1
|
Shen V, Kuruvilla D, Ladehoff L, Talsania A, Talsania J. Ligament Suspensionplasty With Suture Tape Augmentation for Basal Thumb Arthritis. Tech Hand Up Extrem Surg 2024:00130911-990000000-00101. [PMID: 38907603 DOI: 10.1097/bth.0000000000000489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2024]
Abstract
Thumb carpometacarpal arthritis is common with aging, more common in women than men, and usually occurs after age 40. If a patient fails conservative treatments such as splinting, medications, and corticosteroid injections, then surgical intervention may be appropriate. Currently, there is no consensus on the best surgical treatment. By limiting metacarpal subsidence, ligament suspensionplasty with suture tape augmentation offers great pain relief, excellent functional outcomes, and limited postoperative immobilization. With this technique, trapeziectomy is first performed. A portion of the abductor pollicis longus tendon is resected and loaded onto the SwiveLock anchor using 4-0 FiberLoop, in addition to suture tape. The prepared graft and tape construct is anchored into the lateral first metacarpal (MC) base and index metacarpal base. After surgery, patients are put in a short arm thumb spica splint, interphalangeal (IP) joints free. Active motion is initiated at the first postoperative visit, usually within 1 week. All patients who had thumb arthritis treated with carpometacarpal suspensionplasty and suture tape augmentation between 2015 and 2022 by a single hand surgeon at our institution were queried. A total of 110 patients were invited to take part in this study, and 61 patients consented and were included in this study. Mean last in-office follow up was at 7.5±4.0 months, which showed significant improvements in pinch strength (P=0.011). A survey taken at a mean 2.8±1.3 years (range: 0.5 to 5.2 y) after surgery reports a postoperative DASH score of 7.3±7.7 (range: 0 to 23.3), and VAS pain score of 0.7±1.1 (range: 0 to 5).
Collapse
Affiliation(s)
- Victor Shen
- University of Southern Florida Health Morsani College of Medicine, Tampa, FL
| | - Davis Kuruvilla
- University of Southern Florida Health Morsani College of Medicine, Tampa, FL
| | - Lauren Ladehoff
- University of Southern Florida Health Morsani College of Medicine, Tampa, FL
| | - Alec Talsania
- Lewis Katz School of Medicine at Temple University, Philadelphia
| | - Jay Talsania
- University of Southern Florida Health Morsani College of Medicine, Tampa, FL
- OAA Orthopaedic Specialists, Allentown, PA
| |
Collapse
|
2
|
Zimmerman M, Nilsson P, Rydberg M, Dahlin L. Risk of hand and forearm conditions due to vibrating hand-held tools exposure: a retrospective cohort study from Sweden. BMJ Open 2024; 14:e080777. [PMID: 38890140 PMCID: PMC11191761 DOI: 10.1136/bmjopen-2023-080777] [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: 10/10/2023] [Accepted: 06/02/2024] [Indexed: 06/20/2024] Open
Abstract
OBJECTIVES The occurrence of hand and forearm disorders related to vibration exposure, adjusted for relevant background factors, is scarcely reported. We analysed the prevalence of such conditions in a large population cohort, stratified by sex, and associations with exposure to vibrating hand-held tools. DESIGN This is a retrospective cohort study. SETTING Individuals in the Malmö Diet and Cancer Study cohort (MDCS; inclusion 1991-1996; followed until 2018) were asked, 'does your work involve working with vibrating hand-held tools?' (response: 'not at all', 'some' and 'much'). Data were cross-linked with national registers to identify treatment for carpal tunnel syndrome (CTS), ulnar nerve entrapment (UNE), Dupuytren's disease, trigger finger or first carpometacarpal joint (CMC-1) osteoarthritis (OA). Cox regression models, unadjusted and adjusted (age, sex, prevalent diabetes, smoking, hypertension and alcohol consumption), were performed to analyse the effects of reported vibration exposure. PARTICIPANTS Individuals in the MDCS who had answered the questionnaire on vibration exposure (14 342 out of the originally 30 446 individuals in MDCS) were included in the study. RESULTS In total, 12 220/14 342 individuals (76%) reported 'no' exposure, 1392/14 342 (9%) 'some' and 730/14 342 (5%) 'much' exposure to vibrating hand-held tools. In men, 'much' exposure was independently associated with CTS (HR 1.71 (95% CI 1.11 to 2.62)) and UNE (HR 2.42 (95% CI 1.15 to 5.07)). 'Some' exposure was independently associated with UNE in men (HR 2.10 (95% CI 1.12 to 3.95)). 'Much' exposure was independently associated with trigger finger in women (HR 2.73 (95% CI 1.49 to 4.99)). We found no effect of vibration exposure on Dupuytren's disease or CMC-1 OA. 'Much' vibration exposure predicted any hand and forearm diagnosis in men (HR 1.44 (95% CI 1.08 to 1.80)), but not in women. CONCLUSIONS Vibration exposure by hand-held tools increases the risk of developing CTS and UNE and any common hand and forearm conditions in men, whereas women only risk trigger finger and CMC-1 OA. Adjustment for relevant confounders in vibration exposure is crucial.
