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Resch T, Szymski D, Hartz F, Zehnder P, Römmermann G, Angele P. Open-wedge high tibial osteotomy with and without bone void filler: Allograft leads to faster bone union and weight bearing with comparable return to work and sports rates. Knee Surg Sports Traumatol Arthrosc 2024; 32:1785-1797. [PMID: 38666752 DOI: 10.1002/ksa.12213] [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: 02/27/2024] [Revised: 04/11/2024] [Accepted: 04/15/2024] [Indexed: 07/22/2024]
Abstract
PURPOSE To compare the clinical and radiological outcome of open-wedge high tibial osteotomy (OWHTO) with allogenous bone chips to a control group without bone void filler. The focus was on the rates and timelines of return to work (RTW) and return to sports (RTS), given the significance of these factors for the satisfaction of young and active patients. METHODS One hundred and ninety-five cases of OWHTO (112 cases with allograft vs. 83 cases without graft) with a follow-up of 17 ± 4.8 months were included in this retrospective analysis. Various metrics were investigated, including time to return to full weight bearing, RTW and RTS rates and timelines, International Knee Documentation Committee (IKDC) Score, Cincinnati-Sportsmedicine and Orthopaedic Centre Score and Tegner Score. The time to bone union was determined on radiographs taken at 6, 16, 28 and 53 weeks. RESULTS Patients returned to full weight bearing after 8.8 ± 4.8 weeks. RTW was possible for 92.8% after 13.7 ± 12.3 weeks. 96.2% returned to sports after 22.7 ± 8.3 weeks, but the number of disciplines and workouts per week diminished (p < 0.001, p = 0.006). A shift to low-impact and recreational sports was observed. Patients with allograft filling had earlier bone union (21 ± 12.3 vs. 31.9 ± 14.2 weeks, p < 0.001) and returned faster to full weight bearing (8.2 ± 4.5 vs. 9.8 ± 5 weeks, p = 0.013). There was no difference between groups in the IKDC Score (69 ± 17.2 vs. 69.9 ± 15.2, p = 0.834), Cincinnati-Sportsmedicine and Orthopaedic Centre Score (68 ± 18.3 vs. 69.4 ± 18.2, p = 0.698) and Tegner Score (3.8 ± 1.5 vs. 4 ± 1.5, p = 0.246). CONCLUSION Allograft filling leads to faster bone union and return to full weight bearing but showed no significant advantage in terms of RTW/RTS, overall patient satisfaction and functional scores. The decision for or against filling the osteotomy gap, therefore, remains a case-by-case decision. LEVEL OF EVIDENCE Level III, Retrospective cohort study.
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Affiliation(s)
- Tobias Resch
- Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany
- Department of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Dominik Szymski
- Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany
- FIFA Medical Centre of Excellence, University Medical Centre Regensburg, Regensburg, Germany
| | - Frederik Hartz
- Department of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Philipp Zehnder
- Department of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Gregor Römmermann
- Department of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Peter Angele
- Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany
- FIFA Medical Centre of Excellence, University Medical Centre Regensburg, Regensburg, Germany
- Sporthopaedicum Regensburg, Regensburg, Germany
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Sundstrup E, Seeberg KGV, Dyreborg J, Clausen T, Andersen LL. Systematic Review of Workplace Interventions to Support Young Workers' Safety, Work Environment and Health. JOURNAL OF OCCUPATIONAL REHABILITATION 2024:10.1007/s10926-024-10186-y. [PMID: 38689184 DOI: 10.1007/s10926-024-10186-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/23/2024] [Indexed: 05/02/2024]
Abstract
PURPOSE This systematic review investigates the effectiveness of workplace interventions to support young workers' work environment, safety and health. METHODS A systematic search was conducted in bibliographic databases including PubMed, Web of Science Core Collection and PsycInfo for English or Scandinavian articles published from 2007 to 2022. The PICO strategy guided the assessment of study relevance and the bibliographical search for randomized controlled trials (RCTs) and non-RCTs in which (1) participants were young workers (mean age: 15-29), (2) interventions were initiated and/or carried out at the workplace, (3) a comparison group was included, and (4) an outcome measure related to work environment, safety and health was reported. We categorized each included study using the intervention classification framework. The quality assessment and evidence synthesis adhered to the guidelines developed by the Institute for Work & Health (Toronto, Canada). RESULTS A total of 33 high and medium quality studies showed a moderate level of evidence for no benefit of 'Mental training' on stress. We found limited evidence of a positive effect of the following intervention types: 'Attitude and belief' on mental health problems, 'Behavior based' on anxiety, and 'Multifaceted' on hand eczema. We found limited evidence for no benefit of the following intervention types: 'Mental training' on mental health problems, and 'Physiological modifications' on musculoskeletal disorders. The remaining intervention types showed mixed or insufficient evidence. CONCLUSIONS Except for a moderate level of evidence for no benefit of 'Mental training' on stress, the evidence synthesis recommends, that there is not enough evidence from the scientific literature to guide current practices. The results emphasizes a strong need for high quality interventions specifically aiming at increasing or maintaining young workers' work environment, safety and health. Included studies focused mainly on individual measures, highlighting the need for studies investigating possible preventive measures at the group or organizational level.
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Affiliation(s)
- Emil Sundstrup
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark.
| | | | - Johnny Dyreborg
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark
| | - Thomas Clausen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark
| | - Lars Louis Andersen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark
- Department of Health Science and Technology, Aalborg University, 9220, Aalborg, Denmark
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van Zaanen Y, Siertsema T, Kievit AJ, van Geenen RCI, Pahlplatz TMJ, Hoozemans MJM, Blankevoort L, Schafroth MU, Haverkamp D, Vervest TMJS, Das DHPW, Scholtes VA, Kuijer PPFM. Only Low Patients' Expectations Are Prognostic for Dissatisfaction With Performing Work-Related Knee-Straining Activities After Total Knee Arthroplasty: A Prospective Multicenter Cohort Study. Arch Phys Med Rehabil 2023; 104:2051-2058. [PMID: 37270023 DOI: 10.1016/j.apmr.2023.05.004] [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: 12/27/2022] [Revised: 05/11/2023] [Accepted: 05/18/2023] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To investigate whether preoperative expectations regarding performing work-related knee-straining activities were associated with being dissatisfied 6 months after total knee arthroplasty (TKA) among working patients, and, to identify prognostic factors for being dissatisfied with performing these work-related knee-straining activities. DESIGN Multicenter prospective cohort study. SETTING Orthopedic surgery departments of 7 hospitals in the Netherlands. PARTICIPANTS A consecutive sample of 175 working patients who were on the waiting list for TKA (median age 59 years, 53% women) and intended to return to work (N=175). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE(S) Dissatisfaction with performing work-related knee-straining activities 6 months postoperative was measured using the Work Osteoarthritis or joint-Replacement Questionnaire (score range 0-100). The clinically relevant cut-off points for being satisfied and dissatisfied were ≥71 and ≤50, respectively. RESULTS Thirty-three patients (19%) were dissatisfied with performing work-related knee-straining activities 6 months after TKA. Patients who expected to be dissatisfied preoperative had a 5.1 times higher odds (95% CI 1.7-15.5) of being dissatisfied 6 months postoperatively compared with patients who expected to be satisfied preoperative. Regression analyses revealed that only patients' expectations were prognostic for being dissatisfied 6 months postoperatively rather than age, pain level, or having a knee-straining job. CONCLUSIONS Two in 10 working patients are dissatisfied with performing work-related knee-straining activities 6 months after TKA. Only preoperative patients' expectations appeared prognostic. Therefore, we should better prepare working patients with low expectations by managing their preoperative expectations and improving their performance of work-related knee-straining activities in rehabilitation.
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Affiliation(s)
- Yvonne van Zaanen
- Amsterdam UMC, University of Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam Movement Sciences, Amsterdam, Netherlands.
| | - Tessa Siertsema
- Amsterdam UMC, University of Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Arthur J Kievit
- Amsterdam UMC, University of Amsterdam, Orthopaedic Research Center Amsterdam, Amsterdam, Netherlands
| | | | - Thijs M J Pahlplatz
- Amsterdam UMC, University of Amsterdam, Orthopaedic Research Center Amsterdam, Amsterdam, Netherlands
| | - Marco J M Hoozemans
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Leendert Blankevoort
- Amsterdam UMC, University of Amsterdam, Orthopaedic Research Center Amsterdam, Amsterdam, Netherlands
| | - Matthias U Schafroth
- Amsterdam UMC, University of Amsterdam, Orthopaedic Research Center Amsterdam, Amsterdam, Netherlands
| | | | - Ton M J S Vervest
- Department of Orthopaedic Surgery, Tergooi Hospital, Hilversum, Netherlands
| | - Dirk H P W Das
- Department and Research Center of Orthopaedic Surgery, St. Anna Hospital, Geldrop, Netherlands
| | | | - P Paul F M Kuijer
- Amsterdam UMC, University of Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam Movement Sciences, Amsterdam, Netherlands
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Fujita K, Makimoto K, Tabuchi Y, Matsunaga-Myoji Y, Mawatari M. Oxford Hip Scores, Floor-Sitting Score Trajectories, and Postoperative Satisfaction Rates at 10 Years After Primary Total Hip Arthroplasty. J Arthroplasty 2023; 38:2673-2679. [PMID: 37321523 DOI: 10.1016/j.arth.2023.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 06/06/2023] [Accepted: 06/07/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND Available evidence on outcomes at 5 years and beyond for total hip arthroplasty (THA) is mainly limited to patient-reported outcome measures (PROMs). This study documented the trajectory of functional measurement using the Oxford hip score (OHS) and floor-sitting posture in Japan for up to 10 years post-THA and investigated predictors of dissatisfaction at 10 years with THA. METHODS Patients scheduled for primary THA at a university hospital in Japan between 2003 and 2006 were enrolled in this prospective study. Overall, 826 preoperative participants were eligible for follow-up, with response rates ranging from 93.6% to 69.4% at each postoperative survey point. The OHS and floor-sitting scores were calculated using a self-administered questionnaire 6 times up to 10 years postoperatively. Patient satisfaction, including general surgery, walking ability, and activities of daily living (ADL), was assessed in the 10-year survey. RESULTS The linear mixed-effects model demonstrated a postoperative improvement, peaking at 7 years for OHS and 5 years earlier for the floor-sitting score. The postoperative overall surgical dissatisfaction at 10 years with THA was very low (3.2%). No predictors of surgical dissatisfaction were identified in the logistic regression analyses. Predictors of walking ability dissatisfaction were older age, men, and worse OHS at 1 year postoperatively. Predictors of ADL dissatisfaction were poorer preoperative and 1-year postoperative floor-sitting scores and 1-year postoperative OHS. CONCLUSION The floor-sitting score is a simple PROM suitable for the Japanese population; other populations would require a scale suitable for their lifestyles.
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Affiliation(s)
- Kimie Fujita
- Department of Health Sciences, Kyushu University, Fukuoka, Japan
| | - Kiyoko Makimoto
- Department of Health Sciences, Osaka University, Osaka, Japan
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Tjøsvoll SO, Steiro Fimland M, Gonzalez V, Seeberg TM, Holtermann A, Færevik H, Wiggen Ø. Physical Work Demands of Maintenance Workers on Onshore Petroleum Facilities in Norway: An Observational Study Utilizing Wearable Sensor Technology. Ann Work Expo Health 2023; 67:706-719. [PMID: 37171985 PMCID: PMC10324642 DOI: 10.1093/annweh/wxad022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 04/05/2023] [Indexed: 05/14/2023] Open
Abstract
OBJECTIVES High physical work demands can cause musculoskeletal disorders and sick leave in petroleum workers. However, our knowledge of their physical work demands is scarce and based on self-report. The objective of our study is to work towards closing this knowledge gap by assessing the physical work demands of onshore petroleum maintenance workers using body-worn sensors. METHODS A total of 46 of 69 eligible maintenance workers (37 mechanics and 9 process technicians) from three onshore petroleum facilities in Norway filled in a questionnaire and diary and wore five accelerometers and a heart rate sensor for up to six consecutive workdays. Work-related physical activity and postures were classified using rule-based modelling in a modified version of the validated Acti4 software. RESULTS The onshore maintenance petroleum workers were working an average of 10 h a day and spent on average this time with 48% (SD = 16.5) sitting, 1% (SD = 2.8) lying down, 39% (SD = 16.2) in light physical activity, and 9% (SD = 3.8) in moderate to vigorous physical activity. During work hours while at feet, we found arm elevation ≥60° to be 11% (SD = 7.1) (68 min), and forward bending of the trunk ≥60° to be 2% (SD = 2.2) (14 min). The workers spent 2% (SD = 2.5) (12 minu) of the workhours kneeling. We observed a high inter-individual variation for all these work exposures. Moreover, 26% (12) of the workers conducted static standing for >30% of the workday, and 17% (8) spent more than half of the work hours >33% of their estimated maximal cardiovascular capacity. CONCLUSIONS While onshore maintenance petroleum workers on average spend about half of the workday sitting or lying down, the remaining worktime is spent with a rather high duration of arm elevation and forward bending. Quite high fraction of the workers spends much of the workhours in static standing and kneeling. We see a substantial variation in these work exposures between the workers. The findings indicate a need for preventive measures in how work is organized and performed.
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Affiliation(s)
- Svein O Tjøsvoll
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU Norwegian University of Science and Technology, Edvard Griegs gate 8, Trondheim N-7491, Norway
| | - Marius Steiro Fimland
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU Norwegian University of Science and Technology, Edvard Griegs gate 8, Trondheim N-7491, Norway
- Unicare Helsefort Rehabilitation Centre, Rissa, Hysnesveien 11, 7112 Hasselvika, Norway
| | - Victor Gonzalez
- Department of Smart Sensor and Microsystems, SINTEF Digital, SINTEF AS, Dept. of Health Research, P.O. Box 124 Blindern, NO-0314 Oslo, Norway
| | - Trine M Seeberg
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU Norwegian University of Science and Technology, Edvard Griegs gate 8, Trondheim N-7491, Norway
- Department of Smart Sensor and Microsystems, SINTEF Digital, SINTEF AS, Dept. of Health Research, P.O. Box 124 Blindern, NO-0314 Oslo, Norway
| | - Andreas Holtermann
- Department of Musculoskeletal Disorders and Physical Workload, National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen, Denmark
| | - Hilde Færevik
- Department of Health Research, SINTEF Digital, SINTEF AS, P.O. Box 4760 Torgaarden, NO-7465 Trondheim, Norway
| | - Øystein Wiggen
- Department of Health Research, SINTEF Digital, SINTEF AS, P.O. Box 4760 Torgaarden, NO-7465 Trondheim, Norway
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Kothurkar R, Lekurwale R, Gad M, Rathod CM. Finite element analysis of a healthy knee joint at deep squatting for the study of tibiofemoral and patellofemoral contact. J Orthop 2023; 40:7-16. [PMID: 37143926 PMCID: PMC10151221 DOI: 10.1016/j.jor.2023.04.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/20/2023] [Accepted: 04/20/2023] [Indexed: 05/06/2023] Open
Abstract
Background In non-western countries, deep squatting is a daily activity, and prolonged deep squatting is common among occupational squatters. Household tasks, taking a bath, socializing, using toilets, and performing religious acts are among the activities frequently carried out while squatting by the Asian population. High knee loading is responsible for a knee injury and osteoarthritis. Finite element analysis is an effective tool to determine stresses on the knee joint. Methods Magnetic Resonance Imaging (MRI) and Computed Tomographic (CT) images were acquired of one adult without knee injuries. The CT images were acquired at the fully extended knee and one more set of images was acquired with the knee at a deeply flexed knee position. The MRI was acquired with the fully extended knee. 3-Dimensional models of bones were created using CT and soft tissue using MRI with the help of 3D Slicer software. Kinematics and finite element analysis of the knee was performed for standing and deep squatting posture using Ansys Workbench 2022. Results High peak stresses were observed at deep squatting compared to standing along with the reduction in the contact area. Peak von Mises stresses on femoral cartilage, tibial cartilage, patellar cartilage, and meniscus were increased from 3.3 MPa to 19.9 MPa, 2.9 MPa to 12.4 MPa, 1.5 MPa to 16.7 MPa and 15.8 MPa to 32.8 MPa respectively during deep squatting. Posterior translation of 7.01 mm, and 12.58 mm was observed for medial and lateral femoral condyle respectively from full extension to 153° knee flexion. Conclusions Increased stresses in the knee joint at deep squat posture may cause cartilage damage. A sustained deep squat posture should be avoided for healthy knee joints. More posterior translations of the medial femoral condyle at higher knee flexion angle warrant further investigation.
