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Power JD, Perruccio AV, Canizares M, Davey JR, Gandhi R, Mahomed NN, Syed K, Veillette C, Rampersaud YR. The impact of diabetes status on pain and physical function following total joint arthroplasty for hip and knee osteoarthritis: variation by sex and body mass index. Sci Rep 2024; 14:11152. [PMID: 38750058 PMCID: PMC11096302 DOI: 10.1038/s41598-024-61847-0] [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: 12/20/2023] [Accepted: 05/10/2024] [Indexed: 05/18/2024] Open
Abstract
Few studies have examined diabetes impact on total joint arthroplasty (TJA) outcomes, with variable findings. We investigated the association between diabetes and post-TJA physical function and pain, examining whether diabetes impact differs by sex and BMI. Patient sample completed questionnaires within 3 months prior to hip or knee TJA for osteoarthritis (OA) and 1-year post-surgery. Surgical 'non-response' was defined as < 30% improvement in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and physical function at 1-year. Two adjusted logistic regression models were estimated: (1) excluding, (2) including an interaction between diabetes, sex and BMI. The sample (626 hip, 754 knee) was 54.9% female, had mean BMI of 30.1, 13.0% reported diabetes. In adjusted models excluding an interaction, diabetes was not associated with non-response. However, a significant 3-way interaction (physical function: p = 0.003; pain: p = 0.006) between diabetes, sex, and BMI was found and was associated with non-response: non-response probability increased with increasing BMI in men with diabetes, but decreased with increasing BMI in women in diabetes. Findings suggest uncertainty in diabetes impact may be due to differential impacts by sex and BMI. A simple consideration of diabetes as present vs. absent may not be sufficient, with implications for the large TJA population.
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Affiliation(s)
- J Denise Power
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, 399 Bathurst Street MP10-326, Toronto, ON, M5T 2S8, Canada.
- Arthritis Community Research & Epidemiology Unit, Toronto, ON, Canada.
| | - Anthony V Perruccio
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, 399 Bathurst Street MP10-326, Toronto, ON, M5T 2S8, Canada
- Arthritis Community Research & Epidemiology Unit, Toronto, ON, Canada
- Orthopaedics, Department of Surgery, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Mayilee Canizares
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, 399 Bathurst Street MP10-326, Toronto, ON, M5T 2S8, Canada
- Arthritis Community Research & Epidemiology Unit, Toronto, ON, Canada
| | - J Roderick Davey
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, 399 Bathurst Street MP10-326, Toronto, ON, M5T 2S8, Canada
- Orthopaedics, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Rajiv Gandhi
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, 399 Bathurst Street MP10-326, Toronto, ON, M5T 2S8, Canada
- Orthopaedics, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Nizar N Mahomed
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, 399 Bathurst Street MP10-326, Toronto, ON, M5T 2S8, Canada
- Orthopaedics, Department of Surgery, University of Toronto, Toronto, ON, Canada
- ICES, Toronto, ON, Canada
| | - Khalid Syed
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, 399 Bathurst Street MP10-326, Toronto, ON, M5T 2S8, Canada
- Orthopaedics, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Christian Veillette
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, 399 Bathurst Street MP10-326, Toronto, ON, M5T 2S8, Canada
- Orthopaedics, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Y Raja Rampersaud
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, 399 Bathurst Street MP10-326, Toronto, ON, M5T 2S8, Canada
