Study Results
Results pending
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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Recruitment Status
COMPLETED
Clinical Phase
NA
Total Enrollment
102 participants
Study Classification
INTERVENTIONAL
Study Start Date
2023-04-26
Study Completion Date
2024-11-02
Brief Summary
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Osteoarthritis is a pathology with high prevalence in the world and is increasing due to sedentary lifestyles. Recent researches that claim for conservative treatment have shown the utility of genicular nerve blocks for relief of chronic knee pain.
Likewise, the ultrasound-guided technique has been more popular among professionals in recent years due to its low cost and safety.
This pilot study tries to evaluate if the infiltration of local anesthetic could avoid the use of corticosteroids with the secondary effects that they entail, therefore, it is carried out with the intention of estimating the size of the effect and the use of the variable response for later carrying out a clinical trial.
For this, we propose the comparative analysis of three randomized groups of patients (n=90), where all of them will perform a quadriceps strengthening exercise at home. Moreover, we will assess the reduction of pain through the visual analog scale (VAS) after the genicular nerve block with ultrasound-guided infiltration. Group 1 (n=30) will be infiltrated with local anesthetic and steroid, group 2 (n=30) with local anesthetic and group 3 (n=30), as a control group, will receive physiological saline. We will also record demographic data, functionality and mood using validated scales.
Likewise, the ultrasound-guided technique has been more popular among professionals in recent years due to its low cost and safety.
This pilot study tries to evaluate if the infiltration of local anesthetic could avoid the use of corticosteroids with the secondary effects that they entail, therefore, it is carried out with the intention of estimating the size of the effect and the use of the variable response for later carrying out a clinical trial.
For this, we propose the comparative analysis of three randomized groups of patients (n=90), where all of them will perform a quadriceps strengthening exercise at home. Moreover, we will assess the reduction of pain through the visual analog scale (VAS) after the genicular nerve block with ultrasound-guided infiltration. Group 1 (n=30) will be infiltrated with local anesthetic and steroid, group 2 (n=30) with local anesthetic and group 3 (n=30), as a control group, will receive physiological saline. We will also record demographic data, functionality and mood using validated scales.
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Detailed Description
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Osteoarthritis affects approximately 302 million people worldwide, with the knee, hip, and hands being the most commonly affected areas. Knee osteoarthritis is highly prevalent and increasing in the region due to aging, obesity, and the progressive sedentary lifestyle of the population. According to recent epidemiological studies, it has a prevalence of 29.3% in the Spanish population.
Currently, multiple treatment options are available, ranging from conservative measures to surgical procedures. Within conservative treatment, various tools benefit patients and may even avoid the need for surgery. These non-surgical options include patient education, weight control, physical exercise, orthotics, oral analgesics, topical anti-inflammatories, and interventional procedures. However, there are no prior studies demonstrating the advantages of one over another, and many do not follow up beyond three months.
When conservative treatment is ineffective, surgical intervention is usually considered. Therapeutic options include knee arthroscopy, high tibial osteotomy, total knee replacement, and unicompartmental knee replacement in patients without lateral compartment disease.
Traditionally, rest and caution in exercise were recommended for knee osteoarthritis pain. However, this paradigm has been strongly rejected. One of the current first-line treatments for knee osteoarthritis is physical exercise, with quadriceps strengthening being the most indicated. Most patients seek recommendations on what type of exercise to perform, including the duration, intensity, and frequency for better adherence. No exercise has been shown to be superior to another, with the most studied being yoga and tai chi exercises.
Despite the well-documented benefits of exercise for this condition, one emerging procedure for pain management is the genicular nerve block. This treatment option can facilitate progress in the exercise program. It is also indicated for patients who have previously had successful genicular block, those who do not wish to undergo surgery, those not eligible for surgery, or even post-surgical patients for better pain control.
