scholarly journals Intra-Articular Injections in Knee Osteoarthritis: A Review of Literature

2021 ◽  
Vol 6 (1) ◽  
pp. 15
Author(s):  
Gianluca Testa ◽  
Serena Maria Chiara Giardina ◽  
Annalisa Culmone ◽  
Andrea Vescio ◽  
Matteo Turchetta ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Platelet Rich Plasma ◽  
Adult Population ◽  
Cartilage Damage ◽  
Management Options ◽  
Knee Oa ◽  
Increased Risk ◽  
First Choice ◽  
Joint Revision ◽  
Complications Rate

Knee osteoarthritis (OA) is a chronic, degenerative, and progressive disease of articular cartilage, producing discomfort and physical disability in older adults. Thirteen percent of elderly people complain of knee OA. Management options for knee OA could be divided into the following categories: conservative, pharmacological, procedural, and surgical. Joint replacement is the gold standard, reserved for severe grades of knee OA, due to its complications rate and increased risk of joint revision. A nonsurgical approach is the first choice in the adult population with cartilage damage and knee OA. Yearly, more than 10% of knee OA-affected patients undergo intra-articular injections of different drugs, especially within three months after OA diagnosis. Several molecules, such as corticosteroids injection, hyaluronic acid (HA), and platelet-rich plasma (PRP), are managed to reduce the symptoms of patients with knee OA. The aim of this review was to offer an overview of intra-articular injections used for the treatment of OA and report the conventional pharmacological products used.

scholarly journals In vitro responses to platelet-rich-plasma are associated with variable clinical outcomes in patients with knee osteoarthritis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Habib Zahir ◽  
Bijan Dehghani ◽  
Xiaoning Yuan ◽  
Yurii Chinenov ◽  
Christine Kim ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Clinical Outcomes ◽  
Inflammatory Responses ◽  
Platelet Rich Plasma ◽  
Autologous Blood ◽  
Limited Information ◽  
Knee Oa ◽  
Patient Reported ◽  
Treatment Comparisons

AbstractAutologous blood-derived products such as platelet-rich plasma (PRP) are widely used to treat musculoskeletal conditions, including knee osteoarthritis (OA). However, the clinical outcomes after PRP administration are often variable, and there is limited information about the specific characteristics of PRP that impact bioactivity and clinical responses. In this study, we aimed to develop an integrative workflow to evaluate responses to PRP in vitro, and to assess if the in vitro responses to PRP are associated with the PRP composition and clinical outcomes in patients with knee OA. To do this, we used a coculture system of macrophages and fibroblasts paired with transcriptomic analyses to comprehensively characterize the modulation of inflammatory responses by PRP in vitro. Relying on patient-reported outcomes and achievement of minimal clinically important differences in OA patients receiving PRP injections, we identified responders and non-responders to the treatment. Comparisons of PRP from these patient groups allowed us to identify differences in the composition and in vitro activity of PRP. We believe that our integrative workflow may enable the development of targeted approaches that rely on PRP and other orthobiologics to treat musculoskeletal pathologies.

scholarly journals Associations of Metabolic Syndrome and Its Components with the Risk of Incident Knee Osteoarthritis Leading to Hospitalization: A 32-Year Follow-up Study

Cartilage ◽  
2019 ◽  
pp. 194760351989473
Author(s):  
Sanna Konstari ◽  
Katri Sääksjärvi ◽  
Markku Heliövaara ◽  
Harri Rissanen ◽  
Paul Knekt ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Confidence Interval ◽  
Knee Osteoarthritis ◽  
Fasting Glucose ◽  
Full Model ◽  
Knee Oa ◽  
Increased Risk ◽  
Metabolic Syndrome Components ◽  
Reduced Risk

