1
|
Unverzagt S, Bergmann A, Denny K, Frese T, Hirpa S, Weyer J. Physically demanding occupations among females and sex-related differences to develop osteoarthritis of the hip: a systematic review and meta-analysis. J Occup Med Toxicol 2024; 19:14. [PMID: 38711071 DOI: 10.1186/s12995-024-00415-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 04/25/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND Hip osteoarthritis (HOA) is a leading cause of disability increasing with age and is more prevalent in women and in various physically demanding occupations. This systematic review identifies and summarises occupational exposures for women in physically demanding occupations and discusses sex differences and consequences. METHODS In this systematic review, we searched various electronic databases for reports published between date of database inception and October 2022. We included cohort studies and case-control studies that assessed the association between exposure to physically demanding occupations and the development of HOA. We then assessed the methodological quality of selected studies, extracted relative effects, compared the risk for women and men and meta-analytically reviewed the effects of physically demanding occupations. All steps were based on a study protocol published in PROSPERO (CRD42015016894). RESULTS We included six cohort studies and two case-control studies in this systematic review. These studies showed a considerably increased risk of developing HOA in both sexes. Women working in traditionally female-dominated occupations such as cleaning, sales, catering, childcare and hairdressing that are physically demanding, have a higher risk of developing HOA than men in similarly physically demanding occupations. Conversely, in traditionally male-dominated occupations with a high heterogeneity of work activities, such as agriculture, crafts, construction, as well as in low-skilled occupations, the risk was higher for men. One exception are health occupations, which are grouped together with a wide range of other technical occupations, making it difficult to draw conclusions. CONCLUSIONS Existing studies indicate an association between various occupations with a high physical workload and an increased risk of developing HOA. Occupational prevention and individual health promotion strategies should focus on reducing the effects of heavy physical workloads at work. The aforementioned as well as early detection should be specifically offered to women in female-dominated occupations and to people working in elementary occupations.
Collapse
Affiliation(s)
- Susanne Unverzagt
- Institute of General Practice and Family Medicine, Martin Luther University Halle-Wittenberg, Faculty of Medicine, Halle (Saale), Germany.
| | - Annekatrin Bergmann
- Department of Occupational Medicine, Martin Luther University Halle-Wittenberg, Faculty of Medicine, Halle (Saale), Germany
| | - Kathleen Denny
- Institute of General Practice and Family Medicine, Martin Luther University Halle-Wittenberg, Faculty of Medicine, Halle (Saale), Germany
| | - Thomas Frese
- Institute of General Practice and Family Medicine, Martin Luther University Halle-Wittenberg, Faculty of Medicine, Halle (Saale), Germany
| | - Selamawit Hirpa
- Institute of General Practice and Family Medicine, Martin Luther University Halle-Wittenberg, Faculty of Medicine, Halle (Saale), Germany
| | - Johannes Weyer
- Department of Occupational Medicine, Martin Luther University Halle-Wittenberg, Faculty of Medicine, Halle (Saale), Germany
| |
Collapse
|
2
|
Segal NA, Nilges JM, Oo WM. Sex differences in osteoarthritis prevalence, pain perception, physical function and therapeutics. Osteoarthritis Cartilage 2024:S1063-4584(24)01150-6. [PMID: 38588890 DOI: 10.1016/j.joca.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 03/19/2024] [Accepted: 04/02/2024] [Indexed: 04/10/2024]
Abstract
OBJECTIVE Women have a higher prevalence of osteoarthritis (OA) and worse clinical courses than men. However, the underlying factors and therapeutic outcomes of these sex-specific differences are incompletely researched. This review examines the current state of knowledge regarding sex differences in OA prevalence, risk factors, pain severity, functional outcomes, and use and response to therapeutics. METHODS PubMed database was used with the title keyword combinations "{gender OR sex} AND osteoarthritis" plus additional manual search of the included papers for pertinent references, yielding 212 references. Additional references were added and 343 that were reviewed for appropriateness. RESULTS Globally, women account for 60% of people with osteoarthritis with a greater difference after age 40. The higher risk for women may be due to differences in joint anatomy, alignment, muscle strength, hormonal influences, obesity, and/or genetics. At the same radiographic severity, women have greater pain severity than men, which may be explained by biologically distinct pain pathways, differential activation of central pain pathways, differences in pain sensitivity, perception, reporting, and coping strategies. Women have greater limitations of physical function and performance than men independent of BMI, OA severity, injury history, amount of weekly exercise. Women also have greater use of analgesic medications than men but less use of arthroplasty and poorer prognosis after surgical interventions. CONCLUSIONS The recognition of sex differences in OA manifestations and management could guide tailoring of sex-specific treatment protocols, and analysis of sex as a biological variable in future research would enhance development of precision medicine.
Collapse
Affiliation(s)
- Neil A Segal
- University of Kansas Medical Center, Kansas City, KS, USA; The University of Iowa, Iowa City, IA, USA.
| | | | - Win Min Oo
- The University of Sydney, Sydney, Australia; University of Medicine, Mandalay, Mandalay, Myanmar.
| |
Collapse
|
3
|
Weninger P, Feichtinger X, Steffel C, Kerschbaumer C, Duscher D. Arthroscopy with Lipoaspirate and Plasma Infiltration Using Adipose-Derived Stem Cells Plus Platelet-Rich Plasma: Harvesting and Injection for Arthroscopic Treatment of Cartilage Defects of the Knee. Arthrosc Tech 2023; 12:e2265-e2271. [PMID: 38196888 PMCID: PMC10773146 DOI: 10.1016/j.eats.2023.07.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 07/30/2023] [Indexed: 01/11/2024] Open
Abstract
Osteoarthritis, predominantly of the knee, is a highly prevalent disease leading to pain, reduced quality of life, and significantly reduced ability to work. With autologous orthobiologic options, new regenerative treatment methods have emerged, offering an alternative to early surgical intervention. Supercharged Liparthroplasty combines arthroscopy with lipoaspirate and plasma infiltration of the joint. Lipoaspirate contains high levels of adipose-derived stem cells, which show chondroprotective and anti-inflammatory qualities. Intra-articular injection, combined with platelet-rich plasma administration for accelerated cartilage metabolism, thus provides an optional approach in osteoarthritis treatment. This article aims to provide in detail our regimen for Supercharged Liparthroplasty, including tissue harvesting and preparation of the injectables, therefore enabling physicians to adopt this point-of-care technique.
Collapse
Affiliation(s)
- Patrick Weninger
- Sports Medical Center, Vienna, Austria
- Academic Stem Cell Center Vienna, Vienna, Austria
| | | | - Caterina Steffel
- Sports Medical Center, Vienna, Austria
- Academic Stem Cell Center Vienna, Vienna, Austria
| | | | - Dominik Duscher
- The Face and Longevity Center Munich, Munich, Germany
- Department of Plastic, Reconstructive, Hand and Burn Surgery, BG-Trauma Center, Eberhard Karls University Tübingen, Tübingen, Germany
| |
Collapse
|
4
|
Skovlund SV, Bláfoss R, Calatayud J, López Bueno R, Sundstrup E, Andersen LL. Musculoskeletal pain intensity and risk of long-term sickness absence in the general working population: A prospective cohort study with register follow-up. Prev Med 2023; 174:107636. [PMID: 37473925 DOI: 10.1016/j.ypmed.2023.107636] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/13/2023] [Accepted: 07/17/2023] [Indexed: 07/22/2023]
Abstract
Determining predictors of sickness absence could allow for better screening, guidance, and development of preventive efforts aimed at those in increased risk. This study aimed to determine the prospective association between musculoskeletal pain intensity and risk of incident register-based long-term sickness absence in the general working population, as well as to determine the population attributable fraction. Drawing on data from a nation-wide questionnaire survey, this prospective cohort study followed a representative sample of the Danish general working population without recent long-term sickness absence (≥6 consecutive weeks) (n = 69,273) for long-term sickness absence up to two years (mean follow-up: 93 weeks) in a national register. The predictor was musculoskeletal pain intensity in the neck/shoulder and low-back during the preceding three months rated on an 11-point numerical rating scale from 0 to 10. The weighted incidence of long-term sickness-absence was 8.9% during two-year follow-up (n = 6165). We observed a clear dose-response association between musculoskeletal pain intensity of the neck/shoulder or low-back and the risk of incident long-term sickness absence, with a lower threshold of increased risk of 4 and 3 (scale 0-10) for neck/shoulder (HR (95% CI): 1.25 (1.09-1.42)) and low-back pain (HR (95% CI): 1.13 (1.00-1.29)), respectively. Prevention of pain intensities at or above 4 out of 10 could potentially prevent 17% (population attributable fraction, PAF (95% CI): 16.8 (13.6-20.1)) of the total long-term sickness absence in the general working population. Large-scale interventions to prevent and manage musculoskeletal pain need to be documented and implemented.
