Review Article Healthcare and Scientific Treatment of Knee Osteoarthritis
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Hindawi
Journal of Healthcare Engineering
Volume 2022, Article ID 5919686, 7 pages
https://doi.org/10.1155/2022/5919686
Review Article
Healthcare and Scientific Treatment of Knee Osteoarthritis
Huan Wang and Baoan Ma
Orthopedics, The Second Affiliated Hospital of the Air Military Force Military Medical University, Xi’an,
Shanxi Province 710000, China
Correspondence should be addressed to Baoan Ma; gukemba@fmmu.edu.cn
Received 2 November 2021; Revised 29 November 2021; Accepted 8 January 2022; Published 28 January 2022
Academic Editor: Rahim Khan
Copyright © 2022 Huan Wang and Baoan Ma. This is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is
properly cited.
Knee osteoarthritis is a chronic degenerative disease companied with chronic knee pain and dysfunction. However, the etiology
and pathogenesis of knee osteoarthritis were unclear. Currently, age, diet, trauma, obesity, and inheritance are the main risk
factors. The major pathological hallmarks of knee osteoarthritis included subchondral bone sclerosis, articular cartilage de-
generation, arthrosynovitis, and osteophyte. With the acceleration of the aging process in China, the treatment of knee arthritis
and the methods to improve the quality of life have become the focus of medical staff. Currently, therapies in clinical practice
include surgery and nonoperative treatment; however, the clinical effects of different individuals at different stages will still be very
different. This article reviews the recent advances in the treatment of knee osteoarthritis from three aspects: nonsurgical treatment,
surgical treatment, and modern new medical means.
1. Introduction 1.1. The Etiology and Pathogenesis of KOA. Currently, age,
diet, trauma, obesity, and inheritance are the main risk factors
Knee osteoarthritis (KOA) is a type of chronic degenerative [8–10]. The articular cartilage layer is worn out, the biome-
arthritis [1], and its chronic inflammation is characterized by chanical changes in contact with the subchondral bone, and the
degeneration or loss of articular cartilage, articular margin, loss and reduction of articular fluid with the acceleration of the
and subchondral bone regeneration [2]. However, the eti- aging process. In addition, with weight gain, ligament de-
ology and pathogenesis of knee osteoarthritis were unclear. generation, relaxation, and muscle weakness, there were ob-
With the acceleration of the aging process in China, the vious degenerative changes in articular cartilage and
incidence rate of KOA is increasing [3]. The methods of subchondral bone [11]. Inflammatory cells inside the joint,
improving the quality of life [4–7] and the living standards of including macrophages, release inflammatory factors [12–14],
patients become an urgent problem for medical workers. At accelerate the degradation of articular cartilage, aggravate the
present, there is still controversy about which intervention is inflammation of the synovial joint, and produce early in-
the best method. flammatory pain. As mechanistic research continues, relevant
Currently therapies in clinical practice include surgery cytokines and signaling pathways involved in developing ar-
and nonoperative treatment; however, the clinical effects of thritis are also constantly mined, including TGF-β, neural
different individuals at different stages will still be very growth factor (NGF), and hypoxia-inducible factor (HIF)
different. This article reviews the recent advances in the [15, 16]. Although the pathogenesis of KOA is still unclear, we
treatment of knee osteoarthritis from three aspects: non- have found the key to opening the door, provided a strong basis
surgical treatment, surgical treatment, and modern new for better achieving the molecular level of treatment inter-
medical means. vention; moreover, we do our best to improve the quality of life.2 Journal of Healthcare Engineering
2. Conservative Treatment of 2.2. Drug Treatments
Knee Osteoarthritis 2.2.1. Topical Treatment. Zhao et al. [36] found that oral
At present, there are many conservative treatments methods loxoprofen sodium (LOX-O) was found to be comparable to
for primary KOA in middle-aged; although it can play a role loxoprofen sodium hydrogel transdermal patch (LOX-T),
in improving and delay progressing of the disease, there are indicating promising topical use of nonsteroid anti-in-
some elderly patients with poor curative effects. flammatory drugs (NSAIDS). Coskun Benlidayi et al. [37]
found that both ibuprofen gels and creams had significant
clinical efficacy. Wadsworth et al. [38] found that topical
2.1. Nondrug Treatment. In the early stage of KOA, patients administration of 2% sodium diclofenac had not only a good
had no obvious symptoms, and it did not impact on work clinical effect, but also, it was well tolerated by patients.
and life; patients can take actions like self-management, Moreover, piroxicam, Tongning gel, also has an obvious
prevention to improve the function of the knee joint and curative effect [39, 40]. At the same time, Teymouri et al. [41]
improve the quality of life, moreover, delaying and changing found that the bioactive ingredients of herbal gels have
the pathological process of osteoarthritis. obvious healing effects on knee pain, stiffness, and mobility,
such as hemp oil, quercetin, Phyllanthus amarus Schumach.
& Thonn, and Guilu Erxian Glue [40, 42–44].
