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Yu H, Meng J, Xu Y, Xu K, Lin C, Bao J. Comparison of early curative effects of lateral unicompartmental knee arthroplasty with total knee arthroplasty and the legacy constrained condylar knee arthroplasty in the treatment of isolated lateral osteoarthritis: a single-center retrospective study. J Orthop Surg Res 2024; 19:597. [PMID: 39342362 PMCID: PMC11438380 DOI: 10.1186/s13018-024-05076-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2024] [Accepted: 09/12/2024] [Indexed: 10/01/2024] Open
Abstract
BACKGROUND Aims of this study were to compare the functional and radiographic results, perioperative complication after lateral unicompartmental knee arthroplasty (LUKA) with total knee arthroplasty (TKA) and the legacy constrained condylar knee (LCCK) arthroplasty for the treatment of lateral compartmental knee osteoarthritis (LCKOA), and to provide a basis for the treatment of LCKOA. METHODS From January 2021 to January 2024, analyzed retrospectively clinical data of 74 patients with LCKOA treated with LUKA, TKA and LCCK arthroplasty. According to the operation plan, the patients were divided into three groups: LUKA group (23 cases), TKA group (23 cases) and LCCK group (28 cases). The changes of hip-knee-ankle (HKA) angle of the affected knee before and after operation were measured. All patients were assessed using the operation time, blood loss during operation, incision length, visual analogue scale (VAS) score before operation and after operation, Hospital for Special Surgery score (HSS), Oxford Knee Score (OKS), range of motion (ROM). RESULTS All 74 patients were followed up for (2.38 ± 0.33) years. The operation time, blood loss during operation, incision length and VAS score after operation in the LUKA group were significantly less than those in the TKA group and LCCK group (P < 0.05); HKA valgus angle, ROM, HSS score and OKS score of the three groups after operation were significantly better than those before operation (P < 0.05); There was no significant difference among the three groups in HSS score and OKS score (P > 0.05). CONCLUSION LUKA, TKA and LCCK arthroplasty have good clinical effect in the treatment of LCKOA; Compared with TKA and LCCK arthroplasty, LUKA has the advantages of less trauma, less bleeding, less pain and quick recovery. The short-term effect is satisfactory, and the long-term effect remains to be observed.
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Affiliation(s)
- Hui Yu
- Department of Orthopedics Surgery, The Second Affiliated Hospital of Medical College, Zhejiang University, Hangzhou, 310000, China
- Orthopedics Research Institute of Zhejiang University, Hangzhou City, Zhejiang Province, PR China
- Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou City, PR China
- Zhejiang Key Laboratory of Motor System Disease Precision Research and Therapy, Hangzhou City, Zhejiang Province, PR China
| | - Jiahong Meng
- Department of Orthopedics Surgery, The Second Affiliated Hospital of Medical College, Zhejiang University, Hangzhou, 310000, China
- Orthopedics Research Institute of Zhejiang University, Hangzhou City, Zhejiang Province, PR China
- Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou City, PR China
- Zhejiang Key Laboratory of Motor System Disease Precision Research and Therapy, Hangzhou City, Zhejiang Province, PR China
| | - Yibo Xu
- Department of Orthopedics Surgery, The Second Affiliated Hospital of Medical College, Zhejiang University, Hangzhou, 310000, China
- Orthopedics Research Institute of Zhejiang University, Hangzhou City, Zhejiang Province, PR China
- Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou City, PR China
- Zhejiang Key Laboratory of Motor System Disease Precision Research and Therapy, Hangzhou City, Zhejiang Province, PR China
| | - Kai Xu
- Department of Orthopedics Surgery, The Second Affiliated Hospital of Medical College, Zhejiang University, Hangzhou, 310000, China
- Orthopedics Research Institute of Zhejiang University, Hangzhou City, Zhejiang Province, PR China
- Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou City, PR China
- Zhejiang Key Laboratory of Motor System Disease Precision Research and Therapy, Hangzhou City, Zhejiang Province, PR China
| | - Changjian Lin
- Department of Orthopedics Surgery, The Second Affiliated Hospital of Medical College, Zhejiang University, Hangzhou, 310000, China
- Orthopedics Research Institute of Zhejiang University, Hangzhou City, Zhejiang Province, PR China
- Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou City, PR China
- Zhejiang Key Laboratory of Motor System Disease Precision Research and Therapy, Hangzhou City, Zhejiang Province, PR China
| | - Jiapeng Bao
- Department of Orthopedics Surgery, The Second Affiliated Hospital of Medical College, Zhejiang University, Hangzhou, 310000, China.
- Orthopedics Research Institute of Zhejiang University, Hangzhou City, Zhejiang Province, PR China.
- Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou City, PR China.
- Zhejiang Key Laboratory of Motor System Disease Precision Research and Therapy, Hangzhou City, Zhejiang Province, PR China.
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Mizuno Y, Takata Y, Shima Y, Goshima K, Kuroda K, Kanayama T, Ishida Y, Takemoto N, Nishimura M, Sengoku T, Demura S, Nakase J. Relationship between ultrasonographic findings and subscales of the Knee Injury and Osteoarthritis Outcome Score in patients with early knee osteoarthritis: a multicenter study. J Med Ultrason (2001) 2024:10.1007/s10396-024-01498-w. [PMID: 39322823 DOI: 10.1007/s10396-024-01498-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Accepted: 08/16/2024] [Indexed: 09/27/2024]
Abstract
PURPOSE To characterize the ultrasonographic findings of patients with early knee osteoarthritis (KOA) and determine which findings were associated with the Knee Injury and Osteoarthritis Outcome Score (KOOS) subscale. METHODS The study included 98 knees (35 men, 63 women, 60.3 ± 11.5 years) diagnosed with early KOA with no major deformity radiographically, but with pain during activity and tenderness in the medial knee. Synovial hyperplasia in the suprapatellar bursa, knee joint effusion, horizontal tear of the medial meniscus (MM), osteophytes of the medial condyle of the femur and tibia, blood flow signals in the synovium of the suprapatellar bursa, medial collateral ligament bursa, infrapatellar fat pad, MM extrusion (MME) in the supine and upright positions, and the amount of change in MME were observed using ultrasonography. RESULTS Correlations (p < 0.05) were found between the presence of synovial hyperplasia of the suprapatellar bursa (r<-0.20) and amount of MME in the upright position (r< - 0.24) and all KOOS subscales. Presence of joint effusion and the four KOOS subscales except quality of life (QOL) were correlated (p < 0.05). Partial correlation coefficients showed correlations (p < 0.05) between knee joint effusion and symptoms (r = 0.299) and activities of daily living (ADL) (r = 0.254) of the KOOS subscales, and between MME in the upright position and symptoms (r= - 0.263), pain (r= - 0.256), and ADL (r= - 0.212). CONCLUSION Quality and difficulty of life of patients with early KOA may be influenced by synovial hyperplasia in the suprapatellar bursa, joint effusion, and MME values in the upright position. Among them, synovial hyperplasia of the suprapatellar bursa and amount of MME in the upright position were independently associated with the KOOS subscales.
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Affiliation(s)
- Yushin Mizuno
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8641, Japan.
- Section of Rehabilitation, Kanazawa University Hospital, Kanazawa, Ishikawa, Japan.
| | - Yasushi Takata
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Yosuke Shima
- Department of Orthopaedic Surgery, KKR Hokuriku Hospital, Kanazawa, Ishikawa, Japan
| | - Kenichi Goshima
- Department of Orthopaedic Surgery and Joint Reconstructive Surgery, Kanazawa Munehiro Hospital, Kanazawa, Ishikawa, Japan
| | - Kazunari Kuroda
- Department of Orthopaedic Surgery, Yawata Medical Center, Komatsu, Ishikawa, Japan
| | - Tomoyuki Kanayama
- Department of Orthopaedic Surgery, KKR Hokuriku Hospital, Kanazawa, Ishikawa, Japan
| | - Yoshihiro Ishida
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Naoki Takemoto
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Manase Nishimura
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Takuya Sengoku
- Section of Rehabilitation, Kanazawa University Hospital, Kanazawa, Ishikawa, Japan
| | - Satoru Demura
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Junsuke Nakase
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8641, Japan
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Talebianpoor E, Mohammadi HR, Dehbanizadeh A, Afrasiabifar A, Najafi Doulatabad S. Investigating the effect of an Orem-based self-care educative supportive nursing system on the joint function of patients with knee osteoarthritis. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 13:223. [PMID: 39297107 PMCID: PMC11410195 DOI: 10.4103/jehp.jehp_52_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 07/25/2023] [Indexed: 09/21/2024]
Abstract
BACKGROUND Osteoarthritis is the most common form of arthritis. It is a common progressive joint disease characterized by chronic pain and functional disability, which disturbs functional movements, body balance, and quality of life in patients with knee osteoarthritis. This study investigates the effect of an Orem-based self-care educative supportive nursing system on the joint function of patients with knee osteoarthritis. MATERIALS AND METHODS This semi-experimental paper studies 130 patients with knee osteoarthritis. The patients are selected using convenience sampling and randomly assigned to intervention and control groups equally. The K00S questionnaire was used to collect patients' demographic information and other information relating to their knees' function. We carried out interventions for six weeks, with a session of 45 to 60 minutes each week. Data were collected before the intervention and three months after the intervention. SPSS 21.0 and descriptive and inferential statistics were used to analyze the collected data at the significance level of 0.05. RESULTS The results show significant differences between the two groups in terms of joint symptoms (P = 0.001), pain (P = 0.001), daily activities (P = 0.001), sports and recreational activities (P = 0.001), and quality of life (P = 0.02). In other words, there was a significant difference in the average subscale scores of activities in all five dimensions between the intervention and control groups (P < 0.05). CONCLUSION Orem's self-care model has a positive and significant effect on the functional movement of patients with knee osteoarthritis and improves their joint function.
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Affiliation(s)
- Elham Talebianpoor
- Department of Nursing, Nursing School, Yasuj University of Medical Sciences, Yasuj, Iran
| | | | - Abolfazl Dehbanizadeh
- Department of Nursing, Nursing School, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Ardashir Afrasiabifar
- Department of Nursing, Nursing School, Yasuj University of Medical Sciences, Yasuj, Iran
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Demmer W, Schinacher J, Wiggenhauser PS, Giunta RE. Use of Acellular Matrices as Scaffolds in Cartilage Regeneration: A Systematic Review. Adv Wound Care (New Rochelle) 2024. [PMID: 38775424 DOI: 10.1089/wound.2024.0065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2024] Open
Abstract
Significance: Cartilage regeneration remains a significant challenge in the field of regenerative medicine. Acellular matrix (AM)-based cartilage tissue regeneration offers an innovative approach to repairing cartilage defects by providing a scaffold for new tissue growth. Its significance lies in its potential to restore joint function, mitigate pain, and improve the quality of life for patients suffering from cartilage-related injuries and conditions. Recent Advances: Recent advances in AM-based cartilage regeneration have focused on enhancing scaffold properties for improved cell adhesion, proliferation, and differentiation. Moreover, several scaffold techniques such as combining acellular dermal matrix (ADM) and acellular cartilage matrix (ACM) with cartilage tissue, as well as biphasic scaffolding, enjoy rising research activity. Incorporating bioactive factors and advanced manufacturing techniques holds promise for producing more biomimetic scaffolds, advancing efficient cartilage repair and regeneration. Critical Issues: Obstacles in AM-based cartilage regeneration include achieving proper integration with the surrounding tissue and ensuring long-term durability of the regenerated cartilage. Furthermore, issues such as high costs and limited availability of suitable cells for scaffold seeding must be considered. The heterogeneity and limited regenerative capabilities of cartilage need to be addressed for successful clinical translation. Future Directions: Research should focus on exploring advanced biomaterials and developing new techniques, regarding easily reproducible scaffolds, ideally constructed from clinically validated and readily available commercial products. Findings underline the potential of AM-based approaches, especially the rising exploration of tissue-derived ADM and ACM. In future, the primary objective should not only be the regeneration of small cartilage defects but rather focus on fully regenerating a joint or larger cartilage defect.
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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) 2024; 20:562-571. [PMID: 38176976 DOI: 10.1016/j.explore.2023.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [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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Hoffman RM, Davis-Wilson HC, Hanlon S, Swink LA, Kline PW, Juarez-Colunga E, Melanson EL, Christiansen CL. Maximal daily stepping cadence partially explains functional capacity of individuals with end-stage knee osteoarthritis. PM R 2024; 16:532-542. [PMID: 37819260 PMCID: PMC11006829 DOI: 10.1002/pmrj.13082] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 06/01/2023] [Accepted: 09/16/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Individuals with end-stage knee osteoarthritis (OA) walk at a lower intensity (ie, slower step cadence) contributing to worse physical function. Previous literature reports daily step counts and sedentary time, with little information regarding stepping bouts or cadence. Determining relationships between daily higher stepping cadence duration and clinical outcomes can move the field toward optimal daily stepping prescription. OBJECTIVE To quantify daily physical activity patterns of individuals with end-stage knee OA and determine the contribution of high stepping cadence to explain functional capacity variability. DESIGN Cross-sectional analysis. SETTING Veterans Administration medical center. PARTICIPANTS U.S. military veterans (n = 104; age: 67.1 years [7.2]; mean [SD]; male [89.3%]) with end-stage knee OA were enrolled. INTERVENTION Not applicable. MAIN OUTCOME MEASURE Functional capacity (6-Minute Walk Test [6MWT]). Physical activity (activPAL wearable sensor; cadence and time sitting, standing, and stepping), pain (Western Ontario and McMaster Universities Osteoarthritis Index-pain subscale) sociodemographic variables, and comorbidities (body mass index and Functional Comorbidity Index) are the main explanatory variables. RESULTS Participants' wake time was mainly sitting (11.0 h/day) in ≥60-minute bouts (29.7% ± 12.7 of sitting time). Standing (3.4 hours/day) and stepping (1.4 h/day) primarily occurred in 0-5 minute bouts (standing: 87.7% ± 14.4 of standing time, stepping: 98.7% ± 12.7 of stepping time) and stepping cadence was predominantly incidental (1-19 spm; 52.9% ± 9.6 of total stepping time). Backward elimination model results indicated shorter medium-to-brisk cadence bout duration, older age, and higher pain significantly explained shorter 6MWT distance (AdjR2=0.24, p < .01). CONCLUSIONS Individuals with knee OA spend most of their waking hours sitting, while standing and stepping occurs in short bouts at very low stepping cadence. Decreased time in high stepping cadence is associated with lower functional capacity. Future studies should explore if increasing the daily time spent in higher step cadence can improve functional capacity in this population.
