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Negishi Y, Kaneko H, Aoki T, Liu L, Adili A, Arita H, Hada S, Momoeda M, Huang H, Tomura J, Wakana S, Shiozawa J, Kubota M, Someya Y, Tamura Y, Aoki S, Watada H, Kawamori R, Negishi-Koga T, Okada Y, Ishijima M. Medial meniscus extrusion is invariably observed and consistent with tibial osteophyte width in elderly populations: The Bunkyo Health Study. Sci Rep 2023; 13:22805. [PMID: 38129496 PMCID: PMC10739745 DOI: 10.1038/s41598-023-49868-7] [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: 09/20/2022] [Accepted: 12/13/2023] [Indexed: 12/23/2023] Open
Abstract
We reported that the full-length width of medial tibial osteophytes comprising cartilage and bone parts correlates with medial meniscus extrusion (MME) in early-stage knee osteoarthritis (OA). However, no data exist on the prevalence of MME and its relationship with osteophytes in the elderly population. 1191 elderly individuals (females 57%; 72.9 years old on average) in the Bunkyo Health Study underwent standing plain radiograph and proton density-weighted MRI on knee joints. MRI-detected OA changes were evaluated according to the Whole-Organ Magnetic Resonance Imaging Score. A new method of assessing the cartilage and bone parts of osteophytes was developed using pseudo-coloring images of proton density-weighted fat-suppressed MRI. Most subjects showed Kellgren-Lawrence grade 1 or 2 radiographic medial knee OA (88.1%), MME (98.7%, 3.90 ± 2.01 mm), and medial tibial osteophytes (99.3%, 3.27 ± 1.50 mm). Regarding OA changes, MME was closely associated with the full-length width of medial tibial osteophytes (β = 1.114; 95% CI 1.069-1.159; p < 0.001) in line with osteophyte width (intraclass correlation coefficient, 0.804; 95% CI 0.783-0.823). Our data revealed that MME and medial tibial osteophytes are observed in the elderly and demonstrate that the degree of MME is consistent with the full-length width of medial tibial osteophytes, suggesting that osteophytes might be implicated in MME.
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Affiliation(s)
- Yoshifumi Negishi
- Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Haruka Kaneko
- Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
- Department of Pathophysiology for Locomotive Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takako Aoki
- Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Lizu Liu
- Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Arepati Adili
- Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hitoshi Arita
- Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Shinnosuke Hada
- Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Masahiro Momoeda
- Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
- Department of Pathophysiology for Locomotive Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hui Huang
- Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Jun Tomura
- Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Suguru Wakana
- Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Jun Shiozawa
- Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
- Department of Pathophysiology for Locomotive Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Mitsuaki Kubota
- Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
- Department of Community Medicine and Research for Bone and Joint Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yuki Someya
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yoshifumi Tamura
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shigeki Aoki
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hirotaka Watada
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Ryuzo Kawamori
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takako Negishi-Koga
- Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
- Department of Community Medicine and Research for Bone and Joint Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yasunori Okada
- Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
- Department of Pathophysiology for Locomotive Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan.
| | - Muneaki Ishijima
- Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
- Department of Pathophysiology for Locomotive Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan.
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan.
- Department of Community Medicine and Research for Bone and Joint Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan.
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Adili A, Kaneko H, Aoki T, Liu L, Negishi Y, Tomura J, Wakana S, Momoeda M, Arita H, Hada S, Shiozawa J, Kubota M, Someya Y, Tamura Y, Aoki S, Watada H, Kawamori R, Negishi-Koga T, Okada Y, Ishijima M. Anterior meniscus extrusion is associated with anterior tibial osteophyte width in knee osteoarthritis - The Bunkyo Health Study. OSTEOARTHRITIS AND CARTILAGE OPEN 2023; 5:100364. [PMID: 37207278 PMCID: PMC10189494 DOI: 10.1016/j.ocarto.2023.100364] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 04/17/2023] [Indexed: 05/21/2023] Open
Abstract
Background In knee osteoarthritis (OA), medial meniscus extrudes both medially and anteriorly. We reported that full-length width of medial tibial osteophyte, which comprises cartilage and bone parts, is directly associated with medial meniscus extrusion in early-stage knee OA and hypothesized that anterior tibial osteophyte (ATO) is also associated with anterior meniscus extrusion (AME). Thus, we aimed to examine their prevalence and relationship. Methods Elderly subjects (638 females and 507 males; average 72.9 years old) in the Bunkyo Health Study cohort were enrolled. MRI-detected OA changes were evaluated according to the Whole Organ Magnetic Resonance Imaging Score. ATO was evaluated using the method which can assess both cartilage and bone parts of osteophyte by pseudo-coloring images of proton density-weighted fat-suppressed MRI. Results Most subjects showed the Kellgren-Lawrence grade 1/2 of the medial knee OA (88.1%), AME (94.3%, 3.7 ± 2.2 mm), and ATO (99.6%, 4.2 ± 1.5 mm). Among the OA changes, AME was most closely associated with full-length width of ATO (multivariable β = 0.877, p < 0.001). The area under the receiver operating characteristic curve for determining the presence of AME as evaluated by ATO width was 0.75 (95% confidence interval 0.60-0.84, p < 0.001). The odds ratio for the presence of AME as evaluated by ATO width at 2.9 mm was 7.16 (4.23-12.15, p < 0.001, age, gender, BMI, and K-L adjusted). Conclusions AME and ATO were inevitably observed in the elderly subjects and AME was closely associated with full-length width of ATO. Our study provides the first evidence on the close relationship between AME and ATO in knee OA.
