Clinical Studies of Osteoarthritis

Top PDF Clinical Studies of Osteoarthritis:

Harmonising data collection from osteoarthritis studies to enable stratification : recommendations on core data collection from an Arthritis Research UK clinical studies group

Harmonising data collection from osteoarthritis studies to enable stratification : recommendations on core data collection from an Arthritis Research UK clinical studies group

where possible, items are captured using validated tools and with reference to other clinical studies that might pro- vide an opportunity for later data pooling. Within the scope of these recommendations, we have therefore provided guidance on potential tools that may be considered during study design, but this does not represent a definitive list. For capturing multisite joint pain, use of a joint pain manikin is suggested, since joint counts do not reflect the distribution of joints. At a minimum, such a manikin should capture the joint region (e.g. hand, foot, ankle), although at the discretion of the investigator further differentiation may be captured (e.g. ball of the foot, mid-foot, hindfoot). In line with current IMMPACT guidelines, an 11-point numerical rating scale with a 1-week recall period is suggested for capturing baseline pain [38]. Other validated questionnaires may also be considered for assessing pain and function, including but not limited to joint-specific scales such as the Knee Injury and Osteoarthritis Outcomes Score, Hip Injury and Osteoarthritis Outcomes Score, WOMAC, Oxford Knee/Hip Score, Australian/Canadian Osteoarthritis Hand Index and Functional Index for Hand Osteoarthritis [39–43]. It is recommended that alignment should be cap- tured at a minimum using a measure of varus/valgus de- formity, but where possible, consideration should be made for inclusion of either a weight-bearing long leg X-ray, which would indicate static alignment in the sagittal plane, or gait assessment, to indicate coronal and sagittal plane hip–knee–ankle angles and tibial rotation and, if pos- sible, a measure of anterior–posterior deceleration/acceler- ation of the centre of mass [44]. Where imaging outcomes are included in studies, X-rays should be captured using published protocols to ensure consistency and a weight- bearing (where appropriate) KL grade assessed as a minimum [45, 46]. It is suggested that physical activity be captured using an accelerometer or combined gyroscopic- based measures where possible. Alternatively, a simple performance-based test, such as the 30 s chair stand test, the 4 10 m fast walk test and/or the timed stair test [47], or a patient-reported outcome (PRO) may be con- sidered. Potential PROs include the Physical Activity Scale in the Elderly, International Physical Activity Questionnaire or Tegner Activity Scale, or a simple question that captures sedentary versus active lifestyle [48, 49].
Show more

10 Read more

Recommendations for the conduct of efficacy trials of treatment devices for osteoarthritis: a report from a working group of the Arthritis Research UK Osteoarthritis and Crystal Diseases Clinical Studies Group.

Recommendations for the conduct of efficacy trials of treatment devices for osteoarthritis: a report from a working group of the Arthritis Research UK Osteoarthritis and Crystal Diseases Clinical Studies Group.

A MEDLINE search of therapeutic devices and controlled clinical trials failed to identify publications that contained recommendations on how to approach this set of challenges (search strategies shown in appendix table 1). The findings of this review were presented to the Arthritis Research UK Osteoarthritis and Crystals Disorders Clinical Study Group in January 2014. This group consisted of 30 people including rheumatologists, physiotherapists, podiatrists, engineers, orthopaedists, trialists and patient representatives who have a particular interest in osteoarthritis, many who have carried out device trials. The panel meeting started with a pre-defined objective presented by the two chairs (AR/DF). This objective was to determine what design features should be included in future device trials. The chairs commenced by presenting a review of the literature summarizing the issues raised in studies of physical devices in the previous 4-5 years and setting the scene for areas of common concern. The panel was then prompted to identify what features were felt relevant. These were compiled onto flipcharts and a preliminary list of approximately 20 challenges to the successful conduct of device trials was identified. Once identified, each design feature was discussed and refined with pooling of overlapping areas and reduction of the list to a suitable number of items for inclusion in formal guidance. Consensus on
Show more

20 Read more

Recommendations for the conduct of efficacy trials of treatment devices for osteoarthritis : a report from a working group of the Arthritis Research UK Osteoarthritis and Crystal Diseases Clinical Studies Group

Recommendations for the conduct of efficacy trials of treatment devices for osteoarthritis : a report from a working group of the Arthritis Research UK Osteoarthritis and Crystal Diseases Clinical Studies Group

