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Mayfield CK, Liu KC, Abu-Zahra MS, Bolia IK, Gamradt SC, Weber AE, Liu JN, Petrigliano FA. Shoulder arthroplasty for inflammatory arthritis is associated with higher rates of medical and surgical complications: a nationwide matched cohort analysis from 2016-2020. J Shoulder Elbow Surg 2024; 33:e233-e247. [PMID: 37852429 DOI: 10.1016/j.jse.2023.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/03/2023] [Accepted: 09/04/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND Inflammatory arthritis (IA) represents a less common indication for anatomic and reverse total shoulder arthroplasty (TSA) than osteoarthritis (OA). The safety and efficacy of anatomic and reverse TSA in this population has not been as well studied compared to OA. We analyzed the differences in outcomes between IA and OA patients undergoing TSA. METHODS Patients who underwent primary anatomic total shoulder arthroplasty (aTSA) and reverse total shoulder arthroplasty (rTSA) from 2016-2020 were identified in the Premier Healthcare Database. Inflammatory arthritis (IA) patients were identified using International Classification of Diseases, Tenth Revision, diagnosis codes and compared to osteoarthritis controls. Patients were matched in a 1:8 fashion by age (±3 years), sex, race, and presence of pertinent comorbidities. Patient demographics, hospital factors, and patient comorbidities were compared. Multivariate regression was performed following matching to account for any residual confounding and 90-day complications were compared between the 2 cohorts. Descriptive statistics and regression analysis were employed with significance set at P < .05. RESULTS Prior to matching, 5685 IA cases and 93,539 OA controls were identified. Patients with IA were more likely to be female, have prolonged length of stay and increased total costs (P < .0001). After matching and multivariate analysis, 4082 IA cases and 32,656 controls remained. IA patients were at increased risk of deep wound infection (OR 3.14, 95% CI 1.38-7.16, P = .006), implant loosening (OR 4.11, 95% CI 1.17-14.40, P = .027), and mechanical complications (OR 6.34, 95% CI 1.05-38.20, P = .044), as well as a decreased risk of postoperative stiffness (OR 0.36, 95% CI 0.16-0.83, P = .002). Medically, IA patients were at increased risk of PE (OR 2.97, 95% CI 1.52-5.77, P = .001) and acute blood loss anemia (OR 1.27, 95% CI 1.12-1.44, P < .0001). DISCUSSION AND CONCLUSION Inflammatory arthritis represents a distinctly morbid risk profile compared to osteoarthritis patients with multiple increased surgical and postoperative medical complications in patients undergoing aTSA and rTSA. Surgeons should consider these potential complications and employ a multidisciplinary approach in preoperative risk stratification of IA undergoing shoulder replacement.
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Affiliation(s)
- Cory K Mayfield
- Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA.
| | - Kevin C Liu
- Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Maya S Abu-Zahra
- Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Ioanna K Bolia
- Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Seth C Gamradt
- Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Alexander E Weber
- Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Joseph N Liu
- Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Frank A Petrigliano
- Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA
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Qi B, Wang Z, Cao Y, Zhao H. Study on the treatment of osteoarthritis by acupuncture combined with traditional Chinese medicine based on pathophysiological mechanism: A review. Medicine (Baltimore) 2024; 103:e37483. [PMID: 38579081 PMCID: PMC10994424 DOI: 10.1097/md.0000000000037483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 02/13/2024] [Indexed: 04/07/2024] Open
Abstract
Osteoarthritis (OA) is a major contributor to disability and social costs in the elderly. As the population ages and becomes increasingly obese, the incidence of the disease is higher than in previous decades. In recent years, important progress has been made in the causes and pathogenesis of OA pain. Modern medical treatment modalities mainly include the specific situation of the patient and focus on the core treatment, including self-management and education, exercise, and related weight loss. As an important part of complementary and alternative medicine, TCM has remarkable curative effect, clinical safety, and diversity of treatment methods in the treatment of OA. Traditional Chinese Medicine treatment of OA has attracted worldwide attention. Therefore, this article will study the pathophysiological mechanism of OA based on modern medicine, and explore the treatment of OA by acupuncture combined with Chinese Medicine.
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Affiliation(s)
- Biao Qi
- Shenzhen Baoan District Shiyan People’s Hospital, Shenzhen, China
| | - Zeyu Wang
- Shenzhen Pingshan District Hospital of Traditional Chinese Medicine, Shenzhen, China
| | - Ying Cao
- Shenzhen Pingshan District Hospital of Traditional Chinese Medicine, Shenzhen, China
| | - Haishen Zhao
- Community Health Service Center of Nanhui New Town, Shanghai, China
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Nové-Josserand L, Nerot C, Colotte P, Guery J, Godenèche A. Reverse shoulder arthroplasty for primary glenohumeral osteoarthritis: significantly different characteristics and outcomes in shoulders with intact vs. torn rotator cuff. J Shoulder Elbow Surg 2024; 33:850-862. [PMID: 37633591 DOI: 10.1016/j.jse.2023.07.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 07/11/2023] [Accepted: 07/21/2023] [Indexed: 08/28/2023]
Abstract
PURPOSE To compare outcomes of reverse shoulder arthroplasty (RSA) for primary osteoarthritis (OA) with and without rotator cuff (RC) tears to those with secondary OA due to RC tears. METHODS We reviewed records of all patients who received RSA for primary OA or secondary OA. All patients had preoperative radiographs, computed tomographic arthrography (CTA), and/or magnetic resonance imaging (MRI) scans of their shoulders to assess their etiology, glenoid morphology, and fatty infiltration. Pre- and postoperative (at minimum follow-up of 2 years) Constant scores and range of motion were compared between patients who had RSA for primary OA with and without RC tears to those with secondary OA due to RC tears. RESULTS Of the initial cohort of 605 shoulders (583 patients), 153 were lost to follow-up (25.3%), 25 required revision with implant removal (4.1%), and 13 died of causes unrelated to the surgery (2.1%), and left a final cohort of 414 patients. Of the final cohort, 97 had primary OA with intact RC, 62 had primary OA with RC tears, and 255 had secondary OA. Postoperative Constant scores were significantly higher for primary OA with intact RC (73.8 ± 14.3), compared with both primary OA with RC tears (66.1 ± 14.6, P < .001) and secondary OA (64.1 ± 14.8, P < .001). There were no differences in pre- or postoperative scores between primary OA with RC tears and secondary OA. CONCLUSION At 2 or more years following RSA, Constant scores were significantly higher for primary OA with intact RC, compared to either primary OA with RC tears or secondary OA, whereas there were no differences in pre- or postoperative scores of shoulders that had primary OA with RC tears vs. secondary OA. The authors recommend distinguishing primary OA with intact RC from primary OA with RC tears, as the two have considerably different characteristics and prognosis following RSA.
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Affiliation(s)
- Laurent Nové-Josserand
- Hôpital Privé Jean Mermoz, Centre Orthopédique Santy, Ramsay Santé, Lyon, France; SoFEC - French Shoulder and Elbow Society, Paris, France
| | - Cecile Nerot
- SoFEC - French Shoulder and Elbow Society, Paris, France; Reims University Hospital, Reims, France
| | - Philippe Colotte
- Hôpital Privé Jean Mermoz, Centre Orthopédique Santy, Ramsay Santé, Lyon, France; SoFEC - French Shoulder and Elbow Society, Paris, France
| | - Jacques Guery
- SoFEC - French Shoulder and Elbow Society, Paris, France; Polyclinique du Val de Loire, ELSAN, Nevers, France
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DeClercq MG, Martin MD, Whalen RJ, Cote MP, Midtgaard KS, Peebles LA, Di Giacomo G, Provencher MT. Postoperative Radiographic Outcomes Following Primary Open Coracoid Transfer (Bristow-Latarjet) Vary in Definition, Classification, and Imaging Modality: A Systematic Review. Arthroscopy 2024; 40:1311-1324.e1. [PMID: 37827435 DOI: 10.1016/j.arthro.2023.09.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/10/2023] [Accepted: 09/17/2023] [Indexed: 10/14/2023]
Abstract
PURPOSE To analyze radiographic outcomes by conventional radiography, computed tomography (CT), or both and complication rates of open coracoid transfer at a minimum of 12-months follow-up. METHODS A literature search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, using PubMed, Medline (Ovid), and EMBASE library databases. Inclusion criteria were clinical studies reporting on open Latarjet as the primary surgical procedure(revision coracoid transfer after failed prior stabilization excluded) with postoperative radiographic outcomes at a minimum mean 1-year follow-up. Patient demographics, type of postoperative imaging modality, and radiographic outcomes and complications including graft union, osteoarthritis, and osteolysis were systematically reviewed. Data were summarized as ranges of reported values for each outcome metric. Each radiographic outcome was graphically represented in a Forest plot with point estimates of the incidence of radiographic outcomes with corresponding 95% confidence intervals and I2. RESULTS Thirty-three studies met inclusion criteria, with a total of 1,456 shoulders. The most common postoperative imaging modality was plain radiography only (n = 848 [58.2%]), both CT and radiography (n = 287 [19.7%]), and CT only (n = 321 [22.1%]). Overall, the reported graft union rate ranged from 75% to 100%, of which 79.8% (n = 395) were detected on plain radiography. The most common reported postoperative radiographic complications after the open coracoid transfer were osteoarthritis (range, 0%-100%, pooled mean 28%), graft osteolysis (range, 0%-100%, pooled mean 30%), nonunion (range, 0%-32%, pooled mean 5.1%), malpositioned graft (range, 0%-75%, pooled mean 14.75%), hardware issues (range, 0%-9.1%, pooled mean 5%), and bone block fracture (range, 0%-8%, pooled mean 2.1%). Graft healing was achieved in a majority of cases (range, 75%-100%). CONCLUSION Postoperative radiographic outcomes after open coracoid transfer vary greatly in definition, classification, and imaging modality of choice. Greater consistency in postoperative radiographic outcomes is essential to evaluate graft healing, osteolysis, and nonunion. LEVEL OF EVIDENCE Level IV, systematic review of Level III-IV studies.
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Affiliation(s)
| | | | - Ryan J Whalen
- Steadman Philippon Research Institute, Vail, Colorado
| | - Mark P Cote
- Department of Orthopaedic Surgery, University of Connecticut, Farmington, Connecticut, U.S.A
| | - Kaare S Midtgaard
- Steadman Philippon Research Institute, Vail, Colorado; Steadman Clinic, Vail, Colorado; Norwegian Armed Forces Joint Medical Services, Oslo, Norway; Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
| | | | | | - Matthew T Provencher
- Steadman Philippon Research Institute, Vail, Colorado; Steadman Clinic, Vail, Colorado.
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Liu PW, Zhang H, Werley CA, Pichler M, Ryan SJ, Lewarch CL, Jacques J, Grooms J, Ferrante J, Li G, Zhang D, Bremmer N, Barnett A, Chantre R, Elder AE, Cohen AE, Williams LA, Dempsey GT, McManus OB. A phenotypic screening platform for chronic pain therapeutics using all-optical electrophysiology. Pain 2024; 165:922-940. [PMID: 37963235 PMCID: PMC10950549 DOI: 10.1097/j.pain.0000000000003090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 08/30/2023] [Indexed: 11/16/2023]
Abstract
ABSTRACT Chronic pain associated with osteoarthritis (OA) remains an intractable problem with few effective treatment options. New approaches are needed to model the disease biology and to drive discovery of therapeutics. We present an in vitro model of OA pain, where dorsal root ganglion (DRG) sensory neurons were sensitized by a defined mixture of disease-relevant inflammatory mediators, here called Sensitizing PAin Reagent Composition or SPARC. Osteoarthritis-SPARC components showed synergistic or additive effects when applied in combination and induced pain phenotypes in vivo. To measure the effect of OA-SPARC on neural firing in a scalable format, we used a custom system for high throughput all-optical electrophysiology. This system enabled light-based membrane voltage recordings from hundreds of neurons in parallel with single cell and single action potential resolution and a throughput of up to 500,000 neurons per day. A computational framework was developed to construct a multiparameter OA-SPARC neuronal phenotype and to quantitatively assess phenotype reversal by candidate pharmacology. We screened ∼3000 approved drugs and mechanistically focused compounds, yielding data from over 1.2 million individual neurons with detailed assessment of functional OA-SPARC phenotype rescue and orthogonal "off-target" effects. Analysis of confirmed hits revealed diverse potential analgesic mechanisms including ion channel modulators and other mechanisms including MEK inhibitors and tyrosine kinase modulators. Our results suggest that the Raf-MEK-ERK axis in DRG neurons may integrate the inputs from multiple upstream inflammatory mediators found in osteoarthritis patient joints, and MAPK pathway activation in DRG neurons may contribute to chronic pain in patients with osteoarthritis.
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Affiliation(s)
- Pin W. Liu
- Quiver Bioscience, Cambridge, MA, United States
| | | | | | | | | | | | | | | | | | - Guangde Li
- Quiver Bioscience, Cambridge, MA, United States
| | - Dawei Zhang
- Quiver Bioscience, Cambridge, MA, United States
| | | | | | | | | | - Adam E. Cohen
- Department of Chemistry and Chemical Biology, Harvard University, Cambridge, MA, United States
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Ide J, Shoaibi A, Wagner K, Weinstein R, Boyle KE, Myers A. Patterns of Comorbidities and Prescribing and Dispensing of Non-steroidal Anti-inflammatory Drugs (NSAIDs) Among Patients with Osteoarthritis in the USA: Real-World Study. Drugs Aging 2024; 41:357-366. [PMID: 38520626 PMCID: PMC11021340 DOI: 10.1007/s40266-024-01108-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND Osteoarthritis (OA) is a major cause of chronic pain. Non-steroidal anti-inflammatory drugs (NSAIDs) are analgesics commonly used for musculoskeletal pain; however, NSAIDs can increase the risk of certain adverse events, such as gastrointestinal bleeding, edema, heart failure, and hypertension. OBJECTIVE The objective of this study was to characterize existing comorbidities among patients with OA. For patients with OA with and without a coexisting medical condition of interest (CMCOI), we estimated the prevalence of prescribing and dispensing NSAIDs pre-OA and post-OA diagnosis. METHODS Data from three large administrative claims databases were used to construct an OA retrospective cohort. Databases leveraged were IBM MarketScan Medicare Supplemental Database (MDCR), IBM MarketScan Commercial Database (CCAE), and Optum's de-identified Clinformatics® Data Mart Database (Optum CDM). The OA study population was defined to be those patients who had an OA diagnosis from an inpatient or outpatient visit with at least 365 days of prior observation time in the database during January 2000 through May 2021. Asthma, cardiovascular disorders, renal impairment, and gastrointestinal bleeding risks were the CMCOI of interest. Patients with OA were then classified as having or not having evidence of a CMCOI. For both groups, NSAID dispensing patterns pre-OA and post-OA diagnosis were identified. Descriptive analysis was performed within the Observational Health Data Sciences and Informatics framework. RESULTS In each database, the proportion of the OA population with at least one CMCOI was nearly 50% or more (48.0% CCAE; 74.4% MDCR; 68.6% Optum CDM). Cardiovascular disease was the most commonly observed CMCOI in each database, and in two databases, nearly one in four patients with OA had two or more CMCOI (23.2% MDCR; 22.6% Optum CDM). Among the OA population with CMCOI, NSAID utilization post-OA diagnosis ranged from 33.0 to 46.2%. Following diagnosis of OA, an increase in the prescribing and dispensing of NSAIDs was observed in all databases, regardless of patient CMCOI presence. CONCLUSIONS This study provides real-world evidence of the pattern of prescribing and dispensing of NSAIDs among patients with OA with and without CMCOI, which indicates that at least half of patients with OA in the USA have a coexisting condition. These conditions may increase the risk of side effects commonly associated with NSAIDs. Yet, at least 32% of these patients were prescribed and dispensed NSAIDs. These data support the importance of shared decision making between healthcare professionals and patients when considering NSAIDs for the treatment of OA in patients with NSAID-relevant coexisting medical conditions.
