Knee Osteoarthritis Patients Research Articles

Electroacupuncture combined with extracorporeal shock wave therapy improves pain symptoms and inflammatory factor levels in knee osteoarthritis patients

ObjectiveTo compare the clinical efficacy and safety of electroacupuncture combined with extracorporeal shock wave therapy (EESWT) and extracorporeal shock wave therapy (ESWT) in the treatment of knee osteoarthritis (KOA). MethodsA total of 135 KOA patients who received EESWT treatment were selected as the EESWT group, and 135 KOA patients who received extracorporeal shock wave therapy (ESWT) were selected as the ESWT group. The clinical efficacy, inflammatory factors in joint synovial fluid and adverse events during treatment were compared before and after treatment. ResultsThe clinical effective rate of patients in the EESWT group (89.63 %) after treatment was significantly higher than that of the ESWT group (74.81 %) (p < 0.01). The lysholm kness (LKSS) score and range of motion (ROM) of the patients in the EESWT group after treatment were higher than those of the ESWT group, while Lequesne index score, visual analogue scale (VAS) score and Western Ontario and McMaster Universities Arthritis Index (WOMAC) were lower than those of the ESWT group (p < 0.01). Compared with ESWT group, the changes in the expression levels of nitric oxide (NO), superoxide dismutase (SOD), interleukin 1β (IL-1β), tumor necrosis factor-α (TNF-α), matrix metalloproteinase-3 (MMP-3), and transforming growth factor β1 (TGF-β1) in the synovial fluid of the EESWT group after treatment were significantly greater than those of the ESWT group (p < 0.01). No significant difference in the incidence of adverse events between the EESWT group and the ESWT group (p > 0.05). ConclusionEESWT significantly improves pain symptoms and inflammatory factor levels in KOA patients and is an optional KOA treatment option worthy of clinical attention.

Effects of Calcitonin on Apoptosis and B-Cell Lymphoma 2 Expression in Knee Osteoarthritis Articular Chondrocytes

Knee osteoarthritis (KOA) is a prevalent joint disorder characterized by articular cartilage degeneration and apoptosis. This research was aimed to demonstrate effects of calcitonin (CT) on apoptosis and Bcl-2 in KOA articular chondrocytes. In vitro cellular experiments were conducted using articular chondrocytes obtained from KOA patients, with a portion of the cells undergoing passaging and proliferation culture. The remaining cells were rolled into control group (normal chondrocytes), KOA group (chondrocytes from arthritis joints), and CT group (chondrocytes from arthritis joints treated with CT). Control and KOA groups were treated with an equivalent amount of saline solution. Apoptosis and Bcl-2 protein expression levels were assessed in each group to evaluate the impact of CT on articular chondrocytes. It was revealed that proliferation rate of human chondrocytes decreased with increasing passage number, and the exponential growth phase was shorter. After day 6, the proliferation rate drastically increased, exhibiting an exponential growth trend. Relative to KOA group, the CT group demonstrated a notable reduction in apoptosis of articular chondrocytes (P &lt;0.05). Bcl-2 protein level was greatly upregulated in CT group (P &lt; 0.05). In short, CT can inhibit apoptosis of articular chondrocytes and promote Bcl-2 expression, thereby contributing to the stability and survival of articular chondrocytes. In summary, CT has a positive effect on apoptosis and Bcl-2 expression in KOA articular chondrocytes.

Effect of Lower Extremity Osteoarthritis on Outcomes of Lumbar Decompression.