Collapse
Affiliation(s)
- Malin Zimmerman
- Department of Translational Medicine-Hand Surgery, Lund University, Malmö, Sweden
- Department of Orthopedics, Helsingborgs lasarett, Helsingborg, Sweden
| | | | - Mattias Rydberg
- Department of Translational Medicine, Lund University, Malmö, Sweden
- Department of Hand Surgery, Skånes universitetssjukhus Malmö, Malmo, Sweden
| | - Lars Dahlin
- Department of Translational Medicine, Lund University, Malmö, Sweden
- Department of Hand Surgery, Skånes universitetssjukhus Malmö, Malmo, Sweden
| |
Collapse
|
3
|
Knappe K, Schonhoff M, Jaeger S, Bickert B, Harhaus L, Panzram B. Computer-simulated TOUCH prosthesis cup malposition and solutions. HAND SURGERY & REHABILITATION 2024; 43:101712. [PMID: 38701947 DOI: 10.1016/j.hansur.2024.101712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Revised: 04/18/2024] [Accepted: 04/21/2024] [Indexed: 05/06/2024]
Abstract
INTRODUCTION Total joint replacement has become significantly more common as a treatment for advanced trapeziometacarpal joint osteoarthritis in recent years. The latest generation of prostheses with dual-mobility designs leads to very good functional results and low rates of loosening and dislocation in the short and medium term. Biomechanical studies showed that central placement and parallel alignment of the cup with respect to the proximal articular surface of the trapezium are crucial for both cup stability and prevention of dislocation. Despite correct positioning of the guidewire, incorrect placement or tilting of the inserted cup may occur, requiring immediate intraoperative revision. METHODS The existing spherical and conical cup models in sizes 9 mm and 10 mm were transferred to a computer-aided design dataset. Depending on the intraoperative complication (tilting or incorrect placement), the revision options resulting from the various combinations of cup type and size were simulated and analyzed according to the resulting defect area and bony contact area. RESULTS In well centered cups, a size 9 conical cup could be replaced by a size 9 spherical cup and still be fixed by press-fit. Conversely, a size 9 spherical cup could not be replaced by a size 9 conical cup, but only by a size 10 cup, of whatever shape. When a size 9 conical cup was tilted up to 20°, the best revision option was to resect the sclerotic margin and insert a size 10 conical cup deeper into the cancellous bone, to achieve the largest contact area with the surrounding bone. When a size 9 cup of whatever shape was poorly centered (misplaced with respect to the dorsopalmar or radioulnar line of the trapezium), placement should be corrected using a size 10 cup, combined with autologous bone grafting of the defect. Again, the size 10 conical cup showed the largest bony contact area. CONCLUSION Our computer-based measurements suggested options for intraoperative cup revision depending on cup shape and size and on type of misalignment with resulting bone defects. These suggestions, however, need to be confirmed in anatomic specimens before introducing them into clinical practice.
Collapse
Affiliation(s)
- Kevin Knappe
- Department of Orthopaedics, Heidelberg University Hospital, Heidelberg, Germany.
| | - Mareike Schonhoff
- Laboratory of Biomechanics and Implant Research, Department of Orthopaedics, Heidelberg University Hospital, Heidelberg, Germany
| | - Sebastian Jaeger
- Laboratory of Biomechanics and Implant Research, Department of Orthopaedics, Heidelberg University Hospital, Heidelberg, Germany
| | - Berthold Bickert
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center, Ludwigshafen, Germany
| | - Leila Harhaus
- Department of Orthopaedics, Heidelberg University Hospital, Heidelberg, Germany; Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center, Ludwigshafen, Germany
| | - Benjamin Panzram
- Department of Orthopaedics, Heidelberg University Hospital, Heidelberg, Germany
| |
Collapse
|
4
|
Daeschler SC, Sommer J, Tu TJZ, Jaeger S, Knappe K, Harhaus L, Panzram B. [Cup Placement in Thumb Carpometacarpal Joint Prostheses: The Role of the Guidewire]. HANDCHIR MIKROCHIR P 2024; 56:212-218. [PMID: 38861976 DOI: 10.1055/a-2319-1157] [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: 06/13/2024] Open
Abstract
BACKGROUND The increasing use of thumb carpometacarpal joint prostheses for advanced CMC 1 (carpometacarpal) joint arthritis reflects the success of the latest prosthesis generations, which has been achieved through their improved functional outcomes and lower complication rates. Precise alignment of the prosthesis cup parallel to the proximal joint surface of the trapezium is essential for stability and the prevention of dislocation. This is a challenging surgical step, particularly for surgeons new to this technique. Despite adequate positioning of the guidewire, misplacements of the cup may occur, necessitating intraoperative revision. MATERIAL AND METHODS This study examined the deviations in cup and guidewire positioning in thumb carpometacarpal joint prosthesis implantations by inexperienced and experienced surgeons through radiological analysis of 65 prostheses. RESULTS Both inexperienced and experienced surgeons achieved precise guidewire positioning with mean deviations of<2.2°. Inexperienced surgeons showed significantly larger cup deviations in the dorsopalmar and lateral view (7.6±6.1° and 7.3±5.9°) compared with experienced surgeons (3.6±2.7° and 3.6±2.5°; p=0.012, p=0.017). The deviation of the cup position exhibited by inexperienced surgeons tends to be in the direction opposite to the initial guidewire position (p<0.0038). CONCLUSION The results highlight the current challenges in cup positioning depending on a surgeon's level of experience, questioning the reliability of the current guidewire placement.
