Life In Osteoarthritis Research Articles

A Comprehensive Update of Prolotherapy in the Management of Osteoarthritis of the Knee.

This is a comprehensive review of the literature focusing on the use of prolotherapy in the treatment of osteoarthritis of the knee. It covers the background, efficacy, and advantages of prolotherapy in the management of osteoarthritis symptoms and then covers the existing evidence of the use of prolotherapy for this purpose. Current treatments for osteoarthritis of the knee are numerous, yet patients continue to endorse chronic pain and poor quality of life. Prolotherapy is a treatment that has been inadequately studied with poor sample sizes and lack of standardization between trials. However, in recent years the literature on prolotherapy in the treatment of knee osteoarthritis has grown. Although there is still a lack of homogeneity, trials have shown that dextrose prolotherapy, autologous conditioned serum, hyaluronic injections, and normal saline administered either intra- or peri-articularly are comparable in reducing pain scores to other primary treatment options. The mechanism of action for prolotherapy is still unclear, but researchers have found that prolotherapy plays some role in cartilage growth or chondrogenesis and has been shown to have improved radiographic outcomes. Prolotherapy appears to be a safe treatment alternative that has been shown to improve stiffness, pain, function, and quality of life in osteoarthritis of the knee. Knee osteoarthritis is remarkably prevalent in the United States and is one of the most common causes of disability in the elderly population. Although there are many treatment options, patients continue to live with chronic pain which can incur high costs for patients. A safe, long-term, and effective solution has not yet been identified. Prolotherapy has been shown to be a safe option for improving pain, function, and quality of life as effectively as other treatment options.

Quality of Life in Osteoarthritis: Relationship with Demographic and Clinical Variables

Quality of Life in Osteoarthritis: Relationship with Demographic and Clinical Variables

Trajectory of healthcare use at end of life in osteoarthritis: a matched cohort study

Purpose: Previous research suggests an increasing trend in the healthcare use towards death. However, little is known about the healthcare use in the last year of life among patients with osteoarthritis (OA). In this study, we aimed to fill this knowledge gap by comparing healthcare use at last year of life in persons with and without OA. Methods: The study is based on register data for the entire population of Skåne, the southernmost region in Sweden with a population of about 1.3 million in 2014 (13.2% of the Sweden’s population). The subjects were eligible for the study if they: 1) resided in Skåne in the 5 years prior to death, 2) were aged ≥65 years at death, 3) died between January 1, 2003 and December 31, 2014. Among eligible subjects, we identified those with a principal OA diagnosis (knee, hip, hand or other location) prior to the last year of life using data from the Skåne Healthcare Register (SHR) between 1998 and 2014 (n=18,520). For each OA subject, we randomly selected up to 4 comparators free of diagnosed OA (n=59,945) matched by sex, age at death, and year of death (527 persons with OA did not have any matched comparator and were excluded). We measured monthly physical healthcare consultations and inpatient days for each individual during the last 12 months of life. We applied two-part regression models to estimate the total and incremental healthcare use attributable to OA adjusted for sociodemographic variables and comorbidity. Results: During the last year of life, the estimated number of healthcare consultations per-person in the OA cohort was 18.7 (95% CI 18.4, 19.0) versus 16.2 (95% CI 16.0, 16.3) in subjects without OA, corresponding to an incremental healthcare consultation of 2.5 (95% CI 2.2, 2.8) per-person attributable to OA (1.2 [95% CI 1.1, 1.4] primary care consultations, 1.1 [0.9, 1.3] secondary outpatient care consultations, and 0.2 [0.1, 0.2] hospital admissions per-person). Moreover, persons with OA spent, on average, 1.8 (95% CI 1.3, 2.1) more days in hospital than their non-OA comparators during the last year of life. In both cohorts the healthcare consultations and inpatient days increased towards death (Figure 1). While excess healthcare consultations attributable to OA declined with time to death, the opposite was seen for inpatient days (Figure 2). Conclusions: OA was associated with greater healthcare use during the individuals’ last year of life. The contribution of hospital-based care increased toward deaths and this was more pronounced among persons with OA than those without, highlighting the need for improvement in outpatient care for OA patients.Figure 2Mean monthly excess healthcare consultations and inpatient days per-person attributable to osteoarthritis.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Immunoregulatory properties of I.A. mesenchymal stem cells are maintained in a xenogenic animal model

