This article should also mention boswellia, an herbal analgesic known in Aryuvedic medicine and widely available in health food stores as well as online. It is highly effective and, unlike NSAIDs, has no known side effects. 162.83.183.71 14:42, 29 September 2007 (UTC)
I have begun editing and adding to this article, feel free to edit and . 16, 2004.
Congenital hip luxation - if the article does not exist then you shouldn't remove the red link but write the article! It is a major health problem, and relatively simple to diagnose. In countries with regular child-health follow-up, the Ortolani test is often performed as a screening test, with ultrasound as second line. Treatment is simple, with plaster cast immobilisation. JFW | T@lk 09:45, 17 Nov 2004 (UTC)
Thank you for your help Jdwolff, this was my first attempt at editing. Your help is appreciated. User:Gilgameshfuel 17 Nov 2004
Feel free to delete that section if you see best, and thanks once again. I have had severe OA for three years now. User:Gilgameshfuel 18 Nov 2004
I tried double checking the article by GREEN GA that said over 80% for elderly, but couldn't access it. I do know the Farmingham studies, which are the most cited articles on osteoarthritis prevalence, state that 10% of people over 65 have osteoarthritis (Incidence and Natural History of Knee osteoarthritis in the Elderly 1995 Arthritis and Rheumatism). They said 82.7% PARTICIPATED in the follow up study from the original in 1987, and I suspect that GREEN GA or the whoever, might have got that prevalence wrong. Simonfrid ( talk) 16:34, 4 June 2008 (UTC)simonfrid
With diff not working 100% I am not sure how much was changed, but PM Poon ( talk · contribs) has effectively rewritten the whole page! Most of it sounds like reasonable edits, but use of edit summaries would have been helpful.
Is anyone willing to tidy up the references? JFW | T@lk 11:41, 19 September 2005 (UTC)
maybe hip luxation should be congenital hip subluxation?
a discussion of common x-ray findings would be helpful.
In the article it is mentioned a primary and secondary type of OA, but these types are not distinguised between when stating that there is no cure for OA. As far as I know, this is not correct. If OA is caused by trauma to the joint (not caused by a degenerative disease), there is options for treatment such as Autologous Chondrocyte Implantation. Whether this procedure is feasible probably depends on how far the OA has gotten, i.e. the condition of the remaining cartilage. I don't know enough about this topic to add this to the article, anyone who does? Hildre 10:19, 11 July 2006 (UTC)
OA affects nearly 21 million people in the United States, accounting for 25% of visits to primary care physicians, and half of all NSAID (Non-Steroidal Anti-Inflammatory Drugs) prescriptions. It is estimated that 80% of the population will have radiographic evidence of OA by age 65, although only 60% of those will be symptomatic (Green 2001).
Can someone update this with global data instead of just the US.
What about steem cells? I think some people are working on this kind of surgery in different countries. Can anyone specify something else? -- ZUIA2 23:08, 1 January 2007 (UTC)
A self help book, which was on NY Times best seller list, is The Arthritis Cure by Jason Theodosakis. LoopTel ( talk) 16:37, 22 December 2007 (UTC)
Chronic smokers have higher risk of OA. Cessation of smoking would at least delay further deterioration of the joints.
Suggest adding this comment to treatment. LoopTel ( talk) 13:23, 26 December 2007
(UTC)
The article says that glucosomine has NOT been helpful for the knee. My experience in speaking with a large number of people taking the glucosomine/chondroitin supplement have found help ONLY for their knees. I am a statistician with no statistical evidence, but wanted to tell you this.
Walk in any drugstore or vitamin store and you will see scores of brands consisting of glucosamine, chondroitin, and MSM, either separately or in combinations, all touting as treatment of osteoarthritis. Some even claim proof of efficacy through unnamed trials. When NY Times reported on FDA sponsored clinical trials that showed no benefit, interestingly enough the reporter ended the article with a personal note: "I don't care what the trial says. All I know is that without these supplements I am a prisoner in my own house. After taking these supplements, I can climb mountains." (citation needed) One possible explanation is that these supplements can be of benefit in mild cases but not in cases studied in the trials. LoopTel ( talk) 18:27, 5 December 2007 (UTC) —Preceding unsigned comment added by LoopTel ( talk • contribs) 18:19, 5 December 2007 (UTC)
In a study published in 2007, glucosamine sulfate appears to help patients avoid or delay total knee replacement (TKR). The study relates to treatment of knee OA with glucosamine sulphate for at least 12 months and up to 3 years and in an average follow-up of 5 years after drug discontinuation. The placebo group had twice as many TKR compared to those formerly receiving glucosamine sulphate. LoopTel ( talk) 02:22, 26 August 2008 (UTC) —Preceding unsigned comment added by LoopTel ( talk • contribs) 02:16, 26 August 2008 (UTC)
I have deleted the latest addition to this -- the statement that fishoil obviates the need for prescription medication. "www.TheKneeCenter.com" is a commercial endorsement for a Dr. Cooper -- hardly up to Wiki-standards for adequate support. Celia Kozlowski ( talk) 12:03, 2 April 2009 (UTC)
In a Fox News Channel talk show "Ask Dr. Manny" aired 12 February 2009, available for download from FoxNews.com, Dr. Mark Liponis told his listeners to take the following, divided into several doses daily, to relieve joint pain. Glucosamine 1500 mg, chondroitin 1200 mg, curcumin 1800 mg, fish oil EPA DHA 3000 mg, and vitamin D3 1000 IU. LoopTel ( talk) 17:52, 27 July 2009 (UTC)
Here are c. 10 summarized healing reports from osteoarthritis (through healing on the spiritual path): http://www.bruno-groening.org/english/heilungen/defaultheilungen.htm (go to chapter 10)
Kind regards, Dave
-- 83.173.234.146 20:53, 22 November 2006 (UTC)
I would like to see references to articles about the heritability of Osteoarthritis.
-- Herman 2 january 2007 (UTC)
Unreferenced statements such as, "found quite effective," "revolutionary," and, "the treatment is painless, safe and scientifically proven," without providing references to peer-reviewed or at least reputable sources show an obvious bias. Given the website of this company is provided, I would guess it stems from a commercial interest, or even a misplaced attempt at sharing what was a personally successful treatment; I have not investigated the writer to find out.
As I am not an editor I decided to note it as non-neutral and post this comment, instead of cleaning it up myself; at the moment I stick to grammar fixes.
—Podboy —The preceding unsigned comment was added by 199.212.21.22 ( talk) 21:27, 4 April 2007 (UTC).
There is an article in the Indian Journal of Aerospace Medicine which is peer-reviewed, which substantiates some of the above statements. --kv
Is this true? I have read that gout is the most common form of arthritis. 205.158.168.99 03:37, 5 June 2007 (UTC)Steve P.
