scholarly journals AB0875 HYBRID COOPERATIVE COMPLEXES OF SODIUM HYALURONATE + SODIUM CHONDROITIN NON-SULFATED (HA-SC) IN THE TREATMENT OF HIP OA: CLINICAL RESULTS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1743.2-1744
Author(s):  
R. Papalia
Keyword(s):  
Conservative Treatment ◽  
Sodium Hyaluronate ◽  
Hip Osteoarthritis ◽  
The Elderly ◽  
Clinical Results ◽  
Beneficial Effects ◽  
New Formulation ◽  
And Function ◽  
Open Prospective Study

Background:Hip Osteoarthritis (OA) is a widespread disease characterized by pain and functional impairment, which, particularly in the elderly, may compromise overall health and quality of life. In the last decades, Intra-articular (I.a.) injections of hyaluronic acid (HA) gained more space among the conservative treatment of OA because of their beneficial effects and positive outcomes without relevant complications. (1,2). An innovative and patented formulation containing hybrid cooperative complexes of sodium hyaluronate 2.4% + sodium chondroitin non-sulfated 1.6% of biotechnological origin (HA-SC) has been recently developed for the I.a. treatment of hip OA and evaluated in a pilot study (3).Objectives:1) Primary aim: Evaluation of the safety of HA-SC in the treatment of symptomatic hip OA; 2) Secondary aim: Evaluation of the efficacy of HA-SC in terms of pain reduction (VAS) and function improvement (Lequesne) of the affected hip joint.Methods:This is a pilot, multicentric, open, prospective study. The following inclusion criteria were established: Patients (both genders) aged ≥ 40 years suffering for primary hip OA confirmed by X-Ray; Grade I-II-III according to K&L grading scale; Basal VAS pain at the target hip > 40 mm; Failure of at least two lines of conservative treatments. All patients underwent a single I.a. hip injection of a 3mL vial of HA-SC and followed-up for six months.Results:48 patients have been enrolled and completed the study. The treatment was generally well-tolerated, with only ten patients out of 48 (20.8%) reporting local effects mainly consisting of injection site pain and arthralgia localized in the treated area. All these patients completed the study. The treatment with HA-SC was associated with a statistically significant decrease of VAS scale from a basal value of 67.5 (mean) to 22.8 (mean, p<0.0001) at the end of the observation period at six months, with a statistically significant decrease at seven days of follow-up evaluation (29.3, mean, p<0.0001). The mean Lequesne’s Index total score after the single injection of HA-SC decreased from a baseline value of 10.4 (mean) to 5.1 (mean, p<0.0001) at six months. The decrease was marked and significant also at any of the other evaluated time point (p<0.0001).Conclusion:A single I.a. injection of the innovative formulation containing hybrid cooperative complexes of sodium hyaluronate + sodium chondroitin non-sulfated (HA-SC) showed to be well tolerated and safe in the treatment of symptomatic hip OA. A rapid and significant decrease in hip pain (VAS) and Lequesne’s Index was also observed starting immediately after the I.a. injection and lasting until the end of the follow-up period. However, conservative treatment of hip OA is still challenging. This new formulation could represent a promising, long-lasting, and effective I.a. treatment.References:[1]Papalia R. et al. J. Biol. Regul. Homeost. Agents 2017; 31 (4 Suppl. 2): 103-109.[2]Abate M. et al. Int. J. Immunopathol.Pharmacol. 2017; 30 (1): 89-93.[3]IBSA Data on file.Acknowledgments:The author thanks all the investigators of the study: Costantino Cosimo, UO Medicina Riabilitativa, Azienda Ospedaliero-Universitaria di Parma, Italy; Fortina Mattia, Unità di Ortopedia Universitaria, AOU Senese Policlinico Santa Maria alle Scotte, Italy; Sadile Francesco, II Ortopedia - Ortopedia Infantile, Università degli studi di Napoli Federico II, Italy; Salini Vincenzo, Clinica Ortopedica e Traumatologica, Ospedale SS Annunziata di Chieti, Italy; Voglino Nicola, UO Ortopedia e Traumatologia, Ospedale Alto Tevere Città di Castello Azienda USL Umbria 1, ItalyDisclosure of Interests:Rocco Papalia Speakers bureau: Speaker for IBSA

scholarly journals Intra-articulaar treatment with Hylan G-F 20 under ultrasound guidance in hip osteoarthritis. Clinical results after 12 months follow-up

