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Robert M. Levy Roman Saikovsky Evgeniya Shmidt Alexander Khokhlov Bruce P. Burnett 《Nutrition Research》2009
Flavocoxid (Limbrel), a proprietary mixture of flavonoid molecules (baicalin and catechin), was tested against a traditional nonsteroidal anti-inflammatory drug, naproxen, for the management of the signs and symptoms of moderate osteoarthritis (OA) in humans. Discomfort and global disease activity were used as the primary end points, and safety assessments were also taken for both treatments as a secondary endpoint. In this double-blind study, 103 subjects were randomly assigned to receive either flavocoxid [500 mg twice daily (BID)] or naproxen (500 mg BID) in a 1-month onset of action trial. Outcome measures included the short Western Ontario and McMaster University Osteoarthritis Index, subject Visual Analogue Scale for discomfort and global response, and investigator Visual Analogue Scale for global response and fecal occult blood. Both flavocoxid and naproxen showed significant reduction in the signs and symptoms of knee OA (P ≤ .001). There were no statistically detectable differences between the flavocoxid and naproxen groups with respect to any of the outcome variables. Similarly, there were no statistically detectable differences between the groups with respect to any adverse event, although there was a trend toward a higher incidence of edema and nonspecific musculoskeletal discomfort in the naproxen group. In this short-term pilot study, flavocoxid was as effective as naproxen in controlling the signs and symptoms of OA of the knee and would present a safe and effective option for those individuals on traditional nonsteroidal anti-inflammatory drugs or cyclooxygenase-2 inhibitors. A low incidence of adverse events was reported for both groups. 相似文献
5.
U. Böhling H. Schamberger U. Grittner J. Scholz 《Journal of orthopaedics and traumatology》2005,6(2):69-75
Abstract The objective of the study was to evaluate the precision, concordance, practicability and the early clinical outcome of the use of a computerised navigation system in a comparative study with a group of 100 patients. Two groups of 50 patients each underwent implantation of a bicondylar knee prosthesis either by means of the freehand navigation system or by means of technical instrumentation. We found that the computerised navigation system provided a higher precision than the technically instrumented implantation: 94% of the prostheses implanted with the navigation system have an alignment within a range of -3° to 3° on of the Mikulicz line. Only 46% of the patients operated by means of the technical instrumentation reached this aspired result. Furthermore, the navigation system showed smaller ranges in the deviation of the aspired alignment. The radiological and computer-modeled alignment values differed both pre- and postoperatively, but to a larger extent before surgery. The varus or valgus deviations of the axis were more distinct radiologically under the weight of the patient’s body than in the computer model. The clinical outcome examined by the use of the HSS score after a mean followup of 7 months is good in both groups, and without significant differences. On average, the duration of surgery was 13 minutes longer in the computerised navigation group. We conclude that the benefit of the computerised navigation system is represented by the high improvement of precision. Achieving early clinical results identical to those in the technical instrumentation group, we expect a reduction of aseptic loosening in the computerised navigation group. 相似文献
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C. Rossi P. Cellocco F. Bizzarri E. Margaritondo G. Costanzo 《Journal of orthopaedics and traumatology》2005,6(3):145-149
Abstract
Surgical management of trapeziometacarpal joint osteoarthritis (OA) is still controversial. The aim of this study was to evaluate
and compare results of trapeziometacarpal arthrodesis and of tendon interposition arthroplasty. One hundred twenty-six patients
suffering from trapeziometacarpal OA underwent surgery between 1996 and 2001. Of these patients, 62 (78 thumbs) treated with
joint arthrodesis and 33 (41 thumbs) treated with tendon interposition arthroplasty with abductor pollicis longus (APL) have
been evaluated at follow-up and therefore entered this study. Mean age was 53 years, while the mean follow-up was 36 months.
