Improved WOMAC score following 16-week treatment with bromelain for knee osteoarthritis

2016 ◽  
Vol 35 (10) ◽  
pp. 2531-2540 ◽  
Author(s):  
Thitima Kasemsuk ◽  
Nadhaporn Saengpetch ◽  
Nathawut Sibmooh ◽  
Supeenun Unchern
Keyword(s):  
Knee Osteoarthritis ◽  
Womac Score ◽  
Score Following

Improved WOMAC Score Following Treatment with Nanoparticle Phyllanthus Amarus Phonophoresis Gel for Knee Osteoarthritis

2019 ◽  
Vol 10 (12) ◽  
pp. 1623
Author(s):  
Decha Pinkaew ◽  
Kanokwan Kiattisin ◽  
Khanittha Wonglangka ◽  
Pisittawoot Awoot
Keyword(s):  
Knee Osteoarthritis ◽  
Womac Score ◽  
Phyllanthus Amarus ◽  
Score Following

scholarly journals Short-Term Effect of a New Oral Sodium Hyaluronate Formulation on Knee Osteoarthritis: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial

Diseases ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 26
Author(s):  
Arrigo F. G. Cicero ◽  
Nicolò Girolimetto ◽  
Crescenzio Bentivenga ◽  
Elisa Grandi ◽  
Federica Fogacci ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Knee Osteoarthritis ◽  
Sodium Hyaluronate ◽  
Womac Score ◽  
Term Effect ◽  
Controlled Clinical Trial ◽  
Short Term ◽  
Double Blind ◽  
Oral Supplementation ◽  
Short Term Effect

Objective: the aim of this pilot study was to test the short-term effect of oral supplementation with a sodium hyaluronate with a large spectrum of molecular weights (FS-HA®) on the symptoms and functionality of knee osteoarthritis (OA). Methods: 60 subjects affected by clinical and/or radiological diagnosis of symptomatic knee OA were consecutively enrolled in a randomized, double blind, placebo-controlled, clinical trial. At randomization visit, at day 28 (visit 2), and day 56 (visit 3), the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC), the Lequesne Functional Index (LFI) and the Visual Analogue Scale (VAS) for pain (VAS-p) were administered to the enrolled patients. Then, patients were asked how many times they used rescue medications (non-steroidal antinflammatory drugs–NSAIDs and/or anti-pain drugs) during the previous 4 weeks. Finally, the range of knee joint motion (ROM) was also instrumentally measured. Results: In FS-HA® treated subjects, VAS-p, pain and total WOMAC score, LFI and ROM significantly improved compared to the baseline values (p < 0.05). At 60 days, the VAS-p and the pain WOMAC score were significantly lower after FS-HA® treatment when compared with placebo as well (p < 0.05). The FS-HA® treated subjects significantly reduced the weekly use of NSAIDs and/or antipain drugs when compared to the placebo-treated ones (p < 0.05). Conclusion: the oral supplementation with a FS-HA® characterized by a large spectrum of molecular weight was associated with a short-term improvement in symptomatology and functionality of osteoarthritis-affected knees, and associated with a reduction in the use of NSAIDS and anti-pain drugs.

scholarly journals Repairing effects of glucosamine sulfate in combination with etoricoxib on articular cartilages of patients with knee osteoarthritis

2020 ◽  
Author(s):  
Yong Sun ◽  
Changde Wang ◽  
Chunzhu Gong
Keyword(s):  
Knee Osteoarthritis ◽  
Womac Score ◽  
Effective Rate ◽  
Glucosamine Sulfate ◽  
Inflammatory Factors ◽  
Chondrocyte Apoptosis ◽  
Mrna Levels ◽  
Related Factors ◽  
Articular Cartilages ◽  
Experimental Group

