exudates and Osteoarthritis--Knee

Psychosocial interventions for patients with osteoarthritis (OA) of the knee to reduce pain and improve physical and psychological functioning are still lacking in Malaysia.. A parallel-group unblinded randomized controlled trial involving 300 patients was conducted in two hospital orthopedics clinics in Malaysia. Patients were randomly assigned to receive cognitive behavioral-based group therapy (. At 6 months, mean change from baseline in the KOOS knee pain score was 0.6 points (95% CI -1.73 to 2.94) in the control group and 8.9 points (95% CI 6.62 to 11.23) (denoting less knee pain intensity) in the intervention group (significant treatment effect. The intervention module delivered by healthcare professionals had a sustained effect on knee OA pain and functionality over 6 months, thereby leading to an overall improvement in psychological well-being, thus benefitting most of the Malaysian knee OA patients.

Topics: Activities of Daily Living; Adult; Aged; Cognition; Cognitive Behavioral Therapy; Female; Humans; Malaysia; Male; Middle Aged; Osteoarthritis, Knee; Pain; Pain Management; Pain Measurement; Psychotherapy, Group; Treatment Outcome

Osteoarthritis (OA) exacerbates skeletal muscle functioning, leading to postural instability and increased falls risk. However, the link between impaired physical function, OA and falls have not been elucidated. We investigated the role of impaired physical function as a potential mediator in the association between OA and falls. This study included 389 participants [229 fallers (≥2 falls or one injurious fall in the past 12 months), 160 non-fallers (no history of falls)], age (≥65 years) from a randomized controlled trial, the Malaysian Falls Assessment and Intervention Trial (MyFAIT). Physical function was assessed using Timed Up and Go (TUG) and Functional Reach (FR) tests. Knee and hip OA were diagnosed using three methods: Clinical, Radiological and Self-report. OA symptom severity was assessed using the Western Ontario and McMaster Universities Arthritis Index (WOMAC). The total WOMAC score was categorized to asymptomatic, mild, moderate and severe symptoms. Individuals with radiological OA and 'mild' overall symptoms on the WOMAC score had reduced risk of falls compared to asymptomatic OA [OR: 0.402(0.172-0.940), p = 0.042]. Individuals with clinical OA and 'severe' overall symptoms had increased risk of falls compared to those with 'mild' OA [OR: 4.487(1.883-10.693), p = 0.005]. In individuals with radiological OA, mild symptoms appear protective of falls while those with clinical OA and severe symptoms have increased falls risk compared to those with mild symptoms. Both relationships between OA and falls were not mediated by physical limitations. Larger prospective studies are needed for further evaluation.

Topics: Accidental Falls; Activities of Daily Living; Aged; Case-Control Studies; Cross-Sectional Studies; Female; Follow-Up Studies; Humans; Knee Joint; Malaysia; Male; Osteoarthritis, Knee; Prognosis; Radiography; Risk Factors; Severity of Illness Index

Knee osteoarthritis (KOA) is closely related with ageing, physical disability and functional dependency. The course of KOA is considered progressive and irreversible. Engagement with self-management may, however, minimize the impact of KOA. To be fully engaged with self-management activities, knowledge about KOA is a prerequisite. There is limited empirical data on older adults' understanding on KOA and their information needs about KOA. Therefore, the aims of this study were to explore older adults' knowledge about KOA and their perspectives on the information required to enable self-management. Three focus groups were conducted with 16 older adults with KOA. The sample consisted of three men and thirteen women with the mean age 73.2 years (range from 61 to 89). Thematic content analysis revealed two themes which were understanding about KOA and information needed about KOA. Participants' knowledge about KOA varied between individuals with many expressing that they needed more information about KOA. A targeted strategy is needed to educate older adults about KOA in order to support and prepare them for self-management.

Topics: Aged; Aged, 80 and over; Female; Health Knowledge, Attitudes, Practice; Humans; Malaysia; Male; Middle Aged; Osteoarthritis, Knee; Patient Education as Topic; Qualitative Research; Self-Management

Topics: Age Factors; Aged; Arthroplasty, Replacement, Knee; Asian People; Body Mass Index; China; Female; Humans; India; Malaysia; Male; Middle Aged; Osteoarthritis, Knee; Range of Motion, Articular; Singapore; Treatment Outcome; White People

To adapt and validate the Malay version of Osteoarthritis Knee and Hip Quality of Life (OAKHQOL) questionnaire.. The OAKHQOL was adapted into Malay version using forward-backward translation methodology. It was then validated in a cross-sectional study of 191 patients with knee osteoarthritis (OA). Patients completed the OAKHQOL and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire. Confirmatory analysis, reliability analysis, and Pearson correlation test were performed.. The new five-factor model of 28 items demonstrated an acceptable level of goodness of fit (comparative fit index = 0.915, Tucker-Lewis index = 0.905, incremental fit index = 0.916, chi-squared/degree of freedom = 1.953, and root mean square error of approximation = 0.071), signifying a fit model. The Cronbach's alpha value and the composite reliability of each construct ranged from 0.865 to 0.933 and 0.819 to 0.921, respectively. The Pearson correlation coefficient between the OAKHQOL and the WOMAC showed adequate criterion validity. Known groups validity showed statistical difference in body mass index in physical activity, mental health, and pain construct. The pain domain was statistically different between the age groups.. The Malay version OAKHQOL questionnaire is a valid and reliable instrument to assess health-related quality of life in knee OA patients.

