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Meng X, Li H, Liu X, Li B, Liu Y, Li M, Sun D, Yang Y, Gao Y, Pei J. Drinking brick tea containing high fluoride increases the prevalence of osteoarthritis in Tibetan, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024:1-11. [PMID: 38445824 DOI: 10.1080/09603123.2024.2324936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 02/26/2024] [Indexed: 03/07/2024]
Abstract
The prevalence of osteoarthritis (OA) in Tibetans is higher than that in Han, while Tibetans have a habit of drinking brick tea with high fluoride. A cross-sectional study was conducted to explore the association between fluoride exposure in drinking brick tea and OA. All subjects were divided into four groups by the quartiles (Q) of tea fluoride (TF) and urine fluoride (UF). ROC was plotted and OR were obtained using logistic regression model. The prevalence of OA in the Q3 and Q4 group of TF were 2.2 and 2.7 times higher than in the Q1 group, and the prevalence of OA in the Q2, Q3 and Q4 group of UF were 3.2, 3.5, and 4.1 times higher than in the Q1 group. ROC analysis showed the cutoff values were 4.523 mg/day (TF) and 1.666 mg/L (UF). In conclusion, excessive fluoride in drinking brick tea could be a risk factor for developing OA.
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Affiliation(s)
- Xinyue Meng
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Heilongjiang Province, China
| | - Hanying Li
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Heilongjiang Province, China
| | - Xiaona Liu
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Heilongjiang Province, China
| | - Bingyun Li
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Heilongjiang Province, China
| | - Yang Liu
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Heilongjiang Province, China
| | - Mang Li
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Heilongjiang Province, China
| | - Dianjun Sun
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Heilongjiang Province, China
| | - Yanmei Yang
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Heilongjiang Province, China
| | - Yanhui Gao
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Heilongjiang Province, China
| | - Junrui Pei
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Heilongjiang Province, China
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Hiranaka T, Furumatsu T, Yokoyama Y, Higashihara N, Tamura M, Kawada K, Xue H, Ozaki T. Intercondylar notch width and osteophyte width impact meniscal healing and clinical outcomes following transtibial pullout repair of medial meniscus posterior root tears. Knee Surg Sports Traumatol Arthrosc 2024; 32:116-123. [PMID: 38226691 DOI: 10.1002/ksa.12032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 12/08/2023] [Indexed: 01/17/2024]
Abstract
PURPOSE This retrospective study aimed to investigate the relationship between intercondylar notch width (ICNW), osteophyte width (OW), and the healing of medial meniscus posterior root tears (MMPRTs) following arthroscopic pullout repair. METHODS The study included 155 patients diagnosed with MMPRTs who underwent transtibial pullout repair. Meniscal healing status was evaluated on second-look arthroscopy using a previously reported meniscus healing score. Patients were divided into two groups based on this score: the high healing score (group HH, healing score ≥ 8 points) and suboptimal healing score (group SO, healing score ≤ 6 points) groups. Computed tomography scans were performed on patients 1 week postsurgery. ICNW and OW widths were measured and relatively evaluated based on their ratio to the intercondylar distance (ICD), represented as the ICNW/ICD ratio (%) and OW/ICD ratio (%), respectively. Patient-reported outcomes were assessed preoperatively and on second-look arthroscopy using the Knee injury and Osteoarthritis Outcome Score (KOOS) and visual analogue scale (VAS). RESULTS There were no significant demographic differences between the SO and HH group (n = 35 and 120 patients, respectively). Regarding radiographic measurements, significant differences were observed in the ICNW/ICD ratio (group SO, 24.2%; group HH, 25.2%; p = 0.024), OW (group SO, 2.6 mm; group HH, 2.0 mm; p < 0.001), and OW/ICD ratio (group SO, 3.5%; group HH, 2.7%; p < 0.001). Both groups had similar preoperative clinical scores, but postoperative clinical scores, including KOOS-activities of daily living (group SO, 83.4; group HH, 88.7; p = 0.035) and VAS (group SO, 19.1; group HH, 11.3; p = 0.005), were significantly better in group HH. CONCLUSION The study suggests that ICNW and OW may play a crucial role in MMPRT healing following arthroscopic pullout repair, as evidenced by the worse clinical outcomes associated with a narrower ICNW and wider OW. These findings highlight the potential significance of ICNW and OW assessments when evaluating meniscal repair indications. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Takaaki Hiranaka
- Department of Orthopaedic Surgery, Okayama Saiseikai General Hospital, Okayama, Japan
- Department of Orthopaedic Surgery, Okayama University Hospital, Okayama, Japan
| | - Takayuki Furumatsu
- Department of Orthopaedic Surgery, Okayama University Hospital, Okayama, Japan
| | - Yusuke Yokoyama
- Department of Orthopaedic Surgery, Okayama University Hospital, Okayama, Japan
| | - Naohiro Higashihara
- Department of Orthopaedic Surgery, Okayama University Hospital, Okayama, Japan
| | - Masanori Tamura
- Department of Orthopaedic Surgery, Okayama University Hospital, Okayama, Japan
| | - Koki Kawada
- Department of Orthopaedic Surgery, Okayama University Hospital, Okayama, Japan
| | - Haowei Xue
- Department of Orthopaedic Surgery, Okayama University Hospital, Okayama, Japan
| | - Toshifumi Ozaki
- Department of Orthopaedic Surgery, Okayama University Hospital, Okayama, Japan
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Meng X, Wang J, Liu Y, Li M, Guan Z, Sowanoua A, Yang D, Pei J, Gao Y. Relatively low fluoride in drinking water increases risk of knee osteoarthritis (KOA): a population-based cross-sectional study in China. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2023; 45:8735-8747. [PMID: 37715839 DOI: 10.1007/s10653-023-01742-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 08/21/2023] [Indexed: 09/18/2023]
Abstract
Previous studies indicate that fluoride in drinking water has a toxic effect on cartilage and skeleton, which triggers osteoarthritis (OA) of which the most frequent is knee OA (KOA). A cross-sectional study was conducted to assess the association between fluoride exposure and KOA among 1128 subjects. Water fluoride (WF) and urinary fluoride (UF) were chosen as external exposure (internal exposure) of fluoride. Logistic regression analysis showed that an increased fluoride exposure was a risk factor for KOA (WF: OR = 1.318, 95% CI 1.162-1.495, p < 0.001; UF: OR = 1.210, 95% CI 1.119-1.310, p < 0.001). After adjusting for covariates, the risk of KOA in the 4th quartile (Q) of WF was twice that of the 1st Q (OR = 2.079, 95% CI 1.448-2.986, p < 0.001). The risks of KOA in the 2nd Q, 3rd Q and 4th Q of UF were 1.6, 1.5, and 2.9 times higher than in the 1stQ (OR = 1.597, 95% CI 1.066-2.393, p = 0.023; OR = 1.560, 95% CI 1.043-2.333, p = 0.030; OR = 2.897, 95% CI 1.957-4.288, p < 0.001). The population aged < 60 exposed to the 4th Q of WF (or UF) had a higher risk than the population exposed to the 1st Q of WF (or UF) (ORWF = 1.958, 95% CI 1.249-3.070, p = 0.003; ORUF = 2.923, 95% CI 1.814-4.711, p < 0.001). With increasing UF by Q, the male had a risk of KOA. In conclusion, excessive fluoride dose in drinking water could increase the risk of KOA. Especially, the population with aged < 60, male and obesity more likely to having KOA when they exposed to same higher fluoride.
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Affiliation(s)
- Xinyue Meng
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang Province, China
| | - Jian Wang
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang Province, China
| | - Yang Liu
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang Province, China
| | - Mang Li
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang Province, China
| | - Zhizhong Guan
- Department of Pathology and Key Lab of Endemic and Ethnic Diseases, Ministry of Education, Guizhou Medical University, Guiyang, Guizhou Province, China
| | - Alphonse Sowanoua
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang Province, China
| | - Dan Yang
- Chongqing Blood Center, Jiulongpo, 400015, Chongqing, China.
- , Chongqing, China.
| | - Junrui Pei
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang Province, China.
| | - Yanhui Gao
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang Province, China.