Collapse
Affiliation(s)
- Simeon C Daeschler
- Abteilung für Handchirurgie, Periphere Nervenchirurgie und Rehabilitation, Klinik für Hand- und Plastische Chirurgie, BG Klinik Ludwigshafen, Ludwigshafen, Germany
| | - Jan Sommer
- Zentrum für Orthopädie, Unfallchirurgie und Paraplegiologie, UniversitätsKlinikum Heidelberg, Heidelberg, Germany
| | - Thomas Jing Zhi Tu
- Labor für Biomechanik und Implantatforschung, Klinik für Orthopädie, Universitätsklinikum Heidelberg, UniversitätsKlinikum Heidelberg, Heidelberg, Germany
| | - Sebastian Jaeger
- Labor für Biomechanik und Implantatforschung, Klinik für Orthopädie, Universitätsklinikum Heidelberg, UniversitätsKlinikum Heidelberg, Heidelberg, Germany
| | - Kevin Knappe
- Zentrum für Orthopädie, Unfallchirurgie und Paraplegiologie, UniversitätsKlinikum Heidelberg, Heidelberg, Germany
| | - Leila Harhaus
- Abteilung für Handchirurgie, Periphere Nervenchirurgie und Rehabilitation, Klinik für Hand- und Plastische Chirurgie, BG Klinik Ludwigshafen, Ludwigshafen, Germany
| | - Benjamin Panzram
- Zentrum für Orthopädie, Unfallchirurgie und Paraplegiologie, UniversitätsKlinikum Heidelberg, Heidelberg, Germany
| |
Collapse
|
5
|
Salis Z, Driban JB, McAlindon TE, Eaton CB, Sainsbury A. Association of Weight Loss and Weight Gain With Structural Defects and Pain in Hand Osteoarthritis: Data From the Osteoarthritis Initiative. Arthritis Care Res (Hoboken) 2024; 76:652-663. [PMID: 38130021 PMCID: PMC11039366 DOI: 10.1002/acr.25284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 11/13/2023] [Accepted: 12/19/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE Our aim was to define the association of weight change (weight loss or weight gain) with the incidence and progression of hand osteoarthritis (OA), assessed either by radiography or by pain, using data from the Osteoarthritis Initiative. METHODS Among the 4,796 participants, we selected 4,598 participants, excluding those with cancer or rheumatoid arthritis or a body mass index under 18.5 kg/m2. We investigated the association of weight change with incidence and progression of radiographic hand OA and the development and resolution of hand pain. Using multivariable logistic regression, we investigated the association of weight change from baseline to the 4-year follow-up with the incidence and progression of radiographic hand OA at the 4-year follow-up. Additionally, multivariable repeated-measure mixed-effects logistic regression analyzed the association of weight change with the development and resolution of hand pain across 2-year, 4-year, 6-year, and 8-year follow-ups. RESULTS No statistically significant associations were observed between weight change and the investigated outcomes. Specifically, for each 5% weight loss, the odds ratios for the incidence and progression of radiographic hand OA were 0.90 (95% confidence interval [95% CI] 0.67-1.23) and 0.92 (95% CI 0.84-1.00), respectively. Similarly, for each 5% weight loss, the odds ratios for the development and resolution of hand pain at the 8-year follow-up were 1.00 (95% CI 0.92-1.09) and 1.07 (95% CI 0.91-1.25), respectively. CONCLUSION Our study found no evidence of an association between weight change and the odds of incidence or progression of radiographic hand OA over 4 years, nor the development or resolution of hand pain over 8 years.
