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Correia R, Oliveira L, Andrade I, de Castro Correia M, Gonçalves E, Borges A, Lopes T, Carvalho JL. Ultrasound-Guided Radiofrequency Ablation for Chronic Hip Pain Due to Osteoarthritis. Cureus 2024; 16:e53743. [PMID: 38465076 PMCID: PMC10920965 DOI: 10.7759/cureus.53743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND AND AIMS Hip osteoarthritis (OA) has a prevalence of 2.9% in Portugal and is a related cause of pain and disability. A sufficient number of patients report these symptoms even after total hip arthroplasty (THA), while others are contraindicated to such surgery and suffer from uncontrolled pain. Percutaneous denervation of hip nerve branches using radiofrequency ablation (RFA) has emerged as a powerful therapeutic avenue to consider for patients with chronic hip pain. METHODS Between January 2020 and March 2021, 26 patients with chronic hip pain received ultrasound-guided RFA with a pericapsular nerve group (PENG) block technique adaptation. Patients suffering from chronic hip pain for more than three months with radiographic evidence of osteoarthritis were included. A numeric rating scale (NRS) and pain medication reduction were defined as outcome variables assessed before treatment and at three-, six-, nine-, and 12-month follow-ups. RESULTS All selected patients underwent the procedure. All the patients had hip osteoarthritis. Twelve-month follow-up data revealed a statistically significant decrease in the numeric rating scale. The mean NRS for pain was 2 after the procedure. Over 75% of patients reported >50% pain relief during the follow-up and 85% reduced pain medication consumption. No side effects were reported. CONCLUSION Hip sensory articular branch RFA is a treatment option with interesting outcomes for chronic hip pain, as demonstrated by our study.
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Affiliation(s)
- Rodrigo Correia
- Physical Medicine and Rehabilitation, Centro de Reabilitação do Norte, Vila Nova de Gaia, PRT
| | - Luís Oliveira
- Physical Medicine and Rehabilitation, Centro de Reabilitação do Norte, Vila Nova de Gaia, PRT
| | - Inês Andrade
- Physical Medicine and Rehabilitation, Centro de Medicina de Reabilitação de Alcoitão, Lisboa, PRT
| | | | - Eugénio Gonçalves
- Physical Medicine and Rehabilitation, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, PRT
| | - Andre Borges
- Physical Medicine and Rehabilitation, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, PRT
| | - Tiago Lopes
- Intervention and Musculoskeletal Rehabilitation, Centro de Reabilitação do Norte, Vila Nova de Gaia, PRT
| | - José Luís Carvalho
- Intervention and Musculoskeletal Rehabilitation, Centro de Reabilitação do Norte, Vila Nova de Gaia, PRT
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de Sire A, Marotta N, Spanó R, Fasano S, Sgro M, Lippi L, Invernizzi M, Ammendolia A. Efficacy of proprioceptive neuromuscular facilitation on functioning in patients with bilateral hip osteoarthritis: A pilot randomized controlled trial. J Back Musculoskelet Rehabil 2024; 37:445-457. [PMID: 37955078 DOI: 10.3233/bmr-230148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
BACKGROUND Hip osteoarthritis (OA) is a chronic progressive disease that impresses a noticeable burden to society and healthcare systems. Physical exercise constitutes the first-line hip OA treatment approach, nevertheless, there is currently no gold standard method to treat this disease. OBJECTIVE To evaluate the efficacy of proprioceptive neuromuscular facilitation (PNF) on functioning in patients with hip OA. METHOD A pilot randomized controlled trial (RCT) was carried out on patients with painful bilateral hip OA with a body mass index (BMI) < 30 kg/m2. After the randomization, the experimental group was treated with PNF protocol and the control group with conventional physical therapy (10 sessions of manual therapy, 5 sessions/week for 2 weeks). The Harris Hip Score (HHS) was the primary outcome, whereas we assessed as secondary outcomes: pain, range of motion, and muscle strength of hip, physical performance, and quality of life. RESULTS Twenty patients (40 hips) were enrolled and randomized into two groups: PNF group (mean age: 70.7 ± 8.07; BMI: 25.1 ± 3.07; 7 females and 3 males) and control group (mean age: 74.9 ± 10.72; BMI: 26.8 ± 3.78; 6 females and 4 males). The results showed a statistically significant improvement of HHS in the study group (T1: 90.6 ± 5.63) than in the control group (T1: 77.3 ± 10.9) (between-group p value < 0.001). Three months after the treatment we have statistically significant maintenance in the PNF group (T2:89.6±6.32, within-group ΔT0-T2 p< 0.01) while the control group did not maintain the improvements recorded at T1 (T2: 71.4 ± 15.8). CONCLUSION The results of this pilot RCT showed that incorporating PNF exercises into the rehabilitation program yielded notable enhancements in improving lower limb function, strength and ROM in hip OA patients. Nonetheless, further prospective studies including wider sample size are needed to implement scientific knowledge on this physical therapy approach, in patients with hip osteoarthritis.
