scholarly journals Consistency of Knee Pain and Risk of Knee Replacement: The Multicenter Osteoarthritis Study

2011 ◽  
Vol 38 (7) ◽  
pp. 1390-1395 ◽  
Author(s):  
BARTON L. WISE ◽  
DAVID T. FELSON ◽  
MARGARET CLANCY ◽  
JINGBO NIU ◽  
TUHINA NEOGI ◽  
...  
Keyword(s):  
Knee Pain ◽  
Knee Replacement ◽  
Clinic Visit ◽  
Pain Severity ◽  
Relative Risks ◽  
Increased Risk ◽  
Symptomatic Knee Osteoarthritis ◽  
Symptomatic Knee ◽  
Risk Of Disease ◽  
Total Knee

Objective.To examine whether the consistency or persistence of knee pain, in addition to its severity, predicts incident total knee replacement (TKR).Methods.The Multicenter Osteoarthritis Study (MOST) is a longitudinal study of persons aged 50 to 79 years with symptomatic knee osteoarthritis or at high risk of disease. Subjects were queried about the presence of knee pain on most days of the previous 30 days (i.e., frequent knee pain; FKP) at 2 timepoints: a telephone screen followed by a clinic visit (median separation 4 weeks). We defined a knee as having “consistent pain” if the subject answered positively to the FKP question at both timepoints, “inconsistent pain” if FKP was positive at only one timepoint, or as “no FKP” if negative at both. We examined the association between consistent FKP and risk of TKR using multiple binomial regression with generalized estimating equations.Results.In 3026 persons (mean age 63 yrs, mean body mass index 30.4), 2979 knees (50%) had no FKP at baseline, 1279 knees (21.5%) had inconsistent FKP, and 1696 knees (28.5%) had consistent FKP. Risk of TKR over 30 months was 0.8%, 2.6%, and 8.8% for knees with no, inconsistent, and consistent FKP, respectively. Relative risks of TKR over 30 months were 1.2 (95% CI 0.6–2.3) and 2.3 (95% CI 1.2–4.4) for knees with inconsistent and consistent FKP, compared with those without FKP. This association was consistent across each level of pain severity on the Western Ontario and McMaster Universities Osteoarthritis Index.Conclusion.Consistency of frequent knee pain is associated with an increased risk of TKR independently of knee pain severity.

Iliotibial band enthesopathy: an unusual cause of lateral knee pain post total knee replacement

2021 ◽  
Author(s):  
G. Hegde ◽  
A. Subramanian ◽  
C. Azzopardi ◽  
A. Patel ◽  
S. L. James ◽  
...  
Keyword(s):  
Total Knee Replacement ◽  
Knee Pain ◽  
Knee Replacement ◽  
Iliotibial Band ◽  
Total Knee ◽  
Lateral Knee Pain

scholarly journals US-Approved Intra-Articular Hyaluronic Acid Injections are Safe and Effective in Patients with Knee Osteoarthritis: Systematic Review and Meta-Analysis of Randomized, Saline-Controlled Trials

2013 ◽  
Vol 6 ◽  
pp. CMAMD.S12743 ◽  
Author(s):  
Larry E. Miller ◽  
Jon E. Block
Keyword(s):  
Systematic Review ◽  
Hyaluronic Acid ◽  
Knee Osteoarthritis ◽  
Knee Pain ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Serious Adverse Events ◽  
Safety Outcome ◽  
Symptomatic Knee Osteoarthritis ◽  
Symptomatic Knee

We conducted a systematic review and meta-analysis of randomized saline-controlled trials to determine the safety and efficacy of US-approved intra-articular hyaluronic acid (IAHA) injections for symptomatic knee osteoarthritis. A total of 29 studies representing 4,866 unique subjects (IAHA: 2,673, saline: 2,193) were included. IAHA injection resulted in very large treatment effects between 4 and 26 weeks for knee pain and function compared to pre-injection values, with standardized mean difference (SMD) values ranging from 1.07–1.37 (all P < 0.001). Compared to saline controls, SMDs with IAHA ranged from 0.38–0.43 for knee pain and 0.32–0.34 for knee function (all P < 0.001). There were no statistically significant differences between IAHA and saline controls for any safety outcome, including serious adverse events (SAEs) ( P = 0.12), treatment-related SAEs ( P = 1.0), study withdrawal ( P = 1.0), and AE-related study withdrawal ( P = 0.46). We conclude that intra-articular injection of US-approved HA products is safe and efficacious in patients with symptomatic knee osteoarthritis.

scholarly journals Literature review of the causes of pain following total knee replacement surgery: prosthesis, inflammation and arthrofibrosis

2020 ◽  
Vol 5 (9) ◽  
pp. 534-543
Author(s):  
Cheuk Yin Li ◽  
Kenneth Jordan Ng Cheong Chung ◽  
Omar M. E. Ali ◽  
Nicholas D. H. Chung ◽  
Cheuk Heng Li
Keyword(s):  
Risk Factors ◽  
Literature Review ◽  
Knee Pain ◽  
Knee Replacement ◽  
Polyethylene Wear ◽  
Publication Date ◽  
Ageing Population ◽  
Replacement Surgery ◽  
Patellar Maltracking ◽  
Total Knee

Adverse knee pain occurs in 10–34% of all total knee replacements (TKR), and 20% of TKR patients experience more pain post-operatively than pre-operatively. Knee pain is amongst the top five reasons for knee replacement revision in the United Kingdom. The number of TKRs is predicted to continue increasing due to the ageing population. A narrative literature review was performed on the different causes of pain following TKR. A database search on Scopus, PubMed, and Google Scholar was conducted to look for articles related to TKR, pain, and cause. Articles were selected based on relevance, publication date, quality of research and validation. Relevant sections were added to the review. One hundred and fourteen articles were identified and potential causes of TKR pain included: arthrofibrosis, aseptic loosening, avascular necrosis, central sensitization, component malpositioning, infection, instability, nerve damage, overstuffing, patellar maltracking, polyethylene wear, psychological factors and unresurfaced patella. It is important to tailor our approach to address the individual causes of pain. Certain controllable risk factors can be managed pre-operatively to minimize post-operative pain. Risk factors help to predict adverse pain outcomes and identify specific causes. There are multiple causes of pain following TKR. Some factors will require further extensive studies, and as pain is a commonly attributed reason for TKR revision, its underlying aetiologies should be explored. Understanding these factors helps to develop effective methods for diagnosis, prevention and management of TKR pain, which help to improve patient outcomes. Cite this article: EFORT Open Rev 2020;5:534-543. DOI: 10.1302/2058-5241.5.200031

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