Influence of yoga on pain, lower extremity kinetics, kinematics and function in patients with knee osteoarthritis

Background: Knee osteoarthritis (OA), is one of the leading cause of disability that causes significant reduction in function and strength with an increase in pain. The present study evaluates effects of Yoga with Physiotherapy exercises on pain, kinetics, kinematics and function in patients with knee osteoarthritis. Methods: A randomized controlled trial was conducted for evaluating the effect of Yoga on pain, lower limb kinetics, kinematics and function in patients with knee osteoarthritis over a period of 6 weeks. A total of 50 participants volunteered for the study. The participants were randomly allocated into Control group (n=25) and Intervention group (n=25). The participants of control group performed conventional exercises. The participants of intervention group performed conventional exercises along with Yoga. Results: Findings from present study reported significant improvement in muscle flexibility of Rectus Femoris (p<0.05) and Tensor Fascia Lata (p<0.05) in the interventional group as compared to the control group. There was a significant improvement in knee flexion range of motion(p<0.05) in the interventional group compared to the control group. Lower extremity muscle strength evaluation demonstrated a significant improvement(p<0.05) in muscle strength of hip and knee musculature in the interventional group as compared to the control group. There was a significant reduction in pain scores(p<0.05) for stair climbing in the interventional group as compared to the control group. There was no significant improvement in function pre and post intervention. Conclusions: Findings from present study report yoga practice improves knee flexion range of muscle, muscle strength and flexibility in patients with knee osteoarthritis.

Effects of Magnesium in Physiotherapy Treatment for Patients with Knee Osteoarthritis

Background: Osteoarthritis (OA) is a complex joint degenerative disorder. Pain is a dominant characteristic, becoming persistent and more limiting as the disease progresses, resulting in reduced physical function, quality-of-life. Magnesium deficiency is considered to be a major risk factor for osteoarthritis development and progression. Oral magnesium presents unique challenges for many individuals to effectively restore intracellular magnesium levels. Transdermal magnesium absorption could be more effective than oral absorption due to its greater absorption rate and presents fewer negative effects due to its gastrointestinal tract-bypassing nature. Method: Total 40 subjects with knee osteoarthritis were selected as per the inclusion and exclusion criteria and randomly assigned to either Group A (intervention) or Group B (conventional), each having 20 patients. Assessment of the outcome measures was done pre and post 8 sessions. Outcome measures used were Visual Analogue Scale (VAS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), Timed up and go test (TUG), 9 Step stair climb test, Knee ROM, Quadriceps strength using pressure biofeedback. Group A was given conventional therapy along with Epsom salt foot soak and Magnesium oil application. Group B was given conventional therapy alone. Result: There was statistically significant improvement seen in all the outcome measures in intragroup analysis with p<0.05. Intergroup analysis showed statistically significant difference in VAS on activity, WOMAC, Knee ROM, Quadriceps strength with p <0.05 indicating Group A performed better than Group B.Conclusion: The study found that Magnesium when used as an adjunct to conventional therapy shows significant difference in pain levels, knee mobility, quadriceps strength and better functionality in activities of daily living.

Empleo empírico de cannabis para control del dolor crónico de origen musculoesquelético / Empirical use of cannabis to control chronic pain of musculoskeletal origin

Resumen: Introducción: La creciente aceptación de los cannabinoides con fines terapéuticos se ha vinculado a cambios en la legislación, alta prevalencia y control ineficaz de dolor crónico con analgésicos convencionales. Objetivo: Determinar la prevalencia del dolor crónico, la modalidad de tratamiento analgésico con terapias herbales (cannabis) en adultos del sureste de México. Material y métodos: Se efectuó un estudio transversal y etnográfico en 267 personas con dolor crónico y empleo regular de la herbolaria con fines analgésicos. Se efectuaron pruebas de hipótesis para evaluar diferencias entre valores promedio, edad e intensidad del dolor, comparándose el empleo de cannabis con el tipo de dolor, género, diagnósticos algológicos y comorbilidades. Resultados: Se observó asociación entre dolor crónico con: diabetes, hipertensión, neoplasias en mujeres, adultos mayores. El 46% de los participantes padecía osteoartritis y 20.9% presentaba otros diagnósticos. Las modalidades preferidas para la administración tópica de cannabis fueron tinturas en mezcal o en alcohol y, en menor proporción, macerados en aceites e inhalación. Conclusiones: Los hallazgos no permiten considerar a la cannabis como monoterapia para pacientes con dolor crónico. Sin embargo, ofrecen un campo promisorio en la búsqueda de alternativas analgésicas que eviten el consumo crónico de opiáceos o antiinflamatorios no esteroideos (AINE).

