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Di J, Bai J, Zhang J, Chen J, Hao Y, Bai J, Xiang C. Regional disparities, age-related changes and sex-related differences in knee osteoarthritis. BMC Musculoskelet Disord 2024; 25:66. [PMID: 38225636 PMCID: PMC10788997 DOI: 10.1186/s12891-024-07191-w] [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: 10/17/2022] [Accepted: 01/10/2024] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND The objective of the study is to analyse the regions, age and sex differences in the incidence of knee osteoarthritis (KOA). METHODS Data were extracted from the global burden of diseases (GBD) 2019 study, including incidence, years lived with disability (YLD), disability-adjusted life-years (DALYs) and risk factors. Estimated annual percentage changes (EAPCs) were calculated to quantify the temporal trends in age standardized rate (ASR) of KOA. Paired t-test, paired Wilcoxon signed-rank test and spearman correlation were performed to analyze the association of sex disparity in KOA and socio-demographic index (SDI). RESULTS There were significant regional differences in the incidence of knee osteoarthritis. In 2019, South Korea had the highest incidence of knee osteoarthritis (474.85,95%UI:413.34-539.64) and Thailand had the highest increase in incidence of knee osteoarthritis (EAPC = 0.56, 95%CI = 0.54-0.58). Notably, higher incidence, YLD and DALYs of knee osteoarthritis were associated with areas with a high socio-demographic index (r = 0.336, p < 0.001; r = 0.324, p < 0.001; r = 0.324, p < 0.001). In terms of age differences, the greatest increase in the incidence of knee osteoarthritis was between the 35-39 and 40-44 age groups. (EAPC = 0.52, 95%CI = 0.40-0.63; 0.47, 95%CI = 0.36-0.58). In addition, there were significant sex differences in the disease burden of knee osteoarthritis (P < 0.001). CONCLUSIONS The incidence of knee osteoarthritis is significantly different with regions, age and sex.
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Affiliation(s)
- Jingkai Di
- Department of Orthopedics, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Jiang Bai
- The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Junrui Zhang
- The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Jiaoyang Chen
- The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Yuxuan Hao
- The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Jiaqi Bai
- The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Chuan Xiang
- Department of Orthopedics, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.
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Streck LE, Hanreich C, Cororaton AD, Boettner CS, Boettner F. Does high activity after total and unicompartmental knee arthroplasty increase the risk for aseptic revision? Arch Orthop Trauma Surg 2023; 143:5843-5848. [PMID: 36881148 DOI: 10.1007/s00402-023-04794-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 01/22/2023] [Indexed: 03/08/2023]
Abstract
INTRODUCTION It has been suggested that high activity might negatively impact implant survival following total and unicompartmental knee arthroplasty (TKA/UKA) and many surgeons advise their patients to only participate in moderate level sport activities. To date, it remains unclear whether such restraints are necessary to assure longevity of the implants. MATERIALS AND METHODS We conducted a retrospective study on 1906 knees (1745 TKA, 161 UKA) in 1636 patients aged 45-75 years who underwent primary arthroplasty for primary osteoarthritis. Lower extremity activity scale (LEAS) at a two year follow-up was assessed to define the activity level. Cases were grouped in low (LEAS ≤ 6), moderate (LEAS 7-13) and high activity (LEAS ≥ 14). Cohorts were compared with Kruskal-Wallis- or Pearson-Chi2-Test. Univariate logistic regression was conducted to test for association between activity level at two years and later revisions. Odds ratio was reported and converted to predicted probability. A Kaplan-Meier curve was plotted to predict implant survival. RESULTS The predicted implant survival for UKA was 100.0% at two years and 98.1% at five years. The predicted implant survival for TKA was 99.8% at two years, 98.1% at five years. The difference was not significant (p = 0.410). 2.5% of the UKA underwent revision, one knee in the low and three knees in the moderate activity group, differences between the moderate and high activity group were not significant (p = 0.292). The revision rate in the high activity TKA group was lower than in the low and moderate activity groups (p = 0.008). A higher LEAS two years after surgery was associated with a lower risk for future revision (p = 0.001). A one-point increase in LEAS two years after surgery lowered the odds for undergoing revision surgery by 19%. CONCLUSIONS The study suggests that participating in sports activity following both UKA and TKA is safe and not a risk factor for revision surgery at a mid-term follow-up. Patients should not be prevented from an active lifestyle following knee replacement.