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Affiliation(s)
- Joshua Ide
- Johnson & Johnson Consumer Inc., Skillman, NJ, 08558, USA.
| | | | - Kerstin Wagner
- Johnson & Johnson Consumer Inc., Skillman, NJ, 08558, USA
| | | | | | - Andrew Myers
- Johnson & Johnson Consumer Inc., Fort Washington, PA, USA
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7
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Smith M, Murrell JC, Mendl M. Spatial working memory in a disappearing object task is impaired in female but not male dogs with chronic osteoarthritis. Anim Cogn 2024; 27:13. [PMID: 38429533 PMCID: PMC10907419 DOI: 10.1007/s10071-024-01845-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 10/31/2023] [Accepted: 11/18/2023] [Indexed: 03/03/2024]
Abstract
Chronic pain in humans is associated with impaired working memory but it is not known whether this is the case in long-lived companion animals, such as dogs, who are especially vulnerable to developing age-related chronic pain conditions. Pain-related impairment of cognitive function could have detrimental effects on an animal's ability to engage with its owners and environment or to respond to training or novel situations, which may in turn affect its quality of life. This study compared the performance of 20 dogs with chronic pain from osteoarthritis and 21 healthy control dogs in a disappearing object task of spatial working memory. Female neutered osteoarthritic dogs, but not male neutered osteoarthritic dogs, were found to have lower predicted probabilities of successfully performing the task compared to control dogs of the same sex. In addition, as memory retention interval in the task increased, osteoarthritic dogs showed a steeper decline in working memory performance than control dogs. This suggests that the effects of osteoarthritis, and potentially other pain-related conditions, on cognitive function are more clearly revealed in tasks that present a greater cognitive load. Our finding that chronic pain from osteoarthritis may be associated with impaired working memory in dogs parallels results from studies of human chronic pain disorders. That female dogs may be particularly prone to these effects warrants further investigation.
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Affiliation(s)
- Melissa Smith
- Bristol Veterinary School, University of Bristol, Langford House, Langford, BS40 5DU, UK
| | - Joanna C Murrell
- Bristol Veterinary School, University of Bristol, Langford House, Langford, BS40 5DU, UK
- Highcroft Veterinary Referrals, 615 Wells Rd, Whitchurch, Bristol, BS14 9BE, UK
| | - Michael Mendl
- Bristol Veterinary School, University of Bristol, Langford House, Langford, BS40 5DU, UK.
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Malek N, Mlost J, Kostrzewa M, Rajca J, Starowicz K. Description of Novel Molecular Factors in Lumbar DRGs and Spinal Cord Factors Underlying Development of Neuropathic Pain Component in the Animal Model of Osteoarthritis. Mol Neurobiol 2024; 61:1580-1592. [PMID: 37731080 PMCID: PMC10896862 DOI: 10.1007/s12035-023-03619-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 08/28/2023] [Indexed: 09/22/2023]
Abstract
Osteoarthritis (OA) is one of the most common joint disorder, with pain accompanied by functional impairment, as the most pronounced clinical symptom. Currently used pharmacotherapy involves symptomatic treatment that do not always provide adequate pain relief. This may be due to concomitance of central sensitization and development of neuropathic features in OA patients. Here we performed studies in the animal model of OA to investigate of the neuropathic component. Intraarticular injection of monoiodoacetate (MIA, 1 mg) was used to induce OA in Wistar male rats. Development of pain phenotype was assessed by behavioral testing (PAM test and von Frey's test), while corresponding changes in dorsal root ganglia (DRGs L3-L5) and spinal cord (SC) gene expression were assessed by means of qRT-PCR technique. We also performed microtomography of OA-affected knee joints to correlate the level of bone degradation with observed behavioral and molecular changes. We observed gradually developing remote allodynia after MIA treatment, indicating the presence of neuropathic component. Our results showed that, among DRGs innervating knee joint, development of central sensitization is most likely due to peripheral input of stimuli through DRG L5. In SC, development of secondary hypersensitivity correlated with increased expression of TAC1 and NPY. Our studies provided molecular records on abnormal activation of pain transmission markers in DRG and SC during development of OA that are responsible for the manifestation of neuropathic features. The obtained results increase insight into molecular changes occurring in the neuronal tissue during OA development and may contribute to readdressing treatment paradigms.
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Affiliation(s)
- Natalia Malek
- Department of Neurochemistry, Maj Institute of Pharmacology, Polish Academy of Sciences, Krakow, Poland.
- Department of Chemical Biology and Bioimaging, Faculty of Chemistry, Wroclaw University of Science and Technology, Wroclaw, Poland.
| | - Jakub Mlost
- Department of Neurochemistry, Maj Institute of Pharmacology, Polish Academy of Sciences, Krakow, Poland
| | - Magdalena Kostrzewa
- Department of Neurochemistry, Maj Institute of Pharmacology, Polish Academy of Sciences, Krakow, Poland
| | - Jolanta Rajca
- Galen Orthopaedics, Bierun, Poland
- Galen Lab, Bierun, Poland
| | - Katarzyna Starowicz
- Department of Neurochemistry, Maj Institute of Pharmacology, Polish Academy of Sciences, Krakow, Poland
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Buldt AK, Gregory JS, Munteanu SE, Allan JJ, Tan JM, Auhl M, Landorf KB, Roddy E, Marshall M, Menz HB. Association of Bone Shape and Alignment Analyzed Using Statistical Shape Modeling With Severity of First Metatarsophalangeal Joint Osteoarthritis. Arthritis Care Res (Hoboken) 2024; 76:385-392. [PMID: 37728065 DOI: 10.1002/acr.25237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 08/22/2023] [Accepted: 09/14/2023] [Indexed: 09/21/2023]
Abstract
OBJECTIVE We aimed to explore the relationship between bone shape and radiographic severity in individuals with first metatarsophalangeal joint osteoarthritis (first MTP joint OA). METHODS Weightbearing lateral and dorsoplantar radiographs were obtained for the symptomatic foot of 185 participants (105 females, aged 22 to 85 years) with clinically diagnosed first MTP joint OA. Participants were classified into none/mild, moderate, or severe categories using a standardized atlas. An 80-point model for lateral radiographs and 77-point model for dorsoplantar radiographs was used to define independent modes of variation using statistical shape modeling software. Odds ratios adjusted for confounders were calculated using ordinal regression to determine the association between radiographic severity and mode scores. RESULTS After assessment and grading of radiographs, 35 participants (18.9%) were included in the none/mild first MTP joint OA severity category, 69 (37.2%) in the moderate severity category, and 81 (43.7%) in the severe category. For lateral-view radiographs, 16 modes of variation were included, which collectively represented 83.2% of total shape variance. Of these, four modes were associated with radiographic severity. For dorsoplantar-view radiographs, 15 modes of variation were included, representing 82.6% of total shape variance. Of these, six modes were associated with radiographic severity. CONCLUSIONS Variations in the shape and alignment of the medial cuneiform, first metatarsal, and proximal and distal phalanx of the hallux are significantly associated with radiographic severity of first MTP joint OA. Prospective studies are required to determine whether bone shape characteristics are associated with the development and/or progression of this condition.
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Affiliation(s)
| | | | | | | | - Jade M Tan
- The University of Western Australia, Crawley, Perth, Western Australia, Australia
| | - Maria Auhl
- La Trobe University, Melbourne, Victoria, Australia
| | | | - Edward Roddy
- Keele University, Keele, Staffordshire, UK and Midlands Partnership University NHS Foundation Trust, Haywood Hospital, Burslem, Staffordshire, UK
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Andronic O, Chaharbakhshi EO, Zingg PO, Germann C, Rahm S, Lall AC, Domb BG. No Difference in Patient-Reported Outcomes for Periacetabular Osteotomy and Hip Arthroscopy With Capsular Plication in the Setting of Borderline Hip Dysplasia: A Propensity-Matched Multicenter Study With Minimum 5-Year Follow-Up. Arthroscopy 2024; 40:754-762. [PMID: 37422025 DOI: 10.1016/j.arthro.2023.06.045] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 06/22/2023] [Accepted: 06/22/2023] [Indexed: 07/10/2023]
Abstract
PURPOSE To compare minimum 5-year patient-reported outcome measures after hip arthroscopy (HA) and periacetabular osteotomy (PAO) for borderline hip dysplasia. METHODS Hips with a lateral center-edge angle (LCEA) between 18° and less than 25° that underwent either PAO or HA were selected from 2 institutions. The exclusion criteria were as follows: LCEA less than 18°, Tönnis osteoarthritis grade greater than 1, prior hip surgical procedures, active inflammatory disease, Workers' Compensation, and concomitant surgery. Patients underwent propensity matching based on age, sex, body mass index, and Tönnis osteoarthritis grade. Patient-reported outcome measures included the modified Harris Hip Score, as well as calculation of the minimal clinically important difference, patient acceptable symptom state, and maximum outcome improvement satisfaction threshold. Preoperative radiographic predictors included comparison of the Femoro-epiphyseal Acetabular Roof index and ligamentum teres lesions. RESULTS A total of 28 PAO patients underwent propensity matching to 49 HA patients. The 2 groups were similar in terms of mean age, sex, preoperative body mass index, and LCEA. The PAO group had a longer mean follow-up period (95.8 months vs 81.3 months, P = .001). The mean Femoro-epiphyseal Acetabular Roof index was significantly lower preoperatively in the HA group (P < .001). The 2 groups showed similar and significant improvements in the mean modified Harris Hip Score from preoperatively to latest follow-up (P < .001). The relative risk of subsequent surgery in the PAO group was 3.49 (P = .024), mostly attributed to hardware removal (25%). The revision rate was 3.6% in the PAO group and 8.2% in the HA group (P = .65). One patient in the PAO group required revision HA for intra-articular adhesions. Three of the patients requiring revision in the HA group underwent PAO because of persistent pain, and one underwent revision HA alone. Conversion to total hip arthroplasty was required in 1 patient in the HA group and no patients in the PAO group. CONCLUSIONS Both PAO and HA with capsular plication provide borderline hip dysplasia patients with clinically significant improvements and low revision rates at a minimum of 5 years postoperatively. LEVEL OF EVIDENCE Level III, retrospective, comparative therapeutic trial.
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Affiliation(s)
- Octavian Andronic
- Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
| | | | - Patrick O Zingg
- Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Christoph Germann
- Department of Radiology, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Stefan Rahm
- Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Ajay C Lall
- LALL Orthopedics Research Academy, Paramus, New Jersey, U.S.A
| | - Benjamin G Domb
- American Hip Institute Research Foundation, Chicago, Illinois, U.S.A
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Lichtiger A, Fadaei G, Tagoe CE. Autoimmune thyroid disease and rheumatoid arthritis: where the twain meet. Clin Rheumatol 2024; 43:895-905. [PMID: 38340224 PMCID: PMC10876734 DOI: 10.1007/s10067-024-06888-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 01/12/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024]
Abstract
Autoimmune thyroid disease (AITD) is the most prevalent autoimmune disease. It shares multiple genetic, clinical, and serologic characteristics with rheumatoid arthritis (RA). Although frequently described as a classic form of single-organ autoimmunity, the AITD disease burden in a subset of patients extends well beyond the thyroid gland. This review explores the complex interaction between the two diseases and the clinical consequences when they overlap. Beyond the well-known effects of AITD on thyroid function in RA, there is mounting evidence of the association of both conditions impacting the presentation and outcomes of diabetes, metabolic syndrome, and cardiovascular disease. An increasing number of studies suggest that there are negative effects of AITD on RA disease activity both in the presence and in the absence of thyroid dysfunction. Recent evidence suggests that AITD may not only worsen the cumulative damage of RA through higher disease activity but may also worsen secondary osteoarthritis changes. Less well-known is the significant association between AITD and chronic widespread pain syndromes including fibromyalgia. Importantly, the presence of fibromyalgia, which is increased in RA patients, appears to be further increased when it overlaps with AITD. Lastly, we probe the possible influence of AITD interacting with RA on fertility and clinical depression. Key Points • Autoimmune thyroid disease is the most common autoimmune disease and is frequently associated with rheumatoid arthritis. • Autoimmune thyroid disease can present with osteoarthritis, inflammatory arthritis, and chronic widespread pain syndromes. • The co-occurrence of autoimmune thyroid disease and rheumatoid arthritis may worsen disease activity and exacerbate other disease manifestations including cardiovascular disease, fertility, and depression. • The overlap of rheumatoid arthritis with autoimmune thyroid disease needs further research and should be sought in general clinical practice.
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Affiliation(s)
- Anna Lichtiger
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | | | - Clement E Tagoe
- Division of Rheumatology, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA.
- Division of Rheumatology, Montefiore Medical Center, 111 East 210th Street, Bronx, NY, 10467-2490, USA.
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Hosokawa T, Ikoma K, Maki M, Kido M, Hara Y, Sotozono Y, Takahashi K. Relationship between arthritis of the second and third tarsometatarsal joints and incongruity of the first tarsometatarsal joint in patients with hallux valgus. Mod Rheumatol 2024; 34:410-413. [PMID: 36688576 DOI: 10.1093/mr/road009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 12/12/2022] [Accepted: 01/04/2023] [Indexed: 01/24/2023]
Abstract
OBJECTIVES Hallux valgus is associated with tarsometatarsal arthritis; its pathophysiology remains unknown. Therefore, we aimed to elucidate the relationship between arthritis of the second and third tarsometatarsal joints and incongruity of the first tarsometatarsal joint in the sagittal plane. METHODS Forty-three patients (64 feet) with hallux valgus who underwent surgery at University Hospital Kyoto Prefectural University of Medicine were included and divided into two groups: control (without second and third tarsometatarsal joint degeneration) and osteoarthritis (with second and third tarsometatarsal joint degeneration). Intergroup comparisons of the incongruity of the first tarsometatarsal joint in the sagittal plane, age, body mass index, hallux valgus angle, first-second intermetatarsal angle, metatarsus adductus angle, Meary's angle, and calcaneal pitch angle were performed. RESULTS The proportion of patients with incongruity of the first tarsometatarsal joint was significantly higher in the osteoarthritis group than in the control group. Logistic regression analysis identified incongruity of the first tarsometatarsal joint and metatarsus adductus angle as significant related factors for arthritis of the second and third tarsometatarsal joints. CONCLUSIONS Incongruity of the first tarsometatarsal joint in the sagittal plane was involved in the development of arthritis of the second and third tarsometatarsal joints in patients with hallux valgus.