Abstract: Introduction: The increasing acceptance of cannabinoids for therapeutic purposes has been linked to changes in legislation, high prevalence and ineffective control of chronic pain with conventional analgesics. Objective: Determine the prevalence of chronic pain, the analgesic treatment modality with herbal therapies (cannabis) in adults in southeastern Mexico. Material and methods: A cross-sectional and ethnographic study was carried out on 267 people with chronic pain and regular use of herbal medicine for analgesic purposes. Hypothesis tests were carried out to evaluate differences between average values, age and pain intensity, comparing the use of cannabis with the type of pain, gender, algological diagnoses and comorbidities. Results: An association was observed between chronic pain: diabetes, hypertension, neoplasms in women, in older adults. 46% of the participants suffered from osteoarthritis and 20.9% had other diagnoses. The preferred modality for the topical administration of cannabis was tinctures in Mezcal or alcohol and to a lesser extent macerated in oils and inhalation. Conclusions: The findings do not allow cannabis to be considered as monotherapy for chronic pain in patients with chronic pain. However, they offer a promising field in the search for analgesic alternatives that avoid the chronic consumption of opiates or non-steroidal anti-inflammatory drugs (NSAIDs).

Updates in the Treatment of Knee Osteoarthritis / Atualizações no tratamento da osteoartrite de joelho

Abstract Knee osteoarthritis (OA) is an inflammatory and degenerative condition resulting in articular cartilage destruction and functional loss. Its prevalence has grown considerably due to increased life expectancy and obesity, and its diagnosis relies on evaluation, medical examination, and confirmation by supplementary radiographic images. Knee OA is multifactorial and influenced by several local, systemic, and external aspects. In addition, its progress and therapeutic responses highly depend on the characteristics of each subject. The initial recommendation is drug treatment and alternative therapies to improve quality of life. However, if these treatments are unsuccessful, one must consider surgical treatment. Surgical options include arthroscopies, osteotomies, and partial and total arthroplasties, while non-surgical treatments include medications and alternative therapies such as infiltrations, acupuncture, and physical exercise. It is worth highlighting that biomarkers can be a significant strategy for early disease detection, assessment of disease activity, prediction of prognosis, and monitoring a better response to therapy. Nevertheless, this topic must be the focus of further research to confirm its findings.

Resumo A osteoartrite (OA) do joelho é uma doença inflamatória e degenerativa que ocasiona a destruição da cartilagem articular e leva à perda de funções. Sua prevalência vem crescendo consideravelmente devido ao aumento da expectativa de vida e da obesidade, e o diagnóstico pode ser feito por meio de avaliação e exames médicos, e é confirmado em imagens radiográficas complementares. Uma condição multifatorial, a OA do joelho pode ser influenciada por diversos aspectos locais, sistêmicos e externos; além disso, a sua evolução e as respostas aos tratamentos dependem muito das características de cada indivíduo. Inicialmente, recomenda-se proceder a um tratamento medicamentoso e a terapias alternativas que melhorem a qualidade de vida do paciente; mas, a partir do momento em que se verifica que tais terapias não estão proporcionando resultados satisfatórios, um tratamento cirúrgico deve ser considerado. Entre os tratamentos cirúrgicos, as artroscopias, as osteotomias e as artroplastias parciais e totais são destacadas; os métodos não cirúrgicos incluem o uso de medicamentos e de terapias alternativas, como infiltrações, acupuntura e prática de exercícios físicos. Vale ressaltar ainda que a utilização de biomarcadores pode ser uma importante estratégia para detectar precocemente a doença, avaliar sua atividade, prever um prognóstico e monitorar uma melhor resposta à terapia; porém, esse tema ainda deve ser foco de mais estudos para que os seus resultados sejam comprovados.

Correlation between clinical, radiological and arthroscopic findings in cases of osteoarthritis of knee joint

Background: Osteoarthritis (OA) is the most common degenerative joint disorder and a major public health problem throughout the world. The knees are the most commonly affected joints. In view of multiple conflicting reports in the literature the present study was undertaken to study the correlation amongst radiological, arthroscopic and pain findings in knee OA patients to facilitate early and precise diagnosis leading to appropriate and timely treatment. Methods: Total 53 (39 female and 14 male) cases of primary OA were screened and selected for our study. Apley’s pain score equated to Visual Analogue Score and Western Ontario and MacMaster Universities Osteoarthritis score (WOMAC) sub scales were used for assessment of pain, stiffness and physical function respectively. Radiographic evaluation were done according to Kellgren-Lawrence Grading scale (X-ray) and modification of Outerbridge classification system (MRI). Outerbridge classification system was used to assess arthroscopic findings. Results: Clinical symptom of pain had statistically significant correlation with stiffness, physical disability, radiological severity and arthroscopic findings. Stiffness and physical disability scores individually doesn’t have any statistically significant correlation with MRI and arthroscopic severity. Radiological findings were found to corroborate with the arthroscopic findings significantly. Conclusions: Radiological and clinical findings in combination should be considered in concluding the final diagnosis and treatment of OA knee. Improvised criteria for precise diagnosis yet to be evolved.

