Function scores of different surgeries in the treatment of knee osteoarthritis

Liu, Chengyao; Li, Chuandong; Wang, Liang; Ren, Shuo; Yu, Fu-Bin; Li, Jin-Guang; Ma, Jiang-Xiong; Ma, Xing-Long

doi:10.1097/md.0000000000010828

Cited by 27 publications

(24 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Nonsurgical treatment options include weight loss, oral medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen, injectables such as corticosteroids and hyaluronic acid (HA), physical treatments such as rehabilitative therapy, unloading braces, assistive devices (ie, canes or walkers), activity modification, and genicular nerve radiofrequency ablation. 11,32,45,48 Surgical options include arthroscopic surgery, osteotomy, and total joint replacement. However, expectations are not always met with current surgical options, and not all patients with knee OA are candidates for surgical treatments.…”

mentioning

confidence: 99%

Bone Marrow Aspirate Concentrate Is Equivalent to Platelet-Rich Plasma for the Treatment of Knee Osteoarthritis at 1 Year: A Prospective, Randomized Trial

Anz

Hubbard

Rendos

et al. 2020

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

Background: Approximately 47 million people in the United States have been diagnosed with arthritis. Autologous platelet-rich plasma (PRP) injections have been documented to alleviate symptoms related to knee osteoarthritis (OA) in randomized controlled trials, systematic reviews, and meta-analyses. Autologous bone marrow aspirate concentrate (BMC) injections have also emerged as a treatment option for knee OA, with a limited clinical evidence base. Purpose: To compare the efficacy of BMC to PRP for the treatment of knee OA regarding pain and function at multiple time points up to 12 months after an injection. We hypothesized that BMC will be more effective in improving outcomes in patients with knee OA. Study Design: Randomized controlled trial; Level of evidence, 2 Methods: A total of 90 participants aged between 18 and 80 years with symptomatic knee OA (Kellgren-Lawrence grades 1-3) were randomized into 2 study groups: PRP and BMC. Both groups completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and subjective International Knee Documentation Committee (IKDC) questionnaires before and 1, 3, 6, 9, and 12 months after a single intra-articular injection of leukocyte-rich PRP or BMC. Results: There were no statistically significant differences in baseline IKDC or WOMAC scores between the 2 groups. All IKDC and WOMAC scores for both the PRP and BMC groups significantly improved from baseline to 1 month after the injection ( P < .001). These improvements were sustained for 12 months after the injection, with no difference between PRP and BMC at any time point. Conclusion: Both PRP and BMC were effective in improving patient-reported outcomes in patients with mild to moderate knee OA for at least 12 months; neither treatment provided a superior clinical benefit. Autologous PRP and BMC showed promising clinical potential as therapeutic agents for the treatment of OA, and while PRP has strong clinical evidence to support its efficacy, BMC has limited support. This study did not prove BMC to be superior to PRP, providing guidance to clinicians treating OA. It is possible that the results were affected by patients knowing that there was no control group. Registration: NCT03289416 ( ClinicalTrials.gov identifier).

show abstract

mentioning

confidence: 99%

Bone Marrow Aspirate Concentrate Is Equivalent to Platelet-Rich Plasma for the Treatment of Knee Osteoarthritis at 1 Year: A Prospective, Randomized Trial

Anz

Hubbard

Rendos

et al. 2020

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

show abstract

“…Notwithstanding the aforementioned advantages of a review focused on return to physical activity after surgery, to our knowledge recent systematic reviews and meta-analyses comparing HTO and UKA have focused on issues such as survivorship/revision, pain, complications, and knee function but have not focused sufficiently on return to physical activity. 8,14,15,17,26,28,43,50 The implementation of patient-reported outcome questionnaires is common to assess the outcome of HTO and UKA, and the Tegner activity scale is one such questionnaire that is often used to assess patient physical activity levels after either procedure. 12,54 The Tegner activity score is based on a 10-point scale where 0 represents a patient who is on sick leave from work as a result of knee problems, 5 represents a job involving heavy labor or participation in activities such as competitive cycling or recreational jogging on uneven ground, and 10 represents a patient who plays competitive high-impact sports such as soccer at the national or international level.…”

