1
|
Mononen ME, Liukkonen MK, Turunen MJ. X-ray with finite element analysis is a viable alternative for MRI to predict knee osteoarthritis: Data from the Osteoarthritis Initiative. J Orthop Res 2024; 42:1964-1973. [PMID: 38650428 DOI: 10.1002/jor.25861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 02/29/2024] [Accepted: 04/03/2024] [Indexed: 04/25/2024]
Abstract
Magnetic resonance imaging (MRI) offers superior soft tissue contrast compared to clinical X-ray imaging methods, while also providing accurate three-dimensional (3D) geometries, it could be reasoned to be the best imaging modality to create 3D finite element (FE) geometries of the knee joint. However, MRI may not necessarily be superior for making tissue-level FE simulations of internal stress distributions within knee joint, which can be utilized to calculate subject-specific risk for the onset and development of knee osteoarthritis (KOA). Specifically, MRI does not provide any information about tissue stiffness, as the imaging is usually performed with the patient lying on their back. In contrast, native X-rays taken while the patient is standing indirectly reveal information of the overall health of the knee that is not seen in MRI. To determine the feasibility of X-ray workflow to generate FE models based on the baseline information (clinical image data and subject characteristics), we compared MRI and X-ray-based simulations of volumetric cartilage degenerations (N = 1213) against 8-year follow-up data. The results suggest that X-ray-based predictions of KOA are at least as good as MRI-based predictions for subjects with no previous knee injuries. This finding may have important implications for preventive care, as X-ray imaging is much more accessible than MRI.
Collapse
Affiliation(s)
- Mika E Mononen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Mimmi K Liukkonen
- Department of Clinical Radiology, Kuopio University Hospital, The Wellbeing Services County of North Savo, Kuopio, Finland
| | - Mikael J Turunen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
- Science Service Center, Kuopio University Hospital, The Wellbeing Services County of North Savo, Kuopio, Finland
| |
Collapse
|
2
|
Kang Y, Liu C, Ji Y, Zhang H, Wang Y, Bi W, Xu J, Guo B. The burden of knee osteoarthritis worldwide, regionally, and nationally from 1990 to 2019, along with an analysis of cross-national inequalities. Arch Orthop Trauma Surg 2024; 144:2731-2743. [PMID: 38761235 DOI: 10.1007/s00402-024-05250-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 02/17/2024] [Indexed: 05/20/2024]
Abstract
OBJECTIVE To describe the disease burden of knee osteoarthritis (KOA) globally, regionally, and in 204 countries by age, sex, and sociodemographic index (SDI) from 1990 to 2019, and to explore cross-national inequalities across SDI. METHODS The Global Burden of Disease (GBD) 2019 database collected data on KOA worldwide from 1990 to 2019, including prevalence, incidence, years lived with disability (YLDs). The average annual percentage change (AAPC) was used to measure temporal trends. In addition, the inequality slope index and the health concentration index were calculated to quantify the unequal distribution of the burden of KOA across 204 countries worldwide. RESULTS In 2019, the global age-standardized prevalence rate increased by 7.5% compared with 1990, and the age-standardized incidence rate increased by about 6.2%; The age-standardized YLDs rate increased by about 7.8%. In addition to the Republic of Korea and the United States of America, the disease burden of KOA has increased year by year in other countries around the world. The incidence of KOA was highest at ages 50-59, while the prevalence and rates of YLDs were highest at ages 75-84. The burden of KOA was higher in women than in men. Cross-country inequality suggests that the inequality in the burden of KOA between high SDI and low SDI countries becomes greater, and that countries with high SDI bear a disproportionately high burden. CONCLUSION The global KOA burden has risen steadily between 1990 and 2019, and cross-national inequality gaps remain large. Targeted measures must therefore be taken to address this inequality and the increasing global KOA disease burden.
Collapse
Affiliation(s)
- Yunkang Kang
- Department of Orthopedic Surgery, Fuyang People's Hospital, Anhui Medical University, 501, Sanqing Road, Fuyang, 236000, China
| | - Chunlong Liu
- Department of Hepatobiliary and Pancreatic Surgery, Fuyang People's Hospital, Anhui Medical University, Fuyang, 236000, China
| | - Yuncong Ji
- Department of Orthopedic Surgery, Fuyang Hospital, Bengbu Medical College, Fuyang, 236000, China
| | - Haoran Zhang
- Department of Orthopedic Surgery, Fuyang People's Hospital, Anhui Medical University, 501, Sanqing Road, Fuyang, 236000, China
| | - Yanbo Wang
- Department of Orthopedic Surgery, Fuyang People's Hospital, Anhui Medical University, 501, Sanqing Road, Fuyang, 236000, China
| | - Wenzhi Bi
- Department of Orthopedic Surgery, Fuyang People's Hospital, Anhui Medical University, 501, Sanqing Road, Fuyang, 236000, China
| | - Jian Xu
- Department of Orthopedic Surgery, Fuyang People's Hospital, Anhui Medical University, 501, Sanqing Road, Fuyang, 236000, China.
| | - Biao Guo
- Department of Orthopedic Surgery, Fuyang People's Hospital, Anhui Medical University, 501, Sanqing Road, Fuyang, 236000, China.
- Department of Orthopedic Surgery, Fuyang Hospital, Bengbu Medical College, Fuyang, 236000, China.
| |
Collapse
|
3
|
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.
Collapse
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
| |
Collapse
|
4
|
Lan Z, Yang Y, Wang H, Guo X, Wu Z, Jin Q. Impact of Prevention Strategies on Quality of Life in Patients with Osteoarthritis: A Meta-Analysis of Randomized Controlled Trials. World Neurosurg 2024; 182:159-164.e4. [PMID: 37995990 DOI: 10.1016/j.wneu.2023.11.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 11/15/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVE To evaluate the impact of prevention strategies on the quality of life in patients with osteoarthritis (OA) through a comprehensive analysis of randomized controlled trials (RCTs). METHODS A systematic search was conducted in multiple electronic databases, including Cochrane Library, PubMed, Embase, and ClinicalTrials.gov, up to June 10th, 2023. Eligible studies were RCTs assessing the effectiveness of prevention strategies in adult patients diagnosed with OA, with validated instruments used to measure quality of life outcomes. A total of 10 RCTs met the inclusion criteria and were included in the meta-analysis. The analyzed prevention strategies encompassed enhanced exercise, education, or a combination of both. The quality of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation approach. RESULTS The pooled results revealed a significant improvement in the quality of life of OA patients who underwent enhanced exercise or education compared to control groups (standardized mean difference = 0.44, 95% confidence interval 0.08-0.8). However, the overall quality of evidence was graded as low according to the Grading of Recommendations Assessment, Development and Evaluation assessment. CONCLUSIONS This meta-analysis provides evidence that prevention strategies, particularly enhanced exercise or education, have a positive impact on the quality of life in patients with OA. Despite the observed benefits, the overall quality of evidence is limited, highlighting the need for larger, well-designed trials to strengthen the evidence base. These findings underscore the importance of implementing effective prevention strategies in the management of OA to improve patient outcomes and enhance their quality of life. Further research is warranted to optimize the selection and implementation of prevention strategies for OA patients.
Collapse
Affiliation(s)
- Zhibin Lan
- The General Hospital of Ningxia Medical University, Ningxia Medical University, Ningxia Hui Autonomous Region, Yinchuan, China; Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Yang Yang
- The General Hospital of Ningxia Medical University, Ningxia Medical University, Ningxia Hui Autonomous Region, Yinchuan, China; Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Hui Wang
- The General Hospital of Ningxia Medical University, Ningxia Medical University, Ningxia Hui Autonomous Region, Yinchuan, China; Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Xuefang Guo
- Quanzhou Orthopedic-Traumatological Hospital, Quanzhou, China
| | - Zhiqiang Wu
- Quanzhou Orthopedic-Traumatological Hospital, Quanzhou, China
| | - Qunhua Jin
- The General Hospital of Ningxia Medical University, Ningxia Medical University, Ningxia Hui Autonomous Region, Yinchuan, China; Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan, China.
| |
Collapse
|
5
|
Xu D, Schiphof D, Hirvasniemi J, Klein S, Oei EHG, Bierma-Zeinstra S, Runhaar J. Factors associated with meniscus volume in knees free of degenerative features. Osteoarthritis Cartilage 2023; 31:1644-1649. [PMID: 37598744 DOI: 10.1016/j.joca.2023.08.003] [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: 08/25/2022] [Revised: 07/13/2023] [Accepted: 08/10/2023] [Indexed: 08/22/2023]
Abstract
OBJECTIVES To explore factors that were associated with meniscus volume in knees free of radiographic osteoarthritis (OA) features and symptoms of OA. METHODS In the third Rotterdam Study cohort, clinical, radiographic, and magnetic resonance data were obtained at baseline (BL) and after 5 years of follow-up. Meniscus volumes and their change over time were calculated after semi-automatic segmentation on Magnetic Resonance Imaging. Knees with radiographic OA features (Kellgren and Lawrence>0) or clinical diagnosis of OA (American College of Rheumatology) at BL were excluded. Ten OA risk factors were adjusted in the multivariable analysis (generalized estimating equations), treating two knees within subjects as repeated measurements. RESULTS From 1065 knees (570 subjects), the average (standard deviation) age and Body mass index (BMI) of included subjects were 54.3 (3.7) years and 26.5 (4.4) kg/m2. At BL, nine factors (varus alignment, higher BMI, meniscus pathologies, meniscus extrusion, cartilage lesions, injury, greater physical activity level, quadriceps muscle strength, and higher age) were significantly associated with greater meniscus volume. Five factors (injury, meniscus pathologies, meniscus extrusion, higher age, and change of BMI) were significantly associated with meniscus volume loss. CONCLUSIONS Modifiable factors (varus alignment, BMI, physical activity level, and quadriceps muscle strength) and non-modifiable factors (higher age, injury, meniscus pathologies, meniscus extrusion, and cartilage lesions) were all associated with meniscus volume or meniscus volume loss over time.
Collapse
Affiliation(s)
- Dawei Xu
- Dept. of General Practice, Erasmus MC University Medical Center Rotterdam, the Netherlands
| | - Dieuwke Schiphof
- Dept. of General Practice, Erasmus MC University Medical Center Rotterdam, the Netherlands
| | - Jukka Hirvasniemi
- Dept. of Radiology & Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, the Netherlands
| | - Stefan Klein
- Dept. of Radiology & Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, the Netherlands
| | - Edwin H G Oei
- Dept. of Radiology & Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, the Netherlands
| | - Sebastia Bierma-Zeinstra
- Dept. of General Practice, Erasmus MC University Medical Center Rotterdam, the Netherlands; Dept. of Orthopedics & Sports Medicine, Erasmus MC University Medical Center Rotterdam, the Netherlands
| | - Jos Runhaar
- Dept. of General Practice, Erasmus MC University Medical Center Rotterdam, the Netherlands.
| |
Collapse
|
6
|
Yang G, Wang J, Liu Y, Lu H, He L, Ma C, Zhao Z. Burden of Knee Osteoarthritis in 204 Countries and Territories, 1990-2019: Results From the Global Burden of Disease Study 2019. Arthritis Care Res (Hoboken) 2023; 75:2489-2500. [PMID: 37221154 DOI: 10.1002/acr.25158] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 05/07/2023] [Accepted: 05/16/2023] [Indexed: 05/25/2023]
Abstract
OBJECTIVE To report the global, regional, and national estimates of knee osteoarthritis (OA) burden and associated risk factors (high body mass index [BMI]) by age, sex, and sociodemographic index (SDI) for 204 countries from 1990 to 2019. METHODS We analyzed the prevalence, incidence, years lived with disability (YLDs), and age-standardized rates of knee OA using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019. Estimates of the knee OA burden were derived from data modeled using a Bayesian meta-regression analytical tool (DisMod-MR 2.1). RESULTS The global prevalence of knee OA in 2019 was ~364.6 million (95% uncertainty interval [95% UI] 315.3 to 417.4). The age-standardized prevalence in 2019 was 4,376.0 per 100,000 (95% UI 3,793.0 to 5,004.9), an increase of 7.5% between 1990 and 2019. There were ~29.5 million incident cases of knee OA in 2019 (95% UI 25.6 to 33.7), with an age-standardized incidence of 350.3 per 100,000 (95% UI 303.4 to 398.9). The global age-standardized YLD resulting from knee OA was 138.2 (95% UI 68.5 to 281.3) per 100,000 population in 2019, an increase of 7.8% (95% UI 7.1 to 8.4) from 1990. Globally in 2019, 22.4% (95% UI 12.1 to 34.2) of YLD resulting from knee OA was attributable to high BMI, an increase of 40.5% since 1990. CONCLUSION The prevalence, incidence, YLDs, and age-standardized rates of knee OA increased substantially in most countries and regions from 1990 to 2019. Continuous monitoring of this burden is important for establishing appropriate public prevention policies and raising public awareness, especially in high- and high-middle SDI regions.