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Costa MQ, Badger GJ, Chrostek CA, Carvalho OD, Faiola SL, Fadale PD, Hulstyn MJ, Gil HC, Shalvoy RM, Fleming BC. Effects of Initial Graft Tension and Patient Sex on Knee Osteoarthritis Outcomes After ACL Reconstruction: A Randomized Controlled Clinical Trial With 10- to 12-Year Follow-up. Am J Sports Med 2022; 50:3510-3521. [PMID: 36259724 PMCID: PMC9633422 DOI: 10.1177/03635465221124917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The initial graft tension applied during anterior cruciate ligament (ACL) graft fixation may promote posttraumatic osteoarthritis (PTOA). PURPOSE/HYPOTHESIS This study sought to assess the effect of initial graft tension and patient sex on PTOA outcomes at 10 to 12 years after ACL reconstruction (ACLR). The hypothesis was that there would be no group- or sex-based differences in outcomes. STUDY DESIGN Randomized controlled trial; Level of evidence, 1. METHODS Patients were randomized to receive ACLR with a low or high initial graft tension. Outcomes were evaluated at 10 to 12 years postoperatively and compared with a matched, uninjured control group. Outcomes included clinical assessments (anteroposterior [AP] knee laxity measurement, International Knee Documentation Committee [IKDC] examination score), a functional assessment (single-leg hop for distance), patient-reported outcomes (Knee injury and Osteoarthritis Outcome Score [KOOS], 36-Item Short Form Health Survey, Tegner activity level, patient satisfaction), and PTOA imaging (Osteoarthritis Research Society International [OARSI] radiographic score and Whole-Organ Magnetic Resonance Imaging Score [WORMS]). Two-way mixed-model analyses of variance were used to evaluate differences in outcomes between tension groups and the control group and between female and male patients. RESULTS Both tension groups scored worse than the control group for the IKDC examination (P≤ .021), KOOS (Pain, Activities of Daily Living, Sport/Recreation, and Quality of Life subscales) (P≤ .049), and WORMS difference score (P≤ .042). The low-tension group scored worse than the control group for KOOS Symptoms (P = .016) and the OARSI difference score (P = .015). The index limb had worse scores than the contralateral limb within the high-tension group for AP laxity (P = .030) and hop deficit (P = .011). This result was also observed within both tension groups for the WORMS (P≤ .050) and within the low-tension group for the OARSI score (P = .001). Male patients had higher Tegner scores (mean ± SE) relative to female patients (male, 5.49 ± 1.88; female, 4.45 ± 1.65) and worse OARSI difference scores (male, 1.89 ± 5.38; female, 0.244 ± 0.668) (P = .007 and .034, respectively). However, no significant differences were detected between tension groups for any of the outcomes measured. CONCLUSION Overall, ACLR failed to prevent PTOA regardless of initial graft tension. However, male patients treated with a low initial graft tension may be at greater risk for PTOA. These results do not support the hypothesis of no sex differences in outcomes at 10 to 12 years after ACLR.
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Affiliation(s)
- Meggin Q. Costa
- Dept of Orthopaedics, Brown University/Rhode Island Hospital, Providence, RI
| | - Gary J. Badger
- Dept of Medical Biostatistics, University of Vermont, Burlington, VT
| | - Cynthia A. Chrostek
- Dept of Orthopaedics, Brown University/Rhode Island Hospital, Providence, RI
| | - Orianna D. Carvalho
- Dept of Orthopaedics, Brown University/Rhode Island Hospital, Providence, RI
| | - Stacy L. Faiola
- Dept of Orthopaedics, Brown University/Rhode Island Hospital, Providence, RI
| | - Paul D. Fadale
- Dept of Orthopaedics, Brown University/Rhode Island Hospital, Providence, RI
| | - Michael J. Hulstyn
- Dept of Orthopaedics, Brown University/Rhode Island Hospital, Providence, RI
| | - Holly C. Gil
- Dept of Diagnostic Imaging, Brown University/Rhode Island Hospital, Providence, RI
| | - Robert M. Shalvoy
- Dept of Orthopaedics, Brown University/Rhode Island Hospital, Providence, RI
| | - Braden C. Fleming
- Dept of Orthopaedics, Brown University/Rhode Island Hospital, Providence, RI
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Karpiński R, Krakowski P, Jonak J, Machrowska A, Maciejewski M, Nogalski A. Diagnostics of Articular Cartilage Damage Based on Generated Acoustic Signals Using ANN-Part I: Femoral-Tibial Joint. SENSORS 2022; 22:s22062176. [PMID: 35336346 PMCID: PMC8950358 DOI: 10.3390/s22062176] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/02/2022] [Accepted: 03/09/2022] [Indexed: 02/01/2023]
Abstract
Osteoarthritis (OA) is a chronic, progressive disease which has over 300 million cases each year. Some of the main symptoms of OA are pain, restriction of joint motion and stiffness of the joint. Early diagnosis and treatment can prolong painless joint function. Vibroarthrography (VAG) is a cheap, reproducible, non-invasive and easy-to-use tool which can be implemented in the diagnostic route. The aim of this study was to establish diagnostic accuracy and to identify the most accurate signal processing method for the detection of OA in knee joints. In this study, we have enrolled a total of 67 patients, 34 in a study group and 33 in a control group. All patients in the study group were referred for surgical treatment due to intraarticular lesions, and the control group consisted of healthy individuals without knee symptoms. Cartilage status was assessed during surgery according to the International Cartilage Repair Society (ICRS) and vibroarthrography was performed one day prior to surgery in the study group. Vibroarthrography was performed in an open and closed kinematic chain for the involved knees in the study and control group. Signals were acquired by two sensors placed on the medial and lateral joint line. Using the neighbourhood component analysis (NCA) algorithm, the selection of optimal signal measures was performed. Classification using artificial neural networks was performed for three variants: I—open kinetic chain, II—closed kinetic chain, and III—open and closed kinetic chain. Vibroarthrography showed high diagnostic accuracy in determining healthy cartilage from cartilage lesions, and the number of repetitions during examination can be reduced only to closed kinematic chain.
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Affiliation(s)
- Robert Karpiński
- Department of Machine Design and Mechatronics, Faculty of Mechanical Engineering, Lublin University of Technology, Nadbystrzycka 36, 20-618 Lublin, Poland; (J.J.); (A.M.)
- Correspondence: (R.K.); (P.K.)
| | - Przemysław Krakowski
- Department of Trauma Surgery and Emergency Medicine, Medical University of Lublin, Staszica 11, 20-081 Lublin, Poland;
- Orthopaedic Department, Łęczna Hospital, Krasnystawska 52 str, 21-010 Łęczna, Poland
- Correspondence: (R.K.); (P.K.)
| | - Józef Jonak
- Department of Machine Design and Mechatronics, Faculty of Mechanical Engineering, Lublin University of Technology, Nadbystrzycka 36, 20-618 Lublin, Poland; (J.J.); (A.M.)
| | - Anna Machrowska
- Department of Machine Design and Mechatronics, Faculty of Mechanical Engineering, Lublin University of Technology, Nadbystrzycka 36, 20-618 Lublin, Poland; (J.J.); (A.M.)
| | - Marcin Maciejewski
- Department of Electronics and Information Technology, Faculty of Electrical Engineering and Computer Science, Lublin University of Technology, Nadbystrzycka 36, 20-618 Lublin, Poland;
| | - Adam Nogalski
- Department of Trauma Surgery and Emergency Medicine, Medical University of Lublin, Staszica 11, 20-081 Lublin, Poland;
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Schenk H, Simon D, Waldenmeier L, Evers C, Janka R, Welsch GH, Pachowsky ML. Regions at Risk in the Knee Joint of Young Professional Soccer Players: Longitudinal Evaluation of Early Cartilage Degeneration by Quantitative T2 Mapping in 3 T MRI. Cartilage 2021; 13:595S-603S. [PMID: 32449383 PMCID: PMC8808898 DOI: 10.1177/1947603520924773] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
PURPOSE The study aims to detect regions at risk for (pre-)osteoarthritis in the tibiofemoral joint of young professional soccer players by evaluating cartilage composition by T2 mapping in a 3 T magnetic resonance imaging setting. METHODS In this longitudinal study, 20 professional adolescent soccer players were included. Tibiofemoral cartilage was assessed by quantitative T2 mapping and T2 values were evaluated by regions of interest analysis. Statistical evaluation, using Wilcoxon signed-rank tests, was performed to compare global T2 values and subregional T2 values between a baseline and a follow-up investigation 4.3 years later. Based on the average of playing time (15 years) we divided the cohort in 2 groups and differences were evaluated. RESULTS When comparing baseline and follow-up, our findings showed statistically significant increases of the global medial tibial and femoral T2 values. The most noticeable results of the subregional T2 analysis were statistically significant increases in the medial posterior zones (deep femoral 36.1 vs. 39.5, P = 0.001; superficial femoral 57.0 vs. 62.4, P = 0.034; deep tibial 28.3 vs. 34.1, P = 0.009; superficial tibial 43.2 vs. 55.3, P = 0.002). CONCLUSION The elevation of T2 values in the medial, especially medial posterior, compartment of the knee joint indicates that these regions are at risk for early cartilage degeneration already at the time of adolescence. The findings can help individualize and optimize training concepts and to be aware of the chronic stress on these vulnerable areas. Prevention programs should be established in young players to avoid further cartilage damage.
