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Marriott KA, Hall M, Maciukiewicz JM, Almaw RD, Wiebenga EG, Ivanochko NK, Rinaldi D, Tung EV, Bennell KL, Maly MR. The control group matters: Pain, physical function and strength improvements relative to the comparator intervention in knee and hip osteoarthritis. Semin Arthritis Rheum 2024; 68:152538. [PMID: 39214068 DOI: 10.1016/j.semarthrit.2024.152538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 07/11/2024] [Accepted: 08/09/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND In knee and hip osteoarthritis (OA), the mechanism for resistance exercise improving clinical outcomes and the dose-response between strength and clinical outcomes are unknown; in part due to inconsistent trial designs across studies. PURPOSE To determine whether the effects of resistance exercise interventions on pain and function differ based on comparator group; and whether there is an association between improvements in lower extremity strength with improvements in pain and function in knee and hip OA. METHODS We searched 6 databases (inception to January 28 2023,) for randomized controlled trials (RCTs) comparing land-based, resistance exercise-only interventions with no intervention or any other intervention. There were four subgroups for comparator intervention: NONE (none/placebo/sham/usual care), EXE (other exercise interventions alone), NONEXE (non-exercise interventions alone), COMBO (combined exercise + non-exercise interventions). The between-group effect (ES) was calculated for immediate post-intervention pain and function (activities of daily living (ADL) and sports/recreation (SPORT)). Meta-regression analyses were completed to evaluate the association between improvements in lower extremity strength (independent variable) and improvements in pain, ADL and SPORT (dependent variables), irrespective of comparator intervention. RESULTS For knee OA (257 studies), there were large benefits for pain [ES (95 % CI) = -0.92 (-1.15, -0.69)], ADL [-0.79 (-1.01, -0.56)] and SPORT [-0.79 (-1.02, -0.56)] favouring resistance exercise interventions compared to NONE. For knee pain, there was also a moderate benefit favouring COMBO interventions compared to resistance exercise interventions [0.44 (0.23, 0.65)]. For hip OA (15 studies), there were moderate benefits for pain [-0.51 (-0.68, -0.33)], ADL [-0.57 (-0.78, -0.36)] and SPORT [-0.52 (-0.70, -0.35)] favouring exercise interventions compared to NONE. For hip pain, there was also a moderate benefit favouring NONEXE interventions compared to resistance exercise interventions [0.57 (0.17, 0.97)]. For knee OA, greater strength gains were associated with larger improvements in pain [β (95 % CI) = -0.24 (-0.38, -0.09)], ADL [-0.43 (-0.73, -0.12)] and SPORT [-0.37 (-0.73, -0.00)]. CONCLUSION In knee and hip OA, the effects of resistance exercise on pain and function improvements depend on the comparator intervention. For knee OA, a dose-response relationship was observed between lower extremity strength gains with pain and function improvements.
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Affiliation(s)
- Kendal A Marriott
- Department of Kinesiology and Health Sciences, University of Waterloo, Ontario, Canada
| | - Michelle Hall
- Sydney Musculoskeletal Health, The Kolling Institute, School of Health Sciences, University of Sydney, Australia
| | | | - Rachel D Almaw
- Department of Kinesiology and Health Sciences, University of Waterloo, Ontario, Canada
| | - Emily G Wiebenga
- Department of Kinesiology and Health Sciences, University of Waterloo, Ontario, Canada
| | - Natasha K Ivanochko
- Department of Kinesiology and Health Sciences, University of Waterloo, Ontario, Canada
| | - Daniel Rinaldi
- Department of Kinesiology and Health Sciences, University of Waterloo, Ontario, Canada
| | - Emma V Tung
- Department of Kinesiology and Health Sciences, University of Waterloo, Ontario, Canada
| | - Kim L Bennell
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, The University of Melbourne, Victoria, Australia
| | - Monica R Maly
- Department of Kinesiology and Health Sciences, University of Waterloo, Ontario, Canada.
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Li Z, Huang C, Leung KL, Huang J, Huang X, Fu SN. Strength and passive stiffness of the quadriceps are associated with patellar alignment in older adults with knee pain. Clin Biomech (Bristol, Avon) 2023; 110:106131. [PMID: 37925827 DOI: 10.1016/j.clinbiomech.2023.106131] [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: 04/15/2023] [Revised: 10/18/2023] [Accepted: 10/23/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Maintaining normal patellar alignment is important for knee health. Altered activation of individual quadriceps muscles have been found related to patellar alignment. However, the relationships between strength and passive stiffness of the quadriceps and patellar alignment remains unexplored. METHODS Participants aged between 60 and 80 years with activity-induced knee pain were recruited. Knee pain was quantified using an 11-point numeric rating scale. Quadriceps strength was assessed using a Cybex dynamometer and passive stiffness of rectus femoris, vastus lateralis, and vastus medialis were measured by shear-wave ultrasound elastography. Patellar alignments were assessed using MR imaging. Linear regression was used to examine relationships between quadriceps properties and patellar alignments with and without controlling for potential covariates. FINDINGS Ninety-two eligible participants were assessed (71.7% females, age: 65.6 ± 3.8 years; pain scale: 4.6 ± 2.0), most of whom had knee pain during stair climbing (85.9%). We found that 17% of patellar lateral tilt angle could be explained by lower quadriceps strength (adjusted R2 = 0.117; P < 0.001), especially in females (R2 = 0.281; P < 0.001; adjusted R2 = 0.211; P < 0.001). In addition, a higher stiffness ratio of vastus lateralis/medialis accounted for 12% of patellar lateral displacement (adjusted R2 = 0.112; P = 0.008). INTERPRETATION Quadriceps strength and relative stiffness of lateral to medial heads are associated with patellar alignment in older adults with knee pain. It suggests that quadriceps weakness and relatively stiffer lateral quadriceps may be risk factors related to patellar malalignments in the elderly.
