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Yau MS, Jonsson H, Lynch JA, Lewis CE, Torner JC, Nevitt MC, Felson DT. Do associations with hand OA vary by knee osteoarthritis phenotype? Cross-sectional data from the Multicenter Osteoarthritis Study. OSTEOARTHRITIS AND CARTILAGE OPEN 2023; 5:100331. [PMID: 36605850 PMCID: PMC9807822 DOI: 10.1016/j.ocarto.2022.100331] [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: 06/25/2022] [Revised: 12/07/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
Objective Osteoarthritis (OA) is highly heterogeneous and has both biomechanical and systemic components that may not have the same etiology. We therefore aimed to identify specific knee OA phenotypes that may be more strongly associated with hand OA to refine the criteria used to define multi-joint OA. Design We assessed data from the Multicenter Osteoarthritis Study (MOST). We ascertained hand OA from bilateral hand photographs; scores for each joint row were summed to yield an aggregate hand OA score. Knee OA was ascertained from bilateral posteroanterior knee radiographs read for Kellgren-Lawrence grade and individual radiographic features. We tested associations between hand and knee OA with phenotypes including symptomatic OA, hyper- and atrophic knee OA, and one excluding post-traumatic OA. Associations between hand and knee OA were assessed with logistic regression, adjusted for age. Results We studied 2493 participants with hand and knee OA measures. Median age was 63 years with 57% women. 55% had an aggregate hand OA score ≥2; frequency of knee OA phenotypes ranged from 8% to 34%. The age-adjusted odds ratio (OR) was 1.14 (95% confidence interval (CI) = 1.04-1.26) for knee OA per standard deviation of the hand OA aggregate score. Hand OA associations with symptomatic knee OA and knee OA excluding post-traumatic knee OA were OR = 1.16 (95% CI = 1.03-1.31) and OR = 1.21 (95% CI = 1.08-1.35), respectively. No other knee OA phenotype reached statistical significance. Conclusions Age-adjusted associations between hand and knee OA were modest and were largely similar across knee OA phenotypes.
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Affiliation(s)
- Michelle S. Yau
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA
- Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Helgi Jonsson
- Department of Rheumatology, Landspitalinn University Hospital, University of Iceland, Reykjavik, Iceland
| | - John A. Lynch
- MRI Quality Assurance, Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Cora E. Lewis
- Division of Preventive Medicine, Department of Epidemiology, University of Alabama, Birmingham, AL, USA
| | - James C. Torner
- Department of Epidemiology, University of Iowa, Iowa City, IA, USA
| | - Michael C. Nevitt
- Department of Epidemiology & Biostatistics, University of California, San Francisco, USA
| | - David T. Felson
- Section of Rheumatology, Department of Medicine, Boston University School of Medicine, USA
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2
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T. J, Stewart CJ, Tong PY, Lam WL, Rajaratnam V. Comparison of Prevalence of Osteoarthritis in the Hand: A Multicenter Retrospective Cohort Study. J Hand Microsurg 2022; 14:284-291. [PMID: 36398154 PMCID: PMC9666057 DOI: 10.1055/s-0040-1715927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Introduction Several studies have previously been undertaken to investigate the prevalence of radiologic hand osteoarthritis (OA) in Caucasian, Japanese, Chinese, and Arabic populations. To date, there has been no direct international comparison study on the prevalence of radiologic hand OA between a Western and a Southeast Asian population. We hypothesize that there is difference in the pattern of joint involvement among individuals of both populations. Materials and Methods Consecutive hand radiographs from individuals aged 60 years and above were reviewed. Radiographic evidence of osteoarthritis in the various joints in the hands was graded using Kellgren-Lawrence (K-L) score. Chi-square test, Fisher's exact test, or Student's t -test was used as appropriate. Multiple logistic regression analysis was performed to evaluate the associations and relationships of radiographic hand OA between joints. Results A total of 194 patients exhibited radiographic OA. Singaporean patients were more likely to have radiographic OA of the thumb interphalangeal joint (IPJ) (65.1%) compared with the thumb carpometacarpal joint (CMCJ; 40.2%); British patients were more likely to have CMCJ (43.3%) OA than thumb IPJ (21.0%). The difference was statistically significant ( p = 0.00026). In the Singapore population, it was more likely that a patient had concurrent OA of both thumb and finger joints, whereas in the British population, this was apparent in only the above-80-year-old group. The most commonly affected joint was the left thumb IPJ (joint specific prevalence of 35%) in the Singapore population, and the right index finger distal interphalangeal joint (DIPJ; joint specific prevalence of 41.5%) in the British population. Conclusion Our study, the first study to compare between Singaporean and British populations, showed statistically significant difference in the prevalence of OA in the hands. These findings suggest ethnic and cultural factors play a part in such a distribution trend.