The term \"genicular nerves\" refers to a group of nerves responsible for the sensory innervation of the knee joint capsule and the internal and external ligaments. The superior and inferior medial genicular nerves are sensory branches of the tibial nerve, whereas the superior and inferior lateral genicular nerves are branches of the common peroneal nerve. These nerves are named after the arteries they accompany, which are located using ultrasound during the procedure.
Genicular nerve block is a simple technique that significantly reduces opioid consumption in patients undergoing total knee arthroplasty within the first 24 hours. It also provides temporary relief that allows progression in the rehabilitation program through a structured exercise regimen. This technique involves injecting medication into the genicular nerves, locating the genicular artery using Doppler ultrasound. Various cadaveric studies have investigated the anatomical distribution of the descending genicular artery and the nerves accompanying its branches.
Some authors suggest that up to 10 points may need to be blocked for complete coverage. However, this is not feasible in routine clinical practice. Most studies target three sensory nerves of the knee: the superior lateral genicular nerve, the superior medial genicular nerve, and the inferior medial genicular nerve. In most studies, 2 to 3 ml of local anesthetic is administered per point. It has been shown that 0.5 ml of injected fluid spreads within the tissue over an area of 6 cm², likely covering more nerve targets with 2 ml. Typically, the procedure involves infiltrating local anesthetic (lidocaine, bupivacaine, ropivacaine, levobupivacaine) and 20 mg of corticosteroid (triamcinolone).
In this study, bupivacaine is chosen as the local anesthetic, as it inhibits prostaglandin production by binding to the E2 receptor, providing an anti-inflammatory effect. It is a lipophilic amide-type anesthetic with 100% bioavailability and a longer duration than other local anesthetics. Additionally, it produces a more significant blockade of sensory and sympathetic nerve fibers than motor fibers, differentiating it from other local anesthetics.
Recent guidelines for the treatment of knee osteoarthritis highlight the recommendation of intra-articular corticosteroid injections. However, several studies mention that systemic and local corticosteroid effects can cause adverse effects such as skin atrophy, hypertension, insulin resistance, decreased bone mineralization, and septic arthritis, among others. Nonetheless, these effects have not demonstrated a direct relationship with pain, functionality, or radiological changes.
The clinical benefit of corticosteroid administration compared to local anesthesia alone remains unclear. Given the potential adverse effects, corticosteroids may not be suitable as adjuvants. Therefore, genicular nerve block using local anesthetic alone proves to be a promising technique, avoiding the use of corticosteroids and not being an intra-articular procedure.
A study is proposed at a tertiary hospital in the Community of Madrid (Hospital Universitario Fundación Alcorcón). Considering the absence of previous studies that evaluate and quantify the three described treatment options, this study aims to address this objective through a pilot experimental randomized controlled trial. All patients will receive guidelines for an exercise program, and the outcomes of adding genicular nerve block with and without corticosteroid will be assessed. This unprecedented study could identify the optimal treatment for this prevalent and debilitating condition in a significant portion of the population. Additionally, it will help optimize resource allocation for these patients by identifying the best therapeutic target, thus avoiding unnecessary resource consumption
Currently, multiple treatment options are available, ranging from conservative measures to surgical procedures. Within conservative treatment, various tools benefit patients and may even avoid the need for surgery. These non-surgical options include patient education, weight control, physical exercise, orthotics, oral analgesics, topical anti-inflammatories, and interventional procedures. However, there are no prior studies demonstrating the advantages of one over another, and many do not follow up beyond three months.
When conservative treatment is ineffective, surgical intervention is usually considered. Therapeutic options include knee arthroscopy, high tibial osteotomy, total knee replacement, and unicompartmental knee replacement in patients without lateral compartment disease.
Traditionally, rest and caution in exercise were recommended for knee osteoarthritis pain. However, this paradigm has been strongly rejected. One of the current first-line treatments for knee osteoarthritis is physical exercise, with quadriceps strengthening being the most indicated. Most patients seek recommendations on what type of exercise to perform, including the duration, intensity, and frequency for better adherence. No exercise has been shown to be superior to another, with the most studied being yoga and tai chi exercises.
