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Practice guidelines for knee osteoarthritis

Julia Hart, Michelle Hall, Tim V Wrigley, Charlotte J Marshall, Kim L Bennell
BACKGROUND: Walking canes are a self-management strategy recommended for people with knee osteoarthritis (OA) by clinical practice guidelines. Ensuring that an adequate amount of body-weight support (%BWS) is taken through the walking cane is important as this reduces measures of knee joint loading. RESEARCH QUESTION: 1) How much body weight support do people with knee OA place through a cane? 2) Do measures of body weight support increase following a brief simple training session? METHODS: Seventeen individuals with knee pain who had not used a walking cane before were recruited...
September 24, 2018: Gait & Posture
Vincent Marot, Jérôme Murgier, Alessandro Carrozzo, Nicolas Reina, Edoardo Monaco, Philippe Chiron, Emilie Berard, Etienne Cavaignac
PURPOSE: The KOOS questionnaire is used to assess the symptoms and function of patients with traumatic or degenerative knee pathology. The WOMAC score has been validated mainly in the context of knee osteoarthritis. The distribution of these scores in a non-diseased population is not known. The hypothesis was that KOOS and WOMAC scores were influenced by patients' age, sex, and BMI. The primary objective of this study was to describe, for the first time, the distribution of KOOS and WOMAC scores in a healthy population based on age, sex, and BMI...
September 24, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
C Bartholdy, S M Nielsen, S Warming, D J Hunter, R Christensen, M Henriksen
OBJECTIVE: To examine the reporting completeness of exercise-based interventions for knee osteoarthritis (OA) in studies that forms the basis of current clinical guidelines, and examine if the clinical benefit (pain and disability) from exercise is associated with the intervention reporting completeness. DESIGN: Review of clinical OA guidelines METHODS: We searched MEDLINE and EMBASE for guidelines published between 2006 and 2016 including recommendations about exercise for knee OA...
September 22, 2018: Osteoarthritis and Cartilage
Dan Xing, Qi Wang, Ziyi Yang, Yunfei Hou, Wei Zhang, Yaolong Chen, Jianhao Lin
OBJECTIVE: To formulate and evaluate clinical questions about intra-articular injection for knee osteoarthritis in developing clinical practice guidelines and to introduce a new methodology for framing relevant questions. METHODS: We framed the clinical questions and evaluated the importance of these questions according to the following four steps: (a) first round questionnaire survey intended to get the clinical questions from doctors; (b) evaluating importance of questions via second round questionnaire survey intended to summarize and rank the clinical questions; (c) consensus conference was conducted by clinical and methodological experts; and (d) confirm the important clinical questions according to PICO (Patients, Intervention, Comparison and Outcomes) principles...
August 2018: International Journal of Rheumatic Diseases
Aderson Loureiro, Maria Constantinou, Laura E Diamond, Belinda Beck, Rod Barrett
BACKGROUND: Individuals with advanced hip osteoarthritis (OA) exhibit generalized muscle weakness of the affected limb and so clinical practice guidelines recommend strength training for the management of hip OA. However, the extent and pattern of muscle weakness, including any between-limb asymmetries, in early stages of the disease are unclear. This study compared hip and knee muscle strength and volumes between individuals with mild-to-moderate symptomatic and radiographic hip OA and a healthy control group...
August 21, 2018: BMC Musculoskeletal Disorders
Jane O'Brien, Kyra Hamilton, Andrew Williams, James Fell, Jonathan Mulford, Michael Cheney, Sam Wu, Marie-Louise Bird
BACKGROUND: Osteoarthritis often results in prolonged periods of reduced physical activity and is associated with adverse health outcomes, including increased risk of cardiovascular and metabolic diseases. Exercise interventions for patients on the waiting list for arthroplasty can reduce the risk of long-term adverse outcomes by increasing activity levels. However, uptake and ongoing positive rates of physical activity in this population are low and the impact of pre-operative behaviour counselling on exercise is not known...
August 7, 2018: Trials
Emmanuel Maheu, Raveendhara R Bannuru, Gabriel Herrero-Beaumont, Fadoua Allali, Hervé Bard, Alberto Migliore
OBJECTIVES: There is a discrepancy between evidence in support of the widespread use of intra-articular hyaluronic acid (IAHA) to treat knee osteoarthritis (OA) in clinical practice, and the often discordant recommendations from multiple international guideline committees, which requires further investigation. METHODS: We conducted a literature review to determine the strength of evidence in support of the efficacy and safety of IAHA, from randomized controlled trials and meta-analyses...
