1051
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Follistatin alleviates synovitis and articular cartilage degeneration induced by carrageenan. Int J Inflam 2014; 2014:959271. [PMID: 25574420 PMCID: PMC4276300 DOI: 10.1155/2014/959271] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 11/06/2014] [Accepted: 11/19/2014] [Indexed: 12/23/2022] Open
Abstract
Activins are proinflammatory cytokines which belong to the TGFβ superfamily. Follistatin is an extracellular decoy receptor for activins. Since both activins and follistatin are expressed in articular cartilage, we hypothesized that activin-follistatin signaling participates in the process of joint inflammation and cartilage degeneration. To test this hypothesis, we examined the effects of follistatin in a carrageenan-induced mouse arthritis model. Synovitis induced by intra-articular injection of carrageenan was significantly alleviated by preinjection with follistatin. Macrophage infiltration into the synovial membrane was significantly reduced in the presence of follistatin. In addition, follistatin inhibited proteoglycan erosion induced by carrageenan in articular cartilage. These data indicate that activin-follistatin signaling is involved in joint inflammation and cartilage homeostasis. Our data suggest that follistatin can be a new therapeutic target for inflammation-induced articular cartilage degeneration.
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1052
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Lourenço S, Lucas R, Araújo F, Bogas M, Santos RA, Barros H. Osteoarthritis medical labelling and health-related quality of life in the general population. Health Qual Life Outcomes 2014; 12:146. [PMID: 25433808 PMCID: PMC4260189 DOI: 10.1186/s12955-014-0146-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 09/12/2014] [Indexed: 11/13/2022] Open
Abstract
Background Osteoarthritis is the most common chronic joint disease. In the absence of an effective medical treatment and due to the chronic nature of this condition, an osteoarthritis medical diagnosis may finally result in decreased health-related quality of life. Therefore, the aim of this study was to measure the impact of the osteoarthritis medical labelling on physical and mental health-related quality of life. Methods Subjects (n = 1132, 58.7% women) were approached as participants of an urban population-based cohort (EPIPorto). Self-reported information on previous diagnosis of knee, hip or hand osteoarthritis was obtained and rheumatologists established knee, hip or hand osteoarthritis clinical diagnosis in symptomatic individuals. Physical and mental dimensions of health-related quality of life were evaluated using the self-administered Medical Outcomes Study: 36-Item Short Form Survey. Crude and adjusted linear regression coefficients (beta) and the corresponding 95% confidence intervals (95% CI) were computed to estimate the associations between being labelled as an osteoarthritis case and health-related quality of life. Results Regardless of disease medical labelling, individuals with osteoarthritis scored significantly lower physical health-related quality of life when compared to those without joint disease (kneeunexposed: beta = −5.3, 95% CI: −7.6, −3.1; kneeexposed: beta = −6.0, 95% CI: −8.4, −3.7; hipunexposed: beta = −6.0, 95% CI: −9.8, −2.3; hipexposed: beta = −11.0, 95% CI: −15.6, −6.4; handunexposed: beta = −4.3, 95% CI: −6.5, −2.0; handexposed: beta = −4.3, 95% CI: −6.6, −2.1). The same was not observed regarding mental health-related quality of life. Among subjects with clinically confirmed osteoarthritis, the medical labelling of this joint disease was not significantly associated to health-related quality of life. Conclusions The labelling of knee, hip and hand osteoarthritis diagnosis may not add specific benefit to osteoarthritis patients in terms of its capability to improve health-related quality of life.
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Affiliation(s)
- Sara Lourenço
- Institute of Public Health of the University of Porto, Rua das Taipas, 135-139, 4050-600, Porto, Portugal.
| | - Raquel Lucas
- Institute of Public Health of the University of Porto, Rua das Taipas, 135-139, 4050-600, Porto, Portugal. .,Department of Clinical Epidemiology, Predictive Medicine and Public Health of the University of Porto Medical School, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
| | - Fábio Araújo
- Institute of Public Health of the University of Porto, Rua das Taipas, 135-139, 4050-600, Porto, Portugal.
| | - Mónica Bogas
- Ponte de Lima Hospital, Largo Conde de Bertiandos, 4990-041, Ponte de Lima, Portugal.
| | - Rui André Santos
- Beatriz Ângelo Hospital, Avenida Carlos Teixeira, 3, 2674-514, Loures, Portugal.
| | - Henrique Barros
- Institute of Public Health of the University of Porto, Rua das Taipas, 135-139, 4050-600, Porto, Portugal. .,Department of Clinical Epidemiology, Predictive Medicine and Public Health of the University of Porto Medical School, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
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1053
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Sauerschnig M, Stolberg-Stolberg J, Schulze A, Salzmann GM, Perka C, Dynybil CJ. Diverse expression of selected cytokines and proteinases in synovial fluid obtained from osteoarthritic and healthy human knee joints. Eur J Med Res 2014; 19:65. [PMID: 25432384 PMCID: PMC4263050 DOI: 10.1186/s40001-014-0065-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 11/14/2014] [Indexed: 01/22/2023] Open
Abstract
Background Osteoarthritis (OA) is defined by signs and symptoms of inflammation within the affected joint. The aim of this study is to determine the mRNA expression levels of selected cytokines and matrix-metalloproteinases of cells found in synovial fluid (SF) obtained from osteoarthritic knee joints compared to healthy controls. Methods SF was obtained from 40 patients undergoing total knee arthroplasty due to evident OA and from 10 healthy controls. Expression of TNF-α, IL-1β, MMP-1 and MMP-3 was assayed among both groups by performing qPCR. Patients were configured concerning age, gender and BMI. Results IL-1β, MMP-1 and MMP-3 showed significantly higher expression among the OA group compared to control (P < 0.001). Strong correlation appeared between expression of MMP-1 and MMP-3 among OA patients (r = 0.856); no correlation was found between age, gender or BMI and cytokine/proteinase expression. Expression of IL-1β, MMP-1 and MMP-3 within SF was elevated in OA-patients. Conclusion Consequently, cells within SF expressing cytokines and proteinases may play a relevant role in the progression of joint destruction. Considering the fact that SF in an OA joint comprises abnormal amounts of detrimental bioactive proteins, temporary clearance, dilution or suppression/modulation by means of lavage or disease-modifying medication may be promising to constitute interim relief or even postpone disease progression due to decreased inflammatory and/or degrading activity within the articular environment.
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Affiliation(s)
- Martin Sauerschnig
- Department of Trauma Surgery, Klinikum rechts der Isar, Technische Universitaet Muenchen, Munich, Germany. .,Centrum für Muskuloskeletale Chirurgie, Charité-Universitätsmedizin Berlin, Berlin, Germany.
| | - Josef Stolberg-Stolberg
- Department of Trauma Surgery, Klinikum rechts der Isar, Technische Universitaet Muenchen, Munich, Germany.
| | - Anne Schulze
- Centrum für Muskuloskeletale Chirurgie, Charité-Universitätsmedizin Berlin, Berlin, Germany.
| | - Gian Max Salzmann
- Department of Orthopaedic and Trauma Surgery, Albert-Ludwigs University Freiburg, Freiburg im Breisgau, Germany.
| | - Carsten Perka
- Centrum für Muskuloskeletale Chirurgie, Charité-Universitätsmedizin Berlin, Berlin, Germany.
| | - Christian Jiri Dynybil
- Centrum für Muskuloskeletale Chirurgie, Charité-Universitätsmedizin Berlin, Berlin, Germany.
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1054
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An update on risk factors for cartilage loss in knee osteoarthritis assessed using MRI-based semiquantitative grading methods. Eur Radiol 2014; 25:883-93. [DOI: 10.1007/s00330-014-3464-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 09/20/2014] [Accepted: 10/01/2014] [Indexed: 02/01/2023]
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1055
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Cunha-Miranda L, Faustino A, Alves C, Vicente V, Barbosa S. [Assessing the magnitude of osteoarthritis disadvantage on people's lives: the MOVES study]. REVISTA BRASILEIRA DE REUMATOLOGIA 2014; 55:22-30. [PMID: 25582997 DOI: 10.1016/j.rbr.2014.07.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 06/05/2014] [Accepted: 07/28/2014] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Osteoarthritis (OA) is one of the ten most disabling diseases in developed countries and one of the leading causes of pain and disability over the world. Early diagnosis increases the likelihood of preventing disease progression. OBJECTIVES To estimate the prevalence of self-reported osteoarthritis and quality of life in Portuguese adults with 45 or more years old. METHODS Observational, cross-sectional study, implemented in households by face-to-face interview. RESULTS 1,039 subjects with mean age of 62 years and 54.2% female were included. The prevalence of self-reported osteoarthritis was 9.9%. Knees and hands were the most frequent site of disease. The prevalence of OA was higher in women and in participants without professional activity. Presence of OA was higher in participants with comorbidities. Most subjects have done some treatment at some point in time for this disease: 94.5% had drug therapy, 49.5% physiotherapy, and 19.8% physical activity. Pain was associated with height, with some disease locations specifically neck, lower spine and shoulders, SF12 scores of quality of life, and measurements of impact in daily living, severity of disease and disability. The impact of OA in daily living was greater in subjects that had been on sick leave or stopped working due to OA, had worse physical and mental health, and with more severe of disease. CONCLUSION This study confirmed that osteoarthritis is a very relevant disease with a high potential impact on quality of life, function and work ability and because of its prevalence with a very high growing social impact.
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Affiliation(s)
| | | | | | - Vera Vicente
- Eurotrials, Scientific Consultants, Lisboa, Portugal
| | - Sandra Barbosa
- AstraZeneca, Produtos Farmacêuticos, Lda., Barcarena, Portugal
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1056
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Nam CW, Kim K, Lee HY. The influence of exercise on an unstable surface on the physical function and muscle strength of patients with osteoarthritis of the knee. J Phys Ther Sci 2014; 26:1609-12. [PMID: 25364125 PMCID: PMC4210410 DOI: 10.1589/jpts.26.1609] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 04/21/2014] [Indexed: 11/27/2022] Open
Abstract
[Purpose] This study investigated the influence of exercise on an unstable surface on ROM
of the knee, muscle strength and the physical function of patients with osteoarthritis of
the knee. [Subjects] The subjects were 30 patients diagnosed with degenerative
osteoarthritis of the knee, they were divided into an experimental group (n=15) and a
control group (n=15). [Methods] The experimental group performed exercise using an aero
step XL (TOGU, Germany) 3 times a week, for 6 weeks. A control group performed the same
exercise on a stable surface and without aero step XL. [Results] After the intervention,
the experimental group showed statistically significant improvements in active knee
flexion, knee joint manual muscle test (MMT), knee joint MMT hamstring and WOMAC score.
[Conclusion] Exercise on the unstable surface improved the symptoms of patient with
osteoarthritis. Exercise on an unstable surface might be helpful for improving the muscle
strength and alignment of lower extremities as well as improving physical function related
to the knee joint.