Yes it is. Check the Farmingham study Simonfrid ( talk) 16:35, 4 June 2008 (UTC)simonfrid
I looked around but couldn't really find anything that suggested that humidity actually has an effect on arthritis. The closest is the idea that changes in barometric pressure might, but it seems like your body would come into equilibrium eventually wherever you were. If we can't find citations in support of it, then I think we ought to get rid of it, because it is likely unsupported by anything but anecdotes. -- The Hanged Man 15:02, 4 July 2007 (UTC)
Maybe one could rephrase the text to s.th. like "doctors report increased numbers of patients complaining of pain caused by OA in cold and humid conditions". Since packed waiting rooms would not qualify as "evidence" for a wiki article "anecdotes" might be all there will be for quite a while. Most researchers have their hands full finding treatment options. An interesting, but possibly unrelated fact is that researchers in Cardiff have found that cold feet reduce blood flow in the nose. If the same happened in the capilary system around the cartilage of OA joints that might be a link. (Maybe the guys in Cardiff will look into it somewhen.) Unconscious/involuntary muscle contractions (like e.g. shivering) might be another cause. (No one seems to have studied that yet either) —Preceding unsigned comment added by 71.236.23.251 ( talk) 16:51, 17 February 2008 (UTC)
Ok, I am only 19 and i suffer from chronic knee pain, muscle contractions and cracking noises. This has been so ever since an incident in Karate practice a few years ago when a roundhouse sent my knee the wrong way. Does this mean i have this sort of arthritis? PayneXKiller 20:35, 28 September 2007 (UTC)
Quite possibly, yes. I'm 47 and recently developed osteoarthritis after a bad fall. Medical people tell me I'm unfortunate to have it at my age. You may, like me, have what is known as patellar maltracking. If you haven't already, see a doctor for confirmation. You may need physiotherapy and a visit to a podiatrist. Eligius ( talk) 07:22, 10 June 2010 (UTC)
Are these terms exactly the same? This is as far as I got: -itis indicates inflammation and arthr- means joint if I got it right, and if osteo related to osseous it's bone. Osteoarthritis would then be bone-joint-inflammation. But what is an "-osis"? Is one term old and the other modern or is one a layman's term and the other the proper medical one?? thks. —Preceding unsigned comment added by 66.56.30.124 ( talk) 04:53, 5 February 2008 (UTC)
Wikipedia shouldn't be used for advertizing. —Preceding unsigned comment added by 146.9.22.121 ( talk) 14:00, 12 March 2008 (UTC)
Hello I would like to assis on this lemma but my English is not good enough. Would it be helpfull if I post in this discussion some recent PUBMED studies on the possibele causes of osteoarthritis and that somebody else makes the changes in the lemma. Regards, Willy Witsel, Netherlands —Preceding unsigned comment added by 217.120.103.16 ( talk) 11:22, 13 March 2008 (UTC)
I agree on gluco and chondro. These articles I use in The Netherlands to show not only pain relieve
but also therapeutic aspects
Would these documents be accpetable for this osteo article?? Regards Willy -- 217.120.103.16 ( talk) 13:22, 14 March 2008 (UTC)
If DDD and OA is the same, I can upload more images into Commons for the cervical vertebrae. I could also use some help in trying to place images into spine articles on Wikipedia. Please see my discussion page if you have time. MsTopeka ( talk) 13:41, 24 July 2008 (UTC)
Not entirely sure, but I don't think there is any actual decrease in Synovial fluid in this condition. Cheers!
-- 220.253.43.190 ( talk) 07:41, 19 October 2008 (UTC)
Given that natural supplements which don't have established efficiency are included should investigational drugs not be included as well. Calcitonin is on phase III trial, and other trials have already suggested efficiency. Besides, Calcitonin is already used for other conditions and noting prevent physicians to use it off-label.
I don't want to open a worldwar on chiropractic here, but IF it is going to be included as something that is useful for OA, this should be justified with the highest level of evidence -- placebo-controlled, double-blind clinical trials -- not blurbs from the American Chiropractic Association. What else are they going to say but that chiropractic works for OA -- and best to come in frequently for expensive manipulations? I have a brother-in-law who thinks it helps and a father who thought it helped exactly once and was a total waste of money thereafter. Show me the medical literature and I'll go along with keeping this section in. For now I'm going to pare it down and make it so it doesn't sound like such a commercial advertisement. Celia Kozlowski ( talk) 12:11, 26 March 2009 (UTC)
I wish people would just stick to talking about things that they truly have knowledge about. Simply claiming an absence of citation or study does not negate the validity or truth of the statement. Second if you're basing your entire position on one study that you claim to have read, your basis for that position is sorely lacking. After all I could claim just about anything I wanted to claim if I based those claims on a single study. BTW where's the citation on that study? Also, your implication that chiropractic treatment is "expensive" or a "total waste of money" is completely contradicted by actual long term government research demonstrating that chiropractic treatment is not only effective but also cost effective when compared to medical treatment for similar complaints. Furthermore, when was the last time you disputed a medical claim based on a lack of supporting studies or "proof?" If you've actually read any medical studies you'll find that most of them are not of the "highest level of evidence -- placebo-controlled, double-blind clinical trials" In fact, many of them have obvious confounding factors and conflicts of interest. Simply knowing the terminology does not mean that you understand what you're talking about. Then consider, since we're talking about OA, why it is that most of the general public thinks OA is caused by aging. If you're honest you'll realize that it is because most physicians have been telling their patients for generations that arthritis is caused by aging. "You're just getting old, accept it" Chiropractors have been telling their patients for generations that age although a factor (through time) is not the determinant of this disease; it's actually the biomechanics of the joints. Wikipedia got it right under the "Causes" section. However, if you want to understand why chiropractors claim that chiropractic treatment can help some cases of OA particularly spinal OA, consider something called Wolff's Law. It's in just about every first year students' physiology text book. Then look up the basis for this law called the Piezoelectric Effect. I'll let you connect the dots but please do at least a semblance of research yourself before you criticize someone else's comments. Also, consider that studies that seem to "prove" some scientific "fact" are often disputed or found faulty shortly thereafter. It may be more appropriate for you criticize the pharmacological or medical approach for lack of efficacy, higher risk for detrimental side effects and eventual push for ineffective and overly utilized surgery. Chiropractic treatment can not only prevent/delay OA in many cases it can actually reverse OA by restoring the normal biomechanics of the joints. This claim is based on Wolff's Law. However, it's not a quick fix. In most cases it takes years for the degenerative changes to develop. It makes sense that it will take in some cases years for the body to remodel those bones. What doesn't make sense is to claim that some pills will make it all better in a matter of hours. Why, because they are magical? Where's the study on that?
DrChun (
talk) 06:10, 20 August 2010 (UTC)
Hyaluronan considered by one alternative specialist as important was added, however I do not see it here anymore...
