Aged ; Biological Monitoring ; Female ; Femur/chemistry* ; Humans ; Knee Joint/chemistry* ; Male ; Meniscus/chemistry* ; Metals/analysis* ; Middle Aged ; Tibia/chemistry*

OBJECTIVE: To observe the therapeutic effects of different waves of electroacupuncture (EA) on knee osteoarthritis (KOA), and to explore the mechanism of different waves of EA on promoting cartilage repair. METHODS: Ninety- seven patients with KOA were randomly divided into a dilatational wave group (32 cases, 2 cases dropped off), a continuous wave group (32 cases, 2 cases dropped off) and a discontinuous wave group (33 cases, 3 cases dropped off). The same acupoints of Xuehai (SP 10), Liangqiu (ST 34), Dubi (ST 35) and Neixiyan (EX-LE 4) were selected in the three groups. The dilatational wave (frequency of 2 Hz/10 Hz) was used in the dilatational wave group, the continuous wave (frequency of 10 Hz) was used in the continuous wave group, and the discontinuous wave (frequency of 10 Hz) was used in the discontinuous wave group. All the needles were retained for 30 min. All the treatment was given 3 times a week (on Monday, Wednesday and Friday) for 4 weeks. Lysholm knees scoring scale (LKSS) was used to evaluate the knee joint function before and after treatment, and the content of transforming growth factor-β1 (TGF-β1) in the joint effusion before and after treatment was determined by enzyme-linked immunosorbent assay (ELISA). RESULTS: Compared before treatment, the total score and each score of LKSS were increased after treatment in the three groups (all <0.05). The improvements of total score, pain score, instability score, swelling score of LKSS in the continuous wave group and the dilatational wave group were superior to those in the discontinuous wave group (all <0.05). The content of TGF-β1 in the joint effusion in each group was increased after treatment (<0.05), and the improvement in dilatational wave group was superior to thoes in the continuous wave group and the discontinuous wave group (all <0.05). CONCLUSION The three different waves of EA could all improve the clinical symptoms of KOA, which may promote cartilage repair by increasing TGF-β1 content. The dilatational wave had the best overall effect, which can be used as a clinical optimal treatment.
Acupuncture Points ; Electroacupuncture ; Humans ; Knee Joint ; Osteoarthritis, Knee ; therapy ; Synovial Fluid ; chemistry ; Transforming Growth Factor beta1 ; analysis ; Treatment Outcome

OBJECTIVE: To evaluate the effects of piroxicam patch(Trast) in rheumatoid arthritis patients with knee joint pain and swelling and to determine the concentration of plasma and synovial fluid following patch application. METHODS: Twenty-two patients with rheumatoid arthritis participated in a double-blind, placebo-controlled study. The patients were instructed to apply piroxicam or placebo patch at one knee and re-apply it every other day for 2 weeks. They had washout period for 2 weeks and then applied the other patch for 2 weeks at the same joint. The patients recorded knee joint pain using visual analog scale. Knee joint swelling and tenderness were assessed before and after application of piroxicam and placebo patch. Complete blood count, AST, ALT, BUN, creatinine, joint fluid analysis were also done. Piroxicam concentration in plasma and synovial fluid were measured by high performance liquid chromatography(HPLC) after 2 weeks of piroxicam patch application. RESULTS: Knee joint pain improved significantly after the application of piroxicam patch for 2 weeks(visual analog scale, 56. 2+5. 9m vs 48. 2+5. 7mm, p=0. 03 by Wilcoxon signed rank test). There was no significant change in white cell count of synovial fluid, peripheral blood cell count, chemistry, C-reactive protein and erythrocyte sedimentation rate. In terms of adverse effects, mild gastrointesti nal disturbance(8/21 cases, 38%) and local side effects such as pruritus and ery thema(3/21 cases, 14%) were developed, which were insignificant compared with control groups(30%, 15% respectively). Piroxicam concentrations in plasma and synovial fluid after the application of piroxicam patch were 0. 129+0. 04ug/ ml (mean+SE) and 0. 644+0. 202ug/ml respectively. CONCLUSIONS: Piroxicam patch is a safe and effective therapeutic modality for knee joint pain in patients with rheumatoid arthritis. Mild adverse effects such as gastrointestinal disturbance and local side effects were noted. Piroxicam concentration was higher in synovial fluid than in plasma following the application of piroxicam patch.
Arthritis, Rheumatoid* ; Blood Cell Count ; Blood Sedimentation ; C-Reactive Protein ; Cell Count ; Chemistry ; Creatinine ; Humans ; Joints ; Knee ; Knee Joint ; Piroxicam ; Plasma ; Pruritus ; Synovial Fluid ; Visual Analog Scale

