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Latest & greatest articles for osteoarthritis
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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
Monoclonal Antibodies for Osteoarthritis of the Hip or Knee Monoclonal Antibodies for Osteoarthritis of the Hip or Knee | CADTH.ca CADTH Document Viewer Monoclonal Antibodies for Osteoarthritis of the Hip or Knee Table of Contents Search this document Monoclonal Antibodies for Osteoarthritis of the Hip or Knee July 2018 Summary Osteoarthritis (OA) is a common and chronic disease of the synovial joints caused by biomechanical factors, inflammation, and joint tissue damage. The current (...) therapeutic options include non-pharmacologic therapy and topical analgesics, followed by oral analgesics and injectable agents, followed by surgery for end-stage disease. OA typically affects the knees, hips, hands, spine, and feet. Treatment with anti-nerve growth factors monoclonal antibodies (anti-NGFs) may improve joint pain and physical function, as nerve growth factor is associated with chronic pain conditions, and is elevated in the joints of patients with osteoarthritis. Within the indication
, subchondral sclerosis, and osteophytes. Treatments are non-pharmacological and pharmacological. Joint replacement surgery is effective for controlling the pain of osteoarthritis in advanced disease. Definition Osteoarthritis (OA) is the result of mechanical and biological events that destabilise the normal process of degradation and synthesis of articular cartilage chondrocytes, extracellular matrix, and subchondral bone. It involves the entire joint, including the articular cartilage, subchondral bone (...) OsteoarthritisOsteoarthritis - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Osteoarthritis Last reviewed: February 2019 Last updated: March 2018 Summary A degenerativejoint disorder; prevalence increases with age. Most commonly affected joints are the knee, hip, hands, and lumbar and cervical spine. Presents with joint pain and stiffness that is typically worse with activity. Radiographs show loss of joint space
Exercise, Manual Therapy, and Booster Sessions in Knee Osteoarthritis: Cost-Effectiveness Analysis From a Multicenter Randomized Controlled Trial 29088393 2019 04 19 2019 04 19 1538-6724 98 1 2018 01 01 Physical therapy Phys Ther Exercise, Manual Therapy, and Booster Sessions in Knee Osteoarthritis: Cost-Effectiveness Analysis From a Multicenter Randomized Controlled Trial. 16-27 10.1093/ptj/pzx104 Bove Allyn M AM Department of Physical Therapy, School of Health and Rehabilitation Sciences (...) States P30 AG024827 AG NIA NIH HHS United States Journal Article Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S. United States Phys Ther 0022623 0031-9023 AIM IM Aged Combined Modality Therapy Cost-Benefit Analysis Exercise Therapy economics methods Female Follow-Up Studies Health Care Costs statistics & numerical data Humans Male Middle Aged Musculoskeletal Manipulations economics methods Osteoarthritis, Knee economics
Cost-Utility Analysis of High Molecular Weight Hyaluronic Acid for Knee Osteoarthritis in Everyday Clinical Care in Patients at a Working Age: An Economic Evaluation of a Randomized Clinical Trial Knee osteoarthritis (OA) is associated with high medical costs and especially with high productivity costs, in particular in patients in their working years. High molecular weight (HMW) hyaluronic acid (HA) is an alternative treatment for nonsteroidal antiinflammatory drugs, which are known (...) for their serious side-effects. The cost-utility of intraarticular HMW-HA treatment in these patients is unknown, however, and was assessed in this study.Secondary care patients ages 18-65 years with knee OA were randomized to usual care plus HMW-HA (intervention group) or to usual care only (control group). A cost-utility analysis over 52 weeks from the societal and health care perspective was performed. Uncertainty for costs, effects, and cost-utility ratio was analyzed by nonparametric bootstrapping
