1
|
Tan Yijia B, Goff A, Lang KV, Tham Yen Yu S, Su Khaing Myint Zu D, Munro YL, Yang SY, Callahan LF, Bowden JL, Briggs AM, Hunter DJ. Psychosocial factors in knee osteoarthritis: Scoping review of evidence and future opportunities. Osteoarthritis Cartilage 2024; 32:1327-1338. [PMID: 38851526 DOI: 10.1016/j.joca.2024.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 04/03/2024] [Accepted: 05/30/2024] [Indexed: 06/10/2024]
Abstract
OBJECTIVE Identify, describe and produce an evidence map of studies investigating psychosocial factors association with, or effect on, clinical outcomes for people with knee osteoarthritis. METHODS Scoping review of interventional and observational studies was performed. Medline (Ovid), Embase (Ovid), Cumulated Index in Nursing and Allied Health Literature, PsycInfo and Web of Science were searched on the 15th May 2023. Screening, data extraction and analysis was performed by two independent researchers. Extracted information included characteristics of studies plus which psychosocial factors were used to investigate association with, or effect on, clinical outcome(s). Descriptive statistics summarized the study design, temporal trend, geographic distribution, frequency of each psychosocial factor and whether associations/effects were observed. RESULTS 23,065 records were screened, with 108 studies selected. Eighty-two percent of studies (n = 89/108) were cross-sectional in design. Number of studies increased over time and spanned 28 countries. Most research originated from the Americas region (55 %, 59/108). Twenty-four psychosocial factors (11 psychological, 13 social) were identified. Depression (47 %, n = 48/102) and education (28 %, n = 29/102) were the most frequently reported psychological and social factors, respectively. Psychological factors were often reported to have an association with/effect on pain (81 %, n = 71/88) and physical function (75 %, n = 56/74). Social factors were less frequently reported to have an association with or effect on pain (57 %, n = 46/81) and physical function (50 %, n = 18/36). CONCLUSION Psychosocial factors are often associated with clinical outcomes for people with knee osteoarthritis. High-quality longitudinal studies examining a wide range of psychosocial factors across diverse cultural and geographical settings are key to continue informing the development of biopsychosocial models of care.
Collapse
Affiliation(s)
- Bryan Tan Yijia
- Department of Orthopaedic Surgery, Woodlands Health, National Healthcare Group, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
| | - Anthony Goff
- Health and Social Sciences, Singapore Institute of Technology, Singapore
| | | | | | | | - Yasmin Lynda Munro
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Su-Yin Yang
- Psychology Service, Woodlands Health, National Healthcare Group, Singapore
| | - Leigh F Callahan
- Thurson Arthritis Research Centre, University of North Carolina, United States of America
| | - Jocelyn L Bowden
- Sydney Musculoskeletal Health, Kolling Institute, University of Sydney, Australia; Rheumatology Department, Royal North Shore Hospital, Northern Sydney Local Health District, Sydney, NSW, Australia
| | - Andrew M Briggs
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - David J Hunter
- Sydney Musculoskeletal Health, Kolling Institute, University of Sydney, Australia; Rheumatology Department, Royal North Shore Hospital, Northern Sydney Local Health District, Sydney, NSW, Australia
| |
Collapse
|
2
|
Fiedler J, Bergmann MR, Sell S, Woll A, Stetter BJ. Just-in-Time Adaptive Interventions for Behavior Change in Physiological Health Outcomes and the Use Case for Knee Osteoarthritis: Systematic Review. J Med Internet Res 2024; 26:e54119. [PMID: 39331951 PMCID: PMC11470223 DOI: 10.2196/54119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 06/13/2024] [Accepted: 07/20/2024] [Indexed: 09/29/2024] Open
Abstract
BACKGROUND The prevalence of knee osteoarthritis (KOA) in the adult population is high and patients profit from individualized therapy approaches. Just-in-time adaptive interventions (JITAIs) are upcoming digital interventions for behavior change. OBJECTIVE This systematic review summarizes the features and effectiveness of existing JITAIs regarding important physiological health outcomes and derives the most promising features for the use case of KOA. METHODS The electronic databases PubMed, Web of Science, Scopus, and EBSCO were searched using keywords related to JITAIs, physical activity (PA), sedentary behavior (SB), physical function, quality of life, pain, and stiffness. JITAIs for adults that focused on the effectiveness of at least 1 of the selected outcomes were included and synthesized qualitatively. Study quality was assessed with the Quality Assessment Tool Effective Public Health Practice Project. RESULTS A total of 45 studies with mainly weak overall quality were included in this review. The studies were mostly focused on PA and SB and no study examined stiffness. The design of JITAIs varied, with a frequency of decision points from a minute to a day, device-based measured and self-reported tailoring variables, intervention options including audible or vibration prompts and tailored feedback, and decision rules from simple if-then conditions based on 1 variable to more complex algorithms including contextual variables. CONCLUSIONS The use of frequent decision points, device-based measured tailoring variables accompanied by user input, intervention options tailored to user preferences, and simple decision rules showed the most promising results in previous studies. This can be transferred to a JITAI for the use case of KOA by using target variables that include breaks in SB and an optimum of PA considering individual knee load for the health benefits of patients.
Collapse
Affiliation(s)
- Janis Fiedler
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Matteo Reiner Bergmann
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Stefan Sell
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Alexander Woll
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Bernd J Stetter
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| |
Collapse
|
3
|
Jönsson V, Orozco GA, Pierantoni M, Dejea H, Gustafsson A, Grassi L, Isaksson H. Influence of articular cartilage sample geometry on mechanical response and properties using finite element simulation. J Biomech 2024; 176:112323. [PMID: 39332325 DOI: 10.1016/j.jbiomech.2024.112323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 08/26/2024] [Accepted: 09/11/2024] [Indexed: 09/29/2024]
Abstract
Mechanical testing of articular cartilage yields highly variable results, posing challenges for tissue characterization. Many factors cause variability, one is sample geometry. Using in-situ phase-contrast enhanced synchrotron micro-tomographs of cartilage samples while tested in unconfined compression (stress relaxation) our group found high variability in the mechanical response. Since all samples originated from a single bovine knee, they were assumed to share mechanical properties. Microscale tomography images showed geometric irregularities in samples that were not accounted for in the often assumed intended cylindrical shape. We aimed to determine the influence of sample shape on mechanical response in unconfined compression and how sample geometry affects identified mechanical properties. Using a parametric FE model incorporating geometric irregularities in a Design of Experiments approach, results were analysed with 2-way ANOVA. Furthermore, a material parameter fitting was done with multiple segmented sample-specific finite element models simultaneously to assess the influence of sample geometry on material parameters. Results revealed that the average inclined sample surface (4°) caused a 15 % decrease in reaction forces compared to the intended cylinder. Fitting multiple sample-specific geometries simultaneously altered material parameters between -70 to +159 % compared to the average model. Strikingly, initial fibril stiffness and permeability increased by 137 % and 159 %, while the root-mean-square error of the fit was reduced by ∼2/3 compared to using parameters from a cylindrical shape model. In conclusion, minor variability in sample geometry affects property characterization and can account for some of the inter-sample variability in the mechanical data for cartilage.
Collapse
Affiliation(s)
- Viktor Jönsson
- Department of Biomedical Engineering, Lund University, Box 118, 2210 Lund, Sweden.
| | - Gustavo A Orozco
- Department of Biomedical Engineering, Lund University, Box 118, 2210 Lund, Sweden.
| | - Maria Pierantoni
- Department of Biomedical Engineering, Lund University, Box 118, 2210 Lund, Sweden.
| | - Hector Dejea
- Department of Biomedical Engineering, Lund University, Box 118, 2210 Lund, Sweden; MAX IV Laboratory, Lund University, Sweden.
| | - Anna Gustafsson
- Department of Biomedical Engineering, Lund University, Box 118, 2210 Lund, Sweden.
| | - Lorenzo Grassi
- Department of Biomedical Engineering, Lund University, Box 118, 2210 Lund, Sweden.
| | - Hanna Isaksson
- Department of Biomedical Engineering, Lund University, Box 118, 2210 Lund, Sweden.
| |
Collapse
|
4
|
García-Muñoz AM, Abellán-Ruiz MS, García-Guillén AI, Victoria-Montesinos D. Efficacy of Eggshell Membrane in Knee Osteoarthritis: A Systematic Review and Meta-Analysis. Nutrients 2024; 16:2640. [PMID: 39203777 PMCID: PMC11356944 DOI: 10.3390/nu16162640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2024] [Revised: 08/07/2024] [Accepted: 08/08/2024] [Indexed: 09/03/2024] Open
Abstract
Osteoarthritis (OA) is a prevalent, degenerative joint disease, with knee OA being particularly common and impactful. This systematic review and meta-analysis aimed to assess the efficacy of eggshell membrane (ESM) supplementation in improving joint functionality and reducing pain in individuals with knee OA. A comprehensive search was conducted across PubMed, Scopus, Web of Science, and Cochrane Database up to July 2024, following PRISMA guidelines. Seven randomized controlled trials (RCTs) met the inclusion criteria, with five included in the meta-analysis. The studies compared ESM to a placebo, evaluating outcomes based on assessment tools such as the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Visual Analogue Scale (VAS), and Knee Injury and Osteoarthritis Outcome Score (KOOS). Results indicated that ESM significantly reduced pain and improved functionality, with notable improvements in total WOMAC score (effect size -0.34; 95% CI: -0.56 to -0.13; p < 0.001) and pain subscale (SMD -0.23; 95% CI: -0.42 to -0.04; p < 0.02). The findings support ESM as a promising adjunctive treatment for knee OA, offering a safe, natural supplement to enhance quality of life. Further high-quality RCTs are needed to confirm these results and explore the long-term effects and mechanisms of ESM.
Collapse
Affiliation(s)
- Ana María García-Muñoz
- Faculty of Pharmacy and Nutrition, UCAM Universidad Católica de Murcia, 30107 Murcia, Spain; (A.M.G.-M.); (D.V.-M.)
| | | | | | - Desirée Victoria-Montesinos
- Faculty of Pharmacy and Nutrition, UCAM Universidad Católica de Murcia, 30107 Murcia, Spain; (A.M.G.-M.); (D.V.-M.)
| |
Collapse
|
5
|
Hertel E, Arendt-Nielsen L, Olesen AE, Andersen MS, Petersen KKS. Quantitative sensory testing, psychological factors, and quality of life as predictors of current and future pain in patients with knee osteoarthritis. Pain 2024; 165:1719-1726. [PMID: 38381930 DOI: 10.1097/j.pain.0000000000003194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 01/08/2024] [Indexed: 02/23/2024]
Abstract
ABSTRACT Substantial interindividual variability characterizes osteoarthritis (OA) pain. Previous findings identify quantitative sensory testing (QST), psychological factors, and health-related quality of life as contributors to OA pain and predictors of treatment outcomes. This exploratory study aimed to explain baseline OA pain intensity and predict OA pain after administration of a nonsteroidal anti-inflammatory drug in combination with paracetamol for 3 weeks. The Knee Injury and Osteoarthritis Outcome Score (KOOS) pain score was used to estimate OA pain presentation. One hundred one patients were assessed at baseline and follow-up using QST (pressure pain thresholds and temporal summation of pain [TSP]), symptoms of depression and anxiety, pain catastrophizing scales (PCSs), and health-related quality of life. Linear regression with backward selection identified that PCS significantly explained 34.2% of the variability in baseline KOOS pain, with nonsignificant contributions from TSP. Pain catastrophizing score and TSP predicted 29.3% of follow-up KOOS pain, with nonsignificant contributions from symptoms of anxiety. When assessed separately, PCS was the strongest predictor (32.2% of baseline and 24.1% of follow-up pain), but QST, symptoms of anxiety and depression, PCS, and quality of life also explained some variability in baseline and follow-up knee OA pain. Further analyses revealed that only TSP and PCS were not mediated by any other included variables, highlighting their role as unique contributors to OA pain presentation. This study emphasizes the importance of embracing a multimodal approach to OA pain and highlights PCS and TSP as major contributors to the baseline OA pain experience and the OA pain experience after OA treatment.
Collapse
Affiliation(s)
- Emma Hertel
- Center for Mathematical Modeling of Knee Osteoarthritis (MathKOA), Department of Materials and Production, Aalborg University, Aalborg, Denmark
| | - Lars Arendt-Nielsen
- Center for Mathematical Modeling of Knee Osteoarthritis (MathKOA), Department of Materials and Production, Aalborg University, Aalborg, Denmark
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark
- Steno Diabetes Center North Denmark, Clinical Institute, Aalborg University Hospital, Aalborg, Denmark
| | - Anne Estrup Olesen
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Department of Clinical Pharmacology, Aalborg University Hospital, Aalborg, Denmark
| | - Michael Skipper Andersen
- Center for Mathematical Modeling of Knee Osteoarthritis (MathKOA), Department of Materials and Production, Aalborg University, Aalborg, Denmark
| | - Kristian Kjær-Staal Petersen
- Center for Mathematical Modeling of Knee Osteoarthritis (MathKOA), Department of Materials and Production, Aalborg University, Aalborg, Denmark
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| |
Collapse
|
6
|
Muthu S, Ramanathan K, Alagar Yadav S, Jha SK, Ranjan R. Increased Cellular Dosage of Bone Marrow Aspiration Concentrate Does Not Translate to Increased Clinical Effectiveness in Knee Osteoarthritis: A Phase I Dose Escalation Study. Indian J Orthop 2024; 58:1001-1008. [PMID: 39087042 PMCID: PMC11286881 DOI: 10.1007/s43465-024-01197-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 05/31/2024] [Indexed: 08/02/2024]
Abstract
Introduction Knee osteoarthritis (KOA), a chronic degenerative disease, significantly impairs quality of life due to pain and mobility limitations. Traditional treatments focus on symptom management without addressing the underlying disease progression, leading to a growing interest in regenerative medicine approaches. Bone marrow aspirate concentrate (BMAC), rich in mesenchymal stem cells and growth factors, has shown potential for cartilage repair and symptom relief in KOA. Despite promising outcomes, the optimal BMAC dosage for knee OA treatment remains undetermined. This study aims to evaluate the clinical efficacy and safety of varying BMAC dosages in knee OA treatment. Methods This prospective controlled dose-escalation study involved 75 patients with early-stage knee OA, categorized into three groups based on BMAC dosage administered 10 × 106 cells (low-dose group), 50 × 106 cells (medium-dose group), or 100 × 106 cells (high-dose group). All the patients underwent a single intra-articular injection of BMAC and were monitored over a year. The primary outcomes include Visual Analog Scale (VAS) for pain and the Knee Injury and Osteoarthritis Outcome Score (KOOS) for joint function recorded at baseline, 1, 3, 6, and 12 months post-intervention. Adverse events were also documented. Results Significant clinical improvements in VAS and KOOS scores were noted across all groups at all time points compared to the baseline. However, these improvements did not significantly differ between dosage groups throughout the follow-up period. Adverse effects were minimal and primarily consisted of transient post-injection pain and effusion, with no dose-dependent increase in complications. Conclusion BMAC treatment for knee OA is safe and demonstrates potential for significant pain relief and functional improvement, irrespective of the dosage administered within the tested range. The lack of significant differences among varying dosages suggests a plateau in therapeutic efficacy beyond a certain threshold. Further research is necessary on the long-term outcomes to optimize the dosing strategy.
Collapse
Affiliation(s)
- Sathish Muthu
- Department of Biotechnology, School of Engineering and Technology, Sharda University, Greater Noida, Uttar Pradesh 201310 India
- Department of Orthopaedics, Government Medical College, Dindigul, Tamil Nadu 624001 India
| | - Karthikraja Ramanathan
- Department of Orthopaedics, Government Medical College, Dindigul, Tamil Nadu 624001 India
| | - Sangilimuthu Alagar Yadav
- Department of Biotechnology, Karpagam Academy of Higher Education, Coimbatore, Tamil Nadu 641021 India
| | - Saurabh Kumar Jha
- Department of Biotechnology, School of Engineering and Technology, Sharda University, Greater Noida, Uttar Pradesh 201310 India
- Department of Zoology, Kalindi College, University of Delhi, New Delhi, 110008 India
| | - Rajni Ranjan
- Department of Orthopaedics, School of Medical Sciences and Research, Sharda University, Greater Noida, Uttar Pradesh 201310 India
| |
Collapse
|
7
|
Cp A, Jayaraman K, Babkair RA, Nuhmani S, Nawed A, Khan M, Alghadir AH. Effectiveness of extracorporeal shock wave therapy on functional ability in grade IV knee osteoarthritis - a randomized controlled trial. Sci Rep 2024; 14:16530. [PMID: 39020015 PMCID: PMC11254909 DOI: 10.1038/s41598-024-67511-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 07/11/2024] [Indexed: 07/19/2024] Open
Abstract
Extracorporeal shockwave therapy (ESWT) is a non-invasive physical therapy intervention that has emerged in the recent past to address the upswing of osteoarthritis (OA). However, insufficient evidence is present to prove the efficacy of ESWT on grade IV knee osteoarthritis (KOA). The present study aimed to examine the effects of ESWT on functional ability in patients suffering from grade IV KOA. Thirty volunteers aged 45-60 years with grade IV primary KOA diagnosed by an orthopaedic surgeon based on the Kellgren-Lawrence score participated in the study. The participants were equally and randomly divided into two groups (i.e. experimental and control), with 15 participants in each group. The participants in the control group performed conventional physiotherapy (CPT) that included ultrasound therapy, isometric quadriceps, SLR and isometric hip adductor strengthening exercises. The participants in the experimental group received ESWT in addition to CPT. Lower extremity functional scale (LEFS) score was measured before and after the four weeks of intervention. In both groups, a statistically significant (p = 0.001) improvement in LEFS was observed. In the experimental groups, it improved by 81.92% and in the control groups by 48.15%. A statistically significant (p < 0.001) difference was observed in LEFS post-intervention values between both groups. As demonstrated by our trial results, the addition of ESWT to the CPT program will yield beneficial results in ameliorating the functional disability in patients with primary KOA (grade IV). Further studies are needed to confirm and apply these findings to a larger cohort.
