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Qi B, Wang Z, Cao Y, Zhao H. Study on the treatment of osteoarthritis by acupuncture combined with traditional Chinese medicine based on pathophysiological mechanism: A review. Medicine (Baltimore) 2024; 103:e37483. [PMID: 38579081 PMCID: PMC10994424 DOI: 10.1097/md.0000000000037483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 02/13/2024] [Indexed: 04/07/2024] Open
Abstract
Osteoarthritis (OA) is a major contributor to disability and social costs in the elderly. As the population ages and becomes increasingly obese, the incidence of the disease is higher than in previous decades. In recent years, important progress has been made in the causes and pathogenesis of OA pain. Modern medical treatment modalities mainly include the specific situation of the patient and focus on the core treatment, including self-management and education, exercise, and related weight loss. As an important part of complementary and alternative medicine, TCM has remarkable curative effect, clinical safety, and diversity of treatment methods in the treatment of OA. Traditional Chinese Medicine treatment of OA has attracted worldwide attention. Therefore, this article will study the pathophysiological mechanism of OA based on modern medicine, and explore the treatment of OA by acupuncture combined with Chinese Medicine.
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Affiliation(s)
- Biao Qi
- Shenzhen Baoan District Shiyan People’s Hospital, Shenzhen, China
| | - Zeyu Wang
- Shenzhen Pingshan District Hospital of Traditional Chinese Medicine, Shenzhen, China
| | - Ying Cao
- Shenzhen Pingshan District Hospital of Traditional Chinese Medicine, Shenzhen, China
| | - Haishen Zhao
- Community Health Service Center of Nanhui New Town, Shanghai, China
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Yang C, Chen Q. Effects of ozone combined with articular injection of sodium hyaluronate on patients with knee osteoarthritis and their inflammatory factors and hemorheological indices. Afr Health Sci 2023; 23:360-366. [PMID: 38223641 PMCID: PMC10782347 DOI: 10.4314/ahs.v23i2.40] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2024] Open
Abstract
Objective Knee osteoarthritis (KOA) is a common chronic progressive disease. We aimed to evaluate the effects of ozone combined with articular injection of sodium hyaluronate on KOA patients and their inflammatory factors and hemorheological indices. Methods A total of 292 KOA patients treated from October 2020 to October 2021 were randomly divided into observation and control groups (n=146). Observation group was treated with ozone combined with articular injection of sodium hyaluronate, while control group was routinely given glucosamine hydrochloride tablets and articular injection of sodium hyaluronate. The treatment was performed once a week for 5 consecutive weeks. Their general data, treatment outcomes, visual analogue scale (VAS) score, Hospital for Special Surgery (HSS) knee score, inflammatory factor levels and hemorheological indices were compared. Results After treatment, observation group had significantly lower VAS score and higher HSS score than those of control group (P<0.05). The total response rate of observation group was higher than that of control group (P<0.05). The levels of inflammatory factors in the joint fluid were significantly lower in observation group than those in control group (P<0.05). The hemorheological indices were improved in both groups, especially in observation group (P<0.05). Conclusion Ozone combined with articular injection of sodium hyaluronate has obvious therapeutic effects on KOA.
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Affiliation(s)
- Chengyong Yang
- Department of Orthopedics, Affiliated Hospital of Yangzhou University, Yangzhou 225000, Jiangsu Province, China
| | - Qun Chen
- Department of Orthopedics, Affiliated Hospital of Yangzhou University, Yangzhou 225000, Jiangsu Province, China
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Marshall M, Blagojevic‐Bucknall M, Rathod‐Mistry T, Thomas MJ, Edwards JJ, Peat G, Menz HB, Roddy E. Identifying Long-Term Trajectories of Foot Pain Severity and Potential Prognostic Factors: A Population-Based Cohort Study. Arthritis Care Res (Hoboken) 2023; 75:1123-1131. [PMID: 34806345 PMCID: PMC10952181 DOI: 10.1002/acr.24823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 10/19/2021] [Accepted: 11/18/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVES To identify distinct foot pain trajectories over 7 years and examine their associations with potential prognostic factors. METHODS Adults ages ≥50 years and registered with 4 general practices in North Staffordshire, UK were mailed a baseline health survey. Those reporting current or recent foot pain were invited to attend a research assessment clinic. Follow-up was by repeated postal surveys at 18, 36, 54, and 84 months. Distinct trajectories of foot pain were explored using latent class growth analysis (LCGA). Subsequently, identified trajectories were combined into most and least progressive groups, and covariate-adjusted associations with a range of prognostic factors were examined. RESULTS Of 560 adults with foot pain attending baseline research clinics, 425 (76%) provided data at baseline and 2 or more follow-up time points. LCGA for foot pain severity (0-10 numerical rating scale) identified a 4-trajectory model: "mild, improving" (37%); "moderate, improving" (33%); "moderate-severe, persistent" (24%); and "severe, persistent" (6%). Compared with individuals in more favorable (improving) pain trajectories, those in less favorable (persistent) pain trajectories were more likely to be obese, have routine/manual and intermediate occupations, have poorer physical and mental health, have catastrophizing beliefs, have greater foot-specific functional limitation, and have self-assessed hallux valgus at baseline. CONCLUSIONS Four distinct trajectories of foot pain were identified over a 7-year period, with one-third of individuals classified as having pain that is persistently moderate-severe and severe in intensity. The effect of intervening to target modifiable prognostic factors such as obesity and hallux valgus on long-term outcomes in people with foot pain requires investigation.
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Affiliation(s)
- Michelle Marshall
- Primary Care Centre Versus Arthritis, School of MedicineKeele UniversityStaffordshireUK
| | | | - Trishna Rathod‐Mistry
- Primary Care Centre Versus Arthritis, School of MedicineKeele UniversityStaffordshireUK
| | - Martin J. Thomas
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Staffordshire, UK, and Haywood Academic Rheumatology Centre, Midlands Partnership NHS Foundation Trust, Haywood HospitalBurslemStaffordshireUK
| | - John J. Edwards
- Primary Care Centre Versus Arthritis, School of MedicineKeele UniversityStaffordshireUK
| | - George Peat
- Primary Care Centre Versus Arthritis, School of MedicineKeele UniversityStaffordshireUK
| | - Hylton B. Menz
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Staffordshire, UK, and School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe UniversityMelbourneVictoriaAustralia
| | - Edward Roddy
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Staffordshire, UK, and Haywood Academic Rheumatology Centre, Midlands Partnership NHS Foundation Trust, Haywood HospitalBurslemStaffordshireUK
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Harkey MS, Baez S, Lewis J, Grindstaff TL, Hart J, Driban JB, Schorfhaar A, Kuenze C. Prevalence of Early Knee Osteoarthritis Illness Among Various Patient-Reported Classification Criteria After Anterior Cruciate Ligament Reconstruction. Arthritis Care Res (Hoboken) 2022; 74:377-385. [PMID: 34738341 DOI: 10.1002/acr.24809] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 08/02/2021] [Accepted: 10/19/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To compare the prevalence of participants meeting different patient-reported criteria for early osteoarthritis (OA) illness after anterior cruciate ligament reconstruction (ACLR). METHODS Participants completed the Knee Injury and Osteoarthritis Outcomes Score (KOOS) at a single time point 5.0-7.9 months post-ACLR. We used established KOOS subscale criteria (i.e., Luyten original and Englund original) to define patient-reported early OA illness. A two-by-two contingency table and McNemar's test were used to compare the prevalence of participants who met the Luyten original versus Englund original KOOS criteria for early OA illness. These analyses were repeated using KOOS subscale thresholds based on established population-specific patient acceptable symptom state (PASS) within the Luyten and Englund KOOS criteria (i.e., Luyten PASS and Englund PASS). RESULTS A greater prevalence of participants with ACLR met the Luyten original criteria (n = 165 [54%]) compared to those who met the Englund original criteria (n = 128 [42%]; χ2 = 19.3, P < 0.001). When using the KOOS subscale PASS as thresholds, a significantly greater prevalence of participants with ACLR met the Luyten PASS criteria (n = 133 [43%]) compared to those who met the Englund PASS criteria (n = 85 [28%]; χ2 = 48.0, P < 0.001). When combining the Luyten and Englund KOOS criteria and using the original/PASS subscale thresholds, respectively, 40%/57% of participants met neither, 24%/15% met only 1, and 36%/28% met both KOOS criteria. CONCLUSION Regardless of the classification criteria used to define early OA illness, it is concerning that 28-54% of patients report considerable symptoms ~6 months post-ACLR. Our findings will improve the classification criteria to define early OA illness, which may raise awareness for the need of population-specific criteria.
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Effectiveness of an individualized comprehensive rehabilitation program in women with chronic knee osteoarthritis. Menopause 2022; 29:687-692. [DOI: 10.1097/gme.0000000000001959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Roman-Blas JA, Mendoza-Torres LA, Largo R, Herrero-Beaumont G. Setting up distinctive outcome measures for each osteoarthritis phenotype. Ther Adv Musculoskelet Dis 2020; 12:1759720X20937966. [PMID: 32973934 PMCID: PMC7491224 DOI: 10.1177/1759720x20937966] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 06/05/2020] [Indexed: 12/16/2022] Open
Abstract
Osteoarthritis (OA) is an evolving chronic joint disease with a huge global impact. Given the intricate nature of the etiopathogenesis and subsequent high heterogeneity in the clinical course of OA, it is crucial to discriminate between etiopathogenic endotypes and clinical phenotypes, especially in the early stages of the disease. In this sense, we propose that an OA phenotype should be properly assessed with a set of outcome measures including those specifically related to the main underlying pathophysiological mechanisms. Thus, each OA phenotype can be related to different and clinically meaningful outcomes. OA phenotyping would lead to an adequate patient stratification in well-designed clinical trials and the discovery of precise therapeutic approaches. A significant effort will be required in this field in light of inconclusive results of clinical trials of tissue-targeting agents for the treatment of OA.