The purpose of this study is to evaluate how hip or knee osteoarthritis (OA) and total joint arthroplasty impact the outcomes of patients undergoing lumbar decompression. A retrospective review of 342 patients undergoing lumbar decompression without fusion from January 2019 and June 2021 at a single institution was performed. Univariate and multivariate analyses were used to compare outcomes between patients with and without concomitant hip or knee OA. Forty-six percent of patients had a hip or knee OA diagnosis and were higher risk as they were older, had higher BMIs, were more likely to be former smokers, had higher ASA scores, and were more likely to undergo 3+ level surgery. Postoperatively, after adjusting for differences between groups, hip or knee OA patients were more likely to be readmitted (OR=12.45, p=0.026) or have a complication (OR=13.77, p=0.031). However, patient reported outcomes as measured by Patient Reported Outcomes Measurement Information System-physical function. were similar at 1-3 months and 3-6 months. Higher levels of physical function were observed at 3-6 months postoperatively in hip OA patients with a history of THA. Patients with concomitant hip or knee OA are at higher risk for readmission and postoperative complications but may achieve similar levels of physical function as those without OA.

Effect of acupuncture duration in patients with knee osteoarthritis: A secondary analysis of a multi-center randomized controlled trial: 治疗时长对针刺治疗膝骨关节炎疗效的影响:一项多中心随机对照试验的二次分析

ObjectiveTo explore the influence of acupuncture duration on the effect of acupuncute for patients with knee osteoarthritis (KOA). MethodsThis secondary analysis was conducted based on the data of a randomized controlled trial about acupuncture on KOA. A total of 480 patients were recruited at nine centers. Only data from the manual acupuncture (MA) group and electroacupuncture (EA) group were included in this secondary analysis. The needles were retained for 30-min each time and treatment was given three times a week for 8 weeks. The follow-up visit lasted until week 26. Outcomes were numerical rating scale (NRS) on pain, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) function and the response rate. ResultsThe NRS and WOMAC function at week 8 were lower than those at week 4 (P<0.05), and were no significant difference compared with those at week 26 in MA and EA groups (P>0.05). Greater changes were observed in NRS and WOMAC function during 0–4 weeks compared with those during 4–8 weeks (P<0.05) in both groups. The response rate at week 8 was higher than it at week 4 (P<0.05), and was no significant difference compared with it at week 26 (P>0.05) in both groups. Association was found between BMI and changes of NRS (P<0.05), but not between BMI and WOMAC function (P>0.05) in MA group, while no asscoaition was found between BMI and NRS or WOMAC function in EA group (P>0.05). There was no association found between other factors and NRS or WOMAC function in both groups (P>0.05). ConclusionFor KOA patients, 8-week acupuncture was more effective than 4-week acupuncture in relieving pain and improving joint function, but growth rate of the effect slowed down with increasing duration of intervention. It was uncertain whether the long-term effect of 8-week acupuncture was better than that of 4-week acupuncture. Further studies are required to further determine the effect of duration of intervention.

Effect of acupuncture duration in patients with knee osteoarthritis: A secondary analysis of a multi-center randomized controlled trial 治疗时长对针刺治疗膝骨关节炎疗效的影响:一项多中心随机对照试验的二次分析

ObjectiveTo explore the influence of acupuncture duration on the effect of acupuncute for patients with knee osteoarthritis (KOA). MethodsThis secondary analysis was conducted based on the data of a randomized controlled trial about acupuncture on KOA. A total of 480 patients were recruited at nine centers. Only data from the manual acupuncture (MA) group and electroacupuncture (EA) group were included in this secondary analysis. The needles were retained for 30-min each time and treatment was given three times a week for 8 weeks. The follow-up visit lasted until week 26. Outcomes were numerical rating scale (NRS) on pain, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) function and the response rate. ResultsThe NRS and WOMAC function at week 8 were lower than those at week 4 (P<0.05), and were no significant difference compared with those at week 26 in MA and EA groups (P>0.05). Greater changes were observed in NRS and WOMAC function during 0-4 weeks compared with those during 4-8 weeks (P<0.05) in both groups. The response rate at week 8 was higher than it at week 4 (P<0.05), and was no significant difference compared with it at week 26 (P>0.05) in both groups. Association was found between BMI and changes of NRS (P<0.05), but not between BMI and WOMAC function (P>0.05) in MA group, while no asscoaition was found between BMI and NRS or WOMAC function in EA group (P>0.05). There was no association found between other factors and NRS or WOMAC function in both groups (P>0.05). ConclusionFor KOA patients, 8-week acupuncture was more effective than 4-week acupuncture in relieving pain and improving joint function, but growth rate of the effect slowed down with increasing duration of intervention. It was uncertain whether the long-term effect of 8-week acupuncture was better than 4-week acupuncture. Further studies are required to further determine the effect of duration of intervention.