Collapse
Affiliation(s)
- Zubeyir Salis
- Division of Rheumatology, Geneva University Hospital and Faculty of Medicine, University of Geneva, Geneva, Switzerland
- The University of Western Australia, School of Human Sciences, Perth, WA, Australia
- The University of New South Wales, Centre for Big Data Research in Health, Kensington, NSW, Australia
| | - Jeffrey B. Driban
- UMass Chan Medical School, Department of Population and Quantitative Health Sciences
| | - Timothy E. McAlindon
- Division of Rheumatology, Allergy, and Immunology; Tufts Medical Center; Boston, MA, USA
| | - Charles B. Eaton
- Alpert Medical School of Brown University, Providence, Rhode Island; Center for Primary Care and Prevention, Pawtucket, Rhode Island; and Brown University School of Public Health, Providence, Rhode Island
| | - Amanda Sainsbury
- The University of Western Australia, School of Human Sciences, Perth, WA, Australia
| |
Collapse
|
6
|
Fouasson-Chailloux A, Morel X, Jager T, Duysens C, Falcone A, Pomares G. Joint capsule innervation does not explain the difference in symptoms between scaphotrapezial and trapeziometacarpal osteoarthritis. HAND SURGERY & REHABILITATION 2023; 42:470-474. [PMID: 37567415 DOI: 10.1016/j.hansur.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/03/2023] [Accepted: 08/05/2023] [Indexed: 08/13/2023]
Abstract
OBJECTIVES Peritrapezial osteoarthritis (OA) includes scaphotrapezial and trapeziometacarpal OA. In clinical practice, scaphotrapezial OA seems better tolerated than trapeziometacarpal OA, with fewer complaints and better tolerance. The difference in pain could be linked to a difference in joint capsule innervation, perhaps with fewer nerve fibers in the scaphotrapezial than the trapeziometacarpal joint. MATERIALS AND METHODS We performed a histologic evaluation of these two joints to compare their respective innervation in 17 cadaveric specimens with peritrapezial OA. Radiographic scoring confirmed the presence of peritrapezial OA. Mean Kellgren-Lawrence score was 2.2 ± 1.1 in the trapeziometacarpal joint and 1.5 ± 0.7 in the scaphotrapezial joint (p = 0.08). RESULTS There was no difference between scaphotrapezial and trapeziometacarpal joints in number of neurofilaments: 5.2 ± 3.9 and 4.4 ± 4.5, respectively (p = 0.20). A significant difference was found in S100 staining (myelinated structures), with a higher rate in the scaphotrapezial joint: 11.8 ± 7.5 vs 6.6 ± 5.2 (p = 0.005). CONCLUSION The present study suggests that lower tolerance of trapeziometacarpal OA is not due to a difference in joint capsule innervation. On the contrary, we found a higher rate of myelinated tissues in the scaphotrapezial joint. These results suggested other pain pathways to explain clinical observations.
Collapse
Affiliation(s)
- Alban Fouasson-Chailloux
- Institut Européen de la Main, Hôpital Kirchberg, 2540 Luxembourg, Luxembourg; Medical Training Center, Hôpital Kirchberg, 2540 Luxembourg, Luxembourg; Service de Médecine Physique et Réadaptation Locomotrice et Respiratoire, CHU Nantes, Nantes Université, 44093 Nantes, France; Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, ONIRIS, Nantes Université, Nantes, France.
| | - Xavier Morel
- Institut Européen de la Main, Hôpital Kirchberg, 2540 Luxembourg, Luxembourg
| | - Thomas Jager
- Institut Européen de la Main, Hôpital Kirchberg, 2540 Luxembourg, Luxembourg; Medical Training Center, Hôpital Kirchberg, 2540 Luxembourg, Luxembourg
| | - Christophe Duysens
- Institut Européen de la Main, Hôpital Kirchberg, 2540 Luxembourg, Luxembourg
| | - Andrea Falcone
- Institut Européen de la Main, Hôpital Kirchberg, 2540 Luxembourg, Luxembourg
| | - Germain Pomares
- Institut Européen de la Main, Hôpital Kirchberg, 2540 Luxembourg, Luxembourg; Medical Training Center, Hôpital Kirchberg, 2540 Luxembourg, Luxembourg
| |
Collapse
|
7
|
Ling K, Wang KE, Kim ND, Komatsu DE, Wang ED. Body Mass Index as a Predictor for Postoperative Complications Following Carpometacarpal Arthroplasty. JOURNAL OF HAND SURGERY GLOBAL ONLINE 2023; 5:787-792. [PMID: 38106953 PMCID: PMC10721512 DOI: 10.1016/j.jhsg.2023.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 06/24/2023] [Indexed: 12/19/2023] Open
Abstract
Purpose Carpometacarpal (CMC) arthroplasty is an effective surgical treatment to relieve pain and improve function for osteoarthritis of the CMC joint. The association between body mass index (BMI) and postoperative complications has been studied for other orthopedic procedures, including total knee arthroplasty, total hip arthroplasty, and total shoulder arthroplasty. However, BMI has not been studied as a risk factor for postoperative complications following CMC arthroplasty. The purpose of this study was to determine the postoperative complications associated with different categories of BMI following CMC arthroplasty. We hypothesized that increasing BMI is associated with more severe complications. Methods The American College of Surgeons National Surgical Quality Improvement Program database was queried for all patients who underwent CMC arthroplasty between 2015 and 2020. Patient