AbobotulinumtoxinA: A New Therapy for Hip Osteoarthritis. A Prospective Randomized Double-Blind Multicenter Study

Hip Osteoarthritis (OA) causes pain and disability. Here we evaluate abobotulinumtoxinA (Dysport®) (AboBoNT-A) injections versus placebo as a novel treatment option to improve hip range of motion, pain and quality of life. This prospective randomized double-blind multicenter study (EudraCT # 2012-004890-25) recruited 46 outpatients with hip OA who were randomized 2:1 to the Treatment Group (TG; 31 subjects), or the Placebo Group (PG; 15 subjects). The TG received 400 U of AboBoNT-A injected into the adductor muscles, and the PG received placebo solution. The primary endpoints were the difference in Harris Hip Score (HHS) and Visual Analogic Scale for pain (VAS) at Week 4 between groups (TG vs. PG). Secondary endpoints were the change from baseline in HHS, VAS pain, Medical Research Council scale for muscle strength (MRC) and Short Form scale (SF-36) scores. In TG at Week 4, the HHS and VAS score were significantly improved compared to PG, and pairwise assessments showed significant improvements in HSS and VAS pain at each time point compared to baseline for TG. No significant changes were observed in MRC and SF-36 over time, though SF-36 showed a positive trend. There were no significant differences from baseline in the PG. No adverse events were detected in either treatment group. AboBoNT-A injections in hip OA improve range of motion and pain without any significant side effects.

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Functional Condition of Patients after Unilateral Hip Arthroscopy in the Process of FAI—Femoroacetabular Impingement: A Case–Control Study and Preliminary Report

Journal of Clinical Medicine ◽

10.3390/jcm10051023 ◽

2021 ◽

Vol 10 (5) ◽

pp. 1023

Author(s):

Olga Nieszporska ◽

Aleksandra Truszczyńska-Baszak

Keyword(s):

Muscle Strength ◽

Range Of Motion ◽

Femoroacetabular Impingement ◽

Short Form ◽

Well Being ◽

Functional Condition ◽

High Rate ◽

Harris Hip Score ◽

Sf 36 ◽

The Mean

Introduction: Femoroacetabular impingement is a commonly recognized condition among people with hip pain. Aim: The aim of this study was to assess how arthroscopy and physiotherapy treatment influenced the quality of life and functional condition of patients after arthroscopic femoroacetabular impingement (FAI) surgery. Materials and methods: We examined 19 people for the study and included 12 (6 men and 6 women). Their mean age was 40.1 ± 9.7 years. Manual and digital goniometers were used for the range of motion (ROM) measurements, and a dynamometer for muscle strength was used. Results from the operated limb were compared to the nonoperated healthy limb. We examined the patient’s health and well-being using the Harris Hip Score (HHS) and Short-Form Health Survey (SF-36) scales. The mean follow-up period was 21.2 months. Results: The postsurgery mean range of motion for all movements was lower in the operated limb. Statistically significant differences between limbs in ROM were observed for flexion, abduction, extension, and external rotation. Muscle strength was comparable between hip joints, except extension and adduction, which were statistically significantly weaker. The mean strength of the hip flexors and internal rotators was higher in the operated limb. After surgery, 67% of patients returned to exercise at the same or higher level. The mean HHS results were good, with values of 88.00 ± 11.48. The SF-36 scores were >50. Conclusion: After surgery and physiotherapy of FAI, ROM remained lower in the operated limb. Flexion and rotations remained to cause pain. The strength of flexors and internal rotators improved, and there was a high rate of return to sport.

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Evaluation of the Use of Sterilized and Non-Sterilized Peruibe Black Mud in Patients with Knee Osteoarthritis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18041666 ◽

2021 ◽

Vol 18 (4) ◽

pp. 1666 ◽

Cited By ~ 1

Author(s):

Paulo Fávio Macedo Gouvêa ◽

Zélia Maria Nogueira Britschka ◽

Cristina de Oliveira Massoco Salles Gomes ◽

Nicolle Gilda Teixeira de Queiroz ◽

Pablo Antonio Vásquez Salvador ◽

...

