Knee Pain Visual Analog Scale Research Articles

Effect of anterior femoral cortical notch grade on postoperative function and complications during TKA surgery: A multicenter, retrospective study.

To explore the effect of AFN on knee function and complications in patients after TKA. We evaluated 150 patients undergoing unilateral TKA, specifically including 102 patients with varying degrees of AFN after selection. They were divided into four groups based on AFN grade. About 48 patients did not produce AFN, 63 patients were grade I, 29 patients were grade II, and 10 patients were grade III. All patients were followed up for 24 months, and knee function, pain, complications, and other indicators were compared between the four groups. Correlation analysis and regression analysis were used to study the relationship between AFN and other indicators. Two cases of periprosthetic fractures (PPF) occurred in our study, with an incidence of 1.35%, which did not show a significant association with AFN. The changes in knee social score (ΔKSS), Western Ontario and McMaster Universities Osteoarthritis Index (ΔWOMAC), and postoperative anterior knee pain visual analog scale (VAS) score were higher in patients with AFN than in those without. Particularly, grades II and III AFN demonstrated superior efficacy. Pearson's correlation analysis showed that AFN grade is positively correlated with both ΔKSS and ΔWOMAC (r = 0.44, P < 0.001), and AFN grade had a negative correlation with the anterior knee pain VAS (r = -0.250, P < 0.05). In linear regression analysis, AFN grade was positively correlated with both ΔKSS (β = 5.974, 95% CI: 3.968-7.981, P < 0.001) and ΔWOMAC (β = 6.356, 95% CI: 4.223-8.490, P < 0.001). Besides that, there was a negative correlation between AFN grade and anterior knee pain (β = 5.974, 95% CI: 3.968-7.981, P < 0.05). Patients with grade II and III AFN who underwent TKA exhibited better knee function and lower levels of anterior knee pain post-surgery.

＜Editors' Choice＞ The relationship between preoperative foot alignment and postoperative outcomes in patients who underwent initial total knee arthroplasty.

We compared the relationship between foot alignments and quality of life in patients who underwent initial total knee arthroplasty (TKA). Among the patients with knee osteoarthritis (KOA) who underwent TKA from May 2015 to May 2017 at our hospital, we focused on those in whom weight-bearing foot radiographs had been evaluated preoperatively. The hallux valgus angle and Meary angle were measured by preoperative radiography, and those with hallux valgus angles of 20 degrees or more were classified into the hallux valgus (HV) group, and those with Meary angles of 4 degrees or more into the high arch (HA) group. Also knee and ankle range of motion, knee pain Visual Analog Scale, and the 36-item short-form health survey (SF-36) were measured preoperatively and at discharge, and the amount of these changes was compared in the presence/absence of HV and HA. Regarding HV, there were no significant differences in any of these items between the HV and non-HV groups. However, the SF-physical function was significantly lower in the HA group than in the normal group. In addition, ankle dorsiflexion was lower in the HA group than that in the normal group, although this difference was not statistically significant. There was little improvement of the ankle dorsiflexion, and it was associated with deterioration of the physical function items of SF-36. In total knee arthroplasty patients with HA, physical therapy of the ankles and feet, as well as of the knees, was considered to enhance the improvement of physical function.

Decision-making factors and their thresholds for total knee arthroplasty in lateral tibiofemoral osteoarthritis patients: a retrospective cohort study