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Affiliation(s)
- Arepati Adili
- Department of Orthopaedics, Juntendo University Faculty of Medicine, Tokyo, Japan
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Haruka Kaneko
- Department of Orthopaedics, Juntendo University Faculty of Medicine, Tokyo, Japan
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Corresponding author. Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421, Japan. Fax: +81 3 3813 3428.
| | - Takako Aoki
- Department of Orthopaedics, Juntendo University Faculty of Medicine, Tokyo, Japan
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Lizu Liu
- Department of Orthopaedics, Juntendo University Faculty of Medicine, Tokyo, Japan
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yoshifumi Negishi
- Department of Orthopaedics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Jun Tomura
- Department of Orthopaedics, Juntendo University Faculty of Medicine, Tokyo, Japan
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Suguru Wakana
- Department of Orthopaedics, Juntendo University Faculty of Medicine, Tokyo, Japan
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Masahiro Momoeda
- Department of Orthopaedics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Hitoshi Arita
- Department of Orthopaedics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Shinnosuke Hada
- Department of Orthopaedics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Jun Shiozawa
- Department of Orthopaedics, Juntendo University Faculty of Medicine, Tokyo, Japan
- Department of Pathophysiology for Locomotive Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Mitsuaki Kubota
- Department of Orthopaedics, Juntendo University Faculty of Medicine, Tokyo, Japan
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Community Medicine and Research for Bone and Joint Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yuki Someya
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yoshifumi Tamura
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shigeki Aoki
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hirotaka Watada
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Ryuzo Kawamori
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takako Negishi-Koga
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Community Medicine and Research for Bone and Joint Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yasunori Okada
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Pathophysiology for Locomotive Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Muneaki Ishijima
- Department of Orthopaedics, Juntendo University Faculty of Medicine, Tokyo, Japan
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Pathophysiology for Locomotive Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Community Medicine and Research for Bone and Joint Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Corresponding author. Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421, Japan. Fax: +81 3 3813 3428.
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Takahashi S, Nonomiya Y, Terai H, Hoshino M, Ohyama S, Shintani A, Nakamura H. Artificial intelligence model to identify elderly patients with locomotive syndrome: A cross-section study. J Orthop Sci 2022; 28:656-661. [PMID: 35148912 DOI: 10.1016/j.jos.2022.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 01/12/2022] [Accepted: 01/18/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Identifying elderly individuals with locomotive syndrome is important to prevent disability in this population. Although screening tools for locomotive syndrome are available, these require time commitment and are limited by an individual's ability to complete questionnaires independently. To improve on this limitation, we developed a screening tool that uses information on the distribution of pressure on the plantar surface of the foot with an artificial intelligence (AI)-based decision system to identify patients with locomotor syndrome. Herein, we describe our AI-based system and evaluate its performance. METHODS This was a cross-sectional study of 409 participants (mean age, 73.5 years). A foot scan pressure system was used to record the planter pressure distribution during gait. In the image processing step, we developed a convolutional neural network (CNN) to return the logit of the probability of locomotive syndrome based on foot pressure images. In the logistic regression step of the AI model, we estimated the predictor coefficients, including age, sex, height, weight, and the output of the CNN, based on foot pressure images. RESULTS The AI model improved the identification of locomotive syndrome among elderly individuals compared to clinical data, with an area under curve of 0.84 (95% confidence interval, 0.79-0.88) for the AI model compared to 0.80 (95% confidence interval, 0.75-0.85) for the clinical model. Including the footprint force distribution image significantly improved the prediction algorithm (the net reclassification improvement was 0.675 [95% confidence interval, 0.45-0.90] P < 0.01; the integrated discrimination improvement was 0.059 [95% confidence interval, 0.039-0.088] P < 0.01). CONCLUSIONS The AI system, which includes force distribution over the plantar surface of the foot during gait, is an effective tool to screen for locomotive syndrome.
