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Steingrebe H, Spancken S, Sell S, Stein T. Effects of hip osteoarthritis on lower body joint kinematics during locomotion tasks: a systematic review and meta-analysis. Front Sports Act Living 2023; 5:1197883. [PMID: 38046934 PMCID: PMC10690786 DOI: 10.3389/fspor.2023.1197883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 10/09/2023] [Indexed: 12/05/2023] Open
Abstract
Introduction Motion analysis can be used to gain information needed for disease diagnosis as well as for the design and evaluation of intervention strategies in patients with hip osteoarthritis (HOA). Thereby, joint kinematics might be of great interest due to their discriminative capacity and accessibility, especially with regard to the growing usage of wearable sensors for motion analysis. So far, no comprehensive literature review on lower limb joint kinematics of patients with HOA exists. Thus, the aim of this systematic review and meta-analysis was to synthesise existing literature on lower body joint kinematics of persons with HOA compared to those of healthy controls during locomotion tasks. Methods Three databases were searched for studies on pelvis, hip, knee and ankle kinematics in subjects with HOA compared to healthy controls during locomotion tasks. Standardised mean differences were calculated and pooled using a random-effects model. Where possible, subgroup analyses were conducted. Risk of bias was assessed with the Downs and Black checklist. Results and Discussion A total of 47 reports from 35 individual studies were included in this review. Most studies analysed walking and only a few studies analysed stair walking or turning while walking. Most group differences were found in ipsi- and contralateral three-dimensional hip and sagittal knee angles with reduced ranges of motion in HOA subjects. Differences between subjects with mild to moderate and severe HOA were found, with larger effects in severe HOA subjects. Additionally, stair walking and turning while walking might be promising extensions in clinical gait analysis due to their elevated requirements for joint mobility. Large between-study heterogeneity was observed, and future studies have to clarify the effects of OA severity, laterality, age, gender, study design and movement execution on lower limb joint kinematics. Systematic Review Registration PROSPERO (CRD42021238237).
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Affiliation(s)
- Hannah Steingrebe
- BioMotion Center, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
- Sports Orthopedics, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| | - Sina Spancken
- BioMotion Center, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| | - Stefan Sell
- Sports Orthopedics, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
- Joint Center Black Forest, Hospital Neuenbürg, Neuenbürg, Germany
| | - Thorsten Stein
- BioMotion Center, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
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González-Sáenz-de-Tejada M, Quintana JM, Arenaza JC, Azcarate-Garitano JR, Esnaola-Guisasola PM, García-Sánchez I, Baguer-Antonio A, Bilbao-González A. Long-term health related quality of life in total knee arthroplasty. BMC Musculoskelet Disord 2023; 24:327. [PMID: 37098518 PMCID: PMC10127408 DOI: 10.1186/s12891-023-06399-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 04/04/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND To analyze evolution and factors related with greater gains in Health Related Quality of Life (HRQOL) and with a greater probability of exceed their corresponding minimal clinically important differences (MCID) in patients with Osteoarthritis of the knee, undergoing total knee arthroplasty (TKA) at long-term. METHODS Data were obtained from two previously recruited multicenter cohorts of patients who underwent TKA in the Basque Country. Patients were follow-up at 6 months and 10 years after surgery. Patients completed specific and generic HRQOL questionnaires plus sociodemographic, and clinical data at 10 years. Associations were analysed using linear and logistic regression models. RESULTS A total of 471 patients responded at 10-year follow-up. The multivariable analysis showed that low preoperative HRQOL scores, higher age, higher BMI, some comorbidities and readmissions at 6 months were associated with less gains in HRQOL. Apart from aforementioned, to have a peripheral vascular disease (odd ratio 0.49 (95% CI, 0.24-0.99)), complications (odd ratio 0.31 (95% CI, 0.11-0.91)), and readmissions within 6 months of discharge (odd ratio 2.12 (95% CI, 1.18-3.80)) were associated with a lower probability of exceeding the MCID. The effect sizes (ESs) of changes from baseline to 6 months (range, 1.20-1.96) and to 10 years (range, 1.54-1.99) were large in all dimensions, nevertheless the ESs from 6 months to 10 years were not appreciable for pain (ES = 0.03) or stiffness (ES = 0.09), and small for function (ES = 0.30). CONCLUSIONS Low preoperative HRQOL scores, to be elderly, severe obesity, the presence of some comorbidities -depression and rheumatology disease-, having readmissions or complications and not having rehabilitation of discharge, are good predictors of long-term lower gains in HRQOL. Some other non-registered parameters of the follow-up may also influence those outcomes. KEY INDEXING TERMS (MESH TERMS) Health-Related Quality of Life, Knee Arthroplasty, Total, Osteoarthritis.
