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Manatrakul R, Pirmoazen AM, Bharadwaj UU, Akkaya Z, Giesler PJ, Lynch JA, Nevitt MC, McCulloch CE, Joseph GB, Link TM. Thigh muscle and fat volumes are associated with knee cartilage abnormalities and bone marrow edema-like lesions: data from the osteoarthritis initiative. Skeletal Radiol 2024; 53:1279-1286. [PMID: 38206355 DOI: 10.1007/s00256-024-04565-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 01/03/2024] [Accepted: 01/03/2024] [Indexed: 01/12/2024]
Abstract
OBJECTIVE To investigate the associations of thigh muscle and fat volumes with structural abnormalities on MRI related to knee osteoarthritis. MATERIALS AND METHODS MRI studies of the thighs and knees from 100 individuals were randomly selected from the Osteoarthritis Initiative Cohort. Whole Organ MR Scoring (WORMS) and effusion-synovitis scoring were performed in all knee MRI. Thigh muscles, intermuscular fat, and subcutaneous fat were manually segmented in 15 consecutive MR thigh images. Radiographic Kellgren-Lawrence grades (KLG) were also obtained in all knee radiographs. Independent t-tests were used to investigate the associations between thigh muscle and fat volumes, and sex. Mixed-effects analyses were obtained to investigate the associations between thigh muscle and fat volumes, KLG, WOMAC pain score, cartilage and bone marrow WORMS, as well as effusion-synovitis scores. RESULTS Women had higher subcutaneous fat volume than men (616.82 vs. 229.13 cm3, p < 0.01) and men had higher muscle volumes than women (p < 0.01). Quadriceps (coef = -2.15, p = 0.01) and vastus medialis (coef = -1.84, p = 0.03) volumes were negatively associated with the WORMS cartilage scores. Intermuscular fat volume (coef = 0.48, p = 0.01) was positively associated with WORMS bone marrow edema-like lesion (BMEL) scores. The quadriceps (coef = -0.99, p < 0.01) and hamstring (coef = -0.59, p = 0.01) volumes were negatively associated with WORMS BMEL scores. No evidence of an association was found between thigh muscle and fat volumes with KLG and effusion-synovitis grading (p > 0.05). CONCLUSION Increased quadriceps and hamstring volumes were negatively associated with cartilage lesion and BMEL scores while no evidence of an association was found between thigh muscle and fat volumes, and radiographic knee osteoarthritis or effusion-synovitis grading.
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Affiliation(s)
- Rawee Manatrakul
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry St, Suite 350, San Francisco, CA, 94158, USA.
- Department of Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
| | - Amir M Pirmoazen
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry St, Suite 350, San Francisco, CA, 94158, USA
- Department of Radiology, University of Florida, Jacksonville, FL, USA
| | - Upasana U Bharadwaj
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry St, Suite 350, San Francisco, CA, 94158, USA
| | - Zehra Akkaya
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry St, Suite 350, San Francisco, CA, 94158, USA
| | - Paula J Giesler
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry St, Suite 350, San Francisco, CA, 94158, USA
- Medical Center, University of Freiburg, Freiburg, Germany
| | - John A Lynch
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Michael C Nevitt
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Charles E McCulloch
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Gabby B Joseph
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry St, Suite 350, San Francisco, CA, 94158, USA
| | - Thomas M Link
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry St, Suite 350, San Francisco, CA, 94158, USA
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Wu Y, Chen W, Jian J, Liu W, Wang H, Gao D, Liu W. The potential molecular markers of inflammatory response in KOA with AD based on single-cell transcriptome sequencing analysis and identification of ligands by virtual screening. Mol Divers 2024:10.1007/s11030-024-10854-4. [PMID: 38622351 DOI: 10.1007/s11030-024-10854-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 03/20/2024] [Indexed: 04/17/2024]
Abstract
Alzheimer's disease (AD) and osteoarthritis (OA) are both senile degenerative diseases. Clinical studies have found that OA patients have a significantly increased risk of AD in their later life. This study hypothesized that chronic aseptic inflammation might lead to AD in KOA patients. However, current research has not yet clarified the potential mechanism between AD and KOA. Therefore, this study intends to use KOA transcriptional profiling and single-cell sequencing analysis technology to explore the molecular mechanism of KOA affecting AD development, and screen potential molecular biomarkers and drugs for the prediction, diagnosis, and prognosis of AD in KOA patients. It was found that the higher the expression of TXNIP, MMP3, and MMP13, the higher the risk coefficient of AD was. In addition, the AUC of TXNIP, MMP3, and MMP13 were all greater than 0.70, which had good diagnostic significance for AD. Finally, through the virtual screening of core proteins in FDA drugs and molecular dynamics simulation, it was found that compound Cobicistat could be targeted to TXNIP, Itc could be targeted to MMP3, and Isavuconazonium could be targeted to MMP13. To sum up, TXNIP, MMP3, and MMP13 are prospective molecular markers in KOA with AD, which could be used to predict, diagnose, and prognosis.
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Affiliation(s)
- Yufeng Wu
- Traditional Chinese Medicine Hospital of Zhongshan, Zhongshan, 528400, Guangdong, China
- Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, China
| | - Weijian Chen
- Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, China
- The Fifth Clinical College of Guangzhou, University of Chinese Medicine, Guangzhou, 510095, China
- Guangdong Provincial Second Hospital of Traditional Chinese Medicine (Guangdong Provincial Engineering Technology Research Institute of Traditional Chinese Medicine), Guangzhou, 510095, China
| | - Junde Jian
- Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, China
- Guangzhou Orthopedic Hospital, Guangdong Province, Guangzhou University of Chinese Medicine, Guangzhou, 510045, China
| | - Weinian Liu
- Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, China
- Guangzhou Orthopedic Hospital, Guangdong Province, Guangzhou University of Chinese Medicine, Guangzhou, 510045, China
| | - Haibin Wang
- Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, China
- The First Clinical Medical College, Guangdong Province, Guangzhou University of Chinese Medicine, Guangzhou, 510405, China
| | - Dawei Gao
- Traditional Chinese Medicine Hospital of Zhongshan, Zhongshan, 528400, Guangdong, China
- Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, China
| | - Wengang Liu
- Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, China.
- The Fifth Clinical College of Guangzhou, University of Chinese Medicine, Guangzhou, 510095, China.
- Guangdong Provincial Second Hospital of Traditional Chinese Medicine (Guangdong Provincial Engineering Technology Research Institute of Traditional Chinese Medicine), Guangzhou, 510095, China.
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Minoretti P, Santiago Sáez A, Liaño Riera M, Gómez Serrano M, García Martín Á. Efficacy and Safety of Two Chondroprotective Supplements in Patients With Knee Osteoarthritis: A Randomized, Single-Blind, Pilot Study. Cureus 2024; 16:e57579. [PMID: 38707049 PMCID: PMC11069075 DOI: 10.7759/cureus.57579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2024] [Indexed: 05/07/2024] Open
Abstract
Background: Hyaluronic acid (HA), glucosamine (Glc), and chondroitin sulfate (CS) are key ingredients commonly incorporated into dietary chondroprotective supplements for the management of osteoarthritis (OA). Despite their widespread use, there is a paucity of published data regarding their efficacy and safety, necessitating rigorous investigation in clinical settings. To address this knowledge gap, we conducted a randomized, single-blind pilot study to evaluate the effects of two commercially available multi-ingredient supplements on patients with mild-to-moderate knee OA. Methods: A total of 51 patients diagnosed with mild-to-moderate knee OA were enrolled in a four-week randomized study and allocated equally (1:1:1 ratio) into three groups: a control group (n = 17) that received no treatment, an HA group (n = 17) given Syalox® 300 Plus (1 tablet/day) containing HA (300 mg) and Boswellia serrata extract (100 mg), and a Glc + CS group (n = 17) given Cartijoint® Forte (1 tablet/day) containing Glc (415 mg), CS (400 mg), and curcuminoids from rhizomes of Curcuma longa L (50 mg).Physicians conducting evaluations were blinded to group assignments, whereas patients were not. All participants underwent assessments of pain relief, functional capacity improvement, and serum adropin levels, an emerging biomarker of knee OA, at baseline and after the four-week intervention period. Results: Both the HA and the Glc + CS groups exhibited improvements at the end of the study relative to baseline, with statistically significant differences (p < 0.05) observed in pain at rest, pain during movement, range of motion, and the overall Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, including its pain, stiffness, and physical function subscales. Notably, the HA group outperformed the Glc + CS group in the alleviation of pain at rest, pain during movement, and on the WOMAC pain subscale, with all differences being statistically significant (p < 0.05). Additionally, both groups showed a significant elevation in serum adropin levels from baseline (p < 0.05), with the HA group experiencing a more substantial increase when compared to the Glc + CS group (p < 0.05). Both supplements showed a limited number of treatment-emergent adverse events. Conclusion: Oral supplementation with either HA or Glc + CS demonstrated potential benefits for managing symptoms of mild-to-moderate knee OA. Notably, HA supplementation was associated with greater improvements in pain relief and higher elevations in serum adropin levels compared to Glc + CS supplementation. However, larger-scale and longer-term studies are necessary to further evaluate the safety and efficacy of these dietary supplements within the clinical management arsenal for knee OA.
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Affiliation(s)
| | - Andrés Santiago Sáez
- Legal Medicine, Hospital Clinico San Carlos, Madrid, ESP
- Legal Medicine, Psychiatry, and Pathology, Complutense University of Madrid, Madrid, ESP
| | - Miryam Liaño Riera
- Legal Medicine, Psychiatry and Pathology, Complutense University of Madrid, Madrid, ESP
| | - Manuel Gómez Serrano
- Legal Medicine, Psychiatry and Pathology, Complutense University of Madrid, Madrid, ESP
| | - Ángel García Martín
- Legal Medicine, Psychiatry and Pathology, Complutense University of Madrid, Madrid, ESP
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Chen L, Zhou H, Gong Y, Tang Y, Su H, Jin Z, Chen G, Tong P. How Do Muscle Function and Quality Affect the Progression of KOA? A Narrative Review. Orthop Surg 2024; 16:802-810. [PMID: 38438160 PMCID: PMC10984828 DOI: 10.1111/os.14022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 01/26/2024] [Accepted: 02/03/2024] [Indexed: 03/06/2024] Open
Abstract
Knee osteoarthritis (KOA) is widely recognized as a chronic joint disease characterized by degeneration of knee cartilage and subsequent bone hyperplasia. However, it is important to acknowledge the significant role of muscles in the development and progression of KOA. Muscle function (MF) and muscle quality (MQ) are key factors in understanding the involvement of muscles in KOA. Quantitative indices such as muscle mass, muscle strength, muscle cross-sectional area, muscle thickness, and muscle fatigue are crucial in assessing MF and MQ. Despite the growing interest in KOA, there is a scarcity of studies investigating the relationship between muscles and this condition. This review aims to examine the commonly used indices and measurement methods for assessing MF and MQ in clinical settings, while also exploring the association between muscles and KOA. Furthermore, this article highlights the importance of restoring MF and MQ to enhance symptom management and improve the quality of life for patients with KOA.
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Affiliation(s)
- Lei Chen
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine)The First Clinical College of Zhejiang Chinese Medical UniversityHangzhouChina
| | - Haojing Zhou
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine)The First Clinical College of Zhejiang Chinese Medical UniversityHangzhouChina
| | - Yichen Gong
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine)The First Clinical College of Zhejiang Chinese Medical UniversityHangzhouChina
| | - Yi Tang
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine)The First Clinical College of Zhejiang Chinese Medical UniversityHangzhouChina
| | - Hai Su
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine)The First Clinical College of Zhejiang Chinese Medical UniversityHangzhouChina
| | - Zhaokai Jin
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine)The First Clinical College of Zhejiang Chinese Medical UniversityHangzhouChina
| | - Guoqian Chen
- Department of Orthopaedics and TraumatologyThe First Affiliated Hospital of Zhejiang Chinese Medical UniversityHangzhouChina
| | - Peijian Tong
- Department of Orthopaedics and TraumatologyThe First Affiliated Hospital of Zhejiang Chinese Medical UniversityHangzhouChina
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Kang M, Seo S, Lee H, Han MW. Knee Measurement System with Osteoarthritis Levels Using Artificial Cartilage and Skeletons. Biomimetics (Basel) 2024; 9:166. [PMID: 38534851 DOI: 10.3390/biomimetics9030166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 03/04/2024] [Accepted: 03/07/2024] [Indexed: 03/28/2024] Open
Abstract
Knee osteoarthritis (OA), also known as degenerative arthritis, is a disease characterized by irreversible changes in the cartilage and bones comprising the joints, resulting in pain, impaired function, and deformity. Furthermore, independent of natural aging, the rate of change in joint cartilage has increased in recent years, which is mainly attributed to environmental factors. The rising incidence of knee-related disorders emphasizes the importance of analyzing the morphology and kinematics of knee structure. This study introduces a knee measurement system designed to replicate the motions of knee using 3D-printing technology, providing insights into knee mechanics with OA level. The research explores the stages of OA using the Kellgren-Lawrence (KL) grade scale, highlighting the variations in the force applied to the knee bone according to movement. The developed knee-simulation system, utilizing the four-bar-link theory, presents a novel approach to studying OA levels 0 to 4. As OA progresses, the cartilage deteriorates, affecting the movement of OA. The OA-based knee measurement system that incorporates soft tissues and skeletons can assist in developing a personalized diagnostic approach for knee disease. This will also help to enhance surgical effectiveness by facilitating the creation of personalized prosthetic joints for individual patients and offering a customized surgical simulation.
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Affiliation(s)
- Minchae Kang
- Department of Mechanical Engineering, Advanced Manufacturing & Soft Robotics Lab, Dongguk University, 30 Pildong-ro 1, Jung-gu, Seoul 04620, Republic of Korea
| | - Suyeon Seo
- Department of Mechanical Engineering, Advanced Manufacturing & Soft Robotics Lab, Dongguk University, 30 Pildong-ro 1, Jung-gu, Seoul 04620, Republic of Korea
| | - Hyewon Lee
- Department of Mechanical, Robotics and Energy Engineering, Advanced Manufacturing & Soft Robotics Lab, Dongguk University, 30 Pildong-ro 1, Jung-gu, Seoul 04620, Republic of Korea
| | - Min-Woo Han
- Department of Mechanical Engineering, Advanced Manufacturing & Soft Robotics Lab, Dongguk University, 30 Pildong-ro 1, Jung-gu, Seoul 04620, Republic of Korea
- Department of Mechanical, Robotics and Energy Engineering, Advanced Manufacturing & Soft Robotics Lab, Dongguk University, 30 Pildong-ro 1, Jung-gu, Seoul 04620, Republic of Korea
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Bonanzinga T, De Sensi AG, Balzarini B, Doro GL, Bertolino L, Forte L, Kon E. An Innovative Topical Medical Device with Hyaluronic Acid and Polypeptides in Patients with Reduced Knee Function. J Funct Morphol Kinesiol 2024; 9:31. [PMID: 38390931 PMCID: PMC10885074 DOI: 10.3390/jfmk9010031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 02/08/2024] [Accepted: 02/11/2024] [Indexed: 02/24/2024] Open
Abstract
A topical medical device, AI500®, constituted of a single-chain polypeptide embedded in hyaluronic acid, was tested and evaluated in patients with reduced knee function due to osteoarthritis and other knee conditions. A total of 35 participants with reduced knee function assessed by the WOMAC Physical Function score were recruited. Four study visits were planned, from the first application at V0 to 1 week follow up at V3. Patient symptomatology was evaluated after 24 h (V1) and after 48 h (V2) through phone contact, and after 1 week from V0, on site (V3). The overall duration of the follow up was one week. An amelioration of 40% in WOMAC Physical Functional scores after 1 week of treatment was recorded, thus achieving the primary endpoint of 20%. Furthermore, a reduction of 29% in Physical Functional scores and of 28% in total WOMAC scores between V0-V2 was registered, together with a decrease of 39% between V0 and V3. The NRS scale showed a 29% and 37% reduction in pain between V0-V1 and V0-V2, respectively. Product safety was confirmed by the very low rate of adverse effects, non-device related, observed in only 2 patients out of 35, resolved spontaneously within 24-48 h. No safety concerns or risks associated with the use of the device were highlighted. There are few the studies on the topical use of HA-based gels for the treatment of knee problems. Compared to invasive intra-articular injections and oral pharmacological therapies used in cases of knee pain, the topical application of AI500® is non-invasive, safe, and appreciated by patients. Good results in terms of functional improvement and symptoms resolution were obtained in less than 1 week.