Collapse
Affiliation(s)
- Guangmin Yang
- School of Clinical Medicine, Tsinghua University and Department of Orthopedics, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, China
| | - Jue Wang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and National Clinical Research Center for Cardiovascular Diseases, Beijing, China
| | - Yun Liu
- School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Haojie Lu
- School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Liu He
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and National Clinical Research Center for Cardiovascular Diseases, Beijing, China
| | - Changsheng Ma
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and National Clinical Research Center for Cardiovascular Diseases, Beijing, China
| | - Zhe Zhao
- School of Clinical Medicine, Tsinghua University and Department of Orthopedics, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, China
| |
Collapse
|
7
|
Arbeeva L, Minnig MC, Yates KA, Nelson AE. Machine Learning Approaches to the Prediction of Osteoarthritis Phenotypes and Outcomes. Curr Rheumatol Rep 2023; 25:213-225. [PMID: 37561315 PMCID: PMC10592147 DOI: 10.1007/s11926-023-01114-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2023] [Indexed: 08/11/2023]
Abstract
PURPOSE OF REVIEW Osteoarthritis (OA) is a complex heterogeneous disease with no effective treatments. Artificial intelligence (AI) and its subfield machine learning (ML) can be applied to data from different sources to (1) assist clinicians and patients in decision making, based on machine-learned evidence, and (2) improve our understanding of pathophysiology and mechanisms underlying OA, providing new insights into disease management and prevention. The purpose of this review is to improve the ability of clinicians and OA researchers to understand the strengths and limitations of AI/ML methods in applications to OA research. RECENT FINDINGS AI/ML can assist clinicians by prediction of OA incidence and progression and by providing tailored personalized treatment. These methods allow using multidimensional multi-source data to understand the nature of OA, to identify different OA phenotypes, and for biomarker discovery. We described the recent implementations of AI/ML in OA research and highlighted potential future directions and associated challenges.
Collapse
Affiliation(s)
- Liubov Arbeeva
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 3300 Doc J. Thurston Bldg, Campus Box #7280, Chapel Hill, NC, 27599-7280, USA
| | - Mary C Minnig
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Katherine A Yates
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 3300 Doc J. Thurston Bldg, Campus Box #7280, Chapel Hill, NC, 27599-7280, USA
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Amanda E Nelson
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 3300 Doc J. Thurston Bldg, Campus Box #7280, Chapel Hill, NC, 27599-7280, USA.
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| |
Collapse
|
8
|
van der Voet JA, Schiphof D, Vroegindeweij D, Oei EH, Bierma-Zeinstra SMA, Runhaar J. Association between baseline meniscal extrusion and long-term incident knee osteoarthritis in two different cohorts. Semin Arthritis Rheum 2023; 59:152170. [PMID: 36753837 DOI: 10.1016/j.semarthrit.2023.152170] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 01/20/2023] [Accepted: 01/24/2023] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Previously, we identified a significant association between meniscal extrusion and short-term incident knee osteoarthritis (KOA). To validate these findings, we evaluated long-term incident KOA in knees with meniscus extrusion, using two different cohorts. METHODS We used data from the PROOF study, which evaluated a high-risk population of overweight women, and a female subcohort of the population-based Rotterdam Study (RS). Meniscal extrusion was defined as ≥ 3 mm on MRI. Outcomes were incident radiographic (KL ≥ 2) or clinical KOA according to the ACR criteria, assessed at 6.6 years (PROOF) and 5.1 years (RS). With generalized estimating equations, we determined the association of knees with and without baseline meniscal extrusion and incident KOA, adjusting for confounders. Furthermore, we computed the population attributable risk percentage (PAR%) of meniscal extrusion. RESULTS PROOF: of 421 available knees 23% had baseline meniscal extrusion. Incident radiographic KOA was significantly higher in knees with meniscal extrusion compared to those without (adjusted OR 2.54, 95% CI 1.34, 4.80; p = 0.004; PAR 21%). Incident clinical KOA was also significantly higher (adjusted OR 2.44, 95% CI 1.29, 4.60; p = 0.006; PAR 19%). RS: 46% of 872 available knees had meniscal extrusion. Incident radiographic KOA was significantly higher (adjusted OR 9.86, 95% CI 2.13, 45.67; p = 0.002; PAR 77%). Incident clinical KOA was borderline significantly higher (adjusted OR 2.65, 95% CI 0.96, 7.30; p = 0.06; PAR 44%). CONCLUSION Meniscal extrusion is significantly associated with long-term incident KOA. A high number of incident cases were attributable to extrusion.
Collapse
Affiliation(s)
- Jan A van der Voet
- Dept. of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Dept. of Radiology, Alrijne Hospital, Leiderdorp, the Netherlands.
| | - Dieuwke Schiphof
- Dept. of General Practice, Erasmus MC University Medical Center Rotterdam, the Netherlands
| | | | - Edwin H Oei
- Dept. of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Sita M A Bierma-Zeinstra
- Dept. of General Practice, Erasmus MC University Medical Center Rotterdam, the Netherlands; Dept. of Orthopedics, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Jos Runhaar
- Dept. of General Practice, Erasmus MC University Medical Center Rotterdam, the Netherlands
| |
Collapse
|
9
|
Kim KI, Kim MS, Kim JH. Intra-articular Injection of Autologous Adipose-Derived Stem Cells or Stromal Vascular Fractions: Are They Effective for Patients With Knee Osteoarthritis? A Systematic Review With Meta-analysis of Randomized Controlled Trials. Am J Sports Med 2023; 51:837-848. [PMID: 35019764 DOI: 10.1177/03635465211053893] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Intra-articular injection of adipose-derived stem cells, which are divided into adipose-derived mesenchymal stem cells (ASCs) and adipose-derived stromal vascular fractions (ADSVFs), has been reported to be a viable treatment modality for knee osteoarthritis (OA); however, its efficacy remains limited. PURPOSE This study aimed to provide comprehensive information about the efficacy and safety of intra-articular injections of autologous ASCs and ADSVFs without adjuvant treatment in patients with knee OA. STUDY DESIGN Meta-analysis; Level of evidence, 1. METHODS A systematic search of the MEDLINE, Embase, Web of Science, and Cochrane Library databases was performed to identify randomized controlled trials (RCTs) that evaluated the efficacy and safety of intra-articular injections of autologous ASCs or ADSVFs without adjuvant treatments compared with placebo or hyaluronic acid in patients with knee OA. Clinically, the 100-mm visual analog scale for pain relief and the Western Ontario and McMaster Universities Osteoarthritis Index for functional improvement were implemented. Radiologically, cartilage status was assessed using magnetic resonance imaging (MRI). Procedure-related knee pain, swelling, and adverse events (AEs) were evaluated for safety. Additionally, we performed subgroup analyses comparing ASCs versus ADSVFs. Methodological quality was assessed using the modified Coleman Methodology Score (mCMS). RESULTS A total of 5 RCTs were included in this study. Based on the meta-analysis, ASCs or ADSVFs showed significantly better pain relief at 6 months (Z = 7.62; P < .0001) and 12 months (Z = 7.21; P < .0001) and functional improvement at 6 months (Z = 4.13; P < .0001) and 12 months (Z = 3.79; P = .0002), without a difference in procedure-related knee pain or swelling compared with controls. Although a meta-analysis with regard to cartilage improvements was not performed owing to heterogeneous MRI assessment, 3 studies reported significantly improved cartilage status after the injection. No serious AEs associated with ASCs or ADSVFs were reported. Subgroup analyses showed similar efficacy between ASC and ADSVF treatments. The median mCMS was 70 (range, 55-75). CONCLUSION For patients with knee OA, intra-articular injection of autologous ASCs or ADSVFs without adjuvant treatment showed remarkable clinical efficacy and safety at short-term follow-up. Some degree of efficacy has been shown for cartilage regeneration in knee OA, although the evidence remains limited. Further RCTs that directly compare ASCs and ADSVFs are needed.
Collapse
Affiliation(s)
- Kang-Il Kim
- Department of Orthopaedic Surgery, Center for Joint Diseases, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea.,Department of Orthopaedic Surgery, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Myung-Seo Kim
- Department of Orthopaedic Surgery, Center for Joint Diseases, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
| | - Jun-Ho Kim
- Department of Orthopaedic Surgery, Center for Joint Diseases, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
| |
Collapse
|
10
|
Potential surrogate outcomes in individuals at high risk for incident knee osteoarthritis. Osteoarthritis Cartilage 2023; 31:414-420. [PMID: 36646305 DOI: 10.1016/j.joca.2023.01.003] [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: 06/09/2022] [Revised: 12/22/2022] [Accepted: 01/09/2023] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To study potential surrogate outcomes for osteoarthritis (OA) incidence by evaluating the association of short-term changes in clinical and imaging biomarkers with long-term clinical knee OA incidence. DESIGN Middle-aged women with overweight/obesity, but free of knee symptoms were recruited through their general practitioners. At baseline, after 2.5 years, and after 6.5 years, questionnaires, physical examination, radiographs, and Magnetic resonance imaging (MRI) scans were obtained. The percentage of knees with a minimal clinically important difference for knee pain severity, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain/stiffness/function, and joint space narrowing, and of those with progression/regression of medial knee alignment, chronic knee pain, radiographic osteophytes, and cartilage defects, bone marrow lesions, osteophytes, and effusion/synovitis on MRI were determined. For each of these potential surrogate outcomes with ≥10% improvement or progression in the population over 2.5 years, the association with incident clinical knee OA, defined using the combined ACR-criteria, after 6.5 years was determined. RESULTS Most pre-defined potential surrogate outcomes showed ≥10% change in the population over 2.5 years, but only worsening of TF cartilage defects, worsening of TF osteophytes on MRI, and an increase in pain severity were significantly associated with greater clinical knee OA incidence after 6.5 years. These potential surrogate outcomes had high specificity and negative predictive value (89-91%) and low sensitivity and positive predictive value (20-28%) CONCLUSIONS: Worsening of TF cartilage defects and TF osteophytes on MRI, and increased pain severity could be seen as surrogate outcomes for long-term OA incidence. However, higher positive predictive values seem warranted for the applicability of these factors in future preventive trials.
Collapse
|
11
|
Baker MC, Sheth K, Liu Y, Lu D, Lu R, Robinson WH. Development of Osteoarthritis in Adults With Type 2 Diabetes Treated With Metformin vs a Sulfonylurea. JAMA Netw Open 2023; 6:e233646. [PMID: 36939700 PMCID: PMC10028483 DOI: 10.1001/jamanetworkopen.2023.3646] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/21/2023] Open
Abstract
IMPORTANCE Metformin may have a protective association against developing osteoarthritis (OA), but robust epidemiological data are lacking. OBJECTIVE To determine the risk of OA and joint replacement in individuals with type 2 diabetes treated with metformin compared with a sulfonylurea. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study used claims data from the Optum deidentified Clinformatics Data Mart Database between December 2003 and December 2019. Participants included individuals aged 40 years or older with at least 1 year of continuous enrollment and type 2 diabetes. Individuals with type 1 diabetes or a prior diagnosis of OA, inflammatory arthritis, or joint replacement were excluded. Time-conditional propensity score matching was conducted using age, sex, race, Charlson comorbidity score, and treatment duration to create a prevalent new-user cohort. Data were analyzed from April to December 2021. EXPOSURES Treatment with metformin or a sulfonylurea. MAIN OUTCOMES AND MEASURES The outcomes of interest were incident OA and joint replacement. Cox proportional hazard models were used to calculate adjusted hazard ratios (aHRs) of incident OA and joint replacement. In a sensitivity analysis, individuals only ever treated with metformin were compared with individuals only ever treated with a sulfonylurea, allowing for longer-term follow up of the outcome (even after stopping the medication of interest). RESULTS After time-conditional propensity score matching, the metformin and control groups each included 20 937 individuals (mean [SD] age 62.0 [11.5] years; 24 379 [58.2%] males). In the adjusted analysis, the risk of developing OA was reduced by 24% for individuals treated with metformin compared with a sulfonylurea (aHR, 0.76; 95% CI, 0.68-0.85; P < .001), but there was no significant difference for risk of joint replacement (aHR, 0.80; 95% CI, 0.50-1.27; P = .34). In the sensitivity analysis, the risk of developing OA remained lower in individuals treated with metformin compared with a sulfonylurea (aHR, 0.77; 95% CI, 0.65-0.90; P < .001) and the risk of joint replacement remained not statistically significant (aHR, 1.04; 95% CI, 0.60-1.82; P = .89). CONCLUSIONS AND RELEVANCE In this cohort study of individuals with diabetes, metformin treatment was associated with a significant reduction in the risk of developing OA compared with sulfonylurea treatment. These results further support preclinical and observational data that suggest metformin may have a protective association against the development of OA; future interventional studies with metformin for the treatment or prevention of OA should be considered.