- Orthopaedics, Department of Surgery, University of Toronto, Toronto, ON, Canada
- Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada
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Tsukada A, Takata K, Aikawa J, Iwase D, Mukai M, Uekusa Y, Metoki Y, Inoue G, Miyagi M, Takaso M, Uchida K. Association between High HbA1c Levels and Mast Cell Phenotype in the Infrapatellar Fat Pad of Patients with Knee Osteoarthritis. Int J Mol Sci 2024; 25:877. [PMID: 38255949 PMCID: PMC10815720 DOI: 10.3390/ijms25020877] [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: 12/13/2023] [Revised: 01/02/2024] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
Diabetes mellitus (DM) has been suggested as a potential risk factor for knee osteoarthritis (KOA), and its underlying mechanisms remain unclear. The infrapatellar fat pad (IPFP) contributes to OA through inflammatory mediator secretion. Mast cells' (MCs) role in diabetic IPFP pathology is unclear. In 156 KOA patients, hemoglobin A1c (HbA1c) was stratified (HbA1c ≥ 6.5, n = 28; HbA1c < 6.5, n = 128). MC markers (TPSB2, CPA3) in IPFP were studied. Propensity-matched cohorts (n = 27 each) addressed demographic differences. MC-rich fraction (MC-RF) and MC-poor fraction (MC-PF) were isolated, comparing MC markers and genes elevated in diabetic skin-derived MC (PAXIP1, ARG1, HAS1, IL3RA). TPSB2 and CPA3 expression were significantly higher in HbA1c ≥ 6.5 vs. <6.5, both before and after matching. MC-RF showed higher TPSB2 and CPA3 expression than MC-PF in both groups. In the HbA1c ≥ 6.5 group, PAXIP1 and ARG1 expression were significantly higher in the MC-RF than MC-PF. However, no statistical difference in the evaluated genes was detected between the High and Normal groups in the MC-RF. Elevated TPSB2 and CPA3 levels in the IPFP of high HbA1c patients likely reflect higher numbers of MCs in the IPFP, though no difference was found in MC-specific markers on a cell-to-cell basis, as shown in the MC-RF comparison. These findings deepen our understanding of the intricate interplay between diabetes and KOA, guiding targeted therapeutic interventions.
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Affiliation(s)
- Ayumi Tsukada
- Department of Orthopedic Surgery, Kitasato University School of Medicine, 1-15-1 Minami-ku Kitasato, Sagamihara City 252-0374, Kanagawa, Japan; (A.T.); (K.T.); (J.A.); (D.I.); (M.M.); (Y.U.); (Y.M.); (G.I.); (M.M.); (M.T.)
| | - Ken Takata
- Department of Orthopedic Surgery, Kitasato University School of Medicine, 1-15-1 Minami-ku Kitasato, Sagamihara City 252-0374, Kanagawa, Japan; (A.T.); (K.T.); (J.A.); (D.I.); (M.M.); (Y.U.); (Y.M.); (G.I.); (M.M.); (M.T.)
| | - Jun Aikawa
- Department of Orthopedic Surgery, Kitasato University School of Medicine, 1-15-1 Minami-ku Kitasato, Sagamihara City 252-0374, Kanagawa, Japan; (A.T.); (K.T.); (J.A.); (D.I.); (M.M.); (Y.U.); (Y.M.); (G.I.); (M.M.); (M.T.)
| | - Dai Iwase
- Department of Orthopedic Surgery, Kitasato University School of Medicine, 1-15-1 Minami-ku Kitasato, Sagamihara City 252-0374, Kanagawa, Japan; (A.T.); (K.T.); (J.A.); (D.I.); (M.M.); (Y.U.); (Y.M.); (G.I.); (M.M.); (M.T.)
| | - Manabu Mukai
- Department of Orthopedic Surgery, Kitasato University School of Medicine, 1-15-1 Minami-ku Kitasato, Sagamihara City 252-0374, Kanagawa, Japan; (A.T.); (K.T.); (J.A.); (D.I.); (M.M.); (Y.U.); (Y.M.); (G.I.); (M.M.); (M.T.)
| | - Yui Uekusa
- Department of Orthopedic Surgery, Kitasato University School of Medicine, 1-15-1 Minami-ku Kitasato, Sagamihara City 252-0374, Kanagawa, Japan; (A.T.); (K.T.); (J.A.); (D.I.); (M.M.); (Y.U.); (Y.M.); (G.I.); (M.M.); (M.T.)
| | - Yukie Metoki
- Department of Orthopedic Surgery, Kitasato University School of Medicine, 1-15-1 Minami-ku Kitasato, Sagamihara City 252-0374, Kanagawa, Japan; (A.T.); (K.T.); (J.A.); (D.I.); (M.M.); (Y.U.); (Y.M.); (G.I.); (M.M.); (M.T.)
