scholarly journals Intra-Articular Hybrid Hyaluronic Acid Injection Treatment in Overweight Patients with Knee Osteoarthritis: A Single-Center, Open-Label, Prospective Study

2021 ◽  
Vol 11 (18) ◽  
pp. 8711
Author(s):  
Dalila Scaturro ◽  
Fabio Vitagliani ◽  
Pietro Terrana ◽  
Daniele Cuntrera ◽  
Vincenzo Falco ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hyaluronic Acid ◽  
Knee Osteoarthritis ◽  
Disease Severity ◽  
Prospective Trial ◽  
Open Label ◽  
Knee Oa ◽  
Symptomatic Knee ◽  
Significant Difference

Background: A BMI > 25 is the most decisive, albeit modifiable, risk factor for knee osteoarthritis (KOA). This study aimed at assessing the efficacy of intra-articular injections of hybrid hyaluronic acid (HA) complexes (Sinovial® H-L) for the treatment of KOA in overweight patients in terms of disease severity, cardiocirculatory capacity, and quality of life. Materials: In this single-site, open-label, prospective trial, 37 patients with symptomatic knee OA were assessed at baseline and 3 months after ultrasound-guided intra-articular injection of hybrid HA complexes (Sinovial® H-L). Results: Primary variables displaying a statistically significant improvement after treatment were pain (VAS), disease severity (WOMAC), and cardiopulmonary capacity (6 min walk test). Among secondary variables, quality of life (SF-12) improved significantly, as did analgesic intake for pain control. No statistically significant difference was observed in body fat and muscle mass percentage measured by bioelectrical impedance analysis. Conclusions: Intra-articular hybrid HA injections are significantly effective in improving OA-related disease severity, cardiopulmonary function, and analgesic intake. This supports the role of hybrid HA viscosupplementation as a nonpharmacological treatment to relieve pain, reduce disability, improve quality of life, and limit the risk of polypharmacy in overweight patients with knee OA.

scholarly journals Platelet-Rich Plasma Injections for Advanced Knee Osteoarthritis: A Prospective, Randomized, Double-Blinded Clinical Trial

2017 ◽  
Vol 5 (2) ◽  
pp. 232596711668938 ◽  
Author(s):  
Nayana Joshi Jubert ◽  
Luciano Rodríguez ◽  
Maria Mercedes Reverté-Vinaixa ◽  
Aurora Navarro
Keyword(s):  
Quality Of Life ◽  
Knee Osteoarthritis ◽  
Late Stage ◽  
Platelet Rich Plasma ◽  
Short Form ◽  
Controlled Trial ◽  
Young Patients ◽  
Knee Oa ◽  
Symptomatic Knee

Background: Intra-articular injections of platelet-rich plasma (PRP) to treat symptoms of knee osteoarthritis (OA) have been successfully used in young patients and in the early stages of disease. No previous studies have analyzed outcomes of PRP injections during the late stages. Hypothesis: PRP reduces pain and leads to a more effective and lasting functional recovery than corticosteroid with local anesthetic. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: A total of 75 patients with symptomatic knee OA (Kellgren-Lawrence grade 3 to 4) were enrolled in this study between August 2013 and July 2014. Patients were randomized to treatment either with a single leukocyte-reduced PRP or corticosteroid intra-articular injection. The primary variable was visual analog scale assessment at 1 month. Secondary outcomes were the Knee injury and Osteoarthritis Outcome Score (KOOS) and Short Form–36 (SF-36) at 1, 3, and 6 months after treatment. Patient satisfaction at final follow-up was assessed. Both groups were homogeneous and comparable in baseline characteristics. Results: All variables improved in both groups. Statistical differences between groups were not found for the majority of the outcome variables, although the magnitude of improvements tended to be greater in the PRP group. Quality-of-life differences between values at 3 and 6 months versus baseline increased significantly more in the study group ( P = .05 and .03, respectively), and so did general health perception differences at 6 months ( P = .018). Conclusion: A single PRP intra-articular injection is effective for relieving pain and improving activities of daily living and quality of life in late-stage knee OA. For patients with late-stage knee OA who are 67 years or older, 1 intra-articular injection of PRP has similar results to 1 shot of corticosteroid.

scholarly journals Bone marrow aspirate concentrate versus platelet-rich plasma for treating knee osteoarthritis: a one-year non-randomized retrospective comparative study

2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Abed El-Hakim El-Kadiry ◽  
Carlos Lumbao ◽  
Natasha Salame ◽  
Moutih Rafei ◽  
Riam Shammaa
Keyword(s):  
Quality Of Life ◽  
Bone Marrow ◽  
Comparative Study ◽  
Knee Osteoarthritis ◽  
Bone Marrow Aspirate ◽  
Platelet Rich Plasma ◽  
Knee Oa ◽  
Symptomatic Knee ◽  
Retrospective Comparative Study