Collapse
Affiliation(s)
- Matthew C Baker
- Division of Immunology and Rheumatology, Department of Medicine, Stanford University, Stanford, California
| | - Khushboo Sheth
- Division of Immunology and Rheumatology, Department of Medicine, Stanford University, Stanford, California
- Chinook Therapeutics, Seattle, Washington
- The VA Palo Alto Health Care System, Palo Alto, California
| | - Yuhan Liu
- The Quantitative Sciences Unit, Division of Biomedical Informatics Research, Department of Medicine, Stanford University, Stanford, California
| | - Di Lu
- The Quantitative Sciences Unit, Division of Biomedical Informatics Research, Department of Medicine, Stanford University, Stanford, California
| | - Rong Lu
- The Quantitative Sciences Unit, Division of Biomedical Informatics Research, Department of Medicine, Stanford University, Stanford, California
| | - William H Robinson
- Division of Immunology and Rheumatology, Department of Medicine, Stanford University, Stanford, California
- The VA Palo Alto Health Care System, Palo Alto, California
| |
Collapse
|
12
|
Ma YT, Dong YL, Wang B, Xie WP, Huang QM, Zheng YJ. Dry needling on latent and active myofascial trigger points versus oral diclofenac in patients with knee osteoarthritis: a randomized controlled trial. BMC Musculoskelet Disord 2023; 24:36. [PMID: 36650486 PMCID: PMC9847151 DOI: 10.1186/s12891-022-06116-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 12/26/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Latent and active myofascial trigger points (MTrPs) in knee-associated muscles may play a key role in pain management among patients with knee osteoarthritis (KOA). The aim of this study was to investigate the effect of dry needling treatment on pain intensity, disability, and range of motion (ROM) in patients with KOA. METHODS This randomized, single-blinded, clinical trial was carried out for 6 weeks of treatment and 6-month follow-up. A total of 98 patients met the entry criteria and were randomly assigned to the dry needling latent and active myofascial trigger point (MTrPs) with the stretching group or the oral diclofenacwith the stretching group. Numeric Pain Rating Scale (NPRS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and ROM were statistically analyzed before and after treatment and at the 6-month follow-up. RESULTS A total of 42 patients in the dry needling group (DNG) and 35 patients in the diclofenac group (DG), respectively, completed the study, and there was no significant difference in the general data between the two groups. After treatments, both the groups showed a good effect in knee pain, function, and ROM, However, the DNG showed a significantly better result than the DG. Especially in the results of the 6-month follow-up, the DNG showed much better results than the DG. CONCLUSIONS Dry needling on latent and active MTrPs combined with stretching and oral diclofenac combined with stretching can effectively relieve pain, improve function, and restore knee ROM affected by KOA. However, the effects of dry needling and stretching are better and longer lasting than those of oral diclofenac and stretching for at least 6 months. TRIAL REGISTRATION Registered in the Chinese Clinical Trial Registry ( www.chictr.org.cn ) in 17/11/2017 with the following code: ChiCTR-INR-17013432.
Collapse
Affiliation(s)
- Yan-Tao Ma
- grid.413597.d0000 0004 1757 8802Department of Pain Management, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Yu-Lin Dong
- Department of Treatment, Yang Zhi Affiliated Rehabilition Hospital of Tongji, Shanghai, China
| | - Bo Wang
- grid.413597.d0000 0004 1757 8802Department of Pain Management, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Wen-Pin Xie
- grid.413597.d0000 0004 1757 8802Department of Pain Management, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Qiang-Min Huang
- grid.412543.50000 0001 0033 4148Department of Sport Rehabilitation, School of Kinesiology, Shanghai University of Sport, Shanghai, China ,Department of Pain Management, Shanghai Ciyuan Rehablitation Hospital, Sinophama Holding, Shanghai, China
| | - Yong-Jun Zheng
- grid.413597.d0000 0004 1757 8802Department of Pain Management, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| |
Collapse
|
13
|
Hirvasniemi J, Runhaar J, van der Heijden RA, Zokaeinikoo M, Yang M, Li X, Tan J, Rajamohan HR, Zhou Y, Deniz CM, Caliva F, Iriondo C, Lee JJ, Liu F, Martinez AM, Namiri N, Pedoia V, Panfilov E, Bayramoglu N, Nguyen HH, Nieminen MT, Saarakkala S, Tiulpin A, Lin E, Li A, Li V, Dam EB, Chaudhari AS, Kijowski R, Bierma-Zeinstra S, Oei EHG, Klein S. The KNee OsteoArthritis Prediction (KNOAP2020) challenge: An image analysis challenge to predict incident symptomatic radiographic knee osteoarthritis from MRI and X-ray images. Osteoarthritis Cartilage 2023; 31:115-125. [PMID: 36243308 DOI: 10.1016/j.joca.2022.10.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 09/02/2022] [Accepted: 10/03/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVES The KNee OsteoArthritis Prediction (KNOAP2020) challenge was organized to objectively compare methods for the prediction of incident symptomatic radiographic knee osteoarthritis within 78 months on a test set with blinded ground truth. DESIGN The challenge participants were free to use any available data sources to train their models. A test set of 423 knees from the Prevention of Knee Osteoarthritis in Overweight Females (PROOF) study consisting of magnetic resonance imaging (MRI) and X-ray image data along with clinical risk factors at baseline was made available to all challenge participants. The ground truth outcomes, i.e., which knees developed incident symptomatic radiographic knee osteoarthritis (according to the combined ACR criteria) within 78 months, were not provided to the participants. To assess the performance of the submitted models, we used the area under the receiver operating characteristic curve (ROCAUC) and balanced accuracy (BACC). RESULTS Seven teams submitted 23 entries in total. A majority of the algorithms were trained on data from the Osteoarthritis Initiative. The model with the highest ROCAUC (0.64 (95% confidence interval (CI): 0.57-0.70)) used deep learning to extract information from X-ray images combined with clinical variables. The model with the highest BACC (0.59 (95% CI: 0.52-0.65)) ensembled three different models that used automatically extracted X-ray and MRI features along with clinical variables. CONCLUSION The KNOAP2020 challenge established a benchmark for predicting incident symptomatic radiographic knee osteoarthritis. Accurate prediction of incident symptomatic radiographic knee osteoarthritis is a complex and still unsolved problem requiring additional investigation.
Collapse
Affiliation(s)
- J Hirvasniemi
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands.
| | - J Runhaar
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - R A van der Heijden
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - M Zokaeinikoo
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, USA
| | - M Yang
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, USA
| | - X Li
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, USA
| | - J Tan
- Department of Radiology, New York University Langone Health, New York, USA
| | - H R Rajamohan
- Department of Radiology, New York University Langone Health, New York, USA
| | - Y Zhou
- Department of Radiology, New York University Langone Health, New York, USA
| | - C M Deniz
- Department of Radiology, New York University Langone Health, New York, USA
| | - F Caliva
- Department of Radiology, University of California, San Francisco, San Francisco, USA
| | - C Iriondo
- Department of Radiology, University of California, San Francisco, San Francisco, USA
| | - J J Lee
- Department of Radiology, University of California, San Francisco, San Francisco, USA
| | - F Liu
- Department of Radiology, University of California, San Francisco, San Francisco, USA
| | - A M Martinez
- Department of Radiology, University of California, San Francisco, San Francisco, USA
| | - N Namiri
- Department of Radiology, University of California, San Francisco, San Francisco, USA
| | - V Pedoia
- Department of Radiology, University of California, San Francisco, San Francisco, USA
| | - E Panfilov
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - N Bayramoglu
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - H H Nguyen
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - M T Nieminen
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - S Saarakkala
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland; Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - A Tiulpin
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - E Lin
- Akousist Co., Ltd., Taoyuan City, Taiwan
| | - A Li
- Akousist Co., Ltd., Taoyuan City, Taiwan
| | - V Li
- Akousist Co., Ltd., Taoyuan City, Taiwan
| | - E B Dam
- Department of Computer Science, University of Copenhagen, Copenhagen, Denmark
| | - A S Chaudhari
- Department of Radiology, Stanford University, Stanford, USA
| | - R Kijowski
- Department of Radiology, New York University Langone Health, New York, USA
| | - S Bierma-Zeinstra
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Orthopedics & Sport Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - E H G Oei
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - S Klein
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| |
Collapse
|
14
|
Molendijk E, Schiphof D, Oei EHG, de Vos RJ, Bos PK, van Meurs JBJ, Lubberts E, Zillikens MC, van der Eerden BCJ, Kavousi M, Schouten BWV, de Rooij-Duran MIB, Bierma-Zeinstra SMA. Accelerated menopausal changes as human disease model 'FOCUM' for the development of osteoarthritis and other degenerative disorders: protocol for a prospective cohort study. BMJ Open 2022; 12:e064779. [PMID: 36375984 PMCID: PMC9664313 DOI: 10.1136/bmjopen-2022-064779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION The incidence of degenerative disorders, including osteoarthritis (OA), increases rapidly in women after menopause. However, the influence of the menopause is still insufficiently investigated due to the slowness of menopausal transition. In this study, a novel human model is used in which it is expected that menopausal-related changes will occur faster. This is the Females discontinuing Oral Contraceptives Use at Menopausal age model. The ultimate aim is to link these changes to OA and other degenerative disorders, including cardiovascular diseases, diabetes, osteoporosis and tendinopathies. METHODS AND ANALYSIS This is a pilot observational prospective cohort study with 2 years of follow-up. Fifty women aged 50-60 who use oral contraceptive (OC) and have the intention to stop are included. Measurements are performed once before stopping OC, and four times thereafter at 6 weeks, 6 months, 1 year and 2 years. At every time point, a questionnaire is filled in and a sample of blood is drawn. At the first and final time points, a physical examination, hand radiographs and a MRI scan of one knee are performed. The primary OA outcome is progression of the MRI Osteoarthritis Knee Score. Secondary OA outcomes are the development of clinical knee and hand OA, development of knee OA according to the MRI definition, and progression of radiographic features for hand OA. Principal component analysis will be used to assess which changes occur after stopping OC. Univariate and multivariate generalised estimating equation models will be used to test for associations between these components and OA. ETHICS AND DISSEMINATION The study has been approved by the Medical Ethics Committee of the Erasmus MC University Medical Center Rotterdam (MEC-2019-0592). All participants must give informed consent before data collection. Results will be disseminated in national and international journals. TRIAL REGISTRATION NUMBER NL70796.078.19.
Collapse
Affiliation(s)
- Eveline Molendijk
- Department of General Practice, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Dieuwke Schiphof
- Department of General Practice, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Edwin H G Oei
- Department of Radiology and Nuclear Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Robert-Jan de Vos
- Department of Orthopaedics and Sports Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - P Koen Bos
- Department of Orthopaedics and Sports Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Joyce B J van Meurs
- Department of Orthopaedics and Sports Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Erik Lubberts
- Department of Rheumatology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - M Carola Zillikens
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Maryam Kavousi
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Boris W V Schouten
- Department of General Practice, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Sita M A Bierma-Zeinstra
- Department of General Practice, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Orthopaedics and Sports Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| |
Collapse
|
15
|
Sedaghati-Khayat B, Boer CG, Runhaar J, Bierma-Zeinstra SMA, Broer L, Ikram MA, Zeggini E, Uitterlinden AG, van Rooij JGJ, van Meurs JBJ. Risk assessment for hip and knee osteoarthritis using polygenic risk scores. Arthritis Rheumatol 2022; 74:1488-1496. [PMID: 35644035 PMCID: PMC9541521 DOI: 10.1002/art.42246] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 04/24/2022] [Accepted: 05/24/2022] [Indexed: 11/25/2022]
Abstract
Objective Polygenic risk scores (PRS) allow risk stratification using common single‐nucleotide polymorphisms (SNPs), and clinical applications are currently explored for several diseases. This study was undertaken to assess the risk of hip and knee osteoarthritis (OA) using PRS. Methods We analyzed 12,732 individuals from a population‐based cohort from the Rotterdam Study (n = 11,496), a clinical cohort (Cohort Hip and Cohort Knee [CHECK] study; n = 908), and a high‐risk cohort of overweight women (Prevention of Knee OA in Overweight Females [PROOF] study; n = 328), for the association of the PRS with prevalence/incidence of radiographic OA, of clinical OA, and of total hip replacement (THR) or total knee replacement (TKR). The hip PRS and knee PRS contained 44 and 24 independent SNPs, respectively, and were derived from a recent genome‐wide association study meta‐analysis. Standardized PRS (with Z transformation) were used in all analyses. Results We found a stronger association of the PRS for clinically defined OA compared to radiographic OA phenotypes, and we observed the highest PRS risk stratification for TKR/THR. The odds ratio (OR) per SD was 1.3 for incident THR (95% confidence interval [95% CI] 1.1–1.5) and 1.6 (95% CI 1.3–1.9) for incident TKR in the Rotterdam Study. The knee PRS was associated with incident clinical knee OA in the CHECK study (OR 1.3 [95% CI 1.1–1.5]), but not for the PROOF study (OR 1.2 [95% CI 0.8–1.7]). The OR for OA increased gradually across the PRS distribution, up to 2.1 (95% CI 1.4–3.2) for individuals with the 10% highest PRS compared to the middle 50% of the PRS distribution. Conclusion Our findings validated the association of PRS across OA definitions. Since OA is becoming frequent and primary prevention is not commonly applicable, PRS‐based risk assessment could play a role in OA prevention. However, the utility of PRS is dependent on the setting. Further studies are needed to test the integration of genetic risk assessment in diverse health care settings.