Abstract Purpose: To evaluate the repairing effects of glucosamine sulfate combined with etoricoxib on articular cartilages of patients with knee osteoarthritis (KOA). Methods: A total of 106 KOA patients were randomly divided into control (n=40) and experimental groups (n=66), and treated with etoricoxib alone and glucosamine sulfate plus etoricoxib respectively. Changes in WOMAC score and clinical efficacy were observed. The synovial fluid was extracted. Bone metabolism indices, growth factors, inflammatory factors, matrix metalloproteinases (MMPs) and NO-induced apoptosis-related factors were measured by ELISA. JNK and Wnt5a mRNA levels were determined using RT-PCR. Results: After treatment, the total WOMAC scores of both groups significantly declined (P<0.05), being lower in experimental group. The total effective rate of experimental group was higher (P<0.05). BGP and OPG levels rose, especially in experimental group (P<0.05). CTX-II, COMP and RANKL levels decreased, particularly in experimental group (P<0.05). TGF-β, IGF-1 and FGF-2 levels increased, especially in experimental group (P<0.05). Both groups, particularly experimental group, had decreased levels of IL-1β, IL-17, IL-18, TNF-α, MMP-3, MMP-9 and MMP-13 (P<0.05). JNK and Wnt5a mRNA levels of both groups dropped, which were lower in experimental group (P<0.05). NO and LPO levels reduced, being lower in experimental group. SOD level rose, especially in experimental group (P<0.05). Conclusion: Glucosamine sulfate plus etoricoxib can repair the articular cartilages of KOA patients. Probably, JNK and Wnt5a are down-regulated to inhibit the secretion of MMPs through lowering the levels of inflammatory factors, thereby delaying cartilage matrix degradation. NO-induced chondrocyte apoptosis may be suppressed via the SOD pathway.

scholarly journals Effectiveness of intra-articular autologous-conditioned serum injection in knee osteoarthritis: a meta-analysis study

2021 ◽  
Author(s):  
Seyed A Raeissadat ◽  
Seyed M Rayegani ◽  
Mohammad R Sohrabi ◽  
Nafisseh Jafarian ◽  
Mohammad N Bahrami
Keyword(s):  
Knee Osteoarthritis ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Womac Score ◽  
Mean Difference ◽  
Weighted Mean ◽  
Analog Scale ◽  
Autologous Conditioned Serum ◽  
Before And After ◽  
Standardized Mean Difference

Aim: Knee osteoarthritis is a common disabling disorder, with no curative treatment. This study aims to assess autologous conditioned serum effectiveness in its treatment. Materials & methods: Following a systematic search (2000–2020) on major databases and screening and filtering processes, eight articles were included in the final analyses. The pooled effect of visual analog scale (VAS) and the Western Ontario and McMaster Universities (WOMAC) variables was evaluated before and after the intervention. Results: The combined standardized mean difference for the global WOMAC score was -2.44 and the combined weighted mean difference was -22.92. The combined standardized mean difference for the VAS score was -3.77 and the combined weighted mean difference was -32.37 (p < 0.000). Conclusion: This meta-analysis reported that the autologous conditioned serum can reduce pain and improve function (VAS and WOMAC outcome measures) in patients with knee osteoarthritis.

scholarly journals A Comparison Between Low-Level Laser Therapy and Intra-articular Ozone Injection in Knee Osteoarthritis Treatment: A Randomized Clinical Trial

2021 ◽  
Vol 12 (1) ◽  
pp. e44-e44
Author(s):  
Solmaz Fakhari ◽  
Alireza Pishghahi ◽  
Hojjat Pourfathi ◽  
Haleh Farzin ◽  
Eissa Bilehjani
Keyword(s):  
Clinical Trial ◽  
Exercise Training ◽  
Knee Osteoarthritis ◽  
Physical Function ◽  
Randomized Clinical Trial ◽  
Laser Therapy ◽  
Joint Pain ◽  
Womac Score ◽  
Low Level Laser Therapy ◽  
Level Laser

Introduction: Knee osteoarthritis (KOA) is a common degenerative joint disease, causing deformity, pain and a limited joint range of motion. Modification of the lifestyle and an exercise training program are the cornerstone of treatment. Alternative therapies such as laser or ozone are commonly used, but there is not any comparative study of low-level laser therapy (LLLT) versus ozone therapy. The aim of the study was to compare the efficacy and safety of the LLLT versus ozone in patients with KOA. Methods: In this single-blinded randomized clinical trial, 60 patients with KOA were assigned to LLLT or ozone groups (n=30). The First basic pain severity, the Western Ontario and McMaster Universities Arthritis Index (WOMAC) score and physical function were determined. Then in the LLLT group, the patients were provided with 12 sessions of LLLT. In the ozone group, 6 sessions of intra-articular injection of ozone were organized (in each session a mixture of 10 mL of bupivacaine 0.25% with 15 mL of ozone 30 μg/mL). In the middle and at the end of the intervention period, we reassessed the joint pain and physical function and the degree of improvement compared between the two groups. Results: In the middle and at the end of the treatment period in both groups, the joint pain decreased significantly. The same as pain, the self-administrated WOMAC score and the range of joint motion improved significantly in both groups. All of these variables exposed more improvement in the ozone group patients. Conclusion: The study showed that both LLLT and ozone are acceptable non-invasive methods in the non-surgical treatment of KOA. Compared to LLLT, the ozone was more effective. These methods must be considered in any patient who is not suitable for surgical interventions or does not experience enough improvement in symptoms following long periods of common exercise training programs.

