scholarly journals EFFICACY OF PANCHAKARMA IN SANDHIVATA W.S.R. TO KNEE ARTHRITIS

2021 ◽  
Vol 09 (1) ◽  
pp. 212-218
Author(s):  
Tanuja Mehta ◽  
Vipin Kumar ◽  
Sheetal Verma ◽  
Uttam Kumar Sharma
Keyword(s):  
Knee Osteoarthritis ◽  
Cost Effective ◽  
Knee Arthritis ◽  
Motor Disability ◽  
Traditional System ◽  
Pharmaceutical Management ◽  
Knee Oa ◽  
Therapeutic Benefits ◽  
Therapeutic Measures ◽  
Inflammatory Drugs

Inflammation of knee joint is called knee arthritis. Among various forms of knee arthritis common is degenerative type of knee osteoarthritis It is the major cause of loco motor disability in old age people particularly among women. Analgesics and Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are the current available pharmaceutical management of knee osteoarthritis which are associated with adverse side effects. Thus, there is need of research in traditional system of medicines for cost effective and long-term management of knee OA. Degenerative Knee osteo arthritis is almost similar to the Sandhivata describes in Ayuveda with respect to aetiology, pathology and clinical features. With the use of medicines Ayurveda also employs the prospective of Panchakarma in the various therapeutic measures, which is a kind of Shodhan Chikitsa. Panchakarma provides various therapeutic benefits as detoxification, improved circulation, spasm and pain relief. Hence objective of this review article is to describe the efficacy of Panchakarma in knee-arthritis with taking consideration of disease mentioned in Ayurvedic classics as Sandhivata

scholarly journals Comparison of Diagnostic Performance of Semi-Quantitative Knee Ultrasound and Knee Radiography with MRI: Oulu Knee Osteoarthritis Study

2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Jana Podlipská ◽  
Ali Guermazi ◽  
Petri Lehenkari ◽  
Jaakko Niinimäki ◽  
Frank W. Roemer ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Knee Osteoarthritis ◽  
Diagnostic Performance ◽  
Structural Changes ◽  
Morphological Changes ◽  
Cost Effective ◽  
Conventional Radiography ◽  
Joint Space ◽  
Meniscal Extrusion ◽  
Knee Oa

Abstract Osteoarthritis (OA) is a common degenerative musculoskeletal disease highly prevalent in aging societies worldwide. Traditionally, knee OA is diagnosed using conventional radiography. However, structural changes of articular cartilage or menisci cannot be directly evaluated using this method. On the other hand, ultrasound is a promising tool able to provide direct information on soft tissue degeneration. The aim of our study was to systematically determine the site-specific diagnostic performance of semi-quantitative ultrasound grading of knee femoral articular cartilage, osteophytes and meniscal extrusion, and of radiographic assessment of joint space narrowing and osteophytes, using MRI as a reference standard. Eighty asymptomatic and 79 symptomatic subjects with mean age of 57.7 years were included in the study. Ultrasound performed best in the assessment of femoral medial and lateral osteophytes, and medial meniscal extrusion. In comparison to radiography, ultrasound performed better or at least equally well in identification of tibio-femoral osteophytes, medial meniscal extrusion and medial femoral cartilage morphological degeneration. Ultrasound provides relevant additional diagnostic information on tissue-specific morphological changes not depicted by conventional radiography. Consequently, the use of ultrasound as a complementary imaging tool along with radiography may enable more accurate and cost-effective diagnostics of knee osteoarthritis at the primary healthcare level.

Does Intra-Articular Injection of Platelet-Rich Plasma Have an Effect on Cartilage Thickness in Patients with Primary Knee Osteoarthritis?

