scholarly journals FRI0390 IMPACT OF ULTRASONOGRAPHY‑DETECTED QUADRICEPS CALCIFIC TENDONITIS ON PAIN AND FUNCTION IN PATIENTS WITH PRIMARY KNEE OSTEOARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 793.3-793
Author(s):  
M. A. Mortada ◽  
Y. A. Amer
Keyword(s):  
Knee Osteoarthritis ◽  
Vastus Lateralis ◽  
Health Assessment ◽  
Quadriceps Tendon ◽  
Knee Joints ◽  
Knee Oa ◽  
Vastus Intermedius ◽  
Calcific Tendonitis ◽  
Advanced Stages ◽  
And Function

Background:Calcific tendonitis is most commonly seen around shoulder joint. Few cases of quadriceps calcific tendonitis (QCT) of were reported. Routine use of ultrasonography in diagnosis of knee osteoarthritis has resulted in detection of many cases of QCT.Up to the best of our knowledge, this is the first study to detect impact of QCT in knee osteoarthritis by ultrasonography.Objectives:To compare pain, function, and clinical and radiological findings among primary KOA patients with or without ultrasonography-detected QCT.Methods:A prospective, observational study study was conducted on 214 patients with knee OA in the period between february 2019 to july 2019. Ultrasonography of knee joints was done according to EULAR guidelines. Quadriceps calcific tendonitis is defined as hyperechoic mass within the quadriceps tendon with posterior shadowing. The patients were categorized into two groups according to the presence or absence of QCT.Radiological grades of Kellgren–Lawrence were recorded. Pain and functional status was assessed by visual analog scale (VAS), Health Assessment Questionnaire-II (HAQ-II), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)Results:QCT were detected in 25 (11.6%) patients. Most cases of QCT were detected in vastus lateralis 18 (72%), then in vastus intermedius 5 (20%) and only 2 cases were detected in vastus medialis.QCT were detected mainly in advanced stages of knee OA; 22 cases of QCT were found in patients with grade 4 KOA.The presence of QCT was statistically significant related (P< 0.05*) with age, VAS, HAQ-II, WOMAC subscales, synovitis and effusion.Conclusion:Quadriceps calcific tendonitis is not rare. Ultrasonography can detect QCT in many cases with advanced knee OA. QCT is associated with increased pain and dysfunction in knee OAReferences:NoneDisclosure of Interests:None declared

scholarly journals Impact of ultrasonography detected quadriceps calcific tendinopathy on pain and function in patients with primary knee osteoarthritis

Reumatismo ◽  
2021 ◽  
Vol 73 (2) ◽  
pp. 111-116
Author(s):  
M.A. Mortada ◽  
L.I. Kotb ◽  
Y.A. Amer
Keyword(s):  
Knee Osteoarthritis ◽  
Vastus Lateralis ◽  
Health Assessment ◽  
Cross Sectional Study ◽  
Knee Joints ◽  
Cross Sectional ◽  
Calcific Tendinopathy ◽  
Knee Oa ◽  
Grade 3 ◽  
And Function

Calcific tendinopathy is most commonly seen around the shoulder joint. Only a few cases of quadriceps calcific tendinopathy (QCT) were reported. This study compares pain, function, clinical examination results, and ultrasonographic findings among primary knee osteoarthritis (KOA) patients with or without ultrasonography-detected QCT. A cross-sectional study was conducted on 214 patients with knee OA. Ultrasonography (US) of knee joints was performed according to the EULAR guidelines. Kellgren-Lawrence radiographic grading was used to score OA. Pain and functional status were assessed using the visual analog scale (VAS), the Health Assessment Questionnaire-II (HAQ-II), and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). QCT was detected in 50 out of 428 knees (11.6%), i.e. in 46 out of 214 patients (21.49%). Most cases of QCT were detected in the following sites: 36 in the vastus lateralis (72%), 10 in the vastus intermedius (20%), and only 4 in the vastus medialis (8%). QCT was found mainly in advanced KOA stages: 44 cases of QCT were found in patients with grade 4 KOA and 6 cases in grade 3 KOA. The presence of QCT showed a statistically significant association (p<0.05) with VAS, HAQ-II, WOMAC subscales, synovitis, and effusion detected by US. In knees with ultrasound-detected QCT, ultrasonographic features of CPPD were found in 31 knees (62%). QCT was found in cases with advanced KOA and mainly with ultrasonographic findings of CPPD disease. QCT could be considered an independent poor prognostic finding regarding pain, functional activity, and response to NSAIDs.

