Improved function and strength in patients with knee osteoarthritis as a result of adding a two-day educational program to usual care. Prospective randomized trial

Rezende, Márcia Uchôa de; Brito, N.L.; Farias, F.S.; Silva, Cac; Cernigoy, C.H.; Silva, JM Rodrigues da; Moreira, MM; Santana, O.F.; Hissadomi, M.I.; Frucchi, Renato; Pasqualin, Thiago; Campos, G.C.; Pailo, A.F.; Ocampos, GP; Camargo, O.P.

doi:10.1016/j.ocarto.2020.100137

Cited by 9 publications

(30 citation statements)

References 69 publications

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“…This signi cant clinical bene t was indeed achieved early (2 weeks after the injection) and maintained for, at least, 24 weeks. In general, clinical improvement has been established with a minimum difference of 20% in e cacy outcomes [23], like scores in the WOMAC questionnaire. Our results are in agreement with the literature implicating diverse HA products [8- 10,12,24,25].…”

Section: Discussionmentioning

confidence: 99%

Effect of a Single-Shot of a High-Density Viscoelastic Solution of Hyaluronic Acid in Patients with Symptomatic Primary Knee Osteoarthritis: The No-Dolor Study

Calvet¹,

Khorsandi

Tío

et al. 2021

Preprint

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Background Pronolis®HD mono 2.5% is a novel, one-shot, high-density sterile viscoelastic solution, recently available in Spain, which contains a high amount of intermediate molecular weight hyaluronic acid (HA), highly concentrated (120 mg in 4.8 mL solution: 2.5%). The objective of the study was to analyze the efficacy and safety of this treatment in symptomatic primary knee osteoarthritis (OA). Methods This observational, prospective, multicenter, single-cohort study involved 166 patients with knee OA treated with a single-shot of Pronolis®HD mono 2.5% and followed up as many as 24 weeks. Results Compared with baseline, the score of the Western Ontario and McMaster Universities Arthritis Osteoarthritis Index (WOMAC) pain subscale significantly reduced at the 12-week visit (primary endpoint, median: 9 interquartile range [IQR]: 7-11 versus median: 4; IQR: 2-6). The percentage of patients achieving >50% improvement in the pain subscale increased progressively from 37.9% (at 2 weeks) to 66.0% (at 24 weeks). Similarly, WOMAC scores for pain on movement, stiffness subscale, and functional capacity subscale showed significant reductions at the 12-week visit which were maintained up to the 24-week visit. The EuroQol visual analog scale score significantly increased after 12 weeks (median: 60 versus 70). The need for rescue medication (analgesics/nonsteroidal anti-inflammatory drugs) also significantly decreased in all post-injection visits. Three patients (1.6%) reported local adverse events (joint swelling) of mild intensity. Conclusions In conclusion, a single intra-articular injection of the high-density viscoelastic gel of HA is effective and safe for the relief of symptoms in patients with knee OA. Trial registration: ClinicalTrial# NCT04196764

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Section: Discussionmentioning

confidence: 99%

Effect of a Single-Shot of a High-Density Viscoelastic Solution of Hyaluronic Acid in Patients with Symptomatic Primary Knee Osteoarthritis: The No-Dolor Study

Calvet¹,

Khorsandi

Tío

et al. 2021

Preprint

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“…Ultimately, thirteen studies remained. After further reading, it was determined that they met the inclusion criteria and were included in this meta-analysis [28,[31][32][33][40][41][42][43][44][45][46][47][48] (Figure 1). 1 shows the characteristics of these 13 studies, with all included studies being RCTs.…”

Section: Study Selectionmentioning

confidence: 99%

“…ailand [31], Australia [28], Iran [40][41][42]44], France [32], USA [43], and Brazil [45]. A total of 1610 participants were included in the 13 RCTs, 853 in the selfmanagement group and 757 in the control group.…”

Section: Overview Of the Included Studies Tablementioning

confidence: 99%

“…e 1,610 participants came from different countries, including 607 from China, 40 from ailand, 136 from Australia, 344 from Iran, 106 from France, 186 from the United States, and 191 from Brazil. Six studies were based on the diagnosis of KOA based on clinical and radiographic features by a physician [28,31,[40][41][42]44], while the remaining seven studies were based on the diagnosis criteria of the American College of Rheumatology [32,33,43,[45][46][47]. e sample size of RCTs ranged from 40 to 205, and the average age of participants ranged from 52.35 to 79.26.…”

