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Memmel C, Sporrer D, Szymski D, Weber J, Hanke A, Denzinger M, Kerschbaum M, Alt V, Krutsch W, Koch M. High Prevalence of Varus Knee Malalignment in Adolescent Football Players-Clinical Lower Leg Axis Measurements of Male Junior Football Players Aged 7 to 18 Years. CHILDREN (BASEL, SWITZERLAND) 2024; 11:953. [PMID: 39201888 PMCID: PMC11352970 DOI: 10.3390/children11080953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Revised: 07/30/2024] [Accepted: 08/06/2024] [Indexed: 09/03/2024]
Abstract
BACKGROUND Football, as the most popular sport worldwide, has long been under suspicion of causing varus knee alignment as early as adolescence. However, no causal relationship has yet been found. The first step to do so would be to determine the prevalence of lower leg malalignment among male junior football players depending on age, performance level and the number of active seasons played. METHODS Leg axis alignment in frontal plane was determined in male junior football players of different age levels between 7 and 18 years by measuring the intercondylar/intermalleolar distance (ICD/IMD) in an upright position. In addition to anthropometric data, multiple sport-specific data such as the start of their football career or training time per week were collected by means of questionnaires (clinical trial registration number: DRKS00020446). RESULTS 207 male junior football players were included in this survey. The mean age was 12.8 years. Within the group of 15 to 18 year olds, the prevalence of varus knee malalignment was highest at just under a third (32.1%). In the subpopulation that played actively for more than ten seasons, 28.9% showed varus leg axis. Regarding performance level, the highest IMD/ICD values and highest prevalence of varus alignment were found among football players who play on a semi-professional level (16.7%), compared to amateur (11.4%) and high-performance levels (2.8%). CONCLUSIONS Further research is necessary to investigate if this high prevalence of varus knee in children of a higher age and higher playing levels is due to the selection bias of football players with varus knee or a real development of varus knee in individuals.
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Affiliation(s)
- Clemens Memmel
- Department of Pediatric Surgery and Orthopedics, Clinic St. Hedwig, Barmherzige Brueder Regensburg, KUNO Pediatric University Medical Center, 93049 Regensburg, Germany
- Department of Trauma Surgery, University Medical Center Regensburg, 93053 Regensburg, Germany
- FIFA Medical Center of Excellence, University Medical Center Regensburg, 93053 Regensburg, Germany
| | - Dominik Sporrer
- Department of Trauma Surgery, University Medical Center Regensburg, 93053 Regensburg, Germany
- FIFA Medical Center of Excellence, University Medical Center Regensburg, 93053 Regensburg, Germany
| | - Dominik Szymski
- Department of Trauma Surgery, University Medical Center Regensburg, 93053 Regensburg, Germany
- FIFA Medical Center of Excellence, University Medical Center Regensburg, 93053 Regensburg, Germany
| | - Johannes Weber
- Department of Trauma Surgery, University Medical Center Regensburg, 93053 Regensburg, Germany
- FIFA Medical Center of Excellence, University Medical Center Regensburg, 93053 Regensburg, Germany
| | - Alexander Hanke
- Department of Pediatric Surgery and Orthopedics, Clinic St. Hedwig, Barmherzige Brueder Regensburg, KUNO Pediatric University Medical Center, 93049 Regensburg, Germany
| | - Markus Denzinger
- Department of Pediatric Surgery and Orthopedics, Clinic St. Hedwig, Barmherzige Brueder Regensburg, KUNO Pediatric University Medical Center, 93049 Regensburg, Germany
| | - Maximilian Kerschbaum
- Department of Trauma Surgery, University Medical Center Regensburg, 93053 Regensburg, Germany
- FIFA Medical Center of Excellence, University Medical Center Regensburg, 93053 Regensburg, Germany
| | - Volker Alt
- Department of Trauma Surgery, University Medical Center Regensburg, 93053 Regensburg, Germany
- FIFA Medical Center of Excellence, University Medical Center Regensburg, 93053 Regensburg, Germany
| | - Werner Krutsch
- Department of Trauma Surgery, University Medical Center Regensburg, 93053 Regensburg, Germany
- FIFA Medical Center of Excellence, University Medical Center Regensburg, 93053 Regensburg, Germany
| | - Matthias Koch
- Department of Trauma Surgery, University Medical Center Regensburg, 93053 Regensburg, Germany
- FIFA Medical Center of Excellence, University Medical Center Regensburg, 93053 Regensburg, Germany
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Merčun A, Drobnič M, Žlak N, Krajnc Z. Knee osteoarthritis in the former elite football players and the ordinary population: a comparative cross-sectional study. SCI MED FOOTBALL 2024; 8:196-200. [PMID: 37352118 DOI: 10.1080/24733938.2023.2228279] [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] [Accepted: 06/14/2023] [Indexed: 06/25/2023]
Abstract
A cross-sectional case-control study compared subjective knee function, quality of life and radiographic knee osteoarthritis (OA) between 45 former elite football players and an age-matched general male population. Participants completed the Knee OA Outcome Score (KOOS), a quality-of-life assessment (EQ-5D-3 L) and standing knee radiographs. Among the players, 24 (53%) sustained at least one moderate or severe knee injury, while 21 (47%) did not recall any injury. Players with previous knee injuries reported significantly lower knee-specific and general quality-of-life scores (KOOS 69; EQ-5D-3 L 0.69 (0.2)) compared to the non-injured players (KOOS 92; EQ-5D-3 L 0.81 (0.2)) or the control population (KOOS 90; EQ-5D-3 L 0.83 (0.2)). The injured knees had higher radiographic OA Kellgren-Lawrence (KL) scale grades 1.7 (1.3) than the knees of the non-injured players 0.8 (1.0) or the control knees 0.8 (1.0)Former elite football players who had previously sustained a moderate or severe knee injury reported inferior knee function and lower quality of life. Injured knees had higher levels of radiographic OA. Non-injured players reported similar knee and general function and their knees had similar grades of OA to those in the control group. The defining moment for long-term knee preservation in football should be injury prevention protocols.
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Affiliation(s)
- Aljaž Merčun
- Department of Orthopedic Surgery, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Chair of Orthopedics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Matej Drobnič
- Department of Orthopedic Surgery, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Chair of Orthopedics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Nik Žlak
- Department of Orthopedic Surgery, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Chair of Orthopedics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Zmago Krajnc
- Department of Orthopedic Surgery, University Medical Centre Maribor, Maribor, Slovenia
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Cao F, Xu Z, Li XX, Fu ZY, Han RY, Zhang JL, Wang P, Hou S, Pan HF. Trends and cross-country inequalities in the global burden of osteoarthritis, 1990-2019: A population-based study. Ageing Res Rev 2024; 99:102382. [PMID: 38917934 DOI: 10.1016/j.arr.2024.102382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Revised: 06/13/2024] [Accepted: 06/14/2024] [Indexed: 06/27/2024]
Abstract
OBJECTIVE To evaluate the trends and cross-country inequalities of global osteoarthritis (OA) burden over the last 30 years, and further predicted its changes to 2035. METHODS The estimates and 95 % uncertainty intervals (UIs) for incidence, prevalence, and disability-adjusted life-years (DALYs) of OA were extracted from Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. We described OA epidemiology at global, regional, and national levels, analyzed 1990-2019 trends in OA burden from overall, local, and multi-dimension scopes, decomposed OA burden according to population size, age structure, and epidemiologic changes, quantified cross-country inequalities in OA burden using standard health equity methods recommended by World Health Organization, and predicted changes of OA burden to 2035. RESULTS GBD 2019 estimated 527,811,871 (95 % UIs: 478,667,549 to 584,793,491) prevalent cases, 41,467,542 (95 % UIs: 36,875,471 to 46,438,409) incident cases and 18,948,965 (95 % UIs: 9,571,298 to 37,659,660) DALYs cases of OA worldwide in 2019, with the highest cases in East Asia and highest age-standardized rate (ASR) in high-income North America. The global burden of OA increased overall from 1990 to 2019 with the fastest growth observed in the first decade of the 21st century. Decomposition analysis revealed that OA knee (62.78 %), women (60.47 %), and middle sociodemographic index (SDI) quintile (32.35 %) were responsible for the most significant DALYs, whose changes were primarily driven by population growth and aging. A significant increase in SDI-related inequalities was detected, and the gap in DALYs between the highest SDI country and the lowest SDI country increased from 179.5 [95 % confidence interval (CI): 149.3-209.8] per 100,000 in 1990 to 341.9 (95 % CI: 309.5-374.4) per 100,000 in 2019. Notably, although the ASR of incidence, prevalence, and DALYs of OA was predicted to decrease annually from 2020 to 2035, the case number of these metrics was predicted to keeping increasing, with predicted values of 52,870,737 [95 % credible interval (Crl): 39,330,063 to 66,411,411], 727,532,373 (95 % Crl: 542,765,783 to 912,298,962), and 25,986,983 (95 % Crl: 19,216,928 to 32,757,038) in 2035, respectively. CONCLUSIONS As a major public health issue, the global burden of OA showed an overall increasing trend from 1990 to 2019, which was primarily driven by population growth and aging. Countries with high SDI shouldered disproportionately high OA burden, and the SDI-related inequalities across countries exacerbated over time. This study highlighted great challenges in the control and management of OA, including both growing case number and distributive inequalities worldwide, which may be instructive for better making public health policy and reasonably allocating medical source.
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Affiliation(s)
- Fan Cao
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Zhiwei Xu
- School of Medicine and Dentistry, Griffith University, Gold Coast, QLD 4214, Australia
| | - Xiao-Xiao Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Zi-Yue Fu
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, Anhui, China
| | - Rong-Ying Han
- The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, Anhui, China
| | - Jun-Lin Zhang
- The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, Anhui, China
| | - Peng Wang
- Teaching Center for Preventive Medicine, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China.
| | - Shengping Hou
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China.
| | - Hai-Feng Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China..
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Neculăeș M, Hernandez-Lucas P, Lucaci P. Implications of Stabilometric Assessment in Determining Functional Deficits in Patients with Severe Knee Osteoarthritis: Observational Study. J Clin Med 2024; 13:3181. [PMID: 38892890 PMCID: PMC11172977 DOI: 10.3390/jcm13113181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 05/20/2024] [Accepted: 05/27/2024] [Indexed: 06/21/2024] Open
Abstract
Background: Osteoarthritis is one of the most frequent joint disorders in the world. The specialists in the field strongly support the role of physical exercise as a key component in the holistic management of arthrosis. The aim of the current study was to identify and assess the functional deficit of these patients and to identify means to alleviate it through pre-surgery physiotherapy programs. Methods: The study was conducted on two samples of patients: a witness sample, encompassing 126 subjects without pathologies at the level of their lower limbs, and a study sample, formed of 116 subjects diagnosed with severe gonarthrosis with total knee arthroplasty indication. The assessment protocol was accomplished with the GPS 400 stabilometric platform. Results: The barycenter differences within the support polygon, recorded for the two samples within sagittal deviation, emphasize that the barycenter shifting mainly towards the healthy lower limb will demand, from the individual, more intense rebalancing postural reactions that will place the center-of-gravity projection in the sagittal plane, closer to the central area of the support polygon. Conclusions: In the case of gonarthrosis and other joint disorders, the use of functional testing to assess body weight distribution and center-of-gravity imbalances represents a promising direction in the research on and management of these disorders, providing essential information for functional diagnosing and thus enabling the elaboration and monitoring of individualized functional rehabilitation plans.
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Affiliation(s)
- Marius Neculăeș
- Faculty of Physical Education and Sport, “Alexandru Ioan Cuza” University of Iași, 3 Toma Cozma Street, 700554 Iasi, Romania; (M.N.); (P.L.)
| | - Pablo Hernandez-Lucas
- Faculty of Physiotherapy, University of Vigo, Campus A Xunqueira, 36005 Pontevedra, Spain
| | - Paul Lucaci
- Faculty of Physical Education and Sport, “Alexandru Ioan Cuza” University of Iași, 3 Toma Cozma Street, 700554 Iasi, Romania; (M.N.); (P.L.)
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Wållgren JO, Ferré-Aniorte A, Senorski EH, Veznaver D, Snaebjornsson T, Samuelsson K, Alentorn-Geli E. Does Playing Football (Soccer) Really Increase the Risk of Knee Osteoarthritis? A Systematic Review and Meta-analysis. J Orthop Sports Phys Ther 2024; 54:328-339. [PMID: 38406871 DOI: 10.2519/jospt.2024.12029] [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] [Indexed: 02/27/2024]
Abstract
OBJECTIVE: To evaluate the relationship between football (soccer) participation and tibiofemoral knee osteoarthritis (OA), considering the influence of competitive level and previous knee injuries. DESIGN: Etiology systematic review with meta-analysis. LITERATURE SEARCH: PubMed, Embase, AMED, and Cochrane were searched for relevant publications. STUDY SELECTION CRITERIA: Studies of football players that included a control group consisting of mainly sedentary nonfootball players, and the relationship of knee OA, were considered. The studies had to report radiographically verified knee OA and specify football activity. DATA SYNTHESIS: Eleven studies, involving 1805 football players and 4022 control individuals were included. Subgroups consisting of data regarding level of play and previous injuries were also synthesized. RESULTS: The overall prevalence of knee OA among football players was increased among professional and recreational players, compared with controls. When knee injuries were excluded, there was no difference in knee OA between football players and controls (OR = 1.25; 95% CI: 0.61, 2.54). Football players with a previous knee injury had a greater risk of knee OA when compared with football players with no history of previous knee injury (OR = 4.16; 95% CI: 1.97, 8.77). CONCLUSION: Football players were at increased risk of knee OA. However, after excluding participants with a history of previous knee injury, there were no differences in knee OA between football players and controls. Previous knee injury was important for developing knee OA. Playing football, in the absence of major knee injuries, did not increase the risk of knee OA. J Orthop Sports Phys Ther 2024;54(5):1-12. Epub 26 February 2024. doi:10.2519/jospt.2024.12029.
