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ObjectiveTo investigate the clinical efficacy of Tenghuang Jiangu tablets （THJGT） combined with oral non-steroidal anti-inflammatory drugs （NSAIDs） in the treatment of osteoarthritis of the knee and its applicable stage based on real-world data， and provide a basis for the rational clinical use of THJGT. MethodA total of 218 cases treated with THJGT combined with oral NSAIDs included in the "THJGT for knee osteoarthritis case registry" from September 2019 to January 2021 were selected as the observation group， and 126 cases treated with oral NSAIDs alone as the control group （CG）. The data of gender， age， body mass index， Kellgren-Lawrence grading scale （K-L scale） score， visual analogue score （VAS score）， Western Ontario and McMaster Universities Osteoarthritis Index （WOMAC） score， swelling grade， joint fear of cold score， back pain and weakness score， and occurrence of adverse events/reactions of the patients in both groups were used for the evaluation of efficacy with full analysis set. The propensity score matching method was used to exclude the influence of confounding factors between groups， and the sub-data sets were established， with which the repeated measures analysis of variance （ANOVA） was carried out to evaluate the efficacy. Visit points were at registration， 4 weeks and 8 weeks after registration. The data were statistically analyzed in Excel 2019 and SPSS 23.0. ResultThe proportion of females in the observation group was 66.06% （144/218）， which was higher than that （58.73%， 74/126） in the control group （χ2=1.846）. The average age in the observation group was （61.12±7.01） years， which was higher than that ［（59.38±5.99） years］ in the control group （W=19 918.50， P<0.05）. The remission rate in the observation group was 98.17% （214/218）. In the observation group， the proportions of the patients at K-L grades Ⅱ and Ⅲ were 64.22% （144/218） and 25.23% （55/218）， respectively. The effect analysis of the whole data set for enrollment and treatment for 8 weeks showed that the VAS score of the experimental group decreased by （3.27±1.24） points on average， which was better than that of the control group [（2.75±1.20）， W=34 179.00， P<0.05]. The average WOMAC score decreased （23.43±11.46） points， which was better than that of the control group [（16.71±8.86）， W=32 387.00， P<0.05]. The average swelling grade decreased （0.63±0.64）， which was better than the control group [（0.33±0.59）， W=33 847.50， P<0.05]. The average score of joint chills decreased （1.90±1.84）， points， which was better than that of control group [（1.40±1.28）， W=35 165.00， P<0.05]. The average lumbar acid fatigue score decreased by （2.02±1.64） points, which was better than that of the control group [（1.10±1.28）， W=32 986.50， P<0.05]. Efficacy analysis of subdata sets for enrollment， 4 weeks of medication and 8 weeks of medication showed that VAS scores of both groups showed a downward trend after treatment， and the improvement of experimental group was more significant than that of control group at 4 weeks， with statistical significance （P<0.05）. After treatment， the total WOMAC score of both groups showed a downward trend， and the improvement of experimental groups was more significant at 4 weeks and 8 weeks （P<0.05）. After treatment， swelling， cold fear grade and lumbar acid fatigue score of both groups showed a decreasing trend,， and the improvement of experimental group was more significant at 8 weeks （P<0.05）. The therapeutic effect analysis of patients in the attack stage and remission stage of the experimental group showed that the total WOMAC score of the two groups showed a downward trend after treatment， and the trend was basically the same， and there was no statistical difference between the two groups at enrollment， 4 weeks after treatment， and 8 weeks after treatment （t=1.675， t=2.068， t=2.364）. The total WOMAC score of the patients in remission stage in the experimental group with K-L grading between grade 0 and grade Ⅲ had statistical significance at 4 weeks after treatment compared with the time of entry （P<0.05， P<0.01）. Group of adverse event rate was 4.13% （9/218）， lower than the control group 10.32% （13/126） （χ2= 5.109， P<0.05）. ConclusionThe population receiving THJGT combined with oral NSAIDs is mostly female， old， in remission， and with K-L grades Ⅱ and Ⅲ. THJGT can enhance the anti-inflammatory and analgesic effects of oral NSAIDs and keep the drug effect in improving joint function and alleviating fear of cold， swelling， and back pain and weakness. The drug combination can be applied to patients in both attack and remission， and the clinical application should take patient's disease stage and degree of osteoarthritis into account. Furthermore， the combination has the potential to reduce the incidence of adverse events caused by NSAIDs.