Collapse
Affiliation(s)
- Arshed Cp
- Department of Physiotherapy, AWH Special College, Kozhikode, Affiliated to Kerala University of Health Sciences, Kozhikode, India
| | - Kavitha Jayaraman
- Department of Physiotherapy, AWH Special College, Kozhikode, Affiliated to Kerala University of Health Sciences, Kozhikode, India
| | | | - Shibili Nuhmani
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Alvina Nawed
- Department of Rehabilitation Science, Jamia Hamdard, New Delhi, India
| | - Masood Khan
- Rehabilitation Research Chair, Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
| | - Ahmad H Alghadir
- Rehabilitation Research Chair, Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
8
|
Gesheff MG, Scalzitti DA, Bains SS, Dubin J, Delanois RE. Time to Total Knee Arthroplasty (TKA) Post Intra-Articular Injection. J Clin Med 2024; 13:3764. [PMID: 38999330 PMCID: PMC11242844 DOI: 10.3390/jcm13133764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 06/08/2024] [Accepted: 06/24/2024] [Indexed: 07/14/2024] Open
Abstract
Background: Disease-modifying treatments are not currently developed to target the underlying causes of knee osteoarthritis (KOA). Corticosteroids (CS), hyaluronic acid (HA), and platelet-rich plasma (PRP) intra-articular (IA) injections are commonly used for patients that do not respond to non-pharmacological treatments, oral nonsteroidal anti-inflammatory, or pain medications to address solely KOA symptoms. Utilizing TKA as an endpoint in the KOA disease progression provides a basis to determine efficacy of this treatment pathway. The primary objective is to evaluate a large national database to determine the time between first injection and total knee arthroplasty in patients solely administered intra-articular IA, CS, and HA. Methods: A retrospective query was performed on a national, all-payer claims database (PearlDiver, Colorado Springs, CO, USA), a composite of over 160 million Health Insurance Portability and Accountability Act compliant orthopedic records across all states and territories of the United States spanning 2016 to 2022. The database was queried to produce three distinct cohorts for analysis (PRP, HA, and CS). A 4:1 case match was conducted to compare cohorts receiving a subsequent TKA. Kaplan-Meier survival analysis analyzed the TKA-free survival of patients within each group at 6 months and 1 to 4 years. The log-rank test was performed for comparisons between survival cohorts. Results: The PRP cohort had a total population of 3240 patients, of which 71 (2.2%) received a subsequent TKA. The corticosteroid cohort had a total population of 1,382,572, of which 81,271 (5.9%) received a subsequent TKA. The HA cohort had a total population of 164,000, of which 13,044 (8.0%) received a subsequent TKA. Due to the low population within the PRP group, this group was excluded from comparison. The mean time to TKA from first injection in the HA group was 377.8 days, while in the corticosteroid group it was 370.0 days. The proportions of TKA-free survival for CS and HA when compared at 4 years post-injection was similar between groups (p = 0.05). Discussion and Conclusion: Patients that received only IA-corticosteroids or IA-hyaluronic acid had a similar length of time between the first injection and the total knee arthroplasty associated with the injected joint. This evidence provides information for clinicians and patients alike when contemplating these non-surgical injection modalities for KOA. The similarity observed between these treatments supports the need for future research to determine whether there is any potential for reduction in healthcare costs for KOA treatment prior to TKA.
Collapse
Affiliation(s)
- Martin G. Gesheff
- Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, LifeBridge Health, Baltimore, MD 21215, USA; (M.G.G.); (S.S.B.); (J.D.)
- Health, Human Function, and Rehabilitation Sciences, George Washington University School of Medicine and Health Sciences, Washington, DC 20052, USA;
| | - David A. Scalzitti
- Health, Human Function, and Rehabilitation Sciences, George Washington University School of Medicine and Health Sciences, Washington, DC 20052, USA;
| | - Sandeep S. Bains
- Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, LifeBridge Health, Baltimore, MD 21215, USA; (M.G.G.); (S.S.B.); (J.D.)
| | - Jeremy Dubin
- Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, LifeBridge Health, Baltimore, MD 21215, USA; (M.G.G.); (S.S.B.); (J.D.)
| | - Ronald E. Delanois
- Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, LifeBridge Health, Baltimore, MD 21215, USA; (M.G.G.); (S.S.B.); (J.D.)
| |
Collapse
|
9
|
Shen X, Wang S, Chen J, Li J, Li C, Xiang R, Zhao C, Xu X. Inter-rater reliability and test-retest reliability of the foot posture index (FPI-6) for assessing static foot posture in elderly female patients with knee osteoarthritis and its association with quadriceps muscle tone and stiffness. Front Bioeng Biotechnol 2024; 12:1385986. [PMID: 38983600 PMCID: PMC11232489 DOI: 10.3389/fbioe.2024.1385986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 05/29/2024] [Indexed: 07/11/2024] Open
Abstract
Objective 1. To assess the Inter-rater reliability and test-retest reliability of FPI-6 total score and individual scores in static foot posture evaluation among elderly female patients with knee osteoarthritis (KOA), aiming to establish the reliability of the FPI-6 scale. 2. To investigate the disparity between dominant and non-dominant quadriceps characteristics in elderly female KOA patients, as well as explore the correlation between quadriceps characteristics and abnormal foot posture, thereby offering novel insights for the prevention and treatment of KOA. Methods The study enrolled a total of 80 lower legs of 40 participants (all female) with unilateral or bilateral KOA, who were assessed by two raters at three different time points. The inter-rater and test-retest reliability of the FPI-6 was evaluated using the intra-class correlation coefficient (ICC), while the absolute reliability of FPI-6 was examined using the standard error of measurement (SEM), minimum detectable change (MDC), and Bland-Altman analysis. The internal consistency of FPI-6 was assessed using Spearman's correlation coefficient. Additionally, MyotonPRO was employed to assess quadriceps muscle tone and stiffness in all participants, and the association between quadriceps muscle tone/stiffness and the total score of FPI-6 was analyzed. Result Our study found excellent inter-rater and test-retest reliability (ICC values of 0.923 and 0.931, respectively) for the FPI-6 total score, as well as good to excellent reliability (ICC values ranging from 0.680 to 0.863 and 0.739-0.883) for individual items. The SEM and MDC values for the total score of FPI-6 among our study inter-rater were 0.78 and 2.15, respectively. and the SEM and MDC values for the test-retest total score of FPI-6 were found to be 0.76 and 2.11, respectively. Furthermore, the SEM and MDC values between inter-rater and test-retest across six individual items ranged from 0.30 to 0.56 and from 0.84 to 1.56. The Bland-Altman plots and respective 95% LOA showed no evidence of systematic bias. In terms of the mechanical properties of the quadriceps on both sides, the muscle tone and stiffness of rectus femoris (RF), vastus medialis (VM), and vastus lateralis (VL) were significantly higher in the non-dominant leg compared to the dominant leg. Additionally, in the non-dominant leg, there was a significant positive correlation between the muscle tone and stiffness of VM, VL, RF and the total score of FPI-6. However, in the dominant leg, only VM's muscle tone and stiffness showed a significant positive correlation with the total score of FPI-6. Conclusion The reliability of the FPI-6 total score and its six individual items was good to excellent. Our findings offer a straightforward and dependable approach for researchers to assess foot posture in elderly female patients with KOA. Furthermore, we observed significantly greater quadriceps tension and stiffness in the non-dominant leg compared to the dominant leg. The FPI-6 total score exhibited a significant correlation with changes in quadriceps muscle performance among KOA patients. These observations regarding the relationship between changes in quadriceps muscle performance and foot posture in elderly female KOA patients may provide novel insights for disease prevention, treatment, and rehabilitation.
Collapse
Affiliation(s)
- XingXing Shen
- The Fifth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shuai Wang
- The Fifth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jiahao Chen
- The Fifth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Junyi Li
- The Fifth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Congcong Li
- The Fifth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ruian Xiang
- The Fifth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chuanxi Zhao
- The Fifth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China
| | - Xuemeng Xu
- The Fifth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China
| |
Collapse
|
10
|
Han R, Guo C, Lau K, Hu J. Efficacy of knee osteoarthritis by use of laser acupuncture: A systematic review and meta-analysis. Medicine (Baltimore) 2024; 103:e38325. [PMID: 38905420 PMCID: PMC11191916 DOI: 10.1097/md.0000000000038325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 05/01/2024] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND Previous studies need to be aggregated and updated. We aim to assess the efficacy of laser acupuncture (LA) in knee osteoarthritis (OA) through a meta-analysis. METHODS Electronic databases were searched for studies investigating laser acupuncture's efficacy in managing OA. Data were collected from the beginning of each database to 2022 (up to March). The "WOMAC total score," "WOMAC stiffness score," "WOMAC pain score," "WOMAC physical function score," and "VAS score" were the key outcomes of interest. The Der Simonian-Laird method for random effects was used. RESULTS Twenty-five randomized controlled clinical trials met our criteria and were included (2075 patients). Comparisons of interest is the LA versus Sham LA (efficacy), LA versus. A (Acupuncture) (comparative effectiveness), LA combined with A versus A (effectiveness as an adjunct), and any other research used LA in their treatment. Laser irradiation is effective in patients with Knee OA. LA is also effective and has almost the same outcome as laser irradiation. LA can achieve almost the same effect as manual acupuncture, even better than acupuncture in some studies. CONCLUSION Laser acupuncture is more or less effective in patients with OA; better efficacy will be achieved under appropriate laser parameters (810 nm, 785 nm) in the LA versus Sham LA group. Many studies have diverse results, possibly due to unstaged analysis of patients' disease, inappropriate selection of acupoints, lack of remote combined acupoints, and unreasonable laser parameters. Furthermore, a combination of acupoints was found to be more effective, which aligns with the combined-acupoints application of traditional Chinese medicine.
Collapse
Affiliation(s)
- Rong Han
- Department of Biomedical Engineering, City University of Hong Kong, Kowloon Tong, Hong Kong, China
| | - Chunxia Guo
- Department of Biomedical Engineering, City University of Hong Kong, Kowloon Tong, Hong Kong, China
| | - Kit Lau
- Department of Biomedical Engineering, City University of Hong Kong, Kowloon Tong, Hong Kong, China
| | - Jinlian Hu
- Department of Biomedical Engineering, City University of Hong Kong, Kowloon Tong, Hong Kong, China
| |
Collapse
|
11
|
韩 龙, 林 天, 何 敏, 何 晓, 詹 芝, 陆 舜, 曾 子, 林 锟, 田 佳, 侯 文, 魏 腾, 魏 秋. [Finite element analysis of the impact of bone mass and volume of low-density area under tibial plateau on lower limb alignment]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2024; 38:734-741. [PMID: 38918196 PMCID: PMC11190682 DOI: 10.7507/1002-1892.202312026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 05/16/2024] [Indexed: 06/27/2024]
Abstract
Objective To investigate the impact of the bone mass and volume of the low-density area under the tibial plateau on the lower limb force line by finite element analysis, offering mechanical evidence for preventing internal displacement of the lower limb force line in conjunction with knee varus in patients with knee osteoarthritis (KOA) and reducing bone mass under the tibial plateau. Methods A healthy adult was selected as the study subject, and X-ray film and CT imaging data were acquired. Mimics 21.0 software was utilized to reconstruct the complete knee joint model and three models representing low-density areas under the tibial plateau with equal volume but varying shapes. These models were then imported into Solidworks 2023 software for assembly and verification. Five KOA finite element models with 22%, 33%, 44%, 55%, and 66% bone mass reduction in the low-density area under tibial plateau and 5 KOA finite element models with 81%, 90%, 100%, 110%, and 121% times of the low-density area model with 66% bone mass loss were constructed, respectively. Under physiological loading conditions of the human lower limb, the distal ends of the tibia and fibula were fully immobilized. An axial compressive load of 1 860 N, following the lower limb force line, was applied to the primary load-bearing area on the femoral head surface. The maximum stress within the tibial plateau, as well as the maximum displacements of the tibial cortical bone and tibial subchondral bone, were calculated and analyzed using the finite element analysis software Abaqus 2022. Subsequently, predictions regarding the alteration of the lower limb force line were made based on the analysis results. Results The constructed KOA model accorded with the normal anatomical structure of lower limbs. Under the same boundary conditions and the same load, the maximum stress of the medial tibial plateau, the maximum displacement of the tibial cortical bone and the maximum displacement of the cancellous bone increased along with the gradual decrease of bone mass in the low-density area under the tibial plateau and the gradual increase in the volume of the low-density area under tibial plateau, with significant differences ( P<0.05). Conclusion The existence of a low-density area under tibial plateau suggests a heightened likelihood of knee varus and inward movement of the lower limb force line. Both the volume and reduction in bone mass of the low-density area serve as critical initiating factors. This information can provide valuable guidance to clinicians in proactively preventing knee varus and averting its occurrence.
Collapse
Affiliation(s)
- 龙飞 韩
- 广州中医药大学第三临床医学院(广州 510405)Third Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou Guangdong, 510405, P. R. China
| | - 天烨 林
- 广州中医药大学第三临床医学院(广州 510405)Third Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou Guangdong, 510405, P. R. China
- 广东省中医骨伤研究院(广州 510378)Guangdong Academy of Traditional Chinese Medicine Orthopedics and Traumatology, Guangzhou Guangdong, 510378, P. R. China
| | - 敏聪 何
- 广州中医药大学第三临床医学院(广州 510405)Third Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou Guangdong, 510405, P. R. China
- 广东省中医骨伤研究院(广州 510378)Guangdong Academy of Traditional Chinese Medicine Orthopedics and Traumatology, Guangzhou Guangdong, 510378, P. R. China
| | - 晓铭 何
- 广州中医药大学第三临床医学院(广州 510405)Third Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou Guangdong, 510405, P. R. China
- 广东省中医骨伤研究院(广州 510378)Guangdong Academy of Traditional Chinese Medicine Orthopedics and Traumatology, Guangzhou Guangdong, 510378, P. R. China
| | - 芝玮 詹
- 广州中医药大学第三临床医学院(广州 510405)Third Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou Guangdong, 510405, P. R. China
| | - 舜 陆
- 广州中医药大学第三临床医学院(广州 510405)Third Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou Guangdong, 510405, P. R. China
| | - 子俊 曾
- 广州中医药大学第三临床医学院(广州 510405)Third Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou Guangdong, 510405, P. R. China
| | - 锟 林
- 广州中医药大学第三临床医学院(广州 510405)Third Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou Guangdong, 510405, P. R. China
| | - 佳庆 田
- 广州中医药大学第三临床医学院(广州 510405)Third Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou Guangdong, 510405, P. R. China
| | - 文渊 侯
- 广州中医药大学第三临床医学院(广州 510405)Third Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou Guangdong, 510405, P. R. China
| | - 腾飞 魏
- 广州中医药大学第三临床医学院(广州 510405)Third Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou Guangdong, 510405, P. R. China
| | - 秋实 魏
- 广州中医药大学第三临床医学院(广州 510405)Third Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou Guangdong, 510405, P. R. China
- 广东省中医骨伤研究院(广州 510378)Guangdong Academy of Traditional Chinese Medicine Orthopedics and Traumatology, Guangzhou Guangdong, 510378, P. R. China
- 广州中医药大学第三附属医院关节中心(广州 510378)Department of Joint Center, the Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou Guangdong, 510378, P. R. China
| |
Collapse
|
12
|
Adouni M, Aydelik H, Faisal TR, Hajji R. The effect of body weight on the knee joint biomechanics based on subject-specific finite element-musculoskeletal approach. Sci Rep 2024; 14:13777. [PMID: 38877075 PMCID: PMC11178890 DOI: 10.1038/s41598-024-63745-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 05/30/2024] [Indexed: 06/16/2024] Open
Abstract
Knee osteoarthritis (OA) and obesity are major public health concerns that are closely intertwined. This intimate relationship was documented by considering obesity as the most significant preventable risk factor associated with knee OA. To date, however, the effects of obesity on the knee joint's passive-active structure and cartilage loading have been inconclusive. Hence, this study investigates the intricate relationship between obesity and knee OA, centering on the biomechanical changes in knee joint active and passive reactions during the stance phase of gait. Using a subject-specific musculoskeletal and finite element approach, muscle forces, ligament stresses, and articular cartilage contact stresses were analyzed among 60 individuals with different body mass indices (BMI) classified under healthy weight, overweight, and obese categories. Our predicted results showed that obesity significantly influenced knee joint mechanical reaction, increasing muscle activations, ligament loading, and articular cartilage contact stresses, particularly during key instances of the gait cycle-first and second peak loading instances. The study underscores the critical role of excessive body weight in exacerbating knee joint stress distribution and cartilage damage. Hence, the insights gained provide a valuable biomechanical perspective on the interaction between body weight and knee joint health, offering a clinical utility in assessing the risks associated with obesity and knee OA.