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Affiliation(s)
- Hanna Schenk
- Friedrich-Alexander University
Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - David Simon
- Friedrich-Alexander University
Erlangen-Nürnberg (FAU), Erlangen, Germany,Department of Internal Medicine
3–Rheumatology and Immunology, University Hospital of Erlangen, Erlangen,
Germany
| | - Leonie Waldenmeier
- Department of Internal Medicine,
University Hospital of Basel, Basel, Switzerland
| | - Christoph Evers
- Department of Radiooncology, University
Hospital of Halle/Saale, Halle, Germany
| | - Rolf Janka
- Friedrich-Alexander University
Erlangen-Nürnberg (FAU), Erlangen, Germany,Department of Radiology, University
Hospital of Erlangen, Erlangen, Germany
| | - Goetz H. Welsch
- UKE Athleticum, University Hospital
Hamburg-Eppendorf, Hamburg, Germany
| | - Milena L. Pachowsky
- Friedrich-Alexander University
Erlangen-Nürnberg (FAU), Erlangen, Germany,Department of Internal Medicine
3–Rheumatology and Immunology, University Hospital of Erlangen, Erlangen,
Germany,Department of Trauma and Orthopedic
Surgery, University Hospital of Erlangen, Erlangen, Germany,Milena L. Pachowsky, Department of Trauma
and Orthopedic Surgery, University Hospital of Erlangen, Maximiliansplatz 1,
Erlangen 91054, Germany.
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Common Biochemical and Magnetic Resonance Imaging Biomarkers of Early Knee Osteoarthritis and of Exercise/Training in Athletes: A Narrative Review. Diagnostics (Basel) 2021; 11:diagnostics11081488. [PMID: 34441422 PMCID: PMC8391340 DOI: 10.3390/diagnostics11081488] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/29/2021] [Accepted: 08/09/2021] [Indexed: 12/24/2022] Open
Abstract
Knee osteoarthritis (OA) is the most common joint disease of the world population. Although considered a disease of old age, OA also affects young individuals and, more specifically among them, those practicing knee-joint-loading sports. Predicting OA at an early stage is crucial but remains a challenge. Biomarkers that can predict early OA development will help in the design of specific therapeutic strategies for individuals and, for athletes, to avoid adverse outcomes due to exercising/training regimens. This review summarizes and compares the current knowledge of fluid and magnetic resonance imaging (MRI) biomarkers common to early knee OA and exercise/training in athletes. A variety of fluid biochemical markers have been proposed to detect knee OA at an early stage; however, few have shown similar behavior between the two studied groups. Moreover, in endurance athletes, they are often contingent on the sport involved. MRI has also demonstrated its ability for early detection of joint structural alterations in both groups. It is currently suggested that for optimal forecasting of early knee structural alterations, both fluid and MRI biomarkers should be analyzed as a panel and/or combined, rather than individually.
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Scott ME, Dust WN, Cooper DML, Walker EG, Lieverse AR. The physiopathology of osteoarthritis: Paleopathological implications of non-articular lesions from a modern surgical sample. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2021; 32:31-40. [PMID: 33276205 DOI: 10.1016/j.ijpp.2020.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 11/02/2020] [Accepted: 11/17/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES This research focused on osteoarthritis (OA) lesions on modern patients to 1) identify consistently observed lesions not included within current paleopathological measures of OA, 2) assess the correspondence of bone and cartilage lesions with clinical OA diagnostic criteria, and 3) discuss the correspondence of bone lesions with sources of pain reported in clinical literature. MATERIALS Tibial plateaus from 62 patients undergoing total knee replacement surgery due to OA were examined. METHODS Plateaus were scored for several non-standard OA criteria, including non-articular and X-ray visible lesions and pre-maceration cartilage lesions, as well as articular surface criteria standard in paleopathology. RESULTS Proliferative bone in the intercondylar region was present in 95 % of specimens, while areas of dense trabecular bone and lytic defects, both on the inferior side of the plateaus, were present in 98 % and 83 %, respectively. CONCLUSIONS The inferior lytic defects may be physical evidence of bone marrow lesions (BML), a clinical OA indicator visible via MRI. Previous research has linked BML to pain, inflammation, and ligament pathology. The latter conditions have also been associated with intercondylar enthesophytes and third intercondylar tubercle of Parsons (TITP), both of which were observed in the intercondylar regions. SIGNIFICANCE Several non-articular lesions not currently included in paleopathological measures of OA were consistently observed. SUGGESTIONS FOR FUTURE RESEARCH A similar analysis of a control sample of non-OA tibial plateaus would better contextualize these results. LIMITATIONS The sample's high average age (65.8 years) and severe OA stage may hamper generalizability to archaeological collections.
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Affiliation(s)
- Maryann E Scott
- Department of Archaeology and Anthropology, University of Saskatchewan, 55 Campus Dr., Saskatoon, Saskatchewan, S7N 5B1, Canada.
| | - William N Dust
- Division of Orthopedics, Royal University Hospital, 103 Hospital Dr., Saskatoon, Saskatchewan, S7N 0W8, Canada
| | - David M L Cooper
- Department of Anatomy, Physiology and Pharmacology, University of Saskatchewan, GA20 Health Sciences Building, 107 Wiggins Rd., Saskatoon, Saskatchewan, S7N 5E5, Canada
| | - Ernest G Walker
- Department of Archaeology and Anthropology, University of Saskatchewan, 55 Campus Dr., Saskatoon, Saskatchewan, S7N 5B1, Canada
| | - Angela R Lieverse
- Department of Archaeology and Anthropology, University of Saskatchewan, 55 Campus Dr., Saskatoon, Saskatchewan, S7N 5B1, Canada
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Freiberg A, Bolm-Audorff U, Seidler A. The Risk of Knee Osteoarthritis in Professional Soccer Players—a Systematic Review With Meta-Analyses. DEUTSCHES ARZTEBLATT INTERNATIONAL 2021; 118:49-55. [PMID: 33759745 PMCID: PMC8182778 DOI: 10.3238/arztebl.m2021.0007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 02/26/2020] [Accepted: 08/24/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND We address the question whether professional soccer players with and without macroinjury of the knee joint are at an elevated risk for knee osteoarthritis. METHODS A systematic review with meta-analyses was conducted. The study protocol was prospectively registered (registration number CRD42019137139). The MEDLINE, EMBASE, and Web of Science databases were searched for relevant publications; in addition, forward searching was performed, and the listed references were considered. All steps of the process were undertaken independently by two reviewers, and any discordances were resolved by consensus. For all publications whose full text was included, the methods used were critically evaluated. The quality of the evidence was judged using the GRADE criteria. RESULTS The pooled odds ratio for objectively ascertained osteoarthrosis of the knee was 2.25 (95% confidence interval [1.41-3.61], I2 = 71%). When only radiologically ascertained knee osteoarthrosis was considered, the odds ratio was 3.98 [1.34; 11.83], I2 = 58%). The pooled risk estimator in studies in which knee joint macroinjury was excluded was 2.81 ([1.25; 6.32], I2 = 71%). CONCLUSION A marked association was found between soccer playing and knee osteoarthritis in male professional soccer players. For female professional soccer players, the risk of knee osteoarthritis could not be assessed because of the lack of data. Knee injuries seem to play an important role in the development of knee osteoarthritis in professional soccer players.
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Affiliation(s)
- Alice Freiberg
- Institute and Policlinic of Occupational and Social Medicine, Medical Faculty Carl Gustav Carus, Technische Universität Dresden; Division of Occupational Health, Department of Occupational Safety and Environment, Regional Government of South Hesse, Wiesbaden; Extraordinary Chair of Occupational Medicine, University of Gießen
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10
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Effect of Physiological Saline Solution Contamination on Selected Mechanical Properties of Seasoned Acrylic Bone Cements of Medium and High Viscosity. MATERIALS 2020; 14:ma14010110. [PMID: 33383870 PMCID: PMC7796448 DOI: 10.3390/ma14010110] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 12/18/2020] [Accepted: 12/21/2020] [Indexed: 12/29/2022]
Abstract
Bone cements play a key role in present-day surgery, including the implantation of hip and knee joint endoprostheses. The correct and durable bonding of the prosthesis to the bone is affected by both the static strength characteristics determined in accordance with ISO 5833:2002 and the resistance to long-term exposure to an aggressive environment of the human body and the impurities that may be introduced into the cement during implementation. The study attempts to demonstrate statistically significant degradation of cement as a result of the seasoning of cement samples in Ringer’s solution with simultaneous contamination of the material with saline solution, which is usually present in the surgical field (e.g., during the fixing of endoprostheses). The results of statistical analysis showed the nature of changes in compressive strength and microhardness due to seasoning time and degree of contamination.
