The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) in Persian Speaking Patients with Knee Osteoarthritis.

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Ebrahimzadeh, Mohammad H; Makhmalbaf, Hadi; Birjandinejad, Ali; Keshtan, Farideh Golhasani; Hoseini, Hosein A; Mazloumi, Seyed Mahdi

2014-03-01

Osteoarthritis of the knee is the most common chronic joint disease that involves middle aged and elderly persons. There are different clinical instruments to quantify the health status of patients with knee osteoarthritis and one example is the WOMAC score that has been translated and adapted into different languages. The purpose of this study was cultural adaptation, validation and reliability testing of the Persian version of the WOMAC index in Iranians with knee osteoarthritis. We translated the original WOMAC questionnaire into Persian by the forward and backward technique, and then its psychometric study was done on 169 native Persian speaking patients with knee degenerative joint disease. Mean age of patients was 53.9 years. The SF-36 and KOOS were used to assess construct validity. Reliability testing resulted in a Cronbach's alpha of 0.917, showing the internal consistency of the questionnaire to be a reliable tool. Inter-correlation matrix among different scales of the Persian WOMAC index yielded a highly significant correlation between all subscales including stiffness, pain, and physical function. In terms of validity, Pearson`s correlation coefficient was significant between three domains of the WOMAC with PF, RP, BP, GH, VT, and PCS dimensions of the SF-36 health survey (P<0.005) and KOOS (P<0.0001) . The Persian WOMAC index is a valid and reliable patient- reported clinical instrument for knee osteoarthritis.

Chondrogenic potential of mesenchymal stem cells from patients with rheumatoid arthritis and osteoarthritis: measurements in a microculture system.

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Dudics, Valeria; Kunstár, Aliz; Kovács, János; Lakatos, Tamás; Géher, Pál; Gömör, Béla; Monostori, Eva; Uher, Ferenc

2009-01-01

Mesenchymal stem cells (MSCs) have the potential to differentiate into distinct mesenchymal tissues; including cartilage and bone, they can be an attractive cell source for cartilage tissue engineering approaches. Our objective here was to compare the in vitro chondrogenic potential of MSCs isolated from patients with rheumatoid arthritis (RA) and osteoarthritis (OA) with cells from normal donors. Marrow samples were removed during bone surgery and adherent cell cultures were established. The cells were then passed into a newly developed microaggregate culture system in a medium containing transforming growth factor beta3, insulin, dexamethasone and/or demineralized bone matrix. In vitro chondrogenic activity was measured as metabolic sulfate incorporation and type II collagen expression in pellet cultures. Culture-expanded MSCs from RA and OA patients did not differ significantly from the normal population with respect to their chondrogenic potential in vitro. Capability of total protein and proteoglycan synthesis as well as collagen II mRNA expression by cell aggregates was similar for all cell preparations in the presence of the appropriate growth and differentiation factors. Chondroprotective drugs such as chondroitin sulfate and glucosamine enhanced, whereas chloroquine inhibited chondrogenesis in normal donor-derived or patient-derived MSC cultures. Galectin-1, a beta-galactoside-binding protein with marked anti-inflammatory activity, stimulated the chondrogenic differentiation of mesenchymal cells in low (<2 microg/ml) concentration. These findings show that MSCs from RA and OA patients possess similar chondrogenic potential as MSCs isolated from healthy donors, therefore these cells may serve as a potential new prospect in cartilage replacement therapy. 2008 S. Karger AG, Basel.

Spa therapy for elderly: a retrospective study of 239 older patients with osteoarthritis

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Karagülle, Mine; Kardeş, Sinan; Dişçi, Rian; Gürdal, Hatice; Karagülle, Müfit Zeki

2016-10-01

Very few studies tested the effectiveness of spa therapy in older patients with osteoarthritis. Therefore, we aimed to evaluate the short-term effects of spa therapy in patients aged 65 years and older with generalized, knee, hip, and cervical and lumbar spine osteoarthritis. In an observational retrospective study design at the Medical Ecology and Hydroclimatology Department of Istanbul Medical Faculty, we analyzed the records of 239 patients aged over 65 years with the diagnosis of all types of osteoarthritis who were prescribed a spa therapy course in some spa resorts in Turkey between 7 March 2002 and 31 December 2012. They travelled to a spa resort where they stayed at a thermal spa hotel and followed the usual therapy packages for 2 weeks. Patients were assessed by an experienced physician within a week before the spa journey and within a week after the completion of the spa therapy. Compared with baseline in whole sample, statistically significant improvements were observed in pain (visual analog scale, VAS), patient and physician global assessments (VAS), Health Assessment Questionnaire disability index (HAQ-DI), Lequesne algofunctional index (LAFI) for knee, Western Ontario and McMaster Universities index (WOMAC), Waddell disability index (WDI), and Neck Pain and Disability Scale (NPAD). According to Outcome Measures in Rheumatology—Osteoarthritis Research Society International (OMERACT-OARSI) Set of Responder Criteria, responder rate were 63.8 % (51/80) in generalized, 52 % (13/25) in knee, 50 % (2/4) in hip, 66.7 % (8/12) in lumbar, and 100 % (6/6) in cervical osteoarthritis subgroups. Spa therapy improved pain and physical functional status in older patients with osteoarthritis, especially generalized osteoarthritis and multiple joint osteoarthritis with involvement of knee. This improvement was clinically important in majority of the patients. To confirm the results of this preliminary study, there is a need of a randomized controlled clinical study

People Getting a Grip on Arthritis: A Knowledge Transfer Strategy to Empower Patients with Rheumatoid Arthritis and Osteoarthritis

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Brosseau, Lucie; Lineker, Sydney; Bell, Mary; Wells, George; Casimiro, Lynn; Egan, Mary; Cranney, Ann; Tugwell, Peter; Wilson, Keith G.; De Angelis, Gino; Loew, Laurianne

2012-01-01

Objective: The purpose of this study was twofold. First, to help people with arthritis become aware of and utilize Rheumatoid Arthritis (RA) and Osteoarthritis (OA) Clinical Practice Guidelines (CPGs) as they relate to self-management strategies. Second, to evaluate the impact of specific Knowledge Translation (KT) activities on CPG uptake. More…

Association of C-reactive protein positivity among groups of patients with knee osteoarthritis in Erbil

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Helen Ahmed Pirdawood

2017-08-01

Full Text Available Background and objective: Osteoarthritis is the most common joint disease and a leading cause of disability. Increased circulating levels of C-reactive protein have been associated with prevalent knee osteoarthritis. This study aimed to assess the association between C- reactive protein positivity in patients with knee osteoarthritis in Erbil Methods: Data from100 participants in this case-control study were enrolled from May 1st to December 1st, 2015 in Rizgary Teaching Hospital in Erbil city. Data were divided into two groups. The cases included 50 patients (17 male and 33 female with a mean age of 58.9 ±3.8 years and diagnosed with primary knee osteoarthritis of one or both knee joints. Controls included 50 persons (17 male and 33 female with a mean age of 58.1 ±3.9 years without knee osteoarthritis and matched for age, sex, and body mass index. C-reactive protein qualitatively measured. Patients were radiologically assessed by Kellgren and Lawrence grading scale (grade 0-4. Results: C-reactive protein was positive in 41 out of 50 (82% of knee osteoarthritis patients compared to 3 out of 50 (6% of healthy controls (P = 0.001. C- reactive protein positivity among knee osteoarthritis patients were significantly associated with body mass index, positive family history of knee osteoarthritis, duration of diseases, and Kellgren and Lawrence grade (P 0.05. Conclusion: C-reactive protein positivity was significantly associated with knee osteoarthritis compared to healthy controls. Furthermore, body mass index, positive family history of knee osteoarthritis, early osteoarthritis, and Kellgren and Lawrence grade II, were significantly associated with positive C-reactive protein in knee osteoarthritis.

Intermittent balneotherapy at the Dead Sea area for patients with knee osteoarthritis.

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Sherman, Gilad; Zeller, Lior; Avriel, Avital; Friger, Michael; Harari, Marco; Sukenik, Shaul

2009-02-01

Balneotherapy, traditionally administered during a continuous stay at the Dead Sea area, has been shown to be effective for patients suffering from knee osteoarthritis. To evaluate the effectiveness of an intermittent regimen of balneotherapy at the Dead Sea for patients with knee osteoarthritis. Forty-four patients with knee osteoarthritis were included in a prospective randomized single-blind controlled study. The patients were divided into two groups: a treatment group (n=24), which were treated twice weekly for 6 consecutive weeks in a sulfur pool heated to 35-36 degrees C, and a control group (n=20) treated in a Jacuzzi filled with tap water heated to 35-36 degrees C. Participants were assessed by the Lequesne index of osteoarthritis severity, the WOMAC index, the SF-36 quality of health questionnaire, VAS scales for pain (completed by patients and physicians), and physical examination. A statistically significant improvement, lasting up to 6 months, was observed in the treatment group for most of the clinical parameters. In the control group the only improvements were in the SF-36 bodily pain scale at 6 months, the Lequesne index at 1 month and the WOMAC pain score at the end of the treatment period. Although the patients in the control group had milder disease, the difference between the two groups was not statistically significant. Intermittent balneotherapy appears to be effective for patients with knee osteoarthritis.

Productivity loss due to absenteeism and presenteeism by different instruments in patients with RA and subjects without RA

NARCIS (Netherlands)

Braakman-Jansen, Louise Marie Antoinette; Kuper, Ina H.; van de Laar, Mart A F J; Taal, Erik

2012-01-01

Objectives. To explore the impact of at-work productivity loss on the total productivity cost by different instruments in patients recently diagnosed with RA and controls without RA. Methods. Cross-sectional data were collected from outpatients with RA between December 2007 and February 2008. The

Obese and non-obese patients with osteoarthritis: a comparison of functioning and outcome.

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Veenhof, C.; Dekker, J.

2009-01-01

Background: The prevalence of obesity among patients with osteoarthritis is high. To find the optimal treatment it is interesting to study in which aspects obese patients with osteoarthritis differ from non-obese patients. The objective of this study was to examine the influence of obesity on (i)

Constructing osteoarthritis through discourse – a qualitative analysis of six patient information leaflets on osteoarthritis

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Ong Bie

2007-04-01

Full Text Available Abstract Background Health service policy in the United Kingdom emphasises the importance of self-care by patients with chronic conditions. Written information for patients about their condition is seen as an important aid to help patients look after themselves. From a discourse analysis perspective written texts such as patient information leaflets do not simply describe the reality of a medical condition and its management but by drawing on some sorts of knowledge and evidence rather than others help construct the reality of that condition. This study explored patient information leaflets on osteoarthritis (OA to see how OA was constructed and to consider the implications for self-care. Methods Systematic and repeated readings of six patient information leaflets on osteoarthritis to look for similarities and differences across leaflets, contradictions within leaflets and the resources called on to make claims about the nature of OA and its management. Results Biomedical discourse of OA as a joint disease dominated. Only one leaflet included an illness discourse albeit limited, and was also the only one to feature patient experiences of living with OA. The leaflets had different views on the causes of OA including the role of lifestyle and ageing. Most emphasised patient responsibility for preventing the progression of OA. Advice about changing behaviour such as diet and exercise was not grounded in lived experience. There were inconsistent messages about using painkillers, exercise and the need to involve professionals when making changes to lifestyle. Conclusion The nature of the discourse impacted on how OA and the respective roles of patients and professionals were depicted. Limited discourse on illness meant that the complexity of living with OA and its consequences was underestimated. Written information needs to shift from joint biology to helping patients live with osteoarthritis. Written information should incorporate patient

Knee motion variability in patients with knee osteoarthritis: the effect of self-reported instability

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Gustafson, Jonathan A.; Robinson, Megan E.; Fitzgerald, G. Kelley; Tashman, Scott; Farrokhi, Shawn

2015-01-01

Background Knee osteoarthritis has been previously associated with a stereotypical knee-stiffening gait pattern and reduced knee joint motion variability due to increased antagonist muscle co-contractions and smaller utilized arc of motion during gait. However, episodic self-reported instability may be a sign of excessive motion variability for a large subgroup of patients with knee osteoarthritis. The objective of this work was to evaluate the differences in knee joint motion variability during gait in patients with knee osteoarthritis with and without self-reported instability compared to a control group of older adults with asymptomatic knees. Methods Forty-three subjects, 8 with knee osteoarthritis but no reports of instability (stable), 11 with knee osteoarthritis and self-reported instability (unstable), and 24 without knee osteoarthritis or instability (control) underwent Dynamic Stereo X-ray analysis during a decline gait task on a treadmill. Knee motion variability was assessed using parametric phase plots during the loading response phase of decline gait. Findings The stable group demonstrated decreased sagittal-plane motion variability compared to the control group (p=0.04), while the unstable group demonstrated increased sagittal-plane motion variability compared to the control (p=0.003) and stable groups (pknee motion variability in patients with knee osteoarthritis without self-reported instability supports previous research. However, presence of self-reported instability is associated with increased knee motion variability in patients with knee osteoarthritis and warrants further investigation. PMID:25796536

Body Mass Index and Western Ontario & McMaster Universities Osteoarthritis Index in Patients with Knee Osteoarthritis in Dr. Hasan Sadikin General Hospital, Bandung in November 2012

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Ainna Binti Mohamad Dat

2015-09-01

Full Text Available Background: Osteoarthritis is one of the major disabilities among elderly. One of its well-recognized potent risk factors is obesity. The aim of this study was to identify the body mass index and severity of knee osteoarthritis patients who were treated in Dr. Hasan Sadikin General Hospital Bandung. Methods: A descriptive study was carried out to 9 patients of the Medical Rehabilitation Policlinic at Dr. Hasan Sadikin General Hospital Bandung in November 2012. Patients were diagnosed as having knee Osteoarthritis based on American College of Rheumatology clinical classification. Exclusion criteria were patient having previous trauma in spine and lower limb, having bleeding disorder like hemophilia, incomplete data in medical records and incomplete data in questionnaire. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC was used to measure the intensity of pain, stiffness, and functional difficulty. The weight (kg and height (cm of the patients were measured and the Body Mass Index was calculated by Weight (kg/Height² (m. The data were analyzed using frequency distribution. Results: The patients who came to the Medical Rehabilitation Policlinic had ranged in age from 57 to78 years, mostly female with knee Osteoarthritis bilateral. Out of 9 patients, 5 patients were overweight, followed by normal BMI and obese type I. Patient with obese type 1 had the highest WOMAC score. Conclusions: Most of the patients with knee osteoarthritis bilateral are overweight and the patient with obese type 1 has the highest WOMAC score.

The Relationship between Chondromalacia Patella, Medial Meniscal Tear and Medial Periarticular Bursitis in Patients with Osteoarthritis.

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Resorlu, Mustafa; Doner, Davut; Karatag, Ozan; Toprak, Canan Akgun

2017-12-01

This study investigated the presence of bursitis in the medial compartment of the knee (pes anserine, semimembranosus-tibial collateral ligament, and medial collateral ligament bursa) in osteoarthritis, chondromalacia patella and medial meniscal tears. Radiological findings of 100 patients undergoing magnetic resonance imaging with a preliminary diagnosis of knee pain were retrospectively evaluated by two radiologists. The first radiologist assessed all patients in terms of osteoarthritis, chondromalacia patella and medial meniscal tear. The second radiologist was blinded to these results and assessed the presence of bursitis in all patients. Mild osteoarthritis (grade I and II) was determined in 55 patients and severe osteoarthritis (grade III and IV) in 45 cases. At retropatellar cartilage evaluation, 25 patients were assessed as normal, while 29 patients were diagnosed with mild chondromalacia patella (grade I and II) and 46 with severe chondromalacia patella (grade III and IV). Medial meniscus tear was determined in 51 patients. Severe osteoarthritis and chondromalacia patella were positively correlated with meniscal tear (p chondromalacia patella (p = 0.023 and p = 0.479, respectively). Evaluation of lateral compartment bursae revealed lateral collateral ligament bursitis in 2 patients and iliotibial bursitis in 5 patients. We observed a greater prevalence of bursitis in the medial compartment of the knee in patients with severe osteoarthritis and medial meniscus tear.

Analyzing the History of Falls in Patients with Severe Knee Osteoarthritis.

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Tsonga, Theano; Michalopoulou, Maria; Malliou, Paraskevi; Godolias, George; Kapetanakis, Stylianos; Gkasdaris, Grigorios; Soucacos, Panagiotis

2015-12-01

One out of three adults over the age of 65 years and one out of two over the age of 80 falls annually. Fall risk increases for older adults with severe knee osteoarthritis, a matter that should be further researched. The main purpose of this study was to investigate the history of falls including frequency, mechanism and location of falls, activity during falling and injuries sustained from falls examining at the same time their physical status. The secondary purpose was to determine the effect of age, gender, chronic diseases, social environment, pain elsewhere in the body and components of health related quality of life such as pain, stiffness, physical function, and dynamic stability on falls frequency in older adults aged 65 years and older with severe knee osteoarthritis. An observational longitudinal study was conducted on 68 patients (11 males and 57 females) scheduled for total knee replacement due to severe knee osteoarthritis (grade 3 or 4) and knee pain lasting at least one year or more. Patients were personally interviewed for fall history and asked to complete self-administered questionnaires, such as the 36-item Short Form Health Survey (SF-36) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC), and physical performance test was performed. The frequency of falls was 63.2% for the past year. The majority of falls took place during walking (89.23%). The main cause of falling was stumbling (41.54%). There was a high rate of injurious falling (29.3%). The time patients needed to complete the physical performance test implied the presence of disability and frailty. The high rates of fall risk, the high disability levels, and the low quality of life were confirmed by questionnaires and the mobility test. Patients with severe knee osteoarthritis were at greater risk of falling, as compared to healthy older adults. Pain, stiffness, limited physical ability, reduced muscle strength, all consequences of severe knee osteoarthritis

The Relationship between Chondromalacia Patella, Medial Meniscal Tear and Medial Periarticular Bursitis in Patients with Osteoarthritis

Science.gov (United States)

Doner, Davut; Karatag, Ozan; Toprak, Canan Akgun

2017-01-01

Abstract Background This study investigated the presence of bursitis in the medial compartment of the knee (pes anserine, semimembranosus-tibial collateral ligament, and medial collateral ligament bursa) in osteoarthritis, chondromalacia patella and medial meniscal tears. Patients and methods Radiological findings of 100 patients undergoing magnetic resonance imaging with a preliminary diagnosis of knee pain were retrospectively evaluated by two radiologists. The first radiologist assessed all patients in terms of osteoarthritis, chondromalacia patella and medial meniscal tear. The second radiologist was blinded to these results and assessed the presence of bursitis in all patients. Results Mild osteoarthritis (grade I and II) was determined in 55 patients and severe osteoarthritis (grade III and IV) in 45 cases. At retropatellar cartilage evaluation, 25 patients were assessed as normal, while 29 patients were diagnosed with mild chondromalacia patella (grade I and II) and 46 with severe chondromalacia patella (grade III and IV). Medial meniscus tear was determined in 51 patients. Severe osteoarthritis and chondromalacia patella were positively correlated with meniscal tear (p chondromalacia patella (p = 0.023 and p = 0.479, respectively). Evaluation of lateral compartment bursae revealed lateral collateral ligament bursitis in 2 patients and iliotibial bursitis in 5 patients. Conclusions We observed a greater prevalence of bursitis in the medial compartment of the knee in patients with severe osteoarthritis and medial meniscus tear. PMID:29333118

Pentosidine in synovial fluid in osteoarthritis and rheumatoid arthritis: relationship with disease activity in rheumatoid arthritis.

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Chen, J R; Takahashi, M; Suzuki, M; Kushida, K; Miyamoto, S; Inoue, T

1998-12-01

Pentosidine is an advanced glycation endproduct formed by glycosylation and oxidation. Our aim was to develop a means to measure pentosidine in synovial fluid (SF), and to compare its concentration in SF in patients with osteoarthritis (OA) and rheumatoid arthritis (RA), and to investigate the relationship between its concentration in SF and the disease activity of RA. SF was collected from knee joints in 31 patients with RA and 40 with OA, who had hydrarthrosis. One patient with RA and 7 with OA who had the complication of diabetes mellitus or chronic renal failure made up the DM/CRF group, and the remaining patients made up the RA group (n = 30) and the OA group (n = 33). Pentosidine was measured by the direct HPLC method with column switching after hydrolysis of SF. Pentosidine was detected in all SF and was greater in RA (83.9 +/- 46.0 nmol/l, mean +/- SD) than in OA (40.1 +/- 19.6 nmol/l). Three DM/CRF patients undergoing hemodialysis had markedly high pentosidine levels (482.5 +/- 280.8 nmol/l). There was a significant correlation between pentosidine and C-reactive protein (CRP), erythrocyte sedimentation rate, and Lansbury Index (p Patients with RA were divided into high and low activity groups according to the CRP and Lansbury Index. Pentosidine was significantly higher in the high activity group (CRP > or = 2.0 mg/dl and Lansbury Index > or = 50%) than in the low activity group (CRP < 2.0 and/or Lansbury Index < 50) (100.9 +/- 42.8 vs 58.5 +/- 39.6 nmol/; p = 0.0013). Pentosidine in synovial fluid was higher in RA than in OA. Pentosidine levels in SF were related to the disease activity in RA.

Exercise therapy may postpone total hip replacement surgery in patients with hip osteoarthritis

DEFF Research Database (Denmark)

Svege, Ida; Nordsletten, Lars; Fernandes, Linda

2015-01-01

Exercise treatment is recommended for all patients with hip osteoarthritis (OA), but its effect on the long-term need for total hip replacement (THR) is unknown.......Exercise treatment is recommended for all patients with hip osteoarthritis (OA), but its effect on the long-term need for total hip replacement (THR) is unknown....

Knee osteoarthritis and perceived social support amongst patients in ...

African Journals Online (AJOL)

Background: Knee osteoarthritis is a chronic disease affecting the lives of patients and their families, with the family characteristics moderating the illness course. The perceived social support received by a patient helps in determining the health and functionality of the patient. Methods: A cross-sectional study was ...

Intrarticular Sodium Hyaluronate for the Treatment of Osteoarthritis of the Knee. A Retrospective Review of 45 Patients

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Yoga R

2009-11-01

Full Text Available Intrarticular Hyaluronic Acid was administered to 45 patients with various grades of osteoarthritis in the knee. Following 3 fortnightly injections, these patients were reviewed at 6 weeks and 3 months with regard to their knee pain. We found that most patients (84.4% had decreased knee pain following these injections. Patients who had severe grade osteoarthritis based on knee radiographs before the injections were less likely to have pain reduction compared to those with milder grade osteoarthritis. Only 4 (8.9% patients showed no improvement and were subsequently considered for surgery. Many patients did not require any further treatment (24.4% and the remaining were given analgesia (64.4% to aid in their pain. One patient required another course of this injection. There were no complications recorded in this study. We concluded that intrarticular Hyaluronic Acid is an easy and safe method to treat osteoarthritis. The short-term outcome with regard to knee pain is good in patients with milder grades of osteoarthritis.

Specificities of anti-neutrophil autoantibodies in patients with rheumatoid arthritis (RA)

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Brimnes, J; Halberg, P; Jacobsen, Søren

1997-01-01

The objective of this study was to characterize antigens recognized by neutrophil-specific autoantibodies from patients with RA. Sera from 62 RA patients were screened by indirect immunofluorescence (IIF). Positive sera were further tested by ELISAs for antibodies against various granule proteins...

The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC in Persian Speaking Patients with Knee Osteoarthritis

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Mohammad H Ebrahimzadeh

2014-03-01

Full Text Available Background: Osteoarthritis of the knee is the most common chronic joint disease that involves middle aged and elderly persons. There are different clinical instruments to quantify the health status of patients with knee osteoarthritis and one example is the WOMAC score that has been translated and adapted into different languages. The purpose of this study was cultural adaptation, validation and reliability testing of the Persian version of the WOMAC index in Iranians with knee osteoarthritis.   Methods: We translated the original WOMAC questionnaire into Persian by the forward and backward technique, and then its psychometric study was done on 169 native Persian speaking patients with knee degenerative joint disease. Mean age of patients was 53.9 years. The SF-36 and KOOS were used to assess construct validity. Results: Reliability testing resulted in a Cronbach’s alpha of 0.917, showing the internal consistency of the questionnaire to be a reliable tool. Inter-correlation matrix among different scales of the Persian WOMAC index yielded a highly significant correlation between all subscales including stiffness, pain, and physical function. In terms of validity, Pearson`s correlation coefficient was significant between three domains of the WOMAC with PF, RP, BP, GH, VT, and PCS dimensions of the SF-36 health survey (P

The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC in Persian Speaking Patients with Knee Osteoarthritis

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Mohammad H Ebrahimzadeh

2014-03-01

Full Text Available   Background: Osteoarthritis of the knee is the most common chronic joint disease that involves middle aged and elderly persons. There are different clinical instruments to quantify the health status of patients with knee osteoarthritis and one example is the WOMAC score that has been translated and adapted into different languages. The purpose of this study was cultural adaptation, validation and reliability testing of the Persian version of the WOMAC index in Iranians with knee osteoarthritis.   Methods: We translated the original WOMAC questionnaire into Persian by the forward and backward technique, and then its psychometric study was done on 169 native Persian speaking patients with knee degenerative joint disease. Mean age of patients was 53.9 years. The SF-36 and KOOS were used to assess construct validity. Results: Reliability testing resulted in a Cronbach’s alpha of 0.917, showing the internal consistency of the questionnaire to be a reliable tool. Inter-correlation matrix among different scales of the Persian WOMAC index yielded a highly significant correlation between all subscales including stiffness, pain, and physical function. In terms of validity, Pearson`s correlation coefficient was significant between three domains of the WOMAC with PF, RP, BP, GH, VT, and PCS dimensions of the SF-36 health survey (P

Topical nonsteroidal anti-inflammatory drugs for management of osteoarthritis in long-term care patients

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Argoff CE

2011-09-01

Full Text Available Charles E Argoff1, F Michael Gloth2 1Albany Medical College and Comprehensive Pain Center, Albany Medical Center, Albany, NY, USA; 2Johns Hopkins University School of Medicine, Baltimore, MD, USA Abstract: Osteoarthritis is common in patients ≥65 years of age. Although nonsteroidal anti-inflammatory drugs (NSAIDs are often prescribed for osteoarthritis pain, they pose age-related cardiovascular, renal, and gastrointestinal risks. Two topical NSAIDs, diclofenac sodium 1% gel (DSG and diclofenac sodium 1.5% in 45.5% dimethylsulfoxide solution (D-DMSO, are approved in the US for the treatment of osteoarthritis pain. Topical NSAIDs have shown efficacy and safety in knee (DSG, D-DMSO and hand (DSG osteoarthritis. Analyses of data from randomized controlled trials of DSG in hand and knee osteoarthritis demonstrate significant improvement of pain and function in both younger patients (<65 years and older patients (≥65 years and suggest good safety and tolerability. However, long-term safety data in older patients are limited. Topical NSAIDs can ease medication administration and help address barriers to pain management in older patients, such as taking multiple medications and inability to swallow, and are a valuable option for long-term care providers. Keywords: nonsteroidal anti-inflammatory drugs, long-term care, nursing homes, chronic pain, topical analgesics

Patient, Provider, and Combined Interventions for Managing Osteoarthritis in Primary Care: A Cluster Randomized Trial.

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Allen, Kelli D; Oddone, Eugene Z; Coffman, Cynthia J; Jeffreys, Amy S; Bosworth, Hayden B; Chatterjee, Ranee; McDuffie, Jennifer; Strauss, Jennifer L; Yancy, William S; Datta, Santanu K; Corsino, Leonor; Dolor, Rowena J

2017-03-21

A single-site study showed that a combined patient and provider intervention improved outcomes for patients with knee osteoarthritis, but it did not assess separate effects of the interventions. To examine whether patient-based, provider-based, and patient-provider interventions improve osteoarthritis outcomes. Cluster randomized trial with assignment to patient, provider, and patient-provider interventions or usual care. (ClinicalTrials.gov: NCT01435109). 10 Duke University Health System community-based primary care clinics. 537 outpatients with symptomatic hip or knee osteoarthritis. The telephone-based patient intervention focused on weight management, physical activity, and cognitive behavioral pain management. The provider intervention involved electronic delivery of patient-specific osteoarthritis treatment recommendations to providers. The primary outcome was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total score at 12 months. Secondary outcomes were objective physical function (Short Physical Performance Battery) and depressive symptoms (Patient Health Questionnaire). Linear mixed models assessed the difference in improvement among groups. No difference was observed in WOMAC score changes from baseline to 12 months in the patient (-1.5 [95% CI, -5.1 to 2.0]; P = 0.40), provider (2.5 [CI, -0.9 to 5.9]; P = 0.152), or patient-provider (-0.7 [CI, -4.2 to 2.8]; P = 0.69) intervention groups compared with usual care. All groups had improvements in WOMAC scores at 12 months (range, -3.7 to -7.7). In addition, no differences were seen in objective physical function or depressive symptoms at 12 months in any of the intervention groups compared with usual care. The study involved 1 health care network. Data on provider referrals were not collected. Contrary to a previous study of a combined patient and provider intervention for osteoarthritis in a Department of Veterans Affairs medical center, this study found no statistically

Pain distribution in primary care patients with hip osteoarthritis

DEFF Research Database (Denmark)

Poulsen, Erik; Overgaard, Søren; Vestergaard, Jacob T

2016-01-01

BACKGROUND: Hip osteoarthritis (OA) is the most common diagnosis in primary care adult patients presenting with hip pain but pain location and pain distribution in primary care patients with hip OA have been reported inadequately. OBJECTIVE: To describe pain location and pain distribution...

Subjective evaluation of the effectiveness of whole-body cryotherapy in patients with osteoarthritis

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Tomasz Chruściak

2016-12-01

Full Text Available Objectives: One of the treatments for osteoarthritis (OA is whole-body cryotherapy (WBC. The aim of this study is to assess the effect of whole-body cryotherapy on the clinical status of patients with osteoarthritis (OA, according to their subjective feelings before and after the application of a 10-day cold treatment cycle. The aim is also to assess the reduction of intensity and frequency of pain, the reduction of the painkiller medication used, and to assess the possible impact on physical activity. Material and methods : The study involved 50 people, including 30 women (60% and 20 men (40%. Thirty-one patients had spondyloarthritis (62% of respondents, 10 had knee osteoarthritis (20%, and 9 hip osteoarthritis (18%. The overall average age was 50.1 ±10.9 years; the youngest patient was 29 years old and the oldest 73 years old. The average age of the women was 6 years higher. The study used a questionnaire completed by patients, and consisted of three basic parts. The modified Laitinen pain questionnaire contained questions concerning the intensity and frequency of pain, frequency of painkiller use and the degree of limited mobility. The visual analogue scale (VAS was used in order to subjectively evaluate the therapy after applying the ten-day treatment cycle. Results: According to the subjective assessment of respondents, after the whole-body cryotherapy treatments, a significant improvement occurred in 39 patients (78%, an improvement in 9 patients (18%, and no improvement was only declared by 2 patients (4%. Conclusions : Whole-body cryotherapy resulted in a reduction in the frequency and degree of pain perception in patients with osteoarthritis. WBC reduced the number of analgesic medications in these patients. It improved the range of physical activity and had a positive effect on the well-being of patients.

The Gait Deviation Index Is Associated with Hip Muscle Strength and Patient-Reported Outcome in Patients with Severe Hip Osteoarthritis

DEFF Research Database (Denmark)

Rosenlund, Signe; Holsgaard-Larsen, Anders; Overgaard, Søren

2016-01-01

) and with severe primary hip osteoarthritis underwent 3-dimensional gait analysis. Mean Gait Deviation Index, pain after walking and maximal isometric hip muscle strength (flexor, extensor, and abductor) were recorded. All patients completed the 'Physical Function Short-form of the Hip disability...... was to investigate associations between Gait Deviation Index as a measure of gait 'quality' and hip muscle strength and between Gait Deviation Index and patient-reported outcomes in patients with primary hip osteoarthritis. METHOD: Forty-seven patients (34 males), aged 61.1 ± 6.7 years, with BMI 27.3 ± 3.4 (kg/m2...... and Osteoarthritis Outcome Score (HOOS-Physical Function) and the Hip disability and Osteoarthritis Outcome Score subscales for pain (HOOS-Pain) and quality-of-life (HOOS-QOL). RESULTS: Mean Gait Deviation Index was positively associated with hip abduction strength (pstrength (p = 0...

A Telephone-based Physiotherapy Intervention for Patients with Osteoarthritis of the Knee

Science.gov (United States)

Odole, Adesola C.; Ojo, Oluwatobi D.

2013-01-01

This study assessed the effects of a 6-week telephone based intervention on the pain intensity and physical function of patients with knee osteoarthritis (OA), and compared the results to physiotherapy conducted in the clinic. Fifty randomly selected patients with knee OA were assigned to one of two treatment groups: a clinic group (CG) and a tele-physiotherapy group (TG). The CG received thrice-weekly physiotherapist administered osteoarthritis-specific exercises in the clinic for six weeks. The TG received structured telephone calls thrice-weekly at home, to monitor self-administered osteoarthritis-specific exercises. Participants’ pain intensity and physical function were assessed at baseline, two, four, and six weeks, in the clinic environment. Within group comparison showed significant improvements across baseline, and at weeks two, four, and six for both TG and CG’s pain intensity and physical function. Between-group comparison of CG and TG’s pain intensity and physical function at baseline and weeks two, four, and six showed no significant differences. This study demonstrated that a six-week course of structured telephone calls thrice-weekly to patients at their home, to monitor self-administered osteoarthritis-specific exercises for patients with knee OA (i.e., tele-physiotherapy) achieved comparable results to physiotherapy conducted in the clinic. PMID:25945214

Osteoarthritis and rheumatoid arthritis pannus have similar qualitative metabolic characteristics and pro-inflammatory cytokine response.

Science.gov (United States)

Furuzawa-Carballeda, J; Macip-Rodríguez, P M; Cabral, A R

2008-01-01

Pannus in osteoarthritis (OA) has only recently been characterized. Little is known, however, regarding the behavior of OA pannus in vitro compared to rheumatoid arthritis (RA) pannus. The purpose of our study was to compare OA with RA pannus. Pannus and synovial tissue co-cultures from 5 patients with OA and 5 patients with RA obtained during arthroplasty were studied. Pannus was defined as the microscopic invasive granulation tissue covering the articular surface. Tissues were cultured for 7 days and stained with Alcian Blue technique. Interleukin-1beta (IL-1beta), IL-8, IL-10, IL-12, tumor necrosis factor-alpha (TNF-alpha), and interferon gamma (IFN-gamma) were also determined in supernatants by ELISA. Cartilage oligomeric matrix protein (COMP), type II collagen, TNF-alpha, IL-10 and Ki-67 expression were also detected by immunohistochemistry. All patients had vascular or fibrous pannus. Synovial proliferation, inflammatory infiltrates and a decrease of extracellular matrix proteins were observed in all tissue samples. Chondrocyte proliferation was lower in OA than RA cartilage. OA synovial tissue expressed lower levels of proteoglycans than RA synoyium. Type II collagen levels were lower in OA than in RA cartilage. Significantly higher levels of IL-1beta were found in the supernatants of RA pannus compared to OA pannus (ppannus supernatants. IL-10, IL-12 and IFN-gamma were undetectable. RA and OA pannus had similar pro-inflammatory and anti-inflammatory cytokine profile expression. OA cartilage, synovial tissue and pannus had lower production of proteoglycans, type II collagen and IL-1beta. It remains to be elucidated why OA pannus invades the cartilage surface but does not cause the marginal erosions typically seen in RA.

A pilot study to evaluate the effects of floatation spa treatment on patients with osteoarthritis.

Science.gov (United States)

Hill, S; Eckett, M J; Paterson, C; Harkness, E F

1999-12-01

To conduct a preliminary investigation of the effects on floatation spa therapy on quality of life in patients with osteoarthritis to see if controlled trials are warranted. Uncontrolled clinical trial. Private floatation spa therapy centre. Fourteen patients with chronic osteoarthritis of the weight-bearing joints, of whom four dropped out. Six weekly sessions of floatation spa therapy. SF36, AIMS2 and MYMOP quality-of-life questionnaires. All patients improved. Differences between baseline and discharge scores showed statistically significant improvement for MYMOP, but not AIMS2 or SF-36. Controlled trials of floatation spa therapy for patients with osteoarthritis are warranted.

Evolution of topical NSAIDs in the guidelines for treatment of osteoarthritis in elderly patients.

Science.gov (United States)

Arnstein, Paul M

2012-07-01

Increasing age is the primary predictor of osteoarthritis, the most prevalent painful condition in the US. Because there are no disease-modifying therapies for osteoarthritis, relief of symptoms and maintenance of quality of life through improving joint function become the focus of management. Although highly effective for pain relief, oral nonsteroidal anti-inflammatory drugs (NSAIDs) are associated with systemic adverse reactions that are sometimes treatment limiting, especially for older patients. Thus, osteoarthritis management in elderly populations is shifting away from traditional NSAIDs to therapies that provide comparable pain relief with improved safety. Since the approval by the US Food and Drug Administration of the use of topical NSAIDs to manage osteoarthritis pain, current treatment guidelines put forth by several professional societies have begun to recommend topical NSAIDs as an alternative therapy and, most recently, as first-line therapy for osteoarthritis management in the elderly. This review provides an overview of the various treatment guidelines that are available to assist prescribers in making safe and effective decisions in the treatment of osteoarthritis in this high-risk patient population.

Association Between Genetic Polymorphisms and Pain Sensitivity in Patients with Hip Osteoarthritis

DEFF Research Database (Denmark)

Olesen, Anne E; Nielsen, Lecia M; Feddersen, Søren

2018-01-01

, kappa, and delta opioid receptor genes (OPRM1, OPRK1, and OPRD1) and the catechol-O-methyltransferase gene (COMT) influenced the pain phenotype in patients with osteoarthritis. METHODS: The frequencies of 17 polymorphisms were examined. Pain sensitivity was assessed preoperatively by (1) hip rotation......BACKGROUND: Factors such as age, gender, and genetic polymorphisms may explain individual differences in pain phenotype. Genetic associations with pain sensitivity have previously been investigated in osteoarthritis patients, with a focus on the P2X7, TRPV1, and TACR1 genes. However, other genes...... may play a role as well. Osteoarthritis is a common joint disease, and many patients suffering from this disease are thought to have increased sensitivity to noxious stimuli resulting from sensitization in the nociceptive system. The aim of this study was to investigate if genetic variants of mu...

Magnetic resonance imaging-determined synovial membrane and joint effusion volumes in rheumatoid arthritis and osteoarthritis: comparison with the macroscopic and microscopic appearance of the synovium

DEFF Research Database (Denmark)

Østergaard, Mikkel; Stoltenberg, M; Løvgreen-Nielsen, P

1997-01-01

OBJECTIVE: To evaluate the relationship between synovial membrane and joint effusion volumes determined by magnetic resonance imaging (MRI) and macroscopic and microscopic synovial pathologic findings in patients with rheumatoid arthritis (RA) and osteoarthritis (OA). METHODS: Synovial biopsies...... were performed, and macroscopic grades of synovitis assigned, at preselected knee sites during arthroscopy or arthrotomy in 17 knees with RA and 25 with OA. Synovial inflammation and 9 separate tissue characteristics were graded histologically. Synovial membrane and joint effusion volumes were...... membrane and effusion volumes may be sensitive markers and/or predictors of disease activity and treatment outcome in RA....

Knee Fat Pad Volumes in Patients with Hemophilia and Their Relationship with Osteoarthritis

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Annette von Drygalski

2017-01-01

Full Text Available Hemophilic arthropathy is a progressive, disabling condition with poorly understood pathobiology. Since there is an emerging interest to study the role of intra-articular fat pad size and biology in arthritic conditions, we explored fat pad volume changes in hemophilic arthropathy and to what extent they differed from osteoarthritis. We matched a cohort of 13 adult patients with hemophilic arthropathy of the knee with age- and gender-matched cohorts without osteoarthritis (“control cohort” and with the same degree of radiographic osteoarthritis (“OA cohort” in 1 : 2 fashion. Infrapatellar fat pad (IPFP and suprapatellar fat pad (SPFP volumes were calculated based on magnetic resonance imaging and differences in fat pad volumes, demographics, height, weight, and osteoarthritis scores were evaluated. Fat pad volumes were positively associated with body size parameters in all three cohorts but were unaffected by the degree of osteoarthritis. While IPFP volumes did not differ between cohorts, SPFP volumes expanded disproportionally with weight in hemophilia patients. Our observations indicate that IPFPs and SPFPs behave biologically differently in response to different arthritic stimuli. The exaggerated expansion of the SPFP in hemophilia patients highlights the importance of further studying the implications of fat pad biology for progression of hemophilic arthropathy.

Effect of balneotherapy on temporospatial gait characteristics of patients with osteoarthritis of the knee.

Science.gov (United States)

Kiliçoğlu, Onder; Dönmez, Arif; Karagülle, Zeki; Erdoğan, Nergis; Akalan, Ekin; Temelli, Yener

2010-04-01

Effects of balneotherapy on gait properties of patients with osteoarthritis of the knee were investigated prospectively. A total of 30 patients with knee osteoarthritis received balneotherapy consisting of two daily thermomineral water baths for 2 weeks. Patients were evaluated using gait analysis and clinical scores, both within 2 weeks, before and after spa treatment. Patients were walking faster in their control analyses (0.81 +/- 0.21 to 0.89 +/- 0.19 m/s; P = 0.017), with a shorter mean stance time (63.0 +/- 3.3 to 61.8 +/- 2.5% stride; P = 0.007), an increased cadence (96 +/- 13.1 to 100 +/- 11.9 steps/min; P = 0.094) and stride length (996 +/- 174 to 1,058 +/- 142 mm; P = 0.017). Balneotherapy also resulted in a significant decrease in Lequesne knee osteoarthritis index (12.1 +/- 3.7 to 10.0 +/- 3.3 points; P = 0.003), VAS for pain (58 +/- 25 to 33 +/- 15; P = 0.0001), VAS for patients' (56 +/- 24 to 29 +/- 19; P Balneotherapy has positive effects on gait properties and clinical health quality parameters of patients with knee osteoarthritis in short-term evaluations.

Effect of a 16 weeks weight loss program on osteoarthritis biomarkers in obese patients with knee osteoarthritis

DEFF Research Database (Denmark)

Bartels, Else Marie; Christensen, R; Christensen, Pia

2014-01-01

OBJECTIVE: Changes in biomarkers for bone and cartilage in knee osteoarthritis (KOA) may reflect changes in tissue turnover induced by interventions. The aim of this study was to assess the effect on osteoarthritis biomarkers of an intensive weight loss intervention in obese KOA patients. METHODS......: 192 obese KOA patients followed a 16 weeks weight loss intervention (ClinicalTrials.gov: NCT00655941). Serum Cartilage Oligomeric Matrix Protein (sCOMP), Urine C-terminal telopeptide of collagen type II (uCTX-II) and type I (uCTX-I) were determined by enzyme-linked immunoassay (ELISA) at baseline....../mmol creatinine, and correlated to weight loss (r = 0.22, P = 0.0007), while not to KOOS-4 (P = 0.93). CONCLUSION: A rapid substantial weight loss in obese KOA patients was weakly, while significantly associated with a reduction in sCOMP, and increases in both uCTX-II and uCTX-I....

Satellite Cells CD44 Positive Drive Muscle Regeneration in Osteoarthritis Patients

Science.gov (United States)

Scimeca, Manuel; Bonanno, Elena; Piccirilli, Eleonora; Baldi, Jacopo; Mauriello, Alessandro; Orlandi, Augusto; Tancredi, Virginia; Gasbarra, Elena; Tarantino, Umberto

2015-01-01

Age-related bone diseases, such as osteoarthritis and osteoporosis, are strongly associated with sarcopenia and muscle fiber atrophy. In this study, we analyzed muscle biopsies in order to demonstrate that, in osteoarthritis patients, both osteophytes formation and regenerative properties of muscle stem cells are related to the same factors. In particular, thanks to immunohistochemistry, transmission electron microscopy, and immunogold labeling we investigated the role of BMP-2 in muscle stem cells activity. In patients with osteoarthritis both immunohistochemistry and transmission electron microscopy allowed us to note a higher number of CD44 positive satellite muscle cells forming syncytium. Moreover, the perinuclear and cytoplasmic expression of BMP-2 assessed by in situ molecular characterization of satellite cells syncytia suggest a very strict correlation between BMP-2 expression and muscle regeneration capability. Summing up, the higher BMP-2 expression in osteoarthritic patients could explain the increased bone mineral density as well as decreased muscle atrophy in osteoarthrosic patients. In conclusion, our results suggest that the control of physiological BMP-2 balance between bone and muscle tissues may be considered as a potential pharmacological target in bone-muscle related pathology. PMID:26101529

Satellite Cells CD44 Positive Drive Muscle Regeneration in Osteoarthritis Patients

Directory of Open Access Journals (Sweden)

Manuel Scimeca

2015-01-01

Full Text Available Age-related bone diseases, such as osteoarthritis and osteoporosis, are strongly associated with sarcopenia and muscle fiber atrophy. In this study, we analyzed muscle biopsies in order to demonstrate that, in osteoarthritis patients, both osteophytes formation and regenerative properties of muscle stem cells are related to the same factors. In particular, thanks to immunohistochemistry, transmission electron microscopy, and immunogold labeling we investigated the role of BMP-2 in muscle stem cells activity. In patients with osteoarthritis both immunohistochemistry and transmission electron microscopy allowed us to note a higher number of CD44 positive satellite muscle cells forming syncytium. Moreover, the perinuclear and cytoplasmic expression of BMP-2 assessed by in situ molecular characterization of satellite cells syncytia suggest a very strict correlation between BMP-2 expression and muscle regeneration capability. Summing up, the higher BMP-2 expression in osteoarthritic patients could explain the increased bone mineral density as well as decreased muscle atrophy in osteoarthrosic patients. In conclusion, our results suggest that the control of physiological BMP-2 balance between bone and muscle tissues may be considered as a potential pharmacological target in bone-muscle related pathology.

Validation of the Mini-OAKHQOL for use in patients with osteoarthritis in Spain.

Science.gov (United States)

Gonzalez Sáenz de Tejada, Marta; Bilbao, Amaia; Herrera, Carmen; García, Lidia; Sarasqueta, Cristina; Escobar, Antonio

2017-08-01

The Mini-Osteoarthritis Knee and Hip Quality of Life (Mini-OAKHQOL) questionnaire osteoarthritis is specific to individuals with knee or hip osteoarthritis. The objective of this study was to perform a validation of the Mini-OAKHQOL for use in Spain in terms of its psychometric properties of reliability, validity and responsiveness. Patients with osteoarthritis from the waiting list for a joint replacement completed the OAKHQOL, Short Form 36 Health Survey and Western Ontario and McMaster Universities Osteoarthritis Index. Reliability was assessed in terms of internal consistency and test-retest data, and convergent validity using Spearman's correlation coefficient. Structural validity was investigated by confirmatory factor analysis, and Rasch analysis was used to examine the unidimensionality of the scales. Responsiveness was assessed by calculating effect sizes. Confirmatory factor analysis confirmed the five-factor model, and the results of the Rasch analyses supported the unidimensionality assumption, with infit and outfit statistics. Cronbach's alpha ranged from 0.76 to 0.89 for all except the social dimensions. Statistically significant differences were observed between patients with different degrees of disease severity on all dimensions. There was convergent validity among dimensions expected to be correlated. The OAKHQOL questionnaire showed good responsiveness, with large changes for all dimensions apart from the two social dimensions, which had small effect sizes. Results of the study support the view that the Spanish version of the Mini-OAKHQOL questionnaire is a valid instrument to measure health-related quality of life in patients with osteoarthritis of the lower limb.

A Telephone-based Physiotherapy Intervention for Patients with Osteoarthritis of the Knee

Directory of Open Access Journals (Sweden)

Adesola C Odole

2013-12-01

Full Text Available This study assessed the effects of a 6-week telephone based intervention on the pain intensity and physical function of patients with knee osteoarthritis (OA, and compared the results to physiotherapy conducted in the clinic. Fifty randomly selected patients with knee OA were assigned to one of two treatment groups: a clinic group (CG and a tele-physiotherapy group (TG. The CG received thrice-weekly physiotherapist administered osteoarthritis-specific exercises in the clinic for six weeks. The TG received structured telephone calls thrice-weekly at home, to monitor self-administered osteoarthritis-specific exercises. Participants’ pain intensity and physical function were assessed at baseline, two, four, and six weeks, in the clinic environment. Within group comparison showed significant improvements across baseline, and at weeks two, four, and six for both TG and CG’s pain intensity and physical function. Between-group comparison of CG and TG’s pain intensity and physical function at baseline and weeks two, four, and six showed no significant differences. This study demonstrated that a six-week course of structured telephone calls thrice-weekly to patients at their home, to monitor self-administered osteoarthritis-specific exercises for patients with knee OA (i.e., tele-physiotherapy achieved comparable results to physiotherapy conducted in the clinic.   12.00 Normal 0 false false false EN-US X-NONE X-NONE

Association of metabolic syndrome in patients with osteoarthritis

International Nuclear Information System (INIS)

Malik, S.; Salim, B.; Khalil, Z.; Nasim, A.

2015-01-01

Objective: To determine association of osteoarthritis (OA) with metabolic syndrome in a tertiary care hospital of Pakistan. Methodology: A cross-sectional study was conducted at Fauji Foundation Hospital, Rawalpindi, Pakistan. Patients were randomly interviewed in the Female Rheumatology department and a total of 240 patients with single rheumatologic disease and age >35 years were selected. Informed consent was taken and patients were interviewed using a self-made questionnaire to evaluate their medical history, physical and laboratory examination. SPSS version 17 was used to analyze the data. Results: Out of 240 subjects, 81 patients had OA and another 81 patients were randomly selected from the age and gender matched control (non-OA) group. The mean age of patients in OA and non-OA group was 56.68 ± 09.76 and 53.57 ± 11.01 years, respectively. In OA group, 48.1% and in non-OA group 22.2% of patients were falling in category of being obese/morbidly obese. According to AHA criteria for Metabolic Syndrome, percentage of OA patients labeled to have metabolic syndrome was 58.8% as compared to 19.5% in non-OA group. Conclusion: There was a strong association of metabolic syndrome with OA and would surely make a foreground for future studies to be conducted on developing preventive strategies and ultimately reducing the morbidities and mortalities associated with Metabolic Osteoarthritis. (author)

[METABOLIC STATUS OF PATIENTS OF DIFFERENT AGE GROUPS ON THE STAGES OF OSTEOARTHRITIS].

Science.gov (United States)

Stogov, M V; Ovchinnikov, E N; Sazonova, N V

2015-01-01

This study investigated the biochemical parameters of blood and urine in patients with osteoarthritis in the stages of the pathological process in different age groups. The patients of all age groups in the stages of osteoarthritis demonstrated metabolic acidosis, activation of the antioxidant system and increase in acute phase proteins. In addition to the total for all age groups metabolic shifts the characteristic age-related changes were observed: activated reaction of lipid peroxidation in middle-aged patients and negative calcium balance, with increasing energy metabolism disorders in elderly patients.

Treatment of patients with hand osteoarthritis : outcome measures, patient satisfaction, and economic evaluation

NARCIS (Netherlands)

Marks, Miriam

2014-01-01

The aim of this thesis was to investigate the limitations in daily life, outcome measures, clinical outcomes with the emphasis on patient satisfaction, and economic aspects of the treatment of hand osteoarthritis (OA). Patients with hand OA report severe restrictions in daily life, in particular in

Taping reduces pain and disability in patients with knee osteoarthritis.

NARCIS (Netherlands)

Ende, E. van den

2004-01-01

Question: Is taping of the knee effective in improving pain and disability in patients with osteoarthritis of the knee? Design Randomised controlled trial. Setting University and private practices in Melbourne, Australia. Patients: Volunteers who responded to advertisements in local newspapers.

Knee osteoarthritis and perceived social support amongst patients in ...

African Journals Online (AJOL)

Temitope Ilori

2016-06-29

Jun 29, 2016 ... ... as marital or relationship status, and the number of children, appear to have a ... its health impact on patients with knee osteoarthritis who presented to .... Children. Spouse. Sibling. Parents. In-laws. Others. FREQUENCY %.

Effect of joint traction on functional improvement and quality of life in patients with severe knee osteoarthritis

OpenAIRE

Sedigheh Sadat Naeimee; Abbas Rahimi; Mehdi Rezaee; Alireza Akbarzadeh Baghban; Khosro Khademi Kalantari; ُSomayeh Mahmoudi Aghdam

2012-01-01

Background and aim: Osteoarthritis (OA) is the most prevalent joint disease in adults around the world and its incidence rises with age. Patients with severe knee osteoarthritis often complain of pain and severe functional disability. Most of conservative treatments used in this group of patients induce poor improvements. This study evaluated the effect of joint traction on quality of life of patients with severe knee osteoarthritis.Materials and Methods: In this clinical trial study, forty f...

Clinical descriptors for the recognition of central sensitization pain in patients with knee osteoarthritis

DEFF Research Database (Denmark)

Lluch, Enrique; Nijs, Jo; Courtney, Carol A

2018-01-01

BACKGROUND: Despite growing awareness of the contribution of central pain mechanisms to knee osteoarthritis pain in a subgroup of patients, routine evaluation of central sensitization is yet to be incorporated into clinical practice. AIM: The objective of this perspective is to design a set...... of clinical descriptors for the recognition of central sensitization in patients with knee osteoarthritis that can be implemented in clinical practice. METHODS: A narrative review of original research papers was conducted by nine clinicians and researchers from seven different countries to reach agreement...... hyperalgesia, hypoesthesia and reduced vibration sense. CONCLUSIONS: This article describes a set of clinically relevant descriptors that might indicate the presence of central sensitization in patients with knee osteoarthritis in clinical practice. Although based on research data, the descriptors proposed...

Traditional and Complementary Medicine Use in Knee Osteoarthritis and its Associated Factors Among Patients in Northeast Peninsular Malaysia.

Science.gov (United States)

Nik Shafii, Nik Abdul Hafiz; Yaacob, Lili Husniati; Ishak, Azlina; Kadir, Azidah Abdul

2018-03-01

We sought to determine the prevalence of traditional and complementary medicine (TCM) use for knee osteoarthritis and its associated factors among patients attending a referral hospital in an eastern coastal state of Malaysia. This cross-sectional study included 214 patients with knee osteoarthritis. A universal sampling method was applied to patients who attended the outpatient clinic in Hospital Universiti Sains Malaysia from May 2013 to October 2013. Participants were given a questionnaire to determine their sociodemographic information and a validated Bahasa Malaysia version of the Western Ontario and McMaster Universities Arthritis Index (WOMAC). This questionnaire was used to assess the severity of knee osteoarthritis (i.e., pain, stiffness, and disturbances in daily activity). Over half (57.9%) of patients reported using TCM to treat knee osteoarthritis. Factors associated with TCM use were gender (odd ratio (OR) = 2.47; 95% confidence interval (CI): 1.28-4.77), duration of knee osteoarthritis (OR = 1.51; 95% CI: 1.03-2.23), and the severity of knee pain (OR = 2.56; 95% CI: 1.71-3.86). The prevalence of TCM use among eastern Malaysian patients with knee osteoarthritis was high. Physicians caring for these patients should be aware of these findings so that inquiries regarding TCM use can be made and patients can be appropriately counseled.

