Osteoarthritis Of Knee Joint Research Articles

Efficacy of Open versus Closed Kinetic Chain Exercises on Dynamic Balance and Health Status in Individuals with Osteoarthritis of Knee Joint: A Quasi-experimental Study

Introduction: Osteoarthritis is an inflammatory disorder characterised by changes in the biomechanics, biochemistry and genetic background of joint cartilage and subchondral bone. When distal parts move freely throughout exercises in a weight-bearing position, the phrase open kinetic exercises is employed. Closed kinetic exercises are employed in a weight-bearing position when the body travels through a hard and quick distal phase. Aim: To compare the efficacy of Open Kinetic Chain (OKC) and Closed Kinetic Chain (CKC) exercises on dynamic balance and health status in individuals with osteoarthritis of knee joint. Materials and Method: A single-blinded experimental study was conducted from April 2020 to May 2021 at Dr D.Y. Patil college of Physiotherapy, Pimpri-Chinchwad area, Pune, Maharashtra, India. A sample of 30 subjects with unilateral osteoarthritis of knee joint, between the age of 40-60 years of both genders, were recruited. They were divided into open kinetic group (Group A) and closed kinetic group (Group B) using convenient sampling method. Y-balance and Western Ontario and McMaster Universities Index of Osteoarthritis (WOMAC) (Pune CRD version) were used as outcome measures-preintervention, post two weeks and post four weeks of intervention. Data normality was tested by Shapiro-wilk test. Significance was tested using paired t-test within the groups for WOMAC and Y-balance test. Unpaired t-test was used between the groups. Results: Among 30 subjects, 17 were males and 13 females. There was a significant improvement in dynamic balance (p-value=0.001) and WOMAC (p-value=0.001) in both the groups. In group A, preintervention mean values for WOMAC was 41.2±10.53, and post four weeks of intervention it was 34.53±10.12 (p-value=0.001). Preintervention mean for Y-balance test was 0.554±14.6 and after four weeks of intervention mean was 0.586±13.8 (p-value <0.001). In group B, preintervention mean for WOMAC was 40.87±8.33, and after four weeks of intervention, mean was 30.47±7.22 (p-value=0.001); while preintervention mean for Y-balance test was 0.583±7.8 and after four weeks of intervention, mean was 0.645±7.0 (p-value=0.001). Between groups, analysis showed p-value=0.051 for both groups post four weeks of intervention. Conclusion: The study concluded that CKC exercises are more effective than OKC exercises in improving dynamic balance and decrease in pain, stiffness, and improving physical function in knee osteoarthritis.

Comparative Effect of Core Stability and Hip Strengthening in Patients with Knee Joint Osteoarthritis: A Randomized Feasibility Trial

Comparative Effect of Core Stability and Hip Strengthening in Patients with Knee Joint Osteoarthritis: A Randomized Feasibility Trial

SYSADOA place in degenerative-dystrophic joints diseases treatment of neurological practice from the standpoint of evidence-based medicine

Neurologists in their practice often face pain syndrome against the background of degenerative-dystrophic changes in the spine, in the therapy of which drugs of delayed-action symptomatic therapy of osteoarthritis (OA) (Symptomatic Slow Acting Drugs for OsteoArthritis, SYSADOA) are used. SYSADOA includes medicinal drugs (MD) containing chondroitin sulfate (CS), glucosamine, avocado/soy unsaponifiables (ASU), diacerein, intra-articular hyaluronic acid, which can give symptomatic benefit with low toxicity, and with prolonged (up to 6 months) the course of treatment. In Russia, they are guided by the clinical recommendations of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO), in which the algorithm for managing patients with knee joint OA with the appointment of CS and glucosamine sulfate (GS) form the basic part of the treatment of OA (Step 1). In order to achieve the expected clinical effects in patients with OA medical drugs (MD) of the SYSADOA class must meet the following criteria: 1) be of pharmaceutical quality and standardization with studied pharmacokinetics; 2) meet the criteria of evidence-based medicine (to have randomized clinical trials (RCTs), to have confirmed the effectiveness of meta-analyses of studies and /or systematic reviews, to have confirmed the safety of use in comorbid patients, to have the conclusions of fundamental and clinical studies of recent years justifying the need for its use); 3) be approved by the regulator - the Ministry of Health of the Russian Federation (be present in the current Clinical Recommendations of the Ministry of Health of the Russian Federation and standards for the treatment of diseases of the musculoskeletal system); 4) be approved and recommended by international and Russian professional communities, associations, experts; 5) have clinical and economic advantages in terms of the outcomes of therapy and the lowest cost-effectiveness coefficient per patient. After analyzing the research materials, it was concluded that the pharmacologically standardized CS (Chondroguard®) satisfies all the above criteria for the reasonable choice of a SYSADOA class MD for the treatment of patients with OA of various localization.

