The efficacy of transcatheter arterial embolization for knee pain on patients with knee osteoarthritis: A case series

2021 ◽  
pp. 1-6
Author(s):  
Kun Yung Kim ◽  
Gi-Wook Kim
Keyword(s):  
Conservative Treatment ◽  
Knee Osteoarthritis ◽  
Knee Pain ◽  
Transcatheter Arterial Embolization ◽  
Rating Scale ◽  
Case Series ◽  
Arterial Embolization ◽  
Numeric Rating Scale ◽  
Knee Oa ◽  
Before And After

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.

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

Pain Medicine ◽  
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.

scholarly journals Evolution of pain at 3 months by oral resveratrol in knee osteoarthritis (ARTHROL): protocol for a multicentre randomised double-blind placebo-controlled trial

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e017652 ◽  
Author(s):  
Christelle Nguyen ◽  
Isabelle Boutron ◽  
Gabriel Baron ◽  
Emmanuel Coudeyre ◽  
Francis Berenbaum ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Knee Pain ◽  
Rating Scale ◽  
Controlled Trial ◽  
Tertiary Care ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Knee Oa ◽  
The Mean ◽  
Anti Inflammatory

IntroductionOsteoarthritis (OA) pathophysiology is driven in part by joint inflammation. Resveratrol has in vitro anti-inflammatory properties. We aim to assess the efficacy of oral resveratrol for knee pain at 3 months in people with knee OA.Methods and analysisWe will conduct a randomised double-blind placebo-controlled trial. Overall, 164 individuals with knee OA fulfilling 1986 American College of Rheumatology criteria will be recruited in three tertiary care centres in France and randomised to receive oral resveratrol, 40 mg (two caplets) two times per day for 1 week, then 20 mg (one caplet) two times per day or a matching placebo for a total of 6 months. Randomisation will be centralised and stratified by centre. The allocation ratio of assignments will be 1:1. The primary outcome will be the mean change from baseline in knee pain on a self-administered 11-point pain Numeric Rating Scale at 3 months. Secondary outcomes will be the mean change in knee pain at 6 months, the function subscore of the Western Ontario and McMaster Universities Arthritis Index score, patient global assessment, proportion of responders according to the Osteoarthritis Research Society International–Outcome Measures in Rheumatology criteria at 3 and 6 months, and self-reported number of intra-articular injections of corticosteroids or hyaluronic acid and consumption of analgesics and non-steroidal anti-inflammatory drugs since the last contact. Other interventions will be allowed and self-reported. Adherence will be monitored by capsule counts and a booklet and adverse events recorded at 3 and 6 months. Statisticians, treating physicians and participants will be blinded to the allocated treatment.Ethics and disseminationThe oral resveratrol in knee osteoarthritis (ARTHROL) trial has been authorised by theAgenceNationale de Sécurité du Médicament et des Produits de Santéand ethics were approved by theComité deProtection des Personnes Île-de-FranceIII. The findings of the study will be published in a peer-reviewed journal and disseminated at conferences. The design of ARTHROL will warrant the translation of its findings into clinical practice.Trial registration numberClinicalTrials.gov identifier:NCT02905799. Pre-results. First received: 14 September 2016. Last updated: 16 September 2016. Status: not yet recruiting.

scholarly journals PENGARUH TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION DENGAN DAN TANPA TERAPI LATIHAN TERHADAP NYERI DAN KINERJA FISIK PADA PENDERITA OSTEOARTRITIS LUTUT

2014 ◽  
Vol 6 (3) ◽  
Author(s):  
Inge Jiemesha ◽  
Engeline Angliadi
Keyword(s):  
Physical Performance ◽  
Exercise Therapy ◽  
Pharmacological Treatment ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Joint Disease ◽  
Timed Up And Go ◽  
Knee Oa ◽  
Before And After ◽  
Numeric Rating