Patient-reported outcome and risk of revision after shoulder replacement for osteoarthritis

DEFF Research Database (Denmark)

Rasmussen, Jeppe V; Polk, Anne; Brorson, Stig

2014-01-01

PURPOSE: We used patient-reported outcome and risk of revision to compare hemiarthroplasty (HA) with total shoulder arthroplasty (TSA) and stemmed hemiarthroplasty (SHA) with resurfacing hemiarthroplasty (RHA) in patients with glenohumeral osteoarthritis. PATIENTS AND METHODS: We included all...... of presentation, the raw scores were converted to a percentage of the maximum score. Revision rates were calculated by checking reported revisions to the DSR until December 2011. WOOS and risk of revision were adjusted for age, sex, previous surgery, and type of osteoarthritis. RESULTS: There were 113 TSAs...... and 1096 HAs (837 RHAs and 259 SHAs). Patients treated with TSA generally had a better WOOS, exceeding the predefined minimal clinically important difference, at 1 year (mean difference 10, p

ISOMETRIC EXERCISE VERSUS COMBINED CONCENTRIC-ECCENTRIC EXERCISE TRAINING IN PATIENTS WITH OSTEOARTHRITIS KNEE

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Nigombam Amit Kumar

2015-12-01

Full Text Available Background: Osteoarthritis is a slowly evolving articular disease, which appears to originate in the cartilage and affects the underlying bone and soft tissues. OA results in pain and functional disability. The purpose of this study was to determine the effect of isometric exercises and combined concentric-eccentric exercises in reducing pain and functional disability in patients with osteoarthritis of knee. Methods: Forty individuals who were diagnosed as osteoarthritis by qualified orthopaedics and orthopaedic surgeons were chosen and were randomly divided into 2 groups Group A (N=20 and Group B (N=20. Group A was treated with isometric exercises and Group B was treated with combined concentric-eccentric exercises. The intervention lasted eight weeks and the physical activity was carried out for 3 days a week. Both the groups were assessed for pain and functional disability of knee joint by using WOMAC osteoarthritis index and VAS. Results: Between group analysis of pre and post study data reveals that VAS and WOMAC osteoarthritis index revealed significant findings (P=0.00. Group B performs significantly better on both the scales after the treatment. Conclusion: Both the groups showed significant improvement in decreasing pain and functional disability. But mean scores of Group B showed greater improvement in reducing pain and functional disability as compared to Group A in patients with knee osteoarthritis. Thus the results suggest that a combined concentric-eccentric e

Radiation exposure of relatives of patients treated with Ra-223 dichloride

International Nuclear Information System (INIS)

Wanke, C.; Szermerski, B.; Solle, A.; Geworski, L.; Kranert, W.T.; Andreeff, M.; TU Dresden

2015-01-01

Since November 2013, a radiopharmaceutical containing Ra-223 dichloride as active substance is approved in the European Union for patients with castration resistant prostate cancer with symptomatic bone metastases and no known visceral metastases. Ra-223 (T 1/2 = 11.43 d) decays via a chain of 4 alpha and 2 beta decays. This therapy is presently the only application of an alpha emitter in clinical routine therapy. To show that the exposure of relatives and caregivers of patients treated with Ra-223 dichloride in an outpatient setting does not exceed a value of 1 mSv, the multicenter study ''RAPSODY'' was conducted. As Ra-223 and most of its progeny emit alpha particles, the internal exposure had to be evaluated in particular. Within this study, measurements of the radiation emitted from the patient were performed using standard dose-rate meters. Wipe-tests were taken in the patients' homes to identify significant contaminations and evaluated by liquid scintillation counting. Samples of saliva and sweat were taken and measured using gamma spectrometry. Ra-223 disintegrates to the noble gas Rn-219 and was measured in the exhaled breath from the patients using conventional Radon Monitors. Furthermore, a computational fluid dynamics simulation (CFD) was performed to assess the radioactivity in the air, which could be inhaled by persons close to the patient. Conclusions: The potential exposure of relatives and caregivers by external irradiation and incorporation of radioactivity exhaled or excreted by the patient with saliva or sweat is well below 1 mSv. No objections are seen regarding outpatient treatment. This paper summarizes contents of a poster presented at the Annual Meeting of the Society of Nuclear Medicine and Molecular Imaging.

Epidemiology of Posttraumatic Osteoarthritis.

Science.gov (United States)

Thomas, Abbey C; Hubbard-Turner, Tricia; Wikstrom, Erik A; Palmieri-Smith, Riann M

2017-06-02

Osteoarthritis is a leading cause of disability whose prevalence and incidence continue to increase. History of joint injury represents an important risk factor for posttraumatic osteoarthritis and is a significant contributor to the rapidly growing percentage of the population with osteoarthritis. This review will present the epidemiology associated with posttraumatic osteoarthritis, with particular emphasis on the knee and ankle joints. It is important to understand the effect of posttraumatic osteoarthritis on the population so that sufficient resources can be devoted to countering the disease and promoting optimal long-term health for patients after joint injury.

Procarti Forte in the Complex Treatment of Patients with Early-Stage Osteoarthritis

Directory of Open Access Journals (Sweden)

O.A. Burianov

2016-04-01

Full Text Available The article deals with the issue of the treatment of osteoarthritis. The review of current recommendations on the feasibility of using glucosamine sulfate, chondroitin sulfate, hyaluronic acid, using of SYSADOA drugs, metabolic drugs was performed. The study on the efficacy and safety of using combination drug Procarti Forte in the system of treatment of patients with early-stage osteoarthritis is presented.

Serum progranulin irrelated with Breg cell levels, but elevated in RA patients, reflecting high disease activity.

Science.gov (United States)

Chen, Jiaxi; Li, Shuang; Shi, Jianfeng; Zhang, Lili; Li, Jun; Chen, Shiyong; Wu, Chunlong; Shen, Bo

2016-03-01

Soluble progranulin (PGRN) is known to directly regulate regulatory T cells; however, whether PGRN levels are elevated in patients with rheumatoid arthritis and affect the regulatory subsets of B cells remain unknown. In this study, a total of 80 RA patients and 60 healthy controls were studied. Serum progranulin levels were determined using enzyme-linked immune-sorbent assay. A receiver operating characteristic (ROC) curve was used to evaluate the feasibility of serum PGRN as a biomarker for distinguishing patients with RA. CD19(+)CD5(+)GrB(+) B cells were analyzed by flow cytometry in peripheral blood mononuclear cells (PBMCs). Serum progranulin levels in RA patients (median, 59.4 ng/mL) and in RA patients DAS28 > 5.1 (median, 71.98 ng/mL) were much higher than those in normal controls (median, 46.3 ng/mL; P progranulin levels was 0.705 for RA versus normal controls and the area under the ROC curve for progranulin levels in RA patients DAS28 > 5.1 was 0.977 versus normal controls (P progranulin and DAS28, CRP, ESR were all positively correlated in RA patients (P 0.05). Our findings indicated that induction of PGRN expression may play a role in RA immune reaction and PGRN levels could be a useful biomarker in RA inflammatory response, but irrelated with Breg cell levels.

Comparing Exercise Prescription Methods in Knee Osteoarthritis Patients in Malaysia

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D’Gasper Dineesha

2018-03-01

Full Text Available Aim: This study was a qualitative study that investigated the exercise prescription method in knee osteoarthritis patients in Malaysia. It purposed to find out the most common and effective method used by physiotherapist in prescribing exercises for knee osteoarthritis patients in Malaysia. Method: This study used a self-administered survey questionnaire. The subjects recruited for this study were diagnosed with knee osteoarthritis, age range of between 50 to 80 years old.The methods of delivery were divided into three categories, which include only verbal instructions, verbal instruction together with demonstration and lastly a combination of all three methods including verbal instruction, demonstration and handouts with diagrams. Results: The results showed that 52% received their exercise prescription with verbal instruction and together with demonstration, about 43% of them received all three types of methods which included the verbal instruction, demonstration and take home handouts and 5% of them only received verbal instruction. Out of 5% who received verbal instruction alone, only 1% understood the exercises and the remaining 4% did not and 45% out of 52% who received verbal and demonstration method understood the exercises and the remaining 7% did not. 5% who received only verbal instruction did not seem to continue the exercises at home. 52% received verbal instruction together with demonstration, with about 44% of them having continued their exercises but the remaining 8% did not. 43% who received all three methods reported to continue. Conclusion: The best method of delivering exercises to knee osteoarthritis patients was proven to be the method with a combination of verbal instruction, demonstration together with a take home handout. This method showed very positive outcome and should be implemented and emphasized more in both the government and private sectors of physiotherapy departments.

A Water Rehabilitation Program in Patients with Hip Osteoarthritis Before and After Total Hip Replacement

OpenAIRE

?yp, Marek; Kaczor, Ryszard; Cabak, Anna; Tederko, Piotr; W?ostowska, Ewa; Stanis?awska, Iwona; Szypu?a, Jan; Tomaszewski, Wies?aw

2016-01-01

Background Pain associated with coxarthrosis, typically occurring in middle-aged and elderly patients, very commonly causes considerable limitation of motor fitness and dependence on pharmacotherapy. This article provides an assessment of a rehabilitation program with tailored water exercises in patients with osteoarthritis before and after total hip replacement. Material/Methods A total of 192 patients (the mean age 61.03?10.89) suffering from hip osteoarthritis (OA) were evaluated before an...

Effect of joint traction on functional improvement and quality of life in patients with severe knee osteoarthritis

Directory of Open Access Journals (Sweden)

Sedigheh Sadat Naeimee

2012-07-01

Full Text Available Background and aim: Osteoarthritis (OA is the most prevalent joint disease in adults around the world and its incidence rises with age. Patients with severe knee osteoarthritis often complain of pain and severe functional disability. Most of conservative treatments used in this group of patients induce poor improvements. This study evaluated the effect of joint traction on quality of life of patients with severe knee osteoarthritis.Materials and Methods: In this clinical trial study, forty female patients with severe knee OA were randomly assigned to two following groups; common physiotherapy treatment and common physiotherapy treatment accompanied by knee distraction. Quality of life was evaluated pre- and post-treatment and also one month follow-up using the Knee injury and Osteoarthritis Outcome Score (KOOS questionnaire.Results: Common physiotherapy treatment accompanied by knee distraction resulted in significantly better quality of life post-treatment and at 1month follow-up, compared to common physiotherapy treatment alone (P<0.01.Conclusion: Common physiotherapy treatment accompanied by knee distraction induces significant improvement in quality of life in patients with severe knee osteoarthritis compared to common physiotherapy treatment alone.

Development of an Autologous Macrophage-based Adoptive Gene Transfer Strategy to Treat Posttraumatic Osteoarthritis (PTOA) and Osteoarithritis (OA)

Science.gov (United States)

2016-05-01

damaged articular cartilage showed evidence of an increase in cell proliferation of chondrocytes, consistent with the literature showing that anabolic ...2. Stiebel M, Miller LE, Block JE (2014) Post-traumatic knee osteoarthritis in the young patient: therapeutic dilemmas and emerging technologies. Open...delivery of an anti-catabolic agent, i.e., IL-1ra, in addition to a pro- anabolic growth factor, i.e., TGF-β3, with the M2-macrophage approach would

 Adiponectin in early and chronic rheumatoid arthritis and osteoarthritis

DEFF Research Database (Denmark)

Laurberg, Trine Bay

  Dato 31. januar 2006Title Adiponectin in early and chronic rheumatoid arthritis and osteoarthritisAuthors:Trine Bay Laurberg,Torkell Ellingsen,Jan Frystyk,Ib Hansen,Anette Jørgensen,Ulrik Tarp,Merete Lund Hetland,Kim Hørslev-Petersen,Nete Hornung,Jørgen Hjelm Poulsen,Allan Flyvbjerg,Kristian St......  Dato 31. januar 2006Title Adiponectin in early and chronic rheumatoid arthritis and osteoarthritisAuthors:Trine Bay Laurberg,Torkell Ellingsen,Jan Frystyk,Ib Hansen,Anette Jørgensen,Ulrik Tarp,Merete Lund Hetland,Kim Hørslev-Petersen,Nete Hornung,Jørgen Hjelm Poulsen,Allan Flyvbjerg......,Kristian Stengaard-PedersenBackground: Rheumatoid arthritis (RA) is a systemic, chronic, autoimmune disease, which affects the joints with inflammation leading to destruction of cartilage and bone. Osteoarthritis (OA) is a degenerative joint disease characterised by low level of chronic inflammation, slow...

Differences in zinc status between patients with osteoarthritis and osteoporosis

DEFF Research Database (Denmark)

Ovesen, Janne; Møller-Madsen, Bjarne; Nielsen, Poul Torben

2009-01-01

Zinc has been suggested to play an important role in the development of osteoporosis, whereas the influence of zinc on osteoarthritis has attracted much less attention. The aim of the study was to investigate and compare the zinc status and bone turnover, density, and biomechanical properties...... of osteoarthritic and osteoporotic patients. The study comprised 40 women who underwent hip replacement due to osteoarthritis or osteoporosis. Serum and urine zinc content, and bone resorption markers and serum bone formation markers were determined. The unaffected hip and the exarticulated affected femoral head...... underwent DEXA scanning. Bone biopsies were obtained from the femoral heads and the biomechanical properties were determined. The biopsies were ashed and the bone zinc content was ascertained. Osteoarthritic patients had significantly higher serum zinc concentrations and lower urine zinc concentrations than...

Long-term clinical investigation of patients with ankylosing spondylitis treated with /sup 224/Ra

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Schmitt, E [Universitatsklinik Friedrichsheim, Frankfurt, West Germany; Ruckbeil, C; Wick, R R

1983-01-01

Between 1952 and 1980 about 250 patients with ankylosing spondylitis were treated with /sup 224/Ra at the Orthopaedic University Hospital of Frankfurt/M. In 1970, 119 of them were examined and X-rayed as was another group of 40 patients in 1980. The results of those examined could be compared with a group of 40 patients treated without /sup 224/Ra. Patients with /sup 224/Ra demonstrated a long-lasting period of subjective improvement after the treatment, with reduced consumption of antirheumatoid and analgesic drugs, on the average. Blood examinations show inflammatory activities. Nevertheless, the ankylosing spondylitis proceeded. In the final stages of the disease, neither the clinical aspects nor the X-rays showed any specific changes. We observed no case of malignant bone tumor. Of the 169 examined patients, 22 had a total of 32 children after the treatment with /sup 224/Ra. Among these was a set of twins with cerebral palsy and diabetes insipidus renalis. In conclusion, /sup 224/Ra in ankylosing spondylitis is a recommended treatment without higher risk compared to the common therapy with drugs.

Tooth breakage in patients injected with 224Ra

International Nuclear Information System (INIS)

Sonnabend, E.; Spiess, H.; Mays, C.W.

1986-01-01

Tooth breakage has been common among the 224 Ra patients, especially those injected as teenagers. The fracture of 1 or more teeth was reported by 26% (8/31) of boys and 23% (7/30) of girls injected with 224 Ra at 16-20 years of age. Combining results from all age groups, the incidence of tooth fractures increased significantly with dose (P=0.01). Unlike the normal loss of permanent teeth by periodontal disease, in which the entire tooth is lost, the tooth loss following 224 Ra injection was primarily from tooth resorption near the gum line causing the tooth crowns to break off easily. Eventually the tooth roots may either become incorporated into the jawbone or are resorbed and replaced with bone. These tooth fractures resembled those observed in the U.S. radium dial painters and in dogs injected with bone-seeking α-emitters. (orig.)

European validation of The Comprehensive International Classification of Functioning, Disability and Health Core Set for Osteoarthritis from the perspective of patients with osteoarthritis of the knee or hip.

Science.gov (United States)

Weigl, Martin; Wild, Heike

2017-09-15

To validate the International Classification of Functioning, Disability and Health Comprehensive Core Set for Osteoarthritis from the patient perspective in Europe. This multicenter cross-sectional study involved 375 patients with knee or hip osteoarthritis. Trained health professionals completed the Comprehensive Core Set, and patients completed the Short-Form 36 questionnaire. Content validity was evaluated by calculating prevalences of impairments in body function and structures, limitations in activities and participation and environmental factors, which were either barriers or facilitators. Convergent construct validity was evaluated by correlating the International Classification of Functioning, Disability and Health categories with the Short-Form 36 Physical Component Score and the SF-36 Mental Component Score in a subgroup of 259 patients. The prevalences of all body function, body structure and activities and participation categories were >40%, >32% and >20%, respectively, and all environmental factors were relevant for >16% of patients. Few categories showed relevant differences between knee and hip osteoarthritis. All body function categories and all but two activities and participation categories showed significant correlations with the Physical Component Score. Body functions from the ICF chapter Mental Functions showed higher correlations with the Mental Component Score than with the Physical Component Score. This study supports the validity of the International Classification of Functioning, Disability and Health Comprehensive Core Set for Osteoarthritis. Implications for Rehabilitation Comprehensive International Classification of Functioning, Disability and Health Core Sets were developed as practical tools for application in multidisciplinary assessments. The validity of the Comprehensive International Classification of Functioning, Disability and Health Core Set for Osteoarthritis in this study supports its application in European patients with

Estimation of Serum Matrix Metalloproteinases-1 Levels in Iraqi Female Patients with Osteoarthritis

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Vean Sabah Ali

2018-05-01

Full Text Available This study was established to investigate the correlation between the expression of matrix metalloproteinases (MMP-1 and the pathogenesis of osteoarthritis (OA. Blood samples were collected from 55 female patients with inflammatory OA and controls for estimation of serum (MMP-1 levels. In the current study, there is significant increase (p<0.001 in the mean of serum MMP-1 levels in osteoarthritis females (4027.73 ± 1345.28 pg/ml than that in control females (798.76 ± 136.79 pg/ml. It was concluded that MMP-1 may be associated with the pathogenesis of osteoarthritis.

Incidence of tumours of the skeleton in 224Ra-treated ankylosing spondylitis patients

International Nuclear Information System (INIS)

Wick, R.R.; Goessner, W.

1983-01-01

We are following 1426 ankylosing spondylitis (a.sp.) patients treated with 224 Ra and 1556 control patients with a.sp. not treated with any form of ionizing radiation. The average follow-up time of the exposure group is 16 years and the average α-dose to the skeleton is 65 rad, resulting from intravenous injection of 4.8μCi/kg 224 Ra on average within a medium injection span of 12 weeks. Injections normally have been performed once a week, and in some cases also half-weekly with a correspondingly shorter injection span. Since 1970 three cases of malignant tumours in the skeleton have been observed in the exposure group in patients with skeletal α-doses below 90 rad compared with 0.6 expected. (No bone tumour has occurred in the control group.) Two of the three cases observed were tumours of the bone marrow. The incidence of leukaemias in both exposure and control groups is discussed with respect to phenylbutazone treatment and α-radiation from 224 Ra. An effect of 224 Ra on the bone marrow not yet detected in the Spiess series of patients treated with higher amounts of 224 Ra cannot be excluded. (author)

Gastrointestinal safety of etoricoxib in osteoarthritis and rheumatoid arthritis: A meta-analysis.

Directory of Open Access Journals (Sweden)

Xiaoting Feng

Full Text Available To ascertain if etoricoxib increases the risk of gastrointestinal adverse events (GAEs compared with placebo, diclofenac, and naproxen in the treatment of patients with osteoarthritis (OA or rheumatoid arthritis (RA.Studies were searched in MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials from inception to August 2017. Randomized Clinical Trials (RCTs that compared etoricoxib with placebo and other active drug for patients with OA or RA and reported data on gastrointestinal safety (which is of interest to patients and clinicians were included. The follow-up time window for GAEs was defined as within 28 days subsequent to the last dose of study medication. A meta-analysis was conducted using a fixed-effect model. Risk ratios (RRs and 95% confidence intervals (CIs were measured.We found nine randomized clinical trials (RCTs that included information on gastrointestinal safety during follow-up time. Among them, five RCTs compared etoricoxib with placebo, four RCTs compared etoricoxib with diclofenac, and three RCTs compared etoricoxib with naproxen. Etoricoxib did not increase the risk of GAEs compared with placebo. Compared with diclofenac and naproxen, etoricoxib reduced the GAE risk (RR, 0.67; 95% CI, 0.59-0.76; p < 0.00001; 0.59; 0.48-0.72; < 0.00001 during follow-up time.In patients with OA or RA, etoricoxib did not increase the GAE risk compared with placebo, but reduced the GAE risk effectively compared with diclofenac and naproxen during follow-up time.

Physiotherapy Effects in Gait Speed in Patients with Knee Osteoarthritis.

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Tani, Klejda; Kola, Irena; Dhamaj, Fregen; Shpata, Vjollca; Zallari, Kiri

2018-03-15

Knee osteoarthritis is a chronic degenerative disease, known as the most common cause of difficulty walking in older adults and subsequently is associated with slow walking. Also one of the main symptoms is a degenerative and mechanics type of pain. Pain is very noticeable while walking in rugged terrain, during ascent and descent of stairs, when changing from sitting to standing position as well as staying in one position for a long time. Many studies have shown that the strength of the quadriceps femoris muscle can affect gait, by improving or weakening it. Kinesio Tape is a physiotherapeutic technique, which reduces pain and increases muscular strength by irritating the skin receptors. The aims of this study was first to verify if the application of Kinesio Tape on quadriceps femoris muscle increases gait speed in patients with knee osteoarthritis and secondly if applying Kinesio Tape on quadriceps femoris muscle reduces pain while walking. Seventy-four patients with primary knee osteoarthritis, aged 50 - 73 years, participated in this study. Firstly we observed the change of gait speed, while walking for 10 meters at normal speed for each patient, before, one day and three days after the application of Kinesio Tape on quadriceps femoris muscle, with the help of the 10 - meter walk test. Secondly, we observed the change of pain, while walking for 10 meters at normal speed for each patient, before, one day and three days after the application, with the help of Numerical Pain Rating Scale - NRS. Our results indicated that there was a significant increase in gait speed while walking for 10 meters one day and also three days after application of Kinesio Tape on quadriceps femoris muscle. Also, there was a significant reduction of pain level 1 and 3 days after application of Kinesio Tape, compared to the level of pain before its application. Our results indicated that there was a significant decrease in pain and increase of gait speed while walking for 10 meters

Treatment modalities for patients with varus medial knee osteoarthritis

NARCIS (Netherlands)

T. Duivenvoorden (Tijs)

2015-01-01

markdownabstractAbstract Osteoarthritis (OA) is one of the most common joint disorders in the Western population, which causes pain, stiffness, loss of function and disability. In patients with OA the cartilage, located at the ends of long bones, is damaged. OA is most prevalent in the knee

Pes Anserine Bursitis in Symptomatic Osteoarthritis Patients: A Mesotherapy Treatment Study.

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Saggini, Raoul; Di Stefano, Alexandra; Dodaj, Ira; Scarcello, Laura; Bellomo, Rosa Grazia

2015-08-01

Pes anserine bursitis strongly affects quality of life in patients with osteoarthritis. Treatment includes nonsteroidal anti-inflammatory drugs (NSAIDs), physiotherapy, and injections of corticosteroid, with highly variable responses; recovery can take 10 days to 36 months. Mesotherapy is a minimally invasive technique consisting of subcutaneous injections of bioactive substances. The goal is to modulate the pharmacokinetics of the injected substance and prolong the effects at a local level. To evaluate the effects of mesotherapy with diclofenac for anserine bursitis associated with knee osteoarthritis. One hundred and seventeen patients with anserine bursitis associated with grade II Kellgren-Lawrence knee osteoarthritis, assessed by clinical, radiographic, and ultrasonographic examination, were evaluated and treated. They were randomly divided into two groups (A, mesotherapy; B, control). Group A completed nine sessions of mesotherapy with sodium diclofenac (25 mg/1 mL; Akis®, IBSA, Lugano, Switzerland), 1 mL for each session, three times per week. Group B received 21 oral administrations of sodium diclofenac (50 mg; Voltaren®, Novartis, Parsippany, NJ), once a day for 3 weeks. Primary outcome measures were pain intensity assessed by visual analogue scale (VAS), along with ability to perform activities of daily living, ability to participate in sports, level of pain, symptoms, and quality of life, as assessed by the Knee injury and Osteoarthritis Outcome Score. These measures were performed before and after the treatment period and at 30 and 90 days' follow up. In both groups pain level decreased significantly after the treatment period. Ultrasonography showed a reduction of the hypoechoic area related to anserine bursitis only in group A. Administration of conventional NSAIDs (diclofenac) by mesotherapy is effective in managing anserine bursitis in knee osteoarthritis in the short term and mid-term. These observations could be of interest for efforts

Clinical osteoarthritis predicts physical and psychological QoL in acromegaly patients

NARCIS (Netherlands)

Wassenaar, M. J. E.; Biermasz, N. R.; Kloppenburg, M.; van der Klaauw, A. A.; Tiemensma, J.; Smit, J. W. A.; Pereira, A. M.; Roelfsema, F.; Kroon, H. M.; Romijn, J. A.

2010-01-01

Quality of life is decreased in patients with long-term control of acromegaly. In addition, these patients suffer from irreversible osteoarthritis. The aim of this study was to assess the impact of joint-specific complaints, clinical and radiological signs of arthropathy on different aspects of

Demographic and clinical characteristics of primary and secondary care patients with osteoarthritis of hip and knee are quite similar.

NARCIS (Netherlands)

Lanson, S.; Lucas, C.; Veenhof, C.

2012-01-01

Purpose: As is stated in many guidelines for patients with osteoarthritis, it is advised to treat patients conservatively before patients are referred to secondary care. Therefore, it can be expected that secondary care patietns with osteoarthritis differ from primary care patients. The purpose of

Osteoarthritis, obesity and weight loss

DEFF Research Database (Denmark)

Bliddal, Henning; Leeds, A R; Christensen, Robin Daniel Kjersgaard

2014-01-01

Obesity is widely acknowledged as a risk factor for both the incidence and progression of osteoarthritis, and has a negative influence on outcomes. Loss of at least 10% of body weight, coupled with exercise, is recognized as a cornerstone in the management of obese patients with osteoarthritis......, and can lead to significant improvement in symptoms, pain relief, physical function and health-related quality of life. However, questions still remain surrounding optimal management. Given the significant health, social and economic burden of osteoarthritis, especially in obese patients, it is imperative...... to advance our knowledge of osteoarthritis and obesity, and apply this to improving care and outcomes. This paper overviews what is already known about osteoarthritis and obesity, discusses current key challenges and ongoing hypotheses arising from research in these areas, and finally, postulates what...

Prevalence of pes anserine bursitis in symptomatic osteoarthritis patients: an ultrasonographic prospective study.

Science.gov (United States)

Uysal, Fatma; Akbal, Ayla; Gökmen, Ferhat; Adam, Gürhan; Reşorlu, Mustafa

2015-03-01

The aim of this prospective study was to determine the prevalence of pes anserine bursitis (PAB) in patients with osteoarthritis. A total of 85 patients with primary knee osteoarthritis diagnosed according to the American College of Rheumatology (ACR) criteria were included in the study. The patients were divided into four groups using the Kellgren-Lawrence staging system. The knee X-rays evaluated according to this system indicated that 15.6% of patients were grade 1, 34.1% grade 2, 37.1% grade 3, and 13.5% grade 4. Ultrasonography (USG) was performed on both knees by a radiologist experienced in musculoskeletal system ultrasonography and unaware of the patients' physical examination or direct X-ray findings. The presence of PAB, longest diameter of bursitis, and area of bursitis were recorded. The average age of the 11 male and 74 female patients included in the study was 58.9 ± 9.0 years. A total of 170 knees of 85 patients were examined. The incidence of bursitis was significantly higher in females (p = 0.026). The incidence of bursitis on ultrasound was 20% (34/170). There was a statistical difference between the grades for bursitis incidence (p = 0.004). There was a significant positive correlation between both the longest length (p = 0.015, r = 0.187) and area (p = 0.003, r = 0.231) of PAB with osteoarthritis grade. The mean age of bursitis patients was higher than that of those without the condition (p = 0.038). In addition, the osteoarthritis (OA) grade and bursitis prevalence increased as the patients' age increased, and these increases were statistically significant (p bursitis was observed in one out of every five symptomatic OA patients and was more common in female patients and with advanced age. A positive correlation was found between OA grade and PAB size and area.

Reliability and responsiveness of algometry for measuring pressure pain threshold in patients with knee osteoarthritis

OpenAIRE

Mutlu, Ebru Kaya; Ozdincler, Arzu Razak

2015-01-01

[Purpose] This study aimed to establish the intrarater reliability and responsiveness of a clinically available algometer in patients with knee osteoarthritis as well as to determine the minimum-detectable-change and standard error of measurement of testing to facilitate clinical interpretation of temporal changes. [Subjects] Seventy-three patients with knee osteoarthritis were included. [Methods] Pressure pain threshold measured by algometry was evaluated 3 times at 2-min intervals over 2 cl...

Cross-cultural adaptation and validation of the French version of the Knee injury and Osteoarthritis Outcome Score (KOOS) in knee osteoarthritis patients

DEFF Research Database (Denmark)

Ornetti, P; Parratte, S; Gossec, L

2008-01-01

OBJECTIVE: To adapt the Knee injury and Osteoarthritis Outcome Score (KOOS) into French and to evaluate the psychometric properties of this new version. METHODS: The French version of the KOOS was developed according to cross-cultural guidelines by using the "translation-back translation" method...... to ensure content validity. KOOS data were then obtained in patients with symptomatic knee osteoarthritis (OA). The translated questionnaire was evaluated in two knee OA population groups, one with no indication for joint replacement (medicine), and the other waiting for joint replacement (surgery......). The psychometric properties evaluated were feasibility: percentage of responses, floor and ceiling effects; construct validity: internal consistency using Cronbach's alpha, correlations with osteoarthritis knee and hip quality of life domains using Spearman's rank test, and known group comparison between medicine...

Adaptation and validation of the Osteoarthritis Knee and Hip Quality of Life (OAKHQOL) questionnaire for use in patients with osteoarthritis in Spain.

Science.gov (United States)

Gonzalez Sáenz de Tejada, Marta; Escobar, Antonio; Herdman, Michael; Herrera, Carmen; García, Lidia; Sarasqueta, Cristina

2011-12-01

This study aims to adapt and validate the Spanish version of the Osteoarthritis Knee and Hip Quality of Life (OAKHQOL) questionnaire. The OAKHQOL was adapted into Spanish using a forward-backward translation methodology. The Spanish version was then validated in a prospective, mixed-design study of 759 patients with hip or knee osteoarthritis (OA). Patients completed the OAKHQOL, Short Form 36 (SF-36), Western Ontario and McMaster Universities Osteoarthritis Index, and the EQ-5D. The internal consistency was evaluated using Cronbach's alpha. Convergent validity was assessed by examining correlations between the OAKHQOL and other patient-reported instruments; known groups' validity was assessed by determining the capacity of the OAKHQOL to discriminate between patients with different levels of disease severity measured using the Lequesne Index. Test-retest reliability was evaluated by calculating the intraclass correlation coefficient (ICC) for all OAKHQOL domains in 409 stable patients with OA. Responsiveness was evaluated by calculating effect sizes among 129 patients undergoing hip or knee replacement. Cronbach's alpha for the five domains of the OAKHQOL ranged from 0.60 to 0.93 while ICCs ranged from 0.75 to 0.81 for all domains except the two social domains. Statistically significant differences (p < 0.001) were observed between patients with different degrees of disease severity on all domains except "social support". The instrument showed convergent validity among hypothesized domains (p < 0.001). Results of the study supported that the Spanish version OAKHQOL questionnaire was a valid instrument to measure health-related quality of life in patients with OA of the lower limb.

Epidemiological studies of German patients injected with Ra-224

International Nuclear Information System (INIS)

Mays, C.W.; Spiess, H.

1983-01-01

The health of 898 patients who received repeated injections of short-lived 224 Ra after World War II, mainly for the treatment of tuberculosis and ankylosing spondylitis has been followed. As of 1980, 53 of these patients had developed bone sarcoma vs only 0.2 cases expected naturally. Two patients with bone sarcoma subsequently developed an additional bone sarcoma. No new bone sarcomas have been reported since the end of 1974. For the patients in each category, the tumor rate at every year after 224 Ra injection was calculated by dividing the yearly number of bone sarcomas by the number of patients whose follow-up extended to that year. This corrected for the effects of death and incomplete follow-up. The yearly tumor rates were then summed to obtain the cumulative tumor rate. Dividing by the average skeletal dose in rads yielded the cumulative risk. The cumulative tumor risk was about 200 bone sarcomas/10 6 person rad of average skeletal dose and, with the dosimetric assumptions used, was not statistically different for (a) juveniles vs adults, (b) males vs females, or (c) TB patients vs spondylitic patients

Healthcare Quality Indicators for Physiotherapy Management in Hip and Knee Osteoarthritis and Rheumatoid Arthritis: A Delphi Study.

Science.gov (United States)

Peter, W F; Hurkmans, E J; van der Wees, P J; Hendriks, E J M; van Bodegom-Vos, L; Vliet Vlieland, T P M

2016-12-01

The aim of the present study was to develop healthcare quality indicators (HCQIs) for the physiotherapy (PT) management of patients with hip or knee osteoarthritis (HKOA) or rheumatoid arthritis (RA) in the Netherlands. Two multidisciplinary expert panels, including patients, were instituted. A draft HCQI set was derived from recommendations included in two existing Dutch PT guidelines for HKOA and RA. The panels suggested additional topics, after which a Delphi procedure was performed. All propositions were scored for their potential to represent good-quality PT care (score range 0-9). Based on predefined rules, the Delphi panel HCQIs were discussed and selected. Lastly, every indicator was rephrased, resulting in its output consisting of a numerator and denominator, to facilitate comparisons within and among practices. After two Delphi rounds, two final sets of 17 HCQI - one for HKOA and one for RA - were composed, both containing 16 process indicators (regarding initial assessment, treatment and evaluation) and one outcome indicator. Two sets of HCQIs for PT management in HKOA and RA were developed for measuring the quality of PT care in daily clinical practice. Each indicator was formulated in a measurable way. Future research should focus on the feasibility of both indicator sets for daily clinical practice. Copyright © 2016 John Wiley & Sons, Ltd.

[Osteoarthritis and patient therapeutic education, learning to move more].

Science.gov (United States)

Coudeyre, Emmanuel; Gay, Chloé; Bareyre, Loïc; Coste, Nicolas; Chérillat, Marie-Sophie

2016-01-01

As part of the prevention strategies offered to people with osteoarthritis, therapeutic education plays a key role. It seeks to help the patient become a player in their own care and focuses in particular on the factors influencing regular participation in suitable physical activity. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Atraumatic medial collateral ligament oedema in medial compartment knee osteoarthritis

International Nuclear Information System (INIS)

Bergin, D.; Keogh, C.; O'Connell, M.; Zoga, A.; Rowe, D.; Shah, B.; Eustace, S.

2002-01-01

Objective: To describe and determine the prevalence of atraumatic medial collateral oedema identified in patients with medial compartment osteoarthritis. Design and patients: Sixty patients, 30 patients with medial compartment knee osteoarthritis (Kellgren and Lawrence grade 2 to 4) and 30 age-matched patients with atraumatic knee pain without osteoarthritis, referred for MR imaging over a 2 year period were included in the study. In each case, severity of osteoarthritis was recorded on radiographs and correlated with the presence or absence of medial collateral ligament oedema at MR imaging. Results: Medial collateral oedema was identified in 27 of the 30 patients with osteoarthritis, of whom 14 had grade 1 oedema and 13 had grade 2 oedema compared with the presence of medial collateral ligament oedema (grade 1) in only two of the 30 control patients without osteoarthritis (P<<0.0001). Conclusion: Medial collateral oedema is common in patients with osteoarthritis in the absence of trauma. When identified, medial collateral ligament oedema should be considered to be a feature of osteoarthritis and should not be incorrectly attributed to an acute traumatic injury. (orig.)

Complementary and Alternative Medicine and Osteoarthritis.

Science.gov (United States)

Wang, Chenchen

2013-01-01

Patients with osteoarthritis experience high levels of pain, psychological distress and have limited therapeutic options. Emerging evidence from clinical trials suggests that both acupuncture and Tai Chi mind-body therapies are safe and effective treatments for osteoarthritis. Acupuncture has effects over and above those of 'sham acupuncture' and the most robust evidence to date demonstrates that acupuncture does have short-term benefits and is a reasonable referral option for patients with symptomatic osteoarthritis. Tai Chi is a mind-body exercise that enhances cardiovascular fitness, muscular strength, balance, and physical function. It also appears to be associated with reduced stress and anxiety and depression, as well as improved quality of life. Thus, Tai Chi may be safely recommended to patients with osteoarthritis as a complementary and alternative medical approach to affect patient well-being. Integrative approaches combine the best of conventional medicine and complementary and alternative medicine to ultimately improve patient care. These modalities may lead to the development of better disease modifying strategies that could improve symptoms and decrease the progression of osteoarthritis. This overview synthesizes the current body of knowledge about Chinese mind-body medicine to better inform clinical decision-making for our rheumatic patients.

Therapeutic Effectiveness and Safety of Mesotherapy in Patients with Osteoarthritis of the Knee.

Science.gov (United States)

Chen, Liang; Li, Dongqing; Zhong, Jun; Qiu, Bo; Wu, Xianglei

2018-01-01

To evaluate the therapeutic effectiveness and safety of mesotherapy by comparing it with the classic systematic therapy in patients with osteoarthritis (OA). Sixty patients were included and classified into two groups based on the existence of contraindications for nonsteroidal anti-inflammatory drugs (NSAIDs). These patients were treated with oral NSAIDs (Group A) or mesotherapy (Group B). After completing the treatment, the patients were followed up for 6 months. Their clinical features, laboratory results, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were evaluated. A total of 50 patients completed treatment and follow-up. The patients in Group B had significantly fewer gastric acid-related complaints and requested less supplementary treatment for recurrent pain ( p Mesotherapy also ameliorated physical function ( p mesotherapy is an effective and safe treatment for patients with OA. Clinicians should consider mesotherapy as an alternative therapy for patients with contraindications for NSAID use.

Physiotherapy Effects in Gait Speed in Patients with Knee Osteoarthritis

Directory of Open Access Journals (Sweden)

Klejda Tani

2018-03-01

CONCLUSIONS: Our results indicated that there was a significant decrease in pain and increase of gait speed while walking for 10 meters. Kinesio Tape can be used in patients with knee osteoarthritis, especially when changing walking stereotypes is a long-term goal of the treatment.

Analgesic use in patients with knee and/or hip osteoarthritis referred to an outpatient center

DEFF Research Database (Denmark)

Knoop, Jesper; van Tunen, Joyce; van der Esch, Martin

2017-01-01

Although analgesics are widely recommended in current guidelines, underuse and inadequate prescription of analgesics seem to result in suboptimal treatment effects in patients with knee and/or hip osteoarthritis (OA). This study aimed (i) to describe the use of analgesics; and (ii) to determine...... factors that are related to analgesic use in patients with knee and/or hip OA referred to an outpatient center. A cross-sectional study with data from 656 patients with knee and/or hip OA referred to an outpatient center (Amsterdam Osteoarthritis (AMS-OA) cohort) was conducted. Self-reported use...

Hand osteoarthritis : natural course and determinants of outcome

NARCIS (Netherlands)

Bijsterbosch, Jessica

2013-01-01

We investigated the clinical and radiographic disease course of hand osteoarthritis as well as determinants of poor clinical outcome and radiographic progression over a period of six years in 289 patients with hand osteoarthritis. Because these patients had osteoarthritis at multiple joints this

Multicomponent Exercise Improves Physical Functioning but Not Cognition and Hemodynamic Parameters in Elderly Osteoarthritis Patients Regardless of Hypertension

Directory of Open Access Journals (Sweden)

Hélio José Coelho-Júnior

2018-01-01

Full Text Available The present study aimed to investigate the impact of a 6-month multicomponent exercise program (MCEP on physical function, cognition, and hemodynamic parameters of elderly normotensive (NTS and hypertensive (HTS osteoarthritis patients. A total of 99 elderly osteoarthritis patients (44 NTS and 55 HTS were recruited and submitted to functional, cognitive, and hemodynamic evaluations before and after six months of a MCEP. The program of exercise was performed twice a week at moderate intensity. The physical exercises aggregated functional and walking exercises. Results indicate that 6 months of MCEP were able to improve one-leg stand and mobility (walking speeds of osteoarthritis patients regardless of hypertension. On the other hand, cognitive and hemodynamic parameters were not altered after the MCEP. The findings of the present study demonstrate that 6 months of MCEP were able to improve the physical functioning (i.e., usual and maximal walking speed and balance of osteoarthritis patients regardless of hypertensive condition.

Elektra prosthesis for trapeziometacarpal osteoarthritis

DEFF Research Database (Denmark)

Klahn, A; Nygaard, Mads; Gvozdenovic, R

2012-01-01

We present a prospective follow-up of 39 Elektra prostheses in 37 patients (32 women and five men), with a mean age of 56.5 (range 46-71) years; 34 patients had osteoarthritis and three had rheumatoid arthritis. Patients were followed using clinical examination, including measurement of pain...... be the key problem in treating trapeziometacarpal osteoarthritis using a total prosthesis....

Clinical gait evaluation of patients with knee osteoarthritis.

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Sun, Jun; Liu, Yancheng; Yan, Songhua; Cao, Guanglei; Wang, Shasha; Lester, D Kevin; Zhang, Kuan

2017-10-01

Knee osteoarthritis (KOA) is the most common osteoarthritis in lower limbs, and gait measurement is important to evaluate walking function of KOA patients before and after treatment. The third generation Intelligent Device for Energy Expenditure and Activity (IDEEA3) is a portable gait analysis system to evaluate gaits. This study is to evaluate the accuracy and reliability of IDEEA3 for gait measurement of KOA patients. Meanwhile, gait differences between KOA patients and healthy subjects are examined. Twelve healthy volunteers were recruited for measurement comparison of gait cycle (GC), cadence, step length, velocity and step counts between a motion analysis system and a high-speed camera (GoPro Hero3). Twenty-three KOA patients were recruited for measurement comparison of former five parameters between GoPro Hero3 and IDEEA3. Paired t-test, Concordance Correlation Coefficient (CCC) and Intraclass Correlation Coefficient (ICC) were used for data analysis. All p-values of paired t-tests for GC, cadence, step length and velocity were greater than 0.05 while all CCC and ICC results were above 0.95. The measurements of GC, cadence, step length, velocity and step counts by motion analysis system are highly consistent with the measurements by GoPro Hero3. The measurements of former parameters by GoPro Hero3 are not statistically different from the measurements by IDEEA3. IDEEA3 can be effectively used for the measurement of GC, cadence, step length, velocity and step counts in KOA patients. The KOA patients walk with longer GC, lower cadence, shorter step length and slower speed compared with healthy subjects in natural speed with flat shoes. Copyright © 2017 Elsevier B.V. All rights reserved.

Cross-cultural adaptation and validation of the French version of the Hip disability and Osteoarthritis Outcome Score (HOOS) in hip osteoarthritis patients

DEFF Research Database (Denmark)

Ornetti, P; Parratte, S; Gossec, L

2010-01-01

osteoarthritis (OA). METHODS: The French version of the HOOS was developed according to published international guidelines to ensure content validity. The new version was then evaluated in two symptomatic hip OA populations, one with no indication for joint replacement (medical group), and the other waiting......OBJECTIVE: To translate and adapt the Hip disability and Osteoarthritis Outcome Score (HOOS) into French and to evaluate the psychometric properties of this new version, by testing feasibility, internal consistency, construct validity, reliability and responsiveness, in patients with hip...

Comparative clinical trial of castor oil and diclofenac sodium in patients with osteoarthritis.

Science.gov (United States)

Medhi, B; Kishore, K; Singh, U; Seth, S D

2009-10-01

A randomized, double-blind, comparative clinical study was conducted to compare the safety and efficacy of castor oil with diclofenac sodium in patients with knee osteoarthritis. Subjects with symptoms of knee osteoarthritis were given a castor oil capsule 0.9 mL (n = 50) thrice daily for 4 weeks or a capsule of diclofenac sodium (n = 50), 50 mg thrice daily for 4 weeks. The subjects completed an overall evaluation of symptom relief at 2 weeks and 4 weeks of completed treatment. The subjects were evaluated by clinical, routine laboratory and radiographic investigations for improvement of disease conditions and also for adverse drug reaction. On completion of 4 weeks treatment it was observed that both drugs were significantly effective in the treatment of knee osteoarthritis (p castor oil there were no adverse effects reported. The present study indicates that castor oil can be used as an effective therapy in primary knee osteoarthritis. (c) 2009 John Wiley & Sons, Ltd.

Validation of the Chinese version 10-item Perceived Efficacy in Patient-Physician Interactions scale in patients with osteoarthritis

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Zhao HW

2016-10-01

Full Text Available Huiwen Zhao,1 Wen Luo,1 Rose C Maly,2 Jun Liu,1 Junyi Lee,1 Yaning Cui1 1Joint Department, The 2nd Ward of Joint Surgery, Tianjin Hospital, Tianjin, the People’s Republic of China; 2Department of Family Medicine David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA Objectives: This study aimed to assess the reliability and validity of the Chinese version of the 10-item Perceived Efficacy in Patient–Physician Interaction (PEPPI-10 scale in hospitalized patients with severe knee osteoarthritis in the People’s Republic of China. Methods: Between January and March 2015, the Chinese versions of PEPPI, self-efficacy for exercise scale, osteoporosis self-efficacy scale, and modified fall efficacy scale were applied to assess 110 severe knee osteoarthritis patients who were hospitalized in the second ward of the department of arthroplasty surgery of Tianjin Hospital. Results: The Chinese version of the PEPPI-10 scale had a high coefficient of internal consistency (Cronbach’s α coefficient, 0.907. The score of the Chinese version of PEPPI was weakly correlated with the scores of the Chinese versions of self-efficacy for exercise scale, osteoporosis self-efficacy scale, and modified fall efficacy scale. Conclusion: The Chinese version of the PEPPI-10 scale exhibits sufficient internal consistency and convergent validity in hospitalized patients with severe knee osteoarthritis in the People’s Republic of China. Keywords: assessment of osteoarthritis, patient–physician communication, self-efficacy, instrument validation

[Follow-up of patients with osteoarthritis. Coordinated management and criteria for referral between healthcare levels].

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Nieto Pol, Enrique

2014-01-01

The correct management of osteoarthritis requires an accurate diagnosis, evaluation of its spread and functional repercussions, and the application of comprehensive and effective individually-tailored treatment aimed at relieving pain and improving physical function with a consequent improvement in quality of life; treatment should also aim to prevent or delay disease progression and its effects. In the National Health Service, primary care is the basic level and the first point of access to healthcare; this level guarantees the continuity of care, coordinates patients, and regulates clinical workflow. Family physicians coordinate the healthcare processes related to chronic diseases and are responsible for the management, diagnosis, evaluation, treatment, and follow-up of patients with osteoarthritis. The clinical practice guidelines internationally accepted as the standard of care for the management of osteoarthritis should be adapted by both Spanish health planning strategies and clinical practice guidelines to the Spanish healthcare setting. The comprehensive assessment of osteoarthritis includes evaluation of its effects on the patient's physical function and quality of life; formulating a treatment plan in collaboration with the patient and adapted to his or her comorbidities; providing advice on basic treatments and their risks and benefits; and carrying out an individually-tailored periodic review. Referral criteria are based on diagnostic confirmation, poor treatment response, and surgical evaluation. Copyright © 2014 Elsevier España, S.L. All rights reserved.

Reliability and responsiveness of algometry for measuring pressure pain threshold in patients with knee osteoarthritis.

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Mutlu, Ebru Kaya; Ozdincler, Arzu Razak

2015-06-01

[Purpose] This study aimed to establish the intrarater reliability and responsiveness of a clinically available algometer in patients with knee osteoarthritis as well as to determine the minimum-detectable-change and standard error of measurement of testing to facilitate clinical interpretation of temporal changes. [Subjects] Seventy-three patients with knee osteoarthritis were included. [Methods] Pressure pain threshold measured by algometry was evaluated 3 times at 2-min intervals over 2 clinically relevant sites-mediolateral to the medial femoral tubercle (distal) and lateral to the medial malleolus (local)-on the same day. Intrarater reliability was estimated by intraclass correlation coefficients. The minimum-detectable-change and standard error of measurement were calculated. As a measure of responsiveness, the effect size was calculated for the results at baseline and after treatment. [Results] The intrarater reliability was almost perfect (intraclass correlation coefficient = 0.93-0.97). The standard error of measurement and minimum-detectable-change were 0.70-0.66 and 1.62-1.53, respectively. The pressure pain threshold over the distal site was inadequately responsive in knee osteoarthritis, but the local site was responsive. The effect size was 0.70. [Conclusion] Algometry is reliable and responsive to assess measures of pressure pain threshold for evaluating pain patients with knee osteoarthritis.

An OMERACT reliability exercise of inflammatory and structural abnormalities in patients with knee osteoarthritis using ultrasound assessment

DEFF Research Database (Denmark)

Bruyn, George Aw; Naredo, Esperanza; Damjanov, Nemanja

2016-01-01

OBJECTIVE: To assess whether ultrasonography (US) is reliable for the evaluation of inflammatory and structural abnormalities in patients with knee osteoarthritis (OA). METHODS: Thirteen patients with early knee OA were examined by 11 experienced sonographers during 2 days. Dichotomous and semiqu......OBJECTIVE: To assess whether ultrasonography (US) is reliable for the evaluation of inflammatory and structural abnormalities in patients with knee osteoarthritis (OA). METHODS: Thirteen patients with early knee OA were examined by 11 experienced sonographers during 2 days. Dichotomous...

Clinical profile, level of affection and therapeutic management of patients with osteoarthritis in primary care: The Spanish multicenter study EVALÚA.

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Castaño Carou, Ana; Pita Fernández, Salvador; Pértega Díaz, Sonia; de Toro Santos, Francisco Javier

2015-01-01

To determine the clinical profile, degree of involvement and management in patients with knee, hip or hand osteoarthritis. Observational study (health centers from 14 autonomous regions, n=363 primary care physicians), involving patients with clinical and/or radiological criteria for osteoarthritis from the American College of Rheumatology, consecutively selected (n=1,258). Sociodemographic variables, clinical and radiological findings, comorbidity and therapeutic management were analyzed. Mean age was 68.0±9.5 years old; 77.8% were women and 47.6% obese. Distribution by location was: 84.3% knee, 23.4% hip, 14.7% hands. All patients reported pain. The most frequent radiographic Kellgren-Lawrence grade was stage 3 for knee and hip (42.9% and 51.9%, respectively), and 3 (37.2%) and 2 (34.5%) for hip. Time since onset of osteoarthritis symptoms was 9.4±7.5 years, with a mean age at onset of around 60 years old and a family history of osteoarthritis in 66.0%. The most frequent comorbidities were: hypertension (55.1%), depression/anxiety (24.7%) and gastroduodenal diseases (22.9%). A total of 97.6% of the patients received pharmacological treatment, with oral analgesics (paracetamol) (70.5%) and oral NSAIDs (67.9%) being the most frequent drugs. Bilateral osteoarthritis was present in 76.9% of patients with knee osteoarthritis, 59.3% in hip and 94.7% in hands. Female gender and time since onset were associated with bilateral knee and hip osteoarthritis. The profile of the osteoarthritis patient is female, >65 years old, overweight/obese, with comorbidity, frequent symptoms and moderate radiologic involvement. Most of patients had bilateral osteoarthritis, associated with female gender and time since onset of disease. Paracetamol was the most common pharmacological treatment. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

Altered Visual and Feet Proprioceptive Feedbacks during Quiet Standing Increase Postural Sway in Patients with Severe Knee Osteoarthritis

DEFF Research Database (Denmark)

Hirata, Rogerio Pessoto; Jørgensen, Tanja Schjødt; Rosager, Sara

2013-01-01

The objective was to investigate how postural control in knee osteoarthritis (KOA) patients, with different structural severities and pain levels, is reorganized under different sensory conditions.......The objective was to investigate how postural control in knee osteoarthritis (KOA) patients, with different structural severities and pain levels, is reorganized under different sensory conditions....

Exercise adherence improves long-term patient outcome in patients with osteoarthritis of the hip and/or knee.

NARCIS (Netherlands)

Pisters, M.; Veenhof, C.; Schellevis, F.; Twisk, J.; Dekker, J.; Bakker, D. de

2011-01-01

Purpose: To determine the effect of patient exercise adherence, within the prescribed physiotherapy treatment period and after discharge, on patients’ outcome on pain, physical function and patient self-perceived effect in individuals with osteoarthritis (OA) of the hip and/or knee. Relevance: The

Predictors of revision, prosthetic joint infection and mortality following total hip or total knee arthroplasty in patients with rheumatoid arthritis

DEFF Research Database (Denmark)

Cordtz, Rene Lindholm; Zobbe, Kristian; Højgaard, Pil

2018-01-01

OBJECTIVES: To investigate predictors of 10-year risk of revision and 1-year risk of prosthetic joint infection (PJI) and death following total hip/total knee arthroplasty (THA/TKA) in (1) patients with rheumatoid arthritis (RA) compared with patients with osteoarthritis (OA); and (2) patients...

Opium addiction increases interleukin 1 receptor antagonist (IL-1Ra) in the coronary artery disease patients.

Science.gov (United States)

Saadat, Habibollah; Ziai, Seyed Ali; Ghanemnia, Maryam; Namazi, Mohammad Hasan; Safi, Morteza; Vakili, Hosein; Dabbagh, Ali; Gholami, Omid

2012-01-01

There is evidence that opium addiction has immunosuppressant effects. Coronary artery disease (CAD) is a condition resulted from atherosclerosis which is dependent on the immune response. To evaluate plasma levels of interleukin-6 and interleukin-1Ra in 30 patients with three-vessel coronary artery disease, ejection fraction of more than 35% and to evaluate their changes after prognostic treadmill test in 15 opium addicted and 15 non-addicted patients. The participants underwent prognostic treadmill test and plasma levels of interleukin-6 (IL-6) and interleukin-1Ra (IL-1Ra) were evaluated with ELISA method before, just after and 4 hours after the test. IL-1Ra (2183 pg/ml) tended to decrease over time in the opium addicted group (1372 pg/ml after prognostic treadmill test and 1034 pg/ml 4 hours after that), although such decrease did not reach the statistical significance. IL-1Ra levels were significantly higher in opium addicted than in non addicted patients. Opium addiction had no significant effect on IL-6 changes. Consumption of opium in CAD patients is associated with higher IL-1Ra levels.

Opium addiction increases interleukin 1 receptor antagonist (IL-1Ra in the coronary artery disease patients.

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Habibollah Saadat

Full Text Available BACKGROUND: There is evidence that opium addiction has immunosuppressant effects. Coronary artery disease (CAD is a condition resulted from atherosclerosis which is dependent on the immune response. PURPOSE: To evaluate plasma levels of interleukin-6 and interleukin-1Ra in 30 patients with three-vessel coronary artery disease, ejection fraction of more than 35% and to evaluate their changes after prognostic treadmill test in 15 opium addicted and 15 non-addicted patients. METHODS: The participants underwent prognostic treadmill test and plasma levels of interleukin-6 (IL-6 and interleukin-1Ra (IL-1Ra were evaluated with ELISA method before, just after and 4 hours after the test. RESULTS: IL-1Ra (2183 pg/ml tended to decrease over time in the opium addicted group (1372 pg/ml after prognostic treadmill test and 1034 pg/ml 4 hours after that, although such decrease did not reach the statistical significance. IL-1Ra levels were significantly higher in opium addicted than in non addicted patients. Opium addiction had no significant effect on IL-6 changes. CONCLUSION: Consumption of opium in CAD patients is associated with higher IL-1Ra levels.

