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osteoarthritis and intraarticular injection and pain duration

Jeffrey S Kroin, Ranjan Kc, Xin Li, John L Hamilton, Vaskar Das, Andre J van Wijnen, Ole M Dall, Daniel A Shelly, Todd Kenworth, Hee-Jeong Im
Intraarticular steroid injection has been the mainstay of short-term treatment of knee osteoarthritis (OA) pain. However, the duration of therapeutic effect from a single injection is not as long as desired. In this study we use a viscous formulation of triamcinolone acetate (TCA) in hyaluronic acid to prolong the anti-allodynia effect of that steroid. OA was induced in mice by a partial medial meniscectomy. Over time the animals' developed a mechanical allodynia in the injected leg. Mice were then given a single intraarticular injection of TCA in a short-acting DMSO formulation, or a standard commercial suspension, or the drug formulated in 5% hyaluronic acid for slow-release...
October 10, 2016: Gene
Colbert E Chavez-Chiang, Wilmer L Sibbitt, Philip A Band, Natalia R Chavez-Chiang, Suzanne L DeLea, Arthur D Bankhurst
BACKGROUND: The extended knee lateral midpatellar portal for intraarticular injection of the knee is accurate but is not practical for all patients. We hypothesized that a modified anteriolateral portal where the synovial membrane of the medial femoral condyle is the target would be highly accurate and effective for intraarticular injection of the knee. METHODS: 83 subjects with non-effusive osteoarthritis of the knee were randomized to intraarticular injection using the modified anteriolateral bent knee versus the standard lateral midpatellar portal...
March 30, 2011: Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology: SMARTT
Jasvinder A Singh, Maren L Mahowald, Siamak Noorbaloochi
OBJECTIVE: To assess short-term efficacy of single intraarticular botulinum toxin (IA-BoNT/A) injection in patients with chronically painful total knee arthroplasty (TKA) in a randomized, placebo-controlled, triple-blind study. METHODS: Patients with chronic TKA pain (pain > 6 on 0-10 scale and > 6 months post-TKA) evaluated in and referred from orthopedic surgery clinics were recruited. The primary outcome, proportion of patients with clinically meaningful decrease of at least 2 points on 0-10 visual analog scale (VAS) for pain, was compared between treatment groups at 2 months using comparison of proportions test and for all efficacy timepoints (2, 3, and 4 months) using generalized estimating equations (GEE)...
November 2010: Journal of Rheumatology
Linda L Black, James Gaynor, Cheryl Adams, Sarit Dhupa, Andrew E Sams, Robert Taylor, Susan Harman, Daniel A Gingerich, Robert Harman
Autologous adipose-derived mesenchymal stem cell (AD-MSC) therapy involves harvesting fat from the patient, isolating the stem and regenerative cells, and administering the cells back to the patient. Autologous AD-MSC therapy in veterinary regenerative medicine has been commercially available since 2003. Previously reported results from a blinded, controlled trial in dogs with chronic osteoarthritis of the coxofemoral (hip) joint demonstrated efficacy of a single intraarticular injection of autologous AD-MSC therapy...
2008: Veterinary Therapeutics: Research in Applied Veterinary Medicine
I V Men'shikova, V I Makolkin, I Iu Sugurova
AIM: To assess efficacy of intraarticular injection of ostenil in knee joint osteoarthrosis. MATERIAL AND METHODS: Sixty patients with gonarthrosis of x-ray stage I-III (mean age 65 years, mean duration of the disease < 7 years) on chondroprotectors and nonsteroid anti-inflammatory drugs (NAD) in a standard dose received a course (3-5 weekly intra-articular injections) of 2 ml injections of ostenil. Assessment of the arthrologic status (VAS, Leken's index, WOMAC index, HAQ index, subjective and objective evaluation of the disease symptoms, need in NAD) was made initially, 5 weeks and 12 months after the treatment...
2007: Terapevticheskiĭ Arkhiv
J C Fernández López, A Ruano-Ravina
OBJECTIVE: This study sought to use a systematic review to ascertain the efficacy and safety of hyaluronic acid (HA) in the treatment of hip osteoarthritis (OA). DESIGN: A protocolized search was made of a number of electronic databases, including Medline, EMBASE, Cochrane Library and Health Technology Assessment (HTA) among others. Two independent reviewers applied a series of inclusion and exclusion criteria to the studies located in the search, and selected only those that included more than 20 patients; had a follow-up period of more than 1 week; and exclusively assessed the efficacy and/or effectiveness of HA in patients with confirmed hip OA...
