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Ekman E, Nevalainen S, Karjalainen E, Kohonen I, Vuohelainen J, Rissanen T, Itälä A. Increased lesion depth, higher body mass index and older age are risk factors for osteoarthritis during long-term follow-up in patients with osteochondritis dissecans of the knee. Arch Orthop Trauma Surg 2023; 143:3863-3869. [PMID: 36169727 PMCID: PMC10293403 DOI: 10.1007/s00402-022-04638-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 09/19/2022] [Indexed: 11/02/2022]
Abstract
INTRODUCTION To report on the long-term prognosis of osteochondritis dissecans (OCD) patients regarding radiological and patient-reported outcomes and to analyze possible risk factors. MATERIALS AND METHODS All patients diagnosed with knee OCD between 2004 and 2014 with radiographic Kellgren-Lawrence (K-L) grades 0-2 at the time of diagnoses, ability to understand the language of the interview, and willingness to participate in the study were retrospectively reviewed. Current knee radiographs and the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire were prospectively collected between May 2020 and March 2021. The extent of osteoarthritis (OA) and KOOS questionnaire results were evaluated. RESULTS 90 patients (103 knees) with a mean age of 21 years (range 6-60) were included. The mean follow-up time was 12 years (range 7-20). 24 knees (23%) were treated conservatively, and 79 knees (77%) operatively. At the time of diagnoses, 90% of the patients had K-L grades of 0-1; during the follow-up period, 45% of the patients showed radiological progression of OA. Patient body mass index (BMI) (p = 0.004; 95% CI 0.25-0.29), age (p = 0.003; 95% CI 0.18-0.30), operative treatment (p = 0.0075; 95% CI 0.41-0.65) and lesion depth (p = 0.0007) were statistically significantly connected to K-L grade change. Patients with no progression in joint space narrowing had statistically significantly better overall KOOS scores (p = 0.03; 95% CI 0.77-0.88) than patients whose K-L grades worsened. CONCLUSIONS During the long-term follow-up of 12 years, patients with knee OCD had good clinical results. Lac of radiological progression of cartilage degeneration was noted in 55% of the patients, regardless of treatment method. Lesion depth, higher BMI and older age were associated with the progression of OA. The progression of OA was related to a worsening of functional scores. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Elina Ekman
- Department of Orthopaedic Surgery, Turku University Hospital, University of Turku, Kiinamyllynkatu 4-8, 20521, Turku, Finland.
| | | | | | - Ia Kohonen
- Medical Imaging Centre of Southwest Finland, Turku University Hospital, Turku, Finland
| | | | - Tiia Rissanen
- Department of Clinical Medicine, Biostatistics, University of Turku, Turku, Finland
| | - Ari Itälä
- Department of Orthopaedics, Pihlajalinna Hospital, Turku, Finland
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Mursu E, Yu J, Karjalainen E, Savukoski S, Niinimäki M, Näpänkangas R, Pesonen P, Pirttiniemi P, Raustia A. Association of climacterium with temporomandibular disorders at the age of 46 years – a cross-sectional study. Acta Odontol Scand 2022; 81:319-324. [PMID: 36403169 DOI: 10.1080/00016357.2022.2146746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Hormonal factors have been suggested to contribute to female dominance among subjects with temporomandibular disorders (TMD). Aim of the study was to examine the association of climacteric status with TMD amongst female participants in the Northern Finland Birth Cohort (NFBC) 1966 at 46 years of age. MATERIAL AND METHODS Among female subjects in NFBC1966, climacteric status was determined based on menstrual anamnesis and measurement of blood follicle-stimulating hormone (FSH) levels. Women with FSH > 25 IU/L and amenorrhoea > 4 months were defined as climacteric (case group, n = 71); women not diagnosed as climacteric were defined as preclimacteric (control group, n = 656). Differences between cases and controls were evaluated on self-reported TMD pain, clinical TMD signs and TMD diagnoses using modified Diagnostic Criteria for TMD (DC/TMD) protocol. Crosstabulation and logistic regression models were used to analyse differences between cases and controls. RESULTS Compared to preclimacteric women, climacteric women had significantly more often pain on palpation in temporomandibular joints (TMJs) (OR = 2.64, 95% CI 1.12-6.21, p= .026) and more crepitus in TMJs (OR = 2.92, 95% CI 1.13-7.56, p= .027). Degenerative joint disease diagnoses were more common in climacteric than preclimacteric women (OR = 2.27, 95% CI 1.05-4.91, p= .037). Differences were statistically significant after adjusting for confounding factors (body mass index (BMI), smoking, parity). No statistically significant differences in self-reported TMD pain were noted between groups. CONCLUSION Among females at the age of 46 years, climacterium seems associated with TMD by increasing pain on palpation in TMJs, subjective symptoms, and clinical signs indicating degenerative changes in TMJs when using DC/TMD.