Keyword(s):

Quality Of Life ◽

Knee Osteoarthritis ◽

Short Form ◽

Serum Levels ◽

Double Blind ◽

Sf 36 ◽

Radiographic Grade ◽

Physical Functions ◽

Kellgren And Lawrence

This study aimed to evaluate the effects of treatment with Peruíbe Black Mud (PBM) on the clinical parameters and quality of life of patients with knee osteoarthritis and to compare the effects of PBM samples simply matured in seawater and PBM sterilized by gamma radiation. A controlled, double-blind trial was conducted with 41 patients divided into two treatment groups composed of 20 and 21 patients: one group was treated with matured PBM and the other with sterilized PBM. Evaluations were done using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Medical Outcomes Study Short Form 36 (SF-36) questionnaires, the Kellgren and Lawrence (KL) radiographic scale, and the quantification of the serum levels of inflammatory biomarkers. An improvement in pain, physical functions, and quality of life was observed in all of the patients who underwent treatment with both simply matured and sterilized PBM. Nine patients showed remission in the KL radiographic scale, but no statistically significant differences were observed in the serum levels of inflammatory mediators before or after treatment. Peruíbe Black Mud proves to be a useful tool as an adjuvant treatment for knee osteoarthritis (OA), as shown by the results of the WOMAC and SF-36 questionnaires and by the remission of the radiographic grade of some patients on the Kellgren and Lawrence scale.

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Assessing the Attitudes, Awareness, and Behavioral Alterations of Patients Awaiting Total Hip Arthroplasty During the COVID-19 Crisis

Geriatric Orthopaedic Surgery & Rehabilitation ◽

10.1177/2151459320969377 ◽

2020 ◽

Vol 11 ◽

pp. 215145932096937

Author(s):

Stephen Fahy ◽

Joss Moore ◽

Michael Kelly ◽

Shane Irwin ◽

Paddy Kenny

Keyword(s):

Mental Health ◽

Short Form ◽

Hip Osteoarthritis ◽

Surgical Care ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Harris Hip Score ◽

Physical And Mental Health ◽

Patient Reported ◽

Hip Function

Background: COVID-19 has placed a huge burden on healthcare systems which has led to widespread cancellation elective surgical care. Ireland is recovering from the first wave of COVID-19 and as such the expeditious return of elective surgical care is important. This is the first study to examine the attitudes of patients to undergoing total joint arthroplasty during the COVID-19 crisis. Methods: A prospective qualitative study was undertaken in our institution during the week 13/05/2020-20/05/2020. 65 patients completed a questionnaire assessing attitudes, awareness, and behavioral changes associated with COVID-19, a Charlson Comorbidity Index, modified-Harris Hip Score, and a Short Form-12 score. Results: 86% of patients felt that they were at little to no risk of COVID-19 infection. The majority of patients were happy to proceed with surgery at the current level of COVID-19 related threat (86%). Patients with higher mHHS were more likely to postpone their operation than those with lower mHHS scores. Our cohort had low patient reported outcome measures in both mHHS and SF-12, indicating the significant burden of hip osteoarthritis on both physical and mental health. Conclusion: Patients reported a significant disease-related impairment of physical function and subsequent deterioration in mental health as a result of hip osteoarthritis. Patients with worse hip function, as measured by the mHHS are more willing to proceed with surgery than those with superior hip function. This offers a potential mechanism by which to triage patients once elective surgical pathways reopen in the coming months.

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Autologous Osteochondral Graft for Early Posttraumatic Arthritis of Tibiotalar Joints After Comminuted Pilon Fractures in Young Patients

Foot & Ankle International ◽

10.1177/1071100719875728 ◽

2019 ◽

Vol 41 (1) ◽

pp. 69-78 ◽

Cited By ~ 1

Author(s):

Xi Liu ◽

Jingjing An ◽

Hui Zhang ◽

Yaxing Li ◽

Yu Chen ◽

...