Abstract Background Knee osteoarthritis (OA) is a debilitating condition affecting human body biomechanics and quality of life. Current standard care for knee OA leads to trivial improvement and entails multiple adverse effects or complications. Recently, investigational cell therapies injected intra-articularly, such as bone marrow aspirate concentrate (BMAC) and platelet-rich plasma (PRP), have shown safety and therapeutic potency providing patients with pain relief. In the current retrospective comparative study, we investigated the differences in pain and functional improvements in patients with symptomatic knee OA receiving intra-articular injections of BMAC vs PRP. Methods Pain and functionality scores were measured at baseline and at different time points post-injection over 12 months, using 3 self-administered, clinically validated questionnaires: the visual analogue scale (VAS) for assessing pain intensity, the knee injury and osteoarthritis outcome score (KOOS) for evaluating functionality and knee-related quality of life, and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) for evaluating physical function. The repeated-measures general linear model with Sidak test for pairwise comparisons was used to investigate the influence of the treatment on the score evolution within groups (between baseline and each time point) and between groups (overall). Results The BMAC group (n = 26 knees) significantly improved in VAS, KOOS, and WOMAC scores between baseline and 12 months (57.4, 75.88, and 73.95% mean score improvement, respectively). In contrast, the PRP group (n = 13 knees) witnessed nonsignificant improvement in all scores. BMAC, in comparison to PRP, induced significant improvement in outcomes by 29.38% on the VAS scale, 53.89% on the KOOS scale, and 51.71% on the WOMAC scale (P < .002, P < .01, P < .011, respectively). Conclusions Intra-articular autologous BMAC injections are safe, effective in treating pain, and ameliorate functionality in patients with symptomatic knee OA to a greater extent than PRP injections. Graphical abstract Intra-articular autologous BMAC therapy is safe and provides more relief to patients with symptomatic knee osteoarthritis compared to PRP therapy.

scholarly journals Knee Osteoarthritis Injection Choices: Platelet- Rich Plasma (PRP) versus Hyaluronic Acid (A one-year randomized clinical trial)

2015 ◽  
Vol 8 ◽  
pp. CMAMD.S17894 ◽  
Author(s):  
Seyed Ahmad Raeissadat ◽  
Seyed Mansoor Rayegani ◽  
Hossein Hassanabadi ◽  
Mohammad Fathi ◽  
Elham Ghorbani ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Clinical Trial ◽  
Hyaluronic Acid ◽  
Knee Osteoarthritis ◽  
Randomized Clinical Trial ◽  
Platelet Rich Plasma ◽  
Healing Process ◽  
Knee Oa ◽  
Sf 36

Introduction Knee osteoarthritis (OA) is the most common articular disease. Different methods are used to alleviate the symptoms of patients with knee OA, including analgesics, physical therapy, exercise prescription, and intra-articular injections (glucocorticoids, hyaluronic acid [HA], etc). New studies have focused on modern therapeutic methods that stimulate cartilage healing process and improve the damage, including the use of platelet-rich plasma (PRP) as a complex of growth factors. Due to the high incidence of OA and its consequences, we decided to study the long-term effect of intraarticular injection of PRP and HA on clinical outcome and quality of life of patients with knee OA. Method This non-placebo-controlled randomized clinical trial involved 160 patients affected by knee OA, grade 1–4 of Kellgren–Lawrence scale. In the PRP group ( n = 87), two intra-articular injections at 4-week interval were applied, and in the HA group ( n = 73), three doses of intra-articular injection at 1-week interval were applied. All patients were prospectively evaluated before and at 12 months after the treatment by Western Ontario and McMaster Universities Arthritis Index (WOMAC) and SF-36 questionnaires. The results were analyzed using SPSS 16.1 software (RCT code: IRCT2014012113442N5). Results At the 12-month follow-up, WOMAC pain score and bodily pain significantly improved in both groups; however, better results were determined in the PRP group compared to the HA group ( P < 0.001). Other WOMAC and SF-36 parameters improved only in the PRP group. More improvement (but not statistically significant) was achieved in patients with grade 2 OA in both the groups. Conclusion This study suggests that PRP injection is more efficacious than HA injection in reducing symptoms and improving quality of life and is a therapeutic option in select patients with knee OA who have not responded to conventional treatment.

scholarly journals Exercise therapy and patient education versus intra-articular saline injections in the treatment of knee osteoarthritis: an evidence-based protocol for an open-label randomised controlled trial (the DISCO trial)

