Evaluation of the Effectiveness of Orthokine Therapy: Retrospective Analysis of 1000 Cases

2020 ◽  
Vol 22 (2) ◽  
pp. 107-119
Author(s):  
Piotr Godek ◽  
Sebastian Szajkowski ◽  
Dominik Golicki
Keyword(s):  
Knee Osteoarthritis ◽  
Retrospective Analysis ◽  
Tennis Elbow ◽  
Hip Osteoarthritis ◽  
Symptomatic Treatment ◽  
Autologous Serum ◽  
Osteoarthritis Of The Knee ◽  
Early Stages ◽  
Canal Stenosis ◽  
Common Diagnosis

Background. Osteoarthritis is a global health problem. Approaches to symptomatic treatment of its consequences in­clude biological methods, including autologous serum. The aim of the study was to evaluate the effectiveness of Orthokine therapy in our experience. Material and methods. Retrospective analysis of 1000 cases. The results were evaluated on a modified McNab scale (A – excellent, B – good, C – fair, D – poor) two and six months after the end of therapy. The effectiveness of the therapy was estimated as the percentage of satisfactory (A or B) or unsatisfactory (C or D) results. Results. Osteoarthritis of the lumbar spine (n = 400) and knee joint (n = 219) was the most common diagnosis. The highest percentage of patients with a grade A or B result after 6 months was seen with therapy of tennis elbow enthesopathy (88.2%), rotator cuff tendinopathy (72.0%), Achilles tendon tendinopathy (75.0%) and in the early stages of osteoarthritis of the knee (75.9%) and small joints of the hand (77.0%). For cervical and lumbar discopathy, treatment efficacy was at 56.0-62.0% regardless of the size of the hernia. Unsatisfactory results (C and D) predominated in the group of patients with lumbar spinal stenosis (66.1%), wrist osteoarthritis (66.7%), and especially in late-stage hip osteoarthritis (85.3 %). For the largest groups, the frequency of unsatisfactory results was analyzed for selected age ranges. A significant increase in this parameter in subjects over 75 years of age was only seen in patients with severe knee osteoarthritis. Conclusions. 1. Orthokine therapy is highly effective in cases of tendinopathy, enthesopathy, osteoarthritis of the small joints of the hand and in early stages of knee osteoarthritis. 2. Satisfactory results are achieved in the treatment of cervical and lumbar discopathy, while unsatisfactory results prevail in severe degenerative changes in the knee and hip joints and in spinal canal stenosis.

scholarly journals Statin use is associated with reduced incidence and progression of knee osteoarthritis in the Rotterdam study

2011 ◽  
Vol 71 (5) ◽  
pp. 642-647 ◽  
Author(s):  
S Clockaerts ◽  
G J V M Van Osch ◽  
Y M Bastiaansen-Jenniskens ◽  
J A N Verhaar ◽  
F Van Glabbeek ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Hip Osteoarthritis ◽  
Estimating Equation ◽  
Population Based ◽  
Joint Disease ◽  
Multivariate Logistic Regression Model ◽  
Osteoarthritis Of The Knee ◽  
X Rays ◽  
Baseline Information ◽  
Statin Use

BackgroundOsteoarthritis is the most frequent chronic joint disease causing pain and disability. Besides biomechanical mechanisms, the pathogenesis of osteoarthritis may involve inflammation, vascular alterations and dysregulation of lipid metabolism. As statins are able to modulate many of these processes, this study examines whether statin use is associated with a decreased incidence and/or progression of osteoarthritis.MethodsParticipants in a prospective population-based cohort study aged 55 years and older (n=2921) were included. x-Rays of the knee/hip were obtained at baseline and after on average 6.5 years, and scored using the Kellgren and Lawrence score for osteoarthritis. Any increase in score was defined as overall progression (incidence and progression). Data on covariables were collected at baseline. Information on statin use during follow-up was obtained from computerised pharmacy databases. The overall progression of osteoarthritis was compared between users and non-users of statins. Using a multivariate logistic regression model with generalised estimating equation, OR and 95% CI were calculated after adjusting for confounding variables.ResultsOverall progression of knee and hip osteoarthritis occurred in 6.9% and 4.7% of cases, respectively. The adjusted OR for overall progression of knee osteoarthritis in statin users was 0.43 (95% CI 0.25 to 0.77, p=0.01). The use of statins was not associated with overall progression of hip osteoarthritis.ConclusionsStatin use is associated with more than a 50% reduction in overall progression of osteoarthritis of the knee, but not of the hip.

