Aims: The aim of the present study was to assess the correlation between the stability metrics related to the center of pressure excursion measurements and the WOMAC questionnaire scores. Method and Materials: Fourteen patients with moderate knee osteoarthritis and fourteen healthy age-matched individuals were participated to stand with open and closed eyes, and on firm and rocking support on a force platform. The WOMAC questionnaire was obtained from the patient group. One-way ANOVA was utilized to determine the effects of knee osteoarthritis, vision, and support on postural stability metrics. Spearman’, s correlation was also used to indicate the correlation between the stability metrics and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) sub scores. Findings: The anterior-posterior variability of the center of pressure was significantly greater in patients (2. 7 mm, p=. 003). Elimination of the visual feedback and the rocking support affected the sway area and the AP (p<. 001), and the ML variability (p<. 024). The pain subscore of the WOMAC questionnaire was negatively and strongly correlated to the AP total mean velocity (open-eyes: r=-. 466, closed-eyes: r=-. 779). The pain was positively and strongly correlated to the AP variability (open-eyes: r=. 796, closed-eyes: r=. 744). Patients with knee osteoarthritis showed more postural instabilities. Conclusion: The instability in the anterior-posterior was more eminent than in the lateral direction. The pain was the most role-playing factor in the destabilization of the posture among the patients with knee osteoarthritis but may be disregarded in physically-difficult conditions of standing.

Background and Aim: Osteoarthritis (OA) is a very common painful disease of the musculoskeletal system. The limitation of the effectiveness of current analgesics had been proven and better analgesics are needed. Duloxetine is one of the drugs that has been observed to have analgesic effects, but there are few studies about it. The aim of this study was to compare the effect of duloxetine and glucosamine sulfate as pain relievers in reducing knee osteoarthritis pain. Methods: We performed a single-blind, trial of 60 mg of duloxetine and 500mg of glucoeamine in 60 subjects with osteoarthritis pain. Patients were divided into two groups and received 6 weeks of duloxetine orglucoeamine. The measured outcome was a reduction in average pain intensity after 6 months for subjects completing the trial. Symptoms were scored by the WOMAC Index. Data analysis was performed using Fisher's, t-test, and Mann-Whitney tests by a person who was unaware of the results. Results: 28 patients in the duloxetine group and 29 patients in the glucosamine sulfate group completed the study. No statistically significant difference was found between the two groups before the intervention (P-value > 0.5). The mean age of patients in the Deloxetine group was 65.47 ± 0.3 years and in the Glucosamine group, it was 65.55 ± 0.4 years (P-value = 0.384). There was no difference in gender distribution between the two groups (P-value = 0.91). The WOMAC score was significantly decreased in the duloxetine group compared to glucosamine (p < 0.05). It was also found that the pain indices were significantly reduced in the Deloxetine group. Conclusion: Duloxetine significantly reduce pain intensity on the WOMAC and could be considered as a suggested treatment for osteoarthritis pain.

Background and Aim: Knee osteoarthritis is one of the most common disabilities and has caused a lot of limitations in human. There are many methods proposed for its treatment. The aim of this study was to assess the effect of grade one mobilization of patellofemoral joint on reducing the pain and joint stiffness and improving the physical function in knee osteoarthritis patients.Materials and Methods: This study was one side blind clinical trial which was carried out in physical therapy department of Sarcheshmeh copper town polyclinic. The patients were selected randomly. Outcome instrument was WOMAC index (sum of data resulted from WOMAC questionnaire form) and measurements were done before and after treatment nearly one week after final treatment session. 30 patients with diagnosis of knee osteoarthritis, grade two or three, were divided into 3 groups randomly: Group 1: Mobilization+Exercise therapy, Group 2: Exercise therapy and Group 3: Mobilization. The ultrasound with the intensity below 0.2 w/cm2 in three minutes was used for all groups as placebo. The duration of treatment was 10 sessions for 3 weeks. To analyze the data, nonparametric tests were used at the significance level of 0.05.Results: In group one, WOMAC index decreased from 61.5+9.69 before treatment to 49.7+11.88 after treatment (P=0.005). In group two, WOMAC index decreased from 56.7+17.24 before treatment to 45.2+19.90 after treatment (p=0.022), and in group three, WOMAC index decreased from 59.6+16.51 before treatment to 47.7+19.72 after treatment (p=0.059). The difference of WOMAC index at the follow-up session, in comparison with the one before treatment, was significant only in group one which decreased to 50.1+11.73 (p=0.005).Conclusion: This study showed that grade 1 mobilization of patellofemoral joint can cause the effect of exercise therapy on reducing the pain and joint stiffness and improving the physical function in patients with grade 2 or 3 knee osteoarthritis continue at least for about one week.

Introduction: Osteoarthritis is the most common chronic joint disease that affects both the elderly and the middle-aged people. This disease is the most common cause of limitation for the elderly and middle-aged people in daily activities significantly affecting the quality of their lives. The aim of this study was to evaluate the ultrasonographic findings in patients with knee osteoarthritis and its correlation with Western Ontario and McMaster Universities Osteoarthritis Indexes (WOMAC). Materials and Methods: In this cross-sectional study, patients with knee osteoarthritis, who were referred to the rheumatology clinic of Imam Hospital from April 2020 to June 2021, were evaluated by radiographic and laboratory assessment. Laboratory tests included Rheumatoid Factor (RF), Anti-Cyclic Citrullinated Peptide (Anti-CCP), Antinuclear Antibodies (ANA), Erythrocyte Sedimentation Ratio (ESR) and C-Reactive Protein (CRP),patients with positive inflammatory and serological tests were excluded from the study. Then, patients with osteoarthritis were visited by a radiologist for ultrasound findings and underwent ultrasound. In addition, the WOMAC questionnaire was administered at the same time. Results: 138 patients over 40 years old and 85. 5% of whom being female were studied. The joint dryness score was significantly higher in patients with left synovial effusion (4. 04 vs. 2. 51,p = 0. 001). In patients with right synovial hypertrophy, the mean overall score of WOMAC and its sub-branches was significantly higher (61. 26 vs. 47. 80,p = 0. 001),also, mean joint dryness score in patients with left synovial hypertrophy is higher (4. 15 vs. 3. 17,p= 0. 017). Conclusion: The results of the present study showed that in terms of synovial inflammation, which includes hypertrophy and synovial effusion, there is a direct relationship with patients' WOMAC score, since ultrasound modality is non-invasive and available everywhere,moreover, the cheapness of this modality makes it possible to follow-up patients with osteoarthritis. This modality is also reliable in assessing synovial changes, but more accuracy is needed in assessing cases such as osteophyte.

