Neoplasms

Skin and Connective Tissue Diseases

All Conditions

Nervous System Diseases

Heart and Blood Diseases

Musculoskeletal Diseases

Symptoms and General Pathology

Wounds and Injuries

Breast Neoplasms

Stroke

Osteoarthritis

Osteoarthritis, Knee

Frailty

Brain Injuries

Brain Injuries, Traumatic

Brain Diseases

Central Nervous System Diseases

Craniocerebral Trauma

Trauma, Nervous System

Both acutely admitted stroke patients undergoing rehabilitation and chronic recovered stroke outpatients will be recruited.

Both acutely admitted TBI patients undergoing rehabilitation and chronic recovered TBI outpatients will be recruited.

For patients with chronic knee osteoarthritis.

Low Ai Mei Jaclyn

Karen Chua

The aging population and its accompanying burden from non-communicable chronic diseases predicts an increasing impact imposed by frailty on healthcare systems. This is due to a lack of normative data for older adults and reliable risk stratification methods to develop effective approaches to the prevention of frailty.

In this study, the investigators plan to form a common dataset for phenotype identification, risk stratification of frailty and its targeted treatment plans in the at-risk and mildly frail population.

Osteosarcopaenia and multimorbidity have emerged as two key antecedent factors driving the cycle of frailty, leading to adverse outcomes. However, it remains unclear how multimorbidity and/or osteosarcopaenia act singly or in concert to influence the expression and trajectory of the frailty continuum.

OPTIMA-C will develop unifying administrative and data platforms, exploring the feasibility of inclusive screening for sarcopaenia early during rehabilitation hospital stay. Early muscle ultrasound will also be utilised to determine key muscles possibly predictive of rehabilitation functional or global outcomes in the studied populations and their correlation with acute disease outcomes. Digital markers are quantified and correlations are investigated with physical, muscle and bone imaging findings.

Venous blood samples will be collected (50ml; about 10 teaspoons) for lab assay to assess metabolic health and inflammation

Targeting Osteosarcopaenia and Multimorbidity for Frailty Prevention

Targeting Osteosarcopaenia and Multimorbidity for Frailty Prevention Through Identification and Deep Phenotyping Methods in Healthy Aging and High-burden Disease Cohorts.

Based off different outcomes determined in the study

Based on CFS - 9-point clinical assessment tool evaluating an individual's frailty status; maximum score: 9; higher score indicates increased frailty.

Measured using weak electrical current passed from feet to estimate proportion of muscle, fat and water mass.

Measures 3 components: (1) 5 times chair stand test; (2) Balance test; (3) Gait speed (4m walk test). Score from 0-12 with higher score indicating greater functional capacity.

Measured seated with arms on a table bent to 90° using a dynamometer (mean of 3 readings will be recorded)

Determines state of muscle health of arm, thigh and jaw muscles through size, area and structural properties.

5-point questionnaire; (1-2 point) indicates pre-frail, (3-5 points) indicates frail

Rehabilitation Research Institute of Singapore (RRIS)

Woodlands Health (WH)

Tan Tock Seng Hospital

Necrosis

Pain

Arthritis

Joint Diseases

Rheumatic Diseases

Collagen Diseases

Central Nervous System Depressants

All Drugs and Chemicals

Anesthetics

Anesthetics, Local

30 patients had moderate knee osteoarthritis

30 patients had severe knee osteoarthritis

The patient was put in 20 degree flexion in supine position with the knee. Under aseptic conditions, a 21-gage needle was used to inject 5 mL of PRP into the suprapatellar knee joint pouch, using a superolateral method. Local anesthetics were not used. Patients were instructed after the injection to refrain from physical exercise for at least 24 hours but no restriction was specified regarding activities of daily living. Three IA-PRP injections were administered at 2-week intervals. The same physician who was engaged in selecting and testing participants did the injections

Intra-articular injection of platelet-rich plasma

Mohammed H Hassan, MD

A prospective study was performed on 90 patients were included and categorized into mild (30 cases, moderate (30 cases) and severe (30 cases) knee OA. Three intra-articular (I.A) injections of PRP, 2 weeks a part, were received. Pain score and MRI Osteoarthritis Knee Score (MOAKS) were assessed. Serial synovial fluid cytokines assays in the form of Tumor necrosis factor-α (TNF-α) and Macrophage migration inhibitory factor (MIF), were performed using commercially available ELISA assay kits. The assays were performed pre-injection (S1), two weeks from the 1st I.A injection and two weeks from the 2nd I.A injection (S3) for all included patients.

