Efficacy of combined proprioceptive exercises and conventional physiotherapy in patients with knee osteoarthritis: A double-blinded two-group pretest–posttest design

Abstract Background: Platelet-rich plasma (PRP) has a still conflicting efficacy for knee osteoarthritis (KOA) and might be a minimally invasive and safe treatment alternative. The potential benefit of only plasma (non-enriched) has never been investigated. Our aim was to evaluate the efficacy of intra-articular platelet-rich plasma (PRP) and plasma to improve pain and function in participants with KOA over 24 weeks. Methods: Randomized, double-blind, placebo-controlled trial with 3 groups (n = 62): PRP (n = 20), plasma (n = 21) and saline (n = 21). Two ultrasound-guided knee injections were performed with a 2-week interval. The primary outcome was visual analog scale 0-10 cm (VAS) for overall pain at week 24, with intermediate assessments at weeks 6 and 12. Main secondary outcomes were: KOOS, OMERACT-OARSI criteria and TUGT. Results: At baseline, 92% of participants were female, with a mean age of 65 years, mean BMI of 28.0 Kg/m2and mean VAS pain of 6.2 cm. Change in pain from baseline at week 24 were -2.9 (SD 2.5), -2.4 (SD 2.5) and -3.5 cm (SD 3.3) for PRP, plasma and saline, respectively (p intergroup = 0.499). There were no differences between the three groups at weeks 6 and 12. Similarly, there were no differences between groups regarding secondary outcomes. The PRP group showed higher frequency of adverse events (65% versus 24% and 33% for plasma and saline, respectively, p = 0.02), mostly mild transitory increase in pain.Conclusions: PRP and plasma were not superior to placebo for pain and function improvement in KOA over 24 weeks. The PRP group had a higher frequency of mild transitory increase in pain.Trial registration: ClinicalTrials.gov, NCT03138317, 03/05/2017.

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Effectiveness of yoga asanas over conventional physiotherapy treatment on functional outcomes in patients with knee osteoarthritis

MOJ Yoga & Physical Therapy ◽

10.15406/mojypt.2018.03.00044 ◽

2018 ◽

Vol 3 (3) ◽

Author(s):

Bid Dibyendunarayan Dhrubaprasad

Keyword(s):

Knee Osteoarthritis ◽

Functional Outcomes ◽

Physiotherapy Treatment ◽

Conventional Physiotherapy

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Effectiveness of low-dose radiation therapy on symptoms in patients with knee osteoarthritis: a randomised, double-blinded, sham-controlled trial

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2018-214104 ◽

2018 ◽

pp. annrheumdis-2018-214104 ◽

Cited By ~ 12

Author(s):

Elien A M Mahler ◽

Michiel JM Minten ◽

Mathilde M Leseman-Hoogenboom ◽

Philip M P Poortmans ◽

Jan Willem H Leer ◽

...

Keyword(s):

Radiation Therapy ◽

Knee Osteoarthritis ◽

Low Dose ◽

Controlled Trial ◽

Controlled Clinical Trial ◽

Low Dose Radiation ◽

Knee Oa ◽

Sham Intervention ◽

Double Blinded ◽

Dose Radiation

ObjectivesLow-dose radiation therapy (LDRT) for benign disorders such as knee osteoarthritis (OA) is widely used in some parts of the world, despite absence of controlled studies. We evaluated the effect of LDRT on symptoms and inflammation in patients with knee OA.MethodsIn this randomised, double-blinded, sham-controlled clinical trial (RCT), we recruited patients with knee OA (clinical ACR criteria) in the Netherlands, aged ≥50 years, pain score ≥5/10 and non-responding to analgesics and exercise therapy. Patients were randomised 1:1 to receive LDRT (1 Gray per fraction) or sham intervention six times in 2 weeks, stratified by pain (<8 versus ≥8/10). Primary outcome was the proportion of OMERACT-OARSI responders, 3 months postintervention. Secondary outcomes included pain, function and inflammatory signs assessed by ultrasound, MRI and serum inflammatory markers.ResultsWe randomly assigned 55 patients: 27 (49%) to LDRT and 28 (51%) to sham. At 3 months postintervention, 12/27 patients (44%; 95% CI 26% to 63%) in the LDRT vs 12/28 patients (43%; 95% CI 25% to 61%) in the sham group responded; difference 2% (95% CI 25% to 28%), OR adjusted for the stratifying variable was 1.1 (95% CI 0.4 to 3.2). Also, for clinical and any of the inflammatory signs, no differences were observed.ConclusionsWe found no substantial beneficial effect on symptoms and inflammatory signs of LDRT in patients knee OA, compared with sham treatment. Therefore, based on this RCT and the absence of other high-quality evidence, we advise against the use of LDRT as treatment for knee OA.Trial registration numberNTR4574.

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