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Haider MA, Lawrence KW, Christensen T, Schwarzkopf R, Macaulay W, Rozell JC. Does Melatonin Improve Sleep Following Primary Total Knee Arthroplasty? A Randomized, Double-Blind, Placebo-Controlled Trial. J Arthroplasty 2024; 39:S154-S160. [PMID: 38401621 DOI: 10.1016/j.arth.2024.02.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 02/09/2024] [Accepted: 02/13/2024] [Indexed: 02/26/2024] Open
Abstract
BACKGROUND Sleep impairment following total knee arthroplasty (TKA) is common and may decrease patient satisfaction and recovery. Standardized postoperative recommendations for sleep disturbances have not been established. We aimed to assess whether melatonin use could promote healthy sleep and reduce sleep disturbance in the acute period following TKA. METHODS Patients undergoing primary, elective TKA between July 19, 2021 and January 4, 2024 were prospectively enrolled and randomized to receive either 5 mg of melatonin nightly or placebo for 14 days postoperatively. Participants recorded their nightly pain on the visual analog scale, the number of hours slept, and the number of night-time awakenings in a sleep diary starting the night of surgery (postoperative day [POD] 0). Sleep disturbance was assessed preoperatively and on POD 14 using the patient-reported outcome measurement information system sleep disturbance form. Epworth Sleepiness Scores were collected on POD 14 to assess sleep quality. RESULTS Of the 138 patients enrolled, 128 patients successfully completed the study protocol, with 64 patients in each group. Melatonin patients trended toward more hours of sleep on POD 2 (placebo: 5.0 ± 2.4, melatonin: 5.8 ± 2.0, P = .084), POD 3 (placebo: 5.6 ± 2.2, melatonin: 6.3 ± 2.0, P = .075), and averaged over POD 1 to 3 (placebo: 4.9 ± 2.0, melatonin: 5.6 ± 1.8, P = .073), although no differences were observed on POD 4 or after. Fewer night-time awakenings in the melatonin group were observed on POD 1 (placebo: 4.4 ± 3.9, melatonin: 3.6 ± 2.4, P = .197), although this was not statistically significant. Preoperative and postoperative Patient-Reported Outcomes Measurement Information System Sleep Disturbance score increases were comparable for both groups (placebo: 4.0 ± 8.4, melatonin: 4.6 ± 8.2, P = .894). The melatonin (65.4%) and placebo (65%) groups demonstrated similar rates of increased sleep disturbance. CONCLUSIONS Melatonin may promote longer sleep in the immediate postoperative period after TKA, although these benefits wane after POD 3. Disturbances in sleep should be expected for most patients, although melatonin may have an attenuating effect. Melatonin is safe and can be considered for TKA patients experiencing early sleep disturbances postoperatively.
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Affiliation(s)
- Muhammad A Haider
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York
| | - Kyle W Lawrence
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York
| | - Thomas Christensen
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York
| | - Ran Schwarzkopf
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York
| | - William Macaulay
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York
| | - Joshua C Rozell
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York
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Wilson LAB, Lynch JT, Ménard JM, Galvin CR, Smith PN. Sex differences in patellar facet shape among healthy and osteoarthritic cohorts. Osteoarthritis Cartilage 2024:S1063-4584(24)01272-X. [PMID: 38986836 DOI: 10.1016/j.joca.2024.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 05/18/2024] [Accepted: 06/29/2024] [Indexed: 07/12/2024]
Abstract
OBJECTIVE Patellofemoral osteoarthritis (OA) may be more common in females than males. Reasons for this are not fully understood, but sex differences in patellar morphology may help explain this phenomenon. We quantified differences in patellar morphology between males and females in healthy and patellofemoral OA populations. DESIGN A total of 97 (50F, 47M) healthy and 67 (40F, 27M) OA knees were scanned via computed tomography. OA individuals were on a waitlist for total knee replacement. Patella 3D models were segmented and 2D measurements were recorded: patellar width and height, lateral and medial facet width, and surface area. Medial and lateral facet surface topography was mapped using 81 points to describe 3D articular surface shape. Sex and group differences were assessed using Procrustes analysis of variance (ANOVA). Data were ordinated using Principal Component Analysis. RESULTS Differences in patellar 2D measurements between healthy and OA individuals were smaller than were differences between males and females from healthy and OA groups. Sex and healthy/OA differences were most pronounced for medial facet shape, which featured a posteriorly-curving facet and taller, narrower facet shape in males compared to females. Lateral facet shape variance was higher in OA cohorts compared to healthy groups. CONCLUSIONS Medial and lateral facet shapes showed different patterning of variation by sex and healthy/OA status. Lateral facet shape may be of interest in future models of OA risk in the patellofemoral joint, here showing increased magnitudes of variance associated with increased severity of disease (patellofemoral Kellgren and Lawrence score).
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Affiliation(s)
- Laura A B Wilson
- School of Archaeology and Anthropology, The Australian National University, Canberra, ACT 2601, Australia; School of Biological, Earth and Environmental Sciences, UNSW Sydney, Sydney, NSW 2052, Australia; ARC Training Centre for M3D Innovation, The Australian National University, Canberra, ACT 2601, Australia.
| | - Joseph T Lynch
- School of Medicine, The Australian National University, Canberra, ACT 2601, Australia; Trauma and Orthopaedic Research Unit, The Canberra Hospital, Canberra, ACT 2606, Australia
| | - Jo M Ménard
- School of Archaeology and Anthropology, The Australian National University, Canberra, ACT 2601, Australia
| | - Catherine R Galvin
- School of Engineering, The Australian National University, Canberra, ACT 2601, Australia
| | - Paul N Smith
- School of Medicine, The Australian National University, Canberra, ACT 2601, Australia; Trauma and Orthopaedic Research Unit, The Canberra Hospital, Canberra, ACT 2606, Australia
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Hay AM, Rhoades MJ, Bangerter S, Ferguson SA, Lee H, T. Gill M, Page GL, Pope A, Measom GJ, Hager RL, Seeley MK. Serum Cartilage Oligomeric Matrix Protein Concentration Increases More After Running Than Swimming for Older People. Sports Health 2024; 16:534-541. [PMID: 37697665 PMCID: PMC11195858 DOI: 10.1177/19417381231195309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Knee osteoarthritis is common in older people. Serum cartilage oligomeric matrix protein (sCOMP) is a biomarker of knee articular cartilage metabolism. The purpose of this study was 2-fold: to (1) determine acute effects of running and swimming on sCOMP concentration in older people; and (2) investigate relationships between sCOMP concentration change due to running and swimming and measures of knee health in older people. HYPOTHESES Running would result in greater increase in sCOMP concentration than swimming, and increase in sCOMP concentration due to running and swimming would associate positively with measures of poor knee health. STUDY DESIGN Cross-sectional. LEVEL OF EVIDENCE Level 3. METHODS A total of 20 participants ran 5 km and 19 participants swam 1500 m. sCOMP concentration was measured immediately before, immediately after, and 15, 30, and 60 minutes after running or swimming. sCOMP concentration change due to running and swimming was compared. Correlations between sCOMP concentration change due to running and swimming, and other measures of knee health were evaluated, including the Tegner Activity Scale and Knee injury and Osteoarthritis Outcome Score. RESULTS sCOMP concentration increased 29% immediately after running, relative to baseline, but only 6% immediately after swimming (P < 0.01). No significant relationship was observed between acute sCOMP change due to running and swimming, and observed measures of knee health (P > 0.05). Participants with clinically relevant knee symptoms exhibited greater sCOMP concentration before and after running and swimming (P = 0.03) and had greater body mass (P = 0.04). CONCLUSION Running results in greater acute articular cartilage metabolism than swimming; however, the chronic effects of this are unclear. Older people with clinically relevant knee symptoms possess greater sCOMP concentration and are heavier, independent of exercise mode and physical activity level. CLINICAL RELEVANCE These results describe the effects of exercise (running and swimming) for older physically active persons, with and without knee pain.
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Affiliation(s)
- Alexandra M. Hay
- Department of Exercise Sciences, Brigham Young University, Provo, Utah
| | | | | | - Seth A. Ferguson
- Department of Exercise Sciences, Brigham Young University, Provo, Utah
| | - Hyunwook Lee
- Department of Exercise Sciences, Brigham Young University, Provo, Utah
| | - Martha T. Gill
- Department of Exercise Sciences, Brigham Young University, Provo, Utah
| | - Garritt L. Page
- Department of Statistics, Brigham Young University, Provo, Utah
| | - Andrew Pope
- Department of Statistics, Brigham Young University, Provo, Utah
| | - Gary J. Measom
- Department of Nursing, Utah Valley University, Orem, Utah
| | - Ronald L. Hager
- Department of Exercise Sciences, Brigham Young University, Provo, Utah
| | - Matthew K. Seeley
- Department of Exercise Sciences, Brigham Young University, Provo, Utah
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4
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Zhang Q, Yao Y, Chen Y, Ren D, Wang P. A Retrospective Study of Biological Risk Factors Associated with Primary Knee Osteoarthritis and the Development of a Nomogram Model. Int J Gen Med 2024; 17:1405-1417. [PMID: 38617053 PMCID: PMC11015847 DOI: 10.2147/ijgm.s454664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 04/04/2024] [Indexed: 04/16/2024] Open
Abstract
Aim A high percentage of the elderly suffer from knee osteoarthritis (KOA), which imposes a certain economic burden on them and on society as a whole. The purpose of this study is to examine the risk of KOA and to develop a KOA nomogram model that can timely intervene in this disease to decrease patient psychological burdens. Methods Data was collected from patients with KOA and without KOA at our hospital from February 2021 to February 2023. Initially, a comparison was conducted between the variables, identifying statistical differences between the two groups. Subsequently, the risk of KOA was evaluated using the Least Absolute Shrinkage and Selection Operator method and multivariate logistic regression to determine the most effective predictive index and develop a prediction model. The examination of the disease risk prediction model in KOA includes the corresponding nomogram, which encompasses various potential predictors. The assessment of disease risk entails the application of various metrics, including the consistency index (C index), the area under the curve (AUC) of the receiver operating characteristic curve, the calibration chart, the GiViTi calibration band, and the model for predicting KOA. Furthermore, the potential clinical significance of the model is explored through decision curve analysis (DCA) and clinical influence curve analysis. Results The study included a total of 582 patients, consisting of 392 patients with KOA and 190 patients without KOA. The nomogram utilized age, haematocrit, platelet count, apolipoprotein a1, potassium, magnesium, hydroxybutyrate dehydrogenase, creatine kinase, and estimated glomerular filtration rate as predictors. The C index, AUC, calibration plot, Giviti calibration band, DCA and clinical influence KOA indicated the ability of nomogram model to differentiate KOA. Conclusion Using nomogram based on disease risk, high-risk KOA can be identified directly without imaging.
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Affiliation(s)
- Qingzhu Zhang
- Orthopedic Trauma Service Center, Third Hospital of Hebei Medical University, Major Laboratory of Orthopedic Biomechanics in Hebei Province, Shijiazhuang, Hebei Province, People’s Republic of China
- Department of Orthopedics, the Affiliated Hospital of Chengde Medical University, Chengde, Hebei Province, People’s Republic of China
| | - Yinhui Yao
- Department of Pharmacy, the Affiliated Hospital of Chengde Medical University, Chengde, Hebei Province, People’s Republic of China
| | - Yufeng Chen
- Orthopedic Trauma Service Center, Third Hospital of Hebei Medical University, Major Laboratory of Orthopedic Biomechanics in Hebei Province, Shijiazhuang, Hebei Province, People’s Republic of China
| | - Dong Ren
- Orthopedic Trauma Service Center, Third Hospital of Hebei Medical University, Major Laboratory of Orthopedic Biomechanics in Hebei Province, Shijiazhuang, Hebei Province, People’s Republic of China
| | - Pengcheng Wang
- Orthopedic Trauma Service Center, Third Hospital of Hebei Medical University, Major Laboratory of Orthopedic Biomechanics in Hebei Province, Shijiazhuang, Hebei Province, People’s Republic of China
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Ilia I, Ciordas PD, Nitusca D, Anton A, Marian C. Analysis of the Level of Adiponectin and Selected Cytokines in Patients with Knee Osteoarthritis. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:571. [PMID: 38674217 PMCID: PMC11052232 DOI: 10.3390/medicina60040571] [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: 02/29/2024] [Revised: 03/25/2024] [Accepted: 03/29/2024] [Indexed: 04/28/2024]
Abstract
Background and Objectives: Knee osteoarthritis (KOA) is a degenerative disease that is continuously targeting people of different ages, but especially the elderly population, the number of which tends to increase continuously at the global level. Apart from age, excess weight can influence the evolution of the disease, with obesity being associated with a weak inflammation stage and an imbalance between pro-inflammatory and anti-inflammatory cytokines. The present work aimed to analyze specific biomarkers, namely ACRP-30, IL-10, TNF-α, and IL-6, in knee synovial fluid, and correlate them with KOA patients' clinical data, radiographic changes, and functional and pain scores. Materials and Methods: 24 subjects with KOA and over 50 years of age participate in the present study. Synovial fluid was harvested using ultrasound guidance from the target knees of the enrolled KOA patients, and the levels of ACRP-30, IL-10, TNF-α, and IL-6 were measured using enzyme-linked immunosorbent assays (ELISA). All patients underwent a supine X-ray at the target knee and were classified using Kellgren-Lawrence (K-L) grading. The Western Ontario and McMaster University Osteoarthritis Index (WOMAC) was used to assess self-reported physical function, pain, and stiffness. Results: The obtained results highlighted a significant correlation between age and adiponectin level (p = 0.0451, r = -0.412). Also, the IL-10 values are lower in cases where the intensity of the pain is more pronounced (p = 0.0405, r = -0.421). In addition, analyzing the data by gender, it was observed that in the case of males, stiffness is more related to age (p = 0.0079, r = 0.7993), compared to women (p = 0.0203, r = 0.6223). In the case of women, the progression of the disease tends to increase more intensively the WOMAC score's total values (p = 0.00031, r = 0.8342), compared with men (p = 0.0289, r = 7013). Regarding interleukins and BMI, significant correlations were observed only in the case of men. Conclusions: A significant correlation between age and adiponectin, and adiponectin and IL-6, suggests that advanced age may contribute to adiponectin reduction. Comparing men with women, it was observed that men's age is more related to rigidity, and IL-6 and IL-10 are directly correlated to BMI; in addition, women seem to be more sensitive to pain and stiffness.
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Affiliation(s)
- Iosif Ilia
- Discipline of Biochemistry, “Victor Babes” University of Medicine and Pharmacy, 300041 Timișoara, Romania; (I.I.); (P.D.C.); (D.N.); (C.M.)
- Faculty of Physical Education and Sport, Physical Activities Research Center, “Aurel Vlaicu” University of Arad, 310025 Arad, Romania
| | - Paula Diana Ciordas
- Discipline of Biochemistry, “Victor Babes” University of Medicine and Pharmacy, 300041 Timișoara, Romania; (I.I.); (P.D.C.); (D.N.); (C.M.)
- Center for Complex Network Science, “Victor Babes” University of Medicine and Pharmacy, 300041 Timişoara, Romania
| | - Diana Nitusca
- Discipline of Biochemistry, “Victor Babes” University of Medicine and Pharmacy, 300041 Timișoara, Romania; (I.I.); (P.D.C.); (D.N.); (C.M.)