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Introduction: The progressive and chronic characteristics of knee osteoarthritis imply the presence of symptoms, such as pain, stiffness, and functional capacity difficulty to varying degrees. However, asso-ciated psychosocial phenomena, such as kinesiophobia, may also arise, impeding the patient's recov-ery. The aim of this study is to determine the association among pain, stiffness, functional capacity, and kinesiophobia in patients with knee osteoarthritis at Hospital Nacional Hipolito Unanue, Peru, in the first two months of 2020. Materials and methods: An observational, correlational, cross-sectional study was conducted on 88 patients with knee osteoarthritis who were selected by census sampling. The Western Ontario and McMaster Universities Osteoarthritis Index questionnaire and the Tampa Scale for Kinesiophobia were used to measure pain, stiffness, functional capacity and kinesiophobia, respectively. Pearson's chi-square test (p < 0.01) was used for bivariate analysis. Results: The results showed a mean age of 66.38 years and a higher frequency in the female sex (68.2 %), current occupation without physical workload (56.8 %), secondary level education (40.9 %), time of illness of 15 years (51.1 %), bilateral lower limb involvement (68.18 %), moderate pain (51.1 %), moderate stiffness (51.1 %), functional capacity dif-ficulties (61.4 %), and a high level of kinesiophobia (60.2 %). A relationship was found between the vari-ables of pain, stiffness, and functional capacity associated with kinesiophobia (0.000). Conclusions: Pain, stiffness, and functional capacity are associated with kinesiophobia in patients with knee osteoarthritis. The degree of symptomatology increases with the increasing level of kinesiophobia.
Introducción: la característica progresiva y crónica de la gonartrosis supone la presencia de síntomas como el dolor, la rigidez y la dificultad de la capacidad funcional en diferentes grados; sin embargo, pueden también surgir fenómenos psicosociales asociados como la kinesiofobia, que impiden la recuperación del paciente. El objetivo del estudio es determinar la asociación entre dolor, rigidez, capacidad funcional y kinesiofobia en pacientes con gonartrosis del Hospital Nacional Hipólito Unanue (Perú), en los primeros dos meses de 2020. Materiales y métodos: estudio observacional, correlacional y de corte transversal realizado en 88 pacientes con gonartrosis seleccionados por muestreo censal. Se empleó el Cuestionario womac y la Escala Tampa para Kinesiofobia (tsk-11) y se utilizó el estadístico chi cuadrado de Pearson (p < 0.01) para el análisis bivariado. Resultados: una edad media de 66.38 años y una mayor frecuencia del sexo femenino (68.2 %), ocupación actual sin carga física (56.8 %), grado de instrucción secundaria (40.9 %), tiempo de enfermedad de 1-5 años (51.1 %), afectación bilateral de miembros inferiores (68.18 %), grado moderado de dolor (51.1 %), grado moderado de rigidez (51.1 %), grado con dificultades de capacidad funcional (61.4 %) y nivel alto de kinesiofobia (60.2 %). Se halló relación entre las variables dolor, rigidez y capacidad funcional con la kinesiofobia (0.000). Conclusiones: el dolor, la rigidez y la capacidad funcional están asociadas con la kinesiofobia en pacientes con gonartrosis. A mayor grado de sintomatología, mayor kinesiofobia.
Introdução: a característica progressiva e crônica da gonartrose supõe a presença de sintomas como dor, rigidez e dificuldade na capacidade funcional em diferentes graus, porém, fenômenos psicosso-ciais associados como a cinesiofobia também podem surgir, impedindo a recuperação do paciente. O objetivo do estudo é determinar a associação entre dor, rigidez, capacidade funcional e cinesiofobia em pacientes com gonartrose do Hospital Nacional Hipólito Unanue, no Peru, nos dois primeiros meses de 2020. Materiais e métodos: estudo observacional, correlacional e de corte transversal realizado em 88 pacientes com gonartrose selecionados por amostragem censitária. Foram utilizados o Questionário womac e a Escala Tampa para Cinesiofobia (tsk-11) e a estatística Qui-quadrado de Pearson (p < 0,01) para análise bivariada. Resultados: idade média de 66,38 anos e maior frequência do sexo feminino (68,2 %), ocupação atual sem carga física (56,8 %), ensino médio (40,9 %), tempo de doença de 1 a 5 anos (51,1 %), acometimento bilateral de membros inferiores (68,18 %), grau moderado de dor (51,1 %), grau moderado de rigidez (51,1 %), grau com dificuldades de capacidade funcional (61,4 %) e alto nível de cinesiofobia (60,2 %). Foi encontrada relação entre as variáveis dor, rigidez e capacidade funcional com cinesiofobia (0,000). Conclusões: dor, rigidez e capacidade funcional estão associadas à cinesiofobia em pacientes com gonartrose. Maior grau de sintomatologia, maior nível de cinesiofobia.