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Ishii Y, Okamoto S, Okinaka R, Hashizume T, Xu C, Zhu K, Nakashima Y, Okada K, Takagi K, Adachi N, Takahashi M. Temporary meniscus extrusion is caused by cumulative stress from uphill and downhill tasks in healthy volunteers. Front Sports Act Living 2024; 6:1271987. [PMID: 38650839 PMCID: PMC11033369 DOI: 10.3389/fspor.2024.1271987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 03/18/2024] [Indexed: 04/25/2024] Open
Abstract
Purpose Excessive mechanical stress accumulates and causes knee injury. Meniscal extrusion is a key factor in detecting the reaction to cumulative mechanical stress. The accumulation of stress strongly depends on environmental conditions such as flat ground or uphill/downhill, and accumulates in knee compartments; only a few studies have reported the effects of different environments on lateral and medial meniscus extrusion. This study aimed to investigate the effects of cumulative uphill/downhill stress on the meniscal extrusion in each compartment. Methods A total of 30 healthy volunteers with 30 affected knees were involved in this cohort study (mean age, 22.0 ± 1.1 years; men, n = 14). The participants were divided into flat-walking, uphill/downhill-walking, and uphill/downhill-jogging groups and their numbers of steps taken were recorded during the effort. Moreover, medial and lateral meniscal extrusions during walking were evaluated using ultrasound three times, before and after efforts (T1) and (T2), and one day after efforts (T3), respectively. Results In the flat-walking group, no significant differences were observed between the follow-up periods. Conversely, in the uphill/downhill-walking and jogging groups, the medial meniscus extrusion at T2 was significantly higher than that at T1. Conversely, the medial meniscus extrusion at T3 was significantly lower than that at T2. By contrast, the lateral meniscus did not show any difference between the follow-up periods in any group. Conclusion Temporary extrusion of the meniscus occurred after uphill/downhill tasks in healthy volunteers, and its reaction was observed only in the medial meniscus.
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Affiliation(s)
- Yosuke Ishii
- Department of Biomechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Saeko Okamoto
- Department of Biomechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Riko Okinaka
- Department of Biomechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Takato Hashizume
- Department of Biomechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Chen Xu
- Department of Biomechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kexin Zhu
- Department of Biomechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yuko Nakashima
- Department of Orthopedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kaoru Okada
- Ultrasound Business Operations, Healthcare Business Headquarters, Konica Minolta, Inc., Tokyo, Japan
| | - Kazuya Takagi
- Ultrasound Business Operations, Healthcare Business Headquarters, Konica Minolta, Inc., Tokyo, Japan
| | - Nobuo Adachi
- Department of Orthopedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Makoto Takahashi
- Department of Biomechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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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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Wilczyński M, Bieniek M, Krakowski P, Karpiński R. Cemented vs. Cementless Fixation in Primary Knee Replacement: A Narrative Review. MATERIALS (BASEL, SWITZERLAND) 2024; 17:1136. [PMID: 38473607 DOI: 10.3390/ma17051136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 02/13/2024] [Accepted: 02/26/2024] [Indexed: 03/14/2024]
Abstract
Knee osteoarthritis (OA) is one of the leading causes of disability around the globe. Osteoarthritis is mainly considered a disease affecting the elderly. However, more and more studies show that sports overuse, obesity, or congenital disorders can initiate a pathologic cascade that leads to OA changes in the younger population. Nevertheless, OA mostly affects the elderly, and with increasing life expectancy, the disease will develop in more and more individuals. To date, the golden standard in the treatment of the end-stage of the disease is total joint replacement (TJR), which restores painless knee motion and function. One of the weakest elements in TJR is its bonding with the bone, which can be achieved by bonding material, such as poly methyl-methacrylate (PMMA), or by cementless fixation supported by bone ingrowth onto the endoprosthesis surface. Each technique has its advantages; however, the most important factor is the revision rate and survivor time. In the past, numerous articles were published regarding TJR revision rate, but no consensus has been established yet. In this review, we focused on a comparison of cemented and cementless total knee replacement surgeries. We introduced PICO rules, including population, intervention, comparison and outcomes of TJR in a PubMed search. We identified 783 articles published between 2010 and 2023, out of which we included 14 in our review. Our review reveals that there is no universally prescribed approach to fixate knee prostheses. The determination of the most suitable method necessitates an individualized decision-making process involving the active participation and informed consent of each patient.
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Affiliation(s)
- Mikołaj Wilczyński
- Orthopaedic and Sports Traumatology Department, Carolina Medical Center, Pory 78, 02-757 Warsaw, Poland
| | - Michał Bieniek
- Orthopaedic and Sports Traumatology Department, Carolina Medical Center, Pory 78, 02-757 Warsaw, Poland
| | - Przemysław Krakowski
- Orthopaedic and Sports Traumatology Department, Carolina Medical Center, Pory 78, 02-757 Warsaw, Poland
- Department of Trauma Surgery and Emergency Medicine, Medical University of Lublin, Staszica 11, 20-081 Lublin, Poland
| | - Robert Karpiński
- Department of Machine Design and Mechatronics, Faculty of Mechanical Engineering, Lublin University of Technology, Nadbystrzycka 36, 20-618 Lublin, Poland
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de Geofroy B, Chateau L, Barbier O, Demoures T, Coste S, Mathieu L, de L'Escalopier N, Choufani C. Return to Sport and Duty in French Military Personnel after Medial Opening Wedge High Tibial Osteotomy. Mil Med 2024:usae005. [PMID: 38294141 DOI: 10.1093/milmed/usae005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/10/2023] [Accepted: 01/03/2024] [Indexed: 02/01/2024] Open
Abstract
INTRODUCTION Medial opening wedge high tibial osteotomy (MOWHTO) is a surgical option for medial femorotibial osteoarthritis, which preserves articular cartilage by correcting the extra-articular deformities of the lower limbs that cause osteoarthritis. This is an increasingly popular treatment in a population with high functional demand, such as the French military population. The aim of this study was to evaluate the rate of return to work and military activities at 6 months postsurgery and at last follow-up in this military population following MOWHTO.The hypothesis of this study was that MOWHTO enabled a majority of service members to return to the same level of activity within 6 months of surgery. MATERIALS AND METHODS This was a retrospective, multicenter study including all French military personnel operated on for MOWHTO alone for osteoarthritis of medial compartment between 2008 and 2018 in different Military Teaching Hospitals. We excluded civilian patients. For each patient, a questionnaire was used to collect epidemiological, professional, sports, and functional data. The primary endpoint was the rate of return to work at 6 months postsurgery. We also studied the recovery of sports activities and functional results at a 6.6-year follow-up by standardized questionnaires (Tegner activity scale, Lysholm, IKDC subjective (International Knee Documentation Commitee)). RESULTS Twenty-four MOWHTOs were performed during this period in a cohort of 22 French military personnel. Return to work at 6 months was possible in 20/24 cases (83.3%). Of the four patients who did not return to work at 6 months, two changed their activities, while the other two returned to their jobs after 6 months. The rate of resumption of sporting activities at an equal or higher level was 50% (11/22). There was no difference between pre- and postoperative Tegner Activity Scale scores at the longest follow-up (P = .08). The mean postoperative Lysholm scores were 73.5 (standard deviation 17.8) and IKDC 59 (standard deviation 8.7). No intraoperative complications were found, and one case of postoperative infection was found. CONCLUSIONS A total of 83% of the operated soldiers were able to return to their professional activities in less than 6 months. We observed a functional improvement at the last follow-up. Comparing these results with data from civilian populations, the rate of occupational recovery is comparable. However, the return to sport is much better in the series of nonmilitary patients with approximately 90% return to work and sport in the year following surgery. MOWHTO improves the functional results of the knee, enabling a return to work and sport in most cases in young, active populations such as the French military.
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Affiliation(s)
- Bernard de Geofroy
- Department of Orthopaedic and Trauma Surgery, Laveran Military Hospital, Marseille 13013, France
- Department of Orthopaedic Surgery and Traumatology Sainte Anne Military Hospital, Toulon Mediterranean Orthopaedic and Trauma, TMOST, Toulon 83000, France
| | - Lucas Chateau
- Department of Orthopaedic surgery and traumatology, Begin Military Hospital, Saint-Mandé 94160, France
| | - Olivier Barbier
- Department of Orthopaedic Surgery and Traumatology Sainte Anne Military Hospital, Toulon Mediterranean Orthopaedic and Trauma, TMOST, Toulon 83000, France
- Department of Orthopaedic Surgery and Traumatology, Edouard Herriot Hospital, Lyon 69003, France
| | - Thomas Demoures
- Department of Orthopaedic surgery and traumatology, Begin Military Hospital, Saint-Mandé 94160, France
| | - Sébastien Coste
- Department of Orthopaedic surgery and traumatology, Begin Military Hospital, Saint-Mandé 94160, France
| | - Laurent Mathieu
- Department of Orthopaedic Surgery and Traumatology, Edouard Herriot Hospital, Lyon 69003, France
| | - Nicolas de L'Escalopier
- Department of Orthopaedic Surgery and Traumatology, Percy Military Hospital, Clamart 92140, France
| | - Camille Choufani
- Department of Orthopaedic Surgery and Traumatology Sainte Anne Military Hospital, Toulon Mediterranean Orthopaedic and Trauma, TMOST, Toulon 83000, France
- Department of Orthopaedic Surgery and Traumatology, Edouard Herriot Hospital, Lyon 69003, France
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Hori M, Terada M, Suga T, Isaka T. The effect of attending rehabilitation after traumatic knee joint injury on femoral articular cartilage morphology in collegiate rugby players with a history of intracapsular knee joint injury during two-year consecutive rugby seasons. Front Sports Act Living 2024; 5:1309938. [PMID: 38274032 PMCID: PMC10808301 DOI: 10.3389/fspor.2023.1309938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 12/14/2023] [Indexed: 01/27/2024] Open
Abstract
Introduction This present study aimed to compare ultrasonographic measures of femoral articular cartilage during two-year seasons between collegiate rugby players who have attended supervised rehabilitation following intracapsular knee joint injury and those without a history of knee injury. Methods Using a prospective observational study design, 12 male collegiate rugby players with a previous history of intracapsular knee joint injury who have received and completed supervised rehabilitation following their injury and 44 players without knee joint injury participated in this study. Ultrasonographic images were used to verify changes in femoral articular cartilage thickness and cross-sectional area (CSA) with or without a previous history of knee joint injury over two consecutive rugby seasons. Results Significant time main effects were observed for the lateral condylar thickness (p < 0.001), the intercondylar thickness (p = 0.001), the medial condylar thickness (p < 0.001), and CSA (p < 0.001). No significant interactions nor group main effects were identified for all femoral articular cartilage (p < 0.05). Conclusions Collegiate rugby players demonstrated a decrease in femoral articular cartilage thickness and CSA over two-year consecutive rugby seasons. These findings indicate that engaging in collegiate rugby induces alterations in femoral articular cartilage structure. Furthermore, there were no differences in all femoral cartilage outcome measures between rugby players with and without a previous history of traumatic knee joint injury. Therefore, attending supervised rehabilitation at the time of their knee joint injury appeared to reduce the impact of a previous history of intracapsular knee joint injury on the change in femoral articular cartilage thickness and CSA among active rugby players.
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Affiliation(s)
- Miyuki Hori
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Masafumi Terada
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Tadashi Suga
- Research Organization of Science and Technology, Ritsumeikan University, Kusatsu, Japan
| | - Tadao Isaka
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
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11
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Romero-Morales C, López-López D, Almazán-Polo J, Mogedano-Cruz S, Sosa-Reina MD, García-Pérez-de-Sevilla G, Martín-Pérez S, González-de-la-Flor Á. Prevalence, diagnosis and management of musculoskeletal disorders in elite athletes: A mini-review. Dis Mon 2024; 70:101629. [PMID: 37716840 DOI: 10.1016/j.disamonth.2023.101629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/18/2023]
Abstract
Musculoskeletal injuries in elite sports are ones of the most impact issue because their remarkable impact on performance caused by drastic absence of training and competition and a progressive deterioration in physical health, emotional and social athletes' dimensions. Also, the prevalence of epidemiologic research found an incidence of musculoskeletal disorders vary within sports and in elite athletes which is even higher as a consequence of higher demand physical performance. This way, the loss of physical performance due to an sport injury impacts not only the individual economic sphere of the professional but also that ofsports entities, reaching, according to some studies, a loss estimated in the range of 74.7 million pounds. Thus, the purpose of this article is to review and to provide an overview of the most common musculoskeletal injuries in elite sports precipitating factors, clinical presentation, evidence-based diagnostic evaluation, and treatment recommendations with a view to preventing medical conditions or musculoskeletal injuries that may alter performance and general health in the elite athletes.
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Affiliation(s)
- Carlos Romero-Morales
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain
| | - Daniel López-López
- Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Industrial Campus of Ferrol , Universidade da Coruña, 15403 Ferrol, Spain.
