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Introduction: Osteoarthritis of the knee is a common musculoskeletal diseases affecting a major population in India. It can impact the individual's functions and activities of daily living. Total knee arthroplasty may raise controversy when treating the younger, athletic patient with arthritis. Arthroscopic debridement, high tibial osteotomy, unicondylar knee arthroplasty, and total knee arthroplasty allow younger patients to maintain an active, healthy lifestyle but can take a longer time to rehabilitate. PFO could be used as an alternative procedure. The Proximal Fibular Osteotomy, which provides immediate short term relief in cases with medial compartment osteoarthritis. Resecting a segment of fibula, loosens the lateral side allowing the upper tibia to settle into a more favorable lateral alignment, shifting the mechanical axis towards neutral or valgus. Aims & objectives: Ÿ To assess the functional, clinical and radiological outcome of proximal fibular osteotomy in grade 2 and 3 OA of knee and followed up for 1 year. Ÿ The clinical and functional outcome is accessed by Knee Society Score and VAS observed pre-op , post-op ,3 months ,6 months and 12 months. Ÿ The improvement in radiology is accessed using change in the medial joint space improvements in CP angle, change in the ratio of medial joint space to lateral joint space observed pre-op and post-op Methodology: The patients selected had grade 2 and 3 Osteoarthritis of knee according to Kellgren Lawrence classification between the age groups 20yrs-80yrs and are admitted to RajaRajeswari Medical College and Hospital, Bangalore. The Sample Size is 30 and is calculated based on previous studies as well as approximate availability of number of cases in the above mentioned duration satisfying inclusion and exclusion criteria. Clinical, functional and radiological outcome were used, Results were calculated using Knee Society Scoring Scale score. This study Conclusion: suggested that Proximal Fibular Osteotomy is an alternative procedure that can be used to treat medial compartment knee Osteoarthritis, if the patients are selected carefully. Patients followed up for one year showed a significant improvement in radiological, clinical and functional outcomes and thereby is an effective method of treatment in younger patients with Grade 2 and Grade 3 Osteoarthritis with an average BMI of 26.2.
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ObjectiveTo investigate the intervention effect of Qufeng Gutong Babu ointment （QFGT） on rats with osteoarthritis （OA） with cold-dampness obstruction， and preliminarily clarify its mechanism. MethodSD male rats were divided into 6 groups， namely， the blank group， model group， positive control drug Huoxue Zhitong ointment （HXZTG） group （1.26 cm2·d-1）， and low， medium， and high-dose QFGT group （75， 150， 300 mg·d-1）. OA model was prepared by joint cavity injection of papain and L-cysteine. On the second day of modeling， climate factors were applied to establish an animal model of combination of disease and syndrome of OA rats with cold-dampness obstruction. Standard VonFrey fiber was used to evaluate the threshold of mechanical pain. Weight bearing difference score and joint function score of both hind limbs were recorded. Hematoxylin-eosin （HE） staining and safranine fixation green staining were used to observe the pathological changes and cartilage degeneration of rat knee joint. Immunohistochemistry （IHC） was used to detect the expression of interleukin-1β （IL-1β）， interleukin-8 （IL-8）， tumor necrosis factor-α （TNF-α）， matrix metalloproteinase-9 （MMP-9）， and cathepsin K （CTSK）. Western blot was used to detect the protein expression of kinase B （Akt）， phosphorylated protein kinase B （p-Akt）， phosphatidylinositol 3-kinase （PI3K）， nuclear factor 1 （NFATc1）， MMP-9， and CTSK in T cells. ResultCompared with the normal group， the model group showed significant mechanical pain sensitivity reaction after modeling （P<0.01）， and the weight bearing difference of both hind limbs and joint function score were significantly increased （P<0.05， P<0.01）. Compared with the model group， both the high-dose QFGT group and the HXZTG group significantly reduced the mechanical pain sensitivity， weight difference， and joint function score of rats （P<0.05， P<0.01）， and the medium-dose QFGT group also improved the joint function to a certain extent， and the degeneration of the knee joint cartilage of rats was significantly reduced （P<0.05， P<0.01）. QFGT and HXZTG both inhibited the protein expression of IL-1β， IL-8， TNF-α， MMP-9， CTAK， PI3K， p-Akt， Akt， and other related proteins in articular cartilage of rats with OA to a certain extent （P<0.05， P<0.01）. ConclusionQFGT can inhibit the release of inflammatory factors and matrix metalloproteinases by inhibiting the PI3K/Akt signal pathway in articular articular cartilage of rats with OA with cold-dampness obstruction， thus ultimately weakening local cartilage degeneration and improving joint function.