Complex effects of physical exertion with dietary supplements Cartilox in pain syndrome effectiveness and safety evaluation

To Identify the effect of physical activity complex effects with dietary supplements Cartilox (composition: hydrolyzed type II collagen, hyaluronic acid, boswellia, curcumin, piperine) on the severity of pain syndrome in OA knee and hip joint patients, low back pain (LBP); assessment of the need for the appointment of NSAIDs against the background of taking Cartilox. The study included 60 patients aged 35-65 years, with a confirmed diagnosis of knee and hip OA I-II st., LBP with a slight degree of severity of pain syndrome - 4-5 points on a numerical rating scale (NRS). Patients with comorbid diseases: arterial hypertension (AH), type 2 diabetes mellitus (DM-2), hypothyroidism, diseases of the gastrointestinal tract (gastrointestinal tract). By randomization, the patients were divided into two groups: Main group (n=30; 54.36±8.57 years) received a complex effect of non-drug therapy (physical therapy complex) with dietary supplements Cartilox 1 sachet per day during or immediately after meals for 1 month, in combination with non-medical therapy (physical therapy complex). And Control group (n=30; 53.03±16.18 years) used only non-medical therapy (physical therapy complex). In both groups, topical NSAIDs were used «on demand». The patients included in the study had imaging data of the spine and joints. Clinical and neurological examination was used: day 0 (Visit 1), Day 14 (Visit 2), Day 30 (Visit 3) of therapy. The dynamics of the condition was assessed: 10-point NRS of pain assessment (at rest, while walking, palpation), functional status of Oswestry Disability Index (ODI), blood pressure (BP) was measured, the dynamics of biochemical parameters (before and after 30 days) of blood glucose, liver enzymes (AST, ALT), weight indicators, registration of adverse events (AEs). A sub-objective assessment (1 to 5 balls) was given to the patient and the physician. Against the background of taking Cartilox, a statistically significant decrease in the severity of pain syndrome was noted, an improvement on ODI (to a greater extent in the Main group vs the Control group). In no case has a registered AEs. Changes in the level of biochemical blood parameters (glucose, liver enzymes) and blood pressure levels were not observed. The topical NSAIDs use was observed only in the Control group. The complex effect of physical exertion with dietary supplements Cartilox can be recommended for patients with unexpressed pain syndrome (4-5 points on the NRS) with LBP and knee and hip OA (I-II st.). The absence of changes in the level of biochemical parameters of blood and blood pressure makes it possible to recommend Cartilox to patients with OA and comorbid diseases.

Early failure of all polyethylene tibial components in bilateral total knee arthroplasty: A case report

Introduction: Outcomes of Total Knee Arthroplasty (TKA) performed with modern all polyethylene (AP) tibial components have been reported to be comparable with or better than those TKAs performed using metal-backed modular (MBM) tibial components in several medium and long term studies. As AP components also provide substantial cost savings, there has been increase in their use in primary TKA. In spite of such good results, failure of AP tibial components has been reported.Case Presentation: A sixty three year old lady operated for bilateral cruciate retaining PFC Sigma TKA utilizing AP tibial components without patellar resurfacing in 2011 presented to us in December 2014 with two-year history of severe pain in both knees and inability to walk or stand. She had marked varus deformity of both knees. Radiological examination revealed fracture of the medial tibial plateau with failure of AP tibial component and marked varus deformity. She was treated with bilateral staged revision TKA which resulted in a satisfactory outcome. Conclusion: This case report describes previously unreported complication of AP tibial component following cruciate retaining bilateral AP tibia PFC Sigma TKA in a patient of varus osteoarthritis of knee joint. Early collapse of medial tibial plateau leading to failure of bilateral TKA, which could be attributed to under correction of varus deformity and instability, was managed with bilateral revision TKA using tibial metaphyseal sleeves which led to a very satisfactory outcome and excellent five year follow up.