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Affiliation(s)
- Toshihiro Hosokawa
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kazuya Ikoma
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Masahiro Maki
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Masamitsu Kido
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yusuke Hara
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yasutaka Sotozono
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kenji Takahashi
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Hu NY, Li YJ, Chen LL, Sun BL, Yang Y. [Total knee arthroplasty for Paget's bone disease complicated with osteoarthritis:a case report]. Zhongguo Gu Shang 2024; 37:211-3. [PMID: 38425075 DOI: 10.12200/j.issn.1003-0034.20220227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Affiliation(s)
- Nai-Yan Hu
- Department of Orthopaedics, Ansteel Hospital, Anshan 114008, Liaoning, China
| | - Yu-Jun Li
- Beijing Jishuitan hospital, Beijing 100035, China
| | - Lin-Lin Chen
- Department of Orthopaedics, Ansteel Hospital, Anshan 114008, Liaoning, China
| | - Bao-Ling Sun
- Department of Orthopaedics, Ansteel Hospital, Anshan 114008, Liaoning, China
| | - Yu Yang
- Department of Orthopaedics, Ansteel Hospital, Anshan 114008, Liaoning, China
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Lee YH, Hong SJ, Lee GJ, Shin SI, Hong JY, Chung SW, Lee YA. Investigation of periodontitis, halitosis, xerostomia, and serological characteristics of patients with osteoarthritis and rheumatoid arthritis and identification of new biomarkers. Sci Rep 2024; 14:4316. [PMID: 38383594 PMCID: PMC10881463 DOI: 10.1038/s41598-024-55004-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/19/2024] [Indexed: 02/23/2024] Open
Abstract
Rheumatoid arthritis (RA) and osteoarthritis (OA) are two different types of arthritis. Within RA, the subsets between seronegative RA (snRA) and seropositive RA (spRA) represent distinct disease entities; however, identifying clear distinguishing markers between them remains a challenge. This study investigated and compared the oral health conditions in patients with RA and OA to clarify the differences from healthy controls. In addition, we investigated the serological characteristics of the patients, the factors that distinguished patients with RA from those with OA, and the main factors that differentiated between snRA and spRA patients. A total of 161 participants (mean age: 52.52 ± 14.57 years, 32 males and 129 females) were enrolled in this study and categorized as: normal (n = 33), OA (n = 31), and RA (n = 97). Patients with RA were divided into the following two subtypes: snRA (n = 18) and spRA (n = 79). Demographics, oral health, and serological characteristics of these patients were compared. The prevalence of periodontal diseases was significantly higher in patients with OA (100%) and RA (92.8%) than in healthy controls (0.0%). However, the presence of periodontal diseases was not utilized as a distinguishing factor between OA and RA. Xerostomia occurred more frequently in patients with RA (84.5%) than in patients with OA (3.2%) and healthy controls (0.0%) (all p < 0.001). ROC analysis revealed that periodontal disease was a very strong predictor in the diagnosis of OA compared to healthy controls, with an AUC value of 1.00 (p < 0.001). Additionally, halitosis (AUC = 0.746, 95% CI 0.621-0.871, p < 0.001) and female sex (AUC = 0.663, 95% CI 0.529-0.797, p < 0.05) were also significant predictors of OA. The strongest predictors of RA diagnosis compared to healthy controls were periodontal diseases (AUC = 0.964), followed by xerostomia (AUC = 0.923), age (AUC = 0.923), female sex (AUC = 0.660), and halitosis (AUC = 0.615) (all p < 0.05). Significant serological predictors of RA were anti-CCP Ab (AUC = 0.808), and RF (AUC = 0.746) (all p < 0.05). In multiple logistic regression analysis, xerostomia (odds ratio, OR: 8124.88, 95% CI 10.37-6368261.97, p-value = 0.008) and Anti-CCP Ab (OR: 671.33, 95% CI 2.18-207,074.02, p = 0.026) were significant predictors for RA compared to OA. When diagnosing spRA compared to snRA, anti-CCP Ab (AUC = 1.000, p < 0.001) and RF (AUC = 0.910, 95%CI 0.854-0.967, p < 0.001) had outstanding predictive performances. Therefore, clinicians and researchers should thoroughly evaluate the oral status of both OA and RA patients, alongside serological factors, and consider these elements as potential predictors.
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Affiliation(s)
- Yeon-Hee Lee
- Department of Orofacial Pain and Oral Medicine, Kyung Hee University Dental Hospital, #613 Hoegi-dong, Dongdaemun-gu, Seoul, 02447, Korea.
| | - Seung-Jae Hong
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, Kyung Hee University, Dongdaemun-gu, Seoul, 02447, Korea
| | - Gi-Ja Lee
- Department of Biomedical Engineering, Kyung Hee University, Dongdaemun-gu, Seoul, 02447, Korea
| | - Seung-Il Shin
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, Dongdaemun-gu, Seoul, 02447, Korea
| | - Ji-Youn Hong
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, Dongdaemun-gu, Seoul, 02447, Korea
| | - Sang Wan Chung
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, Kyung Hee University, Dongdaemun-gu, Seoul, 02447, Korea
| | - Yeon-Ah Lee
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, Kyung Hee University, Dongdaemun-gu, Seoul, 02447, Korea.
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Liang Z, Wu D, Zhang H, Gu J. Association between asymptomatic hyperuricemia and risk of arthritis, findings from a US National Survey 2007-2018. BMJ Open 2024; 14:e074391. [PMID: 38346893 PMCID: PMC10862310 DOI: 10.1136/bmjopen-2023-074391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 01/11/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Arthritis is thought to be closely related to serum uric acid. The study aims to assess the association between asymptomatic hyperuricemia (AH) and arthritis. METHODS A multistage, stratified cluster was used to conduct a cross-sectional study of adult US civilians aged≥20 years from the 2007-2018 National Health and Nutrition Examination Survey. Participants with hyperuricemia and without hyperuricemia prior to gout were included. A questionnaire was used to determine whether participants had arthritis and the type of arthritis. Logistic regression was used to investigate the association between hyperuricemia and arthritis. RESULT During the past 12 years, the percentage of participants with arthritis changed from 25.95% (22.53%-29.36%) to 25.53% (21.62%-29.44%). The prevalence of osteoarthritis (OA) increased from 8.70% (95% CI: 6.56% to 10.85%) to 12.44% (95% CI: 9.32% to 15.55%), the prevalence of AH changed from 16.35% (95% CI: 14.01% to 18.40%) to 16.39% (95% CI: 13.47% to 19.30%). Participants with AH were associated with onset of arthritis (OR=1.34, 95% CI: 1.07 to 1.69), but the association was muted after adjusting demographic and socioeconomic factors. For participants aged 40-49 years, AH is associated with incident arthritis (OR=1.96, 95% CI: 1.23 to 2.99) and the relationship remained after adjusting for education level, income to poverty ratio, body mass index, diabetes, hypertension and smoking (OR=2.00, 95% CI: 1.94 to 3.36). Compared with male, female participants with AH are more likely to develop arthritis, especially in OA (OR=1.35, 95% CI: 1.14 to 1.60). CONCLUSION Our data identified AH as the risk factor for incident arthritis, especially for OA, which might be exaggerated in aged population and female population.
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Affiliation(s)
- Zhenguo Liang
- Department of Rheumatology and Immunology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong, China
- Department of Rheumatology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Dongze Wu
- Department of Rheumatology and Immunology, University of Electronic Science and Technology of China Sichuan Provincial People's Hospital, Chengdu, Sichuan, China
| | - Hua Zhang
- Department of Rheumatology and Immunology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong, China
| | - Jieruo Gu
- Department of Rheumatology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
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16
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Kulakli S, Kulakli F, Yilmaz B, Sari İF, Oğuz ID. Is seborrheic dermatitis associated with early-stage osteoarthritis? Medicine (Baltimore) 2024; 103:e37217. [PMID: 38335384 PMCID: PMC10860987 DOI: 10.1097/md.0000000000037217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2024] Open
Abstract
Seborrheic dermatitis (SD) and osteoarthritis involve similar factors in their pathogenesis. Both of these diseases are associated with an increased frequency of metabolic syndrome and underlying systemic inflammation. This study evaluated the thickness of the distal femoral cartilage using ultrasonography in patients with SD. The study enrolled 60 patients with SD (19 females and 41 males, mean age: 34.07 ± 12.56 years) and 60 controls matched for age and sex (20 females and 40 males, mean age: 35.08 ± 12.78 years). Ultrasonography was used to measure the distal femoral cartilage thickness (FCT) of the right medial condyle, right lateral condyle, right intercondylar area, left medial condyle, left lateral condyle, and left intercondylar area. FCT values at all points were significantly higher in patients with SD than in the controls (P < .05). Further, all FCT values were significantly higher in patients with moderate SD than in those with mild SD (P < .001). A strong positive correlation was observed between disease severity and FCT measured at right medial condyle (r = .7, P < .001), right lateral condyle (r = .749, P < .001), right intercondylar area (r = .79, P < .001), left medial condyle (r = .624, P < .001), and left intercondylar area (r = .703, P < .001). Further, a moderately positive correlation was observed between disease severity and FCT measured at left lateral condyle (r = .581, P < .001). Increased FCT in patients with SD might be an early indicator of osteoarthritis. However, further studies, especially those evaluating older patients with SD, are required to support our findings.
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Affiliation(s)
- Sevgi Kulakli
- Giresun University Faculty of Medicine, Department of Dermatology and Venereology, Giresun, Turkey
| | - Fazil Kulakli
- Giresun University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Giresun, Turkey
| | - Betül Yilmaz
- Giresun University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Giresun, Turkey
| | - İlker Fatih Sari
- Giresun University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Giresun, Turkey
| | - Işil Deniz Oğuz
- Giresun University Faculty of Medicine, Department of Dermatology and Venereology, Giresun, Turkey
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Jennewine BR, James NF, Polio WP, Naser AM, Nieboer MJ, Schoch BS, Throckmorton TW, Bernholt DL, Azar FM, Brolin TJ. Superior humeral head osteophytes are associated with rotator cuff insufficiency in glenohumeral osteoarthritis: a retrospective analysis. Eur J Orthop Surg Traumatol 2024; 34:893-900. [PMID: 37770594 DOI: 10.1007/s00590-023-03727-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 09/04/2023] [Indexed: 09/30/2023]
Abstract
PURPOSE The primary goal of this study was to investigate whether superior humeral head osteophyte (SHO) size is associated with rotator cuff insufficiency, including rotator cuff tear (RCT), supraspinatus tendon thickness, and fatty infiltration of the rotator cuff muscles. METHODS Patients ≥ 18 years who were diagnosed with glenohumeral osteoarthritis were retrospectively reviewed. SHO size was determined by radiograph. MRI measured SHO and RCT presence, type, and size; supraspinatus tendon thickness; and fatty infiltration of rotator cuff musculature. RESULTS A total of 461 patients were included. Mean SHO size was 1.93 mm on radiographs and 2.13 mm on MRI. Risk ratio for a RCT was 1.14. For each 1-mm increase in SHO size on radiograph, supraspinatus tendon thickness decreased by 0.20 mm. SHO presence was associated with moderate-to-severe fatty infiltration of the supraspinatus with a risk ratio of 3.16. CONCLUSION SHOs were not associated with RCT but were associated with higher risk of supraspinatus FI and decreased tendon thickness, which could indicate rotator cuff insufficiency. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Brenton R Jennewine
- Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center-Campbell Clinic, 1211 Union Avenue, Suite 510, Memphis, TN, 38104, USA
| | - Nicholas F James
- Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center-Campbell Clinic, 1211 Union Avenue, Suite 510, Memphis, TN, 38104, USA
| | - William P Polio
- Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center-Campbell Clinic, 1211 Union Avenue, Suite 510, Memphis, TN, 38104, USA
| | - Abu Mohd Naser
- Division of Epidemiology, Biostatistics, and Environmental Health, University of Memphis, Memphis, TN, USA
| | - Micah J Nieboer
- Department of Orthopaedic Surgery, Mayo Clinic, Jacksonville, FL, USA
| | - Bradley S Schoch
- Department of Orthopaedic Surgery, Mayo Clinic, Jacksonville, FL, USA
| | - Thomas W Throckmorton
- Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center-Campbell Clinic, 1211 Union Avenue, Suite 510, Memphis, TN, 38104, USA
| | - David L Bernholt
- Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center-Campbell Clinic, 1211 Union Avenue, Suite 510, Memphis, TN, 38104, USA
| | - Frederick M Azar
- Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center-Campbell Clinic, 1211 Union Avenue, Suite 510, Memphis, TN, 38104, USA
| | - Tyler J Brolin
- Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center-Campbell Clinic, 1211 Union Avenue, Suite 510, Memphis, TN, 38104, USA.
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Vela J, Dreyer L, Petersen KK, Arendt-Nielsen L, Duch KS, Amris K, Kristensen S. Quantitative sensory testing, psychological profiles and clinical pain in patients with psoriatic arthritis and hand osteoarthritis experiencing pain of at least moderate intensity. Eur J Pain 2024; 28:310-321. [PMID: 37712295 DOI: 10.1002/ejp.2183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 08/20/2023] [Accepted: 08/27/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Chronic pain is the hallmark symptom of joint diseases. This study examined the differences in quantitative sensory testing between patients with psoriatic arthritis (PsA), hand osteoarthritis (hand-OA) and a pain-free control group and differences between patients with and without concomitant fibromyalgia (cFM). METHODS All patients and pain-free controls were assessed using pressure pain thresholds (PPT), temporal summation of pain (TSP), conditioned pain modulation (CPM) and clinical pain intensities. Psychological distress was assessed with the Hospital Anxiety and Depression Scale, Pain Catastrophizing Scale, and Pittsburgh Sleep Quality Index. Disability was assessed with the Health Assessment Questionnaire and pain quality with the painDETECT questionnaire. cFM was identified using the revised 2016 American College of Rheumatology diagnostic criteria. RESULTS Patients with hand-OA (n = 75) or PsA (n = 58) had statistically significant lower PPTs and CPM, greater TSP, and higher scores of psychological distress (p < 0.05) than controls (n = 20). Patients with cFM (58%) had higher scores of depression (p = 0.001), anxiety (p = 0.004), catastrophizing (p = 0.012), disability (p < 0.001), higher painDETECT score (p = 0.001), TSP (p = 0.027), and reduced sleep quality (p = 0.021) when compared to patients without cFM. CONCLUSION Patients with hand-OA and PsA exhibited signs of pain sensitization and a higher degree of psychological distress and disability than pain-free individuals. Patients with cFM had greater TSP, painDETECT score, disability, catastrophizing, and reduced sleep quality, than patients without, indicating greater degree of pain sensitization, psychological burden, and disability. STATEMENT OF SIGNIFICANCE This paper shows that a significant proportion of patients with hand osteoarthritis and psoriatic arthritis with moderate pain intensity have significantly increased signs of pain sensitization and markers of psychological distress. A large proportion of these patients fulfil the criteria for concomitant fibromyalgia and these patients show even greater propensity towards pain sensitization and psychological distress.
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Affiliation(s)
- J Vela
- Center of Rheumatic Research Aalborg (CERRA), Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - L Dreyer
- Center of Rheumatic Research Aalborg (CERRA), Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - K K Petersen
- Centre for Neuroplasticity and Pain, SMI, School of Medicine, Aalborg University, Aalborg, Denmark
- Center for Mathematical Modelling of Knee Osteoarthritis, Department of Materials and Production, Aalborg University, Aalborg, Denmark
| | - L Arendt-Nielsen
- Centre for Neuroplasticity and Pain, SMI, School of Medicine, Aalborg University, Aalborg, Denmark
- Department of Gastroenterology & Hepatology, Mech-Sense, Aalborg University Hospital, Aalborg, Denmark
| | - K Skjaerbaek Duch
- Center of Rheumatic Research Aalborg (CERRA), Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark
- Unit of Clinical Biostatistics, Aalborg University Hospital, Aalborg, Denmark
| | - K Amris
- Parker Institute, Copenhagen University Hospital, Frederiksberg, Denmark
| | - S Kristensen
- Center of Rheumatic Research Aalborg (CERRA), Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Kloppenburg M. Synovial inflammation in osteoarthritis. A treatable target? Semin Arthritis Rheum 2024; 64S:152326. [PMID: 38008705 DOI: 10.1016/j.semarthrit.2023.152326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 09/23/2023] [Indexed: 11/28/2023]
Abstract
Synovial inflammation is present in osteoarthritis and associated with pain and structural damage, so it is hypothesized that anti-inflammatory drugs might be of use in osteoarthritis. However, nine randomized clinical trials targeting pro-inflammatory cytokines, especially IL-1 and TNFα, did not show an effect on short-term pain relief (as primary end-points). These results were rather disappointing. The questions is whether the results reflect a true lack of effect of anti-inflammatory drugs in osteoarthritis, or whether there are alternative explanations. Currently, we lack insight in the pathobiology of the synovitis-driven endotype and in cross-talk between tissues in the osteoarthritic joint, complicating identification of the appropriate patients for trials and of the best outcome measures. Furthermore we lack classification criteria to define inflammatory osteoarthritis complicating selection of patients. We do know that anti-inflammatory corticosteroids alleviate pain in osteoarthritis, warranting further investigation of other mediators than IL-1 and TNFα. Now, trials are set up with short follow-up aiming for short-term pain alleviation. For investigation of pain alleviation in the context of disease modification, trials with at least one year follow-up should be performed.
