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Wu Y, Boer CG, Hofman A, Schiphof D, van Middelkoop M, Szilagyi IA, Sedaghati-Khayat B, Bierma-Zeinstra SMA, Voortman T, van Meurs JBJ. Weight-Bearing Physical Activity, Lower-Limb Muscle Mass, and Risk of Knee Osteoarthritis. JAMA Netw Open 2024; 7:e248968. [PMID: 38687476 PMCID: PMC11061770 DOI: 10.1001/jamanetworkopen.2024.8968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 02/22/2024] [Indexed: 05/02/2024] Open
Abstract
Importance It has been demonstrated that total physical activity is not associated with risk of osteoarthritis. However, the association of different types of physical activity with incident knee osteoarthritis remains unclear. Objective To determine whether weight-bearing recreational physical activities are associated with increased risk of incident knee osteoarthritis. Design, Setting, and Participants This prospective cohort study used data from the Rotterdam Study (1996 to 2009), including participants with knee x-ray measurements at baseline and follow-up examinations. Participants with knee osteoarthritis at baseline were excluded. Residents aged 45 years and older of the Ommoord district in the city of Rotterdam in The Netherlands were invited to join the Rotterdam Study (78% response rate). Analysis was conducted in June 2023. Exposure Total, weight-bearing, and non-weight-bearing recreational physical activities collected by questionnaires at baseline. Main Outcomes and Measures Incident radiographic knee osteoarthritis measured by knee x-ray was the primary outcome, and incident symptomatic knee osteoarthritis defined by x-ray and knee pain questionnaire was the secondary outcome. The association of different types of recreational physical activity with radiographic knee osteoarthritis was examined using logistic regression within generalized estimating equation framework after adjusting for potential confounders. A prespecified stratification analysis was planned on the basis of lower-limb muscle mass index (LMI) tertiles, measured by dual-energy x-ray absorptiometry. Results A total of 5003 individuals (2804 women [56.0%]; mean [SD] age, 64.5 [7.9] years) were included. The knee osteoarthritis incident rate was 8.4% (793 of 9483 knees) for a mean (SD) follow-up time of 6.33 (2.46) years. Higher weight-bearing activity was associated with increased odds of incident knee osteoarthritis (odds ratio [OR], 1.22; 95% CI, 1.10-1.35; P < .001), but non-weight-bearing activity was not (OR, 1.04; 95% CI, 0.95-1.15; P = .37). In the analysis stratified by LMI tertiles, the association of weight-bearing activity with incident osteoarthritis was found only among 431 patients in the lowest LMI tertile (OR, 1.53; 95% CI, 1.15-2.04; P = .003), but not among patients in the middle or high LMI tertile. Conclusions and Relevance The findings of this study suggest that weight-bearing activity is associated with incident knee osteoarthritis in people with low levels of lower-limb muscle mass, which might be a promising avenue for tailored advice for physical activity.
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Affiliation(s)
- Yahong Wu
- Department of Epidemiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Internal Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Cindy G. Boer
- Department of Internal Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Amy Hofman
- Department of Epidemiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Dieuwke Schiphof
- Department of General Practice, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Marienke van Middelkoop
- Department of General Practice, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Ingrid A. Szilagyi
- Department of Internal Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of General Practice, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Bahar Sedaghati-Khayat
- Department of Internal Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Sita M. A. Bierma-Zeinstra
- Department of General Practice, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Orthopedics & Sports Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Joyce B. J. van Meurs
- Department of Internal Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Orthopedics & Sports Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
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Qiu F, Li J, Gan L, Legerlotz K. Arthritis prevalence is associated with metabolic syndrome risk factors but not with physical activity in middle-aged and older patients - a cross-sectional study. BMC Geriatr 2024; 24:242. [PMID: 38459429 PMCID: PMC10924363 DOI: 10.1186/s12877-024-04859-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 03/01/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND In light of the aging population, increasingly suffering from the metabolic syndrome (MS), strategies need to be developed to address global public health challenges known to be associated with MS such as arthritis. As physical activity (PA) may play a crucial role in tackling those challenges, this study aimed to determine the association between the number of MS risk factors, PA and arthritis in people ≥ 50 years old. METHODS Data from the Survey of Health, Ageing, and Retirement in Europe (SHARE) were used to estimate the prevalence of arthritis and MS risk factors in the European population ≥ 50 years and to evaluate the associations between MS risk factors, PA and arthritis. Binary logistic regression was performed to calculate the odds ratio of different factors. RESULTS 73,125 participants were included in the analysis. 55.75% of patients stated at least one of the three MS risk factors. The prevalence of rheumatoid arthritis (RA) and osteoarthritis (OA)/other rheumatism among ≥ 50 years population was 10.19% and 19.32% respectively. Females showed a higher prevalence of arthritis than males. Prevalence did not differ between groups with different levels of PA. Arthritis prevalence was positively correlated with the number of MS risk factors (P < 0.01) but not with PA (P > 0.05). CONCLUSION Middle-aged and older Europeans with multiple comorbidities suffered from RA, OA or other rheumatism more frequently than participants with fewer comorbidities, while the level of physical activity was not associated with the number of metabolic risk factors in patients with RA and OA/other rheumatism.
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Affiliation(s)
- Fanji Qiu
- Movement Biomechanics, Institute of Sport Sciences, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099, Berlin, Germany.
| | - Jinfeng Li
- Department of Kinesiology, Iowa State University, 50011, Ames, USA, IA
| | - Liaoyan Gan
- Alberta International School of Recreation, Sport and Tourism of Beijing Sport University, Beijing Sport University, 572423, Lingshui, China
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, T6G2R3, Edmonton, Canada
| | - Kirsten Legerlotz
- Movement Biomechanics, Institute of Sport Sciences, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099, Berlin, Germany
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Huang L, Zhang Y, Li Q. Investigating the causal relationship between physical activity and incident knee osteoarthritis: a two-sample Mendelian randomization study. Sci Rep 2024; 14:1663. [PMID: 38238411 PMCID: PMC10796638 DOI: 10.1038/s41598-024-52175-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 01/15/2024] [Indexed: 01/22/2024] Open
Abstract
There is evidence that physical activity (PA) has a long-term positive impact on disease. Whether PA is a risk factor for knee osteoarthritis (OA) is still controversial. The purpose of this study was to explore whether there is a causal relationship between PA and knee OA. We extracted PA and knee OA data from genome-wide association study (GWAS) databases. We used single-nucleotide polymorphisms (SNPs) as instrumental variables. We performed MR analysis by random-effects inverse-variance weighting (IVW), MR‒Egger, weighted median, simple mode, and weighted mode methods. We evaluated the stability and reliability of the results through sensitivity analysis. There was no significant association between PA and knee OA (p > 0.05). We did not detect any pleiotropy (MR‒Egger intercept test et al.: p > 0.05). The sensitivity analysis confirmed our results (p > 0.05). There is no causal relationship between PA and knee OA.
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Affiliation(s)
- Liufang Huang
- Department of Rehabilitation Medicine, People's Hospital of Guanghan City, 75 Hankou Road, Luocheng Town, Guanghan City, Sichuan Province, People's Republic of China
| | - Yuling Zhang
- Department of Rehabilitation Medicine, People's Hospital of Guanghan City, 75 Hankou Road, Luocheng Town, Guanghan City, Sichuan Province, People's Republic of China
| | - Qian Li
- Department of Rehabilitation Medicine, People's Hospital of Guanghan City, 75 Hankou Road, Luocheng Town, Guanghan City, Sichuan Province, People's Republic of China.
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Hamai S, Harada S, Tsushima H, Kozuma R, Yamate S, Kawahara S, Akasaki Y, Harada T, Kokubu Y, Konishi T, Nakashima Y. Interaction between functional capability and sleep quality at midterm after total knee arthroplasty: a Japanese retrospective cohort study. Sci Rep 2023; 13:18373. [PMID: 37884595 PMCID: PMC10603171 DOI: 10.1038/s41598-023-45603-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 10/21/2023] [Indexed: 10/28/2023] Open
Abstract
No report has clarified the frequency and interacting factors affecting sleep disturbance among Asian patients at midterm after total knee arthroplasty (TKA). This study aimed to evaluate the frequency of sleep disturbance at midterm after TKA in a Japanese cohort and to identify intervening factors for sleep. We hypothesized that residual knee pain and decreased functional capability negatively interact with sleep quality after TKA. A total of 209 Japanese participants (average age: 77.1 ± 8.3 years; postoperative follow-up period: 4.5 ± 1.9 years) who underwent primary TKA for knee osteoarthritis were included in this study. Sleep quality, satisfaction, pain, functional capability, joint awareness, and mental condition were evaluated using the Pittsburgh Sleep Quality Index (PSQI), Knee Society Score (KSS) 2011, Forgotten Joint Score (FJS)-12, and 12-Item Short-Form Health Survey (SF-12) Mental Component Summary (MCS). Multivariable analysis was performed to determine the influencing factors on PSQI. The scores for the PSQI, satisfaction with pain level while lying in bed, pain during level walking, functional activity category in the KSS 2011, awareness of the artificial joint in bed at night in the FJS-12, and SF-12 MCS were 6.7 ± 3.0, 5.8 ± 1.8, 1.6 ± 2.3, 62 ± 22, 1.5 ± 1.4, and 56 ± 9.3 on average, respectively. Sleep disturbance (PSQI ≥ 5.5) occurred in 54% of the Japanese participants. Multivariable analysis revealed that high functional capability was a significant factor associated with sleep quality improvement (p < 0.05). Decreased functional capability, not residual knee pain, negatively interacted with sleep quality. The sleep disturbance rate was high during the middle postoperative period after TKA in the Japanese cohort.
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Affiliation(s)
- Satoshi Hamai
- Department of Medical-Engineering Collaboration for Healthy Longevity, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.
- Department of Orthopedic Surgery, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Satoru Harada
- Department of Orthopedic Surgery, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hidetoshi Tsushima
- Department of Orthopedic Surgery, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Ryutaro Kozuma
- Department of Orthopedic Surgery, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Satoshi Yamate
- Department of Orthopedic Surgery, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shinya Kawahara
- Department of Orthopedic Surgery, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yukio Akasaki
- Department of Orthopedic Surgery, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tetsunari Harada
- Department of Orthopedic Surgery, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yasuhiko Kokubu
- Department of Orthopedic Surgery, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshiki Konishi
- Department of Orthopedic Surgery, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yasuharu Nakashima
- Department of Orthopedic Surgery, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
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Xu D, Van Middelkoop M, Bierma-Zeinstra SMA, Runhaar J. Physical Activity and Features of Knee Osteoarthritis on Magnetic Resonance Imaging in Individuals Without Osteoarthritis: A Systematic Review. Arthritis Care Res (Hoboken) 2023; 75:1908-1913. [PMID: 36576386 DOI: 10.1002/acr.25083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 12/07/2022] [Accepted: 12/20/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To systematically review all studies that have evaluated the association between physical activity (PA) levels and features of knee osteoarthritis (OA) on magnetic resonance imaging (MRI) for subjects without OA. METHODS The inclusion criteria for prospective studies were as follows: 1) subjects without OA; 2) average age 35-80 years; and 3) any self-reported PA or objective measurement of PA. The eligible MRI outcomes were OA-related measures of intraarticular knee joint structures. Exclusion criteria were evaluations of instant associations with transient structural changes after PA. RESULTS Two randomized controlled trials and 16 observational studies were included. One of 11 studies found that PA was harmfully related to cartilage volume or thickness, but 4 studies found a significant protective association. Four of 10 studies found that PA was harmfully related to cartilage defects, while others showed no significant associations. Two of 3 studies reported a significantly increased cartilage T2 value in individuals with more PA. All 3 studies reported no significant association between PA and bone marrow lesions. Two studies assessed the association between PA and meniscus pathology, in which only occupational PA involving knee bending was associated with a greater risk of progression. CONCLUSION Within the sparse and diverse evidence available, no strong evidence was found for the presence or absence of an association between PA and the presence or progression of features of OA on MRI among subjects without OA. Therefore, more research is required before PA in general and also specific forms of PA can be deemed safe for knee joint structures.
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Affiliation(s)
- Dawei Xu
- Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | | | - Jos Runhaar
- Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
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Voinier D, Neogi T, Arbeeva L, Voinier S, Master H, Thoma LM, Brunette M, Jakiela JT, White DK. Association of physical activity with loss of knee joint space width over two years: a compositional data analysis in the Osteoarthritis Initiative. Osteoarthritis Cartilage 2023; 31:1091-1100. [PMID: 36822497 PMCID: PMC10523474 DOI: 10.1016/j.joca.2022.12.012] [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: 07/01/2022] [Revised: 11/18/2022] [Accepted: 12/15/2022] [Indexed: 02/25/2023]
Abstract
OBJECTIVE There is continued debate as to how engaging in physical activity (PA), including moderate-to-vigorous PA (MVPA), light PA (LPA), and sedentary time (SED), affects one's risk for knee osteoarthritis (OA). Traditional regression methods do not account for the codependence of these categories of PA, whereby when one category increases, the others must decrease. Thus, we used compositional data analysis (CoDA) to examine time spent in each category of PA, or PA composition, and its association with loss of knee joint space width (JSW), a common indicator of knee OA progression. METHODS We performed a secondary analysis of data from a subset of participants in the Osteoarthritis Initiative. These participants had minute-by-minute activity data collected over 7 days at baseline; we then categorized each minute as MVPA, LPA, or SED. Our exposure, PA composition, represented min/day spent in each category. Our outcome, medial JSW loss, was the difference in medial tibiofemoral JSW from baseline to 2 years later. We employed CoDA, using an isometric log-ratio transformation, to examine the association of PA composition with medial JSW loss over 2 years, adjusting for potential confounders. RESULTS We included 969 participants (age: 64.5 years, 56% female, body mass index [BMI]: 28.8 kg/m2). Mean PA composition was: MVPA 9.1 min/day, LPA 278 min/day, SED 690 min/day. Per adjusted regression models, higher MVPA was not associated with greater medial JSW loss (β = -0.0005, P = 0.97), nor was LPA (β = 0.06, P = 0.27) or SED (β = -0.06, P = 0.21). CONCLUSION Using CoDA, PA composition was not associated with medial JSW loss over 2 years.