Collapse
Affiliation(s)
- Sebastian Venge Skovlund
- National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230 Odense, Denmark.
| | - Rúni Bláfoss
- National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230 Odense, Denmark.
| | - Joaquín Calatayud
- National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Rubén López Bueno
- National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; Department of Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Spain.
| | - Emil Sundstrup
- National Research Centre for the Working Environment, 2100 Copenhagen, Denmark.
| | - Lars Louis Andersen
- National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark.
| |
Collapse
|
5
|
Ching A, Prior Y, Parker J, Hammond A. Biopsychosocial, work-related, and environmental factors affecting work participation in people with Osteoarthritis: a systematic review. BMC Musculoskelet Disord 2023; 24:485. [PMID: 37312111 DOI: 10.1186/s12891-023-06612-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 06/07/2023] [Indexed: 06/15/2023] Open
Abstract
PURPOSE Osteoarthritis (OA) causes pain and disability, with onset often during working age. Joint pain is associated with functional difficulties and may lead to work instability. The aims of this systematic review are to identify: the impact of OA on work participation; and biopsychosocial and work-related factors associated with absenteeism, presenteeism, work transitions, work impairment, work accommodations, and premature work loss. METHODS Four databases were searched, including Medline. The Joanna Briggs Institute Critical Appraisal tools were used for quality assessment, with narrative synthesis to pool findings due to heterogeneity of study designs and work outcomes. RESULTS Nineteen studies met quality criteria (eight cohort; 11 cross-sectional): nine included OA of any joint(s), five knee-only, four knee and/or hip, and one knee, hip, and hand OA. All were conducted in high income countries. Absenteeism due to OA was low. Presenteeism rates were four times greater than absenteeism. Performing physically intensive work was associated with absenteeism, presenteeism, and premature work loss due to OA. Moderate-to-severe joint pain and pain interference were associated with presenteeism, work transition, and premature work loss. A smaller number of studies found that comorbidities were associated with absenteeism and work transitions. Two studies reported low co-worker support was associated with work transitions and premature work loss. CONCLUSIONS Physically intensive work, moderate-to-severe joint pain, co-morbidities, and low co-worker support potentially affects work participation in OA. Further research, using longitudinal study designs and examining the links between OA and biopsychosocial factors e.g., workplace accommodations, is needed to identify targets for interventions. SYSTEMATIC REVIEW REGISTRATION PROSPERO 2019 CRD42019133343 .
Collapse
Affiliation(s)
- Angela Ching
- Centre for Human Movement and Rehabilitation, University of Salford, Salford, Greater Manchester, UK
| | - Yeliz Prior
- Centre for Human Movement and Rehabilitation, University of Salford, Salford, Greater Manchester, UK.
| | - Jennifer Parker
- Centre for Human Movement and Rehabilitation, University of Salford, Salford, Greater Manchester, UK
| | - Alison Hammond
- Centre for Human Movement and Rehabilitation, University of Salford, Salford, Greater Manchester, UK
| |
Collapse
|
6
|
Scheuing WJ, Reginato AM, Deeb M, Acer Kasman S. The burden of osteoarthritis: Is it a rising problem? Best Pract Res Clin Rheumatol 2023; 37:101836. [PMID: 37633827 DOI: 10.1016/j.berh.2023.101836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 04/27/2023] [Indexed: 08/28/2023]
Abstract
The objective of this review is to provide an overview of the current status of osteoarthritis (OA) as one of the most common joint disorders worldwide. Despite being the 11th cause of disability globally, there has been an increase in the prevalence, annual incidence, and years lived with disability of OA, particularly in developed and developing countries. Erosive hand OA, which affects approximately 10% of the general population, has been associated with a higher clinical burden compared to non-erosive hand OA. Patients with knee and hip OA, but not hand OA, are also at an increased risk of cardiovascular disease and all-cause mortality. Furthermore, OA has a significant contribution to healthcare costs in most countries. The recent COVID-19 pandemic has further exacerbated the disease burden of OA patients due to limited access to medical and surgical treatment. With increasing life expectancy and the aging of the global population, the burden of OA is expected to worsen. Therefore, this review highlights the importance of improving population and policymaker awareness of risk factors, such as obesity and injury, as well as early intervention and management of OA to control the future burden of the disease.
Collapse
Affiliation(s)
| | | | - Mery Deeb
- Department of Internal Medicine, Kent Hospital/Brown University, Warwick, RI, USA.
| | - Sevtap Acer Kasman
- Marmara University School of Medicine, PMR Department, Rheumatology Division, Istanbul, Türkiye.
| |
Collapse
|
7
|
Salinas Fredricson A, Krüger Weiner C, Adami J, Rosén A, Lund B, Hedenberg-Magnusson B, Fredriksson L, Svedberg P, Naimi-Akbar A. Sick leave and disability pension among TMD patients with musculoskeletal diseases, mental and behavioural disorders - a SWEREG-TMD population-based cohort study. BMC Public Health 2023; 23:852. [PMID: 37165335 PMCID: PMC10173494 DOI: 10.1186/s12889-023-15815-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 05/05/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND Temporomandibular disorders (TMD) are associated with musculoskeletal diseases (MSD), mental and behavioural disorders (MBD), and patients with TMD have been shown to have 2-3 times more days of sick leave (SL) and disability pension (DP) than the general population. MSD and MBD are two of the most common causes for SL and DP, and the association between TMD and the influence of comorbidities on the need for SL and DP among TMD patients need further clarification. This study investigates the impact of MSD and MBD comorbidity on SL and DP among TMD patients diagnosed in a hospital setting and/or surgically treated. METHODS All incident TMD patients diagnosed or treated in a hospital setting between 1998 and 2016 and aged 23-59 were included. A non-exposed comparison cohort was collected from the general population. The cohorts were grouped based on the presence of comorbidity: No comorbidity (Group I); MSD comorbidity (Group II); MBD comorbidity (Group III); and combined MSD and MBD comorbidity (Group IV). Main outcomes were mean annual days of SL and DP, and statistical analysis was conducted using generalized estimated equations. RESULTS TMD subjects with no comorbidities (Group I) and with MSD/MBD comorbidity (Group II and III) were 2-3 times more often on SL and DP than the corresponding groups from the general population. However, in the group with both MSD and MBD comorbidity (Group IV), the difference between the TMD subjects and the general population was diminishing, suggesting an additive effect. CONCLUSION TMD patients are more dependent on SL and DP benefits compared to general population and the difference remains even after considering MSD and MBD comorbidity. In individuals with combined MSD and MBD comorbidity, concurrent TMD has less impact on the need for social insurance benefits. The results accentuate the impact TMD has on the patients' impaired ability to return to work and why TMD should be recognized as having a substantial impact on individual and economic suffering as well as on societal costs, with emphasis on the influence of comorbidities on patient suffering.
Collapse
Affiliation(s)
- Adrian Salinas Fredricson
- Public Dental Services, Folktandvården Stockholm, Eastmaninstitutet, Department of Oral and Maxillofacial Surgery, Eastmaninstitutet Käkkirurgi, Dalagatan 11, 102 31, Stockholm, Sweden.