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Affiliation(s)
- Chan-Woo Nam
- Department of Physical Therapy, Graduate School of Physical Therapy, Daegu University, Republic of Korea
| | - Kyoung Kim
- Department of Physical Therapy, Graduate School of Physical Therapy, Daegu University, Republic of Korea
| | - Hae-Yong Lee
- Department of Physical Therapy, Graduate School of Physical Therapy, Daegu University, Republic of Korea
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1057
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Aguiar GC, Do Nascimento MR, De Miranda AS, Rocha NP, Teixeira AL, Scalzo PL. Effects of an exercise therapy protocol on inflammatory markers, perception of pain, and physical performance in individuals with knee osteoarthritis. Rheumatol Int 2014; 35:525-31. [PMID: 25300730 DOI: 10.1007/s00296-014-3148-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Accepted: 10/02/2014] [Indexed: 12/19/2022]
Abstract
Establishing prevention and therapeutic strategies for osteoarthritis (OA) is necessary to minimize functional disability and the impact of the disease on society. The aim of this study was to determine the effects of an exercise therapy protocol on inflammatory markers, perception of pain, and physical performance in individuals with OA of the knee. The protocol consisted of flexibility training and muscle strengthening over 12 weeks with three 80-min sessions per week. Peripheral blood was collected to determine serum levels of interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), and soluble forms of the TNF-α receptor (sTNFR1 and sTNFR2). A clinical assessment of the musculoskeletal system and Western Ontario and McMaster Universities (WOMAC) questionnaire were applied to evaluate the specific symptoms of knee OA. Pain intensity was evaluated using a visual analog scale (VAS). All measurements were taken before and after the intervention. Twenty-two individuals (mean age 58.8 ± 6.4 years) completed the protocol. A decrease in the perception of pain was evident on VAS (p < 0.001) and pain subscale of the WOMAC (p < 0.001). In addition, there was a reduction in serum levels of IL-6 (p < 0.001). However, changes in the levels of the TNF-α and its soluble receptors were not statistically significant. Physical function subscale score and the WOMAC global score improved significantly (p < 0.001). The training also promoted an increase in the progression load for all muscles groups analyzed (p < 0.001). Our data suggest that the exercise therapy protocol could be a strategy for reducing IL-6 levels, managing pain, and improving function in individuals with OA of the knee. However, more studies are necessary to investigate the issue.
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Affiliation(s)
- Grazielle Cordeiro Aguiar
- Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais, CEP 31270-901, Brazil
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1058
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Yázigi F, Carnide F, Espanha M, Sousa M. Development of the Knee OA Pre-Screening Questionnaire. Int J Rheum Dis 2014; 19:567-76. [PMID: 25256737 DOI: 10.1111/1756-185x.12447] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM Self-report questionnaires are still considered to be a useful instrument for disease screening and for epidemiological studies. Few questionnaires have been developed for the purpose of screening for knee osteoarthritis (KOA). The aim of this study was to develop a KOA screening tool that is useful for health and exercise professionals who do not have access to advanced and costly diagnostic instruments. METHODS This study comprised five steps: content validity, reliability, criterion validity, construct validity and responsiveness. Internal consistency was verified using Cronbach's alpha and the intraclass correlation coefficient (ICC). Reproducibility was analyzed using the ICC (1 week). Criterion validity was assessed by comparing the Knee OA Pre-Screening Questionnaire (KOPS) score with the Short Form (SF)-12, the Knee Injury and Osteoarthritis Outcome Scores questionnaire and the 6 min walk test. Construct validity was verified using the receiver operating characteristic (ROC) curve (American College of Rheumatology clinical criteria and X-ray). Responsiveness was analyzed over 3 months of an aquatic exercise program using the pooled effect size. RESULTS The overall KOPS score yielded a Cronbach's alpha of 0.747 and an ICC of 0.646. KOPS was considered reproducible (ICC: 0.895-0.992; Cronbach's alpha: 0.894-0.979). The ROC curve revealed a sensitivity of 86.96 and a specificity of 75.82. The KOPS demonstrated medium responsiveness in terms of the total score and the pain and symptoms components. CONCLUSION The KOPS questionnaire is valid for the purposes for which it was created, and its translation into English should be considered.
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Affiliation(s)
- Flavia Yázigi
- Univ Lisboa, Fac Motricidade Humana, CIPER, LBMF, P-1499-002, Lisbon, Portugal
| | - Filomena Carnide
- Univ Lisboa, Fac Motricidade Humana, CIPER, LBMF, P-1499-002, Lisbon, Portugal
| | - Margarida Espanha
- Univ Lisboa, Fac Motricidade Humana, CIPER, LBMF, P-1499-002, Lisbon, Portugal
| | - Miguel Sousa
- Portuguese Institute of Rheumatology, Lisbon, Portugal
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1059
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Paolillo AR, Paolillo FR, João JP, João HA, Bagnato VS. Synergic effects of ultrasound and laser on the pain relief in women with hand osteoarthritis. Lasers Med Sci 2014; 30:279-86. [PMID: 25239030 DOI: 10.1007/s10103-014-1659-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Accepted: 09/09/2014] [Indexed: 11/25/2022]
Abstract
Patients with pain avoid movements, leading to a gradual impairment of their physical condition and functionality. In this context, the use of ultrasound (US) and low-level laser therapy (LLLT) show promising results for nonpharmacological and noninvasive treatment. The aim of this study was evaluated the synergistic effects of the US and the LLLT (new prototype) with or without therapeutic exercises (TE) on pain and grip strength in women with hand osteoarthritis. Forty-five women with hand osteoarthritis, aged 60 to 80 years, were randomly assigned to one of three groups, but 43 women successfully completed the full study. The three groups were as follows: (i) the placebo group which did not perform TE, but the prototype without emitting electromagnetic or mechanical waves was applied (n = 11); (ii) the US + LLLT group which carried out only the prototype (n = 13); and (iii) the TE + US + LLLT group which performed TE before the prototype is applied (n = 13). The parameters of US were frequency 1 MHz; 1.0 W/cm(2) intensity, pulsed mode 1:1 (duty cycle 50%). Regarding laser, the output power of the each laser was fixed at 100 mW leading to an energy value of 18 J per laser. Five points were irradiated per hand, during 3 min per point and 15 min per session. The prototype was applied after therapeutic exercises. The treatments are done once a week for 3 months. Grip strength and pressure pain thresholds (PPT) were measured. Grip strength did not differ significantly for any of the groups (p ≥ 0.05). The average PPT between baseline and 3 months shows significant decrease of the pain sensitivity for both the US + LLLT group (∆ = 30 ± 19 N, p˂0.001) and the TE + US + LLLT group (∆ = 32 ± 13 N, p < 0.001). However, there were no significant differences in average PPT for placebo group (∆ = -0.3 ± 9 N). There was no placebo effect. The new prototype that combines US and LLLT reduced pain in women with hand osteoarthritis.
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Affiliation(s)
- Alessandra Rossi Paolillo
- Optics Group from Physics Institute of São Carlos (IFSC), University of São Paulo (USP), Av. Trabalhador Sãocarlense, 400-Centro, CEP 13560-970, São Carlos, SP, Brazil,
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1060
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Negrin LL, Hajdu S. Patient-specific evaluation of knee disorders in clinical practice. Wien Klin Wochenschr 2014; 126:650-4. [PMID: 25193485 DOI: 10.1007/s00508-014-0600-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 08/05/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Nowadays, an increasing number of patients expect their physician to provide a measureable and, therefore, comparable treatment effect that quantifies success or failure of the applied therapy. Unfortunately, different knee classification schemes applied to the same patient may provide diverging results. Therefore, the objective of this paper was to present recommendations to clinicians for a meaningful outcome assessment of their patients. METHODS Out of 39 knee evaluation systems available in the literature, we performed an elimination process based on the criteria (1) widespread use, (2) available reference values and (3) publication of at least one validation study. RESULTS Six clinical scores were detected which met the inclusion criteria. Owing to authors' recommendations and personal opinion the International Knee Documentation Committee (IKDC) Score, the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) were identified to be the most suitable outcome measures that enable patients a realistic assessment of their treatment effect compared with individuals in similar life situations. CONCLUSION To our opinion the IKDC should be applied to athletic patients suffering from post-traumatic knee symptoms who are younger than 50 years. For non-athletes aged 50 years and older the WOMAC is considered suitable whereas the KOOS is recommended to all other patients with knee disorders.
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Affiliation(s)
- Lukas Leopold Negrin
- Department of Trauma Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria,
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1061
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Jones G, Winzenberg TM, Callisaya ML, Laslett LL. Lifestyle modifications to improve musculoskeletal and bone health and reduce disability--a life-course approach. Best Pract Res Clin Rheumatol 2014; 28:461-78. [PMID: 25481426 DOI: 10.1016/j.berh.2014.07.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This review covers the evidence relating to lifestye modification in the big three musculoskeletal conditions: osteoarthritis, osteoporosis and rheumatoid arthritis. Lifestyle is of considerable importance in the first two and there is emerging evidence for rheumatoid arthritis despite it not traditionally being considered a lifestyle disease.
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Affiliation(s)
- Graeme Jones
- Menzies Research Institute Tasmania, University of Tasmania, Private bag 23, Hobart, Tasmania 7000, Australia.
| | - Tania M Winzenberg
- Menzies Research Institute Tasmania, University of Tasmania, Private bag 23, Hobart, Tasmania 7000, Australia.
| | - Michele L Callisaya
- Menzies Research Institute Tasmania, University of Tasmania, Private bag 23, Hobart, Tasmania 7000, Australia; Department of Medicine, Monash University, 246 Clayton Rd, Clayton, Victoria 3168, Australia.
| | - Laura L Laslett
- Menzies Research Institute Tasmania, University of Tasmania, Private bag 23, Hobart, Tasmania 7000, Australia.
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1062
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Park YM, Kim SJ, Lee KJ, Yang SS, Min BH, Yoon HC. Detection of CTX-II in serum and urine to diagnose osteoarthritis by using a fluoro-microbeads guiding chip. Biosens Bioelectron 2014; 67:192-9. [PMID: 25172026 DOI: 10.1016/j.bios.2014.08.016] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 08/04/2014] [Accepted: 08/11/2014] [Indexed: 01/17/2023]
Abstract
This study reports a new strategy for simultaneous detection of the C-telopeptide fragments of type II collagen (CTX-II) as a biomarker of osteoarthritis (OA) using a fluoro-microbeads guiding chip. As osteoarthritis progresses, the joint components including matrix and cartilage are degraded by proteases. The degraded products such as CTX-II are released into the serum and urine, and the CTX-II concentration in body fluids reflects OA progression. Because the CTX-II has heterogeneous epitope structure in serum (sCTX-II; homodimers) and urine (uCTX-II; monomers or variant monomers), a multiple-sensing device enabling both sandwich and competitive-type immunoassays is required. For multiple assessments of serum and urinary CTX-II, we designed a fluoro-microbeads guiding chip (FMGC) containing multiple sensing areas and connecting channels. Using the approach, the sandwich (sCTX-II) and competition (uCTX-II) assays could be simultaneously performed on a single chip. We designed a fluidic control device enabling selective control of the open-close function of FMGC channels. The immune-specific signal was quantitatively analyzed by counting the number of fluorescent microbeads from the registered images. The results from the developed FMGC assay showed high correlation with those obtained in ELISA. The completion time of the FMGC assay was 24-fold and 3.5-fold shorter than the ELISA for urinary and serum CTX-II. Taken together, it enabled the simultaneous detection of both sCTX-II and uCTX-II. This FMGC-based assay would be a promising tool for monitoring of osteoarthritis.
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Affiliation(s)
- Yoo Min Park
- Department of Molecular Science and Technology, Ajou University, Suwon 443749, South Korea
| | - Su Jin Kim
- Department of Molecular Science and Technology, Ajou University, Suwon 443749, South Korea
| | - Ki Jung Lee
- Department of Electrical and Computer Engineering, Ajou University, South Korea
| | - Sang Sik Yang
- Department of Electrical and Computer Engineering, Ajou University, South Korea
| | - Byoung-Hyun Min
- Department of Orthopedic Surgery, School of Medicine, Ajou University, South Korea
| | - Hyun C Yoon
- Department of Molecular Science and Technology, Ajou University, Suwon 443749, South Korea.