2.1.1. Health Education and Health Promotion. Through
health education, patients could cultivate a healthy lifestyle
including avoiding wind chill, weight loss, and reasonable 2.2.2. Oral Treatment
physical exercise, avoiding such as climbing, squatting, and
long-distance running. Effective emotional counseling to (1) Nutritional Articular Cartilage. The European Associa-
guide patients is particularly important [17, 18]. The effect of tion for the Osteoporosis and Economic Areas of Osteo-
weight on the knee is of unique importance, and weight loss arthritis (ESCEO) recommends glucosamine sulfate (GS)
makes patients the most benefited from interventions and chondroitin sulfate (CS) as first-line treatments for knee
[19–21]. Hacken et al. [21] found that weight loss was a osteoarthritis (OA) [45]. Lomonte et al. [46] found that the
reliable method to reduce pain and stiffness and improve combination of new glucosamine sulfate and chondroitin
function during the five-year follow-up. However, weight sulfate had good efficacy and tolerance. Meanwhile, Lugo
control cannot be achieved by dieting. Pay special attention et al. [47] found that undenatured type II collagen sup-
to the intake of fruits and vegetables, such as blueberries, plements had good efficacy and be tolerated in regulating
raspberries, and grass pomegranates, which can reduce symptoms of osteoarthritis in the knee.
arthritis pain [22].
(2) NSAIDs. NSAIDs (nonsteroidal anti-inflammatory
drugs) are the cornerstones of osteoarthritis (OA) therapy,
2.1.2. Exercise Therapy. Chronic knee pain seriously influ- but NSAIDs have gastrointestinal toxicity, while taking
ences normal life of patients. Patients often have difficulty gastric mucosal protective agents reduces adverse events in
choosing between restricted activity and appropriate and the stomach [48]. In recent years, obvious upper gastroin-
reasonable exercise. The lack of formal therapeutic reha- testinal and cardiovascular adverse events have made ra-
bilitation training is often the factor of causing the further tional NSAIDs medication very important. It is
development of knee osteoarthritis [23]. The clinical effect of recommended that patients with severe symptomatic OA
muscle strength training is remarkable, which can effectively use weak opioids (e.g., tramadol) for a short time. Diacerein,
relieve pain in patients and promote the recovery of knee an important inhibitor of new osteoarthritis IL-1, can sig-
function [24, 25]. At the same time, Dong et al. found that nificantly improve the joint function of patients with os-
water sport was comparable to land exercise in the thera- teoarthritis, delay the course of disease, reduce pain, and
peutic effect, but patients had better compliance and sat- improve the quality of life of patients [49]. Simental-Mendı́a
isfaction [26]. Tai Chi in traditional medicine in China also et al. [50] found that the avocado soybean unsaponifiables
has a good curative effect [27]. (ASU) was also beneficial for symptomatic KOA.
(3) Traditional Chinese Medicine Treatment. Lai et al. [51]
2.1.3. Physical Therapy. There are many current physical found that in the treatment of knee degenerative osteoar-
treatments, such as electromagnetic therapy [28], acu- thritis, the 4-week treatment with Duhuo Jisheng decoction
puncture [29], ultrasound [30], massage [31], spa [32], can reduce pain and stiffness and improve physical function.
cupping [33], yoga [34], and laser [35], but there are great Other Chinese patent medicines include Biqi capsule,
differences in the treatment effect on different individuals, Fuzheng Guben pill, Xiaohuoluo pill, Gujin pill, Huoxue
and their effect is to relax tense muscles, promote local Zhitong capsule, Jiangu granule, and Xianling Gubao cap-
blood circulation, improve function of the knee joint, and sule. Furthermore, the herbal formulation combined with
promote absorption and discharge of inflammatory conventional treatment appears to be more effective in
substances. improving the physiological function of the knee joint [52].Journal of Healthcare Engineering 3
3. Surgical Treatment lines from the arthritic chamber to a relatively healthy
chamber. Pannell et al. [69] found patients treated with HTO
3.1. Intraarticular Puncture and Injection of Knee Joint. have an 8% increased risk of requiring replacement every 1
Intraarticular puncture and injection of knee joint is an year, and older, higher rates of complications were more
invasive surgical treatment for KOA. Commonly used drugs significant in women than in men. HTO can provide long-
for puncture and injection include glucocorticoid, ozone, term survival for certain patients. Patients selected for this
hyaluronic acid, platelet-rich plasma, and mesenchymal surgery should be carefully considered for their age, gender,
stem cells. Intraarticular injection of corticosteroids (IACI) and osteoarthritis severity.