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Affiliation(s)
- Alessandro de Sire
- Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Nicola Marotta
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro "Magna Graecia", Catanzaro, Italy
- Department of Experimental and Clinical Medicine, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Riccardo Spanó
- Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
- S. Anna Institute, Crotone, Italy
| | - Stefano Fasano
- Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Maria Sgro
- Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Lorenzo Lippi
- Department of Health Sciences, University of Eastern Piedmont "A. Avogadro", Novara, Italy
- Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Marco Invernizzi
- Department of Health Sciences, University of Eastern Piedmont "A. Avogadro", Novara, Italy
- Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Antonio Ammendolia
- Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro "Magna Graecia", Catanzaro, Italy
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Farì G, Megna M, Scacco S, Ranieri M, Raele MV, Noya EC, Macchiarola D, Bianchi FP, Carati D, Gnoni A, Inchingolo AD, Qorri E, Scarano A, Scacco A, Arrigoni R, Rapone B. Effects of Terpenes on the Osteoarthritis Cytokine Profile by Modulation of IL-6: Double Face versus Dark Knight? BIOLOGY 2023; 12:1061. [PMID: 37626947 PMCID: PMC10452224 DOI: 10.3390/biology12081061] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 07/19/2023] [Accepted: 07/26/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Hemp seed oil and terpenes are emerging as a dietary supplement and complementary therapy for patients suffering from knee osteoarthritis (KOA). However, the mechanisms and effects induced by these molecules on inflammatory cytokines are not yet fully understood. The aim of this study was to evaluate the changes in the cytokine IL-1β, IL-1α, IL-2, IL-6, and TNF-α levels from two oral hemp seed oil-based dietary supplements, of which only one included the addition of terpenes, in a population of KOA patients. METHODS Sera from venous blood samples were collected from thirty-eight patients who were divided into two subgroups. The control group underwent a 45-day treatment with a dietary supplement containing only hemp seed oil, while the treatment group assumed a hemp seed oil and terpene-based dietary supplement for the same number of days. A Bio-Plex Human Cytokine assay was performed by a customized human cytokine five-plex panel for IL-1β, IL-1α, IL-2, IL-6, and TNF-α. Patients were evaluated before the beginning of the treatment (T0) and soon after it (T1). RESULTS No measurable levels of IL-2 and TNF-α were found in any of the subjects. Low levels of IL-1β were found, which were significantly decreased in the treatment group. No change in IL-1α levels was observed, while treated patients had a significant increase in IL-6 levels. CONCLUSIONS Hemp seed oil and terpene treatment modified the IL-1β and IL-6 levels, counteracting KOA inflammation in this way. In this study, IL-6 revealed its new and alternative action, since it is traditionally known as a pro-inflammatory factor, but it recently has been found to have anti-inflammatory activity in the muscle-derived form, which is the one it assumes as a myokine when activated by terpenes.
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Affiliation(s)
- Giacomo Farì
- Department of Translational Biomedicine and Neuroscience (DiBraiN), Aldo Moro University, 70121 Bari, Italy; (M.M.); (S.S.); (M.R.); (M.V.R.); (E.C.N.); (D.M.); (A.G.)
- Department of Biological and Environmental Science and Technologies (Di.S.Te.B.A.), University of Salento, Piazza Tancredi 7, 73100 Lecce, Italy
| | - Marisa Megna
- Department of Translational Biomedicine and Neuroscience (DiBraiN), Aldo Moro University, 70121 Bari, Italy; (M.M.); (S.S.); (M.R.); (M.V.R.); (E.C.N.); (D.M.); (A.G.)
| | - Salvatore Scacco
- Department of Translational Biomedicine and Neuroscience (DiBraiN), Aldo Moro University, 70121 Bari, Italy; (M.M.); (S.S.); (M.R.); (M.V.R.); (E.C.N.); (D.M.); (A.G.)
