The Effects of Prolotherapy With Hypertonic Dextrose Versus Prolozone (Intraarticular Ozone) in Patients With Knee Osteoarthritis.

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Abstract

Knee osteoarthritis (KOA) is a common disabling disease. Limited studies have demonstrated that prolotherapy with dextrose or with prolozone can be helpful in the treatment of patients with KOA.

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Knee pain and osteoarthritis in older adults: a review of community burden and current use of primary health care.

G. Peat, R. McCarney, P. Croft (2001)

Osteoarthritis is the single most common cause of disability in older adults, and most patients with the condition will be managed in the community and primary care. To discuss case definition of knee osteoarthritis for primary care and to summarise the burden of the condition in the community and related use of primary health care in the United Kingdom. Narrative review. A literature search identified studies of incidence and prevalence of knee pain, disability, and radiographic osteoarthritis in the general population, and data related to primary care consultations. Findings from UK studies were summarised with reference to European and international studies. During a one year period 25% of people over 55 years have a persistent episode of knee pain, of whom about one in six in the UK and the Netherlands consult their general practitioner about it in the same time period. The prevalence of painful disabling knee osteoarthritis in people over 55 years is 10%, of whom one quarter are severely disabled. Knee osteoarthritis sufficiently severe to consider joint replacement represents a minority of all knee pain and disability suffered by older people. Healthcare provision in primary care needs to focus on this broader group to impact on community levels of pain and disability.

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The economic burden of disabling hip and knee osteoarthritis (OA) from the perspective of individuals living with this condition.

S. Gupta, G A Hawker, A. Laporte … (2005)

To estimate the direct and indirect arthritis-attributable costs to individuals with disabling hip and/or knee osteoarthritis (OA). An established population cohort with disabling hip and/or knee OA from two regions of Ontario, Canada was surveyed to determine participant and caregiver costs related to OA, and the predictors of these costs. The response rate was 87.2%. Of 1378 respondents, 1258 had OA (mean age 73.1 yr, range 59-100). Sixty per cent (n = 758) reported OA-related costs. Among these individuals, the average annual cost was 12,200 dollars(CDN dollars in 2002, where 1.00 CDN dollar approximately 0.81 US dollar). Time lost from employment and leisure by participants and their unpaid caregivers accounted for 80% of the total. Men were less likely than women to report costs (adjusted odds ratio 0.54, P or = 55 were 15 times more likely to report costs, and their costs were 3 times greater (both P < 0.0001). Both the young (<65 yr) and very old were more likely to incur costs (P < 0.0001), and when they did their costs were higher (P < 0.001). Costs incurred were mainly for time lost from employment and leisure, and for unpaid informal caregivers. Failure to value such indirect costs significantly underestimates the true burden of OA. Costs increased with worsening health status and greater OA severity. After adjustment, men were less likely to incur costs, possibly due to greater social resources.

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The sources of pain in knee osteoarthritis.

David T Felson (2005)

To review the mechanisms for the production of pain in knee osteoarthritis. Nociception is produced by stimulation of unmyelinated and small myelinated fibers in the joint and surrounding tissue. To produce pain, the stimuli must be either repeated or spatially clustered. When they reach the spinal cord, stimuli are subject to two inhibitory effectors: interneurons and descending central neurons. Inflammation lowers the threshold for nociception. In the joint, tissues containing nociceptors include primarily the joint capsule, ligaments, synovium, bone, and in the knee, the outer edge of the menisci. Nociceptive stimuli are likely to emanate from one or more of these locations in people with knee pain. This review does not cover psychological aspects of pain. Nociception in the knee is complex, and the nociceptive stimuli are related to but fundamentally different from those producing cartilage loss. Better appreciation for these processes will facilitate the development of new treatments.