scholarly journals T2 mapping evaluation of changes in cartilage matrix after PRP and HA injection therapy in knee osteoarthritis: a prospective, randomized, double blind, placebo controlled study

2020 ◽  
Author(s):  
Matjaz Vogrin ◽  
Jakob Naranda ◽  
Mario Gorenjak ◽  
Tomaz Bajec ◽  
Domen Mongus ◽  
...  
Keyword(s):  
Placebo Group ◽  
Knee Osteoarthritis ◽  
Pain Score ◽  
T2 Mapping ◽  
Womac Score ◽  
Controlled Study ◽  
Womac Pain ◽  
Womac Pain Score ◽  
Knee Oa

Abstract BackgroundIn this study we focused on evaluating the effect of intra-articular platelet-rich plasma (PRP) and hyaluronic acid (HA) on the qualitative and quantitative properties of the articular cartilage in patients with knee osteoarthritis (OA).MethodsWe evaluated 264 patients undergoing treatment of moderate knee OA. Patients aged between 40 and 70 years were included with articular K-L stage ≤ 2. Patients were randomized into three groups and treated with three doses of intra-articular PRP, HA, or placebo injection. Patients were evaluated clinically and by using T2 mapping.ResultsBoth PRP (619.05 ± 243 ms; p = 2.7 × 10− 5) and HA (637.12 ± 273 ms; p = 1.×10− 4) group showed statistically significant lower post-application T2 relaxation times in comparison to the placebo group (859.80 ± 406 ms).Cartilage thickness increased significantly after PRP (2.41±0.87 vs. 2.58±0.97 mm, p=0.033) and HA (2.28±0.81 vs. 2.80±1.00 mm, p=1.8×10) applications. There was a significant decrease in WOMAC pain score by 30% (p=0,001) and the overall WOMAC score by 27 p=1.9×10-4%) in PRP group. The decrease in WOMAC pain score and the overall WOMAC score in the placebo group was similar to the results observed in the PRP group. In the HA group a significant decrease in WOMAC pain score by 14% (p=0,005) was observed only at the first follow-up, whereas no difference was observed at the second follow-up. ConclusionsT2 mapping of cartilage tissue may aid to monitor its properties after the intra-articular therapies in knee OA. However, there is a discrepancy between clinical findings and the results of T2 mapping, suggesting questionable grounds for applying intra-articular therapy.

scholarly journals Profiling of inflammatory mediators in the synovial fluid related to pain in knee osteoarthritis

2019 ◽  
Author(s):  
Li Li ◽  
Zhenxing Li ◽  
Yuyan Li ◽  
Xi Hu ◽  
Yu Zhang ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Synovial Fluid ◽  
Knee Osteoarthritis ◽  
Inflammatory Mediators ◽  
Early Stage ◽  
Womac Score ◽  
Womac Pain ◽  
Womac Pain Score ◽  
Pain Scores ◽  
Tnf Α

