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Lebleu J, Daniels K, Pauwels A, Dekimpe L, Mapinduzi J, Poilvache H, Bonnechère B. Incorporating Wearable Technology for Enhanced Rehabilitation Monitoring after Hip and Knee Replacement. SENSORS (BASEL, SWITZERLAND) 2024; 24:1163. [PMID: 38400321 PMCID: PMC10892564 DOI: 10.3390/s24041163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 01/20/2024] [Accepted: 02/08/2024] [Indexed: 02/25/2024]
Abstract
Osteoarthritis (OA) poses a growing challenge for the aging population, especially in the hip and knee joints, contributing significantly to disability and societal costs. Exploring the integration of wearable technology, this study addresses the limitations of traditional rehabilitation assessments in capturing real-world experiences and dynamic variations. Specifically, it focuses on continuously monitoring physical activity in hip and knee OA patients using automated unsupervised evaluations within the rehabilitation process. We analyzed data from 1144 patients who used a mobile health application after surgery; the activity data were collected using the Garmin Vivofit 4. Several parameters, such as the total number of steps per day, the peak 6-minute consecutive cadence (P6MC) and peak 1-minute cadence (P1M), were computed and analyzed on a daily basis. The results indicated that cadence-based measurements can effectively, and earlier, differ among patients with hip and knee conditions, as well as in the recovery process. Comparisons based on recovery status and type of surgery reveal distinctive trajectories, emphasizing the effectiveness of P6MC and P1M in detecting variations earlier than total steps per day. Furthermore, cadence-based measurements showed a lower inter-day variability (40%) compared to the total number of steps per day (80%). Automated assessments, including P1M and P6MC, offer nuanced insights into the patients' dynamic activity profiles.
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Affiliation(s)
- Julien Lebleu
- moveUp, 1000 Brussels, Belgium; (J.L.); (A.P.); (L.D.)
| | - Kim Daniels
- Department of PXL—Healthcare, PXL University of Applied Sciences and Arts, 3500 Hasselt, Belgium;
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium;
| | | | - Lucie Dekimpe
- moveUp, 1000 Brussels, Belgium; (J.L.); (A.P.); (L.D.)
| | - Jean Mapinduzi
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium;
- Filière de Kinésithérapie et Réadaptation, Département des Sciences Clinique, Institut National de la Santé Publique, 6807 Bujumbura, Burundi
| | - Hervé Poilvache
- Orthopedic Surgery Department, CHIREC, 1420 Braine-l’Alleud, Belgium
| | - Bruno Bonnechère
- Department of PXL—Healthcare, PXL University of Applied Sciences and Arts, 3500 Hasselt, Belgium;
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium;
- Technology-Supported and Data-Driven Rehabilitation, Data Sciences Institute, Hasselt University, 3590 Diepenbeek, Belgium
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Walker J, Thomas A, Stolycia ML, Wilkins RA, Lunn DE. Acute biomechanical responses to wearing a controlled ankle motion (CAM) Walker boot during walking. Gait Posture 2024; 108:208-214. [PMID: 38118224 DOI: 10.1016/j.gaitpost.2023.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 12/09/2023] [Accepted: 12/14/2023] [Indexed: 12/22/2023]
Abstract
BACKGROUND Controlled ankle motion (CAM) boots are often prescribed during the rehabilitation of lower limb injuries and pathologies to reduce foot and ankle movement and loading whilst allowing the patient to maintain normal daily function. RESEARCH QUESTION The aim of this study was to quantify the compensatory biomechanical mechanisms undergone by the ipsilateral hip and knee joints during walking. In addition, the compensatory mechanisms displayed by the contralateral limb were also considered. METHODS Twelve healthy participants walked on an instrumented treadmill at their preferred walking speed. They underwent kinematic and kinetic analysis during four footwear conditions: normal shoes (NORM), a Malleo Immobil Air Walker on the right leg (OTTO), a Rebound® Air Walker on the right leg with (EVEN) and without (OSS) an Evenup Shoelift™ on the contralateral leg. RESULTS CAM boot wear increased the relative joint contribution to total mechanical work from the ipsilateral hip and knee joints (p < 0.05), which was characterised by increased hip and knee abduction during the swing phase of the gait cycle. EVEN increased the absolute work done and relative contribution of the contralateral limb. CAM boot wear reduced walking speed (p < 0.05), which was partially compensated for during EVEN. SIGNIFICANCE The increased hip abduction in the ipsilateral leg was likely caused by the increase in effective leg length and limb mass, which could lead to secondary site complications following prolonged CAM boot wear. Although prescribing an even-up walker partially mitigates these compensatory mechanisms, adverse effects to contralateral limb kinematics and kinetics (e.g., elevated knee joint work) should be considered.