Evaluation of osseous changes of TMJ in internal derangement and osteoarthritis patients using MRI

International Nuclear Information System (INIS)

Cho, Su Beom; Koh, Kwang Joon

2001-01-01

To evaluate the osseous changes of TMJ in internal derangement and osteoarthritis patients using MRI. MR images of 111 TMJs in 64 patients were analyzed to evaluate the osseous changes. 111 TMJs were divided into 6 groups according to the radiologic Stages by Schellhas and Wilkes. On MR images, we evaluate the osseous changes of articular eminence and condylar head. The most frequent Stage in internal derangement of TMJ was Stage Ι. And 38 joints (25.2%) revealed osteoarthritis with internal derangement. When osseous change of articular eminence and condylar head occur, flattening was the most common osseous change. Sclerosis was observed in all Stages and osteophytosis of condylar head was observed in Stage ΙΙ (1.8%) and ΙΙΙ (0.9%). Out of 28 joints with osteoarthritis, 6 joints (21.4%) showed joint effusion. MR image revealed abnormal configuration of disk, but the detection of minimal osseous change was subtle

Weight loss as treatment for knee osteoarthritis symptoms in obese patients

DEFF Research Database (Denmark)

Bliddal, Henning; Leeds, Anthony; Stigsgaard, Lise

2011-01-01

OBJECTIVE: To evaluate 1-year symptomatic improvement in obese patients with knee osteoarthritis (OA) on an intensive low-energy diet (LED) maintained by frequent consultations with a dietician compared to minimal attention. METHODS: The LED programme consisted of group therapy with dietary...

Effects of Motor Learning on Clinical Isokinetic Test Performance in Knee Osteoarthritis Patients

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José Messias Rodrigues-da-Silva

Full Text Available OBJECTIVES: To analyze the effects of motor learning on knee extension-flexion isokinetic performance in knee osteoarthritis patients. METHODS: One hundred and thirty-six middle-aged and older sedentary individuals (111 women, 64.3±9.9 years with knee osteoarthritis (130 patients with bilateral and who had never performed isokinetic testing underwent two bilateral knee extension-flexion (concentric-concentric isokinetic evaluations (5 repetitions at 60°/sec. The tests were first performed on the dominant leg with 2 min of recovery between test, and following a standardized warm-up that included 3 submaximal isokinetic repetitions. The same procedure was repeated on the non-dominant leg. The peak torque, peak torque adjusted for the body weight, total work, coefficient of variation and agonist/antagonist ratio were compared between tests. RESULTS: Patients showed significant improvements in test 2 compared to test 1, including higher levels of peak torque, peak torque adjusted for body weight and total work, as well as lower coefficients of variation. The agonist/antagonist relationship did not significantly change between tests. No significant differences were found between the right and left legs for all variables. CONCLUSION: The results suggest that performing two tests with a short recovery (2 min between them could be used to reduce motor learning effects on clinical isokinetic testing of the knee joint in knee osteoarthritis patients.

Effects of proprioceptive circuit exercise on knee joint pain and muscle function in patients with knee osteoarthritis.

Science.gov (United States)

Ju, Sung-Bum; Park, Gi Duck; Kim, Sang-Soo

2015-08-01

[Purpose] This study applied proprioceptive circuit exercise to patients with degenerative knee osteoarthritis and examined its effects on knee joint muscle function and the level of pain. [Subjects] In this study, 14 patients with knee osteoarthritis in two groups, a proprioceptive circuit exercise group (n = 7) and control group (n = 7), were examined. [Methods] IsoMed 2000 (D&R Ferstl GmbH, Hemau, Germany) was used to assess knee joint muscle function, and a Visual Analog Scale was used to measure pain level. [Results] In the proprioceptive circuit exercise group, knee joint muscle function and pain levels improved significantly, whereas in the control group, no significant improvement was observed. [Conclusion] A proprioceptive circuit exercise may be an effective way to strengthen knee joint muscle function and reduce pain in patients with knee osteoarthritis.

EVALUATION OF SAFETY AND EFFECTIVENESS OF HYLAN GF-20 IN PATIENTS WITH KNEE OSTEOARTHRITIS IN REAL LIFE PRACTICE: PRELIMINARY RESULTS

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G. V. Kuropatkin

2016-01-01

Full Text Available Combined conservative treatment of osteoarthritis includes intra-articular injections of hyaluronic acid. The paper presents the interim results of a prospective observational multicenter non-comparative study conducted in accordance with routine clinical practice to assess the safety and effectiveness of Hylan GF-20 in patients with knee osteoarthritis. The primary objective of the study is to assess walking and rest pain severity by WOMAC VA3.1 scale after 26 weeks and 52 weeks compared to the baseline. To date, 42 patients completed the study (71.43% women, 28.57% men, patients mean age is 59.79 years. After intraarticular injection of Hylan GF-20 patients were examined after 3, 6 and 12 months. After 3 months a positive clinical response was observed: pain severity decreased by 51.31% (p<0,001 on WOMAC A, joint stiffness decreased by 51.02% (p<0,001 on WOMAC B, daily life difficulties decreased by 42.03% (p<0,001 on WOMAC C. The same tendency was observed in the following periods. By week 52 pain severity reduced by 53.25% (p<0,001 on WOMAC A, joint stiffness by 41.63% (p<0,001 on WOMAC B, daily life difficulties -by 47.55% (p<0.001 on WOMAC C. Level of clinical response didn't correlate with the osteoarthritis stage. Therapy resulted in improvement of life quality of patients with knee osteoarthritis by 36% (p<0,001 according to the questionnaire EQ-5D. The general patients status according to physicians improved by 33.96% (p<0,001 on VAS, and by 45.91% (p<0,001 according to patients response on VAS. By week 52 of follow-up 11,90% of patients demonstrated a decrease in required concomitant therapy of osteoarthritis. Given the chronic nature of the osteoarthritis it's the most important that the therapeutic effect of Hylan GF-20 maintains until week 52. The above results confirm the efficiency of intraar-ticular injection of hyaluronic acid in patients with knee osteoarthritis especially in early disease stage.

Impact of socioeconomic gradients within and between countries on health of patients with rheumatoid arthritis (RA): Lessons from QUEST RA

NARCIS (Netherlands)

Putrik, Polina; Sokka, Tuulikki; Ramiro, Sofia; Boonen, Annelies

2012-01-01

In this chapter, we discuss challenges in collecting data on outcomes of patients who receive usual rheumatology care. We present results of the multinational Quantitative Monitoring of Patients with Rheumatoid Arthritis (QUEST RA) study which is a successful example of quantitative clinical

Osteoarthritis after osteosynthesis of ankle injuries

International Nuclear Information System (INIS)

Lange, S.; Mechsner, K.; Langenscheidt, P.; Krankenhaus Spandau, Berlin

1984-01-01

98 patients were clinically and radiographically examined 2 to 9 years following the osteosynthesis of ankle fractures. The rate of secondary osteoarthritis was 70% including 40% of minor, 17% of medium and 13% of serious changes. Depending on the injured structures the frequency of posttraumatic osteoarthritis varies. Medium and serious radiology changes cause obvious dysfunction in 56% and 62% respectively. Joints free of Osteoarthritis one year after the injury will not develop secondary osteoarthritis later. (orig.) [de

Effect of eccentric isokinetic strengthening in the rehabilitation of patients with knee osteoarthritis: Isogo, a randomized trial

Science.gov (United States)

2014-01-01

Background Femorotibial knee osteoarthritis is associated with muscle weakness in the lower limbs, particularly in the quadriceps, which results in disease progression. The interest of having muscular strengthening as part of the therapeutic arsenal for the medical treatment of knee osteoarthritis is now well established. The functional disability induced by knee osteoarthritis manifests itself principally when walking, notably downhill, during which the muscles are called upon to contract eccentrically. We can therefore think that eccentric muscular strengthening could bring a functional benefit that is superior to concentric muscular strengthening. Methods/Design This is a prospective, randomized, bicenter, parallel-group, international study. Eighty patients aged from 40 to 75 years old, suffering from medical-stage knee osteoarthritis, will undertake 6 weeks of isokinetic muscular strengthening. Randomization determines the mode of muscular strengthening: either exclusively eccentric or exclusively concentric. The principal objective is to demonstrate the superiority of the improvement in the quadriceps isokinetic torque after isokinetic muscular strengthening by the eccentric mode compared to the concentric mode. The following parameters are also evaluated: the variations in the level of pain, the parameters of walking (maximum speed over 10 and 200 meters, analysis on a computerized Gaitrite™ treadmill), static equilibrium (on a FUSYO™ force platform), and the functional status of the patient using the Western Ontario and MacMaster Universities osteoarthritis index (WOMAC) questionnaire after the strengthening period and at 6 months. Discussion A better knowledge of the most effective mode of muscular strengthening is needed to optimize the functional benefits to the patients. In case of superiority in terms of efficacy of the eccentric mode, the latter could be given priority in the rehabilitation treatment of knee osteoarthritis patients. Trial

A hierarchy of patient-reported outcome measures for meta-analysis of knee osteoarthritis trials

DEFF Research Database (Denmark)

Juhl, Carsten Bogh; Lund, Hans; Guyatt, GH

2010-01-01

Title A hierarchy of patient-reported outcome measures for meta-analysis of knee osteoarthritis trials: empirical evidence from a survey of high impact journals Objective To develop a prioritized list for extracting patient-reported outcomes (PROs) measuring pain and disability for meta-analyses ......Title A hierarchy of patient-reported outcome measures for meta-analysis of knee osteoarthritis trials: empirical evidence from a survey of high impact journals Objective To develop a prioritized list for extracting patient-reported outcomes (PROs) measuring pain and disability for meta...... composite disability scores. Conclusions As choosing the most favorable PROs from individual trials can overestimate the effect compared to a systematic approach, using a prioritized list as presented in this study is recommended to reduce reviewer's likelihood of biased selection of PROs in meta-analyses....

Clinical characteristics of RA patients with secondary SS and association with joint damage

OpenAIRE

Brown, Lindsay E.; Frits, Michelle L.; Iannaccone, Christine K.; Weinblatt, Michael E.; Shadick, Nancy A.; Liao, Katherine P.

2014-01-01

Objectives. Secondary SS (sSS) is a common extra-articular manifestation of RA. There are conflicting data regarding the association of sSS with worse joint damage. This study aims to characterize sSS patients in an RA cohort and study the association between sSS and joint damage.

Long term safety, efficacy, and patient acceptability of hyaluronic acid injection in patients with painful osteoarthritis of the knee

Science.gov (United States)

McArthur, Benjamin A; Dy, Christopher J; Fabricant, Peter D; Valle, Alejandro Gonzalez Della

2012-01-01

The increasing prevalence of painful knee osteoarthritis has created an additional demand for pharmacologic management to prevent or delay surgical management. Viscosupplementation, via intraarticular injection of hyaluronic acid (HA), aims to restore the favorable milieu present in the nonarthritic joint. The safety profile of intraarticular HA injections for painful knee osteoarthritis is well established, with the most common adverse effect being a self-limited reaction at the injection site. Although acceptance of the early literature has been limited by publication bias and poor study quality, more recent and rigorous meta-analysis suggests that intraarticular HA injection is superior to placebo injection for pain relief and matches, if not surpasses, the effect size of other nonoperative treatments, such as nonsteroidal anti-inflammatory medication. Intraarticular HA injection is effective in providing temporary pain relief in patients with painful knee osteoarthritis. Future investigations should focus on optimizing the composition and administration of HA agents to provide prolonged relief of painful osteoarthritis in the knee and other joints. PMID:23271899

Treatment of Osteoarthritis of the Knee (Nonarthroplasty)

Science.gov (United States)

Richmond, John; Hunter, David; Irrgang, Jay; Jones, Morgan H.; Levy, Bruce; Marx, Robert; Snyder-Mackler, Lynn; Watters, William C.; Haralson, Robert H.; Turkelson, Charles M.; Wies, Janet L.; Boyer, Kevin M.; Anderson, Sara; Andre, St. Justin St.; Sluka, Patrick; McGowan, Richard

2011-01-01

The clinical practice guideline was explicitly developed to include only treatments less invasive than knee replacement (ie, arthroplasty). Patients with symptomatic osteoarthritis of the knee are to be encouraged to participate in self-management educational programs and to engage in self-care, as well as to lose weight and engage in exercise and quadriceps strengthening. The guideline recommends taping for short-term relief of pain as well as analgesics and intra-articular corticosteroids, but not glucosamine and/or chondroitin. Patients need not undergo needle lavage or arthroscopy with débridement or lavage. Patients may consider partial meniscectomy or loose body removal or realignment osteotomy, as conditions warrant. Use of a free-floating interpositional device should not be considered for symptomatic unicompartmental osteoarthritis of the knee. Lateral heel wedges should not be prescribed for patients with symptomatic medial compartmental osteoarthritis of the knee. The work group was unable either to recommend or not recommend the use of braces with either valgus- or varus-directing forces for patients with medial unicompartmental osteoarthritis; the use of acupuncture or of hyaluronic acid; or osteotomy of the tibial tubercle for isolated symptomatic patellofemoral osteoarthritis. PMID:19726743

Prognostic biomarkers in osteoarthritis

Science.gov (United States)

Attur, Mukundan; Krasnokutsky-Samuels, Svetlana; Samuels, Jonathan; Abramson, Steven B.

2013-01-01

Purpose of review Identification of patients at risk for incident disease or disease progression in osteoarthritis remains challenging, as radiography is an insensitive reflection of molecular changes that presage cartilage and bone abnormalities. Thus there is a widely appreciated need for biochemical and imaging biomarkers. We describe recent developments with such biomarkers to identify osteoarthritis patients who are at risk for disease progression. Recent findings The biochemical markers currently under evaluation include anabolic, catabolic, and inflammatory molecules representing diverse biological pathways. A few promising cartilage and bone degradation and synthesis biomarkers are in various stages of development, awaiting further validation in larger populations. A number of studies have shown elevated expression levels of inflammatory biomarkers, both locally (synovial fluid) and systemically (serum and plasma). These chemical biomarkers are under evaluation in combination with imaging biomarkers to predict early onset and the burden of disease. Summary Prognostic biomarkers may be used in clinical knee osteoarthritis to identify subgroups in whom the disease progresses at different rates. This could facilitate our understanding of the pathogenesis and allow us to differentiate phenotypes within a heterogeneous knee osteoarthritis population. Ultimately, such findings may help facilitate the development of disease-modifying osteoarthritis drugs (DMOADs). PMID:23169101

Comparison of efficacy of intra-articular morphine and steroid in patients with knee osteoarthritis

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Serbülent Gökhan Beyaz

2012-01-01

Full Text Available Introduction: Primary therapeutic aim in treatment of osteoarthritis of the knee is to relieve the pain of osteoarthritis. The aim of this study was to compare the efficacy of intra-articular triamcinolone with intra-articular morphine in pain relief due to osteoarthritis of the knee in the elderly population. Materials and Methods: Patients between 50 and 80 years of age were randomized into three groups. Group M received morphine plus bupivacaine intra-articularly, Group T received triamcinolone plus bupivacaine intra-articularly, and Group C received saline plus bupivacaine intra-articularly. Patients were evaluated before injection and in 2nd, 4th, 6th, and 12th weeks after injection. First-line supplementary analgesic was oral paracetamol 1500 mg/day. If analgesia was insufficient with paracetamol, oral dexketoprofen trometamol 50 mg/day was recommended to patients. Results: After the intra-articular injection, there was statistically significant decrease in visual analog scale (VAS scores in Groups M and T, when compared to Group C. The decrease of VAS scores seen at the first 2 weeks continued steadily up to the end of 12th week. There was a significant decrease in Groups M and T in the WOMAC scores, when compared to Group C. There was no significant difference in the WOMAC scores between morphine and steroid groups. Significantly less supplementary analgesics was used in the morphine and steroid groups. Conclusion: Intra-articular morphine was as effective as intra-articular triamcinolone for analgesia in patients with osteoarthritis knee. Intra-articular morphine is possibly a better option than intra-articular steroid as it has lesser side effects.

Long-term weight-loss maintenance in obese patients with knee osteoarthritis

DEFF Research Database (Denmark)

Christensen, Pia; Henriksen, Marius; Bartels, Else Marie

2017-01-01

Background: A formula low-energy diet (LED) reduces weight effectively in obese patients with knee osteoarthritis, but the role of LED in long-term weight-loss maintenance is unclear.Objective: We aimed to determine the effect of intermittent LED compared with daily meal replacements on weight...

Automated radiofrequency-based US measurement of common carotid intima-media thickness in RA patients treated with synthetic vs synthetic and biologic DMARDs.

Science.gov (United States)

Naredo, Esperanza; Möller, Ingrid; Corrales, Alfonso; Bong, David A; Cobo-Ibáñez, Tatiana; Corominas, Hector; Garcia-Vivar, Ma Luz; Macarrón, Pilar; Navio, Teresa; Richi, Patricia; Iagnocco, Annamaria; Garrido, Jesús; Martínez-Hernández, David

2013-02-01

To compare the carotid intima-media thickness (IMT) assessed with automated radiofrequency-based US in RA patients treated with synthetic vs synthetic and biologic DMARDs and controls. Ninety-four RA patients and 94 sex- and age-matched controls were prospectively recruited at seven centres. Cardiovascular (CV) risk factors and co-morbidities, RA characteristics and therapy were recorded. Common carotid artery (CCA)-IMT was assessed in RA patients and controls with automated radiofrequency-based US by the same investigator at each centre. Forty-five (47.9%) RA patients had been treated with synthetic DMARDs and 49 (52.1%) with synthetic and biologic DMARDs. There were no significant differences between the RA patients and controls in demographics, CV co-morbidities and CV disease. There were significantly more smokers among RA patients treated with synthetic and biologic DMARDs (P = 0.036). Disease duration and duration of CS and synthetic DMARD therapy was significantly longer in RA patients treated with synthetic and biologic DMARDs (P radiofrequency-based measurement of CCA-IMT can discriminate between RA patients treated with synthetic DMARDs vs RA patients treated with synthetic and biologic DMARDs.

An 8-Week Neuromuscular Exercise Program for Patients With Mild to Moderate Knee Osteoarthritis

DEFF Research Database (Denmark)

Clausen, Brian; Holsgaard-Larsen, Anders; Roos, Ewa M

2017-01-01

OBJECTIVE:   To describe the feasibility of a neuromuscular exercise (NEMEX) program in patients with mild to moderate knee osteoarthritis (KOA). BACKGROUND:   Neuromuscular exercise has been increasingly used in patients with osteoarthritis to achieve sensorimotor control and improved daily...... function. TREATMENT:   A study of the first 23 physically active patients (11 men, 12 women; age range = 48-70 years) who had mild to moderate KOA and were undergoing an 8-week, twice-weekly program, consisting of 11 exercises with 3 to 4 levels of difficulty, as part of an ongoing randomized controlled...... to increased (n = 2) or persisting (n = 1) knee pain. However, their pain ratings did not show worsening symptoms. UNIQUENESS:   This NEMEX-KOA program was designed for physically active middle-aged patients with mild to moderate KOA; therefore, it involved exercises and difficulty levels that were more...

Prolotherapy for Osteoarthritis and Tendinopathy: a Descriptive Review.

Science.gov (United States)

Rabago, David; Nourani, Bobby

2017-06-01

Osteoarthritis and overuse tendinopathy are common chronic conditions of high societal and patient burden. The precise etiology of pain and disability in both conditions is multifactorial and not well understood. Patients are often refractory to conservative therapy. The development of new therapeutic options in both conditions is a public health priority. Prolotherapy is an injection-based outpatient regenerative therapy for chronic musculoskeletal conditions, including osteoarthritis and tendinopathy. The authors reviewed the basic science and clinical literature associated with prolotherapy for these conditions. Systematic review, including meta-analysis, and randomized controlled trials suggest that prolotherapy may be associated with symptom improvement in mild to moderate symptomatic knee osteoarthritis and overuse tendinopathy. Although the mechanism of action is not well understood and is likely multifactorial, a growing body of literature suggests that prolotherapy for knee osteoarthritis may be appropriate for the treatment of symptoms associated with knee osteoarthritis in carefully selected patients who are refractory to conservative therapy and deserves further basic and clinical science investigation for the treatment of osteoarthritis and tendinopathy.

Barriers for guideline adherence in knee osteoarthritis care: A qualitative study from the patients' perspective

NARCIS (Netherlands)

Spitaels, D.; Vankrunkelsven, P.; Desfosses, J.; Luyten, F.; Verschueren, S.; Assche, D. Van; Aertgeerts, B.; Hermens, R.P.

2017-01-01

RATIONALE, AIMS AND OBJECTIVES: Guidelines for patients with knee osteoarthritis (OA) are suboptimally implemented in clinical care. To improve guideline adherence, patients' perceived barriers and facilitators in current care were investigated. METHODS: Eleven patients with knee OA were extensively

Patient-reported quality indicators for osteoarthritis: a patient and public generated self-report measure for primary care.

Science.gov (United States)

Blackburn, Steven; Higginbottom, Adele; Taylor, Robert; Bird, Jo; Østerås, Nina; Hagen, Kåre Birger; Edwards, John J; Jordan, Kelvin P; Jinks, Clare; Dziedzic, Krysia

2016-01-01

People with osteoarthritis desire high quality care, support and information. However, the quality of care for people with OA in general practice is not routinely collected. Quality Indicators can be used to benefit patients by measuring whether minimum standards of quality care are being met from a patient perspective. The aim of this study was to describe how a Research User Group (RUG) worked alongside researchers to co-produce a set of self-reported quality indicators for people with osteoarthritis when visiting their general practitioner or practice nurse (primary care). These were required in the MOSAICS study, which developed and evaluated a new model of supported self-management of OA to implement the NICE quality standards for OA. This article describes the public involvement in the MOSAICS study. This was 1) the co-development by RUG members and researchers of an Osteoarthritis Quality Indicators United Kingdom (OA QI (UK)) questionnaire for use in primary care, and 2) the comparison of the OA QI (UK) with a similar questionnaire developed in Norway. This study shows how important and effective a research user group can be in working with researchers in developing quality care indicators for osteoarthritis for use in a research study and, potentially, routine use in primary care. The questionnaire is intended to benefit patients by enabling the assessment of the quality of primary care for osteoarthritis from a patient's perspective. The OA QI (UK) has been used to examine differences in the quality of osteoarthritis care in four European countries. Background People with osteoarthritis (OA) desire high quality care, support and information about OA. However, the quality of care for people with OA in general practice is not routinely collected. Quality Indicators (QI) can be used to benefit patients by measuring whether minimum standards of quality care (e.g. NICE quality standards) are being met from a patient perspective. A Research User Group (RUG

224Ra: Risk to bone and haematopoietic tissue in ankylosing spondylitis patients

International Nuclear Information System (INIS)

Wick, R.R.; Goessner, W.; Chmelevsky, D.

1986-01-01

This follow-up study includes 1501 adult patients, who received repeated intraveneous injections of 224 Ra as a treatment for ankylosing spondylitis (a.sp), and a control group of 1557 a.sp. patients not treated with radioactive drugs or X-rays. The average total injected activity for the patients of the exposure group was 4.8 μCi of 224 Ra per kg body weight; the resulting average skeletal dose of α-rays has been 0.65 Gy. The mean duration of the 224 Ra treatment was 12 weeks with the mode at 10 weeks. At present, the mean follow-up time in the group of exposed patients is 16 years, and three cases of malignant skeletal tumours have been observed in patients with α-doses to the skeleton below 0.9 Gy (the lowest skeletal dose found to be associated with a bone tumour in the high dose group followed by Spiess and Mays). Based on general population statistics the expected number of bone tumours (ICD 170) was 0.4-0.7 . A recent risk estimate from data of Spiess and Mays suggests 5.8 radiation induced bone tumours for the present follow-up time. It is, furthermore, notable that 2 of the 3 observed skeletal tumours are tumours of the bone marrow; in the high dose group of Spiess and Mays there has been only 1 bone marrow tumour among 55 bone tumours. No malignant bone tumours have occurred, until now, in the control group. In the 224 Ra-group and the control group there have been 6 and 5 leukaemias, respectively,. Among the 6 leukaemias in the 224 R group 3 were chronic myeloid leukaemias while among the 5 leukaemias in the control group there was no chronic myeloid leukaemia. (orig.)

Effect of a physiotherapy rehabilitation program on knee osteoarthritis in patients with different pain intensities.

Science.gov (United States)

Abdel-Aziem, Amr Almaz; Soliman, Elsadat Saad; Mosaad, Dalia Mohammed; Draz, Amira Hussin

2018-02-01

[Purpose] To examine the effect of physiotherapy rehabilitation program on moderate knee osteoarthritis in patients with different pain intensities. [Subjects and Methods] Sixty subjects (37 men and 23 women) with moderate knee osteoarthritis participated in the current study. Randomization software was used to select the participating subjects' numbers from the clinic records. They were classified into three groups according to pain intensity: mild, moderate, and severe pain groups. All groups underwent a standard set of pulsed electromagnetic field, ultrasound, stretching exercises, and strengthening exercises. Pain intensity, knee range of motion, knee function, and isometric quadriceps strength were evaluated using the visual analogue scale, universal goniometer, Western Ontario and McMaster Universities osteoarthritis index, and Jamar hydraulic dynamometer, respectively. The evaluation was performed before and after a 4-week rehabilitation program. [Results] All groups showed significant differences in pain intensity, knee range of motion, isometric quadriceps strength, and knee function. The score change in moderate pain group was significantly greater than those in mild and severe pain groups. [Conclusion] Pain intensity is one of the prominent factors that are responsible for the improvement of knee osteoarthritis. Consequently, pain intensity should be considered during rehabilitation of knee osteoarthritis.

[Study of the role of miRNA in mesenchymal stem cells isolated from osteoarthritis patients].

Science.gov (United States)

Tornero-Esteban, P; Hoyas, J A; Villafuertes, E; Garcia-Bullón, I; Moro, E; Fernández-Gutiérrez, B; Marco, F

2014-01-01

MiRNAs act as gene silencers that are involved in the regulation of essential cell functions. miR-335 is involved in regulating cell differentiation processes in progenitor cells. Mesenchymal stem cells (MSCs) are progenitor cells of chondrocytes and osteoblasts responsible for homeostatic maintenance of cartilage and bone. The aim of this study was to determine a possible relationship between the expression of miR-335 and osteoarthritis. MSCs obtained from the bone marrow of 3 osteoarthritic patients and 3 controls with no clinical signs of osteoarthritis or osteoporosis were cultured and phenotypically and functionally characterised in a 3-step culture. Expression levels of miR-335 and the mesoderm-specific transcript gene -MEST- that controls its expression were determined by quantitative PCR. Differences in the expression levels of miR-335 and MEST (median [interquartile range]: 1.69 [0.85-1.74], and 3.85 [3.20-5.67] were detected between MSCs isolated from patients with osteoarthritis and controls. Although the differences detected did not reach statistical significance (P=.1), a clear trend towards lower expression of miR-335 in osteoarthritis MSCs was observed. Given that miR-335 has the different genes involved in the Wnt signalling pathway as potential targets, the observed trend may help to ascertain, at least partially, some of the alterations which determine the onset or progression of osteoarthritis, and can therefore serve for the design of future therapeutic targets for the treatment of this disease. Copyright © 2013 SECOT. Published by Elsevier Espana. All rights reserved.

A Young Patient with Temporomandibular Joint Osteoarthritis: Case Report

Directory of Open Access Journals (Sweden)

Iva Alajbeg

2017-01-01

Full Text Available This paper describes a case of a young patient who sought help because of pain in the right temporomandibular joint (TMJ. She also reported increasing of pain during chewing. Clinical examination revealed limited mouth opening with uncorrected deviation to the ipsilateral side. Palpation of the lateral pole of the right condyle discovered crepitus, and maximum assisted opening elicited a report of “familiar pain”. The diagnosis of osteoarthritis of the TMJ (RDC / TMD criteria, Axis I, Group III was confirmed by CBCT of TMJ. There is no “gold standard” for the management of TMD, but the need for TMD treatment has to be based on precise indications related to the presence of pain, limitation in function of the lower jaw and signs of degenerative joint disease. Conservative, reversible therapeutic procedures are considered as the first choice for TMD treatment and their task is to improve the function of the entire masticatory system. In this case patient was treated with the combination of physical therapy and stabilization splint, in order to reduce the pain and restore the normal function of the lower jaw. At 6 months’ follow-up symptoms have almost completely disappeared, while 3 years later, the patient still has no significant subjective symptoms. In the present case non-invasive therapy was sufficient to bring, otherwise recurrent nature of osteoarthritis, in complete remission and keep it like that for years.

224Ra and 226Ra experimentally induced dental changes in rats

International Nuclear Information System (INIS)

Reichart, P.A.; Althoff, J.; Eckhardt, W.; Rippel, W.

1979-01-01

Sprague-Dawley rats received intragastrically a single dose of 226 Ra or 224 Ra once weekly for 21 weeks. During this period the animals of both groups were thus exposed to comparable doses. After 12 weeks, a shortening of the maxillary incisors was observed, and this progressed during the course of the 55-week experiment. Radiologically, a loss of pulpal transparency and an apical irregular opacity in the maxillary incisors were demonstrable. Histologically, dysplastic changes of the maxillary incisors and multiple resorptions at the cemento-enamel junction of the molars were seen. The observed alterations were more pronounced in the 226 Ra group than in the 224 Ra treated group. The experimentally induced resorptions were comparable to those observed in patients who had incorporated 224 Ra or 226 Ra. Clinical, radiological, histological, γspecrometrical, and autoradiographical findings, as well as dose-estimations, are described. (author)

Invasiveness of fibroblast-like synoviocytes is an individual patient characteristic associated with the rate of joint destruction in patients with rheumatoid arthritis.

Science.gov (United States)

Tolboom, Tanja C A; van der Helm-Van Mil, Annette H M; Nelissen, Rob G H H; Breedveld, Ferdinand C; Toes, René E M; Huizinga, Tom W J

2005-07-01

Rheumatoid arthritis (RA) is characterized by inflammation and destruction of synovial joints. Fibroblast-like synoviocytes (FLS) harvested from synovial tissue of patients with RA can invade normal human cartilage in severe combined immunodeficient (SCID) mice and Matrigel basement membrane matrix in vitro. This study was undertaken to investigate the association of these in vitro characteristics with disease characteristics in patients with RA. Synovial tissue samples from 72 RA and 49 osteoarthritis (OA) patients were obtained. Samples of different joints were collected from 7 patients with RA. The FLS invasiveness in Matrigel was studied, and the intraindividual and interindividual differences were compared. From the patients with FLS who exhibited the most extreme differences in in vitro ingrowth (most and least invasive FLS), radiographs of the hands and feet were collected and scored according to the Sharp/van der Heijde method to determine the relationship between in vitro invasion data and estimated yearly joint damage progression. FLS from patients with RA were more invasive than FLS from patients with OA (P patient characteristic. The mean +/- SEM Sharp score on radiographs of the hands or feet divided by the disease duration was 4.4 +/- 1.1 units per year of disease duration in patients with the least invasive FLS (n = 9), which was much lower compared with the 21.8 +/- 3.1 units per year of disease duration in patients with the most invasive FLS (n = 9) (P patient characteristic, given the much smaller intraindividual than interindividual FLS variation.

Osteoarthritis in the neonate

International Nuclear Information System (INIS)

Weigel, W.; Hayek, W.H.; Bens, G.

1979-01-01

A fatally ending index case of sepsis osteoarthritis that was diagnosed retrospectively initiated this report. This patient had severe, asymmetrically distributed metaphyseal growthdisturbances, many long bones. In order to determine the features of early radiologic diagnosis we report the findings of 7 further patients with neonatal septic osteoarthritis with clinical and radiological follow-up. The most important observation for early radiologic diagnosis of osteoarthritis is the displacement of fat layers along the metaphysis. Other findings of the soft tissues have the same diagnostic value as bone destruction and subperiosteal new bone formation found one to three weeks later on roentgenfilms. Detecting early signs of osteoarthritis helps in localizing the focus for bacteriologic diagnosis, which is to be more successful than blood cultures. Diagnosing a joint empyema initiates surgical intervention for pressure relief in order to avoid necrosis of the epiphysis as seen in the femoral bone in septic arthritis of the hip joint. Early diagnosis and treatment to destruction of growing cartilage is necessary to avoid gross disturbances and length discrepancies of long bones. In cases of sepsis called 'babygram' and a repeat examination 10 to 14 days later is mandatory. (orig.) [de

Reliability, validity, and responsiveness of the Western Ontario and McMaster Universities Osteoarthritis Index for elderly patients with a femoral neck fracture

NARCIS (Netherlands)

P.T.P.W. Burgers (Paul); R.W. Poolman (Rudolf); T.M. van Bakel (Theodorus); W.E. Tuinebreijer (Wim); S.M. Zielinski (Stephanie); M. Bhandari (Mohit); P. Patka (Peter); E.M.M. van Lieshout (Esther)

2015-01-01

markdownabstractBackground: The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) has been extensively evaluated in groups of patients with osteoarthritis, yet not in patients with a femoral neck fracture. This study aimed to determine the reliability, construct validity, and

[Degenerative osteoarthritis, osteoporosis and fractures: controversies and evidences].

Science.gov (United States)

Pagès-Castellà, Aina; Prieto Alhambra, Daniel

2013-09-07

Osteoarthritis and osteoporosis are both common conditions in the elderly but their association has long remained obscure. Recently published studies show that patients with osteoarthritis have higher bone mass but no corresponding decrease in fracture risk. This has been proposed to be due to an increased rate of falls in these patients. Multi-disciplinary interventions, vitamin D supplementation and bisphosphonates can play a role on preventing fractures among osteoarthritis patients, but evidence on their efficacy is scarce and of poor quality. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Differences in characteristics and patient-reported questionnaire responses in patients who choose non-surgical versus surgical treatment for severe hip osteoarthritis

DEFF Research Database (Denmark)

Have, Mads; Overgaard, Søren; Jensen, Carsten

Background: Preoperative patient characteristics may influence patient choice for participating in RCT’s. Purpose / Aim of Study: This study aimed to compare patient characteristics, level of pain, physical function and joint space width in patients with severe hip osteoarthritis (OA) who accepted...... or refused to participate in a RCT. Materials and Methods: In this prospective cohort study a total of 137 patients with primary hip OA were asked to choose between surgical or non- surgical treatment. We then compared the characteristics of each patient cohort (demographics, pain level and duration......, analgesic use, exercise habits), the radiographic hip OA state and their responses to Hip dysfunction and Osteoarthritis Outcome Score (HOOS, 0-100) and European Quality of Life Scale (EQ-5D-5L) questionnaires. Findings / Results: The between-group HOOS scores were significantly different in three out...

PADI4 Haplotypes in Association with RA Mexican Patients, a New Prospect for Antigen Modulation

Directory of Open Access Journals (Sweden)

Maria Guadalupe Zavala-Cerna

2013-01-01

Full Text Available Peptidyl arginine deiminase IV (PAD 4 is the responsible enzyme for a posttranslational modification called citrullination, originating the antigenic determinant recognized by anti-cyclic citrullinated peptide antibodies (ACPA. Four SNPs (single nucleotide polymorphisms have been described in PADI4 gene to form a susceptibility haplotype for rheumatoid arthritis (RA; nevertheless, results in association studies appear contradictory in different populations. The aim of the study was to analyze if the presence of three SNPs in PADI4 gene susceptibility haplotype (GTG is associated with ACPA positivity in patients with RA. This was a cross-sectional study that included 86 RA patients and 98 healthy controls. Polymorphisms PADI4_89, PADI4_90, and PADI4_92 in the PADI4 gene were genotyped. The susceptibility haplotype (GTG was more frequent in RA patients; interestingly, we found a new haplotype associated with RA with a higher frequency (GTC. There were no associations between polymorphisms and high scores in Spanish HAQ-DI and DAS-28, but we did find an association between RARBIS index and PADI4_89, PADI4_90 polymorphisms. We could not confirm an association between susceptibility haplotype presence and ACPA positivity. Further evidence about proteomic expression of this gene will determine its participation in antigenic generation and autoimmunity.

Altered Tibiofemoral Joint Contact Mechanics and Kinematics in Patients with Knee Osteoarthritis and Episodic Complaints of Joint Instability

Science.gov (United States)

Farrokhi, Shawn; Voycheck, Carrie A.; Klatt, Brian A.; Gustafson, Jonathan A.; Tashman, Scott; Fitzgerald, G. Kelley

2014-01-01

Background To evaluate knee joint contact mechanics and kinematics during the loading response phase of downhill gait in knee osteoarthritis patients with self-reported instability. Methods Forty-three subjects, 11 with medial compartment knee osteoarthritis and self-reported instability (unstable), 7 with medial compartment knee osteoarthritis but no reports of instability (stable), and 25 without knee osteoarthritis or instability (control) underwent Dynamic Stereo X-ray analysis during a downhill gait task on a treadmill. Findings The medial compartment contact point excursions were longer in the unstable group compared to the stable (p=0.046) and the control groups (p=0.016). The peak medial compartment contact point velocity was also greater for the unstable group compared to the stable (p=0.047) and control groups (p=0.022). Additionally, the unstable group demonstrated a coupled movement pattern of knee extension and external rotation after heel contact which was different than the coupled motion of knee flexion and internal rotation demonstrated by stable and control groups. Interpretation Our findings suggest that knee joint contact mechanics and kinematics are altered during the loading response phase of downhill gait in knee osteoarthritis patients with self-reported instability. The observed longer medial compartment contact point excursions and higher velocities represent objective signs of mechanical instability that may place the arthritic knee joint at increased risk for disease progression. Further research is indicated to explore the clinical relevance of altered contact mechanics and kinematics during other common daily activities and to assess the efficacy of rehabilitation programs to improve altered joint biomechanics in knee osteoarthritis patients with self-reported instability. PMID:24856791

Can stimulating massage improve joint repositioning error in patients with knee osteoarthritis?

DEFF Research Database (Denmark)

Lund, Hans; Henriksen, Marius; Bartels, Else M

2009-01-01

PURPOSE: The purpose of this study was to investigate the effect of massage applied to the thigh muscles on joint repositioning error (JRE) in patients suffering from osteoarthritis (OA).We hypothesized that stimulating massage of the muscles around an osteoarthritic knee joint, could improve the...

Does a family history of RA influence the clinical presentation and treatment response in RA?

Science.gov (United States)

Frisell, Thomas; Saevarsdottir, Saedis; Askling, Johan

2016-06-01

To assess whether family history of rheumatoid arthritis (RA), among the strongest risk factors for developing RA, also carries information on the clinical presentation and treatment response. The prospective Swedish Rheumatology register was linked to family history of RA, defined as diagnosed RA in any first-degree relative, ascertained through the Swedish Multi-Generation and Patient registers. Clinical presentation was examined among patients with early RA 2000-2011 (symptom onset clinical characteristics, drug survival, European League Against Rheumatism (EULAR) response and change in disease activity at 3 and 6 months was estimated using linear and generalised logistic regression models. Correlation in relatives' response measures was also assessed. Patients with early RA with family history of RA were more often rheumatoid factor positive, but with no other clinically meaningful differences in their clinical presentation. Family history of RA did not predict response to MTX or TNFi, with the possible exception of no versus good EULAR response to TNFi at 6 months (OR=1.4, 95% CI 1.1 to 1.7). Having a relative who discontinued TNFi within a year increased the odds of doing the same (OR=3.7, 95% CI 1.8 to 7.5), although we found no significant familial correlations in change in disease activity measures. Family history of RA did not modify the clinical presentation of RA or predict response to standard treatment with MTX or TNFi. Treatment response, particularly drug survival, may itself be familial. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Reliability, validity, and responsiveness of the Western Ontario and McMaster Universities Osteoarthritis Index for elderly patients with a femoral neck fracture

NARCIS (Netherlands)

Burgers, P.T.; Poolman, R.W.; Bakel, T.M. Van; Tuinebreijer, W.E.; Zielinski, S.M.; Bhandari, M.; Patka, P.; Lieshout, E.M. van; Kampen, A. van; Biert, J.; Vugt, A.B. van; Edwards, M.J.R.; Blokhuis, T.J.; Frolke, J.P.; Geeraedts, L.M.G.; Gardeniers, J.W.M.; Tan, E.C.T.H.; Poelhekke, L.M.S.J.; Waal Malefijt, M.C. de; Schreurs, B.W.; et al.,

2015-01-01

BACKGROUND: The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) has been extensively evaluated in groups of patients with osteoarthritis, yet not in patients with a femoral neck fracture. This study aimed to determine the reliability, construct validity, and responsiveness of

Reliability, Validity, and Responsiveness of the Western Ontario and McMaster Universities Osteoarthritis Index for Elderly Patients with a Femoral Neck Fracture

NARCIS (Netherlands)

Burgers, Paul T. P. W.; Poolman, Rudolf W.; van Bakel, Theodorus M. J.; Tuinebreijer, Wim E.; Zielinski, Stephanie M.; Bhandari, Mohit; Patka, Peter; van Lieshout, Esther M. M.; Devereaux, P. J.; Guyatt, Gordon H.; Einhorn, Thomas A.; Thabane, Lehana; Schemitsch, Emil H.; Koval, Kenneth J.; Frihagen, Frede; Tetsworth, Kevin; Guerra-Farfan, Ernesto; Walter, Stephen D.; Sprague, Sheila; Swinton, Marilyn; Scott, Taryn; McKay, Paula; Madden, Kim; Heels-Ansdell, Diane; Buckingham, Lisa; Duraikannan, Aravin; Silva, Heather; Heetveld, Martin J.; Burgers, T. P. W.; Zura, Robert D.; Avram, Victoria; Eygendaal, Denise; Krips, Rover; Raven, Eric E. J.; Haverlag, Robert; Mutsaerts, Eduard L. A. R.; Haverkamp, Daniel; van den Bekerom, Michel P. J.; Beimers, Lijkele; de Vries, Jasper; Zurcher, Arthur W.; Bulstra, Gythe H.; Campo, Martin M.; Somford, Mathijs P.; Schep, Niels W. L.; Festen, Sebastiaan; Geeraedts, Leo M. G.; Peters, Rolf; Goslings, J. Carel; Ponsen, Kees Jan

2015-01-01

Background: The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) has been extensively evaluated in groups of patients with osteoarthritis, yet not in patients with a femoral neck fracture. This study aimed to determine the reliability, construct validity, and responsiveness of

Factors associated with absenteeism, presenteeism and activity impairment in patients in the first years of RA.

Science.gov (United States)

Bansback, Nick; Zhang, Wei; Walsh, David; Kiely, Patrick; Williams, Richard; Guh, Daphne; Anis, Aslam; Young, Adam

2012-02-01

To understand the impact of the early years of RA on all aspects of work productivity, and determine how this is related to clinical markers. Previous research on work productivity has examined predominantly early retirement and absenteeism. The impact of reduced work performance (presenteeism) and activity impairment is less well understood in early RA populations. Working patients enrolled in an RA inception cohort were recruited into a nested study. A questionnaire incorporating the Work Productivity and Activity Impairment (WPAI) instrument was administered with a number of clinical outcomes, including the Multidimensional Health Assessment Questionnaire (MD-HAQ) and scales for pain, fatigue and patient assessment of disease patient global assessment (PtGA). Analysis included 150 RA patients, with the mean age at onset being 48 years (s.d. 10 years) and disease duration from symptom onset being 49 months. Patients had relatively mild disease: MD-HAQ (0.6), pain (3.6), PtGA (3.6) and fatigue (4.6). Of the 92% patients working for pay, 19% reported missing work (absenteeism) in the past week due to their health, accounting for 46% of their working time. Even while at work, ∼25% of actual hours was lost due to poor health, while outside work 33% of patients' regular daily activities were prevented. In multivariate analyses, disease severity was associated with the presence of absenteeism, presenteeism and activity impairment. Patients able to self-schedule their work had lower presenteeism and activity impairment. Productivity loss is common in patients in the first years of RA who are in paid work and was associated with work characteristics and adverse clinical outcomes.

Association of Exercise Therapy and Reduction of Pain Sensitivity in Patients With Knee Osteoarthritis

DEFF Research Database (Denmark)

Henriksen, Marius; Klokker, Louise; Graven-Nielsen, Thomas

2014-01-01

OBJECTIVE: Exercise has beneficial effects on pain in knee osteoarthritis (OA), yet the underlying mechanisms are unclear. The purpose of this study was to investigate the effects of exercise on pressure-pain sensitivity in patients with knee OA. METHODS: In a randomized controlled trial...... visual analog scale pain scores during constant pressure for 6 minutes at 125% of the PPT as a measure of temporal summation (TS) of pressure-pain. Secondary outcomes included self-reported pain using the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire. Analyses were based on the "per...

Short Term Effects of Kinesiotape Application in Patients with Knee Osteoarthritis

Directory of Open Access Journals (Sweden)

Zeliha Başkurt

2017-11-01

Full Text Available Objective: The purpose of this prospective, randomized, controlled study is to determine the effect of kinesiotape on pain, range of motion, muscle strength and lower extremity functions in medial compartmental osteoarthritis patients. Materials and Methods: Patients with medial compartmental knee osteoarthritis were participated in the study. They were randomized into two groups. While kinesiotaping was applied to the first group (n:23, six men, 17 women; age: 57.6±11.5 yrs; BMI: 28.8±4.3 kg/m2; 15 right, eight left knee, sham taping was applied to the second group (n:22, five men, 17 women; age: 61.1±7.0 yrs; BMI: 31.1±4.1 kg/m2; 13 right, nine left knee twice, three days apart. Visual pain scale, knee range of motion, muscle strength measurements, and Lower Extremity Functional Scale scores were recorded at baseline, immediately following the first taping, three days and seven days later. Results: Kinesiotape outperformed sham tape statistically significantly in the test parameters (p

Ochronosis of the knee with secondary osteoarthritis requiring total knee replacement in a patient with cryptogenic organising pneumonia.

Science.gov (United States)

Jasper, Jorrit; Metsaars, Wieneke; Jansen, Joris

2016-05-20

Ochronosis is a rare autosomal recessive metabolic disease caused by homogentisic acid oxidase enzyme deficiency. High homogentisic acid levels will eventually result in black deposits in skin, sclerae, connective tissues and urine (alkaptonuria). It can lead to early degeneration of connective tissues and cartilage. Ochronosis can damage normal cartilage, leading to secondary osteoarthritis. The diagnosis is often delayed because of its low prevalence and non-specific early symptoms. In our patient, the secondary osteoarthritis due to ochronosis deposits in the cartilage was treated by total knee arthroplasty, with good clinical outcome. This article reports the first case of ochronosis with secondary osteoarthritis of the knee in a patient previously diagnosed with cryptogenic organising pneumonia (COP). 2016 BMJ Publishing Group Ltd.

PhosphoLipid transfer protein (PLTP) exerts a direct pro-inflammatory effect on rheumatoid arthritis (RA) fibroblasts-like-synoviocytes (FLS) independently of its lipid transfer activity

Science.gov (United States)

Deckert, Valérie; Daien, Claire I.; Che, Hélène; Elhmioui, Jamila; Lemaire, Stéphanie; Pais de Barros, Jean-Paul; Desrumaux, Catherine; Combe, Bernard; Hahne, Michael; Lagrost, Laurent; Morel, Jacques

2018-01-01

Rheumatoid arthritis (RA) is a chronic inflammatory rheumatic disease with modification of lipids profile and an increased risk of cardiovascular events related to inflammation. Plasma phospholipid transfer protein (PLTP) exerts a lipid transfer activity through its active form. PLTP can also bind to receptors such as ATP-binding cassette transporter A1 (ABCA1). In addition to its role in lipoprotein metabolism and atherosclerosis, the latest advances came in support of a complex role of PLTP in the regulation of the inflammatory response, both with pro-inflammatory or anti-inflammatory properties. The aim of the present study was to decipher the role of PLTP in joint inflammation and to assess its relevance in the context of RA. PLTP expression was examined by western-blot and by immunochemistry. ABCA1 expression was analyzed by flow cytometry. Lipid transfer activity of PLTP and pro-inflammatory cytokines were measured in sera and synovial fluid (SF) from RA patients and controls (healthy subjects or osteoarthritis patients [OA]). FLS were treated with both lipid-transfer active form and inactive form of recombinant human PLTP. IL-8, IL-6, VEGF and MMP3 produced by FLS were assessed by ELISA, and proliferation by measuring 3H-Thymidine incorporation. RA synovial tissues showed higher PLTP staining than OA and PLTP protein levels were also significantly higher in RA-FLS. In addition, RA, unlike OA patients, displayed elevated levels of PLTP activity in SF, which correlated with pro-inflammatory cytokines. Both lipid-transfer active and inactive forms of PLTP significantly increased the production of cytokines and proliferation of FLS. ABCA1 was expressed on RAFLS and PLTP activated STAT3 pathway. To conclude, PLTP is highly expressed in the joints of RA patients and may directly trigger inflammation and FLS proliferation, independently of its lipid transfer activity. These results suggest a pro-inflammatory role for PLTP in RA. PMID:29565987

Green tea (Camellia sinensis) for patients with knee osteoarthritis: A randomized open-label active-controlled clinical trial.

Science.gov (United States)

Hashempur, Mohammad Hashem; Sadrneshin, Sara; Mosavat, Seyed Hamdollah; Ashraf, Alireza

2018-02-01

Green tea is known as a dietary supplement and a novel functional food worldwide. Since there are increasing preclinical evidence about efficacy of green tea for treating osteoarthritis, this study has aimed at assessing its efficacy and safety for patients with knee osteoarthritis. This is a randomized open-label active-controlled clinical trial. As many as fifty adults with osteoarthritis of knee were randomly allocated to receive the green tea extract (in dosage form of tablet) plus diclofenac tablet as "intervention group"; or: diclofenac tablet alone as "control group" for a period of four weeks. Patients were assessed at the beginning of intervention, and then 4 weeks later, in terms of pain score via visual analogue scale (VAS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire's total score in addition to its 3 sub-scores. Furthermore, they were asked about any adverse effects during intervention period. Mean differences of VAS pain, total WOMAC, and WOMAC physical function scores in green tea group showed a significant reduction, compared with the control group (P = 0.038, P = 0.006, and P = 0.004, respectively). However, No significant differences between the two groups were observed, regarding mean differences of WOMAC pain and stiffness scores of the enrolled patients (P = 0.163, and P = 0.150, respectively). Additionally, only 1 patient reported gastric upset [in control group]. It seems that green tea extract might well be considered as an adjunctive treatment both for control of pain and for the betterment of knee joint physical function in adults with osteoarthritis. However, further studies of longer duration and larger sample size are needed. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Strength and voluntary activation in relation to functioning in patients with osteoarthritis.

NARCIS (Netherlands)

Dr. D.M. van Leeuwen

2013-01-01

Osteoarthritis (OA) is characterized by pain, and problems with activities of daily life, especially if the hip or knee joint is affected. The aim of this project was to study associations between strength, voluntary activation and physical functioning in elderly patients with OA. People with OA of

Incidental finding of knee osteoarthritis in bone scans performed in obese patients with neoplasia

International Nuclear Information System (INIS)

Regalado R, R.; Morales G, R.; Cano P, R.; Mendoza P, G.; Vidal N, L.

1996-01-01

Bone scanning performed in the Nuclear Medicine Center (IPEN-INEN) to patients with neoplastic diagnosis between January 1995 and June 1996, permitted the incidental finding of increased uptake images in the knees of 28 patients associated to an asymptomatic arthropathy: osteoarthritis. The histories and bone scanning of this patients were reviewed obtaining their weight, occupation, symptomatology, neoplastic diagnosis and previous scan diagnosis. Patients under 66 years old, asymptomatic, were included, not presenting secondary focuses, without arthropathia antecedent and with a body mass index equal or above class I. The arthropathy was classified according to the localization of the compromised compartment of the knee. >From the body mass index assessment of every patient it was obtained: Class I=12, Class II=11, Class III=3 and Class IV=1. The predominant localization of the osteoarthritic lesions was the patellar zone. We discuss factors that may influence the absence of symptoms of this disease, the relation obesity-osteoarthritis and the usefulness of bone scanning in the diagnosis of this arthropathy in these patients. (authors). 16 refs., 1 fig., 3 tabs

Flexor hallucis longus tendon rupture in RA-patients is associated with MTP 1 damage and pes planus

NARCIS (Netherlands)

Baan, H.; Baan, Henriette; Drossaers-Bakker, K.W.; Dubbeldam, Rosemary; Dubbeldam, Rosemary; Buurke, Jaap J.; Nene, A.V.; van de Laar, Mart A F J

2007-01-01

Background: To assess the prevalence of and relation between rupture or tenosynovitis of the Flexor Hallucis Longus (FHL) tendon and range of motion, deformities and joint damage of the forefoot in RA patients with foot complaints. Methods: Thirty RA patients with painful feet were analysed, their

Fatigue as experienced by patients with rheumatoid arthritis (RA): a qualitative study.

NARCIS (Netherlands)

Repping-Wuts, J.W.J.; Uitterhoeve, R.J.; Riel, P.L.C.M. van; Achterberg, T. van

2008-01-01

OBJECTIVE: Interest in fatigue research has grown since the finding that fatigue is, besides pain, the symptom most frequently reported by patients with rheumatoid arthritis (RA). The aim of this study was to explore the experience of fatigue from the patients' perspective. METHODS: Twenty-nine

Identifying compositional and structural changes in spongy and subchondral bone from the hip joints of patients with osteoarthritis using Raman spectroscopy

Science.gov (United States)

Buchwald, Tomasz; Niciejewski, Krzysztof; Kozielski, Marek; Szybowicz, Mirosław; Siatkowski, Marcin; Krauss, Hanna

2012-01-01

Raman microspectroscopy was used to examine the biochemical composition and molecular structure of extracellular matrix in spongy and subchondral bone collected from patients with clinical and radiological evidence of idiopathic osteoarthritis of the hip and from patients who underwent a femoral neck fracture, as a result of trauma, without previous clinical and radiological evidence of osteoarthritis. The objectives of the study were to determine the levels of mineralization, carbonate accumulation and collagen quality in bone tissue. The subchondral bone from osteoarthritis patients in comparison with control subject is less mineralized due to a decrease in the hydroxyapatite concentration. However, the extent of carbonate accumulation in the apatite crystal lattice increases, most likely due to deficient mineralization. The alpha helix to random coil band area ratio reveals that collagen matrix in subchondral bone is more ordered in osteoarthritis disease. The hydroxyapatite to collagen, carbonate apatite to hydroxyapatite and alpha helix to random coil band area ratios are not significantly changed in the differently loaded sites of femoral head. The significant differences also are not visible in mineral and organic constituents' content in spongy bone beneath the subchondral bone in osteoarthritis disease.

A hierarchy of patient-reported outcomes for meta-analysis of knee osteoarthritis trials

DEFF Research Database (Denmark)

Juhl, Carsten; Lund, Hans; Roos, Ewa M

2012-01-01

Objectives. To develop a prioritised list based on responsiveness for extracting patient-reported outcomes (PROs) measuring pain and disability for performing meta-analyses in knee osteoarthritis (OA). Methods. A systematic search was conducted in 20 highest impact factor general and rheumatology...

Stages of change, barriers, benefits, and preferences for exercise in RA patients: a cross-sectional study.

Science.gov (United States)

Henchoz, Y; Zufferey, P; So, A

2013-01-01

To determine the distribution of exercise stages of change in a rheumatoid arthritis (RA) cohort, and to examine patients' perceptions of exercise benefits, barriers, and their preferences for exercise. One hundred and twenty RA patients who attended the Rheumatology Unit of a University Hospital were asked to participate in the study. Those who agreed were administered a questionnaire to determine their exercise stage of change, their perceived benefits and barriers to exercise, and their preferences for various features of exercise. Eighty-nine (74%) patients were finally included in the analyses. Their mean age was 58.4 years, mean RA duration 10.1 years, and mean disease activity score 2.8. The distribution of exercise stages of change was as follows: precontemplation (n = 30, 34%), contemplation (n = 11, 13%), preparation (n = 5, 6%), action (n = 2, 2%), and maintenance (n = 39, 45%). Compared to patients in the maintenance stage of change, precontemplators exhibited different demographic and functional characteristics and reported less exercise benefits and more barriers to exercise. Most participants preferred exercising alone (40%), at home (29%), at a moderate intensity (64%), with advice provided by a rheumatologist (34%) or a specialist in exercise and RA (34%). Walking was by far the preferred type of exercise, in both the summer (86%) and the winter (51%). Our cohort of patients with RA was essentially distributed across the precontemplation and maintenance exercise stages of change. These subgroups of patients exhibit psychological and functional differences that make their needs different in terms of exercise counselling.