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Affiliation(s)
- Laura E Streck
- Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery, 535 East 70Th Street, New York, NY, 10021, USA
| | - Carola Hanreich
- Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery, 535 East 70Th Street, New York, NY, 10021, USA
- Department for Visceral Surgery and Medicine, Bern University Hospital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland
| | - Agnes D Cororaton
- Biostatistics Core, Research Administration, Hospital for Special Surgery, 535 East 70Th Street, New York, NY, 10021, USA
| | - Cosima S Boettner
- Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery, 535 East 70Th Street, New York, NY, 10021, USA
| | - Friedrich Boettner
- Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery, 535 East 70Th Street, New York, NY, 10021, USA.
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Ventura A, Macchi V, Borgo E, Legnani C. Shift to low-impact sports and recreational activities following total knee replacement. Int J Artif Organs 2022; 45:952-956. [PMID: 35993237 PMCID: PMC9580033 DOI: 10.1177/03913988221119524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: A growing number of physically active patients undergoing total knee replacement (TKR) desires to resume their preoperative activity levels and to be able to engage in sports after surgery. The purpose of this study was to assess the sporting and physical activities of patients who had undergone TKR. It was hypothesized that the majority of patients treated by TKR would have been able to return to amateur sports and recreational activity . Methods: Ninety-seven patients who underwent TKR between 2014 and 2016, were retrospectively reviewed. Mean age was 70.1 years (range 64–83). Average follow-up time was 4.2 years (SD: 1.7). Assessment included Knee Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee (IKDC), and Tegner activity level. Sporting and physical activities of all patients were reported. Wilcoxon’s signed ranks test was used for comparison between pre-operative and follow-up data. Significance was set at p < 0.05. Results: Both KOOS score and IKDC significantly improved after surgery (p < 0.001). No statistically significant differences were reported concerning Tegner activity level before and after surgery (p = n.s.). After surgery, a total number of 52 patients (53.6%) successfully returned to sporting and recreational activities, such as cycling, hiking, dancing and swimming. A return to activity rate of 81% of patients practicing sport before surgery was reported. Conclusions: TKR provides a high rate of return to sport postoperatively and confirms improved subjective results and reduced pain compared to preoperative status. However, most patients returned to low-impact activities, while a significant decrease was reported for mid- and high-impact sports.
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Affiliation(s)
- Alberto Ventura
- IRCCS Istituto Ortopedico Galeazzi, Sports Traumatology and Minimally Invasive Articular Surgery Center, Milan, Lombardy, Italy
| | - Vittorio Macchi
- IRCCS Istituto Ortopedico Galeazzi, Sports Traumatology and Minimally Invasive Articular Surgery Center, Milan, Lombardy, Italy
| | - Enrico Borgo
- IRCCS Istituto Ortopedico Galeazzi, Sports Traumatology and Minimally Invasive Articular Surgery Center, Milan, Lombardy, Italy
| | - Claudio Legnani
- IRCCS Istituto Ortopedico Galeazzi, Sports Traumatology and Minimally Invasive Articular Surgery Center, Milan, Lombardy, Italy
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Martens G, Pioger C, Siboni R, Ollivier M, Fayard JM, Djian P, Argenson JN, Thoreux P, Seil R. Pushing the boundaries? Challenges and ethical considerations for hip and knee joint arthroplasty in elite athletes. Br J Sports Med 2022; 56:bjsports-2021-105376. [PMID: 35738878 DOI: 10.1136/bjsports-2021-105376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2022] [Indexed: 11/04/2022]
Affiliation(s)
- Géraldine Martens
- Physical Medicine and Sport Traumatology Department, Central University Hospital of Liege, Liege, Belgium
| | - Charles Pioger
- Department of Orthopaedic Surgery, Ambroise Paré University Hospital, Boulogne-Billancourt, France
- Department of Orthopedic Surgery, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | - Renaud Siboni
- Department of Orthopedic Surgery, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
- Department of Orthopedic Surgery, Hospital Maison Blanche, Reims, Champagne-Ardenne, France
| | - Matthieu Ollivier
- Institute of Locomotion, Hopital Sainte-Marguerite, Marseille, Provence-Alpes-Côte d'Azur, France
| | | | - Patrick Djian
- Chirurgie Orthopédique et Traumatologique, Clinique Nollet, Paris, France
| | - Jean-Noel Argenson
- Institute of Locomotion, Hopital Sainte-Marguerite, Marseille, Provence-Alpes-Côte d'Azur, France
| | - Patricia Thoreux
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers ParisTech, Université Sorbonne Paris Nord, Paris, France
- Pôle Médical, Institut National du Sport, de l'Expertise et de la Performance, Paris, France
| | - Romain Seil
- Department of Orthopedic Surgery, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
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Ciolli G, Proietti L, Mercurio M, Corona K, Maccauro G, Schiavone Panni A, Cerciello S. Return to sport following distal femur osteotomy: a systematic review. Orthop Rev (Pavia) 2022; 14:33774. [PMID: 35774926 PMCID: PMC9239358 DOI: 10.52965/001c.33774] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 01/04/2022] [Indexed: 08/02/2023] Open
