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1.
The study of physical requirements for windsurfing specialty.
Wu, WL, Hsu, HT, Chu, IH, Liang, JM, Chen, YT, Wu, JH
The Journal of sports medicine and physical fitness. 2016;(9):968-73
Abstract
BACKGROUND In order to prepare beginners to be windsurfing players, windsurf-specific fitness training is necessary besides windsurfing skill training. The aim of this study was to clarify distinguish the difference in physical abilities between college windsurfers and age-matched college students without regular exercise, and to provide further training suggestions for a novice. METHODS Eight windsurfers and a group of eight age and gender-matched students were involved in the present study. In this study, the ability of coordination, proprioception deficit, balance ability, maximum muscle strength, and muscle endurance for upper and lower limb were measured. RESULTS The results showed windsurfers had significantly better coordination ability than the control group in both shoulders and the non-dominant knee. Besides, windsurfers had a significantly smaller sway area of the center of pressure in the balance test. The maximum knee isometric force in non-dominant limbs and upper limb muscle endurance also showed significantly better testing results for the windsurfers. CONCLUSIONS This study verified that windsurfers have better physical capability especially in the non-dominant side limbs when compared to common health people.
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2.
Effect of weight maintenance on symptoms of knee osteoarthritis in obese patients: a twelve-month randomized controlled trial.
Christensen, R, Henriksen, M, Leeds, AR, Gudbergsen, H, Christensen, P, Sørensen, TJ, Bartels, EM, Riecke, BF, Aaboe, J, Frederiksen, R, et al
Arthritis care & research. 2015;(5):640-50
Abstract
OBJECTIVE To compare results of obese patients with knee osteoarthritis (OA) who, after an intensive weight loss regimen, received 1 year of either dietary support (D), a knee-exercise program (E), or "no attention" (C; control group). METHODS We conducted a randomized, 2-phase, parallel-group trial. A total of 192 obese participants with knee OA were enrolled; the mean age was 62.5 years and 81% were women with a mean entry weight of 103.2 kg. In phase 1, all participants were randomly assigned to 1 of 3 groups and began a dietary regimen of 400-810 and 1,250 kcal/day for 16 weeks (2 8-week phases) to achieve a major weight loss. Phase 2 consisted of 52 weeks' maintenance in either group D, E, or C. Outcomes were changes from randomization in pain on a 100-mm visual analog scale, weight, and response according to the Outcome Measures in Rheumatology-Osteoarthritis Research Society International criteria. RESULTS Mean weight loss for phase 1 was 12.8 kg. After 1 year on maintenance therapy, the D group sustained a lower weight (11.0 kg, 95% confidence interval [95% CI] 9.0, 12.8 kg) than those in the E (6.2, 95% CI 4.4, 8.1 kg) and C (8.2, 95% CI 6.4, 10.1 kg) groups (P = 0.002 by analysis of covariance [ANCOVA]). Adherence was low in the E group. All groups had statistically significant pain reduction (D: 6.1; E: 5.6; and C: 5.5 mm) with no difference between groups (P = 0.98 by ANCOVA). In each group 32 (50%), 26 (41%), and 33 (52%) participants responded to treatment in the D, E, and C groups, respectively, with no statistically significant difference in the number of responders (P = 0.41). CONCLUSION A significant weight reduction with a 1-year maintenance program improves knee OA symptoms irrespective of maintenance program.
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3.
Reduced UHMWPE wear using magnesia-stabilized zirconia instead of CoCr femoral components in a knee simulator.
Roy, ME, Whiteside, LA, Tilden, DS, Noel, OF
The Journal of arthroplasty. 2015;(3):468-74
Abstract
Magnesia-stabilized zirconia (Mg-PSZ) is stable and maintains a scratch-resistant surface in hip replacement, but is untested in knees. We assessed whether using Mg-PSZ instead of cobalt-chromium (CoCr) femoral components resulted in less tibial insert wear, and evaluated changes in topography and roughness of the femoral components. Inserts bearing against CoCr or Mg-PSZ were tested using standard (9 Mc) and aggressive (6 Mc) waveforms. Femoral component surface topography and roughness were evaluated before and after testing by optical profilometry. When bearing against Mg-PSZ, UHMWPE wear rate decreased by 73% (standard) and by 59% (aggressive conditions). After 15 Mc, CoCr components featured deep scratches, and roughness increased five-fold, while Mg-PSZ components were unchanged. Mg-PSZ femoral components may be indicated for high-demand patients and those with metal sensitivity.
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4.
Structural changes in the knee during weight loss maintenance after a significant weight loss in obese patients with osteoarthritis: a report of secondary outcome analyses from a randomized controlled trial.
