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Shepherd RF, Kerns JG, Ranganath LR, Gallagher JA, Taylor AM. "Lessons from Rare Forms of Osteoarthritis". Calcif Tissue Int 2021; 109:291-302. [PMID: 34417863 PMCID: PMC8403118 DOI: 10.1007/s00223-021-00896-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 07/27/2021] [Indexed: 12/12/2022]
Abstract
Osteoarthritis (OA) is one of the most prevalent conditions in the world, particularly in the developed world with a significant increase in cases and their predicted impact as we move through the twenty-first century and this will be exacerbated by the covid pandemic. The degeneration of cartilage and bone as part of this condition is becoming better understood but there are still significant challenges in painting a complete picture to recognise all aspects of the condition and what treatment(s) are most appropriate in individual causes. OA encompasses many different types and this causes some of the challenges in fully understanding the condition. There have been examples through history where much has been learnt about common disease(s) from the study of rare or extreme phenotypes, particularly where Mendelian disorders are involved. The often early onset of symptoms combined with the rapid and aggressive pathogenesis of these diseases and their predictable outcomes give an often-under-explored resource. It is these "rarer forms of disease" that William Harvey referred to that offer novel insights into more common conditions through their more extreme presentations. In the case of OA, GWAS analyses demonstrate the multiple genes that are implicated in OA in the general population. In some of these rarer forms, single defective genes are responsible. The extreme phenotypes seen in conditions such as Camptodactyly Arthropathy-Coxa Vara-pericarditis Syndrome, Chondrodysplasias and Alkaptonuria all present potential opportunities for greater understanding of disease pathogenesis, novel therapeutic interventions and diagnostic imaging. This review examines some of the rarer presenting forms of OA and linked conditions, some of the novel discoveries made whilst studying them, and findings on imaging and treatment strategies.
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Affiliation(s)
- Rebecca F Shepherd
- Lancaster Medical School, Faculty of Health & Medicine, Lancaster University, Lancaster, UK
| | - Jemma G Kerns
- Lancaster Medical School, Faculty of Health & Medicine, Lancaster University, Lancaster, UK
| | - Lakshminarayan R Ranganath
- Departments of Clinical Biochemistry and Metabolic Medicine, Royal Liverpool University Hospital, Liverpool, L7 8XP, UK
| | - James A Gallagher
- Department of Musculoskeletal Biology, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, L7 8T, UK
| | - Adam M Taylor
- Lancaster Medical School, Faculty of Health & Medicine, Lancaster University, Lancaster, UK.
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Tudorachi NB, Totu EE, Fifere A, Ardeleanu V, Mocanu V, Mircea C, Isildak I, Smilkov K, Cărăuşu EM. The Implication of Reactive Oxygen Species and Antioxidants in Knee Osteoarthritis. Antioxidants (Basel) 2021; 10:985. [PMID: 34205576 PMCID: PMC8233827 DOI: 10.3390/antiox10060985] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 06/11/2021] [Accepted: 06/17/2021] [Indexed: 12/16/2022] Open
Abstract
Knee osteoarthritis (KOA) is a chronic multifactorial pathology and a current and essential challenge for public health, with a negative impact on the geriatric patient's quality of life. The pathophysiology is not fully known; therefore, no specific treatment has been found to date. The increase in the number of newly diagnosed cases of KOA is worrying, and it is essential to reduce the risk factors and detect those with a protective role in this context. The destructive effects of free radicals consist of the acceleration of chondrosenescence and apoptosis. Among other risk factors, the influence of redox imbalance on the homeostasis of the osteoarticular system is highlighted. The evolution of KOA can be correlated with oxidative stress markers or antioxidant status. These factors reveal the importance of maintaining a redox balance for the joints and the whole body's health, emphasizing the importance of an individualized therapeutic approach based on antioxidant effects. This paper aims to present an updated picture of the implications of reactive oxygen species (ROS) in KOA from pathophysiological and biochemical perspectives, focusing on antioxidant systems that could establish the premises for appropriate treatment to restore the redox balance and improve the condition of patients with KOA.