Keyword(s):

Range Of Motion ◽

Short Form ◽

Young Patients ◽

Joint Surface ◽

Posttraumatic Arthritis ◽

Osteochondral Graft ◽

Tibiotalar Joint ◽

Sf 36 ◽

Pilon Fractures

Background: Posttraumatic arthritis of tibiotalar joints after AO/OTA type C3 pilon fractures, especially in young patients with a significant osteochondral defect in the tibial plafond joint surface, is a challenging situation. We report a joint-preserving technique using autologous osteochondral graft in combination with ankle distraction and supramalleolar osteotomy (SMOT), if necessary, to improve its outcome. Methods: Seventeen patients with an average age of 32.1 years with Takakura grade 1 to 3A posttraumatic arthritis of the tibiotalar joint after AO/OTA type C3 pilon fractures received osteochondral autograft transplantation, ankle distraction, and SMOT, when supramalleolar malalignment was present, between February 2010 and November 2015. The visual analog scale (VAS), Short-Form 36 (SF-36) score, American Orthopaedic Foot & Ankle Society (AOFAS) score, and ankle range of motion were used for outcome analysis. Radiographic assessment of any SMOT and the apparent joint space was performed. Fourteen patients were followed for an average of 18 months. Results: The VAS, SF-36, and AOFAS scores as well as the ankle range of motion all improved significantly at the last follow-up after the surgery ( P < .01). No deep surgical site infection, donor site complication, nonunion, osteochondral block loosening, or resorption was noted. No secondary arthrodesis was needed at the end of follow-up. Conclusion: Autologous osteochondral graft transplantation in combination with ankle distraction and SMOT was a promising joint-preserving technique for early posttraumatic arthritis of tibiotalar joint after severe pilon fractures in young patients. Level of Evidence: Level IV, case series.

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Improved pain, physical functioning and health status in patients with rheumatoid arthritis treated with CP-690,550, an orally active Janus kinase (JAK) inhibitor: results from a randomised, double-blind, placebo-controlled trial

Annals of the Rheumatic Diseases ◽

10.1136/ard.2009.108159 ◽

2009 ◽

Vol 69 (2) ◽

pp. 413-416 ◽

Cited By ~ 103

Author(s):

J H Coombs ◽

B J Bloom ◽

F C Breedveld ◽

M P Fletcher ◽

D Gruben ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Health Status ◽

Short Form ◽

Controlled Trial ◽

Health Assessment ◽

Janus Kinase ◽

Inadequate Response ◽

Double Blind ◽

Sf 36 ◽

Factor Α

Objectives:To determine the efficacy of CP-690,550 in improving pain, function and health status in patients with moderate to severe active rheumatoid arthritis (RA) and an inadequate response to methotrexate or a tumour necrosis factor α inhibitor.Methods:Patients were randomised equally to placebo, CP-690,550 5, 15 or 30 mg twice daily for 6 weeks, with 6 weeks’ follow-up. The patient’s assessment of arthritis pain (pain), patient’s assessment of disease activity, Health Assessment Questionnaire-Disability Index (HAQ-DI) and Short Form-36 (SF-36) were recorded.Results:At week 6, significantly more patients in the CP-690,550 5, 15 and 30 mg twice-daily groups experienced a 50% improvement in pain compared with placebo (44%, 66%, 78% and 14%, respectively), clinically meaningful reductions in HAQ-DI (⩾0.3 units) (57%, 75%, 76% and 36%, respectively) and clinically meaningful improvements in SF-36 domains and physical and mental components.Conclusions:CP-690,550 was efficacious in improving the pain, function and health status of patients with RA, from week 1 to week 6.

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The Efficacy of Continuous Versus Intermittent Celecoxib Treatment in Osteoarthritis Patients with Body Mass Index ≥30 and <30 kg/m2

The Open Rheumatology Journal ◽

10.2174/1874312901307010032 ◽

2013 ◽

Vol 7 (1) ◽

pp. 32-37 ◽

Cited By ~ 5

Author(s):

George H Sands ◽

Pritha Bhadra Brown ◽

Margaret Noyes Essex

Keyword(s):

