Objectives: In order to investigate the efficacy and safety of the newly developed herbal medicine Jetongdan, a placebocontrolled, randomized clinical trial of patients with osteoarthritis of the knee was undertaken. Methods: Data were obtained from 80 patients with OA of the knee. After enrollment, they were asked to answer a disease-specific questionnaire (Western Ontario and McMaster Universities (WOMAC) OA index) and analyzed with the erythrocyte sedimentation rate (ESR) in order to evaluate the efficacy of Jetongdan, and analyzed for aspartate transaminase (AST) level, alanine transaminase (ALT) level, blood mea nitrogen (BUN) level, and creatinine (Cr) level in order to evaluate the safety of Jetongdan. Results: The liver function and renal function did not deteriorate after treatment with Jetongdan. Composite WOMAC score and physical function subscale was improved, but pain subscale, stiffness subscale, and ESR were not improved by. This was possibly because the baseline characteristics of the two groups were not homogenized after randomization. Conclusions: Jetongdan could be a promising treatment option for osteoarthritis of the knee. Further study in a larger population with appropriate severity grades is recommended.
The purpose of this study was to identify the effects of mechanical traction applied to the knee joint on pain, knee range of motion (ROM), timed up and go (TUG) and Western Ontario and MacMaster Universities Osteoarthritis (WOMAC) in patients with knee osteoarthritis (KOA) of Kellgren-Lawrence radiological rating scale II or III. Twenty three patients participated in the experiment for a period of four weeks. After baseline assessment, the patients with KOA were randomized into two groups: the traction group ($n_1=12$), which received traction with general physical therapy; and the control group ($n_2=11$), which received general physical therapy only on unilateral knee joints. Patients received interventions once a day, three times a week, for four weeks. Wilcoxon signed-rank test was used to analyze the change of dependent variances within the group during pre and post intervention. Mann-Whitney U test was used to analyze the change of dependent variances as TUG and passive ROM between the two groups. Analysis of covariance was used to analyze the change of dependent variances as numeric pain rating scale (NPRS) and WOMAC score between the two groups. In Wilcoxon signed-rank test, the traction group improved significantly with regard to NPRS (p<.01), passive knee flexion ROM (p<.01), passive knee extension (p<.05), TUG (p<.01) and WOMAC scores (p<.01) after intervention for four weeks, but not for the control group. In the Mann-Whitney U test and analysis of covariance, no significant difference was seen among all the dependent variances after intervention for four weeks between the two groups. These outcomes suggest that further studies should be carried out to determine the effects of mechanical traction prior to using it for the treatment of patients with knee osteoarthritis.
Park, Mu Seob;Oh, Se Jung;Lee, Jung Hee;Jun, Seung Ah;Gong, Han Mi;Choi, Seong Hun;Hwangbo, Min;Lee, Hyun Jong;Kim, Jae Soo
Journal of Acupuncture Research
/
v.33
no.3
/
pp.161-168
/
2016
Objectives : This study was done to show the clinical effect of miniscalpel acupuncture treatment on osteoarthritis of the knee which is refractory to acupuncture treatment. Methods : A patient was treated with acupuncture for three weeks, non-treated(wash out period) for two weeks, and treated with miniscalpel acupuncture for three weeks. The effect of treatments were measured with Visual Analogue Scale(VAS), Range of Motion(ROM), Short form McGill pain questionnaire(SF-MPQ), Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC). Results : During the three weeks of acupuncture treatment, VAS, SF-MPQ and WOMAC improved, but after two weeks of the wash out period each score worsened. During the three weeks of miniscalpel acupuncture VAS, SF-MPQ, and WOMAC improved while ROM improved remarkably. Conclusion : These results suggest that miniscalpel acupuncture might be a therapeutic option for knee degenerative osteoarthritis patients who does not responded to acupuncture treatment.