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Affiliation(s)
- Eerika Mursu
- Faculty of Medicine, Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Jia Yu
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Stomatology, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Elina Karjalainen
- Faculty of Medicine, Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Susanna Savukoski
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
- Faculty of Medicine, Department of Obstetrics and Gynecology, Oulu University Hospital and PEDEGO Research Unit, University of Oulu, Finland
| | - Maarit Niinimäki
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
- Faculty of Medicine, Department of Obstetrics and Gynecology, Oulu University Hospital and PEDEGO Research Unit, University of Oulu, Finland
| | - Ritva Näpänkangas
- Faculty of Medicine, Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Paula Pesonen
- Faculty of Medicine, Infrastructure for Population Studies, University of Oulu, Oulu, Finland
| | - Pertti Pirttiniemi
- Faculty of Medicine, Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Aune Raustia
- Faculty of Medicine, Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
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Karjalainen E, Repasky G, Wolf M, Wennerberg K. PO-514 High-throughput drug screening to identify therapies reversing aberrant cell differentiation in AML. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.1015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Parkkinen A, Karjalainen E, Vartiainen M, Penttinen J. Physiotherapy for female stress urinary incontinence: individual therapy at the outpatient clinic versus home-based pelvic floor training: a 5-year follow-up study. Neurourol Urodyn 2004; 23:643-8. [PMID: 15382186 DOI: 10.1002/nau.20065] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
AIMS To compare the long-term effects of individual physiotherapy at an outpatient clinic, including electrical stimulation (ES), active pelvic floor muscle exercises (PFMEs), and training with a vaginal ball (VB), with home-based active PFMEs and training with a VB, in cases of female stress urinary incontinence (SUI). MATERIALS AND METHOD Thirty-three women with SUI (outpatient clinic group [Group I, n = 16] and home group [Group II, n = 17]) participated in the 5-year follow-up study. Both groups had an active PFME program and they used a VB during daily activities for intensive pelvic floor muscle (PFM) training. Group I was also treated at the outpatient clinic with maximal interferential ES, using frequencies varying from 10 to 50 Hz, and individually instructed exercises with biofeedback were carried out at the same time, once a week, an average of nine times in the first year. After baseline examinations, both groups visited the outpatient clinic at 4 months, 12 months, and at 5 years. RESULTS At 12 months, there were no statistically significant differences between the study groups in any of the outcome variables, but within the groups both the subjective and objective results were significantly better in comparison with the initial values. After 12 months, two (3%) patients in Group I continued physiotherapy and seven (41%) patients in Group II needed physiotherapy because of an unsatisfactory outcome. At 5 years, according to the urinary incontinence severity score (UISS) questionnaire, subjective discomfort had decreased in both groups (P < 0.01) and 21 of the 33 women (64%) perceived a subjective cure or improvement in their condition. The mean objective urine leakage verified by the pad test decreased from 23.0 to 1.0 g in Group I and from 13.0 to 1.0 g in Group II (P < 0.001 for both groups). The strength of PFMs tested in a standing position increased by 26% in Group I and by 19% in Group II (P values 0.001 and 0.084, respectively), and in a lying position by 28% in Group I and by 32% in Group II (P values 0.001 and 0.008, respectively). CONCLUSIONS Home-based PFMEs and training with a VB proved to be equally effective as once-a-week supervised therapy, and the 5-year follow-up results demonstrated a successful response in the treatment of female SUI.
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Affiliation(s)
- A Parkkinen
- Department of Obstetrics and Gynaecology, Kainuu Central Hospital, Kajaani, Finland.
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