Collapse
Affiliation(s)
- Bahar Sedaghati-Khayat
- Department of Internal medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Cindy G Boer
- Department of Internal medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Jos Runhaar
- Department of General Practice, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Sita M A Bierma-Zeinstra
- Department of General Practice, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands.,Department of Orthopaedics & Sports Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Linda Broer
- Department of Internal medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Eleftheria Zeggini
- Institute of Translational Genomics, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.,Technical University of Munich (TUM) and Klinikum Rechts der Isar, TUM School of Medicine, Munich, Germany
| | - André G Uitterlinden
- Department of Internal medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Jeroen G J van Rooij
- Department of Internal medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Joyce B J van Meurs
- Department of Internal medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| |
Collapse
|
16
|
Xu D, Wu L, Chen Q. Editorial: Bone and Cartilage Diseases—The Role and Potential of Natural Products. Front Pharmacol 2022; 13:938303. [PMID: 35712717 PMCID: PMC9196268 DOI: 10.3389/fphar.2022.938303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 05/13/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Daohua Xu
- Guangdong Key Laboratory for Research and Development of Natural Drugs, School of Pharmacy, Guangdong Medical University, Dongguan, China
- *Correspondence: Daohua Xu,
| | - Longhuo Wu
- College of Pharmacy, Gannan Medical University, Ganzhou, China
| | - Qian Chen
- Department of Orthopaedics, Warren Alpert Medical School of Brown University/Rhode Island Hospital, Providence, United States
| |
Collapse
|
17
|
Runhaar J, Bierma-Zeinstra SM. The Challenges in the Primary Prevention of Osteoarthritis. Clin Geriatr Med 2022; 38:259-271. [DOI: 10.1016/j.cger.2021.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
18
|
Wang Q, Runhaar J, Kloppenburg M, Boers M, Bijlsma J, Bierma-Zeinstra S. Diagnosis for early stage knee osteoarthritis: probability stratification, internal and external validation; data from the CHECK and OAI cohorts. Semin Arthritis Rheum 2022; 55:152007. [DOI: 10.1016/j.semarthrit.2022.152007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 03/22/2022] [Accepted: 04/11/2022] [Indexed: 10/18/2022]
|
19
|
Perslev M, Pai A, Runhaar J, Igel C, Dam EB. Cross-Cohort Automatic Knee MRI Segmentation With Multi-Planar U-Nets. J Magn Reson Imaging 2021; 55:1650-1663. [PMID: 34918423 PMCID: PMC9106804 DOI: 10.1002/jmri.27978] [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: 03/02/2021] [Revised: 10/18/2021] [Accepted: 10/20/2021] [Indexed: 12/16/2022] Open
Abstract
Background Segmentation of medical image volumes is a time‐consuming manual task. Automatic tools are often tailored toward specific patient cohorts, and it is unclear how they behave in other clinical settings. Purpose To evaluate the performance of the open‐source Multi‐Planar U‐Net (MPUnet), the validated Knee Imaging Quantification (KIQ) framework, and a state‐of‐the‐art two‐dimensional (2D) U‐Net architecture on three clinical cohorts without extensive adaptation of the algorithms. Study Type Retrospective cohort study. Subjects A total of 253 subjects (146 females, 107 males, ages 57 ± 12 years) from three knee osteoarthritis (OA) studies (Center for Clinical and Basic Research [CCBR], Osteoarthritis Initiative [OAI], and Prevention of OA in Overweight Females [PROOF]) with varying demographics and OA severity (64/37/24/53/2 scans of Kellgren and Lawrence [KL] grades 0–4). Field Strength/Sequence 0.18 T, 1.0 T/1.5 T, and 3 T sagittal three‐dimensional fast‐spin echo T1w and dual‐echo steady‐state sequences. Assessment All models were fit without tuning to knee magnetic resonance imaging (MRI) scans with manual segmentations from three clinical cohorts. All models were evaluated across KL grades. Statistical Tests Segmentation performance differences as measured by Dice coefficients were tested with paired, two‐sided Wilcoxon signed‐rank statistics with significance threshold α = 0.05. Results The MPUnet performed superior or equal to KIQ and 2D U‐Net on all compartments across three cohorts. Mean Dice overlap was significantly higher for MPUnet compared to KIQ and U‐Net on CCBR (0.83±0.04 vs. 0.81±0.06 and 0.82±0.05), significantly higher than KIQ and U‐Net OAI (0.86±0.03 vs. 0.84±0.04 and 0.85±0.03), and not significantly different from KIQ while significantly higher than 2D U‐Net on PROOF (0.78±0.07 vs. 0.77±0.07, P=0.10, and 0.73±0.07). The MPUnet performed significantly better on N=22 KL grade 3 CCBR scans with 0.78±0.06 vs. 0.75±0.08 for KIQ and 0.76±0.06 for 2D U‐Net. Data Conclusion The MPUnet matched or exceeded the performance of state‐of‐the‐art knee MRI segmentation models across cohorts of variable sequences and patient demographics. The MPUnet required no manual tuning making it both accurate and easy‐to‐use. Level of Evidence 3 Technical Efficacy Stage 2
Collapse
Affiliation(s)
- Mathias Perslev
- Department of Computer Science, University of Copenhagen, Copenhagen, Denmark
| | - Akshay Pai
- Department of Computer Science, University of Copenhagen, Copenhagen, Denmark.,Cerebriu A/S, Copenhagen, Denmark
| | | | - Christian Igel
- Department of Computer Science, University of Copenhagen, Copenhagen, Denmark
| | - Erik B Dam
- Department of Computer Science, University of Copenhagen, Copenhagen, Denmark.,Cerebriu A/S, Copenhagen, Denmark
| |
Collapse
|
20
|
Runhaar J, Dam EB, Oei EH, Bierma-Zeinstra SM. Medial Cartilage Surface Integrity as a Surrogate Measure for Incident Radiographic Knee Osteoarthritis following Weight Changes. Cartilage 2021; 13:424S-427S. [PMID: 31829028 PMCID: PMC8739584 DOI: 10.1177/1947603519892305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Jos Runhaar
- Department of General Practice, Erasmus
MC University Medical Center Rotterdam, Rotterdam, the Netherlands,Jos Runhaar, Department of General Practice,
Erasmus MC University Medical Center Rotterdam, PO-Box 2040, Room NA 1911,
Rotterdam, 3000 CA, the Netherlands.
| | - Erik B. Dam
- Machine Learning Section, Department of
Computer Science, University of Copenhagen, Kobenhavns, Denmark,Biomediq A/S, Copenhagen, Denmark
| | - Edwin H.G. Oei
- Department of Radiology & Nuclear
Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, the
Netherlands
| | - Sita M.A. Bierma-Zeinstra
- Department of General Practice, and the
Department of Orthopedics, Erasmus MC University Medical Center Rotterdam,
Rotterdam, the Netherlands
| |
Collapse
|
21
|
Whittaker JL, Runhaar J, Bierma-Zeinstra S, Roos EM. A lifespan approach to osteoarthritis prevention. Osteoarthritis Cartilage 2021; 29:1638-1653. [PMID: 34560260 DOI: 10.1016/j.joca.2021.06.015] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 05/27/2021] [Accepted: 06/18/2021] [Indexed: 02/02/2023]
Abstract
Prevention is an attractive solution for the staggering and increasingly unmanageable burden of osteoarthritis. Despite this, the field of osteoarthritis prevention is relatively immature. To date, most of what is known about preventing osteoarthritis and risk factors for osteoarthritis is relative to the disease (underlying biology and pathophysiology) of osteoarthritis, with few studies considering risk factors for osteoarthritis illness, the force driving the personal, financial and societal burden. In this narrative review we will discuss what is known about osteoarthritis prevention, propose actionable prevention strategies related to obesity and joint injury which have emerged as important modifiable risk factors, identify where evidence is lacking, and give insight into what might be possible in terms of prevention by focussing on a lifespan approach to the illness of osteoarthritis, as opposed to a structural disease of the elderly. By targeting a non-specialist audience including scientists, clinicians, students, industry employees and others that are interested in osteoarthritis but who do not necessarily focus on osteoarthritis, the goal is to generate discourse and motivate inquiry which propel the field of osteoarthritis prevention into the mainstream.
Collapse
Affiliation(s)
- J L Whittaker
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Arthritis Research Canada, Canada.
| | - J Runhaar
- Erasmus MC University Medical Center Rotterdam, Department of General Practice, Rotterdam, the Netherlands.
| | - S Bierma-Zeinstra
- Erasmus MC University Medical Center Rotterdam, Department of General Practice, Rotterdam, the Netherlands; Erasmus MC University Medical Center Rotterdam, Department of General Practice, and Department of Orthopaedics, Rotterdam, the Netherlands.
| | - E M Roos
- Department of Sports Science and Clinical Biomechanics, Musculoskeletal Function and Physiotherapy, University of Southern Denmark, Denmark.
| |
Collapse
|
22
|
van der Voet JA, Wesselius D, Zhang F, Vroegindeweij D, Oei EH, Bierma-Zeinstra SMA, Englund M, Runhaar J. Factors associated with longitudinal change of meniscal extrusion in overweight women without clinical signs of osteoarthritis. Rheumatology (Oxford) 2021; 60:5175-5184. [PMID: 33693533 DOI: 10.1093/rheumatology/keab228] [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: 11/25/2020] [Revised: 02/17/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To identify variables associated with longitudinal change in meniscal extrusion, which might be used as possible targets for knee osteoarthritis (KOA) prevention. METHODS In a high-risk population of middle-aged overweight women, meniscal extrusion was assessed with magnetic resonance imaging (1.5 T, coronal proton density, in-plane resolution 0.5 mm2, Sante DICOM Editor) at baseline and after 30 months. Outcomes were the absolute change in medial and lateral extrusion (mm) and relative change in extrusion (%). Based upon literature, 11 factors were hypothesized to be associated with longitudinal change. Generalized estimating equations were used to model the effect on meniscal change (P <0.05). RESULTS In total, 677 knees of 343 women were available for analysis, with a mean age of 55.7 years (+/-3.2) and a mean BMI of 32.3 kg/m2 (+/-4.2). The greatest change in meniscal extrusion appeared medially with incident meniscal tear (4.4%; absolute 0.9 mm (95% CI: 0.3, 1.5; P =0.004); relative 14.5% (4.4, 24.7; 0.005)). Varus malalignment was associated with an increase of medial extrusion of 0.6 mm (37.6%; 0.1, 1.0; 0.009). A 5 kg/m2 higher baseline BMI was associated with absolute and relative increase of medial extrusion of 0.2 mm and 2.96% (0.1, 0.3; <0.001 and 1.3, 4.8; 0.002). Less explicit but significant changes in extrusion appeared with longitudinal change in BMI. CONCLUSION Meniscal tears, varus malalignment and BMI were significantly associated with change in meniscal extrusion in middle-aged overweight women, providing viable therapeutic targets to prevent or reduce extrusion and thereby decelerate KOA development.
Collapse
Affiliation(s)
- Jan A van der Voet
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam.,Department of Radiology, Alrijne Hospital, Leiderdorp
| | - Daan Wesselius
- Department of General Practice, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Fan Zhang
- Department of Clinical Sciences Lund, Orthopedics, Clinical Epidemiology Unit, Lund University, Lund, Sweden
| | | | - Edwin H Oei
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam
| | - Sita M A Bierma-Zeinstra
- Department of General Practice, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Orthopedics, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Martin Englund
- Department of Clinical Sciences Lund, Orthopedics, Clinical Epidemiology Unit, Lund University, Lund, Sweden
| | - Jos Runhaar
- Department of General Practice, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| |
Collapse
|
23
|
Are changes in meniscus volume and extrusion associated to knee osteoarthritis development? A structural equation model. Osteoarthritis Cartilage 2021; 29:1426-1431. [PMID: 34298195 DOI: 10.1016/j.joca.2021.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 05/06/2021] [Accepted: 07/14/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To explore the interplay between (changes in) medial meniscus volume, meniscus extrusion and radiographic knee osteoarthritis (OA) development over 30 months follow-up (FU). METHODS Data from the PRevention of knee Osteoarthritis in Overweight Females study were used. This cohort included 407 middle-aged women with a body mass index ≥27 kg/m2, who were free of knee OA at baseline. Demographics were collected by questionnaires at baseline. All menisci at both baseline and FU were automatically segmented from MRI scans to obtain the meniscus volume and the change over time (delta volume). Baseline and FU meniscus body extrusion was quantitatively measured on mid-coronal proton density MR images. A structural equation model was created to assess the interplay between both medial meniscus volume and central extrusion at baseline, delta volume, delta extrusion, and incident radiographic knee OA at FU. RESULTS The structural equation modeling yielded a fair to good fit of the data. The direct effects of both medial meniscus volume and extrusion at baseline on incident OA were statistically significant (Estimate = 0.124, p = 0.029, and Estimate = 0.194, p < 0.001, respectively). Additional indirect effects on incident radiographic OA through delta meniscus volume or delta meniscus extrusion were not statistically significant. CONCLUSION Baseline medial meniscus volume and extrusion were associated to incidence of radiographic knee OA at FU in middle-aged overweight and obese women, while their changes were not involved in these effects. To prevent knee OA, interventions might need to target the onset of meniscal pathologies rather than their progression.
Collapse
|
24
|
De Kanter J, Oei E, Schiphof D, Van Meer B, Van Middelkoop M, Reijman M, Bierma-Zeinstra S, Runhaar J, Van der Heijden R. Prevalence of small osteophytes on knee MRI in several large clinical and population-based studies of various age groups and OA risk factors. OSTEOARTHRITIS AND CARTILAGE OPEN 2021; 3:100187. [DOI: 10.1016/j.ocarto.2021.100187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 05/18/2021] [Accepted: 05/25/2021] [Indexed: 10/21/2022] Open
|
25
|
Lee S, Song K, Lee SY. Epidemiological study of post-traumatic ankle osteoarthritis after ankle sprain in 195,393 individuals over middle age using the National Health Insurance Database: A retrospective design. J Sci Med Sport 2021; 25:129-133. [PMID: 34565662 DOI: 10.1016/j.jsams.2021.08.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 06/27/2021] [Accepted: 08/20/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This study aimed to determine the risk of ankle OA onset after an incidence of sprain, relative to the risk of onset in healthy population, and to investigate the effect of gender, age, BMI, and exercise on the development of ankle OA after sprain. DESIGN Retrospective cohort study. METHODS Using a sample cohort dataset from 2002 to 2013 provided by the Korean National Health Insurance Sharing Service, we calculated the mean survival time and cumulative incidence rate in sprained and healthy populations using Kaplan-Meier analysis. A Cox proportional hazards model was used to analyze the adjusted hazard ratio (HR) of sprain for the development of OA with 95% confidence intervals (CIs). Adjusted HRs of gender, age, BMI, and exercise (yes/no) were analyzed in the sprained group. RESULTS Among the selected population of 195,393 individuals, 40,876 (20.9%) were diagnosed with an ankle sprain, and 1543 (3.85%) of those individuals developed ankle OA. Of the 154,517 healthy individuals (79.1%), 4062 (2.66%) cases had progressed to OA. The sprained group had 46% (HR, 1.46; 95% CI, 1.38-1.55) greater rate of progression to ankle OA than did healthy individuals. In the sprain group, individuals who were female, obese, and overweight had 40% (HR, 1.40; 95% CI, 1.26-1.55), 43% (HR, 1.43; 95% CI, 1.12-1.82), and 22% (HR, 1.22; 95% CI, 1.10-1.35) higher incidence to develop ankle OA, respectively, compared to those who were male, underweight and normal. CONCLUSIONS This study found that ankle sprain was a significant risk factor for a diagnosis of early OA. Female gender and high BMI increased the incidence of ankle OA after sprain.