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11
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Venne G, Tse MY, Pang SC, Ellis RE. Mechanically-induced osteophyte in the rat knee. Osteoarthritis Cartilage 2020; 28:853-864. [PMID: 32147535 DOI: 10.1016/j.joca.2020.02.834] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 02/11/2020] [Accepted: 02/17/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Osteophytes are common anatomical signs of advanced osteoarthritis. It remains unclear whether they develop from physio-molecular, and/or mechanical stimuli. This study examined the effects of mechanical impact on the knee joint periosteum leading to osteophyte formation. DESIGN Eighteen mature rats received one single impact load of 53 N (30 MPa) to the periosteum of the experimental medial femoral condyles. Contralateral knees were used as controls. Animals were sacrificed at 24 h, 3, 6 and 9 weeks post-impact. Distal femurs were harvested and prepared for histology. Hematoxylin and Eosin, and Masson's trichrome stained slides were examined by light microscopy. Nuclear density was quantified to assess the tissue reaction. RESULTS 24 h: The synovium membrane, fibrous and cambium periosteum were damaged. Blood infiltration pooled in the impacted medial collateral ligament (MCL) region. Week 3: A cartilaginous tissue spur, chondrophyte, was found in every rat at the impacted site of the MCL. Chondrophytes were composed of fibrocartilage and cartilage matrix, with signs of cartilage mineralization and remodelling activity. Week 6: Chondrophytes presented signs of more advanced mineralisation, recognized as osteophytes. Week 9: Osteophytes appeared to be more mineralized with almost no cartilage tissue. CONCLUSIONS Osteophytes can be induced with a single mechanical impact applied to the periosteum in rat knees. These data indicate that a moderate trauma to the periosteal layer of the joint may play a role in osteophyte development.
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Affiliation(s)
- G Venne
- Department of Anatomy and Cell Biology, McGill University, Montreal, QC, Canada; 3640, Rue University, Montréal, QC, H3A 0C7, Canada.
| | - M Y Tse
- Department Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
| | - S C Pang
- Department Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
| | - R E Ellis
- Department Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada; Human Mobility Research Center, Kingston General Hospital, 76 Stuart Street, Kingston, ON, K7L 2V7, Canada; Department of Surgery, Queen's University, Kingston, ON, Canada; Kingston General Hospital, Kingston, ON, Canada; Department of Mechanical and Materials Engineering, Queen's University, Kingston, ON, Canada; School of Computing, Queen's University, Kingston, ON, Canada
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12
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Pfeiffer SJ, Spang J, Nissman D, Lalush D, Wallace K, Harkey MS, Pietrosimone LS, Schmitz R, Schwartz T, Blackburn T, Pietrosimone B. Gait Mechanics and T1ρ MRI of Tibiofemoral Cartilage 6 Months after ACL Reconstruction. Med Sci Sports Exerc 2019; 51:630-639. [PMID: 30444797 DOI: 10.1249/mss.0000000000001834] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Aberrant walking biomechanics after anterior cruciate ligament reconstruction (ACLR) are hypothesized to be associated with deleterious changes in knee cartilage. T1ρ magnetic resonance imaging (MRI) is sensitive to decreased proteoglycan density of cartilage. Our purpose was to determine associations between T1ρ MRI interlimb ratios (ILR) and walking biomechanics 6 months after ACLR. METHODS Walking biomechanics (peak vertical ground reaction force (vGRF), vGRF loading rate, knee extension moment, knee abduction moment) were extracted from the first 50% of stance phase in 29 individuals with unilateral ACLR. T1ρ MRI ILR (ACLR limb/uninjured limb) was calculated for regions of interest in both medial and lateral femoral (LFC) and medial and lateral tibial condyles. Separate, stepwise linear regressions were used to determine associations between biomechanical outcomes and T1ρ MRI ILR after accounting for walking speed and meniscal/chondral injury (P ≤ 0.05). RESULTS Lesser peak vGRF in the ACLR limb was associated with greater T1ρ MRI ILR for the LFC (posterior ΔR = 0.14, P = 0.05; central ΔR = 0.15, P = 0.05) and medial femoral condyle (central ΔR = 0.24, P = 0.01). Lesser peak vGRF loading rate in the ACLR limb (ΔR = 0.21, P = 0.02) and the uninjured limb (ΔR = 0.27, P = 0.01) was associated with greater T1ρ MRI ILR for the anterior LFC. Lesser knee abduction moment for the injured limb was associated with greater T1ρ MRI ILR for the anterior LFC (ΔR = 0.16, P = 0.04) as well as the posterior medial tibial condyle (ΔR = 0.13, P = 0.04). CONCLUSION Associations between outcomes related to lesser mechanical loading during walking and greater T1ρ MRI ILR were found 6 months after ACLR. Although preliminary, our results suggest that underloading of the ACLR limb at 6 months after ACLR may be associated with lesser proteoglycan density in the ACLR limb compared with the uninjured limb.
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Affiliation(s)
- Steven J Pfeiffer
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC.,Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Jeffrey Spang
- Department of Orthopaedics, University of North Carolina at Chapel Hill, Chapel Hill NC
| | - Daniel Nissman
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - David Lalush
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC.,Joint Department of Biomedical Engineering, North Carolina State University and University of North Carolina at Chapel Hill, Raleigh, NC
| | - Kyle Wallace
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | - Laura S Pietrosimone
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC.,Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Randy Schmitz
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro NC
| | - Todd Schwartz
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Troy Blackburn
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Brian Pietrosimone
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
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13
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Lane AR, Harkey MS, Davis HC, Luc-Harkey BA, Stanley L, Hackney AC, Blackburn JT, Pietrosimone B. Body Mass Index and Type 2 Collagen Turnover in Individuals After Anterior Cruciate Ligament Reconstruction. J Athl Train 2019; 54:270-275. [PMID: 30829538 DOI: 10.4085/1062-6050-525-17] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Individuals with an anterior cruciate ligament reconstruction (ACLR) are at an increased risk of developing posttraumatic osteoarthritis. How osteoarthritis risk factors, such as increased body mass index (BMI), may influence early changes in joint tissue metabolism is unknown. OBJECTIVE To determine the association between BMI and type 2 cartilage turnover in individuals with an ACLR. DESIGN Cross-sectional study. SETTING Research laboratory. PATIENTS OR OTHER PARTICIPANTS Forty-five individuals (31 women, 14 men) with unilateral ACLR at least 6 months earlier who were cleared for unrestricted physical activity. MAIN OUTCOME MEASURE(S) Body mass index (kg/m2) and type 2 collagen turnover were the primary outcomes. Body mass index was calculated from objectively measured height and mass. Serum was obtained to measure type 2 collagen turnover, quantified as the ratio of degradation (collagen type 2 cleavage product [C2C]) to synthesis (collagen type 2 C-propeptide [CP2]; C2C : CP2). Covariate measures were physical activity level before ACLR (Tegner score) and current level of disability (International Knee Documentation Committee Index score). Associations of primary outcomes were analyzed for the group as a whole and then separately for males and females. RESULTS Overall, greater BMI was associated with greater C2C : CP2 (r = 0.32, P = .030). After controlling for covariates (Tegner and International Knee Documentation Committee Index scores), we identified a similar association between BMI and C2C : CP2 (partial r = 0.42, P = .009). Among women, greater BMI was associated with greater C2C : CP2 before (r = 0.47, P = .008) and after (partial r = 0.50, P = .008) controlling for covariates. No such association occurred in men. CONCLUSIONS Greater BMI may influence greater type 2 collagen turnover in those with ACLR. Individuals, especially women, who maintain or reduce BMI may be less likely to demonstrate greater type 2 collagen turnover ratios after ACLR.
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Affiliation(s)
- Amy R Lane
- Human Movement Science Curriculum, Department of Allied Health Sciences
| | - Matthew S Harkey
- Human Movement Science Curriculum, Department of Allied Health Sciences
| | - Hope C Davis
- Human Movement Science Curriculum, Department of Allied Health Sciences
| | | | - Laura Stanley
- Human Movement Science Curriculum, Department of Allied Health Sciences
| | - Anthony C Hackney
- Human Movement Science Curriculum, Department of Allied Health Sciences.,Department of Exercise and Sport Science, Gillings School of Public Health, University of North Carolina at Chapel Hill.,Department of Nutrition, Gillings School of Public Health, University of North Carolina at Chapel Hill
| | - J Troy Blackburn
- Human Movement Science Curriculum, Department of Allied Health Sciences.,Department of Exercise and Sport Science, Gillings School of Public Health, University of North Carolina at Chapel Hill
| | - Brian Pietrosimone
- Human Movement Science Curriculum, Department of Allied Health Sciences.,Department of Exercise and Sport Science, Gillings School of Public Health, University of North Carolina at Chapel Hill
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14
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MRI-Detected Sports-Related Knee Injuries and Abnormalities at the Rio de Janeiro 2016 Summer Olympic Games. AJR Am J Roentgenol 2018; 211:880-886. [PMID: 30063380 DOI: 10.2214/ajr.17.19334] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The purpose of this article is to describe knee abnormalities and the occurrence of MRI-detected sports-related knee abnormalities by evaluating MRI examinations performed during the Rio de Janeiro Olympic Games held in August 2016. CONCLUSION There were 11,274 athletes at the Rio 2016 Olympic Games, and 113 of them underwent at least one knee MRI in the Olympic Village. Cartilage abnormalities, followed by meniscal tears and ligament sprains, were the most frequent abnormalities.
