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Hoshikawa A, Nakajima K, Okuwaki T, Hangai M, Aono H, Ishizuka S, Morioka Y, Itou S, Kawahara T. Former Olympians had remained on high bone mineral density for a long period: Consecutive checkup of the 1964 Tokyo Olympic Japanese contestants for over 50 years. Bone 2024; 187:117203. [PMID: 39019130 DOI: 10.1016/j.bone.2024.117203] [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: 04/30/2024] [Revised: 07/09/2024] [Accepted: 07/12/2024] [Indexed: 07/19/2024]
Abstract
INTRODUCTION We performed consecutive checkups of the 1964 Tokyo Olympic contestants every 4 years for 50 years. This study evaluated bone mineral density (BMD) and its related factors in former Tokyo Olympic athletes. OBJECTIVES The study population comprised 181 former Olympians (141 men and 40 women) who had undergone BMD measurement in at least one of the four checkups performed every 4 years since 2005. The mean age of the 104 subjects who participated in the last checkup in 2016 was 76.1 years for men and 74.0 years for women. METHODS Health-related information regarding medical history, regular physical activity, alcohol consumption, and smoking was obtained using questionnaires. The areal BMD of the total body was measured using dual-energy X-ray absorptiometry (DXA). The relationship between BMD and anthropometric measurements, medical history, and health behaviors was examined. Furthermore, we assessed the influence of the mode and magnitude of weight-bearing and impact loading during athletic events during their active careers on BMD. RESULTS The mean Z-scores of BMD of the total body, lumbar spine, pelvis, and upper and lower limbs were > 0 in both male and female subjects at each checkup. The subjects had a higher mean height and weight than the Japanese age- and sex-matched individuals. Furthermore, the subjects had higher grip strength than the age- and sex-matched individuals. BMD showed a positive correlation with body weight, lean body mass (LBM), muscle mass, and grip strength, with higher correlation coefficients found between BMD of the pelvis or lower limbs and LBM or muscle mass volume. When the association with current participation in sports activities was examined, male subjects who exercised weekly had significantly higher grip strength and greater muscle mass volume; however, no significant differences were observed among female subjects. After adjusting for age and LMB, BMD was significantly higher in both the lumbar spine and lower limbs of male subjects with relatively more impact loading in sports events during their active careers. CONCLUSION The Tokyo Olympic contestants maintained a high muscle mass even at an older age, regardless of their medical history, which may be one of the reasons for their ability to maintain a high BMD.
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Affiliation(s)
- A Hoshikawa
- Department of Orthopaedic Surgery, Saitama Medical Center, Saitama Medical University, Kamoda 1981, Kawagoe-shi, Saitama 350-8550, Japan; Medical Center, Japan Institute of Sports Science, Japan High Performance Sports Center, Nishigaoka 3-15-1, Kita-ku, Tokyo 115-0056, Japan.
| | - K Nakajima
- Medical Center, Japan Institute of Sports Science, Japan High Performance Sports Center, Nishigaoka 3-15-1, Kita-ku, Tokyo 115-0056, Japan.
| | - T Okuwaki
- Medical Center, Japan Institute of Sports Science, Japan High Performance Sports Center, Nishigaoka 3-15-1, Kita-ku, Tokyo 115-0056, Japan.
| | - M Hangai
- Medical Center, Japan Institute of Sports Science, Japan High Performance Sports Center, Nishigaoka 3-15-1, Kita-ku, Tokyo 115-0056, Japan.
| | - H Aono
- Laboratory of Sports Sciences, Japan Sport Association, 4-2 Kasumigaokacho, Shinjuku, Tokyo 160-0013, Japan.
| | - S Ishizuka
- Laboratory of Sports Sciences, Japan Sport Association, 4-2 Kasumigaokacho, Shinjuku, Tokyo 160-0013, Japan.
| | - Y Morioka
- Laboratory of Sports Sciences, Japan Sport Association, 4-2 Kasumigaokacho, Shinjuku, Tokyo 160-0013, Japan.
| | - S Itou
- Laboratory of Sports Sciences, Japan Sport Association, 4-2 Kasumigaokacho, Shinjuku, Tokyo 160-0013, Japan.
| | - T Kawahara
- Medical Center, Japan Institute of Sports Science, Japan High Performance Sports Center, Nishigaoka 3-15-1, Kita-ku, Tokyo 115-0056, Japan
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Li J, Schaeffer EK, Miller S, Schreiber VM, Hailer YD, Clohisy JC, Kim HK, Mulpuri K. Surgeon Recommendations for Physical Activity in Patients With Pediatric Hip Conditions. J Pediatr Orthop 2024; 44:468-475. [PMID: 38835293 PMCID: PMC11299903 DOI: 10.1097/bpo.0000000000002732] [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] [Indexed: 06/06/2024]
Abstract
BACKGROUND While physical activity (PA) is important during youth, it is unclear if children and adolescents with developmental dysplasia of the hip (DDH), Legg-Calvé-Perthes disease (LCPD), or slipped capital femoral epiphysis (SCFE) are expected or encouraged to return to PA once they have healed. This study examines the orthopaedic surgeons' role in advising pediatric hip patients on the PA they should engage in, assessing their practice, opinions, and consensus when making recommendations. METHODS Orthopaedic surgeons were invited from member lists of 4 hip study groups. The survey included demographics, opinions regarding PA, and 10 case scenarios that queried respondents on the duration and intensity of PA as well as the restrictions on activity type that they would recommend for DDH, LCPD, or SCFE patients. Consensus was evaluated on a scale ranging from 0 to 1, with a value of 0 indicating no agreement among respondents and a value of 1 indicating complete agreement. RESULTS A total of 51 orthopaedic surgeons responded. While 94% agreed that it is important for school-aged hip patients to return to PA after they have healed, 53% believed that PA may compromise the hip and contribute to the development of osteoarthritis. Average standardized consensus was 0.92 for suggesting the patient engage in some amount of PA, 0.44 for suggesting the recommended daily minimum of 60 minutes of moderate-to-vigorous physical activity (MVPA), and 0.33 for suggesting restrictions on activity type. The most frequently selected restrictions included avoiding impact activities (93%, 235/254) and contact activities (58%, 147/254), followed by weight-bearing activities (24%, 62/254). Respondents were not aware of existing PA guidelines, although 57% expressed interest in following guidelines and 39% were uncertain. CONCLUSIONS While there is consensus among orthopaedic surgeons that children with chronic hip conditions should engage in PA, there is considerable variation when recommending the recommended daily MVPA minimum and placing restrictions on activity type. This study suggests interest among orthopaedic surgeons in developing PA guidelines that optimize outcomes for pediatric hip patients. LEVEL OF EVIDENCE Level II-Survey study.