Increased risk of revision for infection in rheumatoid arthritis patients with total hip replacements

DEFF Research Database (Denmark)

Schrama, Johannes Cornelis; Fenstad, Anne M; Dale, Håvard

2015-01-01

Background and purpose-Medical treatment of rheumatoid arthritis (RA) has changed dramatically over the last 15 years, including immune modulation. We investigated the risk of revision for infection after primary total hip replacement (THR) in patients with rheumatoid arthritis over a 16-year...... period, and compared it with that in THR patients with osteoarthritis (OA).Patients and methods-We identified 13,384 THRs in RA patients and 377,287 THRs in OA patients from 1995 through 2010 in a dataset from the Nordic Arthroplasty Register Association (NARA). Kaplan-Meier survival curves......, with revision for infection as the endpoint, were constructed. Cox regression analyses were performed to calculate the relative risk (RR) of revision for infection adjusted for age, sex, fixation technique, and year of primary surgery.Results-RA patients had a 1.3 times (95% CI 1.0-1.6) higher risk of revision...

Effect of Weight Losing on the Improving Clinical Statement of Patients With Knee Osteoarthritis.

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Sadeghi, Alireza; Rad, Zahra Abbaspour; Sajedi, Behnam; Heydari, Amir Hossein; Akbarieh, Samira; Jafari, Behzad

2017-11-01

Osteoarthritis causes severe pain and disability in joints, one of the most prevalent involved joints is the knee joint. There are several therapeutics ways to control pain and disability, but almost none of them are definite treatment. In this article, we tried to reveal the effect of weight loss on improving symptoms of knee osteoarthritis as an effective and permanent therapeutic approach. We chose 62 patients with grade 1-2 (mild to moderate) knee osteoarthritis and divided them equally into case and control groups. Patients should not had used NSAIDs at least for 6 months before study initiation. Symptoms severity was measured by WOMAC and VAS questionnaires before and after 3 months follow up. Weight and BMI were recorded too. Case group was suggested to have weight loss diet of less fat and carbohydrates and control group did not have any limitation. Comparison of variables' average of case and control groups was not logistically meaningful at the initiation and after the end of the study. But there was a meaningful correlation between variables' changes and lifestyle change in both groups, especially in WOMAC and VAS scores. All variables in case group had statistically meaningful differences between their amounts at the beginning and after the end of the study, on the contrary of the control group. In the comparison of our study with similar studies in the world. We deduced that weight loss can improve symptoms of knee osteoarthritis even in short time weight loss diet (3 months). ZUMS.REC.1394.94. Copyright © 2017. Publicado por Elsevier España, S.L.U.

The impact of self-efficacy on physical activity maintenance in patients with hip osteoarthritis

DEFF Research Database (Denmark)

Hammer, Nanna Maria; Bieler, Theresa; Beyer, Nina Ann-Marie

2016-01-01

Purpose: Understanding motivational factors related to physical activity (PA) maintenance is essential in promoting long-term exercise benefits. This study explored the impact of self-efficacy (SE) on post-intervention PA maintenance in patients with hip osteoarthritis. Method: An SE-theory based...... mixed-methods sub-study of a trial investigating the effects of 4 months supervised exercise in patients with hip osteoarthritis. Questionnaire data (n = 52; baseline and 12 months) on PA and SE (Arthritis Self-Efficacy Scale, ASES, score-range 10–100) were analysed (Mann–Whitney test) for differences...... from incorporating the self-efficacy theory in the planning and execution of exercise interventions to promote post-intervention physical activity maintenance and long term health benefits. •Post-intervention physical activity maintenance may be increased by focussing on the patients’ exercise self-efficacy...

Synovial inflammation in patients with different stages of knee osteoarthritis.

Science.gov (United States)

Ene, Răzvan; Sinescu, Ruxandra Diana; Ene, Patricia; Cîrstoiu, Monica Mihaela; Cîrstoiu, Florin Cătălin

2015-01-01

The synovium is an intra-articular mesenchymal tissue and essential for the normal joint function. It is involved in many pathological characteristic processes and sometimes specific for this distinctive tissue. In this study, we refer to synovial proliferative disorders according to the stage of osteoarthritis (OA) disease. Forty-three patients with knee OA were treated in the Department of Orthopedics and Traumatology, Emergency University Hospital of Bucharest, Romania, in the last two years. In all cases, we used at least five criteria for the knee OA: knee pain, knee joint tenderness, no palpable warmth over the knee, stiffness, erythrocyte sedimentation rate and C-reactive protein levels. In all the cases the synovial tissue was selected by the orthopedic surgeon. X-ray examination was taken in every case of the affected joint. Patients who were considered to have early OA underwent arthroscopic synovial biopsy of the symptomatic joint. Synovial tissue samples from patients with late OA were obtained at the time of knee joint arthroplasty. Microscopic examination in early osteoarthritis revealed for more than half of patients with synovial biopsy through arthroscopic technique having synovitis lesions with mononuclear infiltrates, diffuse fibrosis, thickening of the lining layer, macrophages appearance and neoformation vessels also. The synovitis seen in advanced OA knees tends to be diffuse and is not mandatory localized to areas of chondral defects, although an association has been reported between chondral defects and associated synovitis in the knee medial tibio-femoral compartment. The overexpression of mediators of inflammation and the increased mononuclear cell infiltration were seen in early OA, compared with late OA.

Therapeutic Effectiveness and Safety of Mesotherapy in Patients with Osteoarthritis of the Knee

Directory of Open Access Journals (Sweden)

Liang Chen

2018-01-01

Full Text Available Objective. To evaluate the therapeutic effectiveness and safety of mesotherapy by comparing it with the classic systematic therapy in patients with osteoarthritis (OA. Methods. Sixty patients were included and classified into two groups based on the existence of contraindications for nonsteroidal anti-inflammatory drugs (NSAIDs. These patients were treated with oral NSAIDs (Group A or mesotherapy (Group B. After completing the treatment, the patients were followed up for 6 months. Their clinical features, laboratory results, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC scores were evaluated. Results. A total of 50 patients completed treatment and follow-up. The patients in Group B had significantly fewer gastric acid-related complaints and requested less supplementary treatment for recurrent pain (p<0.05. The patients in both groups exhibited decreased blood viscosity after treatment (p<0.05. WOMAC scores, specifically those for pain and stiffness, were found to be significantly improved after either type of treatment (p<0.05. Mesotherapy also ameliorated physical function (p<0.05. Furthermore, Group B presented with better outcomes than Group A (p<0.05 or p<0.01. Conclusion. Our results suggest that mesotherapy is an effective and safe treatment for patients with OA. Clinicians should consider mesotherapy as an alternative therapy for patients with contraindications for NSAID use.

Magnetic resonance imaging signs of iliotibial band friction in patients with isolated medial compartment osteoarthritis of the knee

International Nuclear Information System (INIS)

Vasilevska, Violeta; Szeimies, Ulrike; Staebler, Axel

2009-01-01

The purpose of this retrospective study was to assess the frequency of magnetic resonance imaging (MRI) signs of iliotibial band friction (ITBF) in patients with advanced medial compartment knee osteoarthritis. Proton density-weighted (PDw) fat-saturated (fatsat) MR images (1.5 T, slice thickness (SL) 2.5-3 mm, eight-channel phased array coil) of 128 patients with isolated advanced osteoarthritis of the medial knee compartment and complete or subtotal (>80%) loss of cartilage were evaluated. There were 41 men and 87 women. Mean age was 63 years, range 34-89 years. The control group consisted of 94 patients with medial meniscus degeneration without cartilage loss (56 men and 38 women, mean age 50 years, range 16-89 years). MRI signs of ITBF were evaluated in both groups [poorly defined abnormalities of signal intensity and localized fluid collection lateral, distal or proximal to the lateral epicondyle; signal intensity abnormalities superficial to or deep by the iliotibial band (ITB)]. Transverse images were evaluated separately. Consensus evaluation using all imaging planes was performed. Of 128 patients with osteoarthritis, 95 had moderate or advanced MRI signs of ITBF (74.2%). Eighty-nine patients (69.5%) had advanced degeneration of the meniscus. In the control group, 26 of 94 patients had only moderate MRI signs of ITBF. There was a statistically significant difference between both groups for the presence of MR signs of ITBF (P ≤ 0.01). MRI signs of ITBF were frequently present in patients with severe medial compartment osteoarthritis of the knee. Joint space narrowing with varus knee deformity may be a cause of ITBF. Level 4 (Historic, non-randomized, retrospective, cohort study with a control group) (orig.)

Magnetic resonance imaging signs of iliotibial band friction in patients with isolated medial compartment osteoarthritis of the knee

Energy Technology Data Exchange (ETDEWEB)

Vasilevska, Violeta [University Surgical Clinic ' St. Naum Ohridski' , Skopje (Macedonia (The Former Yugoslav Republic of)); Szeimies, Ulrike; Staebler, Axel [Radiology in Muenchen Harlaching, Orthopedic Clinic Harlaching, Munich (Germany)

2009-09-15

The purpose of this retrospective study was to assess the frequency of magnetic resonance imaging (MRI) signs of iliotibial band friction (ITBF) in patients with advanced medial compartment knee osteoarthritis. Proton density-weighted (PDw) fat-saturated (fatsat) MR images (1.5 T, slice thickness (SL) 2.5-3 mm, eight-channel phased array coil) of 128 patients with isolated advanced osteoarthritis of the medial knee compartment and complete or subtotal (>80%) loss of cartilage were evaluated. There were 41 men and 87 women. Mean age was 63 years, range 34-89 years. The control group consisted of 94 patients with medial meniscus degeneration without cartilage loss (56 men and 38 women, mean age 50 years, range 16-89 years). MRI signs of ITBF were evaluated in both groups [poorly defined abnormalities of signal intensity and localized fluid collection lateral, distal or proximal to the lateral epicondyle; signal intensity abnormalities superficial to or deep by the iliotibial band (ITB)]. Transverse images were evaluated separately. Consensus evaluation using all imaging planes was performed. Of 128 patients with osteoarthritis, 95 had moderate or advanced MRI signs of ITBF (74.2%). Eighty-nine patients (69.5%) had advanced degeneration of the meniscus. In the control group, 26 of 94 patients had only moderate MRI signs of ITBF. There was a statistically significant difference between both groups for the presence of MR signs of ITBF (P {<=} 0.01). MRI signs of ITBF were frequently present in patients with severe medial compartment osteoarthritis of the knee. Joint space narrowing with varus knee deformity may be a cause of ITBF. Level 4 (Historic, non-randomized, retrospective, cohort study with a control group) (orig.)

Measuring the radium quartet (228Ra, 226Ra, 224Ra, 223Ra) in seawater samples using gamma spectrometry

International Nuclear Information System (INIS)

Beek, P. van; Souhaut, M.; Reyss, J.-L.

2010-01-01

Radium isotopes are widely used in marine studies (eg. to trace water masses, to quantify mixing processes or to study submarine groundwater discharge). While 228 Ra and 226 Ra are usually measured using gamma spectrometry, short-lived Ra isotopes ( 224 Ra and 223 Ra) are usually measured using a Radium Delayed Coincidence Counter (RaDeCC). Here we show that the four radium isotopes can be analyzed using gamma spectrometry. We report 226 Ra, 228 Ra, 224 Ra, 223 Ra activities measured using low-background gamma spectrometry in standard samples, in water samples collected in the vicinity of our laboratory (La Palme and Vaccares lagoons, France) but also in seawater samples collected in the plume of the Amazon river, off French Guyana (AMANDES project). The 223 Ra and 224 Ra activities determined in these samples using gamma spectrometry were compared to the activities determined using RaDeCC. Activities determined using the two techniques are in good agreement. Uncertainties associated with the 224 Ra activities are similar for the two techniques. RaDeCC is more sensitive for the detection of low 223 Ra activities. Gamma spectrometry thus constitutes an alternate method for the determination of short-lived Ra isotopes.

Effect of weight maintenance on symptoms of knee osteoarthritis in obese patients

DEFF Research Database (Denmark)

Christensen, Robin; Henriksen, Marius; Leeds, Anthony R

2015-01-01

Objective To compare results of obese patients with knee osteoarthritis (OA) who, after an intensive weight loss regimen, received 1 year of either Dietary support (D), knee-Exercise program (E), or Control (C) "no attention". Methods Randomized, two-phase, parallel-group trial. 192 obese...... of maintenance program. © 2014 American College of Rheumatology....

A randomized controlled trial of aquatic and land-based exercise in patients with knee osteoarthritis

DEFF Research Database (Denmark)

Lund, H.; Weile, U.; Christensen, R.

2008-01-01

patients reported adverse events (i.e. discomfort) in land-based exercise, while only 3 reported adverse events in the aquatic exercise. Conclusion: Only land-based exercise showed some improvement in pain and muscle strength compared with the control group, while no clinical benefits were detectable after......Objective: To compare the efficacy of aquatic exercise and a land-based exercise programme vs control in patients with knee osteoarthritis. Methods: Primary outcome was change in pain, and in addition Knee Injury and Osteoarthritis Outcome Score questionnaire (KOOS). Standing balance and strength...... was also measured after and at 3-month follow-up. Seventy-nine patients (62 women), with a mean age of 68 years (age range 40-89 years) were randomized to aquatic exercise (n = 27), land-based exercise (n = 25) or control (n = 27). Results: No effect was observed immediately after exercise cessation (8...

Comparing two low-energy diets for the treatment of knee osteoarthritis symptoms in obese patients

DEFF Research Database (Denmark)

Riecke, B.F.; Christensen, R.; Christensen, Pia

2010-01-01

OBJECTIVES: To evaluate in a prospective, randomized clinical trial (RCT), symptom response among obese knee osteoarthritis (OA) patients following a feasible, intensive weight-loss program for 16 weeks. METHODS: Eligible patients were obese [body mass index (BMI)>30kg/m(2)]; >50 years old......, with primary knee OA. Participants were randomized to either a very-low-energy diet (VLED) or a low-energy diet (LED) (415kcal/day and 810kcal/day, respectively), using commercially available formula foods - only for the first 8 weeks, managed by dieticians. Followed by an additional 8-week period of a hypo......-energetic diet consisting of normal food plus meal replacements (1200kcal/day). The primary endpoint was the number of patients responding according to the Outcome Measures in Rheumatology Clinical Trials and Osteoarthritis Research Society International (OMERACT-OARSI) responder criterion. The statistical...

Glenohumeral Joint Preservation: A Review of Management Options for Young, Active Patients with Osteoarthritis

Directory of Open Access Journals (Sweden)

Olivier A. van der Meijden

2012-01-01

Full Text Available The management of osteoarthritis of the shoulder in young, active patients is a challenge, and the optimal treatment has yet to be completely established. Many of these patients wish to maintain a high level of activity, and arthroplasty may not be a practical treatment option. It is these patients who may be excellent candidates for joint-preservation procedures in an effort to avoid or delay joint replacement. Several palliative and restorative techniques are currently optional. Joint debridement has shown good results and a combination of arthroscopic debridement with a capsular release, humeral osteoplasty, and transcapsular axillary nerve decompression seems promising when humeral osteophytes are present. Currently, microfracture seems the most studied reparative treatment modality available. Other techniques, such as autologous chondrocyte implantation and osteochondral transfers, have reportedly shown potential but are currently mainly still investigational procedures. This paper gives an overview of the currently available joint preserving surgical techniques for glenohumeral osteoarthritis.

Low-dose SoluMatrix diclofenac in patients with osteoarthritis pain: impact on quality of life in a controlled trial.

Science.gov (United States)

Strand, Vibeke; Bergman, Martin; Singh, Jasvinder A; Gibofsky, Allan; Kivitz, Alan; Young, Clarence

2017-06-01

Low-dose SoluMatrix diclofenac was developed to provide effective pain relief for osteoarthritis pain. We evaluated the effects of SoluMatrix diclofenac on health-related quality of life (HRQoL) measures in patients with osteoarthritis, hypothesizing that SoluMatrix-treated patients would experience significant improvement compared with placebo. In this 12-week, phase 3 randomized controlled trial, 305 patients with osteoarthritis of the hip or knee received SoluMatrix diclofenac 35 mg three times (TID) or twice (BID) daily or placebo. Measures included HRQoL, assessed by Short Form 36 (SF-36, version 2), and pain, stiffness, and physical function, assessed by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at baseline and at week 12. Descriptive statistics were calculated for mean changes from baseline; inferential statistics compared treatment groups with placebo. SoluMatrix diclofenac 35 mg BID (6.2 [0.75]; P = 0.0048) or TID (6.6 [0.80]; P = 0.0014) produced large improvements in the SF-36 physical component summary (PCS) scores at week 12 (least squares mean change from baseline [SE]) compared with placebo (3.5 [0.78]). Minimum clinically important differences were observed in six out of eight SF-36 domains among patients in SoluMatrix diclofenac groups and five out of eight domains in the placebo group; treatment with SoluMatrix diclofenac 35 mg TID produced significant improvements (P ≤ 0.03) in five out of eight domains versus placebo. SoluMatrix diclofenac 35 mg TID significantly improved responses to 23 out of 24 questions in the WOMAC versus placebo (P ≤ 0.0334). Low-dose SoluMatrix diclofenac 35 mg TID and BID significantly improved HRQoL, pain, stiffness, and physical function in patients with osteoarthritis of the hip or knee.

Exercise induced effects on muscle function and range of motion in patients with hip osteoarthritis

DEFF Research Database (Denmark)

Bieler, Theresa; Siersma, Volkert; Magnusson, S Peter

2018-01-01

BACKGROUND AND PURPOSE: Patients with hip osteoarthritis have impairments in muscle function (muscle strength and power) and hip range of motion (ROM), and it is commonly believed that effective clinical management of osteoarthritis should address these impairments to reduce pain and disability......-two patients were randomized to either 4 months of physiotherapist-supervised, moderate, progressive, strength training (n = 50), physiotherapist-supervised NW (n = 50), or unsupervised HBE (n = 52). Maximal isometric hip and thigh muscle strength and leg extensor power and active hip ROM were assessed...... at baseline 2, 4, and 12 months. RESULTS: Intention-to-treat-analyses did not show any significant between-group differences for improvements in muscle strength and power or ROM at any time points. Short-term significant (p

The impact of self-efficacy on physical activity maintenance in patients with hip osteoarthritis - a mixed methods study.

Science.gov (United States)

Hammer, Nanna Maria; Bieler, Theresa; Beyer, Nina; Midtgaard, Julie

2016-08-01

Understanding motivational factors related to physical activity (PA) maintenance is essential in promoting long-term exercise benefits. This study explored the impact of self-efficacy (SE) on post-intervention PA maintenance in patients with hip osteoarthritis. An SE-theory based mixed-methods sub-study of a trial investigating the effects of 4 months supervised exercise in patients with hip osteoarthritis. Questionnaire data (n = 52; baseline and 12 months) on PA and SE (Arthritis Self-Efficacy Scale, ASES, score-range 10-100) were analysed (Mann-Whitney test) for differences in characteristics of maintainers and non-maintainers. Semi-structured individual interviews (n = 15; at 12-months follow-up) were analysed using directed content analysis. Compared to non-maintainers (n = 9; 17%) maintainers (n = 31; 60%) had improved (p exercise outcome expectations and obligation towards the study influenced maintenance. SE contributes to understanding of post-intervention PA maintenance in patients with hip osteoarthritis. However, disease-related factors and clinical trial participation appears significant too. Implications for Rehabilitation Patients' perceived self-efficacy for physical activity contributes to the understanding of post-intervention physical activity maintenance in patients with hip osteoarthritis. Practitioners may benefit from incorporating the self-efficacy theory in the planning and execution of exercise interventions to promote post-intervention physical activity maintenance and long term health benefits. Post-intervention physical activity maintenance may be increased by focussing on the patients' exercise self-efficacy through verbal persuasion and support, disease-specific information and information on normal physiological responses to exercise combined with an individualised training progression to support experiences of success and achievement of desired outcomes.

Rapid Hip Osteoarthritis Development in a Patient with Anterior Acetabular Cyst with Sagittal Alignment Change

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Yasuhiro Homma

2014-01-01

Full Text Available Rapidly destructive coxarthrosis (RDC is rare and develops unusual clinical course. Recent studies suggest multiple possible mechanisms of the development of RDC. However the exact mechanism of RDC is still not clear. The difficulty of the study on RDC is attributed to its rareness and the fact that the data before the onset of RDC is normally unavailable. In this report, we presented the patient having the radiographic data before the onset who had rapid osteoarthritis (OA development after contralateral THA, which meets the current criteria of RDC. We thought that the increased posterior tilt of the pelvis after THA reinforced the stress concentration at pre-existed anterior acetabular cyst, thereby the destruction of the cyst was occurred. As a result the rapid OA was developed. We think that there is the case of rapid osteoarthritis developing due to alternating load concentration by posterior pelvic tilt on preexisting anterior acetabular cyst such as our patient among the cases diagnosed as RDC without any identifiable etiology. The recognition of sagittal alignment changes and anterior acetabular cyst may play important role in prediction and prevention of the rapid hip osteoarthritis development similar to RDC.

Effectiveness of exercise therapy in patients with osteoarthritis of the hip or knee.

NARCIS (Netherlands)

Baar, M.E. van; Assendelft, W.J.J.; Dekker, J.; Oostendorp, R.A.B.; Bijlsma, J.W.J.

1999-01-01

Objectives: To review the effectiveness of exercise therapy in patients with osteoarthritis (OA) of the hip of knee. Methods: A computerized literature search of Medline, Embase, and Cinahl was carried out. Randomized clinical trials on exercise therapy for OA of the hip of knee were selected if

IgG4 Production Against Adalimumab During Long Term Treatment of RA Patients

NARCIS (Netherlands)

van Schouwenburg, Pauline A.; Krieckaert, Charlotte L.; Nurmohamed, Michael; Hart, Margreet; Rispens, Theo; Aarden, Lucien; Wouters, Diana; Wolbink, Gerrit Jan

2012-01-01

A substantial part of rheumatoid arthritis (RA) patients is chronically treated with adalimumab. Some of these patients produce antibodies against adalimumab, which correlate with lower serum drug levels and reduced clinical response. Long term exposure to antigens may result in antigen specific

Proximal fibular osteotomy: a new surgery for pain relief and improvement of joint function in patients with knee osteoarthritis.

Science.gov (United States)

Wang, Xiaohu; Wei, Lei; Lv, Zhi; Zhao, Bin; Duan, Zhiqing; Wu, Wenjin; Zhang, Bin; Wei, Xiaochun

2017-02-01

Objective To explore the effects of proximal fibular osteotomy as a new surgery for pain relief and improvement of medial joint space and function in patients with knee osteoarthritis. Methods From January 2015 to May 2015, 47 patients who underwent proximal fibular osteotomy for medial compartment osteoarthritis were retrospectively followed up. Preoperative and postoperative weight-bearing and whole lower extremity radiographs were obtained to analyse the alignment of the lower extremity and ratio of the knee joint space (medial/lateral compartment). Knee pain was assessed using a visual analogue scale, and knee ambulation activities were evaluated using the American Knee Society score preoperatively and postoperatively. Results Medial pain relief was observed in almost all patients after proximal fibular osteotomy. Most patients exhibited improved walking postoperatively. Weight-bearing lower extremity radiographs showed an average increase in the postoperative medial knee joint space. Additionally, obvious correction of alignment was observed in the whole lower extremity radiographs in 8 of 47 patients. Conclusions The present study demonstrates that proximal fibular osteotomy effectively relieves pain and improves joint function in patients with medial compartment osteoarthritis at a mean of 13.38 months postoperatively.

The effect of self-administered superficial local hot and cold application methods on pain, functional status and quality of life in primary knee osteoarthritis patients.

Science.gov (United States)

Aciksoz, Semra; Akyuz, Aygul; Tunay, Servet

2017-12-01

To investigate the effect of the self-administered superficial local hot and cold applications on pain, and the functional status and the quality of life in primary knee osteoarthritis patients. Superficial local hot and cold application is used as a nonpharmacological method for the treatment of knee osteoarthritis. However, various guidelines for the management of knee osteoarthritis have conflicting recommendation for hot and cold therapy. A randomised clinical trial design. The sample consisted of patients (n = 96) who were diagnosed with primary knee osteoarthritis. During the application stage, patients were designated to the hot and cold application groups and administered hot and cold application twice a day for 3 weeks together with standard osteoarthritis treatment. The control group only used standard osteoarthritis treatment. The data were collected with a Descriptive Information Form, a Pain Scale, the WOMAC Osteoarthritis Index, the Nottingham Health Profile (NHP) and a Patient Satisfaction Evaluation Form. Outcome measures included pain intensity, functional status and quality of life. We found decreased primary measurement pain scores and improved functional status scores and quality of life scores after the application programme compared to the pre-application stage in both the hot and cold application groups. Once the application was completed, the pain scores, functional status scores and quality-of-life scores on the second measurements were found to be still statistically lower than the pre-application scores but higher than the first measurement ([p  .05). It was found that both hot and cold application resulted in a mild improvement in pain, functional status and quality of life, but this improvement was not sufficient to create a significant difference between the groups. This study contributes to the literature on hot and cold application methods as self-management strategies for patients with knee osteoarthritis. © 2017 John Wiley

Middle-aged patients with an MRI-verified medial meniscal tear report symptoms commonly associated with knee osteoarthritis

DEFF Research Database (Denmark)

Hare, Kristoffer B.; Stefan Lohmander, L.; Kise, Nina Jullum

2017-01-01

Background and purpose — No consensus exists on when to perform arthroscopic partial meniscectomy in patients with a degenerative meniscal tear. Since MRI and clinical tests are not accurate in detecting a symptomatic meniscal lesion, the patient’s symptoms often play a large role when deciding...... when to perform surgery. We determined the prevalence and severity of self-reported knee symptoms in patients eligible for arthroscopic partial meniscectomy due to a degenerative meniscal tear. We investigated whether symptoms commonly considered to be related to meniscus injury were associated...... with early radiographic signs of knee osteoarthritis. Patients and methods — We included individual baseline items from the Knee injury and Osteoarthritis Outcome Score collected in 2 randomized controlled trials evaluating treatment for an MRI-verified degenerative medial meniscal tears in 199 patients aged...

Postural stability in patients with knee osteoarthritis: comparison with controls and evaluation of relationships between postural stability scores and International Classification of Functioning, Disability and Health components.

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Hsieh, Ru-Lan; Lee, Wen-Chung; Lo, Min-Tzu; Liao, Wei-Cheng

2013-02-01

To assess the differences in postural stability between patients with knee osteoarthritis and controls without knee osteoarthritis, and to evaluate possible relations between postural stability scores and International Classification of Functioning, Disability and Health (ICF) components. An age-matched, case-controlled trial with a cross-sectional design. A teaching hospital. Patients with knee osteoarthritis (n=73) and age-matched controls (n=60). Data on patients' postural stability and additional health-related variables were collected using various instruments. These included the Hospital Anxiety and Depression Scale, the Multidimensional Fatigue Inventory, the World Health Organization Quality of Life Brief Version, the physical function test (chair-rising time), the Chinese version of the Western Ontario and McMaster Universities Osteoarthritis Index, the Chinese version of the Knee Injury and Osteoarthritis Outcome Score, and the Biodex Stability System. A comparison of postural stability in patients with knee osteoarthritis versus that of controls was performed. The relation between postural stability scores for patients with knee osteoarthritis and ICF components was evaluated. Pearson correlation tests were used to determine the variables that correlated with postural stability among these patients. Patients with knee osteoarthritis displayed lower overall postural stability than controls (scores of 0.7 vs. 0.5, P=.006) and scored lower on the environmental domain of the World Health Organization Quality of Life Brief Version (62.2 vs 66.8, P=.014). For patients with knee osteoarthritis, postural stability was weakly associated with the ICF components of body functions and structures, including pain (r=.33-.34, P=.004), physical fatigue (r=.28, P=.016), and reduced motivation (r=.30, P=.011). Weak to moderate associations between postural stability and the ICF components of activities and participation were found; the relevant ICF variables included

161: BRIDGING BETWEEN PATIENTS PREFERENCE AND EVIDENCE BASED PRACTICE ACCORDING TO GUIDELINES IN OSTEOARTHRITIS MANAGEMENT: A QUALITATIVE STUDY

Science.gov (United States)

Behshid, Mozhgan; Zamanzadeh, Vahid; Ahmadi, Fazlollah; Irajpoor, Alireza

2017-01-01

Background and aims Osteoarthritis is the major cause of disability worldwide that causes significant problems in activities of daily living and deeply affects the quality of life. Osteoarthritis is predicted to become one of the major causes of disability in future that necessitates comprehensive global plans for resolving this health issue in accordance with patients' local culture, beliefs and attitudes. This study was a part of PhD dissertation that was conducted to carry out an in-depth examination of the experiences of patients with OA about their use of strategies for the OA self-management and compare them with scientific evidences. Methods The present qualitative study was conducted using a conventional content analysis approach on 33participantincluding patients with OA, their family members and healthcare personnel who were selected by purposive sampling. Data were collected through unstructured and semi-structured interviews and continued until data saturation occurred. Data analysis was carried out simultaneously. Guba and Lincoln's standards of rigor and trustworthiness were respected including the credibility, transferability, dependability and conformability of the data. A narrative systematic review was conducted on osteoarthritis care guidelines and algorithms in order to compare patients' preference with scientific evidences. Results The analysis of the data revealed four main categories, including: Conservative approach in selecting treatment modalities, trend toward traditional treatment, Preferring complementary and alternative medicine, and concerns and barriers treatment modalities. The review of literature demonstrated little attention by professionals to the patients' values or priorities. Comparing of the modalities that were preferred by patients with scientific guidelines indicated some inconsistencies. Conclusion Patient's perceptions, preference, and adherence to treatment, play an essential role in relieving nagging symptoms and

Glucosamine but not ibuprofen alters cartilage turnover in osteoarthritis patients in response to physical training

DEFF Research Database (Denmark)

Petersen, Susanne Germann; Saxne, T; Heinegard, D

2010-01-01

OBJECTIVE: To investigate changes in levels of serum cartilage oligomeric matrix protein (COMP) and urine c-telopeptide of type-2 collagen (CTX-II) as markers for cartilage turnover in patients with osteoarthritis (OA) of the knee, in response to muscle strength training in combination with treat......OBJECTIVE: To investigate changes in levels of serum cartilage oligomeric matrix protein (COMP) and urine c-telopeptide of type-2 collagen (CTX-II) as markers for cartilage turnover in patients with osteoarthritis (OA) of the knee, in response to muscle strength training in combination......). RESULTS: All three groups increased their muscle strength following 12 weeks of strength training (Preduced in the glucosamine-treated group after the training period (P=0.012), whereas they did not change in the two other groups. Glucosamine reduced COMP statistically...

Comparison of Photo Optical Imaging with Musculoskeletal Ultrasound and Clinical Examination in the Assessment of Inflammatory Activity in Proximal Interphalangeal Joints in Rheumatoid Arthritis and Osteoarthritis.

Science.gov (United States)

Amitai, Isabella; Werner, Stephanie; Schicke, Bernd; Burmester, Gerd-Rüdiger; Minet, Olaf; Zabaryło, Urszula; Backhaus, Marina; Ohrndorf, Sarah

2015-09-01

Lightscan is a novel, rapid, low-cost, easily operated and noninvasive imaging technology used to assess inflammatory activity in proximal interphalangeal (PIP) joints. The results are calculated automatically. To our knowledge, this is the first comparative study of photo optical imaging (POI), with clinical examination (CE), disease activity score at 28 joints (DAS28)-erythrocyte sedimentation rate (ESR), and musculoskeletal ultrasonography (US) in healthy subjects and patients with rheumatoid arthritis (RA) or osteoarthritis (OA). There were 688 PIP joints of both hands examined in 87 subjects (38 RA, 21 OA, 28 healthy) by Lightscan and compared with CE for clinically swollen and tender joints, DAS28-ESR (only RA), and US. With US as reference, POI had a sensitivity of 74% and a specificity of 93%. In the receiver-operating curve (ROC) analysis, the Lightscan showed a higher sensitivity and specificity [area under the curve (AUC) 0.879] for the distinction of healthy subjects versus patients (OA, RA) than US in greyscale (GSUS; AUC 0.797) and power Doppler (PDUS; AUC 0.67). POI correlated significantly with GSUS (r 0.473, p POI and GSUS were up to 79%, between POI and PDUS up to 92%, and between POI and CE up to 66%. POI did not correlate with DAS28-ESR. The Lightscan is a new technology offering sensitive imaging detection of inflammatory changes in subjects with RA and OA with PIP arthritis. POI was more sensitive than CE and correlated significantly to GSUS and PDUS, while presenting a higher sensitivity and specificity for the detection of healthy subjects versus patients (RA, OA) based on the ROC analysis.

Safety and efficacy of bi-annual intra-articular LBSA0103 injections in patients with knee osteoarthritis.

Science.gov (United States)

Lee, Jin Kyu; Choi, Chong-Hyuk; Oh, Kwang-Jun; Kyung, Hee-Soo; Yoo, Ju-Hyung; Ha, Chul-Won; Bin, Seong-Il; Kang, Seung-Baik; Kim, Myung Ku; Lee, Ju-Hong; Lee, Myung Chul

2017-11-01

The objective of this study is to assess the safety and efficacy of repeated intra-articular injection of high molecular weight hyaluronic acid (LBSA0103) at a 26-week interval, in patients with osteoarthritis of the knee. The study was an open-label, single arm, multicentre prospective trial conducted in patients with symptomatic knee osteoarthritis. The intervention consisted of two intra-articular injections of LBSA0103, with the second injection performed 26 weeks after the first injection. The primary outcome was the incidence of adverse drug reactions related to each injection. Assessment of efficacy of repeated injections in terms of maintenance of pain relief was a secondary objective of this study. Of the 185 patients screened, 174 patients received the first injection and 153 patients received both injections of LBSA0103. Nine adverse drug reactions occurred in seven patients (4.02%) after the first injection, while only one adverse drug reaction occurred (0.65%) after the second injection. As a secondary outcome measure, the improvements in the efficacy parameters including total WOMAC score and weight-bearing pain were all significant at both week 13 and 39 compared to the baseline value (P injection were consistent with those after the initial injection of LBSA0103 (between week 26 and week 39, P injection of LBSA0103 at a 26-week interval is safe without increased risk of adverse drug reactions. Additionally, LBSA0103 is effective in reduction of osteoarthritis knee pain and in maintenance of pain reduction for a 39-week period when a second injection is administered.

Relationship between weight loss in obese knee osteoarthritis patients and serum biomarkers of cartilage breakdown

DEFF Research Database (Denmark)

Bartels, E M; Henrotin, Y; Bliddal, H

2017-01-01

OBJECTIVE: To explore effects of weight loss and maintenance on serum cartilage biomarkers denaturation neoepitope for Collagen2 (Coll2-1) and Fibulin3 fragment (Fib3-2), as well as correlations between Coll2-1 and Fib3-2 and symptomatic improvement, in a knee osteoarthritis (KOA) population....... DESIGN: 192 obese KOA patients followed a 16 week weight loss intervention and 52 weeks weight maintenance (ClinicalTrials.gov identifier: NCT00655941). Assessments were at 0, 8, 16 and 68 weeks. Serum Coll2-1 and Fib3-2 were determined with ELISA, and symptoms by the Knee Osteoarthritis Outcome Score...

Neuromuscular versus quadriceps strengthening exercise in patients with medial knee osteoarthritis and varus malalignment

DEFF Research Database (Denmark)

Bennell, Kim L; Kyriakides, Mary; Metcalf, Ben

2014-01-01

OBJECTIVE: To compare the effects of neuromuscular exercise (NEXA) and quadriceps strengthening (QS) on the knee adduction moment (an indicator of mediolateral distribution of knee load), pain, and physical function in patients with medial knee joint osteoarthritis (OA) and varus malalignment. ME...

Development and preliminary testing of a computerized Animated Activity Questionnaire (AAQ) in patients with hip and knee osteoarthritis

DEFF Research Database (Denmark)

Peter, Wf; Loos, M; de Vet, Hcw

2015-01-01

, and to preliminary assess its reliability and validity. We hypothesize that the AAQ correlates highly with performance-based tests, and moderately with self-reports. Methods Item selection was based on 1) the pilot AAQ; 2) pre-specified conditions; 3) the International Classification of Functioning core set for OA......Objective To develop an Animated Activity Questionnaire (AAQ), based on video animations, for assessing activity limitations in patients with hip/knee osteoarthritis (OA), which combines the advantages of self-reported questionnaires and performance-based tests, without many of their limitations......, 4) existing measurement instruments, and 5) focus groups of patients. Test-retest reliability was assessed in 30/110 patients. In 110 patients correlations were calculated between AAQ and self-reported Hip disability and Knee injury Osteoarthritis Outcome ADL subscale (H/KOOS). In 45/110 patients...

Biomechanical considerations in the pathogenesis of osteoarthritis of the knee

NARCIS (Netherlands)

Heijink, Andras; Gomoll, Andreas H.; Madry, Henning; Drobnič, Matej; Filardo, Giuseppe; Espregueira-Mendes, João; van Dijk, C. Niek

2012-01-01

Osteoarthritis is the most common joint disease and a major cause of disability. The knee is the large joint most affected. While chronological age is the single most important risk factor of osteoarthritis, the pathogenesis of knee osteoarthritis in the young patient is predominantly related to an

Autologous Fat Transfer for Thumb Carpometacarpal Joint Osteoarthritis: A Prospective Study.

Science.gov (United States)

Herold, Christian; Rennekampff, Hans-Oliver; Groddeck, Robert; Allert, Sixtus

2017-08-01

Most operations for carpometacarpal joint osteoarthritis of the thumb irreversibly alter or destroy the anatomy. There is a high demand for minimally invasive alternatives. The authors report the results of autologous fat transfer for treatment of thumb carpometacarpal joint osteoarthritis. In a prospective study, 50 patients with thumb carpometacarpal joint osteoarthritis were observed for 1 year after autologous fat transfer. Manual liposuction and centrifugation were performed. Pain rating according to visual analogue pain scale; objective force of pinch grip and fist closure; and Disabilities of the Arm, Shoulder, and Hand questionnaire scores before and after treatment were analyzed. The average pain in stage 2 patients preoperatively was 7.7 ± 1.3; it was 1.8 ± 1.9 after 6 months and 2.4 ± 3.1 after 12 months. Patients with stage 2 osteoarthritis demonstrated a superior benefit from this treatment compared with patients with either stage 3 or stage 4 thumb carpometacarpal joint osteoarthritis. There were similar improvements for the parameters strength and Disabilities of the Arm, Shoulder, and Hand questionnaire score. No serious adverse events were observed. Autologous fat transplantation is an appealing alternative, especially in early-stage basal joint osteoarthritis of the thumb. The low invasiveness of the procedure and early recovery of patients compared with classical procedures such as trapeziectomy, and the superior long-term results compared with classical injection therapy, make this approach feasible as a first-line therapy in early-stage basal joint osteoarthritis of the thumb. Therapeutic, IV.

Efficacy of a Combined Rosemary and Lavender Topical Ointment in the Treatment of Patients with Osteoarthritis of the Knee

Directory of Open Access Journals (Sweden)

Alireza Ghannadi

2013-06-01

Full Text Available Background: One of the preservative treatments of knee osteoarthritis is the use of topical medications. This study is aimed to clinically evaluate the effect of topical products containing essential oils of rosemary and lavender herbs on the treatment of patients with osteoarthritis of the knee. Materials and Methods: Rosemary and lavender essential oils were prepared by steam distillation method and inserted into the ointment with the hydrophilic base. In this study, 15 patients with knee osteoarthritis were treated with this ointment for three months. The results were assessed using WOMAC and Lequesne indices and were evaluated by the Wilcoxon statistical test.Results: At the week of admission to the hospital, mean WOMAC index was equal to 71.4, mean Lequesne index was equal to 18 and the average time of passing through the distance of fifty feet by patients was equal to 19.4. After 4, 8 and 12 weeks, all these indices significantly decreased (p≤ 0.05. The WOMAC questionnaire denotative survey also showed that the pain and physical function at the 4th, 8th and 12th weeks were significantly less than the first week of admission (p≤ 0.05, but there was no significant difference as far as joint stiffness is concerned.Conclusion: Topical application of essential oils of rosemary and lavender herbs in a hydrophilic ointment base can be useful as a preservative treatment for the patients with knee osteoarthritis.

Differential involvement of synovial adipokines in pain and physical function in female patients with knee osteoarthritis. A cross-sectional study.

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Calvet, J; Orellana, C; Albiñana Giménez, N; Berenguer-Llergo, A; Caixàs, A; García-Manrique, M; Galisteo Lencastre, C; Navarro, N; Larrosa, M; Gratacós, J

2018-02-01

Adipokines have been reported to play a role in the development, progression and severity of knee osteoarthritis but the influence of the different adipokines are not well known. The aim of this study was to evaluate the association between different synovial fluid adipokines with pain and disability knee osteoarthritis patients. Cross-sectional study with systematic inclusion of 115 symptomatic primary knee osteoarthritis female patients with ultrasound-confirmed joint effusion. Age, physical exercise, symptoms duration and different anthropometric measurements were collected. Radiographic severity was evaluated according to Kellgren-Lawrence scale. Pain and disability were assessed by WOMAC-total, -pain, -function subscales and Knee injury and Osteoarthritis Outcome Score (KOOS) pain and function scales. Seven adipokines and three inflammatory markers were measured by ELISA in synovial fluid. Partial Correlation Coefficient (PCC) and corresponding 95% confidence interval were used as a measure of association. Leptin, osteopontin and inflammatory factors, especially TNF-alpha, were associated to pain and function. After adjustment for potential confounders including inflammatory factors and all adipokines, an association was found for adiponectin with pain (PCC 0.240 [0.012, 0.444]) and for resistin and visfatin with function (PCC 0.336 [0.117, 0.524] and -0.262 [-0.463, -0.036]). No other adipokines or inflammatory markers were statistically and independently associated. An association between physical exercise and pain and disability remained after adjustment, whereas an attenuation of the influence of anthropometric measurements was observed. Different patterns of association between synovial fluid adipokines were observed regarding pain and disability in knee osteoarthritis patients. Specifically, adiponectin was associated to pain while resistin and visfatin were mainly related to function. Copyright © 2017 Osteoarthritis Research Society International

Osteoarthritis of knees and obesity in Eastern Saudi Arabia

International Nuclear Information System (INIS)

Ismail, Abdullah I.; Al-Abdulwahab, Ahmed H.; Al-Mulhim, Abdulrahman S.

2006-01-01

Objective was to find out the prevalence and relation between osteoarthritis of knees and obesity in Al-Ahsa region, Kingdom of Saudi Arabia (KSA). The study included 243 male and female patients diagnosed with osteoarthritis of knees of knees in between June 2001 to March 2003. All patients were recruited from the Physical Therapy Department, King Fahd Hofuf Hospital, Hofuf, KSA. The clinical diagnosis was supported plain x-rays of knees, and of other joint if needed. The weight and height of all patients were taken using one standard weight and height scale, and body mass index was also calculated and recorded. More than 90.53% of the patients referred with osteoarthritis of knees were obese or overweight. The mean body weight of all patients was 84.61 kg and the mean weight was 1.59 meters. Osteoarthritis of the knees was more in obese female than male patients with a female to male ratio of 2.37:1. Obesity is a disease. The aim of all health professionals and others in the community should be directed to the prevention of this disease and its risk to develop multiple complications. (author)

Osteoarthritis among women in bahrain: a public health audit.

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Asokan, Gv; Hussain, Muna S Hussain Abdullah; Ali, Eman Jm; Awate, Rajendra V; Khadem, Zahra Ka; Al-Safwan, Zainab Am

2011-11-01

This study aims to train students on public health survey; correlate risk factors of osteoarthritis and to identify modifiable risk factors. Osteoarthritis survey was carried out among 420 Bahraini women, above 40 years of age, diagnosed of osteoarthritis, attending ministry of health facilities. Most cases in the study were from the age group of 50-59 years with a mean age of 57. Osteoarthritis: of major joints alone was 74%; of generalized was 21% and of small joints of hands and feet alone was 5%. Within major osteoarthritis: 48% were knees alone; 51% were knee and hip and 2% were hip alone. Combinations of co-morbidities were found among 43%. History of diagnosed: diabetes in 10%, hypertension among 13% and hypercholesterolemia in 5% of cases. Half of the cases in the study were obese and 30% were overweight. Osteoarthritis of the Knee and the combination of the osteoarthritis of knee and hip was highest among obese followed by overweight cases. Menopause was found among 68%of patients. Patients on medication accounted for 85% and 75% were on Physiotherapy. Half of the sample had family history of osteoarthritis. While over 90% were less educated with odds ratio for being housewives at 3.085. The multivariate analysis of ordinal regression returned pseudo R(2) of 30% for the model with the following significant variables: age, BMI, menopause status, exercise, chronic morbidities and family history of osteoarthritis. Overall, the proportion of major osteoarthritis of the weight bearing joints is very high. The modifiable risk factors identified from this study are sedentary lifestyle, obesity and overweight, as well as chronic morbidities.

Assessment of readiness to change in patients with osteoarthritis. Development and application of a new questionnaire

NARCIS (Netherlands)

Heuts, PHTG; de Bie, RA; Dijkstra, A; Aretz, K; Vlaeyen, JW; Schouten, HJA; Hopman-Rock, M; van Weel, C; van Schayck, CP; van Schayk, O.C P

Objective: To develop a self- report measure for assessment of the stage of change in patients with osteoarthritis, in order to identify patients who would benefit from a self- management programme. Methods: According to the ' stages of change' model a questionnaire was developed with three groups

Effect of aromatherapy massage with lavender essential oil on pain in patients with osteoarthritis of the knee: A randomized controlled clinical trial.

Science.gov (United States)

Nasiri, Ahmad; Mahmodi, Mohammad Azim; Nobakht, Zohre

2016-11-01

Osteoarthritis of the knee is the most common chronic joint disease that involves middle aged and elderly people. The purpose of this study was to investigate the effect of aromatherapy massage with lavender essential oil on pain in patients with osteoarthritis of the knee. In this single-blinded, randomized clinical trial, 90 patients with osteoarthritis of the knee who referred to the outpatient rheumatology clinics affiliated with Birjand University of Medical Sciences were selected through convenience sampling method. They were randomly assigned to three groups: intervention (aromatherapy massage with lavender essential oil), placebo (massage with almond oil) and control (without massage). The patients were evaluated at baseline, immediately after the intervention, 1 week, and 4 weeks after the intervention in terms of pain via visual analogue scale. The data were analyzed in SPSS (version 16) using the repeated measure ANOVA, one-way ANOVA, and chi-squared test. Pain severity of the patients in the intervention group was significantly different immediately and 1 week after the intervention compared with their initial status (p Aromatherapy massage with lavender essential oil was found effective in relieving pain in patients with knee osteoarthritis. However, further studies are needed to confirm findings of this study. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Modified painDETECT Questionnaire for Patients with Hip or Knee Osteoarthritis : Translation into Dutch, Cross-Cultural Adaptation and Reliability Assessment

NARCIS (Netherlands)

Rienstra, Wietske; Blikman, Tim; Mensink, Frans B.; van Raay, Jos J. A. M.; Dijkstra, Baukje; Bulstra, Sjoerd K.; Stevens, Martin; van den Akker-Scheek, Inge

2015-01-01

There is a growing amount of evidence that alteration in pain processing by the peripheral and central nervous system play a role in osteoarthritis pain, leading to neuropathic-like symptoms. It is essential to identify knee and hip osteoarthritis patients with a neuropathic pain profile in order to

Spine–hip relations in patients with hip osteoarthritis

Science.gov (United States)

Rivière, Charles; Lazic, Stefan; Dagneaux, Louis; Van Der Straeten, Catherine; Cobb, Justin; Muirhead-Allwood, Sarah

2018-01-01

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 planning, which may improve outcomes. An important component of the concept of kinematically aligned total hip arthroplasty (KA THA) consists of defining the optimal acetabular cup design and orientation based on the assessment of an individual’s SHR, and use of the transverse acetabular ligament to adjust the cup positioning. The Bordeaux classification might advance the understanding of SHR and hopefully help improve THR outcomes. Cite this article: EFORT Open Rev 2018;3:39-44. DOI: 10.1302/2058-5241.3.170020 PMID:29657844

Limited use of surgeon's advice on exercise for knee osteoarthritis

DEFF Research Database (Denmark)

Ryaa, Sofie; Ingelsrud, Lina H; Skou, Søren T

2018-01-01

INTRODUCTION: The Good Life with osteoArthritis in Denmark (GLA:D) programme consists of patient education and supervised exercise therapy and adheres to clinical guidelines for knee osteoarthritis (OA). The purpose of this study was to present the treatment choice and clinical results of patients...

The patellofemoral pain and osteoarthritis subscale of the KOOS (KOOS-PF)

DEFF Research Database (Denmark)

Crossley, Kay M; Macri, Erin M; Cowan, Sallie M

2018-01-01

with patellofemoral pain and/or osteoarthritis and 14 health and medical clinicians. Item reduction was performed using data from patellofemoral cohorts (n=138). We used the COnsesus-based Standards for the selection of health Measurements INstruments guidelines to evaluate reliability, validity, responsiveness......BACKGROUND: Patellofemoral pain and osteoarthritis are prevalent and associated with substantial pain and functional impairments. Patient-reported outcome measures (PROMs) are recommended for research and clinical use, but no PROMs are specific for patellofemoral osteoarthritis, and existing PROMs...... for patellofemoral pain have methodological limitations. This study aimed to develop a new subscale of the Knee injury and Osteoarthritis Outcome Score for patellofemoral pain and osteoarthritis (KOOS-PF), and evaluate its measurement properties. METHODS: Items were generated using input from 50 patients...

Surgical Management of Osteoarthritis of the Knee.

Science.gov (United States)

Quinn, Robert H; Murray, Jayson N; Pezold, Ryan; Sevarino, Kaitlyn S

2018-05-01

The American Academy of Orthopaedic Surgeons has developed Appropriate Use Criteria (AUC) for Surgical Management of Osteoarthritis of the Knee. Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the criteria to improve patient care and obtain best outcomes while considering the subtleties and distinctions necessary in making clinical decisions. The Surgical Management of Osteoarthritis of the Knee AUC clinical patient scenarios were derived from indications of patients under consideration for surgical treatment of osteoarthritis of the knee as well as from current evidence-based clinical practice guidelines and supporting literature to identify the appropriateness of the three treatments. The 864 patient scenarios and 3 treatments were developed by the writing panel, a group of clinicians who are specialists in this AUC topic. Next, a separate, multidisciplinary, voting panel (made up of specialists and nonspecialists) rated the appropriateness of treatment of each patient scenario using a 9-point scale to designate a treatment as Appropriate (median rating, 7 to 9), May Be Appropriate (median rating, 4 to 6), or Rarely Appropriate (median rating, 1 to 3).

Osteoarthritis after rotator cuff repair: A 10-year follow-up study.

Science.gov (United States)

Flurin, P-H; Hardy, P; Valenti, P; Meyer, N; Collin, P; Kempf, J-F

2017-06-01

Joint surgery is often complicated by gradual bone and cartilage deterioration that eventually leads to secondary osteoarthritis. The primary objective of this study was to identify preoperative risk factors for gleno-humeral osteoarthritis after rotator cuff repair. The secondary objectives were to assess whether the risk of gleno-humeral osteoarthritis was influenced by the operative technique, occurrence of postoperative complications, cuff healing, and muscle degeneration and to determine whether gleno-humeral osteoarthritis affected the clinical outcome. The development of gleno-humeral osteoarthritis affects the postoperative clinical outcome. A retrospective multicentre study of patients who underwent rotator cuff repair in 2003 and were re-evaluated at least 10 years later was conducted under the aegis of the Société française de chirurgie orthopédique et traumatique (SOFCOT). Osteoarthritis severity was graded according to the Samilson-Prieto classification. Four hundred and one patients were included. At last follow-up, at least 10 years after surgery, the radiological Samilson-Prieto grades were distributed as follows: 0, n=181 (45%); 1, n=142 (n=35%); 2, n=57 (14%); 3, n=14 (4%); and 4, n=7 (2%). The mean Constant score was significantly higher in the patients without than with osteoarthritis at last follow-up (79/100 vs. 73/100, Posteoarthritis was significantly higher in the group with unhealed or re-torn cuffs (Sugaya type 4 or 5) than in the group with healed cuffs (Sugaya type 1, 2, or 3) (46% vs. 25%, P=0.012). Our study showed no associations linking the risk of gleno-humeral osteoarthritis to the patient activity profile, history of shoulder injury, or preoperative symptom duration. In contrast, statistically significant associations were identified between gleno-humeral osteoarthritis and age, male gender, initial tear severity, and the pain and mobility components of the preoperative Constant score. Decreased invasiveness of the

Responsiveness of observational and self-report methods for assessing disability in mobility in patients with osteoarthritis.

NARCIS (Netherlands)

Steultjens, M.P.M.; Roorda, L.D.; Dekker, J.; Bijlsma, J.W.J.

2001-01-01

Objective: To establish the responsiveness of observational and self-report methods for the assessment of disability in mobility in patients with osteoarthritis (OA). Methods: Data from 186 patients with hip OA of knee OA were used. Data from 1 observational method and 4 self-report methods for the

Responsiveness of observational and self-report methods for assessing disability in mobility in patients with osteoarthritis

NARCIS (Netherlands)

Steultjens, M. P.; Roorda, L. D.; Dekker, J.; Bijlsma, J. W.

2001-01-01

To establish the responsiveness of observational and self-report methods for the assessment of disability in mobility in patients with osteoarthritis (OA). Data from 186 patients with hip OA or knee OA were used. Data from 1 observational method and 4 self-report methods for the assessment of

Development of a Decision Support System to Predict Physicians' Rehabilitation Protocols for Patients with Knee Osteoarthritis

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Hawamdeh, Ziad M.; Alshraideh, Mohammad A.; Al-Ajlouni, Jihad M.; Salah, Imad K.; Holm, Margo B.; Otom, Ali H.

2012-01-01

To design a medical decision support system (MDSS) that would accurately predict the rehabilitation protocols prescribed by the physicians for patients with knee osteoarthritis (OA) using only their demographic and clinical characteristics. The demographic and clinical variables for 170 patients receiving one of three treatment protocols for knee…

Risk factors for osteoarthritis of the hip

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Filipović Karmela

2013-01-01

Full Text Available INTRODUCTION: Osteoarthritis of the hip is a degenerative disease of hip unknown origin, with pain, stiffness and diminished joint function. AIM: determine the influence of the load of the hip joint during professional activity and BMI as risk factors for the hip osteoarthritis. MATERIAL AND METHOD: We analysed 148 patients. Patients were divided into two groups ( I group with osteoarthritis of the hip, II group without osteoarthritis of the hip. In all, performed diagnostic procedure: anamnesis, physical examination (estimate of walking and hip joint movement, laboratory blood test and urine test radiological examination and taking data on the height and weight to calculated BMI. We assessed the data that is related to the load of the hip joint during professional activities (mostly sitting work and mostly standing job with carrying load. Statistical analysis was done using the software package SPSS 14.0, Microsoft Office Word 2003. RESULTS: In the first group, average age was 67.76 years, with females prevailing (67.6%. In this group the larger body mass was noted (81.82 ± 12.18, with statistically significant difference (T-test 2.923, p<0.01; the average BMI was higher the average BMI was higher (30.18 ± 4.6, with statistically significant difference (T-test 3.832, p<0.01. This group had more overweight patients (87.7%,with statistically significant difference (Fisher test, p<0.01. In I group 62,2% of patients were doing hard physical work (standing job with repeated carrying load and we found statistically significant difference between groups (Fisher test p<0,01. CONCLUSION: Patients with osteoarthritis of the hip had a higher body weight, higher BMI. Also we found the influence of hard physical labor at work, and they were performed mostly standing job with carrying load.

