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Prakash R, Gardner JE, Petric UB, Pathak R, Atem F, Jain NB. Association of Age and Sex at Onset With Glenohumeral Osteoarthritis: A Systematic Review and Meta-analysis. Am J Phys Med Rehabil 2024; 103:611-616. [PMID: 38207175 PMCID: PMC11178476 DOI: 10.1097/phm.0000000000002419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
OBJECTIVE The aim of the present systematic review is to synthesize existing evidence (qualitative and quantitative) regarding age- and sex-specific differences with glenohumeral osteoarthritis. DESIGN The electronic databases PubMed, MEDLINE, and Web of Science were searched up to March 15, 2023. Articles reporting on the association of risk factors (age and sex) with glenohumeral osteoarthritis were considered. We used Newcastle-Ottawa Scale to assess study quality. Meta-analysis was conducted to quantitatively summarize the association of age and sex with glenohumeral osteoarthritis. RESULTS A total of 24 articles were retrieved for full-text review. Of 24 articles, 8 reporting age-specific and 5 articles reporting sex-specific associations with glenohumeral osteoarthritis were included. The odds ratio for the age (odds ratio = 3.18; 95% confidence interval = 1.10-15.92) and female sex (odds ratio = 1.78; 95% confidence interval = 0.95-3.42) were increased and observed statistically significant. CONCLUSIONS The present systematic review and meta-analysis suggests the role of increasing age as one of the significant contributors to glenohumeral osteoarthritis. However, association of female sex with glenohumeral osteoarthritis is least convincing. Future studies are required to understand the molecular mechanisms behind the contributory role of increasing age and female sex in the establishment of glenohumeral osteoarthritis.
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Affiliation(s)
- Ravi Prakash
- From the Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, Texas (RPr, RPa); Department of Physical Medicine and Rehabilitation, Emory University School of Medicine, Atlanta, Georgia (JEG); University of Texas Southwestern Medical School, Dallas, Texas (UBP); Department of Biostatistics and Data Science, University of Texas Health Science Center, Houston, Texas (FA); and Department of Physical Medicine and Rehabilitation, Orthopedics, and Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas (NBJ)
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Teng M, Wang J, Su X, Hu J, Tian Y, Zhang Y, Li M. Associations between immune cells signatures and osteoarthritis: An integrated analysis of bidirectional Mendelian randomization and Bayesian colocalization. Cytokine 2024; 179:156633. [PMID: 38733947 DOI: 10.1016/j.cyto.2024.156633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 04/23/2024] [Accepted: 04/28/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND Previous investigations have explored the associations between immune cell signatures and osteoarthritis (OA); however, causality remains unclear. This study employs an integrated analysis, combining bidirectional Mendelian randomization (MR) and Bayesian colocalization (Coloc), to investigate causal relationships between 731 immune cells signatures and OA, identifying shared causal variants. METHODS Utilizing publicly available summary data, this study primarily employs inverse variance weighting (IVW). Supplementary methods include MR-Egger regression, weighted median, weight mode, and simple mode. Various sensitivity tests, including Cochran's Q test, MR pleiotropy Residual Sum and Outlier, and leave-one-out tests, were conducted to assess the robustness of the analysis results. Coloc was employed to identify shared causal genetic variants among potential associations. RESULTS IVW analysis revealed 196 immune cell signatures potentially linked to OA across diverse subtypes. Reverse MR analyses indicated the causal impact of OA on the levels of 140 immune cell signatures, with subtype-specific variations. Notably, several specific associations, including CD64 on CD14-CD16 + monocyte for Hip OA (OR = 1.0593, 95 % CI: 1.0260-1.0938, P = 0.0004), HLA-DR on CD14 + CD16- monocyte (OR = 0.9664, 95 % CI: 0.9497-0.9834, P = 0.0001), HLA-DR on CD14 + monocyte (OR = 0.9680, 95 % CI: 0.9509-0.9853, P = 0.0003) in the Knee or Hip OA, PDL-1 on CD14-CD16 + monocyte by All OA (OR = 1.7091, 95 %CI:1.2494-2.3378, P = 0.0008), and herpesvirus entry mediator on effector memory CD4 + T cell by Spine OA (OR = 0.5200, 95 %CI:0.3577-0.7561, P = 0.0006) remained significant post-Bonferroni correction. Sensitivity tests validated the credibility of the IVW analysis. Additionally, Coloc revealed several potential associations among shared genetic variants, including rs115328872, rs1800973, and rs317667. CONCLUSIONS Our findings provide evidence for the potential involvement of immune cell signatures in OA development, revealing avenues for early prevention and innovative therapeutic strategies.
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Affiliation(s)
- Menghao Teng
- Department of Orthopedics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jiachen Wang
- Department of Joint Surgery, HongHui Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Xiaochen Su
- Department of Orthopedics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jiale Hu
- Department of Implant Dentistry, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Ye Tian
- Healthy Food Evaluation Research Center, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yingang Zhang
- Department of Orthopedics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
| | - Meng Li
- Department of Orthopedics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
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Wu R, Peng Q, Wang W, Zheng J, Zhou Y, Yang Q, Zhang X, Li H, Meng L. Systematic review and network meta-analysis on the efficacy and safety of parmacotherapy for hand osteoarthritis. PLoS One 2024; 19:e0298774. [PMID: 38722915 PMCID: PMC11081354 DOI: 10.1371/journal.pone.0298774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 01/31/2024] [Indexed: 05/13/2024] Open
Abstract
OBJECTIVE Hand osteoarthritis poses a significant health challenge globally due to its increasing prevalence and the substantial burden on individuals and the society. In current clinical practice, treatment options for hand osteoarthritis encompass a range of approaches, including biological agents, antimetabolic drugs, neuromuscular blockers, anti-inflammatory drugs, hormone medications, pain relievers, new synergistic drugs, and other medications. Despite the diverse array of treatments, determining the optimal regimen remains elusive. This study seeks to conduct a network meta-analysis to assess the effectiveness and safety of various drug intervention measures in the treatment of hand osteoarthritis. The findings aim to provide evidence-based support for the clinical management of hand osteoarthritis. METHODS We performed a comprehensive search across PubMed, Embase, Web of Science, and Cochrane Central Register of Controlled Trials was conducted until September 15th, 2022, to identify relevant randomized controlled trials. After meticulous screening and data extraction, the Cochrane Handbook's risk of bias assessment tool was applied to evaluate study quality. Data synthesis was carried out using Stata 15.1 software. RESULTS 21 studies with data for 3965 patients were meta-analyzed, involving 20 distinct Western medicine agents. GCSB-5, a specific herbal complex that mainly regulate pain in hand osteoarthritis, showed the greatest reduction in pain [WMD = -13.00, 95% CI (-26.69, 0.69)]. CRx-102, s specific medication characterized by its significant effect for relieving joint stiffness symptoms, remarkably mitigated stiffness [WMD = -7.50, 95% CI (-8.90, -6.10)]. Chondroitin sulfate displayed the highest incidence of adverse events [RR = 0.26, 95% CI (0.06, 1.22)]. No substantial variation in functional index for hand osteoarthritis score improvement was identified between distinct agents and placebo. CONCLUSIONS In summary, GCSB-5 and CRx-102 exhibit efficacy in alleviating pain and stiffness in HOA, respectively. However, cautious interpretation of the results is advised. Tailored treatment decisions based on individual contexts are imperative.
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Affiliation(s)
- Ruiqi Wu
- Guangxi University of Chinese Medicine, Nanning, 530000, Guangxi Zhuang Autonomous Region, China
| | - Qinglin Peng
- Guangxi University of Chinese Medicine, Nanning, 530000, Guangxi Zhuang Autonomous Region, China
| | - Weiwei Wang
- Guangxi University of Chinese Medicine, Nanning, 530000, Guangxi Zhuang Autonomous Region, China
| | - Jixian Zheng
- Hainan Medical University, Haikou, 570100, Hainan, China
| | - Yi Zhou
- Guangxi University of Chinese Medicine, Nanning, 530000, Guangxi Zhuang Autonomous Region, China
| | - Qipei Yang
- Guangxi University of Chinese Medicine, Nanning, 530000, Guangxi Zhuang Autonomous Region, China
| | - Xuan Zhang
- Guangxi University of Chinese Medicine, Nanning, 530000, Guangxi Zhuang Autonomous Region, China
| | - Hongyu Li
- Guangxi Orthopedic Hospital, Nanning, 530000, Guangxi Zhuang Autonomous Region, China
| | - Lin Meng
- Guangxi Orthopedic Hospital, Nanning, 530000, Guangxi Zhuang Autonomous Region, China
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Crane C, Wagner C, Wong S, Hall B, Hull J, Irwin K, Williams K, Brooks A. Glenohumeral Osteoarthritis: A Biological Advantage or a Missed Diagnosis? J Clin Med 2024; 13:2341. [PMID: 38673614 PMCID: PMC11051042 DOI: 10.3390/jcm13082341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/29/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
(1) Background: Osteoarthritis is a degenerative joint disease that is commonly diagnosed in the aging population. Interestingly, the lower extremity joints have a higher published incidence of osteoarthritis than the upper extremity joints. Although much is known about the disease process, it remains unclear why some joints are more affected than others. (2) Methods: A comprehensive literature review was conducted utilizing the search engines PubMed, Google Scholar, and Elsevier from 2014 to 2024, directing our search to osteoarthritis of various joints, with the focus being on glenohumeral osteoarthritis. (3) Results and Discussion: The literature review revealed a publication difference, which may be explained by the inconsistency in classification systems utilized in the diagnosis of shoulder osteoarthritis. For instance, there are six classification systems employed in the diagnosis of glenohumeral osteoarthritis, making the true incidence and, therefore, the prevalence unobtainable. Furthermore, susceptibility to osteoarthritis in various joints is complicated by factors such as joint anatomy, weight-bearing status, and prior injuries to the joint. (4) Conclusions: This review reveals the lack of understanding of shoulder osteoarthritis's true incidence and prevalence while considering the anatomy and biomechanics of the glenohumeral joint. In addition, this is the first paper to suggest a single criterion for the diagnosis of glenohumeral osteoarthritis.
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Affiliation(s)
- Camille Crane
- Colorado Campus, Rocky Vista University College of Osteopathic Medicine, 8401 South Chambers Road, Greenwood Village, CO 80112, USA; (B.H.); (K.I.)
| | - Caleb Wagner
- Utah Campus, Rocky Vista University College of Osteopathic Medicine, 855 East Center Street, Ivins, UT 84738, USA; (C.W.); (S.W.); (J.H.); (A.B.)
| | - Stephen Wong
- Utah Campus, Rocky Vista University College of Osteopathic Medicine, 855 East Center Street, Ivins, UT 84738, USA; (C.W.); (S.W.); (J.H.); (A.B.)
| | - Bryce Hall
- Colorado Campus, Rocky Vista University College of Osteopathic Medicine, 8401 South Chambers Road, Greenwood Village, CO 80112, USA; (B.H.); (K.I.)
| | - Jillian Hull
- Utah Campus, Rocky Vista University College of Osteopathic Medicine, 855 East Center Street, Ivins, UT 84738, USA; (C.W.); (S.W.); (J.H.); (A.B.)
| | - Katharine Irwin
- Colorado Campus, Rocky Vista University College of Osteopathic Medicine, 8401 South Chambers Road, Greenwood Village, CO 80112, USA; (B.H.); (K.I.)
| | - Kaitlin Williams
- Colorado Campus, Rocky Vista University College of Osteopathic Medicine, 8401 South Chambers Road, Greenwood Village, CO 80112, USA; (B.H.); (K.I.)
| | - Amanda Brooks
- Utah Campus, Rocky Vista University College of Osteopathic Medicine, 855 East Center Street, Ivins, UT 84738, USA; (C.W.); (S.W.); (J.H.); (A.B.)
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Živković SA, Lacomis D, Soman P. Neuromuscular manifestations of wild type transthyretin amyloidosis: a review and single center's experience. Front Cardiovasc Med 2024; 11:1345608. [PMID: 38410247 PMCID: PMC10894993 DOI: 10.3389/fcvm.2024.1345608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 02/02/2024] [Indexed: 02/28/2024] Open
Abstract
Transthyretin amyloidosis (ATTR) is a condition defined by accumulation of insoluble transthyretin amyloid deposits in multiple organs, especially in the peripheral nerve and heart muscle. ATTR may result from transthyretin mutations (variant ATTR or ATTRv) or may occur with normal transthyretin genotype (wild type ATTR or ATTRwt). ATTRwt was previously known as "senile amyloidosis" and causes cardiomyopathy which may lead to heart failure with a preserved ejection fraction, affecting predominantly elderly men. The exact prevalence of ATTRwt in the general population remains unclear, but its occurrence may be underestimated in women. It was observed that a proportion of ATTRwt cardiomyopathy patients may develop slowly progressing neuropathy that is milder and indolent in comparison with typical progressive neuropathy associated with ATTRv. Furthermore, the causality of neuropathy is often uncertain in patients with ATTRwt. Neuropathy symptoms, including distal sensory loss, unsteadiness and (neuropathic) pain are common in elderly patients with multiple potential causes, and as ATTRwt patients are typically older, relatively high prevalence of peripheral neuropathy is expected with frequent comorbidities. Relatively high prevalence of ATTRwt in elderly population contrasts few documented cases of neuropathy caused by ATTRwt, and there is uncertainty whether ATTRwt neuropathy is an infrequent occurrence or a significant manifestation of multisystemic ATTRwt. We review neurologic and musculoskeletal manifestations of ATTRwt and present clinical features of a single center cohort of ATTRwt patients with suspected peripheral neuropathy.
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Affiliation(s)
- Sasha A Živković
- Department of Neurology, Yale University, New Haven, CT, United States
- Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
- Cardiac Amyloidosis Center, UPMC Heart and Vascular Institute, Pittsburgh, PA, United States
| | - David Lacomis
- Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
- Department of Pathology (Neuropathology), University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Prem Soman
- Cardiac Amyloidosis Center, UPMC Heart and Vascular Institute, Pittsburgh, PA, United States
- Division of Cardiology, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
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Song S, Graham-Engeland JE, Kim J. Associations Between Psychological Stress and Hand Pain Among Rural and Urban Adults: Findings From the KoGES Community Cohort Study. THE JOURNAL OF PAIN 2024; 25:362-375. [PMID: 37659447 DOI: 10.1016/j.jpain.2023.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 08/17/2023] [Accepted: 08/28/2023] [Indexed: 09/04/2023]
Abstract
Despite known health disparities in chronic pain conditions between rural and urban adults, few studies have examined whether longitudinal associations between psychological stress and hand pain differ. Utilizing community-based cohort data, this study examined whether rural and urban adults differed in the extent to which psychological distress was associated with hand osteoarthritis (OA) symptoms and later functional limitations related to hand pain. Community-dwelling adults (mean age = 51.97, 52.3% women) in a rural (n = 2,971) and urban area (n = 2,782) provided demographic data at baseline and, at a 4-year follow-up, responded to questionnaires about psychological distress and clinical symptoms of hand OA. Levels of functional limitations in hands were assessed at an 8-year follow-up. Ordinal logistic and linear regression were conducted to examine the effects of psychological distress on hand OA symptoms and functional limitations, and whether associations between psychological distress and these pain outcomes were moderated by residential area. The results showed that psychological distress was associated with a higher risk for hand OA symptoms and functional limitations, even after adjusting for demographic and health covariates. There was significant moderation by residential area, such that the association between psychological distress and hand OA was significant only among rural adults and the association with functional limitations was stronger in rural adults than urban adults. Findings suggest greater vulnerability to hand arthritis and hand-related functional limitations among rural adults and the potential for tailored intervention programs to help resolve health disparities among rural communities. PERSPECTIVE: This study compares the association between psychological distress and hand pain outcomes between rural and urban adults using community-based cohort data and suggests that rural adults are more vulnerable to experiencing negative effects of psychological distress on concurrent hand OA symptoms and longitudinal functional limitations in hands.
