The Effectiveness of Intra-Articular Injection of Hypertonic Saline in Pain Control and Function of Patients with Knee Osteoarthritis

Background: The aim of this study was to report the effectiveness of intra-articular injection of hypertonic saline in pain reduction and functional improvement in patients with knee osteoarthritis (OA). Methods: Patients with knee pain and dysfunction who fulfilled the American College of Rheumatology criteria and whose illness was sub-acute or chronic were enrolled. We performed a single intra-articular injection of 5 cc of hypertonic (5%) saline solution. Measured outcomes were Visual Analogue Scale (VAS) score and Knee Injury and Osteoarthritis Outcome Score (KOOS) evaluated before and 1 month after intervention. Results: A total of 28 patients with mean age of 66.3 years were surveyed. Overall, study participants reported clinically and statistically significant reduction in VAS and KOOS subscales for symptoms, pain, function, daily living, sports, recreational activities, and quality of life in one month of follow-up with respect to the patients’ mean baseline scores (by 24.47%, 42.74%, 54.96%, 43.78%, and 63.63%, respectively). Although obese patients [body mass index (BMI) ≥ 30 kg/m2] showed less improvement in terms of pain, sports, and quality of life subscales of KOOS, compared with non-obese patients (BMI < 30 kg/m2); VAS score difference was not significant. Conclusion: Intra-articular injection of hypertonic saline yields a statistically and clinically significant short-term pain reduction and functional improvement of patients with knee OA.

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Aquatic versus land-based exercise for cardiorespiratory endurance and quality of life in obese patients with knee osteoarthritis: a randomized controlled trial

Medical Journal of Indonesia ◽

10.13181/mji.v27i4.2107 ◽

2018 ◽

Vol 27 (4) ◽

pp. 284-92

Author(s):

Tirza Z. Tamin ◽

Natalia Loekito

Keyword(s):

Quality Of Life ◽

Randomized Controlled Trial ◽

Knee Osteoarthritis ◽

Controlled Trial ◽

Exercise Group ◽

Aquatic Exercise ◽

Obese Patients ◽

Randomized Controlled ◽

Cardiorespiratory Endurance

Background: Obesity with knee osteoarthritis (OA) is related to chronic pain causing physical inactivity that leads to decreased cardiorespiratory endurance and quality of life. Aquatic and land-based exercises are effective in improving physical activity. The aim of this study is to compare between aquatic and land-based exercise to improve cardiorespiratory endurance and quality of life in obese patients with knee osteoarthritis.Methods: A single-blind, randomized, controlled trial was conducted on thirty three obese patients with knee OA who visited Obesity Clinic of Medical Rehabilitation Cipto Mangunkusumo Hospital, from October 2016 to January 2017, subjects were divided into aquatic or land-based exercise group. Aerobic and knee-strengthening exercises were given. Cardiorespiratory endurance was assessed using the Borg Scale, whereas both the BORG CR-10 and SF-36 questionnaires were used to assess quality of life.Results: After intervention, there were significant improvements in the land-based exercise group in the rating of perceived exertion (p=0.02), role limitations due to physical health (p=0.024), role limitations due to emotional problems (p=0.041), energy/fatigue (p=0.016), and the decline in pain (p=0.049) parameters. While in the aquatic exercise, there were significant improvements in leg fatigue (p=0.016), energy/fatigue (p=0.025), emotional well-being (p<0.001), and general health (p=0.045) parameters. Despite this, there were no significant differences between two groups regarding cardiorespiratory endurance and quality of life.Conclusion: This study found that patients could start aquatic exercise to reduce leg fatigue and enhanced general health and energy. After that, exercise could be continued in land-based settings to improve cardiorespiratory endurance and quality of life.

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Therapeutic Effects of Intra-Articular Botulinum Neurotoxin Versus Physical Therapy in Knee Osteoarthritis

Anesthesiology and Pain Medicine ◽

10.5812/aapm.112789 ◽

2021 ◽

Vol 11 (3) ◽

Author(s):

Zahra Rezasoltani ◽

Afsaneh Dadarkhah ◽

Seyed Morteza Tabatabaee ◽

Fateme Abdorrazaghi ◽

Morteza Kazempour Mofrad ◽

...