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Affiliation(s)
- Rashelle M Hoffman
- Department of Physical Therapy, School of Pharmacy and Health Professions, Creighton University, Omaha, Nebraska, USA
| | - Hope C Davis-Wilson
- RTI International, Technology Advancement and Commercialization, Research Triangle Park, North Carolina, USA
| | - Shawn Hanlon
- Geriatric Research Education and Clinical Center, VA Eastern Colorado Healthcare System, Denver, Colorado, USA
- Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, Colorado, USA
| | - Laura A Swink
- Geriatric Research Education and Clinical Center, VA Eastern Colorado Healthcare System, Denver, Colorado, USA
- Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, Colorado, USA
| | - Paul W Kline
- Department of Physical Therapy, High Point University, High Point, North Carolina, USA
| | - Elizabeth Juarez-Colunga
- Geriatric Research Education and Clinical Center, VA Eastern Colorado Healthcare System, Denver, Colorado, USA
- Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus, Denver, Colorado, USA
| | - Edward L Melanson
- Geriatric Research Education and Clinical Center, VA Eastern Colorado Healthcare System, Denver, Colorado, USA
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado, Aurora, Colorado, USA
- Division of Geriatric Medicine, Department of Medicine, University of Colorado, Aurora, Colorado, USA
| | - Cory L Christiansen
- Geriatric Research Education and Clinical Center, VA Eastern Colorado Healthcare System, Denver, Colorado, USA
- Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, Colorado, USA
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Zhai T, Song Y, Su J, Wu R, Wang J, Zhang Z, Feng W. Study protocol for a randomized controlled trial: evaluating the effect of isokinetic eccentric training of the hamstring on knee function and walking function after total knee arthroplasty. Front Med (Lausanne) 2024; 11:1404736. [PMID: 38846149 PMCID: PMC11155448 DOI: 10.3389/fmed.2024.1404736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 05/07/2024] [Indexed: 06/09/2024] Open
Abstract
Introduction Total knee arthroplasty (TKA) is a widely-used treatment for end-stage knee osteoarthritis. However, it is common for patients to experience issues with knee joint function and abnormal gait following the surgery. Previous studies have primarily focused on concentric contraction of the quadriceps during TKA, neglecting the potential benefits of eccentric isokinetic training for the hamstrings. This protocol outlines a randomized, single-blind, controlled trial aimed at assessing the impact of eccentric isokinetic training for the hamstring muscles on pain, function, and gait in patients after TKA. Methods and analysis Fifty participants between the ages of 50 and 80 with knee osteoarthritis undergo unilateral total knee arthroplasty (TKA) for the first time. They will be transferred to the rehabilitation department 10-14 days after the operation. The participants are randomly divided into two groups, with 25 participants in each group: the control group and the Hamstring training group. The Control group will receive routine rehabilitation treatment, while the Hamstring training group will receive a combination of routine rehabilitation treatment and isokinetic eccentric training of the hamstring. The intervention will last four consecutive weeks. Both groups will be assessed at three different times: before the intervention, after 4 weeks of intervention, and 4 weeks after the interventions (follow-up). The primary outcome will be functional capacity (TUGT) and Hospital for Special knee Score (HSS). Secondary outcomes will be knee-related health status (isokinetic knee position perception, Peak torque of hamstring strength), pain intensity (Visual analog scale, VAS) and 3D gait analysis. Discussion The study aims to provide relevant evidence on the effectiveness of eccentric hamstring muscle contraction training in improving knee joint function and walking function after TKA. Clinical trial registration https://www.chictr.org.cn/showproj.html?proj=195544, Identifier ChiCTR2300073497.
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Affiliation(s)
- Tianjun Zhai
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Rehabilitation Department, The Second Rehabilitation Hospital of Shanghai, Shanghai, China
| | - Yongjia Song
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Rehabilitation Department, The Second Rehabilitation Hospital of Shanghai, Shanghai, China
| | - Jianqing Su
- Rehabilitation Department, The Second Rehabilitation Hospital of Shanghai, Shanghai, China
| | - Ruiren Wu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Rehabilitation Department, The Second Rehabilitation Hospital of Shanghai, Shanghai, China
| | - Jie Wang
- Rehabilitation Department, The Second Rehabilitation Hospital of Shanghai, Shanghai, China
| | - Zengqiao Zhang
- Tuina Department, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wei Feng
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Rehabilitation Department, The Second Rehabilitation Hospital of Shanghai, Shanghai, China
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Fu Y, Du Y, Li J, Xi Y, Ji W, Li T. Demonstrating the effectiveness of intra-articular prolotherapy combined with peri-articular perineural injection in knee osteoarthritis: a randomized controlled trial. J Orthop Surg Res 2024; 19:279. [PMID: 38705988 PMCID: PMC11071214 DOI: 10.1186/s13018-024-04762-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 04/21/2024] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND This study aimed to compare the efficacy of intra-articular prolotherapy (IG) combined with peri-articular perineural injection (PG) in the management of knee osteoarthritis (KOA). METHODS A total of 60 patients with the diagnosis of KOA were included in this double-blinded randomized controlled clinical trials. The inclusion criteria were as follow: (1) 48-80 years old; (2) the diagnose of KOA; (3) the grade 2 and 3 of the Kellgern-Lawrence grading scale; (4) the pain, crepitation, and knee joint stiffness continuing for 3 months at least. The main exclusion criteria were as follow: (1) any infection involving the knee skin; (2) history of any Influencing factors of disease. All patients were divided into three groups and received either IG, PG and I + PG under the ultrasound guidance and the 2, 4 and 8 weeks follow-up data of patients were available. (IG n = 20 or PG n = 20, I + PG n = 20). Visual Analogue Scale (VAS), The Western Ontario McMaster University Osteoarthritis Index (WOMAC) and the pressure pain threshold (PPT) were used as outcome measures at baseline, 2, 4 and 8 weeks. RESULTS There were no statistically significant differences in terms of age, sex, BMI, duration of current condition and baseline assessments of pain intensity, WOMAC scores and PPT. After treatment, the improvement of VAS activity, WOMAC and PPT values was showed compared with pre-treatment in all groups (p < 0.05). At 4 and 8 weeks after treatment, the VAS and WOMAC scores of the I + PG were significantly lower than those of the PG or IG, and the difference was statistically significant (p < 0.05). The PPT values of PG and I + PG were significantly improved compared to IG at 2, 4, and 8 weeks after treatment. CONCLUSION The ultrasound guided I + PG of 5% glucose seem to be more effective to alleviate pain and improve knee joint function than single therapy in short term. Clinical rehabilitators could clinically try this combination of I + PG to improve clinical symptoms in patients with KOA.
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Affiliation(s)
- Yiling Fu
- Qilu Hospital of Shandong University (Qingdao), Qingdao, China
| | - Yukun Du
- The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Jianyi Li
- The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yongming Xi
- The Affiliated Hospital of Qingdao University, Qingdao, China.
| | - Wenbin Ji
- Qilu Hospital of Shandong University (Qingdao), Qingdao, China.
| | - Tieshan Li
- The Affiliated Hospital of Qingdao University, Qingdao, China.
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Stocco E, Contran M, Fontanella CG, Petrelli L, Toniolo I, Emmi A, Romanato F, Porzionato A, De Caro R, Macchi V. The suprapatellar fat pad: A histotopographic comparative study. J Anat 2024; 244:639-653. [PMID: 38030148 PMCID: PMC10941559 DOI: 10.1111/joa.13984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 11/15/2023] [Accepted: 11/16/2023] [Indexed: 12/01/2023] Open
Abstract
The suprapatellar fat pad is an adipose tissue located in the anterior knee whose role in osteoarthritis is still debated. Considering that anatomy drives function, the aim of this histotopographic study was to investigate the specific morphological features of the suprapatellar fat pad versus the infrapatellar fat pad in the absence of osteoarthritis, for a broad comparative analysis. Suprapatellar fat pad and infrapatellar fat pad tissue samples (n = 10/group) underwent microscopical/immunohistochemical staining and transmission electron microscopy analysis; thus, tissue-specific characteristics (i.e., vessels and nerve endings presence, lobuli, adipocytes features, septa), including extracellular matrix proteins prevalence (collagens, elastic fibers), were focused. Multiphoton microscopy was also adopted to evaluate collagen fiber orientation within the samples by Fast Fourier Transform (coherency calculation). The absence of inflammation was confirmed, and comparable counted vessels and nerve endings were shown. Like the infrapatellar fat pad, the suprapatellar fat pad appeared as a white adipose tissue with lobuli and septa of comparable diameter and thickness, respectively. Tissue main characteristics were also proved by both semithin sections and transmission electron microscopy analysis. The suprapatellar fat pad adipocytes were roundish and with a smaller area, perimeter, and major axis than that of the infrapatellar fat pad. The collagen fibers surrounding them showed no significant difference in collagen type I and significantly higher values for collagen type III in the infrapatellar fat pad group. Regarding the septa, elastic fiber content was statistically comparable between the two groups, even though more represented by the suprapatellar fat pad. Total collagen was significantly higher in the infrapatellar fat pad and comparing collagen type I and type III they were similarly represented in the whole cohort despite collagen type I appearing to be higher in the infrapatellar fat pad than in the suprapatellar fat pad and vice versa for collagen type III. Second harmonic generation microscopy confirmed through coherency calculation an anisotropic distribution of septa collagen fibers. From a mechanical point of view, the different morphological characteristics determined a major stiffness for the infrapatellar fat pad with respect to the suprapatellar fat pad. This study provides, for the first time, a topographic description of the suprapatellar fat pad compared to the infrapatellar fat pad; differences between the two groups may be attributed to a different anatomical location within the knee; the results gathered here may be useful for a more complete interpretation of osteoarthritis disease, involving not only cartilage but the whole joint.
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Affiliation(s)
- Elena Stocco
- Section of Human Anatomy, Department of NeurosciencesUniversity of PadovaPaduaItaly
- Department of Cardiac, Thoracic and Vascular Science and Public HealthUniversity of PadovaPaduaItaly
| | - Martina Contran
- Section of Human Anatomy, Department of NeurosciencesUniversity of PadovaPaduaItaly
| | - Chiara Giulia Fontanella
- Department of Industrial EngineeringUniversity of PadovaPaduaItaly
- Centre for Mechanics of Biological MaterialsUniversity of PadovaPaduaItaly
| | - Lucia Petrelli
- Section of Human Anatomy, Department of NeurosciencesUniversity of PadovaPaduaItaly
| | - Ilaria Toniolo
- Department of Industrial EngineeringUniversity of PadovaPaduaItaly
| | - Aron Emmi
- Section of Human Anatomy, Department of NeurosciencesUniversity of PadovaPaduaItaly
| | - Filippo Romanato
- Department of Physics and Astronomy ‘G. Galilei’University of PadovaPaduaItaly
| | - Andrea Porzionato
- Section of Human Anatomy, Department of NeurosciencesUniversity of PadovaPaduaItaly
| | - Raffaele De Caro
- Section of Human Anatomy, Department of NeurosciencesUniversity of PadovaPaduaItaly
| | - Veronica Macchi
- Section of Human Anatomy, Department of NeurosciencesUniversity of PadovaPaduaItaly
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10
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Sapoval M, Querub C, Pereira H, Pellerin O, Boeken T, Di Gaeta A, Ahmar MA, Lefevre-Colau MM, Nguyen C, Daste C, Lacroix M, Laredo JD, Sabatier B, Martelli N, Chatellier G, Déan C, Rannou F. Genicular artery embolization for knee osteoarthritis: Results of the LipioJoint-1 trial. Diagn Interv Imaging 2024; 105:144-150. [PMID: 38102013 DOI: 10.1016/j.diii.2023.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 12/06/2023] [Accepted: 12/06/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE The purpose of this study was to evaluate the safety and efficacy of transient genicular artery embolization (GAE) using an ethiodized oil-based emulsion for the treatment of knee osteoarthritis (KOA). MATERIALS AND METHODS This prospective, single-arm, open-label, multicenter, first-in-human cohort trial was registered on ClinicalTrials.gov (NCT04733092). The main inclusion criterion was diagnosis of KOA according to a visual analogue scale (VAS) pain score ≥ 40 mm (score range: 0-100 mm), despite conservative treatment for at least three months. Treatment efficacy was assessed using changes in VAS pain score, Mean Western Ontario & McMaster Universities osteoarthritis (WOMAC) function score (normalized to 100; score ranging from 0 to100) and outcome measures in rheumatoid arthritis clinical trials (OMERACT)-Osteoarthritis Research Society (OARSI) set of responder criteria. RESULTS Twenty-two consecutive participants (13 women; mean age, 66 ± 9 [standard deviation (SD)]) were included and underwent GAE. Emulsion consisted in a mixture of ioversol and ethiodized oil (ratio 1:3, respectively) prepared extemporaneously. The rate of serious adverse events attributed to GAE within one month was 5% (1/22), corresponding to reversible worsening of renal function. Immediate technical success rate was 100%. Mean VAS pain score dropped from 74.4 ± 16.5 (SD) mm at baseline to 37.2 ± 26.7 (SD) mm at three months (P < 0.001). Mean WOMAC function score (normalized to 100: score ranging from 0 to 100) decreased from 57.3 ± 17.1 (SD) at baseline to 33.5 ± 25.9 (SD) at three months (P < 0.001). At three months, 16 out of 22 participants (73%) were considered responders according to the OMERACT-OARSI set of responder criteria, including high improvement in either pain or WOMAC function, or improvement in both pain and WOMAC function. CONCLUSION GAE using an ethiodized oil-based emulsion is safe and improves pain and function in participants with KOA for at least three months.
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Affiliation(s)
- Marc Sapoval
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Vascular and Oncological Interventional Radiology, 75015 Paris, France; Université Paris Cité, PARCC - INSERM Unité-970, 75015 Paris, France.
| | - Charles Querub
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Vascular and Oncological Interventional Radiology, 75015 Paris, France
| | - Helena Pereira
- INSERM, Centre d'investigation Clinique 1418 Épidémiologie Clinique, 75015 Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Clinical Research Unit, 75015 Paris, France
| | - Olivier Pellerin
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Vascular and Oncological Interventional Radiology, 75015 Paris, France; Université Paris Cité, PARCC - INSERM Unité-970, 75015 Paris, France
| | - Tom Boeken
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Vascular and Oncological Interventional Radiology, 75015 Paris, France; HeKA team, INRIA, 75012 Paris, France
| | - Alessandro Di Gaeta
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Vascular and Oncological Interventional Radiology, 75015 Paris, France
| | - Marc Al Ahmar
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Vascular and Oncological Interventional Radiology, 75015 Paris, France
| | - Marie-Martine Lefevre-Colau
- Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, 75014 Paris, France; Université de Paris Cité, INSERM UMR-S 1153, Centre de Recherche Épidémiologie Et Statistique Paris (CRESS), ECaMO Team, 75004 Paris, France
| | - Christelle Nguyen
- Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, 75014 Paris, France; Université Paris Cité, INSERM UMR-S 1124, Toxicité Environnementale, Cibles Thérapeutiques, Signalisation Cellulaire et Biomarqueurs (T3S), Campus Saint-Germain-des-Prés, 75006 Paris, France
| | - Camille Daste
- Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, 75014 Paris, France; Université de Paris Cité, INSERM UMR-S 1153, Centre de Recherche Épidémiologie Et Statistique Paris (CRESS), ECaMO Team, 75004 Paris, France
| | - Maxime Lacroix
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Service d'imagerie, 75015 Paris, France
| | - Jean-Denis Laredo
- Assistance Publique-Hôpitaux de Paris, Hôpital Lariboisière, Service de Chirurgie Orthopédique Et Traumatologique, 75010 Paris, France
| | - Brigitte Sabatier
- HeKA team, INRIA, 75012 Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Pharmacie, 75015 Paris, France; Université Paris-Saclay, Faculté de Pharmacie, Pharmacie Clinique, 91400 Orsay, France
| | - Nicolas Martelli
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Pharmacie, 75015 Paris, France; Université Paris-Saclay, Faculté de Pharmacie, GRADES, 91400 Orsay, France
| | - Gilles Chatellier
- INSERM, Centre d'investigation Clinique 1418 Épidémiologie Clinique, 75015 Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Clinical Research Unit, 75015 Paris, France
| | - Carole Déan
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Vascular and Oncological Interventional Radiology, 75015 Paris, France
| | - François Rannou
- Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, 75014 Paris, France; Université Paris Cité, INSERM UMR-S 1124, Toxicité Environnementale, Cibles Thérapeutiques, Signalisation Cellulaire et Biomarqueurs (T3S), Campus Saint-Germain-des-Prés, 75006 Paris, France
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11
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Huang J, Park HY. Effect of blood flow restriction with low-intensity resistance training in patients with osteoarthritis and rheumatoid arthritis: a systematic review and meta-analysis based on randomized controlled trials. Phys Act Nutr 2024; 28:7-19. [PMID: 38719461 PMCID: PMC11079382 DOI: 10.20463/pan.2024.0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/20/2024] [Accepted: 02/27/2024] [Indexed: 05/12/2024] Open
Abstract
PURPOSE This study evaluated the effects of blood flow restriction with low-intensity resistance training (BFR + LIRT) on pain, adverse events, muscle strength, and function in patients with osteoarthritis (OA) and rheumatoid arthritis (RA) through a systematic review and meta-analysis. METHODS This study adhered to the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analyses 2020 (PRISMA 2020) and applied the A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR2) standards to ensure the high quality of the systematic review. A comprehensive literature search was conducted until August 2023 using four selected keywords (osteoarthritis, rheumatoid arthritis, blood flow restriction training, and resistance training) across five search engines (PubMed, Embase, Web of Science, CENTRAL, and PEDro). RESULTS Ten studies were analyzed. The results showed that BFR + LIRT had similar effects on pain, risk of adverse events, muscle strength, self-reported function, and physical function compared with resistance training (RT). CONCLUSION This systematic review and meta-analysis further support the potential of BFR + LIRT in the disease management of patients with OA or RA. According to this analysis, BFR + LIRT had a lower risk of adverse events than high-intensity resistance training (HIRT) and may be a safer training modality. BFR + LIRT offers greater advantages in improving physical function than LIRT and was able to provide similar benefits to HIRT without increasing the training load. These findings suggest that BFR + LIRT is a safe and effective strategy for treating patients with OA or RA. However, owing to the limited number of studies covered in this analysis, additional higher-quality studies are needed to strengthen this conclusion.
