Reduce Joint Pain Research Articles

Visualization of patient’s knee movement and joint contact area during knee flexion for orthopaedic surgery planing validation

ABSTRACT The high number of revision surgery by total knee replacement to reduce joint pain shows the complexity of the procedure and the current difficulties to make the right diagnosis. This work presents a joint contact area visualization during a recorded flexion and extension of the knee to improve the understanding of the knee kinematics before and after the operation. The position of the patient’s bones is registered using two trackers, one placed on the upper leg and one on the lower leg. The movement of the knee joint is recorded with an infrared stereo camera. Thanks to a visualization software, the doctor can spontaneously observe the pressure zones at the joint and the movement of the bones recorded from live measurements. The visualization of contact areas together with the patient’s bone’s geometry helps for patient diagnosis. The kinematics of the knee flexion brings more information on the validity of the flexion movement before and after surgery, enabling the two to be compared as well as separately analysed. The contact areas can also be compared pre- and post-operatively, or between right and left knees. The accuracy of the visualization software has been tested using a 3D phantom model of a knee joint.

The Influence of Warm Compress and Progressive Muscle Relaxation Therapy in Decreasing Joint Pain to Elderly at Posyandu Lansia RW 04 Kelurahan Bangsal Kota Kediri

Pain management does not always have to use drugs, but there are some nursing measures that can be given to relieve pain such as relaxation therapy, for example TROP and warm compress. The study population was all elderly who experienced joint pain. The samples were 36 respondents, which were divided into two intervention groups. Sampling method used purposive sampling technique. Data collected by using Numerical Rating Scale (NRS). Data were analyzed using Wilcoxon signed ranks test with α = 0.05. The conclusion of this study is TROP and warm compresses can be used to reduce joint pain scale in the elderly, although statistically shows that TROP intervention is more effective in reducing pain.

A QUASI EXPERIMENTAL STUDY TO ASSESS THE EFFECTIVENESS OF ISOMETRIC EXERCISES ON QUALITY OF LIFE AMONG THE INMATES OF ELDERLY PERSONS WITH JOINT PAIN AT SELECTED HOSPITAL, DEHRADUN, UTTARAKHAND

A QUASI EXPERIMENTAL STUDY TO ASSESS THE EFFECTIVENESS OF ISOMETRIC EXERCISES ON QUALITY OF LIFE AMONG THE INMATES OF ELDERLY PERSONS WITH JOINT PAIN AT SELECTED HOSPITAL, DEHRADUN, UTTARAKHAND

Biomaterial strategies for improved intra-articular drug delivery.

Osteoarthritis (OA) is a joint degenerative disease that has become one of the leading causes of disability in the world. It is estimated that OA affects 50 million adults in the United States. Currently, there are no FDA-approved treatments that slow OA progression and its treatment is limited to pain management strategies and life style changes. Despite the discovery of several disease-modifying OA drugs (DMOADs) and promising results in preclinical studies, their clinical translation has been significantly limited because of poor intra-articular (IA) bioavailability and challenges in delivering these compounds to tissues of interest within the joint. Here, we review current OA treatments and their effectiveness at reducing joint pain, as well as novel targets for OA treatment and the challenges related to their clinical translation. Moreover, we discuss intra-articular (IA) drug delivery as a promising route of administration, describe its inherent challenges, and review recent advances in biomaterial-based IA drug delivery for OA treatment. Finally, we highlight the potential of tissue targeting in the development of effective IA drug delivery systems.

Study of a Standardized Plant Extract Used as an Anti-Inflammatory Drug to Reduce Joint Pain

This study was to demonstrate the role of a natural anti-inflammatory, in reducing pain, inflammatory process and increasing joint mobility in elderly patients diagnosed with knee osteoarthritis. Osteoarthritis off knee affect the articular cartilage, but also the articular capsule, leading to disability. This natural anti-inflammatory has a complex composition: extract de Boswellia serrata 300 mg, extract de curcuma 100 mg, extract Pinus pinaster 80 mg si extract de Zingiber officinale 40 mg. The combination of herbal products, which have no side effects, with electrotherapy and kinetotherapy can be a real success in this category of patients, also influencing their well-being.

