scholarly journals THE EFFECTS OF INJECTING INTRA ARTICULAR PLATELET-RICH PLASMA ON PAIN SCORES IN KNEE JOINT OSTEOARTHRITIS

2021 ◽  
Vol 71 (4) ◽  
pp. 1278-81
Author(s):  
Khaleel Ahmad ◽  
Liaquat Ali ◽  
Muhammad Aasam Masoom Maan
Keyword(s):  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Platelet Rich Plasma ◽  
Functional Limitation ◽  
Military Hospital ◽  
Dramatic Improvement ◽  
Pain Scores ◽  
Numerical Rating

Objective: To determine the effects of intra articular platelet rich plasma (PRP) injection on level of pain of knee joint in patients with knee osteoarthritis. Study Design: Prospective observational study. Place and Duration of Study: Combined Military Hospital Rawalpindi, from Aug 2018 to Jan 2019. Methodology: Forty patients with pain due to knee osteoarthritis for intra-articular injection were included in this observational clinical trial after informed consent and fulfilling inclusion criteria. After measuring pain by numerical rating scale, patients received intra articular platelet rich plasma (10ml) therapy in affected knee under fluoroscopy. Using the Numerical rating scale level of pain was evaluated and recorded for each patient at different intervals. Results: There was dramatic improvement in pain score after first and second injection of platelet rich plasma. There was 33.33% improvement at 3rd week, 54.32% at 6th week and 71.60% at 6th month. Conclusion: Platelet rich plasma is safe, cost effective and minimally invasive in reducing pain scores and functional limitation in knee osteoarthritis.

scholarly journals EUS-Guided Versus Percutaneous Celiac Neurolysis for the Management of Intractable Pain Due to Unresectable Pancreatic Cancer: A Randomized Clinical Trial

2020 ◽  
Vol 9 (6) ◽  
pp. 1666
Author(s):  
Won Jae Yoon ◽  
Yul Oh ◽  
Changhoon Yoo ◽  
Sunguk Jang ◽  
Seong-Sik Cho ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Abdominal Pain ◽  
Back Pain ◽  
Cancer Patients ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Intractable Pain ◽  
Point Reduction ◽  
Pain Scores ◽  
Numerical Rating

Although endoscopic ultrasound-guided celiac neurolysis (EUS-CN) and percutaneous celiac neurolysis (PCN) are utilized to manage intractable pain in pancreatic cancer patients, no direct comparison has been made between the two methods. We compared the efficacy and safety of EUS-CN and PCN in managing intractable pain in such patients. Sixty pancreatic cancer patients with intractable pain were randomly assigned to EUS-CN (n = 30) or PCN (n = 30). The primary outcomes were pain reduction in numerical rating scale (NRS) and opioid requirement reduction. Secondary outcomes were: successful pain response (NRS decrease ≥50% or ≥3-point reduction from baseline); quality of life; patient satisfaction; adverse events; and survival rate at 3 months postintervention. Both groups reported sustained decreases in pain scores up to 3 months postintervention (mean reductions in abdominal pain: 0.9 (95% confidence interval (CI): −0.8 to 4.2) and 1.7 (95% CI: −0.3 to 2.1); back pain: 1.3 (95% CI: −0.9 to 3.4) and 2.5 (95% CI: −0.2 to 5.2) in EUS-CN, and PCN groups, respectively). The differences in mean pain scores between the two groups at baseline and 3 months were −0.5 (p = 0.46) and −1.4 (p = 0.11) for abdominal pain and 0.1 (p = 0.85) and −0.9 (p = 0.31) for back pain in favor of PCN. No significant differences were noted in opioid requirement reduction and other outcomes. EUS-CN and PCN were similarly effective and safe in managing intractable pain in pancreatic cancer patients. Either methods may be used depending on the resources and expertise of each institution.

scholarly journals Effectiveness of the quadriceps strengthening exercise on pain and functional ability of the women with Osteoarthritis (OA)

2021 ◽  
Vol 8 (9) ◽  
pp. 1-6
Author(s):  
Absar Ahmed Qureshi ◽  
◽  
Shadia Hamoud Alshahrani ◽  
Premalatha Paulsamy ◽  
Krishnaraju Venkatesan ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Functional Ability ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Exercise Group ◽  
Control Group ◽  
Timed Up And Go ◽  
Strengthening Exercise ◽  
Study Results ◽  
Numerical Rating