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Affiliation(s)
- Jacqueline Li
- Departments of Orthopaedics
- Departments of Orthopaedic Surgery
| | | | - Stacey Miller
- Physical Therapy, University of British Columbia
- Physiotherapy, BC Children’s Hospital, Vancouver, British Columbia, Canada
| | - Verena M. Schreiber
- Orthopedic, Sports Medicine and Spine Institute, Nicklaus Children’s Hospital, Miami, FL
| | - Yasmin D. Hailer
- Section of Orthopaedics, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - John C. Clohisy
- Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO
| | - Harry K.W. Kim
- Scottish Rite for Children
- University of Texas Southwestern Medical Center, Dallas, TX
| | - Kishore Mulpuri
- Departments of Orthopaedics
- Departments of Orthopaedic Surgery
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Kawano T, Nankaku M, Murao M, Yuri T, Kitamura G, Goto K, Kuroda Y, Kawai T, Okuzu Y, Ikeguchi R, Matsuda S. Association of physical activity with fatty infiltration of muscles after total hip arthroplasty. Skeletal Radiol 2024; 53:967-974. [PMID: 37999749 DOI: 10.1007/s00256-023-04516-z] [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: 07/26/2023] [Revised: 11/08/2023] [Accepted: 11/10/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVE This study aimed to investigate the association between muscle density as an indicator of fatty infiltration of lower extremity muscles and physical activity (PA) after total hip arthroplasty (THA) and identify the patient characteristics with high postoperative PA. METHODS This study included 62 female patients who underwent THA for unilateral hip osteoarthritis. Muscle density of the gluteus maximus, gluteus medius, iliopsoas, and quadriceps muscles was measured using computed tomography (CT). PA was assessed using University of California, Los Angeles (UCLA) activity scores. CT and UCLA activity score were obtained before and 1 year after THA. The patients were divided into two groups, sufficient (score ≥ 6) and insufficient (score < 6) activity groups, based on their level of PA as determined by their UCLA activity score 1 year after THA. The association of PA with the amount of changes in muscle density was examined with Spearman's rank correlation coefficient. Logistic regression analysis was performed to identify postoperative factors determining PA at 1 year after THA. RESULTS Spearman's rank correlation coefficient showed a significantly positive association between recovery in PA and an increase in muscle density of the gluteus maximus, gluteus medius, iliopsoas, and quadriceps muscles. Additionally, logistic regression analysis confirmed that postoperative muscle densities of the gluteus maximus and quadriceps muscles were variables determining the PA 1 year after THA. CONCLUSION The findings of this study indicated that the improvement of fatty infiltration in lower limb muscles, especially in the gluteus maximus and quadriceps, is likely to promote the increase in postoperative PA.
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Affiliation(s)
- Takumi Kawano
- Rehabilitation Unit, Kyoto University Hospital, 54 Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507, Japan.
| | - Manabu Nankaku
- Rehabilitation Unit, Kyoto University Hospital, 54 Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507, Japan
| | - Masanobu Murao
- Rehabilitation Unit, Kyoto University Hospital, 54 Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507, Japan
| | - Takuma Yuri
- Rehabilitation Unit, Kyoto University Hospital, 54 Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507, Japan
| | - Gakuto Kitamura
- Rehabilitation Unit, Kyoto University Hospital, 54 Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507, Japan
| | - Koji Goto
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yutaka Kuroda
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Toshiyuki Kawai
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yaichiro Okuzu
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ryosuke Ikeguchi
- Rehabilitation Unit, Kyoto University Hospital, 54 Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507, Japan
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shuichi Matsuda
- Rehabilitation Unit, Kyoto University Hospital, 54 Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507, Japan
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Fu Y, Li L, Gao J, Wang F, Zhou Z, Zhang Y. J-shaped association of dietary catechins intake with the prevalence of osteoarthritis and moderating effect of physical activity: an American population-based cohort study. Front Immunol 2024; 14:1287856. [PMID: 38259454 PMCID: PMC10801035 DOI: 10.3389/fimmu.2023.1287856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 12/15/2023] [Indexed: 01/24/2024] Open
Abstract
Background Catechins are a class of natural compounds with a variety of health benefits, The relationship between catechins and the prevalence of osteoarthritis (OA) is unknown. This study investigated the associations between daily intake of catechins and the prevalence of OA among American adults and assessed the moderating effect of physical activity (PA). Methods This study included 10,039 participants from the National Health and Nutrition Examination Survey (2007-2010,2017-2018). The logistic regression, weighted quantile sum (WQS) regression, and restricted cubic spline (RCS) regression models were conducted to explore the associations between daily intake of catechins and the prevalence of OA. Moreover, interaction tests were performed to assess the moderating effect of PA. Results After multivariable adjustment, the weighted multivariable logistic regression and RCS regression analyses revealed significant J-shaped non-linear correlations between intakes of epigallocatechin and epigallocatechin 3-gallate had significant associations with the prevalence of OA among in U.S. adults. WQS regression analysis showed that excessive epigallocatechin intake was the most significant risk factor for OA among all subtypes of catechins. In the interaction assay, PA showed a significant moderating effect in the relationship between epigallocatechin intake and OA prevalence. Conclusions The intake of gallocatechin and gallocatechin 3-gallate had a significant negative correlation with the prevalence of OA and the dose-response relationship was J-shaped.PA below 150 MET-min/week and the threshold intakes of 32.70mg/d for epigallocatechin and 76.24mg/d for epigallocatechin 3-gallate might be the targets for interventions to reduce the risk of developing OA.
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Affiliation(s)
- Yuesong Fu
- Department of Orthopedics, The First People’s Hospital of Kashi Prefecture, Kashi, Xinjiang, China
| | - Lu Li
- Department of Orthopedics, The First People’s Hospital of Kashi Prefecture, Kashi, Xinjiang, China
| | - Jing Gao
- Department of Orthopedics, The First People’s Hospital of Kashi Prefecture, Kashi, Xinjiang, China
| | - Fazheng Wang
- Department of Orthopedics, The First People’s Hospital of Kashi Prefecture, Kashi, Xinjiang, China
| | - Zihan Zhou
- Department of Hand Surgery and Peripheral Neurosurgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yiwei Zhang
- Department of Orthopedics, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
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De Marziani L, Sangiorgio A, Bensa A, Boffa A, Andriolo L, Filardo G. Intra-articular injections in sport-active patients with degenerative cartilage lesions or osteoarthritis of the knee: a systematic review. J Exp Orthop 2023; 10:112. [PMID: 37938446 PMCID: PMC10632330 DOI: 10.1186/s40634-023-00674-0] [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: 08/13/2023] [Accepted: 10/09/2023] [Indexed: 11/09/2023] Open
Abstract
PURPOSE The aim of this systematic review was to analyse the available clinical evidence on intra-articular knee injections for the treatment of degenerative cartilage lesions and osteoarthritis (OA) in sport-active patients. METHODS A literature search was performed in July 2023 according to the PRISMA guidelines on three electronic databases (PubMed, Cochrane, Web of Science). Studies addressing intra-articular injections for degenerative knee cartilage lesions or knee OA in sport-active patients were included. The Downs and Black's "checklist for measuring quality" was used to evaluate risk of bias and quality of the included studies. RESULTS Only 10 clinical studies for a total of 296 sport-active patients were included, with a publication trend increasing over time. The studies were 9 case series and 1 RCT; 7 studies focused on hyaluronic acid (HA), 2 studies focused on platelet-rich plasma (PRP), while 1 study compared HA and PRP. Overall, safety and positive clinical findings were for both HA and PRP, although not always with satisfactory results in terms of return to sport. The Downs and Black evaluation showed an overall poor quality of the included studies, with an average score of 21.1 points (range 19-25). CONCLUSIONS The available clinical evidence is still limited, with only a few studies published and an overall low-quality of evidence, suggesting a potential role of HA and PRP injections to treat these patients. However, further high-level trials are needed to confirm the real benefits of these treatments for the management of sport-active patients affected by degenerative cartilage lesions or OA of the knee.