A Molecular Cascade Underlying Articular Cartilage Degeneration.

Preserving of articular cartilage is an effective way to protect synovial joints from becoming osteoarthritic (OA) joints. Understanding of the molecular basis of articular cartilage degeneration will provide valuable information in the effort to develop cartilage preserving drugs. There are currently no disease-modifying OA drugs (DMOADs) available to prevent articular cartilage destruction during the development of OA. Current drug treatments for OA focus on the reduction of joint pain, swelling, and inflammation at advanced stages of the disease. However, based on discoveries from several independent research laboratories and our laboratory in the past 15 to 20 years, we believe that we have a functional molecular understanding of articular cartilage degeneration. In this review article, we present and discuss experimental evidence to demonstrate a sequential chain of the molecular events underlying articular cartilage degeneration, which consists of transforming growth factor beta 1, high-temperature requirement A1 (a serine protease), discoidin domain receptor 2 (a cell surface receptor tyrosine kinase for native fibrillar collagens), and matrix metalloproteinase 13 (an extracellularmatrix degrading enzyme). If, as we strongly suspect, this molecular pathway is responsible for the initiation and acceleration of articular cartilage degeneration, which eventually leads to progressive joint failure, then these molecules may be ideal therapeutic targets for the development of DMOADs.

Many years of experience in using a combination of glucosamine and chondroitin in clinical practice

The article presents the main approaches to choosing the treatment of osteoarthritis and the main links in the pathogenesis of this disease. The effects of glucosamine and chondroitin on the main pathogenetic mechanisms of osteoarthritis that prevent its progression are described. There are discussed an effectiveness and safety of treatment of the disease with a focus on the use of a combination of glucosamine hydrochloride and chondroitin sulfate (Arthra), as well as their combination with methylsulfonylmethane and sodium hyaluronic acid (Arthra MSM). Methylsulfonylmethane reduces pain, it is involved in the processes of maintaining and regeneration of connective tissue, in the synthesis of sulfated glycosaminoglycans and collagen. It is suggested that this compound may have analgesic and anti-inflammatory properties due to the inhibition of the nuclear factor kB signaling pathway, which allows to reduce the local and systemic inflammatory response, as well as suppressing the expression of proinflammatory cytokines and much more. This article also presents experimental and clinical evidence of the effectiveness and safety of these compounds. It has been convincingly demonstrated the possibility with these drugs to reduce joint pain and the need for analgesics and non-steroidal anti-inflammatory drugs, to improve the quality of life. Currently, symptomatic slow-acting drugs, which include the discussed ones, are recommended to be prescribed as first-line drugs for the treatment of osteoarthritis. Timely administration of symptomatic slow-acting drugs, their long-term use contributes not only to reducing the progression of the disease, but also makes it possible to avoid or delay endoprosthetics. In this article there is indicated the contribution of Russian scientists to obtaining evidence of the effectiveness and safety of Arthra and Arthra MSM in the application of various treatment modes in osteoarthritis of the knee joints and lower back pain.

Electronic moxibustion apparatus and traditional moxibustion in treating knee osteoarthritis: a randomized controlled trial