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Affiliation(s)
- Tommaso Bonanzinga
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
- IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
| | - Alice Giulia De Sensi
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
- IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
| | - Beatrice Balzarini
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
- IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
| | - Gian Luca Doro
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
- IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
| | - Luca Bertolino
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
| | - Luca Forte
- Contrad Swiss SA, 6900 Lugano, Switzerland
| | - Elizaveta Kon
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
- IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
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Wang HY, Ho CY, Pan MC. Evaluation of lumbar and hip movement characterization and muscle activities during gait in patients with knee osteoarthritis. Gait Posture 2024; 108:1-8. [PMID: 37952348 DOI: 10.1016/j.gaitpost.2023.10.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 09/05/2023] [Accepted: 10/26/2023] [Indexed: 11/14/2023]
Abstract
Patients with knee osteoarthritis (KOA) might have gait deviations, but few previous studies have discussed gait compensatory movements of the proximal and distal parts of muscle groups related to KOA. The study aimed to measure lumbar and hip movements during gait test and collect muscle activities of the lower extremities. Thirty-four participants with KOA and 28 healthy participants aged over 50 years were recruited for this study. Lumbar and hip motions during walking test were measured using inertial measurement units. Four muscle groups of the lower extremity (erector spinae, gluteus maximus, quadriceps muscle, and gastrocnemius) activities in gait were collected using surface EMGs. KOA patients used an 2.12∘anterior inclined lumbar spine (p = 0.007) and 22.94∘ flexed hip (p = 0.001) in gait compared to healthy participants. The KOA patients had a small hip movement range 30.19∘(p = 0.001) and a higher asymmetric stance time ratio 0.39 (p = 0.006). Patients with KOA showed decreased erector spinae and gluteus maximus muscle activation and increased activation of the quadriceps and gastrocnemius muscles during gait. In conclusion, patients with KOA used a hyperlordotic lumbar and hip flexed strategy, which overactivates distal extensor muscles through the whole gait and might cause overstress on the lower extremity joints.
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Affiliation(s)
- Hsin-Yi Wang
- Department of Biomedical Science and Engineering, National Central University, Jhongli 320317, Taiwan; Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, National Defense Medical Center, Taipei 114202, Taiwan.
| | - Cheng-Yi Ho
- Department of Mechanical Engineering, National Central University, Jhongli 320317, Taiwan.
| | - Min-Chun Pan
- Department of Biomedical Science and Engineering, National Central University, Jhongli 320317, Taiwan; Department of Mechanical Engineering, National Central University, Jhongli 320317, Taiwan.
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Mariner Gonzalez A, Reyes SG, Ho AA, Brown O, Franklin P, Suleiman LI. Underrepresentation of Non-White Participants in the American Academy of Orthopaedic Surgeons Guidelines for Surgical Management of Knee Osteoarthritis. J Arthroplasty 2024; 39:520-526. [PMID: 37572721 DOI: 10.1016/j.arth.2023.08.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 08/04/2023] [Accepted: 08/06/2023] [Indexed: 08/14/2023] Open
Abstract
BACKGROUND The aim of this study was to examine the racial and ethnic representation in studies included in the 2015 American Academy of Orthopaedic Surgeons Surgical Management of the Knee Evidence-Based Clinical Practice Guideline relative to their representation of the United States (US). METHODS The demographic characteristics reported in articles included in the 2015 American Academy of Orthopaedic Surgeons Surgical Management of the Knee Evidence-Based Clinical Practice Guideline were analyzed. The primary outcome of interest was the representation quotient, which is the ratio of the proportion of a racial/ethnic group in the guideline studies relative to their proportion in the US. There were 211 studies included, of which 15 (7%) reported race. There were 35 studies based in the US and 7 of the US-based studies reported race. RESULTS No US-based studies reported race and ethnicity separately, no studies reported American Indian/Alaska Native participants and no US-based studies reported Asian participants. The representation quotient of US-based studies was 0.66 for Black participants, 0.33 for Hispanic participants, and 1.30 for White participants, which indicates a relative over-representation of White participants compared to national proportions. CONCLUSION This study illustrated that the evidence base for the surgical management of knee osteoarthritis has been constructed from studies which fail to consider race and ethnicity. Of those US-based studies which do report race or ethnicity, study cohorts do not reflect the US population. These results illustrate a disparity in clinical orthopedic surgical evidence and highlight the need for improved research recruitment strategies.
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Affiliation(s)
- Alba Mariner Gonzalez
- Department of Orthopaedic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Samuel G Reyes
- Department of Orthopaedic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Alisha A Ho
- Department of Orthopaedic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Oluwateniola Brown
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Patricia Franklin
- Department of Orthopaedic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Department of Medicine (Rheumatology), Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Linda I Suleiman
- Department of Orthopaedic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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Nemati D, Munk N, Kaushal N. Identifying behavioral determinants and stage of readiness for performing knee massage among individuals with knee osteoarthritis: An observational study. J Integr Med 2024; 22:54-63. [PMID: 38331653 DOI: 10.1016/j.joim.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 11/02/2023] [Indexed: 02/10/2024]
Abstract
OBJECTIVE Patients who experience knee osteoarthritis or chronic knee pain can alleviate their symptoms by performing self-knee massage. Understanding the readiness and types of determinants needed to facilitate self-knee massage is needed to design effective, theory-informed interventions. The primary objective of this study was to apply the transtheoretical model of behavior change to identify how factors, which include the type of knee condition and pain level, predict an individual's readiness to adopt self-knee massage. The secondary objective employed the capability, opportunity and motivation-behavior (COM-B) model to identify relevant determinants that are predictive of an individual's readiness to undertake self-knee massage. METHODS An observational study design was used to recruit individuals with knee osteoarthritis (n = 270) and chronic knee pain (n = 130). Participants completed an online survey that assessed the transtheoretical model of behavior change stages, COM-B determinants (capability, opportunity and motivation), along with self-administered massage behavior. Multivariate analysis of covariance and structural equation modeling were used to test the primary and secondary objective, respectively. RESULTS Participants who had knee osteoarthritis scored higher on the action stage compared to those with chronic pain (P = 0.003), and those who experienced greater level of pain scored higher in the contemplation (P < 0.001) and action phases (P < 0.001) of performing knee massage compared to those with milder pain. The COM-B structural equation model revealed self-administered knee massage to be predicted by capability (β = 0.31, P = 0.004) and motivation (β = 0.29, P < 0.001), but not opportunity (β = -0.10, P = 0.39). Pain level predicted motivation (β = 0.27, P < 0.001), but not capability (β = 0.09, P = 0.07) or opportunity (β = 0.01, P = 0.83). Tests for mediating effects found that determinants of COM-B (motivation and capability) mediate between pain level and self-administered massage behavior (β = 0.10, P = 0.002). CONCLUSION Clinicians and researchers can expect that patients diagnosed with knee osteoarthritis or who have chronic knee pain are ready (action stage) or are considering the behavior (contemplation stage) of self-knee massage. Individuals who report having knee osteoarthritis or chronic knee pain should be coached to develop the skills to perform self-knee massage and helped to develop the motivation to carry out the therapy. Please cite this article as: Nemati D, Munk N, Kaushal N. Identifying behavioral determinants and stage of readiness for performing knee massage among individuals with knee osteoarthritis: an observational study. J Integr Med. 2024; 22(1): 54-63.
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Affiliation(s)
- Donya Nemati
- College of Nursing, the Ohio State University, Columbus, OH 43210, USA.
| | - Niki Munk
- Department of Health Sciences, School of Health & Human Sciences, Indiana University, Indianapolis, IN 46202, USA; National Centre for Naturopathic Medicine, Southern Cross University, Lismore, New South Wales 2480, Australia; Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Massage & Myotherapy Australia Fellow and Visiting Faculty of Health, University of Technology Sydney, New South Wales 2007, Australia
| | - Navin Kaushal
- Department of Health Sciences, School of Health & Human Sciences, Indiana University, Indianapolis, IN 46202, USA
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Khalid S, Ali A, Deepak FNU, Zulfiqar MS, Malik LU, Fouzan Z, Nasr RA, Qamar M, Bhattarai P. Comparative effectiveness of intra-articular therapies in knee osteoarthritis: a meta-analysis comparing platelet-rich plasma (PRP) with other treatment modalities. Ann Med Surg (Lond) 2024; 86:361-372. [PMID: 38222750 PMCID: PMC10783230 DOI: 10.1097/ms9.0000000000001615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/03/2023] [Indexed: 01/16/2024] Open
Abstract
Introduction Knee osteoarthritis (KOA) is a progressive joint disease commonly treated with intra-articular injections, including platelet-rich plasma (PRP), hyaluronic acid (HA), or corticosteroids (CS). This updated meta-analysis aims to enhance the statistical power of the results and provide comprehensive clinical evidence that reflects the most current research. By doing so, the authors aim to suggest a reliable estimate for the development of guidelines, addressing the pressing need for effective and minimally invasive treatment options. Methods PubMed, Scopus, clinicaltrials.gov, Cochrane Central were searched until March 2023, for randomized controlled trials (RCTs) comparing the effectiveness of intra-articular injectable therapies, including PRP, HA, CS, and placebo, in KOA. Data extraction involved baseline characteristics and outcome measures [Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores, Visual Analog Scale (VAS) pain scores, KOOS, and IKDC scores] at 1, 3, 6 and 12 months. Statistical analysis, including subgroup analysis, assessment of heterogeneity, and publication bias, was conducted using Review Manager. Results Our meta-analysis of 42 studies involving 3696 patients demonstrated that PRP treatment resulted in significant pain relief compared to HA injections, as evidenced by improved WOMAC pain (MD: -0.74; 95% CI: -1.02 to -0.46; P≤0.00001; I 2=94%) and VAS pain (MD: -0.65; 95% CI: -1.24 to -0.06; P=0.03; I2=97%) outcomes. Similarly, PRP showed greater efficacy in reducing WOMAC pain (MD: -8.06; 95% CI: -13.62 to -2.51: P=0.004; I 2=96%) and VAS pain (MD: -1.11; 95% CI: -1.64 to -0.59; P≤0.0001; I 2=68%) compared to CS injections, with the most significant improvement observed at 6 months. Conclusions PRP is an effective treatment for KOA. It provides symptomatic relief, has the potential to reduce disease progression, and has sustained effects up to 12 months. PRP offers superior pain relief and functional enhancement compared to CS and HA injections.
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Affiliation(s)
- Saad Khalid
- Department of Medicine, Dow University of Health Sciences
| | - Abraish Ali
- Department of Medicine, Dow University of Health Sciences
| | - FNU Deepak
- Shaheed Mohtarma Benazir Bhutto Medical College Lyari
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Mou J, Wang Q, Wu J, Zhang L, Li YA, Luo Z, An J, Sun T, Zheng X, Wang Y, Hu K. The effect of Fu's subcutaneous needling in treating knee osteoarthritis patients: A randomized controlled trial. Explore (NY) 2023:S1550-8307(23)00286-0. [PMID: 38176976 DOI: 10.1016/j.explore.2023.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 12/13/2023] [Accepted: 12/27/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND Fu's subcutaneous needling (FSN) is an acupuncture technique for the treatment of soft tissue diseases. Knee osteoarthritis often involves lower limb muscles. This study aimed to observe and compare the clinical efficacy of Fu's subcutaneous acupuncture and electroacupuncture in the treatment of patients with knee osteoarthritis. METHODS 62 patients with early or medial stage of knee osteoarthritis were randomly divided into the FSN therapy group or the electroacupuncture(EA) therapy group (1:1). The Lysholm score, range of motion, and equilibrium function were observed over a 3-month follow-up period. A total of 60 participants completed the study. RESULTS Over the 3 months of follow-up, both treatment regimens showed equally favorable results on all prognostic measures compared with their respective baseline data (P<0.05). Compared with the EA group, the FSN group had a significantly greater improvement in claudication, joint stability, swelling, pain, and ROM after treatment (P<0.05). At 3 months after treatment, the FSN group revealed better scores of claudication, joint stability, swelling, walking up stairs, squatting, pain, ROM, and equilibrium function (forward and backward movement speed, left and right movement speed, movement ellipse area, movement length) compared to the EA group (all P<0.05). CONCLUSIONS This study showed that FSN can significantly improve the pain symptoms, joint stability, and joint function of patients with knee osteoarthritis, and the clinical efficacy can be maintained at least 3 months after treatment.
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Affiliation(s)
- Jianjiao Mou
- Rehabilitation medicine department, Suining Central Hospital, Suining, China.
| | - Qiong Wang
- Department of pain treatment, Suining Central Hospital, Suining, China
| | - Juan Wu
- Rehabilitation medicine department, Suining Central Hospital, Suining, China
| | - Leixiao Zhang
- Division of Internal Medicine, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, China
| | - Yang-An Li
- Rehabilitation medicine department, Suining Central Hospital, Suining, China
| | - Zhichao Luo
- Rehabilitation medicine department, Suining Central Hospital, Suining, China
| | - Jiayi An
- Rehabilitation medicine department, Suining Central Hospital, Suining, China
| | - Tao Sun
- Rehabilitation medicine department, Suining Central Hospital, Suining, China
| | - Xinlei Zheng
- Rehabilitation medicine department, Suining Central Hospital, Suining, China
| | - Yan Wang
- Teaching and training department, Suining Central Hospital, Suining, China.
| | - Kehui Hu
- Rehabilitation medicine department, Suining Central Hospital, Suining, China.
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Ekeuku SO, Tan JK, Al-Saadi HM, Ahmad F, Elvy Suhana MR, Arlamsyah AM, Japar Sidik FZ, Abdul Hamid J, Ima-Nirwana S, Chin KY. Serum Metabolomic Alteration in Rats with Osteoarthritis Treated with Palm Tocotrienol-Rich Fraction Alone or in Combination with Glucosamine Sulphate. Life (Basel) 2023; 13:2343. [PMID: 38137944 PMCID: PMC10744932 DOI: 10.3390/life13122343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 12/12/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023] Open
Abstract
Osteoarthritis (OA) is a degenerative joint condition with limited disease-modifying treatments currently. Palm tocotrienol-rich fraction (TRF) has been previously shown to be effective against OA, but its mechanism of action remains elusive. This study aims to compare serum metabolomic alteration in Sprague-Dawley rats with monosodium iodoacetate (MIA)-induced OA which were treated with palm TRF, glucosamine sulphate, or a combination of both. This study was performed on thirty adult male rats, which were divided into normal control (n = 6) and OA groups (n = 24). The OA group received intra-articular injections of MIA and daily oral treatments of refined olive oil (vehicle, n = 6), palm TRF (100 mg/kg, n = 6), glucosamine sulphate (250 mg/kg, n = 6), or a combination of TRF and glucosamine (n = 6) for four weeks. Serum was collected at the study's conclusion for metabolomic analysis. The findings revealed that MIA-induced OA influences amino acid metabolism, leading to changes in metabolites associated with the biosynthesis of phenylalanine, tyrosine and tryptophan as well as alterations in the metabolism of phenylalanine, tryptophan, arginine and proline. Supplementation with glucosamine sulphate, TRF, or both effectively reversed these metabolic changes induced by OA. The amelioration of metabolic effects induced by OA is linked to the therapeutic effects of TRF and glucosamine. However, it remains unclear whether these effects are direct or indirect in nature.