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Affiliation(s)
- Jegathesan T.
- Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Novena, Singapore
| | - Camilla J. Stewart
- Department of Plastic Surgery, Chelsea and Westminster Hospital, United Kingdom
| | - Pei Y. Tong
- Department of Orthopaedic Surgery, Khoo Teck Puat Hospital, Singapore
| | - Wee L. Lam
- Department of Plastic Surgery, St John's Hospital, Livingston, United Kingdom
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3
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Wallace IJ, Lea AJ, Lim YAL, Chow SKW, Sayed IBM, Ngui R, Shaffee MTH, Ng KS, Nicholas C, Venkataraman VV, Kraft TS. Orang Asli Health and Lifeways Project (OA HeLP): a cross-sectional cohort study protocol. BMJ Open 2022; 12:e058660. [PMID: 36127083 PMCID: PMC9490611 DOI: 10.1136/bmjopen-2021-058660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Non-communicable disease (NCD) risk is influenced by environmental factors that are highly variable worldwide, yet prior research has focused mainly on high-income countries where most people are exposed to relatively homogeneous and static environments. Understanding the scope and complexity of environmental influences on NCD risk around the globe requires more data from people living in diverse and changing environments. Our project will investigate the prevalence and environmental causes of NCDs among the indigenous peoples of Peninsular Malaysia, known collectively as the Orang Asli, who are currently undergoing varying degrees of lifestyle and sociocultural changes that are predicted to increase vulnerability to NCDs, particularly metabolic disorders and musculoskeletal degenerative diseases. METHODS AND ANALYSIS Biospecimen sampling and screening for a suite of NCDs (eg, cardiovascular disease, type II diabetes, osteoarthritis and osteoporosis), combined with detailed ethnographic work to assess key lifestyle and sociocultural variables (eg, diet, physical activity and wealth), will take place in Orang Asli communities spanning a gradient from remote, traditional villages to acculturated, market-integrated urban areas. Analyses will first test for relationships between environmental variables, NCD risk factors and NCD occurrence to investigate how environmental changes are affecting NCD susceptibility among the Orang Asli. Second, we will examine potential molecular and physiological mechanisms (eg, epigenetics and systemic inflammation) that mediate environmental effects on health. Third, we will identify intrinsic (eg, age and sex) and extrinsic (eg, early-life experiences) factors that predispose certain people to NCDs in the face of environmental change to better understand which Orang Asli are at greatest risk of NCDs. ETHICS AND DISSEMINATION Approval was obtained from multiple ethical review boards including the Malaysian Ministry of Health. This study follows established principles for ethical biomedical research among vulnerable indigenous communities, including fostering collaboration, building cultural competency, enhancing transparency, supporting capacity building and disseminating research findings.