Keyword(s):

Quality Of Life ◽

Physical Therapy ◽

Knee Osteoarthritis ◽

Botulinum Neurotoxin ◽

Demographic Data ◽

Therapeutic Effects ◽

Vas Score ◽

Chronic Knee Pain ◽

Significant Difference

Background: Knee osteoarthritis (KOA) is the most common cause of chronic knee pain, and disability and different modalities have been used to improve pain and function. Botulinum toxin intra-articular injection is proposed to manage resistant joint pains. Objectives: This study was carried out to compare therapeutic effects of intra-articular botulinum neurotoxin (BTX) versus physical therapy (PT) in KOA. Methods: In this single-blind randomized clinical trial, patients with KOA attending to Imam-Reza Hospital, Tehran, Iran, from June 2018 to March 2019 were enrolled. Patients who met the inclusion criteria were randomly divided into BTX receiving a single intra-articular dose of 100 units (250 units from disport brand) and PT groups. The study was described for patients, and informed consent forms were received. For assessment of the pain and related severity, the VAS score and KOOS scales were used. Post-intervention assessment was done 1, 3, and 6 months after the intervention. The level of significance was set at α = 0.05. All data analyses were performed with SPSS version 26 for windows. Results: In this study, 50 patients were randomly divided into BTX and PT groups. All patients completed the study, and there was no loss to follow-up. There was no significant difference between demographic data of the two groups, including age and BMI. The VAS score was similar in the two groups at the beginning. KOOS subscales were not significantly different, but the quality of life was better in the BTX than the PT group (86.2 ± 15 vs. 72.1 ± 11.5, P < 0.001). One month after the intervention, all KOOS subscales were improved in the BTX group in comparison to the PT group (P < 0.001). This difference was statistically significant in the 3rd (P < 0.001 in all comparisons except Sport/Rec subscale in which P = 0.02) and 6th months (P < 0.001) after the intervention, and the improvement in all KOOS subscales and VAS score were higher in the BTX group than the PT group. The trend of KOOS subscales and VAS score was improved over time in the BTX (P < 0.001 in all tests), but the PT group showed no improvement (P > 0.05) except for Sport/Rec and VAS score (P < 0.001). Conclusions: Totally, it is concluded that the use of BTX can reduce pain and improve the function and quality of life in patients with KOA.

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Effects of variable frequencies of kinesthesia, balance and agility exercise program in adults with knee osteoarthritis: study protocol for a randomized controlled trial

10.21203/rs.3.rs-28963/v2 ◽

2020 ◽

Author(s):

Aysha I. Adhama ◽

Mukadas O. Akindele ◽

Aminu A. Ibrahim

Keyword(s):

Quality Of Life ◽

Randomized Controlled Trial ◽

Knee Osteoarthritis ◽

Conventional Therapy ◽

Controlled Trial ◽

Hip Osteoarthritis ◽

Life Questionnaire ◽

Knee Oa ◽

Randomized Controlled

Abstract Background: Knee osteoarthritis (OA) is a common painful and disabling condition that affects older individuals. Proprioceptive training programs in the form of kinesthesia, balance and agility (KBA) exercises have been reported to be beneficial for individuals with knee OA. However, the most optimal treatment dosage of KBA exercise is still unclear. The aim of this study is to determine the effects of different frequencies of KBA treatment (i.e. twice-weekly or thrice-weekly) in adults with knee OA.Methods: A single (assessor) blind, three-arm parallel, multi-center randomized controlled trial will be conducted. Eighty-four adults with knee OA will be recruited from four tertiary hospitals in Northwestern Nigeria and randomly assigned into one of three intervention groups; twice-weekly KBA (n = 28), thrice-weekly KBA (n = 28), and conventional physiotherapy or control (n = 28) in the ratio of 1:1:1. Participants in the conventional therapy group will receive two sessions of brief patient education, and 16 sessions of ultrasound therapy, stretching and strengthening exercises for 8 weeks. Participants in the two different KBA groups will receive KBA exercise according to the designed sessions for 8 weeks in addition to the conventional therapy. All groups will be assessed pre-intervention, immediately post-intervention and at 8 weeks, 3-month, 4-month, and 6-month post-randomization. The primary outcome will be physical function (Ibadan Knee and Hip Osteoarthritis Outcome Measure) while the secondary outcomes will be pain (Visual Analogue Scale for pain), knee stability (Knee Outcome Survey-Activities of Daily Living Scale), proprioception (electronic goniometer), and quality of life (Osteoarthritis Knee and Hip Quality of Life Questionnaire).Discussion: Findings of this study may provide evidence on the effectiveness of KBA exercise and the ideal number of sessions needed to achieve the highest effectiveness in adults with knee OA.Trial registration: Pan African Clinical Trials Registry, (PACTR201810713260138), Retrospectively registered on 28 November 2017.

