Surgical interventions for symptomatic mild to moderate knee osteoarthritis

Palmer, Jonathan; Monk, Paul; Hopewell, Sally; Bayliss, Lee; Jackson, William M.; Beard, David; Price, Andrew

doi:10.1002/14651858.cd012128.pub2

Cited by 36 publications

(27 citation statements)

References 127 publications

(13 reference statements)

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“…Only seven SRs (4.2%) had high methodological quality, 23 – 29 of which all were Cochrane reviews. Eight (4.8%) had moderate quality, 25 (15.0%) had low quality, while the remaining 127 (76.0%) had critically low quality.…”

Section: Resultsmentioning

confidence: 99%

“…Overall methodological quality and associated factors. Only seven SRs (4.2%) had high methodological quality, [23][24][25][26][27][28][29] Final meta-analyses were included in this study (N=167) Results from multi-ordinal logistic regression analyses indicated that the following factors were associated with higher overall methodological quality ( Binary logistic regression analyses showed that SRs published in journals with a higher JIF had better performance in presenting the research question with PICO components (AOR 2.4, 95% CI 1.1-5.5) and considering risk of bias during meta-analysis (AOR 1.4, 95% CI 1.1-1.8). SRs published more recently were more likely to account for risk of bias when interpreting results (AOR 1.3, 95% CI 1.1-1.5).…”

Section: Methodological Qualitymentioning

confidence: 99%

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Methodological quality of systematic reviews on interventions for osteoarthritis: a cross-sectional study

Wang

Zhu

et al. 2020

Therapeutic Advances in Musculoskeletal

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Background: Healthcare providers need reliable evidence for supporting the adoption of new interventions, of which the source of evidence often originates from systematic reviews (SRs). However, little assessment on the rigor of SRs related to osteoarthritis interventions has been conducted. This cross-sectional study aimed to evaluate the methodological quality and predictors among SRs on osteoarthritis interventions. Methods: Four electronic databases (Cochrane Database of Systematic Reviews, MEDLINE, Embase, and PsycINFO) were searched, from 1 January 2008 to 10 October 2019. An SR was eligible if it focused on osteoarthritis interventions, and we performed at least one meta-analysis. Methodological quality was assessed using the validated AMSTAR 2 instrument. Multivariate regression analyses were conducted to assess predictors of methodological quality. Results: In total, 167 SRs were included. The most SRs were non-Cochrane reviews (88.6%), and 54.5% investigated non-pharmacological interventions. Only seven (4.2%) had high methodological quality. Respectively, eight (4.8%), 25 (15.0%), and 127 (76.0%) SRs had moderate, low, and critically low quality. Main methodological weaknesses were as follows: only 16.8% registered protocol a priori, 4.2% searched literature comprehensively, 25.7% included lists of excluded studies with justifications, and 30.5% assessed risk of bias appropriately by considering allocation concealment, blinding of patients and assessors, random sequence generation and selective reported outcomes. Cochrane reviews [adjusted odds ratio (AOR) 251.5, 95% confidence interval (CI) 35.5–1782.6], being updates of previous SRs (AOR 3.9, 95% CI 1.1–13.7), and SRs published after 2017 (AOR 7.7, 95% CI 2.8–21.5) were positively related to higher methodological quality. Conclusion: Despite signs of improvement in recent years, most of the SRs on osteoarthritis interventions have critically low methodological quality, especially among non-Cochrane reviews. Future SRs should be improved by conducting comprehensive literature search, justifying excluded studies, publishing a protocol, and assessing the risk of bias of included studies appropriately.

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Section: Resultsmentioning

confidence: 99%

Section: Methodological Qualitymentioning

confidence: 99%

Methodological quality of systematic reviews on interventions for osteoarthritis: a cross-sectional study

Wang

Zhu

et al. 2020

Therapeutic Advances in Musculoskeletal

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“…Indeed, a recently published systematic review that investigated the role of arthroscopic partial meniscectomy in knees with degenerative changes by extracting data from five randomized clinical trials (RCTs) found that patients with symptomatic meniscal tears and degenerative changes in the knee can benefit from arthroscopic meniscectomy, particularly if the osteoarthritis is mild 38 . However, other studies have suggested that the progression of OA may be more rapid in patients who underwent arthroscopic meniscectomy than in those who underwent conservative therapy 39,40 . There is still controversy regarding the influence of meniscectomy on the progression of OA 41,42 …”