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Affiliation(s)
- Sophia Ogechi Ekeuku
- Department of Biochemistry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras 56000, Malaysia; (S.O.E.)
| | - Jen-Kit Tan
- Department of Biochemistry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras 56000, Malaysia; (S.O.E.)
| | - Hiba Murtadha Al-Saadi
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras 56000, Malaysia
| | - Fairus Ahmad
- Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras 56000, Malaysia
| | - Mohd Ramli Elvy Suhana
- Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras 56000, Malaysia
| | - Azlan Mohd Arlamsyah
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras 56000, Malaysia
| | | | - Juliana Abdul Hamid
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras 56000, Malaysia
| | - Soelaiman Ima-Nirwana
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras 56000, Malaysia
| | - Kok-Yong Chin
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras 56000, Malaysia
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Rahimi F, Sadeghisani M, Karimzadeh A. Efficacy of transcranial direct current stimulation in patients with knee osteoarthritis: A systematic review. Neurophysiol Clin 2023; 53:102918. [PMID: 37944293 DOI: 10.1016/j.neucli.2023.102918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 10/18/2023] [Accepted: 10/21/2023] [Indexed: 11/12/2023] Open
Abstract
OBJECTIVE Transcranial direct current stimulation (tDCS) has demonstrated its efficacy in alleviating pain among individuals with musculoskeletal disorders. This review focuses on the application of tDCS as a therapeutic intervention for managing knee osteoarthritis (OA), a prevalent musculoskeletal condition. The primary objective is to assess the effectiveness of tDCS(add-on tDCS and /or stand-alone tDCS), whether as an add-on to existing treatments or as a standalone therapy, in reducing pain and enhancing functional capacity in patients with knee OA. METHODS A comprehensive search was conducted across multiple databases, including PubMed, Science Direct, OVID, MEDLINE, CINAHL, EMBASE, ProQuest, and Google Scholar, and Web of Science. The search terms employed were "Transcranial direct current stimulation" or "tDCS" in combination with "Osteoarthritis" or "OA" and "knee." After eliminating duplicates and studies that did not meet the inclusion criteria, a total of 14 relevant articles were identified for review. RESULTS Among the included studies, twelve reported statistically significant improvements in pain levels when comparing the active tDCS group to the sham tDCS group. Only two studies reported no significant difference in pain intensity between the active tDCS and sham tDCS groups. Findings regarding functional abilities were diverse, with some studies demonstrating a significant enhancement in functional outcomes in the active tDCS group, while others observed no statistically significant differences. CONCLUSION The results of this review suggest that tDCS holds promise as a pain management intervention for individuals with knee OA. Notably, anodal tDCS applied over the primary motor cortex (M1) appears to be particularly effective in alleviating pain in patients with knee OA. However, the impact of tDCS on functional performance appears to be limited.
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Affiliation(s)
- Fatemeh Rahimi
- Department of Physiotherapy, School of Allied Medical Sciences, Social Determinants of Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran.
| | - Meissam Sadeghisani
- Department of Physiotherapy, School of Allied Medical Sciences, Social Determinants of Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Atefeh Karimzadeh
- Department of Physiotherapy, School of Allied Medical Sciences, Social Determinants of Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran; Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
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14
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Öztürk MU, Baygutalp F. A comparative analysis of prolotherapy efficacy in patients with knee osteoarthritis across varied dextrose concentrations. Clin Rheumatol 2023; 42:3321-3331. [PMID: 37540383 DOI: 10.1007/s10067-023-06723-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 07/01/2023] [Accepted: 07/25/2023] [Indexed: 08/05/2023]
Abstract
OBJECTIVE To compare the effectiveness of prolotherapy with dextrose concentrations of 5%, 10%, and 20% in patients diagnosed with knee osteoarthritis. METHODS This study was planned as a prospective, randomized controlled interventional trial. Prolotherapy at 5% dextrose concentration in group 1, 10% in group 2, and 20% in group 3 was applied to the knee intra-articularly and periarticularly at 0, 3, and 6 weeks, and a home exercise program was given. Group 4 received a home exercise program. All groups received hotpack therapy at weeks 0, 3, and 6. Outcome measures included the visual analog scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), knee range of motion, timed up and go test, and Short Form-36. RESULTS A total of 128 patients were divided into 4 groups. At the 6th and 12th weeks, VAS scores were significantly lower in groups 2 and 3 than in group 4 (p < 0.05). At the 12th week, the WOMAC pain score was significantly lower in group 3 than in group 4, and WOMAC physical function and WOMAC total scores were significantly lower in groups 1, 2, and 3 than in group 4 (p < 0.05). Week 6 active and passive knee flexion and week 12 passive knee flexion were significantly higher in group 3 than in group 4 (p < 0.05). CONCLUSIONS Although no significant difference was observed among the dextrose prolotherapy groups, higher dextrose concentrations demonstrated a greater improvement compared to the control group. Therefore, the use of 20% dextrose is recommended due to its significant superiority. Long-term follow-up and placebo-controlled studies are needed. TRIAL REGISTRATION ClinicalTrial.gov Identifier: NCT05537077, registration date: 09.03.2022, retrospectively registered. Key Points • The utilization of dextrose prolotherapy has gained popularity in the management of osteoarthritis, aiming to harness its regenerative and proliferative properties. However, the comparative efficacy of various concentrations of dextrose prolotherapy in treating knee osteoarthritis remains unexplored in the literature. This study aimed to address this gap by comparing different concentrations of dextrose prolotherapy in the treatment of knee osteoarthritis. The findings revealed no statistically significant difference among the various concentrations of dextrose prolotherapy for knee osteoarthritis treatment.
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Affiliation(s)
- Muhammet Uğur Öztürk
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Atatürk University, Erzurum, Turkey.
| | - Fatih Baygutalp
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Atatürk University, Erzurum, Turkey
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Alshahrani A, Alzahrani SM, Albaker AB, Alkhaldi AH, Almogbil I, Alshaeri NM, Al-Awn RMM, Alharbi MA. Society's Misconceptions About Intra-articular Injections: A Cross-Sectional Study From Saudi Arabia. Cureus 2023; 15:e50285. [PMID: 38205492 PMCID: PMC10776479 DOI: 10.7759/cureus.50285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2023] [Indexed: 01/12/2024] Open
Abstract
Objective This cross-sectional study aimed to identify and analyze misconceptions prevalent in Saudi Arabian society regarding intra-articular injections and their sources. It also sought to explore factors influencing patients' decision-making in the context of osteoarthritis (OA) treatment. Methods A sample of 405 adult participants from various educational backgrounds residing in Saudi Arabia completed a self-administered questionnaire. The survey focused on participants' knowledge about intra-articular injections, their sources of information, and their beliefs and perceptions related to these injections. Results The study unveiled a significant lack of awareness among the participants, with almost half (48.4%) reporting no knowledge of intra-articular injections. Of all, 16.1% held misconceptions about these injections, including believing that they are painful or they liquify the bone. Participants expressed varied thoughts on the effects of intra-articular injections, with 69.6% associating them with short-term pain relief. While 60.2% disagreed that intra-articular injections could provide long-term pain relief, 65.2% believed that these injections could delay the need for surgery. The source of knowledge varied, with 34.4% relying on orthopedics and 32.5% on friends and relatives. In those who had received intra-articular injections (n = 62), 83.9% cited the desire to delay or avoid surgery as a reason. While 56.5% were very satisfied with their doctor's guidance, 46.8% expressed concerns about relying on injections in the future. Furthermore, educational levels were correlated with knowledge, highlighting the need for more accessible and tailored patient education materials. However, even among those with a university education, misconceptions persisted. Effective patient-doctor communication was associated with secondary or university education (χ² = 11.05, p = 0.011). Conclusion The prevalence of misconceptions regarding intra-articular injections in Saudi Arabia underscores the need for comprehensive patient education and improved communication between healthcare providers and patients. Addressing these misconceptions is essential for empowering patients to make informed decisions about their healthcare and enhancing the overall quality of care they receive. This study's findings have implications not only for Saudi Arabia but also for healthcare systems globally, emphasizing the significance of patient-centered care and informed decision-making.
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Affiliation(s)
| | - Saud M Alzahrani
- Orthopaedic Surgery, Prince Meshari Bin Saud General Baljarshi Hospital, Al Baha, SAU
| | | | - Ali H Alkhaldi
- Medicine, South Al-Qunfudhah Hospital, Al Qunfudhah, SAU
| | - Ismail Almogbil
- Surgery, Unaizah College of Medicine and Medical Sciencese, Qassim University, Buraidah, SAU
| | - Naif M Alshaeri
- Orthopedic Surgery, South Al-Qunfudhah Hospital, Al Qunfudhah, SAU
| | | | - Mohammad A Alharbi
- Orthopaedic Surgery, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
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Gür O, Başar S. The effect of virtual reality on pain, kinesiophobia and function in total knee arthroplasty patients: A randomized controlled trial. Knee 2023; 45:187-197. [PMID: 37931366 DOI: 10.1016/j.knee.2023.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 09/07/2023] [Accepted: 09/29/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND Virtual reality (VR) has emerged as a promising new therapeutic approach, showing promise in the treatment of patients with a variety of diseases. This study aimed to investigate the effect of VR on pain, kinesiophobia, and function in patients undergoing total knee arthroplasty (TKA). METHODS This randomized controlled trial was performed on patients who had TKA due to osteoarthritis at Gazi University Hospital from October 2019 to August 2021. For this study, 21 female TKA patients were divided into two groups by the blocked randomization method: VR (n = 10) and exercise (n = 11). The exercise group was given a home exercise program. The VR group received immersive VR application in addition to the exercise. Pain, kinesiophobia, pain catastrophizing, knee range of motion, functional status, and quality of life were assessed. The Wilcoxon Test and Mann-Whitney U Test were used for comparison of the results. RESULTS The VR group had a statistically significant difference in the intensity of pain at rest, at night, and during the Timed Up and Go Test (TUG), kinesiophobia, pain catastrophizing, active knee flexion, the TUG, and the stair-climb test scores (P = 0.005 (95% confidence interval (CI) (-5.000, -1.000)), P = 0.005 (95% CI (-7.000, -2.000)), P = 0.023 (95% CI (-4.000, 0)), P = 0.006 (95% CI (-15.000, -3.000)), P = 0.012 (95% CI (-19.000, -3.000)), P = 0.010 (95% CI (4.000, 17.333)), P = 0.017 (95% CI (-14.700, -0.850)), P = 0.011 (95% CI (-23.100, -1.000)), respectively). CONCLUSION In the early period following total knee arthroplasty, using virtual reality integrated with exercise helps to reduce pain, kinesiophobia and pain catastrophizing, and to improve functional outcomes in female patients.
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Affiliation(s)
- Ozan Gür
- Physical Therapy and Rehabilitation Department, Kırklareli University, Kırklareli, Turkey.
| | - Selda Başar
- Physical Therapy and Rehabilitation Department, Gazi University, Ankara, Turkey
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Lou Y, Song F, Kang Y, Xu Y. Periodic Mechanical Stress Inhibits the Development of Osteoarthritis via Regulating ATF3-Akt Axis. J Inflamm Res 2023; 16:5613-5628. [PMID: 38046403 PMCID: PMC10693248 DOI: 10.2147/jir.s419186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 10/25/2023] [Indexed: 12/05/2023] Open
Abstract
Purpose The development of osteoarthritis (OA) has been linked to mechanical factors. Studies suggest that periodic mechanical stress (PMS) may be a factor contributing to cartilage repair and the onset of OA. Therefore, this study was designed to explore the effects and underlying mechanisms of PMS on OA development. Patients and Methods Firstly, surgery and interleukin (IL)-1β were used for the establishment of rat/cell models of OA, respectively. Subsequently, activating transcription factor (ATF) 3 expression was knocked down in OA rats, and OA chondrocytes were treated with different heights (0, 1, 2, 4, 8 cm) of PMS or si-ATF. Safranin O staining was used to observe the histological changes in the rat knee joint, and enzyme-linked immunosorbent assay (ELISA) was performed to detect levels of tumor necrosis factor (TNF)-α, IL-6, and IL-8 in vivo and in vitro. Further, the expression of extracellular matrix (ECM) proteins in the rat knee joint was assessed immunohistochemistry. Flow cytometry was used to evaluate chondrocyte apoptosis. Lastly, Western blot was performed to detect the expression of related proteins of the protein kinase B (Akt) signaling pathway and ECM. Results The OA rat model was successfully constructed. Further experiments indicated that the knockdown of ATF3 not only alleviated joint swelling, pain, inflammatory response and pathological damage, but also promoted ECM synthesis and the phosphorylation of Akt in OA rats. In vitro experiments showed that PMS (4 cm) effectively inhibited cell apoptosis, decreased the levels of TNF-α, IL-6 and IL-8, promoted ECM synthesis, and activated the Akt signaling pathway in osteoarthritic chondrocytes. However, ATF3 overexpression reversed the positive effects of PMS on osteoarthritic chondrocytes. Conclusion PMS can effectively inhibit the development of OA, and its protective effects may be attributed to the down-regulation of ATF3 expression and activation of the Akt signaling pathway.
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Affiliation(s)
- Yi Lou
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Suzhou, 215006, People’s Republic of China
- Department of Orthopaedics, Shanghai Eastern Hepatobiliary Surgery Hospital, Naval Military Medical University, Shanghai, 201805, People’s Republic of China
| | - Fanglong Song
- Department of Orthopaedics, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, People’s Republic of China
| | - Yifan Kang
- Department of Orthopaedics, Shanghai Eastern Hepatobiliary Surgery Hospital, Naval Military Medical University, Shanghai, 201805, People’s Republic of China
| | - Yaozeng Xu
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Suzhou, 215006, People’s Republic of China
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18
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Lu H, Yu J, Hong H. Effects of an enhanced recovery after surgery nursing programme on surgical site wound infection and postoperative complications in patients undergoing total knee arthroplasty: A meta-analysis. Int Wound J 2023; 21:e14485. [PMID: 37973530 PMCID: PMC10898380 DOI: 10.1111/iwj.14485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 10/18/2023] [Accepted: 10/22/2023] [Indexed: 11/19/2023] Open
Abstract
This meta-analysis aimed to investigate the effects of the enhanced recovery after surgery (ERAS) nursing program on surgical wound infection (SWI) and postoperative complications in patients undergoing total knee arthroplasty (TKA). The PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure and Wanfang databases were searched from the date of establishment of the database until August 2023 for randomised controlled trials (RCTs) that assessed the effects of the ERAS nursing program on SWI and postoperative complications in patients undergoing TKA. The literature was screened, data were extracted by two independent investigators, and the literature quality was assessed using the methods recommended by the Cochrane Collaboration. Data analysis was performed using Stata 17.0 software. Nineteen RCTs with 1580 patients were included in the study. The meta-analysis results showed that the rates of SWI (odds ratio [OR] = 0.19, 95% confidence interval [CI]: 0.10-0.37, p < 0.001) and postoperative complications (OR = 0.18, 95% CI: 0.12-0.25, p < 0.001) were significantly lower in the ERAS intervention group than those in the control group. Therefore, ERAS intervention after TKA can significantly reduce the occurrence of SWI and postoperative complications. It has a remarkable rehabilitation effect and can be widely used in clinical settings.
