I-ONE therapy in patients undergoing total knee arthroplasty: a prospective, randomized and controlled study

Moretti, Biagio; Notarnicola, Angela; Moretti, Luigi; Setti, Stefania; Terlizzi, Francesca de; Pesce, Vito; Patella, Vittorio

doi:10.1186/1471-2474-13-88

Cited by 36 publications

(37 citation statements)

References 30 publications

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“…However, grade IV OA outpatients could become candidates for joint replacement and be considered end-stage patients if their pain was to exceed 70 cm according to the VAS, as severe pain usually leads to total joint replacement [69]. This could be accompanied by an increase in mTOR and proinflammatory cytokine gene expression.…”

Section: Discussionmentioning

confidence: 99%

Differences in Mammalian Target of Rapamycin Gene Expression in the Peripheral Blood and Articular Cartilages of Osteoarthritic Patients and Disease Activity

et al. 2013

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The gene expression of mTOR, autophagy-related ULK1, caspase 3, CDK-inhibitor p21, and TNF α was measured in the peripheral blood of osteoarthritic (OA) patients at different stages of the disease aiming to establish a gene expression profile that might indicate the activity of the disease and joint destruction. Whole blood of 65 OA outpatients, 27 end-stage OA patients, 27 healthy volunteers, and knee articular cartilages of 28 end-stage OA patients and 26 healthy subjects were examined. OA outpatients were subjected to clinical testing, ultrasonography, and radiographic and WOMAC scoring. Protein levels of p70-S6K, p21, and caspase 3 were quantified by ELISA. Gene expression was measured using real-time RT-PCR. Upregulation of mTOR gene expression was observed in PBMCs of 42 OA outpatients (“High mTOR expression subset”) and in PBMCs and articular cartilages of all end-stage OA patients. A positive correlation between mTOR gene expression in PBMCs and cartilage was observed in the end-stage OA patients. 23 OA outpatients in the “Low mTOR expression subset” exhibited significantly lower mTOR gene expression in PBMCs compared to healthy controls. These “Low mTOR” subset subjects experienced significantly more pain upon walking, and standing and increased total joint stiffness versus “High mTOR” subset, while the latter more often exhibited synovitis. The protein concentrations of p70-S6K, p21, and caspase 3 in PBMCs were significantly lower in the “Low” subset versus “High” subset and end-stage subjects. Increases in the expression of mTOR in PBMCs of OA patients are related to disease activity, being associated with synovitis more than with pain.

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Section: Discussionmentioning

confidence: 99%

Differences in Mammalian Target of Rapamycin Gene Expression in the Peripheral Blood and Articular Cartilages of Osteoarthritic Patients and Disease Activity

et al. 2013

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“…Local joint swelling, inflammation, and pain following THA and TKA are factors affecting patient recovery and joint function [44,45]. Holm et al .…”

Section: Non-surgical Interventionsmentioning

confidence: 99%

Peri-operative interventions producing better functional outcomes and enhanced recovery following total hip and knee arthroplasty: an evidence-based review

Ibrahim

Khan

Nizam

et al. 2013

BMC Med

172

117

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The increasing numbers of patients undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA), combined with the rapidly growing repertoire of surgical techniques and interventions available have put considerable pressure on surgeons and other healthcare professionals to produce excellent results with early functional recovery and short hospital stays. The current economic climate and the restricted healthcare budgets further necessitate brief hospitalization while minimizing costs.Clinical pathways and protocols introduced to achieve these goals include a variety of peri-operative interventions to fulfill patient expectations and achieve the desired outcomes.In this review, we present an evidence-based summary of common interventions available to achieve enhanced recovery, reduce hospital stay, and improve functional outcomes following THA and TKA. It covers pre-operative patient education and nutrition, pre-emptive analgesia, neuromuscular electrical stimulation, pulsed electromagnetic fields, peri-operative rehabilitation, modern wound dressings, standard surgical techniques, minimally invasive surgery, and fast-track arthroplasty units.

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“…23,24 Pulsed electromagnetic fields (PEMFs) is a safe and non-invasive modality to reduce joint swelling and inflammation, the need for NSAIDs and the time to functional recovery through its effect on the IBRAHIM ALAzzAWI NIzAM HADDAD An evidence-BAsed review of enhAnced recovery interventions in Knee replAceMent surgery A 2A receptors of inflammatory cells. 24,25 Many studies have demonstrated the effect of PEMFs following knee surgery.…”

Section: Pulsed Electromagnetic Fieldsmentioning

confidence: 99%

An evidence-based review of enhanced recovery interventions in knee replacement surgery

Ibrahim

Alazzawi

Nizam

et al. 2013

annals

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Introduction Total knee replacement (TKR) is a very common surgical procedure. Improved pain management techniques, surgical practices and the introduction of novel interventions have enhanced the patient’s postoperative experience after TKR. Safe, efficient pathways are needed to address the increasing need for knee arthroplasty in the UK. Enhanced recovery programmes can help to reduce hospital stays following knee replacements while maintaining patient safety and satisfaction. This review outlines common evidence-based pre, intra and postoperative interventions in use in enhanced recovery protocols following TKR. Methods A thorough literature search of the electronic healthcare databases (MEDLINE®, Embase™ and the Cochrane Library) was conducted to identify articles and studies concerned with enhanced recovery and fast track pathways for TKR. Results A literature review revealed several non-operative and operative interventions that are effective in enhanced recovery following TKR including preoperative patient education, pre-emptive and local infiltration analgesia, preoperative nutrition, neuromuscular electrical stimulation, pulsed electromagnetic fields, perioperative rehabilitation, modern wound dressings, different standard surgical techniques, minimally invasive surgery and computer assisted surgery. Conclusions Enhanced recovery programmes require a multidisciplinary team of dedicated professionals, principally involving preoperative education, multimodal pain control and accelerated rehabilitation; this will be boosted if combined with minimally invasive surgery. The current economic climate and restricted healthcare budget further necessitate brief hospitalisation while minimising costs. These non-operative interventions are the way forward to achieve such requirements.

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I-ONE therapy in patients undergoing total knee arthroplasty: a prospective, randomized and controlled study

Cited by 36 publications

References 30 publications

Differences in Mammalian Target of Rapamycin Gene Expression in the Peripheral Blood and Articular Cartilages of Osteoarthritic Patients and Disease Activity

Differences in Mammalian Target of Rapamycin Gene Expression in the Peripheral Blood and Articular Cartilages of Osteoarthritic Patients and Disease Activity

Peri-operative interventions producing better functional outcomes and enhanced recovery following total hip and knee arthroplasty: an evidence-based review

An evidence-based review of enhanced recovery interventions in knee replacement surgery

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