L-PRF in Osteoarthritis Treatment: Results of a Pilot study

2020 ◽  
Author(s):  
Valerio Di Nicola
Keyword(s):  
Primary Outcome ◽  
Musculoskeletal Disorder ◽  
Chronic Wound ◽  
Bone Erosion ◽  
Treatment Results ◽  
Platelet Rich Fibrin ◽  
Knee Oa ◽  
Osteoarthritis Treatment ◽  
Connective Tissue Regeneration ◽  
Early Oa

Osteoarthritis (OA) is the most common chronic musculoskeletal disorder and is the most frequent single cause of disability in older adults [1]. OA is a chronic disease progressively involving the entire joint. Progression involves capsule-bursa inflammation, synovial fluid modifications, cartilage erosions, and osteochondral inflammatory deteriorations leading to bone erosion and distortion [1]. Early OA defines the initial cascade of events that trigger the disease and lead to the full-blown OA. The disease progression can sometimes last for years being quite often neglected or mistreated with palliative medications. Joint resident MSCs has always been a target for our research into and treatment of OA [1,2,3]. Recently L-PRF (leukocyte and platelet-rich fibrin), showed promising properties in connective tissue regeneration and, for this reason, is now widely applied in chronic wound healing and jawbone growth [4,5,6]. After centrifugation, L-PRF membranes hold vital platelets, leukocytes, and various peripheral blood cells [7,8]. As a result, we exposed these membranes to a thermic shock aimed to increase the pool of HSPs. The final product was named supercharged L-PRF. Supercharged L-PRF components -membranes and hyper-acute serum- were used in knee OA patients in a small preliminary comparative study. 20 consecutive patients were randomly divided into 2 groups: 10 patients treated with supercharged L-PRF and 10 with PRP+HA (PRP+ Hyaluronic acid). The primary outcome of this study was to induce persistent pain relief and recovery of motility. This article reports supercharged L-PRF preliminary experience in degenerative OA treatment.

scholarly journals Can Ultrasound Therapy Be an Environmental-Friendly Alternative to Non-Steroidal Anti-Inflammatory Drugs in Knee Osteoarthritis Treatment?

Materials ◽  
2021 ◽  
Vol 14 (11) ◽  
pp. 2715
Author(s):  
Rodica Ana Ungur ◽  
Viorela Mihaela Ciortea ◽  
Laszlo Irsay ◽  
Alina Deniza Ciubean ◽  
Bogdana Adriana Năsui ◽  
...  
Keyword(s):  
Ultrasound Therapy ◽  
Negative Effects ◽  
Beneficial Effects ◽  
Knee Oa ◽  
Environmental Friendly ◽  
Chemical Pollutants ◽  
Osteoarthritis Treatment ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
And Function

The non-steroidal anti-inflammatory drugs (NSAIDs) are the most used drugs in knee OA (osteoarthritis) treatment. Despite their efficiency in pain and inflammation alleviation, NSAIDs accumulate in the environment as chemical pollutants and have numerous genetic, morphologic, and functional negative effects on plants and animals. Ultrasound (US) therapy can improve pain, inflammation, and function in knee OA, without impact on environment, and with supplementary metabolic beneficial effects on cartilage compared to NSAIDs. These features recommend US therapy as alternative for NSAIDs use in knee OA treatment.

scholarly journals AB0587 ASSESSING THE CHARACTERISTICS AND MANAGEMENT OF KNEE OSTEOARTHRITIS PATIENTS WITH HYPERTENSION BY CLINICIAN SPECIALITY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1330.2-1331
Author(s):  
D. Baldock ◽  
E. Baynton ◽  
C. F. Ng
Keyword(s):  
Knee Osteoarthritis ◽  
Sports Medicine ◽  
Primary Care Physicians ◽  
Bone Erosion ◽  
Holistic Treatment ◽  
Knee Oa ◽  
Patient Demographics ◽  
Medical Chart Review ◽  
Complex Patients ◽  
Minimum Number