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Affiliation(s)
- Junzhen Huang
- Department of Sports Medicine and Science, Graduate School, Konkuk University, Seoul, Republic of Korea
| | - Hun-Young Park
- Department of Sports Medicine and Science, Graduate School, Konkuk University, Seoul, Republic of Korea
- Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul, Republic of Korea
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12
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Prost D, Bardot T, Baud A, Calvo A, Aumont S, Collado H, Borne J, Rajon O, Ponsot A, Malaterre A, Dahak Y, Magalon G, Sabatier F, Magalon J. Long term improvement of knee osteoarthritis after injection of single high/very high volume of very pure PRP: A retrospective analysis of patients optimally managed in dedicated centers. Regen Ther 2024; 25:203-212. [PMID: 38234679 PMCID: PMC10792744 DOI: 10.1016/j.reth.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 11/26/2023] [Accepted: 12/17/2023] [Indexed: 01/19/2024] Open
Abstract
Introduction PRP is gaining increasing interest for pain relief and improvement of joint function in patients with knee osteoarthritis (KOA) but practices and results remain heterogeneous limiting its adoption as standard of care. Current international recommendations are to collect real-life evidence of efficacy with a systematic monitoring of PRP quality and patients' outcomes. We aimed to analyze the response of patients presenting KOA and treated with standardized PRP injection in routine care. We also investigated the potential contributing factors including patient's phenotype and PRP characteristics. Methods Patients with symptomatic KOA and that failed first-line therapy received a single injection of a qualified PRP prepared using medical devices allowing to recover a high/very high volume of very pure PRP. Visual analogue scale (VAS) and Western Ontario and McMaster Osteoarthritis Index (WOMAC) score were recorded at baseline and during 18 months follow-up. Results 431 patients had available follow-up data at 3 months, 291 at 6 months, 137 at 12 months and 44 at 18 months. PRP induced a significant decrease of WOMAC score at all follow up endpoints (29.2 ± 19.2 at 3 months, p < 0.001 and 25.9 ± 19.7 at 12 months, p < 0.01, compared to 39.7 ± 18.9 at baseline). Similar results were observed for pain VAS (38.9 ± 23.3 at 3 months, p < 0.001 and 35.3 ± 24.1 at 12 months, p < 0.05, compared to 56.0 ± 20.7 at baseline). Changes at 12 months were correlated to baseline scores and to the level of improvement at 3 months. The proportion of OMERACT OARSI responders reached 56.2 % for the total cohort and 60.4 % for severe patients at 6 months. Treatment failure occurred for 8.4 % of patients. Age, BMI or Kellgren-Lawrence grade did not impact on efficacy. Conclusion This real-life study evidences the clinical benefit of a standardized high or very high-volume injection of very pure PRP in patients with KOA, including those with a severe grade. It opens perspectives in the positioning of such strategy to delay arthroplasty and provide insights on factors able to anticipate long term efficacy.
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Affiliation(s)
- Didier Prost
- Regenerative Medicine Department of Excellence, Marseille, France
| | - Thomas Bardot
- Regenerative Medicine Department of Excellence, Marseille, France
| | - Alexandre Baud
- Regenerative Medicine Department of Excellence, Marseille, France
| | - Anthony Calvo
- Regenerative Medicine Department of Excellence, Marseille, France
| | - Stephane Aumont
- Regenerative Medicine Department of Excellence, Marseille, France
| | - Herve Collado
- Regenerative Medicine Department of Excellence, Marseille, France
| | - Julien Borne
- Regenerative Medicine Department of Excellence, Lyon, France
| | - Olivier Rajon
- Regenerative Medicine Department of Excellence, Lyon, France
| | - Antoine Ponsot
- Regenerative Medicine Department of Excellence, Lyon, France
| | | | - Yannis Dahak
- Regenerative Medicine Department of Excellence, Marseille, France
| | - Guy Magalon
- Regenerative Medicine Department of Excellence, Marseille, France
| | - Florence Sabatier
- Regenerative Medicine Department of Excellence, Marseille, France
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, Marseille, France
- Aix Marseille Univ, INSERM, INRA, C2VN, Marseille, France
| | - Jeremy Magalon
- Regenerative Medicine Department of Excellence, Marseille, France
- Cell Therapy Laboratory, Hôpital de la Conception, AP-HM, INSERM CIC BT 1409, Marseille, France
- Aix Marseille Univ, INSERM, INRA, C2VN, Marseille, France
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13
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Wilczyński M, Bieniek M, Krakowski P, Karpiński R. Cemented vs. Cementless Fixation in Primary Knee Replacement: A Narrative Review. MATERIALS (BASEL, SWITZERLAND) 2024; 17:1136. [PMID: 38473607 DOI: 10.3390/ma17051136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 02/13/2024] [Accepted: 02/26/2024] [Indexed: 03/14/2024]
Abstract
Knee osteoarthritis (OA) is one of the leading causes of disability around the globe. Osteoarthritis is mainly considered a disease affecting the elderly. However, more and more studies show that sports overuse, obesity, or congenital disorders can initiate a pathologic cascade that leads to OA changes in the younger population. Nevertheless, OA mostly affects the elderly, and with increasing life expectancy, the disease will develop in more and more individuals. To date, the golden standard in the treatment of the end-stage of the disease is total joint replacement (TJR), which restores painless knee motion and function. One of the weakest elements in TJR is its bonding with the bone, which can be achieved by bonding material, such as poly methyl-methacrylate (PMMA), or by cementless fixation supported by bone ingrowth onto the endoprosthesis surface. Each technique has its advantages; however, the most important factor is the revision rate and survivor time. In the past, numerous articles were published regarding TJR revision rate, but no consensus has been established yet. In this review, we focused on a comparison of cemented and cementless total knee replacement surgeries. We introduced PICO rules, including population, intervention, comparison and outcomes of TJR in a PubMed search. We identified 783 articles published between 2010 and 2023, out of which we included 14 in our review. Our review reveals that there is no universally prescribed approach to fixate knee prostheses. The determination of the most suitable method necessitates an individualized decision-making process involving the active participation and informed consent of each patient.
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Affiliation(s)
- Mikołaj Wilczyński
- Orthopaedic and Sports Traumatology Department, Carolina Medical Center, Pory 78, 02-757 Warsaw, Poland
| | - Michał Bieniek
- Orthopaedic and Sports Traumatology Department, Carolina Medical Center, Pory 78, 02-757 Warsaw, Poland
| | - Przemysław Krakowski
- Orthopaedic and Sports Traumatology Department, Carolina Medical Center, Pory 78, 02-757 Warsaw, Poland
- Department of Trauma Surgery and Emergency Medicine, Medical University of Lublin, Staszica 11, 20-081 Lublin, Poland
| | - Robert Karpiński
- Department of Machine Design and Mechatronics, Faculty of Mechanical Engineering, Lublin University of Technology, Nadbystrzycka 36, 20-618 Lublin, Poland
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14
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Cheng YY, Chen CH, Wang SP. Isokinetic training of lower extremity during the early stage promote functional restoration in elder patients with disability after Total knee replacement (TKR) - a randomized control trial. BMC Geriatr 2024; 24:173. [PMID: 38373934 PMCID: PMC10875742 DOI: 10.1186/s12877-024-04778-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 02/04/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Transient progressive weakness and disability of lower limb during the early stage after TKR will increase the risk of fall, but the superior postoperative strength training mode have not been elucidated for functional restoration. This study aimed to compare whether the isokinetic lower limb training is superior to either isotonic or home isometric exercise during early stage after TKR in older people. METHODS A total of 43 recruited old participants (mean age, 68.40 years old) receiving TKR were divided randomly based on the different four-week training modes into three groups including isokinetic, isotonic, and home isometric exercise (control group). The primary outcome was set as functional performance in terms of Timed Up and Go (TUG) test and the secondary outcomes include the peak torque of knee at 60 and 120 degree/ second, Short-Form 36 Health Survey (SF-36), and Western Ontario and McMaster Universities Arthritis index (WOMAC). RESULTS All of the peak torque measurements of the knee improved significantly in both the isokinetic and the isotonic group, but not in the control group. Although isotonic training resulted in more strength gains, a significant enhancement in TUG test was observed in the isokinetic group only (p = 0.003). However, there were no significantly improvement of TUG test after training in other two groups. SF-36 and WOMAC improved after training in all three groups, with no significant difference in the degree of improvement between groups. CONCLUSION Isokinetic training for 4 weeks following TKR effectively improved all the outcome parameters in this study, including the TUG test, lower limb strength, and functional scores. However, both isokinetic and isotonic training modes could be recommended after TKR because of no significant difference in the degree of improvement between these two groups. TRIAL REGISTRATION Clinical trial registration number: NCT02938416. LEVEL OF EVIDENCE I.
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Affiliation(s)
- Yuan-Yang Cheng
- Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, Taichung, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Cheng-Hsu Chen
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- Ph.D. Program in Tissue Engineering and Regenerative Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Shun-Ping Wang
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan.
- Department of Orthopedics, Taichung Veterans General Hospital, Taichung, Taiwan.
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15
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Feng H, Feng ML, Cheng JB, Zhang X, Tao HC. Meta-analysis of factors influencing anterior knee pain after total knee arthroplasty. World J Orthop 2024; 15:180-191. [PMID: 38464355 PMCID: PMC10921178 DOI: 10.5312/wjo.v15.i2.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/20/2023] [Accepted: 01/22/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Total knee arthroplasty (TKA) is a mature procedure recommended for correcting knee osteoarthritis deformity, relieving pain, and restoring normal biomechanics. Although TKA is a successful and cost-effective procedure, patient dissatisfaction is as high as 50%. Knee pain after TKA is a significant cause of patient dissatisfaction; the most common location for residual pain is the anterior region. Between 4% and 40% of patients have anterior knee pain (AKP). AIM To investigate the effect of various TKA procedures on postoperative AKP. METHODS We searched PubMed, EMBASE, and Cochrane from January 2000 to September 2022. Randomized controlled trials with one intervention in the experimental group and no corresponding intervention (or other interventions) in the control group were collected. Two researchers independently read the title and abstract of the studies, preliminarily screened the articles, and read the full text in detail according to the selection criteria. Conflicts were resolved by consultation with a third researcher. And relevant data from the included studies were extracted and analyzed using Review Manager 5.4 software. RESULTS There were 25 randomized controlled trials; 13 were comparative studies with or without patellar resurfacing. The meta-analysis showed no significant difference between the experimental and control groups (P = 0.61). Six studies were comparative studies of circumpatellar denervation vs non-denervation, divided into three subgroups for meta-analysis. The two-subgroup meta-analysis showed no significant difference between the experimental and the control groups (P = 0.31, P = 0.50). One subgroup meta-analysis showed a significant difference between the experimental and control groups (P = 0.001). Two studies compared fixed-bearing TKA and mobile-bearing TKA; the results meta-analysis showed no significant difference between the experimental and control groups (P = 0.630). Two studies compared lateral retinacular release vs non-release; the meta-analysis showed a significant difference between the experimental and control groups (P = 0.002); two other studies compared other factors. CONCLUSION Patellar resurfacing, mobile-bearing TKA, and fixed-bearing TKA do not reduce the incidence of AKP. Lateral retinacular release can reduce AKP; however, whether circumpatellar denervation can reduce AKP is controversial.
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Affiliation(s)
- Hui Feng
- Department of Orthopaedic Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Ming-Li Feng
- Department of Orthopaedic Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Jing-Bo Cheng
- Department of Orthopaedic Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Xiang Zhang
- Department of Orthopaedic Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Hai-Cheng Tao
- Department of Orthopaedic Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
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16
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Chen M, Jiang Z, Zou X, You X, Cai Z, Huang J. Advancements in tissue engineering for articular cartilage regeneration. Heliyon 2024; 10:e25400. [PMID: 38352769 PMCID: PMC10862692 DOI: 10.1016/j.heliyon.2024.e25400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 01/25/2024] [Accepted: 01/25/2024] [Indexed: 02/16/2024] Open
Abstract
Articular cartilage injury is a prevalent clinical condition resulting from trauma, tumors, infection, osteoarthritis, and other factors. The intrinsic lack of blood vessels, nerves, and lymphatic vessels within cartilage tissue severely limits its self-regenerative capacity after injury. Current treatment options, such as conservative drug therapy and joint replacement, have inherent limitations. Achieving perfect regeneration and repair of articular cartilage remains an ongoing challenge in the field of regenerative medicine. Tissue engineering has emerged as a key focus in articular cartilage injury research, aiming to utilize cultured and expanded tissue cells combined with suitable scaffold materials to create viable, functional tissues. This review article encompasses the latest advancements in seed cells, scaffolds, and cytokines. Additionally, the role of stimulatory factors including cytokines and growth factors, genetic engineering techniques, biophysical stimulation, and bioreactor systems, as well as the role of scaffolding materials including natural scaffolds, synthetic scaffolds, and nanostructured scaffolds in the regeneration of cartilage tissues are discussed. Finally, we also outline the signaling pathways involved in cartilage regeneration. Our review provides valuable insights for scholars to address the complex problem of cartilage regeneration and repair.