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Elisabeth Bandak ◽  
Anders F. Overgaard ◽  
Lars Erik Kristensen ◽  
Karen Ellegaard ◽  
Jørgen Guldberg-Møller ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Patient Education ◽  
Knee Osteoarthritis ◽  
Education Intervention ◽  
Open Label ◽  
Knee Oa ◽  
Link Type ◽  
Pain Subscale ◽  
Randomised Controlled

Abstract Background Knee osteoarthritis (OA) is a highly prevalent musculoskeletal condition causing pain, physical disability, and reduced quality of life. Exercise and patient education are non-pharmacological interventions for knee OA unanimously recommended as first-line treatments based on extensive research evidence. However, none of the numerous randomised controlled trials of exercise and education for knee OA has used adequate sham/placebo comparison groups because the ‘active’ ingredients are unknown. Designing and executing an adequate and ‘blindable placebo’ version of an exercise and education intervention is impossible. Therefore, using an open-label study design, this trial compares the efficacy of a widely used ‘state-of-art’ exercise and education intervention (Good Life with osteoarthritis in Denmark; GLAD) with presumably inert intra-articular saline injections on improvement in knee pain in patients with knee OA. Methods In this open-label randomised trial, we will include 200 patients with radiographically verified OA of the knee and randomly allocate them to one of two interventions: (i) 8 weeks of exercise and education (GLAD) or (ii) Intra-articular injections of 5 ml isotonic saline every second week for a total of 4 injections. Outcomes are taken at baseline, after 8 weeks of treatment (week 9; primary endpoint) and after an additional 4 weeks of follow-up (week 12). The primary outcome is change from baseline in the Knee Injury and Osteoarthritis Outcome Score questionnaire (KOOS) pain subscale score. Secondary outcomes include the Physical function in Activities of Daily Living, Symptoms, and Knee-related Quality of Life subscales of the KOOS, the patients’ global assessment of disease impact, physical performance tests, and presence of knee joint swelling. Discussion This current trial compares a presumably active treatment (GLAD) with a presumably inert treatment (IA saline injections). Both study interventions have well-established and anticipated similar effects on knee OA symptoms, but the underlying mechanisms are unknown. The interpretation of the results of this trial will likely be difficult and controversial but will contribute to a better understanding of the bias introduced in the effect estimation of classically unblindable exercise and education interventions for knee OA. Trial registration www.ClinicalTrials.govNCT03843931. Prospectively registered on 18 February 2019.

scholarly journals Impact of Tart Cherry Juice on Joint Flexibility and Pain in Individuals with Self-Reported Knee Osteoarthritis (P01-030-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Chen Du ◽  
Sarah Collins Chapman ◽  
Young-Hoo Kwon ◽  
Parakat Vijayagopal ◽  
Shanil Juma
Keyword(s):  
Quality Of Life ◽  
Hyaluronic Acid ◽  
Placebo Group ◽  
Growth Factor ◽  
Knee Osteoarthritis ◽  
Tart Cherry ◽  
Daily Consumption ◽  
Cherry Juice ◽  
Igfbp 3

Abstract Objectives The purpose of this study was to examine the daily consumption of tart cherry juice in comparison to a placebo juice on symptoms associated with knee osteoarthritis in both men and woman, age 45–79 years old, for a treatment period of 120 days. Methods In a randomized, double-blind control trial, a total of 66 adults with self-reported symptomatic knee OA, were randomized to either consume a 16 oz of tart cherry juice (TCJ) or a placebo juice daily for 4 months. Pain, mobility, plasma biomarkers of cartilage metabolism were evaluated at baseline, 2 months and 4 months. Pain, stiffness, and impact on quality of life were assessed using Self-administered Modified Short Form McGill Pain Questionnaire, while flexibility of the afflicted joint(s) was assessed via range of motion assessment (ROM). Plasma biomarkers related to cartilage metabolism such as glycoprotein 39 (YKL-40), hyaluronic acid, insulin-like growth factor(IGF)-1, and insulin-like growth factor binding protein (IGFBP-3) were determined. Results A total of 57 participants completed the study with an attrition rate of 9%. Pain and impact on quality of life decreased significantly at mid-point in the TCJ group, but these improvements were not maintained at the final time point. At midpoint, right knee ROM increased significantly in the TCJ at mid-point, but did not maintain significant at the end of the treatment period. Knee extension and knee flexion also improved significantly in the TCJ group from baseline to midpoint, while there was no significant change in the placebo group. The TCJ group had an overall significant decrease in plasma YKL-40, a marker of cartilage destruction, while no changes were observed in the placebo group. A significant decrease in the plasma IGF-1 and a non-significant up trend in IGFBP-3 were observed in the placebo group, while in the TCJ group no changes in IGF-1 and a non-significant decrease in IGFBP-3 was observed. There were no changes in the hyaluronic acid in the TCJ group during the study duration, but a non-significant up trending was noticed in the placebo group. Conclusions The findings of the study suggest that daily consumption of tart cherry juice results in improvement in mobility, relief of pain-related symptoms and quality of life, and selective markers of cartilage health. Funding Sources Cherry Marketing Institute.