- Center for Complex Network Science, “Victor Babes” University of Medicine and Pharmacy, 300041 Timişoara, Romania
| | - Alina Anton
- Department of Toxicology and Drug Industry, Faculty of Pharmacy, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania
- Research Center for Pharmaco-Toxicological Evaluations, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania
| | - Catalin Marian
- Discipline of Biochemistry, “Victor Babes” University of Medicine and Pharmacy, 300041 Timișoara, Romania; (I.I.); (P.D.C.); (D.N.); (C.M.)
- Center for Complex Network Science, “Victor Babes” University of Medicine and Pharmacy, 300041 Timişoara, Romania
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6
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Messier SP, Callahan LF, Losina E, Mihalko SL, Guermazi A, Ip E, Miller GD, Katz JN, Loeser RF, Pietrosimone BG, Soto S, Cook JL, Newman JJ, DeVita P, Spindler KP, Runhaar J, Armitano-Lago C, Duong V, Selzer F, Hill R, Love M, Beavers DP, Saldana S, Stoker AM, Rice PE, Hunter DJ. The osteoarthritis prevention study (TOPS) - A randomized controlled trial of diet and exercise to prevent Knee Osteoarthritis: Design and rationale. OSTEOARTHRITIS AND CARTILAGE OPEN 2024; 6:100418. [PMID: 38144515 PMCID: PMC10746515 DOI: 10.1016/j.ocarto.2023.100418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/19/2023] [Accepted: 11/13/2023] [Indexed: 12/26/2023] Open
Abstract
Background Osteoarthritis (OA), the leading cause of disability among adults, has no cure and is associated with significant comorbidities. The premise of this randomized clinical trial is that, in a population at risk, a 48-month program of dietary weight loss and exercise will result in less incident structural knee OA compared to control. Methods/design The Osteoarthritis Prevention Study (TOPS) is a Phase III, assessor-blinded, 48-month, parallel 2 arm, multicenter randomized clinical trial designed to reduce the incidence of structural knee OA. The study objective is to assess the effects of a dietary weight loss, exercise, and weight-loss maintenance program in preventing the development of structural knee OA in females at risk for the disease. TOPS will recruit 1230 ambulatory, community dwelling females with obesity (Body Mass Index (BMI) ≥ 30 kg/m2) and aged ≥50 years with no radiographic (Kellgren-Lawrence grade ≤1) and no magnetic resonance imaging (MRI) evidence of OA in the eligible knee, with no or infrequent knee pain. Incident structural knee OA (defined as tibiofemoral and/or patellofemoral OA on MRI) assessed at 48-months from intervention initiation using the MRI Osteoarthritis Knee Score (MOAKS) is the primary outcome. Secondary outcomes include knee pain, 6-min walk distance, health-related quality of life, knee joint loading during gait, inflammatory biomarkers, and self-efficacy. Cost effectiveness and budgetary impact analyses will determine the value and affordability of this intervention. Discussion This study will assess the efficacy and cost effectiveness of a dietary weight loss, exercise, and weight-loss maintenance program designed to reduce incident knee OA. Trial registration ClinicalTrials.gov Identifier: NCT05946044.
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Affiliation(s)
- Stephen P. Messier
- J.B. Snow Biomechanics Laboratory, Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - Leigh F. Callahan
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Elena Losina
- Orthopedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Shannon L. Mihalko
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - Ali Guermazi
- Boston University School of Medicine, Boston, MA, USA
| | - Edward Ip
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Gary D. Miller
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - Jeffrey N. Katz
- Orthopedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Richard F. Loeser
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Brian G. Pietrosimone
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sandra Soto
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - James L. Cook
- Department of Orthopaedic Surgery, Thompson Laboratory for Regenerative Orthopaedics, Missouri Orthopaedic Institute, University of Missouri School of Medicine, Columbia, MO, USA
| | - Jovita J. Newman
- J.B. Snow Biomechanics Laboratory, Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - Paul DeVita
- Department of Kinesiology, East Carolina University, Greenville, NC, USA
| | - Kurt P. Spindler
- Clinical Research and Outcomes, Cleveland Clinic Florida, Weston, FL, USA
| | - Jos Runhaar
- Erasmus MC University Medical Center Rotterdam, Department of General Practice, Rotterdam, the Netherlands
| | - Cortney Armitano-Lago
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Vicky Duong
- Sydney Musculoskeletal Health, Kolling Institute, University of Sydney, Sydney, Australia
| | - Faith Selzer
- Orthopedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Ryan Hill
- J.B. Snow Biomechanics Laboratory, Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - Monica Love
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - Daniel P. Beavers
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Santiago Saldana
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Aaron M. Stoker
- Department of Orthopaedic Surgery, Thompson Laboratory for Regenerative Orthopaedics, Missouri Orthopaedic Institute, University of Missouri School of Medicine, Columbia, MO, USA
| | - Paige E. Rice
- J.B. Snow Biomechanics Laboratory, Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - David J. Hunter
- Sydney Musculoskeletal Health, Kolling Institute, University of Sydney, Sydney, Australia
- Rheumatology Department, Royal North Shore Hospital, Sydney, Australia
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Adhitya IPGS, Kurniawati I, Sawa R, Wijaya TF, Dewi NPAC. The Risk Factors and Preventive Strategies of Poor Knee Functions and Osteoarthritis after Anterior Cruciate Ligament Reconstruction: A Narrative Review. Phys Ther Res 2023; 26:78-88. [PMID: 38125289 PMCID: PMC10730125 DOI: 10.1298/ptr.r0028] [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: 08/25/2023] [Accepted: 10/31/2023] [Indexed: 12/23/2023]
Abstract
Anterior cruciate ligament reconstruction (ACLR) is the standard surgical treatment for ACL injury, which typically uses a graft to replace the torn ligament in the knee that uses small incisions with minimally invasive surgery. The optimal knee functions following ACLR depend on rehabilitation processes before and after the surgery. Knee function is the ability of the knee to perform various types of functional movements like walking, squatting, running, jumping, and pivoting where patients expect to achieve maximum knee function or at least more than 80% of its initial condition before the injury to avoid being categorized as poor knee function after ACLR. Patients use patient-reported outcome measures to collect data on their health status and quality of life after ACLR. Post-traumatic osteoarthritis (PTOA) is a type of OA that manifests in local cartilage injury caused by chondrocyte death, and matrix dispersion occurs following a joint injury like ACL injury. Gender, time from injury to surgery, and graft type were considered as risk factors for poor knee function after ACLR, while overweight, meniscus tear, and cartilage defect as risk factors for PTOA. However, age is an internal risk factor for both poor knee function and PTOA following ACLR. This review suggests several strategies to prevent both conditions, including a pre-operative program, comprehensive rehabilitation, body weight control, and return to sport (RTS) consideration based on physical capacity, proper time, and psychological readiness.
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Affiliation(s)
| | - Ida Kurniawati
- Department of Histology, Faculty of Medicine and Health Sciences, Universitas Warmadewa, Indonesia
| | - Ryuichi Sawa
- Department of Physical Therapy, Faculty of Health Science, Juntendo University, Japan
| | - Tabita Febyola Wijaya
- Bachelor and Professional Program of Physical Therapy, College of Medicine, Universitas Udayana, Indonesia
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Altowijri AA, Alnadawi AA, Almutairi JN, Almutairi AK, Alhawiti MS, Abu Sinah AK, Alhassun JA. The Prevalence of Knee Osteoarthritis and Its Association With Obesity Among Individuals in Saudi Arabia. Cureus 2023; 15:e49625. [PMID: 38161841 PMCID: PMC10755688 DOI: 10.7759/cureus.49625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2023] [Indexed: 01/03/2024] Open
Abstract
Introduction This research, set in 2023 in Saudi Arabia, addresses the rising prevalence of knee osteoarthritis (OA) among obese individuals. It explores associations with age, BMI, and gender, aiming to enhance our understanding of this pressing health issue within the Saudi context and contribute to global research on OA and obesity. Methodology A retrospective cohort study was conducted at King Saud Hospital and Buraydah Central Hospital in the Al-Qassim region from November 2022 to February 2023. It included the patients' records that fit the inclusion criteria during the study period. A data collection sheet was used to collect data, and data was analyzed using SPSS Statistics version 27.0.1 (IBM Corp. Released 2020. IBM SPSS Statistics for Windows, Version 27.0. Armonk, NY: IBM Corp.). Results In 2023, a study on knee OA among 267 obese individuals in Saudi Arabia yielded significant findings. The median age of participants was 60 years, with an average weight of 77.00 kg (IQR:15) and a median BMI of 29.14, categorizing participants as overweight. Ninety percent (n=240) of knee OA cases occurred in individuals classified as "obese" (n=118) or "overweight (n=122)". Furthermore, OA primarily affected both knees in 79.4% (n=212) of cases. Conclusion Study participants, predominantly older and female, reflect OA's age-related and gender-specific prevalence trends. Notably, excess weight and a higher BMI highlight the role of obesity as a significant OA risk factor. Bilateral knee involvement is common, with a strong link between OA and obesity.
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Affiliation(s)
| | - Aseel A Alnadawi
- College of Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, SAU
| | - Jawaher N Almutairi
- College of Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, SAU
| | - Alhanouf K Almutairi
- College of Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, SAU
| | | | | | - Joud A Alhassun
- College of Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, SAU
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Samih M, Fadili H, Chagou A, Jaafar A, Zryouil B. Resurfacing Versus Non-resurfacing Patella in Total Knee Replacement: When and What to Choose. Cureus 2023; 15:e44276. [PMID: 37772249 PMCID: PMC10523826 DOI: 10.7759/cureus.44276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2023] [Indexed: 09/30/2023] Open
Abstract
INTRODUCTION The opinion on the necessity of patella resurfacing has been deeply divided in the scientific community. There are three approaches to the management of the patella in total knee arthroplasty (TKA). The first method involves always resurfacing the patella, the second method involves never resurfacing it, and the third method involves resurfacing the patella only under specific circumstances. Different data support each of these strategies, but no consensus on the best management has been reached. METHODS This is a retrospective study of 106 cases of TKA (including 29 resurfaced patellas and 77 non-resurfaced patellas), over 5 years, at the Trauma-Orthopedics Department of the Cheikh Khalifa International University Hospital, Mohammed VI University of Health Sciences, Casablanca, Morocco. Our objective is to conduct a comparative study between TKA with patella resurfacing and those without resurfacing, by analyzing the functional and radiological results obtained after the operation, to show each technique's advantages and disadvantages. RESULTS The average age of our patients was 65 years with extremes ranging from 46 to 80 years. There was a clear female predominance with a sex ratio of 0.2. The left side was predominantly affected. Primary gonarthrosis was the main diagnosis. Our results showed no significant difference between the two groups in terms of patient satisfaction and Knee Society Score (KSS). Nevertheless, complications generated by resurfacing, such as infection, anterior pain, stiffness, and loosening of the patellar component, as well as additional costs and increased operative time, were observed. In the majority of meta-analyses, there was no discernible difference in clinical and functional results between the resurfaced and non-resurfaced groups, suggesting that patellar resurfacing is not beneficial and, therefore, unnecessary. CONCLUSION It appears that regular resurfacing is not necessary. However, there is agreement that resurfacing the patella is the best course of action for patients with inflammatory arthropathy, considerable patella malalignment, and severe patellofemoral osteoarthritis. There are arguments in favor of each of the patella resurfacing techniques, but none of them are particularly compelling, each of these strategies has its advantages and should not be considered bad. The final decision, therefore, rests on each surgeon's practice, training, and experience.
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Affiliation(s)
- Mohamed Samih
- Orthopedics and Traumatology, Cheikh Khalifa Bin Zayed Al Nahyan Hospital, Mohammed VI University of Health Sciences (UM6SS), Casablanca, MAR
| | - Hajar Fadili
- Neurology, Cheikh Khalifa Bin Zayed Al Nahyan Hospital, Mohammed VI University of Health Sciences (UM6SS), Casablanca, MAR
| | - Aniss Chagou
- Orthopedics and Traumatology, Cheikh Khalifa Bin Zayed Al Nahyan Hospital, Mohammed VI University of Health Sciences (UM6SS), Casablanca, MAR
| | - Abdeloaihab Jaafar
- Orthopedics and Traumatology, Faculty of Medicine, Mohammed VI University of Health Sciences (UM6SS), Casablanca, MAR
| | - Bouchaib Zryouil
- Orthopedics and Traumatology, Cheikh Khalifa Bin Zayed Al Nahyan Hospital, Mohammed VI University of Health Sciences (UM6SS), Casablanca, MAR
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10
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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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11
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Shumnalieva R, Kotov G, Monov S. Obesity-Related Knee Osteoarthritis-Current Concepts. Life (Basel) 2023; 13:1650. [PMID: 37629507 PMCID: PMC10456094 DOI: 10.3390/life13081650] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/23/2023] [Accepted: 07/25/2023] [Indexed: 08/27/2023] Open
Abstract
The knee is the joint most frequently involved in osteoarthritis and represents a significant contributor to patient morbidity and impaired functional status. Major risk factors include genetics, age, sex, mechanical load and obesity/metabolic syndrome. Recent studies highlighted the role of obesity and metabolic syndrome in the pathogenesis of knee osteoarthritis not simply through increased mechanical loading but the systemic effects of obesity-induced inflammation. The current concept of knee osteoarthritis is that of a 'whole joint disease', which highlights the involvement not only of articular cartilage but also the synovium, subchondral bone, ligaments and muscles. Obesity and metabolic syndrome are associated with higher levels of pro-inflammatory cytokines, increased production of adipokines with both protective and destructive effects on articular cartilage, an up-regulation of proteolytic enzymes such as matrix metalloproteinases and aggrecanases and an increase in free fatty acids and reactive oxygen species induced by dyslipidemia. These findings underscore that the adequate management of knee osteoarthritis needs to include an optimization of body weight and a beneficial mobility regimen. The possible introduction of pharmacological therapy targeting specific molecules involved in the pathogenesis of obesity-related osteoarthritis will likely also be considered in future therapeutic strategies, including personalized treatment approaches.
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Affiliation(s)
| | - Georgi Kotov
- Clinic of Rheumatology, Department of Rheumatology, Medical University of Sofia, 1431 Sofia, Bulgaria; (R.S.); (S.M.)
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12
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Gilmer G, Bean AC, Iijima H, Jackson N, Thurston RC, Ambrosio F. Uncovering the "riddle of femininity" in osteoarthritis: a systematic review and meta-analysis of menopausal animal models and mathematical modeling of estrogen treatment. Osteoarthritis Cartilage 2023; 31:447-457. [PMID: 36621591 PMCID: PMC10033429 DOI: 10.1016/j.joca.2022.12.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 12/06/2022] [Accepted: 12/15/2022] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Post-menopausal women are disproportionately affected by osteoarthritis (OA). As such, the purpose of this study was to (1) summarize the state-of-the-science aimed at understanding the effects of menopause on OA in animal models and (2) investigate how dosage and timing of initiation of estrogen treatment affect cartilage degeneration. DESIGN A systematic review identified articles studying menopausal effects on cartilage in preclinical models. A meta-analysis was performed using overlapping cartilage outcomes in conjunction with a rigor and reproducibility analysis. Ordinary differential equation models were used to determine if a relationship exists between cartilage degeneration and the timing of initiation or dosage of estrogen treatment. RESULTS Thirty-eight manuscripts were eligible for inclusion. The most common menopause model used was ovariectomy (92%), and most animals were young at the time of menopause induction (86%). Most studies did not report inclusion criteria, animal monitoring, protocol registration, or data accessibility. Cartilage outcomes were worse in post-menopausal animals compared to age-matched, non-menopausal animals, as evidenced by cartilage histological scoring [0.75, 1.72], cartilage thickness [-4.96, -0.96], type II collagen [-4.87, -0.56], and c-terminal cross-linked telopeptide of type II collagen (CTX-II) [2.43, 5.79] (95% CI of Effect Size (+greater in menopause, -greater in non-menopause)). Moreover, modeling suggests that cartilage health may be improved with early initiation and higher doses of estrogen treatment. CONCLUSIONS To improve translatability, animal models that consider aging and natural menopause should be utilized, and more attention to rigor and reproducibility is needed. Timing of initiation and dosage may be important factors modulating therapeutic effects of estrogen on cartilage.