High Tibial Osteotomy versus Proximal Fibular Osteotomy in Medial Compartmental Osteoarthritis of Knee: A Longitudinal Study

Introduction: Osteoarthritis (OA) is a chronic degenerative intra-articular disorder of cartilage and bone. Knee joint is most commonly involved due to its pivotal role in weight bearing as it is constantly exposed to wear and tear. Osteotomy procedures can achieve normal alignment of the weight bearing axis of the lower limbs. Aim: To evaluate and compare the functional outcome of High Tibial Osteotomy (HTO) and Proximal Fibular Osteotomy (PFO) in medial compartmental osteoarthritis of knee joint. Materials and Methods: This prospective longitudinal study was conducted in a tertiary healthcare centre, IPGMER and SSKMH, Kolkata,West Bangal, India from October 2019 to November 2021 for a duration of 26 months, in which 40 osteotomies were performed around the knee. Considering the inclusion and exclusion criteria 20 proximal fibular osteotomies and 20 high tibial osteotomies were operated avoiding the patients with advanced stage or tricompartmental OA. The scoring system considered for evaluation of the functional outcome was Oxford Knee Score (OKS) and Visual Analouge Scale (VAS) Score. The analysis was done through paired t-test with determining of p-value where value ≤0.05 was considered for statistically significant. Results: Majority of the patients in the present study were more than 45 years of age. The most frequent age group was 46-50 years followed by 51-55 years. The follow-up period was at least 15 months where the OKS score was 39.35±3.51 and 41.20±4.50 with p-value of 0.1556 and VAS score was 5.50±1.10 and 3.80±1.10 with p value of <0.0001 for PFO and HTO respectively. Only two of the patients developed surgical site infection in both cases. Conclusion: In long term follow-up the final functional status of both treatment modalities were comparable although HTO was considered superior with significant improvement in pain relief perspective than PTO.

Medial opening wedge high tibial osteotomy with tibial plate fixation in medial compartment osteoarthritis of knee

Aim: Prospective evaluation of medial opening wedge high tibial osteotomy with tibial plate fixation for the treatment of medial compartment osteoarthritis of knee.Method: The study included 31 cases of medial compartment osteoarthritis of knee joint of which 18 were males and 13 were females in the age group of 40-60 years. All the osteotomies were fixed with either wedged plate (n=11) or non wedged plate(n=20).For the clinical evaluation of the patients Hospital of Special Surgery (HSS) score, Knee Society score(KSS) and visual analogue score were taken into consideration for clinical evaluation of the patients. Results: The mean preoperative HSS score was 58.4 and objective and functional knee society score was 57.4 and 57.2 respectively. In the last assessments of our cases, mean improvements detected in HSS scores, Objective and functional scores of Knee Society score were 85.8, 87.3, and 87.1, respectively at 6 months follow up post operatively. Visual analogue score was improved from 8 preoperatively to 1.2 post operatively. Complications such as tendinitis (9.6%), hardware irritation (9.6%), delayed union (6.4%), lateral cortex fracture (3.2%) and superficial infection (3.2%). Conclusion: According to our information, there was significant improvement in the functional outcome and was concluded that medial opening wedge high tibial osteotomy with plate fixation is a reliable and effective procedure for medial compartment osteoarthritis of knee joint.

A prospective study to analyse functional outcome of intraarticular autologous platelet rich plasma (PRP) in management of osteoarthritis of knee joint

Knee osteoarthritis (OA) is a usual problem in the elderly population, which is treated with lifestyle modifications, non-steroidal anti-inflammatory drugs, physiotherapy, and intraarticular injections of corticosteroids/hyaluronic acid/autologous platelet-rich plasma (PRP) in the early stages, and in the late stages, surgical procedures, such as arthroscopic debridement, unicompartmental arthroplasty, patellofemoral arthroplasty, and total knee replacement, are performed. Gradually, there is an increasing trend in the use of intraarticular autologous PRP for treatment of Kellgren Lawrence grade 1 and 2 knee OA. This prospective study aimed to assess the functional outcome of patients with OA when treated with autologous intraarticular PRP for a follow-up period of up to 15 months.This study included 40 individuals with Kellgren Lawrence grade 1 and 2 knee OA who were aged 50–70 years and treated with single autologous intraarticular PRP injection and followed at 1, 3, 6, 12, and 15 months after injection, and visual analog scale (VAS) score was calculated at each follow-up.Preprocedure VAS score of all patients was obtained as 100 mm, and the VAS score was calculated at follow-up on 1, 3, 6, 12, and 15 months and ranged from 13 to 45.