Comparison of temporal-spatial gait parameter in patients with osteoarthritis knee: an observational cross-sectional study

Background: Osteoarthritis knee (OA) symptoms, including pain, joint stiffness, reduced joint movement, and muscle strength, can affect gait kinetics, kinematics, and temporal-spatial characteristics. Spatial-temporal gait parameters are useful for assessing and identifying clinically significant changes in an individual's gait patterns and helps in rehabilitation. Methods: In this study 108 patients diagnosed with osteoarthritis knee according to EULAR classification knee OA were included in study. Age, gender and BMI were recorded for pain and function WOMAC Score was used, gait analysis was done to evaluate difference in temporo-spatial gait parameters between OA knee patients with KL grade 2 and 3. Results: A total of 108 patients with osteoarthritis knee were enrolled, including 40 men and 68 women. Total mean age was 55.92±9.05 years with P-value <0.05, and their average BMI was 27.24 kg/m2. Total WOMAC score mean 29.3±1.03. Mean WOMAC scores for pain 4.57±3.26, stiffness 2.60±0.12, function score 22.20±7.55 respectively. There was no significance difference between KL grade II and III including gender in temporal spatial gait parameters. Conclusions: This study suggests there is no significant difference in temporal-spatial gait parameters between Kl grade 2 and 3. Potential confounders including age, gender, BMI disease severity did not alter magnitude, although 95% CI.

Benefits of core strengthening exercise in osteoarthritis knee patients: a narrative review

Osteoarthritis is a degenerative joint disease results from breakdown of cartilage that covers the ends of bones in joint. Breakdown causes bones to rub each other leading to pain, stiffness, swelling, loss of function in joint and can be accompanied by synovitis with or without joint fluid effusion. Muscle atrophy may develop if patient was inactive and did not perform exercises, which will affect functionality and stability of joint including activities of daily life. The aim of the study was to evaluate current literature and provide comprehensive overview of benefits of core muscle strengthening exercise in managing OA. The objective of this study was to discuss effectiveness of core muscle strengthening exercise in reducing pain, improving physical function, and enhancing quality of life in individuals with osteoarthritis knee. A systematic search was conducted to identify all relevant studies related to core muscle strengthening, database such as Pubmed, Cochrane library, Scopus had been used. Studies demonstrating clinical importance of core strengthening in treatment of osteoarthritis knee are limited. By performing randomized controlled trials with a big sample size, new researchers should produce more unique findings.

EROSIVE OSTEOARTHRITIS: A RARE CASE REPORT

Osteoarthritis, also known as OA, is a type of joint degeneration characterized by changes in the morphology and biochemistry of the synovial membrane and joint capsule, as well as degradation of cartilage joint and expansion of the marginal bone. Inflammation causes the joints to deteriorate in a subtype of osteoarthritis called erosive OA. DIP (distal interphalangeal), PIP (proximal interphalangeal), CMC (carpometacarpal) and metacarpophalangeal (MCP) joints are the most often affected joints in the hand. Other joints in other body regions are extremely seldom affected. Our patient’s diagnosis report suggests erosive osteoarthritis and seronegative arthritis as negative anti-RF factors.

EFFECTS OF PLATELET-RICH PLASMA INJECTIONS ON OSTEOARTHRITIC PATIENTS

Objective: Various treatment options are available for knee osteoarthritis such as medical treatment with NSAID, conservative management with platelet-rich plasma (PRP) and corticosteroids. We have done this prospective study to know the use and safety of platelet- rich plasma (PRP) injections in knee osteoarthritis (KOA) patients. We know platelet rich plasma (PRP) clinical and functional outcome in knee osteoarthritis (KOA) by doing this study and using the available literature.Methods: This prospective study consisted of a total number of 96 patients suffering from knee osteoarthritis. Both males and females are included. Intra-articular injection of platelet rich plasma (PRP) was given in sterile conditions and clinical and functional outcomes were analyzed with Western Ontario and McMaster University Arthritis Index (WOMAC), Visual Analogic Scale (VAS), and Knee Society score (KSS). This study is done in a tertiary care institute during the study period. Results: Most patients were females aged>40 years with knee osteoarthritis. The injections of platelet rich plasma (PRP) showed results at three, six and twelve months follow-up showed significantly reduced WOMAC scores, Visual Analogic Scale (VAS) and Knee Society score (KSS). No complications were observed during the follow-up period.Conclusion: The results confirm the efficacy of the PRP injections on Knee osteoarthritis, suggesting that decreasing pain was obtained one month after injection, with the best results observed after 12 months—however, a more extensive study group. Follow-up is required for a prolonged period to assess the efficacy of PRP injection.