is a common method to relieve pain in patients with knee
osteoarthritis (OA). The effective time of intraarticular in-
jection of glucocorticoid is reported to be different, about 3.3.2. PFO. Proximal fibular osteotomy (PFO) is a simple
1–3 months, while F006, as a new microsphere-based tri- and effective method for medial septal OA. Qin et al. [70]
amcinolone acetonide sustained-release preparation, pro- performed a proximal fibula osteotomy (PFO) in 52 patients
longs the action time [53–56]. The mechanism of ozone may with medial knee OA and varus deformity. The larger distal
be through activation of the cellular metabolism, reducing displacement of the fibula head suggests a greater range of
prostaglandin synthesis, thereby relieving pain, improving activity in the tibial fibula joint and a more pronounced
function, and quality of life [57], Intraarticular cavity in- postoperative improvement in OA symptoms, and proximal
jection of ozone coupled with oral celecoxib and amino bula osteotomy has proven very effective in young patients
glucose significantly reduced the pain intensity in patients with medial knee osteoarthritis.
with mild to moderate KOA [58]. Currently, the volume and
large variability in the concentration of ozone treatment of
3.3.3. DFO. Distal femur osteotomy (DFO) is a recognized
KOA exist at the time of injection, so more trials are needed
treatment of femoral malformations and associated symp-
to determine the optimal dose of ozone. Hyaluronic acid
toms (including osteoarthritis). It is commonly used to treat
(HA) is still in the second-line treatment of NSAIDs in KOA
young and physically active patients who do not want a knee
patients, and the benefits are durable compared to IA [59].
replacement. After DFO, 80% of patients could exercise
Platelet-rich plasma (PRP) is a safe treatment that benefits
normally and 90% returned to normal work [71]. Shivji et al.
patients at least in the short term (up to 12 months) and is
[72] retrospectively studied 83 patients with good DFO,
more effective than HA [60]. Transplanted MSC can dif-
results with an average follow-up of 99 months, meaning
ferentiate directly into chondrocytes and promote cartilage
survival of 113 months (95% CI 106–120), and 89% likeli-
regeneration, also secreting a range of growth factors and
hood of survival of 10 years.
cytokines, where (platelet-derived growth factor) PDGF is
the most efficient growth factor and may contribute to tissue
integration during cartilage repair or tissue engineering 3.3.4. Knee Joint Replacement
[61, 62]. Early transplantation may yield better results in
long-term follow-up [63]. Mesenchymal stem cell therapy (1) Univentricular Knee Arthroplasty. Univentricular knee
may be widely used in the future, as it may confer substantial arthroplasty is an operation to protect the bones and preserve
benefit to patients with KOA. ligaments. It has become a lasting and effective method for the
treatment of end-stage single compartment KOA. It can ef-
fectively reduce postoperative pain and reduce the incidence
3.2. Knee Arthroscopy. Knee clearing achieved good results of postoperative complications [73]. Opioid demand was also
in early and middle KOA, and a randomized controlled trial reduced when compared to total knee replacement (TKA)
indicated that knee arthroscopic loose lobectomy was more [74]. Batailler et al. [75] through studies of robotic-assisted
effective than conservative treatment [64]; it can relieve the single-cell knee replacement (57 medial and 23 exception side
symptoms for up to 2 years without increasing the risk of surgeries) found that robotic total knee replacement (TKA)
joint replacement [65]. In addition, inlay plasty is the re- has improved the accuracy of implant positioning and re-
placement of lost cartilage with an autograft harvested from duced outliers in achieving planned limb alignment [76].
nonload-bearing areas of articular cartilage [66]. Micro-
fracture (MF) prompts the recruitment of pluripotent bone (2) TKA. Total knee arthroplasty (TKA) is a new technology
marrow-derived stromal cells to cartilage defects [67]. ACI is for the treatment of knee diseases. The annual incidence of
an in vitro expansion of autologous chondrocytes harvested KOA is estimated at 240 per 100,000 patients. About 400,000
from nonload-bearing regions of articular cartilage, then initial total knee replacements are done each year in the US.
injected into the defect, and covered with a biodegradable Patient-reported pain and functional outcome scores were
collagen membrane [68]. significantly improved after successful TKA surgery. Al-
though the overall lifespan of the TKA prosthesis is affected
3.3. Osteotomy around the Knee by numerous patients and prosthetic technology-related
factors, in all, the average service life is 15–20 years. Cli-
3.3.1. HTO. The biomechanical goal of high tibia osteotomy nicians are encouraged to ensure that after all nonsurgical
(HTO) is to readjust the load-bearing line within the coronal treatments are exhausted, excellent treatment results can be
plane. The aim was to achieve the transfer of load-bearing expected in population [77].4 Journal of Healthcare Engineering
4. Conclusion Acknowledgments
In conclusion, patients with KOA should first choose The authors thank Mr. Xingguang Ren for his technical
nonsurgical treatment. If this method fails, the surgical assistance in study and contribution to amending the lan-
treatment can be selected according to the patient’s actual guage of the manuscripts. This work was financially sup-
situation. KOA should not use arthroscopic lavage and ported by the National Natural Science Foundation of China
debridement as routine treatment as only some patients may (81372297 and 81702660).