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Affiliation(s)
- Maohua Chen
- Department of Plastic Surgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Zhiyuan Jiang
- Department of Plastic Surgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Xiuyuan Zou
- Department of Plastic Surgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Xiaobo You
- Department of Plastic Surgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Zhen Cai
- Department of Plastic Surgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Jinming Huang
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
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León-Román VE, García-Mato D, López-Torres II, Vaquero-Martín J, Calvo-Haro JA, Pascau J, Sanz-Ruíz P. Is a greater degree of constraint really harmful? Clinical biomechanical comparative study between condylar constrained knee and rotating hinge prosthesis. Clin Biomech (Bristol, Avon) 2024; 111:106149. [PMID: 37976691 DOI: 10.1016/j.clinbiomech.2023.106149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 11/04/2023] [Accepted: 11/10/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND The real degree of constraint of rotating hinge knee and condylar constrained prostheses is a matter of discussion in revision knee arthroplasty. The objective of this study is to compare the tibial rotation between implants in the clinical settings. METHODS An investigator blinded experimental study was designed including 20 patients: in 10 of them a rotating hinge knee prosthesis (Endomodel®, LINK) was implanted and in the remaining 10 a constrained condylar knee prosthesis (LCCK®, Zimmer) was used. A medial parapatellar approach was performed and implantation was performed according to conventional surgical technique. Tibial rotation was measured with two accelerometers in full extension and at 30°, 60° and 90° of flexion. Pre and postoperative Knee Injury and Osteoarthritis Outcome Score was recorded. FINDINGS Both groups were homogenous in age (73.4 years in rotating hinge knee prosthesis vs 74 years in constrained condylar knee group), sex, laterality and preoperative Knee Injury and Osteoarthritis Outcome Score (p > 0.05). The postoperative Knee Injury and Osteoarthritis Outcome Score was significantly higher in the rotating hinge knee prosthesis group (80.98 vs 76.28). The degrees of tibial rotation measured by inertial sensors in the rotating hinge knee prosthesis group were also significantly higher than those measured in the constrained condylar knee group (5.66° vs 2.1°) with p = 0.001. INTERPRETATION Rotating hinge knee prosthesis appears to represent a lower rotational constraint degree than constrained condylar knee systems in clinical practice and it may increase the clinical satisfaction. The clinical significance: Rotating hinge knee prosthesis appears to represent a lower constraint degree than constrained condylar knee systems in clinical practice.
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Affiliation(s)
- Víctor-Estuardo León-Román
- Villalba General Hospital, Carretera de Alpedrete a Moralzarzal M-608 km 41, 28400 Collado Villalba, Madrid, Spain.
| | - David García-Mato
- Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Avda. de la Universidad, 30, 28911 Leganés, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Calle Dr. Esquerdo, 46, 28007, Madrid, Spain.
| | | | - Javier Vaquero-Martín
- Gregorio Marañón General Hospital, C/ Doctor Esquerdo 46, 28007, Madrid, Spain; Surgery Department, Faculty of Medicine, Complutense University of Madrid, Plaza Ramón y Cajal s/n, 28040, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Calle Dr. Esquerdo, 46, 28007, Madrid, Spain
| | - José Antonio Calvo-Haro
- Gregorio Marañón General Hospital, C/ Doctor Esquerdo 46, 28007, Madrid, Spain; Surgery Department, Faculty of Medicine, Complutense University of Madrid, Plaza Ramón y Cajal s/n, 28040, Madrid, Spain
| | - Javier Pascau
- Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Avda. de la Universidad, 30, 28911 Leganés, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Calle Dr. Esquerdo, 46, 28007, Madrid, Spain.
| | - Pablo Sanz-Ruíz
- Gregorio Marañón General Hospital, C/ Doctor Esquerdo 46, 28007, Madrid, Spain; Surgery Department, Faculty of Medicine, Complutense University of Madrid, Plaza Ramón y Cajal s/n, 28040, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Calle Dr. Esquerdo, 46, 28007, Madrid, Spain
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18
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De Marziani L, Boffa A, Di Martino A, Andriolo L, Reale D, Bernasconi A, Corbo VR, de Caro F, Delcogliano M, di Laura Frattura G, Di Vico G, Manunta AF, Russo A, Filardo G. The reimbursement system can influence the treatment choice and favor joint replacement versus other less invasive solutions in patients affected by osteoarthritis. J Exp Orthop 2023; 10:146. [PMID: 38135778 PMCID: PMC10746689 DOI: 10.1186/s40634-023-00699-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 11/16/2023] [Indexed: 12/24/2023] Open
Abstract
PURPOSE The aim of this study was to assess how physicians perceive the role of the reimbursement system and its potential influence in affecting their treatment choice in the management of patients affected by osteoarthritis (OA). METHODS A survey was administered to 283 members of SIAGASCOT (Italian Society of Arthroscopy, Knee, Upper Limb, Sport, Cartilage and Orthopaedic Technologies), a National scientific orthopaedic society. The survey presented multiple choice questions on the access allowed by the current Diagnosis-Related Groups (DRG) system to all necessary options to treat patients affected by OA and on the influence toward prosthetic solutions versus other less invasive options. RESULTS Almost 70% of the participants consider that the current DRG system does not allow access to all necessary options to best treat patients affected by OA. More than half of the participants thought that the current DRG system favors the choice of prosthetic solutions (55%) and that it can contribute to the increase in prosthetic implantation at the expense of less invasive solutions (54%). The sub-analyses based on different age groups, professional roles, and places of work allowed to evaluate the response in each specific category, confirming the findings for all investigated aspects. CONCLUSIONS This survey documented that the majority of physicians consider that the reimbursement system can influence the treatment choice when managing OA patients. The current DRG system was perceived as unbalanced in favor of the choice of the prosthetic solution, which could contribute to the increase in prosthetic implantation at the expense of other less invasive options for OA management.
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Affiliation(s)
- Luca De Marziani
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli, Bologna, 1 - 40136, Italy
| | - Angelo Boffa
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli, Bologna, 1 - 40136, Italy.
| | - Alessandro Di Martino
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli, Bologna, 1 - 40136, Italy
| | - Luca Andriolo
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli, Bologna, 1 - 40136, Italy
| | - Davide Reale
- Ortopedia e Traumatologia, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Alessio Bernasconi
- Orthopaedics and Traumatology Unit, Department of Public Health, University Federico II of Naples Federico II, Naples, Italy
| | | | - Francesca de Caro
- Department of Orthopaedic Surgery, Istituto Di Cura Città Di Pavia, Pavia, Italy
| | - Marco Delcogliano
- Servizio di Ortopedia e Traumatologia dell'Ospedale Regionale di Bellinzona e Valli, Ente Ospedaliero Cantonale, Ticino, Switzerland
| | | | - Giovanni Di Vico
- Department of Orthopaedics and Trauma Surgery, Clinica San Michele, Maddaloni, Italy
| | | | | | - Giuseppe Filardo
- Applied and Translational Research (ATR) Center, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- Service of Orthopaedics and Traumatology, Department of Surgery, EOC, Lugano, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
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Yetişir A, Öztürk GY. Effects of low-level laser therapy on acupuncture points on knee pain and function in knee osteoarthritis. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 70:e20230264. [PMID: 38126411 PMCID: PMC10740188 DOI: 10.1590/1806-9282.20230264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 06/03/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE Knee osteoarthritis is a common and disabling disease. We aimed to examine the effect of low-level laser therapy in addition to routine physical therapy modalities (transcutaneous electrical stimulation, superficial heating modality of infrared, ultrasound, and exercise) on the functional status and pain in knee osteoarthritis. METHODS Patients with knee osteoarthritis (n=71) who underwent physical therapy (transcutaneous electrical stimulation, infrared, ultrasound, exercise therapy, and low-level laser therapy) were retrospectively screened. Patients who received low-level laser therapy on acupuncture points, transcutaneous electrical stimulation, infrared, ultrasound, and exercise were included in the low-level laser therapy (+) (n=35), and patients who received only transcutaneous electrical stimulation, ultrasound, infrared, and exercise were included in the low-level laser therapy (-) group (n=36). The Visual Analog Scale for activity pain, Lysholm Knee Scoring Scale, and walking and stair climbing tests were used before and after treatment obtained from patient files. RESULTS The post-treatment Visual Analog Scale activity score and walking and stair climbing test results were statistically significantly lower in the low-level laser therapy (+) group than in the low-level laser therapy (-) group. There was no significant difference in post-treatment Lysholm Knee Scoring Scale scores between the two groups. In both groups, the Visual Analog Scale activity, Lysholm Knee Scoring Scale, and walking and stair climbing test scores statistically significantly decreased after treatment. CONCLUSION Knee osteoarthritis increases with aging and creates significant functional limitations. low-level laser therapy with routine physiotherapy contributed to the improvement in the pain and functional status of the patients with knee osteoarthritis. Low-level laser therapy can be recommended in osteoarthritis treatment guidelines with the support of further studies, which is an easy-to-apply, effective, and reliable method.
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Affiliation(s)
- Ayşegül Yetişir
- Çukurova University, Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Division of Rheumatology – Adana, Turkey
| | - Gülşah Yaşa Öztürk
- Adana City Training and Research Hospital, Department of Physical Medicine and Rehabilitation – Adana, Turkey
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20
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Wang Z, Xu H, Wang Z, Zhou H, Diao J, Zhang L, Wang Y, Li M, Zhou Y. Effects of externally-applied, non-pharmacological Interventions on short- and long-term symptoms and inflammatory cytokine levels in patients with knee osteoarthritis: a systematic review and network meta-analysis. Front Immunol 2023; 14:1309751. [PMID: 38155966 PMCID: PMC10752972 DOI: 10.3389/fimmu.2023.1309751] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 11/30/2023] [Indexed: 12/30/2023] Open
Abstract
Background With the continuous development of clinical medicine, an increasing number of non-pharmacological interventions have been applied for the treatment of knee osteoarthritis (KOA), with the results of several recent randomized controlled trials (RCTs) showing that a variety of externally-applied, non-pharmacological interventions (EANPI) can improve symptoms and inflammation in patients with KOA. However, the relative benefits and disadvantages of non-drug therapies remain uncertain, and an optimal treatment strategy has not yet been determined. Objective This study applied network meta-analysis (NMA) to compare and rank the effectiveness of EANPI on the short- and long-term clinical symptoms and inflammatory cytokine levels in patients with KOA. Methods Two independent researchers searched online databases and performed manual retrieval of related citations to identify RCTs that met the selection criteria for the network meta-analysis. These researchers retrieved studies indexed from database inception to August 2023 and performed data extraction and assessment of the risk of bias. Results The analysis included 80 RCTs involving 8440 participants and nine externally-applied, non-pharmacological therapies, namely extracorporeal shock wave, radiofrequency, acupotomy, laser therapy, Tuina therapy, kinesio taping, electroacupuncture, platelet-rich plasma injection, and ozone therapy. The treatment courses ranged from 1 to 12 weeks, with follow-up periods ranging from 4 to 24 weeks. The results of the NMA indicated that each non-drug therapy was superior to sham intervention in improving all outcome indicators. Except for the visual analog scale (VAS) and Western Ontario MacMaster (WOMAC) pain outcomes, all non-drug therapies had better efficacy than pharmacological treatments. For short-term VAS and tumor necrosis factor-alpha (TNF-α), extracorporeal shock wave performed better than other therapies (90.2% and 85.2% respectively). Radiofrequency therapy may be the most promising method to reduce long-term VAS, short- and long-term WOMAC pain, and interleukin (IL)-1β level (84.8%, 97.8%, 90.1%, 94.8% respectively). Tuina therapy may be a significant choice for short- and long-term outcomes of WOMAC function and range of motion (ROM). Conclusions The results of the comprehensive comparison of the outcome indicators in 9 different EANPI indicated that radiofrequency and Tuina therapy were more effective and consistently ranked high in improving clinical symptoms in the short and long term. Radiofrequency is effective at relieving pain, and Tuina therapy can be given priority for treatment when hypofunction is the main symptom. EANPI to improve pain symptoms may be related to the regulation of inflammatory cytokine levels, which may be a potential mechanism of action. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?, identifier CRD42023464177.
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Affiliation(s)
- Zhen Wang
- College of Acupuncture and Massage, Henan University of Chinese Medicine, Zhengzhou, China
| | - Hui Xu
- College of Acupuncture and Massage, Henan University of Chinese Medicine, Zhengzhou, China
- Tuina Department, The Third Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Zheng Wang
- College of Acupuncture and Massage, Henan University of Chinese Medicine, Zhengzhou, China
| | - Hang Zhou
- College of Acupuncture and Massage, Henan University of Chinese Medicine, Zhengzhou, China
| | - Jieyao Diao
- College of Acupuncture and Massage, Henan University of Chinese Medicine, Zhengzhou, China
| | - Lijuan Zhang
- Rehabilitation Department, Jiaozuo Coal Industry (Group) Co. Ltd., Central Hospital, Jiaozuo, China
| | - Yu Wang
- College of Computer Science, Xidian University, Xian, China
| | - Miaoxiu Li
- College of Acupuncture and Massage, Shanghai University of Chinese Medicine, Shanghai, China
| | - Yunfeng Zhou
- College of Acupuncture and Massage, Henan University of Chinese Medicine, Zhengzhou, China
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Jiang W, Chen H, Lin Y, Cheng K, Zhou D, Chen R, Song C, Zeng L, Yu H. Mechanical stress abnormalities promote chondrocyte senescence - The pathogenesis of knee osteoarthritis. Biomed Pharmacother 2023; 167:115552. [PMID: 37748410 DOI: 10.1016/j.biopha.2023.115552] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/15/2023] [Accepted: 09/18/2023] [Indexed: 09/27/2023] Open
Abstract
Knee osteoarthritis (KOA) is a common chronic disease in orthopedics, which brings great pain to patients' life and spirit. Therefore, it is necessary to elucidate the pathogenesis of KOA. The pathophysiology of KOA has been linked to numerous factors, including oxidative stress, apoptosis, cellular senescence, mitochondrial dysfunction, and inflammatory factors. Cellular senescence has grown in importance as a topic of study for age-related illnesses recently. KOA has also been discovered to be closely related to human aging, a process in which chondrocyte senescence may be crucial. Numerous researches have looked at the pathogenesis of KOA from the perspectives of mechanical stress abnormalities, oxidative stress, inflammatory overexpression, and mitochondrial dysfunction. Many studies have discovered that the primary pathogenesis of KOA is inflammatory overexpression and chondrocyte death brought on by an imbalance in the joint microenvironment. And abnormal mechanical stress is the initiating cause of oxidative stress, inflammation, and mitochondrial disorders. However, few findings have been reported in the literature on the relationship between these factors, especially for mechanical stress abnormalities, and chondrocyte senescence. This time, in order to better understand the pathogenesis of KOA and identify potential connections between chondrocyte senescence and these microenvironments in KOA, as well as oxidative stress, inflammatory overexpression, and mitochondrial dysfunction microenvironmental dysfunctions, we will use chondrocyte senescence as a starting point. This will allow us to develop new therapeutic approaches for KOA.
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Affiliation(s)
- Wei Jiang
- Department of Rehabilitation Medicine, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China
| | - Haixu Chen
- Department of Human Anatomy and Histoembryology, School of Basic Medical Sciences, Southwest Medical University, Luzhou 646000, Sichuan, China; Department of Basic Medicine, Sichuan Vocational College of Health and Rehabilitation, Zigong 643000, Sichuan, China
| | - Yu Lin
- Department of Human Anatomy and Histoembryology, School of Basic Medical Sciences, Southwest Medical University, Luzhou 646000, Sichuan, China; Department of Clinical and Medical Technology, Sichuan Vocational College of Health and Rehabilitation, Zigong 643000, Sichuan, China
| | - Kang Cheng
- Department of Orthopedics and Traumatology, The Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University, Luzhou 646000, Sichuan, China
| | - Daqian Zhou
- Department of Orthopedics and Traumatology, The Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University, Luzhou 646000, Sichuan, China
| | - Rui Chen
- Department of Orthopedics and Traumatology, The Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University, Luzhou 646000, Sichuan, China
| | - Chao Song
- Department of Orthopedics and Traumatology, The Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University, Luzhou 646000, Sichuan, China.
| | - Lianlin Zeng
- Department of Rehabilitation Medicine, Suining Central Hospital, Suining 629000, Sichuan, China.
| | - Hong Yu
- Department of Human Anatomy and Histoembryology, School of Basic Medical Sciences, Southwest Medical University, Luzhou 646000, Sichuan, China.
