scholarly journals Effects of the use of hyaluronic acid as compared with standard chondroprotectors therapy in patients with various degrees of gonarthrosis

2020 ◽  
pp. 111-120
Author(s):  
V. I. Kuznetsov
Keyword(s):  
Hyaluronic Acid ◽  
Visual Analogue Scale ◽  
Knee Joint ◽  
Analogue Scale ◽  
Comparison Group ◽  
Local Therapy ◽  
Pain Level ◽  
Pain Visual Analogue Scale ◽  
Acid Therapy ◽  
Time Required

Introduction. Knee osteoarthritis (gonarthrosis) of different etiology is the most common age-related joint disease affecting over 80% people beyond 55 years of age. The use of hyaluronic acid “replacement” intraarticular injections is the priority method for treating gonarthrosis. Implants with human synovial fluid containing hyaluronic acid with a concentration of 10 mg/ml are the most commonly used therapy in world practice.Objective of the study: compare the efficacy of RIPART hyaluronic acid, 3.0 ml (Ingal LLC, Russia) and the standard Mucosat chondroprotector therapy (chondroitin sodium sulfate 100 mg, Russia) in patients with degree 1–3 gonarthrosis in the outpatient setting.Materials and methods. A total of 90 patients with degree 1–3 gonarthrosis were included in the study. The patients had not previously received any treatment with Mucosat chondroprotector and RIPART hyaluronic acid. The drugs for the treatment of patients with gonarthrosis were selected in accordance with the clinical guidelines for the management of osteoarthritis, taking into account the age and comorbidity of patients. Of the non-steroidal anti-inflammatory drugs, Nimesulide, 100 mg was selected at a standard dosage of 200 mg/day for 14 days, followed by reduction of the dose to 100 mg/day for a period of 14 days to 1 month. Mucosat was used as a chondroprotector in two comparison groups No. 1 and No. 3 (n = 60) at a dose of 2.0 ml intramuscularly No. 30 ampoules every other day for 8 weeks. In comparison groups No. 2 and No. 3, a local injection of RIPART 3.0 hyaluronic acid preparation was made into the knee joint (a single injection per week, 3 in total). In comparison group No. 3 (n = 30), the patients with degree 1–3 gonarthrosis received a combined course of local therapy with RIPART 3.0 No. 3 hyaluronic acid and Mucosat injection IM.In addition to clinical examination, the time required for an individual to climb the 10-step stairs and the time required for an individual to walk the 30-m distance were used to assess the effectiveness of treatment (с). The knee joint volume was measured using a centimeter tape in the middle third of the joint, the knee range of motion was measured with electrogoniometers, the joint swelling was assessed in points (0 to 2 points), pain during palpation along the joint gap was assessed in points (0 to 2). The pain level was assessed using a visual analogue scale, and the functional WOMAC index and Leken index were determined based on the patient-reported outcomes.Results. In study group No. 1 (nimesulide + Mucosate), 30 patients with degree 1–2 gonarthrosis received nimesulide and Mucosate therapy for 6 months, which resulted in the reduction of pain on a visual-analogue scale on Days 8–9. After 6-month observation, the level of pain on the visual analogue scale in patients with degree 1–2 gonarthrosis did not exceed 20–25 mm, in patients with degree 3 gonarthrosis, the pain level on the pain visual analogue scale did not reduce less than 35–40 mm. The Leken index decreased to 2 points in degree 1–2 gonarthrosis and to 5 points in degree 3 gonarthrosis.In comparison group No. 2, the effectiveness of local RIPART hyaluronic acid therapy exceeded the indicators in group 1, which made itself evident in the fact that pain decreased on a visual-analogue scale after the first knee joint injection in patients with degree 1 and 2 gonarthrosis and resulted in a decrease of nimesulide doses on Day 2–3 followed by its cancellation. Local RIPART hyaluronic acid therapy in patients with degree 3 gonarthrosis resulted in the reduction of nimesulide dose on Day 22 after the third knee joint injection.After 6-month observation, the level of pain did not exceed 20–25 mm on the pain visual-analogue scale in patients with degree 1–2 of gonarthrosis and did not decrease less than 35–40 mm on the pain visual-analogue scale in patients with degree 3 gonarthrosis. The Leken index decreased to 5 points.In comparison group No. 3, the combined treatment “nimesulide + Mucosat + RIPART” in 30 patients with degree 1–3 gonarthrosis showed a significant and noticeable reduction in pain to 15–20 mm on the visual-analogue scale in degree 1–2 gonarthrosis and to35 mmin degree 3 gonarthrosis, the Leken index decreased to 1–2 and 5–6 points, respectively.Patients with degree 3 gonarthrosis continued to administer nimesulide at a dose of 200 mg/day for 21–23 days, followed by switching to on-demand therapy during the entire observation period (before exercise, after exercise). The pain level on the visual analogue scale in patients with degree 3 gonarthrosis decreased on day 20–23 from the baseline figures of 80–85 mm to 35–40 mm; the relapse rate of pain and reactive synovitis decreased. In patients with degree 1–2 gonarthrosis, nimesulide was cancelled on Day 8, pain level after 6 months did not exceed 15–20 mm on the visual-analogue scale. Changes in the Leken index and WOMAC index correlated with an indicator of pain level of the visual analogue scale.Conclusions. The study findings showed that the outpatient local therapy with RIPART hyaluronic acid combined with Mucosat chondroprotector and a short course of nimesulide as non-steroidal anti-inflammatory drugs may be recommenced as the preferred treatment method compared to the prescription of any of the chondroprotectors in degree 1–3 gonarthrosis.

