Case definitions of knee osteoarthritis in 4,151 unselected subjects: relevance for epidemiological studies. The Copenhagen osteoarthritis study

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Laxafoss, Erling; Jacobsen, Steffen; Gosvig, Kasper K.; Sonne-Holm, Stig [Copenhagen University Hospital of Hvidovre (Denmark). Department of Orthopaedic Surgery

2010-09-15

The aims of the present study were threefold: to examine the distribution of knee joint osteoarthritis in a large, standardized radiological study; to examine the relationships between self reported knee pain and radiological OA; and to examine the natural history of radio-morphological change over age in individuals without radiological features of OA. The Copenhagen Osteoarthritis Study - COS is a substudy of the Copenhagen City Heart Study, a longitudinal regional health survey. From the third inclusion of the CCHS (1992-1994) 4,151 subjects were selected for subsequent standardized radiography of the pelvis, the knees, the hands, the wrists, and the lumbar spine. Images were analyzed and knee joint osteoarthritis (OA) was classified according to the radiographic atlas of Kellgren and Lawrence. Joint space width (JSW) was measured at three sites within both the medial and the lateral compartment. For the entire cohort the prevalence of radiological knee joint OA of all grades was 38.7% for men and 44.2% for women. Age stratification documented increasing knee joint OA both in regard to prevalence and morphological severity. Knee pain was universally correlated to the Kellgren and Lawrence severity of OA. In a subgroup with no features of radiological OA, a significant and linear decline in JSW with increasing age was found. We found a clear relationship between self-reported knee pain and radiological osteoarthritis. Pain was proportionally related to the severity of change. We also demonstrated a significant diminishing of joint space width with increasing age in individuals without apparent radiological degeneration. (orig.)

A Novel Method to Simulate the Progression of Collagen Degeneration of Cartilage in the Knee: Data from the Osteoarthritis Initiative

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Mononen, Mika E.; Tanska, Petri; Isaksson, Hanna; Korhonen, Rami K.

2016-02-01

We present a novel algorithm combined with computational modeling to simulate the development of knee osteoarthritis. The degeneration algorithm was based on excessive and cumulatively accumulated stresses within knee joint cartilage during physiological gait loading. In the algorithm, the collagen network stiffness of cartilage was reduced iteratively if excessive maximum principal stresses were observed. The developed algorithm was tested and validated against experimental baseline and 4-year follow-up Kellgren-Lawrence grades, indicating different levels of cartilage degeneration at the tibiofemoral contact region. Test groups consisted of normal weight and obese subjects with the same gender and similar age and height without osteoarthritic changes. The algorithm accurately simulated cartilage degeneration as compared to the Kellgren-Lawrence findings in the subject group with excess weight, while the healthy subject group’s joint remained intact. Furthermore, the developed algorithm followed the experimentally found trend of cartilage degeneration in the obese group (R2 = 0.95, p osteoarthritis (0-2 years, p  0.05). The proposed algorithm revealed a great potential to objectively simulate the progression of knee osteoarthritis.

Interphalangeal Osteoarthritis Radiographic Simplified (iOARS) score: a radiographic method to detect osteoarthritis of the interphalangeal finger joints based on its histopathological alterations.

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Sunk, Ilse-Gerlinde; Amoyo-Minar, Love; Stamm, Tanja; Haider, Stefanie; Niederreiter, Birgit; Supp, Gabriela; Soleiman, Afschin; Kainberger, Franz; Smolen, Josef S; Bobacz, Klaus

2014-11-01

To develop a radiographic score for assessment of hand osteoarthritis (OA) that is based on histopathological alterations of the distal (DIP) and proximal (PIP) interphalangeal joints. DIP and PIP joints were obtained from corpses (n=40). Plain radiographies of these joints were taken. Joint samples were prepared for histological analysis; cartilage damage was graded according to the Mankin scoring system. A 2×2 Fisher's exact test was applied to define those radiographic features most likely to be associated with histological alterations. Receiver operating characteristic curves were analysed to determine radiographic thresholds. Intraclass correlation coefficients (ICC) estimated intra- and inter-reader variability. Spearman's correlation was applied to examine the relationship between our score and histopathological changes. Differences between groups were determined by a Student's t test. The Interphalangeal Osteoarthritis Radiographic Simplified (iOARS) score is presented. The score is based on histopathological changes of DIP and PIP joints and follows a simple dichotomy whether OA is present or not. The iOARS score relies on three equally ranked radiographic features (osteophytes, joint space narrowing and subchondral sclerosis). For both DIP and PIP joints, the presence of one x-ray features reflects interphalangeal OA. Sensitivity and specificity for DIP joints were 92.3% and 90.9%, respectively, and 75% and 100% for PIP joints. All readers were able to reproduce their own readings in DIP and PIP joints after 4 weeks. The overall agreement between the three readers was good; ICCs ranged from 0.945 to 0.586. Additionally, outcomes of the iOARS score in a hand OA cohort revealed a higher prevalence of interphalangeal joint OA compared with the Kellgren and Lawrence score. The iOARS score is uniquely based on histopathological alterations of the interphalangeal joints in order to reliably determine OA of the DIP and PIP joints radiographically. Its high

Hidden osteophyte formation on plain X-ray is the predictive factor for development of knee osteoarthritis after 48 months--data from the Osteoarthritis Initiative.

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Katsuragi, J; Sasho, T; Yamaguchi, S; Sato, Y; Watanabe, A; Akagi, R; Muramatsu, Y; Mukoyama, S; Akatsu, Y; Fukawa, T; Endo, J; Hoshi, H; Yamamoto, Y; Sasaki, T; Takahashi, K

2015-03-01

To examine whether the detection of osteophytes anywhere in the knee could serve as a pre-radiographic biomarker for osteoarthritis (OA) development. Baseline magnetic resonance imaging (MRIs) of 132 participants in the Osteoarthritis Initiative (OAI) were studied. Based on radiographs, 66 knees were assessed as osteoarthritis-free (no-osteoarthritis [NOA], or Kellgren/Lawrence [K/L] severity grade 0/1 both at baseline and 48 months), and another 66 knees were assessed as having radiographic OA changes (pre-radiographic osteoarthritis [PROA], or with K/L grade 0/1 at baseline and grade ≥ 2 at 48 months). Using baseline MRI data, we examined eight sites of osteophyte formation: the medial and lateral femoral condyle (MFC and LFC, respectively); medial and lateral tibial plateau (MTP and LTP, respectively); medial and lateral facets of the patellofemoral joint (PM and PL, respectively); tibial spine (TS); and femoral intercondylar notch (IC). Knee joint osteophyte size was assessed via the 8-point marginal osteophytes item of the whole-organ magnetic resonance imaging score (WORMS). The frequencies and distributions of osteophytes were compared between groups. Mild-size osteophytes (defined as score ≥ 2) were observed more frequently at the MFC (P = 0.00278), MTP (P = 0.0046), TS (P = 0.0146), PM (P formation at the IC, even those of K/L severity grade 0/1, are at risk for the development of radiographic OA by 48 months. Copyright © 2014 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

T2 map signal variation predicts symptomatic osteoarthritis progression: data from the Osteoarthritis Initiative

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Zhong, Haoti; Miller, David J. [The Pennsylvania State University, Department of Electrical Engineering, University Park, PA (United States); Urish, Kenneth L. [Magee Womens Hospital of the University of Pittsburgh Medical Center, The Bone and Joint Center, Pittsburgh, PA (United States); University of Pittsburgh School of Medicine, Department of Orthopaedic Surgery, Pittsburgh, PA (United States)

2016-07-15

The aim of this work is to use quantitative magnetic resonance imaging (MRI) to identify patients at risk for symptomatic osteoarthritis (OA) progression. We hypothesized that classification of signal variation on T2 maps might predict symptomatic OA progression. Patients were selected from the Osteoarthritis Initiative (OAI), a prospective cohort. Two groups were identified: a symptomatic OA progression group and a control group. At baseline, both groups were asymptomatic (Western Ontario and McMaster Universities Arthritis [WOMAC] pain score total <10) with no radiographic evidence of OA (Kellgren-Lawrence [KL] score ≤ 1). The OA progression group (n = 103) had a change in total WOMAC score greater than 10 by the 3-year follow-up. The control group (n = 79) remained asymptomatic, with a change in total WOMAC score less than 10 at the 3-year follow-up. A classifier was designed to predict OA progression in an independent population based on T2 map cartilage signal variation. The classifier was designed using a nearest neighbor classification based on a Gaussian Mixture Model log-likelihood fit of T2 map cartilage voxel intensities. The use of T2 map signal variation to predict symptomatic OA progression in asymptomatic individuals achieved a specificity of 89.3 %, a sensitivity of 77.2 %, and an overall accuracy rate of 84.2 %. T2 map signal variation can predict symptomatic knee OA progression in asymptomatic individuals, serving as a possible early OA imaging biomarker. (orig.)

Treatment of Osteoarthritis of the Knee with a Combination of Autologous Conditioned Serum and Physiotherapy: A Two-Year Observational Study.

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Baselga García-Escudero, Jaime; Miguel Hernández Trillos, Pedro

2015-01-01

Autologous conditioned serum (ACS) is an autologous blood product that has shown efficacy against knee osteoarthritis (OA) in randomized controlled trials. However, there are few reports of its effectiveness in everyday practice. Here, we report clinical efficacy results from a two-year prospective observational study of patients with highly symptomatic knee OA who received ACS in conjunction with physiotherapy. 118 patients with unilateral knee OA (Kellgren-Lawrence grades I-IV), who were candidates for surgery but instead chose conservative treatment, were treated with a combination of four intra-articular injections of ACS (2 mL each) once weekly over four weeks and subsequent physiotherapy applied 4 weeks after ACS injection. Main endpoints of the study were pain (Numeric Rating Scale [NRS]) assessed at 0, 3, 6, 12 and 24 months, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) global score, assessed at 0 and 24 months. The effect size (Cohen's d) was calculated for pain and WOMAC outcomes, with effect sizes >0.8 considered large. By 3 months, there were significant improvements in pain (NRS) from baseline (-63.0%, p5) and WOMAC improvement (8.0-13.6) were very large. Only one patient received total knee joint replacement during the study. Clinical improvement did not correlate with gender, age, Kellgren-Lawrence grade, or body mass index. Treatment with ACS and physiotherapy produced a rapid decline in pain, which was sustained for the entire two years of the study. This was accompanied by a large improvement in WOMAC scores at two years. These results confirm that ACS combined with physiotherapy is an effective treatment for OA of the knee.

Treatment of Osteoarthritis of the Knee with a Combination of Autologous Conditioned Serum and Physiotherapy: A Two-Year Observational Study.

Directory of Open Access Journals (Sweden)

Jaime Baselga García-Escudero

Full Text Available Autologous conditioned serum (ACS is an autologous blood product that has shown efficacy against knee osteoarthritis (OA in randomized controlled trials. However, there are few reports of its effectiveness in everyday practice. Here, we report clinical efficacy results from a two-year prospective observational study of patients with highly symptomatic knee OA who received ACS in conjunction with physiotherapy.118 patients with unilateral knee OA (Kellgren-Lawrence grades I-IV, who were candidates for surgery but instead chose conservative treatment, were treated with a combination of four intra-articular injections of ACS (2 mL each once weekly over four weeks and subsequent physiotherapy applied 4 weeks after ACS injection. Main endpoints of the study were pain (Numeric Rating Scale [NRS] assessed at 0, 3, 6, 12 and 24 months, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC global score, assessed at 0 and 24 months. The effect size (Cohen's d was calculated for pain and WOMAC outcomes, with effect sizes >0.8 considered large.By 3 months, there were significant improvements in pain (NRS from baseline (-63.0%, p5 and WOMAC improvement (8.0-13.6 were very large. Only one patient received total knee joint replacement during the study. Clinical improvement did not correlate with gender, age, Kellgren-Lawrence grade, or body mass index.Treatment with ACS and physiotherapy produced a rapid decline in pain, which was sustained for the entire two years of the study. This was accompanied by a large improvement in WOMAC scores at two years. These results confirm that ACS combined with physiotherapy is an effective treatment for OA of the knee.

[Quality of life in patients with knee and hip osteoarthritis].

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Bernad-Pineda, M; de Las Heras-Sotos, J; Garcés-Puentes, M V

2014-01-01

To evaluate the quality of life in patients with knee and hip osteoarthritis through self-assessment and those made by the physician. An observational and cross-sectional multicenter study in which 628 traumatologists or rheumatologists evaluated 1,849 patients with knee and/or hip osteoarthritis, aged ≥ 50 years old, and representative of 49 Spanish provinces. Each researcher evaluated three patients and also completed the SF-12v2 health questionnaire. The patients completed the WOMAC and SF-12v2 questionnaires. The patients were 68.5 ± 9.5 years old, 61.5% had knee osteoarthritis, 19% had hip osteoarthritis, and 19.5% in both locations. Older patients and those who had both knee and hip osteoarthritis had a poorer quality of life, according to patients and researchers. Physical health perceived by the researchers was better than patients reported (36.74 ± 8.6 and 35.21 ± 8.53; respectively, p<0.001), and the mental health score was similar between physicians and patients. Kellgren/Lawrence scale and test Timed Up & Go predict better the quality of life, assessed by WOMAC and SF-12v2 questionnaires. This is the Spanish study on quality of life in osteoarthritis of the knee and hip of larger amplitude and number of patients. These results could be considered as reference values of Spanish population aged ≥ 50 years with knee or hip osteoarthritis. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

Quantitative 3D analysis of bone in hip osteoarthritis using clinical computed tomography

International Nuclear Information System (INIS)

Turmezei, Tom D.; Treece, Graham M.; Gee, Andrew H.; Fotiadou, Anastasia F.; Poole, Kenneth E.S.

2016-01-01

To assess the relationship between proximal femoral cortical bone thickness and radiological hip osteoarthritis using quantitative 3D analysis of clinical computed tomography (CT) data. Image analysis was performed on clinical CT imaging data from 203 female volunteers with a technique called cortical bone mapping (CBM). Colour thickness maps were created for each proximal femur. Statistical parametric mapping was performed to identify statistically significant differences in cortical bone thickness that corresponded with the severity of radiological hip osteoarthritis. Kellgren and Lawrence (K and L) grade, minimum joint space width (JSW) and a novel CT-based osteophyte score were also blindly assessed from the CT data. For each increase in K and L grade, cortical thickness increased by up to 25 % in distinct areas of the superolateral femoral head-neck junction and superior subchondral bone plate. For increasing severity of CT osteophytes, the increase in cortical thickness was more circumferential, involving a wider portion of the head-neck junction, with up to a 7 % increase in cortical thickness per increment in score. Results were not significant for minimum JSW. These findings indicate that quantitative 3D analysis of the proximal femur can identify changes in cortical bone thickness relevant to structural hip osteoarthritis. (orig.)

Atraumatic medial collateral ligament oedema in medial compartment knee osteoarthritis

International Nuclear Information System (INIS)

Bergin, D.; Keogh, C.; O'Connell, M.; Zoga, A.; Rowe, D.; Shah, B.; Eustace, S.

2002-01-01

Objective: To describe and determine the prevalence of atraumatic medial collateral oedema identified in patients with medial compartment osteoarthritis. Design and patients: Sixty patients, 30 patients with medial compartment knee osteoarthritis (Kellgren and Lawrence grade 2 to 4) and 30 age-matched patients with atraumatic knee pain without osteoarthritis, referred for MR imaging over a 2 year period were included in the study. In each case, severity of osteoarthritis was recorded on radiographs and correlated with the presence or absence of medial collateral ligament oedema at MR imaging. Results: Medial collateral oedema was identified in 27 of the 30 patients with osteoarthritis, of whom 14 had grade 1 oedema and 13 had grade 2 oedema compared with the presence of medial collateral ligament oedema (grade 1) in only two of the 30 control patients without osteoarthritis (P<<0.0001). Conclusion: Medial collateral oedema is common in patients with osteoarthritis in the absence of trauma. When identified, medial collateral ligament oedema should be considered to be a feature of osteoarthritis and should not be incorrectly attributed to an acute traumatic injury. (orig.)

Using multidimensional topological data analysis to identify traits of hip osteoarthritis.