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15
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Pfeiffer S, Harkey MS, Stanley LE, Blackburn JT, Padua DA, Spang JT, Marshall SW, Jordan JM, Schmitz R, Nissman D, Pietrosimone B. Associations Between Slower Walking Speed and T1ρ Magnetic Resonance Imaging of Femoral Cartilage Following Anterior Cruciate Ligament Reconstruction. Arthritis Care Res (Hoboken) 2018; 70:1132-1140. [PMID: 29193888 DOI: 10.1002/acr.23477] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 11/21/2017] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To determine whether walking speed, collected at 6 and 12 months following anterior cruciate ligament reconstruction (ACLR), is associated with inter-extremity differences in proteoglycan density, measured via T1ρ magnetic resonance imaging, in tibiofemoral articular cartilage 12 months following ACLR. METHODS Twenty-one individuals with a unilateral patellar-tendon autograft ACLR (10 women and 11 men, mean ± SD age 23.9 ± 2.7 years, mean ± SD body mass index 23.9 ± 2.7 kg/m2 ) were recruited for participation in this study. Walking speed was collected using 3-dimensional motion capture at 6 and 12 months following ACLR. The articular cartilage of the medial femoral condyle (MFC) and lateral femoral condyle and medial and lateral tibial condyles was manually segmented and subsectioned into 3 regions of interest (anterior, central, and posterior) based on the location of the meniscus in the sagittal plane. Inter-extremity mean T1ρ relaxation time ratios (T1ρ ACLR extremity / T1ρ contralateral extremity) were calculated and used for analysis. Pearson product-moment correlations were used to determine associations between walking speed and inter-extremity differences in T1ρ relaxation time ratios. RESULTS Slower walking speed 6 months post-ACLR was significantly associated with higher T1ρ relaxation time ratios in the MFC of the ACLR extremity 12 months following ACLR (posterior MFC, r = -0.51, P = 0.02; central MFC, r = -0.47, P = 0.04). Similarly, slower walking speed at 12 months post-ACLR was significantly associated with higher T1ρ relaxation time ratios in the posterior MFC ACLR extremity (r = -0.47, P = 0.04) 12 months following ACLR. CONCLUSION Slower walking speed at 6 and 12 months following ACLR may be associated with early proteoglycan density changes in medial femoral compartment cartilage health in the first 12 months following ACLR.
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16
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Birch CE, Mensch KS, Desarno MJ, Beynnon BD, Tourville TW. Subchondral trabecular bone integrity changes following ACL injury and reconstruction: a cohort study with a nested, matched case-control analysis. Osteoarthritis Cartilage 2018; 26:762-769. [PMID: 29572129 PMCID: PMC5962427 DOI: 10.1016/j.joca.2018.02.905] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 01/31/2018] [Accepted: 02/27/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE There is limited information regarding changes in bone architecture following anterior cruciate ligament (ACL) injury. The objective of this study was to evaluate differences in tibial fractal signature in the medial and lateral compartments following ACL injury and describe how these values change following ACL-reconstruction and return to activity. DESIGN This was a prospective cohort study with a nested case-control analysis. ACL-injured subjects and matched controls were evaluated at pre-surgical baseline and post ACL reconstruction follow-up at a mean of 46 months. Serial Fractal Dimensions (FD) of tibial subchondral bone architecture were calculated in medial and lateral regions of interest in the horizontal and vertical dimensions. RESULTS In the medial and lateral compartments, there were significant differences in the vertical FD signature for ACL-injured subjects at final follow-up, when compared to the contralateral healthy tibia (medial P < 0.0001; lateral P < 0.0001) and the control group (medial P = 0.01; lateral P < 0.0001). Similarly, in the lateral compartment, there were significant differences in the horizontal FD profile for ACL-injured subjects at final follow-up, when compared to the contralateral healthy tibia (P = 0.003) and the controls (P < 0.0001). There were no significant side-to-side differences in FDs among healthy control subjects in the medial or lateral compartments at baseline or final follow-up. CONCLUSION At 46-month follow-up, FD profiles are significantly different, and show an overall lower FD signature, for ACL-injured knees when compared to the contralateral healthy knee and uninjured controls. Additionally, this study provided the first side-to-side symmetry data of medial and lateral FD values in healthy controls.
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Affiliation(s)
- C E Birch
- University of Vermont, Department of Orthopaedics and Rehabilitation, San Antonio, TX, USA.
| | - K S Mensch
- University of Texas Health Science Center at San Antonio, Department of Orthopaedics, Burlington, VT, USA.
| | - M J Desarno
- University of Vermont, Department of Medical Biostatistics, Burlington, VT, USA.
| | - B D Beynnon
- University of Vermont, Department of Orthopaedics and Rehabilitation, San Antonio, TX, USA.
| | - T W Tourville
- University of Vermont, Department of Orthopaedics and Rehabilitation, San Antonio, TX, USA; University of Vermont, Department of Rehabilitation and Movement Science, Burlington, VT, USA.
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17
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Manoukian MAC, Migdal CW, Tembhekar AR, Harris JA, DeMesa C. Topical Administration of Ibuprofen for Injured Athletes: Considerations, Formulations, and Comparison to Oral Delivery. SPORTS MEDICINE-OPEN 2017; 3:36. [PMID: 28983850 PMCID: PMC5629190 DOI: 10.1186/s40798-017-0103-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 09/26/2017] [Indexed: 12/15/2022]
Abstract
Non-steroidal anti-inflammatory drugs (NSAIDs) are a class of drugs commonly used to treat both the acute and chronic injuries sustained by athletes during training and competition. In many parts of the world, NSAIDs can be purchased over-the-counter and used without any physician oversight. However, the chronic nature of overuse injuries requires NSAIDs to be taken orally for an extended period of time. As a result, they can have significant adverse effects on athletes, namely gastrointestinal (GI), renal, and cardiovascular damage. Dyspepsia and upper GI ulceration and bleeding are of great concern in chronic NSAID use, and as such oral NSAIDs are generally contraindicated in those with a history of peptic ulcers or irritable bowel disease. In the setting of chronic overuse soft tissue or joint disease, topically administered NSAIDs offer an alternate route of administration that has the potential to deliver a similar level of pain and anti-inflammatory relief while bypassing the harmful side effects associated with oral intake. Topically applied NSAIDs are able to achieve high concentrations within the targeted site of action while simultaneously keeping plasma concentrations low, offering several advantages over oral administration. One commonly used generic NSAID is ibuprofen (2-(4-isobutylphenyl)propanoic acid). First synthesized in the 1960s, ibuprofen has since become widely available as an over-the-counter pharmaceutical. In this review, we outline new and different techniques that have been used to deliver ibuprofen into diseased tissues, including supersaturations, microemulsions, gels, nanosystems, and microneedles. We also review relevant clinical trials comparing transdermally delivered ibuprofen to placebo and orally administered ibuprofen.