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Affiliation(s)
- Luca De Marziani
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Alessandro Sangiorgio
- Service of Orthopaedics and Traumatology, Department of Surgery, EOC, Lugano, Switzerland
| | - Alessandro Bensa
- Service of Orthopaedics and Traumatology, Department of Surgery, EOC, Lugano, Switzerland
| | - Angelo Boffa
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Luca Andriolo
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
| | - Giuseppe Filardo
- Service of Orthopaedics and Traumatology, Department of Surgery, EOC, Lugano, Switzerland
- Applied and Translational Research (ATR) Center, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
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Wang B, Liu Y, Zhang YC, Han ZY, Hou JL, Chen S, Xiang C. Assessment of causal effects of physical activity on the risk of osteoarthritis: a two-sample Mendelian randomization study. BMC Med Genomics 2023; 16:237. [PMID: 37814247 PMCID: PMC10561455 DOI: 10.1186/s12920-023-01681-x] [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: 05/11/2023] [Accepted: 10/01/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND Growing evidence supports an association between physical activity (PA) and the risk of osteoarthritis (OA), but this may be influenced by confounding and reverse causality. Therefore, we performed a two-sample Mendelian randomization (MR) analysis to reveal the causal relationship between PA and OA. METHODS MR was performed to explore the causation of PA and OA with genetic variants as instrumental variables. The genetic variants were derived from the summary statistics of a large genome-wide association study meta-analysis based on the European population (n = 661,399), including self-reported leisure screen time (LST) and moderate-to-vigorous physical activity (MVPA), and Arthritis Research UK Osteoarthritis Genetics Consortium cohorts (417,596, 393,873 and 403,124 for overall, hip and knee OA, respectively). The major MR analysis used in this work was the inverse variance weighted (IVW) approach, and sensitivity, pleiotropy, and heterogeneity studies were performed to evaluate the validity of the findings. RESULTS IVW estimates indicated that LST had a risk effect on overall OA (odds ratio (OR) = 1.309, 95% confidence interval (CI): 1.198-1.430, P = 2.330 × 10-9), hip OA (OR = 1.132, 95% CI: 1.009-1.269, P = 0.034) and knee OA (OR = 1.435. 95% CI: 1.286-1.602, P = 1.225 × 10-10). In contrast, no causal relationship was found between MVPA and OA (overall OA: OR = 0.895, 95% CI: 0.664-1.205, P = 0.465; hip OA: OR = 1.189, 95% CI: 0.792-1.786, P = 0.404; knee OA: OR = 0.707, 95% CI: 0.490 -1.021, P = 0.064). In addition, we observed significant heterogeneity in instrumental variables, but no horizontal pleiotropy was detected. CONCLUSIONS Recent findings demonstrated a protective impact of reducing LST on OA, independent of MVPA. This provides valuable insights into the role of physical activity in OA and offers lifestyle recommendations, such as reducing recreational sedentary behaviors and promoting appropriate exercise, for individuals at risk of OA.
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Affiliation(s)
- Bin Wang
- Department of Orthopedic, Second Hospital of Shanxi Medical University, Taiyuan, 030001, China
| | - Yang Liu
- Department of Orthopedic, Second Hospital of Shanxi Medical University, Taiyuan, 030001, China
- Department of Emergency Medicine, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yao-Chen Zhang
- Ministry of Education, Key Laboratory of Cellular Physiology at Shanxi Medical University, Taiyuan, China
| | - Zi-Yi Han
- Ministry of Education, Key Laboratory of Cellular Physiology at Shanxi Medical University, Taiyuan, China
| | - Jia-Lin Hou
- Ministry of Education, Key Laboratory of Cellular Physiology at Shanxi Medical University, Taiyuan, China
| | - Shuai Chen
- Department of Orthopedic, Second Hospital of Shanxi Medical University, Taiyuan, 030001, China
| | - Chuan Xiang
- Department of Orthopedic, Second Hospital of Shanxi Medical University, Taiyuan, 030001, China.
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White DK, Jakiela J, Bye T, Aily J, Voinier D. Stepping Forward: A Scoping Review of Physical Activity in Osteoarthritis. J Rheumatol 2023; 50:611-616. [PMID: 36455947 PMCID: PMC10159874 DOI: 10.3899/jrheum.220728] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2022] [Indexed: 05/03/2023]
Abstract
Physical activity (PA) is recommended to mitigate the symptoms of osteoarthritis (OA); however, this modality remains an unfamiliar construct for many patients and clinicians. Moreover, there can be confusion over the nuanced differences in terminology, such as exercise, sedentary behavior, and moderate intensity. The purpose of this scoping review is to provide a basic overview of PA including terminology, summarize the importance of PA for adults with OA, and discuss current gaps in the literature. Broadly, PA is defined as any energy expenditure from skeletal muscle above a resting level, and exercise is considered a type of PA that is planned, structured, and repetitive. Robust literature shows that PA has a modest protective effect on pain, functional limitation, and disability for OA, in addition to positive effects on a broad range of outcomes from mood and affect to mortality and morbidity in the general population. We provide recommendations for which measurement instruments can be used to record PA, both from a clinical and research perspective, as well as which metrics to employ for summarizing daily activity.
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Affiliation(s)
- Daniel K White
- D.K. White, PT, ScD, MSc, J. Jakiela, MSc, T. Bye, PT, J. Aily, PT, D. Voinier, PT, PhD, Department of Physical Therapy, University of Delaware, Newark, Delaware, USA.
| | - Jason Jakiela
- D.K. White, PT, ScD, MSc, J. Jakiela, MSc, T. Bye, PT, J. Aily, PT, D. Voinier, PT, PhD, Department of Physical Therapy, University of Delaware, Newark, Delaware, USA
| | - Tom Bye
- D.K. White, PT, ScD, MSc, J. Jakiela, MSc, T. Bye, PT, J. Aily, PT, D. Voinier, PT, PhD, Department of Physical Therapy, University of Delaware, Newark, Delaware, USA
| | - Jessica Aily
- D.K. White, PT, ScD, MSc, J. Jakiela, MSc, T. Bye, PT, J. Aily, PT, D. Voinier, PT, PhD, Department of Physical Therapy, University of Delaware, Newark, Delaware, USA
| | - Dana Voinier
- D.K. White, PT, ScD, MSc, J. Jakiela, MSc, T. Bye, PT, J. Aily, PT, D. Voinier, PT, PhD, Department of Physical Therapy, University of Delaware, Newark, Delaware, USA
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Kacprzak B, Rosińska K, Siuba-Jarosz N. Hyalofast Cartilage Repair Surgery with a Full Load-Bearing Rehabilitation Program One Day after Operation Reduces the Time for Professional Athletes to Return to Play. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59040804. [PMID: 37109762 PMCID: PMC10145501 DOI: 10.3390/medicina59040804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/15/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023]
Abstract
Background and Objectives: This study evaluated the effectiveness of Hyalofast cartilage repair surgery with an early, full load-bearing rehabilitation program one day after the operation for reducing the time needed for professional athletes to return to play. Materials and Methods: This prospective study included 49 patients aged between 19 and 38 years who had undergone surgical reconstruction of cartilage using the microfracture technique combined with a Hyalofast scaffold. All patients were active professional athletes. Early rehabilitation was implemented from the first postoperative day, fully loading the operated limb. A clinical evaluation was based on the KOOS and SF-36 questionnaires used during subsequent follow-up visits. All patients underwent magnetic resonance imaging (MRI) to evaluate the effect of the surgery after one year. Results: The clinical results demonstrated a statistically significant improvement in the number of complaints about pain and in the quality of life of the patients, measured in all of the applied scales, with comparisons made between six months or one year post-surgery and pre-surgery. Importantly for athletes, the parameter related to sports and recreation improved from 14 ± 11.1 to 95 ± 7.7 6 months after surgery and to 99.8 ± 1.8 one year after surgery. The overall quality of life score improved from 30 ± 18 to 88 ± 8.8 one year after surgery. Conclusions: These results show that this approach significantly shortened the time needed for the athletes to return to sports at the same level as before the surgery (athletes returned to sports in approximately 2.5-3 months). The mean follow-up time was 19.75 months. This technique can be considered a viable option for the treatment of cartilage injuries in professional athletes, allowing them to return to play more quickly in a safe and healthy way.