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Affiliation(s)
- D Voinier
- Department of Physical Therapy, University of Delaware, Newark, DE, USA.
| | - T Neogi
- Department of Medicine, Section of Rheumatology, Boston University School of Medicine, Boston, MA, USA.
| | - L Arbeeva
- University of North Carolina at Chapel Hill, Thurston Arthritis Research Center, Chapel Hill, NC, USA.
| | - S Voinier
- Department of Mechanical Engineering, University of Delaware, Newark, DE, USA.
| | - H Master
- Vanderbilt University Medical Center, Vanderbilt Institute for Clinical and Translational Research, Nashville, TN, USA.
| | - L M Thoma
- University of North Carolina at Chapel Hill, Division of Physical Therapy, Chapel Hill, NC, USA.
| | - M Brunette
- Evidation Health Inc, San Mateo, CA, USA.
| | - J T Jakiela
- Department of Physical Therapy, University of Delaware, Newark, DE, USA.
| | - D K White
- Department of Physical Therapy, University of Delaware, Newark, DE, USA.
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Higa S, Nakata K, Karasawa Y, Ohwaki K. Comparative effectiveness of early initiation of oral nonsteroidal anti-inflammatory drug and oral acetaminophen therapies on the time to knee replacement in patients with knee osteoarthritis in Japan. BMC Musculoskelet Disord 2023; 24:297. [PMID: 37060072 PMCID: PMC10103473 DOI: 10.1186/s12891-023-06415-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 04/10/2023] [Indexed: 04/16/2023] Open
Abstract
BACKGROUND Although disease-modifying properties of nonsteroidal anti-inflammatory drugs (NSAIDs) for osteoarthritis (OA) have been reported, the effects of NSAIDs on OA progression remain controversial. The purpose of this study was to investigate the effect of early initiation of oral NSAID therapy on the progression of knee OA. METHODS In this retrospective cohort study, we extracted data of patients newly diagnosed with knee OA between November 2007 and October 2018 from a Japanese claims database. The primary outcome was the time to knee replacement (KR), and the secondary outcome was the time to composite event including joint lavage and debridement, osteotomy, or arthrodesis in addition to KR. Weighted Cox regression analysis with standardized mortality/morbidity ratio (SMR) weight was performed to compare the outcomes between patients prescribed oral NSAID (NSAID group) and those prescribed oral acetaminophen (APAP) (APAP group) early after a diagnosis of knee OA. Propensity scores were calculated using logistic regression conditioned on potential confounding factors, and SMR weights were calculated using the propensity scores. RESULTS The study population comprised 14,261 patients, who were divided into two groups as follows: 13,994 in the NSAID group and 267 in the APAP group. The mean ages of patients in the NSAID and APAP groups were 56.9 and 56.1 years, respectively. Furthermore, 62.01% and 68.16% patients in the NSAID and APAP groups, respectively, were female. The NSAID group had a reduced risk of KR compared with the APAP group in the analysis using SMR weighting (SMR-weighted hazard ratio, 0.19; 95% confidence interval, 0.05-0.78). While no statistically significant difference was found for the risk of composite event between the two groups (SMR-weighted hazard ratio, 0.56; 95% confidence interval, 0.16-1.91). CONCLUSIONS The risk of KR in the NSAID group was significantly lower than that in the APAP group after accounting for residual confounding using SMR weighting. This finding suggests that oral NSAID therapy early after the initial diagnosis is associated with a reduced risk of KR in patients with symptomatic knee OA.
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Affiliation(s)
- Shingo Higa
- Teikyo University Graduate School of Public Health, Tokyo, Japan.
- Medical Affairs, Viatris Pharmaceuticals Japan Inc., Tokyo, Japan.
| | - Ken Nakata
- Department of Health and Sport Sciences, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yusuke Karasawa
- Medical Affairs, Viatris Pharmaceuticals Japan Inc., Tokyo, Japan
| | - Kazuhiro Ohwaki
- Teikyo University Graduate School of Public Health, Tokyo, Japan
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d’Errico A, Fontana D, Sebastiani G, Ardito C. Risk of symptomatic osteoarthritis associated with exposure to ergonomic factors at work in a nationwide Italian survey. Int Arch Occup Environ Health 2023; 96:143-154. [PMID: 35900451 PMCID: PMC9823078 DOI: 10.1007/s00420-022-01912-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 07/08/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The risk of developing osteoarthritis (OA) has been reported to increase with exposure to various ergonomic factors at work, although this finding is still debated in the literature. Aim of this study was to assess the association between prevalence of symptomatic OA and exposure to workplace ergonomic factors assigned through a job-exposures matrix (JEM). METHODS The study population was composed of 24,604 persons of 40-69 years who participated in the National Health Survey 2013 and were employed at that occasion. Exposure to ergonomic factors was assigned to the study population through a JEM constructed from the Italian O*NET database, consisting of 17 physical factors, which were summed and averaged by job title (796 jobs) to obtain a combined exposure index. The outcome was self-reported OA characterized by moderate or severe limitations in daily activities. The relationship between OA prevalence and the combined exposure index in quartiles was examined using robust Poisson regression models adjusted for socio-demographics and potential confounders. RESULTS In the analysis adjusted for age and gender, the risk of OA was increased by approximately 20-30% in the second and third quartiles, and by 80% in the highest exposure quartile, compared to the least exposed, with a risk attenuation by approximately 15-20% controlling for other significant covariates. CONCLUSION Our results support a causal role of exposure to physical factors at work in the development of OA. As OA is associated with a great burden of disability, any effort should be made to reduce workers' exposure to ergonomic factors.
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Affiliation(s)
| | | | | | - Chiara Ardito
- Department of Economics and Statistics "Cognetti de Martiis", University of Turin, Lungo Dora Siena 100A, 10153, Turin, Italy. .,LABORatorio R. Revelli-Centre for Employment Studies, Turin, Italy. .,NETSPAR-Network for Studies on Pensions, Aging and Retirement, Tilburg, The Netherlands.
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Migliorini F, Pintore A, Torsiello E, Oliva F, Spiezia F, Maffulli N. Intensive Physical Activity Increases the Risk of Knee and Hip Arthroplasty: A Systematic Review. Sports Med Arthrosc Rev 2022; 30:111-116. [PMID: 35533064 DOI: 10.1097/jsa.0000000000000340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The present study investigated the type of sport and activity level of athletes before they underwent knee and/or hip arthroplasty for osteoarthritis (OA), and compared them with a control group of subjects who did not undergo knee and hip arthroplasty. We hypothesed athletes exposed to high physical loads during sports had the highest risk of developing OA requiring arthroplasty. MATERIALS AND METHODS This systematic review was conducted according to the PRISMA guidelines. All the comparative clinical trials to August 2021 investigating the sport activity level between subjects who underwent arthroplasty versus those who did not undergo arthroplasty for OA were considered. RESULTS Data from 5 studies and 3638 patients were collected. The mean age for both groups was 47.61±15.5 years, and the mean body mass index was 24.6±2.1 kg/m2 17.6% were women. The Newcastle-Ottawa scale attested good quality of the methodology of the investigations included in the present study. CONCLUSION Intense physical exercise, implying a high cumulative number of hours of exercise which can lead to excessive joint overload, in both sexes is associated with greater likelihood of early knee and hip OA which may lead to prosthetic surgery. Moderate and recreational exposure to sport has minor degenerative effects, and is not associated with early onset OA requiring arthroplasty.
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Affiliation(s)
- Filippo Migliorini
- Department of Orthopaedics, University Clinic Aachen, RWTH Aachen University Clinic, Aachen, Germany
| | - Andrea Pintore
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi
| | - Ernesto Torsiello
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi
| | - Francesco Oliva
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi
| | - Filippo Spiezia
- Department of Orthopaedics and Trauma Surgery, San Carlo Hospital, Potenza, Italy
| | - Nicola Maffulli
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi
- School of Pharmacy and Bioengineering, Keele University Faculty of Medicine, Stoke on Trent
- Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, London, England
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Gates LS, Perry TA, Golightly YM, Nelson AE, Callahan LF, Felson D, Nevitt M, Jones G, Cooper C, Batt ME, Sanchez-Santos MT, Arden NK. Recreational Physical Activity and Risk of Incident Knee Osteoarthritis: An International Meta-Analysis of Individual Participant-Level Data. Arthritis Rheumatol 2022; 74:612-622. [PMID: 34730279 PMCID: PMC9450021 DOI: 10.1002/art.42001] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 09/13/2021] [Accepted: 10/07/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The effect of physical activity on the risk of developing knee osteoarthritis (OA) is unclear. We undertook this study to examine the relationship between recreational physical activity and incident knee OA outcomes using comparable physical activity and OA definitions. METHODS Data were acquired from 6 global, community-based cohorts of participants with and those without knee OA. Eligible participants had no evidence of knee OA or rheumatoid arthritis at baseline. Participants were followed up for 5-12 years for incident outcomes including the following: 1) radiographic knee OA (Kellgren-Lawrence [K/L] grade ≥2), 2) painful radiographic knee OA (radiographic OA with knee pain), and 3) OA-related knee pain. Self-reported recreational physical activity included sports and walking/cycling activities and was quantified at baseline as metabolic equivalents of task (METs) in days per week. Risk ratios (RRs) were calculated and pooled using individual participant data meta-analysis. Secondary analysis assessed the association between physical activity, defined as time (hours per week) spent in recreational physical activity and incident knee OA outcomes. RESULTS Based on a total of 5,065 participants, pooled RR estimates for the association of MET days per week with painful radiographic OA (RR 1.02 [95% confidence interval (95% CI) 0.93-1.12]), radiographic OA (RR 1.00 [95% CI 0.94-1.07]), and OA-related knee pain (RR 1.00 [95% CI 0.96-1.04]) were not significant. Similarly, the analysis of hours per week spent in physical activity also showed no significant associations with all outcomes. CONCLUSION Our findings suggest that whole-body, physiologic energy expenditure during recreational activities and time spent in physical activity were not associated with incident knee OA outcomes.
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Affiliation(s)
| | | | | | | | | | - David Felson
- Boston University School of Medicine, Boston, Massachusetts
| | | | - Graeme Jones
- University of Tasmania, Hobart, Tasmania, Australia
| | - Cyrus Cooper
- Southampton General Hospital and University of Southampton, Southampton, UK
| | - Mark E Batt
- Nottingham University Hospitals, Nottingham, UK
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Osteoarthrosis. TOPICS IN GERIATRIC REHABILITATION 2021. [DOI: 10.1097/tgr.0000000000000329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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12
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A Retrospective Chart Review of 122 Inpatients with Knee Osteoarthritis Treated with Korean Medicine: An Analysis of the Effects of Treatment. JOURNAL OF ACUPUNCTURE RESEARCH 2021. [DOI: 10.13045/jar.2021.00087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Korean medicine treatment was assessed in patients with knee osteoarthritis (OA) according to subgroups of: sex, age, cause of knee OA, body mass index, hospitalization period, history, OA compartment, phenotype, and comorbidity. Methods: A retrospective review was performed of 122 inpatients who were admitted to the Hospital of Korean Medicine for Korean medicine treatment of knee pain, and were diagnosed with knee OA based on magnetic resonance imaging findings. Analysis of patient subgroups (sex, age, cause of knee OA, body mass index, hospitalization period, history, OA compartment, phenotype, and comorbidity) was carried out and treatments including acupuncture, cupping, pharmacopuncture, herbal medicine, chuna therapy, medicinal steaming therapy, manual therapy, and extracorporeal shock wave therapy were listed. The numeric rating scale (NRS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and 5-level EuroQol- 5 Dimension (EQ-5D-5L) scores were measured before and after treatment to assess the effects of treatment on pain and quality of life. Results: Seventeen males and 105 females were included in this study. Most patients were in their 60s. In the total study population, NRS, WOMAC, and EQ-5D-5L scores were improved statistically significant when comparing before and after treatment. The NRS and WOMAC scores improved statistically significant in the medial, patellofemoral, medial + patellofemoral, medial + lateral + patellofemoral compartment. Conclusion: Korean medicine treatment significantly reduced pain, stiffness, and physical dysfunction, and improved the quality of life of patients with knee OA, suggesting that it may be an effective alternative to the current conservative treatments.