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1063
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Kloek CJJ, Bossen D, Veenhof C, van Dongen JM, Dekker J, de Bakker DH. Effectiveness and cost-effectiveness of a blended exercise intervention for patients with hip and/or knee osteoarthritis: study protocol of a randomized controlled trial. BMC Musculoskelet Disord 2014; 15:269. [PMID: 25103686 PMCID: PMC4243525 DOI: 10.1186/1471-2474-15-269] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 07/29/2014] [Indexed: 01/04/2023] Open
Abstract
Background Exercise therapy in patients with hip and/or knee osteoarthritis is effective in reducing pain, increasing physical activity and physical functioning, but costly and a burden for the health care budget. A web-based intervention is cheap in comparison to face-to-face exercise therapy and has the advantage of supporting in home exercises because of the 24/7 accessibility. However, the lack of face-to-face contact with a professional is a disadvantage of web-based interventions and is probably one of the reasons for low adherence rates. In order to combine the best of two worlds, we have developed the intervention e-Exercise. In this blended intervention face-to-face contacts with a physical therapist are partially replaced by a web-based exercise intervention. The aim of this study is to investigate the short- (3 months) and long-term (12 months) (cost)-effectiveness of e-Exercise compared to usual care physical therapy. Our hypothesis is that e-Exercise is more effective and cost-effective in increasing physical functioning and physical activity compared to usual care. Methods/Design This paper presents the protocol of a prospective, single-blinded, multicenter cluster randomized controlled trial. In total, 200 patients with OA of the hip and/or knee will be randomly allocated into either e-Exercise or usual care (physical therapy). E-Exercise is a 12-week intervention, consisting of maximum five face-to-face physical therapy contacts supplemented with a web-based program. The web-based program contains assignments to gradually increase patients’ physical activity, strength and stability exercises and information about OA related topics. Primary outcomes are physical activity and physical functioning. Secondary outcomes are health related quality of life, self-perceived effect, pain, tiredness and self-efficacy. All measurements will be performed at baseline, 3 and 12 months after inclusion. Retrospective cost questionnaires will be sent at 3, 6, 9 and 12 months and used for the cost-effectiveness and cost-utility analysis. Discussion This study is the first randomized controlled trial in the (cost)-effectiveness of a blended exercise intervention for patients with osteoarthritis of the hip and/or knee. The findings will help to improve the treatment of patients with osteoarthritis. Trial registration NTR4224.
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Affiliation(s)
- Corelien J J Kloek
- Tilburg University, Tranzo, PO Box 90153, Tilburg, LE, 5000, The Netherlands.
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1064
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Rajgopal A, Vasdev N, Pathak A, Gautam D, Vasdev A. Histological changes and neural elements in the posterior cruciate ligament in osteoarthritic knees. J Orthop Surg (Hong Kong) 2014; 22:142-5. [PMID: 25163942 DOI: 10.1177/230949901402200204] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE To evaluate histological changes and neural elements in 100 posterior cruciate ligaments (PCLs) in patients with osteoarthritis. METHODS 100 PCLs were obtained from a consecutive series of 46 women and 16 men aged 49 to 91 (mean, 67) years who underwent primary PCL-retaining total knee replacement for osteoarthritis. Histology was examined using conventional light microscopy. The PCLs were graded histologically in terms of parallel orientation of collagen fibres, mucoid degeneration, inflammation, and haemosiderin deposition. Histological changes were graded as normal, mild degeneration, moderate degeneration, and severe degeneration. The neural elements were assessed using immunohistochemical staining for S100 protein and neurofilaments. The histopathologist was blinded to the age, gender, and clinical and radiological grades of osteoarthritis. RESULTS One specimen was excluded from analysis owing to inadequate tissue. In the remaining 99 specimens, histology was normal in 72, mildly degenerative in 4, moderately degenerative in 4, and severely degenerative in 15. 76 specimens were positive for S100 protein or neurofilament or both by immunohistochemical staining, indicating the presence of neural elements. CONCLUSION Most knees with osteoarthritis present with viable PCLs. Retaining the PCL in total knee replacement is a good option for better kinematics, stability, and proprioception.
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Affiliation(s)
- A Rajgopal
- Medanta Bone and Joint Institute, Medanta-The Medicity, Gurgaon, Haryana, India
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1065
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Burguera EF, Vela-Anero A, Magalhães J, Meijide-Faílde R, Blanco FJ. Effect of hydrogen sulfide sources on inflammation and catabolic markers on interleukin 1β-stimulated human articular chondrocytes. Osteoarthritis Cartilage 2014; 22:1026-35. [PMID: 24831018 DOI: 10.1016/j.joca.2014.04.031] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2013] [Revised: 04/13/2014] [Accepted: 04/30/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Hydrogen sulfide (H2S), the third gasotransmitter together with NO and CO, is emerging as a regulator of inflammation. To test if it might offer therapeutic value in the treatment of osteoarthritis (OA) we evaluated the effects of two exogenous sources of H2S, NaSH and GYY4137, on inflammation and catabolic markers that characterize OA. METHOD Human chondrocytes (CHs) were isolated from OA tissue. Cells were stimulated with a pro-inflammatory cytokine (interleukin-1β, IL1β, 5 ng/ml) and the ability of the two H2S sources to ameliorate its effects on the cells was tested. Nitric oxide (NO) production was quantified through the Griess reaction. Protein levels of inducible NO synthase (NOS2) and matrix metalloproteinase 13 (MMP13) were visualized through immunocytochemistry (ICC). Relative mRNA expression was quantified with qRT-PCR. Prostaglandin-2 (PGE-2), interleukin 6 (IL6) and MMP13 levels were measured with specific EIAs. NFκB nuclear translocation was visualized with immunofluorescence. RESULTS Both H2S sources led to significant reductions in NO, PGE-2, IL6 and MMP13 released by the cells and at the protein level. This was achieved by downregulation of relevant genes involved in the synthesis routes of these molecules, namely NOS2, cyclooxigenase-2 (COX2), prostaglandin E synthase (PTGES), IL6 and MMP13. NFκB nuclear translocation was also reduced. CONCLUSION NaSH and GYY4137 show anti-inflammatory and anti-catabolic properties when added to IL1β activated osteoarthritic CHs. Supplementation with exogenous H2S sources can regulate the expression of relevant genes in OA pathogenesis and progression, counteracting IL1β pro-inflammatory signals that lead to cartilage destruction in part by reducing NFκB activation.
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Affiliation(s)
- E F Burguera
- CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Spain; Grupo de Bioingieneria Tisular y Terapia Celular (CBTTC), Servicio de Reumatología, Instituto de, Investigacion Biomédica (INIBIC), Complexo Hospitalario Universitario A Coruna (CHUAC), A Coruña, Spain.
| | - A Vela-Anero
- CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Spain; Departmento de Medicina, INIBIC-Universidad de A Coruña, A Coruña, Spain.
| | - J Magalhães
- CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Spain; Grupo de Bioingieneria Tisular y Terapia Celular (CBTTC), Servicio de Reumatología, Instituto de, Investigacion Biomédica (INIBIC), Complexo Hospitalario Universitario A Coruna (CHUAC), A Coruña, Spain.
| | - R Meijide-Faílde
- Departmento de Medicina, INIBIC-Universidad de A Coruña, A Coruña, Spain.
| | - F J Blanco
- CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Spain; Grupo de Bioingieneria Tisular y Terapia Celular (CBTTC), Servicio de Reumatología, Instituto de, Investigacion Biomédica (INIBIC), Complexo Hospitalario Universitario A Coruna (CHUAC), A Coruña, Spain.
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1066
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Qin J, Chow SKH, Guo A, Wong WN, Leung KS, Cheung WH. Low magnitude high frequency vibration accelerated cartilage degeneration but improved epiphyseal bone formation in anterior cruciate ligament transect induced osteoarthritis rat model. Osteoarthritis Cartilage 2014; 22:1061-7. [PMID: 24852700 DOI: 10.1016/j.joca.2014.05.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 05/07/2014] [Accepted: 05/12/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To evaluate the effects of low-magnitude high-frequency vibration (LMHFV) on degenerated articular cartilage and subchondral bone in anterior cruciate ligament transection (ACLT) induced osteoarthritis (OA) rat model. METHODS 6 months old female Sprague-Dawley rats received ACLT on right knee and randomly divided into treatment and control groups. OA developed 12 weeks after surgery. LMHFV (35 Hz, 0.3 g) treatment was given 20 min/day and 5 days/week. After 6, 12 and 18 weeks, six rats of each group were sacrificed at each time point and the right knees were harvested. OA grading score, distal femur cartilage volume (CV), subchondral bone morphology, elastic modulus of cartilage and functional changes between groups were analyzed. RESULTS Increased cartilage degradation (higher OA grading score) and worse functional results (lower duty cycle, regular index and higher limb idleness index) were observed after LMHFV treatment (P = 0.011, 0.020, 0.012 and 0.005, respectively). CV increased after LMHFV treatment (P = 0.019). Subchondral bone density increased with OA progress (P < 0.01). Increased BV/TV, Tb.N and decreased Tb.Sp were observed in distal femur epiphysis in LMHFV treatment group (P = 0.006, 0.018 and 0.011, respectively). CONCLUSION LMHFV accelerated cartilage degeneration and caused further functional deterioration of OA affected limb in ACLT-induced OA rat model. In contrast, LMHFV promoted bone formation in OA affected distal femur epiphysis, but did not reverse OA progression.
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Affiliation(s)
- J Qin
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
| | - S K-H Chow
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
| | - A Guo
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
| | - W-N Wong
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
| | - K-S Leung
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
| | - W-H Cheung
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
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1067
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Abstract
Disabling for nearly 27 million people, osteoarthritis is expected to double by the year 2030. Although age is a strong predictor of osteoarthritis, it is not an inevitable consequence of aging. Nurse practitioners, frequently the first healthcare providers to see patients with osteoarthritis, must be up-to-date on current treatment recommendations.
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1068
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Smith TO, Purdy R, Lister S, Salter C, Fleetcroft R, Conaghan P. Living with osteoarthritis: a systematic review and meta-ethnography. Scand J Rheumatol 2014; 43:441-52. [PMID: 24882107 DOI: 10.3109/03009742.2014.894569] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To review and synthesize the existing literature on the experience of living with a diagnosis of hip and/or knee osteoarthritis (OA). METHOD A systematic review was undertaken using meta-ethnography. A search of both published (AMED, CINAHL, EMBASE, PsychINFO, SportsDisc, MEDLINE, Cochrane Clinical Trials Registry, PubMed) and unpublished/trial registry databases [World Health Organization (WHO) International Clinical Trials Registry Platform, Current Controlled Trials, the United States National Institute of Health Trials Registry, National Institute for Health Research (NIHR) Clinical Research Portfolio Database] was undertaken from their inception to 5 June 2013. RESULTS Thirty-two studies formed the meta-ethnography of the lived experiences of people with OA. In total, 1643 people with OA were sampled, the majority diagnosed with knee OA. The evidence base was weak to moderate in quality. The majority of studies indicated that people viewed living with OA negatively. Four key factors influenced their attitudes to the condition: the severity of their symptoms; the impact of these symptoms on their functional capability; their attitude towards understanding their disease; and their perceptions of other people's beliefs towards their disease. CONCLUSIONS The current literature suggests that greater knowledge of the pathology of OA, management of symptoms, promotion of functional activity for patients and their family/friends networks, and understanding to better inform OA patient's role in society are all important elements that affect a person's attitude to OA. By better understanding these factors during future consultations, clinicians may forge stronger relationships with their patients to more effectively manage this long-term disabling condition.