scholarly journals Efficiency Of Intra-Articular Administration In Early Osteoarthrosis

2020 ◽  
Vol 02 (11) ◽  
pp. 22-27
Author(s):  
Islamova K. A . ◽  
◽  
Khasanov F. Sh ◽  
Toirov E. S. ◽  
◽  
...  
Keyword(s):  
Visual Analogue Scale ◽  
Knee Joint ◽  
Treatment Outcomes ◽  
Analogue Scale ◽  
Clinical Effect ◽  
Early Stage ◽  
Knee Joints ◽  
Joint Function ◽  
Early Osteoarthritis ◽  
Positive Clinical Effect

The purpose of this study was to investigate the function of knee joints in patients with early osteoarthritis (OA, according to the criteria of the American rheumatology Association 2010) stage I-III using visual analogue scale (VAS) for pain intensity and treatment outcomes, Lequesne index, expert indicators, samples of 4 meter walk to assess the effectiveness of intra-articular injection Hyaluronic Chondro. 80 patients aged 28 to 55 years were examined. The treatment regimen included recommendations from the European rheumatology League (EULAR, 2016) and Russia (Nasonov E. L., 2017). The results of therapy were evaluated in two groups. The first group included 43 patients who received Hyaluronic Chondro in the form of intra-articular injections, the second-37 patients who received chondroprotectors inside or in the form of intramuscular injections. Conclusion. Intra-articular administration of the drug Chondrogard has a positive clinical effect in early stage II-III OA with moderate impairment of knee joint function. The course of treatment should last at least 2 months

scholarly journals Az állkapocsízületi károsodás kezelése szteroiddal, illetve hialuronsavval

2018 ◽  
Vol 159 (36) ◽  
pp. 1475-1482 ◽  
Author(s):  
Szonja Vingender ◽  
László Restár ◽  
Krisztián Benedek Csomó ◽  
Péter Schmidt ◽  
Péter Hermann ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Hyaluronic Acid ◽  
Visual Analogue Scale ◽  
High Molecular Weight ◽  
Analogue Scale ◽  
Mouth Opening ◽  
Facial Region ◽  
Prolonged Effect ◽  
Maximal Mouth Opening ◽  
Invasive Intervention

Abstract: Introduction: Derangement of the temporomandibular joint complicates everyday life, due to the masticatory malfunction and the continuous pain sensation of the head and facial region. The therapy is multidisciplinary and varying. In case of the inefficiency of conservative therapy, minimally invasive intervention is needed with intraarticular injection. Aim: The aim of our study was to examine whether hyaluronic acid injection is more beneficial compared to corticosteroid in 37 joints. We also examined whether the efficacy of the therapy is influenced by hyaluronic acid molecular weight and the used protocol. Method: Wilkes stage, maximal mouth opening and the Visual Analogue Scale were determined pre-operatively and 6 months later. Corticosteroid application was performed once, hyaluronic acid was injected on a weekly bases 3 times in a row, by use of low (6–10 × 105 dalton) or high molecular weight (24–36 × 105 dalton) preparations. Results: The medical state of the patients treated with corticosteroid temporarily improved, but the symptoms returned. Due to hyaluronic acid treatment, significant improvement was revealed in all parameters (pwilkes<0.0001; pmouth-opening = 0.0002; pVAS<0.0001). There was no significant relapse (T = 2.05). The third administration of hyaluronic acid resulted in a significant improvement of the Visual Analogue Scale compared to the first and second injection (T3.–1. = 20.37; T3.–2. = 9.57). Conclusions: Comparing the two agents we can state that hyaluronic acid was significantly more effective and its application for three times seems to be the most effective treatment decreasing the symptoms. The high molecular weight solution was more effective in increasing mouth opening. In contrast to hyaluronic acid, corticosteroid had no prolonged effect in higher Wilkes stages. Orv Hetil. 2018; 159(36): 1475–1482.