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13
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Zhang L, Lin C, Liu Q, Gao J, Hou Y, Lin J. Incidence and related risk factors of radiographic knee osteoarthritis: a population-based longitudinal study in China. J Orthop Surg Res 2021; 16:474. [PMID: 34332606 PMCID: PMC8325223 DOI: 10.1186/s13018-021-02577-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 06/24/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To explore the incidence and risk factors for radiographic knee osteoarthritis (ROA) in a suburban area of China. METHODS Shunyi Osteoarthritis Study was a population-based, longitudinal study of knee osteoarthritis in Shunyi, a suburban area of Beijing, China. A total of 1295 residents aged over 50 years were recruited with fully informed by randomized cluster sampling and were followed up 3 years later. At the time of baseline and follow-up visits, participants completed a home interview questionnaire and received a clinical examination including height, weight, range of motion (ROM), chair stand test, 50-foot walk test, and weight-bearing posterior-anterior semi-flexed view of radiographs at tibiofemoral joints. The incident ROA for a knee was defined if its KL grade was no more than grade 1 at baseline visit and no less than grade 2 at the follow-up visit. A patient without ROA in both knees at the baseline visit and with ROA in at least one knee at the follow-up visit was viewed as an incident case of ROA in patient level. Generalized linear model and generalized estimating equation were performed to examine the association between socio-demographic factors, physical function as well as baseline knee joint condition, and incident ROA in patient and knee level. RESULTS A total of 1295 residents were recruited at baseline in 2014, and 962 (74.3%) residents were followed in 2017. The annual cumulative incidence of ROA was 3.6% at knee level and 5.7% at patient level. Older age (per year, adjusted odds ratio (OR) = 1.079; 95% confidence interval (CI), 1.042-1.117), overweight (adjusted OR = 2.086; 95% CI, 1.286-3.385), female (adjusted OR = 1.756; 95% CI, 1.074-2.877), less ROM (per degree, adjusted OR = 0.952; 95% CI, 0.923-0.983) and Kellgren and Lawrence (KL) grade 1 at baseline (adjusted OR = 8.527; 95% CI, 5.489-13.246) were risk factors for incident ROA. CONCLUSION The incidence of knee ROA in Chinese suburban area was high. Advanced age, female, overweight, less range of motion, and KL grade 1 at baseline were associated with an increased risk of incident ROA.
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Affiliation(s)
- Liyi Zhang
- Arthritis Clinic and Research Center, Peking University People's Hospital, Peking University, No. 11 Xizhimen South Road, Xicheng District, Beijing, 100044, China.,Arthritis Institute, Peking University, Beijing, China
| | - Chutong Lin
- Arthritis Clinic and Research Center, Peking University People's Hospital, Peking University, No. 11 Xizhimen South Road, Xicheng District, Beijing, 100044, China.,Arthritis Institute, Peking University, Beijing, China.,Department of Thoracic Surgery, Peking University Third Hospital, Peking University, Beijing, China
| | - Qiang Liu
- Arthritis Clinic and Research Center, Peking University People's Hospital, Peking University, No. 11 Xizhimen South Road, Xicheng District, Beijing, 100044, China.,Arthritis Institute, Peking University, Beijing, China
| | - Jiaxiang Gao
- Arthritis Clinic and Research Center, Peking University People's Hospital, Peking University, No. 11 Xizhimen South Road, Xicheng District, Beijing, 100044, China.,Arthritis Institute, Peking University, Beijing, China
| | - Yunfei Hou
- Arthritis Clinic and Research Center, Peking University People's Hospital, Peking University, No. 11 Xizhimen South Road, Xicheng District, Beijing, 100044, China.,Arthritis Institute, Peking University, Beijing, China
| | - Jianhao Lin
- Arthritis Clinic and Research Center, Peking University People's Hospital, Peking University, No. 11 Xizhimen South Road, Xicheng District, Beijing, 100044, China. .,Arthritis Institute, Peking University, Beijing, China.
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14
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Mobasheri A, Trumble TN, Byron CR. Editorial: One Step at a Time: Advances in Osteoarthritis. Front Vet Sci 2021; 8:727477. [PMID: 34336985 PMCID: PMC8322576 DOI: 10.3389/fvets.2021.727477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 06/21/2021] [Indexed: 12/14/2022] Open
Affiliation(s)
- Ali Mobasheri
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
- Department of Regenerative Medicine, State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania
- Departments of Orthopedics, Rheumatology and Clinical Immunology, University Medical Center Utrecht, Utrecht, Netherlands
- Department of Joint Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- World Health Organization Collaborating Center for Public Health Aspects of Musculoskeletal Health and Aging, Université de Liège, Liège, Belgium
| | - Troy N. Trumble
- Veterinary Population Medicine, University of Minnesota Twin Cities, St. Paul, MN, United States
| | - Christopher R. Byron
- Department of Large Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, United States
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15
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Physical activity thresholds for predicting longitudinal gait decline in adults with knee osteoarthritis. Osteoarthritis Cartilage 2021; 29:965-972. [PMID: 33865966 DOI: 10.1016/j.joca.2021.04.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 04/01/2021] [Accepted: 04/06/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the longitudinal relationship between physical performance (via real-life accelerometry) and physical capacity (laboratory measurement of gait speed) in patients with knee osteoarthritis (KOA), and to derive accelerometry measured thresholds associated with gait speed decline in KOA that may provide targets for disease-specific physical activity guidelines. DESIGN Longitudinal data from the Osteoarthritis Initiative (OAI) accelerometer sub-study was extracted from 1,229 participants assessed 2 years apart. Extracted data include functional capacity, demographic and anthropometric characteristics, patient-reported outcome measures, and accelerometry-based physical activity measures. A "poor capacity" group was defined based on the gait speed quintile decline between baseline and the 2-yr follow-up. A Random Forest classifier was trained to classify individuals' capacity status, and the impact of each extracted factor on the prediction outcome was analyzed using a novel machine learning interpretation algorithm. RESULTS The most impactful predicting feature for gait decline is low minutes in the performance of moderate-vigorous activity (count per min 2,500+). Slower sit-to-stand performance, higher age and self-reported knee pain, and lower minutes in performance light activities (count per min 350-2499) also contributed to the model prediction. The overall classification accuracy is 76.3% (75.4% sensitivity, 76.5% specificity). CONCLUSIONS We investigated the impact magnitude and direction of each predicting feature on the longitudinal capacity status among KOA patients. Using novel data interpretation method, we established feature thresholds that may increase the probability of gait decline. These identified thresholds may provide meaningful information for establishing specific physical activity guidelines for KOA.
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16
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Bjerre-Bastos JJ, Nielsen HB, Andersen JR, Karsdal M, Boesen M, Mackey AL, Byrjalsen I, Thudium CS, Bihlet AR. A biomarker perspective on the acute effect of exercise with and without impact on joint tissue turnover: an exploratory randomized cross-over study. Eur J Appl Physiol 2021; 121:2799-2809. [PMID: 34156534 DOI: 10.1007/s00421-021-04751-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 06/18/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE To investigate acute changes in biochemical markers of bone and cartilage turnover in response to moderate intensity exercise with and without joint impact in healthy human subjects. METHODS A randomized, cross-over, exploratory, clinical study was conducted. Twenty healthy subjects with no history of joint trauma completed 30 min interventions of standardized moderate intensity cycling and running as well as a resting intervention 1 week apart. Blood samples were taken immediately before, four times after exercise and again the next day. Urine was sampled, before, after and the next day. On the day of rest, samples were taken at timepoints similar to the days of exercise. Markers of type I (CTX-I), II (C2M, CTX-II) and VI (C6M) collagen degradation, cartilage oligomeric matrix protein (COMP) and procollagen C-2 (PRO-C2) was measured. TRIAL REGISTRATION NUMBER NCT04542655, 02 September 2020, retrospectively registered. RESULTS CTX-I was different from cycling (4.2%, 95%CI: 0.4-8.0%, p = 0.03) and resting (6.8%, 95%CI: 2.9-10.7%, p = 0.001) after running and the mean change in COMP was different from cycling (10.3%, 95%CI: 1.1-19.5%, p = 0.03), but not from resting (8.6%, 95%CI: - 0.7-17.8%, p = 0.07) after running. Overall, changes in other biomarkers were not different between interventions. CONCLUSION In this exploratory study, running, but not cycling, at a moderate intensity and duration induced acute changes in biomarkers of bone and cartilage extra-cellular matrix turnover.
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Affiliation(s)
- Jonathan J Bjerre-Bastos
- Xlab, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark.
- Nordic Bioscience Clinical Development, Herlev, Denmark.
| | - Henning Bay Nielsen
- Sanos Clinic, Herlev, Denmark
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | | | | | - Mikael Boesen
- Department of Radiology, Bispebjerg Hospital, Copenhagen, Denmark
| | - Abigail L Mackey
- Xlab, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
- Institute of Sports Medicine, Bispebjerg Hospital, Copenhagen, Denmark
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17
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Alves-Cardoso F, Assis S. Exploring "wear and tear" of joints and "muscle function" assumptions in skeletons with known occupation at death. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2021; 175:689-700. [PMID: 34013541 DOI: 10.1002/ajpa.24334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 04/13/2021] [Accepted: 05/02/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Changes in the joints are believed to result from "wear and tear," a consequence of activity, as entheseal changes (EC) result from muscle use. However, clinical data showed that activity does not necessarily increase the likelihood of degenerative joint changes (DJC) and that exercise results in healthier joints. We tested whether individuals with continuous repetitive biomechanical efforts (Group 1) were more likely to exhibit EC and if occupations known to exert strenuous but discontinued efforts (Group 2) would more likely cause DJC. MATERIALS AND METHODS Eighty-nine males with known occupations from Portuguese identified collections were used: shoemakers and carpenters (Group 1), workers (Group 2), and civil servants, and shop assistants as a control group. Major upper and lower limb joints and entheses sites were used. DJC and EC were tested between occupations - while controlling for age (overall approach) - and within occupation (occupation-specific approach). RESULTS The overall approach showed that age - as a covariant - had a significant impact on DJC and EC development (p < 0.05), with occupation being non-significant (p > 0.05) despite the variability in the mean-values of lesions. The occupation-specific approach showed a significant variability of DJC and EC correlations, within and between occupations, with no clear trend of DJC and EC development according to occupation. DISCUSSION The results showed that exploring overall patterns might conceal occupation-specific joint and muscle use, emphasizing age as a major contributor of changes; and that the occupation-specific approach highlighted particular aspects associated with occupations, allowing for a more informative assessment of strenuous repetitive or discontinuous activity-related technical gestures and their impact on skeletal biology.
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Affiliation(s)
- Francisca Alves-Cardoso
- Laboratório de Antropologia Biológica e Osteologia Humana (LABOH), Centro em Rede de Investigação em Antropologia (CRIA), Faculdade de Ciências Sociais e Humanas, Universidade NOVA de Lisboa (FCSH/NOVA), Lisbon, Portugal
| | - Sandra Assis
- Laboratório de Antropologia Biológica e Osteologia Humana (LABOH), Centro em Rede de Investigação em Antropologia (CRIA), Faculdade de Ciências Sociais e Humanas, Universidade NOVA de Lisboa (FCSH/NOVA), Lisbon, Portugal.,CIAS-Research Center for Anthropology and Health, University of Coimbra, Coimbra, Portugal
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18
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Wang L, Lu H, Chen H, Jin S, Wang M, Shang S. Development of a model for predicting the 4-year risk of symptomatic knee osteoarthritis in China: a longitudinal cohort study. Arthritis Res Ther 2021; 23:65. [PMID: 33632294 PMCID: PMC7908741 DOI: 10.1186/s13075-021-02447-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 02/11/2021] [Indexed: 12/02/2022] Open
Abstract
Objectives We aimed to develop a model for predicting the 4-year risk of knee osteoarthritis (KOA) based on survey data obtained via a random, nationwide sample of Chinese individuals. Methods Data was analyzed from 8193 middle-aged and older adults included in the China Health and Retirement Longitudinal Study (CHARLS). The incident of symptomatic KOA was defined as participants who were free of symptomatic KOA at baseline (CHARLS2011) and diagnosed with symptomatic KOA at the 4-year follow-up (CHARLS2015). The effects of potential predictors on the incident of KOA were estimated using logistic regression models and the final model was internally validated using the bootstrapping technique. Model performance was assessed based on discrimination—area under the receiver operating characteristic curve (AUC)—and calibration. Results A total of 815 incidents of KOA were identified at the 4-year follow-up, resulting in a cumulative incidence of approximately 9.95%. The final multivariable model included age, sex, waist circumference, residential area, difficulty with activities of daily living (ADLs)/instrumental activities of daily living (IADLs), history of hip fracture, depressive symptoms, number of chronic comorbidities, self-rated health status, and level of moderate physical activity (MPA). The risk model showed good discrimination with AUC = 0.719 (95% confidence interval [CI] 0.700–0.737) and optimism-corrected AUC = 0.712 after bootstrap validation. A satisfactory agreement was observed between the observed and predicted probability of incident symptomatic KOA. And a simple clinical score model was developed for quantifying the risk of KOA. Conclusion Our prediction model may aid the early identification of individuals at the greatest risk of developing KOA within 4 years.
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Affiliation(s)
- Limin Wang
- School of Nursing, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Han Lu
- School of Nursing, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Hongbo Chen
- School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Shida Jin
- School of Nursing, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Mengqi Wang
- School of Nursing, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Shaomei Shang
- School of Nursing, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China.
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19
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Lawrence EA, Hammond CL, Blain EJ. Potential of zebrafish as a model to characterise MicroRNA profiles in mechanically mediated joint degeneration. Histochem Cell Biol 2020; 154:521-531. [PMID: 32935147 PMCID: PMC7609428 DOI: 10.1007/s00418-020-01918-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2020] [Indexed: 12/19/2022]
Abstract
Mechanically mediated joint degeneration and cartilage dyshomeostasis is implicated in highly prevalent diseases such as osteoarthritis. Increasingly, MicroRNAs are being associated with maintaining the normal state of cartilage, making them an exciting and potentially key contributor to joint health and disease onset. Here, we present a summary of current in vitro and in vivo models which can be used to study the role of mechanical load and MicroRNAs in joint degeneration, including: non-invasive murine models of PTOA, surgical models which involve ligament transection, and unloading models based around immobilisation of joints or removal of load from the joint through suspension. We also discuss how zebrafish could be used to advance this field, namely through the availability of transgenic lines relevant to cartilage homeostasis and the ability to accurately map strain through the cartilage, enabling the response of downstream MicroRNA targets to be followed dynamically at a cellular level in areas of high and low strain.