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Affiliation(s)
- Margreet Kloppenburg
- Departments of Rheumatology and Clinical Epidemiology, Leiden University Medical Centre, Postbox 9600, Leiden 2300RC, the Netherlands.
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Kvist J, Pettersson M. Knee-Related Quality of Life Compared Between 20 and 35 Years After an Anterior Cruciate Ligament Injury Treated Surgically With Primary Repair or Reconstruction, or Nonsurgically. Am J Sports Med 2024; 52:311-319. [PMID: 38230888 PMCID: PMC10838479 DOI: 10.1177/03635465231218237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 10/06/2023] [Indexed: 01/18/2024]
Abstract
BACKGROUND Quality of life (QoL) is affected up to 5 years after an anterior cruciate ligament (ACL) injury. Knee impairment and osteoarthritis (OA) development increase over time, and this may affect QoL at a long-term follow-up. PURPOSE To investigate changes in health- and knee-related QoL between 20 and 35 years after ACL injury and compare it between patients treated with or without ACL surgery, as well as to study how symptomatic OA (SOA) is associated with change in QoL. STUDY DESIGN Cohort study; Level of evidence, 2. METHODS Between 1980 and 1983, 139 patients with acute ACL rupture were allocated to surgical or nonsurgical treatment of the ACL. Both groups completed a structured rehabilitation program. Of those patients, 59 were followed for 20 and 35 years after ACL rupture. After 10 crossovers, 33 patients were treated with primary repair or ACL reconstruction, and 26 were treated without ACL surgery. Combined radiographic OA and knee symptoms at 35 years was defined as SOA. QoL was assessed at 20 and 35 years after injury with the Knee injury and Osteoarthritis Outcome Score QoL (KOOS-QoL) subscale (range, 1-100), ACL-QoL questionnaire (total score and 5 subscales; range, 1-100), European QoL-5 Dimensions Questionnaire, and visual analog scale. Results were analyzed with paired and independent-sample t tests and chi-square tests. RESULTS Knee-related QoL was impaired at both 20 and 35 years after ACL injury, and differences were dependent on the measurement outcome. In the total cohort, KOOS-QoL did not change but both total ACL-QoL score (7.1 points; 95% CI, 2.2-11.9) and 4 of 5 subscales (5-10 points) decreased (P < .05). No differences were found between treatment groups. QoL decreased overall in patients with SOA, with a 21-point difference within-group change in KOOS-QoL (SOA or non-SOA) between 20 and 35 years of follow-up (P = .001; Cohen d = 1.0). CONCLUSION An ACL injury impairs knee-related QoL for up to 35 years, with no difference between treatment approaches (initial repair or later reconstruction compared with nonsurgical treatment). The deterioration decreases with longer follow-up. Clinicians should be aware of differences in QoL depending on the measurement outcome.
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Affiliation(s)
- Joanna Kvist
- Unit of Physiotherapy, Department of Health, Medicine and Caring Science, Linköping University, Linköping, Sweden
- Stockholm Sports Trauma Research Center, FIFA Medical Centre of Excellence, Karolinska Institute, Stockholm, Sweden
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Roth KE, Simons P, Egermann M, Knobe M, Ossendorff R, Drees P, Klos K. [Treatment of symptomatic end-stage osteoarthritis of the ankle with anterolateral approach and an anatomical plate]. Oper Orthop Traumatol 2024; 36:73-79. [PMID: 37845377 DOI: 10.1007/s00064-023-00831-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 05/23/2023] [Accepted: 06/10/2023] [Indexed: 10/18/2023]
Abstract
OBJECTIVE The aim of this paper is to describe the anterolateral approach using an anatomical plate for ankle arthrodesis and to present the first mid-term results with this technique in a high-risk population. INDICATIONS The indication for arthrodesis of the ankle joint with this described technique is moderate to severe osteoarthritis of the ankle. CONTRAINDICATIONS In addition to the general contraindications typical of any operation, there is a specific contraindication in cases of active infection of the soft tissues and accompanying osteomyelitis at the ankle. SURGICAL TECHNIQUE The incision is made along the course of the peroneus tertius muscle. After that, the mobilization of the peroneus superficialis nerve is carried out, followed by the mobilization of the long extensor tendons, especially the extensor digitorum muscle in a medial direction opening the capsule and removal of the residual cartilage on the distal tibia and talus. Subsequently, the subchondral sclerosis is opened, and the implantation of a suitable osteosynthesis material, e.g., an anatomical angle-stable plate, is carried out. Finally, wound closure is performed involving the muscle belly of the extensor digitorum muscle covering the plate. POSTOPERATIVE MANAGEMENT Immobilization of the ankle for 5-7 days in a dorsal knee-high splint. Retention in a walker after decongestion for another 5 weeks. Increased loading can be done after X‑ray/computed tomography (CT) control from the 6th week. RESULTS In all, 11 patients were observed retrospectively for an average of 14 months. There were no complications. The European Foot and Ankle Society (EFAS) score improved significantly from 3.3 to 17.8 points. All patients were subjectively satisfied with the result and would have the operation again.
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Affiliation(s)
- Klaus Edgar Roth
- Gelenkzentrum Rheinmain, Frankfurterstr. 94, 65239, Hochheim, Deutschland
| | - Paul Simons
- Scivias Caritas Krankenhaus St Josef, Eibingerstr. 1, 65385, Rüdesheim am Rhein, Deutschland
| | - Markus Egermann
- Gelenkzentrum Rheinmain, Frankfurterstr. 94, 65239, Hochheim, Deutschland
| | - Matthias Knobe
- Klinik für Unfall- und orthopädische Chirurgie, St. Marien-Krankenhaus, Wüllener Str. 101, 48683, Ahaus, Deutschland
| | - Robert Ossendorff
- Klinik für Unfall- und orthopädische Chirurgie, St. Marien-Krankenhaus, Wüllener Str. 101, 48683, Ahaus, Deutschland.
- Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Venusberg-Campus 1, 53127, Bonn, Deutschland.
| | - Philipp Drees
- Zentrum für Orthopädie und Unfallchirurgie, Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Kajetan Klos
- Gelenkzentrum Rheinmain, Frankfurterstr. 94, 65239, Hochheim, Deutschland
- Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Friedrich-Schiller-Universität Jena, Am Klinikum 1, 07747, Jena, Deutschland
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Lu Y, Zhang J, Li H, Li T. Association of non-alcoholic fatty liver disease with self-reported osteoarthritis among the US adults. Arthritis Res Ther 2024; 26:40. [PMID: 38297351 PMCID: PMC10829206 DOI: 10.1186/s13075-024-03272-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/19/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND The association between non-alcoholic fatty liver disease (NAFLD) and osteoarthritis (OA) has not been well elucidated. The aim of the present study was to investigate the association between NAFLD and OA in the US adults. METHODS A cross-sectional study was performed on participants in the 2017-2018 National Health and Nutrition Examination Survey (NHANES) cycle. NAFLD was defined by the vibration-controlled transient elastography. The diagnosis of OA was based on self-reported data. Weighted multiple logistic regression models and stratified analyses were performed to explore the relationship and verify the stability of the conclusions. Sensitivity analysis using multiple imputation for missing data and propensity score matching (PSM) were performed. RESULTS In total, 2622 participants [Male: 1260 (47.8%)] were included in this study with a mean age of 48.1 years old (95% CI, 46.6-49.6 years old), containing 317 (12.8%) OA patients and 1140 NAFLD patients (41.5%). A logistic regression indicated a significant association between NAFLD and OA without adjustment [odds ratio (OR) = 2.05; 95% CI, 1.52-2.78]. The association remained stable after adjustment for covariates (OR = 1.72; 95% CI, 1.26-2.34). Sensitivity analysis of missing data with multiple interpolation and PSM found similar results. A significant and consistent association of NAFLD with OA was still observed in each subgroup stratified by age and metabolic syndrome (MetS). Stratified by sex, obesity, and sensitivity c-reactive protein (hs-CRP) category, a statistically significant association was only shown in females, those without obesity, and those without hyper hs-CRP. The results illustrated that the relationship between NAFLD and OA was stable in all subgroups and had no interaction. CONCLUSIONS NAFLD was positively correlated with OA. Given the current pandemic of NAFLD and OA, clinicians should screen for NAFLD in arthritis patients and intervene early.
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Affiliation(s)
- Yu Lu
- Department of Rheumatology and Immunology, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jianyu Zhang
- Department of Rheumatology and Immunology, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Hejun Li
- Department of Rheumatology and Immunology, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Ting Li
- Department of Rheumatology and Immunology, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
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23
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Tong EYH, Jeong SJ, Farook MZ, Volpin A. Multifocal stress fractures in a patient with rheumatoid arthritis. BMJ Case Rep 2024; 17:e254840. [PMID: 38290983 PMCID: PMC10828864 DOI: 10.1136/bcr-2023-254840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024] Open
Abstract
Stress fractures are often associated to activities that requires repetitive stress such as running. However, insufficiency-type stress fractures can also occur in patients with risk factors such as rheumatoid arthritis. Diagnosis of stress fracture would require a thorough clinical evaluation along with radiological imaging. However, this may be difficult due to how it mimics other musculoskeletal problems. The case of a woman in her 60s presenting with 2 months of severe ipsilateral right knee and ankle pain is used as an example. Based on initial clinical assessment and plain radiograph, her provisional diagnosis was osteoarthritis or inflammatory arthritis secondary to rheumatoid disease. However, MRI scan revealed that she had multifocal stress fractures in her knee, ankle and foot. Hence, we hope that this case study can allow clinicians to consider multifocal stress fracture as a possible diagnosis in patients with risk factors and to have lower threshold in performing MRI scans.
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Affiliation(s)
| | | | | | - Andrea Volpin
- Trauma and Orthopaedics, Dr Gray's Hospital, Elgin, Moray, UK
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24
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Zhang S, Wang D, Zhao J, Zhao H, Xie P, Zheng L, Sheng P, Yuan J, Xia B, Wei F, Zhang Z. Metabolic syndrome increases osteoarthritis risk: findings from the UK Biobank prospective cohort study. BMC Public Health 2024; 24:233. [PMID: 38243159 PMCID: PMC10799367 DOI: 10.1186/s12889-024-17682-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 01/05/2024] [Indexed: 01/21/2024] Open
Abstract
OBJECTIVE The association between Metabolic Syndrome (MetS), its components, and the risk of osteoarthritis (OA) has been a topic of conflicting evidence in different studies. The aim of this present study is to investigate the association between MetS, its components, and the risk of OA using data from the UK Biobank. METHODS A prospective cohort study was conducted in the UK Biobank to assess the risk of osteoarthritis (OA) related to MetS. MetS was defined according to the criteria set by the International Diabetes Federation (IDF). Additionally, lifestyle factors, medications, and the inflammatory marker C-reactive protein (CRP) were included in the model. Cox proportional hazards regression was used to calculate hazard ratios (HR) and 95% confidence intervals (CI). The cumulative risk of OA was analyzed using Kaplan-Meier curves and log-rank tests. To explore potential nonlinear associations between MetS components and OA risk, a restricted cubic splines (RCS) model was employed. In addition, the polygenic risk score (PRS) of OA was calculated to characterize individual genetic risk. RESULTS A total of 45,581 cases of OA were identified among 370,311 participants, with a median follow-up time of 12.48 years. The study found that individuals with MetS had a 15% higher risk of developing OA (HR = 1.15, 95%CI:1.12-1.19). Additionally, central obesity was associated with a 58% increased risk of OA (HR = 1.58, 95%CI:1.5-1.66), while hyperglycemia was linked to a 13% higher risk (HR = 1.13, 95%CI:1.1-1.15). Dyslipidemia, specifically in triglycerides (HR = 1.07, 95%CI:1.05-1.09) and high-density lipoprotein (HR = 1.05, 95%CI:1.02-1.07), was also found to be slightly associated with OA risk. When stratified by PRS, those in the high PRS group had a significantly higher risk of OA compared to those with a low PRS, whereas no interaction was found between MetS and PRS on OA risks. Furthermore, the presence of MetS significantly increased the risk of OA by up to 35% in individuals with elevated CRP levels (HR = 1.35, 95% CI:1.3-1.4). CONCLUSION MetS and its components have been found to be associated with an increased risk of OA, particularly in individuals with elevated levels of CRP. These findings highlight the significance of managing MetS as a preventive and intervention measure for OA.
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Affiliation(s)
- Shiyong Zhang
- Department of Joint Surgery, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China
| | - Danni Wang
- Department of Epidemiology and Biostatistics, Clinical Big Data Research Center, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, 518000, Guangdong, China
- Chinese Health RIsk MAnagement Collaboration (CHRIMAC), Shenzhen, 518000, Guangdong, China
| | - Jinyu Zhao
- Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, 730000, Gansu, China
| | - Haitong Zhao
- Evidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, Gansu, China
| | - Peng Xie
- Digestive Diseases Center, The Seventh Affiliated Hospital,, Sun Yat-Sen University, Shenzhen, 518107, Guangdong, China
- Guangdong Provincial Key Laboratory of Digestive Cancer Research, The Seventh Affiliated Hospital of Sun Yat-Sen University, No. 628 Zhenyuan Road, Shenzhen, 518107, Guangdong, China
| | - Linli Zheng
- Department of Joint Surgery, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China
| | - Puyi Sheng
- Department of Joint Surgery, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China
| | - Jinqiu Yuan
- Department of Epidemiology and Biostatistics, Clinical Big Data Research Center, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, 518000, Guangdong, China
- Chinese Health RIsk MAnagement Collaboration (CHRIMAC), Shenzhen, 518000, Guangdong, China
- Guangdong Provincial Key Laboratory of Gastroenterology, Center for Digestive Disease, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, 518000, Guangdong, China
| | - Bin Xia
- Department of Epidemiology and Biostatistics, Clinical Big Data Research Center, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, 518000, Guangdong, China.
- Chinese Health RIsk MAnagement Collaboration (CHRIMAC), Shenzhen, 518000, Guangdong, China.
| | - Fuxin Wei
- Department of Orthopedics, the Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, 518000, Guangdong, China.
| | - Ziji Zhang
- Department of Joint Surgery, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China.
