AB0603 THE NEW POSSIBILITIES OF USING CHONDROITIN SULFATE IN PATIENTS WITH KNEE OSTEOARTHRITIS

Background:Administration of Chondroitin Sulfate for treatment of osteoarthritis included treatment types include systemic and parenteral therapies. The benefits of local therapies between difference route is ambivalent.Objectives:To evaluate effectiveness and safety of Chondroitin Sulfate (CS) by intramuscular and concomitant (intramuscular and intraarticular) route of administration in patients with knee osteoarthritis (OA).Methods:In total 150 patients with knee OA according by ACR criteria and with radiological stages 2 and 3 according to Kellgren-Lawrence were enrolled. Patients were divided by 2 groups: 75 patients (R) received course of 25 intramuscular injection every other day: at the first 3 injection’s in dose 100 mg, and in continue in dose 200 mg, 75 patients in 2nd group (N) received 5 intra-articular injections in target knee in dose 200 mg once per 3 days, in continue 16 intramuscular injections every other day in dose 200 mg. All patients received NSAID - meloxicam in stable dose 15 mg per day. All patients were checked by WOMAC, pain by visual analog scale (VAS), McGiIl Pain Questionnaire (MPQ). At the baseline, standard clinical examination for all patients were blood tests, urine test, coagulation panel and ECG.Results:After comparing of two groups by the end of course the intensity of pain by VAS was significantly greater in R group (21,88±13,24 vs 16,81±13,49; р<0,0001). There were no significant differences between groups in improvement of WOMAC, WOMAC subscales and MPQ from baseline. Serious adverse events (AE) were absent. 11 AE’s were detected 3,3% (5/150), but in 100% of cases AE’s were resolved by the end of course.Conclusion:CS is effective decreased intensity of pain and stiffness, improved functional ability of joints both intramuscular and concomitant route of administration. However, significantly greater results at pain intensity by VAS shows combination: pain intensity by the end of course was significantly lower in group with concomitant intramuscular and intra-articular injections. Probably, it was associated with faster resolution of synovitis by intraarticular route of administration, that leads to choose this route for patients with comorbidity.Disclosure of Interests:None declared.

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Effect of a Single-Shot of a High-Density Viscoelastic Solution of Hyaluronic Acid in Patients with Symptomatic Primary Knee Osteoarthritis: The No-Dolor Study

10.21203/rs.3.rs-1088483/v1 ◽

2021 ◽

Author(s):

Joan Calvet ◽

Danial Khorsandi ◽

Laura Tío ◽

Jordi Monfort

Keyword(s):

Hyaluronic Acid ◽

Knee Osteoarthritis ◽

Visual Analog Scale Score ◽

High Density ◽

Womac Pain ◽

Single Shot ◽

Analog Scale ◽

Knee Oa ◽

Pain Subscale ◽

Inflammatory Drugs

Abstract Background Pronolis®HD mono 2.5% is a novel, one-shot, high-density sterile viscoelastic solution, recently available in Spain, which contains a high amount of intermediate molecular weight hyaluronic acid (HA), highly concentrated (120 mg in 4.8 mL solution: 2.5%). The objective of the study was to analyze the efficacy and safety of this treatment in symptomatic primary knee osteoarthritis (OA). Methods This observational, prospective, multicenter, single-cohort study involved 166 patients with knee OA treated with a single-shot of Pronolis®HD mono 2.5% and followed up as many as 24 weeks. Results Compared with baseline, the score of the Western Ontario and McMaster Universities Arthritis Osteoarthritis Index (WOMAC) pain subscale significantly reduced at the 12-week visit (primary endpoint, median: 9 interquartile range [IQR]: 7-11 versus median: 4; IQR: 2-6). The percentage of patients achieving >50% improvement in the pain subscale increased progressively from 37.9% (at 2 weeks) to 66.0% (at 24 weeks). Similarly, WOMAC scores for pain on movement, stiffness subscale, and functional capacity subscale showed significant reductions at the 12-week visit which were maintained up to the 24-week visit. The EuroQol visual analog scale score significantly increased after 12 weeks (median: 60 versus 70). The need for rescue medication (analgesics/nonsteroidal anti-inflammatory drugs) also significantly decreased in all post-injection visits. Three patients (1.6%) reported local adverse events (joint swelling) of mild intensity. Conclusions In conclusion, a single intra-articular injection of the high-density viscoelastic gel of HA is effective and safe for the relief of symptoms in patients with knee OA. Trial registration: ClinicalTrial# NCT04196764