Radical surgical approach to chronic suppurative osteomyelitis: Case report / Abordaje quirúrgico radical de una osteomielitis crónica supurativa: reporte de caso

Abstract Diabetes mellitus is a systemic condition potentially related to an increased risk of progression of various infections such as chronic osteomyelitis by accelerating the inflammatory process with bone tissue necrosis and suppuration. Therefore, if there is no proper management of these infections, they can be life-threatening as they spread to deeper spaces in the head and neck. We describe the case of a 52-year-old male patient with a history of diabetes mellitus and grade III osteoarthritis who was diagnosed with chronic suppurative osteomyelitis of the mandible. He underwent a multidisciplinary surgical intervention in which he underwent a hemimandibulectomy with immediate mandibular reconstruction. The present case highlights the importance of early and radical treatment of patients with chronic suppurative osteomyelitis of the mandible and systemic comorbidities. In addition, this case presents a review of diabetes mellitus and the risk of developing odontogenic infections and complications when invading deeper spaces in the head and neck. Therefore, in this population, careful planning is required for early surgical and pharmacological treatment.

Resumen La diabetes mellitus es una condición sistémica potencialmente relacionada con un mayor riesgo de progresión de diversas infecciones como la osteomielitis crónica al acelerar el proceso inflamatorio con necrosis del tejido óseo y supuración. Por lo tanto, si no hay un manejo adecuado de estas infecciones pueden ser potencialmente mortales al llegar a propagarse a espacios más profundos de la cabeza y cuello. Describimos el caso de un paciente varón de 52 años con antecedentes de diabetes mellitus y osteoartrosis grado III a quien se le diagnosticó de osteomielitis crónica supurativa mandibular. Se le realizó una intervención quirúrgica multidisciplinaria en la cual se le realizó una hemimandibulectomía con reconstrucción mandibular inmediata. El presente caso destaca la importancia del tratamiento temprano y radical de los pacientes con osteomielitis mandibular crónica supurativa y comorbilidades sistémicas. Además, en este caso se presenta una revisión sobre la diabetes mellitus y el riesgo de desarrollar infecciones odontogénicas y complicaciones al invadir espacios más profundos de la cabeza y cuello. Por lo tanto, en esta población se requiere de una planificación cuidadosa para realizar un tratamiento quirúrgico y farmacológico temprano.

Ejercicio terapéutico en la disminución del dolor en pacientes con artrosis de rodilla grado 1: revisión sistemática / Therapeutic exercise to reduce pain in patients with grade 1 knee arthrosis: systematic review / Exercício terapêutico para reduzir a dor em pacientes com artrose grau 1 do joelho: revisão sistemática

La artrosis de rodilla grado 1 es un problema frecuente a escala mundial. La fisioterapia se presenta como una alternativa prometedora para el tratamiento conservador de esta patología, ya que reduce eficazmente la artralgia. Objetivo. Describir la eficacia de los ejercicios terapéuticos para aliviar el dolor en la artrosis de rodilla grado I. Metodología. Se trata de una revisión sistemática, que abarcó una búsqueda exhaustiva en varias bases de datos como Pubmed, Scielo y Elsevier. Los criterios de búsqueda incluyeron ensayos de control aleatorios, experimentales y cuasiexperimentales realizados entre los años 2017 y 2023. Resultados. De un total de 82 documentos se excluyeron 40 al ser estudios secundarios. Posteriormente, se excluyeron 21 estudios adicionales debido a la escasa relación entre las variables del estudio y a su falta de disponibilidad. Finalmente, se seleccionaron 21 artículos que cumplieron con los criterios de evaluación de calidad metodológica mediante la escala CRF-QS. Para evaluar el dolor, la rigidez, la funcionalidad y la calidad de vida, se utilizaron escalas como EVA, NPRS, WOMAC y OXFORD. Los ejercicios isocinéticos resultaron ser los más efectivos, ya que demostraron un aumento de la fuerza y el grosor del cartílago articular, lo que resultó en una disminución de las puntuaciones de EVA de 8,05 a 3,75. Conclusión. El ejercicio terapéutico supervisado centrado en el fortalecimiento de las extremidades inferiores ha demostrado ser una alternativa efectiva para el tratamiento conservador de la artrosis de rodilla grado I. Este enfoque alivia eficazmente el dolor, mejora la calidad de vida e incluso puede detener la progresión de la enfermedad.

