1
|
Jansen NEJ, Schiphof D, Runhaar J, Oei EHG, Bierma-Zeinstra SMA, Middelkoop MV. Planned or recent first consultation with the general practitioner for knee complaints: Is it indicative of early-stage knee osteoarthritis? OSTEOARTHRITIS AND CARTILAGE OPEN 2024; 6:100493. [PMID: 38966077 PMCID: PMC11223112 DOI: 10.1016/j.ocarto.2024.100493] [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: 03/07/2024] [Accepted: 06/03/2024] [Indexed: 07/06/2024] Open
Abstract
Objective No established definition for early-stage knee osteoarthritis (KOA) is available, nor classification criteria. Identifying the characteristics of individuals presenting with early-stage KOA symptoms can enhance diagnosis to prevent progression. This study aimed to describe clinical and structural features of individuals presenting with knee complaints within two years after their first consultation, while exploring differences in the duration of knee complaints. Method Baseline data was used from the LITE randomized controlled trial, assessing the effectiveness of a lifestyle intervention for individuals with knee complaints and overweight in primary care. Baseline assessments included questionnaires, clinical assessment, and MRI of the most symptomatic knee. Differences between groups with varying durations of knee complaints (<12, ≥12-<24, ≥24 months) were evaluated. Results Participants (N = 218, 65% female, mean age 59 ± 6 years, mean BMI 32 ± 5 kg/m2) had a median knee complaint duration of 14 months, with an average KOOS pain score of 60 ± 17.46% reported their symptoms as unacceptable. Structural MRI-defined KOA was observed in 71% of participants. There were no significant differences in clinical or structural MRI features between different durations of knee complaints. Conclusion Within 24 months of initial consultation, over two-thirds of participants displayed MRI-defined structural KOA, and nearly half reported unacceptable symptom states. This study found no association between the duration of knee complaints and symptoms severity or structural KOA presence, underscoring the complexity of identifying stages of KOA among individuals with overweight. Future studies should explore additional features beyond current considerations to facilitate early-stage KOA diagnosis, specifically for individuals with overweight.
Collapse
Affiliation(s)
- Nuria EJ. Jansen
- Department of General Practice, Erasmus MC University Medical Center Rotterdam, the Netherlands
| | - Dieuwke Schiphof
- Department of General Practice, Erasmus MC University Medical Center Rotterdam, the Netherlands
| | - Jos Runhaar
- Department of General Practice, Erasmus MC University Medical Center Rotterdam, the Netherlands
| | - Edwin HG. Oei
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, the Netherlands
| | | | - Marienke van Middelkoop
- Department of General Practice, Erasmus MC University Medical Center Rotterdam, the Netherlands
| |
Collapse
|
2
|
Eckstein F, Putz R, Wirth W. Sexual dimorphism in peri-articular tissue anatomy - More keys to understanding sex-differences in osteoarthritis? OSTEOARTHRITIS AND CARTILAGE OPEN 2024; 6:100485. [PMID: 38946793 PMCID: PMC11214405 DOI: 10.1016/j.ocarto.2024.100485] [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: 05/03/2024] [Accepted: 05/07/2024] [Indexed: 07/02/2024] Open
Abstract
Objective Osteoarthritis prevalence differs between women and men; whether this is the result of differences in pre-morbid articular or peri-articular anatomical morphotypes remains enigmatic. Albeit sex within humans cannot be reduced to female/male, this review focusses to the sexual dimorphism of peri-articular tissues, given lack of literature on non-binary subjects. Methods Based on a Pubmed search and input from experts, we selected relevant articles based on the authors' judgement of relevance, interest, and quality; no "hard" bibliometric measures were used to evaluate the quality or importance of the work. Emphasis was on clinical studies, with most (imaging) data being available for the knee and thigh. Results The literature on sexual dimorphism of peri-articular tissues is reviewed: 1) bone size/shape, 2) subchondral/subarticular bone, 3) synovial membrane and infra-patellar fad-pad (IPFP), 4) muscle/adipose tissue, and 5) peri-articular tissue response to treatment. Conclusions Relevant sex-specific differences exist for 3D bone shape and IPFP size, even after normalization to body weight. Presence of effusion- and Hoffa-synovitis is associated with greater risk of incident knee osteoarthritis in overweight women, but not in men. When normalized to bone size, men exhibit greater muscle, and women greater adipose tissue measures relative to the opposite sex. Reduced thigh muscle specific strength is associated with incident knee osteoarthritis and knee replacement in women, but not in men. These observations may explain why women with muscle strength deficits have a poorer prognosis than men with similar deficits. A "one size/sex fits all" approach must be urgently abandoned in osteoarthritis research.
Collapse
Affiliation(s)
- Felix Eckstein
- Research Program for Musculoskeletal Imaging, Center for Anatomy and Cell Biology, Paracelsus Medical University, Salzburg, Austria
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation (LBIAR), Paracelsus Medical University, Salzburg, Austria
- Chondrometrics GmbH, Ainring, Germany
| | - Reinhard Putz
- Anatomische Anstalt, Ludwig Maximilians Universität München, Munich, Germany
| | - Wolfgang Wirth
- Research Program for Musculoskeletal Imaging, Center for Anatomy and Cell Biology, Paracelsus Medical University, Salzburg, Austria
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation (LBIAR), Paracelsus Medical University, Salzburg, Austria
- Chondrometrics GmbH, Ainring, Germany
| |
Collapse
|
3
|
Eckstein F, Wirth W, Putz R. Sexual dimorphism in articular tissue anatomy - Key to understanding sex differences in osteoarthritis? Osteoarthritis Cartilage 2024; 32:1019-1031. [PMID: 38871022 DOI: 10.1016/j.joca.2024.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 05/06/2024] [Accepted: 05/31/2024] [Indexed: 06/15/2024]
Abstract
OBJECTIVE Osteoarthritis (OA) prevalence and incidence varies between women and men, but it is unknown whether this follows sex-specific differences in systemic factors (e.g. hormones) and/or differences in pre-morbid joint anatomy. We recognize that classifications of sex within humans cannot be reduced to female/male, but given the lack of literature on non-binary individuals, this review is limited to the sexual dimorphism of articular morphotypes. METHODS Based on a Pubmed search using relevant terms, and input from experts, we selected articles based on the authors' judgment of their relevance, interest, originality, and scientific quality; no "hard" bibliometric measures were used to evaluate their quality or importance. Focus was on clinical rather than pre-clinical studies, with most (imaging) data being available for the knee joint. RESULTS After introducing "sexual dimorphism", the specific literature on articular morphotypes is reviewed, structured by: radiographic joint space width (JSW), meniscus, ligaments, articular cartilage morphology, articular cartilage composition and deformation, and articular tissue response to treatment. CONCLUSIONS Sex-specific differences were clearly observed for JSW, meniscus damage, ligament size, and cartilage morphometry (volume, thickness, and surface areas) but not for cartilage composition. Ligament and cartilage measures were smaller in women even after matching for confounders. Taken together, the findings indicate that female (knee) joints may be structurally more vulnerable and at greater risk of OA. The "one size/sex fits all" approach must be abandoned in OA research, and all observational and interventional studies should report their results for sex-specific strata, at least in pre-specified secondary or post-hoc analyses.
Collapse
MESH Headings
- Humans
- Female
- Male
- Cartilage, Articular/pathology
- Cartilage, Articular/diagnostic imaging
- Sex Characteristics
- Osteoarthritis, Knee/diagnostic imaging
- Osteoarthritis, Knee/pathology
- Knee Joint/diagnostic imaging
- Knee Joint/pathology
- Sex Factors
- Osteoarthritis/diagnostic imaging
- Osteoarthritis/pathology
- Menisci, Tibial/diagnostic imaging
- Menisci, Tibial/pathology
- Menisci, Tibial/anatomy & histology
- Radiography
- Ligaments, Articular/anatomy & histology
- Ligaments, Articular/pathology
- Ligaments, Articular/diagnostic imaging
Collapse
Affiliation(s)
- Felix Eckstein
- Research Program for Musculoskeletal Imaging, Center for Anatomy and Cell Biology, Paracelsus Medical University, Salzburg, Austria; Ludwig Boltzmann Institute for Arthritis and Rehabilitation (LBIAR), Paracelsus Medical University, Salzburg, Austria; Chondrometrics GmbH, Freilassing, Germany.
| | - Wolfgang Wirth
- Research Program for Musculoskeletal Imaging, Center for Anatomy and Cell Biology, Paracelsus Medical University, Salzburg, Austria; Ludwig Boltzmann Institute for Arthritis and Rehabilitation (LBIAR), Paracelsus Medical University, Salzburg, Austria; Chondrometrics GmbH, Freilassing, Germany
| | - Reinhard Putz
- Anatomische Anstalt, Ludwig Maximilians Universität München, Munich, Germany
| |
Collapse
|
4
|
Petersen KKS, Arendt-Nielsen L, Ghafouri B, Giordano R. Reply to Devor. Pain 2024; 165:2135. [PMID: 39159473 DOI: 10.1097/j.pain.0000000000003328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/21/2024]
Affiliation(s)
- Kristian Kjær-Staal Petersen
- Department of Materials and Production, Center for Mathematical Modeling of Knee Osteoarthritis (MathKOA), Aalborg University, Aalborg, Denmark
- Department of Health Science and Technology, Center for Neuroplasticity and Pain, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Lars Arendt-Nielsen
- Department of Health Science and Technology, Center for Neuroplasticity and Pain, Faculty of Medicine, Aalborg University, Aalborg, Denmark
- Department of Gastroenterology and Hepatology, Mech-Sense, Aalborg University Hospital, Aalborg, Denmark
- Steno Diabetes Center North Denmark, Clinical Institute, Aalborg University Hospital, Aalborg, Denmark
| | - Bijar Ghafouri
- Department of Health, Medicine and Caring Sciences, Pain and Rehabilitation Centre, Linköping University, Linköping, Sweden
| | - Rocco Giordano
- Department of Health Science and Technology, Center for Neuroplasticity and Pain, Faculty of Medicine, Aalborg University, Aalborg, Denmark
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg, Denmark
| |
Collapse
|
5
|
Uchio Y, Ishijima M, Ikeuchi M, Ikegawa S, Ishibashi Y, Omori G, Shiba N, Takeuchi R, Tanaka S, Tsumura H, Deie M, Tohyama H, Yoshimura N, Nakashima Y. Japanese Orthopaedic Association (JOA) clinical practice guidelines on the management of Osteoarthritis of the knee - Secondary publication. J Orthop Sci 2024:S0949-2658(24)00139-8. [PMID: 39127581 DOI: 10.1016/j.jos.2024.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 06/28/2024] [Indexed: 08/12/2024]
Affiliation(s)
- Yuji Uchio
- Department of Orthopaedic Surgery, Shimane University, Izumo, Japan.
| | | | - Masahiko Ikeuchi
- Department of Orthopaedic Surgery, Kochi University, Nankoku, Japan
| | - Shiro Ikegawa
- Laboratory for Bone and Joint Diseases, Center for Integrated Medical Science (IMS), RIKEN, Tokyo, Japan
| | - Yasuyuki Ishibashi
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Go Omori
- Department of Health and Sports, Niigata University of Health and Welfare, Niigata, Japan
| | - Naoto Shiba
- Department of Orthopaedics, Kurume University School of Medicine, Fukuoka, Japan
| | - Ryohei Takeuchi
- Department of Joint Surgery Center, Yokohama Sekishinkai Hospital, Yokohama, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery, University of Tokyo, Tokyo, Japan
| | - Hiroshi Tsumura
- Department of Orthopaedic Surgery, Oita University, Oita, Japan
| | - Masataka Deie
- Department of Orthopaedic Surgery, Aichi Medical University, Nagakute, Japan
| | | | - Noriko Yoshimura
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, University of Tokyo, Tokyo, Japan
| | | |
Collapse
|
6
|
Lee JH, Oh S, Kim K, Lee D, Son E, Kim TW, Goh TS, Cho NR, Kim YH. Body mass index and meniscal tears: Evidence from meta-analysis of observational studies and Mendelian randomization. Obes Rev 2024; 25:e13749. [PMID: 38616612 DOI: 10.1111/obr.13749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 03/07/2024] [Accepted: 03/19/2024] [Indexed: 04/16/2024]
Abstract
Obesity is a potential risk factor for meniscal tear (MT). We utilized meta-analysis of observational studies and Mendelian randomization (MR) analyses to elucidate the association between body mass index (BMI) and MT. In meta-analysis, a search was performed on June 27, 2022, using PubMed and Embase databases. Odds ratios and 95% confidence intervals were extracted from included studies. In MR analyses, the research utilized summary-level data on BMI and MT obtained from Genetic Investigation of Anthropometric Traits and the FinnGen Consortium, respectively. In meta-analysis, four studies comprising 826,383 participants were included. The pooled odds ratio of MT in the high BMI group was 1.32 (95% confidence interval, 0.83-2.09), compared with the nonhigh BMI group. The pooled odds ratio in the under 30 group was 1.76 (95% confidence interval, 0.61-5.03). In MR analyses, one standard deviation increase in genetically predicted BMI was associated with meniscus derangement as a chronic subtype of MT (odds ratio, 1.36; 95% confidential interval, 1.17-1.59). We found that a high BMI was not associated with an increased likelihood of MT based on meta-analysis of observational studies; however, by complementing MR analyses, we elucidated the causality of BMI increase on meniscus derangement as a chronic subtype of MT.
Collapse
Affiliation(s)
- Jung Hoon Lee
- School of Korean Medicine, Pusan National University, Yangsan-si, Republic of Korea
| | - Seungyeop Oh
- School of Korean Medicine, Pusan National University, Yangsan-si, Republic of Korea
| | - Kihun Kim
- Department of Biomedical Informatics, School of Medicine, Pusan National University, Yangsan-si, Republic of Korea
- Department of Anatomy, School of Medicine, Pusan National University, Yangsan-si, Republic of Korea
| | - Dongjun Lee
- Department of Convergence Medicine, School of Medicine, Pusan National University, Yangsan-si, Republic of Korea
| | - Eunjeong Son
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan-si, Republic of Korea
| | - Tae Woo Kim
- Department of Orthopaedic Surgery, Pusan National University Yangsan Hospital, Yangsan-si, Republic of Korea
| | - Tae Sik Goh
- Department of Orthopaedic Surgery, Pusan National University Hospital and School of Medicine, Pusan National University, Busan, Republic of Korea
| | - Noo Ree Cho
- Department of Anesthesiology and Pain Medicine, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Yun Hak Kim
- Department of Biomedical Informatics, School of Medicine, Pusan National University, Yangsan-si, Republic of Korea
- Department of Anatomy, School of Medicine, Pusan National University, Yangsan-si, Republic of Korea
| |
Collapse
|
7
|
Ibounig T, Sanders S, Haas R, Jones M, Järvinen TL, Taimela S, Docking S, Rämö L, Buchbinder R. Systematic Review of Shoulder Imaging Abnormalities in Asymptomatic Adult Shoulders (SCRUTINY): Abnormalities of the glenohumeral joint. Osteoarthritis Cartilage 2024:S1063-4584(24)01215-9. [PMID: 38876437 DOI: 10.1016/j.joca.2024.06.001] [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: 02/14/2024] [Revised: 05/20/2024] [Accepted: 06/04/2024] [Indexed: 06/16/2024]
Abstract
OBJECTIVE The primary objective was to determine the population prevalence of glenohumeral joint imaging abnormalities in asymptomatic adults. METHOD We systematically reviewed studies reporting the prevalence of X-ray, ultrasound (US), computed tomography, and magnetic resonance imaging (MRI) abnormalities in adults without shoulder symptoms (PROSPERO registration number CRD42018090041). This report presents the glenohumeral joint imaging findings. We searched Ovid MEDLINE, Embase, CINAHL and Web of Science from inception to June 2023 and assessed risk of bias using a tool designed for prevalence studies. The primary analysis was planned for the general population. The certainty of evidence was assessed using a modified Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) for prognostic studies. RESULTS Thirty-five studies (4 X-ray, 10 US, 20 MRI, 1 X-ray and MRI) reported useable prevalence data. Two studies were population-based (846 shoulders), 15 studies included miscellaneous study populations (1715 shoulders) and 18 included athletes (727 shoulders). All were judged to be at high risk of bias. Clinical diversity precluded pooling. Population prevalence of glenohumeral osteoarthritis ranged from 15% to 75% (2 studies, 846 shoulders, 1 X-ray, 1 X-ray and MRI; low certainty evidence). Prevalence of labral abnormalities, humeral head cysts and long head of biceps tendon abnormalities were 20%, 5%, 30% respectively (1 study, 20 shoulders, X-ray and MRI; very low certainty evidence). CONCLUSION The population-based prevalence of glenohumeral joint imaging abnormalities in asymptomatic individuals remains uncertain, but may range between 30% and 75%. Better estimates are needed to inform best evidence-based management of people with shoulder pain.