Dose-Response Relationships of Resistance Training in Adults With Knee Osteoarthritis: A Systematic Review and Meta-analysis.

To determine the effects of resistance training (RT) on symptoms, function, and lower limb muscle strength in patients with knee osteoarthritis (KOA), and to determine the optimal dose-response relationships. We searched the PubMed, MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, and ClinicalTrials.gov databases from inception to January 23, 2022. Randomized controlled trials that examined the effects of RT in KOA patients (mean age ≥50 years) were included. We applied Hedges' g of the random-effects model to calculate the between-subject standardized mean difference (SMDbs). A random-effects metaregression was calculated to explain the influence of key training variables on the effectiveness of RT. We used the Grading of Recommendations Assessments, Development and Evaluation (GRADE) method to appraise the certainty of evidence. A total of 46 studies with 4289 participants were included. The analysis revealed moderate effects of RT on symptoms and function (SMDbs =-0.52; 95% CI: -0.64 to -0.40), and lower limb muscle strength (SMDbs = 0.53; 95% CI: 0.42 to 0.64) in the intervention group compared with the control group. The results of the metaregression revealed that only the variable "training period" (P< .001) had significant effects on symptoms, function, and lower limb muscle strength, and the 4 to 8 weeks of training subgroup showed greater effects than other subgroups (SMDbs =-0.70, -0.91 to -0.48; SMDbs = 0.76, 0.56 to 0.96). Compared with inactive treatments, RT is strongly recommended to improve symptoms, function, and muscle strength in individuals with KOA. Dose-response relationship analysis showed that 4 to 8 weeks of RT had more benefits.

Specification, validation, and adherence of quality indicators to optimize the safe use of nonsteroidal anti-inflammatory drugs for knee osteoarthritis pain in the primary care setting

BackgroundNonsteroidal anti-inflammatory drugs (NSAIDs) used for osteoarthritis (OA) in primary care may cause gastrointestinal or renal injury. This study estimated adherence to two quality indicators (QIs) to optimize NSAID safety: add proton pump inhibitors (PPI) to NSAIDs for patients with gastrointestinal (GI) risk (QI #1 NSAID-PPI) and avoid oral NSAIDs in chronic kidney disease (CKD) stage G4 or G5 (QI #2 NSAID-CKD).MethodsThis retrospective study included index primary care clinic visits for knee OA at our health system in 2019. The validation cohort consisted of a random sample of 60 patients. The remainder were included in the expanded cohort. Analysis of structured data extracts was validated against chart review of clinic visit notes (validation cohort) and estimated QI adherence (expanded cohort).ResultsAmong 60 patients in the validation cohort, analysis of data extracts was validated against chart review for QI #1 NSAID-PPI (100% sensitivity and 91% specificity) and QI #2 NSAID-CKD (100% accuracy). Among 335 patients in the expanded cohort, 44% used NSAIDs, 27% used PPIs, 73% had elevated GI risk, and only 2% had CKD stage 4 or 5. Twenty-one percent used NSAIDs and had elevated GI risk but were not using PPIs. Therefore, adherence to QI #1 NSAID-PPI was 79% (95% CI, 74–83%). No patients with CKD stage 4 or 5 used NSAIDs. Therefore, adherence to QI #2 NSAID-CKD was 100%.ConclusionA substantial proportion of knee OA patients with GI risk factors did not receive PPI with NSAID therapy during primary care visits.