Generalized tonic-clonic convulsion was noted immediately after arriving at recovery room in eighteen year-old female patient who underwent an uneventful knee joint arthroscopy with spinal anesthesia. The first attack was successfully controlled with immediate treatment such as airway insertion, oxygenation and ventilation with mask, and infusion of 100 mg thiopental and 5 mg diazepam. The seizure activity changed to generalized status epilepticus after several recurrences of generalized convulsion, which was hard to control. The seizure activity was controlled by loading dose and continuous infusion of thiopental (total 1750 mg) and dilantin (total 1500 mg). A thorough diagnostic evaluation including a detailed medical investigation, neurologic physical examination, laboratory investigation with particular reference to blood chemistry test, computed tomogram, and magnetic resonance image except past history and electroencephalography (EEG) showed no abnormal findings. The patient has the past history of several attacks of idiopathic generalized convulsion in five or six year-old age and she showed generalized slow wave in EEG. No definite precipitating factor could be found in this case. But it may be vaguely suspected that the emotional stress of awakening state during operation under spinal anesthesia could have precipitated asymtomatic underlying seizure activity especially in the adolescent period even though the patient had clinically insignificant history of seizure attack.
Adolescent ; Anesthesia, Spinal* ; Arthroscopy ; Chemistry ; Diazepam ; Electroencephalography ; Female ; Humans ; Knee Joint ; Masks ; Oxygen ; Phenytoin ; Physical Examination ; Precipitating Factors ; Recovery Room ; Recurrence ; Seizures* ; Status Epilepticus* ; Stress, Psychological ; Thiopental ; Ventilation

OBJECTIVETo evaluate the effect of length of tibial stump on proprioceptive recovery after anterior cruciate ligament (ACL) reconstruction.

METHODSFrom March 2011 to December 2011,42 patients with ACL tear were performed with reconstruction. The patients were divided randomly into three groups: group A, the patients with remained length of tibial stump ranging from 15 to 20 mm, including 8 males and 6 females, with an average age of (28.2 ± 6.6) years old; group B, the patients with remained length of tibial stump ranging from 5 to 10 mm, including 9 males and 5 females, with an average age of (27.9 ± 6.4) years old; group C, the patients with remained length of tibial stump less than 2 mm, including 9 males and 5 females, with an average age of (28.6 ± 6.8) years, old. The stability of knee were assessed by Lanchman test and anterior drawer test. The function of knee was assessed by Lysholm score and Tegner activity rating. The proprioceptive recovery was evaluated by assessing the passive reproduction of the angles with limb movement into flexion and extension in no weight bearing position.

RESULTSLanchman test and anterior drawer test of all patients were negative at 6 months postoperatively., and there was one case of positive outcome in each group at 12 month and 18 month postoperatively. Lysholm score and Tegner activity score of all patients at 18 month postoperatively were significantly better than that preoperatively, and there were no significant difference among three groups at 18 month postoperatively. There were no significant difference in the production of the angles at flexion to 20° and extention to 80° and 20° among these groups before and after operation. The reproduction of the angles of group A and B at flexion to 50° and extention to 50° at 6 month postoperatively were significantly better than that of group A and B preoperatively and that of group C at 6 month postoperatively, and there were no significant difference among three groups at 18 month postoperatively. The reproduction of the angles of group A and B at flexion to 80° at 12 month postoperatively were significantly better than that of group A and B preoperatively and that of group C at 12 month postoperatively, and there were no significant difference among three groups at 18 month postoperatively.