| | - Jaime Almazán-Polo
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain
| | - Sara Mogedano-Cruz
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain
| | - María Dolores Sosa-Reina
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain
| | | | - Sebastián Martín-Pérez
- Faculty of Health Sciences, Universidad Europea de Canarias, La Orotava, Santa Cruz de Tenerife 38300, Spain
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12
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Steinmetz JD, Culbreth GT, Haile LM, Rafferty Q, Lo J, Fukutaki KG, Cruz JA, Smith AE, Vollset SE, Brooks PM, Cross M, Woolf AD, Hagins H, Abbasi-Kangevari M, Abedi A, Ackerman IN, Amu H, Antony B, Arabloo J, Aravkin AY, Argaw AM, Artamonov AA, Ashraf T, Barrow A, Bearne LM, Bensenor IM, Berhie AY, Bhardwaj N, Bhardwaj P, Bhojaraja VS, Bijani A, Briant PS, Briggs AM, Butt NS, Charan J, Chattu VK, Cicuttini FM, Coberly K, Dadras O, Dai X, Dandona L, Dandona R, de Luca K, Denova-Gutiérrez E, Dharmaratne SD, Dhimal M, Dianatinasab M, Dreinhoefer KE, Elhadi M, Farooque U, Farpour HR, Filip I, Fischer F, Freitas M, Ganesan B, Gemeda BNB, Getachew T, Ghamari SH, Ghashghaee A, Gill TK, Golechha M, Golinelli D, Gupta B, Gupta VB, Gupta VK, Haddadi R, Hafezi-Nejad N, Halwani R, Hamidi S, Hanif A, Harlianto NI, Haro JM, Hartvigsen J, Hay SI, Hebert JJ, Heidari G, Hosseini MS, Hosseinzadeh M, Hsiao AK, Ilic IM, Ilic MD, Jacob L, Jayawardena R, Jha RP, Jonas JB, Joseph N, Kandel H, Karaye IM, Khan MJ, Kim YJ, Kolahi AA, Korzh O, Koteeswaran R, Krishnamoorthy V, Kumar GA, Kumar N, Lee SW, Lim SS, Lobo SW, Lucchetti G, Malekpour MR, Malik AA, Mandarano-Filho LGG, Martini S, Mentis AFA, Mesregah MK, Mestrovic T, Mirrakhimov EM, Misganaw A, Mohammadpourhodki R, Mokdad AH, Momtazmanesh S, Morrison SD, Murray CJL, Nassereldine H, Netsere HB, Neupane Kandel S, Owolabi MO, Panda-Jonas S, Pandey A, Pawar S, Pedersini P, Pereira J, Radfar A, Rashidi MM, Rawaf DL, Rawaf S, Rawassizadeh R, Rayegani SM, Ribeiro D, Roever L, Saddik B, Sahebkar A, Salehi S, Sanchez Riera L, Sanmarchi F, Santric-Milicevic MM, Shahabi S, Shaikh MA, Shaker E, Shannawaz M, Sharma R, Sharma S, Shetty JK, Shiri R, Shobeiri P, Silva DAS, Singh A, Singh JA, Singh S, Skou ST, Slater H, Soltani-Zangbar MS, Starodubova AV, Tehrani-Banihashemi A, Valadan Tahbaz S, Valdez PR, Vo B, Vu LG, Wang YP, Yahyazadeh Jabbari SH, Yonemoto N, Yunusa I, March LM, Ong KL, Vos T, Kopec JA. Global, regional, and national burden of osteoarthritis, 1990-2020 and projections to 2050: a systematic analysis for the Global Burden of Disease Study 2021. THE LANCET. RHEUMATOLOGY 2023; 5:e508-e522. [PMID: 37675071 PMCID: PMC10477960 DOI: 10.1016/s2665-9913(23)00163-7] [Citation(s) in RCA: 124] [Impact Index Per Article: 124.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
Background Osteoarthritis is the most common form of arthritis in adults, characterised by chronic pain and loss of mobility. Osteoarthritis most frequently occurs after age 40 years and prevalence increases steeply with age. WHO has designated 2021-30 the decade of healthy ageing, which highlights the need to address diseases such as osteoarthritis, which strongly affect functional ability and quality of life. Osteoarthritis can coexist with, and negatively effect, other chronic conditions. Here we estimate the burden of hand, hip, knee, and other sites of osteoarthritis across geographies, age, sex, and time, with forecasts of prevalence to 2050. Methods In this systematic analysis for the Global Burden of Disease Study, osteoarthritis prevalence in 204 countries and territories from 1990 to 2020 was estimated using data from population-based surveys from 26 countries for knee osteoarthritis, 23 countries for hip osteoarthritis, 42 countries for hand osteoarthritis, and US insurance claims for all of the osteoarthritis sites, including the other types of osteoarthritis category. The reference case definition was symptomatic, radiographically confirmed osteoarthritis. Studies using alternative definitions from the reference case definition (for example self-reported osteoarthritis) were adjusted to reference using regression models. Osteoarthritis severity distribution was obtained from a pooled meta-analysis of sources using the Western Ontario and McMaster Universities Arthritis Index. Final prevalence estimates were multiplied by disability weights to calculate years lived with disability (YLDs). Prevalence was forecast to 2050 using a mixed-effects model. Findings Globally, 595 million (95% uncertainty interval 535-656) people had osteoarthritis in 2020, equal to 7·6% (95% UI 6·8-8·4) of the global population, and an increase of 132·2% (130·3-134·1) in total cases since 1990. Compared with 2020, cases of osteoarthritis are projected to increase 74·9% (59·4-89·9) for knee, 48·6% (35·9-67·1) for hand, 78·6% (57·7-105·3) for hip, and 95·1% (68·1-135·0) for other types of osteoarthritis by 2050. The global age-standardised rate of YLDs for total osteoarthritis was 255·0 YLDs (119·7-557·2) per 100 000 in 2020, a 9·5% (8·6-10·1) increase from 1990 (233·0 YLDs per 100 000, 109·3-510·8). For adults aged 70 years and older, osteoarthritis was the seventh ranked cause of YLDs. Age-standardised prevalence in 2020 was more than 5·5% in all world regions, ranging from 5677·4 (5029·8-6318·1) per 100 000 in southeast Asia to 8632·7 (7852·0-9469·1) per 100 000 in high-income Asia Pacific. Knee was the most common site for osteoarthritis. High BMI contributed to 20·4% (95% UI -1·7 to 36·6) of osteoarthritis. Potentially modifiable risk factors for osteoarthritis such as recreational injury prevention and occupational hazards have not yet been explored in GBD modelling. Interpretation Age-standardised YLDs attributable to osteoarthritis are continuing to rise and will lead to substantial increases in case numbers because of population growth and ageing, and because there is no effective cure for osteoarthritis. The demand on health systems for care of patients with osteoarthritis, including joint replacements, which are highly effective for late stage osteoarthritis in hips and knees, will rise in all regions, but might be out of reach and lead to further health inequity for individuals and countries unable to afford them. Much more can and should be done to prevent people getting to that late stage. Funding Bill & Melinda Gates Foundation, Institute of Bone and Joint Research, and Global Alliance for Musculoskeletal Health.
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Le Stum M, Gicquel T, Dardenne G, Le Goff-Pronost M, Stindel E, Clavé A. Total knee arthroplasty in France: Male-driven rise in procedures in 2009-2019 and projections for 2050. Orthop Traumatol Surg Res 2023; 109:103463. [PMID: 36374765 DOI: 10.1016/j.otsr.2022.103463] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 06/03/2022] [Accepted: 06/09/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND The number of Total Knee Arthroplasty (TKA) procedures has been rising steadily for several decades in Europe and the USA. The increase varies in pace across countries, with a gradual climb in northern and central Europe, a slowing in the USA, and an exponential surge in the UK. In France, a 32.2% rise in the number of TKA and unicompartmental knee arthroplasty procedures was documented between 2012 and 2018. However, no study has focussed specifically on changes in both TKA procedures and the features of TKA patients. The objective of this study was to use the French national healthcare database to evaluate (1) increases in TKA procedures according to sex and age, (2) whether TKA is being performed at increasingly younger ages, (3) whether the comorbidity profile at TKA is changing, and (4) whether the TKA incidence rate will stabilise in the future, with a projection for 2050. HYPOTHESIS In France, the number of TKA procedures is rising in both males and females but the pace of the increases differs between sexes. MATERIAL AND METHOD This study used data collected in France in 2009-2019, separately for different age groups and for males and females, in the French national healthcare database (Système national des données de santé, SNDS) that collects information on all surgical procedures performed nationwide. Based on information about the TKA procedures, we determined (1) the TKA incidence rates with their time trends and (2) indirectly, the comorbidity profiles of the patients at TKA. Linear, Poisson, and logistic models were built to predict incidence rates in 2030, 2040, and 2050. RESULTS Between 2009 and 2019, the TKA incidence rate showed a steeper increase in males than in females (from 71.2 to 122.9 [+73%] vs. 124.2 to 181.0 [+46%], respectively). Although this increase was replicated in all age groups, it was sharper in patients younger than 65 years, in both males and females (from 20.9 to 37.9 [+82%] and 33.6 to 51.3 [+53%], respectively). During the study period, the number and proportion of patients increased in the group with mild comorbidities (from 40 093 to 67 430 TKAs, i.e., from 53.1% to 65.7% of all TKAs) but not in the other comorbidity groups. All projection models were validated. Nonetheless, the most likely scenario, provided by the logistic model, is a 33% rise by 2050 in both males and females (i.e., to 151 575 TKA procedures) with a plateau starting around 2030. CONCLUSION Although the increase in TKA procedures is more marked in males than in females, the trends are similar in both sexes, with a sharper rise in the group younger than 65 years and a shift toward patients with milder comorbidities. In the longer term, incidence rate trends follow logistic dynamics, with a plateau starting around 2030. To meet the increasing demand, a corresponding development in relevant healthcare resources must be planned. LEVEL OF EVIDENCE IV, descriptive epidemiological study.
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Affiliation(s)
- Mathieu Le Stum
- Institut national de la santé et de la recherche médicale (Inserm), laboratoire de traitement de l'information médicale (LATIM), UMR1101, 22, avenue Camille-Desmoulins, 29200 Brest, France.
| | - Thomas Gicquel
- Clinique mutualiste de la porte de l'Orient, 3, rue Robert-de-la-Croix, 56324 Lorient, France
| | - Guillaume Dardenne
- Centre hospitalo-universitaire de Brest, CHRU de Brest, LATIM, UMR 1101, 2, avenue Foch, 29200 Brest, France
| | - Myriam Le Goff-Pronost
- Institut Mines-Telecom, IMT Atlantique, LATIM - Inserm UMR 1101, M@rsouin, 655, avenue du Technopôle, 29280 Plouzane, France
| | - Eric Stindel
- Centre hospitalo-universitaire de Brest, CHRU de Brest, LATIM, UMR 1101, 2, avenue Foch, 29200 Brest, France; Université de Bretagne Occidentale, UBO, LATIM, UMR 1101, 22, avenue Camille-Desmoulins, 29200 Brest, France
| | - Arnaud Clavé
- Université de Bretagne Occidentale, UBO, LATIM, UMR 1101, 22, avenue Camille-Desmoulins, 29200 Brest, France; Service d'orthopédie, clinique Saint-George, 2, avenue de Rimiez, 06100 Nice, France
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14
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Huebner M, Lavallee ME. Arthralgia in female Masters weightlifters. BMC Musculoskelet Disord 2023; 24:670. [PMID: 37620827 PMCID: PMC10464145 DOI: 10.1186/s12891-023-06814-y] [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: 05/21/2023] [Accepted: 08/19/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Arthralgia or joint pain is a heterogeneous condition including organic and nonorganic joint pain. It is common in older populations, particularly in females. There is evidence that menopausal changes are associated with increased prevalence of arthralgia. While physical activities have been recommended to mitigate osteoarthritis (OA) and arthralgia, sport participation also carries risk factors due to excessive loading of some joints and possible injuries. The aim was to evaluate the association of training patterns, prior injuries, and severity of menopausal symptoms with arthralgia in female Masters weightlifters. METHODS Competitive female Masters weightlifters (n=868, 30-78 years) from 30 countries completed an online survey including joint pain for different anatomical sites, weightlifting training and performance, sport history, and menopausal symptoms. Logistic regression models were used to estimate the association of training patterns, prior sport participation, and menopausal symptom severity with arthralgia separately for shoulders, spine, hips, knees, ankles, elbows, and hands. RESULTS Arthralgia was most reported in knees (38.8%), shoulders (29.8%), hands/wrists (28.8%), and hips (24.9%). The prevalence of arthralgia was 51.5% in pre-menopausal women, 62.4% in women post natural menopause and 73.3% in women post medical or surgical menopause. Lifting heavier weights was associated with arthralgia in hips (OR=1.05, p=0.03), knees (OR=1.06, p=0.01), and hands/wrists (OR=1.05, p=0.04), but prior strength training was protective for arthralgia in the shoulders (OR=0.66, p=0.02). Prior injuries and psychological menopausal symptom severity were associated with an increased risk for arthralgia (p<0.01). CONCLUSIONS Arthralgia was common in competitive female weightlifters. Training frequency was not associated with arthralgia, but lifting heavier weights relative to age and body mass was. Prior injuries and menopausal symptoms were associated with arthralgia, but prior strength training was protective of arthralgia in the shoulders. Athletes, coaches and sports medicine professionals should be aware that prevalence of polyarthralgia increases in post-menopausal athletes.
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Affiliation(s)
- Marianne Huebner
- Department of Statistics and Probability, Michigan State University, East Lansing, MI, USA.
- Department of Kinesiology, Michigan State University, East Lansing, MI, USA.
| | - Mark E Lavallee
- Department of Orthopedics, UPMC Central Pennsylvania, Harrisburg, PA, USA
- USA Weightlifting Sports Medicine Society, Colorado Springs, CO, USA
- Executive Medical Committee, International Weightlifting Federation, Lausanne, Switzerland
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15
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Ponkilainen VT, Uimonen M, Sihvonen R, Partio N, Paloneva J, Mattila VM. Evaluation of the changes in incidence and patient age of knee arthroscopy along with changes in time between knee arthroscopy and arthroplasty between 1998 and 2018: a nationwide register study. Knee Surg Relat Res 2023; 35:19. [PMID: 37434234 DOI: 10.1186/s43019-023-00194-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 06/29/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND Recent evidence has led to guidelines to refrain from recommending knee arthroscopy for patients with an osteoarthritis diagnosis. The aim of this study was to evaluate the latest changes in the incidence of arthroscopic surgery for degenerative knee disease, changes in the ages of those patients and the delay between knee arthroscopy and arthroplasty, in Finland between 1998 and 2018. METHOD The data for were collected from the Finnish National Hospital Discharge Register (NHDR). All knee arthroplasties and arthroscopies performed due to osteoarthritis, degenerative meniscal tears, and traumatic meniscal tears were included. Incidence rates (per 100,000 person-years) as well as the median age of patients were calculated. RESULTS The incidence of arthroscopy decreased 74% (413 to 106 per 100,000 person-years) and knee arthroplasty increased 179% (94 to 262 per 100,000 person-years) between 1998 and 2018. The incidence of all arthroscopies increased until 2006. Subsequently, the incidence of arthroscopy due to OA decreased by 91% and arthroscopic partial meniscectomy (APM) for degenerative meniscal tears decreased by 77% until 2018. The decrease of traumatic meniscal tears begun later, leading to decrease of 57% between 2011 and 2018. Conversely, the incidence of patients undergoing APM of traumatic meniscal tear increased 375%. The median age of patients who underwent knee arthroscopy decreased from 51 to 46 and from 71 to 69 in knee arthroplasty patients. CONCLUSIONS Increasing evidence that recommends refraining from knee arthroscopy in OA and degenerative meniscal tears has led to a dramatic decrease in the incidence of arthroscopies. Simultaneously, the median age of the patients who undergo these operations has continued to decrease.
