View clinical trials related to Joint Diseases.
Filter by:The purpose of this study is to see whether power Doppler sonography (PDS) can be used to diagnose synovitis in patients with inherited bleeding disorders.
The study is designed to evaluate artificial hips with a 28 mm ceramic head and a ceramic liner to determine whether they perform as well as artificial hips with a 28 mm ceramic head and a polyethylene liner.
The purpose of this study is to compare the performance of artificial hips with metal heads and metal sockets to artificial hips with ceramic heads articulating with metal socket components. The success of the total hip arthroplasty (THA) will be based upon all of the following clinical and radiographic criteria being met at the two-year evaluation: (1) the patient's clinical results as measured using modified Harris Hip evaluation rating system, and the absence of a complication that requires the surgical removal or replacement of a component; and (2) radiographic findings at study endpoint (i.e., two years follow-up). Clinical and radiographic success at two (2) years postoperative is required for the study hip to be deemed successful.
This is a 10 year follow-up investigation of patients who have underwent total hip arthroplasty with a cemented Bimetric stem.
The purpose of this study is to compare two total hip replacement systems: Hip Resurfacing System (ReCap) versus Mallory-Head/Exeter.
People with knee osteoarthritis (OA) frequently complain of knee instability. This study will test whether certain exercises can improve knee stability, reduce pain, and improve physical function in people with knee OA. Study hypotheses: 1) Participants in the stability training group will demonstrate less pain and higher levels of physical function, based on self-report measures of pain and function (WOMAC, Lower Extremity Function Scale), and less time to complete the Get Up and Go test, a physical performance measure of function. 2) During walking and the step down task, participants in the stability training group will demonstrate greater knee motion during weight bearing, greater vertical ground reaction forces and loading rates, and reduced ratios of co-contraction between quadriceps/hamsting and tibialis anterior/gastrocnemius muscle pairs compared to the standard group. Participants in the stability group will also demonstrate greater step lengths, single limb support times, and average walking velocity compared to the standard group.
This study will evaluate the safety and effectiveness of anakinra (Kineret ) for treating patients with neonatal onset multisystem inflammatory disease (NOMID), also known as chronic infantile neurological, cutaneous and arthropathy (CINCA) syndrome. This disease can cause rash, joint deformities, brain inflammation, eye problems, and learning difficulties. Immune suppressing medicines commonly used to treat NOMID do not completely get rid of the disease symptoms and, if used for a long time in high doses, can cause harmful side effects. Anakinra, approved by The Food and Drug Administration for treating rheumatoid arthritis in adults, blocks a substance called IL-1 that may be an important factor in causing the inflammation in NOMID. Patients 2 years of age and older with NOMID whose disease symptoms appeared by at least 6 months of age may be eligible for this study. During a 3-week observation before beginning medication, patients will have a physical examination and evaluation of their condition. They will keep a daily diary of symptoms ratings, and will have blood drawn once a week to measure inflammation and monitor disease. At the end of this period, patients will be admitted to the NIH Clinical Center for 5 days to start daily anakinra injections, given under the skin of the thigh, upper arm, or belly. They will also be taught how to self-inject the medication. After 3 months on medication, patients will be randomly assigned to: 1) continue taking anakinra, or 2) receive a placebo injection (an inactive substance identical in appearance to the study drug). Follow-up visits at NIH for 5 days each will be scheduled at 1, 3, and 12 months, plus one visit between months 5 and 7. During this time, patients will undergo the following procedures: - Magnetic resonance imaging (MRI) scans of the brain and of affected joints. This test uses a magnetic field and radio waves to image the parts of the body under study. Patients who cannot lie still during the brain scan will be sedated. Only patients who do not require sedation will have their joints scanned. - Lumbar puncture (spinal tap). A local anesthetic is given and a needle is inserted in the space between the bones in the lower back where the cerebrospinal fluid circulates below the spinal cord. A small amount of fluid is collected through the needle for analysis. - Examinations by specialists, including an ophthalmologist (eye exam); otolaryngologist (ear, nose and throat exam and hearing test); neurologist (evaluate neurological symptoms such as headache, weakness, walking difficulties, blurred vision); dermatologist (skin exam with photography for record of rashes and joint changes); psychologist or psychiatrist (test memory and learning ability); rehabilitation medicine specialist (evaluate ability walk, move, and use the hands); speech therapist (evaluate ability to talk). - X-rays of joints and bones to look for changes during treatment with anakinra. - DEXA scan to examine bone density. - Blood samples to assess overall clinical condition, measure blood levels of anakinra, and - with the patient's agreement - to perform DNA studies to look for gene differences associated with NOMID. - Skin biopsy (optional) to examine how gene differences in NOMID are related to the rash. - Quality of life questionnaires and review of symptom ratings diaries. Between NIH visits, patients will be evaluated by their local doctor once a month for a checkup, blood tests, symptoms review, evaluation of drug side effects, and completion of quality of life questionnaires.
The purpose of this study is to determine whether the combination of cognitive-behavioral treatment and nortriptyline are more effective than each treatment alone in reducing the pain and disability associated with TMD.
This study will determine whether selected complementary approaches to temporomandibular joint (TMJ) pain management-acupuncture are as effective as usual care.
Temporomandibular disorders (TMD) are characterized by pain and tenderness in the muscles of mastication and/or the temporomandibular joint (TMJ), limitations of jaw opening often accompanied by deviations in mandibular path, and clicking, popping or grating TMJ sounds. TMD is often found in association with other problems: depression, anxiety, sleep disturbances, gastrointestinal symptoms, frequent infections, etc. This project proposes to holistically address patient symptoms through three different approaches, Naturopathic Medicine (NM), Traditional Chinese Medicine (TCM), and usual care at KPNW. We will conduct a pilot test and Phase II trial to evaluate the two alternative healing approaches, TCM (n=50) and NM (n=50) delivered by TCM and NM practitioners, are as effective as usual TMD care (n=50) provided by dental clinicians in the KPNW TMD Clinic. Subjects will be females 25-55 years of age with multiple health problems (defined as patients who have had at least 4 organ system-grouped diagnoses in the past year, not including TMD). Subjects will be evaluated at baseline, 6 and 12 months after start of treatment. The primary endpoint is change from baseline in the Axis II Pain Related Disability and Psychological Status Scale. Clinical examinations, saliva samples to assess salivary cortisol levels, and responses to a series of questionnaires to assess pain, chronic pain, psychosocial functioning, and other physical symptoms will be used to assess outcomes. We will passively monitor health care utilization within KPNW using clinical, research, and administrative databases to determine whether the interventions have an impact on overall health care utilization. If either of these alternative interventions is shown to merit Phase III trial, our goal is to design and implement such a clinical trial to further evaluate the health consequences and costs of these alternative healing paradigms.