Reumatismo ◽  
2011 ◽  
Vol 57 (1) ◽  
Author(s):  
A. Migliore ◽  
S. Tormenta ◽  
C. Valente ◽  
U. Massafra ◽  
L.S. Martin Martin ◽  
...  
Keyword(s):  
Ultrasound Guidance ◽  
Hip Osteoarthritis ◽  
Clinical Results

A New Approach to Elbow Arthroplasty

1981 ◽  
Vol 10 (2) ◽  
pp. 59-64 ◽  
Author(s):  
W A Souter
Keyword(s):  
Body Weight ◽  
Methyl Methacrylate ◽  
Clinical Results ◽  
Medial Epicondyle ◽  
New Approach ◽  
Articular Surfaces ◽  
Two Component ◽  
And Function

The development of a two component endoprosthesis, the articular surfaces of which are modelled very closely on those of the normal trochlear joint, is described. Fixation is achieved through the use of methyl methacrylate cement around a keel and stem on the ulnar side and around a supracondylar metal stirrup with projecting flanges in the capitellum and medial epicondyle in the humerus. In vitro studies suggest that this fixation should be adequate to resist the forces normally transmitted across the elbow, these forces ranging according to the activity from half to three times body weight. Early clinical results have proved very satisfactory with regard to relief of pain and recovery of flexion, pronation, supination, power and function as a whole. The recovery of lost extension has proved more elusive. A much longer follow-up of two to five years will be required in order to ascertain whether the problem of loosening has been solved.

scholarly journals Total ankle arthroplasty incorporating a total talar prosthesis

2019 ◽  
Vol 101-B (4) ◽  
pp. 443-446 ◽  
Author(s):  
H. Kurokawa ◽  
A. Taniguchi ◽  
S. Morita ◽  
Y. Takakura ◽  
Y. Tanaka
Keyword(s):  
Clinical Results ◽  
Total Ankle Arthroplasty ◽  
Ankle Osteoarthritis ◽  
Ankle Arthroplasty ◽  
Custom Made ◽  
The Mean ◽  
Ct Data ◽  
End Stage ◽  
And Function

AimsTotal ankle arthroplasty (TAA) has become the most reliable surgical solution for patients with end-stage arthritis of the ankle. Aseptic loosening of the talar component is the most common complication. A custom-made artificial talus can be used as the talar component in a combined TAA for patients with poor bone stock of the talus. The purpose of this study was to investigate the functional and clinical outcomes of combined TAA.Patients and MethodsTen patients (two men, eight women; ten ankles) treated using a combined TAA between 2009 and 2013 were matched for age, gender, and length of follow-up with 12 patients (one man, 11 women; 12 ankles) who underwent a standard TAA. All had end-stage arthritis of the ankle. The combined TAA features a tibial component of the TNK ankle (Kyocera, Kyoto, Japan) and an alumina ceramic artificial talus (Kyocera), designed using individualized CT data. The mean age at the time of surgery in the combined TAA and standard TAA groups was 71 years (61 to 82) and 75 years (62 to 82), respectively. The mean follow-up was 58 months (43 to 81) and 64 months (48 to 88), respectively. The outcome was assessed using the Japanese Society for Surgery of the Foot (JSSF) ankle-hindfoot scale, the Ankle Osteoarthritis Scale (AOS), and the Self-Administered Foot Evaluation Questionnaire (SAFE-Q).ResultsThe mean preoperative JSSF score of the combined TAA and standard TAA groups was 44 (sd 11) and 49 (sd 10), respectively. The mean postoperative JSSF scores were 89 (sd 6.1) and 72 (sd 15), respectively. The mean postoperative JSSF score of the combined TAA group was significantly higher (p = 0.0034). The mean preoperative AOS scores for pain and function in the combined TAA and standard TAA groups were 5.8 (sd 3.3) and 5.5 (sd 3.1), and 8.6 (sd 1.3), and 7.1 (sd 2.9), respectively. The mean postoperative AOS scores of pain and function were 2.5 (sd 2.5) and 2.2 (sd 1.9), and 2.5 (sd 3.3) and 3.4 (sd 2.9), respectively. There were no significant differences between the two groups in terms of postoperative AOS scores. The mean postoperative SAFE-Q scores were: for pain, 76 (sd 23) and 70 (sd 23); for physical function, 66 (sd 25) and 55 (sd 27); for social function, 73 (sd 35) and 62 (sd 34); for shoe-related, 73 (sd 19) and 65 (sd 26); and for general health, 78 (sd 28) and 67 (sd 29), respectively. There were no significant differences between the two groups in terms of postoperative SAFE-Q scores.ConclusionCombined TAA resulted in better clinical results than standard TAA. Cite this article: Bone Joint J 2019;101-B:443–446.