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Cross-cultural adaptation, reliability and validity of the Fremantle Knee Awareness Questionnaire in Italian subjects with painful knee osteoarthritis

Health and Quality of Life Outcomes ◽

10.1186/s12955-021-01754-4 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Marco Monticone ◽

Cristiano Sconza ◽

Igor Portoghese ◽

Tomohiko Nishigami ◽

Benedict M. Wand ◽

...

Keyword(s):

Construct Validity ◽

Knee Osteoarthritis ◽

Pain Intensity ◽

Internal Consistency ◽

Structural Validity ◽

Retest Reliability ◽

Knee Oa ◽

Pain Catastrophising ◽

Test Retest Reliability ◽

Painful Knee

Abstract Background and aim Growing attention is being given to utilising physical function measures to better understand and manage knee osteoarthritis (OA). The Fremantle Knee Awareness Questionnaire (FreKAQ), a self-reported measure of body-perception specific to the knee, has never been validated in Italian patients. The aims of this study were to culturally adapt and validate the Italian version of the FreKAQ (FreKAQ-I), to allow for its use with Italian-speaking patients with painful knee OA. Methods The FreKAQ-I was developed by means of forward–backward translation, a final review by an expert committee and a test of the pre-final version to evaluate its comprehensibility. The psychometric testing included: internal structural validity by Rasch analysis; construct validity by assessing hypotheses of FreKAQ correlations with the knee injury and osteoarthritis outcome score (KOOS), a pain intensity numerical rating scale (PI-NRS), the pain catastrophising scale (PCS), and the Hospital anxiety and depression score (HADS) (Pearson’s correlations); known-group validity by evaluating the ability of FreKAQ scores to discriminate between two groups of participants with different clinical profiles (Mann–Whitney U test); reliability by internal consistency (Cronbach’s alpha) and test–retest reliability (intraclass correlation coefficient, ICC2.1); and measurement error by calculating the minimum detectable change (MDC). Results It took one month to develop a consensus-based version of the FreKAQ-I. The questionnaire was administered to 102 subjects with painful knee OA and was well accepted. Internal structural validity confirmed the substantial unidimensionality of the FreKAQ-I: variance explained was 53.3%, the unexplained variance in the first contrast showed an eigenvalue of 1.8, and no local dependence was detected. Construct validity was good as all of the hypotheses were met; correlations: KOOS (rho = 0.38–0.51), PI-NRS (rho = 0.35–0.37), PCS (rho = 0.47) and HADS (Anxiety rho = 0.36; Depression rho = 0.43). Regarding known-groups validity, FreKAQ scores were significantly different between groups of participants demonstrating high and low levels of pain intensity, pain catastrophising, anxiety, depression and the four KOOS subscales (p ≤ 0.004). Internal consistency was acceptable (α = 0.74) and test–retest reliability was excellent (ICC = 0.92, CI 0.87–0.94). The MDC95 was 5.22 scale points. Conclusion The FreKAQ-I is unidimensional, reliable and valid in Italian patients with painful knee OA. Its use is recommended for clinical and research purposes.