Background:Though the pathogenesis of knee osteoarthritis (OA) is complex, patients with OA frequently have other comorbidities, including hypertension, which eludes to other considerations needed when deciding appropriate treatment management.Objectives:This study aims to examine the profiles of knee OA patients with hypertension vs. those without any comorbidities, and to elucidate key differences between these patient groups as potential areas of consideration.Methods:A multi-center, online medical chart review study of patients with OA was conducted between May – July 2020 among US rheumatologists (rheums), orthopedic surgeons (orthos), primary care physicians with a focus in sports medicine (SM PCPs), and pain specialists. Physicians recruited were screened for duration of practice in their specialty (3-50 years) and caseload (>=35 knee OA patients personally managed, at least 10 being moderate-severe). Patient charts were recorded for the next 5 eligible patients seen during the screening period. Respondents abstracted patient demographics and treatments used. Descriptive statistics were used to analyse the data.Results:260 physicians were recruited and collectively reported 796 knee OA patients; 559 were reported to experience hypertension whilst 237 were reported as not experiencing any comorbidities.Reported hypertension patients were significantly older (mean 67 vs 59 years old, respectively; p≤0.01) and weighed more (mean 82kg vs 77kg, respectively; p≤0.01) than patients without comorbidities; they were also significantly more likely to be previous smokers compared to those without comorbidities (23% vs 8%, respectively; p≤0.01). With regards to current knee OA severity, both orthos and SM PCPs reported a significantly higher proportion of hypertension patients that were deemed ‘severe’ (physician opinion) vs patients without comorbidities (orthos: 50% vs 32%, respectively; SM PCPs: 42% vs 23%, respectively; p≤0.01).Rheums and pain specialists reported greater mild opioid usage amongst hypertension patients compared to those without comorbidities (rheums: 28% vs 10%, respectively (p≤0.05); pain specialists: 40% vs 9%, respectively; (p≤0.01)); orthos and SM PCPs stated significantly greater use of corticosteroid injections amongst their reported hypertension patients vs those without comorbidities (orthos: 60% vs 41%, respectively; SM PCPs: 40% vs 19%, respectively; p≤0.01). Hypertension patients reported by orthos and SM PCPs are more likely to be considered for total knee replacement (TKR) surgery compared to those without comorbidities (orthos: 59% vs 32%, respectively; SM PCPs: 37% vs 19%, respectively; p≤0.01). Conversely, hypertension patients reported by rheums are less likely to be considered for TKR vs those without comorbidities (41% vs 18%, respectively; p≤0.05).Reported hypertension patients had a significantly higher mean Visual Analogue Scale for Pain (VAS) score than patients without comorbidities (6.6 vs 5.9, respectively; p≤0.01). A significantly higher proportion of patients with hypertension demonstrate radiographic evidence of bone erosion compared to those without comorbidities (69% vs 56%, respectively; p≤0.01).Conclusion:From the sample surveyed, knee OA patients with hypertension may require a more specific and holistic treatment approach that takes into account their CV status and managing physician specialty. Further investigation using comparator cohort is warranted.References:[1]Ipsos Osteoarthritis Therapy Monitor (May – July 2020, 260 specialists reporting on 769 knee OA patients seen in consultation, data collected online. Participating physicians were primary treaters and saw a minimum number of 35 knee OA patients). Data © Ipsos 2021, all rights reserved.[2]Ipsos Osteoarthritis Therapy Monitor (May – July 2020, 260 specialists reporting on 769 knee OA patients seen in consultation, data collected online. Participating physicians were primary treaters and saw a minimum number of 35 knee OA patients). Data © Ipsos 2021, all rights reserved.Disclosure of Interests:None declared.

scholarly journals Clinical Efficacy of Cortex Daphnes (Zushima) Patch in Patients With Symptomatic Knee Osteoarthritis: A Multicenter Non-Inferiority Randomized Controlled Clinical Trial

2021 ◽  
Vol 12 ◽  
Author(s):  
Yan-Ting Li ◽  
Juan Jiao ◽  
Yi Zhang ◽  
Ci-Bo Huang ◽  
Hai-Dong Wang ◽  
...  
Keyword(s):  
Clinical Efficacy ◽  
Primary Outcome ◽  
Protocol Analysis ◽  
Womac Pain ◽  
Knee Oa ◽  
Symptomatic Knee Osteoarthritis ◽  
Symptomatic Knee ◽  
Full Analysis ◽  
Secondary Outcomes ◽  
Patch Group