Grade 1 knee osteoarthritis is a common problem worldwide. Physiotherapy is presented as a promising alternative for the conservative treatment of this pathology, since it effectively reduces arthralgia. Aim. To describe the effectiveness of therapeutic exercises to relieve pain in grade I knee osteoarthritis. Methodology. This is a systematic review, which included an exhaustive search in several databases such as Pubmed, Scielo and Elsevier. Search criteria included randomized, experimental and quasi-experimental control trials conducted between the years 2017 and 2023. Results. Of a total of 82 documents, 40 were excluded as they were secondary studies. Subsequently, 21 additional studies were excluded due to poor relationships between study variables and lack of availability. Finally, 21 articles were selected that met the methodological quality evaluation criteria using the CRF-QS scale. To evaluate pain, stiffness, functionality and quality of life, scales such as VAS, NPRS, WOMAC and OXFORD were used. Isokinetic exercises were found to be the most effective, demonstrating an increase in articular cartilage strength and thickness, resulting in a decrease in VAS scores from 8.05 to 3.75. Conclusion. Supervised therapeutic exercise focused on strengthening the lower extremities has been shown to be an effective alternative to the conservative treatment of grade I knee osteoarthritis. This approach effectively relieves pain, improves quality of life, and may even stop the progression of osteoarthritis. disease.

A osteoartrite do joelho grau 1 é um problema comum em todo o mundo. A fisioterapia apresenta-se como uma alternativa promissora para o tratamento conservador desta patologia, uma vez que reduz eficazmente a artralgia. Mirar. Descrever a eficácia dos exercícios terapêuticos no alívio da dor na osteoartrite de joelho grau I. Metodologia. Trata-se de uma revisão sistemática, que incluiu uma busca exaustiva em diversas bases de dados como Pubmed, Scielo e Elsevier. Os critérios de pesquisa incluíram ensaios de controle randomizados, experimentais e quase-experimentais realizados entre os anos de 2017 e 2023. Resultados. De um total de 82 documentos, 40 foram excluídos por se tratarem de estudos secundários. Posteriormente, 21 estudos adicionais foram excluídos devido às más relações entre as variáveis do estudo e à falta de disponibilidade. Por fim, foram selecionados 21 artigos que atenderam aos critérios de avaliação da qualidade metodológica pela escala CRF-QS. Para avaliar dor, rigidez, funcionalidade e qualidade de vida foram utilizadas escalas como VAS, NPRS, WOMAC e OXFORD. Os exercícios isocinéticos foram considerados os mais eficazes, demonstrando um aumento na força e espessura da cartilagem articular, resultando em uma diminuição nos escores VAS de 8,05 para 3,75. Conclusão. O exercício terapêutico supervisionado focado no fortalecimento das extremidades inferiores tem se mostrado uma alternativa eficaz ao tratamento conservador da osteoartrite do joelho grau I. Esta abordagem alivia eficazmente a dor, melhora a qualidade de vida e pode até interromper a progressão da osteoartrite.

An Assessment of Ankle Function, Oxidative Damage, and Inflammatory Factor Levels in Minimally Invasive Ankle Joint Fusion Surgery for the Treatment of Traumatic Ankle Osteoarthritis

SUMMARY: Traumatic ankle osteoarthritis is a degenerative condition resulting from traumatic injuries. The objective of this study was to evaluate the impact of minimally invasive ankle joint fusion surgery on ankle function, oxidative damage, and inflammatory factor levels in traumatic ankle osteoarthritis patients. A total of 112 traumatic ankle osteoarthritis patients treated in our hospital from January 2022 to January 2023 were enrolled. They were randomly rolled into a control group (Group C) and an experimental group (Group E), with the former undergoing conventional open ankle joint fusion surgery and the latter receiving minimally invasive ankle joint fusion surgery. A comparison was made between the two groups based on American Orthopedic Foot and Ankle Society (AOFAS), bony fusion rates, and visual analog scale (VAS) scores at pre-operation, and at 1, 2, and 3 months post-operation. Additionally, serum oxidative damage indicators and inflammatory factor levels were measured to evaluate the recovery effects in both groups. Relative to Group C, Group E showed drastically increased AOFAS scores and bony fusion rates (P<0.05), as well as greatly decreased VAS scores (P<0.05). Moreover, Group E exhibited more pronounced improvements in oxidative damage indicators and inflammatory factors versus Group C (P<0.05). Minimally invasive ankle joint fusion surgery drastically improves ankle function in traumatic ankle osteoarthritis patients and reduces levels of oxidative damage and inflammatory response. This provides an important clinical treatment option.