demographics, comorbidities, surgical characteristics, and 30-day postoperative complication data were collected. Patients were stratified into cohorts based on BMI as follows: underweight (BMI < 18.5 kg/m2), normal/reference (18.5 kg/m2 ≤ BMI < 30.0 kg/m2), obese (30.0 kg/m2 ≤ BMI < 35.0 kg/m2), severely obese (35.0 kg/m2 ≤ BMI < 40.0 kg/m2), and morbidly obese (BMI ≥ 40.0 kg/m2). Multivariate logistic regression was used to identify postoperative complications associated with each cohort. Results In total, 6,432 patients were included in this study: 3,622 (56.3%) patients were included in the normal/reference cohort, 77 (1.2%) patients were included in the underweight cohort, 1,479 (23.0%) patients were included in the obese cohort, 718 (11.2%) patients were included in the severely obese cohort, and 536 (8.3%) patients were included in the morbidly obese cohort. The obese cohort was independently associated with a higher rate of superficial incisional surgical-site infection (odds ratio [OR], 2.11; 95% confidence interval [CI], 1.00-4.44; P = .050). The morbidly obese cohort was independently associated with readmission (OR, 3.35; 95% CI, 1.15-9.74; P = .026) and reoperation (OR, 3.40; 95% CI, 1.04-1.11; P = .043). Conclusions Morbid obesity is a clinically significant predictor for readmission and reoperation within 30 days following CMC arthroplasty. Obesity is a clinically significant predictor for superficial incisional surgical-site infection within 30 days following CMC arthroplasty. Clinical relevance A better understanding of BMI as a risk factor for postoperative complications may allow surgeons to improve preoperative risk stratification and patient counseling. Type of study/level of evidence Prognostic III.
Collapse
Affiliation(s)
- Kenny Ling
- Department of Orthopaedics, Stony Brook University, Stony Brook, NY
| | - Katherine E. Wang
- Renaissance School of Medicine at Stony Brook University, Stony Brook, NY
| | - Noah D. Kim
- Renaissance School of Medicine at Stony Brook University, Stony Brook, NY
| | - David E. Komatsu
- Department of Orthopaedics, Stony Brook University, Stony Brook, NY
| | - Edward D. Wang
- Department of Orthopaedics, Stony Brook University, Stony Brook, NY
| |
Collapse
|
8
|
Condemi S, Panuel M, Chaumoitre K, Belcastro MG, Pietrobelli A, Voisin JL. A pathological Neandertal thumb phalanx from Moula-Guercy (France). INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2023; 42:14-17. [PMID: 37354658 DOI: 10.1016/j.ijpp.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 06/17/2023] [Accepted: 06/18/2023] [Indexed: 06/26/2023]
Abstract
OBJECTIVE To discuss a Neandertal pathological adult first pollical proximal phalanx (I2-104) from the Baume de Moula-Guercy (Ardèche, France) and evaluate the possible causes of this pathology. METHODS Macroscopic analyses of external features, as well as CT imaging, were used in the analysis RESULTS: The presence of asymmetric eburnation on the distal epiphysis associated with an osteophyte on the palmar surface, as well as the absence of periosteal bone reaction visible on CT images, is consistent with osteoarthritis. CONCLUSION Osteoarthritis (OA) can have different origins and the cause is difficult to identify. The pathology of the Moula-Guercy I2-104 phalanx may be due to a genetic predisposition for OA known in Neandertals and associated with short limb bones. The OA could have been aggravated by the age of this individual and by an inflammatory reaction caused by repeated movements and intense vibrations provoked by high-frequency knapping or by other use of the hands SIGNIFICANCE: The I2-104 phalanx is the first Neandertal pollical phalanx known to display OA, although joints of this bone are frequently affected by this pathology in modern humans. Thus, greater insight into the presence and consequences of Neandertal behaviors is offered LIMITATION: It is impossible to give a definitive conclusion on the cause(s) of the OA in this case. SUGGESTIONS FOR FURTHER RESEARCH More data is needed concerning OA within Neandertals and its relationship with behavior and genetics.
Collapse
Affiliation(s)
- Silvana Condemi
- UMR 7268 ADES, Aix-Marseille Université/EFS/CNRS, Faculté de Médecine - La Timone, 27 Bd Jean Moulin, 13385 Marseille Cedex 05, France.
| | - Michel Panuel
- UMR 7268 ADES, Aix-Marseille Université/EFS/CNRS, Faculté de Médecine - La Timone, 27 Bd Jean Moulin, 13385 Marseille Cedex 05, France
| | - Kathia Chaumoitre
- UMR 7268 ADES, Aix-Marseille Université/EFS/CNRS, Faculté de Médecine - La Timone, 27 Bd Jean Moulin, 13385 Marseille Cedex 05, France
| | - Maria Giovanna Belcastro
- Dipartimento di Scienze Biologiche, Geologiche e Ambientali, Alma Mater Studiorum Università di Bologna, Via Selmi 3, Bologna, Italy
| | - Annalisa Pietrobelli
- Dipartimento di Scienze Biologiche, Geologiche e Ambientali, Alma Mater Studiorum Università di Bologna, Via Selmi 3, Bologna, Italy
| | - Jean-Luc Voisin
- UMR 7268 ADES, Aix-Marseille Université/EFS/CNRS, Faculté de Médecine - La Timone, 27 Bd Jean Moulin, 13385 Marseille Cedex 05, France.
