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Objective: To identify the efficacy and safety of multiple doses of intravenous tranexamic acid (IV‐TXA) following primary total knee arthroplasty (TKA) with a tourniquet. Methods: This is a single‐blind randomized controlled study that recruited osteoarthritis patients who had undergone primary unilateral TKA from May 2019 to May 2020 at our medical center. A total of 300 patients were randomly divided into three groups to receive: one dose (1 g) of IV‐TXA before skin incision combined with one dose (1.5 g) of intra‐articular tranexamic acid（IA‐TXA) followed by a single dose of IV‐TXA (1 g) for 3 h (group A); two doses of IV‐TXA (1 g) for 3 and 6 h (group B); or three doses of IV‐TXA (1 g) for 3, 6, and 12 h (group C) postoperatively. TKA with a tourniquet was performed by the same surgical team. The primary outcomes were total blood cell loss (TBL), hidden blood loss (HBL), maximum hemoglobin (Hb) drop, and transfusion rate. Secondary outcomes were levels of C‐reactive protein (CRP) and D‐dimer, and the incidence of postoperative complications. One‐way analysis of variance, subgroup analysis, and multivariate correlation analysis were used to calculate the differences among the three groups. Results: The study included 56 male and 244 female patients aged 60–80 years. The mean TBL, the mean HBL, and the maximum Hb drop in group C (471.2 ± 190.6 mL, 428.4 ± 190.3 mL, and 21.2 ± 3.8 g/L, respectively) were significantly lower than those in groups B (563.4 ± 224.6 mL, P = 0.030; 519.9 ± 226.4 mL, P = 0.033; and 23.2 ± 4.1 g/L, P = 0.001, respectively), and A (651.6 ± 254.1 mL, P < 0.001; 607.1 ± 254.3 mL, P < 0.001; and 25.1 ± 4.3 g/L, P < 0.001, respectively). No transfusions were required. The postoperative acute inflammatory reaction was less problematic for patients in Group C, and the incidence of thromboembolic events was similar among the groups (P > 0.05). In addition, there were positive correlations between the HBL and the tourniquet inflation time (r = 0.844, P < 0.001). Similarly, the level of CRP on POD1 (r = 0.393, P < 0.001) and POD3 (r = 0.149, P = 0.010), and the level of D‐dimer on POD1 (r = 0.382, P < 0.001) were positively correlated with the HBL. Conclusion: Three doses of postoperative IV‐TXA decreased blood loss and diminished the postoperative inflammatory and fibrinolytic response more than a single dose or two doses in elderly patients following TKA without increasing the incidence of adverse events. [ABSTRACT FROM AUTHOR]

Objective: To observe the clinical effect of knee-bitong prescription combined with plateletrich plasma in the treatment of knee osteoarthritis in the middle stage. Methods: From May 2018 to January 2019, 90 patients with moderate knee osteoarthritis (K-L classification II and III) with liver and kidney deficiency were admitted, and 45 patients were divided into experimental group and control group. The test group included 15 males and 30 females; aged 46 to 70 (58.93 ± 10.671) years; course of disease was 1 to 8 years (27.06 ± 4.216) months; K-L classification: 33 cases in grade II and 12 cases in grade III. Jibitongfang Jianjian Granules is taken orally once a day, once in the morning and evening, 14 days a course of treatment, and combined with platelet-rich plasma (2ml) articular cavity injection, once every 14 days, a total of two, 14 days apart; control group male 12 There were 33 females aged 43-68 (57.00 ± 8.832) years old; the course of disease was 1-8 years (25.40 ± 3.718) months; KL classification: 36 cases of grade II, 9 cases of grade III, and the control group were given platelet-rich plasma (2ml) Injection into the joint cavity, the treatment course and frequency are the same as the experimental group. Record and compare the VAS score, WOMAC score, matrix metalloproteinase-1 and interleukin-1β levels of joint fluid before and after treatment for one month to evaluate the therapeutic effect. Results: All 90 cases were followed up without serious adverse reactions or other complications. The WOMAC scores of the experimental group and the control group before and after treatment were: 106.40 ± 47.962, 116.13 ± 41.151, 55.13 ± 22.022, 62.67 ± 26.232. The VAS scores of the two groups before and after treatment were: 5.87 ± 2.446, 5.80 ± 2.145, 2.67 ± 1.345, 4.00 ± 1.964. The levels of interleukin 1β in the test group and the control group before and after treatment were: 78.33 ± 7.227, 76.60 ± 7.069, 25.73 ± 3.239, 31.13 ± 5.743. The levels of matrix metalloproteinase-1 before and after treatment in the two groups were: 2299.66 ± 179.343, 2206.66 ± 194.235, 1741.86 ± 183.077, 1762.46 ± 192.097. Conclusion: The combination of platelet-rich plasma and knee-bitong decoction in the treatment of moderate knee osteoarthritis is better than platelet-rich plasma group in relieving knee pain, improving knee function and reducing the levels of interleukin-1β and matrix metalloproteinase-1 in joint fluid. And the side effects are small, it is worth clinical application. [ABSTRACT FROM AUTHOR]

Osteoarthritis is the most common joint disease, commonly affecting the knee, and total knee arthroplasties have greatly increased in recent decades. The infrapatellar fat pad, also known as Hoffa's fat pad, is often resected during total knee arthroplasty in order to improve the surgeon's visibility/access. In the relevant literature there is no consensus regarding infrapatellar fat pad preservation. Its resection may affect the blood supply to the patellar tendon, and it may also be blamed for other postoperative changes in the knee. On the other hand, preservation of the fat pad has been associated with increased postoperative anterior knee pain. It is preferable that the surgeon should try to preserve the infrapatellar fat pad, but if preservation causes problems regarding visibility and access, it should be removed. The choice of full resection, preservation or partial resection of the fat pad depends on the surgeon's preferences and experience, and on the needs of the patient. [ABSTRACT FROM AUTHOR]