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Carina Krüger Weiner
- Public Dental Services, Folktandvården Stockholm, Eastmaninstitutet, Department of Oral and Maxillofacial Surgery, Eastmaninstitutet Käkkirurgi, Dalagatan 11, 102 31, Stockholm, Sweden
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Oral and Maxillofacial Surgery, Gävle County Hospital, Gävle, Sweden
| | | | - Annika Rosén
- Public Dental Services, Folktandvården Stockholm, Eastmaninstitutet, Department of Oral and Maxillofacial Surgery, Eastmaninstitutet Käkkirurgi, Dalagatan 11, 102 31, Stockholm, Sweden
- Department of Clinical Dentistry, Division of Oral and Maxillofacial Surgery, University of Bergen, Bergen, Norway
- Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway
| | - Bodil Lund
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
- Medical Unit for Reconstructive Plastic- and Craniofacial Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Britt Hedenberg-Magnusson
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Orofacial Pain and Jaw Function, Public Dental Services, Folktandvården Stockholm, EastmaninstitutetStockholm, Sweden
| | - Lars Fredriksson
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Orofacial Pain and Jaw Function, Public Dental Services, Folktandvården Stockholm, EastmaninstitutetStockholm, Sweden
| | - Pia Svedberg
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Aron Naimi-Akbar
- Public Dental Services, Folktandvården Stockholm, Eastmaninstitutet, Department of Oral and Maxillofacial Surgery, Eastmaninstitutet Käkkirurgi, Dalagatan 11, 102 31, Stockholm, Sweden
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
- Health Technology Assessment-Odontology (HTA-O), Malmö University, Malmö, Sweden
| |
Collapse
|
8
|
Motta F, Barone E, Sica A, Selmi C. Inflammaging and Osteoarthritis. Clin Rev Allergy Immunol 2023; 64:222-238. [PMID: 35716253 DOI: 10.1007/s12016-022-08941-1] [Citation(s) in RCA: 68] [Impact Index Per Article: 68.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2022] [Indexed: 12/15/2022]
Abstract
Osteoarthritis is a highly prevalent disease particularly in subjects over 65 years of age worldwide. While in the past it was considered a mere consequence of cartilage degradation leading to anatomical and functional joint impairment, in recent decades, there has been a more dynamic view with the synovium, the cartilage, and the subchondral bone producing inflammatory mediators which ultimately lead to cartilage damage. Inflammaging is defined as a chronic, sterile, low-grade inflammation state driven by endogenous signals in the absence of infections, occurring with aging. This chronic status is linked to the production of reactive oxygen species and molecules involved in the development of age-related disease such as cancer, diabetes, and cardiovascular and neurodegenerative diseases. Inflammaging contributes to osteoarthritis development where both the innate and the adaptive immune response are involved. Elevated systemic and local inflammatory cytokines and senescent molecules promote cartilage degradation, and antigens derived from damaged joints further trigger inflammation through inflammasome activation. B and T lymphocyte populations also change with inflammaging and OA, with reduced regulatory functions, thus implicating self-reactivity as an additional mechanism of joint damage. The discovery of the underlying pathogenic pathways may help to identify potential therapeutic targets for the management or the prevention of osteoarthritis. We will provide a comprehensive evaluation of the current literature on the role of inflammaging in osteoarthritis and discuss the emerging therapeutic strategies.
Collapse
Affiliation(s)
- Francesca Motta
- Division of Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital, via Manzoni 56, 20089, Rozzano, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini, 20090, Pieve Emanuele, Milan, Italy
| | - Elisa Barone
- Division of Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital, via Manzoni 56, 20089, Rozzano, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini, 20090, Pieve Emanuele, Milan, Italy
| | - Antonio Sica
- Division of Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital, via Manzoni 56, 20089, Rozzano, Milan, Italy.,Department of Pharmaceutical Sciences, Università del Piemonte Orientale "Amedeo Avogadro", Largo Donegani 2, 28100, Novara, Italy
| | - Carlo Selmi
- Division of Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital, via Manzoni 56, 20089, Rozzano, Milan, Italy. .,Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini, 20090, Pieve Emanuele, Milan, Italy.
| |
Collapse
|
9
|
Alexandres Rios de Los Rios D, Guaschi Herretes A, Hernández Herrero D. [Analysis of reinjection periodicity in knee osteoarthritis with different types of hyaluronic acids]. Rehabilitacion (Madr) 2023; 57:100734. [PMID: 35527076 DOI: 10.1016/j.rh.2022.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 12/29/2021] [Accepted: 02/13/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To evaluate the periodicity of hyaluronic acid (HA) reinjection in patients with knee osteoarthritis. Secondary aim: To relate the degree of arthrosis with the time between infiltrations and the possible study by subgroups between the different commercial preparations. DESIGN Retrospective observational study. MATERIALS AND METHOD Review of medical records and X-rays of patients with knee osteoarthritis that had been treated with intra-articular HA at the Rehabilitation Service in the period between January 2017 and June 2019. VARIABLES Socio-demographic, Laterality, Intervention Date, Degree of Arthrosis according to Kellgren and Lawrence, HA used, Time between filtrations. Statistical analysis carried out by Kaplan-Meier curves, taking into account the reinfiltration as final event, and Kruskal-Wallis test for non-parametric quantitative data. RESULTS We analysed 110 infiltration acts in 67 patients: average age at the time of infiltration 72.12 years, 85.1% women, 59.1% right knee. 4 types of HA: 33 cases at 1%. MW: 0.9MDa (HA1), 12 at 1.5%. MW: 1.5-2MDa (HA2), 42 at 2%. MW: 1.2MDa (HA3) and 6 Hylan G-F20. MW: 6MDa (HA4). We reinfiltrated in 31 occasions (28.2%). Average of months (IC 95%) between infiltrations: HA1 6.9 (5.7-8.16), HA2 12.5 (0-35), HA3 9.3 (5.5-13.1), HA4 5 (3-6.9). In 2 cases where it was not possible to establish the type of infiltrated formulations, the mean value between reinfiltrations was 8.5 (5.6-11.4) There were no statistically significant results by relating the HA type or the degree of arthrosis with the reinfiltration time. CONCLUSIONS In our study, we observe that the HA3 presented a longer time between infiltrations in comparison with other types, with no possibility to detect significant differences.
Collapse
Affiliation(s)
| | - A Guaschi Herretes
- Departamento de Medicina Física y Rehabilitación, Hospital Universitario La Paz, Madrid, España
| | - D Hernández Herrero
- Departamento de Medicina Física y Rehabilitación, Hospital Universitario La Paz, Madrid, España
| |
Collapse
|
10
|
Unverzagt S, Bolm-Audorff U, Frese T, Hechtl J, Liebers F, Moser K, Seidler A, Weyer J, Bergmann A. Influence of physically demanding occupations on the development of osteoarthritis of the hip: a systematic review. J Occup Med Toxicol 2022; 17:18. [PMID: 36002875 PMCID: PMC9400208 DOI: 10.1186/s12995-022-00358-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 07/20/2022] [Indexed: 11/12/2022] Open
Abstract
Background Hip osteoarthritis (HOA) is a disabling disease affecting around 33 million people worldwide. People of working age and the elderly are at increased risk of developing HOA and the disease is associated with high costs at individual and societal levels due to sick leaves, job loss, total hip replacements and disability pension. This systematic review evaluated the influence of physically demanding occupations on the development of HOA in men. Methods Cohort studies, case–control studies and cross-sectional studies with publications in English or German, which assessed the association between exposure to physically demanding occupations and development of HOA, were searched in electronic databases (Medline, Embase, HSE-Line, Cochrane Library) and conference abstracts from 1990 until May 2020. We assessed the methodological quality of selected studies, interpreted all relative effect estimators as relative risks (RRs) and meta-analytically reviewed the effects of occupations with high physical workloads. All steps are based on a study protocol published in PROSPERO (CRD42015016894). Results Seven cohort studies and six case–control studies were included. An elevated risk to develop HOA was shown for six physically demanding occupational groups. Working in agriculture including fishery and forestry and food production doubles the risk of HOA. Construction, metal working and sales as well as exposure to whole body vibration while driving vehicles increases the risk by roughly 50 to 60%. Unskilled or basic level workers, who were frequently exposed to repetitive heavy manual work, had nearly a doubled risk (RR 1.89 95%CI: 1.29 to 2.77) compared to workers with lower exposure. Conclusions Existing studies state an association between various occupations with high physical workload and an increased risk of developing HOA. High Physical workloads include including lifting and carrying heavy loads, demanding postures, repetitive activities, long standing and running, as well as exposure to body vibrations. Occupational prevention and early detection as well as individual health promotion strategies should place their focus on reducing the impact of high physical strain at work sites. Supplementary Information The online version contains supplementary material available at 10.1186/s12995-022-00358-y.
Collapse
Affiliation(s)
- Susanne Unverzagt
- Institute of General Practice and Family Medicine, Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle (Saale), Germany.
