Joint pain, particularly in the knees and shoulders as well as back pain constitute the large majority of patients who present to their doctor's office with a complaint of pain. Many of these patients proceed to have surgery, all too often with less than optimal outcomes. Many of these patients still have the same pain
A physician can also recommend exercises that stretch and strengthen the muscles and surrounding tendons. Along with this, anti-inflammatory medication can be prescribed to reduce the swelling of and around the knee. For the more serious stages of tendonitis, usually around stage three patients, a relatively new method of treatment is becoming available. The treatment includes a series of injections of platelet rich plasma to the patella region. One reason more doctors are turning towards this solution is because “injections for tendinopathy are a less invasive treatment than surgery if ‘strengthening rehabilitation’ fails” (Wiley, 2013, p. 122). This form of treatment promotes cell regeneration and the discarding of the dead or torn cells around the kneecap. Success of this treatment usually is tracked over a long term basis over about six months. Bowman et all (2013) concluded that “Treatment with autologous blood products holds many theoretical advantages, and recent basic science and clinical studies have demonstrated promising results. However, the paucity of clinical evidence combined with the potential adverse effects should caution clinicians considering the use of PRP for the management of patellar tendinitis”. The science behind the injections needs to be developed more to be an option that all doctors can turn
1. The researchers found a significant difference between the two groups (control and treatment) for change in mobility of the women with osteoarthritis (OA) over 12 weeks with the results of F(1, 22) = 9.619, p = 0.005. Discuss each aspect of these results.
The risk of K/L grade 2 and K/L grade 3 and 4 for knee pain.
Several studies have been done to show the efficacy and successes surrounding the use of MSC in the treatment of OA. However, another study done by Kim et al. in 2015 knew and trusted that MSC was effective in helping slow the disease process of OA in knee joints, but was curious as to if, and how, the cells are placed in the joints makes a difference on the outcomes. They utilized a cohort study, finding 182 patients who were treated for knee OA either by having the cells injected along with plasma rich proteins (PRP), or implanted on a fibrin glue scaffoid in the joint. The researchers utilized two different scoring methods, the International knee documentation committee and the Tegner activity scale, as well as arthroscopically looking at the joints for their study. Kim et al. concluded that MSC implantation into the OA knee had better clinical outcomes than knees injected with MSC. This is interesting considering most studies being done at this time, and still today, utilize MSC intra-articular injections as their primary procedure method but according to this study, their trials would have better outcomes should they start implanting the cells instead.
PRP injection is used in medicine for the treatment of various orthopedic injuries. There are reports from doctors at military hospitals that PRP knee injection is safe and effective in treating internal knee malalignment. Arthroscopic doctors also claimed that it is a good option in the treatment of symptoms of early degenerative disease. They also said that
Study 1 primarily focused on functional and clinical outcomes and knee ROM. Half of the patients in this study undergoing a TKA surgery received an inflated tourniquet, whereas the other half received an un-inflated tourniquet. The primary outcome measurements were Knee Injury and Osteoarthritis Outcome Score (KOOS), a knee specific questionnaire, and knee ROM measurements. KOOS feedback evaluated functional and clinical outcomes, which were expressed as the change in the average score over the period of 12 months for each subscale: pain, symptom, activities of daily living (ADL), sport/recreation, quality of life (QOL). This review will focus on ADL, sports and recreation, and QOL, because these subscales pertain to the knee ROM.
The first study reviewed was a randomized control trial of treatment for ACL tears by, Frobell, Roos, Roos, Ranstam, & Lohmander (2010)
Osteoarthritis is the most common joint disorder, and more than half of all Americans who are older than 65 have been diagnosed with osteoarthritis. However, recent US data has revealed knee osteoarthritis does not discriminate age, and there is growing evidence that osteoarthritis affects individuals at a young age. The annual cost of osteoarthritis due to treatment and loss of productivity in the US is estimated to be more than 65 billion dollars.1 With no cure currently available for osteoarthritis, current treatments focus on management of symptoms. The primary goals of therapy include improved joint function, pain relief, and increased joint stability. Although the exact cause of osteoarthritis is unknown, many risk factors have been identified including increased age, female gender, obesity, and trauma.2 Within these risk factors, the etiology of osteoarthritis has been divided into anatomy, body mass, and gender.
PFPS as a common knee injury has placed a huge burden on the society. While surgeries are available, they are not needed in most cases. Post-injury management strategies of acute management and rehabilitation are more commonly used to counter the problem of PFPS. As PFPS is a multifactorial injury, a combination of multiple methods are therefore required as part of its treatment. Understanding of the aetiology and mechanisms behind PFPS is also important to ensure the appropriate methods of rehabilitation are chosen. Increased future efforts in educating the public on the causes of PFPS and ways to prevent its onset. Particularly, ensuring proper equipment usage and avoiding sudden changes in activity patterns, as well as proper posture, can
OA is a musculoskeletal disease that causes chronic joint pain and reduced physical functioning (Laba, brien, Fransen, & jan, 2013). Osteoarthritis (OA) is a non-inflammatory disorder of synovial joints that results in loss of hyaline cartilage and remodeling of surrounding bone. OA is the single most common joint disease, with an estimated prevalence of 60% in men and 70% in women later in life after the age of 65 years, affecting an estimated 40 million people in the United States (Goodman & Fuller, 2009). Women are more commonly affected after the age of 55, almost everyone has some symptoms by the age of 70 (Tan, Zahara, Colburn & Hawkins, 2013, p.78). Osteoarthritis can be described radiological, clinical, or subjective.
Numerous self-reported questionnaires for knee pathologies, such as the WOMAC or the KOOS, have been reported.21 The WOMAC, developed in 1988, is a standardized self-reported questionnaire that examines the health-related quality of life of patients with osteoarthritis of the knee and the hip.2 The KOOS, originated in 1998, however, evaluates the reduction of health-related quality of life especially after a knee injury.19 Both questionnaires are nonspecific for usage in patients with isolated meniscal lesions.
First is Platelet Rich Plasma injections. Platelet Rich Plasma, or PRP, is typically used in athletes with chronic ligament or tendon injuries. It involves taking a sample of blood then spinning it down to pull off the plasma portion filled with platelets. This plasma works to stimulate the healing process by healing the tissue which are already present.
In the United States, arthritis has become the second most common disorder, in the past years. Moreover, the condition affects more than 34 million Caucasians, 4.6 million African-Americans and nearly 3.1 million Hispanics with women being the most affected (Helmick, 2008). 28.3% of people suffering from arthritis are women whereas 18.2% are men (Helmick, 2008). By the year 2030, it is predicted that the number of patients with arthritis will double if prevalence rates remain the same. Apart from being cost-intensive, Osteoarthritis (OA) affects nearly twenty seven million Americans, which effectively limits their work (Reid, Shengelia & Parker, 2012). The statistics show that Caucasians are the most affected and the Hispanics to be the less affected from Caucasians, Hispanics, and African Americans. It also shows how women also have greater possibilities of getting arthritis than man ever did.
A placebo-based study performed at Cardiff University (UK) included 755 participants, over 4-months, at 3–5 doses, daily.