benefit. Neither method could alter disease progression. ACI
or MACI can be used for focal cartilage defect. Osteotomy is References
recommended for young active KOA patients who are not
suitable for joint replacement. Total knee arthroplasty is a [1] P. Creamer, M. Lethbridge-Cejku, and M. C. Hochberg,
safe, economical, and effective method for the treatment of “Where does it hurt? Pain localization in osteoarthritis of the
knee,” Osteoarthritis and Cartilage, vol. 6, no. 5, pp. 318–323,
severe knee osteoarthritis. However, relative risks and
1998.
benefits should be fully considered in treatment. Single [2] L. Huang, H. Hu, and Y. Liang, “Review of knee function
compartment knee arthroplasty, HTO, PFO, or DFO can be scale,” Chinese medical science, vol. 6, no. 13, pp. 50–53, 2016.
considered for unilateral severe knee osteoarthritis after [3] X. Zhan, R. G. Zheng, and M. Zhao, “Prevalence of knee
considering age, gender, and basic diseases. In conclusion, osteoarthritis in middle-aged and elderly Chinese: a meta-
the treatment of KOA should follow the principle of indi- analysis,” Chinese Journal of Tissue Engineering Research,
vidualization and step-by-step treatment according to the vol. 22, no. 04, pp. 650–656, 2018.
actual situation of patients, so as to maximize the benefits of [4] W. F. Deng, X. Y. Hu, and R. Sun, “Investigation and analysis
patients. of influencing factors on quality of life of elderly patients with
knee osteoarthritis in Jingzhou city,” Chongqing Medicine,
vol. 45, no. 33, pp. 4711–4714, 2016.
Abbreviations [5] J. Ma and J. Gong, “Investigation and analysis of quality of life
KOA: Knee osteoarthritis status and influencing factors of patients with knee osteo-
arthritis in a city,” Journal of Preventive Medicine of Chinese
NGF: Neural growth factor
People’s Liberation Army, vol. 35, no. 10, pp. 1282–1285, 2017.
HIF: Hypoxia-inducible factor [6] B. M. Tang, X. Y. Zheng, and W. X. Zhang, “Quality of life
LOX-O: Oral loxoprofen sodium status and influencing factors of patients with knee osteo-
LOX-T: Loxoprofen sodium hydrogel transdermal patch arthritis in Zunyi area,” Modern Preventive Medicine, vol. 43,
NSAIDS: Nonsteroidal anti-inflammatory drugs no. 03, pp. 506–509, 2016.
ESCEO: Economic areas of osteoarthritis [7] C. S. Zhao, Q. J. Zhong, and J. H. Lin, “Epidemiological
GS: Glucosamine sulfate investigation of knee osteoarthritis in China,” Guangdong
CS: Chondroitin sulfate medicine, vol. 37, no. 13, pp. 2050–2052, 2016.
OA: Knee osteoarthritis [8] J. S. Lewis Jr, B. D. Furman, E. Zeitler et al., “Genetic and
ASU: Avocado soybean unsaponifiable cellular evidence of decreased inflammation associated with
IACI: Intraarticular injection of corticosteroids reduced incidence of posttraumatic arthritis in MRL/MpJ
mice,” Arthritis & Rheumatism, vol. 65, no. 3, pp. 660–670,
HA: Hyaluronic acid
2013.
PRP: Platelet-rich plasma [9] C. Zhao, H. Li, and Z. F. Hu, “Dali, Y risk factors of knee
PDGF: Platelet-derived growth factor osteoarthritis in dali, yunnan,” Journal of Dali University,
MF: Microfracture vol. 4, no. 04, pp. 75–78, 2019.
HTO: High tibia osteotomy [10] Y. Ren, J. Hu, J. Tan et al., “Incidence and risk factors of
PFO: Proximal fibular osteotomy symptomatic knee osteoarthritis among the Chinese pop-
DFO: Distal femur osteotomy ulation: analysis from a nationwide longitudinal study,” BMC
TKA: Total knee replacement. Public Health, vol. 20, no. 1, p. 1491, 2020.
[11] F. W. Roemer, A. Guermazi, D. T. Felson et al., “Presence of
Data Availability MRI-detected joint effusion and synovitis increases the risk of
cartilage loss in knees without osteoarthritis at 30 month
The data used to support the findings of this study are follow-up: the MOST study,” Annals of the Rheumatic Dis-
available from the corresponding author upon request. eases, vol. 70, no. 10, pp. 1804–1809, 2011.
[12] A. Haseeb and T. M. Haqqi, “Immunopathogenesis of oste-
oarthritis,” Clinical Immunology, vol. 146, no. 3, pp. 185–196,
Conflicts of Interest 2013.
[13] E. Aref-Eshghi, M. Liu, P. E. Harper et al., “Overexpression of
The authors declare that they have no conflicts of interest. MMP13 in human osteoarthritic cartilage is associated with
the SMAD-independent TGF-β signalling pathway,” Arthritis
Authors’ Contributions Research and Therapy, vol. 17, no. 1, p. 264, 2015.