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Affiliation(s)
- Nicoleta Bianca Tudorachi
- Faculty of Medicine, “Ovidius” University of Constanța, Mamaia Boulevard 124, 900527 Constanța, Romania; (N.B.T.); (V.A.)
| | - Eugenia Eftimie Totu
- Faculty of Applied Chemistry and Material Science, University Politehnica of Bucharest, 1–5 Polizu Street, 011061 Bucharest, Romania
| | - Adrian Fifere
- Centre of Advanced Research in Bionanoconjugates and Biopolymers Department, “Petru Poni” Institute of Macromolecular Chemistry, 41A Grigore Ghica Voda Alley, 700487 Iasi, Romania
| | - Valeriu Ardeleanu
- Faculty of Medicine, “Ovidius” University of Constanța, Mamaia Boulevard 124, 900527 Constanța, Romania; (N.B.T.); (V.A.)
| | - Veronica Mocanu
- Faculty of Pharmacy, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania; (V.M.); (C.M.)
| | - Cornelia Mircea
- Faculty of Pharmacy, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania; (V.M.); (C.M.)
| | - Ibrahim Isildak
- Faculty of Chemistry-Metallurgy, Department of Bioengineering, Yildiz Technical University, Istanbul 34220, Turkey;
| | - Katarina Smilkov
- Faculty of Medical Sciences, Division of Pharmacy, Department of Applied Pharmacy, Goce Delcev University, Krste Misirkov Street, No. 10-A, 2000 Stip, North Macedonia;
| | - Elena Mihaela Cărăuşu
- Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, “Nicolae Leon” Building, 13 Grigore Ghica Street, 700259 Iasi, Romania;
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TUDORACHI NB, EVA I, MOSCALU M, AL- HIARY R, MORARU AC, BARBIERU B, STANCIU C, CORCIOVA C, ARDELEANU V. Evaluating risk factors involved in the alteration of biomechanics in relation to knee osteoarthritis. BALNEO RESEARCH JOURNAL 2019. [DOI: 10.12680/balneo.2019.305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The knee joint is very complex in terms of degrees of mobility and for normal biomechanics it is necessary for all the anatomical structures at this level to be within physiological limits. Problems can be caused by a number of risk factors such as age, sex, weight, or local risk factors such as patellar changes represented by patela alta or patella baja, which can lead to instability of the lower limb. Risk factors that may influence the development and progression of knee osteoarthritis have been evaluated. Changes in patellar position in relation to knee osteoarthritis were also studied. A group of 377 patients hospitalized for unilateral or bilateral knee pain with instability were included in the study. 239 of the 377 starting group presented knee osteoarthritis, constituting the study group. The risk factors analyzed were age, patient sex, BMI, weight status, anatomical changes in position of the patella (patella alta and patella baja), COBB angle and spine deviation. The results indicated that obesity, anatomical changes in the position of the patella, (patella alta), COBB angle and spine deviations represent significant risk factors in the onset of knee osteoarthritis.