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Bernetti A, Agostini F, Paoloni M, Raele MV, Farì G, Megna M, Mangone M. Could Hyaluronic Acid Be Considered as a Senomorphic Agent in Knee Osteoarthritis? A Systematic Review. Biomedicines 2023; 11:2858. [PMID: 37893231 PMCID: PMC10604344 DOI: 10.3390/biomedicines11102858] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 10/19/2023] [Accepted: 10/20/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Knee osteoarthritis (KOA) is one of the most common causes of disability in elderly patients and tends to be a major burden on social and health care spending. Despite its severe socioeconomic impact, KOA remains, to date, an incurable disease. Due to its proper characteristics, KOA represents a favorable disease model for experimenting with senotherapeutics, a group of treatments that counteract the development of age-related disorders and chronic diseases. In recent years, the use of intra-articular hyaluronic acid (IAHA) in the treatment of diseases related to the wear and tear of the articular cartilage has been gaining popularity. Given its ability in joint lubrification, shock absorption, and cell signaling, our aim is to investigate, through the existing scientific literature, its potential role as a senomorphic agent, emphasizing its crucial function in KOA patients. Indeed, senomorphics are a particular group of senotherapeutics capable of modulating the functions and morphology of senescent cells to those of young cells or delaying the progression of young cells to senescent cells in tissues. METHODS A search in the scientific literature (PubMed, Cochrane Library, and Google Scholar) was carried out from 2019 to 2023, thus the last 5 years. RESULTS One hundred thirty-eight articles were found concerning the role of hyaluronic acid injections in KOA patients. In these studies, its therapeutic efficacy, its anti-inflammatory properties, and its low risk of side effects emerged. CONCLUSION IAHA injections are a valuable treatment option for KOA while they can provide pain relief, improve joint function, and slow the progression of joint degeneration. The inhibitory effect of HA on MMP13 and its action as a senomorphic agent suggests that it may have additional benefits beyond its lubricating and shock-absorbing properties. In order to clarify its mechanisms of action and to optimize its clinical use, further studies are definitely needed.
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Affiliation(s)
- Andrea Bernetti
- Department of Biological and Environmental Sciences and Technologies (DiSTeBA), Università del Salento, 73100 Lecce, Italy;
| | - Francesco Agostini
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00189 Rome, Italy; (F.A.); (M.P.); (M.M.)
| | - Marco Paoloni
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00189 Rome, Italy; (F.A.); (M.P.); (M.M.)
| | - Maria Vittoria Raele
- Department of Translational Biomedicine and Neuroscience (DiBraiN), Aldo Moro University, 70121 Bari, Italy; (M.V.R.); (M.M.)
| | - Giacomo Farì
- Department of Biological and Environmental Sciences and Technologies (DiSTeBA), Università del Salento, 73100 Lecce, Italy;
| | - Marisa Megna
- Department of Translational Biomedicine and Neuroscience (DiBraiN), Aldo Moro University, 70121 Bari, Italy; (M.V.R.); (M.M.)
| | - Massimiliano Mangone
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00189 Rome, Italy; (F.A.); (M.P.); (M.M.)
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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] [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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Wang Y, Pan X, Wang J, Chen H, Chen L. Exploration of Simiao-Yongan Decoction on knee osteoarthritis based on network pharmacology and molecular docking. Medicine (Baltimore) 2023; 102:e35193. [PMID: 37800753 PMCID: PMC10552997 DOI: 10.1097/md.0000000000035193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 08/22/2023] [Indexed: 10/07/2023] Open
Abstract
Use network pharmacology combined with molecular docking to study the effects of Simiao-Yongan Decoction (SMYAD) intervenes in Knee Osteoarthritis (KOA) related targets and signaling pathways, and explores the molecular mechanism of SMYAD in treating KOA. The active ingredients and targets of SMYAD, which concluded 4 traditional Chinese medicines, were screened in TCMSP, and the related gene targets of KOA were screened in the disease databases GeneCards, MalaCards, DisGeNET, and Comparative Toxicogenomics Database, and their intersection data were obtained after integration. And used Cytoscape 3.9.1, the software topologies the network diagram of "compound-drug-active ingredient-target protein-disease." Obtains the protein-protein interaction network diagram through STRING, and enriches and analyzes the obtained core targets. Carry out molecular docking matching verification on the main active ingredients and key targets of the drug. 106 active ingredients and 175 targets were screened from SMYAD to intervene in KOA, 36 core targets were obtained through protein-protein interaction screening, and 10 key targets played an important role. The enrichment results showed that the biological process of gene ontology mainly involved positive regulation of gene expression, negative regulation of apoptosis process, and positive regulation of apoptosis process. KEGG signaling pathway mainly involves AGE-RAGE signaling pathway in diabetic complications, TNF signaling pathway, hypoxia-inducible factor-1 signaling pathway, IL-17 signaling pathway. The pathway of Reactome mainly involves interleukin-4 and interleukin-13 signaling, cytokine signaling in immune system, immune system, apoptosis. Molecular docking showed that the mainly effective components of SMYAD can fully combine with TNF, IL1B, IL6, and CASP3. The results show that the main active ingredients and potential mechanism of action of SMYAD in the treatment of KOA have the characteristics of multiple targets and multiple pathways, which provides ideas and basis for further in-depth exploration of its specific mechanism.
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Affiliation(s)
- Ying Wang
- Department of Basic Medicine, Sichuan Vocational College of Health and Rehabilitation, Zigong, Sichuan Province, China
| | - Xiangyu Pan
- Department of Rehabilitation Medicine, Zigong First People’s Hospital, Zigong, Sichuan Province, China
| | - Junwei Wang
- Department of Pediatric Surgery & Vascular Surgery, Zigong Fourth People’s Hospital, Zigong, Sichuan Province, China
| | - Haixu Chen
- Department of Basic Medicine, Sichuan Vocational College of Health and Rehabilitation, Zigong, Sichuan Province, China
| | - Lan Chen
- Department of Basic Medicine, Sichuan Vocational College of Health and Rehabilitation, Zigong, Sichuan Province, China
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25
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Cohen D, Greenberg A, Maliarov A, Seligman D, Backstein D. Long-term outcomes of the Nexgen © posterior stabilized knee: minimum 15 year follow-safe and effective. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY : ORTHOPEDIE TRAUMATOLOGIE 2023; 33:2943-2949. [PMID: 36912950 PMCID: PMC10009351 DOI: 10.1007/s00590-023-03514-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 03/02/2023] [Indexed: 03/14/2023]
Abstract
PURPOSE Studying long-term survivorship and functional outcomes for specific prostheses is critical for elucidating areas in need of design improvement. This study reports the long-term of the NexGen Posterior Stabilized (PS) Total Knee implant (TKA) (Zimmer Biomet, Warsaw IN) Performed by a single surgeon. METHODS Data from patients treated with the NexGen PS TKA between January 2003 and December 2005 with a minimal follow-up of 15 years was collected from a prospectively collected database. Survivorship rates and Oxford Knee Scores (OKS) were obtained for those patients available for follow-up. RESULTS Ninety-five patients met the inclusion criteria during the study period. OKS was available for 44 (46%) patients. Ten patients required revision surgery (10.52%). Implant-specific survivorship of all cases that were reviewed was 98%. Survivorship of implants in patients that we were able to reach, or deceased patients was 93%. The average Oxford Knee Score was 39.1 (14-48. SD ± 7.70) with 48 being the maximal score. CONCLUSION Despite some concerns about durability of this implant, good longevity and function was demonstrated. At a minimum of 15 years follow-up in this cohort. Given these results design features of this system should be considered for future generations of implants.
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Affiliation(s)
- Daniel Cohen
- Granovsky Gluskin Orthopedic Division, Sinai Health System, University of Toronto, Toronto, ON Canada
| | - Arieh Greenberg
- Granovsky Gluskin Orthopedic Division, Sinai Health System, University of Toronto, Toronto, ON Canada
| | - Anton Maliarov
- Granovsky Gluskin Orthopedic Division, Sinai Health System, University of Toronto, Toronto, ON Canada
| | - David Seligman
- Granovsky Gluskin Orthopedic Division, Sinai Health System, University of Toronto, Toronto, ON Canada
| | - David Backstein
- Granovsky Gluskin Orthopedic Division, Sinai Health System, University of Toronto, Toronto, ON Canada
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Eremeev A, Pikina A, Ruchko Y, Bogomazova A. Clinical Potential of Cellular Material Sources in the Generation of iPSC-Based Products for the Regeneration of Articular Cartilage. Int J Mol Sci 2023; 24:14408. [PMID: 37833856 PMCID: PMC10572671 DOI: 10.3390/ijms241914408] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/06/2023] [Accepted: 09/06/2023] [Indexed: 10/15/2023] Open
Abstract
Inflammatory joint diseases, among which osteoarthritis and rheumatoid arthritis are the most common, are characterized by progressive degeneration of the cartilage tissue, resulting in the threat of limited or lost joint functionality in the absence of treatment. Currently, treating these diseases is difficult, and a number of existing treatment and prevention measures are not entirely effective and are complicated by the patients' conditions, the multifactorial nature of the pathology, and an incomplete understanding of the etiology. Cellular technologies based on induced pluripotent stem cells (iPSCs) can provide a vast cellular resource for the production of artificial cartilage tissue for replacement therapy and allow the possibility of a personalized approach. However, the question remains whether a number of etiological abnormalities associated with joint disease are transmitted from the source cell to iPSCs and their chondrocyte derivatives. Some data state that there is no difference between the iPSCs and their derivatives from healthy and sick donors; however, there are other data indicating a dissimilarity. Therefore, this topic requires a thorough study of the differentiation potential of iPSCs and the factors influencing it, the risk factors associated with joint diseases, and a comparative analysis of the characteristics of cells obtained from patients. Together with cultivation optimization methods, these measures can increase the efficiency of obtaining cell technology products and make their wide practical application possible.
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Affiliation(s)
- Artem Eremeev
- Lopukhin Federal Research and Clinical Center of Physical-Chemical Medicine, Federal Medical Biological Agency, Malaya Pirogovskaya 1a, Moscow 119435, Russia; (A.P.); (A.B.)
- Koltzov Institute of Developmental Biology, Russian Academy of Sciences, 26 Vavilov Street, Moscow 119334, Russia;
| | - Arina Pikina
- Lopukhin Federal Research and Clinical Center of Physical-Chemical Medicine, Federal Medical Biological Agency, Malaya Pirogovskaya 1a, Moscow 119435, Russia; (A.P.); (A.B.)
- Department of Embryology, Faculty of Biology, Lomonosov Moscow State University, GSP-1 Leninskie Gory, Moscow 119991, Russia
| | - Yevgeny Ruchko
- Koltzov Institute of Developmental Biology, Russian Academy of Sciences, 26 Vavilov Street, Moscow 119334, Russia;
| | - Alexandra Bogomazova
- Lopukhin Federal Research and Clinical Center of Physical-Chemical Medicine, Federal Medical Biological Agency, Malaya Pirogovskaya 1a, Moscow 119435, Russia; (A.P.); (A.B.)
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Rasovic P, Dulic O, Lalic I, Matijevic R, Janjic N, Tosic M, Aleksandric D, Abazovic D, Miskulin M, Matijevic S, Kovacevic L. The role of osteoarthritis severity, BMI and age on clinical efficacy of bone marrow aspirate concentrate in the treatment of knee osteoarthritis. Regen Med 2023; 18:735-747. [PMID: 37577967 DOI: 10.2217/rme-2023-0042] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023] Open
Abstract
Aim: The aim of this study was to assess whether BMI, severity of knee osteoarthritis, age and gender have any influence on the final clinical results of bone marrow aspirate concentrate injection. Method: A total of 111 study participants with painful knee osteoarthritis and different characteristics concerning before mentioned factors underwent bone marrow aspirate concentrate (BMAC) therapy and were followed up for 1 year. Result: Significant pain and functional improvement were observed in all participant groups. Participants' age and BMI did not influence the clinical outcome, but there was an influence of OA severity, especially among older patients. Conclusion: This study shows that BMAC therapy is effective. Younger patients with milder OA changes could be better candidates for long-lasting and more efficient BMAC therapy. Clinical Trial Registration: NCT03825133 (ClinicalTrials.gov).
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Affiliation(s)
- Predrag Rasovic
- University of Novi Sad, Serbia, Medical Faculty, University Clinical Center of Vojvodina, Novi Sad, Serbia
| | - Oliver Dulic
- University of Novi Sad, Serbia, Medical Faculty, University Clinical Center of Vojvodina, Novi Sad, Serbia
| | - Ivica Lalic
- University Business Academy in Novi Sad, Faculty Of Pharmacy, Novi Sad, Serbia
| | - Radmila Matijevic
- University of Novi Sad, Serbia, Medical Faculty, University Clinical Center of Vojvodina, Novi Sad, Serbia
| | - Natasa Janjic
- University of Novi Sad, Serbia, Medical Faculty, University Clinical Center of Vojvodina, Novi Sad, Serbia
| | - Milan Tosic
- University of Novi Sad, Serbia, Medical Faculty, University Clinical Center of Vojvodina, Novi Sad, Serbia
| | - Dejan Aleksandric
- Institute for Orthopaedic Surgical Diseases "Banjica", Belgrade, Serbia
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Shimozaki K, Nakase J, Kanayama T, Yanatori Y, Ishida Y, Ohno N, Miyati T, Tsuchiya H. Extrusion of the medial meniscus under a weight-loading condition in early knee osteoarthritis: an investigation using special upright magnetic resonance imaging. BMC Musculoskelet Disord 2023; 24:680. [PMID: 37633935 PMCID: PMC10463466 DOI: 10.1186/s12891-023-06807-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 08/17/2023] [Indexed: 08/28/2023] Open
Abstract
BACKGROUND Whether the medial meniscus morphology and movement occur under upright loading conditions in early knee osteoarthritis (OA) or medial meniscus posterior root tear (MMPRT) remains unknown. This study aimed to evaluate the medial and anteroposterior extrusion of the medial meniscus under unloaded and upright-loaded conditions in patients with early knee OA. METHODS Twelve patients with early knee OA and 18 healthy adult volunteers participated in this study. Magnetic resonance imaging using special equipment was performed with the participants in the unloaded and upright-loaded conditions. Medial, anterior, and posterior extrusions of the medial meniscus against the tibial edge were evaluated and compared between the early knee OA and healthy adult control groups. Additionally, 12 patients in the early knee OA group were divided into 2 subgroups based on whether MMPRT was observed, and the extrusion of the medial meniscus was compared. RESULTS The amount of medial extrusion of the medial meniscus in both the unloaded and upright-loaded conditions was significantly greater in the early knee OA group than in the control group (unloaded: 2.6 ± 1.0 mm vs 0.7 ± 0.5 mm; upright-loaded: 3.7 ± 0.9 mm vs 1.8 ± 0.8 mm). Similarly, the anterior and posterior extrusion of the medial meniscus in the upright-loaded condition was significantly larger in the early knee OA group (anterior: 4.6 ± 1.0 mm vs 3.7 ± 1.1 mm; posterior: -3.4 ± 1.1 mm vs -4.6 ± 1.6 mm). However, no difference was observed in meniscal extrusion between unloaded and upright-loaded conditions. The posterior extrusion of the medial meniscus in the upright-loaded condition was significantly greater in MMPRT cases than in non-MMPRT cases in the early knee OA group (MMPRT: -2.7 ± 1.1 mm; non-MMPRT -4.1 ± 1.5 mm). CONCLUSIONS In early knee OA, significantly large meniscal extrusions of the medial meniscus in both unloaded and upright-loaded conditions were found compared with healthy adults. Among patients with early knee OA, those with MMPRT showed a large posterior extrusion of the medial meniscus in the upright-loaded condition compared with those without MMPRT. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Kengo Shimozaki
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-Machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Junsuke Nakase
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-Machi, Kanazawa, Ishikawa, 920-8641, Japan.
