A randomized controlled pilot study comparing the efficacy of Pulsed Radiofrequency combined with Exercise versus Exercise in pain relief and functional improvement for chronic knee osteoarthritis

Pain Practice ◽  
2020 ◽  
Author(s):  
Qi Han ◽  
Yantao Ma ◽  
Peiyu Jia ◽  
Xiaolei Wang ◽  
Bo Wang ◽  
...  
Keyword(s):  
Pilot Study ◽  
Pain Relief ◽  
Knee Osteoarthritis ◽  
Functional Improvement ◽  
Pulsed Radiofrequency ◽  
Randomized Controlled

Effects of therapeutic ultrasound for knee osteoarthritis: a systematic review and meta-analysis

2019 ◽  
Vol 33 (12) ◽  
pp. 1863-1875 ◽  
Author(s):  
Yu Wu ◽  
Shibo Zhu ◽  
Zenghui Lv ◽  
Shunli Kan ◽  
Qiuli Wu ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Randomized Controlled Trials ◽  
Physical Function ◽  
Therapeutic Ultrasound ◽  
Functional Improvement ◽  
Cochrane Library ◽  
Womac Pain ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Relieve Pain

Objective: To assess the effectiveness and safety of therapeutic ultrasound with sham ultrasound on pain relief and functional improvement in knee osteoarthritis patients. As phonophoresis is a unique therapeutic ultrasound, we also compared the effects of phonophoresis with conventional non-drug ultrasound. Data sources: PubMed, EMBASE, and the Cochrane Library were systematically searched for randomized controlled trials from inception up to June 2019. Review methods: Randomized controlled trials comparing therapeutic ultrasound with sham ultrasound in knee osteoarthritis patients were included. Phonophoresis in the experimental and control groups were compared through conventional ultrasound, and corresponding trials were also included. Two reviewers independently identified eligible studies and extracted data. Risk of bias assessments and therapeutic ultrasound safety assessments were also performed. Results: Fifteen studies including three phonophoresis-related studies with 1074 patients were included. Meta-analyses demonstrated that therapeutic ultrasound significantly relieved pain ( P < 0.00001) and reduced the Western Ontario and McMaster Universities (WOMAC) physical function score ( P = 0.03). In addition, therapeutic ultrasound increased the active range of motion ( P < 0.00001) and reduced the Lequesne index ( P < 0.00001). Subgroup analysis of phonophoresis ultrasound illustrated significant differences on the visual analogue scale ( P = 0.009), but no significant differences on WOMAC pain subscales ( P = 0.10), and total WOMAC scores were observed ( P = 0.30). There was no evidence to suggest that ultrasound was unsafe treatment. Conclusions: Therapeutic ultrasound is a safe treatment to relieve pain and improve physical function in patients with knee osteoarthritis. However, phonophoresis does not produce additional benefits to functional improvement, but may relieve pain compared to conventional non-drug ultrasound.

Intra-articular Injection of Autologous Adipose-Derived Stem Cells or Stromal Vascular Fractions: Are They Effective for Patients With Knee Osteoarthritis? A Systematic Review With Meta-analysis of Randomized Controlled Trials

2022 ◽  
pp. 036354652110538
Author(s):  
Kang-Il Kim ◽  
Myung-Seo Kim ◽  
Jun-Ho Kim
Keyword(s):  
Stem Cells ◽  
Pain Relief ◽  
Meta Analysis ◽  
Functional Improvement ◽  
Controlled Trials ◽  
Adipose Derived Stem Cells ◽  
Efficacy And Safety ◽  
Knee Oa ◽  
Randomized Controlled ◽  
Subgroup Analyses

Background: Intra-articular injection of adipose-derived stem cells, which are divided into adipose-derived mesenchymal stem cells (ASCs) and adipose-derived stromal vascular fractions (ADSVFs), has been reported to be a viable treatment modality for knee osteoarthritis (OA); however, its efficacy remains limited. Purpose: This study aimed to provide comprehensive information about the efficacy and safety of intra-articular injections of autologous ASCs and ADSVFs without adjuvant treatment in patients with knee OA. Study Design: Meta-analysis; Level of evidence, 1. Methods: A systematic search of the MEDLINE, Embase, Web of Science, and Cochrane Library databases was performed to identify randomized controlled trials (RCTs) that evaluated the efficacy and safety of intra-articular injections of autologous ASCs or ADSVFs without adjuvant treatments compared with placebo or hyaluronic acid in patients with knee OA. Clinically, the 100-mm visual analog scale for pain relief and the Western Ontario and McMaster Universities Osteoarthritis Index for functional improvement were implemented. Radiologically, cartilage status was assessed using magnetic resonance imaging (MRI). Procedure-related knee pain, swelling, and adverse events (AEs) were evaluated for safety. Additionally, we performed subgroup analyses comparing ASCs versus ADSVFs. Methodological quality was assessed using the modified Coleman Methodology Score (mCMS). Results: A total of 5 RCTs were included in this study. Based on the meta-analysis, ASCs or ADSVFs showed significantly better pain relief at 6 months ( Z = 7.62; P < .0001) and 12 months ( Z = 7.21; P < .0001) and functional improvement at 6 months ( Z = 4.13; P < .0001) and 12 months ( Z = 3.79; P = .0002), without a difference in procedure-related knee pain or swelling compared with controls. Although a meta-analysis with regard to cartilage improvements was not performed owing to heterogeneous MRI assessment, 3 studies reported significantly improved cartilage status after the injection. No serious AEs associated with ASCs or ADSVFs were reported. Subgroup analyses showed similar efficacy between ASC and ADSVF treatments. The median mCMS was 70 (range, 55-75). Conclusion: For patients with knee OA, intra-articular injection of autologous ASCs or ADSVFs without adjuvant treatment showed remarkable clinical efficacy and safety at short-term follow-up. Some degree of efficacy has been shown for cartilage regeneration in knee OA, although the evidence remains limited. Further RCTs that directly compare ASCs and ADSVFs are needed.