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Affiliation(s)
- Ian J Wallace
- Department of Anthropology, University of New Mexico, Albuquerque, New Mexico, USA
| | - Amanda J Lea
- Department of Biological Sciences, Vanderbilt University, Nashville, Tennessee, USA
- Child and Brain Development Program, CIFAR, Toronto, Ontario, Canada
| | - Yvonne A L Lim
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Steven K W Chow
- Federation of Private Medical Practitioners' Associations of Malaysia, Kuala Lumpur, Malaysia
- Pantai Hospital, Kuala Lumpur, Malaysia
| | | | - Romano Ngui
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | | | - Kee-Seong Ng
- Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | | | - Vivek V Venkataraman
- Department of Anthropology and Archaeology, University of Calgary, Calgary, Alberta, Canada
| | - Thomas S Kraft
- Department of Anthropology, University of Utah, Salt Lake City, Utah, USA
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4
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Louvion E, Santos C, Samuel D. Rehabilitation after proximal interphalangeal joint replacement: A structured review of the literature. HAND SURGERY & REHABILITATION 2021; 41:14-21. [PMID: 34619399 DOI: 10.1016/j.hansur.2021.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/07/2021] [Accepted: 09/14/2021] [Indexed: 11/29/2022]
Abstract
Proximal interphalangeal (PIP) joint arthroplasty is an unsolved biomechanical challenge despite advances in materials and new implant designs. This leads to a high rate of complications. Moreover, there is heterogeneity in postoperative management according to the literature. The present structured review examined the therapeutic strategies utilized by physiotherapists to restore a functional finger chain and prevent postoperative complications following PIP joint replacement. Patients undergoing primary total PIP joint arthroplasty of the index, ring, middle or little finger were included. Articles published from 2008 onwards, in French or English, and reporting on PIP joint replacement and postoperative management, were included. Therapeutic strategies were organized according to the surgical approach. Details of splint strategies, mobilization and muscle strengthening and management of postoperative complications were collected. Forty-eight studies, 3 of which provided a description of surgical techniques, were included. In relation to hand function, most authors advocated joint mobilization (n = 45) and some recommended muscle strengthening (n = 4). Static (n = 43) and dynamic splints (n = 14) and buddy taping (n = 12) were frequently recommended to prevent and manage postoperative complications. Few studies (n = 13) reported wound assessment or control of postoperative edema. Precise recommendations concerning therapeutic strategies following PIP joint arthroplasty cannot be made based on available evidence. Specific protocols for rehabilitation following PIP joint replacement need to be clarified in future research.
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Affiliation(s)
- E Louvion
- Institut de formation en Masso-Kinésithérapie de Dijon, 6 Bis Rue de Cromois, 21000 Dijon, France.
| | - C Santos
- Institut de formation en Masso-Kinésithérapie de Dijon, 6 Bis Rue de Cromois, 21000 Dijon, France.
| | - D Samuel
- Faculty of Environmental and Life Sciences, University of Southampton, Southampton SO17 1BJ, United Kingdom.
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5
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Styrkarsdottir U, Lund SH, Saevarsdottir S, Magnusson MI, Gunnarsdottir K, Norddahl GL, Frigge ML, Ivarsdottir EV, Bjornsdottir G, Holm H, Thorgeirsson G, Rafnar T, Jonsdottir I, Ingvarsson T, Jonsson H, Sulem P, Thorsteinsdottir U, Gudbjartsson D, Stefansson K. The CRTAC1 protein in plasma associates with osteoarthritis and predicts progression to joint replacements: a large-scale proteomics scan in Iceland. Arthritis Rheumatol 2021; 73:2025-2034. [PMID: 33982893 PMCID: PMC8596997 DOI: 10.1002/art.41793] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 04/27/2021] [Indexed: 11/17/2022]
Abstract
Objective Biomarkers for diagnosis and progression of osteoarthritis (OA) are lacking. This study was undertaken to identify circulating biomarkers for OA that could predict disease occurrence and/or progression to joint replacement. Methods Using the SomaScan platform, we measured 4,792 proteins in plasma from 37,278 individuals, of whom 12,178 individuals had OA and 2,524 had undergone joint replacement. We performed a case–control study for identification of potential protein biomarkers for hip, knee, and/or hand OA, and a prospective study for identification of biomarkers for joint replacement. Results Among the large panel of plasma proteins assessed, cartilage acidic protein 1 (CRTAC1) was the most strongly associated with both OA diagnosis (odds ratio 1.46 [95% confidence interval 1.41–1.52] for knee OA, odds ratio 1.36 [95% confidence interval 1.29–1.43] for hip OA, and odds ratio 1.33 [95% confidence interval 1.26–1.40] for hand OA) and progression to joint replacement (hazard ratio 1.40 [95% confidence interval 1.30–1.51] for knee replacement and hazard ratio 1.31 [95% confidence interval 1.19–1.45] for hip replacement). Patients with OA who were in the highest quintile of risk of joint replacement, based on known risk factors (i.e., age, sex, and body mass index) and plasma CRTAC1 level, were 16 times more likely to undergo knee replacement within 5 years of plasma sample collection than those in the lowest quintile, and 6.5 times more likely to undergo hip replacement. CRTAC1 was not associated with other types of inflammatory arthritis. A specific protein profile was identified in those patients who had undergone joint replacement prior to plasma sample collection. Conclusion Through a hypothesis‐free approach, we identified CRTAC1 in plasma as a novel promising candidate biomarker for OA that is both associated with occurrence of OA and predictive of progression to joint replacement. This biomarker might also be useful in the selection of suitable patients for clinical trial enrollment.