| | - Ulrich Bolm-Audorff
- Department for Occupational Safety and the Environment, Regional Authority Darmstadt, Wilhelminenstraße 1 - 3, 64283, Darmstadt, Germany
| | - Thomas Frese
- Institute of General Practice and Family Medicine, Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle (Saale), Germany
| | - Julia Hechtl
- Department of Occupational Medicine, Martin Luther University Halle-Wittenberg, Magdeburger Str. 20, 06112, Halle (Saale), Germany
| | - Falk Liebers
- Division 3 Work and Health, Unit 3.1 Prevention of Work-related Diseases, Federal Institute for Occupational Safety and Health (BAuA), Friedrich-Henkel-Weg 1-25, 44149, Dortmund, Germany
| | - Konstantin Moser
- Institute of General Practice and Family Medicine, Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle (Saale), Germany
| | - Andreas Seidler
- Institute and Polyclinic for Occupational and Social Medicine, Technical University of Dresden, Faculty of Medicine, Löscherstraße 18, 01309, Dresden, Germany
| | - Johannes Weyer
- Department of Occupational Medicine, Martin Luther University Halle-Wittenberg, Magdeburger Str. 20, 06112, Halle (Saale), Germany
| | - Annekatrin Bergmann
- Department of Occupational Medicine, Martin Luther University Halle-Wittenberg, Magdeburger Str. 20, 06112, Halle (Saale), Germany
| |
Collapse
|
11
|
Andersson MLE, Haglund E, Aili K, Bremander A, Bergman S. Cohort profile: the Halland osteoarthritis (HALLOA) cohort-from knee pain to osteoarthritis: a longitudinal observational study in Sweden. BMJ Open 2022; 12:e057086. [PMID: 35835523 PMCID: PMC9289013 DOI: 10.1136/bmjopen-2021-057086] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
PURPOSE The overall objective in this study is to investigate the early development of radiographic knee osteoarthritis (OA) and its association with hand or/and knee OA, metabolic diseases, biomarkers, chronic pain, physical function and daily physical activity types. PARTICIPANTS The Halland osteoarthritis (HALLOA) cohort is a longitudinal cohort study that includes individuals with knee pain in the southwest of Sweden. Enrolment took place from 2017 to 2019. The inclusion criteria were current knee pain, with no former known radiographic knee OA and no cruciate ligament rupture or rheumatological disorder. The participants were recruited: (1) when seeking care for knee pain in primary healthcare or (2) by advertisements in local newspapers. There are 306 individuals included in the study, mean age (SD) 51.7 (8.7) years and 69% are women. The baseline and follow-ups include clinical tests, radiographical examinations, blood samples, metabolic measures, pain pressure thresholds, tests of physical functions, daily physical activity types and patient-reported outcomes. FINDINGS TO DATE There were associations between metabolic factors and radiographic knee OA, even in those with normal body mass index at baseline. In addition, clinical hand OA was positively associated with fasting plasma glucose. We also found that modifiable factors as increased visceral fat and total body fat were associated with increased pain sensitivity among individuals with knee pain. FUTURE PLANS By studying possible pathophysiological mechanisms of OA over time, we aim to provide new insights on OA progression, identify usable preventive measures helping the clinicians in the management of the disease and improve health for the patients. It is also important to study the development of chronic pain in OA, to get tools to identify individuals at risk and to be able to offer them treatment. TRIAL REGISTRATION NUMBER ClinicalTrials.gov (NCT04928170).
Collapse
Affiliation(s)
- Maria L E Andersson
- Department of Clinical Sciences, Rheumatology, Lund University, Lund, Sweden
- Spenshult Research and Development Centre, Halmstad, Sweden
| | - Emma Haglund
- Department of Clinical Sciences, Rheumatology, Lund University, Lund, Sweden
- Department of Enviromental and Biosciences, School of Business, Innovation and Sustainibility, Halmstad University, Halmstad, Sweden
| | - Katarina Aili
- Department of Health and Care, School of Health and Welfare, Halmstad University, Halmstad, Sweden
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Ann Bremander
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Sonderborg, Denmark
| | - S Bergman
- Spenshult Research and Development Centre, Halmstad, Sweden
- School of Public Health and Community Medicine/Primary Health Care, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
12
|
Zhang R, Guo H, Yang X, Zhang D, Zhang D, Li Q, Wang C, Yang X, Xiong Y. Patients with Osteoarthritis and Kashin-Beck Disease Display Distinct CpG Methylation Profiles in the DIO2, GPX3, and TXRND1 Promoter Regions. Cartilage 2021; 13:797S-808S. [PMID: 33455417 PMCID: PMC8808858 DOI: 10.1177/1947603520988165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE We aimed to analyze deoxycytidine-deoxyguanosine dinucleotide (CpGs) methylation profiles in DIO2, GPX3, and TXNRD1 promoter regions in osteoarthritis (OA) and Kashin-Beck disease (KBD) patients. METHODS Blood samples were collected from 16 primary OA patients and corresponding 16 healthy individuals and analyzed for methylations in the CpGs of DIO2, GPX3, and TXNRD1 promoter regions using MALDI-TOF-MS. The methylation profiles of these regions were then compared between OA and KBD patients. RESULTS DIO2-1_CpG_2 and DIO2-1_CpG_3 methylations were significantly lower in OA than KBD patients (P < 0.05). A similar trend was observed for GPX3-1_CpG_4, GPX3-1_CpG_7, GPX3-1_CpG_8.9.10, GPX3-1_CpG_13.14.15 and GPX3-1_CpG_16 (P < 0.05) as well as TXNRD1-1_CpG_1 and TXNRD1-1_CpG_2 methylation between OA and KBD patients (P < 0.05). However, there was no difference in methylation levels of other CpGs between the 2 groups (P > 0.05). CONCLUSION OA and KBD patients display distinct methylation profiles in the CpG sites of DIO2, GPX3, and TXNRD1 promoter regions. These findings provide a strong background and new perspective for future studies on mechanisms underlying epigenetic regulation of selenoprotein genes associated with OA and KBD diseases.
Collapse
Affiliation(s)
- Rongqiang Zhang
- School of Public Health, Shaanxi
University of Chinese Medicine, Xianyang, China
- Institute of Key Laboratory of Trace
Elements and Endemic Diseases, National Health Commission of the People’s Republic
of China, School of Public Health, Xi’an Jiaotong University Health Science Center,
Xi’an, Shaanxi, China
| | - Hao Guo
- Institute of Key Laboratory of Trace
Elements and Endemic Diseases, National Health Commission of the People’s Republic
of China, School of Public Health, Xi’an Jiaotong University Health Science Center,
Xi’an, Shaanxi, China
| | - Xiaoli Yang
- Institute of Key Laboratory of Trace
Elements and Endemic Diseases, National Health Commission of the People’s Republic
of China, School of Public Health, Xi’an Jiaotong University Health Science Center,
Xi’an, Shaanxi, China
| | - Dandan Zhang
- Institute of Key Laboratory of Trace
Elements and Endemic Diseases, National Health Commission of the People’s Republic
of China, School of Public Health, Xi’an Jiaotong University Health Science Center,
Xi’an, Shaanxi, China
| | - Di Zhang
- Institute of Key Laboratory of Trace
Elements and Endemic Diseases, National Health Commission of the People’s Republic
of China, School of Public Health, Xi’an Jiaotong University Health Science Center,
Xi’an, Shaanxi, China
| | - Qiang Li
- Institute of Key Laboratory of Trace
Elements and Endemic Diseases, National Health Commission of the People’s Republic
of China, School of Public Health, Xi’an Jiaotong University Health Science Center,
Xi’an, Shaanxi, China
| | - Chen Wang
- Institute of Key Laboratory of Trace
Elements and Endemic Diseases, National Health Commission of the People’s Republic
of China, School of Public Health, Xi’an Jiaotong University Health Science Center,
Xi’an, Shaanxi, China
| | - Xuena Yang
- Institute of Key Laboratory of Trace
Elements and Endemic Diseases, National Health Commission of the People’s Republic
of China, School of Public Health, Xi’an Jiaotong University Health Science Center,
Xi’an, Shaanxi, China
| | - Yongmin Xiong
- Institute of Key Laboratory of Trace
Elements and Endemic Diseases, National Health Commission of the People’s Republic
of China, School of Public Health, Xi’an Jiaotong University Health Science Center,
Xi’an, Shaanxi, China
| |
Collapse
|
13
|
Xu C, Wang S, Ti W, Yang J, Yasen Y, Memetsidiq M, Shi SQ. Role of dietary patterns and factors in determining the risk of knee osteoarthritis: A meta-analysis. Mod Rheumatol 2021; 32:815-821. [PMID: 34918108 DOI: 10.1093/mr/roab059] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/28/2021] [Accepted: 08/07/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To evaluates the role of diet in determining knee osteoarthritis risk. METHODS Literature search was conducted in Ovid, PubMed, Science Direct, and Springer. To estimate knee osteoarthritis risk with high use of vegetarian, prudent, and omnivorous diets, dairy products, vitamin C/E, and carotenoids, the odds ratios (ORs) or relative risks (RRs) reported by included studies were pooled. RESULTS Fifteen studies (97,157 individuals) were included. High use of vegetarian diet {OR 0.71 [95% confidence interval (CI): 0.45, 0.97]}, prudent diet [OR 0.87 (95% CI: 0.76, 0.98)/RR 0.89 (95% CI: 0.82, 0.97)], and dairy [OR 0.66 (95% CI: -0.08, 1.39)/RR 0.58 (95% CI: 0.41, 0.75)] were associated with lower risk of knee osteoarthritis but risk was relatively higher with high use of omnivorous diet [OR 1.13 (95% CI: 0.95, 1.30)/RR 1.06 (95% CI: 0.84, 1.29) and 1.05 (0.78, 1.33)]. High intake of vitamin C [OR 0.92 (0.29, 1.56)] or E [OR 0.93 (0.64, 1.21)] did not reduce knee osteoarthritis risk, but high use of carotenoids was associated with the lower risk [OR 0.66 (0.37, 0.96)]. CONCLUSIONS Knee osteoarthritis risk is low with high use of vegetarian diet, prudent diet, and dairy, but cannt be reduced by high intakes of vitamin C/E.