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Affiliation(s)
- Ville T Ponkilainen
- Department of Surgery, Hospital Nova, Central Finland Healthcare District, Hoitajantie 3, 40620, Jyväskylä, Finland.
| | - Mikko Uimonen
- Department of Surgery, Hospital Nova, Central Finland Healthcare District, Hoitajantie 3, 40620, Jyväskylä, Finland
| | | | - Nikke Partio
- Department of Orthopaedics and Traumatology, Tampere University Hospital, Teiskontie 35, PL2000, 33521, Tampere, Finland
| | - Juha Paloneva
- Department of Surgery, Hospital Nova, Central Finland Healthcare District, Hoitajantie 3, 40620, Jyväskylä, Finland
- Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Ville M Mattila
- Department of Orthopaedics and Traumatology, Tampere University Hospital, Teiskontie 35, PL2000, 33521, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- COXA Hospital for Joint Replacement, Biokatu 6, 33520, Tampere, Finland
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Szilagyi IA, Waarsing JH, van Meurs JBJ, Bierma-Zeinstra SMA, Schiphof D. A systematic review of the sex differences in risk factors for knee osteoarthritis. Rheumatology (Oxford) 2023; 62:2037-2047. [PMID: 36495186 PMCID: PMC10234207 DOI: 10.1093/rheumatology/keac688] [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: 05/11/2022] [Accepted: 12/01/2022] [Indexed: 07/30/2023] Open
Abstract
OBJECTIVES Previous systematic reviews focused on the evidence of common risk factors for knee OA (KOA); however, the effect and strength of association between risk factors and KOA might be different between the two sexes. The aim of the present systematic review was to determine the current evidence on sex differences in the association between risk factors and KOA and their prevalence. METHODS We searched the following electronic bibliographic databases: MEDLINE (PubMed), EMBASE and Web of Science. A methodological quality assessment was conducted independently by two researchers according to an adapted version of the standardized set of criteria known as the Newcastle-Ottawa Quality Assessment Scale (NOS). The NOS, a star system, was converted to three categories of quality. RESULTS In total, 27 studies reported sex-specific risk estimates on several risk factors for KOA. Out of the 22 longitudinal cohort studies (except one nested case-control), 12 were of good quality and 10 were of fair quality. The five cross-sectional studies consisted of one of good, three of fair and one of poor quality. There was an indication of sex differences in risk factors leading to higher risk of KOA: high BMI, alcohol consumption, atherosclerosis and high vitamin E levels in women, and high physical activity, soft drink consumption and abdominal obesity in men. Knee injury, high blood pressure and low step rate seem to affect both women and men. CONCLUSION More good quality studies are needed to assess sex differences in risk factors for KOA, especially for symptomatic/clinical OA.
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Affiliation(s)
- Ingrid A Szilagyi
- Correspondence to: Ingrid A. Szilagyi, Department of General Practice, Erasmus MC, University Medical Center Rotterdam, PO Box 2400, Rotterdam 3000 CA, The Netherlands. E-mail:
| | - Jan H Waarsing
- Department of General Practice, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Joyce B J van Meurs
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Sita M A Bierma-Zeinstra
- Department of General Practice, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Dieuwke Schiphof
- Department of General Practice, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Norman MB, Norman ER, Langer GH, Allen MR, Meller L, Vitale KC. Return to Sport Using Corticosteroid Injections for Knee Pain in Triathletes. Cureus 2023; 15:e39985. [PMID: 37416041 PMCID: PMC10321459 DOI: 10.7759/cureus.39985] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2023] [Indexed: 07/08/2023] Open
Abstract
Introduction Despite the prevalence of corticosteroid injections in athletes, little is known about their efficacy in triathletes. We aim to assess attitudes, use, subjective effectiveness, and time to return to sport with corticosteroid injections compared to alternative methods in triathletes with knee pain. Methods This is an observational study during the COVID-19 pandemic. Triathletes answered a 13-question survey posted to three triathlon-specific websites. Results Sixty-one triathletes responded, 97% of whom experienced knee pain at some point in their triathlete career; 63% with knee pain received a corticosteroid injection as treatment (average age 51 years old). The most popular attitude (44.3%) regarding corticosteroid injections was "tried them, with good improvement". Most found the cortisone injection helpful for two to three months (28.6%), or more than one year (28.6%); of individuals who found the injections useful for more than one year, four-eight (50%) had received multiple injections during that same period. After injection, 80.6% returned to sport within one month. The average age of people using alternative treatment methods was 39 years old; most returned to sport within one month (73.7%). Compared to alternative methods, there was an ~80% higher odds of returning to sport within one month using corticosteroid injections; however, this relationship was not significant (OR=1.786, p=0.480, 95% CI:0.448-7.09). Conclusion This is the first study to examine corticosteroid use in triathletes. Corticosteroid use is more common in older triathletes and results in subjective pain improvement. A strong association does not exist for a quicker return to sport using corticosteroid injections compared to alternative methods. Triathletes should be counseled on the timing of injections, duration of side effects, and be aware of potential risks.
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Affiliation(s)
| | - Emily R Norman
- Physical Medicine and Rehabilitation, Dartmouth Geisel School of Medicine, Hanover, USA
| | | | - Matthew R Allen
- Orthopedic Surgery, University of California San Diego School of Medicine, La Jolla, USA
| | - Leo Meller
- Orthopedic Surgery, University of California San Diego School of Medicine, La Jolla, USA
| | - Kenneth C Vitale
- Orthopedic Surgery, University of California San Diego School of Medicine, La Jolla, USA
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Pelletier JP, Paiement P, Dorais M, Raynauld JP, Martel-Pelletier J. Risk factors for the long-term incidence and progression of knee osteoarthritis in older adults: role of nonsurgical injury. Ther Adv Chronic Dis 2023; 14:20406223231169715. [PMID: 37197137 PMCID: PMC10184209 DOI: 10.1177/20406223231169715] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 03/28/2023] [Indexed: 05/19/2023] Open
Abstract
Background For one of the most chronic medical conditions, osteoarthritis, uncertainties remain on the impact of injury chronology, the role of repeat injury on the incidence/progression of this disease and the need for knee arthroplasty. Objectives To explore, in an older adult population, how nonsurgical knee injuries relate to osteoarthritis incidence/progression and the weight of independent risk factors for arthroplasty. Design A cohort study design evaluates the long-term impact of injuries on knee osteoarthritis outcomes. Methods Knees with no prior injury (n = 6358) and with at least one injury (n = 819) ⩽20 years before study inclusion were from the Osteoarthritis Initiative cohort. Sociodemographic, clinical and structural [X-ray, magnetic resonance imaging (MRI)] data at study inclusion and changes within 96 months were analysed. Statistics included a mixed model for repeated measurements, generalized estimating equations and multivariable Cox regression with covariates. Results At inclusion, knees with prior injury demonstrated greater incidence and severity of osteoarthritis (p ⩽ 0.001). At 96 months, there was a greater increase in symptoms [Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, p = 0.002], joint space width (JSW, p = 0.039) loss, medial cartilage volume loss (CVL, p ⩽ 0.001) and bone marrow lesion size (BML, p ⩽ 0.049). Knees with/without injury at inclusion but with new ones over time had a pronounced increase in symptoms (all WOMAC scores, p ⩽ 0.001), JSW loss, lateral (without) and medial CVL, lateral (without) and medial meniscal extrusion and medial BML (without; all p ⩽ 0.030). Levels of lateral and medial meniscal extrusion (without) and symptoms (with/without; all WOMAC scores, p ⩽ 0.001) were all accentuated with a repeated new injury. Risk factors associated with the highest knee arthroplasty occurrence are new meniscal extrusion and new injury (p ⩽ 0.001). Conclusion This study highlights the importance of nonsurgical knee injury in older adults as an independent risk factor for knee osteoarthritis and arthroplasty. These data will be beneficial in clinical practice as they will help identify individuals at greater risk of significant disease progression and worst disease outcomes for a customized therapeutic approach.
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Affiliation(s)
- Jean-Pierre Pelletier
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), 900 Saint-Denis, Room R11.412A, Montreal, QC H2X 0A9, Canada
| | - Patrice Paiement
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, QC, Canada
| | - Marc Dorais
- StatSciences Inc., Notre-Dame-de-l’Île-Perrot, QC, Canada
| | - Jean-Pierre Raynauld
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, QC, Canada
| | - Johanne Martel-Pelletier
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, QC, Canada
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White DK, Jakiela J, Bye T, Aily J, Voinier D. Stepping Forward: A Scoping Review of Physical Activity in Osteoarthritis. J Rheumatol 2023; 50:611-616. [PMID: 36455947 PMCID: PMC10159874 DOI: 10.3899/jrheum.220728] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2022] [Indexed: 05/03/2023]
Abstract
Physical activity (PA) is recommended to mitigate the symptoms of osteoarthritis (OA); however, this modality remains an unfamiliar construct for many patients and clinicians. Moreover, there can be confusion over the nuanced differences in terminology, such as exercise, sedentary behavior, and moderate intensity. The purpose of this scoping review is to provide a basic overview of PA including terminology, summarize the importance of PA for adults with OA, and discuss current gaps in the literature. Broadly, PA is defined as any energy expenditure from skeletal muscle above a resting level, and exercise is considered a type of PA that is planned, structured, and repetitive. Robust literature shows that PA has a modest protective effect on pain, functional limitation, and disability for OA, in addition to positive effects on a broad range of outcomes from mood and affect to mortality and morbidity in the general population. We provide recommendations for which measurement instruments can be used to record PA, both from a clinical and research perspective, as well as which metrics to employ for summarizing daily activity.
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Affiliation(s)
- Daniel K White
- D.K. White, PT, ScD, MSc, J. Jakiela, MSc, T. Bye, PT, J. Aily, PT, D. Voinier, PT, PhD, Department of Physical Therapy, University of Delaware, Newark, Delaware, USA.
| | - Jason Jakiela
- D.K. White, PT, ScD, MSc, J. Jakiela, MSc, T. Bye, PT, J. Aily, PT, D. Voinier, PT, PhD, Department of Physical Therapy, University of Delaware, Newark, Delaware, USA
| | - Tom Bye
- D.K. White, PT, ScD, MSc, J. Jakiela, MSc, T. Bye, PT, J. Aily, PT, D. Voinier, PT, PhD, Department of Physical Therapy, University of Delaware, Newark, Delaware, USA
| | - Jessica Aily
- D.K. White, PT, ScD, MSc, J. Jakiela, MSc, T. Bye, PT, J. Aily, PT, D. Voinier, PT, PhD, Department of Physical Therapy, University of Delaware, Newark, Delaware, USA
| | - Dana Voinier
- D.K. White, PT, ScD, MSc, J. Jakiela, MSc, T. Bye, PT, J. Aily, PT, D. Voinier, PT, PhD, Department of Physical Therapy, University of Delaware, Newark, Delaware, USA
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20
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Kacprzak B, Rosińska K, Siuba-Jarosz N. Hyalofast Cartilage Repair Surgery with a Full Load-Bearing Rehabilitation Program One Day after Operation Reduces the Time for Professional Athletes to Return to Play. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59040804. [PMID: 37109762 PMCID: PMC10145501 DOI: 10.3390/medicina59040804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/15/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023]
Abstract
Background and Objectives: This study evaluated the effectiveness of Hyalofast cartilage repair surgery with an early, full load-bearing rehabilitation program one day after the operation for reducing the time needed for professional athletes to return to play. Materials and Methods: This prospective study included 49 patients aged between 19 and 38 years who had undergone surgical reconstruction of cartilage using the microfracture technique combined with a Hyalofast scaffold. All patients were active professional athletes. Early rehabilitation was implemented from the first postoperative day, fully loading the operated limb. A clinical evaluation was based on the KOOS and SF-36 questionnaires used during subsequent follow-up visits. All patients underwent magnetic resonance imaging (MRI) to evaluate the effect of the surgery after one year. Results: The clinical results demonstrated a statistically significant improvement in the number of complaints about pain and in the quality of life of the patients, measured in all of the applied scales, with comparisons made between six months or one year post-surgery and pre-surgery. Importantly for athletes, the parameter related to sports and recreation improved from 14 ± 11.1 to 95 ± 7.7 6 months after surgery and to 99.8 ± 1.8 one year after surgery. The overall quality of life score improved from 30 ± 18 to 88 ± 8.8 one year after surgery. Conclusions: These results show that this approach significantly shortened the time needed for the athletes to return to sports at the same level as before the surgery (athletes returned to sports in approximately 2.5-3 months). The mean follow-up time was 19.75 months. This technique can be considered a viable option for the treatment of cartilage injuries in professional athletes, allowing them to return to play more quickly in a safe and healthy way.
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Affiliation(s)
| | - Karolina Rosińska
- Wolf Project Studio Krzysztof Król, ul. Gdańska 79/D01, 90-612 Łódź, Poland
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21
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Giorgino R, Albano D, Fusco S, Peretti GM, Mangiavini L, Messina C. Knee Osteoarthritis: Epidemiology, Pathogenesis, and Mesenchymal Stem Cells: What Else Is New? An Update. Int J Mol Sci 2023; 24:ijms24076405. [PMID: 37047377 PMCID: PMC10094836 DOI: 10.3390/ijms24076405] [Citation(s) in RCA: 55] [Impact Index Per Article: 55.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 03/22/2023] [Accepted: 03/28/2023] [Indexed: 03/31/2023] Open
Abstract
Osteoarthritis (OA) is a chronic disease and the most common orthopedic disorder. A vast majority of the social OA burden is related to hips and knees. The prevalence of knee OA varied across studies and such differences are reflected by the heterogeneity of data reported by studies conducted worldwide. A complete understanding of the pathogenetic mechanisms underlying this pathology is essential. The OA inflammatory process starts in the synovial membrane with the activation of the immune system, involving both humoral and cellular mediators. A crucial role in this process is played by the so-called “damage-associated molecular patterns” (DAMPs). Mesenchymal stem cells (MSCs) may be a promising option among all possible therapeutic options. However, many issues are still debated, such as the best cell source, their nature, and the right amount. Further studies are needed to clarify the remaining doubts. This review provides an overview of the most recent and relevant data on the molecular mechanism of cartilage damage in knee OA, including current therapeutic approaches in regenerative medicine.
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22
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Driban JB, Vincent HK, Trojian TH, Ambrose KR, Baez S, Beresic N, Berkoff DJ, Callahan LF, Cohen B, Franek M, Golightly YM, Harkey M, Kuenze CM, Minnig MC, Mobasheri A, Naylor A, Newman CB, Padua DA, Pietrosimone B, Pinto D, Root H, Salzler M, Schmitt L, Snyder-Mackler L, Taylor JB, Thoma LM, Vincent KR, Wellsandt E, Williams M. Evidence Review for Preventing Osteoarthritis After an Anterior Cruciate Ligament Injury: An Osteoarthritis Action Alliance Consensus Statement. J Athl Train 2023; 58:198-219. [PMID: 37130279 PMCID: PMC10176847 DOI: 10.4085/1062-6050-0504.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
CONTEXT The Osteoarthritis Action Alliance formed a secondary prevention task group to develop a consensus on secondary prevention recommendations to reduce the risk of osteoarthritis after a knee injury. OBJECTIVE Our goal was to provide clinicians with secondary prevention recommendations that are intended to reduce the risk of osteoarthritis after a person has sustained an anterior cruciate ligament injury. Specifically, this manuscript describes our methods, literature reviews, and dissenting opinions to elaborate on the rationale for our recommendations and to identify critical gaps. DESIGN Consensus process. SETTING Virtual video conference calls and online voting. PATIENTS OR OTHER PARTICIPANTS The Secondary Prevention Task Group consisted of 29 members from various clinical backgrounds. MAIN OUTCOME MEASURE(S) The group initially convened online in August 2020 to discuss the target population, goals, and key topics. After a second call, the task group divided into 9 subgroups to draft the recommendations and supportive text for crucial content areas. Twenty-one members completed 2 rounds of voting and revising the recommendations and supportive text between February and April 2021. A virtual meeting was held to review the wording of the recommendations and obtain final votes. We defined consensus as >80% of voting members supporting a proposed recommendation. RESULTS The group achieved consensus on 15 of 16 recommendations. The recommendations address patient education, exercise and rehabilitation, psychological skills training, graded-exposure therapy, cognitive-behavioral counseling (lacked consensus), outcomes to monitor, secondary injury prevention, system-level social support, leveraging technology, and coordinated care models. CONCLUSIONS This consensus statement reflects information synthesized from an interdisciplinary group of experts based on the best available evidence from the literature or personal experience. We hope this document raises awareness among clinicians and researchers to take steps to mitigate the risk of osteoarthritis after an anterior cruciate ligament injury.