scholarly journals Gait Characteristics, Symptoms, and Function in Persons With Hip Osteoarthritis: A Longitudinal Study With 6 to 7 Years of Follow-up

2015 ◽  
Vol 45 (7) ◽  
pp. 539-549 ◽  
Author(s):  
Ingrid Eitzen ◽  
Linda Fernandes ◽  
Heidi Kallerud ◽  
Lars Nordsletten ◽  
Brian Knarr ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Hip Osteoarthritis ◽  
Gait Characteristics ◽  
And Function

Treatment of Osteoarthritis of the Ankle by Intra-articular Injections of Hyaluronic Acid

2010 ◽  
Vol 100 (2) ◽  
pp. 93-100 ◽  
Author(s):  
Omer Mei-Dan ◽  
Beni Kish ◽  
Shai Shabat ◽  
Sabri Masarawa ◽  
Avi Shteren ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Conservative Treatment ◽  
Global Assessment ◽  
Symptomatic Relief ◽  
Sodium Hyaluronate ◽  
Signs And Symptoms ◽  
Ankle Osteoarthritis ◽  
Large Joint ◽  
Kellgren And Lawrence

Background: Treatment of osteoarthritis of the ankle is similar to that of any other large joint and includes conservative and surgical options. Surgical treatment in severe cases is fusion or joint replacement, whereas conservative treatment is limited and includes mainly ankle supports and physiotherapy. Hyaluronic acid was discovered by Meyer and Palmer in 1934 and has recently been widely used in the treatment of knee osteoarthritis. We evaluated the efficacy of an intra-articular preparation containing sodium hyaluronate in the treatment of osteoarthritis of the ankle. Methods: We studied 16 patients aged 31 to 79 years (mean age, 43 years) with symptomatic ankle osteoarthritis of 9 months' to 27 years' duration. The radiographic severity of the ankle osteoarthritis was graded II, III, or IV according to Kellgren and Lawrence. Arthritic ankles underwent intra-articular injections of 25 mg of sodium hyaluronate for 5 consecutive weeks. Follow-up visits were performed 4, 8, 11, 17, and 32 weeks after treatment and included clinical evaluation and objective scoring. Results: Global assessment showed improvement in 13 of 15 patients who completed the study. There was improvement by 20% in range of motion and a significant reduction in pain assessed by visual analog scale and ankle-hindfoot scores, all statistically significant. Seven months after treatment, no decrease in efficacy was shown. Two patients did not show any significant improvement in global assessment after treatment. One patient was dropped from follow-up owing to concurrent back surgery. Conclusions: Symptomatic relief of signs and symptoms of osteoarthritis of the ankle was achieved by injection of an intra-articular preparation containing sodium hyaluronate. There were significant improvements, in objective and subjective parameters, that lasted for more than 7 months. Ankle intra-articular injection of sodium hyaluronate is a valid conservative treatment for ankle osteoarthritis. (J Am Podiatr Med Assoc 100(2): 93–100, 2010)

scholarly journals Beneficial Effects of Fixed-Dose Combination of Amlodipine and Atorvastatin in Patients with Concomitant Hypertension and Hypercholesterolemia: A Multi-Institutional Cohort Study

2021 ◽  
Author(s):  
Chia-Pin Lin ◽  
Fu-Chih Hsiao ◽  
Chia-Tung Wu ◽  
Yu-Sheng Lin ◽  
Shao-Wei Chen ◽  
...  
Keyword(s):  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Clinical Results ◽  
Fixed Dose Combination ◽  
Fixed Dose ◽  
Beneficial Effects ◽  
Significant Difference ◽  
Dose Combination ◽  
Concomitant Hypertension