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Affiliation(s)
| | | | | | | | - Charles DeMesa
- Department of Anesthesiology and Pain Medicine, University of California Davis School of Medicine, 4610 X Street, Sacramento, CA, USA
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18
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Geng B, Wang J, Ma JL, Zhang B, Jiang J, Tan XY, Xia YY. Narrow Intercondylar Notch and Anterior Cruciate Ligament Injury in Female Nonathletes with Knee Osteoarthritis Aged 41-65 Years in Plateau Region. Chin Med J (Engl) 2017; 129:2540-2545. [PMID: 27779159 PMCID: PMC5125331 DOI: 10.4103/0366-6999.192771] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background: Few data are available concerning intercondylar notch dimensions in female nonathletes with knee osteoarthritis (OA) in plateau region. The aim of this study was to assess the relation of intercondylar notch morphology to anterior cruciate ligament (ACL) injuries in female nonathletes with knee OA aged 41–65 years from the Chinese Loess Plateau. Methods: The study was conducted on 330 patients with ACL injury (aged 31–65 years; 159 males, 171 females), 141 patients with OA (aged 31–65 years; 59 males, 82 females), and 89 female healthy controls (aged 41–65 years), and this evaluation included identifying the distribution of patients with OA or ACL injury and measuring the intercondylar notch width indexes (NWIs). Results: There was a significant rising trend in patients with OA (the Kellgren and Lawrence grade = 3) with ACL injury (OA-S + ACL) aged 41–65 years, especially in females. We found that the notches of OA-S + ACL had a smaller NWI compared with control and OA without ACL injury (OA-S-only, P = 0.000, 95% confidence interval [CI] = −0.059–−0.030; P = 0.000, 95% CI = −0.049–−0.016). A similar trend was found in notch shape index (NSI), but not in notch depth index and the cross-sectional area. The cutoff of NWI and NSI value was 0.26, and 0.65, and area under the receiver operating characteristic curve was 0.82, and 0.79, respectively. Further study displayed a significant correlation between a reduced NWI and NSI and OA-S + ACL (P = 0.000, χ2 = 14.012; P = 0.000, χ2 = 14.286). Conclusion: A narrower intercondylar notch and a plateau environment are risk factors of predisposing female nonathletes with knee OA to ACL injury aged 41–65 years.
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Affiliation(s)
- Bin Geng
- Department of Orthopaedics, The Second Hospital of Lanzhou University, Lanzhou, Gansu 730000; Orthopaedics Key Laboratory of Gansu Province, Lanzhou, Gansu 730000, China
| | - Jing Wang
- Orthopaedics Key Laboratory of Gansu Province, Lanzhou, Gansu 730000, China
| | - Jing-Lin Ma
- Orthopaedics Key Laboratory of Gansu Province, Lanzhou, Gansu 730000, China
| | - Bo Zhang
- Department of Orthopaedics, The Second Hospital of Lanzhou University, Lanzhou, Gansu 730000, China
| | - Jin Jiang
- Department of Orthopaedics, The Second Hospital of Lanzhou University, Lanzhou, Gansu 730000, China
| | - Xiao-Yi Tan
- Department of Orthopaedics, The Second Hospital of Lanzhou University, Lanzhou, Gansu 730000, China
| | - Ya-Yi Xia
- Department of Orthopaedics, The Second Hospital of Lanzhou University, Lanzhou, Gansu 730000; Orthopaedics Key Laboratory of Gansu Province, Lanzhou, Gansu 730000, China
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19
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Abstract
An osteophyte is a fibrocartilage-capped bony outgrowth that is one of the features of osteoarthritis. This study reviewed the types, risk factors, pathophysiology, clinical presentations, and medical and surgical treatment of osteophytes. Extraspinal osteophytes are classified as marginal, central, periosteal, or capsular, whereas vertebral osteophytes are classified as traction or claw. Risk factors for development of osteophytes include age, body mass index, physical activity, and other genetic and environmental factors. Transforming growth factor β plays a role in the pathophysiology of osteophyte formation. Osteophytes can cause pain, limit range of motion, affect quality of life, and cause multiple symptoms at the spine. Medical treatment involves the use of bisphosphonates and other non-steroidal anti-inflammatory agents. Surgical treatment in the form of cheilectomy for impingement syndromes during joint replacement is recommended.
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Affiliation(s)
- Siu Him Janus Wong
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong
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20
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Ogura T, Bryant T, Minas T. Biological Knee Reconstruction With Concomitant Autologous Chondrocyte Implantation and Meniscal Allograft Transplantation: Mid- to Long-term Outcomes. Orthop J Sports Med 2016; 4:2325967116668490. [PMID: 27803938 PMCID: PMC5076751 DOI: 10.1177/2325967116668490] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Treating articular cartilage defects and meniscal deficiency is challenging. Although some short- to mid-term follow-up studies report good clinical outcomes after concurrent autologous chondrocyte implantation (ACI) and meniscal allograft transplantation (MAT), longer follow-up is needed. PURPOSE To evaluate mid- to long-term outcomes after combined ACI with MAT. STUDY DESIGN Case series; Level of evidence, 4. METHODS We performed a retrospective review of prospectively gathered data from patients who had undergone ACI with MAT between 1999 and 2013. A single surgeon treated 18 patients for symptomatic full-thickness chondral defects with meniscal deficiency. One patient was lost to follow-up. Thus, 17 patients (18 knees; mean age, 31.7 years) were evaluated over a mean 7.9-year follow-up (range, 2-16 years). A mean 1.8 lesions per knee were treated over a total surface area of 7.6 cm2 (range, 2.3-21 cm2) per knee. Seventeen lateral and 1 medial MATs were performed. Survival was analyzed using the Kaplan-Meier method. The modified Cincinnati Knee Rating Scale, Western Ontario and McMaster Universities Osteoarthritis Index, visual analog scale, and Short Form-36 were used to evaluate clinical outcomes. Patients also self-reported knee function and satisfaction. Standard radiographs were scored for Kellgren-Lawrence (K-L) grade. RESULTS Both 5- and 10-year survival rates were 75%. Outcomes for 6 knees were considered failures. Of the 6 failures, 4 knees were converted to arthroplasty and the other 2 knees underwent biological revision surgery. Of the 12 successfully operated knees, all clinical measures significantly improved postoperatively. Ten patients representing 11 of the 12 knees rated outcomes for their knees as good or excellent, and 1 rated their outcome as fair. Eight patients representing 9 of the 12 knees were satisfied with the procedure. There was no significant osteoarthritis progression based on K-L grading from preoperatively to a mean 5.9 years after surgery. Seven of the 12 knees (58%) required subsequent surgical procedures (5 arthroscopic alone, 2 both arthroscopic and open). CONCLUSION Combined ACI with MAT provided significant improvement in 65% of the operated knees over a mid- to long-term follow-up. This procedure can allow patients to retain their biological knees, delay or prevent rapid degeneration to osteoarthritis, and could be recognized as a bridge procedure before artificial knee replacement. However, careful discussion between the patient and surgeon is necessary before surgery to ensure realistic expectations.
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Affiliation(s)
- Takahiro Ogura
- Cartilage Repair Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Tim Bryant
- Cartilage Repair Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Tom Minas
- Cartilage Repair Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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21
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Tran G, Smith TO, Grice A, Kingsbury SR, McCrory P, Conaghan PG. Does sports participation (including level of performance and previous injury) increase risk of osteoarthritis? A systematic review and meta-analysis. Br J Sports Med 2016; 50:1459-1466. [PMID: 27683348 PMCID: PMC5136708 DOI: 10.1136/bjsports-2016-096142] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2016] [Indexed: 11/04/2022]
Abstract
BACKGROUND To assess the relationship between sport and osteoarthritis (OA), and specifically to determine whether previous participation, in terms of level (elite or non-elite), type of sport, intensity or previous injury, was associated with OA. METHODS This systematic review was developed using PRISMA guidelines. Databases were searched (to May 2016). Narrative review and meta-analysis (with risk ratio (RR) and 95% CIs) approaches were undertaken where appropriate. Study quality was assessed using GRADE. RESULTS 46 studies were included. Narratively, 31 studies reported an increased risk of OA, with 19 demonstrating an increased risk in elite athletes. There was an increased risk after sports exposure (irrespective of type; RR 1.37; 95% CI 1.14 to 1.64; 21 studies). It remained uncertain whether there was a difference in risk of OA between elite and non-elite athletes (RR 1.37; 95% CI 0.84 to 2.22; 17 studies). The risk was higher in soccer (RR 1.42; 95% CI 1.14 to 1.77; 15 studies) but lower in runners (RR 0.86; 95% CI 0.53 to 1.41; 12 studies). 9 studies showed an association with the intensity of sport undertaken and OA. 5 studies demonstrated a higher prevalence of OA following meniscectomies and anterior cruciate ligament tears. Overall, the evidence was of GRADE 'very low' quality. CONCLUSIONS There was very low-quality evidence to support an increased relationship between sports participation and OA in elite participants. It is unclear whether there is a difference in risk between elite and non-elite participants with further prospective studies needed to evaluate this. Pooled findings suggested that significant injuries were associated with OA in soccer players.