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Affiliation(s)
- G Gilmer
- Medical Scientist Training Program, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Cellular and Molecular Pathology Graduate Program, University of Pittsburgh, Pittsburgh, PA, USA; Discovery Center for Musculoskeletal Recovery, Schoen Adams Research Institute at Spaulding, Rehabilitation Hospital, Boston, MA, USA; Department of Physical Medicine & Rehabilitation, Harvard Medical School, Boston, MA, USA.
| | - A C Bean
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA; McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
| | - H Iijima
- Institute for Advanced Research, Nagoya University, Nagoya University, Nagoya, Japan.
| | - N Jackson
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA.
| | - R C Thurston
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
| | - F Ambrosio
- Discovery Center for Musculoskeletal Recovery, Schoen Adams Research Institute at Spaulding, Rehabilitation Hospital, Boston, MA, USA; Department of Physical Medicine & Rehabilitation, Harvard Medical School, Boston, MA, USA; Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA; McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA.
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13
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Searle HKC, Rahman A, Desai AP, Mellon SJ, Murray DW. Incidence and severity of radiological lateral osteoarthritis 15 years following medial unicompartmental knee arthroplasty. Bone Jt Open 2023; 4:210-218. [PMID: 37051833 PMCID: PMC10061351 DOI: 10.1302/2633-1462.43.bjo-2022-0153.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/14/2023] Open
Abstract
To assess the incidence of radiological lateral osteoarthritis (OA) at 15 years after medial unicompartmental knee arthroplasty (UKA) and assess the relationship of lateral OA with symptoms and patient characteristics. Cemented Phase 3 medial Oxford UKA implanted by two surgeons since 1998 for the recommended indications were prospectively followed. A 15-year cumulative revision rate for lateral OA of 5% for this series was previously reported. A total of 163 unrevised knees with 15-year (SD 1) anterior-posterior knee radiographs were studied. Lateral joint space width (JSWL) was measured and severity of lateral OA was classified as: nil/mild, moderate, and severe. Preoperative and 15-year Oxford Knee Scores (OKS) and American Knee Society Scores were determined. The effect of age, sex, BMI, and intraoperative findings was analyzed. Statistical analysis included one-way analysis of variance and Kruskal-Wallis H test, with significance set at 5%. The mean age was 80.6 years (SD 8.3), with 84 females and 79 males. The mean JSWL was 5.6 mm (SD 1.4), and was not significantly related to age, sex, or intraoperative findings. Those with BMI > 40 kg/m2 had a smaller JSWL than those with a 'normal' BMI (p = 0.039). The incidence of severe and moderate lateral OA were both 4.9%. Overall, 2/142 (1.4%) of those with nil/mild lateral OA, 1/8 (13%) with moderate, and 2/8 (25%) with severe subsequently had a revision. Those with severe (mean OKS 35.6 (SD 9.3)) and moderate OA (mean OKS 35.8 (SD 10.5)) tended to have worse outcome scores than those with nil/mild (mean OKS 39.5 (SD 9.2)) but the difference was only significant for OKS-Function (p = 0.044). This study showed that the rate of having severe or moderate radiological lateral OA at 15 years after medial UKA was low (both 4.9%). Although patients with severe or moderate lateral OA had a lower OKS than those with nil/mild OA, their mean scores (OKS 36) would be classified as good.
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Affiliation(s)
- Henry K C Searle
- John Radcliffe Hospital, Oxford University Hospital NHS Foundation Trust, Oxford, UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Azmi Rahman
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Aditya P Desai
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Stephen J Mellon
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - David W Murray
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- Nuffield Orthopaedic Centre, Oxford, UK
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Association of general and central obesity, and their changes with risk of knee osteoarthritis: a nationwide population-based cohort study. Sci Rep 2023; 13:3796. [PMID: 36882508 PMCID: PMC9992488 DOI: 10.1038/s41598-023-30727-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 02/28/2023] [Indexed: 03/09/2023] Open
Abstract
In this study, we aimed to evaluate the association between general and central obesity, and their changes with risk of knee osteoarthritis (OA) using retrospective cohort data collected from the Korean National Health Insurance Service. We studied 1,139,463 people aged 50 and over who received a health examination in 2009. To evaluate the association between general and/or central obesity and knee OA risk, a Cox proportional hazard models were used. Additionally, we investigate knee OA risk according to the change in obesity status over 2 years for subjects who had undergone health examinations for 2 consecutive years. General obesity without central obesity (HR 1.281, 95% CI 1.270-1.292) and central obesity without general obesity (HR 1.167, 95% CI 1.150-1.184) were associated with increased knee OA risk than the comparison group. Individuals with both general with central obesity had the highest risk (HR 1.418, 95% CI 1.406-1.429). This association was more pronounced in women and younger age group. Remarkably, the remission of general or central obesity over two years was associated with decreased knee OA risk (HR 0.884; 95% CI 0.867-0.902; HR 0.900; 95% CI 0.884-0.916, respectively). The present study found that both general and central obesity were associated with increased risk of knee OA and the risk was highest when the two types of obesity were accompanied. Changes in obesity status have been confirmed to alter the risk of knee OA.
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15
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Prevalence of Symptomatic Knee Osteoarthritis in Saudi Arabia and Associated Modifiable and Non-Modifiable Risk Factors: A Population-Based Cross-Sectional Study. Healthcare (Basel) 2023; 11:healthcare11050728. [PMID: 36900733 PMCID: PMC10001239 DOI: 10.3390/healthcare11050728] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/22/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023] Open
Abstract
OBJECTIVE This study aimed to determine the prevalence of knee osteoarthritis (OA) in Saudi Arabia and the association between knee OA and modifiable and non-modifiable risk factors. METHODS A self-reported, population-based, cross-sectional survey between January 2021 and October 2021 was conducted. A large, population-representative sample (n = 2254) of adult subjects aged 18 years and over from all regions of Saudi Arabia was collected electronically using convenience sampling. The American College of Rheumatology (ACR) clinical criteria were used to diagnose OA of the knee. The knee injury and osteoarthritis outcome score (KOOS) was used to investigate the severity of knee OA. This study focused on modifiable risk factors (body mass index, education, employment status, marital status, smoking status, type of work, previous history of knee injury, and physical activity level) and non-modifiable risk factors (age, gender, family history of OA, and presence of flatfoot). RESULTS The overall prevalence of knee OA was 18.9% (n = 425), and women suffered more compared to their male counterparts (20.3% vs. 13.1%, p = 0.001). The logistic regression analysis model showed age (OR: 1.06 [95% CI: 1.05-1.07]; p < 0.01), sex (OR: 2.14 [95% CI: 1.48-3.11]; p < 0.01), previous injury (OR: 3.95 [95% CI: 2.81-5.56]; p < 0.01), and obesity (OR: 1.07 [95% CI: 1.04-1.09]; p < 0.01) to be associated with knee OA. CONCLUSIONS A high prevalence of knee OA underlines the need for health promotion and prevention programmes that focus on modifiable risk factors to decrease the burden of the problem and the cost of treatment in Saudi Arabia.
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Giordano L, Maffulli N, Carimati G, Morenghi E, Volpi P. Increased Time to Surgery After Anterior Cruciate Ligament Tear in Female Patients Results in Greater Risk of Medial Meniscus Tear: A Study of 489 Female Patients. Arthroscopy 2023; 39:613-622. [PMID: 36309227 DOI: 10.1016/j.arthro.2022.10.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 09/25/2022] [Accepted: 10/10/2022] [Indexed: 11/05/2022]
Abstract
PURPOSE This study assessed the incidence of meniscal tears in anterior cruciate ligament (ACL)-deficient knees, considering the time between injury and reconstruction in a large sample of female patients. Furthermore, we evaluated whether the rate of meniscal repair or meniscectomy was affected by age and body mass index (BMI). METHODS The medical records of 489 patients who underwent ACL-reconstructive surgery between January 2011 and April 2021 were analyzed to collect data on the prevalence of meniscal tears, surgical timing, patient age, and BMI. Logistic regression was performed to estimate the association between the prevalence of meniscal tears and the independent variables of surgical timing, age, and BMI. RESULTS Between 24 and 60 months after their injury, female patients showed a statistically significant increase in the presence of associated meniscal lesions when compared with ACL reconstruction performed earlier (odds ratio [OR] of 3.11; 95% 1.06-9.10 confidence interval [CI]), especially for medial meniscal tears, with an OR of 1.94 (95% CI 1.23-3.05, P = .004) between 12 and 24 months. There is a statistically significant difference after 12 months in the rate of meniscal suturing for medial meniscus tears (OR 3.30; CI 1.37-7.91 P = .007). Increasing age was associated with a greater prevalence of meniscal tears up to 30-50 years, but there was no clear association between BMI and associated lesions other than a greater rate of meniscectomies. CONCLUSIONS In female patients who experienced an ACL injury, a delay in surgery greater than 12 months is associated with a gradual increase in the risk of nonrepairable medial meniscal tear; this risk becomes statistically significant after 24 months. A high BMI does not seem to have relevance in the onset of associated lesions in women but results in a greater rate of meniscectomies compared with meniscal sutures, whereas age between 30 and 50 years is associated with a greater risk of associated injuries. LEVEL OF EVIDENCE III, retrospective comparative prognostic trial.
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Affiliation(s)
- Lorenzo Giordano
- Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Nicola Maffulli
- Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Salerno, Italy; Centre for Sports and Exercise Medicine, Queen Mary University of London, London, United Kingdom; School of Pharmacy and Bioengineering, Keele University School of Medicine, Staffordshire, United Kingdom.
| | - Giulia Carimati
- Knee Surgery and Sport Traumatology Unit, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Emanuela Morenghi
- Biostatistics Unit, Humanitas Research Hospital, IRCCS, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Piero Volpi
- Knee Surgery and Sport Traumatology Unit, Humanitas Research Hospital, Rozzano, Milan, Italy
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Snyder SJ, Chu E, Um J, Heo YJ, Miller RH, Shim JK. Prediction of knee adduction moment using innovative instrumented insole and deep learning neural networks in healthy female individuals. Knee 2023; 41:115-123. [PMID: 36657209 DOI: 10.1016/j.knee.2022.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 10/18/2022] [Accepted: 12/14/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND The knee adduction moment, a biomechanical risk factor of knee osteoarthritis, is typically measured in a gait laboratory with expensive equipment and inverse dynamics modeling software. We aimed to develop a framework for a portable knee adduction moment estimation for healthy female individuals using deep learning neural networks and custom instrumented insole and evaluated its accuracy compared to the standard inverse dynamics approach. METHODS Feed-forward, convolutional, and recurrent neural networks were applied to the data extracted from five piezo-resistive force sensors attached to the insole of a shoe. RESULTS All models predicted knee adduction moment variables during walking with high correlation coefficients, r > 0.72, and low root mean squared errors (RMSE), ranging from 0.5% to 1.2%. The convolutional neural network is the most accurate predictor of average knee adduction moment (r = 0.96; RMSE = 0.5%) followed by the recurrent and feed-forward neural networks. CONCLUSION These findings and the methods presented in the current study are expected to facilitate a cost-effective clinical analysis of knee adduction moment for healthy female individuals and to facilitate future research on prediction of other biomechanical risk factors using similar methods.
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Affiliation(s)
- Samantha J Snyder
- Department of Kinesiology, University of Maryland, College Park, MD, USA.
| | - Edward Chu
- Department of Kinesiology, University of Maryland, College Park, MD, USA.
| | - Jumyung Um
- Department of Industrial & Management Systems Engineering, Kyung Hee University, Yongin-Si, Gyeonggi-do, South Korea.
| | - Yun Jung Heo
- Department of Mechanical Engineering, Kyung Hee University, Yongin-Si, Gyeonggi-do, South Korea; Integrated Education Institute for Frontier Science & Technology, Kyung Hee University, Gyeonggi-do 17104, South Korea.
| | - Ross H Miller
- Department of Kinesiology, University of Maryland, College Park, MD, USA; Neuroscience and Cognitive Science Program, University of Maryland, College Park, MD, USA.
| | - Jae Kun Shim
- Department of Kinesiology, University of Maryland, College Park, MD, USA; Department of Mechanical Engineering, Kyung Hee University, Yongin-Si, Gyeonggi-do, South Korea; Neuroscience and Cognitive Science Program, University of Maryland, College Park, MD, USA; Fischell Department of Bioengineering, University of Maryland, College Park, MD, USA.
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Clement ND, Avery P, Mason J, Baker PN, Deehan DJ. First-time revision knee arthroplasty using a hinged prosthesis : temporal trends, indications, and risk factors associated with re-revision using data from the National Joint Registry for 3,855 patients. Bone Joint J 2023; 105-B:47-55. [PMID: 36587261 DOI: 10.1302/0301-620x.105b1.bjj-2022-0522.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
AIMS The aim of this study was to identify variables associated with time to revision, demographic details associated with revision indication, and type of prosthesis employed, and to describe the survival of hinge knee arthroplasty (HKA) when used for first-time knee revision surgery and factors that were associated with re-revision. METHODS Patient demographic details, BMI, American Society of Anesthesiologists (ASA) grade, indication for revision, surgical approach, surgeon grade, implant type (fixed and rotating), time of revision from primary implantation, and re-revision if undertaken were obtained from the National Joint Registry data for England, Wales, Northern Ireland, and the Isle of Man over an 18-year period (2003 to 2021). RESULTS There were 3,855 patient episodes analyzed with a median age of 73 years (interquartile range (IQR) 66 to 80), and the majority were female (n = 2,480, 64.3%). The median time to revision from primary knee arthroplasty was 1,219 days (IQR 579 to 2,422). Younger age (p < 0.001), decreasing ASA grade (p < 0.001), and indications for revision of sepsis (p < 0.001), unexplained pain (p < 0.001), non-polyethylene wear (p < 0.001), and malalignment (p < 0.001) were all associated with an earlier time to revision from primary implantation. The median follow-up was 4.56 years (range 0.00 to 17.52), during which there were 410 re-revisions. The overall unadjusted probability of re-revision for all revision HKAs at one, five, and ten years after surgery were 2.7% (95% confidence interval (CI) 2.2 to 3.3), 10.7% (95% CI 9.6 to 11.9), and 16.2% (95% CI 14.5 to 17.9), respectively. Male sex (p < 0.001), younger age (p < 0.001), revision for septic indications (p < 0.001) or implant fracture (p = 0.010), a fixed hinge (p < 0.001), or surgery performed by a non-consultant grade (p = 0.023) were independently associated with an increased risk of re-revision. CONCLUSION There were several factors associated with time to first revision. The re-revision rate was 16.2% at ten years; however, the risk factors associated with an increased risk of re-revision could be used to counsel patients regarding their outcome.Cite this article: Bone Joint J 2023;105-B(1):47-55.
