Abstract
Objective:
To evaluate the effectiveness of a conservative protocol for the relief of pain and dysfunction in a patient with knee osteoarthritis (OA).
Design:
Prospective interventional case report.
Patient:
A 54-year-old female presented with a complaint of moderate knee pain in both knees with an onset of approximately 3 years. The diagnosis was symptomatic OA of the knees.
Intervention and Outcome:
The patient was treated conservatively with active, passive, and nutritional therapy. The progress of the patient was scored by knee ranges of motion, the Lequesne index, and the WOMAC index at baseline and every four weeks there after. The total follow-up time was five months.
Results:
Positive trends were seen in the knee flexion ROM, the Lequesne index, and the WOMAC index.
Conclusion:
The treatment protocol in this study was effective for the treatment of knee OA. Conservative chiropractic treatment of knee OA has not been well documented in the literature. There is a need to document the effect of chiropractic care on the progression of OA. This case report may serve as a stepping-stone for prospective controlled trials concerning chiropractic management of knee osteoarthritis.
Keywords: chiropractic, osteoarthritis, knee, exercise, glucosamine, ultrasound, pulsed interferential current
Full text
PDF








Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Barclay T. S., Tsourounis C., McCart G. M. Glucosamine. Ann Pharmacother. 1998 May;32(5):574–579. doi: 10.1345/aph.17235. [DOI] [PubMed] [Google Scholar]
- Bellamy N., Buchanan W. W., Goldsmith C. H., Campbell J., Stitt L. W. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988 Dec;15(12):1833–1840. [PubMed] [Google Scholar]
- Bellamy N. Pain assessment in osteoarthritis: experience with the WOMAC osteoarthritis index. Semin Arthritis Rheum. 1989 May;18(4 Suppl 2):14–17. doi: 10.1016/0049-0172(89)90010-3. [DOI] [PubMed] [Google Scholar]
- Berkson D. L. Osteoarthritis, chiropractic, and nutrition: osteoarthritis considered as a natural part of a three stage subluxation complex: its reversibility: its relevance and treatability by chiropractic and nutritional correlates. Med Hypotheses. 1991 Dec;36(4):356–367. doi: 10.1016/0306-9877(91)90010-v. [DOI] [PubMed] [Google Scholar]
- Creamer P., Hochberg M. C. Osteoarthritis. Lancet. 1997 Aug 16;350(9076):503–508. doi: 10.1016/S0140-6736(97)07226-7. [DOI] [PubMed] [Google Scholar]
- Deal C. L., Moskowitz R. W. Nutraceuticals as therapeutic agents in osteoarthritis. The role of glucosamine, chondroitin sulfate, and collagen hydrolysate. Rheum Dis Clin North Am. 1999 May;25(2):379–395. doi: 10.1016/s0889-857x(05)70074-0. [DOI] [PubMed] [Google Scholar]
- Dexter P. A. Joint exercises in elderly persons with symptomatic osteoarthritis of the hip or knee. Performance patterns, medical support patterns, and the relationship between exercising and medical care. Arthritis Care Res. 1992 Mar;5(1):36–41. doi: 10.1002/art.1790050109. [DOI] [PubMed] [Google Scholar]
- Dieppe P. Strategies for the prevention of osteoarthritis. Int J Tissue React. 1993;15(3):93–97. [PubMed] [Google Scholar]
- Gottlieb M. S. Conservative management of spinal osteoarthritis with glucosamine sulfate and chiropractic treatment. J Manipulative Physiol Ther. 1997 Jul-Aug;20(6):400–414. [PubMed] [Google Scholar]
- Hochberg M. C., Altman R. D., Brandt K. D., Clark B. M., Dieppe P. A., Griffin M. R., Moskowitz R. W., Schnitzer T. J. Guidelines for the medical management of osteoarthritis. Part II. Osteoarthritis of the knee. American College of Rheumatology. Arthritis Rheum. 1995 Nov;38(11):1541–1546. doi: 10.1002/art.1780381104. [DOI] [PubMed] [Google Scholar]
- Lawrence R. C., Hochberg M. C., Kelsey J. L., McDuffie F. C., Medsger T. A., Jr, Felts W. R., Shulman L. E. Estimates of the prevalence of selected arthritic and musculoskeletal diseases in the United States. J Rheumatol. 1989 Apr;16(4):427–441. [PubMed] [Google Scholar]
- McAlindon T., Dieppe P. The medical management of osteoarthritis of the knee: an inflammatory issue? Br J Rheumatol. 1990 Dec;29(6):471–473. doi: 10.1093/rheumatology/29.6.471. [DOI] [PubMed] [Google Scholar]
- Minor M. A. Exercise in the treatment of osteoarthritis. Rheum Dis Clin North Am. 1999 May;25(2):397-415, viii. doi: 10.1016/s0889-857x(05)70075-2. [DOI] [PubMed] [Google Scholar]
- Setnikar I., Cereda R., Pacini M. A., Revel L. Antireactive properties of glucosamine sulfate. Arzneimittelforschung. 1991 Feb;41(2):157–161. [PubMed] [Google Scholar]
- Slemenda C., Brandt K. D., Heilman D. K., Mazzuca S., Braunstein E. M., Katz B. P., Wolinsky F. D. Quadriceps weakness and osteoarthritis of the knee. Ann Intern Med. 1997 Jul 15;127(2):97–104. doi: 10.7326/0003-4819-127-2-199707150-00001. [DOI] [PubMed] [Google Scholar]
- Tapadinhas M. J., Rivera I. C., Bignamini A. A. Oral glucosamine sulphate in the management of arthrosis: report on a multi-centre open investigation in Portugal. Pharmatherapeutica. 1982;3(3):157–168. [PubMed] [Google Scholar]
- da Camara C. C., Dowless G. V. Glucosamine sulfate for osteoarthritis. Ann Pharmacother. 1998 May;32(5):580–587. doi: 10.1345/aph.17214. [DOI] [PubMed] [Google Scholar]