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Osteoarthritis non pharmacological

Andreas Leonidou, Panagiotis Lepetsos, Michalis Mintzas, Eustathios Kenanidis, George Macheras, Maria Tzetis, Michael Potoupnis, Eleftherios Tsiridis
Inducible nitric oxide synthase (iNOS) is the enzyme responsible for the production of nitric oxide (NO), a major proinflammatory and destructive mediator in osteoarthritis (OA). Areas covered: This is a comprehensive review of the recent literature on the involvement of iNOS in osteoarthritis and its potential to be used as a target for OA treatment. Evidence from in vitro, in vivo and human studies was systematically collected using medical search engines. Preclinical studies have focused on the effect of direct and indirect iNOS inhibitors in both animal and human tissues...
March 5, 2018: Expert Opinion on Therapeutic Targets
Shannon Stark Taylor, Eugene Z Oddone, Cynthia J Coffman, Amy S Jeffreys, Hayden B Bosworth, Kelli D Allen
PURPOSE: Although non-pharmacological interventions have been shown to improve physical functioning in individuals with osteoarthritis (OA), the mechanisms by which this occurs are often unclear. This study assessed whether changes in arthritis self-efficacy, perceived pain control, and pain catastrophizing mediated changes in physical functioning following an osteoarthritis intervention involving weight management, physical activity, and cognitive-behavioral pain management. METHOD: Three hundred Veteran patients of 30 primary care providers with knee and/or hip OA were cluster randomized to an OA intervention group or usual care...
February 16, 2018: International Journal of Behavioral Medicine
Augustine C Lee, William F Harvey, Lori Lyn Price, Xingyi Han, Jeffrey B Driban, Maura D Iversen, Sima A Desai, Hans E Knopp, Chenchen Wang
BACKGROUND: Therapeutic exercise is a currently recommended non-pharmacological treatment for knee osteoarthritis (KOA). The optimal treatment dose (frequency or duration) has not been determined. OBJECTIVE: To examine dose-response relationships, minimal effective dose, and baseline factors associated with the timing of response from two exercise interventions in KOA. DESIGN: Secondary analysis of a single-blind, randomized trial comparing 12-week Tai Chi and Physical Therapy exercise programs (Trial Registry #NCT01258985)...
January 30, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
Emmanuel Coudeyre, Christelle Nguyen, Aurore Chabaud, Bruno Pereira, Johann Beaudreuil, Jean-Marie Coudreuse, Philippe Deat, Frédéric Sailhan, Alain Lorenzo, François Rannou
OBJECTIVE: To develop a decision-making tool (DMT) to facilitate the prescription of knee orthoses for patients with osteoarthritis (OA) in daily practice. METHODS: A steering committee gathered a multidisciplinary task force experienced in OA management/clinical research. Two members performed a literature review with qualitative analysis of the highest-quality randomized controlled trials and practice guidelines to confirm evidence concerning knee orthosis for OA...
February 2, 2018: Annals of Physical and Rehabilitation Medicine
Seyed Ahmad Raeissadat, Seyed Mansoor Rayegani, Bijan Forogh, Porya Hassan Abadi, Mahsa Moridnia, Shahram Rahimi Dehgolan
Purpose: Knee osteoarthritis (OA) is a common disease, imposing a great burden through pain and decreased function. There are many therapeutic modalities including non-pharmacologic choices and oral, topical, and intra-articular medications. New studies have shown promising results for ozone application in knee OA. Our aim was to compare the effects of ozone therapy versus hyaluronic acid (HA) intra-articular injection in knee OA patients. Methods: In this randomized clinical trial, a total of 174 patients with more than 3 months of chronic pain or swelling in the knee joints along with consistent imaging findings were enrolled and randomly allocated into two groups of HA and ozone, which were planned to undergo 3 weekly injections of HA (Hyalgan®) and 10 mL of a 30 μg/mL ozone solution, respectively...
2018: Journal of Pain Research
Songjiang Yin, Peimin Wang, Runlin Xing, Linrui Zhao, Xiaochen Li, Li Zhang, Yancheng Xiao
Transient receptor potential ankyrin 1 (TRPA1) is a membrane-associated cation channel, widely expressed in neuronal and non-neuronal cells. Recently, emerging evidences suggested the crucial role of TRPA1 in the disease progression of osteoarthritis (OA). Therefore, we aimed to investigate whether TRPA1 mediate lipopolysaccharide (LPS)-induced inflammatory responses in primary human OA fibroblast-like synoviocytes (OA-FLS). The expression of TRPA1 in LPS-treated OA-FLS was assessed by polymerase chain reaction (PCR) and western blot (WB), and the functionality of TRPA1 channel by Ca2+ influx measurements...
