May 2 2018An estimated 45 percent of people are at risk of developing knee osteoarthritis (OA) in their lifetime. According to a network meta-analysis research article published in the May 1, 2018 issue of the Journal of the American Academy of Orthopaedic Surgeons (JAAOS), the nonsteroidal anti-inflammatory drug (NSAID) naproxen was ranked most effective in individual knee OA treatment for improving both pain and function, and is considered a relatively safe and low-cost treatment method.Nonsurgical treatments for knee OA supported by previous research evidence include strength training, low-impact aerobic exercises, NSAIDs, and weight loss in individuals with a body mass index over 25. This new research analyzed data from multiple trials to determine the relative effectiveness of various nonsurgical treatments for knee OA. The treatments that were compared and ranked included acetaminophen; ibuprofen; intra-articular (IA) or joint injections of cortisone; platelet-rich plasma (PRP); hyaluronic acid (HA); several NSAIDs, such as naproxen, celecoxib, and diclofenac; and both oral and IA placebo.”This is the first comprehensive mixed-comparison analysis comparing best-evidence scientific research and excluding lower quality studies that can bias the outcomes,” said lead author and orthopedic surgeon David Jevsevar, MD, MBA. “Using a statistical ranking technique, we worked to provide evidence regarding which of the most common NSAIDs are most likely to decrease pain and improve function, and we attempted to fill in the gaps in evidence for more inconclusive treatments such as HA, PRP, and corticosteroids.”Authors analyzed 53 randomized controlled trials that examined knee OA treatments for at least 28 days and included a minimum of 30 participants per study group. Knee OA treatments were ranked on a scale of one to five, with one being the most effective. They found the following:Related StoriesArthroscopy more accurate than MRI for chondral defects of the knee, study findsTAU’s new Translational Medical Research Center acquires MILabs’ VECTor PET/SPECT/CTResearch sheds light on sun-induced DNA damage and repair For pain reduction, cortisone injections provided the greatest short-term (4 to 6 weeks) pain relief, followed by ibuprofen, PRP injections, naproxen, and celecoxib. Naproxen ranked the highest for probability for improving function, followed by diclofenac, celecoxib, ibuprofen, and PRP injections. Naproxen was ranked the most effective individual knee OA treatment for improving both pain and function followed by cortisone injections, PRP injections, ibuprofen and celecoxib. HA injections did not achieve a rank in the top five treatments for pain, function, or combined pain and function. An analysis of 12 articles also found that results with HA are not significantly different from those with IA placebo for treatment of knee OA. Source:http://newsroom.aaos.org/media-resources/news/non-surgical-treat-of-knee-osteoarthritis.htm “Because knee OA has both a high disease burden and high treatment costs, additional prospective studies using similar outcomes, timelines, and measures of clinically important changes are needed,” explained Dr. Jevsevar. “While the information in this analysis is helpful to physicians, patients also can benefit from these findings and use it with their doctors to weigh all possible treatment options.”Although the use of NSAIDs for arthritic conditions such as knee OA has potential risks, including heart attack and stroke, existing evidence indicates that naproxen has less potential for adverse cardiovascular events.