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Affiliation(s)
- Zongpan Li
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Chen Huang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Kam Lun Leung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Jiebin Huang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Xiuping Huang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Siu Ngor Fu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China.
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Li Y, Hou Y, Sun J, Wei J, Chai Y, Guo M, Wang R. Therapeutic Effect of Acupotomy at Sanheyang for Cartilage Collagen Damage in Moderate Knee Osteoarthritis: A Rabbit Model. J Inflamm Res 2023; 16:2241-2254. [PMID: 37256203 PMCID: PMC10225278 DOI: 10.2147/jir.s400956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 05/02/2023] [Indexed: 06/01/2023] Open
Abstract
Objective Acupotomy based on the meridian-sinew theory of traditional Chinese medicine has benefits in treating knee osteoarthritis (KOA). The current study aims to prove that acupotomy at the sinew points of Sanheyang protect the knee joint and alleviate the progression of moderate KOA by evaluating KOA symptoms, cartilage structure, and analyzing the changes of cytokines in rabbit cartilage. Methods The model used was mono-iodoacetate-induced moderate KOA in the rabbit's right leg. Rabbits were divided into the model group, the acupotomy group, and the control group, with each group receiving two parts of treatment for 2 weeks and 4 weeks. We evaluated pain in the knee joint and range of motion. The articular cartilage sections were stained with Safranin O/Fast Green and Masson. We used immunohistochemistry and real-time PCR to detect the protein and mRNA expressions of collagen prototype II (COL-II), matrix metalloproteinase 13 (MMP13), and integrin-β1 (ITG-β1). Results Compared with the model group, the acupotomy group had higher body weight, lower pain score, higher range of motion, lower Mankin score, and significantly lower protein and mRNA expression of MMP13. After 4 weeks of treatment, Col-II expression in the acupotomy group was significantly higher than that in the model group and the expression of ITG-β1 in the model group was abnormally increased. Conclusion Acupotomy at Sanheyang improved the pain symptoms and range of joint motion in rabbits with moderate KOA, and could protect Col-II by regulating MMP13, which may be related to ITG-β1-mediated mechanical force transmission, thus reducing the damage to cartilage structure and delaying the progression of moderate KOA.
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Affiliation(s)
- Yuanyuan Li
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, People’s Republic of China
| | - Yimin Hou
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, People’s Republic of China
| | - Jiwei Sun
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, People’s Republic of China
| | - Jiabi Wei
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, People’s Republic of China
| | - Yemao Chai
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, People’s Republic of China
| | - Mengwei Guo
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, People’s Republic of China
| | - Rongguo Wang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, People’s Republic of China
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Li Z, Leung KL, Huang C, Huang X, Chung R, Fu SN. Passive stiffness of the quadriceps predicts the incidence of clinical knee osteoarthritis in twelve months. Eur J Phys Rehabil Med 2023; 59:65-74. [PMID: 36598343 PMCID: PMC10037105 DOI: 10.23736/s1973-9087.22.07634-1] [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: 01/05/2023]
Abstract
BACKGROUND Quadriceps weakness is a known risk factor for the onset of knee osteoarthritis (OA). In addition to muscle weakness, increased passive stiffness of the quadriceps may affect knee biomechanics and hence contribute to the pathogenesis of knee OA. However, the association between quadriceps stiffness and the risk of knee OA development has not been prospectively investigated. AIM The aim of this study was to investigate how baseline quadriceps passive stiffness predicts the incidence of clinical knee OA at the 12-month follow-up. DESIGN Prospective cohort study. SETTING University laboratory. POPULATION Community-dwelling adults aged 60-80 years were recruited. We excluded participants with: 1) knee pain or known arthritis; 2) knee injury; 3) knee or hip joint replacement, 4) cognitive impairment; or 5) neurological conditions. METHODS At baseline, passive stiffness of the three superficial quadriceps muscle heads (rectus femoris [RF], vastus lateralis [VL], and vastus medialis oblique [VMO]) was evaluated using shear-wave ultrasound elastography. Knee muscle (quadriceps and hamstrings) strength was tested using a Cybex dynamometer. Knee OA was defined based on clinical criteria 12 months after baseline measurements. Generalized estimating equations were used to examine the associations of quadriceps stiffness and knee muscle strength with the risk of knee OA, controlling for age, sex, Body Mass Index, comorbidities, and activity level. RESULTS The analyses included 158 knees (58.2% females, age: 65.6±4.1 years). Twenty-eight knees (17.7%) were classified as having clinical OA at 12 months. Compared with the lowest stiffness tertiles, the highest stiffness tertiles of the RF (relative risk =5.31, 95% CI: 1.34-21.0), VMO (4.15, 1.04-16.6), and total superficial quadriceps (6.35, 1.48-27.3) at baseline were significantly associated with a higher risk of knee OA at the follow-up. The highest strength tertile of quadriceps has a trend of association with a lower risk of knee OA than the lowest tertile (0.18, 0.03-1.25, P=0.083). CONCLUSIONS Greater passive stiffness of the quadriceps at baseline was associated with a higher risk of clinical knee OA incidence at the 12-month follow-up. CLINICAL REHABILITATION IMPACT Interventions for reducing the passive stiffness of the quadriceps should be included in preventative training programs for older adults.
