Physical therapy, intra-articular dextrose prolotherapy, botulinum neurotoxin, and hyaluronic acid for knee osteoarthritis: randomized clinical trial
This study aimed to compare the efficacy of four treatments in the management of knee osteoarthritis. We carried out a randomized clinical trial with four study arms in an outpatient Department of Physical Medicine and Rehabilitation at a University Hospital. In total, 120 patients with knee osteoarthritis ≥50 years of age were randomly allocated to four groups. The primary outcome was knee pain in visual analog scale and the secondary outcome was the Knee Injury and Osteoarthritis Outcome Score. The exercise was prescribed daily for all participants throughout the study. For physical therapy (group 1), participants received superficial heat, transcutaneous electrical nerve stimulation and pulsed ultrasound. We administered a single intra-articular injection of botulinum neurotoxin type A (group 2) and three injections of hyaluronic acid (group 3) or 20% dextrose (group 4) to patients in the corresponding groups. Mixed analysis of variance showed that there was statistically significant difference between the groups in pain (P
Conclusion: It appears that the knee OA pain and disability can be decreased after a dual-frequency LLLT applied to acupoints (SP9, SP10, and EX-LE2). The clinical efficacy of LLLT is highly related to the therapeutic settings of the laser apparatus; hence, more clinical trials with diffident parameter settings are needed to be further clarified. PMID: 33029170 [PubMed]
ConclusionSignificantly improved knee functionality, increased level of physical activity, and reduced pain. MRI analysis revealed the meniscal transplant morphology and volume loss, as well as its extrusion without progression.
This study is designed to evaluate the efficacy of IMPACT compared to nonsurgical care. Additionally, safety of IMPACT will be assessed in 30 to 60 patients. Lastly, this study will evaluate the cost-effectiveness of IMPACT compared to nonsurgical care.Trial registrationNL67161.000.18 [Registry ID: CCMO]2018#003470#27 [EU-CTR; registered on 26 March 2019]NCT04236739 [ClinicalTrials.gov] [registered after start of inclusion; 22 January 2020]
This study aimed to investigate the effect of curcumin
ConclusionsSimilar profiles for pain intensity, signs of sensitization and conditioned pain modulation were observed. Patients with TKA seems to have impaired physical performances compared with the OA group, underlining the importance of targeting physical performances. Only the OA patients showed an association between sensitization (TS) and physical performance.SignificanceQuantitative pain profiling assessment was used to assess pain intensities and pain mechanisms. We observed associations between physical performances and temporal summation in the OA group underlining the importance of assessing motor functions and p...
AbstractPurposeThe management of knee pain secondary to meniscal tears with osteoarthritis is limited by the poor inherent healing potential of the meniscus. Previous studies have reported on the benefit of autologous micro-fragmented fat as a therapeutic for various knee pathologies. The goal of this prospective pilot study was to determine the safety and potential treatment effect of micro-fragmented adipose tissue injection for patients with knee pain secondary to osteoarthritis and meniscal tears who have failed conservative management.MethodsTwenty subjects with knee pain secondary to osteoarthritis with associated me...
DiscussionTo our knowledge, RSA has never been used to access migration of a stemmed or a stemless humeral component nor has the stemmed and the stemless humeral component been compared with regard to pain relief and shoulder function in a randomized clinical trial. Today, the two designs are considered equal in the treatment of osteoarthritis. The study will provide surgeons and patients with information about shoulder arthroplasty for osteoarthritis and assist them in decision-making.Trial registrationClinicalTrials.govNCT04105478. Registered on 25 September 2019
Conclusions: Ultrasonography is an effective, safe, nonradiative, and easily applicable guidance method for RF in pain relief and functional improvement in KOA patients. PMID: 33014212 [PubMed - in process]
In Reply Dr Lei and colleagues correctly state that the positioning of the external pods of the biomechanical footwear in our trial was individually adjusted. The treatment protocol for adjusting the pods was described in detail in Supplement 3 in the article. This is considerably more detail than most physical therapy or exercise intervention trials provide. Adjustments were done according to this protocol by experienced and trained technicians based on gait patterns and patient-reported symptoms. The attempt to shift the center of pressure in the shoe and foot laterally in patients with medial knee osteoarthritis has bee...
To the Editor Dr Reichenbach and colleagues reported that among participants with knee pain from osteoarthritis, use of biomechanical footwear compared with control footwear resulted in an improvement in pain after 24 weeks of follow-up. There are several issues regarding the trial that are worth considering.