Prognostic factors after intra-articular hyaluronic acid injection in ankle osteoarthritis.

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Han, Seung Hwan; Park, Do Young; Kim, Tae Hun

2014-07-01

The goal of this study was to identify baseline prognostic factors of outcome in ankle osteoarthritis patients after intra-articular hyaluronic acid injection. Patients with ankle osteoarthritis who received hyaluronic acid injection therapy were retrospectively reviewed. Each patient received weekly intra-articular hyaluronic acid injections (2 mL) for 3 weeks. Six predictors including gender, age, symptom duration, radiographic osteoarthritis stage, radiographic subchondral cyst, and fracture history were evaluated. Visual analogue scale (VAS) and patient satisfaction were evaluated as outcome measures. These predictors and outcome measurements were included in a logistic regression model for statistical analysis. Total of 40 consecutive patients (21 male, 19 female) were included in this study. Mean age was 60.6. Average follow up period was 13 months. The mean VAS recorded 3, 6, and 12 months after the first injection was 3.6 (SD 2.54, phyaluronic acid injection for ankle osteoarthritis is a safe and effective treatment, careful selection of patients should be made according to the above prognostic predictors.

Is Telephysiotherapy an Option for Improved Quality of Life in Patients with Osteoarthritis of the Knee?

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Adesola C. Odole

2014-01-01

Full Text Available This study investigated effect of a 6-week telephysiotherapy programme on quality of life (QoL of patients with knee osteoarthritis (OA. Fifty patients with knee OA were randomly and equally assigned into two treatment groups: clinic group (CG and telephysiotherapy group (TG. The CG received physiotherapist-administered osteoarthritis-specific exercises in the clinic thrice weekly for 6 weeks while the TG received structured telephone monitoring with self-administered osteoarthritis-specific exercises for the same duration at home. Participants’ QoL was assessed using WHOQoL-Bref at baseline, second, fourth, and sixth week of intervention. Data were analyzed using ANOVA and independent Student’s t-test. Within-group comparison showed significant improvements in physical health domain (P=0.00* for TG and CG and psychological domain (P=0.02* for TG; P=0.00* for CG of WHOQoL following six-week intervention. However, there were no significant differences (P>0.05 in TG and CG’s social relationship and environment domains. Between-group comparison showed no significant differences (P>0.05 between CG and TG’s physical health, psychological, and social relationships domains of WHOQoL following 6-week intervention. However, there was significant difference in the environment domain (P<0.05. Telephysiotherapy using telephone medium improved QoL in patients with knee OA comparable to clinic based treatment.

Effect of muscle strength and pain on hand function in patients with trapeziometacarpal osteoarthritis. A cross-sectional study.

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Cantero-Téllez, Raquel; Martín-Valero, Rocío; Cuesta-Vargas, Antonio

2015-01-01

To assess the relationship between muscle strength (Jama), and pain (VAS) levels with hand function (DASH) in patients with trapeziometarcapal osteoarthritis. Cross-sectional study. Sample of 72 patients with osteoarthritis stage 2-3 (Eaton) and trapeziometacarpal osteoarthritis. Patients were recruited when they came to the Hand Surgery Unit. Grip strength, pinch, pain and hand function were measured, and correlation and regression coefficients between them were obtained. For function, the most significant model (R(2)=0.83) included pain and strength. But it is tip to tip pinch force which has a stronger relationship with DASH (Standardized B: -57) questionnaire. Pain also influenced strength measured with the dynamometer but it was tip to tip pinch force that was the most affected. Findings confirm that there is a significant correlation between function referred by the patient and variables that can be measured in the clinic such as grip strength and pinch. The correlation between pain intensity and function was also significant, but tip to tip pinch strength had the greatest impact on the function. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

The efficacy of balneotherapy and mud-pack therapy in patients with knee osteoarthritis.

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Evcik, Deniz; Kavuncu, Vural; Yeter, Abdurrahman; Yigit, Ilknur

2007-01-01

Knee osteoarthritis (OA) is a common chronic degenerative disorder. There are various treatment modalities. This study was planned to investigate the efficacy of balneotherapy, mud-pack therapy in patients with knee OA. A total of 80 patients with knee OA were included. Their ages ranged between 39-78. The patients were separated in to three groups. Group I (n=25) received balneotherapy, group II (n=29) received mud-pack therapy and group III (n=26) was hot-pack therapy group. The therapies were applied for 20 min duration, once a day, five times per week and a total of 10 session. Patients were assessed according to pain, functional capacity and quality of life parameters. Pain was assessed by using Visual Analogue Scale (VAS) and Western Ontario McMaster Osteoarthritis Index (WOMAC) pain scale (0-4 likert scale). Functional capacity was assessed by using WOMAC functional capacity and WOMAC global index. Quality of life was evaluated by Nottingham Health Profile (NHP) self-administered questionnaire. Also physician's global assessment and the maximum distance that patient can walk without pain, were evaluated. The assessment parameters were evaluated before and after three months. There were statistically significant improvement in VAS and WOMAC pain scores in group I (pbalneotherapy and mud-pack therapy groups (p0.05). The maximum distance was improved both in group I and II (pBalneotherapy and mud-pack therapy were effective in treating patients with knee OA.

[The usefullness of hyaluronate injection in patients with RA].

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Saito, Seiji

2003-06-01

In this seminar, we reported the usefulness of hyaluronate injection in clinical application with patients of RA. In basic research areas, however, the mechanisms responsible for the reported beneficial clinical effects of these treatments remain unclear. There is accumulating experimental evidence to show that the receptors of HA, eg, CD-44, accelerate the inflammation of joint. Administration high molecular weight HA may modulate CD-44 sensitive macromolecular in joint inflammation in part to reduce the activity of proteinases such as MMP-9.

Association between Patient History and Physical Examination and Osteoarthritis after Ankle Sprain.

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van Ochten, John M; de Vries, Anja D; van Putte, Nienke; Oei, Edwin H G; Bindels, Patrick J E; Bierma-Zeinstra, Sita M A; van Middelkoop, Marienke

2017-09-01

Structural abnormalities on MRI are frequent after an ankle sprain. To determine the association between patient history, physical examination and early osteoarthritis (OA) in patients after a previous ankle sprain, 98 patients with persistent complaints were selected from a cross-sectional study. Patient history taking and physical examination were applied and MRI was taken. Univariate and multivariable analyses were used to test possible associations. Signs of OA (cartilage loss, osteophytes and bone marrow edema) were seen in the talocrural joint (TCJ) in 40% and the talonavicular joint (TNJ) in 49%. Multivariable analysis showed a significant positive association between swelling (OR 3.58, 95%CI 1.13;11.4), a difference in ROM of passive plantar flexion (OR 1.09, 95%CI 1.01;1.18) and bone edema in the TCJ. A difference in ROM of passive plantar flexion (OR 1.07, 95%CI 1.00;1.15) and pain at the end range of dorsiflexion/plantar flexion (OR 5.23, 95%CI 1.88;14.58) were associated with osteophytes in the TNJ. Pain at the end of dorsiflexion/plantar flexion, a difference in ROM of passive plantar flexion and swelling seem to be associated with features of OA (bone marrow edema, osteophytes) in the TCJ and TNJ. Our findings may guide physicians to predict structural joint abnormalities as signs of osteoarthritis. 1b. © Georg Thieme Verlag KG Stuttgart · New York.

The knee adduction moment measured with an instrumented force shoe in patients with knee osteoarthritis

NARCIS (Netherlands)

van den Noort, J.C.; van den Noort, Josien C.; van der Esch, Martin; Steultjens, Martijn P.M.; Dekker, Joost; Schepers, H. Martin; Veltink, Petrus H.; Harlaar, Jaap

2012-01-01

The external knee adduction moment (KAdM) during gait is an important parameter in patients with knee osteoarthritis (OA). KAdM measurement is currently restricted to instruments only available in gait laboratories. However, ambulatory movement analysis technology, including instrumented force shoes

Health related quality of life in rheumatoid arthritis, osteoarthritis, diabetes mellitus, end stage renal disease and geriatric subjects. Experience from a General Hospital in Mexico.

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Ambriz Murillo, Yesenia; Menor Almagro, Raul; Campos-González, Israel David; Cardiel, Mario H

2015-01-01

Chronic diseases have a great impact in the morbidity and mortality and in the health-related quality of life (HRQoL) of patients around the world. The impact of rheumatic diseases has not been fully recognized. We conducted a comparative study to evaluate the HRQoL in different chronic diseases. The aim of the present study was to assess the HRQoL and identify specific areas affected in patients with rheumatoid arthritis (RA), osteoarthritis (OA), diabetes mellitus, end-stage renal disease, geriatric subjects and a control group. We conducted a cross-sectional study, in a General Hospital in Morelia, Mexico. All patients met classification criteria for RA, OA, diabetes mellitus, end-stage renal disease; the geriatric subjects group was≥65 years, and the control group≥30 years. Demographic characteristics were recorded, different instruments were applied: SF-36, visual analogue scale for pain, patient's and physician's global assessments, Beck Depression Inventory and specific instruments (DAS-28, HAQ-Di, WOMAC, Diabetes Quality of Life [DQOL] and Kidney Disease Questionnaire of Life [KDQOL]). Biochemical measures: erythrocyte sedimentation rate, blood count, glucose, HbA1C, serum creatinine and urea. We evaluated 290 subjects (control group: 100; geriatric subjects: 30 and 160 for the rest of groups). Differences were detected in baseline characteristics (Prenal disease group (±SD: 48.06±18.84 x/SD). The general health was the principal affected area in RA. The pain was higher in rheumatic diseases: OA (5.2±2.4) and RA (5.1±3). HAQ was higher in OA compared to RA (1.12±0.76 vs 0.82±0.82, respectively; P=.001). Forty five percent of all subjects had depression. The HRQoL in RA patients is poor and comparable to other chronic diseases (end-stage renal disease and diabetes mellitus). Rheumatic diseases should be considered high impact diseases and therefore should receive more attention. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

Cross-cultural adaptation and validation of the persian version of the oxford knee score in patients with knee osteoarthritis.

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Ebrahimzadeh, Mohammad Hosein; Makhmalbaf, Hadi; Birjandinejad, Ali; Soltani-Moghaddas, Seyed Hosein

2014-11-01

The Oxford Knee Score (OKS) is a short patient-reported outcome instrument that measures pain and physical activity related to knee osteoarthritis. The purpose of this study is to evaluate, construct validity and consistent reliability of the Persian version of the OKS. The case series consisted of 80 patients who were clinically diagnosed with having knee osteoarthritis. All patients were requested to fill-in the Persian OKS and Short-Form 36 Health Survey (SF-36). Correlation analysis between the Persian versions of these two instruments was then carried out. The scores of the Persian SF-36 were used to evaluate convergent and divergent validity of the 12-item Persian OKS. From a total of 80 patients, 63 were female (79%) and the remaining 17 were male (21%) with a mean age of 52.2 years. In the present study, high Cronbach's alpha of 0.95 confirms excellent internal consistency of the Persian OKS scale similar to previous investigations. The results confirm that the Persian version of this instrument is valid and reliable, similar to its English index and its subsequent translations in different languages. The Persian OKS is a reliable instrument to evaluate knee function in patients with knee osteoarthritis and is a useful tool for outcome measurement in clinical research.

Measuring the radium quartet ({sup 228}Ra, {sup 226}Ra, {sup 224}Ra, {sup 223}Ra) in seawater samples using gamma spectrometry

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Beek, P. van, E-mail: vanbeek@legos.obs-mip.f [LEGOS, Laboratoire d' Etudes en Geophysique et Oceanographie Spatiales (CNRS/CNES/IRD/UPS), Observatoire Midi Pyrenees, 14 Avenue Edouard Belin, 31400 Toulouse (France); Souhaut, M. [LEGOS, Laboratoire d' Etudes en Geophysique et Oceanographie Spatiales (CNRS/CNES/IRD/UPS), Observatoire Midi Pyrenees, 14 Avenue Edouard Belin, 31400 Toulouse (France); Reyss, J.-L. [LSCE, Laboratoire des Sciences du Climat et de l' Environnement (CNRS/CEA/UVSQ), Avenue de la Terrasse, 91198 Gif-sur-Yvette (France)

2010-07-15

Radium isotopes are widely used in marine studies (eg. to trace water masses, to quantify mixing processes or to study submarine groundwater discharge). While {sup 228}Ra and {sup 226}Ra are usually measured using gamma spectrometry, short-lived Ra isotopes ({sup 224}Ra and {sup 223}Ra) are usually measured using a Radium Delayed Coincidence Counter (RaDeCC). Here we show that the four radium isotopes can be analyzed using gamma spectrometry. We report {sup 226}Ra, {sup 228}Ra, {sup 224}Ra, {sup 223}Ra activities measured using low-background gamma spectrometry in standard samples, in water samples collected in the vicinity of our laboratory (La Palme and Vaccares lagoons, France) but also in seawater samples collected in the plume of the Amazon river, off French Guyana (AMANDES project). The {sup 223}Ra and {sup 224}Ra activities determined in these samples using gamma spectrometry were compared to the activities determined using RaDeCC. Activities determined using the two techniques are in good agreement. Uncertainties associated with the {sup 224}Ra activities are similar for the two techniques. RaDeCC is more sensitive for the detection of low {sup 223}Ra activities. Gamma spectrometry thus constitutes an alternate method for the determination of short-lived Ra isotopes.

Quality of osteoarthritis care in family medicine – A cross-sectional study.

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Račić, Maja; Tošić, Milena; Mašić, Srdjan

2016-01-01

Effective treatments for osteoarthritis are available, yet little is known about the quality of primary care in the Republic of Srpska for this disabling condition. The main objective of this study was to analyze the overall quality of osteoarthritis treatment in a family medicine setting, as well as to explore whether the achievement of quality indicators was associated with particular patient characteristics and severity of osteoarthritis. The cross-sectional study included 120 patients with confirmed hand, knee, and hip osteoarthritis, recruited at seven family practices in the town of Ugljevik, Republic of Srpska, Bosnia and Herzegovina. Data were extracted from a patient questionnaire on quality indicators, as well as from their electronic and paper records, to assess care against 14 indicators. The included quality indicators were based on the Arthritis Foundation’s Quality Indicator set for Osteoarthritis. Summary achievement rates for hip, knee, or hand osteoarthritis, as well as for the total sample, were calculated. The mean achievement rate for all 14 quality indicators obtained from medical records was 74%, and 77% obtained from patient interview. The quality indicators concerning referral for weight reduction (23%) and pharmacological treatment (24%) had the lowest achievement rates, whereas the highest achievement rates were related to physical examination (100%), pain and functional assessment (100%), and education (90.8%). Patients physical functioning was significantly associated with the quality indicator achievement rate (p = 0.001). Pharmacological therapy and the referral of osteoarthritis patients in need of weight reduction seem to have the greatest potential for improvement in primary health care.

Functional annotation of rheumatoid arthritis and osteoarthritis associated genes by integrative genome-wide gene expression profiling analysis.

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Zhan-Chun Li

Full Text Available BACKGROUND: Rheumatoid arthritis (RA and osteoarthritis (OA are two major types of joint diseases that share multiple common symptoms. However, their pathological mechanism remains largely unknown. The aim of our study is to identify RA and OA related-genes and gain an insight into the underlying genetic basis of these diseases. METHODS: We collected 11 whole genome-wide expression profiling datasets from RA and OA cohorts and performed a meta-analysis to comprehensively investigate their expression signatures. This method can avoid some pitfalls of single dataset analyses. RESULTS AND CONCLUSION: We found that several biological pathways (i.e., the immunity, inflammation and apoptosis related pathways are commonly involved in the development of both RA and OA. Whereas several other pathways (i.e., vasopressin-related pathway, regulation of autophagy, endocytosis, calcium transport and endoplasmic reticulum stress related pathways present significant difference between RA and OA. This study provides novel insights into the molecular mechanisms underlying this disease, thereby aiding the diagnosis and treatment of the disease.

Signs of knee osteoarthritis common in 620 patients undergoing arthroscopic surgery for meniscal tear

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Pihl, Kenneth; Englund, Martin; Lohmander, L. Stefan

2017-01-01

Background and purpose - Recent evidence has questioned the effect of arthroscopic knee surgery for middle-aged and older patients with degenerative meniscal tears with or without concomitant radiographic knee osteoarthritis (OA). We investigated the prevalence of early or more established knee OA...... and patients' characteristics in a cohort of patients undergoing arthroscopic surgery for a meniscal tear. Patients and methods - 641 patients assigned for arthroscopy on suspicion of meniscus tear were consecutively recruited from February 2013 through January 2015. Of these, 620 patients (mean age 49 (18...... established knee OA was present in 43% of patients undergoing knee arthroscopy for meniscal tear....

Internal consistency and validity of an observational method for assessing disability in mobility in patients with osteoarthritis.

NARCIS (Netherlands)

Steultjens, M.P.M.; Dekker, J.; Baar, M.E. van; Oostendorp, R.A.B.; Bijlsma, J.W.J.

1999-01-01

Objective: To establish the internal consistency of validity of an observational method for assessing diasbility in mobility in patients with osteoarthritis (OA), Methods: Data were obtained from 198 patients with OA of the hip or knee. Results of the observational method were compared with results

Impact of wearable technology on psychosocial factors of osteoarthritis management: a qualitative study.

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Belsi, Athina; Papi, Enrica; McGregor, Alison H

2016-02-03

To identify the impact the use of wearable technology could have in patients with osteoarthritis in terms of communication with healthcare providers and patients' empowerment to manage their condition. Qualitative study using focus groups with patients with osteoarthritis; data from patients' responses were analysed using Framework Methodology. 21 patients with knee osteoarthritis from the London area (age range 45-65 years) participated in a total of four focus groups. Recruitment continued until data saturation. The study was conducted in a university setting. Patients' responses suggested a positive attitude on the impact wearable technology could have on the management of osteoarthritis. It was perceived that the use of wearable devices would benefit patients in terms of feeling in control of their condition, providing them with awareness of their progress, empowering in terms of self-management and improving communication with their clinician. This paper suggests positive patient perspectives on the perceived benefits wearable technology could have on the management of osteoarthritis. The data that could be collected with the use of wearable technology could be beneficial both to patients and clinicians. The information obtained from this study suggests that introducing wearable technology into patient-centred care could enhance patient experience in the field of osteoarthritis and beyond. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Which patients with osteoarthritis of hip and/or knee benefit most from behavorial graded activity?

NARCIS (Netherlands)

Veenhof, C.; Ende, C.H.M. van den; Dekker, J.; Köke, A.J.A.; Oostendorp, R.A.; Bijlsma, J.W.J.

2007-01-01

Our objective was to investigate whether behavioral graded activity (BGA) has particular benefit in specific subgroups of osteoarthritis (OA) patients. Two hundred participants with OA of hip or knee, or both (clinical American College of Rheumatology, ACR, criteria) participated in a randomized

Which patients with osteoarthritis of hip and/or knee benefit most from behavioral graded activity?

NARCIS (Netherlands)

Veenhof, C.; Ende, C.H.M. van den; Dekker, J.; Kiike, A.J.; Oostendorp, R.A.B.; Bijlsma, J.W.J.

2007-01-01

Our objective was to investigate whether behavioral graded activity (BGA) has particular benefit in specific subgroups of osteoarthritis (OA) patients. Two hundred participants with OA of hip or knee, or both (clinical American College of Rheumatology, ACR, criteria) participated in a randomized

Pain and senzitisation after total knee replacement or nonsurgical treatment in patients with knee osteoarthritis

DEFF Research Database (Denmark)

Arendt-Nielsen, Lars; Simonsen, Ole; Laursen, Mogens Berg

2018-01-01

BACKGROUND: This study is a secondary analysis of 12-month follow-ups from two parallel, randomised controlled trials (RCT) in painful knee osteoarthritis patients. RCT1: Total knee replacement (TKR) followed by non-surgical treatment compared with non-surgical treatment. RCT2: Non...

A novel biomarker in patients with knee osteoarthritis: adropin.

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Gundogdu, Gulsah; Gundogdu, Koksal

2018-03-16

Adropin is newly discovered peptide hormone. Osteoarthritis (OA) is a kind of joint disease characterized by progressive joint cartilage loss and joint pain. The present study was carried out to investigate adropin and tumor necrosis factor alpha (TNF-α) levels and the relationship between adropin in patients with knee OA classified by Kellgren-Lawrence (KL). A total of 60 knee OA patients and 30 healthy controls were included in this study. KL grading was carried out using the radiographic findings. Demographic characteristics and laboratory parameters were recorded. Adropin and TNF-α levels were determined by using enzyme-linked immunosorbent assay (ELISA). Adropin level was lower in the knee OA patients compared with the healthy controls (p  30 (p < 0.01). Mean NLR of KL grade 4 was significantly increased compared with other grades (p < 0.05). The consequence of the present study suggested that serum adropin level could be used as a new biomarker indicating the early grade of knee OA.

Osteoarthritis

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Osteoarthritis is the most common form of arthritis. It causes pain, swelling, and reduced motion in your ... it affects your hands, knees, hips or spine. Osteoarthritis breaks down the cartilage in your joints. Cartilage ...

A Survey On The Effects Of Iontophoresis Of Piroxicam Gel On Pain And Knee Muscles Strengthn Patients With Knee Osteoarthritis

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Asghar RezaSoltani

2012-04-01

Full Text Available Background and Aim: Knee osteoarthritis is the most common cause of disability in many societies. Therapeutic measures such as using anti-inflammation drugs and physiotherapy programs have been used to suppress knee pain and improve knee joint function in patients with knee osteoarthritis. The aim of this study was to compare the effects of iontophoresis of piroxicam gel, galvanic current with or without piroxicam gel on pain, functional ability and knee muscle strength in patients with knee osteoarthritis.Materials and Method: This study was a clinical trial conducted in Akhtar hospital. Forty two female patients (mean age 58.52 years old with knee osteoarthritis participated in this study. The protocol was performed in Physiotherapy Clinic of Mazandaran Medical University, Mazandaran, Iran. All patients were randomly assigned to three groups. Iontophoresis of piroxicam gel was applied for group 1 (n=14, proxicam gel for group 2 (n=14 and galvanic current for group 3 (n=14. The procedure was carried out for 20-minutes, three times a week and for two following weeks. Knee pain and functional ability were estimated by knee injury and osteoarthritis outcome score (KOOS questioner and the strength of knee extensor and flexor muscles by an isometric device just before the first treatment and immediately after the last treatment times.Results: A significant decrease in pain and a significant increase in functional ability and the strength of knee extensor muscles were resulted in all studied groups (P < 0.05. According to ANOVA test, the level of the percentage difference which was computed for KOOS and knee muscle strength before and after treatments was significantly higher in group 1 than the other two (P < 0.01.Conclusion: Pain and knee functional ability were significantly improved in patients in all three methods. But iontophoresis of piroxicam gel appeared to be more effective in relieving pain and improving knee functional abilities than the

Internal consistency and validity of an observational method for assessing disability in mobility in patients with osteoarthritis

NARCIS (Netherlands)

Steultjens, M. P.; Dekker, J.; van Baar, M. E.; Oostendorp, R. A.; Bijlsma, J. W.

1999-01-01

To establish the internal consistency and validity of an observational method for assessing disability in mobility in patients with osteoarthritis (OA). Data were obtained from 198 patients with OA of the hip or knee. Results of the observational method were compared with results of self-report

Do intra-articular hyaluronic acid injections delay total knee replacement in patients with osteoarthritis – A Cox model analysis

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Amor, Bernard; Bardoulat, Isabelle; Tetafort, Aymeric; Pelletier-Fleury, Nathalie

2017-01-01

Due to the growing worldwide prevalence of knee osteoarthritis, the optimal management of this issue is critical for reducing its burden. Objectives This study aimed to describe patients treated for knee osteoarthritis between 2006 and 2013 in France and to compare the delay from diagnosis to total knee replacement between patients who received intra-articular hyaluronic acid injections and those who did not receive the injections. A second objective was to compare direct medical costs for ambulatory care between treatment groups. Materials and methods Patients were selected from a representative sample of the real world administrative claims database using an algorithm developed by experts from the scientific committee of the study. Data were matched with the medico-administrative database for hospital care. A Cox proportional hazards model was stratified for the treatment group and adjusted for available socio-demographic and medical covariates to compare restricted mean survival times at different time points (1, 3, 5 and 7.5 years) between groups. Costs were expressed in 2013 euros. Results A total of 14,782 patients were treated for knee osteoarthritis (67% women; mean age = 68 years). Among this population, 1,662 patients had total knee replacement (11.2%). At each time point, restricted mean survival time without total knee replacement was significantly higher (p-valueshyaluronic acid group, from +51 to +217 days at 1 and 7.5 years, respectively. For the year preceding total knee replacement, the means for total direct medical costs were similar between groups, €744 vs €805 for treatment and control groups, respectively, (p-value = 0.104). Intra-articular injections accounted for less than 10% of the total costs. Conclusion This is the first retrospective longitudinal study involving knee osteoarthritis patients using medico-administrative databases in France. The results support the effectiveness of hyaluronic acid injections in delaying total knee

Efficacy of Magnetotherapy in knee osteoarthritis.

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José Alberto Rodríguez-Gallo

2012-04-01

Full Text Available Osteoarthritis is the most common of Artropathies, highly heterogeneous in their causes and clinical evolution which have a negative economical impact in terms of productivity in the presence of the problematic situation. An almost experimental prospective and longitudinal study was carried out with the objective of evaluating the efficacy of treatment with magnetic field in patients suffering from knee osteoarthritis in Rehabilitation Provincial Hospital Dr. Faustino Pérez Hernández in Sancti Spíritus. The universe is constituted by 126 patients who have knee osteoarthritis diagnosed from clinical and X-ray view by Rheumatology Services, so as orthopedics and Internal Medicine Services who attended the Rehabilitation Provincial Hospital. In order to work with statistical analysis, several variables were used such as: Wilcoxon Signed Ranks Test (to determine the statistical differences using statistical significance levels (p=0.05. That’s why, as a conclusion knee Magneto therapy treatment is effective and better up the functional capacity and relief of pain.

Correlation between knee and hindfoot alignment in patients with rheumatoid arthritis: The effects of subtalar joint destruction.

Science.gov (United States)

Nakada, Izumi; Nakamura, Ichiro; Juji, Takuo; Ito, Katsumi; Matsumoto, Takumi

2015-09-01

Compensatory hindfoot alignment for deformities at the knee level has been demonstrated in patients with knee osteoarthritis. However, this phenomenon has not been elucidated in patients with rheumatoid arthritis (RA). The aim of this study is to investigate the relationship between knee deformity and hindfoot alignment and the effect of subtalar joint destruction in patients with RA. We retrospectively investigated RA patients (110 patients, 205 limbs) using radiographs in the standing anteroposterior knee, standing lateral foot, and hindfoot alignment views. The grade of destruction at the knee and subtalar joints was assigned using Larsen's grading system. The correlation between the femorotibial and tibiocalcaneal angles and the effect of joint destruction on this correlation were analyzed using Pearson's correlation coefficients. There was moderate correlation between the femorotibial and tibiocalcaneal angles in a group of knees with a Larsen grade of ≥ 4 (r = 0.544, p = 0.0239). This correlation was stronger in a group with less damaged subtalar joints with a Larsen grade of ≤ 3 (r = 0.705, p = 0.0049). These findings emphasized the importance of examining foot and ankles in patients with RA who undergo total knee arthroplasty.

Comparison of Patient-Reported Outcome from Neck-Preserving, Short-Stem Arthroplasty and Resurfacing Arthroplasty in Younger Osteoarthritis Patients

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Marius Dettmer

2015-01-01

Full Text Available Hip resurfacing has been considered a good treatment option for younger, active osteoarthritis patients. However, there are several identified issues concerning risk for neck fractures and issues related to current metal-on-metal implant designs. Neck-preserving short-stem implants have been discussed as a potential alternative, but it is yet unclear which method is better suited for younger adults. We compared hip disability and osteoarthritis outcome scores (HOOS from a young group of patients (n=52, age 48.9 ± 6.1 years who had received hip resurfacing (HR with a cohort of patients (n=73, age 48.2 ± 6.6 years who had received neck-preserving, short-stem implant total hip arthroplasty (THA. Additionally, durations for both types of surgery were compared. HOOS improved significantly preoperatively to last followup (>1 year in both groups (p<0.0001, η2=0.69; there were no group effects or interactions. Surgery duration was significantly longer for resurfacing (104.4 min ± 17.8 than MiniHip surgery (62.5 min ± 14.8, U=85.0, p<0.0001, η2=0.56. The neck-preserving short-stem approach may be preferable to resurfacing due to the less challenging surgery, similar outcome, and controversy regarding resurfacing implant designs.

[Correlations Between Joint Proprioception, Muscle Strength, and Functional Ability in Patients with Knee Osteoarthritis].

Science.gov (United States)

Chen, Yoa; Yu, Yong; He, Cheng-qi

2015-11-01

To establish correlations between joint proprioception, muscle flexion and extension peak torque, and functional ability in patients with knee osteoarthritis (OA). Fifty-six patients with symptomatic knee OA were recruited in this study. Both proprioceptive acuity and muscle strength were measured using the isomed-2000 isokinetic dynamometer. Proprioceptive acuity was evaluated by establishing the joint motion detection threshold (JMDT). Muscle strength was evaluated by Max torque (Nm) and Max torque/weight (Nm/ kg). Functional ability was assessed by the Western Ontario and McMaster Universities Osteoarthritis Index physical function (WOMAC-PF) questionnaire. Correlational analyses were performed between proprioception, muscle strength, and functional ability. A multiple stepwise regression model was established, with WOMAC-PF as dependent variable and patient age, body mass index (BMI), visual analogue scale (VAS)-score, mean grade for Kellgren-Lawrance of both knees, mean strength for quadriceps and hamstring muscles of both knees, and mean JMDT of both knees as independent variables. Poor proprioception (high JMDT) was negatively correlated with muscle strength (Pcoefficient (B) = 0.385, P<0.50 and high VAS-scale score (B=0.347, P<0.05) were significant predictors of WOMAC-PF score. Patients with poor proprioception is associated with poor muscle strength and limitation in functional ability. Patients with symptomatic OA of knees commonly endure with moderate to considerable dysfunction, which is associated with poor proprioception (high JMDT) and high VAS-scale score.

Radium isotope (223Ra, 224Ra, 226Ra and 228Ra) distribution near Brazil's largest port, Paranaguá Bay, Brazil

International Nuclear Information System (INIS)

Dias, Thais H.; Oliveira, Joselene de; Sanders, Christian J.; Carvalho, Franciane; Sanders, Luciana M.; Machado, Eunice C.; Sá, Fabian

2016-01-01

This work investigates the 223 Ra, 224 Ra, 226 Ra and 228 Ra isotope distribution in river, estuarine waters and sediments of the Paranaguá Estuarine Complex (PEC). The stratification of the Ra isotopes along water columns indicate differing natural sources. In sediments, the radium isotope activities was inversely proportional to the particle size. The highest concentrations of 223 Ra, 224 Ra, 226 Ra and 228 Ra in the water column were found in the bottom more saline waters and towards the inner of the estuary. These relatively high concentrations towards the bottom of the estuary may be attributed to the influence of tidally driven groundwater source and desorption from particles at the maximum turbidity zone. The apparent river water ages from the radium isotope ratios, 223 Ra/ 224 Ra and 223 Ra/ 228 Ra, indicate that the principal rivers that flow into the estuary have residence times from between 6 and 11 days. - Highlights: • Radium isotope concentrations were evaluated along a large estuarine system. • The radioactivity level in river, estuary and sediments was within a normal range. • Spatial distributions of site specific radionuclides have differing activities and sources.

Correlation between Gene Expression and Osteoarthritis Progression in Human

NARCIS (Netherlands)

Zhong, Leilei; Huang, Xiaobin; Karperien, Hermanus Bernardus Johannes; Post, Janine Nicole

2016-01-01

Osteoarthritis (OA) is a multifactorial disease characterized by gradual degradation of joint cartilage. This study aimed to quantify major pathogenetic factors during OA progression in human cartilage. Cartilage specimens were isolated from OA patients and scored 0–5 according to the Osteoarthritis

Development of a brief multidisciplinary education programme for patients with osteoarthritis

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Moe Rikke H

2011-11-01

Full Text Available Abstract Background Osteoarthritis (OA is a prevalent progressive musculoskeletal disorder, leading to pain and disability. Patient information and education are considered core elements in treatment guidelines for OA; however, there is to our knowledge no evidence-based recommendation on the best approach, content or length on educational programmes in OA. Objective: to develop a brief, patient oriented disease specific multidisciplinary education programme (MEP to enhance self-management in patients with OA. Method Twelve persons (80% female mean age 59 years diagnosed with hand, hip or knee OA participated in focus group interviews. In the first focus group, six participants were interviewed about their educational needs, attitudes and expectations for the MEP. The interviews were transcribed verbatim and thereafter condensed. Based on results from focus group interviews, current research evidence, clinical knowledge and patients' experience, a multidisciplinary OA team (dietist, nurse, occupational therapist, pharmacist, physical therapist and rheumatologist and a patient representative developed a pilot-MEP after having attended a work-shop in health pedagogics. Finally, the pilot-MEP was evaluated by a second focus group consisting of four members from the first focus group and six other experienced patients, before final adjustments were made. Results The focus group interviews revealed four important themes: what is OA, treatment options, barriers and coping strategies in performing daily activities, and how to live with osteoarthritis. Identified gaps between patient expectations and experience with the pilot-programme were discussed and adapted into a final MEP. The final MEP was developed as a 3.5 hour educational programme provided in groups of 6-9 patients. All members from the multidisciplinary team are involved in the education programme, including a facilitator who during the provision of the programme ensures that the individual

Satisfactory cross cultural equivalence of the Dutch WOMAC in patients with hip osteoarthritis waiting for arthroplasty

NARCIS (Netherlands)

Roorda, L.D.; Jones, C.A.; Waltz, M.; Lankhorst, G.J.; Bouter, L.M.; van der Eijken, J.W.; Willems, W.J.; Heyligers, I.C.; Voaklander, D.C.; Kelly, K.D.; Suarez-Almazor, M.E.

2004-01-01

Background: Cross cultural validity is of vital importance for international comparisons. Objective: To investigate the validity of international Dutch-English comparisons when using the Dutch translation of the Western Ontario and McMaster Universities osteoarthritis index (WOMAC). Patients and

Anti-inflammatory activity of silymarin in patients with knee osteoarthritis

International Nuclear Information System (INIS)

Hussain, Saad A.; Numan, Intesar T.; Al-Khalifa, Ihab I.; Jassim, Nizar A.; Abdullah, Talal A.

2009-01-01

Objective was to evaluate the anti-inflammatory effect of Silymarin in patients with knee osteoarthritis (OA) in comparison with piroxicam and meloxicam. A double-blind clinical trial was performed at the Department of Rheumatology, Baghdad Teaching Hospital, Iraq during the period from October 2004 to September 2005, in which 220 patients (79 males and 141 females) with painful knee osteoarthritis were randomized into 5 groups, treated with either silymarin (300mg/day), piroxicam (20mg/day), meloxicam (15mg) or a combination of silymarin with piroxicam or meloxicam. Serum levels of interleukin-1 alpha, interleukin-8 and the complement proteins C3 and C4 were assessed at zero time and after 8 weeks. Silymarin reduces significantly serum levels of IL-1 alpha and IL-8, C3 and C4 after 8 weeks compared to the pre-treatment levels, while IL-8 decreased significantly, compared to pre-treatment value. Meloxicam elevates serum levels of IL-1 alpha significantly, IL-8 did not significantly change compared to the pre-treatment value. Piroxicam or meloxicam produced slight, non-significant increase in serum levels of complement proteins after the 8-week treatment period. Adjunct use of silymarin with piroxicam results in significant reduction in both cytokines (IL-1 alpha and IL-8) and serum levels of C3 and C4. However, its adjunct use with, meloxicam did not reveal any significant changes in this respect. Silymarin reduces the elevated levels of interleukins and complement proteins, when used alone, or in combination with NSAIDs for treatment of knee OA. (author)

Value of body mass index in the diagnosis of obesity according to DEXA in well-controlled RA patients.

Science.gov (United States)

Tello-Winniczuk, Nina; Vega-Morales, David; García-Hernandez, Pedro A; Esquivel-Valerio, Jorge A; Garza-Elizondo, Mario A; Arana-Guajardo, Ana C

Rheumatoid arthritis (RA) has an indirect effect on body composition. Body mass index (BMI) is not a valid predictor of body fat in RA patients. To evaluate the accuracy of BMI in identifying obesity diagnosed according to dual energy X-ray absorptiometry (DXA) in well-controlled RA patients. An observational, cross-sectional, descriptive, analytical study. We used 3 different cutoffs for obesity as determined by DXA: >35% total fat, >40% total fat, and >35% central fat mass (central obesity). One hundred one patients were included. We found that 35% total fat corresponded to a BMI of 24kg/m 2 , with a sensitivity of 90% and specificity of 75% (area under the curve [AUC] 0.917); 40% total fat to a BMI of 25kg/m 2 , with a sensitivity of 86% and specificity of 39% (AUC 0.822); and 35% central fat mass to a BMI of 22kg/m 2 , with a sensitivity of 97% and specificity of 84% (AUC 0.951). Obesity according to DXA was underdiagnosed when the classic BMI cutoffs were used in well-controlled RA patients. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

Cross-Cultural Adaptation and Validation of the Persian Version of the Oxford Knee Score in Patients with Knee Osteoarthritis

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Mohammad Hosein Ebrahimzadeh

2014-11-01

Full Text Available Background: The Oxford Knee Score (OKS is a short patient-reported outcome instrument that measures pain and physical activity related to knee osteoarthritis. The purpose of this study is to evaluate, construct validity and consistent reliability of the Persian version of the OKS. Methods: The case series consisted of 80 patients who were clinically diagnosed with having knee osteoarthritis. All patients were requested to fill-in the Persian OKS and Short-Form 36 Health Survey (SF-36. Correlation analysis between the Persian versions of these two instruments was then carried out. The scores of the Persian SF-36 were used to evaluate convergent and divergent validity of the 12-item Persian OKS. Results: From a total of 80 patients, 63 were female (79% and the remaining 17 were male (21% with a mean age of 52.2 years. In the present study, high Cronbach’s alpha of 0.95 confirms excellent internal consistency of the Persian OKS scale similar to previous investigations. The results confirm that the Persian version of this instrument is valid and reliable, similar to its English index and its subsequent translations in different languages. Conclusion: The Persian OKS is a reliable instrument to evaluate knee function in patients with knee osteoarthritis and is a useful tool for outcome measurement in clinical research.

Knee joint stabilization therapy in patients with osteoarthritis of the knee: a randomized, controlled trial.

Science.gov (United States)

Knoop, J; Dekker, J; van der Leeden, M; van der Esch, M; Thorstensson, C A; Gerritsen, M; Voorneman, R E; Peter, W F; de Rooij, M; Romviel, S; Lems, W F; Roorda, L D; Steultjens, M P M

2013-08-01

To investigate whether an exercise program, initially focusing on knee stabilization and subsequently on muscle strength and performance of daily activities is more effective than an exercise program focusing on muscle strength and performance of daily activities only, in reducing activity limitations in patients with knee osteoarthritis (OA) and instability of the knee joint. A single-blind, randomized, controlled trial involving 159 knee OA patients with self-reported and/or biomechanically assessed knee instability, randomly assigned to two treatment groups. Both groups received a supervised exercise program for 12 weeks, consisting of muscle strengthening exercises and training of daily activities, but only in the experimental group specific knee joint stabilization training was provided. Outcome measures included activity limitations (Western Ontario and McMaster Universities Osteoarthritis Index - WOMAC physical function, primary outcome), pain, global perceived effect and knee stability. Both treatment groups demonstrated large (∼20-40%) and clinically relevant reductions in activity limitations, pain and knee instability, which were sustained 6 months post-treatment. No differences in effectiveness between experimental and control treatment were found on WOMAC physical function (B (95% confidence interval - CI) = -0.01 (-2.58 to 2.57)) or secondary outcome measures, except for a higher global perceived effect in the experimental group (P = 0.04). Both exercise programs were highly effective in reducing activity limitations and pain and restoring knee stability in knee OA patients with instability of the knee. In knee OA patients suffering from knee instability, specific knee joint stabilization training, in addition to muscle strengthening and functional exercises, does not seem to have any additional value. Dutch Trial Register (NTR) registration number: NTR1475. Copyright © 2013 Osteoarthritis Research Society International. Published by Elsevier

Intra-rater reliability and agreement of muscle strength, power and functional performance measures in patients with hip osteoarthritis

DEFF Research Database (Denmark)

Bieler, Theresa; Magnusson, S Peter; Kjær, Michael

2014-01-01

OBJECTIVE: To investigate the reliability and agreement of measures of lower extremity muscle strength, power and functional performance in patients with hip osteoarthritis at different time intervals, and to compare these with the same measures in healthy peers. DESIGN: Intra-rater test...... extensor power, and functional performance (8-foot Up & Go, stair climbing, chair stand and 6-min walk) were measured in patients, and quadriceps strength, leg extensor power and functional performance were measured in healthy peers. Systematic error, reliability and agreement were calculated. RESULTS......-retest separated by 1, 2, or 2.5 weeks in patients, and 1 week in healthy peers. SUBJECTS: Patients with hip osteoarthritis (age range 61-83 years) with 1 (n = 37), 2 (n = 35), or 2.5 weeks (n = 15) between tests, and 35 healthy peers (age range 63-82 years). METHODS: Maximal isometric hip and thigh strength, leg...

Our Patients with Knee Osteoarthritis Risk Factors and Relationship with Osteoarhritis-Osteoporosis

OpenAIRE

Nadide Torlak Koca; Vesile Sepici; Aliye Kapukıran Tosun; Gökhan Koca

2015-01-01

Aim: Osteoarthritis (OA) is a degenerative disease, that developes as a result of the impairment of formation and destruction processes in cartilage and sinovial tissues, with the effect of various traumatic, biomechanic, inflammatory and genetic factors. Material and Methods: In this study, risk factors and relation between OA and OP (osteoporosis) is evaluated in 127 patients with knee OA. Age, gender, obesity, menopause, ligamentous laxity, DM, injury of joint, genetic predisposition an...

One year effectiveness of neuromuscular exercise compared with instruction in analgesic use on knee function in patients with early knee osteoarthritis

DEFF Research Database (Denmark)

Holsgaard-Larsen, A; Christensen, R; Clausen, B

2018-01-01

of California Activity Score (UCLA) and the European Quality of Life-5 Dimensions. RESULTS: Ninety-three patients (57% women, 58 ± 8 years, body mass index 27 ± 4 kg/m(2)) were randomized to NEMEX (n = 47) or PHARMA group (n = 46) with data from 85% being available at 12-months follow-up. Good compliance......OBJECTIVE: To test long-term effectiveness of neuromuscular exercise (NEMEX) with instructions in optimized pharmacological treatment (PHARMA) on activities of daily living (ADL) in patients with early knee osteoarthritis. DESIGN: 12-months follow-up from a randomized controlled trial. Participants...... with mild-to-moderate medial tibiofemoral knee osteoarthritis were randomly allocated to 8 weeks NEMEX or PHARMA. The primary outcome measure was the ADL-subscale of the Knee Injury and Osteoarthritis Outcome Score (KOOS). Secondary outcome measures included the other four KOOS-subscales, the University...

Patient education and basic body awareness therapy in hip osteoarthritis - a qualitative study of patients' movement learning experiences.

Science.gov (United States)

Olsen, Aarid Liland; Strand, Liv Inger; Skjaerven, Liv Helvik; Sundal, Mary-Anne; Magnussen, Liv Heide

2017-08-01

Osteoarthritis (OA) is associated with pain, dysfunction and reduced quality of life. Patient education (PE) followed by 12 weekly sessions of Basic Body Awareness Therapy (BBAT) was offered to patients with hip OA, aiming to strengthen their ability to move and act functionally in daily life. To explore how patients described their experiences and outcome from participating in PE and BBAT. Individual, semi-structured interviews with five patients, aged 52-78 years, were performed after PE and BBAT at four and ten months. Interview data were analyzed by systematic text condensation. Three main themes emerged. "Becoming motivated and involved" reflected experiences of encouragement and support from information given and communication with group members. In "Movement awareness learning" patients described becoming aware of and improving functional movement, alleviating symptoms and increasing daily functioning. "Movement and disease in a long-term perspective" reflected patientś experience of increased self-awareness and taking better care of themselves at 10 months after baseline. Practicing basic movement principles, they felt empowered to handle daily life challenges in more functional and energy-economical ways. PE followed by BBAT in groups may be beneficial to patients with hip OA, and provide lasting benefits regarding daily life function. Implications for Rehabilitation Insight into disease process and relationship to functional movement gained through patient education may empower patients with hip osteoarthritis in management of daily life Movement awareness and exploration of movement quality using principles from Basic Body Awareness Therapy was found to support patients in finding resources for functional movement, implemented in daily actions Movement strategies characterized by adjustment rather than force was experienced by the patients to support their general functioning, despite of prevailing hip pain Implementing group therapeutic factors (Yalom

Psychometric Properties of the Malay Language Version of Knee Injury and Osteoarthritis Outcome Score (KOOS Questionnaire among Knee Osteoarthritis Patients: A Confirmatory Factor Analysis

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Zulkifli MM

2017-07-01

Full Text Available INTRODUCTION: This study aimed to cross-culturally adapt a Malay version of Knee Injury and Osteoarthritis Outcome Score (KOOS and to evaluate its psychometric properties in patients with knee osteoarthritis (OA. MATERIALS AND METHODS: The English version KOOS was translated into a Malay version using forward and backward translation process, followed by face validity and content validity. Two hundred and twenty-six knee OA patients attending the Outpatient and Orthopaedic Clinics, Universiti Sains Malaysia Hospital, completed the Malay version KOOS. Construct validity using confirmatory factor analysis and internal reliability assessment were performed. RESULTS: The results showed that the original five-factor model with 42 items failed to achieve acceptable values of the goodness of fit indices, indicating poor model fit. A new five-factor model of 26 items demonstrated acceptable level of goodness of fit (comparative fit index= 0.929, incremental fit index= 0.930, Tucker Lewis fit index= 0.920, root mean square error of approximation= 0.073 and Chisquared/ degree of freedom= 2.183 indices to signify a model fit. The Cronbach’s alpha value for the new model ranged from 0.776 to 0.946. The composite reliability values of each construct ranged between 0.819 and 0.921, indicating satisfactory to high level of convergent validity. CONCLUSION: The five-factor model with 26 items in the Malay version of KOOS questionnaire demonstrated a good degree of goodness of fit and was found to be valid, reliable and simple as an assessment tool for symptoms, pain, activity of daily living, sports and recreational activity and quality of life for Malaysian adults suffering from knee osteoarthritis.

 Osteoarthritis Among Women in Bahrain: A Public Health Audit

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Zainab AM Al-Safwan

2011-11-01

Full Text Available  Objective: This study aims to train students on public health survey; correlate risk factors of osteoarthritis and to identify modifiable risk factors. Methods: Osteoarthritis survey was carried out among 420 Bahraini women, above 40 years of age, diagnosed of osteoarthritis, attending ministry of health facilities. Results: Most cases in the study were from the age group of 50-59 years with a mean age of 57. Osteoarthritis: of major joints alone was 74�20of generalized was 21�0and of small joints of hands and feet alone was 5�20Within major osteoarthritis: 48�0were knees alone; 51�0were knee and hip and 2�0were hip alone. Combinations of co-morbidities were found among 43�20History of diagnosed: diabetes in 10�20hypertension among 13�0and hypercholesterolemia in 5�0of cases. Half of the cases in the study were obese and 30�0were overweight. Osteoarthritis of the Knee and the combination of the osteoarthritis of knee and hip was highest among obese followed by overweight cases. Menopause was found among 68� patients. Patients on medication accounted for 85�0and 75�0were on Physiotherapy. Half of the sample had family history of osteoarthritis. While over 90�0were less educated with odds ratio for being housewives at 3.085. The multivariate analysis of ordinal regression returned pseudo R2 of 30�0for the model with the following significant variables: age, BMI, menopause status, exercise, chronic morbidities and family history of osteoarthritis. Conclusion: Overall, the proportion of major osteoarthritis of the weight bearing joints is very high. The modifiable risk factors identified from this study are sedentary lifestyle, obesity and overweight, as well as chronic morbidities.

Assessment of reliability, validity, responsiveness and minimally important change of the German Hip dysfunction and osteoarthritis outcome score (HOOS) in patients with osteoarthritis of the hip.

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Arbab, Dariusch; van Ochten, Johannes H M; Schnurr, Christoph; Bouillon, Bertil; König, Dietmar

2017-12-01

Patient-reported outcome measures are a critical tool in evaluating the efficacy of orthopedic procedures. The intention of this study was to evaluate reliability, validity, responsiveness and minimally important change of the German version of the Hip dysfunction and osteoarthritis outcome score (HOOS). The German HOOS was investigated in 251 consecutive patients before and 6 months after total hip arthroplasty. All patients completed HOOS, Oxford-Hip Score, Short-Form (SF-36) and numeric scales for pain and disability. Test-retest reliability, internal consistency, floor and ceiling effects, construct validity and minimal important change were analyzed. The German HOOS demonstrated excellent test-retest reliability with intraclass correlation coefficient values > 0.7. Cronbach´s alpha values demonstrated strong internal consistency. As hypothesized, HOOS subscales strongly correlated with corresponding OHS and SF-36 domains. All subscales showed excellent (effect size/standardized response means > 0.8) responsiveness between preoperative assessment and postoperative follow-up. The HOOS and all subdomains showed higher changes than the minimal detectable change which indicates true changes. The German version of the HOOS demonstrated good psychometric properties. It proved to be valid, reliable and responsive to the changes instrument for use in patients with hip osteoarthritis undergoing total hip replacement.

Effectiveness of Glucosamine and Chondroitin Sulfate Combination in Patients with Primary Osteoarthritis

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Laszlo IRSAY

2010-12-01

Full Text Available Purpose: Studying the effectiveness of chondroprotective agents for patients with primary knee arthritis or primary generalized osteoarthritis, according to the American College of Rheumatology 2000 criteria. Material and Methods: comparative study, the groups were constituted out of 25 patients in the study group and 15 patients in the control group. The patients were evaluated with the WOMAC test, Lequesne, cross-linked C-terminal (CTX telopeptide of type I collagen on inclusion, at 6 and 12 months and through bilateral- knee radiography, using the Kellgren-Lawrence classification on inclusion and 12 months later. Patients from the study group received a chondroprotectiv agent orally for 12 months. Results: WOMAC score was improved in the study group at 6 and 12 months -4.1 (CI -6.1 to -2.1 and -5.9 (CI -8 to -3.8 compared to the control group 1.5 (CI -0.7 to 3.7 and 2 (CI -0.2 to 4.2, with a statistical significance p=0.02. There has also been an amelioration of the Lequesne score in the study group at 6 and 12 months -3.8 (CI -6.3 to -1.3 and -6.2 (CI -9.1 to -3.3, and the control group 1.3 (CI -1.5 to 4.1 to 6 months and 1.9 (CI -0.8 to 4.6 to 12 months, with a statistical significance p=0.03. No adverse reactions were registered. Conclusions: The chondroprotective agent was effective in improving the function of patients with osteoarthritis, the studied marker cannot be used to monitor the treatment effectiveness, and the radiological modifications in the knee are statistically insignificant after 12 months of monitoring.

Patient preference and willingness to pay for knee osteoarthritis treatments

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Posnett J

2015-06-01

Full Text Available John Posnett,1 Sanjeev Dixit,2 Brooks Oppenheimer,2 Sven Kili,3 Nazanin Mehin4 1HERONTM Commercialization, PAREXEL® International, London, UK; 2Reason Research, Philadelphia, PA, USA; 3Sanofi Biosurgery, Oxford, UK; 4Sanofi, Paris, France Purpose: To review treatments for osteoarthritis of the knee (OAK received by patients across five European countries, and to obtain patients’ perceptions and willingness to pay for current treatments.Patients and methods: A prospective, internet-based, double-blind survey of adults with OAK was conducted in France, Germany, Italy, Spain, and the United Kingdom. The questionnaire included questions about diagnosis, treatment history, and perceptions of OAK treatments, followed by a discrete choice-based conjoint exercise to identify preferred attributes of OAK treatments, evaluating 14 sets of four unbranded products.Results: Two thousand and seventy-three patients with self-reported OAK completed the survey; 17.4% of patients rated their knee pain as drastically affecting their ability to perform normal daily activities, and 39.3% of employed patients reported that they had lost work time because of OAK. The most common treatments were exercise (69.7%, physical therapy (68.2%, and nonprescription oral pain medication (73.9%. Treatments perceived as most effective were: viscosupplement injections (74.1%, narcotics (67.8%, and steroid injection (67.6%. Patient co-pay, duration of pain relief, and type of therapy exhibited the largest impact on patient preference for OAK treatments. The average patient was willing to pay €35 and €64 more in co-pay for steroid and viscosupplement injections, respectively, over the cost of oral over-the-counter painkillers (per treatment course, per knee (each P<0.05.Conclusion: OAK is a debilitating condition that affects normal daily activities. In general, treatments most commonly offered to patients are not those perceived as being the most effective. Patients are

The Clinical Study on Bee Venom Acupuncture Treatment on Osteoarthritis of Knee Joint

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Lim Jeong a

2005-06-01

Full Text Available Objective : This study is performed for the purpose of examining into the efficacy of the Bee Venom Acupuncture Treatment for Osteoarthritis of Knee Joint Methods : We investitigated 25 cases of patients with Osteoarthritis of Knee Joint from 1st June 2005 to 13th July 2005. The 25 patients were taken Bee Venom Acupuncture over three times irregularly. Treatment efficiency was monitored through VAS (Visual Analog Scale and improvement degree of the grade of clinical symptoms Conclusion : We brought to the conclusion that the Bee Venom Acupuncture has possibility to be efficient to cure the Osteoarthritis of Knee Joint patients. So we suggest the possibility to use this new remedy for the Osteoarthritis of Knee Joint

Knee joint pain potentially due to bone alterations in a knee osteoarthritis patient.

Science.gov (United States)

Komatsu, Masatoshi; Nakamura, Yukio; Kamimura, Mikio; Uchiyama, Shigeharu; Mukaiyama, Keijiro; Ikegami, Shota; Kato, Hiroyuki

2014-12-01

Osteoarthritis (OA) is the leading cause of musculoskeletal pain and functional disability worldwide. However, the etiology of this condition is still largely unknown. We report the clinical course of an elderly man with knee OA. Plain radiographs and MRI examinations performed during follow-up suggested that the pathophysiology of the patient's knee OA and joint pain may have been primarily due to bone alterations.

The effectiveness of exercise therapy in patients with osteoarthritis of the hip or knee: a randomized clinical trial.

NARCIS (Netherlands)

Baar, M.E. van; Dekker, J.; Oostendorp, R.A.B.; Bijl, D.; Voorn, T.B.; Lemmens, J.A.M.; Bijlsma, J.W.J.

1998-01-01

Objective: To determine the effectiveness of exercise therapy in patients with osteoarthritis (OA) of the hip or knee. Methods: A randomized single blind, clinical trial was conducted in a primary care setting. Patients with hip or knee OA by American College of Rheumatology criteria were

Oxford Knee Score: cross-cultural adaptation and validation of the Turkish version in patients with osteoarthritis of the knee.