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Affiliation(s)
- Elizabeth A Lawrence
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, BS8 1TD, UK.
| | - Chrissy L Hammond
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, BS8 1TD, UK
| | - Emma J Blain
- Biomechanics and Bioengineering Centre Versus Arthritis, School of Biosciences, Cardiff University, Cardiff, CF10 3AX, UK
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20
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Hu L, Wang Y, Liu X, Ji X, Ma Y, Man S, Hu Z, Cheng J, Huang F. Tai Chi exercise can ameliorate physical and mental health of patients with knee osteoarthritis: systematic review and meta-analysis. Clin Rehabil 2020; 35:64-79. [PMID: 32954819 DOI: 10.1177/0269215520954343] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To systematically review the effects of Tai Chi exercise as a nonpharmacological therapeutic strategy on the physical and mental health in individuals with knee osteoarthritis. DATA SOURCES A systematic literature retrieval has been conducted in PubMed, Web of Science, EMbase, CENTRAL, OVID, CINAHL, Physiotherapy Evidence Database, Chinese Biomedical Database and China National Knowledge Infrastructure up to June 2020 to identify the relevant randomised controlled trials (RCTs). METHODS Two authors assessed independently the risk of bias using the Cochrane Collaboration's tool. Standardised mean difference (SMD) and 95% CI were calculated and data were combined using the fixed or random-effect model. The strength of evidence was rated with Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. RESULTS A total of 16 RCTs involving 986 patients with knee osteoarthritis met the established inclusion criteria. The strength of evidence for the main outcomes was low or moderate. The systematic review illustrated the efficacy of Tai Chi exercise in treating and managing knee osteoarthritis. Patients' outcomes practising Tai Chi exercise were improved significantly, including pain (SMD = ‒0.69, 95%CI: ‒0.95 to ‒0.44, P < 0.001), stiffness (SMD = ‒0.59, 95%CI: ‒0.91 to ‒0.27, P < 0.001), physical function (SMD = ‒0.92, 95%CI: -1.16 to ‒0.69, P < 0.001), dynamic balance (SMD = 0.69, 95%CI: 0.38 to 0.99, P < 0.001), physiological and psychological health (SF-36 PCS: SMD = 0.48, 95%CI: 0.28 to 0.68, P < 0.001; SF-36 MCS: SMD = 0.26, 95%CI: 0.06 to 0.45, P = 0.01). No adverse events associated with Tai Chi exercise were reported. CONCLUSION Tai Chi exercise was beneficial for ameliorating physical and mental health of patients with knee osteoarthritis and should be available as an alternative non-pharmacological therapy in rehabilitation programmes.
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Affiliation(s)
- Lidong Hu
- Department of Rheumatology, Xiang'an Hospital of Xiamen University, Xiamen, Fujian, China
| | - Yiwen Wang
- Department of Rheumatology, Chinese PLA General Hospital, Beijing, China
| | - Xingkang Liu
- Sport Medicine and Physical Therapy College, Beijing Sport University, Beijing, China
| | - Xiaojian Ji
- Department of Rheumatology, Chinese PLA General Hospital, Beijing, China
| | - Yingpei Ma
- Department of Rheumatology, Chinese PLA General Hospital, Beijing, China
| | - Siliang Man
- Department of Rheumatology, Chinese PLA General Hospital, Beijing, China
| | - Zhengyuan Hu
- Department of Rheumatology, Chinese PLA General Hospital, Beijing, China
| | - Jidong Cheng
- Department of Rheumatology, Xiang'an Hospital of Xiamen University, Xiamen, Fujian, China
| | - Feng Huang
- Department of Rheumatology, Chinese PLA General Hospital, Beijing, China.,State Key Laboratory of Kidney Disease, Chinese PLA General Hospital, Beijing, China
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21
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Pisaniello HL, Dixon WG. What does digitalization hold for the creation of real-world evidence? Rheumatology (Oxford) 2020; 59:39-45. [PMID: 31834405 PMCID: PMC6909915 DOI: 10.1093/rheumatology/kez068] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 02/07/2019] [Indexed: 12/25/2022] Open
Abstract
Health-related information is increasingly being collected and stored digitally. These data, either structured or unstructured, are becoming the ubiquitous assets that might enable us to comprehensively map out a patient's health journey from an asymptomatic state of wellness to disease onset and its trajectory. These new data could provide rich real-world evidence for better clinical care and research, if they can be accessed, linked and analyzed-all of which are possible. In this review, these opportunities will be explored through a case vignette of a patient with OA, followed by discussion on how this digitalized real-world evidence could best be utilized, as well as the challenges of data access, quality and maintaining public trust.
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Affiliation(s)
- Huai Leng Pisaniello
- Arthritis Research UK Centre for Epidemiology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Department of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - William Gregory Dixon
- Arthritis Research UK Centre for Epidemiology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Correspondence to: William Gregory Dixon, Arthritis Research UK Centre for Epidemiology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Oxford Road, Manchester M13 9PT, UK. E-mail:
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22
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Jayabalan P, Kocherginsky M, Chang AH, Rouleau GW, Koloms KL, Lee J, Dunlop D, Chang RW, Sharma L. Physical Activity and Worsening of Radiographic Findings in Persons With or at Higher Risk of Knee Osteoarthritis. Arthritis Care Res (Hoboken) 2019; 71:198-206. [PMID: 30238649 DOI: 10.1002/acr.23756] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 09/11/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The benefits of physical activity among persons with or at higher risk for knee osteoarthritis are well established. However, activity levels in this population are low, in part due to concern that activity will damage the knee joint. We hypothesized that sedentary and moderate-vigorous physical activity are each associated with greater risk of radiographic worsening of knee OA. METHODS In Osteoarthritis Initiative participants with or at higher risk for knee OA enrolled in an accelerometer substudy at 48 months (study baseline), physical activity was measured by a uniaxial accelerometer (ActiGraph GT1M). Radiographic progression was defined as any 48 month to 96 month worsening of Kellgren/Lawrence (K/L) grade scores. All analyses were knee-level; we used multivariable logistic regression with generalized estimating equations, adjusting for key covariates. RESULTS Of the 1,206 participants, 631 (52%) were female, the mean ± SD age was 64 ± 9 years, and mean ± SD body mass index (BMI) was 28 ± 5. The mean ± SD average daily sedentary activity was 602 ± 86 minutes, average daily light activity was 284 ± 75 minutes, and average daily moderate-vigorous activity was 20 ± 20 minutes. In 1,978 knees, 267 (14%) had worsening of K/L grade scores. In the multivariable model, age, sex, BMI, and pain, were associated with K/L grade worsening, but neither sedentary activity (adjusted odds ratio [OR] 0.99 [95% confidence interval (95% CI) 0.97-1.01]) nor moderate-vigorous activity (adjusted OR 1.00 [95% CI 0.91-1.09]) were associated with K/L grade worsening. CONCLUSION In persons with or at higher risk for knee OA, age, sex, BMI, and pain, but not objectively measured average daily minutes of sedentary or moderate-vigorous activity, were associated with subsequent worsening of K/L grade. Whether findings differ in persons with more severe knee OA and/or engaged more frequently in moderate-vigorous activity should be examined in future studies.
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Affiliation(s)
- Prakash Jayabalan
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | | | - Alison H Chang
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Gerald W Rouleau
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Kimberly L Koloms
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Jungwha Lee
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Dorothy Dunlop
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Rowland W Chang
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Leena Sharma
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
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23
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Azukizawa M, Ito H, Hamamoto Y, Fujii T, Morita Y, Okahata A, Tomizawa T, Furu M, Nishitani K, Kuriyama S, Nakamura S, Yoshitomi H, Nakatani T, Tsuboyama T, Hamaguchi M, Matsuda S, Yasuda T. The Effects of Well-Rounded Exercise Program on Systemic Biomarkers Related to Cartilage Metabolism. Cartilage 2019; 10:451-458. [PMID: 29644876 PMCID: PMC6755879 DOI: 10.1177/1947603518767998] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Nonsurgical treatment such as exercise is the preferred method for management of knee osteoarthritis (OA). A combination of aerobic, muscle strengthening, and flexibility exercises is recommended for older adults. However, effects of the exercise intervention on cartilage metabolism remain unclear. This study used biomarkers to investigate the effects of well-rounded exercise program on cartilage metabolism in 42 women (mean age: 59 years). Participants started a weekly supervised exercise program and continued for 12 weeks. Before and after the program, we measured physical performance on the Timed Up-and-Go Test, 3-Minute Walk Test, and 30-Second Chair Stand Test. We collected serum and urine samples at the start of the program until 24 weeks and measured the concentrations of 4 biomarkers related to type II collagen metabolism: serum cartilage type II procollagen carboxy propeptide (sPIICP), urine C-terminal telopeptide of collagen type II (uCTX-II), urine cleavage of type II collagen by collagenases (uC2C), and serum cartilage oligomeric matrix protein (sCOMP). Participants were divided into pre-OA and OA groups based on X-ray findings. The pre-OA group showed significant increases and decreases in sPIICP and uCTX-II concentrations with improved physical performance, respectively. sCOMP concentrations significantly increased in both groups. The exercise also improved physical performance with no detrimental effect on type II collagen metabolism in the OA group. Thus, well-rounded exercise may not only improve physical capacity but also have beneficial effects on type II collagen metabolism, especially in people without radiological OA.
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Affiliation(s)
- Masayuki Azukizawa
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiromu Ito
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan,Hiromu Ito, Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
| | - Yosuke Hamamoto
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takayuki Fujii
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yugo Morita
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akinori Okahata
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takuya Tomizawa
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Moritoshi Furu
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kohei Nishitani
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shinichi Kuriyama
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shinichiro Nakamura
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiroyuki Yoshitomi
- Institute for Frontier Life and Medical Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Toshiaki Nakatani
- Department of Sports Medicine, Faculty of Health, Budo, and Sports Studies, Tenri University, Tenri, Japan
| | - Tadao Tsuboyama
- Human Health Sciences, Kyoto University Faculty of Medicine, Kyoto, Japan
| | | | - Shuichi Matsuda
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tadashi Yasuda
- Department of Orthopaedic Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
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Soutakbar H, Lamb SE, Silman AJ. The different influence of high levels of physical activity on the incidence of knee OA in overweight and obese men and women-a gender specific analysis. Osteoarthritis Cartilage 2019; 27:1430-1436. [PMID: 31326552 DOI: 10.1016/j.joca.2019.05.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 05/10/2019] [Accepted: 05/17/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the influence of physical activity on incidence of knee osteoarthritis (OA) in overweight and obese men and women. DESIGN Data were extracted from the Osteoarthritis Initiative cohort on 1,667 participants without symptomatic knee OA at baseline. We used logistic regression and marginal effect models to estimate the effect of body mass index (BMI) and reported physical activity score, together with the interaction between them, on the development of radiographic knee OA, symptomatic knee OA and joint space narrowing (JSN) after 96-months. RESULTS Men in the most active quartile had almost double the likelihood of knee OA, independent of OA definition [e.g., odds ratio (OR) 2.4 (95%CI: 1.2-4.5) for radiographic knee OA]. Interaction analyses showed statistically significant interactions between physical activity and BMI on developing knee OA (i) radiographic OA interaction(P = 0.039), (ii) symptomatic OA interaction(P = 0.022), (iii) JSN interactionP = 0.012). The margin plots in men also demonstrated that the effect of physical activity on different measures of knee OA were modified by high levels of BMI. These effects were not mirrored in women where at all BMI levels, the level of reported physical activity did not influence likelihood of knee OA independent of OA definition. CONCLUSIONS In overweight and obese men, there appears to be a threshold above which increasing levels of physical activity are associated with higher risk of knee OA. This is absent in women.
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Affiliation(s)
- H Soutakbar
- University of Oxford, Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, Oxford, UK.
| | - S E Lamb
- University of Oxford, Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, Oxford, UK.
| | - A J Silman
- University of Oxford, Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, Oxford, UK.
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25
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Zhu Z, Aitken D, Cicuttini F, Jones G, Ding C. Ambulatory activity interacts with common risk factors for osteoarthritis to modify increases in MRI-detected osteophytes. Osteoarthritis Cartilage 2019; 27:650-658. [PMID: 30654117 DOI: 10.1016/j.joca.2018.12.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Revised: 12/10/2018] [Accepted: 12/24/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the longitudinal association between objectively measured ambulatory activity (AA) and knee MRI-detected osteophytes (OPs), and to test whether this relationship was modified by common risk factors for OA including sex, obesity, disease severity and knee injury history. METHODS 408 community-dwelling adults aged 51-81 years were assessed at baseline and 2.7 years. T1-weighted fat-suppressed MRI was used to evaluate knee OPs at both time points. AA was assessed at baseline by pedometers and categorized as: less active (≤7499 steps per day), moderately active (7500-9999 steps per day) and highly active (≥10,000 steps per day). RESULTS Statistically significant interactions were detected between knee OA risk factors and AA on increases in MRI-detected OPs (all P < 0.05). In stratified analyses, being moderately active, compared to being less active, was protective against an increase in MRI-detected OPs (score change of ≥1) in females (relative risk (RR) = 0.42, 95%CI, 0.25-0.70, P < 0.01), those who were obese (RR = 0.50, 95%CI, 0.30-0.83, P < 0.01), those with radiographic OA (ROA) (RR = 0.68, 95%CI, 0.47-0.97, P = 0.02) and those with a history of knee injury (RR = 0.27, 95%CI, 0.08-0.88, P = 0.02) in almost every knee compartment, after adjustment for confounders. No statistically significant associations were found in males, non-obese, non-ROA or non-injury groups. CONCLUSIONS Being moderately active is protective against an increase in MRI-detected OPs in females, those with ROA, those who are obese and those with a history of knee injury. These findings suggest that being moderately active is beneficial for individuals who are at higher risk of knee OA.