The Correlation Between Plantar Fascia Thickness and Symptoms of Plantar Fasciitis

2011 ◽  
Vol 101 (5) ◽  
pp. 385-389 ◽  
Author(s):  
Sarah Mahowald ◽  
Bradford S. Legge ◽  
John F. Grady
Keyword(s):  
Visual Analogue Scale ◽  
Plantar Fasciitis ◽  
Analogue Scale ◽  
Ultrasound Examination ◽  
Plantar Fascia ◽  
Pain Level ◽  
Treatment Protocols ◽  
Average Improvement ◽  
Subjective Pain ◽  
Efficacy Of Treatment

Background: The purpose of this study was to determine whether changes in plantar fascia thickness are a reliable gauge of efficacy of treatment protocols for plantar fasciitis. Methods: Thirty-nine feet (30 patients) with plantar fasciitis received an ultrasound examination to measure the thickness of the medial band of the plantar fascia. Each patient assessed his or her pain using the visual analogue scale. Following various treatments, a second ultrasound examination was performed and the thickness of the plantar fascia was again measured and subjective pain level assessed. Results: Twenty-nine feet (74.4%) showed a decrease in plantar fascia thickness and a decrease in pain. One foot (2.6%) experienced an increase in fascia thickness and reported an increase in pain. Four feet (10.3%) had an increase in thickness of the plantar fascia and reported no change in pain level. Three feet had minor increases in fascia thickness but reported a decrease in pain (7.7%). One foot (2.6%) had no change in fascia thickness but a decrease in pain and one foot (2.6%) had a decrease in the plantar fascia but no change in pain level. The average reduction in fascia thickness was 0.82 mm ±1.04 mm, correlating with an average improvement in pain of 3.64 ± 2.7 (P &lt; 0.005). Conclusions: This study provides evidence that changing thickness of the plantar fascia is a valid objective measurement to assess effectiveness of new or existing treatment protocols. (J Am Podiatr Med Assoc 101(5): 385–389, 2011)

scholarly journals Exploration of the Clinical Effect of Modified Peroneal Nerve Block in Foot Operation Under the Plane of the Ankle joint: A Non-Randomized Clinical Feasibility Observational Study.

2020 ◽  
Author(s):  
ya tuo ◽  
XUEQIANG FU ◽  
YI QIU ◽  
XIAODONG WANG ◽  
SHENGJUAN YAN ◽  
...  
Keyword(s):  
Visual Analogue Scale ◽  
Scale Score ◽  
Nerve Block ◽  
Analogue Scale ◽  
Peroneal Nerve ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Deep Peroneal Nerve ◽  
Pain Visual Analogue Scale ◽  
Numeric Rating

Abstract Background This study was aimed at exploring the clinical effect of a modified dorsal peroneal nerve block in foot operation under the ankle plane. Methods The study was observational study, thirty patients ( n =30) were observed with single-center and non-randomized. The patients were treated with an ankle nerve block (including the posterior tibial nerve, superficial peroneal nerve, saphenous nerve, and sural nerve block in the plane of the ankle) and a deep peroneal nerve block (7.5 mg/ml). The primary outcomes were intraoperative visual analogue scale score (0-10 points), numeric rating scale score (0-10 points), and Neuropen score (0-2 points). The secondary outcomes were postoperative pain visual analogue scale and numeric rating scale scores (0-10). Histograms and normal probability QQ plots were used to test the distribution of normality. Results We analyzed the data of 30 patients. It was found that after 20 min of ankle block and deep peroneal nerve block, 23 patients achieved a perfect block effect (visual analogue scale and Neuropen scores = 0), and the operation was performed smoothly. Six patients experienced slight pain (visual analogue scale score: ≤ 3, Neuropen score = 1). An intravenous sedative drip (dexmedetomidine 4 µg/ml, 1 µg/kg dexmedetomidine hydrochloride injection 2 ml:0.2 g; Jiangsu Nhwa Pharmaceutical Co., Ltd . , China) was used. The block failed in one patient, and the operation was performed under general anesthesia with a laryngeal mask in this patient. Conclusions The modified deep peroneal nerve block combined with an ankle nerve block can meet the anesthesia needs for foot surgery under the ankle plane. However, due to the limited number of patients evaluated, it is difficult to accurately predict the effect and a large degree of uncertainty exists regarding these findings. Trial registration This study had been registered at http://www.chictr.org.cn/index.aspx with No. ChiCTR2000037880 on Sep 3, 2020.It was a retrospectively registered.