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Affiliation(s)
| | | | - Saedis Saevarsdottir
- deCODE genetics/Amgen Inc, Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Reykjavik, Iceland.,Department of Medicine, Landspitali The National University Hospital of Iceland, Reykjavik, Iceland.,Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | | | | | | | | | | | | | - Hilma Holm
- deCODE genetics/Amgen Inc, Reykjavik, Iceland
| | - Gudmundur Thorgeirsson
- deCODE genetics/Amgen Inc, Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Reykjavik, Iceland.,Department of Medicine, Landspitali The National University Hospital of Iceland, Reykjavik, Iceland
| | | | - Ingileif Jonsdottir
- deCODE genetics/Amgen Inc, Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Reykjavik, Iceland.,Department of Immunology, Landspitali The National University Hospital of Iceland, Reykjavik, Iceland
| | - Thorvaldur Ingvarsson
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland.,Department of Orthopedic Surgery, Akureyri Hospital, Akureyri, Iceland.,Institution of Health Science, University of Akureyri, Akureyri, Iceland
| | - Helgi Jonsson
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland.,Department of Medicine, Landspitali The National University Hospital of Iceland, Reykjavik, Iceland
| | | | - Unnur Thorsteinsdottir
- deCODE genetics/Amgen Inc, Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Daniel Gudbjartsson
- deCODE genetics/Amgen Inc, Reykjavik, Iceland.,School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | - Kari Stefansson
- deCODE genetics/Amgen Inc, Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
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6
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Froschauer SM, Holzbauer M, Hager D, Schnelzer R, Kwasny O, Duscher D. Elektra prosthesis versus resection-suspension arthroplasty for thumb carpometacarpal osteoarthritis: a long-term cohort study. J Hand Surg Eur Vol 2020; 45:452-457. [PMID: 31510855 PMCID: PMC7232778 DOI: 10.1177/1753193419873230] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 08/07/2019] [Accepted: 08/11/2019] [Indexed: 02/03/2023]
Abstract
The present study compares 34 patients with thumb carpometacarpal osteoarthritis (37 thumbs) treated with the Elektra® prosthesis, with 18 patients (18 thumbs) treated with resection-suspension arthroplasty, with an overall mean follow-up period of 13.3 years. Evaluation with disability of arm and shoulder scores, pain via visual analogue scale and range of motion (radial and palmar abduction, and opposition) indicated no significant difference. However, the cohort with a surviving prosthesis showed significantly better subjective grip strength (p = 0.04). Complications occurred in 23 of the 37 thumbs in the prosthesis group compared with two in the resection-suspension arthroplasty patients. Seventeen prostheses required revision. At revision operations, we observed local signs of metallosis in 15 of 17 cases. The patients receiving resection-suspension arthroplasty were more satisfied with their treatment (p = 0.003). Therefore, we cannot recommend the implantation of Elektra® prosthesis and we speculate that the key problem of aseptic cup loosening is a result of the metal-on-metal bearing. Level of evidence: III.