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Background: Osteoarthritis (OA) is the most common type of rheumatic disease and a leading cause of disability. Current treatments aim at alleviating these symptoms by several different methods: non-pharmacological and pharmacological treatments and invasive interventions. Among the regenerative methods, hyaluronic acid (HA) is popular now-a-days where differences exist in concentration, molecular weight, dosage, expected duration of effects and added formulations. Based on HA molecular weight, these products are classified in two groups (high and low). Due to cost effectiveness, low molecular weight HA is commonly used. To find out the outcome of single intra-articular injection of high-molecular- weight HA in patients with knee osteoarthritis.Material & Methods:This was a randomized clinical trial conducted among purposively selected 55 patients suffering from Knee OA attending at the Physical Medicine and Rehabilitation outpatient department, DMCH during July 2020 to June 2021. Patients were randomly allocated into two groups; group A received single dose of high molecular weight HA and designed exercise program and group B received same exercise program only. Pre-treatment and 3 weekly post treatment assessment were done up to 12 weeks in each group. In each follow up visit, pain, and functional status were measured in Visual Analog Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) respectively and compared between group A and group B where was considered as significant (p value <0.050.Results:The mean age of the participants in group A and group B were 56.8 (±9.8) and 53.3 (±7.4) years respectively where majority of the patients in both groups were female patients with overweight. In group A, VAS and WOMAC significantly decreased from base line to each follow up till 12th weeks after treatment with high-molecular-weight HA (P<0.001). In group B, VAS and WOMAC significantly decreased from base line to each follow up till 12th weeks after treatment with conservative management (P<0.001). After 6 weeks of intervention, the mean VAS scores of the patients became 4.9 ±1.1 and 6.0±1.0 in group A and group B respectively which showed significant statistical difference (P<0.001). At the end of 12 weeks, the VAS score was significantly decreased in group A (2.8±1.3) than group B (4.9±1.7) (P<0.001). After 3 weeks of intervention, the mean WOMAC scores of the patients became 71.2±6.6 and 75.0 ±4.9 in group A and group B respectively which showed significant statistical difference (P<0.001). At the end of 12 weeks, the WOMAC score was significantly decreased in group A (61.9±6.6) than group B (68.1±4.6) (P<0.001). Conclusion:Single intra-articular injection of high-molecular-weight Hyaluronic Acid is effective in patients with knee osteoarthritis in reducing pain and improving functional impairment. Long term and large scale research studies are needed to establish the effectiveness and safety of this procedure in patients with knee osteoarthritis.
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Background: Osteoarthritis (OA) are common diseases that frequently co-exist, along with overweight/obesity and diabetes. It affects mostly the hips, knees, hands and feet that causes severe disability and loss of quality of life, particularly in the elderly population. Objective: The present study was conducted to access the Prevalence of knee osteoarthritis in diabetes and obese patients.Material & Methods:This case study was conducted among 110 diabetic and 70 obese patients who attended Bangladesh Korea Friendship Hospital and Dhaka Pain Management center, Dhaka, Bangladesh. The data were analyzed using the SPSS version 25.0.Results:Out of 110 diabetic patients 55% were female and out of 70 obese patients 57% were female. Prevalence of knee osteoarthritis among diabetic patients was 50% and 65% for obese patients.Conclusions:Our findings bolster current public health strategies targeted at lowering the burden of knee OA by addressing obesity and diabetes. Obesity and diabetes are linked to knee osteoarthritis, and the risk is especially high among obese adults.