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Pharmaceutical-grade Chondroitin sulfate is as effective as celecoxib and superior to placebo in symptomatic knee osteoarthritis: the ChONdroitin versus CElecoxib versus Placebo Trial (CONCEPT)

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2016-210860 ◽

2017 ◽

Vol 76 (9) ◽

pp. 1537-1543 ◽

Cited By ~ 39

Author(s):

Jean-Yves Reginster ◽

Jean Dudler ◽

Tomasz Blicharski ◽

Karel Pavelka

Keyword(s):

Placebo Group ◽

Knee Osteoarthritis ◽

Chondroitin Sulfate ◽

Controlled Trial ◽

European Medicines Agency ◽

Double Blind ◽

Knee Oa ◽

Symptomatic Knee Osteoarthritis ◽

Symptomatic Knee ◽

Secondary Endpoints

ObjectivesChondroitin sulfate 800 mg/day (CS) pharmaceutical-grade in the management of symptomatic knee osteoarthritis consistent with the European Medicines Agency guideline.MethodsA prospective, randomised, 6-month, 3-arm, double-blind, double-dummy, placebo and celecoxib (200 mg/day)-controlled trial assessing changes in pain on a Visual Analogue Scale (VAS) and in the Lequesne Index (LI) as coprimary endpoints. Minimal-Clinically Important Improvement (MCII), Patient-Acceptable Symptoms State (PASS) were used as secondary endpoints.Results604 patients (knee osteoarthritis) diagnosed according to American College of Rheumalogy (ACR) criteria, recruited in five European countries and followed for 182 days. CS and celecoxib showed a greater significant reduction in pain and LI than placebo. In the intention-to-treat (ITT) population, pain reduction in VAS at day 182 in the CS group (−42.6 mm) and in celecoxib group (−39.5 mm) was significantly greater than the placebo group (−33.3 mm) (p=0.001 for CS and p=0.009 for celecoxib), while no difference observed between CS and celecoxib. Similar trend for the LI, as reduction in this metric in the CS group (−4.7) and celecoxib group (−4.6) was significantly greater than the placebo group (−3.7) (p=0.023 for CS and p=0.015 for celecoxib), no difference was observed between CS and celecoxib. Both secondary endpoints (MCII and PASS) at day 182 improved significantly in the CS and celecoxib groups. All treatments demonstrated excellent safety profiles.ConclusionA 800 mg/day pharmaceutical-grade CS is superior to placebo and similar to celecoxib in reducing pain and improving function over 6 months in symptomatic knee osteoarthritis (OA) patients. This formulation of CS should be considered a first-line treatment in the medical management of knee OA.

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AN OPEN-LABEL MULTICENTER OBSERVATIONAL STUDY OF THE EFFICACY, TOLERABILITY, AND SAFETY OF THE NONSTEROIDAL ANTI-INFLAMMATORY DRUG AMTOLMETIN GUACIL IN PATIENTS WITH KNEE OSTEOARTHRITIS AND DYSPEPSIA

Rheumatology Science and Practice ◽

10.14412/1995-4484-2016-654-659 ◽

2017 ◽

Vol 54 (6) ◽

pp. 654-659 ◽

Cited By ~ 1

Author(s):

E. S. Tsvetkova ◽

L. N. Denisov ◽

A. N. Otteva ◽

A. L. Dubikov ◽

S. P. Yakupova ◽

...

Keyword(s):

Observational Study ◽

Knee Osteoarthritis ◽

Analgesic Effect ◽

Varicose Veins ◽

Health Assessment ◽

Open Label ◽

Serious Adverse Events ◽

Multicenter Observational Study ◽

Knee Oa ◽

Anti Inflammatory

Objective: to investigate the efficacy and tolerability of amtolmetin guacil (AMG; Niselat®, Dr. Reddy's Laboratories Ltd, India) versus previous therapy with nonsteroidal anti-inflammatory drugs (NSAIDs) in patients with knee osteoarthritis (OA) and signs of dyspepsia.Subjects and methods. The open-label observational study included 220 patients aged 30–65 years who suffered from knee OA and intense pain during NSAID intake and had symptoms of dyspepsia in the absence of contraindications to the use of AMG. Among the comorbidities that generally occurred in 68% of the patients, there was a preponderance of hypertension (42%), lower extremity varicose veins (6.4%), and diabetes mellitus (6%). Treatment efficacy was evaluated using three domains of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), by also taking into account pain intensity and general health assessment on the visual analogue scale. A Severity of Dyspepsia Assessment (SODA) scale was used to rate dyspepsia.Results and discussion. AMG had a marked analgesic effect confirmed by 40% or more pain reduction that occurred in 72.5% of the patients. The high analgesic effect of AMG was confirmed by a statistically significant (p <0.001) reduction in the WOMAC index (pain and stiffness) and by an increase in functional activity. There was a significant decrease in painless and painful signs of dyspepsia, as well as positive changes in the measures “overall assessment of dyspepsia severity” (p < 0.001) and “satisfaction with treatment”. Overall assessment of AMG tolerability was only positive: excellent (33%), good (56%), and satisfactory (11%). There were no serious adverse events (AE). AE were graded as moderate and mild in 8 and 82% of cases, respectively. AE were recorded in 7.7% of the patients. Conclusion. The findings suggest that AMG offers good prospects for knee OA treatment.

