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Couch JL, King MG, De Oliveira Silva D, Whittaker JL, Bruder AM, Serighelli F, Kaplan S, Culvenor AG. Noisy knees - knee crepitus prevalence and association with structural pathology: a systematic review and meta-analysis. Br J Sports Med 2024:bjsports-2024-108866. [PMID: 39375004 DOI: 10.1136/bjsports-2024-108866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2024] [Indexed: 10/09/2024]
Abstract
OBJECTIVE Knee crepitus, the audible crackling or grinding noise during knee movement, can be experienced across the lifespan and create concern for underlying pathology. Our systematic review aims to provide a summary estimate of knee crepitus prevalence and its association with structural pathology among the general population and across knee conditions. DESIGN Systematic review and meta-analysis. DATA SOURCES Medline, Embase, CENTRAL, Web of Science, SPORTDiscus and CINAHL. ELIGIBILITY CRITERIA Studies evaluating knee crepitus prevalence. RESULTS 103 studies involving 36 439 participants (42 816 knees) were included. Based on very low certainty evidence, the pooled prevalence of knee crepitus in the general population was 41% (7609 knees; 95% CI 36% to 45%; I2=92.6%); in pain-free persons 36% (852 knees; 95% CI 23% to 50%; I2=91.9%), and in those with osteoarthritis (OA) 81% (18 821 knees; 95% CI 75% to 87%; I2=97.9%). Across other musculoskeletal knee conditions, the pooled prevalence of knee crepitus ranged from 35% (ligament injury; 2740 knees; 95% CI 27% to 44%; I2=95.6%) to 61% (cartilage pathology; 1445 knees; 95% CI 40% to 81%; I2=98.2%). There was low to very low certainty evidence of an association between knee crepitus and radiographic OA (OR 3.79, 95% CI 1.99 to 7.24; 1725 knees; I2=53.0%) and several OA-related features on magnetic resonance imaging (MRI). CONCLUSION In this review, knee crepitus was prevalent in the general population, pain-free persons, those with knee OA and other musculoskeletal knee conditions. Knee crepitus was associated with a more than threefold increased odds of radiographic OA diagnosis and several OA-related MRI features. The low to very low certainty of evidence informing our aggregated prevalence estimates and association outcomes suggest that results should be interpreted with caution.
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Affiliation(s)
- Jamon L Couch
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- Australian IOC Research Centre, La Trobe University, Melbourne, Victoria, Australia
- Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Matthew G King
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- Australian IOC Research Centre, La Trobe University, Melbourne, Victoria, Australia
- Department of Physiotherapy, Podiatry, Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Danilo De Oliveira Silva
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- Australian IOC Research Centre, La Trobe University, Melbourne, Victoria, Australia
- Department of Physiotherapy, Podiatry, Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Jackie L Whittaker
- Arthritis Research Canada, Vancouver, British Columbia, Canada
- Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrea M Bruder
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- Australian IOC Research Centre, La Trobe University, Melbourne, Victoria, Australia
- Department of Physiotherapy, Podiatry, Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Fernanda Serighelli
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- Australian IOC Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Sean Kaplan
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- Australian IOC Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Adam G Culvenor
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- Australian IOC Research Centre, La Trobe University, Melbourne, Victoria, Australia
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2
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Goh SL, Chong MW, Ling J, Jaafar Z, Lim ZL, Yau MY, Ong T, Richards J. Semi-invasive therapies for pain in knee osteoarthritis: A systematic review and network meta-analysis. Pain Pract 2024. [PMID: 39267256 DOI: 10.1111/papr.13404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 07/17/2024] [Accepted: 08/13/2024] [Indexed: 09/17/2024]
Abstract
BACKGROUND The increasing number of semi-invasive pain therapies in knee osteoarthritis poses challenges in decision-making. This review aimed to simultaneously compare established intra-articular therapies with newer peri-articular therapies and explore effect modifiers. METHODS Randomized controlled trials were searched from five electronic databases without date or language restrictions. Study selection and data extraction of reports, retrieved up to May 2024, were performed independently by paired assessors. The primary outcome was 6-month pain score. Nine treatments were included. The effect size (ES) for each treatment, relative to placebo, was estimated using standardized means difference and expressed with 95% confidence intervals (CI). The rigor of results was evaluated with subgroup/sensitivity analyses. RESULTS A total of 111 studies (14,695 participants) were included, with intra-articular hyaluronic acid having the greatest number of participants. Neuroablation demonstrated the greatest ES (1.08, 95% CI: 0.07, 2.10). While platelet-rich plasma (PRP) ranked second (ES: 0.75, 95% CI: 0.28, 1.22), it was the only intervention demonstrating statistically significant effect at 3, 6, and 12 months. However, this statistical significance was lost in some sensitivity analyses. Larger estimates for biologics and PRP compared with prolotherapy, steroid, and hyaluronic acid injections were consistently observed across different timepoints and in multiple sensitivity analyses. Generally, no statistically significant difference was found between the nine types of therapies. CONCLUSION Although there is robust evidence suggesting greater efficacy of PRP, potentially including biologics, over other interventions, future research is needed to identify the phenotype or patient subgroup that would benefit most from PRP.