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Abstract This study aimed to investigate the acute effects of oleic acid (OA) on glucose homeostasis in mice fed a standard chow diet (SCD) and a high-fructose, high-fat diet (HFrHFD); moreover, the role of free fatty acid receptor 1 (FFAR1) was evaluated. The mice in the two groups were further divided into three subgroups as follows: control, OA (40 mg/kg), and OA + GW1100 (0.4 mg/kg, selective FFAR1 blocker). After a 16-week feeding period, the mice received the drugs via intraperitoneal (i.p.) injection followed by an i.p. glucose tolerance test (IPGTT) 30 min later. After 3 days, the mice received the same drugs to examine the effects of the drugs on the hepatic levels of phosphatidylinositol-4,5-bisphosphate (PIP2) and diacylglycerol (DAG). OA in the SCD-fed mice significantly increased the blood glucose level (48%, P < 0.001) after 30 min of glucose load compared to that in the control group, but did not affect the levels of PIP2 and DAG. Pre-injection with GW1100 significantly decreased the area under the curve of the IPGTT (28%, P < 0.05) in the SCD group compared to that in the SCD + OA group. OA reduced the blood glucose level (35%, P < 0.001) after 120 min of glucose load in the HFrHFD-fed mice; in addition, it increased hepatic PIP2 (160%, P < 0.01) and decreased hepatic DAG (60%, P < 0.001) levels. Pre-injection with GW1100 blocked the effects of OA on hepatic PIP2 and DAG without affecting the glucose tolerance. In conclusion, OA acutely impaired the glucose tolerance in the SCD-fed mice by acting on FFAR1 but did not improve it in the HFrHFD-fed mice.
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Generally, extracellular matrix (ECM) has the characteristics of viscoelasticity. In osteoarthritis (OA), catabolic processes alter the viscoelastic properties of functional pericellular matrix (PCM) of chondrocytes. Chondrocytes sense and respond to their mechanical microenvironment via an array of mechanosensitive receptors and channels that activate a complex network of downstream signaling pathways to regulate several cell processes central to OA pathology. Advances in understanding the specific mechanosignalling mechanisms in articular cartilage will promote the development of cell microenvironment construction in cartilage tissue engineering and the targeted precision therapeutics for OA. In this review, the work on the mechanism of matrix viscoelasticity regulating chondrocytes mechanotransduction by Agarwal et al. was briefly commented, and the recent advances related with their work was also discussed.
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Osteoarthritis (OA) is a common degenerative disease of the motor system with a high morbidity and disability rate. The pathogenesis of OA is not clear at present. Previous studies believe that the pathogenesis of OA is mainly related to trauma factors, while recent studies have shown that metabolic factors, including abnormal cholesterol metabolism, are also closely related to OA. The treatment of OA is mainly symptomatic treatment at the early stage and surgical treatment at the late stage, and there is no specific drug. Previously, BNTA, a small molecule drug with cartilage protective effects, has been shown to have a good effect on OA caused by trauma, but its effect on OA caused by high cholesterol remains unclear. In order to explore the therapeutic effect of BNTA on OA caused by high cholesterol and its mechanism, the OA model of rats was constructed by adopting high cholesterol diets, and paraffin sections of knee joints were taken for histological evaluation. Lipid accumulation in chondrocytes of rats was assessed by oil red O staining. The expression of genes and proteins related to anabolism, catabolism and cholesterol metabolism in chondrocytes was assessed by RT-qPCR, immunofluorescence and immunohistochemistry. The results showed that BNTA could alleviate OA pathological manifestations and improve the OARSI (Osteoarthritis Research Society International) score in the OA model of high cholesterol rats. In rat chondrocytes, BNTA can promote the expression of anabolism-related genes col2, sox9 and acan, inhibit the expression of catabolism-related genes mmp13 and adamts5, and improve the lipid accumulation caused by high cholesterol in rat chondrocytes. BNTA can up-regulate Insig1 expression in rat chondrocytes and the OA model of high cholesterol rats. This study confirmed that high cholesterol can aggravate OA in vivo and in vitro, and can increase lipid accumulation in rat chondrocytes. Taken together, BNTA can alleviate OA phenotypes induced by high cholesterol and improve abnormal lipid accumulation in chondrocytes, possibly by inhibiting cholesterol biosynthesis in cells by upregulating Insig1, thereby alleviating abnormal lipid accumulation.