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Affiliation(s)
- Jorge A Roman-Blas
- Joint and Bone Research Unit, IIS-Fundacion Jimenez Diaz, UAM, Av. Reyes Catolicos 2, Madrid, 28040, Spain
| | | | - Raquel Largo
- Joint and Bone Research Unit, IIS-Fundacion Jimenez Diaz UAM, Madrid, Spain
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Sandhar S, Smith TO, Toor K, Howe F, Sofat N. Risk factors for pain and functional impairment in people with knee and hip osteoarthritis: a systematic review and meta-analysis. BMJ Open 2020; 10:e038720. [PMID: 32771991 PMCID: PMC7418691 DOI: 10.1136/bmjopen-2020-038720] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To identify risk factors for pain and functional deterioration in people with knee and hip osteoarthritis (OA) to form the basis of a future 'stratification tool' for OA development or progression. DESIGN Systematic review and meta-analysis. METHODS An electronic search of the literature databases, Medline, Embase, CINAHL, and Web of Science (1990-February 2020), was conducted. Studies that identified risk factors for pain and functional deterioration to knee and hip OA were included. Where data and study heterogeneity permitted, meta-analyses presenting mean difference (MD) and ORs with corresponding 95% CIs were undertaken. Where this was not possible, a narrative analysis was undertaken. The Downs & Black tool assessed methodological quality of selected studies before data extraction. Pooled analysis outcomes were assessed and reported using the Grading of Reccomendation, Assessment, Development and Evaluation (GRADE) approach. RESULTS 82 studies (41 810 participants) were included. On meta-analysis: there was moderate quality evidence that knee OA pain was associated with factors including: Kellgren and Lawrence≥2 (MD: 2.04, 95% CI 1.48 to 2.81; p<0.01), increasing age (MD: 1.46, 95% CI 0.26 to 2.66; p=0.02) and whole-organ MRI scoring method (WORMS) knee effusion score ≥1 (OR: 1.35, 95% CI 0.99 to 1.83; p=0.05). On narrative analysis: knee OA pain was associated with factors including WORMS meniscal damage ≥1 (OR: 1.83). Predictors of joint pain in hip OA were large acetabular bone marrow lesions (BML; OR: 5.23), chronic widespread pain (OR: 5.02) and large hip BMLs (OR: 4.43). CONCLUSIONS Our study identified risk factors for clinical pain in OA by imaging measures that can assist in predicting and stratifying people with knee/hip OA. A 'stratification tool' combining verified risk factors that we have identified would allow selective stratification based on pain and structural outcomes in OA. PROSPERO REGISTRATION NUMBER CRD42018117643.
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Affiliation(s)
- Sandeep Sandhar
- Institute for Infection and Immunity, University of London St George's, London, UK
| | - Toby O Smith
- Nuffield Department of Orthopaedics and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Kavanbir Toor
- Institute for Infection and Immunity, University of London St George's, London, UK
| | - Franklyn Howe
- Molecular and Clinical Sciences Research Institute, University of London St George's, London, UK
| | - Nidhi Sofat
- Institute for Infection and Immunity, University of London St George's, London, UK
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Driban JB, Harkey MS, Barbe MF, Ward RJ, MacKay JW, Davis JE, Lu B, Price LL, Eaton CB, Lo GH, McAlindon TE. Risk factors and the natural history of accelerated knee osteoarthritis: a narrative review. BMC Musculoskelet Disord 2020; 21:332. [PMID: 32471412 PMCID: PMC7260785 DOI: 10.1186/s12891-020-03367-2] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 05/25/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Osteoarthritis is generally a slowly progressive disorder. However, at least 1 in 7 people with incident knee osteoarthritis develop an abrupt progression to advanced-stage radiographic disease, many within 12 months. We summarize what is known - primarily based on findings from the Osteoarthritis Initiative - about the risk factors and natural history of accelerated knee osteoarthritis (AKOA) - defined as a transition from no radiographic knee osteoarthritis to advanced-stage disease < 4 years - and put these findings in context with typical osteoarthritis (slowly progressing disease), aging, prior case reports/series, and relevant animal models. Risk factors in the 2 to 4 years before radiographic manifestation of AKOA (onset) include older age, higher body mass index, altered joint alignment, contralateral osteoarthritis, greater pre-radiographic disease burden (structural, symptoms, and function), or low fasting glucose. One to 2 years before AKOA onset people often exhibit rapid articular cartilage loss, larger bone marrow lesions and effusion-synovitis, more meniscal pathology, slower chair-stand or walking pace, and increased global impact of arthritis than adults with typical knee osteoarthritis. Increased joint symptoms predispose a person to new joint trauma, which for someone who develops AKOA is often characterized by a destabilizing meniscal tear (e.g., radial or root tear). One in 7 people with AKOA onset subsequently receive a knee replacement during a 9-year period. The median time from any increase in radiographic severity to knee replacement is only 2.3 years. Despite some similarities, AKOA is different than other rapidly progressive arthropathies and collapsing these phenomena together or extracting results from one type of osteoarthritis to another should be avoided until further research comparing these types of osteoarthritis is conducted. Animal models that induce meniscal damage in the presence of other risk factors or create an incongruent distribution of loading on joints create an accelerated form of osteoarthritis compared to other models and may offer insights into AKOA. CONCLUSION Accelerated knee osteoarthritis is unique from typical knee osteoarthritis. The incidence of AKOA in the Osteoarthritis Initiative and Chingford Study is substantial. AKOA needs to be taken into account and studied in epidemiologic studies and clinical trials.
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Affiliation(s)
- Jeffrey B Driban
- Division of Rheumatology, Allergy & Immunology, Tufts Medical Center, 800 Washington Street, Box #406, Boston, MA, 02111, USA.
| | - Matthew S Harkey
- Division of Rheumatology, Allergy & Immunology, Tufts Medical Center, 800 Washington Street, Box #406, Boston, MA, 02111, USA.,Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Mary F Barbe
- Department of Anatomy and Cell Biology, Temple University School of Medicine, 3500 North Broad Street, Philadelphia, PA, 19140, USA
| | - Robert J Ward
- Department of Radiology, Tufts Medical Center, 800 Washington Street, Boston, MA, 02111, USA
| | - James W MacKay
- Department of Radiology, University of Cambridge School of Clinical Medicine, Box 218, Level 5, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK.,Department of Radiology, Norwich Medical School, University of East Anglia, Research Park NR4 7U1, Norwich, UK
| | - Julie E Davis
- Milken Institute of Public Health, The George Washington University, 950 New Hampshire Ave NW, Washington, DC, 20052, USA
| | - Bing Lu
- Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street PBB-B3, Boston, MA, 02115, USA
| | - Lori Lyn Price
- The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, 800 Washington Street, Box #63, Boston, MA, 02111, USA.,Tufts Clinical and Translational Science Institute, Tufts University, 800 Washington Street, Box #63, Boston, MA, 02111, USA
| | - Charles B Eaton
- Center for Primary Care and Prevention, Alpert Medical School of Brown University, 111 Brewster Street, Pawtucket, RI, 02860, USA
| | - Grace H Lo
- Medical Care Line and Research Care Line, Houston Health Services Research and Development (HSR&D) Center of Excellence Michael E. DeBakey VAMC, Houston, TX, USA.,Section of Immunology, Allergy, and Rheumatology, Baylor College of Medicine, Houston, TX. 1 Baylor Plaza, BCM-285, Houston, TX, 77030, USA
| | - Timothy E McAlindon
- Division of Rheumatology, Allergy & Immunology, Tufts Medical Center, 800 Washington Street, Box #406, Boston, MA, 02111, USA
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Opioids and Cannabinoids for Osteoarthritis: Either, Both, or Neither. CURRENT TREATMENT OPTIONS IN RHEUMATOLOGY 2020. [DOI: 10.1007/s40674-020-00140-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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The incidence and characteristics of accelerated knee osteoarthritis among women: the Chingford cohort. BMC Musculoskelet Disord 2020; 21:60. [PMID: 32005116 PMCID: PMC6995080 DOI: 10.1186/s12891-020-3073-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 01/16/2020] [Indexed: 01/26/2023] Open
Abstract
Background Prior research on accelerated knee osteoarthritis (AKOA) was primarily confined to the Osteoarthritis Initiative, which was enriched with people with risk factors for knee osteoarthritis (KOA). It is unclear how often AKOA develops in a community-based cohort and whether we can replicate prior findings from the Osteoarthritis Initiative in another cohort. Hence, we determined the incidence and characteristics of AKOA among women in the Chingford Study, which is a prospective community-based cohort. Methods The Chingford Study had 1003 women with quinquennial knee radiographs over 15 years. We divided the 15-year observation period into three consecutive 5-year phases. Within each 5-year phase, we selected 3 groups of participants among women who started a phase without KOA (Kellgren-Lawrence [KL] < 2): 1) incident AKOA developed KL grade ≥ 3, 2) typical KOA increased radiographic scoring (excluding AKOA), and 3) no KOA had the same KL grade over time. Study staff recorded each participant’s age, body mass index (BMI), and blood pressure at baseline, 5-year, and 10-year study visits. We used multinomial logistic regression models to test the association between groups (outcome) and age, BMI, and blood pressure at the start of each phase. The cumulative incidences and odds ratios (OR) from each phase were pooled using a fixed-effect meta-analysis model. Results The person-based cumulative incidence of AKOA was 3.9% over 5 years (pooled estimate across the three 5-year phases). Among incident cases of KOA, AKOA represented ~ 15% of women with incident KOA. Women with AKOA were older than those with typical (OR = 1.56, 95%CI = 1.16–2.11) or no KOA (OR = 1.84, 95%CI = 1.40–2.43). Women with AKOA had a greater BMI than those without KOA (OR = 1.52, 95%CI = 1.17–1.97). We observed no association between group and blood pressure. Conclusions In a community-based cohort, > 1 in 7 women with incident KOA had AKOA. Like the Osteoarthritis Initiative, people with AKOA were more likely to have greater age and BMI.