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Affiliation(s)
- Stefan M. Froschauer
- Department for Trauma Surgery and
Sportstraumatology, Johannes Kepler University Linz, Linz, Austria
- Faculty of Medicine, Johannes
Kepler University Linz, Linz, Austria
| | | | | | - Richard Schnelzer
- Department for Trauma Surgery and
Sportstraumatology, Johannes Kepler University Linz, Linz, Austria
| | - Oskar Kwasny
- Department for Trauma Surgery and
Sportstraumatology, Johannes Kepler University Linz, Linz, Austria
- Faculty of Medicine, Johannes
Kepler University Linz, Linz, Austria
| | - Dominik Duscher
- Department for Trauma Surgery and
Sportstraumatology, Johannes Kepler University Linz, Linz, Austria
- Technical University Munich,
Department for Plastic and Hand Surgery, Munich, Germany
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7
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Marshall M, Jonsson H, Helgadottir GP, Nicholls E, Myers H, Jansen V, van der Windt D. Longitudinal validity of using digital hand photographs for assessing hand osteoarthritis progression over 7 years in community-dwelling older adults with hand pain. BMC Musculoskelet Disord 2019; 20:484. [PMID: 31656178 PMCID: PMC6815403 DOI: 10.1186/s12891-019-2829-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 09/12/2019] [Indexed: 11/28/2022] Open
Abstract
Background To determine the longitudinal construct validity of assessing hand OA progression on digital photographs over 7 years compared with progression determined from radiographs, clinical features and change in symptoms. Methods Participants were community-dwelling older adults (≥50 years) in North Staffordshire, UK. Standardized digital hand photographs were taken at baseline and 7 years, and hand joints graded for OA severity using an established photographic atlas. Radiographic hand OA was assessed using the Kellgren and Lawrence grading system. Hand examination determined the presence of nodes, bony enlargement and deformity. Symptoms were reported in self-complete questionnaires. Radiographic and clinical progression and change in symptoms were compared to photographic progression. Differences were examined using analysis of covariance and Chi-Square tests. Results Of 253 individuals (61% women, mean age 63 years) the proportion with photographic progression at the joint and joint group-level was higher in individuals with radiographic or clinical progression compared to those without, although differences were not statistically significant. At the person-level, those with moderate photographic progression over 7 years had significantly higher summed radiographic and clinical scores (adjusted for baseline scores) compared to those with no or mild photographic progression. Similar findings were observed for change in symptoms, although differences were small and not statistically significant. Conclusion Assessing hand OA on photographs shows modest longitudinal construct validity over 7 years compared with change in radiographic and clinical hand OA at the person-level. Using photographs to assess overall long-term change in a person with hand OA may be a reasonable alternative when hand examinations and radiographs are not feasible.
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Affiliation(s)
- Michelle Marshall
- Arthritis Research UK Primary Care Centre, School of Primary, Community and Social Care, Keele University, Keele, Staffordshire, ST5 5BG, UK.
