Total knee arthroplasty in elderly patients with severe Kashin-Beck disease of the knee

Tang, Xin; Zhou, Zongke; Shen, Bin; Kang, Pengde; Yang, Jing; Li, Jian; Pei, Fuxing

doi:10.1007/s00264-013-2171-3

Cited by 12 publications

(15 citation statements)

References 24 publications

(30 reference statements)

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“…In addition, the proportions of physical therapy and surgical procedures were both signi cantly low, although previous studies reported that the two methods were effective. [17][18][19]. One explanation for this nding may be that the KBD patients may not have the stamina to engage in physical therapy due to long-term treatment; the other is that the subjects may not be able to afford the cost of surgery due to nancial reasons [40].…”

Section: Discussionmentioning

confidence: 99%

“…Currently, relieving the pain is an important target in the treatment of KBD [14]. However, pain treatment for KBD is mainly derived from experiences of osteoarthritis (OA) [15], including the administration of analgesic drugs [5], selenium supplementation [16], intra-articular injections of hyaluronic acid (IAHA) [14], surgical procedures [17,18] and physical therapy [19]. Despite various treatment approaches, there is no speci c disease pain measurement to assess joint pain after treatment.…”

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confidence: 99%

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Does Kashin-beck Disease Present Only Multisite Pain? A Cross-sectional Study of Pain Characteristics in Northwest China

Wang

Younus²,

Xu³

et al. 2020

Preprint

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BackgroundKashin-Beck Disease (KBD) is an endemic, chronic joint disease. Multisite joint pain is the primary symptom of KBD, which have profound negative effects on individuals and society. However, studies on joint pain characteristics among the KBD population are still limited. The aims of this study were to explore characteristics of joint pain in patients with KBD and determine associated factors with joint pain. MethodsThis cross-sectional study included 167 patients with KBD and 169 patients from the general population with joint pain from Shaanxi Province in northwest China. Subjects were asked about joint pain characteristics and completed the numeric rating scale (NRS), the graded chronic pain scale (GCPS) and the EuroQol (EQ-5D) questionnaire. Differences between groups were determined using Chi-square, Student’s t, Mann–Whitney U and 1-way ANOVA tests.ResultsCompared with the general group, patients with KBD reported a higher number of pain sites (7.2±3.8 vs 3.5± 1.8), a higher frequency of persistent pain (98.8% vs 50.9%), a higher percentage of analgesics usage (89.2% vs 30.7%), a higher pain intensity (73.8±15.2 vs 50.0±20.7) and pain –related disability (61.2±23.3 vs 41.6±23.2), and lower EQ-5D scores (0.34±0.27 vs 0.59±0.16). Among the 167 KBD patients, painful joints were symmetrically distributed between the bilateral limbs; the 5 most frequently reported painful joints for the bilateral sides were the knees (84.8%), ankles (79.2%), wrists (51.2%), shoulders (49.5%) and elbows (47.7%). The most severe pain joint was the knee (NRS:6.6), followed by the ankles (NRS:5.1), the fingers, shoulders and elbows had the similar NRS scores (NRS:4.0). Additionally, KBD patients experienced neuropathic pain to varying degrees. Compared to males, females reported a higher number of total pain sites, higher intensity and lower quality of life. ConclusionsBesides multisite pain, the KBD patients suffered from symmetrical, persistent, and neuropathic pain. Weight-bearing joints (e.g., knee and ankle) were the most painful. These findings will provide scientific basis for establishing joint pain evaluation criteria and future pain intervention strategies for these KBD patients in China.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Does Kashin-beck Disease Present Only Multisite Pain? A Cross-sectional Study of Pain Characteristics in Northwest China

Wang

Younus²,

Xu³

et al. 2020

Preprint

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“…[20,21]. Studies focusing on treatment evaluation have shown that medication, physical therapy, and surgery can help to alleviate symptoms, delay cartilage degeneration, and improve joint function [6][7][8][9][10][11][12]. In addition, results from 2520 children and adults with KBD (ages, 1-60 years) using single-factor logistic regression modeling showed that, along with increased age and prolonged disease, the major indicators of KBD were joint pain, morning stiffness, joint dysfunction (wrist, elbow, ankle, knee, and shoulder), finger coarse, bone end, knee deformity, and scoliosis [22].…”