The Relationship Between Early-Stage Knee Osteoarthritis and Lower-Extremity Alignment, Joint Laxity, and Subjective Scores of Pain, Stiffness, and Function

2016 ◽  
Vol 25 (3) ◽  
pp. 213-218
Author(s):  
Charlie A. Hicks-Little ◽  
Richard D. Peindl ◽  
Tricia J. Hubbard-Turner ◽  
Mitchell L. Cordova
Keyword(s):  
Knee Joint ◽  
Lower Extremity ◽  
Knee Osteoarthritis ◽  
Outcome Measures ◽  
Early Stage ◽  
Joint Laxity ◽  
Knee Oa ◽  
Lower Extremity Alignment ◽  
Knee Joint Laxity ◽  
And Function

Context:Knee osteoarthritis (OA) is a debilitating disease that affects an estimated 27 million Americans. Changes in lowerextremity alignment and joint laxity have been found to redistribute the medial and/or lateral loads at the joint. However, the effect that changes in anteroposterior knee-joint laxity have on lower-extremity alignment and function in individuals with knee OA remains unclear.Objective:To examine anteroposterior knee-joint laxity, lower-extremity alignment, and subjective pain, stiffness, and function scores in individuals with early-stage knee OA and matched controls and to determine if a relationship exists among these measures.Design:Case control.Setting:Sports-medicine research laboratory.Participants:18 participants with knee OA and 18 healthy matched controls.Intervention:Participants completed the Western Ontario McMaster (WOMAC) osteoarthritis questionnaire and were tested for total anteroposterior knee-joint laxity (A-P) and knee-joint alignment (ALIGN).Main Outcome Measures:WOMAC scores, A-P (mm), and ALIGN (°).Results:A significant multivariate main effect for group (Wilks’ Λ = 0.30, F7,26 = 8.58, P < .0001) was found. Knee-OA participants differed in WOMAC scores (P < .0001) but did not differ from healthy controls on ALIGN (P = .49) or total A-P (P = .66). No significant relationships were identified among main outcome measures.Conclusion:These data demonstrate that participants with early-stage knee OA had worse pain, stiffness, and functional outcome scores than the matched controls; however, ALIGN and A-P were no different. There was no association identified among participants’ subjective scores, ALIGN, or A-P measures in this study.

scholarly journals Knee Osteoarthritis: A Review of Pathogenesis and State-Of-The-Art Non-Operative Therapeutic Considerations

Genes ◽  
2020 ◽  
Vol 11 (8) ◽  
pp. 854
Author(s):  
Dragan Primorac ◽  
Vilim Molnar ◽  
Eduard Rod ◽  
Željko Jeleč ◽  
Fabijan Čukelj ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Platelet Rich Plasma ◽  
Treatment Options ◽  
Stromal Vascular Fraction ◽  
Disease Stage ◽  
Knee Oa ◽  
Marrow Mesenchymal Stem Cells ◽  
The Moment ◽  
And Function ◽  
Orthopedic Patients

Being the most common musculoskeletal progressive condition, osteoarthritis is an interesting target for research. It is estimated that the prevalence of knee osteoarthritis (OA) among adults 60 years of age or older is approximately 10% in men and 13% in women, making knee OA one of the leading causes of disability in elderly population. Today, we know that osteoarthritis is not a disease characterized by loss of cartilage due to mechanical loading only, but a condition that affects all of the tissues in the joint, causing detectable changes in tissue architecture, its metabolism and function. All of these changes are mediated by a complex and not yet fully researched interplay of proinflammatory and anti-inflammatory cytokines, chemokines, growth factors and adipokines, all of which can be measured in the serum, synovium and histological samples, potentially serving as biomarkers of disease stage and progression. Another key aspect of disease progression is the epigenome that regulates all the genetic expression through DNA methylation, histone modifications, and mRNA interference. A lot of work has been put into developing non-surgical treatment options to slow down the natural course of osteoarthritis to postpone, or maybe even replace extensive surgeries such as total knee arthroplasty. At the moment, biological treatments such as platelet-rich plasma, bone marrow mesenchymal stem cells and autologous microfragmented adipose tissue containing stromal vascular fraction are ordinarily used. Furthermore, the latter two mentioned cell-based treatment options seem to be the only methods so far that increase the quality of cartilage in osteoarthritis patients. Yet, in the future, gene therapy could potentially become an option for orthopedic patients. In the following review, we summarized all of the latest and most important research in basic sciences, pathogenesis, and non-operative treatment.