Despite the well-documented benefits of exercise for this condition, one emerging procedure for pain management is the genicular nerve block. This treatment option can facilitate progress in the exercise program. It is also indicated for patients who have previously had successful genicular block, those who do not wish to undergo surgery, those not eligible for surgery, or even post-surgical patients for better pain control.
The term \"genicular nerves\" refers to a group of nerves responsible for the sensory innervation of the knee joint capsule and the internal and external ligaments. The superior and inferior medial genicular nerves are sensory branches of the tibial nerve, whereas the superior and inferior lateral genicular nerves are branches of the common peroneal nerve. These nerves are named after the arteries they accompany, which are located using ultrasound during the procedure.
Genicular nerve block is a simple technique that significantly reduces opioid consumption in patients undergoing total knee arthroplasty within the first 24 hours. It also provides temporary relief that allows progression in the rehabilitation program through a structured exercise regimen. This technique involves injecting medication into the genicular nerves, locating the genicular artery using Doppler ultrasound. Various cadaveric studies have investigated the anatomical distribution of the descending genicular artery and the nerves accompanying its branches.
Some authors suggest that up to 10 points may need to be blocked for complete coverage. However, this is not feasible in routine clinical practice. Most studies target three sensory nerves of the knee: the superior lateral genicular nerve, the superior medial genicular nerve, and the inferior medial genicular nerve. In most studies, 2 to 3 ml of local anesthetic is administered per point. It has been shown that 0.5 ml of injected fluid spreads within the tissue over an area of 6 cm², likely covering more nerve targets with 2 ml. Typically, the procedure involves infiltrating local anesthetic (lidocaine, bupivacaine, ropivacaine, levobupivacaine) and 20 mg of corticosteroid (triamcinolone).
In this study, bupivacaine is chosen as the local anesthetic, as it inhibits prostaglandin production by binding to the E2 receptor, providing an anti-inflammatory effect. It is a lipophilic amide-type anesthetic with 100% bioavailability and a longer duration than other local anesthetics. Additionally, it produces a more significant blockade of sensory and sympathetic nerve fibers than motor fibers, differentiating it from other local anesthetics.
Recent guidelines for the treatment of knee osteoarthritis highlight the recommendation of intra-articular corticosteroid injections. However, several studies mention that systemic and local corticosteroid effects can cause adverse effects such as skin atrophy, hypertension, insulin resistance, decreased bone mineralization, and septic arthritis, among others. Nonetheless, these effects have not demonstrated a direct relationship with pain, functionality, or radiological changes.
The clinical benefit of corticosteroid administration compared to local anesthesia alone remains unclear. Given the potential adverse effects, corticosteroids may not be suitable as adjuvants. Therefore, genicular nerve block using local anesthetic alone proves to be a promising technique, avoiding the use of corticosteroids and not being an intra-articular procedure.
A study is proposed at a tertiary hospital in the Community of Madrid (Hospital Universitario Fundación Alcorcón). Considering the absence of previous studies that evaluate and quantify the three described treatment options, this study aims to address this objective through a pilot experimental randomized controlled trial. All patients will receive guidelines for an exercise program, and the outcomes of adding genicular nerve block with and without corticosteroid will be assessed. This unprecedented study could identify the optimal treatment for this prevalent and debilitating condition in a significant portion of the population. Additionally, it will help optimize resource allocation for these patients by identifying the best therapeutic target, thus avoiding unnecessary resource consumption
Conditions
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Osteoarthritis, Knee/Rehabilitation
Study Design
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Allocation Method
RANDOMIZED
Intervention Model
PARALLEL
Study Design Type of Study: Pilot randomized controlled experimental clinical trial. Number of Groups: Three parallel treatment arms.
Intervention Groups:
Group 1: Block with 0.5% bupivacaine and corticosteroid (triamcinolone). Group 2: Block with 0.5% bupivacaine. Group 3 (Control): Block with saline solution. Randomization
Technique Description:
Patient Position: Supine with knee extended. Ultrasound-Guided Localization: Use of ultrasound with Doppler to locate genicular nerves and associated arteries.