| | - Helgi Jonsson
- Department of Rheumatology, Landspitalinn University Hospital, University of Iceland, IS-108 Fossvogur, Reykjavik, Iceland
| | | | - Elaine Nicholls
- Arthritis Research UK Primary Care Centre, School of Primary, Community and Social Care, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - Helen Myers
- Arthritis Research UK Primary Care Centre, School of Primary, Community and Social Care, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - Victoria Jansen
- Pulvertaft Hand Centre, Royal Derby Hospital, Derbyshire, DE22 3NE, UK
| | - Danielle van der Windt
- Arthritis Research UK Primary Care Centre, School of Primary, Community and Social Care, Keele University, Keele, Staffordshire, ST5 5BG, UK
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8
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Platelet-rich plasma for thumb carpometacarpal joint osteoarthritis in a professional pianist: case-based review. Rheumatol Int 2019; 39:2167-2175. [DOI: 10.1007/s00296-019-04454-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 09/26/2019] [Indexed: 01/09/2023]
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9
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Moon YH, Yang YJ, Do SY, Kim JY, Lee CG, Chae HJ, Kim SH, Song HS. Evaluation of the prevalence of musculoskeletal symptoms, presumptive diagnosis, medical care use, and sick leave among female school meal service workers. Ann Occup Environ Med 2019; 31:1. [PMID: 30675364 PMCID: PMC6334380 DOI: 10.1186/s40557-019-0281-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 01/04/2019] [Indexed: 11/30/2022] Open
Abstract
Background Most of the school meal service workers in Korea are middle-aged individuals. They have high workload, which increases their incidence of musculoskeletal disorders. This study aimed to evaluate the prevalence and risk factors of subjective musculoskeletal symptoms, presumptive diagnosis, medical care use, and sick leave among female school meal workers. Methods We analyzed the results of musculoskeletal disease screening of 1581 female school meal workers. The screening consisted of self-administered questionnaire, history taking by occupational physicians, and physical examination. The prevalence of subjective musculoskeletal symptoms, presumptive diagnosis after initial examination by occupational physicians, use of medical care for more than 7 days, and sick leave due to musculoskeletal diseases during the past year were evaluated in this study. The relative risk of four outcome indicators of musculoskeletal disorders was compared with respect to potential factors, such as age, subjective physical loading, present illness, injury experience, and type of school, using log-binomial regression. Results The prevalence of subjective musculoskeletal symptom was 79.6%; presumptive diagnosis, 47.6%; hospital visits over 7 days, 36.4%; and sick leave, 7.3%. The relative risk of musculoskeletal symptoms by age (≥50 years vs < 50 years) was 1.04 (95% confidence interval (CI): 1.00–1.09); presumptive diagnosis of musculoskeletal disease, 1.17 (95% CI: 1.06–1.30); hospital visits over 7 days, 1.26 (95% CI: 0.85–1.85); and sick leave, 1.17 (95% CI: 1.02–1.34). The relative risk of musculoskeletal symptoms due to subjective physical loading (very hard vs low) was 1.45 (95% CI: 1.33–1.58); presumptive diagnosis, 2.92 (95% CI: 2.25); hospital visits over 7 days, 1.91 (95% CI: 1.02–3.59); and sick leave, 2.11 (95% CI: 1.63–2.74). Conclusions Subjective physical loading was a more important factor in musculoskeletal disorders than the age of female school meal workers.
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Affiliation(s)
- Young Hoon Moon
- 1Department of Occupational and Environmental Medicine, Chosun University Hospital, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Young Joon Yang
- 1Department of Occupational and Environmental Medicine, Chosun University Hospital, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Sang Yoon Do
- 1Department of Occupational and Environmental Medicine, Chosun University Hospital, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Jae Yoon Kim
- 1Department of Occupational and Environmental Medicine, Chosun University Hospital, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Chul Gab Lee
- 1Department of Occupational and Environmental Medicine, Chosun University Hospital, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Hong Jae Chae
- Department of Occupational and Environmental Medicine, Donggunsan Hospital, Gunsan, South Korea
| | - Soo Hyeon Kim
- Department of Occupational and Environmental Medicine, KS hospital, Gwangju, South Korea
| | - Han Soo Song
- 1Department of Occupational and Environmental Medicine, Chosun University Hospital, College of Medicine, Chosun University, Gwangju, Republic of Korea