Topics: Aged; Cross-Sectional Studies; Female; Humans; Malaysia; Male; Middle Aged; Osteoarthritis, Knee; Pain Measurement; Psychometrics; Quality of Life; Reproducibility of Results; Severity of Illness Index; Surveys and Questionnaires

The aim of this study was to investigate the correlations between serum cartilage oligomeric matrix protein (COMP), interleukin-16 (IL-16) and different grades of knee osteoarthritis (KOA) in Malaysian subjects.. Ninety subjects were recruited comprising 30 with Kellgren-Lawrence (K-L) grade 2 KOA, 27 with K-L grade 3 KOA, 7 with grade 4 KOA, and 30 healthy controls. All subjects completed the Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire. Serum COMP and IL-16 levels were measured using ELISA and their values log transformed to ensure a normal distribution.. There was no significant differences in levels of log serum COMP and IL-16 between healthy controls and KOA patients. There were no significant differences in the log serum COMP and IL-16 levels within the different K-L grades in the KOA patients. In KOA patients, log serum IL-16 levels significantly correlated with the WOMAC score (p = 0.001) and its subscales, pain (p = 0.005), stiffness (p = 0.019) and physical function (p<0.0001). Serum IL-16 levels were significantly higher in Malaysian Indians compared to Malays and Chinese (p = 0.024).. In this multi-ethnic Malaysian population, there was no difference in serum COMP and IL-16 levels between healthy controls and patients with KOA, nor was there any difference in serum COMP or IL-16 levels across the various K-L grades of KOA. However, there were significant inter-racial differences in serum IL-16 levels.

Topics: Aged; Asian People; Cartilage Oligomeric Matrix Protein; Female; Humans; Interleukin-6; Malaysia; Male; Middle Aged; Osteoarthritis, Knee; Pilot Projects; Severity of Illness Index

We aim to compare the patient profile and outcomes after TKA between the different racial groups in Singapore. Prospective data were collected from 364 patients who underwent TKA in Singapore General Hospital from January 2006 to May 2010. Patients were stratified according to ethnicity and we compared their preoperative demographic data, Short-Form 36 (SF-36), Oxford Knee (OKS) as well as Knee Society Scores (KSS). Malays were younger (62.0 ± 5.3) at time of surgery (p=0.05) and the body mass index of Chinese (27.9 ± 4.7) was lower than Malay (30.4 ± 5.0) and Indian (31.5 ± 4.5) patients (P<0.005). Malay (40.3 ± 11.0) and Indian (39.2 ± 9.3) patients had less favourable preoperative OKS than Chinese (35.9 ± 7.8) patients (P<0.05). All 3 ethnic groups achieved statistically significant improvements in outcome measures but did not differ significantly between the ethnicities.

Topics: Aged; Arthroplasty, Replacement, Knee; Asian People; China; Female; Humans; India; Knee Joint; Malaysia; Male; Middle Aged; Osteoarthritis, Knee; Singapore; Treatment Outcome

Symptomatic knee osteoarthritis, an ancient malady greatly impairing modern population quality of life, has stimulated global attention to find effective modes of prevention and intervention.. This study aimed to assess factors affecting knowledge of symptomatic knee osteoarthritis (knee OA) among Malaysian railway workers.. A cross-sectional study was conducted among 513 railway workers involving eight major states within Peninsular Malaysia using population-based sampling. The assessment instrument was a face-validated, prepiloted, self-administered instrument with sociodemographics and knowledge items on knee OA.. Mean (± SD) age of the respondents was 41.4 (± 10.7), with the majority aged 50 years or older (34.9%). Of the total respondents, 53.6% had low levels of knowledge of knee OA disease. Multivariate analysis found that four demographic predictors, age ≥ 50 years, family history of knee OA, self-awareness, and clinical diagnosis of the disease entity, were significantly associated with knowledge scores.. The finding of a low level knee OA knowledge among Malaysian railway workers points to an urgent need for massive information to be disseminated among the workers at risk to foster primary prevention and self-care.