Background: Osteoarthritis (OA) is imposing substantial burdens on individuals and society with the aging population. Cortex Daphnes patch is widely used for symptomatic knee OA in China with a satisfying clinical efficacy; however, there is scant clinical evidence supporting its use. To evaluate its efficacy, we conducted a multicenter, non-inferiority, randomized, parallel-group study comparing Cortex Daphnes patch with topical nonsteroidal anti-inflammatory drugs in patients with knee OA (NCT02770950).Methods: A total of 264 symptomatic knee OA patients were treated with Cortex Daphnes or indomethacin cataplasms applied to affected sites once daily for 2 weeks. The primary outcome was improvement in knee pain on walking as assessed using a visual analog scale (VAS). The non-inferiority margin based on the full analysis population was set as –5 mm on the pain VAS. The secondary outcomes were changes of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total score, WOMAC scores for pain, function and stiffness, the 36-item Short Form Health Survey (SF-36), and global assessment of knees by the patients. Responder rates for pain VAS, WOMAC total score, and WOMAC pain were also included in the secondary outcomes.Results: The Cortex Daphnes patch was non-inferior to indomethacin cataplasms for the primary outcome with a group difference (Cortex Daphnes patch–indomethacin cataplasm) of 2.1 mm (95% confidence interval: 2.1–6.4); similar results were found in the per-protocol population. For all other outcomes, no significant differences were found in the full analysis set or in the per-protocol analysis set, except the responder rates for WOMAC pain was higher in the Cortex Daphnes patch group than in the indomethacin cataplasm group (78.4 vs. 64.7%, p = 0.022) in the per-protocol analysis set. Overall, 28.8% patients in the Cortex Daphnes patch group and 9.8% in the indomethacin cataplasm group reported treatment-related adverse events, the vast majority of which were mild-to-moderate skin irritation, resulting in only 3.8 and 0.8% of patients dropping out, respectively.Conclusion: The Cortex Daphnes patch, which provides satisfactory analgesic efficacy and enhances the physical function of the knee, as well as improving quality of life, may be a promising alternative to knee OA.

scholarly journals Association between meniscal volume and development of knee osteoarthritis

Rheumatology ◽  
2020 ◽  
Author(s):  
Dawei Xu ◽  
Jan van der Voet ◽  
Nils M Hansson ◽  
Stefan Klein ◽  
Edwin H G Oei ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Primary Outcome ◽  
Joint Space Narrowing ◽  
Joint Space ◽  
Primary Outcome Measure ◽  
Obese Women ◽  
Knee Oa ◽  
Kellgren And Lawrence ◽  
Over Time

Abstract Objective To assess the association between meniscal volume, its change over time and the development of knee OA after 30 months in overweight/obese women. Methods Data from the PRevention of knee Osteoarthritis in Overweight Females study were used. This cohort included 407 women with a BMI ≥ 27 kg/m2, free of OA-related symptoms. The primary outcome measure was incident OA after 30 months, defined by one out of the following criteria: medial or lateral joint space narrowing (JSN)  ≥ 1.0 mm, incident radiographic OA [Kellgren and Lawrence (K&L)  ≥ 2], or incident clinical OA. The secondary outcomes were either of these items separately. Menisci at both baseline and follow-up were automatically segmented to obtain meniscal volume and delta-volumes. Generalized estimating equations were used to evaluate associations between the volume measures and the outcomes. Results Medial and lateral baseline and delta-volumes were not significantly associated to the primary outcome. Lateral meniscal baseline volume was significantly associated to lateral JSN [odds ratio (OR) = 0.87; 95% CI: 0.75, 0.99], while other measures were not. Medial and lateral baseline volume were positively associated to K&L incidence (OR = 1.32 and 1.22; 95% CI: 1.15, 1.50 and 1.03, 1.45, respectively), while medial and lateral delta-volume were negatively associated to K&L incidence (OR = 0.998 and 0.997; 95% CI: 0.997, 1.000 and 0.996, 0.999, respectively). None of the meniscal measures were significantly associated to incident clinical OA. Conclusion Larger baseline meniscal volume and the decrease of meniscal volume over time were associated to the development of structural OA after 30 months in overweight and obese women.

scholarly journals CLINICAL AND HISTOPATHOLOGICAL EVALUATION OF USING PLATELET-RICH PLASMA AND PLATELET-RICH FIBRIN MATRIX IN TREATMENT OF INDUCED CHRONIC OPEN WOUNDS IN BUCKS

2018 ◽  
Vol 11 (5) ◽  
pp. 337 ◽  
Author(s):  
Falah H Khalaf ◽  
Serwa Ibrahim Salih
Keyword(s):  
Chronic Wound ◽  
Platelet Rich Plasma ◽  
Healing Process ◽  
Experimental Period ◽  
Control Group ◽  
Full Thickness ◽  
Platelet Rich Fibrin ◽  
Fibrin Matrix ◽  
Four Square ◽  
Prp Gel