Objectives To examine whether metabolic syndrome or its individual components predict the risk of incident knee osteoarthritis (OA) in a prospective cohort study during a 32-year follow-up period. Design The cohort consisted of 6274 participants of the Mini-Finland Health Survey, who were free from knee OA and insulin-treated diabetes at baseline. Information on the baseline characteristics, including metabolic syndrome components, hypertension, elevated fasting glucose, elevated triglycerides, reduced high-density lipoprotein, and central obesity were collected during a health examination. We drew information on the incidence of clinical knee OA from the national Care Register for Health Care. Of the participants, 459 developed incident knee OA. In our full model, age, gender, body mass index, history of physical workload, smoking history, knee complaint, and previous injury of the knee were entered as potential confounding factors. Results Having metabolic syndrome at baseline was not associated with an increased risk of incident knee OA. In the full model, the hazard ratio for incident knee OA for those with metabolic syndrome was 0.76 (95% confidence interval [0.56, 1.01]). The number of metabolic syndrome components or any individual component did not predict an increased risk of knee OA. Of the components, elevated plasma fasting glucose was associated with a reduced risk of incident knee OA (hazard ratio 0.71, 95% confidence interval [0.55, 0.91]). Conclusions Our findings do not support the hypothesis that metabolic syndrome or its components increase the risk of incident knee OA. In fact, elevated fasting glucose levels seemed to predict a reduced risk.

scholarly journals Knee Osteoarthritis: A Review of Pathogenesis and State-Of-The-Art Non-Operative Therapeutic Considerations

Genes ◽  
2020 ◽  
Vol 11 (8) ◽  
pp. 854
Author(s):  
Dragan Primorac ◽  
Vilim Molnar ◽  
Eduard Rod ◽  
Željko Jeleč ◽  
Fabijan Čukelj ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Platelet Rich Plasma ◽  
Treatment Options ◽  
Stromal Vascular Fraction ◽  
Disease Stage ◽  
Knee Oa ◽  
Marrow Mesenchymal Stem Cells ◽  
The Moment ◽  
And Function ◽  
Orthopedic Patients

Being the most common musculoskeletal progressive condition, osteoarthritis is an interesting target for research. It is estimated that the prevalence of knee osteoarthritis (OA) among adults 60 years of age or older is approximately 10% in men and 13% in women, making knee OA one of the leading causes of disability in elderly population. Today, we know that osteoarthritis is not a disease characterized by loss of cartilage due to mechanical loading only, but a condition that affects all of the tissues in the joint, causing detectable changes in tissue architecture, its metabolism and function. All of these changes are mediated by a complex and not yet fully researched interplay of proinflammatory and anti-inflammatory cytokines, chemokines, growth factors and adipokines, all of which can be measured in the serum, synovium and histological samples, potentially serving as biomarkers of disease stage and progression. Another key aspect of disease progression is the epigenome that regulates all the genetic expression through DNA methylation, histone modifications, and mRNA interference. A lot of work has been put into developing non-surgical treatment options to slow down the natural course of osteoarthritis to postpone, or maybe even replace extensive surgeries such as total knee arthroplasty. At the moment, biological treatments such as platelet-rich plasma, bone marrow mesenchymal stem cells and autologous microfragmented adipose tissue containing stromal vascular fraction are ordinarily used. Furthermore, the latter two mentioned cell-based treatment options seem to be the only methods so far that increase the quality of cartilage in osteoarthritis patients. Yet, in the future, gene therapy could potentially become an option for orthopedic patients. In the following review, we summarized all of the latest and most important research in basic sciences, pathogenesis, and non-operative treatment.

What Is the Price and Claimed Efficacy of Platelet-Rich Plasma Injections for the Treatment of Knee Osteoarthritis in the United States?