| | - Tomoyuki Kanayama
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-Machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Yusuke Yanatori
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-Machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Yoshihiro Ishida
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-Machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Naoki Ohno
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa, 920-0942, Japan
| | - Tosiaki Miyati
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa, 920-0942, Japan
| | - Hiroyuki Tsuchiya
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-Machi, Kanazawa, Ishikawa, 920-8641, Japan
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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] [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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Chalidis B, Papadopoulos P, Givissis P, Pitsilos C. Is Radiofrequency Ablation Superior to Intra-Articular Injections for the Treatment of Symptomatic Knee Osteoarthritis?-A Systematic Review. J Pers Med 2023; 13:1227. [PMID: 37623477 PMCID: PMC10455107 DOI: 10.3390/jpm13081227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/26/2023] [Accepted: 08/01/2023] [Indexed: 08/26/2023] Open
Abstract
The radiofrequency ablation (RFA) is considered a valid, minimally invasive treatment modality for the management of symptomatic knee osteoarthritis (OA). The aim of this study was to compare the outcomes of RFA with that of commonly used intra-articular injections for the persistent knee pain due to OA. Medline/Pubmed and Scopus databases were systematically searched up to April 2023 to identify studies comparing the effect of RFA and intra-articular injections (IAIs) on knee OA. Nine studies including 899 patients fulfilled the eligibility criteria and were included in the systematic review. The RFA procedure was related with improved knee pain relief compared to IAIs at 3-, 6- and 12-month follow-up (p < 0.001). Similarly, functional improvement was greater in RFA treatment than that observed after hyaluronic acid (HA), steroid or platelet-rich plasma (PRP) injections (Visual Analogue Scale p < 0.001, Numeric Rating Scale p = 0.019, Western Ontario and McMaster University Osteoarthritis Index p = 0.012). The overall procedural complication rate of RFA was 10.2% and was higher than steroid (p = 0.023) and PRP (p = 0.017) injections. However, no severe adverse events were reported. For patients with symptomatic knee OA, RFA seems to be more effective than IAIs in alleviating pain and improving joint function, despite the relatively higher incidence of non-serious adverse events. However, due to the limited number of studies and patients, this result should be interpreted with caution and not be generalized to the entire knee OA population.
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Affiliation(s)
- Byron Chalidis
- 1st Orthopaedic Department, Aristotle University of Thessaloniki, 57010 Thessaloniki, Greece;
| | - Pericles Papadopoulos
- 2nd Orthopaedic Department, Aristotle University of Thessaloniki, 54635 Thessaloniki, Greece; (P.P.); (C.P.)
| | - Panagiotis Givissis
- 1st Orthopaedic Department, Aristotle University of Thessaloniki, 57010 Thessaloniki, Greece;
| | - Charalampos Pitsilos
- 2nd Orthopaedic Department, Aristotle University of Thessaloniki, 54635 Thessaloniki, Greece; (P.P.); (C.P.)
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Palumbo A, Atzeni F, Murdaca G, Gangemi S. The Role of Alarmins in Osteoarthritis Pathogenesis: HMGB1, S100B and IL-33. Int J Mol Sci 2023; 24:12143. [PMID: 37569519 PMCID: PMC10418664 DOI: 10.3390/ijms241512143] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 07/26/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
Osteoarthritis (OA) is a multifactorial disease in which genetics, aging, obesity, and trauma are well-known risk factors. It is the most prevalent joint disease and the largest disability problem worldwide. Recent findings have described the role of damage-associated molecular patterns (DAMPs) in the course of the disease. In particular, alarmins such as HMGB1, IL-33, and S100B, appear implicated in enhancing articular inflammation and favouring a catabolic switch in OA chondrocytes. The aims of this review are to clarify the molecular signalling of these three molecules in OA pathogenesis, to identify their possible use as staging biomarkers, and, most importantly, to find out whether they could be possible therapeutic targets. Osteoarthritic cartilage expresses increased levels of all three alarmins. HMGB1, in particular, is the most studied alarmin with increased levels in cartilage, synovium, and synovial fluid of OA patients. High levels of HMGB1 in synovial fluid of OA joints are positively correlated with radiological and clinical severity. Counteracting HMGB1 strategies have revealed improving results in articular cells from OA patients and in OA animal models. Therefore, drugs against this alarmin, such as anti-HMGB1 antibodies, could be new treatment possibilities that can modify the disease course since available medications only alleviate symptoms.
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Affiliation(s)
- Antonino Palumbo
- Rheumatology Unit, Department of Experimental and Internal Medicine, University of Messina, 98124 Messina, Italy; (A.P.); (F.A.)
| | - Fabiola Atzeni
- Rheumatology Unit, Department of Experimental and Internal Medicine, University of Messina, 98124 Messina, Italy; (A.P.); (F.A.)
| | - Giuseppe Murdaca
- Department of Internal Medicine, University of Genova, 16132 Genova, Italy
- IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Sebastiano Gangemi
- School and Operative Unit of Allergy and Clinical Immunology, Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy;
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Guo L, Guo H, Zhang Y, Chen Z, Sun J, Wu G, Wang Y, Zhang Y, Wei X, Li P. Upregulated ribosome pathway plays a key role in HDAC4, improving the survival rate and biofunction of chondrocytes. Bone Joint Res 2023; 12:433-446. [PMID: 37414410 DOI: 10.1302/2046-3758.127.bjr-2022-0279.r2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/08/2023] Open
Abstract
Aims To explore the novel molecular mechanisms of histone deacetylase 4 (HDAC4) in chondrocytes via RNA sequencing (RNA-seq) analysis. Methods Empty adenovirus (EP) and a HDAC4 overexpression adenovirus were transfected into cultured human chondrocytes. The cell survival rate was examined by real-time cell analysis (RTCA) and EdU and flow cytometry assays. Cell biofunction was detected by Western blotting. The expression profiles of messenger RNAs (mRNAs) in the EP and HDAC4 transfection groups were assessed using whole-transcriptome sequencing (RNA-seq). Volcano plot, Gene Ontology, and pathway analyses were performed to identify differentially expressed genes (DEGs). For verification of the results, the A289E/S246/467/632 A sites of HDAC4 were mutated to enhance the function of HDAC4 by increasing HDAC4 expression in the nucleus. RNA-seq was performed to identify the molecular mechanism of HDAC4 in chondrocytes. Finally, the top ten DEGs associated with ribosomes were verified by quantitative polymerase chain reaction (QPCR) in chondrocytes, and the top gene was verified both in vitro and in vivo. Results HDAC4 markedly improved the survival rate and biofunction of chondrocytes. RNA-seq analysis of the EP and HDAC4 groups showed that HDAC4 induced 2,668 significant gene expression changes in chondrocytes (1,483 genes upregulated and 1,185 genes downregulated, p < 0.05), and ribosomes exhibited especially large increases. The results were confirmed by RNA-seq of the EP versus mutated HDAC4 groups and the validations in vitro and in vivo. Conclusion The enhanced ribosome pathway plays a key role in the mechanism by which HDAC4 improves the survival rate and biofunction of chondrocytes.
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Affiliation(s)
- Li Guo
- Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Department of Orthopedics, the Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Hua Guo
- Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Department of Orthopedics, the Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Yuanyu Zhang
- Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Department of Orthopedics, the Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Zhi Chen
- Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Department of Orthopedics, the Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Jian Sun
- Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Department of Orthopedics, the Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Gaige Wu
- Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Department of Orthopedics, the Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Yunfei Wang
- Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Department of Orthopedics, the Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Yang Zhang
- Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Department of Orthopedics, the Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Xiaochun Wei
- Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Department of Orthopedics, the Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Pengcui Li
- Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Department of Orthopedics, the Second Hospital of Shanxi Medical University, Taiyuan, China
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Ssamy AC, Patro BP, Jeyaraman M, Das G, Nallakumarasamy A, Yadav S. Evaluation of Pre-emptive Analgesia in Total Knee Arthroplasty During Early Post-operative Periods. Cureus 2023; 15:e41433. [PMID: 37546118 PMCID: PMC10403783 DOI: 10.7759/cureus.41433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2023] [Indexed: 08/08/2023] Open
Abstract
INTRODUCTION Pre-emptive analgesia is expected to decrease post-operative pain. The degree of soft tissue release is directly related to preoperative deformity; we presume the severity of pain has a similar correlation in patients undergoing total knee arthroplasty (TKA). The main purpose of this research was to evaluate the effects of pre-emptive analgesia of different drugs in TKA with different degrees of preoperative genu varus. METHODS In this prospective observational study, 67 patients were enrolled with different degrees of genu varus deformity. They were subdivided into two groups: those with ≥15° and those with <15° varus deformities of the knee. Etoricoxib 60 mg and pregabalin 75 mg were administered orally in all the patients as pre-emptive analgesia two hours before surgery. Parameters such as the amount of soft tissue release, visual analog score (VAS), knee range of motion, complications, etc. were documented from the pre-operative period to 72 hours post-TKA. RESULTS With pre-emptive analgesia in post-TKA patients, the VAS score demonstrated a statistically significant difference at 24, 48, and 72 hours. The comparison of intraoperative flexion between <15° and ≥15° showed a statistically significant difference with pre-emptive analgesia in post-TKA patients. CONCLUSION The use of etoricoxib 60 mg and pregabalin 75 mg, two hours before surgery reduced the pain scores in patients undergoing TKA with different degrees of genu varus and correlated with intraoperative parameters associated with soft medial tissue release for genu varus.
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Affiliation(s)
- Ajay C Ssamy
- Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
| | - Bishnu P Patro
- Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
| | - Madhan Jeyaraman
- Orthopaedics, ACS Medical College and Hospital, Dr. MGR Educational and Research Institute, Chennai, IND
| | - Gurudip Das
- Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
| | | | - Sankalp Yadav
- Medicine, Shri Madan Lal Khurana Chest Clinic, New Delhi, IND
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Giorgino R, Nannini A, Scuttari E, Nuara A, Ciliberto R, Sosio C, Sirtori P, Peretti GM, Mangiavini L. Analysis of Short-Term Clinical and Functional Outcomes in Patients Undergoing Total Knee Arthroplasty with Kinematic Alignment Technique. J Clin Med 2023; 12:3978. [PMID: 37373671 DOI: 10.3390/jcm12123978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/07/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Surgery remains the best option for more advanced stages of knee osteoarthritis (OA). Kinematic alignment (KA) is an innovative surgical technique that aims to co-align the rotational axes of the femoral, tibial, and patella components with the three kinematic axes of the knee. This study aims to evaluate and analyze short-term clinical, psychological, and functional outcomes in patients undergoing total knee replacement with the KA technique. METHODS Twelve patients who underwent total knee replacement surgery with kinematic alignment from May 2022 until July 2022 were prospectively followed and interviewed. Before surgery, the day after surgery, and postoperative day 14, the following tests were evaluated: VAS, SF-12 PS, SF-12 MS, KSS, KSS-F, PHQ-9, and KOOS-PS. RESULTS The mean BMI value of 30.4 (±3.4) Kg/m2, mean age of 71.8 (±7.2) years. All the scores on the various tests administered consistently showed statistically significant improvement, not only immediately after surgery but also comparing the first to the fourteenth postoperative day. CONCLUSION Kinematic alignment technique as a surgical treatment for KO allows the patient a fast postoperative recovery and good clinical, psychological, and functional results in a short time. Further studies are needed with a larger sample size, and prospective randomized studies are essential to compare these results with mechanical alignment.
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Affiliation(s)
- Riccardo Giorgino
- Residency Program in Orthopaedics and Traumatology, University of Milan, 20141 Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy
| | - Alessandra Nannini
- Residency Program in Orthopaedics and Traumatology, University of Milan, 20141 Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy
| | - Edoardo Scuttari
- Faculty of Medicine and Surgery, University of Milan, 20122 Milan, Italy
| | - Alessandro Nuara
- Residency Program in Orthopaedics and Traumatology, University of Milan, 20141 Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy
| | | | - Corrado Sosio
- IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy
| | - Paolo Sirtori
- IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy
| | - Giuseppe M Peretti
- IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20122 Milan, Italy
| | - Laura Mangiavini
- IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20122 Milan, Italy
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Rudisill KE, Ratnasamy PP, Joo PY, Rubin LE, Grauer JN. Magnetic Resonance Imaging in the Year Prior to Total Knee Arthroplasty: A Potential Overutilization of Healthcare Resources. J Am Acad Orthop Surg Glob Res Rev 2023; 7:01979360-202305000-00019. [PMID: 37205731 PMCID: PMC10566819 DOI: 10.5435/jaaosglobal-d-22-00262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 03/26/2023] [Indexed: 05/21/2023]
Abstract
BACKGROUND Total knee arthroplasty (TKA) is a common procedure for late-stage degenerative changes, a situation for which magnetic resonance imaging (MRI) is typically not considered useful. In an era attempting to contain healthcare expenditures, the rate, timing, and predictors for MRI before TKA were assessed in a large, national, administrative data set. METHODS The 2010 to Q3 2020 MKnee PearlDiver data set was used to identify patients undergoing TKA for osteoarthritis. Those with lower extremity MRI for knee indications within 1 year before TKA were then defined. Patient age, sex, Elixhauser Comorbidity Index, region in the country, and insurance plan were characterized. Predictors of having had an MRI were assessed by univariate and multivariate analyses. The costs and timing of the obtained MRIs were also assessed. RESULTS Of 731,066 TKAs, MRI was obtained within 1 year prior for 56,180 (7.68%) with 28,963 (51.9%) within the 3 months of TKA. Independent predictors of having had an MRI included younger age (odds ratio [OR], 0.74 per decade increase), female sex (OR, 1.10), higher Elixhauser Comorbidity Index (OR, 1.15), region of the country (relative to South, Northeast OR, 1.08, West OR, 1.22, Midwest OR, 1.36), and insurance (relative to Medicare, Medicaid OR, 1.36 and Commercial OR, 1.35) with P < 0.0001 for each. The total cost of MRIs among patients who received a TKA is $44,686,308. CONCLUSION Noting that TKA is typically done for advanced degenerative changes, MRI should rarely be indicated in the preoperative period for this procedure. Nonetheless, this study found that MRI was done within the year before TKA for 7.68% of the study cohort. In an era striving for evidence-based medicine, the almost $45 million dollars spent on MRI in the year before TKA may represent overutilization.
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Affiliation(s)
- Katelyn E. Rudisill
- From the Department of Orthopedics and Rehabilitation, Yale School of Medicine, New Haven, CT
| | - Philip P. Ratnasamy
- From the Department of Orthopedics and Rehabilitation, Yale School of Medicine, New Haven, CT
| | - Peter Y. Joo
- From the Department of Orthopedics and Rehabilitation, Yale School of Medicine, New Haven, CT
| | - Lee E. Rubin
- From the Department of Orthopedics and Rehabilitation, Yale School of Medicine, New Haven, CT
| | - Jonathan N. Grauer
- From the Department of Orthopedics and Rehabilitation, Yale School of Medicine, New Haven, CT
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Simonetta R, Russo A, Palco M, Costa GG, Mariani PP. Meniscus tears treatment: The good, the bad and the ugly-patterns classification and practical guide. World J Orthop 2023; 14:171-185. [PMID: 37155506 PMCID: PMC10122773 DOI: 10.5312/wjo.v14.i4.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 01/22/2023] [Accepted: 03/31/2023] [Indexed: 04/18/2023] Open
Abstract
Over the years, several studies demonstrated the crucial role of knee menisci in joint biomechanics. As a result, save the meniscus has become the new imperative nowadays, and more and more studies addressed this topic. The huge amount of data on this topic may create confusion in those who want to approach this surgery. The aim of this review is to provide a practical guide for treatment of meniscus tears, including an overview of technical aspects, outcomes in the literature and personal tips. Taking inspiration from a famous movie directed by Sergio Leone in 1966, the authors classified meniscus tears in three categories: The good, the bad and the ugly lesions. The inclusion in each group was determined by the lesion pattern, its biomechanical effects on knee joint, the technical challenge, and prognosis. This classification is not intended to substitute the currently proposed classifications on meniscus tears but aims at offering a reader-friendly narrative review of an otherwise difficult topic. Furthermore, the authors provide a concise premise to deal with some aspects of menisci phylogeny, anatomy and biomechanics.