CONCLUSIONPreservation of tibial stump in ACL reconstruction has benefit in proprioceptive recovery at early stage postoperatively and the length of tibial stump should be reserved with a range from 5 to 10 mm.

Adult ; Anterior Cruciate Ligament ; physiopathology ; surgery ; Anterior Cruciate Ligament Injuries ; Anterior Cruciate Ligament Reconstruction ; Female ; Humans ; Knee Joint ; physiopathology ; surgery ; Male ; Proprioception ; Range of Motion, Articular ; Tibia ; chemistry ; physiopathology ; surgery ; Young Adult

No abstract available.
Arthritis, Gouty/drug therapy/*metabolism/*radiography ; Calcium Pyrophosphate/*analysis ; Crystallization ; Female ; Glucocorticoids/administration & dosage ; Humans ; Injections, Intra-Articular ; Knee Joint/*chemistry/drug effects/*radiography ; Middle Aged ; Predictive Value of Tests ; Tomography, X-Ray Computed/*methods ; Treatment Outcome ; Triamcinolone/administration & dosage

OBJECTIVETo observe the influence of Jingu tablet (JGT) on the development and repair of osteoarthritis (OA).

METHODThe admixture of 4% papain and 0.3 mol x L(-1) cysteine was injected into the rat's knee joint to make the model of rat OA, and distilled water, Gucining Capsule and JGT was given ig simultaneously to treat for 4 weeks in succession, and then animals were killed to measure every index.

RESULTJGT could obviously improve the scope of activities of knee joint. There were significant differences between every dosage group and model group. In every dosage group, JGT could suppress the swelling of thickness of slippery membrane of joint, alleviate the inflammation symptoms of OA and obviouslical improve the pathologicol changes of slippery membrane and cartilage. JGT could also obviously reduce the content of MDA of slippery membrane and lighten the degree of cell damage.

CONCLUSIONJGT can lighten the retrograde affection of joint cartilage, obviously suppress the slippery membrane's inflammation and alleviate the scathing degree of cell. Therefore JGT has definite remedial effect to OA.

Animals ; Cartilage, Articular ; pathology ; Cysteine ; Drug Combinations ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Female ; Knee Joint ; pathology ; Male ; Osteoarthritis ; chemically induced ; drug therapy ; pathology ; Papain ; Plants, Medicinal ; chemistry ; Rats ; Rats, Sprague-Dawley ; Synovial Membrane ; pathology ; Tablets

The aim of this study was to develop a sustained release converse thermosensitive hydrogel for intra-articular injection using chitosan-glycerol-borax as matrix, its physical properties and biocompatibility were investigated. Taking gelation time and gelation condition as index, the influence of concentration of chitosan, ratio of chitosan to glycerol, pH on physical properties of hydrogel were investigated. And then the in vitro drug release, rheological properties and biocompatibility were studied. The thermosensitive hydrogel flows easily at room temperature and turns to gelation at body temperature, which can certainly prolong the release of drug and has good biocompatibility.
Analgesics ; administration & dosage ; adverse effects ; chemistry ; Animals ; Chitosan ; administration & dosage ; chemistry ; Delayed-Action Preparations ; Drug Compounding ; Hydrogels ; administration & dosage ; chemistry ; Hydrogen-Ion Concentration ; Inflammation ; chemically induced ; Injections, Intra-Articular ; Knee Joint ; drug effects ; Male ; Materials Testing ; Plants, Medicinal ; chemistry ; Rats ; Rats, Sprague-Dawley ; Rheology ; Seeds ; chemistry ; Strychnine ; administration & dosage ; adverse effects ; analogs & derivatives ; chemistry ; Strychnos nux-vomica ; chemistry ; Surface Properties ; Synaptic Membranes ; drug effects ; Temperature