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Affiliation(s)
| | - Karolina Rosińska
- Wolf Project Studio Krzysztof Król, ul. Gdańska 79/D01, 90-612 Łódź, Poland
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Driban JB, Vincent HK, Trojian TH, Ambrose KR, Baez S, Beresic N, Berkoff DJ, Callahan LF, Cohen B, Franek M, Golightly YM, Harkey M, Kuenze CM, Minnig MC, Mobasheri A, Naylor A, Newman CB, Padua DA, Pietrosimone B, Pinto D, Root H, Salzler M, Schmitt L, Snyder-Mackler L, Taylor JB, Thoma LM, Vincent KR, Wellsandt E, Williams M. Evidence Review for Preventing Osteoarthritis After an Anterior Cruciate Ligament Injury: An Osteoarthritis Action Alliance Consensus Statement. J Athl Train 2023; 58:198-219. [PMID: 37130279 PMCID: PMC10176847 DOI: 10.4085/1062-6050-0504.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
CONTEXT The Osteoarthritis Action Alliance formed a secondary prevention task group to develop a consensus on secondary prevention recommendations to reduce the risk of osteoarthritis after a knee injury. OBJECTIVE Our goal was to provide clinicians with secondary prevention recommendations that are intended to reduce the risk of osteoarthritis after a person has sustained an anterior cruciate ligament injury. Specifically, this manuscript describes our methods, literature reviews, and dissenting opinions to elaborate on the rationale for our recommendations and to identify critical gaps. DESIGN Consensus process. SETTING Virtual video conference calls and online voting. PATIENTS OR OTHER PARTICIPANTS The Secondary Prevention Task Group consisted of 29 members from various clinical backgrounds. MAIN OUTCOME MEASURE(S) The group initially convened online in August 2020 to discuss the target population, goals, and key topics. After a second call, the task group divided into 9 subgroups to draft the recommendations and supportive text for crucial content areas. Twenty-one members completed 2 rounds of voting and revising the recommendations and supportive text between February and April 2021. A virtual meeting was held to review the wording of the recommendations and obtain final votes. We defined consensus as >80% of voting members supporting a proposed recommendation. RESULTS The group achieved consensus on 15 of 16 recommendations. The recommendations address patient education, exercise and rehabilitation, psychological skills training, graded-exposure therapy, cognitive-behavioral counseling (lacked consensus), outcomes to monitor, secondary injury prevention, system-level social support, leveraging technology, and coordinated care models. CONCLUSIONS This consensus statement reflects information synthesized from an interdisciplinary group of experts based on the best available evidence from the literature or personal experience. We hope this document raises awareness among clinicians and researchers to take steps to mitigate the risk of osteoarthritis after an anterior cruciate ligament injury.
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Affiliation(s)
| | - Jeffrey B. Driban
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA
| | - Heather K. Vincent
- UF Health Sports Performance Center, Department of Physical Medicine and Rehabilitation, University of Florida, Gainesville
| | - Thomas H. Trojian
- UF Health Sports Performance Center, Department of Physical Medicine and Rehabilitation, University of Florida, Gainesville
| | | | - Shelby Baez
- Osteoarthritis Action Alliance, Thurston Arthritis Research Center, University of North Carolina at Chapel Hill
| | | | - David J. Berkoff
- Department of Kinesiology, Michigan State University, East Lansing
| | - Leigh F. Callahan
- Osteoarthritis Action Alliance, Thurston Arthritis Research Center, University of North Carolina at Chapel Hill
| | | | - Madison Franek
- University of North Carolina Therapy Services, UNC Wellness Center at Meadowmont, Chapel Hill
| | - Yvonne M. Golightly
- Department of Epidemiology, Thurston Arthritis Research Center, Injury Prevention Research Center, Osteoarthritis Action Alliance, University of North Carolina at Chapel Hill
| | - Matthew Harkey
- Department of Kinesiology, Michigan State University, East Lansing
| | | | - Mary Catherine Minnig
- Department of Epidemiology, Thurston Arthritis Research Center, Injury Prevention Research Center, Osteoarthritis Action Alliance, University of North Carolina at Chapel Hill
| | - Ali Mobasheri
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Finland; Department of Regenerative Medicine, State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania; Department of Joint Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China; World Health Organization Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liege, Belgium
| | | | - Connie B. Newman
- Department of Medicine, Division of Endocrinology, Diabetes & Metabolism, NYU Grossman School of Medicine, New York, NY
| | - Darin A. Padua
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | - Brian Pietrosimone
- Department of Physical Therapy, Congdon School of Health Sciences, High Point University, NC
| | - Daniel Pinto
- Department of Physical Therapy, Marquette University, Milwaukee, WI
| | - Hayley Root
- Department of Physical Therapy, Marquette University, Milwaukee, WI
| | - Matthew Salzler
- Department of Physical Therapy and Athletic Training, Northern Arizona University, Flagstaff
| | - Laura Schmitt
- Division of Physical Therapy, School of Health and Rehabilitation Sciences, Ohio State University, Columbus
| | | | - Jeffrey B. Taylor
- Department of Physical Therapy, Congdon School of Health Sciences, High Point University, NC
| | - Louise M. Thoma
- Division of Physical Therapy, Department of Allied Health Sciences, University of North Carolina at Chapel Hill
| | - Kevin R. Vincent
- UF Health Sports Performance Center, Department of Physical Medicine and Rehabilitation, University of Florida, Gainesville
| | - Elizabeth Wellsandt
- Division of Physical Therapy Education, University of Nebraska Medical Center, Omaha
| | - Monette Williams
- Division of Physical Therapy Education, University of Nebraska Medical Center, Omaha
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10
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Philpott HT, Birmingham TB, Fiset B, Walsh LA, Coleman MC, Séguin CA, Appleton CT. Tensile strain and altered synovial tissue metabolism in human knee osteoarthritis. Sci Rep 2022; 12:17367. [PMID: 36253398 PMCID: PMC9576717 DOI: 10.1038/s41598-022-22459-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 10/14/2022] [Indexed: 01/10/2023] Open
Abstract
Synovium is critical for maintaining joint homeostasis and may contribute to mechanobiological responses during joint movement. We investigated mechanobiological responses of whole synovium from patients with late-stage knee osteoarthritis (OA). Synovium samples were collected during total knee arthroplasty and assigned to histopathology or cyclic 10% tensile strain loading, including (1) static (control); (2) low-frequency (0.3 Hz); and iii) high-frequency (1.0 Hz) for 30-min. After 6-h incubation, tissues were bisected for RNA isolation and immunostaining (3-nitrotyrosine; 3-NT). RNA sequencing was analyzed for differentially expressed genes and pathway enrichment. Cytokines and lactate were measured in conditioned media. Compared to controls, low-frequency strain induced enrichment of pathways related to interferon response, Fc-receptor signaling, and cell metabolism. High-frequency strain induced enrichment of pathways related to NOD-like receptor signaling, high metabolic demand, and redox signaling/stress. Metabolic and redox cell stress was confirmed by increased release of lactate into conditioned media and increased 3-NT formation in the synovial lining. Late-stage OA synovial tissue responses to tensile strain include frequency-dependent increases in inflammatory signaling, metabolism, and redox biology. Based on these findings, we speculate that some synovial mechanobiological responses to strain may be beneficial, but OA likely disturbs synovial homeostasis leading to aberrant responses to mechanical stimuli, which requires further validation.