Abstract: Osteoarthritis (OA) of the knee is a chronic degenerative joint disease which causes disability affecting the quality of life. Its management may include pharmacological and non-pharmacological treatment. In the non-pharmacological treatment there are a variety of treatment options. This study aimed to prove the effect of Transcutaneous Electrical Nerves Stimulation (TENS) with and without exercise on pain and physical performance in patients with knee OA. There were thirty five patients with knee OA who met the inclusion criteria that visited the Medical Rehabilitation Department of Prof. Dr. R.D. Kandou Hospital. The samples were divided into 2 groups: TENS with exercise therapy and TENS without exercise therapy. Each group undergone their therapy for 6 weeks with a frequency of 2 times per week. Pain was measured by using the Numeric Rating Scale (NRS) and physical performance was measured by using the Timed-Up and Go test (TUG) and the Stair Climb Test (SCT). There were 91.4% females meanwhile overweight and obese patients were 34.3%. The results showed that there were significant differences in pain and physical performance between before and after TENS with exercise (P <0.001) as well as before and after TENS without exercise (P < 0.001). There was no difference in pain and physical performance between the two groups. Conclusion: TENS with and without exercise can reduce pain and improve physical performance in patients with knee osteoarthritis.Keywords: knee osteoarhtritis, TENS, pain, physical performanceAbstrak: Osteoartritis (OA) lutut adalah penyakit degeneratif sendi yang bersifat kronis dan menyebabkan disabilitas yang memengaruhi kualitas hidup penderita. Tatalaksana OA lutut terdiri dari farmakologi dan non-farmakologi dengan bermacam-macam pilihan terapi. Penelitian ini bertujuan untuk membuktikan pengaruh Transcutaneous Electrical Nerves Stimulation (TENS) dengan dan tanpa terapi latihan terhadap nyeri dan kinerja fisik pada penderita OA lutut. Sebanyak 35 penderita OA lutut lama maupun baru yang memenuhi kriteria inklusi, yang berkunjung ke Poliklinik Rehabilitasi Medik RSUP Prof Dr. R.D. Kandou dan bersedia mengikuti penelitian. Sampel dibagi menjadi 2 kelompok: diberikan TENS dengan terapi latihan dan yang tanpa terapi latihan selama 6 minggu dengan frekuensi 2 kali per minggu. Nyeri diukur dengan Numeric Rating Scale (NRS) dan kinerja fisik diukur dengan Timed-Up and Go test (TUG) dan Stair Climb Test (SCT). Dari hasil analisis 35 subyek penelitian didapatkan 32 orang (91,4%) subyek wanita, serta indeks massa tubuh yang overweight dan obese sebanyak 34,3 %. Hasil uji perbedaan nyeri dan kinerja fisik sebelum dan sesudah TENS dengan terapi latihan memperlihatkan perbedaan bermakna (P <0,001). Hasil perbedaan nyeri dan kinerja fisik sebelum dan sesudah TENS juga memperlihatkan perbedaan bermakna (P <0,001). Pada hasil uji perbedaan nyeri dan kinerja fisik pada kedua kelompok didapatkan tidak terdapat perbedaan antara keduanya. Simpulan: TENS dengan dan tanpa terapi latihan dapat mengurangi nyeri dan meningkatkan kinerja fisik pada penderita osteoartritis lutut.Kata kunci: osteoartritis lutut, TENS, nyeri, kinerja fisik

scholarly journals Effects of Mantra Meditation versus Music Listening on Knee Pain, Function, and Related Outcomes in Older Adults with Knee Osteoarthritis: An Exploratory Randomized Clinical Trial (RCT)

2018 ◽  
Vol 2018 ◽  
pp. 1-19 ◽  
Author(s):  
Kim E. Innes ◽  
Terry Kit Selfe ◽  
Sahiti Kandati ◽  
Sijin Wen ◽  
Zenzi Huysmans
Keyword(s):  
Knee Pain ◽  
Perceived Stress ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Music Listening ◽  
Post Intervention ◽  
Knee Oa ◽  
Core Outcomes ◽  
Related Quality ◽  
Mantra Meditation

Objective. Disease-modifying treatments for OA remain elusive, and commonly used medications can have serious side effects. Although meditation and music listening (ML) have been shown to improve outcomes in certain chronic pain populations, research in OA is sparse. In this pilot RCT, we explore the effects of two mind-body practices, mantra meditation (MM) and ML, on knee pain, function, and related outcomes in adults with knee OA.Methods. Twenty-two older ambulatory adults diagnosed with knee OA were randomized to a MM (N=11) or ML program (N=11) and asked to practice 15-20 minutes, twice daily for 8 weeks. Core outcomes included knee pain (Knee Injury and Osteoarthritis Outcome Score [KOOS] and Numeric Rating Scale), knee function (KOOS), and perceived OA severity (Patient Global Assessment). Additional outcomes included perceived stress (Perceived Stress Scale), mood (Profile of Mood States), sleep (Pittsburgh Sleep Quality Index), and health-related quality of life (QOL, SF-36). Participants were assessed at baseline and following completion of the program.Results. Twenty participants (91%) completed the study (9 MM, 11 ML). Compliance was excellent; participants completed an average of 12.1±0.83 sessions/week. Relative to baseline, participants in both groups demonstrated improvement post-intervention in all core outcomes, including knee pain, function, and perceived OA severity, as well as improvement in mood, perceived stress, and QOL (Physical Health) (p’s≤0.05). Relative to ML, the MM group showed greater improvements in overall mood and sleep (p’s≤0.04), QOL-Mental Health (p<0.07), kinesiophobia (p=0.09), and two domains of the KOOS (p’s<0.09).Conclusions. Findings of this exploratory RCT suggest that a simple MM and, possibly, ML program may be effective in reducing knee pain and dysfunction, decreasing stress, and improving mood, sleep, and QOL in adults with knee OA.