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Osteoarthritis (OA) is one of the most common geriatric motor system diseases in the clinical practice. Aging, whose hallmark is cellular senescence, is an important factor leading to the occurrence and development of OA, but its exact role in the pathological development of OA is not completely clear. Studies have proved that targeting senescence can effectively treat aging-related diseases. In this study, the heterozygous mouse model of Cdkn2a-e (Luc-2A-tdTomato-2a-CreerT2-Wpre-PA)1 was established by the CRISPR/ Cas9 technique. The expression of Cdkn2a (p16, p16INK4a), a classical marker of senescence, can be traced in vivo in mice. We then utilized anterior cruciate ligament transection (ACLT) to induce OA in Cdkn2a mice, and we hope to verify the relationship between aging and the occurrence and development of OA and visualize aging changes during OA development through the mice model. In this study, 10-12 weeks old Cdkn2a mice were randomly divided into no surgery control group, sham operation group and ACLT group. OA model was constructed in mice by ACLT operation. After surgery for 4 weeks, animals were collected for fluorescence imaging detection in vivo, which showed that local fluorescence expression of Cdkn2a increased in knee joints of mice in the ACLT group four weeks after surgery (P < 0. 05) . The Safranin O-Fast Green Staining of mouse knee tissue sections showed degeneration of the knee cartilage in the ACLT group at 4 weeks after surgery (P < 0. 05) . Immunohistochemical staining of Cdkn2a was performed on the knee tissue of mice. Compared with the other two groups, Cdkn2a staining on the cartilage surface of the knee tissue of mice in the ACLT group was deeper. The results showed that the OA model induced by surgery showed local aging, which further verified the relationship between aging and OA. At the same time, the Cdkn2a tracer mouse model can reflect the aging progress of mice in vivo, with combination of imaging examinations, so that the occurrence and progress of the relationship between aging and OA can be observed in real time. This heterozygous mouse model of Cdkn2a-e(Luc-2A-tdTomato-2a-CreerT2-Wpre-PA) 1 is not only useful for mechanism research of aging and OA diseases, but also beneficial for finding more potential therapy targets to OA and aging.
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Background:Knee osteoarthritis (OA) damages the proprioceptors within the joint cavity which in turn may lead to impairment of balance, an integral part of mobility.Fears and beliefs about knee osteoarthritis in patients with knee osteoarthritis are found to have an adverse impact on their function. Objectives:The study aimed to evaluate the correlation between fearsand beliefs about knee osteoarthritis and balance in patientswith Knee OA. Material andMethods:In an observational analytical study males and females with OA knee were included. Fears and beliefs wereassesse d usingthe Knee Osteoarthritis Fears and Beliefs Questionnaire (KOFBeQ), balancewas tested using the Functional Reach Test (FRT) and pain was assessed by Visual Analogue Scale (VAS).Result:Forty-six patients were evaluated. Mean pain scorewas 4±1.5, FRT score 8.7±2.4inches, KOFBeq score33 ±13.8. Correlation was found using Spearman coefficient, r=0.178, p=0.23(balance and KOFBeq), r=-0.264, p=0.7 (pain and balance), r=-0.3, p=0.018(pain and KOFBeq) was seen.Conclusion:Fears and beliefs about knee osteoarthritis were present with impaired functional balance. Weaknegative correlationwas found between pain and balance and pain and fears and beliefs and no correlation were found between balance and fearsand beliefs.
