Low back pain and radiographic severity as predictors in hip osteoarthritis patients receiving steroid injection therapy

Prevalence of low back pain and related disability in patients with femoroacetabular impingement syndrome

BACKGROUND

Low back pain (LBP) has been associated with worse hip function for persons with femoroacetabular impingement syndrome (FAIS). Reports are limited to surgical populations and based on the presence or absence of LBP, regardless of pain severity.

OBJECTIVES

To report the prevalence of clinically significant LBP for persons with FAIS; compare demographics, pain, and function between those with and without clinically significant LBP; and evaluate relationships between hip function and both LBP-related disability and LBP severity. We hypothesized that participants with LBP would be older, have higher body mass index (BMI), and report worse groin pain, longer symptom duration, and worse hip function. We hypothesized that worse LBP-related disability and LBP severity would be related to worse hip function.

DESIGN

Observational cross-sectional study.

SETTING

Hip preservation clinic.

PARTICIPANTS

158 persons with FAIS.

INTERVENTIONS

n/a MAIN OUTCOME MEASURE(S): Visual analog pain scales (VAS 0-100) were used to categorize participants with (≥30) and without (<30) clinically significant LBP. Age, sex, BMI, pain severity and duration, and hip function (33-item Hip Outcome Tool [iHOT33]) were compared between those with and without clinically significant LBP. Correlations were evaluated between the modified Oswestry Disability Index (ODI) and iHOT33, ODI and groin pain severity, LBP severity and iHOT33, and LBP and groin pain severity.

RESULTS

Sixty percent of participants reported clinically significant LBP (n = 95). These participants reported worse iHOT33 scores (mean difference: 10.1 points) than those without clinically significant LBP (p = .001). Worse ODI scores were associated with worse iHOT33 scores (P < .001; ρ = -0.74). Significant relationships were also observed between (1) ODI and groin pain, (2) LBP and iHOT33, and (3) LBP and groin pain, but the magnitudes of these correlations were weak (ρ ≤ 0.36).

CONCLUSIONS

Clinically significant LBP is highly prevalent in persons with FAIS and is associated with worse hip function. Worse LBP-related disability, but not LBP severity, was strongly associated with worse hip function.

[A study of low back pain and changes in spinal sagittal parameters after total hip arthroplasty in patients with unilateral Crowe type developmental dysplasia of the hip]

Objective

To investigate the changes of low back pain (LBP) and spinal sagittal parameters in patients with unilateral Crowe type Ⅳ developmental dysplasia of the hip (DDH) after total hip arthroplasty (THA).

Methods

The clinical data of 30 patients who met the selection criteria between October 2018 and March 2020 were retrospectively analyzed. Patients were divided into LBP group (16 cases) and control group (14 cases) according to whether there was LBP before operation. There was no significant difference between the two groups of patients in gender, age, body mass index, affected sides, preoperative Harris score ( P>0.05). Full-length lateral X-ray films of the spine were taken within 1 week before operation and at 1 year after operation, and the following imaging indicators were measured: sacral slope (SS), lumbar lordosis (LL ), spinal tilt (ST), spine-sacral angle (SSA), sagittal vertebral axis (SVA). The visual analogue scale (VAS) score, lumbar Oswestry disability index (ODI), the Harris score of the hip joint before operation and at 1 year after operation, and the occurrence of postoperative complications were collected and analysed.

Results

In the LBP group, LBP was relieved to varying degrees at 1 year after operation, of which 13 patients (81.3%) had complete LBP remission; VAS score decreased from 4.9±2.3 preoperatively to 0.3±0.8, ODI decreased from 33.5±22.6 preoperatively to 1.3±2.9, the differences were all significant ( t=7.372, P=0.000; t=5.499, P=0.000). There was no new chronic LBP in the control group during follow-up. The Harris scores of the two groups significantly improved when compared with those before operation ( P<0.05); there was no significant difference between the two groups at 1 year after operation ( t=0.421, P=0.677). There was no significant difference in imaging indexes between the two groups before operation and the difference between pre- and post-operation ( P>0.05). At 1 year after operation, ST and SVA in the LBP group, SSA in the control group, and SS in the two groups significantly improved when compared with those before operation ( P<0.05); there was no significant difference in the other indexes between the two groups before and after operation ( P>0.05).

Conclusion

Unilateral Crowe type Ⅳ DDH patients with LBP before operation were all relieved of LBP after THA. The relief of LBP may be related to the improvement of spinal balance, but not to lumbar lordosis and its changes.

RIP2 knockdown inhibits cartilage degradation and oxidative stress in IL-1β-treated chondrocytes via regulating TRAF3 and inhibiting p38 MAPK pathway

Receptor-interacting protein 2 (RIP2) is a key mediator implicated in multiple cellular processes, and its dysregulation has been recently reported in colitis, asthma and other inflammatory diseases. However, the effects of RIP2 on osteoarthritis (OA) and the underlying mechanisms remain unclear. In this study, we found that RIP2 expression was upregulated in human articular cartilage tissues with OA and interleukin-1β (IL-1β)-treated chondrocytes. Knockdown of RIP2 inhibited IL-1β-induced extracellular matrix (ECM) and oxidative stress. Moreover, knockdown of TRAF3 reversed the effects of RIP2 silencing on cartilage degradation and oxidative stress in IL-1β-induced chondrocytes. In addition, p38 mitogen-activated protein kinase (MAPK) activator dehydrocorydalmine chloride (Dc) also reversed the effects of RIP2 silencing on IL-1β-induced chondrocytes. Taken together, our data reveal that RIP2 knockdown inhibits cartilage degradation and oxidative stress in IL-1β-treated chondrocytes by regulating TRAF3 expression and p38 MAPK pathway activation.