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Latest & greatest articles for osteoarthritis
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with that in osteoarthritis (OA).Nested case-control studies were performed using The Health Improvement Network (THIN). Underlying cohorts included adults with incident SpA or OA who had >1 NSAID prescription and no history of MI. Within each cohort, we matched each MI case to four controls without MI. NSAID use was categorised as: (a) current (prescription date 0-180 days prior to index date), (b) recent (181-365 days) or (c) remote (>365 days). We performed conditional logistic regression to compare the odds (...) Risk of myocardial infarction with use of selected non-steroidal anti-inflammatory drugs in patients with spondyloarthritis and osteoarthritis Spondyloarthritis (SpA) is associated with an increased risk of myocardial infarction (MI) due to underlying inflammation and possibly due to medications such as certain non-steroidal anti-inflammatory drugs (NSAIDs). We sought to describe MI risk among patients with SpA who were prescribed NSAIDs, and to compare the pattern of risk in SpA
Fluoroscopic Guided Radiofrequency of Genicular Nerves for Pain Alleviation in Chronic Knee Osteoarthritis: A Single-Blind Randomized Controlled Trial Nowadays, pain and disability due to chronic knee arthritis is a very common problem in middle aged people. A lot of modalities for management are available, including conservative analgesics and up to surgical interventions. Radiofrequency ablation of genicular nerves is assumed to be an effective less invasive and safe pain alleviation (...) pretreatment values with the values during the whole follow-up period with regard to the VAS and total WOMAC index in both groups.No diagnostic block was done prior to radiofrequency. We recommend the use of such a technique on a larger number of OA patients, with a longer follow-up period.RF can ameliorate pain and disability in chronic knee osteoarthritis in a safe and effective manner.Chronic pain, radiofrequency (RF), knee osteoarthritis.
Effectiveness of aquatic exercises compared to patient-education on health status in individuals with knee osteoarthritis: a randomized controlled trial To compare the effectiveness of aquatic exercises with patient-education in individuals with knee osteoarthritis.Randomized controlled trial with blinded assessor and intention-to-treat analysis.Aquatic Physiotherapy Centre and Primary Health Care Unit.A total of 60 patients, aged 68.3 (SD = 4.8) with clinical symptoms and radiographic grading (...) (Kellgren-Lawrence 1-4) of knee osteoarthritis were included.An eight-week treatment protocol of aquatic exercise ( n = 31) (16 individual sessions, twice a week) and an educational program (group sessions, once a week) ( n = 29).Before, after eight-week intervention, and a three-month follow-up with results for the following outcome measures: pain, function, quality of life, functional mobility, and depression.At the end of treatment, the WOMAC (Western Ontario and McMaster Universities Osteoarthritis
Exercise interventions and patient beliefs for people with hip, knee or hip and knee osteoarthritis: 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
[Comparison of the Results of Lundborg's and Sirotakova's Resection-Suspension Arthroplasty for the Treatment of Trapeziometacarpal JointOsteoarthritis]. The aim of this prospective randomised study was to compare Sirotakova's and Lundborg's methods of resection-suspension arthroplasty using the abductor pollicis longus tendon in the surgical treatment of osteoarthritis of the trapeziometacarpal joint.Between 2009 and 2012, 38 patients (29 female, 9 male) with symptomatic trapeziometacarpal (...) osteoarthritis (34% stage II, 58% stage III and 8% stage IV according to the Eaton-Littler classification) were randomly allocated to one of the surgical methods (mean age 62.7 years, range 43-85). Preoperatively, the following data were collected: pain intensity (Visual Analogue Scale, VAS; at rest: Lundborg 4.4±1.7; Sirotakova 4.6±2.1), strength (key pinch force Lundborg 8.1 kPa±6.6; Sirotakova 10.4 kPa±10.8), range of motion in the trapeziometacarpal joint (Lundborg 61.64±26.4; Sirotakova 46.67±25.6
The role of meniscal repair for prevention of early onset of osteoarthritis The meniscus plays an important role in the integrity of the knee joint. Therefore, meniscus tissue preserving techniques for the therapy of meniscus injuries seem to be reasonable. One of the important questions is whether meniscal repair can prevent the knee joint from early onset of osteoarthritis.According to the review of the current literature, the principles of a successful meniscal repair are explained (...) as preventive effect on the development of osteoarthritis within the knee joint in long-term, it is of importance to preserve as much meniscus tissue as possible in meniscus therapy. Patients previously have to be informed about the higher revision rate in context to meniscus suturing.