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Affiliation(s)
| | - Jeffrey B. Driban
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA
| | - Heather K. Vincent
- UF Health Sports Performance Center, Department of Physical Medicine and Rehabilitation, University of Florida, Gainesville
| | - Thomas H. Trojian
- UF Health Sports Performance Center, Department of Physical Medicine and Rehabilitation, University of Florida, Gainesville
| | | | - Shelby Baez
- Osteoarthritis Action Alliance, Thurston Arthritis Research Center, University of North Carolina at Chapel Hill
| | | | - David J. Berkoff
- Department of Kinesiology, Michigan State University, East Lansing
| | - Leigh F. Callahan
- Osteoarthritis Action Alliance, Thurston Arthritis Research Center, University of North Carolina at Chapel Hill
| | | | - Madison Franek
- University of North Carolina Therapy Services, UNC Wellness Center at Meadowmont, Chapel Hill
| | - Yvonne M. Golightly
- Department of Epidemiology, Thurston Arthritis Research Center, Injury Prevention Research Center, Osteoarthritis Action Alliance, University of North Carolina at Chapel Hill
| | - Matthew Harkey
- Department of Kinesiology, Michigan State University, East Lansing
| | | | - Mary Catherine Minnig
- Department of Epidemiology, Thurston Arthritis Research Center, Injury Prevention Research Center, Osteoarthritis Action Alliance, University of North Carolina at Chapel Hill
| | - Ali Mobasheri
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Finland; Department of Regenerative Medicine, State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania; Department of Joint Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China; World Health Organization Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liege, Belgium
| | | | - Connie B. Newman
- Department of Medicine, Division of Endocrinology, Diabetes & Metabolism, NYU Grossman School of Medicine, New York, NY
| | - Darin A. Padua
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | - Brian Pietrosimone
- Department of Physical Therapy, Congdon School of Health Sciences, High Point University, NC
| | - Daniel Pinto
- Department of Physical Therapy, Marquette University, Milwaukee, WI
| | - Hayley Root
- Department of Physical Therapy, Marquette University, Milwaukee, WI
| | - Matthew Salzler
- Department of Physical Therapy and Athletic Training, Northern Arizona University, Flagstaff
| | - Laura Schmitt
- Division of Physical Therapy, School of Health and Rehabilitation Sciences, Ohio State University, Columbus
| | | | - Jeffrey B. Taylor
- Department of Physical Therapy, Congdon School of Health Sciences, High Point University, NC
| | - Louise M. Thoma
- Division of Physical Therapy, Department of Allied Health Sciences, University of North Carolina at Chapel Hill
| | - Kevin R. Vincent
- UF Health Sports Performance Center, Department of Physical Medicine and Rehabilitation, University of Florida, Gainesville
| | - Elizabeth Wellsandt
- Division of Physical Therapy Education, University of Nebraska Medical Center, Omaha
| | - Monette Williams
- Division of Physical Therapy Education, University of Nebraska Medical Center, Omaha
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23
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Ishii Y, Hashizume T, Okamoto S, Iwamoto Y, Ishikawa M, Nakashima Y, Hashiguchi N, Okada K, Takagi K, Adachi N, Takahashi M. Cumulative knee adduction moment during jogging causes temporary medial meniscus extrusion in healthy volunteers. J Med Ultrason (2001) 2023; 50:229-236. [PMID: 36800121 DOI: 10.1007/s10396-023-01288-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 12/27/2022] [Indexed: 02/18/2023]
Abstract
PURPOSE The cumulative knee adduction moment (KAM) is a key parameter evaluated for the prevention of overload knee injuries on the medial compartment. Medial meniscus extrusion (MME), typical in hoop dysfunctions, is a measure for the cumulative mechanical stress in individual knees; however, its correlation with cumulative KAM is unknown. The aim of this study was to investigate the effect of temporary overload stress on MME and its correlation with cumulative KAM. METHODS Thirteen healthy asymptomatic volunteers (13 knees) were recruited for a cohort study (mean age, 23.1 ± 3.3 years; males: n = 8). The cumulative KAM was calculated using a three-dimensional motion analysis system, in addition to the number of steps taken while jogging uphill or downhill. MME was evaluated using ultrasound performed in the standing position. The evaluations were performed four times: at baseline (T0), before and after (T1 and T2, respectively) jogging uphill or downhill, and 1 day after (T3) jogging. Additionally, the Δ-value was calculated using the change of meniscus after efforts as the difference in MME between T1 and T2. RESULTS The MME in T2 was significantly greater than those in T0 and T1. Conversely, the MME in T3 was significantly lesser than that in T2. No significant difference was found between those in T0 and T1, and T3. ΔMME exhibited a significant positive correlation with the cumulative KAM (r = 0.68, p = 0.01), but not for peak KAM. CONCLUSION The temporary reaction of MME observed in ultrasound correlates with the cumulative stress of KAM.
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Affiliation(s)
- Yosuke Ishii
- Department of Biomechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
| | - Takato Hashizume
- Department of Biomechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Saeko Okamoto
- Department of Biomechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yoshitaka Iwamoto
- Department of Biomechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masakazu Ishikawa
- Department of Orthopaedic Surgery, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Yuko Nakashima
- Department of Musculoskeletal Ultrasound in Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Naofumi Hashiguchi
- Department of Orthopedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kaoru Okada
- Ultrasound Business Operations, Healthcare Business Headquarters, KONICA MINOLTA, INC, Tokyo, Japan
| | - Kazuya Takagi
- Ultrasound Business Operations, Healthcare Business Headquarters, KONICA MINOLTA, INC, Tokyo, Japan
| | - Nobuo Adachi
- Department of Orthopedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Makoto Takahashi
- Department of Biomechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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24
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Burfield M, Sayers M, Buhmann R. The association between running volume and knee osteoarthritis prevalence: A systematic review and meta-analysis. Phys Ther Sport 2023; 61:1-10. [PMID: 36809693 DOI: 10.1016/j.ptsp.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 02/15/2023]
Abstract
There is conflicting evidence regarding whether regular running is associated with knee osteoarthritis prevalence. Previous evidence reports lower knee osteoarthritis prevalence in recreational runners compared with professionals (with a higher training volume) and controls (who have a lower training volume). The aim of this systematic review and meta-analysis was to determine if weekly running volume is associated with knee osteoarthritis prevalence. Four databases (PubMed, Web of Science, Scopus and SPORTDiscus) were searched from earliest record to November 2021. Included studies must i) recruit participants who ran regularly and recorded weekly running volume; ii) include a control group (running <8 km per week); iii) record knee osteoarthritis prevalence (either by radiological imaging or self-reported diagnosis from a doctor or physiotherapist). Study bias was assessed using the Newcastle-Ottawa Scale (NOS). Pooled effects were estimated using a random effects model. Odds ratios with 95% prediction and confidence intervals are reported. Nine observational case control studies with a total of 12,273 participants (1272 runners) were included in the meta-analysis. Most of the included studies were rated as having a very high (n = 2) or high (n = 3) risk of bias on the Newcastle Ottawa Scale. There was no difference in knee osteoarthritis prevalence between runners and controls (OR = 0.97, 95% CI = 0.56 to 1.68). Runners undertaking 8-32.1 km (OR = 1.17, 95% CI = 0.77 to 1.80), 32.2-48 km (OR = 1.04, 95% CI = 0.48 to 2.31) or > 48 km per week (OR = 0.62, 95% CI = 0.35 to 1.10) did not exhibit higher knee osteoarthritis prevalence compared with controls. It is unclear whether running volume is associated with increased knee osteoarthritis prevalence, future large-scale, high quality prospective studies are required.
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Affiliation(s)
- M Burfield
- School of Health and Behavioural Sciences, Australian Catholic University, Brisbane, Australia
| | - M Sayers
- School of Health and Behaviour Sciences, University of the Sunshine Coast, Maroochydore, Australia
| | - R Buhmann
- School of Health and Behaviour Sciences, University of the Sunshine Coast, Maroochydore, Australia.
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25
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Coburn SL, Crossley KM, Kemp JL, Warden SJ, West TJ, Bruder AM, Mentiplay BF, Culvenor AG. Is running good or bad for your knees? A systematic review and meta-analysis of cartilage morphology and composition changes in the tibiofemoral and patellofemoral joints. Osteoarthritis Cartilage 2023; 31:144-157. [PMID: 36402349 DOI: 10.1016/j.joca.2022.09.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 09/06/2022] [Accepted: 09/14/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND The general health benefits of running are well-established, yet concern exists regarding the development and progression of osteoarthritis. AIM To systematically review the immediate (within 20 min) and delayed (20 min-48 h) effect of running on hip and knee cartilage, as assessed using magnetic resonance imaging (MRI). METHOD Studies using MRI to measure change in hip or knee cartilage within 48 h pre- and post-running were identified. Risk of bias was assessed using a modified Newcastle-Ottawa Scale. Percentage change in cartilage outcomes were estimated using random-effects meta-analysis. Certainty of evidence was evaluated with the Grading of Recommendations Assessment, Development and Evaluation tool. RESULTS Twenty-four studies were included, evaluating 446 knees only. One third of studies were low risk of bias. Knee cartilage thickness and volume decreased immediately after running, with declines ranging from 3.3% (95% confidence interval [CI]: 2.6%, 4.1%) for weight-bearing femoral cartilage volume to 4.9% (95% CI: 4.43.6%, 6.2%) for patellar cartilage volume. T1ρ and T2 relaxation times were also reduced immediately after running, with the largest decline being 13.1% (95% CI: -14.4%, -11.7%) in femoral trochlear cartilage. Tibiofemoral cartilage T2 relaxation times recovered to baseline levels within 91 min. Existing cartilage defects were unchanged within 48 h post-run. CONCLUSIONS There is very low certainty evidence that running immediately decreases the thickness, volume, and relaxation times of patellofemoral and tibiofemoral cartilage. Hip cartilage changes are unknown, but knee changes are small and appear transient suggesting that a single bout of running is not detrimental to knee cartilage.
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Affiliation(s)
- S L Coburn
- La Trobe Sport & Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.
| | - K M Crossley
- La Trobe Sport & Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.
| | - J L Kemp
- La Trobe Sport & Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.
| | - S J Warden
- La Trobe Sport & Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia; Department of Physical Therapy, School of Health & Human Sciences, Indiana University, Indianapolis, IN, USA.
| | - T J West
- La Trobe Sport & Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.
| | - A M Bruder
- La Trobe Sport & Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.
| | - B F Mentiplay
- La Trobe Sport & Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.
| | - A G Culvenor
- La Trobe Sport & Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.
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26
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Esculier JF, Barton C. Recreational running is not bad for healthy people's joints - it is time to study the safety of running in people with osteoarthritis. Osteoarthritis Cartilage 2023; 31:135-137. [PMID: 36402350 DOI: 10.1016/j.joca.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 11/09/2022] [Indexed: 11/19/2022]
Affiliation(s)
- J-F Esculier
- The Running Clinic, Lac Beauport, Canada; Department of Physical Therapy, University of British Columbia, Vancouver, Canada; MoveMed Physiotherapy, Kelowna, Canada.
| | - C Barton
- Department of Physiotherapy, Podiatry, Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia; La Trobe Sport and Exercise Medicine Research Centre (LASEM), School of Allied Health, La Trobe University, Melbourne, Australia
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27
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Knee Joint Contact Forces during High-Risk Dynamic Tasks: 90° Change of Direction and Deceleration Movements. Bioengineering (Basel) 2023; 10:bioengineering10020179. [PMID: 36829673 PMCID: PMC9952676 DOI: 10.3390/bioengineering10020179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 01/26/2023] [Accepted: 01/28/2023] [Indexed: 02/04/2023] Open
Abstract
Pivoting sports expose athletes to a high risk of knee injuries, mainly due to mechanical overloading of the joint which shatters overall tissue integrity. The present study explored the magnitude of tibiofemoral contact forces (TFCF) in high-risk dynamic tasks. A novel musculoskeletal model with modifiable frontal plane knee alignment was developed to estimate the total, medial, and lateral TFCF developed during vigorous activities. Thirty-one competitive soccer players performing deceleration and 90° sidestepping tasks were assessed via 3D motion analysis by using a marker-based optoelectronic system and TFCF were assessed via OpenSim software. Statistical parametric mapping was used to investigate the effect of frontal plane alignment, compartment laterality, and varus-valgus genu on TFCF. Further, in consideration of specific risk factors, sex influence was also assessed. A strong correlation (R = 0.71 ÷ 0.98, p < 0.001) was found between modification of compartmental forces and changes in frontal plane alignment. Medial and lateral TFCF were similar throughout most of the tasks with the exception of the initial phase, where the lateral compartment had to withstand to higher loadings (1.5 ÷ 3 BW higher, p = 0.010). Significant sex differences emerged in the late phase of the deceleration task. A comprehensive view of factors influencing the mediolateral distribution of TFCF would benefit knee injury prevention and rehabilitation in sport activities.