followup (week 24) end points. Patients were allocated to either a 10-week iCBT program for depression added to treatment as usual (TAU) or to a TAU control group. Primary outcomes were depression symptoms (9-Item Patient Health Questionnaire [PHQ-9]) and psychological distress (Kessler-10 [K-10]). Secondary outcomes included arthritis self-efficacy (Arthritis Self-Efficacy Scale [ASES]), OA pain, stiffness, physical function (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC (...) Internet Cognitive-Behavioral Therapy for Depression in Older Adults With Knee Osteoarthritis: A Randomized Controlled Trial To determine the efficacy of an internet-based cognitive-behavioral therapy (iCBT) program for depression in older adults with osteoarthritis (OA) of the knee and comorbid major depressive disorder (MDD).We conducted a randomized controlled trial in 69 adults (ages ≥50 years) meeting criteria for MDD and OA of the knee with 1-week postintervention (week 11) and 3-month
Prospective, Multicenter, Randomized, Crossover Clinical Trial Comparing the Safety and Effectiveness of Cooled Radiofrequency Ablation With Corticosteroid Injection in the Management of Knee Pain From OsteoarthritisOsteoarthritis (OA) of the knee affects the aging population and has an associated influence on the health care system. Rigorous studies evaluating radiofrequency ablation for OA-related knee pain are lacking. This study compared long-term clinical safety and effectiveness (...) of cooled radiofrequency ablation (CRFA) with intra-articular steroid (IAS) injection in managing OA-related knee pain.This is a prospective, multicenter, randomized trial with 151 subjects with chronic (≥6 months) knee pain that was unresponsive to conservative modalities. Knee pain (Numeric Rating Scale [NRS]), Oxford Knee Score, overall treatment effect (Global Perceived Effect), analgesic drug use, and adverse events were compared between CRFA and IAS cohorts at 1, 3, and 6 months after
Preoperative Pain Neuroscience Education Combined With Knee Joint Mobilization for Knee Osteoarthritis: A Randomized Controlled Trial This study aimed to first compare the effects of a preoperative treatment combining pain neuroscience education (PNE) with knee joint mobilization versus biomedical education with knee joint mobilization on central sensitization (CS) in patients with knee osteoarthritis, both before and after surgery. Second, we wanted to compare the effects of both interventions (...) on knee pain, disability, and psychosocial variables.Forty-four patients with knee osteoarthritis were allocated to receive 4 sessions of either PNE combined with knee joint mobilization or biomedical education with knee joint mobilization before surgery. All participants completed self-administered questionnaires and quantitative sensory testing was performed at baseline, after treatment and at a 1 month follow-up (all before surgery), and at 3 months after surgery.Significant and clinically relevant
Unicompartmental Knee Arthroplasty vs High Tibial Osteotomy for Knee Osteoarthritis: A Systematic Review and Meta-Analysis Prior studies have compared unicompartmental knee arthroplasty (UKA) with high tibial osteotomy (HTO) suggesting that both procedures had good clinical outcomes. However, which treatment is more beneficial for unicompartmental knee osteoarthritis is still a controversy. The purpose of our study is to obtain postoperative outcomes of revision rate, complications, function (...) -analysis. UKA patients showed less revision rate, less complications, and less postoperative pain than HTO patients; however, HTO patients obtained more ROM. No significant difference was observed between the group accruing to the knee function scores and excellent/good surgical results.UKA offers a safe and efficient alternative to osteoarthritis reduced postoperative pain, less postoperative complication, and revision. The 2 surgical techniques showed satisfactory function results for the patients
A Meta-Analysis of Patellar Replacement in Total Knee Arthroplasty for Patients With Knee Osteoarthritis This meta-analysis (MA) aims at comparing the clinical outcomes of resurfacing and nonresurfacing the patella in patients undergoing total knee arthroplasty in the treatment of knee osteoarthritis.Randomized controlled trials were included by retrieving data from electronic English databases. Both fixed and random-effects models were employed, and standardized mean difference and 95