scholarly journals A Randomized Controlled Single-Blind Study Demonstrating Superiority of Amniotic Suspension Allograft Injection Over Hyaluronic Acid and Saline Control for Modification of Knee Osteoarthritis Symptoms

2019 ◽  
Vol 32 (11) ◽  
pp. 1143-1154 ◽  
Author(s):  
Jack Farr ◽  
Andreas H. Gomoll ◽  
Adam B. Yanke ◽  
Eric J. Strauss ◽  
Katie C. Mowry ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Hyaluronic Acid ◽  
Knee Osteoarthritis ◽  
Controlled Trial ◽  
Saline Control ◽  
Knee Oa ◽  
Randomized Controlled ◽  
Symptomatic Knee ◽  
Multicenter Randomized Controlled Trial ◽  
Patient Reported

AbstractPlacental-derived tissues are a known source of anti-inflammatory and immune modulating factors. Published pilot data on amniotic suspension allograft (ASA) for the treatment of osteoarthritis (OA) demonstrated safety and trends for improved pain and function. A multicenter randomized controlled trial was designed to evaluate the efficacy of symptom modulation with ASA compared with saline and hyaluronic acid (HA) in subjects with knee OA. A total of 200 subjects were randomized 1:1:1 to ASA, HA, or saline, with subjects blinded to their allocation. Changes from baseline of patient-reported outcomes (PROs)—EQ-5D-5L, Knee Osteoarthritis Outcome Score (KOOS), visual analog scale (VAS), Tegner, and Single Assessment Numerical Evaluation (SANE)—were compared between groups. Patients reporting unacceptable pain at 3 months were considered treatment failures and withdrawn from the study. Statistical analysis was completed by comparing changes in PROs from baseline to 3 and 6 months for all groups. Comparison of demographics between treatment groups showed no significant differences between groups. Patients reporting unacceptable pain at 3 months in each group were ASA (13.2%), HA (68.8%), and saline (75%). Patients receiving ASA demonstrated significantly greater improvements from baseline for overall pain (VAS), KOOS pain, and KOOS-activities of daily living scores compared with those in the HA group (3 months) and both groups (6 months). ASA patients had significantly greater improvements in KOOS symptom scores compared with HA and saline at 3 and 6 months, respectively. OMERACT-OARSI responder rates for ASA, HA, and saline groups were 69.1, 39.1, and 42.6%, respectively (p = 0.0007). Subjects receiving ASA treatment showed greater improvements in PROs and fewer patients reported unacceptable pain compared with HA and saline. The evidence presented in this Level I Randomized Controlled Trial suggests that ASA injection is an effective treatment for the nonoperative management of symptomatic knee OA.

scholarly journals Is Telephysiotherapy an Option for Improved Quality of Life in Patients with Osteoarthritis of the Knee?

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Adesola C. Odole ◽  
Oluwatobi D. Ojo
Keyword(s):  
Quality Of Life ◽  
Physical Health ◽  
Osteoarthritis Of The Knee ◽  
Group Comparison ◽  
Treatment Groups ◽  
Knee Oa ◽  
Significant Difference ◽  
Environment Domain ◽  
Telephone Monitoring

This study investigated effect of a 6-week telephysiotherapy programme on quality of life (QoL) of patients with knee osteoarthritis (OA). Fifty patients with knee OA were randomly and equally assigned into two treatment groups: clinic group (CG) and telephysiotherapy group (TG). The CG received physiotherapist-administered osteoarthritis-specific exercises in the clinic thrice weekly for 6 weeks while the TG received structured telephone monitoring with self-administered osteoarthritis-specific exercises for the same duration at home. Participants’ QoL was assessed using WHOQoL-Bref at baseline, second, fourth, and sixth week of intervention. Data were analyzed using ANOVA and independent Student’st-test. Within-group comparison showed significant improvements in physical health domain (P=0.00*for TG and CG) and psychological domain (P=0.02*for TG;P=0.00*for CG) of WHOQoL following six-week intervention. However, there were no significant differences (P>0.05) in TG and CG’s social relationship and environment domains. Between-group comparison showed no significant differences (P>0.05) between CG and TG’s physical health, psychological, and social relationships domains of WHOQoL following 6-week intervention. However, there was significant difference in the environment domain (P<0.05). Telephysiotherapy using telephone medium improved QoL in patients with knee OA comparable to clinic based treatment.

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