• Korean Journal of Clinical Pharmacy
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• v.17 no.1
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• pp.38-45
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• 2007

Background: The multitude of the therapeutic usefulness of intra-articular injection of hyaluronate on oateoarthritis of the knee is still in question. The objective of this systemic review was to elucidate both the therapeutic efficacy and the safety of intra-articular administration of hyaluronic acid for degenerative osteoarthritis of the knee joints. Methods: I searched MEDLINE and Korea Medical Database (KMbase) from January 1990 to April 2007 using a combination search terms for knee osteoarthritis and hyaluronic acid and a filter for randomized controlled trials. I extracted data on pain at rest, and during or just after movement, on joint function, and on adverse events. Results: Ten trials that reported usable quantitative information on any of the predefined end points were identified and included in the systemic review. Intra-articular injection of hyaluronic acid can decrease symptoms of osteoarthritis of the knee. The study revealed significant improvements in pain and functional outcomes with few adverse effects. However, there was significant between-study heterogeneity in the estimates of the efficacy of hyaluronic acid. Sub-group analysis showed that lower methodological quality such as a single-blind or single-center design resulted in higher estimates hyaluronic acid efficacy, and that patients older than sixty years of age and those with the most advanced radiographic stage of osteoarthritis were less likely to benefit from intra-articular injection of hyaluronic acid. Conclusion: According to the currently available evidence, intra-articular hyaluronic acid has been proven clinically effective for the patients bearing the knee osteoarthritis with NSAID-induced GI troubles or inapplicable to any surgery, and may be associated with lower risk of adverse events.

• Journal of Korean Medicine Rehabilitation
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• v.23 no.4
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• pp.23-37
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• 2013

Objectives This study was performed to investigate the effects of Saengkanggamchotang (SKT) on the monosodium iodoacetate (MIA) induced osteoarthritis in rats. Methods Osteoarthritis was induced by injection of MIA (50 ul, 60 mg/ml) into knee joints of rats. Rats are divided into a total of 4 groups (normal, control, positive comparison group, SKT treated group, each n=6). Normal group are not treated at all without inducing osteoarthritis whereas control group were induced for osteoarthritis by MIA and oral medicated with 20 ml of distilled water per day. Positive comparison group was injected with MIA and after 7 days, that was taken indomethacin (30 mg/kg/mouse). SKT treated group was injected with MIA and after 7 days that was taken SKT (30 mg/kg/mouse). Positive comparison group and SKT treated group were oral medicated for each substance a total of 4 weeks with one time per day. After experiments (from 1 week after injection of papain to 4 weeks elapsed), the functions of liver and kidney, Prostaglandin E2, inflammatory cytokine (IL-$1{\beta}$, IL-6, TNF-${\alpha}$), osteocalcin, TIMP-1, MMP-9 within serum. Knee joint structures were observed by H&E, safranin-O staining method, and amount of cartilage were measured by ${\mu}CT$-arthrography. Results 1) Hind paw weight bearing ability was significantly improved. 2) Functions of liver and kidney were not affected. 3) Prostaglandin E2, osteocalcin, TIMP-1, MMP-9 in serum were significantly decreased. 4) Inflammatory cytokine IL-$1{\beta}$ was significantly decreased, and IL-6, TNF-${\alpha}$ were decreased but had not significant. 5) In terms of histopathology, significantly reduced subsidence of cartilage and bone in H&E staining. And in Safranin O staining, proteoglycan content in synovial membrane was significantly increased compared with control group. 6) Destruction of cartilage on ${\mu}CT$-arthrography was significantly reduced. Conclusions Based on all results mentioned above, Saengkanggamchotang (SKT) is believed to be meaningful for suppressing the progress of osteoarthritis and its treatments.

• Journal of muscle and joint health
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• v.10 no.2
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• pp.188-202
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• 2003

The aim of study was to investigate the effects of 12 forms of Sun-style Tai-Chi for arthritis(TCA) on physical symptom(pain, tenderness, swelling fatigue, and blood pressure), physical function(balance, flexibility, grip strength) and social-psychological health status in osteoarthritis(OA) patients and rheumatoid arthritis(RA) patients. This study was done with one group pretest-posttest design. A total 21 arthritis patients(6 OA patient and 15 RA patient) participated in 60 minute session consisting of warm-up exercise 12-main movement including qigong, and cool-down exercise twice a week for 6weeks. Physiological and social-psychological variables were measured before and after TCA 12 form. The researcher who completed a Tai Chi workshop for exercise leaders in Australia and Seoul taught the Tai Chi movement step by step until the patient felt comfort enough to perform them correctly by themselves during the first 4 weeks. At the last 2 weeks, the subject perform 10-15set of these at a session with traditional music to help patients move in a slow tempo. TCA 12 forms program showed significant improvement in fatigue(p=0.039) of rheumatoid arthritis patient and pain(p=0.006), fatigue(p=0.013), tenderness(p=0.032), flexibility(rt arm up, p=0.014, If arm up, P=0.003), grip strength(rt hand, p=0.002, If hand, P=0.003) of osteoarthritis patients. With assessment by Arthritis Impact Measurement Scale 2 questionnaire(AIMS2), physical component(0.002) and social interaction(0.025) on osteoarthritis patients were significantly improved. Evaluation of the participants about TCA exercise noted that the exercise was fairly easy(23.6%), moderately difficult(57.1%), and fairly difficult(14.3%). Considering the result of this study, TCA exercise program was more effective in pain, tenderness, grip strength, flexibility, and physical and social interaction on osteoarthritis patients than rheumatoid arthritis patients. Tai-Chi for arthritis 12 form was an appropriate intensity exercise for osteoarthritis patients.