in men [ ; ]. Obesity — increases the load on weight-bearing joints; increases the risk of developing knee osteoarthritis more than threefold, and accelerates disease progression [ ; ]. High bone density — increases risk for development of osteoarthritis [ ]. Low bone density — increases risk for rapid progression of knee and hip osteoarthritis [ ]. Biomechanical Joint injury and damage — damage to bone, cartilage, or ligaments; history of inflammatory arthropathy can adversely affect joint (...) that lines the joint capsule). In some people, these repair processes may alleviate symptoms, but in others they cannot fully compensate for the joint damage, and symptoms of pain and stiffness may occur. Any synovial joint can be involved, and the most commonly affected peripheral joints are the knees, then the hips, and the small joints of the hand. [ ; ; ] Prevalence How common is it? Osteoarthritis is the most common jointdisease worldwide, affecting an estimated 10% of men and 18% of women over 60
The effect of pregabalin or duloxetine on arthritis pain: a clinical and mechanistic study in people with hand osteoarthritisOsteoarthritis (OA) is the most prevalent arthritis worldwide and is characterized by chronic pain and impaired physical function. We hypothesized that heightened pain in hand OA could be reduced with duloxetine or pregabalin. In this prospective, randomized clinical study, we recruited 65 participants, aged 40-75 years, with a Numerical Rating Scale (NRS) for pain (...) , the pregabalin group showed improvement for NRS pain (P=0.023), AUSCAN pain (P=0.008), and AUSCAN function (P=0.009), but no difference between duloxetine and placebo (P>0.05) was observed. In the per protocol analysis, NRS pain was reduced for pregabalin (P<0.0001) and duloxetine (P=0.029) compared to placebo. We conclude that centrally acting analgesics improve pain outcomes in people with hand arthritis, offering new treatment paradigms for OA pain.
Efficacy of Vibrating Gloves for Chronic Hand Pain due to Osteoarthritis This study investigated the efficacy of vibration technology for women with hand pain due to osteoarthritis (OA) to see if mild compression and small vibrating motors were beneficial with periodic use.Sixty-nine (N = 69) women with OA hand pain were randomized into two groups, one that used vibrating gloves once a day for 20 minutes (Experimental, N = 34) and one that was monitored for three months without gloves (Control (...) helpful in reducing hand pain in women with OA (53.5%), and most expressed willingness to use the gloves (71.4%) and use the pain app (55.8%) in the future. Additional studies to determine the mechanism of action of the gloves in managing pain would be recommended.
Comparative effectiveness of intra-articular prolotherapy versus peri-articular prolotherapy on pain reduction and improving function in patients with knee osteoarthritis: A randomized clinical trial Osteoarthritis is a common degenerativedisease. Prolotherapy is an alternative therapy used in multiple musculoskeletal disorders.To compare the effectiveness of intra-articular dextrose injection versus peri-articular prolotherapy in patients with knee osteoarthritis (KOA).Fifty-two adults (...) with painful primary knee osteoarthritis for at least three months were randomized to intra- and peri-articular injection groups. Prolotherapy was done twice with two week intervals. The outcome measures included the Oxford Knee Scale (OKS), Western Ontario McMaster University Osteoarthritis Index (WOMAC), and Visual Analogue Scale (VAS), which were obtained from patients before the first injection at the base line and after the second injection at the fourth and eighth weeks.There were no statistically
Clinical Outcomes of Knee Osteoarthritis Treated With an Autologous Protein Solution Injection: A 1-Year Pilot Double-Blinded Randomized Controlled Trial Osteoarthritis (OA) is a debilitating disease resulting in substantial pain and functional limitations. A novel blood derivative has been developed to concentrate both growth factors and antagonists of inflammatory cytokines, with promising preliminary findings in terms of safety profile and clinical improvement.To investigate if one intra (...) -articular injection of autologous protein solution (APS) can reduce pain and improve function in patients affected by knee OA in a multicenter, randomized, double-blind, saline-controlled study.Randomized controlled trial; Level of evidence, 2.Forty-six patients with unilateral knee OA (Kellgren-Lawrence 2 or 3) were randomized into the APS group (n = 31), which received a single ultrasound-guided injection of APS, and the saline (control) group (n = 15), which received a single saline injection