Comparing Patient-Reported Outcomes From Sham and Saline-Based Placebo Injections for Knee Osteoarthritis: Data From a Randomized Clinical Trial of Lorecivivint

2022 ◽  
pp. 036354652110672
Author(s):  
Jeyanesh R.S. Tambiah ◽  
Ismail Simsek ◽  
Christopher J. Swearingen ◽  
Sarah Kennedy ◽  
Brian J. Cole ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Patient Reported Outcomes ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Womac Pain ◽  
Time Points ◽  
Knee Oa ◽  
Patient Reported ◽  
Mean Differences ◽  
Numeric Rating

Background: Durable, meaningful symptom responses to intra-articular saline placebo injections are observed in knee osteoarthritis (OA) trials, but it is unclear if these are due to physiological effects. Purpose: To perform a prospective comparison of patient-reported outcome responses among participants with knee OA who underwent intra-articular injection of saline-based placebo or sham (dry needle). Study Design: Randomized controlled trial; Level of evidence, 2. Methods: From a 24-week randomized double-blind trial, participants with moderate to severe knee OA received 2-mL intra-articular injections of saline-based placebo (PBO; 99.45% PBS) or sham (dry needle) to the target knee. Least squares mean differences of changes from baseline to week 24 were compared between the PBO and sham groups for the following: pain Numeric Rating Scale; Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, stiffness, and function; and patient global assessment. Bang Blinding Index was used to evaluate all-group blinding on day 1 and week 24. Results: In total, 116 and 117 participants were randomized to the PBO and sham groups, respectively. Within the full trial population, the mean ± SD age and body mass index were 59.0 ± 8.5 years and 28.97 ± 4.01, respectively. An overall 406 (58.4%) were female, and 394 (57.3%) had Kellgren-Lawrence grade 3 target knee OA. The PBO and sham groups demonstrated clinically meaningful improvements (≥10%) from baseline in all patient-reported outcomes at all time points (ie, weeks 4-24). Mean differences (95% CI) at week 24 between the PBO and sham groups were as follows: pain Numeric Rating Scale, –0.10 (–0.79 to 0.59; P = .78); WOMAC pain, –2.89 (–9.70 to 3.92; P = .40); WOMAC stiffness, –2.37 (–9.37 to 4.63; P = .51); and WOMAC function, –1.39 (–8.06 to 5.29; P = .68). Bang Blinding Index indicated that blinding was maintained. Conclusion: PBO and sham groups demonstrated equivalent patient-reported outcomes at all time points through week 24, suggesting that responses attributed to saline were contextual (ie, to the procedure) and not physiological. Registration: NCT03122860 (ClinicalTrials.gov identifier).

scholarly journals Reliability and Construct Validity of the SENS Motion® Activity Measurement System as a Tool to Detect Sedentary Behaviour in Patients with Knee Osteoarthritis

Arthritis ◽  
2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Cecilie Bartholdy ◽  
Henrik Gudbergsen ◽  
Henning Bliddal ◽  
Morten Kjærgaard ◽  
Kasper Lundberg Lykkegaard ◽  
...  
Keyword(s):  
Construct Validity ◽  
Knee Osteoarthritis ◽  
Sedentary Behaviour ◽  
Measurement System ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Activity Measurement ◽  
Activity Data ◽  
Knee Oa ◽  
Motion Activity

