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Törnblom M, Bremander A, Aili K, Andersson MLE, Nilsdotter A, Haglund E. Development of radiographic knee osteoarthritis and the associations to radiographic changes and baseline variables in individuals with knee pain: a 2-year longitudinal study. BMJ Open 2024; 14:e081999. [PMID: 38458788 DOI: 10.1136/bmjopen-2023-081999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/10/2024] Open
Abstract
OBJECTIVES The aim was to study the development of radiographic knee osteoarthritis (RKOA) in individuals with knee pain over 2 years, and the associations between radiographic changes and baseline variables. DESIGN Longitudinal cohort study. PARTICIPANTS AND SETTING This study is part of the Halland Osteoarthritis cohort. The included 178 individuals, aged 30-67, had knee pain, without cruciate ligament injury or radiographic findings and 67% were women. The presence of RKOA was defined as Ahlbäck score of ≥1 in ≥1 knee. (Ahlbäck grade 1: joint space narrowing in the tibiofemoral joint <3 mm). Diagnosis of clinical KOA was based on the clinical guideline from the National Institute for Health and Care Excellence (NICE). Knee injury and Osteoarthritis Outcome Score (KOOS), pain intensity, physical function, body mass index (BMI) and visceral fat area (VFA) were measured. Associations to RKOA were analysed with logistic regression (OR). RESULTS In all, 13.8% (n=24) developed RKOA in 2 years whereof all had clinical KOA at baseline, as defined by NICE. Deterioration to RKOA was significantly associated with higher BMI, OR 1.119 (95% CI 1.024 to 1.223; p=0.013), and VFA, 1.008 (95% CI 1.000 to 1.016; p=0.049), worse knee pain intensity, 1.238 (95% CI 1.028 to 1.490; p=0.024), worse scores for KOOS Pain, 0.964 (95% CI 0.937 to 0.992; p=0.013) and KOOS Symptoms, 0.967 (95% CI 0.939 to 0.996; p=0.027), KOOS Activities of daily living 0.965 (95% CI 0.935 to 0.996; p=0.026) and KOOS Quality of Life 0.973 (95% CI 0.947 to 0.999; p=0.044), at baseline. CONCLUSIONS One out of seven individuals with clinical KOA developed RKOA in only 2 years. Baseline variables associated with RKOA after 2 years may possibly be detected early by using the NICE guideline, assessment of obesity and self-reported data of symptoms to support first-line treatment: education, exercise and weight control. TRIAL REGISTRATION NUMBER ClinicalTrials.gov (NCT04928170).
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Affiliation(s)
- Margareta Törnblom
- Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden
- Spenshult R & D center, Halmstad, Sweden
| | - Ann Bremander
- Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Katarina Aili
- Spenshult R & D center, Halmstad, Sweden
- Department of Health and Sports, School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Maria L E Andersson
- Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden
- Spenshult R & D center, Halmstad, Sweden
| | - Anna Nilsdotter
- Department of Orthopaedics, Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
- Department of Orthopaedics, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Emma Haglund
- Spenshult R & D center, Halmstad, Sweden
- Department of Environmental and Biosciences School of Business, Innovation and Sustainability, Halmstad University, Halmstad, Sweden
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Andersson M, Haglund E, Aili K, Bremander A, Bergman S. Associations between metabolic factors and radiographic knee osteoarthritis in early disease - a cross-sectional study of individuals with knee pain. BMC Musculoskelet Disord 2022; 23:938. [PMID: 36307803 PMCID: PMC9615348 DOI: 10.1186/s12891-022-05881-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 10/12/2022] [Indexed: 05/06/2024] Open
Abstract
Objective Metabolic factors have been shown to be associated to severe radiographic knee osteoarthritis (RKOA). However, more knowledge is needed in early clinical knee osteoarthritis (KOA). The aim was to study associations between metabolic factors and radiographic knee osteoarthritis (OA) in individuals with knee pain. A second aim was to study associations between metabolic factors and RKOA in those with normal BMI and in those overweight/obese, respectively. Method This cross-sectional study included 282 individuals with knee pain (without cruciate ligament injury) and aged 30–67 years, and 70% women. Waist circumference, body mass index (BMI), proportion of fat and visceral fat area (VFA) were assessed. RKOA was defined as Ahlbäck grade 1 in at least one knee. Fasting blood samples were taken and triglycerides, cholesterol (total, low density lipoprotein (LDL) and high density lipoprotein (HDL)), C-reactive protein (CRP), glucose, HbA1C were analysed. Metabolic syndrome was defined in accordance with the International Diabetes Federation (IDF). Associations were analysed by logistic regression. Results Individuals with RKOA were older, had higher BMI, higher VFA, larger waist circumference and had increased total cholesterol, triglycerides and LDL-cholesterol, but not fasting glucose. There was no difference between the group with RKOA vs. non-radiographic group regarding the presence of metabolic syndrome. In a subgroup analysis of individuals with normal BMI (n = 126), those with RKOA had higher VFA, more central obesity, higher levels of CRP and total cholesterol, compared with individuals without RKOA. In individuals with obesity, age was the only outcome associated to RKOA. Conclusion There were clear associations between metabolic factors and RKOA in individuals with knee pain, also in those with normal BMI. In individuals with obesity age was the only variable associated to RKOA. Trial registration: clinicalTrials.gov Identifier: NCT04928170.
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Alves-Cardoso F, Assis S. Exploring "wear and tear" of joints and "muscle function" assumptions in skeletons with known occupation at death. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2021; 175:689-700. [PMID: 34013541 DOI: 10.1002/ajpa.24334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 04/13/2021] [Accepted: 05/02/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Changes in the joints are believed to result from "wear and tear," a consequence of activity, as entheseal changes (EC) result from muscle use. However, clinical data showed that activity does not necessarily increase the likelihood of degenerative joint changes (DJC) and that exercise results in healthier joints. We tested whether individuals with continuous repetitive biomechanical efforts (Group 1) were more likely to exhibit EC and if occupations known to exert strenuous but discontinued efforts (Group 2) would more likely cause DJC. MATERIALS AND METHODS Eighty-nine males with known occupations from Portuguese identified collections were used: shoemakers and carpenters (Group 1), workers (Group 2), and civil servants, and shop assistants as a control group. Major upper and lower limb joints and entheses sites were used. DJC and EC were tested between occupations - while controlling for age (overall approach) - and within occupation (occupation-specific approach). RESULTS The overall approach showed that age - as a covariant - had a significant impact on DJC and EC development (p < 0.05), with occupation being non-significant (p > 0.05) despite the variability in the mean-values of lesions. The occupation-specific approach showed a significant variability of DJC and EC correlations, within and between occupations, with no clear trend of DJC and EC development according to occupation. DISCUSSION The results showed that exploring overall patterns might conceal occupation-specific joint and muscle use, emphasizing age as a major contributor of changes; and that the occupation-specific approach highlighted particular aspects associated with occupations, allowing for a more informative assessment of strenuous repetitive or discontinuous activity-related technical gestures and their impact on skeletal biology.
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Affiliation(s)
- Francisca Alves-Cardoso
- Laboratório de Antropologia Biológica e Osteologia Humana (LABOH), Centro em Rede de Investigação em Antropologia (CRIA), Faculdade de Ciências Sociais e Humanas, Universidade NOVA de Lisboa (FCSH/NOVA), Lisbon, Portugal
| | - Sandra Assis
- Laboratório de Antropologia Biológica e Osteologia Humana (LABOH), Centro em Rede de Investigação em Antropologia (CRIA), Faculdade de Ciências Sociais e Humanas, Universidade NOVA de Lisboa (FCSH/NOVA), Lisbon, Portugal.,CIAS-Research Center for Anthropology and Health, University of Coimbra, Coimbra, Portugal
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Hadamus A, Białoszewski D, Błażkiewicz M, Kowalska AJ, Urbaniak E, Wydra KT, Wiaderna K, Boratyński R, Kobza A, Marczyński W. Assessment of the Effectiveness of Rehabilitation after Total Knee Replacement Surgery Using Sample Entropy and Classical Measures of Body Balance. ENTROPY (BASEL, SWITZERLAND) 2021; 23:164. [PMID: 33573057 PMCID: PMC7911395 DOI: 10.3390/e23020164] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/20/2021] [Accepted: 01/27/2021] [Indexed: 12/01/2022]
Abstract
Exercises in virtual reality (VR) have recently become a popular form of rehabilitation and are reported to be more effective than a standard rehabilitation protocol alone. The aim of this study was to assess the efficacy of adjunct VR training in improving postural control in patients after total knee replacement surgery (TKR). Forty-two patients within 7-14 days of TKR were enrolled and divided into a VR group and a control group (C). The C group underwent standard postoperative rehabilitation. The VR group additionally attended twelve 30-min exercise sessions using the Virtual Balance Clinic prototype system. Balance was assessed on the AMTI plate in bipedal standing with and without visual feedback before and after the four-week rehabilitation. Linear measures and sample entropy of CoP data were analyzed. After four weeks of rehabilitation, a significant reduction in parameters in the sagittal plane and ellipse area was noted while the eyes remained open. Regression analysis showed that sample entropy depended on sex, body weight, visual feedback and age. Based on the sample entropy results, it was concluded that the complexity of the body reaction had not improved. The standing-with-eyes-closed test activates automatic balance mechanisms and offers better possibilities as a diagnostic tool.
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Affiliation(s)
- Anna Hadamus
- Department of Rehabilitation, Faculty of Medical Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland; (A.H.); (D.B.); (K.W.)
| | - Dariusz Białoszewski
- Department of Rehabilitation, Faculty of Medical Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland; (A.H.); (D.B.); (K.W.)
| | - Michalina Błażkiewicz
- The Józef Piłsudski University of Physical Education in Warsaw, 00-809 Warsaw, Poland
| | - Aleksandra J. Kowalska
- Professor Adam Gruca Independent Public Teaching Hospital in Otwock, Rehabilitation Clinic, 05-400 Otwock, Poland; (A.J.K.); (E.U.); (K.T.W.); (R.B.); (A.K.)
| | - Edyta Urbaniak
- Professor Adam Gruca Independent Public Teaching Hospital in Otwock, Rehabilitation Clinic, 05-400 Otwock, Poland; (A.J.K.); (E.U.); (K.T.W.); (R.B.); (A.K.)
| | - Kamil T. Wydra
- Professor Adam Gruca Independent Public Teaching Hospital in Otwock, Rehabilitation Clinic, 05-400 Otwock, Poland; (A.J.K.); (E.U.); (K.T.W.); (R.B.); (A.K.)
| | - Karolina Wiaderna
- Department of Rehabilitation, Faculty of Medical Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland; (A.H.); (D.B.); (K.W.)
| | - Rafał Boratyński
- Professor Adam Gruca Independent Public Teaching Hospital in Otwock, Rehabilitation Clinic, 05-400 Otwock, Poland; (A.J.K.); (E.U.); (K.T.W.); (R.B.); (A.K.)
| | - Agnieszka Kobza
- Professor Adam Gruca Independent Public Teaching Hospital in Otwock, Rehabilitation Clinic, 05-400 Otwock, Poland; (A.J.K.); (E.U.); (K.T.W.); (R.B.); (A.K.)
| | - Wojciech Marczyński
- Medical Centre for Postgraduate Education, Professor Adam Gruca Independent Public Teaching Hospital in Otwock, Orthopaedics Clinic, 05-400 Otwock, Poland;
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Aprile I, Iacovelli C, Cruciani A, Simbolotti C, Loreti S, Galli G, Vulpiani MC, Padua L. Technological rehabilitation versus conventional rehabilitation following hip replacement: A prospective controlled study. J Back Musculoskelet Rehabil 2020; 33:561-568. [PMID: 31743982 DOI: 10.3233/bmr-181211] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Among new technological rehabilitation systems, there are proprioceptive platforms. These could be useful to improve static and dynamic balance. OBJECTIVE To evaluate technological proprioceptive rehabilitation compared to conventional rehabilitation in patients after total hip arthroplasty (THA). METHODS Sixty-four patients after THA were divided in two groups: a conventional group (CG) and a technological group (TG) treated with proprioceptive platforms. Before (T0) and after 20 sessions (T1), we recorded static and dynamic balance. Clinical and disability scales (Modified Harris Hip Score, Barthel Index, Deambulation Index), pain scales (ID-PAIN, DN4, VAS) and QoL scale (SF-36) were administered to patients during T0 and T1. Mann-Whitney U test was used for stabilometric and dynamic assessments to detect differences between groups of patients and healthy subjects. The Wilcoxon signed-rank test was used for the within-group analysis and the ANCOVA test for the analysis between groups of patients. RESULTS All scales improved significantly in both groups after treatment (p< 0.05). Static balance improved in both groups, but there were greater improvements in the TG than in the CG. All dynamic balance indexes showed significant improvements only in the TG after treatment. CONCLUSIONS Both treatments improved the clinical, disability, pain, and QoL scales, as well as static balance, but only proprioceptive technological rehabilitation improved dynamic balance. Rehabilitation through proprioceptive platforms can indeed improve static and dynamic balance, which are both crucial for the patient's safety and autonomy.