Introduction: Knee osteoarthritis (KOA) stands out as the most common synovial joint disease among people, leading to a reduced quality of life, persistent pain, muscle weakness, and significant functional impairments. The aim of this study is to carry out an investigation that assesses the efficacy of clinic-supervised and internet-based exercise therapy (IET) on pain, range of knee flexion, and physical function of patients with KOA. Methods: This randomized controlled trial enrolled 54 patients between the ages of 50 and 75, all of whom had confirmed KOA. These patients were randomly allocated to one of two groups, both of which underwent 18 sessions of exercise therapy. One group received supervised therapy, while the other received therapy delivered via the internet. The study measured various outcomes, including pain intensity assessed with the VAS, thigh girth (TG), knee active flexion range of motion (FROM), the six-minute walk test (6MWT), the timed up and go test (TUG), and knee functionality evaluated using the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) questionnaire, both before and after the intervention. We used the paired t-test for intra-group analysis and the independent samples t-test and analysis of covariance (ANCOVA) test to compare differences between the groups. Results: Significant differences in outcomes were observed before and after the intervention in both groups (P=0. 001). However, the ANCOVA test revealed no significant differences between the groups following the study. The statistical analysis, performed with an independent-samples t-test, indicated no significant differences between the two groups concerning VAS, active knee flexion, thigh girth, and WOMAC scores, suggesting that both supervised exercise therapy (SET) and IET protocols yielded similar effectiveness. Nevertheless, when employing the independent-samples t-test, there were significant differences between the groups in the TUG (P=0. 001) and the 6MWT (P=0. 017), with the IET group demonstrating superior performance. Conclusion: The results of this study indicate that both SET and IET produce comparable outcomes in terms of reducing pain, increasing thigh girth, increasing knee flexion range, and improving WOMAC scores and the physical function of patients with KOA. The internet-based approach may offer added convenience and motivation for patients.

Background and Aim: With regards to the increasing prevalence of knee osteoarthritis (OA), the complaints of these patients from pain, some reports from the positive effects of glucosamine in decreasing pain in these patients and due to some defects in previous researches and for the comparison of the effects of Glucosamine Sulphate and Glucosamine/MSM, this study was done on the quality of pain and sign and symptoms of knee OA in a private clinic in 2008. Materials and Methods: A randomized matched clinical trial was conducted. Patients over 40 years old with knee OA according to ACR criteria, BMI<30, without history of recent knee surgery (recent one year) and after ruling out secondary OA, were enrolled in our study. The patients were randomly divided into 2 groups: glucosamine 1tab/BID and glucosamine/MSM 1tab/BID for 6 months. Outcome included WOMAC index. The change in pain score was studied in each group under Wilkacson statistic method and between the 2 groups, it was studied using Mann Whitney method. Results: 27 patients were included in glucosamine group and 26 patients in glucosamine/MSM group. The incidence of side effects was similar in both groups (p<0.9). Pain severity in the beginning, sex, age, and other studied factors were similar too. The decrease in pain score was 27.4±17.3 in Glucosamine group and 25.5±15.7 in Glucosamine/MSM group which means 28.8% reduction in Glucosamine group and 26.1% reduction in Glucosamine /MSM group (p<0.005), but in comparison, it was not meaningful statistically (P<0.8). Conclusion: It seems that these two groups of drugs have similar effects, but due to prices and side effects, Glucosamine is better than Glucosamine/MSM.

Background: Osteoarthritis (OA) is a chronic health condition that affects millions of people worldwide. It not only causes pain and physical limitations but also impacts mental health, sleep, work participation, and even mortality. Peri-articular dextrose prolotherapy has been shown to reduce knee osteoarthritis pain; however, the effect of injection sites on its effectiveness is not clear. Objectives: This study aimed to investigate the effect of injection points on pain intensity, joint stiffness, and physical activity in patients with knee osteoarthritis who underwent peri-articular dextrose prolotherapy. Methods: This double-blind clinical trial involved 26 patients with grade 2 and 3 bilateral knee osteoarthritis. Three times every one week, dextrose and lidocaine were injected as interventions. Injection sites were positioned within acupuncture points on one knee, but were relocated by 1.5 centimeters to the medial side of the same acupuncture points on the other knee. Pain intensity, joint stiffness, and physical activity were evaluated using the Visual Analog Pain Scale (VAS) and the Persian version of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) before the intervention and at each follow-up visit at 1 and 2 months post-injection. Results: Pain intensity score, joint stiffness, physical performance, and WOMAC were significantly decreased one and two months after the intervention in both groups (P = 0.0001). The improvement in the patients of both groups was similar, and the two study groups did not have a statistically significant difference in terms of study outcomes (P = 0.37). Conclusions: Prolotherapy with dextrose is an effective treatment for knee osteoarthritis.