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Affiliation(s)
- Z Zhu
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - D Aitken
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - F Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - G Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - C Ding
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Department of Rheumatology and Immunology, Arthritis Research Institute, The First Affiliate Hospital of Anhui Medical University, Hefei, China.
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26
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O'Neill TW, McCabe PS, McBeth J. Update on the epidemiology, risk factors and disease outcomes of osteoarthritis. Best Pract Res Clin Rheumatol 2018; 32:312-326. [PMID: 30527434 DOI: 10.1016/j.berh.2018.10.007] [Citation(s) in RCA: 220] [Impact Index Per Article: 36.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 10/12/2018] [Accepted: 10/12/2018] [Indexed: 12/20/2022]
Abstract
Osteoarthritis (OA) is the most frequent form of arthritis and a leading cause of pain and disability worldwide. OA can affect any synovial joint, although the hip, knee, hand, foot and spine are the most commonly affected sites. Knowledge about the occurrence and risk factors for OA is important to define the clinical and public health burden of the disease to understand mechanisms of disease occurrence and may also help to inform the development of population-wide prevention strategies. In this article, we review the occurrence and risk factors for OA and also consider patient-reported outcome measures that have been used for the assessment of the disease.
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Affiliation(s)
- Terence W O'Neill
- Arthritis Research UK Centre for Epidemiology, The University of Manchester, Manchester, UK & NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Paul S McCabe
- Royal Oldham Hospital, Pennine Acute NHS Trust, Rochdale Rd, Oldham OL1 2JH, UK
| | - John McBeth
- Arthritis Research UK Centre for Epidemiology, The University of Manchester, Manchester, UK & NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
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27
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Qin J, Barbour KE, Nevitt MC, Helmick CG, Hootman JM, Murphy LB, Cauley JA, Dunlop DD. Objectively Measured Physical Activity and Risk of Knee Osteoarthritis. Med Sci Sports Exerc 2018; 50:277-283. [PMID: 28976494 DOI: 10.1249/mss.0000000000001433] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE This study aimed to examine the association between objectively measured physical activity and risk of developing incident knee osteoarthritis (OA) in a community-based cohort of middle-age and older adults. METHODS We used data from the Osteoarthritis Initiative, an ongoing prospective cohort study of adults 45 to 83 yr of age at initial enrollment with elevated risk of symptomatic knee OA. Moderate-vigorous physical activity (MVPA) was measured by a uniaxial accelerometer for seven continuous days in two data collection cycles and was categorized as inactive (<10 min·wk), low activity (10-<150 min·wk), and active (≥150 min·wk). Incident knee OA based on radiographic and symptomatic OA and joint space narrowing were analyzed as outcomes over 4 yr of follow-up. Participants free of the outcome of interest in both knees at study baseline were included (sample sizes ranged from 694 to 1331 for different outcomes). We estimated hazard ratio (HR) with 95% confidence intervals (CI). RESULTS In multivariate analyses, active MVPA participation was not significantly associated with risk of incident radiographic knee OA (HR = 1.52, 95% CI = 0.68-3.40), symptomatic knee OA (HR = 1.17, 95% CI = 0.44-3.09), or joint space narrowing (HR = 0.87, 95% CI = 0.37-2.06) when compared with inactive MVPA participation. Similar results were found for participants with low activity MVPA. CONCLUSION MVPA was not associated with the risk of developing incident knee OA or joint space narrowing over 4 yr of follow-up among Osteoarthritis Initiative participants who are at increased risk of knee OA.
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Affiliation(s)
- Jin Qin
- Arthritis Program, Division of Population Health, Centers for Disease Control and Prevention, Atlanta, GA.,Arthritis Program, Division of Population Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Kamil E Barbour
- Arthritis Program, Division of Population Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Michael C Nevitt
- Arthritis Program, Division of Population Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Charles G Helmick
- Arthritis Program, Division of Population Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Jennifer M Hootman
- Arthritis Program, Division of Population Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Louise B Murphy
- Arthritis Program, Division of Population Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Jane A Cauley
- Arthritis Program, Division of Population Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Dorothy D Dunlop
- Arthritis Program, Division of Population Health, Centers for Disease Control and Prevention, Atlanta, GA
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28
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Peeters G, Edwards KL, Brown WJ, Barker AL, Arden N, Redmond AC, Conaghan PG, Cicuttini F, Mishra GD. Potential Effect Modifiers of the Association Between Physical Activity Patterns and Joint Symptoms in Middle-Aged Women. Arthritis Care Res (Hoboken) 2018; 70:1012-1021. [PMID: 29210208 PMCID: PMC6033095 DOI: 10.1002/acr.23430] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 09/26/2017] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To examine whether body mass index (BMI), menopausal status, and hormone therapy (HT) use modify the association between physical activity (PA) patterns throughout middle age and the incidence and prevalence of joint symptoms in women in later middle age. METHODS Data were from 6,661 participants (born 1946-1951) in the Australian Longitudinal Study on Women's Health. Surveys, with questions on joint pain and stiffness, PA, height and weight, menopausal symptoms, and HT use, were completed every 3 years from 1998 to 2010. PA patterns were defined as none or low, low or meeting guidelines, fluctuating, or meeting guidelines at all times (reference pattern). Logistic regression was used to examine the association between PA patterns and prevalent (in 2010) and cumulative incident (1998-2010) joint symptoms and effect modification by patterns in BMI, menopausal status, and HT. RESULTS The groups representing fluctuating PA (odds ratio [OR] 1.34 [99% confidence interval (99% CI) 1.04-1.72]) and no or low PA (OR 1.60 [99% CI 1.08-2.35]) had higher odds of incident joint symptoms than those described as meeting guidelines at all times. Stratification by BMI showed that this association was statistically significant in the obese group only. No evidence for effect modification by menopausal status or HT use was found. The findings were similar for prevalent joint symptoms. CONCLUSION Maintaining at least low levels of PA throughout middle age was associated with a lower prevalence and incidence of joint symptoms later in life. This apparent protective effect of PA on joint symptoms was stronger in obese women than in under- or normal-weight women, and not related to menopause or HT status.
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Affiliation(s)
- Geeske Peeters
- University of California, San Francisco, Trinity College Dublin, Dublin, Ireland, Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia, University of Queensland School of Public Health, Brisbane, Queensland, Australia, and Arthritis Research UK Centre for Sport Exercise and OsteoarthritisNottinghamUK
| | - Kimberley L. Edwards
- Arthritis Research UK Centre for Sport Exercise and Osteoarthritis and the University of Nottingham School of MedicineNottinghamUK
| | - Wendy J. Brown
- University of Queensland School of Human Movement and Nutrition SciencesBrisbaneQueenslandAustralia
| | - Anna L. Barker
- Monash University School of Public Health and Preventive MedicineMelbourneVictoriaAustralia
| | - Nigel Arden
- Oxford University Arthritis Research UK Centre for Sport, Exercise, and OsteoarthritisOxfordUK
| | - Anthony C. Redmond
- Arthritis Research UK Centre for Sport Exercise and Osteoarthritis, Nottingham, UK, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research CentreLeedsUK
| | - Philip G. Conaghan
- Arthritis Research UK Centre for Sport Exercise and Osteoarthritis, Nottingham, UK, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research CentreLeedsUK
| | - Flavia Cicuttini
- Monash University School of Public Health and Preventive MedicineMelbourneVictoriaAustralia
| | - Gita D. Mishra
- University of Queensland School of Public HealthBrisbaneQueenslandAustralia
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29
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Halilaj E, Hastie TJ, Gold GE, Delp SL. Physical activity is associated with changes in knee cartilage microstructure. Osteoarthritis Cartilage 2018; 26:770-774. [PMID: 29605382 PMCID: PMC6086595 DOI: 10.1016/j.joca.2018.03.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 02/27/2018] [Accepted: 03/22/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The purpose of this study was to determine if there is an association between objectively measured physical activity and longitudinal changes in knee cartilage microstructure. METHODS We used accelerometry and T2-weighted magnetic resonance imaging (MRI) data from the Osteoarthritis Initiative, restricting the analysis to men aged 45-60 years, with a body mass index (BMI) of 25-27 kg/m2 and no radiographic evidence of knee osteoarthritis. After computing 4-year changes in mean T2 relaxation time for six femoral cartilage regions and mean daily times spent in the sedentary, light, moderate, and vigorous activity ranges, we performed canonical correlation analysis (CCA) to find a linear combination of times spent in different activity intensity ranges (Activity Index) that was maximally correlated with a linear combination of regional changes in cartilage microstructure (Cartilage Microstructure Index). We used leave-one-out pre-validation to test the robustness of the model on new data. RESULTS Nineteen subjects satisfied the inclusion criteria. CCA identified an Activity Index and a Cartilage Microstructure Index that were significantly correlated (r = .82, P < .0001 on test data). Higher levels of sedentary time and vigorous activity were associated with greater medial-lateral differences in longitudinal T2 changes, whereas light activity was associated with smaller differences. CONCLUSIONS Physical activity is better associated with an index that contrasts microstructural changes in different cartilage regions than it is with univariate or cumulative changes, likely because this index separates the effect of activity, which is greater in the medial loadbearing region, from that of patient-specific natural aging.
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Affiliation(s)
- Eni Halilaj
- Postdoctoral Fellow, Department of Bioengineering, Stanford University
| | - Trevor J. Hastie
- John A. Overdeck Professor, Department of Statistics, Stanford University
| | - Garry E. Gold
- Professor, Department of Radiology, Stanford University
| | - Scott L. Delp
- James H. Clark Professor, Departments of Bioengineering, Mechanical Engineering, and Orthopaedic Surgery, Stanford University
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30
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Yoo JJ, Kim DH, Kim HA. Risk factors for progression of radiographic knee osteoarthritis in elderly community residents in Korea. BMC Musculoskelet Disord 2018. [PMID: 29530005 PMCID: PMC5848445 DOI: 10.1186/s12891-018-1999-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Knee osteoarthritis (OA) is the most common form of arthritis affecting the elderly. Understanding the risk factors for knee OA has been derived from cross sectional studies. There have been few longitudinal studies of risk factors for knee OA among Asian populations. The purpose of this study was to evaluate the risk factors for knee OA in elderly Korean community residents. METHODS This prospective, population-based study was conducted on residents over 50 years of age in Chuncheon who participated in the Hallym Aging Study. Standardized weight-bearing semi-flexed knee anteroposterior radiographs were obtained in 2007 and in 2010. Of 504 participants at baseline, 322 participants (male: female = 150:172) underwent follow-up knee radiographs. Radiographic knee OA was defined as Kellgren/Lawrence (K-L) grade of ≥ 2. Risk factors assessed at baseline were tested for their association with incidence, progression, and worsening of radiographic knee OA by logistic regression analysis. RESULTS The median age of these participants at follow-up was 71 years (interquartile range 66-75 years). Incident OA was observed in 33 (10.2%) and progression of OA (defined as an increase of Kellgren-Lawrence (K-L) grade at follow-up, from grades 2 or 3 at baseline) in 43 (13.55%) participants. In multivariate logistic regression analysis, only females were significantly associated with the progression of radiographic knee OA (odds ratio [OR] = 4.41, 95% confidence interval [CI] 1.32-14.77). CONCLUSIONS In this 3-year longitudinal study, the yearly incidence and progression of knee OA was higher than those previously reported in Western populations.
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Affiliation(s)
- Jong Jin Yoo
- Department of Internal Medicine, Kangdong Sacred Heart Hospital, Seoul, South Korea
| | - Dong Hyun Kim
- Department of Social and Preventive Medicine, Hallym University College of Medicine, Chuncheon, South Korea
| | - Hyun Ah Kim
- Rheumatology Division, Department of Internal Medicine, Hallym University Sacred Heart Hospital, 896, Pyongchondong, Dongan-gu, Anyang, Kyunggi-do, 431-070, South Korea.