Background: Osteoarthritis (OA) is a multifactorial disease that commonly affects the knee. Tumor necrosis factor-α (TNF-α) is able to regulate inflammation in OA. Macrophage migration inhibitory factor (MIF) may be involved in the pathophysiology of arthritis. Platelet-rich plasma (PRP) may reduce pain associated with OA. The current study aimed to assess the possible therapeutic effects of PRP in patients with knee OA of various severities.

Methods: A prospective study was performed on 90 patients were included and categorized into mild (30 cases, moderate (30 cases) and severe (30 cases) knee OA. Three intra-articular (I.A) injections of PRP, 2 weeks a part, were received. Pain score and MRI Osteoarthritis Knee Score (MOAKS) were assessed. Serial synovial fluid cytokines assays in the form of Tumor necrosis factor-α (TNF-α) and Macrophage migration inhibitory factor (MIF), were performed using commercially available ELISA assay kits. The assays were performed pre-injection (S1), two weeks from the 1st I.A injection and two weeks from the 2nd I.A injection (S3) for all included patients.

PRP preparation: The PRP needed for IA injection has been prepared under complete aseptic conditions. In order to avoid the effect of food intake on purified PRP, on the day of injection the patients were instructed to fast for 4 hours before blood collection. Approximately 20 mL of venous blood were drawn from the antecubital vein using an aseptic technique in an effort to avoid irritation and trauma to the platelets. Anti-coagulated blood was obtained in ten extraction tubes (2 mL each), containing sodium citrate. The tubes were then centrifuged at 2100 rpm at room temperature for 8 minutes to separate the blood in each tube into the citrated plasma, the buffy coat and the residual red blood cells ( RBCs) . Using a pipette, the PRP situated just above the selectively precipitated RBCs but not including the buffy coat was carefully aspirated from each tube. In each affected joint, 10-mL PRP samples (from the collected venous blood) were used for IA injection . For each intra-articular injection new fresh PRP samples were made from the patients.

Platelet-rich Plasma and Synovial Cytokines in Knee Osteoarthritis

Assessments of Therapeutic Effects of Platelet-rich Plasma in Knee Osteoarthritis: Possible Role of Inflammatory Cytokines

Using Visual Analog Scale (VAS) score to assess the pain score in patients with knee osteoarthritis will be done twice , pre-intra-articular injection of PRP and 2 weeks from the second I.A injection of PRP.

The VAS is a common tool that uses a 10 cm scale for pain intensity measurement, where 0= no pain and 10= unable to move.

Using ELISA assay kits, synovial fluid concentration of both TNF-α and MIF levels will be measured three times for the same patient (before injection, 2 weeks from the first injection and 2 weeks from the second injection) to explore the serial changes in their levels following IA i injection PRP.

Regarding MRI knee score will be done twice , pre-intra-articular injection of PRP and 2 weeks from the second I.A injection of PRP.

For assessment of both bone marrow abnormality or patella-femoral cartilage volume (grade I (mild if the lesion involves ˂33% of subregional volume); grade II (Moderate: if the lesion involves 33%- 66% of subregional volume), and grade III (severe: if the lesion involves ˃ 66% of subregional volume).Regarding synovitis: grade 1 (mild or small - fluid continuous in the retropatellar space); grade 2 (Moderate or medium - slight convexity of the suprapatellar bursa), and grade 3 (severe or large - evidence of capsular distension ). Meniscal desintegrity score of 0-3 applied for amount of extrusion in 4 locations: medial meniscus (medial and anterior extrusion) and lateral meniscus (medial and anterior extrusion).

Correlate visual Analog pain Scale and MRI Osteoarthritis Knee Score with the pre-injection cytokine synovial levels and synovial level values 2 weeks from the second IA injection of PRP

South Valley University

Associate Professor of Medical Biochemistry, Faculty of Medicine , South Valley University

Rare Diseases

Ganglion Cysts

Synovial Cyst

Cysts

Mucinoses

Connective Tissue Diseases

Chronic Graft Versus Host Disease

DRG-S for knee osteoarthritis patients with no history of knee surgery

DRG-S for knee osteoarthritis patients with history of surgical repair of the knee

Stimulation at L2, L3, L4 and S1 spinal levels

Dorsal Root Ganglion Stimulation

Kenneth B Chapman, MD

Tariq a Yousef, MD

Ahmad Amireh, BS

Dorsal root ganglion stimulation (DRG-S) may be able to treat mechanical pain caused by tissue injury or damage such as trauma or arthritis in addition to pain caused by nerve dysfunction or injury. The purpose of this study is to determine if dorsal root ganglion stimulation (DRG-S) can effectively treat arthritic pain of the knee.