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Affiliation(s)
- Irene Aprile
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | | | | | | | - Simona Loreti
- Physical Medicine and Rehabilitation Unit, Sant'Andrea Hospital, University of Rome - "La Sapienza", Rome, Italy
| | - Giulia Galli
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Maria Chiara Vulpiani
- Physical Medicine and Rehabilitation Unit, Sant'Andrea Hospital, University of Rome - "La Sapienza", Rome, Italy
| | - Luca Padua
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
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Muñoz-García N, Cordero-Ampuero J, Madero-Jarabo R. Diagnostic Accuracy of Magnetic Resonance Images and Weight-Bearing Radiographs in Patients With Arthroscopic-Proven Medial Osteoarthritis of the Knee. CLINICAL MEDICINE INSIGHTS-ARTHRITIS AND MUSCULOSKELETAL DISORDERS 2020; 13:1179544120938369. [PMID: 32843843 PMCID: PMC7418247 DOI: 10.1177/1179544120938369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 05/11/2020] [Indexed: 01/07/2023]
Abstract
Aims: The aim of this study is to analyze the diagnostic value of weight-bearing radiographs, magnetic resonance images (MRI), and the combination of both in osteoarthritic knees when using arthroscopic findings as the “gold standard” to compare with. Methods: A total of 59 patients were studied because of chronic pain in 1 of their knees. Radiographs were classified according to Kellgren-Lawrence scale. Magnetic resonance images were classified according to Vallotton, and arthroscopic findings according to Outerbridge criteria. Results: Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were, respectively, 75.0%, 60.0%, 56.2%, 77.8%, and 66.1% for weight-bearing radiographs, and 70.8%, 88.6%, 81.0%, 81.6%, and 81.4% for MRI. Logistic regression analysis showed that a weight-bearing radiograph added to MRI offered no additional diagnostic value compared with MRI alone (P < .001). Conclusions: Magnetic resonance images presented higher specificity, positive and negative predictive values, and accuracy than weight-bearing radiographs for knee osteoarthritis. The combination of radiographs and MRI did not improve the diagnostic accuracy, compared with MRI alone.
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Affiliation(s)
- Nuria Muñoz-García
- Department of Orthopaedic Surgery, Santa Cristina University Hospital, Madrid, Spain
| | - José Cordero-Ampuero
- Department of Orthopaedic Surgery, La Princesa University Hospital, Autonoma University, Madrid, Spain
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Osteoarthritis – a problematic skeletal trait in past human populations. Osteoarthritic changes vs. entheseal changes in the late medieval and early modern population form Łekno. ANTHROPOLOGICAL REVIEW 2020. [DOI: 10.2478/anre-2020-0011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Abstract
According to medical knowledge, physical activity plays a role in osteoarthritic changes formation. The impact of occupation on osteoarthritic changes development in past human populations is not clear enough, causing problems with interpretation. The aim of the current study is to examine the relationship between osteoarthritis and entheseal changes. Skeletal material comes from the late medieval, early modern population from Łekno (Poland). The sample consists of 110 males and 56 females (adults only). Osteophytes, porosity and eburnation were analyzed in the shoulder, elbow, wrist, hip, knee, and ankle. Entheses on the humerus, radius, femur, and tibia were examined. Standard ranked categorical scoring systems were used for the osteoarthritic and entheseal changes examination.
Males with more developed osteophytes in the shoulder have more “muscular” upper limbs (higher values of muscle markers). Males with more developed osteophytes in the hip and knee are predicted to have more “muscular” lower limbs. Males with more developed osteoarthritis in the shoulder, wrist, hip, and knee exhibit more developed entheseal changes. Males with more developed entheses tend to yield more developed osteophytes (all joints taken together) and general osteoarthritis (all changes and all joints taken together). Females with more developed entheses have more developed osteoarthritis in the elbow, wrist, and hip. Individuals with more developed entheses have much more developed osteophytes. When all the three types of changes are taken together, more “muscular” females exhibit more developed osteoarthritis. The lack of uniformity of the results, wild discussions on the usage of entheses in activity patterns reconstruction and other limitations do not allow to draw unambiguous conclusions about the impact of physical activity on the osteoarthritis in past populations and further studies are needed.
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Myszka A, Piontek J, Tomczyk J, Lisowska-Gaczorek A, Zalewska M. Relationships between osteoarthritic changes (osteophytes, porosity, eburnation) based on historical skeletal material. Ann Hum Biol 2020; 47:263-272. [PMID: 32295434 DOI: 10.1080/03014460.2020.1741682] [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: 10/24/2022]
Abstract
Background: Three main diagnostic types of osteoarthritic changes are distinguished in clinical and anthropological literature: osteophytes, porosity, and eburnation. The nature of the relationship between these changes and how lesions progress over time is still unclear.Aim: The aim of the present study is the analysis of the relationships between osteophytes, porosity, and eburnation based on skeletal material.Subjects and methods: The analysis employed the skeletal collection from Cedynia (199 individuals) from tenth to fourteenth-century Poland. Marginal osteophytes (OP), porosity (POR), and eburnation (EB) were examined on a shoulder, elbow, wrist, hip, knee, and ankle.Results: Osteophytes and porosity occurred independently of each other. Combinations of osteophytes and porosity (OP + POR) and osteophytes, porosity, and eburnation (OP + POR + EB) were rarely observed. Combinations of osteophytes and eburnation (OP + EB) or porosity and eburnation (POR + EB) were not found. There was a significant correlation between osteophytes and porosity in the scapula, proximal end of the ulna and proximal end of the femur. Osteophytes and eburnation were correlated at the distal end of the ulna. Porosity and eburnation were correlated at the distal end of the radius and distal end of the ulna. When all joints were considered together, all the types of osteoarthritic changes were correlated. However, the relationship between osteophytes and eburnation and between porosity and eburnation was only slightly significant. Osteophytes preceded porosity, but there were a few cases where more developed porosity accompanied less developed osteophytes.Conclusions: The findings indicate that correlations between osteoarthritic changes are weak, albeit statistically significant and further studies of the relationship between changes are necessary.
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Affiliation(s)
- Anna Myszka
- Institute of Biological Sciences, Cardinal Stefan Wyszynski University, Warsaw, Poland
| | - Janusz Piontek
- Institute of Anthropology, Adam Mickiewicz University in Poznań, Poznań, Poland
| | - Jacek Tomczyk
- Institute of Biological Sciences, Cardinal Stefan Wyszynski University, Warsaw, Poland
| | | | - Marta Zalewska
- Department of the Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
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Xiao D, Bi R, Liu X, Mei J, Jiang N, Zhu S. Notch Signaling Regulates MMP-13 Expression via Runx2 in Chondrocytes. Sci Rep 2019; 9:15596. [PMID: 31666602 PMCID: PMC6821756 DOI: 10.1038/s41598-019-52125-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 10/14/2019] [Indexed: 02/05/2023] Open
Abstract
Notch signaling is involved in the early onset of osteoarthritis. The aim of this study was to investigate the role of Notch signaling changes during proliferation and differentiation of chondrocyte, and to testify the mechanism of MMP-13 regulation by Notch and Runx2 expression changes during osteoarthritis. In this study, Chondrocytes were isolated from rat knee cartilages. Notch signaling was activated/inhibited by Jagged-1/DAPT. Proliferative capacity of Chondrocytes was analyzed by CCK-8 staining and EdU labeling. ColX, Runx2 and MMP-13 expressions were analyzed as cell differentiation makers. Then, Runx2 gene expression was interfered using lentivirus transfection (RNAi) and was over-expressed by plasmids transfected siRNA in chondrocytes, and MMP-13 expression was analyzed after Jagged-1/DAPT treatment. In vivo, an intra-articular injection of shRunx2 lentivirus followed with Jagged1/DAPT treatments was performed in rats. MMP-13 expression in articular cartilage was detected by immunohistochemistry. Finally, MMP-13 expression changes were analyzed in chondrocytes under IL-1β stimulation. Our findings showed that, CCK-8 staining and EdU labeling revealed suppression of cell proliferation by Notch signaling activation after Jagged-1 treatment in chondrocytes. Promoted differentiation was also observed, characterized by increased expressions of Col X, MMP-13 and Runx2. Meanwhile, Sox9, aggrecan and Col II expressions were down-regulated. The opposite results were observed in Notch signaling inhibited cells by DAPT treatment. In addition, Runx2 RNAi significantly attenuated the ‘regulatory sensitivity’ of Notch signaling on MMP-13 expression both in vitro and in vivo. However, we found there wasn’t significant changes of this ‘regulatory sensitivity’ of Notch signaling after Runx2 over-expression. Under IL-1β circumstance, MMP-13 expression could be reduced by both DAPT treatment and Runx2 RNAi, while Runx2 interference also attenuated the ‘regulatory sensitivity’ of Notch in MMP-13 under IL-1β stimulation. In conclusion, Notch signaling is an important regulator on rat chondrocyte proliferation and differentiation, and this regulatory effect was partially mediated by proper Runx2 expression under both normal and IL-1β circumstances. In the meanwhile, DAPT treatment could effectively suppress expression of MMP-13 stimulated by IL-1 β.