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Mohamed AA, Zhang X, Jan YK. Evidence-based and adverse-effects analyses of cupping therapy in musculoskeletal and sports rehabilitation: A systematic and evidence-based review. J Back Musculoskelet Rehabil 2023; 36:3-19. [PMID: 35848010 DOI: 10.3233/bmr-210242] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Cupping therapy has been used to treat musculoskeletal impairments for about 4000 years. Recently, world athletes have provoked an interest in it, however, the evidence to support its use in managing musculoskeletal and sports conditions remains unknown. OBJECTIVE To evaluate the evidence level of the effect of cupping therapy in managing common musculoskeletal and sports conditions. METHODS 2214 studies were identified through a computerized search, of which 22 met the inclusion criteria. The search involved randomized and case series studies published between 1990 and 2019. The search involved five databases (Scopus, MEDLINE (PubMed), Web of Science, Academic Search Complete PLUS (EBSCO), and CrossRef) and contained studies written in the English language. Three analyses were included: the quality assessment using the PEDro scale, physical characteristic analysis, and evidence-based analysis. RESULTS The results showed that most studies used dry cupping, except five which used wet cupping. Most studies compared cupping therapy to non-intervention, the remaining studies compared cupping to standard medical care, heat, routine physiotherapy, electrical stimulation, active range of motion and stretching, passive stretching, or acetaminophen. Treatment duration ranged from 1 day to 12 weeks. The evidence of cupping on increasing soft tissue flexibility is moderate, decreasing low back pain or cervical pain is low to moderate, and treating other musculoskeletal conditions is very low to low. The incidence of adverse events is very low. CONCLUSION This study provides the first attempt to analyze the evidence level of cupping therapy in musculoskeletal and sports rehabilitation. However, cupping therapy has low to moderate evidence in musculoskeletal and sports rehabilitation and might be used as a useful intervention because it decreases the pain level and improves blood flow to the affected area with low adverse effects.
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Affiliation(s)
- Ayman A Mohamed
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA.,Department of Basic Sciences, Faculty of Physical Therapy, Beni-Suef University, Beni Suef, Egypt.,Faculty of Physical Therapy, Nahda University, Beni Suef, Egypt
| | - Xueyan Zhang
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Yih-Kuen Jan
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
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29
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Nilsen DH, Furnes O, Kroken G, Robsahm TE, Johnsen MB, Engebretsen L, Nordsletten L, Bahr R, Lie SA. Risk of total hip arthroplasty after elite sport: linking 3304 former world-class athletes with the Norwegian Arthroplasty Register. Br J Sports Med 2022; 57:bjsports-2022-105575. [PMID: 36588424 PMCID: PMC9811096 DOI: 10.1136/bjsports-2022-105575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVES At present, there is no cure for osteoarthritis (OA), but severe hip joint degeneration can require total hip arthroplasty (THA). The literature on OA after elite sport is limited. We hypothesise that elite athletic activity increases the risk of receiving a THA later in life. METHODS We linked a cohort of former Norwegian world-class athletes (1402 females and 1902 males, active 1936-2006) to the Norwegian Arthroplasty Register (THA performed 1987-2020). We used standardised incidence ratio (SIR), one-minus Kaplan-Meier and relative Cox regression (relative HR, RHR), with 95% CIs, and funnel plots at age 75, to assess THA risk for different sport disciplines, joint impact categories of sport disciplines and sex. The risk of THA for the corresponding general Norwegian population was used as reference. RESULTS We found an overall increased risk for THA for the former elite athletes (SIR 2.11, 95% CI 1.82 to 2.40) at age 75 years, compared with the general population. THA risk at age 75 years was 11.6% for female athletes and 8.3% for male athletes. SIR was 1.90 (95% CI 1.49 to 2.31) for female and 2.28 (95% CI 1.87 to 2.70) for male athletes. Among males, high joint impact sport disciplines were associated with increased risk compared with low-impact sport disciplines (RHR 1.81, 95% CI 1.06 to 3.08, p=0.029). CONCLUSION Having been an elite athlete was associated with a doubling of THA risk compared with the general population for both sexes. High joint impact sport disciplines were associated with subsequent THA for male athletes.
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Affiliation(s)
- Daniel Hoseth Nilsen
- Norwegian Arthroplasty Register, Department of Orthopedic Surgery, Haukeland University Hospital, Bergen, Norway
| | - Ove Furnes
- Norwegian Arthroplasty Register, Department of Orthopedic Surgery, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Gard Kroken
- Norwegian Arthroplasty Register, Department of Orthopedic Surgery, Haukeland University Hospital, Bergen, Norway
| | | | - Marianne Bakke Johnsen
- Department of Rehabilitation Science and Health Technology, Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Lars Engebretsen
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
| | - Lars Nordsletten
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
| | - Roald Bahr
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - Stein Atle Lie
- Norwegian Arthroplasty Register, Department of Orthopedic Surgery, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
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30
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Philpott HT, Birmingham TB, Fiset B, Walsh LA, Coleman MC, Séguin CA, Appleton CT. Tensile strain and altered synovial tissue metabolism in human knee osteoarthritis. Sci Rep 2022; 12:17367. [PMID: 36253398 PMCID: PMC9576717 DOI: 10.1038/s41598-022-22459-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 10/14/2022] [Indexed: 01/10/2023] Open
Abstract
Synovium is critical for maintaining joint homeostasis and may contribute to mechanobiological responses during joint movement. We investigated mechanobiological responses of whole synovium from patients with late-stage knee osteoarthritis (OA). Synovium samples were collected during total knee arthroplasty and assigned to histopathology or cyclic 10% tensile strain loading, including (1) static (control); (2) low-frequency (0.3 Hz); and iii) high-frequency (1.0 Hz) for 30-min. After 6-h incubation, tissues were bisected for RNA isolation and immunostaining (3-nitrotyrosine; 3-NT). RNA sequencing was analyzed for differentially expressed genes and pathway enrichment. Cytokines and lactate were measured in conditioned media. Compared to controls, low-frequency strain induced enrichment of pathways related to interferon response, Fc-receptor signaling, and cell metabolism. High-frequency strain induced enrichment of pathways related to NOD-like receptor signaling, high metabolic demand, and redox signaling/stress. Metabolic and redox cell stress was confirmed by increased release of lactate into conditioned media and increased 3-NT formation in the synovial lining. Late-stage OA synovial tissue responses to tensile strain include frequency-dependent increases in inflammatory signaling, metabolism, and redox biology. Based on these findings, we speculate that some synovial mechanobiological responses to strain may be beneficial, but OA likely disturbs synovial homeostasis leading to aberrant responses to mechanical stimuli, which requires further validation.
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Affiliation(s)
- Holly T. Philpott
- grid.39381.300000 0004 1936 8884Faculty of Health Sciences, Western University, London, ON N6G 1H1 Canada ,grid.39381.300000 0004 1936 8884Bone and Joint Institute, Western University, London, ON N6A 5B5 Canada
| | - Trevor B. Birmingham
- grid.39381.300000 0004 1936 8884Faculty of Health Sciences, Western University, London, ON N6G 1H1 Canada ,grid.39381.300000 0004 1936 8884Bone and Joint Institute, Western University, London, ON N6A 5B5 Canada
| | - Benoit Fiset
- grid.14709.3b0000 0004 1936 8649Rosalind and Morris Goodman Cancer Research Centre, McGill University, Montreal, QC H3A 1A3 Canada
| | - Logan A. Walsh
- grid.14709.3b0000 0004 1936 8649Rosalind and Morris Goodman Cancer Research Centre, McGill University, Montreal, QC H3A 1A3 Canada ,grid.14709.3b0000 0004 1936 8649Department of Human Genetics, McGill University, Montreal, QC H3A 0C7 Canada
| | - Mitchell C. Coleman
- grid.214572.70000 0004 1936 8294Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA 52242 USA ,grid.214572.70000 0004 1936 8294Department of Radiation Oncology, University of Iowa, Iowa City, IA 52242 USA
| | - Cheryle A. Séguin
- grid.39381.300000 0004 1936 8884Bone and Joint Institute, Western University, London, ON N6A 5B5 Canada ,grid.39381.300000 0004 1936 8884Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5C1 Canada
| | - C. Thomas Appleton
- grid.39381.300000 0004 1936 8884Bone and Joint Institute, Western University, London, ON N6A 5B5 Canada ,grid.39381.300000 0004 1936 8884Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5C1 Canada ,grid.39381.300000 0004 1936 8884Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5C1 Canada ,SJHC Rheumatology Centre, 268 Grosvenor St., London, ON N6A 4V2 Canada
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31
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Coaccioli S, Sarzi-Puttini P, Zis P, Rinonapoli G, Varrassi G. Osteoarthritis: New Insight on Its Pathophysiology. J Clin Med 2022; 11:6013. [PMID: 36294334 PMCID: PMC9604603 DOI: 10.3390/jcm11206013] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/19/2022] [Accepted: 10/08/2022] [Indexed: 11/17/2022] Open
Abstract
Understanding of the basis of osteoarthritis (OA) has seen some interesting advancements in recent years. It has been observed that cartilage degeneration is preceded by subchondral bone lesions, suggesting a key role of this mechanism within the pathogenesis and progression of OA, as well as the formation of ectopic bone and osteophytes. Moreover, low-grade, chronic inflammation of the synovial lining has gained a central role in the definition of OA physiopathology, and central immunological mechanisms, innate but also adaptive, are now considered crucial in driving inflammation and tissue destruction. In addition, the role of neuroinflammation and central sensitization mechanisms as underlying causes of pain chronicity has been characterized. This has led to a renewed definition of OA, which is now intended as a complex multifactorial joint pathology caused by inflammatory and metabolic factors underlying joint damage. Since this evidence can directly affect the definition of the correct therapeutic approach to OA, an improved understanding of these pathophysiological mechanisms is fundamental. To this aim, this review provides an overview of the most updated evidence on OA pathogenesis; it presents the most recent insights on the pathophysiology of OA, describing the interplay between immunological and biochemical mechanisms proposed to drive inflammation and tissue destruction, as well as central sensitization mechanisms. Moreover, although the therapeutic implications consequent to the renewed definition of OA are beyond this review scope, some suggestions for intervention have been addressed.
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Affiliation(s)
| | | | - Panagiotis Zis
- Attikon University Hospital, National & Kapodistrian University, 157 72 Athens, Greece
- Medical School, University of Cyprus, Nicosia 1678, Cyprus
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32
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Martel-Pelletier J, Pelletier JP. Is there a mitochondrial DNA haplogroup connection between osteoarthritis and elite athletes? A narrative review. RMD Open 2022; 8:rmdopen-2022-002602. [PMID: 36113964 PMCID: PMC9486370 DOI: 10.1136/rmdopen-2022-002602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 09/06/2022] [Indexed: 11/04/2022] Open
Abstract
Elite athletes are at greater risk of joint injuries linked to the subsequent risk of developing osteoarthritis (OA). Genetic factors such as mitochondrial (mt) DNA haplogroups have been associated with the incidence/progression of OA and athletic performance. This review highlights an area not yet addressed: is there a common pattern in the mtDNA haplogroups for OA occurrence in individuals and elite athletes of populations of the same descent? Haplotypes J and T confer a decreased risk of OA in Caucasian/European descent, while H and U increase this risk. Both J and T haplogroups are under-represented in Caucasian/European individuals and endurance athletes with OA, but power athletes showed a greater percentage of the J haplogroup. Caucasian/European endurance athletes had a higher percentage of haplogroup H, which is associated with increased athletic performance. In a Chinese population, haplogroup G appears to increase OA susceptibility and is over-represented in Japanese endurance athletes. In contrast, in Koreans, haplogroup B had a higher frequency of individuals with OA but was under-represented in the endurance athlete population. For Caucasian endurance athletes, it would be interesting to evaluate if those carrying haplotype H would be at an increased risk of accelerated OA, as well as the haplogroup G in Chinese and Japanese endurance athletes. The reverse might be studied for the Korean descent for haplogroup B. Knowledge of such genetic data could be used as a preliminary diagnosis to identify individuals at high risk of OA, adding prognostic information and assisting in personalising the early management of both populations.
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Affiliation(s)
- Johanne Martel-Pelletier
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - Jean-Pierre Pelletier
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
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33
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Osteoarthritis Risks and Sports: An Evidence-based Systematic Review. Sports Med Arthrosc Rev 2022; 30:118-140. [PMID: 35921595 DOI: 10.1097/jsa.0000000000000351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Regular sports activities are associated with multiple physical and psychological health benefits. However, sports also may lead to injuries and the development of osteoarthritis (OA). This systematic review investigated the association between sports activity, sports type, and the risk of developing OA. METHODS A systematic review was performed by assessing studies that have investigated the risk of OA development in sports. Data extracted included general information, study design, number of participants, related body mass index, sports type, and assessment of OA. The methodological quality of the studies was assessed using the Newcastle-Ottawa Scale. RESULTS A total of 63 studies were included in this systematic review. The overall Newcastle-Ottawa Scale score was 6.46±1.44 demonstrating a good methodological quality of the articles included in the present study. A total of 628,036 participants were included, with a mean follow-up of 8.0±8.4 years. The mean age of the included athletes was 45.6±15.8, with a mean body mass index of 24.9±2.3 kg/m 2 . CONCLUSION Football and soccer players seem to be at higher risk for the development of OA, although the injury status of the joint should be considered when assessing the risk of OA. High equipment weight and increased injury risk also put military personnel at a higher risk of OA, although elite dancing leads to more hip labral tears. Femoroacetabular impingement was also often diagnosed in ice-hockey players and ballet dancers.
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34
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Esculier JF, Besomi M, Silva DDO, Passigli S, Rathleff MS, Van Middelkoop M, Barton C, Callaghan MJ, Harkey MS, Hoens AM, Krowchuk NM, Teoli A, Vicenzino B, Willy RW, Hunt MA. Do the General Public and Health Care Professionals Think That Running Is Bad for the Knees? A Cross-sectional International Multilanguage Online Survey. Orthop J Sports Med 2022; 10:23259671221124141. [PMID: 36199830 PMCID: PMC9528027 DOI: 10.1177/23259671221124141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 07/12/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Running is a popular sport with widely recognized health benefits. Given the high rates of knee injury in runners and the growing prevalence of knee osteoarthritis (KOA), it may be useful to assess perceptions about running and knee joint health. Purpose: The objectives of this study were to (1) explore and compare the perceptions of the general public (PUB) and health care professionals (HCPs) on the topic of running and knee health and (2) explore recommendations about running and knee health provided by HCPs. Study Design: Cross-sectional study. Methods: We conducted an online survey between June 18 and October 1, 2020. The questionnaire included questions on running and knee health, and HCPs were asked about their typical recommendations and level of confidence in providing recommendations on the topic. Perceptions (proportions) were compared between the PUB and HCPs using the chi-square test. Results: In total, 4521 responses (PUB, n = 2514; HCPs, n = 2007) were analyzed. A greater proportion of HCPs perceived regular running as healthy for knees (86% vs 68%; P < .001). More of the PUB than HCPs ( P < .001) believed that running frequently (29% vs 13%), long distances (54% vs 45%), and on hard surfaces (60% vs 36%) increased the risk of developing KOA. Running for those with KOA was perceived by the PUB as posing an increased risk of getting more knee pain (48%) and needing joint replacement surgery (38%), more so than by HCPs (26% and 17%, respectively). The majority of HCPs reported being relatively confident in providing evidence-based recommendations about running and knee health and mostly recommended that runners with KOA modify training parameters instead of quit. Conclusion: More HCPs perceived running as healthy for knees when compared with the PUB. Most HCPs felt confident in providing evidence-based recommendations about running and knee health.
