scholarly journals The temporal effect of intra-articular ozone injections on pain in knee osteoarthritis

2019 ◽  
Author(s):  
Antonio Oliviero ◽  
Lorenzo Giordano ◽  
Nicola Maffulli
Keyword(s):  
Quality Of Life ◽  
Pain Relief ◽  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Joint Pain ◽  
Therapeutic Modality ◽  
Ozone Therapy ◽  
Treatment Protocols

Abstract Background Osteoarthritis (OA) is a most common orthopaedic condition, often complicated by inflammatory features. Sources of data A systematic search in PubMed, Embase, Google Scholar and Scopus databases (to January 2019) was performed to define the effect obtained in patients with OA of the knee by injections of ozone, on pain and physical function. Six RCTs and 353 patients were included. Areas of agreement Recently, an increasing number of physicians have used ozone therapy to alleviate the symptoms of acute and chronic OA of the knee. Ozone can allow greater mobility of the knee joint, pain relief and decrease in effusion. Areas of controversy The volume and concentration of ozone injected are different in the various treatment protocols published. Growing points The action of ozone is unclear, but it is a promising therapeutic modality capable of impacting, favourably, function and quality of life. Areas timely for developing research The lack of a clear protocol of use is a major limitation, and to date there is no clear evidence of long-term efficacy.

Guideline for the management of long tunnelled external ventricular drains in chronic hydrocephalus

2021 ◽  
Vol 30 (7) ◽  
pp. 416-421
Author(s):  
Phillip Correia Copley ◽  
John Emelifeonwu ◽  
Pasquale Gallo ◽  
Drahoslav Sokol ◽  
Jothy Kandasamy ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Nursing Care ◽  
Pilocytic Astrocytoma ◽  
Parental Education ◽  
Chronic Hydrocephalus ◽  
Treatment Protocols ◽  
New Approach ◽  
Viable Treatment

This article reports on the journey of a child with an inoperable hypothalamic-origin pilocytic astrocytoma causing hydrocephalus, which was refractory to treatment with shunts, and required a new approach. With multidisciplinary support, excellent nursing care and parental education, the child's hydrocephalus was managed long term in the community with bilateral long-tunnelled external ventricular drains (LTEVDs). This article describes the patient's journey and highlights the treatment protocols that were created to achieve this feat. Despite the difficulties in initially setting up these protocols, they proved successful and thus the team managing the patient proposed that LTEVDs are a viable treatment option for children with hydrocephalus in the context of inoperable tumours to help maximise quality of life.

Spinal Cord Stimulation in Treatment of Chronic Benign Pain: Challenges in Treatment Planning and Present Status, a 22-Year Experience

Neurosurgery ◽  
2006 ◽  
Vol 58 (3) ◽  
pp. 481-496 ◽  
Author(s):  
Krishna Kumar ◽  
Gary Hunter ◽  
Denny Demeria
Keyword(s):  
Quality Of Life ◽  
Spinal Cord ◽  
Pain Relief ◽  
Success Rate ◽  
Spinal Cord Stimulation ◽  
Pain Clinic ◽  
Axial Component

Abstract OBJECTIVE: To present an in-depth analysis of clinical predictors of outcome including age, sex, etiology of pain, type of electrodes used, duration of pain, duration of treatment, development of tolerance, employment status, activities of daily living, psychological status, and quality of life. Suggestions for treatment of low back pain with a predominant axial component are addressed. We analyzed the complications and proposed remedial measures to improve the effectiveness of this modality. METHODS: Study group consists of 410 patients (252 men, 58 women) with a mean age of 54 years and a mean follow-up period of 97.6 months. All patients were gated through a multidisciplinary pain clinic. The study was conducted over 22 years. RESULTS: The early success rate was 80% (328 patients), whereas the long-term success rate of internalized patients was 74.1% (243 patients) after the mean follow-up period of 97.6 months. Hardware-related complications included displaced or fractured electrodes, infection, and hardware malfunction. Etiologies demonstrating efficacy included failed back syndrome, peripheral vascular disease, angina pain, complex regional pain syndrome I and II, peripheral neuropathy, lower limb pain caused by multiple sclerosis. Age, sex, laterality of pain or number of surgeries before implant did not play a role in predicting outcome. The percentage of pain relief was inversely related to the time interval between pain onset and time of implantation. Radicular pain with axial component responded better to dual Pisces electrode or Specify-Lead implantation. CONCLUSION: Spinal cord stimulation can provide significant long-term pain relief with improved quality of life and employment. Results of this study will be effective in better defining prognostic factors and reducing complications leading to higher success rates with spinal cord stimulation.