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Affiliation(s)
- Rohan Kothurkar
- Department of Mechanical Engineering, K. J. Somaiya College of Engineering, Mumbai, India
| | - Ramesh Lekurwale
- Department of Mechanical Engineering, K. J. Somaiya College of Engineering, Mumbai, India
| | - Mayuri Gad
- St. Xavier's Gait Lab, Xavier Institute of Engineering, Mumbai, India
| | - Chasanal M. Rathod
- St. Xavier's Gait Lab, Xavier Institute of Engineering, Mumbai, India
- Department of Orthopaedics, SRCC Children's Hospital, Haji Ali, Mumbai, India
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van Zaanen Y, Kievit AJ, van Geenen RCI, Pahlplatz TMJ, Hoozemans MJM, Blankevoort L, Schafroth MU, Haverkamp D, Vervest TMJS, Das DHPW, Scholtes VA, van der Beek AJ, Kuijer PPFM. Does Consulting an Occupational Medicine Specialist Decrease Time to Return to Work Among Total Knee Arthroplasty Patients? A 12-Month Prospective Multicenter Cohort Study. JOURNAL OF OCCUPATIONAL REHABILITATION 2023; 33:267-276. [PMID: 36083360 PMCID: PMC10172284 DOI: 10.1007/s10926-022-10068-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/17/2022] [Indexed: 05/12/2023]
Abstract
PURPOSE The aim of this study is to investigate whether total knee arthroplasty (TKA) patients who consulted an occupational medicine specialist (OMS) within 3 months after surgery, return to work (RTW) earlier than patients who did not consult an OMS. METHODS A multi-center prospective cohort study was performed among working TKA patients, aged 18 to 65 years and intending to RTW. Time to RTW was analyzed using Kaplan Meier and Mann Whitney U (MWU), and multiple linear regression analysis was used to adjust for effect modification and confounding. RESULTS One hundred and eighty-two (182) patients were included with a median age of 59 years [IQR 54-62], including 95 women (52%). Patients who consulted an OMS were less often self-employed but did not differ on other patient and work-related characteristics. TKA patients who consulted an OMS returned to work later than those who did not (median 78 versus 62 days, MWU p < 0.01). The effect of consulting an OMS on time to RTW was modified by patients' expectations in linear regression analysis (p = 0.05). A median decrease in time of 24 days was found in TKA patients with preoperative high expectations not consulting an OMS (p = 0.03), not in patients with low expectations. CONCLUSIONS Consulting an OMS within 3 months after surgery did not result in a decrease in time to RTW in TKA patients. TKA patients with high expectations did RTW earlier without consulting an OMS. Intervention studies on how OMSs can positively influence a timely RTW, incorporating patients' preoperative expectations, are needed.
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Affiliation(s)
- Y van Zaanen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Location AMC, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands.
| | - A J Kievit
- Orthopaedic Research Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - R C I van Geenen
- Department of Orthopaedic Surgery, Amphia Hospital, Breda, Netherlands
| | - T M J Pahlplatz
- Orthopaedic Research Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - M J M Hoozemans
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - L Blankevoort
- Orthopaedic Research Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - M U Schafroth
- Orthopaedic Research Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | | | - T M J S Vervest
- Department of Orthopaedic Surgery, Tergooi Hospital, Hilversum, Netherlands
| | - D H P W Das
- Department and Research Center of Orthopaedic Surgery, St. Anna Hospital, Geldrop, Netherlands
| | - V A Scholtes
- Joint Research Orthopedic Surgery, OLVG+, Amsterdam, Netherlands
| | - A J van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - P P F M Kuijer
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Location AMC, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands
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Velasco Castro JC, Nossa Rodriguez PM, Osma García NS, Vargas Rodríguez L, Cely Castro LB. Factores de riesgo asociados a la artrosis de rodilla: Revisión sistemática de la literatura. REPERTORIO DE MEDICINA Y CIRUGÍA 2023. [DOI: 10.31260/repertmedcir.01217372.1371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023] Open
Abstract
Introducción: la osteoartritis de rodilla (OR) se define como una enfermedad crónica, inflamatoria, degenerativa y progresiva, caracterizada por el deterioro del cartílago articular. Tiene manifestaciones clínicas y etiológicas diferentes según el grupo etario y se encuentra asociada con múltiples factores que intervienen en la fisiopatología, entre los que están: edad, raza, sexo, sobrepeso, obesidad y síndrome metabólico. Objetivo: determinar los factores de riesgo que influyen en el proceso degenerativo de la OR en la adultez temprana y tardía. Materiales y métodos: revisión sistemática de la literatura científica en diferentes bases de datos que incluyeron estudios de cohorte, transversales, casos y controles, evaluando los factores de riesgo predisponentes. Resultados: se seleccionaron 50 artículos que cumplieron con los criterios, identificando diferentes factores que afectan el desarrollo o progresión de la OR como las alteraciones metabólicas, sistémicas y estilo de vida que influyen en esta patología, además de factores modificables y no modificables. Conclusión: la OR es una afección de carácter multifactorial, donde la obesidad, la hipertensión arterial (HTA), el índice de masa corporal (IMC) elevado, los niveles altos de LDL, la debilidad muscular e incluso la profesión del paciente, son los principales factores predisponentes para desarrollar o aumentar su progresión.
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Kuijer PPFM, van der Molen HF, Visser S. A Health-Impact Assessment of an Ergonomic Measure to Reduce the Risk of Work-Related Lower Back Pain, Lumbosacral Radicular Syndrome and Knee Osteoarthritis among Floor Layers in The Netherlands. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4672. [PMID: 36901682 PMCID: PMC10001867 DOI: 10.3390/ijerph20054672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/01/2023] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
Sand-cement-bound screed floor layers are at risk of work-related lower back pain, lumbosacral radicular syndrome and knee osteoarthritis, given their working technique of levelling screed with their trunk bent while mainly supported by their hands and knees. To reduce the physical demands of bending of the trunk and kneeling, a manually movable screed-levelling machine was developed for floor layers in the Netherlands. The aim of this paper is to estimate the potential health gains of working with a manually movable screed-levelling machine on the risk of lower back pain (LBP), lumbosacral radicular syndrome (LRS) and knee osteoarthritis (KOA) compared to traditional working techniques. This potential health gain was assessed using the epidemiological population estimates of the Population Attributable Fraction (PAF) and the Potential Impact Fraction (PIF), combined with work-related risk estimates for these three disorders from systematic reviews. The percentage of workers exceeding these risk estimates was based on worksite observations among 28 floor layers. For LBP, 16/18 workers were at risk when using traditional working techniques, with a PAF = 38%, and for those using a manually movable screed-levelling machine, this was 6/10 with a PIF = 13%. For LRS, these data were 16/18 with a PAF = 55% and 14/18 with a PIF = 18%, and for KOA, 8/10 with a PAF = 35% and 2/10 with a PIF = 26%. A manually movable screed-levelling machine might have a significant impact on the prevention of LBP, LRS and KOA among floor layers in the Netherlands, and health-impact assessments are a feasible approach for assessing health gains in an efficient way.
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What Personal and Work-Related Characteristics of Dutch Construction Workers With Knee Osteoarthritis Are Associated With Future Work Ability? J Occup Environ Med 2023; 65:271-276. [PMID: 36240753 PMCID: PMC9988233 DOI: 10.1097/jom.0000000000002730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To assess personal and work-related characteristics of construction workers with knee osteoarthritis (KO) associated with their ability to perform their current profession in the following 2 years. METHODS A cross-sectional study was performed among Dutch construction workers diagnosed with KO using data from the Worker Health Surveillance. Logistic regression was used to assess the characteristics associated with future work ability. RESULTS On the basis of 344 construction workers with KO, being able to perform their current profession in 2 years' time was associated with working weekly 36 to 45 hours (odds ratio [OR], 3.0 to 6.3), performing high-intensity exercises 1 to 2 times weekly (OR, 2.0 to 2.6), being younger than 56 years (OR, 0.2 to 0.3), and not performing strenuous work activities such as lifting and kneeling (OR, 0.4 to 0.5). CONCLUSIONS To keep construction workers with KO at work, intervention studies should evaluate the effects of reducing strenuous work activities and promote leisure-time exercise.
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Kirby JC, Whitehead TS, Webster KE, Feller JA, McClelland JA, Klemm HJ, Devitt BM. Impact of Occupation on 12-Month Outcomes After Anterior Cruciate Ligament Reconstruction in Male Patients. Orthop J Sports Med 2023; 11:23259671221130377. [PMID: 36846817 PMCID: PMC9950609 DOI: 10.1177/23259671221130377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 08/07/2022] [Indexed: 02/25/2023] Open
Abstract
Background The impact of a physically demanding occupation on clinical outcomes after anterior cruciate ligament (ACL) reconstruction (ACLR) is largely unknown. Purpose/Hypothesis The purpose of this study was to assess the influence of occupation on 12-month outcomes after ACLR in male patients. It was hypothesized that patients undertaking manual work would not only have better functional outcomes in terms of strength and range of motion but also higher rates of joint effusion and greater anterior knee laxity. Study Design Cohort study; Level of evidence, 3. Methods From an initial cohort of 1829 patients, we identified 372 eligible patients aged 18 to 30 years who underwent primary ACLR between 2014 and 2017. Based on a preoperative self-assessment, 2 groups were established: patients engaged in heavy manual occupations and those engaged in low-impact occupations. Data were collected from a prospective database including effusion, knee range of motion (using side-to-side difference), anterior knee laxity, limb symmetry index for single hop and triple hop, International Knee Documentation Committee (IKDC) subjective score, and complications up to 12 months. Because of the significantly lower rate of female patients undertaking heavy manual occupations compared to low-impact occupations (12.5% and 40.0%, respectively), data analysis was focused on male patients. Outcome variables were assessed for normality, and statistical comparisons were made between the heavy manual and low-impact groups using either an independent-samples t test or the Mann-Whitney U test. Results Of 230 male patients, 98 were included in the heavy manual occupation group, and 132 were included in the low-impact occupation group. Patients in the heavy manual occupation group were significantly younger than those in the low-impact occupation group (mean age, 24.1 vs 25.9 years, respectively; P < .005). There was a greater range of active and passive knee flexion in the heavy manual occupation group than in the low-impact occupation group (mean active, 3.38° vs 5.33°, respectively [P = .021]; mean passive, 2.76° vs 5.00°, respectively [P = .005]). There was no difference in effusion, anterior knee laxity, limb symmetry index, IKDC score, return-to-sport rate, or graft rupture rate at 12 months. Conclusion At 12 months after primary ACLR, male patients engaged in heavy manual occupations had a greater range of knee flexion, with no difference in the effusion rate or anterior knee laxity, compared with those engaged in low-impact occupations.
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Affiliation(s)
| | - Timothy S. Whitehead
- OrthoSport Victoria, Richmond, Victoria, Australia.,Timothy S. Whitehead, MBBS(Hons), OrthoSport Victoria, 89 Bridge
Road, Richmond, VIC 3121, Australia (
)
| | - Kate E. Webster
- School of Allied Health, Human Services and Sport, La Trobe
University, Melbourne, Victoria, Australia
| | - Julian A. Feller
- OrthoSport Victoria, Richmond, Victoria, Australia.,School of Allied Health, Human Services and Sport, La Trobe
University, Melbourne, Victoria, Australia
| | - Jodie A. McClelland
- School of Allied Health, Human Services and Sport, La Trobe
University, Melbourne, Victoria, Australia
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van de Wijdeven B, Visser B, Daams J, Kuijer PP. A first step towards a framework for interventions for individual working practice to prevent work-related musculoskeletal disorders: a scoping review. BMC Musculoskelet Disord 2023; 24:87. [PMID: 36726094 PMCID: PMC9890723 DOI: 10.1186/s12891-023-06155-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 01/10/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Work-related musculoskeletal disorders (WMSDs) are a key topic in occupational health. In the primary prevention of these disorders, interventions to minimize exposure to work-related physical risk factors are widely advocated. Besides interventions aimed at the work organisation and the workplace, interventions are also aimed at the behaviour of workers, the so-called individual working practice (IWP). At the moment, no conceptual framework for interventions for IWP exists. This study is a first step towards such a framework. METHODS A scoping review was carried out starting with a systematic search in Ovid Medline, Ovid Embase, Ovid APA PsycInfo, and Web of Science. Intervention studies aimed at reducing exposure to physical ergonomic risk factors involving the worker were included. The content of these interventions for IWP was extracted and coded in order to arrive at distinguishing and overarching categories of these interventions for IWP. RESULTS More than 12.000 papers were found and 110 intervention studies were included, describing 810 topics for IWP. Eventually eight overarching categories of interventions for IWP were distinguished: (1) Workplace adjustment, (2) Variation, (3) Exercising, (4) Use of aids, (5) Professional skills, (6) Professional manners, (7) Task content & task organisation and (8) Motoric skills. CONCLUSION Eight categories of interventions for IWP are described in the literature. These categories are a starting point for developing and evaluating effective interventions performed by workers to prevent WMSDs. In order to reach consensus on these categories, an international expert consultation is a necessary next step.
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Affiliation(s)
- Bert van de Wijdeven
- grid.7177.60000000084992262Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, K0-116 1105 AZ Amsterdam, The Netherlands
| | - Bart Visser
- grid.431204.00000 0001 0685 7679Centre of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Joost Daams
- grid.7177.60000000084992262Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, K0-116 1105 AZ Amsterdam, The Netherlands
| | - Paul P.F.M. Kuijer
- grid.7177.60000000084992262Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, K0-116 1105 AZ Amsterdam, The Netherlands
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13
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d’Errico A, Fontana D, Sebastiani G, Ardito C. Risk of symptomatic osteoarthritis associated with exposure to ergonomic factors at work in a nationwide Italian survey. Int Arch Occup Environ Health 2023; 96:143-154. [PMID: 35900451 PMCID: PMC9823078 DOI: 10.1007/s00420-022-01912-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 07/08/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The risk of developing osteoarthritis (OA) has been reported to increase with exposure to various ergonomic factors at work, although this finding is still debated in the literature. Aim of this study was to assess the association between prevalence of symptomatic OA and exposure to workplace ergonomic factors assigned through a job-exposures matrix (JEM). METHODS The study population was composed of 24,604 persons of 40-69 years who participated in the National Health Survey 2013 and were employed at that occasion. Exposure to ergonomic factors was assigned to the study population through a JEM constructed from the Italian O*NET database, consisting of 17 physical factors, which were summed and averaged by job title (796 jobs) to obtain a combined exposure index. The outcome was self-reported OA characterized by moderate or severe limitations in daily activities. The relationship between OA prevalence and the combined exposure index in quartiles was examined using robust Poisson regression models adjusted for socio-demographics and potential confounders. RESULTS In the analysis adjusted for age and gender, the risk of OA was increased by approximately 20-30% in the second and third quartiles, and by 80% in the highest exposure quartile, compared to the least exposed, with a risk attenuation by approximately 15-20% controlling for other significant covariates. CONCLUSION Our results support a causal role of exposure to physical factors at work in the development of OA. As OA is associated with a great burden of disability, any effort should be made to reduce workers' exposure to ergonomic factors.
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Affiliation(s)
| | | | | | - Chiara Ardito
- Department of Economics and Statistics "Cognetti de Martiis", University of Turin, Lungo Dora Siena 100A, 10153, Turin, Italy. .,LABORatorio R. Revelli-Centre for Employment Studies, Turin, Italy. .,NETSPAR-Network for Studies on Pensions, Aging and Retirement, Tilburg, The Netherlands.