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Rossi-deVries, Jasmine; Pedoia, Valentina; Samaan, Michael A; Ferguson, Adam R; Souza, Richard B; Majumdar, Sharmila

2018-05-07

Osteoarthritis (OA) is a multifaceted disease with many variables affecting diagnosis and progression. Topological data analysis (TDA) is a state-of-the-art big data analytics tool that can combine all variables into multidimensional space. TDA is used to simultaneously analyze imaging and gait analysis techniques. To identify biochemical and biomechanical biomarkers able to classify different disease progression phenotypes in subjects with and without radiographic signs of hip OA. Longitudinal study for comparison of progressive and nonprogressive subjects. In all, 102 subjects with and without radiographic signs of hip osteoarthritis. 3T, SPGR 3D MAPSS T 1ρ /T 2 , intermediate-weighted fat-suppressed fast spin-echo (FSE). Multidimensional data analysis including cartilage composition, bone shape, Kellgren-Lawrence (KL) classification of osteoarthritis, scoring hip osteoarthritis with MRI (SHOMRI), hip disability and osteoarthritis outcome score (HOOS). Analysis done using TDA, Kolmogorov-Smirnov (KS) testing, and Benjamini-Hochberg to rank P-value results to correct for multiple comparisons. Subjects in the later stages of the disease had an increased SHOMRI score (P Analysis of this subgroup identified knee biomechanics (P analysis of an OA subgroup with femoroacetabular impingement (FAI) showed anterior labral tears to be the most significant marker (P = 0.0017) between those FAI subjects with and without OA symptoms. The data-driven analysis obtained with TDA proposes new phenotypes of these subjects that partially overlap with the radiographic-based classical disease status classification and also shows the potential for further examination of an early onset biomechanical intervention. 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018. © 2018 International Society for Magnetic Resonance in Medicine.

Validity and reliability of three definitions of hip osteoarthritis: cross sectional and longitudinal approach

OpenAIRE

Reijman, Max; Hazes, Mieke; Pols, Huib; Bernsen, Roos; Koes, Bart; Bierma-Zeinstra, Sita

2004-01-01

textabstractOBJECTIVES: To compare the reliability and validity in a large open population of three frequently used radiological definitions of hip osteoarthritis (OA): Kellgren and Lawrence grade, minimal joint space (MJS), and Croft grade; and to investigate whether the validity of the three definitions of hip OA is sex dependent. METHODS: SUBJECTS: from the Rotterdam study (aged > or= 55 years, n = 3585) were evaluated. The inter-rater reliability was tested in a random set of 148 x rays. ...

Hyaluronic acid injections for osteoarthritis of the knee: predictors of successful treatment.

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Bowman, Eric N; Hallock, Justin D; Throckmorton, Thomas W; Azar, Fredrick M

2018-04-01

This study aimed to identify patient and treatment factors that predict a favourable response to intra-articular hyaluronic acid (HA) treatment to better guide patient and treatment selection. This prospective, observational study evaluated patients with mild-to-moderate (Kellgren-Lawrence grades 1-3) primary knee osteoarthritis treated between March 2013 and May 2016. Patient function and pain scores were assessed by the Western Ontario and McMaster Universities Arthritis Index/Knee Injury and Osteoarthritis Outcome Score (WOMAC/KOOS) and visual analogue scale (VAS) surveys, with response to treatment defined according to the Osteoarthritis Research Society International (OARSI) 2004 criteria. Surveys were completed at each injection and three months post-treatment. Patients were followed an average of 27 months. Of 102 patients, 57% had a positive response. Those at least twice as likely to respond were patients with grades 1-2 osteoarthritis or a positive response to the first injection and those who were ≥60 years. Gender, race, body mass index (BMI), smoking status, HA brand, and initial VAS and WOMAC/KOOS scores were not significant predictors of success. Mean time to arthroplasty following injection series was 11 months (30% of nonresponders, 12% of responders). The VAS strongly correlated with KOOS pain scores and successful outcomes. Patients with mild-to-moderate osteoarthritis (grades 1-2) and those responding positively to the first injection were twice as likely to respond positively to the injection series, as were patients ≥60 years. Patients who did not respond positively were more likely to proceed to arthroplasty. The VAS appears to be a reliable method of defining and monitoring treatment success. Judicious patient selection and counseling may improve outcomes associated with intra-articular HA injections.

Predictive value of MRI features for development of radiographic osteoarthritis in a cohort of participants with pre-radiographic knee osteoarthritis-the CHECK study

NARCIS (Netherlands)

van Oudenaarde, Kim; Jobke, Björn; Oostveen, Ans C M; Marijnissen, Annekarien C A; Wolterbeek, Ron; Wesseling, Janet; Bierma-Zeinstra, Sita M A; Bloem, Hans L; Reijnierse, Monique; Kloppenburg, Margreet

OBJECTIVE: To determine whether MRI features are associated with development of radiographic knee OA and can be used as a predictive tool in early knee OA. METHODS: In 148 participants of the Cohort Hip and Cohort Knee study (mean age 56 years, 78% women), with a Kellgren Lawrence (KL) score ⩽1, we

New View on the Initial Development Site and Radiographic Classification System of Osteoarthritis of the Knee Based on Radiographic Analysis

OpenAIRE

Moon, Ki-Ho

2012-01-01

Introduction: Radiographic pathology of severe osteoarthritis of the knee (OAK) such as severe osteophyte at tibial spine (TS), compartment narrowing, marginal osteophyte, and subchondral sclerosis is well known. Kellgren-Lawrence grading system, which is widely used to diagnose OAK, describes narrowing-marginal osteophyte in 4-grades but uses osteophyte at TS only as evidence of OAK without detailed-grading. However, kinematically the knee employs medial TS as an axis while medial and latera...

Quantitative 3D analysis of bone in hip osteoarthritis using clinical computed tomography.

Science.gov (United States)

Turmezei, Tom D; Treece, Graham M; Gee, Andrew H; Fotiadou, Anastasia F; Poole, Kenneth E S

2016-07-01

To assess the relationship between proximal femoral cortical bone thickness and radiological hip osteoarthritis using quantitative 3D analysis of clinical computed tomography (CT) data. Image analysis was performed on clinical CT imaging data from 203 female volunteers with a technique called cortical bone mapping (CBM). Colour thickness maps were created for each proximal femur. Statistical parametric mapping was performed to identify statistically significant differences in cortical bone thickness that corresponded with the severity of radiological hip osteoarthritis. Kellgren and Lawrence (K&L) grade, minimum joint space width (JSW) and a novel CT-based osteophyte score were also blindly assessed from the CT data. For each increase in K&L grade, cortical thickness increased by up to 25 % in distinct areas of the superolateral femoral head-neck junction and superior subchondral bone plate. For increasing severity of CT osteophytes, the increase in cortical thickness was more circumferential, involving a wider portion of the head-neck junction, with up to a 7 % increase in cortical thickness per increment in score. Results were not significant for minimum JSW. These findings indicate that quantitative 3D analysis of the proximal femur can identify changes in cortical bone thickness relevant to structural hip osteoarthritis. • CT is being increasingly used to assess bony involvement in osteoarthritis • CBM provides accurate and reliable quantitative analysis of cortical bone thickness • Cortical bone is thicker at the superior femoral head-neck with worse osteoarthritis • Regions of increased thickness co-locate with impingement and osteophyte formation • Quantitative 3D bone analysis could enable clinical disease prediction and therapy development.

Atlas of radiographic features of osteoarthritis of the ankle and hindfoot.

Science.gov (United States)

Kraus, V B; Kilfoil, T M; Hash, T W; McDaniel, G; Renner, J B; Carrino, J A; Adams, S

2015-12-01

To develop a radiographic atlas of osteoarthritis (OA) for use as a template and guide for standardized scoring of radiographic features of OA of the ankle and hindfoot joints. Under Institutional Review Board approval, ankle and hindfoot images were selected from a cohort study and from among cases that underwent ankle radiography during a 6-month period at Duke University Medical Center. Missing OA pathology was obtained through supplementation of cases with the assistance of a foot and ankle specialist in Orthopaedic surgery and a musculoskeletal radiologist. Images were obtained and reviewed without patient identifying information. Images went through multiple rounds of review and final images were selected by consensus of the study team. For intra-rater and inter-rater reliability, the kappa statistic was calculated for two readings by three musculoskeletal radiologists, a minimum of two weeks apart, of ankle and hindfoot radiographs from 30 anonymized subjects. The atlas demonstrates individual radiographic features (osteophyte and joint space narrowing (JSN)) and Kellgren-Lawrence grade for all aspects of the talocrural (ankle joint proper) and talocalcaneal (subtalar) joints. Reliability of scoring based on the atlas was quite good to excellent for most features indicated. Additional examples of ankle joint findings are illustrated including sclerosis, os trigonum, subchondral cysts and talar tilt. It is anticipated that this atlas will assist with standardization of scoring of ankle and hindfoot OA by basic and clinical OA researchers. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Knee Injuries Are Associated with Accelerated Knee Osteoarthritis Progression: Data from the Osteoarthritis Initiative

Science.gov (United States)

Driban, Jeffrey B.; Eaton, Charles B.; Lo, Grace H.; Ward, Robert J.; Lu, Bing; McAlindon, Timothy E.

2014-01-01

Objective We aimed to evaluate if a recent knee injury was associated with accelerated knee osteoarthritis (KOA) progression. Methods In the Osteoarthritis Initiative (OAI) we studied participants free of KOA on their baseline radiographs (Kellgren-Lawrence [KL]knee that progressed to end-stage KOA (KL Grade 3 or 4) within 48 months, 2) common KOA progression: at least one knee increased in radiographic scoring within 48 months (excluding those defined as accelerated KOA), and 3) no KOA: no change in KL grade in either knee. At baseline, participants were asked if their knees had ever been injured and at each annual visit they were asked about injuries during the prior 12 months. We used multinomial logistic regressions to determine if a new knee injury was associated with the outcome of accelerated KOA or common KOA progression after adjusting for age, sex, body mass index, static knee malalignment, and systolic blood pressure. Results A knee injury during the total observation period was associated with accelerated KOA progression (n=54, odds ratio [OR]=3.14) but not common KOA progression (n=187, OR=1.08). Furthermore, a more recent knee injury (within a year of the outcome) was associated with accelerated (OR=8.46) and common KOA progression (OR=3.12). Conclusion Recent knee injuries are associated with accelerated KOA. Most concerning is that certain injuries may be associated with a rapid cascade towards joint failure in less than one year. PMID:24782446

Reliability and Accuracy of Cross-sectional Radiographic Assessment of Severe Knee Osteoarthritis: Role of Training and Experience.

Science.gov (United States)

Klara, Kristina; Collins, Jamie E; Gurary, Ellen; Elman, Scott A; Stenquist, Derek S; Losina, Elena; Katz, Jeffrey N

2016-07-01

To dêtermine the reliability of radiographic assessment of knee osteoarthritis (OA) by nonclinician readers compared to an experienced radiologist. The radiologist trained 3 nonclinicians to evaluate radiographic characteristics of knee OA. The radiologist and nonclinicians read preoperative films of 36 patients prior to total knee replacement. Intrareader and interreader reliability were measured using the weighted κ statistic and intraclass correlation coefficient (ICC). Scores κ reliability among nonclinicians (κ) ranged from 0.40 to 1.0 for individual radiographic features and 0.72 to 1.0 for Kellgren-Lawrence (KL) grade. ICC ranged from 0.89 to 0.98 for the Osteoarthritis Research Society International (OARSI) summary score. Interreader agreement among nonclinicians ranged from κ of 0.45 to 0.94 for individual features, and 0.66 to 0.97 for KL grade. ICC ranged from 0.87 to 0.96 for the OARSI Summary Score. Interreader reliability between nonclinicians and the radiologist ranged from κ of 0.56 to 0.85 for KL grade. ICC ranged from 0.79 to 0.88 for the OARSI Summary Score. Intrareader and interreader agreement was variable for individual radiograph features but substantial for summary KL grade and OARSI Summary Score. Investigators face tradeoffs between cost and reader experience. These data suggest that in settings where costs are constrained, trained nonclinicians may be suitable readers of radiographic knee OA, particularly if a summary score (KL grade or OARSI Score) is used to determine radiographic severity.

Reliability of classification for post-traumatic ankle osteoarthritis.

Science.gov (United States)

Claessen, Femke M A P; Meijer, Diederik T; van den Bekerom, Michel P J; Gevers Deynoot, Barend D J; Mallee, Wouter H; Doornberg, Job N; van Dijk, C Niek

2016-04-01

The purpose of this study was to identify the most reliable classification system for clinical outcome studies to categorize post-traumatic-fracture-osteoarthritis. A total of 118 orthopaedic surgeons and residents-gathered in the Ankle Platform Study Collaborative Science of Variation Group-evaluated 128 anteroposterior and lateral radiographs of patients after a bi- or trimalleolar ankle fracture on a Web-based platform in order to rate post-traumatic osteoarthritis according to the classification systems coined by (1) van Dijk, (2) Kellgren, and (3) Takakura. Reliability was evaluated with the use of the Siegel and Castellan's multirater kappa measure. Differences between classification systems were compared using the two-sample Z-test. Interobserver agreement of surgeons who participated in the survey was fair for the van Dijk osteoarthritis scale (k = 0.24), and poor for the Takakura (k = 0.19) and the Kellgren systems (k = 0.18) according to the categorical rating of Landis and Koch. This difference in one categorical rating was found to be significant (p osteoarthritis scale, and poor interobserver agreement for the Takakura and Kellgren osteoarthritis classification systems. Because of the low interobserver agreement for the van Dijk, Kellgren, and Takakura classification systems, those systems cannot be used for clinical decision-making. Development of diagnostic criteria on basis of consecutive patients, Level II.

Multiple PRP injections are more effective than single injections and hyaluronic acid in knees with early osteoarthritis: a randomized, double-blind, placebo-controlled trial.

Science.gov (United States)

Görmeli, Gökay; Görmeli, Cemile Ayşe; Ataoglu, Baybars; Çolak, Cemil; Aslantürk, Okan; Ertem, Kadir

2017-03-01

To compare the effectiveness of intraarticular (IA) multiple and single platelet-rich plasma (PRP) injections as well as hyaluronic acid (HA) injections in different stages of osteoarthritis (OA) of the knee. A total of 162 patients with different stages of knee OA were randomly divided into four groups receiving 3 IA doses of PRP, one dose of PRP, one dose of HA or a saline injection (control). Then, each group was subdivided into two groups: early OA (Kellgren-Lawrence grade 0 with cartilage degeneration or grade I-III) and advanced OA (Kellgren-Lawrence grade IV). The patients were evaluated before the injection and at the 6-month follow-ups using the EuroQol visual analogue scale (EQ-VAS) and International Knee Documentation Committee (IKDC) subjective scores. Adverse events and patient satisfaction were recorded. There was a statistically significant improvement in the IKDC and EQ-VAS scores in all the treatment groups compared with the control group. The knee scores of patients treated with three PRP injections were significantly better than those patients of the other groups. There was no significant difference in the scores of patients injected with one dose of PRP or HA. In the early OA subgroups, significantly better clinical results were achieved in the patients treated with three PRP injections, but there was no significant difference in the clinical results of patients with advanced OA among the treatment groups. The clinical results of this study suggest IA PRP and HA treatment for all stages of knee OA. For patients with early OA, multiple (3) PRP injections are useful in achieving better clinical results. For patients with advanced OA, multiple injections do not significantly improve the results of patients in any group. I.

Oral Administration of Polymer Hyaluronic Acid Alleviates Symptoms of Knee Osteoarthritis: A Double-Blind, Placebo-Controlled Study over a 12-Month Period

Science.gov (United States)

Tashiro, Toshiyuki; Seino, Satoshi; Sato, Toshihide; Matsuoka, Ryosuke; Masuda, Yasunobu; Fukui, Naoshi

2012-01-01

This study was conducted to investigate the efficacy of oral hyaluronic acid (HA) administration for osteoarthritis (OA) in knee joints. Sixty osteoarthritic subjects (Kellgren-Lawrence grade 2 or 3) were randomly assigned to the HA or placebo group. The subjects in the HA group were given 200 mg of HA once a day everyday for 12 months, while the subjects in the placebo group were given placebo. The subjects in both groups were requested to conduct quadriceps strengthening exercise everyday as part of the treatment. The subjects' symptoms were evaluated by the Japanese Knee Osteoarthritis Measure (JKOM) score. The symptoms of the subjects as determined by the JKOM score improved with time in both the HA and placebo groups. This improvement tended to be more obvious with the HA group, and this trend was more obvious with the subjects aged 70 years or less. For these relatively younger subjects, the JKOM score was significantly better than the one for the placebo group at the 2nd and 4th months after the initiation of administration. Oral administration of HA may improve the symptoms of knee OA in patients aged 70 years or younger when combined with the quadriceps strengthening exercise. PMID:23226979

Oral Administration of Polymer Hyaluronic Acid Alleviates Symptoms of Knee Osteoarthritis: A Double-Blind, Placebo-Controlled Study over a 12-Month Period

Directory of Open Access Journals (Sweden)

Toshiyuki Tashiro

2012-01-01

Full Text Available This study was conducted to investigate the efficacy of oral hyaluronic acid (HA administration for osteoarthritis (OA in knee joints. Sixty osteoarthritic subjects (Kellgren-Lawrence grade 2 or 3 were randomly assigned to the HA or placebo group. The subjects in the HA group were given 200 mg of HA once a day everyday for 12 months, while the subjects in the placebo group were given placebo. The subjects in both groups were requested to conduct quadriceps strengthening exercise everyday as part of the treatment. The subjects’ symptoms were evaluated by the Japanese Knee Osteoarthritis Measure (JKOM score. The symptoms of the subjects as determined by the JKOM score improved with time in both the HA and placebo groups. This improvement tended to be more obvious with the HA group, and this trend was more obvious with the subjects aged 70 years or less. For these relatively younger subjects, the JKOM score was significantly better than the one for the placebo group at the 2nd and 4th months after the initiation of administration. Oral administration of HA may improve the symptoms of knee OA in patients aged 70 years or younger when combined with the quadriceps strengthening exercise.