January 9, 2018: Inflammation
Holly Jackson, Lauren A Barnett, Kelvin P Jordan, Krysia S Dziedzic, Elizabeth Cottrell, Andrew G Finney, Zoe Paskins, John J Edwards
OBJECTIVE: To determine common patterns of recorded primary care for osteoarthritis (OA), and patient and provider characteristics associated with the quality of recorded care. DESIGN: An observational study nested within a cluster-randomised controlled trial. SETTING: Eight UK general practices who were part of the Management of Osteoarthritis in Consultations study. PARTICIPANTS: Patients recorded as consulting within the eight general practices for clinical OA...
December 29, 2017: BMJ Open
A E Nelson
This review is based on a systematic review of the literature relevant to clinical topics in osteoarthritis (OA) performed for the time period February 22, 2016 to April 1, 2017. A PubMed search using the terms "osteoarthritis" and "treatment or epidemiology" returned over 800 papers, of which 57 are reviewed here, with inclusion primarily based on relevance to clinical OA. Epidemiologic studies in this time frame focused on the incidence and prevalence of OA, comorbidities and mortality in relation to OA (particularly obesity and cardiovascular disease), and multiple joint involvement...
March 2018: Osteoarthritis and Cartilage
D S Amaral, A L B P Duarte, S S Barros, S V Cavalcanti, A Ranzolin, V M M Leite, A T Dantas, A S C R C Oliveira, P S Santos, J C A Silva, C D L Marques
This study aims to evaluate the use of assistive devices as a strategy in non-pharmacological treatment for hand osteoarthritis (HOA). This is a randomized, prospective, parallel, assessor-blinded clinical trial, in which patients with a diagnosis of HOA were randomly allocated to an intervention group (IG), where they received assistive devices for daily life activities, or to a control group (CG), where they received a guideline leaflet with information on joint protection and disease features. The primary outcomes considered were occupational performance, measured by the Canadian Occupational Performance Measure (COPM), and hand function was evaluated through the Score for the Assessment and Quantification of Chronic Rheumatoid Affections of the Hands (SACRAH)...
March 2018: Rheumatology International
Sara Tenti, Nicola Antonio Pascarelli, Stefano Giannotti, Mauro Galeazzi, Nicola Giordano, Antonella Fioravanti
BACKGROUND: Osteoarthritis (OA) of the trapeziometacarpal joint (TMJ) is a disabling condition with a significant impact on quality of life. The optimal management of hand OA requires a combination of non-pharmacological and pharmacological treatments that include intra-articular (i.a.) therapy. EULAR experts recommend corticosteroid injections in TMJ OA and underline the usefulness of hyaluronic acid (HA). The aim of this study was the assessment of the efficacy and tolerability of i...
November 13, 2017: BMC Musculoskeletal Disorders
Jochen Schmitt, Toni Lange, Klaus-Peter Günther, Christian Kopkow, Elisabeth Rataj, Christian Apfelbacher, Martin Aringer, Eckhardt Böhle, Hartmut Bork, Karsten Dreinhöfer, Niklaus Friederich, Karl-Heinz Frosch, Sascha Gravius, Erika Gromnica-Ihle, Karl-Dieter Heller, Stephan Kirschner, Bernd Kladny, Hendrik Kohlhof, Michael Kremer, Nicolai Leuchten, Maike Lippmann, Jürgen Malzahn, Heiko Meyer, Rainer Sabatowski, Hanns-Peter Scharf, Johannes Stoeve, Richard Wagner, Jörg Lützner
Background and Objectives Knee osteoarthritis (OA) is a significant public health burden. Rates of total knee arthroplasty (TKA) in OA vary substantially between geographical regions, most likely due to the lack of standardised indication criteria. We set out to define indication criteria for the German healthcare system for TKA in patients with knee OA, on the basis of best evidence and transparent multi-stakeholder consensus. Methods We undertook a complex mixed methods study, including an iterative process of systematic appraisal of existing evidence, Delphi consensus methods and stakeholder conferences...
October 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
Mario Maresca, Laura Micheli, Lorenzo Cinci, Anna Rita Bilia, Carla Ghelardini, Lorenzo Di Cesare Mannelli
OBJECTIVES: The evaluation of the pharmacological profile of the dried 50% hydroalcoholic extract (50%HA) of Astragali radix in two different animal models of articular damage resembling osteoarthritis and rheumatoid arthritis. METHODS: Sodium monoiodoacetate (MIA) or complete Freund's adjuvant (CFA) was intra-articular injected (day 0) in the rat tibiotarsal joint to induce damages mimicking osteoarthritis or rheumatoid arthritis. Pain measurements (responses to non-noxious and noxious stimuli, spontaneous pain, articular pain) were assessed on days 7 and 14...
September 29, 2017: Journal of Pharmacy and Pharmacology
Ellen M H Selten, Johanna E Vriezekolk, Marc W Nijhof, Henk J Schers, Roelien G van der Meulen-Dilling, Willemijn H van der Laan, Rinie Geenen, Cornelia H M van den Ende
BACKGROUND: Non-pharmacological, non-surgical treatment modalities are underused in the management of knee and hip osteoarthritis (OA). One possible explanation for this could be healthcare providers' opinions about these treatment modalities. The objective of this qualitative study was to identify healthcare providers' views on non-pharmacological, non-surgical care for OA. METHODS: Semi-structured in-depth interviews with 24 healthcare providers (rheumatologists, orthopedic surgeons, physical therapists and general practitioners) were held...