La osteoartritis traumática del tobillo es una afección degenerativa resultante de lesiones traumáticas. El objetivo de este estudio fue evaluar el impacto de la cirugía mínimamente invasiva de fusión de la articulación talocrural sobre la función del tobillo, el daño oxidativo y los niveles de factor inflamatorio en pacientes con osteoartritis traumática del tobillo. Se inscribieron un total de 112 pacientes con artrosis traumática de tobillo tratados en nuestro hospital desde enero de 2022 hasta enero de 2023. Fueron divididos aleatoriamente en un grupo de control (Grupo C) y un grupo experimental (Grupo E), donde el primero se sometió a una cirugía de fusión de la articulación talocrural abierta convencional y el segundo recibió una cirugía de fusión de la articulación talocrural mínimamente invasiva. Se realizó una comparación entre los dos grupos según la Sociedad Estadounidense de Ortopedia de Pie y Tobillo (AOFAS), las tasas de fusión ósea y las puntuaciones de la escala visual analógica (EVA) antes de la operación y 1, 2 y 3 meses después de la operación. Además, se midieron los indicadores de daño oxidativo sérico y los niveles de factor inflamatorio para evaluar los efectos de la recuperación en ambos grupos. En relación con el grupo C, el grupo E mostró puntuaciones AOFAS y tasas de fusión ósea drásticamente aumentadas (P <0,05), así como puntuaciones VAS muy disminuidas (P <0,05). Además, el grupo E exhibió mejoras más pronunciadas en los indicadores de daño oxidativo y factores inflamatorios en comparación con el grupo C (P <0,05). La cirugía de fusión de la articulación talocrural mínimamente invasiva mejora drásticamente la función del tobillo en pacientes con osteoartritis traumática del tobillo y reduce los niveles de daño oxidativo y la respuesta inflamatoria. Esto proporciona una importante opción de tratamiento clínico.

The effectiveness of exercises in patients with thumb carpometacarpal osteoarthritis: a study protocol for a systematic review and meta-analysis

Background: The thumb carpometacarpal osteoarthritis (CMC-OA) is a common musculoskeletal condition of the hand causing increased pain and significant disability. Although different modes of exercises are usually prescribed during the management of the condition, the evidence for their effectiveness is sparse. The aim of this protocol is to investigate through a systematic review the effectiveness of exercises compared with other non-surgical interventions in reducing pain and improving function in the management of the thumb CMC-OA. Methods: We will conduct this systematic review following the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. PubMed, CINAHL, EMBASE, PEDro, ScienceDirect, Cochrane Library, Grey literature databases and clinical trial registries will be searched. Two reviewers will independently evaluate the retrieved results. Subsequently, data extraction of the eligible trials will be conducted by two independent researchers. We will use the grading of recommendations assessment, development, and evaluation (GRADE) approach to assess the certainty of evidence. Conclusions: This systematic review will provide evidence for the clinical benefits of exercises compared with other conservative interventions in the management of patients with thumb CMC-OA. Trial registration: PROSPERO registration number is CRD42023461505.

Curcumin Liposomal Formulations as Potential Therapeutics for Canine Osteoarthritis

Osteoarthritis (OA) is a multifaceted joint disorder affecting various structures, including articular cartilage, peri-articular bone, synovial joint lining, and connective tissues. This degenerative condition manifests as joint pain, stiffness, reduced mobility, and functional decline, impacting both dogs and humans globally. Risk factors include breed predispositions, joint diseases, higher body weight, and age. The current clinical approaches aim at symptom management and disease progression delay, with limited curative methods available. Nanoparticle (NPs)-based drug delivery systems, particularly curcumin liposomal formulations, show promise in OA treatment. Liposomes, lipid-based NPs, provide targeted drug distribution, extended-release, and enhanced retention in affected joints. Curcumin, a tetraterpenoid, exhibits anti-inflammatory, and antioxidant properties. Despite its efficacy, poor oral bioavailability led to the development of curcumin NPs to enhance therapeutic impact. Intra-articular administration of curcumin, especially in the form of curcumin monoglucuronide, addresses challenges associated with low hydrophilicity, demonstrating effectiveness in suppressing cartilage degeneration in OA. While non-encapsulated curcumin exhibits efficacy, its limited bioavailability prompts innovative approaches like curcumin NPs. The combination of curcumin with non-steroidal anti-inflammatory drugs or chondroprotective agents enhances anti-inflammatory effects, minimizing adverse reactions. Studies support curcumin’s multifaceted therapeutic potential, promoting chondrogenic differentiation and inhibiting inflammatory mediators. This comprehensive review provides insights into canine OA treatment, emphasizing curcumin liposomal formulations as a promising avenue for informed decision-making in veterinary practice.

Pharmacological Therapy approaches for the treatment of Knee Osteoarthritis

To date, no effective treatment has been able to modify the pathological progression of osteoarthritis (OA).Current therapy can be broadly categorized into pharmacological and non-pharmacological approaches before considering surgical interventions. Non-pharmacological methods address lifestyle modifications, weight reduction and physical therapy, all aiming at alleviating mechanical stress on the affected joint.In this article, we focused on pharmacological treatment options, that primarily target pain reduction by reducing joint inflammation or restoring the altered synovial environment to a normal state.In this literature review , the main focus is on approved conservative therapies and examined emerging conservative strategies. Evaluating their advantages and limitations.

