Clinical algorithms to aid osteoarthritis guideline dissemination

Meneses, Sarah Rúbia Ferreira de; Goode, Adam P.; Nelson, Amanda; Lin, Jianhao; Jordan, Joanne M.; Allen, Kelli D.; Bennell, Kim L; Lohmander, L. Stefan; Fernandes, Linda; Hochberg, Marc C.; Underwood, Martin; Conaghan, Philip G.; Liu, Samuel; McAlindon, Timothy E.; Golightly, Yvonne M.; Hunter, David J.

doi:10.1016/j.joca.2016.04.004

Cited by 52 publications

(43 citation statements)

References 33 publications

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“…Current treatments focus on symptomatic relieve, such as the reduction of overloading and inflammation by physiotherapy and anti‐inflammatory drugs in early stage OA . Currently, physiotherapy and anti‐inflammatory drugs are only a postponement of surgical treatment in OA and most patients eventually undergo arthroplasty . Most patients regain their mobility soon after surgery and remain free of pain and disability for some 10 years .…”

Section: Clinical Perspective On Intervertebral Disc Degeneration and Oamentioning

confidence: 99%

“…144,145 Currently, physiotherapy and anti-inflammatory drugs are only a postponement of surgical treatment in OA and most patients eventually undergo arthroplasty. 146,147 Most patients regain their mobility soon after surgery and remain free of pain and disability for some 10 years. 148 Arthroplasty in DD is less typical, but artificial intervertebral discs are starting to show promising results, although spinal fusion is still more common.…”

Section: Treatmentmentioning

confidence: 99%

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Osteoarthritis and intervertebral disc degeneration: Quite different, quite similar

et al. 2018

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Intervertebral disc degeneration describes the vicious cycle of the deterioration of intervertebral discs and can eventually result in degenerative disc disease (DDD), which is accompanied by low‐back pain, the musculoskeletal disorder with the largest socioeconomic impact world‐wide. In more severe stages, intervertebral disc degeneration is accompanied by loss of joint space, subchondral sclerosis, and osteophytes, similar to osteoarthritis (OA) in the articular joint. Inspired by this resemblance, we investigated the analogy between human intervertebral discs and articular joints. Although embryonic origin and anatomy suggest substantial differences between the two types of joint, some features of cell physiology and extracellular matrix in the nucleus pulposus and articular cartilage share numerous parallels. Moreover, there are great similarities in the response to mechanical loading and the matrix‐degrading factors involved in the cascade of degeneration in both tissues. This suggests that the local environment of the cell is more important to its behavior than embryonic origin. Nevertheless, OA is widely regarded as a true disease, while intervertebral disc degeneration is often regarded as a radiological finding and DDD is undervalued as a cause of chronic low‐back pain by clinicians, patients and society. Emphasizing the similarities rather than the differences between the two diseases may create more awareness in the clinic, improve diagnostics in DDD, and provide cross‐fertilization of clinicians and scientists involved in both intervertebral disc degeneration and OA.

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Section: Clinical Perspective On Intervertebral Disc Degeneration and Oamentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Osteoarthritis and intervertebral disc degeneration: Quite different, quite similar

et al. 2018

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“…OA is a common form of chronic degenerative joint disease that is slowly induced in the bone, synovium and muscle by several processes including progressive cartilage deterioration, subchondral bone remodelling, loss of joint space, marginal osteophytosis and loss of joint function . Current treatment options for articular injury, for instance, physical therapy and anti‐inflammatory drugs, aim to remedy the symptoms, but they do little to treat the underlying causes . When symptomatic medical treatments fail, patients usually resort to receiving autologous chondrocyte implantation (ACI) and total knee arthroplasty (TKA) .…”

Section: Introductionmentioning

confidence: 99%

A comparative assessment of adipose‐derived stem cells from subcutaneous and visceral fat as a potential cell source for knee osteoarthritis treatment

Tang

Pan

Zou

et al. 2017

J Cellular Molecular Medi

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The intra‐articular injection of adipose‐derived stem cells (ASCs) is a novel potential therapy for patients with osteoarthritis (OA). However, the efficacy of ASCs from different regions of the body remains unknown. This study investigated whether ASCs from subcutaneous or visceral adipose tissue provide the same improvement of OA. Mouse and human subcutaneous and visceral adipose tissue were excised for ASC isolation. Morphology, proliferation, surface markers and adipocyte differentiation of subcutaneous ASCs (S‐ASCs) and visceral ASCs (V‐ASCs) were analysed. A surgically induced rat model of OA was established, and 4 weeks after the operation, S‐ASCs, V‐ASCs or phosphate‐buffered saline (PBS, control) were injected into the articular cavity. Histology, immunohistochemistry and gene expression analyses were performed 6 weeks after ASC injection. The ability of ASCs to differentiate into chondrocytes was assessed by in vitro chondrogenesis, and the immunosuppressive activity of ASCs was evaluated by co‐culturing with macrophages. The proliferation of V‐ASCs was significantly greater than that of S‐ASCs, but S‐ASCs had the greater adipogenic capacity than V‐ASCs. In addition, the infracted cartilage treated with S‐ASCs showed significantly greater improvement than cartilage treated with PBS or V‐ASCs. Moreover, S‐ASCs showed better chondrogenic potential and immunosuppression in vitro. Subcutaneous adipose tissue is an effective cell source for cell therapy of OA as it promotes stem cell differentiation into chondrocytes and inhibits immunological reactions.

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“…The algorithm proposed by Meneses et al, (2016) recommends short-term opioid treatment of patients with severe and disabling pain that cannot be controlled by other pharmacological interventions, but emphasizes the simultaneous administration of non-pharmacological interventions as well [34].…”

Section: Discussionmentioning

confidence: 99%

Osteoarthritis Patients’ Experiences of Pharmacotherapy for Pain Management in Iran: A Qualitative Study

et al. 2017

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Despite the effectiveness of pharmacotherapy for pain management in patients with osteoarthritis (OA), personal biases in the selection, administration, and continuation of pharmacotherapy challenge the proper management of symptoms and the effectiveness of the therapy. This study was conducted to carry out an in-depth examination of the experiences of patients with OA about their use of pharmacotherapy for the OA pain management and the existing challenges. The present qualitative study was conducted on 17 patients with OA, 5 of their family members and 8 healthcare personnel using a conventional content analysis approach. Data were collected through 35 interviews, which were unstructured at first but became semi-structured later on. Data collection continued until data saturation and analyzed simultaneously. The criteria used to determine the rigor of the study included the credibility, transferability, dependability and conformability of the data. The analysis of the data revealed 3 main categories and 8 subcategories. The main categories including preference for non-pharmacological modalities, preference for symptomatic slow-acting drugs for osteoarthritis (SySADOAs) and preference for vitamins and minerals. Briefing the patients on the therapeutic goals, participating them in the clinical decision-making process, modifying drug administration patterns through prescribing the minimum effective dosage and substituting alternative therapies whenever possible, consistently monitoring the therapeutic responses and any unexpected complications and use of complementary treatments, makes up strategies that can help improve OA pain management.

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Clinical algorithms to aid osteoarthritis guideline dissemination

Cited by 52 publications

References 33 publications

Osteoarthritis and intervertebral disc degeneration: Quite different, quite similar

Osteoarthritis and intervertebral disc degeneration: Quite different, quite similar

A comparative assessment of adipose‐derived stem cells from subcutaneous and visceral fat as a potential cell source for knee osteoarthritis treatment

Osteoarthritis Patients’ Experiences of Pharmacotherapy for Pain Management in Iran: A Qualitative Study

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