Steroid Injections May Be No Better Than Placebo For Pain Linked To Knee Osteoarthritis, Study Suggests
Nicholas Bakalar writing for the New York Times reported that while physicians “often prescribe steroid injections for the pain of knee arthritis,” research published in the Journal of the American Medical Association “has found they work no better than a placebo.”
Randy Dotinga writing for Healthday added that investigators found that individuals with knee osteoarthritis who received “steroid injections every three months for two years had no less pain than those taking a placebo treatment.” Additionally, researchers found that “they had greater loss of cartilage.”
Comment: What a bunch of horse doo-doo. These injections do work and this study is an example of stupidity.
An early sign of osteoarthritis in the knees… next
Noisy Knees Could Signal Onset Osteoarthritis Research Finds.
Diane King writing in the Edinburgh News reported noisy knees may be an early sign of osteoarthritis, new research suggests. People who hear grating, cracking or popping sounds in and around their knee joints are more likely to develop the condition, say scientists. Researchers conducted a multi-centre observational study that included almost 3,500 participants at high risk of knee osteoarthritis. The chances of them developing pain symptoms over a period of up to four years increased with greater frequency of knee noise. It doubled when the noises were heard “often” and trebled for patients who said they “always” experienced them. The findings, published in the journal Arthritis Care & Research, may lead to new ways of diagnosing and treating osteoarthritis earlier, said the researchers. US lead author Dr Grace Lo, from Baylor College of Medicine in Houston, Texas, said: “Many people who have signs of osteoarthritis on X-rays do not necessarily complain of pain, and there are no known strategies for preventing the development of pain in this group of people. “This study suggests that if these people have noisy knees, they are at higher risk for developing pain within the next year compared with the people who do not have noisy knees.
Comment: Noisy knees are pretty common and so is osteoarthritis of the knees.
Your orthopedic surgeon wants to do arthroscopic surgery for your meniscus… better watch out!
Arthroscopic surgery for degenerative meniscus tears increases risk for eventual knee replacement
A recent study published in the journal Osteoarthritis Cartilage showed that patients with osteoarthritis of the knee who undergo arthroscopic surgery for degenerative meniscus tears are at markedly increased risk for potentially having total joint replacement. In the study, 335 patients with osteoarthritis of the knee underwent arthroscopic surgery for degenerative meniscus tears. They were followed for two years.
The authors demonstrated that in patients with knee osteoarthritis, arthroscopic knee surgery with meniscectomy is associated with a 3 fold increase in the risk for future knee replacement surgery.
Comment: Don’t do it if you can avoid it. The meniscus serves of function. It helps to cushion the knee. Any meniscus tissue should be preserved.
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.