PERBEDAAN HOLD RELAX DAN CONTRACT RELAX PADA PENDERITA OSTEOARTHRITIS KNEE JOINT

ABSTRAKHold relax dan Contract relax merupakan teknik terapi untuk mengurangi nyeri, kekakuan sendi, meningkatkan kekuatan otot, dan meningkatkan aktivitas fungsional pada penderita Osteoarthritis knee joint. Tujuan penelitian untuk mengetahui perbedaan aktivitas fungsional pada penderita osteoarthritis knee joint antara sebelum dengan setelah pemberian hold relax dan Contract relax. Subjek berjumlah 20 orang. Kelompok hold relax 5 subjek laki-laki dan 5 subjek perempuan, sedangkan untuk keompok contract relax 3 subjek perempuan, dan 7 subjek laki-lakis. Metode yang digunakan dalam penelitian ini adalah Purposive Sampling. Hasil penelitian menunjukkan bahwa terdapat perbedaan bermakna antara Hold relax, sebelum dan setelah pemberian 3 kali terapi dan 6 kali terapi dengan alat ukur WOMAC, ROM, MMT. Hasil penelitian juga menunjukkan bahwa terdapat perbedaan bermakna tehnik Contract relax, sebelum dan setelah pemberian 3 kali terapi dan 6 kali terapi, dengan alat ukur WOMAC (p<0,000), ROM (p<0,000), MMT (p<0,000). Kesimpulan dalam penelitian ini adalah tehnik Hold relax, sebelum dan setelah pemberian 3 kali terapi dan 6 kali terapi, lebih cepat mengurangi nyeri, kekakuan sendi,meningkatkan kekuatan otot, dan meningkatkan aktivitas fungsional penderita osteoarthritis knee joint, dibandingkan dengan tehnik Contract relax, sebelum dan setelah pemberian 3 kali terapi dan 6 kali terapi. Kata Kunci : Osteoarhtiris knee joint; WOMAC, ROM, MMT

Unprecedented emergencies during radiofrequency ablation procedure: a case series

Radiofrequency ablation (RFA) of nerves is an upcoming intervention for relieving chronic musculoskeletal pain. However, being relatively new not much publications are available on emergencies during the procedure. 66 years old male, a case of Osteoarthritis knee, underwent RFA genicular nerve of right knee. Conventional RFA of Superolateral, Inferomedial, Superomedial genicular nerves were done under C- arm guidance. Thirty minutes after the procedure, we found a boggy swelling developing over his right knee. It was a hematoma developing on the superomedial aspect of the right kneecap most likely due to injury to Superomedial genicular vessels accompanying the nerve. 67 years old female planned for RFA genicular nerves of both knees under C arm guidance. During the intervention, she complained of numbness around face, and suddenly went into disoriented state with muscle twitching and bluish discoloration of lips. Medicine consultation diagnosed the incident as LA associated systemic toxicity. 57 years old female with chief complaints of pain in left hemiplegic shoulder pain for 6 months duration admitted for suprascapular nerve block. During the procedure patient goes into hypotensive bradycardic episode. 65 years old female admitted for Medial calcaneal block for right heel pain. 24 hours after the procedure she has aggravated pain of foot. RFA is considered as a non-invasive, OPD based procedure for effective pain relief but it is also important to understand such unprecedented emergencies that can happen.

Potential New Treatments for Knee OA: A Prospective Review of Registered Trials

We aimed to evaluate potential new treatments for knee osteoarthritis (OA). The National Institute of Health ClinicalTrials.gov database was searched for “Osteoarthritis, Knee”. We found 565 ongoing interventional studies with a total planned enrollment of 111,276 subjects. Ongoing studies for knee OA represent a very small fraction of the registered clinical trials, but they are over a quarter of all knee trials and over two thirds of all OA studies. The most researched topic was arthroplasty, with aspects such as implant design changes, cementless fixation, robotic guidance, pain management, and fast track recovery. Intraarticular injections focused on cell therapies with mesenchymal stem cells sourced from adipose tissue, bone marrow, or umbilical cord. We could see the introduction of the first disease modifying drugs with an impact on knee OA, as well as new procedures such as geniculate artery embolization and geniculate nerve ablation.

Validity and reliability of the Mini-Osteoarthritis Knee and Hip Quality of Life scale in Turkish population

Objectives: This study aims to investigate the validity and reliability of the Turkish version of the Mini-Osteoarthritis Knee and Hip Quality of Life (Mini-OAKHQoL) scale developed to assess the quality of life (QoL) in patients with knee and/or hip osteoarthritis. Patients and methods: Between May 2018 and May 2020, a total of 83 patients (11 males, 72 females; mean age: 58.1±10.0 years; range, 39 to 81 years) with knee and/or hip osteoarthritis were included. Demographic, clinical, and survey data (Mini-OAKHQoL, Nottingham Health Profile, Short Form-36, Western Ontario and McMaster Universities Osteoarthritis Index, Lequesne Index, and Visual Analog Scale of pain intensity) were recorded. Missing data, floor effect, and ceiling effect were calculated. For reliability analysis, internal consistency and test-retest reliability were discovered. Face, content, convergent, and divergent validities were applied. Results: Among the patients, 52 (62.65%) had knee osteoarthritis, 26 (31.32%) had hip osteoarthritis, and five (6.02%) had both. Mini-OAKHQoL had a good face and content validity. The average item completion rate was 96.9%, with the time needed to perform was about 4 min. None of the subscales of Mini-OAKHQoL presented floor or ceiling effect, with a good range of responses. The Cronbach alpha coefficients and intraclass correlation coefficient (ICC) analysis of the subscales ranged from 0.927 to 0.676 and 0.987 to 0.843, respectively. Regarding convergent validity, the physical activities, mental health, and pain subscales of Mini-OAKHQoL had moderate to high correlations with the topic-related subset of the other QoL surveys. There were no or weak correlations between Mini-OAKHQoL and non-QoL parameters, indicating its divergent validity. Conclusion: The Turkish version of Mini-OAKHQoL is a valid, reliable, simple, practical, accurate, completable, comprehensive, and disease-specific self-report instrument to assess QoL in patients with knee and/or hip osteoarthritis.

Result of high Fibular Osteotomy (HFO) in Osteoarthritis knee

To assess the effectiveness of high fibular osteotomy (HFO) in improving function and reducing pain among patients diagnosed with osteoarthritis knee admitted in the orthopedic department of Dibba Hospital Fujairah, United Arab Emirates. This is a descriptive, correlational cross-sectional study design. The study was conducted at the Orthopedic department Dibba Hospital Fujairah, United Arab Emirates, during the period from March 2019 to March 2020. All patients had knee osteoarthritis and were managed using HFO. All patients were adults and older than 18 years of age. Data was analyzed using the SPSS program. Ethical approval was gained from the hospital as well as from patients. The mean age of the patients was 32.5 ± 8.3 years. The study included 100 participants, among them, 28 were females, and 72 were males. There was a statistically significant relationship between knee injury and osteoarthritis outcome score and Lysholm. Also, knee x-rays images demonstrated clinical improvements among most of the patients. According to previous results, HFO and mesenchymal cell induced chondrogenesis (MCIC)should be considered for treating of medial compartment osteoarthritis, especially in patients with varus deformity.