mentioning

confidence: 99%

Return to Physical Activity After High Tibial Osteotomy or Unicompartmental Knee Arthroplasty: A Systematic Review and Pooling Data Analysis

et al. 2020

View full text Add to dashboard Cite

Background: The 2 most common definitive surgical interventions currently performed for the treatment of medial osteoarthritis of the knee are medial opening wedge high tibial osteotomy (HTO) and medial unicompartmental knee arthroplasty (UKA). Research exists to suggest that physically active patients may be suitably indicated for either procedure despite HTO being historically indicated in active patients and UKA being more appropriate for sedentary individuals. Purpose: To help consolidate the current indications for both procedures regarding physical activity and to ensure that they are based on the best information presently available. Study Design: Systematic review. Methods: A search of the literature via the MEDLINE, Embase, and PubMed databases was conducted independently by 2 reviewers in accordance with the PRISMA (Preferred Reporting Items for Systematic Meta-Analyses) guidelines. Studies that reported patient physical activity levels with the Tegner activity score were eligible for inclusion. Patient demographics, operative variables, and patient-reported outcome scores were abstracted from the included studies. Results: Thirteen eligible studies were included, consisting of 401 knees that received HTO (399 patients) and 1622 that received UKA (1400 patients). The patients’ mean age at surgery was 48.4 years for the HTO group and 60.6 years for the UKA group. Mean follow-up was 46.6 months (HTO) and 53.4 months (UKA). All outcome scores demonstrated an equal or improved score for activity and knee function regardless of the operation performed. Operative variables during HTO had a larger effect on outcome than during UKA. Conclusion: Patients who underwent HTO were more physically active pre- and postoperatively, but patients undergoing UKA experienced an overall greater increase in their physical activity levels and knee function according to Tegner and Lysholm scores. Activity after HTO may be influenced by operative factors such as the implant used and the decision to include a graft material in the osteotomy gap, although this requires further research. Some studies found that patients were able to return to physical activity postoperatively despite having an age or body mass index that would traditionally be a relative contraindication for HTO or UKA.

show abstract

“…Another study evaluated the hip, knee, and ankle angles, and corrected the affected limb to an average of -4.3° to 3.7°, enabling patients to regain excellent function and daily physical activity ability through micro-orthosis [26]. At present, it is generally believed that setting different intraoperative force lines according to different knee wear conditions can reduce the pressure in the medial compartment of the knee to the greatest extent, thus reducing knee pain [27,28].There was no statistical signi cance in HSS score between the two groups, which may be because knee HSS score was affected by factors such as joint range of motion and muscle strength, and the pain improvement and daily motor function were more affected by lower limb line and cartilage repair, so the improvement in HSS score was not statistically signi cant [29,30]. In this study, there was no statistically signi cant difference between THE HSS score and WOMAC score in patients with OWHTO posterior extremity line over-migration compared with the normal correction group so far.If the orthopedic Angle is too large and the lower limb force line is overcorrected, it is bound to cause excessive knee eversion, resulting in the wear and degeneration of the lateral compartment cartilage, and increasing the probability of postoperative lateral compartment degeneration of the knee.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Radiological and Clinical Efficacy of Normal and Overcorrected Varus Deformity After Medial Open Wedge High Tibial Osteotomy: A Two-Year Follow-up Investigation

