The Experts below are selected from a list of 3033 Experts worldwide ranked by ideXlab platform
Nikolaos K Paschos - One of the best experts on this subject based on the ideXlab platform.
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effectiveness of aspiration in Knee joint Effusion management a prospective randomized controlled study
Knee Surgery Sports Traumatology Arthroscopy, 2014Co-Authors: Nikolaos K Paschos, Dimitrios Giotis, Khaled Abuhemoud, Anastasios D GeorgoulisAbstract:Purpose Knee Effusion is a common symptom in various Knee disorders of both traumatic and non-traumatic aetiology. Although intra-articular aspiration is a widespread treatment approach, its beneficial effect has not been confirmed by a randomized controlled study. The purpose was to evaluate the effectiveness and safety of joint aspiration in acute Knee Effusion, in relation to traumatic or non-traumatic aetiology. Methods One hundred and sixty-seven consecutive patients with acute Knee joint Effusion were allocated in a randomized controlled fashion into two groups. In the first group, joint aspiration was performed, while in the second group, no aspiration was performed. Range of motion, pain relief, use of analgesics and oedema were evaluated post management. The Knee Society Score and the International Knee Documentation Committee Subjective Evaluation Form were also obtained. In addition, a subgroup analysis of our results in relation to the presence of trauma or not was performed. Results Aspiration exhibited a temporary improvement in all clinical parameters evaluated, especially in the post-traumatic Effusion. However, this improvement lasted only for the first week, due to the early re-accumulation of the Effusion. There was no difference between the different groups regarding the clinical outcome in neither trauma or non-trauma patients at the end of the follow-up period. Aspiration aided in earlier establishment of the diagnosis in the non-trauma cases of Effusion. Conclusions Aspiration resulted in only temporary improvement of the outcome in the treatment of traumatic or not traumatic Knee Effusion. Aspiration is suggested in Effusions of unknown origin in order to establish the diagnosis and for immediate clinical relief. However, aspiration should be performed with consideration in the presence of trauma.
Anastasios D Georgoulis - One of the best experts on this subject based on the ideXlab platform.
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effectiveness of aspiration in Knee joint Effusion management a prospective randomized controlled study
Knee Surgery Sports Traumatology Arthroscopy, 2014Co-Authors: Nikolaos K Paschos, Dimitrios Giotis, Khaled Abuhemoud, Anastasios D GeorgoulisAbstract:Purpose Knee Effusion is a common symptom in various Knee disorders of both traumatic and non-traumatic aetiology. Although intra-articular aspiration is a widespread treatment approach, its beneficial effect has not been confirmed by a randomized controlled study. The purpose was to evaluate the effectiveness and safety of joint aspiration in acute Knee Effusion, in relation to traumatic or non-traumatic aetiology. Methods One hundred and sixty-seven consecutive patients with acute Knee joint Effusion were allocated in a randomized controlled fashion into two groups. In the first group, joint aspiration was performed, while in the second group, no aspiration was performed. Range of motion, pain relief, use of analgesics and oedema were evaluated post management. The Knee Society Score and the International Knee Documentation Committee Subjective Evaluation Form were also obtained. In addition, a subgroup analysis of our results in relation to the presence of trauma or not was performed. Results Aspiration exhibited a temporary improvement in all clinical parameters evaluated, especially in the post-traumatic Effusion. However, this improvement lasted only for the first week, due to the early re-accumulation of the Effusion. There was no difference between the different groups regarding the clinical outcome in neither trauma or non-trauma patients at the end of the follow-up period. Aspiration aided in earlier establishment of the diagnosis in the non-trauma cases of Effusion. Conclusions Aspiration resulted in only temporary improvement of the outcome in the treatment of traumatic or not traumatic Knee Effusion. Aspiration is suggested in Effusions of unknown origin in order to establish the diagnosis and for immediate clinical relief. However, aspiration should be performed with consideration in the presence of trauma.
B Amor - One of the best experts on this subject based on the ideXlab platform.