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Comparative study between the effect of neural versus intra-articular dextrose prolotherapy on pain and disability in patients with knee osteoarthritis

Egyptian Rheumatology and Rehabilitation ◽

10.1186/s43166-021-00079-w ◽

2021 ◽

Vol 48 (1) ◽

Author(s):

Rehab A. Sallam ◽

Aya A. Abdelkhabir ◽

Adel A. Shabana

Keyword(s):

Knee Osteoarthritis ◽

Womac Pain ◽

Knee Oa ◽

Natural Substances ◽

Group I ◽

Skin Targeting ◽

Vas Scores ◽

Group Ii ◽

Reduced Mobility

Abstract Background Osteoarthritis (OA) is a degenerative disease which presents with joint pain and stiffness and reduced mobility. Knee OA is the commonest cause of disability in adults. Dextrose prolotherapy is a new option used to treat mild-to-moderate knee OA. Neural prolotherapy (NPT) is multiple small injections under the skin targeting painful areas with natural substances. The aim of work was to evaluate and compare neural prolotherapy versus intra-articular dextrose prolotherapy effect on relieving pain and improving disability of knee OA. Results VAS and WOMAC scores improved significantly immediately and at 3 and at 6 months, respectively, in group I compared with group II (P < 0.001). The decrease in VAS scores and all the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores in group I along the follow-up period in comparison with the baseline scores was statistically significant (P < 0.001). In group II, only WOMAC pain and stiffness scores improved significantly. ROM showed insignificant increase in both groups at 3 and 6 months assessment. On follow-up, range of motion increased in both groups and reached significance in group I (P = .002). Conclusion Dextrose prolotherapy both intra-articular and periarticular (neural) is a very effective and cheap therapy for knee OA with good patient selection. Neural prolotherapy significantly relieves pain and improves function in patients with knee osteoarthritis when compared with intra-articular prolotherapy thus avoiding hazards of intra-articular knee injections.

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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

10.21203/rs.3.rs-36493/v1 ◽

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.

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Comparison Of Diacerein-Ginger With Diacerein Alone In Treating Knee Osteoarthritis

Journal of Bahria University Medical and Dental College ◽

10.51985/jbumdc2019096 ◽

2019 ◽

Vol 09 (04) ◽

pp. 308-311

Author(s):

Mehtab Munir ◽

Shahid Mustafa Memon ◽

Sajid Abbas Jaffri ◽

Khalid Mustafa Memon

Keyword(s):