EVALUATION OF SHORT AND LONG TERM BENEFITS/SIDE EFFECTS OF CEMENT AUGMENTATION IN PATIENTS WITH NON INFECTIVE PATHOLOGICAL OSTEOPOROTIC VERTEBRAL COMPRESSION FRACTURES

2020 ◽  
pp. 44-48
Author(s):  
Abhay Singh ◽  
Rahul Gupta ◽  
Shachi Shachi
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Pain Relief ◽  
Vertebral Compression Fracture ◽  
Compression Fracture ◽  
Cement Augmentation ◽  
Vertebral Compression Fractures ◽  
Hybrid Technique

BACKGROUND: Vertebral compression fracture usually occurs in old age population with osteoporosis. Due to severity of pain, quality of life becomes very poor. During the study period 67 patients fullling the eligibility cri METHODS: teria underwent vertebroplasty/ kyphoplasty/ cement augmented screw xation/ hybrid procedures were included. Short term and long term benets /side effects were evaluated in all patients. Patients were evaluated on visual analogue score and modied ranking scale. RESULTS: Vertebroplasty was performed in 26(38.8%) whereas kyphoplasty, cement augmented screw xation and hybrid procedure were performed in 18(26.8%), 17(25.4%) and 6(9.0%) respectively. Signicant pain relief occurred in all patients which were evaluated by Visual Analogue Scale. Quality of life also improved which was evaluated with Modied Rankin Scale. In our study, complications which occurred were local cement leak, hematoma formation, infection in 8 (11.9%), 3(4.5%) and 2(3.0%) patients respectively. Use of biological cement has revolutionized CONCLUSION: the management of vertebral compression fracture. Both vertebroplasty and kyphoplasty procedures which are minimal invasive, almost cure the non infective pathological fractures with instant pain relief and very low procedure related morbidity. In cases requiring xation, cement augmentation signicantly improves the purchase of the screw and makes the construct more reliable. Hybrid technique helps to prevent extensive long level xation.

Neurosurgical Choice for Glossopharyngeal Neuralgia: A Benefit–Harm Assessment of Long-Term Quality of Life

Neurosurgery ◽  
2020 ◽  
Vol 88 (1) ◽  
pp. 131-139 ◽  
Author(s):  
Tao Du ◽  
Bing Ni ◽  
Wei Shu ◽  
Yongsheng Hu ◽  
Hongwei Zhu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pain Relief ◽  
Brief Pain Inventory ◽  
Glossopharyngeal Neuralgia ◽  
Significant Difference ◽  
Patient Database ◽  
Global Impression Of Change ◽  
Satisfaction Rates

Abstract BACKGROUND Microvascular decompression (MVD) and vagoglossopharyngeal rhizotomy (VGR) are effective treatment for glossopharyngeal neuralgia (GN). However, surgical choice is controversial due to the need to maximize pain relief and reduce complications. OBJECTIVE To retrospectively compare safety, efficacy, long-term quality of life (QOL), and global impression of change following MVD and VGR for treatment of GN. METHODS Patient database reviews and telephone surveys were conducted to assess baseline characteristics and long-term outcomes. The effects of pain and complications on QOL were assessed using Brief Pain Inventory-Facial (BPI-Facial) questionnaire. Complication tolerance and surgery satisfaction were sorted using the global impression of change survey. RESULTS Of 87 patients with GN, 63 underwent MVD alone, 20 underwent VGR alone, and 4 underwent VGR following a failed MVD. The long-term rate of pain relief was slightly, but not significantly, lower following MVD than VGR (83.6% vs 91.7%, P = .528). However, long-term complications occurred much more frequently following VGR (3.0% vs 50.0%, P < .001). The BPI-Facial, which evaluates pain and complications, showed that MVD had better postoperative QOL than VGR (P < .001). However, 91.7% of patients who underwent VGR experienced no or mild complications. There was no significant difference in the overall satisfaction rates between the groups (83.3% vs 83.6%, P > .99). CONCLUSION Although VGR resulted in lower postoperative QOL due to a high complication rate, most of these complications were mild. The overall satisfaction rates for the 2 surgeries were similar.