Collapse
Affiliation(s)
- Chao Xu
- Department of Orthopaedics, The Second Affiliated Hospital of Xinjiang Medical University, Urumchi, Xinjiang, China
| | - Shun Wang
- Department of Orthopaedics, The Second Affiliated Hospital of Xinjiang Medical University, Urumchi, Xinjiang, China
| | - Weiye Ti
- Department of Orthopaedics, The Second Affiliated Hospital of Xinjiang Medical University, Urumchi, Xinjiang, China
| | - Jun Yang
- Department of Orthopaedics, The Second Affiliated Hospital of Xinjiang Medical University, Urumchi, Xinjiang, China
| | - Yalikun Yasen
- Department of Orthopaedics, The Second Affiliated Hospital of Xinjiang Medical University, Urumchi, Xinjiang, China
| | - Miryaqup Memetsidiq
- Department of Orthopaedics, The Second Affiliated Hospital of Xinjiang Medical University, Urumchi, Xinjiang, China
| | - Song-Qing Shi
- Department of Orthopaedics, The Affiliated Yangming Hospital of Ningbo University, Yuyao People's Hospital of Zhejiang Province, Yuyao, Zhejiang, China
| |
Collapse
|
14
|
Coutu MF, Durand MJ, Coté D, Tremblay D, Sylvain C, Gouin MM, Bilodeau K, Nastasia I, Paquette MA. How does Gender Influence Sustainable Return to Work Following Prolonged Work Disability? An Interpretive Description Study. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:552-569. [PMID: 33394267 DOI: 10.1007/s10926-020-09953-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/07/2020] [Indexed: 06/12/2023]
Abstract
PURPOSE A sustainable return to work (S-RTW) following prolonged work disability poses different challenges, depending on gender. This article provides a synthesis of gender differences in the issues and factors influencing the S-RTW of workers following such a disability. METHODS Using an interpretive description method, an integrative review was conducted of the literature on gender differences in S-RTW issues and factors associated with four major causes of work disability. The initial review concerned the 2000-2016 literature; it was subsequently updated for November 2016-March 2020. To explore and contextualise the results, four focus groups were held with stakeholders representing the workplace, insurance, and healthcare systems and workers. Qualitative thematic analysis was performed. RESULTS A total of 47 articles were reviewed, and 35 stakeholders participated in the focus groups. The prevailing traditional gender roles were found to have a major gender-specific influence on the attitudes, behaviours, processes and outcomes associated with S-RTW. These differences related to the (1) cumulative workload, (2) work engagement, and (3) expressed and addressed needs. CONCLUSIONS The results highlight the importance of taking into account both professional and personal aspects when integrating gender issues into the assessment of workers' needs and subsequently into interventions.
Collapse
Affiliation(s)
- Marie-France Coutu
- Centre d'action en Prévention et réadaptation des Incapacités au Travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada.
- Centre de Recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean Sur Les Innovations en Santé (CR-CSIS), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada.
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada.
| | - Marie-José Durand
- Centre d'action en Prévention et réadaptation des Incapacités au Travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- Centre de Recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean Sur Les Innovations en Santé (CR-CSIS), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
| | - Daniel Coté
- Institut de Recherche Robert-Sauvé en Santé et en Sécurité du Travail (IRSST), 505 Boulevard De Maisonneuve West, Montreal, QC, H3A 3C2, Canada
| | - Dominique Tremblay
- Centre de Recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean Sur Les Innovations en Santé (CR-CSIS), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- School of Nursing, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Longueuil, QC, J4K 0A8, Canada
| | - Chantal Sylvain
- Centre d'action en Prévention et réadaptation des Incapacités au Travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- Centre de Recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean Sur Les Innovations en Santé (CR-CSIS), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
| | - Marie-Michelle Gouin
- Department of Management and Human Resource Management, School of Management, Université de Sherbrooke, 2500 Boulevard de l'Université, Sherbrooke, QC, J1K 2R1, Canada
| | - Karine Bilodeau
- Faculty of Nursing, Université de Montréal, Station Centre-ville, PO Box 6128, Montreal, QC, H3C 3J7, Canada
| | - Iuliana Nastasia
- Institut de Recherche Robert-Sauvé en Santé et en Sécurité du Travail (IRSST), 505 Boulevard De Maisonneuve West, Montreal, QC, H3A 3C2, Canada
| | - Marie-Andrée Paquette
- Centre d'action en Prévention et réadaptation des Incapacités au Travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- Centre de Recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean Sur Les Innovations en Santé (CR-CSIS), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
| |
Collapse
|
15
|
Lee JY, Han K, Park YG, Park SH. Effects of education, income, and occupation on prevalence and symptoms of knee osteoarthritis. Sci Rep 2021; 11:13983. [PMID: 34234235 PMCID: PMC8263710 DOI: 10.1038/s41598-021-93394-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 06/02/2021] [Indexed: 11/28/2022] Open
Abstract
To examine the effect of socioeconomic status (SES) as measured by three components of education level, income level, and occupation on prevalence and symptom severity of knee osteoarthritis (OA) and to determine which of these factors has the strongest association. We conducted a cross-sectional study using data from the Fifth Korean National Health and Nutrition Examination Survey that were collected between 2010 and 2012. Male and female participants 50 years or older were included. Analyses to examine the associations of the three SES components with prevalence and symptom severity of knee OA were performed. A total 9,071 participants was included in the study. As expected, lower education, lower income level, and non-managerial or no job were associated with higher prevalence of knee OA and knee symptoms. Among the three SES components, lower education was most strongly associated with knee pain and radiographic knee OA after adjusting for the other two. Lower education level is the component of SES that most strongly relates to higher prevalence of knee OA and knee symptoms. Improving societal education level might decrease the socioeconomic burden of knee OA.
Collapse
Affiliation(s)
- Ji Yeon Lee
- Division of Rheumatology, Department of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, South Korea
| | - Kyungdo Han
- Department of Biostatistics, The Catholic University of Korea, Seoul, South Korea
| | - Yong Gyu Park
- Department of Biostatistics, The Catholic University of Korea, Seoul, South Korea
| | - Sung-Hwan Park
- Division of Rheumatology, Department of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, South Korea.
| |
Collapse
|
16
|
Agarwal N, Mak C, Bojanic C, To K, Khan W. Meta-Analysis of Adipose Tissue Derived Cell-Based Therapy for the Treatment of Knee Osteoarthritis. Cells 2021; 10:1365. [PMID: 34206010 PMCID: PMC8228374 DOI: 10.3390/cells10061365] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/20/2021] [Accepted: 05/28/2021] [Indexed: 12/17/2022] Open
Abstract
Osteoarthritis (OA) is a degenerative disorder associated with cartilage loss and is a leading cause of disability around the world. In old age, the capacity of cartilage to regenerate is diminished. With an aging population, the burden of OA is set to rise. Currently, there is no definitive treatment for OA. However, cell-based therapies derived from adipose tissue are promising. A PRISMA systematic review was conducted employing four databases (MEDLINE, EMBASE, Cochrane, Web of Science) to identify all clinical studies that utilized adipose tissue derived mesenchymal stem cells (AMSCs) or stromal vascular fraction (SVF) for the treatment of knee OA. Eighteen studies were included, which met the inclusion criteria. Meta-analyses were conducted on fourteen of these studies, which all documented WOMAC scores after the administration of AMSCs. Pooled analysis revealed that cell-based treatments definitively improve WOMAC scores, post treatment. These improvements increased with time. The studies in this meta-analysis have established the safety and efficacy of both AMSC therapy and SVF therapy for knee OA in old adults and show that they reduce pain and improve knee function in symptomatic knee OA suggesting that they may be effective therapies to improve mobility in an aging population.