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Davis JE, Ward RJ, MacKay JW, Lu B, Price LL, McAlindon TE, Eaton CB, Barbe MF, Lo GH, Harkey MS, Driban JB. Effusion-synovitis and infrapatellar fat pad signal intensity alteration differentiate accelerated knee osteoarthritis. Rheumatology (Oxford) 2020; 58:418-426. [PMID: 30346594 DOI: 10.1093/rheumatology/key305] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 09/04/2018] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES To determine whether greater effusion-synovitis volume and infrapatellar fat pad (IFP) signal intensity alteration differentiate incident accelerated knee OA (KOA) from a gradual onset of KOA or no KOA. METHODS We classified three sex-matched groups of participants in the Osteoarthritis Initiative who had a knee with no radiographic KOA at baseline (recruited 2004-06; Kellgren-Lawrence <2; n = 125/group): accelerated KOA: ⩾1 knee progressed to Kellgren-Lawrence grade ⩾3 within 48 months; common KOA: ⩾1 knee increased in radiographic scoring within 48 months; and no KOA: both knees had the same Kellgren-Lawrence grade at baseline and 48 months. The observation period included up to 2 years before and after when the group criteria were met. Two musculoskeletal radiologists reported presence of IFP signal intensity alteration and independent readers used a semi-automated method to segment effusion-synovitis volume. We used generalized linear mixed models with group and time as independent variables, as well as testing a group-by-time interaction. RESULTS Starting at 2 years before disease onset, adults who developed accelerated KOA had greater effusion-synovitis volume than their peers (accelerated KOA: 11.94 ± 0.90 cm3, KOA: 8.29 ± 1.19 cm3, no KOA: 8.14 ± 0.90 cm3) and have greater odds of having IFP signal intensity alteration than those with no KOA (odds ratio = 2.07, 95% CI = 1.14-3.78). Starting at 1 year prior to disease onset, those with accelerated KOA have greater than twice the odds of having IFP signal intensity alteration than those with common KOA. CONCLUSION People with IFP signal intensity alteration and/or greater effusion-synovitis volume in the absence of radiographic KOA may be at high risk for accelerated KOA, which may be characterized by local inflammation.
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Affiliation(s)
- Julie E Davis
- Division of Rheumatology, Tufts Medical Center, Boston, MA, USA
| | - Robert J Ward
- Department of Radiology, Tufts Medical Center, Boston, MA, USA
| | - James W MacKay
- Department of Radiology, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, UK
| | - Bing Lu
- Brigham & Women's Hospital and Harvard Medical School, Tufts University, Boston, MA, USA
| | - Lori Lyn Price
- The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Tufts University, Boston, MA, USA.,Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA
| | | | - Charles B Eaton
- Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, RI, USA
| | - Mary F Barbe
- Department of Anatomy and Cell Biology, Temple University School of Medicine, Philadelphia, PA, USA
| | - Grace H Lo
- Medical Care Line and Research Care Line, Houston Health Services Research and Development (HSR&D) Center of Excellence Michael E. DeBakey VAMC, Houston, TX, USA.,Section of Immunology, Allergy, and Rheumatology, Baylor College of Medicine, Houston, TX, USA
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Price LL, Harkey MS, Ward RJ, MacKay JW, Zhang M, Pang J, Davis JE, McAlindon TE, Lo GH, Amin M, Eaton CB, Lu B, Duryea J, Barbe MF, Driban JB. Role of Magnetic Resonance Imaging in Classifying Individuals Who Will Develop Accelerated Radiographic Knee Osteoarthritis. J Orthop Res 2019; 37:2420-2428. [PMID: 31297900 PMCID: PMC6778707 DOI: 10.1002/jor.24413] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 07/05/2019] [Indexed: 02/04/2023]
Abstract
We assessed whether adding magnetic resonance (MR)-based features to a base model of clinically accessible participant characteristics (i.e., serological, radiographic, demographic, symptoms, and physical function) improved classification of adults who developed accelerated radiographic knee osteoarthritis (AKOA) or not over the subsequent 4 years. We conducted a case-control study using radiographs from baseline and the first four annual visits of the osteoarthritis initiative to define groups. Eligible individuals had no radiographic KOA in either knee at baseline (Kellgren-Lawrence [KL] grade <2). We classified two groups matched on sex (i) AKOA: at least one knee developed advanced-stage KOA (KL = 3 or 4) within 48 months and (ii) did not develop AKOA within 48 months. The MR-based features were assessments of bone, effusion/synovitis, tendons, ligaments, cartilage, and menisci. All characteristics and MR-based features were from the baseline visit. Classification and regression tree analyses were performed to determine classification rules and identify statistically important variables. The CART models with and without MR features each explained approximately 40% of the variability. Adding MR-based features to the model yielded modest improvements in specificity (0.90 vs. 0.82) but lower sensitivity (0.62 vs. 0.70) than the base model. There was consistent evidence that serum glucose, effusion-synovitis volume, and cruciate ligament degeneration are statistically important variables in classifying individuals who will develop AKOA. We found common MR-based measures failed to dramatically improve classification. These findings also show a complex interplay among participant characteristics and a need to identify novel characteristics to improve classification. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:2420-2428, 2019.
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Affiliation(s)
- Lori Lyn Price
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA,Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA
| | - Matthew S. Harkey
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA,Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School,
Worcester, MA, USA
| | - Robert J. Ward
- Department of Radiology, Tufts Medical Center, Boston, MA, USA
| | - James W. MacKay
- University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Ming Zhang
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA
| | - Jincheng Pang
- Internal Medicine Research Unit, Pfizer, Cambridge, MA, USA
| | - Julie E. Davis
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA
| | - Timothy E. McAlindon
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA
| | - Grace H. Lo
- Medical Care Line and Research Care Line, Houston Health Services Research and Development Center of
Excellence Michael E. DeBakey VAMC, Houston, TX, USA,Section of Immunology, Allergy, and Rheumatology, Baylor College of Medicine, Houston, TX, USA
| | - Mamta Amin
- Temple University School of Medicine, Philadelphia, PA, USA
| | | | - Bing Lu
- Brigham & Women’s Hospital and Harvard Medical School, Boston, MA
| | - Jeffrey Duryea
- Department of Radiology, Brigham & Women’s Hospital and Harvard Medical School, Boston, MA,
USA
| | - Mary F. Barbe
- Temple University School of Medicine, Philadelphia, PA, USA
| | - Jeffrey B. Driban
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA
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Harkey MS, Price LL, McAlindon TE, Davis JE, Stout AC, Lu B, Zhang M, Eaton CB, Barbe MF, Lo GH, Driban JB. Association Between Declining Walking Speed and Increasing Bone Marrow Lesion and Effusion Volume in Individuals with Accelerated Knee Osteoarthritis. Arthritis Care Res (Hoboken) 2019; 71:259-270. [PMID: 29882630 DOI: 10.1002/acr.23613] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 06/05/2018] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To determine whether a decline in walking speed during the year prior to disease onset is associated with concurrent changes in cartilage, bone marrow lesions (BMLs), or effusion in adults who develop common knee osteoarthritis (OA), accelerated knee OA, or no knee OA. METHODS We identified 3 groups from the Osteoarthritis Initiative based on annual radiographs from baseline to 48 months: accelerated knee OA, common knee OA, and no knee OA. We used the cartilage damage index (CDI) to assess tibiofemoral cartilage damage and used a semiautomated program to measure BML and effusion volume. Walking speed was assessed as an individual's habitual walking speed over 20 meters. One-year change in walking speed and structural measures were calculated as index visit measurements minus measurements from the year prior visit. Logistic regression models were used to determine whether change in walking speed (exposure) was associated with change in each structural measure (outcome) for the overall group and then separately for the accelerated knee OA, common knee OA, and no knee OA groups. RESULTS Adults who slowed their walking speed were almost twice as likely to present with increased BML volume, with a significant association (odds ratio 3.04 [95% confidence interval (95% CI) 1.03-8.95]) among adults with accelerated knee OA. Adults with accelerated knee OA who slowed their walking speed were approximately 3.4 times (95% CI 1.10-10.49) more likely to present with increased effusion volume. Walking speed change was not significantly associated with CDI change. CONCLUSION A change in an easily assessable clinical examination (i.e., 20-meter walk test) was associated with concurrent worsening in BML and effusion volume in adults who developed accelerated knee OA.
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Affiliation(s)
| | - Lori Lyn Price
- Tufts Medical Center and Tufts University, Boston, Massachusetts
| | | | | | | | - Bing Lu
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Ming Zhang
- Tufts Medical Center, Boston, Massachusetts
| | - Charles B Eaton
- Alpert Medical School of Brown University, Pawtucket, Rhode Island
| | - Mary F Barbe
- Temple University School of Medicine, Philadelphia, Pennsylvania
| | - Grace H Lo
- Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston Texas
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14
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Ruan G, Xu J, Wang K, Zheng S, Wu J, Bian F, Chang B, Zhang Y, Meng T, Zhu Z, Han W, Ding C. Associations between serum IL-8 and knee symptoms, joint structures, and cartilage or bone biomarkers in patients with knee osteoarthritis. Clin Rheumatol 2019; 38:3609-3617. [PMID: 31377918 DOI: 10.1007/s10067-019-04718-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 06/23/2019] [Accepted: 07/30/2019] [Indexed: 01/24/2023]
Abstract
OBJECTIVE The aim of this study was to investigate cross-sectional associations between serum levels of IL-8 and the above outcomes in patients with knee osteoarthritis (OA). METHODS A total of 160 subjects with clinical knee OA were included. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score and Lequesne index were used to assess the joint symptom. Magnetic resonance imaging was used to measure knee structural abnormalities including infrapatellar fat pad (IPFP) signal intensity alternation. Knee radiographic OA was assessed by radiography using the Kellgren-Lawrence (K-L) grading system. Enzyme-linked immunosorbent assay was used to measure the serum levels of IL-8 and cartilage or bone biomarkers. RESULTS In multivariable analyses, serum IL-8 was positively associated with WOMAC weight-bearing pain (β 2.85, P = 0.028), WOMAC physical dysfunction (β 12.71, P = 0.048), and Lequesne index (β 1.65, P = 0.015), and had positive associations with IPFP signal intensity alteration (OR 3.18, P = 0.011) and serum levels of N-telopeptide of type I collagen (NTXI), N-terminal procollagen III propeptide (PIIINP), matrix metalloproteinase (MMP)3, and MMP13 (β 0.24-1.44, all P < 0.05) in patients with clinical knee OA. Furthermore, there were positive associations between IL-8 and WOMAC score (β 22.49, P = 0.037), K-L grades (OR 3.88, P = 0.013), and IPFP signal intensity alteration (OR 3.20, P = 0.033) in patients with radiographic OA. CONCLUSIONS Serum levels of IL-8 were positively associated with increased knee symptoms, IPFP signal intensity alteration, and serum levels of bone and/or cartilage biomarkers, suggesting that IL-8 may have a role to play in knee OA.Key Point• This study systemically investigates the associations between serum IL 8 and knee symptoms, joint structures, and cartilage or bone biomarkers in patients with knee osteoarthritis, and some significant associations have been found, suggesting that IL 8 may have a role to play in knee OA.