Key words: risk factors, joint instability, knee osteoarthritis,
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Affiliation(s)
| | - Iuliana EVA
- „Iacob Czihac” Emergency Military Clinical Hospital, Iasi, România
| | - Mihaela MOSCALU
- “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, România
| | - Rami AL- HIARY
- „Ovidius” University of Constanta, Faculty of Medicine, PhD student, România
| | | | - Bogdan BARBIERU
- „Iacob Czihac” Emergency Military Clinical Hospital, Iasi, România
| | - Costin STANCIU
- „Iacob Czihac” Emergency Military Clinical Hospital, Iasi, România
| | - Calin CORCIOVA
- “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, România
| | - Valeriu ARDELEANU
- „Ovidius” University, Constanta, „Dunarea de Jos” University, Galati, General Hospital CF, Galati, România
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Nelligan RK, Hinman RS, Kasza J, Bennell KL. Effectiveness of internet-delivered education and home exercise supported by behaviour change SMS on pain and function for people with knee osteoarthritis: a randomised controlled trial protocol. BMC Musculoskelet Disord 2019; 20:342. [PMID: 31351449 PMCID: PMC6661079 DOI: 10.1186/s12891-019-2714-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 07/09/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Knee osteoarthritis (OA) is a prevalent and chronic condition with no known cure. Exercise is advocated in all clinical guidelines due to its positive effects on symptoms. Despite this, exercise participation is often poor in people with knee OA with access to exercise treatments a known barrier. Internet-delivered exercise interventions have the potential to improve access to evidence-based exercise treatments and can benefit OA outcomes, although non-usage and low adherence potentially limit their effectiveness. Short message services (SMS) show promise in facilitating exercise adherence and may be one solution to improve adherence to internet-delivered exercise interventions. The combination of internet-delivered exercise and SMS adherence support has not been specifically evaluated in people with knee OA. METHODS This protocol reports a two-arm parallel-design, assessor- and participant-blinded randomised controlled trial. This trial is recruiting 206 people aged 45 years and older, with a clinical diagnosis of knee OA from the Australian-wide community. Eligible and consenting participants are enrolled and randomised to receive access to either i) 'My Knee Education', an education control website containing OA and exercise information only or ii) a combined intervention that includes a website, 'My Knee Exercise', containing the same educational information as the control, guidance to increase general physical activity, and the prescription of a 24-week self-directed home-based lower-limb strengthening program in addition to a 24-week behaviour change SMS exercise adherence program. Outcome measures are being collected at baseline and 24-weeks. Primary outcomes are self-reported knee pain and physical function. Secondary outcomes include another self-reported measure of knee pain, function in sport and recreation, quality-of-life, physical activity, self-efficacy, participant satisfaction and perceived global change. DISCUSSION This randomised controlled trial will provide evidence about the effectiveness of a combined intervention of internet-delivered OA and exercise education, physical activity guidance and prescription of a 24-week lower-limb strengthening exercise program supported by a behaviour change SMS program compared to internet delivered OA and exercise education alone. TRIAL REGISTRATION ACTRN12618001167257/13th July 2018.
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Affiliation(s)
- Rachel K. Nelligan
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, VIC Australia
| | - Rana S. Hinman
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, VIC Australia
| | - Jessica Kasza
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC Australia
| | - Kim L. Bennell
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, VIC Australia
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Wang YL, An CM, Song S, Lei FL, Wang Y. Cupping Therapy for Knee Osteoarthritis: A Synthesis of Evidence. Complement Med Res 2018; 25:249-255. [PMID: 30007978 DOI: 10.1159/000488707] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND This systematic review was aimed to evaluate the efficacy and safety of cupping therapy for treating patients with knee osteoarthritis (KOA). METHODS The following databases were searched from their inception until June 2017: the Cochrane Central Register of Controlled Trials, PubMed, EMBASE, and 4 Chinese databases (Wan Fang Data, Chinese Biomedical Literature Database (CBM), VeiPu, and China National Knowledge Infrastructure (CNKI)). Randomized controlled trials (RCTs) assessing the effects of cupping therapy on KOA were included in this systematic review. A quantitative synthesis of the RCTs was conducted using RevMan 5.3 software. Study selection and data extraction and validation were performed independently by 2 reviewers. Cochrane criteria for risk of bias were used to assess the methodological quality of the trials. RESULTS A total of 5 studies met our inclusion criteria. We analyzed the data from these 5 RCTs involving 535 participants. All included studies were judged to be at high risk for bias. Dry cupping therapy plus Western medicine therapy was more effective than Western therapy alone in reducing the pain scores (mean difference (MD) = -1.79, 95% confidence interval (CI) -2.40 to -1.18; p < 0.01). In addition, the study participants in the dry cupping therapy plus Western medicine therapy group showed significantly greater improvements in the pain (MD = -0.73, 95% CI -1.61 to -0.41; p < 0.01), stiffness (MD = -0.94, 95% CI -1.30 to -0.58; p < 0.01), and physical function (MD = -10.07, 95% CI -13.45 to -6.69; p < 0.01) domains of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) compared to participants in the Western medicine therapy group. Moreover, when compared with Western medicine therapy alone, a meta-analysis of 4 RCTs suggested statistically significant favorable effects of wet cupping therapy plus Western medicine on the Lequesne Algofunctional Index (LAI) (MD = -3.44, 95% CI -4.21 to -2.68; p < 0.01). CONCLUSION There is weak evidence to support the hypothesis that cupping therapy has beneficial effects on reducing the pain intensity and improving the physical function in patients with KOA.