Collapse
Affiliation(s)
- Malek Adouni
- Biomedical and Instrumentation Engineering, Abdullah Al Salem University, Khalidiya, Kuwait.
- Physical Medicine and Rehabilitation Department, Northwestern University, 345 East Superior Street, Chicago, IL, 60611, USA.
| | - Harun Aydelik
- Mathematics, College of Integrative Studies, Abdullah Al Salem University, Khalidiya, Kuwait
| | - Tanvir R Faisal
- Department of Mechanical Engineering, University of Louisiana at Lafayette, Lafayette, LA, 70508, USA
| | - Raouf Hajji
- Internal Medicine Department, Medicine Faculty of Sousse, University of Sousse, Sousse, Tunisia
| |
Collapse
|
13
|
Paolucci T, Tommasi M, Pozzato G, Pozzato A, Pezzi L, Zuccarini M, Di Lanzo A, Palumbo R, Porto D, Messeri R, Pesce M, Pantalone A, Buda R, Patruno A. Management and Rehabilitative Treatment in Osteoarthritis with a Novel Physical Therapy Approach: A Randomized Control Study. Diagnostics (Basel) 2024; 14:1200. [PMID: 38893726 PMCID: PMC11171699 DOI: 10.3390/diagnostics14111200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 05/17/2024] [Accepted: 06/03/2024] [Indexed: 06/21/2024] Open
Abstract
Knee osteoarthritis (KOA) is a chronic degenerative disease characterized by progressive joint damage leading to significant disability. Although rehabilitative treatment methods for KOA have been widely implemented, the optimal integrated instrumental physical therapy approach remains unclear. Therefore, this study aimed to analyze the effect of Quantum Molecular Resonance (QMR) on pain reduction as the primary outcome and the functional improvement in activity daily living (ADL) as a secondary outcome. The study was designed as a double-blind, randomized, controlled trial in an outpatient setting. Fifty-four (N = 54) patients were enrolled and then randomized into three groups according to a simple randomization list: Group 1 (intensive protocol, N = 22), Group 2 (extensive protocol, N = 21), and a Sham group (N = 11). Patients were evaluated over time with scales assessing pain and function. Treatment was performed with the QMR model electro-medical device, which generates alternating electric currents characterized by high frequency (4-64 MHz). The results showed that QMR had a positive effect with respect to the Sham group in terms of pain and function (p < 0.01), and intensive treatment was more effective than the extensive treatment in terms of "speed of response" to the treatment (p < 0.05). In conclusion, QMR in KOA could be effective in slowing the progression of clinical symptoms and improving patients' pain and functionality and thus quality of life. Future studies will be necessary to investigate further treatment algorithms and therapeutic associations with rehabilitative exercise.
Collapse
Affiliation(s)
- Teresa Paolucci
- Department of Oral, Medical and Biotechnological Sciences, Physical Medicine and Rehabilitation, G. D’Annunzio University of Chieti-Pescara, 66100 Chieti, Italy; (T.P.); (M.Z.); (A.D.L.)
| | - Marco Tommasi
- Department of Medicine and Aging Sciences, G. D’Annunzio University of Chieti-Pescara, 66100 Chieti, Italy; (M.T.); (A.P.); (R.B.); (A.P.)
| | | | | | - Letizia Pezzi
- Unit of Physical Medicine and Rehabilitation, Hospital of Cremona, 26100 Cremona, Italy;
| | - Mariachiara Zuccarini
- Department of Oral, Medical and Biotechnological Sciences, Physical Medicine and Rehabilitation, G. D’Annunzio University of Chieti-Pescara, 66100 Chieti, Italy; (T.P.); (M.Z.); (A.D.L.)
| | - Alessio Di Lanzo
- Department of Oral, Medical and Biotechnological Sciences, Physical Medicine and Rehabilitation, G. D’Annunzio University of Chieti-Pescara, 66100 Chieti, Italy; (T.P.); (M.Z.); (A.D.L.)
| | - Rocco Palumbo
- Department of Psychological, Health and Territorial Sciences, G. D’Annunzio University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Daniele Porto
- Institute Don Orione, Medical-Social Recovery Center, 65128 Pescara, Italy; (D.P.); (R.M.)
| | - Riccardo Messeri
- Institute Don Orione, Medical-Social Recovery Center, 65128 Pescara, Italy; (D.P.); (R.M.)
| | - Mirko Pesce
- Department of Medicine and Aging Sciences, G. D’Annunzio University of Chieti-Pescara, 66100 Chieti, Italy; (M.T.); (A.P.); (R.B.); (A.P.)
- UdA-TechLab, Research Center, University of Chieti-Pescara, 65100 Pescara, Italy
| | - Andrea Pantalone
- Department of Medicine and Aging Sciences, G. D’Annunzio University of Chieti-Pescara, 66100 Chieti, Italy; (M.T.); (A.P.); (R.B.); (A.P.)
| | - Roberto Buda
- Department of Medicine and Aging Sciences, G. D’Annunzio University of Chieti-Pescara, 66100 Chieti, Italy; (M.T.); (A.P.); (R.B.); (A.P.)
| | - Antonia Patruno
- Department of Medicine and Aging Sciences, G. D’Annunzio University of Chieti-Pescara, 66100 Chieti, Italy; (M.T.); (A.P.); (R.B.); (A.P.)
- UdA-TechLab, Research Center, University of Chieti-Pescara, 65100 Pescara, Italy
| |
Collapse
|
14
|
Valdenassi L, Chierchia M, Pandolfi S, Bellardi D, Chirumbolo S, Franzini M. Adjunct treatment with ozone to enhance therapy of knee osteoarthritis: preliminary results. Clin Rheumatol 2024; 43:2093-2101. [PMID: 38671261 DOI: 10.1007/s10067-024-06972-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 04/16/2024] [Accepted: 04/17/2024] [Indexed: 04/28/2024]
Abstract
Knee osteoarthritis (knee OA), commonly known as gonarthrosis, is a chronic pathology involving knee at the joint level causing progressive pain, stiffness and difficulty in ambulation and leg movements. So far in situ infiltration therapies such as platelet rich plasma, conditioned autologous serum or hyaluronic acid, provided some encouraging though limited hopes for a routinely recommended therapy for knee OA. Recent clinical successful observations about the use of whole autologous blood ozonated with a calibrated mixture of oxygen and ozone, has promoted the present research study, in order to treat knee OA. A number of 250 patients suffering with knee OA of different Ahlback scores, were treated with infiltration of ozonated blood and evaluated for their WOMAC and Lequesne indexes, pre- and post-treatment, to evaluate pain, disability and stiffness. Patients recovered about 50% of their health status, reducing pain, stiffness and disability by only 5 sessions, one/week, with 20 μg/ml O3 ozonated autologous blood knee infiltrations. The evidence asks for further supporting results yet encourages our efforts to go ahead in this research issue. Key Points •The oxygen-ozone therapy via ozonated blood infiltration was used in this study. •Ozone reduced pain, disability, and stiffness in both female and male patients. •The treatment with ozone improved WOMAC both in type I and type II Ahlback knee OA. •The oxygen-ozone therapy via ozonated blood ameliorated Lequesne functional index.
Collapse
Affiliation(s)
- Luigi Valdenassi
- Magenta Medical Center, Genoa, Italy
- Italian Scientific Society of Oxygen Ozone Therapy (SIOOT) and Master School of Oxygen Ozone Therapy, University of Pavia, Pavia, Italy
| | - Marianna Chierchia
- Department of Orthopedics and Traumatology, University of Caserta "Luigi Vanvitelli", Caserta, Italy
| | - Sergio Pandolfi
- Italian Scientific Society of Oxygen Ozone Therapy (SIOOT) and Master School of Oxygen Ozone Therapy, University of Pavia, Pavia, Italy
| | | | - Salvatore Chirumbolo
- Department of Engineering and Innovation Medicine (DIMI), University of Verona, Strada Le Grazie 8, 37134, Verona, Italy.
| | - Marianno Franzini
- Italian Scientific Society of Oxygen Ozone Therapy (SIOOT) and Master School of Oxygen Ozone Therapy, University of Pavia, Pavia, Italy
| |
Collapse
|
15
|
Berrimi M, Hans D, Jennane R. A semi-supervised multiview-MRI network for the detection of Knee Osteoarthritis. Comput Med Imaging Graph 2024; 114:102371. [PMID: 38513397 DOI: 10.1016/j.compmedimag.2024.102371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 03/09/2024] [Accepted: 03/13/2024] [Indexed: 03/23/2024]
Abstract
Knee OsteoArthritis (OA) is a prevalent chronic condition, affecting a significant proportion of the global population. Detecting knee OA is crucial as the degeneration of the knee joint is irreversible. In this paper, we introduce a semi-supervised multi-view framework and a 3D CNN model for detecting knee OA using 3D Magnetic Resonance Imaging (MRI) scans. We introduce a semi-supervised learning approach combining labeled and unlabeled data to improve the performance and generalizability of the proposed model. Experimental results show the efficacy of our proposed approach in detecting knee OA from 3D MRI scans using a large cohort of 4297 subjects. An ablation study was conducted to investigate the contributions of various components of the proposed model, providing insights into the optimal design of the model. Our results indicate the potential of the proposed approach to improve the accuracy and efficiency of OA diagnosis. The proposed framework reported an AUC of 93.20% for the detection of knee OA.
Collapse
Affiliation(s)
- Mohamed Berrimi
- University of Orleans, Institut Denis Poisson, UMR CNRS 7013, Orleans, 45067, France
| | - Didier Hans
- Lausanne University Hospital, Center of Bone Diseases & University of Lausanne, Lausanne, Switzerland
| | - Rachid Jennane
- University of Orleans, Institut Denis Poisson, UMR CNRS 7013, Orleans, 45067, France.
| |
Collapse
|
16
|
Boddu SP, Gill VS, Haglin JM, Brinkman JC, Deckey DG, Bingham JS. Lower Income and Nonheterosexual Orientation Are Associated With Poor Access to Care in Patients With Knee Osteoarthritis. Arthroplast Today 2024; 27:101353. [PMID: 38774403 PMCID: PMC11106826 DOI: 10.1016/j.artd.2024.101353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 01/20/2024] [Accepted: 02/14/2024] [Indexed: 05/24/2024] Open
Abstract
Background Social determinants of health are implicated in the experience of knee osteoarthritis, a key component of which is access to care and healthcare utilization. The objective of this study was to describe difficulties in access to care and healthcare utilization in the United States knee osteoarthritis population. Methods The publicly available All of Us Database was utilized to conduct a retrospective cohort study. Patients with a diagnosis of knee osteoarthritis were included and matched to a control group who did not have knee osteoarthritis. The association of knee osteoarthritis and patient-specific demographic features with self-reported domains of access to care was analyzed. Results Among 15,718 patients with knee osteoarthritis, 27.6% reported delayed care (n = 4343), 25.6% reported inability to afford care (n = 4015), 12.8% reported skipped medications (n = 2011), and 1.6% reported not seeing a healthcare provider in over 1 year (n = 247). Patients with knee osteoarthritis were more likely to be unable to afford care (odds ratio 1.21, P < .001) or skip medications (odds ratio 1.12, P = .004) in comparison to matched patients without knee osteoarthritis. Among the knee osteoarthritis cohort, low income and nonheterosexual orientation were both associated with increased rates of delayed care and an inability to afford care. Conclusions Patients with knee osteoarthritis report significant challenges with delayed care, affordability of care, and medication adherence. Among patients with knee osteoarthritis, patients who are younger age, female sex, low-income, low-education, nonheterosexual orientation, or have poor physical and mental health are at increased risk of having decreased access to treatment.
Collapse
Affiliation(s)
- Sayi P. Boddu
- Mayo Clinic Alix School of Medicine, Scottsdale, AZ, USA
| | - Vikram S. Gill
- Mayo Clinic Alix School of Medicine, Scottsdale, AZ, USA
| | - Jack M. Haglin
- Department of Orthopedic Surgery, Mayo Clinic, Phoenix, AZ, USA
| | | | - David G. Deckey
- Department of Orthopedic Surgery, Mayo Clinic, Phoenix, AZ, USA
| | | |
Collapse
|
17
|
Pires DPDC, Monte FAD, Monteiro LF, Soares FRDC, Faria JLRD. Updates in the Treatment of Knee Osteoarthritis. Rev Bras Ortop 2024; 59:e337-e348. [PMID: 38911892 PMCID: PMC11193585 DOI: 10.1055/s-0044-1786351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 07/21/2023] [Indexed: 06/25/2024] Open
Abstract
Knee osteoarthritis (OA) is an inflammatory and degenerative condition resulting in articular cartilage destruction and functional loss. Its prevalence has grown considerably due to increased life expectancy and obesity, and its diagnosis relies on evaluation, medical examination, and confirmation by supplementary radiographic images. Knee OA is multifactorial and influenced by several local, systemic, and external aspects. In addition, its progress and therapeutic responses highly depend on the characteristics of each subject. The initial recommendation is drug treatment and alternative therapies to improve quality of life. However, if these treatments are unsuccessful, one must consider surgical treatment. Surgical options include arthroscopies, osteotomies, and partial and total arthroplasties, while non-surgical treatments include medications and alternative therapies such as infiltrations, acupuncture, and physical exercise. It is worth highlighting that biomarkers can be a significant strategy for early disease detection, assessment of disease activity, prediction of prognosis, and monitoring a better response to therapy. Nevertheless, this topic must be the focus of further research to confirm its findings.
Collapse
Affiliation(s)
| | - Felipe Alves do Monte
- Departamento de Ortopedia e Traumatologia, Hospital da Restauração Governador Paulo Guerra, Recife, PE, Brasil
| | | | - Francisco Rafael do Couto Soares
- Serviço de Traumatologia e Ortopedia, Hospital Metropolitano Norte Miguel Arraes (HMA), Recife, PE, Brasil
- Serviço de Traumatologia e Ortopedia, Instituto de Medicina Integral Professor Fernando Figueira (IMIP), Recife, PE, Brasil
| | | |
Collapse
|
18
|
Abu-Awwad A, Tudoran C, Abu-Awwad SA, Tudoran M, Voita-Mekeres F, Faur C, Szilagyi G. Analogies Between Platelet-Rich Plasma Versus Hyaluronic Acid Intra-articular Injections in the Treatment of Advanced Knee Arthritis: A Single-Center Study. Cureus 2024; 16:e61163. [PMID: 38933627 PMCID: PMC11202161 DOI: 10.7759/cureus.61163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2024] [Indexed: 06/28/2024] Open
Abstract
Background Knee osteoarthritis (KOA), a degenerative joint disease, is a common cause of chronic knee pain and disability in adults. Conservative management options are the first-line approach, but intra-articular injections, such as platelet-rich plasma (PRP) and hyaluronic acid (HA), are considered for advanced cases. This study aims to compare the efficacy of PRP versus HA injections in patients with advanced KOA. Methods A retrospective study was conducted on 145 patients with advanced KOA. Seventy patients received PRP injections, while 75 patients received HA injections. The Visual Analog Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and International Knee Documentation Committee (IKDC) score were employed to evaluate the treatment's efficacy. Adverse events associated with these injections were also recorded. Results Both PRP and HA injections significantly reduced pain and improved joint function in patients with advanced KOA. PRP injections were slightly more effective than HA injections in reducing pain scores. Both treatments showed similar improvements in functional outcomes. Adverse events were minimal and self-limiting for both treatments. Conclusions Both PRP and HA injections effectively ameliorate advanced KOA by reducing pain and improving function. PRP injections showed a slightly greater improvement in pain scores and functional outcomes. The choice between PRP and HA injections may depend on factors like cost, availability, and patient preference. Further research is needed to validate these findings and understand treatment suitability for different patient populations.