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Affiliation(s)
- Holly T. Philpott
- grid.39381.300000 0004 1936 8884Faculty of Health Sciences, Western University, London, ON N6G 1H1 Canada ,grid.39381.300000 0004 1936 8884Bone and Joint Institute, Western University, London, ON N6A 5B5 Canada
| | - Trevor B. Birmingham
- grid.39381.300000 0004 1936 8884Faculty of Health Sciences, Western University, London, ON N6G 1H1 Canada ,grid.39381.300000 0004 1936 8884Bone and Joint Institute, Western University, London, ON N6A 5B5 Canada
| | - Benoit Fiset
- grid.14709.3b0000 0004 1936 8649Rosalind and Morris Goodman Cancer Research Centre, McGill University, Montreal, QC H3A 1A3 Canada
| | - Logan A. Walsh
- grid.14709.3b0000 0004 1936 8649Rosalind and Morris Goodman Cancer Research Centre, McGill University, Montreal, QC H3A 1A3 Canada ,grid.14709.3b0000 0004 1936 8649Department of Human Genetics, McGill University, Montreal, QC H3A 0C7 Canada
| | - Mitchell C. Coleman
- grid.214572.70000 0004 1936 8294Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA 52242 USA ,grid.214572.70000 0004 1936 8294Department of Radiation Oncology, University of Iowa, Iowa City, IA 52242 USA
| | - Cheryle A. Séguin
- grid.39381.300000 0004 1936 8884Bone and Joint Institute, Western University, London, ON N6A 5B5 Canada ,grid.39381.300000 0004 1936 8884Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5C1 Canada
| | - C. Thomas Appleton
- grid.39381.300000 0004 1936 8884Bone and Joint Institute, Western University, London, ON N6A 5B5 Canada ,grid.39381.300000 0004 1936 8884Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5C1 Canada ,grid.39381.300000 0004 1936 8884Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5C1 Canada ,SJHC Rheumatology Centre, 268 Grosvenor St., London, ON N6A 4V2 Canada
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11
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Vasiliadis AV, Chatziravdeli V, Metaxiotis D, Beletsiotis A. A Prospective Randomized Comparative Study Between Midvastus and Standard Medial Parapatellar Approaches for Total Knee Replacement Regarding the Peri-Operative Factors. Cureus 2022; 14:e29889. [DOI: 10.7759/cureus.29889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2022] [Indexed: 11/07/2022] Open
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12
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Migliorini F, Vecchio G, Pintore A, Oliva F, Maffulli N. The Influence of Athletes' Age in the Onset of Osteoarthritis: A Systematic Review. Sports Med Arthrosc Rev 2022; 30:97-101. [PMID: 35533061 DOI: 10.1097/jsa.0000000000000345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Whether sport participation is a risk factor for osteoarthritis (OA) development or progression is controversial. Mechanical overload, injuries, genetics, and acquired disorders concur to the onset of OA, with high variability between sports and participants. This study investigated the association between participation in specific sports and the risk of developing knee and hip OA in athletes at different ages. We hypothesized that young athletes who are exposed to high levels of physical activities have a greater risk of developing OA. MATERIALS AND METHODS This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Google scholar, EMABSE, and Web of Science were accessed in October 2021. No time constrains were used for the search. All the published clinical studies reporting data about relationship between physical activity, OA, and age were included. RESULTS The Newcastle-Ottawa Scale resulted in a final score ≥7 for all studies, attesting good quality of the methodological assessment. Data from 27,364 patients were retrieved. The mean age was 48.2±16.7 years. In all, 21.8% were women. CONCLUSIONS Our systematic review suggests an association between high levels of physical activities and knee and hip OA in men younger than 50 years. People who practice intense physical activity, such as professional athletes or heavy workers, are more prone to develop early-onset OA.
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Affiliation(s)
- Filippo Migliorini
- Department of Orthopaedics, University Clinic Aachen, RWTH Aachen University Clinic, Aachen, Germany
| | - Gianluca Vecchio
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi (SA), Italy
| | - Andrea Pintore
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi (SA), Italy
| | - Francesco Oliva
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi (SA), Italy
| | - Nicola Maffulli
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi (SA), Italy
- School of Pharmacy and Bioengineering, Keele University Faculty of Medicine, Stoke on Trent
- Centre for Sports and Exercise Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, England
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13
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Jiao J, Tang H, Zhang S, Qu X, Yue B. The relationship between mental health/physical activity and pain/dysfunction in working-age patients with knee osteoarthritis being considered for total knee arthroplasty: a retrospective study. ARTHROPLASTY 2021; 3:22. [PMID: 35236496 PMCID: PMC8796639 DOI: 10.1186/s42836-021-00077-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 03/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Increasing total knee arthroplasty (TKA) surgeries are being performed on working-age patients with prominent manifestations of pain and dysfunction. But few studies have explored the risk factors for pain and dysfunction in working-age patients with knee osteoarthritis (KOA) being considered for TKA. Therefore, this study sought to explore the relationship between mental health/physical activity and pain/dysfunction in working-age patients with KOA being considered for TKA. METHODS This study was a secondary analysis of data derived from a public database, the Work participation In Patients with Osteoarthritis cohort study, which included 152 working-age patients (65 men and 87 women) with KOA planning for TKA. We analyzed preoperative data comprising age, educational level, body mass index (BMI), mental factors (Patient Health Questionnaire-9 [PHQ-9] and the 36-Item Short Form Survey Instrument [SF-36 mental health]), physical activity level, and clinical outcomes (the Western Ontario and McMaster Universities Osteoarthritis Index and SF-36 sub-item score). Multivariate regression analysis was performed to determine risk factors for pain and dysfunction in working-age patients with KOA being considered for TKA. RESULTS Women had lower pain, worse function, and higher PHQ-9 scores than men (p < 0.001). The depression scores were significantly linearly related to pain and function scores in women after adjusting for age, BMI, educational level, and physical activity (P < 0.05), whereas this relation was not observed in men. After adjusting for age, BMI, educational level, and mental factors, exercise time was found to be positively correlated with pain scores in women (P < 0.05). CONCLUSIONS Depression scores and exercise time were significantly correlated with pain and dysfunction in working-age women with KOA being considered for TKA.
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Affiliation(s)
- Juyang Jiao
- Department of Bone and Joint Surgery, Department of Orthopaedics, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 145, Shandong Road, Shanghai, 200011, China
| | - Haozheng Tang
- Department of Bone and Joint Surgery, Department of Orthopaedics, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 145, Shandong Road, Shanghai, 200011, China
| | - Shutao Zhang
- Department of Bone and Joint Surgery, Department of Orthopaedics, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 145, Shandong Road, Shanghai, 200011, China
| | - Xinhua Qu
- Department of Bone and Joint Surgery, Department of Orthopaedics, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 145, Shandong Road, Shanghai, 200011, China.
| | - Bing Yue
- Department of Bone and Joint Surgery, Department of Orthopaedics, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 145, Shandong Road, Shanghai, 200011, China.