December 2006: Osteoarthritis and Cartilage
Jacob M Buchowski, Khaled M Kebaish, Vladimir Sinkov, David B Cohen, Ann N Sieber, John P Kostuik
BACKGROUND CONTEXT: The sacroiliac joint is known to be a possible cause of chronic low back pain, but the diagnosis and treatment of disorders of the sacroiliac joint have been difficult and controversial. PURPOSE: To describe the outcome of sacroiliac joint arthrodesis for sacroiliac joint disorders, with the hypothesis that sacroiliac arthrodesis leads to improved postoperative function. STUDY DESIGN/SETTING: Consecutive case series performed in an academic medical institution...
September 2005: Spine Journal: Official Journal of the North American Spine Society
Beyhan Karamanlioğlu, Ayşin Alagöl, Fatma Nesrin Turan
This study was designed to test the hypothesis whether preemptive administration of rofecoxib, a novel selective COX-2 inhibitor, can prolong intraarticular bupivacaine analgesia after arthroscopic knee surgery. Sixty-two patients were randomly assigned to one of the three groups. Group 1 (n=21) was administered oral rofecoxib 50 mg 1 h before surgery plus intraarticular 0.5 % bupivacaine 20 ml postoperatively. Group 2 (n=21) was administered the same dose of bupivacaine. Group 3 (n=20) was administered saline 20 ml intraarticularly after surgery...
April 2005: Aǧrı: Ağrı (Algoloji) Derneği'nin Yayın Organıdır, the Journal of the Turkish Society of Algology
Robert J Petrella
OBJECTIVE: Intraarticular hyaluronic acid is indicated for patients with osteoarthritis of the knee. However, clinical experience, especially efficacy and adverse events, with repeated injection series in the long term are limited. DESIGN: Patients were referred to a large primary care center for management of osteoarthritis of the knee. All were naive to intraarticular hyaluronic acid therapy and met our entry criteria, including resting visual analog scale pain of > 45 mm, radiographic confirmation of unilateral knee grade 1-3 osteoarthritis, and willingness to receive intraarticular therapy...
April 2005: American Journal of Physical Medicine & Rehabilitation
E I Shmidt, I V Belozerova, F M Akhmedzhanov, D G Soldatov
AIM: To study efficacy of the chondroprotector chondroitin sulphate (structum, Pier Fabr Medicament Production, France) in patients with rheumatoid arthritis (RA) and secondary osteoarthrosis of the knee joints. MATERIAL AND METHODS: 15 women with a long history of RA (mean duration 11.9 years) entered an open non-randomized trial of structum. The patients had a severe progressive highly active RA with a definite x-ray stage of the disease. 13 patients had a positive rheumatoid factor (1:80 to 1:1280) and involved knee joints which had been affected for 1 to 10 years (mean 5...
2004: Terapevticheskiĭ Arkhiv
Ana Gomis, Matthias Pawlak, Endre A Balazs, Robert F Schmidt, Carlos Belmonte
OBJECTIVE: To compare 3 different hyaluronan (HA) preparations used as therapeutic agents for osteoarthritis pain in humans in order to establish the degree to which a single application affects the sensitivity of nociceptors in both the normal and the acutely inflamed rat joint. METHODS: In anesthetized rats, single-unit recordings were performed from the medial articular nerve of the right knee joint under normal conditions and during an acute experimental arthritis...
January 2004: Arthritis and Rheumatism
J Glémarec, P Guillot, Y Laborie, J M Berthelot, A Prost, Y Maugars
OBJECTIVES: To evaluate the overall efficacy in various disorders of glucocorticoid injection into the lateral atlantoaxial joints, performed via the posterior route under fluoroscopic control. METHODS: Retrospective study of 26 patients including 16 (19 injections) with mechanical disorders and ten (16 injections) with inflammatory disorders. RESULTS: The response rate was 69.3%, the mean pain scale score decrease was 52.3 +/- 40.1%, and the mean duration of pain relief was 8...