Collapse
Affiliation(s)
- Ahmed Abu-Awwad
- Orthopedics and Traumatology, Department XV-Discipline of Orthopedics-Traumatology, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, ROU
- Orthopedics and Traumatology, "Pius Brinzeu" County Emergency Hospital, Timisoara, ROU
- Orthopedics and Traumatology, Research Center University Professor Doctor Teodor Șora, Victor Babes University of Medicine and Pharmacy, Timisoara, ROU
| | - Cristina Tudoran
- Department VII, Internal Medicine II, Discipline of Cardiology, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, ROU
- Cardiology, Center of Molecular Research in Nephrology and Vascular Disease, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, ROU
- Cardiology, "Pius Brinzeu" County Emergency Hospital, Timisoara, ROU
| | - Simona-Alina Abu-Awwad
- Gynecology, "Pius Brinzeu" County Emergency Hospital, Timisoara, ROU
- Gynecology, Department XII-Discipline of Obstetrics and Gynecology, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, ROU
| | - Mariana Tudoran
- Cardiology, "Pius Brinzeu" County Emergency Hospital, Timisoara, ROU
| | - Florica Voita-Mekeres
- Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, ROU
| | - Cosmin Faur
- Orthopedics and Traumatology, Department XV-Discipline of Orthopedics-Traumatology, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, ROU
- Orthopedics and Traumatology, "Pius Brinzeu" County Emergency Hospital, Timisoara, ROU
- Orthopedics and Traumatology, Research Center University Professor Doctor Teodor Șora, Victor Babes University of Medicine and Pharmacy, Timisoara, ROU
| | - Gheorghe Szilagyi
- Surgical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, ROU
| |
Collapse
|
19
|
Irshad S, Waleed U, Zafar MH, Ramzan MT, Tariq MA, Hassan M, Sohaib MA, Liaquat S, Mehmood S, Ali RS, Khan TM. The Efficacy of Intra-articular Platelet-Rich Plasma Injection Versus Corticosteroid Injection in the Treatment of Knee Osteoarthritis: A Prospective Comparative Analysis. Cureus 2024; 16:e61040. [PMID: 38916012 PMCID: PMC11194758 DOI: 10.7759/cureus.61040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2024] [Indexed: 06/26/2024] Open
Abstract
Background Knee osteoarthritis (KOA) is the most typical cause of knee pain and impairment worldwide. It is typified by slow and progressive degeneration of the articular cartilage of the knee joint. Although KOA is being managed with a variety of therapies, the comparison of the effectiveness of different intra-articular injections in KOA treatment in Pakistan is still not thoroughly investigated. Therefore, the purpose of this current study is to compare the efficacy of intra-articular administration of platelet-rich plasma (PRP) and corticosteroids (CSs) in the treatment of KOA. Methods This prospective comparative study was performed among one hundred patients diagnosed with KOA in Benazir Bhutto Hospital, Rawalpindi, for one year from April 2022 to March 2023. Specified inclusion and exclusion criteria were employed for patient enrollment. Patients were divided into two equal groups through simple random sampling. Group A patients received an intra-articular injection of PRP solution whereas group B patients received an intra-articular injection of CSs. Informed consent and ethical approval were also acquired prior to data collection. A self-designed proforma based on interviews was used to collect data. The data analysis in Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Version 25.0, Armonk, NY) was carried out via descriptive statistics and an independent t-test. Results Women (N=71, 71%) had a higher prevalence of KOA than men (N=29, 29%). The means of study variables like age, Visual Analog Scale (VAS) score, and Western Ontario and McMaster Universities (WOMAC) score were 56.10 ± 8.70 years, 8.08 ± 1.6, and 70.08 ± 8.76 respectively. The frequency of KOA on the right side was 62% (N=62) while it was 38% (N=38) on the left side. In the study population, 69% (N=69) patients had grade II KOA, and 31% (N=31) patients had grade III KOA. At the first-month, second-month, and third-month follow-up visits, there were statistically significant differences in the mean scores of the WOMAC and VAS between the study groups. However, at the first-month follow-up visit, mean scores of VAS and WOMAC were lower in group B than in group A while these were lower in group A as compared to group B, at the second-month and third-month follow-up appointments. Conclusions Intra-articular infiltration of both PRP and CSs was efficacious in the treatment of KOA-related pain and functional limitations; however, overall improvement in the PRP group was higher than CS group.
Collapse
Affiliation(s)
- Sumbal Irshad
- Internal Medicine, Philadelphia College of Osteopathic Medicine, Philadelphia, USA
| | - Usman Waleed
- Orthopaedic Surgery, Benazir Bhutto Hospital, Rawalpindi, PAK
| | | | | | | | - Muhammad Hassan
- Internal Medicine, Allama Iqbal Medical College, Lahore, PAK
| | | | - Sana Liaquat
- Orthopaedic Surgery, Sheikh Zayed Medical College and Hospital, Rahim Yar Khan, PAK
| | - Sanwal Mehmood
- Internal Medicine, Allama Iqbal Medical College, Lahore, PAK
| | - Rana Shahzaib Ali
- Orthopaedic Surgery, Sheikh Zayed Medical College and Hospital, Rahim Yar Khan, PAK
| | | |
Collapse
|
20
|
Tran Quoc L, Le Khanh T, Mai Thi Hong N, Pham Son T. Influence of Changes in Patella Indices on Total Knee Replacement Surgery Outcomes. Orthop Rev (Pavia) 2024; 16:116365. [PMID: 38682045 PMCID: PMC11045340 DOI: 10.52965/001c.116365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Accepted: 03/24/2024] [Indexed: 05/01/2024] Open
Abstract
Summary Total knee replacement is increasingly widely prescribed, not only for degenerative joint disease but also for other problems such as articular cartilage disease, misalignment due to causes other than degeneration, bone and joint cancer, and diseases that cause joint destruction. However, changes in knee joint biomechanics as well as complications of the patellofemoral joint after surgery lead to instability, joint pain, patellar rupture, and patellar tendon rupture. These are issues that challenge surgeons as well as make patients hesitant when considering knee replacement surgery. Understanding the changes in patella index that can occur after total knee replacement surgery will help surgeons carefully evaluate patients before surgery and calculate intraoperative techniques to minimize complications. Methods Fifty-eight patients with 62 knees were diagnosed with osteoarthritis and underwent total knee replacement surgery. All patients had clinical and radiographic evaluation of the knee joint before and after surgery. Results Patellar indexes did not change significantly after surgery compared to before surgery. Before surgery, 2 patients (3.23%) had true patella baja. After surgery, 7 patients (11.29%) had true patella baja and 3 patients (4.84%) had pseudo-patella baja. The average knee flexion amplitude after surgery was 103.11±15.440, with only 2 patients losing extension >50º. The average KS score after surgery was 83.69±9.98, significantly improved compared to before surgery 33.44±11.38. Similarly, KFS score after surgery was 81.01±8.84 compared to before surgery 37.05±8.08. Conclusion Changes in index of the patella before and after surgery affect the surgical results, the normal patella group has better results than the group with patella baja.
Collapse
Affiliation(s)
- Lam Tran Quoc
- Ha Noi University Public Health
- Pham Ngoc Thach General Hospital
| | | | | | | |
Collapse
|
21
|
Tan BY. CORR Insights®: What Are the Underlying Mental Health Constructs Associated With Level of Capability in People With Knee and Hip Osteoarthritis? Clin Orthop Relat Res 2024; 482:645-647. [PMID: 38416421 PMCID: PMC10936974 DOI: 10.1097/corr.0000000000003023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 02/07/2024] [Indexed: 02/29/2024]
Affiliation(s)
- Bryan Yijia Tan
- Department of Orthopedic Surgery, Woodlands Health, National Healthcare Group, Singapore , Singapore
| |
Collapse
|
22
|
Kennedy O, Kitson A, Okpara C, Chow LW, Gonzalez-Fernandez T. Immunomodulatory Strategies for Cartilage Regeneration in Osteoarthritis. Tissue Eng Part A 2024; 30:259-271. [PMID: 38126327 DOI: 10.1089/ten.tea.2023.0255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
Osteoarthritis (OA) is the most prevalent musculoskeletal disorder and a leading cause of disability globally. Although many efforts have been made to treat this condition, current tissue engineering (TE) and regenerative medicine strategies fail to address the inflammatory tissue environment that leads to the rapid progression of the disease and prevents cartilage tissue formation. First, this review addresses in detail the current anti-inflammatory therapies for OA with a special emphasis on pharmacological approaches, gene therapy, and mesenchymal stromal cell (MSC) intra-articular administration, and discusses the reasons behind the limited clinical success of these approaches at enabling cartilage regeneration. Then, we analyze the state-of-the-art TE strategies and how they can be improved by incorporating immunomodulatory capabilities such as the optimization of biomaterial composition, porosity and geometry, and the loading of anti-inflammatory molecules within an engineered structure. Finally, the review discusses the future directions for the new generation of TE strategies for OA treatment, specifically focusing on the spatiotemporal modulation of anti-inflammatory agent presentation to allow for tailored patient-specific therapies. Impact statement Osteoarthritis (OA) is a prevalent and debilitating musculoskeletal disorder affecting millions worldwide. Despite significant advancements in regenerative medicine and tissue engineering (TE), mitigating inflammation while simultaneously promoting cartilage tissue regeneration in OA remains elusive. In this review article, we discuss current anti-inflammatory therapies and explore their potential synergy with cutting-edge cartilage TE strategies, with a special focus on novel spatiotemporal and patient-specific anti-inflammatory strategies.
Collapse
Affiliation(s)
- Orlaith Kennedy
- Department of Bioengineering, Lehigh University, Bethlehem, Pennsylvania, USA
- Department of Biomedical Engineering, College of Science and Engineering, University of Galway, Galway, Ireland
| | - Andrew Kitson
- Department of Materials Science and Engineering, Lehigh University, Bethlehem, Pennsylvania, USA
| | - Chiebuka Okpara
- Department of Bioengineering, Lehigh University, Bethlehem, Pennsylvania, USA
| | - Lesley W Chow
- Department of Bioengineering, Lehigh University, Bethlehem, Pennsylvania, USA
- Department of Materials Science and Engineering, Lehigh University, Bethlehem, Pennsylvania, USA
| | | |
Collapse
|
23
|
de Souza DM, Malange KF, Nishijima CM, de Melo Lima BH, Capetini VC, de Oliveira ALR, Anhê GF, Tambeli CH, Parada CA. Intraarticular monomethyl fumarate as a perspective therapy for osteoarthritis by macrophage polarization. Inflammopharmacology 2024; 32:1239-1252. [PMID: 38472616 DOI: 10.1007/s10787-024-01443-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 01/24/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND Osteoarthritis (OA) is a chronic disease that may lead to joint structure degeneration, cartilage destruction, osteophyte formation, subchondral bone disruption, and pain. In this scenario, a higher proportion of the proinflammatory macrophage type 1 (M1) than the anti-inflammatory macrophage type 2 (M2) could be highlighted as a hallmark of OA progression. The balance between these two macrophage types emerges as a new therapeutic target in OA. This study aimed to evaluate the analgesia and macrophage profile in the treatment of experimental osteoarthritis (EOA) with systemic dimethyl fumarate (DMF) or local intra-articular monomethyl fumarate (MMF). RESULTS DMF via gavage or MMF via intra-articular in the right knee of EOA rats showed improvements in gait parameters and the nociceptive recovery of the mechanical threshold assessment by adapted electronic von Frey treatment on the twenty-first day (long-lasting phase). DMF treatment decreased proinflammatory TNF-α while increasing anti-inflammatory IL-10 cytokines from the macerated capsule on the fifth day (inflammatory phase). MMF treatment showed joint capsule mRNA extraction downregulating iNOS and TNF-α gene expression while upregulating IL-10 and MCP-1. However, CD206 was not significant but higher than untreated EOA rats' joints on the seventh day (inflammatory phase). CONCLUSIONS Our studies with EOA model induced by MIA suggest a new perspective for human treatment committed with OA based on macrophage polarization as a therapeutic target, switching the proinflammatory profile M1 to the anti-inflammatory profile M2 with DMF systematic or by MMF locally treatment according to the OA severity.
Collapse
Affiliation(s)
- Douglas Menezes de Souza
- Department of Pharmacology, School of Medical Sciences, University of Campinas (UNICAMP), Cidade Universitária Zeferino Vaz, Rua Tessália Vieira de Camargo, 126Campinas, Sao Paulo, 13083-887, Brazil.
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas (UNICAMP), Cidade Universitária Zeferino Vaz, Rua Carl Von Linnaeus, Campinas, Sao Paulo, 13083-864, Brazil.
| | - Kauê Franco Malange
- Department of Anesthesiology, University of California, La Jolla, San Diego, CA, 92037, USA
| | - Catarine Massucato Nishijima
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas (UNICAMP), Cidade Universitária Zeferino Vaz, Rua Carl Von Linnaeus, Campinas, Sao Paulo, 13083-864, Brazil
| | - Bruno Henrique de Melo Lima
- Laboratory of Nerve Regeneration, University of Campinas (UNICAMP), Cidade Universitária Zeferino Vaz, Rua Monteiro Lobato, 255, Campinas, Sao Paulo, 13083-862, Brazil
| | - Vinicius Cooper Capetini
- Department of Translational Medicine, School of Medical Sciences, University of Campinas, Cidade Universitária Zeferino Vaz, Rua Tessália Vieira de Camargo, 126, Campinas, Sao Paulo, 13083-887, Brazil
| | - Alexandre L R de Oliveira
- Laboratory of Nerve Regeneration, University of Campinas (UNICAMP), Cidade Universitária Zeferino Vaz, Rua Monteiro Lobato, 255, Campinas, Sao Paulo, 13083-862, Brazil
| | - Gabriel Forato Anhê
- Department of Translational Medicine, School of Medical Sciences, University of Campinas, Cidade Universitária Zeferino Vaz, Rua Tessália Vieira de Camargo, 126, Campinas, Sao Paulo, 13083-887, Brazil
| | - Claudia Herrera Tambeli
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas (UNICAMP), Cidade Universitária Zeferino Vaz, Rua Carl Von Linnaeus, Campinas, Sao Paulo, 13083-864, Brazil
| | - Carlos Amilcar Parada
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas (UNICAMP), Cidade Universitária Zeferino Vaz, Rua Carl Von Linnaeus, Campinas, Sao Paulo, 13083-864, Brazil.
| |
Collapse
|
24
|
Sun J, Song X, Wang C, Ruan Q. Geniposidic acid alleviates osteoarthritis progression through inhibiting inflammation and chondrocytes ferroptosis. J Cell Mol Med 2024; 28:e18228. [PMID: 38520209 PMCID: PMC10960175 DOI: 10.1111/jcmm.18228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 02/16/2024] [Accepted: 02/23/2024] [Indexed: 03/25/2024] Open
Abstract
Osteoarthritis is one of the common diseases that seriously affects the quality of life of middle-aged and elderly people worldwide. Geniposidic acid (GPA) is extracted from Eucommia ulmoides that exhibits various pharmacological effects. This study investigated the function of GPA on osteoarthritis (OA) in IL-1β-stimulated mouse chondrocytes and mouse OA model. Mouse OA model was established by destabilization of the medial meniscus (DMM) and GPA was given intraperitoneal injection. The results demonstrated that GPA could alleviate DMM-induced OA in mice. In vitro, IL-1β-induced PGE2, NO, MMP1 and MMP3 were suppressed by GPA. Furthermore, IL-1β-induced ferroptosis was inhibited by GPA, as confirmed by the inhibition of MDA, iron, and ROS, as well as the upregulation of GSH, GPX4, and Ferritin. In addition, GPA was found to increase the expression of Nrf2 and HO-1. And the inhibition of GPA on IL-1β-induced inflammation and ferroptosis were prevented by Nrf2 inhibitor. In conclusion, GPA alleviates OA progression through inhibiting inflammation and chondrocytes ferroptosis via Nrf2 signalling pathway.
Collapse
Affiliation(s)
- Jiayang Sun
- Department of OrthopedicsChina‐Japan Union Hospital of Jilin UniversityChangchunJilinChina
| | - Xianji Song
- Department of OrthopedicsChina‐Japan Union Hospital of Jilin UniversityChangchunJilinChina
| | - Cuijie Wang
- Department of AnesthesiologyChina‐Japan Union Hospital of Jilin UniversityChangchunJilinChina
| | - Qing Ruan
- Department of OrthopedicsChina‐Japan Union Hospital of Jilin UniversityChangchunJilinChina
| |
Collapse
|
25
|
Aratikatla A, Maffulli N, Gupta M, Potti IA, Potty AG, Gupta A. Wharton's jelly and osteoarthritis of the knee. Br Med Bull 2024; 149:13-31. [PMID: 38061765 PMCID: PMC10993459 DOI: 10.1093/bmb/ldad030] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 11/14/2023] [Accepted: 11/15/2023] [Indexed: 03/16/2024]
Abstract
INTRODUCTION The existing treatment modalities for knee osteoarthritis (OA) do not actually address the pathology. Biological therapies, including those using material derived from perinatal tissues, represent a ground-breaking approach to alleviating the symptoms of OA of the knee. SOURCE OF DATA Current scientific literature published in PubMed (MEDLINE), Embase and Scopus databases. Trials registered in various clinical trial databases. AREAS OF AGREEMENT Perinatal tissues including Wharton's jelly (WJ) and associated mesenchymal stem cells (MSCs) can be used for the management of knee OA. AREAS OF CONTROVERSY The efficacy of WJ and associated MSCs in the management of knee OA is still controversial. GROWING POINTS The use of WJ and associated MSCs in the management of knee OA is safe and appears to be effective. AREAS TIMELY FOR DEVELOPING RESEARCH The present published evidence suggests that WJ tissue and associated MSCs offer an encouraging alternative for the management of knee OA. The published in vitro, preclinical and clinical investigations demonstrate the therapeutic potential of WJ and promote further research in this field to provide symptomatic relief to patients suffering from OA, aiming also to regenerate the osteoarthritic hyaline cartilage, with disease-modifying effects. Future adequately powered randomized controlled trials should be undertaken to establish whether WJ is helpful in the management of OA of the knee.