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Affiliation(s)
- Di Xiao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Stomatology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Ruiye Bi
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xianwen Liu
- Department of Oral and Maxillofacial Surgery, Guangdong Provincial Hospital of Stomatology, Southern Medical University, Guangzhou, China
| | - Jie Mei
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Nan Jiang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Songsong Zhu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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The role of matrix metalloproteinases in osteoarthritis pathogenesis: An updated review. Life Sci 2019; 234:116786. [DOI: 10.1016/j.lfs.2019.116786] [Citation(s) in RCA: 161] [Impact Index Per Article: 32.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 08/19/2019] [Accepted: 08/20/2019] [Indexed: 12/22/2022]
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11
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Peultier-Celli L, Lion A, Chary-Valckenaere I, Loeuille D, Zhang Z, Rat AC, Gueguen R, Paysant J, Perrin PP. Comparison of high-frequency intensive balneotherapy with low-frequency balneotherapy combined with land-based exercise on postural control in symptomatic knee osteoarthritis: a randomized clinical trial. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2019; 63:1151-1159. [PMID: 31065841 DOI: 10.1007/s00484-019-01727-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 04/24/2019] [Accepted: 04/25/2019] [Indexed: 05/19/2023]
Abstract
Knee osteoarthritis (KOA) can generate postural control impairments which can increase fall risk. Land-based exercise (LBE) and balneotherapy are two modalities currently prescribed, but the impact of the latter on balance control has not been studied. This study aimed to compare two programs of balneotherapy with or without LBE to improve postural control, looking at frequency and duration of treatment. A total of 236 KOA patients (mean age = 64 years) were included in this prospective and randomized study: 122 patients went through 3 weeks of standardized continuous balneotherapy (high frequency/short duration) program (Gr1) and 114 went through 3 weeks of discontinuous (low frequency) balneotherapy program followed by 3 weeks of LBE (Gr2). The total number of treatment sessions was the same for both groups. Posturography was carried out before balneotherapy (W0) and at 3 (W3), 6 (W6), and 12 (W12) weeks after the beginning of treatment. Postural control increased in Gr1 from W0 to W3 and from W0 to W12 and in Gr2 from W0 to W6 and from W3 to W6. The improvement was greater in Gr1 from W0 to W3 and from W6 to W12 and in Gr2 from W3 to W6. High-frequency intensive balneotherapy improved posture control at 3 weeks, while low-frequency balneotherapy did not. This improvement persisted over a 12-week assessment period at the same level. LBE generated an improvement that did not persist over time. Sustained improvement of postural control requires high-frequency repetition of consecutive balneotherapy sessions.
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Affiliation(s)
- Laetitia Peultier-Celli
- EA 3450, Development, Adaptation and Handicap, Faculty of Medicine and UFR STAPS, University of Lorraine, F-54600 Villers-lès-Nancy, Nancy, France
- Laboratory for the Analysis of Posture, Equilibrium and Motor Function (LAPEM), University Hospital of Nancy, F-54500 Vandoeuvre-lès-Nancy, Nancy, France
| | - Alexis Lion
- EA 3450, Development, Adaptation and Handicap, Faculty of Medicine and UFR STAPS, University of Lorraine, F-54600 Villers-lès-Nancy, Nancy, France
- Laboratory for the Analysis of Posture, Equilibrium and Motor Function (LAPEM), University Hospital of Nancy, F-54500 Vandoeuvre-lès-Nancy, Nancy, France
- Fédération Luxembourgeoise des Associations de Sport de Santé, L-1445, Strassen, Luxembourg
| | - Isabelle Chary-Valckenaere
- Department of Rheumatology, University Hospital of Nancy, F-54511, Vandoeuvre-lès-Nancy, Nancy, France
- UMR-CNRS 7365, Ingénierie Moléculaire et Physiopathologie Articulaire-IMoPA, F-54500 Vandoeuvre-lès-Nancy, Nancy, France
| | - Damien Loeuille
- Department of Rheumatology, University Hospital of Nancy, F-54511, Vandoeuvre-lès-Nancy, Nancy, France
- UMR-CNRS 7365, Ingénierie Moléculaire et Physiopathologie Articulaire-IMoPA, F-54500 Vandoeuvre-lès-Nancy, Nancy, France
| | - Zheng Zhang
- EA 3450, Development, Adaptation and Handicap, Faculty of Medicine and UFR STAPS, University of Lorraine, F-54600 Villers-lès-Nancy, Nancy, France
- Department of Orthopaedics, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Anne-Christine Rat
- Department of Rheumatology, University Hospital of Nancy, F-54511, Vandoeuvre-lès-Nancy, Nancy, France
- INSERM, CIC-EC, CIE6, F-54000, Nancy, France
| | - René Gueguen
- EA 3450, Development, Adaptation and Handicap, Faculty of Medicine and UFR STAPS, University of Lorraine, F-54600 Villers-lès-Nancy, Nancy, France
| | - Jean Paysant
- EA 3450, Development, Adaptation and Handicap, Faculty of Medicine and UFR STAPS, University of Lorraine, F-54600 Villers-lès-Nancy, Nancy, France
- Regional Institute of Physical Medicine and Rehabilitation, F-54042, Nancy Cedex, France
| | - Philippe P Perrin
- EA 3450, Development, Adaptation and Handicap, Faculty of Medicine and UFR STAPS, University of Lorraine, F-54600 Villers-lès-Nancy, Nancy, France.
- Laboratory for the Analysis of Posture, Equilibrium and Motor Function (LAPEM), University Hospital of Nancy, F-54500 Vandoeuvre-lès-Nancy, Nancy, France.
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12
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Kiadaliri AA, Lohmander LS, Moradi-Lakeh M, Petersson IF, Englund M. High and rising burden of hip and knee osteoarthritis in the Nordic region, 1990-2015. Acta Orthop 2018; 89:177-183. [PMID: 29160139 PMCID: PMC5901515 DOI: 10.1080/17453674.2017.1404791] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Background and purpose - Osteoarthritis (OA) imposes a substantial burden on individuals and societies. We report on the burden of knee and hip OA in the Nordic region. Patients and methods - We used the findings from the 2015 Global Burden of Diseases Study to explore prevalence, years lived with disability (YLDs), and disability-adjusted life-years (DALYs) of OA in the 6 Nordic countries during 1990-2015 (population of about 27 million in 2015). Results - During 1990-2015, the number of prevalent OA cases increased by 43% to 1,507,587 (95% uncertainty interval [UI] 1,454,338-1,564,778) in the region. OA accounted for 1.3% (UI 1.0-1.7) of YLDs in 1990, increasing to 1.6% (UI 1.2-2.0) in 2015. Of 315 causes studied, OA was the 15th leading cause of YLDs, causing 52,661 (UI 34,056-77,499) YLDs in 2015; of these 23% were attributable to high body mass index. The highest relative importance of OA was reported for women aged 65-74 years (8th leading cause of YLDs in 2015). Among the top 30 leading causes of YLDs in the region, OA had the 5th greatest relative increase in total YLDs during 1990-2015. From 1990 to 2015, increase in age-standardized YLDs from OA in the region was slightly lower than increase at the global level (7.5% vs. 10.5%). OA was, however, responsible for a higher proportional burden of DALYs in the region compared with the global level. Interpretation - The OA burden is high and rising in the Nordic region. With population growth, aging, and the obesity epidemic, a substantial rise in the burden of OA is expected and should be addressed in health policies.
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Affiliation(s)
- Aliasghar A Kiadaliri
- Lund University, Faculty of Medicine, Department of Clinical Sciences-Lund, Orthopedics, Clinical Epidemiology Unit, Lund, Sweden,Correspondence:
| | - L Stefan Lohmander
- Lund University, Faculty of Medicine, Department of Clinical Sciences-Lund, Orthopedics, Clinical Epidemiology Unit, Lund, Sweden
| | - Maziar Moradi-Lakeh
- Preventive Medicine and Public Health Research Center, Department of Community Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ingemar F Petersson
- Lund University, Faculty of Medicine, Department of Clinical Sciences-Lund, Orthopedics, Clinical Epidemiology Unit, Lund, Sweden,Epidemiology and Register Centre South, Skåne University Hospital Lund, Lund, Sweden
| | - Martin Englund
- Lund University, Faculty of Medicine, Department of Clinical Sciences-Lund, Orthopedics, Clinical Epidemiology Unit, Lund, Sweden,Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, MA, USA
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13
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Eagle S, Potter HG, Koff MF. Morphologic and quantitative magnetic resonance imaging of knee articular cartilage for the assessment of post-traumatic osteoarthritis. J Orthop Res 2017; 35:412-423. [PMID: 27325163 DOI: 10.1002/jor.23345] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 06/14/2016] [Indexed: 02/04/2023]
Abstract
Orthopedic trauma, such as anterior cruciate ligament (ACL) disruption, is a common source of osteoarthritis in the knee. Magnetic resonance imaging (MRI) is a non-invasive multi-planar imaging modality commonly used to evaluate hard and soft tissues of diarthrodial joints following traumatic injury. The contrast provided by generated images enables the evaluation of bone marrow lesions as well as delamination and degeneration of articular cartilage. We will provide background information about MRI signal generation and decay (T1 and T2 values), the utility of morphologic MRI, and the quantitative MRI techniques of T1ρ , T2 , and T2 * mapping, to evaluate subjects with traumatic knee injuries, such as ACL rupture. Additionally, we will provide information regarding the dGEMRIC, sodium, and gagCEST imaging techniques. Finally, the description and utility of newer post hoc analysis techniques, such as texture analysis, will be given. Continued development and refinement of these advanced MRI techniques will facilitate their clinical translation. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:412-423, 2017.
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Affiliation(s)
- Sonja Eagle
- MRI Laboratory, Department of Radiology and Imaging-MRI, Hospital for Special Surgery, 535 East 70th Street, Room: BW-08G, New York, New York, 10021
| | - Hollis G Potter
- MRI Laboratory, Department of Radiology and Imaging-MRI, Hospital for Special Surgery, 535 East 70th Street, Room: BW-08G, New York, New York, 10021
| | - Matthew F Koff
- MRI Laboratory, Department of Radiology and Imaging-MRI, Hospital for Special Surgery, 535 East 70th Street, Room: BW-08G, New York, New York, 10021
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14
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Giotis D, Aryaei A, Vasilakakos T, Paschos NK. Effectiveness of Biologic Factors in Shoulder Disorders. Open Orthop J 2017; 11:163-182. [PMID: 28400884 PMCID: PMC5366381 DOI: 10.2174/1874325001711010163] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2016] [Revised: 04/20/2016] [Accepted: 04/20/2016] [Indexed: 12/17/2022] Open
Abstract
Background: Shoulder pathology can cause significant pain, discomfort, and loss of function that all interfere with activities of daily living and may lead to poor quality of life. Primary osteoarthritis and rotator cuff diseases with its sequalae are the main culprits. Management of shoulder disorders using biological factors gained an increasing interest over the last years. This interest reveals the need of effective treatments for shoulder degenerative disorders, and highlights the importance of a comprehensive and detailed understanding of the rapidly increasing knowledge in the field. Methods: This study will describe most of the available biology-based strategies that have been recently developed, focusing on their effectiveness in animal and clinical studies. Results: Data from in vitro work will also be briefly presented; in order to further elucidate newly acquired knowledge regarding mechanisms of tissue degeneration and repair that would probably drive translational work in the next decade. The role of platelet rich-plasma, growth factors, stem cells and other alternative treatments will be described in an evidence-based approach, in an attempt to provide guidelines for their clinical application. Finally, certain challenges that biologic treatments face today will be described as an initiative for future strategies. Conclusion: The application of different growth factors and mesenchymal stem cells appears as promising approaches for enhancing biologic repair. However, data from clinical studies are still limited, and future studies need to improve understanding of the repair process in cellular and molecular level and evaluate the effectiveness of biologic factors in the management of shoulder disorders.