June 19, 2018: Seminars in Arthritis and Rheumatism
Jianji Wang, Long Yang, Qingjun Li, Zhanyu Wu, Yu Sun, Qiang Zou, Xuanze Li, Zhe Xu, Chuan Ye
BACKGROUND: Knee osteoarthritis (KOA) is one of the most common chronic diseases in the elderly and is the primary cause of the loss of motor function and disability in this population. Exercise therapy is a core, basic and matureand treatment method of treating patients with KOA. Exercise therapy is "strongly recommended" or "recommended" in the diagnosis and treatment guidelines of osteoarthritis in many countries, and most scholars advocate exercise therapy as the preferred rehabilitation method for KOA patients...
July 27, 2018: BMC Musculoskeletal Disorders
Yves Henrotin, Xavier Chevalier, Raghu Raman, Pascal Richette, Jordi Montfort, Jörg Jerosch, Dominique Baron, Hervé Bard, Yannick Carrillon, Alberto Migliore, Thierry Conrozier
Objectives Hyaluronic acid viscosupplementation is a commonly used intra-articular treatment for osteoarthritis (OA). Some recent preclinical and clinical trials have demonstrated a potential for its disease-modifying effects. The goal of this expert opinion, consensus-driven exercise is to provide guidelines for the design and conduct of clinical trials assessing the disease-modifying effect of viscosupplementation in the knee. Methods The EUROVISCO group constitutes 10 members who had expertise in clinical research methodology in the field of OA and viscosupplementation...
July 1, 2018: Cartilage
Debbie Amini, Deborah Lieberman, Elizabeth Hunter
Evidence Connection articles provide a clinical application of systematic reviews developed in conjunction with the American Occupational Therapy Association's (AOTA's) Evidence-Based Practice Project. In this Evidence Connection article, we describe a case report of a person who underwent a total knee replacement due to severe osteoarthritis of his left knee. The occupational therapy assessment and intervention process both before and after surgery in the home setting is described. Findings from the systematic review (Dorsey & Bradshaw, 2017) on this topic were published in the January/February 2017 issue of the American Journal of Occupational Therapy and in AOTA's Occupational Therapy Practice Guidelines for Adults With Musculoskeletal Conditions...
July 2018: American Journal of Occupational Therapy: Official Publication of the American Occupational Therapy Association
Esther Waugh, Lauren King, Natasha Gakhal, Gillian Hawker, Fiona Webster, Daniel White
Physical activity (PA) is recommended by osteoarthritis (OA) international organizations as an essential component of first-line management of knee OA. Primary care physicians (PCP) and rheumatologists can play a key role in promoting PA but the extent that PA recommendation is occurring in primary and rheumatology care is unclear. This review provides an overview of current practice of PCP- and rheumatology-delivered PA intervention in the United States, Canada and Europe for the management of knee OA and explores barriers to implementing PA intervention in primary and rheumatology care...
June 19, 2018: Arthritis Care & Research
Stijn Van de Velde, Tiina Kortteisto, David Spitaels, Gro Jamtvedt, Pavel Roshanov, Ilkka Kunnamo, Bert Aertgeerts, Per Olav Vandvik, Signe Flottorp
BACKGROUND: Clinical practice patterns greatly diverge from evidence-based recommendations to manage knee osteoarthritis conservatively before resorting to surgery. OBJECTIVE: This study aimed to tailor a guideline-based computerized decision support (CDS) intervention that facilitates the conservative management of knee osteoarthritis. METHODS: Experts with backgrounds in clinical medicine, research, implementation, or health informatics suggested the most important recommendations for implementation, how to develop an implementation strategy, and how to form the CDS algorithms...
June 11, 2018: JMIR Research Protocols
Corelien J J Kloek, Daniël Bossen, Peter M Spreeuwenberg, Joost Dekker, Dinny H de Bakker, Cindy Veenhof
Background: Integrating physical therapy sessions and an online application (e-Exercise) might support people with hip osteoarthritis (OA), knee OA, or both (hip/knee OA) in taking an active role in the management of their chronic condition and may reduce the number of physical therapy sessions. Objective: The objective of this study was to investigate the short- and long-term effectiveness of e-Exercise compared to usual physical therapy in people with hip/knee OA...