- Mater Dei Hospital C.B.H., 70125 Bari, Italy
| | - Maurizio Ranieri
- Department of Translational Biomedicine and Neuroscience (DiBraiN), Aldo Moro University, 70121 Bari, Italy; (M.M.); (S.S.); (M.R.); (M.V.R.); (E.C.N.); (D.M.); (A.G.)
| | - Maria Vittoria Raele
- Department of Translational Biomedicine and Neuroscience (DiBraiN), Aldo Moro University, 70121 Bari, Italy; (M.M.); (S.S.); (M.R.); (M.V.R.); (E.C.N.); (D.M.); (A.G.)
| | - Enrica Chiaia Noya
- Department of Translational Biomedicine and Neuroscience (DiBraiN), Aldo Moro University, 70121 Bari, Italy; (M.M.); (S.S.); (M.R.); (M.V.R.); (E.C.N.); (D.M.); (A.G.)
| | - Dario Macchiarola
- Department of Translational Biomedicine and Neuroscience (DiBraiN), Aldo Moro University, 70121 Bari, Italy; (M.M.); (S.S.); (M.R.); (M.V.R.); (E.C.N.); (D.M.); (A.G.)
- Istituti Clinici Scientifici Maugeri, IRCCS, 70124 Bari, Italy;
| | - Francesco Paolo Bianchi
- Department of Interdisciplinary Medicine, Aldo Moro University of Bari, 70121 Bari, Italy; (F.P.B.); (A.D.I.); (B.R.)
| | - Davide Carati
- Ansce Bio Generic, 73020 Carpignano Salentino, Italy;
| | - Antonio Gnoni
- Department of Translational Biomedicine and Neuroscience (DiBraiN), Aldo Moro University, 70121 Bari, Italy; (M.M.); (S.S.); (M.R.); (M.V.R.); (E.C.N.); (D.M.); (A.G.)
| | - Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, Aldo Moro University of Bari, 70121 Bari, Italy; (F.P.B.); (A.D.I.); (B.R.)
| | - Erda Qorri
- Dean Faculty of Medical Sciences, Albanian University, Bulevardi Zogu I, 1001 Tirana, Albania;
| | - Antonio Scarano
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Antonio Scacco
- Istituti Clinici Scientifici Maugeri, IRCCS, 70124 Bari, Italy;
| | - Roberto Arrigoni
- CNR Institute of Biomembranes, Bioenergetics and Molecular Biotechnologies (IBIOM), 70125 Bari, Italy;
| | - Biagio Rapone
- Department of Interdisciplinary Medicine, Aldo Moro University of Bari, 70121 Bari, Italy; (F.P.B.); (A.D.I.); (B.R.)
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Hemp Seed Oil in Association with β-Caryophyllene, Myrcene and Ginger Extract as a Nutraceutical Integration in Knee Osteoarthritis: A Double-Blind Prospective Case-Control Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59020191. [PMID: 36837393 PMCID: PMC9960141 DOI: 10.3390/medicina59020191] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/11/2023] [Accepted: 01/15/2023] [Indexed: 01/19/2023]
Abstract
Background and Objectives: Nutraceuticals are gaining more and more importance as a knee osteoarthritis (KOA) complementary treatment. Among nutraceuticals, hemp seed oil and terpenes are proving to be very useful as therapeutic support for many chronic diseases, but there are still few studies regarding their effectiveness for treating KOA, both in combination and separately. The aim of this study is thus to compare the effect of two dietary supplements, both containing hemp seed oil, but of which only one also contains terpenes, in relieving pain and improving joint function in patients suffering from KOA. Materials and Methods: Thirty-eight patients were recruited and divided into two groups. The control group underwent a 45 day treatment with a hemp seed oil-based dietary supplement, while the treatment group assumed a hemp seed oil and terpenes dietary supplement for the same period. Patients were evaluated at the enrollment (T0) and at the end of treatment (T1). Outcome measures were: Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), Short-Form-12 (SF-12), Knee Injury Osteoarthritis Outcome Score (KOOS), and Oxford Knee Score (OKS). Results: All outcome measures improved at T1 in both groups, but NRS, KOOS and OKS had a greater significant improvement in the treatment group only. Conclusions: Hemp seed oil and terpenes resulted a more effective integrative treatment option in KOA, improving joint pain and function and representing a good complementary option for patients suffering from osteoarthritis.
