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Chondroitin sulfate and glucosamine combination in patients with knee and hip osteoarthritis:A long-term observational study in Russia

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World Journal of Orthopedics 2023年第6期14卷 443-457页

作者： Alexander M Lila Lyudmila I Alekseeva Andrey A Baranov Elena A Taskina Natalya G Kashevarova Natalia A Lapkina Evgeny A Trofimov Director Research Institute of Rheumatology Named after VA NasonovaMoscow 115522MoscowRussia Bone and Joints Metabolic Diseases Laboratory Research Institute of Rheumatology Named after VA NasonovaMoscow 115522MoscowRussia Department of Therapy Clinical Laboratory Diagnostics and Medical BiochemistryYaroslavl State Medical UniversityYaroslavl 150000YaroslavlRussia Department of Therapy and Rheumatology North-Western State Medical University named after I.I.MechnikovSt.Petersburg 191015St.PetersburgRussia

BACKGROUND Oral treatment of glucosamine(GA) combined with chondroitin sulfate(CS) was reportedly effective for pain relief and function improvement in osteoarthritis patients with moderate to severe knee pain in clinical trials. While the effectiveness of GA and CS on both clinical and radiological findings has been demonstrated, only a few high-quality trials exist. Therefore, controversy regarding their effectiveness in real-world clinical practice *** To investigate the impact of GA + CS on clinical outcomes of patients with knee and hip osteoarthritis in routine clinical *** A multicenter prospective observational cohort study included 1102 patients of both genders with knee or hip osteoarthritis(Kellgren & Lawrence grades Ⅰ-Ⅲ) in 51 clinical centers in the Russian Federation from November 20, 2017, to March 20,2020, who had started to receive oral capsules of glucosamine hydrochloride 500 mg and CS 400mg according to the approved patient information leaflet starting from 3 capsules daily for 3 wk,followed by a reduced dosage of 2 capsules daily before study inclusion(minimal recommended treatment duration is 3-6 mo). Changes in subscale scores [Pain, Symptoms, Function, and Quality of Life(QOL)] of the Knee Injury and osteoarthritis Outcome Score(KOOS)/hip Disability and osteoarthritis Outcome Score(HOOS) questionnaires during the observational period(up to 54-64wk with a total of 4 visits). Patients’ treatment satisfaction, data on the combined oral use of glucosamine hydrochloride and CS, concomitant use of non-steroidal anti-inflammatory drugs(NSAIDs), and adverse events(AEs) were also *** A total of 1102 patients with knee and hip osteoarthritis were included in the study. The mean patient age was 60.4 years, most patients were women(87.8%), and their average body mass index was 29.49 kg/m2. All subscale scores(Pain, Symptoms, Function, and QOL) of the KOOS and HOOS demonstrated clinically and statistically significant im

关键词： Glucosamine Chondroitin sulfate Knee osteoarthritis hip osteoarthritis Knee injury and osteoarthritis outcome score hip disability and osteoarthritis outcome score

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Viscosupplementation or Steroid? Which Might Be the Optimal Strategy in Intra-articular Treatments for Patients with hip osteoarthritis? A Meta-Analysis of Randomized Controlled Trials

Viscosupplementation or Steroid? Which Might Be the Optimal ...

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2012年浙江省骨科学术年会

作者： Tiao Lin Ming-Min Shi Shi-Gui Yan Department of Orthopaedic Surgery Second Affiliated Hospital School of Medicine Zhejiang University

Objective To review the efficacy and safety of intra-articular (IA) treatments for hip osteoarthritis (OA). Methods Our data sources were Medline, EMBASE, Clinical Trial Register Center, the Cochrane database. References of all the selected articles were also hand-searched. We identified eligible studies, evaluated the methodological quality and abstracted relevant data of pain reduction, symptom improvement at different time points, and safety profiles. Thus three comparisons were performed:Viscosupplementation (VS) vs. placebo, VS vs. steroid and steroid vs. placebo (including direct and indirect comparisons). And we also carried out sensitivity analysis to explore some potential modifiers. Result Five high quality Randomized controlled studies trials (RCTs) with 607 patients with hip OA were identified. The primary finding is that both IA VS and steroid might be effective and tolerated for hip OA, however, only IA steroid could reduce pain and ameliorate OA symptoms to a significant greater extent than placebo in a short-term follow-up. The results of direct and indirect comparison between IA VS and steroid and the sensitivity analysis might further confirm the superiority of IA steroid over IA VS for hip OA. Conclusion Thus, the recommendation of IA steroid rather than IA VS for OA from the guideline was further strengthened by the current evidence. However, short-lived effect and the safety of IA steroid for hip OA still needed considerations.

