Adding Acupuncture to Physical Therapy and Anti-Inflammatory Drugs in the Treatment of Knee Osteoarthritis

Abstract Objective: Through the bioinformatics analysis, to identify the genes and pathways of nonsteroidal anti-inflammatory drugs(NSARDs) acting on synovia from women with knee osteoarthritis (KOA), and to provide reference for clinical application. Methods: We downloaded the gene microarray datasets with the accession number of GSE55457 and GSE55584 from the Gene Expression Omnibus (GEO; https://www.ncbi.nlm.nih.gov/geo/) database, including 5 untreated KOA patients, 9 NSARDs treated KOA patients and 2 patients without KOA The samples in the untreated KOA group and the NSARDs treated KOA group were used for main analysis. The samples in the untreated KOA group and the normal control group were used for cooperative analysis. Then we performed robust multi-array (RMA) normalization with affy R programming package. After that, differential expression genes (DEGs) in main analysis and cooperative analysis were identified based on limma package separately. Screening the common DEGs from main analysis and cooperative analysis. Enriched gene ontology (GO) terms and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways of DEGs were obtained through the Database for Annotation, Visualization and Integrated Discovery (DAVID). What's more, protein-protein interaction (PPI) network was constructed, and we identified modules of PPI network through Cytoscape to screen valuable targets. The value of gene expression fold change (FC) ≥1.4 or ≤1/1.4, and P <0.05 were used as the screening conditions. P <0.05 and Associated genes count>5 were used as the screening conditions.Results: There were 338 DEGs in main analysis. Among them, 211 genes were up-regulated and 127 genes were down-regulated. There were 7005 DEGs in cooperative analysis. Among them, 6952 genes were up-regulated and 53 genes were down-regulated. A total of 129 common DEGs were identified between main analysis and cooperative analysis. There are 2 biological processes, 3 cell components and 2 molecular functions for the enrichment of differentially expressed genes.Conclusion: NSARDs may play a certain role in synovia from women with KOA by regulating the mRNA expressions of il-6, TNFRSF11A and CSF1R, which may become one of the indicators for monitoring the efficacy of NSAIDs.

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Effectiveness of Physical Therapy in the Correction of the Functional Status of the Temporomandibular Joint in Arthrosis

Ukraïnsʹkij žurnal medicini bìologìï ta sportu ◽

10.26693/jmbs06.06.188 ◽

2021 ◽

Vol 6 (6) ◽

pp. 188-193

Author(s):

M. G. Aravitska ◽

◽

L. M. Sheremeta ◽

S. I. Danylchenko ◽

Dovgan O. V. ◽

...

Keyword(s):

