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Latest & greatest articles for osteoarthritis
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supervision . References 1. The Royal Australian College of General Practitioners (RACGP). 2018. Guideline for the management of knee and hip osteoarthritis. 2nd edn. East Melbourne, Vic: RACGP. https://www.racgp.org.au/FSDEDEV/media/documents/Clinical%20Resources/Guidelines/Joint%20replacement/Guidelin e-for-the-management-of-knee-and-hip-OA-2nd-edition.pdf 2. Allen S, Forney-Gorman A, Homan M, Kearns A, Kramlinger A, Sauer M. 2017. Diagnosis and treatment of osteoporosis. Bloomington (MN): Institute (...) up until referral for joint replacement. While this guideline is intended for use in the primary care setting it is considered relevant to other health professionals who treat people with osteoarthritis High Exercise for management recommended. Specifically, regular, varied, high-intensity resistance training and progressive balance training. It notes that high-impact training should be avoided by individuals at high risk of fracture, avoiding forward flexion and twisting in vertebral
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
Accuracy comparisons of intra-articular knee injection between the new modified anterolateral Approach and superolateral approach in patients with symptomatic knee osteoarthritis without effusion. Intra-articular knee injection with steroid or various other agents have been used to control the local inflammation and relieve pain in the osteoarthritis knee. To achieve the maximal potential therapeutic worth and decrease the complications from the inaccurate knee injection, these medications (...) should be delivered directly into the intra-articular space. Injection technique is one of the most important factors for accuracy of knee injection. Therefore, this study was aimed to propose the new modified anterolateral injection technique for higher accuracy of knee injection in symptomatic osteoarthritis knee without effusion.Patients with symptomatic osteoarthritis without effusion were included prospectively from May 2014 to May 2015 and randomized into 2 groups for knee injection: Modified
to appropriately give evidence based advice whilst keeping patients as functional as possible and not limiting their desired sporting activities. Search timeframe 1946 - 2018 Inclusion Criteria Description Search terms Population and Setting Adults, Clinical diagnosis of PFJ OA and/or Tibiofemoral OA Runners. Adults Runner/s Patello femoral jointosteoarthritis Tibiofemoral jointosteoarthritisOsteoarthritis Jogging Intervention or Exposure Running High impact lower limb exercise Plyometric exercises Running (...) with standard strengthening exercises? Clinical bottom line There was no evidence that answered this specific question. Whilst appraising the identified articles we found information of interest pertaining to running and arthritis however these were not comparative studies. Why is this important? Patients with knee osteoarthritis often ask if running will cause harm or whether they should only do the standard prescribed physiotherapy exercises. As a group of clinicians we felt we needed more evidence
Clinical meaningfulness of duloxetine's effect in Chinese patients with chronic pain due to osteoarthritis: post hoc analyses of a phase 3 randomized trial. To evaluate the analgesic effect of duloxetine in Chinese patients with osteoarthritis (OA) of the knee/hip at individual patient level and report the relationship between pain intensity reduction, overall improvement, and physical functioning.Post hoc analysis of 13-week, phase 3, parallel-group, randomized, placebo-controlled study (...) of duloxetine in Chinese patients with OA pain. Patients were randomized (1:1, computer-generated, interactive web-response system) to duloxetine (60 mg once daily, n=202) or placebo (n=207). Patients, investigators, and study staff were blinded throughout the study. Duloxetine's efficacy was evaluated using the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) and the Osteoarthritis Research Society International and Outcome Measures in Rheumatology (OARSI-OMERACT
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
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 (...) 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
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 (...) intervention groups, five days a week, for three weeks: the combination of NMES application, hot pack, and exercise therapy was applied to the NMES group. The combination of therapeutic ultrasound, hot pack and exercise therapy was applied to the ultrasound therapy group.Subjects were evaluated for pain and functional capacity with the use of the visual analog pain scale (VAS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), and 15 meter walking test. The muscle architecture (muscle
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
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
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 (...) of the mobilization.Randomized controlled trial.Sixty patients with unilateral hip OA were randomized to three groups: low, medium or high force mobilization group. Participants received three treatment sessions of long-axis distraction mobilization (LADM) in open packed position and distraction forces were measured at each treatment. Primary outcomes: passive hip ROM assessed before and after each session.pain recorded with Western Ontario and McMaster Universities (WOMAC) pain subscale before and after the three treatment