-- Caesar J.B. Squitti: Son of Maryann Rosso and Arthur Natale Squitti (talk) 16:05, 25 May 2009 (UTC)
I am not a medical doctor, but I have been writing about arthritis for a while. All I have to go on is what is actually published in the scientific literature. Although Brandt has his slant on things -- namely that OA is caused by mechanical damage (with various sources) and the body's attempt to fix it (with diminishing success and worsening consequences as we get older and the damage is ongoing)-- his article seems to be a largely reasonable recent review and I can see no reason why he would be misleading us about inflammation in OA. It is on this basis that I have put back the modest mentions of inflammation. Although Brandt finds the definition uselessly over-broad, here is what he quotes as the definition of OA put out in 1995 by "a workshop of experts in OA sponsored by the American Academy of Orthopaedic Surgeons; the National Institute of Arthritis, Musculoskeletal, and Skin Diseases; the National Institute on Aging; the Arthritis Foundation; and the Orthopaedic Research and Education Foundation":
Osteoarthritis is a group of overlapping distinct diseases which may have different etiologies, but with similar biologic, morphologic, and clinical outcomes. The disease processes not only affect the articular cartilage, but involve the entire joint, including the subchondral bone, ligaments, capsule, synovial membrane, and periarticular muscles. Ultimately, the articular cartilage degenerates with fibrillation, fissures, ulceration, and full thickness loss of the joint surface. OA diseases are a result of both mechanical and biologic events that destabilize the normal coupling of degradation and synthesis of articular cartilage of chondrocytes and extracellular matrix, and subchondral bone. Although they may be initiated by multiple factors, including genetic, developmental, metabolic, and traumatic, OA changes involve all of the tissues of the diarthrodial joint. Ultimately, OA dis- eases are manifested bymorphologic, biochemical, molecular, and biomechani- cal changes of both cells and matrix which lead to a softening, fibrillation, ulceration, loss of articular cartilage, sclerosis and eburnation of subchondral bone, osteophytes, and subchondral cysts. When clinically evident, OA diseases are characterized by joint pain, tenderness, limitation of movement, crepitus, occasional effusion, and variable degrees of inflammation without systemic effects.
citation: Kuettner K, GoldbergVM. Introduction. In: Kuettner K, GoldbergVM, editors.
Osteoarthritic disorders. Rosemont (IL): American Academy of Orthopaedic Surgeons; 1995. p. xxi–v., as quoted and cited in the Brandt article.
Here are the quotes about inflammation from the Brandt article: "The inflammatory changes in OA are secondary and are caused by particulate and soluble breakdown products of cartilage and bone." Also, "The remodeling of connective tissues requires removal of damaged matrix to allow for its replacement. Inflammation and alterations of cell metabolism are an essential part of this healing process."
And here is his long section about inflammation of the joint (synovitis):
" Synovitis
The synovial membrane from patients who have advanced OA commonly exhibits hyperplasia of the lining cell layer and focal infiltration of lymphocytes and monocytes. In advanced OA the intensity of the synovitis may resemble that in rheumatoid arthritis. Synovitis in OA may be due to phagocytosis of wear particles of cartilage and bone from the abraded joint surface26,69,70, release from the cartilage of soluble matrix macromolecules71 (eg, proteoglycans, collagen, fibronectin fragments), or the presence of crystals of calcium pyrophosphate dihydrate or calcium hydroxyapatite.72 In some cases, immune complexes containing antigens derived from the cartilage matrix may be sequestered in collagenous tissue of the joint, such as meniscus, leading to chronic low-grade inflammation.73
Earlier in the course of OA, however, the synovium—even from symptomatic patients who have full-thickness ulceration of their articular cartilage—may be histologically normal, suggesting that the early pain in those cases is not attributable to synovitis.74 Conversely, in patients who have knee OA who have no joint pain, the severity of articular cartilage damage and of synovitis may be as great as in those who have knee pain.
Synovitis is an important cause of pain in patients who have OA, however. In cross- sectional MRI analyses of subjects who had knee OA, synovial thickening was much more common in those who had pain than in those who were asymptomatic and, among those who had knee pain, was associated with more severe pain.75 Furthermore, in a 30- month longitudinal study of patients who had symptomatic knee OA,76 changes in synovitis, as graded by MRI, correlated only modestly with changes in knee pain. The relatively weak correlation suggests that synovitis was not the only, or even the major, cause of the joint pain. Furthermore, pain was not correlated with the loss of articular cartilage in either the tibiofemoral or patellofemoral compartment and changes in synovial effusion were not correlated with changes in pain. In contrast, in a sample of symptomatic subjects from the Osteoarthritis Initiative (OAI), Lo and colleagues77 found that maximal joint effusion scores on MRI were highly associated with knee pain even after adjustment for bone marrow lesion (BML) scores, suggesting that effusion (a manifestation of underlying synovitis) was independently associated with knee pain. Brandtetal 14"
With this justification and sourcing, I am putting the mentions of local inflammation back in the article and would request that if they are removed again, it should be with appropriate references stating that OA never entails localized inflammation. Celia Kozlowski ( talk) 12:59, 29 September 2009 (UTC)
I updated the section on acupuncture treament for osteoarthritis since there was more new research available. —Preceding unsigned comment added by 99.255.196.199 ( talk) 03:03, 3 October 2009 (UTC)
Reverted edit by WLU because that source was previously rejected on the Acupuncture main page for being outdated. The 4 newer reviews that support acupuncture effectiveness in OA should suffice. 99.255.196.199 ( talk) 12:45, 8 October 2009 (UTC)
On May 14, Doc James made about 40 edits and reduced the page size from about 45k to about about 27k. Boldness is good and I think there is some good editing that happened here, but I've also got a few concerns. I think a fair bit of important information has been removed, including the clinical significant of standard treatments, side-effects of treatments, some comparative effectiveness, and some less notable but still relevant items. Comparison between Revision as of 14:20, 14 May 2010 to Revision as of 21:03, 14 May 2010. I'll admit that some of the material I added so I have an interest in it.
Anyway, I hope to get a response although I'm not sure when I can spend some time on this. II | ( t - c) 09:31, 16 May 2010 (UTC)
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Doc James (
talk ·
contribs ·
email) 20:24, 16 May 2010 (UTC)There are a number of books that report that diet, apart from weight loss, can affect osteoarthritis. This deserves a mention and discussion of the data either supporting or refuting or lacking for these positions.