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Affiliation(s)
- Shinji Takahashi
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, Japan.
| | - Yuta Nonomiya
- Department of Medical Statistics, Graduate School of Medicine Osaka City University, Osaka, Japan
| | - Hidetomi Terai
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, Japan
| | | | - Shoichiro Ohyama
- Department of Orthopaedic Surgery, Nishinomiya Watanabe Hospital, Japan
| | - Ayumi Shintani
- Department of Medical Statistics, Graduate School of Medicine Osaka City University, Osaka, Japan
| | - Hiroaki Nakamura
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, Japan
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Snoeker BAM, Ishijima M, Kumm J, Zhang F, Turkiewicz AT, Englund M. Are structural abnormalities on knee MRI associated with osteophyte development? Data from the Osteoarthritis Initiative. Osteoarthritis Cartilage 2021; 29:1701-1708. [PMID: 34284113 DOI: 10.1016/j.joca.2021.06.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 05/26/2021] [Accepted: 06/28/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To assess which structural abnormalities on knee MRI are associated with development of osteophytes in middle-aged subjects without radiographic knee osteoarthritis. DESIGN We included subjects from the Osteoarthritis Initiative, aged 40-55 years, Kellgren & Lawrence grade 0 in both knees, and knee MRIs from both knees available at baseline, 24, 48 and 72 months. Structural exposures on MRI assessed using MOAKS included cartilage damage, bone marrow lesions, meniscal tear, meniscal extrusion, and Hoffa/effusion synovitis. We assessed whether each structural exposure was associated with the development of osteophytes on MRI in the medial and lateral tibiofemoral, and patellofemoral compartment. We estimated hazard ratios (HR) including 95% confidence intervals (CI) for osteophyte development using a mixed complementary log-log regression model adjusted for age, sex, and body mass index. RESULTS We included 680 knees from 340 subjects with a mean (SD) age of 50 years (3.0), and 51% men. In the medial tibiofemoral compartment, the absolute risk of osteophyte development in the first 24-month period was 4% in knees without, and 15% in knees with medial meniscal tear. Corresponding adjusted HR was 6.6 (95%CI = 3.4-12.9). In the lateral tibiofemoral compartment, the adjusted HR for developing osteophytes having a lateral meniscal tear was 3.3 (95%CI = 1.3-8.4). In the patellofemoral compartment, patellofemoral cartilage damage was most clearly associated with developing osteophytes (HR = 2.6, 95%CI = 1.8-3.7). CONCLUSIONS Meniscal tear seem to be the strongest structural risk factor for the development of tibiofemoral osteophytes, and patellofemoral cartilage damage for the development of patellofemoral osteophytes, respectively. Local biomechanical factors are important in early osteophyte development.
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Affiliation(s)
- B A M Snoeker
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Orthopaedics, Clinical Epidemiology Unit, Lund, Sweden.