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Abnormal mechanical loading is the main risk factor for the development of osteoarthritis (OA), and it can lead to collagen degradation, glycosaminoglycan loss and chondrocyte apoptosis, as well as damage to articular cartilage and subchondral bone. However, due to the lack of understanding in chondrocytes mechanotransduction pathway and invalid method of cartilage repair and regeneration, there is an urgent need for understanding chondrocytes mechanotransduction pathway and mechanism of cartilage damage induced by mechanical loading. In this review, how chondrocytes sense and transmit mechanical signals from cell membrane to cecullar mechanosensors is introduced in detail, and the role of chondrocytes mechanotransduction in OA development is discussed with emphasis.
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Osteoarthritis (OA) is the most common chronic disabling joint disease, and currently there is no effective treatment for the cause. Necroptosis plays a key role in many diseases, and receptor-interacting protein kinase 3 (RIP3) is a key regulator during necroptosis process. Studies have shown that the expression level of RIP3 was significantly upregulated in human and mouse OA degenerative cartilage tissues, suggesting the occurrence of necroptosis. However, the specific pathophysiological role of RIP3 in cartilage is still unclear. This study intends to sequence and analyze the transcriptome of chondrocytes before and after RIP3 overexpression, and explore the specific functional mechanism of RIP3 in OA pathogenesis. RNA sequencing results showed that overexpression of RIP3 induced upregulation of 244 genes and downregulation of 277 genes in chondrocytes. Sixteen candidate target genes were screened out by constructing gene co-expression network for further verification at mRNA level, and the results suggested that RIP3 had the most significant inductive effect on the expression of phosphoinositide-3kinase, regulatory subunit 5 (Pik3r5), integrin subunit beta 3 (Itgb3) and MYB proto-oncogene like 2 (Mybl2). Results from CCK-8 and lactate dehydrogenase activity analysis showed that silencing the expression of Itgb3 by siRNA significantly rescued chondrocyte viability decline and necroptosis induced by RIP3, and it also inhibited the upregulating effect of RIP3 on the expression of catabolism-related genes Mmp1, Mmp13 and Il6, as well as the downregulating effect of RIP3 on the expression of anabolism-related genes Acan, Col2a1 and Sox9. This study has demonstrated that RIP3 promotes chondrocyte necrosis and cartilage matrix metabolism disorders by upregulating the expression of Itgb3 in chondrocytes, and ultimately leads to cartilage degeneration. These findings provided potential novel targets for the clinical treatment of OA, and further clarified the pathophysiological significance of necroptosis.
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Among various types of arthritis Osteoarthritis (OA), Psoriatic arthritis (PA) and Gouty arthritis (GA) are the major ones which have been studied and cause hindrance in movements in many patients. Here we have discussed the treatment modality, a combination of manual therapy and NSAIDs (Ibuprofen) for relieving the symptoms of arthritis. A total of six patients were included consisting of osteoarthritis, psoriatic arthritis and gouty arthritis who presented at the medical office of Dr. Barengolts (MD in USA) and Aybek Izzatov (MD in Uzbekistan) Tyan Anmo Massage School. The study was conducted from October 2019 to March 2020. The treatment consisted of 30 sessions performed for half a year, one week per month (5 days in a month). Significant improvement in symptoms was seen as after 6 months we saw there was reduction in morning stiffness and improved range of motion. The pain score shifted from 5-6 to 2-3 on VAS pain scale. The results signify that the combination therapy wherein manual therapy and NSAIDs worked in an effective way to reduce the level of severity of pain and other associated symptoms.