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Affiliation(s)
- Sunmi Song
- Rehabilitation Science Program, Department of Health Science, Graduate School, Korea University, Seoul, South Korea; Department of Health and Environmental Science, College of Health Science, Korea University, Seoul, South Korea; Department of Physical Therapy, College of Health Science, Korea University, Seoul, South Korea
| | | | - Junesun Kim
- Rehabilitation Science Program, Department of Health Science, Graduate School, Korea University, Seoul, South Korea; Department of Health and Environmental Science, College of Health Science, Korea University, Seoul, South Korea; Department of Physical Therapy, College of Health Science, Korea University, Seoul, South Korea; BK21FOUR Program: Learning Health Systems, College of Health Science, Korea University, Seoul, South Korea
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Dai J, Jiang H, Cheng Z, Li Y, Yang Z, Cheng C, Tang X. Genetic polymorphism of WNT9A is functionally associated with thumb osteoarthritis in the Chinese population. Adv Rheumatol 2024; 64:12. [PMID: 38287451 DOI: 10.1186/s42358-023-00337-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 11/04/2023] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND In a recent genome-wide association study, novel genetic variations of WNT9A were reported to be involved in the etiopathogenesis of thumb osteoarthritis (TOA) in Caucasians. Our purposes were to replicate the association of WNT9A with the development of TOA in the Chinese population and to further unveil the functional role of the risk variants. METHODS SNP rs11588850 of WNT9A were genotyped in 953 TOA patients and 1124 healthy controls. The differences of genotype and allele distributions between the patients and healthy controls were evaluated using the Chi-square test. Luciferase Reporter Assay was performed to investigate the influence of variant on the gene expression. RESULTS There was significantly lower frequency of genotype AA in TOA patients than in the controls 74.9% vs. 81.9%, p < 0.001). The frequency of allele A was remarkably lower in the patients than in the controls (86.3% vs. 90.5%, p < 0.001), with an odds ratio of 0.66 (95% CI = 0.54-0.80). Luciferase Reporter Assay showed that the construct containing mutant allele G of rs11588850 displayed 29.1% higher enhancer activity than the wild allele A construct (p < 0.05). CONCLUSIONS Allele G of rs11588850 was associated with the increased risk of TOA possibly via up-regulation of WNT9A expression. Further functional analysis into the regulatory role of rs11588850 in WNT9A expression can shed new light on the genetic architecture of TOA.
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Affiliation(s)
- Jian Dai
- Department of Orthopedics Surgery, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu Province, China
| | - Haitao Jiang
- Department of Orthopedics Surgery, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu Province, China
| | - Zhang Cheng
- Department of Orthopedics Surgery, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu Province, China
| | - Yao Li
- Department of Orthopedics Surgery, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu Province, China
| | - Zhaoqi Yang
- Postgraduate in Orthopedics Surgery, Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Chuan Cheng
- Department of Orthopedics Surgery, Third People's Hospital of Jiujiang City, Jiujiang, Jiangxi Province, China.
| | - Xiaoming Tang
- Department of Orthopedics Surgery, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu Province, China.
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Zhang YF, Zhang LF, Zhang HY, Jiang W, Li GY, Zhang TP. Short-term exposure to gaseous pollutants is neglected factors for knee osteoarthritis: evidence from a humid subtropical region of China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:2920-2929. [PMID: 38079043 DOI: 10.1007/s11356-023-31374-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 12/01/2023] [Indexed: 01/18/2024]
Abstract
Few studies were performed on the impact of exposure to gaseous pollutants on the risk of knee osteoarthritis (KOA). We conducted this study to analyze the association between short-term exposure to gaseous pollutants and the risk of hospitalizations for KOA. A total of 2952 KOA hospitalizations derived from two hospitals in Hefei, and the relationship between gaseous pollutants and KOA hospitalizations was analyzed by a distributed lag non-linear model combined with a generalized linear model. We found that the decreased risk of hospitalizations for KOA were both related to exposure to NO2 (RR = 0.993, lag19 day) and O3 (RR = 0.984, lag0 day), while exposure to CO could increase the risk of hospitalizations for KOA (RR = 1.076, lag2 day). Stratified analyses suggested that the KOA patients < 65 years were more susceptible to O3 exposure, and the female, male, patients ≥ 65 years, and patients < 65 years were both more sensitive to CO exposure. Our findings demonstrated that exposure to NO2, O3 resulted in a decreased risk for KOA hospitalizations, and CO exposure might increase the risk of KOA hospitalizations.
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Affiliation(s)
- Yi-Fei Zhang
- Department of Orthopaedics, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Li-Feng Zhang
- Department of Orthopaedics, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Han-Yuan Zhang
- Department of Orthopaedics, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Wei Jiang
- Department of Orthopaedics, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Guang-Yu Li
- Department of Orthopaedics, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Tian-Ping Zhang
- Centre for Leading Medicine and Advanced Technologies of IHM, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
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Perruccio AV, Badley EM, Antflek D, Power JD, Baltzer H. Frequency of multisite non-hand joint involvement in patients with thumb-base osteoarthritis, and associations with functional and patient-reported outcomes. OSTEOARTHRITIS AND CARTILAGE OPEN 2023; 5:100397. [PMID: 37609061 PMCID: PMC10440563 DOI: 10.1016/j.ocarto.2023.100397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 08/02/2023] [Accepted: 08/07/2023] [Indexed: 08/24/2023] Open
Abstract
Purpose In OA studies, the focus often is on an index-joint; other affected joint sites are often overlooked. In this thumb-base OA study, we documented the frequency of symptomatic non-hand joint sites and investigated whether their count was associated with thumb-specific functional and patient-reported outcome measures. Design Patients seeking care for thumb-base OA (conservative or surgical) were included. A patient-completed questionnaire captured sociodemographic and health characteristics, symptomatic hand and non-hand joint sites, and outcome measures (thumb-base pain intensity, symptoms and disability (TASD) and upper-extremity disability/symptoms (quickDASH)). Grip and pinch strength were measured. Linear regressions examined the association between each outcome and symptomatic joint site count, adjusted for several covariates. Results The mean age of the 145 patients was 62 years, 72% were female. Mean symptomatic non-hand joint site count was 3.6. Ten percent reported only their hands as symptomatic; 30% reported 2-3 other symptomatic sites, and 49% reported 4+. From cross-sectional multivariable analyses, a higher symptomatic non-hand joint site count was associated with worse scores for all patient-reported outcomes and grip strength. Every unit increase in joint site count (49% had a 4+ count) was associated with a 2.1-3.3 unit increase (worse) in patient-reported outcome scores (all p < 0.02). Conclusions In this sample, nearly 80% of patients had 2+ symptomatic non-hand joint sites. These symptoms were associated with worse thumb- and hand-specific outcomes, suggesting a need for awareness of whole body OA burden, with implications for outcome score interpretations, study designs, and provision of care in thumb-base OA.
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Affiliation(s)
- Anthony V. Perruccio
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Canada
- Arthritis Community Research and Epidemiology Unit (ACREU), Canada
- Institute of Health Policy, Management & Evaluation, Dalla Lana School of Public Health, University of Toronto, Canada
- Department of Surgery, Faculty of Medicine, University of Toronto, Canada
| | - Elizabeth M. Badley
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Canada
- Arthritis Community Research and Epidemiology Unit (ACREU), Canada
- Dalla Lana School of Public Health, University of Toronto, Canada
| | - Daniel Antflek
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Canada
| | - J Denise Power
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Canada
| | - Heather Baltzer
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Canada
- Department of Surgery, Faculty of Medicine, University of Toronto, Canada
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Zhu Y, Li J, Zhang Y, Zhang W, Doherty M, Yang Z, Cui Y, Zeng C, Lei G, Yang T, Wei J. Association between hyperuricaemia and hand osteoarthritis: data from the Xiangya Osteoarthritis Study. RMD Open 2023; 9:e003683. [PMID: 38053456 DOI: 10.1136/rmdopen-2023-003683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 11/13/2023] [Indexed: 12/07/2023] Open
Abstract
OBJECTIVE The pathogenesis of hand osteoarthritis (OA) remains unknown. Hyperuricaemia, which is related to inflammation, may play a role in hand OA, but evidence is lacking. In a large population-based study, we examined the association between hyperuricaemia and hand OA. METHODS Participants were from the Xiangya OA Study, a community-based observational study. Hyperuricaemia was defined as serum urate >416 µmol/L in men and >357 µmol/L in women. Radiographic hand OA (RHOA) was defined as presence of the modified Kellgren-Lawrence grade ≥2 in any hand joint. Symptomatic hand OA (SHOA) was defined as presence of both self-reported symptoms and RHOA in the same hand. The associations of hyperuricaemia with RHOA or SHOA were examined using generalised estimating equations. RESULTS Among 3628 participants, the prevalence of RHOA was higher in participants with hyperuricaemia than those with normouricaemia (26.9% vs 20.9%), with an adjusted OR (aOR) of 1.34 (95% CI 1.11 to 1.61). The associations were consistent in men (aOR 1.33, 95% CI 1.01 to 1.74) and women (aOR 1.35, 95% CI 1.05 to 1.74). Hyperuricaemia was mainly associated with bilateral RHOA (aOR 1.54, 95% CI 1.18 to 2.01) but not unilateral RHOA (aOR 1.13, 95% CI 0.89 to 1.45). Prevalence of SHOA was higher, although statistically insignificant, in participants with hyperuricaemia (aOR 1.39, 95% CI 0.94 to 2.07). CONCLUSION In this population-based study, hyperuricaemia was associated with a higher prevalence of hand OA. Future prospective studies are required to investigate the temporal relationship. TRIAL REGISTRATION NUMBER NCT04033757.
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Affiliation(s)
- Yanqiu Zhu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Jiatian Li
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Yuqing Zhang
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- The Mongan Institute, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Weiya Zhang
- Academic Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK
- Pain Centre Versus Arthritis, University of Nottingham, Nottingham, UK
- Versus Arthritis Centre for Sport, Exercise and Osteoarthritis Research, University of Nottingham, Nottingham, UK
| | - Michael Doherty
- Academic Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK
- Pain Centre Versus Arthritis, University of Nottingham, Nottingham, UK
- Versus Arthritis Centre for Sport, Exercise and Osteoarthritis Research, University of Nottingham, Nottingham, UK
| | - Zidan Yang
- Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Joint Degeneration and Injury, Xiangya Hospital, Central South University, Changsha, China
| | - Yang Cui
- Xiangya International Medical Center, Xiangya Hospital, Central South University, Changsha, China
| | - Chao Zeng
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Joint Degeneration and Injury, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Guanghua Lei
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Joint Degeneration and Injury, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Tuo Yang
- Academic Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK
- Pain Centre Versus Arthritis, University of Nottingham, Nottingham, UK
- Health Management Center, Xiangya Hospital, Central South University, Changsha, China
| | - Jie Wei
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Joint Degeneration and Injury, Xiangya Hospital, Central South University, Changsha, China
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Li J, Zhao F, Dong W, Yu X, Zhu C, Liu S, Jia G, Liu G. Medial open-wedge high tibial osteotomy for the treatment of degenerative varus knee osteoarthritis in geriatric patients: a retrospective study. Sci Rep 2023; 13:16848. [PMID: 37803059 PMCID: PMC10558429 DOI: 10.1038/s41598-023-44051-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 10/03/2023] [Indexed: 10/08/2023] Open
Abstract
HTO has proven to be a cost-effective surgical procedure in the treatment of KOA, but few investigations have studied radiological changes and clinical effectiveness of OWHTO in geriatric patients. 76 patients were recruited in this retrospective study. According to the age, patients were divided into two groups (≤ 60, Group "Young"; > 60, Group "Geriatric"). Demographic data, radiological imaging and postoperative complications were analyzed. Kellgren-Lawrence grade (K-L), weight-bearing line ratio (WBLR); posterior tibial slope angle (PTS); American knee score (AKS); Western Ontario and McMaster Universities Arthritis Index (WOMAC) and visual analog scale (VAS) were introduced to estimate the clinical outcome of OWHTO. There were 18 male and 58 female patients in the present study with a mean age of 58.5 ± 9.2 years (ranges from 40 to 82 years); the average age was 51.4 ± 4.1 years and 67.3 ± 4.9 years for group Y and G respectively, 44.7% and 31.5% patients were older than 60 and 65 years. BMI for the 76 patients was 26.6 ± 3.2 kg/m2, and geriatric patients were more likely accompanied by one or more comorbidities (70.6 vs. 45.2%). There were 34 and 42 patients in group Geriatric and group Young respectively, and no significant difference of MPTA, WBLR, PTS and WOMAC, VAS, AKS and ROM between the two group (P > 0.05) were found. After more than a two-year follow-up period, postoperative WBLR, AKS, WOMAC and VAS were much more desired than preoperative, and no significant difference of these variables between the young and geriatric group (P > 0.05), however, elderly patients were more likely to suffer from a longer bone union time. OWHTO can avoid geriatric patients from undergoing secondary knee surgery in the short term, however the survival rate of OWHTO in geriatric patients should be ultimately clarified by different studies.
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Affiliation(s)
- Jia Li
- Department of Orthopedic Surgery, The First Hospital of Hebei Medical University, No. 89 Donggang Road, Shijiazhuang, 050031, Hebei, People's Republic of China
| | - Feng Zhao
- Department of Orthopedic Surgery, The First Hospital of Hebei Medical University, No. 89 Donggang Road, Shijiazhuang, 050031, Hebei, People's Republic of China
| | - Wei Dong
- Department of Orthopedic Surgery, The First Hospital of Hebei Medical University, No. 89 Donggang Road, Shijiazhuang, 050031, Hebei, People's Republic of China
| | - Xiaoguang Yu
- Department of Orthopedic Surgery, The First Hospital of Hebei Medical University, No. 89 Donggang Road, Shijiazhuang, 050031, Hebei, People's Republic of China
| | - Chaohua Zhu
- Department of Orthopedic Surgery, The First Hospital of Hebei Medical University, No. 89 Donggang Road, Shijiazhuang, 050031, Hebei, People's Republic of China
| | - Sen Liu
- Department of Orthopedic Surgery, The First Hospital of Hebei Medical University, No. 89 Donggang Road, Shijiazhuang, 050031, Hebei, People's Republic of China
| | - Guoxing Jia
- Department of Orthopedic Surgery, The First Hospital of Hebei Medical University, No. 89 Donggang Road, Shijiazhuang, 050031, Hebei, People's Republic of China
| | - Guobin Liu
- Department of Orthopedic Surgery, The First Hospital of Hebei Medical University, No. 89 Donggang Road, Shijiazhuang, 050031, Hebei, People's Republic of China.