The Effectiveness of High-intensity Pulsed Magnetic Therapy in Rehabilitation of Servicemen with Post-traumatic Osteoarthritis of Knee Joints

Aim: To increase the effectiveness of complex rehabilitation of servicemen with PTO by using high-intensity pulse magnetic therapy (НIP MT). Materials and Methods: The study design included 62 patients with PTO of stage I-III who were divided into: – control group (32 patients) received rehabilitation complex (RC) №1, which included: climatotherapy, kinesiotherapy, massage and balneotherapy; – main group (30 patients) received RC №2 with adding of HIP MT on the affected joints. The analysis of the effectiveness was performed using an algometric clinical examination, Lequesne’s algo-functional index (AFI), WOMAC, visual analog pain scale (VAS), HAQ questionnaire. Results: It was shown reliable benefits of RC № 2: the intensity of pain by VAS decreased by 3,1 times, according to the AFI gonarthrosis was assessed as mild, the value of the total WOMAC index was 20.2% better than in control group (p<0.05). The HAQ index showed a significant improvement in 41.3% (1.5 times better than in patients of control group). During long-term observation (3 months) after rehabilitation improvement was observed in 96.6% of patients of main group. Conclusions: The use of HIP MT in the complex rehabilitation of patients with PTO has significantly reduced the manifestations of pain, increase functioning of joints and restore combat readiness.

Течение остеоартрита коленного сустава в системе комплексной терапии хондропротекторами

The article estimates the influence of various chondroprotective agents in the complex treatment of a knee joint osteoarthritis after sanitizing operations and in patients who did not undergo operative treatment but underwent PRP therapy.

Оценка эффективности обогащенной тромбоцитами аутоплазмы в лечении остеоартроза у пациентов с гиперурикемией

Conservative treatment of osteoarthritis includes drugs that cause side effects in the cardiovascular system, gastrointestinal tract, kidneys, and hepatobiliary system. Hence the steadily growing interest in the use of platelet-rich autoplasma as an effective and safe treatment, and it is still an urgent task to estimate its effectiveness in osteoarthritis aggravated by hyperuricemia or gout. The purpose was to estimate the effectiveness of platelet-rich autoplasma in the complex therapy of knee joints osteoarthritis of 2–4 degree (Kellgren — Lawrence, 1987), with concomitant hyperuricemia or gout. The study involved 32 patients (20 women, 12 men, mean age 67 ± 7.8 years, body mass index 32.7 ± 4.8, disease duration 10.3 ± 3.7 months) with knee osteoarthritis and hyperuricemia or gout. All patients of the main group received intra-articular injections of platelet-rich autoplasma during remission. The results were assessed after 1 day, 1 week, 1, 3, 6, and 12 months after the injection using the VAS, Lequesne, and Satisfaction Scales, as well as MRI of the joints after 3 and 6 months after the injection. When compared with traditional medical treatment, the use of PRP did not show a clear benefit, however, this procedure can be recommended as a maintenance procedure to improve the condition of the synovium in patients who have contraindications to non-steroidal anti-inflammatory drugs and glucocorticosteroids. When comparing the results separately in the group of male and female patients, there was a statistically significant improvement in the group of women compared to men.