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Introduction: Rheumatoid arthritis is characterized by local and systemic effects of inflammation while osteoarthritis is aninflammatory degenerative disorder of joints. A wide range of inflammatory markers are implicated in pathogenesis of rheumatoidarthritis and osteoarthritis as a consequence of persistent imbalance between pro- and anti-inflammatory immune mechanisms,leading to chronic inflammation. Hence the present study is an attempt to estimate the levels of serum ceruloplasmin , C-reactiveprotein (CRP) and rheumatoid factor (RF) factor as inflammatory markers in serum of rheumatoid arthritis and osteoarthritispatients and compare them with normal healthy controls. Materials and Methods: Serum ceruloplasmin was estimated byspectrophotometric method while serum C-reactive protein and RA factor were detected using agglutination test in thirty patientsof rheumatoid arthritis ,osteoarthritis and age and sex matched healthy controls each were included in the study. Results:Significant increase in ceruloplasmin was observed (p<0.0001) in rheumatoid arthritis and osteoarthritis as compared to healthycontrols and in that especially ceruloplasmin was more elevated in rheumatoid arthritis than osteoarthritis. C-reactive proteinwas found to be positive in rheumatoid arthritis and osteoarthritis and none of the controls. RF factor was found positive inrheumatoid arthritis and none of the osteoarthritis and controls. Conclusion: There was increased level of serum ceruloplasmin inthe patients with rheumatoid arthritis and osteoarthritis. C-reactive protein and RF factor was found to be positive in rheumatoidarthritis while C-reactive protein was found to be positive in rheumatoid arthritis and osteoarthritis. These findings suggest apossible role of these inflammatory markers in the pathogenesis of rheumatoid arthritis.
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Background: Appendectomy is the most common surgicalprocedure performed in emergency surgery. Appendectomy isstill being performed by both open (OA) and laparoscopic (LA)methods as no other technique is formulated. In this study, weaimed to compare the laparoscopic procedure and thestandard technique in the treatment of acute appendicitis.Methods: Retrospectively collected data from 60 consecutivepatients with acute appendicitis were studied. These comprised30 patients who underwent conventional appendectomy and 30patients treated laparoscopically. The two groups werecompared for Intra operative parameters like duration ofsurgery, conversion, complications, and post-operativeparameters like pain, requirement of pain medications, woundcomplications, hospital stay, any other complications, andcosmetic outcome.Results: In our study Laparoscopic Appendectomy have ashorter hospital stay (Mean duration of hospital stay aftersurgery was 3.1 & 1.9 day in OA & LA group respectively),Operative time was significantly less in the open group (Meanduration of surgery was 71.2 minutes in OA group and 48.8minutes in LA group). Total number of complications werefewer in the LA group with a significantly less incidence ofwound infection (5 Vs 11, P <0.04).Conclusion: The laparoscopic method is a safe andcompetent operative method in appendicectomy. Postoperativepain in our study is notably lesser in laparoscopic group ascompared to open appendectomy, also post-operativecomplication especially wound infections are less frequent inlaparoscopic group of patients. Patient’s recovery fromoperation is also better in laparoscopic appendicectomy groupwhich includes early bowel activity, minimum hospital stay andearly return to work. Overall cosmetic outcome is preferable inlaparoscopic group of patients.