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Wong AY, Samartzis D, Maher C. The global burden of osteoarthritis: past and future perspectives. THE LANCET. RHEUMATOLOGY 2023; 5:e496-e497. [PMID: 38251491 DOI: 10.1016/s2665-9913(23)00207-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 07/25/2023] [Indexed: 01/23/2024]
Affiliation(s)
- Arnold Yl Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China.
| | - Dino Samartzis
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Chris Maher
- School of Public Health, The University of Sydney, Sydney, NSW, Australia
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13
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Mustari MN, Massi MN, Usman MA, Fikry A, Bukhari A, Idris I, Zainuddin AA, Adnan E, Bakri S, Hatta M. Dynamic interaction of obesity, age, MCP-1 Level, and ACE-1 gene with the severity of knee osteoarthritis: a cross-sectional study. Ann Med Surg (Lond) 2023; 85:3845-3851. [PMID: 37554897 PMCID: PMC10406059 DOI: 10.1097/ms9.0000000000000973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 06/10/2023] [Indexed: 08/10/2023] Open
Abstract
UNLABELLED The risk factors most strongly associated with knee osteoarthritis (OA) are old age and obesity. However, few studies have evaluated the interaction between aging and obesity in conjunction with inflammatory markers and knee OA severity as part of a complete assessment of knee OA management. Therefore, this study aims to evaluate the interaction between obesity, age, inflammation [including the I/D polymorphism of angiotensin converting enzyme-1 (ACE-1)], and the severity of knee OA. METHODS A total of 80 knee OA patients were included in this cross-sectional study. The severity of knee OA was determined based on the Kellgren-Lawrence system. All patients underwent physical and radiological examination; monocyte chemoattractant protein 1 (MCP-1) markers were measured. The parameters of the ACE-1 gene were examined with sequencing DNA. RESULTS There was a significant relationship between age and severity of knee OA (P=0.007), with subjects aged greater than or equal to 65 having a 3.56-fold higher risk of developing moderate to severe OA than subjects aged less than 65. There was a significant difference between body weight and knee OA severity (P=0.026), in which subjects weighing greater than or equal to 60 kg had 3.14 times the risk of experiencing severe knee OA. Multivariate regression analysis indicated that age was the strongest independent variable for knee OA severity compared with body weight. MCP-1 levels were significantly higher in mild knee OA than in moderate to severe knee OA. The DD genotype of the ACE-1 gene increases the risk of severe knee OA by four times in subjects aged greater than or equal to 65 compared to subjects aged less than 65. However, the DD genotype of the ACE-1 gene does not increase the risk of severe knee OA in subjects weighing greater than or equal to 60 kg. CONCLUSION While obesity and age were found to be associated with the severity of knee OA, age emerged as the independent risk factor for knee OA severity. Furthermore, MCP-1 levels were significantly higher in cases of mild knee OA compared to severe knee OA. It was observed that the DD genotype of the ACE-1 gene increases the risk of severe knee OA in individuals aged 65 years or older.
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Affiliation(s)
| | | | | | | | | | | | - Andi A. Zainuddin
- Department of Public Health and Community Medicine Science, Faculty of Medicine, Hasanuddin University
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Gu Y, Jin Q, Hu J, Wang X, Yu W, Wang Z, Wang C, Liu Y, Chen Y, Yuan W. Causality of genetically determined metabolites and metabolic pathways on osteoarthritis: a two-sample mendelian randomization study. J Transl Med 2023; 21:357. [PMID: 37259122 DOI: 10.1186/s12967-023-04165-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 04/27/2023] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND Osteoarthritis (OA) is one of the most prevalent musculoskeletal diseases and is the leading cause of pain and disability in the aged population. However, the underlying biological mechanism has not been fully understood. This study aims to reveal the causal effect of circulation metabolites on OA susceptibility. METHODS A two-sample Mendelian Randomization (MR) analysis was performed to estimate the causality of GDMs on OA. A genome-wide association study (GWAS) of 486 metabolites was used as the exposure, whereas 8 different OA phenotypes, including any-site OA (All OA), knee and/or hip OA (knee/hip OA), knee OA, hip OA, spine OA, finger and/or thumb OA (hand OA), finger OA, thumb OA, were set the outcomes. Inverse-variance weighted (IVW) was used for calculating causal estimates. Methods including weight mode, weight median, MR-egger, and MR-PRESSO were used for the sensitive analysis. Furthermore, metabolic pathway analysis was performed via the web-based Metaconflict 4.0. All statistical analyses were performed in R software. RESULTS In this MR analysis, a total of 235 causative associations between metabolites and different OA phenotypes were observed. After false discovery rate (FDR) correction and sensitive analysis, 9 robust causative associations between 7 metabolites (e.g., arginine, kynurenine, and isovalerylcarnitine) and 5 OA phenotypes were finally identified. Additionally, eleven significant metabolic pathways in 4 OA phenotypes were identified by metabolic pathway analysis. CONCLUSION The finding of our study suggested that identified metabolites and metabolic pathways can be considered useful circulating metabolic biomarkers for OA screening and prevention in clinical practice, and can also serve as candidate molecules for future mechanism exploration and drug target selection.
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Affiliation(s)
- Yifei Gu
- Department of Orthopaedics, Changzheng Hospital, Naval Medical University, Shanghai, 200003, China
| | - Qianmei Jin
- Department of Rheumatology and Immunology, Changzheng Hospital, Naval Medical University, Shanghai, 200003, China
| | - Jinquan Hu
- Department of Orthopaedics, Changzheng Hospital, Naval Medical University, Shanghai, 200003, China
| | - Xinwei Wang
- Department of Orthopaedics, Changzheng Hospital, Naval Medical University, Shanghai, 200003, China
| | - Wenchao Yu
- Department of Orthopaedics, Changzheng Hospital, Naval Medical University, Shanghai, 200003, China
| | - Zhanchao Wang
- Department of Orthopaedics, Changzheng Hospital, Naval Medical University, Shanghai, 200003, China
| | - Chen Wang
- Department of Orthopaedics, Changzheng Hospital, Naval Medical University, Shanghai, 200003, China
| | - Yang Liu
- Department of Orthopaedics, Changzheng Hospital, Naval Medical University, Shanghai, 200003, China.
| | - Yu Chen
- Department of Orthopaedics, Changzheng Hospital, Naval Medical University, Shanghai, 200003, China.
| | - Wen Yuan
- Department of Orthopaedics, Changzheng Hospital, Naval Medical University, Shanghai, 200003, China.
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Fan Z, Yan L, Liu H, Li X, Fan K, Liu Q, Li JJ, Wang B. The prevalence of hip osteoarthritis: a systematic review and meta-analysis. Arthritis Res Ther 2023; 25:51. [PMID: 36991481 PMCID: PMC10053484 DOI: 10.1186/s13075-023-03033-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 03/17/2023] [Indexed: 03/31/2023] Open
Abstract
OBJECTIVE To estimate the global prevalence of hip osteoarthritis (HOA) through a systematic review and meta-analysis, and to determine by regression analysis the respective relationships between age and sex, and sex and prevalence. METHODS EMBASE, PubMed, Web of science, CINAHL, and SCOPUS were searched from inception until August 2022. Two authors independently extracted data and assessed the quality of the retrieved literature. Random-effects meta-analysis was performed to derive the pooled prevalence. Variations in the prevalence estimate in different subgroups, including diagnostic methods, region, and patient sex, were examined by subgroup meta-analysis. Meta-regression was used to construct the age-specific prevalence of HOA. RESULTS A total of 31 studies were included in our analysis, involving 326,463 participants. Quality evaluation showed that all studies included in the analysis had a Quality Score of at least 4. The most frequently used method for diagnosing HOA was the Kellgren-Lawrence (K-L) grade classification, accounting for 19/31 (61.3%) studies. The pooled prevalence of HOA diagnosed based on the K-L grade ≥ 2 criterion was 8.55% (95% CI 4.85-13.18) worldwide. The prevalence of HOA was lowest in Africa at 1.20% (95% CI: 0.40-2.38), followed by Asia at 4.26% (95% CI 0.02-14.93) and North America at 7.95% (95% CI 1.98-17.36), and highest in Europe at 12.59% (95% CI 7.17-19.25). There was no statistically significant difference in HOA prevalence between men (9.42%, 95% CI:4.81-15.34) and women at (7.94%, 95% CI: 3.57-13.81). The regression model showed a correlation between age and the prevalence of HOA. CONCLUSION HOA has high prevalence worldwide and increases with age. The prevalence varies significantly by region but not by patient sex. High-quality epidemiological studies are warranted to more accurately estimate the prevalence of HOA.
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Affiliation(s)
- Zijuan Fan
- Department of Orthopaedic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Qingchun Road No. 79, Hangzhou, China
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Lei Yan
- Department of Orthopaedic Surgery, Shanxi Medical University Second Affiliated Hospital, Taiyuan, China
| | - Haifeng Liu
- Department of Orthopaedic Surgery, Shanxi Medical University Second Affiliated Hospital, Taiyuan, China
| | - Xiaoke Li
- Department of Orthopaedic Surgery, Shanxi Medical University Second Affiliated Hospital, Taiyuan, China
| | - Kenan Fan
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Qiang Liu
- Arthritis Clinic and Research Center, Peking University People's Hospital, Beijing, China.
| | - Jiao Jiao Li
- School of Biomedical Engineering, Faculty of Engineering and IT, University of Technology Sydney, Sydney, Australia.
| | - Bin Wang
- Department of Orthopaedic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Qingchun Road No. 79, Hangzhou, China.
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16
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Yoo HJ, Jeong HW, Kim SW, Kim M, Lee JI, Lee YS. Prediction of progression rate and fate of osteoarthritis: Comparison of machine learning algorithms. J Orthop Res 2023; 41:583-590. [PMID: 35716159 DOI: 10.1002/jor.25398] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 05/15/2022] [Accepted: 06/15/2022] [Indexed: 02/04/2023]
Abstract
Appropriate prediction models can assist healthcare systems in delaying or reversing osteoarthritis (OA) progression. We aimed to identify a reliable algorithm for predicting the progression rate and fate of OA based on patient-specific information. From May 2003 to 2019, 83,280 knees were collected. Age, sex, body mass index, bone mineral density, physical demands for occupation, comorbidities, and initial Kellgren-Lawrence (K-L) grade were used as variables for the prediction models. The prediction targets were divided into dichotomous groups for even distribution. We compared the performances of logistic regression (LR), random forest (RF), and extreme gradient boost (XGB) algorithms. Each algorithm had the best precision when the model used all variables. XGB showed the best results in accuracy, recall, F1 score, specificity, and error rates (progression rate/fate of OA: 0.710/0.877, 0.542/0.637, 0.637/0.758, 0.859/0.981, and 0.290/0.123, respectively). The feature importance of RF and XGB had the same order up to the top six for each prediction target. Age and initial K-L grade had the highest feature importance in RF and XGB for the progression rate and fate of OA, respectively. The XGB and RF machine learning algorithms showed better performance than conventional LR in predicting the progression rate and fate of OA. The best performance was obtained when all variables were combined using the XGB algorithm. For each algorithm, the initial K-L grade and physical demand for occupation were the greatest contributors with superior feature importance compared with the others.
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Affiliation(s)
- Hyun Jin Yoo
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul, South Korea.,Department of Orthopedic Surgery, Konyang University College of Medicine, Daejeon, South Korea
| | - Ho Won Jeong
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul, South Korea
| | - Sung Woon Kim
- Department of Mathematics, Sungkyunkwan University College of Natural Sciences, Suwon, South Korea
| | - Myeongju Kim
- Center for Artificial Intelligence in Healthcare, Seoul National University Bundang Hospital, Seoul, South Korea
| | - Jae Ik Lee
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul, South Korea
| | - Yong Seuk Lee
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul, South Korea
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17
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Yoo HJ, Jeong HW, Park SB, Shim SJ, Nam HS, Lee YS. Do Individualized Patient-Specific Situations Predict the Progression Rate and Fate of Knee Osteoarthritis? Prediction of Knee Osteoarthritis. J Clin Med 2023; 12:jcm12031204. [PMID: 36769856 PMCID: PMC9918059 DOI: 10.3390/jcm12031204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 01/16/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
Factors affecting the progression rate and fate of osteoarthritis need to be analyzed when considering patient-specific situation. This study aimed to identify the rate of remarkable progression and fate of primary knee osteoarthritis based on patient-specific situations. Between May 2003 and May 2019, 83,280 patients with knee pain were recruited for this study from the clinical data warehouse. Finally, 2492 knees with pain that were followed up for more than one year were analyzed. For analyzing affecting factors, patient-specific information was categorized and classified as demographic, radiologic, social, comorbidity disorders, and surgical intervention data. The degree of contribution of factors to the progression rate and the fate of osteoarthritis was analyzed. Bone mineral density (BMD), Kellgren-Lawrence (K-L) grade, and physical occupational demands were major contributors to the progression rate of osteoarthritis. Hypertension, initial K-L grade, and physical occupational demands were major contributors to the outcome of osteoarthritis. The progression rate and fate of osteoarthritis were mostly affected by the initial K-L grade and physical occupational demands. Patients who underwent surgical intervention for less than five years had the highest proportion of initial K-L grade 2 (49.0%) and occupations with high physical demand (41.3%). In identifying several contributing factors, the initial K-L grade and physical occupational demands were the most important factors. BMD and hypertension were also major contributors to the progression and fate of osteoarthritis, and the degree of contribution was lower compared to the two major factors.
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Affiliation(s)
- Hyun Jin Yoo
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul 13620, Republic of Korea
- Department of Orthopedic Surgery, Konyang University College of Medicine, Daejeon 35365, Republic of Korea
| | - Ho Won Jeong
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul 13620, Republic of Korea
| | - Sung Bae Park
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul 13620, Republic of Korea
| | - Seung Jae Shim
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul 13620, Republic of Korea
| | - Hee Seung Nam
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul 13620, Republic of Korea
| | - Yong Seuk Lee
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul 13620, Republic of Korea
- Correspondence: or ; Tel.: +82-31-787-7199; Fax: +82-31-787-4056
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Mank VMF, Arter Z, Mank J, Eum KS, Roberts J. Improving Self-Confidence of Military Medical Providers With Joint Procedure Simulation: A Pilot Study. Mil Med 2023; 188:e382-e387. [PMID: 34318332 DOI: 10.1093/milmed/usab319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 06/09/2021] [Accepted: 07/14/2021] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION Military medical providers are a unique population that encounter different environments across the world. From hospital clinics to war zones, these providers must perform procedures and rely on their training and skill to help their patients. This pilot study aimed to assess the self-confidence of military medical providers performing joint aspiration and injection before and after a simulation workshop in both clinical and austere settings. METHODS In 2016, 25 military physicians from various military facilities participated in a 1-hour knee arthrocentesis and injection and shoulder injection workshop. Education was provided on the knee and shoulder anatomy and various approaches to performing the procedures before the hands-on portion of the workshop. Surveys assessing self-reported confidence levels by performing the procedures in the clinic and austere settings were completed before and after simulation training. RESULTS The results were analyzed and grouped based on the provider experience level, simulation environment, and specific procedure performed. There was a statistical significance seen in the shoulder arthrocentesis group, which included all participating providers, with a P-value of <.01 in the clinic setting and a P-value of <.001 in the austere setting. In the knee aspiration simulation, there were also improvements in the provider confidence, but it was not statistically significant with P-values of .36 and .14 in the clinical and austere settings, respectively. CONCLUSION Simulation training can lead to increased medical provider self-confidence in performing musculoskeletal joint aspirations and injections in both clinic and austere settings. The military medicine demographics have had little research in joint injections and provider confidence to date. This pilot study was one of the first to evaluate this unique population. The methods used in this study, and the positive data collected on provider confidence, can be used in larger studies, encompassing other medical providers to increase the confidence of providers throughout various fields of medicine.