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Affiliation(s)
- T O Smith
- Faculty of Medicine and Health Sciences, University of East Anglia , Norwich , UK
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1069
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Yerges-Armstrong LM, Yau MS, Liu Y, Krishnan S, Renner JB, Eaton CB, Kwoh CK, Nevitt MC, Duggan DJ, Mitchell BD, Jordan JM, Hochberg MC, Jackson RD. Association analysis of BMD-associated SNPs with knee osteoarthritis. J Bone Miner Res 2014; 29:1373-9. [PMID: 24339167 PMCID: PMC4080308 DOI: 10.1002/jbmr.2160] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Revised: 11/19/2013] [Accepted: 12/03/2013] [Indexed: 01/27/2023]
Abstract
Osteoarthritis (OA) risk is widely recognized to be heritable but few loci have been identified. Observational studies have identified higher systemic bone mineral density (BMD) to be associated with an increased risk of radiographic knee osteoarthritis. With this in mind, we sought to evaluate whether well-established genetic loci for variance in BMD are associated with risk for radiographic OA in the Osteoarthritis Initiative (OAI) and the Johnston County Osteoarthritis (JoCo) Project. Cases had at least one knee with definite radiographic OA, defined as the presence of definite osteophytes with or without joint space narrowing (Kellgren-Lawrence [KL] grade ≥ 2) and controls were absent for definite radiographic OA in both knees (KL grade ≤ 1 bilaterally). There were 2014 and 658 Caucasian cases, respectively, in the OAI and JoCo Studies, and 953 and 823 controls. Single nucleotide polymorphisms (SNPs) were identified for association analysis from the literature. Genotyping was carried out on Illumina 2.5M and 1M arrays in Genetic Components of Knee OA (GeCKO) and JoCo, respectively and imputation was done. Association analyses were carried out separately in each cohort with adjustments for age, body mass index (BMI), and sex, and then parameter estimates were combined across the two cohorts by meta-analysis. We identified four SNPs significantly associated with prevalent radiographic knee OA. The strongest signal (p = 0.0009; OR = 1.22; 95% CI, 1.08-1.37) maps to 12q3, which contains a gene coding for SP7. Additional loci map to 7p14.1 (TXNDC3), 11q13.2 (LRP5), and 11p14.1 (LIN7C). For all four loci the allele associated with higher BMD was associated with higher odds of OA. A BMD risk allele score was not significantly associated with OA risk. This meta-analysis demonstrates that several genomewide association studies (GWAS)-identified BMD SNPs are nominally associated with prevalent radiographic knee OA and further supports the hypothesis that BMD, or its determinants, may be a risk factor contributing to OA development. © 2014 American Society for Bone and Mineral Research.
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Affiliation(s)
- Laura M Yerges-Armstrong
- Program in Personalized and Genomic Medicine, Division of Endocrinology, Diabetes, and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
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1070
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Papathanasiou G, Stasi S, Oikonomou L, Roussou I, Papageorgiou E, Chronopoulos E, Korres N, Bellamy N. Clinimetric properties of WOMAC Index in Greek knee osteoarthritis patients: comparisons with both self-reported and physical performance measures. Rheumatol Int 2014; 35:115-23. [PMID: 24871159 DOI: 10.1007/s00296-014-3043-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 05/12/2014] [Indexed: 12/12/2022]
Abstract
This observational study aimed to examine the clinimetric properties of the Greek for Greece translation of the Western Ontario and McMaster Osteoarthritis Index (WOMAC(®)). One hundred and twenty-three patients with knee osteoarthritis (mean age 69.5 years) participated in the study. An extensive reliability study was carried out to assess WOMAC's internal consistency and repeatability (8-day interval). In addition, we examined the construct (convergent, nomological and known-groups) and criterion-related (concurrent and predictive) validity of the index against both self-report [SF-36 and combined visual analog/faces pain scale-revised (VAS/FPS-R)] and physical performance measures [timed up and go test (TUG)]. The internal consistency of the WOMAC subscales ranged from high (0.804) to excellent (0.956). Intra-class correlation coefficients for test-retest reliability were excellent, ranging from 0.91 to 0.95. Partial correlation analysis, adjusted for age and use of an assistive device, showed that WOMAC scores were significantly associated with all validation criteria, presenting fair to strong (-0.33 to -0.86) correlation coefficients. WOMAC-function was strongly associated with SF36-function (-0.86) and TUG (0.71), WOMAC-pain to VAS/FPS-R (0.71) and SF36-pain (-0.67). Of all WOMAC outcomes, stiffness subscale had the lowest, though still significant, correlations with all validation criteria. Multiple linear regression analyses indicated that WOMAC-function was a significant factor for TUG, WOMAC-pain for VAS/FPS-R and both for SF36-function and SF36-pain. The WOMAC LK3.1 Greek for Greece Index is a reliable and valid assessment tool for the evaluation of individuals with knee osteoarthritis, showing excellent reliability and significant validity properties.
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Affiliation(s)
- George Papathanasiou
- Physiotherapy Department, Technological Educational Institute of Athens, 24 Mitrodorou St., 10441, Athens, Greece,
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1071
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Abstract
BACKGROUND Medicinal plant products are used orally for treating osteoarthritis. Although their mechanisms of action have not yet been elucidated in full detail, interactions with common inflammatory mediators provide a rationale for using them to treat osteoarthritic complaints. OBJECTIVES To update a previous Cochrane review to assess the benefits and harms of oral medicinal plant products in treating osteoarthritis. SEARCH METHODS We searched electronic databases (CENTRAL, MEDLINE, EMBASE, AMED, CINAHL, ISI Web of Science, World Health Organization Clinical Trials Registry Platform) to 29 August 2013, unrestricted by language, and the reference lists from retrieved trials. SELECTION CRITERIA Randomised controlled trials of orally consumed herbal interventions compared with placebo or active controls in people with osteoarthritis were included. Herbal interventions included any plant preparation but excluded homeopathy or aromatherapy products, or any preparation of synthetic origin. DATA COLLECTION AND ANALYSIS Two authors used standard methods for trial selection and data extraction, and assessed the quality of the body of evidence using the GRADE approach for major outcomes (pain, function, radiographic joint changes, quality of life, withdrawals due to adverse events, total adverse events, and serious adverse events). MAIN RESULTS Forty-nine randomised controlled studies (33 interventions, 5980 participants) were included. Seventeen studies of confirmatory design (sample and effect sizes pre-specified) were mostly at moderate risk of bias. The remaining 32 studies of exploratory design were at higher risk of bias. Due to differing interventions, meta-analyses were restricted to Boswellia serrata (monoherbal) and avocado-soyabean unsaponifiables (ASU) (two herb combination) products.Five studies of three different extracts from Boswellia serrata were included. High-quality evidence from two studies (85 participants) indicated that 90 days treatment with 100 mg of enriched Boswellia serrata extract improved symptoms compared to placebo. Mean pain was 40 points on a 0 to 100 point VAS scale (0 is no pain) with placebo, enriched Boswellia serrata reduced pain by a mean of 17 points (95% confidence interval (CI) 8 to 26); number needed to treat for an additional beneficial outcome (NNTB) 2; the 95% CIs did not exclude a clinically significant reduction of 15 points in pain. Physical function was 33 points on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) 0 to 100 point subscale (0 is no loss of function) with placebo, enriched Boswellia serrata improved function by 8 points (95% CI 2 to 14); NNTB 4. Assuming a minimal clinically important difference of 10 points, we cannot exclude a clinically important benefit in some people. Moderate-quality evidence (one study, 96 participants) indicated that adverse events were probably reduced with enriched Boswellia serrata (18/48 events versus 30/48 events with placebo; relative risk (RR) 0.60, 95% CI 0.39 to 0.92). Possible benefits of other Boswellia serrata extracts over placebo were confirmed in moderate-quality evidence from two studies (97 participants) of Boswellia serrata (enriched) 100 mg plus non-volatile oil, and low-quality evidence from small single studies of a 999 mg daily dose of Boswellia serrata extract and 250 mg daily dose of enrichedBoswellia serrata. It was uncertain if a 99 mg daily dose of Boswellia serrata offered benefits over valdecoxib due to the very low-quality evidence from a small single study. It was uncertain if there was an increased risk of adverse events or withdrawals with Boswellia serrata extract due to variable reporting of results across studies. The studies reported no serious adverse events. Quality of life and radiographic joint changes were not measured.Six studies examined the ASU product Piasclidine®. Moderate-quality evidence from four studies (651 participants) indicated that ASU 300 mg produced a small and clinically questionable improvement in symptoms, and probably no increased adverse events compared to placebo after three to 12 months treatment. Mean pain with placebo was 40.5 points on a VAS 0 to 100 scale (0 is no pain), ASU 300 mg reduced pain by a mean of 8.5 points (95% CI 1 to 16 points); NNTB 8. ASU 300 mg improved function (standardised mean difference (SMD) -0.42, 95% CI -0.73 to -0.11). Function was estimated as 47 mm (0 to 100 mm scale, where 0 is no loss of function) with placebo, ASU 300 mg improved function by a mean of 7 mm (95% CI 2 to 12 mm); NNTB 5 (3 to 19). There were no differences in adverse events (5 studies, 1050 participants) between ASU (53%) and placebo (51%) (RR 1.04, 95% CI 0.97 to 1.12); withdrawals due to adverse events (1 study, 398 participants) between ASU (17%) and placebo (15%) (RR 1.14, 95% CI 0.73 to 1.80); or serious adverse events (1 study, 398 participants) between ASU (40%) and placebo (33%) (RR 1.22, 95% CI 0.94 to 1.59). Radiographic joint changes, measured as change in joint space width (JSW) in two studies (453 participants) did not differ between ASU 300 mg treatment (-0.53 mm) and placebo (-0.65 mm); mean difference of -0.12 (95% CI -0.43 to 0.19). Moderate-quality evidence from a single study (156 participants) confirmed possible benefits of ASU 600 mg over placebo, with no increased adverse events. Low-quality evidence (1 study, 357 participants) indicated there may be no differences in symptoms or adverse events between ASU 300 mg and chondroitin sulphate. Quality of life was not measured.All other herbal interventions were investigated in single studies, limiting conclusions. No serious side effects related to any plant product were reported. AUTHORS' CONCLUSIONS Evidence for the proprietary ASU product Piasclidine® in the treatment of osteoarthritis symptoms seems moderate to high for short term use, but studies over a longer term and against an apparently active control are less convincing. Several other medicinal plant products, including extracts of Boswellia serrata, show trends of benefits that warrant further investigation in light of the fact that the risk of adverse events appear low.There is no evidence that Piasclidine® significantly improves joint structure, and limited evidence that it prevents joint space narrowing. Structural changes were not tested for with any other herbal intervention.Further investigations are required to determine optimum daily doses producing clinical benefits without adverse events.
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Affiliation(s)
- Melainie Cameron
- University of the Sunshine CoastSchool of Health and Sport Sciences, Cluster for Health ImprovementSippy Downs campusLocked Bag 4Maroochydore DCQueenslandAustralia4558
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1072
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Serebrakian AT, Poulos T, Liebl H, Joseph GB, Lai A, Nevitt MC, Lynch JA, McCulloch CE, Link TM. Weight loss over 48 months is associated with reduced progression of cartilage T2 relaxation time values: data from the osteoarthritis initiative. J Magn Reson Imaging 2014; 41:1272-1280. [PMID: 24700497 DOI: 10.1002/jmri.24630] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Accepted: 02/20/2014] [Indexed: 02/06/2023] Open
Abstract
PURPOSE To assess whether changes in knee cartilage MR-based T2 relaxation times are associated with weight loss in individuals with risk factors for knee osteoarthritis (OA) compared with controls with stable weight. MATERIALS AND METHODS One hundred twenty-seven individuals with risk factors for knee OA were studied: 62 subjects had a body mass index (BMI) decrease≥10% over 48 months and 65 controls had a BMI change <3%. Cartilage segmentation from five knee compartments at baseline and 48-month follow-up was performed, and T2 maps were generated. The association of change in T2 values over 48 months in the weight-loss group versus the control group was assessed using multiple linear regression models. RESULTS Weight loss was associated with significantly smaller increases in cartilage T2 in the medial femoral condyle (P = 0.035) and overall medial compartment (P = 0.006) compared with the controls. In a subgroup analysis comparing weight-loss subjects who were obese (BMI≥30 kg/m(2) ) and overweight (BMI 25-30 kg/m(2) ) at baseline, obesity was associated with smaller increases in cartilage T2 values in the medial femoral condyle (P = 0.022), lateral femoral condyle (P = 0.015), patella (P = 0.002), and globally across all compartments (P = 0.002). CONCLUSION A decrease in BMI of ≥ 10% was associated with a slower progression of T2 values in individuals with risk factors for OA, suggesting a beneficial impact of weight loss on cartilage matrix degeneration.