Abstract Background: Inflammatory mediators in the synovial fluid (SF) play critical roles in the initiation and development of pain in knee osteoarthritis (KOA). However, the expression of inflammatory mediators is controversial and the role of SF inflammatory mediators in neuropathic pain is not clear. Therefore, the aim of this study is to identify the SF inflammatory mediators associated with nociceptive and neuropathic pain in KOA. Methods: The levels of IL-1β, IL-6, TNF-α, macrophage colony-stimulating factor, MMP-3, MMP-13, metalloproteinase with thrombospondin motifs 5, calcitonin gene-related peptide, neuropeptide Y, substance P and bradykinin were measured in 86 patients using enzyme-linked immunosorbent assays. Nociceptive pain was measured using the numeric rating scale (NRS), visual analog scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score. Neuropathic pain was measured using the PainDETECT questionnaire. Moreover, knee function was evaluated by the WOMAC score and range of motion (ROM) assessments. Radiological grade was defined using the Kellgren-Lawrence (K-L) grading scale. Results: Pain scores measured using different methods were highly correlated to each other. The worse the pain, the worse the K-L grade and knee function were. The expression of IL-1β and IL-6 was increased in the early stage compared with the late stage. The NRS was positively correlated to age, K-L grade, and the WOMAC score and negatively correlated to ROM and TNF-α expression. The VAS was positively correlated to age, K-L grade, and the WOMAC score but negatively correlated to ROM and the levels of IL-1β, IL-6 and TNF-α. The WOMAC pain score was not correlated to any of the measured inflammatory mediators; it correlated to only ROM. The PainDETECT score correlated to only the WOMAC score. The expression of other inflammatory mediators was not correlated to any of the pain scores. Conclusions: IL-1β, IL-6 and TNF-α play critical roles in pain in the early stage of KOA and correlated to pain. The measured catabolic enzymes and neuropeptides are not correlated to nociceptive and neuropathic pain. New biomarkers related to pain in the late stage need to be further investigated.

scholarly journals Profiling of inflammatory mediators in the synovial fluid related to pain in knee osteoarthritis

2020 ◽  
Author(s):  
Li Li ◽  
Zhenxing Li ◽  
Yuyan Li ◽  
Xi Hu ◽  
Yu Zhang ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Synovial Fluid ◽  
Knee Osteoarthritis ◽  
Inflammatory Mediators ◽  
Early Stage ◽  
Womac Score ◽  
Womac Pain ◽  
Womac Pain Score ◽  
Pain Scores ◽  
Tnf Α

Abstract Background: Inflammatory mediators in the synovial fluid (SF) play critical roles in the initiation and development of pain in knee osteoarthritis (KOA). However, data for inflammatory marker expression are conflicting, and the role of SF inflammatory mediators in neuropathic pain is not clear. Therefore, the aim of this study was to identify SF inflammatory mediators associated with nociceptive and neuropathic pain in KOA. Methods: Levels of IL-1β, IL-6, TNF-α, macrophage colony-stimulating factor, MMP-3, MMP-13, metalloproteinase with thrombospondin motifs 5, calcitonin gene-related peptide, neuropeptide Y, substance P and bradykinin were measured using enzyme-linked immunosorbent assays in 86 patients. Nociceptive pain was assessed using the numeric rating scale (NRS), visual analog scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score. Neuropathic pain was determined using the PainDETECT questionnaire. Moreover, knee function was evaluated by the WOMAC score and range of motion (ROM) assessments. Radiological grade was defined using the Kellgren-Lawrence (K-L) grading scale. Results: Pain scores measured using different methods correlated highly with each other. A worse K-L grade and knee function were associated with worse pain. Expression of IL-1β and IL-6 was increased in the early stage compared with the late stage. The NRS score correlated positively with age, K-L grade, and the WOMAC score and negatively with ROM and TNF-α expression. The VAS correlated positively with age, K-L grade, and the WOMAC score but negatively with ROM and levels of IL-1β, IL-6 and TNF-α. The WOMAC pain score did not correlate with any of the inflammatory mediators measured; it correlated only with ROM. The PainDETECT score correlated only with the WOMAC score. Expression of other inflammatory mediators did not correlate with any of the pain scores. Conclusions: IL-1β, IL-6 and TNF-α play critical roles in pain in the early stage of KOA and correlate with pain. The catabolic enzymes and neuropeptides measured do not correlate with nociceptive and neuropathic pain. New biomarkers related to pain in the late stage need to be further investigated.

scholarly journals Repairing effects of glucosamine sulfate in combination with etoricoxib on articular cartilages of patients with knee osteoarthritis

2020 ◽  
Author(s):  
Yong Sun ◽  
Changde Wang ◽  
Chunzhu Gong
Keyword(s):  
Knee Osteoarthritis ◽  
Womac Score ◽  
Effective Rate ◽  
Glucosamine Sulfate ◽  
Inflammatory Factors ◽  
Chondrocyte Apoptosis ◽  
Mrna Levels ◽  
Related Factors ◽  
Articular Cartilages ◽  
Experimental Group