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25
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Callan KT, Donnelly M, Lung B, McLellan M, DiGiovanni R, McMaster W, Yang S, Stitzlein R. Risk factors for postoperative delirium in orthopaedic hip surgery patients: a database review. BMC Musculoskelet Disord 2024; 25:71. [PMID: 38233831 PMCID: PMC10792907 DOI: 10.1186/s12891-024-07174-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 01/05/2024] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Postoperative delirium is a common problem affecting admitted patients that decreases patient satisfaction and increases the cost and complexity of care. The purpose of this study was to use the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database to compare rates and risk factors of postoperative delirium for total hip arthroplasty (THA) and hemiarthroplasty patients indicated for osteoarthritis or proximal femur fracture. METHODS The 2021 NSQIP database was queried for patients using Current Procedural Terminology (CPT) codes for THA and hemiarthroplasty and ICD-10 codes for osteoarthritis or proximal femur fracture. Demographic, past medical history, preoperative labs, and functional status data were recorded. Procedural data were also collected. Finally, postoperative outcomes and complications were reviewed. RESULTS Overall, 16% of patients had postoperative delirium. Delirium patients were older on average (82.4 years vs. 80.7 years, p < 0.001), had a lower BMI (19.5 vs. 24.8, p < 0.001), were more likely to have a history of dementia (54.6% vs. 13.6%, p < 0.001), were less likely to have an independent functional status (p < 0.001) or live alone (p < 0.001), and were more likely to have sustained a recent fall (p < 0.001). Delirium patients were more likely to be hyponatremic or hypernatremic (p = 0.002), anemic (p < 0.001), and severely dehydrated (p < 0.001), among other lab abnormalities. Delirium patients were also more likely to experience additional postoperative complications, including pneumonia, pulmonary embolism, urinary tract infection, stroke, cardiac arrest, sepsis, and unplanned reoperation and readmission after discharge (all p < 0.05). CONCLUSIONS In this study, factors associated with postoperative delirium in patients undergoing hemiarthroplasty and THA were identified, including older age, lower BMI, certain medical conditions, decreased functional status, certain lab abnormalities, and postoperative complications. These findings can be used by clinicians to better inform care and to determine when orthopaedic joint replacement patients may be at an increased risk for postoperative delirium.
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Affiliation(s)
- Kylie T Callan
- University of California Irvine School of Medicine, Irvine, CA, USA.
| | - Megan Donnelly
- New York University Langone Medical Center, New York, NY, USA
| | - Brandon Lung
- University of California Irvine Health, Orange, CA, USA
| | | | | | | | - Steven Yang
- University of California Irvine Health, Orange, CA, USA
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26
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Lee K, Niku S, Koo SJ, Belezzuoli E, Guma M. Molecular imaging for evaluation of synovitis associated with osteoarthritis: a narrative review. Arthritis Res Ther 2024; 26:25. [PMID: 38229205 PMCID: PMC10790518 DOI: 10.1186/s13075-023-03258-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 12/28/2023] [Indexed: 01/18/2024] Open
Abstract
Recent evidence highlights the role of low-grade synovial inflammation in the progression of osteoarthritis (OA). Inflamed synovium of OA joints detected by imaging modalities are associated with subsequent progression of OA. In this sense, detecting and quantifying synovitis of OA by imaging modalities may be valuable in predicting OA progressors as well as in improving our understanding of OA progression. Of the several imaging modalities, molecular imaging such as positron emission tomography (PET) and single-photon emission computed tomography (SPECT) has an advantage of visualizing the cellular or subcellular events of the tissues. Depending on the radiotracers used, molecular imaging method can potentially detect and visualize various aspects of synovial inflammation. This narrative review summarizes the recent progresses of imaging modalities in assessing inflammation and OA synovitis and focuses on novel radiotracers. Recent studies about imaging modalities including ultrasonography (US), magnetic resonance imaging (MRI), and molecular imaging that were used to detect and quantify inflammation and OA synovitis are summarized. Novel radiotracers specifically targeting the components of inflammation have been developed. These tracers may show promise in detecting inflamed synovium of OA and help in expanding our understanding of OA progression.
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Affiliation(s)
- Kwanghoon Lee
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
- Department of Medicine, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Soheil Niku
- Nuclear Medicine Service, Jennifer Moreno VA San Diego Healthcare System, San Diego, CA, USA
| | - Sonya J Koo
- Department of Radiology, West Los Angeles VA Medical Center, Los Angeles, CA, USA
| | - Ernest Belezzuoli
- Nuclear Medicine Service, Jennifer Moreno VA San Diego Healthcare System, San Diego, CA, USA
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
| | - Monica Guma
- Department of Medicine, University of California San Diego, La Jolla, CA, USA.
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27
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Rao C, Huang G, Mu F, Tan Z, Yuan J. Anesthetic management of patients with difficult intubation due to temporomandibular joint osteoarthritis: A case report. Medicine (Baltimore) 2024; 103:e36956. [PMID: 38215095 PMCID: PMC10783316 DOI: 10.1097/md.0000000000036956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 12/21/2023] [Indexed: 01/14/2024] Open
Abstract
INTRODUCTION Temporomandibular joint osteoarthritis (TMJOA) affects 8% to 16% of the global population, yet TMJOA remains relatively underappreciated clinically. To anesthesiologists, who is concerned about patient safety, adequate preoperative evaluation and preparation, as well as individualized anesthetic management of patients, are necessary. Therefore, the anesthesiologist should be alert for difficult airways due to TMJOA, have a full and comprehensive understanding of the disease, and possess the appropriate expertise for difficult airway intubation. CASE PRESENTATION A 52-year-old female patient was scheduled for laparoscopic operation of uterine adnexa under general anesthesia. The patient preoperative evaluation showed only 1 finger width of mouth opening, and the computed tomography scan showed bilateral temporomandibular arthritis, which was evident on the right side. Intraoperatively, the expected airway difficulties occurred, and the anesthesiologist opted to use lightwand intubation, which was ultimately successful in 1 pass without any complications. CONCLUSION Intubation using a lightwand for patients with difficult intubation due to TMJOA is a very effective intubation modality.
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Affiliation(s)
- Changle Rao
- Department of Anesthesiology, The Third Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Guihua Huang
- Department of Anesthesiology, The Third Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Fangfang Mu
- Department of Anesthesiology, The Third Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Zhengquan Tan
- Department of Anesthesiology, The Third Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Jie Yuan
- Department of Anesthesiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- Department of Pain Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China
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28
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Peng P, Wu J, Fang W, Tian J, He M, Xiao F, Lin K, Xu X, He W, Liu W, Wei Q. Association between sarcopenia and osteoarthritis among the US adults: a cross-sectional study. Sci Rep 2024; 14:296. [PMID: 38167445 PMCID: PMC10761973 DOI: 10.1038/s41598-023-50528-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 12/20/2023] [Indexed: 01/05/2024] Open
Abstract
The association between sarcopenia and OA still presents many uncertainties. We aimed to assess whether sarcopenia is associated with occurrence of OA in US adults. We conducted a cross-sectional study consisting of 11,456 participants from National Health and Nutrition Examination Survey 1999-2006. Sarcopenia was defined by a low muscle mass. The skeletal muscle index (SMI) was calculated as the appendicular skeletal muscle mass divided by body mass indexes (BMI) or body weight. OA status was assessed by using self-reported questionnaire. We evaluated the association between sarcopenia and OA using multivariate regression models. In addition, subgroup and interaction analysis were performed. Sarcopenia was associated with OA when it was defined by the BMI-adjusted SMI (OR = 1.23 [95% CI, 1.01, 1.51]; P = 0.038) and defined by the weight-adjusted SMI (OR = 1.30 [95% CI, 1.10, 1.55]; P = 0.003). Subgroup and interaction analysis found that the strongest positive association mainly exists in smoker (OR = 1.54 [95% CI, 1.21, 1.95], Pint = 0.006), and this association is not significant in other groups. In conclusion, we found that sarcopenia was associated with occurrence of OA. Subgroup analysis revealed that the association between sarcopenia and OA was more pronounced in smoker. Further well-designed prospective cohort studies are needed to assess our results.
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Affiliation(s)
- Peng Peng
- Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
| | - Jiawei Wu
- Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
| | - Weihua Fang
- Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
| | - Jiaqing Tian
- Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
| | - Mincong He
- Guangdong Research Institute for Orthopedics and Traumatology of Chinese Medicine, No. 261, Longxi Road, Liwan District, Guangzhou, 510378, People's Republic of China
- Department of Orthopaedics, The Third Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
| | - Fangjun Xiao
- Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
| | - Kun Lin
- Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
| | - Xuemeng Xu
- Guangdong Provincial Second Hospital of Traditional Chinese Medicine, No. 60, Hengfu Road, Yuexiu District, Guangzhou, 510405, People's Republic of China
| | - Wei He
- Guangdong Research Institute for Orthopedics and Traumatology of Chinese Medicine, No. 261, Longxi Road, Liwan District, Guangzhou, 510378, People's Republic of China
- Department of Orthopaedics, The Third Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
| | - Wengang Liu
- Guangdong Provincial Second Hospital of Traditional Chinese Medicine, No. 60, Hengfu Road, Yuexiu District, Guangzhou, 510405, People's Republic of China.
| | - Qiushi Wei
- Guangdong Research Institute for Orthopedics and Traumatology of Chinese Medicine, No. 261, Longxi Road, Liwan District, Guangzhou, 510378, People's Republic of China.
- Department of Orthopaedics, The Third Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China.
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29
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Mookerjee N, Schmalbach N, Antinori G, Thampi S, Windle-Puente D, Gilligan A, Huy H, Andrews M, Sun A, Gandhi R, Benedict W, Chang A, Sanders B, Nguyen J, Keesara MR, Aliev J, Patel A, Hughes I, Millstein I, Hunter K, Roy S. Association of Risk Factors and Comorbidities With Chronic Pain in the Elderly Population. J Prim Care Community Health 2024; 15:21501319241233463. [PMID: 38366930 PMCID: PMC10874592 DOI: 10.1177/21501319241233463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 01/24/2024] [Accepted: 02/01/2024] [Indexed: 02/19/2024] Open
Abstract
INTRODUCTION/OBJECTIVE Chronic pain disorders affect about 20% of adults in the United States, and it disproportionately affects individuals living in the neighborhoods of extreme socioeconomic disadvantage. In many instances, chronic pain has been noted to arise from an aggregation of multiple risk factors and events. Therefore, it is of importance to recognize the modifiable risk factors. The aim of this study was to investigate the comorbid medical conditions and risk factors associated with chronic pain disorders in patients aged 65 years and older. METHODS Our team retrospectively reviewed medical records of elderly patients (65 years and older) who were evaluated in our outpatient medicine office between July 1, 2020 and June 30, 2021 for acute problems, management of chronic medical problems, or well visits. We divided our patients into a group who suffered from chronic pain disorder, and another group who did not have chronic pain disorder. The association of variables were compared between those groups. RESULTS Of the 2431 patients, 493 (20.3%) had a chronic pain disorder. A higher frequency of females in the group with chronic pain disorder was found compared to the group without a chronic pain disorder (60.6% vs 55.2%; P = .033). The mean ages between the two groups were similar in the group with a chronic pain disorder compared to the group without (76.35 ± 7.5 year vs 76.81 ± 7.59 year; P = .228). There were significant associations of certain comorbidities in the group with a chronic pain disorder compared to the group without a chronic pain disorder, such as depression (21.9% vs 15.2%; P < .001), anxiety (27.0% vs 17.1%; P < .001), chronic obstructive pulmonary disease (8.7% vs 6.1%; P = .036), obstructive sleep apnea (16.8% vs 11.6%; P = .002), gastroesophageal reflux disease (40.8% vs 29.0%; P < .001), osteoarthritis (49.3% vs 26.1%; P < .001), other rheumatologic diseases (24.9% vs 19.4%; P = .006), and peripheral neuropathy (14.4% vs 5.3%; P < .001). CONCLUSION Female sex, depression, anxiety, chronic obstructive pulmonary disease, obstructive sleep apnea, gastroesophageal reflux disease, osteoarthritis, other rheumatologic diseases, and peripheral neuropathy were significantly associated with chronic pain disorder in elderly patients, while BMI was not associated with chronic pain disorder.
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Affiliation(s)
- Neil Mookerjee
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | | | | | | | | | - Amy Gilligan
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Ha Huy
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Megha Andrews
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Angela Sun
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Roshni Gandhi
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | | | - Austin Chang
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Ben Sanders
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Justin Nguyen
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | | | - Janet Aliev
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Aneri Patel
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Isaiah Hughes
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Ian Millstein
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Krystal Hunter
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Satyajeet Roy
- Cooper Medical School of Rowan University, Camden, NJ, USA
- Cooper University Health Care, Camden, NJ, USA
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Fu W, Vasylyev D, Bi Y, Zhang M, Sun G, Khleborodova A, Huang G, Zhao L, Zhou R, Li Y, Liu S, Cai X, He W, Cui M, Zhao X, Hettinghouse A, Good J, Kim E, Strauss E, Leucht P, Schwarzkopf R, Guo EX, Samuels J, Hu W, Attur M, Waxman SG, Liu CJ. Na v1.7 as a chondrocyte regulator and therapeutic target for osteoarthritis. Nature 2024; 625:557-565. [PMID: 38172636 PMCID: PMC10794151 DOI: 10.1038/s41586-023-06888-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 11/22/2023] [Indexed: 01/05/2024]
Abstract
Osteoarthritis (OA) is the most common joint disease. Currently there are no effective methods that simultaneously prevent joint degeneration and reduce pain1. Although limited evidence suggests the existence of voltage-gated sodium channels (VGSCs) in chondrocytes2, their expression and function in chondrocytes and in OA remain essentially unknown. Here we identify Nav1.7 as an OA-associated VGSC and demonstrate that human OA chondrocytes express functional Nav1.7 channels, with a density of 0.1 to 0.15 channels per µm2 and 350 to 525 channels per cell. Serial genetic ablation of Nav1.7 in multiple mouse models demonstrates that Nav1.7 expressed in dorsal root ganglia neurons is involved in pain, whereas Nav1.7 in chondrocytes regulates OA progression. Pharmacological blockade of Nav1.7 with selective or clinically used pan-Nav channel blockers significantly ameliorates the progression of structural joint damage, and reduces OA pain behaviour. Mechanistically, Nav1.7 blockers regulate intracellular Ca2+ signalling and the chondrocyte secretome, which in turn affects chondrocyte biology and OA progression. Identification of Nav1.7 as a novel chondrocyte-expressed, OA-associated channel uncovers a dual target for the development of disease-modifying and non-opioid pain relief treatment for OA.
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Affiliation(s)
- Wenyu Fu
- Department of Orthopaedic Surgery, New York University Grossman School of Medicine, New York, NY, USA
- Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT, USA
| | - Dmytro Vasylyev
- Department of Neurology, Yale School of Medicine, New Haven, CT, USA
- Center for Neuroscience and Regeneration Research, Veterans Affairs Connecticut Healthcare, West Haven, CT, USA
| | - Yufei Bi
- Department of Orthopaedic Surgery, New York University Grossman School of Medicine, New York, NY, USA
| | - Mingshuang Zhang
- Department of Orthopaedic Surgery, New York University Grossman School of Medicine, New York, NY, USA
| | - Guodong Sun
- Department of Orthopaedic Surgery, New York University Grossman School of Medicine, New York, NY, USA
| | - Asya Khleborodova
- Department of Orthopaedic Surgery, New York University Grossman School of Medicine, New York, NY, USA
| | - Guiwu Huang
- Department of Orthopaedic Surgery, New York University Grossman School of Medicine, New York, NY, USA
- Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT, USA
| | - Libo Zhao
- Department of Orthopaedic Surgery, New York University Grossman School of Medicine, New York, NY, USA
- Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT, USA
| | - Renpeng Zhou
- Department of Orthopaedic Surgery, New York University Grossman School of Medicine, New York, NY, USA
- Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT, USA
| | - Yonggang Li
- Department of Orthopaedic Surgery, New York University Grossman School of Medicine, New York, NY, USA
- Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT, USA
| | - Shujun Liu
- Department of Neurology, Yale School of Medicine, New Haven, CT, USA
- Center for Neuroscience and Regeneration Research, Veterans Affairs Connecticut Healthcare, West Haven, CT, USA
| | - Xianyi Cai
- Department of Orthopaedic Surgery, New York University Grossman School of Medicine, New York, NY, USA
| | - Wenjun He
- Department of Orthopaedic Surgery, New York University Grossman School of Medicine, New York, NY, USA
| | - Min Cui
- Department of Orthopaedic Surgery, New York University Grossman School of Medicine, New York, NY, USA
| | - Xiangli Zhao
- Department of Orthopaedic Surgery, New York University Grossman School of Medicine, New York, NY, USA
- Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT, USA
| | - Aubryanna Hettinghouse
- Department of Orthopaedic Surgery, New York University Grossman School of Medicine, New York, NY, USA
| | - Julia Good
- Department of Orthopaedic Surgery, New York University Grossman School of Medicine, New York, NY, USA
| | - Ellen Kim
- Department of Orthopaedic Surgery, New York University Grossman School of Medicine, New York, NY, USA
| | - Eric Strauss
- Department of Orthopaedic Surgery, New York University Grossman School of Medicine, New York, NY, USA
| | - Philipp Leucht
- Department of Orthopaedic Surgery, New York University Grossman School of Medicine, New York, NY, USA
| | - Ran Schwarzkopf
- Department of Orthopaedic Surgery, New York University Grossman School of Medicine, New York, NY, USA
| | - Edward X Guo
- Department of Biomedical Engineering, Columbia University, New York, NY, USA
| | - Jonathan Samuels
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Wenhuo Hu
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Marie-Josée and Henry R. Kravis Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Mukundan Attur
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Stephen G Waxman
- Department of Neurology, Yale School of Medicine, New Haven, CT, USA.