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14
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Impact of different physical activity types on knee joint structural degeneration assessed with 3-T MRI in overweight and obese subjects: data from the osteoarthritis initiative. Skeletal Radiol 2021; 50:1427-1440. [PMID: 33404670 PMCID: PMC8122031 DOI: 10.1007/s00256-020-03642-2] [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: 04/21/2020] [Revised: 09/25/2020] [Accepted: 10/05/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To assess the impact of different types of physical activity types on longitudinal knee joint structural changes over 48 months in overweight and obese subjects. MATERIALS AND METHODS We included 415 subjects with a BMI ≥ 25 kg/m2, Kellgren-Lawrence scores ≤ 3 at baseline and Whole-Organ Magnetic Resonance Imaging Score (WORMS) scores available from the Osteoarthritis Initiative cohort. Regular self-reported participation in six physical activity types was assessed: ball sports, bicycling, jogging/running, elliptical-trainer, racquet sports, and swimming. Moreover, they were classified into high- and low-impact physical activity groups. Evaluation of structural knee abnormalities was performed using WORMS obtained by two independent observers blinded to the subjects' physical activity and time point. Linear regression models were used to assess the associations between participation in different physical activity types and changes in WORMS. RESULTS No significant differences in epidemiological data were found between the groups except for gender composition, and there were no significant differences in baseline WORMS. In the cohort as a whole and most exercise groups overall WORMS significantly increased during the observational period. Highest increases compared to the remainder of the group were found in the high impact group (increase in WORMS 4.65; [95% CI] [3.94,5.35]; p = 0.040) and the racquet sports group (6.39; [95% CI] [5.13,7.60]; p ≤ 0.001). Subjects using an elliptical-trainer showed the lowest increase in WORMS (- 1.50 [- 0.21, 3.22]; p = 0.002). CONCLUSION Progression of knee joint degeneration was consistently higher in subjects engaging in high-impact and racquet sports while subjects using an elliptical-trainer showed the smallest changes in structural degeneration. This work was presented during the 2020 Radiological Society of North America Annual meeting.
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15
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Schroeder AN, Jelsing EJ. Optimizing Combination Hyaluronic Acid and Platelet-Rich Plasma Injections: Does Composition of Hyaluronic Acid Product Matter? Curr Sports Med Rep 2021; 20:233-235. [PMID: 33908906 DOI: 10.1249/jsr.0000000000000836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Allison N Schroeder
- Department of Physical Medicine, Mayo Clinic, Rochester, MN, and Rehabilitation
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16
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Freiberg A, Bolm-Audorff U, Seidler A. The Risk of Knee Osteoarthritis in Professional Soccer Players—a Systematic Review With Meta-Analyses. DEUTSCHES ARZTEBLATT INTERNATIONAL 2021; 118:49-55. [PMID: 33759745 PMCID: PMC8182778 DOI: 10.3238/arztebl.m2021.0007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 02/26/2020] [Accepted: 08/24/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND We address the question whether professional soccer players with and without macroinjury of the knee joint are at an elevated risk for knee osteoarthritis. METHODS A systematic review with meta-analyses was conducted. The study protocol was prospectively registered (registration number CRD42019137139). The MEDLINE, EMBASE, and Web of Science databases were searched for relevant publications; in addition, forward searching was performed, and the listed references were considered. All steps of the process were undertaken independently by two reviewers, and any discordances were resolved by consensus. For all publications whose full text was included, the methods used were critically evaluated. The quality of the evidence was judged using the GRADE criteria. RESULTS The pooled odds ratio for objectively ascertained osteoarthrosis of the knee was 2.25 (95% confidence interval [1.41-3.61], I2 = 71%). When only radiologically ascertained knee osteoarthrosis was considered, the odds ratio was 3.98 [1.34; 11.83], I2 = 58%). The pooled risk estimator in studies in which knee joint macroinjury was excluded was 2.81 ([1.25; 6.32], I2 = 71%). CONCLUSION A marked association was found between soccer playing and knee osteoarthritis in male professional soccer players. For female professional soccer players, the risk of knee osteoarthritis could not be assessed because of the lack of data. Knee injuries seem to play an important role in the development of knee osteoarthritis in professional soccer players.
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Affiliation(s)
- Alice Freiberg
- Institute and Policlinic of Occupational and Social Medicine, Medical Faculty Carl Gustav Carus, Technische Universität Dresden; Division of Occupational Health, Department of Occupational Safety and Environment, Regional Government of South Hesse, Wiesbaden; Extraordinary Chair of Occupational Medicine, University of Gießen
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17
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Courties A, Berenbaum F. Is hip osteoarthritis preventable? Joint Bone Spine 2020; 87:371-375. [PMID: 31811930 DOI: 10.1016/j.jbspin.2019.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Alice Courties
- Inserm UMR_S 938, Centre de Recherche Saint-Antoine, Sorbonne université, 75012 Paris, France; Service de rhumatologie, hôpital Saint-Antoine, AP-HP, 75012 Paris, France
| | - Francis Berenbaum
- Inserm UMR_S 938, Centre de Recherche Saint-Antoine, Sorbonne université, 75012 Paris, France; Service de rhumatologie, hôpital Saint-Antoine, AP-HP, 75012 Paris, France.
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18
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Weng K, Luo M, Dong D. Elucidation of the Mechanism by Which a ADAMTS5 Gene MicroRNA-Binding Site Single Nucleotide Polymorphism Affects the Risk of Osteoarthritis. Genet Test Mol Biomarkers 2020; 24:467-477. [PMID: 32700984 DOI: 10.1089/gtmb.2020.0067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: The aim of this study was to investigate the relationship between single nucleotide polymorphisms (SNPs) within the 3' untranslated region of the microRNA (miRNA)-binding site of the ADAM metallopeptidase with thrombospondin type 1 motif 5 (ADAMTS5) gene and the risk of knee osteoarthritis (KOA) and its mechanism. Materials and Methods: Sanger sequencing was used to determine the genotypes of three ADAMTS5 gene SNPs (rs3171407, rs229071, and rs229077) from 310 patients suffering from osteoarthritis of the knee joint (KOA) and 310 healthy controls. The levels of the miRNAs, thsa-miR-103b, hsa-miR-144-3p, and hsa-miR-105-5p in plasma, and the level of ADAMTS5 mRNA in the articular cartilage of 132 patients with KOA were detected by real-time quantitative PCR. Results: The G allele at the rs3171407 locus of the ADAMTS5 gene was demonstrated to be a protective genetic factor for KOA. In addition, the risk of developing KOA was significantly increased in subjects carrying the C allele at the rs229071 locus. The risk of developing KOA in carriers of the G allele at locus rs229077 was 1.49 times greater than those with the A allele. The level of the hsa-miR-144-3p was increased, and the expression level of the ADAMTS5 protein was decreased in carriers of the T allele at the rs229071 locus. In carriers of rs229077 locus A allele the hsa-miR-105-5p level was increased and the expression level of ADAMTS5 protein was decreased. Conclusion: SNPs at the rs3171407, rs229071, and rs229077 loci of the ADAMTS5 gene are related to the risk of OA. The likely mechanism underlying these observations is that these SNPs affect the regulation of ADAMTS5 protein expression through miRNAs; however, this needs to be verified using in vivo models.