Purpose: Osteoarthritis is a chronic joint disease afflicting a significant portion of the world’s population with no currently available cure. Clinical trials using mesenchymal stem cell-based therapies have a positive effect on pain and quality of life in osteoarthritis but the mechanism of action remains unclear. This study aimed to identify the lymphocyte response to a xenogeneic human umbilical cord-derived MSC-based cell therapy in the face of osteoarthritis progression. Methods: A unilateral medial meniscal release model was employed in 14 sheep to create OA where n=7 sheep received I.A. cell therapy (OACT) in the operated knee and n=7 received saline as controls (OA). Another unoperated group (n=7) received cell therapy (CT Control). Three months later IA cell therapy consisting of 1.0× 107 Human SHC-MSCs* (Small Mesenchymal Stem Cells primed with Hypoxia and Calcium ions) was administered into the medial knee joint space. Synovial fluid was aspirated periodically for 13 weeks for flow cytometry analysis. At termination of the study, the stifle joints underwent macroscopic and histologic assessments using the OARSI histology scoring system for subchondral bone, cartilage and synovial membrane. Flow cytometry data was analyzed with a linear mixed effects model while pathology scores were analyzed by the Mann-Whitney U test and Wilcoxon signed rank test, with the Bonferroni correction for multiple comparisons. Results: There were no adverse reactions to the I.A. therapy. Cell therapy administration induced an influx of CD4+ leukocytes (Fig 1). Of these there was a significant increase in the proportion of CD4+CD25+ and CD4+CD25hi leukocytes; the CD4+CD25hi being subset that may be composed of regulatory T cells. There was no significant effect of the cell therapy treatment on the proportion of synovial fluid CD8+ cells or B cells (BAQ44A+), and B cells occurred in small numbers. Conclusions: Xenogeneic cell therapy did not trigger a classical host versus graft reaction leading to tissue injury. Cell therapy induced chemotaxis of CD4+ cells to the joint space but this was not associated with pathological change in tissues. Despite expression of activation markers (CD25+) these cells may regulate the immune response since CD4+cells can be sources of anti-inflammatory cytokines such as IL-4 and IL-10, as well as inhibiting the release of pro-inflammatory cytokines such as IL-1β or TNF-α. These findings support the notion that phenomena unrelated to long-term survival and engraftment of injected cells may have clear immunoregulatory effects.

Massage Therapy and Quality of Life in Osteoarthritis of the Knee: A Qualitative Study.

We hypothesized that participants receiving Swedish massage would experience benefits such as stress reduction and enhanced quality of life, in addition to the osteoarthritis-specific effects assessed in a randomized controlled clinical trial. Qualitative methods were used to explore a deeper contextual understanding of participants' experiences with massage and osteoarthritis, in addition to the quantitative data collected from primary and secondary outcome measures of the dose-finding study. Two community hospitals affiliated with academic health centers in Connecticut and New Jersey. Eighteen adults who previously participated in a dose-finding clinical trial of massage therapy for osteoarthritis of the knee. Face-to-face and telephone interviews using a standardized interview guide. Triangulation of qualitative and quantitative data allowed for a more thorough understanding of the effects of massage therapy. Three salient themes emerged from our analysis. Participants discussed 1) relaxation effects, 2) improved quality of life associated with receiving massage therapy, and 3) the accessibility of massage therapy in treating osteoarthritis. Participant responses noted empowerment with an improved ability to perform activities of daily living after experiencing massage therapy. The majority of statements were consistent with their quantitative changes on standard osteoarthritis measures. Future research in pain conditions should include health-related quality of life assessments as well as outcomes related to perceived well-being, along with greater exploration of the concept of salutogenic side effects of an intervention in the context of complementary and integrative therapies.