- Center for Neuroscience and Regeneration Research, Veterans Affairs Connecticut Healthcare, West Haven, CT, USA.
| | - Chuan-Ju Liu
- Department of Orthopaedic Surgery, New York University Grossman School of Medicine, New York, NY, USA.
- Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT, USA.
- Department of Cell Biology, New York University Grossman School of Medicine, New York, NY, USA.
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Shima H, Togei K, Hirai Y, Yasuda T, Okuda R, Neo M. Operative outcomes of hallux valgus with painful osteoarthritis of the lesser tarsometatarsal joints. J Orthop Sci 2024; 29:230-235. [PMID: 36564235 DOI: 10.1016/j.jos.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 10/03/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Hallux valgus is sometimes accompanied by osteoarthritis of the lesser tarsometatarsal joint. However, information on the operative procedures and outcomes for the treatment of hallux valgus with osteoarthritis of the lesser tarsometatarsal joint simultaneously is limited. We aimed to describe this operative procedure and evaluate the outcomes of the treatment of hallux valgus with osteoarthritis of the lesser tarsometatarsal joint. METHODS Fifteen patients (17 feet; average age, 66.9 years; average follow-up, 59.4 months; and minimum follow-up, 24 months) with symptomatic hallux valgus accompanied by painful osteoarthritis of the lesser tarsometatarsal joint were enrolled. All feet showed osteoarthritis of the second and/or third tarsometatarsal joint on dorsoplantar weight-bearing radiograph. The operative procedure included a proximal osteotomy of the first metatarsal and arthrodesis of the lesser tarsometatarsal joint with an autologous bone graft. RESULTS The mean Japanese Society for Surgery of the Foot hallux metatarsophalangeal-interphalangeal score significantly improved from 54.8 points preoperatively to 91.7 points postoperatively (P <0.001). The mean postoperative visual analog score (15 feet) was 1.0 (0-3.9). Preoperative midtarsal pain disappeared in 14 feet and decreased in one foot postoperatively. Preoperative metatarsalgia was found in five feet, of which, it disappeared in two feet, decreased in two feet, and transferred to another region in one foot at the latest follow-up. The mean hallux valgus and intermetatarsal angles were 42.4° and 18.4° preoperatively, which decreased significantly to 12.5° and 6.9° postoperatively, respectively (P <0.001, all). Recurrence of hallux valgus (hallux valgus angle ≥20°) was observed in two feet (11.8%). Nonunion of the third tarsometatarsal joint was observed in one foot (3.1% among 32 joints). CONCLUSIONS The clinical and radiographic results indicated that operative treatment for hallux valgus with painful osteoarthritis of the lesser tarsometatarsal joint significantly improves forefoot and midfoot pain and function and has low complication rates. LEVEL OF EVIDENCE Level IV, retrospective case series.
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Affiliation(s)
- Hiroaki Shima
- Department of Orthopedic Surgery, Osaka Medical and Pharmaceutical University, Takatsuki, Japan.
| | - Kosho Togei
- Department of Orthopedic Surgery, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Yoshihiro Hirai
- Department of Orthopedic Surgery, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Toshito Yasuda
- Faculty of Nursing, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Ryuzo Okuda
- Depatment of Orthopaedic Surgery, Rakusai-Shimizu Hospital, Kyoto, Japan
| | - Masashi Neo
- Department of Orthopedic Surgery, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
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Kim GM, Kim J, Lee JY, Park MC, Lee SY. IgSF11 deficiency alleviates osteoarthritis in mice by suppressing early subchondral bone changes. Exp Mol Med 2023; 55:2576-2585. [PMID: 38036734 PMCID: PMC10767117 DOI: 10.1038/s12276-023-01126-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 09/14/2023] [Accepted: 09/26/2023] [Indexed: 12/02/2023] Open
Abstract
Osteoarthritis (OA) is a degenerative joint disease. While it is classically characterized by articular cartilage destruction, OA affects all tissues in the joints and is thus also accompanied by local inflammation, subchondral bone changes, and persistent pain. However, our understanding of the underlying subchondral bone dynamics during OA progression is poor. Here, we demonstrate the contribution of immunoglobulin superfamily 11 (IgSF11) to OA subchondral bone remodeling by using a murine model. In particular, IgSF11 was quickly expressed by differentiating osteoclasts and upregulated in subchondral bone soon after destabilization-of-the-medial-meniscus (DMM)-induced OA. In mice, IgSF11 deficiency not only suppressed subchondral bone changes in OA but also blocked cartilage destruction. The IgSF11-expressing cells in OA subchondral bone were found to be involved in osteoclast maturation and bone resorption and colocalized with receptor-activator of nuclear-factor κ-B (RANK), the key osteoclast differentiation factor. Thus, our study shows that blocking early subchondral bone changes in OA can ameliorate articular cartilage destruction in OA.
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Affiliation(s)
- Gyeong Min Kim
- Department of Life Sciences, Ewha Womans University, Seoul, 03760, Republic of Korea
- The Research Center for Cellular Homeostasis, Ewha Womans University, Seoul, 03760, Republic of Korea
| | - Jihee Kim
- Department of Life Sciences, Ewha Womans University, Seoul, 03760, Republic of Korea
- The Research Center for Cellular Homeostasis, Ewha Womans University, Seoul, 03760, Republic of Korea
| | - June-Yong Lee
- Department of Microbiology and Immunology, Institute for Immunology and Immunological Diseases, and Brain Korea 21 PLUS Project for Medical Sciences, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Min-Chan Park
- Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, 06273, Republic of Korea
| | - Soo Young Lee
- Department of Life Sciences, Ewha Womans University, Seoul, 03760, Republic of Korea.
- The Research Center for Cellular Homeostasis, Ewha Womans University, Seoul, 03760, Republic of Korea.
- Multitasking Macrophage Research Center, Ewha Womans University, Seoul, 03760, Republic of Korea.
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Rahman SO, Bariguian F, Mobasheri A. The Potential Role of Probiotics in the Management of Osteoarthritis Pain: Current Status and Future Prospects. Curr Rheumatol Rep 2023; 25:307-326. [PMID: 37656392 PMCID: PMC10754743 DOI: 10.1007/s11926-023-01108-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2023] [Indexed: 09/02/2023]
Abstract
PURPOSE OF REVIEW This narrative review article comprehensively explains the pathophysiology of osteoarthritis (OA) pain perception, how the gut microbiota is correlated with it, possible molecular pathways involved in probiotics-mediated OA pain reduction, limitations in the current research approaches, and future perspectives. RECENT FINDINGS The initiation and progression of OA, including the development of chronic pain, is intricately associated with activation of the innate immune system and subsequent inflammatory responses. Trauma, lifestyle (e.g., obesity and metabolic disease), and chronic antibiotic treatment can disrupt commensal homeostasis of the human microbiome, thereby affecting intestinal integrity and promoting leakage of bacterial endotoxins and metabolites such as lipopolysaccharides (LPS) into circulation. Increased level of LPS is associated with knee osteophyte severity and joint pain. Both preclinical and clinical studies strongly suggest that probiotics may benefit patients with OA pain through positive gut microbiota modulation and attenuating low-grade inflammation via multiple pathways. Patent data also suggests increased interest in the development of new innovations that involve probiotic use for reducing OA and joint pain. Recent data suggest that probiotics are attracting more and more attention for OA pain management. The advancement of knowledge in this area may pave the way for developing different probiotic strains that can be used to support joint health, improve treatment outcomes in OA, and reduce the huge impact of the disease on healthcare systems worldwide.
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Affiliation(s)
| | - Frédérique Bariguian
- Haleon (Formerly GSK Consumer Healthcare), Route de L'Etraz 2, Case Postale 1279, 1260, Nyon 1, Switzerland.
| | - Ali Mobasheri
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, 90014, Oulu, FI, 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.
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Perrot S, Roucoux G, Bertin P, Beauvais C, Alliot-Launois F, Chassany O, Duracinsky M. Cross-perspectives on care pathways for painful osteoarthritis: A qualitative analysis in patients and healthcare professionals. Musculoskeletal Care 2023; 21:1142-1153. [PMID: 37404113 DOI: 10.1002/msc.1795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/20/2023] [Accepted: 06/22/2023] [Indexed: 07/06/2023]
Abstract
PURPOSE To analyse and compare patients' and healthcare professionals' (HPs) perspectives concerning patient care pathways for painful osteoarthritis (OA). PATIENTS AND METHODS We performed a qualitative study of two focus groups corresponding to eight patients with painful OA and eight HPs involved in OA management. RESULTS Six key themes emerged from the interviews: (1) representations of OA, (2) OA pain, (3) quality of life, (4) care pathways, (5) actors involved in the care pathway, and (6) treatments. Both groups considered general practitioners, pharmacists and physiotherapists to be first-line HPs, and no well-defined OA specialist was identified. Patients and HPs reported similar difficulties concerning the adaptation of management to individual cases, late diagnosis and treatment, whereas only patients mentioned financial issues. Communication difficulties were identified as a major problem both between patients and HPs, and between HPs. Patients reported a lack of knowledge concerning pain and OA. The coordination between the various HPs is required, with education on both pain and OA. Several possible solutions were put forward by both patients and HPs. CONCLUSION The care pathways of patients with painful OA are complex, with an unclear definition of the roles of the various HPs and suboptimal coordination. The role of HPs should be defined and collaboration between HPs developed.
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Affiliation(s)
- Serge Perrot
- Pain Center, INSERM U987, Hôpital Cochin, Université Paris Cité University, Paris, France
| | - Guillaume Roucoux
- Patient-Reported Outcomes Unit (PROQOL), Health Economics Clinical Trial Unit (URC-ECO), Hotel-Dieu Hospital, AP-HP, Paris, France
- ECEVE, INSERM UMR 1123, Paris Cité University, Paris, France
| | - Philippe Bertin
- Rheumatology Department, University Hospital, Limoges, France
| | | | | | - Olivier Chassany
- Patient-Reported Outcomes Unit (PROQOL), Health Economics Clinical Trial Unit (URC-ECO), Hotel-Dieu Hospital, AP-HP, Paris, France
| | - Martin Duracinsky
- Patient-Reported Outcomes Unit (PROQOL), Health Economics Clinical Trial Unit (URC-ECO), Hotel-Dieu Hospital, AP-HP, Paris, France
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Halperin SJ, Dhodapkar MM, Radford Z, Frumberg DB, Rubin LE, Grauer JN. Patients With Down Syndrome and Total Hip and Total Knee Arthroplasty: Outcome Measures Show Increased Risk of Perioperative Complications. J Am Acad Orthop Surg Glob Res Rev 2023; 7:01979360-202312000-00008. [PMID: 38054749 PMCID: PMC10697628 DOI: 10.5435/jaaosglobal-d-23-00108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 09/27/2023] [Accepted: 10/28/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND Patients with Down syndrome (DS) are being considered for total joint arthroplasty. There is limited literature regarding outcomes of patients with DS after total hip arthroplasty (THA) and total knee arthroplasty (TKA). METHODS Data were abstracted from the 2010 to 2021 Q1 PearlDiver M151 database. THA and TKA osteoarthritis adult patients with and without DS were identified. Patients were matched 1:10. Ninety-day postoperative events and 2-year revision rates were compared. RESULTS For THA, 154 patients with DS were matched with 1,532 patients without DS. For TKA, 150 patients with DS were matched with 1,495 patients without DS. On multivariable logistic regression, THA and TKA patients with DS were at markedly greater odds of postoperative events including any adverse event, sepsis, minor adverse event, urinary tract infection (UTI), acute kidney injury (AKI), and pneumonia. For both THA and TKA, 2-year revision rates were not increased for those with DS. DISCUSSION This study represents the largest cohorts for matched patients with DS undergoing THA or TKA through 90 days postoperatively. For both procedures, DS patients were found to have greater risk of several adverse events, but not 2-year revisions. These findings may help guide perioperative risk assessment, patient/family counseling, and care pathways.
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Affiliation(s)
- Scott J Halperin
- From the Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT
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Lohan C, Coates G, Clewes P, Stevenson H, Wood R, Tritton T, Massey L, Knaggs R, Dickson AJ, Walsh D. Estimating the cost and epidemiology of mild to severe chronic pain associated with osteoarthritis in England: a retrospective analysis of linked primary and secondary care data. BMJ Open 2023; 13:e073096. [PMID: 38030255 PMCID: PMC10689390 DOI: 10.1136/bmjopen-2023-073096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023] Open
Abstract
OBJECTIVE Osteoarthritis (OA) affects 10% of adults in the UK. Despite over one-third of people with OA experiencing chronic pain, few studies have examined the population-level impact of chronic pain associated with OA. We compared resource-use and epidemiological outcomes in patients with mild, moderate and severe chronic OA-associated pain and matched controls without known OA. DESIGN Retrospective, longitudinal, observational cohort study (July 2008 to June 2019). SETTING Electronic records extracted from Clinical Practice Research Datalink GOLD primary care linked to Hospital Episode Statistics (HES). PARTICIPANTS Patients (cases; n=23 016) aged ≥18 years with chronic OA-associated pain. Controls (n=23 016) without OA or chronic pain matched on age, sex, comorbidity burden, general practitioner practice and available HES data. INTERVENTIONS None. PRIMARY AND SECONDARY OUTCOME MEASURES Total healthcare resource use (HCRU), direct healthcare costs in 0-12, 12-24 and 24-36 months postindex. Secondary outcomes included incidence and prevalence of chronic OA-associated pain and pharmacological management. RESULTS HCRU was consistently greater in cases versus controls for all resource categories during preindex and postindex periods. Across follow-up periods, resource use was greatest in patients with severe pain. In the first 12 months postindexing, mean total costs incurred by cases were four times higher versus matched controls (£256 vs £62); costs were approximately twice as high in cases vs controls for months 12-24 (£166 vs £86) and 24-36 (£150 vs £81; all p<0.0001). The incidence of new cases of chronic pain associated with OA was 2.64 per 1000 person-years; the prevalence was 1.4%. CONCLUSIONS This study highlights the real-world cost of chronic pain associated with OA in cases versus matched controls. We included patients with mild, moderate and severe pain associated with OA, and showed HCRU in discrete 1-year time frames. The true economic burden of pain associated with OA is likely to be considerably higher when indirect costs are considered.