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Affiliation(s)
- Haiying Lu
- Department of Emergency, Chun'an County Traditional Chinese Medicine Hospital, Hangzhou, China
| | - Jinjiao Yu
- Department of Orthopedics and Traumatology, Chun'an County Traditional Chinese Medicine Hospital, Hangzhou, China
| | - Huiqin Hong
- Department of Acupuncture and Moxibustion, Chun'an County Traditional Chinese Medicine Hospital, Hangzhou, China
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Martin CL, Nocera M, Mercer J, Marshall SW, Davi SM, Curtin JJ, Cameron KL. Efficacy of a Novel Telehealth Application in Health Behavior Modification and Symptomology in Military Service Members at Risk for Post-traumatic Osteoarthritis. Mil Med 2023:usad435. [PMID: 37966139 DOI: 10.1093/milmed/usad435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 09/24/2023] [Accepted: 10/27/2023] [Indexed: 11/16/2023] Open
Abstract
INTRODUCTION Mobile applications (apps) may be beneficial to promote self-management strategies to mitigate the risk of developing post-traumatic osteoarthritis in military members following a traumatic knee injury. This study investigated the efficacy of a mobile app in facilitating behavior modification to improve function and symptomology among military members. MATERIALS AND METHODS This is a preliminary pre and post hoc analysis of a randomized control trial. The MARX scale, Intermittent and Constant Osteoarthritis Pain (ICOAP) questionnaire, and the Knee Injury and Osteoarthritic Outcome Score Readiness to Manage Osteoarthritis Questionnaire were completed at baseline, 6-week, 6-month, and 12-month follow-up. Participants in the treatment arm completed the System Usability Scale. Data were analyzed using descriptive statistics, the Wilcoxon sum of ranks test, the Wilcoxon signed-rank test, and Cohen's d effect size. RESULTS A total of 28 participants were included. Between-group differences for baseline and 6-week follow-up were significantly improved in the injured knee ICOAP constant pain score for the treatment group (treatment: -4.2 ± 12, 95% CI: -11.5, 3.1; control: 5.5 ± 9.9, 95% CI: 0.9, 10.1; P = .035, effect size = 0.905). Within-group differences for baseline and 6-week follow-up demonstrated a significant decline in the injured knee ICOAP constant pain score among the control group (signed-rank: 16.0, P = .031, Cohen's d = 0.339). No other significant differences were observed. A good System Usability Scale score for usability was found (76.6 ± 8.8). CONCLUSIONS These results indicate that the mobile app is easy to use and may contribute to improved constant pain symptomology for patients at risk for post-traumatic osteoarthritis.
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Affiliation(s)
- Chelsea Leonard Martin
- Department of Epidemiology, Gillings School of Global Public Health, University of Chapel Hill at North Carolina, Chapel Hill, NC 27516, USA
- Injury Prevention Research Center, University of Chapel Hill at North Carolina, Chapel Hill, NC 27516, USA
| | - Maryalice Nocera
- Injury Prevention Research Center, University of Chapel Hill at North Carolina, Chapel Hill, NC 27516, USA
| | - Jeremy Mercer
- Injury Prevention Research Center, University of Chapel Hill at North Carolina, Chapel Hill, NC 27516, USA
| | - Stephen W Marshall
- Department of Epidemiology, Gillings School of Global Public Health, University of Chapel Hill at North Carolina, Chapel Hill, NC 27516, USA
- Injury Prevention Research Center, University of Chapel Hill at North Carolina, Chapel Hill, NC 27516, USA
| | - Steven M Davi
- John A. Feagin Sports Medicine Fellowship, Keller Army Hospital, United States Military Academy, West Point, NY 10996, USA
| | - Jessica J Curtin
- John A. Feagin Sports Medicine Fellowship, Keller Army Hospital, United States Military Academy, West Point, NY 10996, USA
| | - Kenneth L Cameron
- John A. Feagin Sports Medicine Fellowship, Keller Army Hospital, United States Military Academy, West Point, NY 10996, USA
- Department of Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
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Vomer RP, Larick RS, Milon R, York E. The Effect of Intra-articular Hypertonic Dextrose Prolotherapy on Pain, Quality of Life, and Functional Outcomes Scores in Patients With Knee Osteoarthritis. Cureus 2023; 15:e48096. [PMID: 38046716 PMCID: PMC10690838 DOI: 10.7759/cureus.48096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2023] [Indexed: 12/05/2023] Open
Abstract
Introduction Knee osteoarthritis is a common chronic condition leading to pain and debility. Prolotherapy is a safe and cost-effective treatment option. Our team conducted a case series to examine the effect of prolotherapy on functional measures and quality of life in patients with knee osteoarthritis. Methods Our case series included 15 total patients consisting of male and female patients aged 50-85 years old with a prior diagnosis of knee osteoarthritis and moderate pain. The patients completed baseline Western Ontario and McMaster Universities Arthritis Index (WOMAC) and EuroQol-5 Dimension (EQ5D) surveys and received an ultrasound-guided intra-articular prolotherapy injection. The patients were then followed up by Telehealth at one-, two-, and three-month post-procedure. Results Data points for 15 patients were recorded over the duration of the three months. Results revealed significantly improved functional scores from the baseline period (M = 0.60) to the one-month (M = 0.43), two-month (M = 0.48), and three-month (M = 0.46), observed power = 0.99. Participants reported significantly lower pain scores between the baseline period (M = 0.60) compared to the one-month (M = 0.34), two-month (M = 0.35) and three-month (M = 0.39) periods. There was no statistical significance across time in participants' EQ5D scores. The repeated-measures analysis of variance (ANOVA) revealed no statistically significant differences in participants scores between the baseline (M = 64.4), one-month (M = 68.93), two-month (M = 68.47), or three-month (M = 68.33), observed power = 0.31. There were no statistically significant differences in participants WOMAC stiffness scores between the baseline (M = 0.67), one-month (M = 0.46), two-month (M = 0.57), or three-month (M = 0.56) periods, observed power = 0.73. The results revealed no significant change in participants' EQ5D and WOMAC stiffness scores. The results support a statistically significant improvement in patients' self-reported functioning and pain scores between the baseline and one-month, two-month, and three-month periods. Discussion The significant improvement in function occurred between the baseline and one-month time periods and the pain reduction was sustained throughout the two-month and three-month periods. Our study supports prolotherapy as an effective treatment option to improve pain and function in knee osteoarthritis. The study could be repeated with a large sample size to further investigate the effects of prolotherapy on quality-of-life measures.
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Affiliation(s)
- Rock P Vomer
- Family Medicine, Mayo Clinic Jacksonville Campus, Jacksonville, USA
- Family Medicine and Community Health, Duke University, Durham, USA
| | - Rayghan S Larick
- Physical Medicine and Rehabilitation, Eastern Virginia Medical School, Norfolk, USA
| | - Ryan Milon
- Sports Medicine, Mayo Clinic Jacksonville Campus, Jacksonville, USA
| | - Emma York
- Family Medicine, Prisma Health University of South Carolina, Columbia, USA
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Shah N, Borrelli B, Kumar D. Perceptions about smartphone-based interventions to promote physical activity in inactive adults with knee pain - A qualitative study. Disabil Rehabil Assist Technol 2023:1-8. [PMID: 37873670 PMCID: PMC11039564 DOI: 10.1080/17483107.2023.2272854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 10/13/2023] [Indexed: 10/25/2023]
Abstract
PURPOSE Smartphone-based interventions offer a promising approach to address inactivity in people with knee osteoarthritis (OA). We explored perceptions towards smartphone-based interventions to improve physical activity, pain, and depressed mood in inactive people with knee pain. METHODS This qualitative study included six focus groups at Boston University with inactive people with knee pain (n = 35). A smartphone app, developed by our team, using constructs of Social Cognitive Theory, was used to obtain participant feedback. RESULTS Participants discussed wanting to use smartphone-based interventions for personalized exercise advice, for motivation (e.g., customized voice messages, virtual incentives), and to make exercise "less boring" (e.g., music, virtual gaming). Preferred app features included video tutorials on how to use the app, the ability to select information that can be viewed on the home screen, and the ability to interact with clinicians. Features that received mixed responses included daily pain tracking, daily exercise reminders, peer-interaction for accountability, and peer-competition for motivation. All participants discussed privacy and health data security concerns while using the app. CONCLUSIONS Using a co-design approach, we report preferences and concerns related to using smartphone-based physical activity interventions in inactive people with knee pain. This information may help improve acceptability of such interventions in this population.
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Affiliation(s)
- Nirali Shah
- Department of Physical Therapy, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, 02215, USA
| | - Belinda Borrelli
- Center for Behavioral Science Research, Henry M. Goldman School of Dental Medicine, Boston University, 560 Harrison Ave, Boston, MA, 02118, USA
| | - Deepak Kumar
- Department of Physical Therapy, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, 02215, USA
- Section of Rheumatology, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
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22
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Cheng L, Huang C, Li M, Shang S, Chen J, Tang Z. Chonggu Granules Improve Cartilage Matrix Metabolism in Knee Osteoarthritis via the miR-148a-3p/Wnt/β-Catenin Pathway. J Inflamm Res 2023; 16:4751-4762. [PMID: 37881649 PMCID: PMC10596237 DOI: 10.2147/jir.s428582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 09/27/2023] [Indexed: 10/27/2023] Open
Abstract
Purpose This study aims to explore the effect and underlying mechanism of Chonggu Granules (CGG) in knee osteoarthritis (KOA) in rats. Methods A papain-induced KOA model was established in rats. The pathological alterations of extracellular matrix in rat cartilage tissues were observed through hematoxylin and eosin (H&E) staining, followed by Mankin score for quantitative scoring. The ultrastructure of cartilage extracellular matrix was examined under a transmission electron microscopy (TEM). ELISA was used to measure the levels of IL-6, TNF-α, and IL-1β in rat serum. Immunofluorescence was performed for assessing the levels of MMP-3, MMP-13, and Col2al in rat cartilage. Western blot was used to identify the protein expressions of wnt1, GSK-3β, β-catenin, and Aggrecan in rat cartilage. The mRNA relative expressions of miR-148a-3p, wnt1, β-catenin, and GSK-3β in rat cartilage were detected by RT-PCR. Luciferase reporter gene was used to detect the target genes of miR-148a-3p. Results CGG significantly improved articular cartilage tissue and extracellular matrix metabolism compared to the model group as indicated by H&E, Mankin score, and TEM data. Moreover, low, medium, and high doses of CGG reduced the levels of IL-6, TNF-α, IL-1β, MMP-3, and MMP-13 in serum to varying degrees but increased the levels of Col2al and Aggrecan. Mechanistically, CGG targeted wnt1 by increasing the expression of miR-148a-3p in a dose-dependent manner, thereby downregulating the mRNA and protein expressions of β-catenin in cartilage tissue and upregulating the mRNA and protein expressions of GSK-3β. Conclusion CGG may control the miR-148a-3p/wnt/β-catenin signaling pathway to decrease the levels of its downstream target genes MMP-13 and MMP-3, increase the expressions of Col2al and Aggrecan, and downregulate the contents of inflammatory cytokines IL-6, TNF-α, and IL-1β, thereby improving the metabolism of cartilage extracellular matrix and alleviating the degeneration of articular cartilage in KOA.
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Affiliation(s)
- Lili Cheng
- The First Clinical Medical College, Anhui University of Traditional Chinese Medicine, Hefei, Anhui Province, 230038, People’s Republic of China
| | - Chuanbing Huang
- Department of Rheumatology and Immunology, First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, Anhui Province, 230038, People’s Republic of China
| | - Ming Li
- Department of Rheumatology and Immunology, First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, Anhui Province, 230038, People’s Republic of China
| | - Shuangshuang Shang
- Department of Rheumatology and Immunology, First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, Anhui Province, 230038, People’s Republic of China
| | - Junjie Chen
- The First Clinical Medical College, Anhui University of Traditional Chinese Medicine, Hefei, Anhui Province, 230038, People’s Republic of China
| | - Zhongfu Tang
- The First Clinical Medical College, Anhui University of Traditional Chinese Medicine, Hefei, Anhui Province, 230038, People’s Republic of China
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Chen Y, Zhang Y, Ge Y, Ren H. Integrated single-cell and bulk RNA sequencing analysis identified pyroptosis-related signature for diagnosis and prognosis in osteoarthritis. Sci Rep 2023; 13:17757. [PMID: 37853066 PMCID: PMC10584952 DOI: 10.1038/s41598-023-44724-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 10/11/2023] [Indexed: 10/20/2023] Open
Abstract
Osteoarthritis (OA), a degenerative disease of the joints, has one of the highest disability rates worldwide. This study investigates the role of pyroptosis-related genes in osteoarthritis and their expression in different chondrocyte subtypes at the individual cell level. Using OA-related datasets for single-cell RNA sequencing and RNA-seq, the study identified PRDEGs and DEGs and conducted Cox regression analysis to identify independent prognostic factors for OA. CASP6, NOD1, and PYCARD were found to be prognostic factors. Combined Weighted Gene Correlation Network Analysis with PPI network, a total of 15 hub genes related to pyroptosis were involved in the notch and oxidative phosphorylation pathways, which could serve as biomarkers for the diagnosis and prognosis of OA patients. The study also explored the heterogeneity of chondrocytes between OA and normal samples, identifying 19 single-cell subpopulation marker genes that were significantly different among 7 chondrocyte cell clusters. AGT, CTSD, CYBC, and THYS1 were expressed differentially among different cell subpopulations, which were associated with cartilage development and metabolism. These findings provide valuable insights into the molecular mechanisms underlying OA and could facilitate the development of new therapeutic strategies for this debilitating disease.
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Affiliation(s)
- Yanzhong Chen
- School of Sport Science, Beijing Sport University, Beijing, 100084, China
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, 10084, China
| | - Yaonan Zhang
- School of Sport Science, Beijing Sport University, Beijing, 100084, China
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, 10084, China
- Department of Orthopedics, Beijing Hospital, Beijing, 10000, China
| | - Yongwei Ge
- School of Sport Science, Beijing Sport University, Beijing, 100084, China
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, 10084, China
| | - Hong Ren
- School of Sport Science, Beijing Sport University, Beijing, 100084, China.
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, 10084, China.
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Jiang Y, Liao H, Yan L, Jiang S, Zheng Y, Zhang X, Wang K, Wang Q, Han L, Lu X. A Metal-Organic Framework-Incorporated Hydrogel for Delivery of Immunomodulatory Neobavaisoflavone to Promote Cartilage Regeneration in Osteoarthritis. ACS Appl Mater Interfaces 2023; 15:46598-46612. [PMID: 37769191 DOI: 10.1021/acsami.3c06706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
The treatment of osteoarthritis (OA)-related cartilage defects is a great clinical challenge due to the complex pathogenesis of OA and poor self-repair ability of cartilage tissue. Combining local and long-term anti-inflammatory therapies to promote cartilage repair is an effective method to treat OA. In this study, a zinc-organic framework-incorporated extracellular matrix (ECM)-mimicking hydrogel platform was constructed for the inflammatory microenvironment-responsive delivery of neobavaisoflavone (NBIF) to promote cartilage regeneration in OA. The NBIF was encapsulated in situ in zeolitic imidazolate frameworks (ZIF-8 MOFs). The NBIF@ZIF-8 MOFs were decorated with polydopamine and incorporated into a methacrylate gelatin/hyaluronic acid hybrid network to form the NBIF@ZIF-8/PHG hydrogel. The hydrogel featured excellent cell/tissue affinity, providing a favorable microenvironment for recruiting cells and cytokines to the defect sites. The hydrogel enabled the on-demand NBIF released in response to a weakly acidic microenvironment at the injured joint site to resolve inflammatory responses during the early stages of OA. Consequently, the cooperativity of the loaded NBIF and hydrogel synergistically modulated the immune response and assisted in cartilage defect repair. In summary, the NBIF@ZIF-8/PHG hydrogel delivery platform represents an effective treatment strategy for OA-related cartilage defects and may attract attentions for applications in other inflammatory diseases.