To observe the clinical efficacy of DZWJY-1 type electronic moxibustion apparatus and traditional moxibustion in treating knee osteoarthritis (KOA). A total of 76 eligible patients were randomized into an electronic moxibustion apparatus group and a traditional moxibustion group, with 38 cases in each group. The electronic moxibustion apparatus group was intervened by DZWJY-1 type electronic moxibustion apparatus, and the traditional moxibustion group received moxa stick moxibustion for treatment. Neixiyan (EX-LE 4), Dubi (ST 35), Xuehai (SP 10) and Liangqiu (ST 34) were selected for both groups and the treatment was conducted 3 times a week for a total of 12 times. The visual analog scale (VAS) and the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) scores were observed before treatment and after 6 and 12 sessions of treatment, respectively. There were 4 dropout cases in the traditional moxibustion group. Therefore, this trial had 72 valid cases, including 38 cases in the electronic moxibustion apparatus group and 34 cases in the traditional moxibustion group, the differences in the baseline data between the two groups were statistically insignificant (P>0.05). After 6 and 12 sessions of treatment, the VAS scores decreased significantly with the increase of treatment sessions in both groups (all P 0.05). The pain intensity was evaluated using the weighted value of VAS score. The markedly effective rate was 47.4% and the total effective rate was 89.5% in the electronic moxibustion apparatus group, versus 50.0% and 94.1% in the traditional moxibustion group, and the between-group differences were statistically insignificant (both P>0.05). After 6 and 12 sessions of treatment, the total score and the component scores including pain, stiffness and difficulty moving in the WOMAC decreased significantly with the increase of treatment sessions in both groups (all P 0.05). Electronic moxibustion apparatus and traditional moxibustion both are effective in reducing joint pain and improving joint function in KOA patients, and they are equivalent comparing the clinical efficacy.

Treatment of avascular osteonecrosis of femoral head by core decompression and platelet-rich plasma: a prospective not controlled study.

Core decompression is a surgical option since the 1960s for hip osteonecrosis treatment. This technique promotes bone repair by reducing intramedullary pressure, but this is not often enough to stop the progression of necrosis. The aim of this study was to associate core decompression with the regenerative stimulus provided by platelet-rich plasma (PRP) and compare our results with other regenerative techniques. Femoral head osteonecrosis was prospectively evaluated in 30 hips (22 patients, 15-60years) treated by core decompression and PRP graft. Patients presented monolateral or bilateral osteonecrosis in stage I-IIA-IIB according to Arlet and Ficat classification. The outcome was assessed by changes in Harris Hip Score (HHS) and the need for total hip replacement (THA). The mean preoperative HHS was 64 points, at two years from surgery was roughly 84 points. Sixteen of 30 hips showed osteonecrosis progression of the femoral head and were converted to THA. At the fiveyear follow-up, the survival rate was 100% for patients at stage I, 67% for stage IIA, and 0% for stage IIB and was 68% and 32% for idiopathic and secondary osteonecrosis, respectively. Core decompression combined with PRP could be indicated as a treatment for the I and IIA stages of osteonecrosis, as it significantly reduces joint pain and delays THA. This procedure should be avoided in AVNFH related to cortisone therapy because only a few benefits have been proven. It also has the advantage of being technically simple, minimally invasive, and free from complications.

Efficacy and safety of two “Carmolis” forms for combined local therapy of knee osteoarthritis: results of a multicenter clinical trial