Collapse
Affiliation(s)
| | - Nicola Maffulli
- Department of Musculoskeletal Disorders, School of Medicine and Surgery, University of Salerno, Fisciano 84084, Italy
- Department of Trauma and Orthopaedics, Ospedale Sant’ Andrea, Sapienza University of Rome, Rome, Italy
- Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Queen Mary University of London, London E1 4DG, UK
- School of Pharmacy and Bioengineering, Keele University School of Medicine, Stoke on Trent ST5 5BG, UK
| | - Manu Gupta
- Polar Aesthetics Dental & Cosmetic Centre, Noida, Uttar Pradesh 201301, India
| | - Ishana A Potti
- South Texas Orthopaedic Research Institute (STORI Inc.), Laredo, TX 78045, USA
| | - Anish G Potty
- South Texas Orthopaedic Research Institute (STORI Inc.), Laredo, TX 78045, USA
| | - Ashim Gupta
- South Texas Orthopaedic Research Institute (STORI Inc.), Laredo, TX 78045, USA
- Future Biologics, Lawrenceville, GA 30043, USA
- BioIntegrate, Lawrenceville, GA 30043, USA
- Regenerative Orthopaedics, Noida 201301, India
| |
Collapse
|
26
|
Tümtürk İ, Bakırhan S, Özden F, Gültaç E, Kılınç CY. Effect of Telerehabilitation-Based Exercise and Education on Pain, Function, Strength, Proprioception, and Psychosocial Parameters in Patients With Knee Osteoarthritis: A Randomized Controlled Clinical Trial. Am J Phys Med Rehabil 2024; 103:222-232. [PMID: 37678215 DOI: 10.1097/phm.0000000000002335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
OBJECTIVE In middle-aged individuals with early-stage knee osteoarthritis, follow-up with remote rehabilitation methods may provide effective clinical outcomes. The present study aimed to investigate the effect of telerehabilitation on pain, function, performance, strength, proprioception, and psychosocial parameters in patients with knee osteoarthritis. DESIGN A randomized controlled study was conducted with 54 participants with knee osteoarthritis. All patients were randomized into two groups: the home-based telerehabilitation group ( n = 29) and the home-based paper group ( n = 28). The home exercise program and training were provided with an instruction manual to paper group. The same home exercise and education prescriptions were given to individuals in telerehabilitation group via an online platform. Pain, function, quality of life, physical performance, muscle strength, and proprioception were evaluated at baseline and after 8 wks of intervention. In addition, satisfaction and usability were evaluated at week 8. RESULTS Telerehabilitation group demonstrated better improvement in terms of pain, function, quality of life index score, and left extremity proprioception ( P < 0.05). Telerehabilitation group was not superior to paper group in terms of muscle strength and performance tests (except the Five Times Sit to Stand Test) ( P > 0.05). CONCLUSIONS The home-based telerehabilitation program was superior to the home-based paper group program for pain, function, quality of life, and proprioception in patients with knee osteoarthritis.
Collapse
Affiliation(s)
- İsmet Tümtürk
- From the Department of Physiotherapy and Rehabilitation, Institute of Health Sciences, Ege University, İzmir, Turkey (IT); Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Ege University, İzmir, Turkey (SB); Department of Health Care Services, Köyceğiz Vocational School of Health Services, Muğla Sıtkı Koçman University, Muğla, Turkey (FO); and Department of Orthopedics and Traumatology, Faculty of Medicine, Muğla Sıtkı Koçman University, Muğla, Turkey (EG, CYK)
| | | | | | | | | |
Collapse
|
27
|
Obermüller D, Jerosch J, Bovy L, Häckl D, Ivanavicius S, Liedgens H. Epidemiology and treatment of pain associated with osteoarthritis of the knee in Germany: A retrospective health claims data analysis. OSTEOARTHRITIS AND CARTILAGE OPEN 2024; 6:100430. [PMID: 38283579 PMCID: PMC10811424 DOI: 10.1016/j.ocarto.2023.100430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 11/28/2023] [Accepted: 12/16/2023] [Indexed: 01/30/2024] Open
Abstract
Objective Osteoarthritis of the knee (knee OA) is a serious joint disease leading to pain and reduced quality of life. Pharmacological treatments include anti-inflammatories, analgesics, intraarticular hyaluronic acid, and intraarticular corticosteroids while for severe knee OA, knee replacement is an option. This study examined the incidence, prevalence, patient characteristics, and uptake of medical and surgical treatments in knee OA patients in Germany. Design A non-interventional, retrospective health claims data analysis with anonymized data from the InGef database was performed. Patients ≥18 years were analyzed cross-sectionally for each year 2015-2020. Newly diagnosed patients in 2015 were also longitudinally analyzed until end of 2020. Results Annual knee OA prevalence increased from 7.07 % in 2015 to 7.39 % in 2020. Annual incidence proportions ranged from 1.71 % in 2015 to 1.46 % in 2020. Knee replacement was the most common surgery, with rising patient numbers (e.g., 7918 patients in 2015 and 8975 patients in 2019). Approximately 62 % of patients newly diagnosed in 2015 received prescription pharmacological pain treatment during follow-up. Most (96.95 %) received non-opioid analgesics, followed by weak opioids (8.14 %) and strong opioids (3.00 %) as first-line treatment (combinations possible). Knee surgery was performed in 16.6 % of patients during follow-up. Median time from first diagnosis until surgery was 346 days for any knee surgery and 564 days for knee replacement. Conclusions The number of patients with knee OA in Germany is steadily rising, along with an increasing number of surgical interventions, especially knee replacement. Time until first surgery and knee replacement is relatively short, even for newly diagnosed patients.
Collapse
Affiliation(s)
- Dominik Obermüller
- InGef – Institute for Applied Health Research Berlin GmbH, Otto-Ostrowski-Str. 5, 10249 Berlin, Germany
| | - Jörg Jerosch
- Medizinisches Wissenschafts- und Gutachten-Institut Meerbusch, Grabenstr. 11, 40667 Meerbusch, Germany
| | - Leonore Bovy
- InGef – Institute for Applied Health Research Berlin GmbH, Otto-Ostrowski-Str. 5, 10249 Berlin, Germany
| | | | | | | |
Collapse
|
28
|
Vu HM, Tran HD, Nguyen AK, Han BO, Hoang BX. Effectiveness of Bach Nien Kien Health Supplement in the Treatment of Patients With Symptomatic Knee Osteoarthritis. In Vivo 2024; 38:963-970. [PMID: 38418140 PMCID: PMC10905488 DOI: 10.21873/invivo.13528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/12/2023] [Accepted: 09/18/2023] [Indexed: 03/01/2024]
Abstract
BACKGROUND/AIM Knee osteoarthritis (KOA) is the most common disease in adults. We conducted a clinical study to evaluate the efficacy and safety of Bach Nien Kien (BNK) in supportive therapy for patients with symptomatic KOA. PATIENTS AND METHODS An open interventional study was performed on 60 patients aged 38 to 70 with the diagnosis of symptomatic KOA. The patients were assigned to a study group (SG) with 30 subjects and a control group (CG) with 30 subjects using a matching method. The patients in SG were treated with electroacupuncture, glucosamine supplement, and BNK, while the patients in CG received the same treatment without BNK. RESULTS At the end of the 30-day treatment (d30), the SG had a reduction in VAS score compared to a pre-treatment level of 3.03±0.96 points, which was more than the CG of 2.5±0.90 points. The excellent result in the SG was 10%, and the CG had no excellent result. The good result in the SG was 56.7%, and the CG group was only 26.7%. The moderate and poor results in the CG were high, 63.3%, and 10%, respectively; in the SG, only 26.7% and 6.7%. The difference in overall treatment results between the SG and CG was statistically significant (p<0.05). During the 30-day treatment period in both groups, no patient reported any undesirable effects. CONCLUSION Bach Nien Kien health supplement is effective and safe for controlling KOA symptoms and improving joint motion and quality of life for patients with symptomatic KOA.
Collapse
Affiliation(s)
- Hoan M Vu
- Department of Geriatrics, Hanoi Hospital of Traditional Medicine, Hanoi, Vietnam
| | - Hau D Tran
- Inventive Medical Foundation, Department of Surgery, Keck School of Medicine of University of Southern California, Los Angeles, CA, U.S.A
| | - Anh K Nguyen
- Inventive Medical Foundation, Department of Surgery, Keck School of Medicine of University of Southern California, Los Angeles, CA, U.S.A
| | - B O Han
- USC FOBIC Therapeutic Innovations Initiative, Department of Surgery, Keck School of Medicine of University of Southern California, Los Angeles, CA, U.S.A
| | - Ba X Hoang
- USC FOBIC Therapeutic Innovations Initiative, Department of Surgery, Keck School of Medicine of University of Southern California, Los Angeles, CA, U.S.A.
| |
Collapse
|
29
|
Bamania P, Osmani HT, Robinson P, McDonnell S, Ahmed N. The patient with a painful knee. Br J Hosp Med (Lond) 2024; 85:1-10. [PMID: 38416527 DOI: 10.12968/hmed.2023.0408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
Knee pain encompasses a wide array of differential diagnoses and can often pose a diagnostic challenge, as it can have traumatic or non-traumatic causes. A good clinical history, assessment and anatomical knowledge gives a strong foundation to narrow down the diagnosis, and understanding the correct imaging modality and findings further informs correct and timely management. This article reviews various disease processes including fractures, inflammatory, infective and neoplastic causes, and discusses the assessment and various imaging modalities to aid diagnosis in both primary and secondary care.
Collapse
Affiliation(s)
- Prashant Bamania
- Department of Radiology, Chelsea and Westminster Hospital, London, UK
| | - Humza T Osmani
- Department of Trauma and Orthopaedics, Addenbrooke's Hospital, Cambridge, UK
| | - Philip Robinson
- University of Leeds and Biochemical Research Centre, Musculoskeletal Centre, Department of Radiology, Chapel Allerton Hospital, Leeds Teaching Hospitals, Leeds, UK
| | - Stephen McDonnell
- Department of Trauma and Orthopaedics, Addenbrooke's Hospital, Cambridge, UK
| | - Naeem Ahmed
- Department of Radiology, Chelsea and Westminster Hospital, London, UK
| |
Collapse
|
30
|
Su S, Yu CCW, Cheing GLY, Chung RCK, Tsang SMH, Chan LL, Tang TWS, Cheung W, Lee QJ, Kwong PWH. Cross-Cultural Adaptation and Psychometric Properties of the Chinese Version of the Knee Osteoarthritis Fears and Beliefs Questionnaire. Healthcare (Basel) 2024; 12:310. [PMID: 38338195 PMCID: PMC11154236 DOI: 10.3390/healthcare12030310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 01/16/2024] [Accepted: 01/18/2024] [Indexed: 02/12/2024] Open
Abstract
This study aimed to adapt and validate the Knee Osteoarthritis Fears and Beliefs Questionnaire (KOFBeQ) for Chinese patients, thereby advancing the understanding of fear-avoidance behaviors. Adopting a cross-sectional design, data were collected for 241 subjects (78.8% women; mean age 68.0 ± 7.8 years) across various healthcare settings in Hong Kong. Exploratory factor analysis resulted in an 11-item questionnaire with three distinct subscales, covering fears and beliefs related to physicians and disease (six items), daily living activities (three items), and sports and leisure activities (two items). The overall Cronbach's α coefficient was 0.86, indicating strong internal consistency. The questionnaire exhibited favorable convergent validity. Confirmatory factor analyses confirmed a good model fit. Test-retest reliability analysis indicated a high intraclass correlation coefficient of 0.93 (95% confidence interval: 0.88, 0.96), and a Bland-Altman plot revealed a slight bias in two measurements (0.97 [0.19]) without a systematic trend. The adapted Chinese version of the KOFBeQ demonstrated robust psychometric properties in terms of validity and reliability, providing an effective tool for surveying Chinese patients with knee osteoarthritis. These findings offer valuable insights for clinicians and patients, aiding in informed decision-making and improved rehabilitation strategies.
Collapse
Affiliation(s)
- Shan Su
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong; (S.S.); (G.L.-Y.C.); (R.C.-K.C.); (S.M.-H.T.); (L.-L.C.); (P.W.-H.K.)
| | - Clare Chung-Wah Yu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong; (S.S.); (G.L.-Y.C.); (R.C.-K.C.); (S.M.-H.T.); (L.-L.C.); (P.W.-H.K.)
| | - Gladys Lai-Ying Cheing
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong; (S.S.); (G.L.-Y.C.); (R.C.-K.C.); (S.M.-H.T.); (L.-L.C.); (P.W.-H.K.)
| | - Raymond Chi-Keung Chung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong; (S.S.); (G.L.-Y.C.); (R.C.-K.C.); (S.M.-H.T.); (L.-L.C.); (P.W.-H.K.)
| | - Sharon Man-Ha Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong; (S.S.); (G.L.-Y.C.); (R.C.-K.C.); (S.M.-H.T.); (L.-L.C.); (P.W.-H.K.)
| | - Lok-Lok Chan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong; (S.S.); (G.L.-Y.C.); (R.C.-K.C.); (S.M.-H.T.); (L.-L.C.); (P.W.-H.K.)
| | - Tracy Wing-Shan Tang
- Physiotherapy Department, Yan Chai Hospital, New Territories, Hong Kong; (T.W.-S.T.); (W.C.)
| | - Winky Cheung
- Physiotherapy Department, Yan Chai Hospital, New Territories, Hong Kong; (T.W.-S.T.); (W.C.)
| | - Qunn Jid Lee
- Department of Orthopaedics and Traumatology, Yan Chai Hospital, New Territories, Hong Kong;
| | - Patrick Wai-Hang Kwong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong; (S.S.); (G.L.-Y.C.); (R.C.-K.C.); (S.M.-H.T.); (L.-L.C.); (P.W.-H.K.)
| |
Collapse
|
31
|
Fernández-Moreno M, Hermida-Gómez T, Larkins N, Reynolds A, Blanco FJ. Anti-Inflammatory Activity of APPA (Apocynin and Paeonol) in Human Articular Chondrocytes. Pharmaceuticals (Basel) 2024; 17:118. [PMID: 38256951 PMCID: PMC10818286 DOI: 10.3390/ph17010118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/10/2024] [Accepted: 01/12/2024] [Indexed: 01/24/2024] Open
Abstract
Osteoarthritis (OA) is a chronic joint disease leading to cartilage loss and reduction in the joint space which results in pain. The current pharmacological treatment of OA is inadequate and pharmacological interventions focus on symptom management. APPA, a combination of apocynin (AP) and paeonol (PA), is a potential drug for treating OA. The aim of this study was to analyze the effects of APPA on the modulation of the inflammatory response in chondrocytes. Samples were incubated with IL-1β and APPA, and their responses to proinflammatory cytokines, catabolic mediators and redox responses were then measured. The effect of APPA on mitogenesis was also evaluated. Results show that APPA attenuated the expression of IL-8, TNF-α, MMP-3, MMP-13, SOD-2 and iNOS, resulting in the protection of human articular cartilage. APPA decreased PGC-1α gene expression induced by IL-1β. APPA did not modulate the gene expression of Mfn2, Sirt-1 or Sirt-3. The overall findings indicate that APPA may be an effective treatment for OA by targeting several of the pathways involved in OA pathogenesis.
Collapse
Affiliation(s)
- Mercedes Fernández-Moreno
- Grupo de Investigación en Reumatología (GIR), Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidade de A Coruña (UDC), 15071 A Coruña, Spain;
- Grupo de Investigación en Reumatología y Salud (GIR-S), Centro Interdisciplinar de Química y Biología (CICA), Universidade de A Coruña (UDC), Campus de Elviña, 15071 A Coruña, Spain
| | - Tamara Hermida-Gómez
- Grupo de Investigación en Reumatología (GIR), Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidade de A Coruña (UDC), 15071 A Coruña, Spain;
- Grupo de Investigación en Reumatología y Salud (GIR-S), Centro Interdisciplinar de Química y Biología (CICA), Universidade de A Coruña (UDC), Campus de Elviña, 15071 A Coruña, Spain
- Centro de Investigación Biomédica en Red, Bioingenieria, Biomatereial y Nanomedicina (CIBER-BBN), 50018 Zaragoza, Spain
| | - Nicholas Larkins
- AKL Therapeutics Ltd., Stevenage Bioscience, Gunnels Wood Rd, Stevenage SG1 2FX, UK; (N.L.); (A.R.)
| | - Alan Reynolds
- AKL Therapeutics Ltd., Stevenage Bioscience, Gunnels Wood Rd, Stevenage SG1 2FX, UK; (N.L.); (A.R.)
| | - Francisco J. Blanco
- Grupo de Investigación en Reumatología (GIR), Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidade de A Coruña (UDC), 15071 A Coruña, Spain;
- Grupo de Investigación en Reumatología y Salud (GIR-S), Departamento de Fisioterapia, Medicina y Ciencias Biomédicas, Facultad de Fisioterapia, Centro Interdisciplinar de Química y Biología (CICA), INIBIC-Sergas, Universidade de A Coruña (UDC), Campus de Oza, 15008 A Coruña, Spain
| |
Collapse
|
32
|
Basak S, Hridayanka KSN, Duttaroy AK. Bioactives and their roles in bone metabolism of osteoarthritis: evidence and mechanisms on gut-bone axis. Front Immunol 2024; 14:1323233. [PMID: 38235147 PMCID: PMC10792057 DOI: 10.3389/fimmu.2023.1323233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 12/11/2023] [Indexed: 01/19/2024] Open
Abstract
Bioactives significantly modify and maintain human health. Available data suggest that Bioactives might play a beneficial role in chronic inflammatory diseases. Although promised, defining their mechanisms and opting to weigh their benefits and limitations is imperative. Detailed mechanisms by which critical Bioactives, including probiotics and prebiotics such as dietary lipids (DHA, EPA, alpha LA), vitamin D, polysaccharides (fructooligosaccharide), polyphenols (curcumin, resveratrol, and capsaicin) potentially modulate inflammation and bone metabolism is limited. Certain dietary bioactive significantly impact the gut microbiota, immune system, and pain response via the gut-immune-bone axis. This narrative review highlights a recent update on mechanistic evidence that bioactive is demonstrated demonstrated to reduce osteoarthritis pathophysiology.