Injection Points:
Superior medial and lateral genicular nerves: Femoral condyle and junction with the femoral shaft.
Inferior medial genicular nerve: Medial tibial-femoral joint line.
Injection Doses:
Group 1: 2.5 mL of 0.5% bupivacaine + 20 mg of triamcinolone. Group 2: 2.5 mL of 0.5% bupivacaine. Group 3: 2.5 mL of saline solution.
Intervention Groups:
Group 1: Block with 0.5% bupivacaine and corticosteroid (triamcinolone). Group 2: Block with 0.5% bupivacaine. Group 3 (Control): Block with saline solution. Randomization
Technique Description:
Patient Position: Supine with knee extended. Ultrasound-Guided Localization: Use of ultrasound with Doppler to locate genicular nerves and associated arteries.
Injection Points:
Superior medial and lateral genicular nerves: Femoral condyle and junction with the femoral shaft.
Inferior medial genicular nerve: Medial tibial-femoral joint line.
Injection Doses:
Group 1: 2.5 mL of 0.5% bupivacaine + 20 mg of triamcinolone. Group 2: 2.5 mL of 0.5% bupivacaine. Group 3: 2.5 mL of saline solution.
Primary Study Purpose
TREATMENT
Blinding Strategy
DOUBLE
Participants
Investigators
Concealed Random Assignment: Participants will be assigned to one of three treatment groups using a computer-generated sequence. Opaque, sequentially numbered envelopes with treatment assignments will be opened after patient inclusion.
Blinding of Participants: Participants will not know the specific injection content (bupivacaine with or without corticosteroids, or saline). They will only know they are receiving one of the study interventions.
Blinding of Investigators: Investigators for initial evaluation and follow-up will not administer treatments. Independent personnel will prepare and administer treatments without evaluating outcomes.
Blind Evaluations: Pain and functionality (VAS, KOOS, WOMAC, KUJALA) will be assessed by blinded investigators. Follow-up consultations will be handled by personnel unaware of treatment details.
Documentation and Verification: Secure treatment assignment records will be accessible only to the data and safety monitoring committee.
Blinding of Participants: Participants will not know the specific injection content (bupivacaine with or without corticosteroids, or saline). They will only know they are receiving one of the study interventions.
Blinding of Investigators: Investigators for initial evaluation and follow-up will not administer treatments. Independent personnel will prepare and administer treatments without evaluating outcomes.
Blind Evaluations: Pain and functionality (VAS, KOOS, WOMAC, KUJALA) will be assessed by blinded investigators. Follow-up consultations will be handled by personnel unaware of treatment details.
Documentation and Verification: Secure treatment assignment records will be accessible only to the data and safety monitoring committee.
Study Groups
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Group 1: Block with 0.5% bupivacaine and corticosteroid (triamcinolone).
Injection Doses: 2.5 mL of 0.5% bupivacaine + 20 mg of triamcinolone.
Group Type
ACTIVE_COMPARATOR
Genicular nerve block with bupivacaine and corticosteroids
Intervention Type
DRUG
\- GROUP 1:Genicular Nerve Block with Bupivacaine and Corticosteroids: 2.5 mL at three genicular nerve points.
All injections are ultrasound-guided and administered once. The primary outcome is pain reduction, measured using NRS, KOOS, WOMAC, and KUJALA scales at 4, 12, and 24 weeks post-injection. Follow-up includes phone and in-person consultations to monitor pain, functionality, and adverse effects.
Group 2: Block with 0.5% bupivacaine.
Injection Doses: 2.5 mL of 0.5% bupivacaine.
Group Type
ACTIVE_COMPARATOR
Genicular nerve block with bupivacaine
Intervention Type
DRUG
\- GROUP 2: Genicular Nerve Block with Bupivacaine: 2.5 mL at three genicular nerve points.
