Online ISSN: 2515-8260

Keywords : Osteoarthritis


An observational study to assess the serum Vitamin D levels and Kellgren-Lawrence grading in patients of primary osteoarthritis

Dr. Sangeeta Khyalia, Dr. Ravinder Kumar Lamoria, Dr. Rahul Dhaka, Dr. Pramod Singh Chahar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 608-614

Aim: To assess the serum Vitamin D levels and Kellgren-Lawrence grading in patients of
Primary Osteoarthritis.
Materials and Methods: The present observational study was carried out on the patients
coming to the OPD of the Department of Orthopedics, SMS Medical College and Hospital,
Jaipur. All patients complaining of Osteoarthritis of the knee joint and willing to participate
in the study were interviewed for age, sex, history of inflammatory arthritis or any rheumatic
disease, complain of celiac disease & malabsorption syndrome or any history of intake of any
drug that might affect serum Vit D levels. After the successful running of Quality Controls
the clear serum obtained from patient’s serum was analyzed on Advia Centaur XP (for
Vitamin D & PTH) & fully automated chemistry analyzer Beckman Coulter AU 680 (for
routine biochemical parameters). Based on the serum biochemistry results, patients with
deranged RFT & LFT were excluded from the study & the Serum Vitamin D, PTH, Calcium
and Phosphorus levels of the patients with normal RFT & LFT were documented.
Results: In our study maximum number of patients (109, 41.44%) fell in the age group 51-60
years with age ranging from 37-70 years. Mean age is 55.37 ± 8.04 years. Male female ratio
was 0.81:1. Mean serum Vitamin D level is 18.27±8.34 ng/ml with range from 4.2-44.34
ng/ml. Maximum no. of patients were in the Vitamin D deficient group (148, 56.27%), 96
(36.5%) patients were Vitamin D insufficient while only 19 (7.23%) patients had Vitamin D
levels above normal range. Maximum number of cases were of grade 3 (90, 34.22%).
followed by grade 2 (82, 31.18%). Minimum no. of cases are of grade 0 (7, 2.66%) followed
by grade 1 (22, 8.36%). The mean Kellgren- Lawrence grading for the cases is 2.68 ± 1.01.
Conclusion: There is high prevalence of Vitamin D deficiency in Osteoarthritis patients. But
this prevalence needs to be compared with the prevalence in general population by including
age & sex-matched healthy controls. The present study could be further taken in this
direction.

The Role of Platelet-Rich Plasma in Inducing Musculoskeletal Tissue Healing in Chronic Tendinopathies

Dr. Uma Durga Vinod D, Dr Rakesh Chandra M, Dr Jakku Kranthi, Dr Pradeep Chandra Chetamoni

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1618-1623

Background: Platelet-rich plasma [PRP] has received increasing interest across many
musculoskeletal disciplines and has been widely applied clinically to stimulate tissue
healing in numerous anatomical regions. The known actions of platelet-derived factors
suggest that PRP may have significant potential in the treatment of pathological
conditions of cartilage, tendon, ligament, and muscle.
Purpose: The aim of this manuscript is to review current literature regarding the
biology of PRP and the efficacy of using PRP to augment healing of tendon ligament
and muscle injuries, as well as early osteoarthritis.
Methods: A comprehensive literature review of musculoskeletal applications of PRP
was performed, including basic science and clinical studies such as randomized
controlled trials, case controlled series, and case series.
Results: The most compelling evidence to support the efficacy of PRP is for its
application to tendon damage associated with lateral and medial epicondylitis. Although
some promising studies have been reported supporting the use of PRP in osteoarthritis
and ligament and muscle injuries, it currently remains unknown whether PRP
effectively alters the progression of osteoarthritis or aids the healing of ligament and
muscle tissues.
Conclusion: The rationale for the use of PRP to improve tissue healing is strong, but the
efficacy for many musculoskeletal applications remains unproven. PRP has been shown
to be a safe treatment. A number of questions regarding PRP remain unanswered,
including the optimal concentration of platelets, what cell types should be present, the
ideal frequency of application, or the optimal rehabilitation regimen for tissue repair
and return to full function

Functional outcomes of proximal fibular osteotomy in osteoarthritis knee grade II & III

Govind Pratap Singh, Bhupinder Singh Brar, Dr. Punit, Navneet Singh, Sandeep Singh Jaura