| |
Collapse
|
9
|
Warmink K, Vinod P, Korthagen NM, Weinans H, Rios JL. Macrophage-Driven Inflammation in Metabolic Osteoarthritis: Implications for Biomarker and Therapy Development. Int J Mol Sci 2023; 24:ijms24076112. [PMID: 37047082 PMCID: PMC10094694 DOI: 10.3390/ijms24076112] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 03/19/2023] [Accepted: 03/21/2023] [Indexed: 04/14/2023] Open
Abstract
Osteoarthritis (OA) is a common and debilitating joint disorder that leads to progressive joint breakdown and loss of articular cartilage. Accompanied by a state of low-grade inflammation, its etiology extends beyond that of a wear-and-tear disease, and the immune system might have a role in its initiation and progression. Obesity, which is directly associated with an increased incidence of OA, alters adipokine release, increases pro-inflammatory macrophage activity, and affects joint immune regulation. Studying inflammatory macrophage expression and strategies to inhibit inflammatory macrophage phenotype polarization might provide insights into disease pathogenesis and therapeutic applications. In pre-clinical studies, the detection of OA in its initial stages was shown to be possible using imaging techniques such as SPECT-CT, and advances are made to detect OA through blood-based biomarker analysis. In this review, obesity-induced osteoarthritis and its mechanisms in inducing joint degeneration are summarized, along with an analysis of the current developments in patient imaging and biomarker use for diagnostic and therapeutic strategies.
Collapse
Affiliation(s)
- Kelly Warmink
- Department of Orthopedics, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Prateeksha Vinod
- Department of Orthopedics, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Nicoline M Korthagen
- Department of Orthopedics, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, 3584 CL Utrecht, The Netherlands
| | - Harrie Weinans
- Department of Orthopedics, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
- Department of Biomechanical Engineering, TU Delft, 2628 CD Delft, The Netherlands
| | - Jaqueline L Rios
- Department of Orthopedics, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| |
Collapse
|
10
|
Gavile CM, Kazmers NH, Novak KA, Meeks HD, Yu Z, Thomas JL, Hansen C, Barker T, Jurynec MJ. Familial Clustering and Genetic Analysis of Severe Thumb Carpometacarpal Joint Osteoarthritis in a Large Statewide Cohort. J Hand Surg Am 2022; 47:923-933. [PMID: 36184273 PMCID: PMC9547951 DOI: 10.1016/j.jhsa.2022.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/29/2022] [Accepted: 08/04/2022] [Indexed: 02/02/2023]
Abstract
PURPOSE Our goals were to identify individuals who required surgery for thumb carpometacarpal (CMC) joint osteoarthritis (OA), determine if CMC joint OA clusters in families, define the magnitude of familial risk of CMC joint OA, identify risk factors associated with CMC joint OA, and identify rare genetic variants that segregate with familial CMC joint OA. METHODS We searched the Utah Population Database to identify a cohort of CMC joint OA patients who required surgery. Affected individuals were mapped to pedigrees to identify high-risk families with excess clustering of CMC joint OA. Cox regression models were used to calculate familial risk of CMC joint OA in related individuals. Risk factors were evaluated using logistic regression models. Whole exome sequencing was used to identify rare coding variants associated with familial CMC joint OA. RESULTS We identified 550 pedigrees with excess clustering of severe CMC joint OA. The relative risk of CMC joint OA requiring surgical treatment was elevated significantly in first- and third-degree relatives of affected individuals, and significant associations with advanced age, female sex, obesity, and tobacco use were observed. We discovered candidate genes that dominantly segregate with severe CMC joint OA in 4 independent families, including a rare variant in Chondroitin Sulfate Synthase 3 (CHSY3). CONCLUSIONS Familial clustering of severe CMC joint OA was observed in a statewide population. Our data indicate that genetic and environmental factors contribute to the disease process, further highlighting the multifactorial nature of the disease. Genomic analyses suggest distinct biological processes are involved in CMC joint OA pathogenesis. CLINICAL RELEVANCE Awareness of associated comorbidities may guide the diagnosis of CMC joint OA in at-risk populations and help identify individuals who may not do well with nonoperative treatment. Further pursuit of the genes associated with severe CMC joint OA may lead to assays for detection of early stages of disease and have therapeutic potential.