Astragalus heteropolysaccharides (AHPS) is obtained from the dried roots of Astragalus membranaceus (Fisch.) Bunge var. mongholious (Bunge) Hsiao. In the present study, we observed its effects on erythrocyte immune adherence function in mice with adjuvant-induced arthritis (AA). The mice were treated intragastrically with AHPS of 1 000, 500, and 250 mg x kg(-1) x d(-1) separately and treated with tripterygium glycosides (TG) of 60 mg x kg(-1) x d(-1) as positive control. The number of complement receptor type 1 (CR1) on erythrocyte, the concentration of circulating immune complex (CIC) in serum and the amount of immune complex (IC) deposition in synovium of knee joint were determined by flow cytometry, polyethylene glycol (PEG-6000) precipitation and ponceau S (P-S) staining and fluorescent immunohistochemistry respectively. The pathological change of knee joint was evaluated by histological section. The results showed that both AHPS and TG improved significantly the primary and secondary local or systemic symptoms of the mice with AA and reduced the synovium hyperplasia, inflammatory cell infiltrate, pannus and cartilage demolish of knee joint, and AHPS of 1 000, 500, and 250 mg x kg(-1) x d(-1) could significantly increase the number of CR1 on erythrocyte, improve the elimination of CIC in the peripheral blood and reduce the deposition of IC in joint synovium in a dose-dependent manner (P < 0.01 or P < 0.05). The results indicate that one of the therapeutic effective mechanisms of AHPS on mice with AA could be to increase gene expression of CR1 of mice with AA.
Animals ; Antigen-Antibody Complex ; blood ; metabolism ; Arthritis, Experimental ; metabolism ; pathology ; Astragalus Plant ; chemistry ; Dose-Response Relationship, Drug ; Erythrocytes ; immunology ; Knee Joint ; pathology ; Male ; Mice ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Polysaccharides ; administration & dosage ; isolation & purification ; pharmacology ; Random Allocation ; Receptors, Complement ; blood ; Synovial Membrane ; immunology

OBJECTIVETo study clinical outcomes of Chinese medidine fumigation and massage therapy for the treatment of knee stability and functional recovery after anterior cruciate ligament reconstruction operation,and to explore the effect on tendon-bone healing.

METHODSTotal 50 patients were divided into two groups: the control group (normal rehabilitation therapy group),the treatment group (Chinese medicine fumigation and manipulation group). There were 25 patients in the control group, including 16 males and 9 females, who were treated with isometric muscle training, with the gradually enlarging amplitude of flexion and progressive loading of bearing training for knee recovery. There were 25 patients in the treatment group, including 15 males and 10 females,who were treated with the conventional rehabilitation therapy combined with Chinese medicine fumigation and massage therapy. The Chinese herbs named as Haitongpi decoction was steamed by a special equipment to fumigate the knee after operation; Based on the biomechanical parameters of the ligament reconstruction, the massage therapy was designed to control the degree of the knee flexion and release the adhesion for early recovery of knee functions. The Lysholm knee function evaluation system was used, and MRI examination was performed to measure the change in width of ligament tunnel in femur and tibia to evaluate the safety and stability of the treatment.

RESULTSLysholm system showed that two groups both had improving results from the 1st month after operation to the 3rd month (treatment group, F=36.54, P<0.05; the control group, F=28.12, P<0.05), and the results of the treatment group was better than that of the control group at the observation point (the 1st month, t=0.105, P<0.05; the 3rd month, t=5.361, P<0.01). There was no difference between the two groups when evaluating the bone and tendon healing 3 and 12 months after operation (P>0.05), indicating that Chinese rehabilitation therapy was a safety treatment without the influence on the loosing of tendon.

CONCLUSIONChinese medicine fumigation and massage therapy can early improve the knee function after the anterior cruciate ligament reconstruction operation without the disturbance of the knee stability.

Adult ; Anterior Cruciate Ligament ; surgery ; Anterior Cruciate Ligament Injuries ; Anterior Cruciate Ligament Reconstruction ; Case-Control Studies ; Combined Modality Therapy ; Drugs, Chinese Herbal ; administration & dosage ; chemistry ; Female ; Fumigation ; Humans ; Knee Injuries ; drug therapy ; physiopathology ; surgery ; therapy ; Knee Joint ; drug effects ; physiopathology ; surgery ; Male ; Massage ; Range of Motion, Articular ; Recovery of Function