Viscosupplementation for Knee Osteoarthritis: Current Evidence and Recommendations

2013 ◽  
Vol 23 (2-03) ◽  
pp. 151-159 ◽  
Author(s):  
Nathan Evaniew ◽  
Beate Hanson ◽  
Mitchell Winemaker
Keyword(s):  
Knee Osteoarthritis ◽  
Current Evidence

Does running protect against knee osteoarthritis? Or promote it? Assessing the current evidence

2015 ◽  
Vol 49 (21) ◽  
pp. 1355-1356 ◽  
Author(s):  
Richard D Leech ◽  
Kim L Edwards ◽  
Mark E Batt
Keyword(s):  
Knee Osteoarthritis ◽  
Current Evidence

scholarly journals Complex Lifestyle and Psychological Intervention in Knee Osteoarthritis: Scoping Review of Randomized Controlled Trials

2021 ◽  
Vol 18 (23) ◽  
pp. 12757
Author(s):  
Bryan Yijia Tan ◽  
Tivona Thach ◽  
Yasmin Lynda Munro ◽  
Soren Thorgaard Skou ◽  
Julian Thumboo ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Scoping Review ◽  
Psychological Intervention ◽  
Care Delivery ◽  
Data Extraction ◽  
Psychosocial Interventions ◽  
Current Evidence ◽  
Future Research ◽  
Controlled Trials ◽  
Knee Oa

Knee osteoarthritis (OA) causes pain, disability and poor quality of life in the elderly. The primary aim was to identify and map out the current evidence for randomised controlled trials (RCTs) on complex lifestyle and psychosocial interventions for knee OA. The secondary aim was to outline different components of complex lifestyle and psychosocial interventions. Our scoping review searched five databases from 2000 to 2021 where complex lifestyle or psychosocial interventions for patients with knee OA were compared to other interventions. Screening and data extraction were performed by two review authors independently and discrepancies resolved through consensus and in parallel with a third reviewer. A total of 38 articles were selected: 9 studied the effectiveness of psychological interventions; 11 were on self-management and lifestyle interventions; 18 looked at multifaceted interventions. This review highlights the substantial variation in knee OA interventions and the overall lack of quality in the current literature. Potential areas of future research, including identifying prognostic social factors, stratified care models, transdisciplinary care delivery and technology augmented interventions, have been identified. Further high-quality RCTs utilizing process evaluations and economic evaluation in accordance with the MRC guidelines are critical for the development of evidence-based knee OA programs globally.

Experiences of Wearable Technology by Persons with Knee Osteoarthritis Participating in a Physical Activity Counselling Intervention: A Qualitative Study Using a Relational Ethics Lens (Preprint)

2021 ◽  
Author(s):  
Jenny Leese ◽  
Graham MacDonald ◽  
Catherine L Backman ◽  
Anne Townsend ◽  
Laura Nimmon ◽  
...  
Keyword(s):  
Physical Activity ◽  
Qualitative Study ◽  
Knee Osteoarthritis ◽  
Relational Ethics ◽  
Current Evidence ◽  
Knee Oa ◽  
Everyday Lives ◽  
Physical Activity Counselling ◽  
Phone Calls ◽  
Counselling Intervention

BACKGROUND Current evidence indicates physical activity wearables could support persons with knee osteoarthritis (OA) to be more physically active. Recent evidence also identifies, however, some persons with arthritis experience guilt or worry while using a wearable if they are not as active as they feel they should be. Questions remain around how persons with knee OA experience benefits or downsides in using a wearable in their everyday lives. Better understanding is needed if wearables are to be incorporated in arthritis self-management in ways that are ethically aware. OBJECTIVE Using an ethics lens, describe a range of experiences from persons with knee OA who used a wearable during a physical activity counselling intervention study. METHODS This is a secondary analysis of qualitative interviews (60-90 mins) nested within a randomized controlled trial (RCT). Guided by phenomenography, we explored the experiences of persons with knee OA, following participation in a physical activity counselling intervention. The intervention consisted of a 1.5-hour education session about physical activity, using a Fitbit Flex, and receiving 4 biweekly phone calls for activity counselling with a study physiotherapist (PT) in an 8-week period. All PTs were trained in the Brief Action Planning approach, whereby they guided participants to identify activity goals, develop an action plan, and identify barriers and solutions. Benefits or downsides experienced in participants’ relationships with themselves or the study PT when using the wearable were identified using a relational ethics lens. RESULTS Interviews with 21 participants (12 females, 9 males) aged 40-82 years were analyzed. Education ranged from high school graduate (n=4) to bachelor’s degree or above (n=11). Three categories of description were identified: 1) Participants experienced their wearable as a motivating or nagging influence to be more active, depending on how freely they were able to make autonomous choices about physical activity in their everyday lives; 2) Some participants felt a sense of accomplishment from seeing progress in their wearable data, which fuelled motivation. One participant experienced negative emotions (e.g., self-blame) if his wearable data indicated physical activity goals were not met; 3) For some participants, sharing wearable data helped to build mutual trust in their relationship with the study PT. They also expressed, however, there was potential for sharing wearable data to undermine this trust, particularly if this data was inaccurate. CONCLUSIONS To our knowledge, this is the first qualitative study that uses a relational ethics lens to explore how persons with arthritis experienced changes in their relationship with a health professional when using a wearable during research participation. Findings also provide an early glimpse into positive and negative emotional impacts of using a wearable that can be experienced by participants with knee OA when participating in an RCT to support physical activity.