Collapse
Affiliation(s)
- Thomas Ibounig
- Finnish Centre for Evidence-Based Orthopaedics, University of Helsinki, Helsinki, Finland; Department of Orthopaedics and Traumatology, Helsinki University Hospital, Helsinki, Finland.
| | - Sharon Sanders
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
| | - Romi Haas
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Mark Jones
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
| | - Teppo Ln Järvinen
- Finnish Centre for Evidence-Based Orthopaedics, University of Helsinki, Helsinki, Finland; Department of Orthopaedics and Traumatology, Helsinki University Hospital, Helsinki, Finland
| | - Simo Taimela
- Finnish Centre for Evidence-Based Orthopaedics, University of Helsinki, Helsinki, Finland; Department of Orthopaedics and Traumatology, Helsinki University Hospital, Helsinki, Finland
| | - Sean Docking
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Lasse Rämö
- Finnish Centre for Evidence-Based Orthopaedics, University of Helsinki, Helsinki, Finland; Department of Orthopaedics and Traumatology, Helsinki University Hospital, Helsinki, Finland
| | - Rachelle Buchbinder
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| |
Collapse
|
8
|
Louw A, Schuemann T, Zimney K, Puentedura EJ. Pain Neuroscience Education for Acute Pain. Int J Sports Phys Ther 2024; 19:758-767. [PMID: 38835986 PMCID: PMC11144658 DOI: 10.26603/001c.118179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 05/16/2024] [Indexed: 06/06/2024] Open
Abstract
In musculoskeletal and sports medicine, pain has traditionally been linked to tissue injury, often assuming a linear correlation between tissue damage and pain intensity. However, modern pain science has illuminated the complexity of the human pain experience, incorporating psychosocial elements, nervous system sensitization, immune responses, and structural changes in the brain as factors. This contemporary understanding of pain has proven highly beneficial for both clinicians treating individuals in pain and those experiencing pain. Pain neuroscience education (PNE) provides individuals in pain with an understanding of the underlying neurobiology and neurophysiology of their pain experience, which has been shown to result in decreased self-reported pain, reduced disability, the alleviation of fear and fear-avoidance behaviors, diminished pain catastrophizing, and improved movement. Currently, research on PNE predominantly focuses on interventions with individuals with persistent or chronic pain conditions. However, those who experience acute, sub-acute, and perioperative pain also have the potential for elevated levels of fear, fear-avoidance, and pain catastrophizing, indicating potential benefits from PNE. This invited commentary seeks to inform readers about the latest advancements in pain science and propose a conceptual model for delivering PNE in acute pain experiences. Level of Evidence 5.
Collapse
Affiliation(s)
| | | | - Kory Zimney
- Evidence In Motion
- University of South Dakota
| | | |
Collapse
|
9
|
Schmidt S, Klampfleuthner FAM, Renkawitz T, Diederichs S. Cause and chondroprotective effects of prostaglandin E2 secretion during mesenchymal stromal cell chondrogenesis. Eur J Cell Biol 2024; 103:151412. [PMID: 38608422 DOI: 10.1016/j.ejcb.2024.151412] [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: 02/16/2024] [Revised: 03/27/2024] [Accepted: 04/04/2024] [Indexed: 04/14/2024] Open
Abstract
Mesenchymal stromal cells (MSCs) that are promising for cartilage tissue engineering secrete high amounts of prostaglandin E2 (PGE2), an immunoactive mediator involved in endochondral bone development. This study aimed to identify drivers of PGE2 and its role in the inadvertent MSC misdifferentiation into hypertrophic chondrocytes. PGE2 release, which rose in the first three weeks of MSC chondrogenesis, was jointly stimulated by endogenous BMP, WNT, and hedgehog activity that supported the exogenous stimulation by TGF-β1 and insulin to overcome the PGE2 inhibition by dexamethasone. Experiments with PGE2 treatment or the inhibitor celecoxib or specific receptor antagonists demonstrated that PGE2, although driven by prohypertrophic signals, exerted broad autocrine antihypertrophic effects. This chondroprotective effect makes PGE2 not only a promising option for future combinatorial approaches to direct MSC tissue engineering approaches into chondral instead of endochondral development but could potentially have implications for the use of COX-2-selective inhibitors in osteoarthritis pain management.
Collapse
Affiliation(s)
- Sven Schmidt
- Experimental Orthopaedics, Research Centre for Molecular and Regenerative Orthopaedics, Department of Orthopaedics, Heidelberg, Germany
| | - Felicia A M Klampfleuthner
- Experimental Orthopaedics, Research Centre for Molecular and Regenerative Orthopaedics, Department of Orthopaedics, Heidelberg, Germany
| | - Tobias Renkawitz
- Research Centre for Molecular and Regenerative Orthopaedics, Department of Orthopaedics, Heidelberg University Hospital, Heidelberg, Germany
| | - Solvig Diederichs
- Experimental Orthopaedics, Research Centre for Molecular and Regenerative Orthopaedics, Department of Orthopaedics, Heidelberg, Germany.
| |
Collapse
|
10
|
Alaia EF, Samim M, Khodarahmi I, Zech JR, Spath AR, Da Silva Cardoso M, Gyftopoulos S. Utility of MRI for Patients 45 Years Old and Older With Hip or Knee Pain: A Systematic Review. AJR Am J Roentgenol 2024; 222:e2430958. [PMID: 38568033 DOI: 10.2214/ajr.24.30958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
BACKGROUND. MRI utility for patients 45 years old and older with hip or knee pain is not well established. OBJECTIVE. We performed this systematic review to assess whether MRI-diagnosed hip or knee pathology in patients 45 years old and older correlates with symptoms or benefits from arthroscopic surgery. EVIDENCE ACQUISITION. A literature search (PubMed, Web of Science, Embase) of articles published before October 3, 2022, was performed to identify original research pertaining to the study question. Publication information, study design, cohort size, osteoarthritis severity, age (range, mean), measured outcomes, minimum follow-up length, and MRI field strength were extracted. Study methods were appraised with NIH's study quality assessment tools. EVIDENCE SYNTHESIS. The search yielded 1125 potential studies, of which 31 met the inclusion criteria (18 knee, 13 hip). Knee studies (10 prospective, eight retrospective) included 5907 patients (age range, 45-90 years). Bone marrow edema-like lesions, joint effusions, and synovitis on MRI were associated with symptoms. In patients with osteoarthritis, meniscal tears were less likely to be symptom generators and were less likely to respond to arthroscopic surgery with osteoarthritis progression. Hip studies (11 retrospective, two prospective) included 6385 patients (age range, 50 to ≥ 85 years). Patients with Tönnis grade 2 osteoarthritis and lower with and without femoroacetabular impingement (FAI) showed improved outcomes after arthroscopy, suggesting a role for MRI in the diagnosis of labral tears, chondral lesions, and FAI. Although this group benefited from arthroscopic surgery, outcomes were inferior to those in younger patients. Variability in study characteristics, follow-up, and outcome measures precluded a meta-analysis. CONCLUSION. In patients 45 years old and older, several knee structural lesions on MRI correlated with symptoms, representing potential imaging biomarkers. Meniscal tear identification on MRI likely has diminished clinical value as osteoarthritis progresses. For the hip, MRI can play a role in the diagnosis of labral tears, chondral lesions, and FAI in patients without advanced osteoarthritis. CLINICAL IMPACT. Several structural lesions on knee MRI correlating with symptoms may represent imaging biomarkers used as treatment targets. Osteoarthritis, not age, may play the greatest role in determining the utility of MRI for patients 45 years old and older with hip or knee pain.
Collapse
Affiliation(s)
- Erin F Alaia
- Department of Radiology, NYU Langone Health, 550 First Ave, New York, NY 10016
| | - Mohammad Samim
- Department of Radiology, NYU Langone Health, 550 First Ave, New York, NY 10016
| | - Iman Khodarahmi
- Department of Radiology, NYU Langone Health, 550 First Ave, New York, NY 10016
| | - John R Zech
- Department of Radiology, NYU Langone Health, 550 First Ave, New York, NY 10016
| | - Alexandra R Spath
- University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY
| | | | - Soterios Gyftopoulos
- Department of Radiology, NYU Langone Health, 550 First Ave, New York, NY 10016
- Department of Orthopedic Surgery, NYU Langone Health, New York, NY
| |
Collapse
|
11
|
Dowell K, Dluzniewski A, Casanova MP, Allred CM, Cady AC, Baker RT. International Knee Documentation Committee Subjective Knee Form Latent Growth Model Analysis: Assessing Recovery Trajectories. Healthcare (Basel) 2024; 12:1021. [PMID: 38786431 PMCID: PMC11121256 DOI: 10.3390/healthcare12101021] [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: 03/26/2024] [Revised: 05/01/2024] [Accepted: 05/11/2024] [Indexed: 05/25/2024] Open
Abstract
Patient-Reported Outcome Measures (PROMs), such as the six-item International Knee Documentation Committee Subjective Knee Form (IKDC-6), play a crucial role in assessing health conditions and guiding clinical decisions. Latent Growth Modeling (LGM) can be employed to understand recovery trajectories in patients post-operatively. Therefore, the purpose of this study was to assess LGM properties of the IKDC-6 in patients with knee pathologies that require surgical intervention and to assess differences between subgroups (i.e., sex and age). A cross-sectional study was conducted using the Surgical Outcome System (SOS) database with patients who had undergone knee arthroscopy. Our results found that preoperative scores did not influence the rate of change overtime. Perceived knee health improved over time, with varying rates among individuals. The adolescent age subgroup and male subgroup exhibited faster recovery rates compared to the older age subgroup and female subgroup. While initial hypotheses suggested IKDC-6 could serve as a prognostic tool, results did not support this. However, results indicated favorable outcomes irrespective of preoperative perceived knee impairment levels. This study provides valuable insights into recovery dynamics following knee surgery, emphasizing the need for personalized rehabilitation strategies tailored to individual patient characteristics.
Collapse
Affiliation(s)
- Katrina Dowell
- WWAMI Medical Education Program, University of Washington School of Medicine, Seattle, WA 98195, USA;
| | - Alexandra Dluzniewski
- WWAMI Medical Education Program, University of Idaho, Moscow, ID 83844, USA; (A.D.); (M.P.C.); (C.M.A.)
- Idaho Office of Underserved and Rural Medical Research, University of Idaho, Moscow, ID 83844, USA
| | - Madeline P. Casanova
- WWAMI Medical Education Program, University of Idaho, Moscow, ID 83844, USA; (A.D.); (M.P.C.); (C.M.A.)
- Idaho Office of Underserved and Rural Medical Research, University of Idaho, Moscow, ID 83844, USA
| | - Caleb M. Allred
- WWAMI Medical Education Program, University of Idaho, Moscow, ID 83844, USA; (A.D.); (M.P.C.); (C.M.A.)
| | - Adam C. Cady
- Kaiser Permanente, Woodland Hills, CA 91367, USA;
| | - Russell T. Baker
- WWAMI Medical Education Program, University of Idaho, Moscow, ID 83844, USA; (A.D.); (M.P.C.); (C.M.A.)
- Idaho Office of Underserved and Rural Medical Research, University of Idaho, Moscow, ID 83844, USA
| |
Collapse
|
12
|
Porter MD, Shadbolt B. Improved Outcome With Knee Arthroscopy Relative to Physiotherapy for Symptomatic Unstable Meniscal Tears: 2-Year Prospective Cohort Study. Sports Health 2024; 16:370-376. [PMID: 36896669 PMCID: PMC11025505 DOI: 10.1177/19417381231156378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Although preservation of meniscal tissue is paramount, there are occasions when repair of a torn meniscus is not possible. The surgical option may be a partial meniscectomy, the objective being to alleviate the patient's symptoms with resection of only that portion of the meniscus that is no longer functioning but is the cause of symptoms. Previous studies have questioned the need to perform such surgery and have recommended nonoperative treatment instead. Our goal was to compare the outcome of partial meniscectomy with that of physiotherapy alone for irreparable meniscal tears. HYPOTHESIS Clinical outcome following arthroscopic partial meniscectomy may differ from that following physiotherapy alone, for patients with symptomatic irreparable meniscal tears. STUDY DESIGN Nonrandomized prospective cohort study. LEVEL OF EVIDENCE Level 2. METHODS Patients satisfying the inclusion criteria chose to undergo knee arthroscopy (group A) or physiotherapy (group B). The diagnosis of a meniscal tear was made on physical assessment and magnetic resonance imaging examination. The meniscal tear was preventing them from continuing with their regular weightbearing exercise. Outcomes of interest were the following patient-reported outcomes (PROs): the Knee Osteoarthritis Outcome Score (KOOS) and Tegner Activity Score (TAS), with minimal clinically important differences being 10 and 1, respectively. PROs were completed at baseline, and at 1-year and 2-year follow-up. Changes in scores within and between groups were compared using analysis of variance and Wilcoxon tests (P <0.05). A power analysis demanded 65 patients in each group to produce a power of 80% and a P value of 5%. RESULTS Of 528 patients enrolled in the study, 10 were lost to follow-up and 8 were excluded. Data were complete for 269 in group A, and 228 in Group B. Group A and B were similar in terms of age (41.1 years, SD 7.8 vs 40 years, SD 13.3), body mass index (22.5 kg/m2, SD 3.1 vs 23.1 kg/m2, SD 2.3), radiographic grade of osteoarthritis (median grade 2, range 0-3 in both groups), gender (male:female = 134:135 vs 112:116), and duration of symptoms (44.4 days, SD 5.6 vs 46.6 days, SD 8.8), with P >0.05. At both 1-year and 2-year follow-up, Group A had higher scores in the mean total KOOS (88.8, SD 8.0 vs 72.4, SD 3.8), as well as in all subscales within the KOOS, and the TAS (median 7, range 5-9 vs median 5, range 3-6), with P <0.001 for each variable. CONCLUSION Performing a knee arthroscopy with partial meniscectomy is associated with improved KOOS and TAS, relative to treatment with physiotherapy alone, at 2-year follow-up. CLINICAL RELEVANCE Physically active patients with symptomatic irreparable meniscal tears may experience a better clinical outcome following knee arthroscopy, relative to to physiotherapy alone.