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Affiliation(s)
- Marta González-Sáenz-de-Tejada
- Kronikgune Institute for Health Services Research, Barakaldo, Spain.
- Osakidetza Basque Health Service, Research Unit, Basurto University Hospital, Bilbao, Spain.
- Health Services Research on Chronic Patients Network (REDISSEC), Bilbao, Spain.
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Bilbao, Spain.
- Hospital Universitario de Basurto. Unidad de Investigación, Jado 4º Planta. Avda. Montevideo 18, Bilbao, 48013, Bizkaia, Spain.
| | - Jose M Quintana
- Kronikgune Institute for Health Services Research, Barakaldo, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Bilbao, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Bilbao, Spain
- Osakidetza Basque Health Service, Research Unit, Galdakao-Usansolo University Hospital, Galdakao, Bizkaia, Spain
| | - Juan C Arenaza
- Health Services Research on Chronic Patients Network (REDISSEC), Bilbao, Spain
- Osakidetza Basque Health Service, Traumatology and Orthopedic Surgery Service, Basurto University Hospital, Bilbao, Bizkaia, Spain
| | - Jesús R Azcarate-Garitano
- Osakidetza Basque Health Service, Mendaro Hospital, Traumatology and Orthopedic Surgery Service, Mendaro, Spain
| | - Pedro M Esnaola-Guisasola
- Osakidetza Basque Health Service, Traumatology and Orthopedic Surgery Service, Donostia University Hospital, Donostia, Gipuzkoa, Spain
| | - Isidoro García-Sánchez
- Osakidetza Basque Health Service, Galdakao-Usansolo University Hospital, Traumatology and Orthopedic Surgery Service, Galdakao, Bizkaia, Spain
| | - Alejandro Baguer-Antonio
- Osakidetza Basque Health Service, Traumatology and Orthopedic Surgery Service, Donostia University Hospital, Donostia, Gipuzkoa, Spain
| | - Amaia Bilbao-González
- Kronikgune Institute for Health Services Research, Barakaldo, Spain
- Osakidetza Basque Health Service, Research Unit, Basurto University Hospital, Bilbao, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Bilbao, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Bilbao, Spain
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Silva-Díaz M, Blanco FJ, Quevedo Vila V, Seoane-Mato D, Pérez-Ruiz F, Juan-Mas A, Pego-Reigosa JM, Narváez J, Quilis N, Cortés R, Romero Pérez A, Fábregas Canales D, Font Gayá T, Bordoy Ferrer C, Prado-Galbarro FJ, Sánchez-Piedra C, Díaz-González F, Bustabad-Reyes S. Prevalence of symptomatic axial osteoarthritis phenotypes in Spain and associated socio-demographic, anthropometric, and lifestyle variables. Rheumatol Int 2022; 42:1085-1096. [PMID: 34755205 PMCID: PMC9124650 DOI: 10.1007/s00296-021-05038-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 10/22/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Axial osteoarthritis (OA) is a common cause of back and neck pain, however, few studies have examined its prevalence. The aim was to estimate the prevalence and the characteristics of symptomatic axial OA in Spain. METHODS EPISER2016 is a cross-sectional multicenter population-based study of people aged 40 years or older. Subjects were randomly selected using multistage stratified cluster sampling. Participants were contacted by telephone to complete rheumatic disease screening questionnaires. Two phenotypes were analyzed, patients with Non-exclusive axial OA (NEA-OA) and Exclusive axial OA (EA-OA). To calculate the prevalence and its 95% confidence interval (CI), the sample design was considered and weighting was calculated according to age, sex and geographic origin. RESULTS Prevalence of NEA-OA by clinical or clinical-radiographic criteria was 19.17% (95% CI: 17.82-20.59). The frequency of NEA-OA increased with age (being 3.6 times more likely in patients aged 80 s or more than in those between 40 and 49 years) and body mass index. It was significantly more frequent in women, as well as in the center of Spain. It was less frequent in those with a higher level of education. Lumbar OA was more frequent than cervical OA. This difference grew with increasing age and was not associated with gender. It was also greater in overweight and obese subjects. CONCLUSIONS This is the first study on the prevalence of axial OA phenotypes in Europe describing the associated socio-demographic, anthropometric, and lifestyle variables.