The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. Part one: introduction, and mind-body exercise programs

2017 ◽  
Vol 31 (5) ◽  
pp. 582-595 ◽  
Author(s):  
Lucie Brosseau ◽  
Jade Taki ◽  
Brigit Desjardins ◽  
Odette Thevenot ◽  
Marlene Fransen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pain Relief ◽  
Knee Osteoarthritis ◽  
Physical Function ◽  
Tai Chi ◽  
Statistical Significance ◽  
Clinical Importance ◽  
Exercise Programs ◽  
High Quality

Objective: To identify effective mind-body exercise programs and provide clinicians and patients with updated, high-quality recommendations concerning non-traditional land-based exercises for knee osteoarthritis. Methods: A systematic search and adapted selection criteria included comparative controlled trials with mind-body exercise programs for patients with knee osteoarthritis. A panel of experts reached consensus on the recommendations using a Delphi survey. A hierarchical alphabetical grading system (A, B, C+, C, D, D+, D-) was used, based on statistical significance ( P < 0.5) and clinical importance (⩾15% improvement). Results: The four high-quality studies identified demonstrated that various mind-body exercise programs are promising for improving the management of knee osteoarthritis. Hatha Yoga demonstrated significant improvement for pain relief (Grade B) and physical function (Grade C+). Tai Chi Qigong demonstrated significant improvement for quality of life (Grade B), pain relief (Grade C+) and physical function (Grade C+). Sun style Tai Chi gave significant improvement for pain relief (Grade B) and physical function (Grade B). Conclusion: Mind-body exercises are promising approaches to reduce pain, as well as to improve physical function and quality of life for individuals with knee osteoarthritis.

scholarly journals Use of Artra and Artra MSM Forte in osteoarthritis of the large joints and lowback pain

2019 ◽  
pp. 96-100
Author(s):  
E. P. Sharapova ◽  
L. I. Alekseeva
Keyword(s):  
Quality Of Life ◽  
Pain Relief ◽  
International Organizations ◽  
Joint Pain ◽  
Common Symptom ◽  
First Line ◽  
Knee Oa ◽  
Concomitant Medications ◽  
Lowback Pain

Knee and hip joint pain is the first and most common symptom that forces a patient to visit the doctor. Osteoarthritis (OA) treatment is aimed «primarily» at managing symptoms of the disease, i.e. reducing pain, improving the functional state of the joints, and finally at improving the patients’ quality of life. The Russian and international organizations have developed numerous guidelines for the treatment of OA, which include non-pharmacological and pharmacological methods, among which symptomatic slow-acting drugs are of special interest. These drugs are currently recommended to prescribe as the first-line drugs to treat OA. Analgesics and NSAIDs that rarely cause adverse effects, especially in older people and in patients with co-morbidities, who receive concomitant medications, are the most commonly prescribed medications for pain relief. This creates a problem when the drugs affect one another’s exposure and can limit the prescription of a range of drugs, which determines an increase in interest in other drugs called sustained-release symptomatic drugs, which are widely recognized in arthrology.The article presents the results of studies of Artra and Artra MSM Forte in patients with hip and knee OA, which were conducted in Russia.

scholarly journals Is Life Better After Motor Cortex Stimulation for Pain Control? Results at Long-Term and their Prediction by Preoperative rTMS

2014 ◽  
Vol 17;1 (1;17) ◽  
pp. 53-62 ◽  
Author(s):  
Nathalie André-Obadia
Keyword(s):  
Quality Of Life ◽  
Neuropathic Pain ◽  
Pain Relief ◽  
Motor Cortex ◽  
Predictive Value ◽  
Drug Intake ◽  
Motor Cortex Stimulation ◽  
Pain Scores