Objective – to evaluate efficacy and safety of “Carmolis” fluid and gel in patients with knee osteoarthritis, as well as the gel efficacy combined with ultraphonophoresis.Materials and methods. The study included 200 patients, who were divided into 2 groups depending on the way of application of “Carmolis” forms. Group 1 included 165 patients with knee osteoarthritis (the main group included 90 patients, the control group – 75 patients), who underwent complex local treatment with 2 “Carmolis” forms. Group 2 included 35 patients (20 people in the main group and 15 in the control one). The main group received phonophoresis with “Carmolis” gel, and the control group received “Carmolis” gel locally on the affected knee joint. Patients’ average age in group 1 was 62,7 ± 8,5 years, the average age in the control group was 61.4 ± 8.7 years, the disease duration was 10.1 ± 4.7 and 9.2 ± 6, 0 years, respectively. In group 2 the average age and disease duration were 60.1 ± 12.8 and 5.7 ± 5.4 years, respectively.At the initial stage 90 patients of the main group 1 were rubbed “Carmolis” fluid locally in the joint followed by massage. After the fluid absorbed completely, “Carmolis” gel was applied, followed by massage. In the comparison group (75 patients), standard therapy was combined only with “Carmolis” fluid applied on the II knee joint.Twenty patients of the main group 2 were treated with phonophoresis combined with “Carmolis” gel. Clinical efficacy was assessed by pain dynamics.Results. Treatment with two “Carmolis” local forms significantly decreased average on moving from 61.8 ± 14.2 to 30.7 ± 14.2 (р <0,001), at rest – from 49 ± 19, 9 to 20.4 ± 8.5 (р <0,001), on palpation – from 38.7 ± 10.4 to 18.4 ± 5.7 (р <0,001). A similar dynamics was also revealed during WOMAC assessment (Western Ontario McMaster Universities OA Index). Before the treatment start the average WOMAC pain level in the main group was 240.5 ± 39.8, after the treatment – 114.8 ± 30.4 (р <0,001). The control group also showed pain decrease, but to a much lesser extent than in the main one. At the end of the treatment course, patients of both groups demonstrated a pronounced decrease of synovitis sings, but there were no differences between the groups. The dose of non-steroidal anti-inflammatory drugs in the main group was reduced in 70 (77.8 %) patients, in the control group – in 50 (66.7 %). The tolerability of both forms was very good and good. No adverse events were registered. Data on the effectiveness and safety of “Carmolis” gel combined with ultraphonophoresis are presented in the article.Conclusion. According to the results, combined therapy using “Carmolis” liquid and gel significantly reduces joint pain and synovitis severity, increases joints» functional ability and improves patients» general condition, which allows reducing the dose of non-steroidal anti-inflammatory drugs. Both “Carmolis” forms had excellent and good tolerability.

Does cartilage loss cause pain in osteoarthritis and if so, how much?

ObjectivesAlthough treatment development in osteoarthritis (OA) focuses on chondroprotection, it is unclear how much preventing cartilage loss reduces joint pain. It is also unclear how nociceptive tissues may be involved.MethodsUsing...

Intra-Articular Injections of Hyaluronic Acid or Steroids Associated With Better Outcomes Than Platelet-Rich Plasma, Adipose Mesenchymal Stromal Cells, or Placebo in Knee Osteoarthritis: A Network Meta-analysis

To evaluate the clinical effects of hyaluronic acid (HA), steroids, platelet-rich plasma (PRP), or adipose mesenchymal stromal cell (MSC) injections in the treatment of knee osteoarthritis (OA). Randomized controlled trials with OA of the knee that compared HA, steroids, PRP, adipose MSC, or their combination with placebo or in head-to-head combination were identified from the MEDLINE, EMBASE, Cochrane Library, Web of Science, and SCOPUS databases up to June 30, 2019. We performed a network meta-analysis of the relevant literature to determine whether there was benefit from HA, steroids, PRP, or adipose MSC treatment as compared with placebo. A total of 43 trials covering 5554 patients were included. Steroids were ranked most likely to be effective for the management of pain or function, with adipose MSC and multiple PRP appearing least likely to be effective. Although no significant difference was observed among the 6 interventions, except for single PRP with respect to adverse effects, steroids and HA exhibited a lower rate of AEs compared with the placebo. In view of severe adverse effects, only single PRP was superior to placebo. Direct pairwise meta-analysis for pain relief showed that HA was superior to placebo or single PRP, but steroids had a significantly worse effect than single PRP. In addition, direct pairwise meta-analysis for adverse effects favored steroids in comparison to HA. The ranking statistics like surface under the cumulative ranking curve values of our network meta-analysis support the use of steroids and HA for appropriate patients with knee OA. For pain relief and AEs, steroids are most likely the best treatment, followed by HA. Single PRP, multiple PRP, and adipose MSC interventions do not result in a relevant reduction of joint pain nor improvement of joint function compared with placebo. However, treatment effect differences were small and potentially not clinically meaningful, indicating that other factors, such as cost and patient preferences, may be more important in patients with knee OA. meta-analysis of non-homogenous randomized controlled trials, Level II.