2018 ◽  
Vol 32 (09) ◽  
pp. 879-885 ◽  
Author(s):  
Nicolas S. Piuzzi ◽  
Mitchell Ng ◽  
Ariel Kantor ◽  
Kenneth Ng ◽  
Stephanie Kha ◽  
...  
Keyword(s):  
United States ◽  
Standard Deviation ◽  
Knee Osteoarthritis ◽  
Clinical Efficacy ◽  
Health Care Providers ◽  
Platelet Rich Plasma ◽  
The United States ◽  
Care Providers ◽  
Knee Oa ◽  
The Mean

AbstractPlatelet-rich plasma (PRP) injections are often used for the treatment of knee osteoarthritis (OA), despite clinical value and cost-effectiveness not being definitely established. PRP injections are considered as a potential means of reducing pain and improving function in patients with knee OA, in the hope of delaying or avoiding the need for surgical intervention. Centers that offer PRP injections usually charge patients out of pocket and directly market services. Therefore, the purpose of this study was to quantify the current (1) prices and (2) marketed clinical efficacy of autologous PRP injections for knee OA. A prospective cross-sectional study was performed based on 286 centers identified in the United States offering PRP injections for knee OA. A total of 179 (73.4%) centers were successfully contacted via e-mail or phone, using a simulated 52-year-old male patient with knee OA. Scripted questions were asked by the simulated patient to determine the current marketed prices and clinical efficacy, either reported as “good results” or “symptomatic improvement,” claimed by each treating center. The mean price for a single unilateral knee same-day PRP injection was $714 with a standard deviation of $144 (95% confidence interval [CI]: $691–737, n = 153). The mean claim of clinical efficacy was 76% with a standard deviation of 11% (95% CI: 73.5–78.3%, n = 84). Out of the 84 clinics, 10 claimed “90 to 100% efficacy,” 27 claimed “80 to 90%,” 29 claimed “70 to 80%,” 9 claimed “60 to 70%,” 8 claimed “50 to 60%,” and 1 claimed “40 to 60%.” These findings provide a unique perspective on the PRP market for the treatment of knee OA that is valuable to physicians and health care providers in providing better education to patients on the associated costs and purported clinical benefits of PRP injections.

scholarly journals P129 Adolescent knee pain and risk of knee osteoarthritis 50 years later

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Michael A Clynes ◽  
Faidra Laskou ◽  
Mark H Edwards ◽  
Cyrus Cooper ◽  
Angela Taylor ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Knee Pain ◽  
Meniscal Tear ◽  
Later Life ◽  
Self Report ◽  
P Value ◽  
Knee Oa ◽  
American College Of Rheumatology ◽  
Increased Risk ◽  
The Mean

Abstract Background Adolescent knee pain is a common complaint which may be due to patellar dislocation, meniscal tear, Osgood-Schlatter’s disease or patellofemoral maltracking. We studied the association of such pain with knee osteoarthritis (OA) 50 years later using a retrospective cohort design. Methods This study was based in the Hertfordshire Cohort Study, a cohort of men and women born in 1931 - 9. Participants completed a questionnaire detailing recall of adolescent knee pain, self-reported OA, demographics, lifestyle and The Western Ontario and McMaster Universities Arthritis Index (WOMAC). Clinical OA was defined based on the American College of Rheumatology (ACR) criteria and assessed at a clinical visit where knee radiographs were also taken and graded according to the methods of Kellgren and Lawrence. Results Completed data were available for 135 men and 139 women. The mean age was 78.8 (SD 2.6) years and the mean (SD) BMI was 26.3 (4.0). Two percent of men (n = 3) and 5% of women (n = 7) reported adolescent knee pain, of which 2 men and 3 women sought medical advice for their knee pain. 1 man and 2 women reported that their pain had been constant since teenage years while 2 men and 4 women reported that it was intermittent in nature. A report of adolescent knee pain was associated with an increased risk of clinical (odds ratio (OR) 5.45, p-value 0.015, 95% confidence interval (CI) 1.39 - 21.36); radiological (OR 2.33, p-value 0.228, 95% CI 0.60 - 9.24) and self-report (OR 2.71, p-value 0.134, 95% CI 0.74 - 10.0) of knee OA in later life. After adjustments for age, sex and BMI, adolescent knee pain was associated with an increased risk of clinical (OR 4.80, p-value 0.047, 95% CI 1.02 - 22.53); radiological (OR 1.85, p-value 0.404, 95% CI 0.44 - 7.78); self-report (OR 3.23, p-value 0.10, 95% CI 0.80 - 12.94) although relationships were only significant for clinical knee OA. Conclusion Recalled adolescent knee pain was associated with a clinical diagnosis of knee OA in later life. The lack of association with self-report of OA suggests that this is not simply a consequence of recall bias and exploration in other data sets is now indicated. Disclosures M.A. Clynes: None. F. Laskou: None. M.H. Edwards: None. C. Cooper: None. A. Taylor: None. M. Stokes: None. E.M. Dennison: None.

