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Sathiyanarayanan, S., S. Shankar, and S. K. Padmini. "Usefulness of WOMAC index as a screening tool for knee osteoarthritis among patients attending a rural health care center in Tamil Nadu." International Journal Of Community Medicine And Public Health 4, no. 11 (2017): 4290. http://dx.doi.org/10.18203/2394-6040.ijcmph20174846.
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Background: Osteoarthritis is the eighth leading cause of disability and a degenerative disease that worsens over time. Hence, early diagnosis and treatment remains the key in the management of Osteoarthritis. The aim and objective of the study was to evaluate the usefulness of WOMAC index for screening Osteoarthritis among the patients older than 50 years of age attending a Rural Health Centre.Methods: A cross sectional study was done among patients complaining of knee pain who visited a rural centre between June-August 2016. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was applied to all participants with knee pain to assess risk for OA. Also, American College of Rheumatology criteria (ACR) was used as a standard. Descriptive statistics were used. Chi-square test with Odds Ratio was calculated to find out of the strength of association. To test the agreement of WOMAC score with ACR Clinical Criteria, McNemar’s test analysis was done.Results: Out of 103 study subjects 45 were males and 58 were females. According to WOMAC Index Scores, 20 (19.4%) subjects belonged to high risk (score ≥81) and 38 (39.6%) subjects belonged to moderate risk (score 60 - 80). The Mean±SD WOMAC Score was 64.40±15.2. Age group [OR 2.85; 95% CI 1.25-6.48) and gender [OR 2.29; 95% CI 1.01-5.24) were significantly associated with WOMAC score percentage. Comparing WOMAC score percentages with ACR criteria for knee OA revealed statistically significant agreement (p-value, 0.009) which indicated the diagnostic accuracy of WOMAC index.Conclusions: WOMAC Index can be a useful screening tool for people at risk for Osteoarthritis and will help in identifying the disease early.
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Maaoui, R., M. Hfaidh, K. Ben Amor, et al. "AB1002 CLASSIC VERSUS AQUATIC REHABILITATION IN GONARTHROSIS: WOMAC SCORE." Annals of the Rheumatic Diseases 81, Suppl 1 (2022): 1625.2–1625. http://dx.doi.org/10.1136/annrheumdis-2022-eular.5308.
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BackgroundGonarthrosis is the most frequent and common condition of the lower limb, responsible for gonalgia, stiffness, leading sometimes to major functional impotence. The WOMAC with its three domains (pain, stiffness and function) is a valid index for the evaluation of lower limb osteoarthritis [1].The management of gonarthrosis is multidisciplinary with rehabilitation as the mainstay.Currently, aquatic gymnastics is more and more prescribed in the management of this pathology.ObjectivesThe objective of our work was to compare the contribution of aquatic rehabilitation to classical one in patients with gonarthrosis through the WOMAC score.MethodsThis is a prospective, comparative study conducted over a period of 15 months, between September 2016 and December 2017, including 120 patients recruited at the Physical Medicine and Functional Rehabilitation Department of The HMPIT, in whom the diagnosis of gonarthrosis was made according to the ACR criteria.The patients were randomly divided into 2 groups of 60 patients each. The first group, called G1, received a conventional rehabilitation program. The second group, called G2, received aquatic rehabilitation.Two evaluations were made, the first (T1) before the beginning of the rehabilitation and the second (T2) at the end of the eight weeks of treatment.ResultsThe average age of the general population was 54.85 ± 9.5 years [40- 81 years].The average age of G1 was 59.07 ± 10.2 years versus 50.63 ± 6.4 years for G2.Among the 120 patients, 28 were male (23%) and 92 were female(77%) There were 6 males and 54 females in group 1 versus 22 males and 38 females in group 2.Initially, the average WOMAC pain was 15.1 ± 3.9 in G1 and 12.3 ± 1.22 in G2.There was a statistically significant difference between the 2 groups (p=0.01). After rehabilitation, there was an improvement in the WOMAC pain score of 17% in G1 and 50% in G2 with a statistically significant difference between the 2 groups (p<0.001).The average WOMAC score for stiffness was initially 5.1 ± 2 in G1 and 3.2 ± 2 in G2 with no statistically significant difference between the 2 groups (p=0.076).After rehabilitation, an improvement of this score was noted in both groups, it was 19% in G1 and 50% in G2 with a statistically significant difference between the 2 groups (p<0.001).The average initial WOMAC function score was 42.32 ±15.7 in G1 and 33 ± 11 in G2 with a statistically significant difference between the 2 groups (p=0.002).After conventional rehabilitation, this score had improved by 10% and after hydrotherapy, the improvement was 46% with a statistically significant difference between the 2 groups (p<0.001).ConclusionThese results were aligned with the literature and confirmed the effectiveness of functional treatment whether aquatic or classic with better outcome for aquatic rehabilitation. The best would be to combine the different methods according to the needs of the patient and their functional capacities in order to ensure a better adherence.References[1]Guermazi M, Poiraudeau S, Yahia M, Mezganni M, Fermanian J, Elleuch MH, et al. Translation, adaptation and validation of the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) for an Arab population. Osteoarthr Car- tilage. 2004;12(6):459-68.Disclosure of InterestsNone declared
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Dwicandra, Ni Made Oka, and Made Krisna Adi Jaya. "THE EFFECT OF DIACEREIN AND MELOXICAM COMBINATION VERSUS MELOXICAM ALONE ON PHYSICAL FUNCTION IN PATIENTS WITH KNEE OSTEOARTHRITIS." Asian Journal of Pharmaceutical and Clinical Research 11, no. 10 (2018): 325. http://dx.doi.org/10.22159/ajpcr.2018.v11i10.27427.
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Objective: More than 50% of patients with knee osteoarthritis (OA) had an inadequate pain relief in its management. Combination therapy could be the solution to this problem. The aim of this study was to compare the efficacy of combination therapy of diacerein and meloxicam with meloxicam alone in the patient with knee OA.Methods: A total of 64 knee OA patients were recruited from Rumah Sakit Umum Daerah Dr. Mohammad Soewandhie Surabaya. They were allocated to combination group and single therapy group using randomized controlled trial design. The Western Ontario and McMaster Universities Arthritis Index (WOMAC) physical function questionnaire were assessed in weeks 0–4th. The difference between pre- and post-treatment score and area under the curve (AUC) of WOMAC score were calculated.Results: Combination therapy and single therapy had significant clinical effect with the downregulated score of WOMAC physical function after 4th week (p<0.05). However, there were no differences in AUC of WOMAC physical function score between combination and single therapy.Conclusion: Patient with knee OA could gain beneficial efficacies from combination therapy of diacerein and meloxicam. Studies of longer follow-up time to get the differences in AUC of WOMAC physical function score are needed.
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Sharma, Sushil, Chakra Raj Pandey, Rajiv Baral, Ram Thapa, Sunit Dahal, and Prakash Dware. "Patient Reported Outcome of Total Knee Arthroplasty using WOMAC Score." Civil Medical Journal 2, no. 1 (2024): 5–8. https://doi.org/10.59338/cmj.34.
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Introduction: Total Knee Arthroplasty (TKA) is one of the most commonly performed surgery worldwide. TKA ensures pain relief and improved function. With any surgery, evaluation of value and effectiveness depends on relief of the patient’s symptoms, restoration of physical function, and realization of their expectations. Many patient-reported outcome measures have been developed to address this gap. The objective of the study was to assess the functional outcome of TKA with a standardized WOMAC scoring system Methods: All cases planned for TKA were assessed pre-operatively for pain, stiffness and function with WOMAC score. Patients were followed up one year following surgery and reassessed with WOMAC score. Complications of surgery were assessed Results: Total of 45 cases that underwent TKA in a period of 4 years (2014-2018) were included in the study. All patient had at least one-year follow-up following surgery. Mean age of the patient was 66 years (35-77yrs). 35 case (78%) were female; 10 case (22%) were male. Most common indication of surgery was osteoarthritis of knee (44 patients; 98%) followed by rheumatoid arthritis of knee (1 patient; 2%). 25 (57%) underwent bilateral TKR. 96% of patients were satisfied with surgery and 86% were willing to undergo the same surgery again. 96% of patients reported improved function and decreased pain following surgery. Pre-operative WOMAC mean score was 49 (16-64) which improved significantly following surgery with mean postoperative WOMAC score 5 (0-22) (p<0.01). Conclusion: TKA has excellent functional outcome in carefully selected cases. Majority of patients have improved quality of life and are satisfied with the surgery.
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AB RAHMAN, SHAFUZAIN, NURUL FAKHRI AMIR, and MOHD ARIFF SHARIFUDIN. "RELATIONSHIP BETWEEN INDEX-TO-RING FINGER LENGTH RATIO (2D:4D) AND WOMAC OSTEOARTHRITIS INDEX IN WOMEN WITH KNEE OSTEOARTHRITIS." Malaysian Applied Biology 50, no. 2 (2021): 185–91. http://dx.doi.org/10.55230/mabjournal.v50i2.2200.
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The difference in the index-to-ring finger length ratio (2D:4D) is associated with human behavior, physical capability, andrisk of developing knee osteoarthritis in women. We aimed to determine the relationship between 2D:4D, Western Ontarioand McMaster (WOMAC) osteoarthritis index, and body mass index (BMI) in women with mild to moderate kneeosteoarthritis. A cross-sectional study was conducted on 118 women with Kellgren-Lawrence grade 2-3 knee osteoarthritisusing the WOMAC questionnaire. The length of the index and ring fingers were measured using right-hand posterioanteriorview plain radiographs. The participants were classified into three groups: type I (index finger longer than ring finger),type II (equal length), and type III (index finger shorter than ring finger). BMI was determined using standard measurementsand calculations. There was no significant mean difference between the mean total WOMAC score and each of its componentswith the 2D:4D ratio. BMI correlated significantly with symptoms of knee osteoarthritis and the total WOMAC score(P<0.001). There was a significant relationship between the 2D:4D ratio and BMI (P=0.015). No relationship was foundbetween the 2D:4D ratio and WOMAC score. However, there was a positive correlation between the WOMAC score andBMI. The 2D:4D ratio had a significant relationship with BMI.
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Wang, Ying-Chun, Chia-Ling Lee, Yu-Jen Chen, et al. "Comparing the Efficacy of Intra-Articular Single Platelet-Rich Plasma(PRP) versus Novel Crosslinked Hyaluronic Acid for Early-Stage Knee Osteoarthritis: A Prospective, Double-Blind, Randomized Controlled Trial." Medicina 58, no. 8 (2022): 1028. http://dx.doi.org/10.3390/medicina58081028.
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Background and Objectives: For the treatment of knee osteoarthritis (OA), intra-articular platelet-rich plasma (PRP) and novel crosslinked single-dose hyaluronic acid (HA) have both been reported to improve outcomes, but no study has compared them for the treatment of knee OA. We hypothesized patients with early-stage knee OA who received PRP injections would have more WOMAC score changes than those who received HA injections. This is the first prospective, double-blind, parallel, randomized controlled trial comparing the efficacy of intra-articular single-dose PRP versus novel crosslinked HA (HyajointPlus) for treating early-stage knee OA. Materials and Methods: This study analyzed 110 patients randomized into the PRP (n = 54) or HA (n = 56) groups. The primary outcome is the change of WOMAC score at 1-, 3-, and 6-month follow-ups compared to baseline. Results: The data revealed significant improvements in all WOMAC scores in the PRP group at 1-, 3-, and 6-month follow-up visits compared with the baseline level except for the WOMAC stiffness score at the 1-month follow up. In the HA group, significant improvements were observed only in the WOMAC pain score for all the follow-up visits and in WOMAC stiffness, function, and total scores at 6-month follow-up. When comparing the change of WOMAC score at 1-, 3-, and 6-month follow-ups, no significant differences were found between PRP and HA group. Conclusions: This study revealed that both PRP and HA can yield significant improvements in WOMAC scores at 6-month follow-up without any between-group differences at 1-, 3-, and 6-month follow-ups. Thus, both the single-injection regimens of PRP and HA can improve the functional outcomes for treating early-stage knee OA.
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Zhang, Yujie, Ye Zhao, Kaoqiang Liu, et al. "Test reliability and comparability of paper and Chinese electronic version of the western Ontario and McMaster University osteoarthritis index: protocol for a randomised controlled clinical trial." BMJ Open 12, no. 11 (2022): e063576. http://dx.doi.org/10.1136/bmjopen-2022-063576.