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Affiliation(s)
- Kedi Weng
- Department of Orthopedics and Zhejiang Rongjun Hospital, Jiaxing, China
| | - Minjuan Luo
- The Operating Room Department, Zhejiang Rongjun Hospital, Jiaxing, China
| | - Dahai Dong
- Department of Orthopedics, Suichang People's Hospital, Lishui, China
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Louis J, Tiollier E, Lamb A, Bontemps B, Areta J, Bernard T. Retraining and Nutritional Strategy of an Endurance Master Athlete Following Hip Arthroplasty: A Case Study. Front Sports Act Living 2020; 2:9. [PMID: 33345004 PMCID: PMC7739816 DOI: 10.3389/fspor.2020.00009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 01/23/2020] [Indexed: 11/13/2022] Open
Abstract
Retraining and resuming competition following surgery is challenging for athletes due to the prolonged period of reduced physical activity and subsequent alteration of body composition and physical performance. This is even more challenging for master athletes who endure the additional effect of aging. Within this context, the purpose of this study was to evaluate the feasibility and benefits that evidence-based nutritional and training recommendations could have on the time course of reconditioning and retraining following hip arthroplasty in an endurance master triathlete. During 38 weeks (from 6 weeks prior to surgery through to the return to competition in week 32), the athlete was provided with detailed training and nutritional recommendations. Dietary intake (via the remote food photographic method), body composition (via DXA), peak oxygen uptake (VO2peak), peak power output (PPO), cycling efficiency (GE), and energy availability (EA) were assessed 6 weeks pre- and 8, 12, 18, 21, and 25-weeks post-surgery. Training load was quantified (via TRIMP score and energy expenditure) daily during the retraining. Total body mass increased by 8.2 kg (attributable to a 3.5-4.6 kg increase in fat mass and lean mass, respectively) between week -6 and 8 despite a reduction in carbohydrate (CHO) intake post-surgery (<3.0 g/kg body mass/day). This was accompanied with a decrease in VO2peak, PPO, and GE due to a drop in training load. From week 7, the athlete resumed training and was advised to increase gradually CHO intake according to the demands of training. Eventually the athlete was able to return to competition in week 32 with a higher PPO, improved VO2peak, and GE. Throughout retraining, EA was maintained around 30 kcal/kg Lean Body Mass/day, protein intake was high (~2 g/kg/day) while CHO intake was periodized. Such dietary conditions allowed the athlete to maintain and even increase lean mass, which represents a major challenge with aging. Data reported in this study show, for the first time, the conditions required to recover and return to endurance competition following hip surgery.
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Affiliation(s)
- Julien Louis
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Eve Tiollier
- French National Institute of Sport, Expertise and Performance, Sport, Expertise and Performance Lab, Paris, France
| | - Antonia Lamb
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Bastien Bontemps
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom.,Research Unit "Impact of Physical Activity on Health (IAPS N°201723207F) University of Toulon, Toulon, France
| | - Jose Areta
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Thierry Bernard
- Laboratoire Motricité Humaine, Education, Sport, Santé (LAMHESS), Université Côte d'Azur, Nice, France
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20
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Quantifying the biochemical state of knee cartilage in response to running using T1rho magnetic resonance imaging. Sci Rep 2020; 10:1870. [PMID: 32024873 PMCID: PMC7002650 DOI: 10.1038/s41598-020-58573-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 01/16/2020] [Indexed: 12/16/2022] Open
Abstract
Roughly 20% of Americans run annually, yet how this exercise influences knee cartilage health is poorly understood. To address this question, quantitative magnetic resonance imaging (MRI) can be used to infer the biochemical state of cartilage. Specifically, T1rho relaxation times are inversely related to the proteoglycan concentration in cartilage. In this study, T1rho MRI was performed on the dominant knee of eight asymptomatic, male runners before, immediately after, and 24 hours after running 3 and 10 miles. Overall, (mean ± SEM) patellar, tibial, and femoral cartilage T1rho relaxation times significantly decreased immediately after running 3 (65 ± 3 ms to 62 ± 3 ms; p = 0.04) and 10 (69 ± 4 ms to 62 ± 3 ms; p < 0.001) miles. No significant differences between pre-exercise and recovery T1rho values were observed for either distance (3 mile: p = 0.8; 10 mile: p = 0.08). Percent decreases in T1rho relaxation times were significantly larger following 10 mile runs as compared to 3 mile runs (11 ± 1% vs. 4 ± 1%; p = 0.02). This data suggests that alterations to the relative proteoglycan concentration of knee cartilage due to water flow are mitigated within 24 hours of running up to 10 miles. This information may inform safe exercise and recovery protocols in asymptomatic male runners by characterizing running-induced changes in knee cartilage composition.
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Rabelo GD, Vom Scheidt A, Klebig F, Hemmatian H, Citak M, Amling M, Busse B, Jähn K. Multiscale bone quality analysis in osteoarthritic knee joints reveal a role of the mechanosensory osteocyte network in osteophytes. Sci Rep 2020; 10:673. [PMID: 31959806 PMCID: PMC6971279 DOI: 10.1038/s41598-019-57303-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 12/24/2019] [Indexed: 02/06/2023] Open
Abstract
Osteophytes - bony outgrowths on joint structures - are found in healthy individuals but are specifically present in late osteoarthritis (OA). Osteophyte development and function is not well understood, yet biomechanical stimuli are thought to be critical. Bone adapts to mechanical forces via the cellular network of osteocytes. The involvement of osteocytes in osteophyte formation and maturation has not been unravelled. Forty-three osteophytes from tibias of 23 OA patients (65 ± 9 years) were analysed. The trabecular bone structure of osteophytes presented with fewer trabeculae of lower bone mineral density compared to subchondral bone. We identified 40% early stage and 60% late stage osteophytes that significantly differed in their trabecular bone characteristics. Osteophyte bone revealed a higher number of osteocytes and a lower number of empty osteocyte lacunae per bone area than the subchondral bone. We found that OA osteophytes consist of younger bone material comprised of woven and lamellar bone with the capacity to develop into a late stage osteophyte potentially via the involvement of the osteocyte network. Our analysis of OA osteophytes implies a transition from woven to lamellar bone as in physiological bone growth within a pathological joint. Therefore, osteophyte development and growth present a valuable research subject when aiming to investigate the osteogenic signalling cascade.
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Affiliation(s)
- Gustavo Davi Rabelo
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Annika Vom Scheidt
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Haniyeh Hemmatian
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Michael Amling
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Björn Busse
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Katharina Jähn
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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Gessel T, Harrast MA. Running Dose and Risk of Developing Lower-Extremity Osteoarthritis. Curr Sports Med Rep 2019; 18:201-209. [PMID: 31385835 DOI: 10.1249/jsr.0000000000000602] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Whether or not running leads to the development of knee and hip osteoarthritis has been a much-debated topic and is often a question patients pose to their physicians. Recent literature adds to a growing body of evidence suggesting that lower-dose running may be protective against the development of osteoarthritis, whereas higher-dose running may increase one's risk of developing lower-extremity osteoarthritis. However, running dose remains challenging to define, leading to difficulty in providing firm recommendations to patients regarding the degree of running which may be safe. Furthermore, when counseling patients regarding their risk of developing lower-extremity osteoarthritis secondary to running, clinicians must consider many additional factors, such as the numerous health benefits from running and individual risk factors for developing osteoarthritis.