Physical inactivity is important to address, and an objective way of measuring inactivity is by accelerometry. The objective of this study was to determine the reliability and construct validity of the SENS motion system to record physical activity and inactivity in patients with knee osteoarthritis. Participants with an age > 40 years and an average weekly pain above 0 on a numeric rating scale (0 = no pain, 10 = worst pain) were included. Participants had a total of two study visits and at each visit participants completed a standardized activity. Data from 24 participants were analysed. A mean agreement of 99% (SD 3%) for sedentary behaviour and a mean agreement of 97% (SD 9%) for active behaviour were found. The agreement for “walking” was 28% (SD 18%). Mean agreement between recordings on the two visits was 96% (SD 8%) for sedentary behaviour and 99% (SD 1%) for active behaviour. The SENS motion activity measurement system can be regarded as a reliable and valid device for measuring sedentary behaviour in patients with knee OA, whereas detection of walking is not reliable and would require further work.

scholarly journals Preliminary Evaluation of a New Orthotic for Patellofemoral and Multicompartment Knee Osteoarthritis

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Aleksandra R. Budarick ◽  
Emily L. Bishop ◽  
Marcia L. Clark ◽  
Christopher D. Cowper-Smith
Keyword(s):  
Physical Activity ◽  
Knee Osteoarthritis ◽  
Physical Function ◽  
Outcome Measures ◽  
Case Series ◽  
Secondary Outcome ◽  
Preliminary Evaluation ◽  
Activity Levels ◽  
Knee Oa ◽  
Before And After

Purpose. Traditional knee osteoarthritis (OA) braces are usually indicated for a minority of patients with knee OA, as they are only suitable for those with unicompartmental disease affecting the tibiofemoral joint. A new assistive brace design is intended for use in a wider range of knee OA patients with heterogeneous symptoms characteristic of patellofemoral, tibiofemoral, or multicompartmental knee OA. The purpose of this case series was to explore whether the use of this novel “tricompartment offloader” (TCO) brace was associated with clinically relevant improvements in pain and function. Materials and Methods. A retrospective analysis of individuals with knee OA ( n = 40 ) was conducted to assess pain, function, physical activity, and use of medication and other treatments before and after brace use. Validated outcome measures including the Visual Analog Scale (VAS) and Lower Extremity Functional Scale (LEFS) were used to assess pain and physical function (primary outcome measures). Exploratory measures were used to quantify physical activity levels and use of medication and other treatments (secondary outcome measures). Results. Average total pain (VAS) scores decreased by 36.6 mm and physical function (LEFS) scores increased by 16.0 points following the use of the TCO brace. Overall, 70% of the participants indicated increased weekly physical activity and 60% reported a decrease in their use of at least one other treatment. Conclusions. Results from this case series suggest that the TCO brace shows strong potential to fill a conservative treatment gap for patients with heterogeneous symptoms of knee OA that are characteristic of patellofemoral or multicompartment disease. Further investigation is warranted.

scholarly journals A Novel Application of Buprenorphine Transdermal Patch to Relieve Pain in the Knee Joint of Knee Osteoarthritis Patients: A Retrospective Case-Control Study

2019 ◽  
Vol 8 (7) ◽  
pp. 1009 ◽  
Author(s):  
Ho Young Gil ◽  
Sungchul Park ◽  
Na Eun Kim ◽  
Yi Hwa Choi ◽  
Jae Hyung Kim ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Knee Joint ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Knee Joints ◽  
Transdermal Patch ◽  
Retrospective Case ◽  
Knee Oa ◽  
Before And After ◽  
Painful Knee

Osteoarthritis (OA) is considered to be one of the most disabling diseases. The intra-articular opioid injection has been widely studied for its simplicity, safety, and efficacy in OA. In this study, however, we suggest a novel method of buprenorphine transdermal patch (BTDP) to painful knee joints of OA patients, instead of intra-articular opioid injection, and subsequently compared the knee application with conventional chest application. We retrospectively enrolled 213 patients with knee OA who did not respond to conventional therapy. The Numeric Rating Scale (NRS), adverse effects, and compliance were recorded before and after the application of the BTDP. All parameters were compared between the knee applied group and the chest applied group. After the BTDP application, the NRS score in the knee applied group was lower than that of the chest applied group (p = 0.007). NRS scores after buprenorphine patch decreased to 2.21 ± 0.77, and 2.55 ± 0.71 in the chest applied group and the knee applied group, respectively. The adverse effects were 19.32% in the knee applied group, and 64.00% in the chest applied group. The compliances were 82.95% and 37.60% in the knee applied group and chest applied group, respectively. This novel application of BTDP directly to the painful knee joint of knee OA patients led to a decrease in the NRS score, adverse effects, and an increase in compliance compared with the chest application method.

Sign in / Sign up

Export Citation Format

Share Document