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IntroductionThe Western Ontario and McMaster University osteoarthritis index (WOMAC) is the most commonly used indicator of disease-specific outcome in knee osteoarthritis for its convenience and reliability. It has two formats the paper-based WOMAC (p-WOMAC) and the electronic WOMAC (e-WOMAC). In China, the p-WOMAC has been widely used though e-WOMAC is yet untested. This study aims to test whether e-WOMAC is consistent with the p-WOMAC before and after the intervention.Methods and analysisA total of 70 patients from Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine will be randomly assigned in two groups, named, group A and group B. This study is divided into three stages. In the first stage, patients in group A will be evaluated first by p-WOMAC and then by e-WOMAC. Patients in group B will be evaluated by e-WOMAC and then by p-WOMAC. In the second stage of the study, drug interventions will be implemented. 200 mg celecoxib will be administered orally once a day starting from the second day of enrolment for a period of 21 days. In the third stage, postintervention evaluation will be conducted after administration. Patients in group A will be evaluated first by e-WOMAC and then by p-WOMAC. Patients in group B will be evaluated first by p-WOMAC and then by e-WOMAC. In order to avoid the possible bias because of patients’ potential memory, e-WOMAC and p-WOMAC will be taken for each patient at 15 min apart. The primary outcome of the study is the mean score difference in WOMAC, and the secondary outcomes are the score differences in WOMAC subscales: pain, stiffness and physical function.Ethics and disseminationThe protocol has been approved by the Independent Review Board of SGH (approval number: 2020-814-21-01). The results of the trial will be submitted for publication in a peer-reviewed journal.Trial registration numberChiCTR2100050914.
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Hong, Mao, Chongjie Cheng, Xiaowei Sun, et al. "Efficacy and Safety of Intra-Articular Platelet-Rich Plasma in Osteoarthritis Knee: A Systematic Review and Meta-Analysis." BioMed Research International 2021 (April 29, 2021): 1–14. http://dx.doi.org/10.1155/2021/2191926.
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Background. Knee osteoarthritis (KOA) is a common disease in aged adults. Intra-articular (IA) injection of platelet-rich plasma (PRP) therapy is an effective minimally invasive treatment for KOA. We aimed to compare the efficacy and safety of platelet-rich plasma (PRP) with placebo or other conservative treatments. Methods. We conducted a meta-analysis to identify relevant articles from online register databases such as PubMed, Medline, Embase, and the Cochrane Library. The primary outcomes were the visual analogue scale (VAS) score, Western Ontario and McMaster Universities Arthritis Index (WOMAC) score, and International Knee Documentation Committee (IKDC) subjective score. The secondary outcome was the adverse event rate. Results. A total of 895 articles were identified, of which 23 randomized controlled trials that met the inclusion criteria were determined as eligible. Compared with placebo, PRP had a lower VAS score and higher IKDC subjective score at the 6th month after treatment and significantly less WOMAC score during the follow-up period. Compared with oral NSAIDs, PRP gained a lower WOMAC score at the 6th month after treatment. The VAS score decreased after treatment when reaching PRP and CS. As compared to the HA, the VAS score, WOMAC score, and IKDC subjective score all revealed better PRP results. There were no significant differences in adverse event rates comparing PRP versus placebo or HA. Different PRP applications did not show significant differences in VAS score in the 1st month and WOMAC score in the 3rd month after treatment. Conclusion. To compare with the conservative treatments mentioned above, PRP is more effective in relieving symptoms. There were no significant differences between triple PRP application and single PRP application in short-term curative effect.
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Supartono, Basuki, Salma Rahmadati, and Diana Agustini. "The Role of PRP and Its Platelet Concentration in Improving WOMAC Score on Early-Stage Knee Osteoarthritis (OA) Patients." Orthopaedic Journal of Sports Medicine 8, no. 5_suppl5 (2020): 2325967120S0010. http://dx.doi.org/10.1177/2325967120s00108.
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Platelet concentration is one of the important factors in OA treatment with platelet-rich plasma (PRP). The purpose of this study was to determine the effect of PRP quality, which was determined by its platelet concentration, on Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores in early-stage knee OA patients. This study involved 50 patients diagnosed with early-stage knee OA (stage I to III). Twenty-five patients received PRP with moderate platelet concentration (1× to 4×), another twenty-five patients received PRP with high platelet concentration (>4× to 6×). Patients were evaluated using WOMAC questionnaire before and three months after injection with PRP. Bivariate analysis showed that there was a significant improvement of three WOMAC score subscales (pain, stiffness, and function) in both group (p<0.05) and a significant difference in the differences between WOMAC pain scores between the two groups (p<0.05), meanwhile, significant differences in the differences between WOMAC stiffness and function scores between the two groups weren’t found (p>0.05). The conclusions of this study was, PRP with moderate and high platelet concentration had been shown to improve the three WOMAC score subscales of early-stage knee OA patients, but the effect of PRP’s platelet concentration was only significant in the improvement of WOMAC pain score.
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BELLAMY, N., C. H. GOLDSMITI, W. W. BUCHANAN, J. CAMPBELL, and E. DUKU. "Prior Score Availability: Observations Using The WOMAC Osteoarthritis Index." Rheumatology 30, no. 2 (1991): 150–51. http://dx.doi.org/10.1093/rheumatology/30.2.150.
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Serban, Oana, Mihai Porojan, Maria Deac, et al. "Pain in bilateral knee osteoarthritis – correlations between clinical examination, radiological, and ultrasonographical findings." Medical Ultrasonography 18, no. 3 (2016): 318. http://dx.doi.org/10.11152/mu.2013.2066.183.pin.
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Aims: The aim of the study was to evaluate the correlations between clinical symptoms (pain), physical examination, ultrasound (US), and radiological findings in patients with bilateral knee osteoarthritis (OA). Material and methods: Knee pain was appreciated during medial and lateral palpation of each knee joint and using visual analogue scale (VAS) and The Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC). US evaluation (osteophytes, meniscal protrusion, synovial fluid, femoral hyaline cartilage thickness) and radiological assessment (osteophytes, femoral-tibial space, Kellgren–Lawrence [K-L] score, enthesopathies) were performed by two examiners blinded to the clinical results and to each other. All these findings were scored with a five-point scale. Results: A total of 52 consecutive patients aged 63.44±9.49 were examined, 33 (80.5%) being females. In patients with bilateral knee OA the pain, evaluated by WOMAC score and VAS, was correlated with the presence of osteophytes and cartilage thickness but no association with medial meniscal protrusion and effusion was demonstrated. Pain produced by palpation of the knee was strongly associated with the presence of medial osteophytes. VAS and WOMAC scores increased with the severity of radiological and US findings. The presence of osteophytes and articular cartilage damage at US examination were strongly and positively correlated with radiological K-L score. US examiners agreement was good for osteophytes and moderate for meniscal protrusion, cartilage damage, and synovial fluid. The cartilage damage score was the only independent predictor for VAS scale;for WOMAC score thesex, cartilage damage, the presence of medial osteophytes and lateral meniscal protrusion were the independent predictors. Conclusion: Pain intensity was correlated with the severity of USfindings, cartilage damage score being an independent predictor for both VAS and WOMAC scores. Medial osteophytes and lateral meniscal protrusion and are independent predictors for WOMAC score.
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Longo, Umile Giuseppe, Rocco Papalia, Stefano Campi, et al. "Evaluating the Minimum Clinically Important Difference and Patient Acceptable Symptom State for the Womac Osteoarthritis Index after Unicompartmental Knee Arthroplasty." Journal of Clinical Medicine 12, no. 24 (2023): 7618. http://dx.doi.org/10.3390/jcm12247618.
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Patient-Reported Outcome Measures (PROMs) are standardized questionnaires that gather information on health-related quality of life directly from patients. Since a significant statistical mean change may not correspond to a clinical improvement, there is a need to calculate a considerable change in scores. This is done by the Minimum Clinically Important Difference (MCID) and Patient Acceptable Symptom State (PASS). The objective of this article is to report the MCID and the PASS values of the WOMAC (Western Ontario and McMaster University) osteoarthritis index for patients undergoing Unicompartmental Knee Arthroplasty (UKA). A total of 37 patients (25 females and 12 males; mean age 68 ± 8.1 years and mean BMI 28.7 ± 4) who underwent UKA were enrolled. All patients were assessed using the WOMAC and the Oxford Knee Score (OKS) questionnaires before and six months following the procedure. To measure the cut-off values for MCID, distribution methods and anchor methods were applied, while the PASS was assessed only via anchor approaches. The MCID related to the WOMAC average global score was 90.7 ± 7.6, the average pain dimension score was 93.2 ± 6.6, the average stiffness dimension score was 92.6 ± 17, and the average physical function dimension score was 89.7 ± 7.6. In terms of PASS, the normalized WOMAC was 82.8, the pain dimension was 87.5, the stiffness dimension was 93.7, and the functional dimension was 83.1. A 34.5 amelioration in the WOMAC score, from initial evaluation to final follow-up, using change in OKS > 5 as anchor, indicates that the patients’ health state improved to a clinically significant degree. A value at least of 82.8 in WOMAC score after treatment denotes that the symptom state is deemed acceptable by most of the patients.
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Dai, Wen-Li, Ze-Ming Lin, Dong-Hong Guo, Zhan-Jun Shi, and Jian Wang. "Efficacy and Safety of Hylan versus Hyaluronic Acid in the Treatment of Knee Osteoarthritis." Journal of Knee Surgery 32, no. 03 (2018): 259–68. http://dx.doi.org/10.1055/s-0038-1641142.
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AbstractThe purpose of this study was to use meta-analytic approach to compare the efficacy and safety of intraarticular hylan and hyaluronic acid (HA) for knee osteoarthritis (OA) treatment. We searched PubMed, Embase, and the Cochrane databases through July 2017 to identify Level I randomized controlled trials (RCTs) that evaluated clinical efficacy and safety of hylan compared with HA for knee OA. The primary outcomes were Visual Analogue Scale (VAS) for pain and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, and WOMAC function scores. In each study and for the outcome measures (VAS for pain, WOMAC pain, function and stiffness scores, and Lequesne score), we calculated the treatment effect from the difference between the preintervention and postintervention changes in the hylan and HA groups. Twenty-one RCTs involving 3,058 patients were included. Pooled analysis suggested that compared with HA, hylan was associated with similar pain relief and function improvement in patients with knee OA (VAS for pain: mean difference [MD], –3.04; 95% confidence interval [CI], –9.13 to 3.04; p = 0.33; I 2 = 76%. WOMAC pain score: MD, 0.23; 95% CI, –0.25 to 0.70; p = 0.35; I 2 = 0%. WOMAC function score: MD, –0.47; 95% CI, –6.81 to 5.88; p = 0.88; I 2 = 84%). No significant difference was found comparing the patients with treatment-related adverse events. The relationship was robust in sensitivity analysis and consistent in most of the subgroup analyses. As to the primary outcomes (WOMAC pain, function scores, VAS for pain), the difference between hylan and HA did not reach the previously reported minimum clinically important difference (MCID) values (–13.4 for VAS for pain, –2.0 for WOMAC pain score, –7.7 for WOMAC function score). Our meta-analysis showed that there were no statistically and clinically significant differences in pain relief and function improvement between hylan and HA injections for knee OA treatment. In view of its higher costs, we discourage the use of hylan in patients with knee OA in clinical practice. The level of evidence is I, meta-analysis of Level I studies.
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Nair, Sreeni, Anish Desai, Sunaina Anand, and Parita Chorghe. "Assessing the effectiveness and NSAIDs sparing effect of celery seeds and Boswellia serrata in osteoarthritis management." Indian Journal of Orthopaedics Surgery 10, no. 4 (2024): 318–23. https://doi.org/10.18231/j.ijos.2024.052.
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: This study examines the anti-inflammatory and analgesic properties of Celery seed and extracts as potential alternatives for OA treatment, focusing on their effectiveness in reducing pain and improving joint functionality.Osteoarthritis (OA), a prevalent joint disorder, particularly affects the knees and hips. Current management primarily involves NSAIDs, which can lead to severe side effects, especially in older adults with comorbidities. A multicentre observational study enrolled 394 participants clinically diagnosed with knee osteoarthritis. They continued their usual treatment while taking Celery seeds and extract tablet twice daily for three months. Primary outcomes included Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores and changes in painkiller and NSAID usage. Secondary outcomes included visual analogue scale (VAS) pain scores.The study demonstrated significant improvements in primary outcome measures: WOMAC score improved by 17.07% (p&#60;0.001), WOMAC pain score by 75.00% (p&#60;0.001), WOMAC stiffness score by 72.05% (p&#60;0.001) and WOMAC physical function score by 78.93% (p&#60;0.001). Secondary outcomes showed VAS score reductions at rest by 67.17% (p&#60;0.001) and during movement by 64.28% (p&#60;0.001). There was a notable decrease in NSAID usage from baseline 70.09% to 31.89% (p&#60;0.001).Celery seeds and extract demonstrate promising efficacy as a safer and effective adjunctive therapy for knee osteoarthritis, offering pain relief, enhanced joint functionality and potential reduction in NSAID usage.