There are a number of books that report that diet, apart from weight loss, can affect osteoarthritis. This deserves a mention and discussion of the data either supporting or refuting or lacking for these positions. —Preceding unsigned comment added by 96.252.61.70 ( talk) 00:42, 23 January 2011 (UTC)
I am a little bit surprised of not finding any reference to thermotherapy in this article. I am a patient of osteoarthritis that affects my hands, shoulder and spinal bones. I do not take any drug. When my hands hurt, I apply hot water to them, and pain subsides pretty much. I used to develop pain in my shoulder after simple actions consisting in few repetitions of arm movement involving the shoulder. A physician recommended me to apply cold water after a regular hot water shower. Very simple, though mildly unpleasant in winter, but very effective. I have greatly reduced shoulder pain. According to the physician that recommended the treatment, the effect of cold water shock is to increase blood flow toward joints. Blood carries the "chemicals" that repair the connective tissue.
I see that this article is a "serious" one, subjected to the use of "high-quality medical sources". I am sure these sources have to exist for Thermotherapy, only I am not trained to find them. I, therefore would appreciate if some medical wikipedist could help in this task.-- Auró ( talk) 13:48, 30 January 2011 (UTC)
This [7] recent edit removed a secondary source (systematic review and meta-analysis). The reason provided for the deletion is that "the ref does not support this..." however, the deleted text was a direct summary of the deleted sources' abstract:
WP:MEDRS outlines what constitutes a reliable source for wikipedia, and the source that was removed meets those standards for the highest level of evidence (systematic review and meta-analysis). Moreover, I cannot find a conflicting viewpoint published in the literature that contradicts the findings nor that criticizes the methodology. If a noteable controversy exists then both viewpoints could be included. However, without a noteable controversy, I fail to see why this source and its findings should not be included. Puhlaa ( talk) 21:18, 29 September 2011 (UTC)
We could say "it is not possible to conclude with certainty which treatment program is superior as there are no trials which compares them but after meta regression exercise plus manual mobilisations appears to improved pain greater than exercise alone(p =0.03)" And for those who understand what it means... Doc James ( talk · contribs · email) 23:56, 30 September 2011 (UTC)
Loeser, RF (2012 Jun). "Osteoarthritis: a disease of the joint as an organ". Arthritis and rheumatism. 64 (6): 1697–707.
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Doc James (
talk ·
contribs ·
email) (if I write on your talk page please reply on mine) 21:48, 25 July 2012 (UTC)
The following two sources, [11] and [12] were used to cite the clause:
But upon looking at these sources, they do not support this assertion. The Reichenbach source only deals with chondroitin, but it acknowledges that "Previous meta-analyses described moderate to large benefits of chondroitin in patients with osteoarthritis.". There is hardly a consensus on this particular issue.
The Rosenbaum source concludes that there are studies supporting some of the treatments, and that they in particular cannot recommend them yet because more research needs to be done. This is a far cry from the claim of "no evidence", it's just insufficient evidence to support these authors from recommending them. Their conclusion is "Whether any of these supplements can be effectively and safely recommended to reduce nonsteroidal antiinflammatory drug or steroid usage is unclear and requires more high-quality research".
We need to be very careful of introducing bias for or against any sort of supplements. Be careful about how you cite things, and make sure to maintain WP:NPOV. I'm going to try to clean this sentence up. Cazort ( talk) 18:11, 23 September 2012 (UTC)
I'm always thrilled when a page is given more impact through shortening and getting back to the best current sources. But it is ham-handed editing to say every bloody source in an article has to be a SECONDARY source or a review. While I appreciate the stipulation that sourcing should be to reliable journals, I would contend that if this means only reviews you will NEVER have a page that is up-to-date. Why should medicine not be as current as any other subject? Could it be that the M.D. and Chiropractor who want to remove my well-sourced additions simply don't want their patients to be better informed than they are??? Wikipedia:Identifying reliable sources (medicine) does NOT say we should only have secondary sources or reviews. It says: "Ideal sources for such content includes general or systematic reviews published in reputable medical journals, academic and professional books written by experts in the relevant field and from a respected publisher, and medical guidelines or position statements from nationally or internationally recognised expert bodies." And then there's the rest: "All Wikipedia articles should be based on reliable, published secondary sources. Reliable primary sources may occasionally be used with care as an adjunct to the secondary literature, but there remains potential for misuse. For that reason, edits that rely on primary sources should only describe the conclusions of the source, and should describe these findings clearly so the edit can be checked by editors with no specialist knowledge. In particular, this description should follow closely to the interpretation of the data given by the authors or by other reliable secondary sources. Primary sources should not be cited in support of a conclusion that is not clearly made by the authors or by reliable secondary sources, as defined above .... When citing primary sources, particular care must be taken to adhere to Wikipedia's undue weight policy. Secondary sources should be used to determine due weight."
With respect to my added section on DMOADs, I made it clear that this is about *research*; I began with two very reputable medical sources. When "Doc James" removed my addition to the page because it was primary sources only, I added two reputable secondary sources, leaving the very reputable primary sources as useful supporting references so that people who actually want to weigh the strength of the underlying evidence behind the secondary sources can readily access it. I really feel the edits that "Doc James" made and that "Puhlaa" threatened me with ("If you dont replace the primary sources with secondary sources, someone will revert your changes again.Puhlaa (talk) 15:52, 9 November 2012 (UTC)" are efforts to dumb-down the OA article and make it antiquated. Research progress on OA has stalled out appallingly. My section on the search for DMOADs at least points to the direction of a glimmer of hope. It's contemporary; it is grounded in reliable sources; and it at least touches on research -- something that will be crucial to making progress on OA and other diseases but something that has been edited right off this page, thanks to "Doc James" and misguided application of Wikipedia:Identifying reliable sources (medicine) Celia Kozlowski ( talk) 18:55, 9 November 2012 (UTC)
Might not some of the contribution that was recently reverted [17] be incorporated into a Research directions section per WP:MEDMOS/ WP:PRESERVE? Biosthmors ( talk) 20:32, 10 November 2012 (UTC)
Added section on research. Doc James ( talk · contribs · email) (if I write on your page reply on mine) 17:53, 11 November 2012 (UTC)
On this new page, I would suggest a strong "caveat" paragraph making it clear that this page is not to be construed as medical advice and underscoring that many therapies that look promising in early-stage testing in animals never work in humans, and, in fact, barely more than half of drugs that make it to clinical trials offer any improvement over existing therapies [ http://onlinelibrary.wiley.com/doi/10.1002/14651858.MR000024.pub3/abstract "New treatments compared to established treatments in randomized trialsNew treatments compared to established treatments in randomized trials The Cochrane Library, DOI:10.1002/14651858.MR000024.pub3, Published Online: 17 OCT 2012.
IMHO, the new page should include at least:
According to my surgeon, my MRIs beautifully show the severe (but not painful!) osteoarthritis in my right hip joint, which is why I'm getting an artificial hip next week. According to the Radiology clinic, the MRIs are my property, so I may post them on Wikipedia if I so wish. So should I post those images? Old_Wombat ( talk) 09:26, 15 November 2012 (UTC)
This article should also mention boswellia, an herbal analgesic known in Aryuvedic medicine and widely available in health food stores as well as online. It is highly effective and, unlike NSAIDs, has no known side effects. 162.83.183.71 14:42, 29 September 2007 (UTC)
I have begun editing and adding to this article, feel free to edit and . 16, 2004.