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Affiliation(s)
- Arman T Serebrakian
- Musculoskeletal and Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California San Francisco
| | - Theresa Poulos
- Musculoskeletal and Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California San Francisco
| | - Hans Liebl
- Musculoskeletal and Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California San Francisco
| | - Gabby B Joseph
- Musculoskeletal and Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California San Francisco
| | - Andrew Lai
- Musculoskeletal and Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California San Francisco
| | - Michael C Nevitt
- Department of Epidemiology and Biostatistics, University of California San Francisco
| | - John A Lynch
- Department of Epidemiology and Biostatistics, University of California San Francisco
| | - Charles E McCulloch
- Department of Epidemiology and Biostatistics, University of California San Francisco
| | - Thomas M Link
- Musculoskeletal and Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California San Francisco
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1073
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Smith T, Kirby E, Davies L. A systematic review to determine the optimal type and dosage of land-based exercises for treating knee osteoarthritis. PHYSICAL THERAPY REVIEWS 2014. [DOI: 10.1179/1743288x13y.0000000108] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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1074
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Miller RH, Brandon SCE, Deluzio KJ. Predicting sagittal plane biomechanics that minimize the axial knee joint contact force during walking. J Biomech Eng 2014; 135:011007. [PMID: 23363218 DOI: 10.1115/1.4023151] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Both development and progression of knee osteoarthritis have been associated with the loading of the knee joint during walking. We are, therefore, interested in developing strategies for changing walking biomechanics to offload the knee joint without resorting to surgery. In this study, simulations of human walking were performed using a 2D bipedal forward dynamics model. A simulation generated by minimizing the metabolic cost of transport (CoT) resembled data measured from normal human walking. Three simulations targeted at minimizing the peak axial knee joint contact force instead of the CoT reduced the peak force by 12-25% and increased the CoT by 11-14%. The strategies used by the simulations were (1) reduction in gastrocnemius muscle force, (2) avoidance of knee flexion during stance, and (3) reduced stride length. Reduced gastrocnemius force resulted from a combination of changes in activation and changes in the gastrocnemius contractile component kinematics. The simulations that reduced the peak contact force avoided flexing the knee during stance when knee motion was unrestricted and adopted a shorter stride length when the simulated knee motion was penalized if it deviated from the measured human knee motion. A higher metabolic cost in an offloading gait would be detrimental for covering a long distance without fatigue but beneficial for exercise and weight loss. The predicted changes in the peak axial knee joint contact force from the simulations were consistent with estimates of the joint contact force in a human subject who emulated the predicted kinematics. The results demonstrate the potential of using muscle-actuated forward dynamics simulations to predict novel joint offloading interventions.
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Affiliation(s)
- Ross H Miller
- Department of Mechanical and Materials Engineering, Queen's University, Kingston, ON, K7L 3N6, Canada.
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1075
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Li B, Li F, Ma L, Yang J, Wang C, Wang D, Gao C. Poly(lactide-co-glycolide)/Fibrin Gel Construct as a 3D Model to Evaluate Gene Therapy of Cartilage in Vivo. Mol Pharm 2014; 11:2062-70. [DOI: 10.1021/mp5000136] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Bo Li
- MOE
Key Laboratory of Macromolecular Synthesis and Functionalization,
Department of Polymer Science and Engineering, Zhejiang University, Hangzhou 310027, China
| | - Feifei Li
- MOE
Key Laboratory of Macromolecular Synthesis and Functionalization,
Department of Polymer Science and Engineering, Zhejiang University, Hangzhou 310027, China
| | - Lie Ma
- MOE
Key Laboratory of Macromolecular Synthesis and Functionalization,
Department of Polymer Science and Engineering, Zhejiang University, Hangzhou 310027, China
| | - Junzhou Yang
- MOE
Key Laboratory of Macromolecular Synthesis and Functionalization,
Department of Polymer Science and Engineering, Zhejiang University, Hangzhou 310027, China
| | - Chunfen Wang
- MOE
Key Laboratory of Macromolecular Synthesis and Functionalization,
Department of Polymer Science and Engineering, Zhejiang University, Hangzhou 310027, China
| | - Dongan Wang
- Division of Bioengineering, School of Chemical & Biomedical Engineering, Nanyang Technological University, 70 Nanyang Drive, N1.3-B2-13, 637457 Singapore
| | - Changyou Gao
- MOE
Key Laboratory of Macromolecular Synthesis and Functionalization,
Department of Polymer Science and Engineering, Zhejiang University, Hangzhou 310027, China
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1076
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Odole AC, Ojo OD. Is telephysiotherapy an option for improved quality of life in patients with osteoarthritis of the knee? Int J Telemed Appl 2014; 2014:903816. [PMID: 24778645 PMCID: PMC3980780 DOI: 10.1155/2014/903816] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Revised: 01/18/2014] [Accepted: 02/03/2014] [Indexed: 01/12/2023] Open
Abstract
This study investigated effect of a 6-week telephysiotherapy programme on quality of life (QoL) of patients with knee osteoarthritis (OA). Fifty patients with knee OA were randomly and equally assigned into two treatment groups: clinic group (CG) and telephysiotherapy group (TG). The CG received physiotherapist-administered osteoarthritis-specific exercises in the clinic thrice weekly for 6 weeks while the TG received structured telephone monitoring with self-administered osteoarthritis-specific exercises for the same duration at home. Participants' QoL was assessed using WHOQoL-Bref at baseline, second, fourth, and sixth week of intervention. Data were analyzed using ANOVA and independent Student's t-test. Within-group comparison showed significant improvements in physical health domain (P = 0.00* for TG and CG) and psychological domain (P = 0.02* for TG; P = 0.00* for CG) of WHOQoL following six-week intervention. However, there were no significant differences (P > 0.05) in TG and CG's social relationship and environment domains. Between-group comparison showed no significant differences (P > 0.05) between CG and TG's physical health, psychological, and social relationships domains of WHOQoL following 6-week intervention. However, there was significant difference in the environment domain (P < 0.05). Telephysiotherapy using telephone medium improved QoL in patients with knee OA comparable to clinic based treatment.
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Affiliation(s)
- Adesola C. Odole
- Department of Physiotherapy, College of Medicine, University of Ibadan, Ibadan 200284, Nigeria
- School of Research and Postgraduate Studies, Faculty of Agriculture, Science and Technology, North West University, Mafikeng Campus, Mafikeng 2735, South Africa
| | - Oluwatobi D. Ojo
- Department of Physiotherapy, College of Medicine, University of Ibadan, Ibadan 200284, Nigeria
- Department of Physiotherapy, Neuropsychiatric Hospital, Aro, Abeokuta 110251, Nigeria
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1077
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Drugs and Polymers for Delivery Systems in OA Joints: Clinical Needs and Opportunities. Polymers (Basel) 2014. [DOI: 10.3390/polym6030799] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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1078
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Losina E, Burbine SA, Suter LG, Hunter DJ, Solomon DH, Daigle ME, Dervan EE, Jordan JM, Katz JN. Pharmacologic regimens for knee osteoarthritis prevention: can they be cost-effective? Osteoarthritis Cartilage 2014; 22:415-30. [PMID: 24487044 PMCID: PMC4006219 DOI: 10.1016/j.joca.2014.01.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Revised: 12/20/2013] [Accepted: 01/17/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE We sought to determine the target populations and drug efficacy, toxicity, cost, and initiation age thresholds under which a pharmacologic regimen for knee osteoarthritis (OA) prevention could be cost-effective. DESIGN We used the Osteoarthritis Policy (OAPol) Model, a validated state-transition simulation model of knee OA, to evaluate the cost-effectiveness of using disease-modifying OA drugs (DMOADs) as prophylaxis for the disease. We assessed four cohorts at varying risk for developing OA: (1) no risk factors, (2) obese, (3) history of knee injury, and (4) high-risk (obese with history of knee injury). The base case DMOAD was initiated at age 50 with 40% efficacy in the first year, 5% failure per subsequent year, 0.22% major toxicity, and annual cost of $1,000. Outcomes included costs, quality-adjusted life expectancy (QALE), and incremental cost-effectiveness ratios (ICERs). Key parameters were varied in sensitivity analyses. RESULTS For the high-risk cohort, base case prophylaxis increased quality-adjusted life-years (QALYs) by 0.04 and lifetime costs by $4,600, and produced an ICER of $118,000 per QALY gained. ICERs >$150,000/QALY were observed when comparing the base case DMOAD to the standard of care in the knee injury only cohort; for the obese only and no risk factors cohorts, the base case DMOAD was less cost-effective than the standard of care. Regimens priced at $3,000 per year and higher demonstrated ICERs above cost-effectiveness thresholds consistent with current US standards. CONCLUSIONS The cost-effectiveness of DMOADs for OA prevention for persons at high risk for incident OA may be comparable to other accepted preventive therapies.
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Affiliation(s)
- E Losina
- Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA, USA; Section of Clinical Sciences, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Boston University School of Public Health, Boston, MA, USA.
| | - S A Burbine
- Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA, USA.
| | - L G Suter
- Yale University, New Haven, CT, USA.
| | - D J Hunter
- University of Sydney and Royal North Shore Hospital, Sydney, Australia.
| | - D H Solomon
- Section of Clinical Sciences, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
| | - M E Daigle
- Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA, USA.
| | - E E Dervan
- Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA, USA.
| | - J M Jordan
- Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA.
| | - J N Katz
- Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA, USA; Section of Clinical Sciences, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
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1079
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Abstract
BACKGROUND Osteoarthritis (OA) of the knee is a chronic, progressive condition which often requires surgical intervention. The evidence for the benefits of arthroscopic debridement or washout for knee OA is weak and arthroscopy is currently only indicated in the UK if there is a history of mechanical locking of the knee. OBJECTIVES To investigate whether there has been any change in the number of arthroscopies performed in the UK since the 2007 NICE guidance on knee arthroscopy and the 2008 Cochrane review of arthroscopic debridement for OA of the knee. METHODS We interrogated data from the Hospital Episodes Statistics (HES) database with Office of Population Censuses and Surveys-4 (OPSC-4) codes pertaining to therapeutic endoscopic operations in the 60-74 year old and 75 and over age groups. RESULTS The number of arthroscopic knee interventions in the UK decreased overall from 2000 to 2012, with arthroscopic irrigations decreasing the most by 39.6 per 100,000 population (80%). However, the number of arthroscopic meniscal resections increased by 105.3 per 100,000 (230%) population. These trends were mirrored in both the 60-74 and 75 and over age groups. CONCLUSIONS Knee arthroscopy in the 60-74 and 75 and over age groups appears to be decreasing but there is still a large and increasing number of arthroscopic meniscal resections being performed.