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Objective: To investigate the therapeutic effects of curcumin on sodium iodide-induced osteoarthritis (OA) rats. Methods: Thirty-six rats were randomly divided into three experimental groups: control group, model group (OA+DMSO) and treatment group (OA+DMSO + curcumin). A knee OA rat model was established in the right knee joint cavity of male Sprague-Dawley rats with a single injection of monoiodoacetic acid (MIA). The control group was injected with the same volume of normal saline. Three days later, the treatment group was treated with intraperitoneal injection of curcumin, and the model group was injected with the same volume of DMSO. The rats in each group were observed for 2 weeks and 3 weeks after the swelling of the knee joint and the hind paw retraction test. The knee joint cartilage specimens were taken, and the femoral condyle and tibial plateau were observed under a dissecting microscope and the Pelletier scoring was performed. Sections were frozen and subjected to HE, toluidine blue, safranin O staining and Mankin scoring. Results: The model group had severe cartilage defects, rough surface, synovial hyperplasia with inflammatory changes, and osteophytes. The articular cartilage of the curcumin group was obviously repaired, and the cartilage surface was relatively smooth with no obvious hyperplasia and callus. There was a significant difference between the model group and the treatment group in Pelletier score and Mankin score (P<0.05). Conclusion :Curcumin can slow the degradation of articular cartilage, repair damaged articular cartilage, and reduce inflammation. This experiment provides an experimental basis and evidence for curcumin as a potential clinical drug for the treatment of knee osteoarthritis.
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@#With the advances in cataract phacoemulsification and intraocular lens implantation, more and more attention has been paid to the postoperative effects by both clinicians and patients. Meanwhile, the instruments for the preoperative measurements are also evolving. Various types of ocular biometers have emerged, which have evolved the principles from ultrasound to swept-source optical coherence tomography(SS-OCT). The OA-2000, a new type of SS-OCT based ocular biometer with fully automatic three-dimensional scanning, has the advantages of simple and safe operation, high resolution, excellent repeatability, fast measurement and good tissue penetration. It can obtain multiple ocular biological parameters in one measurement, which enables a wide application prospect. Here, we review the measurement principle and clinical application of OA-2000.
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@#AIM: To study the reliability of Pentacam, OCT, Tomey OA-2000, IOL Master700, and A ultrasound pachymetry in the measurement of central corneal thickness(CCT)in myopic eyes. <p>METHODS: CCTs of 56 myopic patients(112 eyes)were measured using Pentacam, RTVue OCT, Tomey OA-2000, IOL Master 700, and A ultrasound pachymetry(NIDEK US-500). The difference, correlation, and consistency were statistically analyzed using average values taken from the five devices and the measured values produced by each device. <p>RESULTS: CCTs of 112 eyes were determined using Pentacam(530.17±25.08)μm, OCT(519.79±26.90)μm, Tomey OA-2000(521.75±26.51)μm, IOL Master 700(519.53±28.15)μm, and A ultrasound pachymetry(542.23±26.88)μm. The average value across all five devices was 526.69±26.08μm. The results of root mean square error(RMSE)and theil inequality coefficient(TIC)showed that the degree of deviation from the average of the values measured using Pentacam was the smallest. The other four devices were, from least deviation to most, Tomey OA-2000, OCT, IOL Master 700, and A ultrasound pachymetry. Typical correlation analysis showed that the correlation coefficients between the measured values of Pentacam, OCT, Tomey OA-2000, IOL Master 700, and A ultrasound pachymetry and the average values were <i>ρ</i>=0.957, <i>P</i>=0.950, <i>P</i>=0.953, <i>P</i>=0.930, and <i>ρ</i>=0.949, respectively. The results of correlation coefficient showed that Pentacam and Tomey OA-2000 had the closest correlation with the average value. The other three were, in order of closest to furthest correlation, OCT, A ultrasound pachymetry and IOL master 700. The results also showed that the measurements of Pentacam and Tomey OA-2000 were more reliable, which was consistent with the clinical situation. The results of Bland-Altman analysis showed that the five groups of measurements were closely consistent with the average values, and the CCT measurements of Pentacam and Tomey OA-2000 were the most consistent with the average values.<p>CONCLUSION: Among the five instruments, Pentacam and Tomey OA-2000 produced results that were closest to the average value in CCT measurement, with the best correlation and consistency. Their measurement methods are more objective and safer than A-scan, so they may provide better reference data for clinical practice.