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14
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Estimation and Comparison of Knee Joint Contact Forces During Heel Contact and Heel Rise Deep Squatting. Indian J Orthop 2022; 57:310-318. [PMID: 36777124 PMCID: PMC9880086 DOI: 10.1007/s43465-022-00798-y] [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: 11/13/2022] [Accepted: 12/08/2022] [Indexed: 12/26/2022]
Abstract
Background Increased knee flexion is required for deep squatting in the daily life of the non-western population as well as in many sports activities. The purpose of this study was to estimate as well as to compare knee joint contact forces during heel contact (HC) and heel rise (HR) deep squatting in 10 healthy young Indian participants. Materials and Methods Kinematic data were captured using a 12-camera Motion Analysis system. Kinetic data were collected using two Kistler force plates. EMG of 6 lower limb muscles was monitored by Noraxon wireless EMG. OpenSim musculoskeletal model was customized to increase the maximum knee flexion capability of the existing model and knee joint contact forces were estimated. Results A significant difference in tibiofemoral (p < 0.001) as well as patellofemoral (p = 0.006) knee joint contact force was observed between HC and HR squatting. The resultant maximum tibiofemoral KJCF was 5.9 (± 0.54) times body weight (BW) and 5.3 (± 0.6) BW for the HC and HR, respectively. The resultant maximum patellofemoral KJCF was 7.8 (± 0.57) BW and 7.1 (± 0.73) BW for the HC and HR, respectively. Conclusion The findings can provide implications for physiotherapists to design rehabilitation exercise protocols, exercise professionals, and the development of high flexion knee implants. Graphical Abstract Supplementary Information The online version contains supplementary material available at 10.1007/s43465-022-00798-y.
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15
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Deltreil G, Tardivel P, Graczyk P, Escobar-Bach M, Descatha A. How to Use Biomechanical Job Exposure Matrices with Job History to Access Work Exposure for Musculoskeletal Disorders? Application of Mathematical Modeling in Severe Knee Pain in the Constances Cohort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16217. [PMID: 36498290 PMCID: PMC9740575 DOI: 10.3390/ijerph192316217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 11/25/2022] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION Musculoskeletal disorders related to work might be caused by the cumulative effect of occupational exposures during working life. We aimed to develop a new model which allows to compare the accuracy of duration of work and intensity/frequency associations in application to severe knee pain. METHODS From the CONSTANCES cohort, 62,620 subjects who were working at inclusion and coded were included in the study. The biomechanical job exposure matrix "JEM Constances" was used to assess the intensity/frequency of heavy lifting and kneeling/squatting at work together with work history to characterize the association between occupational exposure and severe knee pain. An innovative model G was developed and evaluated, allowing to compare the accuracy of duration of work and intensity/frequency associations. RESULTS The mean age was 49 years at inception with 46 percent of women. The G model developed was slightly better than regular models. Among the men subgroup, odds ratios of the highest quartile for the duration and low intensity were not significant for both exposures, whereas intensity/duration were for every duration. Results in women were less interpretable. CONCLUSIONS Though higher duration increased strength of association with severe knee pain, intensity/frequency were important predictors among men. Exposure estimation along working history should have emphasis on such parameters, though other outcomes should be studied and have a focus on women.
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Affiliation(s)
- Guillaume Deltreil
- Univ. Angers, CHU Angers, Univ. Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)—UMRS 1085, SFR ICAT, 49100 Angers, France
- CNRS, LAREMA, SFR MATHSTIC, Université d’Angers, 49100 Angers, France
| | - Patrick Tardivel
- UMR 5584 CNRS, Université de Bourgogne Franche-Comté, 21078 Dijon, France
| | - Piotr Graczyk
- CNRS, LAREMA, SFR MATHSTIC, Université d’Angers, 49100 Angers, France
| | | | - Alexis Descatha
- Univ. Angers, CHU Angers, Univ. Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)—UMRS 1085, SFR ICAT, 49100 Angers, France
- Epidemiology and Prevention, Donald and Barbara Zucker School of Medicine, Hofstra University Northwell Health, Hempstead, NY 11549, USA
- CHU Angers, Centre Antipoison—Centre de Données Cliniques, 49000 Angers, France
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16
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Li M, Zeng Y, Nie Y, Wu Y, Liu Y, Wu L, Shen B. Do Knee-Straining Activities Influence the Subchondral Bone Microarchitecture and Accelerate Knee Osteoarthritis Progression? Am J Phys Med Rehabil 2022; 101:1014-1019. [PMID: 35019873 DOI: 10.1097/phm.0000000000001958] [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: 02/05/2023]
Abstract
BACKGROUND Knee overload was detrimental to knee osteoarthritis subjects. We aim to analyze the association between the subchondral bone microarchitecture sclerosis and typical knee-straining activities. METHODS The frequency of experiencing squatting, kneeling, lifting, and climbing of 481 knee osteoarthritis subjects was investigated. Subchondral bone microarchitecture (bone volume fraction, trabecular thickness, trabecular separation, and trabecular number) was measured by the fast imaging with steady-state free precession magnetic resonance imaging applying trabecular sequencing, at baseline and 12-mo follow-up. Logistic regression was conducted to investigate the relationship between microarchitecture change and each knee-straining activity, adjusted by age, sex, weight, and Kellgren-Lawrence grade. All data were from the Osteoarthritis Initiative. RESULTS Long kneeling was associated with increased bone volume fraction (adjusted odds ratio = 1.16, confidence interval = 1.01-1.33) and trabecular number (adjusted odds ratio = 1.16, confidence interval = 1.02-1.33). Long squatting was associated with a lower risk of increased trabecular separation (adjusted odds ratio = 0.84, confidence interval = 0.71-0.98) and a higher risk of increased trabecular thickness (adjusted odds ratio = 1.29, confidence interval = 1.06-1.55). Long squatting also increased the medial compartment joint width narrowing (-0.21 in squatting group vs -0.03 in no squatting group, P < 0.05). CONCLUSIONS Knee osteoarthritis patients should avoid long squatting and kneeling, and subchondral bone microarchitecture possesses excellent potential as a monitoring indicator in subjects who kneel or squat for long.
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Affiliation(s)
- Mingyang Li
- From the Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
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17
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Werner DM, Golightly YM, Tao M, Post A, Wellsandt E. Environmental Risk Factors for Osteoarthritis: The Impact on Individuals with Knee Joint Injury. Rheum Dis Clin North Am 2022; 48:907-930. [PMID: 36333003 DOI: 10.1016/j.rdc.2022.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Osteoarthritis is a debilitating chronic condition involving joint degeneration, impacting over 300 million people worldwide. This places a high social and economic burden on society. The knee is the most common joint impacted by osteoarthritis. A common cause of osteoarthritis is traumatic joint injury, specifically injury to the anterior cruciate ligament. The purpose of this review is to detail the non-modifiable and modifiable risk factors for osteoarthritis with particular focus on individuals after anterior cruciate ligament injury. After reading this, health care providers will better comprehend the wide variety of factors linked to osteoarthritis.
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Affiliation(s)
- David M Werner
- Office of Graduate Studies, Medical Sciences Interdepartmental Area, University of Nebraska Medical Center, 987815 Nebraska Medical Center, Omaha, NE 68198-7815, USA; Division of Physical Therapy Education, College of Allied Health Professions, University of Nebraska Medical Center, 984420 Nebraska Medical Center, Omaha, NE 68198-4420, USA.
| | - Yvonne M Golightly
- College of Allied Health Professions, University of Nebraska Medical Center, 984035 Nebraska Medical Center Omaha, NE 68198-4035, USA
| | - Matthew Tao
- Division of Physical Therapy Education, College of Allied Health Professions, University of Nebraska Medical Center, 984420 Nebraska Medical Center, Omaha, NE 68198-4420, USA; Department of Orthopedic Surgery and Rehabilitation, University of Nebraska Medical Center, 984420 Nebraska Medical Center, Omaha, NE 68198-4420, USA
| | - Austin Post
- College of Medicine, University of Nebraska Medical Center, 984420 Nebraska Medical Center, Omaha, NE 68198-4420, USA
| | - Elizabeth Wellsandt
- Division of Physical Therapy Education, College of Allied Health Professions, University of Nebraska Medical Center, 984420 Nebraska Medical Center, Omaha, NE 68198-4420, USA; Department of Orthopedic Surgery and Rehabilitation, University of Nebraska Medical Center, 984420 Nebraska Medical Center, Omaha, NE 68198-4420, USA
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Bär M, Luger T, Seibt R, Gabriel J, Rieger MA, Steinhilber B. Effects of a Passive Back-Support Exoskeleton on Knee Joint Loading during Simulated Static Sorting and Dynamic Lifting Tasks. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9965. [PMID: 36011596 PMCID: PMC9408483 DOI: 10.3390/ijerph19169965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 08/05/2022] [Accepted: 08/10/2022] [Indexed: 06/15/2023]
Abstract
Due to the load shifting mechanism of many back-support exoskeletons (BSEs), this study evaluated possible side effects of using a BSE on knee joint loading. Twenty-nine subjects (25.9 (±4.4) years, 179.0 (±6.5) cm; 73.6 (±9.4) kg) performed simulated static sorting and dynamic lifting tasks, including stoop and squat styles and different trunk rotation postures. Ground reaction force, body posture and the force between the chest and the BSE's contact interface were recorded using a force plate, two-dimensional gravimetric position sensors, and a built-in force sensor of the BSE, respectively. Using these parameters and the subject's anthropometry, median and 90th percentile horizontal (HOR50, HOR90) and vertical (VERT50, VERT90) tibiofemoral forces were calculated via a self-developed inverse quasi-static biomechanical model. BSE use had a variable effect on HOR50 dependent on the working task and body posture. Generally, VERT50 increased without significant interaction effects with posture or task. HOR90 and VERT90 were not affected by using the BSE. In conclusion, utilizing the investigated exoskeleton is likely to induce side effects in terms of changed knee joint loading. This may depend on the applied working task and the user's body posture. The role of these changes in the context of a negative contribution to work-related cumulative knee exposures should be addressed by future research.
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19
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Lo GH, Richard MJ, McAlindon TE, Park C, Strayhorn MT, Harkey MS, Price LL, Eaton CB, Driban JB. Increased risk of incident knee osteoarthritis in those with greater work-related physical activity. Occup Environ Med 2022; 79:543-549. [PMID: 35618387 PMCID: PMC9337839 DOI: 10.1136/oemed-2022-108212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 05/05/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Occupations involving greater physical activity may increase risk for knee osteoarthritis (OA). Existing studies have not evaluated work-related physical activity before OA onset. Hence, we aimed to evaluate the association between work-related physical activity and knee OA incidence. METHODS We performed a person-based longitudinal study using Osteoarthritis Initiative (OAI) data among people who volunteered or worked for pay without baseline radiographic knee OA or knee pain. Bilateral knee radiographs were obtained at baseline and annual follow-ups. We defined radiographic OA as Kellgren-Lawrence grade ≥2. Questions from the Physical Activity Scale for the Elderly at baseline and annual OAI visits provided information about work-related physical activity level and hours. We performed logistic regression with work-related physical activity level ( mainly sitting , standing and some walking , walking while handling some materials ) and hours as predictors. The outcome was incident person-based radiographic OA within the ensuing 12 months, over 48 months. RESULTS Among 951 participants (2819 observations), higher work-related physical activity levels had greater adjusted ORs for incident radiographic OA (people with jobs with standing and some walking : 1.11 (0.60-2.08), and walking while handling some materials : 1.90 (1.03-3.52), when compared with those with mainly sitting work-related activity ). There was no association between number of hours worked and incident radiographic OA. CONCLUSIONS People performing work that require walking while handling some materials have greater odds of incident knee OA than those with jobs mostly involving sitting. Strategies are needed to mitigate risk factors predisposing them to radiographic OA.
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Affiliation(s)
- Grace H Lo
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA .,Medical Care Line and Research Care Line, Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA
| | - Michael J Richard
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, Massachusetts, USA
| | - Timothy E McAlindon
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, Massachusetts, USA
| | - Chantel Park
- Division of Rheumatology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Michael T Strayhorn
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.,Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA
| | - Matthew S Harkey
- Department of Kinesiology, Michigan State University, East Lansing, Michigan, USA
| | - Lori Lyn Price
- The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts, USA
| | - Charles B Eaton
- Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Department of Epidemiology, School of Public Health of Brown University, Providence, Rhode Island, USA
| | - Jeffrey B Driban
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, Massachusetts, USA
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Kothurkar R, Lekurwale R. Techniques to determine knee joint contact forces during squatting: A systematic review. Proc Inst Mech Eng H 2022; 236:775-784. [DOI: 10.1177/09544119221091609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This review article provides an overview of techniques used to determine human knee joint contact forces during squatting. The main two approaches are experimental and theoretical. Thigh calf contact has a significant effect on knee forces and should not be neglected. In this study, data were searched electronically and organized by techniques to find knee joint contact force during squatting theoretically and experimentally. There was a large variation in peak tibiofemoral (CV = 0.45) and patellofemoral (CV = 0.38) contact forces predicted theoretically. However, very little variation was observed between peak tibiofemoral contact forces (CV = 0.12) measured in vivo experimentally but measured knee joint force is available up to a limited knee flexion angle. There was a reduction in knee joint contact forces due to thigh calf contact. Literature of knee joint contact force prediction theoretically during squatting incorporating thigh calf contact force is very limited.
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Affiliation(s)
- Rohan Kothurkar
- Department of Mechanical Engineering, K. J. Somaiya College of Engineering, Ghatkopar, Mumbai, India
| | - Ramesh Lekurwale
- Department of Mechanical Engineering, K. J. Somaiya College of Engineering, Ghatkopar, Mumbai, India
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21
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Hardenberg M, Speklé EM, Coenen P, Brus IM, Kuijer PPFM. The economic burden of knee and hip osteoarthritis: absenteeism and costs in the Dutch workforce. BMC Musculoskelet Disord 2022; 23:364. [PMID: 35436874 PMCID: PMC9017043 DOI: 10.1186/s12891-022-05306-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 04/01/2022] [Indexed: 11/25/2022] Open
Abstract
Background This study aimed to quantify the absenteeism costs of knee and hip osteoarthritis in the Netherlands for the Dutch workforce and specific groups of workers. Methods We used a longitudinal, dynamic database from a large occupational health service in which occupational physicians register information about personal information and sick leave of workers with the diagnosis of knee- and/or hip osteoarthritis. We included all employees aged 15 to 75 years performing paid work and diagnosed with knee and/or hip osteoarthritis. Costs were calculated annually and per episode for different subgroups from an employer’s perspective using the Human Capital Approach. In the Netherlands, the employer has to pay 70% of the employee's wage out of pocket for the first two years of sick leave and also for the occupational health care. In this way, employers receive information about the costs of workers on sick leave due to knee or hip osteoarthritis. This might stimulate investments in targeted prevention and work-directed care. Results For the period 2015–2017, 1399 workers fulfilled the inclusion criteria. An average sick leave episode of knee osteoarthritis had a duration of 186 calendar days and was associated with €15,550 in costs. For hip osteoarthritis these data were 159 calendar days and €12,482 in costs. These costs are particularly high among male workers and workers with a higher number of weekly working hours. The average annual costs for the Dutch workforce due to sick leave for knee and hip osteoarthritis were €26.9 million and €13.8 million, respectively. Sick leave costs decreased for hip and not for knee osteoarthritis during 2015–2017. Conclusions Annual sick leave costs due to knee and hip osteoarthritis are about €40 million for the Dutch workforce and approximately twice as high for knee compared to hip osteoarthritis. Average costs per sick leave episode are particularly high among male workers and workers with a higher number of weekly working hours. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05306-9.