Collapse
Affiliation(s)
- Mark D. Porter
- Canberra Orthopaedics and Sports Medicine, Deakin, Australia
| | - Bruce Shadbolt
- Department of Epidemiology, Canberra Hospital, Garran, Australia
| |
Collapse
|
13
|
Shrestha R, Tulk AH, Shah AS, Buckner-Petty SA, Long JR, Fox MG. Does MRI alter management in patients 60 years and older with chronic knee pain: correlation with radiographs and clinical parameters. Skeletal Radiol 2024:10.1007/s00256-024-04691-7. [PMID: 38683469 DOI: 10.1007/s00256-024-04691-7] [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: 02/07/2024] [Revised: 04/06/2024] [Accepted: 04/18/2024] [Indexed: 05/01/2024]
Abstract
OBJECTIVE To determine if MRI altered management in patients ≥ 60 years old with chronic knee pain. MATERIALS AND METHODS Consecutive patients ≥ 60 years old with knee MRI and radiographs within 90 days were included. Exclusion criteria included mass/malignancy, recent trauma, and infection. Standing AP and PA flexion views were evaluated using Kellgren-Lawrence (KL) and International Knee Documentation Committee (IKDC) scales. Pertinent clinical history was recorded. MRIs were considered to alter management if subchondral fracture was identified or subsequent arthroscopy was performed due to an MRI finding. RESULTS Eighty-five knee MRI/radiograph exams were reviewed; mean 68.2 years (60-88), 47:38 F:M. Twenty knee MRIs (24%) had either a subchondral fracture (n = 9) or meniscal tear (n = 11) prompting arthroscopy. On PA flexion view, 0/20 of these studies had KL grade 4 and 70% (14/20) had KL grade 0-1 compared to the remaining MRIs having 15.4% (10/65) KL grade 4 and 38.5% (25/65) KL grade 0-1 (p = 0.03). A 10-pack-year tobacco history, 38% vs 18%, was associated with a subchondral fracture or arthroscopy (p = 0.06). Subchondral fractures were more prevalent in older patients (mean 72.4 vs 67.7 years; p = 0.03). CONCLUSION In patients ≥ 60 years old with chronic knee pain, MRI altered management in ~ 24% of cases; 70% in patients with KL grade 0-1, and none in patients with KL grade 4. MRI may benefit older patients with minimal osteoarthritis but not those with end-stage disease. Patients with ≥ 10 pack years of smoking may also benefit from MRI.
Collapse
|
14
|
Wang H, Yuan T, Wang Y, Liu C, Li D, Li Z, Sun S. Osteoclasts and osteoarthritis: Novel intervention targets and therapeutic potentials during aging. Aging Cell 2024; 23:e14092. [PMID: 38287696 PMCID: PMC11019147 DOI: 10.1111/acel.14092] [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: 10/17/2023] [Revised: 12/28/2023] [Accepted: 01/02/2024] [Indexed: 01/31/2024] Open
Abstract
Osteoarthritis (OA), a chronic degenerative joint disease, is highly prevalent among the aging population, and often leads to joint pain, disability, and a diminished quality of life. Although considerable research has been conducted, the precise molecular mechanisms propelling OA pathogenesis continue to be elusive, thereby impeding the development of effective therapeutics. Notably, recent studies have revealed subchondral bone lesions precede cartilage degeneration in the early stage of OA. This development is marked by escalated osteoclast-mediated bone resorption, subsequent imbalances in bone metabolism, accelerated bone turnover, and a decrease in bone volume, thereby contributing significantly to the pathological changes. While the role of aging hallmarks in OA has been extensively elucidated from the perspective of chondrocytes, their connection with osteoclasts is not yet fully understood. There is compelling evidence to suggest that age-related abnormalities such as epigenetic alterations, proteostasis network disruption, cellular senescence, and mitochondrial dysfunction, can stimulate osteoclast activity. This review intends to systematically discuss how aging hallmarks contribute to OA pathogenesis, placing particular emphasis on the age-induced shifts in osteoclast activity. It also aims to stimulate future studies probing into the pathological mechanisms and therapeutic approaches targeting osteoclasts in OA during aging.
Collapse
Affiliation(s)
- Haojue Wang
- Department of Joint Surgery, Shandong Provincial Hospital, Cheeloo College of MedicineShandong UniversityJinanShandongChina
| | - Tao Yuan
- Department of Joint Surgery, Shandong Provincial Hospital, Cheeloo College of MedicineShandong UniversityJinanShandongChina
| | - Yi Wang
- Department of Joint SurgeryShandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinanShandongChina
- Orthopaedic Research Laboratory, Medical Science and Technology Innovation CenterShandong First Medical University and Shandong Academy of Medical SciencesJinanShandongChina
| | - Changxing Liu
- Department of Joint Surgery, Shandong Provincial Hospital, Cheeloo College of MedicineShandong UniversityJinanShandongChina
| | - Dengju Li
- Department of Joint SurgeryShandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinanShandongChina
- Orthopaedic Research Laboratory, Medical Science and Technology Innovation CenterShandong First Medical University and Shandong Academy of Medical SciencesJinanShandongChina
| | - Ziqing Li
- Department of Joint SurgeryShandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinanShandongChina
- Orthopaedic Research Laboratory, Medical Science and Technology Innovation CenterShandong First Medical University and Shandong Academy of Medical SciencesJinanShandongChina
| | - Shui Sun
- Department of Joint Surgery, Shandong Provincial Hospital, Cheeloo College of MedicineShandong UniversityJinanShandongChina
- Department of Joint SurgeryShandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinanShandongChina
- Orthopaedic Research Laboratory, Medical Science and Technology Innovation CenterShandong First Medical University and Shandong Academy of Medical SciencesJinanShandongChina
| |
Collapse
|
15
|
Husen M, Wang AS, Levy BA, Saris DBF, Stuart MJ, Krych AJ. Influence of Concomitant Meniscal Allograft Transplantation on Midterm Outcomes After Osteochondral Allograft Transplantation: A Comparative Matched-Pair Analysis. Am J Sports Med 2024; 52:1238-1249. [PMID: 38523473 DOI: 10.1177/03635465241234534] [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: 03/26/2024]
Abstract
BACKGROUND Osteochondral allograft transplantation (OCAT) is an accepted knee joint-preserving treatment strategy for focal osteochondral lesions that is often conducted in combination with meniscal allograft transplantation (MAT). Despite its frequent and simultaneous utilization, there remains a lack in the literature reporting on outcomes and failure rates after concomitant procedures. PURPOSE To determine (1) the midterm clinical success rate after OCAT+MAT in comparison with a matched-pair cohort undergoing isolated OCAT, (2) whether patient-specific and procedural variables influence the risk of failure, and (3) patient-reported outcome measures over time. STUDY DESIGN Cohort study; Level of evidence, 3. METHODS A single-center matched-pair cohort study was conducted investigating outcomes in patients who underwent OCAT of the medial or lateral femoral condyle with and without MAT between 2004 and 2020. Patients were matched 1:1 by age (±5 years), sex (male or female), body mass index (±5), and grouped Kellgren and Lawrence grade (grades 0-1 or 2-4). The minimum follow-up time was 2 years. Radiographic variables (International Cartilage Regeneration & Joint Preservation Society [ICRS] grade and Kellgren and Lawrence grade) were assessed preoperatively and at follow-up. Subjective patient-reported outcome measures (Lysholm score, Knee injury and Osteoarthritis Outcome Score [KOOS] including subscores, International Knee Documentation Committee [IKDC] score, and visual analog scale score) were collected preoperatively and at follow-up. Clinical failure was defined as revision surgery for graft failure or conversion to total knee arthroplasty. Patient-reported, clinical, and radiographic outcomes were compared between groups. RESULTS In total, 66 patients (33 treated with isolated OCAT, 33 treated with OCAT+MAT; 57.6% male) with a mean age of 26.3 years (range, 18-62 years) were followed for a mean of 5.6 years (minimum, 2 years; range, 24-218 months). The 2 cohorts showed no difference in Kellgren and Lawrence grade postoperatively (P = .59). There was a significantly higher ICRS grade detected at follow-up in the OCAT+MAT group (2.81 ± 1.10) compared with the OCAT group (2.04 ± 0.96) (P < .05). There were no statistically significant differences between the groups regarding reoperation rate (OCAT: n = 6; OCAT+MAT: n = 13; P = .116), time to reoperation (OCAT: 46.67 ± 47.27 months vs OCAT+MAT: 28.08 ± 30.16 months; P = .061), and failure rate (OCAT: n = 4 [12.1%] vs OCAT+MAT: n = 5 [15.2%]; P = .66). In the OCAT+MAT group, an increase of tibial slope by 1° conferred a 1.65-fold increase in the hazard for failure over decreased slope (hazard ratio, 1.65; 95% CI, 1.10-2.50; P < .05). The overall survival rate was 86% at a mean follow-up of 5.6 years. Patient-reported outcome scores were significantly improved at the final follow-up compared with preoperative status. No significant differences were seen between groups with respect to subjective IKDC, Lysholm, Tegner, and KOOS results, except for the KOOS Symptoms subscale score, which was significantly higher in the OCAT+MAT group than in the OCAT group (mean difference, 14.6; P < .05) and did exceed the minimal clinically important difference threshold of 10.7. CONCLUSION Midterm results after isolated OCAT and OCAT+MAT show high rates of healing and sustainable subjective improvement of knee function and quality of life. However, it should be noted that the difference in reoperation rate and time to reoperation between the groups is arguably clinically important and that lack of statistical significance may be because of low power. These results imply that isolated OCAT is an efficient joint-preserving treatment that can be combined with MAT in well-selected patients with meniscal insufficiency without negative influence on global clinical outcomes.
Collapse
Affiliation(s)
- Martin Husen
- Department of Orthopedic Surgery and Sports Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Department of Orthopaedics, University Hospital Heidelberg, Heidelberg, Germany
| | - Allen S Wang
- Department of Orthopedic Surgery and Sports Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Bruce A Levy
- Department of Orthopedic Surgery and Sports Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Daniël B F Saris
- Department of Orthopedic Surgery and Sports Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Department of Orthopaedics, UMC Utrecht, Utrecht, the Netherlands
| | - Michael J Stuart
- Department of Orthopedic Surgery and Sports Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Aaron J Krych
- Department of Orthopedic Surgery and Sports Medicine, Mayo Clinic, Rochester, Minnesota, USA
| |
Collapse
|
16
|
Roemer FW, Jarraya M, Hayashi D, Crema MD, Haugen IK, Hunter DJ, Guermazi A. A perspective on the evolution of semi-quantitative MRI assessment of osteoarthritis: Past, present and future. Osteoarthritis Cartilage 2024; 32:460-472. [PMID: 38211810 DOI: 10.1016/j.joca.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 12/15/2023] [Accepted: 01/04/2024] [Indexed: 01/13/2024]
Abstract
OBJECTIVE This perspective describes the evolution of semi-quantitative (SQ) magnetic resonance imaging (MRI) in characterizing structural tissue pathologies in osteoarthritis (OA) imaging research over the last 30 years. METHODS Authors selected representative articles from a PubMed search to illustrate key steps in SQ MRI development, validation, and application. Topics include main scoring systems, reading techniques, responsiveness, reliability, technical considerations, and potential impact of artificial intelligence (AI). RESULTS Based on original research published between 1993 and 2023, this article introduces available scoring systems, including but not limited to Whole-Organ Magnetic Resonance Imaging Score (WORMS) as the first system for whole-organ assessment of the knee and the now commonly used MRI Osteoarthritis Knee Score (MOAKS) instrument. Specific systems for distinct OA subtypes or applications have been developed as well as MRI scoring instruments for other joints such as the hip, the fingers or thumb base. SQ assessment has proven to be valid, reliable, and responsive, aiding OA investigators in understanding the natural history of the disease and helping to detect response to treatment. AI may aid phenotypic characterization in the future. SQ MRI assessment's role is increasing in eligibility and safety evaluation in knee OA clinical trials. CONCLUSIONS Evidence supports the validity, reliability, and responsiveness of SQ MRI assessment in understanding structural aspects of disease onset and progression. SQ scoring has helped explain associations between structural tissue damage and clinical manifestations, as well as disease progression. While AI may support human readers to more efficiently perform SQ assessment in the future, its current application in clinical trials still requires validation and regulatory approval.
Collapse
Affiliation(s)
- Frank W Roemer
- Universitätsklinikum Erlangen & Friedrich Alexander Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany; Chobanian & Avedisian School of Medicine, Boston University, Boston, MA, USA.
| | - Mohamed Jarraya
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Daichi Hayashi
- Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA; Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Michel D Crema
- Chobanian & Avedisian School of Medicine, Boston University, Boston, MA, USA; Institute of Sports Imaging, French National Institute of Sports (INSEP), Paris, France
| | - Ida K Haugen
- Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
| | - David J Hunter
- Department of Rheumatology, Royal North Shore Hospital and Sydney Musculoskeletal Health, Kolling Institute, University of Sydney, St. Leonards, NSW, Australia
| | - Ali Guermazi
- Chobanian & Avedisian School of Medicine, Boston University, Boston, MA, USA; Boston VA Healthcare System, West Roxbury, MA, USA
| |
Collapse
|
17
|
Messier SP, Callahan LF, Losina E, Mihalko SL, Guermazi A, Ip E, Miller GD, Katz JN, Loeser RF, Pietrosimone BG, Soto S, Cook JL, Newman JJ, DeVita P, Spindler KP, Runhaar J, Armitano-Lago C, Duong V, Selzer F, Hill R, Love M, Beavers DP, Saldana S, Stoker AM, Rice PE, Hunter DJ. The osteoarthritis prevention study (TOPS) - A randomized controlled trial of diet and exercise to prevent Knee Osteoarthritis: Design and rationale. OSTEOARTHRITIS AND CARTILAGE OPEN 2024; 6:100418. [PMID: 38144515 PMCID: PMC10746515 DOI: 10.1016/j.ocarto.2023.100418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/19/2023] [Accepted: 11/13/2023] [Indexed: 12/26/2023] Open
Abstract
Background Osteoarthritis (OA), the leading cause of disability among adults, has no cure and is associated with significant comorbidities. The premise of this randomized clinical trial is that, in a population at risk, a 48-month program of dietary weight loss and exercise will result in less incident structural knee OA compared to control. Methods/design The Osteoarthritis Prevention Study (TOPS) is a Phase III, assessor-blinded, 48-month, parallel 2 arm, multicenter randomized clinical trial designed to reduce the incidence of structural knee OA. The study objective is to assess the effects of a dietary weight loss, exercise, and weight-loss maintenance program in preventing the development of structural knee OA in females at risk for the disease. TOPS will recruit 1230 ambulatory, community dwelling females with obesity (Body Mass Index (BMI) ≥ 30 kg/m2) and aged ≥50 years with no radiographic (Kellgren-Lawrence grade ≤1) and no magnetic resonance imaging (MRI) evidence of OA in the eligible knee, with no or infrequent knee pain. Incident structural knee OA (defined as tibiofemoral and/or patellofemoral OA on MRI) assessed at 48-months from intervention initiation using the MRI Osteoarthritis Knee Score (MOAKS) is the primary outcome. Secondary outcomes include knee pain, 6-min walk distance, health-related quality of life, knee joint loading during gait, inflammatory biomarkers, and self-efficacy. Cost effectiveness and budgetary impact analyses will determine the value and affordability of this intervention. Discussion This study will assess the efficacy and cost effectiveness of a dietary weight loss, exercise, and weight-loss maintenance program designed to reduce incident knee OA. Trial registration ClinicalTrials.gov Identifier: NCT05946044.
Collapse
Affiliation(s)
- Stephen P. Messier
- J.B. Snow Biomechanics Laboratory, Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - Leigh F. Callahan
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Elena Losina
- Orthopedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Shannon L. Mihalko
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - Ali Guermazi
- Boston University School of Medicine, Boston, MA, USA
| | - Edward Ip
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Gary D. Miller
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - Jeffrey N. Katz
- Orthopedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Richard F. Loeser
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Brian G. Pietrosimone
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sandra Soto
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - James L. Cook
- Department of Orthopaedic Surgery, Thompson Laboratory for Regenerative Orthopaedics, Missouri Orthopaedic Institute, University of Missouri School of Medicine, Columbia, MO, USA
| | - Jovita J. Newman
- J.B. Snow Biomechanics Laboratory, Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - Paul DeVita
- Department of Kinesiology, East Carolina University, Greenville, NC, USA
| | - Kurt P. Spindler
- Clinical Research and Outcomes, Cleveland Clinic Florida, Weston, FL, USA
| | - Jos Runhaar
- Erasmus MC University Medical Center Rotterdam, Department of General Practice, Rotterdam, the Netherlands
| | - Cortney Armitano-Lago
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Vicky Duong
- Sydney Musculoskeletal Health, Kolling Institute, University of Sydney, Sydney, Australia
| | - Faith Selzer
- Orthopedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Ryan Hill
- J.B. Snow Biomechanics Laboratory, Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - Monica Love
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - Daniel P. Beavers
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Santiago Saldana
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Aaron M. Stoker
- Department of Orthopaedic Surgery, Thompson Laboratory for Regenerative Orthopaedics, Missouri Orthopaedic Institute, University of Missouri School of Medicine, Columbia, MO, USA
| | - Paige E. Rice
- J.B. Snow Biomechanics Laboratory, Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - David J. Hunter
- Sydney Musculoskeletal Health, Kolling Institute, University of Sydney, Sydney, Australia
- Rheumatology Department, Royal North Shore Hospital, Sydney, Australia
| |
Collapse
|
18
|
Felson D, Lotz MK, Jin Y, Jones M, Kim JS, Spindler K. New approach to testing treatments for osteoarthritis: FastOA. Ann Rheum Dis 2024; 83:274-276. [PMID: 37821213 PMCID: PMC10922495 DOI: 10.1136/ard-2023-224675] [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: 07/03/2023] [Accepted: 09/21/2023] [Indexed: 10/13/2023]
Abstract
Animal models of post traumatic osteoarthritis have shown many promising treatments for disease, but human trials have mostly failed to identify effective treatments. This viewpoint suggests that the frequent failure of drug and treatment development in osteoarthritis is due, in part, to the advanced stage of disease of patients in trials and suggests that mirroring the animal model approach might be more successful. It suggests a path forward by enriching trial enrollees with those likely to develop post traumatic OA quickly.