Association of Irisin and CRP Levels with the Radiographic Severity of Knee Osteoarthritis.

Science.gov (United States)

Mao, Yongtao; Xu, Wei; Xie, Zonggang; Dong, Qirong

2016-02-01

Irisin, a recently identified myokine, is implicated in protecting mice from obesity. This study was designed to examine the relation of irisin levels in serum and synovial fluid (SF) with the radiographic severity of osteoarthritis (OA). Our study included 215 patients with knee OA. Irisin levels in serum and SF were evaluated using an enzyme-linked immunosorbent assay. The progression of OA was assessed using Kellgren-Lawrence grading system. Knee OA patients had lower serum irisin concentrations and increased serum C-reactive protein (CRP) levels compared with healthy controls. There were markedly decreased irisin levels in both the serum and the SF, as well as increased serum CRP levels of knee OA patients with Kellgren and Lawrence (KL) grade 4 compared with patients classified as KL grade 2 and 3. Furthermore, patients with KL grade 3 showed markedly reduced serum and SF levels of irisin, as well as increased serum CRP levels compared with patients classified as KL grade 2. Irisin levels in serum and SF of knee OA patients were negatively correlated with disease severity evaluated by KL grading criteria. Irisin levels in the serum and SF of knee OA patients were negatively correlated with disease severity evaluated by the radiographic KL grading criteria.

Existence of a neuropathic pain component in patients with osteoarthritis of the knee.

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Ohtori, Seiji; Orita, Sumihisa; Yamashita, Masaomi; Ishikawa, Tetsuhiro; Ito, Toshinori; Shigemura, Tomonori; Nishiyama, Hideki; Konno, Shin; Ohta, Hideyuki; Takaso, Masashi; Inoue, Gen; Eguchi, Yawara; Ochiai, Nobuyasu; Kishida, Shunji; Kuniyoshi, Kazuki; Aoki, Yasuchika; Arai, Gen; Miyagi, Masayuki; Kamoda, Hiroto; Suzkuki, Miyako; Nakamura, Junichi; Furuya, Takeo; Kubota, Gou; Sakuma, Yoshihiro; Oikawa, Yasuhiro; Suzuki, Masahiko; Sasho, Takahisa; Nakagawa, Koichi; Toyone, Tomoaki; Takahashi, Kazuhisa

2012-07-01

Pain from osteoarthritis (OA) is generally classified as nociceptive (inflammatory). Animal models of knee OA have shown that sensory nerve fibers innervating the knee are significantly damaged with destruction of subchondral bone junction, and induce neuropathic pain (NP). Our objective was to examine NP in the knees of OA patients using painDETECT (an NP questionnaire) and to evaluate the relationship between NP, pain intensity, and stage of OA. Ninety-two knee OA patients were evaluated in this study. Pain scores using Visual Analogue Scales (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), painDETECT, duration of symptoms, severity of OA using the Kellgren-Lawrence (KL) system, and amount of joint fluid were evaluated and compared using a Spearman's correlation coefficient by rank test. Our study identified at least 5.4% of our knee OA patients as likely to have NP and 15.2% as possibly having NP. The painDETECT score was significantly correlated with the VAS and WOMAC pain severity. Compared with the painDETECT score, there was a tendency for positive correlation with the KL grade, and tendency for negative correlation with the existence and amount of joint fluid, but these correlations were not significant. PainDETECT scores classified 5.4% of pain from knee OA as NP. NP tended to be seen in patients with less joint fluid and increased KL grade, both of which corresponded to late stages of OA. It is important to consider the existence of NP in the treatment of knee OA pain.

MR imaging findings in early osteoarthritis of the knee

International Nuclear Information System (INIS)

Karachalios, Theofilos; Zibis, Aristidis; Papanagiotou, Panagiotis; Karantanas, Apostolos H.; Malizos, Konstantinos N.; Roidis, Nikolaos

2004-01-01

Purpose: To carry out a modern diagnostic survey among patients with a clinical and radiological diagnosis of early osteoarthritis of the knee. Materials and methods:A magnetic resonance imaging survey was performed on 70 patients (82 knees) with a mean age of 59 years. (range, 40-71 years) who had chronic knee pain, clinical diagnosis of early osteoarthritis of the knee and conventional knee radiographs classified as 1 and 2 on the Kellgren-Lawrence scale. Results: A variety of different disorders was found; degenerative meniscal lesions with or without ruptures of the anterior cruciate ligament in 70.7% of the knees, osteonecrosis of the femoral and tibial condyles in 9.75%, osteophytes and degenerative articular cartilage lesions in 8.54%, transient osteoporosis in 2.44% and benign neoplasms and cysts in 6.1%. Conclusions: The existence of such a heterogenous group of disorders in these 'early osteoarthritic knees' may explain failures in treatment and it may justify a modern MRI imaging approach to proper diagnosis

New view on the initial development site and radiographic classification system of osteoarthritis of the knee based on radiographic analysis.

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Moon, Ki-Ho

2012-12-01

Radiographic pathology of severe osteoarthritis of the knee (OAK) such as severe osteophyte at tibial spine (TS), compartment narrowing, marginal osteophyte, and subchondral sclerosis is well known. Kellgren-Lawrence grading system, which is widely used to diagnose OAK, describes narrowing-marginal osteophyte in 4-grades but uses osteophyte at TS only as evidence of OAK without detailed-grading. However, kinematically the knee employs medial TS as an axis while medial and lateral compartments carry the load, suggesting that early OAK would occur sooner at TS than at compartment. Then, Kellgren-Lawrence system may be inadequate to diagnose early-stage OAK manifested as a subtle osteophyte at TS without narrowing-marginal osteophyte. This undiagnosed-OAK will deteriorate becoming a contributing factor in an increasing incidence of OAK. This study developed a radiographic OAK-marker based on both osteophyte at TS and compartment narrowing-marginal osteophyte and graded as normal, mild, moderate, and severe. With this marker, both knee radiographs of 1,728 patients with knee pain were analyzed. Among 611 early-stage mild OAK, 562 or 92% started at TS and 49 or 8% at compartment. It suggests the initial development site of OAK, helping develop new site-specific radiographic classification system of OAK accurately to diagnose all severity of OAK at early, intermediate, or late-stage. It showed that Kellgren-Lawrence system missed 92.0% of early-stage mild OAK from diagnosis. A subtle osteophyte at TS is the earliest radiographic sign of OAK. A new radiographic classification system of OAK was suggested for accurate diagnosis of all OAK in severity and at stage.

Hand joint space narrowing and osteophytes are associated with magnetic resonance imaging-defined knee cartilage thickness and radiographic knee osteoarthritis: data from the Osteoarthritis Initiative.

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Haugen, Ida K; Cotofana, Sebastian; Englund, Martin; Kvien, Tore K; Dreher, Donatus; Nevitt, Michael; Lane, Nancy E; Eckstein, Felix

2012-01-01

To evaluate whether features of radiographic hand osteoarthritis (OA) are associated with quantitative magnetic resonance imaging (MRI)-defined knee cartilage thickness, radiographic knee OA, and 1-year structural progression. A total of 765 participants in Osteoarthritis Initiative (OAI; 455 women, mean age 62.5 yrs, SD 9.4) obtained hand radiographs (at baseline), knee radiographs (baseline and Year 1), and knee MRI (baseline and Year 1). Hand radiographs were scored for presence of osteophytes and joint space narrowing (JSN). Knee radiographs were scored according to the Kellgren-Lawrence (KL) scale. Cartilage thickness in the medial and lateral femorotibial compartments was measured quantitatively from coronal FLASHwe images. We examined the cross-sectional and longitudinal associations between features of hand OA (total osteophyte and JSN scores) and knee cartilage thickness, 1-year knee cartilage thinning (above smallest detectable change), presence of knee OA (KL grade ≥ 3), and progression of knee OA (KL change ≥ 1) by linear and logistic regression. Both hand OA features were included in a multivariate model (if p ≤ 0.25) adjusted for age, sex, and body mass index (BMI). Hand JSN was associated with reduced knee cartilage thickness (ß = -0.02, 95% CI -0.03, -0.01) in the medial femorotibial compartment, while hand osteophytes were associated with the presence of radiographic knee OA (OR 1.10, 95% CI 1.03-1.18; multivariate models) with both hand OA features as independent variables adjusted for age, sex, and BMI). Radiographic features of hand OA were not associated with 1-year cartilage thinning or radiographic knee OA progression. Our results support a systemic OA susceptibility and possibly different mechanisms for osteophyte formation and cartilage thinning.

Pes Anserine Bursitis in Symptomatic Osteoarthritis Patients: A Mesotherapy Treatment Study.

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Saggini, Raoul; Di Stefano, Alexandra; Dodaj, Ira; Scarcello, Laura; Bellomo, Rosa Grazia

2015-08-01

Pes anserine bursitis strongly affects quality of life in patients with osteoarthritis. Treatment includes nonsteroidal anti-inflammatory drugs (NSAIDs), physiotherapy, and injections of corticosteroid, with highly variable responses; recovery can take 10 days to 36 months. Mesotherapy is a minimally invasive technique consisting of subcutaneous injections of bioactive substances. The goal is to modulate the pharmacokinetics of the injected substance and prolong the effects at a local level. To evaluate the effects of mesotherapy with diclofenac for anserine bursitis associated with knee osteoarthritis. One hundred and seventeen patients with anserine bursitis associated with grade II Kellgren-Lawrence knee osteoarthritis, assessed by clinical, radiographic, and ultrasonographic examination, were evaluated and treated. They were randomly divided into two groups (A, mesotherapy; B, control). Group A completed nine sessions of mesotherapy with sodium diclofenac (25 mg/1 mL; Akis®, IBSA, Lugano, Switzerland), 1 mL for each session, three times per week. Group B received 21 oral administrations of sodium diclofenac (50 mg; Voltaren®, Novartis, Parsippany, NJ), once a day for 3 weeks. Primary outcome measures were pain intensity assessed by visual analogue scale (VAS), along with ability to perform activities of daily living, ability to participate in sports, level of pain, symptoms, and quality of life, as assessed by the Knee injury and Osteoarthritis Outcome Score. These measures were performed before and after the treatment period and at 30 and 90 days' follow up. In both groups pain level decreased significantly after the treatment period. Ultrasonography showed a reduction of the hypoechoic area related to anserine bursitis only in group A. Administration of conventional NSAIDs (diclofenac) by mesotherapy is effective in managing anserine bursitis in knee osteoarthritis in the short term and mid-term. These observations could be of interest for efforts

Outcomes of total knee arthroplasty in relation to preoperative patient-reported and radiographic measures: data from the osteoarthritis initiative.

Science.gov (United States)

Kahn, Timothy L; Soheili, Aydin; Schwarzkopf, Ran

2013-12-01

Total knee arthroplasty (TKA) is the preferred surgical treatment for end-stage osteoarthritis. However, substantial numbers of patients still experience poor outcomes. Consequently, it is important to identify which patient characteristics are predictive of outcomes in order to guide clinical decisions. Our hypothesis is that preoperative patient-reported outcome measures and radiographic measures may help to predict TKA outcomes. Using cohort data from the Osteoarthritis Initiative, we studied 172 patients who underwent TKA. For each patient, we compiled pre- and postoperative Western Ontario and McMaster University Arthritis Index (WOMAC) scores. Radiographs were measured for knee joint angles, femorotibial angles, anatomical lateral distal femoral angles, and anatomical medial proximal tibial angles; Kellgren and Lawrence (KL) grades were assigned to each compartment of the knee. All studied measurements were compared to WOMAC outcomes. Preoperative WOMAC disability, pain, and total scores were positively associated with postoperative WOMAC total scores (P = .010, P = .010, and P = .009, respectively) and were associated with improvement in WOMAC total scores (P < .001, P < .001, and P < .001, respectively). For radiographic measurements, preoperative joint angles were positively associated with improvements in postoperative WOMAC total scores (P = .044). Combined KL grades (medial and lateral compartments) were negatively correlated with postoperative WOMAC disability and pain scores (P = .045 and P = .044) and were positively correlated with improvements in WOMAC total scores (P = .001). All preoperative WOMAC scores demonstrated positive associations with postoperative WOMAC scores, while among the preoperative radiographic measurements only combined KL grades and joint angles showed any correlation with postoperative WOMAC scores. Higher preoperative KL grades and joint angles were associated with better (lower) postoperative WOMAC scores, demonstrating an

Variations in Hip Shape Are Associated with Radiographic Knee Osteoarthritis: Cross-sectional and Longitudinal Analyses of the Johnston County Osteoarthritis Project.

Science.gov (United States)

Nelson, Amanda E; Golightly, Yvonne M; Renner, Jordan B; Schwartz, Todd A; Liu, Felix; Lynch, John A; Gregory, Jenny S; Aspden, Richard M; Lane, Nancy E; Jordan, Joanne M

2016-02-01

Hip shape by statistical shape modeling (SSM) is associated with hip radiographic osteoarthritis (rOA). We examined associations between hip shape and knee rOA given the biomechanical interrelationships between these joints. Bilateral baseline hip shape assessments [for those with at least 1 hip with a Kellgren-Lawrence arthritis grading scale (KL) 0 or 1] from the Johnston County Osteoarthritis Project were available. Proximal femur shape was defined on baseline pelvis radiographs and evaluated by SSM, producing mean shape and continuous variables representing independent modes of variation (14 modes = 95% of shape variance). Outcomes included prevalent [baseline KL ≥ 2 or total knee replacement (TKR)], incident (baseline KL 0/1 with followup ≥ 2), and progressive knee rOA (KL increase of ≥ 1 or TKR). Limb-based logistic regression models for ipsilateral and contralateral comparisons were adjusted for age, sex, race, body mass index (BMI), and hip rOA, accounting for intraperson correlations. We evaluated 681 hips and 682 knees from 342 individuals (61% women, 83% white, mean age 62 yrs, BMI 29 kg/m(2)). Ninety-nine knees (15%) had prevalent rOA (4 knees with TKR). Lower modes 2 and 3 scores were associated with ipsilateral prevalent knee rOA, and only lower mode 3 scores were associated with contralateral prevalent knee rOA. No statistically significant associations were seen for incident or progressive knee rOA. Variations in hip shape were associated with prevalent, but not incident or progressive, knee rOA in this cohort, and may reflect biomechanical differences between limbs, genetic influences, or common factors related to both hip shape and knee rOA.

Effect of Sri Lankan traditional medicine and Ayurveda on Sandhigata Vata (osteoarthritis of knee joint)

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Perera, Pathirage Kamal; Perera, Manaram; Kumarasinghe, Nishantha

2014-01-01

Reported case was a 63-year-old female with end-stage osteoarthritis (OA) (Sandhigata Vata) of the left knee joint accompanied by exostoses. Radiology (X-ray) report confirmed it as a Kellgren-Lawrence grade III or less with exostoses. At the beginning, the Knee Society Rating System scores of pain, movement and stability were poor, and function score was fair. Srilankan traditional and Ayurveda medicine treatment was given in three regimens for 70 days. After 70 days, external treatment of oleation and 2 capsules of Shallaki (Boswellia serrata Triana and Planch) and two tablets of Jeewya (comprised of Emblica officinalis Gaertn., Tinospora cordifolia [Willd.] Millers. and Terminalia chebula Retz.), twice daily were continued over 5 months. Visual analogue scale for pain, knee scores in the Knee Society online rating system and a Ayurveda clinical assessment criteria was used to evaluate the effects of treatments in weekly basis. After treatment for 70 days, the Knee Society Rating System scores of pain, movement and stability were also improved up to good level and function score was improved up to excellent level. During the follow-up period, joint symptoms and signs and the knee scores were unchanged. In conclusion, this OA patient's quality of life was improved by the combined treatment of Sri Lankan traditional medicine and Ayurveda. PMID:26195904

The Knee injury and Osteoarthritis Outcome Score (KOOS)

DEFF Research Database (Denmark)

Roos, Ewa M.; Lohmander, L Stefan

2003-01-01

The Knee injury and Osteoarthritis Outcome Score (KOOS) was developed as an extension of the WOMAC Osteoarthritis Index with the purpose of evaluating short-term and long-term symptoms and function in subjects with knee injury and osteoarthritis. The KOOS holds five separately scored subscales...... be used for short-term and long-term follow-up of several types of knee injury including osteoarthritis. The measure is relatively new and further use of the instrument will add knowledge and suggest areas that need to be further explored and improved....