A Quasi experimental design was adopted for this study to find out the effectiveness of quadriceps strengthening exercise program on pain and functional ability of women with knee osteoarthritis (OA). Fifty women with OA were selected in which first 25 women were enrolled in the control group and second 25 women were allotted in the exercise group. Assessments were performed at baseline and at 8 weeks. The functional ability was assessed using the Timed Up and Go (TUG) test and Numerical Rating Scale (NRS) was used to assess the pain level .For the exercise group, quadriceps strengthening exercises were taught and asked the patients to follow the exercise schedule for 8 weeks. The study results show that the pain and functional abilty scores were improved in the exercise group and the difference was statistically significant (p<0.001). The study concluded that a simple quadriceps strengthening exercise programme can significantly improve self reported knee pain and functional ability among women with Knee osteoarthritis. Keywords: Osteoarthritis, Pain, Functional Ability, Exercise, Quadriceps strengthening, Timed Up and Go (TUG) test, Numerical Rating Scale (NRS)

scholarly journals Moderators of Effects of Internet-Delivered Exercise and Pain Coping Skills Training for People With Knee Osteoarthritis: Exploratory Analysis of the IMPACT Randomized Controlled Trial (Preprint)

2018 ◽  
Author(s):  
Belinda J Lawford ◽  
Rana S Hinman ◽  
Jessica Kasza ◽  
Rachel Nelligan ◽  
Francis Keefe ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Self Efficacy ◽  
Rating Scale ◽  
Coping Skills ◽  
Numerical Rating Scale ◽  
Skills Training ◽  
Control Group ◽  
Pain Coping ◽  
Coping Skills Training ◽  
Numerical Rating

BACKGROUND Internet-delivered exercise, education, and pain coping skills training is effective for people with knee osteoarthritis, yet it is not clear whether this treatment is better suited to particular subgroups of patients. OBJECTIVE The aim was to explore demographic and clinical moderators of the effect of an internet-delivered intervention on changes in pain and physical function in people with knee osteoarthritis. METHODS Exploratory analysis of data from 148 people with knee osteoarthritis who participated in a randomized controlled trial comparing internet-delivered exercise, education, and pain coping skills training to internet-delivered education alone. Primary outcomes were changes in knee pain while walking (11-point Numerical Rating Scale) and physical function (Western Ontario and McMaster Universities Osteoarthritis Index function subscale) at 3 and 9 months. Separate regression models were fit with moderator variables (age, gender, expectations of outcomes, self-efficacy [pain], education, employment status, pain catastrophizing, body mass index) and study group as covariates, including an interaction between the two. RESULTS Participants in the intervention group who were currently employed had significantly greater reductions in pain at 3 months than similar participants in the control group (between-group difference: mean 2.38, 95% CI 1.52-3.23 Numerical Rating Scale units; interaction P=.02). Additionally, within the intervention group, pain at 3 months reduced by mean 0.53 (95% CI 0.28-0.78) Numerical Rating Scale units per unit increase in baseline self-efficacy for managing pain compared to mean 0.11 Numerical Rating Scale units (95% CI –0.13 to 0.35; interaction P=.02) for the control group. CONCLUSIONS People who were employed and had higher self-efficacy at baseline were more likely to experience greater improvements in pain at 3 months after an internet-delivered exercise, education, and pain coping skills training program. There was no evidence of a difference in the effect across gender, educational level, expectation of treatment outcome, or across age, body mass index, or tendency to catastrophize pain. Findings support the effectiveness of internet-delivered care for a wide range of people with knee osteoarthritis, but future confirmatory research is needed. CLINICALTRIAL Australian New Zealand Clinical Trials Registry ACTRN12614000243617; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=365812&isReview=true (Archived by WebCite at http://www.webcitation.org/6z466oTPs)

