Impact of soft tissue around the knee on the efficacy of extracorporeal shockwave therapy in knee osteoarthritis
Bibliographic record
Abstract
Abstract Background: Knee osteoarthritis (KOA) is the leading cause of knee pain in middle-aged and older individuals. In recent years, extracorporeal shockwave therapy (ESWT) has been applied to treat patients with KOA to reduce pain and improve function. We aimed to determine the association between the distribution of tissue around the knee joint and the efficacy of ESWT in KOA treatment. We were also interested in studying KOA pathogenesis from the perspective of imaging evaluation. Materials and methods: Patients (n=123) diagnosed with KOA who received ESWT were selected to participate in this study, and were grouped according to their body mass index (BMI). The treatment parameters were as follows: 8000 pulses, 2.0 bar, 0.25 mJ/mm 2 , and 6 Hz/s once per week for 8 weeks. The visual analog scale (VAS), Lequesne index, and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) were measured before and after treatment to assess knee pain and functional recovery in all patients and according to BMI groups. Radiographs were used to measure the richness of the soft tissue around the knee joint. The correlation between the distribution of tissue, pain, and functional improvement was analyzed using the receiver operator characteristic (ROC) curve. The effect of BMI and the distribution of tissue around the knee joint on the efficacy of ESWT treatment in KOA patients were evaluated. Results: A total of 123 patients were enrolled; 59 were in the normal or below normal BMI (<25 kg/m 2 ) category (NBB group) and 64 were classified as overweight and above (BMI ≥ 25 kg/m 2 ) (OAB group). All the patients showed a reduction in pain after treatment compared to that before treatment (P <0.01). As measured by VAS, after the intervention, pain in the OAB group decreased to a greater extent than that in the NBB group (P < 0.01). As measured by the Lequesne and WOMAC indexes, after the intervention, the functional index of the OAB group improved to a greater extent than that of the NBB group (P < 0.01). We determined through the area under the curve (AUC) that, with VAS as the demarcation criterion, when the tibial plateau soft tissue ratio (TPSTR), femoral intercondylar apex soft tissue ratio (FIASTR), and medial tibial soft tissue ratio (MTSTR) exceeded 1.538, 1.534, and 1.296, respectively, the patient's pain relief was more pronounced the ESWT treatment was better. With pain in WOMAC as the demarcation criterion, the TPSTR, FIASTR, and MTSTR also are positively correlated with pain relief in patients. When the Lequesne and WOMAC scores were the demarcation criteria, the patients' function improved significantly when the the patella apical soft tissue ratio (PASTR) exceeded 2.401 and 2.635, respectively. Conclusion: ESWT can effectively alleviate pain and improve knee function in patients with KOA, and the efficacy of ESWT is closely related to the abundance around the knee joint; the soft tissue around the knee joint should also be an important reference factor and the focus of research in KOA treatment.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".