Background: A positive effect of motor cortex stimulation (MCS) (defined as subjective estimations of pain relief ≥ 30%) has been reported in 55 – 64% of patients. Repetitive magnetic cortical stimulation (rTMS) is considered a predictor of MCS effect. These figures are, however, mostly based on subjective reports of pain intensity, and have not been confirmed in the long-term. Objectives: This study assessed long-term pain relief (2 – 9 years) after epidural motor cortex stimulation and its pre-operative prediction by rTMS, using both intensity and Quality of Life (QoL) scales. Study Design: Analysis of the long-term evolution of pain patients treated by epidural motor cortex stimulation, and predictive value of preoperative response to rTMS. Setting: University Neurological Hospital Pain Center. Methods: Patients: Twenty patients suffering chronic pharmaco-resistant neuropathic pain. Intervention: All patients received first randomized sham vs. active 20Hz-rTMS, before being submitted to MCS surgery. Measurement: Postoperative pain relief was evaluated at 6 months and then up to 9 years post-MCS (average 6.1 ± 2.6 y) using (i) pain numerical rating scores (NRS); (ii) a combined assessment (CPA) including NRS, drug intake, and subjective quality of life; and (iii) a short questionnaire (HowRu) exploring discomfort, distress, disability, and dependence. Results: Pain scores were significantly reduced by active (but not sham) rTMS and by subsequent MCS. Ten out of 20 patients kept a long-term benefit from MCS, both on raw pain scores and on CPA. The CPA results were strictly comparable when obtained by the surgeon or by a third-party on telephonic survey (r = 0.9). CPA scores following rTMS and long-term MCS were significantly associated (Fisher P = 0.02), with 90% positive predictive value and 67% negative predictive value of preoperative rTMS over long-term MCS results. On the HowRu questionnaire, long-term MCSrelated improvement concerned “discomfort” (physical pain) and “dependence” (autonomy for daily activities), whereas “disability” (work, home, and leisure activities) and “distress” (anxiety, stress, depression) did not significantly improve. Limitations: Limited cohort of patients with inhomogeneous pain etiology. Subjectivity of the reported items by the patient after a variable and long delay after surgery. Predictive evaluation based on a single rTMS session compared to chronic MCS. Conclusions: Half of the patients still retain a significant benefit after 2 – 9 years of continuous MCS, and this can be reasonably predicted by preoperative rTMS. Adding drug intake and QoL estimates to raw pain scores allows a more realistic assessment of long-term benefits and enhance the rTMS predictive value. The aims of this study and its design were approved by the local ethics committee (University Hospitals St Etienne and Lyon, France). Key words: Neuropathic pain, chronic refractory pain, repetitive transcranial magnetic stimulation, rTMS, epidural motor cortex stimulation, MCS, quality of life, predictive value

scholarly journals Percutaneous Radiofrequency Hip Joint Denervation

2021 ◽  
Author(s):  
Nieves Saiz-Sapena ◽  
Vicente Vanaclocha-Vanaclocha ◽  
José María Ortiz-Criado ◽  
Leyre Vanaclocha
Keyword(s):  
Quality Of Life ◽  
Pain Relief ◽  
Hip Joint ◽  
Pain Control ◽  
Joint Pain ◽  
Pulsed Radiofrequency ◽  
Total Hip ◽  
Sensory Denervation ◽  
Hip Arthroplasties

With an aging population, chronic osteoarthritic hip joint pain is becoming a major issue. Most patients with hip pain can control their pain with conservative measures but with a gradual reduction in their quality of life. When gradually reduced ambulation and pain become recalcitrant, total hip arthroplasty is the next step. For most patients, this is a good way to improve pain control and to recover some quality of life, but for a few this aggressive surgical procedure is not possible. Sometimes co-morbidities make total hip arthroplasties undesirable. At other times, the age of the patients recommends to wait for a while. In these cases, other options have to be explored. Percutaneous partial hip joint sensory denervation has become a notable option as it can provide acceptable rates of pain relief with minimal surgical aggressiveness. There are three modalities to perform it: thermal, cooled and pulsed radiofrequency.

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