Lee, Young Min;Song, Eun-Kyoo;Oh, Ho-Seok;Kim, Yu-Seok;Seon, Jong-Keun
Journal of the Korean Orthopaedic Association
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v.56
no.5
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pp.404-412
/
2021
Purpose: This study examined the degree of cartilage regeneration by performing second-look arthroscopy in a group of patients who underwent high tibial osteotomy and microfractures for unicompartmental osteoarthritis of the medial knee joint and to determine the factors affecting cartilage regeneration. In addition, this study analyzed whether there is a relationship between the degree of cartilage regeneration and functional results. Materials and Methods: From 2007 to 2015, this study evaluated 81 cases who underwent second-look arthroscopy at the time of plate removal after a microfracture and high tibial osteotomy with a minimum two-year follow-up. The degree of femoral cartilage injury before surgery was classified by ICRS (International Cartilage Research Society), and all were grade III and IV. After second-look arthroscopy, cartilage regeneration was classified into a well-regenerated group (grade I, II) and a poorly regenerated group (grade III, IV). The independent factors influencing cartilage regeneration were identified through multivariate logistic regression analysis. In addition, the functional results were compared before and after surgery between the two groups using the Knee Society score (KSS) and the Western Ontario and McMaster Universities Osteoarthritis Index score (WOMAC). Results: Age, sex, body mass index, postoperative radiologic factors, and preoperative joint condition did not affect the degree of cartilage regeneration significantly. The large cartilage defect (≥2.0 cm2) (p=0.011) and the presence of kissing lesions (p=0.027) were associated with poor cartilage regeneration. No significant difference in the KSS and WOMAC scores was observed between the group with good and poor cartilage regeneration. Conclusion: The presence of a large cartilage defect and kissing lesions is associated with poor cartilage regeneration after high tibial osteotomy and microfracture. On the other hand, the degree of the regenerated cartilage did not show any correlation with the functional outcome.
The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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v.13
no.1
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pp.26-35
/
2007
The purpose are to demonstrate the pain, stiffness, and physical function by the Korean Western Ontario MacMaster University(KWOMAC) score of the patients with varus deformity osteoarthritis of the knee after treatment period. Twenty outpatients with knee osteoarthritis(OA) were randomized and divided into the control(n=10) and wedge(n=10) groups. The remission scores of the KWOMAC index of severity for knee OA were compared between the groups. The result of repeated two-way ANOVA's revealed that a contact lateral-wedged insole with strapping produced significantly differences in the pain and physical function score between groups after treatment period(P<0.05), but it was not significant differences in the stiffness score between groups(P>0.05). These results suggest that the pain relief and improvement in function reported by patients with osteoarthritis while using lateral-wedged insole with strapping may be achieved by a reduction in external varus moment and medial compartment load.
Objective : To test the hypotheses that individualized traditional Korean acupuncture improves pain and disability in patients with osteoarthritis of the knee and that benefits remain after stopping treatment more so than is the case for standardized minimal acupuncture. Design : Randomized single blind controlled trial with two intervention arms (individualized traditional Korean acupuncture, standardized minimal acupuncture) of six weeks' duration and three months follow-up. Setting : Acupuncture interventions were applied by two training doctors in the Department of Acupuncture and Moxibustion in a 1000-bed hospital. Assessment of the result was performed in a university-based laboratory. Participants : 50 patients with symptoms of knee osteoarthritis as diagnosed by an orthopedist. Intervention : Individualized traditional Korean acupuncture or standardized minimal acupuncture for six weeks. Main outcome measures: Primary outcome measure was pain as measured by the visual analogue scale. Secondary measures of pain and disability included the Western Ontario and McMaster Universities (WOMAC) index, Short Form-36 (SF-36), Lequesne Functional Index (LFI) score and Korean version of Health Assessment Questionnaire (KHAQ). Discussion : This paper presents detail on the rationale, design, methods and operational aspects of the trial.
The Journal of Churna Manual Medicine for Spine and Nerves
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v.11
no.2
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pp.35-44
/
2016
Objective : The objective of this study is to report the effect of Korean Rehabilitation Treatment with CHUNA Manual Therapy and Exercise Therapy on Postoperative Anterior Cruciate Ligament rupture of knee. Methods : Two patients were treated by Korean Rehabilitation with CHUNA Manual Therapy and Exercise Therapy at knee. We evaluated the effectiveness by Visual Analog Scale(VAS) and Western Ontario and McMaster Universities Arthritis Index(WOMAC) and Range of motion(ROM) Results : Both patients had significant improvement on Knee ROM, VAS score and WOMAC index. Also physical examination of Knee was improved. Conclusions : This study showed that Korean Rehabilitation Treatment with CHUNA Manual Therapy and Exercise Therapy has meaningful effect on Postoperative of anterior cruciate ligament rupture of knee. But there is a limit on this study due to sufficient number of cases. Further studies will be needed.