| | - Gen Inoue
- Department of Orthopedic Surgery, Kitasato University School of Medicine, 1-15-1 Minami-ku Kitasato, Sagamihara City 252-0374, Kanagawa, Japan; (A.T.); (K.T.); (J.A.); (D.I.); (M.M.); (Y.U.); (Y.M.); (G.I.); (M.M.); (M.T.)
| | - Masayuki Miyagi
- Department of Orthopedic Surgery, Kitasato University School of Medicine, 1-15-1 Minami-ku Kitasato, Sagamihara City 252-0374, Kanagawa, Japan; (A.T.); (K.T.); (J.A.); (D.I.); (M.M.); (Y.U.); (Y.M.); (G.I.); (M.M.); (M.T.)
| | - Masashi Takaso
- Department of Orthopedic Surgery, Kitasato University School of Medicine, 1-15-1 Minami-ku Kitasato, Sagamihara City 252-0374, Kanagawa, Japan; (A.T.); (K.T.); (J.A.); (D.I.); (M.M.); (Y.U.); (Y.M.); (G.I.); (M.M.); (M.T.)
| | - Kentaro Uchida
- Department of Orthopedic Surgery, Kitasato University School of Medicine, 1-15-1 Minami-ku Kitasato, Sagamihara City 252-0374, Kanagawa, Japan; (A.T.); (K.T.); (J.A.); (D.I.); (M.M.); (Y.U.); (Y.M.); (G.I.); (M.M.); (M.T.)
- Shonan University Medical Sciences Research Institute, Nishikubo 500, Chigasaki City 253-0083, Kanagawa, Japan
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Gong Y, Ma H, Zhao X. Comment on Mariana Rosada et al.: Eight weeks of a lower limb resistance training protocol and gait performance in patients with symptomatic mild to moderate knee osteoarthritis. J Orthop Sci 2024; 29:463. [PMID: 37926617 DOI: 10.1016/j.jos.2023.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 09/12/2023] [Indexed: 11/07/2023]
Affiliation(s)
- Yuhan Gong
- School of Clinical Medicine, Jining Medical University, Jining, Shandong 272067, China
| | - Hui Ma
- Department of Joint Surgery and Sports Medicine, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong 272029, China
| | - Xiaowei Zhao
- Department of Joint Surgery and Sports Medicine, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong 272029, China.
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Alenazi AM, Alkhathami KM. Hypertension Is Associated with Joint Pain Severity Among Individuals with Osteoarthritis. Pain Manag Nurs 2023; 24:e97-e101. [PMID: 37544788 DOI: 10.1016/j.pmn.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 07/11/2023] [Accepted: 07/15/2023] [Indexed: 08/08/2023]
Abstract
Previous studies have reported an association between hypertension (HTN) and osteoarthritis (OA). However, limited research has examined the association between HTN and symptoms, such as pain severity, in people with OA. Therefore, the aim was to investigate the prevalence of HTN in individuals with OA and the association between HTN and pain severity in this population. This study was cross-sectional and included participants aged 50 years and older from the community. Demographic data were included and self-reported history of chronic illnesses including diabetes, HTN, cardiovascular disease, dyslipidemia, anemia, osteoporosis, neurological disease, and back pain were obtained. Numerous medications and chronic diseases were included. A subsample of people who self-reported osteoarthritis was included in this study. Pain severity was measured over the past 7 days using a pain numeric rating scale. Multiple linear regression was used after adjusting for covariates. A total of 82 participants with OA were included, and the prevalence of HTN among individuals with OA was 28.91%. Hypertension was significantly associated with increased joint pain severity in this population after adjustments for covariates (B=1.81; 95% CI, 0.65, 2.97; p = .003). Hypertension is prevalent in individuals with OA and is significantly associated with pain severity in this population. Future research should consider the effect of HTN control and medication on symptoms in people with OA. Clinicians may implement screening for HTN among individuals with OA because of the association between HTN and symptoms, such as pain, in this population.
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Affiliation(s)
- Aqeel M Alenazi
- Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Riyadh, Saudi Arabia.
| | - Khalid M Alkhathami
- Department of Health Rehabilitation, Shaqra University, Shaqra, Riyadh, Saudi Arabia
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