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OBJETIVOS: A osteoartrite do joelho (OAJ) é a doença crônica das articulações mais prevalente. Existem vários fatores biomecânicos que afetam o alinhamento das articulações do joelho, resultando em deformidades em varo ou valgo, o que leva a cargas desiguais nas estruturas articulares. O objetivo principal do estudo é determinar as correções biomecânicas na tíbia e deformidade em varo na osteoartrite tibiofemoral medial do joelho (MTKJOA). O objetivo secundário é ver a melhora nas funções físicas dos pacientes. METODOLOGIA / DESENHO: Um ensaio clínico randomizado equivalente de dois grupos pré-teste-pós-teste. O total de '52' pacientes será incluído entre a idade de 35 a 80 anos com osteoartrite da articulação tibiofemoral medial. Os sujeitos serão divididos no grupo de correção biomecânica (Técnica de correção manual de deformidade em varo além do tratamento fisioterapêutico convencional). E grupo de fisioterapia convencional, que inclui eletroterapia e terapia por exercícios. Para medir a dor, será realizada a Escala Numérica de Dor (NPRS) para o goniômetro de amplitude de movimento. O Índice de Artrite da Western Ontario McMaster Universities (WOMAC) será utilizado para avaliar o desempenho físico; e o Software TraumaCaD será utilizado para determinar o alinhamento do membro afetado. Em ambos os grupos, o tratamento fisioterapêutico convencional será realizado por 9 dias. No total, 9 sessões serão dadas em três semanas, e em cada semana, 3 sessões serão dadas em dias alternativos. O resultado será medido no início do estudo. REGISTRO DE ENSAIOS: Registro de Ensaios Clínicos - Índia. (NCT04324931). NÚMERO UNIVERSAL DE ENSAIO: U1111-1249-3661. DISCUSSÃO: Até onde sabemos, este estudo será o primeiro a corrigir o eixo biomecânico das articulações do joelho. Após a Correção Biomecânica, a distribuição da descarga de peso será ajustada e a progressão da deformidade poderá ser reduzida, o que ajudará a melhorar as tarefas funcionais e evitar a realização precoce da Artroplastia Total do Joelho (ATJ).
OBJECTIVES: Knee osteoarthritis (KOA) is the most prevalent chronic disease of joints. Various biomechanical factors affect the alignment of the knee joints resulting in the varus or valgus deformities, which leads to unequal loading on the joints structures. The study's primary aim is to determine the biomechanical corrections on tibia and varus deformity in Medial Tibiofemoral Knee Joint Osteoarthritis (MTKJOA). A secondary aim is to see the improvement in the physical functions of the patients. METHODOLOGY/DESIGN: A Two Group Pretest-Posttest Equivalent Randomized Clinical Trial. Total '52' patients will be included between 35 to 80 years with medial tibiofemoral joint osteoarthritis. Subjects will be divided into the biomechanical correction group (Manual varus deformity correction technique in addition to conventional physiotherapy treatment). Conventional physiotherapy group, which includes electrotherapy and exercise therapy. For measuring the pain, the Numeric Pain Rating Scale (NPRS) will be taken, for a range of motion goniometer will be taken, Western Ontario McMaster Universities Arthritis Index (WOMAC) will be taken for assessing the physical performance, and TraumaCaD Software will be used to determine the alignment of the affected limb. In both groups, conventional physiotherapy treatment will be given for nine days. A total of nine sessions will be given in three weeks, and each week, 3 sessions will be given on alternate days. The outcome will be measured at baseline. TRIAL REGISTRATION: Clinical Trials Registry India. (NCT04324931). UNIVERSAL TRIAL NUMBER: U1111-1249-3661. DISCUSSION: To our knowledge, this study will be the first to correct the biomechanical axis of knee joints. After Biomechanical Correction, the weight-bearing distribution will be adjusted, and progression of deformity can be reduced, which will help improve the functional tasks and prevent early Total Knee Arthroplasty (TKA).
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Osteoarthritis , Exercise Therapy , Knee JointABSTRACT
Objective To study the endogenous metabolites of liver-kidney deficiency syndrome in knee-joint osteoarthritis (KOA) and explore the metabolic profile of KOA liver-kidney deficiency syndrome. Methods Totally 50 cases of KOA with liver-kidney deficiency syndrome and 50 cases of KOA with non-liver-kidney deficiency syndrome were collected respectively, and 20 cases of healthy volunteers were collected as the normal group. The serum samples of subjects were collected after fasting for 8 h. Hydro-Nuclear Magnetic Resonance (1H-NMR) spectrometer was collected. Principal component analysis and partial least squares discrimination analysis were used to conduct multivariate statistical analysis. Results 1H-NMR could identify 23 kinds of metabolites, and there was statistical significance between KOA patients and healthy volunteers (P<0.05, P<0.01). There was statistical significance in cartilage matrix metabolism, energy metabolism, lipid metabolism, pain, inflammation-related metabolites in patients with KOA liver-kidney deficiency syndrome and patients with KOA non-liver-kidney deficiency syndrome (P<0.05). Conclusion Patients with KOA liver-kidney deficiency syndrome have a unique 1H-NMR metabolic profile, KOA syndrome has a metabolic material basis.