Acute Cervical Radiculopathy Outcomes: Soft Disc Herniations vs Osteophytes

Pain Medicine ◽  
2020 ◽  
Author(s):  
William Jeremy Beckworth ◽  
Benjamin A Abramoff ◽  
Iain M Bailey ◽  
Sook Yoon ◽  
Monica Umpierrez ◽  
...  
Keyword(s):  
Pain Score ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Neck Disability Index ◽  
Cervical Radiculopathy ◽  
Pain Scores ◽  
Plain Films ◽  
Numerical Rating ◽  
Disc Herniations

Abstract Objective Prospectively evaluate the clinical outcomes of acute cervical radiculopathy with respect to soft disc herniations vs osteophytes. Methods Sixty consecutive patients who had had cervical radiculopathy for ≤1 month were enrolled in the study. Inclusion criteria were radicular pain greater than axial pain and a pain score ≥4 out of 10 on a numerical rating scale. Patients had at least one positive clinical finding: motor, sensory, or reflex changes. Plain films and magnetic resonance imaging were ordered. Follow-up was at 6 weeks and 3, 6, and 12 months. Outcomes included pain scores (neck and upper limb), neck disability index, medication use, opioid use, and need for surgery. Two attending musculoskeletal radiologists reviewed imaging findings for osteophytes vs soft disc herniations at the symptomatic level. Results More than 75% reduction in pain was seen in 77% of patients with soft disc herniations and 66% of patients with osteophytes (P &gt; 0.05) at 12 months. A pain score ≤2 out of 10 within 6 to 12 months was seen in 86% of patients with soft disc herniations and 81% of patients with osteophytes (P &gt; 0.05). Moderate or marked improvement at 12 months was seen in 85% of patients with soft discs and 77% of patients with osteophytes (P &gt; 0.05). Baseline–to–12-month numerical rating scale pain scores of patients with soft discs vs osteophytes had overlapping confidence intervals at each follow-up. At 12 months, very few had undergone surgery (7% of patients with soft discs, 11% of patients with osteophytes; P &gt; 0.05) or were on opioids (7% of patients with soft discs, 9% of patients with osteophytes; P &gt; 0.05). Conclusions The majority of patients, but not all patients, with acute radiculopathies improved with time. This was seen with both soft disc herniations and osteophytes.

Low dose ketamine versus morphine for acute severe vaso occlusive pain in children: a randomized controlled trial

2018 ◽  
Vol 18 (1) ◽  
pp. 19-27 ◽  
Author(s):  
Felix Anthony Lubega ◽  
Mithrika S. DeSilva ◽  
Deogratias Munube ◽  
Rita Nkwine ◽  
Janat Tumukunde ◽  
...  
Keyword(s):  
Side Effects ◽  
Sickle Cell ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Duration Of Action ◽  
Pain Scores ◽  
Sickle Cell Crisis ◽  
Numerical Rating ◽  
Life Threatening ◽  
Intravenous Ketamine