Collapse
Affiliation(s)
- Soyoung Lee
- Department of Physical Education, Yonsei University, Republic of Korea
| | - Kyeongtak Song
- Sports Medicine Research Institute, Department of Athletic Training and Clinical Nutrition, University of Kentucky, USA
| | - Sae Yong Lee
- Department of Physical Education, Yonsei University, Republic of Korea; International Olympic Committee Research Centre KOREA, Yonsei University, Republic of Korea; Institute of Convergence Science, Yonsei University, Republic of Korea.
| |
Collapse
|
26
|
Wang Q, Runhaar J, Kloppenburg M, Boers M, Bijlsma JWJ, Bierma-Zeinstra SMA. Diagnosis of early stage knee osteoarthritis based on early clinical course: data from the CHECK cohort. Arthritis Res Ther 2021; 23:217. [PMID: 34412670 PMCID: PMC8375192 DOI: 10.1186/s13075-021-02598-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 08/03/2021] [Indexed: 12/23/2022] Open
Abstract
Background Early diagnosis of knee osteoarthritis (OA) is important in managing this disease, but such an early diagnostic tool is still lacking in clinical practice. The purpose of this study was to develop diagnostic models for early stage knee OA based on the first 2-year clinical course after the patient’s initial presentation in primary care and to identify whether these course factors had additive discriminative value over baseline factors. Methods We extracted eligible patients’ clinical and radiographic data from the CHECK cohort and formed the first 2-year course factors according to the factors’ changes over the 2 years. Clinical expert consensus-based diagnosis, which was made via evaluating patients’ 5- to 10-year follow-up data, was used as the outcome factor. Four models were developed: model 1, included clinical course factors only; model 2, included clinical and radiographic course factors; model 3, clinical baseline factors + clinical course factors; and model 4, clinical and radiographic baseline factors + clinical and radiographic course factors. All the models were built by a generalized estimating equation with a backward selection method. Area under the receiver operating characteristic curve (AUC) and its 95% confidence interval (CI) were calculated for assessing model discrimination. Delong’s method compared AUCs. Results Seven hundred sixty-one patients with 1185 symptomatic knees were included in this study. Thirty-seven percent knees were diagnosed as OA at follow-up. Model 1 contained 6 clinical course factors; model 2: 6 clinical and 3 radiographic course factors; model 3: 6 baseline clinical factors combined with 5 clinical course factors; and model 4: 4 clinical and 1 radiographic baseline factors combined with 5 clinical and 3 radiographic course factors. Model discriminations are as follows: model 1, AUC 0.70 (95% CI 0.67–0.74); model 2, 0.74 (95% CI 0.71–0.77); model 3, 0.77 (95% CI 0.74–0.80); and model 4, 0.80 (95% CI 0.77–0.82). AUCs of model 3 and model 4 were slightly but significantly higher than corresponding baseline-factor models (model 3 0.77 vs 0.75, p = 0.031; model 4 0.80 vs 0.76, p = 0.003). Conclusions Four diagnostic models were developed with “fair” to “good” discriminations. First 2-year course factors had additive discriminative value over baseline factors. Supplementary Information The online version contains supplementary material available at 10.1186/s13075-021-02598-5.
Collapse
Affiliation(s)
- Qiuke Wang
- Department of General Practice, Erasmus MC University Center Rotterdam, Rotterdam, The Netherlands.
| | - Jos Runhaar
- Department of General Practice, Erasmus MC University Center Rotterdam, Rotterdam, The Netherlands
| | - Margreet Kloppenburg
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Maarten Boers
- Department of Epidemiology & Biostatistics, Amsterdam UMC, Amsterdam, The Netherlands
| | - Johannes W J Bijlsma
- Department of Rheumatology and Clinical Immunology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Sita M A Bierma-Zeinstra
- Department of General Practice, Erasmus MC University Center Rotterdam, Rotterdam, The Netherlands.,Department of Orthopaedics, Erasmus MC University Center Rotterdam, Rotterdam, The Netherlands
| | | |
Collapse
|
27
|
Xu D, van der Voet J, Hansson NM, Klein S, Oei EHG, Wagner F, Bierma-Zeinstra SMA, Runhaar J. Association between meniscal volume and development of knee osteoarthritis. Rheumatology (Oxford) 2021; 60:1392-1399. [PMID: 32974683 PMCID: PMC7937026 DOI: 10.1093/rheumatology/keaa522] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 07/06/2020] [Accepted: 07/06/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To assess the association between meniscal volume, its change over time and the development of knee OA after 30 months in overweight/obese women. METHODS Data from the PRevention of knee Osteoarthritis in Overweight Females study were used. This cohort included 407 women with a BMI ≥ 27 kg/m2, free of OA-related symptoms. The primary outcome measure was incident OA after 30 months, defined by one out of the following criteria: medial or lateral joint space narrowing (JSN) ≥ 1.0 mm, incident radiographic OA [Kellgren and Lawrence (K&L) ≥ 2], or incident clinical OA. The secondary outcomes were either of these items separately. Menisci at both baseline and follow-up were automatically segmented to obtain meniscal volume and delta-volumes. Generalized estimating equations were used to evaluate associations between the volume measures and the outcomes. RESULTS Medial and lateral baseline and delta-volumes were not significantly associated to the primary outcome. Lateral meniscal baseline volume was significantly associated to lateral JSN [odds ratio (OR) = 0.87; 95% CI: 0.75, 0.99], while other measures were not. Medial and lateral baseline volume were positively associated to K&L incidence (OR = 1.32 and 1.22; 95% CI: 1.15, 1.50 and 1.03, 1.45, respectively), while medial and lateral delta-volume were negatively associated to K&L incidence (OR = 0.998 and 0.997; 95% CI: 0.997, 1.000 and 0.996, 0.999, respectively). None of the meniscal measures were significantly associated to incident clinical OA. CONCLUSION Larger baseline meniscal volume and the decrease of meniscal volume over time were associated to the development of structural OA after 30 months in overweight and obese women.
Collapse
Affiliation(s)
- Dawei Xu
- Department of General Practice, Erasmus MC University Medical Center Rotterdam, The Netherlands
| | - Jan van der Voet
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, The Netherlands
| | - Nils M Hansson
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, The Netherlands.,Department of Medical Informatics, Erasmus MC University Medical Center Rotterdam, The Netherlands
| | - Stefan Klein
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, The Netherlands.,Department of Medical Informatics, Erasmus MC University Medical Center Rotterdam, The Netherlands
| | - Edwin H G Oei
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, The Netherlands
| | - Femke Wagner
- Department of General Practice, Erasmus MC University Medical Center Rotterdam, The Netherlands
| | - Sebastia M A Bierma-Zeinstra
- Department of General Practice, Erasmus MC University Medical Center Rotterdam, The Netherlands.,Department of Orthopedics, Erasmus MC University Medical Center Rotterdam, The Netherlands
| | - Jos Runhaar
- Department of General Practice, Erasmus MC University Medical Center Rotterdam, The Netherlands
| |
Collapse
|
28
|
Szilagyi IA, Waarsing JH, Schiphof D, van Meurs JBJ, Bierma-Zeinstra SMA. Towards sex-specific osteoarthritis risk models: evaluation of risk factors for knee osteoarthritis in males and females. Rheumatology (Oxford) 2021; 61:648-657. [PMID: 33895803 PMCID: PMC8824415 DOI: 10.1093/rheumatology/keab378] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 04/20/2021] [Indexed: 11/26/2022] Open
Abstract
Objectives The aim of this study was to identify sex-specific prevalence and strength of risk factors for the incidence of radiographic knee OA (incRKOA). Methods Our study population consisted of 10 958 Rotterdam Study participants free of knee OA in one or both knees at baseline. One thousand and sixty-four participants developed RKOA after a median follow-up time of 9.6 years. We estimated the association between each available risk factor and incRKOA using sex stratified multivariate regression models with generalized estimating equations. Subsequently, we statistically tested sex differences between risk estimates and calculated the population attributable fractions (PAFs) for modifiable risk factors. Results The prevalence of the investigated risk factors was, in general, higher in women compared with men, except that alcohol intake and smoking were higher in men and high BMI showed equal prevalence. We found significantly different risk estimates between men and women: high level of physical activity [relative risk (RR) 1.76 (95% CI: 1.29–2.40)] or a Kellgren and Lawrence score 1 at baseline [RR 5.48 (95% CI: 4.51–6.65)] was higher in men. Among borderline significantly different risk estimates was BMI ≥27, associated with higher risk for incRKOA in women [RR 2.00 (95% CI: 1.74–2.31)]. The PAF for higher BMI was 25.6% in women and 19.3% in men. Conclusion We found sex-specific differences in both presence and relative risk of several risk factors for incRKOA. Especially BMI, a modifiable risk factor, impacts women more strongly than men. These risk factors can be used in the development of personalized prevention strategies and in building sex-specific prediction tools to identify high risk profile patients.
Collapse
Affiliation(s)
| | | | | | - Joyce B J van Meurs
- Department of Internal Medicine and Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | | |
Collapse
|
29
|
Sarma S, Sockalingam S, Dash S. Obesity as a multisystem disease: Trends in obesity rates and obesity-related complications. Diabetes Obes Metab 2021; 23 Suppl 1:3-16. [PMID: 33621415 DOI: 10.1111/dom.14290] [Citation(s) in RCA: 134] [Impact Index Per Article: 44.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 12/05/2020] [Accepted: 12/06/2020] [Indexed: 12/12/2022]
Abstract
Obesity is a chronic multisystem disease associated with increased morbidity and mortality. The increasing prevalence of obesity makes it a major healthcare challenge across both developed and developing countries. Traditional measures such as body mass index do not always identify individuals at increased risk of comorbidities, yet continue to be used in deciding who qualifies for weight loss treatment. A better understanding of how obesity is associated with comorbidities, in particular non-metabolic conditions, is needed to identify individuals at risk in order to prioritize treatment. For metabolic disorders such as type 2 diabetes (T2D), weight loss can prevent T2D in individuals with prediabetes. It can improve and reverse T2D if weight loss is achieved early in the course of the disease. However, access to effective weight loss treatments is a significant barrier to improved health for people with obesity. In the present paper, we review the rising prevalence of obesity and why it should be classed as a multisystem disease. We will discuss potential mechanisms underlying its association with various comorbidities and how these respond to treatment, with a particular focus on cardiometabolic disease, malignancy and mental health.
Collapse
Affiliation(s)
- Shohinee Sarma
- Department of Medicine, University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - Sanjeev Sockalingam
- Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Satya Dash
- Department of Medicine, University Health Network and University of Toronto, Toronto, Ontario, Canada
- Banting and Best Diabetes Centre, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
30
|
Tsubosaka M, Matsumoto T, Sobajima S, Matsushita T, Iwaguro H, Kuroda R. Comparison of Clinical and Imaging Outcomes of Different Doses of Adipose-Derived Stromal Vascular Fraction Cell Treatment for Knee Osteoarthritis. Cell Transplant 2021; 30:9636897211067454. [PMID: 35392685 PMCID: PMC9003644 DOI: 10.1177/09636897211067454] [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: 08/17/2021] [Revised: 11/21/2021] [Accepted: 12/01/2021] [Indexed: 12/14/2022] Open
Abstract
Favorable clinical outcomes of intra-articular injection of adipose-derived stromal vascular fraction (SVF) cells for knee osteoarthritis (OA) have been reported, but the effects of different doses of SVF cells have not been examined. This study aimed to compare the short-term clinical and imaging outcomes of different doses of SVF cells for knee OA treatment. This study included 60 patients with knee OA who underwent intra-articular injection of SVF cells. The follow-up period was at least 12 months. Thirty patients received an intra-articular injection of 2.5×107 SVF cells (low-dose group), and the remaining 30 patients received an intra-articular injection of 5.0×107 SVF cells (high-dose group). Clinical evaluations were performed for the Knee injury and Osteoarthritis Outcome Score (KOOS). Imaging evaluations, including the magnetic resonance imaging Osteoarthritis Knee Score (MOAKS) features (bone marrow lesions, cartilage defects, osteophytes, Hoffa's synovitis, and effusion synovitis), were also performed. All clinical and imaging evaluations were performed preoperatively and 12 months postoperatively and compared between the groups. In demographic data, no significant differences were found between the two groups. The total score of KOOS at 12 months postoperatively was significantly more favorable than the preoperative score in the high-dose groups. Pain and symptoms subscale scores of KOOS at 12 months postoperatively were significantly better in the high-dose group than in the low-dose group. The bone marrow lesions, Hoffa's synovitis, and effusion synovitis improved approximately 30-40% at 12 months postoperatively compared to baseline in both groups. However, there were no significant differences in imaging evaluations between the two groups. In conclusion, the pain and symptoms subscale scores of KOOS from baseline to 12 months postoperatively improved better in the high-dose group than in the low-dose group. Our findings suggest that intra-articular injection of SVF cells for knee OA is an innovative approach.