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Affiliation(s)
- Trevor Gessel
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA
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Takiguchi R, Komatsu R, Kitamura K, Watanabe Y, Takahashi A, Kobayashi R, Oshiki R, Saito T, Kabasawa K, Takachi R, Tsugane S, Iki M, Sasaki A, Yamazaki O, Nakamura K. Modifiable factors associated with symptomatic knee osteoarthritis: The Murakami cohort study. Maturitas 2019; 128:53-59. [PMID: 31561824 DOI: 10.1016/j.maturitas.2019.06.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 03/08/2019] [Accepted: 06/29/2019] [Indexed: 01/19/2023]
Abstract
OBJECTIVES Modifiable risk factors for knee osteoarthritis (OA) have not been studied in detail. This study aimed to determine lifestyle-related modifiable factors of symptomatic knee osteoarthritis in an East Asian population. STUDY DESIGN This 5-year cohort study involved 11,091 individuals (age range 40-72 years) living in the Murakami region of Niigata, Japan, who did not have a history of knee OA. At baseline, information on sociodemographic characteristics, body size, lifestyle, and living condition was obtained using a self-administered questionnaire. MAIN OUTCOME MEASURES Incident symptomatic knee OA observed at hospitals and orthopaedic clinics in the five years to 2016. Clinical grades of knee OA were based on the Kellgren-Lawrence scale. P for trend was assessed to examine linear associations between predictors and the outcome in multiple logistic regression analysis. RESULTS The mean age of participants was 58.1 (SD 9.3) years. The number of cases of grade 2 or more incident knee OA was 429. In men, older age (P for trend < 0.0001), higher BMI (P for trend < 0.0001), higher METs score (P for trend = 0.0150), less smoking (P for trend = 0.0249), and lower green tea consumption (P for trend = 0.0437) were associated with incident knee OA. In women, older age (P for trend < 0.0001), higher BMI (P for trend < 0.0001), and alcohol consumption (P = 0.0153) were associated with incident knee OA. CONCLUSIONS Several lifestyle-related factors were found to be associated with incident knee OA and exhibited sex-dependent differences. In particular, higher consumption of green tea was associated with a lower incidence of knee OA in men.
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Affiliation(s)
| | | | - Kaori Kitamura
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yumi Watanabe
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Akemi Takahashi
- Department of Rehabilitation, Niigata University of Rehabilitation, Niigata, Japan
| | - Ryosaku Kobayashi
- Department of Rehabilitation, Niigata University of Rehabilitation, Niigata, Japan; Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Rieko Oshiki
- Department of Rehabilitation, Niigata University of Rehabilitation, Niigata, Japan
| | - Toshiko Saito
- Department of Health and Nutrition, Niigata University of Health and Welfare, Niigata, Japan
| | - Keiko Kabasawa
- Department of Health Promotion Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Ribeka Takachi
- Department of Food Science and Nutrition, Nara Women's University Graduate School of Humanities and Sciences, Nara, Japan
| | - Shoichiro Tsugane
- Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Masayuki Iki
- Department of Public Health, Kindai University Faculty of Medicine, Osaka, Japan
| | | | | | - Kazutoshi Nakamura
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
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Mahmoudian A, Van Assche D, Herzog W, Luyten FP. Towards secondary prevention of early knee osteoarthritis. RMD Open 2018; 4:e000468. [PMID: 30167325 PMCID: PMC6109947 DOI: 10.1136/rmdopen-2017-000468] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 06/15/2018] [Accepted: 06/21/2018] [Indexed: 01/09/2023] Open
Abstract
Osteoarthritis (OA) of the knee is the most common arthritic disease, yet a convincing drug treatment is not available. The current narrative review focuses on integration of scientific evidence and professional experience to illustrate which management approaches can be taken for prototypical individual patient profiles with early knee OA. Animal models suggest that: (1) OA can progress even in the presence of fully recovered movement kinetics, kinematics and muscle activation patterns; (2) muscle weakness is an independent risk factor for the onset and possibly the rate of progression of knee OA; (3) onset and progression of OA are not related to body weight but appear to depend on the percentage of body fat. From studies in the human model, one could postulate that risk factors associated with progression of knee OA include genetic traits, preceding traumatic events, obesity, intensity of pain at baseline, static and dynamic joint malalignment and reduced muscle strength. Taken this into account, an individual can be identified as early knee OA at high risk for disease progression. A holistic patient-tailored management including education, supportive medication, weight loss, exercise therapy (aerobic, strengthening and neuromuscular) and behavioural approaches to improve self-management of early knee OA is discussed in individual prototypic patients. Secondary prevention of early knee OA provides a window of opportunity to slow down or even reverse the disease process. Yet, as the sheer number of patients early in the OA disease process is probably large, a more structured approach is needed to provide appropriate care depending on the patient's individual risk profile.
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Affiliation(s)
- Armaghan Mahmoudian
- Skeletal Biology & Engineering Research Center, Department of Development & Regeneration, KU Leuven, Leuven, Belgium
| | - Dieter Van Assche
- Skeletal Biology & Engineering Research Center, Department of Development & Regeneration, KU Leuven, Leuven, Belgium
| | - Walter Herzog
- Human Performance Laboratory, The University of Calgary, Calgary, Alberta, Canada
| | - Frank P Luyten
- Skeletal Biology & Engineering Research Center, Department of Development & Regeneration, KU Leuven, Leuven, Belgium
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The Association of Recreational and Competitive Running With Hip and Knee Osteoarthritis: A Systematic Review and Meta-analysis. J Orthop Sports Phys Ther 2017; 47:373-390. [PMID: 28504066 DOI: 10.2519/jospt.2017.7137] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Study Design Systematic review and meta-analysis. Background Running is a healthy and popular activity worldwide, but data regarding its association with osteoarthritis (OA) are conflicting. Objectives To evaluate the association of hip and knee OA with running and to explore the influence of running intensity on this association. Methods PubMed, Embase, and Cochrane Library databases were used to identify studies investigating the occurrence of OA of the hip and/or knee among runners. A meta-analysis of studies comparing this occurrence between runners and controls (sedentary, nonrunning individuals) was conducted. Runners were regarded as "competitive" if they were reported as professional/elite athletes or participated in international competitions. Recreational runners were individuals running in a nonprofessional (amateur) context. The prevalence rate and odds ratio (with 95% confidence interval [CI]) for OA between runners (at competitive and recreational levels) and controls were calculated. Subgroup analyses were conducted for OA location (hip or knee), sex, and years of exposure to running (less or more than 15 years). Results Twenty-five studies (n = 125810 individuals) were included and 17 (n = 114829 individuals) were meta-analyzed. The overall prevalence of hip and knee OA was 13.3% (95% CI: 11.6%, 15.2%) in competitive runners, 3.5% (95% CI: 3.4%, 3.6%) in recreational runners, and 10.2% (95% CI: 9.9%, 10.6%) in controls. The odds ratio for hip and/or knee OA in competitive runners was higher than that in recreational runners (1.34; 95% CI: 0.97, 1.86 and 0.86; 95% CI: 0.69, 1.07, respectively; controls as reference group; for difference, P<.001). Exposure to running of less than 15 years was associated with a lower association with hip and/or knee OA compared with controls (OR = 0.6; 95% CI: 0.49, 0.73). Conclusion Recreational runners had a lower occurrence of OA compared with competitive runners and controls. These results indicated that a more sedentary lifestyle or long exposure to high-volume and/or high-intensity running are both associated with hip and/or knee OA. However, it was not possible to determine whether these associations were causative or confounded by other risk factors, such as previous injury. Level of Evidence Etiology/harm, level 2a. J Orthop Sports Phys Ther 2017;47(6):373-390. doi:10.2519/jospt.2017.7137.
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