2021 ◽  
Vol 17 ◽  
Author(s):  
Noha M Abdel Baki ◽  
Zeinab O. Nawito ◽  
Nehal M. S. Abdelsalam ◽  
Dina Sabry ◽  
Hossam Elashmawy ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Platelet Rich Plasma ◽  
Womac Score ◽  
Cartilage Thickness ◽  
Condylar Cartilage ◽  
Knee Oa ◽  
Group I ◽  
Grading Scale ◽  
Inflammatory Drugs ◽  
Group Ii

Objectives: To determine the effect of intra-articular injection of platelet-rich plasma (PRP) in patients with primary knee osteoarthritis (OA) by clinical evaluation and ultrasonographic (US) assessment of cartilage thickness. Patients and Methods: A total of 100 patients with mild to severe primary knee OA using the Kellgren-Lawrence (K-L) grading scale were included and divided into two groups. Group I included 50 patients who were given two intra-articular knee injections of PRP, 1 week apart; Group II included 50 patients who received non-steroidal anti-inflammatory drugs (NSAIDs) and chondroprotective drugs. Functional assessment of all OA patients done using the basal WOMAC score, at 2 and 6 months.US assessment of femoral condylar cartilage thickness was conducted basally and at 6 months. Results: Improvement of WOMAC score was observed at 2 and 6 months in Group I following PRP injection compared to Group II (p values < 0.001), The improvement of WOMAC in Group I occurred in all severity degrees of OA (p < 0.001). Moreover, a significant increase in cartilage thickness at the intercondylar area (ICA) at 6 months relative to baseline assessment by US in Group I (p = 0.041) was found. Conclusion: Treatment with PRP injections can reduce pain and improve knee function in patients with various degrees of articular degeneration. Further studies are needed to clarify the anabolic effect of PRP on the articular cartilage.

VITAMIN SUPPLEMENTS AND RADIOGRAPHIC KNEE OSTEOARTHRITIS: THE CLEARWATER OSTEOARTHRITIS STUDY

2009 ◽  
Vol 12 (02) ◽  
pp. 85-93 ◽  
Author(s):  
Frances Vaughn Wilder ◽  
Paul E. Leaverton ◽  
Matthew W. Rogers ◽  
Nancy B. Lemrow
Keyword(s):  
Knee Osteoarthritis ◽  
Cost Effective ◽  
Protective Role ◽  
Ordinal Scale ◽  
Vitamin Supplement ◽  
Vitamin Supplements ◽  
Knee Oa ◽  
Supplement Usage ◽  
History Of ◽  
Radiographic Knee Osteoarthritis

Objective: To evaluate the association between vitamin supplements and the incidence and progression of radiographic knee osteoarthritis (OA). Study Design: Prospective cohort. Methods: Men and women aged 40 years and older (N = 2239) participating in the community-based Clearwater Osteoarthritis Study (1988–current) with biennial, sequential radiographs. The Lawrence & Kellgren ordinal scale was used to determine evidence of the study outcome, radiographic knee OA, and progression of radiographic knee OA. The study exposure was baseline history of self-reported vitamin supplement usage. Results: Individuals without baseline knee OA who self-reported vitamin supplement usage were 12% less likely to develop knee OA than were those individuals who self-reported no vitamin supplement usage (RR = 0.88; 95% C.I. 0.86–0.89). Those with baseline knee OA who self-reported vitamin supplement usage were 7% less likely to experience knee OA progression than were those individuals who self-reported no vitamin supplement usage (RR = 0.93; 95% C.I. 0.87–0.99). Conclusion: After consideration of BMI, gender, age, history of knee trauma, exercise and vitamin supplement usage prior to study baseline, these findings suggest that vitamin supplement usage may play a protective role in knee OA. Vitamin supplements may be a cost-effective strategy to reduce the incidence and/or slow the progression of knee OA. As many approved OA drugs are accompanied by adverse side effects, the role of vitamin supplements in the development and progression of knee OA warrants further investigation.

