Osteoarthritis and cartilage
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Osteoarthr. Cartil. · Sep 2013
Review Meta AnalysisEfficacy of low frequency pulsed subsensory threshold electrical stimulation vs placebo on pain and physical function in people with knee osteoarthritis: systematic review with meta-analysis.
To determine if low frequency (≤100 Hz) pulsed subsensory threshold electrical stimulation produced either through pulsed electromagnetic field (PEMF) or pulsed electrical stimulation (PES) vs sham PEMF/PES intervention is effective in improving pain and physical function at treatment completion in adults with knee osteoarthritis (OA) blinded to treatment. ⋯ Current evidence of low and very low quality suggests that low frequency (≤100 Hz) pulsed subsensory threshold electrical stimulation produced either through PEMF/PES vs sham PEMF/PES is effective in improving physical function but not pain intensity at treatment completion in adults with knee OA blinded to treatment. Methodologically rigorous and adequately powered RCTs are needed to confirm the findings of this review.
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Nerve growth factor (NGF) is a key regulator of nociceptive pain and thus appears to be an interesting target molecule for an innovative class of analgesic medication. We set out to review the principles of neurogenic inflammation and results of anti-NGF regimens in animal studies as well as clinical trials with patients with back pain and osteoarthritis (OA). ⋯ Anti-NGF agents either alone or in combination with non-steroidal anti-inflammatory agents (NSAIDs) were more efficacious for the treatment of pain in a number of trials of knee and hip pain compared to NSAIDs alone. However, adverse effects that included rapidly progressive OA and joint replacement were more common in patients treated with anti-NGF and NSAIDs than either treatment alone. Anti-NGF treatment related neurologic symptoms including paresthesias, and potentially other types of adverse effects were usually transient but warrant additional investigation.
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Osteoarthr. Cartil. · Sep 2013
Randomized Controlled TrialThe effects of nonsteroidal anti-inflammatory drugs on clinical outcomes, synovial fluid cytokine concentration and signal transduction pathways in knee osteoarthritis. A randomized open label trial.
We investigated the effects of celecoxib, diclofenac, and ibuprofen on the disease-specific quality of life, synovial fluid cytokines and signal transduction pathways in symptomatic knee osteoarthritis (OA). ⋯ Short-term NSAID treatment improves the patient disease-specific quality of life with a parallel decrease in pro-inflammatory synovial fluid cytokine levels in knee OA. Signal transduction pathways may be involved in regulating the anti-inflammatory effects of NSAIDs. ClinicalTrial.gov: NCT01860833.
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Osteoarthr. Cartil. · Sep 2013
The factors associated with pain severity in patients with knee osteoarthritis vary according to the radiographic disease severity: a cross-sectional study.
Knee osteoarthritis (OA) pain is suggested to be associated with inflammation and detrimental mechanical loading across the joint. In this cross-sectional study, we simultaneously examined the inflammation and alignment of the lower limb and examined how the pain components varied depending on the disease progression. ⋯ The presence of a higher level of sIL-6 and the varus alignment of the joint is associated with pain in early- and advanced-stage knee OA patients, respectively.
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Osteoarthr. Cartil. · Sep 2013
Comparative StudyDifferences in structural and pain phenotypes in the sodium monoiodoacetate and meniscal transection models of osteoarthritis.
To characterize differences in joint pathology and pain behavior between two rat models of osteoarthritis (OA) in order to inform selection of animal models for interventional studies. ⋯ The comparison of the two models of OA in rats, using identical assessment tools has demonstrated that although both models display features of OA, there are differences between the models which may represent different aspects of human OA. Thus, model selection should be based on the pathological aspects of OA under investigation.