SAINTS travel to Huddersfield on Sunday in the Fourth Round of the Tetley’s Challenge Cup.The Giants are seeking their first home Challenge Cup victory against the Saints since 1954 – and first ever at the John Smith’s Stadium.St Helens have emerged victorious from Cup visits to Huddersfield on three successive occasions since then.The Giants have won their last three home Super League fixtures against the Saints however – last tasting league defeat against Sunday’s opponents on 28 March, 2010 (24-6).Previous Challenge Cup Meetings:2009 (Semi-Final) Huddersfield 24 St Helens 14 (at Halliwell Jones Stadium, Warrington)2006 (FINAL) Huddersfield 12 St Helens 42 (at Twickenham)2005 (Round 4) Huddersfield 22 St Helens 262004 (Semi-Final) Huddersfield 6 St Helens 46 (at Halliwell Jones Stadium, Warrington)2001 (Quarter Final) St Helens 54 Huddersfield 161994 (Round 4) Huddersfield 16 St Helens 231981 (Round 1) Huddersfield 8 St Helens 101978 (Quarter Final) St Helens 31 Huddersfield 51972 (Round 2) St Helens 32 Huddersfield 91968 (Round 1) St Helens 0 Huddersfield 51962 (Round 2) St Helens 2 Huddersfield 131954 (Round 2) Huddersfield 12 St Helens 51953 (FINAL) Huddersfield 15 St Helens 10 (at Wembley Stadium)1937 (Round 1) St Helens 4 Huddersfield 111924 (Round 2) Huddersfield 24 St Helens 131915 (FINAL) Huddersfield 37 St Helens 3 (at Watersheddings, Oldham)1913 (Round 1) St Helens 0 Huddersfield 19Last Meeting:Huddersfield 25 St Helens 16 (SLR17, 3/6/13)Career Milestones:Paul Wellens needs one point to reach 1,000 for his career.He’s scored 953 points (218 tries, 40 goals, 1 field goal) for St Helens since 1998.He has also scored points for Great Britain (18 – 4 tries, 1 goal), England (16 – 4 tries) and Lancashire (12 – 3 tries).Challenge Cup Milestones:(Super League players reaching significant figures in Challenge Cup games only)Paul Wellens – 10 points away from 150 (140 for St Helens, 2001-2002, 2004-2007 & 2009-2013)Try-Scoring Runs:Tommy Makinson (1-2-1-2) has scored tries in their Saints’ last four games.Winning Runs:Saints and Leigh share the longest winning streak in the game, having both won their first seven matches of 2014.Consecutive Appearances:Castleford’s Craig Huby has the longest run of consecutive appearances amongst Super League players, with 52. He last missed a Tigers game on 9 April, 2012 – an 18-12 home defeat to St Helens. His streak then started on 14 April, 2012 – a 23-16 Challenge Cup defeat at Featherstone.1 Craig Huby (Castleford Tigers) 522 Danny Houghton (Hull FC) 473 Josh Jones (St Helens) 414 Daryl Clark (Castleford Tigers) 375 Danny Addy (Bradford Bulls) 36First Utility Super League Leading Scorers:Tries:1 Tommy Makinson (St Helens) 82 = Justin Carney (Castleford Tigers) 7Kevin Brown (Widnes Vikings) 74 = Jermaine McGillvary (Huddersfield Giants) 6Omari Caro (Hull Kingston Rovers) 6Goals:1 Luke Walsh (St Helens) 282 = Danny Brough (Huddersfield Giants) 25Jarrod Sammut (Wakefield Trinity Wildcats) 254 = Kevin Sinfield (Leeds Rhinos) 22Danny Tickle (Widnes Vikings) 22Goals Percentage:1 Marc Sneyd (Castleford Tigers) 90.90 (20/22)2 Luke Walsh (St Helens) 90.32 (28/31)3 Jarrod Sammut (Wakefield Trinity Wildcats) 89.28 (25/28)4 Danny Tickle (Widnes Vikings) 84.61 (22/26)5 Jamie Foster (Bradford Bulls) 83.33 (15/18)Points:1 Luke Walsh (St Helens) 642 = Danny Brough (Huddersfield Giants) 54Jarrod Sammut (Wakefield Trinity Wildcats) 544 Kevin Sinfield (Leeds Rhinos) 525 Danny Tickle (Widnes Vikings) 486 Marc Sneyd (Castleford Tigers) 457 Matty Smith (Wigan Warriors) 418 Tom Makinson (St Helens) 38Cup Draw:Rugby League Hall of Fame members Alex Murphy and Garry Schofield will conduct the draw for the fifth round of the Tetley’s Challenge Cup live on BBC2 on Sunday (April 6).The 16 winners from this weekend’s fourth round ties will go into the draw, which takes place between 4.00pm and 4.30pm following the conclusion of the televised tie, Huddersfield Giants v St Helens.The fifth round ties will be played over the weekend of April 26 and 27 with one tie screened live on BBC1 on Saturday April 26 (2.30pm)
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