Faculty of 1000 evaluation for Comparison of Intra-articular Hyaluronic Acid Injections With Transcutaneous Electric Nerve Stimulation for the Management of Knee Osteoarthritis: A Randomized Controlled Trial.

AbstractPlacental-derived tissues are a known source of anti-inflammatory and immune modulating factors. Published pilot data on amniotic suspension allograft (ASA) for the treatment of osteoarthritis (OA) demonstrated safety and trends for improved pain and function. A multicenter randomized controlled trial was designed to evaluate the efficacy of symptom modulation with ASA compared with saline and hyaluronic acid (HA) in subjects with knee OA. A total of 200 subjects were randomized 1:1:1 to ASA, HA, or saline, with subjects blinded to their allocation. Changes from baseline of patient-reported outcomes (PROs)—EQ-5D-5L, Knee Osteoarthritis Outcome Score (KOOS), visual analog scale (VAS), Tegner, and Single Assessment Numerical Evaluation (SANE)—were compared between groups. Patients reporting unacceptable pain at 3 months were considered treatment failures and withdrawn from the study. Statistical analysis was completed by comparing changes in PROs from baseline to 3 and 6 months for all groups. Comparison of demographics between treatment groups showed no significant differences between groups. Patients reporting unacceptable pain at 3 months in each group were ASA (13.2%), HA (68.8%), and saline (75%). Patients receiving ASA demonstrated significantly greater improvements from baseline for overall pain (VAS), KOOS pain, and KOOS-activities of daily living scores compared with those in the HA group (3 months) and both groups (6 months). ASA patients had significantly greater improvements in KOOS symptom scores compared with HA and saline at 3 and 6 months, respectively. OMERACT-OARSI responder rates for ASA, HA, and saline groups were 69.1, 39.1, and 42.6%, respectively (p = 0.0007). Subjects receiving ASA treatment showed greater improvements in PROs and fewer patients reported unacceptable pain compared with HA and saline. The evidence presented in this Level I Randomized Controlled Trial suggests that ASA injection is an effective treatment for the nonoperative management of symptomatic knee OA.

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Transcutaneous Electrical Nerve Stimulation as an Adjunct to Education and Exercise for Knee Osteoarthritis: A Randomized Controlled Trial

Arthritis Care & Research ◽

10.1002/acr.22147 ◽

2014 ◽

Vol 66 (3) ◽

pp. 387-394 ◽

Cited By ~ 27

Author(s):

Shea Palmer ◽

Melissa Domaille ◽

Fiona Cramp ◽

Nicola Walsh ◽

Jon Pollock ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Knee Osteoarthritis ◽

Nerve Stimulation ◽

Transcutaneous Electrical Nerve Stimulation ◽

Controlled Trial ◽

Electrical Nerve Stimulation ◽

Randomized Controlled

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Corrigendum

The American Journal of Sports Medicine ◽

10.1177/0363546517700110 ◽

2017 ◽

Vol 45 (5) ◽

pp. NP10-NP10

Keyword(s):

Randomized Controlled Trial ◽

Hyaluronic Acid ◽

Knee Osteoarthritis ◽

Clinical Outcomes ◽

Platelet Rich Plasma ◽

Controlled Trial ◽

Double Blind ◽

Randomized Controlled ◽

Acid Versus

Cole BJ, Karas V, Hussey K, Merkow DB, Pilz K, Fortier LA. Hyaluronic acid versus platelet-rich plasma: a prospective, double-blind randomized controlled trial comparing clinical outcomes and effects on intra-articular biology for the treatment of knee osteoarthritis. Am J Sports Med. 2017;45(2):339-346. (Original DOI: 10.1177/0363546516665809 )

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Effect of Transcutaneous Electric Nerve Stimulation on Pain after Total Knee Arthroplasty: A Blind Randomized Controlled Trial

The Journal of Knee Surgery ◽

10.1055/s-0037-1602134 ◽

2017 ◽

Vol 31 (02) ◽

pp. 189-196

Author(s):

Ivan Bautmans ◽

Nina Lefeber ◽

Pierre Lievens ◽

Thierry Scheerlinck ◽

Peter Vaes ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Randomized Controlled Trial ◽

Knee Pain ◽

Knee Arthroplasty ◽

Controlled Trial ◽

Transcutaneous Electric Nerve Stimulation ◽

Analgesic Tolerance ◽

Randomized Controlled ◽

Total Knee ◽

Electric Nerve Stimulation

AbstractTranscutaneous electric nerve stimulation (TENS) has proven to be effective for postsurgical pain relief. However, there is a lack of well-constructed clinical trials investigating the effect of TENS after total knee arthroplasty (TKA). In addition, previous investigations reported that low- and high-frequency TENSs produced analgesic tolerance after 4 or 5 days of treatment. The aim of this study is to explore the effect of burst TENS on pain during hospitalization after TKA and to investigate whether burst TENS produces analgesic tolerance after 4 or 5 days of treatment. This stratified, triple blind, randomized controlled trial was approved by the University Hospital Brussels. Sixty-eight subjects were screened for eligibility before surgery; 54 were found eligible and 53 were included in the analyses. Patients were allocated to either a burst TENS or sham burst TENS group. TENS was applied daily during continuous passive mobilization. Knee pain intensity, knee range of motion, and analgesic consumption were assessed daily. Patients received burst TENS (N = 25) or sham burst TENS (N = 28). No significant differences in knee pain intensity were found between the groups (p > 0.05). Within the TENS and the sham TENS groups, the difference in knee pain before and after treatment did not evolve over time (p > 0.05). This study found no effects of burst TENS compared with sham burst TENS on pain during hospitalization after TKA.

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