The aim of this non-inferiority study was to evaluate and compare the effects of Tiszasüly and Kolop mud pack therapy on pain, function and quality of life in patients with knee osteoarthritis. In this double-blind, randomised, follow-up study, 60 patients with knee osteoarthritis were treated with either Tiszasüly hot mud pack (group 1) or with Kolop hot mud pack (group 2) on 10 occasions for 2 weeks (10 working days). One hundred millimetre visual analogue scale (VAS) for knee pain, the Western Ontario and McMaster Universities Arthritis Index (WOMAC), the Knee injury and Osteoarthritis Outcome Score (KOOS), the Lequesne Index for physical function and EuroQoL-5D for quality-of-life measurements were recorded at baseline, at the end of treatment (week 2) and 3 months later (week 12). In both groups, all measured parameters improved significantly from the baseline until the end of treatment and during the follow-up period (p < 0.05). There were no significant differences between the groups in terms of the WOMAC, KOOS, EQ-5D and Lequesne Index at any visits. Knee pain improved in both groups at week 2 and week 12; the only significant difference visible between the groups was at the end of the treatment in favour of the Tiszasüly mud pack group (p = 0.009). Tiszasüly and Kolop mud packs both have a favourable effect on knee pain, physical function and quality of life in patients with knee osteoarthritis. Our results proved non-inferiority of Tiszasüly mud pack. [ABSTRACT FROM AUTHOR]

Objective: To test the acceptability and feasibility of self-administered acupressure as an intervention for knee pain among middle-aged and older adults with knee osteoarthritis (KOA). Methods: In this pilot randomized controlled trial, 35 participants with KOA were randomized to receive self-administered acupressure (n = 17, two self-administered acupressure training sessions followed by self-practice for 6 weeks) or knee health education (n = 18, two health education sessions about KOA management followed by self-care for 6 weeks). Current pain intensity (primary outcome) was measured using a Numeric Rating Scale (NRS) at baseline and weeks 1, 2, 4 and 6 (post-intervention). Secondary outcome measures included worst and least pain intensity, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), range of motion (ROM) of the knee joints and Short-Form Six-Dimension (SF-6D) scores for health-related quality of life. Results: Participants in both groups attended all training sessions. In the self-administered acupressure group, all subjects mastered the acupressure technique and passed a consistency check. Both groups showed a decreasing trend in current knee pain intensity measured using NRS post-intervention. A medium between-group effect size (0.40) was found, but between-group differences were not statistically significant. The other secondary outcome measures were also comparable between both groups post-intervention (all p > 0.05). Conclusion: A two-session self-administered acupressure training was acceptable to and feasible in participants with KOA. The data generated allowed for calculation of a sample size for a definitive randomized controlled trial (RCT) to confirm whether self-acupressure is effective for pain management in KOA. Furthermore trials with adequate power and longer follow-up periods are warranted. [ABSTRACT FROM AUTHOR]

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Purpose: To evaluate the postoperative change in patellar position after medial closed distal femoral osteotomy (DFO) performed for valgus osteoarthritic knees. Methods: The study included 21 consecutive knees in 20 patients undergoing DFO. A minimum of 2-year follow-up data was obtained for all subjects with a mean follow-up period of 42 months (range 31–59 months). The patellar position was evaluated on plain radiographs preoperatively, 1-year postoperatively, and 2-year postoperatively. For patellar height, the modified Insall–Salvati Index (mISI), modified Caton–Deschamps Index (mCDI) and modified Blackburne–Peel Index (mBPI) were measured on the standing lateral radiographs. Patellofemoral alignment on the axial plane was assessed on skyline views with 30° flexion based on the measurements for lateral patellar tilt (LPT) and lateral patellar shift (LPS). Measured values at pre- and postoperative phases were statistically compared using a two-way analysis of variance. Results: All indices including mISI, mCDI, mBPI, LPT and LPS showed no statistically significant postoperative changes. Conclusion: Medial closed-wedge DFO performed for valgus osteoarthritic knees did not significantly influence patellofemoral alignment either on the sagittal or axial plane. Therefore, to highlight the clinical relevance of our findings, medial closed-wedge DFO for the valgus knee does not adversely affect the patellofemoral joint. Level of evidence: Level IV, case series. [ABSTRACT FROM AUTHOR]

The first peak of the external knee abduction moment (KAM) is often used as a surrogate measure of the medial compartment loading and has been correlated with pain and progression of knee osteoarthritis (OA). As a result, reducing the KAM is often the target of conservative interventions. OA should be considered as a “Whole Person” disease, including ecological psychosocial aspects. Scientists have developed gait alteration strategies to reduce the KAM. They attempted to force into a new position any particular part without reference to the pattern of the whole. We propose an alternative approach: in the vicinity of a special configuration of the knee, some or all of the components of the knee become overloaded. This study has shown that when six lines $1′,$2′,$3′,$4′,$5′,$6′ are so situated that forces acting along them equilibrate when applied to one degree of freedom, 1° F knee, a certain determinant vanishes. We wish to define the six lines as the knee complex in involution by virtue of some constraint upon the knee.

Abstract Background Knee pain is common and related to knee osteoarthritis. However, there is a discrepancy between knee pain and radiographic osteoarthritis. In the general population, knee pain is associated with psychological and cognitive factors, which would be one explanation for the discrepancy. Limited evidence demonstrates that somatization is associated with knee pain. This study examined the association between disability due to knee pain and a high somatising tendency. Methods Japanese adults (aged 20–64 years) who had experienced knee pain in the past four weeks were included in this study (n = 14,695, 50% women). Data were extracted from a large internet survey. Somatising tendency was assessed using the Somatic Symptom Scale-8 (SSS-8). Disability due to knee pain was categorized into three levels: 1) knee pain without difficulty with activities of daily living (ADL), 2) knee pain with ADL difficulty but without requiring sick leave, and 3) knee pain requiring sick leave. The association between ≥ high somatising tendency (SSS-8 score ≥ 12) as well as very high somatising tendency (SSS-8 score ≥ 16) and disability due to knee pain was examined using logistic regression models adjusted for age, sex, body mass index, depressive symptoms, education level, regular exercise, chronicity of knee pain (≥3 months), osteoarthritis, rheumatoid arthritis, and fibromyalgia. Results Greater disability due to knee pain was associated with a higher odds ratio for ≥ high somatising tendency (adjusted odds ratio (aOR) = 2.36 [2.10–2.66] in group 2 vs. group 1, aOR = 3.23 [2.66–3.92] in group 3 vs. group 1). Stronger associations were found for a very high somatising tendency (aOR = 2.80 [2.42–3.23] in group 2 vs. group 1, aOR = 4.51 [3.64–5.58] in group 3 vs. group 1). Conclusions Somatization may play a role in disability due to knee pain in the general adult population with knee pain, similar to the role of somatization in low back pain.