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1080
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Rufino AT, Ribeiro M, Judas F, Salgueiro L, Lopes MC, Cavaleiro C, Mendes AF. Anti-inflammatory and chondroprotective activity of (+)-α-pinene: structural and enantiomeric selectivity. JOURNAL OF NATURAL PRODUCTS 2014; 77:264-9. [PMID: 24455984 DOI: 10.1021/np400828x] [Citation(s) in RCA: 128] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Previous studies have suggested that α-pinene, a common volatile plant metabolite, may have anti-inflammatory effects in human chondrocytes, thus exhibiting potential antiosteoarthritic activity. The objective of this study was to further characterize the potential antiosteoarthritic activity of selected pinene derivatives by evaluating their ability to modulate inflammation and extracellular matrix remodeling in human chondrocytes and to correlate the biological and chemical properties by determining whether the effects are isomer- and/or enantiomer-selective. To further elucidate chemicopharmacological interactions, the activities of other naturally occurring monoterpenes with the pinane nucleus were also investigated. At noncytotoxic concentrations, (+)-α-pinene (1) elicited the most potent inhibition of the IL-1β-induced inflammatory and catabolic pathways, namely, NF-κB and JNK activation and the expression of the inflammatory (iNOS) and catabolic (MMP-1 and -13) genes. (-)-α-Pinene (2) was less active than the (+)-enantiomer (1), and β-pinene (3) was inactive. E-Pinane (4) and oxygenated pinane-derived compounds, pinocarveol (5), myrtenal (6), (E)-myrtanol (7), myrtenol (8), and (Z)-verbenol (9), were less effective or even completely inactive and more cytotoxic than the pinenes tested (1-3). The data obtained show isomer- and enantiomer-selective anti-inflammatory and anticatabolic effects of α-pinene in human chondrocytes, (+)-α-pinene (1) being the most promising for further studies to determine its potential value as an antiosteoarthritic drug.
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Affiliation(s)
- Ana T Rufino
- Center for Neuroscience and Cell Biology, University of Coimbra , Coimbra, Portugal
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1081
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Ganasegeran K, Menke JM, Challakere Ramaswamy VM, Abdul Manaf R, Alabsi AM, Al-Dubai SAR. Level and determinants of knowledge of symptomatic knee osteoarthritis among railway workers in Malaysia. BIOMED RESEARCH INTERNATIONAL 2014; 2014:370273. [PMID: 24701573 PMCID: PMC3950488 DOI: 10.1155/2014/370273] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Revised: 12/14/2013] [Accepted: 01/07/2014] [Indexed: 02/06/2023]
Abstract
BACKGROUND Symptomatic knee osteoarthritis, an ancient malady greatly impairing modern population quality of life, has stimulated global attention to find effective modes of prevention and intervention. PURPOSE This study aimed to assess factors affecting knowledge of symptomatic knee osteoarthritis (knee OA) among Malaysian railway workers. METHODS A cross-sectional study was conducted among 513 railway workers involving eight major states within Peninsular Malaysia using population-based sampling. The assessment instrument was a face-validated, prepiloted, self-administered instrument with sociodemographics and knowledge items on knee OA. RESULTS Mean (± SD) age of the respondents was 41.4 (± 10.7), with the majority aged 50 years or older (34.9%). Of the total respondents, 53.6% had low levels of knowledge of knee OA disease. Multivariate analysis found that four demographic predictors, age ≥ 50 years, family history of knee OA, self-awareness, and clinical diagnosis of the disease entity, were significantly associated with knowledge scores. CONCLUSION The finding of a low level knee OA knowledge among Malaysian railway workers points to an urgent need for massive information to be disseminated among the workers at risk to foster primary prevention and self-care.
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Affiliation(s)
- Kurubaran Ganasegeran
- International Medical School, Management and Science University (MSU), Shah Alam 40100 Selangor, Malaysia
| | - J. Michael Menke
- International Medical University (IMU), 57000 Bukit Jalil, Kuala Lumpur, Malaysia
| | | | - Rizal Abdul Manaf
- Community Health Department, Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM), Cheras, 56000 Kuala Lumpur, Malaysia
| | - Aied M. Alabsi
- Department Oral Biology and Biomedical Science, Faculty of Dentistry, University of Malaya (UM), 50603 Petaling Jaya, Kuala Lumpur, Malaysia
| | - Sami Abdo Radman Al-Dubai
- Department of Community Medicine, International Medical University (IMU), 57000 Bukit Jalil, Kuala Lumpur, Malaysia
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1082
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Pelletier D, Gingras-Hill C, Boissy P. Power training in patients with knee osteoarthritis: a pilot study on feasibility and efficacy. Physiother Can 2014; 65:176-82. [PMID: 24403682 DOI: 10.3138/ptc.2012-05] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To explore the feasibility and efficacy of using a power training exercise programme for the quadriceps femoris (QF) in elderly women with knee osteoarthritis (OA). METHOD A one-group quasi-experimental design with pre- and post-intervention measurements was conducted on 17 older adult women with knee OA pain. A bilateral QF exercise programme (24 sessions over 8 weeks) consisting of 3 series of 10 repetitions of flexion-extension as fast as possible at 40% of their one-repetition maximum (1RM) was performed in an outpatient physiotherapy clinic. The primary outcome measures were the knee function and associated problems using the Knee injury Osteoarthritis Outcome Score (KOOS) questionnaire and the weekly mean pain score from pain diaries using a visual analogue scale (VAS). QF strength (QFS), power (QFP) and work (QFW) were measured with an isokinetic dynamometer as secondary outcomes. RESULTS Significant improvements (p<0.05) were noted on the five categories of the KOOS. Significant decrease (p<0.01) was noted in pain intensity on VAS. QFP and QFW increased significantly on both sides (p<0.05). Exercise compliance was 99.5% for 16 participants. CONCLUSIONS A short power-training exercise programme is a feasible training modality for patients with knee OA, and significant functional improvements can be achieved. Further studies must be conducted to better understand the effects of the programme parameters and the generalizability of the findings.
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Affiliation(s)
- Denis Pelletier
- Faculty of Physical Education and Sports, Department of Kinesiology ; Research Centre on Aging, Health and Social Services Centre - University Institute of Geriatrics of Sherbrooke (CSSS-IUGS), Sherbrooke Que
| | - Cédric Gingras-Hill
- Faculty of Medicine and Health Sciences, Department of Surgery, Université de Sherbrooke ; Research Centre on Aging, Health and Social Services Centre - University Institute of Geriatrics of Sherbrooke (CSSS-IUGS), Sherbrooke Que
| | - Patrick Boissy
- Faculty of Medicine and Health Sciences, Department of Surgery, Université de Sherbrooke ; Research Centre on Aging, Health and Social Services Centre - University Institute of Geriatrics of Sherbrooke (CSSS-IUGS), Sherbrooke Que
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1083
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Gandini F, Giannitti C, Fattore G, Giordano N, Galeazzi M, Fioravanti A. Validation of an Italian version of the functional index for hand osteoarthritis (FIHOA). Mod Rheumatol 2014. [DOI: 10.3109/s10165-011-0579-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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1084
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Hamilton CB, Maly MR, Clark JM, Speechley M, Petrella RJ, Chesworth BM. Activity-Modifying Behaviour Mediates the Relationship between Pain Severity and Activity Limitations among Adults with Emergent Knee Pain. Physiother Can 2014; 65:12-9. [PMID: 24381376 DOI: 10.3138/ptc.2011-61] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To determine whether activity-modifying behaviour mediates the relationship between the severity of knee pain and each of physical function and knee-related quality of life. METHODS A total of 105 participants with medial knee pain and no diagnosis of knee osteoarthritis (mean age 52.2 [SD 6.7] y) completed two self-report questionnaires. The Questionnaire to Identify Knee Symptoms assessed activity-modifying behaviour; the Knee injury and Osteoarthritis Outcome Score assessed pain severity, physical function, and knee-related quality of life. Simple mediation analysis was performed using linear regression. RESULTS The unstandardized regression coefficient for activity-modifying behaviour revealed partial mediation of the effect of pain severity on physical function (0.31 (SE 0.09), p<0.001) and on knee-related quality of life (0.24 (SE 0.07), p<0.001). After accounting for activity-modifying behaviour, the variance in physical function that was explained by pain decreased from 45% to 15%, and the variance in knee-related quality of life that was explained by pain decreased from 64% to 25%. CONCLUSION Activity-modifying behaviour partially mediates the relationship between pain severity and physical function and between pain severity and knee-related quality of life. Activity-modifying behaviour may thus counteract the impact of knee pain on physical function and knee-related quality of life, which explains why it is used by people with emergent knee pain.
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Affiliation(s)
- Clayon B Hamilton
- Graduate Program in Health and Rehabilitation Sciences, Faculty of Health Sciences ; School of Physical Therapy
| | - Monica R Maly
- School of Physical Therapy ; School of Rehabilitation Science, McMaster University, Hamilton, Ont
| | - Jessica M Clark
- Graduate Program in Health and Rehabilitation Sciences, Faculty of Health Sciences
| | | | - Robert J Petrella
- Department of Family Medicine, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ont
| | - Bert M Chesworth
- Graduate Program in Health and Rehabilitation Sciences, Faculty of Health Sciences ; School of Physical Therapy ; Department of Epidemiology and Biostatistics
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1085
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Alshami AM. Knee osteoarthritis related pain: a narrative review of diagnosis and treatment. Int J Health Sci (Qassim) 2014; 8:85-104. [PMID: 24899883 PMCID: PMC4039588 DOI: 10.12816/0006075] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Osteoarthritis is a common progressive joint disease, involving not only the joint lining but also cartilage, ligaments, and bone. For the last ten years, majority of published review articles were not specific to osteoarthritis of the knee, and strength of evidence and clinical guidelines were not appropriately summarized. OBJECTIVES To appraise the literature by summarizing the findings of current evidence and clinical guidelines on the diagnosis and treatment of knee osteoarthritis pain. METHODOLOGY English journal articles that focused on knee osteoarthritis related pain were searched via PubMed (1 January 2002 - 26 August 2012) and Physiotherapy Evidence Database (PEDro) databases, using the terms 'knee', 'osteoarthritis' and 'pain'. In addition, reference lists from identified articles and related book chapters were included as comprehensive overviews. RESULTS For knee osteoarthritis, the highest diagnostic accuracy can be achieved by presence of pain and five or more clinical or laboratory criteria plus osteophytes. Some inconsistencies in the recommendations and findings were found between the clinical guidelines and systematic reviews. Generally, paracetamol, oral and topical non-steroidal anti-inflammatory drugs, opioids, corticosteroid injections and physical therapy techniques, such as therapeutic exercises, joint manual therapy and transcutaneous electrical nerve stimulation, can help reduce pain and improve function. Patient education programs and weight reduction for overweight patients are important to be considered. CONCLUSIONS Some inconsistencies in the recommendations and findings were found between the clinical guidelines and systematic reviews. However, it is likely that a combination of pharmacological and non-pharmacological treatments is most effective in treating patients with knee osteoarthritis.
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Affiliation(s)
- Ali M. Alshami
- Assistant Professor, Department of Physical Therapy, College of Applied Medical Sciences, University of Dammam
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1086
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Fioravanti A, Tenti S, Giannitti C, Fortunati NA, Galeazzi M. Short- and long-term effects of mud-bath treatment on hand osteoarthritis: a randomized clinical trial. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2014; 58:79-86. [PMID: 23314489 DOI: 10.1007/s00484-012-0627-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Revised: 12/19/2012] [Accepted: 12/20/2012] [Indexed: 05/28/2023]
Abstract
The aim of this study was to evaluate both the short-term and the long-term effectiveness of spa therapy in patients with primary hand osteoarthritis (OA). This was a prospective randomized, single blind controlled trial. Sixty outpatients with primary bilateral hand OA were included in the study and randomized to one of two groups. One group (n = 30) was treated with 12 daily local mud packs and generalized thermal baths with a sulfate-calcium-magnesium-fluorides mineral water added to usual treatment. The control group (n = 30) continued regular outpatient care routine (exercise, NSAIDs and/or analgesics). Each patient was examined at baseline, after 2 weeks, and after 3, 6, 9 and 12 months. Primary outcome measures were global spontaneous hand pain on a visual analogue scale (VAS) and the functional index for hand osteoarthritis (FIHOA) score; secondary outcomes were health assessment questionnaire (HAQ), duration of morning stiffness, medical outcomes study 36-item short form (SF-36) and symptomatic drugs consumption. Our results demonstrated that the efficacy of spa therapy was significant in all the assessed parameters, both at the end of therapy and after 3 months; the values of FIHOA, HAQ and drugs consumption continued to be significantly better after 6 months in comparison with baseline. There were no significant modifications of the parameters throughout the follow-up in the control group. Differences between the two groups were significant for all parameters at the 15th day and at 3 months follow-up; regarding FIHOA, HAQ, and symptomatic drugs consumption, the difference between the two groups persisted and was significant at 6month follow-up. Tolerability of spa therapy seemed to be good. In conclusion, our results confirm that the beneficial effects of spa therapy in patients with hand OA last over time.