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Affiliation(s)
- Dimitrios Giotis
- Department of Trauma & Orthopaedic Surgery, University of Ioannina, Ioannina, Greece
| | - Ashkan Aryaei
- Department of Biomedical Engineering, University of California, Davis, USA
| | - Theofanis Vasilakakos
- Department of Trauma & Orthopaedic Surgery, University of Ioannina, Ioannina, Greece
| | - Nikolaos K Paschos
- Department of Trauma & Orthopaedic Surgery, University of Ioannina, Ioannina, Greece; Department of Biomedical Engineering, University of California, Davis, USA
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15
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Prodinger B, Stamm T, Peterson D, Stucki G, Tennant A. Toward a Standardized Reporting of Outcomes in Hand Osteoarthritis: Developing a Common Metric of Outcome Measures Commonly Used to Assess Functioning. Arthritis Care Res (Hoboken) 2016; 68:1115-27. [DOI: 10.1002/acr.22816] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 12/01/2015] [Accepted: 12/08/2015] [Indexed: 11/10/2022]
Affiliation(s)
- Birgit Prodinger
- Swiss Paraplegic Research and International Classification of Functioning, Disability, and Health Research Branch, World Health Organization Collaborating Centre, Nottwil, Switzerland, and University of Lucerne; Lucerne Switzerland
| | - Tanja Stamm
- Medical University of Vienna; Vienna Austria
| | - Diana Peterson
- Swiss Paraplegic Research, Nottwil, Switzerland, and University of Lucerne; Lucerne Switzerland
| | - Gerold Stucki
- Swiss Paraplegic Research and International Classification of Functioning, Disability, and Health Research Branch, World Health Organization Collaborating Centre, Nottwil, Switzerland, and University of Lucerne; Lucerne Switzerland
| | - Alan Tennant
- Swiss Paraplegic Research and International Classification of Functioning, Disability, and Health Research Branch, World Health Organization Collaborating Centre, Nottwil, Switzerland, and University of Lucerne; Lucerne Switzerland
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16
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A study on the role of articular cartilage soft tissue constitutive form in models of whole knee biomechanics. Biomech Model Mechanobiol 2016; 16:117-138. [PMID: 27387306 DOI: 10.1007/s10237-016-0805-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 06/27/2016] [Indexed: 01/12/2023]
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17
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Abstract
BACKGROUND In industrialized nations, arthrosis is one of the most frequent causes of physical disability and impaired quality of life in older people. OBJECTIVES There are still no direct and curative therapies. In addition, the causative mechanisms of this disease have not been sufficiently deciphered and investigated so far. MATERIALS AND METHODS For the present article, publications from 1900-2013 in the ISI Web of Science were reviewed. Quantitative and qualitative aspects are taken into account and are examined based on scientometric analysis methods. The illustrations demonstrate the global structure of the research and citation activity by Density Equalizing Map Projection. In addition, the radar charts illustrate the bi- and multilateral research and institutional cooperation. RESULTS On the basis of the search criteria, a total of 46,212 publications were identified. Approximately 95 % of the publications date back to the last 25 years. In addition to the number of publications, the number of citations has increased continuously. The analysis of the country collaborations as well as the number of institutions indicates a predominance of the United States. Most articles about arthrosis concern the subject areas of rheumatology, orthopedics, and surgery. CONCLUSION This study provides the first comprehensive, scientometric findings and illustrates corresponding representations of research activities, geographical contexts as well as research cooperation. It shows a great scientific interest, especially by North American and European scientists. The steady growth of research is explained by the high prevalence of arthrosis.
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18
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Cuperus N, Hoogeboom TJ, Kersten CC, den Broeder AA, Vlieland TPMV, van den Ende CHM. Randomized trial of the effectiveness of a non-pharmacological multidisciplinary face-to-face treatment program on daily function compared to a telephone-based treatment program in patients with generalized osteoarthritis. Osteoarthritis Cartilage 2015; 23:1267-75. [PMID: 25887365 DOI: 10.1016/j.joca.2015.04.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 03/10/2015] [Accepted: 04/02/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To compare the effectiveness of a non-pharmacological multidisciplinary face-to-face self-management treatment program with a telephone-based program on daily function in patients with generalized osteoarthritis (GOA). DESIGN A pragmatic single-blind randomized clinical superiority trial involving 147 patients clinically diagnosed with GOA, randomly allocated to either a 6 week non-pharmacological multidisciplinary face-to-face treatment program comprising seven group sessions or a 6 week telephone-based treatment program comprising two group sessions combined with four telephone contacts. Both programs aimed to improve daily function and to enhance self-management to control the disease. The programs critically differed in mode of delivery and intensity. Daily function (primary outcome) and secondary outcomes were assessed at baseline, 6, 26 and 52 weeks. Data were analyzed using linear or logistic multilevel regression models corrected for baseline, sex and group-wise treatment. RESULTS No differences in effectiveness between both treatment programs were observed on the primary outcome (group difference (95% CI): -0.03 (-0.14, 0.07)) or on secondary outcome measures, except for a larger improvement in pain in the face-to-face treatment group (group difference (95% CI): 1.61 (0.01, 3.21)). Within groups, significant improvements were observed on several domains, especially in the face-to-face group. However, these benefits are relatively small and unlikely to be of clinical importance. CONCLUSIONS We found no differences in treatment effect between patients with GOA who followed a non-pharmacological multidisciplinary face-to-face self-management program and those who received a telephone-delivered program. Besides, our findings demonstrated limited benefits of a self-management program for individuals with GOA. Dutch Trial Register trial number: NTR2137.
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Affiliation(s)
- N Cuperus
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands.
| | - T J Hoogeboom
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, CCTR Centre for Care Technology Research, Maastricht University, The Netherlands.
| | - C C Kersten
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands.
| | - A A den Broeder
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands.
| | - T P M Vliet Vlieland
- Department of Orthopaedics, Leiden University Medical Centre, Leiden, The Netherlands.
| | - C H M van den Ende
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands.
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19
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Pereira D, Severo M, Ramos E, Branco J, Santos RA, Costa L, Lucas R, Barros H. Potential role of age, sex, body mass index and pain to identify patients with knee osteoarthritis. Int J Rheum Dis 2015; 20:190-198. [PMID: 26016803 DOI: 10.1111/1756-185x.12611] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
AIM To evaluate the potential role of age, sex, body mass index (BMI), radiographic features and pain in knee osteoarthritis (OA) case ascertainment. METHODS A cross-sectional study was performed using information from the EPIPorto cohort; social, demographic, behavioral and clinical data was obtained. Pain was assessed using a pain frequency score (regarding ever having knee pain, pain in the last year, in the last 6 months and in the last month). Knee radiographs were classified using the Kellgren-Lawrence scale (0-4). Path analysis was used to assess the plausibility of the causal assumptions and a classification tree to identify characteristics that could improve the identification of patients with radiographic OA. RESULTS Higher age and higher BMI were associated with higher radiographic score, but sex had no statistical association. Females, higher age, higher BMI and higher radiographic score were statistically associated with higher pain scores. For both genders, the classification tree estimated age as the first variable to identify individuals with knee radiographic features. In females older than 56 years, pain frequency score is the second discriminator characteristic, followed by age (> 65 years) and (BMI > 30 kg/m2 ). Higher pain frequency and BMI > 29 kg/m2 were relevant for identifying OA in men with ages between 43.5 and 55.5 years. CONCLUSIONS Age, BMI and pain frequency are independently associated with radiographic OA and the use of information on these characteristics can improve the identification of patients with knee OA. Beyond age, pain complaints are particularly relevant but the level of pain is different by sex.
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Affiliation(s)
- Duarte Pereira
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal.,Public Health Institute, University of Porto, Porto, Portugal
| | - Milton Severo
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal.,Public Health Institute, University of Porto, Porto, Portugal
| | - Elisabete Ramos
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal.,Public Health Institute, University of Porto, Porto, Portugal
| | - Jaime Branco
- Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, CEDOC, Lisboa, Portugal.,Rheumatology Department, CEDOC, CHLO, EPE - Hospital Egas Moniz, Lisboa, Portugal
| | | | - Lúcia Costa
- Rheumatology Department, EPE-Hospital S. João, Porto, Portugal
| | - Raquel Lucas
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal.,Public Health Institute, University of Porto, Porto, Portugal
| | - Henrique Barros
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal.,Public Health Institute, University of Porto, Porto, Portugal
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20
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Rubak TS, Svendsen SW, Søballe K, Frost P. Total hip replacement due to primary osteoarthritis in relation to cumulative occupational exposures and lifestyle factors: a nationwide nested case-control study. Arthritis Care Res (Hoboken) 2015; 66:1496-505. [PMID: 24664794 DOI: 10.1002/acr.22326] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 03/18/2014] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To investigate the risk of total hip replacement (THR) due to primary osteoarthritis in relation to cumulative occupational mechanical exposures and lifestyle factors. METHODS Using register information, we identified first-time THR cases within the Danish working population in 2005-2006. For each case, 2 age- and sex-matched controls were drawn. Persons within 2,500 randomly selected case-control sets received a questionnaire about job history, weight at age 25 years, present weight and height, smoking, and sports activities at age 25 years. The job history was combined with a job exposure matrix. Cumulative exposure estimates were expressed according to the pack-year concept of smoking (e.g., cumulative lifting was expressed as ton-years). We used conditional logistic regression for statistical analyses. RESULTS In total, 1,776 case-control sets (71%) were available for analysis. The adjusted odds ratio (OR) for exposure to ≥20 ton-years was 1.35 (95% confidence interval [95% CI] 1.05-1.74) for men and 1.00 (95% CI 0.73-1.41) for women. Standing/walking and whole body vibration showed no associations. The adjusted OR for body mass index (BMI) ≥30 kg/m(2) at age 25 years was 2.44 (95% CI 1.38-4.32) for men and 5.12 (95% CI 2.30-11.39) for women. The corresponding adjusted ORs for an increase in BMI of ≥10 kg/m(2) since age 25 years were 2.16 (95% CI 1.25-3.70) and 2.46 (95% CI 1.47-4.13). Sports participation showed weak positive associations, while pack-years of smoking showed no associations. CONCLUSION The results indicated a modest increase in risk of THR in relation to cumulative lifting among men and an increased risk in relation to a high BMI at age 25 years and to a gain in BMI in both sexes.
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21
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Cuperus N, Vliet Vlieland TPM, Mahler EAM, Kersten CC, Hoogeboom TJ, van den Ende CHM. The clinical burden of generalized osteoarthritis represented by self-reported health-related quality of life and activity limitations: a cross-sectional study. Rheumatol Int 2014; 35:871-7. [PMID: 25300731 DOI: 10.1007/s00296-014-3149-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Accepted: 10/02/2014] [Indexed: 01/30/2023]
Abstract
The involvement of multiple joints is common in osteoarthritis (OA), often referred to as generalized osteoarthritis (GOA). However, since research and practice mainly focus on a specific OA localization, the health status of patients with GOA is largely unknown. Therefore, we aimed to describe the clinical burden of GOA in terms of self-reported health-related quality of life (HRQoL) and activity limitations. In this cross-sectional study, individuals clinically diagnosed with GOA and referred to multidisciplinary treatment, completed questionnaires on socio-demographics, joint involvement, HRQoL (SF-36) and activity limitations (HAQ-DI). SF-36 physical (PCS) and mental component summary scores (MCS) were calculated using norm-based data. The patient's specific most important activity limitations were linked to the International Classification of Functioning, Disability and Health. A total of 147 patients participated [85 % female; mean (SD) age 60 (8) years]. The majority (93 %) had symptomatic OA in both the upper and lower extremities. Predominant joints with symptomatic OA were the hands (85 %) and knees (82 %). Mean (SD) SF-36 PCS and MCS scores were 37 (7) and 48 (10), respectively, showing a broad impact of GOA on the physical component of health. The mean (SD) HAQ-DI score was 1.27 (0.50) indicating moderate to severe functional limitations. Activities concerning mobility and domestic life were considered most important activity limitations, especially walking. The results show a high clinical burden of GOA in terms of HRQoL and activity limitations. This study points to the need of developing non-pharmacological interventions for patients with GOA that should target on improving the physical component of health and mobility limitations.