Osteoarthritis – A Randomized Clinical Trial April 6, 2018 6 min read By Rebecca Lazarus, MD Peer Reviewed Why does this matter? Osteoarthritis (OA) is a leading cause of disability in the United States and is the most common type of arthritis. The pathogenesis involves the progressive destruction of articular cartilage in a joint, which is accompanied by new bone formation and synovial proliferation. On a cellular level, this process is believed to involve mononuclear cells and pro-inflammatory mediators (...) age 45 years or older, and met knee OA criteria as defined by the American College of Rheumatology. These criteria are based on a standardized questionnaire about knee pain, as well as tibiofemoral OA evident on radiographs. Eligibility criteria further included ultrasonographic evidence of effusion and synovitis. Participants were excluded if they had other disorders affecting the study joint, including systemic inflammatory jointdisease, prior sepsis, or osteonecrosis; chronic or recent use
Differences in Safety of Nonsteroidal Antiinflammatory Drugs in Patients With Osteoarthritis and Patients With Rheumatoid Arthritis: A Randomized Clinical Trial To determine the relative risks of cardiovascular (CV), gastrointestinal (GI), and renal adverse events during long-term treatment with celecoxib, compared with ibuprofen and naproxen, in patients with osteoarthritis (OA) and patients with rheumatoid arthritis (RA).A total of 24,081 patients with OA or RA who had a moderate or high risk (...) for CV disease were enrolled internationally into a double-blind randomized controlled trial. Interventions included celecoxib at a dosage of 100-200 mg twice daily, ibuprofen at a dosage of 600-800 mg 3 times daily, or naproxen at a dosage of 375-500 mg twice daily. The main outcomes were the first occurrence of a major adverse CV event, GI event, or renal event, and mortality.In the subgroup of patients with OA, the risk of a major adverse CV event was significantly reduced when celecoxib
Intramuscular glucocorticoid injection versus placebo injection in hip osteoarthritis: a 12-week blinded randomised controlled trial Guidelines recommend intra-articular glucocorticoid injection in patients with painful hip osteoarthritis. However, intra-articular hip injection is an invasive procedure. The efficacy of systemic glucocorticoid treatment for pain reduction in hip osteoarthritis is unknown. This randomised, double-blind, trial assessed effectiveness in hip pain reduction (...) of an intramuscular glucocorticoid injection compared with a placebo injection in patients with hip osteoarthritis.Patients with painful hip osteoarthritis were randomised to either 40 mg triamcinolone acetate or placebo with an intramuscular injection into the gluteus muscle. The primary outcomes were severity of hip pain at rest, during walking (0-10) and WOMAC pain at 2-week postinjection. We used linear mixed models for repeated measurements at 2, 4, 6 and 12 weeks for the intention-to-treat data analysis.Of
Effect of Opioid vs Nonopioid Medications on Pain-Related Function in Patients With Chronic Back Pain or Hip or Knee Osteoarthritis 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 knee osteoarthritis 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
Ultrasound-Guided Genicular Nerve Block for Knee Osteoarthritis: A Double-Blind, Randomized Controlled Trial of Local Anesthetic Alone or in Combination with Corticosteroid Recently, several studies suggested that radiofrequency (RF) ablation of the genicular nerves is a safe and effective therapeutic procedure for intractable pain associated with chronic knee osteoarthritis (OA). Diagnostic genicular nerve block (GNB) with local anesthetic has been generally conducted before making decisions (...) regarding RF ablation. Although GNB has been recently performed together with corticosteroid, the analgesic effects of corticosteroids for treating chronic pain remain controversial.The current study aims to assess the effects of combining corticosteroids and local anesthesia during ultrasound-guided GNB in patients with chronic knee OA.A randomized, double-blinded institutional study.This study took place at Asan Medical Center in Seoul, Korea.Forty-eight patients with chronic knee OA were randomly
Intra-articular ozone or hyaluronic acid injection: Which one is superior in patients with knee osteoarthritis? A 6-month randomized clinical trial Knee osteoarthritis (OA) is a common disease, imposing a great burden through pain and decreased function. There are many therapeutic modalities including non-pharmacologic choices and oral, topical, and intra-articular medications. New studies have shown promising results for ozone application in knee OA. Our aim was to compare the effects of ozone (...) therapy versus hyaluronic acid (HA) intra-articular injection in knee OA patients.In this randomized clinical trial, a total of 174 patients with more than 3 months of chronic pain or swelling in the knee joints along with consistent imaging findings were enrolled and randomly allocated into two groups of HA and ozone, which were planned to undergo 3 weekly injections of HA (Hyalgan®) and 10 mL of a 30 μg/mL ozone solution, respectively. Patients were evaluated at baseline and 6 months after the last
osteoarthritis received a single injection of either PRP (26 patients) or HA (28 patients). They were assessed at baseline and at 1, 3, and 6 months. The primary endpoint was the change in Western Ontario and McMaster Universities Arthritis Index (WOMAC) score at 3 months, and secondary endpoints were responders' rate (improvement of at least 5 points or 40% of WOMAC total score at 3 months) of pain evaluation and patient's subjective satisfaction. Cell counts and the contents of vascular endothelial growth (...) Growth Factors Levels Determine Efficacy of Platelets Rich Plasma Injection in Knee Osteoarthritis: A Randomized Double Blind Noninferiority Trial Compared With Viscosupplementation To assess the noninferiority of a single platelet-rich plasma (PRP) injection compared with hyaluronic acid (HA), to alleviate pain and enhance functional capacity in knee osteoarthritis, and identify biological characteristics of PRP that may affect their efficacy.Fifty-four patients with symptomatic knee
