Clinical Research Directory

Effects Of Sensor Assisted Neuro-muscular Exercise Vs Electrical Stimulation On Bio-mechnical And Functional Parameters In Grade II And III Knee Osteoarthritis.

This two-arm randomized controlled trial compared Sensory-Assisted Neuromuscular Exercise (Group A) with Electrical Stimulation (Group B) in 40 adults aged 40-65 with Kellgren-Lawrence Grade II-III knee osteoarthritis, recruited from Ziauddin Hospital and Nemat Begum Hamdard Hospital. Both interventions were given three times a week for eight weeks, with outcomes assessed at baseline, week 8, and week 12 across eighteen variables covering pain, stiffness, function, range of motion, muscle activation, strength, alignment, and quality of life. Both groups improved significantly, but the neuromuscular exercise group outperformed electrical stimulation on most outcomes by week 12. Only the HKA alignment angle remained unchanged in both groups, as expected for a fixed skeletal measure. The authors conclude that neuromuscular exercise should be prioritized as a first-line conservative treatment, with electrical stimulation serving as an adjunct.

Condylar Offset and Outcomes in Primary Total Knee Arthroplasty

This prospective cohort study aims to evaluate the effect of posterior condylar offset (PCO) and anterior condylar offset (ACO) changes on functional outcomes after primary total knee arthroplasty (TKA). Standardized imaging and clinical assessment protocols will be used to determine optimal PCO and ACO ranges associated with improved postoperative range of motion, patient-reported outcomes, and reduced anterior knee symptoms.

Telerehabilitation Versus Clinic-Based Rehabilitation for Functional Recovery Following Primary Total Knee Arthroplasty

The goal of this clinical trial is to determine if rehabilitation delivered by telehealth works as well as rehabilitation delivered in person at a clinic, for people recovering from total knee replacement surgery. The main question it aims to answer is: • Does rehabilitation by video call lead to knee-related quality of life that is just as good as rehabilitation completed in person at a clinic? Researchers will compare a telehealth group to a clinic group to see if telehealth rehabilitation works as well as in-person rehabilitation. Participants will: * Take part in 9 rehabilitation sessions over 6 weeks, either by video call from home or in person at a clinic * Follow a home exercise program using an online app * Answer questions about their knee and daily activities before surgery, and again at 7 weeks, 6 months, and 12 months after surgery * Have their knee movement and physical abilities, such as walking speed and climbing stairs, measured by a therapist before surgery, and again at 7 weeks, and 12 months after surgery

Popliteus and Quadriceps Muscle Thickness and Clinical Parameters in Knee Osteoarthritis

This study aims to examine the relationships between the ultrasonographic muscle thicknesses of the popliteus and quadriceps muscles and functional capacity, balance, and pain levels in elderly patients with knee osteoarthritis (KOA). Knee osteoarthritis is a major degenerative joint disorder causing pain, stiffness, and reduced mobility, where surrounding muscle architecture plays a pivotal role in functional performance and joint stability. The study will recruit approximately 150 participants aged 65 years and older with Grade 3-4 KOA (Kellgren-Lawrence) and intact cognitive status (SMMSE score ≥24) presenting to the Physical Medicine and Rehabilitation Outpatient Clinic of Afyonkarahisar Health Sciences University Health Application and Research Center, while excluding individuals with central nervous system, visual pathologies, or prior lower extremity surgeries. Muscle thicknesses of the popliteus and quadriceps (rectus femoris and vastus intermedius) will be measured via high-frequency B-mode ultrasonography by a specialist physician, using standardized anatomical landmarks and patient positioning. Functional capacity and mobility will be evaluated using the Timed Up and Go (TUG) and 5-Times Sit-to-Stand (5STS) tests, balance and proprioception via the Romberg Test, and knee-specific functional status and pain severity using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Visual Analog Scale (VAS).