Congenital hip luxation - if the article does not exist then you shouldn't remove the red link but write the article! It is a major health problem, and relatively simple to diagnose. In countries with regular child-health follow-up, the Ortolani test is often performed as a screening test, with ultrasound as second line. Treatment is simple, with plaster cast immobilisation. JFW | T@lk 09:45, 17 Nov 2004 (UTC)
Thank you for your help Jdwolff, this was my first attempt at editing. Your help is appreciated. User:Gilgameshfuel 17 Nov 2004
Feel free to delete that section if you see best, and thanks once again. I have had severe OA for three years now. User:Gilgameshfuel 18 Nov 2004
I tried double checking the article by GREEN GA that said over 80% for elderly, but couldn't access it. I do know the Farmingham studies, which are the most cited articles on osteoarthritis prevalence, state that 10% of people over 65 have osteoarthritis (Incidence and Natural History of Knee osteoarthritis in the Elderly 1995 Arthritis and Rheumatism). They said 82.7% PARTICIPATED in the follow up study from the original in 1987, and I suspect that GREEN GA or the whoever, might have got that prevalence wrong. Simonfrid ( talk) 16:34, 4 June 2008 (UTC)simonfrid
With diff not working 100% I am not sure how much was changed, but PM Poon ( talk · contribs) has effectively rewritten the whole page! Most of it sounds like reasonable edits, but use of edit summaries would have been helpful.
Is anyone willing to tidy up the references? JFW | T@lk 11:41, 19 September 2005 (UTC)
maybe hip luxation should be congenital hip subluxation?
a discussion of common x-ray findings would be helpful.
In the article it is mentioned a primary and secondary type of OA, but these types are not distinguised between when stating that there is no cure for OA. As far as I know, this is not correct. If OA is caused by trauma to the joint (not caused by a degenerative disease), there is options for treatment such as Autologous Chondrocyte Implantation. Whether this procedure is feasible probably depends on how far the OA has gotten, i.e. the condition of the remaining cartilage. I don't know enough about this topic to add this to the article, anyone who does? Hildre 10:19, 11 July 2006 (UTC)
OA affects nearly 21 million people in the United States, accounting for 25% of visits to primary care physicians, and half of all NSAID (Non-Steroidal Anti-Inflammatory Drugs) prescriptions. It is estimated that 80% of the population will have radiographic evidence of OA by age 65, although only 60% of those will be symptomatic (Green 2001).
Can someone update this with global data instead of just the US.
What about steem cells? I think some people are working on this kind of surgery in different countries. Can anyone specify something else? -- ZUIA2 23:08, 1 January 2007 (UTC)
A self help book, which was on NY Times best seller list, is The Arthritis Cure by Jason Theodosakis. LoopTel ( talk) 16:37, 22 December 2007 (UTC)
Chronic smokers have higher risk of OA. Cessation of smoking would at least delay further deterioration of the joints.
Suggest adding this comment to treatment. LoopTel ( talk) 13:23, 26 December 2007
(UTC)
The article says that glucosomine has NOT been helpful for the knee. My experience in speaking with a large number of people taking the glucosomine/chondroitin supplement have found help ONLY for their knees. I am a statistician with no statistical evidence, but wanted to tell you this.
Walk in any drugstore or vitamin store and you will see scores of brands consisting of glucosamine, chondroitin, and MSM, either separately or in combinations, all touting as treatment of osteoarthritis. Some even claim proof of efficacy through unnamed trials. When NY Times reported on FDA sponsored clinical trials that showed no benefit, interestingly enough the reporter ended the article with a personal note: "I don't care what the trial says. All I know is that without these supplements I am a prisoner in my own house. After taking these supplements, I can climb mountains." (citation needed) One possible explanation is that these supplements can be of benefit in mild cases but not in cases studied in the trials. LoopTel ( talk) 18:27, 5 December 2007 (UTC) —Preceding unsigned comment added by LoopTel ( talk • contribs) 18:19, 5 December 2007 (UTC)
In a study published in 2007, glucosamine sulfate appears to help patients avoid or delay total knee replacement (TKR). The study relates to treatment of knee OA with glucosamine sulphate for at least 12 months and up to 3 years and in an average follow-up of 5 years after drug discontinuation. The placebo group had twice as many TKR compared to those formerly receiving glucosamine sulphate. LoopTel ( talk) 02:22, 26 August 2008 (UTC) —Preceding unsigned comment added by LoopTel ( talk • contribs) 02:16, 26 August 2008 (UTC)
I have deleted the latest addition to this -- the statement that fishoil obviates the need for prescription medication. "www.TheKneeCenter.com" is a commercial endorsement for a Dr. Cooper -- hardly up to Wiki-standards for adequate support. Celia Kozlowski ( talk) 12:03, 2 April 2009 (UTC)
In a Fox News Channel talk show "Ask Dr. Manny" aired 12 February 2009, available for download from FoxNews.com, Dr. Mark Liponis told his listeners to take the following, divided into several doses daily, to relieve joint pain. Glucosamine 1500 mg, chondroitin 1200 mg, curcumin 1800 mg, fish oil EPA DHA 3000 mg, and vitamin D3 1000 IU. LoopTel ( talk) 17:52, 27 July 2009 (UTC)
Here are c. 10 summarized healing reports from osteoarthritis (through healing on the spiritual path): http://www.bruno-groening.org/english/heilungen/defaultheilungen.htm (go to chapter 10)
Kind regards, Dave
-- 83.173.234.146 20:53, 22 November 2006 (UTC)
I would like to see references to articles about the heritability of Osteoarthritis.
-- Herman 2 january 2007 (UTC)
Unreferenced statements such as, "found quite effective," "revolutionary," and, "the treatment is painless, safe and scientifically proven," without providing references to peer-reviewed or at least reputable sources show an obvious bias. Given the website of this company is provided, I would guess it stems from a commercial interest, or even a misplaced attempt at sharing what was a personally successful treatment; I have not investigated the writer to find out.
As I am not an editor I decided to note it as non-neutral and post this comment, instead of cleaning it up myself; at the moment I stick to grammar fixes.
—Podboy —The preceding unsigned comment was added by 199.212.21.22 ( talk) 21:27, 4 April 2007 (UTC).
There is an article in the Indian Journal of Aerospace Medicine which is peer-reviewed, which substantiates some of the above statements. --kv
Is this true? I have read that gout is the most common form of arthritis. 205.158.168.99 03:37, 5 June 2007 (UTC)Steve P.