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Affiliation(s)
- Christoph Lohan
- Pfizer Australia Pty Ltd, Sydney, New South Wales, Australia
| | | | | | | | | | | | | | - Roger Knaggs
- Pain Centre Versus Arthritis and NIHR Nottingham Biomedical Research Centre, School of Pharmacy, University of Nottingham, Nottingham, UK
| | - Alastair J Dickson
- Primary Care Rheumatology & Musculoskeletal Medicine Society, York, UK
- The North of England Low Back Pain Pathway, NIHR Applied Research Collaboration (ARC) North East and North Cumbria, Saint Nicholas Hospital, Newcastle upon Tyne, UK
| | - David Walsh
- Pain Centre Versus Arthritis and NIHR Nottingham Biomedical Research Centre, School of Medicine, University of Nottingham, Nottingham, UK
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Coates G, Clewes P, Lohan C, Stevenson H, Wood R, Tritton T, Knaggs RD, Dickson AJ, Walsh DA. Chronic Low Back Pain with and without Concomitant Osteoarthritis: A Retrospective, Longitudinal Cohort Study of Patients in England. Int J Clin Pract 2023; 2023:5105810. [PMID: 38020538 PMCID: PMC10653975 DOI: 10.1155/2023/5105810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/18/2023] [Accepted: 10/10/2023] [Indexed: 12/01/2023] Open
Abstract
Objective Despite the high prevalence of chronic low back pain (CLBP) and osteoarthritis (OA), few estimates of the economic cost of these conditions in England have been published. The aim of the present analysis was to characterise the economic burden of moderate-to-severe pain associated with CLBP + OA and CLBP alone compared with general population-matched controls without CLBP or OA. The primary objective was to describe the total healthcare resource use (HCRU) and direct healthcare costs associated with the target patient populations. Secondary objectives were to describe treatment patterns and surgical procedures. Methods This was a retrospective, observational cohort study of patients receiving healthcare indicative of moderate-to-severe chronic pain associated with CLBP, with or without OA. We used linked longitudinal data from the Clinical Practice Research Datalink GOLD and Hospital Episode Statistics (HES). Patients (cases) were matched 1 : 1 with controls on age, sex, comorbidity burden, GP practice, and HES data availability. Results The CLBP-alone cohort comprised 13 554 cases with CLBP and 13 554 matched controls; the CLBP + OA cohort comprised 7803 cases with both OA and CLBP and 7803 matched controls. Across all follow-up periods, patients with CLBP alone and those with CLBP + OA had significantly more GP consultations, outpatient attendances, emergency department visits, and inpatient stays than controls (all p < 0.0001). By 36 months after indexing, the mean (SD) per-patient total direct healthcare cost in the CLBP-alone cohort was £5081 (£5905) for cases and £1809 (£4451) for controls (p < 0.0001); in the CLBP + OA cohort, the mean (SD) per-patient total direct healthcare cost was £8819 (£7143) for cases and £2428 (£4280) for controls (p < 0.0001). Conclusion Moderate-to-severe chronic pain associated with CLBP-with or without OA-has a substantial impact on patients and healthcare providers, leading to higher HCRU and costs versus controls among people with CLBP alone or together with OA.
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Affiliation(s)
| | | | | | | | | | | | - Roger D. Knaggs
- Pain Centre Versus Arthritis and NIHR Nottingham Biomedical Research Centre, School of Medicine, University of Nottingham, Nottingham, UK
| | - Alastair J. Dickson
- Primary Care Rheumatology & Musculoskeletal Medicine Society, York, UK
- The North of England Low Back Pain Pathway, NIHR Applied Research Collaboration (ARC) North East and North Cumbria, St. Nicholas' Hospital, Newcastle Upon Tyne, UK
- AD Outcomes Ltd., York, UK
| | - David A. Walsh
- Pain Centre Versus Arthritis and NIHR Nottingham Biomedical Research Centre, School of Medicine, University of Nottingham, Nottingham, UK
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Choi JH, Choi YH, Kim DH, Lee DY, Koo S, Lee KM. Effect of flatfoot correction on the ankle joint following lateral column lengthening: A radiographic evaluation. PLoS One 2023; 18:e0286013. [PMID: 37917738 PMCID: PMC10621939 DOI: 10.1371/journal.pone.0286013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 05/05/2023] [Indexed: 11/04/2023] Open
Abstract
OBJECTIVES The effects of foot deformities and corrections on the ankle joint without osteoarthritis has received little attention. This study aimed to investigate the effect of flatfoot correction on the ankle joint of patients without osteoarthritis. METHODS Thirty-five patients (24 men and 11 women; mean age 17.5 years) who underwent lateral column lengthening for flatfoot deformities were included. The mean postoperative follow-up period was 20.5 months (standard deviation [SD]: 15.7 months). Radiographic indices were measured pre- and postoperatively, including anteroposterior (AP) and lateral talo-first metatarsal angles, naviculocuboid overlap, position of the articulating talar surface, and lateral talar center migration. Postoperative changes in the radiographic indices were statistically analyzed. RESULTS There was significant postoperative improvement in flatfoot deformity in terms of AP and lateral talo-first metatarsal angles (p<0.001 and p<0.001, respectively) and naviculocuboid overlap (p<0.001). On lateral radiographs, the talar articulating surface dorsiflexed by 7.3% (p<0.001), and the center of the talar body shifted anteriorly by 0.85 mm (p<0.001) postoperatively. CONCLUSIONS Flatfoot correction using lateral column and Achilles tendon lengthening caused dorsiflexion and an anterior shift of the articular talar body in patients without osteoarthritis. Correction of flatfoot deformity might affect the articular contact area at the ankle joint. The biomechanical effects of this change need to be investigated further.
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Affiliation(s)
- Ji Hye Choi
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Yoon Hyo Choi
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Dae Hyun Kim
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Dong Yeon Lee
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, South Korea
| | - Seungbum Koo
- Department of Mechanical Engineering, Korea Advanced Institute for Science and Technology, Daejon, South Korea
| | - Kyoung Min Lee
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
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Wirth W. Joint-adjacent subcutaneous adipose tissue - An obesity-related imaging biomarker associated with structural osteoarthritis progression? Osteoarthritis Cartilage 2023; 31:1420-1422. [PMID: 37597653 DOI: 10.1016/j.joca.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 08/10/2023] [Indexed: 08/21/2023]
Affiliation(s)
- Wolfgang Wirth
- Department for Imaging and Functional Musculoskeletal Research, Institute of Anatomy and Cell Biology, Paracelsus Medical University Salzburg and Nuremberg, Salzburg, Austria; Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Paracelsus Medical University Salzburg and Nuremberg, Salzburg, Austria; Chondrometrics GmbH, Freilassing, Germany.
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Kuş G, Yasacı Z, Boz C, Türkmen E. Association of Osteoarthritis Prevalence With Age and Obesity Factors in Organization for Economic Cooperation and Development Countries: Panel Regression Model. Am J Phys Med Rehabil 2023; 102:901-906. [PMID: 37026825 DOI: 10.1097/phm.0000000000002244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Abstract
INTRODUCTION According to cross-sectional analysis studies supported by microdata, incidence of Osteoarthritis increases in parallel with ageing and obesity, which are common predictors of the disease. The aim of this study is to reveal whether ageing and obesity have an effect on the increase in osteoarthritis prevalence by analyzing cross-country data from Organization for Economic Cooperation and Development countries. METHODS We used static panel data regression analysis for 36 countries for the period between 2000 and 2017. Along with osteoarthritis prevalence, we used a group of people with a body mass index ≤ 30 within the population as obesity indicator and those older than 65 yrs within the population as ageing indicator. We calculated the effect of ageing and obesity on osteoarthritis prevalence using STATA 13 software. RESULTS Both variable coefficients, age, and obesity, respectively, were found to be positive and statistically significant at the 1% level. This study shows that both ageing and obesity contribute to an increase in the osteoarthritis prevalence based on macro data from 36 Organization for Economic Cooperation and Development countries. CONCLUSIONS These findings have significant implications that can be used by both the public and policymakers for preventing the osteoarthritis. Adopting the preventive measures could contribute to decrease in health expenditures.
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Affiliation(s)
- Gamze Kuş
- From the Hatay Mustafa Kemal University-Faculty of Health Sciences, Division of Physiotherapy and Rehabilitation, Hatay, Turkey (GK); Harran University-Faculty of Health Sciences, Division of Physiotherapy and Rehabilitation, Şanlıurfa, Turkey (ZY); Istanbul University-Cerrahpaşa, Faculty of Health Sciences, Health Economics, Istanbul, Turkey (CB); and Istanbul University-Cerrahpaşa, Institute of Graduate Studies, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey (ET)
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Tzilas V, Roussis I, Sakellaropoulou K, Chrysikos S, Hillas G, Ryu JH. A 68-Year-Old Patient With Dyspnea and Hypoxemia After Total Hip Arthroplasty. Chest 2023; 164:e107-e110. [PMID: 37805247 DOI: 10.1016/j.chest.2023.04.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/09/2023] [Accepted: 04/29/2023] [Indexed: 10/09/2023] Open
Abstract
CASE PRESENTATION A 68-year-old patient with obesity (BMI, 4 7 kg/m2) was transferred to the ED of our hospital because of dyspnea and pronounced hypoxemia. The patient underwent total right hip arthroplasty in an outside hospital because of osteoarthritis; there was no history of trauma. After 48 h, she experienced dyspnea with severe hypoxemia. The next day she was transferred to our hospital. Her history was notable for arterial hypertension and depression, but not heart failure. Her medications included candesartan (16 mg once daily) and sertraline (100 mg once daily). Perioperatively, she received enoxaparin 4.000 International Units subcutaneously once daily. There was no family history of respiratory diseases. The patient currently smokes (50 pack-years) with no recent increase in her habit and denied vaping, alcohol consumption, illicit drug use, and any home or occupational exposures. Prior to surgery, the family of the patient reported that she maintained modest mobility despite her osteoarthritis and was able to fulfill her daily activities. Interestingly, she reported a similar event of severe dyspnea and hypoxemia after total knee arthroplasty 3 years earlier; however, no further details were available.
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Affiliation(s)
- Vasilios Tzilas
- 5th Respiratory Department, Chest Diseases Hospital "Sotiria," Athens Greece.
| | - Ioannis Roussis
- 5th Respiratory Department, Chest Diseases Hospital "Sotiria," Athens Greece
| | | | - Serafeim Chrysikos
- 5th Respiratory Department, Chest Diseases Hospital "Sotiria," Athens Greece
| | - Georgios Hillas
- 5th Respiratory Department, Chest Diseases Hospital "Sotiria," Athens Greece
| | - Jay H Ryu
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN
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Gløersen M, Steen Pettersen P, Neogi T, Sexton J, Kvien TK, Hammer HB, Haugen IK. Associations between pain sensitization and measures of physical function in people with hand osteoarthritis: Results from the Nor-Hand study. Osteoarthritis Cartilage 2023; 31:1388-1395. [PMID: 37495183 PMCID: PMC10528207 DOI: 10.1016/j.joca.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 06/28/2023] [Accepted: 07/18/2023] [Indexed: 07/28/2023]
Abstract
OBJECTIVE To examine whether pain sensitization is associated with hand and lower extremity function in people with hand osteoarthritis (OA) in the Nor-Hand study. DESIGN Pain sensitization was assessed by pressure pain thresholds (PPTs) and temporal summation (TS). Hand function was assessed by Australian/Canadian Osteoarthritis Hand Index (AUSCAN) (range: 0-36), grip strength and Moberg pick-up test, and lower extremity function was assessed by Western Ontario and McMaster Universities Osteoarthritis Index (range: 0-68), 30-s chair stand test, and 40-m walk test. We examined whether sex-standardized PPT and TS values were cross-sectionally associated with measures of physical function using linear regression analyses. Beta coefficients were presented per sex-specific standard deviation of PPT and TS. The mediating effect of pain was examined by causal-inference based mediation analysis. RESULTS In 206 participants, higher PPTs at/near the hand, indicative of less peripheral and/or central pain sensitization, were associated with greater grip strength and better self-reported hand function (beta for PPT at finger joint on AUSCAN function: -1.41, 95% CI -2.40, -0.42). Higher PPTs at/near the hand, near the knee and at trapezius were associated with lower extremity function, although not statistically significant for all outcomes. Self-reported pain severity mediated the effect of PPT on self-reported function. TS was not associated with hand or lower extremity function. CONCLUSION Peripheral sensitization, and possibly central sensitization, was associated with impaired function. Effects of PPTs on self-reported function were mediated by self-reported pain, whereas there might be a direct effect of sensitization or effects through other mediators on performance-based function.
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Affiliation(s)
- Marthe Gløersen
- Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway; University of Oslo, Faculty of Medicine, Oslo, Norway.
| | - Pernille Steen Pettersen
- Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway.
| | - Tuhina Neogi
- Section of Rheumatology, Boston University School of Medicine, Boston, United States of America.
| | - Joseph Sexton
- Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway.
| | - Tore K Kvien
- Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway; University of Oslo, Faculty of Medicine, Oslo, Norway.
| | - Hilde Berner Hammer
- Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway; University of Oslo, Faculty of Medicine, Oslo, Norway.
| | - Ida K Haugen
- Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway.
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Zhou J, Ren R, Li Z, Zhu S, Jiang N. Temporomandibular joint osteoarthritis: A review of animal models induced by surgical interventions. Oral Dis 2023; 29:2521-2528. [PMID: 35615772 DOI: 10.1111/odi.14266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 04/14/2022] [Accepted: 05/10/2022] [Indexed: 02/05/2023]
Abstract
OBJECTIVES The pathological mechanism of temporomandibular joint osteoarthritis (TMJOA) is still unclear. Animal models induced by surgical interventions are one of the most ideal tools to imitate human pathological conditions. This review aims to define the similarities and differences of different surgical animal models. METHODS Articles of TMJOA surgical animal models were collected including anterior disc displacement, disc perforation, and discectomy. We analyzed their experiments strategies based on comparing preoperative selection, intraoperative methodology, and postoperative manifestations. RESULTS No matter which surgical intervention is selected, abnormal stress forces the whole joint to remodel its structure so that it could adapt to functional requirements, resulting in TMJOA eventually. However, anterior disc displacement needs more than 16 weeks to obtain typical manifestations, where the methodology is complicated. The course of perforation and discectomy is around 12-16 weeks, but they could cause excessive damage to the TMJ structure. CONCLUSIONS All surgical interventions can cause TMJOA, but the extent of pathology varies from each other. This review will assist future experiments to better understand the pathogenesis of TMJOA and choose the most appropriate model.
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Affiliation(s)
- Jiahao Zhou
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Disease and West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Rong Ren
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Disease and West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zhen Li
- AO Research Institute Davos, Davos, Switzerland
| | - Songsong Zhu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Disease and West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Nan Jiang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Disease and West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Karsdal MA, Tambiah J, Felson D, Ladel C, Nikolov NP, Hodgins D, Bihlet AR, Neogi T, Baatenburg de Jong C, Bay-Jensen AC, Baron R, Laslop A, Mobasheri A, Kraus VB. Reflections from the OARSI 2022 clinical trials symposium: The pain of OA-Deconstruction of pain and patient-reported outcome measures for the benefit of patients and clinical trial design. Osteoarthritis Cartilage 2023; 31:1293-1302. [PMID: 37380011 DOI: 10.1016/j.joca.2023.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 06/01/2023] [Accepted: 06/19/2023] [Indexed: 06/30/2023]
Abstract
OBJECTIVE Osteoarthritis (OA) drug development is hampered by a number of challenges. One of the main challenges is the apparent discordance between pain and structure, which has had a significant impact on drug development programs and has led to hesitance among stakeholders. Since 2017, the Clinical Trials Symposium (CTS) has been hosted under the Osteoarthritis Research Society International (OARSI) leadership. OARSI and the CTS steering committee yearly invite and encourage discussions on selected special subject matter between regulators, drug developers, clinicians, clinical researchers, biomarker specialists, and basic scientists to progress drug development in the OA field. METHOD The main topic for the 2022 OARSI CTS was to elucidate the many facets of pain in OA and to enable a discussion between regulators (Food and Drug Administration (FDA) and the European Medicines Agency (EMA)) and drug developers to clarify outcomes and study designs for OA drug development. RESULTS Signs or symptoms indicative of nociceptive pain occur in 50-70% of OA patients, neuropathic-like pain in 15-30% of patients, and nociplastic pain in 15-50% of patients. Weight-bearing knee pain is associated with bone marrow lesions and effusions. There are currently no simple objective functional tests whose improvements correlate with patient perceptions. CONCLUSIONS The CTS participants, in collaboration with the FDA and EMA, raised several suggestions that they consider key to future clinical trials in OA including the need for more precise differentiation of pain symptoms and mechanisms, and methods to reduce placebo responses in OA trials.