Efficacy and Safety of GNSC-001 Intra-articular Injection for Knee Osteoarthritis

The goal of this clinical trial is to learn if GNSC-001 works to treat knee osteoarthritis in adults. It will also learn about the safety of GNSC-001. The main questions it aims to answer are: 1. Does GNSC-001 lower daily knee joint pain and improve function in participants? 2. What medical problems do participants have when taking GNSC-001? Researchers will compare GNSC-001 to a placebo (a look-alike substance that contains no drug) to see if GNSC-001 works to treat knee osteoarthritis. Participants will: 1. Receive a single injection of immune-modulation, and GNSC-001 or a placebo, in their knee 2. Take an oral immune-modulating pill every day for the first 22 days 3. Visit the clinic at least 9 times over 2 years for checkups and tests 4. Keep a diary of their symptoms and the number of times they use a rescue medication

Comparing Pain Science Education to Biomedical Education for People With Knee Osteoarthritis: A Randomized Controlled Trial

Knee osteoarthritis (OA) is a common cause of pain and disability in older adults. Many people with knee OA believe that pain is primarily caused by joint damage or "wear and tear." These beliefs may contribute to fear of movement, reduced physical activity, and lower engagement in recommended self-management strategies. However, current evidence suggests that pain is influenced by multiple biological, psychological, and social factors and is not always directly related to the degree of structural joint changes visible on imaging. Pain Science Education (PSE) is an educational approach designed to improve understanding of pain by explaining the complex factors that contribute to the pain experience. In contrast, traditional biomedical education focuses primarily on structural joint pathology as the source of symptoms. Although patient education is recommended as a first-line intervention for knee OA, little is known about whether PSE is more effective than biomedical education in changing beliefs, improving disease understanding, or influencing behavior and physiological responses in older adults with knee OA. The purpose of this randomized controlled trial is to compare the effectiveness of PSE with standard biomedical education in community-dwelling older adults aged 55 years and older with knee OA. Eighty-two participants will be randomly allocated to receive either PSE or biomedical education through an interactive website-based educational platform. The primary outcome is osteoarthritis conceptualization, assessed using the Osteoarthritis Conceptualization Questionnaire (OACQ). Secondary outcomes include physiological measures of nervous system functioning, including heart rate variability, electrodermal activity, eye-tracking measures, and temporal summation testing. The study will also assess movement behaviors using accelerometry, including sleep, sedentary behavior, and physical activity across a 24-hour day. Additional outcomes include self-efficacy, fear of movement, knee pain, physical function, well-being, exercise intentions, and intentions regarding knee replacement surgery. Participants will complete baseline questionnaires and one week of physical activity monitoring before attending an in-person assessment. During the in-person visit, participants will complete physiological and sensory testing and review the educational materials assigned to their group. Participants will then complete a talk-aloud exercise to explore how they interpret and engage with the educational content. Following the visit, participants will complete a second week of physical activity monitoring and follow-up questionnaires. The investigators hypothesize that participants receiving PSE will demonstrate greater improvements in OA conceptualization than those receiving biomedical education. Exploratory analyses will examine whether PSE is associated with differences in nervous system responses, movement behaviors, self-reported outcomes, and whether these effects differ according to sex and gender. Findings from this study may help inform evidence-based educational strategies for older adults living with knee OA.

The Predictive Value of Ultrasonographic Quadriceps Muscle Parameters for Genicular Nerve Block Outcomes in Knee Osteoarthritis

The goal of this observational study is to learn whether thigh muscle structure can help predict pain relief after a genicular nerve block in people with knee osteoarthritis. A genicular nerve block is an injection used to reduce pain signals from the knee. The main questions are: * Are muscle thickness, fiber length, and fiber angle linked to pain relief after the procedure? * Are these muscle measurements linked to changes in physical function and quality of life? Participants are adults aged 50 to 80 with long-term pain from osteoarthritis in one knee. They are already scheduled to receive a genicular nerve block as part of their regular medical care. The study does not assign participants to receive this procedure. Before the procedure, researchers will use ultrasound to measure the vastus lateralis muscle in the thigh. Participants will also answer questions about pain, daily function, and quality of life. Researchers will repeat these assessments after 1 hour, 3 weeks, and 3 months. Pain relief will be considered successful when pain is at least half as severe as it was before the procedure.

Comparison of Platelet-rich Plasma and Activated Cytokine-rich Serum Injection Treatments in Patients With Knee Osteoarthritis. (KOA PRP ACS)

The effects of single dose injection of platelet rich plasma or conditioned serum in the knee joint in patients with knee osteoarthritis will be compared

Effects of Motivational Interviewing on Pain Self-Efficacy and Exercise Behavior in Individuals With Knee Osteoarthritis

This randomized controlled trial aims to investigate the effects of motivational interviewing added to a neuromuscular exercise and home exercise program on pain self-efficacy, exercise behavior, pain intensity, physical performance, and functional status in individuals with knee osteoarthritis. Sixty individuals diagnosed with knee osteoarthritis will be randomly allocated to either an intervention group or a control group. The intervention group will receive motivational interviewing in addition to neuromuscular exercise and a home exercise program, whereas the control group will receive neuromuscular exercise and the same home exercise program. Outcomes will be assessed at baseline, immediately after the intervention, and six weeks after the intervention.