Collapse
Affiliation(s)
- David Felson
- Boston University School of Medicine, Boston, Massachusetts, USA
| | - Martin K Lotz
- Molecular and Experimental Medicine, The Scripps Research Institute, La Jolla, California, USA
| | - Yuxuan Jin
- Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Morgan Jones
- Brigham and Women's Hospital, Boston, Massachusetts, USA
| | | | | |
Collapse
|
19
|
Roemer FW, Wirth W, Demehri S, Kijowski R, Jarraya M, Hayashi D, Eckstein F, Guermazi A. Imaging Biomarkers of Osteoarthritis. Semin Musculoskelet Radiol 2024; 28:14-25. [PMID: 38330967 DOI: 10.1055/s-0043-1776432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
Currently no disease-modifying osteoarthritis drug has been approved for the treatment of osteoarthritis (OA) that can reverse, hold, or slow the progression of structural damage of OA-affected joints. The reasons for failure are manifold and include the heterogeneity of structural disease of the OA joint at trial inclusion, and the sensitivity of biomarkers used to measure a potential treatment effect.This article discusses the role and potential of different imaging biomarkers in OA research. We review the current role of radiography, as well as advances in quantitative three-dimensional morphological cartilage assessment and semiquantitative whole-organ assessment of OA. Although magnetic resonance imaging has evolved as the leading imaging method in OA research, recent developments in computed tomography are also discussed briefly. Finally, we address the experience from the Foundation for the National Institutes of Health Biomarker Consortium biomarker qualification study and the future role of artificial intelligence.
Collapse
Affiliation(s)
- Frank W Roemer
- Department of Radiology, Chobanian & Avedisian Boston University School of Medicine, Boston, Massachusetts
- Department of Radiology, Universitätsklinikum Erlangen & Friedrich Alexander Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Wolfgang Wirth
- Center of Anatomy, and Ludwig Boltzmann Institute for Arthritis and Rehabilitation (LBIAR), Paracelsus Medical University, Salzburg, Austria
- Chondrometrics, GmbH, Freilassing, Germany
| | - Shadpour Demehri
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Richard Kijowski
- Department of Radiology, New York University Grossmann School of Medicine, New York, New York
| | - Mohamed Jarraya
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Daichi Hayashi
- Department of Radiology, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Felix Eckstein
- Center of Anatomy, and Ludwig Boltzmann Institute for Arthritis and Rehabilitation (LBIAR), Paracelsus Medical University, Salzburg, Austria
- Chondrometrics, GmbH, Freilassing, Germany
| | - Ali Guermazi
- Department of Radiology, Chobanian & Avedisian Boston University School of Medicine, Boston, Massachusetts
- Department of Radiology, Boston VA Healthcare System, West Roxbury, Massachusetts
| |
Collapse
|
20
|
Singh A, Venn A, Blizzard L, March L, Eckstein F, Jones G, Wirth W, Cicuttini F, Ding C, Antony B. Association between knee magnetic resonance imaging markers and knee symptoms over 6-9 years in young adults. Rheumatology (Oxford) 2024; 63:436-445. [PMID: 37202358 PMCID: PMC10836990 DOI: 10.1093/rheumatology/kead227] [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: 11/17/2022] [Revised: 03/16/2023] [Accepted: 04/04/2023] [Indexed: 05/20/2023] Open
Abstract
OBJECTIVES To describe associations between MRI markers with knee symptoms in young adults. METHODS Knee symptoms were assessed using the WOMAC scale during the Childhood Determinants of Adult Health Knee Cartilage study (CDAH-knee; 2008-2010) and at the 6- to 9-year follow-up (CDAH-3; 2014-2019). Knee MRI scans obtained at baseline were assessed for morphological markers (cartilage volume, cartilage thickness, subchondral bone area) and structural abnormalities [cartilage defects and bone marrow lesions (BMLs)]. Univariable and multivariable (age, sex, BMI adjusted) zero-inflated Poisson (ZIP) regression models were used for analysis. RESULTS The participants' mean age in CDAH-knee and CDAH-3 were 34.95 (s.d. 2.72) and 43.27 (s.d. 3.28) years, with 49% and 48% females, respectively. Cross-sectionally, there was a weak but significant negative association between medial femorotibial compartment (MFTC) [ratio of the mean (RoM) 0.99971084 (95% CI 0.9995525, 0.99986921), P < 0.001], lateral femorotibial compartment (LFTC) [RoM 0.99982602 (95% CI 0.99969915, 0.9999529), P = 0.007] and patellar cartilage volume [RoM 0.99981722 (95% CI 0.99965326, 0.9999811), P = 0.029] with knee symptoms. Similarly, there was a negative association between patellar cartilage volume [RoM 0.99975523 (95% CI 0.99961427, 0.99989621), P = 0.014], MFTC cartilage thickness [RoM 0.72090775 (95% CI 0.59481806, 0.87372596), P = 0.001] and knee symptoms assessed after 6-9 years. The total bone area was negatively associated with knee symptoms at baseline [RoM 0.9210485 (95% CI 0.8939677, 0.9489496), P < 0.001] and 6-9 years [RoM 0.9588811 (95% CI 0.9313379, 0.9872388), P = 0.005]. The cartilage defects and BMLs were associated with greater knee symptoms at baseline and 6-9 years. CONCLUSION BMLs and cartilage defects were positively associated with knee symptoms, whereas cartilage volume and thickness at MFTC and total bone area were weakly and negatively associated with knee symptoms. These results suggest that the quantitative and semiquantitative MRI markers can be explored as a marker of clinical progression of OA in young adults.
Collapse
Affiliation(s)
- Ambrish Singh
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TS, Australia
| | - Alison Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TS, Australia
| | - Leigh Blizzard
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TS, Australia
| | - Lyn March
- Institute of Bone and Joint Research, Kolling Institute of Medical Research, University of Sydney, Sydney, NSW, Australia
- Florance and Cope Professorial Rheumatology Department, University of Sydney Royal North Shore Hospital, St Leonards, Sydney, NSW, Australia
| | - Felix Eckstein
- Chondrometrics GmbH, Ainring, Germany
- Department of Imaging and Functional Musculoskeletal Research, Institute of Anatomy & Cell Biology, Paracelsus Medical University Salzburg & Nuremberg, Salzburg, Austria
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TS, Australia
| | - Wolfgang Wirth
- Chondrometrics GmbH, Ainring, Germany
- Department of Imaging and Functional Musculoskeletal Research, Institute of Anatomy & Cell Biology, Paracelsus Medical University Salzburg & Nuremberg, Salzburg, Austria
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Flavia Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Changhai Ding
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TS, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Benny Antony
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TS, Australia
| |
Collapse
|
21
|
Negishi Y, Adili A, de Vega S, Momoeda M, Kaneko H, Cilek MZ, Yoshinaga C, Takafuji K, Otsuka Y, Shimoda M, Negishi-Koga T, Ishijima M, Okada Y. IL-6 Reduces Spheroid Sizes of Osteophytic Cells Derived from Osteoarthritis Knee Joint via Induction of Apoptosis. THE AMERICAN JOURNAL OF PATHOLOGY 2024; 194:135-149. [PMID: 37918800 DOI: 10.1016/j.ajpath.2023.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 09/01/2023] [Accepted: 10/02/2023] [Indexed: 11/04/2023]
Abstract
Osteophytes in osteoarthritis (OA) joints contribute to restriction of joint movement, joint pain, and OA progression, but little is known about osteophyte regulators. Examination of gene expression related to cartilage extracellular matrix, endochondral ossification, and growth factor signaling in articular cartilage and osteophytes obtained from OA knee joints showed that several genes such as COL1A1, VCAN, BGLAP, BMP8B, RUNX2, and SOST were overexpressed in osteophytes compared with articular cartilage. Ratios of mesenchymal stem/progenitor cells, which were characterized by co-expression of CD105 and CD166, were significantly higher in osteophytic cells than articular cells. A three-dimensional culture method for cartilage and osteophyte cells was developed by modification of cultures of self-assembled spheroid cell organoids (spheroids). These spheroids cultured in the media for mesenchymal stem cells containing transforming growth factor-β3 showed characteristic morphologies and gene expression profiles of articular cartilage and osteophytes, respectively. The effects of IL-1β, tumor necrosis factor-α, and IL-6 on the spheroids of articular and osteophytic cells were studied. To the best of our knowledge, they provide the first evidence that IL-6 suppresses the spheroid size of osteophytic cells by inducing apoptosis and reducing extracellular matrix molecules. These data show that IL-6 is the suppressor of osteophyte growth and suggest that IL-6 expression and/or activity are implicated in the regulation of osteophyte formation in pathologic joints.
Collapse
Affiliation(s)
- Yoshifumi Negishi
- Department of Pathophysiology for Locomotive Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Arepati Adili
- Department of Pathophysiology for Locomotive Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan; Sportology Center, Juntendo University, Tokyo, Japan
| | - Susana de Vega
- Department of Pathophysiology for Locomotive Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Masahiro Momoeda
- Department of Pathophysiology for Locomotive Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Haruka Kaneko
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Mehmet Z Cilek
- Department of Pathophysiology for Locomotive Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan; Sportology Center, Juntendo University, Tokyo, Japan
| | - Chiho Yoshinaga
- Department of Pathophysiology for Locomotive Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kazuaki Takafuji
- Research Institute, Suntory Global Innovation Center, Ltd., Kyoto, Japan
| | - Yuta Otsuka
- Institute for Science of Life, Suntory Wellness, Ltd., Kyoto, Japan
| | - Masayuki Shimoda
- Department of Pathology, Jikei University School of Medicine, Tokyo, Japan
| | - Takako Negishi-Koga
- Department of Pathophysiology for Locomotive Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Community Medicine and Research for Bone and Joint Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan.
| | - Muneaki Ishijima
- Department of Pathophysiology for Locomotive Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan; Sportology Center, Juntendo University, Tokyo, Japan; Department of Community Medicine and Research for Bone and Joint Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yasunori Okada
- Department of Pathophysiology for Locomotive Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan.
| |
Collapse
|
22
|
Negishi Y, Kaneko H, Aoki T, Liu L, Adili A, Arita H, Hada S, Momoeda M, Huang H, Tomura J, Wakana S, Shiozawa J, Kubota M, Someya Y, Tamura Y, Aoki S, Watada H, Kawamori R, Negishi-Koga T, Okada Y, Ishijima M. Medial meniscus extrusion is invariably observed and consistent with tibial osteophyte width in elderly populations: The Bunkyo Health Study. Sci Rep 2023; 13:22805. [PMID: 38129496 PMCID: PMC10739745 DOI: 10.1038/s41598-023-49868-7] [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: 09/20/2022] [Accepted: 12/13/2023] [Indexed: 12/23/2023] Open
Abstract
We reported that the full-length width of medial tibial osteophytes comprising cartilage and bone parts correlates with medial meniscus extrusion (MME) in early-stage knee osteoarthritis (OA). However, no data exist on the prevalence of MME and its relationship with osteophytes in the elderly population. 1191 elderly individuals (females 57%; 72.9 years old on average) in the Bunkyo Health Study underwent standing plain radiograph and proton density-weighted MRI on knee joints. MRI-detected OA changes were evaluated according to the Whole-Organ Magnetic Resonance Imaging Score. A new method of assessing the cartilage and bone parts of osteophytes was developed using pseudo-coloring images of proton density-weighted fat-suppressed MRI. Most subjects showed Kellgren-Lawrence grade 1 or 2 radiographic medial knee OA (88.1%), MME (98.7%, 3.90 ± 2.01 mm), and medial tibial osteophytes (99.3%, 3.27 ± 1.50 mm). Regarding OA changes, MME was closely associated with the full-length width of medial tibial osteophytes (β = 1.114; 95% CI 1.069-1.159; p < 0.001) in line with osteophyte width (intraclass correlation coefficient, 0.804; 95% CI 0.783-0.823). Our data revealed that MME and medial tibial osteophytes are observed in the elderly and demonstrate that the degree of MME is consistent with the full-length width of medial tibial osteophytes, suggesting that osteophytes might be implicated in MME.
Collapse
Affiliation(s)
- Yoshifumi Negishi
- Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Haruka Kaneko
- Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
- Department of Pathophysiology for Locomotive Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takako Aoki
- Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Lizu Liu
- Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Arepati Adili
- Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hitoshi Arita
- Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Shinnosuke Hada
- Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Masahiro Momoeda
- Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
- Department of Pathophysiology for Locomotive Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hui Huang
- Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Jun Tomura
- Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Suguru Wakana
- Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Jun Shiozawa
- Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
- Department of Pathophysiology for Locomotive Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Mitsuaki Kubota
- Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
- Department of Community Medicine and Research for Bone and Joint Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yuki Someya
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yoshifumi Tamura
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shigeki Aoki
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hirotaka Watada
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Ryuzo Kawamori
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takako Negishi-Koga
- Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
- Department of Community Medicine and Research for Bone and Joint Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yasunori Okada
- Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
- Department of Pathophysiology for Locomotive Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan.
| | - Muneaki Ishijima
- Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
- Department of Pathophysiology for Locomotive Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan.
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan.
- Department of Community Medicine and Research for Bone and Joint Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan.
| |
Collapse
|
23
|
Ishibashi HK, Sasaki E, Ishibashi K, Chiba D, Tsushima T, Kimura Y, Kumagai G, Tsuda E, Sawada K, Mikami T, Ishibashi Y. Greater medial proximal tibial slope is associated with bone marrow lesions in middle-aged women with early knee osteoarthritis. J Orthop Traumatol 2023; 24:60. [PMID: 38015276 PMCID: PMC10684457 DOI: 10.1186/s10195-023-00739-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 10/30/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Bone marrow lesion (BML) is an important magnetic resonance finding (MRI) finding that predicts knee osteoarthritis. The purpose of this study was to investigate the influence of proximal tibial morphology on BML, including the spreading root sign (SRS), in women without radiographic knee osteoarthritis (OA). It was hypothesized that varus alignment and a greater posterior tibial slopes (PTS) are associated with BML. MATERIALS AND METHODS A total of 359 female volunteers without knee OA who were participants in the Iwaki Health Promotion Project in 2017 or 2019 were enrolled. Participants were divided into the non-OA and early knee OA (EKOA) groups based on the Luyten's classification criteria. The presence of pathological cartilage lesions, BMLs, attritions, meniscal lesions and effusions was scored on T2-weighted fat-suppressed magnetic resonance imaging (MRI) according to the Whole-Organ MRI Scoring system. The medial proximal tibial angle (MPTA) and medial and lateral PTS (MPTS and LPTS, respectively) were measured. Regression and receiver operating characteristic (ROC) analyses were performed to reveal the relationship between BMLs and proximal tibial morphological parameters. RESULTS Of the 359 participants, 54 (15%) were classified as having EKOA. The prevalence of cartilage lesions, BMLs, attritions, meniscal lesions and effusions was higher in the EKOA group than in the non-OA group. The two groups had no significant difference in the proximal tibial parameters. Regression analysis revealed that age and a smaller MPTA were associated with BML in both groups. Attrition (p = 0.029) and the MPTS (p = 0.025) were positively associated with BML in the EKOA group. CONCLUSION The prevalence of BMLs was higher in women with EKOA and correlated with the varus and greater posterior slopes in those without radiographic knee OA. LEVEL OF EVIDENCE Level III, retrospective case-control study.