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Affiliation(s)
- Yanan Jiang
- Department of General Surgery, The Third People's Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, College of Medicine, Southwest Jiaotong University, Chengdu, Sichuan 610031, China
| | - Haixia Liao
- Institute of Biomedical Engineering, College of Medicine, Southwest Jiaotong University, Chengdu, Sichuan 610031, China
| | - Liwei Yan
- Institute of Biomedical Engineering, College of Medicine, Southwest Jiaotong University, Chengdu, Sichuan 610031, China
| | - Shengxi Jiang
- Institute of Biomedical Engineering, College of Medicine, Southwest Jiaotong University, Chengdu, Sichuan 610031, China
| | - Yujia Zheng
- Institute of Biomedical Engineering, College of Medicine, Southwest Jiaotong University, Chengdu, Sichuan 610031, China
| | - Xin Zhang
- Institute of Biomedical Engineering, College of Medicine, Southwest Jiaotong University, Chengdu, Sichuan 610031, China
| | - Kefeng Wang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, Sichuan 610064, China
| | - Qiguang Wang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, Sichuan 610064, China
| | - Lu Han
- Laboratory for Marine Drugs and Bioproducts, Pilot National Laboratory for Marine Science and Technology, School of Medicine and Pharmaceutics, Ocean University of China, Qingdao, Shandong 266003, China
| | - Xiong Lu
- Department of General Surgery, The Third People's Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, College of Medicine, Southwest Jiaotong University, Chengdu, Sichuan 610031, China
- Institute of Biomedical Engineering, College of Medicine, Southwest Jiaotong University, Chengdu, Sichuan 610031, China
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25
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Fozo ZA, Ghazal AH, Hesham Gamal M, Matar SG, Kamal I, Ragab KM. A Systematic Review and Meta-Analysis of Conventional Versus Robotic-Assisted Total Knee Arthroplasty. Cureus 2023; 15:e46845. [PMID: 37869051 PMCID: PMC10589058 DOI: 10.7759/cureus.46845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2023] [Indexed: 10/24/2023] Open
Abstract
This study aims to compare the outcomes and advantages of total knee arthroplasty (TKA) performed using conventional surgical techniques with those conducted using robotic-assisted methods in terms of operation time, Oxford knee score, range of motion, tourniquet time, and Western Ontario and McMaster Universities Arthritis index. We performed a literature search through five databases, namely, PubMed, Cochrane Central, Scopus, Embase, and Web of Science, from inception until July 3, 2023. Randomized clinical trials (RCTs) and cohorts comparing conventional TKA with robotic-assisted TKA were included. The risk of bias of the included RCTs was determined using the Cochrane risk of bias tool and the National Institutes of Health tool for cohort studies. We conducted a meta-analysis using Review Manager 5.4. To analyze continuous data, we calculated the mean difference (MD) along with its corresponding 95% confidence interval (CI). By synthesizing data from a comprehensive analysis, the study unveiled noteworthy distinctions between robotic-assisted arthroplasty and conventional arthroplasty across critical parameters. First, a substantial alteration in the hip-knee-ankle (HKA) angle was observed, with the robotic-assisted approach demonstrating a significant difference (MD = 0.84, 95% CI = 0.25-1.43, p = 0.005). Second, in terms of operative time, a notable reduction in surgical duration was noted with conventional TKA (MD = 16.85, 95% CI = 8.08-25.63, p = 0.0002). The assessment of tourniquet time exhibited a significantly longer duration for robotic-assisted arthroplasty (MD = 35.70, 95% CI = 27.80-43.61, p < 0.001). Our findings indicate that conventional TKA outperforms robotic-assisted TKA, primarily due to its shorter operative and tourniquet times, along with a more favorable change in the HKA angle. However, it is worth noting that robotic-assisted TKA showed a slight advantage in pain outcomes, although this advantage was not statistically significant. To gain a more comprehensive understanding, we recommend conducting a large-scale randomized controlled trial that directly compares both TKA methods. This trial should evaluate costs and long-term outcomes while ensuring consistent follow-up durations among studies. Such an approach would greatly assist orthopedic decision-making and contribute to improved TKA outcomes.
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Affiliation(s)
| | - Ahmed Hussein Ghazal
- Orthopaedics, Northwick Park Hospital, London North West University Healthcare NHS Trust, Harrow, GBR
| | - Mohamed Hesham Gamal
- Pharmacology and Therapeutics, Faculty of Pharmacy, Tanta University, Tanta, EGY
| | | | - Ibrahim Kamal
- General Medicine, Al-Azhar University, Alexandria, EGY
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Wang J, Sun T. Mir-25-3p in extracellular vesicles from fibroblast-like synoviocytes alleviates pyroptosis of chondrocytes in knee osteoarthritis. J Bioenerg Biomembr 2023; 55:365-380. [PMID: 37725203 DOI: 10.1007/s10863-023-09964-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 03/29/2023] [Indexed: 09/21/2023]
Abstract
Knee osteoarthritis (KOA) is defined as a joint disease that occurs mostly among elderly people. Fibroblast-like synoviocytes-derived extracellular vesicles (FLS-EVs) have impacts on the treatment of OA. This study elucidated the mechanism of miR-25-3p in pyroptosis of chondrocytes in KOA. FLSs and EVs were extracted from neonatal mice; destabilization of the medial meniscus (DMM) was used to simulate KOA in mice, followed by the evaluation of cartilage damage and the contents of MMP-3 and MMP-13 in KOA mice. Lipopolysaccharide (LPS) was used to induce inflammation damage in mouse chondrocytes ATDC5, and the cell viability and the expressions of NLRP3, Cleaved-Caspase-1, GSDMD-N, IL-18, and IL-1β were examined. We found that FLS-EV treatment mitigated the knee-joint damage and symptoms of KOA mice, decreased MMP-3 and MMP-13, and inhibited pyroptosis of chondrocytes in DMM mice and LPS-induced ATD5 cells. Then, Cy3-labeled miR-25-3p in mice chondrocytes was observed and the expressions and the binding relation of miR-25-3p and cytoplasmic polyadenylation element-binding protein 1 (CPEB1) were verified. It showed that FLS-EVs carried miR-25-3p into chondrocytes, and upregulated miR-25-3p expression while inhibited CPEB1 transcription, resulting in mitigation of pyroptosis of chondrocytes, and CPEB1 overexpression reversed the inhibition of FLS-EVs on pyroptosis of chondrocytes in KOA.
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Affiliation(s)
- Jianhang Wang
- Trauma department of orthopedics Yantaishan Hospital, 10087 Keji Avenue, Laishan District, Yantai, Shandong, 264003, China
| | - Tao Sun
- Trauma department of orthopedics Yantaishan Hospital, 10087 Keji Avenue, Laishan District, Yantai, Shandong, 264003, China.
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27
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Tantuway V, Thomas W, Parikh MB, Sharma R, Jeyaraman N, Jeyaraman M. Clinical Outcome of Minimally Manipulated, Mechanically Isolated Autologous Adipose Tissue-Derived Stromal Vascular Fraction (Sahaj Therapy®) in Knee Osteoarthritis-Randomized Controlled Trial. Indian J Orthop 2023; 57:1646-1658. [PMID: 37766954 PMCID: PMC10519910 DOI: 10.1007/s43465-023-00981-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 08/18/2023] [Indexed: 09/29/2023]
Abstract
Introduction Regenerative therapy has shown promising results in the treatment of osteoarthritis (OA) knee with Kellgren-Lawrence (KL) Grades I-III. We compared the safety, efficacy, functional, and clinical outcomes of intra-articular implantation of autologous adipose tissue-derived stromal vascular fraction (SVF) isolated using direct ultrasonic cavitation (Sahaj therapy-Cell Innovation Patented Technology) and saline injection in knee osteoarthritis. Materials and Methods The present prospective observational study was conducted over 3 years. We enrolled 120 patients in our study, where four patients got excluded as they did not meet the inclusion criteria. The remaining 116 patients were randomized into two groups, one with autologous adipose tissue-derived SVF and the other group with saline injection. A comparison of mean KOOS and VAS scores at different follow-ups was done using Paired 't' test. A p value of < 0.05 was considered significant. Results The results show that the SVF group had significantly higher KOOS scores (78.49 ± 6.54 in the SVF group vs 59.19 ± 5.14 in the saline group), respectively (p < 0.001). Similarly, the SVF group had significantly lesser VAS scores (3.17 ± 0.94 in the SVF group vs 3.89 ± 1.04 in the saline group), respectively (p < 0.001). Conclusions Autologous adipose tissue-derived SVF is a better choice for treating knee osteoarthritis. For individuals with degenerative osteoarthritis, autologous SVF grafting in the same surgical procedure is an innovative and promising treatment modality. Even after 3 years of follow-up, the study participants with OA knee have shown a good clinical and functional outcome.
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Affiliation(s)
- Vinay Tantuway
- Department of Orthopaedics & Traumatology, Index Medical College Hospital and Research Centre, Indore, Madhya Pradesh India
| | - Wayne Thomas
- Department of Tumor Immunology, The University of Newcastle, Callaghan, Australia
| | - Mittal B. Parikh
- Department of Orthopaedics, Navjivan Hospital, Ahmedabad, Gujarat India
| | - Raj Sharma
- Sahaj Regenerative Cell Therapeutics, Indore, Madhya Pradesh India
| | - Naveen Jeyaraman
- Department of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai, Tamil Nadu India
| | - Madhan Jeyaraman
- Department of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai, Tamil Nadu India
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Kumar P, Bansal P, Rajnish RK, Sharma S, Dhillon MS, Patel S, Kumar V. Efficacy of undenatured collagen in knee osteoarthritis: review of the literature with limited meta-analysis. Am J Transl Res 2023; 15:5545-5555. [PMID: 37854210 PMCID: PMC10579002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 08/24/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND Early knee osteoarthritis (OA) treatment is multimodal, with physical therapy and pharmacotherapy commonly used. Although popular, oral supplements like glucosamine and diacerein have not been reported to have high efficacy. Undenatured collagen type II (UC-II) has been introduced for therapy in early OA; it helps in cartilage repair and preservation. The present review was done to ascertain its efficacy in pain relief and knee function. MATERIALS AND METHODS A systematic literature search was performed on MEDLINE (PubMed), Embase, Scopus, and Cochrane Library for published literature; studies comparing the outcome of UC-II supplementation with placebo/control in adult humans with early knee OA were included. The outcomes evaluated were VAS Score, quality of life - Western Ontario and McMaster Universities (WOMAC-score), Knee function, Knee range of motion, and any complications during the course of treatment. RESULTS A total of 293 results were obtained after a primary search; 8 randomized control trials (RCT) were finally included. A total of 243 patients received UC-II supplementation (91 men and 152 women). The overall mean age range for the intervention group was 53.5±0.99 to 68.7±5.3 years across all included studies, and the mean follow-up duration was 3 to 6 months. Outcome measures like WOMAC and VAS scores showed better outcomes with UC-II in comparison to placebo. Walking measurements improved significantly from the baseline, reflected in improved timed up-and-go and 6-minute walk tests (6MWT). The overall complications were similar to other supplements. CONCLUSION With limited literature, UC-II has shown promise as a potent supplement in early knee OA with good pain relief and improved function. However, further large-scale studies are needed to substantiate these findings.
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Affiliation(s)
- Prasoon Kumar
- Department of Orthopaedics, Post-Graduate Institute of Medical Education and ResearchChandigarh 160012, India
| | - Parth Bansal
- Department of Orthopaedics, Post-Graduate Institute of Medical Education and ResearchChandigarh 160012, India
| | - Rajesh Kumar Rajnish
- Department of Orthopaedics, All India Institute of Medical SciencesJodhpur, Rajasthan 342001, India
| | - Siddhartha Sharma
- Department of Orthopaedics, Post-Graduate Institute of Medical Education and ResearchChandigarh 160012, India
| | - Mandep S Dhillon
- Department of Orthopaedics, Post-Graduate Institute of Medical Education and ResearchChandigarh 160012, India
| | - Sandeep Patel
- Department of Orthopaedics, Post-Graduate Institute of Medical Education and ResearchChandigarh 160012, India
| | - Vishal Kumar
- Department of Orthopaedics, All India Institute of Medical SciencesDeoghar, Jharkhand, India
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29
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Mai N, Hang N, Hanh D, Le H, Hinh N, Ky N, Tuan N, Tong H, Quan D, Toan N. Leptin and interleukin-1β levels associated with osteoarthritis in Vietnamese patients: a cross-sectional analysis. Braz J Med Biol Res 2023; 56:e12746. [PMID: 37703108 PMCID: PMC10496761 DOI: 10.1590/1414-431x2023e12746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 07/23/2023] [Indexed: 09/15/2023] Open
Abstract
Leptin and interleukin-1 beta (IL-1β) are two extensively studied biomarkers associated with metabolic syndrome (MetS) and osteoarthritis (OA). Previous studies have mostly focused on either MetS or OA alone, with no available data on Vietnamese patients. This study aimed to investigate the levels of leptin and IL-1β in this patient population and explore their association with clinical parameters of MetS and OA. The study included 164 patients with primary knee OA, who were classified into two categories based on the presence of MetS, and 78 healthy controls. The plasma leptin and IL-1β levels were quantified by ELISA and correlated with clinical parameters. Leptin levels were higher in patients with OA (11.50±10.04 ng/mL) than in healthy controls (0.54±0.37 ng/mL) and increased in patients with MetS compared to those without MetS. IL-1β levels were also significantly higher in OA patients (14.63±15.87 pg/mL) than in controls (7.79±5.11 pg/mL), but were not significantly different between the MetS and non-MetS groups. Leptin levels were positively correlated with body mass index, waist-to-hip ratio, visual analogue scale scores, HbA1c and insulin levels, and HOMA-IR index, whereas IL-1β levels were only correlated with insulin levels and HOMA-IR index. ROC curve analysis revealed that leptin and IL-1β levels could distinguish individuals with and without OA (AUC=0.96; 0.88, respectively), and individuals with and without MetS (AUC=0.82; 0.71, respectively). Our findings suggested that both leptin and IL-1β levels were associated with both MetS and OA and may play a critical role in the pathogenesis of MetS-related OA.