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Affiliation(s)
- Victoria M F Mank
- Department of Internal Medicine, Tripler Army Medical Center, Honolulu, HI 96859, USA
| | - Zhaohui Arter
- Department of Internal Medicine, Tripler Army Medical Center, Honolulu, HI 96859, USA
| | - Jeffrey Mank
- University of New England, Biddeford, ME 04005, USA
| | - Ki Suk Eum
- Division of Rheumatology, Scripps Green Hospital, La Jolla, CA 92037, USA
| | - Jefferson Roberts
- Department of Rheumatology, Tripler Army Medical Center, Honolulu, HI 96859, USA
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Wen YR, Shi J, Wang YF, Lin YY, Hu ZY, Lin YT, Wang XQ, Wang YL. Are Mind-Body Exercise Beneficial for Treating Pain, Function, and Quality of Life in Middle-Aged and Old People With Chronic Pain? A Systematic Review and Meta-Analysis. Front Aging Neurosci 2022; 14:921069. [PMID: 35800981 PMCID: PMC9255956 DOI: 10.3389/fnagi.2022.921069] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 05/23/2022] [Indexed: 11/22/2022] Open
Abstract
Background Aging is a significant risk factor in chronic pain development with extensive disability and greater health care costs. Mind-body exercise (MBE) has been scientifically proven to affect the pain intensity and physical health. Objectives To assess the effects of MBE modes (Tai Chi, yoga, and qigong) for treating chronic pain among middle-aged and old people, compared with nonactive and active treatment, as well as function, quality of life, and adverse events. Methods We searched PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Database, and Chinese Scientific Journals Full-Text Database (VIP) till March 2022. No restrictions were chartered within the year and language of publication. We included randomized controlled trials of MBE treatment in middle-aged and elderly people with chronic pain. The overall certainty of evidence was evaluated by using the GRADE approach. Results A total of 17 studies (n = 1,332) were included in this review. There was low-certainty evidence indicating that MBE had a moderate effect on reducing pain compared with the nonactive and active control group (standard mean difference (SMD): −0.64, 95% confidence interval (CI): −0.86 to −0.42, P < 0.001). Very-low-certainty evidence showed that the pooled SMD for the functional improvement was −0.75 (95% CI: −1.13 to −0.37, P < 0.001). Low-certainty evidence presented that no influence was observed in physical component summary (SMD: 0.23, 95% CI: −0.16 to 0.62, P = 0.24) and mental component summary (SMD: −0.01, 95% CI −0.39 to 0.36, P = 0.95). Conclusion Our results indicated that MBE was an effective treatment for reducing symptoms of middle-aged and elderly people with chronic pain compared with nonactive and active control groups. TC and qigong had obvious benefits for knee osteoarthritis in self-reported function, but the efficacy of chronic low back pain was uncertain. No significant benefit of MBE on quality of life in older adults with chronic pain was found. More high-quality RCTs should be conducted to explore the efficacy and mechanism of MBE on chronic pain in middle-aged and elderly people from various dimensions, such as affective and cognitive dimensions. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=316591, identifier CRD42022316591.
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Affiliation(s)
- Yu-Rong Wen
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jian Shi
- College of Kinesiology, Shenyang Sport University, Shenyang, China
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Ya-Fei Wang
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yang-Yang Lin
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zheng-Yu Hu
- College of Kinesiology, Shenyang Sport University, Shenyang, China
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - You-Tian Lin
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Postgraduate Research Institute, Guangzhou Sport University, Guangzhou, China
| | - Xue-Qiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai, China
- *Correspondence: Xue-Qiang Wang
| | - Yu-Ling Wang
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Yu-Ling Wang
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Chen H, Wang C, Wu J, Wang M, Wang S, Wang X, Wang J, Yu H, Hu Y, Shang S. Measurement properties of performance-based measures to assess physical function in knee osteoarthritis: A systematic review. Clin Rehabil 2022; 36:1489-1511. [PMID: 35702008 DOI: 10.1177/02692155221107731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To systematically review the measurement properties of performance-based measures to assess physical function in people with knee osteoarthritis. DATA SOURCES PubMed, Web of Science, Embase, Scopus, CINAHL, and PsycINFO were searched in May 2022. METHODS This study was conducted in accordance with the guidelines recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Clinical trials on the psychometric properties of performance-based tools for measuring physical function in people with knee osteoarthritis were included. Two reviewers independently rated measurement properties using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). "Best evidence synthesis" was made using COnsensus-based Standards for the selection of health Measurement INstruments outcomes and the quality of findings. RESULTS Thirty-six out of 3425 publications were eligible for inclusion. Thirty-two performance-based measures were evaluated including 26 single-activity measures and 6 multi-activity measures. Measurement properties evaluated included internal consistency (2 measures), reliability (23 measures), measurement error (20 measures), hypotheses testing for construct validity (22 measures), and responsiveness (23 measures). On balance of the limited evidence, the walk 40 m fast-paced test and 6-minute walking test were the best rated walking tests. The 30-second chair stand test and timed up and go test were the best rated sit-to-stand tests. The Performance Tests Measures and Physical Activity Restrictions may be the suitable multi-activity measures for knee osteoarthritis. CONCLUSIONS Further good quality research investigating the measurement properties, and in particular, the measurement error of performance-based measures in patients with knee osteoarthritis is needed.
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Affiliation(s)
- Hongbo Chen
- Department of Epidemiology and Biostatistics, School of Public Health, 12465Peking University, Beijing, China.,School of Nursing, 12465Peking University, China, Beijing, China
| | - Cui Wang
- School of Nursing, 12465Peking University, China, Beijing, China
| | - Junhui Wu
- Department of Epidemiology and Biostatistics, School of Public Health, 12465Peking University, Beijing, China.,School of Nursing, 12465Peking University, China, Beijing, China
| | - Mengying Wang
- Department of Epidemiology and Biostatistics, School of Public Health, 12465Peking University, Beijing, China
| | - Siyue Wang
- Department of Epidemiology and Biostatistics, School of Public Health, 12465Peking University, Beijing, China
| | - Xiaowen Wang
- Department of Epidemiology and Biostatistics, School of Public Health, 12465Peking University, Beijing, China
| | - Jiating Wang
- Department of Epidemiology and Biostatistics, School of Public Health, 12465Peking University, Beijing, China
| | - Huan Yu
- Department of Epidemiology and Biostatistics, School of Public Health, 12465Peking University, Beijing, China
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, 12465Peking University, Beijing, China.,Medical Informatics Center, 12465Peking University, Beijing, China
| | - Shaomei Shang
- School of Nursing, 12465Peking University, China, Beijing, China
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Silva-Díaz M, Blanco FJ, Quevedo Vila V, Seoane-Mato D, Pérez-Ruiz F, Juan-Mas A, Pego-Reigosa JM, Narváez J, Quilis N, Cortés R, Romero Pérez A, Fábregas Canales D, Font Gayá T, Bordoy Ferrer C, Prado-Galbarro FJ, Sánchez-Piedra C, Díaz-González F, Bustabad-Reyes S. Prevalence of symptomatic axial osteoarthritis phenotypes in Spain and associated socio-demographic, anthropometric, and lifestyle variables. Rheumatol Int 2022; 42:1085-1096. [PMID: 34755205 PMCID: PMC9124650 DOI: 10.1007/s00296-021-05038-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 10/22/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Axial osteoarthritis (OA) is a common cause of back and neck pain, however, few studies have examined its prevalence. The aim was to estimate the prevalence and the characteristics of symptomatic axial OA in Spain. METHODS EPISER2016 is a cross-sectional multicenter population-based study of people aged 40 years or older. Subjects were randomly selected using multistage stratified cluster sampling. Participants were contacted by telephone to complete rheumatic disease screening questionnaires. Two phenotypes were analyzed, patients with Non-exclusive axial OA (NEA-OA) and Exclusive axial OA (EA-OA). To calculate the prevalence and its 95% confidence interval (CI), the sample design was considered and weighting was calculated according to age, sex and geographic origin. RESULTS Prevalence of NEA-OA by clinical or clinical-radiographic criteria was 19.17% (95% CI: 17.82-20.59). The frequency of NEA-OA increased with age (being 3.6 times more likely in patients aged 80 s or more than in those between 40 and 49 years) and body mass index. It was significantly more frequent in women, as well as in the center of Spain. It was less frequent in those with a higher level of education. Lumbar OA was more frequent than cervical OA. This difference grew with increasing age and was not associated with gender. It was also greater in overweight and obese subjects. CONCLUSIONS This is the first study on the prevalence of axial OA phenotypes in Europe describing the associated socio-demographic, anthropometric, and lifestyle variables.
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Affiliation(s)
- Maite Silva-Díaz
- Unidad de Investigación Clínica, Grupo de Investigación de Reumatología (GIR), Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidade da Coruña, A Coruña, Spain
| | - Francisco J Blanco
- Unidad de Investigación Clínica, Grupo de Investigación de Reumatología (GIR), Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidade da Coruña, A Coruña, Spain.
- Universidade da Coruña (UDC), Grupo de Investigación de Reumatología y Salud (GIR-S). Departamento de Fisioterapia, Medicina y Ciencias Biomédicas, Facultad de Fisioterapia,, Campus de Oza, A Coruña, España.
| | - Víctor Quevedo Vila
- Rheumatology Unit, Hospital Comarcal Monforte de Lemos, Monforte de Lemos, Lugo, España
| | | | - Fernando Pérez-Ruiz
- Rheumatology Department, Hospital Universitario Cruces, Baracaldo, Vizcaya, España
| | - Antonio Juan-Mas
- Rheumatology Department, Hospital Son LLàtzer, Palma de Mallorca, Baleares, España
| | - José M Pego-Reigosa
- Rheumatology Department, Complejo Hospitalario Universitario de Vigo, Grupo IRIDIS, Instituto de Investigación Sanitaria Galicia Sur (IISGS), Vigo, Pontevedra, España
| | - Javier Narváez
- Rheumatology Department, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España
| | - Neus Quilis
- Rheumatology Department, Hospital General Universitario de Elda, Elda, Alicante, España
| | - Raúl Cortés
- Rheumatology Department, Hospital General de Ontinyent, Ontinyent, Valencia, España
| | | | | | - Teresa Font Gayá
- Rheumatology Department, Hospital Comarcal de Inca, Inca, Baleares, España
| | | | | | | | - Federico Díaz-González
- Department of Internal Medicine, Dermatology and Psyquiatry, Universidad de La Laguna, La Laguna, Santa Cruz de Tenerife, España
- Rheumatology Department, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, España
| | - Sagrario Bustabad-Reyes
- Rheumatology Department, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, España
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22
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Kim SK, Kwak SG, Choe JY. Decline of Lung Function in Knee and Spine Osteoarthritis in the Korean Population: Cross-Sectional Analysis of Data from the Korea National Health and Nutrition Examination Survey. Healthcare (Basel) 2022; 10:healthcare10040736. [PMID: 35455913 PMCID: PMC9027391 DOI: 10.3390/healthcare10040736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 04/01/2022] [Accepted: 04/13/2022] [Indexed: 12/15/2022] Open
Abstract
Background: Evidence on the close association between osteoarthritis (OA) and lung diseases is supported by the shared pathogenesis of the two diseases. We assessed the association between knee and spine OA and chronic obstructive pulmonary disease (COPD) in the Korean population. Methods: Using data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2012, a total of 2006 subjects who underwent both plain radiography for assessment of knee and lumbar spine and spirometry analysis for lung function were analyzed. Radiographic severity grade for OA was assessed using the Kellgren−Lawrence (K-L) grading scale. COPD was defined as a ratio of forced expiratory volume in one second (FEV1) to forced vital capacity (FVC) less than 0.7. Results: Subjects with spine OA had higher prevalence of COPD than controls (p < 0.001), but not knee OA (p = 0.990). FVC (L), FEV1 (L), and FVC/FEV1 (%) were significantly decreased in spine OA compared to in controls (p = 0.003, p < 0.001, and p < 0.001, respectively). FVC (L), FVC (%), FEV1 (L), and FEV1 (%) were significantly different between knee OA and controls. Univariate regression analysis showed that spine OA was significantly associated with COPD (OR 1.581, 95% CI 1.204−2.076, p = 0.001), but not knee OA. Multivariate analysis revealed that spine OA lost statistical significance for COPD. Conclusion: This study found that subjects with knee OA and spine OA had a decline of lung function compared to subjects without OA, although OA was not associated with COPD.
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Affiliation(s)
- Seong-Kyu Kim
- Division of Rheumatology, Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu 42472, Korea;
- Correspondence: ; Tel.: +82-53-6503465; Fax: +82-53-6298248
| | - Sang Gyu Kwak
- Department of Medical Statistics, Catholic University of Daegu School of Medicine, Daegu 42472, Korea;
| | - Jung-Yoon Choe
- Division of Rheumatology, Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu 42472, Korea;
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Wang W, Yu S, Long Z, Liu Y, Yan Y, Sun T, Liu Z. Electroacupuncture vs topical diclofenac sodium gel for patients with hand osteoarthritis: study protocol for a randomized controlled trial. J Orthop Surg Res 2022; 17:233. [PMID: 35413861 PMCID: PMC9004119 DOI: 10.1186/s13018-022-03125-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 04/05/2022] [Indexed: 11/25/2022] Open
Abstract
Background Hand osteoarthritis (OA) is a prevalent joint disorder and a great burden to both patients and society. While electroacupuncture (EA) and topical diclofenac sodium gel (DSG) are both currently used to treat OA, no head-to-head study of EA and topical DSG for hand OA exists. Thus, it remains unknown whether one intervention offers improved outcomes over the other. This study aims to compare the effects of EA and topical DSG in patients with hand OA. Methods A total of 108 participants with hand OA according to the American College of Rheumatology criteria will be recruited and randomly assigned to the EA group or topical DSG group with a 1:1 allocation ratio. Participants in the EA group will receive EA treatment thrice weekly for 4 weeks, followed by a 12-week follow-up. In the topical DSG group, topical DSG at a dose of 2 g over the affected joints per hand will be applied four times per day for 4 weeks. The outcomes will be measured at weeks 4, 8, and 16. The primary outcome will be the change in average overall finger joint pain intensity in the dominant hand from baseline to week 4. All outcome variables will be analyzed on an intention-to-treat principle. All statistical tests will be two-sided. Discussion This study will help determine which of the two treatment protocols, EA or topical DSG, is more effective for the clinical treatment of hand OA. Trial registration ClinicalTrials.gov identifier: NCT04402047. Registered 16 May 2020, https://clinicaltrials.gov/ct2/show/NCT04402047
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Affiliation(s)
- Weiming Wang
- Department of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences Guang'anmen Hospital, No. 5 Beixiange, Xicheng District, Beijing, 100053, China
| | - Shudan Yu
- Department of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences Guang'anmen Hospital, No. 5 Beixiange, Xicheng District, Beijing, 100053, China
| | - Zilin Long
- Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Yan Liu
- Key Laboratory of Chinese Internal Medicine of Ministry of Education, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Yan Yan
- Department of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences Guang'anmen Hospital, No. 5 Beixiange, Xicheng District, Beijing, 100053, China
| | - Tianheng Sun
- Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Zhishun Liu
- Department of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences Guang'anmen Hospital, No. 5 Beixiange, Xicheng District, Beijing, 100053, China.
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Son JH, Seo ZW, Choi W, Lee YY, Kang SW, Lee CH. Etiologic Factors of Rotator Cuff Disease in Elderly: Modifiable Factors in Addition to Known Demographic Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063715. [PMID: 35329402 PMCID: PMC8948663 DOI: 10.3390/ijerph19063715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/17/2022] [Accepted: 03/18/2022] [Indexed: 12/29/2022]
Abstract
With the aging society, musculoskeletal degenerative diseases are becoming a burden on society, and rotator cuff disease is one of these degenerative diseases. The purpose of this study was to examine the incidence of shoulder osteoarthritis and the etiologic factors of rotator cuff disease in the Korean elderly population. A total of 102 patients performing ultrasonography were recruited, and their demographic factors were analyzed. As functional factors, visual analog scale and the peak torque of external and internal rotators of the shoulder using an isokinetic dynamometer were measured. As an anatomical factor, the acromiohumeral distance in the plain radiograph of the glenohumeral anterior-posterior view was used. There were more female patients (65.7%) than male patients (34.3%). The age range with the highest number of respondents was 50–59 years old. The mean visual analogue score was 4.09 (Min 1 to Max 9). Age and dominant hand side factors appear to be the crucial etiologic factors of the presence and severity of rotator cuff disease. The lower net value of the external rotator strength is weakly related to the presence of rotator cuff disease after adjusting for age, and this is the only modifiable factor in the study.
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Affiliation(s)
- Ju Hyun Son
- Department of Rehabilitation Medicine, Pusan National University Yangsan Hospital, Yangsan-si 50612, Korea; (J.H.S.); (Z.W.S.); (W.C.)
| | - Zee Won Seo
- Department of Rehabilitation Medicine, Pusan National University Yangsan Hospital, Yangsan-si 50612, Korea; (J.H.S.); (Z.W.S.); (W.C.)
| | - Woosik Choi
- Department of Rehabilitation Medicine, Pusan National University Yangsan Hospital, Yangsan-si 50612, Korea; (J.H.S.); (Z.W.S.); (W.C.)
| | - Youn-Young Lee
- Woon-gok Liberal Arts Education College, Halla University, Wonju-si 26404, Korea;
| | - Suk-Woong Kang
- Department of Orthopedics, Pusan National University Yangsan Hospital, Yangsan-si 50612, Korea;
| | - Chang-Hyung Lee
- Department of Rehabilitation Medicine, Pusan National University Yangsan Hospital, Yangsan-si 50612, Korea; (J.H.S.); (Z.W.S.); (W.C.)