Collapse
Affiliation(s)
- Hikaru K Ishibashi
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan.
| | - Eiji Sasaki
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | - Kyota Ishibashi
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | - Daisuke Chiba
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | - Takahiro Tsushima
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | - Yuka Kimura
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | - Gentaro Kumagai
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | - Eiichi Tsuda
- Department of Rehabilitation Medicine, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | - Kaori Sawada
- Department of Innovation Center for Health Promotion, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | - Tatsuya Mikami
- Department of Innovation Center for Health Promotion, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | - Yasuyuki Ishibashi
- Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| |
Collapse
|
24
|
Guermazi A, Roemer FW, Jarraya M, Hayashi D. A call for screening MRI as a tool for osteoarthritis clinical trials. Skeletal Radiol 2023; 52:2011-2019. [PMID: 37126081 DOI: 10.1007/s00256-023-04354-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 04/21/2023] [Accepted: 04/23/2023] [Indexed: 05/02/2023]
Abstract
Conventional radiography is the most commonly used imaging modality for the evaluation of osteoarthritis (OA) in clinical trials of disease-modifying OA drugs (DMOADs). Unfortunately, radiography has many shortcomings as an imaging technique to meaningfully assess the pathological features of OA. In this perspective paper, we will describe the reasons why radiography is not an ideal tool for structural OA assessment and why magnetic resonance imaging (MRI) should be preferred for such purposes. These shortcomings include a lack of reproducibility of radiographic joint space measurements (if conducted without using a standardized positioning frame), a lack of sensitivity and specificity, an insufficient definition of disease severity, a weak association of radiographic structural damage and pain, a lack of ability to depict many faces of OA, and incapability to depict diagnoses of exclusion. MRI offers solutions to these limitations of radiography. Several different phenotypes of OA have been recognized and it is important to recruit appropriate patients for specific therapeutic approaches in DMOAD trials. Radiography does not allow such phenotypical stratification. We will explain known hurdles for widespread deployment of MRI at eligibility screening and how they can be overcome by technological advances and the use of simplified image assessment.
Collapse
Affiliation(s)
- Ali Guermazi
- Department of Radiology, Boston University School of Medicine, Boston, MA, USA
- VA Boston Healthcare System, West Roxbury, MA, USA
| | - Frank W Roemer
- Department of Radiology, Boston University School of Medicine, Boston, MA, USA
- Department of Radiology, Universitätsklinikum Erlangen & Friedrich-Alexander Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Mohamed Jarraya
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Daichi Hayashi
- Department of Radiology, Boston University School of Medicine, Boston, MA, USA.
- Department of Radiology, Tufts Medical Center, Tufts Medicine, Floating 4, 800 Washington Street, Boston, MA, USA.
- Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| |
Collapse
|
25
|
Felson D, Neogi T. A clinician's perspective on the role of imaging in knee osteoarthritis in clinical practice. Skeletal Radiol 2023; 52:2007-2010. [PMID: 36729209 PMCID: PMC10411116 DOI: 10.1007/s00256-023-04285-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 01/09/2023] [Accepted: 01/12/2023] [Indexed: 02/03/2023]
Abstract
Knee osteoarthritis (OA) is a highly prevalent and disabling disease. Most persons age 45 and over with chronic knee pain have OA and with characteristic history and physical findings, diagnostic imaging is usually not necessary. Further, treatment of chronic knee pain with or without evidence of OA is similar, so imaging does not usually alter therapy. The exception is atypical presentations, such as sudden onset of pain perhaps after trauma or evidence of arthritis in atypical locations elsewhere in the body. Imaging is also unnecessary to follow patients. Given the absence of treatments that slow progression, there is little rationale for acquiring repeated imaging. However, ultrasound or other knee imaging may be helpful in locating the joint when carrying out intraarticular corticosteroid injections. There is controversy as to whether imaging should be acquired before these injections, but recent studies suggest no increased risk of disease progression for most persons receiving these injections. While guidelines currently discourage imaging in the diagnosis or management of most persons with OA, this may change for individuals with identifiable correctible lesions, when effective treatments that alter progression emerge or when imaging is used to identify subtypes of disease that may respond to specific treatments.
Collapse
Affiliation(s)
- David Felson
- Section of Rheumatology, Boston University School of Medicine, 650 Albany St. Suite 200, Boston, MA, 02118, USA
| | - Tuhina Neogi
- Section of Rheumatology, Boston University School of Medicine, 650 Albany St. Suite 200, Boston, MA, 02118, USA.
| |
Collapse
|
26
|
Wirth W, Ladel C, Maschek S, Wisser A, Eckstein F, Roemer F. Quantitative measurement of cartilage morphology in osteoarthritis: current knowledge and future directions. Skeletal Radiol 2023; 52:2107-2122. [PMID: 36380243 PMCID: PMC10509082 DOI: 10.1007/s00256-022-04228-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/29/2022] [Accepted: 10/31/2022] [Indexed: 11/16/2022]
Abstract
Quantitative measures of cartilage morphology ("cartilage morphometry") extracted from high resolution 3D magnetic resonance imaging (MRI) sequences have been shown to be sensitive to osteoarthritis (OA)-related change and also to treatment interventions. Cartilage morphometry is therefore nowadays widely used as outcome measure for observational studies and randomized interventional clinical trials. The objective of this narrative review is to summarize the current status of cartilage morphometry in OA research, to provide insights into aspects relevant for the design of future studies and clinical trials, and to give an outlook on future developments. It covers the aspects related to the acquisition of MRIs suitable for cartilage morphometry, the analysis techniques needed for deriving quantitative measures from the MRIs, the quality assurance required for providing reliable cartilage measures, and the appropriate participant recruitment criteria for the enrichment of study cohorts with knees likely to show structural progression. Finally, it provides an overview over recent clinical trials that relied on cartilage morphometry as a structural outcome measure for evaluating the efficacy of disease-modifying OA drugs (DMOAD).
Collapse
Affiliation(s)
- Wolfgang Wirth
- Department of Imaging & Functional Musculoskeletal Research, Institute of Anatomy & Cell Biology, Paracelsus Medical University Salzburg & Nuremberg, Strubergasse 21, 5020 Salzburg, Austria
- Ludwig Boltzmann Inst. for Arthritis and Rehabilitation, Paracelsus Medical University Salzburg & Nuremberg, Salzburg, Austria
- Chondrometrics GmbH, Freilassing, Germany
| | | | - Susanne Maschek
- Department of Imaging & Functional Musculoskeletal Research, Institute of Anatomy & Cell Biology, Paracelsus Medical University Salzburg & Nuremberg, Strubergasse 21, 5020 Salzburg, Austria
- Chondrometrics GmbH, Freilassing, Germany
| | - Anna Wisser
- Department of Imaging & Functional Musculoskeletal Research, Institute of Anatomy & Cell Biology, Paracelsus Medical University Salzburg & Nuremberg, Strubergasse 21, 5020 Salzburg, Austria
- Ludwig Boltzmann Inst. for Arthritis and Rehabilitation, Paracelsus Medical University Salzburg & Nuremberg, Salzburg, Austria
- Chondrometrics GmbH, Freilassing, Germany
| | - Felix Eckstein
- Department of Imaging & Functional Musculoskeletal Research, Institute of Anatomy & Cell Biology, Paracelsus Medical University Salzburg & Nuremberg, Strubergasse 21, 5020 Salzburg, Austria
- Ludwig Boltzmann Inst. for Arthritis and Rehabilitation, Paracelsus Medical University Salzburg & Nuremberg, Salzburg, Austria
- Chondrometrics GmbH, Freilassing, Germany
| | - Frank Roemer
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA USA
- Department of Radiology, Universitätsklinikum Erlangen and Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| |
Collapse
|
27
|
Fukuda T, Yonenaga T, Miyasaka T, Kimura T, Jinzaki M, Ojiri H. CT in osteoarthritis: its clinical role and recent advances. Skeletal Radiol 2023; 52:2199-2210. [PMID: 36287235 DOI: 10.1007/s00256-022-04217-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/16/2022] [Accepted: 10/18/2022] [Indexed: 02/02/2023]
Abstract
Computed tomography (CT) is a widely available imaging method and considered as one of the most reliable techniques in bone assessment. Although CT has limited tissue contrast and needs radiation exposure, it has several advantages like fast scanning time and high spatial resolution. In this regard, CT has unique roles in osteoarthritis (OA) and its variable utilities have been reported. Hence, this review highlights the clinical role of CT in OA of representative joints. In addition, CT showed the several technical advancements recently, for example, acquiring the CT image with standing, obtaining the dual-energy data, and novel photon-counting detector development. Therefore, the recent studies and potential utility of these new CT systems in OA are also discussed.
Collapse
Affiliation(s)
- Takeshi Fukuda
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-Ku, Tokyo, Japan.
| | - Takenori Yonenaga
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-Ku, Tokyo, Japan
| | - Teruyuki Miyasaka
- Department of Orthopedic Surgery, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-Ku, Tokyo, Japan
| | - Tadashi Kimura
- Department of Orthopedic Surgery, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-Ku, Tokyo, Japan
| | - Masahiro Jinzaki
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, Japan
| | - Hiroya Ojiri
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-Ku, Tokyo, Japan
| |
Collapse
|
28
|
Li T, Luo T, Chen B, Huang C, Shen Z, Xu Z, Nissman D, Golightly YM, Nelson AE, Niethammer M, Zhu H. Charting Aging Trajectories of Knee Cartilage Thickness for Early Osteoarthritis Risk Prediction: An MRI Study from the Osteoarthritis Initiative Cohort. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.09.12.23295398. [PMID: 37745529 PMCID: PMC10516090 DOI: 10.1101/2023.09.12.23295398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Knee osteoarthritis (OA), a prevalent joint disease in the U.S., poses challenges in terms of predicting of its early progression. Although high-resolution knee magnetic resonance imaging (MRI) facilitates more precise OA diagnosis, the heterogeneous and multifactorial aspects of OA pathology remain significant obstacles for prognosis. MRI-based scoring systems, while standardizing OA assessment, are both time-consuming and labor-intensive. Current AI technologies facilitate knee OA risk scoring and progression prediction, but these often focus on the symptomatic phase of OA, bypassing initial-stage OA prediction. Moreover, their reliance on complex algorithms can hinder clinical interpretation. To this end, we make this effort to construct a computationally efficient, easily-interpretable, and state-of-the-art approach aiding in the radiographic OA (rOA) auto-classification and prediction of the incidence and progression, by contrasting an individual's cartilage thickness with a similar demographic in the rOA-free cohort. To better visualize, we have developed the toolset for both prediction and local visualization. A movie demonstrating different subtypes of dynamic changes in local centile scores during rOA progression is available at https://tli3.github.io/KneeOA/. Specifically, we constructed age-BMI-dependent reference charts for knee OA cartilage thickness, based on MRI scans from 957 radiographic OA (rOA)-free individuals from the Osteoarthritis Initiative cohort. Then we extracted local and global centiles by contrasting an individual's cartilage thickness to the rOA-free cohort with a similar age and BMI. Using traditional boosting approaches with our centile-based features, we obtain rOA classification of KLG ≤ 1 versus KLG = 2 (AUC = 0.95, F1 = 0.89), KLG ≤ 1 versus KLG ≥ 2 (AUC = 0.90, F1 = 0.82) and prediction of KLG2 progression (AUC = 0.98, F1 = 0.94), rOA incidence (KLG increasing from < 2 to ≥ 2; AUC = 0.81, F1 = 0.69) and rOA initial transition (KLG from 0 to 1; AUC = 0.64, F1 = 0.65) within a future 48-month period. Such performance in classifying KLG ≥ 2 matches that of deep learning methods in recent literature. Furthermore, its clinical interpretation suggests that cartilage changes, such as thickening in lateral femoral and anterior femoral regions and thinning in lateral tibial regions, may serve as indicators for prediction of rOA incidence and early progression. Meanwhile, cartilage thickening in the posterior medial and posterior lateral femoral regions, coupled with a reduction in the central medial femoral region, may signify initial phases of rOA transition.
Collapse
Affiliation(s)
- Tengfei Li
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Biomedical Research Imaging Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Tianyou Luo
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Boqi Chen
- Department of Computer Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Chao Huang
- Department of Statistics, Florida State University, Tallahassee, FL, USA
| | - Zhengyang Shen
- Department of Computer Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Zhenlin Xu
- Department of Computer Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Daniel Nissman
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Yvonne M. Golightly
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, USA
| | - Amanda E. Nelson
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Marc Niethammer
- Biomedical Research Imaging Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Computer Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hongtu Zhu
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Biomedical Research Imaging Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Computer Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| |
Collapse
|
29
|
Yu Y, Lu S, Liu X, Li Y, Xu J. Identification and analysis of RNA-5-methylcytosine-related key genes in osteoarthritis. BMC Genomics 2023; 24:539. [PMID: 37700248 PMCID: PMC10496305 DOI: 10.1186/s12864-023-09651-4] [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: 05/03/2023] [Accepted: 09/05/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND 5-methylcytosine (m5C) modification is widely associated with many biological and pathological processes. However, knowledge of m5C modification in osteoarthritis (OA) remains lacking. Thus, our study aimed to identify common m5C features in OA. RESULTS In the present study, we identified 1395 differentially methylated genes (DMGs) and 1673 differentially expressed genes (DEGs) using methylated RNA immunoprecipitation next-generation sequencing (MeRIP-seq) and RNA-sequencing. A co-expression analysis of DMGs and DEGs showed that the expression of 133 genes was significantly affected by m5C methylation. A protein-protein interaction network of the 133 genes was constructed using the STRING database, and the cytoHubba plug-in of Cytoscape was used to hub genes were screen out 11 hub genes, including MMP14, VTN, COL15A1, COL6A2, SPARC, COL5A1, COL6A3, COL6A1, COL8A2, ADAMTS2 and COL7A1. The Pathway enrichment analysis by the ClueGO and CluePedia plugins in Cytoscape showed that the hub genes were significantly enriched in collagen degradation and extracellular matrix degradation. CONCLUSIONS Our study indicated that m5C modification might play an important role in OA pathogenesis, and the present study provides worthwhile insight into identifying m5C-related therapeutic targets in OA.
Collapse
Affiliation(s)
- Yang Yu
- Department of Orthopedics, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Shitao Lu
- Department of Orthopedics, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaoming Liu
- Department of Gastroenterology, the Third Xiangya Hospital, Central South University, Changsha, China
| | - Yu Li
- Department of Orthopedics, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jianzhong Xu
- Department of Orthopedics, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
| |
Collapse
|
30
|
Adili A, Kaneko H, Aoki T, Liu L, Negishi Y, Tomura J, Wakana S, Momoeda M, Arita H, Hada S, Shiozawa J, Kubota M, Someya Y, Tamura Y, Aoki S, Watada H, Kawamori R, Negishi-Koga T, Okada Y, Ishijima M. Anterior meniscus extrusion is associated with anterior tibial osteophyte width in knee osteoarthritis - The Bunkyo Health Study. OSTEOARTHRITIS AND CARTILAGE OPEN 2023; 5:100364. [PMID: 37207278 PMCID: PMC10189494 DOI: 10.1016/j.ocarto.2023.100364] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 04/17/2023] [Indexed: 05/21/2023] Open
Abstract
Background In knee osteoarthritis (OA), medial meniscus extrudes both medially and anteriorly. We reported that full-length width of medial tibial osteophyte, which comprises cartilage and bone parts, is directly associated with medial meniscus extrusion in early-stage knee OA and hypothesized that anterior tibial osteophyte (ATO) is also associated with anterior meniscus extrusion (AME). Thus, we aimed to examine their prevalence and relationship. Methods Elderly subjects (638 females and 507 males; average 72.9 years old) in the Bunkyo Health Study cohort were enrolled. MRI-detected OA changes were evaluated according to the Whole Organ Magnetic Resonance Imaging Score. ATO was evaluated using the method which can assess both cartilage and bone parts of osteophyte by pseudo-coloring images of proton density-weighted fat-suppressed MRI. Results Most subjects showed the Kellgren-Lawrence grade 1/2 of the medial knee OA (88.1%), AME (94.3%, 3.7 ± 2.2 mm), and ATO (99.6%, 4.2 ± 1.5 mm). Among the OA changes, AME was most closely associated with full-length width of ATO (multivariable β = 0.877, p < 0.001). The area under the receiver operating characteristic curve for determining the presence of AME as evaluated by ATO width was 0.75 (95% confidence interval 0.60-0.84, p < 0.001). The odds ratio for the presence of AME as evaluated by ATO width at 2.9 mm was 7.16 (4.23-12.15, p < 0.001, age, gender, BMI, and K-L adjusted). Conclusions AME and ATO were inevitably observed in the elderly subjects and AME was closely associated with full-length width of ATO. Our study provides the first evidence on the close relationship between AME and ATO in knee OA.