Collapse
Affiliation(s)
| | | | - Kendra A Novak
- Department of Orthopaedics, University of Utah, Salt Lake City, UT
| | - Huong D Meeks
- Huntsman Cancer Institute, Utah Population Database, University of Utah, Salt Lake City, UT
| | - Zhe Yu
- Huntsman Cancer Institute, Utah Population Database, University of Utah, Salt Lake City, UT
| | - Joy L Thomas
- Intermountain Healthcare, Precision Genomics, St. George, UT
| | - Channing Hansen
- Intermountain Healthcare, Biorepository, South Salt Lake City, UT
| | - Tyler Barker
- Department of Orthopaedics, University of Utah, Salt Lake City, UT; Intermountain Healthcare, Precision Genomics, Murray, UT; Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT
| | - Michael J Jurynec
- Department of Orthopaedics, University of Utah, Salt Lake City, UT; Department of Human Genetics, University of Utah, Salt Lake City, UT.
| |
Collapse
|
11
|
Rydberg M, Zimmerman M, Gottsäter A, Svensson AM, Eeg-Olofsson K, Dahlin LB. Diabetic hand: prevalence and incidence of diabetic hand problems using data from 1.1 million inhabitants in southern Sweden. BMJ Open Diabetes Res Care 2022; 10:10/1/e002614. [PMID: 35046015 PMCID: PMC8772403 DOI: 10.1136/bmjdrc-2021-002614] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 12/23/2021] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION 'The diabetic hand' has traditionally referred to hand complications due to diabetes mellitus (DM), including trigger finger (TF) and Dupuytren's disease (DD). Recent publications have also proposed DM as a risk factor for carpal tunnel syndrome (CTS), ulnar nerve entrapment (UNE), and possibly osteoarthritis (OA) of the first carpometacarpal (CMC-1) joint. This study aimed to explore prevalence and incidence of diabetic hand complications among the population in southern Sweden. RESEARCH DESIGN AND METHODS Approximately 1.1 million inhabitants in the region of Skåne aged ≥18 years, whereof 50 000 with DM, were included. Data on incident CTS, UNE, TF, DD, and OA of the CMC-1 joint between 2004 and 2019 were collected from the Skåne Healthcare Register and cross-linked with the National Diabetes Register. Prevalences on December 31, 2019 and 10-year incidence ratios were calculated for type 1 diabetes (T1D), type 2 diabetes (T2D), and the population without DM, stratified for sex. Prevalence ratios and incidence rate ratios with 95% CIs were used for group comparisons. RESULTS The prevalences of all five studied diagnoses were higher in both men and women with T1D and T2D (p<0.01) and both T1D and T2D had more concomitant prevalent diagnoses (p<0.0001). The 10-year incidence rates of all diagnoses were higher among T1D and T2D (p<0.0001), except OA of the CMC-1 joint in men with T1D (p=0.055). CONCLUSIONS CTS, UNE, and possibly also OA of the CMC-1 joint should be included together with TF and DD when referring to 'the diabetic hand'. The incidence of hand disorders was up to eight times higher among T1D, and both T1D and T2D had more concomitant prevalent diagnoses compared with the population without DM. Future studies should elucidate the pathophysiology behind diabetic hand complications to enable development of effective preventive measures in patients with diabetes.
Collapse
Affiliation(s)
- Mattias Rydberg
- Department of Translational Medicine-Hand Surgery, Lund University, Malmo, Sweden
- Hand Surgery, Skåne University Hospital, Malmo, Sweden
| | - Malin Zimmerman
- Department of Translational Medicine-Hand Surgery, Lund University, Malmo, Sweden
- Hand Surgery, Skåne University Hospital, Malmo, Sweden
| | | | - Ann-Marie Svensson
- National Diabetes Register, Centre of Registers in Region Västra Götaland, Gothenburg, Sweden
- Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Katarina Eeg-Olofsson
- Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Lars B Dahlin
- Department of Translational Medicine-Hand Surgery, Lund University, Malmo, Sweden
- Hand Surgery, Skåne University Hospital, Malmo, Sweden
| |
Collapse
|
12
|
Marques Miranda C, de Lima Campos M, Leite-Almeida H. Diet, body weight and pain susceptibility - A systematic review of preclinical studies. NEUROBIOLOGY OF PAIN (CAMBRIDGE, MASS.) 2021; 10:100066. [PMID: 34195483 PMCID: PMC8237587 DOI: 10.1016/j.ynpai.2021.100066] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/26/2021] [Accepted: 06/11/2021] [Indexed: 02/07/2023]
Abstract
Obesity has been associated with increased chronic pain susceptibility but causes are unclear. In this review, we systematize and analyze pain outcomes in rodent models of obesity as these can be important tools for mechanistic studies. Studies were identified using MEDLINE/PubMed and Scopus databases using the following search query: (((pain) OR (nociception)) AND (obesity)) AND (rat OR (mouse) OR (rodent))). From each eligible record we extracted the following data: species, strain, sex, pain/obesity model and main behavioral readouts. Out of 695 records 33 were selected for inclusion. 27 studies assessed nociception/acute pain and 17 studies assessed subacute or chronic pain. Overall genetic and dietary models overlapped in pain-related outcomes. Most acute pain studies reported either decreased or unaltered responses to noxious painful stimuli. However, decreased thresholds to mechanical innocuous stimuli, i.e. allodynia, were frequently reported. In most studies using subacute and chronic pain models, namely of subcutaneous inflammation, arthritis and perineural inflammation, decreased thresholds and/or prolonged pain manifestations were reported in obesity models. Strain comparisons and longitudinal observations indicate that genetic factors and the time course of the pathology might account for some of the discrepancies observed across studies. Two studies reported increased pain in animals subjected to high fat diet in the absence of weight gain. Pain-related outcomes in experimental models and clinical obesity are aligned indicating that the rodent can be an useful tool to study the interplay between diet, obesity and pain. In both cases weight gain might represent only a minor contribution to abnormal pain manifestation.
