Physical Therapy versus Glucocorticoid Injection for Osteoarthritis of the Knee

Deyle, Gail D.; Allen, Chris; Allison, Stephen; Gill, Norman W.; Hando, Ben R; Petersen, Evan J.; Dusenberry, Douglas I; Rhon, Daniel I.

doi:10.1056/nejmoa1905877

Cited by 176 publications

(131 citation statements)

References 37 publications

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“…Arthroscopic surgery of the knee or hip is one of the most common orthopedic procedures, but of contested patient value for those with degenerative joint changes [37]. As for joint replacement surgery for OA, preceding a shared decision on arthroscopic surgery with a structured first-line OA management may help avoid a considerable number of surgical procedures with ensuing annual cost savings of billions of USD [38][39][40][41].…”

Section: Plos Onementioning

confidence: 99%

Costing analysis of a digital first-line treatment platform for patients with knee and hip osteoarthritis in Sweden

et al. 2020

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Osteoarthritis (OA) constitutes a major and increasing burden on patients, health care systems and the broader society. It is estimated that around a quarter of the adult population is affected by OA in the knee and hip and that the prevalence of OA will increase over the coming decades largely due to aging and adverse lifestyle factors. Prevention and effective care are critical to manage the challenges posed by OA. Digital technologies offer opportunities to deliver cost-effective care for chronic diseases, including for OA. We report the results of a costing analysis of a new digital platform for delivering first-line care including disease information and physiotherapy to patients with OA and compare this with an existing face-to-face model of treatment. Both models are in accordance with National Treatment Guidelines in Sweden. The results show that overall the digital model costs around 25% of the existing face-to-face model of care. Based on existing evidence on the effects of these models, our findings also suggest that the digital platform offers a cost-effective alternative to the existing model of OA care. Depending on the extent to which the digital model substitutes for the existing model of care, significant resources can be saved.

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Section: Plos Onementioning

confidence: 99%

Costing analysis of a digital first-line treatment platform for patients with knee and hip osteoarthritis in Sweden

et al. 2020

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“…Surgery and joint replacement, if possible in the early stages of OA, are expensive and may need to be performed multiple times during an individual’s life [ 22 , 43 ]. Alternative modalities of treatment may well be helpful in the short term, but may not be a sustainable strategy for OA treatment and potential prevention [ 44 , 45 ].…”

Section: Current Treatment Options and Limitationsmentioning

confidence: 99%

Emerging Gene-Editing Modalities for Osteoarthritis

Tanikella

Hardy

Frahs

et al. 2020

IJMS

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Osteoarthritis (OA) is a pathological degenerative condition of the joints that is widely prevalent worldwide, resulting in significant pain, disability, and impaired quality of life. The diverse etiology and pathogenesis of OA can explain the paucity of viable preventive and disease-modifying strategies to counter it. Advances in genome-editing techniques may improve disease-modifying solutions by addressing inherited predisposing risk factors and the activity of inflammatory modulators. Recent progress on technologies such as CRISPR/Cas9 and cell-based genome-editing therapies targeting the genetic and epigenetic alternations in OA offer promising avenues for early diagnosis and the development of personalized therapies. The purpose of this literature review was to concisely summarize the genome-editing options against chronic degenerative joint conditions such as OA with a focus on the more recently emerging modalities, especially CRISPR/Cas9. Future advancements in novel genome-editing therapies may improve the efficacy of such targeted treatments.

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“…The current main treatment method is symptomatic treatment, and there are certain hidden dangers, and only knee replacement can be performed in the late stage. [4][5] It is precisely because the pathogenesis of KOA is still unclear that it leads to unsatisfactory e cacy. At the same time, imaging technology alone cannot diagnose early lesions of KOA, which is not conducive to early detection and treatment.…”

Section: Introductionmentioning

confidence: 99%

Extraction and quality evaluation of exosomes from joint effusion

Ruan

Yin

Chen

et al. 2020

Preprint

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Objective: The aim of this study was to compare the quality and efficiency of exosomes extracted from knee joint effusion by different methods, laying a foundation for further research on exosomes from knee joint effusion. Methods:To separate and extract joint exosomes by 8% polyethylene glycol (PEG) precipitation method, ultracentrifugation method (UC) and ultrafiltration with exclusion chromatography (SECF). Transmission electron microscopy (TEM) and nanoparticle tracing technology (NTA) were used to detect particle morphology and particle size, and Western Blot (WB) was used to detect marker proteins of granule surface (CD9, CD63, Flotillin-1 and calnexin).Results: Three methods separated vesicle-like round particles from joint effusion successfully. The results of TEM show that the particles obtained by the three extraction methods are round or oval vesicles, the plasma membrane is intact, the size is different, and the diameter is distributed between 30 and 150 nm. Compared with SECF group, PEG group had more background particle impurities. and the broken vesicle fragments can be seen in the UC group; The results of NTA show that the main peaks of the three groups of particles are between 100-120nm, and the particle concentration is greater than 1×1010/ml; The results of WB show that the protein expressions of CD9, CD63 and Flotillin-1 in the suspension extracted by the three methods were higher, the expression of calnexin protein in the PEG group was higher than the UC group and SECF group.Conclusion: The three extraction methods can extract the exosomes of joint effusion successfully. The quality of exosomes obtained by the SECF method is relatively high, while the PEG precipitation method contains a small amount of impurity particles. UC method does not guarantee the integrity of exosomes. In summary, we recommend the SECF method to extract and isolate joint effusion exudates-derived exosomes when further studying the role of exosomes in the pathogenesis of knee osteoarthritis.

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Physical Therapy versus Glucocorticoid Injection for Osteoarthritis of the Knee

Cited by 176 publications

References 37 publications

Costing analysis of a digital first-line treatment platform for patients with knee and hip osteoarthritis in Sweden

Costing analysis of a digital first-line treatment platform for patients with knee and hip osteoarthritis in Sweden

Emerging Gene-Editing Modalities for Osteoarthritis

Extraction and quality evaluation of exosomes from joint effusion

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