Is BMI Outdated in TKA Patient Selection? Assessment of the Impact of Pre-tubercular Subcutaneous Tissue Thickness and the Risk of Postoperative Infection Following Total Knee Arthroplasty

While Body Mass Index (BMI) is currently used as a primary tool for risk stratification in patients undergoing Total Knee Athroplasty(TKA), its limitations raise concerns regarding its accuracy and fairness in guiding surgical decision-making. In particular, reliance on BMI alone may lead to the exclusion of patients who could safely benefit from surgery, while failing to identify others at increased risk due to unfavourable local anatomical factors. Pre-tubercular subcutaneous fat thickness (PTFT) offers a simple, reproducible, and anatomically relevant measurement that directly reflects the soft tissue envelope at the operative site. As such may provide a more clinically meaningful assessment of infection risk than BMI. This study aims to evaluate the association between PTFT and postoperative infection following TKA. By doing so, it seeks to determine whether PTFT could serve as an adjunct or alternative risk stratification tool in clinical practice. The findings of this study have the potential to inform a more individualized approach to patient selection and preoperative counselling, improving shared decision-making and resource utilisation.

How Patient Education Helps Patients With Chronic Musculoskeletal Disorders Stick to Home Exercise for Pain Relief.

The study aims to evaluate the effectiveness of a structured patient education program in enhancing adherence to prescribed home exercise regimens in individuals with chronic low back pain, knee osteoarthritis, and shoulder pain.

Effects of Various Types of Ultrasound Therapy in Knee Osteoarthritis

Knee osteoarthritis (KOA) is a degenerative joint condition characterized by degeneration, which is commonly attributed to the cumulative effects of mechanical stress and the slow deterioration of articular cartilage. KOA is a highly prevalent musculoskeletal disorder that affected 300 million people globally in 2017. It can affect any joint, although the most commonly affected are the knees, hands, hips, and spine

The Effect of Lipedema on Knee Osteoarthritis

This study will be one of the few to examine the effect of lipedema on knee osteoarthritis in a comparative manner with a control group within the same osteoarthritis context. Although the relationship between obesity and osteoarthritis has been extensively studied in the literature, the effect of specific adipose tissue pathologies, such as lipedema, on osteoarthritis has not been sufficiently investigated. This study aims to demonstrate the independent effect of lipedema on osteoarthritis, evaluate clinical and ultrasonographic parameters together, and contribute to early diagnosis and targeted rehabilitation strategies.

Laser vs Lontophoresis in KOA

This randomized controlled trial aims to compare the effectiveness of laser therapy and iontophoresis in patients with knee osteoarthritis. The study will evaluate pain reduction, functional improvement, and knee joint mobility following

Comparison Between Velys J&J Robotic-assisted and Cori S&N Robotic-assisted Total Knee Arthroplasty

This randomised controlled trial will include patients with end-stage osteoarthritis of the knee undergoing primary TKR. Patients meeting the criteria that consent to be in the study will be randomised at a ratio of 1:1 to either Velys J\&J robotic-assisted or Cori S\&N robotic-assisted TKR. The primary objective will assess pre- and postoperative HKA angle, CPAK and range of motion using goniometer to compare two groups.The secondary objectives are to compare patient expectation, functional ability, quality of life using functional 48-point Oxford Knee Score and Forgotten joint score.

Perturbation Based Balance Training Versus Progressive Neuromuscular Training as an Adjunct to Conventional Physiotherapy for Pain Reduction and Functional Improvement in Knee Osteoarthritis

This is an RCT aims to explore Perturbation-Based Balance Training versus Progressive Neuromuscular Training as an Adjunct to Conventional Physiotherapy for Pain Reduction and Functional Improvement in Knee Osteoarthritis.