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Barbour KE, Murphy LB, Helmick CG, Hootman JM, Renner JB, Jordan JM. Bone Mineral Density and the Risk of Hip and Knee Osteoarthritis: The Johnston County Osteoarthritis Project. Arthritis Care Res (Hoboken) 2017; 69:1863-1870. [PMID: 28129489 DOI: 10.1002/acr.23211] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 01/24/2017] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To address knowledge gaps regarding the relationship between bone mineral density (BMD) and incident hip or knee osteoarthritis (OA); specifically, lack of information regarding hip OA or symptomatic outcomes. METHODS Using data (n = 1,474) from the Johnston County Osteoarthritis Project's first (1999-2004) and second (2005-2010) followup of participants ages ≥45 years, we examined the association between total hip BMD and both hip and knee OA. Total hip BMD was measured using dual x-ray absorptiometry, and participants were classified into sex-specific quartiles (low, intermediate low, intermediate high, and high). Radiographic OA (ROA) was defined as development of Kellgren/Lawrence grade ≥2. Symptomatic ROA (sROA) was defined as onset of both ROA and symptoms. Weibull regression modeling was used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs). RESULTS Median followup time was 6.5 years (range 4.0-10.2 years). In multivariate models, and compared with participants with low BMD, those with intermediate high and high BMD were less likely to develop hip sROA (HR 0.52 [95% CI 0.31-0.86] and 0.56 [95% CI 0.31-0.86], respectively; P = 0.024 for trend); high BMD was not associated (HR 0.69 [95% CI 0.45-1.06]) with risk of hip ROA. Compared with participants with low BMD, those with intermediate low and intermediate high total hip BMD were more likely to develop knee sROA (HR 2.15 [95% CI 1.40-3.30] and 1.65 [95% CI 1.02-2.67], respectively; P = 0.325 for trend); similar associations were seen with knee ROA. CONCLUSION Our findings suggest that higher BMD may reduce the risk of hip sROA, while intermediate levels may increase the risk of both knee sROA and ROA.
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Affiliation(s)
- Kamil E Barbour
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Louise B Murphy
- Centers for Disease Control and Prevention, Atlanta, Georgia
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Jarraya M, Guermazi A, Felson D, Roemer F, Nevitt M, Torner J, Lewis C, Stefanik J. Is superolateral Hoffa's fat pad hyperintensity a marker of local patellofemoral joint disease? - The MOST study. Osteoarthritis Cartilage 2017; 25:1459-1467. [PMID: 28606557 PMCID: PMC5583732 DOI: 10.1016/j.joca.2017.05.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 05/13/2017] [Accepted: 05/31/2017] [Indexed: 02/02/2023]
Abstract
PURPOSE To determine the relation of superolateral Hoffa's fat pad (SHFP) hyperintensity to cartilage damage and bone marrow lesions (BMLs) in the patellofemoral joint (PFJ) and tibiofemoral joint (TFJ). METHODS We used data from the 60 and 84-month study visits from the Multicenter Osteoarthritis (MOST) study. SHFP hyperintensity and Hoffa-synovitis were graded from 0 to 3. Cartilage damage and BMLs were scored in the PFJ and TFJ. Structural damage was defined as: any cartilage damage, full-thickness cartilage damage and any BML. Worsening structural damage was defined as any increase in cartilage and BML scores. Logistic regression was used to determine the relation of SHFP hyperintensity and Hoffa-synovitis (>0) to structural damage, adjusting for age, sex and body mass index (BMI). RESULTS 1,094 knees were included in the study. Compared to knees without SHFP hyperintensity, those with SHFP hyperintensity had 1.2 (95% Confidence Interval (CI), 1.1-1.4), 1.7 (1.3-2.3) and 1.6 (1.3-1.9) times the prevalence of any cartilage damage, full-thickness cartilage damage, and BMLs in the lateral PFJ respectively, and 1.1 (1.0-1.2), 1.3 (1.0-1.8), and 1.2 (1.0-1.4) times the prevalence of any cartilage damage, full-thickness cartilage damage, and BMLs in the medial PFJ. SHFP hyperintensity was associated with worsening BMLs in the medial PFJ (RR: 1.4 (1.0-1.9)). In general, there was no relation between SHFP hyperintensity and TFJ outcomes. Hoffa-synovitis was associated both cross-sectionally and longitudinally with structural damage, regardless of definition, in all compartments. CONCLUSION SHFP hyperintensity may be a local marker of PFJ structural damage.
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Affiliation(s)
- M. Jarraya
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, United States,Department of Radiology, Mercy Catholic Medical Center, Darby, PA, United States,Address correspondence and reprint requests to: M. Jarraya, Mercy Catholic Medical Center, 1500 Lansdowne Avenue, Darby, 19023, PA, United States. (M. Jarraya)
| | - A. Guermazi
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, United States
| | - D.T. Felson
- Clinical Epidemiology Research and Training Unit, Boston University, Boston, MA, United States
| | - F.W. Roemer
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, United States,Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany
| | - M.C. Nevitt
- Department of Epidemiology and Biostatistics, UCSF, San Francisco, CA, United States
| | - J. Torner
- Department of Epidemiology, University of Iowa, Iowa City, IA, United States
| | - C.E. Lewis
- Department of Medicine, UAB Medicine, Birmingham, AL, United States
| | - J.J. Stefanik
- Clinical Epidemiology Research and Training Unit, Boston University, Boston, MA, United States,Department of Physical Therapy, Movement & Rehabilitation Sciences, Northeastern University, Boston, MA, United States
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33
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Liukkonen MK, Mononen ME, Klets O, Arokoski JP, Saarakkala S, Korhonen RK. Simulation of Subject-Specific Progression of Knee Osteoarthritis and Comparison to Experimental Follow-up Data: Data from the Osteoarthritis Initiative. Sci Rep 2017; 7:9177. [PMID: 28835668 PMCID: PMC5569023 DOI: 10.1038/s41598-017-09013-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 07/21/2017] [Indexed: 01/05/2023] Open
Abstract
Economic costs of osteoarthritis (OA) are considerable. However, there are no clinical tools to predict the progression of OA or guide patients to a correct treatment for preventing OA. We tested the ability of our cartilage degeneration algorithm to predict the subject-specific development of OA and separate groups with different OA levels. The algorithm was able to predict OA progression similarly with the experimental follow-up data and separate subjects with radiographical OA (Kellgren-Lawrence (KL) grade 2 and 3) from healthy subjects (KL0). Maximum degeneration and degenerated volumes within cartilage were significantly higher (p < 0.05) in OA compared to healthy subjects, KL3 group showing the highest degeneration values. Presented algorithm shows a great potential to predict subject-specific progression of knee OA and has a clinical potential by simulating the effect of interventions on the progression of OA, thus helping decision making in an attempt to delay or prevent further OA symptoms.
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Affiliation(s)
- Mimmi K Liukkonen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.
| | - Mika E Mononen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.
| | - Olesya Klets
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
- Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Jari P Arokoski
- Department of Physical and Rehabilitation Medicine, Helsinki University Hospital, Helsinki, Finland
- University of Helsinki, Helsinki, Finland
| | - Simo Saarakkala
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
- Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Rami K Korhonen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
- Diagnostic Imaging Centre, Kuopio University Hospital, Kuopio, Finland
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Curtis GL, Chughtai M, Khlopas A, Newman JM, Khan R, Shaffiy S, Nadhim A, Bhave A, Mont MA. Impact of Physical Activity in Cardiovascular and Musculoskeletal Health: Can Motion Be Medicine? J Clin Med Res 2017; 9:375-381. [PMID: 28392856 PMCID: PMC5380169 DOI: 10.14740/jocmr3001w] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2017] [Indexed: 11/12/2022] Open
Abstract
Physical activity is a well-known therapeutic tool for various types of medical conditions, including vasculopathic diseases such as coronary artery disease, stroke, type 2 diabetes, and obesity. Additionally, increased physical activity has been proposed as a therapy to improve musculoskeletal health; however, there are conflicting reports about physical activity potentially leading to degenerative musculoskeletal disease, especially osteoarthritis (OA). Additionally, although physical activity is known to have its benefits, it is unclear as to what amount of physical activity is the most advantageous. Too much, as well as not enough exercise can have negative consequences. This could impact how physicians advise their patients about exercise intensity. Multiple studies have evaluated the effect of physical activity on various aspects of health. However, there is a paucity of systematic studies which review cardiovascular and musculoskeletal health as outcomes. Therefore, the purpose of this review was to assess how physical activity impacts these aspects of health. Specifically, we evaluated the effect of various levels of physical activity on: 1) cardiovascular and 2) musculoskeletal health. The review revealed that physical activity may decrease cardiovascular disease and improve OA symptoms, and therefore, motion can be considered a “medicine”. However, because heavy activity can potentially lead to increased OA risk, physicians should advise their patients that excessive activity can also potentially impact their health negatively, and should be done in moderation, until further study.
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Affiliation(s)
- Gannon L Curtis
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Morad Chughtai
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Anton Khlopas
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Jared M Newman
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Rafay Khan
- Raritan Bay Medical Center, Perth Amboy, NJ, USA
| | - Shervin Shaffiy
- St. Georges University School of Medicine, True Blue, Grenada, West Indies
| | - Ali Nadhim
- Raritan Bay Medical Center, Perth Amboy, NJ, USA
| | - Anil Bhave
- Sinai Hospital of Baltimore, Baltimore, MD, USA
| | - Michael A Mont
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH, USA
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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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Behzadi C, Welsch GH, Laqmani A, Henes FO, Kaul MG, Schoen G, Adam G, Regier M. The immediate effect of long-distance running on T2 and T2* relaxation times of articular cartilage of the knee in young healthy adults at 3.0 T MR imaging. Br J Radiol 2016; 89:20151075. [PMID: 27336705 DOI: 10.1259/bjr.20151075] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To quantitatively assess the immediate effect of long-distance running on T2 and T2* relaxation times of the articular cartilage of the knee at 3.0 T in young healthy adults. METHODS 30 healthy male adults (18-31 years) who perform sports at an amateur level underwent an initial MRI at 3.0 T with T2 weighted [16 echo times (TEs): 9.7-154.6 ms] and T2* weighted (24 TEs: 4.6-53.6 ms) relaxation measurements. Thereafter, all participants performed a 45-min run. After the run, all individuals were immediately re-examined. Data sets were post-processed using dedicated software (ImageJ; National Institute of Health, Bethesda, MD). 22 regions of interest were manually drawn in segmented areas of the femoral, tibial and patellar cartilage. For statistical evaluation, Pearson product-moment correlation coefficients and confidence intervals were computed. RESULTS Mean initial values were 35.7 ms for T2 and 25.1 ms for T2*. After the run, a significant decrease in the mean T2 and T2* relaxation times was observed for all segments in all participants. A mean decrease of relaxation time was observed for T2 with 4.6 ms (±3.6 ms) and for T2* with 3.6 ms (±5.1 ms) after running. CONCLUSION A significant decrease could be observed in all cartilage segments for both biomarkers. Both quantitative techniques, T2 and T2*, seem to be valuable parameters in the evaluation of immediate changes in the cartilage ultrastructure after running. ADVANCES IN KNOWLEDGE This is the first direct comparison of immediate changes in T2 and T2* relaxation times after running in healthy adults.
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Affiliation(s)
- Cyrus Behzadi
- 1 Department of Diagnostic and Interventional Radiology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Goetz H Welsch
- 2 Department of Sports Medicine, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Azien Laqmani
- 1 Department of Diagnostic and Interventional Radiology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Frank O Henes
- 1 Department of Diagnostic and Interventional Radiology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Michael G Kaul
- 1 Department of Diagnostic and Interventional Radiology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Gerhard Schoen
- 3 Department of Medical Biometry and Epidemiology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Gerhard Adam
- 1 Department of Diagnostic and Interventional Radiology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Marc Regier
- 1 Department of Diagnostic and Interventional Radiology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
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Kretzschmar M, Lin W, Nardo L, Joseph GB, Dunlop DD, Heilmeier U, Nevitt MC, Alizai H, McCulloch CE, Lynch JA, Link TM. Association of Physical Activity Measured by Accelerometer, Knee Joint Abnormalities, and Cartilage T2 Measurements Obtained From 3T Magnetic Resonance Imaging: Data From the Osteoarthritis Initiative. Arthritis Care Res (Hoboken) 2016; 67:1272-1280. [PMID: 25777255 DOI: 10.1002/acr.22586] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2014] [Revised: 02/10/2015] [Accepted: 03/10/2015] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To study the cross-sectional association between physical activity measured with an accelerometer, structural knee abnormalities, and cartilage T2 values assessed with 3T magnetic resonance imaging (MRI). METHODS We included 274 subjects from the Osteoarthritis Initiative cohort without definite radiographic osteoarthritis (Kellgren/Lawrence grades 0 and 1) and with at most mild pain, stiffness, and functional limitation in the study knee (Western Ontario and McMaster Universities Osteoarthritis Index scale 0-1), which had not limited their activity due to knee pain. Physical activity was measured over 7 days with an ActiGraph GT1M accelerometer. Subjects were categorized by quartile of physical activity based on the average daily minutes of moderate to vigorous physical activity (mv-PA). MRI images of the right knee (at 48-month visit) were assessed for structural abnormalities using a modified Whole-Organ Magnetic Resonance Imaging Score (WORMS) and for T2 relaxation times derived from segmented cartilage of 4 femorotibial regions and the patella. WORMS grades and T2 measurements were compared between activity quartiles using a linear regression model. Covariates included age, sex, body mass index, knee injury, family history of knee replacement, knee symptoms, hip and ankle pain, and daily wear time of the accelerometer. RESULTS Higher mv-PA was associated with increased severity (P = 0.0087) and number of lesions of the medial meniscus (P = 0.0089) and with severity of bone marrow edema lesions (P = 0.0053). No association between cartilage lesions and mv-PA was found. T2 values of cartilage (loss, damage, and abnormalities) tended to be greater in the higher quartiles of mv-PA, but the differences were nonsignificant. CONCLUSION In knees without radiographic osteoarthritis in subjects with no or mild knee pain, higher physical activity levels were associated with increases in meniscal and bone marrow edema pattern lesions.