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high molecular weight sodium hyaluronate hyalectin in osteoarthritis of the Knee a 1 year placebo controlled trial
Osteoarthritis and Cartilage, 1993Co-Authors: M Dougados, M Nguyen, Veronique Listrat, B AmorAbstract:Summary Hyaluronic acid is a natural component of cartilage and is considered not only as a lubricant in joints but also as playing a physiological role in the trophic status of cartilage. Hyalectin, a selected fraction of hyaluronic acid extracted from cocks' combs, has exhibited efficacy in animal models of osteoarthritis. To assess the efficacy and tolerability of intra-articular injections of hyalectin, we conducted a prospective, randomized, placebo-controlled trial of 1 years' duration in 110 patients with painful hydarthrodial osteoarthritis of the Knee. At entry and once a week for 3 weeks, aspiration of the Knee Effusion and intra-articular injections of either hyalectin 20 mg (H) or its vehicle (C) were performed. The vehicle acted as the control treatment. Four weeks after the last injection, the improvement was greater in the H group compared with the C group (pain: −35.5±26.4 mm vs −25.8±21.4, P = 0.03, Lequesne's functional index: −3.8±4.3 vs −2.3±3.3, P = 0.03). During the 1 year follow-up, the need to perform supplementary local therapies (joint fluid aspiration because of painful hydarthrodial episodes and/or local corticosteroid injections) was more frequent in group C (44% vs 30%, P = 0.03). Moreover, at the final visit, the physician's overall assessment of efficacy was in favor of H (77% vs 54%, P = 0.01) and the improvement in the functional index was greater in group H (−4.4±5.1 vs −2.7±4.1, P = 0.05). This study suggests that intra-articular injections of hyalectin may (1) improve clinical condition and (2) have a long-term beneficial effect in patients with osteoarthritis of the Knee.
Z Zhu - One of the best experts on this subject based on the ideXlab platform.
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can low dose methotrexate reduce Effusion synovitis and symptoms in patients with mid to late stage Knee osteoarthritis study protocol for a randomised double blind and placebo controlled trial
Trials, 2020Co-Authors: Z Zhu, Xiaomei Leng, W Han, Cibo Huang, Yi Zhao, Kang Wang, Yifang Mei, Zhiyi Zhang, David J HunterAbstract:Osteoarthritis (OA) is a common chronic disease in older adults. Currently, there are no effective therapies to reduce disease severity and progression of Knee OA (KOA), particularly in mid- to late-stages. This study aims to examine the effect of methotrexate (MTX) on Knee Effusion-synovitis and pain in symptomatic patients with mid- to late-stage KOA. This protocol describes a multicentre randomised placebo-controlled clinical trial aiming to recruit 200 participants with mid- to late-stage symptomatic KOA and with Effusion-synovitis grade of ≥ 2. Participants will be randomly allocated to the MTX group (start from 5 mg per week for the first 2 weeks and increase to 10 mg per week for the second 2 weeks and 15 mg per week for the remaining period if tolerated) or the placebo group. Primary outcomes are Effusion-synovitis size measured by magnetic resonance imaging (MRI) and Knee pain assessed by visual analogue scale (VAS). Secondary outcomes are signal intensity alteration within infrapatellar fat pad (IPFP) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total score and subscores, and the Outcome Measures in Rheumatology Arthritis Clinical Trials-Osteoarthritis Research Society International (OMERACT-OARSI) responders. Both intention-to-treat and per-protocol analyses will be performed. If MTX intervention can relieve symptoms and reduce inflammation in patients with mid- to late-stage KOA, it has the potential for significant clinical and public health impact as this low-cost and commonly used intervention would delay the time to Knee replacement, leading to substantial cost savings and improve quality of life. ClinicalTrials.gov NCT03815448 . Registered on 21 January 2019.
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Knee Effusion synovitis volume measurement and effects of vitamin d supplementation in patients with Knee osteoarthritis
Osteoarthritis and Cartilage, 2017Co-Authors: Xia Wang, Flavia M Cicuttini, Xingzhong Jin, Anita E Wluka, Weiyu Han, Z Zhu, Leigh Blizzard, Benny Antony, Tania WinzenbergAbstract:Summary Objective To develop a measure of Knee joint Effusion-synovitis volume and to examine the effect of vitamin D supplementation on Effusion-synovitis in people with Knee osteoarthritis (OA) and low vitamin D levels over 24 months. Method Symptomatic Knee OA patients with low 25-(OH)D levels (12.5–60 nmol/l) were recruited for a multi-centre, randomised, placebo-controlled and double-blind trial. Participants (age 63 ± 7 years, 208 females) were allocated to either 50,000 IU monthly vitamin D 3 ( n = 209) or placebo ( n = 204) for 24 months. Knee Effusion-synovitis volume in suprapatellar and other regions was measured on magnetic resonance imaging (MRI) using OsiriX software. The intra-class correlation coefficients (ICCs) were used to test inter- and intra-rater reliabilities. The least significant change criterion was used to define the increase/decrease in Effusion-synovitis volume. Result The reproducibilities of Effusion-synovitis volume measurement were high with ICCs ranging from 0.93 to 0.99. Over 24 months, Effusion-synovitis volume remained stable in the vitamin D group but increased in placebos with a significant between-group difference (−1.94 ml, 95% confidence interval (CI): −3.54, −0.33). This effect was evident in those with baseline Effusion-synovitis and with suprapatellar Effusion-synovitis. The proportion with an increase in Effusion-synovitis volume was lower in the vitamin D group than placebo (risk ratio (RR): 0.87, 95% CI: 0.77, 0.97). Conclusion This highly reproducible Effusion-synovitis volume measurement could be a promising outcome measure in OA trials. Vitamin D supplementation could retard the progression of Effusion-synovitis which can potentially benefit people with an inflammatory OA phenotype.