A MEDLINE search of therapeutic devices and controlled clinical trials failed to identify publications that contained recommendations on how to approach this set of challenges (search strategies shown in appendix table 1). The findings of this review were presented to the Arthritis Research UK Osteoarthritis and Crystals Disorders Clinical Study Group in January 2014. This group consisted of 30 people including rheumatologists, physiotherapists, podiatrists, engineers, orthopaedists, trialists and patient representatives who have a particular interest in osteoarthritis, many who have carried out device trials. The panel meeting started with a pre-defined objective presented by the two chairs (AR/DF). This objective was to determine what design features should be included in future device trials. The chairs commenced by presenting a review of the literature summarizing the issues raised in studies of physical devices in the previous 4-5 years and setting the scene for areas of common concern. The panel was then prompted to identify what features were felt relevant. These were compiled onto flipcharts and a preliminary list of approximately 20 challenges to the successful conduct of device trials was identified. Once identified, each design feature was discussed and refined with pooling of overlapping areas and reduction of the list to a suitable number of items for inclusion in formal guidance. Consensus on
Show more

21 Read more

Arthroscopy vs  MRI for a detailed assessment of cartilage disease in osteoarthritis: diagnostic value of MRI in clinical practice

Arthroscopy vs MRI for a detailed assessment of cartilage disease in osteoarthritis: diagnostic value of MRI in clinical practice

In our study, the diagnostic values for MRI assessment of cartilage lesions were relatively low at all grades of dis- ease. The assessment of inter-observer agreement between readers 1 and 2 revealed mostly moderate and good results (weighted kappa = 0.51-0.75). For the intra- observer agreement, when comparing MRI grading to arthroscopic grading, slightly poorer results with fair, moderate and good values (weighted kappa = 0.32-0.65) were demonstrated. Previous clinical studies focused on patients with osteoarthritis showed different values for the agreement of MRI grading and arthroscopic grading of cartilage damage. Drapé et al. demonstrated very good intra- and inter-observer agreements (weighted kappa = 0.91 and 0.64, respectively). Based on this data, MRI was proposed as an outcome measure of cartilage lesions in clinical trials treating osteoarthritis [19]. In contrast to this study, McNicholas et al. noted mainly "slight" or "fair" intra- and inter-observer agreements for the evaluation of cartilage damage in patients with knee osteoarthritis. In regard to this data, reservations about the use of MRI in the assessment of disease severity were stated [21]. Simi- larly to a study of Blackburn et al. [17], our results, lie in the mid range, demonstrating moderate to good kappa values (Table 1). There are several possibilities to explain the differences between these studies and our study. Regarding patient selection, the inclusion criteria for clin- ically relevant osteoarthritis were clearly defined in the study of Drapé et al. and Blackburn et al. [17,19], whereas no inclusion criteria were set in the study of McNicholas et al. [21]. Furthermore, it has to be mentioned that MRI techniques used in the studies were quite different. Drapé et al. used a 0.2-T musculoskeletal dedicated MR unit (Artoscan; Esaote Biomedica) with two successive 3D gradient-echo sequences and 1.4 mm slice thickness [19], whereas McNicholas et al. used a FISP 3 D gradient echo sequence on a 1.0 T scanner (Siemens) and a dedicated surface coil without further description of slice thickness [21]. Similarly to our study, Blackburn et al. used proton
Show more

8 Read more

<p>The role of joint distraction in the treatment of knee osteoarthritis: a systematic review and quantitative analysis</p>

<p>The role of joint distraction in the treatment of knee osteoarthritis: a systematic review and quantitative analysis</p>

All clinical studies investigating the use of joint distraction as a treatment for knee osteoarthritis were selected. Additionally, all included studies met the following cri- teria: (a) radiographic signs of joint damage and primarily tibiofemoral osteoarthritis; (b) no history of in fl ammatory or septic arthritis; (c) patients were under the age of 65 years; (d) valgus/varus malalignment of less than 10º; (e) reporting of at least the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Visual Analogue Scale (VAS), or joint space width (JSW) of the most affected compartment assessed as outcome measures of the effect of the treatment; and (f) full-length article published. Non-human studies, experimental trials, review articles, editorials, case reports, letters, conference abstracts, and unpublished studies were excluded.
Show more

