Pain Efficacy of a Home-Based Low-Intensity Continuous Ultrasound Stimulator for Knee Arthritis: A Single-Arm, Open-Label, Prospective Clinical Trial

1) Background: Osteoarthritis (OA) is defined as a degenerative joint disease that mainly affects the bone. This study aims to evaluate the effect of low-intensity continuous ultrasound (LICUS) treatment on the knee of osteoarthritis patients through home-based intervention using the LICUS medical device. 2) Methods: The clinical trials were designed in a single-arm, open-label, and intervention study. Thirty-five participants, including those who dropped out (12%), were screened and enrolled. The patients received LICUS (1.1 MHz, 1.5 W/cm2, collimated beams) on the knee by the instructions of the investigator at home (5 min/session, 3 times/day, for four-weeks). Outcome measures were assessed using the Visual Analog Scale (VAS) as a primary endpoint and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) as a secondary endpoint to evaluate pain relief and functional recovery of the knee between pre-treatment (baseline) and post-treatment (four-weeks). 3) Results: Knee pain scores measured using the VAS and WOMAC indices were significantly reduced after a four-week treatment with LICUS compared to baseline. Knee stiffness and functional capacity were significantly reduced after the LICUS application. In addition, there were no reports of adverse effects during the study period. 4) Conclusion: Long-term and home-based application of LICUS can be recommended as an alternative option for the treatment of OA patients, as evidenced by the effect of pain relief and knee function recovery.

Adjunctive platelet-rich plasma and hyaluronic acid injection after arthroscopic debridement in Kellgren-Lawrence grade 3 and 4 knee osteoarthritis

BACKGROUND Osteoarthritis(OA)is the most common cause of pain and disability,predominantly affecting the knee.The current management of knee OA falls short of completely stopping disease progression,particularly in Kellgren-Lawrence(KL)grade 3 and 4 knee OA.As such,joint replacement is often recommended,although only 15%-33%of candidates accept it.Alternative therapeutic options are still needed to prevent the progression of joint damage and delay the need for knee arthroplasty.AIM To investigate the effect of adjunctive platelet rich plasma(PRP)and hyaluronic acid(HA)after arthroscopic debridement in KL grade 3 and 4 knee OA.METHODS This retrospective cohort study used the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)score and WOMAC sub-scores(pain,stiffness,and function)to assess 21 patients,grouped according to medical record data of treatment received:Arthroscopic debridement(n=7);arthroscopic debridement with PRP(n=7);or arthroscopic debridement with HA(n=7).WOMAC scores and sub-scores at baseline and at 3 mo and 5 mo posttreatment were recorded.The three-group data were statistically analyzed using the tests of paired t,one-way analysis of variance,and post hoc least significant difference.RESULTS All three treatment groups showed significant improvements in WOMAC score and sub-scores from before treatment to 3 mo and 5 mo after treatment.However,the arthroscopic debridement with PRP treatment group,in particular,showed a significantly lower WOMAC pain score than the group who received arthroscopic debridement alone at 5 mo after the procedure(P=0.03).CONCLUSION Compared to arthroscopic debridement alone,adjunctive PRP after arthroscopic debridement significantly lessened the patients’pain symptom.

Modified green dragon swaying its tail needling manipulation for treatment of knee osteoarthritis

Objective To compare the difference in the effect of modified green dragon swaying its tail needling manipulation and common needling manipulations on the overall rating of pain of patients with knee osteoarthritis, and to evaluate the advantages of modified green dragon swaying its tail needling manipulation for. Methods Ninety-five patients with knee osteoarthritis were divided into 2 groups according to the random number table method with 48 patients in the modified green dragon swaying its tail group（group special manipulation, SM group for short） and 47 patients in the common acupuncture group（group convention needling, CN group for short）, and different acupuncture manipulations were applied in the two groups. Internationally recognized Simplified Mc Gill Pain Questionnaire（SF-MPQ） scale used for description and measurement of pain was applied to evaluate the pain degree, including pain rating index（PRI）, visnal analogue scale（VAS）and present pain intensity（PPI）. The index of severity for osteoarthritis（ISOA） was adopted for evaluation of clinical efficacy. Results（1） In SM group, the scores of PRI, VAS and PPI were 6.63±4.67, 2.23±1.45 and 0.65±1.32, respectively, after treatment, and in CN group, the scores of PRI, VAS and PPI were 13.32±7.96, 4.34±1.79 and 2.28±1.21, respectively, the scores decreased in the two groups after treatment（all P〈0.05）, and the improvement in SM group was superior to that in CN group（all P〈0.01）.（2） The clinical cure rate in SM group was 52.08%, and the total effective rate was 97.92%, the clinical cure rate in CN group was 25.53%, and the total effective rate was 85.10%. The comparison of clinical cure rate in the two groups showed that P〈0.01. Conclusion The SM group is obviously superior to CN group in the improvement of overall rating of pain of patients. It is indicated that modified green dragon swaying its tail acupuncture therapy can effectively relieve the pain of patients with knee osteoarthritis, which was worthy of popularization and application with definite clinical efficacy