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Affiliation(s)
- Marrit Hardenberg
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - Erwin M Speklé
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.,Arbo Unie, Occupational Health Service, Utrecht, The Netherlands
| | - Pieter Coenen
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | - Iris M Brus
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - P Paul F M Kuijer
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.,Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
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22
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Ergonomic Risk Assessment of Aluminum Form Workers’ Musculoskeletal Disorder at Construction Workstations Using Simulation. SUSTAINABILITY 2022. [DOI: 10.3390/su14074356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study analyzes an existing scenario of musculoskeletal disorder (MSD) associated with the ergonomic hazard of the aluminum formwork workstation and its workers. Aluminum form-workers have increasing evidence of MSDs from repetitive tasks such as the adjustment, alignment of pins, pulling, pushing, and installation of panels, because of the cumulative exposure to ergonomic risks. Existing research indicates that this is due to insufficient expertise, form-worker awareness, and a complex construction plan. Using the Tecnomatix process simulate, this study aims to identify awkward postures during the process of lifting, assembling, and installing formwork to quantify MSDs and assess the ergonomic risk of aluminum form-workers and provide simple solutions. This simulation method makes use of input data from a random sample of 92 participants retrieved from four construction sites. The Rapid Upper Limb Assessment (RULA), Ovako Working Analysis System (OWAS) scores, and Energy Expenditure Rate (EER) for three identified awkward cases were determined to be unsatisfactory, unsafe, and acceptable with suggested alternatives. The ergonomic scores correspond to various bodily stresses, allowing workers to better understand which body parts experience major stress when performing manual jobs. The suggested integrated preventive ergonomics system reduces MSDs and improves how people interact with their surroundings.
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Wang X, Perry TA, Caroupapoullé J, Forrester A, Arden NK, Hunter DJ. Monitoring work-related physical activity and estimating lower-limb loading: a proof-of-concept study. BMC Musculoskelet Disord 2021; 22:552. [PMID: 34144697 PMCID: PMC8212530 DOI: 10.1186/s12891-021-04409-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 05/26/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Physical activity (PA) is important to general health and knee osteoarthritis (OA). Excessive workplace PA is an established risk factor for knee OA however, appropriate methods of measurement are unclear. There is a need to examine and assess the utility of new methods of measuring workplace PA and estimating knee load prior to application to large-scale, knee OA cohorts. Our aims, therefore, were to monitor workplace PA and estimate lower-limb loading across different occupations in health participants. METHODS Twenty-four healthy adults, currently working full-time in a single occupation (≥ 35 h/week) and free of musculoskeletal disease, comorbidity and had no history of lower-limb injury/surgery (past 12-months) were recruited across New South Wales (Australia). A convenience sample was recruited with occupations assigned to levels of workload; sedentary, light manual and heavy manual. Metrics of workplace PA including tasks performed (i.e., sitting), step-count and lower-limb loading were monitored over 10 working days using a daily survey, smartwatch, and a smartphone. RESULTS Participants of light manual occupations had the greatest between-person variations in mean lower-limb load (from 2 to 59 kg*m/s3). Lower-limb load for most participants of the light manual group was similar to a single participant in heavy manual work (30 kg*m/s3) and was at least three times greater than the sedentary group (2 kg*m/s3). The trends of workplace PA over working hours were largely consistent, per individual, but rare events of extreme loads were observed across all participants (up to 760 kg*m/s3). CONCLUSIONS There are large interpersonal variations in metrics of workplace PA, particularly among light and heavy manual occupations. Our estimates of lower-limb loading were largely consistent with pre-conceived levels of physical demand. We present a new approach to monitoring PA and estimating lower-limb loading, which could be applied to future occupational studies of knee OA.
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Affiliation(s)
- Xia Wang
- Department of Rheumatology, Royal North Shore Hospital, Institute of Bone and Joint Research, Kolling Institute, University of Sydney, 2065 St Leonards, Sydney, New South Wales Australia
| | - Thomas A Perry
- Department of Rheumatology, Royal North Shore Hospital, Institute of Bone and Joint Research, Kolling Institute, University of Sydney, 2065 St Leonards, Sydney, New South Wales Australia
- Centre for Sport, Exercise and Osteoarthritis Versus Arthritis, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Old Road, OX3 7LD Oxford, United Kingdom
| | - Jimmy Caroupapoullé
- Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, United Kingdom
| | - Alexander Forrester
- Independent Researcher, Town End Cottage, Grindon, Staffordshire, United Kingdom
| | - Nigel K Arden
- Centre for Sport, Exercise and Osteoarthritis Versus Arthritis, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Old Road, OX3 7LD Oxford, United Kingdom
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, United Kingdom
| | - David J Hunter
- Department of Rheumatology, Royal North Shore Hospital, Institute of Bone and Joint Research, Kolling Institute, University of Sydney, 2065 St Leonards, Sydney, New South Wales Australia
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Hulshof CTJ, Pega F, Neupane S, Colosio C, Daams JG, Kc P, Kuijer PPFM, Mandic-Rajcevic S, Masci F, van der Molen HF, Nygård CH, Oakman J, Proper KI, Frings-Dresen MHW. The effect of occupational exposure to ergonomic risk factors on osteoarthritis of hip or knee and selected other musculoskeletal diseases: A systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury. ENVIRONMENT INTERNATIONAL 2021; 150:106349. [PMID: 33546919 DOI: 10.1016/j.envint.2020.106349] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 12/04/2020] [Accepted: 12/16/2020] [Indexed: 05/21/2023]
Abstract
BACKGROUND The World Health Organization (WHO) and the International Labour Organization (ILO) are developing joint estimates of the work-related burden of disease and injury (WHO/ILO Joint Estimates), with contributions from a large network of experts. Evidence from mechanistic data suggests that occupational exposure to ergonomic risk factors may cause selected other musculoskeletal diseases, other than back or neck pain (MSD) or osteoarthritis of hip or knee (OA). In this paper, we present a systematic review and meta-analysis of parameters for estimating the number of disability-adjusted life years from MSD or OA that are attributable to occupational exposure to ergonomic risk factors, for the development of the WHO/ILO Joint Estimates. OBJECTIVES We aimed to systematically review and meta-analyse estimates of the effect of occupational exposure to ergonomic risk factors (force exertion, demanding posture, repetitiveness, hand-arm vibration, lifting, kneeling and/or squatting, and climbing) on MSD and OA (two outcomes: prevalence and incidence). DATA SOURCES We developed and published a protocol, applying the Navigation Guide as an organizing systematic review framework where feasible. We searched electronic academic databases for potentially relevant records from published and unpublished studies, including the International Trials Register, Ovid Medline, EMBASE, and CISDOC. We also searched electronic grey literature databases, Internet search engines and organizational websites; hand-searched reference list of previous systematic reviews and included study records; and consulted additional experts. STUDY ELIGIBILITY AND CRITERIA We included working-age (≥15 years) workers in the formal and informal economy in any WHO and/or ILO Member State but excluded children (<15 years) and unpaid domestic workers. We included randomized controlled trials, cohort studies, case-control studies and other non-randomized intervention studies with an estimate of the effect of occupational exposure to ergonomic risk factors (any exposure to force exertion, demanding posture, repetitiveness, hand-arm vibration, lifting, kneeling and/or squatting, and climbing ≥ 2 h/day) compared with no or low exposure to the theoretical minimum risk exposure level (<2 h/day) on the prevalence or incidence of MSD or OA. STUDY APPRAISAL AND SYNTHESIS METHODS At least two review authors independently screened titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. Missing data were requested from principal study authors. We combined odds ratios using random-effect meta-analysis. Two or more review authors assessed the risk of bias and the quality of evidence, using Navigation Guide tools adapted to this project. RESULTS In total eight studies (4 cohort studies and 4 case control studies) met the inclusion criteria, comprising a total of 2,378,729 participants (1,157,943 females and 1,220,786 males) in 6 countries in 3 WHO regions (Europe, Eastern Mediterranean and Western Pacific). The exposure was measured using self-reports in most studies and with a job exposure matrix in one study and outcome was generally assessed with physician diagnostic records or administrative health data. Across included studies, risk of bias was generally moderate. Compared with no or low exposure (<2 h per day), any occupational exposure to ergonomic risk factors increased the risk of acquiring MSD (odds ratio (OR) 1.76, 95% confidence interval [CI] 1.14 to 2.72, 4 studies, 2,376,592 participants, I2 70%); and increased the risk of acquiring OA of knee or hip (OR 2.20, 95% CI 1.42 to 3.40, 3 studies, 1,354 participants, I2 13%); Subgroup analysis for MSD found evidence for differences by sex, but indicated a difference in study type, where OR was higher among study participants in a case control study compared to study participants in cohort studies. CONCLUSIONS Overall, for both outcomes, the main body of evidence was assessed as being of low quality. Occupational exposure to ergonomic risk factors increased the risk of acquiring MSD and of acquiring OA of knee or hip. We judged the body of human evidence on the relationship between exposure to occupational ergonomic factors and MSD as "limited evidence of harmfulness" and the relationship between exposure to occupational ergonomic factors and OA also as "limited evidence of harmfulness". These relative risks might perhaps be suitable as input data for WHO/ILO modelling of work-related burden of disease and injury. Protocol identifier: https://doi.org/10.1016/j.envint.2018.09.053 PROSPERO registration number: CRD42018102631.
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Affiliation(s)
- Carel T J Hulshof
- Amsterdam UMC, University of Amsterdam, Department Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
| | - Frank Pega
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland.
| | - Subas Neupane
- Unit of Health Sciences, Faculty of Social Science, Tampere University, Tampere, Finland.
| | - Claudio Colosio
- Department of Health Sciences, University of Milan, Milan, Italy; International Centre for Rural Heath, University Hospital San Paolo, Milan, Italy.
| | - Joost G Daams
- Amsterdam UMC, University of Amsterdam, Department Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
| | - Prakash Kc
- Unit of Health Sciences, Faculty of Social Science, Tampere University, Tampere, Finland.
| | - Paul P F M Kuijer
- Amsterdam UMC, University of Amsterdam, Department Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
| | - Stefan Mandic-Rajcevic
- Department of Health Sciences, University of Milan, Milan, Italy; International Centre for Rural Heath, University Hospital San Paolo, Milan, Italy.
| | - Federica Masci
- Department of Health Sciences, University of Milan, Milan, Italy; International Centre for Rural Heath, University Hospital San Paolo, Milan, Italy.
| | - Henk F van der Molen
- Amsterdam UMC, University of Amsterdam, Department Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
| | - Clas-Håkan Nygård
- Unit of Health Sciences, Faculty of Social Science, Tampere University, Tampere, Finland.
| | - Jodi Oakman
- Centre for Ergonomics and Human Factors, School of Psychology and Public Health, LaTrobe University, Melbourne, Australia.
| | - Karin I Proper
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Amsterdam, the Netherlands.
| | - Monique H W Frings-Dresen
- Amsterdam UMC, University of Amsterdam, Department Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
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Data Integration Reveals the Potential Biomarkers of Circulating MicroRNAs in Osteoarthritis. Diagnostics (Basel) 2021; 11:diagnostics11030412. [PMID: 33670901 PMCID: PMC7997238 DOI: 10.3390/diagnostics11030412] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/11/2021] [Accepted: 02/18/2021] [Indexed: 12/29/2022] Open
Abstract
The abnormal expression of circulating miRNAs (c-miRNAs) has become an emerging field in the development of miRNAs-based diagnostic and therapeutic tools for human diseases, including osteoarthritis (OA). OA is the most common form of arthritis leading to disability and a major socioeconomic burden. The abnormal expression of miRNAs plays important roles in the pathogenesis of OA. Unraveling the role of miRNAs in the pathogenesis of OA will throw light on the potential for the development of miRNAs-based diagnostic and therapeutic tools for OA. This article reviews and highlights recent advances in the study of miRNAs in OA, with specific demonstration of the functions of miRNA, especially c-miRNA, in OA pathogenesis as well as its potential implication in the treatment of OA. Based on a systematic literature search using online databases, we figured out the following main points: (1) the integrative systematic review of c-mRNAs and its target genes related to OA pathogenesis; (2) the potential use of c-miRNAs for OA diagnosis purposes as potential biomarkers; and (3) for therapeutic purposes, and we also highlight certain remedies that regulate microRNA expression based on its target genes.
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van der Molen HF, Visser S, Alfonso JH, Curti S, Mattioli S, Rempel D, Roquelaure Y, Kuijer PPFM, Tamminga SJ. Diagnostic criteria for musculoskeletal disorders for use in occupational healthcare or research: a scoping review of consensus- and synthesised-based case definitions. BMC Musculoskelet Disord 2021; 22:169. [PMID: 33573616 PMCID: PMC7879660 DOI: 10.1186/s12891-021-04031-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 01/28/2021] [Indexed: 12/19/2022] Open
Abstract
Background The aim of this study was to identify case definitions of diagnostic criteria for specific musculoskeletal disorders (MSDs) for use in occupational healthcare, surveillance or research. Methods A scoping review was performed in Medline and Web of Science from 2000 to 2020 by an international team of researchers and clinicians, using the Arksey and O’Malley framework to identify case definitions based on expert consensus or a synthesis of the literature. Seven MSDs were considered: non-specific low back pain (LBP), lumbosacral radicular syndrome (LRS), subacromial pain syndrome (SAPS), carpal tunnel syndrome (CTS), lateral or medial elbow tendinopathy, and knee and hip osteoarthritis (OA). Case definitions for occupational healthcare or research were charted according to symptoms, signs and instrumental assessment of signs, and if reported, on work-related exposure criteria. Results In total, 2404 studies were identified of which 39 were included. Fifteen studies (38%) reported on non-specific LBP, followed by knee OA (n = 8;21%) and CTS (n = 8;21%). For non-specific LBP, studies agreed in general on which symptoms (i.e., pain in lower back) and signs (i.e., absence of red flags) constituted a case definition while for the other MSDs considerable heterogeneity was found. Only two studies (5%), describing case definitions for LBP, CTS, and SAPS and lateral and medial elbow tendinopathy respectively, included work-related exposure criteria in their clinical assessment. Conclusion We found that studies on non-specific LBP agreed in general on which symptoms and signs constitute a case definition, while considerable heterogeneity was found for the other MSDs. For prevention of work-related MSDs, these MSD case definitions should preferably include work-related exposure criteria. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-021-04031-z.
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Affiliation(s)
- Henk F van der Molen
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Netherlands Center for Occupational Diseases, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.
| | - Steven Visser
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Netherlands Center for Occupational Diseases, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
| | - Jose Hernán Alfonso
- Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, Oslo, Norway
| | - Stefania Curti
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Stefano Mattioli
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - David Rempel
- Division of Occupational and Environmental Medicine, University of California, San Francisco, USA
| | - Yves Roquelaure
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), UMR_S 1085, F-49000, Angers, France
| | - P Paul F M Kuijer
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Netherlands Center for Occupational Diseases, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
| | - Sietske J Tamminga
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Netherlands Center for Occupational Diseases, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
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Kanto R, Nakayama H, Iseki T, Onishi S, Ukon R, Kanto M, Kambara S, Yoshiya S, Tachibana T. Return to sports rate after opening wedge high tibial osteotomy in athletes. Knee Surg Sports Traumatol Arthrosc 2021; 29:381-388. [PMID: 32248273 DOI: 10.1007/s00167-020-05967-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Accepted: 03/24/2020] [Indexed: 12/29/2022]
Abstract
PURPOSE We hypothesized that patient treated with OWHTO who participate in high-impact sports would attain satisfactory outcome. The purpose of this study was to examine the clinical and radiological outcomes in a consecutive series of opening-wedge high tibial osteotomy (OWHTO) in highly active patients. METHODS Seventy-seven consecutive patients who underwent OWHTO with varus osteoarthritic knees were included in the study. The mean age of the study population was 56.1 years. All patients were followed for a minimum of 2 years. Clinical and radiological evaluations were performed at 12 and 24 months after surgery. The clinical results were evaluated using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the International Knee Documentation Committee (IKDC) Subjective Score. In regards to radiological assessment, the following parameters were measured in full-length weightbearing radiographs both pre- and postoperatively; mechanical tibiofemoral angle (mTFA), mechanical lateral distal femoral angle (mLDFA), and weight bearing line (WBL) ratio. RESULTS Fifty-eight patients (75.3%) returned to the same high-impact sports activities as before surgery, with a mean time to return of 8.7 ± 2.7 months (6-14 months). In the clinical assessments, the IKDC subjective score and KOOS both improved from the mean preoperative scores of 38.4 and 217.4 points to the mean postoperative scores of 74.5 and 421.6 points, respectively. The mean pre-symptomatic Tegner activity scale was 5.3 ± 0.6 and significantly decreased to 4.8 ± 1.2 at 2 years postoperative (p < 0.05). In the radiological evaluation, the postoperative mTFA, mMPTA, and WBL ratio values averaged 1.3° ± 2.2° valgus, 90.7° ± 2.9°, and 51.6% ± 8.4°, respectively, at 24 months after surgery. CONCLUSIONS Clinical outcomes based on postoperative patient-reported outcome measures and rate of return to high-impact sports activities were favorable after OWHTO in patients with knee OA who desired to continue sporting activities with the Tegner activity score of ≥ 5 points. LEVEL OF EVIDENCE Retrospective case series, IV.