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Affiliation(s)
| | - Manuela Besomi
- Investigation performed at University of British Columbia, Vancouver, Canada
| | | | - Samuele Passigli
- Investigation performed at University of British Columbia, Vancouver, Canada
| | | | | | - Christian Barton
- Investigation performed at University of British Columbia, Vancouver, Canada
| | | | - Matthew S. Harkey
- Investigation performed at University of British Columbia, Vancouver, Canada
| | - Alison M. Hoens
- Investigation performed at University of British Columbia, Vancouver, Canada
| | - Natasha M. Krowchuk
- Investigation performed at University of British Columbia, Vancouver, Canada
| | - Anthony Teoli
- Investigation performed at University of British Columbia, Vancouver, Canada
| | - Bill Vicenzino
- Investigation performed at University of British Columbia, Vancouver, Canada
| | - Richard W. Willy
- Investigation performed at University of British Columbia, Vancouver, Canada
| | - Michael A. Hunt
- Investigation performed at University of British Columbia, Vancouver, Canada
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35
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Moraes MS, Fernandes RA, Moreno YMF, Pelegrini A, Silva DAS. Bone Density and Bone Geometry in University Athletes From Sports With Different Levels of Impact: Simultaneous Association With Multiple Factors. J Strength Cond Res 2022; 36:3113-3121. [PMID: 36026482 DOI: 10.1519/jsc.0000000000004132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Moraes, MS, Fernandes, RA, Moreno, YMF, Pelegrini, A, and Silva, DAS. Bone density and bone geometry in university athletes from sports with different levels of impact: simultaneous association with multiple factors. J Strength Cond Res XX(X): 000-000, 2022-The aim of this study was to use the bone loading unit (BLU) classification to compare bone density and bone geometry of sports with different levels of impact, simultaneously controlling the multiple factors that interfere with bone metabolism in athletes. Overall, 167 university athletes (92 men) participated in the study. Bone mineral density (BMD), strength index, cross-sectional area (CSA) at the moment of inertia, section modulus (Z), CSA, neck-shaft angle (NSA), and hip axis length (HAL) were measured. Sports were categorized by level of impact, high BLU (higher impact) and moderate/low BLU (lower impact). Covariates were fat mass, lean tissue mass, training volume, time of practice, dietary supplementation, use of oral contraceptives and menstrual status. Multiple linear regression with 5% significance level (p < 0.05) was used. In men, HAL was higher in sports with high BLU compared with those with moderate/low BLU (β: -0.21; R2: 0.30; p = 0.03). In women, NSA was higher in sports with moderate/low BLU compared with those with high BLU (β: 0.31; R2: 0.11; p = 0.02). There was no difference between BLU groups for BMD. These results persisted when the simultaneous interference of covariates was controlled. Thus, this study recommends BLU to classify sports and reinforces the importance of monitoring HAL and NSA in athletes in addition to the control of multiple factors that interfere with bone metabolism, because they influence physical performance and bone health during and after athletic life.
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Affiliation(s)
- Mikael S Moraes
- Research Center in Kinanthropometry and Human Performance, Federal University of Santa Catarina, Florianopolis, Brazil
| | - Rômulo A Fernandes
- Department of Physical Education, School of Sciences and Technology, São Paulo State University, São Paulo, Brazil
| | - Yara M F Moreno
- Department of Nutrition, Graduate Program in Nutrition, Federal University of Santa Catarina, Florianopolis, Brazil; and
| | - Andreia Pelegrini
- Health and Sport Sciences Center, Santa Catarina State University, Florianopolis, Brazil
| | - Diego A S Silva
- Research Center in Kinanthropometry and Human Performance, Federal University of Santa Catarina, Florianopolis, Brazil
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The Involvement of Neutrophils in the Pathophysiology and Treatment of Osteoarthritis. Biomedicines 2022; 10:biomedicines10071604. [PMID: 35884909 PMCID: PMC9313259 DOI: 10.3390/biomedicines10071604] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 06/29/2022] [Accepted: 07/01/2022] [Indexed: 12/14/2022] Open
Abstract
Osteoarthritis (OA) is a chronic disability that significantly impairs quality of life. OA is one of the most prevalent joint pathologies in the world, characterized by joint pain and stiffness due to the degeneration of articular cartilage and the remodeling of subchondral bone. OA pathogenesis is unique in that it involves simultaneous reparative and degradative mechanisms. Low-grade inflammation as opposed to high-grade allows for this coexistence. Previously, macrophages and T cells have been identified as playing major roles in the inflammation and destruction of OA joints, but recent studies have demonstrated that neutrophils also contribute to the pathogenesis. Neutrophils are the first immune cells to enter the synovium after joint injury, and neutrophilic activity is indispensably a requisite for the progression of OA. Neutrophils act through multiple mechanisms including tissue degeneration via neutrophil elastase (NE), osteophyte development, and the release of inflammatory cytokines and chemokines. As the actions of neutrophils in OA are discovered, the potential for novel therapeutic targets as well as diagnostic methods are revealed. The use of chondrogenic progenitor cells (CPCs), microRNAs, and exosomes are among the newest therapeutic advances in OA treatment, and this review reveals how they can be used to mitigate destructive neutrophil activity.
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Quaranta M, Riccio I, Oliva F, Maffulli N. Osteoarthritis of the Knee in Middle-age Athletes: Many Measures are Practiced, but Lack Sound Scientific Evidence. Sports Med Arthrosc Rev 2022; 30:102-110. [PMID: 35533062 DOI: 10.1097/jsa.0000000000000341] [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: 11/25/2022]
Abstract
Osteoarthritis of the knee generally affects individuals from the fifth decade, the typical age of middle-age athletes. In the early stages, management is conservative and multidisciplinary. It is advisable to avoid sports with high risk of trauma, but it is important that patients continue to be physically active. Conservative management offers several options; however, it is unclear which ones are really useful. This narrative review briefly reports the conservative options for which there is no evidence of effectiveness, or there is only evidence of short-term effectiveness.
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Affiliation(s)
- Marco Quaranta
- Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Baronissi
- Clinica Ortopedica, Ospedale San Giovanni di Dio e Ruggi D'Aragona, Salerno, Italy
| | - Ivano Riccio
- Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Baronissi
- Clinica Ortopedica, Ospedale San Giovanni di Dio e Ruggi D'Aragona, Salerno, Italy
| | - Francesco Oliva
- Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Baronissi
- Clinica Ortopedica, Ospedale San Giovanni di Dio e Ruggi D'Aragona, Salerno, Italy
| | - Nicola Maffulli
- Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Baronissi
- Clinica Ortopedica, Ospedale San Giovanni di Dio e Ruggi D'Aragona, Salerno, Italy
- Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, Queen Mary University of London, London
- Faculty of Medicine, School of Pharmacy and Bioengineering, Guy Hilton Research Centre, Keele University, Stoke-on-Trent, England
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Migliorini F, Vecchio G, Pintore A, Oliva F, Maffulli N. The Influence of Athletes' Age in the Onset of Osteoarthritis: A Systematic Review. Sports Med Arthrosc Rev 2022; 30:97-101. [PMID: 35533061 DOI: 10.1097/jsa.0000000000000345] [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 Whether sport participation is a risk factor for osteoarthritis (OA) development or progression is controversial. Mechanical overload, injuries, genetics, and acquired disorders concur to the onset of OA, with high variability between sports and participants. This study investigated the association between participation in specific sports and the risk of developing knee and hip OA in athletes at different ages. We hypothesized that young athletes who are exposed to high levels of physical activities have a greater risk of developing OA. MATERIALS AND METHODS This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Google scholar, EMABSE, and Web of Science were accessed in October 2021. No time constrains were used for the search. All the published clinical studies reporting data about relationship between physical activity, OA, and age were included. RESULTS The Newcastle-Ottawa Scale resulted in a final score ≥7 for all studies, attesting good quality of the methodological assessment. Data from 27,364 patients were retrieved. The mean age was 48.2±16.7 years. In all, 21.8% were women. CONCLUSIONS Our systematic review suggests an association between high levels of physical activities and knee and hip OA in men younger than 50 years. People who practice intense physical activity, such as professional athletes or heavy workers, are more prone to develop early-onset OA.
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Affiliation(s)
- Filippo Migliorini
- Department of Orthopaedics, University Clinic Aachen, RWTH Aachen University Clinic, Aachen, Germany
| | - Gianluca Vecchio
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi (SA), Italy
| | - Andrea Pintore
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi (SA), Italy
| | - Francesco Oliva
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi (SA), Italy
| | - Nicola Maffulli
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi (SA), Italy
- School of Pharmacy and Bioengineering, Keele University Faculty of Medicine, Stoke on Trent
- Centre for Sports and Exercise Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, England
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Migliorini F, Torsiello E, La Padula G, Oliva F, Maffulli N. The Association Between Sex and Osteoarthritis in the Physically Active Population: A Systematic Review. Sports Med Arthrosc Rev 2022; 30:87-91. [PMID: 35533059 DOI: 10.1097/jsa.0000000000000346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
PURPOSE Intense sporting activity and certain types of work increase the risk of early osteoarthritis (OA). OA can be idiopathic or associated to certain predisposing factors: female sex, obesity, history of joint injury, and joint overuse. The role of gender among the active population as a predisposing factor for OA is not well clear. This study investigated whether the risk of OA changes with age in both sexes in physically active individuals. MATERIALS AND METHODS This systematic review was conducted according to the PRISMA guidelines 2020. PubMed, Google Scholar, Embase, and Web of Science databases were accessed in April 2021. No time constrains were used for the search. All the published clinical studies reporting data about relationship between physical activity and OA were included. RESULTS Data from 7 articles were retrieved including 360,053 patients (271,903 males; 88,150 females). The mean age was 48.2±16.7 years. Males, under the age of 60 had a higher risk of developing OA. People undertaking intense physical activity, such as professional athletes or heavy workers, are more prone to develop early OA. CONCLUSION Physically active males demonstrated a higher risk of developing OA.
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Affiliation(s)
- Filippo Migliorini
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Aachen, Germany
| | - Ernesto Torsiello
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy
| | - Gerardo La Padula
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy
| | - Francesco Oliva
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy
| | - Nicola Maffulli
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy
- 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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Migliorini F, Marsilio E, Oliva F, Hildebrand F, Maffulli N. Elderly Runners and Osteoarthritis: A Systematic Review. Sports Med Arthrosc Rev 2022; 30:92-96. [PMID: 35533060 DOI: 10.1097/jsa.0000000000000347] [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: 10/18/2022]
Abstract
PURPOSE The impact of running on the onset of osteoarthritis (OA) is controversial. This study compared the incidence of OA in elderly runners versus nonrunners. MATERIAL AND METHODS This systematic review was conducted according to the PRISMA guidelines. PubMed, Google scholar, Embase, and Web of Science databases were accessed in January 2022. All the published clinical studies investigating OA onset in runners versus non-runners were considered. Studies reporting data on OA and participants in other sports were excluded. Only studies investigating patients with a mean age older than 55 years were considered. The methodological quality of the articles was evaluated using the Newcastle-Ottawa Scale (NOS). RESULTS Data from 3001 participants and 6674 joints were retrieved. The mean age was 59.4±2.7 years. The mean body mass index was 24.6±2.5 kg/m2. The 5 included articles (963 runners, 2038 nonrunners) did not report significant differences in runners compared with controls. CONCLUSION Middle aged runners did not present greater imaging or clinical signs of OA compared with nonrunner controls. Running at elite or recreational level did not increase the rate of OA progression in individuals older than 50 years.
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Affiliation(s)
- Filippo Migliorini
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Aachen, Germany
| | - Emanuela Marsilio
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi (SA), Italy
| | - Francesco Oliva
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi (SA), Italy
| | - Frank Hildebrand
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Aachen, Germany
| | - Nicola Maffulli
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi (SA), Italy
- 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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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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Migliorini F, Marsilio E, Torsiello E, Pintore A, Oliva F, Maffulli N. Osteoarthritis in Athletes Versus Nonathletes: A Systematic Review. Sports Med Arthrosc Rev 2022; 30:78-86. [PMID: 35533058 DOI: 10.1097/jsa.0000000000000339] [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
INTRODUCTION Joint overload and sport-related injuries may accelerate the development of osteoarthritis (OA). A systematic review of the literature was performed to establish the risk of athletes to develop premature OA compared with nonathletes. MATERIALS AND METHODS This systematic review was conducted according to the PRISMA guidelines. PubMed, Google scholar, Embase, and Web of Science databases were accessed in June 2021. All the published clinical studies investigating OA onset in athletes versus nonathletes were considered. Studies reporting data on secondary and/or post-traumatic OA were excluded. RESULTS Data from 32 articles (20,288 patients) were retrieved. The mean age was 67.8±10.0 years and the mean body mass index was 25.0±2.5 kg/m2. 74% (6859 patients) of the athletes suffered from premature OA. Of them, 21% were active in soccer, 11% in handball, 11% in ice-hockey, 3% in football, and 0.3% in rugby. 26% of the athletes reported no significant differences in OA progression compared with healthy controls. Of these athletes, 47% were runners, 5% dancers, and 1% triathletes. CONCLUSION Certain sports, such as soccer, handball, ice-hockey, and rugby are more likely to be associated with premature knee and hip OA. Conversely, runners and ballet dancers do not evidence significant increase in OA. Moderate and recreational exposure to aerobic sports does not accelerate the development of OA.
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Affiliation(s)
- Filippo Migliorini
- Department of Orthopaedics, University Clinic Aachen, RWTH Aachen University Clinic, Aachen, Germany
| | - Emanuela Marsilio
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy
| | - Ernesto Torsiello
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy
| | - Andrea Pintore
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy
| | - Francesco Oliva
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy
| | - Nicola Maffulli
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy
- School of Pharmacy and Bioengineering, Keele University Faculty of Medicine, Stoke on Trent, England
- Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, Queen Mary University of London, London, England
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Restuccia R, Ruggieri D, Magaudda L, Talotta R. The preventive and therapeutic role of physical activity in knee osteoarthritis. Reumatismo 2022; 74. [PMID: 35506320 DOI: 10.4081/reumatismo.2022.1466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 02/18/2022] [Indexed: 11/22/2022] Open
Abstract
The aim of this narrative review is to discuss the results of studies investigating the role of physical activity in knee osteoarthritis (OA). We also formulated two evidence-based exercise programs that could be prescribed to patients with symptomatic knee OA or after joint replacement. The PubMed and Google Scholar databases were searched for articles related to knee OA and physical activity. A total of 86 papers written in English and published from 1957 to 2021 were selected. Adapted physical activity, even at high intensity, does not appear to trigger or exacerbate knee OA; on the contrary, it may prevent obesity or lower limb muscle weakness, both of which are considered predisposing factors for the disease. In patients already diagnosed with knee OA, scientific evidence suggests that both land-based and aquatic activities combining aerobics, strength, and endurance programs are safe and effective. Physical interventions tailored to the patient may also accelerate recovery time after knee arthroplasty. Knee OA is a painful and disabling rheumatic disease that is very common in the elderly population. Pharmacotherapy has a modest effect in controlling disease progression, possibly due to the still limited understanding of OA pathogenesis. Non-pharmacologic interventions, including dietary and lifestyle changes and physical activity, may be more effective and safer than drugs in preventing or treating knee OA.
