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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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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
The effectiveness of physical therapies for patients with base of thumb osteoarthritis: Systematic review and meta-analysis. Trapeziometacarpal osteoarthritis (known as base of thumb OA) is a common condition causing pain and disability worldwide.The purpose of this review was to evaluate the effectiveness of multimodal and unimodal physical therapies for base of thumb osteoarthritis (OA) compared with usual care, placebo or sham interventions.Systematic review and meta-analysis.We searched
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 (...) as adjuvants during a GNB for chronic knee OA.The study protocol was approved by our institutional review board (2012-0210), and written informed consent was obtained from all patients. The trial was registered with the Clinical Research Information Service (KCT 0001139).Chronic pain, knee osteoarthritis, genicular nerve block, ultrasound, corticosteroid, local anesthetic, visual analog scale, Oxford Knee Score.
Knee Osteoarthritis After Anterior Cruciate Ligament Reconstruction With Bone-Patellar Tendon-Bone Versus Hamstring Tendon Autograft: A Systematic Review of Randomized Controlled Trials The primary purpose of this study was to systematically review high-quality studies in the literature to compare the postoperative radiographic incidence of knee osteoarthritis (OA) after anterior cruciate ligament reconstruction (ACLR) with bone-patellar tendon-bone (BPTB) versus hamstring tendon (HT) autograft (...) ," "hamstring," "randomized," and "osteoarthritis." Patients were assessed based on radiographic evaluation (Kellgren-Lawrence, Ahlbäck, Fairbank, and the Objective International Knee Documentation Committee scales), patient-reported outcome scores (Knee Injury and Osteoarthritis Outcome Score and visual analog scale scores), graft failure, and active knee flexion and extension deficit.Eight studies (6 Level I, 2 Level II) were identified that met inclusion criteria, including a total of 237 and 268
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
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 (...) 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
The Impact of Advanced Age on the Outcomes of Primary Total Hip and Knee Arthroplasty for Osteoarthritis: A Systematic Review. Elective total hip arthroplasty (THA) and total knee arthroplasty (TKA) are effective options for the management of osteoarthritis that has not responded to conservative therapy, and they are increasing in utilization worldwide. Therefore, we sought to investigate how older age influences the outcomes of THA and TKA through a review of the current literature.The Embase (...) other than osteoarthritis unless osteoarthritis was the diagnosis for >90% of the patient cohort. Journal references were manually searched to identify any additional articles.Thirty-two articles were identified in this review. The most elderly groups in these studies were shown to experience higher mortality rates, more postoperative complications, and a longer stay in the hospital. Perioperative mortality was reported to be between 2.6% and 2.9% for nonagenarians and 1.09% and 1.54
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.
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
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
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 degenerative joint 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 (...) , 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
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: firstname.lastname@example.org 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
OsteoarthritisOsteoarthritis - NICE CKS Share Osteoarthritis: Summary Osteoarthritis is a disorder of synovial joints, which occurs when damage triggers repair processes leading to structural changes within a joint. Joint damage may occur through repeated excessive loading and stress of a joint over time, or by injury. Any synovial joint can be involved — most commonly the knees, hips, and small joints of the hand. The clinical features are variable, between people and at different joint sites (...) . These repair processes alter the structure of the joint, causing typical features of: Localized loss of cartilage. Remodelling of adjacent bone and the formation of osteophytes. Mild synovitis. A diagnosis of osteoarthritis should be suspected if a person is aged 45 years or more, with typical clinical features. There may be a history of: Activity-related joint pain, and No morning joint-related stiffness, or morning stiffness lasting no longer than 30 minutes. Functional impairment. On examination
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