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Intra-Articular Hybrid Hyaluronic Acid Injection Treatment in Overweight Patients with Knee Osteoarthritis: A Single-Center, Open-Label, Prospective Study

Applied Sciences ◽

10.3390/app11188711 ◽

2021 ◽

Vol 11 (18) ◽

pp. 8711

Author(s):

Dalila Scaturro ◽

Fabio Vitagliani ◽

Pietro Terrana ◽

Daniele Cuntrera ◽

Vincenzo Falco ◽

...

Keyword(s):

Quality Of Life ◽

Hyaluronic Acid ◽

Knee Osteoarthritis ◽

Disease Severity ◽

Prospective Trial ◽

Open Label ◽

Knee Oa ◽

Symptomatic Knee ◽

Significant Difference

Background: A BMI > 25 is the most decisive, albeit modifiable, risk factor for knee osteoarthritis (KOA). This study aimed at assessing the efficacy of intra-articular injections of hybrid hyaluronic acid (HA) complexes (Sinovial® H-L) for the treatment of KOA in overweight patients in terms of disease severity, cardiocirculatory capacity, and quality of life. Materials: In this single-site, open-label, prospective trial, 37 patients with symptomatic knee OA were assessed at baseline and 3 months after ultrasound-guided intra-articular injection of hybrid HA complexes (Sinovial® H-L). Results: Primary variables displaying a statistically significant improvement after treatment were pain (VAS), disease severity (WOMAC), and cardiopulmonary capacity (6 min walk test). Among secondary variables, quality of life (SF-12) improved significantly, as did analgesic intake for pain control. No statistically significant difference was observed in body fat and muscle mass percentage measured by bioelectrical impedance analysis. Conclusions: Intra-articular hybrid HA injections are significantly effective in improving OA-related disease severity, cardiopulmonary function, and analgesic intake. This supports the role of hybrid HA viscosupplementation as a nonpharmacological treatment to relieve pain, reduce disability, improve quality of life, and limit the risk of polypharmacy in overweight patients with knee OA.

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Serum level of Adrenomedullin in patients with primary knee osteoarthritis; relation to disease severity

Egyptian Rheumatology and Rehabilitation ◽

10.1186/s43166-021-00070-5 ◽

2021 ◽

Vol 48 (1) ◽

Author(s):

Mervat I. Abd Elazeem ◽

Aya B. S. Ahmed ◽

Rabab A. Mohamed ◽

Enas A. Abdelaleem

Keyword(s):