July 1, 2018: Physical Therapy
Nicholas A Bedard, David E DeMik, Natalie A Glass, Robert A Burnett, Kevin J Bozic, John J Callaghan
BACKGROUND: The efficacy of corticosteroid and hyaluronic acid injections for knee osteoarthritis has been questioned. The purpose of this study was to determine the impact of the American Academy of Orthopaedic Surgeons (AAOS) clinical practice guidelines on the use of these injections in the United States and determine if utilization differed by provider specialty. METHODS: Patients with knee osteoarthritis were identified within the Humana database from 2007 to 2015, and the percentage of patients receiving a knee injection relative to the number of patients having an encounter for knee osteoarthritis was calculated and was trended for the study period...
May 16, 2018: Journal of Bone and Joint Surgery. American Volume
Jared Scott, Jake Xavier Checketts, Jarryd G Horn, Craig Cooper, Matt Vassar
PURPOSE: An estimated 85% of research is of limited value or wasted because the wrong research questions are addressed. We sought to identify research gaps using American Academy of Orthopaedic Surgeon (AAOS) clinical practice guidelines Treatment of Osteoarthritis of the Knee and Surgical Management of Osteoarthritis of the Knee. Using these recommendations, we conducted searches of to discover the extent to which new and ongoing research addresses areas of deficiency...
September 2018: International Orthopaedics
Linda C Li, Eric C Sayre, Hui Xie, Ryan S Falck, John R Best, Teresa Liu-Ambrose, Navi Grewal, Alison M Hoens, Greg Noonan, Lynne M Feehan
BACKGROUND: Current practice guidelines emphasize the use of physical activity as the first-line treatment of knee osteoarthritis; however, up to 90% of people with osteoarthritis are inactive. OBJECTIVE: We aimed to assess the efficacy of a technology-enabled counseling intervention for improving physical activity in people with either a physician-confirmed diagnosis of knee osteoarthritis or having passed two validated criteria for early osteoarthritis. METHODS: We conducted a proof-of-concept randomized controlled trial...
April 30, 2018: Journal of Medical Internet Research
Robert H Quinn, Jayson N Murray, Ryan Pezold, Kaitlyn S Sevarino
The American Academy of Orthopaedic Surgeons has developed Appropriate Use Criteria (AUC) for Surgical Management of Osteoarthritis of the Knee. Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the criteria to improve patient care and obtain best outcomes while considering the subtleties and distinctions necessary in making clinical decisions. The Surgical Management of Osteoarthritis of the Knee AUC clinical patient scenarios were derived from indications of patients under consideration for surgical treatment of osteoarthritis of the knee as well as from current evidence-based clinical practice guidelines and supporting literature to identify the appropriateness of the three treatments...
May 1, 2018: Journal of the American Academy of Orthopaedic Surgeons
Jean-Pierre Pelletier, Jean-Pierre Raynauld, François Abram, Marc Dorais, Philippe Delorme, Johanne Martel-Pelletier
BACKGROUND: The weight of recommendation for intra-articular therapies such as hyaluronic acid injections varies from one set of guidelines to another, and they have not yet reached unanimity with respect to the usefulness of intra-articular hyaluronic acid (IAHA) injections for the symptomatic treatment of knee osteoarthritis (OA). Among the reasons for the controversy is that the current literature provides inconsistent results and conclusions about such treatment. This study aimed at identifying determinants associated with a better response to IAHA treatment in knee OA...
March 1, 2018: Arthritis Research & Therapy
Thrmiga Sathiyamoorthy, Shabana Amanda Ali, Marita Kloseck
With the prevalence of osteoarthritis (OA) increasing internationally, there is a need to study the impact of this disease on culturally diverse populations. Individuals of Asian descent make up more than 60% of the world population, yet comprehensive information on the cultural factors that impact OA care is not available. Scoping review methodology using directed content analysis was employed to identify and analyze existing research on OA care for Asians. A categorization matrix was developed using the six care areas from the OA clinical practice guidelines along with an additional three non-clinical areas (cross-cultural adaptation of clinical tools; psychological well-being; family systems and informal care) identified in an initial scan resulting in a total of nine OA care areas to guide initial coding...
August 2018: Journal of Community Health
K Mills, M Hübscher, H O'Leary, N Moloney
Joint pain attributable to osteoarthritis (OA) is complex and influenced by a myriad of factors beyond local joint pathology. Current practice continues to predominantly adopt a biomedical approach to OA despite emerging evidence of the importance of a more holistic approach. This paper will summarise evidence for the presence of multidimensional pain profiles in knee joint pain and the presence of subgroups characterized by systemic features such as psychological distress, high comorbidity load or sensitisation of the nervous system...
February 20, 2018: Der Schmerz
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