The impact of a high tibial valgus osteotomy and unicondylar medial arthroplasty on the treatment for knee osteoarthritis: a meta-analysis

2011 ◽  
Vol 21 (1) ◽  
pp. 96-112 ◽  
Author(s):  
Gunter Spahn ◽  
Gunther O. Hofmann ◽  
Lars Victor von Engelhardt ◽  
Mengxia Li ◽  
Henning Neubauer ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Meta Analysis ◽  
Valgus Osteotomy ◽  
High Tibial Valgus Osteotomy ◽  
The Impact ◽  
Tibial Valgus

Survivorship of the High Tibial Valgus Osteotomy A 10-to 22-Year Followup Study

1999 ◽  
Vol 367 ◽  
pp. 18???27 ◽  
Author(s):  
Douglas Naudie ◽  
Robert B. Bourne ◽  
Cecil H. Rorabeck ◽  
Timothy J. Bourne
Keyword(s):  
Valgus Osteotomy ◽  
High Tibial Valgus Osteotomy ◽  
Tibial Valgus

scholarly journals The Long-Lasting Effects of “Placebo Injections” in Knee Osteoarthritis: A Meta-Analysis

Cartilage ◽  
2020 ◽  
pp. 194760352090659 ◽  
Author(s):  
Davide Previtali ◽  
Giulia Merli ◽  
Giorgio Di Laura Frattura ◽  
Christian Candrian ◽  
Stefano Zaffagnini ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Randomized Controlled Trials ◽  
Placebo Effect ◽  
Meta Analysis ◽  
Grey Literature ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Level Of Evidence ◽  
Randomized Controlled ◽  
The Impact

Objectives To quantify the placebo effect of intraarticular injections for knee osteoarthritis in terms of pain, function, and objective outcomes. Factors influencing placebo effect were investigated. Design Meta-analysis of randomized controlled trials; Level of evidence, 2. PubMed, Web of Science, Cochrane Library, and grey literature databases were searched on January 8, 2020, using the string: (knee) AND (osteoarthritis OR OA) AND (injections OR intra-articular) AND (saline OR placebo). The following inclusion criteria were used: double-blind, randomized controlled trials on knee osteoarthritis, including a placebo arm on saline injections. The primary outcome was pain variation. Risk of bias was assessed using the RoB 2.0 tool, and quality of evidence was graded following the GRADE (Grading of Recommendations Assessment, Development and Evaluation) guidelines. Results Out of 2,363 records, 50 articles on 4,076 patients were included. The meta-analysis showed significant improvements up to the 6-month follow-up: Visual Analogue Scale (VAS)-pain −13.4 mean difference (MD) (95% confidence interval [CI]: −21.7/−5.1; P < 0.001), Western Ontario and McMaster Osteoarthritis Index (WOMAC)-pain −3.3 MD (95% CI: −3.9/−2.7; P < 0.001). Other significant improvements were WOMAC-stiffness −1.1 MD (95% CI: −1.6/−0.6; P < 0.001), WOMAC-function −10.1 MD (95% CI: −12.2/−8.0; P < 0.001), and Evaluator Global Assessment −21.4 MD (95% CI: −29.2/−13.6; P < 0.001). The responder rate was 52% (95% CI: 40% to 63%). Improvements were greater than the “minimal clinically important difference” for all outcomes (except 6-month VAS-pain). The level of evidence was moderate for almost all outcomes. Conclusions The placebo effect of knee injections is significant, with functional improvements lasting even longer than those reported for pain perception. The high, long-lasting, and heterogeneous effects on the scales commonly used in clinical trials further highlight that the impact of placebo should not be overlooked in the research on and management of knee osteoarthritis.

scholarly journals Is Culture Expansion Necessary in Autologous Mesenchymal Stromal Cell Therapy to Obtain Superior Results in the Management of Knee Osteoarthritis?—Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 8 (12) ◽  
pp. 220
Author(s):  
Sathish Muthu ◽  
Randhi Rama Kartheek ◽  
Naveen Jeyaraman ◽  
Ramya Lakshmi Rajendran ◽  
Manish Khanna ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Group Analysis ◽  
Cochrane Library ◽  
Osteoarthritis Of The Knee ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
The Impact