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Affiliation(s)
- Siew-Li Goh
- Sports and Exercise Medicine Research and Education Group, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Melissa Wee Chong
- Sarawak General Hospital, Jalan Hospital, Kuching, Sarawak, Malaysia
| | - Jerri Ling
- Sports Medicine Unit, Department of Orthopedics, Hospital Tengku Ampuan Rahimah Klang, Selangor, Malaysia
| | - Zulkarnain Jaafar
- Sports and Exercise Medicine Research and Education Group, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Zhuang-Li Lim
- Sports and Exercise Medicine Unit, Department of Orthopaedics, Hospital Tengku Ampuan Afzan, Kuantan, Pahang, Malaysia
| | - May-Yann Yau
- Sarawak General Hospital, Jalan Hospital, Kuching, Sarawak, Malaysia
| | - Terence Ong
- Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
- School of Medicine, Taylor's University, Subang Jaya, Selangor, Malaysia
| | - Jim Richards
- Allied Health Research Unit, University of Central Lancashire, Preston, UK
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3
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Chang AH, Roemer FW, Guermazi A, Almagor O, Lee JJ, Chmiel JS, Muhammad LN, Song J, Sharma L. Do Existing MRI Definitions of Knee Osteoarthritis Identify Knees That Will Develop Clinically Significant Disease Over Up To 11 Years of Follow-Up? Arthritis Rheumatol 2024. [PMID: 39229747 DOI: 10.1002/art.42982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 07/25/2024] [Accepted: 08/20/2024] [Indexed: 09/05/2024]
Abstract
OBJECTIVE In individuals without radiographic knee osteoarthritis (OA), we investigated whether magnetic resonance imaging (MRI)-defined knee OA at baseline was associated with incident radiographic and symptomatic disease during up to 11 years of follow-up. METHODS Osteoarthritis Initiative participants without tibiofemoral radiographic knee OA at baseline were assessed for MRI-based tibiofemoral cartilage damage, osteophyte presence, bone marrow lesions, and meniscal damage/extrusion. We defined MRI knee OA using alternative, reported definitions (Def A and Def B). Kellgren-Lawrence (KL) grade, joint space narrowing (JSN), and frequent knee symptoms (Sx) were assessed at baseline, 1-, 2-, 3-, 4-, 6-, 8-, and 10/11-year follow-up visits. Incident tibiofemoral radiographic knee OA (outcome) was defined as (1) KL ≥2, (2) KL ≥2 and JSN, or (3) KL ≥2 and Sx. Adjusted Cox proportional hazards regression models examined associations of baseline MRI-defined knee OA (Def A and Def B) with incident outcomes during up to 11 years of follow-up. RESULTS Among 1,621 participants (mean age ± SD 58.8 ± 9.0 years, mean body mass index ± SD 27.2 ± 4.5 kg/m2, 59.5% women), 17% had MRI-defined knee OA by Def A and 24% by Def B. Baseline MRI-defined knee OA was associated with incident KL ≥2 (odds ratio 2.94 [95% confidence interval (95% CI) 2.34-3.68] for Def A and 2.44 [95% CI 1.97-3.03] for Def B). However, a substantial proportion of individuals with baseline MRI-defined knee OA did not develop incident KL ≥2 during follow-up (59% for Def A and 64% for Def B). Findings were similar for the other two outcomes. CONCLUSION Current MRI definitions of knee OA do not adequately identify knees that will develop radiographic and symptomatic disease.
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Affiliation(s)
- Alison H Chang
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Frank W Roemer
- University of Erlangen-Nuremberg, Erlangen, Germany, and Boston University School of Medicine, Boston, Massachusetts
| | - Ali Guermazi
- Boston University School of Medicine, Boston, Massachusetts
| | - Orit Almagor
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Jungwha Julia Lee
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Joan S Chmiel
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | | | - Jing Song
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Leena Sharma
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
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4
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Gelber AC. Knee Osteoarthritis. Ann Intern Med 2024; 177:ITC129-ITC144. [PMID: 39250809 DOI: 10.7326/annals-24-01249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/11/2024] Open
Abstract
Knee osteoarthritis (OA) typically presents with joint pain that is exacerbated by use and alleviated with rest. There is relatively brief, self-limited morning stiffness and absence of constitutional symptoms. Overweight and obesity are the most important modifiable risk factors. Although pharmacologic and nonpharmacologic interventions are generally effective at alleviating pain and improving physical function, they do not fundamentally reverse the pathologic and radiographic process of knee OA. As the severity of disease increases, the magnitude of pain and functional impairment intensifies. Surgical intervention should be pursued to relieve pain and restore functionality only when nonpharmacologic approaches and pharmacologic agents fail to control pain.
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Affiliation(s)
- Allan C Gelber
- Johns Hopkins University School of Medicine, Baltimore, Maryland (A.C.G.)
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Giaretta S, Magni A, Migliore A, Natoli S, Puntillo F, Ronconi G, Santoiemma L, Sconza C, Viapiana O, Zanoli G. A Review of Current Approaches to Pain Management in Knee Osteoarthritis with a Focus on Italian Clinical Landscape. J Clin Med 2024; 13:5176. [PMID: 39274389 PMCID: PMC11396710 DOI: 10.3390/jcm13175176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 07/24/2024] [Accepted: 08/11/2024] [Indexed: 09/16/2024] Open
Abstract
The global cases of knee osteoarthritis (KOA) are projected to increase by 74.9% by 2050. Currently, over half of patients remain dissatisfied with their pain relief. This review addresses unmet needs for moderate-to-severe KOA pain; it offers evidence and insights for improved management. Italian experts from the fields of rheumatology, physical medicine and rehabilitation, orthopedics, primary care, and pain therapy have identified several key issues. They emphasized the need for standardized care protocols to address inconsistencies in patient management across different specialties. Early diagnosis is crucial, as cartilage responds better to early protective and structural therapies. Faster access to physiatrist evaluation and reimbursement for physical, rehabilitative, and pharmacological treatments, including intra-articular (IA) therapy, could reduce access disparities. Concerns surround the adverse effects of oral pharmacological treatments, highlighting the need for safer alternatives. Patient satisfaction with corticosteroids and hyaluronic acid-based IA therapies reduces over time and there is no consensus on the optimal IA therapy protocol. Surgery should be reserved for severe symptoms and radiographic KOA evidence, as chronic pain post-surgery poses significant societal and economic burdens. The experts advocate for a multidisciplinary approach, promoting interaction and collaboration between specialists and general practitioners, to enhance KOA care and treatment consistency in Italy.