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Humans , Pain , Disease , Osteoarthritis, Knee , Education , HospitalsABSTRACT
Objectives: To evaluate the feasibility and efficacy of treatment for the recovery of knee joint function after total knee arthroplasty (TKA) using a robotic suit.Patients and Methods: Knee joint extension exercise sessions were started with a robotic suit (single-joint hybrid assistive limb [HAL-SJ, Cyberdyne, Inc., Tsukuba, Japan]) in one group of patients after TKA. Patients who underwent standard rehabilitation were enrolled in the control group. To evaluate feasibility and safety, we assessed the adverse events, the number of training sessions, and training time. We compared the changes in knee joint pain and extension lag (°) between the groups.Results: The average age was 71.3 ± 6.2 years in the HAL-SJ group and 74.9 ± 8.7 years in the control group. There were no severe adverse events. In the HAL-SJ group, training was performed 2.9 times, on average, and lasted 18.8 min. In the HAL-SJ group, there was a reduction in the visual analog scale (VAS) for pain after training, which was not significant. In the control group, the VAS score worsened after the sessions. The extension lag significantly improved in the HAL-SJ group after the 2nd and 3rd sessions, and this was more due to improvements in their active extension range of motion than their passive extension range of motion.Conclusions: HAL-SJ-based training is safe and effective, and leads to instantaneous improvement of extension lag, without worsening knee joint pain. HAL-SJ-based knee extension training could represent a viable novel post-TKA rehabilitation modality.
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In this study, we investigated the relationship of an osteoarthritis of the knee (OA) and a knee pain of single-leg on the bilateral difference of ground reaction force in stepping. The subjects were 29 middle-aged women (mean age 63.7±6.7 years). We categorized them into groups based on the following conditions: osteoarthritis of the knee (OA groups; n = 9), knee pain (KP groups; n = 7), and no pain (NP groups; n = 13). We measured the ground reaction force in a vertical direction when stepping on a platform. The evaluation variables were as follows: peak of ground reaction force at the early stance phase (F1), middle phase (F2), and late phase (F3). We calculated the bilateral difference of ground reaction force of the left and right leg and the affected side and the unaffected side ratio. The result of two way ANOVA, there was a significant difference between the leg in F1 and F3 and the group at F2. The result of comparison between the OA groups and the KP groups, there was no significant difference in the unaffected side and the affected side ratio, those in the OA groups tended to have a load on the unaffected side, while those in the KP groups had a load on the affected side. Therefore, it was suggested that there was the relationship of the OA and a knee pain of single-leg on the bilateral difference of ground reaction force in stepping.
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Objective To explore the distribution of the plantar pressure in patients with knee osteoarthritis after knee joint replacement surgery.Methods The plantar pressure of 33 patients with double knee osteoarthritis and single knee replacement was measured using the Belgian footscan plantar pressure test system.The peak pressure,the impulse,the peak time of the peak pressure and the parameters of the foot support period were observed.Results The average peak pressure and average impulse of the 2nd,3rd and 4th foot metatarsal,together with the medial and lateral heel,midfoot and full plantar of the knee replacement side were higher than the other side but without significant differences (P＜0.001,P＜0.05).The duration of the maximum pressure peak of the lst,2nd,3rd,4th and 5th metatarsal area and midfoot of the knee replacement side was significantly longer than the other side (P＜ 0.001,P＜0.05).The time of initial contact phase,the duration of foot flat phase and the duration of all single foot support of knee replacement side were significantly longer than the other side(P＜0.05).Conclusions It shows that the plantar pressure parameters and the knee joint's movement ability have improved significantly after the replacement.The foot pressure analysis can be used to evaluate the function of knee joint,to better understand the biomechanical changes of knee joint,so as to explore the best treatment and rehabilitation after the knee arthroplasty.