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Affiliation(s)
- Gui Tran
- Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Toby O Smith
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich Research Park, Norwich, UK
| | - Adam Grice
- Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Sarah R Kingsbury
- Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Paul McCrory
- The Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre-Austin Campus, Heidelberg, Australia
| | - Philip G Conaghan
- Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.,NIHR Leeds Musculoskeletal Biomedical Research Unit, University of Leeds, Leeds, UK.,Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, Nottingham, UK
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22
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Antony B, Jones G, Jin X, Ding C. Do early life factors affect the development of knee osteoarthritis in later life: a narrative review. Arthritis Res Ther 2016; 18:202. [PMID: 27623622 PMCID: PMC5022173 DOI: 10.1186/s13075-016-1104-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Osteoarthritis (OA) mainly affects older populations; however, it is possible that early life factors contribute to the development of OA in later life. The aim of this review is to describe the association between childhood or early adulthood risk factors and knee pain, structural imaging markers and development of knee OA in later life. A narrative overview of the literature synthesising the findings of literature retrieved from searches of computerised databases and manual searches was conducted. We found that only a few studies have explored the long-term effect of childhood or early adulthood risk factors on the markers of joint health that predispose people to OA or joint symptoms. High body mass index (BMI) and/or overweight status from childhood to adulthood were independently related to knee pain and OA in later life. The findings regarding the association between strenuous physical activity and knee structures in young adults are still conflicting. However, a favourable effect of moderate physical activity and fitness on knee structures is reported. Childhood physical activity and performance measures had independent beneficial effects on knee structures including knee cartilage in children and young adults. Anterior knee pain syndrome in adolescence could lead to the development of patellofemoral knee OA in the late 40s. Furthermore, weak evidence suggests that childhood malalignment, socioeconomic status and physical abuse are associated with OA in later life. The available evidence suggests that early life intervention may prevent OA in later life.
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Affiliation(s)
- Benny Antony
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania, 7000, Australia.
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania, 7000, Australia
| | - Xingzhong Jin
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania, 7000, Australia
| | - Changhai Ding
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania, 7000, Australia.,Institute of Bone & Joint Translational Research, Southern Medical University, Guangzhou, Guangdong, China
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23
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Tsoukas D, Fotopoulos V, Basdekis G, Makridis KG. No difference in osteoarthritis after surgical and non-surgical treatment of ACL-injured knees after 10 years. Knee Surg Sports Traumatol Arthrosc 2016; 24:2953-2959. [PMID: 25854500 DOI: 10.1007/s00167-015-3593-9] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Accepted: 03/30/2015] [Indexed: 01/13/2023]
Abstract
PURPOSE Aim of this study was to record and compare the functional and activity level as well as the manifestations of osteoarthritis after isolated ACL ruptures between patients with conservative treatment and ACL reconstruction with hamstrings tendon graft. METHODS Thirty-two patients diagnosed with ACL rupture were recorded. Clinical examination included the Tegner and Lysholm activity scale, the International Knee Documentation Committee Subjective Form and KT-1000 arthrometer. Narrowing of the medial and lateral joint spaces was assessed using the IKDC knee examination score. RESULTS Median follow-up was 10.3 years (range 10-11). Fifteen patients were conservatively treated (median age 33 years, range 25-39). Seventeen patients were operated (median age 31 years, range 20-36). There was significant difference between the mean values of IKDC scores in favour of the ACL-reconstruction group of patients, 86.8 (SD 6.5) versus 77.5 (SD 13.8), respectively (p = 0.04). The mean value of anteroposterior tibial translation was 1.5 mm (SD 0.2) for ACL-reconstruction group of patients, while the corresponding mean value for ACL-conservative group was 4.5 mm (SD 0.5), p = 0.03. Four patients in ACL-reconstruction group had radiological findings of grade C or D according to IKDC form. In ACL-conservative group, five patients presented similar signs (n.s.). CONCLUSIONS ACL reconstruction using hamstrings autograft resulted in better functional outcome and laxity measurements than ACL-conservative management. However, the incidence of radiological osteoarthritis was similar between the two groups and independent on the pre-operative grade of laxity and functional status of the patients. Equally, bone bruises were not found as a risk factor for the development of osteoarthritis after ACL rupture. LEVEL OF EVIDENCE Prospective randomized study, Level II.
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Affiliation(s)
- Dimitrios Tsoukas
- Orthopaedic Sports Medicine Clinic, 1-3 Distomou Street, Maroussi, 15125, Athens, Greece
| | - Vasilios Fotopoulos
- Royal Sussex County Hospital, Eastern Road, Brighton, East Sussex, BN2 5BE, UK
| | - Georgios Basdekis
- Academic Department of Orthopaedic Surgery and Musculoskeletal Trauma, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Konstantinos G Makridis
- , Flat 155F, Block D, The Plaza, Claypit Lane, Leeds, LS2 8BN, UK.
- Centre Nollet (Teaching center - approved by ESSKA), Leeds Teaching Hospitals NHS Trust, Leeds, UK.
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24
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Blackburn JT, Pietrosimone B, Harkey MS, Luc BA, Pamukoff DN. Inter-limb differences in impulsive loading following anterior cruciate ligament reconstruction in females. J Biomech 2016; 49:3017-3021. [DOI: 10.1016/j.jbiomech.2016.07.030] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 05/18/2016] [Accepted: 07/26/2016] [Indexed: 11/26/2022]
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25
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Paxinos O, Karavasili A, Delimpasis G, Stathi A. Prevalence of Knee Osteoarthritis in 100 Athletically Active Veteran Soccer Players Compared With a Matched Group of 100 Military Personnel. Am J Sports Med 2016; 44:1447-54. [PMID: 26933134 DOI: 10.1177/0363546516629648] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Although knee injuries in professional soccer (football) have been extensively studied, the prevalence of knee osteoarthritis (OA) in veteran players is not well documented. PURPOSE To investigate the prevalence of knee OA in retired professional soccer players in comparison with a group of athletically active military personnel. STUDY DESIGN Cross-sectional study; Level of evidence, 3. METHODS A group of 100 veteran Greek soccer players aged 35 to 55 years (mean [±SD] age, 46.90 ± 5.9 years) were examined for knee OA and were administered the Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire. A matched group of 100 athletically active military personnel served as a comparison group. RESULTS The sonographic prevalence of OA was significantly higher in the veteran soccer group (52%) than in the military group (33%) (n = 200; P = .010). This difference remained significant even after excluding participants with a history of knee surgery (44.1% vs 25.3%, respectively) (n = 151; P = .010). Femoral cartilage thickness was similar between the 2 groups (P = .473), while altered knee alignment had no effect on the prevalence of OA (P = .740). With the exception of perceived pain being more prevalent in the military group, there were no other statistically significant differences between the 2 groups in KOOS values. CONCLUSION Veteran soccer players had a higher sonographic prevalence of knee OA but better pain scores than a matched group of athletically active military personnel.
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Affiliation(s)
- Odysseas Paxinos
- Orthopedic Department, 251 Hellenic Air Force General Hospital, Athens, Greece
| | | | - Georgios Delimpasis
- Orthopedic Department, 251 Hellenic Air Force General Hospital, Athens, Greece
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26
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Pietrosimone B, Blackburn JT, Harkey MS, Luc BA, Hackney AC, Padua DA, Driban JB, Spang JT, Jordan JM. Greater Mechanical Loading During Walking Is Associated With Less Collagen Turnover in Individuals With Anterior Cruciate Ligament Reconstruction. Am J Sports Med 2016; 44:425-32. [PMID: 26684662 DOI: 10.1177/0363546515618380] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Individuals who have sustained an anterior cruciate ligament (ACL) injury and undergo ACL reconstruction (ACLR) are at higher risk of developing knee osteoarthritis. It is hypothesized that altered knee loading may influence the underlying joint metabolism and hasten development of posttraumatic knee osteoarthritis. PURPOSE To explore the associations between serum biomarkers of cartilage metabolism and peak vertical ground-reaction force (vGRF) and vGRF loading rate in the injured and uninjured limbs of individuals with ACLR. STUDY DESIGN Descriptive laboratory study. METHODS Patients with a history of a primary unilateral ACLR who had returned to unrestricted physical activity (N = 19) participated in the study. Resting blood was collected from each participant before completing 5 walking gait trials at a self-selected comfortable speed. Peak vGRF was extracted for both limbs during the first 50% of the stance phase of gait, and the linear vGRF loading rate was determined between heel strike and peak vGRF. Sera were assessed for collagen breakdown (collagen type II cleavage product [C2C]) and synthesis (collagen type II C-propeptide [CPII]), as well as aggrecan concentrations, via commercially available specific enzyme-linked immunosorbent assays. Pearson product-moment correlations (r) and Spearman rank-order correlations (ρ) were used to evaluate associations between loading characteristics and biomarkers of cartilage metabolism. RESULTS Lower C2C:CPII ratios were associated with higher peak vGRF in the injured limb (ρ = -0.59, uncorrected P = .007). There were no significant associations between peak vGRF or linear vGRF loading rate and CPII, C2C, or aggrecan serum concentrations. CONCLUSION Lower C2C:CPII ratios were associated with higher peak vGRF in the ACLR limb during gait, suggesting that higher peak loading in the ACLR limb is related to lower type II collagen breakdown relative to type II collagen synthesis. CLINICAL RELEVANCE These data suggest that type II collagen synthesis may be higher relative to the amount of type II collagen breakdown in the ACLR limb with higher lower extremity loading. Future study should determine if metabolic compensations to increase collagen synthesis may affect the risk of developing osteoarthritis after ACLR.