Background. It is well known that meniscectomy leads to osteoarthritis of the knee and proprioception impairment. Objective. The aim of this study was to assess retrospectively the joint position sense after meniscal suture and partial medial meniscal resection and to estimate the patients’ satisfaction with knee function. Material and Methods. We evaluated the outcomes of 27 patients after meniscal repair and compared them to those of 24 patients after partial meniscal resection. We estimated the joint position sense at 30°, 45° and 60° of flexion using the Biodex system 4 Pro. All patients were assessed with the IKDC 2000 subjective knee score. Results. A statistically significant worsening in reproducing the injured joint position in comparison to the healthy limb in both groups was observed. These impairments were mostly expressed at 45° and 60° of knee flexion, and were worsening over time in the group of patients who had undergone medial meniscal resection. An average value by the IKDC 2000 scale after 24 months in the meniscorrhaphy group was 76.73 ± 11.17% and 68.93 ± 14.76% after partial medial meniscal resection. Сonclusion. The control over position of the knee is not impaired after meniscal repair. An overall satisfaction with joint function is higher in patients who undergo meniscal suture in comparison to the partial medial meniscal resection group.

Background: Osteoarthritis of the knee (KOA) is the main cause of disability in elderly people. Patients with KOA may often not achieve adequate pain control even after receiving all treatment modalities., Objectives: The objective of this study was to examine the efficacy of ultrasound-guided radiofrequency ablation (RFA) as a treatment for moderate and severe KOA., Study Design: A prospective randomized controlled study., Setting: The study was performed in the National Pain Management and Research Center of China-Japan Friendship Hospital., Methods: Eligible participants were over 50 years old and had suffered from chronic knee joint pain for more than 6 months, scoring at least 4 on a numeric rating scale (NRS) and grade III-IV according to the Kellgren-Lawrence classification system. The target nerve selection principle was as follows: the superomedial genicular nerve (SMGN) branch and inferior medial genicular nerve (IMGN) branch of the saphenous nerve for medial knee pain, the superolateral genicular nerve (SLGN) branch of the femoral nerve for lateral pain, and the SMGN, IMGN, and SLGN branches for total knee pain. The main outcomes were the NRS pain score (including the most severe pain), the average pain, and the proportion of patients who had reached pain reduction of more than 2 points. The secondary outcome was the Western Ontario McMaster University Osteoarthritis Index (WOMAC) score. RFA at 70ºC was performed for 120 seconds per patient in the RFA group, and knee nerve blocks were performed in the control group., Results: A total of 120 patients who met the inclusion criteria were selected in this study. The treatment groups showed significant differences in their mean NRS scores and worst pain during the first, third, and sixth months after treatment. There were significant differences in the mean WOMAC pain, physical function, and total scores between the treatment groups and over time. Between the treatment groups and over time, the mean WOMAC stiffness scores were not different. At each time point after treatment, the proportion of patients who needed analgesic drugs was significantly lower in the RFA group than in the control group. Univariate analysis showed that gender, age, pain course, and body mass index were not significantly correlated with the positive rate (NRS >= 2 score reduction). After we adjusted for multiple factors, the perceived beneficial effect of therapy was less when gonarthritis was more severe (P < 0.01)., Limitation: This study's limitation is that it was performed in only one unit of the National Pain Management and Research Center., Conclusions: Ultrasound-guided RFA applied to knee nerves can significantly reduce KOA pain, improve knee joint function, improve patient satisfaction, and provide a feasible, safe, and effective minimally invasive procedure for moderate to severe KOA in elderly patients.

Introduction: it is estimated that 302 million people worldwide are affected by osteoarthritis, corresponding to 60% osteoarthritis (OA) of the knee, which responsible 80% of disability in older adults, hence the importance of the association of the sign with the early inflammatory process in OA., Objective: to determine the association of digital pressure sign in patients with and without osteoarthritis of the knee., Material and Methods: this was an observational, comparative cross-sectional study, carried out in patients with and without a diagnosis of knee OA, to whom the digital pressure sign was determined. The sample was calculated with the formula for two proportions, obtaining a total of 40 participants per group, obtained by non-probabilistic sampling for convenience. The statistical analysis included frequencies, percentages, 2 and OR. The bioethics regulations in force were respected., Results: the study included 80 participants, with a median age of 48.9 years (RQI 46-53.7), 73.1% were predominantly female sex (38), and a statistically significant association was found between patients with OA and the presence of digital pressure sign, 2 4.62 and p value = 0.41, OR of 2.65., Conclusions: the presence of digital pressure sign increases the probability of having OA 2.65 times more.

Background: To treat the increasing number of patients with osteoarthritis (OA) of the knee, high-volume institutions rely on central referral services as first contact point. Depending on the grading of arthritis, patients will be referred to a nonoperative or operative care provider. The present study reports on a simple 5-step questionnaire to identify patients with OA (Kellgren/Lawrence [KL] grade ≥2) of the knee to improve efficiency of referrals.Methods: We included 998 patients who contacted the physician referral service at the author's institution complaining of knee pain and divided them into 2 groups. The study group included patients with an appointment and consisted of 646 patients (345 women [53.4%] and 301 men [46.6%]). X-rays of the knee were graded according to the KL classification system. The control group of patients who did not make an appointment consisted of 352 patients (187 women [53.1%] and 165 men [46.9%]). These patients were contacted to evaluate whether they had been diagnosed with OA of the knee since their initial call, to assure that the study group was not exposed to a selection bias.Results: Logistic regression revealed 5 questions as significant predictors for OA of the knee (KL grade ≥2). When combining both groups, an 86.9% sensitivity, a 73.3% specificity, and an 84.3% overall accuracy were reached, when patients answered 3 or more questions positively.Conclusion: The present study revealed a simple 5-step questionnaire to identify patients with OA of the knee. Implementation of the questionnaire has the potential to improve the accuracy of referral processes and streamline organization before the first appointment. [ABSTRACT FROM AUTHOR]

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Objective: To study the clinical efficacy of total knee arthroplasty (TKA) in the treatment of knee osteoartlmtis (KOA) and its effect on the serum Superoxide dismutase (SOD), nitric oxide (NO), tumor necrosis factor (TNF-α) levels. Methods: 94 patients with KOA who admitted to our hospital from August 2014 to January 2016 were selected, they were divided into the control group and the observation group with 47 cases in each group by the random number method. Patients in the control group were treated with traditional conservative medicine, while patients in the observation group were treated with TKA and followed up for 1 year. The therapeutic effects, changes of knee joint score (AKS), visual analogue score (VAS) and serum SOD, NO and TNF-α levels before and after treatment were compared between two groups. Results: After treatment, the excellent and good rate of observation group (93.61 %) was significantly higher than that in the the control group (65.96%)(P < 0.00). After 1 year of follow-up, the VAS score of observation group was significantly lower than that of the control group (P<0.01), the knee score and functional score of AKS were significantly higher than those of the control group (P<0.01), the serum SOD level was significantly higher than that of the control group (P<0.01), and serum NO and TNF-α levels were significantly lower than those of the control group (P<0.01). Conclusion: The operative effect of TKA on KOA patients is significantly be甘er than that of traditional conservative medicine, which can significantly reduce the pain sensation of knee joint and promote the recovery of knee joint function. The mechanism may be related to the increase of serum SOD level and the decrease of serum NO and TNF-α levels. [ABSTRACT FROM AUTHOR]