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Affiliation(s)
- N.T.T. Mai
- Bach Mai Hospital, Hanoi, Vietnam
- Department of Pathophysiology, Vietnam Military Medical University, Hanoi, Vietnam
| | - N.T. Hang
- Department of Pathophysiology, Vietnam Military Medical University, Hanoi, Vietnam
| | | | - H.Y. Le
- 108 Military Central Hospital, Hanoi, Vietnam
| | - N.V. Hinh
- 108 Military Central Hospital, Hanoi, Vietnam
| | - N.D. Ky
- Department of Endocrinology, Nghe An Friendship General Hospital, Nghe An, Vietnam
| | - N.M. Tuan
- National Hospital of Endocrinology, Hanoi, Vietnam
| | - H.V. Tong
- Department of Pathophysiology, Vietnam Military Medical University, Hanoi, Vietnam
- Institute of Biomedicine and Pharmacy, Vietnam Military Medical University, Hanoi, Vietnam
| | | | - N.L. Toan
- Department of Pathophysiology, Vietnam Military Medical University, Hanoi, Vietnam
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Wang Z, Wang R, Gao C. Effect of knee arthroscopic debridement combined with peripatellar denervation on restoration of knee function in patients with knee osteoarthritis. BMC Surg 2023; 23:229. [PMID: 37568189 PMCID: PMC10422829 DOI: 10.1186/s12893-023-02113-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/20/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND This research examines knee osteoarthritis (OA), a prevalent orthopedic disease marked by cartilage degeneration and chronic synovitis, leading to pain, restricted mobility, and eventual loss of knee function. Notably, patellofemoral osteoarthritis constitutes a significant proportion of knee OA cases. Our study aims to assess the impact of knee arthroscopic debridement coupled with peripatellar denervation on restoring knee function in OA patients and analyze the risk factors affecting treatment outcomes. By doing so, we hope to contribute to the informed selection of clinical treatment plans, addressing a disease that, if untreated, significantly impairs patients' quality of life. METHODS A total of 211 patients with knee osteoarthritis treated in our hospital from June 2020 to June 2022 were analyzed retrospectively. Among them, 116 patients received arthroscopic knee debridement treatment alone as the control group, and 95 in the observation group were combined with denervation treatment based on the control group. The clinical efficacy of the two groups of patients after treatment was evaluated, and patients' pain was counted using the pain visual analogue score (VAS) method. The knee range of motion (ROM) was used to count the mobility of the patients and to compare the operative time, intraoperative perfusion volume, and length of stay between the two groups. According to the effectiveness after treatment, patients were divided into the improvement group (effective + markedly effective) and the non-improvement group, and the risk factors affecting the clinical efficacy of patients after treatment were analyzed by logistic regression. RESULTS The total treatment efficiency of patients in the control group was lower than that of those in the observation group (P < 0.05). There was no difference in intraoperative perfusion volume and length of stay between patients in both groups (P > 0.05). However, the operative time was shorter in the control group compared with that in the observation group (P < 0.001). The post-treatment VAS scores of patients in the observation group were lower than those in the control group, while the ROM scores were higher than those of the control group (P < 0.001). Age, BMI, and preoperative VAS score were found to be independent risk factors for patient outcome by logistic regression analysis (P < 0.05). CONCLUSION knee arthroscopic debridement combined with peripatellar denervation has a significant improvement in the restoration of knee function in patients with knee osteoarthritis and reduces their level of pain.
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Affiliation(s)
- Zhijia Wang
- Department of Bone Trauma and Arthrology, Huai'an Hospital, No. 19, Shanyang Avenue, Huai'an District, Huai'an, 223200, Jiangsu Province, China
| | - Rui Wang
- Department of Bone Trauma and Arthrology, Huai'an Hospital, No. 19, Shanyang Avenue, Huai'an District, Huai'an, 223200, Jiangsu Province, China
| | - Congliang Gao
- Department of Bone Trauma and Arthrology, Huai'an Hospital, No. 19, Shanyang Avenue, Huai'an District, Huai'an, 223200, Jiangsu Province, China.
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Rosada M, Speciali D, Dias de Oliveira FB, Campedelli RR, Rodrigues H, Antonioli E, Ferretti M. Eight weeks of a lower limb resistance training protocol and gait performance in patients with symptomatic mild to moderate knee osteoarthritis. J Orthop Sci 2023:S0949-2658(23)00196-3. [PMID: 37532651 DOI: 10.1016/j.jos.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 04/13/2023] [Accepted: 07/14/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND The role of strengthening the lower limbs to optimize the biomechanics of the hip, knee and ankle during walking in patients with knee osteoarthritis, is still unclear. This study aimed to analyse the walking biomechanics of individuals with symptomatic mild to moderate knee osteoarthritis before and after a simplified lower limb resistance training protocol, focused on knee joint exercises with individualized load. METHODS Forty-one patients with symptomatic and radiographic mild to moderate knee osteoarthritis underwent 3D gait analysis pre-post 8 weeks lower limb resistance training protocol performed 3 times a week. Parameters investigated were spatiotemporal, sagittal range of motion, flexion and extension minimum and maximum values, power and moment of hip, knee and ankle, as well as self-reported pain and physical function by the Western Ontario MacMaster University Osteoarthritis Index. Paired t test, Wilcoxon, Spearman's correlation and a logistic model were used for statistical analysis, with p < 0.05. Pain improvement more than 2 points was considered clinically relevant. The effect size (ES) was calculated using Cohen's d. RESULTS Post protocol walking speed increased 6.7% (ES: 0.711), cadence 3.7% (ES: 0.655), stride length 2.6% (ES: 0.542), and double support time reduced 6.9% (ES:0.459). It was also observed a significant increase in one maximum repetition test for legpress 46%, knee extension 23% and knee flexion chair 27% (p < 0.001). Patients reported a 62.5% reduction in pain (ES:1.518) and 64.9% improvement in physical function (ES:1.376). 82% of the patients presented more than 2 points improvement in pain. No evidence of strong correlations between pain, strength gains and gait parameters were found. CONCLUSIONS There was a significant and clinical improvement of spatiotemporal gait parameters, pain, physical function, and strength after 8-week lower limb resistance training protocol. Patients who had a clinically relevant pain improvement presented better gait performance.
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Affiliation(s)
- Mariana Rosada
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | | | | | | | | | | | - Mario Ferretti
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
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Shin D, Choi CW, Desrochers PC, Gill SV. Factors Mediating or Moderating the Effects of Obesity on Walking: Targeting Areas for Rehabilitation. J Mot Behav 2023; 56:62-68. [PMID: 37491006 PMCID: PMC10808260 DOI: 10.1080/00222895.2023.2237920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 05/15/2023] [Accepted: 06/30/2023] [Indexed: 07/27/2023]
Abstract
Increased physical activity, such as walking, is often prescribed to address obesity. Several factors that may influence the connection between obesity and walking include the biomechanics of gait, pain, depressive symptoms, physical health, and activity. The objective of this study was to assess the moderation and mediation effects of knee pain and buckling, depressive symptoms, physical activity, and physical health on spatiotemporal gait parameters in individuals with obesity. Forty participants with obesity performed a task in which they walked on flat ground and crossed an obstacle. Measures of knee pain and buckling, depressive symptoms, physical activity, and physical health were collected. We conducted mediation analyses with knee buckling and pain as mediators of the effect of the BMI on spatiotemporal gait parameters. Moderation analyses were performed with depressive symptoms, physical activity, and physical health as moderators of the effect of BMI on spatiotemporal gait parameters. We found that depressive symptoms and physical health moderated the relationship between BMI and Step Width in people with obesity. These effects were pronounced when participants crossed an obstacle. In conclusion, depressed mood and physical health influence the relationship between obesity and walking. These factors present potential avenues for rehabilitation interventions to aid individuals with obesity.
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Affiliation(s)
- Danny Shin
- Sargent College of Health and Rehabilitation, Boston University, Boston, MA, USA
| | - Chi-Whan Choi
- Sargent College of Health and Rehabilitation, Boston University, Boston, MA, USA
| | - Phillip C Desrochers
- Sargent College of Health and Rehabilitation, Boston University, Boston, MA, USA
| | - Simone V Gill
- Sargent College of Health and Rehabilitation, Boston University, Boston, MA, USA
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Ward GH, Montalbano MJ. Postoperative scores for robot-assisted and conventional total knee arthroplasty: A meta-analysis. J Clin Orthop Trauma 2023; 41:102189. [PMID: 37389103 PMCID: PMC10300356 DOI: 10.1016/j.jcot.2023.102189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 03/17/2023] [Accepted: 06/10/2023] [Indexed: 07/01/2023] Open
Abstract
Background Knee osteoarthritis is the most common joint disease globally. As obesity and age rates continue to rise in the U.S., the demand for total knee arthroplasty (TKA) is expected to grow significantly by 2030. Advanced techniques such as robotic-assisted (RA-TKA) aim to address this growing concern and improve patient quality-of-life. Since utilization of RA-TKA increased from 2010 to 2018, it is important to compare RA-TKA to conventional TKA (C-TKA) performance. This study compares RA-TKA to C-TKA in patient-reported WOMAC scores and objective range of motion (ROM) scores in eligible short-term (one-year or less) and long-term (one-year to fifteen-years) postoperative follow-up studies. Methods A systematic review using the PubMed database was performed to identify articles including RA-TKA, CA-TKA, C-TKA, WOMAC scores, and ROM scores. Results Between RA-TKA and C-TKA, weighted analysis found significant effects in short-term (15.45, 95% CI: 4.96-25.94) and long-term (2.62, 95% CI: 0.62-4.61) WOMAC scores. Conclusion As approximately 7-20% of C-TKA surgeries result in poor subjective outcomes, and with revision rates and the demand for TKA set to rise, our analysis suggests that patient quality-of-life and cost effectiveness may be significantly improved by RA-TKA over C-TKA.
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Affiliation(s)
- Gavin H. Ward
- Corresponding author. St. George's University, University Centre, St. George's, Grenada.
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Kitagawa T, Hayashi M. mHealth for the Self-management of Knee Osteoarthritis: Scoping Review. J Med Internet Res 2023; 25:e38798. [PMID: 37155233 DOI: 10.2196/38798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 08/10/2022] [Accepted: 04/03/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND Educating patients on the self-management of knee osteoarthritis (OA) reportedly reduces pain, improves activities of daily living, and even reduces health care costs. OBJECTIVE This scoping review will summarize the current evidence on mobile health (mHealth) and smartphone app-based disease self-management for patients with knee OA. METHODS PubMed, Web of Science, the Cochrane Central Register of Controlled Trials, and CINAHL were systematically searched in May 2021 using the keywords "knee osteoarthritis," "mobile health," and "self-management." Studies that investigated patients with knee OA based on radiography or clinical diagnosis were included. The following criteria were applied to the mobile phone apps included in the search-derived studies: the ability to (1) record and manage symptoms, (2) provide patient education, and (3) guide and record activities of daily living. Studies eligible for inclusion in this scoping review were interventional trials or observational studies published in English. RESULTS This scoping review included 8 reports, of which 3 were randomized controlled trials and 1 was a conference abstract. Most studies provided data on the outcomes of pain, physical function, and quality of life. CONCLUSIONS An increasing number of reports are addressing the effectiveness of mHealth in patients with knee OA, and the data suggest that mHealth efficacy is similar to conventional management of health. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.17504/protocols.io.buuxnwxn.
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Affiliation(s)
- Takashi Kitagawa
- Department of Physical Therapy, School of Health Sciences, Shinshu University, Matsumoto, Japan
| | - Masateru Hayashi
- Department of Rehabilitation, Hanamizuki Orthopedics Sports Clinic, Kiyosu, Japan
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Vomer RP, Boggess S, Boggess B. Ultrasound Evaluation of Knee Osteoarthritis. Cureus 2023; 15:e39188. [PMID: 37378133 PMCID: PMC10292167 DOI: 10.7759/cureus.39188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2023] [Indexed: 06/29/2023] Open
Abstract
While radiographs and magnetic resonance imaging (MRI) have long been used in the assessment of osteoarthritis (OA), ultrasound imaging has been rapidly accepted by musculoskeletal providers in both the assessment and treatment of OA. A limiting factor in the use of ultrasound is the proper training required by the user for results to be reliable and reproducible. A standardized ultrasound protocol can potentially address this limiting factor. The critical information to consider in a standardized protocol include proper patient positioning, probe alignment, probe orientation, and identification of the appropriate anatomic landmarks. The outlined protocol considers these factors with the purpose of providing a step-by-step method to assess and monitor knee OA.
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Affiliation(s)
- Rock P Vomer
- Department of Family and Community Health/Department of Orthopedics, Division of Sports Medicine, Duke University, Durham, USA
- Family Medicine, Mayo Clinic Jacksonville Campus, Jacksonville, USA
| | - Samuel Boggess
- Department of Osteopathic Medicine, Philadelphia College of Osteopathic Medicine-Georgia, Suwanee, USA
| | - Blake Boggess
- Department of Orthopedics, Division of Sports Medicine, Duke University, Durham, USA
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Meng S, Tang C, Deng M, Yuan J, Fan Y, Gao S, Feng Y, Yang J, Chen C. Tropoelastin-Pretreated Exosomes from Adipose-Derived Stem Cells Improve the Synthesis of Cartilage Matrix and Alleviate Osteoarthritis. J Funct Biomater 2023; 14:jfb14040203. [PMID: 37103293 PMCID: PMC10143921 DOI: 10.3390/jfb14040203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 03/24/2023] [Accepted: 04/03/2023] [Indexed: 04/28/2023] Open
Abstract
Mesenchymal stem cells (MSCs) have recently been widely used to treat osteoarthritis (OA). Our prior research shows that tropoelastin (TE) increases MSC activity and protects knee cartilage from OA-related degradation. The underlying mechanism might be that TE regulates the paracrine of MSCs. Exosomes (Exos), the paracrine secretion of MSCs, have been found to protect chondrocytes, reduce inflammation, and preserve the cartilage matrix. In this study, we used Exos derived from TE-pretreated adipose-derived stem cells (ADSCs) (TE-ExoADSCs) as an injection medium, and compared it with Exos derived from unpretreated ADSCs (ExoADSCs). We found that TE-ExoADSCs could effectively enhance the matrix synthesis of chondrocytes in vitro. Moreover, TE pretreatment increased the ability of ADSCs to secrete Exos. In addition, compared with ExoADSCs, TE-ExoADSCs exhibited therapeutic effects in the anterior cruciate ligament transection (ACLT)-induced OA model. Further, we observed that TE altered the microRNA expression in ExoADSCs and identified one differentially upregulated microRNA: miR-451-5p. In conclusion, TE-ExoADSCs helped maintain the chondrocyte phenotype in vitro, and promoted cartilage repair in vivo. These therapeutic effects might be related with the altered expression of miR-451-5p in the ExoADSCs. Thus, the intra-articular delivery of Exos derived from ADSCs with TE pretreatment could be a new approach to treat OA.