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1059-1066

Introduction: Osteoarthritis of the knee is a degenerative condition with a variety of treatment options like high tibial osteotomy (HTO), arthroscopic debridement, unicompartmental knee arthroplasty and total knee arthroplasty. This study was conducted with an aim to assess the outcomes of individuals with Grade II and III medial compartment osteoarthritis treated with a proximal fibular osteotomy (PFO) to alleviate discomfort, improve medial joint space and function of the knee joint.
Methodology: From November 2019 to October 2021, 25 Patients aged 45 to 65 years with knee OA of grade II or III (Kellgren-Lawrence classification) involving the medial compartment of the knee were included and underwent proximal fibular osteotomy and were followed up. Preoperatively as well as postoperatively, the entire lower extremity radiographs were obtained to assess the alignment of the lower extremity and the ratio of the knee joint space (medial/lateral compartment), knee pain was assessed using a visual analogy scale and knee ambulation activities were assessed using the American Knee Society score.
Results: All patients experienced alleviation from medial knee discomfort postoperatively. Postoperative weight-bearing lower limb radiographs revealed an average increase in medial knee joint space. The mean preoperative AKSS improved from 43.92 to 63.88 till the last follow-up.
Conclusion: PFO is a safe, simple and effective procedure that significantly decreases knee discomfort. It also enhances the joint's radiographic appearance and functional outcome in patients with medial compartment osteoarthritis of the knee.

ASSESSMENT OF ROLE OF PRP IN MANAGEMENT OF OSTEOARTHRITIS OF THE KNEE

Dr. Sumit Pal Singh, Dr. Manmeet Singh , Dr. Shubham Pandoh, Dr. Anil Gupta, Dr. Nitish Sharma

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 2382-2386

Background: Osteoarthritis (OA) is a chronic, non-inflammatory rheumatologic disease which affects the synovial joints. The present study was conducted to assess the role of PRP in management of osteoarthritis of the knee.
Materials & Methods: 65 patients of osteoarthritis of the knee of both genders were enrolled.
Cartilage thicknesses were measured radiologically by ultrasound before and at third and sixth months after treatment. The severity of pain was evaluated by using VAS.
Results: Out of 65 patients, males were 30 and females were 35. Right side was involved in 34 cases and left in 31 cases. The mean VAS before treatment was 5.4, after 3 months it was 2.3 and after 6 months it was 0.8. The difference was significant (P< 0.05). The mean cartilage thickness before treatment was 0.5 mm, after 3 months was 0.7 mm and after 6 months it was 0.8 mm. The difference was significant (P< 0.05).
Conclusion: PRP is found to be effective in management of cases of osteoarthritis of the knee.

Association Between Knee Inflammation and Knee Pain in Patients with Knee Osteoarthritis: An Institutional Based Study

Shakti Condil Sharma, Vijay Sharma

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 657-662

Objective: The aim of the present study is to determine the association between knee
inflammation and knee pain in patients with knee osteoarthritis.
Methods: A total of 250 patients with knee OA were included in this study. The
diagnosis was based on the American College of Rheumatology (ACR) criteria for knee
OA. The severity of knee pain, stiffness, and disability were measured using the
Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).
Results: The mean age of the patients was 50.11 ± 6.34 years. Kellgren-Lawrence
grading scale and age or disease duration were positively and significantly associated,
whereas none of the WOMAC sub-scores were found to be related with Kellgren-
Lawrence grading scale (P > 0.05). On the other hand, WOMAC disability scores were
significantly associated with WOMAC pain and WOMAC stiffness (P < 0.01).
Conclusion: Knee pain, stiffness, and duration of disease may affect the level of
disability in the patients with knee OA. Therefore, treatment of knee OA could be
planned according to the clinical features and functional status.