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Affiliation(s)
- Stefano Giaretta
- UOC Ortopedia e Traumatologia OC San Bortolo di Vicenza (AULSS 8 Berica), 36100 Vicenza, Italy
| | - Alberto Magni
- Local Health Department, Desenzano sul Garda, 25015 Brescia, Italy
| | - Alberto Migliore
- Unit of Rheumatology, San Pietro Fatebenefratelli Hospital, 00189 Rome, Italy
| | - Silvia Natoli
- Department of Clinical-Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
- Pain Unit, IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Filomena Puntillo
- Anaesthesia, Intensive Care and Pain Unit, Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Gianpaolo Ronconi
- Department of Rehabilitation, Catholic University of the Sacred Heart, 00168 Rome, Italy
| | | | | | - Ombretta Viapiana
- Rheumatology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, University of Verona, 37126 Verona, Italy
| | - Gustavo Zanoli
- Orthopaedic Ward, Casa di Cura Santa Maria Maddalena, Occhiobello, 45030 Rovigo, Italy
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6
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Vadhan A, Gupta T, Hsu WL. Mesenchymal Stem Cell-Derived Exosomes as a Treatment Option for Osteoarthritis. Int J Mol Sci 2024; 25:9149. [PMID: 39273098 PMCID: PMC11395657 DOI: 10.3390/ijms25179149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2024] [Revised: 08/19/2024] [Accepted: 08/20/2024] [Indexed: 09/15/2024] Open
Abstract
Osteoarthritis (OA) is a leading cause of pain and disability worldwide in elderly people. There is a critical need to develop novel therapeutic strategies that can effectively manage pain and disability to improve the quality of life for older people. Mesenchymal stem cells (MSCs) have emerged as a promising cell-based therapy for age-related disorders due to their multilineage differentiation and strong paracrine effects. Notably, MSC-derived exosomes (MSC-Exos) have gained significant attention because they can recapitulate MSCs into therapeutic benefits without causing any associated risks compared with direct cell transplantation. These exosomes help in the transport of bioactive molecules such as proteins, lipids, and nucleic acids, which can influence various cellular processes related to tissue repair, regeneration, and immune regulation. In this review, we have provided an overview of MSC-Exos as a considerable treatment option for osteoarthritis. This review will go over the underlying mechanisms by which MSC-Exos may alleviate the pathological hallmarks of OA, such as cartilage degradation, synovial inflammation, and subchondral bone changes. Furthermore, we have summarized the current preclinical evidence and highlighted promising results from in vitro and in vivo studies, as well as progress in clinical trials using MSC-Exos to treat OA.
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Affiliation(s)
- Anupama Vadhan
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Yunlin 632007, Taiwan
| | - Tanvi Gupta
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan
| | - Wen-Li Hsu
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Yunlin 632007, Taiwan
- Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung 807378, Taiwan
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7
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García-Muñoz AM, Abellán-Ruiz MS, García-Guillén AI, Victoria-Montesinos D. Efficacy of Eggshell Membrane in Knee Osteoarthritis: A Systematic Review and Meta-Analysis. Nutrients 2024; 16:2640. [PMID: 39203777 PMCID: PMC11356944 DOI: 10.3390/nu16162640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2024] [Revised: 08/07/2024] [Accepted: 08/08/2024] [Indexed: 09/03/2024] Open
Abstract
Osteoarthritis (OA) is a prevalent, degenerative joint disease, with knee OA being particularly common and impactful. This systematic review and meta-analysis aimed to assess the efficacy of eggshell membrane (ESM) supplementation in improving joint functionality and reducing pain in individuals with knee OA. A comprehensive search was conducted across PubMed, Scopus, Web of Science, and Cochrane Database up to July 2024, following PRISMA guidelines. Seven randomized controlled trials (RCTs) met the inclusion criteria, with five included in the meta-analysis. The studies compared ESM to a placebo, evaluating outcomes based on assessment tools such as the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Visual Analogue Scale (VAS), and Knee Injury and Osteoarthritis Outcome Score (KOOS). Results indicated that ESM significantly reduced pain and improved functionality, with notable improvements in total WOMAC score (effect size -0.34; 95% CI: -0.56 to -0.13; p < 0.001) and pain subscale (SMD -0.23; 95% CI: -0.42 to -0.04; p < 0.02). The findings support ESM as a promising adjunctive treatment for knee OA, offering a safe, natural supplement to enhance quality of life. Further high-quality RCTs are needed to confirm these results and explore the long-term effects and mechanisms of ESM.
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Affiliation(s)
- Ana María García-Muñoz
- Faculty of Pharmacy and Nutrition, UCAM Universidad Católica de Murcia, 30107 Murcia, Spain; (A.M.G.-M.); (D.V.-M.)
| | | | | | - Desirée Victoria-Montesinos
- Faculty of Pharmacy and Nutrition, UCAM Universidad Católica de Murcia, 30107 Murcia, Spain; (A.M.G.-M.); (D.V.-M.)