Does cartilage loss cause pain in osteoarthritis?

Purpose: Treatment development in osteoarthritis continues to focus on chondroprotection, but it is unclear if delaying cartilage loss would reduce joint pain. In published studies, less cartilage in a knee has not been consistently associated with more pain in the knee. Studies have not tested whether cartilage loss over time is associated with worsening pain and have not adjusted for other sources of pain. Further they have not examined whether synovitis or bone marrow lesions, nociceptive tissues, might mediate any effect on pain.

The Effects of Tissue Flossing on Perceived Knee Pain and Jump Performance: A Pilot Study

Background: Tissue compression and partial vascular occlusion using band flossing results in reperfusion of blood to the muscle tissue that may ultimately reduce joint pain and increase range of motion, enhancing prevention from or rehabilitation of injury. However, the extent of research examining the effect of tissue flossing in an athletic setting is currently very limited, and the effects of band flossing on knee pain and jump performance have not yet been investigated and remain unclear. Purpose: To investigate the effect of band flossing on perceived knee pain and vertical jump performance in recreational athletes with knee pain. Methods: Five young male recreational athletes with previously reported knee pain took part in this study (age 22±0.5; height 184±6.8cm; weight 79±1.5kg; BMI 23.34±1.2 kg/m2). Participants performed a number of tests pre and post intervention, with the application of a floss band on the knee joint. The experimental protocol consisted in the performance of countermovement jump (CMJ) tests (without occlusion, with occlusion, and after occlusion). Pre and Post intervention measures included a perceived knee pain -by visual analogue scale (VAS)- and CMJ performance -by force platform-. Results: The application of flossing bands in knee joint resulted in enhancements in all test measures pre to post intervention (10% jump height; 4.5% time in the air; 5% jump velocity; 13% jump power; 7.5% jump force). Participants reported a 3.5-point pain enhancement in AVS during performance of CMJ tests. Conclusion: Flossing bands caused a reduction in perceived knee pain and improved vertical jump performance in young male recreational athletes.

The Use of Collagen Hydrolysates and Native Collagen in Osteoarthritis

Osteoarthritis is a chronic degenerative disease that dampens the quality of life of those who suffer it. Conventional treatments are palliative, they are targeted to reduce joint pain. However, more efforts are needed to find new therapies that are able to positively affect or at least stop the course of this degenerative disease. Amongst the different therapeutic options that are being studied, collagen emerges as a good candidate due to its safety and preclinical and clinical evidence. Two different approaches have been taken for collagen: collagen hydrolysates and native collagen.

The use of chondroitin sulfate (Mucosat) for the treatment of chronic back pain and osteoarthritis

