Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders最新文献

{"title":"A Narrative Review on Avulsion Fractures of the Upper and Lower Limbs.","authors":"Christopher Vannabouathong,&nbsp;Olufemi R Ayeni,&nbsp;Mohit Bhandari","doi":"10.1177/1179544118809050","DOIUrl":"https://doi.org/10.1177/1179544118809050","url":null,"abstract":"<p><p>Avulsion fractures compromise function and movement at the affected joint. If left untreated, it can lead to deformity, nonunion, malunion, pain, and disability. The purpose of this review was to identify and describe the epidemiology and available treatment options for common avulsion fractures of the upper and lower extremities. Current evidence suggests that optimal treatment is dependent on the severity of the fracture. Conservative efforts generally include casting or splinting with a period of immobilization. Surgery is typically indicated for more severe cases or if nonoperative treatments fail; patient demographics or preferences and surgeon experience may also play a role in decision making. Some avulsion fractures can be surgically managed with any one of various techniques, each with their own pros and cons, and often there is no clear consensus on choosing one technique over another; however, there is some research suggesting that screw fixation, when possible, may offer the best stability and compression at the fracture site and earlier mobilization and return to function. Physicians should be mindful of the potential complications associated with each intervention.</p>","PeriodicalId":10443,"journal":{"name":"Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders","volume":"11 ","pages":"1179544118809050"},"PeriodicalIF":2.6,"publicationDate":"2018-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179544118809050","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36743072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Discomfort and Resident Confidence After Knee Intra-articular Injection Simulation Training: A Randomized Control Trial Study.","authors":"Adae O Amoako,&nbsp;George Ga Pujalte,&nbsp;Neha Kaushik,&nbsp;Timothy Riley","doi":"10.1177/1179544118782903","DOIUrl":"https://doi.org/10.1177/1179544118782903","url":null,"abstract":"<p><p>Teaching primary care providers how to perform musculoskeletal procedures has become increasingly important as more and more patients with orthopedic conditions present in primary care clinics. This study aims to evaluate whether targeted simulation model training in residency can increase residents' comfort level in performing intra-articular knee injections and decrease the pain of the procedure, as reported by patients injected. Residents were randomized into intervention and control groups. The comfort level of the residents as well as the pain levels from the procedures, as reported by patients, was recorded. The mean comfort level for the intervention group was 1.2, compared with that in the control group, which was 2.13; <i>P</i> value was .047. The mean pain level in the intervention group was 1.8, whereas in the control group was 3.63; <i>P</i> value was .156. Simulation training may boost residents' comfort level, but not necessarily decrease patient discomfort during intra-articular knee injections.</p>","PeriodicalId":10443,"journal":{"name":"Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders","volume":"11 ","pages":"1179544118782903"},"PeriodicalIF":2.6,"publicationDate":"2018-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179544118782903","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36314837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of HLA-B27 Subtypes on Ankylosing Spondylitis Phenotype: Comment on the Article by Akassou et al.","authors":"Sasan Fallahi","doi":"10.1177/1179544118785123","DOIUrl":"https://doi.org/10.1177/1179544118785123","url":null,"abstract":"Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders Volume 11: 1 © The Author(s) 2018 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/1 79544118785123","PeriodicalId":10443,"journal":{"name":"Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders","volume":"11 ","pages":"1179544118785123"},"PeriodicalIF":2.6,"publicationDate":"2018-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179544118785123","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36314838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Predictive Factors of Short-Term Efficacy of a Single Injection of Mannitol-Modified Cross-Linked Hyaluronic Acid in Patients with Trapeziometacarpal Osteoarthritis. Results of a Multicentre Prospective Open-Label Pilot Study (INSTINCT Trial).","authors":"Jérémy Dauvissat,&nbsp;Christophe Rizzo,&nbsp;Henri Lellouche,&nbsp;Jérôme Porterie,&nbsp;Sylvie Melac-Ducamp,&nbsp;Vincent Locquet,&nbsp;Vincent Travers,&nbsp;Bernard Maillet,&nbsp;Thierry Conrozier","doi":"10.1177/1179544118782901","DOIUrl":"https://doi.org/10.1177/1179544118782901","url":null,"abstract":"<p><strong>Purpose: </strong>To assess safety and search predictive factors of efficacy of a single intra-articular injection of a mannitol-modified hyaluronic acid (HA) viscosupplement, in patients having trapeziometacarpal (TMC) osteoarthritis (OA).