Background: Determining the association of neutrophil to lymphocyte ratio (NLR) and clinical disease severity in patients with mild and advanced stage knee osteoarthritis (OA).Method: We analyzed clinical scores and routine hematology panels of 111 subjects with symptomatic knee degeneration: mild OA (66) who underwent knee arthroscopy and advanced OA (45) who had total replacement. Results: Compared to the advanced OA group, the mild OA group was younger (54/67), had fewer females (1.75/5.43), and better scores: Euroqol EQ5D Index (0.50/0.25), VAS (visual analog scale) (65/44); International knee documentation committee subjective knee evaluation form—IKDC (31.6/20.24); Knee disability and osteoarthritis outcome score for joint replacement—KOOSJR (15.5/18.3); and better Kellgren–Lawrence stage (1.3/3.8). Patients with advanced disease had higher NLRs compared to mild OA group and controls: 2.82 versus 1.99 (p = 0.004) and 1.98 (p = 0.002). In the multiple regression model, NLR was only influenced by age (p < 0.001). In the subgroup analysis, for the early OA cases, NLR was significantly dependent to VAS (p = 0.006), IKDC (p = 0.001) and KOOSJR (p < 0.001). Conclusion: NLR was not associated with symptomatic knee OA, as determined by commonly used patient reported outcomes. However, for patients with mild degenerative modifications, EQ5D, VAS, and IKDC were independent predictors of NLR.

We aimed to evaluate potential new treatments for knee osteoarthritis (OA). The National Institute of Health ClinicalTrials.gov database was searched for “Osteoarthritis, Knee”. We found 565 ongoing interventional studies with a total planned enrollment of 111,276 subjects. Ongoing studies for knee OA represent a very small fraction of the registered clinical trials, but they are over a quarter of all knee trials and over two thirds of all OA studies. The most researched topic was arthroplasty, with aspects such as implant design changes, cementless fixation, robotic guidance, pain management, and fast track recovery. Intraarticular injections focused on cell therapies with mesenchymal stem cells sourced from adipose tissue, bone marrow, or umbilical cord. We could see the introduction of the first disease modifying drugs with an impact on knee OA, as well as new procedures such as geniculate artery embolization and geniculate nerve ablation.

The purpose of the study is to show the effects and evolution of patients with back pain treated with a different dose of betamethasone, analyzing both their evolution in terms of pain perception and lifestyle. In this study, 43 patients diagnosed with back pain in the lumbar region were included over a 12-month period. Patients were divided into two categories, depending on the dose of betamethasone administered. At 1 month control after the last injection, the first group of patients, a total of 22, given the local injection of betamethasone, trigger point injection, administering the usual dose: 1 ampoule of betamethasone 1 mL + 1 ampoule 1% xyline, at the clinical examination, they claimed that pain was reduced by about 70%, sustaining the improvement of the quality of life. The same group of patients, called for the final evaluation, at 3 month, claimed the pain was reduced by about 95%, as compared to the initial pain before starting the treatment. In the second category, where 21 patients were treated by local injections, trigger point injection, administering the modified dose of betamethasone: � ampoule of betanethasone 0.5 mL + 1 ampule 1% xyline, at 1 month control after the last injection, at the clinical examination they claimed thtat the pain was reduced with just 40%, sustaining an average quality of life. Even if a low dose of betamethasone shows significantly less systemic effects, a higher dose is required in the treatment of low back pain to have the desired effect and to significantly improve the quality of life of the patient.

The aim of the article was to determine the association between neutrophil to lymphocyte-ratio (NLR), clinical disease severity and joint effusion in patients with early knee osteoarthritis. We evaluated 79 patients with mild knee degeneration. We obtained NLR from routine hematology panels. As controls, 1260 hematology panels were also obtained. Clinical severity was evaluated from patient reported outcome scores: International Knee Documentation Committee Subjective Knee Evaluation Form, Knee Disability And Osteoarthritis Outcome Score For Joint Replacement, Tegner-Lysholm scale and Euroqol EQ-5D-5L questionnaire. Joint effusion was determined by ultrasound. For the statistics software R, version 3.4.4 was used. There were differences in demographics but not in NLR between the study patients and controls (2.03 versus 1.98, p=0.606). There was no correlation between NLR and joint effusion (r2= - 0.121) or between NLR, joint effusion and any other parameter recorded (r2 from - 0.134 to 0.190). In the multiple regression model, NLR was minimally influenced by age (p=0.059) and KOOSJR (p=0.023). Neutrophil to lymphocyte ratio is within normal limits in patients with early stage knee osteoarthritis and is not associated with clinical severity or with joint effusion.

(1) Background: To determine the association between patient-reported outcome measures and return to work after knee arthroscopy. (2) Material and Methods: Retrospective analysis of data on patients scheduled for knee arthroscopy in 2019 for which symptom severity was available using International Knee Documentation Committee subjective knee evaluation form (IKDC), Knee Disability And Osteoarthritis Outcome Score For Joint Replacement (KOOS JR), Tegner Lysholm scale and Euroqol EQ5D5L. Paid sick leave was retrieved from electronic patient records. (3) Results: 61 patients (mean age 46.44 ± 7.61 years, 28 (45.9%) males) met the inclusion criteria. All patients ultimately returned to work. Forty-six (75.41%) received a mean of 28.5 (range 7–68) days of paid medical leave after surgery. Of those, three patients were already on medical leave. There were no differences in demographics and clinical scores between patients who received paid sick leave and those who did not. No significant correlation was found between days of absence and clinical scores. (4) Conclusions: There was no association between absence from work and commonly used clinical scores in patients undergoing knee arthroscopy.