Dorsal root ganglion stimulation (DRG-S) is a novel form of neuromodulation used to treat chronic neuropathic pain of the groin and lower extremities related to complex regional pain syndrome type I or II (causalgia). DRG-S has shown promise in treating traditionally mixed neuropathic and mechanical pain syndromes such as axial low back pain, suggesting DRG-S may be able to treat mechanical pain in addition to neuropathic pain. Additionally, in a rodent model of osteoarthritis of the knee, DRG-S alleviated pain related behavior in rats.

This open label feasibility study seeks to evaluate if dorsal root ganglion stimulation with Abbott's Proclaim Dorsal Root Ganglion Neurostimulator System can effectively treat osteoarthritis of the knee. Patients with either osteoarthritis of the non-operated knee or osteoarthritis of the surgically repaired knee will be trialed for one week with dorsal root ganglion stimulation to determine if they positively respond with 50% or greater pain relief. For those patients that have a successful trial, they will be implanted with a permanent stimulation device system and followed for one year post implant to measure knee pain, function and disability, and other related outcomes with sustained DRG-S therapy.

Patients will be seen and evaluated prior to DRG-S trial, and for those that receive permanent implants, re-evaluated at 1, 3, 6, 9 and 12 months after implant.

Subjects will undergo one week DRG-S trial, and for those that respond as defined by 50% or greater pain relief, proceed to DRG-S permanent device system implant

Dorsal Root Ganglion Stimulation for the Treatment of Arthritic Knee Pain

Dorsal Root Ganglion Stimulation Outcomes for the Treatment of Mechanical Knee Pain Among Patients With Osteoarthritis of the Surgical and Non-surgical Knee

All complications of DRG-S trial, implant, and stimulation therapy will be reported

Percent of DRG-S implanted patients that successfully respond to stimulation therapy as defined by \>=50% reduction in reported pain score from baseline

Patient's pain score using standard 10cm pain scale that represents a continuum between "no pain" and "worst pain."

At each study visit, subjects will complete WOMAC survey which assesses pain, stiffness, and function in patients with OA of the knee.

At each study visit, subjects will complete EQ-5D survey which assesses health-related quality of life

At each study visit, subjects will complete SF-36 MCS survey which assesses mental health

At each study visit, subjects will complete PDI survey which assesses pain-related disability

At each study visit, subjects will complete PDI survey which assesses patient's belief about the efficacy of treatment

Patient's dose of narcotic analgesics measured in morphine milligram equivalents (MME) and non-narcotic analgesics and dosages

Video recordings of motor task exams will be used to measure TUG, a performance-based measure of functional mobility which measures the time for subject to rise from a chair, walk three meters, turn around, return to the chair, and sit down.

Video recordings of motor task exams will be used to measure ROM of the index knee

Serum concentrations of molecular biomarkers related to knee OA including but not limited to C-telopeptide of crosslinked collagen type I and type II (CTX-I and CTX-II)

Radiologic classification of subject's knee x-ray to grade progression/severity of osteoarthritis

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Targeting Osteosarcopaenia and Multimorbidity for Frailty Prevention	NCT06073106	Stroke Traumatic Brain... Knee Osteoarthr... Breast Cancer		50 Years -	Tan Tock Seng Hospital
Platelet-rich Plasma and Synovial Cytokines in Knee Osteoarthritis	NCT04754685	Knee Osteoarthr...	Intra-articular...	25 Years - 65 Years	South Valley University
Dorsal Root Ganglion Stimulation for the Treatment of Arthritic Knee Pain	NCT05103527	Knee Osteoarthr... Knee Pain Chron... Knee Arthritis Knee Arthropath...	Dorsal Root Gan...	21 Years -	Spine and Pain Institute of New York
Platelet-rich Plasma and Synovial Cytokines in Knee Osteoarthritis	NCT04754685	Knee Osteoarthr...	Intra-articular...	25 Years - 65 Years	South Valley University
Targeting Osteosarcopaenia and Multimorbidity for Frailty Prevention	NCT06073106	Stroke Traumatic Brain... Knee Osteoarthr... Breast Cancer		50 Years -	Tan Tock Seng Hospital

Spots Global Cancer Trial Database for knee osteoarthritis