Depression, pain and physical function in patients with osteoarthritis of the knee: implications for interprofessional care

2015 ◽  
Author(s):  
Adesola Christiana Odole ◽  
Michael Opeoluwa Ogunlana ◽  
Babatunde Olusola Adeleke Adegoke ◽  
Faith Ojonima ◽  
Ushotanefe Useh
Keyword(s):  
Knee Osteoarthritis ◽  
Pain Intensity ◽  
Physical Function ◽  
Linear Relationship ◽  
Hip Osteoarthritis ◽  
Osteoarthritis Of The Knee ◽  
Depression Assessment ◽  
The Relationship ◽  
Negative Linear Relationship ◽  
Assessment Questionnaire

Background and purpose: Depression has been found to be associated with pain and poor physical function in patients with knee osteoarthritis though it is not sufficiently documented in Nigeria. This study was aimed at investigating the relationship among pain, depression and physical function in patients with knee osteoarthritis in Ibadan. Methods: Eighty individuals diagnosed with knee osteoarthritis were screened for depression using the mood/ depression assessment questionnaire. Depression, physical function and pain were assessed by Becks Depression Inventory, Ibadan Knee Hip Osteoarthritis Outcome Measure and Modified Visual Analogue Scale respectively. Data were analyzed using Pearson’s correlation test and linear regression (alpha level set at 0.05).  Results: Screening for depression was positive in 28.8% of patients aged 62.69 ± 5.96 years. There were significant correlations between physical function and each of pain intensity (r=-0.659) and depression (r = - 0.660) and between pain intensity and depression (r= 0.611). Negative linear relationship exist between physical function and each of pain (R2=0.434), depression (R2=0.436). A positive linear relationship exists between pain intensity and depression (R2=0.374).Conclusion: About a quarter of patients with knee osteoarthritis had depression. Individuals with knee osteoarthritis who had higher levels of pain were more depressed and had lower level of physical function.

scholarly journals Quality of Life and Negative Affectivity at the Patients with Stroke and Musculoskeletal Disorders

2021 ◽  
Vol 12 (3) ◽  
pp. 275-279
Author(s):  
Juliánna SZAKÁCS ◽  
Lavinia-Corina DUICA ◽  
Mihaela RACHERIU
Keyword(s):  
Quality Of Life ◽  
Knee Osteoarthritis ◽  
Musculoskeletal Disorders ◽  
Negative Affectivity ◽  
Hip Osteoarthritis ◽  
Osteoarthritis Of The Knee ◽  
Low Back ◽  
Average Value ◽  
Maximum Value

Introduction. Stroke can be a severe debilitating medical condition due to its medical consequences. When it occurs at an individual with pre-existent musculoskeletal disorders, the medical recovery becomes more problematic. Some consequences, like negative affectivity and a reduced quality of life intervene to varying degrees. Material and method. Our study included 150 outpatients who were diagnosed with stroke and one of five types of musculoskeletal disorders (low back pain, osteoporosis, hand disorders, hip osteoarthritis, knee osteoarthritis). We divided all the patients in five sub-groups. To assess the negative affectivity (anxiety) and quality of life we administered to the patients two scales: the State Trait Anxiety Inventory (STAI) form X1 (anxiety a s a state) and form X2 (anxiety as a trait) and The Quality of Life (QOL). Results. In patients diagnosed with stroke and osteoporosis, the quality of life was 83.92% of the maximum value. Anxiety as a state rated at an average of 50.5 and anxiety as a trait rated at an average of 45. In the case of stroke and degenerative diseases at the lower limbs, we registered the quality of life of 77.68% in knee osteoarthritis and 75.89% in hip osteoarthritis; anxiety as a condition had an average value of 65 and, as a trait, a value of 63 in knee osteoarthritis, while in hip osteoarthritis the anxiety as a condition, and, in the same time, as a trait, rated both at 49.5. Low back pain in stroke patients had a quality of life of 77.86% of the maximum value; anxiety as a condition was 48 and the anxiety trait has the value of 47. For the patients with stroke and hand disease, the quality of life was assessed at 88.83%. Anxiety as a condition recorded an average value of 48 and the average value of 51 for anxiety as a trait recorded an average value of 51. Conclusions. The lowest score of quality of life is recorded in the patient diagnosed with stroke and hip osteoarthritis (75.89% of the maximum value). This association converges with body dynamics, as the overlap of these two medical conditions may explain reduced functionality. The value of anxiety as a condition and also as a trait was higher in patients with stroke and osteoarthritis of the knee (65 and 63, respectively). The latter result is understandable, as intense pain and, therefore, discomfort related to osteoarthritis of the knee is well known. Keywords: stroke, anxiety, quality of life, musculoskeletal conditions,

scholarly journals AB0862 CONSENSUS STATEMENT ON INTRA-ARTICULAR INJECTIONS OF PLATELET-RICH PLASMA FOR THE MANAGEMENT OF KNEE OSTEOARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1738.3-1738
Author(s):  
F. Eymard ◽  
P. Ornetti ◽  
J. Maillet ◽  
E. Noel ◽  
P. Adam ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Task Force ◽  
Platelet Rich Plasma ◽  
Symptomatic Treatment ◽  
Future Research ◽  
List Type ◽  
Clinical Practices ◽  
Efficient Treatment ◽  
Symptomatic Knee Osteoarthritis ◽  
Symptomatic Knee