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8
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Lawford BJ, Bennell KL, Haber T, Hall M, Hinman RS, Recenti F, Dell'isola A. Osteoarthritis Year In Review 2024: Rehabilitation and outcomes. Osteoarthritis Cartilage 2024:S1063-4584(24)01323-2. [PMID: 39116992 DOI: 10.1016/j.joca.2024.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 07/08/2024] [Accepted: 08/01/2024] [Indexed: 08/10/2024]
Abstract
This Year in Review presents key highlights from recent research relating to osteoarthritis rehabilitation and its outcomes, defined as any non-pharmacological and non-surgical treatment that aims to improve osteoarthritis symptoms at any joint. Three databases (Medline, Embase, and CINAHL Plus) were searched between 1 March 2023 to 12 March 2024. Relevant studies were chosen based on the predefined inclusion/exclusion criteria, perceived clinical importance, quality, controversy in the field, or personal interest, and organised into four overarching themes (with 1-5 sub-themes each). The first theme related to uncertainties regarding exercise benefits. New work has challenged the clinical effectiveness of exercise on symptoms, as well as highlighted uncertainty around our understanding of both mechanisms of effects, how to enhance effectiveness and adherence, and which subgroups of people are more or less likely to improve with exercise. However, we also highlight new work confirming the role of exercise as a first-line management strategy. The second theme related to digital modes of service delivery. There was new evidence to support its effectiveness in improving symptoms and clear potential for creating and evaluating new mobile apps. New work also highlighted the potential future role artificial intelligence can have in providing treatment information and recommendations. The third theme related to patient education, and the call for change to the impairment-based narrative that prevails in osteoarthritis information. The fourth theme is related to weight loss. New work compared the effectiveness of different weight loss diets and explored alternative models of weight loss delivery.
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Affiliation(s)
- Belinda J Lawford
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Victoria, Australia.
| | - Kim L Bennell
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Victoria, Australia
| | - Travis Haber
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Victoria, Australia
| | - Michelle Hall
- Sydney Musculoskeletal Health, The Kolling Institute, School of Health Sciences, University of Sydney, New South Wales, Australia
| | - Rana S Hinman
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Victoria, Australia
| | - Filippo Recenti
- Department of Clinical Sciences Lund, Clinical Epidemiology Unit, Orthopaedics, Lund University, Lund, Sweden; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genoa, Italy
| | - Andrea Dell'isola
- Department of Clinical Sciences Lund, Clinical Epidemiology Unit, Orthopaedics, Lund University, Lund, Sweden
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9
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Fakih O, Verhoeven F, Prati C, Wendling D. Interest in various treatments for osteoarthritis among the French population: A Google Trends analysis. Joint Bone Spine 2024; 91:105762. [PMID: 39029555 DOI: 10.1016/j.jbspin.2024.105762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 06/28/2024] [Accepted: 07/09/2024] [Indexed: 07/21/2024]
Affiliation(s)
- Olivier Fakih
- Service de rhumatologie, CHU de Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France.
| | - Frank Verhoeven
- Service de rhumatologie, CHU de Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France; EA 4267 "PEPITE", UFR Santé, Franche-Comté University, 19, rue Ambroise-Paré, bâtiment S, 25030 Besançon cedex, France
| | - Clément Prati
- Service de rhumatologie, CHU de Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France; EA 4267 "PEPITE", UFR Santé, Franche-Comté University, 19, rue Ambroise-Paré, bâtiment S, 25030 Besançon cedex, France
| | - Daniel Wendling
- Service de rhumatologie, CHU de Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France; EA 4266 "EPILAB", UFR Santé, Franche-Comté University, 19, rue Ambroise-Paré, bâtiment S, 25030 Besançon cedex, France
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10
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Campbell TM. CORR Insights®: Human Infrapatellar Fat Pad Mesenchymal Stem Cell-derived Extracellular Vesicles Purified by Anion Exchange Chromatography Suppress Osteoarthritis Progression in a Mouse Model. Clin Orthop Relat Res 2024; 482:1263-1266. [PMID: 38843517 PMCID: PMC11219161 DOI: 10.1097/corr.0000000000003107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 04/10/2024] [Indexed: 07/04/2024]
Affiliation(s)
- T Mark Campbell
- Clinician Investigator, Physical Medicine and Rehabilitation Department, Élisabeth Bruyère Hospital, Ottawa, Ontario, Canada
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11
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Szala D, Kopańska M, Trojniak J, Jabłoński J, Hanf-Osetek D, Snela S, Zawlik I. The Role of MicroRNAs in the Pathophysiology of Osteoarthritis. Int J Mol Sci 2024; 25:6352. [PMID: 38928059 PMCID: PMC11204066 DOI: 10.3390/ijms25126352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Revised: 06/04/2024] [Accepted: 06/06/2024] [Indexed: 06/28/2024] Open
Abstract
Worldwide, osteoarthritis (OA) is the most common cause of joint pain in older people. Many factors contribute to osteoarthritis' development and progression, including secondary osteoarthritis' underlying causes. It is important to note that osteoarthritis affects all four tissues: cartilage, bone, joint capsule, and articular apparatus. An increasingly prominent area of research in osteoarthritis regulation is microRNAs (miRNAs), a small, single-stranded RNA molecule that controls gene expression in eukaryotes. We aimed to assess and summarize current knowledge about the mechanisms of the action of miRNAs and their clinical significance. Osteoarthritis (OA) is affected by the interaction between miRNAs and inflammatory processes, as well as cartilage metabolism. MiRNAs also influence cartilage cell apoptosis, contributing to the degradation of the cartilage in OA. Studies have shown that miRNAs may have both an inhibitory and promoting effect on osteoporosis progression through their influence on molecular mechanisms. By identifying these regulators, targeted treatments for osteoarthritis may be developed. In addition, microRNA may also serve as a biomarker for osteoarthritis. By using these biomarkers, the disease could be detected faster, and early intervention can be instituted to prevent mobility loss and slow deterioration.