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Affiliation(s)
- Ryo Kanto
- Department of Orthopaedic Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Hiroshi Nakayama
- Department of Orthopaedic Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Tomoya Iseki
- Department of Orthopaedic Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan.
| | - Shintaro Onishi
- Department of Orthopaedic Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Ryosuke Ukon
- Department of Orthopaedic Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Makoto Kanto
- Department of Orthopaedic Surgery, Nishinomiya Kaisei Hospital, Nishinomiya, Japan
| | - Shunichiro Kambara
- Department of Orthopaedic Surgery, Nishinomiya Kaisei Hospital, Nishinomiya, Japan
| | - Shinichi Yoshiya
- Department of Orthopaedic Surgery, Nishinomiya Kaisei Hospital, Nishinomiya, Japan
| | - Toshiya Tachibana
- Department of Orthopaedic Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
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Hulshof CTJ, Pega F, Neupane S, van der Molen HF, Colosio C, Daams JG, Descatha A, Kc P, Kuijer PPFM, Mandic-Rajcevic S, Masci F, Morgan RL, Nygård CH, Oakman J, Proper KI, Solovieva S, Frings-Dresen MHW. The prevalence of occupational exposure to ergonomic risk factors: A systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury. ENVIRONMENT INTERNATIONAL 2021; 146:106157. [PMID: 33395953 DOI: 10.1016/j.envint.2020.106157] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 09/18/2020] [Accepted: 09/21/2020] [Indexed: 05/21/2023]
Abstract
BACKGROUND The World Health Organization (WHO) and the International Labour Organization (ILO) are developing joint estimates of the work-related burden of disease and injury (WHO/ILO Joint Estimates), with contributions from a large network of experts. Evidence from mechanistic and human data suggests that occupational exposure to ergonomic (or physical) risk factors may cause osteoarthritis and other musculoskeletal diseases (excluding rheumatoid arthritis, gout, and back and neck pain). In this paper, we present a systematic review and meta-analysis of the prevalence of occupational exposure to physical ergonomic risk factors for estimating the number of disability-adjusted life years from these diseases that are attributable to exposure to this risk factor, for the development of the WHO/ILO Joint Estimates. OBJECTIVES We aimed to systematically review and meta-analyse estimates of the prevalence of occupational exposure to ergonomic risk factors for osteoarthritis and other musculoskeletal diseases. DATA SOURCES We searched electronic bibliographic databases for potentially relevant records from published and unpublished studies, including Ovid Medline, EMBASE, and CISDOC. We also searched electronic grey literature databases, Internet search engines and organizational websites; hand-searched reference list of previous systematic reviews and included study records; and consulted additional experts. STUDY ELIGIBILITY AND CRITERIA We included working-age (≥15 years) workers in the formal and informal economy in any WHO and/or ILO Member State but excluded children (<15 years) and unpaid domestic workers. The exposure was defined as any occupational exposure to one or more of: force exertion, demanding posture, repetitive movement, hand-arm vibration, kneeling or squatting, lifting, and/or climbing. We included all study types with an estimate of the prevalence of occupational exposure to ergonomic risk factors. STUDY APPRAISAL AND SYNTHESIS METHODS At least two review authors independently screened titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. We combined prevalence estimates using random-effect meta-analysis. Two or more review authors assessed the risk of bias and the quality of evidence, using the ROB-SPEO tool and QoE-SPEO approach developed specifically for the WHO/ILO Joint Estimates. RESULTS Five studies (three cross-sectional studies and two cohort studies) met the inclusion criteria, comprising 150,895 participants (81,613 females) in 36 countries in two WHO regions (Africa, Europe). The exposure was generally assessed with questionnaire data about self-reported exposure. Estimates of the prevalence of occupational exposure to ergonomic risk factors are presented for all five included studies, disaggregated by country, sex, 5-year age group, industrial sector or occupational group where feasible. The pooled prevalence of any occupational exposure to ergonomic risk factors was 0.76 (95% confidence interval 0.69 to 0.84, 3 studies, 148,433 participants, 35 countries in the WHO Europe region, I2 100%, low quality of evidence). Subgroup analyses found no statistically significant differences in exposure by sex but differences by age group, occupation and country. No evidence was found for publication bias. We assessed this body evidence to be of low quality, based on serious concerns for risk of bias due to exposure assessment only being based on self-report and for indirectness due to evidence from two WHO regions only. CONCLUSIONS Our systematic review and meta-analysis found that occupational exposure to ergonomic risk factors is highly prevalent. The current body of evidence is, however, limited, especially by risk of bias and indirectness. Producing estimates for the burden of disease attributable to occupational exposure to ergonomic risk factors appears evidence-based, and the pooled effect estimates presented in this systematic review may perhaps be used as input data for the WHO/ILO Joint Estimates. Protocol identifier:https://doi.org/10.1016/j.envint.2018.09.053. PROSPERO registration number: CRD42018102631.
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Affiliation(s)
- Carel T J Hulshof
- Amsterdam UMC, University of Amsterdam, Department Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
| | - Frank Pega
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland.
| | - Subas Neupane
- Unit of Health Sciences, Faculty of Social Science, Tampere University, Tampere, Finland.
| | - Henk F van der Molen
- Amsterdam UMC, University of Amsterdam, Department Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
| | - Claudio Colosio
- Department of Health Sciences, University of Milan, Milan, Italy; International Centre for Rural Heath, University Hospital San Paolo, Milan, Italy.
| | - Joost G Daams
- Amsterdam UMC, University of Amsterdam, Department Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
| | - Alexis Descatha
- AP-HP (Paris Hospital), Occupational Health Unit, Poincaré University Hospital, Garches, France; Inserm Versailles St-Quentin Univ - Paris Saclay Univ (UVSQ), Villejuif, France; Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), Angers, France.
| | - Prakash Kc
- Unit of Health Sciences, Faculty of Social Science, Tampere University, Tampere, Finland.
| | - Paul P F M Kuijer
- Amsterdam UMC, University of Amsterdam, Department Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
| | - Stefan Mandic-Rajcevic
- Department of Health Sciences, University of Milan, Milan, Italy; International Centre for Rural Heath, University Hospital San Paolo, Milan, Italy.
| | - Federica Masci
- Department of Health Sciences, University of Milan, Milan, Italy; International Centre for Rural Heath, University Hospital San Paolo, Milan, Italy.
| | - Rebecca L Morgan
- Department of Health Research Methods, Evidence and Impact, McMaster University, Ontario, Canada.
| | - Clas-Håkan Nygård
- Unit of Health Sciences, Faculty of Social Science, Tampere University, Tampere, Finland.
| | - Jodi Oakman
- Centre for Ergonomics and Human Factors, School of Psychology and Public Health, LaTrobe University, Melbourne, Australia.
| | - Karin I Proper
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.
| | | | - Monique H W Frings-Dresen
- Amsterdam UMC, University of Amsterdam, Department Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
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Hong CY, Lee CG, Kim DH, Cho YS, Kim KY, Ryu SY, Song HS. Work-Related Risk Factors of Knee Meniscal Tears in Korean Farmers: A Cross-Sectional Study. Saf Health Work 2020; 11:485-490. [PMID: 33329915 PMCID: PMC7728704 DOI: 10.1016/j.shaw.2020.05.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 05/25/2020] [Accepted: 05/27/2020] [Indexed: 01/12/2023] Open
Abstract
Background Meniscal tears are among the major risk factors for knee osteoarthritis progression. This study aimed to investigate the relationship between meniscal tears and work-related factors in the farming occupation. Methods The participants included 486 farmers (238 men and 248 women), aged 40–69 years, who were among the 550 farmers registered in the Korea Farmer's Knee Cohort (KFKC). Data such as those on gender, age, body mass index (BMI), mechanical axis, cumulative heavy-lifting working time (CLWT), cumulative squatting working time (CSWT), and previous knee injury history were collected from the questionnaire, along with whole leg radiographic findings. Two radiologists assessed the magnetic resonance images of both knees to confirm the presence of meniscal tears. The factors related to meniscal tears were analyzed by multiple logistic regression. Results A total of 54.5% of the farmers (48.7% of men and 60.1% of women) had meniscal tears. These tears were associated with gender, age, and BMI. We also identified an association between meniscal tears and CSWT, an especially important factor in farming [10,000–19,999 working hours, odds ratio = 2.16, 95% confidence interval (CI): 1.14-4.07, ≥20,000 working hours, odds ratio = 2.35, 1.45-3.80]. However, mechanical axis, knee injury history, and CLWT were not significantly related to meniscal tears. Conclusion This study's findings show that squatting for long periods, as an occupational factor, is related to meniscal tears.
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Affiliation(s)
- Chae Young Hong
- Department of Occupational and Environmental Medicine, Chosun University Hospital, Gwangju, South Korea
| | - Chul Gab Lee
- Department of Occupational and Environmental Medicine, Chosun University Hospital, Gwangju, South Korea
| | - Dong Hwi Kim
- Department of Orthopedic Medicine, Chosun University Hospital, Gwangju, South Korea
| | - Yong Soo Cho
- Department of Radiology, Chosun University Hospital, Gwangju, South Korea
| | - Kweon Young Kim
- Department of Rehabilitation Medicine, Chosun University Hospital, Gwangju, South Korea
| | - So Yeon Ryu
- Department of Preventive Medicine, Chosun University Hospital, Gwangju, South Korea
| | - Han Soo Song
- Department of Occupational and Environmental Medicine, Chosun University Hospital, Gwangju, South Korea
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Parsons CM, Gates LS, Perry T, Nevitt M, Felson D, Sanchez-Santos MT, Jones G, Golightly YM, Allen KD, Callahan LF, White DK, Walker-Bone K, Cooper C, Arden NK. Predominant lifetime occupation and associations with painful and structural knee osteoarthritis: An international participant-level cohort collaboration. OSTEOARTHRITIS AND CARTILAGE OPEN 2020; 2:100085. [PMID: 36474872 PMCID: PMC9718216 DOI: 10.1016/j.ocarto.2020.100085] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 06/18/2020] [Indexed: 01/05/2023] Open
Abstract
Objective With adults working to older ages, occupation is an important, yet less modifiable domain of physical activity to consider in the risk of knee osteoarthritis (OA). This study aimed to investigate the association between predominant lifetime occupation and prevalent knee OA. Design Participant-level data were used from five international community-based cohorts: Johnston County Osteoarthritis Project, the Hertfordshire Cohort Study, the Multicenter Osteoarthritis Study, the Tasmanian Cohort Study and Framingham Osteoarthritis Study. Self-reported predominant occupation was categorized into sedentary, light, light manual and heavy manual levels. Cross-sectional associations between predominant lifetime occupation and knee OA outcomes including prevalence of radiographic knee OA (RKOA), symptomatic RKOA and knee pain, were assessed using logistic regression, accounting for cohort clustering. Results Data for 7391 participants were included. 24.7% reported sedentary lifetime occupation, 30.0% light, 35.9% light manual and 9.4% heavy manual. 43.3% presented with RKOA, 52.1% with knee pain and 29.0% with symptomatic RKOA. There was over a two-fold increase in the odds of having RKOA, knee pain and symptomatic RKOA in those whose with heavy manual compared to sedentary occupations ((odds ratio (OR): 2.14; 95% confidence interval (CI): 1.79, 2.58), (OR: 2.19; 95% CI: 1.78, 2.70), (OR: 2.41; 95% CI: 1.94, 2.99) respectively). Conclusion This large international multi-cohort study demonstrated an association of heavy manual work with RKOA, symptomatic RKOA and knee pain. Measures that protect workers and are designed to reduce heavy manual related activities remain a priority to reduce the risk of knee OA.
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Affiliation(s)
- Camille M. Parsons
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Lucy S. Gates
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Southampton, Southampton, UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, UK
| | - Thomas Perry
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, UK
| | - Michael Nevitt
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - David Felson
- Arthritis Research UK Epidemiology Unit and National Institute for Health Research Biomedical Research Centre, University of Manchester, Manchester, UK
- Boston University School of Medicine, Boston, MA, USA
| | - Maria T. Sanchez-Santos
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, UK
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Australia
| | - Yvonne M. Golightly
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, USA
- Department of Epidemiology, University of North Carolina at Chapel Hill, USA
- Injury Prevention Research Centre, University of North Carolina at Chapel Hill, USA
- Division of Physical Therapy, University of North Carolina at Chapel Hill; USA
| | - Kelli D. Allen
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, USA
- Centre of Innovation to Accelerate Discovery and Practice Transformation, Department of Veterans Affairs Health Care System, Durham, NC, USA
| | - Leigh F. Callahan
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, USA
- Department of Epidemiology, University of North Carolina at Chapel Hill, USA
- Department of Medicine, Orthopaedics, and Social Medicine, School of Medicine, University of North Carolina at Chapel Hill; USA
| | - Daniel K. White
- Department of Physical Therapy, University of Delaware, Newark, USA
| | - Karen Walker-Bone
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, Southampton, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, UK
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, Southampton, UK
- National Institute for Health Research Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Nigel K. Arden
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Southampton, Southampton, UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, UK
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Kontio T, Heliövaara M, Viikari-Juntura E, Solovieva S. To what extent is severe osteoarthritis preventable? Occupational and non-occupational risk factors for knee and hip osteoarthritis. Rheumatology (Oxford) 2020; 59:3869-3877. [PMID: 32533170 DOI: 10.1093/rheumatology/keaa238] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 04/08/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To explore the relative contribution of cumulative physical workload, sociodemographic and lifestyle factors, as well as prior injury to hospitalization due to knee and hip OA. METHODS We examined a nationally representative sample of persons aged 30-59 years, who participated in a comprehensive health examination (the Health 2000 Study). A total of 4642 participants were followed from mid-2000 to end-2015 for the first hospitalization due to knee or hip OA using the National Hospital Discharge Register. We examined the association of possible risk factors with the outcome using a competing risk regression model (death was treated as competing risk) and calculated population attributable fractions for statistically significant risk factors. RESULTS Baseline age and BMI as well as injury were associated with the risk of first hospitalization due to knee and hip OA. Composite cumulative workload was associated with a dose-response pattern with hospitalizations due to knee OA and with hospitalizations due to hip OA at a younger age only. Altogether, prior injury, high BMI and intermediate to high composite cumulative workload accounted for 70% of hospitalizations due to knee OA. High BMI alone accounted for 61% and prior injury only for 6% of hospitalizations due to hip OA. CONCLUSION Our results suggest that overweight/obesity, prior injury and cumulative physical workload are the most important modifiable risk factors that need to be targeted in the prevention of knee OA leading to hospitalization. A substantial proportion of hospitalizations due to hip OA can be reduced by controlling excess body weight.
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Affiliation(s)
| | | | | | - Svetlana Solovieva
- National Institute for Health and Welfare.,Finnish Institute of Occupational Health, Helsinki, Finland
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Wang X, Perry TA, Arden N, Chen L, Parsons CM, Cooper C, Gates L, Hunter DJ. Occupational Risk in Knee Osteoarthritis: A Systematic Review and Meta-Analysis of Observational Studies. Arthritis Care Res (Hoboken) 2020; 72:1213-1223. [PMID: 32638548 DOI: 10.1002/acr.24333] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 05/19/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To assess the association between occupational exposures and knee osteoarthritis (OA). METHODS We systematically searched for observational studies that examined the relationship between occupational exposures and knee OA and total knee replacement. Four databases were searched up to October 1, 2019. Two reviewers independently assessed study quality using the Newcastle-Ottawa Scale and evidence quality using the Grading of Recommendations Assessment, Development and Evaluation approach. Subgroup meta-analyses were conducted for important study characteristics and each type of occupational exposure. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were estimated for the meta-analysis using random-effects models. RESULTS Eighty eligible studies were identified including 25 case-control (n = 20,505 total participants), 36 cross-sectional (n = 139,463 total participants), and 19 cohort studies (n = 16,824,492 total participants). A synthesis of 71 studies suggested increased odds of knee OA (OR 1.52 [95% CI 1.37-1.69]) by combining different physically demanding jobs and occupational activities as compared to sedentary occupations and/or low-exposure groups. Odds of knee OA were greater in males and in industry-based studies and studies assessing lifetime occupational exposures. There were 9 specific job titles that were associated with knee OA, including farmer, builder, metal worker, and floor layer. Occupational lifting, kneeling, climbing, squatting, and standing were all associated with higher odds of knee OA as compared to the odds of knee OA in sedentary workers. CONCLUSION Strenuous, physically demanding occupations and occupational activities were associated with increased odds of knee OA as supported by moderate-quality evidence. Specifically, agricultural and construction sectors, which typically involve heavy lifting, frequent climbing, prolonged kneeling, squatting, and standing, carried increased odds of knee OA.
