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Latest & greatest articles for knee osteoarthritis
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Full-text links Cite Abstract Objective: Tanezumab, a nerve growth factor inhibitor, was investigated for osteoarthritis (OA) of the hip or knee in a study with 24-week treatment and 24-week safety follow-up. Methods: This double-blind, randomised, phase III study enrolled adults in Europe and Japan with moderate-to-severe OA who had not responded to or could not tolerate standard-of-care analgesics. Patients were randomised to tanezumab 2.5 mg or 5 mg subcutaneously or matching placebo every 8 (...) weeks (three doses). Co-primary end points were change from baseline to week 24 in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain and Physical Function, and Patient's Global Assessment of OA (PGA-OA). Joint safety and neurological assessments continued throughout the 48-week study. Results: From March 2016 to December 2017, 849 patients were randomised and evaluated (placebo n=282, tanezumab 2.5 mg n=283, tanezumab 5 mg n=284). At week 24, there was a statistically
an evidence- based guideline for the comprehensive management of osteoarthritis (OA) as a collabora- tion between the American College of Rheumatology (ACR) and the Arthritis Foundation, updating the 2012 ACR recommenda- tions for the management of hand, hip, and kneeOA. Methods. We identified clinically relevant population, intervention, comparator, outcomes questions and critical outcomes in OA. A Literature Review T eam performed a systematic literature review to summarize evidence supporting (...) low and/ Figure 1. Recommended therapies for the management of osteoarthritis (OA). Strongly and conditionally recommended approaches to management of hand, knee, and/or hip OA are shown. No hierarchy within categories is implied in the figure, with the recognition that the various options may be used (and reused) at various times during the course of a particular patient’s disease. * = Exercise for knee and hip OA could include walking, strengthening, neuromuscular training, and aquatic exercise
Intraarticular injection of platelet-rich plasma in kneeosteoarthritis: single versus triple application approach. Pilot study. To compare the clinical effectiveness of the triple intra-articular injection of platelet-rich plasma (PRP) with respect to the single injection in patients with mild osteoarthritis of the knee.A total of 35 patients with a clinical and radiographic diagnosis of osteoarthritis grade I and II were analyzed. They were randomized into two groups: single application (18 (...) ±7.3; p lt 0.05) at the end of the study. The triple application showed better improvement in the VAS (p= 0.0007) and the total WOMAC (p= 0.0209) scores when comparing the final results between groups.The triple infiltration of PRP in patients with mild kneeosteoarthritis is clinically more effective than the single application at 48 weeks of follow-up.
in Osteoarthritis of the Knee: A Review of Clinical Effectiveness and Safety Last updated: June 24, 2019 Project Number: RC1136-000 Product Line: Research Type: Devices and Systems Report Type: Summary with Critical Appraisal Result type: Report Question What is the clinical effectiveness and safety of intra-articular hyaluronic acid for patients with osteoarthritis of the kneejoint? Key Message Evidence suggests that there may be differences in the efficacy of intraarticular hyaluronic acid for treatment (...) of kneeosteoarthritis with respect to hyaluronic acid products, numbers of injection regimen, and disease severity. Intraarticular hyaluronic acid was found to be more effective with high molecular weight and biological fermented products, with 2-to-4 injection regimens, and in patients with low-to-moderate osteoarthritis. However, studies with direct head-to-head comparison are needed to confirm these findings. Between intraarticular hyaluronic acid and intraarticular corticosteroid, evidence
The clinical and cost-effectiveness of total versus partial knee replacement in patients with medial compartment osteoarthritis (TOPKAT): 5-year outcomes of a randomised controlled trial. Late-stage isolated medial kneeosteoarthritis can be treated with total knee replacement (TKR) or partial knee replacement (PKR). There is high variation in treatment choice and little robust evidence to guide selection. The Total or Partial Knee Arthroplasty Trial (TOPKAT) therefore aims to assess (...) the clinical effectiveness and cost-effectiveness of TKR versus PKR in patients with medial compartment osteoarthritis of the knee, and this represents an analysis of the main endpoints at 5 years.Our multicentre, pragmatic randomised controlled trial was done at 27 UK sites. We used a combined expertise-based and equipoise-based approach, in which patients with isolated osteoarthritis of the medial compartment of the knee and who satisfied general requirements for a medial PKR were randomly assigned (1:1
2019LancetControlled trial quality: predicted high
Surgical interventions for symptomatic mild to moderate kneeosteoarthritis. Osteoarthritis affecting the knee is common and represents a continuum of disease from early cartilage thinning to full-thickness cartilage loss, bony erosion, and deformity. Many studies do not stratify their results based on the severity of the disease at baseline or recruitment.To assess the benefits and harms of surgical intervention for the management of symptomatic mild to moderate kneeosteoarthritis defined (...) been restricted to the primary comparison: surgical intervention versus non-surgical intervention.A single study, included 320 participants with symptoms consistent with meniscal tear. All subjects had the meniscal tear confirmed on knee MRI and radiographic evidence of mild to moderate osteoarthritis (osteophytes, cartilage defect or joint space narrowing). Patients with severe osteoarthritis (KL grade 4) were excluded. The study compared arthroscopic partial meniscectomy and physical therapy