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Se realizó un estudio retrospectivo de observación analítica, de casos y contrles, en 42 pacientes con artrosis de rodilla, pertenecientes al Policlínico Docente José Martí Pérez" de Santiago de Cuba, de septiembre de 2014 a junio de 2015, a fin de evaluar la efectividad del producto homeopático AliviHo®-reuma como tratamiento coadyuvante unido al esquema terapéutico convencional basado en antiinflamatorios no esteroideos y analgésicos. En el procesamiento estadístico de la información se emplearon el porcentaje como medida de resumen, el test exacto de Fisher, para determinar si la asociación era significante, y la oportunidad relativa (OR), con un intervalo de confianza (IC) de 95 por ciento. La favorable evolución en la mayoría de los pacientes reveló la utilidad de esta terapia adyuvante en la disminución de manifestaciones psicosomáticas y en el prolongamiento de los períodos de remisión de la enfermedad; de manera que quedó demostrada la efectividad del AliviHo®-reuma para tratar a pacientes con artrosis de rodilla y mejorar así la calidad de vida de estos
A cases and controls retrospective study of analytic observation was carried out in 42 patients with arthrosis of the knee who belonged to José Martí Pérez Teaching Polyclinic in Santiago de Cuba, from September, 2014 to June, 2015, in order to evaluate the effectiveness of the homeopathic product AliviHo®-rheumatism as coadjuvant treatment with the conventional therapeutic schedule based on non esteroids and analgesic anti-inflammatory drugs. In the statistical processing of the information, the percentage as a summary measure, the exact test of Fisher to determine whether this difference is significant or not, and the odds ratio, with 95 percent of confidence, were used. The favorable clinical course in most of the patients revealed the usefulness of this adjuvant therapy in the decrease of psychosomatic manifestations and in the extension of the referral periods of the disease; so that the effectiveness of the AliviHo®-rheumatism was demonstrated to treat patients with arthrosis of the knee and to improve in this way their life quality
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Humans , Male , Female , Homeopathic Remedy , Rheumatic Diseases/therapy , Osteoarthritis, Knee/therapy , Osteoarthritis , Effectiveness , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Retrospective Studies , Observational StudyABSTRACT
Objective To investigate the clinical effect of Bushen Huoxue Tongluo Recipe in the treatment of acute attack of primary knee osteoarthritis, so as to enrich the treatment method and improve the curative effect. Methods 94 cases of primary knee osteoarthritis acute attack were randomly divided into 2 groups, 47 cases in the control group were treated with conventional western medicine treatment, the observation group of 47 cases, treated with Bushen Huoxue Tongluo Decoction, were observed after treatment in the improvement of the safety index, serum indexes and related score. Results The two groups at the end of the pain, stiffness, ADL, tenderness, swelling, joint activities are significantly lower than before treatment, after treatment were significantly different (P<0.05) at the end of treatment, the observation group in the above six indicators were significantly better than the control group (P<0.05); group MMP-3, two at the end of treatment CRP, IL-1, TNF- were significantly lower than before treatment, after treatment were significantly different (P<0.05) at the end of treatment observation group above index was significantly better than the control group (P<0.05). Conclusion: Bushen Huoxue Tongluo Decoction can improve the primary acute exacerbation of knee osteoarthritis clinical symptoms, reduce inflammation, and high safety.
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Objective To investigate the clinical effect of Bushen Huoxue Tongluo Recipe in the treatment of acute attack of primary knee osteoarthritis, so as to enrich the treatment method and improve the curative effect. Methods 94 cases of primary knee osteoarthritis acute attack were randomly divided into 2 groups, 47 cases in the control group were treated with conventional western medicine treatment, the observation group of 47 cases, treated with Bushen Huoxue Tongluo Decoction, were observed after treatment in the improvement of the safety index, serum indexes and related score. Results The two groups at the end of the pain, stiffness, ADL, tenderness, swelling, joint activities are significantly lower than before treatment, after treatment were significantly different (P<0.05) at the end of treatment, the observation group in the above six indicators were significantly better than the control group (P<0.05); group MMP-3, two at the end of treatment CRP, IL-1, TNF- were significantly lower than before treatment, after treatment were significantly different (P<0.05) at the end of treatment observation group above index was significantly better than the control group (P<0.05). Conclusion: Bushen Huoxue Tongluo Decoction can improve the primary acute exacerbation of knee osteoarthritis clinical symptoms, reduce inflammation, and high safety.