</p><p><strong>Methods: </strong>Patients with symptomatic TMC OA, not adequately relieved by analgesic therapy and/or by the use of a thumb splint, were included in a 3-month prospective multicentre open-label trial. All underwent plain radiographs with the Kapandji incidences allowing the Dell radiological grade assessment (1-4). Primary end point was the variation between injection (D0) and day 90 (D90) of the thumb pain (11-point Likert scale). Treatment consisted in a single injection of 0.6 to 1 mL of a viscosupplement made of a cross-linked HA combined with mannitol. All injections were performed under imaging guidance. Predictive factors of pain decrease were studied in univariate and multivariate analysis.</p><p><strong>Results: </strong>A total of 122 patients (76% women, mean age 60, mean disease duration 36 months) were included and 120 (98%) were assessed at 3 months. The TMC OA was of Dell's grade 1, 2, 3, and 4 in 23%, 36.8%, 36.8%, and 3.5% of cases, respectively. At D0, the average (SD) pain level was 6.5 ± 1.6 without significant difference between Dell groups (<i>P</i> = .21). At day 90, pain decreased from 6.5 ± 1.6 to 3.9 ± 2.5 (difference -2.7 ± 2.5; -42%; <i>P</i> < .0001) without significant difference between Dell grade (<i>P</i> = .055), despite a seemingly smaller number of responders in stage 2 patients. The average analgesic consumption decreased in more than 1 out of 2 patients. In multivariate analysis, no predictor of response was identified. There was no safety issue. All adverse events (11%) were transient increase in pain during or following HA administration and resolved without sequel within 1 to 7 days.</p><p><strong>Conclusions: </strong>This study suggests that a single course of HANOX-M-XL injection is effective in relieving pain in patients with TMC OA, without safety concern. Patients with advanced stage of OA benefit the treatment as much as those with mild or moderate OA.</p>","PeriodicalId":10443,"journal":{"name":"Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders","volume":"11 ","pages":"1179544118782901"},"PeriodicalIF":2.6,"publicationDate":"2018-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179544118782901","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36285797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-Term Outcomes in Treatment of Knee Osteoarthritis With 4 Bone Marrow Concentrate Injections.","authors":"Brent Shaw,&nbsp;Marc Darrow,&nbsp;Armen Derian","doi":"10.1177/1179544118781080","DOIUrl":"https://doi.org/10.1177/1179544118781080","url":null,"abstract":"<p><strong>Background: </strong>Preliminary research suggests that bone marrow concentrate (BMC), which contains mesenchymal stem cells and platelets, is a promising treatment for knee osteoarthritis. The aim of this study was to build on this preliminary research by reporting the short-term progress of 15 patients (20 knees) with knee osteoarthritis through 4 BMC treatments.</p><p><strong>Methods: </strong>Patients underwent four sequential BMC treatments with mean injection times of 13.80 days after the first treatment, 21.40 days after the second treatment, and 33.50 days after the third treatment. The last follow-up was conducted a mean 86 days after the first treatment. Baseline and posttreatment outcomes of resting pain, active pain, lower functionality scale, and overall improvement percentage were compared after each treatment.</p><p><strong>Results: </strong>Patients experienced statistically significant improvements in active pain and functionality score after the first treatment. Additionally, patients experienced a mean decrease in resting pain after the first treatment, yet outcomes were not statistically significant until after the second treatment. On average, patients experienced an 84.31% decrease in resting pain, a 61.95% decrease in active pain, and a 55.68% increase in functionality score at the final follow-up. Patients also reported a mean 67% total overall improvement at study conclusion. Outcomes at the final follow-up after the fourth treatment were statistically significant compared to outcomes at baseline, after first treatment, after second treatment, and after third treatment.</p><p><strong>Conclusions: </strong>These results are promising, and additional research with a larger sample size and longer follow-up is needed to further examine the treatment effectiveness of multiple BMC injections for knee osteoarthritis.</p>","PeriodicalId":10443,"journal":{"name":"Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders","volume":"11 ","pages":"1179544118781080"},"PeriodicalIF":2.6,"publicationDate":"2018-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179544118781080","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36285796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrocalcaneal Bursitis Precedes or Accompanies Achilles Tendon Enthesitis in the Early Phase of Rheumatoid Arthritis.","authors":"Takeshi Suzuki,&nbsp;Yuka Hidaka,&nbsp;Yu Seri","doi":"10.1177/1179544118781094","DOIUrl":"https://doi.org/10.1177/1179544118781094","url":null,"abstract":"<p><p>The consecutive reports and stored images of ultrasound examinations for 100 symptomatic ankles of 74 patients with rheumatoid arthritis (RA) were reviewed for the presence or absence of retrocalcaneal bursitis (RCB) and Achilles tendon enthesitis (ATE). The ankles were classified into 4 categories based on the presence or absence of RCB or ATE. The number of RCB(-)/ATE(-), RCB(+)/ATE(-), RCB(+)/ATE(+), and RCB(-)/ATE(+) ankles was 62, 16, 12, and 10, respectively. When classifying patients into early RA and established RA, the percentage of RCB(-)/ATE(+) ankles with early RA was significantly lower than that with established RA (<i>P</i> = .00595). The disease duration was significantly longer in the RCB(-)/ATE(+) ankles than in the RCB(+)/ATE(-) ankles (median [interquartile range]: 15.29 [8.69] months vs 3.6 [3.06] months, <i>P</i> = .0247). It was speculated that RCB precedes or accompanies ATE in the early phase of RA, which suggests that entheseal inflammation in RA arises from synovial tissues.