Collapse
Affiliation(s)
- Arepati Adili
- Department of Orthopaedics, Juntendo University Faculty of Medicine, Tokyo, Japan
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Haruka Kaneko
- Department of Orthopaedics, Juntendo University Faculty of Medicine, Tokyo, Japan
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Corresponding author. Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421, Japan. Fax: +81 3 3813 3428.
| | - Takako Aoki
- Department of Orthopaedics, Juntendo University Faculty of Medicine, Tokyo, Japan
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Lizu Liu
- Department of Orthopaedics, Juntendo University Faculty of Medicine, Tokyo, Japan
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yoshifumi Negishi
- Department of Orthopaedics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Jun Tomura
- Department of Orthopaedics, Juntendo University Faculty of Medicine, Tokyo, Japan
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Suguru Wakana
- Department of Orthopaedics, Juntendo University Faculty of Medicine, Tokyo, Japan
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Masahiro Momoeda
- Department of Orthopaedics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Hitoshi Arita
- Department of Orthopaedics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Shinnosuke Hada
- Department of Orthopaedics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Jun Shiozawa
- Department of Orthopaedics, Juntendo University Faculty of Medicine, Tokyo, Japan
- Department of Pathophysiology for Locomotive Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Mitsuaki Kubota
- Department of Orthopaedics, Juntendo University Faculty of Medicine, Tokyo, Japan
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Community Medicine and Research for Bone and Joint Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yuki Someya
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yoshifumi Tamura
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shigeki Aoki
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hirotaka Watada
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Ryuzo Kawamori
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takako Negishi-Koga
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Community Medicine and Research for Bone and Joint Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yasunori Okada
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Pathophysiology for Locomotive Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Muneaki Ishijima
- Department of Orthopaedics, Juntendo University Faculty of Medicine, Tokyo, Japan
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Pathophysiology for Locomotive Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Community Medicine and Research for Bone and Joint Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Corresponding author. Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421, Japan. Fax: +81 3 3813 3428.
| |
Collapse
|
31
|
Ehmig J, Engel G, Lotz J, Lehmann W, Taheri S, Schilling AF, Seif Amir Hosseini A, Panahi B. MR-Imaging in Osteoarthritis: Current Standard of Practice and Future Outlook. Diagnostics (Basel) 2023; 13:2586. [PMID: 37568949 PMCID: PMC10417111 DOI: 10.3390/diagnostics13152586] [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: 06/28/2023] [Revised: 07/30/2023] [Accepted: 08/01/2023] [Indexed: 08/13/2023] Open
Abstract
Osteoarthritis (OA) is a common degenerative joint disease that affects millions of people worldwide. Magnetic resonance imaging (MRI) has emerged as a powerful tool for the evaluation and monitoring of OA due to its ability to visualize soft tissues and bone with high resolution. This review aims to provide an overview of the current state of MRI in OA, with a special focus on the knee, including protocol recommendations for clinical and research settings. Furthermore, new developments in the field of musculoskeletal MRI are highlighted in this review. These include compositional MRI techniques, such as T2 mapping and T1rho imaging, which can provide additional important information about the biochemical composition of cartilage and other joint tissues. In addition, this review discusses semiquantitative joint assessment based on MRI findings, which is a widely used method for evaluating OA severity and progression in the knee. We analyze the most common scoring methods and discuss potential benefits. Techniques to reduce acquisition times and the potential impact of deep learning in MR imaging for OA are also discussed, as these technological advances may impact clinical routine in the future.
Collapse
Affiliation(s)
- Jonathan Ehmig
- Institute of Diagnostic and Interventional Radiology, University Medical Center Göttingen, 37075 Göttingen, Germany; (J.E.); (G.E.)
| | - Günther Engel
- Institute of Diagnostic and Interventional Radiology, University Medical Center Göttingen, 37075 Göttingen, Germany; (J.E.); (G.E.)
| | - Joachim Lotz
- Institute of Diagnostic and Interventional Radiology, University Medical Center Göttingen, 37075 Göttingen, Germany; (J.E.); (G.E.)
| | - Wolfgang Lehmann
- Clinic of Trauma, Orthopedics and Reconstructive Surgery, Georg-August-University of Göttingen, 37075 Göttingen, Germany
| | - Shahed Taheri
- Clinic of Trauma, Orthopedics and Reconstructive Surgery, Georg-August-University of Göttingen, 37075 Göttingen, Germany
| | - Arndt F. Schilling
- Clinic of Trauma, Orthopedics and Reconstructive Surgery, Georg-August-University of Göttingen, 37075 Göttingen, Germany
| | - Ali Seif Amir Hosseini
- Institute of Diagnostic and Interventional Radiology, University Medical Center Göttingen, 37075 Göttingen, Germany; (J.E.); (G.E.)
| | - Babak Panahi
- Institute of Diagnostic and Interventional Radiology, University Medical Center Göttingen, 37075 Göttingen, Germany; (J.E.); (G.E.)
| |
Collapse
|
32
|
Richardson RD, Casanova MP, Reeves AJ, Ryu S, Cady AC, Baker RT. Evaluating Psychometric Properties of the International Knee Documentation Committee Subjective Knee Form in a Heterogeneous Sample of Post-Operative Patients. Int J Sports Phys Ther 2023; 18:923-939. [PMID: 37547827 PMCID: PMC10399084 DOI: 10.26603/001c.83940] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 06/16/2023] [Indexed: 08/08/2023] Open
Abstract
Background The International Knee Document Committee Subjective Knee Form (IKDC-SKF) is a patient-reported outcome measure used in orthopedics and sports medicine. Further psychometric assessment is necessary to confirm measurement properties in a large, heterogenous sample. Purpose The purpose of the study was to assess the psychometric properties of the IKDC-SKF in a large, heterogenous sample. Study Design Cross-Sectional Study. Methods An exploratory factor analysis (EFA) was conducted to identify a sound latent structure and to assess internal consistency in a large sample of patients who underwent knee arthroscopy. A confirmatory factor analysis (CFA) was conducted to confirm structural validity. Multi-group invariance was conducted to assess factorial stability across sex and age groups, while longitudinal invariance procedures were performed to assess stability over time. Results A 3-factor, 9-item IKDC-SKF short form was identified with EFA procedures. The model was confirmed with CFA (CFI = 0.983; TLI = 0.975; IFI = 0.983; RMSEA = 0.057), while a sound 2-factor, 6-item model was also identified (CFI = 1.0; TLI = 0.999; IFI = 1.0; RMSEA = 0.11). The 9-item IKDC-SKF short form was invariant across groups but not time; removal of a single item (i.e., 8-item IKDC-SKF short form) resulted in longitudinal invariance. The 6-item IKDC-SKF short form was invariant across groups and time. Conclusion The 6-item, 8-item, and 9-item short form versions of the IKDC-SKF exceed contemporary fit recommendations and present as plausible alternatives to the IKDC-SKF with improved measurement properties, reduced scale response burden, and evidence of multi-group and longitudinal invariance. Further, the 6- and 8-item IKDC-SKF short forms may be used to assess group differences or change across time.# Level of evidence hereLevel 3©The Author(s).
Collapse
Affiliation(s)
| | | | | | | | - Adam C Cady
- Woodland Hills Orthopedics Kaiser Permanente
| | | |
Collapse
|
33
|
Thirumaran AJ, Deveza LA, Atukorala I, Hunter DJ. Assessment of Pain in Osteoarthritis of the Knee. J Pers Med 2023; 13:1139. [PMID: 37511752 PMCID: PMC10381750 DOI: 10.3390/jpm13071139] [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: 06/15/2023] [Revised: 07/10/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
Knee osteoarthritis (KOA) pain is a subjective and personal experience, making it challenging to characterise patients' experiences and assess their pain. In addition, there is no global standard for the assessment of pain in KOA. Therefore, this article examines the possible methods of assessing and characterising pain in patients with KOA using clinical symptoms, pain assessment tools, and imaging. We examine the current methods of assessment of pain in KOA and their application in clinical practice and clinical trials. Furthermore, we explore the possibility of creating individualised pain management plans to focus on different pain characteristics. With better evaluation and standardisation of pain assessment in these patients, it is hoped that patients would benefit from improved quality of life. At the same time, improvement in pain assessment would enable better data collection regarding symptom response in clinical trials for the treatment of osteoarthritis.
Collapse
Affiliation(s)
- Aricia Jieqi Thirumaran
- Nepean Hospital, Kingswood, NSW 2747, Australia
- Sydney Musculoskeletal Health, Kolling Institute, Faculty of Medicine and Health, The University of Sydney, St Leonards, NSW 2065, Australia
| | - Leticia Alle Deveza
- Sydney Musculoskeletal Health, Kolling Institute, Faculty of Medicine and Health, The University of Sydney, St Leonards, NSW 2065, Australia
- Rheumatology Department, Royal North Shore Hospital, St Leonards, NSW 2065, Australia
| | - Inoshi Atukorala
- Senior Lecturer in Clinical Medicine & Consultant Rheumatologist, University Medical Unit, National Hospital Sri Lanka, Colombo 00700, Sri Lanka
- Faculty of Medicine, University of Colombo, Colombo 00800, Sri Lanka
| | - David J Hunter
- Sydney Musculoskeletal Health, Kolling Institute, Faculty of Medicine and Health, The University of Sydney, St Leonards, NSW 2065, Australia
- Rheumatology Department, Royal North Shore Hospital, St Leonards, NSW 2065, Australia
| |
Collapse
|
34
|
Liew JW, Rabasa G, LaValley M, Collins J, Stefanik J, Roemer FW, Guermazi A, Lewis CE, Nevitt M, Torner J, Felson D. Development of a Magnetic Resonance Imaging-Based Definition of Knee Osteoarthritis: Data From the Multicenter Osteoarthritis Study. Arthritis Rheumatol 2023; 75:1132-1138. [PMID: 36693143 PMCID: PMC10361157 DOI: 10.1002/art.42454] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/15/2023] [Accepted: 01/19/2023] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Although magnetic resonance imaging (MRI) is the imaging modality of choice for research, there is no widely accepted MRI definition of knee osteoarthritis (OA). We undertook this study to test the performance of different MRI definitions of OA. METHODS We studied Multicenter Osteoarthritis Study participants with knee symptoms using posteroanterior and lateral knee radiographs and MRIs. Radiographic OA was defined as Kellgren/Lawrence grade ≥2 in the tibiofemoral (TF) and/or patellofemoral (PF) joint. Symptomatic OA was defined using a validated questionnaire. MRI findings of cartilage damage, osteophytes, bone marrow lesions (BMLs), and synovitis were scored using the Whole-Organ MRI Score system. We compared definitions using combinations of MRI features to the validation criteria of prevalent radiographic OA and symptomatic OA. All combinations included cartilage damage score ≥2 (0-6 scale) and osteophyte score ≥2 (0-6 scale); addition of BMLs and synovitis score was also tested. We also evaluated a Delphi panel definition that defined OA differently for the PF and TF joints. For each definition, we calculated sensitivity, specificity, and the area under the curve (AUC). RESULTS We included 1,185 knees from 1,185 participants (mean age 66 years, 62% female, 89% White). Among the 1,185 knees, 482 knees had radiographic OA, and 524 knees had symptomatic OA. The MRI definitions with a cartilage score ≥2 and osteophyte score ≥2 and definitions which added BMLs or synovitis score ≥1 had the highest sensitivities (95.2% and 94.5%, respectively) for prevalent radiographic OA (AUCs 0.67 and 0.69, respectively), and also had the highest sensitivities for symptomatic OA. The Delphi panel definition had similar performance but was more complex to apply. CONCLUSION An MRI OA definition requiring cartilage damage and a small osteophyte with or without BMLs or synovitis had the best performance and was simplest for identifying radiographic OA and symptomatic OA.
Collapse
Affiliation(s)
- Jean W. Liew
- Section of Rheumatology, Boston University School of Medicine, Massachusetts
| | - Gabriela Rabasa
- Section of Rheumatology, Boston University School of Medicine, Massachusetts
| | | | - Jamie Collins
- Department of Orthopedic Surgery, Orthopedic and Arthritis Center for Outcomes Research, Brigham and Women’s Hospital, and Harvard Medical School, Boston, Massachusetts
| | | | - Frank W. Roemer
- Department of Radiology, Universitätsklinikum Erlangen & Friedrich-Alexander Universität Erlangen Nürnberg (FAU), Erlangen, Germany, and Department of Radiology, Boston University School of Medicine, Massachusetts
| | - Ali Guermazi
- Department of Radiology, Boston University School of Medicine, and Department of Radiology, VA Boston Healthcare System, Massachusetts
| | | | | | | | - David Felson
- Section of Rheumatology, Boston University School of Medicine, Massachusetts
| |
Collapse
|
35
|
Hu Y, Zhang H, Wang S, Cao L, Zhou F, Jing Y, Su J. Bone/cartilage organoid on-chip: Construction strategy and application. Bioact Mater 2023; 25:29-41. [PMID: 37056252 PMCID: PMC10087111 DOI: 10.1016/j.bioactmat.2023.01.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/15/2023] [Accepted: 01/16/2023] [Indexed: 01/21/2023] Open
Abstract
The necessity of disease models for bone/cartilage related disorders is well-recognized, but the barrier between ex-vivo cell culture, animal models and the real human body has been pending for decades. The organoid-on-a-chip technique showed opportunity to revolutionize basic research and drug screening for diseases like osteoporosis and arthritis. The bone/cartilage organoid on-chip (BCoC) system is a novel platform of multi-tissue which faithfully emulate the essential elements, biologic functions and pathophysiological response under real circumstances. In this review, we propose the concept of BCoC platform, summarize the basic modules and current efforts to orchestrate them on a single microfluidic system. Current disease models, unsolved problems and future challenging are also discussed, the aim should be a deeper understanding of diseases, and ultimate realization of generic ex-vivo tools for further therapeutic strategies of pathological conditions.
Collapse
|
36
|
Pinto-Cardoso R, Bessa-Andrês C, Correia-de-Sá P, Bernardo Noronha-Matos J. Could hypoxia rehabilitate the osteochondral diseased interface? Lessons from the interplay of hypoxia and purinergic signals elsewhere. Biochem Pharmacol 2023:115646. [PMID: 37321413 DOI: 10.1016/j.bcp.2023.115646] [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: 04/07/2023] [Revised: 06/03/2023] [Accepted: 06/07/2023] [Indexed: 06/17/2023]
Abstract
The osteochondral unit comprises the articular cartilage (90%), subchondral bone (5%) and calcified cartilage (5%). All cells present at the osteochondral unit that is ultimately responsible for matrix production and osteochondral homeostasis, such as chondrocytes, osteoblasts, osteoclasts and osteocytes, can release adenine and/or uracil nucleotides to the local microenvironment. Nucleotides are released by these cells either constitutively or upon plasma membrane damage, mechanical stress or hypoxia conditions. Once in the extracellular space, endogenously released nucleotides can activate membrane-bound purinoceptors. Activation of these receptors is fine-tuning regulated by nucleotides' breakdown by enzymes of the ecto-nucleotidase cascade. Depending on the pathophysiological conditions, both the avascular cartilage and the subchondral bone subsist to significant changes in oxygen tension, which has a tremendous impact on tissue homeostasis. Cell stress due to hypoxic conditions directly influences the expression and activity of several purinergic signalling players, namely nucleotide release channels (e.g. Cx43), NTPDase enzymes and purinoceptors. This review gathers experimental evidence concerning the interplay between hypoxia and the purinergic signalling cascade contributing to osteochondral unit homeostasis. Reporting deviations to this relationship resulting from pathological alterations of articular joints may ultimately unravel novel therapeutic targets for osteochondral rehabilitation. At this point, one can only hypothesize how hypoxia mimetic conditions can be beneficial to the ex vivo expansion and differentiation of osteo- and chondro-progenitors for auto-transplantation and tissue regenerative purposes.