Copyright of Nursing of Integrated Traditional Chinese & Western Medicine is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Osteoarthritis (OA) is by far the most common form of arthritis characterized by focal loss of articular cartilage, subchondral osteosclerosis, osteophyte formation at the joint margin, and remodeling of joint contour with enlargement of affected joints. This randomized, clinical trial aimed to compare the effectiveness of Platelet Rich Plasma (PRP) and Hyaluronic Acid (HA) as individual treatments and PRP in combination with HA in the treatment of mild to moderate knee Osteoarthritis (OA). The study was conducted among 89 patients with mild to moderate knee osteoarthritis in the Department of Physical Medicine and Rehabilitation, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. Patients were randomly allocated to one of the three interventions: HA (n=30), PRP (n=30), or HA+PRP (n=29). Patients in HA group received 3 intra-articular knee injections with 1 week interval while patients in PRP group and PRP+HA group received 2 intra-articular knee injections with 2 week interval. Functional outcome of the treatment were evaluated using the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and Visual Analogue Scale (VAS) questionnaire at baseline and after 1,3,6 and 9 months of treatment. Majority of the patients in all groups were female where mean age of the patients were about 50 years. Pain scores in VAS scale significantly reduced in PRP group when compared to HA group and also in PRP+HA when compared to HA group which persist till nine months (p<0.05). No significant statistical difference was found in VAS scores between PRP and PRP+ HA group. WOMAC pain scores also significantly reduced in PRP group when compared to HA group and also in PRP+HA when compared to HA group (p<0.05). WOMAC stiffness significantly reduced in PRP+ HA group when compared to HA group at three month (p<0.001) and at six month (p=0.011). At nine month, physical activity scores significantly reduced in PRP group compared to HA group (p=0.002) and in PRP+HA when compared to HA group (p<0.001). No significant reduction was observed in WOMAC scores when the outcome of PRP+HA was compared with PRP alone. PRP provides better functional outcome than HA. The combination of PRP and HA also provides better outcome than HA alone but does not provide better outcome than PRP alone. [ABSTRACT FROM AUTHOR]

Objective: To compare the effectiveness of intra-articular injection (IAI) with Botulinum toxin type A (BTA), triamcinolone hexacetonide (TH), and saline in primary knee osteoarthritis. Design: A randomized controlled trial, with blinded patients and assessor. Setting: Outpatient rheumatology service. Subjects: Patients with knee osteoarthritis grades II and III. Interventions: Patients received IAI with 100 IU BTA, 40 mg TH, or isotonic saline solution (SS) 0.9%. Main measures: Patients were assessed at baseline and at 4, 8, and 12 weeks with the following instruments: visual analog scale for pain during movement (VASm; primary outcome) and visual analog scale for pain at rest (VASr), Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC) questionnaire, 6-minute walk test, Timed Up and Go test, Short Form (SF)-36 questionnaire, range of motion of knee, and ultrasound (US) measurement of synovial hypertrophy. Results: In total, 105 patients were randomized, with 35 in each group; 96 were female (91.4%) and 9 were male (8.6%), with a mean age of 64.2 years (±6.9). At 12 weeks, the TH group showed better results only for VASm. At four weeks, the TH group showed better results than the BTA and SS groups for VASm (–68.9% (37.8) vs. –35.3% (40.3) vs. –35.9% (51.4)), WOMAC pain (–56.0% (30.7) vs. –30.8% (34.3) vs. –30.0% (39.9)), WOMAC stiffness (–53.4% (38.4) vs. –17.2% (59.3) vs. –17.3% (78.1)), WOMAC function (–48.2% (34.6) vs. 30.8% (33.6) vs. –13.6% (64.9)), WOMAC total score (–51.2% (31.0) vs. –30.9% (30.0) vs. –18.8% (54.8)), and US measurement of synovial hypertrophy (–11.6% (44.9) vs. –1.5% (47.9) vs. +28.6% (81.3)). Conclusion: IAI with TH had a higher effectiveness than that with TBA or SS in the short-term assessment (four weeks) for pain in movement, WOMAC, and US measurement of synovial hypertrophy. [ABSTRACT FROM AUTHOR]

In this study, we investigated the relationship of an osteoarthritis of the knee (OA) and a knee pain of single-leg on the bilateral difference of ground reaction force in stepping. The subjects were 29 middle-aged women (mean age 63.7±6.7 years). We categorized them into groups based on the following conditions: osteoarthritis of the knee (OA groups; n = 9), knee pain (KP groups; n = 7), and no pain (NP groups; n = 13). We measured the ground reaction force in a vertical direction when stepping on a platform. The evaluation variables were as follows: peak of ground reaction force at the early stance phase (F1), middle phase (F2), and late phase (F3). We calculated the bilateral difference of ground reaction force of the left and right leg and the affected side and the unaffected side ratio. The result of two way ANOVA, there was a significant difference between the leg in F1 and F3 and the group at F2. The result of comparison between the OA groups and the KP groups, there was no significant difference in the unaffected side and the affected side ratio, those in the OA groups tended to have a load on the unaffected side, while those in the KP groups had a load on the affected side. Therefore, it was suggested that there was the relationship of the OA and a knee pain of single-leg on the bilateral difference of ground reaction force in stepping. [ABSTRACT FROM AUTHOR]

Copyright of Travma is the property of Zaslavsky O.Yu and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background & Aims: Osteoarthritis is a common disease, and one of the most important causes of disability in the elderly, with impaired performance as a prominent symptom. This study was conducted to assess the effect of self-management on performance of elderly patients with knee osteoarthritis attending an orthopedic clinic. Material & Methods: In this quasi experimental study, 88 patients with osteoarthritis of the knee were selected by convenient sampling, and consisted to intervention (44 patients) and control (44 patients) groups. Initially, performance of patients was measured using WOMAC inventory. Then, the intervention group received one 70-minute session of training program per week over 4 weeks. Next, they were given the opportunity to practice the program at home for 4 more weeks. Afterwards, performance of both groups was assessed and compared. Data collected were analyzed in SPSS-18 using Chi-square and independent t-test. Results: No significant difference was found between the two groups in mean performance before intervention (P>0/05) but after intervention, mean performance in the intervention group was significantly higher compared to the control group (P0.05). Conclusion: Results obtained showed improved performance in patients with osteoarthritis of the knee due to self-management training program. By using appropriate diet and pain relief methods, along with exercise, patients will be able to better tolerate exercise movements, and thus improve their performance.