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Background: Degenerative changes in the knee occur with increasing frequency after the third decade of life. In early osteoarthritis with no mal-alignment of the knee, arthroscopic surgery is an attractive alternative for many elderly patients as it reduces the degree of surgical insult and postoperative rehabilitation with hope of restoration of painless mobility. To study the role of arthroscopic debridement in alleviation of pain in cases of osteoarthritis knee and to evaluate the effectiveness of arthroscopy in diagnosis of osteoarthritis knee and its co-relation with radiological diagnosis. Methods: The present study is cross-sectional study of consecutive cohort of 53 patients. Body mass index was calculated based on height and weight of the patients and from their assessment of X - Rays patients were graded from 0 to 4 based on Kellegren–Lawrence radiological grading method. Selected patient were then assessed by pain domain of the knee society scoring system, which is joint specific score ranging from 0 to 50. These patients were then subjected to arthroscopic examination and debridement. Results: Overall 17 (32.08%) out of total 53 cases studied showed improvement after one year. Majority of patients improved were grade 2 (57.89%) but none of the grade 4 patients showed improvement at 1 year. Conclusions: Arthroscopic debridement does not influence the ongoing pathological process; it is only useful for symptomatic relief in cases of low grade osteoarthritis where it provides pain relief. Conversely, in patient with sever osteoarthritis there is very limited role of arthroscopy.
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Objective To explore the clinical effect of sodium hyaluronate combined with glucosamine in the treatment of knee osteoarthritis and its improving for knee joint function.Methods 127 patients with knee osteoar-thritis who were treated in our hospital from March 2011 to September 2013 were divided two groups according to the random number table method,the control group was intra -articular injected with sodium hyaluronate,while the obser-vation group was treated with oral glucosamine on the basis of control group therapy.Compared the clinical effect,the keen joint pain by the visual analogue score(VAS)method were evaluated,and the improving of knee joint function and adverse reaction status in two groups after treatment was analyzed.Results Patients were followed up for 3 months,observed in 42 cases,17 cases markedly effective group,progress in 4 cases,invalid 1 cases,in the control group 31 cases were markedly effective,effective in 20 cases,progress in 7 cases,5 cases were ineffective,with a sig-nificant difference between he ttwo groups(Z =-2.120,P =0.034).VAS scores in the two groups after treatment were reduced than before treatment,and the reduced extent in the observation group was bigger than the control group [(2.7 ±0.8)vs (4.2 ±1.0)],the difference was statistically significant(t =3.832,P =0.039).Knee joint func-tion score of the two groups after treatment were increased than before treatment,and increased extent in the observa-tion group was bigger than the control group[(88.9 ±11.8)vs (75.2 ±12.0)],the difference was statistically sig-nificant(t =3.261,P =0.016).There were adverse reactions in the two groups after treatment,but the difference was no statistically significant(P >0.05).Conclusion Sodium hyaluronate combined with glucosamine can significantly promote the clinical effect in the treatment of knee osteoarthritis,it can relieve pain,improve the recovery of knee joint function and will not increased the risk of adverse reaction of patients after treatment,which has an important value to be popularized in clinical field.
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Objective : We performed a systematic review to investigate improvements in body function and structure, activity, and health-related quality of life from exercise programs of >150 days' duration in patients with knee osteoarthritis (OA). Methods : We collected data on randomized controlled trials (RCTs) comparing the effects of exercise intervention with those of either nonintervention or psychoeducational intervention in patients with knee OA. Data were collected on pain, stiffness, muscle strength, range of motion, flexibility, maximal oxygen uptake, proprioception, time to climb a flight of stairs, disability as assessed by the Western Ontario and McMaster Universities Arthritis Index (WOMAC), walking distance (e.g., 6-min walking-distance test), walking time (e.g., time to walk arbitrary distances), walking velocity, and health-related quality of life assessed using the SF-36<sup>®</sup> Health Survey (SF-36). The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was used to determine the quality of the evidence. Results: Forty-one RCTs were identified. Outcomes that were significantly affected by exercise programs of >150 days were knee flexion muscle strength at a functional level, time to climb a flight of stairs and walking distance at activity level, and SF-36 General Health, Physical Functioning, Role-Physical, and Bodily Pain scales. The quality of evidence for these outcomes was moderate to high. Conclusion : In patients with knee OA, improvements in body function, activity, and health-related quality of life can be maintained with exercise programs of >150 days' duration, and these findings are supported by a moderate to high level of evidence.