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Affiliation(s)
- Maite Silva-Díaz
- Unidad de Investigación Clínica, Grupo de Investigación de Reumatología (GIR), Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidade da Coruña, A Coruña, Spain
| | - Francisco J Blanco
- Unidad de Investigación Clínica, Grupo de Investigación de Reumatología (GIR), Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidade da Coruña, A Coruña, Spain.
- Universidade da Coruña (UDC), Grupo de Investigación de Reumatología y Salud (GIR-S). Departamento de Fisioterapia, Medicina y Ciencias Biomédicas, Facultad de Fisioterapia,, Campus de Oza, A Coruña, España.
| | - Víctor Quevedo Vila
- Rheumatology Unit, Hospital Comarcal Monforte de Lemos, Monforte de Lemos, Lugo, España
| | | | - Fernando Pérez-Ruiz
- Rheumatology Department, Hospital Universitario Cruces, Baracaldo, Vizcaya, España
| | - Antonio Juan-Mas
- Rheumatology Department, Hospital Son LLàtzer, Palma de Mallorca, Baleares, España
| | - José M Pego-Reigosa
- Rheumatology Department, Complejo Hospitalario Universitario de Vigo, Grupo IRIDIS, Instituto de Investigación Sanitaria Galicia Sur (IISGS), Vigo, Pontevedra, España
| | - Javier Narváez
- Rheumatology Department, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España
| | - Neus Quilis
- Rheumatology Department, Hospital General Universitario de Elda, Elda, Alicante, España
| | - Raúl Cortés
- Rheumatology Department, Hospital General de Ontinyent, Ontinyent, Valencia, España
| | | | | | - Teresa Font Gayá
- Rheumatology Department, Hospital Comarcal de Inca, Inca, Baleares, España
| | | | | | | | - Federico Díaz-González
- Department of Internal Medicine, Dermatology and Psyquiatry, Universidad de La Laguna, La Laguna, Santa Cruz de Tenerife, España
- Rheumatology Department, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, España
| | - Sagrario Bustabad-Reyes
- Rheumatology Department, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, España
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Sicras-Mainar A, Tornero-Tornero JC, Vargas-Negrín F, Lizarraga I, Sicras-Navarro A, Rejas-Gutierrez J. Sick Leave and Costs in Active Workers with Chronic Osteoarthritis Pain in Spain: Outcomes of the OPIOIDS Real World Study. Open Access Rheumatol 2022; 14:25-38. [PMID: 35321217 PMCID: PMC8937618 DOI: 10.2147/oarrr.s346746] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 02/24/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To estimate the number of sick leave days and productivity costs in active workers with osteoarthritis (OA) who initiated opioid treatment for moderate/severe chronic pain in clinical practice in Spain. Patients and Methods This is a secondary analysis of the longitudinal, retrospective OPIOIDS study, using electronic medical records (EMR) of patients aged ≥18 years, who started an opioid treatment for moderate/severe chronic OA pain between 2010 and 2015 after treatment failure with ≥1 first-line drugs (acetaminophen, metamizole and/or nonsteroidal anti-inflammatory drugs [NSAIDs]). The number of days of sick leave and productivity costs were analyzed during a follow-up period of 36 months. Results A total of 5089 patients with moderate/severe chronic OA pain, aged 56.8 years (standard deviation [SD]: 4.6) (56.6% were female), were analyzed: 73.3% of them started a treatment with weak opioids and 26.7% of them were treated with strong opioids. At 36 months, adherence was 21.0% (strong opioids: 15.4%; weak opioids: 23.0%; p<0.001), and 77% of patients had at least one sick leave related with chronic OA pain, with an average of 93 days off work in all working patients (120.5 days in patients with sick leaves). Besides, 16.9% of the study population had sick leave periods that lasted at least 6 months. Pain reduction was modest (−1.2 points; −4.0%, p<0.001). The cost of sick leave was €2594 patient/year, and factors such as older age (β=0.043), female sex (β=0.036), comorbidities (β=0.035) and strong opioid use (β=0.031) were associated with higher productivity costs (p<0.05 in all associations). Conclusion Active workers who started opioid treatment for moderate/severe chronic OA pain showed an increased frequency of sick leave and productivity cost, with a modest effect on pain relief. Older age, female sex, comorbidities, and strong opioids were associated with higher costs for society.