Background: Evaluation of knee and lower limb function alone is not sufficient to assess gait. For accurate assessment of gait abnormality, gait oscillation should also be measured. The goal of this analysis was to assess the influence of the knee joint on gait oscillation during gait and stair-stepping in patients with osteoarthritis of the knee. Methods: In 33 patients diagnosed with knee osteoarthritis and 33 healthy adults as the control group, we examined acceleration (anterior and lateral directions) and gait barycentric factors (single-support phase and ratio of center of gravity maximum values) during gait and stair-stepping. Results: Acceleration in the anterior direction in the sacral region was greater in healthy adults than in osteoarthritis (OA) patients during gait and stair-down. Acceleration in the anterior direction in the dorsal vertebral region was greater in OA patients than in healthy adults during (up and down) stair-stepping. Acceleration in the lateral direction in the sacral region was greater in healthy adults than in OA patients during stair-up. Acceleration in the lateral direction in the dorsal vertebral region was greater in OA patients than in healthy adults during stair-stepping. The single-support phase was close to 1 for gait and stair-stepping in healthy adults and OA patients. The single-support time was largely the same for gait and stair-stepping in healthy adults. On the other hand, the single-support time was longer for stair-stepping than for gait in OA patients. The ratio of the center of gravity maximum values was greater for the sacral region than for the dorsal vertebral region. There was a significant difference in the stair-stepping ratio of the center of gravity maximum values between healthy adults and OA patients for the sacral region. Conclusion: We considered that knee OA influenced acceleration in the anterior and lateral direction in the dorsal vertebral and the ratio of the center of gravity maximum values on gait oscillation. [ABSTRACT FROM AUTHOR]

Purpose: Osteoarthritis of the knee is a common disease, often associated with a Baker's cyst. Besides osteoarthritis, also other joint pathologies of the knee can be causative for a Baker's cyst. Radiotherapy is known to be an effective treatment for osteoarthritis, with an anti-inflammatory effect. As the excessive production of synovia usually is associated with intraarticular inflammation, our hypothesis was that radiotherapy might positively influence the synovial production and reduce the volume of a Baker's cyst.Materials and Methods: We performed a prospective trial, including 20 knees receiving radiotherapy for knee arthritis. Besides documentation of NRS (numeric rating scale), WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) score and Knee Society Score, the volume of the Baker's cyst was calculated for a short- (6 to 12 weeks) and long-term (9 to 12 months) follow-up. Ultrasonic volumetry was performed using an ultrasound device with a high-resolution multifrequency linear probe (6-9 MHz).Results: Low-dose radiotherapy improved NRS, WOMAC score and Knee Society Score significantly. The mean volume of Baker's cyst decreased from 22.3 ml to 10.7 respectively 3.1 ml during follow-up. A decrease in volume of more than 25% compared to the baseline could be achieved for 75% of the patients in the short-term and 79% of the patients in the long-term follow up.Conclusion: Radiotherapy of knee osteoarthritis is an effective treatment that decreases the volume of a Baker's cyst. Most patients respond to the treatment. Whether radiotherapy is an effective treatment for Baker's cyst without associated osteoarthritis has to be further examined. [ABSTRACT FROM AUTHOR]

Objective: To compare the effect of proximal peroneal osteotomy and total knee arthroplasty (TKA) in the treatment of patients with osteoarthritis of the knee joint. Methods: 98 cases (98 knees) of patients with osteoarthritis of the knee joint who were treated in our hospital from February 2016 to February 2017 were selected, the patients were divided into control group and study group according to the randomnumber table method, 49 cases (49 knees) in each group. The study group was treated with proximal peroneal osteotomy, the control group was treated with TKA, the operation time, blood loss, hospitalization time and postoperative complications of the two groups were compared, the changes of knee function, knee pain, joint activity, varus angle and quality of life were compared between before operation and 1 year after operation. Results: The operation time, the amount of blood loss and hospitalization time in the study group were all lower than those of the control group (P<0.05). There was no statistically significant difference in the incidence of postoperative complications between the two groups (P>0.05). 1 year after operation, knee joint score of American Special Surgery Hospital (HSS), joint activity,visual pain simulation (VAS) score, inversion angle in the two groups were lower than those before operation(P<0. 05), but there was no statistical difference between the two groups (P>0.05). 1 year after operation, the scores of physiological function, Physiologi enginery, social function, vitality, somatic pain, emotional function, mental health and general health of the two groups were all higher than those before operation and the scores in the study group were higher than those in the control group (P<0.05). Conclusion: Comparison of the TKA, the proximal peroneal osteotomy is superior to the patients with varus knee osteoarthritis in the operation time, the amount of blood loss and the time of hospitalization, it can significantly improve the quality of life of patients, and no serious complications occur. [ABSTRACT FROM AUTHOR]

To observe the changes of the expression of bone morphologic VEGF protein in the joint cartilage of rat knee osteoarthritis (KOA) model treated with ligustrazine，and to investigate the mechanism of ligustrazine in the treatment of KOA. Methods Rat knee arthritis model was established. Rats with successful modeling were included in the model control group，with conventional breeding. Rats in ligustrazine high-dose group，ligustrazine low-dose group，and positive control group received ligustrazine and celecoxib lavage intervention，respectively. Rats in normal group and model group received same amount of normal saline for 6 weeks. At the end of the experiment，HE slices from rats of each group were used for cartilage Mankin score. Western blotting was used to test the changes of VEGF expression in the cartilage tissue. Results The cartilage Mankin scores in each ligustrazine dose group and positive control group were higher than in the blank group，but were lower than in the model group (P < 0. 05) . The scores in positive control group were lower than in ligustrazine low-dose group，but higher than in ligustrazine high-dose group (P < 0. 05) . The relative expressions of cartilage VEGF in the normal group，each ligustrazine dose group，and the positive control group were lower than in the model group，and the differences were statistically significant (P < 0. 05) . The expression of cartilage VEGF in the high-dose ligustrazine group was significantly lower than that in the positive control group (P < 0. 05) ，but the expression in low-dose group was higher than that in the positive control group. Conclusion Ligustrazine inhibits early angiogenesis of cartilage to reduce inflammation by down-regulation of VEGF expression in KOA rats，which to some extent may be one of the mechanisms of reducing joint cartilage degeneration and repairing cartilage damage. [ABSTRACT FROM AUTHOR]