Knee Osteoarthritis ◽

Disease Severity ◽

Womac Score ◽

Inflammatory Rheumatic Diseases ◽

Knee Oa ◽

Vas Score ◽

American College Of Rheumatology ◽

Apoptotic Effect ◽

Kellgren And Lawrence ◽

Severity Of The Disease

Abstract Background Adrenomedullin (AM) is a peptide which was suggested to be involved in the pathogenesis of osteoarthritis through its anti-inflammatory and anti-apoptotic effect. AM was found to be elevated in some inflammatory rheumatic diseases as rheumatoid arthritis and ankylosing spondylitis. The current study was performed to measure serum Adrenomodullin (AM) concentrations in patients with primary knee osteoarthritis (KOA) and to assess association with severity of the disease. The study was performed on 50 patients with primary KOA diagnosed according to American College of Rheumatology (ACR) Revised Criteria for Early Diagnosis of Knee Osteoarthritis and 20 age- and sex-matched controls with no clinical features of KOA. The Kellgren and Lawrence (KL) classification was used to evaluate the disease severity of knee OA. Disease activity was assessed by The Western Ontario and McMaster Universities Arthritis Index (WOMAC). Blood samples had been collected from patients with OA and controls for assessing Adrenomodullin in patients’ sera by ELISA. Results There were a significant increase in serum Adrenomedullin concentrations in KOA patients compared to controls (10.64 ±19.2 ng/ml vs. 1.39 ±1.6 ng/ml in cases and controls respectively) (p value = 0.036). There was positive significant correlation of serum Adrenomedullin levels with KL grades (r=0.608, p value <0.001). OA patients with VAS score >6 have significantly higher serum Adrenomedullin levels than OA patients with VAS Score <6. No detected significant correlation between any of (patients’ age, BMI, disease duration, tenderness score, and WOMAC score) with serum Adrenomedullin levels among studied OA cases (p values >0.05). Conclusion This study concluded that serum Adrenomedullin (AM) level is elevated in patients with KOA and is positively correlated with the severity of disease.

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Differences in quality of life between patients with severe hip and knee osteoarthritis

Vojnosanitetski pregled ◽

10.2298/vsp150502317j ◽

2018 ◽

Vol 75 (1) ◽

pp. 62-67

Author(s):

Slavica Jandric

Keyword(s):

Quality Of Life ◽

Diabetes Mellitus ◽

Knee Osteoarthritis ◽

Physical Function ◽

Statistical Significance ◽

Womac Score ◽

Linear Regression Models ◽

Cross Sectional ◽

Knee Oa

Background/Aim. Osteoarthritis (OA) is the clinical manifestation of degenerative joint changes. The aim of this study was to investigate differences in quality of life (QoL) between patients with severe hip and knee OA. Methods. This is the cross-sectional study of 195 patients (average age 63.2 ? 11.1 yrs), with a diagnosis of OA of the hip and knee that were assigned to receive a total hip or knee replacement. The patients were divided into three groups in relation to localization of OA. The first group included patients with hip OA; the second group consisted of patients with knee OA and the third group with both hip and knee OA. Demographic and clinical data were collected for each patient. We measured health related quality of life (QoL) by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaires. Statistical significance of differences was at the level of p < 0.05. Results. The best QoL was in the group of knee OA (42.7 ? 11.3) and the worst in the group with both hip and knee OA patients (35.8 ? 12.7). QoL assessed by WOMAC score and the domain of physical function were significantly different among three groups of patients with OA (F = 5.377, p < 0.01 and F = 5.273, p < 0.01) respectively). Results of three multiple linear regression models where WOMAC score was dependent variable and age, body mass index (BMI), social class, pain, stiffness, physical function, hypertension, cardiomyopathy, diabetes mellitus were independent variables, have shown that QoL was statistically significantly associated with pain and physical function in the hip and knee OA groups, whereas in the group with both hip and knee OA patients, QoL was associated with BMI, pain, physical function and diabetes mellitus. Conclusion. QoL of patients with severe hip and knee osteoarthritis in relation to localization was significantly different. QoL in severe hip and knee OA patients was significantly associated with pain and physical function, but in patients with both hip and knee OA QoL was also associated with BMI and diabetes mellitus.

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The impact of pain on functionality and health related quality of life in patients with knee osteoarthritis

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh171020009j ◽

2019 ◽

Vol 147 (1-2) ◽

pp. 45-51

Author(s):

Aleksandra Jurisic-Skevin ◽

Vesna Grbovic ◽

Ivana Stankovic ◽

Aleksandar Radunovic ◽

Jasmin Nurkovic ◽

...