Objective: This study was designed to identify the effectiveness of platelet-rich plasma gel (PRP) and platelet-rich fibrin matrix (PRF) application on the induced open chronic full-thickness cutaneous wounds in goats.Methods: A total of 24 adult apparently healthy local breed bucks were used in this study. PRP gel and PRF matrix were prepared from whole blood at the time of treatment, four square full-thickness skin wounds (4 cm × 4 cm) on the dorsal sides of the back of each animal were created, by daily scratched to interrupt healing process continuation to prolong inflammatory reaction to form chronic wound, this surgical procedure was continued for 8 weeks to ensure the traditional chronicity wounds, after that they were treated by PRP gel in the first group (n=12), while PRF matrix was used in the second group (n=12). Each group was also subdivided into treatment (n=2 wounds) and control group (n=2 wounds) in each animal. The healing process was evaluated by clinical examination during experimental period and histologically in day 7, 14, 28, and 45 post operation.Conclusion: Both groups showed faster tissue repair and epithelialization in treatment groups compared to control groups. The results of this study confirmed PRP gel and PRF matrix application improved and accelerated cutaneous open chronic wound healing.

scholarly journals Hypertonic dextrose injections (prolotherapy) in the treatment of symptomatic knee osteoarthritis: A systematic review and meta-analysis

2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Regina WS Sit ◽  
Vincent CH Chung ◽  
Kenneth D. Reeves ◽  
David Rabago ◽  
Keith KW Chan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Knee Osteoarthritis ◽  
Primary Outcome ◽  
Meta Analysis ◽  
Knee Oa ◽  
Composite Scale ◽  
Symptomatic Knee Osteoarthritis ◽  
Symptomatic Knee ◽  
Pain Subscale ◽  
Hypertonic Dextrose

Abstract Hypertonic dextrose injections (prolotherapy) is an emerging treatment for symptomatic knee osteoarthritis (OA) but its efficacy is uncertain. We conducted a systematic review with meta-analysis to synthesize clinical evidence on the effect of prolotherapy for knee OA. Fifteen electronic databases were searched from their inception to September 2015. The primary outcome of interest was score change on the Western Ontario and McMaster Universities Arthritis Index (WOMAC). Three randomized controlled trials (RCTs) of moderate risk of bias and one quasi–randomized trial were included, with data from a total of 258 patients. In the meta-analysis of two eligible studies, prolotherapy is superior to exercise alone by a standardized mean difference (SMD) of 0.81 (95% CI: 0.18 to 1.45, p = 0.012), 0.78 (95% CI: 0.25 to 1.30, p = 0.001) and 0.62 (95% CI: 0.04 to 1.20, p = 0.035) on the WOMAC composite scale; and WOMAC function and pain subscale scores respectively. Moderate heterogeneity exists in all cases. Overall, prolotherapy conferred a positive and significant beneficial effect in the treatment of knee OA. Adequately powered, longer-term trials with uniform end points are needed to better elucidate the efficacy of prolotherapy.

scholarly journals CAN PROFESSIONAL QUALIFICATION CHANGE PHYSICAL THERAPISTS PERCEPTION ABOUT KNEE OSTEOARTHRITIS TREATMENT? RESULTS OF A CROSS-SECTIONAL SURVEY IN THE AMAZON REGION

2021 ◽  
Author(s):  
Natalia Camargo Rodrigues Iosimuta ◽  
Nívea Renata Oliveira Monteiro ◽  
Débora Juliana do Rosário ◽  
Vânia Tiê Koga Ferreira ◽  
Daniela Gonçalves Ohara ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Physical Therapists ◽  
Amazon Region ◽  
Treatment Results ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Professional Qualification ◽  
Osteoarthritis Treatment

scholarly journals Proteomics profiling of human synovial fluid suggests global increased protein interplay in early-osteoarthritis (OA) and lost in late-stage OA

2020 ◽  
Author(s):  
Neserin Ali ◽  
Aleksandra Turkiewicz ◽  
Velocity Hughes ◽  
Elin Folkesson ◽  
Jon Tjörnstand ◽  
...  
Keyword(s):  
Synovial Fluid ◽  
Late Stage ◽  
Multilevel Model ◽  
Molecular Mechanisms ◽  
Early Stage ◽  
Meniscal Tear ◽  
Knee Oa ◽  
Data Independent Acquisition ◽  
First Time ◽  
Early Oa

AbstractThe underlying molecular mechanisms in osteoarthritis (OA) development are largely unknown. This study explores the proteome and the pairwise interplay of proteins on a global level in synovial fluid from patients with late-stage knee OA (arthroplasty), early knee OA (arthroscopy due to degenerative meniscal tear) and from deceased controls without knee OA.Synovial fluid samples were analyzed using state-of-the-art mass spectrometry with data-independent acquisition. The differential expression of the proteins detected was clustered and evaluated with data mining strategies and a multilevel model. Group-specific slopes of associations were estimated between expressions of each pair of identified proteins to assess the co-expression (i.e. interplay) between the proteins in each group.More proteins were increased in early-OA vs controls than late-stage OA vs controls. For most of these proteins, the fold changes between late-stage OA vs controls and early stage OA vs controls were remarkably similar suggesting potential involvement in the OA process. Further, for the first time this study illustrated distinct patterns in protein co-expression suggesting that the global interplay between the protein machinery is increased in early-OA and lost in late-stage OA. Further efforts should probably focus on earlier stages of the disease than previously considered.