[14] S. Nasi, H.-K. Ea, V. Chobaz et al., “Dispensable role of
Baoan Ma conceived and designed the study. HW analyzed myeloid differentiation primary response gene 88 (MyD88)
the data and prepared the manuscript. Baoan Ma provided and MyD88-dependent toll-like receptors (TLRs) in a murine
financial support. All authors read and approved the final model of osteoarthritis,” Joint Bone Spine, vol. 81, no. 4,
manuscript. pp. 320–324, 2014.Journal of Healthcare Engineering 5
[15] W. Liu, M. Feng, C. T. Jayasuriya et al., “Human osteoarthritis [31] Q. Xu, B. Chen, Y. Wang et al., “The effectiveness of manual
cartilage-derived stromal cells activate joint degeneration therapy for relieving pain, stiffness, and dysfunction in knee
through TGF-beta lateral signaling,” The FASEB Journal, osteoarthritis: a systematic review and meta-analysis,” Pain
vol. 34, no. 12, pp. 16552–16566, 2020. Physician, vol. 20, no. 4, pp. 229–243, 2017.
[16] J. M. Gow, W. H. Tsuji, G. J. Williams et al., “Safety, toler- [32] R. Forestier, F. B. Erol Forestier, and A. Francon, “Spa therapy
ability, pharmacokinetics, and efficacy of AMG 403, a human and knee osteoarthritis: a systematic review,” Annals of
anti-nerve growth factor monoclonal antibody, in two phase I Physical and Rehabilitation Medicine, vol. 59, no. 3,
studies with healthy volunteers and knee osteoarthritis sub- pp. 216–226, 2016.
jects,” Arthritis Research and Therapy, vol. 17, no. 1, p. 282, [33] J. Q. Li, W. Guo, Z. G. Sun et al., “Cupping therapy for treating
2015. knee osteoarthritis: the evidence from systematic review and
[17] Y. J. Li and Y. Zhang, “To observe the nursing effect of health meta-analysis,” Complementary Therapies in Clinical Practice,
education nursing on knee osteoarthritis,” Journal of Clinic vol. 28, pp. 152–160, 2017.
Nursing’s Practicality.vol. 5, no. 23, p. 181, 2020. [34] Y. Wang, S. Lu, R. Wang et al., “Integrative effect of yoga
[18] W. H. Wu, C. Q. Hu, R. F. Wang et al., “Effect of empowering practice in patients with knee arthritis,” Medicine, vol. 97,
health education on self-efficacy and quality of life of patients no. 31, Article ID e11742, 2018.
undergoing knee osteoarthritis surgery,” International Jour- [35] A. Nazari, A. Moezy, P. Nejati, and A. Mazaherinezhad,
nal of Nursing, no. 07, pp. 1211–1215, 2020. “Efficacy of high-intensity laser therapy in comparison with
[19] A. S. Crushed, A. B. Rushton, A. M. Kanavaki, and conventional physiotherapy and exercise therapy on pain and
C. A. Greig, “Effect of physical activity and dietary restriction function of patients with knee osteoarthritis: a randomized
interventions on weight loss and the musculoskeletal function controlled trial with 12-week follow up,” Lasers in Medical
of overweight and obese older adults with knee osteoarthritis: Science, vol. 34, no. 3, pp. 505–516, 2019.
a systematic review and mixed-method data synthesis,” BMJ [36] D. Zhao, Z. Chen, S. Hu et al., “Efficacy and safety of lox-
Open, vol. 7, no. 6, 2017. oprofen hydrogel transdermal patch versus loxoprofen tablet
[20] K. Kulkarni, T. Karssiens, V. Kumar, and H. Pandit, “Obesity in Chinese patients with myalgia: a double-blind, double-
and osteoarthritis,” Maturitas, vol. 89, pp. 22–28, 2016. dummy, parallel-group, randomized, controlled, non-inferi-
[21] B. Hacken, A. Rogers, V. Chinchilli, M. Silvis, T. Mosher, and ority trial,” Clinical Drug Investigation, vol. 39, no. 4,
K. Black, “Improvement in knee osteoarthritis pain and pp. 369–377, 2019.
function following bariatric surgery: 5 year follow-up,” Sur- [37] I. Coskun Benlidayi, N. Gokcen, and S. Basaran, “Compar-
gery for Obesity and Related Diseases, vol. 15, no. 6, ative short-term effectiveness of ibuprofen gel and cream
pp. 979–984, 2019. phonophoresis in patients with knee osteoarthritis,” Rheu-
[22] A. Basu, J. Schell, and R. H. Scofield, “Dietary fruits and matology International, vol. 38, no. 10, pp. 1927–1932, 2018.
arthritis,” Food & Function, vol. 9, no. 1, pp. 70–77, 2018. [38] L. T. Wadsworth, J. D. Kent, and R. J. Holt, “Efficacy and
[23] J. Nijs, E. Kosek, J. Van Oosterwijck, and M Meeus, “Dys- safety of diclofenac sodium 2% topical solution for osteoar-
functional endogenous analgesia during exercise in patients thritis of the knee: a randomized, double-blind, vehicle-
with chronic pain: to exercise or not to exercise?” Pain controlled, 4 week study,” Current Medical Research and
Physician, vol. 15, no. 3, pp. ES205–13, 2012. Opinion, vol. 32, no. 2, pp. 241–250, 2016.