Different thresholds for detecting osteophytes and joint space narrowing exist between the site investigators and the centralized reader in a multicenter knee osteoarthritis study - data from the Osteoarthritis Initiative

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Guermazi, Ali; Hayashi, Daichi [Boston University School of Medicine, Quantitative Imaging Center, Department of Radiology, Boston, MA (United States); Hunter, David J. [New England Baptist Hospital, Division of Research, Boston, MA (United States); University of Sydney, Northern Clinical School, Sydney (Australia); Li, Ling [New England Baptist Hospital, Division of Research, Boston, MA (United States); Benichou, Olivier [Eli Lilly and Co, Indianapolis, IN (United States); Eckstein, Felix [Paracelsus Medical University, Salzburg (Austria); Chondrometrics GmbH, Ainring (Germany); Kwoh, C.K. [University of Pittsburgh School of Medicine, Division of Rheumatology and Clinical Immunology, Pittsburgh, PA (United States); Nevitt, Michael [University of California, Department of Epidemiology and Biostatistics, San Francisco, CA (United States)

2012-02-15

To evaluate how the reading of knee radiographs by site investigators differs from that by an expert musculoskeletal radiologist who trained and validated them in a multicenter knee osteoarthritis (OA) study. A subset of participants from the Osteoarthritis Initiative progression cohort was studied. Osteophytes and joint space narrowing (JSN) were evaluated using Kellgren-Lawrence (KL) and Osteoarthritis Research Society International (OARSI) grading. Radiographs were read by site investigators, who received training and validation of their competence by an expert musculoskeletal radiologist. Radiographs were re-read by this radiologist, who acted as a central reader. For KL and OARSI grading of osteophytes, discrepancies between two readings were adjudicated by another expert reader. Radiographs from 96 subjects (49 women) and 192 knees (138 KL grade {>=} 2) were included. The site reading showed moderate agreement for KL grading overall (kappa=0.52) and for KL {>=} 2 (i.e., radiographic diagnosis of ''definite OA''; kappa=0.41). For OARSI grading, the site reading showed substantial agreement for lateral and medial JSN (kappa=0.65 and 0.71), but only fair agreement for osteophytes (kappa=0.37). For KL grading, the adjudicator's reading showed substantial agreement with the centralized reading (kappa=0.62), but only slight agreement with the site reading (kappa = 0.10). Site investigators over-graded osteophytes compared to the central reader and the adjudicator. Different thresholds for scoring of JSN exist even between experts. Our results suggest that research studies using radiographic grading of OA should use a centralized reader for all grading. (orig.)

Different thresholds for detecting osteophytes and joint space narrowing exist between the site investigators and the centralized reader in a multicenter knee osteoarthritis study - data from the Osteoarthritis Initiative

International Nuclear Information System (INIS)

Guermazi, Ali; Hayashi, Daichi; Hunter, David J.; Li, Ling; Benichou, Olivier; Eckstein, Felix; Kwoh, C.K.; Nevitt, Michael

2012-01-01

To evaluate how the reading of knee radiographs by site investigators differs from that by an expert musculoskeletal radiologist who trained and validated them in a multicenter knee osteoarthritis (OA) study. A subset of participants from the Osteoarthritis Initiative progression cohort was studied. Osteophytes and joint space narrowing (JSN) were evaluated using Kellgren-Lawrence (KL) and Osteoarthritis Research Society International (OARSI) grading. Radiographs were read by site investigators, who received training and validation of their competence by an expert musculoskeletal radiologist. Radiographs were re-read by this radiologist, who acted as a central reader. For KL and OARSI grading of osteophytes, discrepancies between two readings were adjudicated by another expert reader. Radiographs from 96 subjects (49 women) and 192 knees (138 KL grade ≥ 2) were included. The site reading showed moderate agreement for KL grading overall (kappa=0.52) and for KL ≥ 2 (i.e., radiographic diagnosis of ''definite OA''; kappa=0.41). For OARSI grading, the site reading showed substantial agreement for lateral and medial JSN (kappa=0.65 and 0.71), but only fair agreement for osteophytes (kappa=0.37). For KL grading, the adjudicator's reading showed substantial agreement with the centralized reading (kappa=0.62), but only slight agreement with the site reading (kappa = 0.10). Site investigators over-graded osteophytes compared to the central reader and the adjudicator. Different thresholds for scoring of JSN exist even between experts. Our results suggest that research studies using radiographic grading of OA should use a centralized reader for all grading. (orig.)

Osteoarthritis of the knee at 3.0 T: comparison of a quantitative and a semi-quantitative score for the assessment of the extent of cartilage lesion and bone marrow edema pattern in a 24-month longitudinal study

Energy Technology Data Exchange (ETDEWEB)

Stahl, Robert [University of California, San Francisco, Department of Radiology, San Francisco, CA (United States); Ludwig Maximilians University of Munich, Department of Clinical Radiology, University Hospitals, Campus Grosshadern, Munich (Germany); Jain, Sapna K.; Majumdar, Sharmila; Link, Thomas M. [University of California, San Francisco, Department of Radiology, San Francisco, CA (United States); Lutz, Juergen [Ludwig Maximilians University of Munich, Department of Neuroradiology, University Hospitals, Campus Grosshadern, Munich (Germany); Wyman, Bradley T.; Hellio Le Graverand-Gastineau, Marie-Pierre [Pfizer Inc., Groton, CT (United States); Vignon, Eric [Claude Bernard University Lyon I, Lyon (France)

2011-10-15

To compare a semi-quantitative and a quantitative morphological score for assessment of early osteoarthritis (OA) evolution. 3.0 T MRI of the knee was performed in 60 women, 30 with early OA (each 15 with Kellgren-Lawrence grade 2 and 3) and 30 age-matched controls at baseline and at 12 and 24 months. Pathological condition was assessed with the whole-organ magnetic resonance imaging score (WORMS). Cartilage abnormalities and bone marrow edema pattern (BMEP) were also quantified using a previously introduced morphological quantitative score. These data were correlated with changes in clinical parameters and joint space width using generalized estimation equations (GEE). At baseline, OA patients had significantly (p < 0.05) more and larger cartilage lesions and BMEP. During follow-up, cartilage lesions increased significantly (p < 0.05) in the patients compared with controls: WORMS showed progression only at the lateral patella, whereas the quantitative score revealed progression additionally at the trochlea and at the medial compartment. Both scores showed a significant (p < 0.05) increase in BMEP at the lateral femur in OA patients. In addition, quantitative scores of BMEP of the whole knee decreased significantly (p < 0.05) after 12 months and increased after 24 months in the patients, but showed an increase in controls at all follow-up examinations. Only weak correlations between structural imaging findings and clinical parameters were observed. Quantitative assessment of cartilage lesions and BMEP is more sensitive to changes during the course of the disease than semi-quantitative scoring. However, structural imaging findings do not correlate well with the clinical progression of OA. (orig.)

The comparison of knee osteoarthritis treatment with single-dose bone marrow-derived mononuclear cells vs. hyaluronic acid injections.

Science.gov (United States)

Goncars, Valdis; Jakobsons, Eriks; Blums, Kristaps; Briede, Ieva; Patetko, Liene; Erglis, Kristaps; Erglis, Martins; Kalnberzs, Konstantins; Muiznieks, Indrikis; Erglis, Andrejs

2017-01-01

The aim of this study was to compare treatment methods of the knee joint degenerative osteoarthritis, using autologous bone marrow-derived mononuclear cells and hyaluronic acid injections and observe prevalence of adverse effects in both groups. A prospective randomized controlled clinical trial was carried out. The analysis of pain and changes in osteoarthritis symptoms after a single intra-articular bone marrow-derived mononuclear cell injection into the knee joint in the Kellgren-Lawrence stage II-III osteoarthritis during the 12-month period were performed. The results were compared with the control group treated routinely by hyaluronic acid injections therapy. A therapy group of patients (n=28) received single bone marrow-derived mononuclear cell intra-articular injections. A control group of patients (n=28) was treated with a total of three sodium hyaluronate intra-articular injections each one performed a week apart. The clinical results were obtained using the Knee Osteoarthritis Outcome Score (KOOS) and the Knee Society Score (KSS) before and 3, 6, and 12 months after injection. A statistically significant improvement was observed in the mononuclear cell group over the starting point in all scores. At the endpoint at month 12, the KOOS score improved significantly (Phyaluronic acid versus the bone marrow-derived mononuclear cells group at time points 6 and 12 months demonstrated a statistically significant (Phyaluronic acid group. In both groups serious adverse effects were not observed. The intra-articular injection of bone marrow-derived mononuclear cells is a safe manipulation with no side effects during the 12-month period. This treatment provides statistically significant clinical improvement between the starting point and 1, 3, 6, and 12 months after. When compared to hyaluronic acid treatment, better pain relief in the long-term period of mononuclear cell group was observed. Copyright © 2017 The Lithuanian University of Health Sciences. Production

Relationships among Obesity, Sarcopenia, and Osteoarthritis in the Elderly

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Woo Sung Jin

2017-03-01

Full Text Available Background : The present study examined the correlations between obesity, sarcopenia, and osteoarthritis in Korea’s elderly population. Methods : A cross-sectional analysis of 1,865 and 1,769 respondents with knee osteoarthritis and lumbar spondylosis, respectively, was performed by using data from the 2010 and 2011 Korea National Health and Nutrition Examination Survey. Obesity was defined as a body mass index of ≥25 kg/m²; osteoarthritis, as a Kellgren/Lawrence grade of ≥2; and sarcopenia, as an appendicular skeletal muscle mass (ASM; ASM/weight ×100 on dual-energy X-ray absorptiometry of two standard deviations below the mean reference value. Results : The unadjusted and age-adjusted risks of knee osteoarthritis were as follows: 1.88 and 1.92 times greater, respectively, for male subjects with sarcopenic obesity; 6.03 and 7.64 times greater, respectively, for female subjects with non-sarcopenic obesity; and 1.97 and 2.43 times greater, respectively, for female subjects with sarcopenic obesity. The age-and-waist circumference-adjusted risks were 5.88 and 1.80 times greater for the female subjects with non-sarcopenic and sarcopenic obesities, respectively. No statistically significant finding was obtained for lumbar spondylosis. Conclusion : Obesity and sarcopenia were associated with knee osteoarthritis in the elderly subjects. The risk of knee osteoarthritis was greater in the male subjects with sarcopenic obesity than in the male subjects with non-sarcopenic obesity. In the female subjects, the risk of knee osteoarthritis was high in both obesity groups. Further research to explain the sex-related difference in knee osteoarthritis risk based on body composition will be beneficial.

Osteoarthritis of the knee after meniscal resection

DEFF Research Database (Denmark)

Paradowski, P T; Lohmander, L S; Englund, M

2016-01-01

OBJECTIVE: To determine prevalence, incidence and progression of radiographic knee osteoarthritis (OA) in a cohort of subjects with previous meniscectomy. METHODS: We assessed 221 subjects (177 men and 44 women) with weight bearing knee radiography twice (assessment A and B) with a follow-up time...... Kellgren and Lawrence grade 2 or worse. RESULTS: At assessment A, we found tibiofemoral radiographic OA in 107 subjects' index knee (48%) of which 41 subjects (38%) had bilateral tibiofemoral OA. At assessment B, the corresponding figures were 151 (68%) and 71 (32%). At assessment A, we found...... patellofemoral OA in 32 subjects' index knee (14%) of which 11 (34%) had bilateral patellofemoral OA. At assessment B, the corresponding figures were 51 (23%) and 19 (37%). There was an increase of the sum of joint space narrowing (JSN) and osteophyte grades in the tibiofemoral joint of 144 subjects' index knee...

An ultrasound score for knee osteoarthritis

DEFF Research Database (Denmark)

Riecke, B F; Christensen, R.; Torp-Pedersen, S

2014-01-01

OBJECTIVE: To develop standardized musculoskeletal ultrasound (MUS) procedures and scoring for detecting knee osteoarthritis (OA) and test the MUS score's ability to discern various degrees of knee OA, in comparison with plain radiography and the 'Knee injury and Osteoarthritis Outcome Score' (KOOS......) domains as comparators. METHOD: A cross-sectional study of MUS examinations in 45 patients with knee OA. Validity, reliability, and reproducibility were evaluated. RESULTS: MUS examination for knee OA consists of five separate domains assessing (1) predominantly morphological changes in the medial...... coefficients ranging from 0.75 to 0.97 for the five domains. Construct validity was confirmed with statistically significant correlation coefficients (0.47-0.81, P knee OA. In comparison with standing radiographs...

Some Adipose Derived Hormones in Association with the Risk of Knee Osteoarthritis

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Mehdi Moghtadae

2017-04-01

Full Text Available Background Knee osteoarthritis (OA is the most common form of arthritis and is the major cause of pain and disability in the elderly. The relationship between obesity and increased risk of knee osteoarthritis was known for many years. Since then, many studies have shown the relationship between knee osteoarthritis and obesity. Objectives In this study, we tried to evaluate whether compared to weight, the adipose tissue has a stronger correlation with the occurrence of knee osteoarthritis. Methods In a cross-sectional study that was a part of the Fasa knee osteoarthritis registry (FOAS, 131 patients with OA were sex matched with 262 patients in the control group. Serum samples of the patients, the Western Ontario and McMaster universities arthritis index (WOMAC questionnaire and demographic data were collected. Leptin and adiponectin as hormones secreted by the adipose tissue were measured. Results Weight, body mass index (BMI, and waist circumference (WC were significantly different between the two groups (P < 0.001. The Kellgren and Lawrence (K&L score was significantly higher among the patients (P < 0.001. Pain levels in patients with OA were also significantly higher compared to those in the control group (P < 0.001. Both leptin and adiponectin concentrations were higher in the OA patients. Adiponectin had a negative relationship with BMI in the OA group (r = 0.570, P < 0.001, but leptin had a positive relationship with BMI (r = 0.781, P < 0.001. In the OA group, both adipokines had higher levels in female patients compared to male patients. Conclusions The results of the current study showed that levels of hormones secreted from the adipose tissue, in people with knee OA, were higher compared to the control group, indicating the possible effect of these hormones on the process of osteoarthritis. Finally, we showed that after adjusting for age, sex, and BMI, leptin and adiponectin are significantly correlated with the amount of pain

DINAMICS OF KNEE JOINT SPACE ASYMMETRY ON X-RAY AS A MARKER OF KNEE OSTEOARTHRITIS REHABILITATION EFFICACY.

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Sheveleva, N; Minbayeva, L; Belyayeva, Y

2017-03-01

Reducing of articular cartilage functional volume in knee joint osteoarthritis occurs unevenly and accompanied with pathological changes of lower limb axis as a result of connective tissue and muscle structures dysfunction. Evaluation of X-ray knee joint space asymmetry seems to be informative to analyze the dynamics of lower extremities biomechanical imbalances characteristic for knee joint osteoarthritis. However, standardized method of X-ray joint space determining does not include its symmetry calculation. The purpose of the study was optimization of knee joint radiological examination by developing of X-ray knee joint space asymmetry index calculation method. The proposed method was used for comparative analysis of extracorporeal shock-wave therapy efficacy in 30 patients with knee joint osteoarthritis of 2-3 degrees (Kellgren-Lawrence, 1957). As a result of the conducted treatment statistically significant decrease of the X-ray knee joint space asymmetry index was observed (Me(Q1;Q3): Z=5.20, pknee joint space asymmetry index, calculated according to the proposed method, allows to evaluate dynamics of articular surfaces congruency changes and provide differentiated approach to the treatment of knee joint osteoarthritis.

Ultrasound combined transcutaneous electrical nerve stimulation (UltraTENS) versus phonophoresis of piroxicam (PhP) in symptomatic knee osteoarthritis: A randomized double-blind, controlled trial.

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Boonhong, Jariya; Suntornpiyapan, Phitsanu; Piriyajarukul, Apatchanee

2018-02-02

Ultrasound combined with transcutaneous electrical nerve stimulation (UltraTENS) and phonophoresis of piroxicam (PhP) are combined modality therapy that frequently used in musculoskeletal pain including knee osteoarthritis (OA). But it is lack of a good clinical trial to prove and compare their effects. To compare the effects of UltraTENS with PhP on mild to moderate degree of symptomatic knee OA. Sixty-one patients (55 women), mean age of 63.4 ± 8.1 y, 50-90 mm VAS of knee pain and Kellgren-Lawrence score of grade I-III were randomly allocated into UltraTENS and PhP (N = 31 and 30, respectively). The UltraTENS group received a combined ultrasound with TENS program and a non-drug gel, whereas the PhP group got an ultrasound program with piroxicam gel and sham TENS. All patients were treated for a total of 10 sessions, consisting of five times per week and 10 min per session. Before and after treatment, patients were evaluated knee pain by using the 100-mm VAS and functional performance by Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index. The UltraTENS and PhP groups experienced considerable improvement in both VAS and total WOMAC scores post-treatment (PPhP had better VAS of pain and WOMAC scores but no statistical significance. Results show that UltraTENS and PhP were effective for relieving pain and improve functionality knee OA without significant differences between their effects.