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Affiliation(s)
- Zongpan Li
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Kam L Leung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Chen Huang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Xiuping Huang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Raymond Chung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Siu N Fu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China -
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5
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Gong Z, Li J, He Z, Li S, Cao P, Ruan G, Zhang Y, Zeng Q, Chen R, Zheng P, Fan T, Zhao Y, Lu P, Zhu Z, Huang G. Quadriceps strength is negatively associated with knee joint structural abnormalities-data from osteoarthritis initiative. BMC Musculoskelet Disord 2022; 23:784. [PMID: 35978313 PMCID: PMC9382744 DOI: 10.1186/s12891-022-05635-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 07/06/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The aim of this study was to explore the longitudinal associations between baseline quadriceps strength and knee joint structural abnormalities in knee osteoarthritis (KOA). METHODS This study is a longitudinally observational study based on Osteoarthritis Initiative (OAI) cohort, including men and women aged 45-79. Quadriceps strength was measured by isometric knee extension testing at baseline. Knee joint structural abnormalities, including cartilage damage, bone marrow lesions (BMLs), effusion-synovitis and Hoffa-synovitis, were evaluated by Magnetic Resonance Imaging Osteoarthritis Knee Score (MOAKS) at baseline and 1-year follow-up. Generalized estimating equations were employed to examine the associations between quadriceps strength and knee structural abnormalities. All analyses were stratified by sex. RESULTS One thousand three hundred thirty-eight participants (523 men and 815 women) with a mean age of 61.8 years and a mean BMI of 29.4 kg/m2 were included in this study. For men, no significantly longitudinal association of quadriceps strength with structural abnormalities was detected. In contrast, quadriceps strength was significantly and negatively associated with changes in cartilage damage and BMLs in lateral patellofemoral joint (PFJ) (cartilage damage: OR: 0.91, 95% CI 0.84 to 0.99, P = 0.023; BMLs: OR: 0.85, 95% CI 0.74 to 0.96, P = 0.011) and effusion-synovitis (OR = 0.88, 95% CI 0.78 to 0.99, P = 0.045) among females longitudinally. Higher quadriceps strength was significantly associated with less progression of lateral PFJ cartilage damage, BMLs and effusion-synovitis in females. CONCLUSIONS Higher quadriceps strength was associated with changes in cartilage damage and BMLs within the lateral PFJ and effusion-synovitis among females, suggesting the potential protective role of quadriceps strength on joint structures in women.
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Affiliation(s)
- Ze Gong
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China.,School of Rehabilitation Medicine, Southern Medical University, Haizhu District, 510280, Guangzhou, China
| | - Jia Li
- Division of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Zijun He
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China.,School of Rehabilitation Medicine, Southern Medical University, Haizhu District, 510280, Guangzhou, China
| | - Shilin Li
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China.,School of Rehabilitation Medicine, Southern Medical University, Haizhu District, 510280, Guangzhou, China
| | - Peihua Cao
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Haizhu District 510280, Guangzhou, Guangdong, China
| | - Guangfeng Ruan
- Clinical Research Centre, School of Medicine, Guangzhou First People's Hospital, South China University of Technology, Guangzhou, China
| | - Yan Zhang
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Haizhu District 510280, Guangzhou, Guangdong, China
| | - Qing Zeng
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China.,School of Rehabilitation Medicine, Southern Medical University, Haizhu District, 510280, Guangzhou, China
| | - Rong Chen
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China.,School of Rehabilitation Medicine, Southern Medical University, Haizhu District, 510280, Guangzhou, China
| | - Peng Zheng
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China.,School of Rehabilitation Medicine, Southern Medical University, Haizhu District, 510280, Guangzhou, China
| | - Tao Fan
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China.,School of Rehabilitation Medicine, Southern Medical University, Haizhu District, 510280, Guangzhou, China
| | - Yijin Zhao
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China.,School of Rehabilitation Medicine, Southern Medical University, Haizhu District, 510280, Guangzhou, China
| | - Pengcheng Lu
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China.,School of Rehabilitation Medicine, Southern Medical University, Haizhu District, 510280, Guangzhou, China
| | - Zhaohua Zhu
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Haizhu District 510280, Guangzhou, Guangdong, China.
| | - Guozhi Huang
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China. .,School of Rehabilitation Medicine, Southern Medical University, Haizhu District, 510280, Guangzhou, China.
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Øiestad BE, Juhl CB, Culvenor AG, Berg B, Thorlund JB. Knee extensor muscle weakness is a risk factor for the development of knee osteoarthritis: an updated systematic review and meta-analysis including 46 819 men and women. Br J Sports Med 2021; 56:349-355. [PMID: 34916210 DOI: 10.1136/bjsports-2021-104861] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2021] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To update a systematic review on the association between knee extensor muscle weakness and the risk of incident knee osteoarthritis in women and men. DESIGN Systematic review and meta-analysis. DATA SOURCES Systematic searches in PubMed, EMBASE, SPORTDiscus, CINAHL, AMED and CENTRAL in May 2021. ELIGIBLE CRITERIA FOR SELECTING STUDIES Longitudinal studies with at least 2 years follow-up including baseline measure of knee extensor muscle strength, and follow-up measure of symptomatic or radiographic knee osteoarthritis. Studies including participants with known knee osteoarthritis at baseline were excluded. Risk of bias assessment was conducted using six criteria for study validity and bias. Grading of Recommendations Assessments, Development and Evaluation assessed overall quality of evidence. Meta-analysis estimated the OR for the association between knee extensor muscle weakness and incident knee osteoarthritis. RESULTS We included 11 studies with 46 819 participants. Low quality evidence indicated that knee extensor muscle weakness increased the odds of symptomatic knee osteoarthritis in women (OR 1.85, 95% CI 1.29 to 2.64) and in adult men (OR 1.43, 95% CI 1.14 to 1.78), and for radiographic knee osteoarthritis in women: OR 1.43 (95% CI 1.19 to 1.71) and in men: OR 1.39 (95% CI 1.07 to 1.82). No associations were identified for knee injured populations except for radiographic osteoarthritis in men. DISCUSSION There is low quality evidence that knee extensor muscle weakness is associated with incident symptomatic and radiographic knee osteoarthritis in women and men. Optimising knee extensor muscle strength may help to prevent knee osteoarthritis. PROSPERO REGISTRATION NUMBER CRD42020214976.
