Prolotherapy May Help Ease Pain From Knee Osteoarthritis, Review Suggests
Lisa Rapaport writing fro Reuters reported that a review suggests prolotherapy, “an alternative medicine approach to joint pain that typically uses injections of sugar or sodium, may be worth trying for knee osteoarthritis after traditional approaches fail.” Investigators looked at data from 10 studies. The data suggested that “prolotherapy may be a safe way to help ease pain from knee osteoarthritis.” However, “the evidence on the effectiveness of prolotherapy isn’t strong enough to recommend it until after other treatments fail, said senior study author Dr. Nicola Maffulli.” The findings were published in the British Medical Bulletin.
Comment: Prolotherapy may work but the jury is still out.
Got a kid or grandkid playing soccer, here’s some news…
Study Reveals Increase In Soccer-Related Injuries, Concussions
Lindsey Tanner writing for the AP reported research has found an increase in soccer-related injuries among kids in the US being sent to emergency departments. The trend is “driven in part by young players with concussions seeking urgent medical care.” The findings were based on 25 years of data and found that the overall rate of injuries has “more than doubled to 220 per 10,000 players in 2013, from 106 per 10,000 players in 1990.”
Comment: One of my sons when he was playing soccer had 2 concussions. This is a serious issue.
And your surgeon says you need surgery… maybe not… next
Meniscal Tears May Not Need Surgery
Jack Cush reporting in RheumNow cited a study published in the British Medical Journal examines whether knee surgery or conservative medical management benefits those with degenerative meniscal tears. Patients with knee pain from a degenerative meniscal tear were randomized to either arthroscopic surgery (followed by daily exercises at home) or physical therapy (neuromuscular and strength exercises) two to three times a week for 12 weeks.
Over the next 2 years both groups improved. Muscle strength had improved more, on average, in the physical therapy group at the three-month checkup, but at the final two-year checkup, there was essentially no difference between the surgery and therapy groups, including in pain, ability to function in sports and recreation activities, and quality of life. The researchers noted that 19 percent of the therapy group opted to have surgery at some point but had achieved “no additional benefit” by the end of the study.
Conservative exercise therapy was equal to arthroscopic intervention overall, but also showed positive effects over surgery short-term muscle strength. Clinicians should consider conservative management and physical therapy in middle-aged patients with degenerative meniscal tears.
Comment: Degenerative meniscus tears are secondary to the arthritis. Surgery is not generally warranted.
Low-dose spironolactone seen as safe, effective treatment for patients with OA-related knee effusion
Reported in Healio… “Low dose spironolactone is a safe, effective and noninvasive treatment for osteoarthritis-related effusion. It is effective in mild and moderate cases and, to a lesser extent, in severe cases,” Sarah Ohrndorf, MD, specialist in internal medicine/rheumatology in the Department of Rheumatology and Clinical Immunology at Charité University Hospital in Berlin.
Researchers categorized 200 patients with unilateral knee effusion related to osteoarthritis (OA) into four groups with 50 patients in group 1 receiving spironolactone for 2 weeks, 50 patients in group 2 receiving ibuprofen for 2 weeks, 50 patients in group 3 using cold compresses twice daily for 2 weeks and 50 patients in group 4 receiving placebo for 2 weeks. Group 1 outperformed all other groups.
Sara Freeman writing in Rheumatology news reported on a study that showed that persistent knee pain is in important predictor of structural joint damage and could potentially be used to predict knee osteoarthritis earlier according to Dutch research reported at the World Congress on Osteoarthritis. The analysis found that women participating in the Rotterdam study who had knee pain on most days of the preceding month were more than 4 times more likely to develop knee osteoarthritis within 5 years on MRI than were those without frequent knee pain.