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C.S, Obiorah, Elkanah O.S, and Kela S.L. "Genetic Diversity of Plasmodium falciparum in Northern Taraba State, Nigeria." International Journal of Science and Healthcare Research 9, no. 3 (2024): 205–16. http://dx.doi.org/10.52403/ijshr.20240324.
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Background: Osteoarthritis (OA); a whole joint disorder is a most common and progressive disease that worsens with age. Synovitis and synovial effusion can play important role in early OA diagnosis and progression. Limited pharmacological interventions affecting synovial effusion are studied clinically in Indian population. Aim: This was a pilot, observational, single arm, open label study in real world set-up designed to evaluate the efficacy and safety of Mobileye® capsules containing sodium hyaluronate along with collagen and polysaccharides derived from rooster comb extract in subjects suffering from synovial effusion and knee pain of osteoarthritis. Materials and Method: The study was conducted on total 30 subjects at Outpatient Department (OPD) at three different sites under the supervision of medical doctor. All subjects consumed Mobileye® capsule orally twice daily for 3 months. Synovial effusion, VAS score, WOMAC score and safety parameters were assessed as scheduled. Results: Treatment with Mobileye® capsule showed significant and progressive improvement in all study related parameters. Baseline score vs. day 90 score (mean + SD) for synovial effusion, WOMAC pain score, WOMAC stiffness score, WOMAC physical function score, WOMAC total score and VAS score were 8.52+2.960 mm vs. 2.58+0.903 mm (p<0.0001), 15.13+3.10 vs. 4.13+2.4 (p<0.0001), 6.63+1.098 vs. 1.60+1.192 (p<0.0001), 54.33+8.39 vs. 14.23+8.67 (p<0.0001), 76.13+ 11 vs. 20.33+ 10.86 and 8.13 + 1.28 vs. 1.93+1.17 (p<0.0001) respectively. No significant adverse events were reported. Conclusion: Oral intake of Mobileye® capsule is safe and effective intervention in reducing synovial effusion, pain, stiffness and in improving joint mobility. Keywords: Malaria, Plasmodium falciparum, genetic, merozoites surface proteins.
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Abdel Rahman, Asmaa Abdel Rahman. "Effect of Online Simulation-Based Education on Nurses' Knowledge and Skills Toward Electrocardiogram Interpretation." International Journal of Science and Healthcare Research 8, no. 1 (2023): 190–200. http://dx.doi.org/10.52403/ijshr.20230127.
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Background: Osteoarthritis (OA); a whole joint disorder is a most common and progressive disease that worsens with age. Synovitis and synovial effusion can play important role in early OA diagnosis and progression. Limited pharmacological interventions affecting synovial effusion are studied clinically in Indian population. Aim: This was a pilot, observational, single arm, open label study in real world set-up designed to evaluate the efficacy and safety of Mobileye® capsules containing sodium hyaluronate along with collagen and polysaccharides derived from rooster comb extract in subjects suffering from synovial effusion and knee pain of osteoarthritis. Materials and Method: The study was conducted on total 30 subjects at Outpatient Department (OPD) at three different sites under the supervision of medical doctor. All subjects consumed Mobileye® capsule orally twice daily for 3 months. Synovial effusion, VAS score, WOMAC score and safety parameters were assessed as scheduled. Results: Treatment with Mobileye® capsule showed significant and progressive improvement in all study related parameters. Baseline score vs. day 90 score (mean + SD) for synovial effusion, WOMAC pain score, WOMAC stiffness score, WOMAC physical function score, WOMAC total score and VAS score were 8.52+2.960 mm vs. 2.58+0.903 mm (p<0.0001), 15.13+3.10 vs. 4.13+2.4 (p<0.0001), 6.63+1.098 vs. 1.60+1.192 (p<0.0001), 54.33+8.39 vs. 14.23+8.67 (p<0.0001), 76.13+ 11 vs. 20.33+ 10.86 and 8.13 + 1.28 vs. 1.93+1.17 (p<0.0001) respectively. No significant adverse events were reported. Conclusion: Oral intake of Mobileye® capsule is safe and effective intervention in reducing synovial effusion, pain, stiffness and in improving joint mobility. Keywords: Electrocardiogram interpretation, nurses' knowledge and skills, online simulation education.
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Wang, Jianping. "Efficacy and safety of adalimumab by intra-articular injection for moderate to severe knee osteoarthritis: An open-label randomized controlled trial." Journal of International Medical Research 46, no. 1 (2017): 326–34. http://dx.doi.org/10.1177/0300060517723182.
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Objective To evaluate the efficacy and safety of adalimumab (ADA) versus hyaluronic acid (HA) by intra-articular injection for moderate to severe knee osteoarthritis. Methods Fifty-six consecutive patients with moderate to severe knee osteoarthritis were randomly allocated to either the ADA group or HA group. On day 0, patients in the ADA group received 10 mg of ADA by intra-articular injection, while those in the HA group received 25 mg of HA. All patients received celecoxib at 200 mg/day for 4 weeks. The pain visual analog scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Patient Global Assessment (PGA), and Physician Global Assessment (PhGA) scores were assessed. Results At baseline, the pain VAS, WOMAC, PGA, and PhGA scores were similar between the two groups. The decrease in the pain VAS score, WOMAC pain score, WOMAC physical function score, and WOMAC total score from baseline to week 4 were greater in the ADA than HA group. A greater decrease in the PGA and PhGA scores from baseline to week 4 was noted in the ADA than HA group. No difference in adverse events was observed between the two groups. Conclusion ADA by intra-articular injection was effective and tolerated for moderate to severe knee osteoarthritis.
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Pinzon, Rizaldy Taslim, and Vincent Ongko Wijaya. "Curcuma longa and Boswellia serrata for Improving Functional Status in Osteoarthritis Patients: From Bench to Bedside Evidences." Asian Journal of Medical Sciences 10, no. 5 (2019): 1–5. http://dx.doi.org/10.3126/ajms.v10i5.24918.
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Background: The management of osteoarthritis (OA) represents a real challenge. Curcumin is a highly pleiotropic molecule with an excellent safety profile.Some previous studies showed the extract of Curcuma longa and Boswellia Serrata(CB extract) is a promising potential as therapeutic interventions against OA.
 Aims and Objective: This study aimed to measure the effectiveness and safety of CB extract for improving functional status in patients with OA.
 Materials and Methods: A randomized controlled trial (RCT) in OA patients. The treatment used in this trial were CB extract (350 mg of Curcuma longa and 150 mg Boswellia Serrata) and NSAID (400 mg ibuprofen or 50 mg diclofenac sodium). Subjects were randomized to 3 different group (Group 1: CB extract and NSAID; group 2: CB extract; group 3: NSAID). Each subject would be followed up 3 times: baseline (visit I), 2 weeks after baseline (visit II), and 4 weeks after baseline (visit III). The measurement of functional status with WOMAC (Western Ontario and McMaster Universities Osteoarthitis Index).
 Results: There were 105 osteoarthritis patients. Seven subjects were lost to follow up and three subjects were excluded from the study due to medication side effect. Ninety-five subjects (group 1: 36; group 2: 29, group 3: 30) remained for complete analysis. Delta (Δ) WOMAC score defined as the result of subtraction between WOMAC score at visit I and WOMAC score at visit III. Group 1 showed the greatest reduction of WOMAC score after 4 weeks of treatment (ΔWOMAC = 12.08 ± 18.6). Group 3 has the least WOMAC score reduction (ΔWOMAC = 6.9 ± 16). There was no statistically different of ΔWOMAC score between groups (p = 0.367). There were no statistically different of the prevalence of AE between groups at the visit II (p: 0.119) and at the visit III (p: 0.767).
 Conclusion: CB extract is effective and safe for improving functional status in OA patients.
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Dharmeshkumar, B. Kheni, P. Sureja Varun, and G. Prajapati Divyanshu. "Efficacy and Safety of Nutraceutical Composition Mobileye® Capsules in Improving Synovial Joint Health in Indian Population." International Journal of Science and Healthcare Research 5, no. 1 (2020): 1–5. https://doi.org/10.5281/zenodo.3926869.
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<strong>Background:</strong> Osteoarthritis (OA); a whole joint disorder is a most common and progressive disease that worsens with age. Synovitis and synovial effusion can play important role in early OA diagnosis and progression. Limited pharmacological interventions affecting synovial effusion are studied clinically in Indian population. <strong>Aim:</strong> This was a pilot, observational, single arm, open label study in real world set-up designed to evaluate the efficacy and safety of Mobileye® capsules containing sodium hyaluronate along with collagen and polysaccharides derived from rooster comb extract in subjects suffering from synovial effusion and knee pain of osteoarthritis. <strong>Materials and Method:</strong> The study was conducted on total 30 subjects at Outpatient Department (OPD) at three different sites under the supervision of medical doctor. All subjects consumed Mobileye® capsule orally twice daily for 3 months. Synovial effusion, VAS score, WOMAC score and safety parameters were assessed as scheduled. <strong>Results: </strong>Treatment with Mobileye® capsule showed significant and progressive improvement in all study related parameters. Baseline score vs. day 90 score (mean + SD) for synovial effusion, WOMAC pain score, WOMAC stiffness score, WOMAC physical function score, WOMAC total score and VAS score were 8.52+2.960 mm vs. 2.58+0.903 mm (p<0.0001), 15.13+3.10 vs. 4.13+2.4 (p<0.0001), 6.63+1.098 vs. 1.60+1.192 (p<0.0001), 54.33+8.39 vs. 14.23+8.67 (p<0.0001), 76.13+ 11 vs. 20.33+ 10.86 and 8.13 + 1.28 vs. 1.93+1.17 (p<0.0001) respectively. No significant adverse events were reported. <strong>Conclusion: </strong>Oral intake of Mobileye® capsule is safe and effective intervention in reducing synovial effusion, pain, stiffness and in improving joint mobility.
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Mougui, A., S. Belouaham, and I. El Bouchti. "AB1183 NEUROPATHIC PAIN IN PRIMARY KNEE OSTEOARTHRITIS." Annals of the Rheumatic Diseases 82, Suppl 1 (2023): 1821.2–1822. http://dx.doi.org/10.1136/annrheumdis-2023-eular.4771.
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BackgroundPain is a major symptom in primary knee osteoarthritis. The mechanisms of this pain are heterogeneous explaining the variable response to different treatments. The presence of a neuropathic pain (NP) may be associated with a different phenotype disease.ObjectivesThe present study was conducted to identify the frequency of NP in patients with painful primary knee osteoarthritis, and to investigate its correlation with socio-demographic factors, anthropometric and postural features, physical function, quality of life, and disease severity.MethodsThe study included 200 patients with primary osteoarthritis of the knee who did not have co-morbid disorders and/or were taking drugs that may cause neuropathy. NP was assessed by both Douleur Neuropathique 4 questions (DN4) and painDETECT questionnaires.ResultsThe mean age of the patients was 59.15 7.62 years. The majority were women (87.5%). The mean of the body mass index was 24,72±4, 84 kg/m2. The mean of the quadriceps perimeter was 48,28±4,14cm. The mean of the waist circumference was 93,04±11,43 cm. The mean of the total Womac score was 53,61±4,93. NP was detected in 55.5% of patients according to DN4 questionnaire and in 46% according to painDETECT questionnaire. DN4 score was positively correlated with VAS (VAS Visual analogue Scale)-pain at rest (rs=0,188; P=0,009), VAS pain on movement (rs=0.173; P=0.0017), Womac pain score (rs=0.157; p=0.030), Womac stiffness score (rs=0.253; p=0.000), Physical function Womac score (rs=0.271; p=0.000), total Womac score (rs=0.305; p=0.000) and Lequesne index (rs=0.221; p=0.002), and it was negatively correlated with perimeter quadriceps (rs=-.210;p=0.008), while painDETECT score was positively correlated with VAS pain on movement (rs=0.220; p=0.002), Womac stiffness score (rs=0.147; p=0.043), Womac physical function score (rs=0.172; p=0.017), and total Womac score (rs=0.182; p=0.012). The risk factors of NP retained according to DN4 score were longer symptom duration (p=0,030) and a reduced quadriceps perimeter, whereas painDETECT score was associated with high VAS pain on movement (p=0.022).ConclusionNP is common in primary knee osteoarthritis. The presence of NP is associated with more painful pathology and extreme disability.References[1]Dimitroulas T, Duarte RV, Behura A, Kitas GD, Raphael JH. Neuropathic pain in osteoarthritis: a review of pathophysiological mechanisms and implications for treatment. Semin Arthritis Rheum. 2014;44(2):145-54.[2]Kamel SR, Ibrahim RS, Moens HM, Mohammed RM. Neuropathic pain in primary knee osteoarthritis patients: correlation with physical function, quality of life, disease severity, and serum beta nerve growth factor levels. Egyptian Rheumatology and Rehabilitation. 2021;48(1):1-9.[3]Fernandes GS, Valdes AM, Walsh DA, Zhang W, Doherty M. Neuropathic-like knee pain and associated risk factors: a cross-sectional study in a UK community sample. Arthritis Res Ther. 2018;20(1):215.[4]Güngör Demir U, Demir AN, Toraman NF. Neuropathic pain in knee osteoarthritis. Adv Rheumatol. 2021;61(1):67.Acknowledgements:NIL.Disclosure of InterestsNone Declared.