The representation of pain syndromes of various localization is very extensive: in the knee and hip joints, this figure reaches 57,8% of the general population, in the shoulder joint 48–84%, and pain in the lower back is experienced by up to 85%. The prevalence of osteoarthritis (OA) increases with age. OA occupies a leading position among all rheumatological diseases, accounting for more than 60–70 % of their total number, and is the leading cause of chronic pain syndrome in the older age group. Clinical symptoms of OA are observed in 30–50% of the population in people over 65 years. Non-steroidal anti-inflammatory drugs (NSAIDs) are the most commonly used drugs for the treatment of pain syndromes. NSAIDs are characterized by a good analgesic effect, but are often the cause of the development of adverse events (NSAIDS). Alternative for the treatment of degenerative-dystrophic lesions of the joints is chondroprotectors (CP). CPS belong to the group of drugs of delayed action of symptomatic therapy (SYSADOA). Among CP, chondroitin sulfate (CS) is considered to be the most acceptable means that can affect metabolic processes in cartilage, synovial and bone tissue, suppressing the synthesis of proinflammatory mediators. The main effects that CS has on the joint in OA are: anti-inflammatory, analgesic, and protective. CS improves the phosphorus-calcium metabolism in cartilage, inhibits enzymes that violate the structure and function of articular cartilage, inhibits the degeneration of cartilage; stimulates the synthesis of glycosaminoglycans (GAG), normalizes the metabolism of hyaline tissue, promotes the regeneration of cartilage surfaces and the articular bag. The main effects that show CS on the joint in OA: anti-inflammatory, analgesic, protective. Slowing bone resorption, reduces the loss of Ca2+ and accelerates the processes of bone repair, inhibits the progression of OA. It has analgesic effect, reduces joint pain, pain at rest and when walking, the severity of inflammation, reduces the need for non-steroidal anti-inflammatory drugs (NSAIDs). One of the representatives of medicinal products based on CS is Mucosate (ampoules 1 and 2 ml) containing 100mg of CS in 1ml. A number of studies have demonstrated the effectiveness of therapy with Mucosat in the treatment of patients with low back pain (LBP) using the 2 ml intramuscularly every other day, a course of 25 injections, as well as in the treatment of OA using the 1 ml intramuscularly every other day, starting with the 4th injection – 2 ml every other day, also a course of 25 injections. Recent developments – a new oral form of Mucosate (capsule) containing harpagophytum and the NEM® complex can serve as a supplement to the injectable course of therapy.

Clinical efficacy of arthroscope-assisted treatment of traumatic metacarpophalangeal arthritis

Objective To explore the clinical efficacy of arthroscopic minimally invasive technique in the treatment of traumatic pain and dysfunction of metacarpophalangeal joint in the early and middle stages. Methods From March 2016 to December 2018, nine patients with traumatic metacarpophalangeal arthritis were treated with arthroscopic minimally invasive assistance to understand the lesions of metacarpophalangeal joint, and to clean up the osteophytes, intra-articular free bodies and synovitis. After the operation, the patients were instructed to take progressive functional exercise. The joint motion degree of the affected fingers was followed up. Whether there were swelling, deformity and pain in the fingers was observed. Results The postoperative follow-up time ranged from 6 to 24 months, with an average of 15 months. All the patients did not have any symptoms such as surgical complications and pain discomfort in a short period of time. The joint flexion and extension function were improved in varying degrees. According to the measurement standard of total active motion (TAM) of finger flexion and extension function, before operation the results were good in 1 case, fair in 5 cases and poor in 3 cases; after operation the results were excellent in 6 cases, good in 2 cases and fair in 1 case. Conclusion In the early and middle stage of traumatic arthritis of metacarpophalangeal joint, the minimally invasive treatment under arthroscope has the advantages of small trauma, high accuracy and pertinence, quick postoperative recovery, which is an effective treatment method to improve hand function and reduce joint pain, and is worthy of clinical promotion. Key words: Metacarpophalangeal joint; Treatment outcome; Traumatic arthritis; Arthroscopes

Terapi bekam basah area punggung mengurangi nyeri sendi pada pasien rheumathoid arhtritis

Rheumatoid Arthritis (RA) is a chronic systemic inflammatory disease of unknown cause with peripheral joint manifestations. The numbers of Genesis Rheumatoid Arthritis in Indonesia is quite high. RA Pain prevalence in Indonesia reached 25.6% to 35.8%. This figure suggests that pain due to RA already bothersome activity of Indonesia society. The aim of this research is conducted to know the effect find of wet cupping therapy in the area of paint in the back joint to changes in outpatient RA patients in clinics of the year 2018. A quasi-experimental design with One Group Pretestpostest Design without control. The population in this research is the sufferer Rheumatoid Arthritis 30-50 years old visiting Clinics Sukoharjo, with a sample of 16 respondents, purposive Sampling techniques. Wilcoxon test result indicates that there is a difference between pain before with after bekam, based on the result of the statistical test p-value obtained value is a ρ=0,001 (less than 0,05), this means there is a significant influence of wet cupping therapy to changes pain in people with Rheumtaoid Arthitis. Thus, wet cupping therapy can be a solution to reduce joint pain for patients with Rheumatoid Arthritis.

