Significant Difference In WOMAC Scores Research Articles

Effect of knee pain on muscles imbalance and physical limitation in individuals with bilateral knee osteoarthritis: A comparative cross-sectional study

Objectives: When osteoarthritis (OA) affects the knee, it causes muscle imbalance and physical limitations. This study aimed to determine the impact of knee pain on quadriceps strength, hamstring length, and physical limitations in individuals with bilateral knee OA. Methods: A cross-sectional study at Khyber Teaching Hospital and Northwest General Hospital, Peshawar, included individuals aged 50–65, who met the American College of Rheumatology criteria. Subjects diagnosed with bilateral knee OA (grade II or greater on the Kellgren–Lawrence grading scale) and experiencing pain in both knees (numeric pain rating scale [NPRS] score ≥ 1) were selected through purposive sampling (n = 70). Data collection involved the NPRS, modified belt stabilizer hand-held dynamometer, active knee extension test, and Western Ontario and McMaster Universities Arthritis Index (WOMAC) Urdu version questionnaire. Measurements from both knees assessed quadriceps muscle strength, hamstring length, and physical limitations. Results: The median interquartile range (IQR) of quadricep strength for the more painful knee was 0.53 (0.36) Nm/kg and 1.35 (0.34) Nm/kg for the less painful knee showing a significant difference in quadriceps strength (P < 0.01). In terms of hamstring length, the more painful knee had a median (IQR) of 29.0 (2.0) degrees whereas the less painful knee recorded 11.0 (6.0) degrees indicating a significant difference (P < 0.01). Likewise, there was a significant difference in WOMAC scores between the less painful and more painful knees (P < 0.01). Conclusion: This study found that individuals experiencing more knee pain demonstrated decreased quadriceps muscle strength and increased hamstring muscle tightness. In addition, those with more painful knees exhibited greater physical limitations in bilateral knee OA.

Comparative Effect of Faradic and Russian Currents on the Quadriceps Muscle in Patients with Knee Osteoarthritis

Abstract: Osteoarthritis is amongst the most common musculoskeletal condition which affects overall function and quality of life in the Indian population. Clinical features of knee osteoarthritis include pain that affects the functional mobility of joints and thus interferes with walking and activities of daily living. Quadriceps function declines with age, and is further impaired in patients with knee and may contribute to the risk of falls. The aim of the present study was to compare the effect of Faradic and Russian Currents on the quadriceps muscle in Patients with knee osteoarthritis. Objectives: To evaluate the effect of Faradic Currants on the quadriceps muscle for the management ofknee osteoarthritis. To evaluate the effects of Russian Currants on the quadriceps muscle for t h e management of knee osteoarthritis. To Comparative effects between Faradic and Russian Currants on the quadriceps muscle formanagement of knee osteoarthritis. Methodology: Permission from the head of the department of Sanskriti University Mathura, and approval from the ethical committee. Patients pre-diagnosed with grade II OA were selected for this study. Consent was taken from the patients after confirming the diagnosis of Grade II OA. The subjects were divided into two groups (15 in each group): one group consist of a Faradic current + quadriceps isometric exercise (5 days a week for 4 weeks) and the second group consisted of a Russian current + quadriceps isometric exercise (5 days in a week for 4 weeks). Result: The statistics a r e done based on the objectives and hypotheses and it has been organized by following three sections: Section I: Frequency and percentage distributions of socio-demographic variables.Section II: Effectiveness of pre and post-test values. Section III: Comparison of Faradic Currants and Russian Currants Values. Conclusion: This study concludes that faradic current and Russian current show significant effect in quadriceps muscle in patients with knee osteoarthritis and there is no significant difference between faradic and Russian current on quadriceps muscle Patients with knee osteoarthritis.But the only significant difference in WOMAC scores after intervention (The WOMAC score ismore decreased in Russian as compared to faradic current)

Intra-Articular Injection of Autologous Micro-Fragmented Adipose Tissue for the Treatment of Knee Osteoarthritis: A Prospective Interventional Study.

To investigate the efficacy and safety of autologous micro-fragmented adipose tissue (MF-AT) for improving joint function and cartilage repair in patients with knee osteoarthritis. From March 2019 to December 2020, 20 subjects (40 knees) between 50 and 65 years old suffering from knee osteoarthritis were enrolled in the study and administered a single injection of autologous MF-A. The data of all patients were prospectively collected. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), knee society score (KSS), hospital for special surgery (HSS) score, visual analogue score (VAS) pain score, changes in cartilage Recht grade on magnetic resonance imaging (MRI) and adverse events were analyzed before and 3, 6, 9, 12 and 18 months after injection. The WOMAC, VAS, KSS and HSS scores at 3, 6, 9, 12 and 18 months after injection were improved compared with those before injection (p < 0.05). There was no significant difference in WOMAC scores between 9 and 12 months after injection (p > 0.05), but the WOMAC score 18 months after injection was worse than that at the last follow-up (p < 0.05). The VAS, KSS and HSS scores 9, 12 and 18 months after injection were worse than those at the last follow-up (p < 0.05). The Recht score improvement rate was 25%. No adverse events occurred during the follow-up. Autologous MF-AT improves knee function and relieves pain with no adverse events. However, the improved knee function was not sustained, with the best results occurring 9-12 months after injection and the cartilage regeneration remaining to be investigated.