Collapse
Affiliation(s)
- Masanori Tsubosaka
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tomoyuki Matsumoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Satoshi Sobajima
- Department of Orthopaedic Surgery, Sobajima Clinic, Higashiosaka, Osaka
| | - Takehiko Matsushita
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hideki Iwaguro
- Department of Orthopaedic Surgery, Sobajima Clinic, Higashiosaka, Osaka
| | - Ryosuke Kuroda
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| |
Collapse
|
31
|
Zhao W, Wang H, Han Y, Wang H, Sun Y, Zhang H. Dopamine/Phosphorylcholine Copolymer as an Efficient Joint Lubricant and ROS Scavenger for the Treatment of Osteoarthritis. ACS APPLIED MATERIALS & INTERFACES 2020; 12:51236-51248. [PMID: 33166449 DOI: 10.1021/acsami.0c14805] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Osteoarthritis (OA) is a chronic joint disease and its progression and pathogenesis are highly associated with the significant increase of joint friction and overproduction of reactive oxygen species (ROS) in inflammation. Combination of ROS elimination and lubrication enhancement may provide a novel strategy for the treatment of OA. In the present study, a pure biomaterial and nondrug system P(DMA-co-MPC), synthesized via free radical copolymerization, was designed and developed for the first time using 2-methacryloxyethyl phosphorylcholine (MPC) as a bioinspired lubricant and N-(3,4-dihydroxyphenethyl)methacrylamide (DMA) as an ROS scavenger. Our results showed that the P(DMA-co-MPC) aggregates could efficiently eliminate the ROS radicals and provide good lubrication property by adjusting the molar ratio of DMA and MPC in the copolymer. It is attributed to the antioxidant function of the hydroquinone moiety in DMA and the hydration lubrication effect of the zwitterionic phosphocholine group in MPC. Furthermore, the in vitro experiments demonstrated that the P(DMA-co-MPC) showed good biocompatibility with MC3T3-E1 cells and intracellular anti-inflammatory property by inhibiting the production of ROS and regulating the expression levels of pro-inflammatory cytokines, pain-related gene, anabolic genes, and catabolic genes. In conclusion, the drug-free P(DMA-co-MPC) aggregates developed herein can achieve dual functions of lubrication enhancement and anti-inflammatory effect and thus they may be representative as promising candidates for the treatment of OA.
Collapse
Affiliation(s)
- Weiwei Zhao
- State Key Laboratory of Tribology, Department of Mechanical Engineering, Tsinghua University, Beijing 100084, China
| | - Hua Wang
- Key Lab of Organic Optoelectronics and Molecular Engineering, Department of Chemistry, Tsinghua University, Beijing 100084, China
| | - Ying Han
- State Key Laboratory of Tribology, Department of Mechanical Engineering, Tsinghua University, Beijing 100084, China
| | - Haimang Wang
- State Key Laboratory of Tribology, Department of Mechanical Engineering, Tsinghua University, Beijing 100084, China
| | - Yulong Sun
- State Key Laboratory of Tribology, Department of Mechanical Engineering, Tsinghua University, Beijing 100084, China
| | - Hongyu Zhang
- State Key Laboratory of Tribology, Department of Mechanical Engineering, Tsinghua University, Beijing 100084, China
| |
Collapse
|
32
|
Improved outcomes after mesenchymal stem cells injections for knee osteoarthritis: results at 12-months follow-up: a systematic review of the literature. Arch Orthop Trauma Surg 2020; 140:853-868. [PMID: 31456015 DOI: 10.1007/s00402-019-03267-8] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Indexed: 12/26/2022]
Abstract
PURPOSE According to the World Health organization (WHO), more than 10% in people older than 60 years suffer from osteoarthritis (OA). Over the last years, there has been an increased interest around regenerative medicine, especially regarding stem cell treatments and related applications. We hypothesize that stem cell therapies can represent a feasible option for idiopathic knee OA, delaying or even avoiding the joint replacement. To emphasize the potential of percutaneous injections of mesenchymal stem cells for knee OA, a comprehensive systematic review of the literature was conducted. MATERIAL AND METHODS Two independent authors (FM, GC) performed the literature search. This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA). The main databases were accessed: Pubmed, Embase, Google Scholar, Cochrane Systematic Reviews, Scopus, AMED. For this systematic review, all articles treating percutaneous injections of mesenchymal stem cells for knee OA were considered. Because of the rapid advancements promoted by the scientific progress on stem cell expansion and processing, only articles published within the last five years were included. Solely articles reporting the outcomes of interest across 6- and 12-month follow-up were recruited for eligibility. We included only studies reporting quantitative data under the outcomes of interest. We referred for the quality assessment to the Coleman Methodology Score (CMS). The statistical analysis was performed with Review Manager Software 5.3 (The Nordic Cochrane Centre, Copenhagen). RESULTS A total of 18 studies were enrolled in the present study, comprising 1069 treated knees. The mean age of the samples was 57.39 ± 7.37 years. 72% of the included studies harvested the stem cells from the iliac crest (bone marrow-derived MSCs), the remaining 28% from the adipose tissue (adipose-derived MSCs). The mean visual analogic scale improved from 18.37 to 30.98 and 36.91 at 6- and 12-month follow-up, respectively. The mean WOMAC score improved from 25.66 to 25.23 and 15.60 at 6- and 12-month follow-up, respectively. The mean walking distance improved from 71.90 to 152.22 and 316.72 at 6- and 12-month follow-up, respectively. The mean Lequesne scale improved from 33.76 to 12.90 at 12-month follow-up. The KOOS score improved from 41.07 to 8.47% and 18.94 at 6- and 12-month follow-up. All the KOOS subscales improved significantly from the baseline. A total of 136 (12.7%) local complications were detected. CONCLUSION According to the current evidences and the main findings of this systematic review, we reported that MSC infiltrations for knee OA can represent a feasible option, leading to an overall remarkable improvement of all clinical and functional considered outcomes, regardless of the cell source. Patients treated at earlier-degeneration stages reported statistically significant greater outcomes. The pain and function scores were improved considerably, thus, leading to a significant improvement of patient participation in recreational activities and quality of life.
Collapse
|
33
|
Black JE, Terry AL, Lizotte DJ. Development and evaluation of an osteoarthritis risk model for integration into primary care health information technology. Int J Med Inform 2020; 141:104160. [PMID: 32593009 DOI: 10.1016/j.ijmedinf.2020.104160] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 02/28/2020] [Accepted: 04/24/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND We developed and evaluated a prognostic prediction model that estimates osteoarthritis risk for use by patients and practitioners that is designed to be appropriate for integration into primary care health information technology systems. Osteoarthritis, a joint disorder characterized by pain and stiffness, causes significant morbidity among older Canadians. Because our prognostic prediction model for osteoarthritis risk uses data that are readily available in primary care settings, it supports targeting of interventions delivered as part of clinical practice that are aimed at risk reduction. METHODS We used the CPCSSN (Canadian Primary Sentinel Surveillance Network) database, which contains aggregated electronic health information from a cohort of primary care practices, to develop and evaluate a prognostic prediction model to estimate 5-year osteoarthritis risk, addressing contextual challenges of data availability and missingness. We constructed a retrospective cohort of 383,117 eligible primary care patients who were included in the cohort if they had an encounter with their primary care practitioner between 1 January 2009 and 31 December 2010. Patients were excluded if they had a diagnosis of osteoarthritis prior to their first visit in this time period. Incident cases of osteoarthritis were observed. The model was constructed to predict incident osteoarthritis based on age, sex, BMI, previous leg injury, and osteoporosis. Evaluation of the model used internal 10-fold cross-validation; we argue that internal validation is particularly appropriate for a model that is to be integrated into the same context from which the data were derived. RESULTS The resulting prediction model for 5-year risk of osteoarthritis diagnosis demonstrated state-of-the-art discrimination (estimated AUROC 0.84) and good calibration (assessed visually.) The model relies only on information that is readily available in Canadian primary care settings, and hence is appropriate for integration into Canadian primary care health information technology. CONCLUSIONS If the contextual challenges arising when using primary care electronic medical record data are appropriately addressed, highly discriminative models for osteoarthritis risk may be constructed using only data commonly available in primary care. Because the models are constructed from data in the same setting where the model is to be applied, internal validation provides strong evidence that the resulting model will perform well in its intended application.
Collapse
Affiliation(s)
- Jason E Black
- Graduate Program in Epidemiology & Biostatistics, Western University, 1151 Richmond Street, London, Ontario, N6A 5C1, Canada.
| | - Amanda L Terry
- Department of Family Medicine, Department of Epidemiology & Biostatistics, Schulich Interfaculty Program in Public Health, Western University, 1151 Richmond Street, London, Ontario, N6A 3K7, Canada.
| | - Daniel J Lizotte
- Department of Computer Science, Department of Epidemiology & Biostatistics, Schulich Interfaculty Program in Public Health, Department of Statistical and Actuarial Sciences, 1151 Richmond Street, Western University, London, Ontario, N6A 3K7, Canada.
| |
Collapse
|
34
|
Higuchi J, Yamagami R, Matsumoto T, Terao T, Inoue K, Tsuji S, Maenohara Y, Matsuzaki T, Chijimatsu R, Omata Y, Yano F, Tanaka S, Saito T. Associations of clinical outcomes and MRI findings in intra-articular administration of autologous adipose-derived stem cells for knee osteoarthritis. Regen Ther 2020; 14:332-340. [PMID: 32490058 PMCID: PMC7256437 DOI: 10.1016/j.reth.2020.04.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 04/19/2020] [Indexed: 12/14/2022] Open
Abstract
Introduction Clinical studies of intra-articular injection of mesenchymal stem cells for osteoarthritis (OA) indicate its efficacy. Here, we retrospectively investigated the associations of pretherapeutic magnetic resonance imaging (MRI) findings with the clinical outcomes up to 6 months, after intra-articular administration of adipose-derived stem cells (ASCs) to knee OA patients. Methods We first analyzed alterations of the visual analog scale (VAS) and knee injury and osteoarthritis outcome score (KOOS) in 57 knees of 34 patients from whom clinical scores were obtained before ASC therapy, and at 1, 3, and 6 months. Among the patients, we further examined MRI findings of 34 knees of 19 patients whose pretherapeutic MRI data were available. Results The mean improvement of VAS and KOOS-total during 6 months was 2.6 ± 4.0 (from 6.1 ± 2.5 to 3.5 ± 2.9, P < 0.001) and 10.2 ± 12.4 (from 54.4 ± 12.7 to 64.6 ± 13.8, P < 0.01), respectively. Scales related to pain and symptoms improved earlier than those related to activities of daily living (ADL) and sports/recreation. Improvement of VAS and KOOS-sports/recreation was significantly higher in patients with more severe cartilage lesions. Similarly, osteophyte lesions were associated significantly with improvement of VAS and KOOS-ADL, and BML was associated with KOOS-ADL and KOOS-sports/recreation. Conclusions In intra-articular administration of autologous ASCs for knee OA, improvement of VAS and KOOS-sports/recreation was significantly higher in patients with more severe cartilage lesions. Similarly, osteophyte lesions were associated significantly with improvement of VAS and KOOS-ADL, and BML was associated with KOOS-ADL and KOOS-sports/recreation. Clinical studies with larger numbers of patients and various kinds of data are necessary to predict therapeutic effects.