Knee Osteoarthritis ◽

P Value ◽

Womac Pain ◽

Test Results ◽

Knee Oa ◽

Significant Difference ◽

Group A ◽

Insignificant Difference ◽

Group B ◽

Pain At Rest

Objective: To compare clinical efficacy of diacerein-ginger with diacerein alone in treating knee osteoarthritis. Duration and place of study: It was a randomized clinical trial conducted from 21st September 2018 to 31stMarch 2019, in medical OPD of a private hospital in Karachi. Methodology: 60 diagnosed patients of knee osteoarthritis were included in this study. Male and female patients 50 years of age, fulfilling the inclusion criteria and after written informed consent experienced a wash-out period of 72 hours. These patients were systematically randomized into 2 groups each having 30 members. Group A received capsule Diacerein 50mg + capsule Ginger 550 mg twice daily and group B received capsule Diacerein 50mg twice daily, for 12 weeks. Parameters checked at 0, 6 and 12 weeks were: Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index, pain at rest and movement (Visual Analogue Scale). Comparison of the two groups was done by independent t-test. Results: Among 60 patients; 20 (33.33 %) were males and 40 (66.66%) were females. 4 patients in group A and 4 in B, dropped out during the study. Comparison of group A with group B in WOMAC and pain (at rest and movement) scores showed insignificant difference at day 0 before prescription of the drugs. However comparison showed highly significant difference (P-value < 0.001) between the two groups in WOMAC, pain at rest and movement scores at the end of 6th and 12th weeks of intervention. Conclusion: Diacerein-Ginger is clinically more efficacious for management of knee OA than Diacerein alone

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GAMBARAN KEJADIAN NYERI LUTUT DENGAN KECURIGAAN OSTEOARTRITIS LUTUT PADA PERAWAT DI POLIKLINIK RAWAT JALAN BLU RSUP PROF. DR. R. D. KANDOU MANADO

e-CliniC ◽

10.35790/ecl.2.1.2014.3859 ◽

2014 ◽

Vol 2 (1) ◽

Author(s):

Rita Purnama Deu

Keyword(s):

Body Mass Index ◽

Knee Osteoarthritis ◽

Knee Pain ◽

Visual Analog Scale ◽

Outpatient Treatment ◽

Analog Scale ◽

High Heel ◽

Knee Oa ◽

Lequesne Index ◽

Female Nurses

Abstract: Osteoarthritis (OA) is a degenerative joint disease associated with destruction of joint cartilages. OA can occur in all joints of the cervical, thoracal, and lumbar vertebrae, pelvis, knees, ankles, hands, and fingers. However, it is most commonly found in the knee joints because these joints bear heavier burden than the other joints. OA patients usually complain pain at the time of doing activities or if there is some load on the affected joint. On a more serious degree, there is continuous pain which disturbs the patient’s mobility. This study aimed to find the incidence knee osteoarthritis among nurses at outpatient treatment of Prof. Dr. R.D. Kandou Hospital. This was a descriptive quantitative study. Sample consisted of 25 nurses. Data were obtained through interviews and questionnaires and then were