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Affiliation(s)
| | - Marta Kopańska
- Department of Pathophysiology, Institute of Medical Sciences, Medical College of Rzeszow University, 35-959 Rzeszow, Poland
| | - Julia Trojniak
- Student Research Club “Reh-Tech”, Medical College of Rzeszow University, 35-959 Rzeszow, Poland;
| | - Jarosław Jabłoński
- Faculty of Orthopaedic and Reumatology, Institute of Medical Sciences, Collegium Medicum, University of Rzeszow, 35-959 Rzeszow, Poland; (J.J.); (D.H.-O.); (S.S.)
- Orthopaedics and Traumatology Clinic, Clinical Hospital No. 2, 35-301 Rzeszow, Poland
| | - Dorota Hanf-Osetek
- Faculty of Orthopaedic and Reumatology, Institute of Medical Sciences, Collegium Medicum, University of Rzeszow, 35-959 Rzeszow, Poland; (J.J.); (D.H.-O.); (S.S.)
- Orthopaedics and Traumatology Clinic, Clinical Hospital No. 2, 35-301 Rzeszow, Poland
| | - Sławomir Snela
- Faculty of Orthopaedic and Reumatology, Institute of Medical Sciences, Collegium Medicum, University of Rzeszow, 35-959 Rzeszow, Poland; (J.J.); (D.H.-O.); (S.S.)
- Orthopaedics and Traumatology Clinic, Clinical Hospital No. 2, 35-301 Rzeszow, Poland
| | - Izabela Zawlik
- Department of General Genetics, Institute of Medical Sciences, Medical College of Rzeszow University, Kopisto 2a, 35-959 Rzeszow, Poland;
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Paolucci T, Tommasi M, Pozzato G, Pozzato A, Pezzi L, Zuccarini M, Di Lanzo A, Palumbo R, Porto D, Messeri R, Pesce M, Pantalone A, Buda R, Patruno A. Management and Rehabilitative Treatment in Osteoarthritis with a Novel Physical Therapy Approach: A Randomized Control Study. Diagnostics (Basel) 2024; 14:1200. [PMID: 38893726 PMCID: PMC11171699 DOI: 10.3390/diagnostics14111200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 05/17/2024] [Accepted: 06/03/2024] [Indexed: 06/21/2024] Open
Abstract
Knee osteoarthritis (KOA) is a chronic degenerative disease characterized by progressive joint damage leading to significant disability. Although rehabilitative treatment methods for KOA have been widely implemented, the optimal integrated instrumental physical therapy approach remains unclear. Therefore, this study aimed to analyze the effect of Quantum Molecular Resonance (QMR) on pain reduction as the primary outcome and the functional improvement in activity daily living (ADL) as a secondary outcome. The study was designed as a double-blind, randomized, controlled trial in an outpatient setting. Fifty-four (N = 54) patients were enrolled and then randomized into three groups according to a simple randomization list: Group 1 (intensive protocol, N = 22), Group 2 (extensive protocol, N = 21), and a Sham group (N = 11). Patients were evaluated over time with scales assessing pain and function. Treatment was performed with the QMR model electro-medical device, which generates alternating electric currents characterized by high frequency (4-64 MHz). The results showed that QMR had a positive effect with respect to the Sham group in terms of pain and function (p < 0.01), and intensive treatment was more effective than the extensive treatment in terms of "speed of response" to the treatment (p < 0.05). In conclusion, QMR in KOA could be effective in slowing the progression of clinical symptoms and improving patients' pain and functionality and thus quality of life. Future studies will be necessary to investigate further treatment algorithms and therapeutic associations with rehabilitative exercise.
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Affiliation(s)
- Teresa Paolucci
- Department of Oral, Medical and Biotechnological Sciences, Physical Medicine and Rehabilitation, G. D’Annunzio University of Chieti-Pescara, 66100 Chieti, Italy; (T.P.); (M.Z.); (A.D.L.)
| | - Marco Tommasi
- Department of Medicine and Aging Sciences, G. D’Annunzio University of Chieti-Pescara, 66100 Chieti, Italy; (M.T.); (A.P.); (R.B.); (A.P.)
| | | | | | - Letizia Pezzi
- Unit of Physical Medicine and Rehabilitation, Hospital of Cremona, 26100 Cremona, Italy;
| | - Mariachiara Zuccarini
- Department of Oral, Medical and Biotechnological Sciences, Physical Medicine and Rehabilitation, G. D’Annunzio University of Chieti-Pescara, 66100 Chieti, Italy; (T.P.); (M.Z.); (A.D.L.)
| | - Alessio Di Lanzo
- Department of Oral, Medical and Biotechnological Sciences, Physical Medicine and Rehabilitation, G. D’Annunzio University of Chieti-Pescara, 66100 Chieti, Italy; (T.P.); (M.Z.); (A.D.L.)
| | - Rocco Palumbo
- Department of Psychological, Health and Territorial Sciences, G. D’Annunzio University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Daniele Porto
- Institute Don Orione, Medical-Social Recovery Center, 65128 Pescara, Italy; (D.P.); (R.M.)
| | - Riccardo Messeri
- Institute Don Orione, Medical-Social Recovery Center, 65128 Pescara, Italy; (D.P.); (R.M.)
| | - Mirko Pesce
- Department of Medicine and Aging Sciences, G. D’Annunzio University of Chieti-Pescara, 66100 Chieti, Italy; (M.T.); (A.P.); (R.B.); (A.P.)
- UdA-TechLab, Research Center, University of Chieti-Pescara, 65100 Pescara, Italy
| | - Andrea Pantalone
- Department of Medicine and Aging Sciences, G. D’Annunzio University of Chieti-Pescara, 66100 Chieti, Italy; (M.T.); (A.P.); (R.B.); (A.P.)
| | - Roberto Buda
- Department of Medicine and Aging Sciences, G. D’Annunzio University of Chieti-Pescara, 66100 Chieti, Italy; (M.T.); (A.P.); (R.B.); (A.P.)
| | - Antonia Patruno
- Department of Medicine and Aging Sciences, G. D’Annunzio University of Chieti-Pescara, 66100 Chieti, Italy; (M.T.); (A.P.); (R.B.); (A.P.)