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Affiliation(s)
- Antoni Sicras-Mainar
- Health Economics and Outcomes Research Department, Atrys Health, Barcelona, Spain
| | | | | | | | - Aram Sicras-Navarro
- Health Economics and Outcomes Research Department, Atrys Health, Barcelona, Spain
| | - Javier Rejas-Gutierrez
- Health Economics and Outcomes Research Department, Pfizer, SLU, Alcobendas, Madrid, Spain
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Castro-Domínguez F, Vargas-Negrín F, Pérez C, Gutiérrez-Prieto H, Rebollo P. Unmet Needs in the Osteoarthritis Chronic Moderate to Severe Pain Management in Spain: A Real Word Data Study. Rheumatol Ther 2021; 8:1113-1127. [PMID: 34109548 PMCID: PMC8380598 DOI: 10.1007/s40744-021-00327-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 05/25/2021] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Patients with moderate or severe pain due to osteoarthritis (OAP) usually undergo pharmacological treatment with NSAIDs and/or opioids. Many of them do not get adequate pain relief because of intolerances, contraindications and the ineffectiveness of these treatments. The main objective of the present study was to quantify the group of OAP patients who are inadequately treated for their pain in routine clinical practice in Spain and to describe the prescription flow of these patients. METHODS This was a non-interventional, retrospective cohort study conducted using the IQVIA's electronic medical records database in Spain. Patients with osteoarthritis (OA), aged ≥ 15 years and receiving any pain treatment during 12 out of 24 months between 1 October 2017 and 30 September 2019 were studied. Assumptions were made to identify patients with contraindication or intolerance to NSAIDs or opioids and those who failed NSAID or opioid therapy. RESULTS Out of 136,556 patients with OA, 29,886 had moderate-to-severe pain, which extrapolated to the general population in Spain represents 1,541,286 OAP patients. Mean age (SD) of OAP patients was 75 (12.8) years, and 73.8% were female; 52.8% were treated with NSAIDs and/or weak opioids. There were were 16,748 OAP patients (56.08%) (extrapolated figure 838,620) with one or more conditions associated with being inadequately treated (contraindication, intolerance or failed NSAID and/or opioid therapy). In most OAP patients (91%) pain treatment was initiated by the general practitioner (GP) alone. Considering overall successive therapy lines, after the first prescription, pain drugs were prescribed by a GP in 61% of the cases, by a specialist in 20% and by both in 18%. CONCLUSION More than half of the patients with OA in Spain have unsatisfactory pain control. Pain drugs are mainly prescribed by GPs, and specialists (traumatologists, rheumatologists, physiatrists and pain management specialists) are not very involved in the management of OAP patients.
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Affiliation(s)
- Francisco Castro-Domínguez
- Rheumatology Unit, Teknon Medical Center, Quirónsalud Group, Barcelona, Spain
- Rheumatology Unit, University Hospital "Sagrat Cor", Quirónsalud Group, Barcelona, Spain
- SER Working Group in Osteoarthritis, Spanish Society of Rheumatology, Madrid, Spain
| | | | | | | | - Pablo Rebollo
- IQVIA, C/ Juan Esplandiu 11, 6º, 28007, Madrid, Spain.
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