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Affiliation(s)
- Guangfeng Ruan
- Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University, No. 218, Jixi Street, Hefei, Anhui, China.,Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, Tasmania, Australia.,Clinical Research Centre, Zhujiang Hospital, Southern Medical University, No. 253, Middle Gongye Avenue, Guangzhou, Guangdong, China
| | - Jianhua Xu
- Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University, No. 218, Jixi Street, Hefei, Anhui, China
| | - Kang Wang
- Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University, No. 218, Jixi Street, Hefei, Anhui, China
| | - Shuang Zheng
- Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University, No. 218, Jixi Street, Hefei, Anhui, China.,Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, Tasmania, Australia
| | - Juan Wu
- Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University, No. 218, Jixi Street, Hefei, Anhui, China
| | - Fuqin Bian
- Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University, No. 218, Jixi Street, Hefei, Anhui, China
| | - Bingru Chang
- Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University, No. 218, Jixi Street, Hefei, Anhui, China
| | - Yan Zhang
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, Tasmania, Australia.,Clinical Research Centre, Zhujiang Hospital, Southern Medical University, No. 253, Middle Gongye Avenue, Guangzhou, Guangdong, China
| | - Tao Meng
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, Tasmania, Australia
| | - Zhaohua Zhu
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, Tasmania, Australia.,Clinical Research Centre, Zhujiang Hospital, Southern Medical University, No. 253, Middle Gongye Avenue, Guangzhou, Guangdong, China
| | - Weiyu Han
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, Tasmania, Australia.,Clinical Research Centre, Zhujiang Hospital, Southern Medical University, No. 253, Middle Gongye Avenue, Guangzhou, Guangdong, China
| | - Changhai Ding
- Department of Rheumatology and Immunology, Arthritis Research Institute, the First Affiliated Hospital of Anhui Medical University, No. 218, Jixi Street, Hefei, Anhui, China. .,Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, Tasmania, Australia. .,Clinical Research Centre, Zhujiang Hospital, Southern Medical University, No. 253, Middle Gongye Avenue, Guangzhou, Guangdong, China.
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15
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Davis JE, Harkey MS, Liu SH, Lapane K, Price LL, Lu B, Lo GH, Eaton CB, Barbe MF, McAlindon TE, Driban JB. Adults With Incident Accelerated Knee Osteoarthritis Are More Likely to Use Pharmacological Treatment Options and Receive Arthroscopic Knee Surgery: Data From the Osteoarthritis Initiative. ACR Open Rheumatol 2019; 1:359-364. [PMID: 31777814 PMCID: PMC6857962 DOI: 10.1002/acr2.11058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 06/28/2019] [Indexed: 01/29/2023] Open
Abstract
Objective To determine if people with incident accelerated knee osteoarthritis (AKOA) were more likely to receive a pharmacological treatment or arthroscopic knee surgery than those with typical knee osteoarthritis (KOA) or no KOA. Methods We conducted a nested cohort study using data from baseline and the first 8 years of the Osteoarthritis Initiative. Eligible participants had no radiographic KOA at baseline (Kellgren‐Lawrence [KL] < 2). We classified three groups using KL grades: 1) AKOA: knee progressed to advanced‐stage KOA (KL 3/4) in 4 years or less, 2) typical KOA: knee increased in KL grade by 8 years (excluding AKOA), and 3) No KOA: no change in KL grade by 8 years. The outcome was self‐reported arthroscopic knee surgery or a pharmacological treatment option: nonsteroidal anti‐inflammatory drugs (NSAIDs), hyaluronic acid injections, intra‐articular corticosteroid injections, or prescription analgesics. Between‐group differences in therapeutic use were evaluated with Chi‐square tests. Results Adults who developed AKOA (n = 92) were more likely to report arthroscopic knee surgery (AKOA: 32%, KOA [n = 380]: 8%, no KOA [n = 875]: 3%; P < 0.001), hyaluronic acid injections (AKOA: 10%, KOA: 4%, no KOA: 1%; P < 0.001), intra‐articular corticosteroid injections (AKOA: 30%, KOA: 7%, no KOA: 4%; P < 0.001), and NSAID use (over the counter: AKOA: 65%, KOA: 48%, and no KOA: 46%; P = 0.003; prescription: AKOA: 61%, KOA: 43%, no KOA: 41%; P = 0.002). Conclusion Adults with AKOA are more likely to receive pharmacological treatment or arthroscopic knee surgery than their peers. Adults with AKOA are an important patient population that is understudied in clinical research despite their use of greater health care resources.
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Affiliation(s)
| | - Matthew S Harkey
- Tufts Medical Center, Boston, Massachusetts, and University of Massachusetts Medical School Worcester Massachusetts
| | - Shao-Hsien Liu
- University of Massachusetts Medical School Worcester Massachusetts
| | - Kate Lapane
- University of Massachusetts Medical School Worcester Massachusetts
| | - Lori Lyn Price
- Tufts Medical Center, Boston, Massachusetts and Tufts University Boston Massachusetts
| | - Bing Lu
- Brigham & Women's Hospital and Harvard Medical School Boston Massachusetts
| | - Grace H Lo
- Houston Health Services Research and Development (HSR&D) Center of Excellence, Houston, Texas and Baylor College of Medicine Houston Texas
| | - Charles B Eaton
- Alpert Medical School of Brown University Pawtucket Rhode Island
| | - Mary F Barbe
- Temple University School of Medicine Philadelphia Pennsylvania
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16
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Davis JE, Harkey MS, Ward RJ, MacKay JW, Lu B, Price LL, Eaton CB, Lo GH, Barbe MF, McAlindon TE, Driban JB. Accelerated knee osteoarthritis is associated with pre-radiographic degeneration of the extensor mechanism and cruciate ligaments: data from the Osteoarthritis Initiative. BMC Musculoskelet Disord 2019; 20:308. [PMID: 31253142 PMCID: PMC6599240 DOI: 10.1186/s12891-019-2685-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 06/18/2019] [Indexed: 11/30/2022] Open
Abstract
Background To determine if adults with incident accelerated knee osteoarthritis (KOA) are more likely to have degenerative knee ligaments or tendons compared to individuals with typical or no KOA. Methods We identified 3 sex-matched groups among Osteoarthritis Initiative participants who had a knee without radiographic KOA at baseline (Kellgren-Lawrence [KL] < 2): 1) accelerated KOA: at least 1 knee had KL grade ≥ 3 in ≤48 months, 2) typical KOA: at least 1 knee increased in radiographic scoring within 48 months, 3) no KOA: both knees had the same KL grade at baseline and 48 months. We evaluated knee magnetic resonance images up to 2 years before and after a visit when the accelerated or typical KOA criteria were met (index visit). Radiologists reported degenerative signal changes for cruciate and collateral ligaments, and extensor mechanism and proximal gastrocnemius tendons. We used generalized linear mixed models with 2 independent variables: group and time. Results Starting at least 2 years before onset, adults with accelerated KOA were twice as likely to have degenerative cruciate ligaments than no KOA (odds ratio = 2.10, 95% CI = 1.18, 3.74). A weaker association (not statistically significant) was detected for adults with accelerated versus typical KOA (OR = 1.72, 95%CI = 0.99, 3.02). Regardless of time, adults with accelerated (odds ratio = 2.13) or typical KOA (odds ratio = 2.16) were twice as likely to have a degenerative extensor mechanism than no KOA. No other structural features were statistically significant. Conclusions Degenerative cruciate ligaments or extensor mechanism antedate radiographic onset of accelerated KOA. Hence, knee instability may precede accelerated KOA, which might help identify patients at high-risk for accelerated KOA and novel prevention strategies.
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Affiliation(s)
- Julie E Davis
- Division of Rheumatology, Allergy & Immunology, Tufts Medical Center, 800 Washington Street, Box #406, Boston, MA, 02111, USA
| | - Matthew S Harkey
- Division of Rheumatology, Allergy & Immunology, Tufts Medical Center, 800 Washington Street, Box #406, Boston, MA, 02111, USA.,Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
| | - Robert J Ward
- Department of Radiology, Tufts Medical Center, 800 Washington Street, Boston, MA, 02111, USA
| | - James W MacKay
- Department of Radiology, University of Cambridge School of Clinical Medicine, Box 218, Level 5, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK
| | - Bing Lu
- Brigham & Women's Hospital and Harvard Medical School, 75 Francis Street PBB-B3, Boston, MA, 02115, USA
| | - Lori Lyn Price
- The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, 800 Washington Street, Box #63, Boston, MA, 02111, USA.,Tufts Clinical and Translational Science Institute, Tufts University, 800 Washington Street, Box #63, Boston, MA, 02111, USA
| | - Charles B Eaton
- Center for Primary Care and Prevention, Alpert Medical School of Brown University, 111 Brewster Street, Pawtucket, RI, 02860, USA
| | - Grace H Lo
- Medical Care Line and Research Care Line, Houston Health Services Research and Development (HSR&D) Center of Excellence Michael E. DeBakey VAMC, Houston, TX, USA.,Section of Immunology Allergy and Rheumatology, Baylor College of Medicine, Houston, TX. 1 Baylor Plaza, BCM-285, Houston, TX, 77030, USA
| | - Mary F Barbe
- Department of Anatomy and Cell Biology, Temple University School of Medicine, 3500 North Broad Street, Philadelphia, PA, 19140, USA
| | - Timothy E McAlindon
- Division of Rheumatology, Allergy & Immunology, Tufts Medical Center, 800 Washington Street, Box #406, Boston, MA, 02111, USA
| | - Jeffrey B Driban
- Division of Rheumatology, Allergy & Immunology, Tufts Medical Center, 800 Washington Street, Box #406, Boston, MA, 02111, USA.