Body Mass Index ◽

Treatment Group ◽

Body Mass ◽

Hip Osteoarthritis ◽

International Study ◽

Continuous Treatment ◽

Intermittent Treatment ◽

Double Blind ◽

Parallel Group ◽

To Receive

Objective: Characterize the effect of body mass index (BMI) on the efficacy of continuous daily celecoxib treatment compared with intermittent celecoxib treatment. Methods: Prespecified exploratory analysis of a 24-week, double-blind, parallel-group, randomized, multicenter international study. 858 patients with knee or hip osteoarthritis (OA) were randomized to receive celecoxib 200 mg daily either as continuous or intermittent treatment. Efficacy was measured by Western Ontario and McMaster Universities Arthritis Index (WOMAC) total and subscale scores and the number of flare events. Results: Least squares mean increases (worsening) in WOMAC total scores were significantly less in the continuous treatment group than in the intermittent treatment group in patients with a BMI <30 kg/m2 (1.33 vs 4.85; p=0.016) and in patients with a BMI ≥30 kg/m2 (1.84 vs 5.12; p=0.019). There was a greater worsening in patients with a BMI ≥30 kg/m2 than in those with a BMI <30 kg/m2 in both the continuous and intermittent groups. Fewer flares were reported in the continuous treatment group than in the intermittent group in patients with a BMI <30 kg/m2 (0.55 vs 0.88; p<0.0001) and ≥30 kg/m2 (0.54 vs 0.97; p<0.0001). There were no differences in adverse events in the two BMI groups. Conclusions: Continuous celecoxib treatment was significantly more efficacious than intermittent use in patients with a BMI <30 kg/m2 compared with obese patients (≥30 kg/m2) as assessed by WOMAC total scores and the number of flares. These data suggest that including weight loss as part of a treatment regimen for obese OA patients could be important.

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Moriche Palm (Aguaje) Extract improves indefinite complaints in Japanese females: a randomized, placebo-controlled, double-blind trial

Functional Foods in Health and Disease ◽

10.31989/ffhd.v10i9.742 ◽

2020 ◽

Vol 10 (9) ◽

Author(s):

Hiroshi Shimoda ◽

Tsuyoshi Takara ◽

Kazuo Yamamoto ◽

Naoko Suzuki ◽

Shinichiro Yamashita ◽

...

Keyword(s):

Placebo Group ◽

Short Form ◽

Random Number Generator ◽

Japanese Version ◽

Summary Score ◽

Controlled Study ◽

Clinical Effects ◽

Double Blind ◽

Sf 36 ◽

Menstrual Distress

Background and objective: The fruit of Mauritia flexuosa (moriche palm), which is known as “Aguaje,” has been used for beverages and processed foods. Recently, we found that several methoxyflavans are contained in the fruit and they exhibit estrogenic activities. Therefore, moriche palm extract (MPE) may function as a phytoestrogen and improve the symptoms induced by estrogen deficiency. However, the clinical effects of MPE on females has not yet been reported. We conducted a clinical trial of MPE on undefined complaints related to premenstrual syndrome (PMS) in healthy Japanese females.Methods: This randomized, double-blind, placebo-controlled study examined the effects of MPE (100 mg daily) containing 12.6  g of 5,4'-dihydroxy-7-methoxy-6-methylflavan. Forty-four Japanese women with indefinite complaints in premenstrual and menstrual periods were enrolled in the study. All subjects were randomly allocated into either the MPE (100 mg) group (n=22) or the placebo group (n=22) using a computerized random-number generator. Capsules containing either MPE (100 mg) or placebo were administered for 8 weeks between October and December in 2018. The severity of uncertain complaints and emotional status were evaluated using the Japanese version of the menstrual distress questionnaire (MDQ) as a primary outcome, and Medical Outcomes Study Short-Form 36-Item Health (SF-36) questionnaire at 4 and 8 weeks of ingestion. Blood, urine, and body parameters were also evaluated.Results: Forty-three subjects completed the trial, and the per protocol set comprised 21 subjects in the MPE (100 mg) group and 22 subjects in the placebo group. After ingesting MPE for 4 weeks, arousal in the premenstrual period significantly improved in the MPE (100 mg) group. After 8 weeks, the summary score, water retention, impaired concentration and control during menstrual period significantly improved in the MPE (100 mg) group. Contrarily, among SF-36 domain scores, significant ameliorating effects of MPE were not observed compared with those of the placebo group. Laboratory tests revealed no abnormalities suggesting adverse effects of MPE.Conclusions: MPE (100 mg/day for 8 weeks) improved several indefinite complaint parameters related to mensuration. MPE was suggested to be useful for improving anxiety related to PMS.Keywords: Menstrual distress questionnaire; SF-36 questionnaire; moriche palm; methoxyflavan; indefinite complaint