scholarly journals AN OPEN-LABEL MULTICENTER OBSERVATIONAL STUDY OF THE EFFICACY, TOLERABILITY, AND SAFETY OF THE NONSTEROIDAL ANTI-INFLAMMATORY DRUG AMTOLMETIN GUACIL IN PATIENTS WITH KNEE OSTEOARTHRITIS AND DYSPEPSIA

2017 ◽  
Vol 54 (6) ◽  
pp. 654-659 ◽  
Author(s):  
E. S. Tsvetkova ◽  
L. N. Denisov ◽  
A. N. Otteva ◽  
A. L. Dubikov ◽  
S. P. Yakupova ◽  
...  
Keyword(s):  
Observational Study ◽  
Knee Osteoarthritis ◽  
Analgesic Effect ◽  
Varicose Veins ◽  
Health Assessment ◽  
Open Label ◽  
Serious Adverse Events ◽  
Multicenter Observational Study ◽  
Knee Oa ◽  
Anti Inflammatory

Objective: to investigate the efficacy and tolerability of amtolmetin guacil (AMG; Niselat®, Dr. Reddy's Laboratories Ltd, India) versus previous therapy with nonsteroidal anti-inflammatory drugs (NSAIDs) in patients with knee osteoarthritis (OA) and signs of dyspepsia.Subjects and methods. The open-label observational study included 220 patients aged 30–65 years who suffered from knee OA and intense pain during NSAID intake and had symptoms of dyspepsia in the absence of contraindications to the use of AMG. Among the comorbidities that generally occurred in 68% of the patients, there was a preponderance of hypertension (42%), lower extremity varicose veins (6.4%), and diabetes mellitus (6%). Treatment efficacy was evaluated using three domains of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), by also taking into account pain intensity and general health assessment on the visual analogue scale. A Severity of Dyspepsia Assessment (SODA) scale was used to rate dyspepsia.Results and discussion. AMG had a marked analgesic effect confirmed by 40% or more pain reduction that occurred in 72.5% of the patients. The high analgesic effect of AMG was confirmed by a statistically significant (p <0.001) reduction in the WOMAC index (pain and stiffness) and by an increase in functional activity. There was a significant decrease in painless and painful signs of dyspepsia, as well as positive changes in the measures “overall assessment of dyspepsia severity” (p < 0.001) and “satisfaction with treatment”. Overall assessment of AMG tolerability was only positive: excellent (33%), good (56%), and satisfactory (11%). There were no serious adverse events (AE). AE were graded as moderate and mild in 8 and 82% of cases, respectively. AE were recorded in 7.7% of the patients. Conclusion. The findings suggest that AMG offers good prospects for knee OA treatment.

scholarly journals The use of cellular matrix in symptomatic knee osteoarthritis

2019 ◽  
Author(s):  
Abir Aly Abbassy ◽  
Suad Trebinjac ◽  
Nehad Kotb
Keyword(s):  
Pilot Study ◽  
Knee Osteoarthritis ◽  
Platelet Rich Plasma ◽  
Knee Joints ◽  
Active Components ◽  
Symptomatic Knee Osteoarthritis ◽  
Symptomatic Knee ◽  
Wear And Tear ◽  
And Function ◽  
Cellular Matrix