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Affiliation(s)
- Britt Elin Øiestad
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Carsten B Juhl
- Department of Physiotherapy and Occupational Theray, Copenhagen University Hospital, Herlev and Gentofte, Denmark.,Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Adam G Culvenor
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University School of Allied Health Human Services and Sport, Bundoora, Victoria, Australia
| | - Bjørnar Berg
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
| | - Jonas Bloch Thorlund
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
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7
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The effect of extensor muscle strength on meniscus damage progression in subjects without radiologic knee osteoarthritis – Data from the Osteoarthritis Initiative. Am J Phys Med Rehabil 2021; 101:836-842. [DOI: 10.1097/phm.0000000000001922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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8
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Andrews JS, Gold LS, Nevitt M, Heagerty PJ, Cawthon PM. Appendicular Lean Mass, Grip Strength, and the Development of Knee Osteoarthritis and Knee Pain Among Older Adults. ACR Open Rheumatol 2021; 3:566-572. [PMID: 34245226 PMCID: PMC8363849 DOI: 10.1002/acr2.11302] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 06/11/2021] [Indexed: 12/25/2022] Open
Abstract
Objective The association of sarcopenia with development of knee osteoarthritis (OA) or knee pain in older adults is uncertain. We examined the relationship of grip strength and appendicular lean mass (ALM) with the likelihood of developing knee OA and knee pain in older adults in the Health ABC (Health, Aging, and Body Composition) Study. Methods ALM and grip strength were assessed at baseline by dual‐energy x‐ray absorptiometry and handheld dynamometry, respectively. Incident clinically diagnosed, symptomatic knee OA, defined as new participant report of physician‐diagnosed knee OA and concurrent frequent knee pain, and incident frequent knee pain over 5 years of follow‐up were examined. Separate regression analyses, stratified by sex, modeled associations of baseline ALM and grip strength with the likelihood of incident clinically diagnosed, symptomatic knee OA and incident knee pain over follow‐up, adjusting for covariates. Results Among the 2779 subjects without OA at baseline, 95 men (6.9%) and 158 women (11.3%) developed clinically diagnosed, symptomatic knee OA, and, among the 2182 subjects without knee pain at baseline, 315 men (28.3%) and 385 women (36.1%) developed knee pain over follow‐up. Among men only, each SD decrement of ALM was associated with decreasing likelihood of incident knee OA (odds ratio [OR] per SD decrement: 0.68; 95% confidence interval [CI]: 0.47‐0.97), and each SD decrement of grip strength was associated with increasing likelihood of incident knee pain (OR per SD decrement: 1.20; 95% CI: 1.01‐1.42). Conclusion In older men, ALM and grip strength may be associated with the development of knee OA and knee pain, respectively.
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Affiliation(s)
| | | | | | | | - Peggy M Cawthon
- California Pacific Medical Center Research Institute and University of California, San Francisco
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9
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Berg B, Roos EM, Kise NJ, Engebretsen L, Holm I, Risberg MA. Muscle strength and osteoarthritis progression after surgery or exercise for degenerative meniscal tears: Secondary analyses of a randomized trial. Arthritis Care Res (Hoboken) 2021; 74:70-78. [PMID: 34151533 DOI: 10.1002/acr.24736] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 06/17/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To evaluate muscle strength changes following partial meniscectomy or exercise therapy for degenerative meniscal tears and the relationship between baseline muscle strength and osteoarthritis progression. METHODS Secondary analysis of a randomized trial (n=140 participants). Isokinetic quadriceps and hamstrings strength (peak torque [N·m/kg] and total work [J/kg]) were assessed at baseline, three-, 12-month, and five-year follow-up. Between-group differences were analyzed using intention-to-treat linear mixed models. The relationship between baseline muscle strength and osteoarthritis progression (Kellgren and Lawrence, ≥1 grade increase) were assessed using logistic regression models. RESULTS We found statistically significant between-group differences favoring exercise therapy at three months (quadriceps: -0.30 N·m/kg, 95% CI -0.40, -0.20; hamstrings: -0.10 N·m/kg, 95% CI -0.15, -0.04) and 12 months (quadriceps: -0.13 N·m/kg, 95% CI -0.23, -0.03; hamstrings: -0.08 N·m/kg, 95% CI -0.14, -0.03). At five years, between-group differences were -0.10 N·m/kg (95% CI -0.21 to 0.01) for quadriceps and -0.07 N·m/kg (95% CI -0.13 to -0.01) for hamstrings. Quadriceps muscle weakness at baseline was associated with knee osteoarthritis progression over five years: adjusted odds ratio of 1.40 for every 0.2 N·m/kg decrease (95% CI 1.15 to 1.71). The adjusted odds ratio for hamstrings was 1.14 (95% CI 0.97-1.35) for every 0.1 N·m/kg decrease. CONCLUSION Exercise therapy was effective in improving muscle strength at three and 12-month follow-up compared to partial meniscectomy, but the effect was attenuated at five years. Quadriceps muscle weakness at baseline was associated with higher odds of osteoarthritis progression over five years.