Section: Feasibility Analysismentioning

confidence: 98%

“…The WOMAC score and the visual analog scale (VAS) score were employed for comparison of the efficacy and tolerability of sodium hyaluronate and meloxicam in adult patients with KBD [7,8]. The VAS score, the Hospital for Special Surgery scores (HSS), and the functional score were employed to evaluate the efficacy of total knee arthroplasty in elderly patients with severe KBD [9]. The WOMAC score and the 12-item Short Form Health Survey (SF-12) were used to compare the efficacy of chondroitin sulfate and/or glucosamine hydrochloride for KBD [10].…”

Section: Introductionmentioning

confidence: 99%

Reliability and validation of the joint dysfunction index as a new assessment instrument for therapeutic efficacy for Kashin-Beck disease

Xia

Hua

et al. 2016

Clin Rheumatol

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The objective of this study was to evaluate the reliability and validity of the joint dysfunction index (JDI) for assessment of therapeutic efficacy for Kashin-Beck disease (KBD). In an initial survey, completed questionnaires were obtained from 276 of 281 patients (98.2 %). A follow-up survey was completed with 64 KBD patients among 276 cases. A third survey selected 60 KBD patients who underwent intra-articular injection of sodium hyaluronate in the knees ascertained from the findings of the second questionnaire. Reliability was assessed using test-retest, "split-half" reliability and Cronbach's alpha coefficient. Factor analysis and item-to-domain correlation were used to analyze validity. The coefficient of variation (CV) was used to measure the sensitivity of scale. Feasibility assessment included consideration of completion time, rate of recovery, and time of completion. Reliability analysis comprised a test-retest correlation coefficient of 0.404-0.546 and a kappa test of 0.404-0.546. Internal consistency analysis comprised a Cronbach alpha coefficient of 0.689 and a split-half coefficient of 0.677. Principal component factor analysis for validity testing extracted a common factor with a cumulative variance contribution of 45.44 %. The JDI score from 276 KBD cases revealed no significant difference associated with age, gender, education, or the body mass index. Sensitivity analysis showed that there was no significant difference between pre-treatment and post-treatment values, with a CV of 96.55-172.06 %. In conclusion, the JDI can be used to evaluate the efficacy of agents used to treat KBD.

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“…Likewise Ebert (2014), who noticed improvements in fl exion in a knee joint with its highest fi gure of 110 degrees. By the use of the means of physical therapy, particularly negative thermotherapy, it is possible to inhibit pain (22). Pain management is a main determinant of functional recovery after TKA (23).…”

Section: Discussionmentioning

confidence: 99%

Does standard post-operative rehabilitation have its place after total knee replacement?

Vavro¹,

Žiaková²,

Gazdíková³

et al. 2017

BLL

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OBJECTIVE: The pilot study objective was to evaluate the effect of comprehensive post-operative physiotherapeutic treatment on the selected physiotherapeutic parameters as well as patients' quality of life after a total knee joint replacement surgery. RESULTS: Thirty patients after total knee joint arthroplasty were enrolled into the pilot study. After completing the physiotherapeutic processes, we have observed among the patients who underwent a total knee replacement surgery, a signifi cant increase in muscle strength as with the fl exors as well as the extensors (p = 0.001), improvement in their range of motion in knee joint fl exion, in comparison to its range before treatment (p = 0.001), knee pain reduction (p = 0.001) and post-operative swelling (p <0.001), respectively. After undergoing the physiotherapeutic procedures, we recorded a statistically signifi cant improvement in the monitored physical components: dressing (p = 0.008) and toilet use (p = 0.001), transfer from bed to chair (p = 0.008), walking on fl at surface (p = 0.001), climbing stairs (p = 0.001). Passing the physiotherapy signifi cantly reduced the degree of dependence of operated patients (p = 0.001). CONCLUSION: Early post-operative physiotherapy treatment positively affects patients' general condition. In addition, it improves muscle strength, range of motion of the operated joint, eliminates post-operative pain and reduces swelling that improves patients' self-suffi ciency. Standard physiotherapy nowadays and in the next few years will take a unique place in patients' management after total knee joint replacement (Tab. 5, Ref. 26). Text in PDF www.elis.sk.

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Total knee arthroplasty in elderly patients with severe Kashin-Beck disease of the knee

Cited by 12 publications

References 24 publications

Does Kashin-beck Disease Present Only Multisite Pain? A Cross-sectional Study of Pain Characteristics in Northwest China

Does Kashin-beck Disease Present Only Multisite Pain? A Cross-sectional Study of Pain Characteristics in Northwest China

Reliability and validation of the joint dysfunction index as a new assessment instrument for therapeutic efficacy for Kashin-Beck disease

Does standard post-operative rehabilitation have its place after total knee replacement?

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