Collapse
Key Words
- ADL, activities of daily living
- ASC, adipose-derived stem cell
- Adipose-derived stem cell
- BML, bone marrow lesion
- CPC, cell processing center
- Intra-articular administration
- KOOS
- KOOS, knee injury and osteoarthritis outcome score
- MCID, minimally clinical important difference
- MOAKS
- MOAKS, MRI osteoarthritis knee score
- MRI, magnetic resonance imaging
- MSC, mesenchymal stem cell
- OA, osteoarthritis
- Osteoarthritis
- QOL, quality of life
- VAS
- VAS, visual analog scale
Collapse
Affiliation(s)
- Junya Higuchi
- Orthopaedic Surgery, Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ryota Yamagami
- Orthopaedic Surgery, Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takumi Matsumoto
- Orthopaedic Surgery, Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Bone and Cartilage Regenerative Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | | | | | | | - Yuji Maenohara
- Orthopaedic Surgery, Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tokio Matsuzaki
- Japan Biodesign Program, Department of Cardiac Surgery, The University of Tokyo, Tokyo, Japan
| | - Ryota Chijimatsu
- Bone and Cartilage Regenerative Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Yasunori Omata
- Orthopaedic Surgery, Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Bone and Cartilage Regenerative Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Fumiko Yano
- Bone and Cartilage Regenerative Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Sakae Tanaka
- Orthopaedic Surgery, Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Taku Saito
- Orthopaedic Surgery, Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| |
Collapse
|
35
|
Bauer K, Lau T, Schwille‐Kiuntke J, Schild S, Hauner H, Stengel A, Zipfel S, Mack I. Conventional weight loss interventions across the different
BMI
obesity classes: A systematic review and quantitative comparative analysis. EUROPEAN EATING DISORDERS REVIEW 2020; 28:492-512. [DOI: 10.1002/erv.2741] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 03/29/2020] [Accepted: 04/13/2020] [Indexed: 01/16/2023]
Affiliation(s)
- Kerstin Bauer
- Department of Psychosomatic Medicine and Psychotherapy University Hospital Tübingen Tübingen Germany
| | - Teresa Lau
- Department of Psychosomatic Medicine and Psychotherapy University Hospital Tübingen Tübingen Germany
| | - Juliane Schwille‐Kiuntke
- Department of Psychosomatic Medicine and Psychotherapy University Hospital Tübingen Tübingen Germany
- Institute of Occupational and Social Medicine and Health Services Research University of Tübingen Tübingen Germany
| | - Sandra Schild
- Department of Psychosomatic Medicine and Psychotherapy University Hospital Tübingen Tübingen Germany
| | - Hans Hauner
- Institute of Nutritional Medicine, School of Medicine Technical university of Munich Munich Germany
| | - Andreas Stengel
- Department of Psychosomatic Medicine and Psychotherapy University Hospital Tübingen Tübingen Germany
- Charité Center for Internal Medicine and Dermatology, Department for Psychosomatic Medicine Charité‐Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy University Hospital Tübingen Tübingen Germany
| | - Isabelle Mack
- Department of Psychosomatic Medicine and Psychotherapy University Hospital Tübingen Tübingen Germany
| |
Collapse
|
36
|
Zhang F, Bierma-Zeinstra SM, Oei EH, Turkiewicz A, Englund M, Runhaar J. The association between meniscal body extrusion and the development/enlargement of bone marrow lesions on knee MRI in overweight and obese women. OSTEOARTHRITIS AND CARTILAGE OPEN 2020; 1:100015. [DOI: 10.1016/j.ocarto.2019.100015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 11/14/2019] [Accepted: 11/15/2019] [Indexed: 10/25/2022] Open
|
37
|
Comment on "A Better Way to Decrease Knee Swelling in Patients with Knee Osteoarthritis: A Single-Blind Randomised Controlled Trial". Pain Res Manag 2019; 2019:2619437. [PMID: 31662811 PMCID: PMC6791211 DOI: 10.1155/2019/2619437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 08/21/2019] [Indexed: 11/17/2022]
|
38
|
Abstract
Osteoarthritis is a leading cause of disability and source of societal cost in older adults. With an ageing and increasingly obese population, this syndrome is becoming even more prevalent than in previous decades. In recent years, we have gained important insights into the cause and pathogenesis of pain in osteoarthritis. The diagnosis of osteoarthritis is clinically based despite the widespread overuse of imaging methods. Management should be tailored to the presenting individual and focus on core treatments, including self-management and education, exercise, and weight loss as relevant. Surgery should be reserved for those that have not responded appropriately to less invasive methods. Prevention and disease modification are areas being targeted by various research endeavours, which have indicated great potential thus far. This narrative Seminar provides an update on the pathogenesis, diagnosis, management, and future research on osteoarthritis for a clinical audience.
Collapse
Affiliation(s)
- David J Hunter
- Rheumatology Department, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, NSW, Australia.
| | - Sita Bierma-Zeinstra
- Departments of General Practice and Orthopaedic Surgery, Erasmus University Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
| |
Collapse
|
39
|
Landsmeer MLA, de Vos BC, van der Plas P, van Middelkoop M, Vroegindeweij D, Bindels PJE, Oei EHG, Bierma-Zeinstra SMA, Runhaar J. Effect of weight change on progression of knee OA structural features assessed by MRI in overweight and obese women. Osteoarthritis Cartilage 2018; 26:1666-1674. [PMID: 30144512 DOI: 10.1016/j.joca.2018.08.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 07/17/2018] [Accepted: 08/06/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate the effects of weight change on progression of knee osteoarthritis (OA) structural features by magnetic resonance imaging (MRI) in overweight and obese women without clinical knee OA. DESIGN 347 participants from the Prevention of Knee Osteoarthritis in Overweight Females (PROOF) study were classified with latent class growth analysis into a subgroup with steady weight (n = 260; +0.1 ± 4.0 kg, +0.2 ± 4.4%), weight gain (n = 43; +8.6 ± 4.0 kg, +9.8 ± 4.1%) or weight loss (n = 44; -9.0 ± 7.2 kg, -9.8 ± 7.5%) over 2.5 years. Baseline and follow-up 1.5T MRIs were scored with MRI Osteoarthritis Knee Score (MOAKS) for progression of bone marrow lesions (BMLs), cartilage defects, osteophytes, meniscal abnormalities, meniscal extrusion and synovitis. Associations between subgroups and change in MRI features at knee-level were assessed using adjusted Generalized Estimating Equations. RESULTS 687 knees from 347 women (median age 55.2 years, interquartile range (IQR) 5.5, median body mass index (BMI) 31.2 kg/m2, IQR 5.3) were analyzed. Progression of synovitis was 18% in the weight gain vs 7% in the stable weight subgroup (OR 2.88; 95%CI 1.39-5.94). The odds for progression of patellofemoral (PF) BMLs and cartilage defects increased with 62% (OR 1.62; 95%CI 0.92-2.84) and 53% (OR 1.53; 95%CI 0.92-2.56) in the weight gain vs the stable weight subgroup. CONCLUSIONS In overweight and obese women, progression of synovitis increased more than 2.5 times in a weight gain compared to a stable weight subgroup over 2.5 years. Large effect sizes were also found for the difference in progression of PF BMLs and PF cartilage defects between the weight gain and stable weight subgroup.
Collapse
Affiliation(s)
- M L A Landsmeer
- Department of General Practice, Erasmus MC, University Medical Center Rotterdam, The Netherlands.
| | - B C de Vos
- Department of General Practice, Erasmus MC, University Medical Center Rotterdam, The Netherlands.
| | - P van der Plas
- Department of Radiology, Spijkenisse Medical Center, Spijkenisse, The Netherlands.
| | - M van Middelkoop
- Department of General Practice, Erasmus MC, University Medical Center Rotterdam, The Netherlands.
| | - D Vroegindeweij
- Department of Radiology, Maasstad Hospital, Rotterdam, The Netherlands.
| | - P J E Bindels
- Department of General Practice, Erasmus MC, University Medical Center Rotterdam, The Netherlands.
| | - E H G Oei
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, the Netherlands.
| | - S M A Bierma-Zeinstra
- Department of General Practice, Erasmus MC, University Medical Center Rotterdam, The Netherlands; Department of Orthopaedics, Erasmus MC, University Medical Center Rotterdam, The Netherlands.
| | - J Runhaar
- Department of General Practice, Erasmus MC, University Medical Center Rotterdam, The Netherlands.
| |
Collapse
|
40
|
Messier SP, Resnik AE, Beavers DP, Mihalko SL, Miller GD, Nicklas BJ, DeVita P, Hunter DJ, Lyles MF, Eckstein F, Guermazi A, Loeser RF. Intentional Weight Loss in Overweight and Obese Patients With Knee Osteoarthritis: Is More Better? Arthritis Care Res (Hoboken) 2018; 70:1569-1575. [PMID: 29911741 PMCID: PMC6203601 DOI: 10.1002/acr.23608] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Accepted: 05/12/2018] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To determine the dose response effect of weight loss on clinical and mechanistic outcomes in overweight and obese adults with knee osteoarthritis (OA). METHODS This is a secondary analysis of the diet-induced weight loss only (D) and diet-induced weight loss plus exercise (D + E) groups in the Intensive Diet and Exercise for Arthritis randomized controlled clinical trial. The 240 participants were overweight and obese older community-dwelling adults with pain and radiographic knee OA. Participants were assigned to 1 of 4 groups according to weight loss achieved over an 18-month period: <5% (<5% group), 5-10% (≥5% group), 10-20% (≥10% group), and >20% (≥20% group). RESULTS There were significant dose responses to weight loss for pain (P = 0.01), function (P = 0.0006), 6-minute walk distance (P < 0.0001), physical (P = 0.0004) and mental (P = 0.03) health-related quality of life (HRQoL), knee joint compressive force (P < 0.0001), and interleukin-6 (P = 0.002). Greater weight loss resulted in superior clinical and mechanstic outcomes, with the highest weight loss group (≥20% group) distinguishing itself on all measures compared with the <5% and ≥5% groups; the ≥20% group had 25% less pain and better function compared with the ≥10% group and significantly (P = 0.006) better physical HRQoL. CONCLUSION Long-term weight loss of 10-19.9% of baseline body weight has substantial clinical and mechanistic benefits compared with less weight loss. The value of an additional 10% weight loss includes significantly improved physical HRQoL and a clinically important reduction of pain and improvement in function.
Collapse
Affiliation(s)
- Stephen P. Messier
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
- Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Section on Rheumatology and Immunology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Allison E. Resnik
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - Daniel P. Beavers
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Shannon L. Mihalko
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - Gary D. Miller
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - Barbara J. Nicklas
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
- Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Paul DeVita
- Department of Kinesiology, East Carolina University, Greenville, NC, USA
| | - David J. Hunter
- Rheumatology Department, Royal North Shore Hospital and Institute of Bone and Joint Research, University of Sydney, Sydney, Australia
| | - Mary F. Lyles
- Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Felix Eckstein
- Institute of Anatomy, Paracelsus Medical University, Salzburg, Austria, and Chondrometrics GmbH, Ainring, Germany
| | - Ali Guermazi
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, USA
| | - Richard F. Loeser
- Thurston Arthritis Center, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| |
Collapse
|
41
|
Predictive value of early structural changes on radiographs and MRI for incident clinical and radiographic knee osteoarthritis in overweight and obese women. Semin Arthritis Rheum 2018; 48:190-197. [DOI: 10.1016/j.semarthrit.2018.02.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 02/20/2018] [Accepted: 02/20/2018] [Indexed: 11/20/2022]
|
42
|
Wang J, Wang X, Cao Y, Huang T, Song DX, Tao HR. Therapeutic potential of hyaluronic acid/chitosan nanoparticles for the delivery of curcuminoid in knee osteoarthritis and an in vitro evaluation in chondrocytes. Int J Mol Med 2018; 42:2604-2614. [PMID: 30106112 PMCID: PMC6192775 DOI: 10.3892/ijmm.2018.3817] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 08/06/2018] [Indexed: 01/08/2023] Open
Abstract
Knee osteoarthritis (OA) is the main cause of leg pain in middle-aged and elderly individuals. Hyaluronic acid (HA), as well as curcuminoid, has been used in the treatment of knee OA. In the present study, HA/chitosan nanoparticles (CNPs) were prepared for the delivery of curcuminoid, in order to investigate whether HA and curcuminoid can act synergistically as a better treatment option. The knee OA model was established by the Hulth method, and a knee OA chondrocyte model was constructed by the co-induction of interleukin-1β and tumor necrosis factor (TNF)-α. The drug loading capacity of HA/CNP for the delivery of curcuminoid was measured by an ultraviolet assay, and the cytotoxicity to chondrocytes was measured by an MTT assay. Collagen II was detected by immunofluorescence, and the expression levels of nuclear factor (NF)-κB and inflammation-related genes in cartilage tissue and chondrocytes were detected. Chondrocyte proliferation was determined by an EdU assay, and chondrocyte apoptosis was determined by flow cytometry. The Mankin pathological score of the Outerbridge classification was obtained. The results demonstrated that the optimum drug loading capacity of HA/CNP for the delivery of curcuminoid was 38.44%, with a good sustained release function. HA/CNP treatment resulted in inhibition of the NF-κB pathway, as well as the expression of matrix metalloproteinase (MMP)-1 and MMP-13, but it increased collagen II expression. HA/CNP for the delivery of curcuminoid significantly decreased the Outerbridge classification and Mankin pathological scores to close to normal until the 4th week. Furthermore, it was also observed that all the effects of HA/CNP on the delivery of curcuminoid were more prominent compared with the effects of HA or curcuminoid treatment individually. Taken together, these findings demonstrated that HA/CNP for the delivery of curcuminoid may suppress inflammation and chondrocyte apoptosis in knee OA via repression of the NF-κB pathway.
Collapse
Affiliation(s)
- Jian Wang
- Department of Orthopedics, Baoshan Branch of Shanghai First People's Hospital, Shanghai 200940, P.R. China
| | - Xiang Wang
- Department of Orthopaedics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201999, P.R. China
| | - Yun Cao
- Department of Orthopedics, Baoshan Branch of Shanghai First People's Hospital, Shanghai 200940, P.R. China
| | - Tao Huang
- Department of Orthopedics, Baoshan Branch of Shanghai First People's Hospital, Shanghai 200940, P.R. China
| | - Deng-Xin Song
- Department of Orthopedics, Baoshan Branch of Shanghai First People's Hospital, Shanghai 200940, P.R. China
| | - Hai-Rong Tao
- Department of Orthopaedics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201999, P.R. China
| |
Collapse
|
43
|
Runhaar J, Zhang Y. Can we prevent OA? Epidemiology and public health insights and implications. Rheumatology (Oxford) 2018; 57:iv3-iv9. [PMID: 29506178 DOI: 10.1093/rheumatology/key014] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Indexed: 11/14/2022] Open
Abstract
This narrative review discusses the potential of prevention of OA in different stages of the disease. The theoretical background for primary prevention (i.e. prevention of occurrence of definite structural or clinical OA in subjects free of the disease) and secondary prevention (i.e. prevention of progression of the disease in subjects with pre-clinical pathological changes to the joint) is provided and evidence for effective strategies is discussed. Since direct evidence for the prevention of OA development and progression is scarce, indirect evidence enhancing our current knowledge on the potential of OA prevention is additionally discussed. Also, implications of preventive strategies for study design and public health are considered. Prevention of OA has great potential, but as deliberated in the current review, there are still large gaps in our current knowledge and the implications of preventive strategies for the development and progression of OA require consideration.