Comparison Of Naproxen And Diacerein In The Treatment Of Knee Joint Osteoarthritis

Background: Knee osteoarthritis is a common disease in older age. Pain and limitation of movement are the main symptoms of knee osteoarthritis. Many pharmacological options are available for symptomatic relief but NSAIDs are mostly prescribed. Diacerein is also prescribed for osteoarthritis but data regarding its efficacy is still controversial. Moreover, studies regarding the comparison of diacerein with NSAIDs are deficient in Pakistan.&#x0D; Objective: The objective of the study was to compare the clinical efficacy of naproxen (NSAID) with diacerein in treating knee osteoarthritis.&#x0D; Methodology: Patients fulfilling inclusion criteria were included in the study. After written informed consent 60 patients of knee osteoarthritis were included in the study. They were divided randomly into two groups. Group A (n=30) was prescribed with tablet naproxen 500mg twice daily and group B (n=30) was given capsule diacerein 50mg twice daily for 12 weeks. Baseline VAS and WOMAC scores of the patients were noted. These scores were compared with scores achieved 12 weeks after intervention. Intra-group comparison of the scores was also carried out. SPSS version 23.0 was used for statistical analysis.&#x0D; Results: WOMAC and VAS scores comparison of the two groups (A &amp; B) before intervention showed an insignificant p-value that is 0.815 for the WOMAC score and 0.509 for the VAS score. After intervention means WOMAC score i.e.10.50 ± 2.46 of group A (treated with naproxen) was better than the mean 29.62 ± 7.03 of group B (treated with diacerein) showing significant p-value (&lt; 0.001). Similarly mean VAS of group A 1.92 ± 0.58 improved more than the mean VAS of group B i.e 3.38 ± 0.75 with significant p-value (&lt; 0.001). Intra-group comparison of the groups also showed a significant p-value.&#x0D; Conclusion: Clinical efficacy of naproxen is better than diacerein in treating knee osteoarthritis.

Clinical Analysis of Minimally Invasive Arthroscopic Surgery in the Treatment of Knee Osteoarthritis

Objective: This paper aims to analyze the effect of minimally invasive arthroscopic surgery on knee osteoarthritis (KOA). Methods: A total of 60 patients with KOA admitted to the hospital between January 2021 and February 2023 were selected. They were divided into two groups by table of random numbers, 30 cases in the study group were treated with minimally invasive arthroscopic surgery, and 30 cases in the control group were treated conservatively. The treatment effects of the groups were compared. Results: The total effective rate of the study group was higher than that of the control group (P &lt; 0.05). Before treatment, there was no difference in knee joint function scores between the groups (P &gt; 0.05). After treatment, the knee joint function score in the study group was higher than that in the control group (P &lt; 0.05). The complication rate and recurrence rate in the study group were lower than those in the control group (P &lt; 0.05). Conclusion: Minimally invasive arthroscopic surgery for KOA patients can improve the overall curative effect, significantly restore knee joint function, and reduce complications and recurrence.

Clinical Value of Tranexamic Acid Combined with Total Knee Arthroplasty in the Treatment of Knee Osteoarthritis

This paper aims to explore the clinical value of tranexamic acid combined with total knee arthroplasty (TKA) in patients with knee osteoarthritis (KOA). The research period was from March 2020 to December 2022. A total of 50 samples of KOA patients were selected and divided into the study group (n = 25) and the control group (n = 25) by lottery method of medical record envelopes. The patients in the control group were treated with TKA, and the patients in the study group were treated with tranexamic acid combined with TKA. The surgery-related indicators, visual analogue pain score (VAS), inflammatory factor levels, motor function scores, and incidence of complications were compared between the two groups. The intraoperative blood loss in the study group was lower than that in the control group (P &lt; 0.05), and there was no significant difference in postoperative hospital stay between the two groups (P &gt; 0.05). The postoperative VAS scores in the study group were lower than those in the control group (P &lt; 0.05), while the postoperative inflammatory factor levels of the study group were lower than those of the control group (P &lt; 0.05). The postoperative motor function scores of the study group were higher than those of the control group (P &lt; 0.05), and the incidence of complications in the study group was lower than that in the control group (P &lt; 0.05). The treatment of KOA patients with tranexamic acid combined with TKA can reduce intraoperative blood loss, relieve pain, reduce the level of inflammatory factors, improve postoperative motor function, and reduce the incidence of complications, which can be widely applied in clinical practice.