Keyword(s):

Quality Of Life ◽

Knee Osteoarthritis ◽

Physical Functioning ◽

Short Form ◽

Health Related Quality ◽

Knee Oa ◽

Womac Questionnaire ◽

Related Quality ◽

Health Related

Introduction/Objective. Pain, stiffness and limited mobility are the main factors that lead to difficulties in performing daily activities and are also responsible for the decline in the quality of life in people with knee osteoarthritis (OA). The aim of this study was to evaluate the functional capacity and health related quality of life (HRQoL) compared to pain in patients with knee OA, as well as to determine the correlation between these three clinical variables. Methods. The study involved 931 patients diagnosed with knee OA. In all patients, pain was evaluated by a short form of the McGill pain questionnaire (SF-MPQ), functional status was assessed using the Western Ontario and McMaster Universities Arthritis Index (WOMAC), while life quality was evaluated using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Results. The average age of patients was 61.21 ? 4.62 years, while 71.3% of them were women. The quality of life in patients with knee OA and all pain parameters contained in the SF-MPQ were highly statistically positively associated (p ? 0.01). In addition, the physical functioning was mostly affected by emotional pain (rho = -0.585). A high statistical correlation (p ? 0.01) was noted between stiffness and physical functioning from the WOMAC questionnaire and all of the parameters from the SF-MPQ. The physical functioning from the WOMAC questionnaire had the strongest correlation with total pain incorporated into the McGill questionnaire (rho = 0.530). Conclusion. Knee pain has a significant impact on functional capacity and HRQoL in patients with knee OA. Therefore, one of the main therapy goals for OA of the knee should be to reduce the pain in the affected knee, which can help to improve the functionality and HRQoL of these patients.

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Ultra-Reiz Current Appears to be More Effective Modality than Interferential for People with Knee Osteoarthritis: A Randomized Block Clinical Trial

Physical Therapy Journal of Indonesia ◽

10.51559/ptji.v1i2.13 ◽

2020 ◽

Vol 1 (2) ◽

pp. 29-34

Author(s):

Mahnaz Ahangari ◽

Amin Norouzi Fashkhami ◽

Hamid Zinalpoor ◽

Hamed Ahangari ◽

Mohamad Reza Minator Sajjadi

Keyword(s):

Quality Of Life ◽

Clinical Trial ◽

Knee Osteoarthritis ◽

Life Quality ◽

P Value ◽

Recreational Activity ◽

Knee Oa ◽

Interferential Current ◽

Pain Symptoms

Introduction: Today, increased degenerative disease of the knee, which reduces the efficiency of the activity and quality of life, is one of the most common causes of many population complaints. It is important to properly plan and carry out non-invasive and non-pharmacological therapies to treat the pain and its consequences. The question of which of methods effectively relieves pain, improve function and efficiently increases life quality led to a comparison of two methods, interferential and ultra-reiz (Träbert) currents therapy. Methods: Randomized Block clinical trial carried out at Taleghani general hospital Shahid Beheshti University of Medical Sciences from November 2017 to February 2019. The study included 104 patients of both sexes, aged 38-74 years, with knee osteoarthritis. They were selected based on exclusion and inclusion criteria. The patients were randomly assigned to two groups: A and B. Group A, n: 52 patients, were received ultra-reiz current, and group B, n: 52 patients, were subjected to interferential current. Parameters assessment were evaluated by the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire with 5 domains: pain, symptoms, ADL, sports/recreational activity, and quality of life. Data were collected at the 1st session and at the end of treatment (at least three times a week). The obtained results were subject to statistical analysis. Results: Data were analyzed in SPSS software by using paired and two independent sample t-test. The mean scores before and after treatment with p-value range 0.002~0.764 showed that there were differences in pain, other symptoms, ADL, sport/recreational activity, and quality of life status between ultra-reiz and IFT groups, but the results were statistically more significant in the ultra-reiz group (p < 0.0001). Conclusions: Our study showed that ultra-reiz and IFT were effective for patients with knee OA, but ultra-reiz became a more effective modality than IFT in OA patients.