Science.gov (United States)

Tuğay, Baki Umut; Tuğay, Nazan; Güney, Hande; Kınıklı, Gizem İrem; Yüksel, İnci; Atilla, Bülent

2016-01-01

The Oxford Knee Score (OKS) is a valid, short, self-administered, and site- specific outcome measure specifically developed for patients with knee arthroplasty. This study aimed to cross-culturally adapt and validate the OKS to be used in Turkish-speaking patients with osteoarthritis of the knee. The OKS was translated and culturally adapted according to the guidelines in the literature. Ninety-one patients (mean age: 55.89±7.85 years) with knee osteoarthritis participated in the study. Patients completed the Turkish version of the Oxford Knee Score (OKS-TR), Short-Form 36 Health Survey (SF-36), and Western Ontario and McMaster Universities Index (WOMAC) questionnaires. Internal consistency was tested using Cronbach's α coefficient. Patients completed the OKS-TR questionnaire twice in 7 days to determine the reproducibility. Correlation between the total results of both tests was determined by Spearman's correlation coefficient and intraclass correlation coefficients (ICC). Validity was assessed by calculating Spearman's correlation coefficient between the OKS, WOMAC, and SF-36 scores. Floor and ceiling effects were analyzed. Internal consistency was high (Cronbach's α: 0.90). The reproducibility tested by 2 different methods showed no significant difference (p>0.05). The construct validity analyses showed a significant correlation between the OKS and the other scores (p<0.05). There was no floor or ceiling effect in total OKS score. The OKS-TR is a reliable and valid measure for the self-assessment of pain and function in Turkish-speaking patients with osteoarthritis of the knee.

Osteoarthritis Patients' Experiences of Pharmacotherapy for Pain Management in Iran: A Qualitative Study.

Science.gov (United States)

Zamanzadeh, Vahid; Ahmadi, Fazlollah; Behshid, Mozhgan; Irajpoor, Alireza; Zakeri-Milani, Parvin

2017-06-01

Despite the effectiveness of pharmacotherapy for pain management in patients with osteoarthritis (OA), personal biases in the selection, administration, and continuation of pharmacotherapy challenge the proper management of symptoms and the effectiveness of the therapy. This study was conducted to carry out an in-depth examination of the experiences of patients with OA about their use of pharmacotherapy for the OA pain management and the existing challenges. The present qualitative study was conducted on 17 patients with OA, 5 of their family members and 8 healthcare personnel using a conventional content analysis approach. Data were collected through 35 interviews, which were unstructured at first but became semi-structured later on. Data collection continued until data saturation and analyzed simultaneously. The criteria used to determine the rigor of the study included the credibility, transferability, dependability and conformability of the data. The analysis of the data revealed 3 main categories and 8 subcategories. The main categories including preference for non-pharmacological modalities, preference for symptomatic slow-acting drugs for osteoarthritis (SySADOAs) and preference for vitamins and minerals. Briefing the patients on the therapeutic goals, participating them in the clinical decision-making process, modifying drug administration patterns through prescribing the minimum effective dosage and substituting alternative therapies whenever possible, consistently monitoring the therapeutic responses and any unexpected complications and use of complementary treatments, makes up strategies that can help improve OA pain management. © Georg Thieme Verlag KG Stuttgart · New York.

Radiological imaging of osteoarthritis of the knee

International Nuclear Information System (INIS)

Wick, M.C.; Jaschke, W.; Klauser, A.S.

2012-01-01

Osteoarthritis is the most common degenerative age-related joint disease leading to typical degradation of articular cartilage with severe pain and limitation of joint motion. Although knee radiographs are widely considered as the gold standard for the assessment of knee osteoarthritis in clinical and scientific settings they increasingly have significant limitations in situations when resolution and assessment of cartilage is required. Analysis of osteoarthritis of the knee with conventional x-ray is associated with many technical limitations and is increasingly being replaced by high-quality assessment using magnetic resonance imaging (MRI) or sonography both in the clinical routine and scientific studies. Novel imaging modalities such as MRI or ultrasound enable in vivo visualization of the quality of the cartilaginous structure and bone as well as all articular and periarticular tissue. Therefore, the limitations of radiographs in assessment of knee osteoarthritis could be overcome by these techniques. This review article aims to provide insights into the most important radiological features of knee osteoarthritis and systematic visualization with different imaging approaches. The demographic development in western industrialized countries predicts an increase of ageing-related osteoarthritis of the knee for the next decades. A systematic radiological evaluation of patients with knee osteoarthritis includes the assessment of the periarticular soft tissue, cartilaginous thickness, cartilage volume, possible cartilage defects, the macromodular network of hyaline cartilage, bone marrow edema, menisci and articular ligaments. Modern imaging modalities, such as MRI and sonography allow the limitations of conventional radiography to be overcome and to visualize the knee structures in great detail to quantitatively assess the severity of knee osteoarthritis. (orig.) [de

[Balneotherapy and osteoarthritis treatment].

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Latrille, Christian Roques

2012-09-01

Balneotherapy is a complementary form of medicine which uses natural thermal mineral resources in situ. It provides patients with osteoarthritis with a full treatment to ease pain and improve functions in the long-term without causing any significant therapeutic risks.

Directing clinical care using lower extremity biomechanics in patients with ankle osteoarthritis and ankle arthroplasty.

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Queen, Robin

2017-11-01

Ankle osteoarthritis is a debilitating disease with approximately 50,000 new cases per year leading to skeletal deformity, severe and recurrent pain, cartilage breakdown, and gait dysfunction limiting patient mobility and well-being. Although many treatments (total ankle arthroplasty [TAA], ankle fusion [arthrodesis], and ankle distraction arthroplasty) relieve pain, it is not clear that these procedures significantly improve patient mobility. The goal of the research presented here is to summarize what is presently known about lower extremity gait mechanics and outcomes and to quantify the impact of ankle osteoarthritis and TAA have on these measures using an explicitly holistic and mechanistic approach. Our recent studies have explored physical performance and energy recovery and revealed unexpected patterns and sequelae to treatment including incomplete restoration of gait function. These studies demonstrated for the first time the extreme levels and range of gait and balance dysfunction present in ankle osteoarthritis patients as well as quantifying the ways in which the affected joint alters movement and loading patterns not just in the painful joint, but throughout both the ipsilateral and contralateral lower extremity. Through this work, we determined that relieving pain alone through TAA is not enough to restore normal walking mechanics and balance due to underlying causes including limited ankle range of motion and balance deficits leading to long-term disability despite treatment. The results indicate the need to consider additional therapeutic interventions aimed at restoring balance, ankle range of motion, and movement symmetry in order to improve long-term health and function. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2345-2355, 2017. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

226Ra, 228Ra and 228Ra/226Ra in surface marine sediment of Malaysia

International Nuclear Information System (INIS)

Mei-Wo Yii; Zal Uyun Wan-Mahmood

2013-01-01

Surface sediment samples were collected at the West (east coast and west coast of Peninsular Malaysia) and East (Sabah and Sarawak) Malaysia in several expeditions within August 2003 until June 2008 for determining the level of natural radium isotopes. Activity concentrations of 226 Ra and 228 Ra in surface marine sediment at 176 sampling stations were measured. The activity concentrations of both radionuclides in Malaysia (East and West Malaysia) display varied with the range from 9 to 158 Bq/kg dry wt. and 13 to 104 Bq/kg dry wt., respectively. Meanwhile, the ratio distributions of 228 Ra/ 226 Ra were ranged from 0.62 to 3.75. This indicated that the ratios were slightly high at west coast of Peninsular Malaysia compared to other regions (east coast of Peninsular Malaysia, Sabah and Sarawak). The variation of activity concentrations of 226 Ra and 228 Ra and its ratios were also supported by the statistical analyses of one-way ANOVA and t test at 95 % confidence level, whereby there were proved that the measured values were different between the regions. These different were strictly related to their half-life, potential input sources (included their parents, 238 U and 232 Th), parent's characteristic, the geological setting/formation of the study area, environment origin and behavior. (author)

Emerging targets and therapeutic approaches for the treatment of osteoarthritis pain.

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Rahman, Wahida; Dickenson, Anthony H

2015-06-01

Osteoarthritis is a complex and often painful disease that is inadequately controlled with current analgesics. This review discusses emerging targets and therapeutic approaches that may lead to the development of better analgesics. Aberrant excitability in peripheral and central pain pathways drives osteoarthritis pain, reversing this via modulation of nerve growth factor, voltage-gated sodium channel, voltage-gated calcium channel and transient receptor potential vanilloid one activity, and increasing inhibitory mechanisms through modulation of cannabinoid and descending modulatory systems hold promise for osteoarthritis pain therapy. Somatosensory phenotyping of chronic pain patients, as a surrogate of putative pain generating mechanisms, may predict patient response to treatment. Identification of new targets will inform and guide future research, aiding the development of more effective analgesics. Future clinical trial designs should implement sensory phenotyping of patients, as an inclusion or stratification criterion, in order to establish an individualized, mechanism-based treatment of osteoarthritis pain.

Arthroscopic Ankle Arthrodesis for Treating Osteoarthritis in a Patient with Kashin-Beck Disease

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Kenjiro Iwasa

2014-01-01

Full Text Available Kashin-Beck disease (KBD is an endemic degenerative osteoarthritis. Death of cartilage and growth plate is the pathologic feature; therefore, KBD involves skeletal deformity and often results in osteoarthritis. Deficiency of selenium, high humic acid levels in water, and fungi on storage gains are considered the cause of KBD. The most frequently involved joints are ankles, knees, wrists, and elbows and symptoms are pain and limited motions of those joints. The main treatments for KBD are rehabilitation and osteotomy to correct the deformities because preventive treatment has not been established. In this report, we present a case of ankle osteoarthritis due to KBD and first describe arthroscopic ankle arthrodesis for treating osteoarthritis of KBD.

Knee joint laxity does not moderate the relationship between quadriceps strength and physical function in knee osteoarthritis patients: A cross-sectional study.

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Altubasi, Ibrahim M

2018-06-07

Knee osteoarthritis is a common and a disabling musculoskeletal disorder. Patients with knee osteoarthritis have activity limitations which are linked to the strength of the quadriceps muscle. Previous research reported that the relationship between quadriceps muscle strength and physical function is moderated by the level of knee joint frontal plane laxity. The purpose of the current study is to reexamine the moderation effect of the knee joint laxity as measured by stress radiographs on the relationship between quadriceps muscle strength and physical function. One-hundred and sixty osteoarthritis patients participated in this cross-sectional study. Isometric quadriceps muscle strength was measured using an isokinetic dynamometer. Self-rated and performance-based physical function were measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function subscale and Get Up and Go test, respectively. Stress radiographs which were taken while applying varus and valgus loads to knee using the TELOS device. Knee joint laxity was determined by measuring the distance between joint surfaces on the medial and lateral sides. Hierarchical multiple regression models were constructed to study the moderation effect of laxity on the strength function relationship. Two regression models were constructed for self-rated and performance-based function. After controlling for demographics, strength contributed significantly in the models. The addition of laxity and laxity-strength interaction did not add significant contributions in the regression models. Frontal plane knee joint laxity measured by stress radiographs does not moderate the relationship between quadriceps muscle strength and physical function in patients with osteoarthritis. Copyright © 2018 Elsevier B.V. All rights reserved.

Osteoarthritis - histology and pathogenetic concepts

International Nuclear Information System (INIS)

Sulzbacher, I.

2000-01-01

Osteoarthitis is the most common joint disease affecting over 60% of the elderly population. It is characterized by the progressive erosion of articular cartilage leading to incapacity of movement. In the great majority of instances, osteoarthritis appears insidiously, without apparent initiating cause. This primary form is usually oligoarticular involving hip, knee, cervical vertebrae, interphalangeal joints of the fingers or tarsometatarsal joints of the feet. In case of an underlying systemic diasease or local injury the cartilage destruction is considered as secondary osteoarthritis. The pathogenesis of primary osteoarthritis suggests an intrinsic disease of cartilage in which biochemical and metabolic alterations result in its breakdown. Within the last decades different models were stablished which also concentrated on other joint structures such as bone or ligaments. Changes of the subchondral bone were found to precide cartilage damage suggesting a primary alteration of the subchondral region. Other studies concentrated on the metabolic activity of chondrocytes in healthy cartilage of osteoarthritis patients. The precise event that leads to these changes is still not clear. This review concentrates on the histological features in the course of the disease and tries to provide a summary on different pathogenetic concepts. (orig.) [de

Intra-articular morphine versus bupivacaine for knee motion among patients with osteoarthritis: randomized double-blind clinical trial

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Miriam Bellini Gazi

Full Text Available CONTEXT AND OBJECTIVE: Osteoarthritis causes pain and disability in a high percentage of elderly people. The aim of the present study was to assess the efficacy of intra-articular morphine and bupivacaine on the joint flexion and extension angles of patients with knee osteoarthritis. DESIGN AND SETTING: A randomized double-blind study was performed at a pain clinic of Universidade Federal de São Paulo. METHODS: Thirty-nine patients with pain for more than three months, of intensity greater than three on a numerical scale (zero to 10, were included. G1 patients received 1 mg (1 ml of morphine diluted in 9 ml of saline, intra-articularly, and G2 patients received 25 mg (10 ml of 0.25% bupivacaine without epinephrine. Pain was assessed on a numerical scale and knee flexion and extension angles were measured after administration of the drugs at rest and during movement. The total amount of analgesic supplementation using 500 mg doses of paracetamol was also determined. RESULTS: No significant difference in pain intensity was observed between G1 and G2. Significant decreases in pain at rest and during movement and significant increases in mean flexion and extension angles were observed in both groups, with no significant difference between the two groups. The mean total amount of paracetamol used over a seven-day period was 3578 mg in G1 and 5333 mg in G2 (P = 0.2355; Mann-Whitney test. CONCLUSION: The analgesic effects of 1 mg of morphine and 25 mg of 0.25% bupivacaine were similar among patients with osteoarthritis of the knee.

The effectiveness of exercise therapy in patients with osteoarthritis of the hip or knee: a randomized clinical trial

NARCIS (Netherlands)

van Baar, M. E.; Dekker, J.; Oostendorp, R. A.; Bijl, D.; Voorn, T. B.; Lemmens, J. A.; Bijlsma, J. W.

1998-01-01

To determine the effectiveness of exercise therapy in patients with osteoarthritis (OA) of the hip or knee. A randomized single blind, clinical trial was conducted in a primary care setting. Patients with hip or knee OA by American College of Rheumatology criteria were selected. Two intervention

Transcatheter Arterial Embolization as a Treatment for Medial Knee Pain in Patients with Mild to Moderate Osteoarthritis

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Okuno, Yuji, E-mail: how-lowlow@yahoo.co.jp [Edogawa Hospital, Department of Orthopedic Surgery (Japan); Korchi, Amine Mohamed, E-mail: amine.korchi@gmail.com [Geneva University Hospitals, Department of Diagnostic and Interventional Radiology (Switzerland); Shinjo, Takuma, E-mail: shin.takuma@a7.keio.jp [Keio University, Institute for Integrated Sports Medicine, School of Medicine (Japan); Kato, Shojiro, E-mail: shojiro7@yahoo.co.jp [Edogawa Hospital, Department of Orthopedic Surgery (Japan)

2015-04-15

PurposeOsteoarthritis is a common cause of pain and disability. Mild to moderate knee osteoarthritis that is resistant to nonsurgical options and not severe enough to warrant joint replacement represents a challenge in its management. On the basis of the hypothesis that neovessels and accompanying nerves are possible sources of pain, previous work demonstrated that transcatheter arterial embolization for chronic painful conditions resulted in excellent pain relief. We hypothesized that transcatheter arterial embolization can relieve pain associated with knee osteoarthritis.MethodsTranscatheter arterial embolization for mild to moderate knee osteoarthritis using imipenem/cilastatin sodium or 75 μm calibrated Embozene microspheres as an embolic agent has been performed in 11 and three patients, respectively. We assessed adverse events and changes in Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scores.ResultsAbnormal neovessels were identified within soft tissue surrounding knee joint in all cases by arteriography. No major adverse events were related to the procedures. Transcatheter arterial embolization rapidly improved WOMAC pain scores from 12.2 ± 1.9 to 3.3 ± 2.1 at 1 month after the procedure, with further improvement at 4 months (1.7 ± 2.2) and WOMAC total scores from 47.3 ± 5.8 to 11.6 ± 5.4 at 1 month, and to 6.3 ± 6.0 at 4 months. These improvements were maintained in most cases at the final follow-up examination at a mean of 12 ± 5 months (range 4–19 months).ConclusionTranscatheter arterial embolization for mild to moderate knee osteoarthritis was feasible, rapidly relieved resistant pain, and restored knee function.

Transcatheter Arterial Embolization as a Treatment for Medial Knee Pain in Patients with Mild to Moderate Osteoarthritis

International Nuclear Information System (INIS)

Okuno, Yuji; Korchi, Amine Mohamed; Shinjo, Takuma; Kato, Shojiro

2015-01-01

PurposeOsteoarthritis is a common cause of pain and disability. Mild to moderate knee osteoarthritis that is resistant to nonsurgical options and not severe enough to warrant joint replacement represents a challenge in its management. On the basis of the hypothesis that neovessels and accompanying nerves are possible sources of pain, previous work demonstrated that transcatheter arterial embolization for chronic painful conditions resulted in excellent pain relief. We hypothesized that transcatheter arterial embolization can relieve pain associated with knee osteoarthritis.MethodsTranscatheter arterial embolization for mild to moderate knee osteoarthritis using imipenem/cilastatin sodium or 75 μm calibrated Embozene microspheres as an embolic agent has been performed in 11 and three patients, respectively. We assessed adverse events and changes in Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scores.ResultsAbnormal neovessels were identified within soft tissue surrounding knee joint in all cases by arteriography. No major adverse events were related to the procedures. Transcatheter arterial embolization rapidly improved WOMAC pain scores from 12.2 ± 1.9 to 3.3 ± 2.1 at 1 month after the procedure, with further improvement at 4 months (1.7 ± 2.2) and WOMAC total scores from 47.3 ± 5.8 to 11.6 ± 5.4 at 1 month, and to 6.3 ± 6.0 at 4 months. These improvements were maintained in most cases at the final follow-up examination at a mean of 12 ± 5 months (range 4–19 months).ConclusionTranscatheter arterial embolization for mild to moderate knee osteoarthritis was feasible, rapidly relieved resistant pain, and restored knee function

Icariin Regulates Cellular Functions and Gene Expression of Osteoarthritis Patient-Derived Human Fibroblast-Like Synoviocytes

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Lianhong Pan

2017-12-01

Full Text Available Synovial inflammation plays an important role in the pathogenesis and progress of osteoarthritis (OA. There is an urgent need to find safe and effective drugs that can reduce the inflammation and regulate the pathogenesis of cytokines of the OA disease. Here, we investigated the effect of icariin, the major pharmacological active component of herb Epimedium on human osteoarthritis fibroblast-like synoviocytes (OA–FLSs. The OA–FLSs were isolated from patients with osteoarthritis and cultured in vitro with different concentrations of icariin. Then, cell viability, proliferation, and migration were investigated; MMP14, GRP78, and IL-1β gene expression levels were detected via qRT-PCR. Icariin showed low cytotoxicity to OA–FLSs at a concentration of under 10 μM and decreased the proliferation of the cells at concentrations of 1 and 10 μM. Icariin inhibited cell migration with concentrations ranging from 0.1 to 1 μM. Also, the expression of three cytokines for the pathogenesis of OA which include IL-1β, MMP14 and GRP78 was decreased by the various concentrations of icariin. These preliminary results imply that icariin might be an effective compound for the treatment of OA disease.

Efficacy of Curcuma for Treatment of Osteoarthritis.

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Perkins, Kimberly; Sahy, William; Beckett, Robert D

2017-01-01

The objective of this review is to identify, summarize, and evaluate clinical trials to determine the efficacy of curcuma in the treatment of osteoarthritis. A literature search for interventional studies assessing efficacy of curcuma was performed, resulting in 8 clinical trials. Studies have investigated the effect of curcuma on pain, stiffness, and functionality in patients with knee osteoarthritis. Curcuma-containing products consistently demonstrated statistically significant improvement in osteoarthritis-related endpoints compared with placebo, with one exception. When compared with active control, curcuma-containing products were similar to nonsteroidal anti-inflammatory drugs, and potentially to glucosamine. While statistical significant differences in outcomes were reported in a majority of studies, the small magnitude of effect and presence of major study limitations hinder application of these results. Further rigorous studies are needed prior to recommending curcuma as an effective alternative therapy for knee osteoarthritis. © The Author(s) 2016.

Pelvic movement strategies and leg extension power in patients with end-stage medial compartment knee osteoarthritis: a cross-sectional study.

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Kierkegaard, Signe; Jørgensen, Peter Bo; Dalgas, Ulrik; Søballe, Kjeld; Mechlenburg, Inger

2015-09-01

During movement tasks, patients with medial compartment knee osteoarthritis use compensatory strategies to minimise the joint load of the affected leg. Movement strategies of the knees and trunk have been investigated, but less is known about movement strategies of the pelvis during advancing functional tasks, and how these strategies are associated with leg extension power. The aim of the study was to investigate pelvic movement strategies and leg extension power in patients with end-stage medial compartment knee osteoarthritis compared with controls. 57 patients (mean age 65.6 years) scheduled for medial uni-compartmental knee arthroplasty, and 29 age and gender matched controls were included in this cross-sectional study. Leg extension power was tested with the Nottingham Leg Extension Power-Rig. Pelvic range of motion was derived from an inertia-based measurement unit placed over the sacrum bone during walking, stair climbing and stepping. Patients had lower leg extension power than controls (20-39 %, P 0.06). Furthermore, an inverse association (coefficient: -0.03 to -0.04; R (2) = 13-22 %) between leg extension power and pelvic range of motion during stair and step descending was found in the patients. Compared to controls, patients with medial compartment knee osteoarthritis use greater pelvic movements during advanced functional performance tests, particularly when these involve descending tasks. Further studies should investigate if it is possible to alter these movement strategies by an intervention aimed at increasing strength and power for the patients.

Do intra-articular hyaluronic acid injections delay total knee replacement in patients with osteoarthritis - A Cox model analysis.

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Delbarre, Angélique; Amor, Bernard; Bardoulat, Isabelle; Tetafort, Aymeric; Pelletier-Fleury, Nathalie

2017-01-01

This study aimed to describe patients treated for knee osteoarthritis between 2006 and 2013 in France and to compare the delay from diagnosis to total knee replacement between patients who received intra-articular hyaluronic acid injections and those who did not receive the injections. A second objective was to compare direct medical costs for ambulatory care between treatment groups. Patients were selected from a representative sample of the real world administrative claims database using an algorithm developed by experts from the scientific committee of the study. Data were matched with the medico-administrative database for hospital care. A Cox proportional hazards model was stratified for the treatment group and adjusted for available socio-demographic and medical covariates to compare restricted mean survival times at different time points (1, 3, 5 and 7.5 years) between groups. Costs were expressed in 2013 euros. A total of 14,782 patients were treated for knee osteoarthritis (67% women; mean age = 68 years). Among this population, 1,662 patients had total knee replacement (11.2%). At each time point, restricted mean survival time without total knee replacement was significantly higher (p-valueshyaluronic acid group, from +51 to +217 days at 1 and 7.5 years, respectively. For the year preceding total knee replacement, the means for total direct medical costs were similar between groups, €744 vs €805 for treatment and control groups, respectively, (p-value = 0.104). Intra-articular injections accounted for less than 10% of the total costs. This is the first retrospective longitudinal study involving knee osteoarthritis patients using medico-administrative databases in France. The results support the effectiveness of hyaluronic acid injections in delaying total knee replacement and show that patients treated with hyaluronic acid have similar direct medical costs for ambulatory care compared to patients treated with corticosteroids only.

[The feasibility of the application of cryotherapy and radonotherapy for the treatment of the patients presenting with osteoarthritis].

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Vakulenko, O Y; Rassulova, M A; Razumov, A N

2017-12-05

Osteoarthritis (OA) is currently considered to be one of the most widespread diseases. Its main clinical symptoms include pain and dysfunction of joints. In the present review of the foreign and domestic literature, the questions of pathogenesis and risk factors underlying the development of osteoarthritis are discussed. The understanding of OA pathogenesis have altered essentially in the recent years which made necessary the search for the novel approaches to the treatment of this pathology. According to the modern views of OA origin and progression, its therapy should be based on the application of the combination of medicamentous and non-medicamentous modalities including, in particular, collective and individual activities focused on the implementation of the programs of therapeutic physical training as an obligatory component of ОА prophylaxis and treatment. The present review gives evidence of the feasibility of the application of the methods of cryotherapy and radonotherapy for the management of the patients suffering from osteoarthritis. It is emphasized that many recent publications report extensive investigations of the clinical and pathogenetic aspects of the application of these methods for the combined regenerative treatment of the patients presenting with gonarthrosis. The influence of cryotherapy and radonotherapy on the neuroendocrine and immune systems is discussed with special reference to the possibility of regulation of the metabolic processes and retardation of inflammation. It is concluded that the introduction of the above methods into the compulsory individual program for the regenerative treatment of patients presenting with osteoarthritis is pathologically substantiated since it greatly contributes to the reduction of pain and retardation of the progress of the disease. The main pharmaceutical preparations for the OA treatment remain to be slow-acting symptomatic medicines possessed of the chondro-protective effect.

Reliability of classification for post-traumatic ankle osteoarthritis.

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Claessen, Femke M A P; Meijer, Diederik T; van den Bekerom, Michel P J; Gevers Deynoot, Barend D J; Mallee, Wouter H; Doornberg, Job N; van Dijk, C Niek

2016-04-01

The purpose of this study was to identify the most reliable classification system for clinical outcome studies to categorize post-traumatic-fracture-osteoarthritis. A total of 118 orthopaedic surgeons and residents-gathered in the Ankle Platform Study Collaborative Science of Variation Group-evaluated 128 anteroposterior and lateral radiographs of patients after a bi- or trimalleolar ankle fracture on a Web-based platform in order to rate post-traumatic osteoarthritis according to the classification systems coined by (1) van Dijk, (2) Kellgren, and (3) Takakura. Reliability was evaluated with the use of the Siegel and Castellan's multirater kappa measure. Differences between classification systems were compared using the two-sample Z-test. Interobserver agreement of surgeons who participated in the survey was fair for the van Dijk osteoarthritis scale (k = 0.24), and poor for the Takakura (k = 0.19) and the Kellgren systems (k = 0.18) according to the categorical rating of Landis and Koch. This difference in one categorical rating was found to be significant (p osteoarthritis scale, and poor interobserver agreement for the Takakura and Kellgren osteoarthritis classification systems. Because of the low interobserver agreement for the van Dijk, Kellgren, and Takakura classification systems, those systems cannot be used for clinical decision-making. Development of diagnostic criteria on basis of consecutive patients, Level II.

Imaging of early spontaneous osteonecrosis and osteoarthritis of the knee

International Nuclear Information System (INIS)

Kusayama, Takeshi; Tomatsu, Taisuke

1999-01-01

In this paper, the available of MRI in diagnosis on early spontaneous osteonecrosis and osteoarthritis was investigated. Subjects were 5 cases (5 knees) with spontaneous osteonecrosis (stage 1 in Koshino's classification) and 96 cases (104 knees) in osteoarthritis who were more than 50 years old. Patients with an early spontaneous osteonecrosis were elderly females and had night pain and severe spontaneous pain. On MRI, lesions of all cases were clearly detected in early stage. On the other hand, only 47 of 104 knees (45%) were detected in patients with osteoarthritis, and mirror lesions at shank sides were detected in 45 of 47 knees. These results suggest that it is possible to diagnose early spontaneous osteonecrosis from osteoarthritis by MRI image with the clue to mirror lesion at shank sides, incidence, stage, etc. On the diagnosis of early spontaneous osteonecrosis, MRI image should be performed as soon as possible if a patient was older, had no anamnesis of lesions, and no changes by the X-ray radiography in spite of severe pain of the knee joints. (K.H.)

Pain and disability in patients with osteoarthritis of hip or knee: the relationship with articular, kinesiological, and psychological characteristics

NARCIS (Netherlands)

van Baar, M. E.; Dekker, J.; Lemmens, J. A.; Oostendorp, R. A.; Bijlsma, J. W.

1998-01-01

To determine to what extent articular, kinesiological, and psychological factors each contribute to pain and disability in patients with osteoarthritis (OA), after controlling for other factors. Cross sectional study among 200 patients with OA of the hip or knee. Dependent variables include pain

A Water Rehabilitation Program in Patients with Hip Osteoarthritis Before and After Total Hip Replacement.

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Łyp, Marek; Kaczor, Ryszard; Cabak, Anna; Tederko, Piotr; Włostowska, Ewa; Stanisławska, Iwona; Szypuła, Jan; Tomaszewski, Wiesław

2016-07-25

BACKGROUND Pain associated with coxarthrosis, typically occurring in middle-aged and elderly patients, very commonly causes considerable limitation of motor fitness and dependence on pharmacotherapy. This article provides an assessment of a rehabilitation program with tailored water exercises in patients with osteoarthritis before and after total hip replacement. MATERIAL AND METHODS A total of 192 patients (the mean age 61.03±10.89) suffering from hip osteoarthritis (OA) were evaluated before and after total hip replacement (THR). The clinical study covered measurements of hip active ranges of motion (HAROM) and the forces generated by pelvis stabilizer muscles. Pain intensity was assessed according to analogue-visual scale of pain (VAS) and according to the Modified Laitinen Questionnaire. The patients were divided into 6 groups (4 treatment and 2 control). We compared 2 rehabilitation programs using kinesitherapy and low-frequency magnetic field. One of them also had specially designed exercises in the water. Statistical analysis was carried out at the significance level α=0.05. This was a cross-sectional study. RESULTS A positive effect of water exercises on a number of parameters was found in patients with OA both before and after total hip replacement surgery. We noted a significant reduction of pain (pwater exercises most significantly reduced pain in patients with OA before and after total hip replacement surgery. 2. Inclusion of water exercises in a rehabilitation program can reduce the use of medicines in patient with OA and after THR.

Biological Basis for the Use of Botanicals in Osteoarthritis and Rheumatoid Arthritis: A Review

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Salahuddin Ahmed

2005-01-01

Full Text Available Osteoarthritis (OA of the knee and hip is a debilitating disease affecting more women than men and the risk of developing OA increases precipitously with aging. Rheumatoid arthritis (RA, the most common form of inflammatory joint diseases, is a disease of unknown etiology and affects ∼1% of the population worldwide, and unlike OA, generally involves many joints because of the systemic nature of the disease. Non-steroidal anti-inflammatory drugs (NSAIDs are the first drugs of choice for the symptomatic treatment of both OA and RA. Because of the risks associated with the use of NSAIDs and other limitations, the use of alternative therapies, such as acupuncture and medicinal herbs, is on the rise and according to reports ∼60–90% of dissatisfied arthritis patients are likely to seek the option of complementary and alternative medicine (CAM. This paper reviews the efficacy of some of the common herbs that have a history of human use and their anti-inflammatory or antiarthritic properties have been evaluated in animal models of inflammatory arthritis, in studies employing well defined and widely accepted in vitro models that use human chondrocytes/cartilage explants or in clinical trials. Available data suggests that the extracts of most of these herbs or compounds derived from them may provide a safe and effective adjunctive therapeutic approach for the treatment of OA and RA. This, in turn, argues for trials to establish efficacy and optimum dosage of these compounds for treating human inflammatory and degenerative joint diseases.

The relationship between chondromalacia patella, medial meniscal tear and medial periarticular bursitis in patients with osteoarthritis

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Resorlu Mustafa; Doner Davut; Karatag Ozan; Toprak Canan Akgun

2017-01-01

Abstract Background This study investigated the presence of bursitis in the medial compartment of the knee (pes anserine, semimembranosus-tibial collateral ligament, and medial collateral ligament bursa) in osteoarthritis, chondromalacia patella and medial meniscal tears. Patients and methods Radiological findings of 100 patients undergoing magnetic resonance imaging with a preliminary diagnosis of knee pain were retrospectively evaluated by two radiologists. The first radiologist assessed al...

Sagittal plane gait characteristics in hip osteoarthritis patients with mild to moderate symptoms compared to healthy controls: a cross-sectional study

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Eitzen Ingrid

2012-12-01

Full Text Available Abstract Background Existent biomechanical studies on hip osteoarthritic gait have primarily focused on the end stage of disease. Consequently, there is no clear consensus on which specific gait parameters are of most relevance for hip osteoarthritis patients with mild to moderate symptoms. The purpose of this study was to explore sagittal plane gait characteristics during the stance phase of gait in hip osteoarthritis patients not eligible for hip replacement surgery. First, compared to healthy controls, and second, when categorized into two subgroups of radiographic severity defined from a minimal joint space of ≤/>2 mm. Methods Sagittal plane kinematics and kinetics of the hip, knee and ankle joint were calculated for total joint excursion throughout the stance phase, as well as from the specific events initial contact, midstance, peak hip extension and toe-off following 3D gait analysis. In addition, the Western Ontario and McMaster Universities Osteoarthritis Index, passive hip range of motion, and isokinetic muscle strength of hip and knee flexion and extension were included as secondary outcomes. Data were checked for normality and differences evaluated with the independent Student’s t-test, Welch’s t-test and the independent Mann–Whitney U-test. A binary logistic regression model was used in order to control for velocity in key variables. Results Fourty-eight hip osteoarthritis patients and 22 controls were included in the final material. The patients walked significantly slower than the controls (p=0.002, revealed significantly reduced joint excursions of the hip (pp=0.011, and a reduced hip flexion moment at midstance and peak hip extension (p2 mm suggested that the observed deviations were more pronounced in patients with greater radiographic severity. The biomechanical differences were, however, not reflected in self-reported symptoms or function. Conclusions Reduced gait velocity, reduced sagittal plane joint excursion, and

Influence of weight loss on the clinical manifestations of osteoarthritis of the knee-joints.

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Inna Vladimirovna Solov'eva

2014-10-01

Full Text Available Obesity consistently associated with the development of a number of chronic diseases, leading to a decrease in quality of life, disability and death. The article examines the connection between obesity and disease of the musculoskeletal system, describes the mechanisms by means of which obesity leads to the development of osteoarthritis. It is evident that reduction of body mass can slow the progression of osteoporosis. The own experience of non-pharmacological and pharmacological treatment of obesity with the use of orlistat in 50 obese patients with osteoarthritis of the knee II–III stage is presented. Treatment has resulted in a decrease in body weight, waist circumference, accompanied by a decrease in symptoms osteoarthritis among all the patients. Our results showed that the addition of orlistat to standard osteoarthritis scheme leads to significant reduction in weight and reduction of clinical manifestations of osteoarthritis. According to the above, the drugs that have impact on weight loss, should be included in the treatment regimen of patients with osteoarthritis and obesity.

Osteoarthritis in Spain: A nationwide survey of medical specialists.

Science.gov (United States)

Arriaza, Rafael; Sancho, Carlos; Fernandez-Gutierrez, Benjamin

2017-11-25

To determine the reality of the resources and care needs in Spain for the management of patients with osteoarthritis. An online survey. Description of 190 responses to a structured questionnaire (141 orthopedic surgeons and 49 rheumatologists). Osteoarthritis has yet to receive appropriate medical attention and a patient management model. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

The conservative treatment of ankle osteoarthritis

NARCIS (Netherlands)

Witteveen, A.G.H.

2015-01-01

In 70% to 78% of patients with ankle osteoarthritis (OA), they present themselves with the sequelae of a traumatic event in the past. Ankle trauma occurs in many patients at a relatively young age. Consequently, the expected life span of many patients with ankle OA is relatively long. Many treatment

Vibratory perception threshold in young and middle-aged patients at high risk of knee osteoarthritis compared to controls

DEFF Research Database (Denmark)

Thorlund, Jonas Bloch; Shakoor, Najia; Ageberg, Eva

2012-01-01

Vibratory perception threshold (VPT) is impaired in patients with knee osteoarthritis (OA). It is, however, not known if sensory deficits precede or follow as a consequence of OA. The aim of this study was to investigate VPT in 2 independent groups of patients with high risk of future OA (young a...

The influence of sport participation on physical function in patients with osteoarthritis during and after exercise therapy.

NARCIS (Netherlands)

Veenhof, C.; Perry, S.; Lucas, C.

2012-01-01

Introduction: The objectives of this study were to investigate 1) in which sports activities patients with osteoarthritis (OA) participate, 2) the cross sectional differences in functional outcome between sports participants and nonsports participants and 3) the influence of regular sports

Individual patient data meta-analysis of trials investigating the effectiveness of intra-articular glucocorticoid injections in patients with knee or hip osteoarthritis

DEFF Research Database (Denmark)

van Middelkoop, Marienke; Dziedzic, Krysia S; Doherty, Michael

2013-01-01

Based on small to moderate effect sizes for the wide range of symptomatic treatments in osteoarthritis (OA), and on the heterogeneity of OA patients, treatment guidelines for OA have stressed the need for research on clinical predictors of response to different treatments. A meta...

Is increased joint loading detrimental to obese patients with knee osteoarthritis? A secondary data analysis from a randomized trial.

Science.gov (United States)

Henriksen, M; Hunter, D J; Dam, E B; Messier, S P; Andriacchi, T P; Lohmander, L S; Aaboe, J; Boesen, M; Gudbergsen, H; Bliddal, H; Christensen, R

2013-12-01

To investigate whether increased knee joint loading due to improved ambulatory function and walking speed following weight loss achieved over 16 weeks accelerates symptomatic and structural disease progression over a subsequent 1 year weight maintenance period in an obese population with knee osteoarthritis (OA). Data from a prospective study of weight loss in obese patients with knee OA (the CARtilage in obese knee OsteoarThritis (CAROT) study) were used to determine changes in knee joint compressive loadings (model estimated) during walking after a successful 16 week weight loss intervention. The participants were divided into 'Unloaders' (participants that reduced joint loads) and 'Loaders' (participants that increased joint loads). The primary symptomatic outcome was changes in knee symptoms, measured with the Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire, during a subsequent 52 weeks weight maintenance period. The primary structural outcome was changes in tibiofemoral cartilage loss assessed semi-quantitatively (Boston Leeds Knee Osteoarthritis Score (BLOKS) from MRI after the 52 weight maintenance period. 157 participants (82% of the CAROT cohort) with medial and/or lateral knee OA were classified as Unloaders (n = 100) or Loaders (n = 57). The groups showed similar significant changes in symptoms (group difference: -2.4 KOOS points [95% CI -6.8:1.9]) and cartilage loss (group difference: -0.06 BLOKS points [95% CI -0.22:0.11) after 1 year, with no statistically significant differences between Loaders and Unloaders. For obese patients undergoing a significant weight loss, increased knee joint loading for 1 year was not associated with accelerated symptomatic and structural disease progression compared to a similar weight loss group that had reduced ambulatory compressive knee joint loads. NCT00655941. Copyright © 2013 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Existence of a neuropathic pain component in patients with osteoarthritis of the knee.

Science.gov (United States)

Ohtori, Seiji; Orita, Sumihisa; Yamashita, Masaomi; Ishikawa, Tetsuhiro; Ito, Toshinori; Shigemura, Tomonori; Nishiyama, Hideki; Konno, Shin; Ohta, Hideyuki; Takaso, Masashi; Inoue, Gen; Eguchi, Yawara; Ochiai, Nobuyasu; Kishida, Shunji; Kuniyoshi, Kazuki; Aoki, Yasuchika; Arai, Gen; Miyagi, Masayuki; Kamoda, Hiroto; Suzkuki, Miyako; Nakamura, Junichi; Furuya, Takeo; Kubota, Gou; Sakuma, Yoshihiro; Oikawa, Yasuhiro; Suzuki, Masahiko; Sasho, Takahisa; Nakagawa, Koichi; Toyone, Tomoaki; Takahashi, Kazuhisa

2012-07-01

Pain from osteoarthritis (OA) is generally classified as nociceptive (inflammatory). Animal models of knee OA have shown that sensory nerve fibers innervating the knee are significantly damaged with destruction of subchondral bone junction, and induce neuropathic pain (NP). Our objective was to examine NP in the knees of OA patients using painDETECT (an NP questionnaire) and to evaluate the relationship between NP, pain intensity, and stage of OA. Ninety-two knee OA patients were evaluated in this study. Pain scores using Visual Analogue Scales (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), painDETECT, duration of symptoms, severity of OA using the Kellgren-Lawrence (KL) system, and amount of joint fluid were evaluated and compared using a Spearman's correlation coefficient by rank test. Our study identified at least 5.4% of our knee OA patients as likely to have NP and 15.2% as possibly having NP. The painDETECT score was significantly correlated with the VAS and WOMAC pain severity. Compared with the painDETECT score, there was a tendency for positive correlation with the KL grade, and tendency for negative correlation with the existence and amount of joint fluid, but these correlations were not significant. PainDETECT scores classified 5.4% of pain from knee OA as NP. NP tended to be seen in patients with less joint fluid and increased KL grade, both of which corresponded to late stages of OA. It is important to consider the existence of NP in the treatment of knee OA pain.

Effects of neuromuscular training (NEMEX-TJR) on patient-reported outcomes and physical function in severe primary hip or knee osteoarthritis

DEFF Research Database (Denmark)

Ageberg, Eva; Nilsdotter, Anna; Kosek, Eva

2013-01-01

The benefits of exercise in mild and moderate knee or hip osteoarthritis (OA) are apparent, but the evidence in severe OA is less clear. We recently reported that neuromuscular training was well tolerated and feasible in patients with severe primary hip or knee OA. The aims of this controlled bef...... before-and-after study were to compare baseline status to an age-matched population-based reference group and to examine the effects of neuromuscular training on patient-reported outcomes and physical function in patients with severe primary OA of the hip or knee.......The benefits of exercise in mild and moderate knee or hip osteoarthritis (OA) are apparent, but the evidence in severe OA is less clear. We recently reported that neuromuscular training was well tolerated and feasible in patients with severe primary hip or knee OA. The aims of this controlled...

Validation of the Spanish version of the WOMAC questionnaire for patients with hip or knee osteoarthritis. Western Ontario and McMaster Universities Osteoarthritis Index.

Science.gov (United States)

Escobar, A; Quintana, J M; Bilbao, A; Azkárate, J; Güenaga, J I

2002-11-01

The aim of this study was to validate a translated version of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire in Spanish patients with hip or knee osteoarthritis (OA). The WOMAC questionnaire and the SF-36 were administered to a sample of 269 patients on the waiting list for hip or knee replacement. We studied the convergent validity and the item-scale correlation using Pearson's correlation coefficient and Spearman's pi. For the reliability study we used another sample of 58 patients who received the WOMAC twice within 15 days. The Pearson's, Spearman's pi, and intraclass correlation coefficients were calculated. Internal consistency was measured by Cronbach's alpha. The responsiveness study was carried out by resending the two questionnaires to all patients 6 months after surgical intervention; responsiveness was measured by means of the paired t-test, the effect size I and the standardised response mean. The Pearson's coefficients for the convergent validity ranged from -0.52 to -0.63. The coefficients obtained for the item-scale correlation of the pain area were 0.74 or higher, 0.91 or higher for stiffness, and 0.61 or higher for function. When measuring the test-retest reliability, the coefficients ranged from 0.66 to 0.81. Internal consistency yielded a Cronbach's alpha ranging from 0.81 to 0.93. The responsiveness showed an effect size I ranging from 1.5 to 2.2 in patients who underwent hip replacement; for those who underwent knee replacement the range was 1 to 1.8. The standardised response mean ranged from 1.3 to 1.9 for patients with hip OA; those with knee OA ranged from 0.8 to 1.5. The Spanish version of WOMAC is a valid, reliable and responsive instrument in patients with hip or knee OA.

Cardiovascular safety of biologic therapies for the treatment of RA.

Science.gov (United States)

Greenberg, Jeffrey D; Furer, Victoria; Farkouh, Michael E

2011-11-15

Cardiovascular disease represents a major source of extra-articular comorbidity in patients with rheumatoid arthritis (RA). A combination of traditional cardiovascular risk factors and RA-related factors accounts for the excess risk in RA. Among RA-related factors, chronic systemic inflammation has been implicated in the pathogenesis and progression of atherosclerosis. A growing body of evidence--mainly derived from observational databases and registries--suggests that specific RA therapies, including methotrexate and anti-TNF biologic agents, can reduce the risk of future cardiovascular events in patients with RA. The cardiovascular profile of other biologic therapies for the treatment of RA has not been adequately studied, including of investigational drugs that improve systemic inflammation but alter traditional cardiovascular risk factors. In the absence of large clinical trials adequately powered to detect differences in cardiovascular events between biologic drugs in RA, deriving firm conclusions on cardiovascular safety is challenging. Nevertheless, observational research using large registries has emerged as a promising approach to study the cardiovascular risk of emerging RA biologic therapies.

IL-1Ra: its role in rheumatoid arthritis

Directory of Open Access Journals (Sweden)

M. Cutolo

2011-09-01

Full Text Available Interleukin-1 (IL-1 is one of the pivotal cytokines in initiating and driving the processes of rheumatoid arthritis (RA, and the body’s natural response, IL-1 receptor antagonist (IL-1Ra, has been shown conclusively to block its effects. IL-1 mediate several clinical symptoms of the inflammatory reaction (i.e. fever, pain, sleep disturbances. IL-1 is considered a key mediator in RA joint damage because of its greater capacity (greater than TNF of increasing matrix degradation by inducing the production of MMPs and PGE2 in synovial cells, as well by its role as mediator of bone and cartilage destruction. In addition, IL-1 decreases the repair process by suppressing matrix synthesis and shows a strong synergism with TNF in inducing many inflammatory genes at both local and systemic level. The induced endogenous production of IL-1Ra, in presence of the RA synovitis, is too low to contrast the high affinity of IL-1 for the cell receptors. Therefore, IL-1Ra presence should result in very effective prevention of IL-1 signal transduction particularly in the inflammatory site. In laboratory and animal studies inhibition of IL-1 by either antibodies to IL-1 or IL-1Ra proved beneficial to the outcome. IL-1Ra is a member of the IL-1 superfamily. The effects of different DMARDs on IL-1Ra levels in RA patients support the important role that selected anticytokine treatments might exert in the pathophysiology of the disease. However, since anti TNFα therapy it is not effective in all RA patients, nor does it fully control the arthritic process in affected joints of good responders and complete TNF suppression should be avoided, the combined treatment with intermediate doses of TNF and IL-1 blockers, reaching synergistic suppression of arthritis, seems warranted in RA.

Gait changes in patients with knee osteoarthritis are replicated by experimental knee pain

DEFF Research Database (Denmark)

Henriksen, Marius; Nielsen, Thomas Graven; Aaboe, Jens

2010-01-01

Medial knee osteoarthritis (OA) is characterized by pain and associated with abnormal knee moments during walking. The relationship between knee OA pain and gait changes remains to be clarified, and a better understanding of this link could advance the treatment and prevention of disease...... progression. This study investigated changes in knee moments during walking following experimental knee pain in healthy volunteers, and whether these changes replicated the joint moments observed in medial knee OA patients....

Nonsteroidal anti-inflammatory drug or glucosamine reduced pain and improved muscle strength with resistance training in a randomized controlled trial of knee osteoarthritis patients

DEFF Research Database (Denmark)

Petersen, Susanne G; Beyer, Nina; Hansen, Mette

2011-01-01

Petersen SG, Beyer N, Hansen M, Holm L, Aagaard P, Mackey AL, Kjaer M. Nonsteroidal anti-inflammatory drug or glucosamine reduced pain and improved muscle strength with resistance training in a randomized controlled trial of knee osteoarthritis patients.......Petersen SG, Beyer N, Hansen M, Holm L, Aagaard P, Mackey AL, Kjaer M. Nonsteroidal anti-inflammatory drug or glucosamine reduced pain and improved muscle strength with resistance training in a randomized controlled trial of knee osteoarthritis patients....

How to define responders in osteoarthritis

Science.gov (United States)

Cooper, Cyrus; Adachi, Jonathan D.; Bardin, Thomas; Berenbaum, Francis; Flamion, Bruno; Jonsson, Helgi; Kanis, John A.; Pelousse, Franz; Lems, Willem F.; Pelletier, Jean-Pierre; Martel-Pelletier, Johanne; Reiter, Susanne; Reginster, Jean-Yves; Rizzoli, René; Bruyère, Olivier

2013-01-01

Background Osteoarthritis is a clinical syndrome of failure of the joint accompanied by varying degrees of joint pain, functional limitation, and reduced quality of life due to deterioration of articular cartilage and involvement of other joint structures. Scope Regulatory agencies require relevant clinical benefit on symptoms and structure modification for registration of a new therapy as a disease-modifying osteoarthritis drug (DMOAD). An international Working Group of the European Society on Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) and International Osteoporosis Foundation was convened to explore the current burden of osteoarthritis, review current regulatory guidelines for the conduct of clinical trials, and examine the concept of responder analyses for improving drug evaluation in osteoarthritis. Findings The ESCEO considers that the major challenges in DMOAD development are the absence of a precise definition of the disease, particularly in the early stages, and the lack of consensus on how to detect structural changes and link them to clinically meaningful endpoints. Responder criteria should help identify progression of disease and be clinically meaningful. The ideal criterion should be sensitive to change over time and should predict disease progression and outcomes such as joint replacement. Conclusion The ESCEO considers that, for knee osteoarthritis, clinical trial data indicate that radiographic joint space narrowing >0.5 mm over 2 or 3 years might be a reliable surrogate measure for total joint replacement. On-going research using techniques such as magnetic resonance imaging and biochemical markers may allow the identification of these patients earlier in the disease process. PMID:23557069

226Ra, 228Ra, 223Ra, and 224Ra in coastal waters with application to coastal dynamics and groundwater input

International Nuclear Information System (INIS)

Moore, W.S.

1997-01-01

Four radium isotopes offer promise in unraveling the complex dynamics of coastal ocean circulation and groundwater input. Each isotope is produced by decay of a thorium parent bound to sediment. The activities of these thorium isotopes and the sediment-water distribution coefficient for radium provide an estimate of the source function of each Ra isotope to the water. In salt marshes that receive little surface water input, Ra activities which exceed coastal ocean values must originate within the marsh. In North Inlet, South Carolina, the activities of 226 Ra exported from the marsh far exceed the activities generated within the marsh. To supply the exported activities, substantial groundwater input is required. In the coastal region itself, 226 Ra activities exceed the amount that can be supplied from rivers. Here also, substantial groundwater input is required. Within the coastal ocean, 223 Ra and 224 Ra may be used to determine mixing rates with offshore waters. Shore-perpendicular profiles of 223 Ra and 224 Ra show consistent trends which may be modeled as eddy diffusion coefficients of 350-540 m 2 s -1 . These coefficients allow an assessment of cross-shelf transport and provide further insight on the importance of groundwater to coastal regions. (author)

[Gluteal muscle contracture release for the treatment of gluteal muscle contracture induced knee osteoarthritis: a report of 52 cases].

Science.gov (United States)

Wang, Cheng-xiang; Gong, Yu-suo; Li, Sheng-hua; Liu, Hai-ping; Chai, Xi-ping

2011-07-01

To investigate clinical efficacy and significance of gluteal muscle contracture release for the treatment of gluteal muscle contracture induced knee osteoarthritis. From January 2008 to June 2010,52 patients with gluteal muscle contracture induced knee osteoarthritis were reviewed. Among the patients,15 patients were male and 37 patients were female, ranging in age from 15 to 45 years, with an average of 35 years. Eighteen patients had left knee osteoarthritis, 30 patients had right osteoarthritis, and 4 patients had double knee osteoarthritis. All the patients were treated with gluteal muscle contracture release. Lysholm knee score was used to evaluate therapeutic effects before and after operation. All the patients were followed up,and the duration ranged from 12 to 37 years,with a mean of 15 months. The Lysholm knee score improved from preoperative (68.12 +/- 0.78) points to postoperative (91.23 +/- 0.47) points at the last follow-up, the difference had statistical difference (t=31.269, Pmuscle contracture release is effective to relieve symptoms of gluteal muscles contracture and knee osteoarthritis. The patients with gluteal muscle contracture should be treated early so as to prevent effects of gluteal muscle contracture on knee joint, slow down degeneration of knee joint at early stage, and prevent occurrence of knee osteoarthritis.

Immediate effects of electroacupuncture and manual acupuncture on pain, mobility and muscle strength in patients with knee osteoarthritis: a randomised controlled trial.

Science.gov (United States)

Plaster, Ralph; Vieira, Wellington Bueno; Alencar, Flávia Alves Duarte; Nakano, Eduardo Yoshio; Liebano, Richard Eloin

2014-06-01

To compare the immediate effects of electroacupuncture and manual acupuncture on pain, mobility and muscle strength in patients with knee osteoarthritis. Sixty patients with knee osteoarthritis, with a pain intensity of ≥2 on the pain Numerical Rating Scale, were included. The patients were randomised into two groups: manual acupuncture and electroacupuncture. Pain intensity, degree of dysfunction (Timed Up and Go (TUG) test), maximal voluntary isometric contraction and pressure pain threshold were assessed before and after a single session of manual acupuncture or electroacupuncture treatments. Both groups showed a significant reduction in pain intensity (pelectroacupuncture group). There were no differences between the groups regarding pain intensity (p=0.25), TUG test (p=0.70), maximum voluntary isometric contraction (p=0.43) or pressure pain threshold (p=0.27). This study found no difference between the immediate effects of a single session of manual acupuncture and electroacupuncture on pain, muscle strength and mobility in patients with knee osteoarthritis. RBR-9TCN2X. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The influence of sport participation on physical function in patients with osteoarthritis during and after exercise therapy.

NARCIS (Netherlands)

Perry, S.; Lucas, C.; Veenhof, C.

2012-01-01

Purpose: The objectives of this study were 1. to investigate in which sports activities patients with osteoarthritis (OA) participate, 2. the cross sectional differences in functional outcome between sport participators (SP) and non-sport participators (N-SP) and 3. the influence of sport

Topical Effects of Artemisia Absinthium Ointment and Liniment in Comparison with Piroxicam Gel in Patients with Knee Joint Osteoarthritis: A Randomized Double-Blind Controlled Trial.

Science.gov (United States)

Basiri, Zahra; Zeraati, Fatemeh; Esna-Ashari, Farzaneh; Mohammadi, Farshid; Razzaghi, Keyvan; Araghchian, Malihe; Moradkhani, Shirin

2017-11-01

Pain alleviation and improvement of functional status are the main objectives in the treatment of osteoarthritis. Artemisia absinthium (AA) was used traditionally in reducing pain and inflammation. The aim of the present study was to compare the effects of topical formulations of AA and piroxicam gel (PG) among patients with knee osteoarthritis. In total, 90 outpatients aged 30-70 years with the diagnosis of primary osteoarthritis in at least one knee were enrolled in a randomized double-blind clinical trial. The patients referred to the Rheumatology Clinic at Shahid Beheshti Hospital in Hamadan province during 2012-2013. The patients were randomly assigned into three groups, 30 patients per group, and respectively received AA ointment (AAO) 3%, AA liniment (AAL) 3%, and PG; three times daily (TID) for 4 weeks. The patients were visited at baseline, week 4, and week 6. The effectiveness criteria were pain severity which was assessed with a 10-point visual analog scale (VAS), the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) for total pain score (WTPS), total physical function score (WTPFS), and total stiffness score (WTSS). Repeated measure ANOVA, paired t test and post hoc were used to compare variables. Statistical analysis was performed using the SPSS software, version 13.0 (SPSS Inc., Chicago, Illinois). All groups had similar patient demographics. The administration of PG significantly improved all tested criteria with no recurrence after discontinuing the treatment protocol. AAO alleviated all tested factors except for WTSS. Alleviation was comparable to PG. AAL only reduced pain factors (VAS, WTPS) in week 4 with recurrence in week 6. Administration of Artemisia ointment may have beneficial effects in the treatment of osteoarthritis. Trial Registration Number: IRCT201202123109N3.