Collapse
Affiliation(s)
- Nikhil Agarwal
- MBChB Office, University of Aberdeen College of Life Sciences and Medicine, Foresterhill Rd, Aberdeen AB25 2ZD, UK;
| | - Christopher Mak
- Division of Trauma & Orthopaedic Surgery, Addenbrooke’s Hospital, University of Cambridge, Cambridge CB2 0QQ, UK; (C.M.); (C.B.); (K.T.)
| | - Christine Bojanic
- Division of Trauma & Orthopaedic Surgery, Addenbrooke’s Hospital, University of Cambridge, Cambridge CB2 0QQ, UK; (C.M.); (C.B.); (K.T.)
| | - Kendrick To
- Division of Trauma & Orthopaedic Surgery, Addenbrooke’s Hospital, University of Cambridge, Cambridge CB2 0QQ, UK; (C.M.); (C.B.); (K.T.)
| | - Wasim Khan
- Division of Trauma & Orthopaedic Surgery, Addenbrooke’s Hospital, University of Cambridge, Cambridge CB2 0QQ, UK; (C.M.); (C.B.); (K.T.)
| |
Collapse
|
17
|
Kiadaliri A, Englund M. Trajectory of excess healthcare consultations, medication use, and work disability in newly diagnosed knee osteoarthritis: a matched longitudinal register-based study. Osteoarthritis Cartilage 2021; 29:357-364. [PMID: 33359251 DOI: 10.1016/j.joca.2020.12.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 12/04/2020] [Accepted: 12/14/2020] [Indexed: 02/02/2023]
Abstract
PURPOSE To estimate the excess healthcare use and work disability attributable to knee osteoarthritis (OA) in the first 5 years following diagnosis. METHODS Among individual aged 40-80 years who resided in Skåne on 31st December 2008, we identified those with a main diagnosis of knee OA during 2009-2014 and no previous diagnosis of any OA from 1998 (n = 16,888). We created a comparison cohort matched (1:1) by sex, age, and municipality from individuals with no OA diagnosis (at any site) during 1998-2016. We compared healthcare use and net disability days for 60 months following diagnosis between the two groups. We applied a survival-adjusted regression technique controlling for sociodemographic characteristics as well as pre-diagnosis outcome and comorbidity. RESULTS The estimated 5-year incremental effects of knee OA per-patient were 16.8 (95% CI: 15.8, 17.7) healthcare consultations, 0.7 (0.4, 1.1) inpatient days, 420 (372, 490) defined daily dose of prescribed medications, and 21.8 (15.2, 30.0) net disability days. Primary care consultations constituted about 73% of the excess healthcare consultations. Most of these incremental effects occurred in the first year after diagnosis. Better survival in the knee OA group accounted for 0.7 (95% CI: 0.5, 0.8) and 1.4 (0.7, 2.6) of the excess healthcare consultations and net disability days, respectively. Both estimated total and incremental resources use were generally greater for women than men with knee OA. CONCLUSION Knee OA was associated with considerable excess healthcare use and work disability independent of pre-diagnosis resources use, comorbidity, and sociodemographic characteristics.
Collapse
Affiliation(s)
- A Kiadaliri
- Clinical Epidemiology Unit, Department of Clinical Sciences Lund, Orthopaedics, Lund University, Lund, Sweden; Centre for Economic Demography, Lund University, Lund, Sweden.
| | - M Englund
- Clinical Epidemiology Unit, Department of Clinical Sciences Lund, Orthopaedics, Lund University, Lund, Sweden
| |
Collapse
|
18
|
Joint association of physical work demands and leg pain intensity for work limitations due to pain in senior workers: cross-sectional study. BMC Public Health 2020; 20:1741. [PMID: 33208134 PMCID: PMC7672909 DOI: 10.1186/s12889-020-09860-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 11/09/2020] [Indexed: 12/22/2022] Open
Abstract
Background Leg pain, especially of the knees and hips, is common among senior workers and may limit the ability to perform physically demanding work. In light of the aging workforce, this study determined the joint association of physical work demands and leg pain intensity for work-limiting pain in senior workers. Methods Currently employed senior workers (≥50 years) participated in the SeniorWorkingLife study in 2018 (n = 12,879). Associations between the combination of physical work demands and leg pain intensity (interaction) with work-limiting pain (outcome) were modeled using binary logistic regression analyses while controlling for potential covariates. Results We found a significant interaction (P < 0.001) between physical work demands and leg pain intensity for work-limiting pain. The combination of higher physical work demands and higher leg pain intensity had the worst outcome in terms of the odds of experiencing work-limiting pain. For example, 70% of those with the combination of high physical work demands and leg pain intensity ≥7 (scale 0–10) experienced that the pain limited them to at least some degree in their work. Conclusions The combination of high physical work demands and high leg pain intensity are associated with limited ability to perform work among senior workers. These findings highlight the importance of prioritizing the physical work environment in physically demanding occupations, particularly among senior workers, for prolonging working life. Thus, adjusting the work demands, e.g. through use of assistive devices, and lowering the pain, e.g. through physical rehabilitation, may be necessary to sustain work ability to a high age in this group of workers. Trial registration This was registered as a cohort study in ClinicalTrials.gov (Identifier: NCT03634410) on the 18th of August 2018 (Retrospectively registered).
Collapse
|
19
|
Evaluation of a multimodal pain rehabilitation programme in primary care based on clinical register data: a feasibility study. Prim Health Care Res Dev 2020; 21:e2. [PMID: 31934844 PMCID: PMC7003522 DOI: 10.1017/s1463423619000884] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Aim: Investigate the feasibility of identifying a well-defined treatment group and a comparable reference group in clinical register data. Background: There is insufficient knowledge on how to avert neck/back pain from turning chronic or to impair work ability. The Swedish Government implemented a national multimodal rehabilitation (MMR) programme in primary care intending to promote work ability, reduce sick leave and increase return to work. Since randomised control trial data for effect is lacking, it is important to evaluate existing observational data from clinical settings. Methods: We identified all unique patients with musculoskeletal pain (MSP) diagnoses undergoing the MMR programme in primary care in the Skåne Health care Register (n = 2140) during 2010–2011. A reference cohort in primary care (n = 56 300) with similar MSP diagnoses, same ages and the same level of sick leave before baseline was identified for the same period. The reference cohort received ordinary care and treatment in primary care. The final study group consisted of 603 eligible MMR patients and 2874 eligible reference patients. Socio-economic and health-related baseline data including sick leave one year before up to two years after baseline were compared between groups. Findings: There were significant socio-economic and health differences at baseline between the MMR and the reference patients, with the MMR group having lower income, higher morbidity and more sick leave days. Sick leave days per year decreased significantly in the MMR group (118–102 days, P < 0.001) and in the reference group (50–42 days, P < 0.001) from one year before baseline to two years after. Conclusions: It was not feasible to identify a comparable reference group based on clinical register data. Despite an ambitious attempt to limit selection bias, significant baseline differences in socio-economic and health were present. In absence of randomised trials, effects of MMR cannot be sufficiently evaluated in primary care.
Collapse
|
20
|
Gustafsson K, Kvist J, Eriksson M, Dahlberg LE, Rolfson O. Socioeconomic status of patients in a Swedish national self-management program for osteoarthritis compared with the general population-a descriptive observational study. BMC Musculoskelet Disord 2020; 21:10. [PMID: 31906904 PMCID: PMC6945568 DOI: 10.1186/s12891-019-3016-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 12/19/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND First-line treatment for hip and knee osteoarthritis (OA) including education and supervised exercises, delivered as a self-management program, is considered one of the mainstays in OA treatment. However, the socioeconomic profile of the population that utilizes first-line treatment for hip and knee OA is unclear. The aim of this study was to describe the socioeconomic status (SES) of a population referred to a self-management program for OA, in comparison with that of the general Swedish population. METHODS This is a cross-sectional study including 72,069 patients with hip or knee OA enrolled in the National Quality Register for Better management of patients with Osteoarthritis (BOA) between 2008 and 2016, and registered before participation in a structured OA self-management program. A reference cohort (n = 216,207) was selected from the general Swedish population by one-to-three matching by year of birth, sex and residence. Residential municipality, country of birth, marital status, family type, educational level, employment, occupation, disposable income and sick leave were analyzed. RESULTS The BOA population had higher educational level than the reference group, both regarding patients with hip OA (77.5% vs 70% with ≥10 years of education), and with knee OA (77% vs 72% with ≥10 years of education). Their average disposable income was higher (median [IQR] in Euro (€), for hip €17,442 [10,478] vs €15,998 [10,659], for knee €17,794 [10,574] vs €16,578 [11,221]). Of those who worked, 46% of patients with hip OA and 45% of the reference group had a blue-collar occupation. The corresponding numbers for knee OA were 51 and 44% respectively. Sick leave was higher among those with hip and knee OA (26%) than those in the reference groups (13% vs 12%). CONCLUSIONS The consistently higher SES in the BOA population compared with the general population indicates that this self-management program for OA may not reach the more socioeconomically disadvantaged groups, who are often those with a higher disease burden.