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17
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Driban JB, Davis JE, Lu B, Price LL, Ward RJ, MacKay JW, Eaton CB, Lo GH, Barbe MF, Zhang M, Pang J, Stout AC, Harkey MS, McAlindon TE. Accelerated Knee Osteoarthritis Is Characterized by Destabilizing Meniscal Tears and Preradiographic Structural Disease Burden. Arthritis Rheumatol 2019; 71:1089-1100. [PMID: 30592385 DOI: 10.1002/art.40826] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 12/20/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To determine whether accelerated knee osteoarthritis (KOA) is preceded by, and characterized over time by, destabilizing meniscal tears or other pathologic changes. METHODS We selected 3 sex-matched groups of subjects from the first 48 months of the Osteoarthritis Initiative, comprising adults who had a knee without KOA (Kellgren/Lawrence [K/L] radiographic grade <2) at baseline. Subjects in the accelerated KOA group developed KOA of K/L grade ≥3, those with typical KOA showed increased K/L radiographic scores, and those with no KOA had the same K/L grade over time. An index visit was the visit when the radiographic criteria for accelerated KOA and typical KOA were met (the no KOA group was matched to the accelerated KOA group). The observation period was up to 2 years before and after an index visit. Radiologists reviewed magnetic resonance (MR) images of the index knee and identified destabilizing meniscal tears (root tears, radial tears, complex tears), miscellaneous pathologic features (acute ligamentous or tendinous injuries, attrition, subchondral insufficiency fractures, other incidental findings), and meniscal damage in >2 of 6 regions (3 regions per meniscus: anterior horn, body, posterior horn). In addition, bone marrow lesions (BMLs) and cartilage damage on MR images were quantified. Linear mixed regression models were performed to analyze the results. RESULTS At 1 year before the index visit, >75% of adults with accelerated KOA had meniscal damage in ≥2 regions (odds ratio 3.19 [95% confidence interval 1.70-5.97] versus adults with typical KOA). By the index visit, meniscal damage in ≥2 regions was ubiquitous in adults with accelerated KOA, including 42% of subjects having evidence of a destabilizing meniscal tear (versus 14% of subjects with typical KOA). These changes corresponded to findings of larger BMLs and greater cartilage loss in the accelerated KOA group. CONCLUSION Accelerated KOA is characterized by destabilizing meniscal tears in a knee compromised by meniscal damage in >2 regions, and also characterized by the presence of large BMLs and greater cartilage loss.
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Affiliation(s)
| | | | - Bing Lu
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Lori Lyn Price
- Tufts Medical Center and Tufts University, Boston, Massachusetts
| | | | - James W MacKay
- University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, UK
| | - Charles B Eaton
- Alpert Medical School of Brown University, Pawtucket, Rhode Island
| | - Grace H Lo
- Baylor College of Medicine and Michael E. DeBakey VAMC, Houston, Texas
| | - Mary F Barbe
- Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
| | - Ming Zhang
- Tufts Medical Center, Boston, Massachusetts
| | | | | | - Matthew S Harkey
- Tufts Medical Center, Boston, Massachusetts, and University of Massachusetts Medical School, Worcester
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18
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Mandl LA. Osteoarthritis year in review 2018: clinical. Osteoarthritis Cartilage 2019; 27:359-364. [PMID: 30453055 DOI: 10.1016/j.joca.2018.11.001] [Citation(s) in RCA: 183] [Impact Index Per Article: 36.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 11/07/2018] [Accepted: 11/08/2018] [Indexed: 02/02/2023]
Abstract
Osteoarthritis (OA) is the most common joint disease in the world, with an age-associated increase in both incidence and prevalence. Clinical and epidemiologic research is crucial to better understand risk factors for disease, find the best treatments for symptoms, and identify therapies to slow down or even prevent disease progression. This paper is based on a systematic review of the osteoarthritis literature published in English between 2017/05/01 and 2018/04/25, with a focus on papers which have the potential to improve patient care, or which suggest novel areas for future research.
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Affiliation(s)
- L A Mandl
- Hospital for Special Surgery, USA; Weill Cornell Medicine, USA.
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19
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Hamrin Senorski E, Sundemo D, Svantesson E, Sernert N, Kartus JT, Karlsson J, Samuelsson K. Preoperative and Intraoperative Predictors of Long-Term Acceptable Knee Function and Osteoarthritis After Anterior Cruciate Ligament Reconstruction: An Analysis Based on 2 Randomized Controlled Trials. Arthroscopy 2019; 35:489-499. [PMID: 30301627 DOI: 10.1016/j.arthro.2018.07.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 06/26/2018] [Accepted: 07/05/2018] [Indexed: 02/02/2023]
Abstract
PURPOSE To determine preoperative predictors of long-term acceptable knee function and the development of osteoarthritis (OA) in long-term follow-up after anterior cruciate ligament (ACL) reconstruction. METHODS This study is a long-term follow-up of 2 previous randomized controlled trials that included 193 patients who underwent unilateral ACL reconstruction with ipsilateral hamstring tendon or patellar tendon autografts. Patients who suffered multiligament injuries, major meniscal injuries, chondral lesions requiring surgical treatment, or had a previous ACL reconstruction were excluded. Patient demographics, preoperative clinical assessments, and intraoperative findings were used to create stepwise multivariable regression models to determine the patient-acceptable symptom state (PASS) in the International Knee Documentation Committee and the development of OA defined as a Kellgren-Lawrence grade ≥2. Knee laxity measurements, hop performance, patient-reported outcome, and concomitant injuries were determined as variables. RESULTS A total of 147 patients (63.7% men) were eligible for inclusion, with a mean follow-up of 16.4 ± 1.3 years. The patients were an average age of 27.9 ± 8.3 years at the time of ACL reconstruction. One-half of the cohort reported an International Knee Documentation Committee evaluation system score above the PASS cutoff. The presence of a concomitant injury at operation (odds ratio [OR], 2.61; 95% confidence interval [CI], 1.10-6.21; P = .030) and greater preoperative anteroposterior laxity (OR, 1.87; 95% CI, 1.05-3.35; P = .034) increased the likelihood of achieving a PASS. A longer period between ACL injury and reconstruction (OR, 2.25; 95% CI, 1.02-5.00; P = .046) and older age at reconstruction (OR, 2.28; 95% CI, 1.34-3.86; P = .0023) increased the odds of developing OA at follow-up. CONCLUSIONS Patients who were older at the time of ACL reconstruction and had waited >1 year between the injury and reconstruction ran an increased risk of having OA 16 years after reconstruction. One in 2 patients reported acceptable long-term knee function, but no risk factor for poorer subjective knee function was identified. Patients who had a minor concomitant injury and increased preoperative anteroposterior knee laxity had increased odds of reporting an acceptable long-term knee function. LEVEL OF EVIDENCE Level II; prospective comparative study.
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Affiliation(s)
- Eric Hamrin Senorski
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - David Sundemo
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Eleonor Svantesson
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ninni Sernert
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Research and Development, NU-Hospital Group, Trollhättan/Uddevalla, Sweden; Department of Orthopaedics, NU-Hospital Group, Trollhättan/Uddevalla, Sweden
| | - Jüri-Toomas Kartus
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Research and Development, NU-Hospital Group, Trollhättan/Uddevalla, Sweden; Department of Orthopaedics, NU-Hospital Group, Trollhättan/Uddevalla, Sweden
| | - Jón Karlsson
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Orthopaedics, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Kristian Samuelsson
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Orthopaedics, Sahlgrenska University Hospital, Mölndal, Sweden
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20
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Zhang B, Yu X, Liang L, Zhu L, Dong X, Xiong Y, Pan Q, Sun Y. Is the Wedged Insole an Effective Treatment Option When Compared with a Flat (Placebo) Insole: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2018; 2018:8654107. [PMID: 30622616 PMCID: PMC6304499 DOI: 10.1155/2018/8654107] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 10/24/2018] [Accepted: 11/25/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND Using the lateral wedge insole is a conservative management strategy for knee osteoarthritis. The theoretical basis for this intervention is to correct femorotibial angle, thereby reducing pain and optimising function. OBJECTIVE This systematic review evaluates the evidence on the effectiveness of wedge insole compared with flat insole for the treatment of knee osteoarthritis. METHODS A systematic review was performed, searching published (MEDLINE, EMBASE, CNKI, Cochrane Library, and Web of Science) and unpublished literature from their inception to April 2018. Randomized controlled trials (RCTs) that compared the use of wedge insole with a flat insole were included. Risk of bias and clinical relevance were assessed, and outcomes were analysed through meta-analysis. RESULT From a total of 413 citations, 8 studies adhered to the a priori eligibility criteria. The WOMAC pain was shown to be statistically nonsignificant change with the use of wedge insole (SMD=0.07), and low heterogeneity (I2=22%) and a 95% CI that crossed zero (95% CI: -0.09 to 0.24). The 5 independent trials were not significant in improving pain score (SMD = -0.02, 95% CI: -0.19 to 0.16). This review also revealed no significance in improving Lequesne index (SMD = -0.27, 95% CI: -0.72 to 0.19). The meta-analysis from the 2 independent trials was significant in improving femorotibial angle (SMD = -0.41, 95% CI: -0.73 to -0.09). In conclusion, this meta-analysis suggested that lateral wedge insoles can improve femorotibial angle but are of no benefit with pain and functions in knee osteoarthritis.
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Affiliation(s)
- Bingbing Zhang
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China
- Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China
| | - Xing Yu
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China
| | - Long Liang
- Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China
| | - Liguo Zhu
- Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China
| | - Xiaopeng Dong
- First Affiliated Hospital of Anhui University of Chinese Medicine, Anhui 230031, China
| | - Yang Xiong
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China
| | - Quan Pan
- Dezhou People's Hospital, Dezhou, Shandong 253000, China
| | - Yongsheng Sun
- Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China
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21
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Davis JE, Schaefer LF, McAlindon TE, Eaton CB, Roberts MB, Haugen IK, Smith SE, Duryea J, Lu B, Driban JB. Characteristics of Accelerated Hand Osteoarthritis: Data from the Osteoarthritis Initiative. J Rheumatol 2018; 46:422-428. [PMID: 30504506 DOI: 10.3899/jrheum.180240] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2018] [Indexed: 01/30/2023]
Abstract
OBJECTIVE We aimed to determine whether hand joints develop an accelerated form of osteoarthritis (OA) and to characterize individuals who develop accelerated hand osteoarthritis (AHOA). METHODS We evaluated 3519 participants in the Osteoarthritis Initiative with complete data for baseline and 48-month radiographic hand osteoarthritis (HOA). One reader scored posteroanterior radiographs of the dominant hand using a modified Kellgren-Lawrence (KL) scale and another reader scored the presence of central or marginal erosions. A third reader read images flagged for signs of diseases other than OA. We defined AHOA as ≥ 1 joints that progressed from a KL grade of 0 or 1 at baseline to KL grade 3 or 4 at 48 months. RESULTS The definition of AHOA was met by 1% over 4 years: 37 hands had 1 joint affected and 1 hand had 2 joints affected. At baseline, adults who developed AHOA were more likely to have hand pain (37% vs 22%), radiographic HOA (71% vs 36%), as well as central (22% vs 7%) and marginal erosions (11% vs 2%) in other joints compared to those without AHOA. Adults with AHOA were more likely to develop new erosions over 48 months (central 35%, marginal 5%) than those without AHOA (central 5%, marginal 1%). The most common locations of accelerated OA were the second metacarpophalangeal and first carpometacarpal joint. CONCLUSION Accelerated OA can occur in the hand, especially among digits commonly used for pinching and fine motor skills.