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Xu H, Zhang Y, Wang C. Ultrasound-guided hydrodilatation of glenohumeral joint combined with acupotomy for treatment of frozen shoulder. J Back Musculoskelet Rehabil 2022; 35:1153-1160. [PMID: 35213351 DOI: 10.3233/bmr-210272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Frozen shoulder (FS), also known as shoulder adhesive capsulitis, is a musculoskeletal disorder associated with pain and functional disability. There is a lack of evidence on the optimal treatment strategy for FS. OBJECTIVE The present study aimed to evaluate the effectiveness and safety of ultrasound-guided hydrodilatation of glenohumeral joint combined with acupotomy for treatment of FS. METHODS In this prospective randomized, double-blind, controlled study, 63 FS patients were recruited, and equally allocated to treatment group and control group. The treatment group was treated with ultrasound-guided hydrodilatation of glenohumeral joint combined with acupotomy, while the control group was only treated with ultrasound-guided hydrodilatation of glenohumeral joint. The pain and mobility of shoulder, overall efficacy and adverse reactions were evaluated 3 months after treatment. RESULTS At baseline, no significant difference in all characteristic value was found between the treatment group (n= 33) and control group (n= 30). Three months after operation, the joint's Active Range of Motion (AROM) and Constant-Murley Scale (CMS) scores in the experimental group were higher than those in the control group, and the coracohumeral ligament (CHL) thickness and the rate of hypoechoic thickening in rotator cuff space in the experimental group were lower than those in the control group (all P< 0.05). The amount of injection volume at the third hydrodilatation was significantly higher in the experimental group than that in the control group (15.8 ± 4.7 vs 12.2 ± 5.2, P= 0.03). After 2 times of treatment, the volume increment of glenohumeral joint Δ2 in the experimental group was greater than that in the control group (3.5 ± 1.8 vs 1.2 ± 1.6, P< 0.001). There were significant differences in the effective rate between the two groups (93.94% vs. 76.67%, P= 0.04). CONCLUSION The ultrasound-guided hydrodilatation of glenohumeral joint combined with acupotomy may benefit FS patients.
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Affiliation(s)
- Huajun Xu
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.,Department of Ultrasound, Huzhou Central Hospital, Suzhou, Jiangsu, China.,Department of Ultrasound, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Yingchun Zhang
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.,Department of Ultrasound, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Caishan Wang
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
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Farì G, Santagati D, Macchiarola D, Ricci V, Di Paolo S, Caforio L, Invernizzi M, Notarnicola A, Megna M, Ranieri M. Musculoskeletal pain related to surfing practice: Which role for sports rehabilitation strategies? A cross-sectional study. J Back Musculoskelet Rehabil 2022; 35:911-917. [PMID: 35068441 DOI: 10.3233/bmr-210191] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Surf practice contributes to overuse injuries and musculoskeletal pain. Relationship between the type of surfing practiced and the onset of pain is not fully understood as well as the potential role of rehabilitation in preventing it. OBJECTIVE To investigate musculoskeletal pain and to deepen whether the age and the anatomical region involved influenced the pain appearance in relation to four surfing disciplines. METHODS A cross-sectional study was carried out. An online survey was addressed to a group of Italian surfers (practicing surf, kitesurf, windsurf and stand up paddle since at least 1 year), collecting demographic data, discipline practiced, location of musculoskeletal pain. RESULTS One hundred and twenty-six surfers were involved in the study. Spine and upper limbs pain was more frequent compared to lower limbs one in the surf (p< 0.001) and in the windsurf groups (p= 0.007). In the kitesurf group a greater prevalence of pain was observed in spine and lower limbs compared to upper limbs (p= 0.017). Low back pain is the most represented among the spine pain subgroups (p< 0.001). Pain was lower in younger athletes (p= 0.007). CONCLUSIONS Understanding risk factors and biomechanics of musculoskeletal pain is essential to realize prevention training strategies. Rehabilitation in sinergy with specific training allows pain-free activity, optimizing its overall health benefits.