Comparative efficacy of intra-articular hyaluronic acid and corticoid injections in osteoarthritis of the first carpometacarpal joint: results of a 6-month single-masked randomized study.

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Monfort, Jordi; Rotés-Sala, Delfin; Segalés, Nuria; Montañes, Francisco-Jose; Orellana, Cristobal; Llorente-Onaindia, Jone; Mojal, Sergi; Padró, Isabel; Benito, Pere

2015-03-01

The study aim was to compare the efficacy and safety of ultrasound-guided intra-articular injections of hyaluronic acid and betamethasone in the management of patients with osteoarthritis of the thumb. Eighty-eight evaluable patients diagnosed with osteoarthritis of the thumb (Kellgren-Lawrence grade II-III) received ultrasound-guided intra-articular treatment with hyaluronic acid (48) or betamethasone (40). In total, 3 local injections were scheduled at 7-day intervals. Assessments were performed at baseline and at 7, 14, 30, 90, and 180 days. In both study groups, the pain Visual Analogue Scale and Functional Index for Hand Osteoarthritis scores decreased significantly during follow-up compared to baseline. There were no significant differences between the groups. However, at 90 days, the functional score showed a trend towards greater clinical improvement in the hyaluronic acid group (P 0.071). A subanalysis of patients with Functional Index score≥5 and Visual Analogue Scale score≥3 at baseline showed a significantly higher median functionality score in the hyaluronic acid group (P 0.005 at 90 days and P 0.020 at 180 days). Further limiting analysis to a baseline pain score≥5 showed significantly greater improvement in functionality score (P 0.004 at 180 days), which was already apparent after the second intra-articular injection at 14 days (P 0.028). In this patient subset, the mean pain score also improved significantly at 180 days (P 0.02). Both hyaluronic acid and betamethasone were effective and well-tolerated for the management of rhizarthrosis. Hyaluronic acid was more effective over time and more efficiently improved functionality and pain in patients with more severe symptoms. Copyright © 2014 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

Atlas of Radiographic Features of Osteoarthritis of the Ankle and Hindfoot

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Kraus, Virginia Byers; Kilfoil, Terrence M; Hash, Thomas W.; McDaniel, Gary; Renner, Jordan B; Carrino, John A.; Adams, Samuel

2015-01-01

Objective To develop a radiographic atlas of osteoarthritis (OA) for use as a template and guide for standardized scoring of radiographic features of OA of the ankle and hindfoot joints. Method Under Institutional Review Board approval, ankle and hindfoot images were selected from a cohort study and from among cases that underwent ankle radiography during a 6-month period at Duke University Medical Center. Missing OA pathology was obtained through supplementation of cases with the assistance of a foot and ankle specialist in Orthopaedic surgery and a musculoskeletal radiologist. Images were obtained and reviewed without patient identifying information. Images went through multiple rounds of review and final images were selected by consensus of the study team. For intra-rater and inter-rater reliability, the kappa statistic was calculated for two readings by 3 musculoskeletal radiologists, a minimum of two weeks apart, of ankle and hindfoot radiographs from 30 anonymized subjects. Results The atlas demonstrates individual radiographic features (osteophyte and joint space narrowing) and Kellgren Lawrence grade for all aspects of the talocrural (ankle joint proper) and talocalcaneal (subtalar) joints. Reliability of scoring based on the atlas was quite good to excellent for most features indicated. Additional examples of ankle joint findings are illustrated including sclerosis, os trigonum, subchondral cysts and talar tilt. Conclusions It is anticipated that this atlas will assist with standardization of scoring of ankle and hindfoot OA by basic and clinical OA researchers. PMID:26318654

Efficacy and safety of strontium ranelate in the treatment of knee osteoarthritis: results of a double-blind, randomised placebo-controlled trial

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Jean-Yves Reginster

2013-01-01

Full Text Available Objective. Background Strontium ranelate is currently used for osteoporosis. The international, double-blind, randomised, placebo-controlled Strontium ranelate Efficacy in Knee OsteoarthrItis triAl evaluated its effect on radiological progression of knee osteoarthritis.Methods. Patients with knee osteoarthritis (Kellgren and Lawrence grade 2 or 3, and joint space width (JSW 2.5-5 mm were randomly allocated to strontium ranelate 1 g/day (n=558, 2 g/day (n=566 or placebo (n=559. The primary endpoint was radiographical change in JSW (medial tibiofemoral compartment over 3 years versus placebo. Secondary endpoints included radiological progression, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC score, and knee pain. The trial is registered (ISRCTN41323372.Results. The intention-to-treat population included 1371 patients. Treatment with strontium ranelate was associated with smaller degradations in JSW than placebo (1 g/day: -0.23 (SD 0.56 mm; 2 g/day: -0.27 (SD 0.63 mm; placebo:-0.37 (SD 0.59 mm; treatment-placebo differences were 0.14 (SE 0.04, 95% CI 0.05 to 0.23, p<0.001 for 1 g/day and 0.10 (SE 0.04, 95% CI 0.02 to 0.19, p=0.018 for 2 g/day. Fewer radiological progressors were observed withstrontium ranelate (p<0.001 and p=0.012 for 1 and 2 g/day. There were greater reductions in total WOMAC score (p=0.045, pain subscore (p=0.028, physical function subscore (p=0.099 and knee pain (p=0.065 with strontium ranelate 2 g/day. Strontium ranelate was well tolerated. Conclusions. Treatment with strontium ranelate 1 and 2 g/day is associated with a significant effect on structure in patients with knee osteoarthritis, and a beneficial effect on symptoms for strontium ranelate 2 g/day.Additional supplementary data are published online only. To view these files please visit the journal online (http://dx.doi. org/10.1136/annrheumdis-2012-202231

Differential involvement of synovial adipokines in pain and physical function in female patients with knee osteoarthritis. A cross-sectional study.

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Calvet, J; Orellana, C; Albiñana Giménez, N; Berenguer-Llergo, A; Caixàs, A; García-Manrique, M; Galisteo Lencastre, C; Navarro, N; Larrosa, M; Gratacós, J

2018-02-01

Adipokines have been reported to play a role in the development, progression and severity of knee osteoarthritis but the influence of the different adipokines are not well known. The aim of this study was to evaluate the association between different synovial fluid adipokines with pain and disability knee osteoarthritis patients. Cross-sectional study with systematic inclusion of 115 symptomatic primary knee osteoarthritis female patients with ultrasound-confirmed joint effusion. Age, physical exercise, symptoms duration and different anthropometric measurements were collected. Radiographic severity was evaluated according to Kellgren-Lawrence scale. Pain and disability were assessed by WOMAC-total, -pain, -function subscales and Knee injury and Osteoarthritis Outcome Score (KOOS) pain and function scales. Seven adipokines and three inflammatory markers were measured by ELISA in synovial fluid. Partial Correlation Coefficient (PCC) and corresponding 95% confidence interval were used as a measure of association. Leptin, osteopontin and inflammatory factors, especially TNF-alpha, were associated to pain and function. After adjustment for potential confounders including inflammatory factors and all adipokines, an association was found for adiponectin with pain (PCC 0.240 [0.012, 0.444]) and for resistin and visfatin with function (PCC 0.336 [0.117, 0.524] and -0.262 [-0.463, -0.036]). No other adipokines or inflammatory markers were statistically and independently associated. An association between physical exercise and pain and disability remained after adjustment, whereas an attenuation of the influence of anthropometric measurements was observed. Different patterns of association between synovial fluid adipokines were observed regarding pain and disability in knee osteoarthritis patients. Specifically, adiponectin was associated to pain while resistin and visfatin were mainly related to function. Copyright © 2017 Osteoarthritis Research Society International

Prevalence of abnormalities in knees detected by MRI in adults without knee osteoarthritis: population based observational study (Framingham Osteoarthritis Study).

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Guermazi, Ali; Niu, Jingbo; Hayashi, Daichi; Roemer, Frank W; Englund, Martin; Neogi, Tuhina; Aliabadi, Piran; McLennan, Christine E; Felson, David T

2012-08-29

To examine use of magnetic resonance imaging (MRI) of knees with no radiographic evidence of osteoarthritis to determine the prevalence of structural lesions associated with osteoarthritis and their relation to age, sex, and obesity. Population based observational study. Community cohort in Framingham, MA, United States (Framingham osteoarthritis study). 710 people aged >50 who had no radiographic evidence of knee osteoarthritis (Kellgren-Lawrence grade 0) and who underwent MRI of the knee. Prevalence of MRI findings that are suggestive of knee osteoarthritis (osteophytes, cartilage damage, bone marrow lesions, subchondral cysts, meniscal lesions, synovitis, attrition, and ligamentous lesions) in all participants and after stratification by age, sex, body mass index (BMI), and the presence or absence of knee pain. Pain was assessed by three different questions and also by WOMAC questionnaire. Of the 710 participants, 393 (55%) were women, 660 (93%) were white, and 206 (29%) had knee pain in the past month. The mean age was 62.3 years and mean BMI was 27.9. Prevalence of "any abnormality" was 89% (631/710) overall. Osteophytes were the most common abnormality among all participants (74%, 524/710), followed by cartilage damage (69%, 492/710) and bone marrow lesions (52%, 371/710). The higher the age, the higher the prevalence of all types of abnormalities detectable by MRI. There were no significant differences in the prevalence of any of the features between BMI groups. The prevalence of at least one type of pathology ("any abnormality") was high in both painful (90-97%, depending on pain definition) and painless (86-88%) knees. MRI shows lesions in the tibiofemoral joint in most middle aged and elderly people in whom knee radiographs do not show any features of osteoarthritis, regardless of pain.

Dual-energy X-ray absorptiometry applied to the assessment of tibial subchondral bone mineral density in osteoarthritis of the knee

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Clarke, S.; Duddy, J.; Nickols, G.; Kirwan, J.R.; Wakeley, C.; Watt, I.; Ellingham, K.; Sharif, M.; Elson, C.J.

2004-01-01

Plain X-ray is an imprecise tool for monitoring the subchondral bony changes associated with the development of knee osteoarthritis (OA). Our objective was to develop and validate a technique for assessing tibial subchondral bone density (BMD) in knee OA using dual energy X-ray absorptiometry (DXA). Patients with OA of at least one knee underwent DXA scanning of both knees. Regions of interest (ROI) were placed in the lateral and medial compartments of tibial subchondral bone. Weight-bearing plain X-rays and Te 99m scintiscans of both knees were obtained and scored. One hundred and twelve patients (223 knees) underwent DXA and radiography. Intra-observer CV% was 2.4% and 1.0% for the medial and lateral ROI respectively. Definite OA (Kellgren and Lawrence Grade 2, 3 or 4) was correlated with age-related preservation of subchondral BMD compared to radiographically normal knees. Raised BMD was also associated with subchondral sclerosis, and positive scintigraphy. DXA may provide a safe, rapid and reliable means of assessing knee OA. Cross-sectional age-related subchondral tibial BMD loss is attenuated by knee OA. (orig.)

The relationship of antiresorptive drug use to structural findings and symptoms of knee osteoarthritis.

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Carbone, Laura D; Nevitt, Michael C; Wildy, Kathryn; Barrow, Karen D; Harris, Fran; Felson, David; Peterfy, Charles; Visser, Marjolein; Harris, Tamara B; Wang, Benjamin W E; Kritchevsky, Stephen B

2004-11-01

To examine the cross-sectional association between use of medications that have a bone antiresorptive effect (estrogen, raloxifene, and alendronate) and both the structural features of knee osteoarthritis (OA), assessed by magnetic resonance imaging (MRI) and radiography, and the symptoms of knee OA in elderly women. Women in the Health, Aging and Body Composition Study underwent MRI and radiography of the knee if they reported symptoms of knee OA, and women without significant knee symptoms were selected as controls. MR images of the knee were assessed for multiple features of OA using the Whole-Organ MRI scoring method, and radiographs were read for Kellgren and Lawrence grade and individual features of OA. Concurrent medication use and knee symptoms were assessed by interview, and knee pain severity was evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). There were 818 postmenopausal women from whom we obtained MR images of the knee and data on medication use. Among these women, 214 (26.2%) were receiving antiresorptive drugs. We found no significant association between overall use of antiresorptive drugs and the presence of knee pain and radiographic changes of OA of the knee. Use of alendronate, but not estrogen, was associated with less severity of knee pain as assessed by WOMAC scores. Both alendronate use and estrogen use were associated with significantly less subchondral bone attrition and bone marrow edema-like abnormalities in the knee as assessed by MRI, as compared with women who had not received these medications. Elderly women being treated with alendronate and estrogen had a significantly decreased prevalence of knee OA-related subchondral bone lesions compared with those reporting no use of these medications. Alendronate use was also associated with a reduction in knee pain according to the WOMAC scores.

The Knee injury and Osteoarthritis Outcome Score (KOOS: from joint injury to osteoarthritis

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Roos Ewa M

2003-11-01

Full Text Available Abstract The Knee injury and Osteoarthritis Outcome Score (KOOS was developed as an extension of the WOMAC Osteoarthritis Index with the purpose of evaluating short-term and long-term symptoms and function in subjects with knee injury and osteoarthritis. The KOOS holds five separately scored subscales: Pain, other Symptoms, Function in daily living (ADL, Function in Sport and Recreation (Sport/Rec, and knee-related Quality of Life (QOL. The KOOS has been validated for several orthopaedic interventions such as anterior cruciate ligament reconstruction, meniscectomy and total knee replacement. In addition the instrument has been used to evaluate physical therapy, nutritional supplementation and glucosamine supplementation. The effect size is generally largest for the subscale QOL followed by the subscale Pain. The KOOS is a valid, reliable and responsive self-administered instrument that can be used for short-term and long-term follow-up of several types of knee injury including osteoarthritis. The measure is relatively new and further use of the instrument will add knowledge and suggest areas that need to be further explored and improved.

The efficacy of 12 weeks non-surgical treatment for patients not eligible for total knee replacement

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Skou, Søren Thorgaard; Rasmussen, Sten; Laursen, Mogens Berg

2015-01-01

OBJECTIVE: To compare the efficacy of a 12-week non-surgical treatment program with usual care in patients with knee osteoarthritis (OA) not eligible for total knee replacement (TKR). METHOD: This two-arm parallel group assessor-blinded randomized controlled trial (RCT) included 100 adults from...... secondary care with knee OA, confirmed by radiography (Kellgren-Lawrence grade ≥1), but not eligible for a TKR. The 12-week non-surgical treatment program consisted of individualized progressed neuromuscular exercise, patient education, insoles, dietary advice and prescription of pain medication...... if indicated, while usual care comprised two leaflets with information and advice on knee OA and recommended treatments. The primary outcome was the change from baseline to 12 months in the Knee injury and Osteoarthritis Outcome Score (KOOS)4 defined as the average score for the KOOS subscales of pain...

Anterior Cruciate Ligament OsteoArthritis Score (ACLOAS)

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Roemer, Frank W; Frobell, Richard; Lohmander, Stefan

2014-01-01

OBJECTIVE: To develop a whole joint scoring system, the Anterior Cruciate Ligament OsteoArthritis Score (ACLOAS), for magnetic resonance imaging (MRI)-based assessment of acute anterior cruciate ligament (ACL) injury and follow-up of structural sequelae, and to assess its reliability. DESIGN...

Effectiveness of Glucosamine and Chondroitin Sulfate Combination in Patients with Primary Osteoarthritis

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Laszlo IRSAY

2010-12-01

Full Text Available Purpose: Studying the effectiveness of chondroprotective agents for patients with primary knee arthritis or primary generalized osteoarthritis, according to the American College of Rheumatology 2000 criteria. Material and Methods: comparative study, the groups were constituted out of 25 patients in the study group and 15 patients in the control group. The patients were evaluated with the WOMAC test, Lequesne, cross-linked C-terminal (CTX telopeptide of type I collagen on inclusion, at 6 and 12 months and through bilateral- knee radiography, using the Kellgren-Lawrence classification on inclusion and 12 months later. Patients from the study group received a chondroprotectiv agent orally for 12 months. Results: WOMAC score was improved in the study group at 6 and 12 months -4.1 (CI -6.1 to -2.1 and -5.9 (CI -8 to -3.8 compared to the control group 1.5 (CI -0.7 to 3.7 and 2 (CI -0.2 to 4.2, with a statistical significance p=0.02. There has also been an amelioration of the Lequesne score in the study group at 6 and 12 months -3.8 (CI -6.3 to -1.3 and -6.2 (CI -9.1 to -3.3, and the control group 1.3 (CI -1.5 to 4.1 to 6 months and 1.9 (CI -0.8 to 4.6 to 12 months, with a statistical significance p=0.03. No adverse reactions were registered. Conclusions: The chondroprotective agent was effective in improving the function of patients with osteoarthritis, the studied marker cannot be used to monitor the treatment effectiveness, and the radiological modifications in the knee are statistically insignificant after 12 months of monitoring.