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan-si 50612, Korea
- Correspondence:
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25
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Nelson AE, Hu D, Arbeeva L, Alvarez C, Cleveland RJ, Schwartz TA, Murphy LB, Helmick CG, Callahan LF, Renner JB, Jordan JM, Golightly YM. Point prevalence of hip symptoms, radiographic, and symptomatic OA at five time points: The Johnston County Osteoarthritis Project, 1991–2018. OSTEOARTHRITIS AND CARTILAGE OPEN 2022; 4. [DOI: 10.1016/j.ocarto.2022.100251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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26
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Cheng VK, Hasegawa M, Hattori T, Ito N, Linn E, Cheng K, Hughes-Austin J, Masuda K, Sudo A. Prevalence of radiographic hip dysplasia in Japanese population-based study. Mod Rheumatol 2022; 32:438-443. [PMID: 33910453 DOI: 10.1080/14397595.2021.1918884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 04/11/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The purpose of this study was to measure the indices of radiographic developmental dysplasia of the hip (DDH) in a cross-sectional study of an elderly Japanese population. METHODS Hip radiographs of 427 informed, voluntary Japanese community-dwelling individuals (279 female and 148 male) aged 50-96 years-old were obtained from Miyagawa village in Japan through a health screening. The hip radiographs were measured by a custom-written, semi-automated MATLAB program. The center edge (CE) angle, acetabular roof obliquity (ARO), acetabular head index (AHI), and minimum joint space width (mJSW) were measured. We examined the associations between gender, side-of-hip, and age group on radiographic DDH and hip osteoarthritis (OA). RESULTS The mean CE angle was 31.0°. The mean ARO was 5.8°. The mean AHI was 88.2%. The mean mJSW was 4.0 mm. Of the total population, 29.9% had DDH and 4.0% had hip OA. Of those who had hip OA, 41.2% were secondary OA, and 58.8% were primary OA. The relationship between DDH and OA was not significant. CONCLUSION DDH is unlikely to be an important cause of hip OA in the present population-based study.
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Affiliation(s)
- Veronica K Cheng
- Department of Orthopaedic Surgery, University of California San Diego, San Diego, CA, USA
| | - Masahiro Hasegawa
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Mie, Japan
| | - Tetsuya Hattori
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Mie, Japan
| | - Naoya Ito
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Mie, Japan
| | - Erikka Linn
- Department of Orthopaedic Surgery, University of California San Diego, San Diego, CA, USA
| | - Kevin Cheng
- Department of Orthopaedic Surgery, University of California San Diego, San Diego, CA, USA
| | - Jan Hughes-Austin
- Department of Orthopaedic Surgery, University of California San Diego, San Diego, CA, USA
| | - Koichi Masuda
- Department of Orthopaedic Surgery, University of California San Diego, San Diego, CA, USA
| | - Akihiro Sudo
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Mie, Japan
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Zhang Y, Wu T, Shen S, Xiong Y, Wang X, Yang J, Chen X, Lu Y, Lei X. Association Between Drinking Water Sources and Osteoarthritis Incidence in Chinese Elderly Population: National Population-Based Cohort Study. Front Med (Lausanne) 2022; 8:759514. [PMID: 35186964 PMCID: PMC8851347 DOI: 10.3389/fmed.2021.759514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 12/24/2021] [Indexed: 01/09/2023] Open
Abstract
Background The elderly is a vulnerable group susceptible to toxic environmental factors; however, the association between unsafe water and osteoarthritis (OA) incident among this population is poorly investigated. This study aimed to examine the effects of drinking water sources on OA risk in the Chinese elderly population. Methods Data were obtained from the China Longitudinal Healthy Longevity Survey to perform a 16-year longitudinal study. All participants aged ≥65 years at baseline were potentially eligible. Information on drinking water sources was recorded via a structured questionnaire. The water source was classified as well, surface, spring, or tap. OA was selected as the health outcome. Cox proportional hazard models, adjusted socio-demographics, lifestyle, and chronic disease were used to estimate the hazard ratio (HR) for OA. Subgroup analyses were performed to assess the potential interactive effect. Results A total of 12,543 participants were included. With restriction to the longest follow-up time, the mean survival time of follow-up was 14.56 years. Among the cohort members, 1,585 members suffered from OA. In the full model, drinking from well water and spring water was associated with a higher risk of OA compared with drinking from tap water (HR: 1.37, 95% CI: 1.22–1.54; HR: 1.34, 95% CI: 1.03–1.74). Except for age, the effects of modifications from socioeconomic status, lifestyles, and health conditions were non-significant (p for interaction <0.05). After multiple imputations for missing data and excluding deaths in the first year of follow-up and participants with a history of the disease and using the Shared-frailty Cox model, sensitivity analysis indicated a robust association between the drinking water source and OA incidence. Conclusion Drinking tap water was associated with a low risk of OA among older adults in China. The use of clean water sources as a marker of decreased OA and arthritis risks must be revisited in low- and middle-income countries.
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Affiliation(s)
- Yangchang Zhang
- Department of Public Health, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
- The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China
| | - Tingting Wu
- Chongqing Collaborative Innovation Center for Functional Food, Chongqing University of Education, Chongqing, China
| | - Shisi Shen
- The First School of Clinical Medicine, Chongqing Medical University, Chongqing, China
| | - Yang Xiong
- Department of Urology, The West China Hospital, Sichuan University, Chengdu, China
| | - Xu Wang
- Department of Public Health, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
- The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China
| | - Jialu Yang
- Department of Public Health, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
- The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China
| | - Xirui Chen
- The First School of Clinical Medicine, Chongqing Medical University, Chongqing, China
| | - Yanjun Lu
- The First School of Clinical Medicine, Chongqing Medical University, Chongqing, China
| | - Xun Lei
- Department of Public Health, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
- The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China
- Research Center for Public Health Security, Chongqing Medical University, Chongqing, China
- *Correspondence: Xun Lei
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Ratneswaran A, Rockel JS, Antflek D, Matelski JJ, Shestopaloff K, Kapoor M, Baltzer H. Investigating Molecular Signatures Underlying Trapeziometacarpal Osteoarthritis Through the Evaluation of Systemic Cytokine Expression. Front Immunol 2022; 12:794792. [PMID: 35126358 PMCID: PMC8814933 DOI: 10.3389/fimmu.2021.794792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 12/31/2021] [Indexed: 11/13/2022] Open
Abstract
PurposeNon-operative management of trapeziometacarpal osteoarthritis (TMOA) demonstrates only short-term symptomatic alleviation, and no approved disease modifying drugs exist to treat this condition. A key issue in these patients is that radiographic disease severity can be discordant with patient reported pain, illustrating the need to identify molecular mediators of disease. This study characterizes the biochemical profile of TMOA patients to elucidate molecular mechanisms driving TMOA progression.MethodsPlasma from patients with symptomatic TMOA undergoing surgical (n=39) or non-surgical management (n=44) with 1-year post-surgical follow-up were compared using a targeted panel of 27 cytokines. Radiographic (Eaton-Littler), anthropometric, longitudinal pain (VAS, TASD, quick DASH) and functional (key pinch, grip strength) data were used to evaluate relationships between structure, pain, and systemic cytokine expression. Principal Component Analysis was used to identify clusters of patients.ResultsPatients undergoing surgery had greater BMI as well as higher baseline quick DASH, TASD scores. Systemically, these patients could only be distinguished by differing levels of Interleukin-7 (IL-7), with an adjusted odds ratio of 0.22 for surgery for those with increased levels of this cytokine. Interestingly, PCA analysis of all patients (regardless of surgical status) identified a subset of patients with an “inflammatory” phenotype, as defined by a unique molecular signature consisting of thirteen cytokines.ConclusionOverall, this study demonstrated that circulating cytokines are capable of distinguishing TMOA disease severity, and identified IL-7 as a target capable of differentiating disease severity with higher levels associated with a decreased likelihood of TMOA needing surgical intervention. It also identified a cluster of patients who segregate based on a molecular signature of select cytokines.
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Affiliation(s)
- Anusha Ratneswaran
- Hand Program, Schroeder Arthritis Institute, University Health Network, Toronto, ON, Canada
- Division of Orthopedics, Osteoarthritis Research Program, Schroeder Arthritis Institute, University Health Network, Toronto, ON, Canada
- Krembil Research Institute, University Health Network, Toronto, ON, Canada
| | - Jason S. Rockel
- Division of Orthopedics, Osteoarthritis Research Program, Schroeder Arthritis Institute, University Health Network, Toronto, ON, Canada
- Krembil Research Institute, University Health Network, Toronto, ON, Canada
| | - Daniel Antflek
- Hand Program, Schroeder Arthritis Institute, University Health Network, Toronto, ON, Canada
- Krembil Research Institute, University Health Network, Toronto, ON, Canada
| | - John J. Matelski
- Biostatistics Research Unit, University Health Network, Toronto, ON, Canada
| | - Konstantin Shestopaloff
- Division of Orthopedics, Osteoarthritis Research Program, Schroeder Arthritis Institute, University Health Network, Toronto, ON, Canada
- Krembil Research Institute, University Health Network, Toronto, ON, Canada
| | - Mohit Kapoor
- Division of Orthopedics, Osteoarthritis Research Program, Schroeder Arthritis Institute, University Health Network, Toronto, ON, Canada
- Krembil Research Institute, University Health Network, Toronto, ON, Canada
- Department of Surgery and Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Heather Baltzer
- Hand Program, Schroeder Arthritis Institute, University Health Network, Toronto, ON, Canada
- Krembil Research Institute, University Health Network, Toronto, ON, Canada
- Division of Plastic and Reconstructive Surgery, University of Toronto, Toronto, ON, Canada
- *Correspondence: Heather Baltzer,
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Nakano M, Nakamura Y, Urano T, Miyazaki A, Suzuki T, Watanabe K, Takahashi J, Shiraki M. Associations of Homocysteine Metabolism With the Risk of Spinal Osteoarthritis Progression in Postmenopausal Women. J Clin Endocrinol Metab 2021; 106:3428-3438. [PMID: 34375425 DOI: 10.1210/clinem/dgab591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Indexed: 02/07/2023]
Abstract
CONTEXT Although homocysteine accumulation is a reported risk factor for several age-related disorders, little is known about its relationship with osteoarthritis (OA). OBJECTIVE We investigated for associations of homocysteine and C677T polymorphism in methylenetetrahydrofolate reductase (MTHFR), which is involved in homocysteine clearance, with the development and progression of spinal OA through a combined cross-sectional and longitudinal cohort study. METHODS A total of 1306 Japanese postmenopausal outpatients participating in the Nagano Cohort Study were followed for a mean 9.7-year period. Cross-sectional multiple logistic regression for spinal OA prevalence at registration by serum homocysteine level was performed with adjustment for confounders. In addition to Kaplan-Meier analysis, multivariate Cox regression was employed to examine the independent risk of MTHFR C677T variant for spinal OA progression. RESULTS Multivariate regression analysis revealed a significant association between homocysteine and spinal OA prevalence (odds ratio 1.38; 95% CI 1.14-1.68). Kaplan-Meier curves showed a gene dosage effect of the T allele in MTHFR C677T polymorphism on the accelerated progression of spinal OA severity (P = 0.003). A statistically significant independent risk of the T allele for spinal OA advancement was validated by Cox regression analysis. Respective adjusted hazard ratios for the CT/TT and TT genotypes were 1.68 (95% CI, 1.16-2.42) and 1.67 (95% CI, 1.23-2.28). CONCLUSION Circulating homocysteine and C677T variant in MTHFR are associated with the prevalence rate and ensuing progression, respectively, of spinal OA. These factors may represent potential interventional targets to prevent OA development and improve clinical outcomes.
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Affiliation(s)
- Masaki Nakano
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
| | - Yukio Nakamura
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
| | - Tomohiko Urano
- Department of Geriatric Medicine, International University of Health and Welfare School of Medicine, 4-3 Kozunomori, Narita, Chiba 286-8686, Japan
| | - Akiko Miyazaki
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
| | - Takako Suzuki
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
- Department of Human Nutrition, Faculty of Human Nutrition, Tokyo Kasei Gakuin University, 22 Sanban-cho, Chiyoda-ku, Tokyo 102-8341, Japan
| | - Kazuki Watanabe
- Department of Biology, College of Liberal Arts and Sciences, Tokyo Medical and Dental University, 2-8-30 Kohnodai, Ichikawa, Chiba 272-0827, Japan
| | - Jun Takahashi
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
| | - Masataka Shiraki
- Research Institute and Practice for Involutional Diseases, 1610-1 Meisei, Misato, Azumino, Nagano 399-8101, Japan
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Cable BM, Farooqi AS, Tsai S, Plyler R, Lee A, Parisien RL, Kelly JD. Humeral Head Morphology Influences Outcomes of Arthroscopic Interposition Glenoid Patch Allograft for Glenohumeral Arthritis. Arthrosc Sports Med Rehabil 2021; 3:e1421-e1429. [PMID: 34712980 PMCID: PMC8527262 DOI: 10.1016/j.asmr.2021.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 07/11/2021] [Indexed: 12/05/2022] Open
Abstract
Purpose To determine short- to midterm patient-reported outcomes of arthroscopic soft-tissue interposition arthroplasty using acellular dermal allograft with a minimum follow-up of 1 year and to assess outcomes in patients with and without flattening of the humeral head. Methods Patients with a diagnosis of primary glenohumeral arthritis who underwent arthroscopic soft-tissue interposition arthroplasty with an acellular dermal allograft from July 2010 to November 2019 were retrospectively enrolled. Inclusion criteria were a primary diagnosis of glenohumeral arthritis and Outerbridge 4 full-thickness cartilage loss of ≥50% of the glenoid articular surface. Patients underwent arthroscopic debridement, microfracture, and biological arthroscopic soft-tissue interposition arthroplasty with an acellular dermal matrix. Postoperative outcomes included American Shoulder and Elbow Surgeon (ASES) score, Single Assessment Numeric Evaluation (SANE) score, Penn Shoulder Score (PSS), numeric rating scale (NRS) pain score, analgesic use, and conversion to total shoulder arthroplasty (TSA). Results were stratified according to humeral head morphology on preoperative radiographs. Results A total of 25 patients were included, with a mean age of 56.0 years (range 19.2 to 74.8) and a mean follow-up of 3.36 years (range 1.03 to 8.98). The mean postoperative ASES score was 64.1 (range 11.7 to 100.0), SANE score was 62% (range 5% to 100%), and PSS was 61.2 (range 10.6 to 97.9). Additionally, 56% of patients rated their shoulder function as improved or much improved, and 36% of patients converted to TSA at a mean of 2.35 years. Patients with and without humeral flattening had similar postoperative ASES scores (P = .44), SANE scores (P = .90), PSS (P = .73), and conversions to TSA (P = .83). Patients with humeral flattening were more likely to have shoulder pain at night (83.3% versus 28.6%, P = .02). Conclusion Arthroscopic soft-tissue interposition arthroplasty with an acellular dermal allograft resulted in satisfactory short- to mid-term postoperative outcomes for younger patients with glenohumeral arthritis but demonstrated a TSA conversion rate of 36%. Patients with humeral head flattening also had satisfactory shoulder function but were more likely to experience shoulder pain at night. Level of Evidence Level IV, therapeutic case series
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Affiliation(s)
| | | | | | | | | | - Robert L. Parisien
- Address correspondence to Robert L. Parisien, M.D., University of Pennsylvania, Philadelphia, PA 19103, U.S.A.