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Osteoarthritis (OA) is a chronic degenerative joint disease characterized by joint pain and stiffness, which predisposes to the elderly. The onset of OA is slow, the course of disease is long, and the early clinical manifestations and histological changes are not obvious, which limits the early diagnosis and treatment of the disease. The micro-structure of articular cartilage determines the macro-mechanical properties of cartilage. The micro-structure of articular cartilage changes in a depth-dependent manner, which makes the mechanical properties of cartilage also depth-dependent. From superficial to deep areas of cartilage, the anti-load and anti-deformation ability of cartilage increases gradually. However, with development of the disease, the change of cartilage micro-structure leads to the decrease in load resistance and deformation resistance of OA cartilage. Therefore, the mechanical properties of articular cartilage can be inferred by detecting the micro-structure of articular cartilage. On the other hand, the mechanical properties of articular cartilage can be used to understand the micro-changes of cartilage, which is helpful to understand OA development and facilitate early diagnosis of the disease. This paper reviewed the recent research literatures on mechanical properties of articular cartilage under normal and acute or chronic injuries, and elaborated the relationship between the structure and mechanical properties of articular cartilage, which further provided the theoretical basis for the OA development, early diagnosis and treatment.
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Aim: This study is designed to determine better intervention strategies between pain coping strategies and kinesthesia, balance and agility exercises for chronic knee OA. Study design: Experimental study, Randomized Clinical Trial. Method: 40 participants both male and female with physician diagnosed chronic knee OA were assigned into two groups. The objective of the study was explained, and the subjects were screened based on the inclusion and exclusion criteria. Group A received kinesthesia, balance and agility exercises which include- Wedding march, Backward wedding march, Side stepping, tandem walk, toe walking, heel walking and then exercises progress into leaning forward, backward and sideways, rocker bottom balance board, carioca cross over maneuver and modified grapevine. Group B received Pain coping strategies involving 10 supervised sessions. Both the groups received treatment protocol of 6 weeks with sessions 3 times / week. WOMAC scores were taken at baseline as well as after 6 week of treatment. Results: Both the groups showed clinically and statistically significant improvement in WOMAC scores at the end of 6-weeks of treatment session. i.e., 47.043±11.753 to 5.815±11.079 in group A and 44.579±8.045 to 27.849±5.216 in group B. Conclusion: A significant improvement were observed in both the groups; however the study has demonstrated that KBA exercises presented more beneficial effects in reduction of pain and improvement of functional status whereas pain coping strategies had beneficiary effects in cognitive and behavioral reactions to pain as they affect pain, functional capacity and psychological functioning.
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Background: Present study outlines the outcomes of laparoscopic appendicectomy compared to open conventional appendicectomy in a tertiary care set up with aim to validate advantages and shortcomings of both procedures.Methods: A series of 80 cases above 18 years of age with clinical diagnosis of appendicitis having Alvarado score of seven and above were studied prospectively under the two groups after proper written consent: Open appendectomy-40 cases, Laparoscopic appendectomy-40 cases. Both groups were compared on grounds of intra-operative complications, additional diagnostic potential, operative time, postoperative analgesia, post-operative complications, length of hospital stay, subjective cosmesis, and return to routine normal activities. Values obtained were statistically analyzed.Results: The median operative time in Laparoscopic Appendicectomy was 58.22 minutes (range 32.68-85.46 min) as compared to open procedure which took 43.65 minutes (30.36-65.48min) (P<0.05). Conversion to open procedure was done in 10% (n=4) of laparoscopic cases. Mean value of postoperative pain by visual analogue scale was low in Laparoscopic Appendicectomy (LA) compared to Open Appendicectomy (OA) (P<0.05). Mean post-operative stay (3.2±0.34 days versus 2.3±0.24 days) and surgical site infection was recorded in 10 patients (25%) in OA group and 5 (13.9%) in LA group (P<0.05).Conclusions: It can be concluded that laparoscopic surgery is safe with greater diagnostic potential for additional pathologies and better Subjective cosmesis . But all these merits were at the price of longer operating time and a specialized set up needed for laparoscopy.