Physical Therapy ◽

Temporomandibular Joint ◽

Mouth Opening ◽

Masticatory Muscles ◽

Main Group ◽

Control Group ◽

Maxillofacial Region ◽

Therapeutic Exercises ◽

Inflammatory Drugs ◽

Anti Inflammatory

The purpose of the study was to evaluate the effect of a physical therapy program on the state of functioning of the maxillofacial region in patients with arthrosis of the temporomandibular joint. Materials and methods. The study involved 33 people with arthrosis of the temporomandibular joint of the II-III degrees, which were divided into 2 groups – control and main. The control group consisted of 18 people who received arthrosis therapy only with non-steroidal anti-inflammatory drugs. The main group consisted of 15 people who additionally underwent the developed program of physical therapy (therapeutic exercises, massage, post-isometric relaxation, kinesiotaping of the masticatory muscles, neck muscles, cervical-collar zone; paraffin therapy course for the temporomandibular joint area, patient education). Complaints of patients, the intensity of pain in the temporomandibular joint on a visual analogue scale, the amount of mouth opening were determined, and auscultation of the joint was performed. Results and discussion. After the completion of the treatment course (for patients of the control group) and physical therapy (for the patients of the main group), pain in the temporomandibular joint did not manifest itself at rest and during movement. This is explained, in particular, by the fact that the basis of conservative treatment of arthrosis is the use of non-steroidal anti-inflammatory drugs with analgesic effects. At the same time, the usage of physical therapy, in comparison with medications, in the main group was statistically significant (p <0.05) in relation to control patients, it improved the functional activity of the jaw area and the functioning of the temporomandibular joint, which was manifested by a decrease in the number of persons with complaints of pathological sounds during jaw movements and their auscultatory detection, discomfort when chewing, as well as an increase in the magnitude of opening the mouth. Restoration of the condition of patients with diseases of the maxillofacial region, and, in particular, the temporomandibular joint, is an urgent problem not only for dentists, but also for specialists in the field of rehabilitation, in particular, physical therapists. The objectives of physical therapy in patients with arthrosis of the temporomandibular joint are to reduce the load on the joint, eliminate and reduce pain, synovitis, myalgia, improve joint function, stimulate and activate metabolic processes in cartilaginous and bone tissues, normalize blood flow, and thus improve quality of life. Conclusion. Physical therapy means improve the functional ability of the temporomandibular joint in the complex recovery of patients with arthrosis statistically significantly better than monotherapy with non-steroidal anti-inflammatory drugs

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The Comparative Efficacy and Safety of Long- and Short-Term Continuous Use of Non-Steroidal Anti-Inflammatory Drugs for the Treatment of Knee Osteoarthritis

Traumatology and Orthopedics of Russia ◽

10.21823/2311-2905-2020-26-2-120-127 ◽

2020 ◽

Vol 26 (2) ◽

pp. 120-127

Author(s):

B. V. Zavodovskiy ◽

E. V. Papichev ◽

L. E. Sivordova ◽

Yu. V. Polyakova ◽

Yu. R. Akhverdyan

Keyword(s):

Knee Osteoarthritis ◽

Pain Syndrome ◽

Pain Level ◽

Short Term ◽

On Demand ◽

Average Pain ◽

Inflammatory Drugs ◽

Anti Inflammatory ◽

Continuous Use

Objective. To compare the efficacy and tolerability of long-term and short-term continuous NSAIDs in patients with knee osteoarthritis with insufficient efficacy “on demand” NSAIDs and SYSADOA.Study design. 12-week, prospective, comparative, randomized, single-center study.Materials and Methods. 180 patients with primary knee osteoarthritis aged 40 to 85 years with insufficient efficacy of “on demand” NSAIDs and SYSADOA were examined. Anti-inflammatory drugs were recommended for everyone: 56 people took Naproxen (31.11%), 63 — Etoricoxib (35%), 61 — Ketoprofen (33.89%). Patients were randomized into two groups: 1st group — with 8-week continuous intake of NSAIDs, 2nd group — with a 2-week continuous course of NSAIDs.Results. There was a positive dynamics of pain syndrome according to VAS and decrease in the level of the WOMAC index in both groups after 2 weeks of therapy. The pain level (VAS) and WOMAC indices in 1st group achieved after 8 weeks significantly differed from the ones after 2 weeks of therapy (VAS dynamics —10.93±2.43 mm, t = 42.64; p<0.001). In both groups we noted gradual significant increase in the average pain level according to VAS and WOMAC indices after NSAIDs cancellation. However, there was better control of pain in 1st group with long-term NSAID than in 2nd one. Safety profile of drug therapy was similar in both groups.Conclusion. The long-term 8-week use of NSAIDs in patients with knee osteoarthritis with insufficient efficacy “on demand” NSAIDs and SYSADOA provides better dynamics of the pain syndrome than with 2-week therapy. After treatment is canceled longer prior NSAID therapy contributes to better control of the pain syndrome. Continuous use of NSAIDs demonstrated good tolerance and safety, did not require dose reduction and/or discontinuation of therapy. Thus, anti-inflammatory therapy of osteoarthritis in this group of patients may be prescribed for a longer period with continuous use of NSAIDs.

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