- UdA-TechLab, Research Center, University of Chieti-Pescara, 65100 Pescara, Italy
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13
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Henriksen M. Limitations of the updated EULAR recommendations for osteoarthritis. Nat Rev Rheumatol 2024; 20:321-322. [PMID: 38499850 DOI: 10.1038/s41584-024-01103-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Affiliation(s)
- Marius Henriksen
- The Parker Institute, Copenhagen University Hospital Bispebjerg Frederiksberg, Copenhagen, Denmark.
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
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14
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Martinez-Calderon J, Cano-García FJ, García-Muñoz C, Rufo-Barbero C, Matias-Soto J, Infante-Cano M. How can clinicians enhance self-efficacy beliefs in osteoarthritis? An overview of systematic reviews with meta-analysis. Clin Rheumatol 2024; 43:1435-1446. [PMID: 38517651 DOI: 10.1007/s10067-024-06943-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 03/12/2024] [Accepted: 03/14/2024] [Indexed: 03/24/2024]
Abstract
This overview of reviews aimed to synthesize the effectiveness of non-pharmacological approaches to enhance self-efficacy in people with osteoarthritis. The CINAHL, Embase, PsycINFO, PubMed, SPORTDiscus, and the Cochrane Library databases were searched from inception to December 2023. We considered systematic reviews with meta-analysis of randomized clinical trials evaluating any non-pharmacological intervention. We used AMSTAR 2 to assess the methodological quality of reviews. The overlap between reviews was calculated. We included eight systematic reviews with meta-analysis evaluating 30 different clinical trials. Overall, mind-body exercises, psychological interventions, and self-management strategies may improve arthritis self-efficacy. Specifically, the meta-analyses showed tai chi exercises, coping skills training, and the arthritis self-management program are more effective than controls to enhance arthritis self-efficacy in people with hip and/or knee osteoarthritis. In addition, inconsistent results were detected across meta-analyses regarding the effectiveness of multidisciplinary interventions. Finally, the degree of overlap between all reviews was moderate (CCA = 6%) and many included reviews reported most of the items of AMSTAR 2. Tai chi exercises, coping skills training, and the arthritis self-management program may be beneficial for enhancing arthritis self-efficacy. Open Science Framework Registration: https://doi.org/10.17605/OSF.IO/VX2T6 .
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Affiliation(s)
- Javier Martinez-Calderon
- Departamento de Fisioterapia, Instituto de Biomedicina de Sevilla (IBiS), Universidad de Sevilla, Seville, Spain
- CTS 1110: Understanding Movement and Self in Health From Science (UMSS) Research Group, Andalusia, Spain
| | - Francisco Javier Cano-García
- Departamento de Personalidad Evaluación y Tratamiento Psicológicos, Universidad de Sevilla, 41018, Seville, Spain
| | - Cristina García-Muñoz
- CTS 1110: Understanding Movement and Self in Health From Science (UMSS) Research Group, Andalusia, Spain
- Departamento de Ciencias de La Salud y Biomédicas, Universidad Loyola de Andalucía, Seville, Spain
| | - Carmen Rufo-Barbero
- Departamento de Personalidad Evaluación y Tratamiento Psicológicos, Universidad de Sevilla, 41018, Seville, Spain
| | - Javier Matias-Soto
- CTS 1110: Understanding Movement and Self in Health From Science (UMSS) Research Group, Andalusia, Spain.
- Department of Physical Therapy, Faculty of Health Sciences, Universidad de Malaga, Malaga, Spain.
| | - Marta Infante-Cano
- CTS 1110: Understanding Movement and Self in Health From Science (UMSS) Research Group, Andalusia, Spain
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15
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Tchetina EV, Glemba KE, Markova GA, Glukhova SI, Makarov MA, Lila AM. Metabolic Dysregulation and Its Role in Postoperative Pain among Knee Osteoarthritis Patients. Int J Mol Sci 2024; 25:3857. [PMID: 38612667 PMCID: PMC11011761 DOI: 10.3390/ijms25073857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 03/18/2024] [Accepted: 03/28/2024] [Indexed: 04/14/2024] Open
Abstract
Knee osteoarthritis (KOA) is characterized by low-grade inflammation, loss of articular cartilage, subchondral bone remodeling, synovitis, osteophyte formation, and pain. Strong, continuous pain may indicate the need for joint replacement in patients with end-stage OA, although postoperative pain (POP) of at least a two-month duration persists in 10-40% of patients with OA. STUDY PURPOSE The inflammation observed in joint tissues is linked to pain caused by the production of proinflammatory cytokines. Since the biosynthesis of cytokines requires energy, their production is supported by extensive metabolic conversions of carbohydrates and fatty acids, which could lead to a disruption in cellular homeostasis. Therefore, this study aimed to investigate the association between POP development and disturbances in energy metabolic conversions, focusing on carbohydrate and fatty acid metabolism. METHODS Peripheral blood samples were collected from 26 healthy subjects and 50 patients with end-stage OA before joint replacement surgery. All implants were validated by orthopedic surgeons, and patients with OA demonstrated no inherent abnormalities to cause pain from other reasons than OA disease, such as malalignment, aseptic loosening, or excessive bleeding. Pain levels were assessed before surgery using the visual analogue scale (VAS) and neuropathic pain questionnaires, DN4 and PainDETECT. Functional activity was evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Three and six months after surgery, pain indices according to a VAS of 30 mm or higher were considered. Total RNA isolated from whole blood was analyzed using quantitative real-time RT-PCR (qRT-PCR) for the expression of genes related to carbohydrate and fatty acid metabolism. Protein levels of the examined genes were measured using an ELISA in the peripheral blood mononuclear cells (PBMCs). We used qRT-PCR because it is the most sensitive and reliable method for gene expression analysis, while an ELISA was used to confirm our qRT-PCR results. KEY FINDINGS Among the study cohort, 17 patients who reported POP demonstrated significantly higher (p < 0.05) expressions of the genes PKM2, LDH, SDH, UCP2, CPT1A, and ACLY compared to pain-free patients with KOA. Receiver-operating characteristic (ROC) curve analyses confirmed the association between these gene expressions and pain development post-arthroplasty. A principle component analysis identified the prognostic values of ACLY, CPT1A, AMPK, SDHB, Caspase 3, and IL-1β gene expressions for POP development in the examined subjects. CONCLUSION These findings suggest that the disturbances in energy metabolism, as observed in the PBMCs of patients with end-stage KOA before arthroplasty, may contribute to POP development. An understanding of these metabolic processes could provide insights into the pathogenesis of KOA. Additionally, our findings can be used in a clinical setting to predict POP development in end-stage patients with KOA before arthroplasty.