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Affiliation(s)
- Nick D Clement
- Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Peter Avery
- School of Mathematics, Statistics and Physics, Newcastle University, Newcastle upon Tyne, UK
| | | | - Paul N Baker
- Department of Orthopaedic Surgery, The James Cook University Hospital, Middlesbrough, UK
| | - David J Deehan
- Department of Orthopaedic Surgery, Freeman Hospital, Newcastle upon Tyne, UK
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Park HS, Song JS, Kim EK. Effects of low-intensity resistance exercise with blood flow restriction after high tibial osteotomy in middle-aged women. Medicine (Baltimore) 2022; 101:e32294. [PMID: 36595769 PMCID: PMC9794348 DOI: 10.1097/md.0000000000032294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND High tibial osteotomy (HTO) is an effective surgical method for treating medial compartment osteoarthritis. However, in most cases after surgery, muscle strength is decreased, and rapid muscle atrophy is observed. Therefore, the purpose of this study is to verify the effects of low-intensity resistance exercise (LIE) with blood flow restriction (BFR) on the cross-sectional area (CSA) of thigh muscles, knee extensor strength, pain, and knee joint function and investigate proper arterial occlusion pressure (AOP) in middle-aged women who underwent HTO. METHOD This study was designed as a prospective randomized controlled trial. Forty-two middle-aged women who underwent HTO were randomly divided into three groups and participated in LIE with (40% or 80% AOP applied) or without BFR. The main outcome was the measurement of the CSA of thigh muscles (at 30% and 50% distal length of the femur) before and 12 weeks after treatment. Additionally, knee extension muscle strength, pain, and joint function were evaluated before and 6 and 12 weeks after treatment. RESULTS CSA of thigh muscles at 30% and 50% distal length of the femur decreased in the AOP 40% and control groups and was the largest in the AOP 80% group 12 weeks after treatment. Knee extension strength increased in all groups and was the highest in the AOP 80% group 6 and 12 weeks after treatment. Pain improved in all groups, with no intergroup differences. Knee joint function improved in all groups and was superior in the 80% AOP group 12 weeks after treatment. CONCLUSION LIE with BFR at 80% AOP was effective in preventing atrophy of the thigh muscle, increasing muscle strength, and improving function. BFR at 40% AOP had no difference in the results when compared with the group in which BFR was not applied. Therefore, LIE with an AOP of 80% is recommended for patients undergoing HTO.
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Affiliation(s)
- Han-Soo Park
- Korean National Sports University, Songpa-gu, Seoul, Republic of Korea
| | - Jun-Seob Song
- Gangnam JS Hospital, Gangnam-gu, Seoul, Republic of Korea
| | - Eun-Kuk Kim
- SRC Hospital, Chowol-eup, Gwangju-si, Gyeonggi-do, Republic of Korea
- * Correspondence: Eun-Kuk Kim, SRC Hospital, 25, Gyeongsu-gil, Chowol-eup, Gwangju-si, Gyeonggi-do, Republic of Korea (e-mail: )
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20
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Stefanac S, Oppenauer C, Zauner M, Durechova M, Dioso D, Aletaha D, Hobusch G, Windhager R, Stamm T. From individualised treatment goals to personalised rehabilitation in osteoarthritis: a longitudinal prospective mapping study using the WHO international classification for functioning, disability and health. Ann Med 2022; 54:2816-2827. [PMID: 36259346 PMCID: PMC9586611 DOI: 10.1080/07853890.2022.2131326] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND/OBJECTIVE(S)/INTRODUCTION In clinical practice, treatment goals are often set up without exploring what patients really want. We, therefore, collected individualised treatment goals of patients with osteoarthritis (OA), categorised and mapped them to the World Health Organisation International Classification for Functioning, Disability and Health (ICF). PATIENTS/MATERIALS AND METHODS A longitudinal prospective cohort study was conducted (2019-2021). We used descriptive statistics and Chi2/Fisher's Exact Tests, where appropriate, as well as Kruskal-Wallis-Tests for the mean score ranks of the patients' goals. RESULTS In total, 305 goals reported by 132 participants were analysed (267 women vs. 38 men). The top 3 ICF categories were sensation of pain (ICF:b280), mobility of joint (ICF:b710) and muscle power functions (ICF:b730). Overall, 51% of all individually reported functional goals were achieved after 3 months. Men were more likely to achieve their goals than women (p = 0.009). The majority of the "very important" goals (51%) and "very difficult" goals (57%) was not improved. Goals' mean score ranks significantly differed between baseline and follow-up. CONCLUSION(S) As the human lifespan as well as the number of people affected by OA worldwide increase, there is a growing need to identify and evaluate rehabilitation outcomes that are relevant to people with OA.Key MessagesTreat-to-target agreements between patients and health care providers present a step towards more personalised precision medicine, which will eventually lead to better reported functional and health outcomes.In patients with osteoarthritis, the Goal Attainment Scale instrument can be used to measure health outcomes at different time points and its content may be linked to ICF providing a unified language and conceptual scientific basis.
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Affiliation(s)
- Sinisa Stefanac
- Institute for Outcomes Research, Centre for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria.,Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria
| | - Claudia Oppenauer
- Karl Landsteiner Private University for Health Sciences, Krems, Lower Austria
| | - Michael Zauner
- Clinical Department of Rheumatology, Medical University of Vienna, Vienna, Austria
| | - Martina Durechova
- Clinical Department of Rheumatology, Medical University of Vienna, Vienna, Austria
| | - Daffodil Dioso
- Clinical Department of Rheumatology, Medical University of Vienna, Vienna, Austria
| | - Daniel Aletaha
- Clinical Department of Rheumatology, Medical University of Vienna, Vienna, Austria
| | - Gerhard Hobusch
- Department of Orthopaedics, Medical University of Vienna, Vienna, Austria
| | - Reinhard Windhager
- Department of Orthopaedics, Medical University of Vienna, Vienna, Austria
| | - Tanja Stamm
- Institute for Outcomes Research, Centre for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria.,Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria
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21
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Effects of knee prosthetic surgery on overactive bladder symptoms and incontinence in women. Int Urogynecol J 2022:10.1007/s00192-022-05409-w. [DOI: 10.1007/s00192-022-05409-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 10/31/2022] [Indexed: 11/26/2022]
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22
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Swiggett SJ, Mannino A, Vakharia RM, Ehiorobo JO, Roche MW, Mont MA, Erez O. Impact of Biological Sex on Complications, Lengths of Stay, Readmission Rates, and Costs of Care Following Primary Total Knee Arthroplasty. J Knee Surg 2022; 35:1306-1311. [PMID: 33545731 DOI: 10.1055/s-0041-1723014] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The impact of gender on total knee arthroplasty (TKA) postoperative complications, readmission rates, and costs of care has not been often evaluated. Therefore, the purpose of this study was to investigate which sex had higher rates of: (1) medical complications; (2) implant complications; (3) lengths of stay (LOSs); (4) readmission rates; and (5) costs after TKA. A query was performed using an administrative claims database from January 1, 2005, to March 31, 2015. Patients who had TKAs were identified using International Classification of Diseases, Ninth Revision and Current Procedural Terminology codes. Males and females were filtered separately and matched according to age and various medical comorbidities leading to 1,590,626 patients equally distributed. Primary outcomes analyzed included 90-day medical complications, LOSs, 90-day readmission rates, in addition to day of surgery and total global 90-day episode of care costs. Pearson's chi-square analyses were used to compare medical complications and readmission rates. Welch's t-tests were used to test for significance in matching outcomes and costs. A p-value of less than 0.01 was considered statistically significant. Males had a smaller risk of complications than women (1.35 vs. 1.40%, p < 0.006) and higher rates of implant-related complications (2.28 vs. 1.99%, p < 0.0001). Mean LOSs were lower for males: 3.16 versus 3.34 days (p < 0.0001). The 90-day readmission rates were higher in men (9.67 vs. 8.12%, p < 0.0001). This study demonstrated that males undergoing primary TKA have lower medical complications and shorter LOSs then their female counterparts. However, males have higher implant-related complications, readmission rates, and costs of care.
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Affiliation(s)
- Samuel J Swiggett
- Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, New York
| | - Angelo Mannino
- Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, New York
| | - Rushabh M Vakharia
- Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, New York
| | - Joseph O Ehiorobo
- Department of Orthopaedic Surgery, SUNY Downstate Health Sciences University, Brooklyn, New York
| | - Martin W Roche
- Department of Orthopaedic Surgery, Holy Cross Hospital, Ft. Lauderdale, Florida
| | - Michael A Mont
- Department of Orthopaedic Surgery, Lenox Hill Hospital, Northwell Health, Manhattan, New York
| | - Orry Erez
- Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, New York
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23
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Hernandez PA, Moreno M, Barati Z, Hutcherson C, Sathe AA, Xing C, Wright J, Welch T, Dhaher Y. Sexual Dimorphism in the Extracellular and Pericellular Matrix of Articular Cartilage. Cartilage 2022; 13:19476035221121792. [PMID: 36069595 PMCID: PMC9459468 DOI: 10.1177/19476035221121792] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Women have a higher prevalence and burden of joint injuries and pathologies involving articular cartilage than men. Although knee injuries affecting young women are on the rise, most studies related to sexual dimorphism target postmenopausal women. We hypothesize that sexual dimorphism in cartilage structure and mechanics is present before menopause, which can contribute to sex disparities in cartilage pathologies. DESIGN Bovine knee was used as a model to study healthy adult cartilage. We compared elastic moduli under compression, abundances of extracellular and pericellular matrix (PCM) proteins using proteomics, and PCM constituency with tissue immunofluorescence. The gene expression of matrix-related genes under basal, anabolic, and catabolic conditions was assessed by quantitative polymerase chain reaction (qPCR). RESULTS The equilibrium modulus was higher in male cartilage compared with female cartilage. Proteoglycans were not associated with this biomechanical dimorphism. Proteomic and pathway analyses of tissue showed dimorphic enriched pathways in extracellular matrix (ECM)-related proteins in which male cartilage was enriched in matrix interconnectors and crosslinkers that strengthen the ECM network. Moreover, male and female tissue differed in enriched PCM components. Females had more abundance of collagen type VI and decorin, suggesting different PCM mechanics. Furthermore, the activation of regenerative and catabolic function in chondrocytes triggered sex-dependent signatures in gene expression, indicating dimorphic genetic regulation that is dependent on stimulation. CONCLUSIONS We provide evidence for sexual dimorphism in cartilage before menopause. Some differences are intrinsic to chondrocytes' gene expression defined by their XX versus XY chromosomal constituency.
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Affiliation(s)
- Paula A. Hernandez
- Department of Orthopedic Surgery,
University of Texas Southwestern Medical Center, Dallas, TX, USA,Paula A. Hernandez, Department of
Orthopaedic Surgery, University of Texas Southwestern Medical Center, 5323 Harry
Hines Blvd, Dallas, TX 75390, USA.
| | - Miranda Moreno
- Department of Orthopedic Surgery,
University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Zahra Barati
- Department of Orthopedic Surgery,
University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Conner Hutcherson
- Department of Orthopedic Surgery,
University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Adwait A. Sathe
- Eugene McDermott Center for Human
Growth and Development, University of Texas Southwestern Medical Center, Dallas, TX,
USA
| | - Chao Xing
- Eugene McDermott Center for Human
Growth and Development, University of Texas Southwestern Medical Center, Dallas, TX,
USA,Department of Bioinformatics,
University of Texas Southwestern Medical Center, Dallas, TX, USA,Department of Population and Data
Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Jamie Wright
- Department of Cardiovascular and
Thoracic Surgery, University of Texas Southwestern Medical Center, Dallas, TX,
USA
| | - Tre Welch
- Department of Cardiovascular and
Thoracic Surgery, University of Texas Southwestern Medical Center, Dallas, TX,
USA
| | - Yasin Dhaher
- Department of Orthopedic Surgery,
University of Texas Southwestern Medical Center, Dallas, TX, USA,Department of Physical Medicine &
Rehabilitation, University of Texas Southwestern Medical Center, Dallas, TX,
USA
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24
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Effusion-synovitis worsening mediates the association between body mass index and Kellgren-Lawrence progression in obese individuals: data from the Osteoarthritis Initiative. Osteoarthritis Cartilage 2022; 30:1278-1286. [PMID: 35714760 PMCID: PMC9910445 DOI: 10.1016/j.joca.2022.05.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 05/04/2022] [Accepted: 05/31/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Both obesity and synovitis are independently associated with knee osteoarthritis (KOA) progression. We examined whether synovitis mediates the relationship between body mass index (BMI) and KOA radiographic progression in the Osteoarthritis Initiative (OAI) cohort. DESIGN We conducted a case-control study within the OAI. Cases (n = 315) were right knees with an increase of ≥1 Kellgren-Lawrence from baseline to 48 months of follow-up. Controls (n = 315) were right knees with no KL change. Cases and controls were matched by age, sex, race, and baseline KL. MRI Osteoarthritis Knee Score (MOAKS) at baseline and at 2 years was used for a semi-quantitative scoring (0-3) of effusion-synovitis and Hoffa-synovitis. Conditional logistic regression estimated associations between BMI and synovitis with KOA progression. Mediation analysis was used to assess the mediating effects of synovitis. RESULTS The mean age of participants was 61 years, 70.8% were women, and 87% were White. KOA progression was associated with higher BMI (adjusted OR 1.05; 95%CI 1.01-1.09) and effusion-synovitis relative to no effusion-synovitis (adjusted OR 2.2; 95%CI 1.6-3.1). Associations between effusion-synovitis worsening and KOA progression were more pronounced among obese individuals (OR 34.1; 95%CI 4.2-274.8; P = 0.001) compared to normal weight (OR 3.2; 95%CI 0.8-12.8, P=0.096) individuals. Effusion-synovitis at 2 years, but not at baseline, mediated the relationship between BMI and KOA progression over a 4-year period. CONCLUSIONS We found that effusion-synovitis worsening mediated the association between BMI and KOA progression and was associated with increased risk of KOA progression, particularly among obese individuals.
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25
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Chen L, Zheng M, Chen Z, Peng Y, Jones C, Graves S, Chen P, Ruan R, Papadimitriou J, Carey-Smith R, Leys T, Mitchell C, Huang YG, Wood D, Bulsara M, Zheng MH. The burden of end-stage osteoarthritis in Australia: a population-based study on the incidence of total knee replacement attributable to overweight/obesity. Osteoarthritis Cartilage 2022; 30:1254-1262. [PMID: 34890810 DOI: 10.1016/j.joca.2021.10.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 10/11/2021] [Accepted: 10/27/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To determine the risk of total knee replacement (TKR) for primary osteoarthritis (OA) associated with overweight/obesity in the Australian population. METHODS This population-based study analyzed 191,723 cases of TKR collected by the Australian Orthopaedic Association National Joint Registry and population data from the Australian Bureau of Statistics. The time-trend change in incidence of TKR relating to BMI was assessed between 2015 and 2018. The influence of obesity on the incidence of TKR in different age and gender groups was determined. The population attributable fraction (PAF) was then calculated to estimate the effect of obesity reduction on TKR incidence. RESULTS The greatest increase in incidence of TKR was seen in patients from obese class III. The incidence rate ratio for having a TKR for obesity class III was 28.683 at those aged 18-54 years but was 2.029 at those aged >75 years. Females in obesity class III were 1.7 times more likely to undergo TKR compared to similarly classified males. The PAFs of TKR associated with overweight or obesity was 35%, estimating 14,287 cases of TKR attributable to obesity in 2018. The proportion of TKRs could be reduced by 20% if overweight and obese population move down one category. CONCLUSIONS Obesity has resulted in a significant increase in the incidence of TKR in the youngest population in Australia. The impact of obesity is greatest in the young and the female population. Effective strategies to reduce the national obese population could potentially reduce 35% of the TKR, with over 10,000 cases being avoided.