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Ma SY, Wang Y, Xu JQ, Zheng L. Cupping therapy for treating ankylosing spondylitis: The evidence from systematic review and meta-analysis. Complement Ther Clin Pract 2018; 32:187-194. [PMID: 30057049 DOI: 10.1016/j.ctcp.2018.07.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 06/16/2018] [Accepted: 07/05/2018] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Cupping therapy has been widely used in Eastern Asia, the Middle East, or Central and North Europe to manage the symptom of ankylosing spondylitis (AS). The aim of this systematic review was to review data from randomized controlled trials (RCTs) of cupping therapy for treating patients with AS. METHODS Databases that were searched from their inception until December 2017 included: MEDLINE, CINAHL, EMBASE, AMED, Cochrane Central Register of Controlled Trials, four Chinese databases [Chinese BioMedical Database, China National Knowledge Infrastructure, Wan-Fang Data, and the Chinese WeiPu Database], KoreaMed, The Korean National Assembly Library, Japana Centra Revuo Medicina (http://www.jamas.gr.jp/) and CiNii. In this systematic review, only RCTs that were related to the effects of cupping therapy on managing AS were included. A quantitative synthesis of RCTs will be conducted using RevMan 5.3 software. Study selection, data extraction, and validation were performed independently by two reviewers. Quantitative analysis of RCTs were performed using RevMan 5.3 software, and cochrane criteria for risk-of-bias were used to assess the methodological quality of the trials. RESULTS A total of 5 RCTs met the inclusion criteria, and most were of low methodological quality. Participants in cupping therapy plus Western medicine group showed significantly greater improvements in the response rate [RR = 1.13, 95%CI (1.06, 1.22), p < 0.01] with low heterogeneity (Chi2 = 2.88, p = 0.41, I2 = 0%). Moreover, when compared with western medicine alone, meta-analysis indicated favorable statistically significant effects of cupping therapy plus western medicine on the Bath Ankylosing Spondylitis Functional Index (BASFI) [MD = -16.63, 95%CI (-17.75, -15.51), p < 0.01] and Bath Ankylosing Disease Activity Index (BASDAI) [MD = -9.93, 95%CI (-10.34, -9.52), p < 0.01], with low heterogeneity (Chi2 = 0.32, p = 0.85, I2 = 0% in BASFI; (Chi2 = 2.46, p = 0.29, I2 = 19% in BASDAI). Furthermore, when compared with western medicine alone, meta-analysis demonstrated statistically significant effects of cupping therapy plus western medicine on the serum level of ESR [MD = -1.28, 95% CI (-1.44, -1.13), p < 0.01] and the serum level of CRP [MD = -3.97, 95%CI (-4.71, -3.22), p < 0.01], with low heterogeneity (Chi2 = 0.50, p = 0.78, I2 = 0% in the serum level of ESR; Chi2 = 0.19, p = 0.91, I2 = 0% in the serum level of CRP). CONCLUSION Taken together, only weak evidence supported the hypothesis that cupping therapy had potential benefits for patients with AS.