[24] J. Zhang, X. L. Chen, C. F. Wang et al., “Effect of isokinetic [39] Y. Zhao, Z. B. Shen, and J. R. Ge, “Efficacy and safety of
muscle training combined with semiconductor laser on re- tonguing gel for knee osteoarthritis: a multicentre, ran-
habilitation of acute knee osteoarthritis,” International domized, double-blinded, parallel, placebo-controlled, clini-
Journal of Biomedical Engineering, no. 03, pp. 216–221, 2019. cal trial,” Evid Based Complement Alternat Med, vol. 2020,
[25] J. H. Guo, Y. Zhao, and Z. Q. Nie, “Effect of isokinetic muscle Article ID 8707256, 2020.
training on knee function in patients with early and middle [40] J. Boon Chong, P. Suntornpiyapan, and A. Piriyajarukul,
knee osteoarthritis,” Journal of Medical Information, vol. 32, “Ultrasound combined transcutaneous electrical nerve
no. 9, pp. 65–67, 2019. stimulation (UltraTENS) versus phonophoresis of piroxicam
[26] R. Dong, Y. Wu, S. Xu et al., “Is aquatic exercise more effective (PHP) in symptomatic knee osteoarthritis: a randomized
than land-based exercise for knee osteoarthritis?” Medicine, double-blind, controlled trial,” Journal of Back and Muscu-
vol. 97, no. 52, Article ID e13823, 2018. loskeletal Rehabilitation, vol. 31, no. 3, pp. 507–513, 2018.
[27] L. J. Kong, R. Lauche, P. Klose et al., “Tai chi for chronic pain [41] S. Teymouri, H. Rakhshandeh, H. N. Baghdar, M. Yousefi, and
conditions: a systematic review and meta-analysis of ran- R. Salari, “Analgesic herbal medicines in the treatment of knee
domized controlled trials,” Scientific Reports, vol. 6, no. 1, osteoarthritis: a systematic review,” Current Rheumatology
Article ID 25325, 2016. Reviews, vol. 15, no. 4, pp. 290–303, 2019.
[28] Y. Xu, K. Wu, Y. Liu et al., “The effect of extracorporeal shock [42] Y. J. Chou, J. J. Chuu, Y. J. Peng et al., “The potent anti-
wave therapy on the treatment of moderate to severe knee inflammatory effect of Guilu Erxian Glue extracts remedy
osteoarthritis and cartilage lesion,” Medicine, vol. 98, no. 20, joint pain and ameliorate the progression of osteoarthritis in
Article ID e15523, 2019. mice,” Journal of Orthopaedic Surgery and Research, vol. 13,
[29] L. L. Lin, J. F. Tu, J. K. Shao et al., “Acupuncture of different no. 1, 259 pages, 2018.
treatment frequency in knee osteoarthritis: a protocol for a [43] P. Decha, K. Kanokwan, T. Jiraporn, J. Pichaya, and
pilot randomized clinical trial,” Trials, vol. 20, no. 1, 423 pages, A. Pisittawoot, “Phonopheresis associated with nanoparticle
2019. gel from Phyllanthus amarus relieves pain by reducing oxi-
[30] L. Özgönenel, S. Ç Okur, Y. P. Dogan, and N. S. Çaglar, dative stress and proinflammatory markers in adults with
“Effectiveness of therapeutic ultrasound on clinical parame- knee osteoarthritis,” Chinese Journal of Integrative Medicine,
ters and ultrasonographic cartilage thickness in knee osteo- vol. 25, no. 9, pp. 691–695, 2019.
arthritis: a double-blind trial,” Journal of Medical Ultrasound, [44] A. Askari, S. A. Ravansalar, M. M. Naghizadeh et al., “The
vol. 26, no. 4, pp. 194–199, 2018. efficacy of topical sesame oil in patients with knee6 Journal of Healthcare Engineering
osteoarthritis: a randomized double-blinded active-controlled the treatment of knee osteoarthritis: a randomized, double-
non-inferiority clinical trial,” Complementary Therapies in blinded, placebo-controlled study,” PLoS One, vol. 12, no. 7,
Medicine, vol. 47, Article ID 102183, 2019. Article ID e0179185, 2017.
[45] O. Bruyère, R. D. Altman, and J. Y. Reginster, “Efficacy and [58] X. Feng and L. Beiping, “Therapeutic efficacy of ozone in-
safety of glucosamine sulfate in the management of osteo- jection into the knee for the osteoarthritis patient along with
arthritis: evidence from real-life setting trials and surveys,” oral celecoxib and glucosamine,” Journal of Clinical and
Seminars in Arthritis and Rheumatism, vol. 45, no. 4, Diagnostic Research: Journal of Clinical and Diagnostic Re-
pp. S12–S17, 2016. search, vol. 11, no. 9, pp. UC01–UC03, 2017.
