Future research should focus on larger sample size, standardization of treatment protocol and basic science evidence.

Knee osteoarthritis is a degenerative "wear and tear" disorder affecting mainly population over 50 years old. It can also present in younger people, especially after an injury or as a part of other diseases. While many therapeutic options exist for knee osteoarthritis, none of them has the potential to cure this condition. Cellular Matrix represents a combination of natural non-crosslinked hyaluronic acid (HA), thixotropic cell separation gel, and sodium citrate anticoagulant solution. A combination of Cellular Matrix with autologous platelet-rich plasma (A-PRP) is a novel therapeutic approach to the management of knee osteoarthritis. It is assumed that the active components HA and PRP have a synergistic effect contributing to a better therapeutic outcome in patients with knee osteoarthritis. Physiotherapy could provide an additional benefit. This is a retrospective pilot study assessing the potential benefit of Cellular Matrix and A-PRP combined with physiotherapy in the management of chronic knee osteoarthritis. Twenty-five patients were enrolled in the study and injected with three doses of Cellular Matrix combined with A-PRP with a time span of 2 weeks between each injection. All patients received standardized physiotherapy. The results showed that 68% of patients achieved more than 50% improvement in pain, stiffness, and function of the knee joints. There were no adverse reactions. This retrospective pilot study confirmed the positive effect of PRP and HA combination in the management of mild and moderate knee osteoarthritis. These preliminary results need to be verified in randomized control trials.

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We conclude that MBI is simple, convenient, efficient, gives exact and accurate information about daily activities and ambulation and could be used in inpatient follow up sittings, in the Arab and culturally similar Middle East countries.

The application of extracorporeal shock wave therapy (ESWT) as a treatment for different orthopaedic conditions has experienced a rapid increase over the last several years. However the mechanism of action and the therapeutic effect is not clear. The aim of this study was to review the literature about the efficacy of ESWT in the treatment of plantar fasciitis, lateral epicondylitis, shoulder painful disorders and non-union fractures. Only randomized controlled studies published in the last 5 years were retrieved from electronic database and manual search. Results on efficacy of ESWT are controversial. Studies that have claimed therapeutic benefit did not fulfill scientific criteria and controlled randomized trials were not able to confirm significant improvement after treatment with ESWT.