Collapse
Affiliation(s)
- Jos Runhaar
- Department on General Practice, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Yuqing Zhang
- Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Harvard Medical School, Cambridge, MA, USA
| |
Collapse
|
44
|
Dam EB, Runhaar J, Bierma-Zienstra S, Karsdal M. Cartilage cavity-an MRI marker of cartilage lesions in knee OA with Data from CCBR, OAI, and PROOF. Magn Reson Med 2018; 80:1219-1232. [DOI: 10.1002/mrm.27130] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 01/16/2018] [Accepted: 01/22/2018] [Indexed: 01/18/2023]
Affiliation(s)
- Erik B. Dam
- Biomediq; Copenhagen Denmark
- University of Copenhagen; Copenhagen Denmark
- The D-BOARD European Consortium for Biomarker Discovery
| | - Jos Runhaar
- Erasmus University Medical Center; Rotterdam the Netherlands
- The D-BOARD European Consortium for Biomarker Discovery
| | - Sita Bierma-Zienstra
- Erasmus University Medical Center; Rotterdam the Netherlands
- The D-BOARD European Consortium for Biomarker Discovery
| | - Morten Karsdal
- Nordic Bioscience; Copenhagen Denmark
- The D-BOARD European Consortium for Biomarker Discovery
| |
Collapse
|
45
|
Maximum lifetime body mass index is the appropriate predictor of knee and hip osteoarthritis. Arch Orthop Trauma Surg 2018; 138:99-103. [PMID: 29079909 PMCID: PMC5754409 DOI: 10.1007/s00402-017-2825-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Indexed: 11/08/2022]
Abstract
INTRODUCTION In light of inconsistencies in the literature, this study aimed to investigate the relationship between obesity (current and historic) and osteoarthritis (OA) of the knee or hip. MATERIALS AND METHODS We examined 99 people (knee OA, hip OA and controls), age > 50 years, in a case-control study. The current weight, height and waist circumference were measured on site, and detailed weight changes over their lifetime were based on questionnaires and standardized interviews. We used binomial logistic regression to determine the predictive value for an osteoarthritis group membership of each derived indicator. RESULTS An increase in 'maximum-BMI' increased the odds ratio for both knee OA (OR 1.2; CI 1.1-1.4; p = 0.005; R 2 = 0.36) and hip OA (OR 1.2; CI 1.0-1.3; p = 0.027; R 2 = 0.16). Current BMI was significantly associated with knee OA but not with hip OA. A high "minimum-BMI" (over the age of 18 years) had the highest odds ratio of all calculated indicators for both osteoarthritis groups. CONCLUSIONS Based on our findings, it is concluded that the maximum BMI over one's lifespan is a better predictor of OA of the hip or the knee than the current BMI. The knee joint seems to be more sensitive to obesity as current BMI was associated only with knee OA but not with hip OA.
Collapse
|
46
|
Lazzarini N, Runhaar J, Bay-Jensen AC, Thudium CS, Bierma-Zeinstra SMA, Henrotin Y, Bacardit J. A machine learning approach for the identification of new biomarkers for knee osteoarthritis development in overweight and obese women. Osteoarthritis Cartilage 2017; 25:2014-2021. [PMID: 28899843 DOI: 10.1016/j.joca.2017.09.001] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 08/16/2017] [Accepted: 09/02/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Knee osteoarthritis (OA) is among the higher contributors to global disability. Despite its high prevalence, currently, there is no cure for this disease. Furthermore, the available diagnostic approaches have large precision errors and low sensitivity. Therefore, there is a need for new biomarkers to correctly identify early knee OA. METHOD We have created an analytics pipeline based on machine learning to identify small models (having few variables) that predict the 30-months incidence of knee OA (using multiple clinical and structural OA outcome measures) in overweight middle-aged women without knee OA at baseline. The data included clinical variables, food and pain questionnaires, biochemical markers (BM) and imaging-based information. RESULTS All the models showed high performance (AUC > 0.7) while using only a few variables. We identified both the importance of each variable within the models as well its direction. Finally, we compared the performance of two models with the state-of-the-art approaches available in the literature. CONCLUSIONS We showed the potential of applying machine learning to generate predictive models for the knee OA incidence. Imaging-based information were found particularly important in the proposed models. Furthermore, our analysis confirmed the relevance of known BM for knee OA. Overall, we propose five highly predictive small models that can be possibly adopted for an early prediction of knee OA.
Collapse
Affiliation(s)
- N Lazzarini
- ICOS Research Group, School of Computing, Newcastle University, UK; D-BOARD Consortium, An FP7 Programme By the European Committee
| | - J Runhaar
- D-BOARD Consortium, An FP7 Programme By the European Committee; Erasmus University Medical Center Rotterdam, the Netherlands, Dept. of General Practice
| | - A C Bay-Jensen
- D-BOARD Consortium, An FP7 Programme By the European Committee; Nordic Bioscience, Copenhagen, Denmark
| | - C S Thudium
- D-BOARD Consortium, An FP7 Programme By the European Committee; Nordic Bioscience, Copenhagen, Denmark
| | - S M A Bierma-Zeinstra
- D-BOARD Consortium, An FP7 Programme By the European Committee; Erasmus University Medical Center Rotterdam, the Netherlands, Dept. of General Practice; Erasmus University Medical Center Rotterdam, the Netherlands, Dept. of Orthopedics
| | - Y Henrotin
- D-BOARD Consortium, An FP7 Programme By the European Committee; University of Liège, Belgium; Artialis SA, Liège, Belgium
| | - J Bacardit
- ICOS Research Group, School of Computing, Newcastle University, UK; D-BOARD Consortium, An FP7 Programme By the European Committee.
| |
Collapse
|
47
|
Ma C, Avenell A, Bolland M, Hudson J, Stewart F, Robertson C, Sharma P, Fraser C, MacLennan G. Effects of weight loss interventions for adults who are obese on mortality, cardiovascular disease, and cancer: systematic review and meta-analysis. BMJ 2017; 359:j4849. [PMID: 29138133 PMCID: PMC5682593 DOI: 10.1136/bmj.j4849] [Citation(s) in RCA: 285] [Impact Index Per Article: 40.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Objective To assess whether weight loss interventions for adults with obesity affect all cause, cardiovascular, and cancer mortality, cardiovascular disease, cancer, and body weight.Design Systematic review and meta-analysis of randomised controlled trials (RCTs) using random effects, estimating risk ratios, and mean differences. Heterogeneity investigated using Cochran's Q and I2 statistics. Quality of evidence assessed by GRADE criteria.Data sources Medline, Embase, the Cochrane Central Register of Controlled Trials, and full texts in our trials' registry for data not evident in databases. Authors were contacted for unpublished data.Eligibility criteria for selecting studies RCTs of dietary interventions targeting weight loss, with or without exercise advice or programmes, for adults with obesity and follow-up ≥1 year.Results 54 RCTs with 30 206 participants were identified. All but one trial evaluated low fat, weight reducing diets. For the primary outcome, high quality evidence showed that weight loss interventions decrease all cause mortality (34 trials, 685 events; risk ratio 0.82, 95% confidence interval 0.71 to 0.95), with six fewer deaths per 1000 participants (95% confidence interval two to 10). For other primary outcomes moderate quality evidence showed an effect on cardiovascular mortality (eight trials, 134 events; risk ratio 0.93, 95% confidence interval 0.67 to 1.31), and very low quality evidence showed an effect on cancer mortality (eight trials, 34 events; risk ratio 0.58, 95% confidence interval 0.30 to 1.11). Twenty four trials (15 176 participants) reported high quality evidence on participants developing new cardiovascular events (1043 events; risk ratio 0.93, 95% confidence interval 0.83 to 1.04). Nineteen trials (6330 participants) provided very low quality evidence on participants developing new cancers (103 events; risk ratio 0.92, 95% confidence interval 0.63 to 1.36).Conclusions Weight reducing diets, usually low in fat and saturated fat, with or without exercise advice or programmes, may reduce premature all cause mortality in adults with obesity.Systematic review registration PROSPERO CRD42016033217.
Collapse
Affiliation(s)
- Chenhan Ma
- Health Services Research Unit, University of Aberdeen, Health Sciences Building, Foresterhill, Aberdeen AB25 2ZD, Scotland, UK
| | - Alison Avenell
- Health Services Research Unit, University of Aberdeen, Health Sciences Building, Foresterhill, Aberdeen AB25 2ZD, Scotland, UK
| | - Mark Bolland
- Bone and Joint Research Group, Department of Medicine, University of Auckland, Private Bag 92 019, Auckland 1142, New Zealand
| | - Jemma Hudson
- Health Services Research Unit, University of Aberdeen, Health Sciences Building, Foresterhill, Aberdeen AB25 2ZD, Scotland, UK
| | - Fiona Stewart
- Health Services Research Unit, University of Aberdeen, Health Sciences Building, Foresterhill, Aberdeen AB25 2ZD, Scotland, UK
| | - Clare Robertson
- Health Services Research Unit, University of Aberdeen, Health Sciences Building, Foresterhill, Aberdeen AB25 2ZD, Scotland, UK
| | - Pawana Sharma
- Health Services Research Unit, University of Aberdeen, Health Sciences Building, Foresterhill, Aberdeen AB25 2ZD, Scotland, UK
| | - Cynthia Fraser
- Health Services Research Unit, University of Aberdeen, Health Sciences Building, Foresterhill, Aberdeen AB25 2ZD, Scotland, UK
| | - Graeme MacLennan
- Centre for Healthcare Randomised Trials, University of Aberdeen, Health Sciences Building, Foresterhill, Aberdeen AB25 2ZD, Scotland, UK
| |
Collapse
|
48
|
Wei Y, Jia J, Jin X, Tong W, Tian H. Resveratrol ameliorates inflammatory damage and protects against osteoarthritis in a rat model of osteoarthritis. Mol Med Rep 2017; 17:1493-1498. [PMID: 29138829 PMCID: PMC5780088 DOI: 10.3892/mmr.2017.8036] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 07/13/2017] [Indexed: 12/11/2022] Open
Abstract
Resveratrol is a non-flavonoid polyphenol compound with a stilbene structure. As a type of phytoalexin produced under stress in plants, it improves the plant's resistance against pathogens and environment deterioration, and performs important functions beneficial to human health, such as anti-cancer, anti-oxidation, regulating blood lipid levels and prolonging life span. The effects of resveratrol were examined in a rat model of osteoarthritis (OA) and observed to ameliorate inflammatory damage and protect against OA. In the present study, resveratrol significantly inhibited the induction of clinical scores in rats with OA. Resveratrol inhibited tumor necrosis factor-α, interleukin (IL)-1β, IL-6 and IL-18 expression levels, and decreased caspase-3/9 activity in rats with OA. Inducible nitric oxide synthase, nuclear factor (NF)-κB, phosphorylated-(p)-AMP-activated protein kinase and sirtuin 1 protein expression were significantly suppressed and heme oxygenase 1 (HO-1) and nuclear factor erythroid 2-related factor 2 (Nrf-2) protein expression was stimulated in rats with OA treated with resveratrol. The current results indicate that resveratrol ameliorates inflammatory damage and protects against OA in a rat model of OA via NF-κB and HO-1/Nrf-2 signaling.
Collapse
Affiliation(s)
- Yulong Wei
- Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| | - Jie Jia
- Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| | - Xin Jin
- Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| | - Wei Tong
- Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| | - Hongtao Tian
- Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| |
Collapse
|
49
|
Bierma-Zeinstra S, Waarsing J. The role of atherosclerosis in osteoarthritis. Best Pract Res Clin Rheumatol 2017; 31:613-633. [DOI: 10.1016/j.berh.2018.08.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 05/16/2018] [Accepted: 07/06/2018] [Indexed: 01/06/2023]
|
50
|
Baseline meniscal extrusion associated with incident knee osteoarthritis after 30 months in overweight and obese women. Osteoarthritis Cartilage 2017; 25:1299-1303. [PMID: 28351706 DOI: 10.1016/j.joca.2017.03.014] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 03/15/2017] [Accepted: 03/17/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the association between baseline meniscal extrusion and the incidence of knee osteoarthritis (KOA) after 30 months in a high-risk population of overweight and obese women, free of clinical and radiological KOA at baseline. METHODS 407 middle-aged overweight women (body mass index - BMI ≥ 27 kg/m2) were evaluated at baseline and after 30 months of follow-up. Meniscal extrusion was defined as grade ≥2 on MRI according to MRI Osteoarthritis Knee Score (MOAKS). The primary outcome measure was KOA after 30 months follow-up, defined using the following criteria: either incidence of radiographic KOA (Kellgren & Lawrence grade 2 or higher), or clinical osteoarthritis (OA) according to the American College of Radiology (ACR) criteria, or medial or lateral joint space narrowing (JSN) of ≥1.0 mm. Using generalized estimating equations (GEE), we determined the association between knees with and without meniscal extrusion and both outcomes, corrected for the baseline differences. RESULTS 640 knees were available at baseline of which 24% (153) had meniscal extrusion. There was a significantly higher incidence of KOA according to the primary outcome measure in women with meniscal extrusion compared to those without extrusion (28.8%, odds ratio - OR 2.39, 95% CI 1.53, 3.73). A significantly higher incidence was found for the development of radiographic KOA (12.4%, OR 2.61, 95% CI 1.11, 6.13) and medial JSN (11.8%, OR 3.19, 95% CI 1.59, 6.41). Meniscal extrusion was not significantly associated with clinical KOA and lateral JSN. CONCLUSION Meniscal extrusion was associated with a significantly higher incidence of KOA, providing an interesting target for early detection of individuals at risk for developing KOA.
Collapse
|