Section: Discussionmentioning

confidence: 99%

“…38 However, other studies have suggested that the progression of OA may be more rapid in patients who underwent arthroscopic meniscectomy than in those who underwent conservative therapy. 39,40 There is still controversy regarding the influence of meniscectomy on the progression of OA. 41,42 There are limitations of this study that should be considered.…”

Section: Histopathological Changes In the Medial Meniscusmentioning

confidence: 99%

Comparison between two rabbit models of posttraumatic osteoarthritis: A longitudinal tear in the medial meniscus and anterior cruciate ligament transection

Huang

Cai

Zhang

et al. 2020

Journal Orthopaedic Research

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Animal osteoarthritis (OA) models have been developed to understand OA progression and evaluate new OA therapies. However, individual variations in joint lesions remain a critical problem in most current OA models. We established a novel rabbit model by creating a longitudinal tear in the medial meniscus body that was reproducible and similar to posttraumatic biomechanical disturbances in human OA. New Zealand rabbits underwent surgery and were assessed for 9 weeks. The rabbits were randomized into the sham control, medial meniscal tear (MMT), and anterior cruciate ligament transection (ACLT) groups. The animals were sacrificed at 4, 6, and 9 weeks posttreatment. The knee joints were harvested for histological and gene expression assessments. Both the MMT and ACLT procedures led to time‐dependent degenerative changes in the femoral condyle cartilage. At each time point, the MMT group cartilage showed more severe degenerative changes than did the ACLT group cartilage. Consistently, inflammatory cytokine and catabolic gene expression were significantly higher, and anabolic gene expression was significantly lower in the MMT group than in the ACLT group. MMT treatment caused more severe structural damage to the cartilage and higher catabolic gene expression levels than the ACLT model at each time point. The MMT model may be highly beneficial in investigating posttraumatic OA (PTOA) development, especially PTOA from a meniscal injury. The MMT model replicated key features of human PTOA, including meniscal lesions, inflammatory responses, and the progression to osteoarthritic cartilage degeneration, thereby providing an exciting new avenue for translating promising treatments to clinical practice.

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“…Cortisol, OA pain and surgery Surgery aims to remove the potential pain-generating mechanism (mechanical OA degradation) in OA, but many patients have a poor treatment response after surgery 42 . Cortisol levels rise with the physiological stress of surgery and the range in baseline levels and peak cortisol responses to surgery is wide 43 .…”

Section: Cortisol Oa Pain and Ethnicitymentioning

confidence: 99%

Exploring the relationship between chronic pain and cortisol levels in subjects with osteoarthritis: results from a systematic review of the literature

Villafañe

Bertozzi

Drago

et al. 2020

Osteoarthritis and Cartilage

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Objective: Several reports in the literature have identified an association between cortisol levels and the presence of chronic pain in conditions such as rheumatoid arthritis, low back pain or whiplash. In contrast, few have examined the association of cortisol and pain in people with osteoarthritis (OA). The purpose of this systematic review was to verify the association between cortisol and pain in the OA population. Design: The databases MEDLINE, CINAHL, EMBASE were searched systematically for human studies written in English up to December 2018. Two researchers screened titles and abstracts against predefined inclusion criteria; a third resolved discrepancies. Articles were included if they measured the cortisol levels in adults with pain in the OA population. Methodological quality was assessed using Methodological Index for non-randomized Studies (MINORS) score. Results: Seven studies reporting on 415 patients were included in this review. The MINORS scale yielded mean scores of 8.6 of 16 and 17.5 of 24, for the cohort and caseecontrol studies respectively. In general, the studies were of poor quality. A discrepancy of noteworthy associations between cortisol level comparison and pain was found. Conclusions: This study shows that there is a discrepancy in the relationship between cortisol and pain dependent on how and when cortisol is measured. Evidence from three low-quality studies suggest increased cortisol levels in patients with pain but the conclusions have a high risk of bias. It was not possible to make a quantitative analysis comparing the relationship between cortisol and pain in the OA population.

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Surgical interventions for symptomatic mild to moderate knee osteoarthritis

Abstract: Trusted evidence. Informed decisions. Better health.

Cited by 36 publications

References 127 publications

Methodological quality of systematic reviews on interventions for osteoarthritis: a cross-sectional study

Methodological quality of systematic reviews on interventions for osteoarthritis: a cross-sectional study

Comparison between two rabbit models of posttraumatic osteoarthritis: A longitudinal tear in the medial meniscus and anterior cruciate ligament transection

Exploring the relationship between chronic pain and cortisol levels in subjects with osteoarthritis: results from a systematic review of the literature

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