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Affiliation(s)
- Xia Wang
- Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia
| | - Thomas A Perry
- Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia, and University of Oxford, Oxford, UK
| | - Nigel Arden
- University of Oxford, Oxford, UK, and Southampton General Hospital, University of Southampton, Southampton, UK
| | - Lingxiao Chen
- Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia
| | - Camille M Parsons
- Southampton General Hospital, University of Southampton, Southampton, UK
| | - Cyrus Cooper
- Southampton General Hospital, National Institute for Health Research Biomedical Research Centre, University of Southampton, and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Lucy Gates
- University of Oxford, Oxford, UK, and University of Southampton, Southampton, UK
| | - David J Hunter
- Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia
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Kuijer PPFM, Burdorf A. Prevention at work needed to curb the worldwide strong increase in knee replacement surgery for working-age osteoarthritis patients. Scand J Work Environ Health 2020; 46:457-460. [PMID: 32780145 PMCID: PMC7737795 DOI: 10.5271/sjweh.3915] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- P Paul F M Kuijer
- Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
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Violante FS. Criteria for diagnosis and attribution of an occupational musculoskeletal disease. LA MEDICINA DEL LAVORO 2020; 111:249-268. [PMID: 32869763 PMCID: PMC7809956 DOI: 10.23749/mdl.v111i4.10340] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 07/27/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Criteria for diagnosis and compensation of occupational musculoskeletal diseases varies widely between countries as demonstrated by the large differences between countries with comparable economics and social systems (for example, within the European Union). Several countries have a list of occupational diseases and sometimes these lists include diagnostic and attribution criteria, but these criteria are usually not very specific, and they may also be very different. OBJECTIVES The aim of this paper is to explicitly define what are the information needed for an evidence-based diagnosis and attribution of an occupational musculoskeletal disease. METHODS Based on the general framework of evidence-based medicine, a review is presented of the information required to define: - when a musculoskeletal disease is present, according to the best available techniques; - how to define a relevant exposure to biomechanical risk factors, according to the best available techniques. RESULTS Criteria are presented to combine information regarding the diagnosis of a musculoskeletal disease and exposure to biomechanical risk factors for an evidence-based attribution of the disease to the occupational exposure. The criteria use a probabilistic model that combine epidemiologic and medical findings, workplace exposure assessment, and non-occupational factors evaluation. DISCUSSION The use of the proposed criteria may improve the process of diagnosis and attribution of an occupational musculoskeletal disease. In addition, it makes possible to associate a probability rank to the attribution and, ultimately, it may improve the overall quality of the decisional process of the occupational physician.
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Affiliation(s)
- Francesco Saverio Violante
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna; Occupational Health Unit University of Bologna and Sant'Orsola Malpighi Hospital, Bologna, Italy.
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Gignac MAM, Irvin E, Cullen K, Van Eerd D, Beaton DE, Mahood Q, McLeod C, Backman CL. Men and Women's Occupational Activities and the Risk of Developing Osteoarthritis of the Knee, Hip, or Hands: A Systematic Review and Recommendations for Future Research. Arthritis Care Res (Hoboken) 2020; 72:378-396. [PMID: 30762317 PMCID: PMC7065017 DOI: 10.1002/acr.23855] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 02/12/2019] [Indexed: 12/24/2022]
Abstract
Objective To systematically review the evidence for an increased risk of osteoarthritis in the hip, knee, hand, wrist, finger, ankle, foot, shoulder, neck, and spine related to diverse occupational activities of men and women and to examine dose‐response information related to the frequency, intensity, and duration of work exposures and the risk of osteoarthritis (OA). Methods Established guidelines for systematic reviews in occupational health and safety studies were followed. MEDLINE, Embase, CINAHL, and Cochrane Library were searched from inception to December 2017. Studies were reviewed for relevance, quality was appraised, and data were extracted and synthesized. Results Sixty‐nine studies from 23 countries yielded strong and moderate evidence for lifting, cumulative physical loads, full‐body vibration, and kneeling/squatting/bending as increasing the risks of developing OA in men and women. Strong and moderate evidence existed for no increased risk of OA related to sitting, standing, and walking (hip and knee OA), lifting and carrying (knee OA), climbing ladders (knee OA), driving (knee OA), and highly repetitive tasks (hand OA). Variability in dose‐response data resulted in an inability to synthesize these data. Conclusion Evidence points to the potential for OA occupational recommendations and practice considerations to be developed for women and men. However, research attention is needed to overcome deficits in the measurement and recall of specific work activities so that recommendations and practice considerations can provide the specificity needed to be adopted in workplaces.
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Affiliation(s)
- Monique A M Gignac
- Institute for Work and Health and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Emma Irvin
- Institute for Work and Health, Toronto, Ontario, Canada
| | - Kim Cullen
- Institute for Work and Health, Toronto, and School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | | | | | - Quenby Mahood
- Institute for Work and Health, Toronto, Ontario, Canada
| | - Chris McLeod
- Institute for Work and Health, Toronto, Ontario, and School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Catherine L Backman
- University of British Columbia and Arthritis Research Centre of Canada, Vancouver, British Columbia, Canada
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Canetti EFD, Schram B, Orr RM, Knapik J, Pope R. Risk factors for development of lower limb osteoarthritis in physically demanding occupations: A systematic review and meta-analysis. APPLIED ERGONOMICS 2020; 86:103097. [PMID: 32342888 DOI: 10.1016/j.apergo.2020.103097] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 02/05/2020] [Accepted: 03/06/2020] [Indexed: 06/11/2023]
Abstract
This systematic review and meta-analysis identified and critically reviewed the findings of recent studies (last 15 years) examining relationships between specific physically demanding occupations or occupational tasks and development of lower limb osteoarthritis (OA). Twenty-eight studies with 266,227 cases of lower limb OA were included. Occupational tasks contributing to OA included farming, floor laying, and brick laying. Activities significantly contributing to the risk of knee OA were lifting heavy loads (>10 kg/week) (odds ratio [OR] = 1.52, 95% confidence interval [95%CI] 1.29-1.79), squatting/kneeling (OR = 1.69, 95%CI 1.15-2.49), standing (>2 h/daily) (OR = 1.22 95%CI 1.02-1.46) and walking (OR = 1.40 95%CI 1.14-1.73). Lifting contributed significantly to the risk of hip OA (OR = 1.35, 95%CI 1.16-1.57). The effects of occupational exposures appear to be magnified by previous injury and BMI >25 kg/m2. Since specific occupational activities increase OA risk, ergonomist should encourage the use of existing tools, or oversee the design of new tools that may decrease exposure to such activities.
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Affiliation(s)
- Elisa F D Canetti
- Faculty of Health Sciences and Medicine, Bond University, 14 University Drive, Robina, QLD, 4226, Australia; Tactical Research Unit, Bond University, 2 Promethean Way, Robina, QLD, 4226, Australia.
| | - Ben Schram
- Faculty of Health Sciences and Medicine, Bond University, 14 University Drive, Robina, QLD, 4226, Australia; Tactical Research Unit, Bond University, 2 Promethean Way, Robina, QLD, 4226, Australia.
| | - Robin M Orr
- Faculty of Health Sciences and Medicine, Bond University, 14 University Drive, Robina, QLD, 4226, Australia; Tactical Research Unit, Bond University, 2 Promethean Way, Robina, QLD, 4226, Australia.
| | - Joseph Knapik
- Tactical Research Unit, Bond University, 2 Promethean Way, Robina, QLD, 4226, Australia.
| | - Rodney Pope
- Tactical Research Unit, Bond University, 2 Promethean Way, Robina, QLD, 4226, Australia; School of Community Health, Charles Sturt University, Elizabeth Mitchell Dr, Thurgoona, NSW, 2640, Australia.
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Work-relatedness of inguinal hernia: a systematic review including meta-analysis and GRADE. Hernia 2020; 24:943-950. [PMID: 32474653 PMCID: PMC7520410 DOI: 10.1007/s10029-020-02236-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 05/25/2020] [Indexed: 11/30/2022]
Abstract
Purpose Clinicians need to know whether inguinal hernia (IH) can be attributed to work to answer questions regarding prevention and medical causation. This review describes whether work-related risk factors are associated with IH. Methods A systematic review was performed in Medline via PubMed until February 3rd, 2020. Inclusion criteria were that IH was diagnosed by a clinician, and workers exposed to work-related risk factors were compared to workers less exposed or not at all. A quality assessment and a meta-analysis using Cochrane’s RevMan 5.3 were performed, including GRADE for quality of evidence. Results The search resulted in 540 references. Fourteen studies fulfilled the inclusion criteria, of which three were included in a meta-analysis, all three being of high quality, including 621 workers diagnosed with IH. The meta-analysis revealed significant associations with physically demanding work (OR 2.30, 95% CI 1.56–3.40). Two prospective studies, including 382 and 22,926 cases revealed associations that this was true for male workers with a lateral IH that reported standing or walking for more than six hours per workday (OR 1.45, 95% CI 1.12–1.88) or lifting cumulative loads of more than 4000 kg per workday (OR 1.32, 95% CI 1.27–1.38). The level of certainty for the latter two work-related risk factors was moderate and high according to GRADE. Conclusion Lateral IH among males is associated with work-related risk factors depending on the level of exposure to the time standing/walking per workday, or the amount of load lifted per workday. Electronic supplementary material The online version of this article (10.1007/s10029-020-02236-0) contains supplementary material, which is available to authorized users.
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Landsbergis P, Johanning E, Stillo M, Jain R, Davis M. Occupational risk factors for musculoskeletal disorders among railroad maintenance-of-way workers. Am J Ind Med 2020; 63:402-416. [PMID: 32144807 DOI: 10.1002/ajim.23099] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 02/17/2020] [Accepted: 02/18/2020] [Indexed: 11/12/2022]
Abstract
BACKGROUND Our objective was to examine occupational risk factors for musculoskeletal disorders of the neck, back, and knee among railroad maintenance-of-way (MOW) workers. METHODS Four thousand eight-hundred sixteen active, retired, and disabled members of the Brotherhood of Maintenance of Way Employes Division (BMWED) completed a survey. We computed adjusted prevalence ratios (aPRs) using Poisson regression for neck, back, and knee musculoskeletal symptoms by work exposures, adjusted for age, region, race/ethnicity, smoking, and potential second job and spare time vehicle vibration exposure. RESULTS Among active male BMWED members, we found associations between use of high-vibration vehicles and neck pain (aPR = 1.47, 95% confidence interval (CI): 1.07-2.03) and knee pain (aPR = 1.38, 95% CI: 1.04-1.82) for more than 1.9 years (vs 0) of full-time equivalent use; but not back pain. Back pain radiating below the knee (sciatica indicator) was associated with high-vibration vehicle use greater than 0.4 and less than 1.9 years (aPR = 1.58, 95% CI: 1.15-2.18). We also found significant associations between often or always lifting, pushing, pulling, or bending on the job (vs seldom or never) and neck pain (aPR = 2.43, 95% CI: 1.20-4.90), back pain (aPR = 1.94, 95% CI: 1.24-3.03), the sciatica indicator (aPR = 5.18, 95% CI: 1.28-20.95), and knee pain (aPR = 2.84, 95% CI: 1.47-5.51), along with positive gradients in the outcome by exposure time. CONCLUSIONS Biomechanical work exposures, including force and nonneutral postures, were associated with neck, lower back, and knee pain. Whole-body vibration, as measured by the duration of use of high-vibration vehicles, was associated with neck pain, knee pain, and sciatica. Prevention programs should address occupational risk factors for musculoskeletal disorders among MOW workers.
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Affiliation(s)
- Paul Landsbergis
- State University of New York (SUNY)‐Downstate Health Sciences UniversityBrooklyn New York
| | - Eckardt Johanning
- Johanning MD, PCAlbany New York
- Department of Medicine, Center for Family and Community MedicineColumbia UniversityNew York New York
| | - Marco Stillo
- State University of New York (SUNY)‐Downstate Health Sciences UniversityBrooklyn New York
| | - Rahul Jain
- State University of New York (SUNY)‐Downstate Health Sciences UniversityBrooklyn New York
| | - Michelle Davis
- State University of New York (SUNY)‐Downstate Health Sciences UniversityBrooklyn New York
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Hong JW, Noh JH, Kim DJ. The prevalence of and demographic factors associated with radiographic knee osteoarthritis in Korean adults aged ≥ 50 years: The 2010-2013 Korea National Health and Nutrition Examination Survey. PLoS One 2020; 15:e0230613. [PMID: 32196540 PMCID: PMC7083301 DOI: 10.1371/journal.pone.0230613] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 03/05/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND To reduce the social burden of knee osteoarthritis (OA) by addressing it in the early stages in the population at greatest risk, the epidemiology of knee OA needs to be understood and associated demographic factors need to be identified. OBJECTIVES We evaluated the weighted prevalence of and demographic factors associated with radiographic knee OA in Korean adults. METHODS We analyzed data from 12,287 individuals aged ≥ 50 years who had radiographs of the knee taken in the 2010-2013 Korea National Health and Nutrition Examination Survey (KNHANES). Radiographic knee OA was defined based on the Kellgren-Lawrence grade, as follows: 0: No abnormal finding 1: Mild degenerative changes, minute osteophytes 2: Mild knee OA, definite osteophytes 3: Moderate knee OA, moderate joint-space narrowing and definite osteophytes 4: Severe knee OA, severe joint-space narrowing with subchondral sclerosis. RESULTS We found that the prevalence of radiographic knee OA in the Korean adult population was 35.1%. Logistic regression analyses were performed to identify factors associated independently with radiographic knee OA, with age, sex, area of residence, education level, household income, and obesity serving as covariates. Women were at greater risk than men of having knee OA (OR 2.12, 95% CI 1.90-2.37, p < 0.001). Compared with subjects aged 50-59 years, adults aged ≥ 80 years were at 8.87-fold (95% CI 7.12-11.06, p < 0.001) greater risk of having knee OA. Residence in a rural area was associated with a greater risk of having radiographic knee OA than was residence in an urban area (OR 1.26, 95% CI 1.08-1.48, p = 0.004), regardless of knee OA severity (Kellgren-Lawrence grades ≥2, ≥3, and 4). Elementary school graduates had 1.71-fold (p < 0.001) greater risks of having knee OA than did college graduates. Household incomes ≤24th percentile were associated with a greater risk of having knee OA compared with those ≥75th percentile (OR 1.28, 95% CI 1.08-1.52, p = 0.004). Obesity was associated with an approximately two-fold greater risk of knee OA, regardless of knee OA severity (Kellgren-Lawrence grades ≥2, ≥3, and 4). CONCLUSIONS Using data from the 2010-2013 KNHANES and defining knee OA as Kellgren-Lawrence grade ≥ 2, we found that the prevalence of radiographic knee OA was 35.1% (24.4% in men, 44.3% in women) in a representative sample of Korean adults aged ≥ 50 years, with the highest prevalence (78.7%) observed in women aged ≥ 80 years. Low socioeconomic status and traditional factors, including age, female sex, and obesity, were associated with the risk of knee OA.