Yes it is. Check the Farmingham study Simonfrid ( talk) 16:35, 4 June 2008 (UTC)simonfrid
I looked around but couldn't really find anything that suggested that humidity actually has an effect on arthritis. The closest is the idea that changes in barometric pressure might, but it seems like your body would come into equilibrium eventually wherever you were. If we can't find citations in support of it, then I think we ought to get rid of it, because it is likely unsupported by anything but anecdotes. -- The Hanged Man 15:02, 4 July 2007 (UTC)
Maybe one could rephrase the text to s.th. like "doctors report increased numbers of patients complaining of pain caused by OA in cold and humid conditions". Since packed waiting rooms would not qualify as "evidence" for a wiki article "anecdotes" might be all there will be for quite a while. Most researchers have their hands full finding treatment options. An interesting, but possibly unrelated fact is that researchers in Cardiff have found that cold feet reduce blood flow in the nose. If the same happened in the capilary system around the cartilage of OA joints that might be a link. (Maybe the guys in Cardiff will look into it somewhen.) Unconscious/involuntary muscle contractions (like e.g. shivering) might be another cause. (No one seems to have studied that yet either) —Preceding unsigned comment added by 71.236.23.251 ( talk) 16:51, 17 February 2008 (UTC)
Ok, I am only 19 and i suffer from chronic knee pain, muscle contractions and cracking noises. This has been so ever since an incident in Karate practice a few years ago when a roundhouse sent my knee the wrong way. Does this mean i have this sort of arthritis? PayneXKiller 20:35, 28 September 2007 (UTC)
Quite possibly, yes. I'm 47 and recently developed osteoarthritis after a bad fall. Medical people tell me I'm unfortunate to have it at my age. You may, like me, have what is known as patellar maltracking. If you haven't already, see a doctor for confirmation. You may need physiotherapy and a visit to a podiatrist. Eligius ( talk) 07:22, 10 June 2010 (UTC)
Are these terms exactly the same? This is as far as I got: -itis indicates inflammation and arthr- means joint if I got it right, and if osteo related to osseous it's bone. Osteoarthritis would then be bone-joint-inflammation. But what is an "-osis"? Is one term old and the other modern or is one a layman's term and the other the proper medical one?? thks. —Preceding unsigned comment added by 66.56.30.124 ( talk) 04:53, 5 February 2008 (UTC)
Wikipedia shouldn't be used for advertizing. —Preceding unsigned comment added by 146.9.22.121 ( talk) 14:00, 12 March 2008 (UTC)
Hello I would like to assis on this lemma but my English is not good enough. Would it be helpfull if I post in this discussion some recent PUBMED studies on the possibele causes of osteoarthritis and that somebody else makes the changes in the lemma. Regards, Willy Witsel, Netherlands —Preceding unsigned comment added by 217.120.103.16 ( talk) 11:22, 13 March 2008 (UTC)
I agree on gluco and chondro. These articles I use in The Netherlands to show not only pain relieve
but also therapeutic aspects
Would these documents be accpetable for this osteo article?? Regards Willy -- 217.120.103.16 ( talk) 13:22, 14 March 2008 (UTC)
If DDD and OA is the same, I can upload more images into Commons for the cervical vertebrae. I could also use some help in trying to place images into spine articles on Wikipedia. Please see my discussion page if you have time. MsTopeka ( talk) 13:41, 24 July 2008 (UTC)
Not entirely sure, but I don't think there is any actual decrease in Synovial fluid in this condition. Cheers!
-- 220.253.43.190 ( talk) 07:41, 19 October 2008 (UTC)
Given that natural supplements which don't have established efficiency are included should investigational drugs not be included as well. Calcitonin is on phase III trial, and other trials have already suggested efficiency. Besides, Calcitonin is already used for other conditions and noting prevent physicians to use it off-label.
I don't want to open a worldwar on chiropractic here, but IF it is going to be included as something that is useful for OA, this should be justified with the highest level of evidence -- placebo-controlled, double-blind clinical trials -- not blurbs from the American Chiropractic Association. What else are they going to say but that chiropractic works for OA -- and best to come in frequently for expensive manipulations? I have a brother-in-law who thinks it helps and a father who thought it helped exactly once and was a total waste of money thereafter. Show me the medical literature and I'll go along with keeping this section in. For now I'm going to pare it down and make it so it doesn't sound like such a commercial advertisement. Celia Kozlowski ( talk) 12:11, 26 March 2009 (UTC)
I wish people would just stick to talking about things that they truly have knowledge about. Simply claiming an absence of citation or study does not negate the validity or truth of the statement. Second if you're basing your entire position on one study that you claim to have read, your basis for that position is sorely lacking. After all I could claim just about anything I wanted to claim if I based those claims on a single study. BTW where's the citation on that study? Also, your implication that chiropractic treatment is "expensive" or a "total waste of money" is completely contradicted by actual long term government research demonstrating that chiropractic treatment is not only effective but also cost effective when compared to medical treatment for similar complaints. Furthermore, when was the last time you disputed a medical claim based on a lack of supporting studies or "proof?" If you've actually read any medical studies you'll find that most of them are not of the "highest level of evidence -- placebo-controlled, double-blind clinical trials" In fact, many of them have obvious confounding factors and conflicts of interest. Simply knowing the terminology does not mean that you understand what you're talking about. Then consider, since we're talking about OA, why it is that most of the general public thinks OA is caused by aging. If you're honest you'll realize that it is because most physicians have been telling their patients for generations that arthritis is caused by aging. "You're just getting old, accept it" Chiropractors have been telling their patients for generations that age although a factor (through time) is not the determinant of this disease; it's actually the biomechanics of the joints. Wikipedia got it right under the "Causes" section. However, if you want to understand why chiropractors claim that chiropractic treatment can help some cases of OA particularly spinal OA, consider something called Wolff's Law. It's in just about every first year students' physiology text book. Then look up the basis for this law called the Piezoelectric Effect. I'll let you connect the dots but please do at least a semblance of research yourself before you criticize someone else's comments. Also, consider that studies that seem to "prove" some scientific "fact" are often disputed or found faulty shortly thereafter. It may be more appropriate for you criticize the pharmacological or medical approach for lack of efficacy, higher risk for detrimental side effects and eventual push for ineffective and overly utilized surgery. Chiropractic treatment can not only prevent/delay OA in many cases it can actually reverse OA by restoring the normal biomechanics of the joints. This claim is based on Wolff's Law. However, it's not a quick fix. In most cases it takes years for the degenerative changes to develop. It makes sense that it will take in some cases years for the body to remodel those bones. What doesn't make sense is to claim that some pills will make it all better in a matter of hours. Why, because they are magical? Where's the study on that?
DrChun (
talk) 06:10, 20 August 2010 (UTC)
Hyaluronan considered by one alternative specialist as important was added, however I do not see it here anymore...