scholarly journals Comparing the Efficacy of Hyaluronic Acid and Platelet Rich Plasma Treatment by using Visual analogue Scale in the Patients of Knee Osteoarthritis

Esculapio ◽  
2021 ◽  
Vol 16 (4 (oct 2020 - dec 2020)) ◽  
Author(s):  
Muhammad Ali ◽  
M. Mudassar Azam ◽  
Maimoona Zaheer ◽  
Fahad Wali Shah Khagha ◽  
Amjad Waseem Shah ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Visual Analogue Scale ◽  
Knee Osteoarthritis ◽  
Plasma Treatment ◽  
Analogue Scale ◽  
Platelet Rich Plasma ◽  
Controlled Trial ◽  
Sodium Hyaluronate ◽  
P Value ◽  
Group B

Objective: To compare the efficacy of Hyaluronic acid (HA) and Platelet rich plasma (PRP) for treatment of Knee osteoarthritis. Methods: A randomized controlled trial done at department of Orthopedics Unit-I, Mayo Hospital Lahore. 130 cases fulfilling inclusion criteria were enrolled. All patients were divided into two groups. In group-A, cases were treated with HA (1% sodium Hyaluronate mixed in a phosphate buffered saline). In group-B, cases were treated with 10ml of PRP extracted from 100ml of their blood. Before and after procedure pain and efficacy was recorded. Results: The frequency of pain reduction ≥ 50% was statistically higher in PRP group as compared to HA group, p-value < 0.05. Conclusion: Through the findings of this study we conclude that the efficacy of efficacy of PRP was high than HA for treatment of Knee osteoarthritis. Key Words: Osteoarthritis, platelet-rich plasma, efficacy, hyaluronic acid. How to Cite: Ali M, Azam M.M, Zaheer M, Shah F, Shah A, Masood F. Comparing the efficacy of hyaluronic acid and platelet rich plasma treatment by using visual analogue scale in the patients of knee osteoarthritis. Esculapio.2020;16(04):37-40.

scholarly journals Tratamento cirúrgico de recidivas de hérnias discais lombares: que resultados?

2011 ◽  
Vol 10 (1) ◽  
pp. 14-19
Author(s):  
Pedro Alberto Pinto da Silva ◽  
Paulo Miguel Silva Pereira ◽  
Patrícia Maria Polónia Pinto ◽  
Rui Manuel Cardoso Vaz
Keyword(s):  
Visual Analogue Scale ◽  
Scale Score ◽  
Visual Analogue Scale Score ◽  
Analogue Scale ◽  
Pain Visual Analogue Scale

OBJETIVOS: No tratamento da recidiva de hérnia discal lombar, em particular no âmbito cirúrgico, vários aspectos se mantêm controversos. O presente trabalho pretende contribuir para definir características pré-operatórias que influenciem os resultados subjetivo e objetivo da cirurgia. MÉTODOS: Foram selecionados doentes submetidos à intervenção cirúrgica por hérnia discal lombar recidivada em um período de dez anos; foram revistos os processos clínicos e reavaliados os pacientes, de forma subjetiva (grau de satisfação, Pain Visual Analogue Scale, Score de Stanford) e objetiva (Índice de Incapacidade de Oswestry, Questionário de Zurich). Foi realizada uma análise estatística desses dados. RESULTADOS: O número total foi de 55 doentes, com predomínio do sexo masculino. A taxa de complicações foi de 7,3%. Onze doentes (20%) necessitaram de terceira intervenção cirúrgica. A grande maioria (91,5%) dos doentes afirma-se satisfeita com o tratamento cirúrgico. Houve uma variação média favorável pelo Índice de Oswestry (-46,27%), confirmada pelas restantes escalas; 81,6% dos pacientes ativos retomaram a atividade laboral prévia. Foram encontrados preditores significativos do resultado funcional, e a necessidade de terceira cirurgia para o retorno à atividade laboral. CONCLUSÕES: O tratamento cirúrgico da recidiva de hérnia discal lombar permite resultados favoráveis no controle sintomático e funcional, em todos os testes aplicados. Algumas variáveis pré-operatórias podem ajudar a prever os pacientes menos susceptíveis à melhoria.