Spineâ€“hip relations in patients with hip osteoarthritis Patients with hip osteoarthritis often have an abnormal spine-hip relation (SHR), meaning the presence of a clinically deleterious spine-hip and/or hip-spine syndrome.Definition of the individual SHR is ideally done using the EOS® imaging system or, if not available, with conventional lumbopelvic lateral radiographs.By pre-operatively screening patients with abnormal SHR, it is possible to refine total hip replacement (THR) surgical
Hydroxychloroquine Effectiveness in Reducing Symptoms of Hand Osteoarthritis: A Randomized Trial. Synovitis is believed to play a role in producing symptoms in persons with hand osteoarthritis, but data on slow-acting anti-inflammatory treatments are sparse.To determine the effectiveness of hydroxychloroquine versus placebo as an analgesic treatment of hand osteoarthritis.Randomized, double-blind, placebo-controlled clinical trial with 12-month follow-up. (ISRCTN registry number: ISRCTN91859104 (...) ).13 primary and secondary care centers in England.Of 316 patients screened, 248 participants (82% women; mean age, 62.7 years) with symptomatic (pain ≥4 on a 0- to 10-point visual analogue scale) and radiographic hand osteoarthritis were randomly assigned and 210 (84.7%) completed the 6-month primary end point.Hydroxychloroquine (200 to 400 mg) or placebo (1:1) for 12 months with ongoing usual care.The primary end point was average hand pain during the previous 2 weeks (on a 0- to 10-point
Self-Acupressure for Older Adults With Symptomatic Knee Osteoarthritis: A Randomized Controlled Trial This double-blind randomized controlled trial aimed to test the efficacy of self-administered acupressure for pain and physical function improvement for older adults with knee osteoarthritis (OA).Participants were community-dwelling adults with symptomatic knee OA (n = 150, mean age 73 years), randomized to 1 of 3 groups: verum acupressure, sham acupressure, or usual care. Participants (...) in the verum and sham groups, but not those in the usual care group, were taught to self-apply acupressure once daily, 5 days/week for 8 weeks. Assessments were collected during center visits at baseline, and at 4 and 8 weeks. In addition, pain level was assessed weekly by phone using a numeric rating scale (NRS). Outcomes included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale (primary), and subjective and objective physical function measures and the NRS
Mucoid degeneration of the cruciate ligaments in osteoarthritis under primary total knee arthroplasty Mucoid degeneration of the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) with osteoarthritis is rarely reported. We experienced two knee osteoarthritic patients who had symptomatic mucoid degeneration of their ACL, and their PCL was also diagnosed as mucoid degeneration in histological evaluation. Preoperative radiological evaluation could not reveal precisely whether (...) the degeneration had extended to the PCL. We obtained good clinical results treating them with posterior-stabilized (PS) total knee arthroplasty (TKA) sacrificing both ligaments. In cases of osteoarthritis with mucoid degenerated ACL, PS TKA should be considered, sacrificing both cruciate ligaments, because mucoid degeneration might expand both cruciate ligaments.
setting Adults, OA, osteoarthritis, lower limb, talocrural joint, joint pain Getting Evidence into Clinical Practice: Musculoskeletal Research Facilitation Group (CAT Group) Date: July 2018 CAT Lead: Ben Lannie Date CAT to be reviewed: July 2020 Email: email@example.com Date CAT: July 2018: Intervention or Exposure Hyaluronic in- jections Hyaluronic injections Comparison, if any Conservative treatment physiotherapy, exercise, conserva- tive management, advice, leaflets, education, heat, ice (...) In adults with ankle OA, is hyaluronic acid injection better than no treatment or conservative treatment, for pain, function, and patient satisfaction? Getting Evidence into Clinical Practice: Musculoskeletal Research Facilitation Group (CAT Group) Date: July 2018 CAT Lead: Ben Lannie Date CAT to be reviewed: July 2020 Email: firstname.lastname@example.org Date CAT: July 2018: Specific Question: In adults with ankle OA is hyaluronic acid injection better than no treatment or conservative treatment
In adults with ankle osteoarthritis (OA) is conservative management (excluding injections)/rehabilitation/exercise better than no treatment for pain/swelling/quality of lifte/function/delaying or preventing surgery? Getting Evidence into Clinical Practice: Musculoskeletal Research Facilitation Group (CAT Group) Date: October 2018 CAT Lead: Ben Lannie Date CAT completed: October 2018 Email: email@example.com Date CAT to be reviewed: October 2020 Specific Question: In adults with ankle (...) osteoarthritis (OA) is conservative management (excluding injections) / rehabilitation / exercise better than no treatment for pain / swelling / quality of life / function / delaying or preventing surgery? Clinical Bottom Line There is no published literature to answer the specific question Due to the lack of clear evidence for benefits and harms of conservative management for adults with ankle OA, it would be sensible to recommend audits of current clinical practice within local/regional services/pathways