Background:There has been much debate regarding the use of intra-articular injections of platelet-rich plasma (PRP) as symptomatic treatment for knee osteoarthritis. The heterogeneity of the preparation and injection protocols limits the extrapolation of data from randomized controlled trials and meta-analyses.Objectives:The objective of this expert consensus was to develop the first clinical practice recommendations for PRP injections in knee osteoarthritis.Methods:Fifteen physicians (10 rheumatologists, 4 specialists in rehabilitation and sport medicine and 1 interventional radiologist) from different countries were selected given to their expertise in the fields of PRP and osteoarthritis. Twenty-five recommendations were finally retained after several meetings using the modified Delphi method to establish clinical consensus. All experts voted their agreement or not for each recommendation using a score between 1 (totally inappropriate) and 9 (totally appropriate). Depending on the median value and extreme scores, recommendations were judged as appropriated or unappropriated with a strong or relative agreement but could also be judged as uncertain due to indecision or absence of consensus.Results:The main recommendations are listed below:- Intra-articular injections of PRP constitute an efficient treatment of early or moderate symptomatic knee osteoarthritis. Median = 8 [6-9] – Appropriate. Relative agreement.- Intra-articular injections of PRP may be useful in severe knee osteoarthritis (Kellgren-Lawrence grade IV). Median = 7 [6-7] – Appropriate. Relative agreement.- Intra-articular injections of PRP in knee osteoarthritis should be proposed as second-line therapy, after failure of non-pharmacological and pharmacological (oral and topic) symptomatic treatment. Median = 9 [5-9] – Appropriate. Relative agreement.- Intra-articular injections of PRP should not be performed in osteoarthritis flare-up with significant effusion. Median = 7 [5-9] – Appropriate. Relative agreement.- Intra-articular PRP treatment may include 1 to 3 consecutive injections. Median = 9 [7-9] – Appropriate. Strong agreement.- Leukocyte-poor PRP should be preferred for knee OA treatment. Median = 8 [5-9] – Appropriate. Relative agreement.- PRP injections should be performed under ultrasound or fluoroscopic guidance. Median = 8 [3-9] – Uncertain. No consensus.- PRP should not be mixed with injectable anesthetic or corticosteroid. Median = 9 [6-9] – Appropriate. Relative agreement.Conclusion:Twenty-five recommendations were discussed by an international multidisciplinary task force group in order to provide a basis for standardization of clinical practices and future research protocols.Disclosure of Interests:Florent Eymard Consultant of: Regenlab, Paul Ornetti: None declared, Jérémy Maillet Consultant of: Regenlab, Eric Noel Consultant of: Regenlab, Philippe Adam Consultant of: Regenlab, Virginie Legré Boyer Consultant of: Regenlab, Thierry Boyer Consultant of: Regenlab, Fadoua Allali: None declared, Vincent Grémeaux Bader: None declared, Jean-François Kaux: None declared, Karine Louati: None declared, Martin Lamontagne Consultant of: Pendopharm, Fabrice Michel: None declared, Pascal Richette: None declared, Hervé Bard Consultant of: Regenlab

scholarly journals A comparison between laterally wedged insoles and ankle-foot orthoses for the treatment of medial osteoarthritis of the knee: A randomized cross-over trial

2021 ◽  
pp. 026921552199363
Author(s):  
Martin Schwarze ◽  
Leonie P Bartsch ◽  
Julia Block ◽  
Merkur Alimusaj ◽  
Ayham Jaber ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Controlled Trial ◽  
Oxford Knee Score ◽  
Knee Adduction Moment ◽  
Osteoarthritis Of The Knee ◽  
Knee Score ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis ◽  
Patient Reported ◽  
Angular Impulse