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Affiliation(s)
- Shuo Meng
- College of Medical Informatics, Chongqing Medical University, Chongqing 400016, China
| | - Cong Tang
- College of Medical Informatics, Chongqing Medical University, Chongqing 400016, China
| | - Muhai Deng
- College of Medical Informatics, Chongqing Medical University, Chongqing 400016, China
| | - Jie Yuan
- College of Medical Informatics, Chongqing Medical University, Chongqing 400016, China
| | - Yanli Fan
- College of Medical Informatics, Chongqing Medical University, Chongqing 400016, China
| | - Shasha Gao
- College of Medical Informatics, Chongqing Medical University, Chongqing 400016, China
| | - Yong Feng
- Department of Orthopaedic Surgery, Chongqing Emergency Medical Center, Chongqing University Central Hospital, Chongqing 400014, China
| | - Junjun Yang
- Key Laboratory of Biorheological Science and Technology, College of Bioengineering, Chongqing University, Ministry of Education, Chongqing 400044, China
| | - Cheng Chen
- College of Medical Informatics, Chongqing Medical University, Chongqing 400016, China
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Zhao T, Wang S, Liu W, Shen J, Dai Y, Shi M, Huang X, Wei Y, Li T, Zhang X, Xie Z, Wang N, Qin D, Li Z. Clinical efficacy of Yiqi Yangxue formula on knee osteoarthritis and unraveling therapeutic mechanism through plasma metabolites in rats. Front Genet 2023; 14:1096616. [PMID: 37091797 PMCID: PMC10113924 DOI: 10.3389/fgene.2023.1096616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 03/23/2023] [Indexed: 04/08/2023] Open
Abstract
Objective: To observe the clinical efficacy and safety of Yiqi Yangxue formula (YQYXF) on knee osteoarthritis (KOA), and to explore the underlying therapeutic mechanism of YQYXF through endogenous differential metabolites and their related metabolic pathways.Methods: A total of 61 KOA patients were recruited and divided into the treatment group (YQYXF, 30 cases) and the control group (celecoxib, Cxb, 31 cases). Effects of these two drugs on joint pain, swelling, erythrocyte sedimentation rate (ESR) and c-reactive protein (CRP) were observed, and their safety and adverse reactions were investigated. In animal experiments, 63 SD rats were randomly divided into normal control (NC) group, sham operation (sham) group, model (KOA) group, Cxb group, as well as low-dose (YL), medium-dose (YM), and high-dose groups of YQYXF (YH). The KOA rat model was established using a modified Hulth method. Ultra-high-performance liquid chromatography/Q Exactive HF-X Hybrid Quadrupole-Orbitrap Mass (UHPLC-QE-MS)-based metabolomics technology was used to analyze the changes of metabolites in plasma samples of rats. Comprehensive (VIP) >1 and t-test p < 0.05 conditions were used to screen the disease biomarkers of KOA, and the underlying mechanisms of YQYXF were explored through metabolic pathway enrichment analysis. The related markers of YQYXF were further verified by ELISA (enzyme-linked immunosorbent assay).Results: YQYXF can improve joint pain, swelling, range of motion, joint function, Michel Lequesen index of severity for osteoarthritis (ISOA) score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, ESR, and CRP. No apparent adverse reactions were reported. In addition, YQYXF can improve cartilage damage in KOA rats, reverse the abnormal changes of 16 different metabolites, and exert an anti-KOA effect mainly through five metabolic pathways. The levels of reactive oxygen species (ROS) and glutathione (GSH) were significantly decreased after the treatment of YQYXF.Conclusion: YQYXF can significantly improve the clinical symptoms of KOA patients without obvious adverse reactions. It mainly improved KOA through modulating lipid metabolism-related biomarkers, reducing lipid peroxidation and oxidative stress.
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Affiliation(s)
- Ting Zhao
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China
| | - Shiqi Wang
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China
| | - Wenbin Liu
- The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, China
| | - Jiayan Shen
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China
| | - Youwu Dai
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China
| | - Mingqin Shi
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China
| | - Xiaoyi Huang
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China
| | - Yuanyuan Wei
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China
| | - Tao Li
- Qujing Hospital Affiliated to Yunnan University of Traditional Chinese Medicine, Qujing, China
| | - Xiaoyu Zhang
- The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China
| | - Zhaohu Xie
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China
| | - Na Wang
- Institutes of Integrative Medicine, Fudan University, Shanghai, China
- *Correspondence: Zhaofu Li, ; Na Wang, ; Dongdong Qin,
| | - Dongdong Qin
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China
- *Correspondence: Zhaofu Li, ; Na Wang, ; Dongdong Qin,
| | - Zhaofu Li
- School of Basic Medical Sciences, Yunnan University of Chinese Medicine, Kunming, China
- *Correspondence: Zhaofu Li, ; Na Wang, ; Dongdong Qin,
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Deng C, Sun Y, Zhang Z, Ma X, Liu X, Zhou F. Development and evaluation of nomograms for predicting osteoarthritis progression based on MRI cartilage parameters: data from the FNIH OA biomarkers Consortium. BMC Med Imaging 2023; 23:43. [PMID: 36973670 PMCID: PMC10045658 DOI: 10.1186/s12880-023-01001-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 03/15/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Osteoarthritis (OA) is a leading cause of disability worldwide. However, the existing methods for evaluating OA patients do not provide enough comprehensive information to make reliable predictions of OA progression. This retrospective study aimed to develop prediction nomograms based on MRI cartilage that can predict disease progression of OA. METHODS A total of 600 subjects with mild-to-moderate osteoarthritis from the Foundation for National Institute of Health (FNIH) project of osteoarthritis initiative (OAI). The MRI cartilage parameters of the knee at baseline were measured, and the changes in cartilage parameters at 12- and 24-month follow-up were calculated. The least absolute shrinkage and selection operator (LASSO) regression analysis was used to extract the valuable characteristic parameters at different time points including cartilage thickness, cartilage volume, subchondral bone exposure area and uniform cartilage thickness in different sub regions of the knee, and the MRI cartilage parameters score0, scoreΔ12, and scoreΔ24 at baseline, 12 months, and 24 months were constructed. ScoreΔ12, and scoreΔ24 represent changes between 12 M vs. baseline, and 24 M vs. baseline, respectively. Logistic regression analysis was used to construct the nomogram0, nomogramΔ12, and nomogramΔ24, including MRI-based score and risk factors. The area under curve (AUC) was used to evaluate the differentiation of nomograms in disease progression and subgroup analysis. The calibration curve and Hosmer-Lemeshow (H-L) test were used to verify the calibration of the nomograms. Clinical usefulness of each prediction nomogram was verified by decision curve analysis (DCA). The nomograms with predictive efficacy were analyzed by secondary analysis. Internal verification was assessed using bootstrapping validation. RESULTS Each nomogram included cartilage score, KL grade, WOMAC pain score, WOMAC disability score, and minimum joint space width. The AUC of nomogram0, nomogramΔ12, and nomogramΔ24 in predicing the progression of radiology and pain were 0.69, 0.64, and 0.71, respectively. All three nomograms had good calibration. Analysis by DCA showed that the clinical effectiveness of nomogramΔ24 was higher than others. Secondary analysis showed that nomogram0 and nomogramΔ24 were more capable of predicting OA radiologic progression than pain progression. CONCLUSION Nomograms based on MRI cartilage change were useful for predicting the progression of mild to moderate OA.
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Affiliation(s)
- Chunbo Deng
- Department of Orthopedics, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
- Department of Orthopedics, Central Hospital of Shenyang Medical College, Shenyang, Liaoning Province, China
| | - Yingwei Sun
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
- Department of Radiology, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning Province, China
| | - Zhan Zhang
- Department of Orthopedics, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Xun Ma
- Department of Rehabilitation, Shengjing Hospital of China Medical University, No.16, Puhe Street, Shenyang North New Area, Shenyang, Liaoning Province, 110134, China
| | - Xueyong Liu
- Department of Rehabilitation, Shengjing Hospital of China Medical University, No.16, Puhe Street, Shenyang North New Area, Shenyang, Liaoning Province, 110134, China.
| | - Fenghua Zhou
- Department of Rehabilitation, Shengjing Hospital of China Medical University, No.16, Puhe Street, Shenyang North New Area, Shenyang, Liaoning Province, 110134, China.
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McConaghy K, Klika AK, Apte SS, Erdemir A, Derwin K, Piuzzi NS. A Call to Action for Musculoskeletal Research Funding: The Growing Economic and Disease Burden of Musculoskeletal Conditions in the United States Is Not Reflected in Musculoskeletal Research Funding. J Bone Joint Surg Am 2023; 105:492-498. [PMID: 36574617 DOI: 10.2106/jbjs.22.00693] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
ABSTRACT As a result of an aging population, musculoskeletal disease is a growing source of health and economic burden in the United States. In 2019, musculoskeletal conditions affected approximately 127.4 million people (more than a third of the U.S. population); they were the top driver of health-care spending in 2016, with an estimated direct annual cost of $380.9 billion. While musculoskeletal conditions represent a substantial and growing burden in terms of prevalence, disability, and health-care costs, National Institutes of Health (NIH) research funding has remained disproportionately allocated to other disease conditions. Therefore, our purpose was to provide an assessment of the current burden of musculoskeletal disease in terms of prevalence, disability, and health-care costs, and compare the changing burden of disease to trends in NIH funding.
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Affiliation(s)
- Kara McConaghy
- Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Alison K Klika
- Department of Orthopedic Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Suneel S Apte
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Ahmet Erdemir
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Kathleen Derwin
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Nicolas S Piuzzi
- Department of Orthopedic Surgery, Cleveland Clinic, Cleveland, Ohio.,Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
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EFENDI E, SUGIYANTA S, FEBIANTI Z, HAIRRUDIN H, DWICAHYANDARI WS, ZABIRURROHMAN D, SUTEJO IR. USG guided-intra-articular platelet-rich plasma injection of knee-osteoarthritis patient. Chirurgia (Bucur) 2023. [DOI: 10.23736/s0394-9508.22.05423-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
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He R, Sun M, Xiong R, Yang J, Guo L, Yang L. Semiactive robotic-arm system versus patient-specific instrumentation in primary total knee arthroplasty: Efficacy and accuracy. Asian J Surg 2023; 46:742-750. [PMID: 35835672 DOI: 10.1016/j.asjsur.2022.06.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 04/29/2022] [Accepted: 06/30/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To compare the difference in efficacy and accuracy during total knee arthroplasty (TKA) among robotic-arm system, patient-specific instrumentation (PSI) and conventional TKA (COTKA). METHODS Retrospective analysis of 90 advanced knee osteoarthritis (OA) patients in our hospital between June 2019 and December 2020 was conducted. Patients were divided into robotic arm-assisted (RA)TKA (group A), PSITKA (group B) and COTKA (group C), 30 cases in each group. The operation time, intraoperative bleeding, and length of hospital stay were counted. Imaging data of hip-knee-ankle angle (HKA), posterior condylar angle (PCA), lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), and sagittal tibial component angle (sTCA) were statistically analyzed. The postoperative recovery of the patients was evaluated by Knee Society Score (KSS) and the Western Ontario Mac Master University Index Score (WOMAC). RESULTS Group A had the least intraoperative bleeding. For operation time, group A was the longest compared with group B and group C (P < 0.05), while group B was longer than group C (P < 0.05). There was no significant difference in HKA, LDFA, and MPTA among the three groups, and the lower limb alignments were all restored to the neutral position. PCA of group A and B were both smaller than that of group C and closer to 0° (P < 0.05), but the difference between group A and B was not statistically significant. The sTCA in group A was significantly better than group B, and group B was significantly better than group C (P < 0.05). There were no significant differences in function scores among the three groups. CONCLUSION Compared to the PSI and CO, RA is more minimally invasive and more accurate in radiographic results.
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Affiliation(s)
- Rui He
- Center for Joint Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Maolin Sun
- Center for Joint Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Ran Xiong
- Center for Joint Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Junjun Yang
- Center for Joint Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Lin Guo
- Center for Joint Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China.
| | - Liu Yang
- Center for Joint Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China.
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Kacmaz KS, Unver B, Karatosun V. The Reliability and Validity of the Lie-to-Sit-to-Stand-to-Walk Transfer (LSSWT) Test in Knee Osteoarthritis. Indian J Orthop 2023; 57:290-296. [PMID: 36777119 PMCID: PMC9880116 DOI: 10.1007/s43465-022-00802-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022]
Abstract
Background Several neuromuscular impairments may be observed in older patients with knee osteoarthritis (OA), increasing the risk of falling, which is common during transfer activities. The Lie-to-Sit-to- Stand-to-Walk Transfer (LSSWT) test was developed to evaluate complex transfer abilities. The study aims to investigate the reliability and validity of LSSWT in patients with knee OA. Methods Twenty-nine patients with knee OA were included in this study. The LSSWT, Timed up and go test (TUG), and Western Ontario and McMaster Universities Arthritis Index (WOMAC) were administered to the patients. Patients rested for at least an hour between the trials to avoid fatigue. Results The LSSWT has excellent reliability and high validity in patients with knee OA. The relative (ICC coefficient) and absolute (SEM and SRD95) reliability values are 0.96 (95% CI: 0.91-0.98), 1.00, and 2,75, respectively. The Pearson correlation coefficient of the LSSWT with the TUG is 0.73 (p < 0.01), and the Spearmen correlation coefficient of the LSSWT with the WOMAC is 0.54 (p < 0.05). Conclusions The LSSWT is highly reliable and valid in knee OA and is recommended for routine dynamic balance establishment. Having a low minimal clinically important difference shows the LSSWT's sensitivity. The LSSWT can easily identify dynamic balance deficits in knee OA patients and help prevent fall incidents.
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Affiliation(s)
- Kevser Sevik Kacmaz
- Department of Physical Therapy and Rehabilitation, Izmir Katip Celebi University, TR-35340 Cigli Izmir, Turkey
| | - Bayram Unver
- School of Physical Therapy and Rehabilitation, Dokuz Eylul University, TR-35340 Balçova Izmir, Turkey
| | - Vasfi Karatosun
- Department of Orthopaedics and Traumatology, School of Medicine, Dokuz Eylul University, TR-35340 Balçova-Izmir, Turkey
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Aneja A, Adams SB, Foster JA, Pezold R. AAOS Technology Overview Summary: Concentrated Bone Marrow Aspirate for Knee Osteoarthritis. J Am Acad Orthop Surg 2023; 31:e9-e13. [PMID: 36473210 DOI: 10.5435/JAAOS-D-22-00228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 09/29/2022] [Indexed: 12/12/2022] Open
Abstract
The Concentrated Bone Marrow Aspirate (CBMA) for Knee Osteoarthritis Technology Overview is based on a systematic review of current scientific and clinical research. Through analysis of the current best evidence, this technology overview seeks to evaluate the efficacy of CBMA for patients with knee osteoarthritis. The systematic literature review resulted in 12 articles: three high-quality, four moderate-quality, and five low-quality. The findings of these studies were summarized to present findings on CBMA versus placebo and CBMA versus other treatment modalities. In addition, the work group highlighted areas for needed additional research when evidence proved lacking on the topic and carefully noted the potential harms associated with an intervention, required resource utilization, acceptability, and feasibility.
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Yokota A, Maeshima E, Sasaki K, Ooi T, Sainoh T, Hosokawa H. Physical functions associated with health-related quality of life in older adults diagnosed with knee osteoarthritis. J Phys Ther Sci 2023; 35:60-65. [PMID: 36628147 PMCID: PMC9822827 DOI: 10.1589/jpts.35.60] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 10/19/2022] [Indexed: 01/01/2023] Open
Abstract
[Purpose] The present study aimed to identify the physical functions associated with health-related quality of life in older adults with knee osteoarthritis. [Participants and Methods] A total of 132 participants were included in this study in two groups: the knee osteoarthritis group (n=66) and the control group (n=66). We compared the results of the Medical Outcomes Study 36-Item Short-Form Health Survey with the physical function measures related to health-related quality of life. In the knee osteoarthritis group, we examined the relationship between the degree of knee pain and health-related quality of life. [Results] The knee osteoarthritis group showed a significantly shorter one-leg standing time, lower maximum walking speed, and significantly longer time to complete the Sit-to-Stand-5 and Timed Up and Go tests than the control group. The knee osteoarthritis group had significantly lower 36-Item Short-Form Health Survey scores than the control group on seven subscales and significantly lower scores for physical component summary and role or social component summary. In the knee osteoarthritis group, physical component summary and role or social component summary were correlated with Sit-to-Stand-5, Timed Up and Go, and maximum walking speed. We observed a correlation between physical component summary and knee pain on joint loading. [Conclusion] In older adults with knee osteoarthritis, rehabilitation approaches aimed at achieving a smooth transition from sitting to standing may increase social participation and improve health-related quality of life.