Knee osteoarthritis is a degenerative "wear and tear" disorder affecting mainly population over 50 years old. It can also present in younger people, especially after an injury or as a part of other diseases. While many therapeutic options exist for knee osteoarthritis, none of them has the potential to cure this condition. Cellular Matrix represents a combination of natural non-crosslinked hyaluronic acid (HA), thixotropic cell separation gel, and sodium citrate anticoagulant solution. A combination of Cellular Matrix with autologous platelet-rich plasma (A-PRP) is a novel therapeutic approach to the management of knee osteoarthritis. It is assumed that the active components HA and PRP have a synergistic effect contributing to a better therapeutic outcome in patients with knee osteoarthritis. Physiotherapy could provide an additional benefit. This is a retrospective pilot study assessing the potential benefit of Cellular Matrix and A-PRP combined with physiotherapy in the management of chronic knee osteoarthritis. Twenty-five patients were enrolled in the study and injected with three doses of Cellular Matrix combined with A-PRP with a time span of 2 weeks between each injection. All patients received standardized physiotherapy. The results showed that 68% of patients achieved more than 50% improvement in pain, stiffness, and function of the knee joints. There were no adverse reactions. This retrospective pilot study confirmed the positive effect of PRP and HA combination in the management of mild and moderate knee osteoarthritis. These preliminary results need to be verified in randomized control trials.

A single intraarticular platelet-rich plasma improves pain and function for patients with early knee osteoarthritis: Analyses by radiographic severity and age

2021 ◽  
pp. 1-10
Author(s):  
Shu-Fen Sun ◽  
Chien-Wei Hsu ◽  
Huey-Shyan Lin ◽  
I-Hsiu Liou ◽  
Yi-Chun Chou ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Platelet Rich Plasma ◽  
Age Group ◽  
Radiographic Severity ◽  
Knee Oa ◽  
Patients Satisfaction ◽  
Younger Age ◽  
Subgroup Analyses ◽  
The Mean ◽  
And Function

BACKGROUND: Most studies use platelet-rich plasma (PRP) requiring multiple intraarticular injections for knee osteoarthritis (OA). OBJECTIVE: To investigate the efficacy of a single intraarticular PRP injection for patients with early knee OA and consider subgroup analyses of radiographic severity and age, respectively. METHODS: Forty-one patients with knee OA (Kellgren-Lawrence grade 1–2) received a single PRP injection into the target knee and were assessed at baseline and 1, 3, and 6 months postinjection. The primary outcome was the mean change from baseline in the visual analog scale (VAS) pain (0–100 mm) at 6 months postinjection. Secondary outcomes included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Lequesne index, single leg stance test (SLS), use of rescue analgesics and patients’ satisfaction. RESULTS: Thirty-eight patients completed the study. The mean pain VAS decreased significantly from 45.6 ± 13.0 mm at baseline to 16.9 ± 13.4 mm, 14.0 ± 13.1 mm and 15.5 ± 14.0 mm at 1, 3 and 6-month follow-ups (p< 0.001 for all). Significant improvements in WOMAC, Lequesne index, SLS and consumption of analgesics from baseline (p< 0.001 for all) were noted at each follow-up. Patients’ satisfaction was high. No serious adverse events occurred. Subgroup analyses revealed that patients with grade 1 OA showed significantly greater VAS pain reduction at 3 months (p= 0.006) and 6 months (p= 0.005) than patients with grade 2 OA. The older-age group (age > 60) showed significantly greater improvements in VAS pain, WOMAC function subscale scores and total scores at 6-month postinjection, compared with the younger age-group (age ≤ 60). The younger-age group reported better satisfaction at 1 and 3-month postinjection. CONCLUSIONS: One injection of PRP improved pain and function for 6 months for patients with early knee OA. This study supports putting the one-injection regimen into clinical practice. Further research is needed for more definite conclusions.

scholarly journals Two-Year Results of the PHANTOM High Flex Trial: A Single-Arm Study on the Atlas Unicompartmental Knee System Load Absorber in Patients With Medial Compartment Osteoarthritis of the Knee

2019 ◽  
Vol 12 ◽  
pp. 117954411987717
Author(s):  
Konrad Slynarski ◽  
Jacek Walawski ◽  
Robert Smigielski ◽  
Willem van der Merwe
Keyword(s):  
Knee Osteoarthritis ◽  
Invasive Surgery ◽  
Young Patients ◽  
Osteoarthritis Of The Knee ◽  
Normal Range ◽  
Medial Knee ◽  
Medial Compartment Osteoarthritis ◽  
Knee Oa ◽  
And Function ◽  
Post Implantation

