Effectiveness of neuromuscular exercises (NEMEX) in knee osteoarthritis: a systematic review with metaanalysis

Background: Platelet-rich plasma (PRP) and hyaluronic acid (HA) are injectable treatments for knee osteoarthritis. The focus of previous studies has compared their efficacy against each other as monotherapy. However, a new trend of combining these 2 injections has emerged in an attempt to have a synergistic effect. Purpose: To systematically review the clinical literature examining the combined use of PRP + HA. Design: Systematic review. Methods: A systematic review was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using PubMed and Embase. The following search terms were used: knee osteoarthritis AND platelet rich plasma AND hyaluronic acid. The review was performed by 2 independent reviewers who applied the inclusion/exclusion criteria and independently extracted data, including methodologic scoring, PRP preparation technique, HA composition, and patient-reported outcomes (PROs). Results: A total of 431 articles were screened, 12 reviewed in full, and 8 included in the final analysis: 2 case series, 3 comparative, and 3 randomized studies. Average follow-up was 9 months. The modified Coleman Methodology Score was 38.13 ± 13.1 (mean ± SD). Combination therapy resulted in improved PROs in all studies. Of the comparative and randomized studies, 2 demonstrated that combination therapy was superior to HA alone. However, when PRP alone was used as the control arm (4 studies), combination therapy was not superior to PRP alone. Conclusion: Combination therapy with PRP + HA improves PROs and is superior to HA alone but is not superior to PRP alone.

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Association between hip and knee osteoarthritis with falls: a systematic review and meta‐analysis

International Journal of Clinical Practice ◽

10.1111/ijcp.14537 ◽

2021 ◽

Author(s):

Zhen‐han Deng ◽

Jian Xu ◽

Lu‐jue Long ◽

Fei Chen ◽

Kang Chen ◽

...

Keyword(s):

Systematic Review ◽

Knee Osteoarthritis ◽

Meta Analysis

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Does blood flow restriction training enhance clinical outcomes in knee osteoarthritis: A systematic review and meta-analysis

Physical Therapy in Sport ◽

10.1016/j.ptsp.2021.01.014 ◽

2021 ◽

Vol 49 ◽

pp. 37-49

Author(s):

Brayden Grantham ◽

Vasileios Korakakis ◽

Kieran O’Sullivan

Keyword(s):

Systematic Review ◽

Blood Flow ◽

Knee Osteoarthritis ◽

Clinical Outcomes ◽

Meta Analysis ◽

Blood Flow Restriction ◽

Flow Restriction

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Comparison of Blood Flow Restriction Training versus Non-Occlusive Training in Patients with Anterior Cruciate Ligament Reconstruction or Knee Osteoarthritis: A Systematic Review

Journal of Clinical Medicine ◽

10.3390/jcm10010068 ◽

2020 ◽

Vol 10 (1) ◽

pp. 68

Author(s):

Cristina Bobes Álvarez ◽

Paloma Issa-Khozouz Santamaría ◽

Rubén Fernández-Matías ◽

Daniel Pecos-Martín ◽

Alexander Achalandabaso-Ochoa ◽

...

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Blood Flow ◽

Anterior Cruciate Ligament ◽

Knee Osteoarthritis ◽

Acl Reconstruction ◽

Cruciate Ligament ◽

Flow Restriction ◽

Anterior Cruciate

Patients undergoing anterior cruciate ligament (ACL) reconstruction and patients suffering from knee osteoarthritis (KOA) have been shown to have quadriceps muscle weakness and/or atrophy in common. The physiological mechanisms of blood flow restriction (BFR) training could facilitate muscle hypertrophy. The purpose of this systematic review is to investigate the effects of BFR training on quadriceps cross-sectional area (CSA), pain perception, function and quality of life on these patients compared to a non-BFR training. A literature research was performed using Web of Science, PEDro, Scopus, MEDLINE, Dialnet, CINAHL and The Cochrane Library databases. The main inclusion criteria were that papers were English or Spanish language reports of randomized controlled trials involving patients with ACL reconstruction or suffering from KOA. The initial research identified 159 publications from all databases; 10 articles were finally included. The search was conducted from April to June 2020. Four of these studies found a significant improvement in strength. A significant increase in CSA was found in two studies. Pain significantly improved in four studies and only one study showed a significant improvement in functionality/quality of life. Low-load training with BFR may be an effective option treatment for increasing quadriceps strength and CSA, but more research is needed.

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Author Reply To “Regarding ‘Intra-articular Mesenchymal Stromal Cell Injections Are No Different From Placebo in the Treatment of Knee Osteoarthritis: A Systematic Review and Meta-analysis of Randomized Controlled Trials’”

Arthroscopy The Journal of Arthroscopic and Related Surgery ◽

10.1016/j.arthro.2021.02.025 ◽

2021 ◽

Vol 37 (5) ◽

pp. 1362-1364

Author(s):

Wenli Dai ◽

Xi Leng ◽

Jian Wang ◽

Zhanjun Shi ◽

Jin Cheng ◽

...

Keyword(s):

Systematic Review ◽

Knee Osteoarthritis ◽

Randomized Controlled Trials ◽

Mesenchymal Stromal Cell ◽

Stromal Cell ◽

Meta Analysis ◽

Controlled Trials ◽

Author Reply ◽

Randomized Controlled

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Effects of mechanical interventions in the management of knee osteoarthritis: protocol for an OA Trial Bank systematic review and individual participant data meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-043026 ◽

2021 ◽

Vol 11 (2) ◽

pp. e043026

Author(s):

Erin M Macri ◽

Michael Callaghan ◽

Marienke van Middelkoop ◽

Miriam Hattle ◽

Sita M A Bierma-Zeinstra

Keyword(s):

Systematic Review ◽

Knee Osteoarthritis ◽

Broad Class ◽

Meta Analysis ◽

Individual Participant Data ◽

Knee Oa ◽

International Regulations ◽

Individual Participant ◽

Registration Number ◽

Mechanical Intervention

IntroductionKnee osteoarthritis (OA) is a prevalent and disabling musculoskeletal condition. Biomechanical factors may play a key role in the aetiology of knee OA, therefore, a broad class of interventions involves the application or wear of devices designed to mechanically support knees with OA. These include gait aids, bracing, taping, orthotics and footwear. The literature regarding efficacy of mechanical interventions has been conflicting or inconclusive, and this may be because certain subgroups with knee OA respond better to mechanical interventions. Our primary aim is to identify subgroups with knee OA who respond favourably to mechanical interventions.Methods and analysisWe will conduct a systematic review to identify randomised clinical trials of any mechanical intervention for the treatment of knee OA. We will invite lead authors of eligible studies to share individual participant data (IPD). We will perform an IPD meta-analysis for each type of mechanical intervention to evaluate efficacy, with our main outcome being pain. Where IPD are not available, this will be achieved using aggregate data. We will then evaluate five potential treatment effect modifiers using a two-stage approach. If data permit, we will also evaluate whether biomechanics mediate the effects of mechanical interventions on pain in knee OA.Ethics and disseminationNo new data will be collected in this study. We will adhere to institutional, national and international regulations regarding the secure and confidential sharing of IPD, addressing ethics as indicated. We will disseminate findings via international conferences, open-source publication in peer-reviewed journals and summaries posted on websites serving the public and clinicians.PROSPERO registration numberCRD42020155466.

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