BackgroundThere has been no study examining lateral tibiofemoral (TF) osteoarthritis (OA) and objective decision-making factors affecting when patients decide to have total knee arthroplasty (TKA). The purpose of this study was to assess which factors and their thresholds cause patients with lateral TF OA to decide on TKA.MethodsWe conducted a retrospective cohort study and identified patients who had initially been diagnosed with isolated lateral TF OA from October 2004 to February 2021. We finally included 56 patients; patients who had chosen conservative treatment followed by in-depth interviews for the deliberation stage (n = 32), and the other patients who decided to undergo TKA for the decision-making stage (n = 24). Demographic, clinical, and radiographic characteristics were considered candidate predictive factors. Radiographic variables included the Ahlbäck grade, hip–knee–ankle (HKA) angle, joint line convergence angle (JLCA), and TF subluxation. Univariate and multivariate logistic regression analyses were performed.ResultsClinically, the pain visual analog scale (VAS) score was significantly higher and the knee flexion angle was lower at the decision-making stage. Radiographic measurements showed that the Ahlbäck grade, HKA angle, JLCA, and TF subluxation measured at the center, in addition to the tibiotalar angle, differed statistically between the two stages. According to univariate analyses, two clinical characteristics and six radiographic variables on the ipsilateral side of the leg, and one radiographic variable on the contralateral side of the leg were included as factors influencing the patients’ decision to undergo TKA. After making adjustments based on multivariate analysis, the ipsilateral knee pain VAS (OR = 1.61; 95% CI = 1.14–2.28, p = 0.007) and medial TF subluxation measured at the center (OR = 1.14, 95% CI = 1.01–1.32, p = 0.072) were found to be significant factors for choosing TKA. The area under the curve (AUC) for pain VAS was 0.757 and the cutoff value was 4.5. The AUC for TF subluxation measured at the center was 0.697 and the cutoff value was −4.10% of medial TF subluxation.ConclusionHigher ipsilateral knee pain VAS and more severe medial TF subluxation measured at the center were independent factors affecting patient decisions to undergo TKA with lateral TF OA. Understanding the determining factors that may affect patient decision-making when considering TKA may be an essential aspect of evaluating the prognosis of patients with lateral TF OA.Level of evidenceIII.

The Efficacy and Safety of Highly-Bioavailable Curcumin for Treating Knee Osteoarthritis: A 6-Month Open-Labeled Prospective Study.

Background:We previously developed a surface-controlled water-dispersible form of curcumin that we called Theracurmin®. The area under the blood concentration-time curve (AUC) of Theracurmin in humans was 27-fold higher than that of curcumin powder. Previously, we reported on the anti-inflammatory effects of Theracurmin for knee osteoarthritis.Hypothesis/Purpose:We determined the clinical effects of orally administered Theracurmin in patients with knee osteoarthritis over a 6-month period.Study Design:Open prospective study.Methods:Fifty patients Kellgren-Lawrence grade II, III, or IV knee osteoarthritis who were above 40 years old were enrolled in this clinical study. Theracurmin containing 180 mg/day of curcumin was administered orally every day for 6 months. To monitor for adverse events, blood biochemistry analyses were performed before and after 6 months of each intervention. The patients’ knee symptoms were evaluated at 0, 1, 2, 3, 4, 5, and 6 months based on the Japanese Knee Osteoarthritis Measure, the knee pain visual analog scale, and the knee scoring system of the Japanese Orthopedic Association.Results:Five cases dropped out during the study, but no cases dropped out because of major problems. No major side effects were observed with Theracurmin treatment, including the blood biochemistry analysis results. The effective group included 34 cases (75.6%), while the not-effective group included 11 cases.Conclusion:This study demonstrates the safety and good efficacy of Theracurmin for various types of knee osteoarthritis. Theracurmin shows great potential for the treatment of human knee osteoarthritis.

Efficacy of JOINS on Cartilage Protection in Knee Osteoarthritis: Prospective Randomized Controlled Trial.