Functional Outcome of Proximal Fibular Osteotomy in Medial Compartment Osteoarthritis of The Knee Joint

Background: Proximal Fibular Osteotomy (PFO) has been proposed as a new surgical option for pain relief in patients with medial compartment knee osteoarthritis. It is simple, safe and affordable. To assess functional outcome of proximal fibular osteotomy in medial compartment osteoarthritis of knee joint.
 Materials and methods: This prospective hospital based clinical trial was carried out in the Department of Orthopedic Surgery Chittagong Medical College Hospital (CMCH) Chattogram from July 2019 to June 2020. A total of 30 patients with knee osteoarthritis were enrolled through inclusion and exclusion criteria by purposive sampling. Proximal fibular osteotomy was done after taking written informed consent. Data was recorded in a predesigned case record form. All the patients were followed up to 6 months when final outcome was assessed by Oxford Knee Score. All the data were analyzed statistically by using Statistical Package for Social Sciences (SPSS-25). The result was expressed as frequency, percentage and mean ± SD. Level of significance was calculated at p<0.05.
 Results: In this study, out of 30 cases, majority of the cases (57.7%) was in 55-64 years of age group. Mean ± SD pre-operative and post-operative VAS score were 7.13 ± 1.408 and 2.10 ± 0.803 respectively. According to Oxford Knee Score (OKS) pre-operative and postoperative mean ± SD were, 18.00 ± 2.117 and 36.53 ± 2.403. Mean ± SD pre-operative and post-operative Tibio Femoral Angle were 182.97 ± 1.810 and 178.63 ± 1.377 respectively. Mean ± SD pre-operative and post-operative Medial Joint Space (mm) were 1.223 ± 0.378 and 3.816 ± 0.982 respectively. Mean ± SD pre-operative and postoperative Lateral Joint Space (mm) were 6.640 ± 1.209 and 5.050 ± 0.897 respectively.
 Conclusion: After analyzing the results of present study, it can be concluded that proximal fibular osteotomy is a new, simple procedure in the management of medial compartment osteoarthritis of the knee which may delay the need for definitive knee procedures like unicompartmental knee arthroplasty or total knee replacement.
 JCMCTA 2021 ; 32 (2) : 137-141

A prospective analytical study on the effect of posterior femoral condylar offset on range of knee flexion in patients undergoing cruciate retaining total knee arthroplasty

<p><strong>Background:</strong> Osteoarthritis (OA) of knee joint is a common problem in our society causing pain, deformity, oedema, malalignment and limitation of activity. Total knee arthroplasty (TKA) is the surgery done for treatment of this problem. The range of movement obtained after TKA is an important factor influencing success of surgery. Posterior femoral condylar offset (PCO) is one of the parameters influencing range of movement after surgery. The dearth of studies in Indian population and contradicting results in already conducted studies has been observed in assessing the effect of PCO on range of knee flexion in patients undergoing TKA. Hence this study is done to explore this correlation.</p><p><strong>Methods:</strong> A prospective analytical study on 36 patients (50 knees) who underwent cruciate retaining TKA at Department of Orthopaedics, Rajagiri Hospital, Aluva. PCO and posterior femoral condylar offset ratio (PCOR) were calculated radiologically before and after TKA. Range of flexion (ROF) and knee society scores (for functional outcome assessment) were recorded preoperatively and postoperatively (at 6 weeks and 3 months).</p><p><strong>Results:</strong> The study found a strong positive correlation between PCO difference and ROF difference (r=0.735). Strong positive correlation was also found between PCOR difference and ROF difference (r=0.777). Both these correlations were statistically significant (p<0.05).</p><p><strong>Conclusions:</strong> The study enlightened us about the point that PCO is an important factor in attaining a good ROF after cruciate retaining TKA.</p>

Effect of Mulligan Mobilization on Proprioception in Osteoarthritis of Knee Joint - A Systematic Review

Background: Osteoarthritis (OA) of the knee is a degenerative disorder that affects the joint which causes pain, stiffness, swelling, muscle weakness, and functional impairments. Proprioception in the OA knee seems to be impaired when compared with the normal counterparts. Manual therapy is one of the hands-on therapies delivered by physiotherapists. However, there is not much information on how manual therapy affects joint proprioception, although some studies show a positive response. Mulligan’s mobilization technique is common for spinal and peripheral joints to correct positional faults.
 Aim: To systematically identify and to evaluate the effects of mulligan mobilization on the proprioception of the OA knee.
 Methods: Various electronic databases like PubMed Central, Medline, Google Scholar, ProQuest and CINAHL are searched from 2001 to 2021. Multiple search criteria were used in the search of relevant articles based on the selection criteria used. Four articles that fit the criteria were taken based on the PEDro Scores of above 5. The two specialists analysed all the papers. The articles which cover mulligan’s mobilization and proprioception of the knee were only selected.
 Results: Four articles that fit the criteria were reviewed which demonstrated baseline comparability and reported point estimates and measures of variability.
 Conclusion: This systematic review has concluded that the knee joint proprioception was improved with applying the Mulligan’s manual therapy, whereas the neurophysiological activity is not well understood.