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Affiliation(s)
- Julie E Davis
- From the Division of Rheumatology, Tufts Medical Center; Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, Rhode Island, USA; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.,J.E. Davis, BS, Research Assistant II, Division of Rheumatology, Tufts Medical Center; L.F. Schaefer, MD, Radiology Fellow, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; T.E. McAlindon, MD, MPH, Chief of Rheumatology, Division of Rheumatology, Tufts Medical Center; C.B. Eaton, MD, MS, Professor of Family Medicine and Epidemiology, Director of Center for Primary Care and Prevention, Alpert Medical School of Brown University; M.B. Roberts, MSc, Statistical Programmer, Center for Primary Care and Prevention, Alpert Medical School of Brown University; I.K. Haugen, MD, PhD, Rheumatology Fellow, Department of Rheumatology, Diakonhjemmet Hospital; S.E. Smith, MD, Section Head and Weissman Distinguished Chair of Musculoskeletal Radiology, Associate Radiology Residency Program Director, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; J. Duryea, PhD, Associate Research Associate, Associate Professor of Radiology, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; B. Lu, DrPH, MD, Assistant Professor of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School; J.B. Driban, PhD, ATC, CSCS, Associate Professor, Division of Rheumatology, Tufts Medical Center
| | - Lena F Schaefer
- From the Division of Rheumatology, Tufts Medical Center; Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, Rhode Island, USA; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.,J.E. Davis, BS, Research Assistant II, Division of Rheumatology, Tufts Medical Center; L.F. Schaefer, MD, Radiology Fellow, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; T.E. McAlindon, MD, MPH, Chief of Rheumatology, Division of Rheumatology, Tufts Medical Center; C.B. Eaton, MD, MS, Professor of Family Medicine and Epidemiology, Director of Center for Primary Care and Prevention, Alpert Medical School of Brown University; M.B. Roberts, MSc, Statistical Programmer, Center for Primary Care and Prevention, Alpert Medical School of Brown University; I.K. Haugen, MD, PhD, Rheumatology Fellow, Department of Rheumatology, Diakonhjemmet Hospital; S.E. Smith, MD, Section Head and Weissman Distinguished Chair of Musculoskeletal Radiology, Associate Radiology Residency Program Director, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; J. Duryea, PhD, Associate Research Associate, Associate Professor of Radiology, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; B. Lu, DrPH, MD, Assistant Professor of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School; J.B. Driban, PhD, ATC, CSCS, Associate Professor, Division of Rheumatology, Tufts Medical Center
| | - Timothy E McAlindon
- From the Division of Rheumatology, Tufts Medical Center; Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, Rhode Island, USA; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.,J.E. Davis, BS, Research Assistant II, Division of Rheumatology, Tufts Medical Center; L.F. Schaefer, MD, Radiology Fellow, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; T.E. McAlindon, MD, MPH, Chief of Rheumatology, Division of Rheumatology, Tufts Medical Center; C.B. Eaton, MD, MS, Professor of Family Medicine and Epidemiology, Director of Center for Primary Care and Prevention, Alpert Medical School of Brown University; M.B. Roberts, MSc, Statistical Programmer, Center for Primary Care and Prevention, Alpert Medical School of Brown University; I.K. Haugen, MD, PhD, Rheumatology Fellow, Department of Rheumatology, Diakonhjemmet Hospital; S.E. Smith, MD, Section Head and Weissman Distinguished Chair of Musculoskeletal Radiology, Associate Radiology Residency Program Director, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; J. Duryea, PhD, Associate Research Associate, Associate Professor of Radiology, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; B. Lu, DrPH, MD, Assistant Professor of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School; J.B. Driban, PhD, ATC, CSCS, Associate Professor, Division of Rheumatology, Tufts Medical Center
| | - Charles B Eaton
- From the Division of Rheumatology, Tufts Medical Center; Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, Rhode Island, USA; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.,J.E. Davis, BS, Research Assistant II, Division of Rheumatology, Tufts Medical Center; L.F. Schaefer, MD, Radiology Fellow, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; T.E. McAlindon, MD, MPH, Chief of Rheumatology, Division of Rheumatology, Tufts Medical Center; C.B. Eaton, MD, MS, Professor of Family Medicine and Epidemiology, Director of Center for Primary Care and Prevention, Alpert Medical School of Brown University; M.B. Roberts, MSc, Statistical Programmer, Center for Primary Care and Prevention, Alpert Medical School of Brown University; I.K. Haugen, MD, PhD, Rheumatology Fellow, Department of Rheumatology, Diakonhjemmet Hospital; S.E. Smith, MD, Section Head and Weissman Distinguished Chair of Musculoskeletal Radiology, Associate Radiology Residency Program Director, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; J. Duryea, PhD, Associate Research Associate, Associate Professor of Radiology, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; B. Lu, DrPH, MD, Assistant Professor of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School; J.B. Driban, PhD, ATC, CSCS, Associate Professor, Division of Rheumatology, Tufts Medical Center
| | - Mary B Roberts
- From the Division of Rheumatology, Tufts Medical Center; Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, Rhode Island, USA; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.,J.E. Davis, BS, Research Assistant II, Division of Rheumatology, Tufts Medical Center; L.F. Schaefer, MD, Radiology Fellow, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; T.E. McAlindon, MD, MPH, Chief of Rheumatology, Division of Rheumatology, Tufts Medical Center; C.B. Eaton, MD, MS, Professor of Family Medicine and Epidemiology, Director of Center for Primary Care and Prevention, Alpert Medical School of Brown University; M.B. Roberts, MSc, Statistical Programmer, Center for Primary Care and Prevention, Alpert Medical School of Brown University; I.K. Haugen, MD, PhD, Rheumatology Fellow, Department of Rheumatology, Diakonhjemmet Hospital; S.E. Smith, MD, Section Head and Weissman Distinguished Chair of Musculoskeletal Radiology, Associate Radiology Residency Program Director, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; J. Duryea, PhD, Associate Research Associate, Associate Professor of Radiology, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; B. Lu, DrPH, MD, Assistant Professor of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School; J.B. Driban, PhD, ATC, CSCS, Associate Professor, Division of Rheumatology, Tufts Medical Center
| | - Ida K Haugen
- From the Division of Rheumatology, Tufts Medical Center; Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, Rhode Island, USA; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.,J.E. Davis, BS, Research Assistant II, Division of Rheumatology, Tufts Medical Center; L.F. Schaefer, MD, Radiology Fellow, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; T.E. McAlindon, MD, MPH, Chief of Rheumatology, Division of Rheumatology, Tufts Medical Center; C.B. Eaton, MD, MS, Professor of Family Medicine and Epidemiology, Director of Center for Primary Care and Prevention, Alpert Medical School of Brown University; M.B. Roberts, MSc, Statistical Programmer, Center for Primary Care and Prevention, Alpert Medical School of Brown University; I.K. Haugen, MD, PhD, Rheumatology Fellow, Department of Rheumatology, Diakonhjemmet Hospital; S.E. Smith, MD, Section Head and Weissman Distinguished Chair of Musculoskeletal Radiology, Associate Radiology Residency Program Director, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; J. Duryea, PhD, Associate Research Associate, Associate Professor of Radiology, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; B. Lu, DrPH, MD, Assistant Professor of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School; J.B. Driban, PhD, ATC, CSCS, Associate Professor, Division of Rheumatology, Tufts Medical Center
| | - Stacy E Smith
- From the Division of Rheumatology, Tufts Medical Center; Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, Rhode Island, USA; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.,J.E. Davis, BS, Research Assistant II, Division of Rheumatology, Tufts Medical Center; L.F. Schaefer, MD, Radiology Fellow, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; T.E. McAlindon, MD, MPH, Chief of Rheumatology, Division of Rheumatology, Tufts Medical Center; C.B. Eaton, MD, MS, Professor of Family Medicine and Epidemiology, Director of Center for Primary Care and Prevention, Alpert Medical School of Brown University; M.B. Roberts, MSc, Statistical Programmer, Center for Primary Care and Prevention, Alpert Medical School of Brown University; I.K. Haugen, MD, PhD, Rheumatology Fellow, Department of Rheumatology, Diakonhjemmet Hospital; S.E. Smith, MD, Section Head and Weissman Distinguished Chair of Musculoskeletal Radiology, Associate Radiology Residency Program Director, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; J. Duryea, PhD, Associate Research Associate, Associate Professor of Radiology, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; B. Lu, DrPH, MD, Assistant Professor of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School; J.B. Driban, PhD, ATC, CSCS, Associate Professor, Division of Rheumatology, Tufts Medical Center
| | - Jeffrey Duryea
- From the Division of Rheumatology, Tufts Medical Center; Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, Rhode Island, USA; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.,J.E. Davis, BS, Research Assistant II, Division of Rheumatology, Tufts Medical Center; L.F. Schaefer, MD, Radiology Fellow, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; T.E. McAlindon, MD, MPH, Chief of Rheumatology, Division of Rheumatology, Tufts Medical Center; C.B. Eaton, MD, MS, Professor of Family Medicine and Epidemiology, Director of Center for Primary Care and Prevention, Alpert Medical School of Brown University; M.B. Roberts, MSc, Statistical Programmer, Center for Primary Care and Prevention, Alpert Medical School of Brown University; I.K. Haugen, MD, PhD, Rheumatology Fellow, Department of Rheumatology, Diakonhjemmet Hospital; S.E. Smith, MD, Section Head and Weissman Distinguished Chair of Musculoskeletal Radiology, Associate Radiology Residency Program Director, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; J. Duryea, PhD, Associate Research Associate, Associate Professor of Radiology, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; B. Lu, DrPH, MD, Assistant Professor of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School; J.B. Driban, PhD, ATC, CSCS, Associate Professor, Division of Rheumatology, Tufts Medical Center
| | - Bing Lu
- From the Division of Rheumatology, Tufts Medical Center; Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, Rhode Island, USA; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.,J.E. Davis, BS, Research Assistant II, Division of Rheumatology, Tufts Medical Center; L.F. Schaefer, MD, Radiology Fellow, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; T.E. McAlindon, MD, MPH, Chief of Rheumatology, Division of Rheumatology, Tufts Medical Center; C.B. Eaton, MD, MS, Professor of Family Medicine and Epidemiology, Director of Center for Primary Care and Prevention, Alpert Medical School of Brown University; M.B. Roberts, MSc, Statistical Programmer, Center for Primary Care and Prevention, Alpert Medical School of Brown University; I.K. Haugen, MD, PhD, Rheumatology Fellow, Department of Rheumatology, Diakonhjemmet Hospital; S.E. Smith, MD, Section Head and Weissman Distinguished Chair of Musculoskeletal Radiology, Associate Radiology Residency Program Director, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; J. Duryea, PhD, Associate Research Associate, Associate Professor of Radiology, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; B. Lu, DrPH, MD, Assistant Professor of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School; J.B. Driban, PhD, ATC, CSCS, Associate Professor, Division of Rheumatology, Tufts Medical Center
| | - Jeffrey B Driban
- From the Division of Rheumatology, Tufts Medical Center; Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, Rhode Island, USA; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. .,J.E. Davis, BS, Research Assistant II, Division of Rheumatology, Tufts Medical Center; L.F. Schaefer, MD, Radiology Fellow, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; T.E. McAlindon, MD, MPH, Chief of Rheumatology, Division of Rheumatology, Tufts Medical Center; C.B. Eaton, MD, MS, Professor of Family Medicine and Epidemiology, Director of Center for Primary Care and Prevention, Alpert Medical School of Brown University; M.B. Roberts, MSc, Statistical Programmer, Center for Primary Care and Prevention, Alpert Medical School of Brown University; I.K. Haugen, MD, PhD, Rheumatology Fellow, Department of Rheumatology, Diakonhjemmet Hospital; S.E. Smith, MD, Section Head and Weissman Distinguished Chair of Musculoskeletal Radiology, Associate Radiology Residency Program Director, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; J. Duryea, PhD, Associate Research Associate, Associate Professor of Radiology, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School; B. Lu, DrPH, MD, Assistant Professor of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School; J.B. Driban, PhD, ATC, CSCS, Associate Professor, Division of Rheumatology, Tufts Medical Center.