AbstractBackground and aims:Acute pain episodes associated with sickle cell disease (SCD) are very difficult to manage effectively. Opioid tolerance and side effects have been major roadblocks in our ability to provide these patients with adequate pain relief. Ketamine is cheap, widely safe, readily available drug, with analgesic effects at sub-anesthetic doses and has been used in wide range of surgeries, pediatric burns dressing change and cancer related pain however, literature concerning its use in sickle cell crises is still limited in our setting. This study aimed to establish if 1 mg/kg of intravenous ketamine is non inferior to intravenous morphine 0.1 mg/kg in severe SCD-associated pain.Methods:We performed an institutional review board-approved randomized, prospective, double-blinded, active-control, non-inferiority trial at the national referral sickle cell center. Children between 7 and 18 years of age with severe painful sickle cell crisis, defined by numerical rating scale score of greater or equal to 7 were enrolled. Patients were consented and randomized to receive, either IV ketamine (LDK) 1 mg/kg or IV morphine (MOR) 0.1 mg/kg as an infusion over 10 min. The primary endpoint is maximal change in Numerical Rating Scale (NRS) pain score. Secondary outcomes were, incidence of adverse effects, optimal time to and duration of action of ketamine and incidence of treatment failures by treatment group. A clinically meaningful difference in validated pain scores was defined as 1.3 units. Assuming both treatments are on average equal, a sample size of 240 patients (120 per group) provided 95% power to demonstrate that IV LDK is non-inferior to IV morphine with a 0.05 level of significance and a 10% non-inferiority margin. All analyses were based on a modified intention to treat. This trial was registered with clinicaltrials.gov NCT02434939.Results:Two hundred and forty patients were enrolled (LDK120, MOR120). Demographic variables and baseline NRS scores (8.9 vs. 9.2) were similar. LDK was comparable to MOR in the maximum change in NRS scores, 66.4% vs. 61.3% (MD 5.5; 95% CI −2.2 to −13.2). Time to achieve maximum reduction in NRS pain scores was at 19.8 min for LDK and 34.1 min for MOR. The average duration of action for LDK was 60 min. MOR had more patients still at maximum effect at 120 min (45.8% vs. 37.5%; RR 1.2; 95% CI 0.9–1.7). LDK patients were 11.3 times more likely to develop side effects, though were transient, anticipated and non-life threatening (37.5% vs. 3.3%). MOR had significantly more treatment failures 40% vs. 28.3% (RR 0.7; 95% CI 0.5–1.03,p=0.07) Vital signs and sedation scores were similar in both groups.Conclusions:Intravenous LDK at 1 mg/kg provides comparable analgesic effectiveness as IV MOR in the acute treatment of severe painful sickle cell crisis in children in the day care sickle cell center. However, it is associated with a high incidence of several transient, non-life threatening mild side effects.Implications:Intravenous ketamine at 1 mg/kg can be a reliable alternative to morphine in the management of severe painful sickle cell crisis especially in a resource limited area where morphine is not readily available.

scholarly journals Evaluation of the effectiveness of intra-articular administration of highly purified hyaluronic acid in knee osteoarthritis in real clinical practice

2021 ◽  
Vol 15 (5) ◽  
pp. 57-61
Author(s):  
V. A. Nesterenko ◽  
E. I. Byalik ◽  
M. A. Makarov ◽  
S. A. Makarov ◽  
V. E. Byalik ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Clinical Practice ◽  
Knee Osteoarthritis ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Knee Oa ◽  
Numerical Rating ◽  
Pain At Rest ◽  
Favorable Safety ◽  
Real Clinical Practice

Knee osteoarthritis (kOA) is a common cause of turning for medical advice, associated with chronic pain and disability. One of the methods of OA treatment is the local administration of hyaluronic acid (HA) drugs.Objective: to evaluate the effectiveness of intra-articular (IA) administration of highly purified HA (Armaviskon Plus) in kOA.Patients and methods. The study group consisted of 58 patients (74.1% women and 25.9% men, aged 59.5±11.8 years) with kOA, experiencing moderate/severe pain (≥40 mm on a visual analogue scale, VAS). All patients received IA injection of HA Armaviskon Plus (2 ml of a 1.5% solution), 2 injections with an interval of 7 days. The effectiveness criterion was the dynamics of pain at rest and during movement (VAS 0-100 mm) and the function of the knee joint according to a numerical rating scale (NRS 0-100 points) 2 weeks, 1 and 3 months after administration of therapy.Results and discussion. During the treatment, there was a significant improvement in all indicators. The average severity of pain during movement at baseline, after 2 weeks, 1 and 3 months was 50 [40; 60], 30 [20; 40], 15 [0; 30], 20 [0; 30] mm (p<0.001), at rest 20 [10; 40], 5 [0; 20], 0 [0; 20], 10 [0; 20] mm (p<0.05) by VAS. The average values of functional indicators were 40 [10; 60], 10 [0; 40], 20 [0; 40], 10 [10; 30] scores according to the NRS. A decrease in non-steroidal anti-inflammatory drugs demand was recorded: 67.1% of patients were initially taking them, after 3 months – 36.1% (p<0.001). No serious adverse reactions were noted.Conclusion. IA administration of HA is an effective and safe method for the treatment of kOA. Armaviskon Plus, a highly purified high-molecular- weight HA drug, has shown good results in pain reduction and improvement of function in knee OA as well as a favorable safety profile, which makes it possible to recommend its use in real clinical practice.