Zhang

Shen

et al. 2021

Preprint

View full text Add to dashboard Cite

Objective To study the clinical efficacy of over-correction of varus deformity 2 years after Open wedge High tibial osteotomy (OWHTO), and by using radiographic indicators, the compensatory changes of the hip, patellofemoral, and ankle joints were observed。Methods Since February 2016, were retrospectively analyzed in August 2019 in our hospital during the period of treatment and included in the standard of 63 cases of patients with medial compartment osteoarthritis knee joint data, according to the postoperative measuring weight bearing line ratio（WBLR）, rectify all patients were divided into normal group, 52 cases (50% < WBLR < 67%) and excessive correct set of 11 cases (WBLR≥67% ),Measured at the end of the two groups of patients with preoperative and follow-up sessions Hip-knee-ankle angle (HKA), medial proximal tibial angle (MPTA) and lateral distal femoral angle (LDFA), joint line convergence Angle (JLCA), Posterior tibial slope (PTS) after evaluating the effect of postoperative lower limb power line correction, measurement of Hip abduction angle (HAA), tibial plafond inclination（TPI）, Talar inclination Angle (TIA),Carton index, Lateral patellar tilt(LPT), Lateral patellar shift (LPS), medial patellofemoral space, and lateral patellofemoral space were used to evaluate the postoperative compensatory changes of the adjacent joints in the two groups. The American Hospital for Special Surgery score（HSS）, The Western Ontario and McMaster University Osteoarthritis Index（WOMAC） for the patients with knee arthrosis before and at the last follow-up, and the incidence of complications in patients at the last follow-up。Results In the over-corrected group, the postoperative WBLR averaged (74.43±4.05) %, with 4 cases (36.36%) of postoperative complications, while in the normal corrected group, the postoperative WBLR averaged (55.76±4.88) %, with 6 cases (11.54%) of complications. The difference in postoperative complications between the two groups was statistically significant (P =0.041)。After OWHTO HKA compare two groups of patients at the end of the time, (7.39-1.61) ° for excessive correction group, (3.28-1.59) ° for normal correction group, difference was statistically significant (P = 0.000), compared two groups of patients at the end of the second MPTA, excessive correction group is (94.95 + 1.01) °, (91.1-2.87) ° for normal correction group, difference was statistically significant (P = 0.001), compared two groups of patients at the end of the time HAA, excessive correction group is (2.96 + 1.58) °, normal correction for (0.97 + 2.31) °,The difference was statistically significant (P=0.026), while the comparison of other imaging indicators showed no statistically significant difference. The results of surgical correction of the two groups were satisfactory, and the differences in the score of American Hospital for Special Surgery and the osteoarthritis index of The Western Ontario University and McMaster University were significant compared with those before surgery in the last follow-up (P < 0.05), and there was no statistical difference between the two groups in the last follow-up。Conclusions Overcorrection of varus deformity (postoperative WBLR≥ 67%) did not affect the clinical outcome within 2 years after OWHTO, but increased the incidence of postoperative complications and resulted in increased compensatory adduction of the hip joint。

show abstract

Function scores of different surgeries in the treatment of knee osteoarthritis

Abstract: These results provide evidence that function scores of patients with KOA were improved by osteotomy, UKA, TKA, and arthroscopic surgery. And osteotomy and UKA showed better short-term efficacy, while TKA appeared better long-term efficacy.

Cited by 27 publications

References 49 publications

Bone Marrow Aspirate Concentrate Is Equivalent to Platelet-Rich Plasma for the Treatment of Knee Osteoarthritis at 1 Year: A Prospective, Randomized Trial

Bone Marrow Aspirate Concentrate Is Equivalent to Platelet-Rich Plasma for the Treatment of Knee Osteoarthritis at 1 Year: A Prospective, Randomized Trial

Return to Physical Activity After High Tibial Osteotomy or Unicompartmental Knee Arthroplasty: A Systematic Review and Pooling Data Analysis

Comparison of Radiological and Clinical Efficacy of Normal and Overcorrected Varus Deformity After Medial Open Wedge High Tibial Osteotomy: A Two-Year Follow-up Investigation

Contact Info

Product

Resources

About