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Affiliation(s)
- Nienke Cuperus
- Department of Rheumatology, Sint Maartenskliniek, PO box 9011, 6500 GM, Nijmegen, The Netherlands,
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22
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23
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Hubertsson J, Englund M, Hallgårde U, Lidwall U, Löfvendahl S, Petersson IF. Sick leave patterns in common musculoskeletal disorders--a study of doctor prescribed sick leave. BMC Musculoskelet Disord 2014; 15:176. [PMID: 24886568 PMCID: PMC4060756 DOI: 10.1186/1471-2474-15-176] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 05/21/2014] [Indexed: 11/10/2022] Open
Abstract
Background Comparative data on sick leave within musculoskeletal disorders (MSDs) is limited. Our objective was to give a descriptive overview of sick leave patterns in different MSDs. Methods Using electronic medical records, we collected information on dates and diagnostic codes for all available sick leave certificates, during 2 years (2009–2010), in the North Western part of the Skåne region in Sweden (22 public primary health care centres and two general hospitals). Using the International Classification of Diseases (ICD) 10 codes on the certificates we studied duration, age and sex distribution and recurrent periods of sick leave for six strategically chosen MSDs; low back pain (M54) disc disorders (M51), knee osteoarthritis (M17) hip osteoarthritis (M16) rheumatoid arthritis (M05-M06) and myalgia (M79). Results All together 20 251 sick leave periods were issued for 16 673 individuals 16–64 years of age (53% women). Out of the selected disorders, low back pain and myalgia had the shortest sick leave periods, with a mean of 26 and 27 days, respectively, while disc disorders and rheumatoid arthritis had the longest periods with a mean of 150 and 147 days. For low back pain and myalgia 27% and 26% of all sick leave was short (8–14 days) and only 11% and 13%, were long (≥90 days). For the other selected MSDs, less than 5% of the periods were short. For disc disorders, hip osteoarthritis and rheumatoid arthritis, more than 60% of the periods were long (p > 0.001). For back disorders and myalgia most periods were issued in the age groups between 40–49, with similar patterns for women and men. Osteoarthritis and rheumatoid arthritis had most periods in the age groups of 50–64, and patterns for women and men differed. Low back pain, rheumatoid arthritis and myalgia had the greatest share of recurrent sick leave (31%, 34% and 32% respectively). Conclusion Duration, age and sex distribution and numbers of recurrent sick leave varies considerably between different MSDs. This underscores the importance of using specified diagnosis, in sick leave research as well as in planning of treatment and rehabilitation and evaluation of prognosis.
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Affiliation(s)
- Jenny Hubertsson
- Department of Orthopedics, Clinical Sciences Lund, Lund University, Lund, Sweden.
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24
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Mootanah R, Imhauser CW, Reisse F, Carpanen D, Walker RW, Koff MF, Lenhoff MW, Rozbruch SR, Fragomen AT, Dewan Z, Kirane YM, Cheah K, Dowell JK, Hillstrom HJ. Development and validation of a computational model of the knee joint for the evaluation of surgical treatments for osteoarthritis. Comput Methods Biomech Biomed Engin 2014; 17:1502-17. [PMID: 24786914 PMCID: PMC4047624 DOI: 10.1080/10255842.2014.899588] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
A three-dimensional (3D) knee joint computational model was developed and validated to predict knee joint contact forces and pressures for different degrees of malalignment. A 3D computational knee model was created from high-resolution radiological images to emulate passive sagittal rotation (full-extension to 65°-flexion) and weight acceptance. A cadaveric knee mounted on a six-degree-of-freedom robot was subjected to matching boundary and loading conditions. A ligament-tuning process minimised kinematic differences between the robotically loaded cadaver specimen and the finite element (FE) model. The model was validated by measured intra-articular force and pressure measurements. Percent full scale error between EE-predicted and in vitro-measured values in the medial and lateral compartments were 6.67% and 5.94%, respectively, for normalised peak pressure values, and 7.56% and 4.48%, respectively, for normalised force values. The knee model can accurately predict normalised intra-articular pressure and forces for different loading conditions and could be further developed for subject-specific surgical planning.
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Affiliation(s)
- R Mootanah
- a Medical Engineering Research Group, Faculty of Science and Technology, Anglia Ruskin University , Chelmsford, Essex , UK
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25
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Na SS, Kim SG, Yong MS, Hwangbo G. Study of treadmill exercise effect on rats with osteoarthritis using proteomic analysis. J Phys Ther Sci 2014; 26:487-90. [PMID: 24764617 PMCID: PMC3996405 DOI: 10.1589/jpts.26.487] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 10/16/2013] [Indexed: 11/24/2022] Open
Abstract
[Purpose] To investigate the correlation between the effect treadmill exercise and
change in serum proteins in rats with osteoarthritis, a study of proteins was carried out
using a mass spectrometer. [Subjects and Methods] Rats were randomly divided into five
groups. After 4 weeks of treadmill training, serum from each rat was analyzed by Liquid
chromatography-electrospray ionization tandem mass spectrometry. Complementary component 9
(C9) was discovered to be downregulated in the serum of the exercise groups, and this was
validated by Western blot. [Results] Seventeen proteins were discovered to be elevated in
the monosodium iodoacetate injection osteoarthritis group samples by more than 1.5 fold
compared with the control group. One of the proteins upregulated, C9 protein, was
validated, and it was found to decrease in the middle-intensity exercise group.
[Conclusion] We showed that the serum level of C9, an inflammatory-related protein,
decreased after treadmill exercise. Therefore, treadmill exercise with an appropriate
intensity might be recommended for OA patients.
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Affiliation(s)
- Sang Su Na
- Department of Rehabilitation Science, Graduate School, Daegu University, Republic of Korea
| | - Seong Gil Kim
- Department of Rehabilitation Science, Graduate School, Daegu University, Republic of Korea
| | - Min Sik Yong
- Department of Rehabilitation Science, Graduate School, Daegu University, Republic of Korea
| | - Gak Hwangbo
- Department of Physical Therapy, College of Rehabilitation Science, Daegu University, Republic of Korea
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Woolf AD, Erwin J, March L. The need to address the burden of musculoskeletal conditions. Best Pract Res Clin Rheumatol 2013; 26:183-224. [PMID: 22794094 DOI: 10.1016/j.berh.2012.03.005] [Citation(s) in RCA: 181] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2012] [Accepted: 02/12/2012] [Indexed: 10/28/2022]
Abstract
Musculoskeletal conditions are common in men and women of all ages across all socio-demographic strata of society. They are the most common cause of severe long-term pain and physical disability and affect hundreds of millions of people around the world. They impact on all aspects of life through pain and by limiting activities of daily living typically by affecting dexterity and mobility. They affect one in four adults across Europe [1]. Musculoskeletal conditions have an enormous economic impact on society through both direct health expenditure related to treating the sequelae of the conditions and indirectly through loss of productivity. The prevalence of many of these conditions increases markedly with age, and many are affected by lifestyle factors, such as obesity and lack of physical activity. The burden of these conditions is therefore predicted to increase, in particular in developing countries. The impact on individuals and society of the major musculoskeletal conditions is reviewed and effective prevention, treatment and rehabilitation considered. The need to recognise musculoskeletal conditions as a global public health priority is discussed.
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Affiliation(s)
- Anthony D Woolf
- Department of Rheumatology, Royal Cornwall Hospital, Truro, UK.
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Tsurumoto T, Saiki K, Okamoto K, Imamura T, Maeda J, Manabe Y, Wakebe T. Periarticular osteophytes as an appendicular joint stress marker (JSM): analysis in a contemporary Japanese skeletal collection. PLoS One 2013; 8:e57049. [PMID: 23437307 PMCID: PMC3577756 DOI: 10.1371/journal.pone.0057049] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Accepted: 01/17/2013] [Indexed: 01/10/2023] Open
Abstract
Objective The aim of this study was to investigate the possibility that periarticular osteophytes plays a role as a appendicular joint stress marker (JSM) which reflects the biomechanical stresses on individuals and populations. Methods A total of 366 contemporary Japanese skeletons (231 males, 135 females) were examined closely to evaluate the periarticular osteophytes of six major joints, the shoulder, elbow, wrist, hip, knee, and ankle and osteophyte scores (OS) were determined using an original grading system. These scores were aggregated and analyzed statistically from some viewpoints. Results All of the OS for the respective joints were correlated logarithmically with the age-at-death of the individuals. For 70 individuals, in whom both sides of all six joints were evaluated without missing values, the age-standardized OS were calculated. A right side dominancy was recognized in the joints of the upper extremities, shoulder and wrist joints, and the bilateral correlations were large in the three joints on the lower extremity. For the shoulder joint and the hip joint, it was inferred by some distinctions that systemic factors were relatively large. All of these six joints could be assorted by the extent of systemic and local factors on osteophytes formation. Moreover, when the age-standardized OS of all the joints was summed up, some individuals had significantly high total scores, and others had significantly low total scores; namely, all of the individuals varied greatly in their systemic predisposition for osteophytes formation. Conclusions This study demonstrated the significance of periarticular osteophytes; the evaluating system for OS could be used to detect differences among joints and individuals. Periarticular osteophytes could be applied as an appendicular joint stress marker (JSM); by applying OS evaluating system for skeletal populations, intra-skeletal and inter-skeletal variations in biomechanical stresses throughout the lives could be clarified.
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Affiliation(s)
- Toshiyuki Tsurumoto
- Department of Macroscopic Anatomy, Graduate School of Biomedical Science, Nagasaki University, Nagasaki, Japan.