Efficacy of intra-articular autologous platelet rich plasma injection in primary knee osteoarthritis; a quasi-experimental study

2020 ◽  
pp. 1-10
Author(s):  
Uzma Akhlaque ◽  
Saeed Bin Ayaz ◽  
Noreen Akhtar
Keyword(s):  
Body Mass Index ◽  
Experimental Study ◽  
Knee Osteoarthritis ◽  
Body Mass ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Platelet Rich Plasma ◽  
Pain Reduction ◽  
Quasi Experimental ◽  
The Impact

Abstract Objectives: To observe the efficacy of platelet rich plasma on pain improvement in knee osteoarthritis patients, and to explore the impact of various facotrs on pain reduction with such a treatment. Method: The quasi-experimental study was conducted at the Armed Forces Institute of Rehabilitation Medicine, Rawalpindi, Pakistan, from October 2017 to April 2018, and comprised patients with primary knee osteoarthritis. The sample was sub-grouped into “normal”, “overweight” and “obese” on the basis of body mass index. Two age-based sub-groups  were also formed at ?60 years and >60 years. Three injections of calcium gluconate activated 2.5ml platelet rich plasma were given in the knees at an interval of two weeks each. The pain score was calculated using the numerical rating scale at the 6th week. Data was analysed using SPSS 20. Results: Of the 50 patients, 26(52%) were females and 24(48%) were males. The overall mean age was 59.6±9.6 years (range: 42-75 years), with 22(44%) aged ? 60 years. There were 21(42%) patients who were overweight, 7(14%) had normal weight and 22(44%) were obese. There was significant pain reduction post-treatment compared to the baseline (p<0.001). The reduction in pain was not significantly related to gender, age, knee osteoarthritis grade, or body mass index (p>0.05). Conclusions: Platelet rich plasma significantly improved pain in knee osteoarthritis patients regradless of all age, gender, grade and body mass index. Key Words: Intra-articular injections, Primary knee osteoarthritis, Platelet rich plasma, Efficacy. Continuous...

scholarly journals COMPARISON OF PAIN RELIEF EFFICACY OF PLATELET-RICH PLASMA VERSUS CORTICOSTEROIDS IN KNEE OSTEOARTHRITIS

2021 ◽  
Vol 71 (5) ◽  
pp. 1764-68
Author(s):  
Amir Sohail ◽  
Ameer Yasser Zaid ◽  
Shizan Hamid Feroz ◽  
Mohammed Saeed ◽  
Syed Khurram Naseer ◽  
...  
Keyword(s):  
Pain Relief ◽  
Knee Osteoarthritis ◽  
Rating Scale ◽  
Platelet Rich Plasma ◽  
Corticosteroid Injection ◽  
Numeric Rating Scale ◽  
Rating Score ◽  
Numerical Rating ◽  
Group A ◽  
Group B

Objective: To compare the pain relief efficacy of platelet rich plasma injection with corticosteroid injection in knee osteoarthritis using numeric rating scale. Study Design: Quasi experimental study. Place and Duration of Study: Department of Anesthesia and Pain Management, Combined Military Hospital Peshawar, from Jan 2018 to Dec 2019. Methodology: Total of 310 patients who underwent knee injection for osteoarthritis were included in this study. Patients were divided into two groups; group A and group B comprising of 155 patients each. Patients in group ‘A’ received intra articular corticosteroid injection while patients in group ‘B’ received intra articular platelet rich plasma injection for knee osteoarthritis. Pain assessment via numerical rating score was done at the start of the treatment and at 6 months. Results: In group A female to male ratio was 2.69:1 while in group B the female to male ratio was 2.78:1. Mean age of ‘group A’ was 58.52 ± 11.87 years and that of ‘group B’ was 58.79 ± 11.15 years. Numerical rating score pre-treatment in ‘group A’ vs ‘group B’ was 8.35 ± 1.17 vs 8.42 ± 1.14. While numeric rating scale post treatment in ‘group A’ vs ‘group B’ was 5.74 ± 1.37 vs 4.06 ± 1.19, respectively with p-value of 0.001, which is statistically significant. Conclusion: Patients who received intra-articular platelet rich plasma had significantly more pain relief as compared to patients who received intra-articular steroid on numerical rating score.

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