关键词： Viscosupplementation Steroid Intra-articular Treatments hip osteoarthritis

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Decision aids can decrease decisional conflict in patients with hip or knee osteoarthritis: Randomized controlled trial

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World Journal of Orthopedics 2021年第12期12卷 1026-1035页

作者： Lode A van Dijk Antonius MJS Vervest Dominique C Baas Rudolf W Poolman Daniel Haverkamp Department of Orthopedic Surgery Tergooi HospitalHilversum 1213 XZNoord-HollandNetherlands Department of Orthopedic Surgery Onze Lieve Vrouwe GasthuisAmsterdam 1091 ACNetherlands Department of Orthopedic Surgery Leiden University Medical CentreLeiden 2333 ZANetherlands Department of Orthopedic Surgery Xpert Orthopedie Amsterdam/SCORE(Specialized Center of Orthopedic Research and Education)Amsterdam 1101 EANetherlands

BACKGROUND The interest in shared decision making has increased considerably over the last couple of *** aids(DAs)can help in shared decision *** when there is more than one reasonable option and outcomes between treatments are *** To investigate if the use of DAs decreases decisional conflict in patients when choosing treatment for knee or hip osteoarthritis(OA).METHODS In this multi-center unblinded randomized controlled trial of patients with knee or hip OA were included from four secondary and tertiary referral ***-thirty-one patients who consulted an orthopedic surgeon for the first time with knee or hip OA were included between December 2014 and January *** the first consultation,patients were randomly assigned by a computer to the control group which was treated according to standard care,or to the intervention group which was treated with standard care and provided with a *** the first consultation,patients were asked to complete questionnaires about decisional conflict(DCS),satisfaction,anxiety(PASS-20),gained knowledge,stage of decision making and preferred ***-up was carried out after 26 wk and evaluated decisional conflict,satisfaction,anxiety,health outcomes(HOOS/KOOS),quality of life(EQ5D)and chosen *** After the first consultation,patients in the intervention group(mean DCS:25 out of 100,SD:13)had significantly(P value:0.00)less decisional conflict compared to patients in the control group(mean DCS:39 out of 100,SD 11).The mean satisfaction score for the given information(7.6 out of 10,SD:1.8 vs 8.6 out of 10,SD:1.1)(P value:0.00),mean satisfaction score with the physician(8.3 out of 10,SD:1.7 vs 8.9 out of 10,SD:0.9)(P value:0.01)and the mean knowledge score(3.3 out of 4,SD:0.9 vs 3.7 out of,SD:0.6)(P value:0.01)were all significantly higher in the intervention *** 26-wk follow-up,only 75 of 131 patients(57%)were available for *** sample is too

关键词： Decision aid Decisional conflict Shared decision making Anxiety hip osteoarthritis Knee osteoarthritis

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Mid-term clinical outcomes of the uncemented Robert Mathys pressfit cup

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World Journal of Clinical Cases 2024年第19期12卷 3684-3691页

作者： Kishan Ritek Ramsodit Inger N Sierevelt Esther R C Janssen Sjoerd Kaarsemaker Daniël Haverkamp Department of Orthopedic Surgery Xpert Clinics AmsterdamAmsterdam 1101EANorth-HollandNetherlands Department of Orthopedic Spaarne Gasthuis AcademyHoofddorp 2134 TMNetherlands Department of Orthopaedic Surgery Viecuri Medical CentreVenlo 5912 BLNetherlands Department of Orthopaedic Surgery Viecuri Medisch CentrumVenlo 5912 BLNetherlands

BACKGROUND The use of uncemented cups during total hip arthroplasty(THA)has gained popularity in recent *** Robert Mathys(RM)pressfit cup,an uncemented monoblock implant is expected to preserve bone density due to its composition and external surface,while reducing backside wear with its monoblock *** factors should lead to a high survival rate of the *** To evaluate the mid-term survival and functional outcome of the RM Pressfit cup in a large study *** Between 2011 and 2020,we included 1324 patients receiving a primary THA using the RM pressfit *** clinical follow-up was performed at 2 years postoperatively with the Dutch arthroplasty register used to assess implant status *** for acetabular failure and reason for revision were reported to evaluate implant survival,while the hip disability and osteoarthritis outcome score(HOOS)scores were used to assess functional *** The mean age at surgery was 64.9 *** mean follow-up was 4.6 *** the 1324 THAs performed,13 needed cup revisions within 5 years after index THA:5 due to aseptic loosening,6 due to infection,2 due to dislocation and 2 due to other *** resulted in a 5-year cup survival of 98.8%(95%CI:98.1-99.5).Nine of the cup revisions occurred within the first year after index *** scores increased significantly in all domains during the first year and levelled out during the second *** In the present study,the RM pressfit cup demonstrated excellent clinical outcomes at mid-term follow-up;however,future studies are needed to assess the long-term outcomes of this acetabular implant.

关键词： Total hip arthroplasty Uncemented RM pressfit cup hip osteoarthritis Cup revision Pressfit Aseptic loosening

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