Long-term effect of exercise therapy in patients with osteoarthritis: a randomized controlled trial comparing two different physiotherapy interventions.

NARCIS (Netherlands)

Pisters, M.; Veenhof, C.; Schellevis, F.; Bakker, D. de; Dekker, J.

2011-01-01

Purpose: To determine if behavioural graded activity (BGA) results in better long-term effectiveness (5 years after inclusion) than usual exercise therapy (UC; usual care) in patients with OA of the hip or knee. Relevance: The positive effects of exercise therapy in patients with osteoarthritis seem

Educating patients about the benefits of physical activity and exercise for their hip and knee osteoarthritis. Systematic literature review.

Science.gov (United States)

Gay, C; Chabaud, A; Guilley, E; Coudeyre, E

2016-06-01

Highlight the role of patient education about physical activity and exercise in the treatment of hip and knee osteoarthritis (OA). Systematic literature review from the Cochrane Library, PubMed and Wiley Online Library databases. A total of 125 items were identified, including 11 recommendations from learned societies interested in OA and 45 randomized controlled trials addressing treatment education and activity/exercise for the treatment of hip and knee osteoarthritis. In the end, 13 randomized controlled trials and 8 recommendations were reviewed (1b level of evidence). Based on the analysis, it was clear that education, exercise and weight loss are the pillars of non-pharmacological treatments. These treatments have proven to be effective but require changes in patient behaviour that are difficult to obtain. Exercise and weight loss improve function and reduce pain. Education potentiates compliance to exercise and weight loss programs, thereby improving their long-term benefits. Cost efficiency studies have found a reduction in medical visits and healthcare costs after 12 months because of self-management programs. Among non-surgical treatment options for hip and knee osteoarthritis, the most recent guidelines focus on non-pharmacological treatment. Self-management for general physical activity and exercise has a critical role. Programs must be personalized and adjusted to the patient's phenotype. This development should help every healthcare professional adapt the care they propose to each patient. Registration number for the systematic review: CRD42015032346. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Determination of 226Ra and 228Ra in gypsum

International Nuclear Information System (INIS)

Godoy, J.M.

1989-01-01

The content of 226 Ra and 228 Ra in different samples of phosphogypsum and three samples of gypsite were determined by gamma spectroscopy. For 226 Ra the 295, 352 and 609 KeV lines and for 228 Ra the 911 and 969 KeV lines were used. The specific activities values ranged from 0.36 to 22.8 pCi/g for 226 Ra and 0.90 to 10.3 pCi/g for 228 Ra. The contribution of a sypsum roof-covering to the 222 Rn concentration in a room was estimated, based on the highest value reported. (author) [pt

Manual for guided home exercises for osteoarthritis of the knee

Directory of Open Access Journals (Sweden)

Nilza Aparecida de Almeida Carvalho

2010-06-01

Full Text Available INTRODUCTION: Physiotherapy is one of the most important components of therapy for osteoarthritis of the knee. The objective of this prospective case series was to assess the efficiency of a guidance manual for patients with osteoarthritis of the knee in relation to pain, range of movement , muscle strength and function, active goniometry, manual strength test and function. METHODS: Thirty-eight adults with osteoarthritis of the knee (> 45 years old who were referred to the physiotherapy service at the university hospital (Santa Casa de Misericórdia de São Paulo were studied. Patients received guidance for the practice of specific physical exercises and a manual with instructions on how to perform the exercises at home. They were evaluated for pain, range of movement, muscle strength and function. These evaluations were performed before they received the manual and three months later. Patients were seen monthly regarding improvements in their exercising abilities. RESULTS: The program was effective for improving muscle strength, controlling pain, maintaining range of movement of the knee joint, and reducing functional incapacity. DISCUSSION: A review of the literature showed that there are numerous clinical benefits to the regular practice of physical therapy exercises by patients with osteoarthritis of the knee(s in a program with appropriate guidance. This study shows that this guidance can be attained at home with the use of a proper manual. CONCLUSIONS: Even when performed at home without constant supervision, the use of the printed manual for orientation makes the exercises for osteoarthritis of the knee beneficial.

Immediate Efficacy of Neuromuscular Exercise in Patients with Severe Osteoarthritis of the Hip or Knee

DEFF Research Database (Denmark)

Villadsen, Allan; Overgaard, Søren; Holsgaard-Larsen, Anders

2014-01-01

and Osteoarthritis Outcome Score (HOOS) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire. The secondary outcomes were the HOOS/KOOS subscales Pain, Symptoms, Sport and Recreation, and Joint-related Quality of Life. Exploratory outcomes were functional performance measures and lower limb...... muscle power. RESULTS: Included were 165 patients, 56% female, average age 67 years (SD ± 8), and a body mass index of 30 (SD ± 5), who were scheduled for primary hip or knee replacement. The postintervention difference between mean changes in ADL was 7.2 points (95% CI 3.5 to 10.9, p = 0.0002) in favor...... and objective performance were improved and pain reduced immediately following 8 weeks of neuromuscular exercise. While the effects were moderate in hip OA, they were only small in knee OA. ClinicalTrials.gov Identifier: NCT01003756....

Leptin levels are negatively correlated with 2-arachidonoylglycerol in the cerebrospinal fluid of patients with osteoarthritis.

Directory of Open Access Journals (Sweden)

James Nicholson

Full Text Available There is compelling evidence in humans that peripheral endocannabinoid signaling is disrupted in obesity. However, little is known about the corresponding central signaling. Here, we have investigated the relationship between gender, leptin, body mass index (BMI and levels of the endocannabinoids anandamide (AEA and 2-arachidonoylglycerol (2-AG in the serum and cerebrospinal fluid (CSF of primarily overweight to obese patients with osteoarthritis.Patients (20 females, 15 males, age range 44-78 years, BMI range 24-42 undergoing total knee arthroplasty for end-stage osteoarthritis were recruited for the study. Endocannabinoids were quantified by liquid chromatography - mass spectrometry. AEA and 2-AG levels in the serum and CSF did not correlate with either age or BMI. However, 2-AG levels in the CSF, but not serum, correlated negatively with CSF leptin levels (Spearman's ρ -0.48, P=0.0076, n=30. No such correlations were observed for AEA and leptin.In the patient sample investigated, there is a negative association between 2-AG and leptin levels in the CSF. This is consistent with pre-clinical studies in animals, demonstrating that leptin controls the levels of hypothalamic endocannabinoids that regulate feeding behavior.

Leptin levels are negatively correlated with 2-arachidonoylglycerol in the cerebrospinal fluid of patients with osteoarthritis.

Science.gov (United States)

Nicholson, James; Azim, Syed; Rebecchi, Mario J; Galbavy, William; Feng, Tian; Reinsel, Ruth; Rizwan, Sabeen; Fowler, Christopher J; Benveniste, Helene; Kaczocha, Martin

2015-01-01

There is compelling evidence in humans that peripheral endocannabinoid signaling is disrupted in obesity. However, little is known about the corresponding central signaling. Here, we have investigated the relationship between gender, leptin, body mass index (BMI) and levels of the endocannabinoids anandamide (AEA) and 2-arachidonoylglycerol (2-AG) in the serum and cerebrospinal fluid (CSF) of primarily overweight to obese patients with osteoarthritis. Patients (20 females, 15 males, age range 44-78 years, BMI range 24-42) undergoing total knee arthroplasty for end-stage osteoarthritis were recruited for the study. Endocannabinoids were quantified by liquid chromatography - mass spectrometry. AEA and 2-AG levels in the serum and CSF did not correlate with either age or BMI. However, 2-AG levels in the CSF, but not serum, correlated negatively with CSF leptin levels (Spearman's ρ -0.48, P=0.0076, n=30). No such correlations were observed for AEA and leptin. In the patient sample investigated, there is a negative association between 2-AG and leptin levels in the CSF. This is consistent with pre-clinical studies in animals, demonstrating that leptin controls the levels of hypothalamic endocannabinoids that regulate feeding behavior.

The effect of mud therapy on pain relief in patients with knee osteoarthritis: a meta-analysis of randomized controlled trials.

Science.gov (United States)

Liu, Hua; Zeng, Chao; Gao, Shu-guang; Yang, Tuo; Luo, Wei; Li, Yu-sheng; Xiong, Yi-lin; Sun, Jin-peng; Lei, Guang-hua

2013-10-01

A meta-analysis was conducted to examine the effect of mud therapy on pain relief in patients with knee osteoarthritis (OA). A detailed search of PubMed®/MEDLINE® was undertaken to identify randomized controlled trials and prospective comparative studies published before 9 March 2013 that compared mud therapy with control group treatments in patients with knee OA. A quantitative meta-analysis of seven studies (410 patients) was performed. There was a significant difference between the groups in the visual analogue scale pain score (standardized mean difference [SMD] -0.73) and Western Ontario and McMaster Universities Osteoarthritis Index pain score (SMD -0.30), with differences in favour of mud therapy. Mud therapy is a favourable option for pain relief in patients with knee OA. Additional high-quality randomized controlled trials need to be conducted to explore this issue further and to confirm this conclusion.

Study for synovial lesions by MRI using gadolinium-DTPA (Gd-DTPA) in patients with early phase of rheumatoid arthritis

Energy Technology Data Exchange (ETDEWEB)

Takano, Keiyu (Saint Marianna Univ., Kawasaki, Kanagawa (Japan). School of Medicine)

1993-02-01

To evaluate the usefulness of magnetic resonanse imaging (MRI) enhanced with gadolinium-DTPA (Gd-DTPA) for the detection of the inflamed synovium and for the evaluation of the responce to therapy in rheumatoid arthritis, we studied 49 patients with rheumatoid arthritis (RA) according to the 1987 revised criteria of American Rheumatism Association (ARA), 6 patients with systemic lupus erythematosus (SLE) complicated by arthritis, 3 patients with osteoarthritis (OA), 2 patients with Sjoegren syndrome, 2 patients with progressive systemic sclerosis and 10 healthy volunteers as an age matched control. The 49 patients with RA were divided into three groups: (1) early phase of RA, (2) non progressing RA and (3) slowly progressing RA, and the stage classification of plain X-ray film and enhancement pattern of MR imaging were classified into three groups. Synovial enhancement showed a linear, band-like or diffuse pattern. Almost all cases in early phase of RA group and non progressing RA group showed a linear pattern, a band-like pattern or even no enhancement, while slowly progressing group of stage II or higher showed the diffuse pattern of enhancement in all except 2 cases. Moreover, the linear pattern, the band-like pattern or even no contrast enhancement were seen in all except 1 stage I patient, whereas 26 out of 29 patients with stage II or higher change showed diffuse contrast enhancement. Furthermore, a comparison of MR images before and after administration of disease modifying antirheumatic drugs (DMARDs) in 10 patients showed that the improvement of clinical symptomes correlated fairly well with reduction of contrast enhancement. The present study suggested that MRI of the wrist using Gd-DTPA enhancement may be useful for the diagnosis of RA, the prediction of articular damage, and judgement of the response to therapy. (author).

Joint proprioception, muscle strength, and functional ability in patients with osteoarthritis of the knee.

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van der Esch, M; Steultjens, M; Harlaar, J; Knol, D; Lems, W; Dekker, J

2007-06-15

To test the hypotheses that poor knee joint proprioception is related to limitations in functional ability, and poor proprioception aggravates the impact of muscle weakness on limitations in functional ability in osteoarthritis (OA) of the knee. Sixty-three patients with symptomatic OA of the knee were tested. Proprioceptive acuity was assessed by establishing the joint motion detection threshold (JMDT) in the anteroposterior direction. Muscle strength was measured using a computer-driven isokinetic dynamometer. Functional ability was assessed by the 100-meter walking test, the Get Up and Go (GUG) test, and the Western Ontario and McMaster Universities Osteoarthritis Index physical function (WOMAC-PF) questionnaire. Correlation analyses were performed to assess the relationship between proprioception, muscle strength, and functional ability. Regression analyses were performed to assess the impact of proprioception on the relationship between muscle strength and functional ability. Poor proprioception (high JMDT) was related to more limitation in functional ability (walking time r = 0.30, P < 0.05; GUG time r = 0.30, P < 0.05; WOMAC-PF r = 0.26, P <0.05). In regression analyses, the interaction between proprioception and muscle strength was significantly related to functional ability (walking time, P < 0.001 and GUG time, P < 0.001) but not to WOMAC-PF score (P = 0.625). In patients with poor proprioception, reduction of muscle strength was associated with more severe deterioration of functional ability than in patients with accurate proprioception. Patients with poor proprioception show more limitation in functional ability, but this relationship is rather weak. In patients with poor proprioception, muscle weakness has a stronger impact on limitations in functional ability than in patients with accurate proprioception.

Hyaluronic acid injections for osteoarthritis of the knee: predictors of successful treatment.

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Bowman, Eric N; Hallock, Justin D; Throckmorton, Thomas W; Azar, Fredrick M

2018-04-01

This study aimed to identify patient and treatment factors that predict a favourable response to intra-articular hyaluronic acid (HA) treatment to better guide patient and treatment selection. This prospective, observational study evaluated patients with mild-to-moderate (Kellgren-Lawrence grades 1-3) primary knee osteoarthritis treated between March 2013 and May 2016. Patient function and pain scores were assessed by the Western Ontario and McMaster Universities Arthritis Index/Knee Injury and Osteoarthritis Outcome Score (WOMAC/KOOS) and visual analogue scale (VAS) surveys, with response to treatment defined according to the Osteoarthritis Research Society International (OARSI) 2004 criteria. Surveys were completed at each injection and three months post-treatment. Patients were followed an average of 27 months. Of 102 patients, 57% had a positive response. Those at least twice as likely to respond were patients with grades 1-2 osteoarthritis or a positive response to the first injection and those who were ≥60 years. Gender, race, body mass index (BMI), smoking status, HA brand, and initial VAS and WOMAC/KOOS scores were not significant predictors of success. Mean time to arthroplasty following injection series was 11 months (30% of nonresponders, 12% of responders). The VAS strongly correlated with KOOS pain scores and successful outcomes. Patients with mild-to-moderate osteoarthritis (grades 1-2) and those responding positively to the first injection were twice as likely to respond positively to the injection series, as were patients ≥60 years. Patients who did not respond positively were more likely to proceed to arthroplasty. The VAS appears to be a reliable method of defining and monitoring treatment success. Judicious patient selection and counseling may improve outcomes associated with intra-articular HA injections.

Resurfacing hemiarthroplasty compared to stemmed hemiarthroplasty for glenohumeral osteoarthritis

DEFF Research Database (Denmark)

Rasmussen, Jeppe V; Olsen, Bo S; Sorensen, Anne Kathrine

2015-01-01

PURPOSE: The aim of this study was to conduct a randomised, clinical trial comparing stemmed hemiarthroplasty and resurfacing hemiarthroplasty in the treatment of glenohumeral osteoarthritis. METHODS: A total of 40 shoulders (35 patients) were randomised to stemmed hemiarthroplasty or resurfacing...... hemiarthroplasty and evaluated three and 12 months postoperatively using the Constant-Murley score (CMS) and Western Ontario Osteoarthritis of the Shoulder (WOOS) index. RESULTS: There were no statistically significant differences in age, gender or pre-operative scores except for WOOS at baseline. Two patients...

Efficacy and safety of ginger in osteoarthritis patients

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Bartels, E M; Folmer, V N; Bliddal, Henning

2015-01-01

The aim of this study was to assess the clinical efficacy and safety of oral ginger for symptomatic treatment of osteoarthritis (OA) by carrying out a systematic literature search followed by meta-analyses on selected studies. Inclusion criteria were randomized controlled trials (RCTs) comparing ...

RAPID3 scores and hand outcome measurements in RA patients: a preliminary study.

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Qorolli, Merita; Hundozi-Hysenaj, Hajrije; Rexhepi, Sylejman; Rehxepi, Blerta; Grazio, Simeon

2017-06-01

The Routine Assessment of Patient Index Data 3 (RAPID3) is a patient-reported disease activity measure used to assess physical function, pain, and global health in patients with rheumatoid arthritis (RA) without formal joint counts. Since hand involvement and its decreased function are hallmarks of RA, the aim of our study was to investigate the performance of RAPID3 scores with regard to hand function and to confirm previous findings that the RAPID3 score as a disease activity measure is strongly correlated with the DAS28 score. Sixty-eight consecutive patients with RA (85% female), aged 18-75 years, were included in the study and were recruited during their outpatient visit. Apart from demographic and clinical data, the obtained parameters of interest included RAPID3 scores and assessments of the function of the hand, namely, the signal of functional impairment (SOFI)-hand, grip strength, and pulp-to-palm distance, as well the Health Assessment Questionnaire- Disability Index (HAQ-DI) and DAS28 scores. Pearson's correlation coefficient, Student's t test and linear regression were used in the statistical analysis of the results. The significance was set to p < 0.05. A positive correlation was found between RAPID3 scores and HAQ-DI scores, SOFI-hand scores, and pulp-to-palm distance, and negative correlation was observed between RAPID3 scores and grip strength. The order regarding the strength of correlations between RAPID3 scores and other variables (from the strongest to the weakest) was as follows: HAQ-DI, grip strength, SOFI-hand and pulp-to-palm distance. The hand assessment variables had stronger correlations with RAPID3 scores than with DAS28 scores. Our preliminary study showed that RAPID3 scores were strongly correlated with measurements of the functional ability of the hand, demonstrating that RAPID3 can be used as a measure of disease activity in clinical practice and to characterize hand function. Further studies are needed to confirm this result.

Some Adipose Derived Hormones in Association with the Risk of Knee Osteoarthritis

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Mehdi Moghtadae

2017-04-01

Full Text Available Background Knee osteoarthritis (OA is the most common form of arthritis and is the major cause of pain and disability in the elderly. The relationship between obesity and increased risk of knee osteoarthritis was known for many years. Since then, many studies have shown the relationship between knee osteoarthritis and obesity. Objectives In this study, we tried to evaluate whether compared to weight, the adipose tissue has a stronger correlation with the occurrence of knee osteoarthritis. Methods In a cross-sectional study that was a part of the Fasa knee osteoarthritis registry (FOAS, 131 patients with OA were sex matched with 262 patients in the control group. Serum samples of the patients, the Western Ontario and McMaster universities arthritis index (WOMAC questionnaire and demographic data were collected. Leptin and adiponectin as hormones secreted by the adipose tissue were measured. Results Weight, body mass index (BMI, and waist circumference (WC were significantly different between the two groups (P < 0.001. The Kellgren and Lawrence (K&L score was significantly higher among the patients (P < 0.001. Pain levels in patients with OA were also significantly higher compared to those in the control group (P < 0.001. Both leptin and adiponectin concentrations were higher in the OA patients. Adiponectin had a negative relationship with BMI in the OA group (r = 0.570, P < 0.001, but leptin had a positive relationship with BMI (r = 0.781, P < 0.001. In the OA group, both adipokines had higher levels in female patients compared to male patients. Conclusions The results of the current study showed that levels of hormones secreted from the adipose tissue, in people with knee OA, were higher compared to the control group, indicating the possible effect of these hormones on the process of osteoarthritis. Finally, we showed that after adjusting for age, sex, and BMI, leptin and adiponectin are significantly correlated with the amount of pain

Evaluation of a Patient Decision Aid for Unicompartmental or Total Knee Arthroplasty for Medial Knee Osteoarthritis.

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de Jesus, Christopher; Stacey, Dawn; Dervin, Geoffrey F

2017-11-01

Many patients with isolated medial compartment osteoarthritis are candidates for either unicompartmental knee arthroplasty (UKA) or total knee arthroplasty (TKA). A novel patient decision aid (PDA) was developed to educate patients on both interventions and prepare them for making the decision with their surgeon. The study objective was to evaluate the acceptability and usefulness of a PDA for informing and helping patients reach a surgical preference without increasing decisional conflict. A PDA was developed in accordance with the criteria listed by Ottawa Decision Support Framework and prospectively tested in UKA and TKA patients, who were mailed the PDAs to complete at home along with outcome measures before surgeon consultation. Of 50 patients who consented to participate, 45 patients (26 men, 19 women) used the PDA. Quantitative analysis of acceptability, decisional conflict, knowledge, and preferred surgical option was then performed. Mean patient age was 64.6 years (range, 50-80 years). Patients rated the PDA as acceptable: 84.4% indicated balanced presentation of information and 77.8% asserted that PDA helped them to make decisions between UKA and TKA. Mean knowledge score was 86.6% and total decisional conflict was 19.7 out of 100. Of 45, 33 stated a preferred option (24 UKA; 9 TKA; 12 unsure). Patients understood the majority of the benefits and risks for each surgical option without increasing decisional conflict. The decision aid for advanced medial compartment osteoarthritis is shown to be acceptable and useful for choosing between UKA and TKA. Copyright © 2017 Elsevier Inc. All rights reserved.

Double-blind randomized controlled trial of isoxicam vs piroxicam in elderly patients with osteoarthritis of the hip and knee

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Bellamy, N.; Buchanan, W. W.; Grace, E.

1986-01-01

1 Fifty-seven elderly patients with primary osteoarthritis of the hip and knee were entered into a double-blind, randomized, controlled parallel group trial to compare the efficacy and tolerability of isoxicam (maximum = 200 mg day-1) and piroxicam (maximum = 20 mg day-1). 2 Clinical assessments were made following a 1 week NSAID-free washout period and at biweekly intervals during the next 6 weeks of active treatment. 3 The majority of patients in both groups experienced a clinically important and statistically significant therapeutic response. 4 No statistically significant between-group differences were noted with respect to drug efficacy. 5 One patient was withdrawn from the piroxicam group because of lack of effect, but there were no such withdrawals from the isoxicam group. 6 Five patients were withdrawn from the piroxicam group because of adverse reactions compared to only one withdrawal from the isoxicam group. 7 This study indicates that isoxicam is an efficacious and well-tolerated once-daily NSAID for elderly patients with osteoarthritis. PMID:3620274

Knee Injury and Osteoarthritis Outcome Score (KOOS)

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Collins, N J; Prinsen, C A C; Christensen, R

2016-01-01

OBJECTIVE: To conduct a systematic review and meta-analysis to synthesize evidence regarding measurement properties of the Knee injury and Osteoarthritis Outcome Score (KOOS). DESIGN: A comprehensive literature search identified 37 eligible papers evaluating KOOS measurement properties in partici......OBJECTIVE: To conduct a systematic review and meta-analysis to synthesize evidence regarding measurement properties of the Knee injury and Osteoarthritis Outcome Score (KOOS). DESIGN: A comprehensive literature search identified 37 eligible papers evaluating KOOS measurement properties...... in participants with knee injuries and/or osteoarthritis (OA). Methodological quality was evaluated using the COSMIN checklist. Where possible, meta-analysis of extracted data was conducted for all studies and stratified by age and knee condition; otherwise narrative synthesis was performed. RESULTS: KOOS has...... adequate internal consistency, test-retest reliability and construct validity in young and old adults with knee injuries and/or OA. The ADL subscale has better content validity for older patients and Sport/Rec for younger patients with knee injuries, while the Pain subscale is more relevant for painful...

Estuarine geochemistry of 224Ra, 226Ra, and 222Rn

International Nuclear Information System (INIS)

Elsinger, R.J.

1982-01-01

Desorption from river borne sediments is the most likely source of the excess 226 Ra. Laboratory mixing experiments on Pee Dee River sediments show an increase in 226 Ra desorption with increasing salinities with maximum desorption occurring at or above 20 0 /oo salinity. Desorption and diffusion are the sources for 226 Ra in the estuarine systems. In Winyah Bay the 228 Ra/ 226 Ra activity ratio does not change significantly with salinity, averaging around 1.4, indicating desorption as the major source of 228 Ra. In the Yangtze River the 228 Ra/ 226 Ra activity ratio is constant (approx.1.90) until increasing linearly above 16 0 /oo. A diffusive flux from regeneration by 232 Th decay in shelf sediments is the source of the increase. In Delaware Bay 228 Ra increases faster than 226 Ra in the less than or equal to22 0 /oo water, indicating a source in addition to desorption. The increase can be balanced by a 0.33 dpm/cm 2 -year flux over the upper part of the Bay where fine grained sediments predominate. 224 Ra behavior is controlled by its 3.64 day half-life. In Winyah Bay a flux of around 0.4 dpm/cm 2 -day is necessary to support the standing crop of non-desorbed 224 Ra in the water column. In Delaware Bay the nearly constant 224 Ra in concentration over the 2.5 0 /oo to 12 0 /oo salinity range are maintained by regeneration from 228 Th in the turbidity maximum zones and diffusion from bottom sediments. Water leaving on ebb tide from a salt marsh on Delaware Bay had increases in all three radium isotopes ( 224 Ra > 228 Ra > 226 Ra) compared to water coming in on the flood tide. Excess 222 Rn concentrations in a fresh water section of the Pee Dee River show a decreasing downstream gradient. Using these gradients to determine evasion rates, stagnant film thicknesses range from 21μ to 62μ

Knee osteoarthritis related pain: a narrative review of diagnosis and treatment

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Alshami, Ali M.

2014-01-01

Background Osteoarthritis is a common progressive joint disease, involving not only the joint lining but also cartilage, ligaments, and bone. For the last ten years, majority of published review articles were not specific to osteoarthritis of the knee, and strength of evidence and clinical guidelines were not appropriately summarized. Objectives To appraise the literature by summarizing the findings of current evidence and clinical guidelines on the diagnosis and treatment of knee osteoarthritis pain. Methodology English journal articles that focused on knee osteoarthritis related pain were searched via PubMed (1 January 2002 – 26 August 2012) and Physiotherapy Evidence Database (PEDro) databases, using the terms ‘knee’, ‘osteoarthritis’ and ‘pain’. In addition, reference lists from identified articles and related book chapters were included as comprehensive overviews. Results For knee osteoarthritis, the highest diagnostic accuracy can be achieved by presence of pain and five or more clinical or laboratory criteria plus osteophytes. Some inconsistencies in the recommendations and findings were found between the clinical guidelines and systematic reviews. Generally, paracetamol, oral and topical non-steroidal anti-inflammatory drugs, opioids, corticosteroid injections and physical therapy techniques, such as therapeutic exercises, joint manual therapy and transcutaneous electrical nerve stimulation, can help reduce pain and improve function. Patient education programs and weight reduction for overweight patients are important to be considered. Conclusions Some inconsistencies in the recommendations and findings were found between the clinical guidelines and systematic reviews. However, it is likely that a combination of pharmacological and non-pharmacological treatments is most effective in treating patients with knee osteoarthritis. PMID:24899883

How direct-to-consumer television advertising for osteoarthritis drugs affects physicians' prescribing behavior.

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Bradford, W David; Kleit, Andrew N; Nietert, Paul J; Steyer, Terrence; McIlwain, Thomas; Ornstein, Steven

2006-01-01

Concern about the potential pernicious effect of direct-to-consumer (DTC) drug advertising on physicians' prescribing patterns was heightened with the 2004 withdrawal of Vioxx, a heavily advertised treatment for osteoarthritis. We examine how DTC advertising has affected physicians' prescribing behavior for osteoarthritis patients. We analyzed monthly clinical information on fifty-seven primary care practices during 2000-2002, matched to monthly brand-specific advertising data for local and network television. DTC advertising of Vioxx and Celebrex increased the number of osteoarthritis patients seen by physicians each month. DTC advertising of Vioxx increased the likelihood that patients received both Vioxx and Celebrex, but Celebrex ads only affected Vioxx use.

The dynamics of the pain system is intact in patients with knee osteoarthritis: An exploratory experimental study.

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Jørgensen, Tanja Schjødt; Henriksen, Marius; Rosager, Sara; Klokker, Louise; Ellegaard, Karen; Danneskiold-Samsøe, Bente; Bliddal, Henning; Graven-Nielsen, Thomas

2017-12-29

Background and aims Despite the high prevalence of knee osteoarthritis (OA) it remains one of the most frequent knee disorders without a cure. Pain and disability are prominent clinical features of knee OA. Knee OA pain is typically localized but can also be referred to the thigh or lower leg. Widespread hyperalgesia has been found in knee OA patients. In addition, patients with hyperalgesia in the OA knee joint show increased pain summation scores upon repetitive stimulation of the OA knee suggesting the involvement of facilitated central mechanisms in knee OA. The dynamics of the pain system (i.e., the adaptive responses to pain) has been widely studied, but mainly from experiments on healthy subjects, whereas less is known about the dynamics of the pain system in chronic pain patients, where the pain system has been activated for a long time. The aim of this study was to assess the dynamics of the nociceptive system quantitatively in knee osteoarthritis (OA) patients before and after induction of experimental knee pain. Methods Ten knee osteoarthritis (OA) patients participated in this randomized crossover trial. Each subject was tested on two days separated by 1 week. The most affected knee was exposed to experimental pain or control, in a randomized sequence, by injection of hypertonic saline into the infrapatellar fat pad and a control injection of isotonic saline. Pain areas were assessed by drawings on anatomical maps. Pressure pain thresholds (PPT) at the knee, thigh, lower leg, and arm were assessed before, during, and after the experimental pain and control conditions. Likewise, temporal summation of pressure pain on the knee, thigh and lower leg muscles was assessed. Results Experimental knee pain decreased the PPTs at the knee (P system in individuals with knee OA can be affected even after many years of nociceptive input. This study indicates that the adaptability in the pain system is intact in patients with knee OA, which opens for opportunities to

Attitudes and Self-Care Behaviors of Patients with Knee Osteoarthritis Referred to Rheumatology Clinical Centers in Yazd

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MA Morowatisharifabad

2016-01-01

Full Text Available Abstract Introduction: Knee Osteoarthritis is the most common age-related causes of knee pain which can induce disability, disablement and reduced quality of life. Therefore, the present study aimed to determine attitudes and self-care behaviors of knee osteoarthritis patients referred to three Rheumatology Clinical Centers in Yazd. Methods: This descriptive-analytical study was carried out on 235 patients referred to Health Care Centers of Yazd who were selected randomly. In order to glean the study data, a researcher-designed questionnaire was utilized probing into demographic variables as well as patients' attitudes and self-care behaviors. The reliability and validity of the questionnaire were approved, as well. The study data were analyzed applying SPSS software (ver. 18 via T-Test, ANOVA, Pearson correlation coefficient at 0.05 of the significant level. Results: The participants' mean age and Mean BMI were reported 54.90±9.15 and 28.8±4.61, respectively. Mean score of patients' attitude toward self-care was 47.4±3.95 out of 55 and the mean score of their self-care behaviors was 43.11±5.75 out of 60, which the both scores were at a moderate level. Furthermore, a positive significant correlation was detected between attitude and self-care behaviors (p=0.01. Within different self-care behaviors, participants' attitude towards the positive effect of using crutches while walking was at the lowest level. Meanwhile, according to the patients' attitude, using crutches was demonstrated to have the least performance within the self-care behaviors. Conclusion: Based on the findings of the present study, the attitude level can cause an increase in the patients' self-care behaviors. Moreover, since the participants' attitude towards such behaviors as using crutches, using pool and weight loss were at a low level, interventional programs are recommended to emphasize the mentioned issues. Keywords: Attitude; Knee osteoarthritis; Performance; Self

Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis

DEFF Research Database (Denmark)

Wandel, Simon; Jüni, Peter; Tendal, Britta

2010-01-01

OBJECTIVE: To determine the effect of glucosamine, chondroitin, or the two in combination on joint pain and on radiological progression of disease in osteoarthritis of the hip or knee. Design Network meta-analysis. Direct comparisons within trials were combined with indirect evidence from other t...... and health insurers should not cover the costs of these preparations, and new prescriptions to patients who have not received treatment should be discouraged....... visual analogue scale. DATA SOURCES: Electronic databases and conference proceedings from inception to June 2009, expert contact, relevant websites. Eligibility criteria for selecting studies Large scale randomised controlled trials in more than 200 patients with osteoarthritis of the knee or hip.......02 for interaction). The differences in changes in minimal width of joint space were all minute, with 95% credible intervals overlapping zero. Conclusions Compared with placebo, glucosamine, chondroitin, and their combination do not reduce joint pain or have an impact on narrowing of joint space. Health authorities...

A retrospective non-comparative analysis of the quality of care for osteoarthritis at the general out-patient department of Jos University Teaching Hospital, Nigeria

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Festus E Osajie

2015-01-01

Full Text Available Background: Osteoarthritis is a common condition in primary care and is often associated with disability and limitation of function requiring holistic care. Aim: The aim of this audit was to assess the quality of care provided by family physicians in the management of osteoarthritis at the General Out-patient Department (GOPD of Jos University Teaching Hospital (JUTH as well as ascertain if such care was in line with evidence-based medicine. Methods: This was a retrospective noncomparative study. The recommendations of the Nigerian Standard Treatment Guidelines 2008 and the National Institute for Health and Care Excellence 2014 guidelines were used to form standard targets for each of the structural, process and outcome components of the care process. Each of the consultation rooms was inspected for the structure components of the care process. For the process and outcome components of care, the medical records of all patients being managed for osteoarthritis at the GOPD of JUTH over a 1-year period were retrieved and studied. Results: For one aspect of the structural component (i.e. availability of weighing scale for each consultation room, 80% of the standard target was met which was below the standard target of 100%. The highest performance under the process component was for the documentation of risk associated with the use of nonsteroidal anti-inflammatory drugs (NSAIDs and documentation for NSAID/cyclooxygenase-2 inhibitors use with a gastro-protective agent. For both of these, 22.4% of the standard target was met; less than the standard target of 100% and 80% respectively. None of the standard targets for the outcome component were met. Conclusion: The quality of care for patients with osteoarthritis in this practice setting was sub-optimal. More can be done by family physicians with regards provision of comprehensive care for patients suffering from osteoarthritis.

Erosive osteoarthritis: a more severe form of radiographic hand osteoarthritis rather than a distinct entity?

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Marshall, Michelle; Nicholls, Elaine; Kwok, Wing-Yee; Peat, George; Kloppenburg, Margreet; van der Windt, Danielle; Myers, Helen; Dziedzic, Krysia

2015-01-01

Objectives To determine whether erosive osteoarthritis shares the same pattern of joint involvement and risk profile as increasing grades of non-erosive hand osteoarthritis. Methods Participants were from two population-based cohorts, aged ≥50 years, reporting hand symptoms in the previous month. Interphalangeal joints were assessed for erosive osteoarthritis (Verbruggen–Veys erosive or remodelled phase) and radiographic osteoarthritis (sliding cut-offs of K&L≥2, K&L≥3 and K&L=4). At the joint level, similarities in the frequency and pattern of erosive and non-erosive osteoarthritis were assessed by Spearman's rank correlation coefficients and generalised estimating equations. At the person level, individuals with erosive osteoarthritis were compared to those with non-erosive osteoarthritis using logistic regression, adjusted for age and gender (aOR), for the following exposures: family history, previous injury, overuse and metabolic factors (BMI, dyslipidaemia, hypertension, diabetes). Results In 1076 symptomatic participants the ranked frequency of involvement for erosive joints was comparable to joints with K&L≥3 and K&L=4 (r>0.95). Patterns of joint involvement in erosive osteoarthritis were strongest for symmetry (aOR=6.5; 95% CI 3.0 to 14.1), followed by row (2.0; 0.8 to 5.0) and ray (0.3; 0.0 to 2.5), which was similar to joints with K&L≥3 and K&L=4. Individuals with erosive osteoarthritis (n=80) had an increased risk of metabolic syndrome (2.7; 1.0 to 7.1), notably dyslipidaemia (4.7; 2.1 to 10.6) compared with non-erosive osteoarthritis classed K&L≥3 (n=193). Conclusions The similar frequency of radiographic joint involvement and patterning in erosive osteoarthritis and more severe non-erosive osteoarthritis is consistent with prevalent erosive osteoarthritis being a severe form of hand osteoarthritis rather than a distinct entity. Metabolic exposures, dyslipidaemia in particular, may be implicated in erosive osteoarthritis. PMID:24095935

Reproducibility, validity, and responsiveness of the hip outcome score in patients with end-stage hip osteoarthritis.

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Naal, Florian D; Impellizzeri, Franco M; von Eisenhart-Rothe, Rüdiger; Mannion, Anne F; Leunig, Michael

2012-11-01

To evaluate reproducibility, validity, and responsiveness of the Hip Outcome Score (HOS) in patients with end-stage hip osteoarthritis. In a cohort of 157 consecutive patients (mean age 66 years; 79 women) undergoing total hip replacement, the HOS was tested for the following measurement properties: feasibility (percentage of evaluable questionnaires), reproducibility (intraclass correlation coefficient [ICC] and standard error of measurement [SEM]), construct validity (correlation with the Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC], Oxford Hip Score [OHS], Short Form 12 health survey, and University of California, Los Angeles activity scale), internal consistency (Cronbach's alpha), factorial validity (factor analysis), floor and ceiling effects, and internal and external responsiveness at 6 months after surgery (standardized response mean and change score correlations). Missing items occurred frequently. Five percent to 6% of the HOS activities of daily living (ADL) subscales and 20-32% of the sport subscales could not be scored. ICCs were 0.92 for both subscales. SEMs were 1.8 points (ADL subscale) and 2.3 points (sport subscale). Highest correlations were found with the OHS (r = 0.81 for ADL subscale and r = 0.58 for sport subscale) and the WOMAC physical function subscale (r = 0.83 for ADL subscale and r = 0.56 for sport subscale). Cronbach's alpha was 0.93 and 0.88 for the ADL and sport subscales, respectively. Neither unidimensionality of the subscales nor the 2-factor structure was supported by factor analysis. Both subscales showed good internal and external responsiveness. The HOS is reproducible and responsive when assessing patients with end-stage hip osteoarthritis in whom the items are relevant. However, based on the large proportion of missing data and the findings of the factor analysis, we cannot recommend this questionnaire for routine use in this target group. Copyright © 2012 by the American College of Rheumatology.

The Founder's Lecture 2009: advances in imaging of osteoporosis and osteoarthritis

International Nuclear Information System (INIS)

Link, Thomas Marc

2010-01-01

The objective of this review article is to provide an update on new developments in imaging of osteoporosis and osteoarthritis over the past three decades. A literature review is presented that summarizes the highlights in the development of bone mineral density measurements, bone structure imaging, and vertebral fracture assessment in osteoporosis as well as MR-based semiquantitative assessment of osteoarthritis and quantitative cartilage matrix imaging. This review focuses on techniques that have impacted patient management and therapeutic decision making or that potentially will affect patient care in the near future. Results of pertinent studies are presented and used for illustration. In summary, novel developments have significantly impacted imaging of osteoporosis and osteoarthritis over the past three decades. (orig.)

Osteoarthritis guidelines: a progressive role for topical nonsteroidal anti-inflammatory drugs

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Stanos SP

2013-04-01

Full Text Available Steven P Stanos Rehabilitation Institute of Chicago, Center for Pain Management, Chicago, IL, USA Abstract: Current treatment guidelines for the treatment of chronic pain associated with osteoarthritis reflect the collective clinical knowledge of international experts in weighing the benefits of pharmacologic therapy options while striving to minimize the negative effects associated with them. Consideration of disease progression, pattern of flares, level of functional impairment or disability, response to treatment, coexisting conditions such as cardiovascular disease or gastrointestinal disorders, and concomitant prescription medication use should be considered when creating a therapeutic plan for a patient with osteoarthritis. Although topical nonsteroidal anti-inflammatory drugs historically have not been prevalent in many of the guidelines for osteoarthritis treatment, recent evidence-based medicine and new guidelines now support their use as a viable option for the clinician seeking alternatives to typical oral formulations. This article provides a qualitative review of these treatment guidelines and the emerging role of topical nonsteroidal anti-inflammatory drugs as a therapy option for patients with localized symptoms of osteoarthritis who may be at risk for oral nonsteroidal anti-inflammatory drug-related serious adverse events. Keywords: osteoarthritis, nonsteroidal anti-inflammatory drugs, guidelines, topical analgesics, diclofenac

Age and Early Revision After Primary Total Hip Arthroplasty for Osteoarthritis.

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Meyer, Zachary; Baca, Geneva; Rames, Richard; Barrack, Robert; Clohisy, John; Nam, Denis

2017-11-01

Prior reports have noted an increased risk of early revision among younger patients undergoing total hip arthroplasty (THA) but have been confounded by the inclusion of various diagnoses. The purpose of this study was to assess the revision rate and the time to revision for patients undergoing THA for osteoarthritis based on age. Patients with a diagnosis of osteoarthritis who underwent both primary and revision THA at the same institution were identified. The time between primary and revision surgery and the indication for revision were collected. Patients were stratified into 2 groups based on age at the time of primary THA: 64 years or younger (group 1) or 65 years or older (group 2). Between 1996 and 2016, a total of 4662 patients (5543 hips) underwent primary THA for a diagnosis of osteoarthritis. Of these, 100 patients (104 hips) received a revision THA (62 in group 1 and 42 in group 2). Mean age was 52.7±8.4 years in group 1 vs 73.4±6.3 years in group 2 (Pprimary to revision surgery was 3.0±3.2 years for group 1 and 1.1±2.1 years for group 2 (P=.001). Among patients undergoing primary THA for a diagnosis of osteoarthritis, younger age is not associated with an increased rate of early failure or revision. [Orthopedics. 2017; 40(6):e1069-e1073.]. Copyright 2017, SLACK Incorporated.

Design and testing a web-based physical activity intervention for patients with osteoarthritis in hip and/or knee.

NARCIS (Netherlands)

Bossen, D.

2012-01-01

Purpose: Due to elevated fear of pain, catastrophizing thoughts and joint stiffness, a large group of patients with hip and/or knee osteoarthritis (OA) remain sedentary. Although inactivity may enhance in short-term pain reduction, prolonged inactivity may augment functional decline. Therefore, we

Intra-articular hyaluronan is without clinical effect in knee osteoarthritis: a multicentre, randomised, placebo-controlled, double-blind study of 337 patients followed for 1 year

DEFF Research Database (Denmark)

Jørgensen, Anette; Stengaard-Pedersen, Kristian; Simonsen, Ole

2010-01-01

OBJECTIVE: To examine the long-term efficacy and safety of five intra-articular injections with hyaluronan in knee osteoarthritis. METHODS: A multicentre, randomised, placebo-controlled double-blind study of 337 patients fulfilling the American College of Rheumatology (ACR) criteria for knee...... osteoarthritis (clinical and laboratory) and with a Lequesne algofunctional index score (LFI) of 10 or greater. Patients received a hyaluronan product (sodium hyaluronate; Hyalgan) (n=167) or saline (n=170) intra-articularly weekly for 5 weeks and were followed up to 1 year. Time to recurrence was the primary...... the ACR criteria for osteoarthritis of the knee with moderate to severe disease activity (LFI > or = 10), five intra-articular injections of hyaluronan did not improve pain, function, paracetamol consumption or other efficacy parameters 3, 6, 9 and 12 months after the treatment....

Correlation of the Features of the Lumbar Multifidus Muscle With Facet Joint Osteoarthritis.

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Yu, Bo; Jiang, Kaibiao; Li, Xinfeng; Zhang, Jidong; Liu, Zude

2017-09-01

Facet joint osteoarthritis is considered a consequence of the aging process; however, there is evidence that it may be associated with degenerative changes of other structures. The goal of this study was to investigate the correlation between lumbar multifidus muscle features and facet joint osteoarthritis. This retrospective study included 160 patients who had acute or chronic low back pain and were diagnosed with facet joint osteoarthritis on computed tomography scan. Morphometric parameters, including cross-sectional area, muscle-fat index, and percentage of bilateral multifidus asymmetry at L3-L4, L4-L5, and L5-S1, were evaluated with T2-weighted magnetic resonance imaging. Patients with facet joint osteoarthritis had a smaller cross-sectional area and a higher muscle-fat index than those without facet joint osteoarthritis (Posteoarthritis at all 3 spinal levels (Posteoarthritis only at L4-L5 (P=.005). Asymmetry of the bilateral multifidus cross-sectional area was independently associated with facet joint osteoarthritis at L5-S1 (P=.009), but did not seem to be responsible for asymmetric degeneration of the bilateral facet joints. A higher multifidus muscle-fat index was independently associated with facet joint osteoarthritis, and bilateral multifidus size asymmetry was associated with the development of facet joint osteoarthritis at L5-S1. It seems more accurate to consider facet joint osteoarthritis a failure of the whole joint structure, including the paraspinal musculature, rather than simply a failure of the facet joint cartilage. [Orthopedics. 2017; 40(5):e793-e800.]. Copyright 2017, SLACK Incorporated.

The effect of low-load exercise on joint pain, function, and activities of daily living in patients with knee osteoarthritis.

Science.gov (United States)

Peeler, Jason; Ripat, Jacquie

2018-01-01

Knee osteoarthritis has a lifetime risk of nearly one in two, with obese individuals being most susceptible. While exercise is universally recognized as a critical component for management, unsafe or ineffective exercise frequently leads to exacerbation of joint symptoms. Evaluate the effect of a 12week lower body positive pressure (LBPP) supported low-load treadmill walking program on knee pain, joint function, and performance of daily activities in patients with knee osteoarthritis (OA). Prospective, observational, repeated measures investigation. Community based, multidisciplinary musculoskeletal medicine clinic. Thirty-one patients, aged 50-75, with a BMI ≥25kg/m 2 and radiographic confirmed mild to moderate knee OA. Twelve week LBPP treadmill walking exercise regimen. The Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Canadian Occupational Performance Measure (COPM) were used to quantify joint symptoms and patient function; isokinetic thigh muscle strength was evaluated; and a 10-point VAS was used to quantify acute knee pain while walking. Baseline and follow-up data were compared in order to examine the effect of the 12week exercise intervention. There was a significant difference between baseline and follow-up data: KOOS and COPM scores both improved; thigh muscle strength increased; and acute knee pain during full weight bearing walking diminished significantly. Participation in a 12week LBPP supported treadmill walking exercise regimen significantly enhanced patient function and quality of life, as well as the ability to perform activities of daily living that patient's self-identified as being important, yet difficult to perform. Copyright © 2017 Elsevier B.V. All rights reserved.

Evaluation of gait performance of knee osteoarthritis patients after total knee arthroplasty with different assistive devices

OpenAIRE

Tereso,Ana; Martins,Maria Manuel; Santos,Cristina Peixoto

2015-01-01

IntroductionNowadays Knee Osteoarthritis (KOA) affects a large percentage of the elderly, and one solution is to perform a Total Knee Arthroplasty (TKA). In this paper, one intends to study the gait and posture of these patients after the TKA, while walking with three assistive devices (ADs) (crutches, standard walker (SW) and rollator with forearm supports (RFS)).MethodsEleven patients were evaluated in 2 phases: 5 days and 15 days after surgery. This evaluation was conducted with two inerti...

Increased oxidative stress and its relation with collagen metabolism in knee osteoarthritis.

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Altindag, Ozlem; Erel, Ozcan; Aksoy, Nurten; Selek, Sahabettin; Celik, Hakim; Karaoglanoglu, Mustafa

2007-02-01

The purpose of this study was to determine serum oxidative/antioxidative status in patients with knee osteoarthritis and its relation with prolidase activity, which plays an important role in collagen metabolism. Serum antioxidative status was evaluated by measuring total antioxidant capacity (TAC), thiol level and catalase enzyme activity in patients with osteoarthritis and in healthy controls. Serum oxidative status was evaluated by measuring total peroxide (TP) and lipid hydroperoxide. Oxidative stress index (OSI) was calculated. Prolidase enzyme activity was measured to investigate the collagen metabolism. Serum TAC, thiol level, catalase activity and prolidase activity were significantly lower in patients than in controls (P antioxidant parameters decreased in patients with osteoarthritis; therefore, these patients may be exposed to a potent oxidative stress. Decreased collagen metabolism may be related with oxidative stress, which has a role in the ethiopathogenesis and/or in the progression of the disease.

Multi-joint postural behavior in patients with knee osteoarthritis.

Science.gov (United States)

Turcot, Katia; Sagawa, Yoshimasa; Hoffmeyer, Pierre; Suvà, Domizio; Armand, Stéphane

2015-12-01

Previous studies have demonstrated balance impairment in patients with knee osteoarthritis (OA). Although it is currently accepted that postural control depends on multi-joint coordination, no study has previously considered this postural strategy in patients suffering from knee OA. The objectives of this study were to investigate the multi-joint postural behavior in patients with knee OA and to evaluate the association with clinical outcomes. Eighty-seven patients with knee OA and twenty-five healthy elderly were recruited to the study. A motion analysis system and two force plates were used to investigate the joint kinematics (trunk and lower body segments), the lower body joint moments, the vertical ground reaction force ratio and the center of pressure (COP) during a quiet standing task. Pain, functional capacity and quality of life status were also recorded. Patients with symptomatic and severe knee OA adopt a more flexed posture at all joint levels in comparison with the control group. A significant difference in the mean ratio was found between groups, showing an asymmetric weight distribution in patients with knee OA. A significant decrease in the COP range in the anterior-posterior direction was also observed in the group of patients. Only small associations were observed between postural impairments and clinical outcomes. This study brings new insights regarding the postural behavior of patients with severe knee OA during a quiet standing task. The results confirm the multi-joint asymmetric posture adopted by this population. Copyright © 2014 Elsevier B.V. All rights reserved.

Correlation between ultrasonographic findings and the response to corticosteroid injection in pes anserinus tendinobursitis syndrome in knee osteoarthritis patients.

Science.gov (United States)

Yoon, Ho Sung; Kim, Sung Eun; Suh, Young Ran; Seo, Young-Il; Kim, Hyun Ah

2005-02-01

The objectives of this study were to assess the ultrasonographic (US) findings in patients with knee osteoarthritis (OA) with pes anserinus tendinitis or bursitis (PATB) syndrome and to determine the correlation between the US findings and the response to local corticosteroid injection. We prospectively studied 26 patients with knee OA with clinically diagnosed PATB syndrome. A linear array 7 MHz transducer was used for US examination of the knee. Seventeen patients were injected locally with tramcinolone acetonide in the anserine bursa area. Response to local corticosteroid injection was evaluated by pain visual analog scale (VAS), Western Ontario and MacMaster (WOMAC) osteoarthritis index and Global patient/physician assessment using Likert scale. On US examination, only 2 patients (8.7%) showed evidence of PATB. Pain VAS, WOMAC pain index and WOMAC physical function index improved significantly after corticosteroid injection. Global patient assessment revealed that 2 patients showed best response, 6 good, 1 fair, 8 the same, and none worse. It is of note that the 2 patients who showed the best response were those who showed US evidence of PATB. This finding shows that US can serve as a useful diagnostic tool for guiding treatment in PATB syndrome of OA patients.

THE INFLUENCE OF COMPLEX THERAPY ON THE INFLAMMATORY MARKERS OF PATIENTS WITH SECONDARY OSTEOARTHRITIS

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I. A. Starodubtseva

2015-01-01

Full Text Available The aim of the study is to evaluate the efficacy of complex therapy of secondary osteoarthritis in patients with rheumatoid arthritis with the use of inhibitor of interleukin-1, including the dynamics of inflammatory markers.Materials and methods: 248 patients with secondary osteoarthritis in rheumatoid arthritis were involved in the trial. The participants were divided into 4 groups: patients of group I took inhibitor of interleukin-1 (diacerein in combination with laser therapy and methotrexate; inhibitor of interleukin-1 in complex with methotrexate took patients from group II; group 3 — laser therapy + methotrexate and patients of group IV took only methotrexate. The efficacy of therapy we estimated in 6 months.Results: The constructed model surfaces indicated the decreased levels of IL-1, COMP and DAS 28 in group 1 till 6,68±0,37 pg/ml (p<0,001, 16,92±0,8 ng/ml х 10² (p<0,001 и 2,06±1,19 (p<0,05 accordingly in comparison with groups III and IV. Also the model surfaces revealed the interdependency of all these indicators. The control group (IV reacted to the treatment by decreasing the indicators as well. However, the dynamics of the changes was significantly less. In patients of groups I and II the levels of ESR and CRP decreased to 13,95±0,52* (*p<0,001 and 10,97±0,43* (*p<0,001; 16,53±0,63* (*p<0,001 and 12,81±0,77* (*p<0,001 accordingly.Conclusions: In comparison analysis we noted statistical significant advantages (p<0,01 of the use of diacerein with methotrexate regarding the dynamic of IL-1 and COMP, ESR, CRP in patient’s serum, which is accompanied by the reduction of basic disease activity on DAS 28.

A Brief History of IL-1 and IL-1 Ra in Rheumatology

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Jean-Michel Dayer

2017-05-01

Full Text Available The history of what, in 1979, was called interleukin-1 (IL-1, orchestrator of leukocyte inter-communication, began many years before then, initially by the observation of fever induction via the endogenous pyrogen (EP (1974 and then in rheumatology on the role in tissue destruction in rheumatoid diseases via the induction of collagenase and PGE2 in human synovial cells by a mononuclear cell factor (MCF (1977. Since then, the family has exploded to presently 11 members as well as many membrane-bound and soluble receptor forms. The discovery of a natural Interleukin-1 receptor antagonist (IL-1Ra in human biological fluids has highlighted the importance of IL-1 and IL-1Ra in human diseases. Evidence delineating its role in autoinflammatory syndromes and the elucidation of the macromolecular complex referred to as “inflammasome” have been instrumental to our understanding of the link with IL-1. At present, the IL-1blockade as therapeutic approach is crucial for many hereditary autoinflammatory diseases, as well as for adult-onset Still’s disease, crystal-induced arthropathies, certain skin diseases including neutrophil-triggered skin diseases, Behçet’s disease and deficiency of IL-1Ra and other rare fever syndromes. Its role is only marginally important in rheumatoid arthritis and is still under debate with regard to osteoarthritis, type 2 diabetes mellitus, cardiovascular diseases and cancer. This brief historical review focuses on some aspects of IL-1, mainly IL-1β and IL-Ra, in rheumatology. There are many excellent reviews focusing on the IL-1 family in general or with regard to specific diseases or biological discoveries.

Effectiveness of behavioral graded activity in patients with osteoarthritis of hip and/or knee: a randomized clinical trial.

NARCIS (Netherlands)

Veenhof, C.; Köke, A.J.A.; Dekker, J.; Oostendorp, R.A.; Bijlsma, J.W.J.; Tulder, M.W. van; Ende, C.H.M. van den

2006-01-01

Objective: To determine the effectiveness of a behavioral graded activity program (BGA) compared with usual care (UC; exercise therapy and advice) according to the Dutch guidelines for physiotherapy in patients with osteoarthritis (OA) of the hip and/or knee. The BGA intervention is intended to

Association between obesity, quality of life, physical activity and health service utilization in primary care patients with osteoarthritis.

NARCIS (Netherlands)

Rosemann, T.J.; Grol, R.P.T.M.; Herman, K.; Wensing, M.J.P.; Szecsenyi, J.

2008-01-01

ABSTRACT: OBJECTIVE: To assess the association of obesity with quality of life, health service utilization and physical activity in a large sample of primary care patients with osteoarthritis (OA). METHODS: Data were retrieved from the PraxArt project, representing a cohort of 1021 primary care

Relationship between insulin-like growth factor-1 and radiographic disease in patients with primary osteoarthritis: a systematic review.

NARCIS (Netherlands)

Claessen, K.M.; Ramautar, S.R.; Pereira, A.M.; Smit, J.W.A.; Biermasz, N.R.; Kloppenburg, M.

2012-01-01

OBJECTIVE: To evaluate the association between radiographic osteoarthritis (OA) and either serum insulin-like growth factor-1 (IGF-1) levels or IGF-1 gene polymorphisms in patients with primary OA. METHODS: We conducted a systematic review of reported associations between circulating IGF-1 and/or

Topical Treatment of Degenerative Knee Osteoarthritis.