Objective To observe the effect of Yougui pill on serum levels of matrix metalloproteinase ( MMPs ) and inflammatory cytokines in rats with knee osteoarthritis ( KOA) ． Methods Sixty SD rats were randomly divided into sham group， model group，Yougui pill low-dose，middle-dose，and high-dose group，and glucosamine sulfate group，with 10 rats in each group． KOA model was induced with modified Hulth method for 6 weeks． Animals in sham group and model group received equal volume of distilled water orally． Animals in the rests groups received according drugs． After 8 weeks，HE staining was adopted to observe the pathological changes of articular cartilage in each group． The chondrocyte morphology was observed and Mankin score was counted． ELISA was adopted to detect the serum levels of MMP-1，MMP-3，MMP-13，TIMP-1，IL-1β，IL-6，and TNF-α． Ｒesults Compared with the sham group，Mankin score increased significantly in model group ( P ＜ 0. 05) ． Meantime，the levels of MMP-1，MMP-3，MMP-13，IL-1β，IL-6，and TNF-α increased significantly，but TIMP-1 level decreased obviously in the model group ( P ＜ 0. 05) ． Compared with the model group，Mankin score decreased in Yougui pill high-dose group and glucosamine sulfate group． Meantime，the levels of MMP-1，MMP-3，MMP-13，IL-1β，IL-6，and TNF-α decreased，but TIMP-1 level increased in Yougui pill high-dose group and glucosamine sulfate group ( P ＜ 0. 05) ． Conclusion Yougui pill inhibits cartilage degeneration by down regulation of the levels of MMP and inflammatory factors in KOA. [ABSTRACT FROM AUTHOR]

Objective To provide evidence of the effects of vitamin D supplementation on osteoarthritis of the knee. Methods Computer retrieval the Cochrane Library, PubMed, CNKI, China biomedical database and Wan Fang database to collect data of randomized controlled clinical trials on the effects of vitamin D supplementation in the treatment of knee osteoarthritis. The retrieval time was from database establishment to October 2017. System evaluation and meta-analysis were performed by Revman 5.3. Results Four references were included, including a total of 1130 cases of patients with knee osteoarthritis. Vitamin D had significant effect for the relief of knee pain [SMD =-0.32, 95% CI: (-0.63, -0.02)]. In subgroup analysis, vitamin D supplementation did not significantly affect knee pain in subjects with a low 25(OH)D level [SMD = -0.57, 95% CI: (-1.41，0.27)] or high 25 (OH) D level [SMD = -0.12, 95% CI: (-0.28, 0.04)]. Vitamin D supplementation had no effect on tibial cartilage volume [SMD = 0.12, 95% CI: (-0.05, 0.29)]. There were no statistically significant differences in the joint space structure improvement [SMD = 0.07, 95% CI: (-0.08，0.23)]. Conclusion There is a lack of strong evidence to support that vitamin D supplementation can play a fundamental role in osteoarthritis of the knee. More high quality randomized clinical trials are needed to further clarify the effect of vitamin D supplementation on knee osteoarthritis. [ABSTRACT FROM AUTHOR]

Objective: Aim of this trial was to compare efficacy of activated platelet-rich plasma against hyaluronic acid as intra-articular injections to people with osteoarthritis of the knee. Design: Phase-2 randomized controlled trial, with blind patients and outcome assessors. Setting: Outpatient rehabilitation service; years 2011-2013. Subjects: Patients with knee osteoarthritis grades 2-3 at magnetic resonance imaging (MRI) were included after consent and randomized. Target sample size was 25 patients per group. Interventions: Patients received three activated platelet-rich plasma (intervention group) or hyaluronic acid (controls) intra-articular injections at 4-week intervals. Main measures: Main outcome measure was proportion of patients with >1 grade improvement at six months from last injection, as assessed by a radiologist blind to study group. Patients were evaluated over time clinically and with functional scales (Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Lysholm, Tegner, American Knee Society Score (AKSS), Lequesne, visual analogue scale (VAS) for pain). Results: Overall, 30 patients were randomized to intervention and 28 to control group. For primary outcome, 28 patients (29 knees) in the intervention and 22 (25 knees) in the control group were available. Patients with at least 1 grade improvement at repeat MRI were 14 (48.3%) in the intervention and 2 (8%) in the control group (P < 0.003). Improvement in symptoms and functional scales was consistently higher in the intervention group. No side-effects were observed in either group. Conclusion: Activated platelet-rich plasma reduces articular damage as evident at MRI, as soon as six months after treatment; it reduces pain and improves patient's function and overall quality of life. [ABSTRACT FROM AUTHOR]

The present review is devoted to the problem of progression of the knee osteoarthritis. It has been shown that the most important predictors of the disease progression are female gender, strong knee pain, synovitis,deformation of joints, high body mass index, previous traumas, high bone mineral density of the axial skeleton and subchondral parts of femur and tibia, bone marrow edema. Despite numerous studies conducted in order to reveal risk factors of knee osteoarthritis, results remain controversial and require further investigation.

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Purpose: Patient-reported outcome measures (PROMs), which are generic or condition-specific, are used for a number of reasons, including clinical care, clinical trials, and in national-level efforts to monitor the quality of health care delivery. Creating PROMs that meet different purposes without overburdening patients, healthcare systems, providers, and data systems is paramount. The objective of this study was to test a generalizable method to incorporate condition-specific issues into generic PROM measures as a first step to producing PROMs that efficiently provide a standardized score. This paper outlines the method and preliminary findings focused on a PROM for osteoarthritis of the knee (OA-K).Methods: We used a mixed-methods approach and PROMIS® measures to test development of a combined generic and OA-K-specific PROM. Qualitative methods included patient focus groups and provider interviews to identify impacts of OA-K important to patients. We then conducted a thematic analysis and an item gap analysis: identified areas covered by existing generic PROMIS measures, identified "gap" areas not covered, compared gap areas to legacy instruments to verify relevance, and developed new items to address gaps. We then performed cognitive testing on new items and drafted an OA-K-specific instrument based on findings.Results: We identified 52 existing PROMIS items and developed 24 new items across 14 domains.Conclusions: We developed a process for creating condition-specific instruments that bridge gaps in existing generic measures. If successful, the methodology will create instruments that efficiently gather the patient's perspective while allowing health systems, researchers, and other interested parties to monitor and compare outcomes over time, conditions, and populations. [ABSTRACT FROM AUTHOR]