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Efficacy of physical exercise program in patients with work-related knee osteoarthritis

Romanian Journal of Occupational Medicine ◽

10.2478/rjom-2018-0007 ◽

2018 ◽

Vol 69 (1) ◽

pp. 37-42

Author(s):

Iulia-Rahela Marcu ◽

Ion Toma ◽

Adrian Costin Bighea

Keyword(s):

Quality Of Life ◽

Physical Exercise ◽

Knee Osteoarthritis ◽

Functional Status ◽

Muscular Strength ◽

Exercise Program ◽

Knee Oa ◽

Work Related ◽

Sf 36

Abstract Quality of life studies in patients with knee osteoarthritis (OA) attest to the significant impact of the disease on day-to-day activities and social interactions. The aim of this study was to assess the efficacy of a physical exercise program on functional status and quality of life in patients with work-related knee osteoarthritis. The present study included 144 participants with knee osteoarthritis, 72% women, mean age (SD) 47.2 (11.1) years. The patients were randomly assigned in two lots based on the type of kinetic treatment: lot A-with knee OA and medication (72 patients) and lot B- with knee OA, medication and exercise program (72 patients). They followed for 12 days ambulatory exercise programs based on increasing knee flexion, muscular strength and endurance, improving balance, coordination, and respiratory exercises. The patients in the control group continued their daily living activities. The evaluation was made at the beginning of the study (T0), after 2 weeks (T1) and 8 weeks after the 12 days of exercise program (T2) and was based on the following parameters: knee mobility (knee flexion), muscular strength, pain assessment on a Visual Analogue Scale (VAS), functional status (Western Ontario &McMaster Universities Osteoarthritis Index - WOMAC) and quality of life evaluation using SF-36 Questionnaire (36-Item Short Form Survey). Out of 144 participants who completed the initial evaluation, 138 also completed the 2 weeks and the 8 weeks follow-up assessments: 70 patients from the control lot and 68 patients from the exercise lot. The benefits of the kinetic programs were shown by a significant improvement in knee mobility and muscular strength for knee extensors (quadriceps muscle) and knee flexor muscles. Testing the linear correlations between the SF-36 score and the VAS (r=0.71, p<0.05) and WOMAC (r=0.83, p<0.05) indicators demonstrates a highly positive relationship between the quality of life expression, the pain assessment score and the functional status score in patients with knee OA. The physical exercise program improves both functional status and quality of life in patients with work-related knee osteoarthritis by increasing the range of motion and muscular strength and by reducing pain.

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Aquatic Physical Therapy for Hip and Knee Osteoarthritis: Results of a Single-Blind Randomized Controlled Trial

Physical Therapy ◽

10.2522/ptj.20060006 ◽

2007 ◽

Vol 87 (1) ◽

pp. 32-43 ◽

Cited By ~ 172

Author(s):

Rana S Hinman ◽

Sophie E Heywood ◽

Anthony R Day

Keyword(s):

Quality Of Life ◽

Randomized Controlled Trial ◽

Physical Therapy ◽

Muscle Strength ◽

Knee Osteoarthritis ◽

Physical Function ◽

Controlled Trial ◽

Knee Oa ◽

Randomized Controlled

Background and Purpose Aquatic physical therapy is frequently used in the management of patients with hip and knee osteoarthritis (OA), yet there is little research establishing its efficacy for this population. The purpose of this study was to evaluate the effects of aquatic physical therapy on hip or knee OA. Subjects A total of 71 volunteers with symptomatic hip OA or knee OA participated in this study. Methods The study was designed as a randomized controlled trial in which participants randomly received 6 weeks of aquatic physical therapy or no aquatic physical therapy. Outcome measures included pain, physical function, physical activity levels, quality of life, and muscle strength. Results The intervention resulted in less pain and joint stiffness and greater physical function, quality of life, and hip muscle strength. Totals of 72% and 75% of participants reported improvements in pain and function, respectively, compared with only 17% (each) of control participants. Benefits were maintained 6 weeks after the completion of physical therapy, with 84% of participants continuing independently. Discussion and Conclusion Compared with no intervention, a 6-week program of aquatic physical therapy resulted in significantly less pain and improved physical function, strength, and quality of life. It is unclear whether the benefits were attributable to intervention effects or a placebo response.

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