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Das, Gautam, Sushpa Das, Vikas S. Sharma, Shirish Prasad Amatya, Smruti Rekha Hota, and Anamul Haque Milton. "Efficacy and Safety of Conventional and Cooled Radiofrequency Ablation in Patients with Advanced Knee Osteoarthritis: A Prospective, Randomized, Double-blind Study." Indian Journal of Pain 39, no. 1 (2025): 18–23. https://doi.org/10.4103/ijpn.ijpn_81_24.
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Background: In knee osteoarthritis (KOA), cooled radiofrequency ablation (C-RFA) and conventional radiofrequency ablation (Conv-RFA) are seldom compared directly, and long-term outcome is unclear. Aim: The aim is to compare the efficacy and safety of C-RFA and Conv-RFA in patients with Kellgren and Lawrence grade ≥3. Settings and Design: This prospective, randomized, double-blind study was performed over 30 months (October 2020 to March 2023) with 12 months follow-up in the Department of Pain Medicine. Materials and Methods: The study included 30 patients each in C-RFA and Conv-RFA groups. The outcomes were assessed at baseline, 3, 6, and 12 months and included pain relief (Visual Analogue Scale [VAS] score), rescue analgesic use, functional improvement (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC] scores), and adverse events. Results: At 12 months, both C-RFA and Conv-RFA groups had a significant reduction in VAS score and analgesic use as well as an improvement in WOMAC score (P < 0.0001). In the C-RFA group, VAS score and analgesic use decreased, while WOMAC score improved significantly at 3, 6, and 12 months compared to baseline (P < 0.0001). At corresponding intervals, similar changes were observed in the Conv-RFA group at all the intervals, except no significant reduction in VAS score at 12 months (P = 0.900). The groups had comparable VAS and WOMAC scores at baseline, 3, and 6 months; however, at 12 months, the VAS score decreased significantly and the WOMAC score improved significantly in C-RFA groups (P < 0.0001). Conclusions: C-RFA provided significantly greater and prolonged pain relief and functional improvement in patients with KL grade III–IV KOA, and thus is superior to Conv-RFA.
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Ansari, Muhammad Ilyas, and Rehan Gul. "Outcomes of Ceramic-on-Ceramic Total Hip Arthroplasties After Ten Years at Cork University Hospital Ireland." SVOA Orthopaedics 3, no. 4 (2023): 64–69. http://dx.doi.org/10.58624/svoaor.2023.03.046.
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Objectives: We conducted a retrospective observational study to investigate the patients’ reported outcomes and survival of ceramic-on-ceramic total hip arthroplasty. Patients and Methods: 238 patients underwent ceramic on ceramic hip arthroplasties between January, 2010 and October 2012. Out of these, 205 patients (86.1%) had uncemented fixations and 33 patients (13.9%) had cemented fixations with THA using a CoC femoral head and liner. For each patient, WOMAC and SF-12 scores were measured at six weeks, six months, two years, and five years. Radiological follow up to 10 years. The patients who received revision surgery were identified in the database. Results: The mean preoperative WOMAC and SF-12 scores were 39.83±12.29 and 30.07±2.18, respectively. At 5 years, the mean WOMAC score had improved from 39.83 ± 12.29 to 90.40 ± 5.30 (p < 0.01), Wilcoxon signed-rank test; the mean SF-12 score had improved from 30.07 ± 2.18 to 34.40 ± 2.22 (p < 0.01, Wilcoxon signed-rank test). Four patients (1.68%) got revision within 10 years postoperatively. Conclusion: The CoC THA showed statistically significant clinical improvement in WOMAC score and functional score of SF-12 after 5 years follow-up with satisfactory survival after 10 years.
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Waluyo, Yose, Agussalim Bukhari, Endy Adnan, et al. "Association between cartilage biomarker level and functional outcome in knee osteoarthritis patients receiving dextrose prolotherapy: a cross-sectional study." Bali Medical Journal 11, no. 3 (2022): 1151–56. http://dx.doi.org/10.15562/bmj.v11i3.3395.
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Background: Knee osteoarthritis (KOA) is a degenerative joint disease with relatively high prevalence globally and is one of the leading causes of disability in the elderly population. Dextrose prolotherapy (DPT) has been proven effective in improving functional outcomes in knee osteoarthritis. The effect of hypertonic dextrose on cartilage biomarkers has not been evaluated. Purpose: To evaluate the association between a cartilage biomarker and changes in clinical outcomes among patients with KOA who received dextrose prolotherapy (DPT). Patients and methods: This study was conducted with a cross-sectional design. Twenty-six participants received DPT at weeks 1, 5, and 9. Our primary measures were urinary c-terminal telopeptides of type II collagen (uCTX-II), measured by an enzyme-linked immunosorbent assay (ELISA), and the WOMAC score, measured at baseline and week 12. Results: There were significant improvements in all WOMAC subscales and uCTX-II levels after DPT. There is no significant correlation between biomarker levels with the WOMAC score as a functional outcome indicator in KOA after DPT (p > 0.05), but there are positive correlations between pain, functional, total WOMAC score, and uCTX-II. Conclusion: DPT may reduce cartilage degradation and improve functional outcomes in osteoarthritic knees. Significant drops in uCTX-II levels can affect functional outcomes, especially pain, functional and total WOMAC scores.
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Kim, Man Soo, In Jun Koh, Chul Kyu Kim, Keun Young Choi, Ki Ho Kang, and Yong In. "Preoperative Medial Meniscal Extrusion Is Associated With Patient-Reported Outcomes After Medial Opening Wedge High Tibial Osteotomy." American Journal of Sports Medicine 48, no. 10 (2020): 2376–86. http://dx.doi.org/10.1177/0363546520933834.
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Background: Although the medial compartment continues to sustain some loading after medial opening wedge high tibial osteotomy (MOWHTO) in varus-deformed knees, no studies have examined the relationship between medial meniscal extrusion (MME) and patient-reported outcome measures after MOWHTO. Purpose: To examine whether compartmental baseline MME was associated with patient-reported outcome measures after MOWHTO. Study Design: Cohort study; Level of evidence, 3. Methods: This retrospective study was composed of 149 MOWHTOs in 147 patients with clinical and radiological assessments. Patients were grouped according to severity of MME in the medial compartment at the time of surgery. MME was categorized into 4 groups according to MOAKS (MRI [magnetic resonance imaging] Osteoarthritis Knee Score) criteria and relative value of MME. We compared preoperative characteristics, including Kellgren-Lawrence (KL) grading scale, meniscal tear pattern, and postoperative Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) subscores. Associations between extent of MME and WOMAC subscores at postoperative 1 and 2 years were assessed with generalized linear models. Results: Pattern of meniscal tear ( P < .05) and KL grade ( P < .05) were associated with MME. Patients with KL grades 3 and 4 at the time of surgery had significantly greater MME than those with KL grade 2 ( P < .05). When patients were divided into 4 groups according to MOAKS criteria at the time of surgery, there were significant differences in WOMAC pain scores among groups at 1 and 2 years after the operation (all P < .05). The WOMAC function score also differed among groups at postoperative 1 year ( P < .05) but not postoperative 2 years ( P > .05). When patients were divided into 4 groups according to relative MME at the time surgery, the WOMAC pain score differed significantly among groups at postoperative 1 and 2 years (all P < .05). Analysis of WOMAC pain score as the dependent variable in multivariate analyses revealed that severity of absolute and relative MME and KL grade were independent predictors of worse WOMAC pain score at postoperative 1 and 2 years (all P < .05). Conclusion: Greater preoperative MME at the time of surgery was associated with inferior patient-reported outcomes, especially pain, in patients with MOWHTO at 1 and 2 years after surgery.
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Wagenmakers, Robert, Martin Stevens, Inge van den Akker-Scheek, Wiebren Zijlstra, and Johan W. Groothoff. "Predictive Value of the Western Ontario and McMaster Universities Osteoarthritis Index for the Amount of Physical Activity After Total Hip Arthroplasty." Physical Therapy 88, no. 2 (2008): 211–18. http://dx.doi.org/10.2522/ptj.20060321.
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Background and Purpose Despite the recognized health benefits of physical activity, little is known about the amount of physical activity that patients perform after total hip arthroplasty (THA). To this end, the ability of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) to predict the amount of physical activity that patients with a THA perform, as measured by the Short Questionnaire to Assess Health-Enhancing Physical Activity (SQUASH), was determined. Subjects and Methods Three hundred sixty-four patients who had a THA returned questionnaires. Pearson correlation coefficients were calculated between scores on the WOMAC and SQUASH. Binary logistic regression modeling was used to determine the extent to which the WOMAC score could predict that patients would meet national and international guidelines for health-enhancing physical activity. Results Scores on the WOMAC and SQUASH showed a significant, but low, correlation (r=.14–.24). Although the WOMAC score was a significant predictor for meeting national and international guidelines for physical activity, the odds ratio was low (1.022, 95% confidence interval=1.012–1.033) and only 6.9% of the variance could be explained (Nagelkerke r2=.069). Discussion and Conclusion The results suggest that the WOMAC is not suitable for predicting the amount of physical activity after THA, requiring the use of an additional outcome measure.
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Rahmatika, Rahmatika, Robin Novriansyah, and Lanny Indriastuti. "The Effects Of Prehabilitation Exercise Using Resistance Bands On Functional Performance In Total Knee Replacement." Hip and Knee Journal 1, no. 1 (2020): 8–18. http://dx.doi.org/10.46355/hipknee.v1i1.5.
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Background:Despite the high succesful rate of Total Knee Replacement (TKR), there are still patients with permanent dysfunction and a longer period of rehabilitation that interfere with functional performance. Strengthening exercise before TKR namely prehabilitation exercise using resistance bands is expected to optimize patient’s condition before surgery that will increase functional performance after TKR and accelerate rehabilitation programs.Methods:16 eligible patients were allocated into the treatment group (n=8) and the control group (n=8). The treatment group received 4 weeks of prehabilitation exercise with a frequency of 2 times and one time as a home program. The control group only received conventional therapy. The TUG and WOMAC scores were measured 3 times; at baseline, after 4 weeks of prehabilitation exercise and at 8 weeks of rehabilitation after TKR.Results:Before intervention, there were no significant differences between groups for the TUG score (p=0.674) and WOMAC (p=0.928). After 4 weeks of intervention, there was significant difference in the TUG score (p=0.003) and WOMAC (p=0.002), whereas at 8 weeks after rehabilitation programs there was a significant difference in the TUG score (p=0.009) while for the WOMAC score there was no significant difference (p=0.125).Conclusion:Prehabilitation exercise using resistance band improved functional performances in patients undergone TKR.
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Zhao, Ye, Zhi Bi Shen, Ji Rong Ge, et al. "Efficacy and Safety of Tongning Gel for Knee Osteoarthritis: A Multicentre, Randomized, Double-Blinded, Parallel, Placebo-Controlled, Clinical Trial." Evidence-Based Complementary and Alternative Medicine 2020 (June 11, 2020): 1–9. http://dx.doi.org/10.1155/2020/8707256.
