Pharmacologic and Non-Pharmacologic Treatment of Osteoarthritis

Yusuf, Erlangga

doi:10.1007/s40674-016-0042-y

Cited by 57 publications

(53 citation statements)

References 91 publications

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“…Moreover, there is no known cure and no proven pharmacologic intervention available to treat OA [3,4]. Because the progressive process of joint degeneration is directly associated with the aging population [5,6], the prevalence of OA is anticipated to continually increase, resulting in OA as the leading cause of musculoskeletal disability in the elderly [7].…”

Section: Introductionmentioning

confidence: 99%

Validation of scoring hip osteoarthritis with MRI (SHOMRI) scores using hip arthroscopy as a standard of reference

et al. 2018

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Purpose To validate SHOMRI gradings in preoperative hip magnetic resonance imaging (MRI) with intra-arthroscopic evaluation of intraarticular hip abnormalities. Methods Preoperative non-arthrographic 3.0-T MRIs of 40 hips in 39 patients (1 patient with bilateral hip surgery) with femoroacetabular impingement (FAI) syndrome (mean age, 34.7 years ± 9.0; n = 16 females), refractory to conservative measures, that underwent hip arthroscopy were retrospectively assessed by two radiologists for chondrolabral abnormalities and compared with intra-arthroscopic findings as the standard of reference. Arthroscopically accessible regions were compared with the corresponding SHOMRI subregions and assessed for the presence and grade of cartilaginous pathologies in the acetabulum and femoral head. The acetabular labrum was assessed for the presence or absence of labral tears. For the statistical analysis sensitivity and specificity as well as intraclass correlation (ICC) for interobserver agreement were calculated. Results Regarding chondral abnormalities, 58.8% of the surgical cases showed chondral defects. SHOMRI scoring showed a sensitivity of 95.7% and specificity of 84.8% in detecting cartilage lesions. Moreover, all cases with fullthickness defects (n = 9) were identified correctly, and in n = 6 cases (out of n = 36 with partial-thickness defects) the defective cartilage was identified but the actual depth overestimated. Labral tears were present in all cases and the MR readers identified 92.5% correctly. ICC showed a good interobserver agreement with 86.3% (95% CI 80.0, 90.6%) Conclusion Using arthroscopic correlation, SHOMRI grading of the hip proves to be a reliable and precise method to assess chondrolabral hip joint abnormalities. Key Points • Assessment of hip abnormalities using MRI with surgical correlation.• Comparing surgery and MRI by creating a hybrid anatomic map that covers both modalities.• Non-arthrographic use of 3.0-T MRI provides detailed information on cartilage and labral abnormalities in hip joints.

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Section: Introductionmentioning

confidence: 99%

Validation of scoring hip osteoarthritis with MRI (SHOMRI) scores using hip arthroscopy as a standard of reference

et al. 2018

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“…A qualitative study by Makris et al (2015) on the reasons for the elderly's failure to seek therapeutic care for debilitating back pain showed that the patients' negative attitude toward pharmacotherapy is rooted in their ideas about the inefficiency of pharmacotherapy and their fear of its unexpected side-effects and the chances of addiction [26]. A thorough justification of the goals of pharmacotherapy may therefore improve the adherence to therapeutic recommendations in patients with OA [6]. Furthermore, comorbidities such as hypertension, hyperlipidemia and diabetes mellitus also reduce the patients' medical adherence [13,18].…”

Section: Discussionmentioning

confidence: 99%

“…In a cohort study on patients with OA, Basedow et al (2014) showed that 60 % of the patients had used complementary medicine in the past and found that the tendency to use complementary medicine was correlated directly with a more favorable health status, greater knowledge about the disease and the degree of frustration with the side-effects of conventional treatments; however, the patients required more proof about the actual effectiveness of this treatment [39]. Yusuf (2016) showed that a combination of non-pharmacological therapy and pharmacotherapy can lead to optimum results. The primary non-pharmacological therapies available include weight loss, whether through dieting or exercise(high-impact and isotonic exercises in patients with a lower disease severity and isometric exercises without joint movement in patients in advanced stages of the disease) [6].…”

