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Huang C, Guo Z, Feng Z, Xu J, Pan Z, Liu W, Duan L, Gu E. Comparative study on the association between types of physical activity, physical activity levels, and the incidence of osteoarthritis in adults: the NHANES 2007-2020. Sci Rep 2024; 14:20574. [PMID: 39232062 PMCID: PMC11374984 DOI: 10.1038/s41598-024-71766-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Accepted: 08/30/2024] [Indexed: 09/06/2024] Open
Abstract
It is known that physical activity is beneficial for the prevention of osteoarthritis (OA), but specific discussions on which types and levels of physical activity are more effective in reducing the incidence of OA are restricted. This study is aimed at exploring the correlation concerning the types of physical activity, levels of physical activity, and the incidence of OA by assessing the participation in five typical forms of physical activity (vigorous work activity, vigorous recreational activity, moderate work activity, moderate recreational activity, and walking or bicycling). Cross-sectional study was conducted. Self-reported data on specific types of physical activity were obtained from individuals in the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2020 with the use of the Physical Activity Questionnaire (PAQ). The incidence of OA was assessed through the "Health Conditions" questionnaire section of NHANES. Weighted logistic regression analysis was employed to study the correlation between physical activity types and levels, and the incidence of OA. Different kinds of physical activity and physical activity levels have varying impacts on the incidence of OA. Among the types of physical activity, vigorous recreational activity and moderate recreational activity are found to have a preventive effect on OA. In terms of physical activity levels, low physical activity levels of moderate work activity are associated with an increased risk of OA, while moderate physical activity levels are confirmed to have a protective effect against OA in the age groups of 20-44 and 45-64. However, gender-stratified analyses reveal that both low and moderate physical activity levels provide protection against OA in males, with moderate physical activity levels showing a more significant protective effect.
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Affiliation(s)
- Chenyang Huang
- Orthopedics Department, The First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300000, People's Republic of China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300000, People's Republic of China
| | - Ziyu Guo
- Orthopedics Department, The First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300000, People's Republic of China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300000, People's Republic of China
| | - Zhixiao Feng
- Orthopedics Department, The First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300000, People's Republic of China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300000, People's Republic of China
| | - Jiankang Xu
- Orthopedics Department, The First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300000, People's Republic of China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300000, People's Republic of China
| | - Zhicheng Pan
- The Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Wangxin Liu
- The Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Liqiang Duan
- Binhai New Area Traditional Chinese Medicine Hospital, Tianjin, China.
| | - Enpeng Gu
- The Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.
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Cance N, Batailler C, Lording T, Schmidt A, Lustig S, Servien E. Ten-year minimal follow-up of lateral opening wedge distal femoral osteotomy for lateral femorotibial osteoarthritis: Good survivorship and high patient satisfaction. Knee Surg Sports Traumatol Arthrosc 2024. [PMID: 39105436 DOI: 10.1002/ksa.12404] [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: 04/19/2024] [Revised: 07/23/2024] [Accepted: 07/25/2024] [Indexed: 08/07/2024]
Abstract
PURPOSE This study aimed (1) to determine complications and survival rates of lateral opening wedge distal femoral osteotomy (LOW-DFO) in the long term, (2) to assess their clinical outcomes in the long term and (3) to identify risk factors of failure. METHODS Between 1991 and 2011, 62 LOW-DFOs were performed in the same department. Inclusion criteria were all isolated LOW-DFO performed for isolated lateral tibiofemoral osteoarthritis and valgus malalignment, with a minimum 10-year follow-up. Thirty-eight patients were included, with a mean age of 48 ± 9 years. All patients had clinical and radiological assessments. The survival curves were calculated based on the following endpoints: unicompartmental or total knee arthroplasty. RESULTS The mean follow-up was 15.2 ± 4.4 [10-29] years. The mean preoperative mechanical FemoroTibial Axis (mFTA) was 188.8° ± 3.2° [184°-197°], primarily due to femur deformity (mean lateral distal femoral axis [LDFA] 83.2° ± 2.8°). Bone union was achieved in 89.5% of patients (n = 34) at a mean delay of 6.5 ± 6.7 months. The complication rate was 26% (five stiffness, one nonunion, three secondary displacements and one deep vein thrombosis). Nine revision surgeries (24%) were recorded. Survival rates at 5 and 10 years were 92.1% and 78.9%, respectively. The mean delay between DFO and total knee arthroplasty (TKA) was 11.6 ± 5.7 [1-27] years. Nineteen patients (50%) were free of TKA at the last follow-up. KSS scores were improved significantly. Return to sports was obtained in 92% of cases (n = 35), with a mean delay of 11 ± 8 months. Seventy-four per cent of patients were satisfied or very satisfied with the surgery. Eighty-four per cent would be willing to undergo the surgery again. Older age (p = 0.032) was a significant risk factor for TKA conversion. CONCLUSION LOW-DFO is an efficient procedure to manage lateral knee osteoarthritis in young patients with valgus deformity, with a good survival rate at 10 years and high patient satisfaction. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Nicolas Cance