PurposeIn this study, we compared the clinical efficacy of JOINS (SKI306X, SK Chemicals) with placebo on cartilage protection using magnetic resonance imaging (MRI).Materials and MethodsSixty-nine patients were randomized to the JOINS group (200 mg, three times daily for 1 year; n=33) or the placebo group (n=36). Changes in cartilage volume and thickness were measured using MRI. Changes in the delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) index, subchondral bone marrow abnormality scores, and clinical scores including knee pain visual analog scale (VAS) score and Korean Western Ontario and McMaster Universities Osteoarthritis Index (K-WOMAC) were also evaluated.ResultsChanges in cartilage thickness and volume and subarticular bone marrow abnormality scores were not different between groups. Changes in the dGEMRIC index in the lateral tibial plateau were greater in the JOINS group than in the placebo group (19.64±114.33 msec vs. −57.77±123.30 msec; p=0.011). Significantly greater changes in VAS were observed in the JOINS group than in the placebo group (−26.00±12.25 vs. −12.47±21.54; p=0.002) and K-WOMAC (−15.42 ± 7.73 vs. −8.15±13.71; p=0.003).ConclusionsCompared with placebo, JOINS had superior clinical efficacy in regard to cartilage protection.

Removal of interlocking intramedullary nail for relieve of knee pain after tibial fracture repair

To investigate the effects of intramedullary nail removal after tibial fracture repair. Sixty patients at our hospital were enrolled in a prospective study and divided into moderate/severe knee pain (visual analog scale (VAS) ≥ 4) and mild/no knee pain (VAS < 4) groups after interlocking intramedullary nailing. Variables studied included the distance from the tip of the nail to the tibial plateau and the front of the tibia on a normalized lateral X-ray, the VAS score of knee and ankle pain, the range of motion of the knee and ankle, and Johner-Wruhs criteria before, 6 weeks after operation, and at the last follow-up. Fifty-seven patients were followed for a mean of 8.4 (2-17) months. In patients with moderate or severe knee pain intramedullary nail removal led to significant pain reductions ( p < 0.05). A significantly shorter distance from the tip of the nail to the tibial plateau (<10 mm) and the anterior border of tibia (<6 mm) was found in the 24 patients with moderate or severe knee pain. Knee pain VAS scores significantly lowered 6 weeks postoperatively and at the last follow-up, compared to before the operation ( p < 0.05). However, no significant changes occurred with respect to ankle pain VAS scores, range of motion, and Johner-Wruhs criteria ( p > 0.05). For patients complaining knee pain after interlocking intramedullary nailing of tibial fractures, especially with a short distance from the tip of the nail tail to the tibial plateau (<10 mm) and the anterior border of the tibia (<6 mm) removal of the intramedullary nails relieved the pain significantly.

Short-term effects of highly-bioavailable curcumin for treating knee osteoarthritis: a randomized, double-blind, placebo-controlled prospective study

Background We previously developed a surface-controlled water-dispersible form of curcumin and named it Theracurmin® (Theracurmin; Theravalues, Tokyo, Japan). The area under the blood concentration–time curve of Theracurmin in humans was 27-fold higher than that of curcumin powder. We determined the clinical effects of orally administered Theracurmin in patients with knee osteoarthritis during 8 weeks of treatment.Methods Fifty patients with knee osteoarthritis of Kellgren–Lawrence grade II or III and who were aged more than 40 years were enrolled in this randomized, double-blind, placebo-controlled, prospective clinical study. Placebo or Theracurmin containing 180 mg/day of curcumin was administered orally every day for 8 weeks. To monitor adverse events, blood biochemistry analyses were performed before and after 8 weeks of each intervention. The patients’ knee symptoms were evaluated at 0, 2, 4, 6, and 8 weeks by the Japanese Knee Osteoarthritis Measure, the knee pain visual analog scale (VAS), the knee scoring system of the Japanese Orthopedic Association, and the need for nonsteroidal anti-inflammatory drugs.Results At 8 weeks after treatment initiation, knee pain VAS scores were significantly lower in the Theracurmin group than in the placebo group, except in the patients with initial VAS scores of 0.15 or less. Theracurmin lowered the celecoxib dependence significantly more than placebo. No major side effects were observed with Theracurmin treatment.Conclusion Theracurmin shows modest potential for the treatment of human knee osteoarthritis.