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Affiliation(s)
- M A Karsdal
- Nordic Bioscience, Herlev, Denmark; Southern Danish University, Odense, Denmark.
| | - J Tambiah
- Biosplice Therapeutics, San Diego, USA
| | - D Felson
- Boston University School of Medicine, Boston, MA, USA
| | - C Ladel
- CHL4special Consultancy, Darmstadt, Germany
| | - N P Nikolov
- Office of New Drugs, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | - D Hodgins
- Dynamic Metrics Limited, Codicote, UK
| | | | - T Neogi
- Boston University School of Medicine, Boston, MA, USA
| | | | | | - R Baron
- University Medical Center Schleswig-Holstein (UKSH), Campus Kiel, Kiel, Germany
| | - A Laslop
- Committee for Medicinal Products for Human Use (CHMP), European Medicines Agency, Amsterdam, the Netherlands; Bundesamt für Sicherheit im Gesundheitswesen (BASG), Vienna, Austria
| | - A Mobasheri
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, 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, Université de Liège, Liege, Belgium
| | - V B Kraus
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
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Smith ESJ. A new art to treating osteoarthritis pain? Osteoarthritis Cartilage 2023; 31:1275-1277. [PMID: 37460008 DOI: 10.1016/j.joca.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 07/10/2023] [Indexed: 07/31/2023]
Affiliation(s)
- Ewan St J Smith
- Department of Pharmacology, University of Cambridge, Tennis Court Road, Cambridge CB2 1PD, UK.
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Alenazi AM, Alkhathami KM. Hypertension Is Associated with Joint Pain Severity Among Individuals with Osteoarthritis. Pain Manag Nurs 2023; 24:e97-e101. [PMID: 37544788 DOI: 10.1016/j.pmn.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 07/11/2023] [Accepted: 07/15/2023] [Indexed: 08/08/2023]
Abstract
Previous studies have reported an association between hypertension (HTN) and osteoarthritis (OA). However, limited research has examined the association between HTN and symptoms, such as pain severity, in people with OA. Therefore, the aim was to investigate the prevalence of HTN in individuals with OA and the association between HTN and pain severity in this population. This study was cross-sectional and included participants aged 50 years and older from the community. Demographic data were included and self-reported history of chronic illnesses including diabetes, HTN, cardiovascular disease, dyslipidemia, anemia, osteoporosis, neurological disease, and back pain were obtained. Numerous medications and chronic diseases were included. A subsample of people who self-reported osteoarthritis was included in this study. Pain severity was measured over the past 7 days using a pain numeric rating scale. Multiple linear regression was used after adjusting for covariates. A total of 82 participants with OA were included, and the prevalence of HTN among individuals with OA was 28.91%. Hypertension was significantly associated with increased joint pain severity in this population after adjustments for covariates (B=1.81; 95% CI, 0.65, 2.97; p = .003). Hypertension is prevalent in individuals with OA and is significantly associated with pain severity in this population. Future research should consider the effect of HTN control and medication on symptoms in people with OA. Clinicians may implement screening for HTN among individuals with OA because of the association between HTN and symptoms, such as pain, in this population.
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Affiliation(s)
- Aqeel M Alenazi
- Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Riyadh, Saudi Arabia.
| | - Khalid M Alkhathami
- Department of Health Rehabilitation, Shaqra University, Shaqra, Riyadh, Saudi Arabia
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Amodeo G, Franchi S, D’Agnelli S, Galimberti G, Baciarello M, Bignami EG, Sacerdote P. Supraspinal neuroinflammation and anxio-depressive-like behaviors in young- and older- adult mice with osteoarthritis pain: the effect of morphine. Psychopharmacology (Berl) 2023; 240:2131-2146. [PMID: 37530884 PMCID: PMC10506934 DOI: 10.1007/s00213-023-06436-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 07/24/2023] [Indexed: 08/03/2023]
Abstract
RATIONALE Asteoarthritis (OA) is a leading cause of chronic pain in the elderly population and is often associated with emotional comorbidities such as anxiety and depression. Despite age is a risk factor for both OA and mood disorders, preclinical studies are mainly conducted in young adult animals. OBJECTIVES Here, using young adult (11-week-old) and older adult (20-month-old) mice, we evaluate in a monosodium-iodoacetate-(MIA)-induced OA model the development of anxio-depressive-like behaviors and whether brain neuroinflammation may underlie the observed changes. We also test whether an effective pain treatment may prevent behavioral and biochemical alterations. METHODS Mechanical allodynia was monitored throughout the experimental protocol, while at the end of protocol (14 days), anxio-depressive-like behaviors and cognitive dysfunction were assessed. Neuroinflammatory condition was evaluated in prefrontal cortex, hippocampus and hypothalamus. Serum IFNγ levels were also measured. Moreover, we test the efficacy of a 1-week treatment with morphine (2.5 mg/kg) on pain, mood alterations and neuroinflammation. RESULTS We observed that young adult and older adult controls (CTRs) mice had comparable allodynic thresholds and developed similar allodynia after MIA injection. Older adult CTRs were characterized by altered behavior in the tests used to assess the presence of depression and cognitive impairment and by elevated neuroinflammatory markers in brain areas compared to younger ones. The presence of pain induced depressive-like behavior and neuroinflammation in adult young mice, anxiety-like behavior in both age groups and worsened neuroinflammation in older adult mice. Morphine treatment counteracted pain, anxio-depressive behaviors and neuroinflammatory activation in both young adult and older adult mice. CONCLUSIONS Here, we demonstrated that the presence of chronic pain in young adult mice induces mood alterations and supraspinal biochemical changes and aggravates the alterations already evident in older adult animals. A treatment with morphine, counteracting the pain, prevents the development of anxio-depressive disorders and reduces neuroinflammation.
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Affiliation(s)
- Giada Amodeo
- Dipartimento Di Scienze Farmacologiche E Biomolecolari, University of Milan, Via Vanvitelli 32, 20129 Milano, Italy
| | - Silvia Franchi
- Dipartimento Di Scienze Farmacologiche E Biomolecolari, University of Milan, Via Vanvitelli 32, 20129 Milano, Italy
| | - Simona D’Agnelli
- Anesthesiology, Critical Care and Pain Medicine Division, Department of Medicine and Surgery, University of Parma, Via Gramsci 14, 43126 Parma, Italy
| | - Giulia Galimberti
- Dipartimento Di Scienze Farmacologiche E Biomolecolari, University of Milan, Via Vanvitelli 32, 20129 Milano, Italy
| | - Marco Baciarello
- Anesthesiology, Critical Care and Pain Medicine Division, Department of Medicine and Surgery, University of Parma, Via Gramsci 14, 43126 Parma, Italy
| | - Elena Giovanna Bignami
- Anesthesiology, Critical Care and Pain Medicine Division, Department of Medicine and Surgery, University of Parma, Via Gramsci 14, 43126 Parma, Italy
| | - Paola Sacerdote
- Dipartimento Di Scienze Farmacologiche E Biomolecolari, University of Milan, Via Vanvitelli 32, 20129 Milano, Italy
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Menz HB, Allan JJ, Buldt AK, Landorf KB, Cicuttini FM, Roddy E, Munteanu SE. Neuropathic Pain Associated With First Metatarsophalangeal Joint Osteoarthritis: Frequency and Associated Factors. Arthritis Care Res (Hoboken) 2023; 75:2127-2133. [PMID: 37013633 PMCID: PMC10952225 DOI: 10.1002/acr.25125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 02/23/2023] [Accepted: 03/30/2023] [Indexed: 04/05/2023]
Abstract
OBJECTIVE To determine whether neuropathic pain is a feature of first metatarsophalangeal (MTP) joint osteoarthritis (OA). METHODS A total of 98 participants (mean ± SD age 57.4 ± 10.3 years) with symptomatic radiographic first MTP joint OA completed the PainDETECT questionnaire (PD-Q), which has 9 questions regarding the intensity and quality of pain. The likelihood of neuropathic pain was determined using established PD-Q cutoff points. Participants with unlikely neuropathic pain were then compared to those with possible/likely neuropathic pain in relation to age, sex, general health (Short Form 12 [SF-12] health survey), psychological well-being (Depression, Anxiety and Stress Scale), pain characteristics (self-efficacy, duration, and severity), foot health (Foot Health Status Questionnaire [FHSQ]), first MTP dorsiflexion range of motion, and radiographic severity. Effect sizes (Cohen's d coefficient) were also calculated. RESULTS A total of 30 (31%) participants had possible/likely neuropathic pain (19 possible [19.4%], 11 likely [11.2%]). The most common neuropathic symptoms were sensitivity to pressure (56%), sudden pain attacks/electric shocks (36%) and burning (24%). Compared to those with unlikely neuropathic pain, those with possible/likely neuropathic pain were significantly older (d = 0.59, P = 0.010), had worse SF-12 physical scores (d = 1.10, P < 0.001), pain self-efficacy scores (d = 0.98, P < 0.001), FHSQ pain scores (d = 0.98, P < 0.001), and FHSQ function scores (d = 0.82, P < 0.001), and had higher pain severity at rest (d = 1.01, P < 0.001). CONCLUSION A significant proportion of individuals with first MTP joint OA report symptoms suggestive of neuropathic pain, which may partly explain the suboptimal responses to commonly used treatments for this condition. Screening for neuropathic pain may be useful in the selection of targeted interventions and may improve clinical outcomes.
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Affiliation(s)
| | | | | | | | | | - Edward Roddy
- Keele University, Keele, Staffordshire, UK, and Haywood HospitalBurslemStaffordshireUK
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Alyousef YS, Johnston V, Smith MD. Work-related outcomes in individuals with and without lower limb osteoarthritis: an online survey. BMC Public Health 2023; 23:1885. [PMID: 37773119 PMCID: PMC10540324 DOI: 10.1186/s12889-023-16723-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 09/08/2023] [Indexed: 09/30/2023] Open
Abstract
OBJECTIVE While osteoarthritis (OA) affects people who are still participating in the workforce, there is limited data about the impact of OA on work. The aim of this study was to compare work participation in individuals with and without lower limb OA. METHODS This cross-sectional study included workers with (n = 124) and without (n = 106) lower limb OA. Work participation was assessed as work status (full/part time work), work ability (Work Ability Index (WAI)), absenteeism and presenteeism (World Health Organization's Health and Work Performance Questionnaire (WHO-HPQ)), and perceived difficulties meeting work demands (Work Role Functioning Questionnaire (WRFQ)). The data were analyzed using an analysis of covariance with age, body mass index and physical job demands included as covariates. RESULTS Work ability was poorer (p < 0.001) and loss of work performance (p < 0.001) was higher among workers with OA than healthy controls. There was no statistical difference in absenteeism or overall ability to meet work demands between participants with and without lower limb OA. However, workers with lower limb OA had more difficulty with work scheduling demands (p = 0.05) and physical demands (p = 0.003) than healthy workers. CONCLUSION Lower limb OA was associated with poorer work ability, loss of work performance and difficulty in meeting physical and work scheduling demands. Health professionals and employers should consider these challenges when managing individuals with lower limb OA and supporting them to remain in the workforce.
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Affiliation(s)
- Yousef S Alyousef
- The University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Brisbane, QLD, Australia
- College of Applied Medical Sciences, Majmaah University, Al Majmaah, Saudi Arabia
| | - Venerina Johnston
- College of Applied Medical Sciences, Majmaah University, Al Majmaah, Saudi Arabia
- School of Health and Medical Sciences, University of Southern Queensland, Ipswich, QLD, Australia
| | - Michelle D Smith
- College of Applied Medical Sciences, Majmaah University, Al Majmaah, Saudi Arabia.
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Burley CV, Casey AN, Jones MD, Wright KE, Parmenter BJ. Nonpharmacological approaches for pain and symptoms of depression in people with osteoarthritis: systematic review and meta-analyses. Sci Rep 2023; 13:15449. [PMID: 37723233 PMCID: PMC10507102 DOI: 10.1038/s41598-023-41709-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 08/30/2023] [Indexed: 09/20/2023] Open
Abstract
People with osteoarthritis often experience pain and depression. These meta-analyses examined and compared nonpharmacological randomized controlled trials (RCTs) for pain and symptoms of depression in people living with osteoarthritis. RCTs published up until April 2022 were sourced by searching electronic databases EMBASE, PUBMED & MEDLINE, Web of Science, CINAHL and PEDro. Random-effects meta-analyses were performed to calculate pooled effect sizes (ES) and 95% confidence intervals (CI) for pain and depression. Subgroup analyses examined intervention subtypes. For pain, 29 interventions (n = 4382; 65 ± 6.9 years; 70% female), revealed a significant effect on reducing pain (ES = 0.43, 95% CI [0.25, 0.61], p < 0.001). Effect sizes were significant (p < 0.001) for movement meditation (ES = 0.52; 95% CI [0.35, 0.69]), multimodal approaches (ES = 0.37; 95% CI [0.22, 0.51]), and psychological therapy (ES = 0.21; 95% CI [0.11, 0.31]), and significant (p = 0.046) for resistance exercise (ES = 0.43, 95% CI [- 0.07, 0.94]. Aerobic exercise alone did not improve pain. For depression, 28 interventions (n = 3377; 63 ± 7.0 years; 69% female), revealed a significant effect on reducing depressive symptoms (ES = 0.29, 95% CI [0.08, 0.49], p < 0.001). Effect sizes were significant for movement meditation (ES = 0.30; 95% CI [0.06, 0.55], p = 0.008) and multimodal interventions (ES = 0.12; 95% CI [0.07, 0.18], p < 0.001). Resistance/aerobic exercise or therapy alone did not improve depressive symptoms. Mind-body approaches were more effective than aerobic/resistance exercise or therapy alone for reducing pain and depression in people with osteoarthritis.Systematic review registration: PROSPERO CRD42022338051.
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Affiliation(s)
- Claire V Burley
- UNSW Medicine & Health Lifestyle Clinic, School of Health Sciences, University of New South Wales, Sydney, Australia.
- Centre for Healthy Brain Ageing, School of Clinical Medicine, University of New South Wales, Sydney, Australia.
| | - Anne-Nicole Casey
- Centre for Healthy Brain Ageing, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Matthew D Jones
- Department of Exercise Physiology, School of Health Sciences, University of New South Wales, Sydney, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia
| | - Kemi E Wright
- Department of Exercise Physiology, School of Health Sciences, University of New South Wales, Sydney, Australia
| | - Belinda J Parmenter
- UNSW Medicine & Health Lifestyle Clinic, School of Health Sciences, University of New South Wales, Sydney, Australia
- Department of Exercise Physiology, School of Health Sciences, University of New South Wales, Sydney, Australia
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