Background: Knee pain is common and related to knee osteoarthritis. However, there is a discrepancy between knee pain and radiographic osteoarthritis. In the general population, knee pain is associated with psychological and cognitive factors, which would be one explanation for the discrepancy. Limited evidence demonstrates that somatization is associated with knee pain. This study examined the association between disability due to knee pain and a high somatising tendency.Methods: Japanese adults (aged 20-64 years) who had experienced knee pain in the past four weeks were included in this study (n = 14,695, 50% women). Data were extracted from a large internet survey. Somatising tendency was assessed using the Somatic Symptom Scale-8 (SSS-8). Disability due to knee pain was categorized into three levels: 1) knee pain without difficulty with activities of daily living (ADL), 2) knee pain with ADL difficulty but without requiring sick leave, and 3) knee pain requiring sick leave. The association between ≥ high somatising tendency (SSS-8 score ≥ 12) as well as very high somatising tendency (SSS-8 score ≥ 16) and disability due to knee pain was examined using logistic regression models adjusted for age, sex, body mass index, depressive symptoms, education level, regular exercise, chronicity of knee pain (≥3 months), osteoarthritis, rheumatoid arthritis, and fibromyalgia.Results: Greater disability due to knee pain was associated with a higher odds ratio for ≥ high somatising tendency (adjusted odds ratio (aOR) = 2.36 [2.10-2.66] in group 2 vs. group 1, aOR = 3.23 [2.66-3.92] in group 3 vs. group 1). Stronger associations were found for a very high somatising tendency (aOR = 2.80 [2.42-3.23] in group 2 vs. group 1, aOR = 4.51 [3.64-5.58] in group 3 vs. group 1).Conclusions: Somatization may play a role in disability due to knee pain in the general adult population with knee pain, similar to the role of somatization in low back pain. [ABSTRACT FROM AUTHOR]

Osteoarthritis of joints is a degenerative disease whose main characteristics are damage and loss of articular cartilage, thickening of the bone just beneath the cartilage (subchondral bone) and hypertrophy of bone at the edges of the joint. Clinically, OA of joints knees, depending on the stage of the disease, manifested by pain in degenerative altered joint, stiffness, restricted range of motion, precipitation, joint effusion within deformations, and varying degrees of inflammation. In this research were involved 100 patients and presented the results of the clinical manifestations of the disease, including amnesics and objective parameters, demographics status, radio-logical findings and the presence of co morbid conditions.

Abstract: Background: Asporin is a novel extracellular matrix protein (ECM) with an important role in the development of osteoarthritis (OA), because it has been reported that functional polymorphisms in the aspartic acid repeat (D) of the asporin gene (ASPN) are associated with susceptibility to OA. Aim: This study was planned to investigate the association of the ASPN polymorphism with primary OA of the knee in a Mexican population, including several countryside regions. Methods: We conducted a case‐control study in which 93 cases with primary OA of the knee and 118 controls were included. Cases included patients > 40 years of age, with a body mass index (BMI) ≤ 27 and a radiologic score for OA of the knee of ≥ 2. Controls were subjects > 40 years of age with a radiologic score of < 2. The D repeat polymorphism was genotyped and logistic regression was developed to evaluate risk magnitude. Results: The D14 allele was more common in our cases and was associated with an increased risk for developing OA, while the frequencies of the remaining alleles did not exhibit differences. Conclusion: Our data suggest that the D14 allele of the ASPN polymorphism could exert an influence on primary OA of the knee etiology in a Mexican Mestizo population. [ABSTRACT FROM AUTHOR]

BACKGROUND: Osteoarthritis (OA) of the knee is a degenerative, painful pathology, needing conservative treatment for symptoms' relief. OBJECTIVE: Comparing the effects of Extracorporeal shockwave therapy (ESWT) and Kinesiotherapy (KIN) on perceived health and range of motion (ROM) of the affected knee. METHOD: A pilot randomized controlled trial with concealed allocation, assessor blinding, intention-to-treat analysis. Forty participants, aged 40-75 with OA of the knee were randomized to an ESWT and a KIN groups. The ESWT group completed 5 interventions for 5 weeks, the KIN group completed the same number of interventions. All evaluations were performed at baseline and after the treatment for: perceived health (Western Ontario and McMaster Universities questionnaire - WOMAC), range of motion (ROM). RESULTS: After the intervention the statistical significant between groups differences favoring the ESWT were found in the WOMAC with regard to pain (p < 0.000), stiffness (p = 0.018), physical function (p < 0.000), total score (p < 0.000), extension and flexion of the affected knee (p = 0.015, p < 0.000) respectively. CONCLUSIONS: ESWT improves WOMAC and ROM better then KIN on the affected knee in patients with OA of the knee. [ABSTRACT FROM AUTHOR]

This meta-analysis was performed to determine the effect of balneotherapy on relieving pain and stiffness and improving physical function, compared to controls, among patients with knee osteoarthritis. We searched electronic databases for eligible studies published from 2004 to December 31, 2016, with language restrictions of English or Japanese. We screened publications in Medline, Embase, Cochrane library, and the Japan Medical Abstracts Society Database using two approaches, MeSH terms and free words. Studies that examined the effect of balneotherapy for treating knee osteoarthritis of a ≥2-week duration were included. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were used as the outcome measure. A total of 102 publications were assessed according to the exclusion criteria of the study; eight clinical trial studies, which comprised a total of 359 cases and 375 controls, were included in this meta-analysis. The meta-analysis analyzed improvement in WOMAC score at the final follow-up visit, which varied from 2 to 12 months post-intervention. Our meta-analysis indicates that balneotherapy was clinically effective in relieving pain and stiffness, and improving function, as assessed by WOMAC score, compared to controls. However, there was high heterogeneity (88 to 93%). It is possible that balneotherapy may reduce pain and stiffness, and improve function, in individuals with knee osteoarthritis, although the quality of current publications contributes to the heterogeneity observed in this meta-analysis. [ABSTRACT FROM AUTHOR]