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Affiliation(s)
- Shi-Yu Ma
- Department of Pharmacy, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ying Wang
- Department of Traditional Chinese Medicine, Ruijin Hospital Affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Jia-Qi Xu
- Department of Pharmacy, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lin Zheng
- Department of Bone and Jount Surgery, Shanghai GuangHua Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, China.
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Pain-Associated Transcriptome Changes in Synovium of Knee Osteoarthritis Patients. Genes (Basel) 2018; 9:genes9070338. [PMID: 29973527 PMCID: PMC6070955 DOI: 10.3390/genes9070338] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 06/29/2018] [Indexed: 01/15/2023] Open
Abstract
Joint pain causes significant morbidity in osteoarthritis (OA). The aetiology of joint pain in OA is not well understood. The synovial membrane as an innervated joint structure represents a potential source of peripheral pain in OA. Here we analyse, using a hypothesis-free next generation RNA sequencing, the differences in protein-coding and non-coding transcriptomes in knee synovial tissues from OA patients with high knee pain (n = 5) compared with OA patients with low knee pain (n = 5), as evaluated by visual analogue scale (VAS). We conduct Gene Ontology and pathway analyses on differentially expressed mRNA genes. We identify new protein-coding, long non-coding RNA and microRNA candidates that can be associated with OA joint pain. Top enriched genes in painful OA knees encode neuronal proteins that are known to promote neuronal survival under cellular stress or participate in calcium-dependent synaptic exocytosis and modulation of GABA(γ-aminobutyric acid)ergic activity. Our study uncovers transcriptome changes associated with pain in synovial microenvironment of OA knees. This sets a firm ground for future mechanistic studies and drug discovery to alleviate joint pain in OA.
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Medina-Luna D, Santamaría-Olmedo MG, Zamudio-Cuevas Y, Martínez-Flores K, Fernández-Torres J, Martínez-Nava GA, Clavijo-Cornejo D, Hernández-Díaz C, Olivos-Meza A, Gomez-Quiroz LE, Gutiérrez-Ruiz MC, Pineda C, Blanco F, Reginato AM, López-Reyes A. Hyperlipidemic microenvironment conditionates damage mechanisms in human chondrocytes by oxidative stress. Lipids Health Dis 2017; 16:114. [PMID: 28606092 PMCID: PMC5468939 DOI: 10.1186/s12944-017-0510-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 06/01/2017] [Indexed: 11/30/2022] Open
Abstract
Background Currently, two pathogenic pathways describe the role of obesity in osteoarthritis (OA); one through biomechanical stress, and the other by the contribution of systemic inflammation. The aim of this study was to evaluate the effect of free fatty acids (FFA) in human chondrocytes (HC) expression of proinflammatory factors and reactive oxygen species (ROS). Methods HC were exposed to two different concentrations of FFA in order to evaluate the secretion of adipokines through cytokines immunoassays panel, quantify the protein secretion of FFA-treated chondrocytes, and fluorescent cytometry assays were performed to evaluate the reactive oxygen species (ROS) production. Results HC injury was observed at 48 h of treatment with FFA. In the FFA-treated HC the production of reactive oxygen species such as superoxide radical, hydrogen peroxide, and the reactive nitrogen species increased significantly in a at the two-dose tested (250 and 500 μM). In addition, we found an increase in the cytokine secretion of IL-6 and chemokine IL-8 in FFA-treated HC in comparison to the untreated HC. Conclusion In our in vitro model of HC, a hyperlipidemia microenvironment induces an oxidative stress state that enhances the inflammatory process mediated by adipokines secretion in HC.