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Affiliation(s)
| | - W Lin
- University of California, San Francisco
| | - L Nardo
- University of California, San Francisco
| | | | - D D Dunlop
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | | | | | - H Alizai
- University of California, San Francisco
| | | | - J A Lynch
- University of California, San Francisco
| | - T M Link
- University of California, San Francisco
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Is physical activity, practiced as recommended for health benefit, a risk factor for osteoarthritis? Ann Phys Rehabil Med 2016; 59:196-206. [DOI: 10.1016/j.rehab.2016.02.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 02/04/2016] [Accepted: 02/28/2016] [Indexed: 01/19/2023]
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Pietrosimone B, Blackburn JT, Golightly YM, Harkey MS, Luc BA, DeFreese JD, Padua DA, Jordan JM, Bennell KL. Certified Athletic Trainers' Knowledge and Perceptions of Posttraumatic Osteoarthritis After Knee Injury. J Athl Train 2016; 52:541-559. [PMID: 27145097 DOI: 10.4085/1062-6050-51.2.13] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
CONTEXT Posttraumatic osteoarthritis (PTOA) is a specific phenotype of osteoarthritis (OA) that commonly develops after acute knee injury, such as anterior cruciate ligament (ACL) or meniscal injury (or both). Athletic trainers (ATs) are well positioned to educate patients and begin PTOA management during rehabilitation of the acute injury, yet it remains unknown if ATs currently prioritize long-term outcomes in patients with knee injury. OBJECTIVE To investigate ATs' knowledge and perceptions of OA and its treatment after ACL injury, ACL reconstruction, or meniscal injury or surgery. DESIGN Cross-sectional study. PATIENTS OR OTHER PARTICIPANTS An online survey was administered to 2000 randomly sampled certified ATs. We assessed participants' perceptions of knee OA, the risk of PTOA after ACL or meniscal injury or surgery, and therapeutic management of knee OA. RESULTS Of the 437 ATs who responded (21.9%), the majority (84.7%) correctly identified the definition of OA, and 60.3% indicated that they were aware of PTOA. A high percentage of ATs selected full meniscectomy (98.9%), meniscal tear (95.4%), ACL injury (90.2%), and partial meniscectomy (90.1%) as injuries that would increase the risk of developing OA. Athletic trainers rated undertaking strategies to prevent OA development in patients after ACL injury or reconstruction (73.8%) or meniscal injury or surgery (74.7%) as extremely or somewhat important. Explaining the risk of OA to patients with an ACL or meniscal injury was considered appropriate by 98.8% and 96.8% of respondents, respectively; yet a lower percentage reported that they actually explained these risks to patients after an ACL (70.8%) or meniscal injury (80.6%). CONCLUSIONS Although 84.7% of ATs correctly identified the definition of OA, a lower percentage (60.3%) indicated awareness of PTOA. These results may reflect the need to guide ATs on how to educate patients regarding the long-term risks of ACL and meniscal injuries and how to implement strategies that may prevent PTOA.
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Yoo TK, Kim DW, Choi SB, Oh E, Park JS. Simple Scoring System and Artificial Neural Network for Knee Osteoarthritis Risk Prediction: A Cross-Sectional Study. PLoS One 2016; 11:e0148724. [PMID: 26859664 PMCID: PMC4747508 DOI: 10.1371/journal.pone.0148724] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 01/22/2016] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Knee osteoarthritis (OA) is the most common joint disease of adults worldwide. Since the treatments for advanced radiographic knee OA are limited, clinicians face a significant challenge of identifying patients who are at high risk of OA in a timely and appropriate way. Therefore, we developed a simple self-assessment scoring system and an improved artificial neural network (ANN) model for knee OA. METHODS The Fifth Korea National Health and Nutrition Examination Surveys (KNHANES V-1) data were used to develop a scoring system and ANN for radiographic knee OA. A logistic regression analysis was used to determine the predictors of the scoring system. The ANN was constructed using 1777 participants and validated internally on 888 participants in the KNHANES V-1. The predictors of the scoring system were selected as the inputs of the ANN. External validation was performed using 4731 participants in the Osteoarthritis Initiative (OAI). Area under the curve (AUC) of the receiver operating characteristic was calculated to compare the prediction models. RESULTS The scoring system and ANN were built using the independent predictors including sex, age, body mass index, educational status, hypertension, moderate physical activity, and knee pain. In the internal validation, both scoring system and ANN predicted radiographic knee OA (AUC 0.73 versus 0.81, p<0.001) and symptomatic knee OA (AUC 0.88 versus 0.94, p<0.001) with good discriminative ability. In the external validation, both scoring system and ANN showed lower discriminative ability in predicting radiographic knee OA (AUC 0.62 versus 0.67, p<0.001) and symptomatic knee OA (AUC 0.70 versus 0.76, p<0.001). CONCLUSIONS The self-assessment scoring system may be useful for identifying the adults at high risk for knee OA. The performance of the scoring system is improved significantly by the ANN. We provided an ANN calculator to simply predict the knee OA risk.
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Affiliation(s)
- Tae Keun Yoo
- Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Deok Won Kim
- Department of Medical Engineering, Yonsei University College of Medicine, Seoul, Republic of Korea
- Graduate Program in Biomedical Engineering, Yonsei University, Seoul, Republic of Korea
- * E-mail:
| | - Soo Beom Choi
- Department of Medical Engineering, Yonsei University College of Medicine, Seoul, Republic of Korea
- Graduate Program in Biomedical Engineering, Yonsei University, Seoul, Republic of Korea
| | - Ein Oh
- Department of Anaesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jee Soo Park
- Department of Medical Engineering, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
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Modifiable lifestyle factors are associated with lower pain levels in adults with knee osteoarthritis. Pain Res Manag 2015; 20:241-8. [PMID: 26125195 PMCID: PMC4596631 DOI: 10.1155/2015/389084] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Pain is the most important osteoarthritis (OA) symptom; however, it is poorly understood and markers of disease severity cannot explain pain variability. With no cure for OA, the authors recognized the need to identify modifiable factors to decrease pain and increase physical function. This study examined factors that characterize OA patients experiencing different levels of pain and investigated the relationships among these factors and OA pain. BACKGROUND: With no cure or effective treatments for osteoarthritis (OA), the need to identify modifiable factors to decrease pain and increase physical function is well recognized. OBJECTIVE: To examine factors that characterize OA patients at different levels of pain, and to investigate the relationships among these factors and pain. METHODS: Details of OA characteristics and lifestyle factors were collected from interviews with healthy adults with knee OA (n=197). The Western Ontario and McMaster Universities Osteoarthritis Index was used to assess pain. Factors were summarized across three pain score categories, and χ2 and Kruskal-Wallis tests were used to examine differences. Multiple linear regression analysis using a stepwise selection procedure was used to examine associations between lifestyle factors and pain. RESULTS: Multiple linear regression analysis indicated that pain was significantly higher with the use of OA medications and higher body mass index category, and significantly lower with the use of supplements and meeting physical activity guidelines (≥150 min/week). Stiffness and physical function scores, bilateral knee OA, body mass index category and OA medication use were significantly higher with increasing pain, whereas self-reported health, servings of fruit, supplement use and meeting physical activity guidelines significantly lower. No significant differences across pain categories were found for sex, age, number of diseases, duration of OA, ever smoked, alcoholic drinks/week, over-the-counter pain medication use, OA supplement use, physical therapy use, servings of vegetables or minutes walked/week. CONCLUSIONS: Healthy weight maintenance, exercise for at least 150 min/week and appropriate use of medications and supplements represent important modifiable factors related to lower knee OA pain.
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Hoxha F, Tafaj A, Roshi E, Burazeri G. Distribution of Risk Factors in Male and Female Primary Health Care Patients with Osteoarthritis in Albania. Med Arch 2015; 69:145-8. [PMID: 26261379 PMCID: PMC4500384 DOI: 10.5455/medarh.2015.69.145-148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 05/18/2015] [Indexed: 11/06/2022] Open
Abstract
Aim: We aimed to describe the distribution of the main risk factors among primary health care users diagnosed with osteoarthritis in Albania, a post-communist country in South Eastern Europe. Methods: Our study involved all individuals who were diagnosed with osteoarthritis over a two-year period (January 2013 – December 2014) in several primary health care centers in Tirana, the Albanian capital. On the whole, during this two-year period, 1179 adult individuals were diagnosed with osteoarthritis (521 men aged 60.1±10.6 years and 658 women aged 58.1±9.6 years). According to the criteria of the American College of Rheumatology, the diagnosis of osteoarthritis was based on the history of the disease, physical examination, laboratory findings and radiological findings. Binary logistic regression was used to assess the sex-differences regarding the major risk factors among individuals diagnosed with osteoarthritis. Results: In multivariable-adjusted logistic regression models, female gender was inversely associated with smoking (OR=0.39, 95%CI=0.27-0.56), alcohol intake (OR=0.08, 95%CI=0.06-0.10), overweight but not obesity (OR=0.65, 95%CI=0.46-0.91 and OR=0.74, 95%CI=0.46-1.18, respectively), weight lifting (OR=0.38, 95%CI=0.22-0.66) and heavy physical exercise (OR=0.69, 95%CI=0.46-1.03). Conversely, female gender was positively related to genetic factors (OR=2.17, 95%CI=1.55-3.04) and preexisting inflammatory diseases (OR=1.53, 95%CI=0.93-2.53). Conclusion: This study offers useful evidence about the distribution of the main risk factors for osteoarthritis in adult individuals diagnosed with osteoarthritis in Albania. This information may support health professionals and decision-makers in Albania for evidence-based health planning and policy formulation in order to control the toll of osteoarthritis in this transitional society.
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Affiliation(s)
| | | | | | - Genc Burazeri
- Department of International Health, School for Public Health and Primary Care (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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Fransen M, McConnell S, Harmer AR, Van der Esch M, Simic M, Bennell KL. Exercise for osteoarthritis of the knee. Cochrane Database Syst Rev 2015; 1:CD004376. [PMID: 25569281 PMCID: PMC10094004 DOI: 10.1002/14651858.cd004376.pub3] [Citation(s) in RCA: 283] [Impact Index Per Article: 31.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Knee osteoarthritis (OA) is a major public health issue because it causes chronic pain, reduces physical function and diminishes quality of life. Ageing of the population and increased global prevalence of obesity are anticipated to dramatically increase the prevalence of knee OA and its associated impairments. No cure for knee OA is known, but exercise therapy is among the dominant non-pharmacological interventions recommended by international guidelines. OBJECTIVES To determine whether land-based therapeutic exercise is beneficial for people with knee OA in terms of reduced joint pain or improved physical function and quality of life. SEARCH METHODS Five electronic databases were searched, up until May 2013. SELECTION CRITERIA All randomised controlled trials (RCTs) randomly assigning individuals and comparing groups treated with some form of land-based therapeutic exercise (as opposed to exercise conducted in the water) with a non-exercise group or a non-treatment control group. DATA COLLECTION AND ANALYSIS Three teams of two review authors independently extracted data, assessed risk of bias for each study and assessed the quality of the body of evidence for each outcome using the GRADE (Grades of Recommendation, Assessment, Development and Evaluation) approach. We conducted analyses on continuous outcomes (pain, physical function and quality of life) immediately after treatment and on dichotomous outcomes (proportion of study withdrawals) at the end of the study; we also conducted analyses on the sustained effects of exercise on pain and function (two to six months, and longer than six months). MAIN RESULTS In total, we extracted data from 54 studies. Overall, 19 (20%) studies reported adequate random sequence generation and allocation concealment and adequately accounted for incomplete outcome data; we considered these studies to have an overall low risk of bias. Studies were largely free from selection bias, but research results may be vulnerable to performance and detection bias, as only four of the RCTs reported blinding of participants to treatment allocation, and, although most RCTs reported blinded outcome assessment, pain, physical function and quality of life were participant self-reported.High-quality evidence from 44 trials (3537 participants) indicates that exercise reduced pain (standardised mean difference (SMD) -0.49, 95% confidence interval (CI) -0.39 to -0.59) immediately after treatment. Pain was estimated at 44 points on a 0 to 100-point scale (0 indicated no pain) in the control group; exercise reduced pain by an equivalent of 12 points (95% CI 10 to 15 points). Moderate-quality evidence from 44 trials (3913 participants) showed that exercise improved physical function (SMD -0.52, 95% CI -0.39 to -0.64) immediately after treatment. Physical function was estimated at 38 points on a 0 to 100-point scale (0 indicated no loss of physical function) in the control group; exercise improved physical function by an equivalent of 10 points (95% CI 8 to 13 points). High-quality evidence from 13 studies (1073 participants) revealed that exercise improved quality of life (SMD 0.28, 95% CI 0.15 to 0.40) immediately after treatment. Quality of life was estimated at 43 points on a 0 to 100-point scale (100 indicated best quality of life) in the control group; exercise improved quality of life by an equivalent of 4 points (95% CI 2 to 5 points).High-quality evidence from 45 studies (4607 participants) showed a comparable likelihood of withdrawal from exercise allocation (event rate 14%) compared with the control group (event rate 15%), and this difference was not significant: odds ratio (OR) 0.93 (95% CI 0.75 to 1.15). Eight studies reported adverse events, all of which were related to increased knee or low back pain attributed to the exercise intervention provided. No study reported a serious adverse event.In addition, 12 included studies provided two to six-month post-treatment sustainability data on 1468 participants for knee pain and on 1279 (10 studies) participants for physical function. These studies indicated sustainability of treatment effect for pain (SMD -0.24, 95% CI -0.35 to -0.14), with an equivalent reduction of 6 (3 to 9) points on 0 to 100-point scale, and of physical function (SMD -0.15 95% CI -0.26 to -0.04), with an equivalent improvement of 3 (1 to 5) points on 0 to 100-point scale.Marked variability was noted across included studies among participants recruited, symptom duration, exercise interventions assessed and important aspects of study methodology. Individually delivered programmes tended to result in greater reductions in pain and improvements in physical function, compared to class-based exercise programmes or home-based programmes; however between-study heterogeneity was marked within the individually provided treatment delivery subgroup. AUTHORS' CONCLUSIONS High-quality evidence indicates that land-based therapeutic exercise provides short-term benefit that is sustained for at least two to six months after cessation of formal treatment in terms of reduced knee pain, and moderate-quality evidence shows improvement in physical function among people with knee OA. The magnitude of the treatment effect would be considered moderate (immediate) to small (two to six months) but comparable with estimates reported for non-steroidal anti-inflammatory drugs. Confidence intervals around demonstrated pooled results for pain reduction and improvement in physical function do not exclude a minimal clinically important treatment effect. Since the participants in most trials were aware of their treatment, this may have contributed to their improvement. Despite the lack of blinding we did not downgrade the quality of evidence for risk of performance or detection bias. This reflects our belief that further research in this area is unlikely to change the findings of our review.