Purpose: The purpose of this study was to introduce the ultrasound-guided transmeniscal injection in medial compartment knee osteoarthritis and analyze the clinical outcomes. Materials and Methods: The electronic medical records of 36 patients with medial compartment knee osteoarthritis who were treated with an ultrasound-guided transmeniscal injection from March 2019 to July 2019 were accessed for this retrospective review. Using an ultrasound guided spinal needle, the patients received an intra-articular steroid injection at the medial compartment of the knee. A physical examination was conducted at the initial visit (pre-injection), and at one week, four weeks, and eight weeks after the injection. The numeric pain rating scale (NRS), Lequesne index, and Western Ontario and McMaster Universities Osteoarthritis (WOMAC) score were measured at each visit and analyzed over time. The percentage change of the patients who revealed substantial improvement was analyzed. The NRS, Lequesne index, and percentage of patients, who revealed substantial improvement over time classified by osteoarthritis grade, were analyzed. Results: The NRS and Lequesne index decreased at one week, four weeks, and eight weeks after the injection compared to the initial baseline, and the pain-relief effect continued without change until eight weeks. The percentage of patients who showed substantial improvement at one, four, and eight weeks was 50.0%, 47.2%, and 52.8%, respectively. The WOMAC scores decreased at one, four, and eight weeks compared to the initial baseline, and the decrease was continued without any difference until eight weeks. The percentage of patients with osteoarthritis stage 1 or 2 who revealed more than substantial improvement was significantly higher at one, four, and eight weeks than those with osteoarthritis stages 3 or 4 (p<0.05). Conclusion: In patients with medial compartment knee osteoarthritis, the pain reduction and functional improvement persisted for at least eight weeks after the ultrasound-guided transmeniscal injection at the medial compartment. In particular, patients with medial compartment osteoarthritis stage 1 or 2 showed more effective pain reduction.
Journal of the Korean Society of Physical Medicine
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v.19
no.1
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pp.81-94
/
2024
PURPOSE: This study aimed to investigate the effect of a progressive balance training program with whole-body vibration stimulation on knee joint pain, dysfunction, psychosocial status, and balance ability in individuals aged ≥ 65 years with knee osteoarthritis. METHODS: A total of 40 individuals aged ≥ 65 years with osteoarthritis of the knees participated in the study. Using a randomization program, participants were assigned to an experimental group (n = 20) or a control group (n = 20). Both groups were assigned a knee strength training program, and a progressive balance training program with whole-body vibration stimulation was assigned to the experimental group. All interventions were conducted three times a week for four weeks. Participants were evaluated for the following: pain (numeric rating scale, NRS), knee dysfunction (Korean version of the Western Ontario and McMaster Universities Arthritis Index, K-WOMAC), fall efficacy (Korean Version Falls Efficacy Scale, K-FES), quality of life (Euro Quality of life 5 Dimension, EQ-5D), and advanced balance scale score (Fullerton advanced balance scale, FAB) before and after the intervention, and the effects of the intervention were compared accordingly between groups. RESULTS: Both groups showed significant differences in the results of the NRS, K-WOMAC, K-FES, and EQ-5D assessments before and after the intervention, and there was a significant difference in the amount of change between the two groups (p < .05). There was a significant improvement in FAB in all but items FAB 8 and FAB 9 after the intervention in the experimental group. In the control group, there was a significant improvement in FAB 1, FAB 2, FAB 7, and FAB total after the intervention (p < .05). In addition, there was a significant difference in the amount of change between the two groups in all items except FAB 8 and FAB 9 (p < .05). CONCLUSION: The progressive balance training program with whole body vibration stimulation is an effective intervention method with clinical significance in improving knee joint pain, knee disability index, psychosocial level, and balance ability in adults aged ≥ 65 with osteoarthritis of the knees.
Purpose: We compared the clinical and radiological results of meniscectomy with HTO or without HTO for degenerative medial meniscus posterior horn with varus deformity. Materials and Methods: Forty-two patients who had medial meniscus degenerative root tear with varus deformity more than 3 degrees were included for this study. Among them, 30 patients were performed meniscectomy combined with open wedge HTO and 12 patients were performed only meniscectomy without HTO. The mean follow-up period was 52.5 months. The clinical results were evaluated based on symptom improvement, patients' subjective satisfaction for surgery and HSS score. We also compared the osteoarthritic progression between the group on preoperative and at the final follow up radiographs. Results: Symptom improvement was achieved in 83.3% (25 cases) with HTO group and 66.7% (8 cases) without HTO group at final follow up with a significant difference. Patients' satisfaction was achieved in 83.3% (25 cases) with HTO group and 58.3% (7 cases) without HTO group which has a significant difference. The HSS score was improved in both group (90.8: with HTO group, 89.0: without HTO group) at the final follow up without significant difference. WOMAC score was improved in both groups at the final follow up without significant difference. There were no significant differences in the osteoarthritic progression between two groups. Conclusion: The good clinical result for treatment of patient who have medial meniscus degenerative root tear with varus deformity, proximal high tibial osteotomy is considered absolutely necessary. However, the progression of degenerative arthritis, its effect on long term follow up will be needed.
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