Knee
RCT: Methotrexate Shows Modest Pain Reduction in Knee Osteoarthritis, More Research Needed – Ann Intern Med
18 Aug, 2024 | 18:01h | UTCStudy Design and Population: This multicenter, randomized, double-blind, placebo-controlled trial evaluated the effects of oral methotrexate on 207 participants with symptomatic knee osteoarthritis (KOA) who had persistent knee pain despite prior treatments. Conducted across 15 musculoskeletal clinics in the UK from June 2014 to October 2017, participants were randomly assigned to receive either methotrexate or placebo over a 12-month period.
Main Findings: At 6 months, methotrexate resulted in a modest reduction in knee pain, with a statistically significant difference of 0.79 points on the NRS compared to placebo (95% CI, 0.08 to 1.51; P = 0.030). Small but statistically significant improvements were also noted in knee stiffness and function. However, the clinical significance of these findings remains uncertain, and potential side effects of methotrexate warrant caution.
Implications for Practice: While methotrexate may offer some symptomatic relief for patients with knee osteoarthritis who do not respond to standard treatments, the modest reduction in pain and improvement in function observed in this study may not justify its routine use given the potential for significant side effects. The small magnitude of benefit suggests that methotrexate should be considered cautiously and only in select patients. Further research is necessary to confirm these findings and to better understand the risk-benefit profile of methotrexate in this population before broader clinical adoption.
Podcast | Knee pain pearls
9 Aug, 2023 | 15:08h | UTC#406 Kneedful Things: Knee Pain 201 with Dr. Ted Parks – The Curbsiders
Exploratory Analysis of a RCT | Low-dose colchicine linked to reduced incidence of knee and hip replacements
7 Jun, 2023 | 13:50h | UTCAssociation of Low-Dose Colchicine With Incidence of Knee and Hip Replacements: Exploratory Analyses From a Randomized, Controlled, Double-Blind Trial – Annals of Internal Medicine (link to abstract – $ for full-text)
News Release: Low dose colchicine associated with lower incidence of total knee and hip replacements – American College of Physicians
RCT | No significant differences among three exercise strategies for knee osteoarthritis
23 May, 2023 | 12:38h | UTC
Cohort Study | Patients with joint hypermobility at greater risk of second ACL injury post-surgery within a year of return to sport
18 May, 2023 | 13:33h | UTCEvidence-based recommendations | Mid- to late-term follow-up of primary hip and knee arthroplasty
16 May, 2023 | 14:57h | UTC
Consensus Paper | Diagnosis and antimicrobial treatment for infections post-ACL reconstruction
16 May, 2023 | 14:46h | UTC
M-A | Medial–lateral versus lateral-only pinning fixation in children with displaced supracondylar humeral fractures
16 May, 2023 | 14:32h | UTC
M-A | Postoperative clinical outcomes for kinematically, restricted kinematically, or mechanically aligned total knee arthroplasty
15 May, 2023 | 13:04h | UTC
M-A | Surgical interventions for symptomatic knee osteoarthritis
12 May, 2023 | 13:26h | UTC
Plasma D-Dimer may be useful in the diagnosis of periprosthetic joint infection
29 Mar, 2023 | 12:33h | UTCPlasma D-Dimer Is Noninferior to Serum C-Reactive Protein in the Diagnosis of Periprosthetic Joint Infection – The Journal of Bone and Joint Surgery (link to abstract – $ for full-text)
News Release: D-dimer blood test shows value in detecting prosthetic joint infections – Wolters Kluwer
RCT | Short-term indwelling foley catheters do not reduce the risk of postoperative urinary retention in THA and TKA
22 Mar, 2023 | 13:14h | UTCShort-Term Indwelling Foley Catheters Do Not Reduce the Risk of Postoperative Urinary Retention in Uncomplicated Primary THA and TKA: A Randomized Controlled Trial – The Journal of Bone and Joint Surgery (link to abstract – $ for full-text)
Review | Evidence-based informed consent form for total knee arthroplasty
17 Mar, 2023 | 12:58h | UTC
RCT | Intra-articular 10 mg triamcinolone acetonide non-inferior to 40 mg for knee osteoarthritis pain relief
16 Mar, 2023 | 12:55h | UTC
M-A | Comparison of suture button and syndesmotic screw for ankle syndesmotic injuries
1 Mar, 2023 | 13:50h | UTC
SR | Surgical versus non‐surgical interventions for treating patellar dislocation
1 Mar, 2023 | 13:45h | UTCSurgical versus non‐surgical interventions for treating patellar dislocation – Cochrane Library
Guideline | Exercise-based knee and anterior cruciate ligament injury prevention
15 Feb, 2023 | 16:02h | UTC
Guideline for management of septic arthritis in native joints
10 Feb, 2023 | 14:00h | UTC
Guideline | Management of anterior cruciate ligament injuries
8 Feb, 2023 | 12:31h | UTCRelated:
M-A | Primary surgery vs. primary rehabilitation for treating anterior cruciate ligament injuries.
A Majority of Anterior Cruciate Ligament Injuries Can Be Prevented by Injury Prevention Programs: A Systematic Review of Randomized Controlled Trials and Cluster–Randomized Controlled Trials With Meta-analysis – American Journal of Sports Medicine (link to abstract – $ for full-text)
Guideline on rehabilitation after anterior cruciate ligament reconstruction
8 Feb, 2023 | 12:30h | UTCGuideline: Management of Anterior Cruciate Ligament Injuries Evidence-Based Clinical Practice Guideline
Commentary on Twitter
What are the components of #rehabilitation after #ACLR? Clinical practice #guideline based on 140 RCTs and agreement by 29 expert clinicians.
Open access ? https://t.co/cnLpV0rzgG#Recommendations ?? pic.twitter.com/Lyxuz5tVZE— Roula Kotsifaki (@RoulaKotsifaki) February 3, 2023
M-A | Comparative efficacy of exercise therapy and oral NSAIDs and paracetamol for knee or hip osteoarthritis
1 Feb, 2023 | 13:28h | UTC
Commentary on Twitter
Network meta-analysis of 152 RCTs (17431 pts) comparing efficacy of exercise therapy, NSAIDs, Tylenol for knee or hip osteoarthritis: Found all 3 equivalent at 4 wk, 8 wk and 24 wks. https://t.co/rKck2AacL4 pic.twitter.com/YEAMh9UxTs
— Dr. John Cush (@RheumNow) January 10, 2023
M-A | Continuous cryotherapy vs. traditional cryotherapy after total knee arthroplasty
1 Feb, 2023 | 13:07h | UTC
RCT | Effects of an Extended Knee Control program for injury prevention in adolescent and adult amateur football players
1 Feb, 2023 | 13:00h | UTC
Commentary on Twitter
? #OriginalResearch Extended Knee Control Programme in #Football ⚽ ? #InjuryPrevention #OpenAccess
Randomised trial comparing knee control vs. adductor strengthening vs. self-selected exercises in lower limb injury prevalence
READ NOW ➡️ https://t.co/7tgFjARiDk pic.twitter.com/i7uQ11rK9F
— British Journal of Sports Medicine (BJSM) (@BJSM_BMJ) November 8, 2022
M-A | Arthroscopic partial meniscectomy is not better than sham treatment in patients with degenerative meniscus tears
31 Jan, 2023 | 14:05h | UTCRelated:
M-A | Tourniquet application in primary total knee arthroplasty for osteoarthritis
31 Jan, 2023 | 13:41h | UTC