Outcomes of tourniquet - less total knee arthroplasty

ABSTRACT Introduction: Tourniquet use in total knee arthroplasty (TKA) provides a bloodless field to improve visualization; however, the arguments for improving cement fixation, decreasing operative time, and decreasing overall blood loss have not been supported by the literature. Tourniquetless TKA is gaining popularity with the reported less postoperative pain and improved knee function in addition to no evident increased risk compared to tourniquet use. This study assessed the outcomes of tourniquetless TKA surgery in Hue Central Hospital. Methods: 35 patients with end - stage knee osteoarthritis undergoing tourniquetless TKA surgery were included in this study. Demographic data, physical examination, and radiographic parameters were collected pre - and postoperatively. Intra - and postoperative complications were also reported. The patient’s knee function and clinical outcomes were reassessed at the 1 - month and 3 - month follow - up times. Results: Tourniquetless TKA showed significant improvements regarding knee pain, knee alignment, and knee function. No significant complications were reported post - operatively. Conclusion: Tourniquetless TKA can be safely performed on a routine basis on end - stage knee osteoarthritis patients with relatively no significant complications.

Effect of Weight Bearing Versus Non-Weight Bearing Strengthening Exercises on Dynamic Balance in Knee Osteoarthritis Patients: Randomized Controlled Trial

Background: knee osteoarthritis (OA) is one of the most aging problems that causes many problems such as pain, reduced balance, difficulty of walking, up &amp; down stairs and may result in inability to move and dependency. Dynamic balance has been found to be affected in patients with knee OA. Purpose: The aim of this study was to evaluate and compare the effect of weight bearing (WB) and non-weight bearing (NWB) strengthening exercises on dynamic balance, pain and proprioception in knee OA patients. Subjects &amp; Methods: Sixty patients from both genders, diagnosed with bilateral knee OA mild to moderate (according to Kellgran and Lawrence classification) divided equally into three groups G I (control), G II (WB) and G III (NWB), their mean value of age were 59.7 ± 4.5, 60.6 ± 4 and 60.1 ± 4.9 years respectively and body mass index were 28.8 ± 1, 28.6 ± 0.8and 28.2 ± 1.6 kg/m2 respectively. G I received conventional treatment (TENS and stretching exercises for quadriceps, hamstring and calf muscles), G II received the conventional treatment and WB strengthening exercises while G III received the conventional treatment and NWB strengthening exercises. Interventions were performed for 12 sessions (3 sessions/ week) over a period of four weeks. Outcomes were assessed at the beginning and at the end of the fourth week using biodex balance system for dynamic balance, visual analogue scale (VAS) for pain intensity and bubble inclinometer for joint repositioning error (JRE) for measuring proprioception. Result: G II was improved in all measurements with significant difference between the pre and post measurements of all measured variables, while G II were significant difference of BBS and VAS and G I there was significance difference of VAS only. There were significance differences between G II and G I in VAS, BBS and JRE measurements and between G II and G III in VAS and JRE only with superiority to G II, while there were significance differences between G I and G III in VAS and BBS with superiority to G III. Conclusion: Both WB and NWB exercises are effective in improving dynamic balance and pain in patients with knee OA. With superiority to WB exercises in improving proprioception.