Abstract Background Blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C) are important risk factors for cardiovascular (CV) diseases and treating these factors simultaneously is recommended by current guidelines but only short-term clinical results were available. The objective of this study was to examine the longer-term efficacy and safety of fixed-dose combination (FDC) versus free combination of amlodipine and atorvastatin in patients with concomitant hypertension and hypercholesterolemia. Methods Patients with hypertension and hypercholesterolemia were stratified into three groups (FDC of amlodipine 5 mg/atorvastatin 10 mg [Fixed 5/10], FDC of amlodipine 5 mg/atorvastatin 20 mg [Fixed 5/20], and free combination of amlodipine 5 mg/atorvastatin 10 mg [Free 5/10]). After inverse probability of treatment weighting, the composite CV outcome, liver function, BP, LDL-C and glycated hemoglobin (HbA1c) changes were compared. Results A total of 1,788 patients were eligible for analysis and the mean follow-up period was 1.7 year. There was no significant difference in the composite CV outcome among the three groups during the 30-month follow-up period (Fixed 5/10 6.1%, Fixed 5/20 6.3% and Free 5/10 6.0%). The LDL-C level was significantly reduced in the Fixed 5/20 group (-35.7 mg/dL) compared to the Fixed 5/10 (-23.6 mg/dL) and Free 5/10 (-10.3 mg/dL) groups (P=0.001 and <0.001, respectively). The changes in HbA1c were similar among the three groups. Conclusions FDC of amlodipine and atorvastatin, especially the regimen with higher dosage of statin, significantly reduced the mid-term LDL-C level compared to free combination in patients with concomitant hypertension and hypercholesterolemia. Blood sugar level during the follow-up period was not significantly changed by this aggressive treatment strategy.

scholarly journals Clinical Results of Arthroscopic Treatment for Lateral Epicondylitis of Elbow

1970 ◽  
Vol 14 (2) ◽  
pp. 187-192 ◽  
Author(s):  
Jin Young Park ◽  
Jeong Woo Kim ◽  
Churl Hong Chun ◽  
Hong Je Kang ◽  
Jong Yun Kim ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Lateral Epicondylitis ◽  
Clinical Results ◽  
Loose Body ◽  
Arthroscopic Debridement ◽  
Performance Score ◽  
Analog Scale ◽  
Mayo Elbow Performance Score ◽  
The Mean

PURPOSE: The purpose of this study was to evaluate the clinical result of arthroscopic debridement with treatment of associated intra-articular lesions in lateral epicondylitis patients who did not response to conservative treatment.METHOD: Between March 2005 and January 2010, 43 patients who were diagnosed with lateral epicondylitis and did not response to conservative treatment over 6 months were selected. The mean age of the patients was 51 years (39~68 years) and the mean follow up period was 36.7 months (18~72 months). Among the 43 patients, 15 were male and 28 were female. They were evaluated by visual analog scale (VAS) and Mayo Elbow Performance Score (MEPS).RESULTS: Intra-articular synovitis was found in 11 cases (26%) and intra-articular loose body was observed in 2 cases. The average VAS score was 7(+/-0.7) preoperatively and decreased to 1(+/-1.0) at last follow up. MEPS was 45(+/-10.2) preoperatively and increased to 93(+/-10.0). At last follow up, 41 of the 43 patients showed satisfaction (MEPS <75) and 2 showed dissatisfaction (MEPS > or =75).CONCLUSION: There was a better outcome at 18 months follow up after arthroscopic debridement with treatment of associated intra-articular lesion in lateral epicondylitis patients who had not responsed to conservative treatment.