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Affiliation(s)
- Brian Pietrosimone
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - J Troy Blackburn
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA Department of Orthopaedics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Matthew S Harkey
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Brittney A Luc
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Anthony C Hackney
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, North Carolina, USA
| | - Darin A Padua
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jeffrey B Driban
- Division of Rheumatology, Tufts Medical School, Boston, Massachusetts, USA
| | - Jeffrey T Spang
- Department of Orthopaedics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Joanne M Jordan
- Division of Rheumatology, Allergy, and Immunology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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27
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Sharma L. Osteoarthritis year in review 2015: clinical. Osteoarthritis Cartilage 2016; 24:36-48. [PMID: 26707991 PMCID: PMC4693145 DOI: 10.1016/j.joca.2015.07.026] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 07/21/2015] [Accepted: 07/30/2015] [Indexed: 02/02/2023]
Abstract
The purpose of this review is to highlight clinical research in osteoarthritis (OA). A literature search was conducted using PubMed (http://www.ncbi.nlm.nih.gov/pubmed/) with the search terms "osteoarthritis [All Fields] AND treatment [All Fields]" and the following limits activated: humans, English language, all adult 19+ years, published between April 1, 2014 and April 1, 2015. A second literature search was then conducted with the search terms "osteoarthritis [All Fields] AND epidemiology [All Fields]", with the same limits. Reports of surgical outcome, case series, surgical technique, tissue sample or culture studies, trial protocols, and pilot studies were excluded. Of 1523, 150 were considered relevant. Among epidemiologic and observational clinical studies, themes included physical activity, early knee OA, and confidence/instability/falls. Symptom outcomes of pharmacologic treatments were reported for methotrexate, adalimumab, anti-nerve growth factor monoclonal antibodies, strontium ranelate, bisphosphonates, glucosamine, and chondroitin sulfate, and structural outcomes of pharmacologic treatments for strontium ranelate, recombinant human fibroblast growth factor 18, and glucosamine and chondroitin sulfate. Symptom outcomes of non-pharmacologic interventions were reported for: neuromuscular exercise, quadriceps strengthening, weight reduction and maintenance, TENS, therapeutic ultrasound, stepped care strategies, cognitive behavior therapy for sleep disturbance, acupuncture, gait modification, booster physical therapy, a web-based therapeutic exercise resource center for knee OA; hip physical therapy for hip OA; and joint protection and hand exercises for hand OA. Structure outcomes of non-pharmacologic interventions were reported for patellofemoral bracing.
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Abstract
PURPOSE OF REVIEW This review focuses on recent studies of osteoarthritis epidemiology, including research on prevalence, incidence, and a broad array of potential risk factors at the person level and joint level. RECENT FINDINGS Studies continue to illustrate the high impact of osteoarthritis worldwide, with increasing incidence. Person-level risk factors with strong evidence regarding osteoarthritis incidence and/or progression include age, sex, socioeconomic status, family history, and obesity. Joint-level risk factors with strong evidence for incident osteoarthritis risk include injury and occupational joint loading; the associations of injury and joint alignment with osteoarthritis progression are compelling. Moderate levels of physical activity have not been linked to increased osteoarthritis risk. Some topics of high recent interest or emerging evidence for association with osteoarthritis include metabolic pathways, vitamins, joint shape, bone density, limb length inequality, muscle strength and mass, and early structural damage. SUMMARY Osteoarthritis is a complex, multifactorial disease, and there is still much to learn regarding mechanisms underlying incidence and progression. However, there are several known modifiable and preventable risk factors, including obesity and joint injury; efforts to mitigate these risks can help to lessen the impact of osteoarthritis.
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29
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Roemer FW, Jarraya M, Niu J, Duryea J, Lynch JA, Guermazi A. Knee joint subchondral bone structure alterations in active athletes: a cross-sectional case-control study. Osteoarthritis Cartilage 2015; 23:2184-2190. [PMID: 26187571 DOI: 10.1016/j.joca.2015.07.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 06/12/2015] [Accepted: 07/07/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVE It has been shown that trabecular bone structure parameters extracted from radiographs known as fractal signature analysis (FSA) are able to predict structural outcomes such as radiographic osteoarthritis (OA) progression. Little is known about their involvement in early disease or about differences between subjects exposed to increased joint loading such as young active athletes compared to non-athletes. Aim was to compare horizontal and vertical dimensions of bone texture considering athlete status, gender, previous anterior cruciate ligament (ACL) surgery and age. DESIGN Included were 685 patients of which 135 consecutive athletes (82% soccer players) 18-36 years old and 550 non-athletes controls in the same age range had knee radiography for assessment of subacute or chronic knee complaints. Regions of interest (ROI) were placed in the subchondral medial and lateral tibial plateaus. Fractal signatures were calculated in the horizontal and vertical dimensions. Curve fitting algorithms were applied taking into account all four risk factors in the same model adjusting for each other. RESULTS For the horizontal dimensions significant differences were observed for gender (estimate (E) 0.098 (95% confidence interval(CI)) (-0.009, 0.008), P < .0001), previous ACL surgery (E -0.031, 95% CI (-0.043, -0.019), P < .0001) and highest age group (E -0.039, 95% CI (-0.048, -0.029), P < .0001). For vertical dimensions, significant differences were shown for athletes (E -0.012, 95% CI (-0.020, -0.004), P < .0001), gender (E 0.056, 95% CI (0.049, 0.062), P < .0001), and age range from 28 to 32 years (E -0.028, 95% CI (-0.037, -0.019), P < .0001). CONCLUSIONS Trabecular bone structure differs between athletes and non-athletes, in regard to previous ACL surgery, gender and higher age.
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Affiliation(s)
- F W Roemer
- Aspetar, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar; Quantitative Imaging Center (QIC), Department of Radiology, Boston University School of Medicine, Boston, MA, USA; Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany.
| | - M Jarraya
- Quantitative Imaging Center (QIC), Department of Radiology, Boston University School of Medicine, Boston, MA, USA
| | - J Niu
- Clinical Epidemiology and Training Unit, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - J Duryea
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - J A Lynch
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - A Guermazi
- Aspetar, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar; Quantitative Imaging Center (QIC), Department of Radiology, Boston University School of Medicine, Boston, MA, USA
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30
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Multi-dimensional reliability assessment of fractal signature analysis in an outpatient sports medicine population. Ann Anat 2015; 202:57-60. [PMID: 26343866 DOI: 10.1016/j.aanat.2015.07.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 07/03/2015] [Accepted: 07/13/2015] [Indexed: 11/23/2022]
Abstract
The aim of this study has been to test reproducibility of fractal signature analysis (FSA) in a young, active patient population taking into account several parameters including intra- and inter-reader placement of regions of interest (ROIs) as well as various aspects of projection geometry. In total, 685 patients were included (135 athletes and 550 non-athletes, 18-36 years old). Regions of interest (ROI) were situated beneath the medial tibial plateau. The reproducibility of texture parameters was evaluated using intraclass correlation coefficients (ICC). Multi-dimensional assessment included: (1) anterior-posterior (A.P.) vs. posterior-anterior (P.A.) (Lyon-Schuss technique) views on 102 knees; (2) unilateral (single knee) vs. bilateral (both knees) acquisition on 27 knees (acquisition technique otherwise identical; same A.P. or P.A. view); (3) repetition of the same image acquisition on 46 knees (same A.P. or P.A. view, and same unitlateral or bilateral acquisition); and (4) intra- and inter-reader reliability with repeated placement of the ROIs in the subchondral bone area on 99 randomly chosen knees. ICC values on the reproducibility of texture parameters for A.P. vs. P.A. image acquisitions for horizontal and vertical dimensions combined were 0.72 (95% confidence interval (CI) 0.70-0.74) ranging from 0.47 to 0.81 for the different dimensions. For unilateral vs. bilateral image acquisitions, the ICCs were 0.79 (95% CI 0.76-0.82) ranging from 0.55 to 0.88. For the repetition of the identical view, the ICCs were 0.82 (95% CI 0.80-0.84) ranging from 0.67 to 0.85. Intra-reader reliability was 0.93 (95% CI 0.92-0.94) and inter-observer reliability was 0.96 (95% CI 0.88-0.99). A decrease in reliability was observed with increasing voxel sizes. Our study confirms excellent intra- and inter-reader reliability for FSA, however, results seem to be affected by acquisition technique, which has not been previously recognized.
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