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Affiliation(s)
- Roberto Simonetta
- Department of Orthopaedic and Traumatology, Villa del Sole Clinic, Catanzaro 88100, Italy
| | - Arcangelo Russo
- Orthopaedic and Traumatology Unit, Umberto I Hospital, Enna 94100, Italy
| | - Michelangelo Palco
- Department of Orthopaedic and Traumatology, Villa del Sole Clinic, Catanzaro 88100, Italy
| | | | - Pier Paolo Mariani
- Department of Orthopaedic and Traumatology, Villa Stuart Sport Clinic-FIFA Medical Centre of Excellence, Roma 00135, Italy
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Khan J, Ashraf RA, Bilal Shabbir HM, Haider A, Saeed S, Rauf Khalid A, Shabbir H, Haider Kazmi SN, Abbas K, Basit J. The Effect of Dexamethasone on Postoperative Pain Management in Patients Undergoing Total Knee Arthroplasty: A Randomized Controlled Trial. Cureus 2023; 15:e37052. [PMID: 37143623 PMCID: PMC10153787 DOI: 10.7759/cureus.37052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2023] [Indexed: 04/05/2023] Open
Abstract
Objective The objective of this study was to evaluate the effectiveness of dexamethasone in treating postoperative pain in patients undergoing total knee arthroplasty (TKA). Methodology This randomized controlled trial (RCT) was completed over the course of two years (September 7, 2015, to September 6, 2017). In the course of their treatment for osteoarthritis of the knee, all of the patients who had primary unilateral total knee replacement (TKR) participated in the research. Under spinal anesthesia, each patient had medial para-patellar approach medial orthopedic surgery. Patients were assigned to group A or group B based on a random selection. Each of the groups consisted of 79 individuals. Group A was given dexamethasone through intravenous administration at a dose of 0.1 mg/kg before the operation. During the subsequent period of 24 hours, no more treatment was administered (control group). On a predesigned questionnaire, postoperative pain was measured using the visual analog scale (VAS) for pain. Functional results, duration of hospital stay, and complications were all recorded on the questionnaire (VAS). Analysis of data was carried out using the Statistical Package for the Social Sciences (SPSS) version 23 (IBM SPSS Statistics, Armonk, NY, USA). Results There were 158 patients in total in the study, out of which 98 were females and 60 were males in the group. The patients' average body mass index (BMI) was 26.94 ± 3.14 kg/m2. Patients in group A had lower postoperative analgesic and antiemetic needs and higher VAS scores and spent less time in the hospital than patients in group B. There were no postoperative problems in either group. Conclusion In patients undergoing TKA, the use of dexamethasone during and after surgery decreases pain, the need for analgesics, and the duration of hospital stay.
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Kwak SG, Kwon JB, Seo YW, Choi WK. The effectiveness of acupuncture as an adjunctive therapy to oral pharmacological medication in patient with knee osteoarthritis: A systematic review and meta-analysis. Medicine (Baltimore) 2023; 102:e33262. [PMID: 36930121 PMCID: PMC10019238 DOI: 10.1097/md.0000000000033262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 02/14/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND We aimed to find out whether the combined treatment of acupuncture and oral medication is more effective than sole oral medication in reducing pain and improving knee function at the end of treatment and after short-term period (4-6 weeks after treatment). Second, if it is effective, we investigated whether the effect surpasses the minimal clinically important difference. METHODS Articles published between January 1, 1992, and August 31, 2022, were searched in PubMed, Cochrane, and Embase. The PICO (population, intervention, comparison, and outcome) of this study are as follows: Population: knee osteoarthritis patients; Intervention: acupuncture (non-sham acupuncture) + oral medication (analgesic or non-steroidal anti-inflammatory drugs); Comparison: oral medication (analgesic or non-steroidal anti-inflammatory drugs); Outcome: visual analog scale (VAS) or Western Ontario and McMaster University (WOMAC) osteoarthritis index. RESULTS The combined treatment of oral medication and adjuvant acupuncture showed statistically significant improvement in VAS and WOMAC scores at the end of acupuncture treatment and short-term follow-up time (between 4 and 6 weeks after acupuncture). In addition, the degree of improvement of VAS and WOMAC index showed effects beyond minimal clinically important differences compared to pretreatment at both the end of acupuncture treatment and the short-term follow-up of acupuncture treatment. CONCLUSION The existing evidence suggests that adjuvant acupuncture may play a role in the treatment of knee osteoarthritis. However, physicians should be aware of adverse effects such as hematoma in adjuvant acupuncture treatment.
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Affiliation(s)
- Sang Gyu Kwak
- Department of Medical Statistics, College of Medicine, Daegu Catholic University, Daegu, Korea
| | - Jae Bum Kwon
- Department of Orthopaedic Surgery, College of Medicine, Daegu Catholic University, Daegu, Korea
| | - Young Woo Seo
- Department of Emergency medicine, College of Medicine, Daegu Catholic University, Daegu, Korea
| | - Won-Kee Choi
- Department of Orthopaedic Surgery, College of Medicine, Daegu Catholic University, Daegu, Korea
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Lan T, Zheng Y, Suo Y, Wei Y, Shi H, Yan Q, Zhuang Z, Chen H, Zhang Q, Fan N, Zhao Y, Ouyang Z, Lai C, Liu Z, Zhou J, Tang C, Kim NH, Zou Q, Wang X. Generation of pigs with humanized type II collagen by precise human COL2A1 gene knock-in. J Genet Genomics 2023; 50:212-215. [PMID: 35598861 DOI: 10.1016/j.jgg.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 04/30/2022] [Accepted: 05/03/2022] [Indexed: 12/21/2022]
Affiliation(s)
- Ting Lan
- Guangdong Provincial Key Laboratory of Large Animal Models for Biomedicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Wuyi University, Jiangmen, Guangdong 529020, China; University of Chinese Academy of Sciences, Beijing 100049, China; CAS Key Laboratory of Regenerative Biology, Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, South China Institute for Stem Cell Biology and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, Guangdong 510530, China
| | - Yuling Zheng
- Guangdong Provincial Key Laboratory of Large Animal Models for Biomedicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Wuyi University, Jiangmen, Guangdong 529020, China
| | - Yangyang Suo
- Joint School of Life Science, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou Medical University, Guangzhou, Guangdong 510530, China
| | - Yuhui Wei
- Guangdong Provincial Key Laboratory of Large Animal Models for Biomedicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Wuyi University, Jiangmen, Guangdong 529020, China; CAS Key Laboratory of Regenerative Biology, Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, South China Institute for Stem Cell Biology and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, Guangdong 510530, China
| | - Hui Shi
- Guangdong Provincial Key Laboratory of Large Animal Models for Biomedicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Wuyi University, Jiangmen, Guangdong 529020, China; CAS Key Laboratory of Regenerative Biology, Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, South China Institute for Stem Cell Biology and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, Guangdong 510530, China
| | - Quanmei Yan
- Guangdong Provincial Key Laboratory of Large Animal Models for Biomedicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Wuyi University, Jiangmen, Guangdong 529020, China; CAS Key Laboratory of Regenerative Biology, Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, South China Institute for Stem Cell Biology and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, Guangdong 510530, China
| | - Zhenpeng Zhuang
- Guangdong Provincial Key Laboratory of Large Animal Models for Biomedicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Wuyi University, Jiangmen, Guangdong 529020, China; CAS Key Laboratory of Regenerative Biology, Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, South China Institute for Stem Cell Biology and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, Guangdong 510530, China
| | - Huangyao Chen
- Guangdong Provincial Key Laboratory of Large Animal Models for Biomedicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Wuyi University, Jiangmen, Guangdong 529020, China; CAS Key Laboratory of Regenerative Biology, Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, South China Institute for Stem Cell Biology and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, Guangdong 510530, China
| | - Quanjun Zhang
- Guangdong Provincial Key Laboratory of Large Animal Models for Biomedicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Wuyi University, Jiangmen, Guangdong 529020, China; CAS Key Laboratory of Regenerative Biology, Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, South China Institute for Stem Cell Biology and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, Guangdong 510530, China
| | - Nana Fan
- Guangdong Provincial Key Laboratory of Large Animal Models for Biomedicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Wuyi University, Jiangmen, Guangdong 529020, China; CAS Key Laboratory of Regenerative Biology, Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, South China Institute for Stem Cell Biology and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, Guangdong 510530, China
| | - Yu Zhao
- Guangdong Provincial Key Laboratory of Large Animal Models for Biomedicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Wuyi University, Jiangmen, Guangdong 529020, China; CAS Key Laboratory of Regenerative Biology, Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, South China Institute for Stem Cell Biology and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, Guangdong 510530, China
| | - Zhen Ouyang
- Guangdong Provincial Key Laboratory of Large Animal Models for Biomedicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Wuyi University, Jiangmen, Guangdong 529020, China; CAS Key Laboratory of Regenerative Biology, Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, South China Institute for Stem Cell Biology and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, Guangdong 510530, China
| | - Chengdan Lai
- Guangdong Provincial Key Laboratory of Large Animal Models for Biomedicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Wuyi University, Jiangmen, Guangdong 529020, China; CAS Key Laboratory of Regenerative Biology, Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, South China Institute for Stem Cell Biology and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, Guangdong 510530, China
| | - Zhaoming Liu
- Guangdong Provincial Key Laboratory of Large Animal Models for Biomedicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Wuyi University, Jiangmen, Guangdong 529020, China; CAS Key Laboratory of Regenerative Biology, Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, South China Institute for Stem Cell Biology and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, Guangdong 510530, China
| | - Jizeng Zhou
- The School of Biomedical and Pharmaceutical Sciences, Guangdong University of Technology, Guangzhou, Guangdong 510006, China
| | - Chengcheng Tang
- Guangdong Provincial Key Laboratory of Large Animal Models for Biomedicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Wuyi University, Jiangmen, Guangdong 529020, China
| | - Nam-Hyung Kim
- Guangdong Provincial Key Laboratory of Large Animal Models for Biomedicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Wuyi University, Jiangmen, Guangdong 529020, China
| | - Qingjian Zou
- Guangdong Provincial Key Laboratory of Large Animal Models for Biomedicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Wuyi University, Jiangmen, Guangdong 529020, China.
| | - Xiaomin Wang
- CAS Key Laboratory of Regenerative Biology, Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, South China Institute for Stem Cell Biology and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, Guangdong 510530, China; School of Life Sciences, Westlake University, Hangzhou, Zhejiang 310024, China; Institute of Biology, Westlake Institute for Advanced Study, Hangzhou, Zhejiang 310024, China.
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Bonnin M, Müller-Fouarge F, Estienne T, Bekadar S, Pouchy C, Ait Si Selmi T. Artificial Intelligence Radiographic Analysis Tool for Total Knee Arthroplasty. J Arthroplasty 2023:S0883-5403(23)00184-5. [PMID: 36858127 DOI: 10.1016/j.arth.2023.02.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 02/15/2023] [Accepted: 02/17/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND The postoperative follow-up of a patient after total knee arthroplasty (TKA) requires regular evaluation of the condition of the knee through interpretation of X-rays. This rigorous analysis requires expertize, time, and methodical standardization. Our work evaluated the use of an artificial intelligence tool, X-TKA, to assist surgeons in their interpretation. METHODS A series of 12 convolutional neural networks were trained on a large database containing 39,751 X-ray images. These algorithms are able to determine examination quality, identify image characteristics, assess prosthesis sizing and positioning, measure knee-prosthesis alignment angles, and detect anomalies in the bone-cement-implant complex. The individual interpretations of a pool of senior surgeons with and without the assistance of X-TKA were evaluated on a reference dataset built in consensus by senior surgeons. RESULTS The algorithms obtained a mean area under the curve value of 0.98 on the quality assurance and the image characteristics tasks. They reached a mean difference for the predicted angles of 1.71° (standard deviation, 1.53°), similar to the surgeon average difference of 1.69° (standard deviation, 1.52°). The comparative analysis showed that the assistance of X-TKA allowed surgeons to gain 5% in accuracy and 12% in sensitivity in the detection of interface anomalies. Moreover, this study demonstrated a gain in repeatability for each single surgeon (Light's kappa +0.17), as well as a gain in the reproducibility between surgeons (Light's kappa +0.1). CONCLUSION This study highlights the benefit of using an intelligent artificial tool for a standardized interpretation of postoperative knee X-rays and indicates the potential for its use in clinical practice.
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Zhang X, Xue T, Hou D, Lu C. The efficacy and safety of hydrotherapy in patients with knee osteoarthritis: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2023; 102:e33027. [PMID: 36827039 PMCID: PMC11309594 DOI: 10.1097/md.0000000000033027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 01/30/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND Knee osteoarthritis (OA) is a common clinical degenerative disease of the joints, which is prone to occur in middle-aged and elderly people. At present, the disease cannot be cured, it is mostly treated with drugs to relieve symptoms, improve joint function, protect cartilage, such as glucosamine, anti-inflammatory and analgesic drugs, and but the efficacy is not lasting and the recurrence rate is high. Hydrotherapy has become a long-term alternative therapy in China and is receiving increasing attention. We perform a protocol for systematic review and meta-analysis to determine the efficacy and safety of a hydrotherapy program in individuals living with knee OA. METHODS This protocol will be designed in accordance with the preferred reporting items for systematic reviews and meta-analysis protocols. It is registered on the international prospective register of systematic reviews (No. CRD42022365564). We will search the following databases: The Cochrane Skin Group Trials Register, MEDLINE, EMBASE, The Cochrane central register of controlled trials, Chinese biomedical literature database, Chinese medical current content and China national knowledge infrastructure. The risk of bias of the included studies will be appraised using the Cochrane collaboration tool. Statistical analysis will be performed using IBM SPSS Statistics (Armonk, NY). RESULTS This systematic review will summarize the short- and long-term clinical outcomes of hydrotherapy for knee OA. CONCLUSION The findings from this review will establish the quality of currently available evidence, which will determine the need for further studies to establish the true effect size of hydrotherapy in knee OA.