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Affiliation(s)
- Marlene Fransen
- Faculty of Health Sciences, University of Sydney, Room 0212, Cumberland Campus C42, Sydney, New South Wales, Australia, 1825
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Peeters GMEEG, Pisters MF, Mishra GD, Brown WJ. The influence of long-term exposure and timing of physical activity on new joint pain and stiffness in mid-age women. Osteoarthritis Cartilage 2015; 23:34-40. [PMID: 25452157 DOI: 10.1016/j.joca.2014.06.040] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 05/06/2014] [Accepted: 06/12/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To examine the influence of long-term exposure and timing of physical activity (PA) on new joint pain/stiffness in mid-age women. METHODS Data were from 5105 participants (born 1946-51) in the Australian Longitudinal Study on Women's Health (ALSWH) who completed survey items on PA (1998, 2001 and 2004) and joint pain/stiffness (2007 and 2010). PA was categorized in five levels at each survey and summed into a cumulative PA score (CPA, range 0-12). Associations were analysed using logistic regression, with separate models for the cumulative model (using CPA), the sensitive periods model (i.e., PA measured at each survey in one regression model) and the critical periods model (i.e., separate regression models for PA at each survey). RESULTS 951 (18.6%) participants reported new-onset joint pain/stiffness. In the cumulative model, CPA was associated joint pain/stiffness when included as a continuous variable (adjusted odds ratio [OR] = 0.97, 95% confidence interval [CI] = 0.95-0.99), but not when included as a categorical variable. In both the sensitive periods and critical periods models, low to high levels of PA in 2001 and 2004 had stronger inverse associations with joint pain/stiffness than PA levels in 1998. The model fit was better for the sensitive periods than the cumulative or critical periods models. CONCLUSIONS In mid-age women, PA between the ages 47 and 58 was associated with a lower risk of joint pain/stiffness 9 years later. Associations were stronger for PA in the last 6 years than for earlier PA.
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Affiliation(s)
- G M E E Geeske Peeters
- The University of Queensland, School of Human Movement Studies, Brisbane, Australia; The University of Queensland, School of Population Health, Brisbane, Australia.
| | - M F Pisters
- Physical Therapy Research, Program in Clinical Health Sciences, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Rehabilitation, Nursing Science and Sport, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - G D Mishra
- The University of Queensland, School of Population Health, Brisbane, Australia.
| | - W J Brown
- The University of Queensland, School of Human Movement Studies, Brisbane, Australia.
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Fransen M, Simic M, Harmer AR. Determinants of MSK health and disability: lifestyle determinants of symptomatic osteoarthritis. Best Pract Res Clin Rheumatol 2014; 28:435-60. [PMID: 25481425 DOI: 10.1016/j.berh.2014.07.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
It is frequently considered that, for many people, symptomatic osteoarthritis involving the lower limb joints is a largely preventable 'lifestyle disease'. The purpose of this review is to evaluate the most recent scientific evidence examining the effect of various lifestyle factors, such as physical activity, obesity, diet, smoking, alcohol and injury, on the development of symptomatic knee or hip osteoarthritis. The strengths and weaknesses of various studies are discussed, the magnitude of any demonstrated risks presented and current overall conclusions drawn.
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Affiliation(s)
- Marlene Fransen
- Faculty of Health Sciences, Clinical and Rehabilitation Sciences Research Group, University of Sydney, 75 East Street, Lidcombe NSW 2141, Australia.
| | - Milena Simic
- Faculty of Health Sciences, Clinical and Rehabilitation Sciences Research Group, University of Sydney, 75 East Street, Lidcombe NSW 2141, Australia.
| | - Alison R Harmer
- Faculty of Health Sciences, Clinical and Rehabilitation Sciences Research Group, University of Sydney, 75 East Street, Lidcombe NSW 2141, Australia.
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Foong YC, Khan HI, Blizzard L, Ding C, Cicuttini F, Jones G, Aitken D. The clinical significance, natural history and predictors of bone marrow lesion change over eight years. Arthritis Res Ther 2014; 16:R149. [PMID: 25022807 PMCID: PMC4223560 DOI: 10.1186/ar4611] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 07/02/2014] [Indexed: 12/28/2022] Open
Abstract
Introduction There is increasing evidence to suggest that bone marrow lesions (BMLs) play a key role in the pathogenesis of osteoarthritis (OA). However, there is a lack of long term data. The aim of this study was to describe the natural history of knee BMLs, their association with knee pain and examine predictors of BML change over eight years. Methods A total of 198 subjects (109 adult offspring of subjects who had a knee replacement and 89 community-based controls) were studied. Knee pain and BML size were assessed at two and ten year visits. Results At the two year visit, 64% of participants (n = 127) had 229 BMLs (34% patella, 26% femoral and 40% tibial). Over eight years, 24% (55/229) increased in size, 55% (125/229) remained stable and 21% (49/229) decreased in size or resolved completely. Of the participants without BMLs at baseline, 52% (37/71) developed incident BMLs. After adjusting for confounders, eight year change in total BML size was associated with change in knee pain in offspring (β = 2.50, 95% confidence interval (CI) 0.96 to 4.05) but not controls. This association was stronger in males. Incident BMLs were associated with increase in pain (β = 3.60, 95% CI 1.14 to 6.05). Body mass index (BMI) and strenuous activity (but not radiographic osteoarthritis or smoking) were associated with an increase in BML size. Conclusion In this midlife cohort, the proportion of BMLs increasing in size was similar to those decreasing in size with the majority remaining stable. Change in BMLs was predicted by BMI and strenuous activity. An increase in BML size or a new BML resulted in an increase in pain especially in males and those with a family history of OA.
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Koca I, Boyaci A, Tutoglu A, Boyaci N, Ozkur A. The Relationship between Quadriceps Thickness, Radiological Staging, and Clinical Parameters in Knee Osteoarthritis. J Phys Ther Sci 2014; 26:931-6. [PMID: 25013299 PMCID: PMC4085224 DOI: 10.1589/jpts.26.931] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 01/08/2014] [Indexed: 11/30/2022] Open
Abstract
[Purpose] The aim of this study was to investigate the relationship between clinical parameters, radiological staging and evaluated ultrasound results of quadriceps muscle thickness in knee osteoarthritis. [Subjects] The current study comprised 75 patients (51 female, 24 male) with a mean age of 57.9±5.2 years (range 40-65 years) and a diagnosis of osteoarthritis in both knees. [Methods] Knee radiographs were evaluated according to the Kellgren-Lawrence grading system. Clinical evaluation performed with the visual analog scale (VAS), Western Ontario and McMaster Osteoarthritis Index (WOMAC), the 50-meter walking test, and the 10-step stair test. The thickness of the muscle layer of the quadriceps femoris (M. vastus intermedius and M. rectus femoris) was measured with high-resolution real-time ultrasonography. [Results] The results of this study showed a significant negative correlation between quadriceps thickness and age, duration of disease, stage of knee OA, and VAS, WOMAC, 50-m walking test, and 10-step stair test scores. [Conclusion] The evaluation of quadriceps muscle thickness with ultrasound can be considered a practical and economical method in the diagnosis and follow-up of knee osteoarthritis.
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Affiliation(s)
- Irfan Koca
- Department of Physical Medicine and Rehabilitation,
Gaziantep University School of Medicine, Turkey
| | - Ahmet Boyaci
- Department of Physical Medicine and Rehabilitation, Harran
University School of Medicine, Turkey
| | - Ahmet Tutoglu
- Department of Physical Medicine and Rehabilitation, Harran
University School of Medicine, Turkey
| | - Nurefsan Boyaci
- Department of Radiology, Harran University School of
Medicine, Turkey
| | - Ayhan Ozkur
- Department of Radiology, Gaziantep University School of
Medicine, Turkey
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AAOS appropriate use criteria: optimizing the non-arthroplasty management of osteoarthritis of the knee. J Am Acad Orthop Surg 2014; 22:261-7. [PMID: 24668356 DOI: 10.5435/jaaos-22-04-261] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
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Barbour KE, Hootman JM, Helmick CG, Murphy LB, Theis KA, Schwartz TA, Kalsbeek WD, Renner JB, Jordan JM. Meeting physical activity guidelines and the risk of incident knee osteoarthritis: a population-based prospective cohort study. Arthritis Care Res (Hoboken) 2014; 66:139-46. [PMID: 23983187 DOI: 10.1002/acr.22120] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Accepted: 07/15/2013] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Knee osteoarthritis (OA) is a leading cause of disability and joint pain. Although other risk factors of knee OA have been identified, how physical activity affects incident knee OA remains unclear. METHODS Using data from the first (1999-2004) and second (2005-2010) followup periods of the Johnston County Osteoarthritis Project study, we tested the association between meeting physical activity guidelines and incident knee outcomes among 1,522 adults ages ≥45 years. The median followup time was 6.5 years (range 4.0-10.2 years). Physical activity at baseline (moderate-equivalent physical activity minutes/week) was calculated using the Minnesota Leisure Time Physical Activity questionnaire. Incident knee radiographic OA (ROA) was defined as the development of Kellgren/Lawrence grade ≥2 in a knee at followup. Incident knee symptomatic ROA (sROA) was defined as the development of ROA and symptoms in at least 1 knee at followup. Weibull regression modeling was used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for interval-censored data. RESULTS In multivariable models, meeting the 2008 Department of Health and Human Services (HHS) physical activity guidelines (≥150 minutes/week) was not significantly associated with ROA (HR 1.20 [95% CI 0.92-1.56]) or sROA (HR 1.24 [95% CI 0.87-1.76]). Adults in the highest level (≥300 minutes/week) of physical activity had a higher risk of knee ROA and sROA compared with inactive (0 to <10 minutes/week) participants; however, these associations were not statistically significant (HR 1.62 [95% CI 0.97-2.68] and HR 1.42 [95% CI 0.76-2.65], respectively). CONCLUSION Meeting the HHS physical activity guidelines was not associated with incident knee ROA or sROA in a cohort of middle-aged and older adults.
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Affiliation(s)
- K E Barbour
- Centers for Disease Control and Prevention, Atlanta, Georgia
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Williams PT. Effects of running and walking on osteoarthritis and hip replacement risk. Med Sci Sports Exerc 2014; 45:1292-7. [PMID: 23377837 DOI: 10.1249/mss.0b013e3182885f26] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Running and other strenuous sports activities are purported to increase osteoarthritis (OA) risk, more so than walking and less-strenuous activities. Analyses were therefore performed to test whether running, walking, and other exercise affect OA and hip replacement risk and to assess the role of body mass index (BMI) in mediating these relationships. METHODS In this article, we studied the proportional hazards analyses of patients' report of having physician-diagnosed OA and hip replacement versus exercise energy expenditure (METs). RESULTS Of the 74,752 runners, 2004 reported OA and 259 reported hip replacements during the 7.1-yr follow-up; whereas of the 14,625 walkers, 696 reported OA and 114 reported hip replacements during the 5.7-yr follow-up. Compared with running <1.8 MET · h · d(-1), the risks for OA and hip replacement decreased as follows: 1) 18.1% (P = 0.01) and 35.1% (P = 0.03) for the 1.8- and 3.6-MET · h · d(-1) run, respectively; 2) 16.1% (P = 0.03) and 50.4% (P = 0.002) for the 3.6- and 5.4-MET · h · d(-1) run, respectively; and 3) 15.6% (P = 0.02) and 38.5% (P = 0.01) for the ≥ 5.4-MET · h · d(-1) run, suggesting that the risk reduction mostly occurred by 1.8 MET · h · d(-1). Baseline BMI was strongly associated with both OA (5.0% increase per kilogram per square meter, P = 2 × 10(-8)) and hip replacement risks (9.8% increase per kilogram per square meter, P = 4.8 × 10(-5)), and adjustment for BMI substantially diminished the risk reduction from running ≥ 1.8 MET · h · d(-1) for OA (from 16.5%, P = 0.01, to 8.6%, P = 0.21) and hip replacement (from 40.4%, P = 0.005, to 28.5%, P = 0.07). The reductions in OA and hip replacement risk by exceeding 1.8 MET · h · d(-1) did not differ significantly between runners and walkers. Other (nonrunning) exercise increased the risk of OA by 2.4% (P = 0.009) and hip replacement by 5.0% per MET · h · d(-1) (P = 0.02), independent of BMI. CONCLUSIONS Running significantly reduced OA and hip replacement risk due to, in part, running's association with lower BMI, whereas other exercise increased OA and hip replacement risk.
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Affiliation(s)
- Paul T Williams
- Life Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, CA, USA.
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