Science.gov (United States)

Meng, Zengdong; Huang, Rongzhong

2018-01-01

This article reviews topical management strategies for degenerative osteoarthritis (OA) of the knee. A search of Pubmed, Embase and the Cochrane library using MeSH terms including "topical," "treatment," "knee" and "osteoarthritis" was carried out. Original research and review articles on the effectiveness and safety, recommendations from international published guidelines and acceptability studies of topical preparations were included. Current topical treatments included for the management of knee OA include topical nonsteroidal anti-inflammatory drugs, capsaicin, salicylates and physical treatments such as hot or cold therapy. Current treatment guidelines recommend topical nonsteroidal anti-inflammatory drugs as an alternative and even first-line therapy for OA management, especially among elderly patients. Guidelines on other topical treatments vary, from recommendations against their use, to in favor as alternative or simultaneous therapy, especially for patients with contraindications to other analgesics. Although often well-tolerated and preferred by many patients, clinical care still lags in the adoption of topical treatments. Aspects of efficacy, safety and patient quality of life data require further research. Copyright © 2018 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

Referral recommendations for osteoarthritis of the knee incorporating patients' preferences

Science.gov (United States)

Musila, Nyokabi; Underwood, Martin; McCaskie, Andrew W; Black, Nick; Clarke, Aileen; van der Meulen, Jan H

2011-01-01

Background. GPs have to respond to conflicting policy developments. As gatekeeper they are supposed to manage the growing demand for specialist services and as patient advocate they should be responsive to patients' preferences. We used an innovative approach to develop a referral guideline for patients with chronic knee pain that explicitly incorporates patients' preferences. Methods. A guideline development group of 12 members including patients, GPs, orthopaedic surgeons and other health care professionals used formal consensus development informed by systematic evidence reviews. They rated the appropriateness of referral for 108 case scenarios describing patients according to symptom severity, age, body mass, co-morbidity and referral preference. Appropriateness was expressed on scale from 1 (‘strongly disagree’) to 9 (‘strongly agree’). Results. Ratings of referral appropriateness were strongly influenced by symptom severity and patients' referral preferences. The influence of other patient characteristics was small. There was consensus that patients with severe knee symptoms who want to be referred should be referred and that patient with moderate or mild symptoms and strong preference against referral should not be referred. Referral preference had a greater impact on the ratings of referral appropriateness when symptoms were moderate or severe than when symptoms were mild. Conclusions. Referral decisions for patients with osteoarthritis of the knee should only be guided by symptom severity and patients' referral preferences. The guideline development group seemed to have given priority to avoiding inefficient resource use in patients with mild symptoms and to respecting patient autonomy in patients with severe symptoms. PMID:20817791

The provisional ACR/EULAR definition of remission in RA : a comment on the patient global assessment criterion

NARCIS (Netherlands)

Vermeer, Marloes; Kuper, Hillechiena H.; van der Bijl, Arie E.; Baan, Henriette; Posthumus, Marcel D.; Brus, Herman L. M.; van Riel, Piet L. C. M.; van de Laar, Mart A. F. J.

Objectives. The provisional ACR/European League Against Rheumatism (EULAR) definition of remission in RA requires a score of 41 on the patient global assessment (PGA, 0-10 scale). We explored the relation between the PGA criterion and the patient's clinical disease state in an observational dataset.

Clinical and pathogenetic interrelation between molecular regulation of apoptosis and cell differentiation in osteoarthritis

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M A Kabalyk

2018-02-01

Full Text Available Aim. To determine clinical and pathogenetic relationship between the levels of apoptosis and growth and differentiation regulation (growth inhibitor 1 induced by oxidative stress, growth/differentiation factor 5 in osteoarthritis. Methods. In a rheumatology office of Vladivostok polyclinic №3 65 patients with knee osteoarthritis Kellgren grade 1-4 aged 66.5±8.0 years were examined. 25 healthy volunteers matched by sex and age without clinical and radiologic manifestations of osteoarthritis were included into control group. To measure concentration of the studied molecules in study patients’ blood, ELISA method was used. Results. Patients with osteoarthritis compared to control group had statistically significantly increased levels of Fas, growth/differentiation factor 5 and ratio of growth/differentiation factor 5/growth inhibitor 1 induced by oxidative stress. Fas levels were significantly lower in late stages 2-4 of osteoarthritis compared to stages 1 and 2. Growth/differentiation factor 5 level was lower in patients with stage 3-4 of osteoarthritis compared to stages 1 and 2. As radiologic signs of osteoarthritis progressed, decrease of the ratio of growth/differentiation factor 5/growth inhibitor 1 induced by oxidative stress, was registered which was significantly lower in stages 2 and 3 compared to stage 1. Conclusion. Extrinsic pathway of apoptosis plays a big role in forming pain syndrome in osteoarthritis, and its maintenance is provided by other mechanisms which include influence of oxidative stress via inhibition of cell cycle mediated by growth inhibitor 1 induced by oxidative stress, reduced involvement of growth/differentiation factor 5 in differentiation processes and regulation of protein synthesis of extracellular cartilaginous tissue matrix.

THE ROLE OF MRI IN PATIENTS WITH OSTEOARTHRITIS –A REVIEW ARTICLE

OpenAIRE

Razieh Behzadmehr , Morteza Salarzaei *

2017-01-01

Introduction: Osteoarthritis is the most common disease that affects human joints. This disease is one of the major causes of joint pain and also the most important cause of rheumatoid disability. Despite its high prevalence, the definition of illness is less consensual among scholars. However, what all definitions have in common is that osteoarthritis involves several scaling disorders that may have several etiologies, but have similar biological and clinical outcomes. Findings:Since osteoar...

Intra-articular sodium hyaluronate 2 mL versus physiological saline 20 mL versus physiological saline 2 mL for painful knee osteoarthritis

DEFF Research Database (Denmark)

Lundsgaard, C; Dufour, N; Fallentin, E

2008-01-01

Methodological constraints weaken previous evidence on intra-articular viscosupplementation and physiological saline distention for osteoarthritis. We conducted a randomized, patient- and observer-blind trial to evaluate these interventions in patients with painful knee osteoarthritis.......Methodological constraints weaken previous evidence on intra-articular viscosupplementation and physiological saline distention for osteoarthritis. We conducted a randomized, patient- and observer-blind trial to evaluate these interventions in patients with painful knee osteoarthritis....

Effect of an education programme for patients with osteoarthritis in primary care - a randomized controlled trial

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Bjärnung Åsa

2010-10-01

Full Text Available Abstract Background Osteoarthritis (OA is a degenerative disease, considered to be one of the major public health problems. Research suggests that patient education is feasible and valuable for achieving improvements in quality of life, in function, well-being and improved coping. Since 1994, Primary Health Care in Malmö has used a patient education programme directed towards OA. The aim of this study was to evaluate the effects of this education programme for patients with OA in primary health care in terms of self-efficacy, function and self-perceived health. Method The study was a single-blind, randomized controlled trial (RCT in which the EuroQol-5D and Arthritis self-efficacy scale were used to measure self-perceived health and self-efficacy and function was measured with Grip Ability Test for the upper extremity and five different functional tests for the lower extremity. Results We found differences between the intervention group and the control group, comparing the results at baseline and after 6 months in EuroQol-5D (p Conclusion This study has shown that patient education for patients with osteoarthritis is feasible in a primary health care setting and can improve self-perceived health as well as function in some degree, but not self-efficacy. Further research to investigate the effect of exercise performance on function, as well as self-efficacy is warranted. Trial registration The trial is registered with ClinicalTrials.gov. Registration number: NCT00979914

RA Reactor; Reaktor RA

Energy Technology Data Exchange (ETDEWEB)

NONE

1989-07-01

This chapter includes the following: General description of the RA reactor, organization of work, responsibilities of leadership and operators team, regulations concerning operation and behaviour in the reactor building, regulations for performing experiments, regulations and instructions for inserting samples into experimental channels. [Serbo-Croat] Ovo (prvo) poglavlje sadrzi sledece: Opis reaktora RA; semu organizacije rada i rukovodjenja; prava i duznosti direktora i rukovodioca pogona reaktora, propise o rezimu rada i kretanja u zgradi reaktora, propise o izvodjenju eksperimenata, propise o unosenju uzoraka u eksperimentalne kanale reaktora.

Osteoblast role in osteoarthritis pathogenesis.

Science.gov (United States)

Maruotti, Nicola; Corrado, Addolorata; Cantatore, Francesco P

2017-11-01

Even if osteoarthritis pathogenesis is still poorly understood, numerous evidences suggest that osteoblasts dysregulation plays a key role in osteoarthritis pathogenesis. An abnormal expression of OPG and RANKL has been described in osteoarthritis osteoblasts, which is responsible for abnormal bone remodeling and decreased mineralization. Alterations in genes expression are involved in dysregulation of osteoblast function, bone remodeling, and mineralization, leading to osteoarthritis development. Moreover, osteoblasts produce numerous transcription factors, growth factors, and other proteic molecules which are involved in osteoarthritis pathogenesis. © 2017 The Authors. Journal of Cellular Physiology Published by Wiley Periodicals, Inc.

Good Life with osteoArthritis in Denmark (GLA:D™)

DEFF Research Database (Denmark)

Skou, Søren Thorgaard; Roos, Ewa M.

2017-01-01

BACKGROUND: The uptake of evidence-based guidelines in clinical practice is suboptimal in osteoarthritis (OA) and other chronic diseases. Good Life with osteoArthritis in Denmark (GLA:D) was launched in 2013 with the aim of implementing guidelines for the treatment of knee and hip OA in clinical...... disability and Osteoarthritis Outcome Score (HOOS) quality of life subscale, 0-100, worst to best), number of patients on painkillers and sick leave, and access to care according to guidelines. RESULTS: Data from 9,825 participants from the GLA:D registry were utilised in the analyses. It was demonstrated...... months are pain intensity (0 to 100, best to worst), objective physical function (30-s chair-stand test and 40-m fast-paced walk test), physical activity (number of days per week being physically active for at least 30 min), quality of life (Knee injury and Osteoarthritis Outcome Score (KOOS) and the Hip...

Time spent in primary care for hip osteoarthritis patients once the diagnosis is set : a prospective observational study

NARCIS (Netherlands)

Paans, Nienke; van der Veen, Willem Jan; van der Meer, Klaas; Bulstra, Sjoerd K.; van den Akker-Scheek, Inge; Stevens, Martin

2011-01-01

Background: Previous research on time to referral to orthopaedic surgery has predominantly used hip complaints as starting point instead of the moment the diagnosis of osteoarthritis (OA) of the hip is established, therefore little is known about the length of time a patient diagnosed with hip OA

Role of tumor necrosis factor-alpha and platelet-activating factor in neoangiogenesis induced by synovial fluids of patients with rheumatoid arthritis.

Science.gov (United States)

Lupia, E; Montrucchio, G; Battaglia, E; Modena, V; Camussi, G

1996-08-01

The aim of the present study was to investigate in vivo in a mouse model the stimulation of neoangiogenesis by synovial fluids of patients with rheumatoid arthritis (RA) and to determine the role of tumor necrosis factor (TNF)-alpha and platelet-activating factor (PAF) in the formation of new vessels. Angiogenesis was studied in a mouse model in which Matrigel, injected subcutaneously, was used as a vehicle for the delivery of potential angiogenic stimuli. Synovial fluids of patients with RA but not with osteoarthritis (OA) were shown to induce neoangiogenesis. Since synovial fluid of patients with RA contained significantly higher levels of TNF-alpha-like bioactivity and of PAF than that of patients with OA, the role of these mediators was evaluated by using an anti-TNF-alpha neutralizing monoclonal antibody (mAb) and a PAF receptor antagonist, WEB 2170. When added to Matrigel, anti-TNF-alpha mAb and particularly WEB 2170 significantly reduced neoangiogenesis induced by synovial fluids of RA patients. Moreover, PAF extracted and purified from synovial fluid induced angiogenesis. These results suggest that the neoangiogenesis observed in rheumatoid synovitis may be due, at least in part, to the angiogenic effect of locally produced TNF-alpha and PAF.

Flexibility of Knee Joint Muscles in Women with Knee Osteoarthritis and Healthy Controls

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Sara Abolahrari Shirazi

2015-09-01

Full Text Available Background: Osteoarthritis is one of the most common diseases in synovial joints. Due to high loading forces during weight-bearing activities, the knee joint is prone to degenerative processes. This study aimed to compare the flexibility of muscles around the knee joint in patients with knee osteoarthritis with those of healthy individuals. Methods: Twenty-three women with bilateral knee osteoarthritis and 23 healthy women matched with the patient group for age, height and weight participated in this study. Flexibility of the quadriceps, hamstring, iliotibial band, adductor and gastrocnemius muscles was evaluated with a goniometric device. Pain intensity was assessed with a visual analogue scale. The data were analyzed with independent t-tests to compare the two groups, and Pearson correlation coefficient was calculated to correlate muscle flexibility and pain intensity. Results: significant lower flexibility of the bilateral quadriceps muscles was found in patients compared to healthy women (P<0.05. No significant differences were detected between groups regarding other muscles. Quadriceps flexibility correlated significantly with pain intensity in patients (P<0.001. Conclusion: In patients with osteoarthritis, quadriceps flexibility may be decreased although other muscles may remain unaffected. Quadriceps stretching is thus a potentially important component of treatment, which may influence pain reduction in these patients.

The provisional ACR/EULAR definition of remission in RA: a comment on the patient global assessment criterion

NARCIS (Netherlands)

Vermeer, M.; Kuper, Hillechina H.; van der Bijl, Arie E.; Baan, H.; Posthumus, Marcel D.; Brus, Herman L.M.; van Riel, Piet L.C.M.; van de Laar, Mart A F J

2012-01-01

Objectives. The provisional ACR/European League Against Rheumatism (EULAR) definition of remission in RA requires a score of ≤1 on the patient global assessment (PGA, 0–10 scale). We explored the relation between the PGA criterion and the patient's clinical disease state in an observational dataset.

The Effect of Ginger (Zingiber Officinale Powder Supplement on Pain in Patients with Knee Osteoarthritis: a Double-Blind Randomized Clinical Trial

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A Nadjarzadeh

2013-01-01

Full Text Available Introduction: There is limited evidence that ginger (Zingiber Officinale powder consumption is effective to relieve the pain and inflammation due to special phytichemicals. The aim of this study was to investigate the effect of ginger powder supplementation in pain improvement in patients with knee osteoarthritis. Methods: This double-blind randomized clinical trial was conducted on 120 outpatients with knee osteoarthritis of moderate pain. Patients were randomly assigned to two groups: receiving ginger powder supplement and placebo. Ginger and placebo groups received two identical capsules per day for 12 weeks. Each capsule contained 500 mg ginger powder or starch. Pain severity was measured by VAS (Visual Analog Scale at first and after 3 months. A responder was defined as a reduction in pain of > 1.5 cm on a visual analog scale (VAS. Results: Before intervention, there was no significant difference between the two groups in severity of pain. However, after ginger supplementation, pain score decreased in ginger group. After 12 weeks, Pain reduction was more significant in ginger group than placebo. Response to intervention was 88% and 14% in ginger and placebo groups, respectively. There was statistically significant difference between both groups in response to intervention (p<0.001. Conclusion: The results of this study showed that ginger powder supplementation was effective in reducing pain in patients with knee osteoarthritis, therefore it is recommended as a safe supplement for these patients

EFFECT OF SHOCK WAVE THERAPYVERSUS CORTICOSTEROID INJECTION IN MANAGEMENT OFKNEE OSTEOARTHRITIS

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Ahmed Ebrahim Elerian

2016-04-01

Full Text Available Background: knee Osteoarthritis is the most common cause of musculoskeletal pain and disability. Shockwaves have been used as an alternative treatment for musculoskeletal disorders; intra-articular injection of steroid is a common treatment for osteoarthritis of the knee. This study aimed to investigate the efficacy of Shock wave therapy versus Corticosteroid intra articular injection in case of knee osteoarthritis. Methods: Sixty patients were diagnosed mild to moderate knee osteoarthritis; they were included in the study. Their ages were 43:65 years with mean age 50 ± 3.5 years. Patients were divided randomly into three equal groups, group (A received shock wave therapy, group (B received two intra-articular injections of corticosteroid at 1-month intervals and group (C received sham shock wave. The outcome measurements were Western Ontario and McMaster Universities arthritis index (WOMAC values, knee ROM, and pain severity using the visual analogue scale (VAS were recorded. The patients were evaluated for these parameters before allocated in their groups then after 1, 2, and 6months later. Results: compared to sham group there were significant improvement of VAS and ROM of shock wave group and corticosteroid injection group than sham (placebo group (p<0.000, (p<0.006, and 0.02 respectively. Furthermore there was significant improve of shock wave group than corticosteroid injection group where p was <0.000 for VAS, ROM and (WOMAC. Conclusion: The results of this study suggested that shock wave therapy may provide effective modality for relieving pain, increase Range of motion and improve function in knee osteoarthritis patient than intra articular corticosteroid injection.

Risk of leukaemia following intravenous treatment with 224Ra - results of a long term follow-up study of ankylosing spondylitis patients

International Nuclear Information System (INIS)

Wick, R.R.; Chmelevsky, D.; Goessner, W.

1993-01-01

In an epidemiological study of the somatic late effects risk following incorporation of a short lived α-emitter, 1473 ankylosing spondylitis patients treated with repeated intravenous injections of 224 Ra in the years 1948 - 75, have been observed in the GSF. The usual therapeutic plan consisted of a total of 10 - 12 injections of 1.036 MBq (28 μCi) of 224 Ra each, given at weekly intervals; this would result in an cumulative α-dose of 0.56 - 0.67 Gy to the marrow-free skeleton of a 70-kg-man (standard man). These patients have been followed together with a control group of ankylosing spondylitis patients not treated with radioactive drugs and/or X-rays. Until May 1993 (mean follow-up time 19.9 yr), 595 patients of the exposure group and 722 patients of the control group have died, causes of death have been ascertained for 578, resp. 668 patients. Among others we observed in the exposure group 10 cases of leukaemia (vs. 2.7 - 2.8 cases expected, p 239 Pu, an α-emitter which like 224 Ra deposits preferentially on the bone surface. (orig.) [de

Perna canaliculus Lipid Complex PCSO-524™ Demonstrated Pain Relief for Osteoarthritis Patients Benchmarked against Fish Oil, a Randomized Trial, without Placebo Control

OpenAIRE

Zawadzki, Marek; Janosch, Claudia; Szechinski, Jacek

2013-01-01

Osteoarthritis (OA) typically generates pain, reduced mobility and reduced quality of life. Most conventional treatments for osteoarthritis, such as non-steroidal anti-inflammatory drugs (NSAIDs) and simple analgesics, have side effects. PCSO-524?, a non polar lipid extract from the New Zealand Green Lipped Mussel, is rich in omega-3 fatty acids and has been shown to reduce inflammation in both animal studies and patient trials. This OA trial examined pain relief changes in relation to qualit...

Hip joint biomechanics in those with and without post-traumatic knee osteoarthritis after anterior cruciate ligament injury.

Science.gov (United States)

Wellsandt, E; Zeni, J A; Axe, M J; Snyder-Mackler, L

2017-12-01

Anterior cruciate ligament injury results in altered kinematics and kinetics in the knee and hip joints that persist despite surgical reconstruction and rehabilitation. Abnormal movement patterns and a history of osteoarthritis are risk factors for articular cartilage degeneration in additional joints. The purpose of this study was to determine if hip joint biomechanics early after anterior cruciate ligament injury and reconstruction differ between patients with and without post-traumatic knee osteoarthritis 5years after reconstruction. The study's rationale was that individuals who develop knee osteoarthritis after anterior cruciate ligament injury may also demonstrate large alterations in hip joint biomechanics. Nineteen athletes with anterior cruciate ligament injury completed standard gait analysis before (baseline) and after (post-training) extended pre-operative rehabilitation and at 6months, 1year, and 2years after reconstruction. Weightbearing knee radiographs were completed 5years after reconstruction to identify medial compartment osteoarthritis. Five of 19 patients had knee osteoarthritis at 5years after anterior cruciate ligament reconstruction. Patients with knee osteoarthritis at 5years walked with smaller sagittal plane hip angles (P: 0.043) and lower sagittal (P: 0.021) and frontal plane (P: 0.042) external hip moments in the injured limb before and after reconstruction compared to those without knee osteoarthritis. The current findings suggest hip joint biomechanics may be altered in patients who develop post-traumatic knee osteoarthritis. Further study is needed to confirm whether the risk of non-traumatic hip pathology is increased after anterior cruciate ligament injury and if hip joint biomechanics influence its development. Copyright © 2017 Elsevier Ltd. All rights reserved.

Osteoarthritis guidelines: a progressive role for topical nonsteroidal anti-inflammatory drugs.

Science.gov (United States)

Stanos, Steven P

2013-01-01

Current treatment guidelines for the treatment of chronic pain associated with osteoarthritis reflect the collective clinical knowledge of international experts in weighing the benefits of pharmacologic therapy options while striving to minimize the negative effects associated with them. Consideration of disease progression, pattern of flares, level of functional impairment or disability, response to treatment, coexisting conditions such as cardiovascular disease or gastrointestinal disorders, and concomitant prescription medication use should be considered when creating a therapeutic plan for a patient with osteoarthritis. Although topical nonsteroidal anti-inflammatory drugs historically have not been prevalent in many of the guidelines for osteoarthritis treatment, recent evidence-based medicine and new guidelines now support their use as a viable option for the clinician seeking alternatives to typical oral formulations. This article provides a qualitative review of these treatment guidelines and the emerging role of topical nonsteroidal anti-inflammatory drugs as a therapy option for patients with localized symptoms of osteoarthritis who may be at risk for oral nonsteroidal anti-inflammatory drug-related serious adverse events.

Shoulder Internal Derangement and Osteoarthritis in a 25-Year-Old Female Softball Athlete.

Science.gov (United States)

Cornelson, Stacey M; Hogarth, William; Ault, Daniel L; Kettner, Norman W

2016-06-01

The purpose of this report is to describe osteoarthritis and internal derangement of the shoulder in a collegiate softball player. A 25-year-old female softball athlete presented with a history of chronic right shoulder pain. A thorough clinical examination and multiple imaging studies were performed. Osteoarthritis was demonstrated on radiographs, and ligamentous and rotator cuff tendon tears were displayed on magnetic resonance imaging. The patient's treatment plan included full spine manipulation, cold laser therapy, kinesiotaping, stretching, and neuromuscular reeducation of the right shoulder. The patient reported a decrease in symptoms after 1 month, although treatment was sporadic because of poor patient compliance. Osteoarthritis and internal derangement may occur in overhead-throwing athletes, and correct imaging is needed for timely and accurate diagnoses. Following a timely diagnosis, the young patient in this case had a good recovery with multimodal chiropractic care.

Brief history of /sup 224/Ra usage in radiotherapy and radiobiology

Energy Technology Data Exchange (ETDEWEB)

Schales, F [Gesellschaft fuer Strahlen- und Umweltforschung m.b.H., Neuherberg (Germany, F.R.)

1978-07-01

Attempts were made a short time after its discovery to introduce /sup 224/Ra in therapy. Besides its external application in dermatology the treatment of rheumatic diseases seemed to be promising. From 1944-1952 about 2000 patients, most of them with tuberculosis or ankylosing spondylitis were treated in a German hospital with repeated intravenous injections of Peteosthor, a combination containing /sup 224/Ra with traces of platinum and eosin, totalling about 4000 ..mu..Ci/sup 224/Ra. Different lesions were observed which were suspected to be due to irradiation. The treatment has nevertheless continued. A group of 1500 additional patients, exclusively adults, has received rather low amounts (250-300 ..mu..Ci) of /sup 224/Ra and are now under study. Based on linear hypothetical dose-effect relationships in this group an osteosarcoma incidence of 3-5 per 1000 patients could be expected during the first 20 years following average skeletal doses of 56 rad. In experiments started in 1965 in Neuherberg, Germany, the acute and late effects of /sup 224/Ra and /sup 227/Th in rats and mice are investigated. Similar experiments are under way in Czechoslovakia. In Salt Lake City, Utah, in connection with studies on boneseeking radioisotopes using dogs, a pilot study on /sup 224/Ra was started in 1963. Together with studies of Ra and Th toxicity a mock dial paint containing /sup 224/Ra and /sup 234/Th was developed. As /sup 224/Ra is a /sup 232/Th decay product, it might play a certain role in the Thorotrast problem.

Isolated patellofemoral osteoarthritis.

NARCIS (Netherlands)

Jonbergen, J.P.W. van; Poolman, R.W.; Kampen, A. van

2010-01-01

BACKGROUND AND PURPOSE: The optimal treatment for isolated patellofemoral osteoarthritis is unclear at present. We systematically reviewed the highest level of available evidence on the nonoperative and operative treatment of isolated patellofemoral osteoarthritis to develop an evidenced-based

The Health Seeking Behaviors and Perceptions of Iranian Patient with Osteoarthritis about Pain Management: A Qualitative Study.

Science.gov (United States)

Zamanzadeh, Vahid; Ahmadi, Fazlollah; Foolady, Marjaneh; Behshid, Mozhgan; Irajpoor, Alireza

2017-03-01

Introduction: Pain is the main reason for patients with osteoarthritis (OA) to visit health clinics. Health seeking behaviors indicate unmet patient needs and lack of understanding of OA pain patterns. This study aimed to describe the experiences of Iranian patients with OA and explore their health seeking behaviors and perceptions on pain management related to osteoarthritis. Methods: Using a qualitative approach, data was collected by interviewing 19 patients, 2 family members, and 5 health care providers from the in-patient and out-patient clinics, and physicians' offices. Data saturation was reached after 31 in-depth and semi-structured interviews (five second interviews). Data were analyzed by qualitative content analysis, using comparison, reflection and interpretation techniques. The criteria used to enhance rigor included credibility, transferability, dependability, and confirmability. Results: Two main categories and six subcategories emerged from data analysis. The first main category included "adapting to the reality" which had three subcategories: Facing OA pain, seeking health care, and accepting pain as a part of life. The second main category included "behavior fluctuation" with three subcategory of role conflict, responsibility for self-care and, adherence to prescribed treatment versus self-treatment. Conclusion: Care seeking behaviors for chronic pain sufferers are void of cultural, emotional, social and financial situation and patient expectations. Some misconceptions emerged about the health problem and its management, which may lead to negative attitudes toward treatment and therapists and finally lead to non-adherence to treatment. Patients need for education to enhance appropriate health care utilization.

The Health Seeking Behaviors and Perceptions of Iranian Patient with Osteoarthritis about Pain Management: A Qualitative Study

Directory of Open Access Journals (Sweden)

Vahid Zamanzadeh

2017-03-01

Full Text Available Introduction: Pain is the main reason for patients with osteoarthritis (OA to visit health clinics. Health seeking behaviors indicate unmet patient needs and lack of understanding of OA pain patterns. This study aimed to describe the experiences of Iranian patients with OA and explore their health seeking behaviors and perceptions on pain management related to osteoarthritis. Methods: Using a qualitative approach, data was collected by interviewing 19 patients, 2 family members, and 5 health care providers from the in-patient and out-patient clinics, and physicians’ offices. Data saturation was reached after 31 in-depth and semi-structured interviews (five second interviews. Data were analyzed by qualitative content analysis, using comparison, reflection and interpretation techniques. The criteria used to enhance rigor included credibility, transferability, dependability, and confirmability. Results: Two main categories and six subcategories emerged from data analysis. The first main category included "adapting to the reality" which had three subcategories: Facing OA pain, seeking health care, and accepting pain as a part of life. The second main category included "behavior fluctuation" with three subcategory of role conflict, responsibility for self-care and, adherence to prescribed treatment versus self-treatment. Conclusion: Care seeking behaviors for chronic pain sufferers are void of cultural, emotional, social and financial situation and patient expectations. Some misconceptions emerged about the health problem and its management, which may lead to negative attitudes toward treatment and therapists and finally lead to non-adherence to treatment. Patients need for education to enhance appropriate health care utilization.

Effects of Arctium lappa L. (Burdock) root tea on inflammatory status and oxidative stress in patients with knee osteoarthritis.

Science.gov (United States)

Maghsoumi-Norouzabad, Leila; Alipoor, Beitollah; Abed, Reza; Eftekhar Sadat, Bina; Mesgari-Abbasi, Mehran; Asghari Jafarabadi, Mohammad

2016-03-01

This study was designed to examine the effect of Burdock root tea on inflammatory markers and oxidative stress indicators in patients with knee osteoarthritis (OA). Thirty-six patients (10 men and 26 women) aged 50-70 years old with knee osteoarthritis referred to the Physical Medicine and Rehabilitation Department of the Tabriz University of Medical Sciences Hospitals, were selected for the study and randomly divided into two groups. Anthropometric measurements, including height, weight and body mass index (BMI) were measured. For all individuals along the 42 days of study period, the same drug treatments, including two lots of 500 mg acetaminophen twice a day and one glucosamine 500 mg once a day,were considered. The intervention group received daily three cups of Burdock root tea (each cup containing 2 g/150 mL boiled water) half-hour after the meal. The control group received three cups containing 150 cc boiled water daily. We assessed inflammatory markers such as high sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6) and oxidative stress indicators such as total antioxidants capacity (TAC), glutathione peroxidase (GPX), superoxide dismutase (SOD) and thiobarbituric acid reactive substances before and after the intervention. The results showed that burdock root tea significantly decreased the levels of serum IL-6 (P = 0.002), hs-CRP (P = 0.003) and malondialdehyde (P Arctium lappa L. root tea improves inflammatory status and oxidative stress in patients with knee osteoarthritis. © 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

Running and osteoarthritis.

Science.gov (United States)

Willick, Stuart E; Hansen, Pamela A

2010-07-01

The overall health benefits of cardiovascular exercise, such as running, are well established. However, it is also well established that in certain circumstances running can lead to overload injuries of muscle, tendon, and bone. In contrast, it has not been established that running leads to degeneration of articular cartilage, which is the hallmark of osteoarthritis. This article reviews the available literature on the association between running and osteoarthritis, with a focus on clinical epidemiologic studies. The preponderance of clinical reports refutes an association between running and osteoarthritis. Copyright 2010 Elsevier Inc. All rights reserved.

Long-Term Outcomes in Puerto Ricans with Rheumatoid Arthritis (RA) Receiving Early Treatment with Disease-Modifying Anti-Rheumatic Drugs using the American College of Rheumatology Definition of Early RA.

Science.gov (United States)

Varela-Rosario, Noemí; Arroyo-Ávila, Mariangelí; Fred-Jiménez, Ruth M; Díaz-Correa, Leyda M; Pérez-Ríos, Naydi; Rodríguez, Noelia; Ríos, Grissel; Vilá, Luis M

2017-01-01

Early treatment of rheumatoid arthritis (RA) results in better long-term outcomes. However, the optimal therapeutic window has not been clearly established. To determine the clinical outcome of Puerto Ricans with RA receiving early treatment with conventional and/or biologic disease-modifying anti-rheumatic drugs (DMARDs) based on the American College of Rheumatology (ACR) definition of early RA. A cross-sectional study was performed in a cohort of Puerto Ricans with RA. Demographic features, clinical manifestations, disease activity, functional status, and pharmacotherapy were determined. Early treatment was defined as the initiation of DMARDs (conventional and/or biologic) in less than 6 months from the onset of symptoms attributable to RA. Patients who received early (disease duration was 14.9 years and 337 (87.0%) patients were women. One hundred and twenty one (31.3%) patients received early treatment. In the multivariate analysis adjusted for age and sex, early treatment was associated with better functional status, lower probability of joint deformities, intra-articular injections and joint replacement surgeries, and lower scores in the physician's assessments of global health, functional impairment and physical damage of patients. Using the ACR definition of early RA, this group of patients treated with DMARDs within 6 months of disease had better long-term outcomes with less physical damage and functional impairment.

Bone scan in diagnosis of infectious osteoarthritis

International Nuclear Information System (INIS)

Marandian, M.H.; Mortazavi, H.; Behvad, A.; Haghigat, H.; Lessani, M.; Youssefian, B.

1979-01-01

Bone scan with Technetium 99m is harmless method of evaluation of skeletal lesions. It is safe in pediatrics age group and it can be used in early diagnosis of infectious osteoarthritis. Bone scan differentiate osteomyelitis from cellulitis, and also it may help in diagnosis of subclinical involvement of rheumatoid arthritis, benign and malignant bone tumors, stress fractures and periostitis. We report results of bone scan in 30 pediatrics patients as follow: osteomyelitis 9 cases, cellulitis 4 cases, infectious arthritis 7 cases, tuberculous osteoarthritis 2 cases, rheumatoid arthritis 2 cases, and other different diseases 9 cases [fr

The Effects of Yoga on Pain, Mobility, and Quality of Life in Patients with Knee Osteoarthritis: A Systematic Review

Directory of Open Access Journals (Sweden)

Laidi Kan

2016-01-01

Full Text Available Objective. To systematically assess the effects of yoga on pain, mobility, and quality of life in patients with knee osteoarthritis. Methods. Pubmed, Medline, EMBASE, the Cochrane Central Register of Controlled Trials, Physiotherapy Evidence Database (PEDro, and other sources were searched systematically in this study. Two reviewers identified eligible studies and extracted data independently. Downs and Black’s Quality Index were used to evaluate the methodological quality of the included studies. Results. A total of 9 articles (6 studies involving 372 patients with knee osteoarthritis met the inclusion criteria. The most common yoga protocol is 40~90 minutes/session, lasting for at least 8 weeks. The effect of yoga on pain relief and function improvement could be seen after two-week intervention. Conclusion. This systematic review showed that yoga might have positive effects in relieving pain and mobility on patients with KOA, but the effects on quality of life (QOL are unclear. Besides, more outcome measure related to mental health of yoga effects on people with KOA should be conducted.

Effectiveness of behavioral graded activity in patients with osteoarthritis of the hip and/or knee: A randomized clinical trial.

NARCIS (Netherlands)

Veenhof, C.; Koke, A.J.; Dekker, J.; Oostendorp, R.A.B.; Bijlsma, J.W.J.; Tulder, M.W. van; Ende, C.H.M. van den

2006-01-01

OBJECTIVE: To determine the effectiveness of a behavioral graded activity program (BGA) compared with usual care (UC; exercise therapy and advice) according to the Dutch guidelines for physiotherapy in patients with osteoarthritis (OA) of the hip and/or knee. The BGA intervention is intended to

Determination of sup 226 Ra and sup 228 Ra in gypsum

Energy Technology Data Exchange (ETDEWEB)

Godoy, J M [Instituto de Radioprotecao e Dosimetria, Rio de Janeiro, RJ (Brazil)

1989-01-01

The content of {sup 226}Ra and {sup 228}Ra in different samples of phosphogypsum and three samples of gypsite were determined by gamma spectroscopy. For {sup 226}Ra the 295, 352 and 609 KeV lines and for {sup 228}Ra the 911 and 969 KeV lines were used. The specific activities values ranged from 0.36 to 22.8 pCi/g for {sup 226}Ra and 0.90 to 10.3 pCi/g for {sup 228}Ra. The contribution of a sypsum roof-covering to the {sup 222}Rn concentration in a room was estimated, based on the highest value reported. (author).

Correlation between Ultrasonographic Findings and The Response to Corticosteroid Injection in Pes Anserinus Tendinobursitis Syndrome in Knee Osteoarthritis Patients

OpenAIRE

Yoon, Ho Sung; Kim, Sung Eun; Suh, Young Ran; Seo, Young-Il; Kim, Hyun Ah

2005-01-01

The objectives of this study were to assess the ultrasonographic (US) findings in patients with knee osteoarthritis (OA) with pes anserinus tendinitis or bursitis (PATB) syndrome and to determine the correlation between the US findings and the response to local corticosteroid injection. We prospectively studied 26 patients with knee OA with clinically diagnosed PATB syndrome. A linear array 7 MHz transducer was used for US examination of the knee. Seventeen patients were injected locally with...

The role of knee joint moments and knee impairments on self-reported knee pain during gait in patients with knee osteoarthritis.

Science.gov (United States)

O'Connell, Megan; Farrokhi, Shawn; Fitzgerald, G Kelley

2016-01-01

The association between high mechanical knee joint loading during gait with onset and progression of knee osteoarthritis has been extensively studied. However, less attention has been given to risk factors related to increased pain during gait. The purpose of this study was to evaluate knee joint moments and clinical characteristics that may be associated with gait-related knee pain in patients with knee osteoarthritis. Sixty-seven participants with knee osteoarthritis were stratified into three groups of no pain (n=18), mild pain (n=27), or moderate/severe pain (n=22) based on their self-reported symptoms during gait. All participants underwent three-dimensional gait analysis. Quadriceps strength, knee extension range of motion, radiographic knee alignment and self-reported measures of global pain and function were also quantified. The moderate/severe pain group demonstrated worse global pain (Pknee flexion moments during the midstance phase of gait compared to the no pain group (P=0.02). Additionally, the moderate/severe pain group demonstrated greater varus knee malalignment (P=0.009), which was associated with higher weight acceptance peak knee adduction moments (P=0.003) and worse global pain (P=0.003) and physical function scores (P=0.006). Greater knee flexion moment is present during the midstance phase of gait in patients with knee osteoarthritis and moderate/severe pain during gait. Additionally, greater varus malalignment may be a sign of increased global knee joint dysfunction that can influence many activities of daily living beyond gait. Copyright © 2015 Elsevier Ltd. All rights reserved.

Do Psychosocial Factors Predict Muscle Strength, Pain, or Physical Performance in Patients With Knee Osteoarthritis?

Science.gov (United States)

Baert, Isabel A C; Meeus, Mira; Mahmoudian, Armaghan; Luyten, Frank P; Nijs, Jo; Verschueren, Sabine M P

2017-09-01

The aim of this study was to examine the relationship of psychosocial factors, namely, pain catastrophizing, kinesiophobia, and maladaptive coping strategies, with muscle strength, pain, and physical performance in patients with knee osteoarthritis (OA)-related symptoms. A total of 109 women (64 with knee OA-related symptoms) with a mean age of 65.4 years (49-81 years) were recruited for this study. Psychosocial factors were quantified by the Pain Catastrophizing Scale, Tampa Scale for Kinesiophobia, and Pain Coping Inventory. Clinical features were assessed using isometric and isokinetic knee muscle strength measurements, visual analog scale, Western Ontario and McMaster Universities Osteoarthritis Index, and functional tests. Associations were examined using correlation and regression analysis. In knee OA patients, pain catastrophizing, kinesiophobia, and coping strategy explained a significant proportion of the variability in isometric knee extension and flexion strength (6.3%-9.2%), accounting for more overall variability than some demographic and medical status variables combined. Psychosocial factors were not significant independent predictors of isokinetic strength, knee pain, or physical performance. In understanding clinical features related to knee OA, such as muscle weakness, pain catastrophizing, kinesiophobia, and coping strategy might offer something additional beyond what might be explained by traditional factors, underscoring the importance of a biopsychosocial approach in knee OA management. Further research on individual patient characteristics that mediate the effects of psychosocial factors is, however, required in order to create opportunities for more targeted, personalized treatment for knee OA.

Clinical efficacy of radiation synovectomy in digital joint osteoarthritis

International Nuclear Information System (INIS)

Kampen, Willm Uwe; Hellweg, Leif; Massoudi-Nickel, Schirin; Czech, Norbert; Henze, Eberhard; Brenner, Winfried

2005-01-01

Radiation synovectomy was developed for local treatment of rheumatoid arthritis. In this study, the long-term efficacy of radiation synovectomy was retrospectively evaluated in patients with osteoarthritis (activated arthrosis) of the digital joints using an algofunctional score. Fifty-three digital joints in 29 patients (mean age 64.8 years) were treated by intra-articular injection of 169 Er citrate. All joints were painful despite pharmacotherapy and showed an elevated blood pool pattern in a pretherapeutic three-phase bone scan, indicative for local synovitis. The patients were asked to classify their complaints with respect to different daily manual activities on a ten-step pain scale from 1 (total disability) to 10 (lack of any impairment) prior to and after treatment, with a mean follow-up of 41 months. Local signs of osteoarthritis such as joint swelling or pain were additionally evaluated and were scored from progression of complaints to excellent improvement based on patient self-evaluation. All patients reported a pronounced improvement in their manual activities. The mean total score of 4.73±0.58 for all activities prior to treatment increased significantly to 6.79±0.47 after radiation synovectomy (p<0.05). The best results were obtained in the thumb base joints, whereas distal interphalangeal joints were frequently resistant to therapy. Radiation synovectomy is highly effective in digital joint osteoarthritis with concomitant local synovitis. (orig.)

Clinical efficacy of radiation synovectomy in digital joint osteoarthritis

Energy Technology Data Exchange (ETDEWEB)

Kampen, Willm Uwe; Hellweg, Leif; Massoudi-Nickel, Schirin; Czech, Norbert; Henze, Eberhard [University Hospital Schleswig-Holstein, Clinic of Nuclear Medicine, Kiel (Germany); Brenner, Winfried [University Hospital Hamburg-Eppendorf, Department of Nuclear Medicine (Germany)

2005-04-01

Radiation synovectomy was developed for local treatment of rheumatoid arthritis. In this study, the long-term efficacy of radiation synovectomy was retrospectively evaluated in patients with osteoarthritis (activated arthrosis) of the digital joints using an algofunctional score. Fifty-three digital joints in 29 patients (mean age 64.8 years) were treated by intra-articular injection of{sup 169}Er citrate. All joints were painful despite pharmacotherapy and showed an elevated blood pool pattern in a pretherapeutic three-phase bone scan, indicative for local synovitis. The patients were asked to classify their complaints with respect to different daily manual activities on a ten-step pain scale from 1 (total disability) to 10 (lack of any impairment) prior to and after treatment, with a mean follow-up of 41 months. Local signs of osteoarthritis such as joint swelling or pain were additionally evaluated and were scored from progression of complaints to excellent improvement based on patient self-evaluation. All patients reported a pronounced improvement in their manual activities. The mean total score of 4.73{+-}0.58 for all activities prior to treatment increased significantly to 6.79{+-}0.47 after radiation synovectomy (p<0.05). The best results were obtained in the thumb base joints, whereas distal interphalangeal joints were frequently resistant to therapy. Radiation synovectomy is highly effective in digital joint osteoarthritis with concomitant local synovitis. (orig.)

Redesigning care for chronic conditions: improving hospital-based ambulatory care for people with osteoarthritis of the hip and knee.

Science.gov (United States)

Brand, C A; Amatya, B; Gordon, B; Tosti, T; Gorelik, A

2010-06-01

Osteoarthritis of the hip and knee is a highly prevalent chronic condition in Australia that commonly affects older people who have other comorbidities. We report the pilot implementation of a new chronic disease management osteoarthritis service, which was multidisciplinary, evidence-based, supported patient self-management and care coordination. A musculoskeletal coordinator role was pivotal to service redesign and osteoarthritis pathway implementation. Impact evaluation included: service utilization, patient and general practitioner service experience, a 'before and after' audit of clinician adherence to recommendations, and 3- and 6-month patient health outcomes (pain, physical function, patient and physician global health (Visual Analogue Scale), disability (Multi-Attribute Prioritisation Tool), Partners in Health Scale and body mass index). A total of 123 patients, median age of 66 years, were assessed. Documentation of osteoarthritis assessment and management improved for all parameters. At 3 months there were improvements in self-reported pain (P preferences for therapy. The cost implications for implementation were low. The osteoarthritis service model is feasible to implement, is well received by patients and staff, and provides a template for translation into other settings.

Military Service and Decision Quality in the Management of Knee Osteoarthritis.

Science.gov (United States)

Henderson, Eric R; Titus, Alexander J; Keeney, Benjamin J; Goodney, Philip P; Lurie, Jon D; Ibrahim, Said A

2018-05-18

Decision quality measures the degree to which care decisions are knowledge-based and value-aligned. Because military service emphasizes hierarchy, command, and mandates some healthcare decisions, military service may attenuate patient autonomy in healthcare decisions and lower decision quality. VA is the nation's largest provider of orthopedic care. We compared decision quality in a sample of VA and non-VA patients seeking care for knee osteoarthritis. Our study sample consisted of patients newly referred to our orthopedic clinic for the management of knee osteoarthritis. None of the study patients were exposed to a knee osteoarthritis decision aid. Consenting patients were administered the Hip/Knee Decision Quality Instrument (HK-DQI). In addition, they were surveyed about decision-making preferences and demographics. We compared results to a non-VA cohort from our academic institution's arthroplasty database. The HK-DQI Knowledge Score was lower in the VA cohort (45%, SD = 22, n = 25) compared with the non-VA cohort (53%, SD = 21, n = 177) (p = 0.04). The Concordance Score was lower in the VA cohort (36%, SD = 49%) compared with the control cohort (70%, SD 46%) (p = 0.003). Non-VA patients were more likely to make a high-quality decision (p = 0.05). Non-VA patients were more likely to favor a shared decision-making process (p = 0.002). Decision quality is lower in Veterans with knee osteoarthritis compared with civilians, placing them at risk for lower treatment satisfaction and possibly unwarranted surgical utilization. Our future work will examine if this difference is from conditioned military service behaviors or confounding demographic factors, and if conventional shared decision-making techniques will correct this deficiency.

An ultrasound score for knee osteoarthritis

DEFF Research Database (Denmark)

Riecke, B F; Christensen, R.; Torp-Pedersen, S

2014-01-01

OBJECTIVE: To develop standardized musculoskeletal ultrasound (MUS) procedures and scoring for detecting knee osteoarthritis (OA) and test the MUS score's ability to discern various degrees of knee OA, in comparison with plain radiography and the 'Knee injury and Osteoarthritis Outcome Score' (KOOS......) domains as comparators. METHOD: A cross-sectional study of MUS examinations in 45 patients with knee OA. Validity, reliability, and reproducibility were evaluated. RESULTS: MUS examination for knee OA consists of five separate domains assessing (1) predominantly morphological changes in the medial...... coefficients ranging from 0.75 to 0.97 for the five domains. Construct validity was confirmed with statistically significant correlation coefficients (0.47-0.81, P knee OA. In comparison with standing radiographs...

Hyaluronic Acid Injections for Treatment of Advanced Osteoarthritis of the Knee: Utilization and Cost in a National Population Sample.

Science.gov (United States)

Weick, Jack W; Bawa, Harpreet S; Dirschl, Douglas R

2016-09-07

The prevalence of knee osteoarthritis is increasing in the aging U.S. The efficacy and cost-effectiveness of the use of hyaluronic acid (HA) injections for the treatment of knee osteoarthritis are debated. In this study, we assessed the utilization and costs of HA injections in the 12 months preceding total knee arthroplasty (TKA) and evaluated the usage of HA injections in end-stage knee osteoarthritis management in relation to other treatments. MarketScan Commercial Claims and Encounters and Medicare Supplemental and Coordination of Benefits databases (Truven Health Analytics) were reviewed to identify patients who underwent TKA from 2005 to 2012. The utilization of patient-specific osteoarthritis-related health care (including medications, corticosteroid injections, HA injections, imaging, and office visits) and payment information were analyzed for the 12 months preceding TKA. A total of 244,059 patients met the inclusion criteria. Of those, 35,935 (14.7%) had ≥1 HA injection in the 12 months preceding TKA. HA injections were responsible for 16.4% of all knee osteoarthritis-related payments, trailing only imaging studies (18.2%), and HA injections accounted for 25.2% of treatment-specific payments, a rate that was higher than that of any other treatment. Patients receiving HA injections were significantly more likely to receive additional knee osteoarthritis-related treatments compared with patients who did not receive HA injections. Despite numerous studies questioning the efficacy and cost-effectiveness of HA injections for osteoarthritis of the knee, HA injections are still utilized for a substantial percentage of patients. Given the paucity of data supporting the effectiveness of HA injections and the current cost-conscious health-care climate, decreasing their use among patients with end-stage knee osteoarthritis may represent a substantial cost reduction that likely does not adversely impact the quality of care. Copyright © 2016 by The Journal of Bone

Cross-cultural validity of the animated activity questionnaire (AAQ) that assesses activity limitations in patients with hip or knee osteoarthritis

DEFF Research Database (Denmark)

Peter, W. F.; De Vet, R.; Boers, M.

2015-01-01

Background: The Animated Activity Questionnaire (AAQ) measures activity limitations in hip and knee osteoarthritis (HKOA), and demonstrated good validity and reliability [1]. The AAQ shows stylized video animations of different levels of activity performance. Patients are asked to choose which...

Peripheral Nerve Fibers and Their Neurotransmitters in Osteoarthritis Pathology.

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Grässel, Susanne; Muschter, Dominique

2017-04-28

The importance of the nociceptive nervous system for maintaining tissue homeostasis has been known for some time, and it has also been suggested that organogenesis and tissue repair are under neuronal control. Changes in peripheral joint innervation are supposed to be partly responsible for degenerative alterations in joint tissues which contribute to development of osteoarthritis. Various resident cell types of the musculoskeletal system express receptors for sensory and sympathetic neurotransmitters, allowing response to peripheral neuronal stimuli. Among them are mesenchymal stem cells, synovial fibroblasts, bone cells and chondrocytes of different origin, which express distinct subtypes of adrenoceptors (AR), receptors for vasoactive intestinal peptide (VIP), substance P (SP) and calcitonin gene-related peptide (CGRP). Some of these cell types synthesize and secrete neuropeptides such as SP, and they are positive for tyrosine-hydroxylase (TH), the rate limiting enzyme for biosynthesis of catecholamines. Sensory and sympathetic neurotransmitters are involved in the pathology of inflammatory diseases such as rheumatoid arthritis (RA) which manifests mainly in the joints. In addition, they seem to play a role in pathogenesis of priori degenerative joint disorders such as osteoarthritis (OA). Altogether it is evident that sensory and sympathetic neurotransmitters have crucial trophic effects which are critical for joint tissue and bone homeostasis. They modulate articular cartilage, subchondral bone and synovial tissue properties in physiological and pathophysiological conditions, in addition to their classical neurological features.

Tranexamic acid reduces intraoperative occult blood loss and tourniquet time in obese knee osteoarthritis patients undergoing total knee arthroplasty: a prospective cohort study.

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Meng, Yutong; Li, Zhirui; Gong, Ke; An, Xiao; Dong, Jiyuan; Tang, Peifu

2018-01-01

Obesity can result in increased blood loss, which is correlated with poor prognosis in total knee arthroplasty (TKA). Clinical application of tranexamic acid is effective in reducing blood loss in TKA. However, most previous studies focused on the effect of tranexamic acid in the whole population, neglecting patients with specific health conditions, such as obesity. We hypothesized that tranexamic acid would reduce blood loss to a greater extent in obese patients than in those of normal weight. A total of 304 patients with knee osteoarthritis treated with TKA from October 2013 to March 2015 were separated into tranexamic, non-tranexamic, obese, and non-obese groups. The demographic characteristics, surgical indices, and hematological indices were all recorded. We first investigated the ability of intravenous tranexamic acid to reduce intraoperative blood loss in knee osteoarthritis patients undergoing unilateral TKA. Second, we performed subgroup analysis to compare the effects of tranexamic acid between obese and non-obese patients separately. Of the 304 patients, 146 (52.0%) received tranexamic acid and 130 (42.8%) were obese. In the analysis of the whole group, both the actual and occult blood loss volume were lower in the tranexamic acid group (both P tranexamic acid group ( P tranexamic acid was shown to reduce theoretical and actual blood loss in both the obese and non-obese groups ( P Tranexamic acid reduced occult blood loss and tourniquet time in the obese group ( P 0.05). Tranexamic acid can reduce occult blood loss and tourniquet time in obese patients to a greater extent than in patients of normal weight. Therefore, obese knee osteoarthritis patients undergoing TKA can benefit more from tranexamic acid.

Outcome, revision rate and indication for revision following resurfacing hemiarthroplasty for osteoarthritis of the shoulder

DEFF Research Database (Denmark)

Rasmussen, J V; Polk, A; Sorensen, A K

2014-01-01

In this study, we evaluated patient-reported outcomes, the rate of revision and the indications for revision following resurfacing hemiarthroplasty of the shoulder in patients with osteoarthritis. All patients with osteoarthritis who underwent primary resurfacing hemiarthroplasty and reported...... to the Danish Shoulder Arthroplasty Registry (DSR), between January 2006 and December 2010 were included. There were 772 patients (837 arthroplasties) in the study. The Western Ontario Osteoarthritis of the Shoulder (WOOS) index was used to evaluate patient-reported outcome 12 months (10 to 14) post......-operatively. The rates of revision were calculated from the revisions reported to the DSR up to December 2011 and by checking deaths with the Danish National Register of Persons. A complete questionnaire was returned by 688 patients (82.2%). The mean WOOS was 67 (0 to 100). A total of 63 hemiarthroplasties (7...

Risk for Parkinson's disease among patients with osteoarthritis: a Danish cohort study

DEFF Research Database (Denmark)

Rugbjerg, Kathrine; Friis, Søren; Jørgensen, Thomas

2010-01-01

prevalence of NSAID use among cohort members, and lung cancer (0.77; 95% CI, 0.73-0.80), indicating a lower prevalence of smoking than usual. Our results do not support the hypothesis that patients with prolonged use of NSAID and other analgesics are at reduced risk for Parkinson's disease. A possible lower......It has been suggested that use of nonsteroidal anti-inflammatory drugs (NSAID) protects against Parkinson's disease, although the results are not consistent. We investigated the risk for Parkinson's disease in patients with osteoarthritis, who are typically intensive users of NSAID. By using......-2007 was compared with that expected from the age-, gender- and period-specific hospital contact rates of the general Danish population, and standardized incidence ratios (SIRs) and associated 95% confidence intervals (CIs) were derived. Cohort members were also linked to the Danish Cancer Register to estimate...

Real-Time Tracking of Knee Adduction Moment in Patients with Knee Osteoarthritis

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Kang, Sang Hoon; Lee, Song Joo; Zhang, Li-Qun

2014-01-01

Background The external knee adduction moment (EKAM) is closely associated with the presence, progression, and severity of knee osteoarthritis (OA). However, there is a lack of convenient and practical method to estimate and track in real-time the EKAM of patients with knee OA for clinical evaluation and gait training, especially outside of gait laboratories. New Method A real-time EKAM estimation method was developed and applied to track and investigate the EKAM and other knee moments during stepping on an elliptical trainer in both healthy subjects and a patient with knee OA. Results Substantial changes were observed in the EKAM and other knee moments during stepping in the patient with knee OA. Comparison with Existing Method(s) This is the first study to develop and test feasibility of real-time tracking method of the EKAM on patients with knee OA using 3-D inverse dynamics. Conclusions The study provides us an accurate and practical method to evaluate in real-time the critical EKAM associated with knee OA, which is expected to help us to diagnose and evaluate patients with knee OA and provide the patients with real-time EKAM feedback rehabilitation training. PMID:24361759

Joint laxity and the relationship between muscle strength and functional ability in patients with osteoarthritis of the knee.

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van der Esch, M; Steultjens, M; Knol, D L; Dinant, H; Dekker, J

2006-12-15

To establish the impact of knee joint laxity on the relationship between muscle strength and functional ability in osteoarthritis (OA) of the knee. A cross-sectional study of 86 patients with OA of the knee was conducted. Tests were performed to determine varus-valgus laxity, muscle strength, and functional ability. Laxity was assessed using a device that measures the angular deviation of the knee in the frontal plane. Muscle strength was measured using a computer-driven isokinetic dynamometer. Functional ability was assessed by observation (100-meter walking test) and self report (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]). Regression analyses were performed to assess the impact of joint laxity on the relationship between muscle strength and functional ability. In regression analyses, the interaction between muscle strength and joint laxity contributed to the variance in both walking time (P = 0.002) and WOMAC score (P = 0.080). The slope of the regression lines indicated that the relationship between muscle strength and functional ability (walking time, WOMAC) was stronger in patients with high knee joint laxity. Patients with knee OA and high knee joint laxity show a stronger relationship between muscle strength and functional ability than patients with OA and low knee joint laxity. Patients with OA, high knee joint laxity, and low muscle strength are most at risk of being disabled.

Intra-articular therapies for osteoarthritis.

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