scholarly journals Pain-Induced Pulsograph Changes in Patients with Primary Dysmenorrhea: A Pilot Study

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Wan-hong Chen ◽  
Yan Zhao ◽  
Chang-chun Zeng ◽  
Dao-ning Zhang ◽  
Yan-ping Wang ◽  
...  
Keyword(s):  
Pilot Study ◽  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Acupuncture Analgesia ◽  
Primary Dysmenorrhea ◽  
Pain Level ◽  
Time Points ◽  
Pain Scores ◽  
Changing Trends ◽  
Time Parameters

Objectives. To investigate changes in pulsograph caused by pain in primary dysmenorrhea (PD) patients.Methods. Pulsograph and pain level of PD patients were detected using electropulsograph and Visual-Analogue Scale (VAS), respectively, at four time points, 7–10 days before menstruation(T0), maximal pain during menstruation(T1), immediately after acupuncture analgesia(T2), and 30 mins after acupuncture analgesia(T3). Parameters (t,h,w) and normalized time parameters (t′) of pulsograph were analyzed.Results. VAS pain scores decreased from 6.40 ± 1.13 atT1to 0.70 ± 0.75 atT2to 0.11 ± 0.32 atT3(P<0.001and 0.001). AtT1, compared with those atT0,w1,h3, andh4significantly increased (P<0.01), andt2,t2′,t3′, andh(d) significantly decreased (P<0.01, 0.001, 0.05, and 0.001). AtT2, compared with those atT1,t1,w1,w2,h2,h3,t1′, andt4′ significantly decreased (P<0.05, 0.01, 0.01, 0.001, 0.01, 0.001, and 0.05), andh(d) significantly increased (P<0.001). There was no difference betweenT2andT3.Conclusions. There are almost opposite changing trends in pulsographic parameters when pain occurs and when it is relieved in PD patients.

scholarly journals A HOSPITAL BASED COMPARATIVE STUDY OF TOLERABILITY AND EFFICACY OF TRAMADOL VERSUS ACECLOFENAC ON PATIENTS WITH OSTEOARTHRITIS OF KNEE JOINT.

2019 ◽  
Vol 3 (8) ◽  
Author(s):  
Dr. Sara Sultana ◽  
Dr. Braj Nandan Kumar Sah
Keyword(s):  
Visual Analogue Scale ◽  
Knee Joint ◽  
Analogue Scale ◽  
P Value ◽  
Osteoarthritis Of Knee ◽  
Vas Score ◽  
Group A ◽  
Mean Differences ◽  
Group B ◽  
To Receive

Objectives: This present study was done to compare the tolerability and efficacy of tramadol versus aceclofenac in terms of WOMAC Osteoarthritis Index and Visual Analogue Scale of patients with osteoarthritis of knee joint. Methods: A detail history, clinical examinations and relevant investigations were performed to all cases of osteoarthritis of knee joint. Group A patients were advised to receive tramadol 75 mg twice daily for 8 weeks, and group B patients were advised to receive aceclofenac 100 mg twice daily for 8 weeks. And we had evaluated the WOMAC Osteoarthritis Index and VAS score of first day and last day visit of patients with osteoarthritis of knee joint. Results: Data was analyzed by using SPSS (version 26) software. Paired sample statistical methods were used. Mean and standard deviation was observed and mean differences were compared. P value was taken less than or equal to 0.05 (p≤0.05) for significant differences. Conclusions: This present study concluded that the WOMAC Osteoarthritis Index score and VAS score of patients who had received aceclofenac medication had statistically significant differences as well as greater mean differences than patients who received tramadol. Hence, aceclofenac is effective drugs than tramadol in terms of efficacy and tolerability of patients with osteoarthritis of knee joint. Key words: Osteoarthritis of knee, WOMAC osteoarthritis index, Visual Analogue Scale.

Sign in / Sign up

Export Citation Format

Share Document