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Affiliation(s)
- Daniel Medina-Luna
- Synovial Fluid Laboratory, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra", Calzada México Xochimilco 289, 14389, Mexico City, Mexico
| | - Mónica Guadalupe Santamaría-Olmedo
- Synovial Fluid Laboratory, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra", Calzada México Xochimilco 289, 14389, Mexico City, Mexico
| | - Yessica Zamudio-Cuevas
- Synovial Fluid Laboratory, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra", Calzada México Xochimilco 289, 14389, Mexico City, Mexico
| | - Karina Martínez-Flores
- Synovial Fluid Laboratory, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra", Calzada México Xochimilco 289, 14389, Mexico City, Mexico
| | - Javier Fernández-Torres
- Synovial Fluid Laboratory, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra", Calzada México Xochimilco 289, 14389, Mexico City, Mexico.,Departamento de Ciencias de la Salud, Universidad Autónoma Metropolitana Iztapalapa, Avenida San Rafael Atlixco 186, Iztapalapa, 09340, Mexico City, Mexico
| | - Gabriela Angélica Martínez-Nava
- Synovial Fluid Laboratory, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra", Calzada México Xochimilco 289, 14389, Mexico City, Mexico
| | - Denise Clavijo-Cornejo
- Synovial Fluid Laboratory, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra", Calzada México Xochimilco 289, 14389, Mexico City, Mexico
| | - Cristina Hernández-Díaz
- Musculoeskeletal and Articular Ultrasound Laboratory, Calzada Mexico-Xochimilco 289, Col. Arenal de Guadalupe, Tlalpan, 14389, Mexico D.F, Mexico
| | - Anell Olivos-Meza
- Arthroscopy Service; Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Secretaría de Salud, Calzada Mexico-Xochimilco 289, Col. Arenal de Guadalupe, Tlalpan, 14389, Mexico D.F, Mexico
| | - Luis Enrique Gomez-Quiroz
- Departamento de Ciencias de la Salud, Universidad Autónoma Metropolitana Iztapalapa, Avenida San Rafael Atlixco 186, Iztapalapa, 09340, Mexico City, Mexico
| | - María Concepción Gutiérrez-Ruiz
- Departamento de Ciencias de la Salud, Universidad Autónoma Metropolitana Iztapalapa, Avenida San Rafael Atlixco 186, Iztapalapa, 09340, Mexico City, Mexico
| | - Carlos Pineda
- Musculoeskeletal and Articular Ultrasound Laboratory, Calzada Mexico-Xochimilco 289, Col. Arenal de Guadalupe, Tlalpan, 14389, Mexico D.F, Mexico
| | - Francisco Blanco
- Rheumatology Division, ProteoRed/ISC III Proteomics Group, INBIC, A Coruña, Spain
| | - Anthony M Reginato
- Division of Rheumatology, Warren Alpert School of Medicine at Brown University, Providence, RI, USA
| | - Alberto López-Reyes
- Synovial Fluid Laboratory, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra", Calzada México Xochimilco 289, 14389, Mexico City, Mexico.