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[Shaoyangzhugu Formula regulates p19 Arf-p53-p21 Cip1 signaling pathway to ameliorate cartilage degeneration in aged cynomolgus monkeys with knee osteoarthritis]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2018; 38. [PMID: 29643043 PMCID: PMC6744164 DOI: 10.3969/j.issn.1673-4254.2018.03.17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To study the effect of Shaoyangzhugu (SYZG) Formula (a formula consisting of 9 traditional Chinese drugs) in delaying the degeneration of articular cartilage and the role p19Arf-p53-p21Cip1 signaling pathway in mediating this effect. METHOD Thirteen aged cynomolgus monkeys with degenerative knee joints were selected based on X-ray findings, and one of them was randomly selected for pathological observation. The other monkeys were randomized equally into SYZG Formula group (treated with SYZG decoction), ammonia moxime group and saline group. All the monkeys were sacrificed after 8 weeks of treatment with intragastric administration of the drugs or saline. The pathology in the knee joint articular cartilage was observed and the mRNA and protein expressions of p19Arf, p53, and p21Cip1 in the articular cartilage were detected using RT-qPCR and Western blotting. RESULTS The pathological findings of the articular cartilage in old cynomolgus monkeys were consistent with the characteristics of knee osteoarthritis (KOA). Mankin scores of the cynomolgus monkeys were 7.38∓0.52 in SYZG Formula group, 7.88∓0.83 in ammonia moxime group, and 8.38∓0.74 in saline group, showing a significant difference between SYZG Formula group and saline group (P<0.05). The expressions of p19Arf, p53, and p21Cip1 were the lowest in SYZG Formula group and the highest in saline group with significant differences among the 3 groups (P<0.05). CONCLUSION SYZG Formula can delay chondrocyte senescence by regulating p19Arf-p53-p21Cip1 signaling pathway to delay articular cartilage degeneration in aged cynomolgus monkeys.
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周 鑫, 张 磊, 扶 世, 刘 刚, 郭 晓, 易 刚, 刘 洋, 汪 国. [Shaoyangzhugu Formula regulates p19 Arf-p53-p21 Cip1 signaling pathway to ameliorate cartilage degeneration in aged cynomolgus monkeys with knee osteoarthritis]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2018; 38:346-352. [PMID: 29643043 PMCID: PMC6744164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Indexed: 11/05/2023]
Abstract
OBJECTIVE To study the effect of Shaoyangzhugu (SYZG) Formula (a formula consisting of 9 traditional Chinese drugs) in delaying the degeneration of articular cartilage and the role p19Arf-p53-p21Cip1 signaling pathway in mediating this effect. METHOD Thirteen aged cynomolgus monkeys with degenerative knee joints were selected based on X-ray findings, and one of them was randomly selected for pathological observation. The other monkeys were randomized equally into SYZG Formula group (treated with SYZG decoction), ammonia moxime group and saline group. All the monkeys were sacrificed after 8 weeks of treatment with intragastric administration of the drugs or saline. The pathology in the knee joint articular cartilage was observed and the mRNA and protein expressions of p19Arf, p53, and p21Cip1 in the articular cartilage were detected using RT-qPCR and Western blotting. RESULTS The pathological findings of the articular cartilage in old cynomolgus monkeys were consistent with the characteristics of knee osteoarthritis (KOA). Mankin scores of the cynomolgus monkeys were 7.38∓0.52 in SYZG Formula group, 7.88∓0.83 in ammonia moxime group, and 8.38∓0.74 in saline group, showing a significant difference between SYZG Formula group and saline group (P<0.05). The expressions of p19Arf, p53, and p21Cip1 were the lowest in SYZG Formula group and the highest in saline group with significant differences among the 3 groups (P<0.05). CONCLUSION SYZG Formula can delay chondrocyte senescence by regulating p19Arf-p53-p21Cip1 signaling pathway to delay articular cartilage degeneration in aged cynomolgus monkeys.
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Affiliation(s)
- 鑫 周
- 西南医科大学附属中医医院骨科,四川 泸州 646000Department of Orthopedics, Traditional Chinese Medicine Hospital Affiliated to Southwest Medical University, Luzhou 646000, China
- 泸州市院士工作站,四川 泸州 646000Academician Workstation in Luzhou, Luzhou 646000, China
| | - 磊 张
- 西南医科大学附属中医医院骨科,四川 泸州 646000Department of Orthopedics, Traditional Chinese Medicine Hospital Affiliated to Southwest Medical University, Luzhou 646000, China
- 泸州市院士工作站,四川 泸州 646000Academician Workstation in Luzhou, Luzhou 646000, China
- 南方医科大学 中医药学院,广东 广州 510515School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, China
| | - 世杰 扶
- 西南医科大学附属中医医院骨科,四川 泸州 646000Department of Orthopedics, Traditional Chinese Medicine Hospital Affiliated to Southwest Medical University, Luzhou 646000, China
- 泸州市院士工作站,四川 泸州 646000Academician Workstation in Luzhou, Luzhou 646000, China
| | - 刚 刘
- 西南医科大学附属中医医院骨科,四川 泸州 646000Department of Orthopedics, Traditional Chinese Medicine Hospital Affiliated to Southwest Medical University, Luzhou 646000, China
- 泸州市院士工作站,四川 泸州 646000Academician Workstation in Luzhou, Luzhou 646000, China
| | - 晓光 郭
- 西南医科大学附属中医医院骨科,四川 泸州 646000Department of Orthopedics, Traditional Chinese Medicine Hospital Affiliated to Southwest Medical University, Luzhou 646000, China
- 泸州市院士工作站,四川 泸州 646000Academician Workstation in Luzhou, Luzhou 646000, China
| | - 刚 易
- 西南医科大学附属中医医院骨科,四川 泸州 646000Department of Orthopedics, Traditional Chinese Medicine Hospital Affiliated to Southwest Medical University, Luzhou 646000, China
- 泸州市院士工作站,四川 泸州 646000Academician Workstation in Luzhou, Luzhou 646000, China
| | - 洋 刘
- 西南医科大学附属中医医院骨科,四川 泸州 646000Department of Orthopedics, Traditional Chinese Medicine Hospital Affiliated to Southwest Medical University, Luzhou 646000, China
- 泸州市院士工作站,四川 泸州 646000Academician Workstation in Luzhou, Luzhou 646000, China
| | - 国友 汪
- 西南医科大学附属中医医院骨科,四川 泸州 646000Department of Orthopedics, Traditional Chinese Medicine Hospital Affiliated to Southwest Medical University, Luzhou 646000, China
- 泸州市院士工作站,四川 泸州 646000Academician Workstation in Luzhou, Luzhou 646000, China
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Driban JB, McAlindon TE, Amin M, Price LL, Eaton CB, Davis JE, Lu B, Lo GH, Duryea J, Barbe MF. Risk factors can classify individuals who develop accelerated knee osteoarthritis: Data from the osteoarthritis initiative. J Orthop Res 2018; 36:876-880. [PMID: 28776751 PMCID: PMC5797506 DOI: 10.1002/jor.23675] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 08/01/2017] [Indexed: 02/04/2023]
Abstract
We assessed which combinations of risk factors can classify adults who develop accelerated knee osteoarthritis (KOA) or not and which factors are most important. We conducted a case-control study using data from baseline and the first four annual visits of the Osteoarthritis Initiative. Participants had no radiographic KOA at baseline (Kellgren-Lawrence [KL]<2). We classified three groups (matched on sex): (i) accelerated KOA: >1 knee developed advance-stage KOA (KL = 3 or 4) within 48 months; (ii) typical KOA: >1 knee increased in radiographic scoring (excluding those with accelerated KOA); and (iii) No KOA: no change in KL grade by 48 months. We selected eight predictors: Serum concentrations for C-reactive protein, glycated serum protein (GSP), and glucose; age; sex; body mass index; coronal tibial slope, and femorotibial alignment. We performed a classification and regression tree (CART) analysis to determine rules for classifying individuals as accelerated KOA or not (no KOA and typical KOA). The most important baseline variables for classifying individuals with incident accelerated KOA (in order of importance) were age, glucose concentrations, BMI, and static alignment. Individuals <63.5 years were likely not to develop accelerated KOA, except when overweight. Individuals >63.5 years were more likely to develop accelerated KOA except when their glucose levels were >81.98 mg/dl and they did not have varus malalignment. The unexplained variance of the CART = 69%. These analyses highlight the complex interactions among four risk factors that may classify individuals who will develop accelerated KOA but more research is needed to uncover novel risk factors. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:876-880, 2018.