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Affiliation(s)
- Jae Won Hong
- Department of Internal Medicine, Ilsan-Paik Hospital, College of Medicine, Inje University, Koyang, Gyeonggi-do, Republic of Korea
| | - Jung Hyun Noh
- Department of Internal Medicine, Ilsan-Paik Hospital, College of Medicine, Inje University, Koyang, Gyeonggi-do, Republic of Korea
| | - Dong-Jun Kim
- Department of Internal Medicine, Ilsan-Paik Hospital, College of Medicine, Inje University, Koyang, Gyeonggi-do, Republic of Korea
- * E-mail:
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Sliepen M, Lipperts M, Tjur M, Mechlenburg I. Use of accelerometer-based activity monitoring in orthopaedics: benefits, impact and practical considerations. EFORT Open Rev 2020; 4:678-685. [PMID: 32010456 PMCID: PMC6986392 DOI: 10.1302/2058-5241.4.180041] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Studies of the effectiveness of orthopaedic interventions do not generally measure physical activity (PA). Applying accelerometer-based activity monitoring in orthopaedic studies will add relevant information to the generally examined physical function and pain assessment.Accelerometer-based activity monitoring is practically feasible in orthopaedic patient populations, since current day activity sensors have battery time and memory to measure continuously for several weeks without requiring technical expertise.The ongoing development in sensor technology has made it possible to combine functional tests with activity monitoring.For clinicians, the application of accelerometer-based activity monitoring can provide a measure of PA and can be used for clinical comparisons before and after interventions.In orthopaedic rehabilitation, accelerometer-based activity monitoring may be used to help patients reach their targets for PA and to coach patients towards a more active lifestyle through direct feedback. Cite this article: EFORT Open Rev 2019;4:678-685. DOI: 10.1302/2058-5241.4.180041.
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Affiliation(s)
- Maik Sliepen
- Institut für Experimentelle Muskuloskelettale Medizin (IEMM), Universitätsklinikum Münster (UKM), Westfälische Wilhelms-Universität Münster (WWU), Germany
| | - Matthijs Lipperts
- AHORSE, Department of Orthopaedics, Zuyderland Medical Centre, The Netherlands
| | - Marianne Tjur
- Department of Orthopaedic Surgery, Aarhus University Hospital, Denmark
| | - Inger Mechlenburg
- Department of Orthopaedic Surgery, Aarhus University Hospital, Denmark.,Centre of Research in Rehabilitation (CORIR), Department of Clinical Medicine, Aarhus University Hospital and Aarhus University, Denmark
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Jafri MA, Kalamegam G, Abbas M, Al-Kaff M, Ahmed F, Bakhashab S, Rasool M, Naseer MI, Sinnadurai V, Pushparaj PN. Deciphering the Association of Cytokines, Chemokines, and Growth Factors in Chondrogenic Differentiation of Human Bone Marrow Mesenchymal Stem Cells Using an ex vivo Osteochondral Culture System. Front Cell Dev Biol 2020; 7:380. [PMID: 32010693 PMCID: PMC6979484 DOI: 10.3389/fcell.2019.00380] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 12/17/2019] [Indexed: 12/20/2022] Open
Abstract
Osteoarthritis (OA) is a chronic degenerative joint disorder associated with degradation and decreased production of the extracellular matrix, eventually leading to cartilage destruction. Limited chondrocyte turnover, structural damage, and prevailing inflammatory milieu prevent efficient cartilage repair and restoration of joint function. In the present study, we evaluated the role of secreted cytokines, chemokines, and growth factors present in the culture supernatant obtained from an ex vivo osteochondral model of cartilage differentiation using cartilage pellets (CP), bone marrow stem cells (BM-MSCs), and/or BM-MSCs + CP. Multiplex cytokine analysis showed differential secretion of growth factors (G-CSF, GM-CSF, HGF, EGF, VEGF); chemokines (MCP-1, MIP1α, MIP1β, RANTES, Eotaxin, IP-10), pro-inflammatory cytokines (IL-1β, IL-2, IL-5, IL-6, IL-8, TNFα, IL-12, IL-15, IL-17) and anti-inflammatory cytokines (IL-4, IL-10, and IL-13) in the experimental groups compared to the control. In silico analyses of the role of stem cells and CP in relation to the expression of various molecules, canonical pathways and hierarchical cluster patterns were deduced using the Ingenuity Pathway Analysis (IPA) software (Qiagen, United States). The interactions of the cytokines, chemokines, and growth factors that are involved in the cartilage differentiation showed that stem cells, when used together with CP, bring about a favorable cell signaling that supports cartilage differentiation and additionally helps to attenuate inflammatory cytokines and further downstream disease-associated pro-inflammatory pathways. Hence, the autologous or allogeneic stem cells and local cartilage tissues may be used for efficient cartilage differentiation and the management of OA.
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Affiliation(s)
- Mohammad Alam Jafri
- Centre of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Gauthaman Kalamegam
- Centre of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.,Sheikh Salem Bin Mahfouz Scientific Chair for Treatment of Osteoarthritis by Stem Cells, King Abdulaziz University, Jeddah, Saudi Arabia.,Faculty of Medicine, Asian Institute of Medicine, Science and Technology University, Bedong, Malaysia
| | - Mohammed Abbas
- Sheikh Salem Bin Mahfouz Scientific Chair for Treatment of Osteoarthritis by Stem Cells, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Orthopaedic Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammed Al-Kaff
- Sheikh Salem Bin Mahfouz Scientific Chair for Treatment of Osteoarthritis by Stem Cells, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Orthopaedic Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Farid Ahmed
- Centre of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Sherin Bakhashab
- Department of Biochemistry, Faculty of Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mahmood Rasool
- Centre of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Muhammad Imran Naseer
- Centre of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Vasan Sinnadurai
- Faculty of Medicine, Asian Institute of Medicine, Science and Technology University, Bedong, Malaysia
| | - Peter Natesan Pushparaj
- Centre of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
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Hoorntje A, Kuijer PPFM, van Ginneken BT, Koenraadt KLM, van Geenen RCI, Kerkhoffs GMMJ, van Heerwaarden RJ. Predictors of Return to Work After High Tibial Osteotomy: The Importance of Being a Breadwinner. Orthop J Sports Med 2020; 7:2325967119890056. [PMID: 31909053 PMCID: PMC6935877 DOI: 10.1177/2325967119890056] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Background Limited evidence exists on patient-relevant outcomes after high tibial osteotomy (HTO), including return to work (RTW). Furthermore, prognostic factors for RTW have never been described. Purpose To investigate the extent and timing of RTW in the largest HTO cohort investigated for RTW to date and to identify prognostic factors for RTW after HTO. Study Design Cohort study; Level of evidence, 3. Methods Consecutive patients who underwent HTO between 2012 and 2015 were included. Patients received a questionnaire at a mean follow-up of 3.6 years. Questions were asked pre- and postoperatively regarding work status, job title, working hours, preoperative sick leave, employment status, and whether patients were their family's breadwinner. The validated Work Rehabilitation Questionnaire (WORQ) was used to assess difficulty with knee-demanding activities. Prognostic factors for RTW were analyzed using a logistic regression model. Covariates were selected based on univariate analysis and a directed acyclic graph. Results We identified 402 consecutive patients who underwent HTO, of whom 349 were included. Preoperatively, 299 patients worked, of whom 284 (95%) achieved RTW and 255 (90%) returned within 6 months. Patients reported significant postoperative improvements in performing knee-demanding activities. Being the family's breadwinner was the strongest predictor of RTW (odds ratio [OR], 2.92; 95% confidence interval [CI], 1.27-6.69). In contrast, preoperative sick leave was associated with lower odds of RTW (OR, 0.20; 95% CI, 0.08-0.46). Conclusion After HTO, 95% of patients were able to RTW, of whom 9 of 10 returned within 6 months. Breadwinners were more likely to RTW, and patients with preoperative sick leave were less likely to RTW within 6 months. These findings may be used to improve preoperative counseling and expectation management and thereby enhance work-related outcomes after HTO.
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Affiliation(s)
- Alexander Hoorntje
- Amsterdam Movement Sciences, Department of Orthopaedic Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.,Academic Center for Evidence-Based Sports Medicine, Amsterdam, the Netherlands.,Amsterdam Collaboration on Health & Safety in Sports, AMC/VUmc IOC Research Center, Amsterdam, the Netherlands.,Department of Orthopaedic Surgery, Foundation for Orthopaedic Research Care and Education, Amphia Hospital, Breda, the Netherlands
| | - P Paul F M Kuijer
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Berbke T van Ginneken
- Centre for Deformity Correction and Joint Preserving Surgery, Kliniek ViaSana, Mill, the Netherlands
| | - Koen L M Koenraadt
- Department of Orthopaedic Surgery, Foundation for Orthopaedic Research Care and Education, Amphia Hospital, Breda, the Netherlands
| | - Rutger C I van Geenen
- Department of Orthopaedic Surgery, Foundation for Orthopaedic Research Care and Education, Amphia Hospital, Breda, the Netherlands
| | - Gino M M J Kerkhoffs
- Academic Center for Evidence-Based Sports Medicine, Amsterdam, the Netherlands.,Amsterdam Collaboration on Health & Safety in Sports, AMC/VUmc IOC Research Center, Amsterdam, the Netherlands.,Department of Orthopaedic Surgery, Foundation for Orthopaedic Research Care and Education, Amphia Hospital, Breda, the Netherlands
| | - Ronald J van Heerwaarden
- Department of Orthopaedic Surgery, Maartenskliniek Woerden, Woerden, the Netherlands.,Centre for Deformity Correction and Joint Preserving Surgery, Kliniek ViaSana, Mill, the Netherlands
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Yamamoto SS, Yacyshyn E, Jhangri GS, Chopra A, Parmar D, Jones CA. Household air pollution and arthritis in low-and middle-income countries: Cross-sectional evidence from the World Health Organization's study on Global Ageing and Adult Health. PLoS One 2019; 14:e0226738. [PMID: 31881058 PMCID: PMC6934325 DOI: 10.1371/journal.pone.0226738] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 12/06/2019] [Indexed: 02/07/2023] Open
Abstract
Background Evidence points to a clear link between air pollution exposure and several chronic diseases though investigations regarding arthritis are still lacking. Emerging evidence suggests an association between ambient air pollution and rheumatoid arthritis. Household air pollution exposure, conversely, is largely unstudied but may be an important consideration for arthritis, particularly in low- and middle-income countries (LMICs), where cooking and heating activities can generate high indoor air pollutant levels. Methods We investigated the association of household air pollution (electricity vs. gas; kerosene/paraffin; coal/charcoal; wood; or agriculture/crop/animal dung/shrubs/grass as the main fuel used for cooking) and arthritis in six LMICs (China, Ghana, India, Mexico, the Russian Federation, South Africa) using data from Wave I of the World Health Organization Study on Global AGEing and Adult Health (SAGE) (2007–2010). Multivariable analyses were adjusted for sociodemographic, household and lifestyle characteristics and several comorbidities. Results The use of gas (aOR = 1.76, 95%CI: 1.40–2.21); coal (aOR = 1.74, 95%CI: 1.22–2.47); wood (aOR = 1.69, 95%CI: 1.30–2.19); or agriculture/crop/animal dung/shrubs/grass: aOR = 1.95 (1.46–2.61) fuels for cooking were strongly associated with an increased odds of arthritis, compared to electricity in cluster and stratified adjusted analyses. Gender (female), age (≥50 years), overweight (25.0 ≤BMI<30.0 kg/m2), obesity (BMI ≥30.0 kg/m2), former and current alcohol consumption, and the comorbidities angina pectoris, diabetes, chronic lung disease, depression and hypertension were also associated with a higher odds of arthritis. Underweight (BMI<18.5 kg/m2) and higher education levels (college/university completed/post-graduate studies) were associated with a lower odds of arthritis. Conclusions These findings suggest that exposure to household air pollution from cook fuels is associated with an increased odds of arthritis in these regions, which warrants further investigation.
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Affiliation(s)
- Shelby S. Yamamoto
- School of Public Health, University of Alberta, Edmonton, Canada
- * E-mail:
| | - Elaine Yacyshyn
- Division of Rheumatology, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada
| | - Gian S. Jhangri
- School of Public Health, University of Alberta, Edmonton, Canada
| | | | - Divya Parmar
- School of Health Sciences, City, University of London, London, England, United Kingdom
| | - C. Allyson Jones
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
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Mikkelsen S, Pedersen EB, Brauer C, Møller KL, Alkjaer T, Koblauch H, Simonsen EB, Thygesen LC. Knee osteoarthritis among airport baggage handlers: A prospective cohort study. Am J Ind Med 2019; 62:951-960. [PMID: 31452223 DOI: 10.1002/ajim.23044] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 08/12/2019] [Indexed: 01/30/2023]
Abstract
BACKGROUND Knee osteoarthritis is a common and often disabling disorder, which has been related to knee-straining work. However, exposure response relations are uncertain and there are few prospective studies. We studied prospectively if incident knee osteoarthritis is associated with cumulative exposure as an airport baggage handler, lifting on average 5000 kg/d. METHODS The study is based on the Copenhagen Airport Cohort, a historical cohort of male baggage handlers and a reference group of unskilled men from the greater Copenhagen area, followed from 1990 to 2012. Cumulative years of employment as a baggage handler was based on information from company employment and union registers. Outcome was first hospital admission with a discharge diagnosis of knee osteoarthritis and/or knee replacement, ascertained from the Danish National Patient Register. RESULTS The cohort contained 3442 baggage handlers and 65 511 workers in the reference group. The unadjusted incidence rate ratio (IRR) of knee osteoarthritis increased steeply with cumulative years as a baggage handler. Although the exposure-response pattern became weaker and statistically nonsignificant (P ≈ .10) when adjusting for age, the risk of knee osteoarthritis was still increased in baggage handlers at the highest exposure level. Additional analyses showed that the association between age and osteoarthritis was stronger for baggage handlers (IRR = 2.09; 95% CI: 1.68-2.60) than for referents (IRR = 1.58; 95% CI: 1.53-1.63), indicating that knee osteoarthritis occurred at a younger age among baggage handlers than in the reference group. CONCLUSIONS The results of this prospective cohort study support that long-term heavy lifting increases the risk of knee osteoarthritis.
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Affiliation(s)
- Sigurd Mikkelsen
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Ellen B Pedersen
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Charlotte Brauer
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Karina L Møller
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Tine Alkjaer
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen N, Denmark
- The Department of Physical and Occupational Therapy, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Henrik Koblauch
- Department of Neuroscience, Panum Institute, University of Copenhagen, Copenhagen, Denmark
| | - Erik B Simonsen
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen N, Denmark
- Department of Neuroscience, Panum Institute, University of Copenhagen, Copenhagen, Denmark
| | - Lau C Thygesen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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van Zaanen Y, van Geenen RCI, Pahlplatz TMJ, Kievit AJ, Hoozemans MJM, Bakker EWP, Blankevoort L, Schafroth MU, Haverkamp D, Vervest TMJS, Das DHPW, van der Weegen W, Scholtes VA, Frings-Dresen MHW, Kuijer PPFM. Three Out of Ten Working Patients Expect No Clinical Improvement of Their Ability to Perform Work-Related Knee-Demanding Activities After Total Knee Arthroplasty: A Multicenter Study. JOURNAL OF OCCUPATIONAL REHABILITATION 2019; 29:585-594. [PMID: 30539374 PMCID: PMC6675779 DOI: 10.1007/s10926-018-9823-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Purpose Three out of ten patients do not return to work after total knee arthroplasty (TKA). Patient expectations are suggested to play a key role. What are patients' expectations regarding the ability to perform work-related knee-demanding activities 6 months after TKA compared to their preoperative status? Methods A multi-center cross-sectional study was performed among 292 working patients listed for TKA. The Work Osteoarthritis or joint-Replacement Questionnaire (WORQ, range 0-100, minimal important difference 13) was used to assess the preoperatively experienced and expected ability to perform work-related knee-demanding activities 6 months postoperatively. Differences between the preoperative and expected WORQ scores were tested and the most difficult knee-demanding work-related activities were described. Results Two hundred thirty-six working patients (81%) completed the questionnaire. Patients' expected WORQ score (Median = 75, IQR 60-86) was significantly (p < 0.01) higher than their preoperative WORQ score (Median = 44, IQR 35-56). A clinical improvement in ability to perform work-related knee-demanding activities was expected by 72% of the patients, while 28% of the patients expected no clinical improvement or even worse ability to perform work-related knee-demanding activities 6 months after TKA. Of the patients, 34% expected severe difficulty in kneeling, 30% in crouching and 17% in clambering 6 months after TKA. Conclusions Most patients have high expectations, especially regarding activities involving deep knee flexion. Remarkably, three out of ten patients expect no clinical improvement or even a worse ability to perform work-related knee-demanding activities 6 months postoperatively compared to their preoperative status. Therefore, addressing patients expectations seems useful in order to assure realistic expectations regarding work activities.