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Affiliation(s)
- Bjørnar Berg
- Division of Orthopedic Surgery, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, Department of Interdisciplinary Health Sciences, University of Oslo, Oslo, Norway
| | - Ewa M Roos
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Nina Jullum Kise
- Department of Orthopedic Surgery, Martina Hansens Hospital, Sandvika, Norway
| | - Lars Engebretsen
- Division of Orthopedic Surgery, Oslo University Hospital, Oslo, Norway.,Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway.,Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Inger Holm
- Division of Orthopedic Surgery, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, Department of Interdisciplinary Health Sciences, University of Oslo, Oslo, Norway
| | - May Arna Risberg
- Division of Orthopedic Surgery, Oslo University Hospital, Oslo, Norway.,Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
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10
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Hiranaka T, Furumatsu T, Okazaki Y, Yamawaki T, Okazaki Y, Kodama Y, Kamatsuki Y, Ozaki T. Steep medial tibial slope and prolonged delay to surgery are associated with bilateral medial meniscus posterior root tear. Knee Surg Sports Traumatol Arthrosc 2021; 29:1052-1057. [PMID: 32488369 DOI: 10.1007/s00167-020-06079-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 05/20/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Contralateral medial meniscus posterior root tear (MMPRT) can sometimes occur after primary surgeries for MMPRT and lead to unsatisfactory outcomes. The incidence rate and risk factors for contralateral MMPRT have not been well investigated, despite their clinical importance. Therefore, the incidence and predictors of bilateral MMPRT were aimed to be evaluated. METHODS Fourteen patients with bilateral MMPRT (group B) and 169 patients with unilateral MMPRT (group U) were enrolled in this study. Sex, age, body mass index, time between injury and surgery, and medial tibial slope angle (MTSA) were compared between the groups. MTSA was measured using lateral radiographs. RESULTS The incidence rate of bilateral MMPRT was 6.2% among all patients with MMPRTs. Multivariate logistic regression analysis showed that a prolonged time between injury and surgery (odds ratio [OR], 1.0; 95% confidence interval [CI] 1.00-1.01; P < 0.05) and steeper MTSA (OR, 1.85; 95% CI 1.21-2.64; P < 0.01) were significantly associated with the development of bilateral MMPRT. Receiver operating characteristic curve analysis showed that MTSA > 10.0° was associated with bilateral MMPRT, with a sensitivity of 93% and specificity of 69%. CONCLUSION A longer time between injury and surgery and steeper MTSA were risk factors for the development of bilateral MMPRT. Surgeons need to pay close attention to the contralateral knee in addition to the primary injured knees when treating knees with steep MTSA. Besides, early meniscal repair of primary MMPRT would be important to prevent the events of contralateral MMPRT. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Takaaki Hiranaka
- Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan.,Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan
| | - Takayuki Furumatsu
- Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan.
| | - Yuki Okazaki
- Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan
| | - Tadashi Yamawaki
- Department of Orthopaedic Surgery, Kousei Hospital, 3-8-35 Kouseicho, Kitaku, Okayama, 700-0985, Japan
| | - Yoshiki Okazaki
- Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan
| | - Yuya Kodama
- Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan
| | - Yusuke Kamatsuki
- Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan
| | - Toshifumi Ozaki
- Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan.,Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan
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11
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Freystaetter G, Fischer K, Orav EJ, Egli A, Theiler R, Münzer T, Felson DT, Bischoff‐Ferrari HA. Total Serum Testosterone and Western Ontario and McMaster Universities Osteoarthritis Index Pain and Function Among Older Men and Women With Severe Knee Osteoarthritis. Arthritis Care Res (Hoboken) 2020; 72:1511-1518. [PMID: 31557423 PMCID: PMC7702066 DOI: 10.1002/acr.24074] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 09/17/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To investigate whether serum total testosterone level is associated with knee pain and function in men and women with severe knee osteoarthritis (OA). METHODS We enrolled 272 adults age ≥60 years (mean ± SD age 70.4 ± 4.4 years, 53% women) who underwent unilateral total knee replacement (TKR) due to severe knee OA. Serum testosterone levels and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function of the operated and contralateral knee were measured at 6-8 weeks after surgery. At the nonoperated knee, 56% of participants had radiographic knee OA with a Kellgren/Lawrence grade ≥2. Cross-sectional analyses were performed by sex and body mass index (BMI) subgroups, using multivariable regression adjusted for age, physical activity, and BMI. RESULTS At the operated knee, higher testosterone levels were associated with less WOMAC pain in men (B = -0.62, P = 0.046) and women (B = -3.79, P = 0.02), and less WOMAC disability scores in women (B = -3.62, P = 0.02) and obese men (B = -1.99, P = 0.02). At the nonoperated knee, testosterone levels were not associated with WOMAC pain in men or women, but higher testosterone levels were associated with less disability in women (B = -0.95, P = 0.02). Testosterone levels were inconsistently associated with pain and disability in BMI subgroups among men. Only among obese women, testosterone levels were inversely associated with radiographic knee OA (odds ratio = 0.10, P = 0.003). CONCLUSION Higher total testosterone levels were associated with less pain in the operated knee in men and women undergoing TKR and less disability in women. At the nonoperated knee, higher testosterone levels were inconsistently associated with less pain and disability.