Efficacy of Prolotherapy With Periarticular 5% Dextrose In The Treatment of Knee Joint Osteoarthritis

Objective: Determination of the effectiveness of periarticular 5% dextrose prolotherapy in the treatment of knee pain due to osteoarthritis.Material and Methods: The clinical results of prolotherapy with 5% periarticular dextrose in adult female and male patients with knee pain and complaints related to osteoarthritis were evaluated retrospectively. During the examination, we identified the sensitive ligaments in the knee and injected 1 cc of 5% dextrose with a 0.6 * 60 mm sterican needle. In routine practice, stretching exercises are recommended to patients after prolotherapy and for analgesia, a combined analgesic containing paracetemol 500mg + codeine phosphate 10mg + caffeine 30mg is given for the first 3 days. In addition to the initial application, prolotherapy is performed 3 times with an interval of 20 days, and when the Visual Analogue Scale (VAS) score decreases by 80% or more after the first or second injection, prolotherapy is terminated. Results: 30 patients aged between 36-70 years were included in the study. Patients’ mean age was 52,9±9,0 years. Nineteen patients received 3 sessions and 11 patients received 2 sessions of prolotherapy. A significant decrease was achieved in VAS scores of all patients except one patient. The VAS score was 2.9 at the end of the third session meanwhile the initial VAS average was 8.4. None of the patients had any side effects that would terminate the treatment.Conclusion: The data obtained in the study show that prolotherapy with periarticular 5% dextrose is effective in the treatment of knee pain and complaints related to osteoarthritis. However, more comprehensive studies will be guiding the clarification of its place in the osteoarthritis’ treatment.

A study to compare the effectiveness of maitland mobilization protocol on pain and functional mobility of patients with knee osteoarthritis

Osteoarthritis is a common degenerative condition among the elderly. It is characterized With the damage to the articular cartilage and persists with the symptoms of pain and stiffness in the joint. This study was conducted with 30 patients with Osteoarthritis of knee joint. The subjects were divided into three groups: Group A comprised of 15 subjects. Patients in this group received conventional physiotherapy comprising of Strengthening exercises, Stretching exercises, Range of motion exercises and cryotherapy.Group B (Experimental Group 1) comprised of 15 subjects. Patients in this group received Maitland’s Mobilization and Conventional physiotherapy exercises.All the subjects were assessed pre and post intervention program for VAS scale and WOMAC scale test. After analyzing the data following conclusions were drawn;Results showed that there was significant improvement in the VAS score and WOMAC score of all the two groups for the pre and the post test measurement. The inter group comparison of all the two groups showed that there was highly significant difference between the Maitland’s group and the control group (p<0.001).

Indicators of mineral bone density in male patients with osteoarthritis of knee joint of elderly and old age depending on condition of muscular system

Objective. To evaluate bone mineral density (BMD) indices in elderly and old age male patients with knee osteoarthritis (OA) depending on the state of the muscular system.Subjects and methods. The trial enrolled 32 patients with knee OA. The mean age of the patients was 68.7 (66.1; 70.3) years. The diagnosis of knee OA was established according to the diagnostic criteria of the American College of Rheumatologists (ACR, 1991). For comparative analysis, all patients with knee OA were divided into 3 groups according to muscle condition (EWGSOP, 2010: muscle mass was assessed by multispiral computed tomography, muscle strength was measured using a wrist dynamometer, muscle function was examined using a battery of short tests): the 1st – 9 patients without sarcopenia, the 2nd – 11 patients with presarcopenia, and the 3rd – 12 patients with sarcopenia. BMD was assessed by dual-energy X-ray absorptiometry in the neck and proximal femur as a whole and in the lumbar spine.Results. Osteopenic syndrome in the study cohort was diagnosed in 23 (71,9%) patients: osteopenia – in 19 (59,4%) patients, osteoporosis – in 4 (12,5%). Normal BMD values were observed in 9 (28.1%) patients. Osteopenic syndrome was detected in patients with sarcopenia signifcantly more often compared to patients without sarcopenia (p > 0.05) and with presarcopenia (p = 0.05). BMD indices in patients with sarcopenia in the neck and proximal femur in general were statistically signifcantly lower than in patients without sarcopenia and with presarcopenia (p < 0.05). There was a direct correlation between total skeletal muscle area at the LIII level and densitometric indices of the femoral neck.Conclusions. Sarcopenia is associated with low BMD indices in the neck and proximal femur in general in elderly and senile male patients with knee OA