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ObjectiveTo investigate the efficacy of interactive thumbtack needle embedding plus rehabilitation instruction in treating knee osteoarthritis.Method Seventy outpatients with knee osteoarthritis were randomly allocated to acupuncture-rehabilitation and control groups, 35 cases each. The control group received rehabilitation instruction alone and the treatment group, interactive thumbtack needle embedding in addition. The function of the affected knee was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score and manual muscle test (MMT) in the two groups of patients before and after two courses of treatment. The therapeutic effect was evaluated using Nimodipine method accordingto 2002Guidelines on Clinical Study of New Chinese Herbal Medicine(trial).ResultAfter two courses of treatment, there were a statistically significant pre-/post-treatment differences in the WOMAC total score, pain score, stiffness score and function score in both groups (P0.05). There was a statistically significant difference in therapeutic effect between the two groups (P<0.05).ConclusionInteractive thumbtack needle embedding plus rehabilitation instruction has a definite therapeutic effect on knee osteoarthritis.
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ObjectiveTo investigate the clinical efficacy of electrothermic acupuncture in treating knee osteoarthritis.Method One hundred and twenty patients were randomly allocated to treatment and control groups, 60 cases each. The treatment group received electrothermic acupuncture and the control group took Xianlinggubao capsules orally. The clinical therapeutic effects and changes in the WOMAC score were observed in the two groups after four weeks of treatment.ResultThe total efficacy rate was 95% in the treatment group and 85% in the control group. There was a statistically significant difference in clinical therapeutic effect between the two groups (P<0.05). There was a statistically significant difference in pre-/post-treatment WOMAC score difference value between the two groups (P<0.05).ConclusionThe clinical efficacy of electrothermic acupuncture is better than that of Xianlinggubao capsules in treating knee osteoarthritis with yang deficiency and cold congealment.
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Objective To compare the therapeutic effects of tug-of-war needling method versus conventional electroacupuncture on knee osteoarthritis, seek a better method for treating this disease and prove the importance of needling and moxibustion techniques. Method One hundred patients meeting the criteria of knee osteoarthritis were allocated, in order of visits, to an electroacupuncture group of 50 cases and a tug-of-war needling group of 50 cases. In the tug-of-war needling group of patients, points Zusanli(ST36) and Heding(EX-LE2) were mainly selected and after the arrival of qi following needle insertion, forward pushing or backward pulling was repeatedly made like tug of war to strengthen or eliminate the needling sensation. In the electroacupuncture group, local points were mainly selected according to the routine, and after the arrival of qi, a G6805-1 type electric acupuncture therapeutic instrument was connected and sparse-dense waves were used. Reactions were recorded in the two groups of patients after two courses of treatment. Joint function was assessed using the VAS and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Result Both groups of patients were followed up at six months after the end of treatment. There were statistically significant pre-/post-treatment differences in the VAS score and the WOMAC sub-scores and total score in the two groups (P＜0.01). The VAS score and the WOMAC sub-scores and total score decreased more in the tug-of-war needling group of patients than in the electroacupuncture group (P＜0.01). The total efficacy rates in the tug-of-war needling and electroacupuncture groups were 92.0% and 90.0%, respectively, at the end of treatment and 94.0% and 92.0%, respectively, at the follow-up;there was no statistically significant difference between the two groups and between at the end of treatment and at the follow-up in the two groups (P>0.05). However, the cure and marked efficacy rates in the two groups of patients were 68.0%and 52.0%, respectively, at the end of treatment and 68.0%and 54.0%, respectively, at the follow-up. It was statistically higher in the tug-of-war needling group than in the electroacupuncture group (P＜0.05). Conclusion Both tug-of-war needling and electroacupuncture have a good and very stable therapeutic effect on knee osteoarthritis. Tug-of-war needling is better than electroacupuncture in improving the clinical symptoms.
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@#Objective To analyze the outcome of total knee arthroplasty with retaining patellar in osteoarthritis.Methods 45 knee joints in osteoarthritis were performed operatively with posterior stabilized knee arthroplasty between January 2005 and June 2008. The series include 7 sides(males) and 38 sides(females). The mean age of patients was 65.7 years ranging from 52 to 79 years, and the data were analyzed by The Hospital for Special Surgery(HSS) score system. Results The follow-up period was averagely 25 months ranging from 8 to 51 months. According to HSS score system, 28 sides were rated as excellent（62.2%）, 12 sides as good（26.7%）, 4 fair（8.9%）and 1 poor（2.2%）, and the excellent-good rate was 88.9%. Conclusion Posterior stabilized knee arthroplasty with retaining patellar represents a simple and valuable treatment methodology for the most osteoarthritis of the knee joint.