The Use of Neurodynamic Techniques in the Conservative Treatment of Carpal Tunnel Syndrome – a Critical Appraisal of the Literature

2017 ◽  
Vol 19 (5) ◽  
pp. 0-0
Author(s):  
Tomasz Wolny
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Conservative Treatment ◽  
Carpal Tunnel ◽  
Control Group ◽  
Therapeutic Effects ◽  
Beneficial Effects ◽  
Tunnel Syndrome ◽  
Passive Mobilization ◽  
Motor Abnormalities ◽  
And Function

Background. Carpal tunnel syndrome (CTS) is the most common peripheral neuropathy, characterized by the presence of many sensory and motor abnormalities. In the physiotherapy of patients with CTS, neurodynamic tech­niques are very common, while the scientific literature does not show clear evidence of beneficial effects obtained by using these techniques. Therefore, the aim of this work was to critically evaluate the use of neurodynamic techniques in the conservative treatment of CTS. Material and methods. Three electronic databases (MEDLINE, SCOPUS and POL-index) and Google Scholar were queried to find articles. The search terms were combinations of words (in Polish, English and German) contain­ing abbreviated and full versions of the following expressions: carpal tunnel syndrome, CTS, neuromobilization, neurodynamic techniques and manual therapy. Results. Sixteen research papers met the conditions for inclusion in this review. Most of them used different methodologies of therapeutic intervention, making it difficult to interpret the results of individual works. Fourteen studies were randomized trials, one a case-control retrospective study and one was a clinical study without a control group. The most common evaluation variables were pain, nerve conduction, subjective symptoms and function, grip strength, sensation and range of motion. The therapy used neurodynamic techniques carried out by the patient or passive mobilization by the physiotherapist. Conclusions. 1. A review of existing studies evaluating the effec­tiveness of neurodynamic techniques in the treat­ment of CTS shows that most of them produced beneficial therapeutic effects. 2. Due to a considerable heteroge­n­ei­­ty of the parti­cipants, study design and metho­do­logy of thera­peutic interventions, it is difficult to for­mulate a general conclusion. 3. Hence the need arises for further research to assess the effectiveness of neu­ro­dynamic techniques in conservative therapy of CTS based on a similar therapeutic methodology.

scholarly journals Improved (4 Plus 2) Rituximab Protocol for Severe Cases of Mixed Cryoglobulinemia: A 6-Year Observational Study

2016 ◽  
Vol 43 (4) ◽  
pp. 251-260 ◽  
Author(s):  
Dario Roccatello ◽  
Savino Sciascia ◽  
Simone Baldovino ◽  
Daniela Rossi ◽  
Mirella Alpa ◽  
...  
Keyword(s):  
Mixed Cryoglobulinemia ◽  
Immunosuppressive Drugs ◽  
Long Term Effects ◽  
Beneficial Effects ◽  
Skin Ulcers ◽  
Long Term Follow Up ◽  
Open Prospective Study ◽  
Large Skin

Background: In a prospective, single-center open study, we evaluated the very long-term effects of rituximab (RTX) administered to patients with severe mixed cryoglobulinemia (MC). Methods: RTX was administered to 31 patients with MC (type II in 29 cases and type III in 2) with diffuse membranoproliferative glomerulonephritis (16 cases), peripheral neuropathy (26) and large skin ulcers (7). All but 4 patients had serum anti-hepatitis C virus antibodies. RTX was administered at a dose of 375 mg/m2, according to a ‘4 + 2' protocol (days 1, 8, 15 and 22 plus 1 dose 1 and 2 months later). No other immunosuppressive drugs were added. Response was evaluated over a very long-term follow-up (mean 72.47 months, range 30-148). Results: Complete remission of pretreatment active manifestations was observed in all cases of purpuric lesions and non-healing vasculitic ulcers, and in 80% of the peripheral neuropathies. Cryoglobulinemic nephropathy significantly improved during follow-up, starting from the 2nd month after RTX (serum creatinine from 2.1 ± 1.7 to 1.5 ± 1.6 mg/dl, p ≤ 0.05; 24-hour proteinuria from 2.3 ± 2.1 to 0.9 ± 1.9 g/24 h, p ≤ 0.05). Improvement of cryoglobulinemic serological hallmarks, such as cryocrit and low complement C4, were observed. No clinically relevant side effects were recorded. Re-induction with RTX was carried out in 9 relapsed patients after a mean of 31.1 months (12-54), again with beneficial effects. The survival rate was 75% at 6 years and the probability of remaining symptom-free for 10 years without any therapy was of about 60% after a single ‘4 + 2' infusion cycle, while the probability of living symptom-free 5 years after relapsing was 80% if given the same treatment. Conclusion: In this open, prospective study, RTX appeared to be very effective and safe in the treatment of the most severe cases of MC.

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