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 Osteoarthritis 
Osteoarthritis

Overview of Osteoarthritis

Osteoarthritis, the "wear and tear" arthritis, is common, especially as we age. Causes include aging joints, previous injuries, and obesity, among others. Symptoms of osteoarthritis include joint pain and stiffness. Osteoarthritis may affect any joint, including the hand, wrist, neck, back, knee, and hip. Osteoarthritis treatment depends on the joint but often includes medication and exercise. There is no special osteoarthritis diet, but weight loss may improve symptoms of osteoarthritis

Research

Treatment of Osteoarthritis of the Knee with pulsed Electrical Stimulation
Thomas M. Zizic

Objective: The safety and effectiveness of pulsed electrical stimulation was evaluated for the treatment of osteoarthritis (OA) of the knee.
Methods: A multicenter, double blind, randomized, placebo controlled trial that enrolled 78 patients with OA of the knee incorporated 3 primary efficacy variables of patients' pain, patients' function, and physician global evaluation of patients' condition, and 6 secondary variables that included duration of morning stiffness, range of motion, knee tenderness, joint swelling, joint circumference, and walking time. Measurements were recorded at baseline and during the 4 week treatment period. Results. Patients treated with the active devices showed significantly greater improvement than the placebo group for all primary efficacy variables in comparisons of mean change from baseline to the end of treatment (p <0.05). Improvement of > 50% from baseline was demonstrated in at least one primary efficacy variable in 50% of the active device group, in 2 variables in 32%, and in all 3 variables in 24%. In the placebo group improvement of > 50% occurred in 36% for one, 6% for 2, and 6% for 3 variables. Mean morning stiffness decreased 20 min in the active device group and increased 2 min in the placebo group (p <0.05). No statistically significant differences were observed for tenderness, swelling, or walking time.
Conclusion: The improvements in clinical measures for pain and function found in this study suggest that pulsed electrical stimulation is effective for treating OA of the knee.
Studies for longterm effects are warranted. (J Rheumatol 1995;22:1757-61)

Glycosaminoglycan production

In Vitro Growth of Bovine Articular Cartilage Chondrocytes in Various Capacitively Coupled Electrical Fields

Carl T. Brighton, Anthony S. Unger, and Jeffery L. Stambough Department of Orthopaedic Surgery, University of Pennsylvania School of Medicine, Philadelphia. Pennsylvania

Summary: Isolated articular cartilage chondrocytes from 1- to 3-week-old male Holstein calf knee joints were formed into pellets containing 4 x 106 isolated cells and were grown in tissue culture medium (minimum essential medium/NCTC 135) containing either 1 or 10% newborn calf serum (NBCS) in plastic Petri dishes in 5% CO2 and air at 37C in saturation humidity. On the 4th postisolation day either [3~S]sulfate or [3H]thymidine was added to the medium, and the pellets were exposed for 24 h to capacitively coupled electrical fields (10, 100, 250, and 1,000 V peak-to-peak, 60 kHz, sine wave signals). Current Intensity: 37 uA cm\2 The pellets were then harvested, dialyzed, hydrolyzed, and assayed for DNA, protein, [35S]sulfate incorporation, and [3H]thymidine incorporation.
Results indicated that at 250 V peak-to-peak there was a statistically significant increase in [35S]sulfate in 1% NBCS and a statistically significant increase in [3H]thymidine in 10% NBCS. At potentials above, or below 250 V no changes were noted. Thus, articular cartilage chondrocytes grown in pellet form can be stimulated to increase glycosaminoglycan synthesis or to increase cell proliferation by an appropriate capacitively coupled electrical field. The importance of the serum concentration in the medium in evaluation of biosynthesis in vitro is noted.
Key Words: Articular cartilage chondrocyte--Capacitively coupled electrical field--[35S]Sulfate incorporation--Cell proliferation.

Case Studies on Osteoarthritis of the Knee

Case 1.
An 85 year old female with severe OA of the knee had been kept awake at night with pain. Prior treatments with anti-inflammatories and cortisone provided temporary, short term relief. CellStim treatment consisted of an IFC arrangement of pads on the medial/ lateral line and inf/ sup poles of patella. Treatments began at 3 times a week and then diminished. After 14 treatments in 10 weeks at 30 Hz/ 300 uA x 10 minutes and .3 Hz/ 40 uA x 10 minutes. The pain reduction indicated 95 % improvement.

Case 2.
A 70 year old male with moderate OA of the knee reports on occasion for treatment of knee pain. Previous treatment with IFC gave some improvement for short term relief. 20 - 30 minute CellStim treatments at .3 Hz and 40 uA biphasic gave lasting (2 weeks - 1 month) of significant relief (90-95% improvement). Pad placement was the same as case 1.

Case 3.
A 70 year old female with chronic OA of the 1st MTP was treated on 3 occasions with Cellstim at .3 Hz at 30 uA biphasic once per week for 3 weeks. The joint was probed (using Qtip electrode probes) moving the probe location every 3 to 5 seconds. After 3 treatments the patient reported 90% improvement.
Chiropractic College ... Canada

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