Effect of Tanezumab on Joint Pain, Physical Function, and Patient Global Assessment of Osteoarthritis Among Patients With Osteoarthritis of the Hip or Knee: A Randomized Clinical Trial. Patients with osteoarthritis (OA) may remain symptomatic with traditional OA treatments.To assess 2 subcutaneous tanezumab dosing regimens for OA.A randomized, double-blind, multicenter trial from January 2016 to May 14, 2018 (last patient visit). Patients enrolled were 18 years or older with hip or kneeOA (...) , inadequate response to OA analgesics, and no radiographic evidence of prespecified joint safety conditions.Patients received by subcutaneous administration either tanezumab, 2.5 mg, at day 1 and week 8 (n = 231); tanezumab, 2.5 mg at day 1 and 5 mg at week 8 (ie, tanezumab, 2.5/5 mg; n = 233); or placebo at day 1 and week 8 (n = 232).Co-primary end points were change from baseline to week 16 in Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC) Pain (0-10, no to extreme pain), WOMAC
The effectiveness of high molecular weight hyaluronic acid for kneeosteoarthritis in patients in the working age: a randomised controlled trial High molecular weight (HMW) hyaluronic acid (HA) is a treatment option for kneeosteoarthritis (OA). The efficacy of HMW-HA in kneeOA is investigated extensively, but the effectiveness in patients in the working age is unknown. Nevertheless, the number kneeOA patients in the working age is increasing. Surgical treatment options are less eligible (...) in these patients and productivity losses are high. In this study the effectiveness of intra-articular HMW-HA added to regular non-surgical usual care in everyday clinical practice (UC) compared to UC over 52 weeks in symptomatic kneeOA patients in the working age was investigated.In this open labelled randomized controlled trial, subjects aged between 18 and 65 years with symptomatic kneeOA (Kellgren and Lawrence I-III) were enrolled and randomized to UC + 3 weekly injections with HMW-HA (intervention) or UC
Effect of 6-week retro or forward walking program on pain, functional disability, quadriceps muscle strength, and performance in individuals with kneeosteoarthritis: a randomized controlled trial (retro-walking trial) Previous studies reported the beneficial effects of walking in individual with mild to moderate kneeosteoarthritis (OA). The current study aimed to compare the effect of 6-week retro versus forward walking program versus control group on pain, functional disability, quadriceps (...) muscle strength and physical performance in individuals with knee OA.A three-arm single-blinded, randomized, controlled trial and intention-to-treat analysis was conducted in outpatient physiotherapy department, King Saud University, Saudi Arabia. Sixty-eight individuals (mean age, 55.6 years; 38 female) with kneeOA participated. The participants in the retro or forward walking group completed 10 min of supervised retro or forward walking training in addition to usual care, 3 days/week for 6 weeks
Pooled analysis of tanezumab efficacy and safety with subgroup analyses of phase III clinical trials in patients with osteoarthritis pain of the knee or hip A pooled analysis was conducted to evaluate tanezumab efficacy and safety in patients with osteoarthritis (OA), including subgroup analyses of at-risk patients with diabetes, severe OA symptoms, and those aged ≥65 years.Data from phase III placebo-controlled clinical trials of patients with moderate-to-severe OA of the knee or hip were (...) pooled to evaluate tanezumab efficacy (four trials) and safety (nine trials). Patients received intravenous tanezumab, tanezumab plus an oral NSAID (naproxen, celecoxib, or diclofenac), active comparator (naproxen, celecoxib, diclofenac, or oxycodone), or placebo. Efficacy assessments included change from baseline to week 16 in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and physical function scores, Patient's Global Assessment (PGA) of OA, and percentage of patients
The effects of a home-based exercise intervention on elderly patients with kneeosteoarthritis: a quasi-experimental study Kneeosteoarthritis (KOA) is common in elderly people, causes pain, loss of physical functioning, and disability. This was a two-arm, superiority, quasi-experimental trial. The aim of this study was to evaluate the effectiveness of a home-based exercise intervention (HBEI) to reduce KOA symptoms and improve the physical functioning of elderly patients.A total of 171 elderly (...) and physiotherapists were aware of the group assignment and alternative treatment components, but the study's hypotheses were not disclosed to the participants. Pain intensity, joint stiffness, lower-limb muscle strength, balance, mobility, and quality of life were measured before and after the intervention by the same blinded assessor.A total of 171 patients (IG: n = 84, CG: n = 87) were enrolled. Data were obtained from 141 patients with an average age of 68 (range, 60-86 years) who completed the 12-week study
Newer Interventions for Osteoarthritis of the Knee Health Evidence Review Commission (HERC) Coverage Guidance: Newer Interventions for Osteoarthritis of the Knee Approved 3/14/2019 HERC Coverage Guidance Whole body vibration Whole body vibration is not recommended for coverage (strong recommendation). TENS TENS is not recommended for coverage (strong recommendation). Glucosamine-chondroitin Glucosamine-chondroitin is not recommended for coverage (weak recommendation). Glucosamine alone (...) is not recommended for coverage (strong recommendation). Chondroitin alone is not recommended for coverage (weak recommendation). Platelet-rich plasma Platelet-rich plasma is not recommended for coverage (weak recommendation) Note: Definitions for strength of recommendation are in Appendix A. GRADE Table Element Descriptions. Rationales for each recommendation appear below in the GRADE table. 2 ¦ Newer Interventions for Osteoarthritis of the Knee Approved 3/14/2019 Table of Contents Coverage Guidance: Newer
Could Activity Modifications Indicate Physical Decline Among Adults With Symptomatic KneeOsteoarthritis? Mobility activity modifications indicate early functional losses that act as precursors to future declines among community-dwelling older adults. However, there is scarce evidence on whether activity modifications indicate poorer physical health among adults with symptomatic osteoarthritis, a major cause of disability. Our purpose was to investigate whether patient-reported mobility (...) with symptomatic kneeosteoarthritis. If confirmed, patient-reported activity modifications may enhance symptom evaluation in osteoarthritis and enable a better understanding of the disablement process.