Henriksen, M, Christensen, R, Hunter, DJ, Gudbergsen, H, Boesen, M, Lohmander, LS, Bliddal, H
Osteoarthritis and cartilage. 2014;(5):639-46
Abstract
OBJECTIVE To compare structural knee joint changes in obese patients with knee osteoarthritis (OA) that after an intensive weight loss therapy were randomized to continuous dietetic support, a specialized knee exercise program, or 'no attention' for 1 year. METHODS 192 obese individuals with knee OA underwent an intensive 16-week weight loss program with subsequent randomization to one of the three treatment groups. Changes in cartilage loss, bone marrow lesions (BMLs), synovitis, and effusion were assessed using semi quantitative assessments of magnetic resonance imaging (MRI) obtained at weeks 0 and 68 applying the BLOKS score. RESULTS During the 52 weeks maintenance period the continuous dietary maintenance group support on average gained 1.1 kg (95% CI: -0.3:2.5) body mass, the exercise group gained 6.6 kg (95% CI 5.4:7.8) and the no-attention group gained 4.8 kg (95% CI: 2.9:6.7). There were no statistically significant between-group differences in changes in cartilage loss, synovitis or effusion at the follow-up (analysis of covariance; ANCOVA, P > 0.16), while there was an increased number of medial tibiofemoral BMLs in the exercise group (ANCOVA, P = 0.015) compared to both diet (difference: -0.21 [95%CI -0.40:-0.03]) and "no attention" (difference: -0.26 [95%CI -0.44:-0.07]) groups. CONCLUSION In this 1 year follow-up after weight-loss in obese knee OA patients, we found a potentially increased number of BMLs in the exercise group compared to the diet and no attention groups, with no between-group differences in changes in cartilage loss, synovitis or effusion. These findings should be interpreted with caution for exercise compliance, MRI methodology and follow-up time. (ClinicalTrials.gov identifier: NCT00655941).
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5.
A randomized, double-blind, phase III trial in moderate osteoarthritis knee pain comparing topical ketoprofen gel with ketoprofen-free gel.
Rother, M, Conaghan, PG
The Journal of rheumatology. 2013;(10):1742-8
Abstract
OBJECTIVE This randomized, double-blind, phase III study evaluated the efficacy and safety of ketoprofen in an ultradeformable vesicle gel compared with ketoprofen-free gel in osteoarthritis (OA) knee pain. METHODS Patients with American College of Rheumatology-defined OA of the knee and moderate pain were randomized to receive 100 mg ketoprofen in 4.4 g transfersome gel (IDEA-033) or 4.4 g ketoprofen-free vehicle (TDT 064) topically, twice daily, for 12 weeks. The primary endpoint was mean change in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale score from baseline to Week 12. RESULTS Patients (n = 555) were randomized and treated. Mean baseline WOMAC pain scores were 5.2 (SD 1.0) for IDEA-033 and 5.3 (SD 1.0) for TDT 064. Mean change in WOMAC pain scores from baseline to Week 12 was 38.6% for IDEA-033 and 44.6% for TDT 064 (Mann-Whitney estimator 0.4505; p = 0.022). Both groups reported progressive decreases in pain and improvements in function and stiffness. Mean baseline WOMAC function scores decreased from 5.4 to 3.4 with IDEA-033 and 3.1 with TDT 064 at Week 12. The proportion of patients achieving ≥ 50% decrease in WOMAC pain score from baseline at Week 12 was 41.2% (95% CI 0.35-0.47) with IDEA-033 and 50.5% (95% CI 0.45-0.57) with TDT 064. Mild skin and subcutaneous tissue disorders were the most frequently reported treatment-related adverse events (AE). CONCLUSIONS IDEA-033 was inferior to drug-free gel (TDT 064) in relieving moderate OA knee pain and improving joint function.
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6.
Comparative effectiveness of a complex Ayurvedic treatment and conventional standard care in osteoarthritis of the knee--study protocol for a randomized controlled trial.