Abstract Purpose: To evaluate the repairing effects of glucosamine sulfate combined with etoricoxib on articular cartilages of patients with knee osteoarthritis (KOA). Methods: A total of 106 KOA patients were randomly divided into control (n=40) and experimental groups (n=66), and treated with etoricoxib alone and glucosamine sulfate plus etoricoxib respectively. Changes in WOMAC score and clinical efficacy were observed. The synovial fluid was extracted. Bone metabolism indices, growth factors, inflammatory factors, matrix metalloproteinases (MMPs) and NO-induced apoptosis-related factors were measured by ELISA. JNK and Wnt5a mRNA levels were determined using RT-PCR. Results: After treatment, the total WOMAC scores of both groups significantly declined (P<0.05), being lower in experimental group. The total effective rate of experimental group was higher (P<0.05). BGP and OPG levels rose, especially in experimental group (P<0.05). CTX-II, COMP and RANKL levels decreased, particularly in experimental group (P<0.05). TGF-β, IGF-1 and FGF-2 levels increased, especially in experimental group (P<0.05). Both groups, particularly experimental group, had decreased levels of IL-1β, IL-17, IL-18, TNF-α, MMP-3, MMP-9 and MMP-13 (P<0.05). JNK and Wnt5a mRNA levels of both groups dropped, which were lower in experimental group (P<0.05). NO and LPO levels reduced, being lower in experimental group. SOD level rose, especially in experimental group (P<0.05). Conclusion: Glucosamine sulfate plus etoricoxib can repair the articular cartilages of KOA patients. Probably, JNK and Wnt5a are down-regulated to inhibit the secretion of MMPs through lowering the levels of inflammatory factors, thereby delaying cartilage matrix degradation. NO-induced chondrocyte apoptosis may be suppressed via the SOD pathway.

scholarly journals Profiling of inflammatory mediators in the synovial fluid related to pain in knee osteoarthritis

2019 ◽  
Author(s):  
Li Li ◽  
Zhenxing Li ◽  
Yuyan Li ◽  
Xi Hu ◽  
Yu Zhang ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Synovial Fluid ◽  
Knee Osteoarthritis ◽  
Inflammatory Mediators ◽  
Early Stage ◽  
Womac Score ◽  
Womac Pain ◽  
Womac Pain Score ◽  
Pain Scores ◽  
Tnf Α

Abstract Background: Inflammatory mediators in the synovial fluid (SF) play critical roles in the initiation and development of pain in knee osteoarthritis (KOA). However, data for inflammatory marker expression are conflicting, and the role of SF inflammatory mediators in neuropathic pain is not clear. Therefore, the aim of this study was to identify SF inflammatory mediators associated with nociceptive and neuropathic pain in KOA. Methods: Levels of IL-1β, IL-6, TNF-α, macrophage colony-stimulating factor, MMP-3, MMP-13, metalloproteinase with thrombospondin motifs 5, calcitonin gene-related peptide, neuropeptide Y, substance P and bradykinin were measured using enzyme-linked immunosorbent assays in 86 patients. Nociceptive pain was assessed using the numeric rating scale (NRS), visual analog scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score. Neuropathic pain was determined using the PainDETECT questionnaire. Moreover, knee function was evaluated by the WOMAC score and range of motion (ROM) assessments. Radiological grade was defined using the Kellgren-Lawrence (K-L) grading scale. Results: Pain scores measured using different methods correlated highly with each other. A worse K-L grade and knee function were associated with worse pain. Expression of IL-1β and IL-6 was increased in the early stage compared with the late stage. The NRS score correlated positively with age, K-L grade, and the WOMAC score and negatively with ROM and TNF-α expression. The VAS correlated positively with age, K-L grade, and the WOMAC score but negatively with ROM and levels of IL-1β, IL-6 and TNF-α. The WOMAC pain score did not correlate with any of the inflammatory mediators measured; it correlated only with ROM. The PainDETECT score correlated only with the WOMAC score. Expression of other inflammatory mediators did not correlate with any of the pain scores. Conclusions: IL-1β, IL-6 and TNF-α play critical roles in pain in the early stage of KOA and correlate with pain. The catabolic enzymes and neuropeptides measured do not correlate with nociceptive and neuropathic pain. New biomarkers related to pain in the late stage need to be further investigated.

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