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Affiliation(s)
| | | | - Mamta Amin
- Department of Anatomy and Cell Biology, Temple University School of Medicine, Philadelphia, PA, USA
| | - Lori Lyn Price
- The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA,Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA
| | - Charles B. Eaton
- Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, RI, USA
| | - Julie E. Davis
- Division of Rheumatology, Tufts Medical Center, Boston, MA, USA
| | - Bing Lu
- Division of Rheumatology, Immunology & Allergy, Brigham & Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Grace H. Lo
- Medical Care Line and Research Care Line, Houston Health Services Research and Development (HSR&D) Center of Excellence Michael E. DeBakey VAMC, Houston, TX, USA,Section of Immunology, Allergy, and Rheumatology, Baylor College of Medicine, Houston, TX, USA
| | - Jeffrey Duryea
- Department of Radiology, Brigham & Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Mary F. Barbe
- Department of Anatomy and Cell Biology, Temple University School of Medicine, Philadelphia, PA, USA
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Davis JE, Harkey MS, Ward RJ, Mackay JW, Lu B, Price LL, Eaton CB, Barbe MF, Lo GH, McAlindon TE, Driban JB. Characterizing the distinct structural changes associated with self-reported knee injury among individuals with incident knee osteoarthritis: Data from the osteoarthritis initiative. Clin Anat 2018; 31:330-334. [PMID: 29380495 DOI: 10.1002/ca.23054] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 01/25/2018] [Accepted: 01/26/2018] [Indexed: 11/09/2022]
Abstract
We aimed to characterize the agreement between distinct structural changes on magnetic resonance (MR) imaging and self-reported injury in the 12 months leading to incident common or accelerated knee osteoarthritis (KOA). We conducted a descriptive study using data from baseline and the first 4 annual visits of the Osteoarthritis Initiative. Knees had no radiographic KOA at baseline (Kellgren-Lawrence [KL]<2). We classified two groups: (1) accelerated KOA: a knee developed advanced-stage KOA (KL = 3 or 4) within 48 months and (2) common KOA: a knee increased in radiographic severity (excluding those with accelerated KOA). Adults were 1:1 matched based on sex. The index visit was when a person met the accelerated or common KOA criteria. We limited our sample to people with MR images and self-reported injury data at index visit and year prior. Among 226 people, we found fair agreement between self-reported injuries and distinct structural changes (kappa = 0.24 to 0.31). Most distinct structural changes were medial meniscal pathology. No distinct structural changes (e.g., root or radial tears) appeared to differ between adults who reported or did not report an injury; except, all subchondral fractures occurred in adults who developed accelerated KOA and reported an injury. While there is fair agreement between self-reported knee injuries and distinct structural changes, there is some discordance. Self-reported injury may represent a different construct from distinct structural changes that occur after joint trauma. Clin. Anat. 31:330-334, 2018. © 2018 Wiley Periodicals, Inc.
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Affiliation(s)
- Julie E Davis
- Division of Rheumatology, Tufts Medical Center, 800 Washington Street, Boston, Massachusetts, 02111
| | - Matthew S Harkey
- Division of Rheumatology, Tufts Medical Center, 800 Washington Street, Boston, Massachusetts, 02111
| | - Robert J Ward
- Department of Radiology, Tufts Medical Center, 800 Washington Street, Boson, Massachusetts, 02111
| | - James W Mackay
- Department of Radiology, University of Cambridge School of Clinical Medicine, Level 5, Addenbrooke's Hospital, Cambridge, CB2 0QQ, United Kingdom
| | - Bing Lu
- Brigham & Women's Hospital and Harvard Medical School, Boston, Massachusetts, 02115
| | - Lori Lyn Price
- The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Tufts Clinical and Translational Science Institute, Tufts University, Boston, Massachusetts, 02111
| | - Charles B Eaton
- Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, Rhode Island, 02860
| | - Mary F Barbe
- Department of Anatomy and Cell Biology, Temple University School of Medicine, Philadelphia, Pennsylvania, 19140
| | - Grace H Lo
- Medical Care Line and Research Care Line, Houston Health Services Research and Development (HSR&D) Center of Excellence Michael E. DeBakey VAMC, Houston, Texas 77030.,Section of Immunology, Allergy, and Rheumatology, Baylor College of Medicine, Houston, BCM-285, Houston, Texas, 77030
| | - Timothy E McAlindon
- Division of Rheumatology, Tufts Medical Center, 800 Washington Street, Boston, Massachusetts, 02111
| | - Jeffrey B Driban
- Division of Rheumatology, Tufts Medical Center, 800 Washington Street, Boston, Massachusetts, 02111
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Davis JE, Liu SH, Lapane K, Harkey MS, Price LL, Lu B, Lo GH, Eaton CB, Barbe MF, McAlindon TE, Driban JB. Adults with incident accelerated knee osteoarthritis are more likely to receive a knee replacement: data from the Osteoarthritis Initiative. Clin Rheumatol 2018; 37:1115-1118. [PMID: 29423719 DOI: 10.1007/s10067-018-4025-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 01/25/2018] [Accepted: 02/01/2018] [Indexed: 12/01/2022]
Abstract
We aimed to determine if knees with incident accelerated knee osteoarthritis (AKOA) were more likely to receive a knee replacement (KR) than those with common knee osteoarthritis (KOA) or no KOA. We conducted a nested cohort study using data from baseline and the first 9 years of the Osteoarthritis Initiative (OAI). Eligible knees had no radiographic KOA at baseline (Kellgren-Lawrence [KL] < 2). We classified 3 groups using KL grades from the first 8 years of the OAI: 1) AKOA: knee progressed to advance-stage KOA (KL 3/4) in ≤ 4 years, 2) common KOA: knee increased in KL grade (excluding AKOA), and 3) No KOA: no change in KL grade by 8 years. The outcome was a KR (partial or total) at or before the 9-year OAI visit. We conducted a logistic regression with generalized linear mixed model and adjusted for age, body mass index, and sex. Overall, 14% of knees with AKOA received a KR by the 9th year compared with 1% and < 1% of those with common or no KOA, respectively. Knees that developed AKOA were > 80x and ~ 25x more likely to receive a KR than knees with no KOA or incident common KOA (adjusted odds ratio = 25.08; 95% confidence interval = 9.63-65.34). In conclusion, approximately 1 in 7 knees that develop AKOA received a KR; however, KRs were rare in the OAI among other knees with no radiographic KOA at baseline. Urgent steps are needed to identify adults at high-risk for AKOA and develop prevention strategies regarding the modifiable risk factors.
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Affiliation(s)
- Julie E Davis
- Division of Rheumatology, Tufts Medical Center, 800 Washington Street, Box #406, Boston, MA, 02111, USA
| | - Shao-Hsien Liu
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Avenue North, AC7-073, Worcester, MA, 01655, USA
| | - Kate Lapane
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Avenue North, AC7-073, Worcester, MA, 01655, USA
| | - Matthew S Harkey
- Division of Rheumatology, Tufts Medical Center, 800 Washington Street, Box #406, Boston, MA, 02111, USA
| | - Lori Lyn Price
- The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, 800 Washington Street, Box #63, Boston, MA, 02111, USA.,Tufts Clinical and Translational Science Institute, Tufts University, 800 Washington Street, Box #63, Boston, MA, 02111, USA
| | - Bing Lu
- Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street PBB-B3, Boston, MA, 02115, USA
| | - Grace H Lo
- Medical Care Line and Research Care Line, Houston Health Services Research and Development (HSR&D) Center of Excellence Michael E. DeBakey VAMC, Houston, TX, USA.,Section of Immunology, Allergy, and Rheumatology, Baylor College of Medicine, 1 Baylor Plaza, BCM-285, Houston, TX, 77030, USA
| | - Charles B Eaton
- Center for Primary Care and Prevention, Alpert Medical School of Brown University, 111 Brewster Street, Pawtucket, RI, 02860, USA
| | - Mary F Barbe
- Department of Anatomy and Cell Biology, Temple University School of Medicine, 3500 North Broad Street, Philadelphia, PA, 19140, USA
| | - Timothy E McAlindon
- Division of Rheumatology, Tufts Medical Center, 800 Washington Street, Box #406, Boston, MA, 02111, USA
| | - Jeffrey B Driban
- Division of Rheumatology, Tufts Medical Center, 800 Washington Street, Box #406, Boston, MA, 02111, USA.
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A single recent injury is a potent risk factor for the development of accelerated knee osteoarthritis: data from the osteoarthritis initiative. Rheumatol Int 2017; 37:1759-1764. [PMID: 28831543 DOI: 10.1007/s00296-017-3802-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 08/17/2017] [Indexed: 01/29/2023]
Abstract
We examined the association between previously reported modifiable risk factors for accelerated knee osteoarthritis (AKOA) at the Osteoarthritis Initiative's (OAI) baseline and 48-month visits among adults who develop AKOA between the 48- and 96-month visits. We conducted a case-control study using data from the OAI baseline to the 96-month visit. Participants had no radiographic knee osteoarthritis (KOA) in the index knee at OAI baseline and 48-month visits [Kellgren-Lawrence (KL) <2]. We classified 2 groups: (1) AKOA: >1 knee developed advance-stage KOA (KL = 3 or 4) between 48- and 96-month visits and (2) No KOA: no KOA and no change in radiographic severity bilaterally over 96 months. We used logistic regression models to evaluate the association between the outcome of AKOA (versus no KOA) and several modifiable risk factors collected at OAI baseline and 48-month visits [body mass index (BMI), systolic blood pressure, comorbidity score, and NSAID use]. We also explored a new injury from baseline to 48 months and from 48- to 96 months. Adults with greater baseline and 48-month BMI were more likely to develop AKOA. Injury was only associated with AKOA onset when it occurred within 4 years of developing AKOA [prior 2 years: odds ratio = 6.21; 95% confidence interval (CI) 3.40, 11.35; 2-4 years prior: odds ratio = 4.42, 95% CI 2.06, 9.50]. BMI may consistently predispose an adult to AKOA, but certain injuries are likely a catalyst for AKOA.
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