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Modalities for knee pain

Chetan Gohal, Ajaykumar Shanmugaraj, Patrick Tate, Nolan S Horner, Asheesh Bedi, Anthony Adili, Moin Khan
CONTEXT: Knee osteoarthritis affects 9.3 million adults over age 45 years in the United States. There is significant disability associated with this condition. Given the potential complications and the significant cost to the health care system with the dramatic increase in total knee arthroplasties performed for this condition, assessment of the efficacy of nonoperative modalities, such as offloading knee braces, is essential as part of optimizing nonoperative treatment for this condition...
March 1, 2018: Sports Health
John W Barrington, Ryan N Hansen, Belinda Lovelace, Elaine A Böing, Morad Chughtai, Jared M Newman, An T Pham, Anton Khlopas, Nipun Sodhi, Assem A Sultan, Michael A Mont
Postoperative pain remains difficult to control after total knee arthroplasty (TKA). While various modalities have been used, they have been associated with several side effects. For example, opioids have many side effects including: sedation, dizziness, nausea, vomiting, constipation, respiratory depression, and can lead to dependency. Recently, intravenous (IV) acetaminophen has been introduced as a method to manage postoperative pain. Therefore, the purpose of this study was to compare the postoperative outcomes of TKA patients who received oral acetaminophen versus IV acetaminophen...
March 7, 2018: Journal of Knee Surgery
Jariya Boonhong, Phitsanu Suntornpiyapan
BACKGROUND: Ultrasound combined with transcutaneous electrical nerve stimulation (UltraTENS) and phonophoresis of piroxicam (PhP) are combined modality therapy that frequently used in musculoskeletal pain including knee osteoarthritis (OA). But it is lack of a good clinical trial to prove and compare their effects. OBJECTIVE: To compare the effects of UltraTENS with PhP on mild to moderate degree of symptomatic knee OA. METHODS: Sixty-one patients (55 women), mean age of 63...
February 2, 2018: Journal of Back and Musculoskeletal Rehabilitation
Christian S Kessler, Kartar S Dhiman, Abhimanyu Kumar, Thomas Ostermann, Shivenarain Gupta, Antonio Morandi, Martin Mittwede, Elmar Stapelfeldt, Michaela Spoo, Katja Icke, Andreas Michalsen, Claudia M Witt
OBJECTIVE: Ayurveda is commonly used in South Asia to treat knee osteoarthritis (OA). We aimed to evaluate the effectiveness of Ayurvedic treatment compared to conventional conservative care in patients with knee OA. METHOD: According to American College of Rheumatology (ACR) criteria knee OA patients were included in a multicenter randomized, controlled, open-label trial and treated in 2 hospital clinics and 2 private outpatient clinics in Germany. Participants received either a multi-modal Ayurvedic treatment or multi-modal conventional care with 15 treatments over 12 weeks respectively...
February 6, 2018: Osteoarthritis and Cartilage
Roshan das Nair, Jacqueline R Mhizha-Murira, Pippa Anderson, Hannah Carpenter, Simon Clarke, Sam Groves, Paul Leighton, Brigitte E Scammell, Gogem Topcu, David A Walsh, Nadina B Lincoln
OBJECTIVE: To determine the feasibility of conducting a trial of a pre-surgical psychological intervention on pain, function, and mood in people with knee osteoarthritis listed for total knee arthroplasty. DESIGN: Multi-centre, mixed-methods feasibility randomized controlled trial of intervention plus usual care versus usual care. SETTING: Participants' homes or hospital. PARTICIPANTS: Patients with knee osteoarthritis listed for total knee arthroplasty and score >7 on either subscales of Hospital Anxiety and Depression Scale...
February 1, 2018: Clinical Rehabilitation
Matthew T Philippi, Timothy L Kahn, Temitope F Adeyemi, Travis G Maak, Stephen K Aoki
Many hip arthroscopy patients experience significant pain in the immediate postoperative period. Although peripheral nerve blocks have demonstrated efficacy in alleviating some of this pain, they come with significant costs. Local infiltration analgesia (LIA) may be a significantly cheaper and efficacious treatment modality. Although LIA has been well studied in hip and knee arthroplasty, its efficacy in hip arthroscopy is unclear. The purpose of this retrospective study is to determine the efficacy of a single extracapsular injection of bupivacaine-epinephrine during hip arthroscopy in reducing the rate of elective postoperative femoral nerve blocks...