Collapse
Affiliation(s)
- Rui Pinto-Cardoso
- Laboratório de Farmacologia e Neurobiologia; Center for Drug Discovery and Innovative Medicines (MedInUP), Departamento de Imuno-Fisiologia e Farmacologia, Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto (ICBAS-UP)
| | - Catarina Bessa-Andrês
- Laboratório de Farmacologia e Neurobiologia; Center for Drug Discovery and Innovative Medicines (MedInUP), Departamento de Imuno-Fisiologia e Farmacologia, Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto (ICBAS-UP)
| | - Paulo Correia-de-Sá
- Laboratório de Farmacologia e Neurobiologia; Center for Drug Discovery and Innovative Medicines (MedInUP), Departamento de Imuno-Fisiologia e Farmacologia, Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto (ICBAS-UP)
| | - José Bernardo Noronha-Matos
- Laboratório de Farmacologia e Neurobiologia; Center for Drug Discovery and Innovative Medicines (MedInUP), Departamento de Imuno-Fisiologia e Farmacologia, Instituto de Ciências Biomédicas Abel Salazar - Universidade do Porto (ICBAS-UP).
| |
Collapse
|
37
|
MacKay J, Watkins L, Kogan F. Editorial for "Local Patterns in Two-Year T1ρ and T2 Changes in Hip Cartilage Are Related to Sex and Functional Data: A Prospective Evaluation on Hip Osteoarthritis Participants". J Magn Reson Imaging 2023; 57:1054-1055. [PMID: 36286012 DOI: 10.1002/jmri.28446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 09/13/2022] [Indexed: 11/11/2022] Open
Affiliation(s)
- James MacKay
- Department of Radiology, University of Cambridge, Cambridge, UK.,Norwich Medical School, University of East Anglia, Norwich, UK
| | - Lauren Watkins
- Steadman Philippon Research Institute, Vail, Colorado, USA
| | - Feliks Kogan
- Department of Radiology, Stanford University, Stanford, California, USA
| |
Collapse
|
38
|
Yang L, Wang P, McGill B. The relationship between experience of knee pain and physical activity participation: A scoping review of quantitative studies. Int J Nurs Sci 2023; 10:258-267. [PMID: 37128486 PMCID: PMC10148261 DOI: 10.1016/j.ijnss.2023.03.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 03/17/2023] [Accepted: 03/19/2023] [Indexed: 05/03/2023] Open
Abstract
Objectives Physical activity (PA) in people with knee pain can help to relieve pain and prevent health problems. However, engaging in regular PA is challenging for them due to chronic musculoskeletal pain. An understanding of how the experience of knee pain affects PA is important to minimize the negative effects of knee pain on participation in PA among this population. We examined the quantitative evidence describing the relationship between the experience of knee pain and participation in PA. Methods We conducted a scoping review based on the PRISMA-ScR process across 27 items and Peters' methodological framework. Searches using keywords were performed in Medline, PsycINFO, CINAHL and Scopus. Results Nine studies were included in this review. While one study clearly showed that increased knee pain increased PA, four studies indicated that knee pain decreased PA among individuals with knee pain. One study revealed that increased knee pain decreased moderate PA, but no significant difference with light intensity PA. Three studies showed that knee pain had no impact on PA. Moreover, psychological factors (catastrophizing and pain-related activity interference) and certain activities of daily living were risk factors for insufficient PA among people with knee pain. Conclusions The limited quantitative evidence on the relationship between the experience of knee pain and PA participation highlights a gap in the knowledge base. The review findings found mixed results, with a negative, positive or no relationship between knee pain and levels of PA among individuals with knee pain. The findings also suggest that the relationship can be affected by psychological factors and different levels and types of PA. Therefore, practitioners should consider multi-component interventions which aim to increase PA levels of individuals with knee pain, after considering the above mediating factors.
Collapse
Affiliation(s)
- Lu Yang
- Sydney School of Public Health, University of Sydney, NSW, Australia
| | - Peipei Wang
- Department of Hematology, Huashan Hospital, Shanghai, China
| | - Bronwyn McGill
- Sydney School of Public Health, University of Sydney, NSW, Australia
- Prevention Research Collaboration, Charles Perkins Centre, University of Sydney, NSW, Australia
- Corresponding author. Sydney School of Public Health, University of Sydney, NSW, Australia.
| |
Collapse
|
39
|
Changing primary care requesting practices for MRI knee: A quality improvement project. Radiography (Lond) 2023; 29:519-525. [PMID: 36907026 DOI: 10.1016/j.radi.2023.02.026] [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: 12/11/2022] [Revised: 02/11/2023] [Accepted: 02/23/2023] [Indexed: 03/12/2023]
Abstract
OBJECTIVES The objectives of this work were first to examine referral practices from primary care for MRI knee in patients ≥45 years old and then to develop a new referral pathway to reduce the number of inappropriate MRI knee referrals. Following this, the aim was to re-assess the effect of the intervention and identify further areas for improvement. METHODS A baseline retrospective analysis of knee MRIs requested from primary care in symptomatic patients ≥45years over a two-month period was undertaken. A new referral pathway was implemented in consensus with orthopaedic specialists and the clinical commissioning group (CCG), via the CCG resource webpage and local education. Following implementation, a repeat data analysis was undertaken. RESULTS The number of MRI knees acquired from primary care referrals reduced by 42% after the new pathway was implemented. 67% (46/69) were compliant with the new guidelines. The number of patients having an MRI knee without a prior plain radiograph was 14/69 (20%) compared to 55/118 (47%) prior the pathway changes. CONCLUSION The new referral pathway reduced the number of knee MRI acquisitions in primary care patients ≥45 years by 42%. Changing the pathway has decreased the number of patients undergoing MRI knee without a prior radiograph from 47% to 20%. These outcomes bring our standards towards the evidence-based recommendations of the Royal College of Radiology and have reduced our outpatient waiting list for MRI knee. IMPLICATIONS FOR PRACTICE Implementing a new referral pathway with the local CCG can successfully reduce the number of inappropriate MRI knee acquisitions from primary care referrals in older symptomatic patients.
Collapse
|
40
|
Chung CS, Tu YJ, Lin LS. Comparison of Digital Radiography, Computed Tomography, and Magnetic Resonance Imaging Features in Canine Spontaneous Degenerative Stifle Joint Osteoarthritis. Animals (Basel) 2023; 13:ani13050849. [PMID: 36899706 PMCID: PMC10000064 DOI: 10.3390/ani13050849] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 02/22/2023] [Accepted: 02/24/2023] [Indexed: 03/02/2023] Open
Abstract
Canine stifle joint osteoarthritis (OA) is characterized by damage and degeneration of the articular cartilage and subchondral bone, bony hypertrophy at the margins, and synovial joint membrane changes. Non-invasive imaging modalities, such as digital radiography (DR), computed tomography (CT), and magnetic resonance imaging (MRI), can be used to describe these changes. However, the value of MRI in diagnosing spontaneous canine OA and the comparison of different imaging modalities have seldom been addressed. This study compared multiple noninvasive imaging modalities in canine spontaneous stifle OA cases. Four client-owned dogs with five spontaneously affected OA stifle joints were recruited and underwent DR, CT, and MRI. Information on osteophytes/enthesophytes, ligament/tendon lesions, synovial effusion and membrane thickening, subchondral bone lesions, and meniscal and cartilage lesions were scored and compared. The results showed that MRI provides the most comprehensive and superior lesion detection sensitivity for ligament, meniscus, cartilage, and synovial effusions. DR provides adequate bony structure information, while CT provides the most delicate images of bony structure lesions. These imaging findings may provide further understanding of the disease and help clinicians draft a more precise treatment plan.
Collapse
Affiliation(s)
- Cheng-Shu Chung
- Department of Veterinary Medicine, College of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
- Veterinary Medical Teaching Hospital, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
- UniCore Animal Hospital, Taipei City 11494, Taiwan
| | - Yi-Ju Tu
- Veterinary Medical Teaching Hospital, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
| | - Lee-Shuan Lin
- Department of Veterinary Medicine, College of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
- Veterinary Medical Teaching Hospital, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
- UniCore Animal Hospital, Taipei City 11494, Taiwan
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Medical Imaging and Radiological Sciences, College of Health Sciences, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Correspondence:
| |
Collapse
|
41
|
Liu Z, Wu J, Xiang W, Wu J, Huang S, Zhou Y, Xia H, Ni Z, Liu B. Correlation between the Signal Intensity Alteration of Infrapatellar Fat Pad and Knee Osteoarthritis: A Retrospective, Cross-Sectional Study. J Clin Med 2023; 12:jcm12041331. [PMID: 36835867 PMCID: PMC9965223 DOI: 10.3390/jcm12041331] [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: 11/24/2022] [Revised: 02/02/2023] [Accepted: 02/03/2023] [Indexed: 02/10/2023] Open
Abstract
Infrapatellar fat pad (IPFP) inflammation is a common pathological manifestation in knee osteoarthritis (OA). However, the significance of IPFP signal intensity alteration for clinical diagnosis and treatment of knee OA needs further research. We assessed IPFP signal intensity alteration (0-3), IPFP maximum cross-sectional area (CSA) and IPFP depth, meniscus injury, bone marrow edema, and cartilage injury from magnetic-resonance imaging (MRI) in 41 non-KOA patients (K-L grade 0 and grade I) and 68 KOA patients (K-L grade 2,3 and 4). We found that IPFP signaling was altered in all patients with KOA whose alteration was closely related to the K-L grading. We found that the IPFP signal intensity was increased in most OA patients, especially the ones in the late stage. There were significant differences in IPFP maximum CSA and IPFP depth between groups in KOA and non-KOA patients. Moreover, Spearman correlation analysis showed that IPFP signal intensity was moderately positively correlated with age, meniscal injury, cartilage injury, and bone marrow edema, and negatively correlated with height, while not correlated with visual analogue scale (VAS) scoring and body mass index (BMI). In addition, women have higher IPFP inflammation scores on MRI than men. In conclusion, IPFP signal intensity alteration is associated with joint damage in knee OA, which may have clinical significance for diagnosing and treating KOA.
Collapse
Affiliation(s)
- Zheng Liu
- Department of Joint Surgery and Sport Medicine, The First Affiliated Hospital of Hunan Normal University, Changsha 410000, China
| | - Jiangyi Wu
- Department of Sports Medicine and Rehabilitation, Peking University Shenzhen Hospital, Shenzhen 518036, China
| | - Wei Xiang
- State Key Laboratory of Trauma, Burns and Combined Injury, Department of Rehabilitation Medicine, Daping Hospital, Army Medical University, Chongqing 400042, China
| | - Jinhui Wu
- Department of Joint Surgery and Sport Medicine, The First Affiliated Hospital of Hunan Normal University, Changsha 410000, China
| | - Shu Huang
- Department of Joint Surgery and Sport Medicine, The First Affiliated Hospital of Hunan Normal University, Changsha 410000, China
| | - Yizhao Zhou
- Department of Joint Surgery and Sport Medicine, The First Affiliated Hospital of Hunan Normal University, Changsha 410000, China
| | - Hui Xia
- Surgery Department I, The First Affiliated Hospital of Hunan Normal University, Changsha 410000, China
| | - Zhenhong Ni
- State Key Laboratory of Trauma, Burns and Combined Injury, Department of Rehabilitation Medicine, Daping Hospital, Army Medical University, Chongqing 400042, China
- Correspondence: (Z.N.); (B.L.)
| | - Baorong Liu
- Department of Joint Surgery and Sport Medicine, The First Affiliated Hospital of Hunan Normal University, Changsha 410000, China
- Correspondence: (Z.N.); (B.L.)
| |
Collapse
|
42
|
Brett A, Bowes MA, Conaghan PG. Comparison of 3D quantitative osteoarthritis imaging biomarkers from paired CT and MR images: data from the IMI-APPROACH study. BMC Musculoskelet Disord 2023; 24:76. [PMID: 36710346 PMCID: PMC9885640 DOI: 10.1186/s12891-023-06187-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 01/23/2023] [Indexed: 01/31/2023] Open
Abstract
INTRODUCTION MRI bone surface area and femoral bone shape (B-score) measures have been employed as quantitative endpoints in DMOAD clinical trials. Computerized Tomography (CT) imaging is more commonly used for 3D visualization of bony anatomy due to its high bone-soft tissue contrast. We aimed to compare CT and MRI assessments of 3D imaging biomarkers. METHODS We used baseline and 24-month image data from the IMI-APPROACH 2-year prospective cohort study. Femur and tibia were automatically segmented using active appearance models, a machine-learning method, to measure 3D bone shape, area and 3D joint space width (3DJSW). Linear regression was used to test for correlation between measures. Limits of agreement and bias were tested using Bland-Altman analysis. RESULTS CT-MR pairs of the same knee were available from 434 participants (78% female). B-scores from CT and MR were strongly correlated (CCC = 0.967) with minimal bias of 0.1 (SDD = 0.227). Area measures were also correlated but showed a consistent bias (MR smaller). 3DJSW showed different biases (MR larger) in both lateral and medial compartments. DISCUSSION The strong correlation and small B-score bias suggests that B-score may be measured reliably using either modality. It is likely that the bone surface identified using MR and CT will be at slightly different positions within the bone/cartilage boundary. The negative bone area bias suggests the MR bone boundary is inside the CT boundary producing smaller areas for MR, consistent with the positive 3DJSW bias. The lateral-medial 3DJSW difference is possibly due to a difference in knee pose during acquisition (extended for CT, flexed for MR). TRIAL REGISTRATION NCT03883568.
Collapse
Affiliation(s)
- Alan Brett
- Imorphics, Worthington House, Towers Business Park, Wilmslow Road, Manchester, M20 2HJ UK
| | - Michael A. Bowes
- Imorphics, Worthington House, Towers Business Park, Wilmslow Road, Manchester, M20 2HJ UK
| | - Philip G. Conaghan
- grid.454370.10000 0004 0439 7412Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds & NIHR Leeds Biomedical Research Centre, Leeds, UK
| |
Collapse
|
43
|
Ramazanian T, Fu S, Sohn S, Taunton MJ, Kremers HM. Prediction Models for Knee Osteoarthritis: Review of Current Models and Future Directions. THE ARCHIVES OF BONE AND JOINT SURGERY 2023; 11:1-11. [PMID: 36793660 PMCID: PMC9903309 DOI: 10.22038/abjs.2022.58485.2897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 02/23/2022] [Indexed: 02/17/2023]
Abstract
Background Knee osteoarthritis (OA) is a prevalent joint disease. Clinical prediction models consider a wide range of risk factors for knee OA. This review aimed to evaluate published prediction models for knee OA and identify opportunities for future model development. Methods We searched Scopus, PubMed, and Google Scholar using the terms knee osteoarthritis, prediction model, deep learning, and machine learning. All the identified articles were reviewed by one of the researchers and we recorded information on methodological characteristics and findings. We only included articles that were published after 2000 and reported a knee OA incidence or progression prediction model. Results We identified 26 models of which 16 employed traditional regression-based models and 10 machine learning (ML) models. Four traditional and five ML models relied on data from the Osteoarthritis Initiative. There was significant variation in the number and type of risk factors. The median sample size for traditional and ML models was 780 and 295, respectively. The reported Area Under the Curve (AUC) ranged between 0.6 and 1.0. Regarding external validation, 6 of the 16 traditional models and only 1 of the 10 ML models validated their results in an external data set. Conclusion Diverse use of knee OA risk factors, small, non-representative cohorts, and use of magnetic resonance imaging which is not a routine evaluation tool of knee OA in daily clinical practice are some of the main limitations of current knee OA prediction models.