Section: Overview Of the Included Studies Tablementioning

confidence: 99%

“…e randomization process of three studies was rated as high risk [33,43,46], and the randomization process of the other ten studies was rated as low risk [28, 31, 32, 40-42, 44,45, 47, 48]. For one study, deviations from the Intended interventions were rated as high risk [28], For nine studies, the Deviations from the Intended interventions were rated as low risk [32,33,[41][42][43][44][45][46][47][48], and for three studies, the Deviations from the Intended Interventions was rated as some concerns [31,40,41]. e missing outcome data of four studies were rated as high risk [43,[46][47][48], and the missing outcome data of the other nine studies were rated as low risk [28, 31-33, 40-42, 44, 45].…”

Section: Risk Of Biasmentioning

confidence: 99%

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Self-Management for Knee Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Zhu²,

Zeng

et al. 2022

Pain Research and Management

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Background. Knee osteoarthritis (KOA) is a high incidence chronic joint disease that seriously affects patients’ quality of life, and current treatment methods have limited efficacy. Self-management may be an effective strategy for KOA, and clinicians have been showing increased interest recently. However, the effectiveness of self-management for KOA remains controversial. Purpose. This study aims to systematically evaluate the effectiveness of self-management for KOA. Methods. We screened articles published in MEDLINE, Cochrane Library, EMBASE, and Web of Science until September 17, 2021. The main outcomes included pain, knee function, stiffness, WOMAC (total), physical function, arthritis self-efficacy (ASE-pain), arthritis self-efficacy (ASE-other symptoms), mental health, and quality of life. Results. Thirteen randomized controlled trials (RCTs) were finally included (n = 1610). Meta-analysis showed differences in pain, knee function, stiffness, ASE-pain, ASE-other symptoms, mental health, and quality of life between the self-management and control groups. Of the nine outcomes evaluated, four were highly heterogeneous, and the quality of evidence ranged from very low to moderate. Conclusion. The meta-analysis results showed that self-management might help improve the pain, knee function, stiffness, ASE, mental health, and quality of life in patients with KOA. However, it has no significant effect on WOMAC (total) and physical function. Considering that this study has some limitations, we cannot draw clear conclusions based on the results of this study. Nevertheless, we offer much needed insight and encourage more rigorously designed and implemented RCTs in the future to substantiate our conclusions.

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How Does Osteoarthritis Education Influence Knowledge, Beliefs, and Behavior in People With Knee and Hip Osteoarthritis? A Systematic Review

Simick Behera,

Duong,

Eyles

et al. 2024

Arthritis Care & Research

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ObjectiveTo inform the design and implementation of osteoarthritis (OA) education for people with knee and hip OA, this review investigated: i) the impact of OA education on knowledge, beliefs and behavior, ii) how and why these changes occur.MethodsFive databases ‐ MEDLINE, Excerpta Medica Database (Embase), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, Physiotherapy Evidence Database (PEDro) ‐ were searched in August 2023. Eligible studies were quantitative, qualitative and mixed‐methods, involving OA education interventions, assessing knowledge, beliefs and/or behavioral outcomes. An interpretivist analytic process guided data evaluation, synthesis and description of meta‐themes.ResultsNinety‐eight studies were included (80 quantitative, 12 qualitative, 6 mixed‐methods). OA education was heterogeneous in content and delivery. Outcome measures varied, with poor distinction between knowledge, beliefs and behavior constructs. Trends toward short‐term knowledge improvement were observed, but there were no clear trends in beliefs or behavior change. Intrinsic factors (e.g. pre‐existing beliefs) and extrinsic factors (e.g. socioeconomic factors) appeared to influence change. Three meta‐themes described how and why changes may occur: i) Engagement ‐ how individuals relate with education content and delivery, ii) Embodiment – the role of experiential factors in learning, and iii) Empowerment ‐ the level of agency education generates.ConclusionBeyond the provision of information and instruction, OA education is a complex, relational process influenced by multidimensional factors. This review identifies potentially important strategies at individual, interpersonal and community levels to support the design and delivery of engaging education that promotes holistic, embodied learning, and facilitates meaningful, empowering change.image

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Improved function and strength in patients with knee osteoarthritis as a result of adding a two-day educational program to usual care. Prospective randomized trial

Cited by 9 publications

References 69 publications

Effect of a Single-Shot of a High-Density Viscoelastic Solution of Hyaluronic Acid in Patients with Symptomatic Primary Knee Osteoarthritis: The No-Dolor Study

Effect of a Single-Shot of a High-Density Viscoelastic Solution of Hyaluronic Acid in Patients with Symptomatic Primary Knee Osteoarthritis: The No-Dolor Study

Self-Management for Knee Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

How Does Osteoarthritis Education Influence Knowledge, Beliefs, and Behavior in People With Knee and Hip Osteoarthritis? A Systematic Review

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