[46] A. B. V. Lomonte, J. A. Mendonça, G. de Castro Brandão, and [59] E. Maheu, F. Rannou, and J. Y. Reginster, “Efficacy and safety
M. L. Castro, “Multicenter, randomized, double-blind clinical of hyaluronic acid in the management of osteoarthritis: evi-
trial to evaluate efficacy and safety of combined glucosamine dence from real-life setting trials and surveys,” Seminars in
sulfate and chondroitin sulfate capsules for treating knee Arthritis and Rheumatism, vol. 45, no. 4, pp. S28–S33, 2016.
osteoarthritis,” Advances in Rheumatology, vol. 58, no. 1, [60] K. L. Bennell, D. J. Hunter, and K. L. Paterson, “Platelet-rich
41 pages, 2018. plasma for the management of hip and knee osteoarthritis,”
[47] J. P. Lugo, Z. M. Saiyed, and N. E. Lane, “Efficacy and tol- Current Rheumatology Reports, vol. 19, no. 5, p. 24, 2017.
erability of an undenatured type II collagen supplement in [61] M. Emadedin, M. Ghorbani Liastani, R. Fazeli et al., “Long-
modulating knee osteoarthritis symptoms: a multicenter term follow-up of intra-articular injection of autologous
randomized, double-blind, placebo-controlled study,” Nu- mesenchymal stem cells in patients with knee, ankle, or hip
trition Journal, vol. 15, no. 1, 14 pages, 2016. osteoarthritis,” Archives of Iranian Medicine, vol. 18, no. 6,
[48] C. Cooper, R. Chapurlat, N. Al-Daghri et al., “Safety of oral pp. 336–344, 2015.
non-selective non-steroidal anti-inflammatory drugs in os- [62] M. Horie, I. Sekiya, T. Muneta et al., “Intra-articular injected
teoarthritis: what does the literature say?” Drugs & Aging, synovial stem cells differentiate into meniscal cells directly
vol. 36, no. Suppl 1, pp. 15–24, 2019. and promote meniscal regeneration without mobilization to
[49] K. Pavelka, O. Bruyère, C. Cooper et al., “Erratum to: diac- distant organs in rat massive meniscal defect,” Stem Cells,
erein: benefits, risks and place in the management of osteo- vol. 27, no. 4, pp. 878–887, 2009.
arthritis. An opinion-based report from the ESCEO,” Drugs & [63] F. Davatchi, B. Sadeghi Abdollahi, M. Mohyeddin, and
Aging, vol. 34, no. 5, p. 413, 2017. B. Nikbin, “Mesenchymal stem cell therapy for knee osteo-
[50] M. Simental-Mendı́a, A. Sánchez-Garcı́a, C. A. Acosta-Olivo
arthritis: 5 years follow-up of three patients,” International
et al., “Efficacy and safety of avocado-soybean unsaponifiable
Journal of Rheumatic Diseases, vol. 19, no. 3, pp. 219–225,
for the treatment of hip and knee osteoarthritis: a systematic
2016.
review and meta-analysis of randomized placebo-controlled
[64] B. Zhao, Y. Yu, W. Liu, and J. Du, “Efficacy of arthroscopic
trials,” Int J Rheum Dis, vol. 22, no. 9, pp. 1607–1615, 2019.
loose body removal for knee osteoarthritis,” Experimental and
[51] J. N. Lai, H. J. Chen, C. C. Chen, J. H. Lin, J. S. Hwang, and
Therapeutic Medicine, vol. 15, no. 2, pp. 1666–1671, 2018.
J. D. Wang, “Duhuo Jisheng Tang for treating osteoarthritis of
[65] X. Su, C. Li, W. Liao et al., “Comparison of arthroscopic and
the knee: a prospective clinical observation,” Chinese Medi-
conservative treatments for knee osteoarthritis: a 5 year
cine, vol. 2, no. 1, p. 4, 2007.
retrospective comparative study,” Arthroscopy: The Journal of
[52] L. Zhu, S. Yang, S. Wang, H. Gong, L. Li, and X. Wei, “Ef-
fectiveness and safety of manufactured Chinese herbal for- Arthroscopic & Related Surgery, vol. 34, no. 3, pp. 652–659,
mula for knee osteoarthritis: insights from a systematic 2018.
review,” Evidence-based Complementary and Alternative [66] L. Harangody, G. Kish, Z. Kárpáti, I. Udvarhelyi, I. Szigeti, and
Medicine : eCAM, vol. 2015, Article ID 328642, 2015. M. Bély, “Mosaicplasty for the treatment of articular cartilage
[53] M. Saltychev, R. Mattie, Z. McCormick, and K. Laimi, “The defects: application in clinical practice,” Orthopedics, vol. 21,
magnitude and duration of the effect of intra-articular cor- no. 7, pp. 751–756, 1998.