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Naito S, Takahashi T, Onoda J, Yamauchi A, Kawai T, Kishino J, Yamane S, Fujii I, Fukui N, Numata Y. Development of a Neutralizing Antibody Specific for the Active Form of Matrix Metalloproteinase-13. Biochemistry 2012; 51:8877-84. [DOI: 10.1021/bi301228d] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Shoichi Naito
- Shionogi Pharmaceutical Research Center, Shionogi & Company, Ltd., 3-1-1 Futaba-cho, Toyonaka, Osaka 561-0825, Japan
| | - Tatsuya Takahashi
- Shionogi Pharmaceutical Research Center, Shionogi & Company, Ltd., 3-1-1 Futaba-cho, Toyonaka, Osaka 561-0825, Japan
| | - Junji Onoda
- Shionogi Pharmaceutical Research Center, Shionogi & Company, Ltd., 3-1-1 Futaba-cho, Toyonaka, Osaka 561-0825, Japan
| | - Akira Yamauchi
- Shionogi Pharmaceutical Research Center, Shionogi & Company, Ltd., 3-1-1 Futaba-cho, Toyonaka, Osaka 561-0825, Japan
| | - Taeko Kawai
- Shionogi Pharmaceutical Research Center, Shionogi & Company, Ltd., 3-1-1 Futaba-cho, Toyonaka, Osaka 561-0825, Japan
| | - Junji Kishino
- Shionogi Pharmaceutical Research Center, Shionogi & Company, Ltd., 3-1-1 Futaba-cho, Toyonaka, Osaka 561-0825, Japan
| | - Shoji Yamane
- Shionogi Pharmaceutical Research Center, Shionogi & Company, Ltd., 3-1-1 Futaba-cho, Toyonaka, Osaka 561-0825, Japan
| | - Ikuo Fujii
- School of Science, Osaka Prefecture University, 1-1 Gakuen-cho, Naka-ku,
Sakai, Osaka 599-8531, Japan
| | - Naoshi Fukui
- Clinical Research Center for Allergy
and Rheumatology, National Hospital Organization, Sagamihara National Hospital, Sakuradai 18-1, Sagamihara, Kanagawa
228-8522, Japan
| | - Yoshito Numata
- Shionogi Pharmaceutical Research Center, Shionogi & Company, Ltd., 3-1-1 Futaba-cho, Toyonaka, Osaka 561-0825, Japan
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Metcalfe AJ, Andersson MLE, Goodfellow R, Thorstensson CA. Is knee osteoarthritis a symmetrical disease? Analysis of a 12 year prospective cohort study. BMC Musculoskelet Disord 2012; 13:153. [PMID: 22917179 PMCID: PMC3485166 DOI: 10.1186/1471-2474-13-153] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2011] [Accepted: 08/17/2012] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The aim of this study was to document the development of bilateral knee osteoarthritis over a 12 year period using a middle-aged population-based cohort with knee pain at inclusion. METHODS One hundred and forty three patients aged 35 to 54 were recruited from a population based cohort of 279 subjects who had knee pain at baseline and assessed with clinical and radiographic data, with 5 and 12 year follow up. The data was analysed with regard to the development and progression of uni- and bilateral knee osteoarthritis over 12 years. A definition of KL = 1 was used to define radiographic disease. RESULTS 24 of the 30 (80%) patients with unilateral disease at baseline developed bilateral disease after 12 years. At baseline 37 patients (26%) had bilateral disease, whereas that number increased to 65 (52%) at 5 years and 100 (70%) at the 12 year follow up. The most common pattern was medial compartment involvement in both knees. Six patients had lateral compartment disease in one knee and medial in the other whereas only two had lateral compartment disease bilaterally. CONCLUSIONS Bilateral knee osteoarthritis is very common with time, as the majority of sufferers will eventually develop radiographic disease in both knees. Clinicians need to be aware of the 'joint at risk' and researchers need to remember to account for both knees when assessing the relationship between physical function, pain and structural disease. The other knee should not be used for comparison, even if it appears to be normal at baseline.
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Oppenheimer H, Gabay O, Meir H, Haze A, Kandel L, Liebergall M, Gagarina V, Lee EJ, Dvir-Ginzberg M. 75-kd sirtuin 1 blocks tumor necrosis factor α-mediated apoptosis in human osteoarthritic chondrocytes. ACTA ACUST UNITED AC 2012; 64:718-28. [PMID: 21987377 DOI: 10.1002/art.33407] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Sirtuin 1 (SirT1) has been implicated in the regulation of human cartilage homeostasis and chondrocyte survival. Exposing human osteoarthritic (OA) chondrocytes to tumor necrosis factor α (TNFα) generates a stable and enzymatically inactive 75-kd form of SirT1 (75SirT1) via cathepsin B-mediated cleavage. Because 75SirT1 is resistant to further degradation, we hypothesized that it has a distinct role in OA, and the present study was undertaken to identify this role. METHODS The presence of cathepsin B and 75SirT in OA and normal human chondrocytes was analyzed. Confocal imaging of SirT1 was used to monitor its subcellular trafficking following TNFα stimulation. Coimmunofluorescence staining for cathepsin B, mitochondrial cytochrome oxidase subunit IV, and lysosome-associated membrane protein 1 together with SirT1 was performed. Human chondrocytes were tested for apoptosis by fluorescence-activated cell sorter analysis and immunoblotting for caspases 3 and 8. Human chondrocyte mitochondrial extracts were obtained and analyzed for 75SirT1-cytochrome c association. RESULTS Confocal imaging and immunoblot analyses following TNFα challenge of human chondrocytes demonstrated that 75SirT1 was exported to the cytoplasm and colocalized with the mitochondrial membrane. Consistent with this, immunoprecipitation and immunoblot analyses revealed that 75SirT1 is enriched in mitochondrial extracts and associates with cytochrome c following TNFα stimulation. Preventing nuclear export of 75SirT1 or reducing levels of full-length SirT1 and 75SirT1 augmented chondrocyte apoptosis in the presence of TNFα. Levels of cathepsin B and 75SirT1 were elevated in OA versus normal chondrocytes. Additional analyses showed that human chondrocytes exposed to OA-derived synovial fluid generated the 75SirT1 fragment. CONCLUSION These data suggest that 75SirT1 promotes chondrocyte survival following exposure to proinflammatory cytokines.
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Affiliation(s)
- Hanna Oppenheimer
- Laboratory of Cartilage Biology, Institute of Dental Sciences, Faculty of Dental Medicine, Hebrew University, Hadassah Ein Kerem, Jerusalem, Israel
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Costantino M, Filippelli A, Quenau P, Nicolas JP, Coiro V. [Sulphur mineral water and SPA therapy in osteoarthritis]. Therapie 2012; 67:43-8. [PMID: 22487501 DOI: 10.2515/therapie/2012002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2011] [Accepted: 11/21/2011] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Osteoarthritis (OA), the most common degenerative osteoarticular disease, is cause of pain and limitations in physical function with high disability that can conduct to a state of psycological stress, not always considered adequately, with negative impact on the quality of life. The mud and bath therapy can improve this aspect. However, these studies are insufficient. The objective of our research was to evaluate the impact of SPA therapy cycle on safety, efficacy and psychosocial disability in osteoarthritis. MATERIALS AND METHODS The study was carried out on 99 subjects suffering from OA. The patients has treated for 12 days with applications of sulphurous mud-bath therapy from "Terme di Telese" (Benevento, Italy). At the beginning and at the end of the SPA therapy considered has assessed: 1) the adverse reactions; 2) the efficacy on the pain and functional limitations; c) the impact on the psychosocial function using the VAS scale, the SF-36 questionnaire, the WOMAC index and the SDS-Zung test. Statistical analysis of the data was performed by determining the mean ± SD. The results were compared with the Student "t" test or Wilcoxon test. A p value < 0.05 was considered significant. RESULTS In comparison to the basal values, this investigation has demonstrated that sulphurous mud and bath therapy has induced a significant (p < 0.01) improvement of overall quality of life with reduction of pain at rest (2.1 ± 1.5 → 1.2 ± 1.3) and during daily activities (2.3 ± 1.3 → 1.4 ± 1.3). This has facilitated the physical function and psychosocial disability as shown by the questionnaires SF-36, WOMAC and SDS Zung. CONCLUSIONS In conclusion our data suggest that mud-bath therapy with sulphurous mineral water can be considered as an important phase of the therapeutic strategy in OA.
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Affiliation(s)
- Maria Costantino
- Association à but non lucratif F.I.R.S.Thermae (Formation interdisciplinaire, Recherches et Sciences Thermales), Division Médecine Thermale Impresa A. Minieri - Terme di Telese, Benevento, Italie.
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Transglutaminase 2 as a biomarker of osteoarthritis: an update. Amino Acids 2011; 44:199-207. [PMID: 22139411 DOI: 10.1007/s00726-011-1181-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Accepted: 11/22/2011] [Indexed: 01/05/2023]
Abstract
Osteoarthritis is a progressive joint disease characterized by cartilage degradation and bone remodelling. Under physiologic conditions, articular cartilage displays a stable chondrocyte phenotype, whereas in osteoarthritis a chondrocyte hypertrophy develops near the sites of cartilage surface damage and associates to the pathologic expression of type X collagen. Transglutaminases (TGs) include a family of Ca(2+)-dependent enzymes that catalyze the formation of γ-glutamyl cross-links. Their substrates include a variety of intracellular and extracellular macromolecular components. TGs are ubiquitously and abundantly expressed and implicated in a variety of physiopathological processes. TGs activity is modulated by inflammatory cytokines. TG2 (also known as tissue transglutaminase) mediates the hypertrophic differentiation of joint chondrocytes and interleukin-1-induced calcification. Histomorphometrical and biomolecular investigations document increased TG2 expression in human and experimental osteoarthritis. Consequently, the level of TG2 expression may represent an adjuvant additional marker to monitor tissue remodelling occurring in osteoarthritic joint tissue. Experimental induction of osteoarthritis in TG2 knockout mice is followed from reduced cartilage destruction and increased osteophyte formation compared to wild-type mice, suggesting a different influence on joint bone and cartilage remodelling. The capacity of transamidation by TG2 to regulate activation of latent TGF-β seems to have a potential impact on the regulation of inflammatory response in osteoarthritic tissues. Additional studies are needed to define TG2-regulated pathways that are differently modulated in osteoblasts and chondrocytes during osteoarthritis.
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Briggs L, Hart J, Navis M, Clayton S, Boone R. Surface area congruence of atlas superior articulating facets and occipital condyles. J Chiropr Med 2011; 7:9-16. [PMID: 19674714 DOI: 10.1016/j.jcme.2007.08.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2007] [Revised: 07/31/2007] [Accepted: 08/06/2007] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE The purpose of this study was to compare the surface areas of 12 atlanto-occipital joints from 6 cadavers to determine how well their ipsilateral and contralateral surface areas matched. METHODS Three methods were used. Method 1 consisted of digitized photographs downloaded to the Able Image Analyser software program (Ljubljana, Slovenia; http://able.mulabs.com). The perimeters were measured and expressed as square millimeters. Method 2 consisted of a point count method using moulds of the joint surfaces produced by pressing aluminum paper, leaving a clear imprint for analysis. Method 3 consisted of drawing outlines of the molds from method 2 onto transparencies and assessing overlap. RESULTS Method 1 showed a moderate correlation of matched articular surfaces between the left C1 superior articulating surface and the left condyle (r = 0.573, P = .01). Method 2 showed moderate correlations between all surface areas that were analyzed. The matched pairs compared were left C1 superior articulating surface and left condyle (r = 0.588, P = .01) and right C1 and right condyle (r = 0.730, P = .001). The contralateral surfaces correlated were left C1 and right C1 (r = 0.596, P = .009) and right condyle and left condyle (r = 0.769, P = .000). Method 3 showed no statistically significant differences between surface areas. CONCLUSIONS All 3 methods revealed that the articular surfaces of the atlas and corresponding or contralateral condyle for specimens used in this study were not an exact match.
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Affiliation(s)
- Lafayette Briggs
- Research Associate, Sherman College of Straight Chiropractic (SCSC), Spartanburg, SC 29304
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Sahinbegovic E, Schett G. [Therapeutic strategies in erosive digital polyarthrosis]. Internist (Berl) 2011; 52:682-7. [PMID: 21523453 DOI: 10.1007/s00108-010-2768-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
One of the most common forms of osteoarthritis is hand osteoarthritis. A subgroup, termed erosive hand osteoarthritis (EHOA), shows a highly destructive disease course with involvement of multiple joints, swelling as well as cartilage and bone destruction leading to progressive loss of hand function. EHOA is characterized by subchondral erosions of the finger joints as well as ankylosis. No disease modifying therapy is currently available for the treatment of EHOA and treatment options are confined to the control of symptoms. Acetaminophen and non-steroidal anti-inflammatory drugs are used to treat the signs and symptoms. So far cytokine blocking agents have not shown a convincing therapeutic effect and the effect size of chondroitin sulfate and bisphosphonates in EOHA is small.
