exercise program on pain, stiffness, function, and disability in individuals with painful knee osteoarthritis (OA).In total, 242 participants (n=242) with painful knee OA were randomized to receive 6 weeks of electrical dry needling, MT, and exercise (n=121) or MT (...) and exercise (n=121). The primary outcome was related-disability as assessed by the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index at 3 months.Individuals receiving the combination of electrical dry needling, MT, and exercise experienced significantly greater improvements in related-disability (WOMAC: F=35.504; P<0.001) than those receiving MT and exercise alone at 6 weeks and 3 months. Patients receiving electrical dry needling were 1.7 times more likely to have completely stopped
Clinic-Based Patellar Mobilization Therapy for Knee Osteoarthritis: A Randomized Clinical Trial We performed a phase 2 randomized clinical trial to evaluate the preliminary effectiveness of a clinic-based patellar mobilization therapy (PMT) in patients with knee osteoarthritis.We recruited 208 patients with knee osteoarthritis at primary care clinics in Hong Kong. Patients were randomly assigned (1:1) to the intervention group or the control group. The intervention group received 3 PMT (...) treatment sessions from primary care physicians at 2-month intervals, with concomitant prescription of a home-based vastus medialis oblique muscle exercise. The control group received PMT after the study period. The primary outcome was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score. Secondary outcomes included the WOMAC composite, function, and stiffness scores; the visual analog scale score for pain; objective physical function tests (30-s chair stand, 40-m walk