14 Read more

Clinical effects of Garcinia kola in knee osteoarthritis

Clinical effects of Garcinia kola in knee osteoarthritis

A total of 143 patients who had post traumatic knee oste- oarthritis (unilateral = 94, bilateral = 98) on 192 limbs were recruited. Eighty-four patients (58.7%) with KOA in 121 limbs satisfied the selection criteria. All the patients who received at least a dose of the research drugs had ade- quate documentation of their data in each subgroup and were used for analysis. There were 24 males (28.6%) and 60 females (71.4%) with M: F: 1:2.5. The proportion of bilateral knees involvement is shown in Table 1 which compared patients in the four treatment groups. The effect of knee osteoarthritis bilateralism among the subjects was not significant (p > 0.913). The WOMAC score at day 0 was not significantly different among the four study groups (p > 0.05). A clinical photographs of typical Gar- cinia kola is illustrated in Figure 1. The major sources of trauma were Road Traffic Accident 46(54.8%), Sports injury 19(22.6%), Fall from height 18 (21.4%) and pro- longed over use from driving long distance for over 25 years, 1(1.2%). Knee osteoarthritis in young adults was common after sporting knee injury and fall from height. The women often were those carried as passenger on motor cycle before they sustained injury. The mean dura- tion of trauma before the onset of symptomatic knee oste-
Show more

10 Read more

Clinical efficacy of intra-articular injections in knee osteoarthritis: a prospective randomized study comparing hyaluronic acid and betamethasone

Clinical efficacy of intra-articular injections in knee osteoarthritis: a prospective randomized study comparing hyaluronic acid and betamethasone

the MCII as the 75th percentile of the distribution of change in patient-reported outcomes scores for patients who consid- ered they had slight or moderate improvement. The authors concluded that their work allowed promoting the use of MCII values, which were defined as 15 of 100 for absolute improvement and 20% for relative improvement in clinical trials of rheumatic diseases, with pain, functional disability, patient global assessment, or physician global assessment used as the outcome criteria. To calculate the MCII, total scores were normalized to a 0–100 score. 34
Show more

10 Read more

CLINICAL EVALUATION OF PANCHATIKTA KSHEER BASTI IN SANDHIGATA VATA W.S.R.TO OSTEOARTHRITIS OF KNEE JOINT  .......

CLINICAL EVALUATION OF PANCHATIKTA KSHEER BASTI IN SANDHIGATA VATA W.S.R.TO OSTEOARTHRITIS OF KNEE JOINT .......

The etiology and symptomatology of Osteoarthritis 2 is very much similar to that of sandhigatavata. Osteoarthritis is a degenera- tive joint disease that may cause gross carti- lage loss and morphological damage to other joint tissues, during onset of OA, the collagen matrix becomes more disorganized and there is a decrease in proteoglycan content within cartilage. The breakdown of collagen fibres results in a net increase in water content. Without the protective effects of the pro- teoglycans, the collagen fibres of the cartilage can become susceptible to degradation and thus exaggerate the degeneration. Inflamma- tion of the surrounding joint capsule can also
Show more

9 Read more

Imaging the Esophagus Oval and Circular Defect Reconstruction in Rats

Imaging the Esophagus Oval and Circular Defect Reconstruction in Rats

They included 5 intact animals as a control, 5 animals with chitosan tubes implanted between the muscles of the neck close by the oesophagus, 5 animals with chitosan tube fixed within [r]

5 Read more

The Cumulative Incidence of Stroke, Myocardial Infarction, Heart Failure and Sudden Cardiac Death in Patients with Atrial Fibrillation

The Cumulative Incidence of Stroke, Myocardial Infarction, Heart Failure and Sudden Cardiac Death in Patients with Atrial Fibrillation

2. Unfortunately, in the last 2 decades despite several attempts to establish the laboratory for electrophysiological studies (EPS) and AF ablation, until now we don’t have such one. So, we are not able to perform AF ablation. In the last 2 years, several medical centers have cooperation with experts in EPS from Norway and neighbor countries for education and training of young cardiologists for EPS and we hope that we will have soon our lab for EPS.