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Affiliation(s)
- Josh Walker
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom.
| | - Aaron Thomas
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom
| | - Mason L Stolycia
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom
| | - Richard A Wilkins
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom; Podiatry Department, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - David E Lunn
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom; NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
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Li C, Ouyang Z, Huang Y, Lin S, Li S, Xu J, Liu T, Wu J, Guo P, Chen Z, Wu H, Ding Y. NOD2 attenuates osteoarthritis via reprogramming the activation of synovial macrophages. Arthritis Res Ther 2023; 25:249. [PMID: 38124066 PMCID: PMC10731717 DOI: 10.1186/s13075-023-03230-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVE Synovial inflammation, which precedes other pathological changes in osteoarthritis (OA), is primarily initiated by activation and M1 polarization of macrophages. While macrophages play a pivotal role in the inflammatory process of OA, the mechanisms underlying their activation and polarization remain incompletely elucidated. This study aims to investigate the role of NOD2 as a reciprocal modulator of HMGB1/TLR4 signaling in macrophage activation and polarization during OA pathogenesis. DESIGN We examined NOD2 expression in the synovium and determined the impact of NOD2 on macrophage activation and polarization by knockdown and overexpression models in vitro. Paracrine effect of macrophages on fibroblast-like synoviocytes (FLS) and chondrocytes was evaluated under conditions of NOD2 overexpression. Additionally, the in vivo effect of NOD2 was assessed using collagenase VII induced OA model in mice. RESULTS Expression of NOD2 was elevated in osteoarthritic synovium. In vitro experiments demonstrated that NOD2 serves as a negative regulator of HMGB1/TLR4 signaling pathway. Furthermore, NOD2 overexpression hampered the inflammatory paracrine effect of macrophages on FLS and chondrocytes. In vivo experiments revealed that NOD2 overexpression mitigated OA in mice. CONCLUSIONS Supported by convincing evidence on the inhibitory role of NOD2 in modulating the activation and M1 polarization of synovial macrophages, this study provided novel insights into the involvement of innate immunity in OA pathogenesis and highlighted NOD2 as a potential target for the prevention and treatment of OA.
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Affiliation(s)
- Changchuan Li
- Department of Orthopaedic Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Zhuji Ouyang
- Department of Orthopaedic Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Yuhsi Huang
- Department of Orthopaedic Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Sipeng Lin
- Department of Orthopaedic Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Shixun Li
- Department of Orthopaedic Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Jing Xu
- Department of Orthopaedic Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Taihe Liu
- Department of Orthopaedic Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Jionglin Wu
- Department of Orthopaedic Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Peidong Guo
- Department of Orthopaedic Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Zhong Chen
- Department of Orthopaedic Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Haoyu Wu
- Department of Orthopaedic Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Yue Ding
- Department of Orthopaedic Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China.
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Balkanlı B, Arslan A. Magnetic Resonance Imaging for Acute Musculoskeletal Injuries of the Knee Joint in Coal Miners: A Retrospective Study. Indian J Orthop 2023; 57:102-109. [PMID: 36660484 PMCID: PMC9789271 DOI: 10.1007/s43465-022-00753-x] [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: 05/07/2022] [Accepted: 09/15/2022] [Indexed: 11/28/2022]
Abstract
Aim Coal miners are more prone to musculoskeletal injuries to their knees due to specific repetitive movements while working in the seams. We aimed to identify the kinds of and quantify traumatic musculoskeletal injuries to the knee in the coal miners. Methods A retrospective observational analysis of all consecutive emergency admissions of the coal miners with occupational knee injuries between January 2018 and December 2020 was performed. A total of 94 knee trauma events in 79 knees of 76 patients were analyzed in the study. Musculoskeletal injuries of the meniscal and ligamentous/tendinous structures were identified using magnetic resonance imaging of the affected knees. Results The medial meniscal and the anterior cruciate ligament injuries were detected in 72.3% and 51.1% of the events, respectively. Grade 2 and 3 medial meniscal injuries were the most common grades (39.7% and 41.2%, respectively). For the anterior cruciate ligament injuries, grade 2 was the most common (56.3%). In 48.9% of the cases, we detected bony bruise/edema in the tibial plateau (52.2%), and the condyles of the femur (45.7%) were almost equally affected. Intraarticular effusions appeared in 59.6% of the cases. Conclusions Our findings provide detailed identification of the injuries seen in the coal miners. The medial meniscus and the anterior cruciate ligament are the most frequently injured structures.