Collapse
Affiliation(s)
- Sanjay Basak
- Molecular Biology Division, National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, India
| | - Kota Sri Naga Hridayanka
- Molecular Biology Division, National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, India
| | - Asim K. Duttaroy
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
33
|
Chun JM, Kim JS, Kim C. Integrated Analysis of DNA Methylation and Gene Expression Profiles in a Rat Model of Osteoarthritis. Int J Mol Sci 2024; 25:594. [PMID: 38203768 PMCID: PMC10778961 DOI: 10.3390/ijms25010594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 12/22/2023] [Accepted: 12/27/2023] [Indexed: 01/12/2024] Open
Abstract
Osteoarthritis (OA) is common and affected by several factors, such as age, weight, sex, and genetics. The pathogenesis of OA remains unclear. Therefore, using a rat model of monosodium iodoacetate (MIA)-induced OA, we examined genomic-wide DNA methylation using methyl-seq and characterized the transcriptome using RNA-seq in the articular cartilage tissue from a negative control (NC) and MIA-induced rats. We identified 170 genes (100 hypomethylated and upregulated genes and 70 hypermethylated and downregulated genes) regulated by DNA methylation in OA. DNA methylation-regulated genes were enriched in functions related to focal adhesion, extracellular matrix (ECM)-receptor interaction and the PI3K-Akt and Hippo signaling pathways. Functions related to extracellular matrix organization, extracellular matrix proteoglycans, and collagen formation were involved in OA. A molecular and protein-protein network was constructed using methylated expression-correlated genes. Erk1/2 was a downstream target of OA-induced changes in DNA methylation and RNA expression. We found that the integrin subunit alpha 2 (ITGA2) gene is important in focal adhesion, alpha6-beta4 integrin signaling, and the inflammatory response pathway in OA. Overall, gene expression changes because DNA methylation influences OA pathogenesis. ITGA2, whose gene expression changes are regulated by DNA methylation during OA onset, is a candidate gene. Our findings provide insights into the epigenetic targets of OA processes in rats.
Collapse
Affiliation(s)
- Jin Mi Chun
- Digital Health Research Division, Korea Institute of Oriental Medicine, Yuseong-daero 1672, Daejeon 34054, Republic of Korea;
| | - Joong-Sun Kim
- College of Veterinary Medicine, Chonnam National University, Gwangju 61186, Republic of Korea
| | - Chul Kim
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
| |
Collapse
|
34
|
Adams KR, Famuyide AO, Young JL, Maddox CD, Rhon DI. Pragmatism in manual therapy trials for knee osteoarthritis: a systematic review. Arch Physiother 2024; 14:1-10. [PMID: 38444787 PMCID: PMC10898243 DOI: 10.33393/aop.2024.2916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 01/09/2024] [Indexed: 03/07/2024] Open
Abstract
Introduction Manual therapy is an often-utilized intervention for the management of knee osteoarthritis (OA). The interpretation of results presented by these trials can be affected by how well the study designs align applicability to real-world clinical settings. Aim To examine the existing body of clinical trials investigating manual therapy for knee OA to determine where they fall on the efficacy-effectiveness spectrum. Methods This systematic review has been guided and informed by the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Randomized controlled trials that investigated manual therapy treatments for adults with knee OA were retrieved via searches of multiple databases to identify trials published prior to April 2023. The Rating of Included Trials on the Efficacy-Effectiveness Spectrum (RITES) tool was used to objectively rate the efficacy-effectiveness nature of each trial design. The Cochrane Risk of Bias 2.0 assessment tool (RoB-2) was used to assess the risk of bias across five domains. Results Of the 36 trials, a higher percentage of trials had a greater emphasis on efficacy within all four domains: participant characteristics (75.0%), trial setting (77.8%), flexibility of intervention (58.3%), and clinical relevance of experimental and comparison intervention (47.2%). In addition, 13.9% of the trials had low risk of bias, 41.7% had high risk of bias, and 44.4% had some concerns regarding bias. Conclusions While many trials support manual therapy as effective for the management of knee OA, a greater focus on study designs with an emphasis on effectiveness would improve the applicability and generalizability of future trials.
Collapse
Affiliation(s)
- Kyle R. Adams
- Physical Therapy Program, Bellin College, Green Bay, Wisconsin - USA
- Department of Physical Therapy, Baylor University, Waco, Texas - USA
| | - Ayodeji O. Famuyide
- Physical Therapy Program, Bellin College, Green Bay, Wisconsin - USA
- Greater Baton Rouge Physical Therapy, Baton Rouge, Louisiana - USA
| | - Jodi L. Young
- Physical Therapy Program, Bellin College, Green Bay, Wisconsin - USA
| | - C. Daniel Maddox
- Department of Physical Therapy, Ivester College of Health Sciences, Brenau University, Gainesville, Georgia - USA
- Upstream Rehab Institute, Smyrna, Georgia - USA
| | - Daniel I. Rhon
- Physical Therapy Program, Bellin College, Green Bay, Wisconsin - USA
- Department of Rehabilitation Medicine, School of Medicine, Uniformed Services University of Health Sciences, Bethesda, Maryland - USA
| |
Collapse
|
35
|
Shumnalieva R, Kotov G, Ermencheva P, Monov S. Pathogenic Mechanisms and Therapeutic Approaches in Obesity-Related Knee Osteoarthritis. Biomedicines 2023; 12:9. [PMID: 38275369 PMCID: PMC10812969 DOI: 10.3390/biomedicines12010009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 12/10/2023] [Accepted: 12/14/2023] [Indexed: 01/27/2024] Open
Abstract
The knee is the joint most frequently involved in osteoarthritis, a common joint disorder in the adult population that is associated with significant chronic joint pain, reduced mobility and quality of life. Recent studies have established an association between obesity and the development of knee osteoarthritis that goes beyond the increased mechanical load on the knees as weight-bearing joints. This link is based on the maintenance of a chronic low-grade inflammation, altered secretion of adipokines by the adipose tissue and development of sarcopenia. Major adipokines involved in the pathogenesis of obesity-related knee osteoarthritis include adiponectin, which appears to have a protective effect, as well as leptin, resistin and visfatin, which are associated with higher pain scores and more severe structural damage. Joint pain in knee osteoarthritis may be both nociceptive and neuropathic and is the result of complex mechanisms driven by nerve growth factor, calcitonin gene-related peptide and pro-inflammatory cytokines. The role of endogenous cannabinoids and gut microbiota in common mechanisms between obesity and knee pain has recently been studied. The aim of the present review is to highlight major pathogenic mechanisms in obesity-related knee osteoarthritis with special attention on pain and to comment on possible therapeutic approaches.
Collapse
Affiliation(s)
- Russka Shumnalieva
- Department of Rheumatology, Medical University of Sofia, 1431 Sofia, Bulgaria; (R.S.); (S.M.)
- Clinic of Rheumatology, University Hospital ‘St. Ivan Rilski’, 1612 Sofia, Bulgaria;
| | - Georgi Kotov
- Department of Rheumatology, Medical University of Sofia, 1431 Sofia, Bulgaria; (R.S.); (S.M.)
- Clinic of Rheumatology, University Hospital ‘St. Ivan Rilski’, 1612 Sofia, Bulgaria;
| | - Plamena Ermencheva
- Clinic of Rheumatology, University Hospital ‘St. Ivan Rilski’, 1612 Sofia, Bulgaria;
| | - Simeon Monov
- Department of Rheumatology, Medical University of Sofia, 1431 Sofia, Bulgaria; (R.S.); (S.M.)
- Clinic of Rheumatology, University Hospital ‘St. Ivan Rilski’, 1612 Sofia, Bulgaria;
| |
Collapse
|
36
|
Saud Gany SL, Chin KY, Tan JK, Aminuddin A, Makpol S. Preventative and therapeutic potential of tocotrienols on musculoskeletal diseases in ageing. Front Pharmacol 2023; 14:1290721. [PMID: 38146461 PMCID: PMC10749321 DOI: 10.3389/fphar.2023.1290721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 11/20/2023] [Indexed: 12/27/2023] Open
Abstract
Musculoskeletal health is paramount in an ageing population susceptible to conditions such as osteoporosis, arthritis and fractures. Age-related changes in bone, muscle, and joint function result in declining musculoskeletal health, reduced mobility, increased risk of falls, and persistent discomfort. Preserving musculoskeletal wellbeing is essential for maintaining independence and enhancing the overall quality of life for the elderly. The global burden of musculoskeletal disorders is significant, impacting 1.71 billion individuals worldwide, with age-related muscle atrophy being a well-established phenomenon. Tocotrienols, a unique type of vitamin E found in various sources, demonstrate exceptional antioxidant capabilities compared to tocopherols. This characteristic positions them as promising candidates for addressing musculoskeletal challenges, particularly in mitigating inflammation and oxidative stress underlying musculoskeletal disorders. This review paper comprehensively examines existing research into the preventive and therapeutic potential of tocotrienols in addressing age-related musculoskeletal issues. It sheds light on the promising role of tocotrienols in enhancing musculoskeletal health and overall wellbeing, emphasizing their significance within the broader context of age-related health concerns.
Collapse
Affiliation(s)
- Siti Liyana Saud Gany
- Department of Biochemistry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Kok-Yong Chin
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Jen Kit Tan
- Department of Biochemistry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Amilia Aminuddin
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Suzana Makpol
- Department of Biochemistry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| |
Collapse
|
37
|
Chirumbolo S, Valdenassi L, Tirelli U, Ricevuti G, Pandolfi S, Vaiano F, Galoforo A, Loprete F, Simonetti V, Chierchia M, Bellardi D, Richelmi T, Franzini M. The Oxygen-Ozone Adjunct Medical Treatment According to the Protocols from the Italian Scientific Society of Oxygen-Ozone Therapy: How Ozone Applications in the Blood Can Influence Clinical Therapy Success via the Modulation of Cell Biology and Immunity. BIOLOGY 2023; 12:1512. [PMID: 38132338 PMCID: PMC10740843 DOI: 10.3390/biology12121512] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 11/27/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Ozone is an allotrope of oxygen whose use in medicine has rapidly grown in recent years. Ozonated blood allows for the use of ozone in a safe modality, as plasma and blood cells are endowed with an antioxidant system able to quench ozone's pro-oxidant property and to elicit the Nrf2/Kwap1/ARE pathway. METHODS We present two clinical studies, a case-series (six patients) observational study adopting ozone as a major autohemotherapy and topical ozone to address infected post-surgical wounds with multi-drug resistant bacteria and an observational study (250 patients) using ozonated blood for treating knee osteoarthritis. RESULTS Ozonated blood via major autohemotherapy reduced the extent of infections in wounds, reduced the inflammatory biomarkers by more than 75% and improved patients' QoL, whereas ozonated blood via minor autohemotherapy improved significantly (p < 0.001) WOMAC and Lequesne's parameters in knee osteoarthritis. CONCLUSIONS The models described, i.e., ozone autohemotherapy in wound antimicrobial treatment and ozonated blood in knee osteoarthrosis, following our protocols, share the outstanding ability of ozone to modulate the innate immune response and address bacterial clearance as well as inflammation and pain.
Collapse
Affiliation(s)
- Salvatore Chirumbolo
- Department of Engineering for Innovation Medicine, University of Verona, 37134 Verona, Italy
| | - Luigi Valdenassi
- Italian Scientific Society of Oxygen–Ozone Therapy (SIOOT), High Master School of Oxygen-Ozone Therapy, University of Pavia, 27100 Pavia, Italy; (L.V.); (S.P.); (F.V.); (A.G.); (F.L.); (V.S.); (M.C.); or (T.R.); (M.F.)
| | | | - Giovanni Ricevuti
- Department of Drug Science, University of Pavia, 27100 Pavia, Italy;
| | - Sergio Pandolfi
- Italian Scientific Society of Oxygen–Ozone Therapy (SIOOT), High Master School of Oxygen-Ozone Therapy, University of Pavia, 27100 Pavia, Italy; (L.V.); (S.P.); (F.V.); (A.G.); (F.L.); (V.S.); (M.C.); or (T.R.); (M.F.)
| | - Francesco Vaiano
- Italian Scientific Society of Oxygen–Ozone Therapy (SIOOT), High Master School of Oxygen-Ozone Therapy, University of Pavia, 27100 Pavia, Italy; (L.V.); (S.P.); (F.V.); (A.G.); (F.L.); (V.S.); (M.C.); or (T.R.); (M.F.)
| | - Antonio Galoforo
- Italian Scientific Society of Oxygen–Ozone Therapy (SIOOT), High Master School of Oxygen-Ozone Therapy, University of Pavia, 27100 Pavia, Italy; (L.V.); (S.P.); (F.V.); (A.G.); (F.L.); (V.S.); (M.C.); or (T.R.); (M.F.)
| | - Fortunato Loprete
- Italian Scientific Society of Oxygen–Ozone Therapy (SIOOT), High Master School of Oxygen-Ozone Therapy, University of Pavia, 27100 Pavia, Italy; (L.V.); (S.P.); (F.V.); (A.G.); (F.L.); (V.S.); (M.C.); or (T.R.); (M.F.)
| | - Vincenzo Simonetti
- Italian Scientific Society of Oxygen–Ozone Therapy (SIOOT), High Master School of Oxygen-Ozone Therapy, University of Pavia, 27100 Pavia, Italy; (L.V.); (S.P.); (F.V.); (A.G.); (F.L.); (V.S.); (M.C.); or (T.R.); (M.F.)
| | - Marianna Chierchia
- Italian Scientific Society of Oxygen–Ozone Therapy (SIOOT), High Master School of Oxygen-Ozone Therapy, University of Pavia, 27100 Pavia, Italy; (L.V.); (S.P.); (F.V.); (A.G.); (F.L.); (V.S.); (M.C.); or (T.R.); (M.F.)
| | | | - Tommaso Richelmi
- Italian Scientific Society of Oxygen–Ozone Therapy (SIOOT), High Master School of Oxygen-Ozone Therapy, University of Pavia, 27100 Pavia, Italy; (L.V.); (S.P.); (F.V.); (A.G.); (F.L.); (V.S.); (M.C.); or (T.R.); (M.F.)
| | - Marianno Franzini
- Italian Scientific Society of Oxygen–Ozone Therapy (SIOOT), High Master School of Oxygen-Ozone Therapy, University of Pavia, 27100 Pavia, Italy; (L.V.); (S.P.); (F.V.); (A.G.); (F.L.); (V.S.); (M.C.); or (T.R.); (M.F.)
| |
Collapse
|
38
|
M Robati R, Razzaghi Z, Arjmand B, Rezaei Tavirani M, Sheibani F. Introducing Matrix Metalloproteinases as Crucial Targets for Intra-articular Laser Therapy in Patients with Synovial Fluid of Knee Osteoarthritis. Med J Islam Repub Iran 2023; 37:130. [PMID: 38318399 PMCID: PMC10843209 DOI: 10.47176/mjiri.37.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Indexed: 02/07/2024] Open
Abstract
Background Many elder people have knee osteoarthritis (OA). The patients are faced with pain and disability in movement. Given the challenging lifestyle of the patients, finding an efficient therapy approach is necessary. Since low-level laser therapy applies to the treatment of many diseases, it seems it can be a suitable option for the treatment of knee OA. The present study aimed to evaluate the molecular mechanism of laser therapy on knee OA via a protein expression change study. Methods The present study examines the gene expression profile of patients with OA in the knee using bioinformatics. The protein expression change profile of synovial fluid of knee OA patients is extracted from the literature and is analyzed based on the rate of expression and interactions between the differentially expressed proteins (DEPs). The results are compared with the DEPs of similar tissue of the treated knee OA patients (from published documents) after laser therapy. Results Apolipoprotein B (APOB) and matrix metallopeptidase 2 (MMP2) were determined as the hub bottlenecks of the protein-protein interaction (PPI) network of synovial fluid of knee OA patients. MMP2, complement 5, transthyretin, and apolipoprotein A-1 from laser-treated patients were related to the PPI network of knee OA patients. The reduction of Interleukin-6 activity was highlighted as a critical event as a function of laser on the human body. Conclusion In conclusion, it was noted that the main phenomenon associated with laser therapy-induced improvement in the condition of knee OA patients is the downregulation of MMP2.