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Objective. To evaluate the efficacy and safety of Tongning Gel (TNG) compared to placebo-controlled (PC) for knee osteoarthritis (KOA). Methods. A multicentre, randomized, double-blinded, parallel, placebo-controlled, clinical trial was performed in 576 patients (432 patients in the TNG group, 144 patients in the PC group), and 1 in the experimental group withdrew due to nonuse of drug. Patients were randomized to receive TNG or PC applied to knee skin at 3g per time, 2 times per day, which lasted for 3 weeks. The Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain score was used to evaluate the primary efficacy of TNG and WOMAC stiffness and physical function and total scores were used to evaluate the secondary efficacy of TNG. All participants who received at least one dose of study drug were included in the safety analysis. This trial has been registered in Chinese Clinical Trial Registry (no. CTR20131276). Results. Primary efficiency outcome: there were significant differences in the decreased value of WOMAC pain score between two groups (P<0.05), and the decreased value of WOMAC pain score in the TNG group were better than those in the PC group (P<0.05). Secondary efficiency outcome: the WOMAC total score, WOMAC stiffness score, WOMAC physical function score, and the decrease of the above indexes of the two groups of patients after treatment were statistically significant (P<0.05), and the improvement of the above indexes in the TNG group was better than that of the PC group (P<0.05). Safety Evaluation. A total of 42 adverse events were reported by 29 patients: 25 adverse events reported by 16 patients (3.71%) in the experimental group and 17 adverse events were reported by 13 patients (9.03%) in the control group. And 8 adverse reactions were reported by 6 patients including 2 adverse reactions by 2 patients (0.46%) in the experimental group and 6 adverse reactions by 4 patients (2.78%) in the control group. Two cases of significant adverse events occurred in the experimental group. Both groups had one serious adverse event, respectively, which were not relevant to the intervention. Conclusion. These results of the trial demonstrate that TNG is superior to placebo in the treatment of patients with KOA, and TNG can improve other symptoms of KOA, such as stiffness and physical function. TNG is safe for the treatment of knee osteoarthritis as a whole.
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Maharjan, Promish, Wang Chen, Guo Yu Dong, and Wang Shang Zheng. "Coronal alignment in total knee arthroplasty and its effect on functional outcome: A retrospective study." Grande Medical Journal 4, no. 1 (2024): 43–49. https://doi.org/10.3126/gmj.v4i1.79410.
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Background This retrospective study was conducted to compare the coronal alignment of the lower extremity before and after surgery in patients undergoing total knee replacement by assessing the mechanical axis in the full-length weight-bearing radiograph taken preoperatively and post-operatively, and to assess the clinical outcome after TKA with reference to the mechanical axis. Method Fifty eight patients who underwent primary TKA from date October 2013 to March 2017 were included in the study. The patient’s demographics such as age, gender primary TKA were noted. All patients underwent clinical and radiological evaluation, including standardized radiographs (anterior-posterior long-leg X-ray). For clinical outcome scoring the Hospital for Special Surgery score (HSS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) were used. One-way ANOVA was used to compare the outcome of the surgery and the alignment (p <0.05). Result Out of the 58 patients included in the study, 16 (27.58%) were male and 42 (72.41%) were female with age ranged between 34 to 88 years (mean 65.44 years). The male patient’s age ranged from 53 to 85 (median 63 years) and that of female patients ranged from 52 to 83 (median 65.5 years). The overall mean HSS score improved from 59.86 ± 10.91 preoperatively to 82.52 ± 11.04 in one year postoperatively (<0.0001) and WOMAC score improved from 33.98 ± 11.25 to 10.4 ± 6.06 (P<0.0001) after 1 year from the TKA respectively. Both showed a significant difference in the results. There were 50 patients with pre-operative Varus alignment and 8 with pre-operative valgus alignment. Pre-operative Varus groups have a post-operative HSS score of83.98±9.962153 and that of pre-operative valgus groups has HSS score of 77.625±14.20199. Similarly, pre-operative Varus group had a postoperative WOMAC score of 9.38±5.27949 and that of the valgus group had 12±9.273618. In these two groups, there was no significant difference between their post-operative HSS score (P=0.2571) and WOMAC score (P=0.4590). After the surgery, 25 patients (43.10%) had varus alignment, 22 patients (37.9%) had neutral alignment and 11 patients (18.97%) had valgus alignment. The post-operative mechanical axis group was divided into the post-op varus group, post op neutral group, and post-op valgus group. After comparing within the groups, the neutral group had the highest HSS score (91.3636±4.1946, lowest WOMAC score (5.2272±1.37945), P<0.005, which showed the best result and the HSS score of post-operative varus group was (82.12±7.5), the WOMAC score was (9.64±4.344) showing the moderate result. The postoperative valgus group has HSS score (68.82 + 9.39), WOMAC score (16.3636 + 8.205), showing worst result. Conclusion Total Knee Arthroplasty is a good treatment modality for primary osteoarthritis. The coronal alignment before surgery has no significant effect on the function after total knee arthroplasty. However, the post-operative coronal alignment of the lower limbs was related to the clinical function of the patients. The outcome of the patient with the mechanical axis was the best with neutral groups followed by the Varus group and was the worst in the valgus group.
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Wu, Cong-Zi, Zhen-Yu Shi, Zhen Wu, et al. "Mid-term outcomes of microfragmented adipose tissue plus arthroscopic surgery for knee osteoarthritis: A randomized, active-control, multicenter clinical trial." World Journal of Stem Cells 15, no. 12 (2023): 1063–76. http://dx.doi.org/10.4252/wjsc.v15.i12.1063.
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BACKGROUND Osteoarthritis (OA) is the most prevalent form of degenerative whole-joint disease. Before the final option of knee replacement, arthroscopic surgery was the most widely used joint-preserving surgical treatment. Emerging regenerative therapies, such as those involving platelet-rich plasma, mesenchymal stem cells, and microfragmented adipose tissue (MFAT), have been pushed to the forefront of treatment to prevent the progression of OA. Currently, MFAT has been successfully applied to treat different types of orthopedic diseases. AIM To assess the efficacy and safety of MFAT with arthroscopic surgery in patients with knee OA (KOA). METHODS A randomized, multicenter study was conducted between June 2017 and November 2022 in 10 hospitals in Zhejiang, China. Overall, 302 patients diagnosed with KOA (Kellgren-Lawrence grades 2-3) were randomized to the MFAT group (n = 151, were administered MFAT following arthroscopic surgery), or the control group (n = 151, were administered hyaluronic acid following arthroscopic surgery). The study outcomes were changes in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, the visual analog scale (VAS) score, the Lequesne index score, the Whole-Organ Magnetic Resonance Imaging Score (WORMS), and safety over a 24-mo period from baseline. RESULTS The changes in the WOMAC score (including the three subscale scores), VAS pain score, and Lequesne index score at the 24-mo mark were significantly different in the MFAT and control groups, as well as when comparing values at the posttreatment visit and those at baseline (P < 0.001). The MFAT group consistently demonstrated significant decreases in the WOMAC pain scores and VAS scores at all follow-ups compared to the control group (P < 0.05). Furthermore, the WOMAC stiffness score, WOMAC function score, and Lequesne index score differed significantly between the groups at 12 and 24 mo (P < 0.05). However, no significant between-group differences were observed in the WORMS at 24 mo (P = 0.367). No serious adverse events occurred in both groups. CONCLUSION The MFAT injection combined with arthroscopic surgery treatment group showed better mid-term clinical outcomes compared to the control group, suggesting its efficacy as a therapeutic approach for patients with KOA.
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Sundaraj, K., V. Russsell, L. Salmon, and L. Pinczewski. "TWENTY-YEAR SURVIVAL OF HIGH TIBIAL OSTEOTOMY." Orthopaedic Proceedings 105-B, SUPP_2 (2023): 116. http://dx.doi.org/10.1302/1358-992x.2023.2.116.
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The aim of this study was to determine the long term 20 year survival and outcomes of high tibial osteotomy (HTO).100 consecutive subjects underwent HTO under the care of a single surgeon between 2000 and 2002, consented to participation in a prospective study and completed preoperative WOMAC scores. Subjects were reviewed at 10 years, and again at a minimum of 20 years after surgery. PROMS included further surgery, WOMAC scores, Oxford Knee Score (OHS), KOOS, and EQ-5D, and satisfaction with surgery. 20 year survival was assessed with Kaplan-Meir analysis, and failure defined as proceeding to subsequent knee arthroplasty.The mean age at HTO was 50 years (range 26-66), and 72% were males. The 5, 10, and 20 year survival of the HTO was 88%, 76%, 43% respectively. On multiple regression analysis HTO failure was associated with poor preoperative WOMAC score of 45 or less (HR 3.2, 95% CI 1.7-6.0, p=0.001), age at surgery of 55 or more (HR 2.3, 95% CI 1.3-4.0, p=0.004), and obesity (HR 1.9, 95% CI 1.1-3.4, p=0.023). In patients who met all criteria of preoperative WOMAC score of 45 or less, age <55 years and body mass index of <30 HTO survival was 100%, 94%, and 59% at 5, 10 and 20 years respectively. Of those who had not proceeded to TKA the mean Oxford Score was 40, KOOS Pain score was 91 and KOOS function score was 97. 97% reported they were satisfied with the surgery and 88% would have the same surgery again under the same circumstances.At 20 years after HTO 43% had not proceeded to knee arthroplasty, and were continuing to demonstrate high subjective scores and satisfaction with surgery. HTO survival was higher in those under 55 years, with BMI <30 and baseline WOMAC score of >45 at 59% HTO survival over 20 years. HTO may be considered a viable procedure to delay premature knee arthroplasty in carefully selected subjects.
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Gouda, Wesam, Awad S. Abbas, Tarek M. Abdel-Aziz, et al. "Comparing the Efficacy of Local Corticosteroid Injection, Platelet-Rich Plasma, and Extracorporeal Shockwave Therapy in the Treatment of Pes Anserine Bursitis: A Prospective, Randomized, Comparative Study." Advances in Orthopedics 2023 (September 30, 2023): 1–10. http://dx.doi.org/10.1155/2023/5545520.
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Background. Pes anserine bursitis (PAB) is one of the most common causes of painful knee syndromes. This study aimed at examining the efficacy of local corticosteroid injection, platelet-rich plasma (PRP) injection, and extracorporeal shock wave therapy (ESWT) as different modalities to alleviate pain and enhance function in patients with pes anserine bursitis (PAB). Methods. A prospective, randomized, comparative study was conducted on 180 patients diagnosed with chronic PAB. They were equally divided into three groups as follows: Group I received a local corticosteroid injection of 40 mg of methylprednisolone acetate/1 ml; Group II received a PRP injection; and in Group III, ESWT was used. Outcome measures included the visual analog scale (VAS), Western Ontario and McMaster Universities (WOMAC) pain score, WOMAC physical function score, and Ritchie articular index (RAI) for tenderness, which were recorded at the baseline, after 1 week, and after 8 weeks. Results. Before the application of procedures, there was a statistically significant increase in the WOMAC pain score in the local corticosteroid group compared to the PRP group and the ESWT group ( P < 0.001 ). After the application of procedures, there was a statistically significant improvement in the 1-week and 8-week WOMAC pain score, WOMAC physical function score, and VAS in the local corticosteroid group in comparison to the PRP group and the ESWT group. ( P < 0.001 ). Moreover, RAI for tenderness shows statistically significant improvement at 8 weeks in the local corticosteroid groups compared to the PRP groups ( P < 0.001 ) and ESWT groups ( P < 0.001 ). Similarly, a statistically significant difference was found between the PRP and ESWT groups ( P = 0.023 ). Conclusion. Our data suggest that in patients with PAB, local corticosteroid injection is more efficient than PRP injection and ESWT for reducing pain and enhancing function.
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Burrows, Brett, Sandra Woolson, Cynthia Coffman, and Kelli Allen. "RESULTS OF A STEPPED EXERCISE PROGRAM AMONG VETERANS WITH KNEE OSTEOARTHRITIS AND CO-OCCURRING BACK PAIN." Innovation in Aging 8, Supplement_1 (2024): 1272. https://doi.org/10.1093/geroni/igae098.4068.
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Abstract Co-occurring back pain can exacerbate an already high risk of disability among patients with knee osteoarthritis (OA). We described the effect of a stepped exercise program for patients with knee OA (STEP-KOA) versus arthritis education (AE) on Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores for participants with and without co-occurring back pain. Veterans with knee OA (n= 345) were randomized 2:1 to STEP-KOA or AE control group that received mailed materials. STEP-KOA began with 3 months of internet-supported home exercise (Step 1), followed by 3 months of bi-weekly physical activity coaching (Step 2), then 3 months of physical therapy (Step 3) if participants did not make clinically relevant improvement in pain or function with the prior step. WOMAC, which assesses lower-extremity pain, stiffness and function was the primary outcome at 9 months. Self-reported back pain was reported at baseline. Differences in mean WOMAC scores at 9-months were compared between arms in those with and without back pain using t-tests. Overall, 72.4% (n=250) reported having co-occurring back pain. Among participants with co-occurring back pain (n= 176), 9-month mean WOMAC score was 10.1 points lower (95% CI -15.5, -4.7; p&lt; 0.001) in STEP-KOA vs. AE. Among participants without co-occurring back pain (n= 79), 9-month mean WOMAC score did not differ between arms (Mean Difference= 4.3; 95% CI -5.3, 13.9; p=0.37). In conclusion, among participants with co-occurring back pain, the STEP-KOA intervention resulted in a significant reduction in mean WOMAC score at 9-months compared to AE alone.