Objective: To compare biomechanical and clinical outcome of laterally wedged insoles (LWI) and an ankle-foot orthosis (AFO) in patients with medial knee osteoarthritis. Design: Single-centre, block-randomized, cross-over controlled trial. Setting: Outpatient clinic. Subjects: About 39 patients with symptomatic medial knee osteoarthritis. Interventions: Patients started with either LWI or AFO, determined randomly, and six weeks later changed to the alternative. Main measures: Change in the 1st maximum of external knee adduction moment (eKAM) was assessed with gait analysis. Additional outcomes were other kinetic and kinematic changes and the patient-reported outcomes EQ-5D-5L, Oxford Knee Score (OKS), American Knee Society Clinical Rating System (AKSS), Hannover Functional Ability Questionnaire – Osteoarthritis and knee pain. Results: Mean age (SD) of the study population was 58 (8) years, mean BMI 30 (5). Both aids significantly improved OKS (LWI P = 0.003, AFO P = 0.001), AKSS Knee Score (LWI P = 0.01, AFO P = 0.004) and EQ-5D-5L Index (LWI P = 0.001, AFO P = 0.002). AFO reduced the 1st maximum of eKAM by 18% ( P < 0.001). The LWI reduced both maxima by 6% ( P = 0.02, P = 0.03). Both AFO and LWI reduced the knee adduction angular impulse (KAAI) by 11% ( P < 0.001) and 5% ( P = 0.05) respectively. The eKAM (1st maximum) and KAAI reduction was significantly larger with AFO than with LWI ( P = 0.001, P = 0.004). Conclusions: AFO reduces medial knee load more than LWI. Nevertheless, no clinical superiority of either of the two aids could be shown.

scholarly journals FRI0514 USE OF OPIATE FOR HIP AND KNEE OSTEOARTHRITIS BEFORE AND AFTER JOINT REPLACEMENT SURGERY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 856.1-856
Author(s):  
C. Lao ◽  
D. Lees ◽  
D. White ◽  
R. Lawrenson
Keyword(s):  
New Zealand ◽  
Knee Osteoarthritis ◽  
Knee Replacement ◽  
Charlson Comorbidity Index ◽  
Hip Osteoarthritis ◽  
Index Score ◽  
Charlson Comorbidity Index Score ◽  
Joint Replacement Surgery ◽  
Before And After ◽  
Comorbidity Index

Background:Osteoarthritis of the hip and knee is one of the most common causes of reduced mobility. It also causes stiffness and pain. Opioids can offer pain relief but is usually used for severe acute pain caused by major trauma or surgery. The use of opioids for relief of chronic pain caused by arthritis has increased over the last few decades.[1]Objectives:This study aims to investigate the use of strong opiates for patients with hip and knee osteoarthritis before and after joint replacement surgery, over a 13 years period in New Zealand.Methods:This study included patients with osteoarthritis who underwent publicly funded primary hip and knee replacement surgeries in 2005-2017 in New Zealand. These records were identified from the National Minimum Dataset (NMD). They were cross referenced with the NZJR data to exclude the admissions not for primary hip or knee replacement surgeries. Patients without a diagnosis of osteoarthritis were excluded.The PHARMS dataset was linked to the NMD to identify the use of strong opiates before and after surgeries. The strong opiates available for community dispensing in New Zealand and included in this study are: dihydrocodeine, fentanyl, methadone, morphine, oxycodone and pethidine. Use of opiate within three months prior to surgery and within 12 months post-surgery were examined by gender, age group, ethnicity, Charlson Comorbidity Index score and year of surgery. Differences by subgroup was examined with Chi- square test. Logistic regression model was used to calculate the adjusted odds ratios of strong opiate use before and after surgery compared with no opiate use.Results:We identified 53,439 primary hip replacements and 50,072 primary knee replacements with a diagnosis of osteoarthritis. Of patients with hip osteoarthritis, 6,251 (11.7%) had strong opiate before hip replacement surgeries and 11,939 (22.3%) had opiate after surgeries. Of patients with knee osteoarthritis, 2,922 (5.8%) had strong opiate before knee replacement surgeries and 15,252 (30.5%) had opiate after surgeries.The probability of patients with hip and knee osteoarthritis having opiate decreased with age, increased with Charlson comorbidity index score, and increased over time both before and after surgeries. Male patients with hip and knee osteoarthritis were less likely to have opiate than female patients both before and after surgeries. New Zealand Europeans with hip and knee osteoarthritis were more likely to receive opiate than other ethnic groups prior to surgeries, but were less likely to have opiate than Asians post-surgeries.Patients who had opiate before surgeries were more likely to have opiate after surgeries than those who did not have opiate before surgeries. The odds ratio was 8.34 (95% confidence interval (CI): 7.87-8.84) for hip osteoarthritis and 11.94 (95% CI: 10.84-13.16) for knee osteoarthritis after adjustment for age, gender, ethnicity, year of surgery and Charlson comorbidity index score. Having opiate prior to surgeries also increased the probability of having opiate for 6 weeks or more after surgeries substantially. The adjusted odds ratio was 21.46 (95% CI: 19.74-23.31) for hip osteoarthritis and 27.22 (95% CI: 24.95-29.68) for knee osteoarthritis.Conclusion:Preoperative opiate holidays should be encouraged. Multiple strategies need to be used to develop analgesic plans that allow adequate rehabilitation, without precipitating a chronic opiate dependence. Clinicians would also benefit from clear guidelines for prescribing strong opiates.References:[1] Nguyen, L.C., D.C. Sing, and K.J. Bozic,Preoperative Reduction of Opioid Use Before Total Joint Arthroplasty.J Arthroplasty, 2016.31(9 Suppl): p. 282-7.Disclosure of Interests:None declared