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Affiliation(s)
- Xu Zhang
- Department of Orthopedics, The First People’s Hospital of Chuzhou, Anhui, China
| | - Tianle Xue
- Department of Orthopedics, The First People’s Hospital of Chuzhou, Anhui, China
| | - Desheng Hou
- Department of Orthopedics, The First People’s Hospital of Chuzhou, Anhui, China
| | - Cheng Lu
- Department of Orthopedics, The First People’s Hospital of Chuzhou, Anhui, China
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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] [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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Effects of 24 Weeks of a Supervised Walk Training on Knee Muscle Strength and Quality of Life in Older Female Total Knee Arthroplasty: A Retrospective Cohort Study. Healthcare (Basel) 2023; 11:healthcare11030356. [PMID: 36766931 PMCID: PMC9914605 DOI: 10.3390/healthcare11030356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/16/2023] [Accepted: 01/22/2023] [Indexed: 01/28/2023] Open
Abstract
Poor supervision, impaired exercise adherence, and low compliance with exercise regimens result in inconsistent effects regarding exercise interventions. A supervised-walk training regimen (9 km/week) may have a positive effect on functional recovery in female total knee arthroplasty (TKA). This study aimed to evaluate the effect of a supervised walking regimen on lower limb muscle strength, functional fitness, and patient-reported outcomes in female TKA. Twenty-eight female TKA were allocated into a control (CON) (n = 14) or walk training (WT) (n = 14) group. WT on treadmills was initiated 12 weeks after TKA. All patients were examined for lower muscle strength (including extension and flexion of hip and knee), physical function (including a 6-min walk test, 8-foot up-and-go test, and 30-s chair stand test), and Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire. Knee flexor (WT: CON; 64.4 ± 4.1 nm/kg: 43.7±3.3 nm/kg; p = 0.001; effect size: 5.62) and extensor strengths (WT: CON; 73.1 ± 7.5 nm/kg: 48.2 ± 2.4 nm/kg; p = 0.001; effect size: 4.47) statistically increased in the WT group compared to the CON group. The 6-min walk test (from 341.3 ± 20.5 m to 405.5 ± 30.7 m; p = 0.001; effect size: 2.46) and 8-foot up-and-go test (from 9.5 ± 0.7 s to 8.3 ± 0.7 s; p = 0.002; effect size: 1.71) tests also showed significant improvements in the WT group in the follow-up compared to the baseline. An increase in quality of life score according to the KOOS questionnaire (WT: CON; 91.0 ± 2.8: 68.1 ± 5.8; p = 0.001; effect size: 5.02) was noted in the WT group compared to the CON group in the follow-up. WT facilitated improvements in knee muscle strength and functional outcomes in TKA patients.
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Hemp Seed Oil in Association with β-Caryophyllene, Myrcene and Ginger Extract as a Nutraceutical Integration in Knee Osteoarthritis: A Double-Blind Prospective Case-Control Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59020191. [PMID: 36837393 PMCID: PMC9960141 DOI: 10.3390/medicina59020191] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/11/2023] [Accepted: 01/15/2023] [Indexed: 01/19/2023]
Abstract
Background and Objectives: Nutraceuticals are gaining more and more importance as a knee osteoarthritis (KOA) complementary treatment. Among nutraceuticals, hemp seed oil and terpenes are proving to be very useful as therapeutic support for many chronic diseases, but there are still few studies regarding their effectiveness for treating KOA, both in combination and separately. The aim of this study is thus to compare the effect of two dietary supplements, both containing hemp seed oil, but of which only one also contains terpenes, in relieving pain and improving joint function in patients suffering from KOA. Materials and Methods: Thirty-eight patients were recruited and divided into two groups. The control group underwent a 45 day treatment with a hemp seed oil-based dietary supplement, while the treatment group assumed a hemp seed oil and terpenes dietary supplement for the same period. Patients were evaluated at the enrollment (T0) and at the end of treatment (T1). Outcome measures were: Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), Short-Form-12 (SF-12), Knee Injury Osteoarthritis Outcome Score (KOOS), and Oxford Knee Score (OKS). Results: All outcome measures improved at T1 in both groups, but NRS, KOOS and OKS had a greater significant improvement in the treatment group only. Conclusions: Hemp seed oil and terpenes resulted a more effective integrative treatment option in KOA, improving joint pain and function and representing a good complementary option for patients suffering from osteoarthritis.
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Cui Y, Lin L, Wang Z, Wang K, Xiao L, Lin W, Zhang Y. Research trends of platelet-rich plasma therapy on knee osteoarthritis from 2011 to 2021: A review. Medicine (Baltimore) 2023; 102:e32434. [PMID: 36637944 PMCID: PMC9839303 DOI: 10.1097/md.0000000000032434] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Platelet-rich plasma (PRP) has been widely used to alleviate osteoarthritis of the knee, and research results are abundant. However, there are no bibliometric reports in publications in this field. Therefore, the current status of PRP for the treatment of osteoarthritis of the knee from 2011 to 2021 was analyzed using Citespace 6.1.R2 software. METHODS Publications regarding PRP treating Knee Osteoarthritis between 2011 and 2021 were extracted from the Web of Science database. CiteSpace was used to analyze the number of publications, countries, institutions, journals, authors, cited references, and keywords by using standard bibliometric indicators. RESULTS A total of 988 publications were searched from 2011 to 2021. In the last decade, the number of publications has increased in the field. Brian J. Cole was the author with the most output, with 31 relevant articles, and Giuseppe Filardo ranked first in cited authors. Am J Sport Med was the most cited journal. In this field, the most prolific country is the United States and the most prolific institution is Rush University. An article published by Sandeep Patel ranked first in cited references with 118 citations. "Randomized controlled trial" was the most bursting keyword and other more popular keywords about PRP for knee osteoarthritis: "hyaluronic acid," "double-blind," and "mesenchymal stem cell." CONCLUSION This bibliometric study provides a decade of current clinical research on PRP for the treatment of osteoarthritis of the knee, which can help researchers understand the hot spots in the field and provide a new direction for their research.
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Affiliation(s)
- Yubo Cui
- Department of Orthopedics, Fuzhou Second Hospital Affiliated to Xiamen University, Fuzhou, Fujian, China
- The Second Clinical Medical College of Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Liqiong Lin
- Department of Orthopedics, Fuzhou Second Hospital Affiliated to Xiamen University, Fuzhou, Fujian, China
| | - Zhiwei Wang
- Medical College of Xiamen University, Xiamen, Fujian, China
| | - Kai Wang
- Department of Orthopedics, Fuzhou Second Hospital Affiliated to Xiamen University, Fuzhou, Fujian, China
- The Second Clinical Medical College of Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Lili Xiao
- Department of Orthopedics, Fuzhou Second Hospital Affiliated to Xiamen University, Fuzhou, Fujian, China
| | - Wentao Lin
- Department of Orthopedics, Fuzhou Second Hospital Affiliated to Xiamen University, Fuzhou, Fujian, China
| | - Yiyuan Zhang
- Department of Orthopedics, Fuzhou Second Hospital Affiliated to Xiamen University, Fuzhou, Fujian, China
- * Correspondence: Yiyuan Zhang, Department of Orthopedics, Fuzhou Second Hospital Affiliated to Xiamen University, Fuzhou, Fujian 350007, China (e-mail: )
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Khokhar NS, DePalma MJ. Joints. Regen Med 2023. [DOI: 10.1007/978-3-030-75517-1_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Ramezanpour S, Kanthawang T, Lynch J, McCulloch CE, Nevitt MC, Link TM, Joseph GB. Impact of Sustained Synovitis on Knee Joint Structural Degeneration: 4-Year MRI Data from the Osteoarthritis Initiative. J Magn Reson Imaging 2023; 57:153-164. [PMID: 35561016 PMCID: PMC9653513 DOI: 10.1002/jmri.28223] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 04/20/2022] [Accepted: 04/21/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Synovial inflammation is a risk factor for osteoarthritis (OA). But to date, there is limited information on how inflammation impacts progression of knee OA. PURPOSE To investigate how sustained synovitis, assessed with semi-quantitative magnetic resonance imaging (MRI) scores, impacts progression of knee degenerative changes over 4 years. STUDY TYPE Retrospective cohort study. SUBJECTS In 249 participants (N = 132 women [53%]), from the Osteoarthritis Initiative (OAI) two definitions for synovitis were used resulting in two groups of participants with sustained synovitis at baseline, 2-year, and 4-year follow-up (N = 80 and N = 132), and two groups without synovitis at all three time points (N = 81 and N = 47). FIELD STRENGTH/SEQUENCE 3 T intermediate-weighted (IW) turbo spin-echo (TSE) sequence and three-dimensional (3D) dual-echo steady-state (DESS) sequence. ASSESSMENT Synovitis was scored semi-quantitatively using the Anterior Cruciate Ligament Osteoarthritis Score (ACLOAS), MRI Osteoarthritis Knee Score (MOAKS), and synovial proliferation score (SPS). Two MRI-based definitions of synovitis were used: (i) score ≥2 based on cumulative score of MOAKS and ACLOAS, and (ii) score ≥3 based on the cumulative score of ACLOAS, MOAKS, and SPS. Changes in structural abnormalities from baseline to year 4 measured using the whole-organ MRI score (WORMS) were defined as outcomes. STATISTICAL TESTS Linear regression models were used to compare the differences in longitudinal changes in WORMS scores between participants with and without sustained synovitis for each definition of sustained synovitis. A P-value of <0.05 was considered statistically significant. RESULTS Significantly higher rates of progression were found in participants with synovitis for patellar (Beta coeff. = 0.29) and medial tibial cartilage abnormalities (Beta coeff. = 0.29) for definition (i). For definition (ii), patellar (Beta coeff. = 0.36) and medial femoral cartilage (Beta coeff. = 0.30) abnormalities demonstrated significant differences. DATA CONCLUSION Greater progression of structural degenerative disease was observed in individuals with sustained synovitis compared to those without sustained synovitis, suggesting that sustained synovitis is associated with progressive OA. LEVEL OF EVIDENCE 3 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Sara Ramezanpour
- Department of Radiology and Biomedical Imaging, University of California, San Francisco
| | - Thanat Kanthawang
- Department of Radiology and Biomedical Imaging, University of California, San Francisco
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Thailand
| | - John Lynch
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Charles E. McCulloch
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Michael C. Nevitt
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Thomas M. Link
- Department of Radiology and Biomedical Imaging, University of California, San Francisco
| | - Gabby B. Joseph
- Department of Radiology and Biomedical Imaging, University of California, San Francisco
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Carozzo S, Vatrano M, Coschignano F, Battaglia R, Calabrò RS, Pignolo L, Contrada M, Tonin P, Cerasa A, Demeco A. Efficacy of Visual Feedback Training for Motor Recovery in Post-Operative Subjects with Knee Replacement: A Randomized Controlled Trial. J Clin Med 2022; 11:jcm11247355. [PMID: 36555971 PMCID: PMC9783629 DOI: 10.3390/jcm11247355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 11/21/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
To evaluate the effects of visual feedback training on motor recovery in postoperative patients with a total knee replacement (TKR). The performance of 40 first-ever TKR patients (27 females; mean age: 70.5 (67.2−74.0) years) was evaluated in a single center, single-blind, randomized controlled study. The patients were randomly and equally distributed into two demographically/clinically matched groups undergoing experimental or traditional treatments. All patients have been treated in a 1 h session, 2/day for 5 days a week, for six consecutive weeks. The first group (“control”) underwent conventional physical therapy, whereas the experimental group received advanced knee training with visual feedback using the TecnoBody® device (Walker View 3.0 SCX, Dalmine (BG), Italy). The clinical scales and kinematic parameters coming from the gait analysis were evaluated to demonstrate the dynamic balance function in a standing position before and after each treatment. After the treatment, both experimental and control groups improved significantly and similarly, as measured by the clinical scales (Numeric Rating Scale for Pain and Barthel index). A significant boosting of the motor performance was detected in the experimental group with respect to the control group in the terms of symmetry index 84 (80.8−85.4) vs. 87.15 (84−92.8) p = 0.001 *; single stance support 34.9 (34.1−36.5) vs. 37.8 (36.6−38.9); p < 0.001; and obliquity parameters 58.65 (51.3−70.3) vs. 73 (62.3−82.1); p < 0.001. Applying visual feedback training in addition to traditional rehabilitation strategies improves the knee function and motor control in postoperative TKR patients.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Antonio Cerasa
- S’Anna Institute, 88900 Crotone, Italy
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy, 98164 Messina, Italy
- Pharmacotechnology Documentation and Transfer Unit, Preclinical and Translational Pharmacology, Department of Pharmacy, Health Science and Nutrition, University of Calabria, 87036 Rende, Italy
- Correspondence: (A.C.); (A.D.)
| | - Andrea Demeco
- S’Anna Institute, 88900 Crotone, Italy
- Correspondence: (A.C.); (A.D.)
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Pamuk Ç. Comparison of Intra-articular Hyaluronic Acid and Platelet-Rich Plasma Injection in Knee Osteoarthritis: Do the Results Differ in Geriatric Patients? A Retrospective Observational Study. Ann Geriatr Med Res 2022; 26:340-346. [PMID: 36518061 PMCID: PMC9830060 DOI: 10.4235/agmr.22.0090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 09/15/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The intra-articular application of platelet-rich plasma and hyaluronic acid have gained popularity as treatment options for knee osteoarthritis. Although intra-articular platelet-rich plasma injections have been suggested to be superior to hyaluronic acid injections in the general population of patients with osteoarthritis, the effect of older age on both treatment options has not been thoroughly evaluated. Therefore, this study compared the results of platelet-rich plasma and hyaluronic acid injections in geriatric patients with knee osteoarthritis. METHODS This study evaluated a total of 226 patients treated with intra-articular injections for knee osteoarthritis. The patients were divided into two groups: those who received platelet-rich plasma and those who received hyaluronic acid. All patients attended follow-up appointments at the 1st, 3rd, and 6th months. RESULTS After applying the exclusion criteria, this study included 202 patients. The clinical results revealed significant improvements in all parameters compared to the baseline assessments in both groups (p<0.05). The inter-group comparisons indicated significantly lower pain in the hyaluronic acid recipients at the first and third months compared to those in patients receiving platelet-rich plasma (p<0.05). CONCLUSION Intra-articular platelet-rich plasma and hyaluronic acid injections appear to be effective in patients with knee osteoarthritis. In the geriatric patient population, hyaluronic acid showed superior effects on pain compared to platelet-rich plasma, contrary to the results in the general population.
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Affiliation(s)
- Çağdaş Pamuk
- Department of Orthopedics and Traumatology, Private Silivri Anadolu Hospital, İstanbul, Turkey,Corresponding Author Çağdaş Pamuk, MD Department of Orthopedics and Traumatology, Private Silivri Anadolu Hosptial, Mimarsinan Mah. Mimarsinan Sok. No:72, Istanbul, Turkey E-mail:
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Muacevic A, Adler JR. What Does Postponement of Non-urgent Orthopedic Surgeries During the COVID-19 Pandemic Mean for Patients With Gonarthrosis in Turkey? A Qualitative Study. Cureus 2022; 14:e32448. [PMID: 36644090 PMCID: PMC9833837 DOI: 10.7759/cureus.32448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2022] [Indexed: 12/14/2022] Open
Abstract
Objective During the COVID-19 pandemic, the surgical treatment of orthopedic diseases for elective surgical planning was suspended. This study aimed to evaluate patients' experiences with gonarthrosis regarding the postponement of non-urgent orthopedic surgeries during the COVID-19 pandemic. Materials and Methods This phenomenological qualitative study was carried out with patients diagnosed with grade 3 or 4 gonarthrosis in the orthopedics and traumatology outpatient clinic of a hospital in western Turkey between February 2021 and March 2021. Interviews with patients were conducted face-to-face using the semi-structured interview guide focusing on patients' feelings, thoughts, and experiences. Each participant was interviewed once. Data collection was halted based on the saturation of data. Data from semi-structured interviews with patients were analyzed using Colaizzi's content analysis method. Results The analysis of the study data yielded three themes: "lack of knowledge", "desperation" and "lack of opportunity to cure the gonarthrosis disease". Four sub-themes were identified under these three categories. While "not knowing what to do" and "unconscious drug use" were the sub-themes of the theme of lack of knowledge, "hopelessness" and "economic difficulties" were the sub-themes of the theme of desperation. Conclusion It was determined that patients were helpless due to difficulties accessing health services for other diseases during the COVID-19 pandemic. They experienced severe fear because it was unclear how long this process would continue.
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