STUDY ON FUNCTIONAL OUTCOME ANALYSIS FOLLOWING PRIMARY TOTAL KNEE REPLACEMENT WITH BUECHEL-PAPPAS KNEE

Sankaralingam P; Parthasarathy M.P; ThulasiRaman D; ArulVignesh .; Aravind MC; Vijay MSV

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 9, Pages 1064-1074
DOI: 10.31838/ejmcm.07.09.109

Background: Total knee replacement has arisen, with outstanding pain relief and work, as a safe, longer-lasting form of knee arthroplasty. The goal of this research was to examine the therapeutic, functional and radiological aspects of complete knee replacement with Buechel-Pappas knee Prosthesis for osteoarthritis and rheumatoid arthritis.
Material and Methods:
Material: Buechal Pappas spinning bearing prothesis was implanted in all the surgeries.
Method: The study is a prospective study in which the Meenakshi Medical College& Research Institute from OCT 2016 to SEP 2018 included patients over 50 years of age who have primary knee osteoarthritis and those with rheumatoid arthritis knee who do not respond to conservative treatment. Both cases were implanted with Complete knee arthroplasty using the Buechel Pappas implant Distance balance procedure above the age range of 50yrs. Both patients have cases that do not lead to conservative management. Serious brain defects, poliomyelitis with muscle weakness, or knee joint sepsis were omitted from the study. The study involved 45 total knee replacements. Initially, both patients were judged by the American Knee Society Ranking. To come to a conclusion, pre and post-operative scores were compared.
Results: In the American knee society ratings, there was a major change. The pre-operative average score was 27.44 and the post-operative score was 91.5. After the TKR, there was a 70% increase in the ratings. The average functional preoperative score was 34.6 and the postoperative score was 83.5, indicating a functional score improvement of 80 percent after TKR.
Conclusions: Total knee arthroplasty with Buechel-Pappas knee resulted in an increase in the patient's functional capacity to return to the pre-disease state, as demonstrated by the post-op society score improvement.
 

ASSESS THE KNOWLEDGE OF OSTEOARTHRITIS MANAGEMENT AMONG PRIMARY HEALTH CARE PHYSICIANS AT PRIMARY HEALTH CARE CENTERS OF MINISTRY OF HEALTH MAKKAHAL-MUKARRAMAH CITY, 2019

Mohammad Hamzah Mlibary, Hassan Ali Mohammad Saeed Alahmadi, Yasser Ali Mohammad Saeed Alahmadi, Ahmed Mohsen BakheetAlharbi Mohammed Mohsen BakheetAlharbi, FahadMohammed Mosfer Alqarni, AbdulazizAbdullahhMayudhAlwuthaynani, Ahmad WaselAlharbi, WaadNaser Alotaibi

European Journal of Molecular & Clinical Medicine, 2019, Volume 6, Issue 1, Pages 245-255

Background:
Primary health care physicians manage most patients with osteoarthritis. Osteoarthritis (OA) is one of the leading causes of disability. The prevalence of OA is expected to increase because of ageing and obesity, and health care professionals must prepare for a rise in the demand for OA care. Osteoarthritis (OA) is the most common form of arthritis and the leading source of physical disability in elderly people. The Prevalence of OA is increasing and will continue to do so as the population gets older. The OA is predominantly managed in primary care centers by primary health care physicians and much can be done to alleviate symptoms from osteoarthritis by combinations of therapeutic options including pharmacological and non-pharmacological treatments, in the Kingdom of Saudi Arabia. The diagnosis is made by history, typical x-ray findings and non-contributory laboratory investigations. The understanding of the pathogenesis of the condition is undergoing change. The development of osteoarthritis is dependent on age, sex, genetic predisposition, and previous trauma to the joint and abnormal mechanical forces caused primarily by obesity.
Aim of the study:To  assess the level of knowledge of Osteoarthritis Management among Primary Health Care Physicians at Primary Health CareCenters of Ministry of Health.
Methods:Cross-sectional study was done, including a representative random sample of PHC physicians working at PHC centers of MOH in Makkah city. during the October to December, 2019, the Sample size of physicians working at PHC centers . Our total participants were (150)
.Results:the majority of participant (44.0%) have weak level of total knowledge about Osteoarthritis Management followed by (35.0%) of participant average while Range(2-8) and Mean ±SD(5.15±2.877) and also shows that is a statistical significant were Chi-square 12.52and P=0.0019
Conclusion:Conduct Saudi guidelines and further studies to assess the practice of PHC physicians regarding osteoarthritis, is recommended. Overall knowledge of PHC physicians in Makkah city regarding OA is acceptable; despite being deficient in some important issues.  Finally, when the conservative management by the primary care physician is of benefit no longer, judicious referral to an experienced Orthopedic Surgeon for the modern surgical approaches should be