Varus and valgus deformities in knee osteoarthritis among different ethnic groups (Indian, Portuguese and Canadians) within an urban Canadian rheumatology practice

Chronic pain experiences of immigrant Indian women in Canada: A photovoice exploration

Background

Over the past two decades, the prevalence of chronic pain has significantly increased globally, with approximately 20% of the world's population living with pain. Although quantitative measures are useful in identifying pain prevalence and severity, qualitative methods, and especially arts-based ones, are now receiving attention as a valuable means to understand lived experiences of pain. Photovoice is one such method that utilizes individuals' own photography to document their lived experiences.

Aims

The current study utilized an arts-based method to explore immigrant Indian women's chronic pain experiences in Canada and aimed to enhance the understanding of those experiences by creating a visual opportunity for them to share their stories.

Methods

Twelve immigrant Indian women captured photographs and participated in one-on-one interviews exploring daily experiences of chronic pain.

Results

Women's photographs, and description of these photographs, provided a visual entry into their lives and pain experiences. Three themes emerged from our analysis: (1) bodies in pain, (2) traversing spaces including immigration, and (3) pain management methods. Findings revealed that women's representations of pain were shaped by a clash between culturally shaped gender role expectations and changing gender norms due to immigration processes. The use of photovoice visually contextualized and represented pain experiences, proving to be a valuable tool for self-reflection.

Conclusions

This research uncovers the multifaceted nature of chronic pain and identifies the influence of immigration, gender, and social relations on the exacerbation of pain in immigrant Indian women.

Comparative Study of Pinless Navigation System versus Conventional Instrumentation in Total Knee Arthroplasty

Backgroud

Optimal placement of the components and achieving a neutral mechanical axis are the main goals of total knee arthroplasty (TKA). Different computerised navigation systems are presently used for these purposes. This aim of this study was to compare the pinless navigation (PNA) TKA performed using iAssist with the conventional instrumented (CIN) TKA in terms of functional and radiological outcomes.

Methods

A total of 100 knees operated for TKA by a single surgeon were studied retrospectively for a period of 2 years. Weight-bearing postoperative radiographs of the knees along with scanograms of the lower limbs were used for measurements of component positioning, mechanical axis alignment, and number of outliers. Oxford knee scoring was used for functional analysis.

Results

No statistically significant difference was seen in the mean mechanical axis alignment (hip-knee-ankle angle), coronal alignment (α and β angles) and sagittal alignment (γ and δ angles) of the femoral and tibial components between the two groups. Though the percentage of outliers for mechanical axis alignment was lower in the PNA-TKA group than in the CIN-TKA group, the difference was not statistically significant (p = 0.73). The number of outliers for the femoral and tibial component positioning in coronal and sagittal planes was not statistically significantly different between the two groups. No statistically significant difference (p = 0.68) was noted between the two groups with respect to the Oxford Knee Score. The mean surgical time was greater in the PNA-TKA group by 11 minutes, which was statistically significantly longer (p = 0.018). Complications were seen in 6.89% of the cases in the CIN-TKA group, while none in the PNA-TKA group.

Conclusions

The accurate mechanical axis alignment and component positioning can be achieved with the conventional instrumentation, so the use of PNA system, which adds to the surgical cost, is questionable. Also, equally good short-term functional outcome can be achieved with the conventional instrumentation. The surgeon must be accustomed with the instrumentation of the PNA system, or it adds to the surgical time.

Correlation of serum cartilage oligomeric matrix protein with knee osteoarthritis diagnosis: a meta-analysis

BACKGROUND

The measurement of cartilage oligomeric matrix protein (COMP) has become a novel way for the diagnosis of knee osteoarthritis (OA). However, no conclusive correlation has been drawn between COMP and knee OA. The purpose of this study was to examine the utility of serum COMP as biomarker for knee OA and its relation with disease severity.

METHODS

A systematic search on PubMed, ScienceDirect, and EMBASE was conducted in January 2018 using certain keywords. Initial search yielded a total of 285 publications, and 35 articles were reviewed in full-text. Eventually, nine studies were included in the analysis. All the retrieved studies used Kellgren-Lawrence (K-L) classification for knee OA and provided available data of serum COMP in OA patients and healthy controls. Sensitivity analysis was performed by removing one study result at a time to detect the impact of each study have on the overall effect and to test the stability of the cumulative result. Subgroup study based on K-L grade system was also conducted to disclose the correlation between serum COMP and knee OA disease severity.

RESULTS

Pooled analysis of nine studies demonstrated a significant elevation of serum COMP in knee OA patients (SMD 0.81, [95% CI, 0.36, 1.25], P = 0.0004) compared with controls. In comparisons between K-L 1-4 and controls, significantly higher serum COMP was detected in all three subgroups except K-L grade 1 versus control. Comparisons among K-L grades 1-4 revealed significantly higher serum COMP levels in patients with more serious than less serious disease stage. However, the elevation in patients with K-L grade 3 did not reach statistical significance when compared with K-L grade 1 patients.

CONCLUSION

The overall analysis showed significantly higher serum COMP in knee OA patients compared to controls which indicate the potential ability of serum COMP in differentiating knee OA patients from healthy subjects. Pooled statistic of our meta-analysis showed that serum COMP levels were effective in distinguishing patients with K-L ≥ 2.