scholarly journals Platelet-rich plasma versus hyaluronic acid in knee osteoarthritis: A meta-analysis with the consistent ratio of injection

2020 ◽  
Vol 28 (1) ◽  
pp. 230949901988766 ◽  
Author(s):  
Qipeng Wu ◽  
Xuefen Luo ◽  
Yuan Xiong ◽  
Guohui Liu ◽  
Junwen Wang ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Knee Osteoarthritis ◽  
Randomized Clinical Trials ◽  
Platelet Rich Plasma ◽  
Meta Analysis ◽  
International Knee Documentation Committee ◽  
Joint Disease ◽  
Functional Improvement ◽  
Current Evidence ◽  
Cochrane Library

Osteoarthritis (OA) is an extremely common form of chronic joint disease which can affect the knees and other joints of older adults, leading to debilitating disability in the knee and consequent reduction in quality of life. Intra-articular platelet-rich plasma (PRP) or hyaluronic acid (HA) injections are effective for maintaining long-term beneficial effects without increasing the risk of intra-articular infection. However, few studies have compared the relative value of HA and PRP for OA treatment. PRP is more effective than HA for OA treatment in recent studies of this topic. We systematically searched Medline, SpringerLink, Embase, Pubmed, Clinical Trials.gov, the Cochrane Library, and OVID for all articles published through May 2018. Any study was included that compared the effect of HA and PRP (consistent treatment cycle and frequency of injection) on patient’s pain levels and functionality improvements. Review Manager 5.3 was used to analyze data regarding these two primary outcomes. We included 10 total studies in the present meta-analysis. International Knee Documentation Committee (IKDC; MD: 10.37, 95% confidence interval (CI): 9.13 to 11.62, p < 0.00001), Western Ontario and MacMaster Universities Osteoarthritis Index (WOMAC; MD: −20.69, 95% CI: −24.50 to −16.89, p < 0.00001, I2 = 94%), and Visual Analogue Scale (VAS; MD: −1.50, 95% CI: −1.61 to −1.38, p < 0.00001, I2 = 90%) differed significantly between the PRP and HA groups. Knee Osteoarthritis Outcome Scores (KOOSs) did not differ significantly ( χ2 = 23.53, I2 = 41%, p = 0.11). Our hypothesis appears not to be confirmed because PRP and HA did not differ significantly with respect to KOOS score. However, the IKDC, WOMAC, and VAS scores differed significantly. Thus, based on the current evidence, PRP appears to be better than HA at achieving pain relief and self-reported functional improvement. Ia, meta-analyses of randomized clinical trials.

Current evidence on risk factors for knee osteoarthritis related to hormones or reproductive history

Maturitas ◽  
2015 ◽  
Vol 81 (1) ◽  
pp. 226
Author(s):  
Nathaly Gaudreault ◽  
Nicola Hagemeister ◽  
Debbie Feldman ◽  
Marie-José Durand
Keyword(s):  
Risk Factors ◽  
Knee Osteoarthritis ◽  
Reproductive History ◽  
Current Evidence

scholarly journals Physical Therapists in Primary Care Are Interested in High Quality Evidence Regarding Efficacy of Therapeutic Ultrasound for Knee Osteoarthritis: A Provincial Survey

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Norma J. MacIntyre ◽  
Jason W. Busse ◽  
Mohit Bhandari
Keyword(s):  
Knee Osteoarthritis ◽  
Physical Therapists ◽  
Controlled Trial ◽  
Therapeutic Ultrasound ◽  
Current Evidence ◽  
Surrounding Soft Tissue ◽  
Electronic Survey ◽  
Knee Oa ◽  
Patterns Of Use ◽  
High Level

Recent high-level evidence favours therapeutic ultrasound (US) for reducing pain in people with knee osteoarthritis (OA). It is unknown how current practice patterns align with current evidence regarding US efficacy and whether physical therapists perceive a need for further high-level evidence. We conducted a descriptive electronic survey to characterize the beliefs and use of US among physical therapists in Ontario treating people with nonsurgical knee OA. Most of the 123 respondents (81%) reported at least some use of US with 45% using it often or sometimes. The main goal for using US was to reduce pain in the surrounding soft tissue (n=66) and/or the knee joint (n=43). Almost half (46%) endorsed the belief that US is likely to be beneficial for clients with nonsurgical knee OA. Most respondents (85%) expressed interest in the results of a randomized controlled trial evaluating the effectiveness of US on pain and physical function. Patterns of use reflect the respondents’ belief that US is likely to be beneficial for knee OA pain.