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Affiliation(s)
- E Sahinbegovic
- Universitätsklinik für Innere Medizin 3, Universität Erlangen-Nürnberg, Krankenhausstrasse 12, Erlangen, Germany
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Jiménez-Sánchez S, Jiménez-García R, Hernández-Barrera V, Villanueva-Martínez M, Ríos-Luna A, Alonso-Blanco C, Palacios-Ceña D, Fernández-de-las-Peñas C. Invalidating Musculoskeletal Pain is Associated with Psychological Distress and Drug Consumption: A Spanish Population Case–Control Study. ACTA ACUST UNITED AC 2011. [DOI: 10.3109/10582452.2011.558988] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abstract
OA is not a disease in short supply of phenotypic definitions. Indeed, numerous classification options complicate the design of genetic studies seeking associations within the obscuring array of heterogeneity. New recommendations offer some progress toward clarifying OA definitions, but much-needed guidelines are wanting.
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Biochemical markers in the diagnosis of chondral defects following anterior cruciate ligament insufficiency. INTERNATIONAL ORTHOPAEDICS 2011; 35:1633-7. [PMID: 21221577 DOI: 10.1007/s00264-010-1191-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2010] [Accepted: 12/10/2010] [Indexed: 10/18/2022]
Abstract
PURPOSE The aim of this study was to determine the value of systemic biochemical markers of bone turnover-urine levels of cross-linked C-terminal telopeptide I (uCTX-I), urinary C-terminal telopeptide II (uCTX-II) and serum cartilage oligomeric matrix protein (sCOMP)-in the diagnosis of chondral defects after anterior cruciate ligament (ACL) rupture. Thirty-eight patients with previous ACL rupture were included. METHODS Magnetic resonance imaging (MRI) of the injured and the intact knee joint was performed with volumetric measurement of volume and area of cartilage (VC/AC), area of subchondral bone (cAB), and area of subchondral bone denuded and eroded (dAB). Biochemical markers were measured using commercially available enzyme-linked immunoassays. RESULTS MRI-based volumetric cartilage measurement showed significant differences between the injured and the intact knees. uCTX-I, sCOMP and in parts uCTX-II correlated well with MRI parameters. CTX-I showed a significant correlation with VC and AC of the whole knee joint. CONCLUSIONS The results suggest that uCTX-I, uCTX-II and sCOMP could identify patients with focal cartilage lesions from an early stage of osteoarthritis of the knee.
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Uhlig T, Slatkowsky-Christensen B, Moe RH, Kvien TK. The burden of osteoarthritis:the societal and the patient perspective. ACTA ACUST UNITED AC 2010. [DOI: 10.2217/thy.10.70] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Hoogeboom TJ, Stukstette MJPM, de Bie RA, Cornelissen J, den Broeder AA, van den Ende CHM. Non-pharmacological care for patients with generalized osteoarthritis: design of a randomized clinical trial. BMC Musculoskelet Disord 2010; 11:142. [PMID: 20594308 PMCID: PMC2907317 DOI: 10.1186/1471-2474-11-142] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2010] [Accepted: 07/01/2010] [Indexed: 11/25/2022] Open
Abstract
Background Non-pharmacological treatment (NPT) is a useful treatment option in the management of hip or knee osteoarthritis. To our knowledge however, no studies have investigated the effect of NPT in patients with generalized osteoarthritis (GOA). The primary aim of this study is to compare the effectiveness of two currently existing health care programs with different intensity and mode of delivery on daily functioning in patients with GOA. The secondary objective is to compare the cost-effectiveness of both interventions. Methods/Design In this randomized, single blind, clinical trial with active controls, we aim to include 170 patients with GOA. The experimental intervention consist of six self-management group sessions provided by a multi-disciplinary team (occupational therapist, physiotherapist, dietician and specialized nurse). The active control group consists of two group sessions and four sessions by telephone, provided by a specialized nurse and physiotherapist. Both therapies last six weeks. Main study outcome is daily functioning during the first year after the treatment, assessed on the Health Assessment Questionnaire. Secondary outcomes are health related quality of life, specific complaints, fatigue, and costs. Illness cognitions, global perceived effect and self-efficacy, will also be assessed for a responder analysis. Outcome assessments are performed directly after the intervention, after 26 weeks and after 52 weeks. Discussion This article describes the design of a randomized, single blind, clinical trial with a one year follow up to compare the costs and effectiveness of two non-pharmacological interventions with different modes of delivery for patients with GOA. Trial registration Dutch Trial Register NTR2137
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Affiliation(s)
- Thomas J Hoogeboom
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands.
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Gauchard GC, Vançon G, Meyer P, Mainard D, Perrin PP. On the role of knee joint in balance control and postural strategies: effects of total knee replacement in elderly subjects with knee osteoarthritis. Gait Posture 2010; 32:155-60. [PMID: 20451390 DOI: 10.1016/j.gaitpost.2010.04.002] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2009] [Revised: 01/07/2010] [Accepted: 04/12/2010] [Indexed: 02/02/2023]
Abstract
This study aimed to evaluate the role of the knee joint in the neurosensory organization of balance control and the generation of postural sensorimotor strategies. Ten patients, aged over 60 years and having undergone unilateral total knee replacement (TKR) for osteoarthritis, and 20 controls were submitted to static and dynamic posturographic tests and to a sensory organization test (SOT) aiming at evaluating postural control in quiet stance and during movement. The patients were submitted to these evaluations after the disappearance of pain (TKR(1)) and at the end of a 6-week rehabilitation program (TKR(2)). Balance control being greatly improved at TKR2 compared to TKR1, the patients attain a quality of postural regulation similar to that of the controls; some postural abnormalities did however persist for the static test. Moreover, SOT values at TKR(2) close to those of the controls highlighted an improvement in motor response, better management in altered proprioceptive information situations, and greater use of the ankle to control balance. This model of intervention on the knee joint, namely knee replacement due to osteoarthritis, has shown that gradual functional sensorimotor restoration after TKR, due to intrasensory proprioceptive compensation either at knee, or at other joint levels (hip/ankle), improves dynamic balance control. This reacquisition allows the knee joint to recover its corrective compensatory role in postural regulation allowing, through neuroplasticity, the modification of muscular activation sequences and, thus, the implementation of anticipatory sensorimotor strategies.
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Affiliation(s)
- Gérome C Gauchard
- Nancy-University, Henri Poincaré University, Balance Control and Motor Performance, UFR STAPS, Villers-lès-Nancy, France
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Jiménez-Sánchez S, Jiménez-García R, Hernández-Barrera V, Villanueva-Martínez M, Ríos-Luna A, Fernández-de-las-Peñas C. Has the prevalence of invalidating musculoskeletal pain changed over the last 15 years (1993-2006)? A Spanish population-based survey. THE JOURNAL OF PAIN 2010; 11:612-20. [PMID: 20356799 DOI: 10.1016/j.jpain.2009.09.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2009] [Revised: 09/15/2009] [Accepted: 09/29/2009] [Indexed: 11/27/2022]
Abstract
UNLABELLED The aim of the current study was to estimate the prevalence and time trend of invalidating musculoskeletal pain in the Spanish population and its association with socio-demographic factors, lifestyle habits, self-reported health status, and comorbidity with other diseases analyzing data from 1993-2006 Spanish National Health Surveys (SNHS). We analyzed individualized data taken from the SNHS conducted in 1993 (n = 20,707), 2001 (n = 21,058), 2003 (n = 21,650) and 2006 (n = 29,478). Invalidating musculoskeletal pain was defined as pain suffered from the preceding 2 weeks that decreased main working activity or free-time activity by at least half a day. We analyzed socio-demographic characteristics, self-perceived health status, lifestyle habits, and comorbid conditions using multivariate logistic regression models. Overall, the prevalence of invalidating musculoskeletal pain in Spanish adults was 6.1% (95% CI, 5.7-6.4) in 1993, 7.3% (95% CI, 6.9-7.7) in 2001, 5.5% (95% CI, 5.1-5.9) in 2003 and 6.4% (95% CI 6-6.8) in 2006. The prevalence of invalidating musculoskeletal pain among women was almost twice that of men in every year (P < .05). The multivariate analysis showed that occupational status (unemployed), sleep <8 hours/day and having any accident in the preceding year were significantly associated in both gender with a higher likelihood of suffering from invalidating musculoskeletal pain among Spanish adults. Within men, other predictors of invalidating musculoskeletal pain were to be married and lower educational level, whereas in women were age of 45-64 years old (OR 1.89, 95% CI 1.32-2.7), obesity (OR 1.23, 95% CI 1.06-1.42), a sedentary lifestyle (OR 1.23, 95% CI 1.06-1.42), and presence of comorbid chronic diseases (OR 1.32, 95% CI 1.14-1.53). Further, worse self-reported health status was also related to a greater prevalence of invalidating musculoskeletal pain (OR 6.88, 95% 5.62-8.40 men, OR 7.24, 95% 6.11-8.57 women). Finally, we found that the prevalence of invalidating musculoskeletal pain increased from 1993 to 2001 for both men (OR 1.31, 95% 1.08-1.58) and women (OR 1.19, 95% 1.03-1.39) with no significant increase from the remaining surveys. Our results suggest that invalidating musculoskeletal pain deserves an increased awareness among health professionals. More educational programs which address postural hygiene, physical exercise, and how to prevent obesity and sedentary lifestyle habits should be provided by Public Health Services. PERSPECTIVE This population-based study indicates that invalidating musculoskeletal pain that reduces main working activity is a public health problem in Spain. The prevalence of invalidating musculoskeletal pain was higher in women than in men and associated to lower income, poor sleeping, worse self-reported health status, and other comorbid conditions. Further, the prevalence of invalidating musculoskeletal pain increased from 1993 to 2001, but remained stable from the last years (2001 to 2006).
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Affiliation(s)
- Silvia Jiménez-Sánchez
- Preventive Medicine and Public Health Teaching and Research Unit, Department of Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain
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Wu JZ, Li ZM, Cutlip RG, An KN. A simulating analysis of the effects of increased joint stiffness on muscle loading in a thumb. Biomed Eng Online 2009; 8:41. [PMID: 20015378 PMCID: PMC2804669 DOI: 10.1186/1475-925x-8-41] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2009] [Accepted: 12/16/2009] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The development of osteoarthritis (OA) in the hand results in increased joint stiffness, which in turn affects the grip strength. The goal of the present study is to theoretically analyze the muscle forces in a thumb in response to the increased joint stiffness. METHODS The thumb was modeled as a linkage system consisting of a trapezium, a metacarpal bone, a proximal and a distal phalanx. Nine muscles were included in the model: flexor pollicis longus (FPL), extensor pollicis longus (EPL), extensor pollicis brevis (EPB), abductor pollicis longus (APL), flexor pollicis brevis (FPB), abductor pollicis brevis (APB), the transverse head of the adductor pollicis (ADPt), the oblique head of the adductor pollicis (ADPo), and opponens pollicis (OPP). Numerical tests were performed using an inverse dynamic approach. The joints were prescribed to an angular motion at one degree-of-freedom (DOF) each time with all other DOFs of the joints being mechanically constrained, while the muscle forces in response to the joint motions were predicted. The normal joint stiffness was assumed to be 0.05, 0.10, and 0.15 N m/rad for interphalangeal (IP), metacarpophalangeal (MCP), and carpometacarpal (CMC) joint, respectively. The joint stiffness was assumed to increase by 50% and 100%, simulating the biomechanical consequences of OA. RESULTS Our simulations indicated that the increase in joint stiffness induced substantial increases in muscle forces, especially in the EPL and FPL muscles in response to IP, MCP, or CMC extension/flexion motions. CONCLUSIONS Because the strength of the muscles in the fingers is limited, the muscles will not be able to overcome joint resistance if joint stiffness is increased to its limit due to OA. This may contribute to the reduced range of motion typically seen in OA.