scholarly journals Detection of bone erosions in knee osteoarthrosis by serum biomarkers

2010 ◽  
Vol 138 (1-2) ◽  
pp. 62-66
Author(s):  
Sandra Zivanovic ◽  
Ljiljana Petrovic-Rackov ◽  
Milorad Jevtic
Keyword(s):  
Bone Erosion ◽  
Mean Value ◽  
Joint Surface ◽  
Serum Samples ◽  
Human Cartilage ◽  
Average Value ◽  
Knee Oa ◽  
Central Value ◽  
Primary Osteoarthrosis ◽  
Duration Of Disease

Introduction. Osteoarthrosis (OA) is a degenerative chronic disease characterized by destruction of joint articular cartilage and subchondral bone with formation of osteophytes and usuries on joint surface. Quantitative and dynamic changes in remodeling of joint tissue reflect matrix molecules that dismiss as fragments in joint liquid, blood and urine where they can be detected. Human cartilage glycoprotein (YKL-40) is synthesised by chondrocytes and synovial cells and plays a significant role in remodel tissue. Objective. The aim of the paper was the parallel analysis and determination of the degree of correlation between ultrasound indicators destruction of joints, bone erosion (usuries), and serum YKL-40 concentrations in patients with primary osteoarthrosis of the knee. Methods. The analysis included 88 patients with the diagnosis of knee OA. Ultrasound review of knees was done by two rheumatologists. The analysis of serum samples determined the concentration of YKL40 by ELISA method. Results. The average age of patients was 69.97?9.37 years, duration of knee OA 6.46?6.73 years. The mean value of age in 59 patients with usuries was 72.05?7.74, at 29 without usuries 65.75?11.00 (p=0.003). The average value (median) thickness cartilage in medial condyl femur (front access) in patients with usuries was 1.25 mm (1.12-1.36 mm), without usuries 1.35 mm (1.20-1.51 mm) (p=0.016). The central YKL40 value of biomarkers in the patients without usuries was 81 ng/ml (46.5-120.5 ng/ml), with usuries the medial condyil 138 ng/ml (89.5-175.0 ng/ml), the lateral 106 ng/ml (63.0-201.5 ng/ml) and both condyl 86 ng/ ml (69.75-140.5 ng/ml) (p=0.004). The central value YKL40 after 5 year-duration of disease was 83.68?33.65 ng/ml, after 10 years 138.22?48.88 ng/ml, after 15 years 209.30?79.36 ng/ml, and after 20 years 218.50?106.51 ng/ml (p=0.000). The biomarker YKL 40 may be a marker for usuries (area 0.691, p=0.004; confidence interval 0.574-0.808). If you took the optimal cut-off of 84.5 ng/ml, then YKL40 sensitivity to the usuries was 69.5%, and specificity 51.7%. Conclusion. Increased concentrations of biomarkers YKL40 may be an indicator of the degree of destructive changes in the knee osteoarthrosis.

scholarly journals Interrelation of bone mineral density with kneeosteoarthrosis

2011 ◽  
Vol 14 (1) ◽  
pp. 19-20
Author(s):  
E. M. Zaytseva ◽  
A. V. Smirnov ◽  
L. I. Alekseeva ◽  
E. M. Zaitseva ◽  
A. V. Smirnov ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Bone Mineral ◽  
Disease Onset ◽  
Axial Skeleton ◽  
Knee Joints ◽  
Mineral Density ◽  
X Ray ◽  
Knee Oa ◽  
Early Oa

Association of bone mineral density (BMD) of axial skeleton with age of the disease onset as well as with clinical traits and instrumental investigation findings has been studied in osteoarthritic patients. 116 females with primary knee OA, 74 ofwhich exhibited normal or increased BMD at lumbar spine and 42, with osteoporosis were included in the study. Knee joint pain was measured using visual analog scale (VAS). All the patients were subjected to X-ray analysis of their knee joints at two sites (OA stage was determined according to Kellgren-Lawrence scale), densitometry at lumbar spine and proximal femur using QDR-4500W (Hologic), MRT, and ultrasonography of the knee joints. We determined that the increasedBMD at lumbar spine was associated with early OA onset, more pronounced X-ray changes in the knee joints and higher frequency of varus deformation development in tibial bones.

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