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Affiliation(s)
- Giacomo Farì
- Physical Medicine and Rehabilitation Unit, Department of Basic Medical Science, Neuroscience and Sensory Organs, School of Medicine and Surgery, University of Bari, General Hospital, Bari, Italy
| | - Dario Santagati
- School of Specialization in Physical Medicine and Rehabilitation, Department of Basic Medical Science, Neuroscience and Sensory Organs, School of Medicine and Surgery, University of Bari, General Hospital, Bari, Italy
| | - Dario Macchiarola
- School of Specialization in Physical Medicine and Rehabilitation, Department of Basic Medical Science, Neuroscience and Sensory Organs, School of Medicine and Surgery, University of Bari, General Hospital, Bari, Italy
| | - Vincenzo Ricci
- Physical and Rehabilitation Medicine Unit, Department of Biomedical and Neuromotor Science, IRCCS Rizzoli Orthopedic Institute, Bologna, Italy
| | - Stefano Di Paolo
- Physical and Rehabilitation Medicine Unit, Department of Biomedical and Neuromotor Science, IRCCS Rizzoli Orthopedic Institute, Bologna, Italy
| | | | - Marco Invernizzi
- Physical and Rehabilitation Medicine Unit, Department of Health Sciences, University of Eastern Piedmont "A. Avogadro", Novara, Italy
| | - Angela Notarnicola
- Orthopaedics Unit, Department of Basic Medical Science, Neuroscience and Sensory Organs, School of Medicine and Surgery, University of Bari, General Hospital, Bari, Italy
| | - Marisa Megna
- Physical Medicine and Rehabilitation Unit, Department of Basic Medical Science, Neuroscience and Sensory Organs, School of Medicine and Surgery, University of Bari, General Hospital, Bari, Italy
| | - Maurizio Ranieri
- Physical Medicine and Rehabilitation Unit, Department of Basic Medical Science, Neuroscience and Sensory Organs, School of Medicine and Surgery, University of Bari, General Hospital, Bari, Italy
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Filip A, Veliceasa B, Puha B, Filip N, Cojocaru E, Pertea M, Carp CA, Huzum B, Alexa O, Rommens PM. Pain Intensity and Degree of Disability after Fragility Fractures of the Pelvis. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58040477. [PMID: 35454313 PMCID: PMC9024514 DOI: 10.3390/medicina58040477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 12/03/2022]
Abstract
Background and objectives: Fragility fractures of the pelvis (FFP) are of increasing interest lately, being associated with a loss of mobility and affecting the quality of life. The aim of our study was to investigate the effect of FFP on disability and pain in patients, after one year since injury. Materials and Methods: In the study, we included 76 patients diagnosed with FFP, who were admitted to our trauma department between January 2016 and January 2019, and were above 65 years of age. The Von Korff pain intensity and disability scores were calculated in the hospital at 6 months and after 1 year. Results: Fifty-four patients were female (71%), with an average age of 75.9 ± 7.19 years. Twenty-two patients were male (29%) and had a mean age of 77.22 ± 7.33 years. We did not record significant differences regarding age between the men and women (p > 0.05). Significant improvements appeared between the baseline and the 6 month follow-up; the average pain intensity score at 6 months was 44.94 (SD 21.20) (p < 0.001), and the disability score was 54.30 (SD 21.62). The following average pain intensity and disability scores after 12 months were similar to the values at6 months: 44.48 (SD 21.74) for pain intensity and 52.36 (SD 24.53) for disability. The Von Korff pain score at 6 months and after 1 year depends on gender and on the initial Von Korff pain score (p = 0.02). The Von Korff disability score at 6 months depends on gender, the baseline pain score and the baseline disability score (p = 0.001). Conclusions: our patients reported long-lasting pain that had a severe effect on their daily routines, and they could not return to their normal status prior to injury.
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Affiliation(s)
- Alexandru Filip
- Department of Orthopedics and Traumatology, Surgical Science (II), Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700020 Iasi, Romania; (A.F.); (B.P.); (C.A.C.); (B.H.); (O.A.)
| | - Bogdan Veliceasa
- Department of Orthopedics and Traumatology, Surgical Science (II), Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700020 Iasi, Romania; (A.F.); (B.P.); (C.A.C.); (B.H.); (O.A.)