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Affiliation(s)
- Gregor Freystaetter
- University Hospital ZurichUniversity of Zurichand City Hospital WaidZurichSwitzerland
| | - Karina Fischer
- University Hospital ZurichUniversity of Zurichand City Hospital WaidZurichSwitzerland
| | | | - Andreas Egli
- University Hospital ZurichUniversity of Zurichand City Hospital WaidZurichSwitzerland
| | - Robert Theiler
- University Hospital ZurichUniversity of Zurichand City Hospital WaidZurichSwitzerland
| | - Thomas Münzer
- University Hospital ZurichUniversity of Zurichand City Hospital Waid, Zurich, and Geriatrische KlinikSt. GallenSwitzerland
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12
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Early knee osteoarthritis prevalence is highest among middle-aged adult females with obesity based on new set of diagnostic criteria from a large sample cohort study in the Japanese general population. Knee Surg Sports Traumatol Arthrosc 2020; 28:984-994. [PMID: 31292689 DOI: 10.1007/s00167-019-05614-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Accepted: 07/01/2019] [Indexed: 01/15/2023]
Abstract
PURPOSE A few new criteria for early detection and prevention of early knee osteoarthritis (EKOA) have been proposed. However, its prevalence, risk factors, relationship with function and prognosis have not been clarified. The purpose of this study was to investigate the prevalence of EKOA and its risk factors in the Japanese general population. METHODS A total of 1104 volunteers (443 males, 661 females) who participated in the Iwaki cohort study in Japan were enrolled in this cross-sectional study. Their bilateral weight-bearing anterior-posterior knee radiographs were classified by Kellgren-Lawrence (KL) grade. EKOA (KL grade 0/1) was defined according to the following criteria: knee injury and osteoarthritis outcome score < 85%, joint line tenderness, and crepitus and its prevalence among age-sex groups was calculated. Logistic regression analyses were performed to determine the risk factors for EKOA. RESULTS Eight hundred and twenty-two participants had KL grade 0/1, and the EKOA prevalence was 9.5% in males and 15.0% in females (p = 0.011). The prevalence of EKOA increased with age. The highest prevalence was noted in females aged 50-59 years. Logistic regression analysis showed that the risk factors for EKOA were age (p < 0.001, odds ratio (OR) 1.1), female sex (p = 0.002, OR 2.5), high body mass index (p < 0.001, OR 1.2), and history of knee injury (p < 0.001, OR 21.7). CONCLUSIONS The highest EKOA prevalence was observed in middle adult females (50-59 years old). The risk factors for EKOA were female sex, ageing, obesity and knee injury history, which were extremely similar to those of definitive knee osteoarthritis. LEVEL OF EVIDENCE Level I in diagnostic studies-investigating a diagnostic test.
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13
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Ericsson YB, Roos EM, Owman H, Dahlberg LE. Association between thigh muscle strength four years after partial meniscectomy and radiographic features of osteoarthritis 11 years later. BMC Musculoskelet Disord 2019; 20:512. [PMID: 31679520 PMCID: PMC6827177 DOI: 10.1186/s12891-019-2875-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 10/09/2019] [Indexed: 12/23/2022] Open
Abstract
Background Meniscus injury and meniscectomy both entail increased risk of knee osteoarthritis (OA). Thigh muscle weakness is a suggested mediator of OA but there is little evidence of its importance for knee OA development after meniscectomy. This study aimed to examine the association between thigh muscle strength after partial meniscectomy in middle-aged subjects with a non-traumatic meniscal tear and later radiographic knee OA changes. Methods Thirty-four out of 45 participants in an exercise-trial underwent testing for isokinetic thigh muscle strength 4 years after arthroscopic partial meniscectomy and had radiographic examination 11 years later (15 years post-surgery, mean age at follow-up of 57 years (range 50–61)). Outcomes were grade of joint space narrowing and osteophyte score in the medial tibiofemoral compartment of the operated knee and the contralateral knee. We tested the association between muscle strength at baseline and the radiographic outcomes at follow-up using logistic regression analyses adjusted for sex and overweight. Results At follow-up, 33/34 subjects had joint space narrowing and 27/34 subjects had osteophytes in the operated knee, in the contralateral knee joint space narrowing was found in 23 subjects. In the operated knee baseline knee extensor and flexor strength were negatively associated with grade of joint space narrowing at follow-up (OR 0.972 and 0.956, p = 0.028 and 0.026, respectively) and also with osteophyte score (OR 0.968 and 0.931, p = 0.017 and 0.011, respectively). In the contralateral knee longitudinal associations between strength and radiographic OA features were similar, OR 0.949–0.972, p < 0.05. Conclusion The finding that stronger thigh muscles 4 years after meniscectomy were associated with less severe osteoarthritic changes in the medial tibiofemoral compartment of both the operated and contralateral knee 11 years later, may suggest that strong thigh muscles can help to preserve joint integrity in middle-aged subjects at risk of knee OA.
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Affiliation(s)
- Ylva B Ericsson
- Department of Clinical Sciences Malmö, Lund University, Lund, Sweden. .,Department of Orthopaedics, Skane University Hospital, SE-205 02, Malmö, Sweden.