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10
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Sankah BEA, Stokes M, Adams J. Recommendations for exercises in hand osteoarthritis: a systematic review protocol of clinical guidelines and consensus recommendations. PHYSICAL THERAPY REVIEWS 2018. [DOI: 10.1080/10833196.2018.1482997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Beatrice E. A. Sankah
- Faculty of Health Sciences, Centre for Innovation and Leadership in Health Sciences, University of Southampton, Southampton, UK
- Faculty of Health Sciences, Arthritis Research UK Centre of Excellence for Sport, Exercise and Osteoarthritis, University of Southampton, Southampton, UK
| | - Maria Stokes
- Faculty of Health Sciences, Centre for Innovation and Leadership in Health Sciences, University of Southampton, Southampton, UK
- Faculty of Health Sciences, Arthritis Research UK Centre of Excellence for Sport, Exercise and Osteoarthritis, University of Southampton, Southampton, UK
| | - Joanna Adams
- Faculty of Health Sciences, Centre for Innovation and Leadership in Health Sciences, University of Southampton, Southampton, UK
- Faculty of Health Sciences, Arthritis Research UK Centre of Excellence for Sport, Exercise and Osteoarthritis, University of Southampton, Southampton, UK
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11
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Dauvissat J, Rizzo C, Lellouche H, Porterie J, Melac-Ducamp S, Locquet V, Travers V, Maillet B, Conrozier T. Safety and Predictive Factors of Short-Term Efficacy of a Single Injection of Mannitol-Modified Cross-Linked Hyaluronic Acid in Patients with Trapeziometacarpal Osteoarthritis. Results of a Multicentre Prospective Open-Label Pilot Study (INSTINCT Trial). CLINICAL MEDICINE INSIGHTS-ARTHRITIS AND MUSCULOSKELETAL DISORDERS 2018; 11:1179544118782901. [PMID: 29977118 PMCID: PMC6024274 DOI: 10.1177/1179544118782901] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 05/20/2018] [Indexed: 12/18/2022]
Abstract
Purpose: To assess safety and search predictive factors of efficacy of a single intra-articular injection of a mannitol-modified hyaluronic acid (HA) viscosupplement, in patients having trapeziometacarpal (TMC) osteoarthritis (OA). Methods: Patients with symptomatic TMC OA, not adequately relieved by analgesic therapy and/or by the use of a thumb splint, were included in a 3-month prospective multicentre open-label trial. All underwent plain radiographs with the Kapandji incidences allowing the Dell radiological grade assessment (1-4). Primary end point was the variation between injection (D0) and day 90 (D90) of the thumb pain (11-point Likert scale). Treatment consisted in a single injection of 0.6 to 1 mL of a viscosupplement made of a cross-linked HA combined with mannitol. All injections were performed under imaging guidance. Predictive factors of pain decrease were studied in univariate and multivariate analysis. Results: A total of 122 patients (76% women, mean age 60, mean disease duration 36 months) were included and 120 (98%) were assessed at 3 months. The TMC OA was of Dell’s grade 1, 2, 3, and 4 in 23%, 36.8%, 36.8%, and 3.5% of cases, respectively. At D0, the average (SD) pain level was 6.5 ± 1.6 without significant difference between Dell groups (P = .21). At day 90, pain decreased from 6.5 ± 1.6 to 3.9 ± 2.5 (difference −2.7 ± 2.5; −42%; P < .0001) without significant difference between Dell grade (P = .055), despite a seemingly smaller number of responders in stage 2 patients. The average analgesic consumption decreased in more than 1 out of 2 patients. In multivariate analysis, no predictor of response was identified. There was no safety issue. All adverse events (11%) were transient increase in pain during or following HA administration and resolved without sequel within 1 to 7 days. Conclusions: This study suggests that a single course of HANOX-M-XL injection is effective in relieving pain in patients with TMC OA, without safety concern. Patients with advanced stage of OA benefit the treatment as much as those with mild or moderate OA.
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Affiliation(s)
- Jérémy Dauvissat
- Service de Rhumatologie, Hôpital Nord Franche-Comté, Belfort, France
| | | | | | - Jérôme Porterie
- Service d'Orthopédie du membre supérieur, Cabinet de Rhumatologie, Auch, France
| | | | - Vincent Locquet
- Institut Chirurgical de la Main et du Membre Supérieur, Villeurbanne, France
| | | | - Bernard Maillet
- Service de Rhumatologie, Polyclinique Saint-Odilon, Moulins, France
| | - Thierry Conrozier
- Service de Rhumatologie, Hôpital Nord Franche-Comté, Belfort, France
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