• Journal of muscle and joint health
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• v.9 no.1
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• pp.28-39
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• 2002

Objective. The 12 forms of Sun-style Tai Chi exercise has been developed specifically for arthritis patients in order to reduce their symptoms and to improve physical functioning. This quasi-experimental study examined the changes in pain, balance, muscle strength and physical functioning in women with osteoarthritis at the completion of the 12 week Tai Chi exercise program. Methods. The patients with osteoarthritis who signed the consent form were screened by their primary physician according to the inclusion criteria and invited to the study. Total of 66 osteoarthritis women with an average age of 63 years were participated in the Tai Chi exercise. At the completion of 12 weeks, 34 patients completed both pretest and posttest measures with 48% of overall dropout rate. Outcome measures were physical symptoms, balance, muscle strength, physical functioning, and depression. Paired t-test was utilized to examine differences between pre and post-measures. Results. After participating in the Tai Chi exercise program, the women with osteoarthritis showed significant improvements in their physical fitness measures, and consequently in their physical functioning. In physical fitness test, there were significant improvements in balance, flexibility, muscle strengths of knee, grip, and back muscles after the Tai Chi exercise. However, No significant differences were found in pain and stiffness of their knee joints and depression measure. Conclusion. The 12 forms of Tai Chi exercise has been found safely applicable to the older women with osteoarthritis for 12 weeks, and effective in improving balance, flexibility, and muscle strengths, and consequently lessening difficulties of performing their activities of daily life.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.3
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• pp.109-116
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• 2020

PURPOSE: The objective of this study was to provide a basis for the need to apply psychological factors-based rehabilitation programs to osteoarthritis patients by understanding how the limitations on the activities of osteoarthritis patients relate to the health-related quality of life and depression. METHODS: This study assessed 1,994 osteoarthritis patients from the 7th Korea National Health and Nutrition Examination Survey (KNHANES, 2016-2018). The subjects were divided into two categories: with activity limitation and without activity limitation. A Chi-square test and logistic regression analysis were conducted. RESULTS: The EQ-5D index of subjects with activity limitation was .84 ± .16, it was .94 ± .12 in those with no activity limitation (p < .05). The diagnosis of depression was 16.8% and; 8.3% in those with and without activity limitation, respectively (p < .05). There was a significant difference in the odds ratio for each item in the EQ-5D. Moreover, the odds ratio for depression with an activity limitation was 2.171 (1.512 - 3.118) compared with no activity limitation. CONCLUSION: The activity limitation of osteoarthritis patients reduces the health-related quality of life significantly and increases the probability of depression. Therefore, the treatment of osteoarthritis patients should be approached considering the psychological conditions. Moreover, early diagnosis of depressive symptoms is needed to prevent symptom deterioration and increase the compliance with rehabilitation therapy.

• Physical Therapy Korea
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• v.12 no.1
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• pp.45-54
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• 2005

The quadriceps-angle (Q-angle) and the ratio of hamstring/quadriceps (H/Q) are important for the stability of the knee and for protection from excessive stress. The aim of this study was to examine the association between Q-angle and H/Q ratio with and without knee osteoarthritis. We compared knee osteoarthritis patients with symptom-free women. The mean age of the patients in the arthritis group (25 women, osteoarthritis) was 59.7 years. The non-arthritis group consisted of 25 women with a mean age of 55.2 years. Of the 25 women with osteoarthritis, 5 had the condition in their left knee, 5 had it in their right knee, and 15 had it on both sides. There was no significant difference in the knee Q-angle of the left and right knees of the arthritis group and the non-arthritis-group (p>.05). The strength of all the muscles around the involved right knee in the arthritis group was significantly weaker than that of the non-arthritis group (p<.05). However, in the left knee, only the strength of the knee extensors and internal rotators was significantly weaker than that of the non-arthritis group (p<.05). The Q-angle was not associated with the H/Q ratio and internal rotators/external rotators ratio of the involved knee in the arthritis group (p>.05). Neither was the Q-angle associated with the pain level of an involved knee in the arthritis group (p>.05). The knee pain was not associated with the H/Q ratio of the involved knee in the arthritis group (p>.05). The Q-angle was not associated with the ratio of H/Q and pain level of the involved knee in the osteoarthritis women.