Witt, CM, Michalsen, A, Roll, S, Morandi, A, Gupta, S, Rosenberg, M, Kronpass, L, Stapelfeldt, E, Hissar, S, Müller, M, et al
Trials. 2013;:149
Abstract
BACKGROUND Traditional Indian Ayurvedic medicine uses complex treatment approaches, including manual therapies, lifestyle and nutritional advice, dietary supplements, medication, yoga, and purification techniques. Ayurvedic strategies are often used to treat osteoarthritis (OA) of the knee; however, no systematic data are available on their effectiveness in comparison with standard care. The aim of this study is to evaluate the effectiveness of complex Ayurvedic treatment in comparison with conventional methods of treating OA symptoms in patients with knee osteoarthritis. METHODS AND DESIGN In a prospective, multicenter, randomized controlled trial, 150 patients between 40 and 70 years, diagnosed with osteoarthritis of the knee, following American College of Rheumatology criteria and an average pain intensity of ≥40 mm on a 100 mm visual analog scale in the affected knee at baseline will be randomized into two groups. In the Ayurveda group, treatment will include tailored combinations of manual treatments, massages, dietary and lifestyle advice, consideration of selected foods, nutritional supplements, yoga posture advice, and knee massage. Patients in the conventional group will receive self-care advice, pain medication, weight-loss advice (if overweight), and physiotherapy following current international guidelines. Both groups will receive 15 treatment sessions over 12 weeks. Outcomes will be evaluated after 6 and 12 weeks and 6 and 12 months. The primary endpoint is a change in the score on the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) after 12 weeks. Secondary outcome measurements will use WOMAC subscales, a pain disability index, a visual analog scale for pain and sleep quality, a pain experience scale, a quality-of-life index, a profile of mood states, and Likert scales for patient satisfaction, patient diaries, and safety. Using an adapted PRECIS scale, the trial was identified as lying mainly in the middle of the efficacy-effectiveness continuum. DISCUSSION This trial is the first to compare the effectiveness of a complex Ayurvedic intervention with a complex conventional intervention in a Western medical setting in patients with knee osteoarthritis. During the trial design, aspects of efficacy and effectiveness were discussed. The resulting design is a compromise between rigor and pragmatism. TRIAL REGISTRATION NCT01225133.
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7.
Is the body-coil at 3 Tesla feasible for the MRI evaluation of the painful knee? A comparative study.
Lutterbey, G, Behrends, K, Falkenhausen, MV, Wattjes, MP, Morakkabati, N, Gieseke, J, Schild, H
European radiology. 2007;(2):503-8
Abstract
The purpose of this study was to compare the in-built body coil of the 3.0-Tesla (T) scanner with a dedicated surface coil of a 1.5 T system regarding knee imaging. We performed an intraindividual prospective clinical trial on 17 patients with knee pain using magnetic resonance imaging (MRI) at 1.5 and 3.0 T systems equipped with identical gradient systems. Proton-density-weighted turbo spin echo sequences with the same spatial resolution and comparable contrast parameters were used. A quantitative measurement of signal to noise ratio (SNR), relative contrast (RC) and contrast to noise ratio (CNR) between muscle and bone marrow was performed, followed by a qualitative assessment of anatomic/pathologic structures and the extent of artefacts. At 3.0 T, 30 lesions (91%) compared to 33 lesions at 1.5 T were detected. The SNR/CNR/RC were moderately reduced at 3.0 T versus 1.5 T (muscle 42 vs 47 and bone 83 vs 112/46 vs 69/0.33 vs 0.43). Motion artefacts from the pulsating popliteal artery were significantly increased at 3.0 T. A visible and measurable signal loss occurred at 3.0 T using the built-in body coil compared with the dedicated 1.5 T knee coil, but nearly all clinically important information could be obtained.
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8.
Volume of a wash and the other conditions for maximum therapeutic effect of arthroscopic lavage in rheumatoid knees.
Tanaka, N, Sakahashi, H, Hirose, K, Ishima, T, Ishii, S
Clinical rheumatology. 2006;(1):65-9
Abstract
The objective of this study was to determine the appropriate volume of saline to obtain a beneficial effect of arthroscopic lavage and the prognostic factors related to the clinical effect in a refractory rheumatoid knee. Arthroscopic lavage or arthrocentesis was performed in a random manner in 142 patients with relapsing rheumatoid arthritis. All patients were followed up for 24 months. Intra-articular lavage with 5 l (p < 0.01) or 3 l (p < 0.05) of saline gave better clinical results than did arthrocentesis. There was no significant difference between the cumulative incidence of recurrence of knee synovitis in patients who underwent arthrocentesis and that in patients who underwent lavage with 1 l of saline. Cox regression analysis showed that patients with knee arthritis of more than 6 months in duration and with Larsen grade II or less were more responsive to lavage with 5 or 3 l of saline. The duration of the effect of lavage with 3 l of saline was increased 2.9-fold (p = 0.04) by injection of both steroids and high molecular weight hyaluronan. No bleeding or infectious complications occurred after those procedures. Arthroscopic lavage with 5 l of saline is safe and has good therapeutic effects for rheumatoid knees with mild destruction in which arthritis has persisted for more than 6 months. Lavage with 3 l of saline is recommended when intra-articular injection of corticosteroid and high molecular weight hyaluronan is performed after lavage.