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[Objective]To evaluate the efficacy of the different depth of acupuncture on the motor function and the pain with osteoarthritis of the knee. <BR>[Design]Single blind randomized controlled trial.<BR>[Method]Subjects were randomly allocated to one of two groups. Acupuncture needles were inserted about 3mm in the superficial acupuncture group and 10 to 20 mm in the deep acupuncture group. Subjects in both groups received the treatments for ten minutes on ten tender points. Acupuncture sessions were performed once a week for 8 weeks and without treatment 4 weeks.<BR>[Outcome Measures]Pain intensity (visual analogue scale :VAS) , Objective evaluation of the motor function (Timed Up &Go test, 20m walking time, Time of going up and down stairs) and QOL (Western Ontario and MacMaster Universities osteoarthritis index :WOMAC).<BR>All measurements were recorded at baseline, 4th, 8th and 11thweek.<BR>[Result]Motor function improved significantly only in the superficial acupuncture group(P<0.05). The degree of pain decreased significantly in both groups (P<0.05). <BR>[Conclusion]Superficial acupuncture provided the improvements on pain and motor function and contributed to the QOL improvement. Therefore the superficial acupuncture would be suggested to be one of the most effective method for the acupuncture treatment of OA of the knee.
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Objective : To evaluate the effect of heat and steam generating sheets on osteoarthritis of the knee. Methods : Subjects with osteoarthritis of the knee (<i>n</i>=41) were randomized into 2 groups : a heat and steam generating sheet group or a heat generating sheet group. Functional impairment [Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Japan Orthopaedic Association score (JOA score)] in the index knee were measured at baseline and then again after 2 and 4 weeks of wear. Results : At both the 2 and 4 week patient evaluations, the heat and steam generating sheet group showed improved total WOMAC scores. Although the heat generating sheet groups' WOMAC scores were improved after 2 weeks, the difference between the 2 and 4 week evaluations was not statistically significant. As for individual WOMAC scores, patients in the heat and steam generating sheet group especially demonstrated a highly significant decrease in WOMAC stiffness score. In comparison, patients in the heat generating sheet group showed no improvement in WOMAC stiffness score. Gait ability improvement, as measured by JOA score, showed similar results for both groups. Conclusion : This study showed that using heat and steam generating sheets decreased pain and stiffness, and increased gait ability in patients with osteoarthritis of the knee.
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AIM: To investigate the efficacy and safety of liduofen in the treatment of patients with osteoarthritis of the knee joint. METHODS: A randomized, double-blind, parallel-controlled, multi-centre study was adapted to compare the efficacy and safety between liduofen and Olfen-75 in 136 patients. Patients were randomly assigned into two groups: liduofen group which was received 75 mg (diclofenac) Liduofen injection (n=69) once a day for seven days and Olfen group which was received 75 mg (diclofenac) Olfen-75 injection (n=67) once a day for seven days. RESULTS: After the treatment, similar improvements for rest pain, pain on exercise, swelling of joint, pressing pain of joint, knee joint bend extend function measured using a 10 cm visual analogue scale was performed in two groups. In Olfen-75 group, the rate of efficacy was 62.69% in the 3rd day, 95.76% in the 5th day and 97.88% in the 7th day. While in liduofen group, the rate of efficacy was 57.97% in the 3rd day, 93.87% in the 5th day and 96.94% in the 7th day. In liduofen and Olfen-75 groups, the progressive rates were 56.72% and 55.07%, respectively. The total improvement rates were 89.85% and 92.54% respectively (P＞0.05), and the rates of side effects were 0% and 1.49%, respectively (P＞0.05). CONCLUSION: Liduofen is an effective and safty drug inthe treatment of patients with osteoarthritis of the knee joint. There is no significant difference on efficacy and safety between the two groups using liduofen and Olfen-75.
