P Dieppe

..The authors also believe that the academic community striving to provide help for people who have OA should bear in mind the concept that there is "too much medicine" [37]...

..Central pain sensitisation can also occur, and psychosocial factors are important determinants of pain severity. We present a stepwise approach to the management of osteoarthritis...

..After controlling for the influence of age and gender, there was no significant difference in the rate of return to sport according to the type of operation...

..To carry out a critical appraisal of the literature in an attempt to assess the current value of synovial fluid (SF) analysis in the diagnosis of joint disease...

..To determine the population requirement for total knee replacement (TKR) in England...

..Without such changes there is a danger that 'institutional ageism' will persist in the health service...

..To assess the associations between pain, loss of function, and radiographic changes in knee osteoarthritis (OA), taking into account both the patellofemoral and tibiofemoral compartments...

..They are considered slowly progressive disorders, often resulting in severe pain or disability and the need for joint replacements. There have been few longitudinal studies of progression to inform individual prognoses in primary care...

..Dignity is a complex concept and there is little empirical research to show how older people view dignity. This study, using qualitative methods, explored the concept of dignity from the older person's perspective...

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..To explore patients' perspectives of need for total joint replacement associated with decision making in orthopaedic consultations for hip or knee osteoarthritis...

..Early recognition and treatment of rheumatoid arthritis is important to prevent irreversible joint damage. Anti-citrullinated peptide antibodies (ACPA) have been suggested for early diagnosis...

..To explore the experience of night pain in people with hip or knee osteoarthritis (OA)...

..To apply a new method of analysis to 2 large qualitative datasets in order to examine differences in osteoarthritis (OA) experience according to the affected joint (knee or hip) and sex...

..To examine the experiences of communication between older people and health and social care providers in six European countries...

..We did a systematic review to assess the effectiveness of community-based complex interventions in preservation of physical function and independence in elderly people...

..To investigate determinants of deterioration or improvement in disability in people with chronic hip and knee pain...

..People with musculoskeletal disease often have reduced walking speed. We investigated determinants of slower walking, other than musculoskeletal disease, that might provide valuable additional targets for therapy...

..To explore the pain experience of persons with chronic pain of the hip or knee in the context of self-assessment instruments commonly used to assess pain severity in individuals with osteoarthritis...

..These issues reflect those that have arisen previously in patients with musculoskeletal pain, and need to be considered when assessing persistent joint pain, both before and after joint replacement...

..This provides support for the inclusion of pressure algometry in studies assessing pain perception abnormalities in OA...

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..The authors provide examples of alternative approaches, concluding that there is real scope for improving assessment and measurement of musculoskeletal pain in the clinical setting...

..To improve patient selection for TKR, future research needs to focus on developing a pre-operative screening protocol to identify those patients at risk of medically unexplained pain and disability after TKR...

..We set out to estimate the population requirement for primary total hip replacement in England...

..To understand reasons for compliance and non-compliance with a home based exercise regimen by patients with osteoarthritis of the knee...

..CONCLUSIONS: There is an urgent need for guidelines, standardization and education about the use of synovial fluid assays in the UK...

..However, further research is required to improve the evidence base of the use of nonpharmacologic interventions in and the overall management of osteoarthritis...

..There is a significant deprivation based gradient in rates. If current trends continue there would be almost 47 000 primary hip and 54 000 primary knee operations annually by 2010...

..These group differences appeared to be due to deteriorations in the control group more than improvements in the disclosure group...

..CONCLUSION: The treatment package produced small improvements in knee pain scores and quadriceps muscle strength 10 weeks after the end of the treatment period. There was no difference between the 2 groups at 12 months...

..Concerns about lack of dignity centred on lack of privacy, mixed sex wards, forms of address and loss of independence. The study suggested that older people do not complain about care for fear of retaliation...

..These studies have emphasized the huge variation in disease severity at the time of surgery. The challenge now is to use and implement our findings for maximum patient benefit...

..But much more remains to be done...

..To consider the reasons and context for test ordering by doctors when faced with an undiagnosed complaint in primary or secondary care...

..Virtues and vices possessed by patients may affect their quality of life and how well they cope with disease. The objective of this study is to assess the relevance of the concept of virtue and vice to patients with chronic arthritis...

..We used standard and cumulative random-effects meta-analyses of randomised controlled trials and observational studies to establish whether robust evidence on the adverse effects of rofecoxib was available before September, 2004...

..We would encourage health professionals to acknowledge patient expertise and to consider the expertise of certain patients as a valuable educational resource both for themselves and for other patients...

..Those with the most severe disease at the time of operation made greater gains to those with less disease, but remained in worse health at 5 years, suggesting that earlier surgery may be preferable...

..Previous meta-analyses described moderate to large benefits of chondroitin in patients with osteoarthritis. However, recent large-scale trials did not find evidence of an effect...

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..There was a nonsignificant association between definite bone attrition and night pain. CONCLUSION: Bone attrition is an additional dimension of knee OA that can be measured reliably. Definite attrition may be associated with night pain...

..To compare the efficacy and safety of intraarticular hylan and 2 hyaluronic acids (HAs) in osteoarthritis (OA) of the knee...