The Atlas Knee System was designed to fill the gap between no longer effective conservative treatments and more invasive surgery for young patients with medial knee osteoarthritis (OA). This article reports on the 2-year results of a single-arm study of 26 subjects who previously reported favorable clinical outcomes 1 year post implantation. Western Ontario and McMaster Universities Osteoarthritis Index pain and function scores improved by a clinically meaningful amount relative to baseline, and subjects had a return to normal range of motion. This study confirmed that the benefit of a joint unloading device in the management of young patients with medial knee OA is maintained over 2 years. This trial was registered with ClinicalTrials.gov (NCT02711254).

scholarly journals POS1099 EFFICACY OF INTRA-ARTICULAR CORTICOSTEROID INJECTIONS IN KNEE OSTEOARTHRITIS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 829.2-830
Author(s):  
A. Najm ◽  
A. Alunno ◽  
C. Weill ◽  
J. Gwinnutt ◽  
F. Berenbaum
Keyword(s):  
Knee Osteoarthritis ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Medium Term ◽  
Short Term ◽  
Knee Oa ◽  
Randomized Controlled ◽  
And Function

Background:Knee osteoarthritis (OA) is a frequent degenerative disease representing an important health and economic burden. Symptomatic medical treatments available include intra-articular (IA) injections of corticosteroids (GC) but their efficacy is debated. In addition, safety signals regarding cartilage damage with IA GC have been highlighted in a few studies.Objectives:To perform a meta-analysis of studies assessing IA GC efficacy and safety in knee OA.Methods:A systematic literature review and a meta-analysis of randomized controlled trials (RCTs) assessing the effect of GC IA injections versus other interventions (IA Hyaluronic Acid, IA placebo, IA NSAID, oral NSAID or physiotherapy) in knee OA was performed. The effect of the interventions on pain and function were extracted from the single studies and pooled and are presented as short term (<6weeks), medium term (6-24 weeks) and long term (>24 weeks) follow-up period. Standardized mean differences (SMD) are reported.Results:Of 520 studies screened, 23 were included in the SLR and 14 subsequently included in the MA. While IA GC showed a superior effect compared to control on both pain (SMD -0.61 (95% CI -1,25, 0.03)) and function (SMD -1.02 (95% CI -2.14, 0.10)) in short term follow-up; long term follow-up analysis favored controls (IA HA, IA NSAID, physiotherapy) for both pain (SMD 0.68 (95% CI -0.11, 1.47)) and function (SMD 0.88 (95% CI -0.36, 2.12) outcomes (Figure 1). No difference was found between interventions in the medium term. Safety data were reported in 18/23 studies (n= 1936/2314 patients); and side effects were reported as follows: arthralgia (69 IA GC patients, 146 IA HA patients, and 20 saline patients); site injection pain (7 in the IA GC group, 2 in the IA saline group, 14 in the IA HA group); 16 post injection knee swelling without signs of septic arthritis in the IA GC group and 24 in the IA HA group. In one study assessing cartilage effects of GCs, the rate of cartilage loss was greater in the GC group with a reduction of cartilage thickness at 2 year compared to placebo group. No difference was observed in the progression of cartilage denudation or bone marrow lesion. On the contrary, another study showed no effect of injections on the cartilage structure.Conclusion:We demonstrate in this work that IA GC injections reduce pain and improve function in the early phase (≤6 weeks) of treatment. In the long term (≥24 weeks), other intervention such as IA HA injections or physiotherapy seem to be more efficient, but this effect was largely driven by single studies with large effect sizes and the comparators were heterogeneous.Figure 1.Knee pain outcome at short term (≤6weeks) (A), medium term (>6 & <24 weeks) (B), and long term (≥24 weeks) (C) follow up.Disclosure of Interests:None declared.

scholarly journals TMS-guided physiotherapy reduces pain and induces plasticity in the motor cortex in Chronic Knee Osteoarthritis

2018 ◽  
Vol 8 (2) ◽  
pp. 269-278
Author(s):  
Lucy Chipchase ◽  
Abrahão Fontes Baptista ◽  
Maxine Te ◽  
Simon Summers
Keyword(s):  
Electrical Stimulation ◽  
Motor Cortex ◽  
Knee Osteoarthritis ◽  
Vastus Lateralis ◽  
Quadriceps Strength ◽  
Vastus Medialis ◽  
Intervention Period ◽  
Knee Oa ◽  
Peripheral Electrical Stimulation ◽  
Maladaptive Plasticity

