Thiago Pasqualin

PARQVE-Project Arthritis Recovering Quality of Life by Means of Education Short-term Outcome in a Randomized Clinical Trial

Objective: To evaluate the improvement in pain, function and quality of life of patients with knee osteoarthritis (OA) by means of an educational program. Methods: Two hundred and five patients with knee OA were evenly allocated in four groups. Three groups had two days of lectures on Osteoarthritis (OA). All groups received printed material to read and a video with all the lectures. Groups 1, 2, and 3, had lectures one, two and three months apart respectively. Group 4 received the educational material only. Half of the patients (subgroups A) received a telephone call two months after the final lecture. At enrollment and four months after the final lecture or after receiving the educational material, patients were asked to answer LEQUESNE, WOMAC, VAS, and SF-36 questionnaires, both physical (PCS) and mental (MCS). Results: Age wise all groups were similar. BMI was significantly higher in group 4. In general, all groups improved in pain, function and quality of life with no significant difference between groups for Lequesne, WOMAC, WOMAC pain, and SF36 PCS, or MCS. VAS showed significant difference favoring phone calls (p=0.021). Without telephone calls VAS scores trends (p=0.068) to be less in class attendants than in those that only retrieved the educational material. Conclusions: The educational program improved pain, function and quality of life (both physical and mental). Telephone calls improved pain and classroom programs seem to be superior to educational material alone.

PARQVE: PROJECT ARTHRITIS RECOVERING QUALITY OF LIFE THROUGH EDUCATION: TWO-YEAR RESULTS

ABSTRACT Objective: To evaluate the effects of a multi-professional educational program in patients with knee osteoarthritis (KOA). Methods: Prospective randomized controlled trial with 195 KOA patients. One group was submitted to two-day lectures and received educational material about KOA (Class group), and the control group received the educational material only. Patients were evaluated at baseline, twelve and 24 months. At evaluation, patients answered pain and functional questionnaires (WOMAC, Lequesne, VAS and SF-36); reported the intensity of exercise per week; measured the body fat percentage, weight and height to estimate body mass index (BMI); and performed Timed Up & Go (TUG) and Five-Times-Sit-to-Stand (FTSST) tests. Results: The groups presented similar results in all time points with respect to pain (VAS and WOMAC pain), WOMAC, BMI and body fat percentage (p>0.05). The Class group exhibited improved function according to the Lequesne questionnaire, whereas the control group worsened (p=0.02) during follow-up (p<0.02). TUG (p=0.01) and FTSST (p<0.001) improved in the Class group. A higher percentage of patients in the Class group performed regular physical activity (p=0.045). Conclusions: The educational program with classes improved the consistency of physical activity and the subjective and objective function of patients with KOA.Level of evidence IA, Prospective Randomized Controlled Trial.

Joint lavage followed by viscosupplementation and triamcinolone in patients with severe haemophilic arthropathy: objective functional results.

Viscosupplementation can improve function in haemophilia patients. Viscosupplementation results can be improved by prior joint lavage and triamcinolone administration.

Subjective results of joint lavage and viscosupplementation in hemophilic arthropathy.

OBJECTIVE: To assess whether joint lavage, viscosupplementation and triamcinolone improve joint pain, function and quality of life in patients with severe hemophilic arthropathy. METHODS: Fourteen patients with knee and/or ankle hemophilic arthritis with and without involvement of other joints underwent joint lavage and subsequent injection of hylan G-F20 and triamcinolone in all affected joints. The patients answered algo-functional questionnaires (Lequesne and WOMAC), visual analog scale for pain (VAS) and SF-36 preoperatively, and at one, three, six and twelve months postoperatively. RESULTS: Sixteen knees, 15 ankles, 8 elbows and one shoulder were treated in 14 patients. Six patients had musculoskeletal bleeding [ankle (1), leg muscle (2) and knees (4)] at 3 months affecting the results. Pain did not improve significantly. Function improved (WOMAC p=0.02 and Lequesne p=0.01). The physical component of SF-36 improved at all time points except at 3 months, with best results at one-year follow-up (baseline = 33.4; 1 month = 39.6; 3 months= 37.6; 6 months 39.6 and 1 year = 44.6; p < 0.001). CONCLUSION: Joint lavage followed by injection of triamcinolone and hylan G-F20 improves function and quality of life progressively up to a year, even in severe hemophilic arthropathy. Level of Evidence IV, Case Series.

Study on implant stability in cementless total knee arthroplasty

Objectives Determine the stability of tibial and femoral components of 20 cementless knee arthroplasties with rotating platform. Methods The 20 patients (20 knees) underwent an analysis of dynamic radiographs with an image amplifier and maneuvers of varus and valgus which were compared to static frontal and lateral radiographs of the knees and analyzed by two experienced surgeons in a double-blind way. Results We could observe in this study that both methods showed very similar results for the stability of the tibial and femoral components (p<0.001) using the Kappa method for comparison. Conclusion The tibial component was more unstable in relation to the femoral component in both static and dynamic studies. Level of Evidence IV, Case Series.

Evaluation of the effect of adding corticosteroid to viscosupplementation: a prospective and randomized study

Purpose: The aim of this study is to assess if we can improve the initial results of viscosupplementation by the addition of corticosteroids to the procedure, watching for any interference on the long-term results. Methods:We evaluated 104 patients with knee osteoarthritis (OA), treated at the group for the treatment of osteometabolic diseases of IOT-FMUSP, Sao Paulo. All patients were receiving usual care for OA, and those who underwent to any kind of intraarticular injection or knee surgery in the last 6 months, or presented post-traumatic or rheumatoid arthritis were not Abstracts / Osteoarthritis an