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Li JQ, Guo W, Sun ZG, Huang QS, Lee EY, Wang Y, Yao XD. Cupping therapy for treating knee osteoarthritis: The evidence from systematic review and meta-analysis. Complement Ther Clin Pract 2017; 28:152-160. [PMID: 28779923 DOI: 10.1016/j.ctcp.2017.06.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 06/06/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Cupping therapy is widely used in East Asia, the Middle East, or Central and North Europe to manage the symptom of knee osteoarthritis (KOA). The purpose of this systematic review was to evaluate the available evidence from randomized controlled trials (RCTs) of cupping therapy for treating patients with KOA. METHODS The following databases were searched from their inception until January 2017: PubMed, Embase, the Cochrane Central Register of Controlled Trials and four Chinese databases [WanFang Med Database, Chinese BioMedical Database, Chinese WeiPu Database, and China National Knowledge Infrastructure (CNKI)]. Only the RCTs related to the effects of cupping therapy on KOA were included in this systematic review. A quantitative synthesis of RCTs will be conducted using RevMan 5.3 software. Study selection, data extraction, and validation was performed independently by two reviewers. Cochrane criteria for risk-of-bias were used to assess the methodological quality of the trials. RESULTS Seven RCTs met the inclusion criteria, and most were of low methodological quality. Study participants in the dry cupping therapy plus the Western medicine therapy group showed significantly greater improvements in the pain [MD = -1.01, 95%CI (-1.61, -0.41), p < 0.01], stiffness [MD = -0.81, 95%CI (-1.14, -0.48), p < 0.01] and physical function [MD = -5.53, 95%CI (-8.58, -2.47), p < 0.01] domains of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) compared to participants in the Western medicine therapy group, with low heterogeneity (Chi2 = 0.00 p = 1.00, I2 = 0% in pain; Chi2 = 0.45 p = 0.50, I2 = 0% in stiffness; Chi2 = 1.09 p = 0.30, I2 = 9% in physical function). However, it failed to do so on a Visual Analog Scale (VAS) [MD = -0.32, 95%CI (-0.70, 0.05), p = 0.09]. In addition, when compared with Western medicine therapy alone, meta-analysis of four RCTs suggested favorable statistically significant effects of wet cupping therapy plus western medicine on response rate [MD = 1.06, 95%CI (1.01, 1.12), p = 0.03; heterogeneity: Chi2 = 1.13, p = 0.77, I2 = 0%] and Lequesne Algofunctional Index (LAI) [MD = -2.74, 95%CI (-3.41, -2.07), p < 0.01; heterogeneity: Chi2 = 2.03, p = 0.57, I2 = 0% ]. CONCLUSION Only weak evidence can support the hypothesis that cupping therapy can effectively improve the treatment efficacy and physical function in patients with KOA.
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Affiliation(s)
- Jin-Quan Li
- Department of Orthopedics, Fuzhou General Hospital of Nanjing Command, PLA, FuZhou 350025, China
| | - Wen Guo
- Department of Endocrinology, Fuzhou General Hospital of Nanjing Command, PLA, FuZhou 350025, China
| | - Ze-Gan Sun
- Department of Orthopedics, Fuzhou General Hospital of Nanjing Command, PLA, FuZhou 350025, China
| | - Qing-Song Huang
- Department of Orthopedics, Fuzhou General Hospital of Nanjing Command, PLA, FuZhou 350025, China
| | - En Yeong Lee
- School of Health and Biomedical Sciences, Royal Melbourne Institute of Technology University, Bundoora, Victoria, Australia
| | - Ying Wang
- Department of First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province 210023, China
| | - Xiao-Dong Yao
- Department of Orthopedics, Fuzhou General Hospital of Nanjing Command, PLA, FuZhou 350025, China.
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Cupping therapy for Treating Knee Osteoarthritis: A protocol for systematic review and meta-analysis of randomized controlled trials. Eur J Integr Med 2017. [DOI: 10.1016/j.eujim.2017.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Abstract
Osteoarthritis (OA) is the most common joint disorder, is associated with an increasing socioeconomic impact owing to the ageing population and mainly affects the diarthrodial joints. Primary OA results from a combination of risk factors, with increasing age and obesity being the most prominent. The concept of the pathophysiology is still evolving, from being viewed as cartilage-limited to a multifactorial disease that affects the whole joint. An intricate relationship between local and systemic factors modulates its clinical and structural presentations, leading to a common final pathway of joint destruction. Pharmacological treatments are mostly related to relief of symptoms and there is no disease-modifying OA drug (that is, treatment that will reduce symptoms in addition to slowing or stopping the disease progression) yet approved by the regulatory agencies. Identifying phenotypes of patients will enable the detection of the disease in its early stages as well as distinguish individuals who are at higher risk of progression, which in turn could be used to guide clinical decision making and allow more effective and specific therapeutic interventions to be designed. This Primer is an update on the progress made in the field of OA epidemiology, quality of life, pathophysiological mechanisms, diagnosis, screening, prevention and disease management.
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