| | - Ewa M Roos
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Henrik Owman
- Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Leif E Dahlberg
- Department of Clinical Sciences Lund, Orthopaedics, Lund University, Skane University Hospital, Lund, Sweden
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14
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Bischoff-Ferrari HA, Orav EJ, Egli A, Dawson-Hughes B, Fischer K, Staehelin HB, Rizzoli R, Hodler J, von Eckardstein A, Freystaetter G, Meyer U, Guggi T, Burckhardt P, Schietzel S, Chocano-Bedoya P, Theiler R, Willett WC, Felson D. Recovery after unilateral knee replacement due to severe osteoarthritis and progression in the contralateral knee: a randomised clinical trial comparing daily 2000 IU versus 800 IU vitamin D. RMD Open 2018; 4:e000678. [PMID: 30018805 PMCID: PMC6045766 DOI: 10.1136/rmdopen-2018-000678] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 06/10/2018] [Indexed: 01/24/2023] Open
Abstract
Objective To test whether daily high-dose vitamin D improves recovery after unilateral total knee replacement. Methods Data come from a 24-month randomised, double-blind clinical trial. Adults aged 60 and older undergoing unilateral joint replacement due to severe knee osteoarthritis were 6-8 weeks after surgery randomly assigned to receive daily high-dose (2000 IU) or standard-dose (800 IU) vitamin D3. The primary endpoints were symptoms (Western Ontario and McMaster Universities Arthritis Index pain and function scores) assessed at baseline, 6, 12, 18 and 24 months in both knees, and the rate of falls over 24 months. The secondary outcomes were sit-to-stand performance, gait speed, physical activity and radiographic progression in the contralateral knee. Results We recruited 273 participants, 137 were randomised to receive 2000 IU and 136 were randomised to receive 800 IU vitamin D per day. 2000 IU vitamin D increased 25-hydroxyvitamin D levels to 45.6 ng/mL and 800 IU vitamin D to 37.1 ng/mL at month 24 (p<0.0001). While symptoms improved significantly in the operated knee and remained stable in the contralateral knee over time, none of the primary or secondary endpoints differed by treatment group over time. The rate of falls over 24 months was 1.05 with 2000 IU and 1.07 with 800 IU (p=0.84). 30.5% of participants in the 2000 IU and 31.3% of participants in the 800 IU group had radiographic progression in the contralateral knee over 24 months (p=0.88). Conclusions Our findings suggest that a 24-month treatment with daily 2000 IU vitamin D did not show greater benefits or harm than a daily standard dose of 800 IU among older adults undergoing unilateral total knee replacement.
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Affiliation(s)
- Heike A Bischoff-Ferrari
- Department of Geriatrics and Aging Research, University Hospital Zurich, University of Zurich, Zurich, Switzerland.,Center on Aging and Mobility, University of Zurich, Zurich, Switzerland.,University Clinic for Acute Geriatric Care, City Hospital Waid, Zurich, Switzerland
| | - E John Orav
- Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts, USA
| | - Andreas Egli
- Department of Geriatrics and Aging Research, University Hospital Zurich, University of Zurich, Zurich, Switzerland.,Center on Aging and Mobility, University of Zurich, Zurich, Switzerland
| | - Bess Dawson-Hughes
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts, USA
| | - Karina Fischer
- Center on Aging and Mobility, University of Zurich, Zurich, Switzerland
| | | | - Rene Rizzoli
- Division of Bone Diseases, Geneva University Hospitals, Geneva, Switzerland
| | - Juerg Hodler
- Institute of Radiology, University Hospital Zurich, Zurich, Switzerland
| | | | - Gregor Freystaetter
- Department of Geriatrics and Aging Research, University Hospital Zurich, University of Zurich, Zurich, Switzerland.,Center on Aging and Mobility, University of Zurich, Zurich, Switzerland
| | - Ursina Meyer
- Department of Geriatrics and Aging Research, University Hospital Zurich, University of Zurich, Zurich, Switzerland.,Center on Aging and Mobility, University of Zurich, Zurich, Switzerland
| | - Thomas Guggi
- Department of Orthopaedic Surgery, Schulthess Clinic, Zurich, Switzerland
| | | | - Simeon Schietzel
- Department of Geriatrics and Aging Research, University Hospital Zurich, University of Zurich, Zurich, Switzerland.,Center on Aging and Mobility, University of Zurich, Zurich, Switzerland
| | - Patricia Chocano-Bedoya
- Department of Geriatrics and Aging Research, University Hospital Zurich, University of Zurich, Zurich, Switzerland.,Center on Aging and Mobility, University of Zurich, Zurich, Switzerland
| | - Robert Theiler
- Department of Geriatrics and Aging Research, University Hospital Zurich, University of Zurich, Zurich, Switzerland.,Center on Aging and Mobility, University of Zurich, Zurich, Switzerland
| | - Walter C Willett
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA
| | - David Felson
- Clinical Epidemiology Research and Training Unit, Boston University, Boston, Massachusetts, USA
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15
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Krishnasamy P, Hall M, Robbins SR. The role of skeletal muscle in the pathophysiology and management of knee osteoarthritis. Rheumatology (Oxford) 2018; 57:iv22-iv33. [DOI: 10.1093/rheumatology/kex515] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Indexed: 12/15/2022] Open
Affiliation(s)
- Priathashini Krishnasamy
- Institute of Bone and Joint Research, Kolling Institute of Medical Research, Northern Clinical School, Faculty of Medicine, University of Sydney, Sydney, NSW
- Department of Rheumatology, Royal North Shore Hospital, Sydney, NSW
| | - Michelle Hall
- Centre for Health Exercise and Sports Medicine, Department of Physiotherapy, University of Melbourne, Melbourne, VIC, Australia
| | - Sarah R Robbins
- Institute of Bone and Joint Research, Kolling Institute of Medical Research, Northern Clinical School, Faculty of Medicine, University of Sydney, Sydney, NSW
- Department of Rheumatology, Royal North Shore Hospital, Sydney, NSW
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16
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Turkiewicz A, Timpka S, Thorlund JB, Ageberg E, Englund M. Knee extensor strength and body weight in adolescent men and the risk of knee osteoarthritis by middle age. Ann Rheum Dis 2017; 76:1657-1661. [PMID: 28487313 DOI: 10.1136/annrheumdis-2016-210888] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 04/10/2017] [Accepted: 04/22/2017] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To assess the extent to which knee extensor strength and weight in adolescence are associated with knee osteoarthritis (OA) by middle age. METHODS We studied a cohort of 40 121 men who at age 18 years in 1969/1970 underwent mandatory conscription in Sweden. We retrieved data on isometric knee extensor strength, weight, height, smoking, alcohol consumption, parental education and adult occupation from Swedish registries. We identified participants diagnosed with knee OA or knee injury from 1987 to 2010 through the National Patient Register. We estimated the HR of knee OA using multivariable-adjusted Cox proportional regression model. To assess the influence of adult knee injury and occupation, we performed a formal mediation analysis. RESULTS The mean (SD) knee extensor strength was 234 (47) Nm, the mean (SD) weight was 66 (9.3) kg. During 24 years (median) of follow-up starting at the age of 35 years, 2049 persons were diagnosed with knee OA. The adjusted HR (95% CI) of incident knee OA was 1.12 (1.06 to 1.18) for each SD of knee extensor strength and 1.18 (1.15 to 1.21) per 5 kg of body weight. Fifteen per cent of the increase in OA risk due to higher knee extensor strength could be attributed to knee injury and adult occupation. CONCLUSION Higher knee extensor strength in adolescent men was associated with increased risk of knee OA by middle age, challenging the current tenet of low muscle strength being a risk factor for OA. We confirmed higher weight to be a strong risk factor for knee OA.
