View clinical trials related to Osteoarthritis, Knee.
Filter by:The focus of this project is to determine the immediate efficacy of a combined treatment (lateral wedge insole + simple knee sleeve) in individuals with knee osteoarthritis (OA) and the short term effect over 6 weeks. Secondly, to compare the effect of this combined treatment with each treatment on its own (lateral wedge insole, simple knee sleeve)
Glucosamine is an important part of the treatment strategy for osteoarthritis, but its effectiveness is still controversial. To explain the efficacy differences of glucosamine, in this study the investigators detect the concentration of glucosamine in the plasma and synovial fluid, some effect indexes such as inflammatory markers and gene polymorphism of glucosamine transporters. On the one hand, the investigators compare the plasma peak and gluten glucosamine concentration and the concentration in synovial fluid among participants to observe the individual differences of glucosamine exposure in vivo. On the other hand, the investigators investigate the correlation between drug concentrations, effect index and gene polymorphism. The hypothesis is that glucosamine exposure in vivo has individual differences and gene polymorphism can explain this differences.
Osteoarthritis (Osteoarthritis) of the knee is a high prevalence in the population of people aged 60 years and over, when in some cases does not cause any discomfort or pain, and therefore not diagnosed. In addition, Radio graphic findings of the knee not fully compatible with the patient's symptoms, which resulted in errors in the interpretation and diagnosis. In this study, patients who suffer from two knees or unilateral pain, will take part. Participants will undergo a clinical examination, including evaluation of symptoms by an orthopedist and an X-ray imaging, which are part of the currently accepted medical diagnosis. Patients will perform PET-MRI test in order to assess whether PET MRI is a more efficient tool for active knee osteoarthritis diagnosis.
The purpose of the study is to test 30 individuals with mild-moderate knee joint osteoarthritis to investigate whether the combination of Aquamin (a calcium-rich marine multi-mineral) and a polyphenol-rich pine bark extract (Enzogenol), when taken as a food supplement for 3 months has comparable or superior benefits to glucosamine sulphate in patients with painful knee osteoarthritis (KOA). From here on in we refer to Aquamin's combination product as Aquamin-plus. The main outcome measure is a reduction in pain. Provision of data that demonstrate preliminary equivalency or superiority to current, non-pharmaceutical options such as glucosamine will broaden consumer choice, and provide them with an option that is supported by science, rather than marketing alone. The hypothesis of the study is that the consumption of Aquamin-plus will have comparable effects on reducing pain in individuals with Knee Joint OA to glucosamine.
Platelet-rich plasma (PRP) is an autologous product prepared from the patient's own blood, representing a powerful source of platelet-derived growth factors, particularly useful in the field of regenerative medicine. The active and sequential secretion of these growth factors induces different cell signaling cascades that activate angiogenesis, cell proliferation, cell differentiation, eventually leading to new matrix synthesis and tissue regeneration. The potential benefits from the use of PRP for the treatment of cartilage defects rely on a number of studies conducted in validated animal models or in vitro, demonstrating the ability of PRP to stimulate collagen production and proteoglycans synthesis, as well as the proliferation and differentiation of mesenchymal stem cells into chondrocytes. Additionally, an increasing number of clinical studies shows an improvement of symptoms, most especially pain, without any occurrence of serious adverse events. Hyaluronic acid (HA), as one of the major components of the synovial fluid surrounding the cartilage, assumes an important role in the viscoelastic properties of the articular cartilage, conferring its shock absorbing and lubricating functions. It was demonstrated that rheological properties of synovial fluid decrease with aging and in patients suffering from osteoarthritis. Nowadays, intra-articular injections of hyaluronic acid represent a well recommended therapeutic option to relieve osteoarthritic symptoms, conferring a mechanical action on joints structures, thus leading to reduced pain and improved joint function Based on these data, it seems reasonable to hypothesize that a combination of both PRP and hyaluronic acid could provide greater benefits compared to the administration of each product alone, as their effects on osteoarthritis improvement are based on different mechanisms of action. In fact, on one side PRP promotes cartilage regeneration, while on the other side the HA acts as 3-dimensional support mesh for PRP, providing optimal release of platelets growth factors, strengthening and extending in time the activity of PRP. Cellular MatrixTM is a CE-marked class III medical device manufactured by the Swiss company RegenLab SA. Cellular MatrixTM allows to prepare autologous PRP combined with a non-crosslinked hyaluronic acid in a safe, rapid manner and in a single step. The PRP/HA combination is intended to be injected intra-articularly, in order to relieve osteoarthritic symptoms and to improve joint mobility and function. Therefore, the PRP/HA combination might represent a novel therapeutic option for patient suffering from knee osteoarthritis. This study will evaluate whether the effects of a PRP/HA combination prepared with Cellular Matrix™, when injected intra-articularly for the treatment of mild to moderate knee osteoarthritis, are superior to those of a well-recognized hyaluronic acid treatment (Ostenil® Plus), on one hand, and to those of PRP alone, on the other hand.