Comparison of cartilage thickness with radiologic grade of knee osteoarthritis

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Agnesi, Filippo; Amrami, Kimberly K.; Frigo, Carlo A.; Kaufman, Kenton R.

2008-01-01

To compare joint space width (JSW) measurements obtained from magnetic resonance imaging (MRI) with a semi-automated computer algorithm to the Kellgren and Lawrence grading of osteoarthritis (OA). Three hundred and six patients (234 female, 72 male) with a mean age of 56.7 years (range 31-81 years) underwent MRI of their knees with a fast oblique spiral spoiled gradient (SPGR) sequence. A board-certified musculoskeletal radiologist graded the OA of all the patients in accordance with the Kellgren and Lawrence OA scale. A previously validated computer algorithm was used to determine the minimum JSW for both the tibiofemoral joint and the patellofemoral joint. An analysis of variance (ANOVA) with the Student-Newman-Kuels post-hoc test was used to determine if there were differences in JSW as a function of OA grade. The radiologic grade of OA was inversely associated with the JSW. In the medial compartment the JSW did not change significantly between grade 1 and grade 2, but there was a significant decrease in JSW between grade 0 (normal) and grade 1 and for each OA grade above grade 2. In the lateral compartment no statistical differences were found till grade 2, while grade 3 was found to be statistically different from the previous one. The number of patients with a grade 4 patellofemoral OA was too low for the statistical significance to be assessed. In the patellofemoral joint the JSW did not change significantly until grade 2, while a statistically significant reduction was found for both grade 3 and grade 4. This study showed that an inverse non-linear relationship exists between radiologic grade and JSW. The relationship differs for the tibiofemoral and the patellofemoral joint. (orig.)

Comparison of cartilage thickness with radiologic grade of knee osteoarthritis

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Agnesi, Filippo [Mayo Clinic, Motion Analysis Laboratory, Division of Orthopedic Research, Rochester, MN (United States); Polytechnic of Milan, Department of Bioengineering, Milan (Italy); Amrami, Kimberly K. [Mayo Clinic, Department of Radiology, Rochester, MN (United States); Frigo, Carlo A. [Polytechnic of Milan, Department of Bioengineering, Milan (Italy); Kaufman, Kenton R. [Mayo Clinic, Motion Analysis Laboratory, Division of Orthopedic Research, Rochester, MN (United States); Mayo Clinic/Foundation, Motion Analysis Laboratory, Department of Orthopedic Surgery, Rochester, MN (United States)

2008-07-15

To compare joint space width (JSW) measurements obtained from magnetic resonance imaging (MRI) with a semi-automated computer algorithm to the Kellgren and Lawrence grading of osteoarthritis (OA). Three hundred and six patients (234 female, 72 male) with a mean age of 56.7 years (range 31-81 years) underwent MRI of their knees with a fast oblique spiral spoiled gradient (SPGR) sequence. A board-certified musculoskeletal radiologist graded the OA of all the patients in accordance with the Kellgren and Lawrence OA scale. A previously validated computer algorithm was used to determine the minimum JSW for both the tibiofemoral joint and the patellofemoral joint. An analysis of variance (ANOVA) with the Student-Newman-Kuels post-hoc test was used to determine if there were differences in JSW as a function of OA grade. The radiologic grade of OA was inversely associated with the JSW. In the medial compartment the JSW did not change significantly between grade 1 and grade 2, but there was a significant decrease in JSW between grade 0 (normal) and grade 1 and for each OA grade above grade 2. In the lateral compartment no statistical differences were found till grade 2, while grade 3 was found to be statistically different from the previous one. The number of patients with a grade 4 patellofemoral OA was too low for the statistical significance to be assessed. In the patellofemoral joint the JSW did not change significantly until grade 2, while a statistically significant reduction was found for both grade 3 and grade 4. This study showed that an inverse non-linear relationship exists between radiologic grade and JSW. The relationship differs for the tibiofemoral and the patellofemoral joint. (orig.)

A novel biomarker in patients with knee osteoarthritis: adropin.

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Gundogdu, Gulsah; Gundogdu, Koksal

2018-03-16

Adropin is newly discovered peptide hormone. Osteoarthritis (OA) is a kind of joint disease characterized by progressive joint cartilage loss and joint pain. The present study was carried out to investigate adropin and tumor necrosis factor alpha (TNF-α) levels and the relationship between adropin in patients with knee OA classified by Kellgren-Lawrence (KL). A total of 60 knee OA patients and 30 healthy controls were included in this study. KL grading was carried out using the radiographic findings. Demographic characteristics and laboratory parameters were recorded. Adropin and TNF-α levels were determined by using enzyme-linked immunosorbent assay (ELISA). Adropin level was lower in the knee OA patients compared with the healthy controls (p  30 (p < 0.01). Mean NLR of KL grade 4 was significantly increased compared with other grades (p < 0.05). The consequence of the present study suggested that serum adropin level could be used as a new biomarker indicating the early grade of knee OA.

Body mass index and progressive hand osteoarthritis: data from the Oslo hand osteoarthritis cohort.

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Magnusson, K; Slatkowsky-Christensen, B; van der Heijde, D; Kvien, T K; Hagen, K B; Haugen, I K

2015-01-01

Few longitudinal studies have studied the association between body mass index (BMI) and hand osteoarthritis (OA). We aimed to explore the association between BMI and progressive hand OA in a longitudinal study of the Oslo hand OA cohort. Participants with existing hand OA had hand radiographs and BMI data taken at baseline and 7-year follow-up (n = 103). The radiographs were read according to the Kellgren-Lawrence (KL) scale. First, we examined the association between baseline BMI and incident OA (KL grade ≥ 2) in joints without OA at baseline (adjusted for age and sex) using generalized estimating equation (GEE) analyses. Second, we examined whether changes in BMI from baseline to follow-up were associated with increasing KL sum score from baseline to follow-up using linear regression. We repeated the analyses using changes in number of joints with symptomatic OA and patient-reported pain and physical function as the outcome. The mean (SD) age at baseline was 61.6 (5.6) years and 91 (94%) of the cohort were women. The mean (SD) BMI was 25.7 (4.0) kg/m(2) at baseline and the mean (SD) BMI change was 1.1 (2.0) kg/m(2). There was no relationship between baseline BMI and development of more joints with OA during follow-up. Similarly, there was no association between change in BMI and hand OA progression, increasing hand pain or disability. In the Oslo hand OA cohort, higher BMI was not related to hand OA progression.

Laterality of radiographic osteoarthritis of the knee.

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Komatsu, Daigo; Ikeuchi, Kazuma; Kojima, Toshihisa; Takegami, Yasuhiko; Amano, Takafumi; Tsuboi, Masaki; Ishiguro, Naoki; Hasegawa, Yukiharu

2017-05-01

There are few reports of the laterality in radiological knee osteoarthritis (ROA). This study aimed to evaluate laterality in terms of the minimum joint space width (mJSW) and osteophyte areas (OFs) in a cross-sectorial general population screen and elucidate the association between laterality and risk of osteoarthritis. We enrolled 330 participants (mean age 64.6 years) and examined the presence of ROA (Kellgren-Lawrence grade ≧ 2) laterality in terms of the mJSW and OF on the medial tibia using auto-measuring software. Moreover, we examined the association between laterality and leg dominance. The right and left medial mJSWs were 4.02 ± 0.98 mm and 4.05 ± 1.01 mm, respectively, showing no laterality; the laterals were also similar. The participants who had osteophytes ≥1 mm 2 in the right, left, and bilateral knees were 15, 37, and 57 respectively, with osteophytes being significantly more common in the left knee. The OF was significantly larger in the left knee. Conversely, the medial and lateral mJSWs and OF did not differ according to leg dominance. The prevalence of ROA was higher and the OF was more pronounced in the left knee. However, the mJSW showed no laterality. Additionally, the mJSW and OF showed no differences according to leg dominance.

Associations between floor activities and knee osteoarthritis in Thai Buddhist monks: the Songkhla study.

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Tangtrakulwanich, Boonsin; Chongsuvivatwong, Virasakdi; Geater, Alan F

2006-11-01

Whether floor activity, a common daily activity among Buddhist monks, is a risk factor for knee osteoarthritis remains controversial. The objective of the present study was to search for any association between floor activities and knee osteoarthritis. This population-based survey involved 261 monks, 40 years of age or older from Songkhla province in the southern part of Thailand Histories were taken on lifetime floor activities in four common positions, squatting, lotus, side-knee bending, and kneeling. Radiographic investigations included antero-posterior and skyline views of both knees. Diagnosis of osteoarthritis in each compartment was based on Kellgren & Lawrence grade 2 or more. Logistic regression analysis adjusted for age, body mass index and smoking status was used to identify the associations between lifetime floor activity and knee osteoarthritis. The mean age (SD) of monks in the present study was 60.4 (12.7) with mean age at ordination 44.4 (17.6) years. The lotus and side-knee bending positions were the two most common practices. Using the lowest tertile of exposure to lotus position as a reference, the third tertile had an odds ratio of 1.0 (95% CI; 0.5-2.2) associated with radiographic knee osteoarthritis. The corresponding odds ratio for side-knee bending was 0.8 (95% CI; 0.3-1.7), for squatting 2.1 (95% CI; 0.9-4.5), and for kneeling 0.7 (95% CI; 0.3-1.5). There was no significant association between the average daily lifetime floor activity in any positions and symptomatic radiographic knee osteoarthritis. Floor activities involving squatting, lotus, side-knee bending and kneeling do not increase the risk of knee osteoarthritis in Thai Buddhist monks.

Knee Injury and Osteoarthritis Outcome Score (KOOS)

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Collins, N J; Prinsen, C A C; Christensen, R

2016-01-01

OBJECTIVE: To conduct a systematic review and meta-analysis to synthesize evidence regarding measurement properties of the Knee injury and Osteoarthritis Outcome Score (KOOS). DESIGN: A comprehensive literature search identified 37 eligible papers evaluating KOOS measurement properties in partici......OBJECTIVE: To conduct a systematic review and meta-analysis to synthesize evidence regarding measurement properties of the Knee injury and Osteoarthritis Outcome Score (KOOS). DESIGN: A comprehensive literature search identified 37 eligible papers evaluating KOOS measurement properties...... in participants with knee injuries and/or osteoarthritis (OA). Methodological quality was evaluated using the COSMIN checklist. Where possible, meta-analysis of extracted data was conducted for all studies and stratified by age and knee condition; otherwise narrative synthesis was performed. RESULTS: KOOS has...... adequate internal consistency, test-retest reliability and construct validity in young and old adults with knee injuries and/or OA. The ADL subscale has better content validity for older patients and Sport/Rec for younger patients with knee injuries, while the Pain subscale is more relevant for painful...

Further evidence of the developmental origins of osteoarthritis: results from the Hertfordshire Cohort Study.

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Clynes, M A; Parsons, C; Edwards, M H; Jameson, K A; Harvey, N C; Sayer, A Aihie; Cooper, C; Dennison, E M

2014-12-01

Investigators have suggested a link between birth weight and both hand and lumbar spine osteoarthritis (OA). In this study, we sought to extend these observations by investigating relationships between growth in early life, and clinical and radiological diagnoses of OA at the hand, knee and hip, among participants from the Hertfordshire Cohort Study. Data were available for 222 men and 222 women. Clinical OA was defined based on American College of Rheumatology criteria. Radiographs were taken of the knees and hips, and graded for the presence of osteophytes and overall Kellgren and Lawrence (KL) score. Lower weight at year one was associated with higher rates of clinical hand OA (OR 1.396, 95% CI 1.05, 1.85, P=0.021). Individuals with lower birth weights were more likely to have hip osteophytes (OR 1.512, 95% CI 1.14, 2.00, P=0.004) and this remained robust after adjustment for confounders. Furthermore, a low weight at one year was also associated with a higher osteophyte number in the lateral compartment of the knee, after adjustment for confounders (OR 1.388, 95% CI 1.01, 1.91, P=0.043). We have found further evidence of a relationship between early life factors and adult OA. These findings accord with previous studies.

Diacerein: a treatment option in painful primary knee osteoarthritis

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Akhter, N.; Khan, A.A.; Ayaz, S.B.; Afzal, A.

2015-01-01

To identify the efficacy and side effects of Diacerein in patients with mild to moderate knee osteoarthritis. Study Design: Quasi experimental study. Place and Duration of Study: Outpatient Department of Armed Forces Institute of Rehabilitation Medicine, Rawalpindi from June 2012 to June 2013. Material and Methods: Ninety cases fulfilling American College of Rheumatology criteria for diagnosis of Knee Osteoarthritis and falling in Grades III of Kellgren-Lawrence Radiological Classification for Knee Osteoarthritis were included. Pre-treatment associated symptoms, complete blood count, renal and liver function tests were documented. After a baseline pain assessment on a 10-Point Visual Analogue Scale, 50 mg of Diacerein was given orally for 4 months followed by pain assessment and inquiry about adverse effects at 6th week, 3rd and 6th months. Post-treatment labs were repeated. Reduction in pain was analyzed by paired-sample t-test using SPSS version 17. Chi-Square test was used to assess the frequency of adverse effects. A p-value < 0.05 was considered significant. Results: Mean age was 61.5 ± 7.8 years. Majority 77 (85.6%) were females. Mean Visual Analogue Scale at start was 6.1 ± 0.87. Significant pain reduction measured on Visual Analogue Scale was observed at six weeks (4.6 ± 1.2) (p < 0.001), three months (2.37 ± 0.91) (p < 0.001) and six months (2.2 ± 0.85) (p < 0.001). Very few patients developed diarrhea 3.3% and nausea 4.4%. Conclusion: Diacerein is effective drug with minimal side effects for treatment of mild to moderate painful Knee Osteoarthritis. (author)

Variations in the pre-operative status of patients coming to primary hip replacement for osteoarthritis in European orthopaedic centres

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Puhl Wofhart

2009-02-01

Full Text Available Abstract Background Total hip joint replacement (THR is a high volume, effective intervention for hip osteoarthritis (OA. However, indications and determinants of outcome remain unclear. The 'EUROHIP consortium' has undertaken a cohort study to investigate these questions. This paper describes the variations in disease severity in this cohort and the relationships between clinical and radiographic severity, and explores some of the determinants of variation. Methods A minimum of 50 consecutive, consenting patients coming to primary THR for primary hip OA in each of the 20 participating orthopaedic centres entered the study. Pre-operative data included demographics, employment and educational attainment, drug utilisation, and involvement of other joints. Each subject completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC – Likert version 3.1. Other data collected at the time of surgery included the prosthesis used and American Society of Anaesthesiologists (ASA status. Pre-operative radiographs were read by the same three readers for Kellgren and Lawrence (K&L grading and Osteoarthritis Research Society International (OARSI atlas features. Regression analyses were carried out. Results Data from 1327 subjects has been analysed. The mean age of the group was 65.7 years, and there were more women (53.4% than men. Most (79% were ASA status 1 or 2. Reported disease duration was 5 years or less in 69.2%. Disease in other joint sites was common. Radiographs were available in 1051 subjects and the K&L grade was 3 or 4 in 95.8%. There was much more variation in clinical severity (WOMAC score; the mean total WOMAC score was 59.2 (SD 16.1. The radiographic severity showed no correlation with WOMAC scores. Significantly higher WOMAC scores (worse disease were seen in older people, women, those with obesity, those with worse general health, and those with lower educational attainment. Conclusion 1. Clinical disease severity

Does joint alignment affect the T2 values of cartilage in patients with knee osteoarthritis?

