Active clinical trials for "Osteoarthritis, Knee"

Primary aim: evaluate efficacy of subcutaneous injection of etanercept for moderate and severe knee osteoarthritis. Second aim: investigate the potentiality of serum cytokines (TNF-α, Interleukin 1-α (IL1-α), IL1-β, matrix metalloproteinases1 (MMP1), MMP13) to predict the response of subcutaneous injection of etanercept for moderate and severe knee osteoarthritis.

This is a proof-of-concept study to determine the safety and efficacy of a novel device to increase the reparative capacity of the knee. The discovery of a resident population of mesenchymal stem cells (MSCs) within synovial fluid (SF) was the first description of this reparative cell population having direct access to superficial cartilage and joint structures. The ready access of SF MSC to cartilage and other joint tissues offers a novel strategy for joint repair. Current arthroscopic procedures result in the removal of all SF MSCs due to continuous irrigation throughout the procedure. The current study would benefit the patient by greatly increasing the reparative capacity of the joint by bolstering MSC numbers and retaining those MSCs within the joint after surgery. By accessing MSCs from the synovium it is anticipated that these cells would be entrapped/migrate into the marrow clot formed by microfracture of the sub-chondral bone. These MSCs would supplement those from the marrow and may result in faster, better quality repair.

In France, osteoarthritis affects about 10 million people and knee osteoarthritis represents 35% of cases. It is thought that more than 2.5 million people older than 65 years have knee osteoarthritis. Currently, osteoarthritis management is based on three major axes: Non-pharmacological means, such as patient education, loss of weight and physical activity General pharmacological treatments: mainly paracetamol and then schedule II and III painkillers as well as nonsteroidal anti-inflammatory agent. Intra-articular pharmacological treatments: Intra-articular injections of corticosteroids: they are recommended during hydarthrotic flare-ups Intra-articular injections of hyaluronic acid (HA) (viscosupplementation) in the absence of intra-articular effusion. However, their efficacy is questioned by most experts in the case of symptomatic knee osteoarthrosis. Sometimes, surgery is the only therapeutic option. However, besides the fact of exposing patients, who are sometimes frail, to several peri- and post-operative complications, the recovery rate (variable according to the prosthesis type and ranging from 5% to 25% at 9 years) in an ageing population justifies waiting as much as possible before surgery. Therefore, it is important to test new therapeutic options for symptomatic osteoarthrosis that will allow postponing the surgical treatment. The use of botulinum toxin (BoNT-A) could thus represents an interesting alternative. BoNT-A is habitually used by intra-muscular injection for its myorelaxant effect in the management of painful reactive periarticular muscle contractures. However, BoNT-A has also antalgic activity independently of the myorelaxant effect. This allows explaining in part the antalgic effect of intra-articular BoNT-A injection. In the literature, six randomized controlled studies (RCS) have compared BoNT-A and intra-articular injections of corticosteroids, hyaluronic acid, or placebo. Only two RCS concerned knee osteoarthritis and compared BoNT-A to corticosteroids and a placebo, respectively, with a significant antalgic effect only in the groups treated with BoNT-A. No study has compared yet the intra-articular injection of BoNT-A to the viscosupplementation by HA in knee osteoarthritis and this is the aim of this trial.

Previous study showed that Guli capsule could suppress the adjuvant multiple arthritis; have inhibitory effect on carrageenan gelatinous and formaldehyde foot swelling; improve the symptom of osteoporosis patients; and improve pain and limited joint activities of rheumatoid patients. To further verify the clinical effect of Guli capsule in the treatment of knee osteoarthritis, the investigators perform this multi-center clinical study.

Physiotherapists' knee OA care is suboptimal. Exercise therapy including a combination of aerobic, muscle strengthening and functional exercises is not always performed and a lot of treatments are used for which there is no evidence. By a continuing education session and a pop-up in the electronic patient file, this study wants to improve knee OA care by focusing on combined exercise therapy. The study will be performed in collaboration with Pro-Q-Kine, an independent organization implementing quality improvement in Belgian physiotherapists' care. Besides Pro-Q-Kine the study will be performed in collaboration with two or three software producers of physiotherapists' electronic patient files that reached a national homologation for their respective software packages and covering a large part of the Flemish physiotherapists. Pro-Q-Kine will organize sessions of continuing education with a focus on optimal knee OA care. These sessions will be performed in LOK-groups (local peer-groups of physiotherapists who meet each other for continuing education). At these sessions the physiotherapists will be asked to take part to the study. A pop-up will be installed in the electronic patient file of the participating physiotherapists, lightening up when physiotherapists register a patient with knee OA. The pop-up includes a short message about optimal knee OA care. The physiotherapists will also receive a script for a query in their electronic patient files in order to extract those patients that initiated a treatment for knee OA between 1 year and 3 months before the therapists received education. These patients will receive a letter of their respective physiotherapists in which they are addressed to take part to the study. An informed consent, patient questionnaire and retour-envelope will be included. There will also be the opportunity to complete the questionnaire electronically with an electronic informed consent. The patient questionnaire will include some background details (such as age and gender) and details about the physiotherapeutic treatments they received for knee OA. The patient questionnaire will be coded with a number, referring to the physiotherapist and to the individual patient (the first patient of the first physiotherapist will be coded as 1.01, the 10th patient of the 14th physiotherapist will be coded as 14.10). Patients' names will not be revealed to the investigators and physiotherapists will not have any access to the completed patients' questionnaires. The general practitioners in the environment of the physiotherapist will (probably) receive a letter from the researchers. This letter will contain information about the importance of referral to a physiotherapist in knee OA care and about knee OA care in general. This letter will also refer to the study that is going on in physiotherapists' care, without details. Six months after the installation of the pop-up, the physiotherapists will be asked again to perform the query to extract patients out of the electronic patient file that have been treated for knee OA and whose treatment sessions had been started in the period of three months from the installation of the pop-up.

The primary objective of this study is to determine the levels of proteins and/or cellular components of the synovial fluid that are indicative of microenvironment phenotypes of the osteoarthritic knee compared to unilateral unaffected joints pre-injection to 6 weeks post-Regenexx® SD treatment.

The purpose of this study is to evaluate efficacy and safety of SI000413 in patients with knee osteoarthritis by orally administration and to determine optimal dose.

The purpose of this study is to obtain patient oriented and clinically oriented physical function outcomes both pre-operatively and post-operatively in patients receiving a total knee arthroplasty.

This study is aimed to determine the efficacy and the safety of the tourniquet reinflation after early tourniquet release in total knee arthroplasty, compared to the method of early deflation without reinflation. The investigators hypothesized that the reinflation after early release of the tourniquet would be effective in terms of improved visualization of the surgical field and decreased operation time and blood loss, whereas it would increase tourniquet-related complication due to longer tourniquet-use time.

The primary objective of this study is to evaluate the safety and efficacy of 3 loading and maintenance dose levels of CG100649 administered for 21 days in the treatment of osteoarthritis pain.