January 2018: Journal of Hip Preservation Surgery
Morad Chugthai, Jared M Newman, Samuel Akil, Anton Khlopas, Assem A Sultan, Nipun Sodhi, Anil Bhave, Steven F Harwin, Michael A Mont
Knee pain is a highly prevalent condition in the United States with multiple etiologies, with two of the most common sources being osteoarthritis (OA) and patellofemoral pain (PFP). These conditions can lead to reduced physical function and a poor quality of life. Various modalities have been used to decrease the amount of knee pain that individuals' experience; however, they are not always successful and can be expensive. Several studies have reported on specialized footwear for symptomatic alleviation of conditions that affect the knee, this is because it has been theorized that certain footwear can alter the forces placed by muscles on lower-extremity joints, and can potentially alleviate pain by reducing the load placed on the joint...
February 8, 2018: Journal of Knee Surgery
Rachelle Buchbinder, Allison Bourne
BACKGROUND: Despite the availability of consistent guidelines recommending against arthroscopic treatment for people with symptomatic knee osteoarthritis, Australian data indicate continued use of this treatment modality. A paucity of easy to understand and reliable consumer information about knee arthroscopy may be one explanatory factor. The aim of this study was to determine whether consumer information about knee arthroscopy available in Australia is adequate to inform evidence-based decision-making for people with symptomatic osteoarthritis...
January 30, 2018: ANZ Journal of Surgery
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
Chi-Yu Wang, Chun-Kai Chang, Chang-Yi Chou, Chien-Ju Wu, Tzi-Shiang Chu, Hao-Yu Chiao, Chun-Yu Chen, Tim-Mo Chen, Yuan-Sheng Tzeng
INTRODUCTION: Plantar hyperkeratosis, such as corns and calluses, is common in older people and associated with pain, mobility impairment, and functional limitations. It usually develops on the palms, knees, or soles of feet, especially under the heels or balls. There are several treatment methods for plantar hyperkeratosis, such as salicylic acid plaster and scalpel debridement, and conservative modalities, such as using a shoe insert and properly fitting shoes. METHODS: We present an effective method of reconstructing the wound after corn excision using a split-thickness sole skin graft (STSSG)...
January 24, 2018: Annals of Plastic Surgery
Kara Gaetke-Udager, Corrie M Yablon
Ligamentous structures of the knee are numerous and complex, including the anterior and posterior cruciate ligaments, medial and lateral collateral ligaments, ligaments of the posteromedial and posterolateral corners, and the anterolateral ligament. Clinical assessment after a knee injury is paramount and can direct both the clinician's choice of imaging study and the radiologist's interpretation. Imaging is crucial in that it provides additional information for diagnosis, management, and surgical planning...
February 2018: Journal of Knee Surgery
Assem A Sultan, William A Cantrell, Morad Chughtai, Prem N Ramkumar, Anton Khlopas, Jared M Newman, Nipun Sodhi, Suela Lamaj, Timothy C Wagner, Linsen T Samuel, Michael A Mont
Knee osteonecrosis is a rare, yet debilitating disease that can lead to knee joint destruction and can be associated with significant pain and disability. Various imaging modalities have different roles in the diagnosis, staging, management, and determination of the prognosis in knee osteonecrosis. Plain radiographic images can show gross joint destruction and secondary arthritic changes. In addition, magnetic resonance imaging (MRI) has become the gold-standard imaging modality to diagnose osteonecrosis. Multiple classification systems have been developed for knee osteonecrosis based on these imaging modalities...
December 22, 2017: Surgical Technology International
Nipun Sodhi, Benjamin Yao, Anton Khlopas, Iyooh U Davidson, Assem A Sultan, Linsen T Samuel, Suela Lamaj, Jared M Newman, Robert Pivec, Kristy A Fisher, Benjamin Gaal, Michael A Mont
BACKGROUND: Non-operative management of the elbow, shoulder, and knee typically includes braces, such as the: static progressive stretch (SPS), turnbuckle, and dynamic. However, a paucity of literature exists comparing these three bracing modalities. Therefore, the purpose of this study was to evaluate the current literature on the various bracing modalities for physicians and patients managing elbow, shoulder, or knee joint complications. Specifically, we compared the use of 1) static progressive stretch, 2) dynamic, and 3) turnbuckle braces for the a) elbow, b) knee, and c) shoulder...
December 22, 2017: Surgical Technology International
Ebru Kaya Mutlu, Ersin Ercin, Arzu Razak Ozdıncler, Nadir Ones
A broad spectrum of physical therapy exercise programs provides symptom relief and functional benefit for patients with knee OA. Manual physical therapy, including tailored exercise programs provide relatively higher level benefit that persists to one year. It is currently unknown if there are important differences in the effects of different manual physical therapy techniques for patients with knee OA and there are virtually no studies comparing manual physical therapy and electrotherapy modalities. The aim of the study was to compare long-term results between three treatment groups (mobilization with movements [MWMs], passive joint mobilization [PJM], and electrotherapy) to determine which treatment is most effective in patients with knee OA...