</p>","PeriodicalId":10443,"journal":{"name":"Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders","volume":"11 ","pages":"1179544118781094"},"PeriodicalIF":2.6,"publicationDate":"2018-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179544118781094","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36219815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Pooled Analysis of Two Multicenter, Randomized Controlled Trials of a Single Intra-articular Injection of Gel-200 for Treatment of Osteoarthritis of the Knee.","authors":"Junko Takamura, Takayuki Seo, Vibeke Strand","doi":"10.1177/1179544118773068","DOIUrl":"10.1177/1179544118773068","url":null,"abstract":"<p><strong>Background and objective: </strong>To perform an integrated analysis of 2 randomized controlled trials (RCTs) to assess the efficacy and safety of a single intra-articular injection of Gel-200 compared with phosphate buffered saline (PBS) for treatment of osteoarthritis of the knee.</p><p><strong>Methods: </strong>Data from the intention-to-treat (ITT) populations of both RCTs were pooled for this integrated analysis. Mean changes from baseline in Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain subscores were assessed using a longitudinal model; treatment differences were compared between intra-articular Gel-200 and PBS injections. Analyses included secondary outcome measures repeated at individual time points. The safety populations of both RCTs were pooled for an integrated safety analysis to compare adverse events (AEs).</p><p><strong>Results: </strong>The pooled ITT population included 1184 subjects (649 Gel-200; 535 PBS); demographic characteristics were similar between treatment groups. Mean improvements in pain subscores from baseline to week 12 were -24.7 mm in Gel-200 and -21.8 mm in PBS groups, a statistically significant treatment group difference of -2.9 mm (<i>P</i> = .047). From weeks 3 to 26, mean improvements from baseline in pain subscores were -23.8 mm with Gel-200 and -20.8 mm with PBS; this treatment group difference of -3.0 mm was statistically significant (<i>P</i> = .017). The rate of AEs was similar between Gel-200 and PBS treatment groups.</p><p><strong>Conclusion: </strong>This integrated analysis demonstrated the efficacy of a single intra-articular injection of Gel-200 compared with PBS for treatment of osteoarthritis of the knee over 26 weeks without major safety concerns.</p><p><strong>Trial registration: </strong>NCT00449696 and NCT00450112.</p>","PeriodicalId":10443,"journal":{"name":"Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders","volume":"11 ","pages":"1179544118773068"},"PeriodicalIF":2.6,"publicationDate":"2018-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179544118773068","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36114956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late Presentation of Infected Silicone Granulomas in the Lower Limb.","authors":"Zita M Jessop,&nbsp;Matthew Welck,&nbsp;Emily Zinser,&nbsp;Nicholas Garlick,&nbsp;Susan Hopkins","doi":"10.1177/1179544118759020","DOIUrl":"https://doi.org/10.1177/1179544118759020","url":null,"abstract":"<p><strong>Introduction: </strong>Dermal fillers are used for multiple cosmetic indications including gluteal and thigh augmentation. Complications, although infrequent, are increasing due to the dramatic growth of dermal filler use. Our aim was to describe how the complication of infected silicone granulomas can present following lower limb augmentation.</p><p><strong>Methods: </strong>Two cases presented with pain, oedema, and erythema at the site of previous silicone filler injection, following a considerable delay after the last injection (range 4-7 years). We collected data on their biochemistry, haematology, histology, microbiology, and imaging at the time of presentation.</p><p><strong>Results: </strong>Complications included prolonged cellulitis with recurrent abscesses at sites of previous silicone dermal filler injection. Histology revealed infiltration of chronic inflammatory cells suggestive of silicone granuloma in both cases. Patients were reluctant to divulge use of cosmetic fillers or failed to recognise their significance given the time delay making diagnosis difficult. Delayed or recurring infections can suggest the presence of atypical organisms and we present the first reported case of silicone granuloma infection with <i>Propionibacterium acnes</i>.</p><p><strong>Conclusions: </strong>Microorganisms can induce immune-mediated hypersensitivity and are believed to be the trigger for delayed activation of a quiescent foreign body to a granulomatous reaction. The substantial time delay between injection and reaction must be recognised and may be attributable to atypical microorganisms or biofilm formation. Previous antibiotic use can affect expedient microbiological diagnosis and treatment requires close collaboration with microbiologists. It is important that clinicians are aware of these important complications which are becoming more common with increased use of filler augmentation.