Overall results were satisfactory in 84 patients with good pain improvement. Patients treated with arthrodesis showed better
functional ability in bi-digital pinch and grip strength. First finger opposition motion, however, was better conserved in
patients treated with interposition arthroplasty. Fusions had an 11.5% complication rate (9 thumbs) with nonunions, whereas
14.8% (6 thumbs) of patients treated with interposition arthroplasty developed 1 first metacarpal base collapse, resulting
in 1 first ray length reduction. Despite complications, however, patients did not report unsatisfactory results and generally
experienced marked pain reduction. This study shows that arthrodesis can be considered the treatment of choice in patients
suffering from trapeziometacarpal OA at Eaton stage III or less, whatever the age and when a good pinch strength is needed. 相似文献
7.
The patella and tibial condyle position after combined and after closing wedge high tibial osteotomy
Miklós Papp Zoltán Csernátony Sándor Kazai Zoltán Károlyi László Róde 《Knee surgery, sports traumatology, arthroscopy》2007,15(6):769-780
High tibial osteotomy changes the patella and tibial condyle position, which makes the subsequent total knee replacement technically
demanding. From 1 January 1993 to 31 December 2000, combined osteotomy [After the first osteotomy made 2 cm distally to the
joint line, a bone wedge is removed based laterally. Its tip ends at the center of the tibial condyle (half bone wedge). The
distal part of the tibia is placed into the valgus position and the half bone wedge is placed into the gap opened medially.]
was performed on 103 knees and closing wedge osteotomy was performed on 47 consecutive knees. Eighty combined (group A) and
41 closing wedge (group B) osteotomy were studied. All knees were assessed radiologically before surgery, in the 10th postoperative
week, in the 12th postoperative month and at the time of the final follow-up (in group A—66.15 months, in group B—66.61 months).
We examined the change of the femorotibial angle, of the patellar height according to the method of Insall and Salvati, of
the tibial slope angle according to the method of Bonnin, of the tibial condylar offset according to the method of Yoshida
and of the distance between the lateral tibial plateau and the top of the fibular head. In group A and B, the recurrence of
the varus deformity was not noted and valgus alignment did not increase in any case. In group-A, the Insall–Salvati ratio
remained unchanged in 65% of knees. The tibial slope angle decreased in both groups. There was correlation between the change
of the tibial condylar offset and the angle of the correction in both groups. There was correlation between the change of
the distance between the lateral tibial plateau and the top of the fibular head. After combined osteotomy, the transposition
of the tibial condyle and the decrease of the distance between the lateral tibial plateau and the top of the fibular head
was less than after closing wedge osteotomy, although the average angle of correction was more after combined osteotomy (11.835°),
than after closing wedge osteotomy (9.465°). Theoretically, the recurrence of the varus deformity, the increase of the valgus
alignment and (in majority of cases) the shortening of the patellar tendon do not compromise the likelihood of successful
conversion to the subsequent total knee replacement, either after combined or after closing wedge osteotomy. The combined
osteotomy does not lead to considerable transposition of the tibial condyle and to considerable lateral tibial bone loss;
therefore, theoretically, the combined osteotomy does not impair the subsequent total knee replacement. 相似文献
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Relationship of knee joint proprioception to pain and disability in individuals with knee osteoarthritis. 总被引:7,自引:0,他引:7
Kim L Bennell Rana S Hinman Ben R Metcalf Kay M Crossley Rachelle Buchbinder Michael Smith Geoffrey McColl 《Journal of orthopaedic research》2003,21(5):792-797
Proprioception plays an integral role in neuromotor control of the knee joint and deficits in knee joint proprioception are well documented in individuals with knee osteoarthritis (OA). However, the functional relevance of these deficits is not clear. This cross-sectional study evaluated the relationship between knee joint proprioception and pain and disability in a large cohort of individuals with knee OA. Two hundred and twenty participants (145 F, 75 M) with symptomatic knee OA were recruited from the community. Five non-weight bearing active tests with ipsilateral limb matching responses were performed at 20 degrees and 40 degrees flexion to measure knee joint position sense. Pain and disability were assessed by self-reported questionnaires and objective measures of balance and gait. Results showed little association between knee joint position sense variables and measures of pain and disability (r values <0.24, most p>0.05). When comparing participants with the worst and best joint position sense, no significant differences in pain and disability could be found (p>0.05). While our study design does not allow causality to be established, these results suggest that deficits in joint position sense may be due to factors other than pain and that deficits are not large enough to impact upon disability. 相似文献