Radiofrequency Procedures for the Treatment of Symptomatic Knee Osteoarthritis: A Systematic Review

Pain Medicine ◽  
2019 ◽  
Author(s):  
Prabjit Ajrawat ◽  
Lenny Radomski ◽  
Anuj Bhatia ◽  
Phillip Peng ◽  
Nikhil Nath ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Adverse Events ◽  
Knee Osteoarthritis ◽  
Comparative Studies ◽  
Current Evidence ◽  
Cochrane Library ◽  
Knee Oa ◽  
And Control ◽  
Disease Specific

Abstract Objective To evaluate the effectiveness and safety of radiofrequency (RF) ablation and neuromodulation modalities for knee osteoarthritis (OA). Methods The Pubmed, Medline, Embase, and Cochrane Library databases were searched from inception to August 2018. All comparative and noncomparative studies that reported clinical outcome measures and adverse events related to RF modalities for knee OA were included. Pain scores, physical function measures, quality of life (QOL), patient satisfaction, and adverse events for three months and beyond of postprocedure follow-up were analyzed qualitatively. Results Thirty-three studies, including 13 randomized controlled trials (RCTs), two nonrandomized comparative studies, and 18 noncomparative cohort studies, were identified, with 1,512 patients (mean age = 64.3 years, 32.5% males). All 33 studies were considered to be of moderate or high methodological quality. All 33/33 (100%) studies reported alleviation of OA-related knee pain from baseline until three to 12 months with RF modalities, with six comparative studies reporting 194/296 (65.5%) and 29/150 (19.3%) RF and control patients achieving >50% pain relief, respectively. Three of the 33 studies reported QOL, with three of three studies (100%) achieving improvements in disease-specific QOL from baseline until three to 12 months. Twenty-eight of the 33 studies reported functional outcomes, with 27/28 (96%) studies obtaining enhanced functionality from baseline up until three to 12 months. Ten of the 33 studies reported patient satisfaction, with eight of 10 studies (80%) indicating that patients were significantly satisfied after RF procedures, and from these eight studies, four were comparative studies that indicated that 86/154 (56%) and 33/104 (32%) RF and control patients were extremely satisfied or satisfied, respectively. Regarding adverse events (AEs), 29 of the 33 studies reported AEs, with 20/29 (69%) studies indicating no AEs related to the RF modalities and the remaining nine studies only indicating minor localized AEs. Twenty-nine of the 33 studies indicated no serious knee-related AEs pertaining to RF modalities. Conclusions Current evidence substantiates that RF modalities for knee OA potentially improve pain, functionality, and disease-specific QOL for up to three to 12 months with minimal localized complications. This suggests that RF modalities are perhaps an effective adjunct therapy for patients with knee OA who are unresponsive to conservative therapies. Further RCTs with larger sample sizes and long-term follow-up that directly compare the three primary RF modalities are warranted to confirm the clinical efficaciousness and superiority of these RF modalities for knee OA.

Online Decision Aids for Knee Osteoarthritis and Low Back Pain: An Environmental Scan and Evaluation

2019 ◽  
Vol 39 (4) ◽  
pp. 328-335 ◽  
Author(s):  
Michael Anthony Fajardo ◽  
Bandar Durayb ◽  
Haoxi Zhong ◽  
Lyndal Trevena ◽  
Adrian Traeger ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Knee Osteoarthritis ◽  
Decision Aid ◽  
Decision Aids ◽  
Current Evidence ◽  
Low Back ◽  
Musculoskeletal Conditions ◽  
Wait And See

Background. Musculoskeletal conditions are leading causes of disability. Management options are plentiful, but the current evidence base suggests many are ineffective or unproven. Online decision aids can help support patients make informed health care choices. However, there are little data on the quality of online decision aids for common musculoskeletal conditions such as knee or low back pain. Purpose. To identify all publicly available online decision aids for knee osteoarthritis and low back pain and evaluate them against the International Patient Decision Aids Standards Inventory (IPDASi). Data Sources. Google Australia. Study selection. Two reviewers independently screened websites for inclusion and assessed the quality of included online decision aids between April and May 2018. Included online decision aids were free, provided information about knee osteoarthritis or low back pain, and written in English. Online decision aids that required payment, targeted health professionals, addressed rheumatoid arthritis, or addressed a screening decision were excluded. Data Extraction. IPDASi Version 4. Data Synthesis. Twenty-five online decision aids were identified: 15 knee osteoarthritis and 10 low back pain. Only 3 online decision aids (12%) provided a “wait-and-see” option. Nineteen (75%) met IPDASi criteria to be considered a decision aid and 3 (12%) met IPDASi criteria to state that the online decision aid was unbiased. Limitations. Dynamic nature of Google searches may not be replicable easily. Conclusions. Few good-quality online decision aids are available for people with knee osteoarthritis or low back pain. Most online decision aids failed to explicitly provide a wait-and-see option, suggesting a bias toward intervention. These online decision aids would benefit from explicitly highlighting a wait-and-see option to support informed choice.

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