ABSTRACT
Osteoarthritis [OA] is the most common rheumatologic disorder and the knee is the most involved joint. There are several medications suggested to treat knee OA, each of them has some advantages and disadvantages. The goal of the current study was to compare the effect of piascledine and diclofenac on pain and function of the patients with knee OA. In this clinical trial, 60 patients with knee OA were randomly divided into two groups: piascledine [300 mg daily] and diclofenac [25 mg three times a day]. Patients were treated for 8 weeks. WOMAC score was completed for each patient, and pain was measured using VAS pre- and post-medication. Before the treatment the mean WOMAC score was 53.7 +/- 3.1 in piascledine group and 54.2 +/- 2.9 in diclofenac group; which increased to 64.3 +/- 4.1 and 62 +/- 4.4 after treatment, respectively. The mean WOMAC score was significantly higher in the piascledine group [P<0.05]. The mean of VAS in piascledine and diclofenac group was 6.5 +/- 2.2 and 7.1 +/- 2.1 pre-medication which decreased to 4.2 +/- 1.1 and 4.5 +/- 1.4 post-medication, respectively. There was not a statistically significant difference between the two groups after treatment in the means of VAS. No side effect seen in neither of the groups. Due to improvement in WOMAC score and better patient compliance because of once daily intake, piascledine can be an efficient substitute to NSAIDs in treatment of knee OA
ABSTRACT
Conjugated linoleic acid [CLA] has been shown to positively influence calcium and bone metabolism in experimental animals and cell culture, but there are limited human data available. The study consisted of a double-blind, placebo-controlled trial in which 76 healthy post-menopausal women [aged 55.1] were randomly assigned to receive daily either four capsules CLA G80 containing 3.2 g isomer blend [50:50% cis-9, trans-11: trans-10, cis-12 isomers] or four capsules containing high oleic sunflower oil as placebo for 12 weeks. Urine and blood samples were collected at weeks 0 and 12 and were analyzed for biomarkers of calcium and bone metabolism and inflammatory markers [TNF-alpha and IL-6]. Subjects completed 3-days dietary records during the trial, in weeks 0 [baseline], 6 and 12. Supplementation with 3.2 g CLA isomer blend [50:50% cis-9,trans-l l:trans-10,cis-12 isomers] for 12 weeks had no significant effects on markers of bone formation [serum osteocalcin, bone-specific alkaline phosphatase] or bone resorption [urine C-telopeptide-related fraction of type 1 collagen degradation products], PTH, urinary calcium, urinary creatinine and CTP to creatinine ratio. And serum interIeukine-6 did not change significantly over 12 weeks in postmenopausal women. Under the conditions tested in this double-blind, placebo-controlled trial in postmenopausal women, 3.2 g CLA isomer blend [50:50% cis-9, trans-11: trans-10, cis-12 isomers] did not affect markers of bone metabolism and calcium
ABSTRACT
A combination of polymeric nanofibrous scaffold and bioactive materials is potentially useful in bone regeneration applications. In the present study, Poly [lactide-co-glycolide] [PLGA] nanofibrous scaffolds, fabricated via electrospinning, were initially coated with Type I collagen and then with nano-hydroxyapatite. The prepared scaffolds were then characterized using SEM and their ability for bone regeneration was investigated in a rat critical size bone defect using digital mammography, multislice spiral-computed tomography [MSCT] imaging, and histological analysis. Electrospun scaffolds had nanofibrous structure with homogenous distribution of n-HA on collagen-grafted PLGA. After 8 weeks of implantation, no sign of inflammation or complication was observed at the site of surgery. According to digital mammography and MSCT, PLGA nanofibers coated simultaneously with collagen and HA showed the highest regeneration in rat calvarium. In addition, no significant difference was observed in bone repair in the group which received PLGA and the untreated control. This amount was lower than that observed in the group implanted with collagen-coated PLGA. Histological studies confirmed these data and showed osteointegration to the surrounding tissue. Taking all together, it was demonstrated that nanofibrous structures can be used as appropriate support for tissue-engineered scaffolds, and coating them with bioactive materials will provide ideal synthetic grafts. Fabricated PLGA coated with Type I collagen and HA can be used as new bone graft substitutes in orthopaedic surgery and is capable of enhancing bone regeneration via characteristics such as osteoconductivity and osteointegration
ABSTRACT
Guidelines on implant removal are not clear and the routine removal of orthopaedic fixation devices after fracture healing remains an issue of debate. Few studies have evaluated long-term outcomes of patients with orthopaedic implants left in-situ and this lake of data has made the orthopaedic surgeons decide on implant removal differently. In order to add new data in this field, we designed this study. In a follow up setting, patients with Tibial shaft fractures who had received orthopaedic implants in year 2008 and earlier were clinically examined for any surgical complications such as pain or limited range of motion. Quality of life of each patient was evaluated using short form 36. The total SF-36 score of the patients was not statistically different from the normal population [P >0.05]. 21 patients [31.2%] reported limited range of motion in ankle and 11 [14.9%] complained of weakness in the affected limb. Clinically, 68.9% of patients had full range of motion in ankle and 70.3% had no tenderness in the affected limb. As most patients were clinically normal and had quality of life scores comparable to the normal population, removal of implants is not advisable in all patients