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9.
Comparison of the opioid-sparing efficacy of diclofenac and ketoprofen for 3 days after knee arthroplasty.
Silvanto, M, Lappi, M, Rosenberg, PH
Acta anaesthesiologica Scandinavica. 2002;(3):322-8
Abstract
BACKGROUND Comparative postoperative non-steroidal anti-inflammatory drug (NSAID) studies in orthopedic patients have usually been restricted in time to the first postoperative day. The opioid-sparing effect of NSAIDs may be beneficial postoperatively as long as pain otherwise restricts ambulation and rehabilitation. We therefore compared the analgesic efficacy of the maximum recommended doses of diclofenac and ketoprofen for 3 days after knee arthroplasty. METHODS We studied 64 knee arthroplasty patients, operated on under spinal anesthesia. In a randomized, double-blind and placebo-controlled fashion, the patients received either i.v. diclofenac 75 mg (n = 24), ketoprofen 100 mg (n = 24) or saline (n = 16) in the recovery room, followed by oral diclofenac 150 mg/day, ketoprofen 300 mg/day or placebo, respectively, for 3 days, supplemented by patient-controlled analgesia (PCA) with i.v. oxycodone. RESULTS The mean consumption of oxycodone during the first, second and third study days was 45.3, 22.3 and 15.2 mg in the diclofenac group, 43.5, 37.5 and 21.8 mg in the ketoprofen group, and 61.2, 45.9 and 36.1 mg, respectively, in the placebo group. Oxycodone consumption was significantly lower (P < 0.05) in the ketoprofen group than in the placebo group in the postoperative period 13-24 h and 61-72 h. Diclofenac was superior to placebo in the postoperative period 25-48 h (P < 0.01), 49-60 h (P < 0.05) and to ketoprofen at 49-60 h (P < 0.05). During administration of diclofenac on days 1-3 and ketoprofen on day 2, the mean pain scores (VAS) were lower than in the placebo group (P < 0.05). Six patients had difficulties in operating the PCA device. There were no differences in blood loss. CONCLUSION We conclude that in the first day after knee arthroplasty (13-24 h), ketoprofen exerted an opioid-sparing effect. After day 1 (25-60 h), with the doses used, diclofenac proved to be better than placebo, whereas ketoprofen was not.
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10.
Morphological analysis of knee synovial membrane biopsies from a randomized controlled clinical study comparing the effects of sodium hyaluronate (Hyalgan) and methylprednisolone acetate (Depomedrol) in osteoarthritis.
Pasquali Ronchetti, I, Guerra, D, Taparelli, F, Boraldi, F, Bergamini, G, Mori, G, Zizzi, F, Frizziero, L
Rheumatology (Oxford, England). 2001;(2):158-69
Abstract
OBJECTIVE The study was part of a randomized open-label clinical trial designed to evaluate the effects of intra-articular injections of hyaluronan (Hyalgan) (HY) in osteoarthritis (OA) of the human knee. Data were compared with those obtained after treatment with methylprednisolone acetate (Depomedrol) (MP). METHODS Synovial membranes from patients with OA of the knee, primary or secondary to a traumatic event and classified according to the American College of Rheumatology criteria, were examined by arthroscopy and by light and electron microscopy before and 6 months after local injection of HY (2 ml of 500-730 000 MW hyaluronan, 10 mg/ml in saline, one injection per week for 5 weeks) or MP (1 ml of methylprednisolone acetate, 40 mg/ml, one injection per week for 3 weeks). RESULTS Arthroscopy revealed a significant decrease in inflammatory score after both treatments. Histology showed that HY treatment was effective (P< or =0.05) in reducing the number and aggregation of lining synoviocytes, as well as the number and calibre of the vessels. MP treatment significantly reduced the number of mast cells in primary OA. Both treatments tended to decrease the number of hypertrophic and to increase the number of fibroblast-like lining cells, to decrease the numbers of macrophages, lymphocytes, mast cells and adipocytes, and to decrease oedema, especially in primary OA, and to increase the number of fibroblasts and the amount of collagen. These phenomena were evident throughout the thickness of the synovial tissue. CONCLUSION At least in the medium term, both HY and MP modified a number of structural variables of the synovial membrane of the osteoarthritic human knee towards the appearance of that of normal synovium. The effect was more evident in primary OA than in OA secondary to a traumatic event. This is the first evidence that local hyaluronan injections modify the structural organization of the human knee synovium in OA.