December 2017: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
Semra Aciksoz, Aygul Akyuz, Servet Tunay
AIMS AND OBJECTIVES: To investigate the effect of the self-administered superficial local hot and cold applications on pain, and the functional status and the quality of life in primary knee osteoarthritis patients. BACKGROUND: Superficial local hot and cold application is used as a nonpharmacological method for the treatment of knee osteoarthritis. However, various guidelines for the management of knee osteoarthritis have conflicting recommendation for hot and cold therapy...
December 2017: Journal of Clinical Nursing
Walter Hermann, Sevdalina Lambova, Ulf Müller-Ladner
Background: Osteoarthritis (ОА) is the most common joint disease and a leading cause for impaired function and disability with significant treatment costs and socio-economic burden. Despite recent achievements in the knowledge on disease pathogenesis, the treatment is still a challenge and contrary to inflammatory joint diseases, no disease-modifying drugs are currently available for OA. Objectives: Despite recent achievements in the knowledge on disease pathogenesis, the treatment is still a challenge and contrary to inflammatory joint diseases, no disease-modifying drugs are currently available for OA...
August 29, 2017: Current Rheumatology Reviews
Yafei Jiang, Libo Zhu, Tao Zhang, Haiming Lu, Cong Wang, Bao Xue, Xun Xu, Yu Liu, Zhengdong Cai, Weilin Sang, Yingqi Hua, Jinzhong Ma
Osteoarthritis (OA) has traditionally been defined as a non-inflammatory disease. Recently, many studies have demonstrated that OA also has an inflammatory component. BRD4, a member of the Bromodomain and Extra-Terminal Domain family, has emerged as an important regulator of some chronic inflammatory diseases. JQ1, an antagonist of BRD4, modulates transcription of several genes. Our study demonstrated that BRD4 is up-regulated in articular cartilage of OA. BRD4 inhibition attenuated the inflammation and catabolism of chondrocytes and suppressed NF-κB signalling pathway activation...
August 24, 2017: Biochimica et Biophysica Acta
Thierry Conrozier
Viscosupplementation with intra-articular injections of hyaluronic acid is recommended as a second line treatment for knee OA, after failure of non-pharmacological modalities and usual pain killers. Nevertheless there is still controversies regarding clinical relevance of its effects. Research is looking at the best means to improve the performance of viscosupplementation in order to obtain a faster, more sustainable and more marked effect. Antioxidants have been assessed in combination with hyaluronic acid because the injected hyaluronate is rapidly degraded by the reactive oxygen species present in large amounts in the OA synovial fluid, limiting its residence time into the joint...
July 10, 2017: Current Rheumatology Reviews
S Lue, S Koppikar, K Shaikh, D Mahendira, T E Towheed
OBJECTIVE: To update our earlier systematic reviews which evaluated all published randomized controlled trials (RCTs) evaluating pharmacological and non-pharmacological therapies in patients with hand osteoarthritis (OA). Surgical therapies were not evaluated. DESIGN: RCTs published between March 2008 and December 2015 were added to the previous systematic reviews. RESULTS: A total of 95 RCTs evaluating various pharmacological and non-pharmacological therapies in hand OA were analyzed in this update...
September 2017: Osteoarthritis and Cartilage
Deepak Ramanathan, Anas Saleh, Alison K Klika, Carlos A Higuera, Wael K Barsoum
INTRODUCTION: Multimodal pain management is used after total knee arthroplasty (TKA) to reduce opioid intake. Transcutaneous electrical nerve stimulation (TENS) has generated much interest as a non-pharmacologic, patient-controlled therapy. The aims of this study were to evaluate the efficacy of TENS in reducing opioid intake and improving recovery after TKA. MATERIALS AND METHODS: This was a prospective, parallel-group, double-blinded, randomized trial of patients receiving femoral nerve catheter block with allocation to either active or placebo TENS device groups...
May 24, 2017: Surgical Technology International
Augustine C Lee, William F Harvey, Lori Lyn Price, Xingyi Han, Jeffrey B Driban, John B Wong, Mei Chung, Timothy E McAlindon, Chenchen Wang
OBJECTIVE: To examine the association between baseline mindfulness and response from exercise interventions in knee osteoarthritis (OA). DESIGN: Cohort study; responder analysis of a clinical trial subset. SETTING: Urban tertiary care academic hospital. PARTICIPANTS: Participants with symptomatic, radiographic knee OA (N=86; mean age, 60y; 74% female; 48% white). INTERVENTIONS: Twelve weeks (twice per week) of Tai Chi or physical therapy exercise...
November 2017: Archives of Physical Medicine and Rehabilitation
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