Collapse
Affiliation(s)
- Taghi Ramazanian
- Department of Health Sciences Research, Mayo Clinic, 200 First St SW Rochester, Rochester, Minnesota, USA , Department of Orthopedics, Mayo Clinic, 200 First St SW Rochester, Rochester, Minnesota, USA
| | - Sunyang Fu
- Department of Health Sciences Research, Mayo Clinic, 200 First St SW Rochester, Rochester, Minnesota, USA
| | - Sunghwan Sohn
- Department of Health Sciences Research, Mayo Clinic, 200 First St SW Rochester, Rochester, Minnesota, USA
| | - Michael J. Taunton
- Department of Orthopedics, Mayo Clinic, 200 First St SW Rochester, Rochester, Minnesota, USA
| | - Hilal Maradit Kremers
- Department of Health Sciences Research, Mayo Clinic, 200 First St SW Rochester, Rochester, Minnesota, USA , Department of Orthopedics, Mayo Clinic, 200 First St SW Rochester, Rochester, Minnesota, USA
| |
Collapse
|
44
|
Li X, Roemer FW, Cicuttini F, MacKay JW, Turmezei T, Link TM. Early knee OA definition-what do we know at this stage? An imaging perspective. Ther Adv Musculoskelet Dis 2023; 15:1759720X231158204. [PMID: 36937824 PMCID: PMC10017942 DOI: 10.1177/1759720x231158204] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 02/01/2023] [Indexed: 03/16/2023] Open
Abstract
While criteria for early-stage knee osteoarthritis (OA) in a primary care setting have been proposed, the role of imaging has been limited to radiography using the standard Kellgren-Lawrence classification. Standardized imaging and interpretation are critical with radiographs, yet studies have also shown that even early stages of radiographic OA already demonstrate advanced damage to knee joint tissues such as cartilage, menisci, and bone marrow. Morphological magnetic resonance imaging (MRI) shows degenerative damage earlier than radiographs and definitions for OA using MRI have been published though no accepted definition of early OA based on MRI is currently available. The clinical significance of structural abnormalities has also not been well defined, and the differentiation between normal aging and structural OA development remains a challenge. Compositional MRI of cartilage provides information on biochemical, degenerative changes within the cartilage matrix before cartilage defects occur and when cartilage damage is potentially reversible. Studies have shown that cartilage composition can predict cartilage loss and radiographic OA. However, while this technology is most promising for characterizing early OA it has currently limited clinical application. Better standardization of compositional MRI is required, which is currently work in progress. Finally, there has been renewed interest in computed tomography (CT) for assessing early knee OA as new techniques such as weight bearing and spectral CT are available, which may provide information on joint loading, cartilage, and bone and potentially have a role in better characterizing early OA. In conclusion, while imaging may have a limited role in diagnosing early OA in a primary care setting, there are advanced imaging technologies available, which detect early degeneration and may thus significantly alter management as new therapeutic modalities evolve.
Collapse
Affiliation(s)
- Xiaojuan Li
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Frank W. Roemer
- Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Flavia Cicuttini
- Musculoskeletal Unit, Monash University and Rheumatology, Alfred Hospital, Melbourne, VIC, Australia
| | - Jamie W. MacKay
- Department of Radiology, University of Cambridge, Cambridge, UK
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Tom Turmezei
- Department of Radiology, Norfolk and Norwich University Hospital, Norwich, UK
| | | |
Collapse
|
45
|
Guermazi A, Roemer FW, Crema MD, Jarraya M, Mobasheri A, Hayashi D. Strategic application of imaging in DMOAD clinical trials: focus on eligibility, drug delivery, and semiquantitative assessment of structural progression. Ther Adv Musculoskelet Dis 2023; 15:1759720X231165558. [PMID: 37063459 PMCID: PMC10103249 DOI: 10.1177/1759720x231165558] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 03/02/2023] [Indexed: 04/18/2023] Open
Abstract
Despite decades of research efforts and multiple clinical trials aimed at discovering efficacious disease-modifying osteoarthritis (OA) drugs (DMOAD), we still do not have a drug that shows convincing scientific evidence to be approved as an effective DMOAD. It has been suggested these DMOAD clinical trials were in part unsuccessful since eligibility criteria and imaging-based outcome evaluation were solely based on conventional radiography. The OA research community has been aware of the limitations of conventional radiography being used as a primary imaging modality for eligibility and efficacy assessment in DMOAD trials. An imaging modality for DMOAD trials should be able to depict soft tissue and osseous pathologies that are relevant to OA disease progression and clinical manifestations of OA. Magnetic resonance imaging (MRI) fulfills these criteria and advances in technology and increasing knowledge regarding imaging outcomes likely should play a more prominent role in DMOAD clinical trials. In this perspective article, we will describe MRI-based tools and analytic methods that can be applied to DMOAD clinical trials with a particular emphasis on knee OA. MRI should be the modality of choice for eligibility screening and outcome assessment. Optimal MRI pulse sequences must be chosen to visualize specific features of OA.
Collapse
Affiliation(s)
| | - Frank W. Roemer
- Department of Radiology, Universitätsklinikum Erlangen & Friedrich-Alexander Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
- Department of Radiology, School of Medicine, Boston University, Boston, MA, USA
| | - Michel D. Crema
- Institute of Sports Imaging, Sports Medicine Department, French National Institute of Sports (INSEP), Paris, France
- Department of Radiology, School of Medicine, Boston University, Boston, MA, USA
| | - Mohamed Jarraya
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Ali Mobasheri
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
- Department of Regenerative Medicine, State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania
- Department of Joint Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- World Health Organization Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liege, Belgium
| | - Daichi Hayashi
- Department of Radiology, Tufts Medical Center, Tufts Medicine, Boston, MA, USA
- Department of Radiology, School of Medicine, Boston University, Boston, MA, USA
| |
Collapse
|
46
|
Cha Y, Yoon H, Park C, You SJH. Untacted automated robotic upper-trunk- lower reciprocal locomotor training for knee osteoarthritis: A randomized controlled trial. J Back Musculoskelet Rehabil 2023; 36:1101-1110. [PMID: 37248877 DOI: 10.3233/bmr-220182] [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: 05/31/2023]
Abstract
BACKGROUND Although millions of people with osteoarthritis (OA) have altered biomechanical alignment, movement, and knee joint pain during gait, there are no effective and sustainable interventions. To mitigate such impairments, we developed an untacted self-automated robotic and electromyography (EMG)-augmented upper-trunk-lower reciprocal locomotor training (SRGT) intervention. OBJECTIVE To compare the effects of SRGT and conventional treadmill gait training (CTGT) on the medial knee joint space width (JSW), hip adduction moment (HAM), knee varus deformity, pain, and physical function in community-dwelling older adults with OA. METHODS Older adults diagnosed with medial compartment knee OA (5 men, 35 women; mean age = 78.50 ± 9.10 years) were recruited and underwent either SRGT or CTGT, 30 min a day, 3 times a week, over a 4-week period. Outcome measurements included the JSW, HAM, knee varus angle (VA), and Western Ontario McMaster Universities osteoarthritis index (WOMAC). RESULTS Analysis of covariance (ANCOVA) showed that SRGT ed to greater changes in medial knee JSW (p= 0.00001), HAM (p= 0.00001), VA (p= 0.00001), and WOMAC (p= 0.00001) scores. CONCLUSION This study provides the first evidence for the long-term clinical and biomechanical effects of SRGT on JSW, knee joint kinematics, kinetics, and WOMAC scores in older adults with OA. Most importantly, self-automatic robotic gait training may be an alternative, effective, and sustainable treatment for the upper-trunk-lower reciprocal locomotor training in older adults with OA.
Collapse
Affiliation(s)
- Youngjoo Cha
- Department of Physical Therapy, Cheju Halla University, Jeju, Korea
| | - Hyunsik Yoon
- Chungnam National University Hospital, Daejeon, Korea
| | - Chanhee Park
- Sports Movement Artificial-Intelligence Robotics Technology (SMART) Institute, Department of Physical Therapy, Yonsei University, Wonju, Korea
- Department of Physical Therapy, Yonsei University, Wonju, Korea
| | - Sung Joshua H You
- Sports Movement Artificial-Intelligence Robotics Technology (SMART) Institute, Department of Physical Therapy, Yonsei University, Wonju, Korea
- Department of Physical Therapy, Yonsei University, Wonju, Korea
| |
Collapse
|
47
|
Hayashi D, Roemer FW, Link T, Li X, Kogan F, Segal NA, Omoumi P, Guermazi A. Latest advancements in imaging techniques in OA. Ther Adv Musculoskelet Dis 2022; 14:1759720X221146621. [PMID: 36601087 PMCID: PMC9806406 DOI: 10.1177/1759720x221146621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 12/05/2022] [Indexed: 12/28/2022] Open
Abstract
The osteoarthritis (OA) research community has been advocating a shift from radiography-based screening criteria and outcome measures in OA clinical trials to a magnetic resonance imaging (MRI)-based definition of eligibility and endpoint. For conventional morphological MRI, various semiquantitative evaluation tools are available. We have lately witnessed a remarkable technological advance in MRI techniques, including compositional/physiologic imaging and automated quantitative analyses of articular and periarticular structures. More recently, additional technologies were introduced, including positron emission tomography (PET)-MRI, weight-bearing computed tomography (CT), photon-counting spectral CT, shear wave elastography, contrast-enhanced ultrasound, multiscale X-ray phase contrast imaging, and spectroscopic photoacoustic imaging of cartilage. On top of these, we now live in an era in which artificial intelligence is increasingly utilized in medicine. Osteoarthritis imaging is no exception. Successful implementation of artificial intelligence (AI) will hopefully improve the workflow of radiologists, as well as the level of precision and reproducibility in the interpretation of images.
Collapse
Affiliation(s)
- Daichi Hayashi
- Department of Radiology, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA,Department of Radiology, Chobanian & Avedisian School of Medicine, Boston University, Boston, MA, USA
| | - Frank W. Roemer
- Department of Radiology, Chobanian & Avedisian School of Medicine, Boston University, Boston, MA, USA,Department of Radiology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Thomas Link
- Department of Radiology, University of California San Francisco, San Franciso, CA, USA
| | - Xiaojuan Li
- Department of Radiology, Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA
| | - Feliks Kogan
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Neil A. Segal
- Department of Rehabilitation Medicine, The University of Kansas, Kansas City, KS, USA
| | - Patrick Omoumi
- Department of Radiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | | |
Collapse
|
48
|
Roemer FW, Jansen M, Marijnissen ACA, Guermazi A, Heiss R, Maschek S, Lalande A, Blanco FJ, Berenbaum F, van de Stadt LA, Kloppenburg M, Haugen IK, Ladel CH, Bacardit J, Wisser A, Eckstein F, Lafeber FPJG, Weinans HH, Wirth W. Structural tissue damage and 24-month progression of semi-quantitative MRI biomarkers of knee osteoarthritis in the IMI-APPROACH cohort. BMC Musculoskelet Disord 2022; 23:988. [DOI: 10.1186/s12891-022-05926-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 10/27/2022] [Indexed: 11/18/2022] Open
Abstract
Abstract
Background
The IMI-APPROACH cohort is an exploratory, 5-centre, 2-year prospective follow-up study of knee osteoarthritis (OA). Aim was to describe baseline multi-tissue semiquantitative MRI evaluation of index knees and to describe change for different MRI features based on number of subregion-approaches and change in maximum grades over a 24-month period.
Methods
MRIs were acquired using 1.5 T or 3 T MRI systems and assessed using the semi-quantitative MRI OA Knee Scoring (MOAKS) system. MRIs were read at baseline and 24-months for cartilage damage, bone marrow lesions (BML), osteophytes, meniscal damage and extrusion, and Hoffa- and effusion-synovitis. In descriptive fashion, the frequencies of MRI features at baseline and change in these imaging biomarkers over time are presented for the entire sample in a subregional and maximum score approach for most features. Differences between knees without and with structural radiographic (R) OA are analyzed in addition.
Results
Two hundred eighty-nine participants had readable baseline MRI examinations. Mean age was 66.6 ± 7.1 years and participants had a mean BMI of 28.1 ± 5.3 kg/m2. The majority (55.3%) of included knees had radiographic OA. Any change in total cartilage MOAKS score was observed in 53.1% considering full-grade changes only, and in 73.9% including full-grade and within-grade changes. Any medial cartilage progression was seen in 23.9% and any lateral progression on 22.1%. While for the medial and lateral compartments numbers of subregions with improvement and worsening of BMLs were very similar, for the PFJ more improvement was observed compared to worsening (15.5% vs. 9.0%). Including within grade changes, the number of knees showing BML worsening increased from 42.2% to 55.6%. While for some features 24-months change was rare, frequency of change was much more common in knees with vs. without ROA (e.g. worsening of total MOAKS score cartilage in 68.4% of ROA knees vs. 36.7% of no-ROA knees, and 60.7% vs. 21.8% for an increase in maximum BML score per knee).
Conclusions
A wide range of MRI-detected structural pathologies was present in the IMI-APPROACH cohort. Baseline prevalence and change of features was substantially more common in the ROA subgroup compared to the knees without ROA.
Trial Registration
Clinicaltrials.gov identification: NCT03883568.
Collapse
|
49
|
Ogawa A, Iijima H, Takahashi M. Identification of Early Knee Osteoarthritis Based on Knee Joint Trajectory during Stair Climbing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15023. [PMID: 36429742 PMCID: PMC9691255 DOI: 10.3390/ijerph192215023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/08/2022] [Accepted: 11/08/2022] [Indexed: 06/16/2023]
Abstract
Patients with knee osteoarthritis show low stair climbing ability, but a diagnosis of stair performance time is not enough to identify the early stages of knee osteoarthritis. Therefore, we developed an indicator named range of the knee joint trajectory (RKJT) as a kinematic parameter to express more detailed characteristics than stair performance time. To achieve this, we used our developed "IR-Locomotion", a markerless measurement system that can track the knee joint trajectory when climbing stairs. This study aimed to test whether the RKJT effectively identifies patients with early knee osteoarthritis even after controlling stair performance time. Forty-seven adults with moderate to severe knee pain (mean age 59.2 years; 68.1% women) underwent the radiographic examination (Kellgren and Lawrence grade) of both knees and a stair climbing test on 11 stairs. The RKJT during the stair climbing test was calculated by "IR-Locomotion". A generalized linear mixed model was used to evaluate the discriminative capability of RKJT on early knee osteoarthritis (i.e., Kellgren and Lawrence grade of 1). As expected, patients with early knee osteoarthritis showed larger RKJT than non-radiographic controls (95% confidence interval: 1.007, 1.076). Notably, this finding was consistent even after adjusting stair performance time.
Collapse
Affiliation(s)
- Ami Ogawa
- Department of System Design Engineering, Faculty of Science and Technology, Keio University, Yokohama 223-8522, Japan
| | - Hirotaka Iijima
- Institute for Advanced Research, Nagoya University, Nagoya 464-8601, Japan
- Biomedical and Health Informatics Unit, Graduate School of Medicine, Nagoya University, Nagoya 461-8673, Japan
| | - Masaki Takahashi
- Department of System Design Engineering, Faculty of Science and Technology, Keio University, Yokohama 223-8522, Japan
| |
Collapse
|
50
|
Hada S, Kaneko H, Liu L, Aoki T, Takamura T, Kinoshita M, Arita H, Shiozawa J, Negishi Y, Momoeda M, Kubota M, Aoki S, Okada Y, Ishijima M. Medial meniscus extrusion is directly correlated with medial tibial osteophyte in patients received reconstruction surgery for anterior cruciate ligament injury: A longitudinal study. OSTEOARTHRITIS AND CARTILAGE OPEN 2022; 4:100320. [DOI: 10.1016/j.ocarto.2022.100320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 10/16/2022] [Accepted: 11/07/2022] [Indexed: 11/21/2022] Open
|