ticosteroid injections on pain severity in knee osteoarthritis,” [67] A. Gobbi, G. Karnatzikos, and A. Kumar, “Long-term results
American Journal of Physical Medicine & Rehabilitation, after microfracture treatment for full-thickness knee chondral
vol. 99, no. 7, pp. 617–625, 2020. lesions in athletes,” Knee Surgery, Sports Traumatology, Ar-
[54] L. M. Kershen, N. C. Nacey, J. T. Patrie, and M. G. Fox, throscopy, vol. 22, no. 9, pp. 1986–1996, 2014.
“Fluoroscopically guided facet injections: comparison of in- [68] H. S. McCarthy and S. Roberts, “A histological comparison of
tra-articular and periarticular steroid and anesthetic injection the repair tissue formed when using either Chondrogide or
on immediate and short-term pain relief,” American Journal periosteum during autologous chondrocyte implantation,”
of Neuroradiology, vol. 39, no. 11, pp. 2161–2165, 2018. Osteoarthritis and Cartilage, vol. 21, no. 12, pp. 2048–2057,
[55] P. G. Conaghan, S. B. Cohen, F. Berenbaum, J. Lufkin, 2013.
J. R. Johnson, and N. Bodick, “Brief report: a phase II b trial of [69] W. C. Pannell, K. S. Heidari, E. N. Mayer et al., “High tibial
a novel extended-release microsphere formulation of triam- osteotomy survivorship: a population-based study,” Ortho-
cinolone acetonide for intraarticular injection in knee oste- paedic journal of sports medicine, vol. 7, no. 12, Article ID
oarthritis,” Arthritis & Rheumatology, vol. 70, no. 2, 2325967119890693, 2019.
pp. 204–211, 2018. [70] D. Qin, W. Chen, J. Wang et al., “Mechanism and influencing
[56] R. Klocke, K. Levasseur, G. D. Kitas, J. P Smith, and G. Hirsch, factors of proximal fibular osteotomy for treatment of medial
“Cartilage turnover and intra-articular corticosteroid injec- compartment knee osteoarthritis: a prospective study,”
tions in knee osteoarthritis,” Rheumatology International, Journal of International Medical Research, vol. 46, no. 8,
vol. 38, pp. 455–459, 2018. pp. 3114–3123, 2018.
[57] C. C. Lopes de Jesus, F. C. Dos Santos, L. M. O. B. de Jesus, [71] A. Hoorntje, B. T. van Ginneken, P. P. F. M. Kuijer et al.,
I. Monteiro, M. S. S. C. Sant’Ana, and V. F. M. Trevisani, “Eight respectively nine out of ten patients return to sport and
“Comparison between intra-articular ozone and placebo in work after distal femoral osteotomy,” Knee Surgery, SportsJournal of Healthcare Engineering 7
Traumatology, Arthroscopy, vol. 27, no. 7, pp. 2345–2353,
2019.
[72] F. S. Shivji, A. Foster, M. J. Risebury, A. J. Wilson, and
S. K. Yasen, “The ten-year survival rate of 89% after distal
femoral osteotomy surgery for lateral compartment osteo-
arthritis of the knee,” Knee Surg Sports Traumatol Arthrosc,
vol. 29, no. 2, pp. 594–599, 2020.
[73] Z. Cao, X. Mai, J. Wang, E. Feng, and Y. Huang, “Uni-
compartmental knee arthroplasty vs high tibial osteotomy for
knee osteoarthritis: a systematic review and meta-analysis,”
The Journal of Arthroplasty, vol. 33, no. 3, pp. 952–959, 2018.
[74] H. Wang, Q. Ma, and B. Ma, “Unicompartmental versus total
knee arthroplasty for knee osteoarthritis: a systematic review
and meta-analysis of randomized controlled trial,” Interna-
tional Journal of Surgery: Globalization and Health, vol. 4,
no. 2, e51 pages, 2021.
[75] C. Batailler, N. White, F. M. Ranaldi, P. Neyret, E. Servien, and
S. Lustig, “Improved implant position and lower revision rate
with robotic-assisted unicompartmental knee arthroplasty,”
Knee Surgery, Sports Traumatology, Arthroscopy, vol. 27, no. 4,
pp. 1232–1240, 2019.
[76] B. Kayani, S. Konan, A. Ayuob, E. Onochie, T. Al-Jabri, and
F. S. Haddad, “Robotic technology in total knee arthroplasty: a
systematic review,” EFORT Open Reviews, vol. 4, no. 10,
pp. 611–617, 2019.
[77] F. B. Loures, W. Correia, J. H. Reis et al., “Outcomes after knee
arthroplasty in extra-articular deformity,” International Or-
thopaedics, vol. 43, no. 9, pp. 2065–2070, 2019.You can also read