5 Read more

Higher Levels of Exhaled Dimethylcyclopropane in Patients with Small Intestinal Bowel Overgrowth, Periodontitis when Associated with a
Medical History of Cancer

Higher Levels of Exhaled Dimethylcyclopropane in Patients with Small Intestinal Bowel Overgrowth, Periodontitis when Associated with a Medical History of Cancer

All 65 patients were classified according to the ratio D/TPPP. The sensitivity and the false positive rate were calculated. The figure 1 shows the ROC curve for the ratio D/TPPP. The threshold is close to 0. The sensitivity is equal to 75% and the false positive rate is equal to 31.25%. The negative predictive value is equal to 91.7% and the positive predictive value is equal to 96.4%. Patients in group1 had a higher plasmatic concentration of HA (78.3 ± 40.5 microg/l versus 37.7 ± 19.6; p<0.001). Patients in groups 1or 2 have high and similar percentage of infection with Helicobacter pylori (HP) (respectively 41.7% and 49.1%; p<0.05) or of clinical herpes simplex (58.8% versus 48%, p<0.05).
Show more

7 Read more

A REVIEW ON CLINICAL EFFICACY OF TRADITIONAL PLANTS ON OSTEOARTHRITIS

A REVIEW ON CLINICAL EFFICACY OF TRADITIONAL PLANTS ON OSTEOARTHRITIS

Exercise: This is the most promising and effective intervention which plays a critical role in the management of OA 18, 24 . American College of Rheumatology (ACR) has approved regular exercise as a therapeutic approach for the management of knee OA that improves flexibility and strengthens joint muscles 12 . Evidence suggests that three categories of exercise therapy are used for osteoarthritis: the range of motion and flexibility exercise, muscle conditioning and aerobic cardiovascular exercise which decreases pain and improves muscular strength, functional ability, and psychological well-being 9, 25-27, 30, 31 . Two recent meta-analyses also demonstrate that muscle strengthening and aerobic exercise is important in the management of OA. Muscle strengthening exercises are superior for specific impairment-related outcomes, such as pain, but aerobic exercise contributes to better long-term functional outcomes 28, 30 . Neuromuscular exercise therapy, like aerobic exercise and strength training, also provides effective pain relief in individuals with established OA. The first neuromuscular exercise program developed for use in patients with OA was published in 2010 29 . A recent Cochrane review identified 32 trials investigating a variety of land-based therapeutic exercise programs. Results of a meta-analysis showed mean treatment benefits for both knee pain and physical function.
Show more

14 Read more

To Study the Role of Centesimal Potency in Reducing Pain of  Patients with Osteoarthritis of Knee Joint

To Study the Role of Centesimal Potency in Reducing Pain of Patients with Osteoarthritis of Knee Joint

The benefits to the subject or others, reasonably expected from research are (1) The participants are investigated to find out whether they have osteoarthritis of knee joint based on clinical symptoms and X-ray. (2) Thus study is a benefit not only to the participant but also to the society as a whole. The records are maintained highly confidential. Only the investigator has the access to the subject’s medical records. Participant’s identity will never be disclosed at any time, during or

119 Read more

The value of modular hemiarthroplasty for unstable femoral neck fractures in elderly patients with coxarthrosis

The value of modular hemiarthroplasty for unstable femoral neck fractures in elderly patients with coxarthrosis

under debate [4]. While some authors prefer bipolar HA due to the advantages of smaller dislocation rates, less complex surgery, shorter surgical time, and lower initial costs, recent studies point toward a slightly better func- tion and patient satisfaction with THA; especially in healthy elderly patients with good mental conditions [4–13]. This might be explained by different factors. Hemiarthroplasties in general do not address preexist- ing arthritic changes of the acetabulum, which may lead to restriction of movement and hip pain. Further acetabular erosion might occur, potentially resulting in early revision and conversion to THA. Therefore, some authors name osteoarthritis as a contraindication for HA [14], but a recent study showed no correlation be- tween the grade of preoperative osteoarthritis and func- tional outcome scores [15].
Show more

8 Read more

How to be NICEr in treating osteoarthritis

How to be NICEr in treating osteoarthritis

The work of PGC is supported in part by the Arthritis Research UK Leeds Experimental Osteoarthritis Centre (20083) and the National Institute for Health Research (NIHR) Leeds Biomedical Research Centre. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health.

8 Read more

Outcomes and factors of elbow arthroscopy upon returning to sports for throwing athletes with osteoarthritis

Outcomes and factors of elbow arthroscopy upon returning to sports for throwing athletes with osteoarthritis

In this series, we found consistent satisfactory results of arthroscopic debridement and release regarding osteo- arthritis of the throwing elbow, as in previous reports. All the athletes could return to sports without complica- tions in the mean follow-up period of 2.6 years. The mean durations of returning to training and competition were 2.0 ± 1.5 and 4.5 ± 1.5 months, respectively, which could be a reference for athletes and coaches to estimate the duration of returning to play (Table 2). Another principle finding is that the procedural complexity was significantly related to the duration of returning to competition, which indicated that the complexity of elbow osteoarthritis hindered the interval of returning to competition. Early and aggressive intervention for throwing elbows with osteoarthritis should be considered in patients who fail to respond to conservative treatments for more than 3 months.
Show more

