Immediate and short-term effects of Mulligan's mobilization with movement on knee pain and disability associated with knee osteoarthritis – A prospective case series

BACKGROUND: Knee osteoarthritis (OA) is accompanied by inflammation and angiogenesis. Modifying angiogenesis through transcatheter arterial embolization (TAE) can be a potential treatment for knee OA. OBJECTIVE: We subjected five OA knees in three patients to TAE and report the results of our post-treatment observations. CASE DESCRIPTION: Three patients that had experienced knee pain for a minimum of one year prior to the study, and whose pain had persisted despite conservative treatment, were included in this study. Patients more often chose conservative treatment over surgical treatment. Pain and functional scales were evaluated before, immediately, and 1 month after TAE using the Numeric Rating Scale (NRS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). TAE was performed by an experienced interventional radiologist. The average values of NRS evaluated before and after 5 TAEs were 5.2 before TAE, 3 immediately after TAE, and 3.6 after 1 month of TAE, and the average values of WOMAC were 52, 38.4, and 36.4, respectively. There were no major adverse effects. CONCLUSION: The examined cases support the conclusion that TAE is an effective treatment for patients with knee OA. Substantial pain relief and WOMAC improvement were observed both immediately and one month after TAE.

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Genicular Nerve Radiofrequency Ablation for Chronic Knee Pain Using a Three-Tined Electrode: A Technical Description and Case Series

Pain Medicine ◽

10.1093/pm/pnaa204 ◽

2020 ◽

Vol 21 (12) ◽

pp. 3344-3349

Author(s):

Edvin Koshi ◽

Cole W Cheney ◽

Beau P Sperry ◽

Aaron Conger ◽

Zachary L McCormick

Keyword(s):

Radiofrequency Ablation ◽

Knee Osteoarthritis ◽

Knee Pain ◽

Rating Scale ◽

Case Series ◽

Numeric Rating Scale ◽

Vastus Medialis ◽

The Novel ◽

Chronic Knee Pain ◽

Numeric Rating

Abstract Background Genicular nerve radiofrequency ablation (RFA) for the treatment of chronic knee pain has traditionally targeted the superomedial, superolateral, and inferomedial genicular nerves. However, recent cadaveric studies of knee neuroanatomy demonstrate varied locations of these specific nerves as well as additional articular nerves. This work suggests that traditional genicular nerve RFA lesion locations may be inadequate. Objective 1) To describe a novel protocol utilizing a three-tined RFA electrode to target the superomedial (SMGN), superolateral (SLGN), and inferomedial genicular nerves (IMGN), as well as the terminal articular branches of the nerves to the vastus medialis (NVM), intermedius (NVI), and lateralis (NVL). 2) To assess the ability of this technique to reduce chronic knee pain. Methods Case series of consecutive patients with six or more months of refractory knee pain who underwent genicular nerve RFA according to the novel protocol described. Seven discrete RFA lesions were placed to target the SMGN, NVM, NVI, NVL, SLGN, and IGMN. Results Eleven patients underwent RFA, nine with knee osteoarthritis and two postarthroplasty. At one month, 91% (95% CI = 59–100%), 82% (95% CI = 48–98%), and 9% (95% CI = 2–41%), of patients reported ≥50%, ≥80%, and 100% improvement in knee pain on the numeric rating scale, respectively. These results were sustained at six months. There were no complications. Discussion/Conclusions These preliminary data suggest the feasibility and possible effectiveness of genicular nerve RFA using the described novel protocol including a three-tined electrode. Larger-scale studies with comparative groups are warranted.

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Acute and short-term effects of intra-articular knee pain relief on pain sensitization in knee OA: a cohort study

Osteoarthritis and Cartilage ◽

10.1016/j.joca.2013.02.560 ◽

2013 ◽

Vol 21 ◽

pp. S268

Author(s):

T. Joergensen ◽

T. Graven-Nielsen ◽

S. Rosager ◽

L. Klokker ◽

K. Ellegaard ◽

...

Keyword(s):

Cohort Study ◽

Pain Relief ◽

Knee Pain ◽

Short Term ◽

Knee Oa ◽

Pain Sensitization ◽

Short Term Effects

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Short-Term Effects of Strengthening Exercises of Lower Limb Rehabilitation Protocol on Pain, Stiffness, Physical Function and Body Mass Index among Knee Osteoarthritis Participants Who Were Overweight or Obese: A Clinical Trial

10.1101/2021.11.20.21266300 ◽

2021 ◽

Author(s):

Muhammad Tariq Rafiq ◽

Mohamad Shariff Abdul Hamid ◽

Eliza Hafiz

Keyword(s):

Physical Function ◽

Knee Pain ◽

Exercise Adherence ◽

Short Term ◽

Rehabilitation Protocol ◽

Knee Oa ◽

Strengthening Exercises ◽

Limb Rehabilitation ◽

Lower Limb Rehabilitation ◽

Short Term Effects

Background. Osteoarthritis (OA) of the knee is defined as a progressive disease of the synovial joints and is characterized by wear and tear of cartilage and underlying bone. This study aimed to determine the short-term effects of the lower limb rehabilitation protocol (LLRP) on pain, stiffness, physical function, and body mass index (BMI) among knee OA participants who were overweight or obese. Methodology. Single blinded randomized controlled trial of one-month duration was conducted at Rehmatul-Lil-Alameen Postgraduate Institute, Lahore, Pakistan. Fifty overweight or obese participants with knee OA were randomly divided into two groups by a computer-generated number. Participants in the Rehabilitation Protocol Group (RPG) were provided with leaflets explaining the strengthening exercises of the LLRP and instruction of daily care (IDC), while the participants in the Control Group (CG) were provided with leaflets explaining IDC only for a duration of four weeks. The primary outcome measures were the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores for pain, stiffness and physical function. The secondary outcome measures were BMI, exercise adherence, and patients satisfaction by the numeric rating scale ranging from 0 to 10. Paired Samples t-test was used to analyze the differences within groups from baseline to post-test evaluations. The analysis of variance was used to analyze the difference of BMI, knee pain, stiffness, and physical function between the groups. Results. Participants in the RPG and CG reported a statistically significant reduction in knee pain, and stiffness (p ≤ 0.05) within group. The reduction in the scores of knee pain was higher in participants of the RPG than the CG (p = 0.001). Additionally, participants in the RPG reported greater satisfaction (p = 0.001), higher self-reported exercise adherence (p = 0.010) and coordinator-reported exercise adherence (p = 0.046) compared to the participants in the CG. Conclusion. Short-term effects of the LLRP appear to reduce knee pain and stiffness only, but not physical function and BMI.

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