Section: Discussionmentioning

confidence: 99%

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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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“…Some studies also showed that CPAs like glucosamine and chondroitin sulphate, when taken alone or in combination, did not effectively reduce the pain caused by OA [6]. Besides, chondroitin has been proven to produce only insigni cant bene t in a meta-analysis of large-scale, methodologically sound chondroitin trials [7].…”

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confidence: 99%

Clinical Efficacy of a Single-dose of Platelet Rich Plasma in the Management of Early Knee Osteoarthritis: A Randomized Controlled Study With Mri Assessment and Evaluation of Optimal Dose

Bansal¹,

Leon

Pont³

et al. 2020

Preprint

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Background: Osteoarthritis (OA) causes substantial physical disability that limits a person's ability to indulge in daily activities. Non-steroidal anti-inflammatory drugs provide only minimal symptomatic benefit and are associated with mild to severe side effects, thus limiting its continuous use. This being the case, new alternate healing strategies with minimal adverse effects are being explored scientifically. In our study we have attempted to evaluate the clinical efficacy of a single dose of Platelet Rich Plasma (PRP) in treating osteoarthritis. Our primary objectives are:i) To optimise the correct dose of PRP preparation to achieve therapeutic relief in knee OAii) To identify the therapeutic efficacy of PRP in selected patients suffering from symptomatic primary knee OA through Randomized Clinical Trials and analyse the possible outcome using MRI analysis.Methods: A randomized, double-blind, 12-month, placebo-controlled study was conducted in 100 outpatients. PRP was prepared from the blood drawn from the subjects and administered intra-articularly guided by ultrasound. The degree of pain was assessed using WOMAC scores, the International Knee Documentation Committee score (IKDC) and six-minute pain free walking distance. The joint space width and articular cartilage thickness was evaluated through x-ray, ultrasonagraphy and MRI.Result: PRP with absolute count of approximately 100 billion platelets brings out significant therapeutic relief. The WOMAC scores showed reduction from 54.7 at baseline to 28.8 at one month, and 29.9 at 3 months showing efficacy of PRP over placebo. Improvement was evident in one month scores of IKDC tests (Baseline- 53.6; 1 month - 76.9) and VAS (Baseline - 5.8; 1 month - 2.46) followed by slight decline at 3, 6-month and one-year scores. Similarly, the pain-free distance covered during a 6-min walk was significantly improved at one month in both the groups (PRP-146 ft.; placebo-122 ft; p value <0.001). No change is seen on MRI and Joint space width.Conclusion: 7 times Concentration and absolute count of 100 billion platelets is crucial in a PRP formulation to be therapeutically effective in alleviating symptoms in moderate knee OA. The results indicate prevention of structural modification in the PRP group and better chondroprotective effects compared to placebo group.Trial Registration: This study has been registered in the US Clinical Trial Registry (U.S. National Library of Medicine) with Trial registration no. 04198467. Date of registration: December 13, 2019. (Retrospectively registered) URL - https://clinicaltrials.gov/ct2/show/NCT04198467?term=04198467&draw=2&rank=1

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Pharmacologic and Non-Pharmacologic Treatment of Osteoarthritis

Cited by 57 publications

References 91 publications

Validation of scoring hip osteoarthritis with MRI (SHOMRI) scores using hip arthroscopy as a standard of reference

Validation of scoring hip osteoarthritis with MRI (SHOMRI) scores using hip arthroscopy as a standard of reference

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

Clinical Efficacy of a Single-dose of Platelet Rich Plasma in the Management of Early Knee Osteoarthritis: A Randomized Controlled Study With Mri Assessment and Evaluation of Optimal Dose

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