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Feng Z, Ma M, Wang Y, Yang C, Liu Z, Xia Y. Clinical and Radiological Changes of Ankle in Knee Osteoarthritis With Varus After Total Knee Arthroplasty: A Systematic Review. Front Surg 2021; 8:713055. [PMID: 34527697 PMCID: PMC8435772 DOI: 10.3389/fsurg.2021.713055] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 07/28/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Arthritis with severe varus deformity remains a challenge in total knee arthroplasty (TKA). Until recently, surgeons aimed at a neutral lower limb alignment when performing a TKA. However, the impact of TKA on the ankle joint has been ignored. Therefore, we conducted a systematic review to assess the clinical and radiological changes in the ankle joint after TKA on knees with severe varus deformity. Methods: A systematic search was conducted in four English (PubMed, Embase, Cochrane Library, and Web of Science) and four Chinese (CBM, VIP, CNKI, and Wan Fang Database) databases. Screening of literature and extraction of data were independently performed by two researchers. The modified methodological index for non-randomized studies (MINORS) was used to assess the quality. Results: A total of eight studies were eligible, namely, four prospective and four retrospective studies. TKA resulted in a negative clinical effect in the ankle joint in patients with ankle osteoarthritis. Seven studies reported changes in the mechanical tibiofemoral angle, and four studies reported radiological changes in the hindfoot. The mean score of the MINORS was 9.8 out of eight (9-11). Conclusion: As a result of the correction of the knee osteoarthritis with severe varus deformity following mechanically aligned TKA, the radiological malalignment of the ankle joint was improved. However, some patients experience increased ankle pain after undergoing TKA, especially, if there was a residual knee varus deformity, a stiff hindfoot with varus deformity, or ankle arthritis.
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Affiliation(s)
- Zhiwei Feng
- Department of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, China.,Department of Orthopaedics, Nanchong Central Hospital, The Second Clinical Institute of North Sichuan Medical College, Nanchong, China
| | - Ming Ma
- Department of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, China
| | - Yaobin Wang
- Department of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, China
| | | | - Zhongcheng Liu
- Department of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, China
| | - Yayi Xia
- Department of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, China
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Chen H, Wu J, Wang M, Wang S, Wang J, Yu H, Hu Y, Shang S. Impact of Exposure to Ambient Fine Particulate Matter Pollution on Adults with Knee Osteoarthritis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189644. [PMID: 34574569 PMCID: PMC8466353 DOI: 10.3390/ijerph18189644] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/02/2021] [Accepted: 09/10/2021] [Indexed: 12/18/2022]
Abstract
The impact of exposure to fine particulate matter (PM2.5) on the incidence of knee osteoarthritis is unclear, especially in Beijing which is a highly polluted city. We conducted a time-series study to examine the correlation between PM2.5 exposure and outpatient visits for knee osteoarthritis in Beijing. Changes (in percentage) in the number of outpatient visits corresponding to every 10-μg/m3 increase in the PM2.5 concentration were determined using a generalized additive quasi-Poisson model. There were records of 9,797,446 outpatient visits for knee osteoarthritis in the study period from 1 January 2010 to 31 December 2017. The daily concentration of PM2.5 was 86.8 (74.3) μg/m3 over this period. A 10-μg/m3 increase in PM2.5 concentrations on lag days 0–3 was associated with a 1.41% (95% confidence interval: 1.40–1.41%) increase in outpatient visits for knee osteoarthritis. Females and patients aged above 65 years were more sensitive to the adverse effects of PM2.5 exposure. The present findings demonstrate that short-term exposure to PM2.5 resulted in an increase in the number of outpatient visits for knee osteoarthritis in Beijing. The findings shed light on the effects of air pollution on knee osteoarthritis and could guide risk-mitigating strategies in cities such as Beijing.
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Affiliation(s)
- Hongbo Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100191, China; (H.C.); (J.W.); (M.W.); (S.W.); (J.W.); (H.Y.)
- School of Nursing, Peking University, No. 38 Xueyuan Road, Beijing 100191, China
| | - Junhui Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100191, China; (H.C.); (J.W.); (M.W.); (S.W.); (J.W.); (H.Y.)
| | - Mengying Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100191, China; (H.C.); (J.W.); (M.W.); (S.W.); (J.W.); (H.Y.)
| | - Siyue Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100191, China; (H.C.); (J.W.); (M.W.); (S.W.); (J.W.); (H.Y.)
| | - Jiating Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100191, China; (H.C.); (J.W.); (M.W.); (S.W.); (J.W.); (H.Y.)
| | - Huan Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100191, China; (H.C.); (J.W.); (M.W.); (S.W.); (J.W.); (H.Y.)
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100191, China; (H.C.); (J.W.); (M.W.); (S.W.); (J.W.); (H.Y.)
- Medical Informatics Center, Peking University, No. 38 Xueyuan Road, Beijing 100191, China
- Correspondence: (Y.H.); (S.S.)
| | - Shaomei Shang
- School of Nursing, Peking University, No. 38 Xueyuan Road, Beijing 100191, China
- Correspondence: (Y.H.); (S.S.)
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Chen H, Wu J, Wang Z, Wu Y, Wu T, Wu Y, Wang M, Wang S, Wang X, Wang J, Yu H, Hu Y, Shang S. Trends and Patterns of Knee Osteoarthritis in China: A Longitudinal Study of 17.7 Million Adults from 2008 to 2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168864. [PMID: 34444613 PMCID: PMC8395063 DOI: 10.3390/ijerph18168864] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/19/2021] [Accepted: 08/20/2021] [Indexed: 12/18/2022]
Abstract
Background: Knee osteoarthritis (KOA) provides many challenges on the healthcare system. However, few studies have reported the epidemiology, particularly in a large population. Our study aimed to estimate the prevalence, incidence, trends, and patterns of diagnosed KOA in China. Methods: This was a longitudinal study. We used health insurance claims of 17.7 million adults from 2008-2017 to identify people with KOA. Trends in prevalence and incidence were analyzed using joinpoint regression. Results: We identified 2,447,990 people with KOA in Beijing, 60% of which were women. The 10-year average age-standardized prevalence and incidence of KOA was, respectively, 4.6% and 25.2 per 1000 person-years. Prevalence increased with age, surging after 55 years old. The average crude prevalence was 13.2% for people over 55 years old. The prevalence showed an increasing trend from 2008 to 2017, including a period of rapid rise from 2008 to 2011 (p < 0.05); the increase in prevalence was greatest in people under 35 years old (p < 0.05). Conclusion: Our analyses showed that the annual prevalence rate of KOA increased significantly from 2008 to 2017 in China. We need to increase our attention to women and the elderly over 55 years old, and also be alert to the younger trend of incidence of KOA.
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Affiliation(s)
- Hongbo Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100191, China; (H.C.); (J.W.); (Z.W.); (Y.W.); (T.W.); (Y.W.); (M.W.); (S.W.); (X.W.); (J.W.); (H.Y.)
- School of Nursing, Peking University, No. 38 Xueyuan Road, Beijing 100191, China
| | - Junhui Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100191, China; (H.C.); (J.W.); (Z.W.); (Y.W.); (T.W.); (Y.W.); (M.W.); (S.W.); (X.W.); (J.W.); (H.Y.)
| | - Zijing Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100191, China; (H.C.); (J.W.); (Z.W.); (Y.W.); (T.W.); (Y.W.); (M.W.); (S.W.); (X.W.); (J.W.); (H.Y.)
| | - Yao Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100191, China; (H.C.); (J.W.); (Z.W.); (Y.W.); (T.W.); (Y.W.); (M.W.); (S.W.); (X.W.); (J.W.); (H.Y.)
| | - Tao Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100191, China; (H.C.); (J.W.); (Z.W.); (Y.W.); (T.W.); (Y.W.); (M.W.); (S.W.); (X.W.); (J.W.); (H.Y.)
| | - Yiqun Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100191, China; (H.C.); (J.W.); (Z.W.); (Y.W.); (T.W.); (Y.W.); (M.W.); (S.W.); (X.W.); (J.W.); (H.Y.)
| | - Mengying Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100191, China; (H.C.); (J.W.); (Z.W.); (Y.W.); (T.W.); (Y.W.); (M.W.); (S.W.); (X.W.); (J.W.); (H.Y.)
| | - Siyue Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100191, China; (H.C.); (J.W.); (Z.W.); (Y.W.); (T.W.); (Y.W.); (M.W.); (S.W.); (X.W.); (J.W.); (H.Y.)
| | - Xiaowen Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100191, China; (H.C.); (J.W.); (Z.W.); (Y.W.); (T.W.); (Y.W.); (M.W.); (S.W.); (X.W.); (J.W.); (H.Y.)
| | - Jiating Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100191, China; (H.C.); (J.W.); (Z.W.); (Y.W.); (T.W.); (Y.W.); (M.W.); (S.W.); (X.W.); (J.W.); (H.Y.)
| | - Huan Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100191, China; (H.C.); (J.W.); (Z.W.); (Y.W.); (T.W.); (Y.W.); (M.W.); (S.W.); (X.W.); (J.W.); (H.Y.)
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100191, China; (H.C.); (J.W.); (Z.W.); (Y.W.); (T.W.); (Y.W.); (M.W.); (S.W.); (X.W.); (J.W.); (H.Y.)
- Medical Informatics Center, Peking University, No. 38 Xueyuan Road, Beijing 100191, China
- Correspondence: (Y.H.); (S.S.)
| | - Shaomei Shang
- School of Nursing, Peking University, No. 38 Xueyuan Road, Beijing 100191, China
- Correspondence: (Y.H.); (S.S.)
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Muhammad T, Maurya P, Sharma P. Prevalence and correlates of bone and joint diseases and its association with falls among older adults in India: Evidence from LASI, 2017-18. Geriatr Nurs 2021; 42:1143-1150. [PMID: 34404017 DOI: 10.1016/j.gerinurse.2021.07.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/20/2021] [Accepted: 07/21/2021] [Indexed: 12/13/2022]
Abstract
This study explores the prevalence and correlates of bone and joint diseases and its association with falls among older adults in India. Data from the Longitudinal Aging Study in India (2017-18) were utilized for analysis (n = 31,464). Bivariate and logistic regression was used to fulfill the study objectives. The findings revealed that 19.71% of older adults had bone and joint disease, which was higher among women (22.79%) than men (16.25%). The strongest predictors of such diseases included being currently employed, physically inactive, having difficulties in performing functional activities and higher economic status. The fall in the last two years was reported by 12.63% of older adults, and bone and joints diseases were significantly associated with falls (AOR = 1.287; 95% CI: 1.117-1.483) after adjusting for several socio-demographic and health covariates. These findings imply that policymakers and providers must implement interventions designed to reduce the risk of those diseases and associated falls.
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Affiliation(s)
- T Muhammad
- Department of Population Policies and Programmes, International Institute for Population Sciences, Mumbai, Maharashtra 400088, India.
| | - Priya Maurya
- Department of Development Studies, International Institute for Population Sciences, Mumbai, Maharashtra 400088, India.
| | - Palak Sharma
- Department of Mathematical Demography and Statistics, International Institute for Population Sciences, Mumbai, Maharashtra 400088, India.
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Lee JI, Kim DH, Yoo HJ, Choi HG, Lee YS. Comparison of the Predicting Performance for Fate of Medial Meniscus Posterior Root Tear Based on Treatment Strategies: A Comparison between Logistic Regression, Gradient Boosting, and CNN Algorithms. Diagnostics (Basel) 2021; 11:diagnostics11071225. [PMID: 34359308 PMCID: PMC8304966 DOI: 10.3390/diagnostics11071225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 07/05/2021] [Indexed: 01/17/2023] Open
Abstract
This study aimed to validate the accuracy and prediction performance of machine learning (ML), deep learning (DL), and logistic regression methods in the treatment of medial meniscus posterior root tears (MMPRT). From July 2003 to May 2018, 640 patients diagnosed with MMPRT were included. First, the affecting factors for the surgery were evaluated using statistical analysis. Second, AI technology was introduced using X-ray and MRI. Finally, the accuracy and prediction performance were compared between ML&DL and logistic regression methods. Affecting factors of the logistic regression method corresponded well with the feature importance of the six top-ranked factors in the ML&DL method. There was no significant difference when comparing the accuracy, F1-score, and error rate between ML&DL and logistic regression methods (accuracy = 0.89 and 0.91, F1 score = 0.89 and 0.90, error rate = 0.11 and 0.09; p = 0.114, 0.422, and 0.119, respectively). The area under the curve (AUC) values showed excellent test quality for both ML&DL and logistic regression methods (AUC = 0.97 and 0.94, respectively) in the evaluation of prediction performance (p = 0.289). The affecting factors of the logistic regression method and the influence of the ML&DL method were not significantly different. The accuracy and performance of the ML&DL method in predicting the fate of MMPRT were comparable to those of the logistic regression method. Therefore, this ML&DL algorithm could potentially predict the outcome of the MMRPT in various fields and situations. Furthermore, our method could be efficiently implemented in current clinical practice.
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Current Epidemiology and Risk Factors for the Development of Hand Osteoarthritis. Curr Rheumatol Rep 2021; 23:61. [PMID: 34216294 DOI: 10.1007/s11926-021-01025-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2021] [Indexed: 12/23/2022]
Abstract
PURPOSE OF REVIEW Hand osteoarthritis (hand OA), the most common peripheral arthritis in the world, is less studied than osteoarthritis (OA) of the knee and hip. However, it is uniquely situated to offer novel insight into OA as a disease process by removing weight-bearing as a confounder of systemic disease mechanisms. Here we review the epidemiology of hand OA and key risk factors for its development. RECENT FINDINGS Mounting evidence points to obesity as an important risk factor for hand OA development, with new evidence implicating a role for leptin and serum fatty acids. Disease progression in hand OA and specifically the erosive OA subtype may be associated with diabetes. New evidence supports an association between cardiovascular disease progression and symptomatic hand OA. Alcohol use may be associated with increased synovitis and erosive hand OA. Differences in ethnical distributions of hand OA have become more apparent, with a lower prevalence in Black patients compared to White patients. Novel genetic insights implicating the WNT gene pathway and IL-1β have led to novel potential targets in hand OA pathogenesis. Hand OA is a heterogeneous disease with many modifiable and non-modifiable risk factors that can determine disease severity and shed light on disease pathogenesis.
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Xiao Z, Li G. The effect of Wuqinxi exercises on the balance function and subjective quality of life in elderly, female knee osteoarthritis patients. Am J Transl Res 2021; 13:6710-6716. [PMID: 34306416 PMCID: PMC8290749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 12/28/2020] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To investigate the balance function and subjective quality of life in elderly female knee osteoarthritis patients KOAKOA treated with Wuqinxi exercises. METHODS A total of 284 elderly female patients with knee osteoarthritis (KOA) were randomly divided into an experimental group, which did Wuqinxi exercises for 24-weeks (n=132), and a control group, which didn't do any regular physical exercises (n=134). The experimental group did Wuqinxi exercises for 24 weeks, and the control group didn't engage in any regular physical exercise. We performed limits of stability (LOS) tests, static posture stability (SPS) tests, and dynamic fall index (DFI) tests to assess the patients' balance, and we administered the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire to evaluate the physical functioning of the patients' knees. RESULTS The limits of stability (LOS) test, the static posture stability (SPS) test, and the dynamic fall index (DFI) test results were improved in the experimental group compared with the control group (P < 0.05). From baseline to the week 24 follow-up, the WOMAC tests, and the pain, joint stiffness, and lower limb muscle strength showed significant differences between the two groups (P < 0.05). CONCLUSIONS Wuqinxi exercises are an effective treatment for elderly female patients with knee osteoarthritis, and can improve their balance and subjective quality of life. The therapy effectively alleviates the clinical symptoms of the elderly female knee osteoarthritis patients.