Preoperative high-intensity strength training combined with balance training can improve early outcomes after total knee arthroplasty

BackgroundTo investigate the effect of preoperative high-intensity strength training combined with balance training on the knee function of end-stage knee osteoarthritis (KOA) patients after total knee arthroplasty (TKA).MethodsA prospective study was conducted on end-stage KOA patients awaiting TKA. The patients were divided into an experimental group and a control group according to whether they received a preoperative training intervention. The differences in knee flexor–extensor strength, knee range of motion (ROM), timed up and go (TUG) test result, stair ascend/descend test result, Knee Society score (KSS) and Berg balance scale (BBS) score were assessed in both groups at baseline (T1), before operation (T2), 3 months after operation (T3), and 1 year after operation (T4).ResultsAfter high-intensity strength training and balance training, the knee flexor–extensor strength, TUG test result, stair ascend/descend test result, and KSS were all significantly improved at T2 in the experimental group over the control group. At T3, the knee ROM, knee flexor–extensor strength, TUG test result, BBS score, and KSS clinical and functional scores were all significantly superior in the experimental group. The experimental group enjoyed a superiority in KSS clinical and functional scores until T4. Group × time and between-group interactions were found in all assessment indicators in both groups (p < 0.01).ConclusionPreoperative high-intensity strength training combined with balance training can enhance the knee flexor–extensor strength and balance of patients with end-stage KOA in the short term and help improve early outcomes after KOA.Trial registration ChiCTR2000032857, 2020-05-13.

Effects of gait modifications on tissue-level knee mechanics in individuals with medial tibiofemoral osteoarthritis: A proof-of-concept study towards personalized interventions.

Gait modification is a common nonsurgical approach to alter the mediolateral distribution of knee contact forces, intending to decelerate or postpone the progression of mechanically induced knee osteoarthritis (KOA). Nevertheless, the success rate of these approaches is controversial, with no studies conducted to assess alterations in tissue-level knee mechanics governing cartilage degradation response in KOA patients undertaking gait modifications. Thus, here we investigated the effect of different conventional gait conditions and modifications on tissue-level knee mechanics previously suggested as indicators of collagen network damage, cell death, and loss of proteoglycans in knee cartilage. Five participants with medial KOA were recruited and musculoskeletal finite element analyses were conducted to estimate subject-specific tissue mechanics of knee cartilages during two gait conditions (i.e., barefoot and shod) and six gait modifications (i.e., 0°, 5°, and 10° lateral wedge insoles, toe-in, toe-out, and wide stance). Based on our results, the optimal gait modification varied across the participants. Overall, toe-in, toe-out, and wide stance showed the greatest reduction in tissue mechanics within medial tibial and femoral cartilages. Gait modifications could effectually alter maximum principal stress (~20 ± 7%) and shear strain (~9 ± 4%) within the medial tibial cartilage. Nevertheless, lateral wedge insoles did not reduce joint- and tissue-level mechanics considerably. Significance: This proof-of-concept study emphasizes the importance of the personalized design of gait modifications to account for biomechanical risk factors associated with cartilage degradation.

Osteoarthritis knee and modifiable cardiovascular risk factors: play in tandem.

To know the frequency of modifiable cardiovascular risk factors in knee osteoarthritis patients. Cross sectional study was done at Department of Rheumatology Indus Medical College, Tando Mohammad Khan from March 25, 2022 to November 24, 2022. Total 246 Osteoarthritis of knee cases with (Kellgren-Lawrence grad-II and above) on x-ray, were selected after demographic details, blood pressure, body mass index and physical examination was done, 5ml of venous blood was drawn by phlebotomist, sent for fasting blood sugar, serum lipids analysis and Framingham 10years risk score was calculated afterward for each participant. In this study males (126) and females (120). Overall (78%) had risk factors, Patients having one CVD risk factor were (22.8%), two risk factors in (21.1%), three in (21.5%), four (9.8%) and five factors in (1.6%) while frequency of modifiable cardiovascular risk shows obesity (45.5%) hypertension (40.2%) intermediate to high risk of framingham score (40%) diabetes mellitus (25%), smoking (17%), high low density lipoproteins (8.1%). In males obesity(54.2%), hypertension (47.5% ) and (45.8%) were on medication, diabetes mellitus(31.7%), smoker(31%), high risk FRS(39.2%), K-L grade-IV(58.4%) and in females: obesity (42%), hypertension (43.7%) and (40.5%) were on medication, diabetes mellitus in (19%), smoking (4%), high risk FRS (13.5%), K-L Grade-4 (42%), significant association of diabetes mellitus, smoking, FRS and K-L grades with gender (p<0.05). In OA knee there is high prevalence of modifiable cardiovascular risk factors and together these imposes a major health risk for future cardiac events and disability.