-- Caesar J.B. Squitti: Son of Maryann Rosso and Arthur Natale Squitti (talk) 16:05, 25 May 2009 (UTC)
I am not a medical doctor, but I have been writing about arthritis for a while. All I have to go on is what is actually published in the scientific literature. Although Brandt has his slant on things -- namely that OA is caused by mechanical damage (with various sources) and the body's attempt to fix it (with diminishing success and worsening consequences as we get older and the damage is ongoing)-- his article seems to be a largely reasonable recent review and I can see no reason why he would be misleading us about inflammation in OA. It is on this basis that I have put back the modest mentions of inflammation. Although Brandt finds the definition uselessly over-broad, here is what he quotes as the definition of OA put out in 1995 by "a workshop of experts in OA sponsored by the American Academy of Orthopaedic Surgeons; the National Institute of Arthritis, Musculoskeletal, and Skin Diseases; the National Institute on Aging; the Arthritis Foundation; and the Orthopaedic Research and Education Foundation":
Osteoarthritis is a group of overlapping distinct diseases which may have different etiologies, but with similar biologic, morphologic, and clinical outcomes. The disease processes not only affect the articular cartilage, but involve the entire joint, including the subchondral bone, ligaments, capsule, synovial membrane, and periarticular muscles. Ultimately, the articular cartilage degenerates with fibrillation, fissures, ulceration, and full thickness loss of the joint surface. OA diseases are a result of both mechanical and biologic events that destabilize the normal coupling of degradation and synthesis of articular cartilage of chondrocytes and extracellular matrix, and subchondral bone. Although they may be initiated by multiple factors, including genetic, developmental, metabolic, and traumatic, OA changes involve all of the tissues of the diarthrodial joint. Ultimately, OA dis- eases are manifested bymorphologic, biochemical, molecular, and biomechani- cal changes of both cells and matrix which lead to a softening, fibrillation, ulceration, loss of articular cartilage, sclerosis and eburnation of subchondral bone, osteophytes, and subchondral cysts. When clinically evident, OA diseases are characterized by joint pain, tenderness, limitation of movement, crepitus, occasional effusion, and variable degrees of inflammation without systemic effects.
citation: Kuettner K, GoldbergVM. Introduction. In: Kuettner K, GoldbergVM, editors.
Osteoarthritic disorders. Rosemont (IL): American Academy of Orthopaedic Surgeons; 1995. p. xxi–v., as quoted and cited in the Brandt article.
Here are the quotes about inflammation from the Brandt article: "The inflammatory changes in OA are secondary and are caused by particulate and soluble breakdown products of cartilage and bone." Also, "The remodeling of connective tissues requires removal of damaged matrix to allow for its replacement. Inflammation and alterations of cell metabolism are an essential part of this healing process."
And here is his long section about inflammation of the joint (synovitis):
" Synovitis
The synovial membrane from patients who have advanced OA commonly exhibits hyperplasia of the lining cell layer and focal infiltration of lymphocytes and monocytes. In advanced OA the intensity of the synovitis may resemble that in rheumatoid arthritis. Synovitis in OA may be due to phagocytosis of wear particles of cartilage and bone from the abraded joint surface26,69,70, release from the cartilage of soluble matrix macromolecules71 (eg, proteoglycans, collagen, fibronectin fragments), or the presence of crystals of calcium pyrophosphate dihydrate or calcium hydroxyapatite.72 In some cases, immune complexes containing antigens derived from the cartilage matrix may be sequestered in collagenous tissue of the joint, such as meniscus, leading to chronic low-grade inflammation.73
Earlier in the course of OA, however, the synovium—even from symptomatic patients who have full-thickness ulceration of their articular cartilage—may be histologically normal, suggesting that the early pain in those cases is not attributable to synovitis.74 Conversely, in patients who have knee OA who have no joint pain, the severity of articular cartilage damage and of synovitis may be as great as in those who have knee pain.
Synovitis is an important cause of pain in patients who have OA, however. In cross- sectional MRI analyses of subjects who had knee OA, synovial thickening was much more common in those who had pain than in those who were asymptomatic and, among those who had knee pain, was associated with more severe pain.75 Furthermore, in a 30- month longitudinal study of patients who had symptomatic knee OA,76 changes in synovitis, as graded by MRI, correlated only modestly with changes in knee pain. The relatively weak correlation suggests that synovitis was not the only, or even the major, cause of the joint pain. Furthermore, pain was not correlated with the loss of articular cartilage in either the tibiofemoral or patellofemoral compartment and changes in synovial effusion were not correlated with changes in pain. In contrast, in a sample of symptomatic subjects from the Osteoarthritis Initiative (OAI), Lo and colleagues77 found that maximal joint effusion scores on MRI were highly associated with knee pain even after adjustment for bone marrow lesion (BML) scores, suggesting that effusion (a manifestation of underlying synovitis) was independently associated with knee pain. Brandtetal 14"
With this justification and sourcing, I am putting the mentions of local inflammation back in the article and would request that if they are removed again, it should be with appropriate references stating that OA never entails localized inflammation. Celia Kozlowski ( talk) 12:59, 29 September 2009 (UTC)
I updated the section on acupuncture treament for osteoarthritis since there was more new research available. —Preceding unsigned comment added by 99.255.196.199 ( talk) 03:03, 3 October 2009 (UTC)
Reverted edit by WLU because that source was previously rejected on the Acupuncture main page for being outdated. The 4 newer reviews that support acupuncture effectiveness in OA should suffice. 99.255.196.199 ( talk) 12:45, 8 October 2009 (UTC)
On May 14, Doc James made about 40 edits and reduced the page size from about 45k to about about 27k. Boldness is good and I think there is some good editing that happened here, but I've also got a few concerns. I think a fair bit of important information has been removed, including the clinical significant of standard treatments, side-effects of treatments, some comparative effectiveness, and some less notable but still relevant items. Comparison between Revision as of 14:20, 14 May 2010 to Revision as of 21:03, 14 May 2010. I'll admit that some of the material I added so I have an interest in it.
Anyway, I hope to get a response although I'm not sure when I can spend some time on this. II | ( t - c) 09:31, 16 May 2010 (UTC)
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Doc James (
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email) 20:24, 16 May 2010 (UTC)There are a number of books that report that diet, apart from weight loss, can affect osteoarthritis. This deserves a mention and discussion of the data either supporting or refuting or lacking for these positions.