8 Read more

Clinical features of symptomatic patellofemoral joint osteoarthritis

Clinical features of symptomatic patellofemoral joint osteoarthritis

management, may differ [12,14-17]. For example, a his- tory of knee injury or meniscectomy may tend to indi- cate tibiofemoral joint OA [14,15] while a history of anterior knee pain in young adulthood may suggest patellofemoral joint OA [18]. The direction of frontal plane knee malalignment may serve to indicate patello- femoral joint OA and tibiofemoral joint OA (valgus malalignment being associated with the predominant pattern of lateral patellofemoral joint OA, varus mala- lignment with medial tibiofemoral joint OA) [16,19-21]. Although a recent systematic review revealed only two randomised controlled trials of interventions specifically for isolated patellofemoral joint OA [22], more are now emerging [23,24]. In the context of recommendations that OA can often be confidently diagnosed without the need for imaging [2,25], these developments pose a fun- damental question: can patellofemoral joint OA be iden- tified in routine clinical practice and, if so, which features are most informative?
Show more

10 Read more

The Effect of Manual Therapy, Postural Correction and ACUTENS in the Management of Thoracic Outlet Syndrome - A Case Study

The Effect of Manual Therapy, Postural Correction and ACUTENS in the Management of Thoracic Outlet Syndrome - A Case Study

It is also possible that neck pain radiating to the right upper extremity was not caused by the mechanical effects of pressure on the neurovascular structure alone. It could also be as a result of inflammatory changes at the site of the compression. There has been report that acupuncture stimulate the body’s self-regulation of anti inflammation regulation of the immune system, improve the vertebral blood circulation, alleviate disc degeneration and their respective organizations [13]. Studies have reported the success of acupuncture in the treatment of spinal disorders [11,14,15]. Possible therapeutic effects of acupuncture could be linked to enhancing activation of A- δ and C afferent fibres in muscle during needle stimulation of acupuncture points thus; signals are transmitted to the spinal cord, and via afferent pathways to the midbrain [11]. The resulting flow and integration of this information among specific brain areas will lead to a change in the perception of pain via descending pain modulatory system. Acupuncture analgesia improved the noxious descending inhibitory controls and pain gate mechanism and therefore helped to reduce the patients’ pain levels [13].
Show more

5 Read more

Risks and Comorbid Factors of Frequent Headaches during Childhood and Adolescence

Risks and Comorbid Factors of Frequent Headaches during Childhood and Adolescence

Furthermore, the study showed that the major comorbidities of frequent headaches were other health complaints and psychiatric and psychological factors. For health complaints there was a higher relevance for abdominal pain and dizziness although the OR for back shoulder and neck pain and fatigue were also quite high; the association with abdominal pain has been shown in other studies [11]. Frequent sadness irritability and nervousness are also strongly associated with frequent headaches; this in line with several other observations [8,10,16-18]; the same holds for the psychological variables investigated with special relevance for “low energy” and “low family support” and lower values for obtained marks Variable dependent: headache
Show more

6 Read more

Lethal Co-infection with Coccidiodes immitis/posadasii, MAI, and Pneumocystis jirovecii as a First Presentation of HIV

Lethal Co-infection with Coccidiodes immitis/posadasii, MAI, and Pneumocystis jirovecii as a First Presentation of HIV

DNA probes for MAC targeting the mycobacterial ribosomal 16S RNA have become available for clinical use in the last decade and allow the identification of MAC from a positive culture in a few hours. Rapid culture methods (BACTEC[TM] MGIT[TM] and MB/bacT), in combination with DNA probes accelerates the diagnosis of mycobacterial disease (Accu Probe) [26]. PCR amplification directly from specimens may further accelerate diagnosis, but is not widely available [27]. Matrix- assisted Laser Desorption Ionization-Time of Flight Mass spectrometry (MALDI-TOF MS) is increasingly used for NTM identification from culture, but not from clinical isolates [28]. Treatment for proven disease includes clarithromycin or azithromycin in addition to ethambutol, continued for at least 12 months if macrolide sensitivity is confirmed. In cases of high bacterial burden, absence of HAART, or CD4<50, rifabutin is recommended as a third agent [17].
Show more

5 Read more

Show all 10000 documents...