All injections are ultrasound-guided and administered once. The primary outcome is pain reduction, measured using NRS, KOOS, WOMAC, and KUJALA scales at 4, 12, and 24 weeks post-injection. Follow-up includes phone and in-person consultations to monitor pain, functionality, and adverse effects.
Group 3 (Control): Block with saline solution.
Injection Doses: 2.5 mL of saline solution.
Group Type
PLACEBO_COMPARATOR
Genicular nerve block with saline
Intervention Type
DRUG
\- GROUP 3: Genicular Nerve Block with Saline: 2.5 mL at three genicular nerve points.
All injections are ultrasound-guided and administered once. The primary outcome is pain reduction, measured using NRS, KOOS, WOMAC, and KUJALA scales at 4, 12, and 24 weeks post-injection. Follow-up includes phone and in-person consultations to monitor pain, functionality, and adverse effects.
Interventions
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Genicular nerve block with bupivacaine and corticosteroids
\- GROUP 1:Genicular Nerve Block with Bupivacaine and Corticosteroids: 2.5 mL at three genicular nerve points.
All injections are ultrasound-guided and administered once. The primary outcome is pain reduction, measured using NRS, KOOS, WOMAC, and KUJALA scales at 4, 12, and 24 weeks post-injection. Follow-up includes phone and in-person consultations to monitor pain, functionality, and adverse effects.
Intervention Type
DRUG
Genicular nerve block with bupivacaine
\- GROUP 2: Genicular Nerve Block with Bupivacaine: 2.5 mL at three genicular nerve points.
All injections are ultrasound-guided and administered once. The primary outcome is pain reduction, measured using NRS, KOOS, WOMAC, and KUJALA scales at 4, 12, and 24 weeks post-injection. Follow-up includes phone and in-person consultations to monitor pain, functionality, and adverse effects.
Intervention Type
DRUG
Genicular nerve block with saline
\- GROUP 3: Genicular Nerve Block with Saline: 2.5 mL at three genicular nerve points.
All injections are ultrasound-guided and administered once. The primary outcome is pain reduction, measured using NRS, KOOS, WOMAC, and KUJALA scales at 4, 12, and 24 weeks post-injection. Follow-up includes phone and in-person consultations to monitor pain, functionality, and adverse effects.
Intervention Type
DRUG
Eligibility Criteria
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Inclusion Criteria
* Age over 18 years
* Anterior knee pain of patellofemoral origin and/or femorotibial compartment osteoarthritis with no previous response to pharmacological treatment (oral and/or topical)
* Pain duration of 3 months
* Pain assessment scale (Numerical Rating Scale) ≥ 5
* Radiological study with Kellgren-Lawrence classification \> 2
* Anterior knee pain of patellofemoral origin and/or femorotibial compartment osteoarthritis with no previous response to pharmacological treatment (oral and/or topical)
* Pain duration of 3 months
* Pain assessment scale (Numerical Rating Scale) ≥ 5
* Radiological study with Kellgren-Lawrence classification \> 2
Exclusion Criteria
* Allergy to the active ingredients and excipients of: bupivacaine, triamcinolone, or saline solution
* Patients who have undergone total or unicompartmental knee replacement surgery
* Viscosupplementation or intra-articular corticosteroid injection within the last 3 months
* Pregnant women or those suspected of being pregnant
* Cognitive impairment or additional neuropsychiatric symptoms
* Failure to sign informed consent or revocation of it
* Patients with heart disease requiring blockade with levobupivacaine
* Inability to write, speak, or read in Spanish
* Active tumoral or infectious pathology
* Osteoarthritis secondary to inflammatory pathology
* Patients who have undergone total or unicompartmental knee replacement surgery
* Viscosupplementation or intra-articular corticosteroid injection within the last 3 months
* Pregnant women or those suspected of being pregnant
* Cognitive impairment or additional neuropsychiatric symptoms
* Failure to sign informed consent or revocation of it
* Patients with heart disease requiring blockade with levobupivacaine
* Inability to write, speak, or read in Spanish
* Active tumoral or infectious pathology
* Osteoarthritis secondary to inflammatory pathology
Minimum Eligible Age
18 Years
Eligible Sex
ALL
Accepts Healthy Volunteers
No
Sponsors
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Hospital Universitario Fundación Alcorcón
OTHER
Sponsor Role
lead
Responsible Party
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Claudia de la Fuente Escudero
Consultant Specialist in Physical Medicine and Rehabilitation
Responsibility Role
PRINCIPAL_INVESTIGATOR
Locations
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Hospital Universitario Fundación Alcorcón
Alcorcón, Madrid, Spain
Site Status
Countries
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Spain
References
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Luan L, El-Ansary D, Adams R, Wu S, Han J. Knee osteoarthritis pain and stretching exercises: a systematic review and meta-analysis. Physiotherapy. 2022 Mar;114:16-29. doi: 10.1016/j.physio.2021.10.001. Epub 2021 Oct 11.