scholarly journals A Narrative Review on Measurement Properties of Fixed-distance Walk Tests Up To 40 Meters for Adults With Knee Osteoarthritis

2020 ◽  
pp. jrheum.200771
Author(s):  
Hiral Master ◽  
Grace Coleman ◽  
Fiona Dobson ◽  
Kim Bennell ◽  
Rana S. Hinman ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Walking Speed ◽  
Functional Limitation ◽  
Narrative Review ◽  
Measurement Properties ◽  
Practice Trial ◽  
Walk Test ◽  
Knee Oa ◽  
Fixed Distance ◽  
Increased Risk

Knee osteoarthritis (OA) is a serious disease and has no cure to date. Knee OA is a leading cause of functional limitation (e.g., difficulty walking). Walking speed is 1 method of quantifying difficulty with walking and should be assessed in clinical practice for adults with knee OA because it has prognostic value and is modifiable. Specifically, slow walking speed is associated with increased risk of adverse health outcomes, including all-cause mortality in adults with knee OA and can be modified by engaging in physical activity or exercise. However, at present, there is little consensus on the distance and instructions used to conduct the walk test. Distance is often selected based on space availability, and instruction varies, from asking the participants to walk at a comfortable pace versus as fast as possible. Therefore, the purpose of this narrative review is to summarize the measurement properties, strengths, and limitations of a fixed-distance walk test ≤ 40 meters in adults with knee OA. Good measurement properties in terms of reliability and validity were observed across the different testing protocols for fixed-distance walk test (i.e., any distance ≤ 40 m and fast- or self-paced). Therefore, clinicians and researchers can select a testing protocol that can safely and consistently be performed over time, as well as provide a practice trial to acclimatize the patients to the fixed-distance walk test.

scholarly journals Phenylalanine Is a Novel Marker for Radiographic Knee Osteoarthritis Progression: The MOST Study

2020 ◽  
Vol 48 (1) ◽  
pp. 123-128
Author(s):  
Guangju Zhai ◽  
Xianbang Sun ◽  
Edward W. Randell ◽  
Ming Liu ◽  
Na Wang ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Radiographic Progression ◽  
Phenylalanine Level ◽  
Combined Analysis ◽  
Knee Oa ◽  
Increased Risk ◽  
Group 2 ◽  
Site Significance ◽  
Radiographic Knee Osteoarthritis ◽  
Group 1

Objective.To identify plasma markers associated with an increased risk of radiographic knee osteoarthritis(OA) progression using a metabolomics approach.Methods.Study participants were from the Multicenter Osteoarthritis Study (MOST) and were categorized into 2 groups based on the presence of baseline radiographic OA. Subjects in group 1 had unilateral knee OA and subjects in group 2 had bilateral knee OA. Progression was defined as a half-grade or greater worsening in joint space width at 30-month follow-up. For group 1, a participant progressed when their OA knee showed radiographic progression and the contralateral knee developed OA; for group 2, a participant progressed when both knees with OA showed radiographic progression. Metabolomic profiling was performed on plasma samples collected at baseline and logistic regression was performed to test the association between each metabolite and knee OA progression after adjustment for age, sex, BMI, and clinic site. Significance was defined as P ≤ 0.0003 in the combined analysis.Results.There were 234 progressors (57 in group 1 and 177 in group 2) and 322 nonprogressors (206 in group 1 and 116 in group 2) included in the analyses. Among 157 metabolites studied, we found that odds of progression were 1.46 times higher per SD increase of phenylalanine level (95% CI 1.20–1.77, P = 0.0001) in the combined analysis. Sex-specific analysis showed that an association was seen in women (P = 0.0002) but not in men.Conclusion.Our data suggest that phenylalanine might be a novel plasma marker for higher risk of bilateral radiographic knee OA progression in women.