Jones G - One of the best experts on this subject based on the ideXlab platform.
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Effectiveness of Curcuma longa extract for the treatment of symptoms and Effusion-synovitis of Knee osteoarthritis : a randomized trial
'American College of Physicians', 2020Co-Authors: Wang Z, Jones G, Winzenberg T, Cai G, Ll Laslett, Aitken D, Singh A, Jones R, Fripp JAbstract:Background: Current pharmacologic therapies for patients with osteoarthritis are suboptimal.Objective: To determine the efficacy of Curcuma longa extract (CL) for reducing Knee symptoms and Effusion-synovitis in patients with symptomatic Knee osteoarthritis and Knee Effusion-synovitis.Design: Randomized, double-blind, placebo-controlled trial. (Australian New Zealand Clinical Trials Registry: ACTRN12618000080224).Setting: Single-center study with patients from southern Tasmania, Australia.Participants: 70 participants with symptomatic Knee osteoarthritis and ultrasonography-defined Effusion-synovitis.Intervention: 2 capsules of CL (n = 36) or matched placebo (n = 34) per day for 12 weeks.Measurements: The 2 primary outcomes were changes in Knee pain on a visual analogue scale (VAS) and Effusion-synovitis volume on magnetic resonance imaging (MRI). The key secondary outcomes were change in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and cartilage composition values. Outcomes were assessed over 12 weeks.Results: CL improved VAS pain compared with placebo by -9.1 mm (95% CI, -17.8 to -0.4 mm [P = 0.039]) but did not change Effusion-synovitis volume (3.2 mL [CI, -0.3 to 6.8 mL]). CL also improved WOMAC Knee pain (-47.2 mm [CI, -81.2 to -13.2 mm]; P = 0.006) but not lateral femoral cartilage T2 relaxation time (-0.4 ms [CI, -1.1 to 0.3 ms]). The incidence of adverse events was similar in the CL (n = 14 [39%]) and placebo (n = 18 [53%]) groups (P = 0.16); 2 events in the CL group and 5 in the placebo group may have been treatment related.Limitation: Modest sample size and short duration.Conclusion: CL was more effective than placebo for Knee pain but did not affect Knee Effusion-synovitis or cartilage composition. Multicenter trials with larger sample sizes are needed to assess the clinical significance of these findings
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KARAOKE: Krill oil versus placebo in the treatment of Knee osteoarthritis: protocol for a randomised controlled trial
'Springer Science and Business Media LLC', 2020Co-Authors: Laslett L.l., Antony B., Wluka A.e., Hill C., March L., Keen H.i., Otahal P., Cicuttini F.m., Jones GAbstract:Background: Knee osteoarthritis (OA) is a common and important cause of pain and disability, but interventions aimed at modifying structures visible on imaging have been disappointing. While OA affects the whole joint, synovitis and Effusion have been recognised as having a role in the pathogenesis of OA. Krill oil reduces Knee pain and systemic inflammation and could be used for targeting inflammatory mechanisms of OA. Methods/design: We will recruit 260 patients with clinical Knee OA, significant Knee pain and Effusion-synovitis present on MRI in five Australian cities (Hobart, Melbourne, Sydney, Adelaide and Perth). These patients will be randomly allocated to the two arms of the study, receiving 2 g/day krill oil or inert placebo daily for 6 months. MRI of the study Knee will be performed at screening and after 6 months. Knee symptoms, function and MRI structural abnormalities will be assessed using validated methods. Safety data will be recorded. Primary outcomes are absolute change in Knee pain (assessed by visual analog score) and change in size of Knee Effusion-synovitis over 24 weeks. Secondary outcomes include improvement in Knee pain over 4, 8, 12, 16 and 20 weeks. The primary analyses will be intention-to-treat analyses of primary and secondary outcomes. Per protocol analyses adjusting for missing data and for treatment compliance will be performed as the secondary analyses. Discussion: This study will provide high-quality evidence to assess whether krill oil 2 g/day reduces pain and Effusion-synovitis size in older adults with clinical Knee OA and Knee Effusion-synovitis. If krill oil is effective and confirmed to be safe, we will provide compelling evidence that krill oil improves pain and function, changes disease trajectory and slows disease progression in OA. Given the lack of approved therapies for slowing disease progression in OA, and moderate cost of krill oil, these findings will be readily translated into clinical practice.L. L. Laslett, B. Antony, A. E. Wluka, C. Hill, L. March, H. I. Keen, P. Otahal, F. M. Cicuttini and G. Jone