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Affiliation(s)
- Yvonne van Zaanen
- Department Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
| | | | - Thijs M J Pahlplatz
- Orthopaedic Research Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Arthur J Kievit
- Orthopaedic Research Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Marco J M Hoozemans
- CORAL - Center for Orthopaedic Research Alkmaar, Department of Orthopaedics, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Eric W P Bakker
- Master Evidence Based Practice, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Leendert Blankevoort
- Orthopaedic Research Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Matthias U Schafroth
- Orthopaedic Research Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Daniel Haverkamp
- Slotervaart Center of Orthopedic Research and Education (SCORE), MC Slotervaart, Amsterdam, The Netherlands
| | - Ton M J S Vervest
- Department of Orthopaedic Surgery, Tergooi Hospital, Hilversum, The Netherlands
| | - Dirk H P W Das
- Department and Research Center of Orthopaedic Surgery, St. Anna Hospital, Geldrop, The Netherlands
| | - Walter van der Weegen
- Department and Research Center of Orthopaedic Surgery, St. Anna Hospital, Geldrop, The Netherlands
| | | | - Monique H W Frings-Dresen
- Department Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - P Paul F M Kuijer
- Department Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Abstract
Kneeling ability is consistently the poorest patient-rated outcome after total knee replacement (TKR), with 60-80% of patients reporting difficulty kneeling or an inability to kneel.Difficulty kneeling impacts on many activities and areas of life, including activities of daily living, self-care, leisure and social activities, religious activities, employment and getting up after a fall. Given the wide range of activities that involve kneeling, and the expectation that this will be improved with surgery, problems kneeling after TKR are a source of dissatisfaction and disappointment for many patients.Research has found that there is no association between range of motion and self-reported kneeling ability. More research is needed to understand if and how surgical factors contribute to difficulty kneeling after TKR.Discrepancies between patients' self-reported ability to kneel and observed ability suggests that patients can kneel but elect not to. Reasons for this are multifactorial, including knee pain/discomfort, numbness, fear of harming the prosthesis, co-morbidities and recommendations from health professionals. There is currently no evidence that there is any clinical reason why patients should not kneel on their replaced knee, and reasons for not kneeling could be addressed through education and rehabilitation.There has been little research to evaluate the provision of healthcare services and interventions for patients who find kneeling problematic after TKR. Increased clinical awareness of this poor outcome and research to inform the provision of services is needed to improve patient care and allow patients to return to this important activity. Cite this article: EFORT Open Rev 2019;4:460-467. DOI: 10.1302/2058-5241.4.180085.
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Affiliation(s)
- Vikki Wylde
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, UK.,National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, UK
| | - Neil Artz
- Department of Allied Health Professions, University of the West of England, Bristol, UK
| | - Nick Howells
- North Bristol NHS Trust, Southmead Hospital, Bristol, UK
| | - Ashley W Blom
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, UK.,National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, UK.,North Bristol NHS Trust, Southmead Hospital, Bristol, UK
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Hoorntje A, Kuijer PPF, van Ginneken BT, Koenraadt KL, van Geenen RC, Kerkhoffs GM, van Heerwaarden RJ. Prognostic Factors for Return to Sport After High Tibial Osteotomy: A Directed Acyclic Graph Approach. Am J Sports Med 2019; 47:1854-1862. [PMID: 31157542 PMCID: PMC6604251 DOI: 10.1177/0363546519849476] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND High tibial osteotomy (HTO) is increasingly used in young and physically active patients with knee osteoarthritis. These patients have high expectations, including return to sport (RTS). By retaining native knee structures, a return to highly knee-demanding activities seems possible. However, evidence on patient-related outcomes, including RTS, is sparse. Also, time to RTS has never been described. Furthermore, prognostic factors for RTS after HTO have never been investigated. These data may further justify HTO as a surgical alternative to knee arthroplasty. PURPOSE To investigate the extent and timing of RTS after HTO in the largest cohort investigated for RTS to date and to identify prognostic factors for successful RTS. STUDY DESIGN Case-control study; Level of evidence, 3. METHODS Consecutive patients with HTO, operated on between 2012 and 2015, received a questionnaire. First, pre- and postoperative sports participation questions were asked. Also, time to RTS, sports level and frequency, impact level, the presymptomatic and postoperative Tegner activity score (1-10; higher is more active), and the postoperative Lysholm score (0-100; higher is better) were collected. Finally, prognostic factors for RTS were analyzed using a logistic regression model. Covariates were selected based on univariate analysis and a directed acyclic graph. RESULTS We included 340 eligible patients of whom 294 sufficiently completed the questionnaire. The mean follow-up was 3.7 years (± 1.0 years). Out of 256 patients participating in sports preoperatively, 210 patients (82%) returned to sport postoperatively, of whom 158 (75%) returned within 6 months. We observed a shift to participation in lower-impact activities, although 44% of reported sports activities at final follow-up were intermediate- or high-impact sports. The median Tegner score decreased from 5.0 (interquartile range [IQR], 4.0-6.0) presymptomatically to 4.0 (IQR, 3.0-4.0) at follow-up (P < .001). The mean Lysholm score at follow-up was 68 (SD, ± 22). No significant differences were found between patients with varus or valgus osteoarthritis. The strongest prognostic factor for RTS was continued sports participation in the year before surgery (odds ratio, 2.81; 95% CI, 1.37-5.76). CONCLUSION More than 8 of 10 patients returned to sport after HTO. Continued preoperative sports participation was associated with a successful RTS. Future studies need to identify additional prognostic factors.
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Affiliation(s)
- Alexander Hoorntje
- Department of Orthopaedic Surgery,
Amsterdam UMC, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, the
Netherlands
- Academic Center for Evidence-Based
Sports Medicine, Amsterdam, the Netherlands
- Amsterdam Collaboration on Health &
Safety in Sports, Amsterdam UMC IOC Research Center, Amsterdam, the
Netherlands
- Department of Orthopaedic Surgery,
Foundation FORCE (Foundation for Orthopaedic Research Care and Education), Amphia
Hospital, Breda, the Netherlands
| | - P. Paul F.M. Kuijer
- Amsterdam UMC, University of Amsterdam,
Coronel Institute of Occupational Health, Amsterdam Public Health Research
Institute, Amsterdam, the Netherlands
| | - Berbke T. van Ginneken
- Department of Orthopaedic Surgery, Sint
Maartenskliniek Woerden, Woerden, the Netherlands
| | - Koen L.M. Koenraadt
- Department of Orthopaedic Surgery,
Foundation FORCE (Foundation for Orthopaedic Research Care and Education), Amphia
Hospital, Breda, the Netherlands
| | - Rutger C.I. van Geenen
- Department of Orthopaedic Surgery,
Foundation FORCE (Foundation for Orthopaedic Research Care and Education), Amphia
Hospital, Breda, the Netherlands
| | - Gino M.M.J. Kerkhoffs
- Department of Orthopaedic Surgery,
Amsterdam UMC, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, the
Netherlands
- Academic Center for Evidence-Based
Sports Medicine, Amsterdam, the Netherlands
- Amsterdam Collaboration on Health &
Safety in Sports, Amsterdam UMC IOC Research Center, Amsterdam, the
Netherlands
| | - Ronald J. van Heerwaarden
- Department of Orthopaedic Surgery, Sint
Maartenskliniek Woerden, Woerden, the Netherlands
- Centre for Deformity Correction and
Joint Preserving Surgery, Kliniek ViaSana, Mill, the Netherlands
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Moghimi N, Rahmani K, Delpisheh A, Saidi A, Azadi NA, Afkhamzadeh A. Risk factors of knee osteoarthritis: A case-control study. Pak J Med Sci 2019; 35:636-640. [PMID: 31258567 PMCID: PMC6572946 DOI: 10.12669/pjms.35.3.277] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background and Objective Knee osteoarthritis is one of the most common rheumatologic problems. To investigate risk factors related to the knee osteoarthritis a case-control study was performed using cases diagnosed in the Community Oriented Program for Control of Rheumatic Diseases (COPCORD) study, stage I. Methods Using data from the 2012 COPCORD study, stage-I that was conducted in Sanandaj, northwestern of Iran, we runned a case-control study in 2014-2015. Cases were 700 knee osteoarthritis using American College of Rheumatology (ACR) criteria, frequency matched with 700 healthy controls that were randomly selected from the general population. Results In multivariate analysis, statistical significant relation was observed between knee OA and some studied factors such as body mass index (P <0.001), lodging (living in highland vs. plain) (P <0.001), type of used toilet (regular vs. toilet) (P <0.001), history of using high-heeled shoes (>3 cm) (P = 0.005), history of knee Injury (P = 0.04), history of lower limb fracture (P = 0.02), Number of pregnancies (P <0.001) and history of pain and swelling (lasting for one months) (P = 0.04). Conclusions Living in highland area, using regular toilet, having knee injury and lower limb fracture in the past were most significant associated factors with occurrence of knee osteoarthritis.
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Affiliation(s)
- Nasrin Moghimi
- Nasrin Moghimi (MD). Assistant Professor, Department of Rheumatology, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Khaled Rahmani
- Khaled Rahmani (PhD). Assistant Professor of Epidemiology, Department of Community Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Ali Delpisheh
- Ali Delpisheh (PhD, Postdoc). Professor of Clinical Epidemiology, Ilam University of Medical Sciences, Ilam, Iran
| | - Afshin Saidi
- Afshin Saidi (MPH). Liver & Digestive Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Namam Ali Azadi
- Namam Ali Azadi (PhD). Biostatistics Department, School of public health, Iran University of Medical Sciences, Tehran, Iran
| | - Abdorrahim Afkhamzadeh
- Abdorrahim Afkhamzadeh (MD, MPH). Associate Professor of Community Medicine, Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
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Hulshof CTJ, Colosio C, Daams JG, Ivanov ID, Prakash KC, Kuijer PPFM, Leppink N, Mandic-Rajcevic S, Masci F, van der Molen HF, Neupane S, Nygård CH, Oakman J, Pega F, Proper K, Prüss-Üstün AM, Ujita Y, Frings-Dresen MHW. WHO/ILO work-related burden of disease and injury: Protocol for systematic reviews of exposure to occupational ergonomic risk factors and of the effect of exposure to occupational ergonomic risk factors on osteoarthritis of hip or knee and selected other musculoskeletal diseases. ENVIRONMENT INTERNATIONAL 2019; 125:554-566. [PMID: 30583853 PMCID: PMC7794864 DOI: 10.1016/j.envint.2018.09.053] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 09/27/2018] [Accepted: 09/28/2018] [Indexed: 05/20/2023]
Abstract
BACKGROUND The World Health Organization (WHO) and the International Labour Organization (ILO) are developing a joint methodology for estimating the national and global work-related burden of disease and injury (WHO/ILO joint methodology), with contributions from a large network of experts. In this paper, we present the protocol for two systematic reviews of parameters for estimating the number of disability-adjusted life years from osteoarthritis of hip or knee, and selected other musculoskeletal diseases respectively, attributable to exposure to occupational ergonomic risk factors to inform the development of the WHO/ILO joint methodology. OBJECTIVES We aim to systematically review studies on exposure to occupational ergonomic risk factors (Systematic Review 1) and systematically review and meta-analyze estimates of the effect of exposure to occupational ergonomic risk factors on osteoarthritis of the hip or knee, and selected other musculoskeletal diseases respectively (Systematic Review 2), applying the Navigation Guide systematic review methodology as an organizing framework, conducting both systematic reviews in tandem and in a harmonized way. DATA SOURCES Separately for Systematic Reviews 1 and 2, we will search electronic academic databases for potentially relevant records from published and unpublished studies, including Medline, EMBASE, Web of Science and CISDOC. We will also search electronic grey literature databases, Internet search engines and organizational websites; hand-search reference lists of previous systematic reviews and included study records; and consult additional experts. STUDY ELIGIBILITY AND CRITERIA We will include working-age (≥15 years) workers in the formal and informal economy in any WHO and/or ILO Member State, but exclude children (<15 years) and unpaid domestic workers. The included occupational ergonomic risk factors will be any exposure to one or more of: force exertion; demanding posture; repetitiveness; hand-arm vibration; lifting; kneeling and/or squatting; and climbing. Included outcomes will be (i) osteoarthritis and (ii) other musculoskeletal diseases (i.e., one or more of: rotator cuff syndrome; bicipital tendinitis; calcific tendinitis; shoulder impingement; bursitis shoulder; epicondylitis medialis; epicondylitis lateralis; bursitis elbow; bursitis hip; chondromalacia patellae; meniscus disorders; and/or bursitis knee). For Systematic Review 1, we will include quantitative prevalence studies of any exposure to occupational ergonomic risk factors stratified by country, gender, age and industrial sector or occupation. For Systematic Review 2, we will include randomized controlled trials, cohort studies, case-control-studies and other non-randomized intervention studies with an estimate of the relative effect of any exposure with occupational ergonomic risk factors on the prevalence or incidence of osteoarthritis and/or selected musculoskeletal diseases, compared with the theoretical minimum risk exposure level (i.e., no exposure). STUDY APPRAISAL AND SYNTHESIS METHODS At least two review authors will independently screen titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. At least two review authors will assess risk of bias and the quality of evidence, using the most suited tools currently available. For Systematic Review 2, if feasible, we will combine relative risks using meta-analysis. We will report results using the guidelines for accurate and transparent health estimates reporting (GATHER) for Systematic Review 1 and the preferred reporting items for systematic reviews and meta-analyses guidelines (PRISMA) for Systematic Review 2. PROSPERO registration number: CRD42018102631.
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Affiliation(s)
- Carel T J Hulshof
- Coronel Institute of Occupational Health, Amsterdam UMC, location AMC, Amsterdam Public Health Research Institute, Amsterdam, Netherlands.
| | - Claudio Colosio
- Department of Health Sciences, University of Milan, Milan, Italy; International Centre for Rural Heath, University Hospital San Paolo, Milan, Italy.
| | - Joost G Daams
- Coronel Institute of Occupational Health, Amsterdam UMC, location AMC, Amsterdam Public Health Research Institute, Amsterdam, Netherlands.
| | - Ivan D Ivanov
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - K C Prakash
- Faculty of Social Science (Health Sciences), University of Tampere, Tampere, Finland.
| | - Paul P F M Kuijer
- Coronel Institute of Occupational Health, Amsterdam UMC, location AMC, Amsterdam Public Health Research Institute, Amsterdam, Netherlands.
| | - Nancy Leppink
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Geneva, Switzerland.
| | - Stefan Mandic-Rajcevic
- Department of Health Sciences, University of Milan, Milan, Italy; International Centre for Rural Heath, University Hospital San Paolo, Milan, Italy.
| | - Frederica Masci
- Department of Health Sciences, University of Milan, Milan, Italy; International Centre for Rural Heath, University Hospital San Paolo, Milan, Italy.
| | - Henk F van der Molen
- Coronel Institute of Occupational Health, Amsterdam UMC, location AMC, Amsterdam Public Health Research Institute, Amsterdam, Netherlands.
| | - Subas Neupane
- Faculty of Social Science (Health Sciences), University of Tampere, Tampere, Finland.
| | - Clas-Håkan Nygård
- Faculty of Social Science (Health Sciences), University of Tampere, Tampere, Finland.
| | | | - Frank Pega
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - Karin Proper
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Amsterdam, Netherlands.
| | - Annette M Prüss-Üstün
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - Yuka Ujita
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Geneva, Switzerland.
| | - Monique H W Frings-Dresen
- Coronel Institute of Occupational Health, Amsterdam UMC, location AMC, Amsterdam Public Health Research Institute, Amsterdam, Netherlands.
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Georgiev T, Angelov AK. Modifiable risk factors in knee osteoarthritis: treatment implications. Rheumatol Int 2019; 39:1145-1157. [DOI: 10.1007/s00296-019-04290-z] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 03/19/2019] [Indexed: 12/23/2022]
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