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Affiliation(s)
- Elena V. Tchetina
- Immunology and Molecular Biology Department, Nasonova Research Institute of Rheumatology, Moscow 115522, Russia
| | - Kseniya E. Glemba
- Surgery Department, Nasonova Research Institute of Rheumatology, Moscow 115522, Russia (M.A.M.)
| | - Galina A. Markova
- Immunology and Molecular Biology Department, Nasonova Research Institute of Rheumatology, Moscow 115522, Russia
| | - Svetlana I. Glukhova
- Statistics Department, Nasonova Research Institute of Rheumatology, Moscow 115522, Russia
| | - Maksim A. Makarov
- Surgery Department, Nasonova Research Institute of Rheumatology, Moscow 115522, Russia (M.A.M.)
| | - Aleksandr M. Lila
- Osteoartritis Laboratory, Nasonova Research Institute of Rheumatology, Moscow 115522, Russia;
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16
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Kawde K, Pisulkar G, Salwan A, Jayasoorya A, Jadawala VH, Taywade S. A Comprehensive Review of Current Management Trends in Medial Compartment Arthritis of the Knee Joint. Cureus 2024; 16:e56666. [PMID: 38646379 PMCID: PMC11032692 DOI: 10.7759/cureus.56666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 03/21/2024] [Indexed: 04/23/2024] Open
Abstract
Medial compartment arthritis of the knee joint presents a significant clinical challenge, with diverse management options ranging from nonsurgical interventions to various surgical procedures. This comprehensive review synthesizes current evidence on the management trends in medial compartment arthritis, highlighting both nonsurgical approaches such as physical therapy, pharmacological interventions, and intra-articular injections as well as surgical interventions, including arthroscopic debridement, high tibial osteotomy, and knee arthroplasty. Through a comparative analysis of efficacy, complication rates, and patient outcomes, this review underscores the importance of tailoring treatment strategies to individual patient characteristics and preferences. Furthermore, emerging techniques and technologies promise to advance the field, necessitating ongoing research efforts to refine treatment algorithms and establish standardized guidelines. By adopting a multidisciplinary approach and integrating evidence-based practices, clinicians can optimize the management of medial compartment arthritis and enhance patient care outcomes.
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Affiliation(s)
- Kevin Kawde
- Orthopaedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Gajanan Pisulkar
- Orthopaedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Ankur Salwan
- Orthopaedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Adarsh Jayasoorya
- Orthopaedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Vivek H Jadawala
- Orthopaedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Shounak Taywade
- Orthopaedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
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17
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Battista S, Lohmander LS, Dell’Isola A, Dahlberg LE, Kiadaliri A. Sex and age differences in the patient-reported outcome measures and adherence to an osteoarthritis digital self-management intervention. OSTEOARTHRITIS AND CARTILAGE OPEN 2024; 6:100437. [PMID: 38322146 PMCID: PMC10844664 DOI: 10.1016/j.ocarto.2024.100437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 01/19/2024] [Indexed: 02/08/2024] Open
Abstract
Objective To explore sex and age differences in Patient-Reported Outcomes Measures (PROMs) and adherence to digital osteoarthritis (OA) self-management intervention. Methods A register-based study with data from an OA digital self-management intervention. PROMs and adherence were collected at baseline and/or 3 month follow-up: 'pain intensity' in hip/knee (best/worst: 0-10), 'activity impairments' (best/worst: 0-10), 'overall health' perception (worst/best: 0-10), 'physical function' (30-s chair stand test), 'health-related quality of life' (EQ-5D-5L index score; worst/best: 0.243-0.976), the subscales and total scores of the Knee Injury/Hip Disability and Osteoarthritis Outcome Score (KOOS/HOOS-12; worst/best: 0-100), 'fear of movement' (yes/no), 'walking difficulties' (yes/no), 'programme adherence' (0-100 % and ≥80 % [yes/no]), 'patient acceptable symptom state' (PASS; yes/no), and 'treatment failure' (those who answered no to PASS question and thought the treatment failed [yes/no]). We used linear/logistic regression to calculate mean/risk differences in the PROMs and adherence levels among sex and age groups at 3-month follow-up. We employed entropy balancing to explore the contributions of baseline characteristics and different covariates to the sex/age differences. Results We included 14,610 participants (mean (SD) age: 64.1 (9.1), 75.5 % females). Females generally reported better outcomes than males. Participants aged ≥70 had greater activity impairments, lower KOOS/HOOS-pain/function scores, more walking difficulties, less fear of movement and higher adherence than those <70. However, these differences were small and not likely clinically relevant. Conclusion No clinically relevant differences in PROMs and adherence were found among sex/age groups in this digital OA programme, suggesting that sex/age seemed not to impact the outcomes of this intervention.