Individuals With Knee Osteoarthritis Demonstrate Interlimb Asymmetry in Pedaling Power During Stationary Cycling

2018 ◽  
Vol 34 (4) ◽  
pp. 306-311 ◽  
Author(s):  
Harsh H. Buddhadev ◽  
Daniel L. Crisafulli ◽  
David N. Suprak ◽  
Jun G. San Juan
Keyword(s):  
Knee Osteoarthritis ◽  
Power Output ◽  
Physical Rehabilitation ◽  
Healthy Controls ◽  
Knee Oa ◽  
Pedal Force ◽  
Therapeutic Benefits ◽  
Higher Power ◽  
Effective Component

Cycling is commonly prescribed for physical rehabilitation of individuals with knee osteoarthritis (OA). Despite the known therapeutic benefits, no research has examined interlimb symmetry of power output during cycling in these individuals. We investigated the effects of external workload and cadence on interlimb symmetry of crank power output in individuals with knee OA versus healthy controls. A total of 12 older participants with knee OA and 12 healthy sex- and age-matched controls were recruited. Participants performed 2-minute bouts of stationary cycling at 4 workload-cadence conditions (75 W at 60 rpm, 75 W at 90 rpm, 100 W at 60 rpm, and 100 W at 90 rpm). Power output contribution of each limb toward total crank power output was computed over 60 crank cycles from the effective component of pedal force, which was perpendicular to the crank arm. Across the workload-cadence conditions, the knee OA group generated significantly higher power output with the severely affected leg compared with the less affected leg (10% difference; P = .02). Healthy controls did not show interlimb asymmetry in power output (0.1% difference; P > .99). For both groups, interlimb asymmetry was unaffected by external workload and cadence. Our results indicate that individuals with knee OA demonstrate interlimb asymmetry in crank power output during stationary cycling.

scholarly journals Effect of a Single-Shot of a High-Density Viscoelastic Solution of Hyaluronic Acid in Patients with Symptomatic Primary Knee Osteoarthritis: The No-Dolor Study

2021 ◽  
Author(s):  
Joan Calvet ◽  
Danial Khorsandi ◽  
Laura Tío ◽  
Jordi Monfort
Keyword(s):  
Hyaluronic Acid ◽  
Knee Osteoarthritis ◽  
Visual Analog Scale Score ◽  
High Density ◽  
Womac Pain ◽  
Single Shot ◽  
Analog Scale ◽  
Knee Oa ◽  
Pain Subscale ◽  
Inflammatory Drugs

Abstract Background Pronolis®HD mono 2.5% is a novel, one-shot, high-density sterile viscoelastic solution, recently available in Spain, which contains a high amount of intermediate molecular weight hyaluronic acid (HA), highly concentrated (120 mg in 4.8 mL solution: 2.5%). The objective of the study was to analyze the efficacy and safety of this treatment in symptomatic primary knee osteoarthritis (OA). Methods This observational, prospective, multicenter, single-cohort study involved 166 patients with knee OA treated with a single-shot of Pronolis®HD mono 2.5% and followed up as many as 24 weeks. Results Compared with baseline, the score of the Western Ontario and McMaster Universities Arthritis Osteoarthritis Index (WOMAC) pain subscale significantly reduced at the 12-week visit (primary endpoint, median: 9 interquartile range [IQR]: 7-11 versus median: 4; IQR: 2-6). The percentage of patients achieving >50% improvement in the pain subscale increased progressively from 37.9% (at 2 weeks) to 66.0% (at 24 weeks). Similarly, WOMAC scores for pain on movement, stiffness subscale, and functional capacity subscale showed significant reductions at the 12-week visit which were maintained up to the 24-week visit. The EuroQol visual analog scale score significantly increased after 12 weeks (median: 60 versus 70). The need for rescue medication (analgesics/nonsteroidal anti-inflammatory drugs) also significantly decreased in all post-injection visits. Three patients (1.6%) reported local adverse events (joint swelling) of mild intensity. Conclusions In conclusion, a single intra-articular injection of the high-density viscoelastic gel of HA is effective and safe for the relief of symptoms in patients with knee OA. Trial registration: ClinicalTrial# NCT04196764

scholarly journals Treatment modalities for hip and knee osteoarthritis: A systematic review of safety