Study Design: Meta-analysis. Objectives: We aimed to analyze the impact of cultured expansion of autologous mesenchymal stromal cells (MSCs) in the management of osteoarthritis of the knee from randomized controlled trials (RCTs) available in the literature. Materials and Methods: We conducted independent and duplicate electronic database searches including PubMed, Embase, Web of Science, and Cochrane Library until August 2021 for RCTs analyzing the efficacy and safety of culture-expanded compared to non-cultured autologous MSCs in the management of knee osteoarthritis. The Visual Analog Score (VAS) for pain, Western Ontario McMaster University’s Osteoarthritis Index (WOMAC), Lysholm score, Knee Osteoarthritis Outcome Score (KOOS), and adverse events were the analyzed outcomes. Analysis was performed in R-platform using OpenMeta [Analyst] software. Results: Overall, 17 studies involving 767 patients were included for analysis. None of the studies made a direct comparison of the culture expanded and non-cultured MSCs, hence we pooled the results of all the included studies of non-cultured and cultured types of MSC sources and made a comparative analysis of the outcomes. At six months, culture expanded MSCs showed significantly better improvement (p < 0.001) in VAS outcome. Uncultured MSCs, on the other hand, demonstrated significant VAS improvement in the long term (12 months) in VAS (p < 0.001), WOMAC (p = 0.025), KOOS score (p = 0.016) where cultured-expanded MSCs failed to demonstrate a significant change. Culturing of MSCs did not significantly increase the complications noted (p = 0.485). On sub-group analysis, adipose-derived uncultured MSCs outperformed culture-expanded MSCs at both short term (six months) and long term (12 months) in functional outcome parameters such as WOMAC (p < 0.001, p = 0.025), Lysholm (p < 0.006), and KOOS (p < 0.003) scores, respectively, compared to their controls. Conclusions: We identified a void in literature evaluating the impact of culture expansion of MSCs for use in knee osteoarthritis. Our indirect analysis of literature showed that culture expansion of autologous MSCs is not a necessary factor to obtain superior results in the management of knee osteoarthritis. Moreover, while using uncultured autologous MSCs, we recommend MSCs of adipose origin to obtain superior functional outcomes. However, we urge future trials of sufficient quality to validate our findings to arrive at a consensus on the need for culture expansion of MSCs for use in cellular therapy of knee osteoarthritis.

scholarly journals Long term evaluation of high tibial valgus osteotomy

1990 ◽  
Vol 14 (4) ◽  
Author(s):  
J.R. Valenti ◽  
R. Calvo ◽  
R. Lopez ◽  
J. Ca�adell
Keyword(s):  
Valgus Osteotomy ◽  
Term Evaluation ◽  
High Tibial Valgus Osteotomy ◽  
Tibial Valgus

Fifteen to twenty-eight years' follow-up results of high tibial valgus osteotomy for osteoarthritic knee

The Knee ◽  
2004 ◽  
Vol 11 (6) ◽  
pp. 439-444 ◽  
Author(s):  
Tomihisa Koshino ◽  
Takuji Yoshida ◽  
Yuki Ara ◽  
Izumi Saito ◽  
Tomoyuki Saito
Keyword(s):  
Valgus Osteotomy ◽  
Osteoarthritic Knee ◽  
High Tibial Valgus Osteotomy ◽  
Tibial Valgus

scholarly journals Valgus Knee Braces May Have No Long-term Effect on Pain Improvement and Functional Activity in Patients With Knee Osteoarthritis: A Meta-analysis of Randomized Trials

2020 ◽  
Author(s):  
Yinuo Fan ◽  
zhongfeng Li ◽  
Haitao Zhang ◽  
Guoju Hong ◽  
Zhongshu Wu ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Pain Score ◽  
Functional Activity ◽  
Meta Analysis ◽  
Specific Effect ◽  
Current Evidence ◽  
Valgus Knee ◽  
Knee Braces ◽  
The Impact

Abstract Background:KOA as a high incidence of old age seriously affects the quality of life of the elderly. The valgus knee bracesareaimportantphysical therapy for KOA, but its specific effect is not clear.This meta-analysisis to systematically evaluate the effectiveness of valgus knee braces on pain and function improvement in patients with knee osteoarthritis (KOA).Methods :A meta-analysis of clinical randomized controlled trials(RCTs) on pain and functional changes in patients with KOA after using valgus knee braces. The search period is from the self-built database to May 2020, and the search range is PubMed, Embase, and Web of Science databases. First, two authors independently screened the literature, formulated inclusion criteria and exclusion criteria, and determined the included literature. The researchers then extracted the interventions and outcome indicators of included literature, and assessed the risk of bias through Cochrane Handbook 5.0.1. Finally, Revman5.3 was used for data analysis.Results :A total of 10 articles were included in this study, including 739 patients. 8 articles related to the Visual Analogue Scale (VAS) pain score, the results showed that RR = -0.29, 95% CI [-0.73, 0.15], P = 0.20; There were 4 articles on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) function score, the results showed that RR = -0.15, 95% CI [-0.41,0.11], P = 0.26; Two articles related to the impact of Knee Injury and Osteoarthritis Outcome Score (KOOS) score, the results showed that RR = 0.58, 95% CI [-4.25, 5.42], P = 0.81; 3articles were related to KOOS activities of daily living (KOOS-ADL) score, the results showed that RR = 0.04, 95% CI [-0.62,0.69], P = 0.91.These results indicated that the valgus knee braces have no statistically significant in pain and functional activity improvement of patients with KOA. The subgroup analysis showed that the follow-up time was the source of the heterogeneity of the VAS pain score. Conclusion :The current evidence suggests that valgus knee braces may not effectively improve pain symptom and functional activity in KOA patients in the long-term, but only benefit KOA patients in the short-term.

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