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Affiliation(s)
- Simone Battista
- Clinical Epidemiology Unit, Department of Clinical Sciences Lund, Orthopaedics, Lund University, Lund, Sweden
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Campus of Savona, Italy
| | - L Stefan Lohmander
- Department of Clinical Sciences Lund, Orthopaedics, Lund University, Lund, Sweden
| | - Andrea Dell’Isola
- Clinical Epidemiology Unit, Department of Clinical Sciences Lund, Orthopaedics, Lund University, Lund, Sweden
| | - Leif E. Dahlberg
- Department of Clinical Sciences Lund, Orthopaedics, Lund University, Lund, Sweden
- Arthro Therapeutics, Malmö, Sweden
| | - Ali Kiadaliri
- Clinical Epidemiology Unit, Department of Clinical Sciences Lund, Orthopaedics, Lund University, Lund, Sweden
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18
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Wilczyński M, Bieniek M, Krakowski P, Karpiński R. Cemented vs. Cementless Fixation in Primary Knee Replacement: A Narrative Review. MATERIALS (BASEL, SWITZERLAND) 2024; 17:1136. [PMID: 38473607 DOI: 10.3390/ma17051136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 02/13/2024] [Accepted: 02/26/2024] [Indexed: 03/14/2024]
Abstract
Knee osteoarthritis (OA) is one of the leading causes of disability around the globe. Osteoarthritis is mainly considered a disease affecting the elderly. However, more and more studies show that sports overuse, obesity, or congenital disorders can initiate a pathologic cascade that leads to OA changes in the younger population. Nevertheless, OA mostly affects the elderly, and with increasing life expectancy, the disease will develop in more and more individuals. To date, the golden standard in the treatment of the end-stage of the disease is total joint replacement (TJR), which restores painless knee motion and function. One of the weakest elements in TJR is its bonding with the bone, which can be achieved by bonding material, such as poly methyl-methacrylate (PMMA), or by cementless fixation supported by bone ingrowth onto the endoprosthesis surface. Each technique has its advantages; however, the most important factor is the revision rate and survivor time. In the past, numerous articles were published regarding TJR revision rate, but no consensus has been established yet. In this review, we focused on a comparison of cemented and cementless total knee replacement surgeries. We introduced PICO rules, including population, intervention, comparison and outcomes of TJR in a PubMed search. We identified 783 articles published between 2010 and 2023, out of which we included 14 in our review. Our review reveals that there is no universally prescribed approach to fixate knee prostheses. The determination of the most suitable method necessitates an individualized decision-making process involving the active participation and informed consent of each patient.
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Affiliation(s)
- Mikołaj Wilczyński
- Orthopaedic and Sports Traumatology Department, Carolina Medical Center, Pory 78, 02-757 Warsaw, Poland
| | - Michał Bieniek
- Orthopaedic and Sports Traumatology Department, Carolina Medical Center, Pory 78, 02-757 Warsaw, Poland
| | - Przemysław Krakowski
- Orthopaedic and Sports Traumatology Department, Carolina Medical Center, Pory 78, 02-757 Warsaw, Poland
- Department of Trauma Surgery and Emergency Medicine, Medical University of Lublin, Staszica 11, 20-081 Lublin, Poland
| | - Robert Karpiński
- Department of Machine Design and Mechatronics, Faculty of Mechanical Engineering, Lublin University of Technology, Nadbystrzycka 36, 20-618 Lublin, Poland
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Li Z, Chen H, Chen C. Pain sensitivity genes as therapeutic targets in knee osteoarthritis: A comprehensive analysis. Mol Pain 2024; 20:17448069241289961. [PMID: 39313491 PMCID: PMC11456193 DOI: 10.1177/17448069241289961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2024] [Revised: 09/06/2024] [Accepted: 09/17/2024] [Indexed: 09/25/2024] Open
Abstract
Pain sensitivity is a significant factor in knee osteoarthritis (KOA), influencing patient outcomes and complicating treatment. Genetic differences, particularly in pain-sensing genes (PSRGs), are known to contribute to the variability in pain experiences among KOA patients. This study aims to systematically analyze PSRGs in KOA to better understand their role and potential as therapeutic targets. We utilized bulk RNA-seq data from the GSE114007 and GSE169077 datasets to identify differentially expressed genes, with 20 genes found to be significantly altered. Key PSRGs, including PENK, NGF, HOXD1, and TRPA1, were identified using LASSO, SVM, and random forest algorithms. Further, KEGG and GO enrichment analyses revealed pathways such as "Neuroactive ligand-receptor interaction" and "ECM-receptor interaction," which were validated through external datasets. Single-cell RNA-seq analysis from GSE152805, GSE133449, and GSE104782 datasets demonstrated the heterogeneity and dynamic expression of PSRGs across different cell subpopulations in synovium, meniscus, and cartilage samples. UMAP and pseudotime analyses were used to visualize spatial distribution and developmental trajectories of these genes. The findings emphasize the critical roles of PSRGs in KOA, highlighting their potential as therapeutic targets and suggesting that integrating genetic information into clinical practice could significantly improve pain management and treatment strategies for KOA.
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Affiliation(s)
- Zirui Li
- School of Physical Education and Health, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Haicheng Chen
- The Department of Orthopedics, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chujie Chen
- School of Physical Education and Health, Guangzhou University of Chinese Medicine, Guangzhou, China
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