scholarly journals Neuromuscular exercises: A new perspective in knee osteoarthritis

2021 ◽  
Vol 20 (3) ◽  
pp. 311-316
Author(s):  
Jyoti Sabharwal ◽  
◽  
Shabnam Joshi ◽  
Keyword(s):  
Knee Osteoarthritis ◽  
Functional Performance ◽  
Thigh Muscle ◽  
Intervention Programme ◽  
Limb Weakness ◽  
Knee Oa ◽  
Increased Risk ◽  
New Perspective ◽  
Training Programmes

Background. Knee osteoarthritis (OA) is the most prevalent arthropathy across the world. It presents with swelling, pain, decreased range of motion (ROM) and instability. Patients also complain of thigh muscle weakness and lower limb weakness resulting in poor joint shielding and joint overload. Owing to these presenting features patients are prone to increased risk of morbidity and are forced to live with functional impairment. Exercises are one of the vital intervention programme used in knee OA. Exercises lead to improvement in physical function, strengthening of the muscles and reduction in pain. Neuromuscular exercises have effects on functional performance, biomechanics and activation pattern of surrounding musculatures of the patient. Therefore, neuromuscular exercises may prove to be beneficial in enhancing the efficacy of exercise training programmes in such patients due to functional instability and disturbed neuromuscular function. Purpose. This article intends to review the effect and role of neuromuscular exercises in the management of knee osteoarthritis. Method. Comprehensive computerized search was performed on Google Scholar, Pubmed and Cochrane. Conclusion. By evaluating various articles on neuromuscular exercises in knee osteoarthritis the present review suggest that neuromuscular exercises are helpful in the treatment of knee osteoarthritis.

scholarly journals IL-6 gene rs12700386 Polymorphism is Associated with Increased Risk of Knee Osteoarthritis Development in Chinese Han Population: A Case-Control Study

2020 ◽  
Author(s):  
Hui Yang ◽  
Xindie Zhou ◽  
Dongmei Xu ◽  
Gang Chen
Keyword(s):  
Knee Osteoarthritis ◽  
Case Control Study ◽  
Case Control ◽  
Chinese Han ◽  
Knee Oa ◽  
Reverse Transcription Pcr ◽  
Increased Risk ◽  
Pcr Rflp ◽  
Polymerase Chain ◽  
Control Study

Abstract Background: There is an association between Interleukin-6 (IL-6) polymorphism and knee osteoarthritis (OA) risk. The case-control study aims at exploring how IL-6 rs12700386 polymorphism affects the knee OA risk in Chinese Han individuals.Methods: We extracted the DNA from 763 participants, thereinto, 352 were OA patients and 411 were healthy controls. The polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) assisted in genotyping the IL-6 gene polymorphism. The relative expression exhibited by IL-6 in blood samples of knee OA patients was determined via a quantitative reverse transcription PCR (qRT-PCR). Results: We found that IL-6 rs12700386 enhanced the knee OA susceptibility. Based on a subgroup analysis, the loci magnified the knee OA risk in smokers, drinkers, and subjects ≥ 55 years old or with BMI ≥ 25 kg/m2. The combination of smoking and drinking and rs12700386 genotype led to an increase in the knee OA risk, indicating an underlying interaction between gene and environment. Additionally, the rs12700386 was found to be related to increased IL-6 gene levels. Conclusion: These data indicate that rs12700386 polymorphism of IL-6 gene led to an increase in the knee OA risk specific to Chinese Han individuals.

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