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Affiliation(s)
- L Chen
- Centre for Translational Orthopaedic Research, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - M Zheng
- Institute for Health Research, Medical School, University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Z Chen
- Centre for Translational Orthopaedic Research, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Y Peng
- South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia; Australian Orthopaedic Association National Joint Replacement Registry, Adelaide, South Australia, Australia
| | - C Jones
- Department of Orthopaedic Surgery, Fiona Stanley Hospital Group, Perth, Western Australia, Australia
| | - S Graves
- Australian Orthopaedic Association National Joint Replacement Registry, Adelaide, South Australia, Australia
| | - P Chen
- Centre for Translational Orthopaedic Research, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - R Ruan
- Centre for Translational Orthopaedic Research, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - J Papadimitriou
- Centre for Translational Orthopaedic Research, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia; Pathwest Laboratories, Perth, Western Australia, Australia
| | - R Carey-Smith
- Department of Orthopaedic Surgery, Sir Charles Gardner Hospital, Perth, Western Australia, Australia
| | - T Leys
- Department of Orthopaedic Surgery, Sir Charles Gardner Hospital, Perth, Western Australia, Australia
| | - C Mitchell
- Centre for Translational Orthopaedic Research, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Y G Huang
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - D Wood
- Centre for Translational Orthopaedic Research, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - M Bulsara
- Institute for Health Research, Medical School, University of Notre Dame Australia, Fremantle, Western Australia, Australia.
| | - M H Zheng
- Centre for Translational Orthopaedic Research, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia; Perron Institute for Neurological and Translational Science, Perth, Western Australia, Australia.
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26
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Wang Y, Chyr J, Kim P, Zhao W, Zhou X. Phenotype-Genotype analysis of caucasian patients with high risk of osteoarthritis. Front Genet 2022; 13:922658. [PMID: 36105105 PMCID: PMC9465622 DOI: 10.3389/fgene.2022.922658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 07/26/2022] [Indexed: 11/25/2022] Open
Abstract
Background: Osteoarthritis (OA) is a common cause of disability and pain around the world. Epidemiologic studies of family history have revealed evidence of genetic influence on OA. Although many efforts have been devoted to exploring genetic biomarkers, the mechanism behind this complex disease remains unclear. The identified genetic risk variants only explain a small proportion of the disease phenotype. Traditional genome-wide association study (GWAS) focuses on radiographic evidence of OA and excludes sex chromosome information in the analysis. However, gender differences in OA are multifactorial, with a higher frequency in women, indicating that the chromosome X plays an essential role in OA pathology. Furthermore, the prevalence of comorbidities among patients with OA is high, indicating multiple diseases share a similar genetic susceptibility to OA. Methods: In this study, we performed GWAS of OA and OA-associated key comorbidities on 3366 OA patient data obtained from the Osteoarthritis Initiative (OAI). We performed Mendelian randomization to identify the possible causal relationship between OA and OA-related clinical features. Results: One significant OA-associated locus rs2305570 was identified through sex-specific genome-wide association. By calculating the LD score, we found OA is positively correlated with heart disease and stroke. A strong genetic correlation was observed between knee OA and inflammatory disease, including eczema, multiple sclerosis, and Crohn's disease. Our study also found that knee alignment is one of the major risk factors in OA development, and we surprisingly found knee pain is not a causative factor of OA, although it was the most common symptom of OA. Conclusion: We investigated several significant positive/negative genetic correlations between OA and common chronic diseases, suggesting substantial genetic overlaps between OA and these traits. The sex-specific association analysis supports the critical role of chromosome X in OA development in females.
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Affiliation(s)
| | | | | | | | - Xiaobo Zhou
- Center for Computational Systems Medicine, School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, TX, United States
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27
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Fidelis-de-Paula-Gomes CA, Dibai-Filho AV, Ferreira CSB, da Silva ACB, de Oliveira AR, Politti F, Biasotto-Gonzalez DA. Correlation Among Pain Intensity, Catastrophizing, and Falls in Older Individuals With Unilateral Knee Osteoarthritis: A Cross-Sectional Study. J Manipulative Physiol Ther 2022; 45:196-201. [PMID: 35879126 DOI: 10.1016/j.jmpt.2022.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 04/15/2022] [Accepted: 06/09/2022] [Indexed: 10/16/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate whether pain intensity and catastrophizing are associated with fear of falls and the number of falls in older persons with knee osteoarthritis (OA). METHODS A cross-sectional study was conducted involving 100 volunteers (male and female participants), 60 to 80 years old, with a diagnosis of knee OA. Patients were recruited from a physical therapy clinic in the city of São Paulo, Brazil, from March 2019 to November 2019. The following measures were used for the evaluations: Numerical Rating Pain Scale (NRPS), Pain-Related Self-Statement Scale (PRSS), and Falls Efficacy Scale. In statistical analysis, histograms were created to determine the distribution of data. Spearman's correlation coefficients (rs) were then calculated to determine the strength of the associations among the variables. The receiver operating characteristic curve was used to identify the accuracy of PRSS and NRPS in differentiating participants with a history of falls from those without. RESULTS No significant correlation was found among the pain intensity, pain catastrophizing, fear of falling, and number of falls (rs value ranging from -0.033 to -0.167; P value ranging from .096-.743). The accuracy of PRSS and NRPS in differentiating participants with falls from those without was insufficient, with area under the curve values of 0.46 and 0.42, respectively. CONCLUSION Pain catastrophizing and intensity were not significantly associated with fear of falling and numbers of falls in older individuals with unilateral knee OA.
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Affiliation(s)
| | | | | | | | | | - Fabiano Politti
- Postgraduate Program in Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil
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28
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Gait Improvement in Patients with Knee Osteoarthritis after Proximal Fibular Osteotomy. BIOMED RESEARCH INTERNATIONAL 2022; 2022:1869922. [PMID: 35782074 PMCID: PMC9246634 DOI: 10.1155/2022/1869922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/06/2022] [Accepted: 06/13/2022] [Indexed: 11/29/2022]
Abstract
Proximal fibula osteotomy (PFO) is a relatively new surgery to treat medial compartment knee osteoarthritis (KOA), which can improve varum deformity and relieve knee joint pain. However, the gait alterations in KOA patients after PFO are still poorly understood. The purpose of this study was to evaluate the gait patterns change in patients of medial compartment KOA after PFO. Gait data were collected for 9 females with unilateral medial compartment KOA before and at 6 months after PFO and also for 9 healthy age-matched females. Paired t-test was used to determine the effect of PFO within the KOA group, and independent t-test were performed to compare between KOA and control groups for spatiotemporal, kinematic, and kinetic variables. The results showed that patients with KOA had significantly increased knee peak flexion angle, knee sagittal range of motion, and peak external hip adduction moment but decreased knee frontal range of motion in the affected limb after PFO. The gait symmetry was improved postoperatively confirmed by single support and swing phases, knee peak flexion angle and sagittal range of motion, peak external hip and knee adduction moments, and peak anterior and peak posterior ground reaction forces. These findings provided evidence of a biomechanical benefit and gait improvement following PFO to treat medial compartment KOA.
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29
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Murphy MT, Wang N, Felson DT, Nevitt MC, Lewis CE, Frey-Law L, Guermazi A, Segal NA. Association between hamstring coactivation during isokinetic quadriceps strength testing and knee cartilage worsening over 24 months. Osteoarthritis Cartilage 2022; 30:823-831. [PMID: 35307535 PMCID: PMC9450915 DOI: 10.1016/j.joca.2022.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 02/24/2022] [Accepted: 03/07/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE This study aimed to determine longitudinal associations, including sex-specific differences, between greater knee flexor antagonist coactivation and worsening cartilage morphology in knees with or at risk for osteoarthritis (OA). DESIGN Baseline measurements were collected at the 60-month visit of a longitudinal osteoarthritis study following community-dwelling participants (MOST). Knee flexor and extensor muscle activity were measured with surface electromyography during a maximal isokinetic knee extension task. MRI analyzed knee cartilage morphology at baseline and 24-month follow-up. Multivariable adjusted logistic regression models were used to assess associations between coactivation level and cartilage morphology worsening. RESULTS Analysis of 373 women (mean ± SD age 67.4 ± 7.3 years and BMI 29.7 ± 5.0 kg/m2) and 240 men (66.5 ± 7.8 years and 29.9 ± 4.5 kg/m2) revealed that women had greater medial (P < 0.001), lateral (P < 0.001), and combined (P < 0.001) hamstring coactivation than men. In both sexes, combined hamstring coactivation was associated with patellofemoral cartilage morphology worsening [1.23 (1.02, 1.49)] and to a less significant degree with whole knee cartilage morphology worsening [1.21 (0.98, 1.49)]. In men, greater combined hamstring coactivation was associated with increased risk for whole knee [1.59 (1.06, 2.39)] and patellofemoral [1.38 (1.01, 1.88)] cartilage morphology worsening and point estimates suggested association between medial hamstring coactivation and medial tibiofemoral cartilage morphology worsening. No significant associations were detected between greater hamstring coactivation and cartilage morphology worsening in women. CONCLUSIONS These findings suggest a longitudinal relationship between antagonist hamstring coactivation during isokinetic knee extensor testing and worsening of cartilage morphology over 24 months in men with or at risk for knee OA.
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Affiliation(s)
- M T Murphy
- Department of Rehabilitation Medicine, University of Kansas Medical Center, 3901 Rainbow Boulevard, Mailstop 1046, Kansas City, KS, 66160, USA.
| | - N Wang
- Department of Biostatistics and Epidemiology, Boston University, Boston, MA, USA.
| | - D T Felson
- Department of Epidemiology, Boston University, Boston, MA, USA.
| | - M C Nevitt
- Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, CA, USA.
| | - C E Lewis
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - L Frey-Law
- Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, IA, USA.
| | - A Guermazi
- Department of Radiology, Boston University, Boston, MA, USA.
| | - N A Segal
- Department of Rehabilitation Medicine, University of Kansas Medical Center, 3901 Rainbow Boulevard, Mailstop 1046, Kansas City, KS, 66160, USA.
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30
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Romanchuk NJ, Livock H, Lukas KJ, Del Bel MJ, Benoit DL, Carsen S. Protocol for the systematic review of return-to-activity criteria in adolescent patients following an anterior cruciate ligament reconstruction. Syst Rev 2022; 11:93. [PMID: 35568927 PMCID: PMC9107732 DOI: 10.1186/s13643-022-01965-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 04/21/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Anterior cruciate ligament (ACL) rupture is a debilitating knee injury associated with sequela such as joint instability and progressive degeneration. Unfortunately, following surgical ACL reconstruction in adolescents, the rates of ACL graft failure range from 17 to 19%. A contributing factor to the high reinjury rate in this population may be the limited evidence regarding appropriate criteria for allowing unrestricted return-to-activities (RTA) postoperatively. Several systematic reviews have already sought to develop a consensus on what criteria should be utilized for releasing patients to unrestricted sports activities; however, these reviews have focused on adult populations, a group at much lower risk for reinjury. Our objective is to systematically examine the literature and identify the criteria used when determining unrestricted RTA following an ACL reconstruction in an adolescent population. METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic search will be performed of the MEDLINE/PubMed, Cochrane, Embase, CINAHL, and SPORTDiscus electronic databases. Searches will be conducted from January 1, 2000, until submission of the final review. Studies will be identified that include adolescent patients (10-18 years old) undergoing a primary ACL reconstruction and which have specified the criteria used to determine RTA. Each article will be independently screened by two reviewers. To supplement the electronic database search, citations within all included studies will be manually reviewed. Reviewers will record the RTA assessment utilized and the rates of ACL reinjury through a standardized data extraction sheet. Reviewers will resolve full-text screening and data extraction disagreements through discussion. Synthesis of the collected data will focus on compiling and mapping the most commonly used types of RTA criteria. DISCUSSION This systematic review will determine the most commonly used RTA criteria in adolescent patients post-ACL reconstruction. This will help future interventions build more effective adolescent-specific RTA assessments through the validation of current RTA criteria as well as the implementation of new criteria according to the identified literature gaps.
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Affiliation(s)
- Nicholas J Romanchuk
- Ottawa Carleton Institute for Biomedical Engineering, University of Ottawa, 800 King Edward Ave., Ottawa, ON, K1N 6N5, Canada
| | - Holly Livock
- Division of Orthopaedic Surgery, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Rd, Ottawa, K1H 8L1, Canada
| | - Kenneth J Lukas
- Trinity College, University of Dublin, College Green, Dublin 2, Dublin, Ireland
| | - Michael J Del Bel
- School of Rehabilitation Sciences, University of Ottawa, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada
| | - Daniel L Benoit
- Ottawa Carleton Institute for Biomedical Engineering, University of Ottawa, 800 King Edward Ave., Ottawa, ON, K1N 6N5, Canada.,School of Rehabilitation Sciences, University of Ottawa, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada.,School of Human Kinetics, University of Ottawa, 125 University, Ottawa, ON, K1N 6N5, Canada
| | - Sasha Carsen
- Division of Orthopaedic Surgery, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Rd, Ottawa, K1H 8L1, Canada.
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Koike M, Nagao M, Iwase Y, Kaneko K, Ishijima M, Nojiri H. Clinical Efficacy of Melon GliSODin ® for the Treatment of Aging-Related Dysfunction in Motor Organs-A Double Blind, Randomized Placebo-Controlled Study. J Clin Med 2022; 11:2747. [PMID: 35628874 PMCID: PMC9143343 DOI: 10.3390/jcm11102747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/29/2022] [Accepted: 05/05/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Locomotive syndrome is a concept proposed in Japan involving decreased mobility due to osteoarthritis, osteoporosis, and sarcopenia. This double-blind, randomized study aimed to investigate the effects of superoxide dismutase (SOD)-rich melon extract (Melon GliSODin®) on locomotive syndrome. METHODS For 6 months, we administered oral Melon GliSODin® (500.4 mg/day) or a placebo to 24 and 22 women, respectively (aged 50-80 years), with knee or lower back discomfort or pain. Using baseline and 6-month data, changes in the Verbal Rating Scale and in subjective symptoms (determined using the Japanese Knee Osteoarthritis Measure, Locomo 25, the Roland-Morris Disability questionnaire, and the Chalder Fatigue Scale) were assessed, along with various oxidative markers, antioxidants, inflammatory markers, renal and liver function biochemical markers, bone metabolism markers, body composition, and motor function. RESULTS Oral Melon GliSODin® administration tended to be associated with a larger improvement in subjective symptom scores, a reduction in oxidative markers (malondialdehyde and diacron reactive oxygen metabolites) and tumor necrosis factor-α, and a significant increase in non-fat mass between baseline and 6 months. However, no statistically significant differences were observed between the groups for outcomes at 6 months. CONCLUSIONS Melon GliSODin® tended to improve the subjective symptoms of participants who had knee or lower back pain or discomfort. Melon GliSODin® administration may help to prevent the progression of locomotive syndrome. Future studies involving larger sample sizes and more stringent randomization protocols are needed to determine differences between the placebo and Melon GliSODin® groups.