Collapse
Affiliation(s)
- Carolina Marques Miranda
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
- ICVS/3B’s - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Mariana de Lima Campos
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
- ICVS/3B’s - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Hugo Leite-Almeida
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
- ICVS/3B’s - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| |
Collapse
|
13
|
Current Epidemiology and Risk Factors for the Development of Hand Osteoarthritis. Curr Rheumatol Rep 2021; 23:61. [PMID: 34216294 DOI: 10.1007/s11926-021-01025-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2021] [Indexed: 12/23/2022]
Abstract
PURPOSE OF REVIEW Hand osteoarthritis (hand OA), the most common peripheral arthritis in the world, is less studied than osteoarthritis (OA) of the knee and hip. However, it is uniquely situated to offer novel insight into OA as a disease process by removing weight-bearing as a confounder of systemic disease mechanisms. Here we review the epidemiology of hand OA and key risk factors for its development. RECENT FINDINGS Mounting evidence points to obesity as an important risk factor for hand OA development, with new evidence implicating a role for leptin and serum fatty acids. Disease progression in hand OA and specifically the erosive OA subtype may be associated with diabetes. New evidence supports an association between cardiovascular disease progression and symptomatic hand OA. Alcohol use may be associated with increased synovitis and erosive hand OA. Differences in ethnical distributions of hand OA have become more apparent, with a lower prevalence in Black patients compared to White patients. Novel genetic insights implicating the WNT gene pathway and IL-1β have led to novel potential targets in hand OA pathogenesis. Hand OA is a heterogeneous disease with many modifiable and non-modifiable risk factors that can determine disease severity and shed light on disease pathogenesis.
Collapse
|
14
|
Müller-Ladner U, Frommer K, Karrasch T, Neumann E, Schäffler A. [The effect of obesity on disease activity of inflammatory rheumatic diseases]. Z Rheumatol 2021; 80:353-361. [PMID: 33774725 DOI: 10.1007/s00393-021-00987-4] [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] [Accepted: 02/23/2021] [Indexed: 11/26/2022]
Abstract
One of the most recent scientific fields is the interaction between the immune system and metabolic processes. These interactions increasingly involve intracellular and extracellular signaling molecules and their receptors as well as molecular mechanisms that are used by both systems. The result of these intensive interactions is characterized by the term "metaflammation" and involves in particular, the ubiquitous adipose tissue present throughout the body. The links identified to date between the immune system and metabolism play a greater role in inflammatory rheumatic joint diseases than previously thought. In general, a markedly high body mass index (BMI) in particular, is associated with increased inflammatory activity and this is independent of the underlying disease entity. A higher BMI at the beginning of an immunomodulatory therapy also causes a more difficult response to the medication. Thus, the current scientific objective is to identify the individual "immuno-metabolic" pathways in order to apply the medications specifically to the site of action. Furthermore, all newer therapeutic agents, especially those specifically acting against individual immunological molecules, should be systematically analyzed with respect to their metabolic concomitant effects and their influence on metabolic comorbidities.
Collapse
Affiliation(s)
- Ulf Müller-Ladner
- Abteilung für Rheumatologie und Klinische Immunologie, Justus-Liebig-Universität Gießen, Campus Kerckhoff, Benekestr. 2-8, 61231, Bad Nauheim, Deutschland.
| | - Klaus Frommer
- Abteilung für Rheumatologie und Klinische Immunologie, Justus-Liebig-Universität Gießen, Campus Kerckhoff, Benekestr. 2-8, 61231, Bad Nauheim, Deutschland
| | - Thomas Karrasch
- Klinik und Poliklinik für Innere Medizin III - Endokrinologie und Diabetologie, Justus-Liebig Universität Gießen, Universitätsklinikum Gießen und Marburg, Standort Gießen, Gießen, Deutschland
| | - Elena Neumann
- Abteilung für Rheumatologie und Klinische Immunologie, Justus-Liebig-Universität Gießen, Campus Kerckhoff, Benekestr. 2-8, 61231, Bad Nauheim, Deutschland
| | - Andreas Schäffler
- Klinik und Poliklinik für Innere Medizin III - Endokrinologie und Diabetologie, Justus-Liebig Universität Gießen, Universitätsklinikum Gießen und Marburg, Standort Gießen, Gießen, Deutschland
| |
Collapse
|