- Orthopedic Surgery Department, Croix-Rousse Hospital, Lyon, France
| | - Cécile Batailler
- Orthopedic Surgery Department, Croix-Rousse Hospital, Lyon, France
- Univ Lyon, Université Claude Bernard Lyon 1, IFSTTAR, Villeurbanne, France
| | | | - Axel Schmidt
- Orthopedic Surgery Department, Croix-Rousse Hospital, Lyon, France
| | - Sébastien Lustig
- Orthopedic Surgery Department, Croix-Rousse Hospital, Lyon, France
- Univ Lyon, Université Claude Bernard Lyon 1, IFSTTAR, Villeurbanne, France
| | - Elvire Servien
- Orthopedic Surgery Department, Croix-Rousse Hospital, Lyon, France
- IBM - EA 7424, Interuniversity Laboratory of Biology of Mobility, Claude Bernard Lyon 1 University, Lyon, France
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Finger FC, Schröter S, Ihle C, Herbst M, Histing T, Ahrend MD. Postoperative management following osteotomies around the knee: a narrative review. EFORT Open Rev 2024; 9:658-667. [PMID: 38949151 PMCID: PMC11297401 DOI: 10.1530/eor-23-0153] [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] [Indexed: 07/02/2024] Open
Abstract
The present narrative review provides a summary of postoperative therapy modalities and their effectiveness following osteotomies around the knee. The topics that are discussed in the scientific discourse include support of cartilage cell regeneration, pain management, drainage insertion, tourniquet use, pharmacological and mechanical thromboembolism prophylaxis, weight-bearing protocols and bone consolidation. There is evidence for the use of pharmacological thromboembolism prophylaxis and weight-bearing protocols. A standardized postoperative treatment concept following osteotomies around the knee cannot be derived due to lack of evidence for the other topics in current literature.
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Affiliation(s)
- Felix Christoph Finger
- BG Klinik Tübingen, Department of Traumatology and Reconstructive Surgery, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Steffen Schröter
- Diakonie Klinikum Jung-Stilling GmbH, Department of Trauma and Reconstructive Surgery, Siegen, Germany
- Osteotomie Komitee der Deutschen Knie Gesellschaft (DKG), Munich, Germany
| | - Christoph Ihle
- BG Klinik Tübingen, Department of Traumatology and Reconstructive Surgery, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Moritz Herbst
- BG Klinik Tübingen, Department of Traumatology and Reconstructive Surgery, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Tina Histing
- BG Klinik Tübingen, Department of Traumatology and Reconstructive Surgery, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Marc-Daniel Ahrend
- BG Klinik Tübingen, Department of Traumatology and Reconstructive Surgery, Eberhard Karls University of Tübingen, Tübingen, Germany
- Osteotomie Komitee der Deutschen Knie Gesellschaft (DKG), Munich, Germany
- AO Research Institute Davos, Davos, Switzerland
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Tanaka A, Matsushita T, Nakatsuji T, Katsui Y, Nagai K, Nishida K, Mukai T, Kuroda R. Setting hinge position distal to the proximal margin of the distal lateral femur reduces the maximum principal strains of the hinge area and risk of hinge fractures. J Exp Orthop 2024; 11:e12015. [PMID: 38590755 PMCID: PMC11000132 DOI: 10.1002/jeo2.12015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 03/06/2024] [Indexed: 04/10/2024] Open
Abstract
Purpose The optimal hinge position to prevent hinge fractures in medial closing wedge distal femoral osteotomy (MCWDFO) based on the biomechanical background has not yet been well examined. This study aimed to examine the appropriate hinge position in MCWDFO using finite element (FE) analysis to prevent hinge fractures. Methods Computer-aided design (CAD) models were created using composite replicate femurs. FE models of the MCWDFO with a 5° wedge were created with three different hinge positions: (A) 5 mm proximal to the proximal margin of the lateral epicondylar region, (B) proximal margin level and (C) 5 mm distal to the proximal margin level. The maximum and minimum principal strains in the cortical bone were calculated for each model. To validate the FE analysis, biomechanical tests were performed using composite replicate femurs with the same hinge position models as those in the FE analysis. Results In the FE analysis, the maximum principal strains were in the order of Models A > B > C. The highest value of maximum principal strain was observed in the area proximal to the hinge. In the biomechanical test, hinge fractures occurred in the area proximal to the hinge in Models A and B, whereas the gap closed completely without hinge fractures in Model C. Fractures occurred in an area similar to where the highest maximal principal strain was observed in the FE analysis. Conclusion Distal to the proximal margin of the lateral epicondylar region is an appropriate hinge position in MCWDFO to prevent hinge fractures. Level of Evidence Level V.