Collapse
Affiliation(s)
- Reza M Robati
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Razzaghi
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Babak Arjmand
- Cell Therapy and Regenerative Medicine Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Iranian Cancer Control Center, Tehran, Iran
| | - Mostafa Rezaei Tavirani
- Proteomics Research Center, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Sheibani
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
39
|
Khan TM, Mehmood MZ, Riaz J, Nawaz Z, Arshad H, Ali H, Riaz MH, Afzal O, Ali A, Ahmad MH, Ali RS. Comparison of the Effectiveness of Intra-articular Infiltration of Hyaluronic Acid and Corticosteroids in the Management of Knee Osteoarthritis: A Prospective Comparative Study. Cureus 2023; 15:e50449. [PMID: 38222146 PMCID: PMC10786190 DOI: 10.7759/cureus.50449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2023] [Indexed: 01/16/2024] Open
Abstract
Background Knee osteoarthritis (KOA) is a chronic and progressive disease of the knee joint characterized by articular cartilage destruction. It is the most common cause of knee disability and pain globally. Various treatments are used for the management of KOA; however, the role of intra-articular injections in KOA management in Pakistan remains understudied. Therefore, this study aims to evaluate the effectiveness of intra-articular injections of hyaluronic acid (HA) and corticosteroids in the management of KOA. Methodology This randomized, prospective, comparative study was conducted among 88 patients diagnosed with KOA in the outpatient department clinic of orthopedics in Benazir Bhutto Hospital, Rawalpindi, from January 2022 to January 2023. For patient enrolment, structured inclusion and exclusion criteria and a simple random sampling technique were used. Before data collection, ethical approval and informed consent were obtained. Data collection was done via a self-structured and interview-based proforma. Data analysis was performed through descriptive statistics and independent t-tests using SPSS version 25 (IBM Corp., Armonk, NY, USA). Results KOA was more prevalent in women (60, 68.18%) than men (28, 31.82%). The means for study variables such as age, Visual Analog Scale (VAS) score, and Western Ontario and McMaster Universities (WOMAC) score were 58.08 ± 7.89 years, 7.66 ± 1.8, and 71.86 ± 8.90, respectively. The incidences of right-sided and left-sided KOA were 57 (64.77%) and 31 (35.23%), respectively. Likewise, the frequency of grade II KOA was 55 (62.50%), while the frequency of grade III KOA was 33 (37.50%). Differences in the mean scores of both VAS and WOMAC between study groups were statistically significant at the second-week, sixth-week, and third-month follow-up visits. However, the mean scores of VAS and WOMAC were lower in group B than in group A at the second-week follow-up visit, whereas the scores were lower in group A compared to group B after the sixth week and third month of intra-articular injections. Conclusions Intra-articular injections of both HA and corticosteroids were adequately effective in the management of KOA-associated pain and functional restrictions; nevertheless, the benefits of corticosteroids were acute and short-term, whereas the outcomes of HA were gradual and long-term.
Collapse
Affiliation(s)
| | | | - Javaria Riaz
- Medicine, Mohi-ud-Din Islamic Medical College, Mirpur, PAK
| | - Zoya Nawaz
- Pathology and Laboratory Medicine, Lahore General Hospital, Lahore, PAK
| | - Hamid Arshad
- Surgery, Allama Iqbal Medical College, Lahore, PAK
| | - Haider Ali
- Medicine, Allama Iqbal Medical College, Lahore, PAK
| | | | - Osama Afzal
- Cardiology, Pakistan Kidney & Liver Institute and Research Centre, Lahore, PAK
| | - Asim Ali
- Surgery, Rawalpindi Medical University, Rawalpindi, PAK
| | | | - Rana Shahzaib Ali
- Orthopaedic Surgery, Sheikh Zayed Medical College and Hospital, Rahim Yar Khan, PAK
| |
Collapse
|
40
|
Reina-Mahecha A, Beers MJ, van der Veen HC, Zuhorn IS, van Kooten TG, Sharma PK. A Review of the Role of Bioreactors for iPSCs-Based Tissue-Engineered Articular Cartilage. Tissue Eng Regen Med 2023; 20:1041-1052. [PMID: 37861960 PMCID: PMC10645985 DOI: 10.1007/s13770-023-00573-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Osteoarthritis (OA) is the most common degenerative joint disease without an ultimate treatment. In a search for novel approaches, tissue engineering (TE) has shown great potential to be an effective way for hyaline cartilage regeneration and repair in advanced stages of OA. Recently, induced pluripotent stem cells (iPSCs) have been appointed to be essential stem cells for degenerative disease treatment because they allow a personalized medicine approach. For clinical translation, bioreactors in combination with iPSCs-engineerd cartilage could match patients needs, serve as platform for large-scale patient specific cartilage production, and be a tool for patient OA modelling and drug screening. Furthermore, to minimize in vivo experiments and improve cell differentiation and cartilage extracellular matrix (ECM) deposition, TE combines existing approaches with bioreactors. METHODS This review summarizes the current understanding of bioreactors and the necessary parameters when they are intended for cartilage TE, focusing on the potential use of iPSCs. RESULTS Bioreactors intended for cartilage TE must resemble the joint cavity niche. However, recreating human synovial joints is not trivial because the interactions between various stimuli are not entirely understood. CONCLUSION The use of mechanical and electrical stimulation to differentiate iPSCs, and maintain and test chondrocytes are key stimuli influencing hyaline cartilage homeostasis. Incorporating these stimuli to bioreactors can positively impact cartilage TE approaches and their possibility for posterior translation into the clinics.
Collapse
Affiliation(s)
- Alejandro Reina-Mahecha
- Department of Biomedical Engineering, University of Groningen, University Medical Center Groningen, FB40, Antonius Deusinglaan -1, 9713AV, Groningen, The Netherlands
| | - Martine J Beers
- Department of Orthopedics, University Medical Center Groningen, Groningen, The Netherlands
| | - Hugo C van der Veen
- Department of Orthopedics, University Medical Center Groningen, Groningen, The Netherlands
| | - Inge S Zuhorn
- Department of Biomedical Engineering, University of Groningen, University Medical Center Groningen, FB40, Antonius Deusinglaan -1, 9713AV, Groningen, The Netherlands
| | - Theo G van Kooten
- Department of Biomedical Engineering, University of Groningen, University Medical Center Groningen, FB40, Antonius Deusinglaan -1, 9713AV, Groningen, The Netherlands
| | - Prashant K Sharma
- Department of Biomedical Engineering, University of Groningen, University Medical Center Groningen, FB40, Antonius Deusinglaan -1, 9713AV, Groningen, The Netherlands.
| |
Collapse
|
41
|
Anjum N, Sheikh RK, Omer A, Anwar K, Khan MMH, Aftab A, Awan WA. Comparison of instrument-assisted soft tissue mobilization and proprioceptive neuromuscular stretching on hamstring flexibility in patients with knee osteoarthritis. PeerJ 2023; 11:e16506. [PMID: 38054019 PMCID: PMC10695107 DOI: 10.7717/peerj.16506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 11/01/2023] [Indexed: 12/07/2023] Open
Abstract
Background The association between hamstring tightness and knee osteoarthritis (KOA) is significant because tight hamstrings can put more strain on the knee joint, reduce its range of motion, and cause compensatory movements that worsen the KOA. Objective To compare the effects of instrument-assisted soft tissue mobilization (IASTM) and proprioceptive neuromuscular (PNF) on hamstring flexibility in patients with KOA. Methods Data for the randomized controlled trial (NCT05110326) was collected from n = 60 participants randomly divided into group A received IASTM and group B received PNF stretching. In group A, the therapist made 30 strokes gentle strokes with the tool from the origin to the insertion while holding the plane at a 45-degree angle over the treatment area. In group B, PNF stretching was done with three repetitions and 10 seconds rest between each, after isometric contraction of the hamstring muscle using approximately 50% of their maximum strength, holding it for 8 seconds, and then releasing it. A 30-minute session was given to each patient three times per week and was given for 6 weeks. Outcome measures were the visual analog scale (VAS) for pain intensity, the active knee extension test (AKET) for hamstring flexibility, and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) for the health status of KOA patients. Results The study found a significant interaction (p < 0.001) between interventions and time across several measurements. After 6 weeks, both interventions resulted in significant improvements (p < 0.001) across all dependent variables, with group A (IASTM) showing more significant improvement in hamstring flexibility, pain reduction, and health status (p < 0.001) compared to group B (PNF). Conclusions Both the IASTM technique and PNF stretching resulted in increased hamstring flexibility, decreased pain, and enhanced general health. The IASTM technique, however, showed potential benefits over PNF stretching in terms of flexibility, pain relief, and public health enhancement. Physical therapists and manual therapists may prioritize the usage of the IASTM technique for patients who want to make significant changes in these areas.
Collapse
Affiliation(s)
- Narmeen Anjum
- Physiotherapy Department, Pakistan Railway Hospital,, Rawalpindi, Pakistan
| | | | - Aadil Omer
- Riphah College of Rehabilitation and Allied Health Sciences, Riphah International University, Islamabad, Islamabad, Pakistan
- School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Kinza Anwar
- Riphah College of Rehabilitation and Allied Health Sciences, Riphah International University, Islamabad, Islamabad, Pakistan
| | | | - Anam Aftab
- Faculty of Pharmacy & Allied Health Sciences, University of Sialkot, Sialkot, Pakistan
| | - Waqar Ahmed Awan
- Riphah College of Rehabilitation and Allied Health Sciences, Riphah International University, Islamabad, Islamabad, Pakistan
- Health Education Research Foundation, Islamabad, Pakistan
| |
Collapse
|
42
|
Mohebi S, Farpour HR, Dehghanian KS, Khoshnazar SS. An Oral Form of Cetylated Fatty Acids versus Meloxicam for Knee Osteoarthritis: A Randomised Clinical Trial. Mediterr J Rheumatol 2023; 34:460-468. [PMID: 38282946 PMCID: PMC10815532 DOI: 10.31138/mjr.220823.aof] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 02/25/2023] [Accepted: 03/08/2023] [Indexed: 01/30/2024] Open
Abstract
Objective/Aim This study aimed to assess how effective an oral form of Cetylated fatty acids compounds (CFA) is in improving the physical function, pain, and stiffness of individuals suffering from knee osteoarthritis (OA) and how its effectiveness compares to that of Meloxicam, a non-steroidal anti-inflammatory drug (NSAID). Methods For this parallel-arm randomised clinical trial, 48 adult patients with knee OA were divided into two groups. The intervention group was prescribed 350mg CFA capsule three times per day for 30 days. The control group was given 15mg of Meloxicam, one tablet daily for ten days. Patients were instructed to fill out the Oxford Knee Score (OKS), Western Ontario and McMaster University Osteoarthritis Index (WOMAC), and Visual Analog Scale (VAS). Data were obtained before the administration of the first dose (considered baseline or t0), and two (t1), four (t2), and eight (t3) weeks after the final dose of each intervention. Results No significant differences were observed in total WOMAC and OKS scores between the two groups at t1, t2, or t3. However, both groups had significant improvements in their OKS, VAS, and total WOMAC scores compared to their baselines (t0). No adverse events were noted in the CFA group. Conclusion Improvements in pain intensity and overall physical function were reported in the CFA group. Oral CFAs could safely benefit patients with knee OA.
Collapse
Affiliation(s)
- Sepide Mohebi
- Student Research Committee, Department of Physical Medicine and Rehabilitation, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamid Reza Farpour
- Shiraz Geriatric Research Centre, Department of Physical Medicine and Rehabilitation, Shiraz University of Medical Sciences, Shiraz, Iran
- Bone and Joint Diseases Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kayvon Seyed Dehghanian
- Student Research Committee, Department of Physical Medicine and Rehabilitation, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sana Sadat Khoshnazar
- Student Research Committee, Department of Physical Medicine and Rehabilitation, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
43
|
Chuang HY, Ho SYC, Chou W, Tsai CL. Exploring the top-cited literature in telerehabilitation for joint replacement using the descriptive, diagnostic, predictive, and prescriptive analytics model: A thematic and bibliometric analysis. Medicine (Baltimore) 2023; 102:e36475. [PMID: 38050200 PMCID: PMC10695623 DOI: 10.1097/md.0000000000036475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 11/14/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Telerehabilitation offers a novel approach supplementing or replacing traditional physical rehabilitation. While research on telerehabilitation for joint replacement (TJR) has expanded, no study has investigated the top 100 cited articles (T100TJR) using the descriptive, diagnostic, predictive, and prescriptive analytics (DDPP) model. This study aims to examine the features of T100TJR in TJR through the DDPP approaches. METHODS A comprehensive search of the Web of Science Core Collection was conducted to locate all pertinent English-language documents from the database's inception until August 2, 2023. The T100TJR articles were then identified based on citation counts. The DDPP analytics model, along with 7 visualization techniques, was used to analyze metadata elements such as countries, institutions, journals, authors, references, and keywords. An impact timeline view was employed to highlight 2 particularly noteworthy articles. RESULTS We analyzed 712 articles and observed a consistent upward trend in publications, culminating in a noticeable peak in 2022. The United States stood out as the primary contributor. A detailed examination of the top 100 articles (T100TJR) revealed the following leading contributors since 2010: the United States (by country), University of Sherbrooke, Canada (by institutions), 2017 (by publication year), and Dr Hawker from Canada (by authors). We delineated 4 major themes within these articles. The theme "replacement" dominated, featuring in 89% of them. There was a strong correlation between the citations an article garnered and its keyword prominence (F = 3030.37; P < .0001). Additionally, 2 particularly high-impact articles were underscored for recommendation. CONCLUSIONS Telerehabilitation for TJR has seen rising interest, with the U.S. leading contributions. The study highlighted dominant themes, especially "replacement," in top-cited articles. The significant correlation between article citations and keyword importance indicates the criticality of keyword selection. The research underscores the importance of 2 pivotal articles, recommending them for deeper insights.
Collapse
Affiliation(s)
- Hua-Ying Chuang
- Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
- Institute of Physical Education, Health and Leisure Studies, National Cheng Kung University, Tainan, Taiwan
- Department of Nursing, Chung Hwa University, Tainan, Taiwan
| | - Sam Yu-Chieh Ho
- Department of Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan
| | - Willy Chou
- Department of Physical Medicine and Rehabilitation, Chiali Chi-Mei Hospital, Tainan, Taiwan
- Department of Physical Medicine and Rehabilitation, Chung San Medical University Hospital, Taichung, Taiwan
| | - Chia-Liang Tsai
- Institute of Physical Education, Health and Leisure Studies, National Cheng Kung University, Tainan, Taiwan
| |
Collapse
|
44
|
Crowley JL, Soti V. Platelet-Rich Plasma Therapy: An Effective Approach for Managing Knee Osteoarthritis. Cureus 2023; 15:e50774. [PMID: 38116024 PMCID: PMC10729545 DOI: 10.7759/cureus.50774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 12/18/2023] [Indexed: 12/21/2023] Open
Abstract
Platelet-rich plasma (PRP) is a promising non-invasive therapeutic intervention for knee osteoarthritis (KOA) that has generated significant interest due to anecdotal accounts of its efficacy, resulting in reduced recovery time in various orthopedic interventions. This systematic review examines the effectiveness of PRP in managing KOA. Specifically, it seeks to determine the extent to which PRP can treat KOA patients effectively, alleviate KOA symptoms, and improve patient outcomes. Additionally, the review aims to identify the optimal concentration and composition of PRP required to achieve therapeutic results in KOA. Furthermore, the review investigates whether PRP can modify the synovial environment structurally and immunologically to improve outcomes in KOA patients. We conducted a comprehensive literature search on PubMed, Orthogate, Clinicaltrials.gov, and Embase of clinical trials investigating PRP treatment in KOA patients in the last five years. The results indicated that PRP is effective in treating KOA patients. Evidence shows that PRP therapy can alleviate pain, enhance joint function, increase range of motion, and improve mobility in KOA patients. PRP was effective in treating KOA when the mean platelet concentration of PRP treatment was 4.83 to 5.91 times higher than the baseline whole blood platelet concentration. However, studies investigating PRP with a mean platelet concentration of 3.48 to 4.04 times higher than baseline failed to demonstrate statistically significant improvements. PRP therapy slowed down KOA progression, which validates its effectiveness in impeding further structural damage and arresting the degenerative impact of the disease. Nonetheless, further investigation is necessary to examine how PRP therapy can modify the progression of the disease. Furthermore, future research should identify the most effective platelet concentration levels that provide optimal symptom relief. There is a need for further research to identify the specific PRP configuration that is most pertinent in a clinical setting, as there is a lack of standardization in PRP manufacturing protocols, including the variety of experimental setups and dosing schedules utilized in different studies.
Collapse
Affiliation(s)
- Jack L Crowley
- Orthopedic Surgery, Lake Erie College of Osteopathic Medicine, Elmira, USA
| | - Varun Soti
- Pharmacology and Therapeutics, Lake Erie College of Osteopathic Medicine, Elmira, USA
| |
Collapse
|
45
|
Parente A, Medetti M, Basile G, Parente F. One-Stage Tricompartmental Hypoallergenic UKA for Tricompartmental Osteoarthritis: A Case Report. Healthcare (Basel) 2023; 11:2999. [PMID: 37998491 PMCID: PMC10671051 DOI: 10.3390/healthcare11222999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 11/14/2023] [Accepted: 11/17/2023] [Indexed: 11/25/2023] Open
Abstract
Osteoarthritis (OA) is a degenerative and progressive joint disease. When all three compartments are involved, end-stage OA is treated with a total knee arthroplasty (TKA). Unicompartmental knee arthroplasty (UKA) is a primary treatment for isolated osteoarthritis. UKA has a quicker recovery time than TKA, as well as less morbidity and more tissue sparing. At the time of surgery, 17% of patients have a tricompartmental disease and most patients with a Kellegren-Lawrence grade >3 have an intact anterior cruciate ligament (ACL). Conventional TKA sacrifices the ACL. Patients with concurrent medial and lateral osteoarthritis and a functional ACL may receive a primary bi-unicondylar arthroplasty. Combined partial knee arthroplasty (CPKA) is an established practice either in bicompartmental femoro-tibial OA or in OA progression after UKA, with the addition of another UKA. A conversion of a lateral UKA to a tricompartmental joint replacement has been reported in the literature. In our case report, we describe a one-stage hypoallergenic tricompartmental UKA, with improved clinical score and no sign of early failure at the last follow-up.