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Affiliation(s)
- Ayako Yokota
- Department of Physical Therapy, Kinjo University: 1200
Kasama, Hakusan-shi, Ishikawa 924-8511, Japan, Graduate School of Sports Sciences, Osaka University of
Health and Sport Sciences, Japan,Corresponding author. Ayako Yokota (E-mail: )
| | - Etsuko Maeshima
- Graduate School of Sports Sciences, Osaka University of
Health and Sport Sciences, Japan
| | - Kentaro Sasaki
- Graduate School of Health Sciences, Kinjo University,
Japan
| | - Takafumi Ooi
- Department of Medical Technology Rehabilitation Center,
Kaga Medical Center, Japan
| | - Takeshi Sainoh
- Department of Orthopaedic Surgery, Sainou Hospital,
Japan
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Stensdotter AK, Vårbakken K, Roeleveld K. Factors associated with self-rated difficulty to descend stairs in persons with knee osteoarthritis. PM R 2023; 15:9-19. [PMID: 34432951 DOI: 10.1002/pmrj.12698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 08/01/2021] [Accepted: 08/08/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND Difficulty descending stairs is common in persons with knee osteoarthritis (OA). Clinically, it is important to know if and how this is explained by objectively measured difficulty to descend stairs, muscle weakness, pain, fear of movement, or knee joint status. OBJECTIVE To identify the potential of these factors to explain self-reported difficulty descending stairs. DESIGN Cross sectional, case-control. SETTING Hospital outpatient and physiotherapy clinic. PARTICIPANTS Twenty-eight men and women with knee OA (age 62.2 SD 5.9 years) and 31 controls (age 50.0 SD 8.5 years). INTERVENTION Not applicable. MAIN OUTCOME MEASURES Using multivariate statistics, group comparisons were made for lower extremity kinematics (incorporating hip, knee, and ankle angles) and stance time in stair descent and lower extremity muscle strength. Then, a stepwise linear regression analysis was performed within the OA group to explain self-reported difficulties in stair descent where pain, kinesiophobia, radiographic signs, and outcomes that differed from controls for stair-descent kinematics and muscle strength were independent variables. RESULTS Multivariate statistics showed that the OA group displayed different all-over lower extremity kinematics (F8,42 = 2.44 p = .029, η2 = 0.32) and a longer stance time (F3,50 = 6.46; p = .001, η2 = 0.28) in stair descent and lower muscle strength (F7,47 = 2.39; p = .035, η2 = 0.26) compared to controls. Regression analysis within the OA group to explain self-rated difficulties to descend stairs showed that the strongest association with kinesiophobia (ß = 0.607, p = .001) that combined with pain last week and radiographic signs explained almost 100% (ß = 0.972). Stair descent kinematics and strength variables that differed between groups did not explain self-rated difficulties to descend stairs. CONCLUSION Kinesiophobia and pain rather than stair-descent kinematics and reduced muscle-strength explained self-rated difficulties in stair descent in the OA group.
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Affiliation(s)
- Ann-Katrin Stensdotter
- Faculty of Medicine and Health Sciences, Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Kjartan Vårbakken
- Faculty of Medicine and Health Sciences, Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Karin Roeleveld
- Faculty of Medicine and Health Sciences, Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Tudorachi NB, Totu T, Eva I, Bărbieru B, Totu EE, Fifere A, Pinteală T, Sîrbu PD, Ardeleanu V. Knee Osteoarthritis in Relation to the Risk Factors of the Metabolic Syndrome Components and Environment of Origin. J Clin Med 2022; 11:jcm11247302. [PMID: 36555918 PMCID: PMC9781325 DOI: 10.3390/jcm11247302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/26/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022] Open
Abstract
Background: Knee osteoarthritis (KOA) is a chronic degenerative pathology that is associated with multiple risk factors such as age, sex, obesity, or metabolic syndrome (MetS). The present clinical trial aimed to investigate the influence of the environment of origin, body mass index (BMI), and MetS parameters on the KOA differentiated degrees. Methods: 85 patients were admitted for the clinical study. The KOA presence was investigated using X-rays analysis. The Kellgren−Lawrence classification (KL) of the KOA severity and the MetS characteristic parameters using freshly collected blood were performed for each patient. All data collected were used for ANOVA statistic interpretation. Results: The total cholesterol and glycemia were found to be statistically significant (p < 0.028, and p < 0.03, respectively), with a high level in patients with severe KOA compared to healthy ones. Patients from rural regions are 5.18 times more prone to develop severe KOA when compared to ones from urban areas. Conclusions: The results of the statistical analysis confirmed the correlation between the incidence and severity of KOA and the influence of increased values of BMI, glycemia, triglycerides, and total cholesterol. The investigations revealed a statistically significant influence of the environment of origin on the KOA degree of the patients.
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Affiliation(s)
- Nicoleta Bianca Tudorachi
- Faculty of Medicine, “Ovidius” University of Constanța, Mamaia Boulevard 124, 900527 Constanța, Romania
| | - Tiberiu Totu
- Department of Health Sciences and Technology (D-HEST), ETH Zurich, 8093 Zurich, Switzerland
| | - Iuliana Eva
- Radiology and Medical Imaging Laboratory, “Iacob Czihac” Emergency Military Clinical Hospital, 7-9 General Henri Mathias Berthelot St., 700483 Iași, Romania
| | - Bogdan Bărbieru
- Department of Orthopedics and Traumatology, “Iacob Czihac” Emergency Military Clinical Hospital, 7-9 General Henri Mathias Berthelot St., 700483 Iași, Romania
| | - Eugenia Eftimie Totu
- Department of Analytical Chemistry and Environmental Engineering, Faculty of Industrial Chemistry and Biotechnologies, University Politehnica of Bucharest, 1-5 Polizu Street, Sector 1, 011061 Bucharest, Romania
- Correspondence: (E.E.T.); (A.F.)
| | - Adrian Fifere
- Centre of Advanced Research in Bionanoconjugates and Biopolymers, “Petru Poni” Institute of Macromolecular Chemistry, 41A Grigore Ghica Voda Alley, 700487 Iași, Romania
- Correspondence: (E.E.T.); (A.F.)
| | - Tudor Pinteală
- Department of Orthopedics and Traumatology, Faculty of Medicine, Grigore T Popa University of Medicine and Pharmacy, 16 University Street, 7001 Iași, Romania
| | - Paul-Dan Sîrbu
- Department of Orthopedics and Traumatology, Faculty of Medicine, Grigore T Popa University of Medicine and Pharmacy, 16 University Street, 7001 Iași, Romania
| | - Valeriu Ardeleanu
- Faculty of Medicine, “Ovidius” University of Constanța, Mamaia Boulevard 124, 900527 Constanța, Romania
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Sayre EC, Guermazi A, Nicolaou S, Esdaile JM, Kopec JA, Singer J, Wong H, Thorne A, Cibere J. Magnetic resonance imaging predictors (cartilage, osteophytes and meniscus) of prevalent and 3-year incident medial and lateral tibiofemoral knee joint tenderness and patellofemoral grind. BMC Musculoskelet Disord 2022; 23:1048. [DOI: 10.1186/s12891-022-06033-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 11/25/2022] [Indexed: 12/03/2022] Open
Abstract
Abstract
Objective
To identify magnetic resonance imaging (MRI) predictors (cartilage [C], osteophytes [O] and meniscus [M] scores) of prevalent and 3-year incident medial tibiofemoral (MTF) and lateral tibiofemoral (LTF) knee joint tenderness and patellofemoral (PF) grind.
Methods
Population-based knee pain cohort aged 40–79 was assessed at baseline (N = 255), 3- and 7-year follow-up (N = 108 × 2 = 216). COM scores were measured at 6/8/6 subregions respectively. Age-sex-BMI adjusted logistic models predicted prevalence versus relevant COM predictors (medial, lateral or patellar / trochlear groove scores). Fully adjusted models also included all relevant COM predictors. Binary generalized estimating equations models predicting 3-year incidence were also adjusted for individual follow-up time between cycles.
Results
Significant predictors of prevalent MTF tenderness: medial femoral cartilage (fully adjusted odds ratio [aOR] 1.84; 95% confidence interval [CI] 1.11, 3.05), female (aOR = 3.05; 1.67, 5.58), BMI (aOR = 1.53 per 5 units BMI; 1.10, 2.11). Predictors of prevalent LTF tenderness: female (aOR = 2.18; 1.22, 3.90). There were no predictors of prevalent PF grind in the fully adjusted model. However, medial patellar osteophytes was predictive in the age-sex-BMI adjusted model. There were no predictors of 3-year incident MTF tenderness. Predictors of 3-year incident LTF tenderness: female (aOR = 3.83; 1.25, 11.77). Predictors of 3-year incident PF grind: lateral patellar osteophytes (aOR = 4.82; 1.69, 13.77). In the age-sex-BMI adjusted model, patellar cartilage was also a predictor.
Conclusion
We explored potential MRI predictors of prevalent and 3-year incident MTF/LTF knee joint tenderness and PF grind. These findings could guide preemptive strategies aimed at reducing these symptoms in the present and future (3-year incidence).
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Chiu PE, Fu Z, Sun J, Jian GW, Li TM, Chou LW. Efficacy of Fu's Subcutaneous Needling in Treating Soft Tissue Pain of Knee Osteoarthritis: A Randomized Clinical Trial. J Clin Med 2022; 11. [PMID: 36498758 DOI: 10.3390/jcm11237184] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 11/23/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022] Open
Abstract
Purpose: Fu’s subcutaneous needling (FSN) is a new acupuncture technique that produces a long-lasting effect in soft-tissue injuries. In patients with degenerative knee osteoarthritis (OA), myofascial trigger points (MTrPs) are common in the lower-limb muscles. In this randomized clinical trial, we evaluated the immediate, 1-week and 2-week effectiveness of FSN therapy in the treatment of degenerative knee OA. Patients and methods: We randomly divided 32 patients with knee OA into the FSN group (mean age: 65.73 ± 6.79 years) or the transcutaneous electrical nerve stimulation (TENS) group (mean age: 62.81 ± 5.72 years). The pressure pain threshold (PPT) and tissue hardness (TH) of the muscle and tendon attachment sites, knee range of motion, and physical ability (average walking speed) were measured. The subjective pain intensity index, Western Ontario and McMaster Universities OA Index (WOMAC), and Lequesne index were used to determine the efficacy of FSN on MTrP-induced soft-tissue pain compared with that of TENS. Results: A significantly greater improvement in pain qualities in the VAS (p < 0.05) was found in the FSN group. Moreover, in muscle and tendon qualities (including PPT and TH), a significant difference in the PPT of the quadriceps muscle (p < 0.05) was also observed among the immediate treatments in the FSN group. As for the functional index questionnaire assessment, the FSN group exhibited significant improvements among the immediate, 1-week and 2-week efficacies in terms of WOMAC (p < 0.05) and Lequesne index scores (p < 0.05). Conclusion: FSN was effective in treating soft-tissue pain in degenerative knee OA in terms of alleviating pain, strengthening walking ability, and improving overall functional performance. Pain relief was the primary benefit of FSN and a significant correlation between pain relief and knee joint mobility improvement was found. Trial registration: ClinicalTrials.gov Protocol Registration and Results System (registration number: NCT04356651).
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Greenwood R, Ellison J, Gleeson P, Mitchell K. Reliability of pain scores during a body weight support protocol in individuals with knee osteoarthritis. Disabil Rehabil 2022; 44:8382-8387. [PMID: 34932439 DOI: 10.1080/09638288.2021.2017028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE To explore the reliability of percentage of Body Weight Support (BWS) needed for maximal pain relief and of pain scores across 12 walking conditions including pre and post-over-ground walking and an unweighting protocol from 0% to 40% BWS on a lower body positive pressure (LBPP) treadmill for individuals with knee osteoarthritis (OA). MATERIALS AND METHODS Twenty individuals (64 ± 9.44 years) with knee OA completed over-ground walking and an unweighting protocol on an LBPP treadmill. The amount of BWS started at 0% and increased by 5% increments until it reached 40%. Pain scores were recorded at the end of each increment. RESULTS The reliability of pain scores was assessed using a Spearman's rho. This study found moderate reliability of the percentage of BWS for maximal pain relief. Additionally, there was good reliability of pain scores with pre and post-over-ground walking and from 0% BWS to 30% BWS, but moderate reliability of pain scores was found at 35% and 40% BWS. CONCLUSION This study supports the use of pain scores as a reliable measure during an unweighted walking session on an LBPP treadmill.IMPLICATIONS FOR REHABILITATIONBoth the OARSI and ACR recommend exercise in the treatment of individuals with knee OA but acknowledge that pain during exercise and exercise preference/accessibility are important when considering the type of exercise for an individual.LBPP treadmills decrease pain in individuals with knee OA during walking.Pain scores during unweighted walking show moderate to good reliability for individuals with knee OA.This study provides an unweighting protocol to use clinically to determine the Body Weight Support needed to decrease pain.
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Affiliation(s)
- Rebecca Greenwood
- School of Physical Therapy, Bowling Green State University, Bowling Green, OH, United States
| | - Jennifer Ellison
- School of Physical Therapy, Texas Woman's University, Houston, TX, United States
| | - Peggy Gleeson
- School of Physical Therapy, Texas Woman's University, Houston, TX, United States
| | - Katy Mitchell
- School of Physical Therapy, Texas Woman's University, Houston, TX, United States
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Zhou X, Xiang KM, Li J, Yang G, Wang Y, Xia H, Zhuang R. Efficacy and safety of Chinese herbal medicine Danggui Sini decoction for knee osteoarthritis: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e31516. [PMID: 36401458 PMCID: PMC9678616 DOI: 10.1097/md.0000000000031516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Knee osteoarthritis (KOA) often causes joint pain, weakness and mobility disorders, which seriously affects people's daily life and makes them unable to work and study normally. Traditional Chinese medicine (TCM) prescription Danggui Sini Decoction (DGSND) has been widely used in clinical practice and achieved good results. But there is no high-level evidence to support this result. The aim of this study is to evaluate DGSND's efficacy and safety in the management of KOA. METHODS We will search 7 electronic databases including Chinese National Knowledge Infrastructure (CNKI), Wanfang Data (WF), Chinese Scientific Journals Database (VIP), Chinese databases SinoMed (CBM), PubMed, Embase, and Cochrane Library databases. All the publications, with no time restrictions, will be searched without any restriction of language and status, the time from the establishment of the database to September 2022. Two reviewers will independently assess the quality of the selected studies, NoteExpress and Excel software will be used to extract data, and the content will be stored in an electronic chart. Different researchers will separately screen the titles and abstracts of records acquired potential eligibility which comes from the electronic databases. Full-text screening and data extraction will be conducted afterward independently. Statistical analysis will be conducted using RevMan 5.4 software. RESULTS This study will compare the effects of DGSND and any other different methods on patients with KOA to provide high-quality, evidence-based clinical recommendations. CONCLUSION The study provides a trustable clinical foundation for DGSND in the treatment of KOA.
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Affiliation(s)
- Xing Zhou
- The First Clinical College, Zhejiang Chinese Medical University, Zhejiang, China
- Department of Orthopaedics, The First Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang, China
| | - Ke-Meng Xiang
- Taizhou Traditional Chinese Medicine Hospital, Zhejiang, China
- * Correspondence: Ke-meng Xiang, Taizhou Traditional Chinese Medicine Hospital, Taizhou, No. 278, Zhongshan West Road, Jiaojiang District, Taizhou City, Zhejiang, China (e-mail: )
| | - Jinlei Li
- Kunming Traditional Chinese Medicine Hospital, Yunnan, China
| | - Guang Yang
- Kunming Traditional Chinese Medicine Hospital, Yunnan, China
| | - Yanbo Wang
- Kunming Traditional Chinese Medicine Hospital, Yunnan, China
| | - Hanting Xia
- The First Clinical College, Zhejiang Chinese Medical University, Zhejiang, China
- Department of Orthopaedics, The First Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang, China
| | - Rujie Zhuang
- The First Clinical College, Zhejiang Chinese Medical University, Zhejiang, China
- Department of Orthopaedics, The First Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang, China
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