2018 ◽  
Vol 26 (3) ◽  
pp. 230949901880866 ◽  
Author(s):  
Osama Aweid ◽  
Zakir Haider ◽  
Abdel Saed ◽  
Yegappan Kalairajah
Keyword(s):  
Knee Osteoarthritis ◽  
Medical Management ◽  
Careful Consideration ◽  
Treatment Modalities ◽  
Gastrointestinal Complications ◽  
Knee Oa ◽  
Total Knee ◽  
Inflammatory Drugs ◽  
Surgical Treatments ◽  
Current Guidelines

Current guidelines on the management of hip and knee osteoarthritis (OA) do not compare safety of treatment modalities. We therefore systematically reviewed 20 studies investigating mortality and serious complications of both medical and surgical treatments for hip and knee OA using PubMed, Scopus, Web of Knowledge and Google Scholar. Mortality was the highest for naproxen (hazard ratio (HR) = 3 (1.9, 4.6)) and lowest for total hip replacement (relative risk (RR) = 0.7 (0.7, 0.7)). Highest gastrointestinal complications were reported for diclofenac (odds ratio (OR) = 4.77 (3.94, 5.76)) and lowest for total knee replacement (HR = 0.6 (0.49, 0.75)). Ibuprofen had the highest renal complications (OR = 2.32 (1.45, 3.71)), whereas celecoxib had the highest cardiovascular risk (OR = 2.26 (1, 5.1)) and lowest was for tramadol (RR = 1.1 (0.87, 1.4)). Results show that medical management of hip and knee OA, particularly with non-steroidal anti-inflammatory drugs, may carry higher mortality compared to surgery. Careful consideration should be given to medical management taking into account known co-morbidities.

scholarly journals Hyaluronic Acid Injections or Oral Nonsteroidal Anti-inflammatory Drugs for Knee Osteoarthritis: Systematic Review and Meta-analysis of Randomized Trials

2020 ◽  
Vol 8 (1) ◽  
pp. 232596711989790 ◽  
Author(s):  
Larry E. Miller ◽  
Michael Fredericson ◽  
Roy D. Altman
Keyword(s):  
Systematic Review ◽  
Hyaluronic Acid ◽  
Knee Osteoarthritis ◽  
Knee Pain ◽  
Randomized Trials ◽  
Knee Function ◽  
Knee Oa ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Background: Intra-articular hyaluronic acid (HA) injections and oral nonsteroidal anti-inflammatory drugs (NSAIDs) are common treatments for symptomatic knee osteoarthritis (OA). However, the comparative effects of these treatments are unclear. Purpose: To compare the efficacy and safety of intra-articular HA injections compared with oral NSAIDs for the treatment of knee OA. Study Design: Systematic review; Level of evidence, 1. Methods: We systematically searched Medline, Embase, and the Cochrane Central Register of Controlled Trials for randomized trials of knee OA treatment with HA injections compared with oral NSAIDs. The main outcomes were knee pain, knee function, adverse events (AEs), serious AEs, study withdrawals, and study withdrawals because of AEs. Pooled effect sizes were reported at the final follow-up with standardized mean difference (SMD) for efficacy outcomes and risk ratio (RR) for safety outcomes. Results: In 6 randomized trials of 831 patients (414 HA, 417 NSAIDs), with follow-up ranging from 5 to 26 weeks, HA injections were associated with small, statistically significant improvements in knee pain (SMD, 0.15; P = .04) and knee function (SMD, 0.23; P = .01) compared with oral NSAIDs. The risk of AEs was lower with HA compared with NSAIDs (19.8% vs 29.0%; RR, 0.74; P = .01). The risk of a serious AE (RR, 1.37; P = .71), study withdrawal (RR, 1.05; P = .68), or study withdrawal because of an AE (RR, 0.65; P = .22) was comparable between groups. Gastrointestinal concerns were the most frequent AE reported, occurring more often with NSAIDs (23.4% vs 14.1%; P = .001). AEs reported more frequently with HA injections were injection site pain (11.7% vs 4.7%; P < .001), headache (8.4% vs 4.4%; P = .03), and arthralgia (8.1% vs 2.9%; P = .001). Significant heterogeneity or publication bias was not observed for any outcome. Conclusion: Comparing short-term outcomes of HA injections with oral NSAIDs for treatment of knee OA, HA injections provided statistically significant but not clinically important improvements in knee pain and function, along with a lower overall risk of AEs.