Quality of Life of Patients submitted to Total Knee Arthroplasty / Qualidade de vida de pacientes submetidos à artroplastia total do joelho

Objective: the aim of this study was to evaluate the quality of life between patients who have already undergone the TKA surgery and those who have not. Methodology: 118 patients [60 undergoing TKA (G1) and the remaining 58 awaiting the procedure (G2)] answered questions about QoL using the WOMAC and SF-36 protocols. The comparison was performed using the chi-square test and Student's t-test, with a significance level of 0.05. Results: with regard to clinical aspects, there was a higher level of pain in Group G2, as well as greater frequency in the use of medications, especially for pain relief. In the QoL evaluation, significant difference was observed in all the domains of the generic questionnaire SF-36 and in WOMAC, estando a capacidade functional do G2 reduzida e abaixo do nível observado nos pacientes do G1. Conclusion: patients with advanced knee arthrosis who underwent TKA, compared to those who did not undergo the procedure, had better quality of life in all domains assessed by both the general SF-36 questionnaire and the WOMAC questionnaire.

Objetivo: o objetivo deste estudo foi avaliar a qualidade de vida entre pacientes que já se submeteram à cirurgia de ATJ e aqueles que ainda não passaram pelo procedimento. Metodologia: 118 pacientes [60 submetidos à ATJ (G1) e os 58 restantes aguardando o procedimento (G2)] responderam perguntas sobre QV usando os protocolos WOMAC e SF-36. A comparação foi realizada usando o teste qui-quadrado e o teste t de Student, com um nível de significância de 0,05. Resultados: em relação aos aspectos clínicos, houve um maior nível de dor no Grupo G2, bem como maior frequência no uso de medicamentos, especialmente para alívio da dor. Na avaliação da QV, foi observada diferença significativa em todos os domínios do questionário genérico SF-36 e no WOMAC, estando a capacidade funcional do G2 reduzida e abaixo do nível observado nos pacientes do G1. Conclusão: pacientes com artrose avançada de joelho que se submeteram à ATJ, em comparação com aqueles que não passaram pelo procedimento, apresentaram melhor qualidade de vida em todos os domínios avaliados tanto pelo questionário geral SF-36 quanto pelo questionário WOMAC.

Electro-acupuncture modulated miR-214 expression to prevent chondrocyte apoptosis and reduce pain by targeting BAX and TRPV4 in osteoarthritis rats

Osteoarthritis (OA) is a highly prevalent joint disorder characterized by progressive degeneration of articular cartilage, subchondral bone remodeling, osteophyte formation, synovial inflammation, and meniscal damage. Although the etiology of OA is multifactorial, pro-inflammatory processes appear to play a key role in disease pathogenesis. Previous studies indicate that electroacupuncture (EA) exerts chondroprotective, anti-inflammatory, and analgesic effects in preclinical models of OA, but the mechanisms underlying these potential therapeutic benefits remain incompletely defined. This study aimed to investigate the effects of EA on OA development in a rat model, as well as to explore associated molecular mechanisms modulated by EA treatment. Forty rats were divided into OA, EA, antagomiR-214, and control groups. Following intra-articular injection of monosodium iodoacetate to induce OA, EA and antagomiR-214 groups received daily EA stimulation at acupoints around the knee joint for 21 days. Functional pain behaviors and chondrocyte apoptosis were assessed as outcome measures. The expression of microRNA-214 (miR-214) and its downstream targets involved in apoptosis and nociception, BAX and TRPV4, were examined. Results demonstrated that EA treatment upregulated miR-214 expression in OA knee cartilage. By suppressing pro-apoptotic BAX and pro-nociceptive TRPV4, this EA-induced miR-214 upregulation ameliorated articular pain and prevented chondrocyte apoptosis. These findings suggested that miR-214 plays a key role mediating EA's therapeutic effects in OA pathophysiology, and represents a promising OA treatment target for modulation by acupuncture.

The rs1477196 SNP of the FTO Gene is Associated with Primary Knee Osteoarthritis in a Female Population from Northern Mexico

ABSTRACT Background: Osteoarthritis is a frequent rheumatic disease. Some single-nucleotide polymorphisms of the gene associated with fat mass and obesity are associated with increased body mass index and knee osteoarthritis. Objective: The objective of this study was to analyze the association of single nucleotide polymorphism rs1477196 of the fat mass and obesity gene with primary knee osteoarthritis. Methods: This observational and cross-sectional study included 347 Mexican participants. We performed the genotypification analysis with TaqMan® probe C_2031262_10 for rs1477196 (Thermo Fisher Scientific). Multivariate analysis included covariables such as age, type 2 diabetes, obesity, and postmenopause. Results: Type 2 diabetes, obesity, and postmenopause were associated with primary knee osteoarthritis in female participants. We did not find an association between rs1477196 and obesity. In the codominant and dominant genetic models, rs1477196 was significantly associated with primary knee osteoarthritis only in the female group, including in the model adjusted by other covariables (odds ratio = 2.517; 1.035-6.123; p = 0.042 and odds ratio = 2.387; 1.054-5.407; p = 0.037, respectively). The interaction between rs1477196 and obesity was significantly associated with primary knee osteoarthritis in female participants (p = 0.039 and p = 0.043). Conclusions: Our findings suggest that the rs1477196 variant of the fat and obesity mass gene may be associated with the risk of primary knee osteoarthritis in women.