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
Effectiveness of low-dose radiation therapy on symptoms in patients with knee osteoarthritis: a randomised, double-blinded, sham-controlled trial Low-dose radiation therapy (LDRT) for benign disorders such as knee osteoarthritis (OA) is widely used in some parts of the world, despite absence of controlled studies. We evaluated the effect of LDRT on symptoms and inflammation in patients with knee OA.In this randomised, double-blinded, sham-controlled clinical trial (RCT), we recruited patients (...) with knee OA (clinical ACR criteria) in the Netherlands, aged ≥50 years, pain score ≥5/10 and non-responding to analgesics and exercise therapy. Patients were randomised 1:1 to receive LDRT (1 Gray per fraction) or sham intervention six times in 2 weeks, stratified by pain (<8 versus ≥8/10). Primary outcome was the proportion of OMERACT-OARSI responders, 3 months postintervention. Secondary outcomes included pain, function and inflammatory signs assessed by ultrasound, MRI and serum inflammatory
2018 update of the EULAR recommendations for the management of hand osteoarthritis Since publication of the European League Against Rheumatism (EULAR) recommendations for management of hand osteoarthritis (OA) in 2007 new evidence has emerged. The aim was to update these recommendations. EULAR standardised operating procedures were followed. A systematic literature review was performed, collecting the evidence regarding all non-pharmacological, pharmacological and surgical treatment options (...) -line choice), oral analgesics (particularly NSAIDs to be considered for symptom relief for a limited duration), chondroitin sulfate (for symptom relief), intra-articular glucocorticoids (generally not recommended, consider for painful interphalangeal OA) and conventional/biological disease-modifying antirheumatic drugs (discouraged). Considerations for surgery are described in recommendation 9. The last recommendation relates to follow-up. The presented EULAR recommendations provide up-to-date
Triamcinolone acetonide extended-release in patients with osteoarthritis and type 2 diabetes: a randomized, phase 2 study Approximately 30% of patients with type 2 diabetes mellitus have knee osteoarthritis. IA corticosteroids used to manage osteoarthritis pain can elevate blood glucose in these patients. We compared blood glucose levels following intra-articular injection of triamcinolone acetonide extended-release (TA-ER), an extended-release, microsphere-based triamcinolone acetonide (...) formulation, vs standard triamcinolone acetonide crystalline suspension (TAcs) in patients with knee osteoarthritis and comorbid type 2 diabetes.In this double-blind, randomized, parallel-group, phase 2 study (NCT02762370), 33 patients with knee osteoarthritis (American College of Rheumatology criteria) and type 2 diabetes mellitus (HbA1c 6.5-9.0% [48-75 mmol/mol]; 1-2 oral hypoglycaemic agents) were treated with intra-articular TA-ER (32 mg n = 18) or TAcs 40 mg (n = 15). Continuous glucose monitoring
Structured Education and Neuromuscular Exercise Program for Hip and/or Knee Osteoarthritis Public Comment: Held July 19 to August 9, 2018. Structured Education and Neuromuscular Exercise Program for Hip and/or Knee Osteoarthritis: Health Quality Ontario Recommendation FINAL RECOMMENDATION • Health Quality Ontario, under the guidance of the Ontario Health Technology Advisory Committee, recommends publicly funding a structured education and neuromuscular exercise program for the management (...) of people with osteoarthritis of the hip and/or knee RATIONALE FOR THE RECOMMENDATION The Ontario Health Technology Advisory Committee has reviewed the findings of the health technology assessment 1 and concluded that a structured education and neuromuscular exercise program provides clinical benefit in the management of hip and/or knee osteoarthritis and is consistent with patient values and preferences. The Ontario Health Technology Advisory Committee supported data collection and outcome monitoring
Interposition Arthroplasty Versus Hematoma and Distraction for the Treatment of Osteoarthritis of the Trapeziometacarpal Joint. Various surgical techniques were reported with excellent result for the treatment of trapeziometacarpal jointarthritis. However, the best treatment option was not defined yet.This randomized prospective study compared the result of two surgical techniques: tendon interposition arthroplasty (64 patients) and K. wire distraction (56 patients) after trapeziectomy (...) for stage 3 or 4 osteoarthritis of the trapeziometacarpal joint.After a mean follow-up period of 6.8 (range, 3-10) years it was possible to observe a higher rate of pain relief following trapeziectomy with K. wire suspension, but no significant differences in strength, range of motion and DASH score between the two groups. On lateral unloaded radiographs the height of the space between the base of the thumb metacarpal and the scaphoid showed a mean value of 6.5 mm for both groups; the average distance