Effect of leeches therapy (Hirudo medicinalis) in painful osteoarthritis of the knee: a pilot study

Michalsen, Andreas; Deuse, Ulrich; Esch, T.; Dobos, Gustav; Moebus, Susanne

doi:10.1136/ard.60.10.986

Cited by 36 publications

(13 citation statements)

References 7 publications

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“…According to Michalsen et al [41, 42] vasovagal attacks can occur in 0.1% of patients undergoing hirudotherapy, mainly in those with a history of developing such attacks or syncope during invasive procedures such as venopunction. It is highly recommended that patients drink plenty of fluids during hirudotherapy.…”

Section: Side Effects and Contraindicationsmentioning

confidence: 99%

Recommendations for the Use of Leeches in Reconstructive Plastic Surgery

Mumcuoglu

2014

Evidence-Based Complementary and Alternative Medicine

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A written informed consent should be obtained from the patient before hirudotherapy is initiated. The patients should be treated each day of leech therapy with anti-Aeromonas antibiotics. Leeches should be applied on the darker spots of the reattached body parts or flaps. Usually 1–10 leeches are used for each treatment, while at the beginning, the patient might need two or more treatments per day. Leech therapy is used until venous capillary return is established across the wound border by angiogenesis. Usually the treatment with leeches lasts for 2–6 days. Hematologic evaluations should be performed every 4 hrs and the patient has to receive blood transfusions when the hemoglobin level is lower than 8 g/dL. Signs of regional lymphadenitis, slight swelling, and pain of regional lymph nodes on the side of leech application and subfebrile temperature can occur. Contraindications related to hirudotherapy include arterial insufficiency, hemophilia, hemorrhagic diathesis, hematological malignancies, anemia, hypotension, and sepsis. Leech therapy is not recommended in pregnancy and lactation and in patients with an unstable medical status, history of allergy to leeches or severe allergic diathesis, and disposition to keloid scar formation, as well as in those using anticoagulants and immunosuppressants.

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Section: Side Effects and Contraindicationsmentioning

confidence: 99%

Recommendations for the Use of Leeches in Reconstructive Plastic Surgery

Mumcuoglu

2014

Evidence-Based Complementary and Alternative Medicine

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“…Die Wirksamkeit bei symptomatischer Gonarthrose ist durch 4 kontrollierte Studien (3 davon randomisiert) belegt [4,18,19,20,27]. Hierbei kommt es in der Regel zu einer Beschwerdereduktion um 60-70 % und zu einer signifikanten Funktionsverbesserung.…”

Section: Wirksamkeitunclassified

Ausleitende Verfahren

Michalsen¹

2009

Zeitschrift für Komplementärmedizin

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“…As for Western countries, there are very limited amounts of clinical data on single Ayurvedic interventions (for example, leeches [73,74] and ginger extract [75,76]) and no data for complex Ayurvedic treatment of OA. To date it is unknown whether such a complex treatment approach has a clinically relevant effect and whether its effectiveness can exceed the effectiveness of conventional standard care for OA.…”

Section: Introductionmentioning

confidence: 99%

Comparative effectiveness of a complex Ayurvedic treatment and conventional standard care in osteoarthritis of the knee – study protocol for a randomized controlled trial

Witt

Michalsen

Roll

et al. 2013

Trials

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BackgroundTraditional Indian Ayurvedic medicine uses complex treatment approaches, including manual therapies, lifestyle and nutritional advice, dietary supplements, medication, yoga, and purification techniques. Ayurvedic strategies are often used to treat osteoarthritis (OA) of the knee; however, no systematic data are available on their effectiveness in comparison with standard care. The aim of this study is to evaluate the effectiveness of complex Ayurvedic treatment in comparison with conventional methods of treating OA symptoms in patients with knee osteoarthritis.Methods and designIn a prospective, multicenter, randomized controlled trial, 150 patients between 40 and 70 years, diagnosed with osteoarthritis of the knee, following American College of Rheumatology criteria and an average pain intensity of ≥40 mm on a 100 mm visual analog scale in the affected knee at baseline will be randomized into two groups. In the Ayurveda group, treatment will include tailored combinations of manual treatments, massages, dietary and lifestyle advice, consideration of selected foods, nutritional supplements, yoga posture advice, and knee massage. Patients in the conventional group will receive self-care advice, pain medication, weight-loss advice (if overweight), and physiotherapy following current international guidelines. Both groups will receive 15 treatment sessions over 12 weeks. Outcomes will be evaluated after 6 and 12 weeks and 6 and 12 months. The primary endpoint is a change in the score on the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) after 12 weeks. Secondary outcome measurements will use WOMAC subscales, a pain disability index, a visual analog scale for pain and sleep quality, a pain experience scale, a quality-of-life index, a profile of mood states, and Likert scales for patient satisfaction, patient diaries, and safety. Using an adapted PRECIS scale, the trial was identified as lying mainly in the middle of the efficacy-effectiveness continuum.DiscussionThis trial is the first to compare the effectiveness of a complex Ayurvedic intervention with a complex conventional intervention in a Western medical setting in patients with knee osteoarthritis. During the trial design, aspects of efficacy and effectiveness were discussed. The resulting design is a compromise between rigor and pragmatism.Trial registrationNCT01225133

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Effect of leeches therapy (Hirudo medicinalis) in painful osteoarthritis of the knee: a pilot study

Cited by 36 publications

References 7 publications

Recommendations for the Use of Leeches in Reconstructive Plastic Surgery

Recommendations for the Use of Leeches in Reconstructive Plastic Surgery

Ausleitende Verfahren

Comparative effectiveness of a complex Ayurvedic treatment and conventional standard care in osteoarthritis of the knee – study protocol for a randomized controlled trial

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