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Affiliation(s)
- John Z Wu
- Health Effects Laboratory Division, National Institute for Occupational Safety & Health, Morgantown, WV 26505, USA.
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Connor JR, LePage C, Swift BA, Yamashita D, Bendele AM, Maul D, Kumar S. Protective effects of a cathepsin K inhibitor, SB-553484, in the canine partial medial meniscectomy model of osteoarthritis. Osteoarthritis Cartilage 2009; 17:1236-43. [PMID: 19361586 DOI: 10.1016/j.joca.2009.03.015] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2008] [Revised: 03/13/2009] [Accepted: 03/16/2009] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Cathepsin K (cat K), a cysteine protease expressed in osteoclasts, chondrocytes and synovial fibroblasts, degrades several bone and cartilage matrix components suggesting its potential role in osteoarthritis (OA). We investigated the effects of SB-553484, an inhibitor of cat K, on lesion severity and biomarkers of collagen degradation in the canine partial medial meniscectomy model. METHODS A partial medial meniscectomy was performed in mature female beagle dogs. Animals were dosed orally with vehicle or SB-553484 at 50mg/kg BID for 28 days. The femorotibial joints were evaluated for gross and microscopic histological changes. Biomarkers of collagen degradation were also analyzed. RESULTS In dogs treated with SB-553484, subjective gross and calculated degeneration scores decreased significantly by 29% and 46%, respectively. Histopathologic evaluation demonstrated that the summed tibial degeneration score decreased significantly by 21%. Inhibition of tibial cartilage degeneration was significant in zone 1 (32%) and the depth ratio of any tibial matrix change was decreased significantly by 28%. Urinary biomarkers of bone and cartilage degradation were also significantly reduced. CONCLUSION Treatment with SB-553484 resulted in mild to moderate beneficial effects on gross and histopathological parameters. Reduction of biomarkers of collagen type I and II degradation indicated a direct effect of the compound on bone and cartilage. These data suggest that the prevention of cartilage degradation by cat K inhibition may represent a valid strategy for pharmacological intervention in OA and that monitoring collagen degradation biomarkers may provide an indication of the protective effects of inhibition of bone and cartilage degradation.
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Affiliation(s)
- J R Connor
- Immuno-Inflammation, GlaxoSmithKline Pharmaceuticals, Collegeville, PA 19426, USA.
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Menz HB, Munteanu SE, Landorf KB, Zammit GV, Cicuttini FM. Radiographic evaluation of foot osteoarthritis: sensitivity of radiographic variables and relationship to symptoms. Osteoarthritis Cartilage 2009; 17:298-303. [PMID: 18789728 DOI: 10.1016/j.joca.2008.07.011] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2008] [Accepted: 07/21/2008] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To evaluate a radiographic atlas for grading foot osteoarthritis (OA) in relation to the relative sensitivity of different radiographic and views and features, and to examine the relationship between radiographic OA and foot symptoms. METHODS Weightbearing dorso-plantar (DP) and lateral foot radiographs were obtained from 197 people (126 women and 71 men) aged 62-94 years (mean age 75.9, standard deviation [SD] 6.6). The prevalence of OA in five joints (the first metatarsophalangeal joint [1st MPJ], the first cuneo-metatarsal joint [1st CMJ], the second cuneo-metatarsal joint [2nd CMJ], the navicular-first cuneiform joint [N1st CJ] and the talo-navicular joint [TNJ]) was then determined using both views in combination (as recommended in the atlas), or by using either view in isolation. Associations between radiographic OA in individual foot joints and symptoms were then explored. RESULTS Joint-specific prevalence of OA using both DP and lateral views was 1st MPJ (42.4%), 1st CMJ (22.6%), 2nd CMJ (60.2%), N1st CJ (39.1%) and TNJ (32.7%). Using only the DP view detected almost all cases of 1st MPJ OA (94.6%), however, the sensitivity was lower for the other joints (31.0-60.7%). Using only the lateral view detected almost all cases of OA (83.8 to 86.9%), with the exception of the 1st MPJ and 1st CMJ (50.9% and 60.7%, respectively). Using either osteophytes (OP) alone or joint space narrowing (JSN) alone showed low sensitivity for all joints (14.3-63.0%), with the exception of OP alone in the DP view for the 1st MPJ and JSN in the lateral view for the 2nd CMJ (83.8% and 84.0%, respectively). Radiographic OA in individual foot joints and the total number of joints affected were both moderately associated with foot symptoms. CONCLUSION Epidemiological and clinical studies should incorporate observation of both OP and JSN from both DP and lateral views to determine the presence of OA in the foot, as the number of cases detected is reduced if only one radiographic feature or view is used. Radiographic foot OA is common in older people and is moderately associated with foot symptoms.
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Affiliation(s)
- H B Menz
- Musculoskeletal Research Centre, Faculty of Health Sciences, La Trobe University, Bundoora, Victoria 3086, Australia.
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Dagenais S, Garbedian S, Wai EK. Systematic review of the prevalence of radiographic primary hip osteoarthritis. Clin Orthop Relat Res 2009; 467:623-37. [PMID: 19037710 PMCID: PMC2635466 DOI: 10.1007/s11999-008-0625-5] [Citation(s) in RCA: 139] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2008] [Accepted: 11/04/2008] [Indexed: 01/31/2023]
Abstract
Hip osteoarthritis is a common cause of musculoskeletal pain in older adults and may result in decreased mobility and quality of life. Although the presentation of hip osteoarthritis varies, surgical management is required when the disease is severe, longstanding, and unresponsive to nonoperative treatments. For stakeholders to plan for the expected increased demand for surgical procedures related to hip osteoarthritis, including arthroplasty, it is important to first understand its prevalence. We conducted a systematic review by searching MEDLINE and EMBASE to identify recent English language articles reporting on the prevalence of radiographic primary hip osteoarthritis in the general adult population; references including studies and primary studies from previous systematic reviews were also searched. This strategy yielded 23 studies reporting 39 estimates of overall prevalence ranging from 0.9% to 27% with a mean of 8.0% and a standard deviation of 7.0%. Heterogeneity was noted in study populations, eligibility criteria, age and gender distribution, type of radiographs, and method of diagnosis. Although the association between radiographic hip osteoarthritis and the need for eventual surgical management is still unclear, this study supports assertions that hip osteoarthritis is a prevalent condition whose treatment will continue to place important demands on health services.
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Affiliation(s)
- Simon Dagenais
- Division of Orthopaedics, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
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Bremander A, Bergman S. Non-pharmacological management of musculoskeletal disease in primary care. Best Pract Res Clin Rheumatol 2008; 22:563-77. [PMID: 18519105 DOI: 10.1016/j.berh.2008.01.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Musculoskeletal diseases as a group are one of the most common causes of contact in primary care and the most common causes of disability and long-term sick leave in several Western countries. Pain and dysfunction are often present without any specific findings in the musculoskeletal system, and a strictly biomedical approach is often inadequate. Body structure and function interact with personal and environmental factors, affecting the ability to perform activities and participate in society. It is important to meet these needs in primary care, and non-pharmacological principles such as physical activity and patient education with a cognitive approach are cornerstones in a multimodal management model.
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Affiliation(s)
- Ann Bremander
- Research and Development Centre, Spenshult Hospital for Rheumatic Diseases, SE 313 92 Oskarström, Sweden
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Transglutaminase-2 differently regulates cartilage destruction and osteophyte formation in a surgical model of osteoarthritis. Amino Acids 2008; 36:755-63. [DOI: 10.1007/s00726-008-0129-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2008] [Accepted: 03/12/2008] [Indexed: 10/21/2022]
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Kvien TK, Fjeld E, Slatkowsky-Christensen B, Nichols M, Zhang Y, Prøven A, Mikkelsen K, Palm Ø, Borisy AA, Lessem J. Efficacy and safety of a novel synergistic drug candidate, CRx-102, in hand osteoarthritis. Ann Rheum Dis 2007; 67:942-8. [PMID: 17962237 PMCID: PMC2564788 DOI: 10.1136/ard.2007.074401] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE The novel synergistic drug candidate CRx-102 comprises dipyridamole and low dose prednisolone and is in clinical development for the treatment of immunoinflammatory diseases. The purpose of this clinical study was to examine the efficacy and safety of CRx-102 in patients with hand osteoarthritis (HOA). METHODS The study was conducted as a blinded, randomised, placebo-controlled trial at four centres in Norway. Eligibility criteria included being of age 30-70 years, at least one swollen and tender joint, a Kellgren-Lawrence (K-L) score of 2 or higher on radiographs, and a score of at least 30 mm pain on the Australian/Canadian Osteoarthritis Hand Index (AUSCAN) visual analogue pain scale (VAS). The primary endpoint was a reduction in pain from baseline to day 42 on the AUSCAN pain subscale. Two-sided p values for the differences in least squares (LS) means adjusted for baseline are presented. RESULTS The mean age of the 83 patients with HOA was 60 years and 93% were females. CRx-102 was statistically superior to placebo at 42 days for changes in AUSCAN pain (LS mean -14.2 vs -4.0) and for clinically relevant secondary endpoints (joint pain VAS (-18.6 vs -6.3), patient global VAS (-15.9 vs -4.2)) in the intention to treat population. The most frequently reported adverse event during the study was headache (52% in CRx-102 vs 15% in the placebo group). CONCLUSIONS The novel synergistic drug candidate CRx-102 demonstrated efficacy by statistically reducing pain compared to placebo in HOA and was generally well tolerated.
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Affiliation(s)
- T K Kvien
- Department of Rheumatology, Diakonhjemmet Hospital, Box 23 Vinderen, N-0319 Oslo, Norway.
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Kloppenburg M, Stamm T, Watt I, Kainberger F, Cawston TE, Birrell FN, Petersson IF, Saxne T, Kvien TK, Slatkowsky-Christensen B, Dougados M, Gossec L, Breedveld FC, Smolen JS. Research in hand osteoarthritis: time for reappraisal and demand for new strategies. An opinion paper. Ann Rheum Dis 2007; 66:1157-61. [PMID: 17360780 PMCID: PMC1955144 DOI: 10.1136/ard.2007.070813] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2007] [Indexed: 01/09/2023]
Abstract
BACKGROUND Osteoarthritis of the hands is a prevalent musculoskeletal disease with a considerable effect on patients' lives, but knowledge and research results in the field of hand osteoarthritis are limited. Therefore, the Disease Characteristics in Hand OA (DICHOA) initiative was founded in early 2005 with the aim of addressing key issues and facilitating research into hand osteoarthritis. OBJECTIVE To review and discuss current knowledge on hand osteoarthritis with regard to aetiopathogenesis, diagnostic criteria, biomarkers and clinical outcome measures. METHODS Recommendations were made based on a literature review. RESULTS Outcomes of hand osteoarthritis should be explored, including patient perspective on the separate components of disease activity, damage and functioning. All imaging techniques should be cross-validated for hand osteoarthritis with clinical status, including disease activity, function and performance, biomarkers and long-term outcome. New imaging modalities are available and need scoring systems and validation. The role of biomarkers in hand osteoarthritis has to be defined. CONCLUSION Future research in hand osteoarthritis is warranted.
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Affiliation(s)
- Margreet Kloppenburg
- Department of Rheumatology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands.
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