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Affiliation(s)
- Zhigang Xiao
- Department of Orthopaedics and Traumatology, Hubei Provincial Hospital of Traditional Chinese Medicine Wuhan 430074, Hubei, China
| | - Gang Li
- Department of Orthopaedics and Traumatology, Hubei Provincial Hospital of Traditional Chinese Medicine Wuhan 430074, Hubei, China
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The prevalence of radiographic thumb base osteoarthritis: a meta-analysis. Osteoarthritis Cartilage 2021; 29:785-792. [PMID: 33744429 DOI: 10.1016/j.joca.2021.03.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 02/19/2021] [Accepted: 03/10/2021] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Osteoarthritis (OA) affects millions of people worldwide. In hand OA, the thumb base is the most affected single joint. The reported radiographic prevalence ranges from 0 to 100%, making the true radiographic prevalence unclear. Hence, we conducted a meta-analysis on the age and sex-specific prevalence of radiographic thumb base OA. METHODS We performed a search in Embase, Medline Ovid, Web of Science Core Collection, Cochrane Central Register of Trials, and Google Scholar. We included studies of the general population that reported thumb base OA for males and females separately based on a hand radiograph and reported the age of these groups. Using meta-regression, we estimated the odds ratio (OR) of having radiographic thumb base OA for age and sex, while adjusting for within-study correlation. RESULTS The initial search yielded 4,278 articles; we finally included 16 studies that reported the age- and sex-stratified prevalence. Taken together, there were 104 age and gender specific-prevalence rates that could be derived from the 16 studies. The prevalence of radiographic OA for the 50-year-old male and female participants was 5.8% and 7.3%, respectively, while the respective prevalence for 80-year-old male and female participants was 33.1% and 39.0%. We found an OR for having radiographic OA of 1.06 (95%CI [1.055-1.065], p < 0.001) per increasing year of age, and 1.30 (95%CI: 1.05-1.61], p = 0.014) for females. CONCLUSION In the general population, radiographic thumb base OA is more prevalent in females and is strongly associated with age.
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Leonard G, Paquet N, Guitard P, Toupin-April K, Cavallo S, Paterson G, Aydin SZ, Bakirci S, Coulombe-Lévêque A, Brosseau L. The effects of an 8-week knitting program on osteoarthritis symptoms in elderly women: A pilot randomized controlled trial. J Bodyw Mov Ther 2021; 27:410-419. [PMID: 34391264 DOI: 10.1016/j.jbmt.2021.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 03/18/2021] [Accepted: 04/11/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Exercise therapy is effective in reducing symptoms and disability associated with hand osteoarthritis (HOA) but often has low adherence. An intervention consisting in a meaningful occupation, such as knitting, may improve adherence to treatment. This pilot randomized controlled trial (RCT) studied the adherence and clinical effectiveness of a knitting program in older females suffering from HOA to evaluate the acceptability of this intervention and assess the feasibility of a larger-scale RCT. METHODS Single-blind, two-arm pilot RCT with a parallel group design with 37 participants (18 control, 19 intervention). Control participants were given an educational pamphlet and assigned to a waiting list. The knitting program (8-week duration) had two components: bi-weekly 20-min group knitting sessions and daily 20-min home knitting session on the 5 remaining weekdays. Measures included knitting adherence (implementation outcomes) as well as stiffness, pain, functional status, hand physical activity level, patient's global impression of change, health-related quality of life, self-efficacy, and grip strength (clinical outcomes measured throughout the 8-week program and 4 weeks after the intervention). RESULTS Our protocol is feasible and the intervention was acceptable and enjoyable for participants, who showed high adherence. No difference was observed between the two groups for any of the clinical outcome measures (all p > .05). CONCLUSION Knitting is a safe and accessible activity for older women with HOA. However, our 8-week knitting program did not result in improvements in any of our outcome measures. Knitting for a longer period and/or with higher frequency may yield better outcomes.
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Affiliation(s)
- Guillaume Leonard
- Faculté de médecine et des sciences de la santé, École de réadaptation, Université de Sherbrooke, Sherbrooke, Quebec, Canada; Research Center on Aging, CIUSSS de l'Estrie - CHUS, Sherbrooke, Quebec, Canada.
| | - Nicole Paquet
- Physiotherapy Program, School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.
| | - Paulette Guitard
- Occupational Therapy Program, School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.
| | - Karine Toupin-April
- Occupational Therapy Program, School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, Faculty of Medicine, Ottawa, Ontario, Canada.
| | - Sabrina Cavallo
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada.
| | - Gail Paterson
- The Arthritis Society, Ottawa Office, Ontario Division, Ottawa, Ontario, Canada.
| | - Sibel Z Aydin
- Rheumatologist, Ottawa Hospital, Ottawa, Ontario, Canada.
| | - Sibel Bakirci
- Rheumatologist, Ottawa Hospital, Ottawa, Ontario, Canada.
| | - Alexia Coulombe-Lévêque
- Faculté de médecine et des sciences de la santé, École de réadaptation, Université de Sherbrooke, Sherbrooke, Quebec, Canada; Research Center on Aging, CIUSSS de l'Estrie - CHUS, Sherbrooke, Quebec, Canada.
| | - Lucie Brosseau
- Physiotherapy Program, School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.
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Peng L, Yan Y, Hou X, Niu D, Wei J, Wang J. Evaluation of the effect of a three-color ladder management model for knee osteoarthritis in the community. Am J Transl Res 2021; 13:3074-3083. [PMID: 34017475 PMCID: PMC8129419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 02/06/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To explore the application effect of a three-color ladder management system for knee osteoarthritis in the community. METHODS Eighty-six patients with knee osteoarthritis in our community were obtained for study and randomly grouped. The control group received routine management, while the research group received three-color ladder management for 12 months. The knee joint function (WOMAC score), pain degree (VAS score), joint flexibility, health-related behavior score, self-care ability scale (exercise of self-care agency scale (ESCA) score), quality of life (knee osteoarthritis quality of life scale (AIMS2-SF) score) and knee replacement rate were compared between the two groups before and after management, and the changes of patients' visits and treatment costs before and after management were observed. RESULTS After 12 months, the scores of WOMAC and VAS in the research group were significantly lower than those of the control group (P<0.05), while the scores of joint flexibility and extension, cognition, behavior and condition of Omaha System health-related behaviors, ESCA and AIMS2-SF were significantly higher than those of the control group (P<0.05). After 12 months, the monthly visits and expenses of green cards, yellow cards and red cards in the research group were significantly lower than those before entering the group (P<0.05). After 12 months, the knee replacement rate was 20.93% (9/43) in the research group, while it was 27.91% (12/43) in the control group, with no significant difference between the two groups (P>0.05). CONCLUSION The three-color ladder management system for knee osteoarthritis patients in the community can reduce the number of doctor visits and overall expenses, improve knee joint function, reduce pain, improve self-management ability and quality of life, and it has high community popularization.
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Affiliation(s)
- Lei Peng
- Department of Outpatient, Xujiahui Community Health Service CenterShanghai City, China
| | - Yan Yan
- Medical Department, Xujiahui Community Health Service CenterShanghai City, China
| | - Xiaoqi Hou
- Department of Outpatient, Xujiahui Community Health Service CenterShanghai City, China
| | - Deng Niu
- Xujiahui Community Health Service CenterShanghai City, China
| | - Jing Wei
- Xujiahui Community Health Service CenterShanghai City, China
| | - Jianbo Wang
- Xujiahui Community Health Service CenterShanghai City, China
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Healthcare Utilization and Knee Osteoarthritis Symptoms among Urban Older Malaysian. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073777. [PMID: 33916628 PMCID: PMC8038539 DOI: 10.3390/ijerph18073777] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/10/2021] [Accepted: 03/12/2021] [Indexed: 12/21/2022]
Abstract
Knee osteoarthritis (OA) is a prevalent chronic disorder in the older population. While timely management is important to minimize the consequences of knee OA, information on the utilization of healthcare services among this population remains limited. Therefore, the objectives of this study were to determine the healthcare utilization and its associated factors in older persons with knee OA. Cross-sectional data from 1073 participants aged 60 years and above from the Malaysian Elders Longitudinal Research (MELoR) study were included. The utilization rate of healthcare services was quantified. Factors related to the utilization of healthcare services were determined using logistic regression analysis. Healthcare utilization among participants with knee OA was significantly higher than those without knee OA (p < 0.01). Outpatient usage was higher (p < 0.01) in comparison to inpatient and pharmacotherapy. Being married and having an income were significantly associated with seeking outpatient care (OR: 11.136, 95% CI: 1.73–52.82, p < 0.01) and pharmacotherapy (OR: 10.439, 95% CI: 1.187–91.812, p < 0.05), while females were less likely to utilize inpatient care services (OR: 0.126, 95% CI: 0.021–0.746, p < 0.05). The higher rate of healthcare utilization among older persons with knee OA indicates the increased healthcare needs of this population, who are commonly assumed to suffer from a benign disease.
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Shah K, Cai H, Lane JCE, Collins GS, Arden NK, Furniss D, Filbay SR. Prognostic factors for finger interphalangeal joint osteoarthritis: a systematic review. Rheumatology (Oxford) 2021; 60:1080-1090. [PMID: 33253392 DOI: 10.1093/rheumatology/keaa735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 10/16/2020] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE Radiographic hand OA affects one in five adults. Symptomatic hand OA can result in functional impairment, pain and reduced quality of life. A prevalent form of hand OA is IP joint OA, however prognostic factors for IP joint OA remain poorly understood. This systematic review aimed to identify prognostic factors for IP joint OA, and to summarize the diagnostic criteria for IP joint OA in prognostic studies. METHODS EMBASE, MEDLINE, Scopus and The Cochrane Library were searched from inception until 19 February 2020 (PROSPERO CRD42019116782). Eligible studies described diagnostic criteria defining IP joint OA, and assessed potential prognostic factors for IP joint OA. Risk of bias was assessed using a modified Quality in Prognosis Studies (QUIPS) tool and a best evidence synthesis was used. RESULTS Eighteen studies were included (risk of bias: eight high, three moderate, seven low). All defined OA radiographically, and three studies incorporated clinical symptoms into their definition of OA. Forty-nine potential prognostic factors were assessed. Eight were prognostic: older age in women, female gender (both moderate evidence); family history of Heberden's nodes, Kashin-Beck disease, older age in men, dental occupation in men, finger fracture, parity (all limited evidence). Higher BMI in women (limited evidence) was prognostic for symptomatic radiographic OA. No prognostic factors for symptomatic OA were identified. CONCLUSION IP joint OA is most commonly defined radiographically, yet criteria were heterogeneous. Eight prognostic factors for radiographic IP joint OA and one for symptomatic radiographic IP joint OA were identified, all with limited or moderate evidence. Further studies on causality and on prognostic pathways are needed.
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Affiliation(s)
- Karishma Shah
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - He Cai
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
| | - Jennifer C E Lane
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Gary S Collins
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Nigel K Arden
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Dominic Furniss
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,Department of Plastic and Reconstructive Surgery, Nuffield Orthopaedic Centre, Oxford, Oxford, UK
| | - Stephanie R Filbay
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, Melbourne University, Melbourne, Victoria, Australia
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Wang L, Lu H, Chen H, Jin S, Wang M, Shang S. Development of a model for predicting the 4-year risk of symptomatic knee osteoarthritis in China: a longitudinal cohort study. Arthritis Res Ther 2021; 23:65. [PMID: 33632294 PMCID: PMC7908741 DOI: 10.1186/s13075-021-02447-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 02/11/2021] [Indexed: 12/02/2022] Open
Abstract
Objectives We aimed to develop a model for predicting the 4-year risk of knee osteoarthritis (KOA) based on survey data obtained via a random, nationwide sample of Chinese individuals. Methods Data was analyzed from 8193 middle-aged and older adults included in the China Health and Retirement Longitudinal Study (CHARLS). The incident of symptomatic KOA was defined as participants who were free of symptomatic KOA at baseline (CHARLS2011) and diagnosed with symptomatic KOA at the 4-year follow-up (CHARLS2015). The effects of potential predictors on the incident of KOA were estimated using logistic regression models and the final model was internally validated using the bootstrapping technique. Model performance was assessed based on discrimination—area under the receiver operating characteristic curve (AUC)—and calibration. Results A total of 815 incidents of KOA were identified at the 4-year follow-up, resulting in a cumulative incidence of approximately 9.95%. The final multivariable model included age, sex, waist circumference, residential area, difficulty with activities of daily living (ADLs)/instrumental activities of daily living (IADLs), history of hip fracture, depressive symptoms, number of chronic comorbidities, self-rated health status, and level of moderate physical activity (MPA). The risk model showed good discrimination with AUC = 0.719 (95% confidence interval [CI] 0.700–0.737) and optimism-corrected AUC = 0.712 after bootstrap validation. A satisfactory agreement was observed between the observed and predicted probability of incident symptomatic KOA. And a simple clinical score model was developed for quantifying the risk of KOA. Conclusion Our prediction model may aid the early identification of individuals at the greatest risk of developing KOA within 4 years.
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Affiliation(s)
- Limin Wang
- School of Nursing, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Han Lu
- School of Nursing, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Hongbo Chen
- School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Shida Jin
- School of Nursing, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Mengqi Wang
- School of Nursing, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Shaomei Shang
- School of Nursing, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China.
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Perruccio AV, Power JD, Yip C, Badley EM, Canizares M, Rampersaud YR. The impact of multijoint symptoms on patient-reported disability following surgery for lumbar spine osteoarthritis. Spine J 2021; 21:80-89. [PMID: 32805432 DOI: 10.1016/j.spinee.2020.08.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 08/11/2020] [Accepted: 08/11/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT In the lumbar spine osteoarthritis (LS-OA) population having surgery for lumbar spinal stenosis (LSS) symptoms, a significant proportion of patients experience limited benefit following the intervention. Thus, identifying contributing factors to this is important. Individuals with OA often have multiple joint symptoms, yet this has received limited attention in this population. PURPOSE Document the occurrence of joint symptoms among patients undergoing surgery for LS-OA, and investigate the influence of these symptoms on disability postsurgery. DESIGN Prospective study of consecutive patients followed to 12-month postsurgery. PATIENT SAMPLE Patients undergoing surgery (decompression surgery, with or without fusion) for neurogenic claudication with or without back pain due to LSS with a primary pathology diagnosis of LS-OA. OUTCOMES MEASURES Patient self-reported: Oswestry Disability Index (ODI), completed pre- and 12-month postsurgery; and, completed presurgery, age, sex, education, smoking, comorbid conditions, opioid use, short/long-term disability, depression and anxiety symptoms, back and leg pain intensity, presence of spondylolisthesis, procedure, prior spine surgery, and joints with arthritis and "pain/stiffness/swelling most days of the month" indicated on a homunculus (a joint site count was derived). ASSESSMENTS Height and weight, used to calculate body mass index; timed-up-and-go performance-based test. METHODS Outcome of interest was achieving a clinically important improvement (CII) in ODI by 12-month postsurgery (yes/no). The association between joint site count and achieving a CII was examined by multivariable logistic regression analyses, adjusted for other measures. RESULTS In all, 165 patients were included. The mean age was 67 years (range: 44-90) and 47% were female. Seventy-seven percent reported 1+ joint site other than the back, 62% reported 2+, and 25% reported 4+. Among those achieving a CII, 21% had 4+ joint sites, compared with 31% among those not achieving a CII. Adjusted analyses: Increasing joint site count was associated with increasing risk (odds ratio [OR]: 1.32, 95% confidence interval [CI]: 1.05, 1.66) of not achieving a CII; for those with 4+ joints, adjusted probability of not achieving a CII exceeded 50%. Also associated with an increased risk of not achieving a CII was presurgery anxiety (OR: 2.97, 95% CI: 1.02, 8.65), opioid use (OR: 2.89, 95% CI: 1.07, 7.82), and worse back pain intensity score (OR: 1.27, 95% CI: 1.05, 1.53). CONCLUSIONS Multijoint involvement was highly prevalent in this LS-OA surgical sample. Its association with poorer postsurgery outcome supports a comprehensive approach to OA management and care. Knowledge of multijoint symptoms should inform patient education, shared decision-making, and recommendations for postsurgical rehabilitation and self-management strategies.