scholarly journals An 8-Week Knee Osteoarthritis Treatment Program of Hyaluronic Acid Injection, Deliberate Physical Rehabilitation, and Patient Education is Cost Effective at 2 Years Follow-up: The OsteoArthritis Centers of AmericaSM Experience

2014 ◽  
Vol 7 ◽  
pp. CMAMD.S18356 ◽  
Author(s):  
Larry E. Miller ◽  
Jon E. Block
Keyword(s):  
Cost Effectiveness ◽  
Knee Osteoarthritis ◽  
Treatment Program ◽  
Knee Arthroplasty ◽  
Cost Effective ◽  
Quality Adjusted Life Year ◽  
Program Completion ◽  
Knee Oa ◽  
Symptomatic Knee

Numerous nonsurgical interventions have been reported to improve symptoms of knee osteoarthritis (OA) over the short term. However, longer follow-up is required to accurately characterize outcomes such as cost effectiveness and delayed arthroplasty. A total of 553 patients with symptomatic knee OA who previously underwent a single 8-week multimodal treatment program were contacted at 1 year ( n = 336) or 2 years ( n = 217) follow-up. The percentage of patients who underwent knee arthroplasty was 10% at 1 year and 18% at 2 years following program completion. The treatment program was highly cost effective at $12,800 per quality-adjusted life year at 2 years. Cost effectiveness was maintained under a variety of plausible assumptions and regardless of gender, age, body mass index, disease severity, or knee pain severity. In summary, a single 8-week multimodal knee OA treatment program is cost effective and may lower knee arthroplasty utilization through 2 years follow-up.

A Comparative Study of the Effects of Lateral Wedge Insole Shoe Modification on the Patients with Knee Osteoarthritis

2018 ◽  
Vol 30 (2) ◽  
pp. 13-19
Author(s):  
Md Tariqul Islam Khan ◽  
Badrunnesa Ahmed ◽  
AKM Salek ◽  
Fazlul Karim
Keyword(s):  
Knee Osteoarthritis ◽  
Physical Function ◽  
Cost Effective ◽  
Subscale Score ◽  
Quadriceps Muscle ◽  
Post Intervention ◽  
Female Ratio ◽  
Knee Oa ◽  
Group A ◽  
Group B

Background: Knee osteoarthritis (OA) is the common form of disability in comparatively elderly patient. Lateral wedge shoe insole is an easy, simple and cost effective approach which can be applied as an adjunct to pharmacotherapy to treat the patients with OA knee. The objective of the study is to evaluate the effectiveness of using lateral wedge shoe insole on pain and physical functioning in patients with OA knee.Method: A randomized prospective study was carried out in the department of Physical Medicine and Rehabilitation, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January, 2012 to March, 2012. Patients with OA knee by American College of Rheumatology Criteria were selected. Two intervention groups were compared. In patients of Group-A (32 patients) were treated with aceclofenac100mg and, omeprazole20mg bid, and daily instructions of activities of daily living (ADLs), isometric quadriceps muscle strengthening exercise. Patients of Group-B were given lateral wedge shoe insole along with above treatment. The change between two weeks post intervention and baseline WOMAC (Western Ontario and McMaster Universities) subscale and scores were calculated. There were 4 visits and in each visit, patients were assessed for pain, stiffness and physical function by WOMAC index.Results: A total 65 patients with OA knee were included in this study. The mean age was 56.5± 10 years. Male to female ratio was 1.32:1. Comparison of mean pretreatment and 8th week post treatment WOMAC physical function subscale score in Group A (4.9 ± 1.2 vs. 2.4 ± 0.8) showed significant improvement and in Group B (4.3 ± 1.2 vs. 1.9 ± 0.5) which also shows significant improvement more than group A. The result was compared and student t-test was done to see the level of significance. Method was found significant after treatment (p <0.05).Interpretation: Effects of use of lateral wedge shoe insole in patients with knee OA is beneficial.TAJ 2017; 30(2): 13-19

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