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Affiliation(s)
- Masato Koike
- Department of Orthopaedic Surgery, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo 136-0075, Japan; (M.K.); (Y.I.)
| | - Masashi Nagao
- Department of Orthopaedic Surgery, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan; (M.N.); (K.K.); (M.I.)
- Department of Orthopaedic Surgery, Medical Technology Innovation Center, Clinical Research & Trial Center, Graduate School of Health and Sports Science, Juntendo University, Tokyo 113-8421, Japan
| | - Yoshiyuki Iwase
- Department of Orthopaedic Surgery, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo 136-0075, Japan; (M.K.); (Y.I.)
| | - Kazuo Kaneko
- Department of Orthopaedic Surgery, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan; (M.N.); (K.K.); (M.I.)
| | - Muneaki Ishijima
- Department of Orthopaedic Surgery, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan; (M.N.); (K.K.); (M.I.)
| | - Hidetoshi Nojiri
- Department of Orthopaedic Surgery, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo 136-0075, Japan; (M.K.); (Y.I.)
- Department of Orthopaedic Surgery, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan; (M.N.); (K.K.); (M.I.)
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Madamsetty VS, Mohammadinejad R, Uzieliene I, Nabavi N, Dehshahri A, García-Couce J, Tavakol S, Moghassemi S, Dadashzadeh A, Makvandi P, Pardakhty A, Aghaei Afshar A, Seyfoddin A. Dexamethasone: Insights into Pharmacological Aspects, Therapeutic Mechanisms, and Delivery Systems. ACS Biomater Sci Eng 2022; 8:1763-1790. [PMID: 35439408 PMCID: PMC9045676 DOI: 10.1021/acsbiomaterials.2c00026] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Dexamethasone (DEX) has been widely used to treat a variety of diseases, including autoimmune diseases, allergies, ocular disorders, cancer, and, more recently, COVID-19. However, DEX usage is often restricted in the clinic due to its poor water solubility. When administered through a systemic route, it can elicit severe side effects, such as hypertension, peptic ulcers, hyperglycemia, and hydro-electrolytic disorders. There is currently much interest in developing efficient DEX-loaded nanoformulations that ameliorate adverse disease effects inhibiting advancements in scientific research. Various nanoparticles have been developed to selectively deliver drugs without destroying healthy cells or organs in recent years. In the present review, we have summarized some of the most attractive applications of DEX-loaded delivery systems, including liposomes, polymers, hydrogels, nanofibers, silica, calcium phosphate, and hydroxyapatite. This review provides our readers with a broad spectrum of nanomedicine approaches to deliver DEX safely.
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Affiliation(s)
- Vijay Sagar Madamsetty
- Department of Biochemistry and Molecular Biology, Mayo Clinic College of Medicine and Science, Jacksonville, Florida 32224, United States
| | - Reza Mohammadinejad
- Research Center of Tropical and Infectious Diseases, Kerman University of Medical Sciences, Kerman 7618866749, Iran
| | - Ilona Uzieliene
- Department of Regenerative Medicine, State Research Institute Centre for Innovative Medicine, Santariskiu 5, LT-08406 Vilnius, Lithuania
| | - Noushin Nabavi
- Department of Urologic Sciences, Vancouver Prostate Centre, Vancouver, British Columbia, Canada V6H 3Z6
| | - Ali Dehshahri
- Center for Nanotechnology in Drug Delivery, Shiraz University of Medical Sciences, Shiraz 7146864685, Iran
| | - Jomarien García-Couce
- Department of Radiology, Division of Translational Nanobiomaterials and Imaging, Leiden University Medical Center, Leiden 2333 ZA, The Netherlands
- Department of Polymeric Biomaterials, Biomaterials Center (BIOMAT), University of Havana, Havana 10600, Cuba
| | - Shima Tavakol
- Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran 1417755469, Iran
| | - Saeid Moghassemi
- Pôle de Recherche en Gynécologie, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels 1200, Belgium
| | - Arezoo Dadashzadeh
- Pôle de Recherche en Gynécologie, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels 1200, Belgium
| | - Pooyan Makvandi
- Istituto Italiano di Tecnologia, Centre for Micro-BioRobotics, Viale Rinaldo Piaggio 34, 56025 Pontedera, Pisa, Italy
- Department of Medical Nanotechnology, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran 14496-14535, Iran
| | - Abbas Pardakhty
- Pharmaceutics Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman 7618866748, Iran
| | - Abbas Aghaei Afshar
- Research Center of Tropical and Infectious Diseases, Kerman University of Medical Sciences, Kerman 7618866749, Iran
| | - Ali Seyfoddin
- Drug Delivery Research Group, Auckland University of Technology (AUT), School of Science, Auckland 1010, New Zealand
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Sananta P, Qurotu’ain NA, Widasmara D, Noviya E. Correlation between Grade of Knee Osteoarthritis with Quality of Life of Patient in Secondary Referral Hospital in Indonesia. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Osteoarthritis (OA) is a disorder that occurs in the joints and is the leading cause of pain and disability in adults. In Indonesia, the prevalence of osteoarthritis is still high; it was 15.5% in men and 12.7% in women, out of around 225 million Indonesians. Several factors cause osteoarthritis, including aging, genetics, obesity, gender, and the type of work done by the patient.
Aims: This study aimed to determine the relationship between the grade of knee osteoarthritis based on the Kellgren & Lawrence system with a decrease in quality of life in patients and to determine the decrease in quality of life based on the gender of the patient at Baptis Hospital, Batu.
Methods: This study used a cross-sectional design with a sample size of 31 people who suffer from knee osteoarthritis patients at Baptis Hospital, Batu City. Data collection was carried out directly from respondents using the Short-Form 36 (SF-36) questionnaire.
Results: The results showed that 9 respondents (29%) had grade 1 osteoarthritis, 10 respondents had grade 2 osteoarthritis (32.3%), and 12 respondents (38.7%) had grade 3 osteoarthritis. 38.7% of patients have a good quality of life, whereas 61.3 patients have a poor quality of life. It shows that most of the 31 patients suffering from knee osteoarthritis who participated in this research have a poor quality of life. The Chi-Square test showed a significant relationship (p<0.05) between an increase in the grade of knee osteoarthritis and a decrease in the quality of life of patients
Conclusion: There was a significant relationship between the grade of knee osteoarthritis and quality of life, and there is no significant relationship between the grade of knee osteoarthritis and the quality of life based on the gender of patients.
Keywords: quality of life, knee osteoarthritis, and SF-36.
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Haider MZ, Bhuiyan R, Ahmed S, Zahid-Al-Quadir A, Choudhury MR, Haq SA, Zaman MM. Risk factors of knee osteoarthritis in Bangladeshi adults: a national survey. BMC Musculoskelet Disord 2022; 23:333. [PMID: 35395747 PMCID: PMC8991964 DOI: 10.1186/s12891-022-05253-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 03/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Knee osteoarthritis was reported as the second most prevalent condition in the national musculoskeletal survey. The purpose of this extended study was to identify risk factors for knee osteoarthritis in Bangladeshi adults. METHODS This cross-sectional study was conducted in rural and urban areas of Bangladesh using stratified multistage cluster sample of 2000 adults aged 18 years or older recruited at their households. The Modified Community Oriented Program for Control of Rheumatic Disorders (COPCORD) questionnaire was used to collect data. The diagnosis of knee osteoarthritis was made using the decision tree clinical categorization criteria of the American College of Rheumatology. Univariate and multivariate logistic regression analyses were done to identify the risk factors for knee osteoarthritis. RESULTS A total of 1843 individuals (892 men and 951 women) participated, and 134 had knee osteoarthritis yielding a prevalence of 7.3% (95% confidence interval (CI) 4.9 to 9.6%). The mean (standard deviation) age of the knee osteoarthritis patients was 51.7 (11.2) years. Multivariate logistic regression analysis found a significant association with increasing age (≥38 years OR 8.9, 95% CI 4.8-16.5; ≥58 years OR 13.9, 95% CI 6.9-28.0), low educational level (OR 1.7, 95% CI 1.0-2.7) and overweight (OR 1.9, 95% CI 1.2-2.9) with knee osteoarthritis. Knee osteoarthritis patients had a high likelihood of having work loss preceding 12 months (age and sex-adjusted OR 2.3; 95% CI 1.4-3.8; P < 0.01). CONCLUSIONS Knee osteoarthritis is a commonly prevalent musculoskeletal problem among Bangladeshi adults having link to work loss. Increasing age, low education and overweight are significant risk factors of knee osteoarthritis.
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Affiliation(s)
- Mohammad Ziaul Haider
- Tb Control and Training Institute, Dhaka, Bangladesh.,Present Address: 250 Bedded Tb Hospital, Dhaka, Bangladesh
| | - Rijwan Bhuiyan
- Ministry of Health and Family Welfare Coordination Center, Cox's Bazar, Bangladesh
| | - Shamim Ahmed
- Department of Rheumatology, BSM Medical University, Dhaka, Bangladesh
| | | | | | - Syed Atiqul Haq
- Department of Rheumatology, BSM Medical University, Dhaka, Bangladesh
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Terracciano R, Carcamo-Bahena Y, Royal ALR, Demarchi D, Labis JS, Harris JD, Weiner BK, Gupta N, Filgueira CS. Quantitative high-resolution 7T MRI to assess longitudinal changes in articular cartilage after anterior cruciate ligament injury in a rabbit model of post-traumatic osteoarthritis. OSTEOARTHRITIS AND CARTILAGE OPEN 2022; 4:100259. [DOI: 10.1016/j.ocarto.2022.100259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 02/28/2022] [Accepted: 03/30/2022] [Indexed: 11/25/2022] Open
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Karthik NM, Das SG, Johney J, George M, Issac E, Vasudevan A. Comparison of postoperative analgesia with two different doses of dexmedetomidine as an adjuvant to ropivacaine in adductor canal block for unilateral total knee replacement surgery: A randomized double-blinded study. J Anaesthesiol Clin Pharmacol 2022; 38:428-433. [PMID: 36505212 PMCID: PMC9728424 DOI: 10.4103/joacp.joacp_493_20] [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: 12/22/2020] [Revised: 04/14/2021] [Accepted: 04/22/2021] [Indexed: 11/06/2022] Open
Abstract
Background and Aims Multimodal analgesia is used to treat severe postoperative pain (POP) in total knee replacement (TKR) surgery. Adjuvants are used with local anesthetics to improve the quality and duration of pain relief. Studies comparing different doses of dexmedetomidine in adductor canal block (ACB) are sparse to date. This study compares postoperative analgesia with two different doses of dexmedetomidine as an adjuvant to 0.2% ropivacaine in ACB for unilateral TKR. Material and Methods In this prospective, randomized, double-blinded comparative study, sixty patients were divided into two groups: A and B. Postoperatively perineural catheter was inserted and all patients received 0.2% ropivacaine 20 mL bolus followed by an infusion of 0.2% ropivacaine with dexmedetomidine (0.5 µg/Kg in Group A and 1 µg/Kg in Group B) at 8 mL/h. Postoperative pain, motor blockade, rescue analgesia, hemodynamic parameters, sedation, and adverse effects were recorded. Student t, Chi-square, and Mann-Whitney tests were used. Results Most patients were elderly females (M:15, F:45). Postoperatively, from 2nd to 24th hour, pain score was less in Group B (P < 0.05). The requirement of rescue analgesic was also less in Group B (A:B 330 µg:60 µg; 23%:6%). Motor blockade assessed using modified Bromage scale and sedation using Richmond agitation sedation scale did not show any statistical difference. Conclusion Dexmedetomidine infusion at 1 µg/Kg is a better adjuvant to 0.2% ropivacaine than 0.5 µg/Kg in ACB. It provides better analgesia without producing sedation, motor blockade, hemodynamic changes, or any adverse effects.
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Affiliation(s)
- Naveen M. Karthik
- Department of Anaesthesiology and Critical Care Medicine, Cochin, Kerala, India
| | - S. Gokul Das
- Department of Anaesthesiology and Critical Care Medicine, Cochin, Kerala, India,Address for correspondence: Dr. S. Gokul Das, Department of Anaesthesiology and Critical Care Medicine, Amrita Institute of Medical Science and Research Centre, Cochin - 682 041, Kerala, India.
Postal address: Anantham, Chendamangalam Road, North Paravur - 683 513, Ernakulam District, Kerala, India. E-mail:
| | - Jasmin Johney
- Department of Anaesthesiology and Critical Care Medicine, Cochin, Kerala, India
| | - Mathew George
- Department of Anaesthesiology and Critical Care Medicine, Cochin, Kerala, India
| | - Eldo Issac
- Department of Anaesthesiology and Critical Care Medicine, Cochin, Kerala, India
| | - Anu Vasudevan
- Department of Biostatistics, Amrita Institute of Medical Sciences and Research Centre, Cochin, Kerala, India
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Peters AE, Geraghty B, Bates KT, Akhtar R, Readioff R, Comerford E. Ligament mechanics of ageing and osteoarthritic human knees. Front Bioeng Biotechnol 2022; 10:954837. [PMID: 36082159 PMCID: PMC9446756 DOI: 10.3389/fbioe.2022.954837] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 07/25/2022] [Indexed: 11/18/2022] Open
Abstract
Knee joint ligaments provide stability to the joint by preventing excessive movement. There has been no systematic effort to study the effect of OA and ageing on the mechanical properties of the four major human knee ligaments. This study aims to collate data on the material properties of the anterior (ACL) and posterior (PCL) cruciate ligaments, medial (MCL) and lateral (LCL) collateral ligaments. Bone-ligament-bone specimens from twelve cadaveric human knee joints were extracted for this study. The cadaveric knee joints were previously collected to study ageing and OA on bone and cartilage material properties; therefore, combining our previous bone and cartilage data with the new ligament data from this study will facilitate subject-specific whole-joint modelling studies. The bone-ligament-bone specimens were tested under tensile loading to failure, determining material parameters including yield and ultimate (failure) stress and strain, secant modulus, tangent modulus, and stiffness. There were significant negative correlations between age and ACL yield stress (p = 0.03), ACL failure stress (p = 0.02), PCL secant (p = 0.02) and tangent (p = 0.02) modulus, and LCL stiffness (p = 0.046). Significant negative correlations were also found between OA grades and ACL yield stress (p = 0.02) and strain (p = 0.03), and LCL failure stress (p = 0.048). However, changes in age or OA grade did not show a statistically significant correlation with the MCL tensile parameters. Due to the small sample size, the combined effect of age and the presence of OA could not be statistically derived. This research is the first to report tensile properties of the four major human knee ligaments from a diverse demographic. When combined with our previous findings on bone and cartilage for the same twelve knee cadavers, the current ligament study supports the conceptualisation of OA as a whole-joint disease that impairs the integrity of many peri-articular tissues within the knee. The subject-specific data pool consisting of the material properties of the four major knee ligaments, subchondral and trabecular bones and articular cartilage will advance knee joint finite element models.