</p>","PeriodicalId":10443,"journal":{"name":"Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders","volume":"11 ","pages":"1179544118759020"},"PeriodicalIF":2.6,"publicationDate":"2018-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179544118759020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35889048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is It the Age at Disease Onset or the Disease Radiological Severity That Affects Cervical Spine Involvement in Patients With Rheumatoid Arthritis?","authors":"Hanan Sayed M Abozaid,&nbsp;Reham Alaa El-Din Hassan,&nbsp;Waleed A Elmadany,&nbsp;Mohamed Aly Ismail,&nbsp;Dalia S Elgendy,&nbsp;Sahar A Elsayed,&nbsp;Rania M Gamal,&nbsp;Osama S Daifallah,&nbsp;Esam M Abu Alfadl","doi":"10.1177/1179544118759688","DOIUrl":"https://doi.org/10.1177/1179544118759688","url":null,"abstract":"<p><strong>Background: </strong>Cervical spine involvement in patients with rheumatoid arthritis (RA) can cause pain and disability, with a variety of neurologic signs and symptoms.</p><p><strong>Objectives: </strong>To investigate the relationship between structural cervical spine involvement in patients with RA with the age at disease onset and the degree of radiologic severity of RA measured by Larsen scoring.</p><p><strong>Patients and methods: </strong>This cross-sectional study included 50 adult patients with RA. Patients who complained or not complained from symptoms of cervical spine involvement in RA were included; we did X-ray of the cervical spine, hands, and feet; Larsen scoring method; disease activity score (DAS28); and Neck Disability Index.</p><p><strong>Results: </strong>The results revealed that patients with cervical involvement tend to be younger at their disease onset than those with no cervical involvement, as detected by cervical X-ray. The relation was significant <i>P</i> < .05 regarding all cervical involvements except for basilar invagination. Disease radiological severity (measured by Larsen score) significantly increases the risk for subaxial subluxation, <i>P</i> = .040. All other cervical complications of RA tend to have nonsignificant relation with disease severity. Using univariate binary regression analysis for risk factors for cervical involvement showed that the only probable risk factor for cervical involvement (detected by X-ray) in patients with RA is age at disease onset.</p><p><strong>Conclusions: </strong>The early age at disease onset tends to affect cervical spine involvement in patients with RA more than the disease radiological severity.</p>","PeriodicalId":10443,"journal":{"name":"Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders","volume":"11 ","pages":"1179544118759688"},"PeriodicalIF":2.6,"publicationDate":"2018-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179544118759688","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39766443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Observational 1-Month Trial on the Efficacy and Safety of Promerim for Improving Knee Joint.","authors":"Bekir Eray Kilinc,&nbsp;Yunus Oc,&nbsp;Gungor Alibakan,&nbsp;Emre Bilgin,&nbsp;Muharrem Kanar,&nbsp;Osman Tugrul Eren","doi":"10.1177/1179544118757496","DOIUrl":"https://doi.org/10.1177/1179544118757496","url":null,"abstract":"<p><strong>Objective: </strong>This study was conducted to evaluate the efficacy and tolerability of the oral intake of promerim in the elimination of acute pain and discomfort associated with knee osteoarthritis (OA).</p><p><strong>Methods: </strong>Single-center, 1-month, prospective, observational clinical trial. A total of 92 patients not older than 70 years were included. Patients were offered to use 720-mg promerim for the first 15 days after admission after breakfast and then 360 mg for the second 15 days. All patients were analyzed with the visual analog scale (VAS) for pain, which ranges from 0 to 10, and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score before the start of treatment and 1 month after the start. Statistical analysis was performed by SPSS 15.0 software. An α level of <i>P</i> < .05 was assumed to be statistically significant.</p><p><strong>Results: </strong>This study comprised 92 patients (69 women and 23 men) with a mean age of 51.5 (range: 40-69) years. Before treatment, the mean VAS score was 5.6 ± 1.1, and after treatment, the mean VAS score was 2.6 ± 1.7. Treatment with promerim consistently showed a significant decrease in the VAS score (<i>P</i> < .001). The mean WOMAC score of the patients was 46.4 ± 8.2 before treatment. After treatment, the mean WOMAC score was 72.1 ± 14.4. Treatment with promerim consistently showed a significant increase in the WOMAC score (<i>P</i> < .001).</p><p><strong>Conclusions: </strong>The results of this single-center, open-label clinical study demonstrate that promerim is a viable natural treatment option for treating knee OA. We recommend that 720-mg promerim taken once daily for the first 15 days after admission and 360 mg taken once daily for the next 15 days significantly and rapidly reduced composite pain and stiffness in the knee OA within 1 month.</p>","PeriodicalId":10443,"journal":{"name":"Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders","volume":"11 ","pages":"1179544118757496"},"PeriodicalIF":2.6,"publicationDate":"2018-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179544118757496","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35851846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}