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@#Objective To observe the clinical effect of manipulation combined with physical therapy on middle-elderly knee osteoarthritis (KOA).Methods 32 KOA patients (49 knees) were treated with manual operation, such as manipulation relaxing the end of quadriceps, triceps, surae and other manipulation method for knee joint and combined with physical therapy.Results 11 cases (18 knees) were clinical curative, 16 cases (23 knees) had good effective, 5 cases (knees) had effective. The good effective rate was 84%.Conclusion Manipulation combined with physical therapy is effective on middl-elderly KOA patients.
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@# Objective To explore the characteristics of muscular power changes of knee joint and static balance in the elderly patients with knee osteoarthritis(KOA).Methods Isokinetic test and computerized static posturography were performed in 59 patients with KOA(KOA group) and 50 age-matched controlled subjects(conrtol group). The parameters were recorded.Results Peak torque, total work, average power and torque acceleration energy significantly decreased in KOA group compared with the control group at the low velocity of concentric pattern(P<0.05), while hamstring/quadriceps value increased statistically(P<0.05);The values of covered area, length of path, length/area statistically increased in KOA group compared with the control group only when eyes closed (P<0.01), and so did it in KOA group when eyes closed compared with eyes opened(P<0.05); There was significant relationship between length/area and hamstring/quadriceps value.Conclusion The ability of balance declined as knee muscular power decreased in the patients with KOA, especially the non-spontaneous decrease of extensor and flexor power of the knee joint.
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@#Objective To study the relationship between knee osteoarthritis progression and the ration of fat,lean,or bone mineral content(BMC).Methods 36 joints of knee with osteoarthritis in 31 women were divided into two groups according to the knee joint space,joint space narrowing group and non-narrowing group.The body mass index(BMI)was calculated.The X-ray(weight bearing)of knee joint was taken.The fat,lean,BMC and mass of leg were detected with the dual energy X-ray absorptiometry(DXA).Results There was no distinct difference between sides and age distribution for the tested groups(P>0.05).The BMI and fat/mass ratio of leg in the joint space narrowing group were obviously higher than that of the non-narrowing group(P<0.05),while the lean/mass ratio of leg in the joint space narrowing group was distinctly lower than that of the non-narrowing group(P<0.05).Conclusion The deterioration of the female knee osteoarthritis can be mainly attributed to the increase of the BMI and fat/mass ratio as well as the decrease of the lean/mass ratio of leg.
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@#Objective To evaluate the role of arthroscopy in diagnosis and treatment of osteoarthritis of the knee.Methods The data of 108 patients (118 knees) with osteoarthritis of the knee and received arthroscopic surgery were analyzed retrospectively including sign, X-ray and MRI examinations of knee, the average stage in hospital, diagnoses before and after operation, and prognosis.Results Arthroscopic surgery was of benefit to diagnosis and treatment of osteoarthritis of knee. The average stage in hospital was 11±7 days. The following-up of 98 patients showed that 82 patients were excellent, 16 patients good and only 1 patients not up to standard.Conclusion Arthroscopic surgery has following advantages such as less invasive surgery, shorter stage in hospital, good curative effect in the near future.
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@#Objective To observe the efficacy and safety of joint mobilization therapy for osteoarthritis of knee joint.Methods 120 patients with osteoarthritis of knee joint were randomly divided into the treatment group and control group with 60 cases in each group. The treatment group were treated with joint mobilization and synthesis rehabilitation therapy, and control group only with synthesis rehabilitation therapy.Results The total effective rate was 90.00% in the treatment group and 76.67% in the control group according to analysis of intention-to-treat, and 92.73% in the treatment group and 80.77% in the control group based on analysis of per-protocol population. There was a significant difference between the two groups ( P<0.05). No adverse effect was found in the treatment group.Conclusion The joint mobilization therapy is efficacy and safety for osteoarthritis of knee joint.
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Objective:To study curative effect of Biqi Capsule on Knee joint osteoarthritis patients.Methods:210 patients who meet the full diagnostic criteria were grouped into the therapy group(150 patients)and the control group(60 patients) at random.The therapy group was treated with Biqi Capsule per os,while the control group was treated with western medicine Meloxicam tablets per os.The comprehensive curative effects on the two groups were summarized.Results:The total effective rate of the therapy group and the control group were 93.3%and 75.5%respectively;The curative effect was found to be better in the therapy group than that in the control group(P
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0.05). Conclusion Jingu Tongxiao Granules could effectively relieve the pain, morning stiffness and motor impairment of knee joint osteoarthritis safely. Compared with the original form, the efficacy and safety of Jingu Tongxiao Granules were the same.