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Affiliation(s)
- R Restuccia
- Postgraduate School of Sports and Physical Exercise Medicine, BIOMORF Department, University of Messina.
| | - D Ruggieri
- Degree Course of Theory and Methods of Preventive and Adapted Physical Activities, BIOMORF Department, University of Messina.
| | - L Magaudda
- Postgraduate School of Sports and Physical Exercise Medicine, BIOMORF Department, University of Messina, Italy; Degree Course of Theory and Methods of Preventive and Adapted Physical Activities, BIOMORF Department, University of Messina.
| | - R Talotta
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Messina.
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Sebastianelli WJ, Hanna T, Smith NP. Treatment, Return to Play, and Performance Following Meniscus Surgery. Curr Rev Musculoskelet Med 2022; 15:157-169. [PMID: 35467166 DOI: 10.1007/s12178-022-09754-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/28/2022] [Indexed: 12/01/2022]
Abstract
PURPOSE OF REVIEW The standard of care in meniscal tear management is constantly evolving, especially for athletes and high-demand patients. Meniscus repairs, meniscus transplants, and partial meniscectomies are commonly performed, and rehabilitation methods following these operations are becoming more sophisticated. The ultimate goal of these procedures is returning patients to full activity with minimal risks. Return to play should be systematic, pathology dependent, and individualized to an athlete's needs, expectations, and level of play. This article provides a review of the current treatment modalities of meniscus tears, the rehabilitation protocols following each modality, and the return to play criteria that must be met before releasing the player to competition. In addition, it overviews articles that describe performance outcomes of patients that have undergone meniscus surgery. RECENT FINDINGS Current research shows high return to play rates for athletes that undergo meniscus surgery and describes effective rehabilitation protocols to facilitate recovery. There is an increased emphasis on meniscus preservation in recent literature. In addition, meniscus allograft transplantation has demonstrated its efficacy as a salvage procedure and has become a stronger consideration in the athlete with meniscus pathology. No standardized return to play protocol can be applied uniformly to all kinds of meniscal surgeries, and two athletes with the same pathology cannot be expected to follow identical paths towards full recovery. A multidisciplinary approach to care should be provided to the patients, and in the case of patients with high levels of athleticism, the road to recovery starts even before the injury itself.
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Affiliation(s)
- Wayne J Sebastianelli
- Penn State Department of Orthopedics and Rehabilitation, Penn State Sports Medicine, 1850 East Park Avenue, Suite 112, University Park, State College, PA, 16803, USA.
| | - Tammam Hanna
- Penn State Department of Orthopedics and Rehabilitation, Penn State Sports Medicine, 1850 East Park Avenue, Suite 112, University Park, State College, PA, 16803, USA
| | - Nathan P Smith
- Penn State College of Medicine, Department of Orthopedics and Rehabilitation, Penn State Milton S. Hershey Medical Center, Hershey, PA, 17033, USA
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Driban JB, Harkey MS, Salzler MJ. It's Time to Abandon the Label Posttraumatic Osteoarthritis. J Athl Train 2022; 57:309-311. [PMID: 35439316 PMCID: PMC9020601 DOI: 10.4085/1062-6050-1015.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Driban JB, Lo GH, Roberts MB, Harkey MS, Schaefer LF, Haugen IK, Smith SE, Duryea J, Lu B, Eaton CB, Hochberg MC, Jackson RD, Kwoh CK, Nevitt MC, McAlindon TE. Racket or Bat Sports: No Association With Thumb-Base Osteoarthritis. J Athl Train 2022; 57:341-351. [PMID: 35439314 PMCID: PMC9020592 DOI: 10.4085/1062-6050-0208.21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Repetitive joint use is a risk factor for osteoarthritis, which is a leading cause of disability. Sports requiring a racket or bat to perform repetitive high-velocity impacts may increase the risk of thumb-base osteoarthritis. However, this hypothesis remains untested. OBJECTIVE To determine if a history of participation in racket or bat sports was associated with the prevalence of thumb-base osteoarthritis. DESIGN Descriptive epidemiologic study. SETTING Four US clinical sites associated with the Osteoarthritis Initiative. PATIENTS OR OTHER PARTICIPANTS We recruited 2309 men and women from the community. Eligible participants had dominant-hand radiographic readings, hand symptom assessments, and historical physical activity survey data. MAIN OUTCOME MEASURE(S) A history of exposure to racket or bat sports (badminton, baseball or softball, racketball or squash, table tennis [or ping pong], tennis [doubles], or tennis [singles]) was based on self-reported recall data covering 3 age ranges (12-18, 19-34, and 35-49 years). Prevalent radiographic thumb-base osteoarthritis was defined as Kellgren-Lawrence grade >2 in the first carpometacarpal joint or scaphotrapezoidal joint at the Osteoarthritis Initiative baseline visit. Symptomatic thumb-base osteoarthritis was defined as radiographic osteoarthritis and hand or finger symptoms. RESULTS Radiographic or symptomatic thumb-base osteoarthritis was present in 355 (34%) and 56 (5%), respectively, of men (total = 1049) and 535 (42%) and 170 (13%), respectively, of women (total = 1260). After adjusting for age, race, and education level, we found no significant associations between a history of any racket or bat sport participation and thumb-base osteoarthritis (radiographic or symptomatic; odds ratios ranged from 0.82 to 1.34). CONCLUSIONS In a community-based cohort, a self-reported history of participation in racket or bat sports was not associated with increased odds of having radiographic or symptomatic thumb-base osteoarthritis in the dominant hand.
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Affiliation(s)
- Jeffrey B. Driban
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA
| | - Grace H. Lo
- Department of Medicine, Baylor College of Medicine, Houston, TX
| | - Mary B. Roberts
- Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, RI
| | | | | | - Ida K. Haugen
- Department of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Stacy E. Smith
- Department of
Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Jeffrey Duryea
- Department of
Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Bing Lu
- Department of
Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Charles B. Eaton
- Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, RI
| | - Marc C. Hochberg
- Departments of Medicine and Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore
| | - Rebecca D. Jackson
- Division of Endocrinology, Diabetes and Metabolism, The Ohio State University Medical Center, Columbus
| | | | - Michael C. Nevitt
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Timothy E. McAlindon
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA
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Magosch A, Urhausen AP, Mouton C, Tischer T, Seil R. Das Knie im Spitzensport. ARTHROSKOPIE 2022. [DOI: 10.1007/s00142-022-00517-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Lin Z, Deng Z, Liu J, Lin Z, Chen S, Deng Z, Li W. Chloride Channel and Inflammation-Mediated Pathogenesis of Osteoarthritis. J Inflamm Res 2022; 15:953-964. [PMID: 35177922 PMCID: PMC8846625 DOI: 10.2147/jir.s350432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 01/28/2022] [Indexed: 12/15/2022] Open
Abstract
Articular cartilage allows the human body to buffer and absorb stress during normal exercise. It is mainly composed of cartilage cells and the extracellular matrix and is surrounded by the extracellular microenvironment formed by synovial fluid and various factors in it. Studies have shown that chondrocytes are the metabolic center of articular cartilage. Under physiological conditions, the extracellular matrix is in a dynamic balance of anabolism and catabolism, and various factors and physical and chemical conditions in the extracellular microenvironment are also in a steady state. This homeostasis depends on the normal function of proteins represented by various ion channels on chondrocytes. In mammalian chondrocyte species, ion channels are mainly divided into two categories: cation channels and anion channels. Anion channels such as chloride channels have become hot research topics in recent years. These channels play an extremely important role in various physiological processes. Recently, a growing body of evidence has shown that many pathological processes, abnormal concentration of mechanical stress and chloride channel dysfunction in articular cartilage lead to microenvironment disorders, matrix and bone metabolism imbalances, which cause partial aseptic inflammation. These pathological processes initiate extracellular matrix degradation, abnormal chondrocyte death, hyperplasia of inflammatory synovium and bony. Osteoarthritis (OA) is a common clinical disease in orthopedics. Its typical manifestations are joint inflammation and pain caused by articular cartilage degeneration, but its pathogenesis has not been fully elucidated. Focusing on the physiological functions and pathological changes of chloride channels and pathophysiology of aseptic inflammation furthers the understanding of OA pathogenesis and provides possible targets for subsequent medication development.
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Affiliation(s)
- Zicong Lin
- Hand and Foot Surgery Department, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, 518035, People’s Republic of China
| | - Zhiqin Deng
- Hand and Foot Surgery Department, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, 518035, People’s Republic of China
| | - Jianquan Liu
- Hand and Foot Surgery Department, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, 518035, People’s Republic of China
| | - Zhongshi Lin
- Shenzhen Institute for Drug Control (Shenzhen Testing Center of Medical Devices), Shenzhen, Guangdong, 518057, People’s Republic of China
| | - Siyu Chen
- Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, 518035, People’s Republic of China
| | - Zhenhan Deng
- Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, 518035, People’s Republic of China
- Correspondence: Zhenhan Deng, Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, 3002 Sungang West Road, Shenzhen City, 518025, People’s Republic of China, Tel +86 13928440786, Fax +86 755-83366388, Email
| | - Wencui Li
- Hand and Foot Surgery Department, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, 518035, People’s Republic of China
- Wencui Li, Department of Hand and Foot Surgery, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, 3002 Sungang West Road, Shenzhen City, 518025, People’s Republic of China, Tel +86 13923750767, Email
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Allen KD, Thoma LM, Golightly YM. Epidemiology of osteoarthritis. Osteoarthritis Cartilage 2022; 30:184-195. [PMID: 34534661 PMCID: PMC10735233 DOI: 10.1016/j.joca.2021.04.020] [Citation(s) in RCA: 216] [Impact Index Per Article: 108.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 04/01/2021] [Accepted: 04/19/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To summarize the current state of the evidence regarding osteoarthritis (OA) prevalence, incidence and risk factors at the person-level and joint-level. DESIGN This was a narrative review that took a comprehensive approach regarding inclusion of potential risk factors. The review complements prior reviews of OA epidemiology, with a focus on new research and emerging topics since 2017, as well as seminal studies. RESULTS Studies continue to illustrate the high prevalence of OA worldwide, with a greater burden among older individuals, women, some racial and ethnic groups, and individuals with lower socioeconomic status. Modifiable risk factors for OA with the strongest evidence are obesity and joint injury. Topics of high interest or emerging evidence for a potential association with OA risk or progression include specific vitamins and diets, high blood pressure, genetic factors, metformin use, bone mineral density, abnormal joint shape and malalignment, and lower muscle strength/quality. Studies also continue to highlight the heterogenous nature of OA, with strong interest in understanding and defining OA phenotypes. CONCLUSIONS OA is an increasingly prevalent condition with worldwide impacts on many health outcomes. The strong evidence for obesity and joint injury as OA risk factors calls for heightened efforts to mitigate these risks at clinical and public health levels. There is also a need for continued research regarding how potential person- and joint-level risk factors may interact to influence the development and progression of OA.
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Affiliation(s)
- K D Allen
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Center for Health Services Research in Primary Care, Department of Veterans Affairs Medical Center, Durham, NC, USA.
| | - L M Thoma
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Division of Physical Therapy, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Y M Golightly
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Division of Physical Therapy, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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50
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Frank R, Gilat R, Haunschild ED, Huddleston H, Patel S, Evuarherhe A, Knapik DM, Drager J, Yanke AB, Cole BJ. Do Outcomes of Meniscal Allograft Transplantation Differ Based on Age and Sex? A Comparative Group Analysis. Arthroscopy 2022; 38:452-465.e3. [PMID: 34052385 DOI: 10.1016/j.arthro.2021.05.029] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 05/06/2021] [Accepted: 05/12/2021] [Indexed: 02/02/2023]
Abstract
PURPOSE To analyze the effect of patient age, sex, and associated preoperative factors on patient-reported outcome (PRO) measures and graft survival following primary meniscal allograft transplantation (MAT). METHODS A prospectively collected database was retrospectively reviewed to identify patients who underwent primary MAT with a minimum of 2 years of follow up between 1999 and 2017. Demographic, intraoperative, and postoperative outcome data were collected for each patient. Postoperative outcomes were stratified based on age and sex, and comparative statistical analysis was performed between sexes, both >40 and <40. RESULTS A total of 238 patients underwent primary MAT during the study period, of which 212 patients (mean age, 28.5 ± 9.0 years; range, 15.01-53.67 years) met the inclusion criteria with a mean follow-up of 5.1 ± 3.4 years (range 2.0-15.9 years). At final follow-up, patients ≥40 and <40 years of age demonstrated statistically significant improvements in nearly all PRO scores (P < .05 for both groups). There were no significant differences between either group for achievement of minimal clinically important difference for International Knee Documentation Committee (P = .48) or Knee Injury and Osteoarthritis Outcome Score symptoms (P = .76). Because of insufficient numbers, a statistically significant difference could not be demonstrated in reoperation rate (≥40: 1.49 ± 1.77 years, <40: 1.87 ± 1.98 years, P = .591), failure rate (≥40: 7/32 [21.9%], <40: 19/180 [10.6%], P = .072), or complication rate (≥40: 2/32 [6.3%], <40: 12/180 [6.7%], P = .930) based on age. Both sexes showed a significant improvement in PROs, whereas female patients were more likely to undergo revision surgery (P = .033), with no significant differences based on time to reoperation, failure, or complication rates. CONCLUSIONS PROs similarly improved following MAT in both patients aged ≥40 and those <40 at final follow-up with no significant differences in minimal clinically important difference achievement rate, complication rate, reoperation rate, time to reoperation, or failure rate between groups. Female patients may be more likely to undergo revision surgery after MAT. LEVEL OF EVIDENCE III; therapeutic retrospective comparison study.
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Affiliation(s)
- Rachel Frank
- Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Ron Gilat
- Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Eric D Haunschild
- Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Hailey Huddleston
- Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Sumit Patel
- Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Aghogho Evuarherhe
- Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Derrick M Knapik
- Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Justin Drager
- Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Adam B Yanke
- Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Brian J Cole
- Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, U.S.A..
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