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Kim, Man Soo, In Jun Koh, Keun Young Choi, et al. "The Minimal Clinically Important Difference (MCID) for the WOMAC and Factors Related to Achievement of the MCID After Medial Opening Wedge High Tibial Osteotomy for Knee Osteoarthritis." American Journal of Sports Medicine 49, no. 9 (2021): 2406–15. http://dx.doi.org/10.1177/03635465211016853.
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Background: Many approaches have been used to determine the minimal clinically important difference (MCID) in patients undergoing total knee arthroplasty, but the MCID for outcome measures after medial opening wedge high tibial osteotomy (MOWHTO) for the treatment of medial compartment knee osteoarthritis (OA) has not been reported. Purpose: To define the MCID for the Western Ontario and McMaster Universities Arthritis Index (WOMAC) after MOWHTO and to identify risk factors for not achieving the MCID. Study Design: Case-control study; Level of evidence, 3. Methods: Among patients with medial compartment knee OA who underwent MOWHTO, 174 patients who were followed for 2 years were included in the study. The MCID and substantial clinical benefit (SCB) for the WOMAC were determined using the anchor-based method with a 15-item questionnaire. Preoperative OA severity was measured by the Kellgren-Lawrence (K-L) grading system, and the acceptable range of the postoperative weightbearing line ratio was 50% to 70%. Patients were divided into 2 groups based on whether the MCID and SCB were achieved, and then factors related to failure to achieve the MCID and SCB were analyzed using multivariate logistic regression analysis. Results: The MCID for the WOMAC was 4.2 points for the pain subscale, 1.9 points for the stiffness subscale, 10.1 points for the function subscale, and 16.1 points for the total. Additionally, the SCB for the WOMAC was 6.4 for pain, 2.6 for stiffness, 16.4 for function, and 25.3 for the total. Overall, 116 (66.7%), 99 (56.9%), 127 (73.0%), and 128 (73.6%) patients achieved the MCID for the WOMAC pain, stiffness, function, and total, respectively, after MOWHTO. The odds of not achieving the MCID for the WOMAC total were 1.09 times greater (95% CI, 1.05-1.13; P < .001) in patients with a low preoperative WOMAC total score (cutoff values: 10.5 for pain, 3.5 for stiffness, 34.5 for function, and 51.0 for the total), 11.77 times greater (95% CI, 3.68-37.70; P < .001) in patients with K-L grade 4 OA compared with K-L grades 2 or 3 OA, and 8.39 times greater (95% CI, 2.98-23.63; P < .001) in patients with undercorrection or overcorrection. A low preoperative WOMAC score, K-L grade 4 OA, and undercorrection or overcorrection were also associated with not achieving the SCB for the WOMAC total (all P < .05). Conclusion: Patients treated with a MOWHTO require a 16.1-point improvement in the WOMAC total score to achieve a MCID from the procedure. Low preoperative WOMAC scores, severe OA, and undercorrection or overcorrection were related to failure to achieve the MCID.
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Kim, Jae-Jung, In-Jun Koh, Man-Soo Kim, Keun-Young Choi, Ki-Ho Kang, and Yong In. "Central Sensitization Is Associated with Inferior Patient-Reported Outcomes and Increased Osteotomy Site Pain in Patients Undergoing Medial Opening-Wedge High Tibial Osteotomy." Medicina 58, no. 12 (2022): 1752. http://dx.doi.org/10.3390/medicina58121752.
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Background and Objectives: Studies have shown that centrally sensitized patients have worse clinical outcomes following total knee arthroplasty (TKA) than non-centrally sensitized patients. It is unclear whether central sensitization (CS) affects patient-reported outcomes (PROs) and/or level of osteotomy site pain in patients undergoing medial opening-wedge high tibial osteotomy (MOWHTO). The purpose of this study was to determine whether CS is associated with PROs and osteotomy site pain following MOWHTO. Materials and Methods: A retrospective evaluation was conducted on 140 patients with varus knee osteoarthritis (OA) who were treated with MOWHTO and monitored for two years. Before surgery, the Central Sensitization Inventory (CSI) was used to assess CS status, and a CSI of 40 or higher was considered indicative of CS. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and pain visual analogue scale (VAS) were used to assess PROs. The minimal clinically important difference (MCID) for the WOMAC was set as 4.2 for the pain subscore, 1.9 for the stiffness subscore, 10.1 for the function subscore, and 16.1 for the total based on the results of a previous study. The WOMAC score, pain VAS score of the osteotomy site, and the achievement rates of WOMAC MCID were compared between the CS and non-CS groups. Results: Thirty-seven patients were assigned to the CS group, whereas 84 were assigned to the non-CS group. Before surgery, the CS group showed a higher WOMAC score than the non-CS group (58.7 vs. 49.4, p < 0.05). While there was a statistically significant improvement in WOMAC subscores (pain, stiffness, function, and total) for both groups at two years after surgery (all p < 0.05), the CS group had a higher WOMAC score than the non-CS group (37.1 vs. 21.8, p < 0.05). The CS group showed significantly inferior results in pre- and postoperative changes of WOMAC subscores (pain, function, and total) relative to the non-CS group (all p < 0.05). In addition, pain at the osteotomy site was more severe in the CS group than in the non-CS group at two years after surgery (4.8 vs. 2.2, p < 0.05). Patients with CS had worse MCID achievement rates across the board for WOMAC pain, function, and total scores (all p < 0.05) compared to the non-CS group. Conclusions: Centrally sensitized patients following MOWHTO had worse PROs and more severe osteotomy site pain compared to non-centrally sensitized patients. Furthermore, the WOMAC MCID achievement rate of patients with CS was lower than that of patients without CS. Therefore, appropriate preoperative counseling and perioperative pain management are necessary for patients with CS undergoing MOWHTO. Level of Evidence: Level III, case-control study.
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Longo, Umile Giuseppe, Sergio De Salvatore, Giulia Santamaria, et al. "Total Hip Replacement: Psychometric Validation of the Italian Version of Forgotten Joint Score (FJS-12)." Journal of Clinical Medicine 12, no. 4 (2023): 1525. http://dx.doi.org/10.3390/jcm12041525.
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Background: One million Total Hip Replacements (THA) are thought to be performed annually. To measure prosthesis awareness throughout daily activities, the FJS-12 patient-reported outcome scale was developed. This article’s goal is to undertake a psychometric validation of the Italian FJS-12 among a sample of related THA patients. Methods: Between January and July 2019, data from 44 patients were retrieved. The participants were required to complete the Italian version of FJS-12 and of the WOMAC at preoperative follow-up, after two weeks, 1, 3, and 6 months postoperatively. Results: The Pearson correlation coefficient between the FJS-12 and WOMAC was 0.287 (p = 0.002) at preoperative follow-up, r = 0.702 (p < 0.001) at 1 month, r = 0.516 (p < 0.001) at 3 months and r = 0.585 (p < 0.001) at 6 months. The ceiling effect surpassed the acceptable range (15%) for FJS-12 in 1 month (25.5%) and WOMAC in 6 months follow-up (27.3%). Conclusions: The psychometric validation of the Italian version of this score for THA was executed with acceptable results. FJS-12 and WOMAC reported no ceiling and floor effects. Therefore, to distinguish between patients who had good or exceptional results following UKA, the FJS-12 could be a reliable score. Under the first four months, FJS-12 had a smaller ceiling effect than WOMAC. It is recommended to use this score in clinical research concerning the outcomes of THA.
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Müller, Marcus, and Isabelle Gunselmann. "Ergebnisse ambulanter orthopädischer Rehabilitation Ergebnismessung mittels Funktionsfragebogen-Hannover-Rücken, DASH- und WOMAC-Score." Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin 28, no. 05 (2018): 291–98. http://dx.doi.org/10.1055/s-0044-102010.
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ZusammenfassungDie vorliegende Studie dient der Evaluation der Behandlungsergebnisse einer ambulanten orthopädischen Rehabilitationseinrichtung im Zeitraum 2013–2016. Die Ergebnisse dokumentieren deutliche Verbesserungen im Rehabilitationsverlauf für die verwendeten Assessments Funktionsfragebogen-Hannover-Rücken (FFbH-R, Rückenpatienten), Disability-of-Arm,-Shoulder,-Hand-Score (DASH, Patienten mit Läsionen der oberen Extremitäten) und Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC, Patienten mit Läsionen der unteren Extremitäten). Bei insgesamt 3210 Patienten wurden für alle Scores und Diagnosesubgruppen signifikant positive Veränderungen nachgewiesen. Unterschieden wurde nach: • FFbH-R: lumbale Bandscheiben-OP, cervicale Bandscheiben-OP, Spinalkanaldekompression, konservative Rückenschmerzbehandlung, sonstige; • DASH: Rotatorenmanschettenrekonstruktion, Schultergelenk-Endoprothese, Fraktur (konservativ oder osteosynthetisch versorgt), sonstige; • WOMAC: Hüftgelenk-Endprothese, Kniegelenk-Endoprothese, vordere-Kreuzbandplastik, sonstige. Die mittlere Scoredifferenz betrug beim FFbH-R 20,3 Punkte, -24,0 Punkte für den DASH-Score und für den dreigeteilten WOMAC-Score -8,1 (Schmerz), -4,0 (Steifigkeit) sowie -34,0 (Schwierigkeiten). Männer schätzten sich im Vergleich zu Frauen jeweils zu Beginn und Ende der Rehabilitation signifikant günstiger ein. Die Scoredifferenz von Beginn und Ende zeigte jedoch keinen Geschlechtsunterschied. Damit zeigt diese Untersuchung deutlich positive Effekte orthopädischer Rehabilitation im ambulanten Setting.
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CHAO, JEANNIE, CHRISTOPHER WU, BOB SUN, et al. "Inflammatory Characteristics on Ultrasound Predict Poorer Longterm Response to Intraarticular Corticosteroid Injections in Knee Osteoarthritis." Journal of Rheumatology 37, no. 3 (2010): 650–55. http://dx.doi.org/10.3899/jrheum.090575.
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Objective.To assess whether inflammation on ultrasound is predictive of clinical response to intraarticular (IA) corticosteroid injections in patients with knee osteoarthritis (OA).Methods.Patients with symptomatic knee OA were randomized to receive either an IA injection of 40 mg triamcinolone acetonide in the treatment group or 1 cc 0.9% saline in the placebo group. Clinical response was assessed by changes in baseline Western Ontario and McMaster Universities (WOMAC) index scores and physician global assessment at 4 and 12 weeks. Ultrasounds were performed at each visit. Patients and assessors were blinded to treatment status.Results.Seventy-nine patients were enrolled into the study. Four-week data were available for 67 patients in the primary analysis comparing change in WOMAC pain score from baseline to 4 weeks. There was almost no change in the WOMAC pain subscale score from baseline to 4 weeks in the control group, but there was a significant improvement in WOMAC pain subscale score from 10.8 (SD ± 3.2) at baseline to 8.75 (SD ± 4.0) at 4 weeks in the treatment group (adjusted p = 0.001). Of the 34 patients in the treatment group; 16 (47%) had inflammatory disease and 18 (53%) had noninflammatory disease as determined by ultrasound. There was no difference in the change in WOMAC pain score between the inflammatory and noninflammatory patients in the treatment group at 4 weeks. There was a statistically significant greater improvement in pain subscale scores among noninflammatory patients than among inflammatory patients at 12 weeks.Conclusion.Intraarticular corticosteroid injections are an effective short-term treatment for symptomatic knee OA compared to placebo. Patients with noninflammatory characteristics on ultrasound had a more prolonged benefit from IA corticosteroids compared to inflammatory patients.
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Muhammad, Faizal, Afifah Syifaul Ummah, Farida Aisyah, Isa Ridwan, and Yulie Erida Nur Rahmawati. "Effectiveness of ProlotherapyInjection in Elderly Patients with Knee Osteoarthritis: A Double-Blind Randomized Controlled Trial." Medica Hospitalia : Journal of Clinical Medicine 12, no. 1 (2025): 57–64. https://doi.org/10.36408/mhjcm.v12i1.1201.