- Correspondence: (B.V.); (N.F.)
| | - Bogdan Puha
- Department of Orthopedics and Traumatology, Surgical Science (II), Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700020 Iasi, Romania; (A.F.); (B.P.); (C.A.C.); (B.H.); (O.A.)
| | - Nina Filip
- Department of Morpho-Functional Sciences (II), Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700020 Iasi, Romania
- Correspondence: (B.V.); (N.F.)
| | - Elena Cojocaru
- Department of Morpho-Functional Sciences (I), Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700020 Iasi, Romania;
| | - Mihaela Pertea
- Department Plastic Surgery and Reconstructive, Surgical Sciences (I), Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700020 Iasi, Romania;
| | - Claudiu Adrian Carp
- Department of Orthopedics and Traumatology, Surgical Science (II), Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700020 Iasi, Romania; (A.F.); (B.P.); (C.A.C.); (B.H.); (O.A.)
| | - Bogdan Huzum
- Department of Orthopedics and Traumatology, Surgical Science (II), Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700020 Iasi, Romania; (A.F.); (B.P.); (C.A.C.); (B.H.); (O.A.)
| | - Ovidiu Alexa
- Department of Orthopedics and Traumatology, Surgical Science (II), Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700020 Iasi, Romania; (A.F.); (B.P.); (C.A.C.); (B.H.); (O.A.)
| | - Pol Maria Rommens
- Department of Orthopedics and Traumatology, University Medical Center of Johannes Gutenberg-University Mainz, 55131 Mainz, Germany;
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Farì G, de Sire A, Fallea C, Albano M, Grossi G, Bettoni E, Di Paolo S, Agostini F, Bernetti A, Puntillo F, Mariconda C. Efficacy of Radiofrequency as Therapy and Diagnostic Support in the Management of Musculoskeletal Pain: A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2022; 12:diagnostics12030600. [PMID: 35328153 PMCID: PMC8947614 DOI: 10.3390/diagnostics12030600] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 02/16/2022] [Accepted: 02/24/2022] [Indexed: 12/14/2022] Open
Abstract
Radiofrequency (RF) is a minimally invasive procedure used to interrupt or alter nociceptive pathways for treating musculoskeletal pain. It seems a useful tool to relieve chronic pain syndromes, even if, to date, solid evidence is still needed about the effectiveness of this therapy. By this systematic review and meta-analysis, we aimed to evaluate the efficacy of RF in treating musculoskeletal pain. PubMed, Medline, Cochrane, and PEDro databases were searched to identify randomized controlled trials (RCTs) presenting the following: patients with chronic musculoskeletal pain as participants; RF as intervention; placebo, anesthetic injection, corticosteroid injection, prolotherapy, conservative treatment, physiotherapy, and transcutaneous electrical nerve stimulation as comparisons; and pain and functioning as outcomes. Continuous random-effect models with standardized mean difference (SMD) were used to compare the clinical outcomes. Overall, 26 RCTs were eligible and included in the systematic review. All of them analyzed the efficacy of RF in four different regions: cervical and lumbar spine, knee, sacroiliac (SI) joint, shoulder. The outcomes measures were pain, disability, and quality of life. A medium and large effect in favor of the RF treatment group (SMD < 0) was found for the shoulder according to the Visual Analogical Scale and for the SI joint according to the Oswestry Disability Index. A small effect in favor of the RF treatment group (SMD > 0) was found for the spine according to the 36-item Short Form Survey. Non-significant SMD was found for the other outcomes. RF represents a promising therapy for the treatment of chronic musculoskeletal pain, especially when other approaches are ineffective or not practicable. Further studies are warranted to better deepen the effectiveness of RF for pain and joint function for each anatomical region of common application.