V-Y turndown flap augmentation for acute quadriceps rupture after total knee arthroplasty: a prospective matched cohort study.

To evaluate the effectiveness of the quadriceps V-Y turndown augmentation for acute quadriceps tendon ruptures in the setting of TKA. Prospective cohort of 22 patients with quadriceps rupture after TKA were compared with 44 matched patients underwent TKA without quadriceps rupture. Quadriceps ruptures were treated within threeweeks after injury by suture augmented with Scuderi quadriceps V-Y turndown flap. Clinical evaluation was performed by the Knee Society Scores (KSS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and range of motion. Patellar height was assessed by the Blackburne-Peel ratio. The mean follow-up was 3.3 (range, 3-4) years. At the final follow-up, there were significant improvements in mean KSS scores in both groups (p = 0.001). In the quadriceps group, the mean flexion for all patients, but one with arthrodesis for periprosthetic infection, was 100.1° (range, 90-110°) and mean extensor lag was 7.1° (range, 0-20°). There were significant differences between groups in KSS scores (p = 0.001). Active flexion (p = 0.020) and extension (p = 0.001) were significantly better in the control group. However, there was no significant difference in WOMAC scores (p = 0.252) or patient satisfaction (p = 0.352). There were no quadriceps reruptures. One patient with periprosthetic infection was treated with arthrodesis. The quadriceps V-Y turndown is an effective and safe procedure for quadriceps ruptures in the setting of TKA. Although the functional outcomes were lower than in TKA patients with no quadriceps rupture, the quality of life and satisfaction were successful in the TKA patients with quadriceps rupture.

Effect of Sodium Hyaluronate on Recovery after Arthroscopic Knee Surgery

The aim of this study was to evaluate the effect of a single immediate postoperative instillation of 10 mL of sodium hyaluronate (Viscoseal) into the knee following arthroscopy. A single-center, prospective, randomized, controlled study was undertaken. Consenting knee arthroscopy patients were randomized into two groups following surgery: the study group received 10 mL of sodium hyaluronate intra-articularly, while the control group received an intra-articular instillation of 10 mL of Bupivacaine. Pre- and postoperative visual analogue scale scores for pain and Western Ontario and McMaster Universities (WOMAC) scores for knee function were obtained. Overall, 48 patients under the care of a single surgeon were randomized into two groups of 24. There were no statistically significant demographic differences at baseline. Three patients were lost to follow-up. There was a statistically significant difference in pain scores favoring the study group compared with the control group at 3 and 6 weeks postoperatively (p < 0.05), and a statistically significant difference in WOMAC scores favoring the study group compared with the control group at 3 and 6 weeks postoperatively (p = 0.01). Synovial fluid replacement with sodium hyaluronate following arthroscopic knee surgery conferred statistically significant improvements in pain and function scores compared with Bupivacaine in the short term (3-6 weeks).

The Marine‐derived, Multi‐mineral formula, AquaPT Reduces TNF- Levels in Osteoarthritis Patients

Osteoarthritis (OA) is a common degenerative disease of the joints. Current anti-inflammatory treatment strategies for OA, such as non-steroidal anti-inflammatory drugs (NSAIDs), are effective for symptom relief but are associated with adverse side effects including gastrointestinal and cardiovascular complications during long term use. Thus, alternative treatments for the disease are necessary to supplement current treatment options. The nutraceutical, Aquamin, is a seaweed-derived, multi-mineral supplement that has proven promising in ameliorating the symptoms of moderate to severe OA, potentially through blockade of pro-inflammatory signalling pathways and cytokines. The aim of this study was to evaluate the effect of Aquamin or Aquamin supplemented with green tea and pine bark extract (AquaPT) on inflammatory biomarker levels in the blood of OA patients. OA subjects received Aquamin or AquaPT for 6 weeks. The impact of the treatment on Western Ontario and McMaster Universities (WOMAC) OA index scores and serum tumour necrosis factor-alpha (TNF-α) levels were investigated. While no significant differences in WOMAC scores were evident post treatment, the AquaPT-treated subjects had reduced serum TNF-α levels. These data suggest that the addition of green tea and pine bark extract to Aquamin gives the seaweed-derived supplement a detectable anti- inflammatory effect.