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Messier SP, Mihalko SL, Beavers DP, Nicklas BJ, DeVita P, Carr JJ, Hunter DJ, Lyles M, Guermazi A, Bennell KL, Loeser RF. Effect of High-Intensity Strength Training on Knee Pain and Knee Joint Compressive Forces Among Adults With Knee Osteoarthritis: The START Randomized Clinical Trial. JAMA. 2021 Feb 16;325(7):646-657. doi: 10.1001/jama.2021.0411.
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Mo L, Jiang B, Mei T, Zhou D. Exercise Therapy for Knee Osteoarthritis: A Systematic Review and Network Meta-analysis. Orthop J Sports Med. 2023 Jun 5;11(5):23259671231172773. doi: 10.1177/23259671231172773. eCollection 2023 May.
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Patterson BE, Girdwood MA, West TJ, Bruder AM, Oiestad BE, Juhl C, Culvenor AG. Muscle strength and osteoarthritis of the knee: a systematic review and meta-analysis of longitudinal studies. Skeletal Radiol. 2023 Nov;52(11):2085-2097. doi: 10.1007/s00256-022-04266-4. Epub 2022 Dec 23.
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Puts S, Liberman K, Leysen L, Forti L, Muyldermans E, Vaes P, Nijs J, Beckwee D, Bautmans I. Exercise-induced effects on inflammatory markers and brain-derived neurotrophic factor in patients with knee osteoarthritis. A systematic review with meta-analysis. Exerc Immunol Rev. 2023;29:22-53.
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BACKGROUND
Raposo F, Ramos M, Lucia Cruz A. Effects of exercise on knee osteoarthritis: A systematic review. Musculoskeletal Care. 2021 Dec;19(4):399-435. doi: 10.1002/msc.1538. Epub 2021 Mar 5.
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Reichenbach S, Juni P, Hincapie CA, Schneider C, Meli DN, Schurch R, Streit S, Lucas C, Mebes C, Rutjes AWS, da Costa BR. Effect of transcutaneous electrical nerve stimulation (TENS) on knee pain and physical function in patients with symptomatic knee osteoarthritis: the ETRELKA randomized clinical trial. Osteoarthritis Cartilage. 2022 Mar;30(3):426-435. doi: 10.1016/j.joca.2021.10.015. Epub 2021 Nov 23.
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Rezasoltani Z, Azizi S, Najafi S, Sanati E, Dadarkhah A, Abdorrazaghi F. Physical therapy, intra-articular dextrose prolotherapy, botulinum neurotoxin, and hyaluronic acid for knee osteoarthritis: randomized clinical trial. Int J Rehabil Res. 2020 Sep;43(3):219-227. doi: 10.1097/MRR.0000000000000411.
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BACKGROUND
Rocha TC, Ramos PDS, Dias AG, Martins EA. The Effects of Physical Exercise on Pain Management in Patients with Knee Osteoarthritis: A Systematic Review with Metanalysis. Rev Bras Ortop (Sao Paulo). 2020 Oct;55(5):509-517. doi: 10.1055/s-0039-1696681. Epub 2019 Sep 23.