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Affiliation(s)
- Anthony V Perruccio
- Arthritis Program, Krembil Research Institute, University Health Network, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, Canada.
| | - J Denise Power
- Arthritis Program, Krembil Research Institute, University Health Network, Toronto, Canada
| | - Calvin Yip
- Arthritis Program, Krembil Research Institute, University Health Network, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Elizabeth M Badley
- Arthritis Program, Krembil Research Institute, University Health Network, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Mayilee Canizares
- Arthritis Program, Krembil Research Institute, University Health Network, Toronto, Canada
| | - Y Raja Rampersaud
- Arthritis Program, Krembil Research Institute, University Health Network, Toronto, Canada; Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, Canada
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Treatment and Healthcare Cost Among Patients with Hip or Knee Osteoarthritis: A Cross-sectional Study Using a Real-world Claims Database in Japan Between 2013 and 2019. Clin Drug Investig 2020; 40:1071-1084. [PMID: 32965598 DOI: 10.1007/s40261-020-00968-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND OBJECTIVES The guidelines for osteoarthritis (OA) treatment recommend different therapies including pharmacotherapy, and several analgesic options are available for pain management. In Japan, research on hip and knee OA treatment trends is scarce and OA-related healthcare costs are unknown. Therefore, this study aimed to examine the treatment and healthcare cost trends among Japanese patients with hip or knee OA. METHODS This was a cross-sectional study held between 2013 and 2019, using a medical claims database. The demographic and treatment characteristics of hip or knee OA patients for each year were descriptively analyzed and the medians for healthcare utilization and all-cause healthcare costs were calculated. RESULTS The yearly mean age of 59,218 hip OA and 270,722 knee OA patients ranged from 66.3 to 68.6 years and 71.1 to 73.1 years, respectively. The prevalence of comorbidities was higher in knee OA than hip OA. In both groups, > 70% of patients were female, and the most common treatment was pain-related medication. In hip OA, topical and systemic nonsteroidal anti-inflammatory drugs (NSAIDs) were mostly used throughout the study period (34.1-41.4% and 32.0-40.3%, respectively). Similarly, in knee OA, topical and systemic NSAIDs were used in 58.3-63.3% and 36.5-46.0% patients, respectively. Increase in the use of acetaminophens (10.9% in hip OA and 10.2% in the knee OA) and weak opioids (3.7%, and 3.4%, respectively) from 2013 to 2019 were observed. Most patients were treated as outpatients in both groups. The median all-cause healthcare costs were approximately 35,000 JPY for hip OA and 74,000 JPY for knee OA. CONCLUSIONS Although a considerable change in total healthcare cost was not observed in our study, the contents of medical treatment and cost breakdown were greatly altered due to the treatment and cost for OA itself, and the treatment and cost for comorbidities. Similar studies to investigate such a trend may help predict necessary resources and social needs. Thus, further investigation utilizing other databases is needed.
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Reliability of the assessment of disc degeneration on the lateral DXA scans. Joint Bone Spine 2020; 88:105123. [PMID: 33346108 DOI: 10.1016/j.jbspin.2020.105123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 11/16/2020] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Given the prevalence and costs induced by osteoarthritis (OA), it is necessary to find a cheap and safe technique to evaluate it reliably. OBJECTIVE To assess the value of the lateral dual energy X-ray absorptiometry (DXA) spine scans for the diagnosis of disc degeneration. METHOD Seventy-seven individuals aged 18 and over, with or without disc degeneration, had both lateral thoracolumbar spine radiographs and DXA spine scans (≤6months between both exams). Disc degeneration was assessed using the Lane score. The images of 20 randomly selected individuals were assessed by two readers. RESULTS Almost 13% of the thoracic levels were not assessable on the DXA scans. For the identification of the intervertebral levels on the DXA scans as interpretable or not, the intra-reader agreement was good (κ=0.81) and the inter-reader agreement was fair (κ=0.27-0.36). For the diagnostic criteria (osteophytes, disc space narrowing, osteosclerosis, overall grade), the intra-reader agreement was excellent for the radiographs (κ=0.89-0.92), good for the DXA scans (κ=0.64-0.83) and fair to moderate for the between-method comparison (κ=0.25-0.44). The inter-reader agreement was moderate to good for the radiographs (κ=0.49-0.66) and fair to good for the DXA scans (κ=0.32-0.74). In the per patient analysis (the most severe grade), the intra-reader agreement was excellent for the radiographs (κ=0.85-0.94), moderate to excellent for the DXA scans (κ=0.53-0.85) and poor to good for the between-methods comparison (κ=0.17-0.63). CONCLUSION Our results do not support the use of DXA scans for the assessment of thoracolumbar disc degeneration.
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Cui A, Li H, Wang D, Zhong J, Chen Y, Lu H. Global, regional prevalence, incidence and risk factors of knee osteoarthritis in population-based studies. EClinicalMedicine 2020; 29-30:100587. [PMID: 34505846 PMCID: PMC7704420 DOI: 10.1016/j.eclinm.2020.100587] [Citation(s) in RCA: 402] [Impact Index Per Article: 100.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Knee osteoarthritis (OA) is a major cause of disability in the elderly, however, there are few studies to estimate the global prevalence, incidence, and risk factors of knee OA. METHODS For this study, we searched PUBMED, EMBASE and SCOPUS from inception to April 4, 2020, without language restriction. We identified eligible studies with information on the prevalence or incidence of knee OA in population-based observational studies and extracted data from published reports. We did random-effects meta-analysis to generate estimates. This study was registered with PROSPERO (CRD42020181035). FINDINGS Out of 9570 records identified, 88 studies with 10,081,952 participants were eligible for this study. The pooled global prevalence of knee OA was 16⋅0% (95% CI, 14⋅3%-17⋅8%) in individuals aged 15 and over and was 22⋅9% (95% CI, 19⋅8%-26⋅1%) in individuals aged 40 and over. Correspondingly, there are around 654⋅1 (95% CI, 565⋅6-745⋅6) million individuals (40 years and older) with knee OA in 2020 worldwide. The pooled global incidence of knee OA was 203 per 10,000 person-years (95% CI, 106-331) in individuals aged 20 and over. Correspondingly, there are around annual 86⋅7 (95% CI, 45⋅3-141⋅3) million individuals (20 years and older) with incident knee OA in 2020 worldwide. The prevalence and incidence varied substantially between individual countries and increased with age. The ratios of prevalence and incidence in females and males were 1⋅69 (95% CI, 1⋅59-1⋅80, p<0⋅00) and 1⋅39 (95% CI, 1⋅24-1⋅56, p<0⋅00), respectively. INTERPRETATION Our study provides the global prevalence (16⋅0% [95% CI, 14⋅3%-17⋅8%]) and incidence (203 per 10,000 person-years [95% CI, 106-331]) of knee OA. These findings can be used to better assess the global health burden of knee OA. Further prospective cohort studies are warranted to identify modifiable risk factors for providing effectively preventive strategies in the early stages of the disease. FUNDING This work was supported by grants from the National Natural Science Foundation of China (nos. 81772384 and 81572174).
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Affiliation(s)
| | | | - Dawei Wang
- Department of Orthopaedics, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai 519000, Guangdong, China
| | - Junlong Zhong
- Department of Orthopaedics, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai 519000, Guangdong, China
| | - Yufeng Chen
- Department of Orthopaedics, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai 519000, Guangdong, China
| | - Huading Lu
- Department of Orthopaedics, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai 519000, Guangdong, China
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Pascoalino SD, Lüdtke DD, Heymanns AC, Salm D, Costa DM, Martins DF, Horewicz VV, Bobinski F, Piovezan AP. Antihyperalgesic effect of exercise is augmented by the oral pretreatment with extract of Casearia sylvestris in an animal model of osteoarthritis. JOURNAL OF ORTHOPAEDICS, TRAUMA AND REHABILITATION 2020. [DOI: 10.1177/2210491720935614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Background/Purpose: Osteoarthritis (OA) is the main orthopedic disease to cause pain and edema in humans. This study evaluated the influence of complementary medicine on the hyperalgesia and edema induced by exercise in an animal model of OA as well as possible role for interleukin (IL)-1β to these outcomes. Methods: Mice (25–35 g) were subjected to intraplantar injection of Freund’s complete adjuvant and were subjected to exercise and oral treatment with ethanolic crude extract of Casearia sylvestris (ECE-CS) or vehicle (alone or in combination) and evaluated through behavioral and biochemical tests. Results: At day 5, exercise and ECE-CS alone did not reduce hyperalgesia, while the combination of both enhanced this effect. In muscle and skin tissues from the treated paw of mice, both treatments alone or in combination reduced in similar extent the levels of IL-1β in relation to the control group. Conclusion: Association of both complementary therapies may bring benefits on pain associated with OA in humans.
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Affiliation(s)
- Shayany Dalbem Pascoalino
- Physical Education Undergraduate Course, University of Southern Santa Catarina (UNISUL), Palhoça, Santa Catarina, Brazil
| | - Daniela Dero Lüdtke
- Postgraduate Program in Health Sciences (PPGCS), University of Southern Santa Catarina (UNISUL), Palhoça, Santa Catarina, Brazil
- Laboratory of Experimental Neuroscience (LANEX), University of Southern Santa Catarina (UNISUL), Palhoça, Santa Catarina, Brazil
| | - Ana Caroline Heymanns
- Physical Education Undergraduate Course, University of Southern Santa Catarina (UNISUL), Palhoça, Santa Catarina, Brazil
- Postgraduate Program in Health Sciences (PPGCS), University of Southern Santa Catarina (UNISUL), Palhoça, Santa Catarina, Brazil
- Laboratory of Experimental Neuroscience (LANEX), University of Southern Santa Catarina (UNISUL), Palhoça, Santa Catarina, Brazil
| | - Daiana Salm
- Postgraduate Program in Health Sciences (PPGCS), University of Southern Santa Catarina (UNISUL), Palhoça, Santa Catarina, Brazil
- Laboratory of Experimental Neuroscience (LANEX), University of Southern Santa Catarina (UNISUL), Palhoça, Santa Catarina, Brazil
| | - Déborah M Costa
- Medicine Undergraduate Course, University of Southern Santa Catarina (UNISUL), Palhoça, Santa Catarina, Brazil
| | - Daniel Fernandes Martins
- Postgraduate Program in Health Sciences (PPGCS), University of Southern Santa Catarina (UNISUL), Palhoça, Santa Catarina, Brazil
- Laboratory of Experimental Neuroscience (LANEX), University of Southern Santa Catarina (UNISUL), Palhoça, Santa Catarina, Brazil
| | - Verônica V Horewicz
- Postgraduate Program in Health Sciences (PPGCS), University of Southern Santa Catarina (UNISUL), Palhoça, Santa Catarina, Brazil
- Laboratory of Experimental Neuroscience (LANEX), University of Southern Santa Catarina (UNISUL), Palhoça, Santa Catarina, Brazil
| | - Franciane Bobinski
- Postgraduate Program in Health Sciences (PPGCS), University of Southern Santa Catarina (UNISUL), Palhoça, Santa Catarina, Brazil
- Laboratory of Experimental Neuroscience (LANEX), University of Southern Santa Catarina (UNISUL), Palhoça, Santa Catarina, Brazil
| | - Anna Paula Piovezan
- Postgraduate Program in Health Sciences (PPGCS), University of Southern Santa Catarina (UNISUL), Palhoça, Santa Catarina, Brazil
- Laboratory of Experimental Neuroscience (LANEX), University of Southern Santa Catarina (UNISUL), Palhoça, Santa Catarina, Brazil
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Topical Diclofenac Solution for Osteoarthritis of the Knee: An Updated Meta-Analysis of Randomized Controlled Trials. BIOMED RESEARCH INTERNATIONAL 2020; 2020:1758071. [PMID: 33299860 PMCID: PMC7707945 DOI: 10.1155/2020/1758071] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/03/2020] [Accepted: 11/07/2020] [Indexed: 12/28/2022]
Abstract
This study was performed to assess the efficacy and safety of a topical diclofenac solution in patients with knee osteoarthritis (OA). PubMed, Embase, Cochrane Library, Web of Science, and Scopus databases were searched for randomized controlled trials until June 2020. The WOMAC pain, stiffness, physical function subscales, pain on walking, and the occurrence of adverse events were pooled to comprehensively analyse the efficacy and safety of topical diclofenac solution. All statistical analyses were conducted using Review Manager 5.3 software. Five RCTs were included, which provided high-quality evidence. In comparison to the vehicle control, the mean differences for WOMAC pain, stiffness, and physical function subscales, as well as pain on walking, were all statistically significant in favor of topical diclofenac solution. The safety of topical diclofenac solution was similar to the vehicle control, apart from adverse events involving application-site skin reactions. Topical diclofenac solution is effective and safe for use in patients with knee OA, but may cause minor skin reactions.
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Jain RK, Lee E, Mathai C, Dako F, Gogineni P, Weiner MG, Vokes T. Using opportunistic screening with abdominal CT to identify osteoporosis and osteopenia in patients with diabetes. Osteoporos Int 2020; 31:2189-2196. [PMID: 32623489 DOI: 10.1007/s00198-020-05521-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 06/25/2020] [Indexed: 12/11/2022]
Abstract
UNLABELLED Opportunistic osteoporosis screening involves measuring the attenuation of L1 vertebrae on abdominal computed tomography (CT), which correlates with DXA T-score. We found that this approach is useful for detecting low bone mass in patients with diabetes and propose L1 attenuation ≤ 135 Hounsfield units (HU) as a threshold for which DXA should be strongly considered. INTRODUCTION Attenuation of the L1 vertebrae on computer tomography (CT) images done for other reasons ("Opportunistic Osteoporosis Screening") has been found to correlate well with DXA-derived T-score. However, the method and the thresholds have never been tested specifically in those with diabetes mellitus (DM), in whom the fracture risk is greater than explained by BMD. METHODS In a retrospective study of subjects with DM who had both abdominal CT and DXA within 6 months of each other, we compared L1 attenuation and DXA T-score to define the sensitivity and specificity of thresholds previously established in the general population. RESULTS There were 313 subjects among whom 18 (5.8%) had prior major osteoporotic fracture (MOF). Subjects with MOF had lower T-scores (- 2.3 ± 1.4 vs. - 0.9 ± 1.4, p < 0.001) and L1 attenuation (104 HU ± 46 vs. 149 HU ± 47, p < 0.001) than non-fracture subjects. L1 attenuation ≤ 160 HU was 91% sensitive for osteoporosis, while ≤ 110 HU was 80% specific. For a higher T-score of ≤ - 1.5, L1 attenuation ≤ 135 HU showed balanced sensitivity and specificity (65% and 69%, respectively). CONCLUSION Opportunistic osteoporosis screening with abdominal CT is useful in determining the need for DXA screening in subjects with diabetes. We propose L1 attenuation ≤ 135 HU as a reasonable threshold for detecting the T-score of ≤ - 1.5, which is likely associated with increased fragility in DM.
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Affiliation(s)
- R K Jain
- Section of Endocrinology, Diabetes, and Metabolism, Lewis Katz School of Medicine at Temple University, 3322 N Broad St, Ste 205, Philadelphia, PA, 19140, USA.
| | - E Lee
- Lewis Katz School of Medicine at Temple University, Philadelphia, PA, 19140, USA
| | - C Mathai
- Section of Endocrinology, Diabetes, and Metabolism, Temple University Hospital, Philadelphia, PA, 19140, USA
| | - F Dako
- Department of Radiology, University of Maryland Medical Center, Baltimore, MD, 21201, USA
| | - P Gogineni
- Section of Endocrinology, Diabetes, and Metabolism, Temple University Hospital, Philadelphia, PA, 19140, USA
| | - M G Weiner
- Department of Healthcare Policy and Research, Weill Cornell Medicine, New York, NY, 10038, USA
| | - T Vokes
- Department of Medicine, Section of Endocrinology, Diabetes, and Metabolism, The University of Chicago, Chicago, IL, 60637, USA
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