Collapse
Affiliation(s)
- Kristin Gustafsson
- Unit of Physiotherapy, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden. .,Department of Physiotherapy, Rehabilitation Centre, Ryhov County Hospital, Jönköping, Sweden.
| | - Joanna Kvist
- Unit of Physiotherapy, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Marit Eriksson
- Department of Medical and Health Sciences, Linköping University and Futurum - Academy for Health and Care, Region Jönköping County, Jönköping, Sweden
| | - Leif E Dahlberg
- Department of Clinical Sciences Lund, Orthopedics, Faculty of Medicine, Lund University, Lund, Sweden
| | - Ola Rolfson
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
21
|
Abstract
OBJECTIVES Systematically review the qualitative literature on living with knee osteoarthritis from patient and carer perspectives. DESIGN Systematic review of qualitative studies. Five electronic databases (CINAHL, Embase, MEDLINE, PsycINFO, SPORTDiscus) were searched from inception until October 2018. Data were synthesised using thematic and content analysis. PARTICIPANTS Studies exploring the experiences of people living with knee osteoarthritis, and their carers were included. Studies exploring experiences of patients having participated in specific interventions, including surgery, or their attitudes about the decision to proceed to knee replacement were excluded. RESULTS Twenty-six articles reporting data from 21 studies about the patient (n=665) and carer (n=28) experience of living with knee osteoarthritis were included. Seven themes emerged: (i) Perceived causes of knee osteoarthritis are multifactorial and lead to structural damage to the knee and deterioration over time (n=13 studies), (ii) Pain and how to manage it predominates the lived experience (n=19 studies), (iii) Knee osteoarthritis impacts activity and participation (n=16 studies), (iv) Knee osteoarthritis has a social impact (n=10 studies), (v) Knee osteoarthritis has an emotional impact (n=13 studies), (vi) Interactions with health professionals can be positive or negative (n=11 studies), (vii) Knee osteoarthritis leads to life adjustments (n=14 studies). A single study reporting the perspectives of carers reported similar themes. Psychosocial impact of knee osteoarthritis emerged as a key factor in the lived experience of people with knee osteoarthritis. CONCLUSIONS This review highlights the value of considering patient attitudes and experiences including psychosocial factors when planning and implementing management options for people with knee osteoarthritis. Trial registrationnumber CRD42018108962.
Collapse
Affiliation(s)
- Jason A Wallis
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- Allied Health Clinical Research Office, Eastern Health, Melbourne, Victoria, Australia
| | - Nicholas F Taylor
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- Allied Health Clinical Research Office, Eastern Health, Melbourne, Victoria, Australia
| | - Samantha Bunzli
- Department of Surgery, The University of Melbourne, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Nora Shields
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| |
Collapse
|
22
|
Kontio T, Viikari-Juntura E, Solovieva S. Effect of Osteoarthritis on Work Participation and Loss of Working Life-years. J Rheumatol 2019; 47:597-604. [PMID: 31043546 DOI: 10.3899/jrheum.181284] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2019] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To examine to what extent disabling osteoarthritis (OA), leading to a prolonged sickness absence (SA), interferes with work participation and shortens working life-years. METHODS A total of 4704 wage earners aged 30 to 59 years, whose SA due to OA started in 2006, were followed until October 31, 2014. Kaplan-Meier analysis was used to plot sustained (at least 28 consecutive days) return-to-work curves. The associations of potential determinants with early exit from paid employment were examined applying Cox proportional hazards regression analysis. Years expected to be spent in different work participation statuses until statutory retirement age were estimated based on daily work participation statuses using adapted Sullivan method. RESULTS Persons with knee OA showed the fastest, and persons with hip OA the slowest, sustained return to work. Although most participants typically were at work during the first year of followup, a considerable proportion was permanently retired. Male sex, older age, low education, long initial SA, and having not returned to work sustainably, as well as receiving vocational rehabilitation, predicted early exit from paid employment during the followup. Overall, only 45-53% of potential working life-years were estimated to be spent at work, being highest for the oldest age group. CONCLUSION Our study showed a considerable effect of OA on work participation and working life duration. Clinicians should avoid prescription of long SA or temporary work disability due to OA without a clear treatment or return-to-work plan.
Collapse
Affiliation(s)
- Tea Kontio
- From the University of Helsinki; Finnish Institute of Occupational Health, Helsinki, Finland.,T. Kontio, MD, University of Helsinki; E. Viikari-Juntura, MD, PhD, Finnish Institute of Occupational Health; S. Solovieva, PhD, Finnish Institute of Occupational Health
| | - Eira Viikari-Juntura
- From the University of Helsinki; Finnish Institute of Occupational Health, Helsinki, Finland.,T. Kontio, MD, University of Helsinki; E. Viikari-Juntura, MD, PhD, Finnish Institute of Occupational Health; S. Solovieva, PhD, Finnish Institute of Occupational Health
| | - Svetlana Solovieva
- From the University of Helsinki; Finnish Institute of Occupational Health, Helsinki, Finland. .,T. Kontio, MD, University of Helsinki; E. Viikari-Juntura, MD, PhD, Finnish Institute of Occupational Health; S. Solovieva, PhD, Finnish Institute of Occupational Health.
| |
Collapse
|
23
|
Kontio T, Viikari-Juntura E, Solovieva S. To what extent do education and physical work load factors explain occupational differences in disability retirement due to knee OA? A nationwide register-based study in Finland. BMJ Open 2019; 8:e023057. [PMID: 30798289 PMCID: PMC6278790 DOI: 10.1136/bmjopen-2018-023057] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES To examine the association of education and physical work load factors on the occupational differences in disability retirement due to knee osteoarthritis (OA). DESIGN Longitudinal study. SETTING Linkage of several nationwide registers and a job exposure matrix in Finland. PARTICIPANTS A total of 1 135 654 Finns aged 30-60 years in gainful employment were followed from 2005 to 2013 for full disability retirement due to knee OA. PRIMARY AND SECONDARY OUTCOME MEASURES We calculated age-adjusted incidence rates and examined the association of occupation, education and physical work load factors with disability retirement using competing risk regression model. Disability retirement due to other causes than knee OA, old-age retirement and death were treated as competing risk. RESULTS A total of 6117 persons had disability retirement due to knee OA. Women had a higher age-adjusted incidence rate than men (72 vs 60 per 100 000 person-years, respectively). In men, a very high risk of disability retirement was found among construction workers, electricians and plumbers (HR 16.6, 95% CI 12.5 to 22.2), service workers (HR 12.7, 95% CI 9.2 to 17.4) and in women among building caretakers, cleaners, assistant nurses and kitchen workers (HR 15.5, 95% CI 11.7 to 20.6), as compared with professionals. The observed occupational differences were largely explained by educational level and noticeably mediated by physical work load factors in both genders. CONCLUSION Our observational study suggests that the risk of disability retirement among manual workers is strongly attributed to the physically heavy work.
Collapse
Affiliation(s)
- Tea Kontio
- Medical Faculty, University of Helsinki, Helsinki, Finland
| | | | | |
Collapse
|
24
|
Sun Y, Nold A, Glitsch U, Bochmann F. Hip Osteoarthritis and Physical Workload: Influence of Study Quality on Risk Estimations-A Meta-Analysis of Epidemiological Findings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16030322. [PMID: 30682781 PMCID: PMC6388382 DOI: 10.3390/ijerph16030322] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 01/11/2019] [Accepted: 01/17/2019] [Indexed: 01/13/2023]
Abstract
In this paper, we critically evaluate the quality of epidemiological evidence on hip osteoarthritis and workload published so far. The influence of study quality on risk estimations was analyzed in sensitivity meta-analyses and meta-regression analyses. Comprehensive searches for epidemiological studies of hip osteoarthritis and occupational workload were performed in literature databases and current reviews. All studies were assessed on the basis of study design, defined quality scores, and relevant confounders considered. In total, 34 suitable studies were identified for critical evaluation. Of these, 20 are prevalence studies and 14 incidence studies. Strong heterogeneity is observed in study design, quality level, and estimated exposure parameters. A consistent positive association between heavy physical workload and hip osteoarthritis was observed only among the male populations, not among the female populations. In general, cohort studies provided lower effect estimates than cross-sectional and population-based case-control studies. Studies with high quality scores also produced lower effect estimates than studies with low quality scores. Consideration of BMI as a confounder in published studies also yielded lower effect estimates than studies without consideration of BMI as a confounder. Our analyses indicate that high-quality studies of the association between occupational workload and hip osteoarthritis provide lower effect estimates than studies of lower quality.