Topics: Adult; Aged; Female; Humans; Malaysia; Male; Middle Aged; Osteoarthritis, Knee; Quality of Life; Railroads; Severity of Illness Index; Surveys and Questionnaires; Workforce

To assess the efficacy of oral palm vitamin E in reducing symptoms of patients with osteoarthritis (OA) of the knee compared to oral glucosamine sulphate.. This open study was carried out at the Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia between March 2006 and November 2007. Seventy-nine patients were recruited to receive either 1.5 g oral glucosamine sulphate or 400 mg oral palm vitamin E for 6 months. Symptoms were assessed using the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index and visual analogue scale (VAS).. Sixty-four patients completed the trial (vitamin E n=33, glucosamine sulfate n=31). After 6 months of treatment, both groups showed a significant improvement in WOMAC scale and significant reduction in the VAS score during standing and walking. There was no significant difference in WOMAC scale and VAS score between the 2 groups. Except for mild allergic reaction and abdominal discomfort in one patient, there were no other serious adverse effects reported. Serum malondialdehyde was significantly higher in the glucosamine group compared to palm vitamin E treated group at the end of the study. Serum of vitamin E was significantly higher in the palm vitamin E group compared to glucosamine.. The finding of this study suggests that oral palm vitamin E in a dose of 400 mg taken daily has a potential role in reducing symptoms of patients with OA of the knee. It may be just as effective as glucosamine sulphate in reducing the symptoms and free from serious side effects. Further study is required to ascertain the mechanism of action beside its antioxidant effect.

Topics: Administration, Oral; Age Factors; Aged; Analysis of Variance; Confidence Intervals; Dose-Response Relationship, Drug; Drug Administration Schedule; Female; Follow-Up Studies; Glucosamine; Humans; Malaysia; Male; Middle Aged; Osteoarthritis, Knee; Pain Measurement; Probability; Prospective Studies; Range of Motion, Articular; Regression Analysis; Severity of Illness Index; Sex Factors; Treatment Outcome; Vitamin E

To assess the nature and extent of rheumatic complaints in a semirural area in a multiracial (Malay, Indian, Chinese) community in Malaysia using the Community Oriented Program for the Control of Rheumatic Diseases (COPCORD) protocol initiated by ILAR and the WHO.. All members of a community of 2700 persons over the age of 15 years were offered a questionnaire based interview in Phase 1 of the study. Those with rheumatic complaints (pain in the last 1 week) were invited for a physical examination by a rheumatologist in Phase 2.. In total, 2594 (96%) persons agreed to a questionnaire based interview. Of those interviewed, 21.1% had a current rheumatic complaint. The pain rate was higher in women (23.8%) than in men (17.8%). Chinese men had the lowest age-standardized pain rate (9.9%), while Indian women had the highest rate (28.4%). In the study population, 14.4% complained of pain in the joints and/or musculoskeletal pain and 11.6% had low back pain. The knee was responsible for 64.8% of all complaints pertaining to the joints, and more than half those examined with knee pain had clinical evidence of osteoarthritis (OA). The complaint rate increased with age, up to 53.4% in the group age > 65 years. The major disability encountered was the inability to squat (3.1%). Fibromyalgia, soft tissue lesions, and localized OA of the knees were the main clinical diagnoses. Inflammatory arthritis was uncommon. Both Western and traditional sources of healthcare were used, often together. Self-medication was common (58.8%).. Knee and back pain are the main rheumatic complaints in Malaysia, with complaint rates differing according to race and gender.

Topics: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Arthralgia; Back Pain; China; Female; Fibromyalgia; Health Surveys; Humans; India; Knee Joint; Malaysia; Male; Middle Aged; Occupations; Osteoarthritis, Knee; Racial Groups; Sex Factors

Total knee arthroplasty is the most preferred option for treatment of severe osteoarthritis of the knee. We report the short-term outcome of 48 total knee replacements in 31 patients utilizing the Apollo Total Knee System after an average follow-up of 48 months (range 15 to 70 months). Records of all patients who underwent TKA using Apollo Total Knee System were retrospectively reviewed. Functional outcome was evaluated using visual analogue scale for pain rating and the Oxford 12-item questionnaire. Postoperative radiographs of the replaced knees were assessed by using the Knee Society Total Knee Arthroplasty Roentgenographic Evaluation and Scoring System. Degenerative osteoarthritis was the commonest indication for TKA. The average patient's age was 63.7 years (range, 30-77 years). The mean visual analogue scale for pre- and post-operative pain was eight and zero respectively. The mean Oxford 12-item questionnaire score pre- and post-operatively was 44.8 and 16.5 respectively. Patient satisfaction was notable in 98% of the cases with an average improvement in arc of flexion of 111 degrees. There were four failures; deep infection (one) and aseptic loosening (three) giving rise to a 94% implant survivor. The short-term results of this series is comparable with or better than a number of outcome studies of the Apollo Knee System or other implants of similar design.

Topics: Adult; Aged; Arthroplasty, Replacement, Knee; Female; Hospitals, University; Humans; Malaysia; Male; Middle Aged; Osteoarthritis, Knee; Outcome Assessment, Health Care; Pain Measurement; Patient Satisfaction; Retrospective Studies; Surveys and Questionnaires; Time Factors