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Affiliation(s)
- Giacomo Farì
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University of Bari, 70121 Bari, Italy
- Correspondence: (G.F.); (A.d.S.); Tel.: +39-0805593499 (G.F.); +39-0961712819 (A.d.S.)
| | - Alessandro de Sire
- Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
- Correspondence: (G.F.); (A.d.S.); Tel.: +39-0805593499 (G.F.); +39-0961712819 (A.d.S.)
| | - Cettina Fallea
- Department of Rehabilitation Sciences, Humanitas Gradenigo Hospital, 10153 Turin, Italy; (C.F.); (M.A.); (G.G.); (E.B.); (C.M.)
| | - Mariantonia Albano
- Department of Rehabilitation Sciences, Humanitas Gradenigo Hospital, 10153 Turin, Italy; (C.F.); (M.A.); (G.G.); (E.B.); (C.M.)
| | - Gianluca Grossi
- Department of Rehabilitation Sciences, Humanitas Gradenigo Hospital, 10153 Turin, Italy; (C.F.); (M.A.); (G.G.); (E.B.); (C.M.)
| | - Elisa Bettoni
- Department of Rehabilitation Sciences, Humanitas Gradenigo Hospital, 10153 Turin, Italy; (C.F.); (M.A.); (G.G.); (E.B.); (C.M.)
| | - Stefano Di Paolo
- Department of Biomedical and Neuromotor Science, IRCCS Rizzoli Orthopedic Institute, 40136 Bologna, Italy;
| | - Francesco Agostini
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy; (F.A.); (A.B.)
| | - Andrea Bernetti
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy; (F.A.); (A.B.)
| | - Filomena Puntillo
- Department of Interdisciplinari Medicine, Aldo Moro University, 70124 Bari, Italy;
| | - Carlo Mariconda
- Department of Rehabilitation Sciences, Humanitas Gradenigo Hospital, 10153 Turin, Italy; (C.F.); (M.A.); (G.G.); (E.B.); (C.M.)
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9
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de Sire A, Agostini F, Lippi L, Mangone M, Marchese S, Cisari C, Bernetti A, Invernizzi M. Oxygen-Ozone Therapy in the Rehabilitation Field: State of the Art on Mechanisms of Action, Safety and Effectiveness in Patients with Musculoskeletal Disorders. Biomolecules 2021; 11:biom11030356. [PMID: 33652804 PMCID: PMC7996934 DOI: 10.3390/biom11030356] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 02/11/2021] [Accepted: 02/22/2021] [Indexed: 12/15/2022] Open
Abstract
In recent years, the interest in oxygen–ozone (O2O3) therapy application has considerably increased in the field of rehabilitation. Despite its widespread use in common clinical practice, the biochemical effects of O2O3 are still far from being understood, although its chemical properties seem to play a pivotal role in exerting its positive effects on different pathological conditions. Indeed, the effectiveness of O2O3 therapy might be partly due to the moderate oxidative stress produced by O3 interactions with biological components. O2O3 therapy is widely used as an adjuvant therapeutic option in several pathological conditions characterized by chronic inflammatory processes and immune over-activation, and most musculoskeletal disorders share these pathophysiological processes. The present comprehensive review depicts the state-of-the-art on the mechanisms of action, safety and effectiveness of O2O3 therapy in the complex scenario of the management of musculoskeletal disorders. Taken together, our findings suggest that O2O3 therapy seems to reduce pain and improve functioning in patients affected by low back pain and knee osteoarthritis, as reported by several studies in the literature. However, to date, further studies are warranted to clearly investigate the therapeutic effects of this promising therapy on other musculoskeletal disorders in the field of rehabilitation.
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Affiliation(s)
- Alessandro de Sire
- Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
- Correspondence: ; Tel.: +39-096-136-9768
| | - Francesco Agostini
- Department of Anatomy, Histology, Forensic Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy; (F.A.); (M.M.); (S.M.); (A.B.)
| | - Lorenzo Lippi
- Department of Health Sciences, University of Eastern Piedmont, 28100 Novara, Italy; (L.L.); (C.C.); (M.I.)
| | - Massimiliano Mangone
- Department of Anatomy, Histology, Forensic Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy; (F.A.); (M.M.); (S.M.); (A.B.)
| | - Simone Marchese
- Department of Anatomy, Histology, Forensic Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy; (F.A.); (M.M.); (S.M.); (A.B.)
| | - Carlo Cisari
- Department of Health Sciences, University of Eastern Piedmont, 28100 Novara, Italy; (L.L.); (C.C.); (M.I.)
| | - Andrea Bernetti
- Department of Anatomy, Histology, Forensic Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy; (F.A.); (M.M.); (S.M.); (A.B.)
| | - Marco Invernizzi
- Department of Health Sciences, University of Eastern Piedmont, 28100 Novara, Italy; (L.L.); (C.C.); (M.I.)
- Infrastruttura Ricerca Formazione Innovazione (IRFI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
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