The efficacy of tramadol/acetaminophen combination tablets (Ultracet®) as add-on and maintenance therapy in knee osteoarthritis pain inadequately controlled by nonsteroidal anti-inflammatory drug (NSAID)

The purpose of this study is to compare the efficacy of tramadol 37.5mg/acetaminophen 325mg combination tablets (tramadol/APAP) with that of nonsteroidal anti-inflammatory drugs (NSAIDs) as maintenance therapy following tramadol/APAP and NSAID combination therapy in knee osteoarthritis (OA) pain which was inadequately controlled by NSAIDs. Subjects with knee OA for over 1year and moderate pain (numerical rating scale [NRS] ≥5) despite at least 4weeks' NSAID therapy (meloxicam 7.5mg or 15mg qd or aceclofenac 100mg bid) received tramadol/APAP add-on (combination with NSAID) for 4weeks. Thereafter, subjects with significant pain improvement (NRS <4) were randomized to receive either tramadol/APAP or NSAID for 8weeks. On days29 and 57, Western Ontario and McMaster Universities (WOMAC) OA index score was measured. Secondary measures included pain intensity (NRS), pain relief score, and subjects' and investigators' overall medication assessments. Of 143 subjects enrolled, 112 completed the 4-week tramadol/APAP and NSAID combination phase and 97 (67.8%) experienced significant pain improvement. Of the 97 subjects randomized, 36 in tramadol/APAP group and 47 in NSAID group completed the 8-week comparator study. On days29 and 57, WOMAC scores and pain intensities did not increase in both groups compared to measurements immediately after the combination therapy. At these two time points, there were no significant differences in WOMAC scores, pain intensities, and other secondary measures between the two groups. Overall adverse event rates were similar in both groups. Tramadol/APAP add-on significantly improved knee OA pain which had been inadequately controlled by NSAIDs. In those subjects who showed favorable response to tramadol/APAP and NSAID combination therapy, both tramadol/APAP and NSAIDs were effective at maintaining the pain-reduced state and there was no significant difference in efficacy between tramadol/APAP and NSAIDs.

A natural seaweed derived mineral supplement (Aquamin F) for knee osteoarthritis: A randomised, placebo controlled pilot study

BackgroundOsteoarthritis (OA) is a slowly destructive process that may be influenced by a nutritional mineral balance in the body.MethodsThis small, double blind, placebo controlled pilot study investigated the impact of treatment with a natural multi-mineral supplement from seaweed (Aquamin) on 6 minute walking distance (6 MWD), range of motion (ROM), and pain and joint mobility measured by the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index in subjects with moderate to severe OA of the knee during gradual withdrawal of non-steroidal anti-inflammatory drugs (NSAIDs) that were being used daily for pain management. Subjects (n = 29) with moderate to severe OA of the knee were randomised to receive either Aquamin (2400 mg/d) or Placebo for up to 12 weeks.ResultsOf the 29 subjects initially randomized, only 22 subjects proceeded to treatment due to 7 subjects not meeting study selection criteria at baseline. Fourteen subjects completed the study and an ITT analysis (n = 22) of the data showed no significant differences in WOMAC scores however, the data did reveal significant improvements in passive and active extension ROM (0.83° ± 1.54 vs. -1.54° ± 2.43; difference, 5.2° ± 2.2, p = 0.028) and 6 MWD (150 ± 48 ft vs. 12.5 ± 31.5 ft; difference, 136 ± 57 ft, p = 0.03) in the Aquamin group compared to the placebo group; respectively, following a 50% reduction in NSAID use. The treatments were well tolerated and the adverse event profiles were not significantly different between the groups.ConclusionThis small preliminary study suggests Aquamin may increase range of motion and walking distances in subjects with OA of the knee and may allow partial withdrawal of NSAIDs over 12 weeks of treatment. Additional research is needed to confirm these preliminary observations.Trial registrationNCT00755482

Effect of Coexisting Foot Deformity on Disability in Women with Knee Osteoarthritis

Knee osteoarthritis, a common musculoskeletal disorder, can cause considerable pain and disability. This study investigates the effect of certain foot deformities on the functional status of women with knee osteoarthritis. The common foot deformities pes planus and hallux valgus were evaluated in 115 women with knee osteoarthritis and Kellgren-Lawrence grade 2 and 3 osteoarthritis. Anteroposterior and lateral foot-ankle standard radiographs were obtained bilaterally. A lateral talometatarsal angle greater than 4 degrees was defined as pes planus. A hallux valgus angle greater than 21 degrees was defined as hallux valgus. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used to objectively assess functional impairment. Knee pain intensity was measured with a visual analog scale. Fifty-nine patients had bilateral pes planus, hallux valgus, or both. The mean visual analog scale value was higher for the deformity group, but the difference was not statistically significant. There was a significant difference in WOMAC scores between the group with foot deformities versus the group without (P = .000). Visual analog scale scores were positively correlated with WOMAC scores (r = 0.499, P = .000). Also, there was a significant correlation between WOMAC scores and lateral talometatarsal angle (r = 0.266, P = .004) and hallux valgus angle (r = 0.362, P = .000) values. There is a significant correlation between indicators of pain and disability (visual analog scale and WOMAC scores). Also, the presence of foot deformities increased disability levels in women with knee osteoarthritis.