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Affiliation(s)
- Antonella Fioravanti
- Rheumatology Unit, Department of Clinical Medicine and Immunological Sciences, University of Siena, Viale Bracci,1, 53100, Siena, Italy,
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1087
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Frese T, Peyton L, Mahlmeister J, Sandholzer H. Knee pain as the reason for encounter in general practice. ISRN FAMILY MEDICINE 2013; 2013:930825. [PMID: 24959577 PMCID: PMC4041260 DOI: 10.5402/2013/930825] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Accepted: 10/09/2013] [Indexed: 11/23/2022]
Abstract
Objective. Currently, an overview of the management of knee pain in general practitioner's offices is not available. The main concern of this study was to evaluate the consultation prevalence of knee pain, accompanying symptoms, the frequency of diagnostic and therapeutic procedures, and results of encounters of patients suffering from knee pain. Methods. For the SESAM 2 study cross-sectional data was collected from randomly selected patients during one year and compared with publicly available data from the Dutch Transition Project. Results. Overall, 127 out of 8,877 (1.4%) patients of the SESAM 2 study and 6,754 out of 149,238 (4.5%) patients of the Dutch Transition Project consulted for knee pain. Drug prescription, follow-up consultation, giving doctor's advice, and referral to a specialist or physiotherapist were the most frequent procedures. Osteoarthritis of the knee and other musculoskeletal diseases were the most frequent results of encounter. Overweight, age, gender, and other musculoskeletal diseases were found to be significantly associated with knee pain. Conclusion. Knee pain in general practice settings is mainly associated with chronic problems. Dangerous outcomes (as suspected fracture or thrombosis) are rare. Further research is needed in order to reduce the influence knee pain has on daily living.
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Affiliation(s)
- Thomas Frese
- Department of Primary Care, Leipzig Medical School, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany
| | - Linda Peyton
- Department of Primary Care, Leipzig Medical School, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany
| | - Jarmila Mahlmeister
- Department of Primary Care, Leipzig Medical School, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany
| | - Hagen Sandholzer
- Department of Primary Care, Leipzig Medical School, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany
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1088
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Optical immunosensor for quantifying C-telopeptide fragments of type II collagen as an osteoarthritis biomarker in urine. BIOCHIP JOURNAL 2013. [DOI: 10.1007/s13206-013-7412-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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1089
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Leung GJ, Rainsford KD, Kean WF. Osteoarthritis of the hand I: aetiology and pathogenesis, risk factors, investigation and diagnosis. J Pharm Pharmacol 2013; 66:339-46. [DOI: 10.1111/jphp.12196] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Accepted: 11/16/2013] [Indexed: 01/23/2023]
Abstract
Abstract
Objective
Osteoarthritis (OA) of the hand can be a debilitating condition that hinders an individual's quality of life. With multiple joints within the hand that are commonly affected OA, an individual's ability to use their hand in everyday movements become more limited. The article aims to review literature on the aetiology and pathogenesis of OA, risk factors, characteristics of hand OA and the steps of diagnosis.
Key findings
The aetiology and pathogenesis of OA, in particular hand OA, is not fully understood. However, it is known that several factors play a role. Environmental factors, such as stress from mechanical loading, especially to vulnerable joints predispose individuals to developing OA. Extracellular matrix changes in protein levels have also been noted in individuals with OA. Linked to hand OA development are boney enlargements (Herbeden's and Bouchard's nodes). Several risk factors for OA include: age, obesity, gender, smoking, genetics, diet and occupation. Various diagnostic methods include a combination of using radiographic methods, clinical presentation, a number of developed measurements and scales.
Summary
With OA having several risk factors and various causes and contributing elements, it is important to elucidate the pathogenesis of OA and determine exactly how risk factors play a role in its development. Because of the contributions from several elements, diagnosis is best when it uses multiple methods. In turn, understanding OA and making better diagnoses could lead to improved management of the condition through both pharmacological and non-pharmacological interventions.
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Affiliation(s)
- Garvin J Leung
- Department of Medicine, McMaster University Faculty of Health Sciences, Hamilton, ON, Canada
| | - K D Rainsford
- Biomedical Research Centre, Sheffield Hallam University, Sheffield, UK
| | - Walter F Kean
- Department of Medicine, McMaster University Faculty of Health Sciences, Hamilton, ON, Canada
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1090
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Smith TO, Purdy R, Lister S, Salter C, Fleetcroft R, Conaghan PG. Attitudes of people with osteoarthritis towards their conservative management: a systematic review and meta-ethnography. Rheumatol Int 2013; 34:299-313. [PMID: 24306266 DOI: 10.1007/s00296-013-2905-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Accepted: 11/14/2013] [Indexed: 10/25/2022]
Abstract
This paper determines the perceptions of people diagnosed with osteoarthritis towards their conservative management strategies. A systematic review of the published (AMED, CINAHL, EMBASE, PsychINFO, SportsDisc, MEDLINE, Cochrane Clinical Trials Registry, PubMed) and unpublished/trial registry databases (WHO International Clinical Trials Registry Platform, Current Controlled Trials, the United States National Institute of Health Trials Registry, NIHR Clinical Research Portfolio Database) searched from their inception to July 2013. Eligible studies included those which presented the attitudes or perceptions of people with osteoarthritis towards non-operative management strategies. Study quality was appraised using the CASP and the Gough's weight of evidence appraisal tools. Data were analysed through a meta-ethnography approach. Thirty-three studies including 1,314 people with osteoarthritis were sampled; the majority diagnosed with knee osteoarthritis. The overarching themes indicated people with osteoarthritis delay their diagnosis, opting for self-management and informal information gathering. This informal rather than health professional-led guidance is sought and maintained as an important resource throughout the care of this population and is valued. Diagnosis is sought at a 'critical point'. Healthcare interventions largely provided are poorly perceived. The period of subsequent self-management is an expectation before the inevitable requirement for joint replacement. There remains uncertainty regarding when this is required, but the expected failure of conservative treatment to manage pain and symptoms is common. In conclusion, patients should be enthused towards the principles of self-management and clinicians should not trivialise osteoarthritis. This may provide a more valuable perception of non-operative management to promote its adoption and adherence in managing osteoarthritis.
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Affiliation(s)
- Toby O Smith
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, UK,
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1091
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Salih S, Sutton P. Obesity, knee osteoarthritis and knee arthroplasty: a review. Sports Med Arthrosc Rehabil Ther Technol 2013; 5:25. [PMID: 24304704 PMCID: PMC3879025 DOI: 10.1186/2052-1847-5-25] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 11/24/2013] [Indexed: 12/22/2022]
Abstract
The incidence of obesity is rising worldwide. Obesity is a risk factor for developing osteoarthritis in the knee. Obesity and knee osteoarthritis are independently disabling conditions and in combination pose difficult therapeutic challenges. This review will discuss obesity, osteoarthritis, and the problems associated with knee osteoarthritis in an obese population. Treatment options including surgery and its success will be discussed.
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Affiliation(s)
- Saif Salih
- Department of Trauma and Orthopaedics, Northern General Hospital, Herries Rd, Sheffield S5 7 AU, UK.
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1092
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Abstract
Osteoarthritis (OA) is a disease of the joint, and age is the major risk factor for its development. Clinical manifestation of OA includes joint pain, stiffness, and loss of mobility. Currently, no pharmacological treatments are available to treat this specific joint disease; only symptom-modifying drugs are available. Improvement in imaging technology, identification of biomarkers, and increased understanding of the molecular basis of OA will aid in detecting the early stages of disease. Yet the development of interventional strategies remains elusive and will be critical for effective prevention of OA-associated joint destruction. The potential of cell-based therapies may be applicable in improving joint function in mild to more advanced cases of OA. Ongoing studies to understand the basis of this disease will eventually lead to prevention and treatment strategies and will also be a key in reducing the social and economic burden of this disease. Nurses are advised to provide an integrative approach of disease assessment and management in OA patients' care with a focus on education and implementation. Knowledge and understanding of OA and how this affects the individual patient form the basis for such an integrative approach to all-round patient care and disease management.
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1093
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Kao MH, Tsai YF. Illness experiences in middle-aged adults with early-stage knee osteoarthritis: findings from a qualitative study. J Adv Nurs 2013; 70:1564-72. [PMID: 24237307 DOI: 10.1111/jan.12313] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2013] [Indexed: 11/30/2022]
Abstract
AIM To understand the illness experiences of middle-aged adults with early knee osteoarthritis. BACKGROUND Knee osteoarthritis is one of the most common causes of lower limb disability in middle-aged adults and older people. Nurses lack understanding of the illness experiences of middle-aged patients who were confirmed to have early knee osteoarthritis and of how they manage the disease in Taiwan. DESIGN A qualitative descriptive design was applied. METHODS Participants with knee osteoarthritis, aged 40-55 years, were recruited by purposive sampling (n = 17). The data were collected through semi-structured interviews from July-December 2010. All interview transcripts were analysed using qualitative inductive content analysis to identify key themes. FINDINGS Illness experiences of the seventeen participants were classified into three major themes: (i) unfamiliarity with osteoarthritis; (ii) effects on daily life; and (iii) protection and alleviation. The three main themes occurred repeatedly and affected the life experiences of the patients. CONCLUSIONS This study indicates that patients with osteoarthritis have insufficient knowledge related to disease process and they do not know how to cope effectively. They need healthcare providers to supply them with adequate osteoarthritis disease information. Nurses should also develop interventions in their practices and guide patients to use suitable techniques to improve the functional status of their knee joint(s).
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Affiliation(s)
- Mei-Hua Kao
- Department of Nursing, Mackay Memorial Hospital, New Taipei City, Taiwan; School of Nursing, Mackay Medical College, New Taipei City, Taiwan; Graduate Institute of Clinical Medical Sciences, Chang Gung University, Tao-Yuan, Taiwan
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1094
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Yázigi F, Espanha M, Vieira F, Messier SP, Monteiro C, Veloso AP. The PICO project: aquatic exercise for knee osteoarthritis in overweight and obese individuals. BMC Musculoskelet Disord 2013; 14:320. [PMID: 24219758 PMCID: PMC3830983 DOI: 10.1186/1471-2474-14-320] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 11/07/2013] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Aquatic exercise is recommended by the Osteoarthritis Research Society (OARSI), by the American College of Rheumatology (ACR) and by the European League Against Rheumatism (EULAR) as a nonpharmacological method of controlling the knee osteoarthritis (KOA) symptoms. Moreover, given that weight loss results in a reduction of the load that is exerted upon the knee during daily activities, obesity is also considered to be a modifiable risk factor for the development and or exacerbation of KOA. The implementation of an exercise based weight loss program may, however, itself be limited by the symptoms of KOA. The aquatic program against osteoarthritis (termed "PICO" in Portuguese) prioritizes the control of symptoms and the recovery of functionality, with an attendant increase in the patient's physical activity level and, consequently, metabolic rate. Our laboratory is assessing the effectiveness of 3 months of PICO on the symptoms of KOA, on physical function, on quality of life and on gait. In addition, PICO shall examine the effects of said exercise intervention on inflammatory biomarkers, psychological health, life style and body composition. METHODS/DESIGN The trial is a prospective, single-blinded, randomized controlled trial, and involves 50 overweight and obese adults (BMI = 28-43.5 kg/m²; age 40-65 yrs) with radiographic KOA. The participants are randomly allocated into either an educational attention (control) group or an aquatic (exercise program) group. This paper describes the experimental protocol that is used in the PICO project. DISCUSSION The PICO program shall provide insight into the effectiveness of an aquatic exercise program in the control of KOA symptoms and in the improvement of the quality of life. As such, they are likely to prove a useful reference to health professionals who intend to implement any kind of therapeutic intervention based around aquatic exercise. TRIAL REGISTRATION NCT01832545.