analyzed by using SPSS. The results showed that the highest numbers of nurses (14 nurses, 56.0%) with suspected knee OA were in the age group of 51-60 years. There were as many as 23 female nurses (92.0%) with suspected knee OA. Based on BMI (Body Mass Index) most of the nurses (13 nurses, 52.0%) were obese I, meanwhile based on the degrees of knee pain most of the nurses (19 nurses, 76.0%) experienced mild pain. Based on the Lequesne index functions most samples (13 nurses, 52.0%) showed mild functional. Based on the usage of high heel shoes most of the female nurses (19 nurses, 76.0%) used high heel shoes. Conclusion: Most of the nurses at outpatient treatment of Prof. Dr. R.D.Kandou Hospital that were suspected of knee osteoarthritis were obese I, had associated mild pain, and showed mild functional tested with Lequesne index funtion. Moreover, most of the female nurses wore high heel shoes.Keywords: knee osteoarthritis , knee pain, Lequesne index parameters, BMT (Body Mass Index), VAS (Visual Analog Scale)Abstrak: Osteoartritis (OA) merupakan penyakit degenerative sendi yang berkaitan dengan kerusakan kartilago sendi. OA dapat mengenai semua persendian dari servikal, thorakal, dan lumbal, panggul, lutut, pergelangan kaki, tangan sampai ke jari-jari, tetapi paling sering ditemukan pada sendi lutut karena pada sendi ini terdapat pembebanan yang lebih besar. Pasien OA biasanya mengeluh nyeri pada waktu melakukan aktivitas atau jika ada pembebanan pada sendi yang terkena. Pada derajat yang lebih berat, nyeri dapat dirasakan terus menerus sehingga sangat mengganggu mobilitas pasien. Penelitian ini bertujuan untuk mengetahui angka kejadian nyeri lutut dengan kecurigaan OA lutut pada perawat di Poliklinik Rawat Jalan BLU RSUP Prof. Dr. R. D Kandou Manado. Penelitian ini menggunakanpendekatan deskriptif kuantitatif. Sampel berjumlah 25 perawat. Data diperoleh melalui kuesioner dan wawancara yang kemudian dianalisis menggunakan SPSS. Hasil penelitian memperlihatkan bahwa perawat yang dicurigai OA lutut terbanyak pada kelompok umur 51-60 tahun sebanyak 14 perawat (56,0 %). Berdasarkan jenis kelamin perawat yang di curigai OA lutut terbanyak pada perempuan yaitu sebanyak 23 perawat (92,0 %). Berdasarkan IMT (Indeks Massa Tubuh) sebagian besar perawat ialah obes I yaitu 13 perawat (52,0 %). Berdasarkan derajat nyeri lutut sebagian besar mengalami nyeri ringan yaitu sebanyak 19 perawat (76,0 %). Berdasarkan indeks Lequesne sebagian besar fungsi fungsional ringan yaitu 13 perawat (52,0 %). Berdasarkan pemakaian sepatu tumit tinggi sebagian besar perawat perempuan menggunakan sepatu tumit tinggi yaitu sebanyak 19 perawat (76,0 %). Simpulan: Sebagian besar perawat di Poliklinik Rawat Jalan BLU RSUP Prof. Dr. R.D. Kandou Manado yang dicurigai osteoartritis lutut termasuk obes I, disertai nyeri ringan, dan indeks Lequesne fungsional ringan. Sebagian besar perawat perempuan menggunakan sepatu tumit tinggi.Kata kunci : osteoartritis lutut, nyeri lutut, parameter indeks Lequesne, VAS (Visual Analog Scale)