• Journal of Korean Medicine Rehabilitation
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• v.25 no.4
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• pp.55-63
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• 2015

Objectives The purpose of this study is to analyze the osteoarthritis-related effect of each constituent herb of ChondroT, the herbal medicine that used for osteoarthritis. Methods We searched osteoarthritis-related studies on each constituent herb of ChondroT via five Korean Medicine web databases. We classified these studies by each constituent herb (Ostericii Radix, Angelica Gigas Nakai, Clematidis Radix, Lonicerae Flos, Phellodendri Cortex) and researched the osteoarthritis-related effect. Results We collected 18 studies (two studies of Ostericii Radix, five studies of Angelica Gigas Nakai, three studies of Clematidis Radix, six studies of Lonicerae Flos, and two studies of Phellodendri Cortex). All of these studies were composed of in vivo and in vitro, and there were six pharmacopuncture experimental study. All experiments showed the significant effects on specific inflammatory mediators. Conclusions These results suggest that ChondroT will be able to apply to the treatment of osteoarthritis through continuous research and development.

• Journal of Korean Medicine Rehabilitation
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• v.27 no.2
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• pp.77-91
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• 2017

Objectives The aim of this study was to develop a standard tool of pattern identification for Knee Osteoarthritis, which will be applied to clinical research. Methods The advisor committee for this study was organized by 11 panel of experts (Korean Rehabilitation Medicine professors, Acupuncture and Moxibustion professors belonging to Korean Medicine colleges, Principal Researcher of Korea Institute of Oriental Medicine, Doctor of Korean medicine). The pattern identifications and symptoms for this tool were extracted from published Korean and Chinese literature. Through the discussion among internal experts and consultation from advisors, the Instrument on Pattern Identifications for Knee Osteoarthritis was developed. Results 1) Five pattern identifications (The Wind, Chill, and Moisture, The Moist-Heat, Blood Stasis, Yang Deficiency of Spleen and Kidney, Yin Deficiency of Liver and Kidney) were set for the tool. 2) The mean weights which represent the importance of each symptom and scored on a hundred-point scale was obtained. 3) The Instrument on Pattern Identifications for Knee Osteoarthritis was designed in the self-reporting format composed of 46 questions. Conclusions The Instrument on Pattern Identifications for Knee Osteoarthritis was created through this study. Though this study is not proved about validity, reliability, the instrument of pattern identification for Knee Osteoarthritis is meaningful and expected to be applied to the subsequent.

• Korean Journal of Acupuncture
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• v.36 no.2
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• pp.104-114
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• 2019

Objectives : The purpose of this study is to review the effectiveness of fire needling treatment for knee osteoarthritis in comparison with manual acupuncture treatment. Methods : Through four foreign online databases (PubMed, Cochrane library, EMBASE, and CNKI) and five domestic online databases (NDSL, RISS, KISS, OASIS, and KTKP), we searched for clinical studies that performed fire needling treatment for knee osteoarthritis until May 10, 2019. Only randomized controlled trials were selected and we assessed the risk of bias according to the Cochrane RoB criteria. This review examined the selected studies into first author, publication year, sample size, outcome measurements, results, acupoints, treatment time & period and so on. Results : A total of 7 RCTs were selected in this review and all were conducted in China. Treatment period of more than 4 weeks and treatment visits of 10 to 20 times were the most common. EX-LE4 and ST35 (=EX-LE5) acupoints were most frequently selected in treatment. Among the evaluation indexes, a total efficacy rate was used the most. Most of fire needling groups showed more significant results compared with the manual acupuncture groups statistically. Conclusions : All studies showed that fire needling treatments for knee osteoarthritis were more effective than manual acupuncture treatments statistically. Therefore, the results of this study could be utilized as a preliminary data for another clinical research on fire needling treatment for knee osteoarthritis. However, further well-designed randomized controlled trials will be needed to develop sufficient evidence about the effectiveness and safety of fire needling treatment for knee osteoarthritis in the future.

• Journal of Korean Medicine Rehabilitation
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• v.31 no.4
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• pp.167-191
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• 2021

Objectives Degenerative osteoarthritis of knee is a disease with an increasing number of patients worldwide and its general treatments have some side effects. Methods 102 subjects were classified into test group 1, test group 2, and control group, and clinical trial products were taken for 12 weeks. The effectiveness was evaluated with changes in visual analogue scale, Korean-Western Ontario and McMaster Universities Osteoarthritis Index, inducible nitric oxide synthase, and cyclooxygenase-2. Results Both test group 1 and test group 2 were effective in reducing the pain of degenerative osteoarthritis of knee, and only test group 2 was effective in improving the ability to perform daily activities. No clinically significant changes were observed for any safety parameter. Conclusions In conclusion, the data of this study indicate that Zanthoxylum piperitum leaf extract has effectiveness and safety against mild degenerative osteoarthritis of knee.