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Santos ACG, Caiado VDS, Moreira-Marconi E, Teixeira-Silva Y, De Meirelles AG, Seixas A, Lacerda ACR, Sonza A, Mendonca VA, Bernardo-Filho M, De Sa-Caputo DDC. The Influence of Physical Exercises on the Flexibility of Older Individuals with Knee Osteoarthritis: A Systematic Review. Iran J Public Health. 2024 Feb;53(2):255-267. doi: 10.18502/ijph.v53i2.14911.
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Si J, Sun L, Li Z, Zhu W, Yin W, Peng L. Effectiveness of home-based exercise interventions on pain, physical function and quality of life in individuals with knee osteoarthritis: a systematic review and meta-analysis. J Orthop Surg Res. 2023 Jul 17;18(1):503. doi: 10.1186/s13018-023-04004-z.
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Sinatti P, Sanchez Romero EA, Martinez-Pozas O, Villafane JH. Effects of Patient Education on Pain and Function and Its Impact on Conservative Treatment in Elderly Patients with Pain Related to Hip and Knee Osteoarthritis: A Systematic Review. Int J Environ Res Public Health. 2022 May 19;19(10):6194. doi: 10.3390/ijerph19106194.
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Smith KM, Massey BJ, Young JL, Rhon DI. What are the unsupervised exercise adherence rates in clinical trials for knee osteoarthritis? A systematic review. Braz J Phys Ther. 2023 Jul-Aug;27(4):100533. doi: 10.1016/j.bjpt.2023.100533. Epub 2023 Aug 12.
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Weng Q, Goh SL, Wu J, Persson MSM, Wei J, Sarmanova A, Li X, Hall M, Doherty M, Jiang T, Zeng C, Lei G, Zhang W. Comparative efficacy of exercise therapy and oral non-steroidal anti-inflammatory drugs and paracetamol for knee or hip osteoarthritis: a network meta-analysis of randomised controlled trials. Br J Sports Med. 2023 Aug;57(15):990-996. doi: 10.1136/bjsports-2022-105898. Epub 2023 Jan 2.
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Wolf DF, Carvalho C, Moreira Padovez RFC, Braz de Oliveira MP, Mendes da Silva Serrao PR. Effects of physical exercise on muscle function of the knee, pain and quality of life in postmenopausal women with knee osteoarthritis: A systematic review with meta-analysis. Musculoskelet Sci Pract. 2024 Jun;71:102929. doi: 10.1016/j.msksp.2024.102929. Epub 2024 Mar 11.
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Zhang ZY, Huang L, Tian L, Yi J, Gao M, Wang XQ, Jiang JJ, Liu ZL. Home-based vs center-based exercise on patient-reported and performance-based outcomes for knee osteoarthritis: a systematic review with meta-analysis. Front Public Health. 2024 Mar 14;12:1360824. doi: 10.3389/fpubh.2024.1360824. eCollection 2024.
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Zhu GC, Chen KM, Belcastro F. Comparing Different Stretching Exercises on Pain, Stiffness, and Physical Function Disability in Older Adults With Knee Osteoarthritis. Arch Phys Med Rehabil. 2024 May;105(5):953-962. doi: 10.1016/j.apmr.2023.07.001. Epub 2023 Jul 17.
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Torstensen TA, Osteras H, LoMartire R, Rugelbak GM, Grooten WJA, Ang BO. High- Versus Low-Dose Exercise Therapy for Knee Osteoarthritis : A Randomized Controlled Multicenter Trial. Ann Intern Med. 2023 Feb;176(2):154-165. doi: 10.7326/M22-2348. Epub 2023 Jan 24.
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Other Identifiers
Review additional registry numbers or institutional identifiers associated with this trial.
2022-003885-19
Identifier Type: EUDRACT_NUMBER
Identifier Source: secondary_id
22/149
Identifier Type: -
Identifier Source: org_study_id
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