Abstract
INTRODUCTION Distal femur osteotomies (DFOs) are well-accepted procedures in treating unicompartmental knee osteoarthritis associated with valgus malalignment. This study aims to investigate the Return to sport (RTS) after DFO. MATERIALS AND METHODS We conducted a systematic review of the literature according to the PRISMA guidelines, including all articles published in English, with no time limit, excluding double-level knee osteotomies. RESULTS Five articles were included for an overall cohort of 76 patients. The mean follow-up was 45.53 months. The mean age of the patients at the time of surgery was 33.87 years, and the mean malalignment was 5.59° in valgus. In 70 cases, patients received a lateral DFO, while in 6 cases, a medial closing-wedge DFO. An RTS of 86.1% was observed after DFO and a mean time to RTS of 12.3 months. 76.8% of patients recovered to a level equal to or higher than that practiced before the onset of symptoms. No statistically significant differences were observed in the RTS rate between those who performed lateral or medial DFO. CONCLUSIONS RTS after DFO is ubiquitous and occurs around one year after surgery. In most cases, patients report improved performance compared to what they experienced before the onset of symptoms. Unfortunately, while athletes often have RTS at a similar or better level, other patients often see a return to lower impact sports.
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Affiliation(s)
- Gianluca Ciolli
- Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario A. Gemelli IRCCS - Sacred Heart Catholic University, Rome, Italy
| | - Lorenzo Proietti
- Sant'Andrea Hospital, University of Rome La Sapienza, Rome, Italy
| | - Michele Mercurio
- Department of Orthopaedic and Trauma Surgery, "Magna Græcia" University, "Mater Domini" University Hospital, Catanzaro, Italy
| | - Katia Corona
- Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - Giulio Maccauro
- Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario A. Gemelli IRCCS - Sacred Heart Catholic University, Rome, Italy
| | - Alfredo Schiavone Panni
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Simone Cerciello
- Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario A. Gemelli IRCCS - Sacred Heart Catholic University, Rome, Italy; Marrelli Hospital, Crotone, Italy
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Mooiweer Y, Stevens M, van den Akker-Scheek I. Being active with a total hip or knee prosthesis: a systematic review into physical activity and sports recommendations and interventions to improve physical activity behavior. Eur Rev Aging Phys Act 2022; 19:7. [PMID: 35227191 PMCID: PMC8903715 DOI: 10.1186/s11556-022-00285-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 02/01/2022] [Indexed: 12/19/2022] Open
Abstract
Objectives Regular physical activity (PA) is considered important after total hip and knee arthroplasty (THA/TKA). Objective was to systematically assess literature on recommendations given by healthcare professionals to persons after THA and TKA and to provide an overview of existing interventions to stimulate PA and sports participation. Methods A systematic review with a narrative synthesis including articles published between January 1995 and January 2021 reporting on recommendations and interventions. The PubMed, Embase, CINAHL and PsycInfo databases were systematically searched for original articles reporting on physical activity and sports recommendations given by healthcare professionals to persons after THA and TKA, and articles reporting on interventions/programs to stimulate a physically active lifestyle after rehabilitation or explicitly defined as part of the rehabilitation. Methodological quality was assessed with the Mixed Methods Appraisal Tool (MMAT). The review was registered in Prospero (PROSPERO:CRD42020178556). Results Twenty-one articles reported on recommendations. Low-impact activities were allowed. Contact sports, most ball sports, and martial arts were not recommended. One study informed on whether health-enhancing PA recommendations were used to stimulate persons to become physically active. No studies included recommendations on sedentary behavior. Eleven studies reported on interventions. Interventions used guidance from a coach/physiotherapist; feedback on PA behavior from technology; and face-to-face, education, goal-setting, financial incentives and coaching/financial incentives combined, of which feedback and education seem to be most effective. For methodological quality, 18 out of 21 (86%) articles about recommendations and 7 out of 11 (64%) articles about interventions scored yes on more than half of the MMAT questions (0–5 score). Conclusion There is general agreement on what kind of sports activities can be recommended by healthcare professionals like orthopedic surgeons and physiotherapists. No attention is given to amount of PA. The same is true for limiting sedentary behavior. The number of interventions is limited and diverse, so no conclusions can be drawn. Interventions including provision of feedback about PA, seem to be effective and feasible. Supplementary Information The online version contains supplementary material available at 10.1186/s11556-022-00285-1.