| | - M Ishijima
- Department of Orthopaedic Surgery, Juntendo University, Tokyo, Japan
| | - J Kumm
- Department of Radiology, University of Tartu, Estonia
| | - F Zhang
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Orthopaedics, Clinical Epidemiology Unit, Lund, Sweden
| | - A T Turkiewicz
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Orthopaedics, Clinical Epidemiology Unit, Lund, Sweden
| | - M Englund
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Orthopaedics, Clinical Epidemiology Unit, Lund, Sweden
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Arita H, Kaneko H, Ishibashi M, Sadatsuki R, Liu L, Hada S, Kinoshita M, Aoki T, Negishi Y, Momoeda M, Adili A, Kubota M, Okada Y, Kaneko K, Ishijima M. Medial meniscus extrusion is a determinant factor for the gait speed among MRI-detected structural alterations of knee osteoarthritis. OSTEOARTHRITIS AND CARTILAGE OPEN 2021; 3:100176. [DOI: 10.1016/j.ocarto.2021.100176] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/08/2021] [Accepted: 05/11/2021] [Indexed: 12/29/2022] Open
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Sadatsuki R, Ishijima M, Kaneko H, Liu L, Futami I, Hada S, Kinoshita M, Kubota M, Aoki T, Takazawa Y, Ikeda H, Okada Y, Kaneko K. Bone marrow lesion is associated with disability for activities of daily living in patients with early stage knee osteoarthritis. J Bone Miner Metab 2019; 37:529-536. [PMID: 30187274 DOI: 10.1007/s00774-018-0950-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Accepted: 08/13/2018] [Indexed: 01/19/2023]
Abstract
Osteoarthritis of the knee (knee OA) induces pain, loss of mobility and diminished activities of daily living (ADL). Although an understanding of the pathophysiology of early stage knee OA has been developed, the structural changes associated with disability for ADL in early stage knee OA are still unclear. The aim of the present study was to examine magnetic resonance imaging (MRI)-detected changes associated with disability for ADL in patients with early stage knee OA. One hundred and thirty-two patients with early stage medial knee OA (Kellgren-Lawrence grade ≤ 2) who first visited the outpatient clinic at our university hospital were included. They were also examined by 3.0-Tesla knee MRI. The OA-associated structural changes were scored using the Whole-Organ Magnetic Resonance Imaging Score (WORMS), and clinical manifestations were evaluated by the Japanese Knee Osteoarthritis Measure (JKOM). Median quartile regression was used for the analysis. Cartilage lesion, subchondral bone attrition and osteophytes were observed in all patients. Bone marrow lesions (BMLs) and synovitis were observed in 60% and 55% of the patients, respectively. Subchondral cysts and ligament changes were observed in 6% and 17% of the patients, respectively. Pain severity of the patients was associated with medial cartilage lesions (coefficient 2.50, 95% confidence interval 0.61-4.40, p < 0.01). Disability for ADL of the patients was associated with BMLs in the medial side of the knee joint (0.82, 0.21-1.02, p = 0.04). BMLs in the medial side of the knee joint were associated with disability for ADL of patients with early stage medial knee OA.
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Affiliation(s)
- Ryo Sadatsuki
- Department of Medicine for Orthtopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1 Hongo Bunkyo-ku, Tokyo, 113-8421, Japan
- Orthopaedic Surgery, Yamanashi Prefectural Central Hospital, Yamanashi, Japan
| | - Muneaki Ishijima
- Department of Medicine for Orthtopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1 Hongo Bunkyo-ku, Tokyo, 113-8421, Japan.
- Sportoloy Center, Juntendo University Graduate School of Medicine, Tokyo, Japan.
| | - Haruka Kaneko
- Department of Medicine for Orthtopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1 Hongo Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Lizu Liu
- Department of Medicine for Orthtopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1 Hongo Bunkyo-ku, Tokyo, 113-8421, Japan
- Sportoloy Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Ippei Futami
- Department of Medicine for Orthtopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1 Hongo Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Shinnosuke Hada
- Department of Medicine for Orthtopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1 Hongo Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Mayuko Kinoshita
- Department of Medicine for Orthtopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1 Hongo Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Mitsuaki Kubota
- Department of Medicine for Orthtopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1 Hongo Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Takako Aoki
- Sportoloy Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yuji Takazawa
- Department of Medicine for Orthtopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1 Hongo Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Hiroshi Ikeda
- Department of Medicine for Orthtopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1 Hongo Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Yasunori Okada
- Department of Pathophysiology for Locomotive and Neoplastic Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kazuo Kaneko
- Department of Medicine for Orthtopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1 Hongo Bunkyo-ku, Tokyo, 113-8421, Japan
- Sportoloy Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Pathophysiology for Locomotive and Neoplastic Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan