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Affiliation(s)
- Flávia Yázigi
- Department of Sports and Health, Univ de Lisboa, Fac Motricidade Humana, CIPER, LBMF, P-1499-002 Lisbon, Portugal
| | - Margarida Espanha
- Department of Sports and Health, Univ de Lisboa, Fac Motricidade Humana, CIPER, LBMF, P-1499-002 Lisbon, Portugal
| | - Filomena Vieira
- Department of Sports and Health, Univ de Lisboa, Fac Motricidade Humana, CIPER, LBMF, P-1499-002 Lisbon, Portugal
| | - Stephen P Messier
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - Cristina Monteiro
- Department of Sports and Health, Univ de Lisboa, Fac Motricidade Humana, CIPER, LBMF, P-1499-002 Lisbon, Portugal
| | - Antonio P Veloso
- Department of Sports and Health, Univ de Lisboa, Fac Motricidade Humana, CIPER, LBMF, P-1499-002 Lisbon, Portugal
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1095
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Goislard de Monsabert B, Vigouroux L, Bendahan D, Berton E. Quantification of finger joint loadings using musculoskeletal modelling clarifies mechanical risk factors of hand osteoarthritis. Med Eng Phys 2013; 36:177-84. [PMID: 24210852 DOI: 10.1016/j.medengphy.2013.10.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Revised: 10/01/2013] [Accepted: 10/13/2013] [Indexed: 11/28/2022]
Abstract
Owing to limited quantitative data related to the loadings (forces and pressures) acting upon finger joints, several clinical observations regarding mechanical risk factors of hand osteoarthritis remain misunderstood. To improve the knowledge of this pathology, the present study used musculoskeletal modelling to quantify the forces and pressures acting upon hand joints during two grasping tasks. Kinematic and grip force data were recorded during both a pinch and a power grip tasks. Three-dimensional magnetic resonance imaging measurements were conducted to quantify joint contact areas. Using these datasets as input, a musculoskeletal model of the hand and wrist, including twenty-three degrees of freedom and forty-two muscles, has been developed to estimate joint forces and joint pressures. When compared with the power grip task, the pinch grip task resulted in two to eight times higher joint loadings whereas the grip forces exerted on each finger were twice lower. For both tasks, joint forces and pressures increased along a disto-proximal direction for each finger. The quantitative dataset provided by the present hand model clarified two clinical observations about osteoarthritis development which were not fully understood, i.e., the strong risk associated to pinch grip tasks and the high frequency of thumb-base osteoarthritis.
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Affiliation(s)
| | - Laurent Vigouroux
- Aix-Marseille Université, CNRS, ISM UMR 7287, 13288 Marseille cedex 09, France
| | - David Bendahan
- Aix-Marseille Université, CNRS, CRMBM UMR 7339, 13005 Marseille, France
| | - Eric Berton
- Aix-Marseille Université, CNRS, ISM UMR 7287, 13288 Marseille cedex 09, France
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1096
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Chang J, Wang W, Zhang H, Hu Y, Wang M, Yin Z. The dual role of autophagy in chondrocyte responses in the pathogenesis of articular cartilage degeneration in osteoarthritis. Int J Mol Med 2013; 32:1311-8. [PMID: 24126970 DOI: 10.3892/ijmm.2013.1520] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 09/27/2013] [Indexed: 11/06/2022] Open
Abstract
The present study aimed to analyze the responses to autophagy in osteoarthritis (OA) and aging chondrocytes in order to elucidate the role of autophagy in the pathogenesis of OA. We used multiple assays to confirm that autophagic activity was downregulated in chondrocytes of aged articular cartilage. Surprisingly, we found that the expression of autophagy-related proteins was not decreased in the tissues of patients with OA. We also observed that rapamycin-induced autophagy prevented the accumulation of subdiploid cells in young chondrocytes, while it induced cell death by autophagy in OA chondrocytes. Our results demonstrate that autophagic activity decreases with aging, and may be responsible for the cytoprotective effects in young cartilage. However, we found that autophagic activity in patients with OA was higher than in the aging group, and reported autophagic cell death in OA chondrocytes. These results suggest that autophagy plays both a cytoprotective and death-promoting role in the pathogenesis of OA.
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Affiliation(s)
- Jun Chang
- Department of Orthopaedics, Anhui Geriatric Institute, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, P.R. China
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1097
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Baum T, Joseph G, Karampinos D, Jungmann P, Link T, Bauer J. Cartilage and meniscal T2 relaxation time as non-invasive biomarker for knee osteoarthritis and cartilage repair procedures. Osteoarthritis Cartilage 2013; 21:1474-84. [PMID: 23896316 PMCID: PMC3929642 DOI: 10.1016/j.joca.2013.07.012] [Citation(s) in RCA: 142] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Revised: 06/21/2013] [Accepted: 07/17/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The purpose of this work was to review the current literature on cartilage and meniscal T2 relaxation time. METHODS Electronic searches in PubMed were performed to identify relevant studies about T2 relaxation time measurements as non-invasive biomarker for knee osteoarthritis (OA) and cartilage repair procedures. RESULTS Initial osteoarthritic changes include proteoglycan loss, deterioration of the collagen network, and increased water content within the articular cartilage and menisci. T2 relaxation time measurements are affected by these pathophysiological processes. It was demonstrated that cartilage and meniscal T2 relaxation time values were significantly increased in subjects with compared to those without radiographic OA and focal knee lesions, respectively. Subjects with OA risk factors such as overweight/obesity showed significantly greater cartilage T2 values than normal controls. Elevated cartilage and meniscal T2 relaxation times were found in subjects with vs without knee pain. Increased cartilage T2 at baseline predicted morphologic degeneration in the cartilage, meniscus, and bone marrow over 3 years. Furthermore, cartilage repair tissue could be non-invasively assessed by using T2 mapping. Reproducibility errors for T2 measurements were reported to be smaller than the T2 differences in healthy and diseased cartilage indicating that T2 relaxation time may be a reliable discriminatory biomarker. CONCLUSIONS Cartilage and meniscal T2 mapping may be suitable as non-invasive biomarker to diagnose early stages of knee OA and to monitor therapy of OA.
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Affiliation(s)
- T. Baum
- Institut für Radiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 München, Germany,Address correspondence and reprint requests to: T. Baum, Institut für Radiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 München, Germany. Tel: 49-89-4140-2621; Fax: 49-89-4140-4834
| | - G.B. Joseph
- Musculoskeletal and Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, San Francisco, CA 94107, USA
| | - D.C. Karampinos
- Institut für Radiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 München, Germany
| | - P.M. Jungmann
- Institut für Radiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 München, Germany
| | - T.M. Link
- Musculoskeletal and Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, San Francisco, CA 94107, USA
| | - J.S. Bauer
- Institut für Radiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 München, Germany,Abteilung für Neuroradiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 München, Germany
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1098
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Daniel S, Soleymani T, Garvey WT. A complications-based clinical staging of obesity to guide treatment modality and intensity. Curr Opin Endocrinol Diabetes Obes 2013; 20:377-88. [PMID: 23974764 PMCID: PMC4139285 DOI: 10.1097/01.med.0000433067.01671.f5] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW The current medical model for obesity management is BMI-centric because BMI is the predominant measure used to gauge disease severity, as well as indications for various treatment modalities. Recent advancements in therapy and understanding of the relationship between BMI and obesity-related complications call for a re-examination of this approach. RECENT FINDINGS Advancements in treatment, including the recent approval of two new weight loss medications in the USA, have enabled development of new medical models for management of obesity. On the basis of accumulating data demonstrating the benefits of weight loss regarding multiple obesity-related complications (e.g., diabetes prevention, type 2 diabetes mellitus, cardiovascular disease risk, nonalcoholic steatohepatitis, sleep apnea), a complications-centric model is proposed that employs weight loss as a tool to treat and prevent obesity comorbidities. This model assures that the aggressiveness of therapy is commensurate with disease severity, and that therapy is directed at those obese patients who will benefit most from weight loss therapy. The treatment algorithm is comprehensive in addressing complications and quantitative when possible in the staging of risk or disease severity. SUMMARY A complications-centric approach to obesity management identifies patients who will benefit most from weight loss, and optimizes patient outcomes, benefit/risk ratio, and the cost-effectiveness of interventions.
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Affiliation(s)
- Sunil Daniel
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham VA Medical Center, Birmingham, AL 35294-3360, USA.
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1099
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Liu H, Zeng C, Gao SG, Yang T, Luo W, Li YS, Xiong YL, Sun JP, Lei GH. The effect of mud therapy on pain relief in patients with knee osteoarthritis: a meta-analysis of randomized controlled trials. J Int Med Res 2013; 41:1418-25. [PMID: 24008567 DOI: 10.1177/0300060513488509] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES A meta-analysis was conducted to examine the effect of mud therapy on pain relief in patients with knee osteoarthritis (OA). METHODS A detailed search of PubMed®/MEDLINE® was undertaken to identify randomized controlled trials and prospective comparative studies published before 9 March 2013 that compared mud therapy with control group treatments in patients with knee OA. RESULTS A quantitative meta-analysis of seven studies (410 patients) was performed. There was a significant difference between the groups in the visual analogue scale pain score (standardized mean difference [SMD] -0.73) and Western Ontario and McMaster Universities Osteoarthritis Index pain score (SMD -0.30), with differences in favour of mud therapy. CONCLUSIONS Mud therapy is a favourable option for pain relief in patients with knee OA. Additional high-quality randomized controlled trials need to be conducted to explore this issue further and to confirm this conclusion.
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Affiliation(s)
- Hua Liu
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
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1100
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Caramés B, Kiosses WB, Akasaki Y, Brinson DC, Eap W, Koziol J, Lotz MK. Glucosamine activates autophagy in vitro and in vivo. ACTA ACUST UNITED AC 2013; 65:1843-52. [PMID: 23606170 DOI: 10.1002/art.37977] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2012] [Accepted: 04/09/2013] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Aging-associated changes in articular cartilage represent a main risk factor for osteoarthritis (OA). Autophagy is an essential cellular homeostasis mechanism. Aging-associated or experimentally induced defects in autophagy contribute to organismal- and tissue-specific aging, while enhancement of autophagy may protect against certain aging-related pathologies such as OA. The objective of this study was to determine whether glucosamine can activate autophagy. METHODS Chondrocytes from normal human articular cartilage were treated with glucosamine (0.1- 10 mM). Autophagy activation and phosphorylation levels of Akt, FoxO3, and ribosomal protein S6 were determined by Western blotting. Autophagosome formation was analyzed by confocal microscopy. Reporter mice systemically expressing green fluorescent protein (GFP) fused to light chain 3 (LC3) (GFP-LC3-transgenic mice) were used to assess changes in autophagy in response to starvation and glucosamine treatment. RESULTS Glucosamine treatment of chondrocytes activated autophagy, as indicated by increased LC3-II levels, formation of LC3 puncta, and increased LC3 turnover. This was associated with glucosamine-mediated inhibition of the Akt/FoxO3/mammalian target of rapamycin pathway. Administration of glucosamine to GFP-LC3-transgenic mice markedly activated autophagy in articular cartilage. CONCLUSION Glucosamine modulates molecular targets of the autophagy pathway in vitro and in vivo, and the enhancement of autophagy is mainly dependent on the Akt/FoxO/mTOR pathway. These findings suggest that glucosamine is an effective autophagy activator and should motivate future studies on the efficacy of glucosamine in modifying aging-related cellular changes and supporting joint health.
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