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Affiliation(s)
- Yvet Mooiweer
- Department of Orthopedics, University of Groningen, University Medical Center Groningen, P.O. BOX 30.001, 9700 RB, Groningen, The Netherlands
| | - Martin Stevens
- Department of Orthopedics, University of Groningen, University Medical Center Groningen, P.O. BOX 30.001, 9700 RB, Groningen, The Netherlands.
| | - Inge van den Akker-Scheek
- Department of Orthopedics, University of Groningen, University Medical Center Groningen, P.O. BOX 30.001, 9700 RB, Groningen, The Netherlands
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Hanreich C, Springer B, Waldstein W, Rueckl K, Bechler U, Boettner F. Sport after Knee Replacement Surgery - a Review of Sport Habits and Key Surgical Aspects. ZEITSCHRIFT FUR ORTHOPADIE UND UNFALLCHIRURGIE 2022. [PMID: 35196740 DOI: 10.1055/a-1699-3403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
As an increasing number of younger patients are undergoing total knee replacement (TKR) surgery, many wish to participate in sport, but still expect that the implant will survive for a extended period. Most of the current literature shows that patients predominantly participate in low impact activities, both before and after surgery. A few studies show that with appropriate previous experience, high-impact sports are possible and might not result in increased implant failure rates. These include a decrease in point loads on the polyethylene by using more conform bearing surfaces, avoidance of varus component alignment to minimise stresses at the implant bone interface and avoiding patella resurfacing to facilitate activities in deep knee flexion.A TKR is no longer an absolute contraindication for higher impact activities such as golf, tennis and ski. What is more important than implant specific factors seem to be patient specific factors, including preoperative activity level, and preoperative sport skills.The current review paper reports on the current sport habits of TKR patients, analyses biomechanical loads on the knee during different sport activities and reports on implant selection and technical considerations for the active patient undergoing TKR.
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Affiliation(s)
- Carola Hanreich
- Department of Orthopedic Surgery, Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, United States
| | - Bernhard Springer
- Department of Orthopedics and Trauma Surgery, General Hospital of the City of Vienna - Hospital of the Medical University of Vienna, Wien, Österreich
| | - Wenzel Waldstein
- Department of Orthopedics and Trauma Surgery, General Hospital of the City of Vienna - Hospital of the Medical University of Vienna, Wien, Österreich
| | - Kilian Rueckl
- Department of Orthopaedics, Orthopädische Klinik König-Ludwig-Haus, Würzburg, Deutschland
| | - Ulrich Bechler
- Department of Orthopedics, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - Friedrich Boettner
- Department of Orthopedic Surgery, Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, United States
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Recommendations for Sport and Physical Activity after total Hip and Knee Arthroplasty: A Systematic Review. ACTA MEDICA TRANSILVANICA 2021. [DOI: 10.2478/amtsb-2021-0017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Abstract
Due to the high success of arthroplasty, patients suffering from osteoarthritis have higher expectations regarding the relief of pain, functional recovery and capacity to perform physical and sports activity. The purpose of our article is to present a literature review based on papers published during the last decades, with emphasis on the current recommendations regarding sports after total joint replacement. We conducted a search using PubMed/Medline databases, selecting the scientific articles published between 2005-2020 which discuss the association between physical activity and total hip or knee arthroplasty. The benefits of physical activity in all kinds of joint prostheses outweigh the negative effects; therefore, the recommendation for low-impact sports (hiking, swimming, cycling or golf) at a moderate intensity is considered valid and patients with total hip or knee arthroplasty who preoperatively had a high level of physical activity can return to low-impact sports performed at moderate intensity after 3-6 months.
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