Effect of Intra-Articular Injection of Platelet-Rich Plasma on the Serum Levels of Osteoarthritic Biomarkers in Patients with Unilateral Knee Osteoarthritis.

Background: The aim of this study is to determine the effect of three doses of intra-articular injection of platelet-rich plasma (PRP) into the osteoarthritic (OA) knee joint on the functional status and on the changes in the levels of specific OA biomarkers in blood serum. Methods: Forty patients with unilateral primary knee osteoarthritis were enrolled in this single center, prospective clinical trial. For each patient, three intra-articular PRP injections were administered one week apart. Clinical and laboratory assessment was performed before the first PRP injection (baseline), and 3 months after the third PRP application (3-month follow up). Pain in the affected knee joint was assessed with the Visual Analog Scale for Pain (VAS). Change in clinical status was evaluated with the Western Ontario and McMaster Universities Arthritis Index Questionnaire (WOMAC). Concentrations of 19 biomarkers (EGF, Eotaxin, FGF-2, GRO, IL-10, IL-1RA, IL-8, IP-10, MCP-1, PDGF-AB/BB, RANTES, MMP-3, MMP-13, Collagen type 2, BMP-2, TIMP-1, TIMP-2, TGF beta 1, and COMP) in the serum of studied patients were quantified. Results: At 3-month follow up, there was a significant decrease in the VAS score and significant improvement in the WOMAC score. There was a significant decrease in the levels of Eotaxin, MCP-1, MMP-1, IL-10, EGF, PDGF-AB/BB, TGF- β1 compared to baseline levels. A significant increase in markers BMP-2, COMP, Collagen type 2 and GRO was found at the same time point. There was no significant change in the concentrations of other biomarkers (FGF-2, IL-1RA, IL-8, IL-10, MMP-3, RANTES, TIMP-1, TIMP-3). Conclusions: We found an increase in specific pro-anabolic and anti-inflammatory biomarkers with a concomitant decrease in pro-inflammatory biomarkers at 3 months after three intra-articular applications of PRP. Significant improvement in VAS and WOMAC scores was observed. Treatment with PRP may be an effective therapeutic option with anti-inflammatory and regenerative potential in patients with primary knee OA.

Review of K.H. Pridie (1959) on “A method of resurfacing osteoarthritic knee joints”

This classic discusses the original publication “A method of resurfacing osteoarthritic knee joints” by Dr K.H. Pridie (1959), where this pioneer surgeon described a newly developed method for the treatment of osteoarthritic joint surfaces of the knee, which he named subchondral drilling. This short and concise 11-line publication appeared in the Proceedings of the Congress of the British Orthopaedic Association. It has generated 464 citations since 1959, becoming part of the hundred most-cited publications in knee research. Pridie introduced in clinical experimentation the entity of Marrow Stimulation Techniques to liberate mesenchymal stem cells from cancellous bone. He was aware that the results induced, in terms of quality of the regrown tissue, was limited and “only” fibrocartilage. His idea might have been raised from the work of numerous animal researchers who confirmed repeatedly since 1905 that cartilage needed an osseous perforation to heal. Although the past 60 years brought modifications from the technique described in the original article, the concept of marrow stimulation introduced by Pridie remains the most frequently used in cartilage repair surgery today.

Effect Analysis of Open Wedge High Tibial Osteotomy for Medial Compartment Osteoarthritis of Knee Joint

Effect Analysis of Open Wedge High Tibial Osteotomy for Medial Compartment Osteoarthritis of Knee Joint