Clinical and radiographic characterization of three-dimensional gait profiles of patients with knee osteoarthritis

BackgroundPrevious authors have utilized gait kinematics to categorize knee osteoarthritis patients into four distinct profiles: (1) flexed knee; (2) externally rotated knee; (3) stiff knee; and (4) knee varus thrust and rotational rigidity. However, the relationship between these gait profiles and patients’ characteristics remains poorly understood. Thus, this study aimed to investigate whether differences in clinical and radiographic characteristics were associated with these four gait profiles. MethodsThis cross-sectional study used available data from a previous biomechanical study. Data on the four gait profiles were collected from 42 patients with advanced knee osteoarthritis. Three-dimensional kinematics of the knee was recorded during gait using an optoelectronic system. Subjects were evaluated for knee strength, range of motion, tibial slope, femorotibial angle, radiographic severity, anthropometric measurements, and patient-reported outcomes. Multiple comparisons were made using Dunn's test. The level of significance was set at 5%, and the effect size was calculated. FindingsBody mass index (BMI) was the only variable associated with a specific gait profile: profile 4 (P = 0.01; effect size = P1 × P4: −0.62; P2 × P4: −0.41; P3 × P4: −0.40). InterpretationOur findings suggest that most clinical and radiographic characteristics commonly measured in clinical practice did not differ significantly among knee osteoarthritis patients with the four different gait profiles. The only exception was a higher BMI noted in those with gait profile 4; however, it remains unclear whether it can cause varus thrust or rotation rigidity. The incorporation of three-dimensional motion analysis to identify gait profiles provided clinical insights beyond the limitations of traditional clinical assessments.

Relationship between knee osteophytes and calcitonin gene-related peptide concentrations of serum and synovial fluid in knee of osteoarthritis.

To explore the relationship between knee osteophytes of osteoarthritic knee and calcitonin gene-related peptide (CGRP) concentrations of serum and synovial fluid (SF). 65 patients with knee medial compartment osteoarthritis (OA) were recruited and examined with weight-bearing radiographs of the entire lower limb. The concentrations of CGRP in serum/SF were also detected in surgery. The relationship between the concentrations of CGRP in serum/SF and osteophyte scores were detected with Spearman rank correlation coefficient. CGRP concentrations in serum and SF were significantly correlated with osteophyte score of overall knee respectively (R = 0.462, P < .001; R = 0.435, P < .001). In addition, a correlation tended to be observed about the relationship between CGRP concentrations in serum and SF and osteophyte scores of medial compartment (R = 0.426, P < .001; R = 0.363, P = .003), and osteophyte scores of lateral compartment (R = 0.429, P < .001; R = 0.444, P < .001). In this study, the relationship between CGRP in serum/SF and knee osteophyte scores in different subregions were explored, which showed significant positive correlations, that possibly reflecting the contribution of CGRP influencing osteophyte formation. Positive correlations between osteophyte scores and CGRP suggest that CGRP promote the growth of osteophyte formation. It has the potential to be selected as a biomarker for the assessment of severity in knee OA patients and predict the progression of knee OA. It also provides a potential therapeutic target to delay the progression and relieve the symptom of OA.