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Intra Articular Ozone Modulates Inflammation and Has Anabolic Effect on Knee Osteoarthritis: IL-6 and IGF-1 as Pro-Inflammatory and Anabolic Biomarkers

Processes ◽

10.3390/pr10010138 ◽

2022 ◽

Vol 10 (1) ◽

pp. 138

Author(s):

Marcos E. Fernández-Cuadros ◽

Olga S. Pérez-Moro ◽

María J. Albaladejo-Florín ◽

María M. Tobar-Izquierdo ◽

Amelia Magaña-Sánchez ◽

...

Keyword(s):

Uric Acid ◽

Knee Osteoarthritis ◽

Real World ◽

Secondary Outcome ◽

Womac Pain ◽

Anabolic Effect ◽

Obese Patients ◽

Knee Oa ◽

Before And After ◽

Anti Inflammatory

Objectives: (1) to demonstrate the anti-inflammatory and anabolic effect of Ozone by determining in serum samples the biochemical levels of IL-6 and IGF-1 in knee osteoarthritis (OA) patients in a real world rehabilitation setting; (2) to differentiate Ozone effect in diabetic (DM)/obese and non-DM/non-obese patients; (3) to evaluate clinical effectiveness by visual analog scale (VAS) and WOMAC scale, and biochemical effect by C-reactive protein (CRP), uric acid and erythrocyte sedimentation rate (ESR). Material and methods: 65 patients with knee OA Kellgren Lawrence (KL) grade 2 or more were analyzed in a retrospective observational study. The study ran from January 2018 to September 2021. Inclusion criteria: (a) patients 18 years or older; (b) with knee OA KL 2° or more; (c) biochemical analysis before-and-after treatment; (d) pain more than 3 on VAS. Exclusion Criteria: (a) previous knee surgery; (b) favism; (c) pregnancy; (d) any other disease that originates lack of collaboration for infiltration. Primary Outcome variables: (a) IL-6; (b) IGF-1 in diabetes mellitus (DM)/obese and non-DM/non-obese patients; both before-and-after Ozone treatment. Secondary Outcome variables: (a) CRP, (b) ESR, (c) uric acid, (d) VAS pain, (e) WOMAC pain, function and stiffness. Ozone protocol consisted of four sessions (once a week) of an intra-articular infiltration of 20 mL (20 µg/mL concentration) of a gas mixture of Oxygen-Ozone 95-5% (produced by Ozone generator Ozonosan-α Plus®). For biochemical evaluation, SNIBE MAGLUMI ™ IL-6 (CLIA) and SNIBE MAGLUMI ™ IGF-1 (CLIA) kits were used. CRP and uric acid were analyzed by a Abbott Alinity c kit; and ESR was evaluated by DIESSE VES MATIC CUBE 30. Results: There is a linear correlation between age and OA severity. IL-6 decreased both in DM and non-DM patients and in all OA KL grades (from 2.70 to 1.59 pg/mL). IGF-1 decreased in total group (OA + DM + obesity) from 112.09 to 107.19 ng/mL. When only non-DM/non-obese knee OA patients were analyzed, Ozone improved IGF-1 levels (from 100.17 to 102.03 ng/mL). Ozone decreased CRP, ESR, uric acid, and improved VAS pain, WOMAC pain, function and stiffness (p < 0.05). Conclusions: Ozone is a valid option for the management of knee osteoarthritis in a real world rehabilitation setting, because of its anti-inflammatory, metabolic and anabolic properties. Ozone tends to downregulate pro-inflammatory IL-6 cytokine. Ozone has a metabolic/hypoglycemic effect on obese/diabetic knee osteoarthritis patients by reducing IGF-1. Ozone has an anabolic effect on non-diabetic/non-obese patients by improving IGF-1. Ozone reduces other biomarkers of inflammation (CRP, ESR and uric acid) and improves, pain, function and quality of life.

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Depression in patients with knee osteoarthritis: risk factors and associations with joint symptoms

10.21203/rs.3.rs-31807/v2 ◽

2020 ◽

Author(s):

Shuang Zheng ◽

Liudan Tu ◽

Flavia Cicuttini ◽

Zhaohua Zhu ◽

Weiyu Han ◽

...

Keyword(s):

Risk Factors ◽

Knee Joint ◽

Knee Osteoarthritis ◽

Controlled Trial ◽

Womac Pain ◽

Knee Oa ◽

Symptomatic Knee Osteoarthritis ◽

Symptomatic Knee ◽

Joint Symptoms ◽

Patient Health

Abstract Background:To describe demographic and clinical factors associated with the prevalence and incidence of depression and explore the temporal relationship between depression and joint symptoms in patients with symptomatic knee osteoarthritis (OA). Methods:413 participants were selected from a randomized controlled trial in people with symptomatic knee OA and vitamin D deficiency (age 63.2 ± 7.0 year, 50.4% female). Depression severity and knee joint symptoms were assessed using the patient health questionnaire (PHQ-9) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), respectively, at baseline and 24 months. Results: The prevalence and incidence of depression was 25.4% and 11.2%, respectively. At baseline, having younger age, a higher body mass index (BMI), greater scores of WOMAC pain (PR: 1.05, 95%CI:1.03, 1.07), dysfunction (PR: 1.02, 95%CI:1.01, 1.02) and stiffness (PR: 1.05, 95%CI: 1.02, 1.09), lower education level, having more than one comorbidity and having two or more painful body sites were significantly associated with a higher prevalence of depression. Over 24 months, being female, having a higher WOMAC pain (RR: 1.05, 95%CI: 1.02, 1.09) and dysfunction score (RR: 1.02, 95%CI: 1.01, 1.03) at baseline and having two or more painful sites were significantly associated with a higher incidence of depression. In contrast, baseline depression was not associated with changes in knee joint symptoms over 24 months. Conclusion: Knee OA risk factors and joint symptoms, along with co-existing multi-site pain are associated with the prevalence and development of depression. This suggests that managing common OA risk factors and joint symptoms may be important for prevention and treatment depression in patients with knee OA.Trial registration: ClinicalTrials.gov identifier: NCT01176344Anzctr.org.au identifier: ACTRN12610000495022

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