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Risk Factors for Poor Patient-Reported Quality of Life Outcomes After Posterior Lumbar Interbody Fusion: An Analysis of 2-Year Follow-up. Spine (Phila Pa 1976) 2017; 42:1502-1510. [PMID: 28248893 DOI: 10.1097/brs.0000000000002137] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A retrospective review of prospectively collected data. OBJECTIVE The present study aimed to identify risk factors for poor patient-reported quality of life (QOL) outcomes, based on five categories (pain-related disorders, lumbar spine dysfunction, gait disturbance, social life dysfunction, and psychological disorders) of the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ), after posterior lumbar interbody fusion (PLIF) at the 2-year follow-up. SUMMARY OF BACKGROUND DATA Many studies have been reported on patient QOL outcomes after lumbar surgery; however, few reports have focused on risk factors for poor postoperative QOL outcomes in terms of the various disabilities and dysfunctions after PLIF. METHODS One hundred consecutive patients (39 men and 61 women; mean age 69.6 [44-84] yr) who underwent single- or two-level PLIF for degenerative spondylolisthesis and/or foraminal stenosis with a 2-year follow-up were included. The effectiveness of surgery in each category of the JOABPEQ was evaluated. Demographic and clinical data and radiographic parameters were reviewed. Risk factors for poor postoperative QOL outcomes in each category of the JOABPEQ were investigated by multivariate logistic regression analysis. RESULTS Older age and spinopelvic malalignment (preoperative high pelvic tilt or postoperative decrease in lumbar lordosis [=postoperative increase in the mismatch between pelvic incidence and lumbar lordosis]) were risk factors for poor postoperative QOL outcomes in all categories of the JOABPEQ, except for lumbar spine dysfunction. In contrast, increase in number of PLIF segments, non-union, and radiographic adjacent segment degeneration were risk factors for poor postoperative QOL outcomes in lumbar spine dysfunction and gait disturbance. CONCLUSION The risk factors for poor QOL outcomes after PLIF differed among the five categories of the JOABPEQ. In particular, surgery-related factors (e.g., increase in number of PLIF segments, nonunion, and radiographic adjacent segment degeneration) had a negative effect on the improvement of lumbar spine dysfunction and gait disturbance. LEVEL OF EVIDENCE 4.
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Shimura Y, Kurosawa H, Tsuchiya M, Sawa M, Kaneko H, Liu L, Makino Y, Nojiri H, Iwase Y, Kaneko K, Ishijima M. Serum interleukin 6 levels are associated with depressive state of the patients with knee osteoarthritis irrespective of disease severity. Clin Rheumatol 2017; 36:2781-2787. [PMID: 28900748 DOI: 10.1007/s10067-017-3826-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Revised: 08/26/2017] [Accepted: 09/04/2017] [Indexed: 01/15/2023]
Abstract
This cross-sectional study investigated the prevalence of depressive state and association between depressive state and serum interleukin (IL)-6 levels in knee osteoarthritis (OA) patients. A total of 115 painful knee OA patients were enrolled and divided into two groups according to the radiographic OA severity. Pain was evaluated using a visual analog scale (VAS). Depressive state was assessed by the self-rating depression scale (SDS). Serum IL-6 levels were also measured. Pearson's correlation coefficient was used to assess the correlation between the variants tested, and logistic regression analysis was used to identify factors associated with the depressive state. Fifty-two percent of the patients had an SDS score of ≥ 40, which is indicative of the depressive state. The pain VAS score (r = 0.22, p = 0.02) and serum IL-6 level (r = 0.31, p < 0.01) were independently associated with the SDS score of all early-stage knee OA patients (Kellgren-Lawrence [K/L] grade 2). However, only the serum IL-6 level was independently associated with the SDS scores of advanced-stage knee OA patients (K/L grades 3 and 4, r = 0.36, p < 0.01). A logistic regression analysis revealed that serum IL-6 level was the variable for the SDS score [odds ratio 1.41 (95% confidence interval 1.03-1.94, p < 0.03)]. Approximately half of the knee OA patients were found to be in the depressive state, and their serum IL-6 levels to be associated with the depressive state, irrespective of OA severity.
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Affiliation(s)
- Yukio Shimura
- Department of Orthopedics, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan.,Minamikoshigaya Hospital, Koshigaya, Saitama, Japan
| | - Hisashi Kurosawa
- Department of Orthopedics, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan
| | - Masaru Tsuchiya
- Department of Orthopedics, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan
| | - Mamiko Sawa
- Department of Orthopedics, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan
| | - Haruka Kaneko
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Lizu Liu
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.,Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yuji Makino
- Department of Orthopedics, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan
| | - Hidetoshi Nojiri
- Department of Orthopedics, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan
| | - Yoshiyuki Iwase
- Department of Orthopedics, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan
| | - Kazuo Kaneko
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.,Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Muneaki Ishijima
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan. .,Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan.
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