January 2000: Joint, Bone, Spine: Revue du Rhumatisme
P Ravaud, L Moulinier, B Giraudeau, X Ayral, C Guerin, E Noel, P Thomas, B Fautrel, B Mazieres, M Dougados
OBJECTIVE: To evaluate the efficacy of joint lavage and intraarticular steroid injection, alone and in combination, in the treatment of patients with symptomatic knee osteoarthritis (OA). METHODS: Ninety-eight patients with painful tibiofemoral OA were enrolled in a prospective, randomized, controlled, 2 x 2 factorial-design trial of 6 months' duration. The 4 treatment groups consisted of 1) intraarticular placebo (1.5 ml of 0.9% normal saline), 2) intraarticular corticosteroids (3...
March 1999: Arthritis and Rheumatism
U Fischer, F Kamprad, F Koch, E Ludewig, R Melzer, G Hildebrandt
PURPOSE: Numerous clinical observations demonstrate the efficacy of low radiation doses in the treatment of painful osteoarthritis. Experimental investigations remain scarce. We investigated the effects of locally daily 5 times 1.0 Gy 60-Co irradiation on an artificially induced aseptic gonarthritis in rabbits. MATERIAL AND METHODS: Three separate experiments (EV) were performed (10 rabbits per experiment, 5 treated/5 controls; duration: EV1: 18 days; EV2: 6 days; EV3: 29 days)...
December 1998: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
R Likar, M Schäfer, F Paulak, R Sittl, W Pipam, H Schalk, D Geissler, G Bernatzky
Controlled clinical studies have shown that local administration of morphine can significantly relieve acute postoperative pain. This analgesic effect is long-lasting (up to 48 h) and is mediated by peripheral opioid receptors. Experimental evidence shows that analgesic effects of peripheral opioids and the density of opioid receptors on peripheral sensory nerves increase with the duration of painful inflammatory processes. This study examines the analgesic effects of 1 mg of morphine injected into the arthritic knee joints of two groups of chronic pain patients (n = 23) suffering from osteoarthritis...
June 1997: Anesthesia and Analgesia
A Lussier, A A Cividino, C A McFarlane, W P Olszynski, W J Potashner, R De Médicis
OBJECTIVE: To evaluate viscosupplementation with intraarticular hylan G-F 20 in current clinical practice. METHODS: A retrospective study of all patients with osteoarthritis of the knee treated with hylan by 5 Canadian clinicians over a period of 2.5 years. RESULTS: A total of 1537 injections were performed in 336 patients involving 458 knees. The overall response and the change of activity level were judged better or much better for 77 and 76% of the treated knees after the first course of treatment (3 weekly injections), and 87 and 84% after a 2nd course...
September 1996: Journal of Rheumatology
P F Spooren, J J Rasker, R P Arens
In 33 patients with chronic arthritis of the knee, 48 knees were treated with an intra-articular injection of 5 mCi yttrium silicate (90Y). There were 27 patients with rheumatoid arthritis (RA) and 6 with osteoarthrosis (OA); the mean follow-up period was 33 months. At clinical investigation after 1 year, no signs of pain or swelling were found in 15 knees. In most cases, pain and swelling improved subjectively, with a mean duration of 11 months; in 20 knees, the improvement lasted more than 22 months. When radiographs showed severe destruction, 90Y treatment was unsuccessful, but an important new finding was that most patients with mild or moderate radiological abnormalities appeared to have a long-lasting improvement...
1985: European Journal of Nuclear Medicine
A K Jones, M A al-Janabi, K Solanki, R Sobnack, A Greenwood, D V Doyle, K E Britton, E C Huskisson
We quantitated in vivo migration of neutrophils into the knees of patients with rheumatoid arthritis (RA) and osteoarthritis, using 99mtechnetium-hexamethyl-propylene-amineoxime-labeled leukocytes and gamma scintigraphy. Significant neutrophil migration occurred in patients with RA irrespective of disease duration, and it was reduced by 60% following intraarticular steroid injection. The reduction in neutrophil migration correlated with reduction in pain. Leukocyte migration into osteoarthritic joints was also demonstrated, although it was much less than that seen in rheumatoid joints...
March 1991: Arthritis and Rheumatism
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