There are a number of books that report that diet, apart from weight loss, can affect osteoarthritis. This deserves a mention and discussion of the data either supporting or refuting or lacking for these positions. —Preceding unsigned comment added by 96.252.61.70 ( talk) 00:42, 23 January 2011 (UTC)
I am a little bit surprised of not finding any reference to thermotherapy in this article. I am a patient of osteoarthritis that affects my hands, shoulder and spinal bones. I do not take any drug. When my hands hurt, I apply hot water to them, and pain subsides pretty much. I used to develop pain in my shoulder after simple actions consisting in few repetitions of arm movement involving the shoulder. A physician recommended me to apply cold water after a regular hot water shower. Very simple, though mildly unpleasant in winter, but very effective. I have greatly reduced shoulder pain. According to the physician that recommended the treatment, the effect of cold water shock is to increase blood flow toward joints. Blood carries the "chemicals" that repair the connective tissue.
I see that this article is a "serious" one, subjected to the use of "high-quality medical sources". I am sure these sources have to exist for Thermotherapy, only I am not trained to find them. I, therefore would appreciate if some medical wikipedist could help in this task.-- Auró ( talk) 13:48, 30 January 2011 (UTC)
This [7] recent edit removed a secondary source (systematic review and meta-analysis). The reason provided for the deletion is that "the ref does not support this..." however, the deleted text was a direct summary of the deleted sources' abstract:
WP:MEDRS outlines what constitutes a reliable source for wikipedia, and the source that was removed meets those standards for the highest level of evidence (systematic review and meta-analysis). Moreover, I cannot find a conflicting viewpoint published in the literature that contradicts the findings nor that criticizes the methodology. If a noteable controversy exists then both viewpoints could be included. However, without a noteable controversy, I fail to see why this source and its findings should not be included. Puhlaa ( talk) 21:18, 29 September 2011 (UTC)
We could say "it is not possible to conclude with certainty which treatment program is superior as there are no trials which compares them but after meta regression exercise plus manual mobilisations appears to improved pain greater than exercise alone(p =0.03)" And for those who understand what it means... Doc James ( talk · contribs · email) 23:56, 30 September 2011 (UTC)
Loeser, RF (2012 Jun). "Osteoarthritis: a disease of the joint as an organ". Arthritis and rheumatism. 64 (6): 1697–707.
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Doc James (
talk ·
contribs ·
email) (if I write on your talk page please reply on mine) 21:48, 25 July 2012 (UTC)
The following two sources, [11] and [12] were used to cite the clause:
But upon looking at these sources, they do not support this assertion. The Reichenbach source only deals with chondroitin, but it acknowledges that "Previous meta-analyses described moderate to large benefits of chondroitin in patients with osteoarthritis.". There is hardly a consensus on this particular issue.
The Rosenbaum source concludes that there are studies supporting some of the treatments, and that they in particular cannot recommend them yet because more research needs to be done. This is a far cry from the claim of "no evidence", it's just insufficient evidence to support these authors from recommending them. Their conclusion is "Whether any of these supplements can be effectively and safely recommended to reduce nonsteroidal antiinflammatory drug or steroid usage is unclear and requires more high-quality research".
We need to be very careful of introducing bias for or against any sort of supplements. Be careful about how you cite things, and make sure to maintain WP:NPOV. I'm going to try to clean this sentence up. Cazort ( talk) 18:11, 23 September 2012 (UTC)
I'm always thrilled when a page is given more impact through shortening and getting back to the best current sources. But it is ham-handed editing to say every bloody source in an article has to be a SECONDARY source or a review. While I appreciate the stipulation that sourcing should be to reliable journals, I would contend that if this means only reviews you will NEVER have a page that is up-to-date. Why should medicine not be as current as any other subject? Could it be that the M.D. and Chiropractor who want to remove my well-sourced additions simply don't want their patients to be better informed than they are??? Wikipedia:Identifying reliable sources (medicine) does NOT say we should only have secondary sources or reviews. It says: "Ideal sources for such content includes general or systematic reviews published in reputable medical journals, academic and professional books written by experts in the relevant field and from a respected publisher, and medical guidelines or position statements from nationally or internationally recognised expert bodies." And then there's the rest: "All Wikipedia articles should be based on reliable, published secondary sources. Reliable primary sources may occasionally be used with care as an adjunct to the secondary literature, but there remains potential for misuse. For that reason, edits that rely on primary sources should only describe the conclusions of the source, and should describe these findings clearly so the edit can be checked by editors with no specialist knowledge. In particular, this description should follow closely to the interpretation of the data given by the authors or by other reliable secondary sources. Primary sources should not be cited in support of a conclusion that is not clearly made by the authors or by reliable secondary sources, as defined above .... When citing primary sources, particular care must be taken to adhere to Wikipedia's undue weight policy. Secondary sources should be used to determine due weight."
With respect to my added section on DMOADs, I made it clear that this is about *research*; I began with two very reputable medical sources. When "Doc James" removed my addition to the page because it was primary sources only, I added two reputable secondary sources, leaving the very reputable primary sources as useful supporting references so that people who actually want to weigh the strength of the underlying evidence behind the secondary sources can readily access it. I really feel the edits that "Doc James" made and that "Puhlaa" threatened me with ("If you dont replace the primary sources with secondary sources, someone will revert your changes again.Puhlaa (talk) 15:52, 9 November 2012 (UTC)" are efforts to dumb-down the OA article and make it antiquated. Research progress on OA has stalled out appallingly. My section on the search for DMOADs at least points to the direction of a glimmer of hope. It's contemporary; it is grounded in reliable sources; and it at least touches on research -- something that will be crucial to making progress on OA and other diseases but something that has been edited right off this page, thanks to "Doc James" and misguided application of Wikipedia:Identifying reliable sources (medicine) Celia Kozlowski ( talk) 18:55, 9 November 2012 (UTC)
Might not some of the contribution that was recently reverted [17] be incorporated into a Research directions section per WP:MEDMOS/ WP:PRESERVE? Biosthmors ( talk) 20:32, 10 November 2012 (UTC)
Added section on research. Doc James ( talk · contribs · email) (if I write on your page reply on mine) 17:53, 11 November 2012 (UTC)
On this new page, I would suggest a strong "caveat" paragraph making it clear that this page is not to be construed as medical advice and underscoring that many therapies that look promising in early-stage testing in animals never work in humans, and, in fact, barely more than half of drugs that make it to clinical trials offer any improvement over existing therapies [ http://onlinelibrary.wiley.com/doi/10.1002/14651858.MR000024.pub3/abstract "New treatments compared to established treatments in randomized trialsNew treatments compared to established treatments in randomized trials The Cochrane Library, DOI:10.1002/14651858.MR000024.pub3, Published Online: 17 OCT 2012.
IMHO, the new page should include at least:
According to my surgeon, my MRIs beautifully show the severe (but not painful!) osteoarthritis in my right hip joint, which is why I'm getting an artificial hip next week. According to the Radiology clinic, the MRIs are my property, so I may post them on Wikipedia if I so wish. So should I post those images? Old_Wombat ( talk) 09:26, 15 November 2012 (UTC)