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Affiliation(s)
- Aleksandra Turkiewicz
- Department of Clinical Sciences Lund, Orthopedics, Clinical Epidemiology Unit, Faculty of Medicine, Lund University, Lund, Sweden
| | - Simon Timpka
- Genetic and Molecular Epidemiology Unit, Lund University Diabetes Center, Lund University, Malmö, Sweden.,Division of Women's Health, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Jonas Bloch Thorlund
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Eva Ageberg
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Martin Englund
- Department of Clinical Sciences Lund, Orthopedics, Clinical Epidemiology Unit, Faculty of Medicine, Lund University, Lund, Sweden.,Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, Massachusetts, USA
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17
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Osteoarthritis year in review 2016: imaging. Osteoarthritis Cartilage 2017; 25:216-226. [PMID: 27965137 DOI: 10.1016/j.joca.2016.12.009] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 11/21/2016] [Accepted: 12/05/2016] [Indexed: 02/02/2023]
Abstract
PURPOSE The current narrative review covers original research related to imaging in osteoarthritis (OA) in humans published in English between April 1st 2015 and March 31st 2016, in peer reviewed journals available in Medline via PubMed (http://www.ncbi.nlm.nih.gov/pubmed/). METHODS Relevant studies in humans, subjectively decided by the authors, contributing significantly to the OA imaging field, were selected from an extensive Medline search using the terms "Osteoarthritis" in combination with "MRI", "Imaging", "Radiography", "X-rays", "Ultrasound", "Computed tomography", "Nuclear medicine", "PET-CT", "PET-MRI", "Scintigraphy", "SPECT". Publications were sorted according to relevance for the OA imaging research community with an emphasis on high impact special interest journals using the software for systematic reviews www.covidence.org. RESULTS An overview of newly published studies compared to studies reported previous years is presented, followed by a review of selected imaging studies of primarily knee, hip and hand OA focussing on (1) results for detection of OA and OA-related pathology (2) studies dealing with treatments and (3) studies focussing on prognosis of disease progression or joint replacement. A record high number of 1420 articles were published, among others, of new technologies and tools for improved morphological and pathophysiological understanding of OA-related changes in joints. Also, imaging data were presented of monitoring treatment effect and prognosis of OA progression, primarily using established radiographic, magnetic resonance imaging (MRI), and ultrasound (US) methods. CONCLUSION Imaging continues to play an important role in OA research, where several exciting new technologies and computer aided analysis methods are emerging to complement the conventional imaging approaches.
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18
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Osteoarthritis year in review 2016: mechanics. Osteoarthritis Cartilage 2017; 25:190-198. [PMID: 28100420 DOI: 10.1016/j.joca.2016.09.023] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 09/21/2016] [Accepted: 09/24/2016] [Indexed: 02/02/2023]
Abstract
Inappropriate biomechanics, namely wear-and-tear, has been long believed to be a main cause of osteoarthritis (OA). However, this view is now being re-evaluated, especially when examined alongside mechanobiology and new biomechanical studies. These are multiscale experimental and computational studies focussing on cell- and tissue-level mechanobiology through to organ- and whole-body-level biomechanics, which focuses on the biomechanical and biochemical environment of the joint tissues. This review examined papers from April 2015 to April 2016, with a focus on multiscale experimental and computational biomechanical studies of OA. Assessing the onset or progression of OA at organ- and whole-body-levels, gait analysis, medical imaging and neuromusculoskeletal modelling revealed the extent to which tissue damage changes the view of inappropriate biomechanics. Traditional gait analyses studies reported that conservative treatments can alter joint biomechanics, thereby improving pain and function experienced by those with OA. Results of animal models of OA were consistent with these human studies, showing interactions among bone, cartilage and meniscus biomechanics and the onset and/or progression OA. Going down size scales, experimental and computational studies probed the nanosize biomechanics of molecules, cells and extracellular matrix, and demonstrated how the interactions between biomechanics and morphology affect cartilage dynamic poroelastic behaviour and pathways to OA. Finally, integration of multiscale experimental data and computational models were proposed to predict cartilage extracellular matrix remodelling and the development of OA. Summarising, experimental and computational methods provided a nuanced biomechanical understanding of the sub-cellular, cellular, tissue, organ and whole-body mechanisms involved in OA.
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