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Affiliation(s)
- Abby E Peters
- Department of Mechanical, Materials and Aerospace Engineering, School of Engineering, University of Liverpool, Liverpool, United Kingdom.,Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Brendan Geraghty
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Karl T Bates
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom.,Medical Research Council Versus Arthritis Centre for Integrated Research Into Musculoskeletal Ageing (CIMA), University of Liverpool, Liverpool, United Kingdom
| | - Riaz Akhtar
- Department of Mechanical, Materials and Aerospace Engineering, School of Engineering, University of Liverpool, Liverpool, United Kingdom
| | - Rosti Readioff
- Department of Mechanical, Materials and Aerospace Engineering, School of Engineering, University of Liverpool, Liverpool, United Kingdom.,Institute of Medical and Biological Engineering, School of Mechanical Engineering, Faculty of Engineering, University of Leeds, Leeds, United Kingdom.,School of Dentistry, University of Liverpool, Liverpool, United Kingdom
| | - Eithne Comerford
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom.,Medical Research Council Versus Arthritis Centre for Integrated Research Into Musculoskeletal Ageing (CIMA), University of Liverpool, Liverpool, United Kingdom.,School of Veterinary Science, University of Liverpool, Liverpool, United Kingdom
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Abstract
The last decade has seen an enormous increase in long non-coding RNA (lncRNA) research within rheumatology. LncRNAs are arbitrarily classed as non-protein encoding RNA transcripts that exceed 200 nucleotides in length. These transcripts have tissue and cell specific patterns of expression and are implicated in a variety of biological processes. Unsurprisingly, numerous lncRNAs are dysregulated in rheumatoid conditions, correlating with disease activity and cited as potential biomarkers and targets for therapeutic intervention. In this chapter, following an introduction into each condition, we discuss the lncRNAs involved in rheumatoid arthritis, osteoarthritis and systemic lupus erythematosus. These inflammatory joint conditions share several inflammatory signalling pathways and therefore not surprisingly many commonly dysregulated lncRNAs are shared across these conditions. In the interest of translational research only those lncRNAs which are strongly conserved have been addressed. The lncRNAs discussed here have diverse roles in regulating inflammation, proliferation, migration, invasion and apoptosis. Understanding the molecular basis of lncRNA function in rheumatology will be crucial in fully determining the inflammatory mechanisms that drive these conditions.
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Oğuz R, Belviranlı M, Okudan N. Effects of Exercise Training Alone and in Combination With Kinesio Taping on Pain, Functionality, and Biomarkers Related to the Cartilage Metabolism in Knee Osteoarthritis. Cartilage 2021; 13:1791S-1800S. [PMID: 33870762 PMCID: PMC8808795 DOI: 10.1177/19476035211007895] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To investigate the effects of exercise training alone and in combination with kinesio taping on pain, functionality, and circulating cartilage oligomeric matrix protein (COMP), and matrix metalloproteinase (MMP)-1, and -3 at rest and immediately after walking exercise in knee osteoarthritis (OA). DESIGN A total of 22 female patients diagnosed with knee OA were randomly divided into the exercise training (ET) or exercise training plus kinesio taping (ET + KT) groups. The patients in the ET performed exercise training for 6 weeks. The patients in the ET + KT group were applied with kinesio tape in addition to the exercise training for 6 weeks. In both groups, 20 minutes of walking exercise were performed before and after the interventions. The pain and functional status of the patients were assessed using visual analogue scale (VAS) and Western Ontario McMasters Osteoarthritis Index (WOMAC) before and after the intervention at rest, respectively. Blood samples were taken at rest and immediately after the walking exercise before and after the interventions for the analysis of COMP, MMP-1, and MMP-3 levels. RESULTS In both groups, pain and functionality scores were significantly improved after the interventions (P < 0.05). COMP, MMP-1 and MMP-3 levels were higher immediately after walking exercise when compared with rest in both groups before and after the intervention (P < 0.05). CONCLUSIONS Exercise training and exercise training plus kinesio taping improved pain and physical function; however, the COMP, MMP-1, and MMP-3 levels did not change.
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Affiliation(s)
- Ramazan Oğuz
- Department of Physical Medicine and
Rehabilitation, Konya Numune Hospital, Konya, Turkey
| | - Muaz Belviranlı
- Department of Physiology, Division of
Sports Physiology, School of Medicine, Selçuk University, Konya, Turkey,Muaz Belviranlı, Department of Physiology,
Division of Sports Physiology, School of Medicine, Selçuk University, Konya,
42131, Turkey.
| | - Nilsel Okudan
- Department of Physiology, Division of
Sports Physiology, School of Medicine, Selçuk University, Konya, Turkey
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Rankothgedera S, Atukorala I, Fernando C, Munidasa D, Wijayaratne L, Udagama P. A potential diagnostic serum immunological marker panel to differentiate between primary and secondary knee osteoarthritis. PLoS One 2021; 16:e0257507. [PMID: 34543351 PMCID: PMC8452079 DOI: 10.1371/journal.pone.0257507] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 09/02/2021] [Indexed: 11/19/2022] Open
Abstract
Inflammation contributes to knee osteoarthritis (KOA) where many immunological mediators participate in its initiation and progression. Most clinicians manage primary (pKOA) and secondary osteoarthritis (sKOA) alike. Whether immunological profiles of pKOA and sKOA differ remains obscure. Hence, we aimed to differentially identify potential serum immunologic diagnostic markers of pKOA and of sKOA. This case control study used 46 KOA patients (pKOA, n = 30; sKOA, n = 16), and 60 age, gender matched controls (normal healthy, n = 30; systemic lupus erythematosus [SLE] disease controls, n = 30) where serum was assayed for cytokines (TNF-α, IL-1β, IL-6, IL-10) and nitric oxide derivatives (NOx). Sandwich ELISA assessed cytokine levels, while the ‘Griess assay’ quantified NOx levels. The diagnostic accuracy of optimal marker combinations was evaluated by the CombiROC web tool. Compared with pKOA, sKOA serum displayed significantly elevated levels of pro inflammatory cytokines (TNF-α, IL-1β, IL-6) with a concurrent decrease in the anti-inflammatory cytokine, IL-10 (P<0.05). This was reiterated by significantly higher Th1:Th2 (TNF-α: IL-10) serum cytokine ratio observed in sKOA compared to that of pKOA. The CombiROC curves identified TNF-α, IL-1β, IL-6 and NOx as the best performing panel of potential diagnostic markers to discriminate pKOA from control groups (~97% accuracy, 90% Sensitivity [SE] and 98% specificity [SP]), while TNF-α, IL-1β and IL-6 discriminated sKOA from control groups (~100% accuracy, 100% SE, and 98% SP). The study identified discrete serum immune biomarker panels to differentiate between pKOA (TNF-α, IL-1β, IL-6 and NOx) and sKOA (TNF-α, IL-1β and IL-6). These findings may assist in developing distinct therapeutic agents for the two types of KOA.
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Affiliation(s)
- Sakuni Rankothgedera
- Faculty of Science, Department of Zoology & Environment Sciences, University of Colombo, Colombo, Sri Lanka
| | - Inoshi Atukorala
- Faculty of Medicine, Department of Clinical Medicine, University of Colombo, Colombo, Sri Lanka
| | - Chandrika Fernando
- Faculty of Science and Engineering, School of Electrical Engineering, Computer and Mathematical Sciences (EECMS), Curtin University, Perth, Western Australia
| | | | | | - Preethi Udagama
- Faculty of Science, Department of Zoology & Environment Sciences, University of Colombo, Colombo, Sri Lanka
- * E-mail:
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Study Protocol Modeling Evoked Pain in Older African Americans With Knee Osteoarthritis. Nurs Res 2021; 70:391-398. [PMID: 33951704 DOI: 10.1097/nnr.0000000000000520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND African American (AA) older adults with knee osteoarthritis experience more severe chronic pain and advanced physical disability. One of the most prominent stimuli that provokes knee pain is movement. Research suggests that, compared to Whites, AAs report significantly higher movement-evoked pain (MEP) in the knee. However, little is known about the biopsychosocial-behavioral mechanisms underlying MEP. OBJECTIVES The aim of the study was to present a study protocol to (a) characterize the biopsychosocial-behavioral mechanisms that predict MEP in AAs with knee osteoarthritis and (b) develop a targeted, mechanism-based self-management intervention to reduce MEP and maximize movement. METHODS An observational, mixed-methods cohort study will enroll 90 AA/Black adults (ages 55-90 years) to understand intraindividual and interindividual effects on MEP. Participants will complete assessments of MEP, function and gait, biopsychosocial-behavioral questionnaires, quantitative sensory testing, and 7-day ecological momentary assessments of pain and related symptoms. For the qualitative phase, focus groups will be conducted to co-construct a mechanism-based pain self-management intervention. RESULTS We will develop phenotypes of MEP based on biopsychosocial-behavioral predictors and correlate measures of MEP with function. Our central hypothesis is that higher levels of MEP will predict lower self-reported function and poorer performance on functional tasks and that multiple biopsychosocial and behavioral factors will be associated with MEP and function. Predictors may serve as risk or protective factors for MEP and physical function. In targeting the biopsychosocial-behavioral mechanisms of MEP, we anticipate that older AAs may request that intervention components include culturally tailored self-management education, movement/physical activity training, treatment decision-making skills, coaching, spirituality, and social/kinship support. CONCLUSION Osteoarthritis is now the single most common cause of disability, mobility limitations, and persistent pain in older adults-especially AA older adults. To our knowledge, this will be the first study to systematically phenotype MEP in an older racial minority population with knee osteoarthritis and will be relevant for reducing knee pain and improving function.
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Abshirini M, Coad J, Wolber FM, von Hurst P, Miller MR, Tian HS, Kruger MC. Green-lipped (greenshell™) mussel (Perna canaliculus) extract supplementation in treatment of osteoarthritis: a systematic review. Inflammopharmacology 2021; 29:925-938. [PMID: 33738701 PMCID: PMC8298224 DOI: 10.1007/s10787-021-00801-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 03/06/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Intervention studies using New Zealand green-lipped or greenshell™ mussel (GSM) (Perna canaliculus) extract in osteoarthritis (OA) patients have shown effective pain relief. This systematic review summarises the efficacy of GSM extracts in the treatment of OA. METHODS A literature search of the three databases EMBASE, MEDLINE, and Scopus was performed to identify relevant articles published up to March 2020. Inclusion criteria were clinical trials published in English measuring the effect of supplementation of whole or a lipid extract from GSM on pain and mobility outcomes in OA patients. RESULTS A total of nine clinical trials were included in systematic review, from which five studies were considered appropriate for inclusion in a forest plot. Pooled results showed that GSM extracts (lipid extract or whole powder) provide moderate and clinically significant treatment effects on a visual analogue scale (VAS) pain score (effect size: - 0.46; 95% CI - 0.82 to - 0.10; p = 0.01). The whole GSM extract improved gastrointestinal symptoms in OA patients taking anti-inflammatory medications. The GSM extract was considered to be generally well tolerated in most of the studies. CONCLUSION The overall analysis showed that GSM provided moderate and clinically meaningful treatment effects on OA pain. However, the current evidence is limited by the number and quality of studies, and further larger and high-quality studies are needed to confirm the effectiveness and to identify the optimal GSM format. Nevertheless, it is worth considering using GSM extracts especially for patients seeking alternative pain relief treatments with fewer side effects compared to conventional treatment.
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Affiliation(s)
- Maryam Abshirini
- School of Health Sciences, College of Health, Massey University, Private Bag 11222, Palmerston North, 4442, New Zealand
| | - Jane Coad
- School of Food and Advanced Technology, Massey University, Palmerston North, New Zealand
| | - Frances M Wolber
- School of Food and Advanced Technology, Massey University, Palmerston North, New Zealand
- Centre for Metabolic Health Research, Massey University, Palmerston North, New Zealand
| | - Pamela von Hurst
- School of Food and Nutrition, Massey University, Auckland, New Zealand
| | | | | | - Marlena C Kruger
- School of Health Sciences, College of Health, Massey University, Private Bag 11222, Palmerston North, 4442, New Zealand.
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Abshirini M, Coad J, Wolber FM, von Hurst P, Miller MR, Tian HS, Kruger MC. Effect of Greenshell TM mussel on osteoarthritis biomarkers and inflammation in healthy postmenopausal women: a study protocol for a randomized double-blind placebo-controlled trial. Trials 2021; 22:498. [PMID: 34321048 PMCID: PMC8317363 DOI: 10.1186/s13063-021-05473-5] [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: 09/02/2020] [Accepted: 07/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND New Zealand Greenshell™ mussels (GSM; Perna canaliculus) have recently been shown to decrease cartilage degradation in a rat model of induced metabolic osteoarthritis (MetOA). However, this effect has not been investigated in human subjects. This study aims to determine the effect of GSM powder on biomarkers of cartilage metabolism, bone resorption, and inflammation in New Zealand healthy overweight/obese postmenopausal women who are at early stage or at high risk of OA. METHOD Fifty overweight or obese (BMI 25-35 kg/m2) postmenopausal women (aged 55-75 years) will be recruited by advertisement. Participants will be randomized based on a double-blind randomization schedule and stratified randomization based on BMI and age distribution. The participant will be assigned with a 1:1 allocation ratio to receive 3 g/d whole meat GSM powder or placebo (sunflower seed protein) for 12 weeks. Data on socio-demographics, physical activity, and dietary intake will be collected for each subject. Cartilage turnover biomarkers [(C-telopeptide of type II collagen (CTX-II), C-propeptide of type II procollagen (CPII), Cartilage oligomeric matrix protein (COMP)], and bone resorption marker (CTX-I) will be measured in blood and urine samples. Inflammatory status (hs-CRP and cytokine panel) will be assessed and iron status will be measured. Body composition including fat mass (FM), lean mass (LM), and fat percentage will be measured using dual-energy X-ray absorptiometry (DXA). Joint pain and knee function will be assessed using a 100-mm visual analog scale (VAS) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire, respectively. DISCUSSION This trial will be the first to explore the effects of whole meat GSM powder on cartilage turnover, bone resorption, and inflammation biomarkers in overweight/obese postmenopausal women. The results from this trial will provide evidence on the efficacy of GSM in the prevention of OA. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12620000413921p . Registration on 27 March 2020.
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Affiliation(s)
- Maryam Abshirini
- School of Health Sciences, College of Health, Massey University, Private Bag 11222, Palmerston North, 4442, New Zealand
| | - Jane Coad
- School of Food and Advanced Technology, Massey University, Palmerston North, New Zealand
| | - Frances M Wolber
- School of Food and Advanced Technology, Massey University, Palmerston North, New Zealand.,Centre for Metabolic Health Research, Massey University, Palmerston North, New Zealand
| | - Pamela von Hurst
- School of Food and Nutrition, Massey University, Auckland, New Zealand
| | | | | | - Marlena C Kruger
- School of Health Sciences, College of Health, Massey University, Private Bag 11222, Palmerston North, 4442, New Zealand.
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Li C, Zheng Z. Males and Females Have Distinct Molecular Events in the Articular Cartilage during Knee Osteoarthritis. Int J Mol Sci 2021; 22:ijms22157876. [PMID: 34360640 PMCID: PMC8346087 DOI: 10.3390/ijms22157876] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/15/2021] [Accepted: 07/21/2021] [Indexed: 12/25/2022] Open
Abstract
Osteoarthritis (OA) is a major public health challenge that imposes a remarkable burden on the affected individuals and the healthcare system. Based on the clinical observation, males and females have different prevalence rates and severity levels of OA. Thus, sex-based differences may play essential roles in OA’s prognosis and treatment outcomes. To date, the comprehensive understanding of the relationship between sex and OA is still largely lacking. In the current study, we analyzed a published transcriptome dataset of knee articular cartilage (GSE114007) from 18 healthy (five females, 13 males) and 20 OA (11 females, nine males) donors to provide a slight insight into this important but complex issue. First, comparing female healthy cartilage samples with those of males revealed 36 differential expression genes (DEGs), indicating the fundamental sex-related differences at the molecular level. Meanwhile, 923 DEGs were distinguished between OA and healthy female cartilage, which can be enriched to 15 Reactome pathways. On the other hand, when comparing OA and healthy male cartilage, there are only 419 DEGs were identified, and only six pathways were enriched against the Reactome database. The different signaling response to OA in the male and female cartilage was further enforced by recognizing 50 genes with significantly different OA-responsive expression fold changes in males and females. Particularly, 14 Reactome pathways, such as “Extracellular matrix organization”, “Collagen biosynthesis and modifying enzymes”, “Dissolution of fibrin clot”, and “Platelet Aggregation (Plug formation)”, can be noted from these 50 sex-dependent OA-responsive genes. Overall, the current study explores the Sex as a Biological Variable (SABV) at the transcriptomic level in the knee articular cartilage in both healthy status and OA event, which could help predict the differential OA prognosis and treatment outcome of males and female patients.