January 8, 2018: Physiotherapy Theory and Practice
Nagwa Mohammed, Hemat Allam, Eman Elghoroury, Emad N Zikri, Ghada A Helmy, Aliaa Elgendy
Background Laser acupuncture is one of the complementary modalities used for treating osteoarthritis. The study was performed to evaluate the effectiveness of laser acupuncture in the treatment of grade 2 knee osteoarthritis. Patients and methods Forty patients having bilateral knee osteoarthritis were divided into two groups (20 patients in each group). The patients of the first group were subjected to 12 laser sessions at the following acupoints (St 35, St36, Sp9, Sp10 and Gb 34). During each session, laser of 90 mw was directed to each acupoint for 1 min giving energy of 5...
January 5, 2018: Journal of Complementary & Integrative Medicine
Jad S Husseini, Connie Y Chang, William E Palmer
The tendons of the knee play a critical role in the motion and stability of the knee. Knee pain, a common clinical complaint, can frequently be attributed to pathology of these structures. While the cornerstones of the radiological evaluation of the knee are radiography and magnetic resonance imaging, ultrasound can also play an important diagnostic role and can be useful for guided interventional procedures. Understanding the utility of each modality in the assessment for tendon pathology and a familiarity with the normal and abnormal imaging appearance of these structures are crucial for accurate diagnosis...
February 2018: Journal of Knee Surgery
Emira Svraka, Muris Pecar, Amila Jaganjac, Amra Macak Hadziomerovic, Eldad Kaljic, Almir Kovacevic
Introduction: Osteoarthritis of the joints (osteoarthritis or arthritis) represents the largest group of rheumatic diseases. Within rheumatic diseases 50% are degenerative rheumatic diseases, 10% inflammatory and 40% extra-articular. Goal: To determine the modalities of physical therapy for elderly with degenerative diseases. Material and methods: The study is retrospective-prospective and descriptive. The survey conducted included 25 patients with degenerative diseases of the musculoskeletal and nervous systems in Gerontology Center in Sarajevo, from May 1, 2014- April 30, 2015...
December 2017: Materia Socio-medica
Jiao Xu, Juan Zhang, Xue-Qiang Wang, Xuan-Lin Wang, Ya Wu, Chan-Cheng Chen, Han-Yu Zhang, Zhi-Wan Zhang, Kai-Yi Fan, Qiang Zhu, Zhi-Wei Deng
BACKGROUND: Total knee arthroplasty (TKA) has become the most preferred procedure by patients for the relief of pain caused by knee osteoarthritis. TKA patients aim a speedy recovery after the surgery. Joint mobilization techniques for rehabilitation have been widely used to relieve pain and improve joint mobility. However, relevant randomized controlled trials showing the curative effect of these techniques remain lacking to date. Accordingly, this study aims to investigate whether joint mobilization techniques are valid for primary TKA...
December 2017: Medicine (Baltimore)
R Papalia, G Papalia, F Russo, L A Diaz, F Bressi, S Sterzi, V Denaro
Meniscal extrusion (ME) has shown to play a critical but still unclear role in osteoarthritis (OA) development. ME has been described as an important risk factor in the progression of knee OA, as it is involved in the thinning of articular cartilage, joint space narrowing, spontaneous osteonecrosis of the knee and subchondral bone marrow lesions. Meniscal damage of any degree of severity could cause ME in both compartments, but it is commonly associated with severe meniscal tears or root tears mainly in the medial meniscus...
December 27, 2017: Journal of Biological Regulators and Homeostatic Agents
Ivan Lin, Louise K Wiles, Robert Waller, Roger Goucke, Yusuf Nagree, Michael Gibberd, Leon Straker, Christopher G Maher, Peter P B O'Sullivan
OBJECTIVES: Undertake a systematic critical appraisal of contemporary clinical practice guidelines (CPGs) for common musculoskeletal (MSK) pain conditions: spinal (lumbar, thoracic and cervical), hip/knee (including osteoarthritis) and shoulder. DESIGN: Systematic review of CPGs (PROSPERO number: CRD42016051653).Included CPGs were written in English, developed within the last 5 years, focused on adults and described development processes. Excluded CPGs were for: traumatic MSK pain, single modalities (eg, surgery), traditional healing/medicine, specific disease processes (eg, inflammatory arthropathies) or those that required payment...
March 2018: British Journal of Sports Medicine
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