Evidence map›Paper›PMID 30961569›Full record

SynthesisBMC musculoskeletal disorders2019

Osteoarthritis- a systematic review of long-term safety implications for osteoarthritis of the knee.

Jonathon Charlesworth, Jane Fitzpatrick, Nirmala Kanthi Panagodage Perera, John Orchard

2 registry-linked trialsOpen access · goldAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC musculoskeletal disorders, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 96 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
96citing papers in PubMed, 12 pooled it
21.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04395547 nacompletednot on this mapstarted 2020, after this paper: background citation

A Randomized, Double-blind, Placebo-controlled, Parallel Study to Investigate the Safety and Efficacy of JointAlive™ on Improving Knee Joint Function in Adults With Mild to Moderate Knee Osteoarthritis

TypeinterventionalSponsorChenland Nutritionals Inc.Ran2020 to 2022Enrolled72ConditionsOsteo Arthritis KneeArmsJointAlive™, Placebo
NCT04990128 phase3not yet recruitingnot on this mapstarted 2026, after this paper: background citation

Randomized Trial on the Evaluation of the Effectiveness of One Single Bone Marrow Aspirate Hip Injection Versus Triamcinolone for Hip Osteoarthritis

TypeinterventionalSponsorThe Cleveland ClinicRan2026 to 2027Enrolled100ConditionsHip OsteoarthritisArmsAspire Needle + Emcyte PureBMC, Triamcinolone
3 · Its place in the literature

Who cites it

96 citing papers in PubMed, 12 syntheses or guidelines pooled it, 222 citations in OpenAlex.

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36 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 4 institutions in 2 countries.

Jonathon CharlesworthAustralasian College of Sport and Exercise Physicians, 257 Collins Street, Melbourne, VIC, 3000, Australia. jonathoncharlesworth@hotmail.com.ORCID http://orcid.org/0000-0002-5050-5678
Jane FitzpatrickAustralasian College of Sport and Exercise Physicians, 257 Collins Street, Melbourne, VIC, 3000, Australia.
Nirmala Kanthi Panagodage PereraAustralasian College of Sport and Exercise Physicians, 257 Collins Street, Melbourne, VIC, 3000, Australia.
John OrchardAustralasian College of Sport and Exercise Physicians, 257 Collins Street, Melbourne, VIC, 3000, Australia.
Linköping University · SERoyal Australasian College of Physicians · AUThe University of Melbourne · AUThe University of Sydney · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is no cure for knee osteoarthritis (KOA) and typically patients live approximately 30-years with the disease. Most common medical treatments result in short-term palliation of symptoms with little consideration of long-term risk. This systematic review aims to appraise the current evidence for the long-term (≥12 months) safety of common treatments for knee osteoarthritis (KOA).

methodsCochrane Database of Systematic Reviews, Medline and PubMed were systematically searched from 1990 to July 2017, inclusive. Inclusion criteria were 1) peer-reviewed publications investigating treatments for KOA referred to in the Australian Clinical Care Standard and/or Therapeutic Guidelines: Rheumatology 2) specifically addressing safety of the treatments 3) with ≥12 months of follow-up and 4) Downs and Black quality score ≥ 13.

resultsThirty-four studies fulfilled the inclusion criteria. Lifestyle modifications (moderate exercise and weight loss), paracetamol, glucosamine, Intraarticular Hyaluronic Acid (IAHA) and platelet-rich-plasma (PRP) injections have a low risk of harm and beneficial ≥12 month outcomes. Although Nonsteroidal Anti-inflammatory Drugs (NSAIDs) provide pain relief, they are associated with increased risk of medical complications. Cortisone injections are associated with radiological cartilage degeneration at > 12 months. Arthroscopy for degenerative meniscal tears in KOA leads to a 3-fold increase in total knee arthroplasty (TKA). TKA improves primary outcomes of KOA but has a low rate of significant medical complications.

conclusionsGiven the safety and effectiveness of lifestyle interventions such as weight loss and exercise, these should be advocated in all patients due to the low risk of harm. The use of NSAIDs should be minimized to avoid gastrointestinal complications. Treatment with opioids has a lack of evidence for use and a high risk of long-term harm. The use of IAHA and PRP may provide additional symptomatic benefit without the risk of harm. TKA is associated with significant medical complications but is justified by the efficacy of joint replacement in late-stage disease.

trial registrationPROSPERO International prospective register for systematic reviews; registration number CRD42017072809 .

Indexed as

Risk Reduction BehaviorAdrenal Cortex HormonesAnti-Inflammatory Agents, Non-SteroidalArthroplasty, Replacement, KneeExercise TherapyHumansInjections, Intra-ArticularOsteoarthritis, KneePain ManagementTime FactorsAdrenal Cortex HormonesAnti-Inflammatory Agents, Non-SteroidalExerciseInjectionsKneeOsteoarthritisSurgery

Identifiers

PMID30961569
PMCPMC6454763
OpenAlexW2944676484

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.