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BACKGROUND : Knee osteoarthritis (OA) is a painful chronic disease in elderly population. Research has shown that prolotherapy is an effective pain-relieving treatment, particularly when used in combination with other therapies. AIMS : To evaluate the effectiveness of prolotherapy for knee OA based on The Western Ontario McMaster University OA Index (WOMAC) composite score (100 points), Knee Pain Scale, and self-reported satisfaction. We performed a randomized-controlled trial (RCT) with a double-blinded approach. METHOD: An injection saline, 10% dextrose (D10) prolotherapy, or at-home knee exercise was administered to twenty-seven elderly patients (≥60 years old) experiencing painful knee OA for at least three months. Extra- and intra-articular injections were administered at weeks 1, 4, and 7, with follow-up at weeks 11 and 15. Exercise group received in-person training and an exercise guidebook. WOMAC composite score (100 points), Knee Pain Scale, and self-reported satisfaction evaluated the outcomes. The results were considered statistically significant if p < 0.05. RESULT: There are no significant difference in baseline among groups. At 21 weeks, all groups exhibited improved composite WOMAC scores (p <0.02) compared to baseline. After adjusting for age, sex, and body mass index, D10 prolotherapy showed a significant WOMAC score improvement at 21 weeks (p <0.04) compared to saline and exercise (score change: 16.2 ± 4.4 vs. 8.5 ± 4.3, and 9.1 ± 3.2, respectively), surpassing the minimal clinically significant difference based on WOMAC. Self-reported satisfaction with D10 prolotherapy was high without reported adverse effects. CONCLUSION: When compared to saline injections and at-home exercises, D10 prolotherapy resulted in a clinically significant sustained improvement in pain, function, and stiffness scores for knee OA in elderly.
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Nilesh, Kothari, Deepak Priyank, Chouhan Sandeep, Chouhan Rajesh, and Ghodawat Tushar. "Role of Intra-Articular Hyaluronic Acid Injection in the Management of Early Osteoarthritis of Knee Joint." International Journal of Toxicological and Pharmacological Research 14, no. 3 (2024): 103–6. https://doi.org/10.5281/zenodo.10960504.
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<strong>Background</strong><strong>:</strong> Knee osteoarthritis (OA) is a common entity in adults causing disability and decreased work productivity. Management of early OA is not established showing varied results of conservative and medical treatment. <strong>Aims and Objectives:</strong> We evaluated the functional outcome of intra-articular injection of hyaluronic acid (HA) in OA knee or the management of early stages of OA knee. <strong>Material</strong> <strong>and</strong> <strong>Methods:</strong> 50 patients of OA knee, Kellgren type II or III, more than 45 years of age, were treated with 6 ml of intra-articular HA injection and were assessed by improvement in functional outcome as seen by WOMAC and VAS score. <strong>Results:</strong> The mean age was 52.65 ± 6.4 years (range 45 to 70 years). 19 (38%) were males and 31 (62%) were females. 17 (34%) patients had KL grade 2 and 33 (66 %) patients had KL grade 3 osteoarthritis. The mean pre-procedural WOMAC score of 46.7 ± 6.4 improved to 22.73 ± 5.78, 22.6 ± 5.02 and 24.83 ± 5.59 at 4 weeks, 12 weeks, and 24 weeks after the HA injection, respectively. The mean pre-procedural VAS score of 5.16 ± 0.82, improved to 1.22 ± 1.01, 1.19 ± 0.60, and 1.52 ± 0.55 at 4 weeks,12 weeks, and 24 weeks after the HA injection, respectively. Pain at the injection site was seen in 2 (4%) patients and 1 (2%) patient developed superficial infection. <strong>Conclusion</strong><strong>:</strong> HA injection provides pain relief and improves the functional outcome in the early stages of Osteoarthritis of Knee.
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Ding, Qi Xin, Xu Wang, Tian Shu Li, et al. "Comparative Analysis of Short-Term and Long-Term Clinical Efficacy of Mesenchymal Stem Cells from Different Sources in Knee Osteoarthritis: A Network Meta-Analysis." Stem Cells International 2024 (May 31, 2024): 1–23. http://dx.doi.org/10.1155/2024/2741681.
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Background. Joint articular injection of mesenchymal stem cells (MSCs) has emerged as a novel treatment approach for osteoarthritis (OA). However, the effectiveness of MSCs derived from different sources in treating OA patients remains unclear. Therefore, this study aimed to explore the differences between the effectiveness and safety of different sources of MSCs. Materials and Methods. For inclusion consideration, we searched trial registries and published databases, including PubMed, Cochrane Library, Embase, and Web of Science databases. Revman (V5.3), STATA (V16.0), and R (V4.0) were utilized for conducting data analysis, while the Cochrane Risk of Bias Tool was employed for assessing the quality of the studies. We derived outcome measures at 6 and 12 months based on the duration of study follow-up, including visual analog scale (VAS) score, WOMAC score, WOMAC pain, WOMAC Functional Limitation, and WOMAC stiffness. The evaluation time for short-term effectiveness is set at 6 months, while 12 months is utilized as the longest follow-up time for most studies to assess long-term effectiveness. Results. The evaluation of literature quality showed that the included studies had excellent methodological quality. A meta-analysis revealed that different sources of MSCs improved knee function and pain more effectively among patients suffering from knee OA (KOA) than controls. The results of the network meta-analysis showed the following: short-term functional improvement (the indexes were evaluated after 6 months of follow-up) (WOMAC total score: bone marrow-derived MSC (BMMSC) vs. adipose-derived MSC (ADMSC) (mean difference (MD) = −20.12, 95% confidence interval (CI) −125.24 to 42.88), umbilical cord-derived MSC (UCMSC) (MD = −7.81, 95% CI −158.13 to 74.99); WOMAC stiffness: BMMSC vs. ADMSC (MD = −0.51, 95% CI −7.27 to 4.29), UCMSC (MD = −0.75, 95% CI −9.74 to 6.63); WOMAC functional limitation: BMMSC vs. ADMSC (MD = −12.22, 95% CI −35.05 to 18.86), UCMSC (MD = −9.31, 95% CI −44.26 to 35.27)). Long-term functional improvement (the indexes were evaluated after 12 months of follow-up) (WOMAC total: BMMSC vs. ADMSC (MD = −176.77, 95% CI −757.1 to 378.25), UCMSC (MD = −181.55, 95% CI −937.83 to 541.13); WOMAC stiffness: BMMSC vs. ADMSC (MD = −0.5, 95% CI −26.05 to 18.61), UCMSC (MD = −1.03, 95% CI −30.44 to 21.69); WOMAC functional limitation: BMMSC vs. ADMSC (MD = −5.18, 95% CI −316.72 to 177.1), UCMSC (MD = −8.33, 95% CI −358.78 to 218.76)). Short-term pain relief (the indexes were evaluated after 6 months of follow-up) (VAS score: UCMSC vs. BMMSC (MD = −10.92, 95% CI −31.79 to 12.03), ADMSC (MD = −14.02, 95% CI −36.01 to 9.81), PLMSC (MD = −17.09, 95% CI −46.31 to 13.17); WOMAC pain relief: BMMSC vs. ADMSC (MD = −11.42, 95% CI −39.52 to 11.77), UCMSC (MD = −6.73, 95% CI −47.36 to 29.15)). Long-term pain relief (the indexes were evaluated after 12 months of follow-up) (VAS score: BMMSC vs. UCMSC (MD = −4.33, 95% CI −36.81 to 27.08), ADMSC (MD = −11.43, 95% CI −37.5 to 13.42); WOMAC pain relief: UCMSC vs. ADMSC (MD = 0.23, 95% CI −37.87 to 38.11), BMMSC (MD = 5.89, 95% CI −25.39 to 51.41)). According to the GRADE scoring system, WOMAC, VAS, and AE scores were of low quality. Conclusion. Meta-analysis suggests MSCs can effectively treat KOA by improving pain and knee function compared to control groups. In terms of functional improvement in KOA patients, both short-term (6-month follow-up) and long-term (12-month follow-up) results indicated that while the differences between most treatments were not statistically significant, bone marrow-derived MSCs may have some advantages over other sources of MSCs. Additionally, BM-MSCs and UC-MSCs may offer certain benefits over ADMSCs in terms of pain relief for KOA patients, although the variances between most studies were not statistically significant. Therefore, this study suggests that BM-MSCs may present clinical advantages over other sources of MSCs.
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Joshua, Rompilli, Kalidindi Varun Varma, Sura Yachendra Kumar Reddy, and DR Rehan Saifuddin DR Rehan Saifuddin4. "Assessment of Platelet Rich Plasma (PRP) In the Treatment of Primary Osteoarthritis Knee: An Original Research." International Journal of Medical and Biomedical Studies 7, no. 3 (2023): 15–19. http://dx.doi.org/10.32553/ijmbs.v7i3.2684.
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Introduction: The present therapeutic line of osteoarthritis of knee is primarily symptomatic, therefore the need to discover treatment modality which tackles the disease process in itself. This study was done with an intention to examine the efficacy of platelet rich plasma in primary osteoarthritis of knee.
 Materials and Methods: This prospective investigation was done on 100 knees in 100 individuals having early primary osteoarthritis of the knee. Three injections of platelet rich plasma were administered at four weeks interval and the outcome was analyzed by WOMAC and VAS score at pre injection, 3 weeks, 12 weeks and 24 weeks. Ahlback’s grading was done at pre-injection and at 6 months.
 Results: Most of the cases in our series were in the age category of 50-65 years with female predominance (73%), 51% cases had grade 2 disease and the remaining had grade 1 involvement. Improvement in WOMAC score parameters started after 3 weeks with continuing improvement at successive follow-ups. WOMAC score parameters (pain, stiffness, physical function and total score) at pre injection were 14.22, 5.05, 36.41and 55.8 and at 6 months follow up were 5.92, 2.07, 16.78 and 24.11 correspondingly. Similar improvement was noted in VAS score with pre injection score of 7.12 and final score of 2.96. The average WOMAC score was less for grade 1 as compared to grade 2 (43.42 vs 60.41); (43.63 vs 61.36). Improvement was reported in 86% of patients however the level varied from good to slight improvement. There was no problem associated to the treatment in our series.
 Conclusion: The initial data show that PRP is an effective therapeutic strategy in early grades of primary Osteoarthritis of knee. However, further strong evidence Research is required to check for the long-term impacts and to corroborate the conclusions of this investigation.
 Keywords: , , ,
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Muratović, M., Lj Smilić, and M. Radunović. "THE EVALUATION OF FUNCTIONAL CONDITION OF PATIENTS SICK OF COXARTHROSIS." Praxis medica 37, no. 2 (2009): 69–72. http://dx.doi.org/10.70949/pramed200902298m.
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&lt;p&gt;Artrosis as degenerative rheumatic discase of joints, which is the most often with older people, and if it is not cured adequotety it brings to the serious defects. The air of warr is to evaluate functional condition of people sick of hip osteoarthrosis by using two standardised questionnaires for the hip osteoarthrosis. Material and methods: The examination included 100 patients with hip osteoarthrosis (73 women and 23 men) whase diagnosis was set on the basis of ACR criteria. The result : In the group of 100 patients (73 women and 27 men) with average old of 58,87 years and average lasting of sickness 8,28 years from which 77 had bilateral representation of hip osteoarthrosis and 23 unilateral representation of hip osteoarthrosis showed these results of funcional tests: a) averagevalne of Womac score is 50,18 (min 13,00 max 77,00) that is in the medium category of funcional disableness, b) average volne of Lequesne score is 14,12 (min 4,00 max 23,40) that shows high degrece of functional of functional disableness. Both questionnaires are mutvally correlated with a higs degree of statistic importance in the whale score (r= 0,454; p&amp;lt; 0,0001) and so in the subsections: pain (r= 0,540; p&amp;lt;0,0001) and physical functional scale r= 0,728; p&amp;lt; 0,0001). The intensity of pain also correlated with time of step and Womac score (r= 0,454; p&amp;lt; 0,0001), and with the lasting of sickness, female sex, and there wasnt statisticaly important coreelation with Lequesne score (r= 0,215; p= 0,08). Radiologic findig correlated with reduction of the moveness amplitudes, the time of step, the lasting of sickness, the of the patient, Womac score (p&amp;lt; 0,05), and it isnt correlated with Lequesne score. The reduction of the moveness of amplitudes is the hips correlated with radiographic presentation, the time of step, Womac and Lequesne score, localization, the age of patients and using of help materials. Conculsion: The valne of both indexes correlate with the usual clinical indications of coxarthrosis progression, and Womac index shows better correlation with radiologic progression of sickness than with Lequesne index.&lt;/p&gt;
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Hariyanto, Hori, John Butar Butar, Gatot Susilo Lawrence, FX Budhianto Suhadi, and Andi Husni Tanra. "Association Between Plasma Beta-endorphin and WOMAC Score in Female Patients with Knee Osteoarthritis." Indonesian Biomedical Journal 4, no. 2 (2012): 107. http://dx.doi.org/10.18585/inabj.v4i2.169.