Prescription of chondroitin sulfate in back pains

One of the promising areas of pharmacotherapy in degenerative-dystrophic lesions of the joints, such as osteoarthritis (OA), is the use of chondroprotectors (CP). CPs belong to the group of Symptomatic Slow Acting Drugs for OsteoArthritis (SYSADOA). Among CPs, chondroitin sulfate (CS) is considered to be the most acceptable means capable of influencing metabolic processes in cartilage, synovial and bone tissue, suppressing the synthesis of proinflammatory mediators. CS improves phosphorus-calcium metabolism in cartilage tissue, inhibits enzymes that violate the structure and function of articular cartilage, inhibits the degeneration of cartilage tissue; stimulates the synthesis of glycosaminoglycans (GAG), normalizes the metabolism of hyaline tissue, promotes regeneration of cartilage surfaces and articular bags.The main effects that show CS on the joint in OA: anti-inflammatory, analgesic, protective. Slowing bone resorption, reduces the loss of Ca2+ and accelerates the processes of bone repair, inhibits the progression of OA. It has analgesic effect, reduces joint pain, pain at rest and when walking, the severity of inflammation, reduces the need for non-steroidal anti-inflammatory drugs (NSAIDs). The appointment of correctors of bone and cartilage metabolism is indicated at any stage of the degenerative process in the joints. One of the medicinal product (MP) based on CS is Chondroitin-ACOS (capsules, 25mg), whose effectiveness in the treatment of patients with OA has been demonstrated in a number of studies. Dosage Chondroitin-ACOS: 0,75 g 3 times a day for 3 weeks, then 0,5 g 2 times a day for 9 weeks. The therapeutic effect develops after 8-12 weeks of taking the drug. Within one month after discontinuation of Chondroitin-ACOS, its aftereffect persisted. Chondroitin-ACOS can be recommended for patients with severe pain syndrome, radiologically confirmed OA I-III stages of different localization.

NEM® Brand Eggshell Membrane in the Treatment of Pain and StiffnessAssociated with Knee Osteoarthritis: An Open Label Clinical Study

Abstract Objective: NEM® Brand Eggshell Membrane contains collagen and glycosaminoglycans that have beneficial effects in the treatment of Osteoarthritis (OA). A single-center, open-label clinical study was conducted to evaluate the efficacy and safety of NEM® in management of pain and stiffness associated with knee OA. Methods: Seventy subjects with knee OA received oral NEM® 500 mg once daily for 60 days. The primary outcome measure was to evaluate the effectiveness of NEM® in reducing pain and stiffness associated with knee OA. The primary endpoints were the change in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Visual Analog Scale for Pain (VAS pain) and Lequesne Algofunctional Index measured after 10, 30 and 60 days of NEM® supplementation. Results: NEM® treatment resulted in reduction of WOMAC overall scores at 10 days (16.6%, p=0.012), at 30 days (31.8%, p<0.0001) and at 60 days (46.7%, p<0.0001) post-treatment compared to baseline values. VAS pain was reduced at 10 days (19.6%, p<0.0001), at 30 days (31.8%, p<0.0001) and at 60 days (49.0%, p<0.0001). Overall Lequesne scores were reduced at 10 days (11.2%, p=0.0002), at 30 days (24.0%, p<0.0001) and at 60 days (36.8%, p<0.0001). In a Global Assessment, 68.6% of patients and 78.6% physicians rated the efficacy of NEM® as excellent or good. Three mild and transient, and no serious adverse events were reported. Conclusions: NEM® supplementation resulted in rapid and significant reduction of joint pain and stiffness (at 10 days) which were further improved at 60 days. NEM® treatment was safe and well tolerated.