BACKGROUND: Knee osteoarthritis (OA) is associated with chronic pain, impaired function and loss of quality of life.  Brain maladaptive plasticity may be involved and prevent beneficial effects of exercises and other interventions. Neuromodulation with peripheral electrical stimulation guided by TMS mapping may specifically influence those maladaptive modifications. OBJECTIVE: To compare the cortical organization and excitability of three muscles (straight femuris, vastus lateralis and vastus medialis) in a subject with OA knee.  METHODS: This single case ABA study involved a 66 yo woman with knee OA that was considering an arthroplasty.  She was assessed for pain (VAS), function (WOMAC, ICOAP), and quadriceps strength one time a week, for 10 weeks (A – four weeks assessment; B – two weeks assessment and intervention; A – four weeks assessment). TMS mapping was performed at baseline, after the two-week intervention period and at the end of the study.  This examination initially revealed a prominent decrease in the volume of vastus medialis portion of the quadriceps muscle over the primary motor cortex (M1), which determined a peripheral electrical stimulation protocol specifically designed to increase this muscle’s excitability.  During the intervention period the participant also carried over specific exercises daily.  RESULTS: WOMAC scores, and quadriceps strength were not changed during the study period.  Improvements were seen in the three subscales of the ICOAP following the intervention. This clinical change was associated with an increase in vastus medialis and also Vastus lateralis, and a decrease in rectus femuris TMS map volumes, which were maintained until the last evaluation. CONCLUSION:  TMS mapping may guide specific interventions to counteract motor cortex maladaptive plasticity and positively influence pain and function in knee OA.

scholarly journals Bioavailable turmeric extract for knee osteoarthritis: a randomized, non-inferiority trial versus paracetamol

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Shubha Singhal ◽  
Nazer Hasan ◽  
Kirti Nirmal ◽  
Rohit Chawla ◽  
Shalini Chawla ◽  
...  
Keyword(s):  
Adverse Events ◽  
Knee Osteoarthritis ◽  
Womac Score ◽  
Secondary Outcome ◽  
Womac Pain ◽  
Knee Oa ◽  
Turmeric Extract ◽  
Tnf Α ◽  
Pain Subscale ◽  
And Function

Abstract Background To compare the efficacy and safety of bioavailable turmeric extract versus paracetamol in patients with knee osteoarthritis (OA). Methods In this randomized, non-inferiority, controlled clinical study, patients of knee OA were randomized to receive bioavailable turmeric extract (BCM-95®) 500 mg capsule two times daily or paracetamol 650 mg tablet three times daily for 6 weeks. The primary outcome measure was Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale. The secondary outcome measures were WOMAC total, WOMAC stiffness, and WOMAC physical function scores. Responder analysis of individual patients at different levels (≥ 20%, ≥ 50%, and ≥ 70%) for WOMAC score was calculated. TNF alpha and CRP levels were evaluated and adverse events (AE) were also recorded. Results Seventy-one and seventy-three knee OA patients, respectively in bioavailable turmeric extract and paracetamol groups, completed the study. Non-inferiority (equivalence) test showed that WOMAC scores were equivalent in both the groups (p value < 0.05) in all the domains within the equivalence limit defined by effect size (Cohen’s d) of 0.5 whereas CRP and TNF-α were better reduced with turmeric extract than paracetamol. After 6 weeks of treatment, WOMAC total score, pain, stiffness, and function scores got a significant improvement of 23.59, 32.09, 28.5, and 20.25% respectively with turmeric extract. In the turmeric extract group, 18% of patients got more than 50% improvement and 3% of patients got more than 70% improvement in WOMAC pain and function/stiffness score and none of the patients in the paracetamol group met the criteria. CRP and TNF-α got significantly reduced (37.21 and 74.81% respectively) in the turmeric extract group. Adverse events reported were mild and comparatively less in the turmeric extract group (5.48%) than in the paracetamol group (12.68%). Conclusion The results of the study suggest that bioavailable turmeric extract is as effective as paracetamol in reducing pain and other symptoms of knee osteoarthritis and found to be safe and more effective in reducing CRP and TNF-α. Trial registration Clinical Trials Registry – India CTRI/2017/02/007962. Registered on 27 February 2017

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