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Effect of teriparatide on quality of life in patients with postmenopausal osteoporosis: a retrospective cohort study

Journal of International Medical Research ◽

10.1177/0300060519876744 ◽

2019 ◽

Vol 48 (2) ◽

pp. 030006051987674

Author(s):

Tiansong Yang ◽

Chuwen Feng ◽

Yuanyuan Qu ◽

Qingyong Wang ◽

Yan Yang ◽

...

Keyword(s):

Back Pain ◽

Treatment Group ◽

Postmenopausal Osteoporosis ◽

Short Form ◽

Life Quality ◽

Control Group ◽

Teriparatide Treatment ◽

Sf 36 ◽

Vas Scores

Objective To evaluate the effect of teriparatide on life quality in patients with postmenopausal osteoporosis. Methods Patients treated from January 2014 to December 2016 were retrospectively included. Patients were divided into two groups according the treatment received. Those in the teriparatide treatment group were followed up for 24 months, and patients in the control group received calcium supplements and vitamin D. Scores for back pain using a visual analog scale (VAS) and score of the Oswestry Disability Index (ODI) and 36-item Short Form Health Survey of life quality (SF-36) were evaluated at 3, 6, 12, and 24 months and compared between the groups. Results In total, 126 patients were included in the teriparatide treatment group and 127 in the control group. There were no significant differences between the groups concerning body mass index, bone density, VAS back pain score, ODI, and SF-36 life quality scores at baseline. At 3, 6, 12, and 24 months’ follow-up, VAS scores were significantly lower in the treatment group than in controls; ODI and SF-36 scores were significantly higher in the treatment group than in the control group. Conclusion Teriparatide can significantly decrease pain and increase mobility and life quality in patients with postmenopausal osteoporosis.

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Administration of an Amino Acid–Based Regimen for the Management of Autonomic Nervous System Dysfunction Related to Combat-Induced Illness

Journal of Central Nervous System Disease ◽

10.4137/jcnsd.s13793 ◽

2014 ◽

Vol 6 ◽

pp. JCNSD.S13793

Author(s):

William E Shell ◽

Marcus Charuvastra ◽

Mira Breitstein ◽

Stephanie L. Pavlik ◽

Anthony Charuvastra ◽

...

Keyword(s):

Mental Health ◽

Amino Acid ◽

Short Form ◽

Controlled Trial ◽

Initial Study ◽

Nutritional Deficiencies ◽

Autonomic Nervous System Dysfunction ◽

Double Blind ◽

Average Decrease ◽

Sf 36

The etiology and pathophysiology of posttraumatic stress disorder (PTSD) remains poorly understood. The nutritional deficiencies associated with the altered metabolic processes of PTSD have not previously been studied in detail. This pilot study measured the reduction in symptoms in 21 military veterans reporting moderate to severe symptoms associated with PTSD. Two amino acid-based medical foods specifically formulated with biogenic amines and other nutrients were administered to study subjects targeting specific neurotransmitter deficiencies resulting from altered metabolic activity associated with PTSD. This study included the Physician Checklist – Military (PCL-M), Short Form General Health Survey (SF-36), and Epworth Sleepiness Scale to measure the change in each subject's score after 30 days of administration. An average decrease of 17 points was seen in the PCL-M, indicating a reduction in PTSD symptoms ( P < 0.001). The mental health component of the SF-36 showed an average 57% increase in the subjects’ mental health rating ( P < 0.001). The results of this initial study demonstrate that addressing the increased dietary requirements of PTSD can improve symptoms of the disease while eliminating significant side effects. A larger, double-blind, randomized, placebo-controlled trial is warranted.

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