Handheld MPI Imaging to Track Stem Cells in Osteoarthritis

This clinical trial aims to evaluate the use of a handheld Magnetic Particle Imaging (MPI) device for real-time, non-invasive monitoring of human umbilical cord-derived mesenchymal stromal cells (UC-MSCs) in patients with knee osteoarthritis (OA). The primary objective is to visualize and quantify the distribution, retention, and survival of SPIO (superparamagnetic iron oxide)-labeled MSCs within the joint space following intra-articular injection. By correlating MPI signal dynamics with established clinical outcomes (e.g., WOMAC, VAS scores) and anatomical MRI assessments, the study seeks to predict treatment efficacy and optimize therapeutic strategies for OA. Current assessment of MSC therapy relies largely on MRI for structural evaluation, which has limited sensitivity for tracking early cell viability and migration. MPI offers high-contrast, radiation-free functional imaging capable of directly detecting SPIO-labeled cells. This study will enroll patients with mild-to-moderate OA (Kellgren-Lawrence grade II-III). Participants will receive a single injection of ferumoxytol-labeled UC-MSCs into the affected knee. MPI scans will be performed at multiple timepoints (day 1, 3, 7, and 30) to monitor cell homing, retention rate, and signal decay. MRI will be used in parallel to evaluate cartilage morphology and synovial changes. The study expects to demonstrate that MPI can effectively track MSC behavior in vivo, providing a novel tool to understand cell therapy mechanisms, assess treatment response early, and potentially guide personalized OA management.

Different Hold Durations in Isometric Exercises

this stuy tries to evaulate the best contraction (hold time) during isometric effort that can provide the best therapeutic effects on muscular performance in patients with knee osteoarthritis

Knee Osteoarthritis Rehab: High-Intensity Laser vs Classical Modalities

This study aims to compare the effectiveness and safety of High-Intensity Laser Therapy (HILT) with conventional physical therapy treatments in patients with knee osteoarthritis. Knee osteoarthritis is a common condition, especially in older adults, causing pain, stiffness, reduced movement, and difficulty performing daily activities. Current treatments focus on reducing pain and improving joint function. In this study, 100 patients with knee osteoarthritis will be divided into two groups. One group will receive HILT combined with therapeutic exercises, while the other group will receive conventional physical therapy modalities along with the same exercises. The treatment outcomes will be evaluated over time. The main outcomes include pain reduction (measured by pain scales such as WOMAC and VAS), improvement in joint function, and structural changes in the knee assessed by MRI. In addition, laboratory tests will be used to measure inflammation, cartilage health markers, and oxidative stress before and after treatment. The goal is to determine whether HILT provides better pain relief, improves joint function, and is safe compared to standard therapy. The results may help improve rehabilitation strategies for patients with knee osteoarthritis.

Comparing Treatment of Knee Osteoarthritis With Triamcinolone Injections Using 40mg With Landmark Guidance and 20mg With Ultrasound Guidance

The purpose of this study is to determine whether a lower dose of corticosteroid injection with ultrasound-guidance for the treatment of knee osteoarthritis can be as effective as a higher dose that is landmark-guided. With landmark-guided dosing, it may be reasonable to use a higher amount of corticosteroid in order to ensure a sufficient amount of the medication is administered, however these injections carry the risk of side effects. Alternatively, with the use of ultrasound, it may be reasonable to use less corticosteroid, possibly decreasing the risk of side effects and increasing patient satisfaction.

An Open-Label, Double-Treatment Group Study to Evaluate the Efficacy and Safety of Human Allogeneic Bone-Marrow- Derived Mesenchymal Stromal Cell Product StromaForte Compared With Hyaluronic Acid for the Treatment of Knee Osteoarthritis

StromaForte injection for knee OA

Cryoneurolysis Prior to Total Knee Arthroplasty (CRYO-TKA Trial)

Approximately 20-30% of patients experience persistent pain after a Total Knee Arthroplasty (TKA). This study investigates whether percutaneous cryoneurolysis of genicular nerves can reduce pain and improve physical function when performed at least 24 hours before surgery. Participants will be randomized to receive either the cryoneurolysis procedure + TKA or TKA only. Results will be tracked for 6 months to see if the intervention improves long-term recovery and quality of life.

Effects of 9 Points Electrical Dry Needling in Knee Osteoarthritis

The study will be conducted to compare effects of 9 points electrical dry needling along with standard physical therapy and standard physical therapy alone in knee osteoarthritis patients.

A Retrospective and Prospective Study: Monocompartimental Knee Arthroplasty Combined With Anterior Cruciate Ligament Reconstruction Surgery - a Pilot Study

This study aims to collect datas about patient who underwent simultaneous monocompartimental knee replacement and anterior cruciate ligament recontruction