Effects of Platelet-Rich Plasma on Pain and Muscle Strength in Patients With KneeOsteoarthritis. No studies comparing the effects of platelet-rich plasma (PRP) injection and placebo injection in bilateral kneeosteoarthritis in the same patient, or discussing muscle strength after PRP injection, have been published.Twenty patients with bilateral kneeosteoarthritis were eligible, and 40 knees were randomized into two groups: PRP (knees [right or left by a coin toss] receiving a single intra (...) -articular PRP injection) and saline group (the contralateral knee of the same patient, into which single 4-mL intra-articular injection of normal saline was administered). The primary outcome measure was Western Ontario and McMaster's Universities Osteoarthritis Index and the secondary included isokinetic test results. The evaluation was at baseline and at 2 wks, 1, 3, and 6 mos after injection.The PRP group showed a significant reduction in the Western Ontario and McMaster's Universities Osteoarthritis
supervision . References 1. The Royal Australian College of General Practitioners (RACGP). 2018. Guideline for the management of knee and hip osteoarthritis. 2nd edn. East Melbourne, Vic: RACGP. https://www.racgp.org.au/FSDEDEV/media/documents/Clinical%20Resources/Guidelines/Joint%20replacement/Guidelin e-for-the-management-of-knee-and-hip-OA-2nd-edition.pdf 2. Allen S, Forney-Gorman A, Homan M, Kearns A, Kramlinger A, Sauer M. 2017. Diagnosis and treatment of osteoporosis. Bloomington (MN): Institute (...) Exercise for osteoarthritis of the knee and risk of subsequent osteoporotic vertebral fractures Exercise for osteoarthritis of the knee and subsequent vertebral fracture: An Evidence Snapshot 1 Exercise for osteoarthritis of the knee and risk of subsequent osteoporotic vertebral fractures Citation Garrubba M & Melder A. 2018. Exercise for Osteoarthritis of the knee and risk of subsequent osteoporotic vertebral fractures. Centre for Clinical Effectiveness, Monash Health, Victoria. Contact CCE
Biologic Therapies for the Treatment of KneeOsteoarthritis The use of biologic therapies for the management of kneeosteoarthritis has increased, despite insufficient evidence of efficacy. Our aim was to complete a systematic review and analysis of reports utilizing the highest level-of-evidence evaluating: (1) platelet-rich plasma injections (PRPs); (2) bone marrow-derived mesenchymal stem cells (BMSCs); (3) adipose-derived mesenchymal stem cells (ADSCs); and (4) amnion-derived mesenchymal (...) stem cells (AMSCs).PubMed, Embase, and Cochrane Library databases were queried for studies evaluating PRP injections, BMSCs, ADSCs, and AMSCs in patients with kneeosteoarthritis. Of 1009 studies identified within the last 5 years, 123 met inclusion criteria. A comprehensive analysis of all levels-of-evidence was performed, as well as separate analysis on level-of-evidence I studies. Level-of-evidence was determined by the American Academy of Orthopedic Surgeons classification system.Although
Intra-articular Injection of Platelet-Rich Plasma Is Superior to Hyaluronic Acid or Saline Solution in the Treatment of Mild to Moderate KneeOsteoarthritis: A Randomized, Double-Blind, Triple-Parallel, Placebo-Controlled Clinical Trial To prospectively compare the efficacy of intra-articular injections of platelet-rich plasma (PRP) and hyaluronic acid (HA) with a sham control group (normal saline solution [NS]) for kneeosteoarthritis in a randomized, dose-controlled, placebo-controlled (...) , double-blind, triple-parallel clinical trial.A total of 87 osteoarthritic knees (53 patients) were randomly assigned to 1 of 3 groups receiving 3 weekly injections of either leukocyte-poor PRP (31 knees), HA (29 knees), or NS (27 knees). The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score and International Knee Documentation Committee (IKDC) subjective score were collected at baseline and at 1, 2, 6, and 12 months after treatment. Data were analyzed using generalized