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Friedrich, Klaus M. [Medical University of Vienna, Department of Radiology, Vienna (Austria); Shepard, Timothy; Chang, Gregory; Wang, Ligong; Babb, James S.; Regatte, Ravinder [New York University Langone Medical Center, Department of Radiology, New York, NY (United States); Schweitzer, Mark [Ottawa Hospital, Diagnostic Imaging, Ottawa, ON (Canada)

2010-06-15

To assess the relationship between T2 values of femorotibial cartilage and knee alignment in patients with clinical symptoms of medial osteoarthritis (OA). Twenty-four patients (mean age {+-} standard deviation, 62.5 {+-} 9.9 years) with clinical symptoms of medial knee OA, 12 with varus and 12 with valgus alignment of the femorotibial joint, were investigated on 3T MR using a 2D multi-echo spin echo (MESE) sequence for T2 mapping. Analysis of covariance, Spearman correlation coefficients, exact Mann-Whitney tests, and Fisher's exact tests were used for statistical analysis. Overall the T2 values of cartilage in the medial compartment (median {+-} interquartile-range, 49.44 {+-} 6.58) were significantly higher (P = 0.0043) than those in the lateral compartment (47.15 {+-} 6.87). Patients with varus alignment (50.83 {+-} 6.30 ms) had significantly higher T2 values of cartilage (P < 0.0001) than patients with valgus alignment (46.20 {+-} 6.00 ms). No statistically significant association between the T2 values of cartilage (in either location) and the Kellgren Lawrence score was found in the varus or in the valgus group. T2 measurements were increased in medial knee OA patients with varus alignment, adding support to the theory of an association of OA and joint alignment. (orig.)

MR imaging findings in the follow-up of patients with different stages of knee osteoarthritis and the correlation with clinical symptoms

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Phan, Catherine M.; Link, Thomas M.; Blumenkrantz, Gabrielle; Dunn, Timothy C.; Steinbach, Lynne S.; Ries, Michael D.; Majumdar, Sharmila

2006-01-01

To assess the rate of cartilage loss, the change in bone marrow edema pattern and internal joint derangement at 1.5-T MRI in patients with knee osteoarthritis and to correlate these findings with the clinical Western Ontario and McMaster University Osteoarthitis (WOMAC) score. Methods: Forty subjects (mean age 57.7±15 years; 16 females and 24 males) were recruited: 6 healthy volunteers (OA0), 17 patients with mild osteoarthritis (OA1) and 17 with severe osteoarthritis (OA2) based on the Kellgren-Lawrence scale. MR scans, radiographs and WOMAC scores were obtained at baseline, first follow-up (1.4±0.67 years; n=40) and second follow-up (2.4±0.4 years; n=26). Cartilage morphology, bone marrow edema (BME), meniscal and ligamentous pathology were assessed on MR images and quantified by two radiologists in consensus. Full-thickness cartilage lesions were observed in 12/17 OA2 at baseline, in 13/17 at the first follow-up and in 7/10 at the second follow-up. Cartilage loss was found in eight patients at the first follow-up and five at the second follow-up. BME was observed in 23/40 patients at baseline, in 22/40 at the first follow-up and in 12/26 at the second follow-up. Changes in BME were visualized in 19/22 and 4/13 patients at the first and second follow-up, respectively. Changes in WOMAC scores over time did not correlate significantly with the amount of cartilage loss and the change in BME (P>0.05). MRI is well suited to monitor the progression of OA in the longitudinal follow-up since it shows cartilage defects, BME and internal joint derangement, pathologies that are not visualized by radiographs. The lack of significant correlation between MRI findings and clinical findings is not unexpected, has been previously described and may in part be due to the fact that patients get more accustomed to their pain as the knee progressively degenerates. (orig.)

MR imaging findings in the follow-up of patients with different stages of knee osteoarthritis and the correlation with clinical symptoms

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Phan, Catherine M.; Link, Thomas M.; Blumenkrantz, Gabrielle; Dunn, Timothy C.; Steinbach, Lynne S. [University of California San Francisco, Department of Radiology, San Francisco, CA (United States); Ries, Michael D. [University of California San Francisco, Department of Orthopedic Surgery, San Francisco, CA (United States); Majumdar, Sharmila [University of California San Francisco, Department of Radiology, San Francisco, CA (United States); University of California San Francisco, Department of Orthopedic Surgery, San Francisco, CA (United States)

2006-03-15

To assess the rate of cartilage loss, the change in bone marrow edema pattern and internal joint derangement at 1.5-T MRI in patients with knee osteoarthritis and to correlate these findings with the clinical Western Ontario and McMaster University Osteoarthitis (WOMAC) score. Methods: Forty subjects (mean age 57.7{+-}15 years; 16 females and 24 males) were recruited: 6 healthy volunteers (OA0), 17 patients with mild osteoarthritis (OA1) and 17 with severe osteoarthritis (OA2) based on the Kellgren-Lawrence scale. MR scans, radiographs and WOMAC scores were obtained at baseline, first follow-up (1.4{+-}0.67 years; n=40) and second follow-up (2.4{+-}0.4 years; n=26). Cartilage morphology, bone marrow edema (BME), meniscal and ligamentous pathology were assessed on MR images and quantified by two radiologists in consensus. Full-thickness cartilage lesions were observed in 12/17 OA2 at baseline, in 13/17 at the first follow-up and in 7/10 at the second follow-up. Cartilage loss was found in eight patients at the first follow-up and five at the second follow-up. BME was observed in 23/40 patients at baseline, in 22/40 at the first follow-up and in 12/26 at the second follow-up. Changes in BME were visualized in 19/22 and 4/13 patients at the first and second follow-up, respectively. Changes in WOMAC scores over time did not correlate significantly with the amount of cartilage loss and the change in BME (P>0.05). MRI is well suited to monitor the progression of OA in the longitudinal follow-up since it shows cartilage defects, BME and internal joint derangement, pathologies that are not visualized by radiographs. The lack of significant correlation between MRI findings and clinical findings is not unexpected, has been previously described and may in part be due to the fact that patients get more accustomed to their pain as the knee progressively degenerates. (orig.)

Anterior cruciate ligament reconstruction with 4-strand hamstring autograft and accelerated rehabilitation: a 10-year prospective study on clinical results, knee osteoarthritis and its predictors.

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Janssen, Rob P A; du Mée, Arthur W F; van Valkenburg, Juliette; Sala, Harm A G M; Tseng, Carroll M

2013-09-01

Analysis of long-term clinical and radiological outcomes after anterior cruciate ligament (ACL) reconstruction with special attention to knee osteoarthritis and its predictors. A prospective, consecutive case series of 100 patients. Arthroscopic transtibial ACL reconstruction was performed using 4-strand hamstring tendon autografts with a standardized accelerated rehabilitation protocol. Analysis was performed preoperatively and 10 years postoperatively. Clinical examination included Lysholm and Tegner scores, IKDC, KT-1000 testing (MEDmetric Co., San Diego, CA, USA) and leg circumference measurements. Radiological evaluation included AP weight bearing, lateral knee, Rosenberg and sky view X-rays. Radiological classifications were according to Ahlbäck and Kellgren & Lawrence. Statistical analysis included univariate and multivariate logistic regressions. RESULTS CLINICAL OUTCOME: A significant improvement (p test, IKDC score and one-leg hop test. A pivot shift phenomenon (glide) was still present in 43 (50%) patients and correlated with lower levels of activity (p test. Transtibial ACL reconstruction with 4-strand hamstring autograft and accelerated rehabilitation restored anteroposterior knee stability. Clinical parameters and patient satisfaction improved significantly. At 10-year follow-up, radiological signs of OA were present in 53.5 % of the subjects. Risk factors for OA were meniscectomy prior to or at the time of ACL reconstruction and chondral lesions at the time of ACL reconstruction. II.

In Vivo Quantitative Ultrasound Image Analysis of Femoral Subchondral Bone in Knee Osteoarthritis

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Jana Podlipská

2013-01-01

Full Text Available A potential of quantitative noninvasive knee ultrasonography (US for detecting changes in femoral subchondral bone related to knee osteoarthritis (OA was investigated. Thirty-nine patients referred to a knee arthroscopy underwent dynamic noninvasive US examination of the knee joint. The subchondral bone was semiautomatically segmented from representative US images of femoral medial and lateral condyles and intercondylar notch area. Subsequently, the normalized mean gray-level intensity profile, starting from the cartilage-bone interface and extending to the subchondral bone depth of ~1.7 mm, was calculated. The obtained profile was divided into 5 depth levels and the mean of each level, as well as the slope of the profile within the first two levels, was calculated. The US quantitative data were compared with the arthroscopic Noyes’ grading and radiographic Kellgren-Lawrence (K-L grading. Qualitatively, an increase in relative subchondral bone US gray-level values was observed as OA progressed. Statistically significant correlations were observed between normalized US mean intensity or intensity slope especially in subchondral bone depth level 2 and K-L grading (r=0.600, P<0.001; r=0.486, P=0.006, resp. or femoral arthroscopic scoring (r=0.332, P=0.039; r=0.335, P=0.037, resp.. This novel quantitative noninvasive US analysis technique is promising for detection of femoral subchondral bone changes in knee OA.

Does joint alignment affect the T2 values of cartilage in patients with knee osteoarthritis?

International Nuclear Information System (INIS)

Friedrich, Klaus M.; Shepard, Timothy; Chang, Gregory; Wang, Ligong; Babb, James S.; Regatte, Ravinder; Schweitzer, Mark

2010-01-01

To assess the relationship between T2 values of femorotibial cartilage and knee alignment in patients with clinical symptoms of medial osteoarthritis (OA). Twenty-four patients (mean age ± standard deviation, 62.5 ± 9.9 years) with clinical symptoms of medial knee OA, 12 with varus and 12 with valgus alignment of the femorotibial joint, were investigated on 3T MR using a 2D multi-echo spin echo (MESE) sequence for T2 mapping. Analysis of covariance, Spearman correlation coefficients, exact Mann-Whitney tests, and Fisher's exact tests were used for statistical analysis. Overall the T2 values of cartilage in the medial compartment (median ± interquartile-range, 49.44 ± 6.58) were significantly higher (P = 0.0043) than those in the lateral compartment (47.15 ± 6.87). Patients with varus alignment (50.83 ± 6.30 ms) had significantly higher T2 values of cartilage (P < 0.0001) than patients with valgus alignment (46.20 ± 6.00 ms). No statistically significant association between the T2 values of cartilage (in either location) and the Kellgren Lawrence score was found in the varus or in the valgus group. T2 measurements were increased in medial knee OA patients with varus alignment, adding support to the theory of an association of OA and joint alignment. (orig.)

Quantitative measures of meniscus extrusion predict incident radiographic knee osteoarthritis--data from the Osteoarthritis Initiative.

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Emmanuel, K; Quinn, E; Niu, J; Guermazi, A; Roemer, F; Wirth, W; Eckstein, F; Felson, D

2016-02-01

To test the hypothesis that quantitative measures of meniscus extrusion predict incident radiographic knee osteoarthritis (KOA), prior to the advent of radiographic disease. 206 knees with incident radiographic KOA (Kellgren Lawrence Grade (KLG) 0 or 1 at baseline, developing KLG 2 or greater with a definite osteophyte and joint space narrowing (JSN) grade ≥1 by year 4) were matched to 232 control knees not developing incident KOA. Manual segmentation of the central five slices of the medial and lateral meniscus was performed on coronal 3T DESS MRI and quantitative meniscus position was determined. Cases and controls were compared using conditional logistic regression adjusting for age, sex, BMI, race and clinical site. Sensitivity analyses of early (year [Y] 1/2) and late (Y3/4) incidence was performed. Mean medial extrusion distance was significantly greater for incident compared to non-incident knees (1.56 mean ± 1.12 mm SD vs 1.29 ± 0.99 mm; +21%, P meniscus (25.8 ± 15.8% vs 22.0 ± 13.5%; +17%, P meniscus in incident medial KOA, or for the tibial plateau coverage between incident and non-incident knees. Restricting the analysis to medial incident KOA at Y1/2 differences were attenuated, but reached significance for extrusion distance, whereas no significant differences were observed at incident KOA in Y3/4. Greater medial meniscus extrusion predicts incident radiographic KOA. Early onset KOA showed greater differences for meniscus position between incident and non-incident knees than late onset KOA. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Comparison of hyaluronic acid and PRP intra-articular injection with combined intra-articular and intraosseous PRP injections to treat patients with knee osteoarthritis.

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Su, Ke; Bai, Yuming; Wang, Jun; Zhang, Haisen; Liu, Hao; Ma, Shiyun

2018-05-01

The aim of this study was to evaluate the benefit provided by intraosseous infiltration combined with intra-articular injection of platelet-rich plasma to treat mild and moderate stages of knee joint degeneration (Kellgren-Lawrence score II-III) compared with other treatments, specifically intra-articular injection of PRP and of HA. Eighty-six patients with grade II to grade III knee OA according to the Kellgren-Lawrence classification were randomly assigned to intra-articular combined with intraosseous injection of PRP (group A), intra-articular PRP (group B), or intra-articular HA (group C). Patients in group A received intra-articular combined with intraosseous injection of PRP (administered twice, 2 weeks apart). Patients in group B received intra-articular injection of PRP every 14 days. Patients in group C received a series of five intra-articular injections of HA every 7 days. All patients were evaluated using the Visual Analogue Scale (VAS) and Western Ontario and McMaster Universities (WOMAC) score before the treatment and at 1, 3, 6, 12, and 18 months after treatment. There were significant improvements at the end of the 1st month. Notably, group A patients had significantly superior VAS and WOMAC scores than were observed in groups B and C. The VAS scores were similar in groups B and group C after the 6th month. Regarding the WOMAC scores, groups B and C differed at the 1st, 3rd, 6th, and 12th months; however, no significant difference was observed at the 18th month. The combination of intraosseous with intra-articular injections of PRP resulted in a significantly superior clinical outcome, with sustained lower VAS and WOMAC scores and improvement in quality of life within 18 months.

The alignment of the knee joint in relationship to age and osteoarthritis: the Copenhagen Osteoarthritis Study.

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Laxafoss, Erling; Jacobsen, Steffen; Gosvig, Kasper K; Sonne-Holm, Stig

2013-04-01

The aim of the present study was to describe the changes in the axis of the knee joint in both radiologically osteoarthritic and non-osteoarthritic knees, on the basis of angles measurable in standardized clinical short knee radiographs, in a cross sectional study of an epidemiological cohort. From the third inclusion of the Copenhagen City Heart Study, 4,151 subjects were selected for standardized radiography of the knees. After censuring the inclusion, the resulting cohort was comprised of 3,488 individuals. Images were analyzed for radiological knee joint osteoarthritis (OA) and the anatomical femorotibial axis of the knee joint was measured. The prevalence of knee joint OA in males was 27.9% and 27.5%, for the left and right knees respectively. In females this was 32.8% and 36.4%. The mean knee joint angles were 4.11° in males; and 5.45° in females. A difference of 1.3° was found between the genders. In non-osteoarthritic knees the increase in valgus orientation in relationship to increasing age was found to be 0.03° and 0.04° per year, respectively, for males and females. Likewise, Kellgren and Lawrence found that OA was seen to influence a shift towards varus of 0.55°-0.76° per level of OA. Stratification in accordance with morphological severity of OA documented a clear tendency for the axis of the diseased knees to depart from the mean, primarily in the direction of varus. In knees exhibiting no signs of radiographic osteoarthritis we found a significant relationship between increasing age and a shift in the anatomical axis in the direction of valgus.

Patellar skin surface temperature by thermography reflects knee osteoarthritis severity.

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Denoble, Anna E; Hall, Norine; Pieper, Carl F; Kraus, Virginia B

2010-10-15

Digital infrared thermal imaging is a means of measuring the heat radiated from the skin surface. Our goal was to develop and assess the reproducibility of serial infrared measurements of the knee and to assess the association of knee temperature by region of interest with radiographic severity of knee Osteoarthritis (rOA). A total of 30 women (15 Cases with symptomatic knee OA and 15 age-matched Controls without knee pain or knee OA) participated in this study. Infrared imaging was performed with a Meditherm Med2000™ Pro infrared camera. The reproducibility of infrared imaging of the knee was evaluated through determination of intraclass correlation coefficients (ICCs) for temperature measurements from two images performed 6 months apart in Controls whose knee status was not expected to change. The average cutaneous temperature for each of five knee regions of interest was extracted using WinTes software. Knee x-rays were scored for severity of rOA based on the global Kellgren-Lawrence grading scale. The knee infrared thermal imaging procedure used here demonstrated long-term reproducibility with high ICCs (0.50-0.72 for the various regions of interest) in Controls. Cutaneous temperature of the patella (knee cap) yielded a significant correlation with severity of knee rOA (R = 0.594, P = 0.02). The skin temperature of the patellar region correlated with x-ray severity of knee OA. This method of infrared knee imaging is reliable and as an objective measure of a sign of inflammation, temperature, indicates an interrelationship of inflammation and structural knee rOA damage.