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[Objective] We analyzed the clinical findings in 5 patients with osteonecrosis in the medial condyle of the tibia. We also evaluated the usefulness of a tibial percussion test that we developed for examination of differences between the healthy and affected sides in percussion caused by knocking on the tibial rough surface.<BR>[Methods] The subjects were 5 females, who consulted our hospital with a chief complaint of gonalgia and in whom conditions such as osteonecrosis in the medial condyle of the tibia were confirmed by MRI in 4 limbs. In addition to X-p, MRI findings, medical findings by interview, and findings by physical examination were evaluated as clinical findings. Furthermore, the tibial percussion test was performed.<BR>[Results] The causes of pain in the knee joint were unclear in all patients. Pain was severe in 3 patients and marked in 2 patients. Physical examination showed marked tenderness in the medial articular gap and tenderness in the medial condyle of the tibia. In all patients, a difference in the percussion findings between the healthy and affected sides was confirmed by the tibial percussion test.<BR>[Conclusions] These findings indicated that the tibia percussion test in addition to confirmation of characteristic clinical conditions, such as the initial condition of the disease and the severity of tenderness, is useful for the evaluation of conditions of this disease.
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Purpose : We examined the effect of therapeutic exercise on osteoarthritis (OA) of the knee. Objects and Method : We evaluated seven women with bilateral OA of the knees of over Grade I on the Kellgren and Lawrence scale. The patients were instructed in therapeutic exercise for both knees. The exercise was to tie a Thera-Band <SUP>®</SUP> around the leg just above both ankles in the 8 figure, and then, in a sitting position, extend one leg while simultaneously retracting the other, repeating alternatively every 5 seconds. One set consisted of repeating this motion 10 times, and 2 sets were performed per day. Before exercise, 1 month, and 3 months after exercise, we evaluated the effect of this therapy by the JOA score, isokinetic muscle strength of knee extensors and flexors, and surface EMG signals recorded from rectos femoris (RF), vastus medialis (VM), vastus lateralis (VL), and biceps lemons (BF) . The integrated signal, the root mean square (RMS), and the mean power frequency (MPF) parameters were extracted.<BR>Result : The parameters of the JOA score, muscle strength of knee flexors, integrated EMG from RF, VM, VL, and RMS from VM, VL were significantly increased at 3 months after exercise. MPF from VM at 3 months after exercise decreased significantly.<BR>Conclusion : We thought a proper balance of knee extensors and flexors are related to the improvement of symptoms of OA of the knee. The decrease of MPF might suggest the possibility of muscle fiber type change. It is also possible that pain reduction results from the improvement of balance between knee extensors and flexors as well as from the increase of knee joint stability. Therapeutic exercise with the Thera-Band R is extremely easy and is effective in promoting con-tinuous exercise.
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The tender points treatment has been widely used for both treatment and diagnosis, but there have been very few studies that have examined its diagnostic usefulness. Thus, the purpose of this study was to clarify the diagnostic importance of tender points. The subject was a patient who had osteoarthritis of the knee of Meiji University of Oriental Medicine Hospital. The relationship between pressure pain thresholds (PPTs) and symptoms in osteoarthritis of the knee (painful knee motion) were evaluated with the Japanese Orthopaedic Association scale (JOA scale), a knee scale and the subject's knee pain diary (starting pain, flexion pain, walking pain and total pain Wong-Baker faces pain rating scale). After 40 acupuncture treatments, improvement was noted in the symptoms and PPTs. The changes in PPTs were related to the symptoms of the knee (flexion and walking pain). This suggests that changes in PPTs (around the knee) are a useful indicator for evaluating knee pain.
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0.05 ). CONCLUSION: Liduofen is an effective and safty drug inthe treatment of patients with osteoarthritis of the knee joint. There is no significant difference on efficacy and safety between the two groups using liduofen and Olfen 75.
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According to the Ryodoraku autonomic nervous system therapy the average of the measurement values on Ryodo points (acupuncture point) which belong to the Ryodoraku (meridian) can be obtained from the measurement value on the representative point of the Ryodoraku.<br>They are judged relative excitement which corresponds to “excitement and suppression” (fullness and emptiness) in proportion as to the relative position on Ryodoraku chart.<br>We got the result that the knee joint pain relates to the excitement of H<sub>2</sub>, the suppression of F<sub>1</sub>, and the suppression of F<sub>4</sub>.