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Affiliation(s)
- Bahadır Balkanlı
- Department of Orthopedics and Traumatology, Şişli Hamidiye Etfal Training and Research Hospital, Huzur Mah, Cumhuriyet ve Demokrasi Cad. No: 1, Sarıyer, Istanbul Turkey
| | - Aydan Arslan
- Department of Radiology, Ümraniye Training and Research Hospital, Elmalıkent Mahallesi Adem Yavuz Cad. No: 1, Ümraniye, Istanbul Turkey
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Hardenberg M, Speklé EM, Coenen P, Brus IM, Kuijer PPFM. The economic burden of knee and hip osteoarthritis: absenteeism and costs in the Dutch workforce. BMC Musculoskelet Disord 2022; 23:364. [PMID: 35436874 PMCID: PMC9017043 DOI: 10.1186/s12891-022-05306-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 04/01/2022] [Indexed: 11/25/2022] Open
Abstract
Background This study aimed to quantify the absenteeism costs of knee and hip osteoarthritis in the Netherlands for the Dutch workforce and specific groups of workers. Methods We used a longitudinal, dynamic database from a large occupational health service in which occupational physicians register information about personal information and sick leave of workers with the diagnosis of knee- and/or hip osteoarthritis. We included all employees aged 15 to 75 years performing paid work and diagnosed with knee and/or hip osteoarthritis. Costs were calculated annually and per episode for different subgroups from an employer’s perspective using the Human Capital Approach. In the Netherlands, the employer has to pay 70% of the employee's wage out of pocket for the first two years of sick leave and also for the occupational health care. In this way, employers receive information about the costs of workers on sick leave due to knee or hip osteoarthritis. This might stimulate investments in targeted prevention and work-directed care. Results For the period 2015–2017, 1399 workers fulfilled the inclusion criteria. An average sick leave episode of knee osteoarthritis had a duration of 186 calendar days and was associated with €15,550 in costs. For hip osteoarthritis these data were 159 calendar days and €12,482 in costs. These costs are particularly high among male workers and workers with a higher number of weekly working hours. The average annual costs for the Dutch workforce due to sick leave for knee and hip osteoarthritis were €26.9 million and €13.8 million, respectively. Sick leave costs decreased for hip and not for knee osteoarthritis during 2015–2017. Conclusions Annual sick leave costs due to knee and hip osteoarthritis are about €40 million for the Dutch workforce and approximately twice as high for knee compared to hip osteoarthritis. Average costs per sick leave episode are particularly high among male workers and workers with a higher number of weekly working hours. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05306-9.
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Affiliation(s)
- Marrit Hardenberg
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - Erwin M Speklé
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.,Arbo Unie, Occupational Health Service, Utrecht, The Netherlands
| | - Pieter Coenen
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | - Iris M Brus
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - P Paul F M Kuijer
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.,Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
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Spassim MR, Dos Santos RT, Rossato-Grando LG, Cardoso L, da Silva JS, de Souza SO, Wibelinger LM, Bertol CD. Intra-articular ozone slows down the process of degeneration of articular cartilage in the knees of rats with osteoarthritis. Knee 2022; 35:114-123. [PMID: 35306352 DOI: 10.1016/j.knee.2022.03.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 11/29/2021] [Accepted: 03/03/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Osteoarthritis (OA) is a joint disease of multifactorial etiology, affecting mainly the knees. We aimed to evaluate the effects of two different doses of gaseous ozone intra-articularly on the knee cartilage morphology of rats with osteoarthritis (OA). METHODS The articular lesion was induced by sodium monoiodoacetate (MIA). 40 Wistar rats were divided into 4 groups: G1 control (without lesion and without treatment), G2 articular lesion (AL) (only lesion MIA-induced), G3 AL + treatment with 5 μg/mL of ozone intra-articular, and G4 AL + treatment with 10 μg/mL of ozone intra-articular. The experiment was carried out for 60 days. RESULTS Both doses of ozone intra-articular demonstrated less reduction in joint space (G3 and G4) compared to the G2, formation of osteophytes, but without subchondral sclerosis. Ozone decreased the volumetric density of the articular lesion (VV(AL)) of tibial. The treatments recovered VV(AL) of the femur similar to G1. Ozone lower dose (G3) showed lower tibia and femur macroscopic scores. CONCLUSION Intra-articular gaseous ozone can delay the degeneration of articular cartilage and can represents an integrative therapy in the OA treatment of knee after 60 days of treatment. For the first time the role of ozone in articular cartilage degeneration was evaluated helping to understand this therapy.
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Affiliation(s)
- Marcos Roberto Spassim
- Graduate Program in Human Aging, University of Passo Fundo, Passo Fundo, Rio Grande do Sul, Brazil
| | | | - Luciana Grazziotin Rossato-Grando
- Graduate Program in Bioexperimentation, University of Passo Fundo, Passo Fundo, Rio Grande do Sul, Brazil; College of Pharmacy, University of Passo Fundo, Passo Fundo, Rio Grande do Sul, Brazil
| | - Leonardo Cardoso
- College of Physical Education, University of Passo Fundo, Passo Fundo, Rio Grande do Sul, Brazil
| | - Julia Spanhol da Silva
- Graduate Program in Biological Sciences: Toxicological Biochemistry, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | | | - Lia Mara Wibelinger
- Graduate Program in Human Aging, University of Passo Fundo, Passo Fundo, Rio Grande do Sul, Brazil
| | - Charise Dallazem Bertol
- Graduate Program in Human Aging, University of Passo Fundo, Passo Fundo, Rio Grande do Sul, Brazil; College of Pharmacy, University of Passo Fundo, Passo Fundo, Rio Grande do Sul, Brazil.
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Kuijer PPFM, Burdorf A. Prevention at work needed to curb the worldwide strong increase in knee replacement surgery for working-age osteoarthritis patients. Scand J Work Environ Health 2020; 46:457-460. [PMID: 32780145 PMCID: PMC7737795 DOI: 10.5271/sjweh.3915] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- P Paul F M Kuijer
- Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
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