Traditional Chinese Medicine Regulates Autophagy to Prevent and Treat Osteoarthritis： A Review / 中国实验方剂学杂志

Osteoarthritis （OA） is a common chronic， highly prevalent， painful， and disabling degenerative joint disease. It has imposed a heavy burden on social healthcare and patients' psychology and economy due to its clinical symptoms such as impaired joint mobility and severe joint pain and the immature therapies. Studies have shown that OA is closely associated with articular cartilage dysfunction， synthesis and degradation disorders of chondrocyte extracellular matrix （ECM）， and joint inflammation. Moderate autophagy can restore the function of damaged chondrocytes， regulate chondrocyte apoptosis， and promote the synthesis and metabolism of ECM to alleviate the inflammation of joints and delay the onset and progression of OA. According to the clinical symptoms， OA can be classified into the category of impediment in traditional Chinese medicine. With the theories of holistic conception， treatment based on syndrome differentiation， and individualised diagnosis and treatment， traditional Chinese medicine has demonstrated definite effects in the treatment of OA in thousands of years of practice. Moreover， traditional Chinese medicine causes mild adverse reactions， and the patients have high tolerance and acceptance. This paper briefly explains the roles of autophagy and the related regulatory proteins， such as Unc-51-like autophagy-activated kinase 1 （ULK1）， Beclin-1， and microtubule-associated protein light chain 3 （LC3）， and details the latest research achievements in the prevention and control of OA by traditional Chinese medicines and its related markers via the regulation of autophagy， so as to provide a idea for the in-depth research in this field and the clinical application of traditional Chinese medicine in preventing and treating OA.

Effect of Danggui Niantongtang on Intestinal Flora of Knee Osteoarthritis Mice Based on 16S rDNA Sequencing / 中国实验方剂学杂志

ObjectiveThis study aims to explore the potential mechanism of Danggui Niantongtang in treating knee osteoarthritis （KOA） by regulating the intestinal flora through 16S rDNA analysis. MethodThirty-six C57BL/6J mice were subjected to anterior cruciate ligament transection （ACLT） to establish a KOA model and were randomly divided into the sham surgery group， model group， low-dose Danggui Niantongtang group （0.819 g·kg-1）， medium-dose Danggui Niantongtang group （1.638 g·kg-1）， high-dose Danggui Niantongtang group （3.276 g·kg-1）， and Meloxicam group （0.975 mg·kg-1）， with 6 mice in each group. Except for the treatment groups， the sham surgery group and model group were given normal saline by gavage. After 4 weeks of continuous intervention， feces and intact knee joints of the mice were collected. Hematoxylin-eosin （HE） staining and Safranin O-Fast Green staining were performed to observe the pathological changes in knee joint tissue morphology. The 16S rDNA sequencing was used to analyze changes in the abundance and diversity of intestinal microorganisms before and after treatment， along with corresponding functional predictions. ResultHigh-dose Danggui Niantongtang and Meloxicam significantly relieved pain symptoms in KOA mice， improved the disorder of joint structure， maintained the integrity of knee articular cartilage， increased the expression of type Ⅱ collagen alpha 1 （Col2a1） in articular cartilage， and decreased the expression of matrix metalloproteinase-13 （MMP-13）. The results of 16S rDNA sequencing showed that high-dose Danggui Niantongtang could adjust the abundance and structure of intestinal microbial species. Compared with the sham surgery group， the abundance of Proteobacteria， Actinobacteria， Ruminococcus， and Bacteroides was significantly increased in the model group （P<0.05）， while in the Danggui Niantongtang group， the abundance of these four flora was significantly reduced compared with the model group. Compared with the sham surgery group， the abundance of Verrucomicrobia， Oscillospira， and Akkermansia was significantly decreased in the model group （P<0.05）， while in the Danggui Niantongtang groups， the abundance of these three flora was significantly increased compared with the model group （P<0.05）. Functional pathway prediction of differential genera revealed that species differences among groups mainly involved metabolic pathways with high abundance associated with biosynthesis and precursors， as well as energy production， including amino acid biosynthesis， nucleotide and nucleoside biosynthesis， cofactors， prosthetic groups， electron carriers， and vitamin biosynthesis. ConclusionDanggui Niantongtang can effectively protect articular cartilage and delay the progression of KOA， possibly by regulating the structure of the intestinal flora， promoting probiotics， and inhibiting the growth of harmful pathogenic bacteria.