Pain, disability and health-related quality of life in osteoarthritis-joint matters: an observational, multi-specialty trans-national follow-up study.

The authors aimed to test potential relations between osteoarthritis (OA) features, disability and health-related quality of life (HR-QoL) at different body locations. Outpatients consulting for pain associated to self-reported OA at varied healthcare settings were evaluated in a 3-month observational non-controlled follow-up study. Socio-demographic/anthropometric and medical data were collected at three time points. Lequesne's indices, quick-disabilities of arm, shoulder and hand (DASH) and Oswestry questionnaires provided measures of physical function and disability. HR-QoL measures were obtained with EuroQol-5 Dimensions. Multivariate analyses were used to evaluate the differences of pain severity across body regions and the correlates of disability and HR-QoL. Six thousand patients were evaluated. Pain lasted 2years or more in 3995 patients. The mean pain severity at baseline was moderate (6.4 points). On average, patients had pain in 1.9 joints/areas. The pain was more severe when OA involved the spine or all body regions. Pain severity explained much of the variance in disability and HR-QoL; this association was less relevant in patients with OA in the upper limbs. There were considerable improvements at follow up. Pain severity improved as did disability, which showed particularly strong associations with HR-QoL improvements. Pain severity is associated with functional limitations, disability and poor HR-QoL in patients with self-reported OA. Functional limitations might have particular relevance when OA affects the upper limbs. Improvements are feasible in many patients who consult because of their pain.

Quality of life in patients with knee and hip osteoarthritis

ObjectiveTo evaluate the quality of life in patients with knee and hip osteoarthritis through self-assessment and those made by the physician. Materials and methodsAn observational and cross-sectional multicenter study in which 628 traumatologists or rheumatologists evaluated 1849 patients with knee and/or hip osteoarthritis, aged ≥50 years old, and representative of 49 Spanish provinces. Each researcher evaluated three patients and also completed the SF-12v2 health questionnaire. The patients completed the WOMAC and SF-12v2 questionnaires. ResultsThe patients were 68.5±9.5 years old, 61.5% had knee osteoarthritis, 19% had hip osteoarthritis, and 19.5% in both locations. Older patients and those who had both knee and hip osteoarthritis had a poorer quality of life, according to patients and researchers. Physical health perceived by the researchers was better than patients reported (36.74±8.6 and 35.21±8.53; respectively, p<0.001), and the mental health score was similar between physicians and patients. Kellgren/Lawrence scale and test Timed Up & Go predict better the quality of life, assessed by WOMAC and SF-12v2 questionnaires. DiscussionThis is the Spanish study on quality of life in osteoarthritis of the knee and hip of larger amplitude and number of patients. ConclusionThese results could be considered as reference values of Spanish population aged ≥50 years with knee or hip osteoarthritis.

Calidad de vida en pacientes con artrosis de rodilla y/o cadera

ObjectiveTo evaluate the quality of life in patients with knee and hip osteoarthritis through self-assessment and those made by the physician. Materials and methodsAn observational and cross-sectional multicenter study in which 628 traumatologists or rheumatologists evaluated 1,849 patients with knee and/or hip osteoarthritis, aged≥50 years old, and representative of 49 Spanish provinces. Each researcher evaluated three patients and also completed the SF-12v2 health questionnaire. The patients completed the WOMAC and SF-12v2 questionnaires. ResultsThe patients were 68.5±9.5 years old, 61.5% had knee osteoarthritis, 19% had hip osteoarthritis, and 19.5% in both locations. Older patients and those who had both knee and hip osteoarthritis had a poorer quality of life, according to patients and researchers. Physical health perceived by the researchers was better than patients reported (36.74±8.6 and 35.21±8.53; respectively, p<0.001), and the mental health score was similar between physicians and patients. Kellgren/Lawrence scale and test Timed Up & Go predict better the quality of life, assessed by WOMAC and SF-12v2 questionnaires. DiscussionThis is the Spanish study on quality of life in osteoarthritis of the knee and hip of larger amplitude and number of patients. ConclusionThese results could be considered as reference values of Spanish population aged ≥50 years with knee or hip osteoarthritis.