EFFECTIVENESS OF PNF STRETCHING (CONTRACT-RELAX) IN KNEE OSTEOARTHRITIS

Osteoarthritis of the knee causes pain, restricted range of motion (ROM), diminished physical function, and other symptoms. Due to severe muscular weakness, stiffness, and joint pain, people with knee OA have demonstrated a reduction in their ability to use their lower limbs functionally1 .Hence the need for study is to compare the PNF stretching and conventional treatment in improving physical function and reducing pain in knee osteoarthritis. Objective: The goal of the research is to determine how PNF Stretching Technique and Conventional exercise affect knee osteoarthritis pain and physical function. Method: STUDY DESIGN: Experimental study. SAMPLING TECHNIQUE: Convenient Sampling technique. SAMPLE SIZE: 30. Result:The data that had been gathered was statistically analysed using an unpaired t-test. Compared to the traditional group, the PNF group exhibits, the test indicates significant effects (p 0.05) in lowering pain and improving physical function, as assessed by the NPRS and WOMAC questionnaires. Conclusion:PNF stretching exercises were found to be more successful than conventional exercise in OA knee patients in relieving pain and improving functional ability. Key Words:Osteoarthritis, NPRS, WOMAC questionnaire, PNF Stretching exercise , conventionaltherapy.

Medial and lateral knee contact forces during walking, stair ascent and stair descent are more affected by contact locations than tibiofemoral alignment in knee osteoarthritis patients with varus malalignment.

Introduction: Knee OA progression is related to medial knee contact forces, which can be altered by anatomical parameters of tibiofemoral alignment and contact point locations. There is limited and controversial literature on medial-lateral force distribution and the effect of anatomical parameters, especially in motor activities different from walking. We analyzed the effect of tibiofemoral alignment and contact point locations on knee contact forces, and the medial-lateral force distribution in knee OA subjects with varus malalignment during walking, stair ascending and stair descending. Methods: Fifty-one knee OA subjects with varus malalignment underwent weight-bearing radiographs and motion capture during walking, stair ascending and stair descending. We created a set of four musculoskeletal models per subject with increasing level of personalization, and calculated medial and lateral knee contact forces. To analyze the effect of the anatomical parameters, statistically-significant differences in knee contact forces among models were evaluated. Then, to analyze the force distribution, the medial-to-total contact force ratios were calculated from the fully-informed models. In addition, a multiple regression analysis was performed to evaluate correlations between forces and anatomical parameters. Results: The anatomical parameters significantly affected the knee contact forces. However, the contact points decreased medial forces and increased lateral forces and led to more marked variations compared to tibiofemoral alignment, which produced an opposite effect. The forces were less medially-distributed during stair negotiation, with medial-to-total ratios below 50% at force peaks. The anatomical parameters explained 30%-67% of the variability in the knee forces, where the medial contact points were the best predictors of medial contact forces. Discussion: Including personalized locations of contact points is crucial when analyzing knee contact forces in subjects with varus malalignment, and especially the medial contact points have a major effect on the forces rather than tibiofemoral alignment. Remarkably, the medial-lateral force distribution depends on the motor activity, where stair ascending and descending show increased lateral forces that lead to less medially-distributed loads compared to walking.

A standardized nutraceutical supplement contributes to pain relief, improves quality of life and regulates inflammation in knee osteoarthritis patients; A randomized clinical trial

Osteoarthritis (OA) is a degenerative disease of the joints that affects greatly the elderly population and the health care systems and is on the increase due to aging and obesity. Interventions aim at palliative care and pharmaceutical therapies entail serious adverse events. Whereas polyphenols constitute a promising holistic approach in the arsenal of physicians, trials investigating biomarkers and questionnaires are scarce. As such, a randomized controlled trial (RCT) was conducted to evaluate the potency of a standardized polyphenolic supplement in the management of systemic inflammation, oxidative stress, pain and general quality of life (QoL) in patients with osteoarthritis. Sixty subjects were randomized to receive either a polyphenol supplement (curcuma phospholipid, rosemary extract, resveratrol, ascorbic acid), or an active comparator (ascorbic acid) twice, daily for 12 weeks. The group that received the polyphenols exhibited significantly lower symptoms of pain and improved physical function and QoL as it was depicted by validated questionnaires, compared to the control group. Furthermore, post intervention, inflammation was restrained in the polyphenol group. Since systemic inflammation promotes local inflammation, the decrease of pain herein might be attributed to the attenuation of systemic inflammation by the polyphenols.