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Affiliation(s)
- Atsuki Tanaka
- Department of Orthopaedic SurgeryKobe University Graduate School of MedicineKobeHyogoJapan
| | - Takehiko Matsushita
- Department of Orthopaedic SurgeryKobe University Graduate School of MedicineKobeHyogoJapan
| | - Tatsuya Nakatsuji
- Department of Mechanical EngineeringKobe University Graduate School of EngineeringKobeHyogoJapan
| | - Yosuke Katsui
- Department of Mechanical EngineeringKobe University Graduate School of EngineeringKobeHyogoJapan
| | - Kanto Nagai
- Department of Orthopaedic SurgeryKobe University Graduate School of MedicineKobeHyogoJapan
| | - Kyohei Nishida
- Department of Orthopaedic SurgeryKobe University Graduate School of MedicineKobeHyogoJapan
| | - Toshiji Mukai
- Department of Mechanical EngineeringKobe University Graduate School of EngineeringKobeHyogoJapan
| | - Ryosuke Kuroda
- Department of Orthopaedic SurgeryKobe University Graduate School of MedicineKobeHyogoJapan
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Allahabadi S, Haneberg EC, Elias TJ, Cole BJ, Yanke AB. Lateral Opening-Wedge Distal Femoral Osteotomy Made Easy: Tips and Tricks. Arthrosc Tech 2024; 13:102816. [PMID: 38312890 PMCID: PMC10837839 DOI: 10.1016/j.eats.2023.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 08/26/2023] [Indexed: 02/06/2024] Open
Abstract
A lateral opening-wedge distal femoral osteotomy is useful to offload the lateral tibiofemoral compartment for focal chondral defects or isolated lateral compartment arthritis. Although beneficial for these lateral compartment disorders, a distal femoral osteotomy requires careful forethought to optimize correction accuracy and safety. We recommend the following for effective execution of a distal femoral osteotomy: (1) Plan the desired correction preoperatively while accounting for an individual patient's anatomy and femoral width. (2) Perform an iliotibial band Z-lengthening for large deformity corrections to not overconstrain the lateral structures. (3) Use the plate to help guide the level of the osteotomy, which will facilitate bony contact after the osteotomy and decrease plate prominence. (4) Perform the osteotomy with a saw anteriorly and an osteotome posteriorly for safety and stop the osteotomy approximately 1 cm short of the far cortex. (5) Fashion tricortical wedge grafts at the height of the planned correction to maintain reduction and facilitate plate placement. (6) Control the plate position to lie optimally at the level of the osteotomy, ensuring it is not proud and is parallel with the femoral shaft. With these presurgical and intraoperative steps, a lateral opening-wedge distal femoral osteotomy can be performed effectively.
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Affiliation(s)
| | - Erik C. Haneberg
- Midwest Orthopaedics at Rush University, Chicago, Illinois, U.S.A
| | - Tristan J. Elias
- Midwest Orthopaedics at Rush University, Chicago, Illinois, U.S.A
| | - Brian J. Cole
- Midwest Orthopaedics at Rush University, Chicago, Illinois, U.S.A
| | - Adam B. Yanke
- Midwest Orthopaedics at Rush University, Chicago, Illinois, U.S.A
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Reif TJ, Greenstein MD, Greenberg M, Rozbruch SR. Distal Femoral Osteotomy for the Management of Coronal Deformity Following Total Knee Arthroplasty: A Report of 2 Cases. JBJS Case Connect 2024; 14:01709767-202403000-00007. [PMID: 38207074 DOI: 10.2106/jbjs.cc.23.00378] [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: 01/13/2024]
Abstract
CASE We present 2 cases demonstrating the management of coronal malalignment with an existing total knee arthroplasty using opening wedge distal femur osteotomy. The mechanical axis was corrected, and the primary total knee implants were maintained. Patients resumed full activity 3 to 4 months after surgery. CONCLUSION In certain cases, opening wedge distal femoral osteotomy is an option to correct coronal malalignment with an existing total knee arthroplasty without revising the implant.
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Affiliation(s)
- Taylor J Reif
- Limb Lengthening and Complex Reconstruction Service, Hospital for Special Surgery, New York, New York
| | - Michael D Greenstein
- Limb Lengthening and Complex Reconstruction Service, Hospital for Special Surgery, New York, New York
| | - Michael Greenberg
- Limb Lengthening and Complex Reconstruction Service, Hospital for Special Surgery, New York, New York
- Weill Cornell Medical College, New York, New York
| | - S Robert Rozbruch
- Limb Lengthening and Complex Reconstruction Service, Hospital for Special Surgery, New York, New York
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