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BACKGROUND: β-endorphin plays a role in the descending pain control in the central nervous system. Central sensitization may be involved in the generating and maintenance of osteoarthritis (OA) pain. However, the correlation between β-endorphin and pain severity in OA has shown conflicting results. The aim of this study was to investigate the association between plasma β-endorphin and the severity of the disease. METHODS: This study was an observational cross-sectional study carried out on 60 female subjects with knee OA who fulfilled the inclusion criteria. Plasma β-endorphin was measured by a commercial enzyme-linked immunosorbent assay (ELISA) kit. Osteoarthritis knees were classified by the Kellegren-Lawrence (KL) grading (1-4) criteria. The Western Ontario McMaster University Osteoarthritis (WOMAC) scoring method was used to assess self-reported physical function, pain and stiffness. RESULTS: The mean of the participants' ages was 58 years old, ranging from 42 to 83 years. Overall, more than 70% of the participants were overweight with a mean of body mass index (BMI) of 27.59. More than 54% of the participants were diagnosed of having KL grading 3 or 4. Plasma β-endorphin was correlated inversely with the WOMAC subscale of stiffness (r=-0.286, p=0.0311), but no correlation was noted with the WOMAC subscale of pain and physical activity. There was no significant difference of the mean of plasma β-endorphin among the KL gradings. CONCLUSIONS: Plasma β-endorphin is associated with better WOMAC total score and stiffness subscale, but not associated with KL grading of OA. KEYWORDS: knee osteoarthritis, female, β-endorphin, WOMAC, Kellgren-Lawrence
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Hartana, Pande Made Yosira, Ni Luh Putu Gita Karunia Saraswati, Anak Agung Gede Eka Septian Utama, and I. Dewa Gede Alit Kamayoga. "Validation of the Indonesian version of Western Ontario and McMaster Universities osteoarthritis index in pre-elderly and elderly with osteoarthritis." Physical Therapy Journal of Indonesia 5, no. 2 (2024): 164–70. http://dx.doi.org/10.51559/ptji.v5i2.215.
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Background: This study aimed to examine the psychometric performance of the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) version Indonesia used in pre-elderly and older adults in Indonesia with knee osteoarthritis and hip osteoarthritis. Methods: This study obtained samples from 124 pre-elderly and elderly individuals affected by knee and hip osteoarthritis in the Denpasar, Badung, and Gianyar areas to check the reliability and validity of the Indonesia WOMAC from Karsten et al. (2019). Knee and hip osteoarthritis were examined using the American College of Rheumatology (ACR) clinical criteria. Results: The Indonesian WOMAC was valid with a score of (0.809-0.964) for knee osteoarthritis, (0.870-0.982) for hip osteoarthritis, and (0.744-0.944) for knee osteoarthritis and hip osteoarthritis. It is reliable with Cronbach’s alpha score of (α = 0.992) for knee osteoarthritis, (α = 0.996) for hip osteoarthritis, and (α = 0.980) for knee osteoarthritis and hip osteoarthritis in pre-elderly and elderly patients. Conclusion: Based on the research results, the Indonesian WOMAC was valid and reliable for knee and hip osteoarthritis and is used in pre-elderly and elderly patients.
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Han, Rong, Chunxia Guo, Kit Lau, and Jinlian Hu. "Efficacy of knee osteoarthritis by use of laser acupuncture: A systematic review and meta-analysis." Medicine 103, no. 25 (2024): e38325. http://dx.doi.org/10.1097/md.0000000000038325.
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Background: Previous studies need to be aggregated and updated. We aim to assess the efficacy of laser acupuncture (LA) in knee osteoarthritis (OA) through a meta-analysis. Methods: Electronic databases were searched for studies investigating laser acupuncture’s efficacy in managing OA. Data were collected from the beginning of each database to 2022 (up to March). The “WOMAC total score,” “WOMAC stiffness score,” “WOMAC pain score,” “WOMAC physical function score,” and “VAS score” were the key outcomes of interest. The Der Simonian-Laird method for random effects was used. Results: Twenty-five randomized controlled clinical trials met our criteria and were included (2075 patients). Comparisons of interest is the LA versus Sham LA (efficacy), LA versus. A (Acupuncture) (comparative effectiveness), LA combined with A versus A (effectiveness as an adjunct), and any other research used LA in their treatment. Laser irradiation is effective in patients with Knee OA. LA is also effective and has almost the same outcome as laser irradiation. LA can achieve almost the same effect as manual acupuncture, even better than acupuncture in some studies. Conclusion: Laser acupuncture is more or less effective in patients with OA; better efficacy will be achieved under appropriate laser parameters (810 nm, 785 nm) in the LA versus Sham LA group. Many studies have diverse results, possibly due to unstaged analysis of patients’ disease, inappropriate selection of acupoints, lack of remote combined acupoints, and unreasonable laser parameters. Furthermore, a combination of acupoints was found to be more effective, which aligns with the combined-acupoints application of traditional Chinese medicine.
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Yu, Yang, Qunshan Lu, Songlin Li, et al. "Intra-Articular Injection of Autologous Micro-Fragmented Adipose Tissue for the Treatment of Knee Osteoarthritis: A Prospective Interventional Study." Journal of Personalized Medicine 13, no. 3 (2023): 504. http://dx.doi.org/10.3390/jpm13030504.
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Background: To investigate the efficacy and safety of autologous micro-fragmented adipose tissue (MF-AT) for improving joint function and cartilage repair in patients with knee osteoarthritis. Methods: From March 2019 to December 2020, 20 subjects (40 knees) between 50 and 65 years old suffering from knee osteoarthritis were enrolled in the study and administered a single injection of autologous MF-A. The data of all patients were prospectively collected. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), knee society score (KSS), hospital for special surgery (HSS) score, visual analogue score (VAS) pain score, changes in cartilage Recht grade on magnetic resonance imaging (MRI) and adverse events were analyzed before and 3, 6, 9, 12 and 18 months after injection. Results: The WOMAC, VAS, KSS and HSS scores at 3, 6, 9, 12 and 18 months after injection were improved compared with those before injection (p < 0.05). There was no significant difference in WOMAC scores between 9 and 12 months after injection (p > 0.05), but the WOMAC score 18 months after injection was worse than that at the last follow-up (p < 0.05). The VAS, KSS and HSS scores 9, 12 and 18 months after injection were worse than those at the last follow-up (p < 0.05). The Recht score improvement rate was 25%. No adverse events occurred during the follow-up. Conclusions: Autologous MF-AT improves knee function and relieves pain with no adverse events. However, the improved knee function was not sustained, with the best results occurring 9–12 months after injection and the cartilage regeneration remaining to be investigated.
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Kilinc, Bekir Eray, Yunus Oc, Gungor Alibakan, Emre Bilgin, Muharrem Kanar, and Osman Tugrul Eren. "An Observational 1-Month Trial on the Efficacy and Safety of Promerim for Improving Knee Joint." Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders 11 (January 1, 2018): 117954411875749. http://dx.doi.org/10.1177/1179544118757496.
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Objective: This study was conducted to evaluate the efficacy and tolerability of the oral intake of promerim in the elimination of acute pain and discomfort associated with knee osteoarthritis (OA). Methods: Single-center, 1-month, prospective, observational clinical trial. A total of 92 patients not older than 70 years were included. Patients were offered to use 720-mg promerim for the first 15 days after admission after breakfast and then 360 mg for the second 15 days. All patients were analyzed with the visual analog scale (VAS) for pain, which ranges from 0 to 10, and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score before the start of treatment and 1 month after the start. Statistical analysis was performed by SPSS 15.0 software. An α level of P < .05 was assumed to be statistically significant. Results: This study comprised 92 patients (69 women and 23 men) with a mean age of 51.5 (range: 40-69) years. Before treatment, the mean VAS score was 5.6 ± 1.1, and after treatment, the mean VAS score was 2.6 ± 1.7. Treatment with promerim consistently showed a significant decrease in the VAS score ( P < .001). The mean WOMAC score of the patients was 46.4 ± 8.2 before treatment. After treatment, the mean WOMAC score was 72.1 ± 14.4. Treatment with promerim consistently showed a significant increase in the WOMAC score ( P < .001). Conclusions: The results of this single-center, open-label clinical study demonstrate that promerim is a viable natural treatment option for treating knee OA. We recommend that 720-mg promerim taken once daily for the first 15 days after admission and 360 mg taken once daily for the next 15 days significantly and rapidly reduced composite pain and stiffness in the knee OA within 1 month.
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Sharma, Nishant, Sudhir Singh, Dharmendra Kumar, and Sanjiv Kumar. "Correlation between WOMAC score and hyalrunoic acid levels in knee osteoarthritis." International Journal of Research in Medical Sciences 3, no. 3 (2015): 757. http://dx.doi.org/10.5455/2320-6012.ijrms20150343.
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Ng, Tony Kwun-tung, King Hei Stanley Lam, and Abdallah El-Sayed Allam. "Motor-Sparing Neural Ablation with Modified Techniques for Knee Pain: Case Series on Knee Osteoarthritis and Updated Review of the Underlying Anatomy and Available Techniques." BioMed Research International 2022 (May 31, 2022): 1–13. http://dx.doi.org/10.1155/2022/2685898.
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Knee osteoarthritis (KOA) is ubiquitous. However, effective pain managements for patients with grades 3 or 4 KOA for whom conservative treatments are unsuccessful, but for whom surgery is not an option, remain lacking. This case series presented two motor-sparing interventional pain treatment modalities for five such patients. Three of the patients with a mean total WOMAC score of 41 underwent thermal radiofrequency (RF) ablation using a modified motor-sparing approach. One-week and four-week post-RF, the total score dropped to 27 (by 34%) and 19 (dropped 53.7%), respectively. Two other similar patients with a mean total WOMAC score 96 underwent chemical neurolysis using a motor-sparing approach with modified landmarks. The WOMAC score dropped to 58.5 (by 39.1%) and 49 (dropped by 49.0%), one-week and four-week postchemical neurolysis, respectively. A narrative review of the currently available approaches is also provided, with the conclusion that neural ablation using the modified landmarks approach may achieve better pain control and preserve the motor functions for patients with severe KOA for whom conservative treatment was unsuccessful and who are not candidates for surgery.
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Deo, Veena, Bharatbhushan Shrikhande, and Gayatri Ganu. "A Randomized, Placebo Controlled Clinical Trial to Evaluate the Efficacy and Safety of HFPM-01 in Improving Pain, Stiffness, and Inflammation in Patients Suffering from Knee Osteoarthritis." International Journal of Research and Review 8, no. 4 (2021): 1–11. http://dx.doi.org/10.52403/ijrr.20210401.
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Objective: Osteoarthritis is a common chronic joint condition which causes stiffness and difficulty in moving, loss of muscle tone, strength and stamina. All these difficulties affect daily activities and quality of life and may also have an impact of mental health. Globally over 9.6% men and 18.0% women aged over 60 years has symptomatic osteoarthritis worldwide. It is the second most common rheumatologic problem and it is the most frequent joint disease with a prevalence of 22% to 39% in India. Considering the increasing prevalence and limitations of the conventional treatment for the management of Osteoarthritis, the current research aims at systematic clinical validation of the HFPM-01 in subjects primarily suffering from knee osteoarthritis. Materials and Methods: 90 subjects were enrolled in the study and were randomized to one of the three treatment groups. Subjects were undergoing clinical examination. Vitals were recorded. Blood samples were collected for readings of CRP. Subjective questionnaire scores evaluation was performed like SF-36 health survey score, VAS scale, WOMAC questionnaire. Changes in symptoms severity were noted like morning stiffness, tiredness, tenderness, and muscle spasms along with assessment of GI symptoms. Results: The change in WOMAC score, the increase in SF-36 score, the decrease in VAS score, the decrease in CRP levels, and the reduction in GI symptoms were found to be 33%, 308%, 60.44%, 52%, 40% respectively. Swelling, inflammation and pain was reduced from moderated to mild and eventually to no symptoms. Conclusion: This explains that HFPM-01 tablet is significantly effective in improving SF36 score WOMAC and VAS scale score. It is effective in reducing pain, swelling, and stiffness of knee joints, also improves the mobility of knee joints, and provides gastro protection being effective in managing pain and stiffness. HFPM-01tablet is safe and effective in the management of Osteoarthritis. Keywords: Osteoarthritis, WOMAC, VAS, CRP, Gastro protective.