Introduction Osteoarthritis of the knee is a prevalent and painful condition increasing with age. The aim of this, the first well-controlled randomized controlled trial, was to evaluate the efficacy and safety of co-administered Traumeel 1 1 Traumeel and Zeel are registered trade names of Biologische Heilmittel Heel GmbH, Germany. (Tr14) and Zeel 1 (Ze14) in patients with knee osteoarthritis (OA) experiencing moderate-to-severe pain. Methods This was a double-blind, multi-center, randomized, saline-controlled trial. Eligible patients meeting the American College of Rheumatology criteria for knee OA were randomized to 3, weekly intra-articular Tr14/Ze14 (n = 119) or saline (n = 113) injections. Primary efficacy endpoint was knee pain change from baseline (day 1) to end-of-study visit (day 99), as measured by the WOMAC Pain Subscore. Secondary endpoints included measures of WOMAC OA Index total and subscores, 50-foot walk test, and patient (PGA) and physician (PhGA) global assessments. Safety was assessed by vital signs, treated knee examinations, adverse events (AEs), and concomitant medications use. Effect sizes were calculated post hoc for consistency with published meta-analyses of standard-of-care treatments. Results 232 patients were randomized with no significant baseline differences. For the primary endpoint Tr14/Ze14 was significantly superior to saline (−32.0 vs. −25.5; p = 0.0383, 95% CI for difference: −12.40, −0.35). WOMAC and 50-foot walk pain measures showed statistically significant efficacy for pain relief over study days 15–99 (except Day 29). Safety profile showed no serious adverse events related to the treatment. PhGA indicated significant improvement for Tr14/Ze14 on Days 29, 71 and Day 85. Conclusion In this study, intra-articular Tr14/Ze14 provided significant pain relief compared to saline-control throughout the observation period. Treatment effect sizes were clinically relevant, since these were comparable to those reported for standard-of-care treatments. The safety profile was benign. [ABSTRACT FROM AUTHOR]

A cases and controls retrospective study of analytic observation was carried out in 42 patients with arthrosis of the knee who belonged to "José Martí Pérez" Teaching Polyclinic in Santiago de Cuba, from September, 2014 to June, 2015, in order to evaluate the effectiveness of the homeopathic product AliviHo®-rheumatism as coadjuvant treatment with the conventional therapeutic schedule based on non esteroids and analgesic antiinflammatory drugs. In the statistical processing of the information, the percentage as a summary measure, the exact test of Fisher to determine whether this difference is significant or not, and the odds ratio, with 95% of confidence, were used. The favorable clinical course in most of the patients revealed the usefulness of this adjuvant therapy in the decrease of psychosomatic manifestations and in the extension of the referral periods of the disease; so that the effectiveness of the AliviHo®-rheumatism was demonstrated to treat patients with arthrosis of the knee and to improve in this way their life quality. [ABSTRACT FROM AUTHOR]

Purpose: Tibial condylar valgus osteotomy (TCVO) is a type of opening-wedge high tibial osteotomy for advanced medial knee osteoarthritis (OA) with subluxated lateral joint. We report the concept, the current surgical technique with a locking plate, and the short-term clinical and radiological results of this procedure.Methods: 11 knees with medial OA and a widened lateral joint were treated by TCVO (KL stage III: 6, IV: 5). In this procedure, by the L-shaped osteotomy from the medial side of the proximal tibia to the intercondylar eminence and the valgus correction, lateralization of the mechanical axis and reduction of the subluxated lateral joint are obtained with early postoperative weight-bearing. Before, 6 months, 1, and 5 years after the operation, a visual analog scale (VAS), the Western Ontario and McMaster Universities Arthritis Index (WOMAC), alignment of the lower extremity, and congruency and stability of the femorotibial joint were investigated.Results: The VAS improved from an average of 73 mm to 13 mm, and the total WOMAC score from 52 to 14 before to 5 years after the operation, respectively. The mechanical axis changed from 1 to 60%, and the FTA changed from 186° to 171°. The joint line convergence angle (JLCA) changed from 6° to 1°, and the angle difference of JLCA between varus and valgus stress improved from 8° to 4° after the procedure.Conclusion: Improvements in pain and activities of daily living were observed by TCVO along with valgus correction of the lower extremity and stabilization of the femorotibial joint. [ABSTRACT FROM AUTHOR]

[Purpose] To examine the effect of lateral wedged insoles on the rotation mechanism of the knee joint in patients with knee osteoarthritis. [Participants and Methods] The participants included 11 patients with medial knee osteoarthritis. We asked all participants to stand up from a 40-cm-high chair, and we measured the rotation angle of the knee joint during the movement. The standing motion was performed under four conditions: barefoot and with 7-, 10-, and 13-mm lateral wedged insoles. We also measured four healthy participants as controls for comparison. [Results] During the standing motion, we internally rotated the tibia relative to the femur. In healthy participants, we measured 19.6° internal rotation of the tibia relative to the femur. Patients with knee osteoarthritis had internal rotations of approximately 9.8° when barefoot and 7.1°, 6.4°, and 7.1° when wearing lateral wedged insoles of 7, 10, and 13 mm, respectively. [Conclusion] Lateral wedged insoles do not modify the knee joint rotation motion of patients with knee OA to the correct style., Competing Interests: The author declares that there is no conflict of interest., (2023©by the Society of Physical Therapy Science. Published by IPEC Inc.)

In this study, as a fundamental approach to realize orthotic device for patients with osteoarthritis of the knee considering screw home movement, bending and extension movements of lower thigh of able-bodied persons are analyzed and inherent screw home movement is examined. The analyzed extension movement of lower thigh with screw home movement is mathematically modeled and the structure of an orthotic device is proposed based on the model. It is confirmed by the simulation based on FEM analysis that the force acting on the leg when using the proposed orthotic device is helpful to realize normal screw home movement and valgus rotation, which is expected to be useful for patients with osteoarthritis of the knee.

Objectives : To verify pain relief effects and allergy inhibitory action for the osteoarthritis of the knee joint in Sweet Bee Venom in which allergy causing enzyme is removed. Methods : We randomly allocated 30 participants to treatment group Sweet Bee Venom and Bee Venom. Outcomes on pain reduction were measured by 100mm VAS(Visual Analog Scale). And we recorded into details allergic responses during Pharmacopuncture treatment. Results : Whole body condition and pain rate through VAS measurement were improved significantly in 2 weeks. We could get difference in pain score of two Pharmacopuncture groups significantly in 2 weeks. Sweet BV group(0.1ß㎎/㎖) showed superior reduction in pain compared to the BV group(0.1ß㎎/㎖) significantly. And other allergic responses such as edema, itchiness, pain were significantly lower in the Sweet BV group.