Cross-cultural adaptation and validation of the Filipino translation of the knee injury and osteoarthritis outcome score in Filipinos with knee osteoarthritis at a tertiary hospital

Objectives@#1) To translate and cross-culturally adapt the Knee Injury and Osteoarthritis Outcome Score (KOOS) into Filipino; 2) To validate the Filipino translation of KOOS using the Filipino Short-Form 36 Health Survey (SF-36) among patients with knee osteoarthritis (kOA) at a tertiary hospital. @*Methodology@#A Filipino version of the KOOS was translated and cross-culturally adapted from the original English version and validated following standard guidelines. Adult Fiipino patients with knee osteoarthritis at the University of the Phiippines-Philippine General Hospital were asked to complete identical questionnaires containing the Filipino KOOS and Filipino SF-36, with re-test on the same patients after a median of 14 days. Reliability was assessed using Cronbach’s alpha and intraclass correlation coefficients (ICC); dimensionality using convergent and divergent construct validity. @*Results@#The Filipino translation of the KOOS was administered to 30 patients with knee OA (kOA). Cronbach's α across the Filipino KOOS domains ranged from 0.71 to 0.89 suggesting good internal consistency. The reproducibility of measurements of all KOOS subscales by ICC ranged from 0.97 to 1.0. For convergent construct validity, there was moderate correlation between KOOS ADL (0.38, p =0.03) and knee-related QoL (0.42, p=0.02) by SF-36 Physical Functioning (PF). A strong correlation (0.51, p=0.003) was observed between KOOS sports and recreation domain with SF-36 PF. For divergent construct validity, there was weak correlation between KOOS pain (0.015, p=0.93) and symptoms (0.15, p=0.42) with SF 36 Social Functioning. @*Conclusion@#The Filipino version of the KOOS is a valid and reliable instrument to measure the different aspects of disability affecting quality of life of Filipino patients with kOA.

Effect of acupuncture on knee injury and osteoarthritis outcome score in patients with knee osteoarthritis / 中国针灸

OBJECTIVE@#To verify the clinical effect of acupuncture on knee osteoarthritis (KOA).@*METHODS@#Forty-two patients with KOA were randomly divided into an acupuncture group (21 cases, 1 case dropped off) and a sham acupuncture group (21 cases, 1 case dropped off). The patients in the acupuncture group were treated with routine acupuncture at 5-6 local acupoints [Dubi (ST 35), Neixiyan (EX-LE 4), Heding (EX-LE 2), Yinlingquan (SP 9), Xuehai (SP 10), Zusanli (ST 36), etc.] and 3-4 distal acupoints [Fengshi (GB 31), Waiqiu (GB 36), Xuanzhong (GB 39), Zulinqi (GB 41), etc.]. The patients in the sham acupuncture group were treated with shallow needling technique at non-acupoint. The needles were retained for 30 min in both groups. All the treatment was given three times a week for 8 weeks. Knee injury and osteoarthritis outcome score (KOOS) were recorded before and after treatment and 18-week follow-up.@*RESULTS@#Compared before treatment, the scores of 5 dimensions of KOOS [pain, symptoms (except pain), daily activities, sports and entertainment, and quality of life] were increased after treatment and during follow-up in the two groups (@*CONCLUSION@#Acupuncture can reduce the pain symptoms and improve daily activities in patients with KOA.

Comparative effectiveness of S-adenosylmethionine and etoricoxib in newly diagnosed patients of knee osteoarthritis

Background: Knee osteoarthritis is an important cause for morbidity in elderly people. Therapy is largely symptomatic with nonsteroidal anti-inflammatory drugs which pose risk in the elderly. Methionine is natural body constituent with novel property of blunting S-adenosylmethionine (SAMe) inflammatory process and cartilage degradation. The aim of this study was to compare effectiveness of SAMe, with standard etoricoxib therapy in newly diagnosed knee osteoarthritis cases.Methods: 127 newly diagnosed knee osteoarthritis patients were randomized into two groups. 55 participants received treatment of etoricoxib 600 mg extended release once daily for 90 days (group 1) and 72 received etoricoxib 600 mg extended release once daily and SAMe 400 mg twice daily for initial 15 days followed by SAMe once daily 400 mg as maintenance dose for next 75 days (group 2). The outcomes were measured by knee injury and osteoarthritis outcome score (KOOS). Pre and post treatment KOOS scores of all cases were separately pooled to define the median for whole as well as components of KOOS parameters. Relative frequencies of cases with values around respective medians were compared by MOODS median test. Patient characteristics, disease characteristics were also examined for bearing on outcomes besides the treatment.Results: SAMe treatment was associated with significantly greater improvement in symptoms, activities of daily life, spontaneous recreational activities and the quality of life compared to etoricoxib therapy. The therapy was well-tolerated.Conclusions: The study confirms SAMe as superior therapeutic option in osteoarthritis. SAMe indeed has been reported to have specific anti-arthritic effects and promotive to general well-being.

Preoperative physiotherapy and short-term functional outcomes of primary total knee arthroplasty

<p><b>INTRODUCTION</b>Physiotherapy is an important part of rehabilitation following arthroplasty, but the impact of preoperative physiotherapy on functional outcomes is still being studied. This randomised controlled trial evaluated the effect of preoperative physiotherapy on the short-term functional outcomes of primary total knee arthroplasty (TKA).</p><p><b>METHODS</b>50 patients with primary knee osteoarthritis who underwent unilateral primary TKA were randomised into two groups: the physiotherapy group (n = 24), whose patients performed physical exercises for six weeks immediately prior to surgery, and the nonphysiotherapy group (n = 26). All patients went through a similar physiotherapy regime in the postoperative rehabilitation period. Functional outcome assessment using the algofunctional Knee Injury and Osteoarthritis Outcome Score (KOOS) scale and range of motion (ROM) evaluation was performed preoperatively, and postoperatively at six weeks and three months.</p><p><b>RESULTS</b>Both groups showed a significant difference in all algofunctional KOOS subscales (p < 0.001). The mean score difference at six weeks and three months was not significant in the sports and recreational activities subscale for both groups (p > 0.05). Significant differences were observed in the time-versus-treatment analysis between groups for the symptoms (p = 0.003) and activities of daily living (p = 0.025) subscales. No significant difference in ROM was found when comparing preoperative measurements and those at three months following surgery, as well as in time-versus-treatment analysis (p = 0.928).</p><p><b>CONCLUSION</b>Six-week preoperative physiotherapy showed no significant impact on short-term functional outcomes (KOOS subscales) and ROM of the knee following primary TKA.</p>