Perceptions of Massage Therapists Serving in a Randomized Controlled Trial

The Journal of Alternative and Complementary MedicineVol. 20, No. 5 Clinical ResearchPerceptions of Massage Therapists Serving in a Randomized Controlled TrialTeresa Keever, Ather Ali, and Adam PerlmanTeresa KeeverSearch for more papers by this author, Ather AliSearch for more papers by this author, and Adam PerlmanSearch for more papers by this authorPublished Online:7 May 2014https://doi.org/10.1089/acm.2014.5194.abstractAboutSectionsView articleView Full TextPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail View article"Perceptions of Massage Therapists Serving in a Randomized Controlled Trial." The Journal of Alternative and Complementary Medicine, 20(5), p. A74FiguresReferencesRelatedDetailsCited byThe Effectiveness of Tuina in Relieving Pain, Negative Emotions, and Disability in Knee Osteoarthritis: A Randomized Controlled Trial23 August 2022 | Pain Medicine, Vol. 365Massage Therapy and Quality of Life in Osteoarthritis of the Knee: A Qualitative Study1 September 2016 | Pain Medicine, Vol. 32 Volume 20Issue 5May 2014 InformationCopyright 2014, Mary Ann Liebert, Inc.To cite this article:Teresa Keever, Ather Ali, and Adam Perlman.Perceptions of Massage Therapists Serving in a Randomized Controlled Trial.The Journal of Alternative and Complementary Medicine.May 2014.A74-A74.http://doi.org/10.1089/acm.2014.5194.abstractPublished in Volume: 20 Issue 5: May 7, 2014PDF download

Effect of an integrated approach of yoga therapy on quality of life in osteoarthritis of the knee joint: A randomized control study

Aim:This study was designed to evaluate the efficacy of addition of integrated yoga therapy to therapeutic exercises in osteoarthritis (OA) of knee joints.Materials and Methods:This was a prospective randomized active control trial. A total of t participants with OA of knee joints between 35 and 80 years (yoga, 59.56 ± 9.54 and control, 59.42 ± 10.66) from the outpatient department of Dr. John's Orthopedic Center, Bengaluru, were randomly assigned to receive yoga or physiotherapy exercises after transcutaneous electrical stimulation and ultrasound treatment of the affected knee joints. Both groups practiced supervised intervention (40 min per day) for 2 weeks (6 days per week) with followup for 3 months. The module of integrated yoga consisted of shithilikaranavyayama (loosening and strengthening), asanas, relaxation techniques, pranayama, meditation and didactic lectures on yama, niyama, jnana yoga, bhakti yoga, and karma yoga for a healthy lifestyle change. The control group also had supervised physiotherapy exercises. A total of 118 (yoga) and 117 (control) were available for final analysis.Results:Significant differences were observed within (P < 0.001, Wilcoxon's) and between groups (P < 0.001, Mann–Whitney U-test) on all domains of the Short Form-36 (P < 0.004), with better results in the yoga group than in the control group, both at 15th day and 90th day.Conclusion:An integrated approach of yoga therapy is better than therapeutic exercises as an adjunct to transcutaneous electrical stimulation and ultrasound treatment in improving knee disability and quality of life in patients with OA knees.

The effects of intra-articular hyaluronic acid for quality of life in osteoarthritis of the knee

The effects of intra-articular hyaluronic acid for quality of life in osteoarthritis of the knee

Methods Used to Assess Clinical Outcome and Quality of Life in Osteoarthritis

Methods Used to Assess Clinical Outcome and Quality of Life in Osteoarthritis