scholarly journals Can platelet-rich plasma injections provide better pain relief and functional outcomes in persons with common shoulder diseases: a meta-analysis of randomized controlled trials

2021 ◽  
Author(s):  
Apurba Barman ◽  
Archana Mishra ◽  
Rituparna Maiti ◽  
Jagannatha Sahoo ◽  
Kaustav Basu Thakur ◽  
...  
Keyword(s):  
Pain Relief ◽  
Randomized Controlled Trials ◽  
Functional Outcomes ◽  
Platelet Rich Plasma ◽  
Meta Analysis ◽  
Functional Improvement ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Effective Pain Relief ◽  
Meta Analyses

Background: To evaluate the efficacy of autologous platelet-rich plasma (PRP) injections in the treatment of common shoulder diseases.Methods: The PubMed, Medline, and Central databases and trial registries were searched from their inception to July 2020 for randomized controlled trials of autologous PRP injections for shoulder diseases versus placebo or any control intervention. Preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines were followed in the selection, analysis, and reporting of findings. The primary outcome was pain intensity (visual analog scale), and secondary outcomes were changes in function and quality of life (QoL). Results: A total of 17 randomized controlled trials of PRP versus control were analyzed. From 8–12 weeks to ≥1 year, PRP injections were associated with better pain relief and functional outcomes than control interventions. PRP injections were also associated with greater QoL, with an effect size of 2.61 (95% confidence interval, 2.01–14.17) at medium-term follow-up. Compared with placebo and corticosteroid injections, PRP injections provide better pain relief and functional improvement. In subgroup analyses, trials in which PRP was prepared by the double centrifugation technique, the platelet concentration in the PRP was enriched ≥5 times, leucocyte-rich PRP was used, or an activating agent was used before application reported the most effective pain relief at 6–7 months. Conclusions: PRP injections could provide better pain relief and functional outcomes than other treatments for persons presenting with common shoulder diseases. PRP injections have a greater capacity to improve shoulder-related QoL than other interventions.

A Comparison Between Pulsed Radiofrequency and Electro-acupuncture for Relieving Pain in Patients with Chronic Low Back Pain

2010 ◽  
Vol 35 (3) ◽  
pp. 133-146 ◽  
Author(s):  
Mu-Lien Lin ◽  
Mu-Hung Lin ◽  
Jun-Jeng Fen ◽  
Wei-Tso Lin ◽  
Chii-Wann Lin ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Lumbar Spine ◽  
Pain Relief ◽  
Chronic Low Back Pain ◽  
Outcome Evaluation ◽  
Functional Improvement ◽  
Low Back ◽  
Pulsed Radiofrequency ◽  
Sf 36

Many treatment options for chronic low back pain are available, including varied forms of electric stimulation. But little is known about the electricity effect between electro-acupuncture and pulsed radiofrequency. The objective of this study is to assess the difference in effectiveness of pain relief between pulsed radiofrequency and electro-acupuncture. Visual analog score (VAS) pain score, the Oswestry disability index (ODI) to measure a patient's permanent functional disability, and Short form 36 (SF-36) which is a survey used in health assessment to determine the cost-effectiveness of a health treatment, were used as rating systems to measure the pain relief and functional improvement effect of pulsed radiofrequency and electro-acupuncture, based on the methodological quality of the randomized controlled trials, the relevance between the study groups, and the consistency of the outcome evaluation. First, the baseline status before therapy shows no age and gender influence in the SF-36 and VAS score but it is significant in the ODI questionnaire. From ANOVA analyses, it is apparent that radiofrequency therapy is a significant improvement over electro-acupuncture therapy after one month. But electro-acupuncture also showed functional improvement in the lumbar spine from the ODI. This study provides sufficient evidence of the superiority of pulsed radiofrequency (PRF) therapy for low back pain relief compared with both electro-acupuncture (EA) therapy and the control group. But the functional improvement of the lumbar spine was proved under EA therapy only. Both therapies are related to electricity effects.

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