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Affiliation(s)
- Chenshuang Li
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;
| | - Zhong Zheng
- Division of Growth and Development, Section of Orthodontics, School of Dentistry, University of California, Los Angeles, CA 90095, USA
- Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
- Correspondence: ; Tel.: +1-(310)-206-5646
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Jeong KY, Lee HJ. Prevalence of Knee Osteoarthritis and Health-Related Quality of Life in Stroke Patients over 60 Years Old: A Cross-Sectional Study Using Korean National Health and Nutrition Examination Survey V. Ann Geriatr Med Res 2021; 25:178-186. [PMID: 34275255 PMCID: PMC8497948 DOI: 10.4235/agmr.21.0053] [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: 05/27/2021] [Accepted: 06/18/2021] [Indexed: 11/16/2022] Open
Abstract
Background This study investigated the prevalence of knee osteoarthritis among stroke survivors aged over 60 years and analyzed the association between knee osteoarthritis and health-related quality of life (HRQOL) in stroke survivors. Methods We analyzed data of 287 participants who had experienced a stroke (stroke group) from the 2010–2012 Korean National Health and Nutrition Examination Survey. Among the participants, 65 stroke survivors also had knee osteoarthritis. We used the European Quality of Life-5 Dimensions (EQ-5D) questionnaire to compare the differences in HRQOL according to the presence or absence of knee osteoarthritis in the stroke group. Multiple regression analysis was performed to determine associated factors affecting HRQOL in the stroke group. Results The prevalence of knee osteoarthritis was 21% in the stroke group. The EQ-5D index score was significantly lower in patients in the stroke group with knee osteoarthritis than in those without knee osteoarthritis (adjusted mean±standard error [SE], 0.680±0.011 for stroke with knee osteoarthritis and 0.817±0.003 stroke without knee osteoarthritis; p<0.0001). Knee osteoarthritis, age, income level, education level, smoking, walking days, diabetes, and cardiovascular disease significantly influenced HRQOL in the stroke group. Conclusion The study results confirmed that the prevalence of knee osteoarthritis was 21% in the stroke group and that HRQOL was significantly lower among patients in the stroke group with knee osteoarthritis. These findings suggest the importance of active management of knee osteoarthritis in stroke survivors for HRQOL.
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Affiliation(s)
- Kil-Yong Jeong
- Department of Physical Medicine and Rehabilitation, Ajou University Hospital, Suwon, Korea
| | - Hyun Jung Lee
- Department of Physical Medicine and Rehabilitation, Jeju National University Hospital, Jeju, Korea.,Graduate Program of Medicine, Ajou University Graduate School, Suwon, Korea
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Serrano-Román J, Nicasio-Torres P, Hernández-Pérez E, Jiménez-Ferrer E. Pharmacokinetic Study of Anti-osteoarthritic Compounds of a Standardized Fraction from Sphaeralcea Angustifolia. Pharmaceuticals (Basel) 2021; 14:610. [PMID: 34202137 PMCID: PMC8308911 DOI: 10.3390/ph14070610] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/10/2021] [Accepted: 06/21/2021] [Indexed: 11/16/2022] Open
Abstract
Sphaeralcea angustifolia has been widely used in inflammatory conditions such as blows, bruises, fractures, and wounds. The compounds identified as active in plants and suspension cell culture of S. angustifolia were tomentin, scopoletin, and sphaeralcic acid. To consolidate the integral use of knowledge about the S. angunstifolia and strengthen its pharmacological use in patients with knee osteoarthritis, the pharmacokinetic behavior of the active compounds was characterized. The SaTSS (S. angustifoloia standardized in Tomentin, Scopoletin, and Sphaeralcic acid) anti-ostearthritic fraction was obtained from cell suspension. The analytical method of High-Performance Liquid Chromatography (HPLC) for tomentin, scopoletin, and sphaeralcic acid were validated determining the accuracy, precision linearity, sensibility, specificity, detection limits, and quantification time-range parameters, as well as extraction efficiency and stability of compounds. The pharmacokinetic assay was performed with ICR mice strain, in which the mice were administrated with a single oral or intravenous dose (400 mg/kg with 7.1 mg/kg of scopoletin and tomentin in mixture and 34.6 mg/kg of sphaeralcic acid) of the SaTSS standardized active fraction. The results of the validated analytical methods allowed establishing, in a validated manner, that a coumarin mixture and sphaeralcic acid present in the SaTES fraction were detected in plasma. According to the values of Akaike Information Criteria (AIC), Sum of Squares (SS), Schwarz Criteria (SC), and by the determination coefficient (R2), the compounds follow a two-compartment model.
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Affiliation(s)
- Jade Serrano-Román
- Centro de Investigación Biomédica del Sur (CIBIS), Instituto Mexicano del Seguro Social (IMSS), Argentina 1, Centro, Xochitepec CP 62790, Mexico; (J.S.-R.); (P.N.-T.)
- Doctorado en Ciencias Biológicas y de la Salud, División de Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana Unidad Iztapalapa (UAM-Iztapalapa). San Rafael Atlixco 186, Vicentina, Iztapalapa, Ciudad de Mexico CP 09340, Mexico;
| | - Pilar Nicasio-Torres
- Centro de Investigación Biomédica del Sur (CIBIS), Instituto Mexicano del Seguro Social (IMSS), Argentina 1, Centro, Xochitepec CP 62790, Mexico; (J.S.-R.); (P.N.-T.)
| | - Elizabeth Hernández-Pérez
- Doctorado en Ciencias Biológicas y de la Salud, División de Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana Unidad Iztapalapa (UAM-Iztapalapa). San Rafael Atlixco 186, Vicentina, Iztapalapa, Ciudad de Mexico CP 09340, Mexico;
| | - Enrique Jiménez-Ferrer
- Centro de Investigación Biomédica del Sur (CIBIS), Instituto Mexicano del Seguro Social (IMSS), Argentina 1, Centro, Xochitepec CP 62790, Mexico; (J.S.-R.); (P.N.-T.)
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Bestwick-Stevenson T, Ifesemen OS, Pearson RG, Edwards KL. Association of Sports Participation With Osteoarthritis: A Systematic Review and Meta-Analysis. Orthop J Sports Med 2021; 9:23259671211004554. [PMID: 34179201 PMCID: PMC8207281 DOI: 10.1177/23259671211004554] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 12/21/2020] [Indexed: 12/02/2022] Open
Abstract
Background: The association between participating in sport and osteoarthritis is not fully understood. Purpose: To investigate the association between osteoarthritis and participating in sports not listed in previous reviews: American football, archery, baseball, bobsleigh, curling, handball, ice hockey, shooting, skeleton, speed skating, and wrestling. Study Design: Systematic review; Level of evidence, 3. Methods: We searched 4 electronic databases and hand searched recent/in-press editions of relevant journals. The criteria for study selection were case-control studies, cohort studies, nested case-control studies, and randomized trials with a control group that included adults to examine the effect of exposure to any of the included sports on the development of osteoarthritis. Results: The search returned 6197 articles after deduplication. Nine studies were included in the final review, covering hip, knee, and ankle osteoarthritis. There were no studies covering archery, baseball, skeleton, speed skating, or curling. The 6 sports included in the review were analyzed as a collective; the results of the meta-analysis indicated that participation in the sports analyzed was associated with an increased risk of developing osteoarthritis of the hip (relative risk [RR] = 1.67 [95% confidence interval (CI), 1.15-2.41]; P = .04), knee (RR = 1.60 [95% CI, 1.23-2.08]; P < .001), and ankle (RR = 7.08 [95% CI, 1.24-40.51]; P = .03) as compared with controls. Meta-analysis suggested a significantly increased likelihood of developing hip osteoarthritis through participating in wrestling (RR = 1.78 [95% CI, 1.20-2.64]; P = .004) and ice hockey (RR = 1.70 [95% CI, 1.27-2.29]; P < .001), while there was no significant difference through participating in handball (RR = 2.50 [95% CI, 0.85-7.36]; P = .10). Likelihood of developing knee osteoarthritis was significantly increased in wrestling (RR = 2.22 [95% CI, 1.59-3.11]) and ice hockey (RR = 1.52 [95% CI, 1.18-1.96]; both P < .002). According to the meta-analysis, shooting did not have a significant effect on the RR of knee osteoarthritis as compared with other sports (RR = 0.43 [95% CI, 0.06-2.99]; P = .39). Conclusion: The likelihood of developing hip and knee osteoarthritis was increased for ice hockey and wrestling athletes, and the risk of developing hip osteoarthritis was increased for handball athletes. The study also found that participation in the sports examined, as a collective, resulted in an increased risk of developing hip, knee, and ankle osteoarthritis.
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Affiliation(s)
- Thomas Bestwick-Stevenson
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Nottingham, Nottingham, UK.,Academic Orthopaedics, Trauma and Sports Medicine, School of Medicine, University of Nottingham, Nottingham, UK
| | - Onosi S Ifesemen
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Nottingham, Nottingham, UK
| | - Richard G Pearson
- Academic Orthopaedics, Trauma and Sports Medicine, School of Medicine, University of Nottingham, Nottingham, UK
| | - Kimberley L Edwards
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Nottingham, Nottingham, UK.,Academic Orthopaedics, Trauma and Sports Medicine, School of Medicine, University of Nottingham, Nottingham, UK
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Autologous Micro-Fragmented Adipose Tissue (MFAT) to Treat Symptomatic Knee Osteoarthritis: Early Outcomes of a Consecutive Case Series. J Clin Med 2021; 10:jcm10112231. [PMID: 34064010 PMCID: PMC8196751 DOI: 10.3390/jcm10112231] [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: 04/08/2021] [Revised: 05/13/2021] [Accepted: 05/19/2021] [Indexed: 12/16/2022] Open
Abstract
The study aimed to evaluate the short-term clinical effect, therapeutic response rate (TRR%), and therapy safety of a single intra-articular autologous MFAT injection for symptomatic knee OA. Secondly, patient- and pathology-related parameters were investigated to tighten patient selection for MFAT therapy. Sixty-four subjects with symptomatic mild–severe knee OA were enrolled in a single-center trial and received a unilateral (n = 37) or bilateral (n = 27) MFAT injection. After liposuction, the adipose tissue was mechanically processed with the Lipogem® device, which eventually produced 8–10 cc of MFAT. Subjects were clinically assessed by means of the KOOS, NRS, UCLA, and EQ-5D at baseline and 1, 3, 6, and 12 months after injection. Adverse events were recorded at each follow-up timepoint. The TRR was defined according to the OMERACT-OARSI criteria and baseline MRI was scored following the MOAKS classification. The TRR of the index knee was 64% at 3 months and 45% at 12 months after injection. Therapy responders at 12 months improved with 28.3 ± 11.4 on KOOS pain, while non-responders lost −2.1 ± 11.2 points. All clinical scores, except the UCLA, improved significantly at follow-up compared to baseline (p < 0.05). In the bilateral cohort, no difference in baseline scores or TRR was found between the index knee and contralateral knee (n.s.). An inflammatory reaction was reported in 79% of knees and resolved spontaneously within 16.6 ± 13.5 days after MFAT administration. Numerous bone marrow lesions (BML) were negatively correlated with the TRR at 12 months (p = 0.003). The study demonstrated an early clinical improvement but a mediocre response rate of 45% at 12 months after a single intra-articular injection with autologous MFAT. Assessment of bone marrow lesions on MRI can be helpful to increase the therapeutic responsiveness of MFAT up to 70% at 12 months. In comparison to repetitive injection therapies such as cortisone, hyaluronic acid, and PRP, administration of MFAT might become a relevant alternative in well-selected patients with symptomatic knee OA.
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Ranganath LR, Khedr M, Vinjamuri S, Gallagher JA. Characterizing the alkaptonuria joint and spine phenotype and assessing the effect of homogentisic acid lowering therapy in a large cohort of 87 patients. J Inherit Metab Dis 2021; 44:666-676. [PMID: 33452825 DOI: 10.1002/jimd.12363] [Citation(s) in RCA: 3] [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: 11/27/2020] [Revised: 01/07/2021] [Accepted: 01/13/2021] [Indexed: 01/18/2023]
Abstract
A large alkaptonuria (AKU) cohort was studied to better characterize the poorly understood spondyloarthropathy of rare disease AKU. Eighty-seven patients attended the National Alkaptonuria Centre (NAC) between 2007 and 2020. Seven only attended once. Fifty-seven attended more than once and received nitisinone 2 mg daily. Twenty-three attended at least twice without receiving nitisinone. Assessments included questionnaire analysis, 18F Positron emission tomography computerised tomography (PETCT), as well as photographs of ochronotic pigment in eyes and ears at baseline when 2 mg nitisinone was commenced and yearly thereafter. Blood and urine samples were collected for chemical measurement. The prevalence of ochronosis, as well as pain, PETCT and combined pain and PETCT scores, was greatly increased at 90.5%, 85.7%, 100%, and 100%, respectively. Joint pain scores were greatest in proximal joints in upper and lower limbs. PETCT joint scores were higher in proximal joints in upper limb but higher in distal joints in the lower limb. Spine pain scores were highest in lumbar, followed by cervical, thoracic, and cervical regions at 77.4%, 59.5%, 46.4%, and 25%, respectively. PETCT spine scores were highest in thoracic followed by lumbar, cervical, and sacroiliac regions at 74.4%, 70.7%, 64.6%, and 47.8% respectively; ochronosis associated closely with spondyloarthropathy scores (R = .65; P < .0001). Nitisinone reversed ochronosis significantly, with a similar pattern of decreased joint and spine disease. Spondyloarthropathy is a highly prevalent feature in this NAC cohort. Ochronosis appears to be associated with spondyloarthropathy. Nitisinone decreases ochronosis and had a similar nonsignificant effect pattern on spondyloarthropathy.
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Affiliation(s)
- Lakshminarayan R Ranganath
- Department of Clinical Biochemistry & Metabolic Medicine, Royal Liverpool University Hospital, Liverpool, UK
- Department of Musculoskeletal Biology, University of Liverpool, Liverpool, UK
| | - Milad Khedr
- Department of Clinical Biochemistry & Metabolic Medicine, Royal Liverpool University Hospital, Liverpool, UK
| | | | - James A Gallagher
- Department of Musculoskeletal Biology, University of Liverpool, Liverpool, UK
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Haghighian MK, Rafraf M, Hemmati S, Haghravan S, Asghari-Jafarabadi M. Effects of pomegranate (Punica granatum L.) peel extract supplementation on serum lipid profile and oxidative stress in obese women with knee osteoarthritis: A double blind, randomized, placebo controlled study. ADVANCES IN INTEGRATIVE MEDICINE 2021. [DOI: 10.1016/j.aimed.2020.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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