Collapse
Affiliation(s)
- Andrea Parente
- Hip and Knee Replacement Department, IRCCS Orthopedic Institute Galeazzi, 20161 Milan, Italy; (A.P.)
| | - Marta Medetti
- Hip and Knee Replacement Department, IRCCS Orthopedic Institute Galeazzi, 20161 Milan, Italy; (A.P.)
| | - Giuseppe Basile
- Legal Medicine Unit, IRCCS Orthopedic Institute Galeazzi, 20161 Milan, Italy;
| | - Franco Parente
- Hip and Knee Replacement Department, IRCCS Orthopedic Institute Galeazzi, 20161 Milan, Italy; (A.P.)
| |
Collapse
|
46
|
Partan RU, Putra KM, Kusuma NF, Darma S, Reagan M, Muthia P, Radiandina AS, Saleh MGSI, Salim EM. Umbilical Cord Mesenchymal Stem Cell Secretome Improves Clinical Outcomes and Changes Biomarkers in Knee Osteoarthritis. J Clin Med 2023; 12:7138. [PMID: 38002750 PMCID: PMC10672370 DOI: 10.3390/jcm12227138] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 11/08/2023] [Accepted: 11/10/2023] [Indexed: 11/26/2023] Open
Abstract
(1) Background: The current treatment for osteoarthritis is ineffective due to its focus on pain relief and lack of cartilage repair. Viscosupplementation such as hyaluronic acid improves symptoms but remains unnoticed for several months. Researchers are exploring cell-based therapies such as mesenchymal stem cells secretome and mesenchymal stem cells, which can repair cartilage damage. The objective of the research is to evaluate and compare the effectiveness of the secretome derived from umbilical cord mesenchymal stem cells (UC-MSCs) with hyaluronic acid (HA). (2) Methods: An open-label clinical trial involving 30 knee osteoarthritis patients divided into two groups received UC-MSC secretome and hyaluronic acid doses. The study assessed clinical outcomes using VAS and WOMAC and measured MMP-3 and TGF-β1 levels before and after treatment. (3) Results: A study of 30 subjects found that the UC-MSC secretome group showed a decrease in pain in the OA knee compared to the HA group. The therapy was most effective after the third injection, and the group showed a decrease in the MMP-3 ratio and an increase in TGF-β1 compared to the hyaluronic acid group. (4) Conclusions: UC-MSC secretome intra-articular injections showed superior clinical improvement, biomarker changes, and no side effects compared to hyaluronic acid over a 5-week interval.
Collapse
Affiliation(s)
- Radiyati Umi Partan
- Internal Medicine Department, Division of Rheumatology, Faculty of Medicine, Sriwijaya University—Dr. Mohammad Hoesin Hospital, Palembang 30126, Indonesia
| | - Khoirun Mukhsinin Putra
- Internal Medicine Department, Division of Rheumatology, Faculty of Medicine, Sriwijaya University—Dr. Mohammad Hoesin Hospital, Palembang 30126, Indonesia
| | - Narisa Felinka Kusuma
- Internal Medicine Department, Division of Rheumatology, Faculty of Medicine, Sriwijaya University—Dr. Mohammad Hoesin Hospital, Palembang 30126, Indonesia
| | - Surya Darma
- Internal Medicine Department, Division of Rheumatology, Faculty of Medicine, Sriwijaya University—Dr. Mohammad Hoesin Hospital, Palembang 30126, Indonesia
| | - Muhammad Reagan
- Internal Medicine Department, Division of Rheumatology, Faculty of Medicine, Sriwijaya University—Dr. Mohammad Hoesin Hospital, Palembang 30126, Indonesia
| | - Putri Muthia
- Internal Medicine Department, Division of Rheumatology, Faculty of Medicine, Sriwijaya University—Dr. Mohammad Hoesin Hospital, Palembang 30126, Indonesia
| | - Afifah Salshabila Radiandina
- Stem Cell and Regenerative Therapies, From Bench to Market Program, Faculty of Life Science & Medicine, King’s College London, London WC2R 2LS, UK
| | - MGS Irsan Saleh
- Department of Pharmacology, Faculty of Medicine, Sriwijaya University, Palembang 30126, Indonesia;
| | - Eddy Mart Salim
- Internal Medicine Department, Division of Allergy & Immunology, Faculty of Medicine, Sriwijaya University—Dr. Mohammad Hoesin Hospital, Palembang 30126, Indonesia
| |
Collapse
|
47
|
Lv J, Li X, Qiu W, Ji J, Cao L, Li L, Zhang Y, Su Z. Effect of knee osteoarthritis on the postoperative outcome of proximal femoral nail anti-rotation in the treatment of intertrochanteric fractures in the elderly: a retrospective analysis. BMC Musculoskelet Disord 2023; 24:868. [PMID: 37940993 PMCID: PMC10631145 DOI: 10.1186/s12891-023-07012-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 11/02/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND The proximal femoral nail anti-rotation (PFNA) is a commonly used internal fixation system for intertrochanteric fractures (IFs) in older adults. Knee osteoarthritis (KOA) is a degenerative lower extremity disease that occurs most frequently in the elderly. Some patients have already had KOA before the IFs. However, whether KOA impacts the postoperative outcome of IFs has not been reported. OBJECTIVE This study aimed to investigate the effect of KOA on the fracture side on the outcome after PFNA for IFs in the elderly. METHODS Between January 2016 and November 2021, 297 elderly patients treated with PFNA for IFs were enrolled in this study. They were divided into two groups according to the American Rheumatism Association KOA clinical and radiographic criteria: the control group and the KOA group. Intraoperative bleeding, operative time, length of hospital stay, postoperative time out of bed, fracture healing time, postoperative complications, postoperative Harris hip function score, and Barthel ability to daily living Score were compared between the two groups. Follow-up was routinely scheduled at 1, 3, 6, and 12 months postoperatively. RESULTS Based on the exclusion criteria, 254 patients who met the requirements were left to be included in this study, including the control group (n = 133) and the KOA group (n = 121). Patients were followed up for a mean of 17.5 months (12-24 months). There was no significant difference between the two groups in preoperative demographic data, intraoperative blood loss, operation time, and length of stay in the hospital. The control group was statistically significant compared to the KOA group in terms of postoperative time out of bed (17.8 ± 4.0 days vs. 19.1 ± 5.8 days), fracture healing time (13.7 ± 2.2 weeks vs. 14.6 ± 3.7 weeks), and postoperative complications (12.8 vs. 23.1%). The Harris hip function score and Barthel ability to daily living score were higher in the control group than in the KOA group at 1, 3, 6, and 12 months postoperatively (the control group: 63.8 ± 10.9, 71.8 ± 10.3, 81.5 ± 8.7, and 91.6 ± 6.3 vs. The KOA group 61.0 ± 10.4, 68.6 ± 9.1, 79.0 ± 9.2, and 88.5 ± 5.9). CONCLUSIONS In elderly patients with IFs combined with KOA of the fracture side treated with PFNA internal fixation, KOA increases the incidence of postoperative complications of the fracture, prolongs postoperative time out of bed and fracture healing, and reduces postoperative hip function and ability to daily living. Therefore, treating KOA on the fractured side needs to be considered when treating IFs in the elderly.
Collapse
Affiliation(s)
- Jiaxing Lv
- Kaifeng Central Hospital, Orthopedic Ward 2, Kaifeng/ Henan, 475000, P. R. China
| | - Xiaolong Li
- Kaifeng Central Hospital, Orthopedic Ward 2, Kaifeng/ Henan, 475000, P. R. China
| | - Wenkui Qiu
- Kaifeng Central Hospital, Orthopedic Ward 2, Kaifeng/ Henan, 475000, P. R. China
| | - Jianjun Ji
- Kaifeng Central Hospital, Orthopedic Ward 2, Kaifeng/ Henan, 475000, P. R. China
| | - Lichao Cao
- Kaifeng Central Hospital, Orthopedic Ward 2, Kaifeng/ Henan, 475000, P. R. China
| | - Lei Li
- Kaifeng Central Hospital, Orthopedic Ward 2, Kaifeng/ Henan, 475000, P. R. China
| | - Yihong Zhang
- Kaifeng Central Hospital, Orthopedic Ward 2, Kaifeng/ Henan, 475000, P. R. China.
| | - Zhenyan Su
- Kaifeng Central Hospital, Orthopedic Ward 2, Kaifeng/ Henan, 475000, P. R. China.
| |
Collapse
|
48
|
Rizvi MR, Sharma A, Hasan S, Ahmad F, Asad MR, Iqbal A, Alghadir AH. Exploring the impact of integrated polyvagal exercises and knee reinforcement in females with grade II knee osteoarthritis: a randomized controlled trial. Sci Rep 2023; 13:18964. [PMID: 37923783 PMCID: PMC10624888 DOI: 10.1038/s41598-023-45908-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 10/25/2023] [Indexed: 11/06/2023] Open
Abstract
This study aimed to compare the effects of knee strengthening exercises to those of polyvagal theory-based exercises combined with knee strengthening exercises on selected outcomes in women with grade II knee osteoarthritis (OA). A randomized controlled trial was conducted, in which 60 female participants diagnosed with grade II knee OA, with a mean age of 57.27 ± 7.81 years and knee pain rated between 4 and 7 on the visual analog scale (VAS), were assigned to either the knee strengthening exercise group (Group 1, n = 30) or the polyvagal theory-based exercise plus knee strengthening exercise group (Group 2, n = 30). Pre- and posttreatment assessment of outcome variables, including WOMAC scores (joint pain, joint stiffness, functional limitations, and the overall index), WHOQOL scores (overall quality of life, general health, physical, psychological, social, and environmental domains), and heart rate variability (HRV, time and frequency domains), were analyzed. Group 2 demonstrated significantly greater reductions in joint pain, stiffness, and functional limitations than Group 1 after the intervention. Group 2 presented with significantly improved WOMAC scores, indicating better overall outcomes. Group 2 showed significant improvements in the psychological and social domains regarding quality of life. There were no significant differences in the physical domain or the environmental domain. Group 2 showed a significant increase in high-frequency power (HF) and a significant decrease in the LF/HF ratio, suggesting improved autonomic regulation. A combination of polyvagal exercise and knee strengthening training resulted in superior outcomes compared to knee strengthening exercises alone in women with grade II knee OA. These findings support the potential effectiveness of incorporating polyvagal exercises as an adjunctive intervention for osteoarthritis management.
Collapse
Affiliation(s)
- Moattar Raza Rizvi
- Department of Physiotherapy, School of Allied Health Science, Manav Rachna International Institute of Research and Studies, Faridabad, 121004, India
| | - Ankita Sharma
- Department of Physiotherapy, School of Allied Health Science, Manav Rachna International Institute of Research and Studies, Faridabad, 121004, India
| | - Shahnaz Hasan
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Al-Majmaah, 11952, Saudi Arabia
| | - Fuzail Ahmad
- Respiratory Care Department, College of Applied Sciences, Almaarefa University, Ad Diriyah, 13713, Saudi Arabia
| | - Mohammad Rehan Asad
- Department of Basic Sciences, College of Medicine, Majmaah University, Al-Majmaah, 15341, Saudi Arabia
| | - Amir Iqbal
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box. 10219, Riyadh, 11433, Saudi Arabia.
| | - Ahmad H Alghadir
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box. 10219, Riyadh, 11433, Saudi Arabia
| |
Collapse
|
49
|
Barge TF, Little MW. Musculoskeletal Embolotherapy. Cardiovasc Intervent Radiol 2023; 46:1517-1524. [PMID: 36352126 DOI: 10.1007/s00270-022-03302-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 10/12/2022] [Indexed: 11/10/2022]
Abstract
Painful articular musculoskeletal (MSK) conditions are common, debilitating and sometimes difficult to treat. Transcatheter embolisation may offer an alternative way to manage the pain associated with these conditions, but the field is still in its infancy. To date, the most commonly studied indication is knee osteoarthritis, but the technique has been trailed in multiple other tissue beds, including for adhesive capsulitis and tendinopathies. Whilst early results appear promising, the existing studies are mostly open-labelled and non-randomised; there is a need for high-quality evidence to robustly assess the procedures efficacy. In this review, we set out to evaluate the current evidence underlying the pathophysiology and mechanism of action of embolisation; discuss the technical aspects of the procedure including embolic selection, and appraise the published clinical outcomes and adverse effects. Finally, we discuss the future directions and research priorities in this rapidly developing field.
Collapse
Affiliation(s)
- T F Barge
- University Department of Radiology, Royal Berkshire NHS Foundation Trust, Reading, UK
| | - M W Little
- University Department of Radiology, Royal Berkshire NHS Foundation Trust, Reading, UK.
| |
Collapse
|
50
|
Pérez-Maletzki J, Domínguez-Navarro F, Roig-Casasús S, Díaz-Díaz B, Querol-Giner F, García-Gomáriz C, Blasco JM. Patient, clinician, and performance-based measures provide different information about clinical symptoms in patients with severe knee osteoarthritis presenting with depressive symptoms: a cross-sectional study. BMC Musculoskelet Disord 2023; 24:833. [PMID: 37872554 PMCID: PMC10594887 DOI: 10.1186/s12891-023-06971-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 10/16/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND AND PURPOSE Clinical status of subjects with knee osteoarthritis (KOA) is influenced by a complex interaction of several biopsychosocial factors. The use of patient-reported measures (PROM) is considered the gold standard for their evaluation. However, considering that 1 in 5 subjects with KOA present with depressive symptoms, it is necessary to analyse how this psychological domain may influence the subjective perception of PROM. The objective was to study the impact that depressive symptoms have on functional outcome assessments, according to the degree of objectivity of diverse outcome measures. METHODS Cross-sectional study. Subjects with severe KOA, verified with clinical and radiological symptoms, were assessed with patient-reported (Oxford Knee Score), clinician-reported (knee range of motion), and performance-based (Timed up and go test) measures. The existence of depressive symptoms was assessed with the Yesavage scale, and participants were classified for having no-, mild- or severe-symptoms. Linear correlations (r) and one-way analysis of variance compared groups (95% CI). RESULTS 244 participants were analysed, of which 75 (30.7%) had depressive symptoms. These symptoms had an inverse moderate association with Oxford Knee Score (r = -0.387). However, the correlation with the Timed up and go test was low (r = 0.176), while there was no correlation with knee ROM (r = -0.087). CONCLUSIONS This study supports that patient-reported questionnaires may offer biased information on the clinical status of patients with severe knee osteoarthritis who present with depressive symptoms. Consideration of such symptoms may be critical to ensure data collected to accurately reflect patients' capacities and perceptions.
Collapse
Affiliation(s)
- José Pérez-Maletzki
- Group in Physiotherapy of the Ageing Process: Social and Healthcare Strategies, Departament de Fisioteràpia, Universitat de València, Calle Gascó Oliag 5, Valencia, 46010, Spain
- Department of Physiotherapy, Faculty of Health Science, Universidad Europea de Valencia, Valencia, Spain
| | - Fernando Domínguez-Navarro
- Group in Physiotherapy of the Ageing Process: Social and Healthcare Strategies, Departament de Fisioteràpia, Universitat de València, Calle Gascó Oliag 5, Valencia, 46010, Spain.
- Department of Physiotherapy, Faculty of Health Science, Universidad Europea de Valencia, Valencia, Spain.
- Departament de Fisioterapia, Facultad de Fisioterapia, Universitat de València, València, Spain.
| | - Sergio Roig-Casasús
- Group in Physiotherapy of the Ageing Process: Social and Healthcare Strategies, Departament de Fisioteràpia, Universitat de València, Calle Gascó Oliag 5, Valencia, 46010, Spain
- Hospital Universitari i Politècnic La Fe de València, València, Spain
| | - Beatriz Díaz-Díaz
- Group in Physiotherapy of the Ageing Process: Social and Healthcare Strategies, Departament de Fisioteràpia, Universitat de València, Calle Gascó Oliag 5, Valencia, 46010, Spain
- Departament de Fisioterapia, Facultad de Fisioterapia, Universitat de València, València, Spain
- Hospital Clínic i Universitari de València, València, Spain
| | - Felipe Querol-Giner
- Departament de Fisioterapia, Facultad de Fisioterapia, Universitat de València, València, Spain
| | - Carmen García-Gomáriz
- Group in Physiotherapy of the Ageing Process: Social and Healthcare Strategies, Departament de Fisioteràpia, Universitat de València, Calle Gascó Oliag 5, Valencia, 46010, Spain
- Departament de Podología, Facultad de Podología, Universitat de València, València, Spain
| | - José-María Blasco
- Group in Physiotherapy of the Ageing Process: Social and Healthcare Strategies, Departament de Fisioteràpia, Universitat de València, Calle Gascó Oliag 5, Valencia, 46010, Spain
- Departament de Fisioterapia, Facultad de Fisioterapia, Universitat de València, València, Spain
| |
Collapse
|