Using a double-blind, randomized controlled design to investigate the additional therapeutic effects of 3 times of combined triamcinolone and hyaluronic acid injections to 3 times of hyaluronic acid injections to patients with knee osteoarthritis.
Knee osteoarthritis (KOA) is a major public health problem among the elderly and is associated with considerable disability. A recent analysis of data indicated that about 35% of women and men aged 60 years and above had radiographic knee OA.Despite the high prevalence rate of OA, the treatment of OA is far from satisfactory. Acupuncture may be a promising treatment option for knee OA due to the effectiveness of the pain relief and the rarity of adverse effects. In order to get some more reliable data to confirm acupuncture effectiveness on KOA, a long-term follow up interventional study will be started to confirm the effects of long term for acupuncture treatment.
Estimation of the localization accuracy of the genicular ablation procedure applied for chronic pain suppression
Our purpose of this study is to conduct a prospective randomized controlled trial to investigate the blood-conservation effect of this two topical hemostatic agents in primary TKA procedures in patients with a risk of thromboembolic events. We will also observe if there is increased risk of thromboembolism by use of topical hemostatic agents.
Worldwide, 9.6% of men and 18% of women aged over 60 years suffer from osteoarthritis (OA), most of which involve the knee. Within the OA patient population, 80% of the OA patients have limitations of movement, and 25% cannot perform the majority of their daily activities (WHO). Some of these symptoms contribute to arthrogenic muscle inhibition (AMI), a reflexive decrease in motor output to the muscles surrounding the affected joint. AMI is characterized by abnormal afferent information transmitted to the central nervous system, resulting in altered afferent feedback to the quadriceps motoneurons (MN) which in turn results in reduced excitability of that particular pool. The altered afferent input is suggested to stem from stimulation of mechanoreceptors, via joint effusion or excessive movements, nociceptors as a response to pain, or loss of joint receptors (Palmieri-Smith et al., 2009). Although the evidence concerning the role of the central nervous system is scarce, pre- and postsynaptic spinal mechanisms directly affecting alpha-MNs seem affected. Dysfunction of γ-loops also seems to be involved (Konishi et al., 2002). These mechanisms together result in AMI that manifests through aberrations in voluntary quadriceps torque, force control, and reflex excitability often measured by the H-reflex (Hopkins et al., 2000). Besides the evident role of motor efferents, sensory afferents also influence motor control (Gentilucci et al., 1997) and poor proprioceptive function is predictive of poor chair-stand performance (Sharma et al., 2003). Reduction of the sensory deficits could potentially increase motor function in knee OA. The present study aims to evaluate whether low-intensity peripheral electrical nerve stimulation, a form of increasing afferent input, could potentially improve OA patients' motor function. The most limiting factor in OA patients, however, is pain, experienced at rest and during movement. Although previous paradigms used high-frequency stimulation and the lack of physiological explanations concerning pain reductions after peripheral electrical nerve stimulation, it is possible that reductions in experienced pain are mediated by reduced analgesia, i.e., decreased excitability of nociceptive neurons.