scholarly journals Incidence of severe knee and hip osteoarthritis in relation to different measures of body mass: a population-based prospective cohort study

2008 ◽  
Vol 68 (4) ◽  
pp. 490-496 ◽  
Author(s):  
L S Lohmander ◽  
M Gerhardsson de Verdier ◽  
J Rollof ◽  
P M Nilsson ◽  
G Engström
Keyword(s):  
Cohort Study ◽  
Waist Circumference ◽  
Knee Osteoarthritis ◽  
Body Mass ◽  
Hip Osteoarthritis ◽  
Population Based ◽  
Normal Weight ◽  
Men And Women ◽  
Relative Risks ◽  
Percentage Of Body Fat

Objective:To determine in a prospective population-based cohort study relationships between different measures of body mass and the incidence of severe knee and hip osteoarthritis defined as arthroplasty of knee or hip due to osteoarthritis.Materials and methods:Body mass index (BMI), waist circumference, waist–hip ratio (WHR), weight and percentage of body fat (BF%) were measured at baseline in 11 026 men and 16 934 women from the general population. The incidence of osteoarthritis over 11 years was monitored by linkage with the Swedish hospital discharge register.Results:471 individuals had knee osteoarthritis and 551 had hip osteoarthritis. After adjustment for age, sex, smoking and physical activity, the relative risks (RR) of knee osteoarthritis (fourth vs first quartile) were 8.1 (95% CI 5.3 to 12.4) for BMI, 6.7 (4.5 to 9.9) for waist circumference, 6.5 (4.6 to 9.43) for weight, 3.6 (2.6 to 5.0) for BF% and 2.2 (1.7 to 3.0) for WHR. Corresponding RR for hip osteoarthritis were 2.6 (2.0 to 3.4) for BMI, 3.0 (2.3 to 4.0) for weight, 2.5 (1.9 to 3.3) for waist, 1.3 (0.99 to 1.6) for WHR and 1.5 (1.2 to 2.0) for BF%.Conclusion:All measures of overweight were associated with the incidence of knee osteoarthritis, with the strongest relative risk gradient observed for BMI. The incidence of hip osteoarthritis showed smaller but significant differences between normal weight and obesity. Our results support a major link between overweight and biomechanics in increasing the risk of knee and hip osteoarthritis in men and women.

scholarly journals Confronting a Pandemic in Early Stages: A Retrospective Analysis From a Pandemic Hospital

2020 ◽  
Vol 1 (3) ◽  
pp. 106-118
Author(s):  
Ayşin Kılınç Toker ◽  
Ayşegul Ulu Kılıç ◽  
Esma Eren ◽  
Zehra Beştepe Dursun ◽  
İbrahim Toker ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Early Stages

scholarly journals Research Progress on Acupuncture Treatment of Knee Osteoarthritis

2021 ◽  
Vol 9 (4) ◽  
pp. 106-110
Author(s):  
Zhang Yueyu ◽  
Song Aiqun ◽  
Peng Ying
Keyword(s):  
Acupuncture Therapy ◽  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Joint Pain ◽  
Acupuncture Treatment ◽  
Treatment Plan ◽  
Joint Inflammation ◽  
Research Progress ◽  
Osteoarthritis Of The Knee ◽  
Joint Function

Osteoarthritis of the knee is a common clinical degenerative disease, which occurs in middle-aged and elderly people. Acupuncture therapy has a significant effect in the treatment of knee osteoarthritis, and is gradually accepted by more and more patients. Observing the treatment of knee osteoarthritis by different acupuncture and moxibustion therapies, we can find that acupuncture treatment of knee osteoarthritis has the advantages of relieving knee joint pain, improving knee joint function, absorbing knee joint inflammation, and promoting the recovery of damaged soft tissue. The treatment of osteoarthritis provides a more effective treatment plan.

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