Collapse
Affiliation(s)
- Yi Sun
- Unit Applied Epidemiology, Institute for Occupational Safety and Health of the German Social Accident Insurance, 53757 Sankt Augustin, Germany.
| | - Annette Nold
- Unit Applied Epidemiology, Institute for Occupational Safety and Health of the German Social Accident Insurance, 53757 Sankt Augustin, Germany.
| | - Ulrich Glitsch
- Unit Musculoskeletal Workload, Institute for Occupational Safety and Health of the German Social Accident Insurance, 53757 Sankt Augustin, Germany.
| | - Frank Bochmann
- Unit Applied Epidemiology, Institute for Occupational Safety and Health of the German Social Accident Insurance, 53757 Sankt Augustin, Germany.
| |
Collapse
|
25
|
Bortoluzzi A, Furini F, Scirè CA. Osteoarthritis and its management - Epidemiology, nutritional aspects and environmental factors. Autoimmun Rev 2018; 17:1097-1104. [DOI: 10.1016/j.autrev.2018.06.002] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 06/03/2018] [Indexed: 02/06/2023]
|
26
|
Abstract
PURPOSE OF REVIEW The purpose of this review is to highlight recent studies of osteoarthritis epidemiology, including research on prevalence, disease impact, and potential risk factors. RECENT FINDINGS Osteoarthritis is highly prevalent in the United States and around the globe. It is a leading cause of disability and can negatively impact people's physical and mental well being. Healthcare resources and costs associated with managing the disease can be substantial. There is increasing evidence that there are different osteoarthritis phenotypes that reflect different mechanisms of the disease. Various person-level risk factors are recognized, including sociodemographic characteristics (e.g. female sex, African-American race), genetic predispositions, obesity, diet-related factors, and high bone density/mass. Joint-level risk factors include specific bone/joint shapes, thigh flexor muscle weakness, joint malalignment, participation in certain occupational/sports activities, and joint injury. Recent studies have enhanced our understanding of preradiographic lesions associated with osteoarthritis. SUMMARY Application of these new findings may allow us to develop innovative strategies and novel therapies with the purpose of preventing new disease onset and minimizing disease progression.
Collapse
Affiliation(s)
- Ernest R. Vina
- Division of Rheumatology, Department of Medicine, University of Arizona, Tucson, Arizona, USA
- Arthritis Center, University of Arizona, Tucson, Arizona, USA
| | - C. Kent Kwoh
- Division of Rheumatology, Department of Medicine, University of Arizona, Tucson, Arizona, USA
- Arthritis Center, University of Arizona, Tucson, Arizona, USA
| |
Collapse
|
27
|
Solovieva S, Kontio T, Viikari-Juntura E. Occupation, Physical Workload Factors, and Disability Retirement as a Result of Hip Osteoarthritis in Finland, 2005–2013. J Rheumatol 2018; 45:555-562. [DOI: 10.3899/jrheum.170748] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2017] [Indexed: 10/18/2022]
Abstract
Objective.To identify occupations with a high risk of disability retirement as a result of hip osteoarthritis (OA), and to examine the effect of physical workload factors on the occupational differences in disability retirement.Methods.A total of 1,135,654 (49.4% women) Finns aged 30–60 years in gainful employment were followed from 2005 to 2013 for full disability retirement as a result of hip OA. Information on pensions, occupation, and education were obtained from national registers. Physical workload was assessed by a sex-specific job exposure matrix. We calculated age-adjusted incidence rates and examined the associations of occupation, education, and physical workload factors with disability retirement using a competing risk regression model.Results.Age-adjusted incidence rate was 25 and 22 per 100,000 person-years in men and women, respectively. Both men and women working in lower-level nonmanual and manual occupations had an elevated age-adjusted risk of disability retirement as a result of hip OA. A very high risk of disability retirement was found among male construction workers, electricians, and plumbers (HR 12.7, 95% CI 8.4–19.7), and female professional drivers (HR 15.2, 95% CI 7.5–30.8) as compared with professionals. After adjustment for age and education, the observed occupational differences in disability retirement were largely explained by physical workload factors among men and to a smaller extent, among women.Conclusion.Our results suggest that education and physical workload factors appear to be the major reasons for excess disability retirement as a result of hip OA in manual occupations, particularly among men.
Collapse
|
28
|
Danielsson L, Elf M, Hensing G. Strategies to keep working among workers with common mental disorders - a grounded theory study. Disabil Rehabil 2017; 41:786-795. [PMID: 29182029 DOI: 10.1080/09638288.2017.1408711] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE Most people with common mental disorders (CMDs) are employed and working, but few studies have looked into how they manage their jobs while ill. This study explores workers' experiences of strategies to keep working while suffering from CMDs. METHODS In this grounded theory study, we interviewed 19 women and eight men with depression or anxiety disorders. They were 19-65 years old and had different occupations. Constant comparison method was used in the analysis. RESULTS We identified a core pattern in the depressed and anxious workers' attempts to sustain their capacities, defined as Managing work space. The core pattern comprised four categories describing different cognitive, behavioral, and social strategies. The categories relate to a process of sustainability. Two categories reflected more reactive and temporary strategies, occurring mainly in the onset phase of illness: Forcing the work role and Warding off work strain. The third category, Recuperating from work, reflected strategies during both onset and recovery phases. The fourth category, Reflexive adaptation, was present mainly in the recovery phase and involved reflective strategies interpreted as more sustainable over time. CONCLUSIONS The results can deepen understanding among rehabilitation professionals about different work-related strategies in depressed and anxious workers. Increased awareness of the meaning and characteristics of strategies can inform a person-oriented approach in rehabilitation. The knowledge can be used in clinical encounters to reflect together with the patient, exploring present options and introducing modifications to their particular work and life context. Implications for rehabilitation Self-managed work functioning in common mental disorders involves diverse strategies. Strategies interpreted as sustainable over time, seem to be reflective in the sense that the worker consciously applies and adapts the strategies. However, at the onset of illness, such reflection is difficult to develop as the worker might not want to realize their reduced functioning. Rehabilitation professionals' awareness of different strategies can facilitate a person-centered approach and understanding of the vocational rehabilitation process.
Collapse
Affiliation(s)
- Louise Danielsson
- a Section of Epidemiology and Social Medicine , Institute of Medicine, University of Gothenburg , Gothenburg , Sweden.,b Angered Hospital , Gothenburg , Sweden
| | - Mikael Elf
- a Section of Epidemiology and Social Medicine , Institute of Medicine, University of Gothenburg , Gothenburg , Sweden.,c Närhälsan , Bedömningsteamet , Borås , Sweden
| | - Gunnel Hensing
- a Section of Epidemiology and Social Medicine , Institute of Medicine, University of Gothenburg , Gothenburg , Sweden
| |
Collapse
|
29
|
Rosenberg JH, Rai V, Dilisio MF, Sekundiak TD, Agrawal DK. Increased expression of damage-associated molecular patterns (DAMPs) in osteoarthritis of human knee joint compared to hip joint. Mol Cell Biochem 2017; 436:59-69. [PMID: 28573383 DOI: 10.1007/s11010-017-3078-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 05/25/2017] [Indexed: 01/15/2023]
Abstract
Osteoarthritis (OA) is a degenerative disease characterized by the destruction of cartilage. The greatest risk factors for the development of OA include age and obesity. Recent studies suggest the role of inflammation in the pathogenesis of OA. The two most common locations for OA to occur are in the knee and hip joints. The knee joint experiences more mechanical stress, cartilage degeneration, and inflammation than the hip joint. This could contribute to the increased incidence of OA in the knee joint. Damage-associated molecular patterns (DAMPs), including high-mobility group box-1, receptor for advanced glycation end products, and alarmins (S100A8 and S100A9), are released in the joint in response to stress-mediated chondrocyte and cartilage damage. This facilitates increased cartilage degradation and inflammation in the joint. Studies have documented the role of DAMPs in the pathogenesis of OA; however, the comparison of DAMPs and its influence on OA has not been discussed. In this study, we compared the DAMPs between OA knee and hip joints and found a significant difference in the levels of DAMPs expressed in the knee joint compared to the hip joint. The increased levels of DAMPs suggest a difference in the underlying pathogenesis of OA in the knee and the hip and highlights DAMPs as potential therapeutic targets for OA in the future.
Collapse
Affiliation(s)
- John H Rosenberg
- Department of Clinical and Translational Science, Creighton University School of Medicine, Omaha, NE, 68178, USA
| | - Vikrant Rai
- Department of Clinical and Translational Science, Creighton University School of Medicine, Omaha, NE, 68178, USA
| | - Matthew F Dilisio
- Department of Clinical and Translational Science, Creighton University School of Medicine, Omaha, NE, 68178, USA.,Orthopedic Surgery, Creighton University School of Medicine, Omaha, NE, 68178, USA
| | - Todd D Sekundiak
- Orthopedic Surgery, Creighton University School of Medicine, Omaha, NE, 68178, USA
| | - Devendra K Agrawal
- Department of Clinical and Translational Science, Creighton University School of Medicine, Omaha, NE, 68178, USA. .,Department of Clinical and Translational Science, The Peekie Nash Carpenter Endowed Chair in Medicine, Creighton University School of Medicine, CRISS II Room 510, 2500 California Plaza, Omaha, NE, 68178, USA.
| |
Collapse
|