Enzyme-linked immunosorbent assay (ELISAs) for metalloproteinase derived type II collagen neoepitope, CIIM--increased serum CIIM in subjects with severe radiographic osteoarthritis

DEFF Research Database (Denmark)

Bay-Jensen, Anne-Christine; Liu, Qi; Byrjalsen, Inger

2011-01-01

OBJECTIVES: In joint degenerative diseases, the collagens are degraded by matrix metalloproteinases and protein fragments are released to serum as potential biomarkers. METHODS: A collagen type II specific neoepitope, CIIM, was identified (…RDGAAG(1053)) by mass spectrometry. Two ELISAs against...... the neoepitope were developed. CIIM was measured in cartilage explants in the presence or absence of protease inhibitors. CIIM was measured in OA synovial fluid (n=51) and serum (n=156). Knee OA was graded by standard Kellgren-Lawrence (KL) score. RESULTS: The ELISAs showed good technical performance; CV%,

The Influence of Radiographic Severity on the Relationship between Muscle Strength and Joint Loading in Obese Knee Osteoarthritis Patients

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Jens Aaboe

2011-01-01

Full Text Available Objective. To investigate the relationship between knee muscle strength and the external knee adduction moment during walking in obese knee osteoarthritis patients and whether disease severity influences this relationship. Methods. This cross-sectional study included 136 elderly obese (BMI>30 adults with predominant medial knee osteoarthritis. Muscle strength, standing radiographic severity as measured by the Kellgren and Lawrence scale, and the peak external knee adduction moment were measured at self-selected walking speed. Results. According to radiographic severity, patients were classified as “less severe” (KL 1-2, N=73 or “severe” (KL 3-4, N=63. A significant positive association was demonstrated between the peak knee adduction moment and hamstring muscle strength in the whole cohort (P=.047. However, disease severity did not influence the relationship between muscle strength and dynamic medial knee joint loading. Severe patients had higher peak knee adduction moment and more varus malalignment (P<.001. Conclusion. Higher hamstring muscle strength relates to higher estimates of dynamic knee joint loading in the medial compartment. No such relationship existed for quadriceps muscle strength. Although cross sectional, the results suggest that hamstrings function should receive increased attention in future studies and treatments that aim at halting disease progression.

Partial meniscectomy is associated with increased risk of incident radiographic osteoarthritis and worsening cartilage damage in the following year

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Roemer, Frank W. [Boston University School of Medicine, Quantitative Imaging Center, Department of Radiology, Boston, MA (United States); University of Erlangen-Nuremberg, Department of Radiology, Erlangen (Germany); Kwoh, C.K. [University of Arizona Arthritis Center and University of Arizona College of Medicine, Tucson, AZ (United States); Hannon, Michael J.; Grago, Jason [University of Pittsburgh School of Medicine, Division of Rheumatology and Clinical Immunology, Pittsburgh, PA (United States); Hunter, David J. [University of Sydney, Department of Rheumatology, Royal North Shore Hospital and Kolling Institute, St Leonards (Australia); Eckstein, Felix [Paracelsus Medical University, Institute of Anatomy, Salzburg (Austria); Boudreau, Robert M. [University of Pittsburgh Graduate School of Public Health, Department of Epidemiology, Pittsburgh, PA (United States); Englund, Martin [Lund University, Clinical Epidemiology Unit, Orthopaedics, Department of Clinical Sciences Lund, Lund (Sweden); Guermazi, Ali [Boston University School of Medicine, Quantitative Imaging Center, Department of Radiology, Boston, MA (United States)

2017-01-15

To assess whether partial meniscectomy is associated with increased risk of radiographic osteoarthritis (ROA) and worsening cartilage damage in the following year. We studied 355 knees from the Osteoarthritis Initiative that developed ROA (Kellgren-Lawrence grade ≥ 2), which were matched with control knees. The MR images were assessed using the semi-quantitative MOAKS system. Conditional logistic regression was applied to estimate risk of incident ROA. Logistic regression was used to assess the risk of worsening cartilage damage in knees with partial meniscectomy that developed ROA. In the group with incident ROA, 4.4 % underwent partial meniscectomy during the year prior to the case-defining visit, compared with none of the knees that did not develop ROA. All (n = 31) knees that had partial meniscectomy and 58.9 % (n = 165) of the knees with prevalent meniscal damage developed ROA (OR = 2.51, 95 % CI [1.73, 3.64]). In knees that developed ROA, partial meniscectomy was associated with an increased risk of worsening cartilage damage (OR = 4.51, 95 % CI [1.53, 13.33]). The probability of having had partial meniscectomy was higher in knees that developed ROA. When looking only at knees that developed ROA, partial meniscectomy was associated with greater risk of worsening cartilage damage. (orig.)

Point of no return for improvement of cartilage quality indicated by dGEMRIC before and after weight loss in patients with knee osteoarthritis

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Hangaard, Stine; Gudbergsen, Henrik; Skougaard, Marie

2018-01-01

Background It has been demonstrated that weight loss improves symptoms in obese subjects with knee osteoarthritis (KOA). A parallel change in cartilage morphology remains to be demonstrated. Purpose To demonstrate a parallel change in cartilage morphology. Material and Methods Obese patients...... with KOA were examined before and after weight loss over 16 weeks. Target knee joints were radiographically assessed by the Kellgren/Lawrence grading (KLG) system. Patients with KLG-1 and 2 changes in the lateral compartment were included. Delayed gadolinium-enhanced MRI of cartilage (d...... in body mass index (BMI) after 16 weeks: 12.8% versus 11.4% ( P = 0.74). In the KLG-1 group, several cases of increased dGEMRIC T1 values were seen and median value decreased significantly less than in KLG-2 group (15 ms versus 41 ms, P = 0.03) after weight loss. Conclusion Improvement of cartilage...

Early signs of osteoarthritis in professional ballet dancers: a preliminary study.

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Angioi, Manuela; Maffulli, Gayle D; McCormack, Moira; Morrissey, Dylan; Chan, Otto; Maffulli, Nicola

2014-09-01

To investigate a cohort of professional ballet dancers for evidence of early signs of osteoarthritis (OA). One radiologist and 1 orthopedic surgeon specialized in musculoskeletal disorders analyzed magnetic resonance imaging scans independently. University Teaching Hospital. Fifteen professional ballet dancers (4 males and 11 females; age range, 19-36 years) experiencing chronic pain in the hip, knee, spine, ankle, or foot joints. Presence of osteophytes, subchondral sclerosis, joint space narrowing, cysts, and bone marrow changes; the Kellgren and Lawrence scale was used to quantify the knee OA. In the knee, there was thinning and irregularity of the articular cartilage over the medial femoral condyle and bone marrow changes within the lateral femoral condyle. In the hip, there was a loss of joint space and a frayed labrum with deep recess. The first metatarsophalangeal joint showed evidence of osteophytic development. Early signs of OA, in different joints, were present in a small but highly selected cohort of professional ballet dancers. In future, prospective studies among a number of ballet companies should control for medical and natural history alongside the visual analysis of images and plain radiographs to confirm these preliminary results.

Efficacy and safety of nimesulide long term administration in patients with osteoarthritis: results of 12-months open controlled study DINAMO (long term administration of nimesulide in osteoarthritis multifactor assessment

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L I Alexeeva

2009-01-01

Full Text Available Objective. To compare efficacy and safety of nimesulide and paracetamol in treatment of patients with osteoarthritis (OA during 12 months. Material and methods. 40 women (mean age 66,8±5,1 years with knee osteoarthritis (II-III stage according to Kellgren-Lawrence having intensive pain (>40 mm on VAS were included. Group 1 pts (n=20 received nimesulide 200-100 mg/day. Group 2 pts were treated with paracetamol till 3 g/day. WOMAC was used as efficacy measure. Safety was assessed with endoscopic examination of upper gastrointestinal tract, ECG, blood pressure and ECG Holter monitoring, clinical and biochemical blood parameters. Statistical significance of differences was assessed with Student’s t-test, χ2 and Fisher exact test Results. WOMAC index decreased during treatment from 1182,7±345,9 to 698,4±351,1 for nimesulide and from 1136,4±313,8 to 1031,6±21 for paracetamol (p<0,05. There were 6 cases of gastrointestinal complications and 4 cases of hypertension development or deterioration in each group. Coronary heart disease developed or deteriorated in 4 patients receiving nimesulide but not in control group. Liver function tests did not deteriorated during treatment with nimesulide. Conclusion. Nimesulide was more effective than paracetamol in treatment of OA. But risk of cardiovascular complications development during treatment with NSAIDs requires serious attention. Nimesulide did not induced liver damage during long term treatment.

Clinical profile, level of affection and therapeutic management of patients with osteoarthritis in primary care: The Spanish multicenter study EVALÚA.

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Castaño Carou, Ana; Pita Fernández, Salvador; Pértega Díaz, Sonia; de Toro Santos, Francisco Javier

2015-01-01

To determine the clinical profile, degree of involvement and management in patients with knee, hip or hand osteoarthritis. Observational study (health centers from 14 autonomous regions, n=363 primary care physicians), involving patients with clinical and/or radiological criteria for osteoarthritis from the American College of Rheumatology, consecutively selected (n=1,258). Sociodemographic variables, clinical and radiological findings, comorbidity and therapeutic management were analyzed. Mean age was 68.0±9.5 years old; 77.8% were women and 47.6% obese. Distribution by location was: 84.3% knee, 23.4% hip, 14.7% hands. All patients reported pain. The most frequent radiographic Kellgren-Lawrence grade was stage 3 for knee and hip (42.9% and 51.9%, respectively), and 3 (37.2%) and 2 (34.5%) for hip. Time since onset of osteoarthritis symptoms was 9.4±7.5 years, with a mean age at onset of around 60 years old and a family history of osteoarthritis in 66.0%. The most frequent comorbidities were: hypertension (55.1%), depression/anxiety (24.7%) and gastroduodenal diseases (22.9%). A total of 97.6% of the patients received pharmacological treatment, with oral analgesics (paracetamol) (70.5%) and oral NSAIDs (67.9%) being the most frequent drugs. Bilateral osteoarthritis was present in 76.9% of patients with knee osteoarthritis, 59.3% in hip and 94.7% in hands. Female gender and time since onset were associated with bilateral knee and hip osteoarthritis. The profile of the osteoarthritis patient is female, >65 years old, overweight/obese, with comorbidity, frequent symptoms and moderate radiologic involvement. Most of patients had bilateral osteoarthritis, associated with female gender and time since onset of disease. Paracetamol was the most common pharmacological treatment. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

[Correlations Between Joint Proprioception, Muscle Strength, and Functional Ability in Patients with Knee Osteoarthritis].

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Chen, Yoa; Yu, Yong; He, Cheng-qi

2015-11-01

To establish correlations between joint proprioception, muscle flexion and extension peak torque, and functional ability in patients with knee osteoarthritis (OA). Fifty-six patients with symptomatic knee OA were recruited in this study. Both proprioceptive acuity and muscle strength were measured using the isomed-2000 isokinetic dynamometer. Proprioceptive acuity was evaluated by establishing the joint motion detection threshold (JMDT). Muscle strength was evaluated by Max torque (Nm) and Max torque/weight (Nm/ kg). Functional ability was assessed by the Western Ontario and McMaster Universities Osteoarthritis Index physical function (WOMAC-PF) questionnaire. Correlational analyses were performed between proprioception, muscle strength, and functional ability. A multiple stepwise regression model was established, with WOMAC-PF as dependent variable and patient age, body mass index (BMI), visual analogue scale (VAS)-score, mean grade for Kellgren-Lawrance of both knees, mean strength for quadriceps and hamstring muscles of both knees, and mean JMDT of both knees as independent variables. Poor proprioception (high JMDT) was negatively correlated with muscle strength (Pcoefficient (B) = 0.385, P<0.50 and high VAS-scale score (B=0.347, P<0.05) were significant predictors of WOMAC-PF score. Patients with poor proprioception is associated with poor muscle strength and limitation in functional ability. Patients with symptomatic OA of knees commonly endure with moderate to considerable dysfunction, which is associated with poor proprioception (high JMDT) and high VAS-scale score.

The relationship between clinical characteristics, radiographic osteoarthritis and 3D bone area: data from the osteoarthritis initiative.

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Barr, A J; Dube, B; Hensor, E M A; Kingsbury, S R; Peat, G; Bowes, M A; Conaghan, P G

2014-10-01

Radiographic measures of osteoarthritis (OA) are based upon two dimensional projection images. Active appearance modelling (AAM) of knee magnetic resonance imaging (MRI) enables accurate, 3D quantification of joint structures in large cohorts. This cross-sectional study explored the relationship between clinical characteristics, radiographic measures of OA and 3D bone area (tAB). Clinical data and baseline paired radiographic and MRI data, from the medial compartment of one knee of 2588 participants were obtained from the NIH Osteoarthritis Initiative (OAI). The medial femur (MF) and tibia (MT) tAB were calculated using AAM. 'OA-attributable' tAB (OA-tAB) was calculated using data from regression models of tAB of knees without OA. Associations between OA-tAB and radiographic measures of OA were investigated using linear regression. In univariable analyses, height, weight, and age in female knees without OA explained 43.1%, 32.1% and 0.1% of the MF tAB variance individually and 54.4% when included simultaneously in a multivariable model. Joint space width (JSW), osteophytes and sclerosis explained just 5.3%, 14.9% and 10.1% of the variance of MF OA-tAB individually and 17.4% when combined. Kellgren Lawrence (KL) grade explained approximately 20% of MF OA-tAB individually. Similar results were seen for MT OA-tAB. Height explained the majority of variance in tAB, confirming an allometric relationship between body and joint size. Radiographic measures of OA, derived from a single radiographic projection, accounted for only a small amount of variation in 3D knee OA-tAB. The additional structural information provided by 3D bone area may explain the lack of a substantive relationship with these radiographic OA measures. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Bone marrow abnormality associated with painful osteoarthritis of the knee. A cross-sectional study of magnetic resonance imaging findings with the radiographic stage and clinical findings

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Kubota, Mitsuaki; Kurosawa, Hisashi; Ikeda, Hiroshi; Takazawa, Yuji; Kawasaki, Takayuki; Ishijima, Muneaki; Kim, Song-Gon; Seto, Hiroaki

2009-01-01

Bone marrow abnormalities (BMAs) are frequently found in osteoarthritis (OA) of the knee with magnetic resonance imaging (MRI). Some reports have suggested BMA was correlated with the X-ray stage of OA and also with knee pain, but the reports depended on two-dimensional images without considering the spatial expansion of BMAs. To determine whether three-dimensional expansion of a BMA with MRI in patient with medial-type OA of the knee is correlated with the radiographic stage of OA and clinical findings using a semi-quantitative method. Cross-sectional study. This study enrolled 238 patients with medial-type OA. Radiography and MRI of the knee were taken in all participants. X-rays were graded using the Kellgren-Lawrence (K/L) grade (1-4). T2-weighted fat-suppressed MRI images were used to score the size of the BMA according to the whole-organ MRI score (WORMS). A new scoring system defined as the spatial BMA score (s-score), which specifically addressed the spatial expansion of BMAs, was examined to assess the size of the BMA. BMA frequency was examined in subdivisions of the articular surfaces of the knee according to the X-ray stages of the K/L grade and the correlation of the s-score to the clinical findings. BMA frequency in the medial femorotibial joint (MFTJ; 74%) was significantly higher than in the lateral femorotibial joint (LFTJ; 14%) and patellofemoral joint (PFJ; 14%; P<0.01). The s-score of the MFTJ was strongly correlated with the X-ray stage assessed by the K/L grade. The s-score of the MFTJ was also correlated with the clinical findings. The frequency and spatial expansion of BMAs in the MFTJ are strongly correlated with the X-ray stage of medial-type OA as well as the clinical findings. (author)

Patellar Skin Surface Temperature by Thermography Reflects Knee Osteoarthritis Severity

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Anna E. Denoble

2010-01-01

Full Text Available Background Digital infrared thermal imaging is a means of measuring the heat radiated from the skin surface. Our goal was to develop and assess the reproducibility of serial infrared measurements of the knee and to assess the association of knee temperature by region of interest with radiographic severity of knee Osteoarthritis (rOA. Methods A total of 30 women (15 Cases with symptomatic knee OA and 15 age-matched Controls without knee pain or knee OA participated in this study. Infrared imaging was performed with a Meditherm Med2000™ Pro infrared camera. The reproducibility of infrared imaging of the knee was evaluated through determination of intraclass correlation coefficients (ICCs for temperature measurements from two images performed 6 months apart in Controls whose knee status was not expected to change. The average cutaneous temperature for each of five knee regions of interest was extracted using WinTes software. Knee x-rays were scored for severity of rOA based on the global Kellgren-Lawrence grading scale. Results The knee infrared thermal imaging procedure used here demonstrated long-term reproducibility with high ICCs (0.50–0.72 for the various regions of interest in Controls. Cutaneous temperature of the patella (knee cap yielded a significant correlation with severity of knee rOA (R = 0.594, P = 0.02. Conclusion The skin temperature of the patellar region correlated with x-ray severity of knee OA. This method of infrared knee imaging is reliable and as an objective measure of a sign of inflammation, temperature, indicates an interrelationship of inflammation and structural knee rOA damage.

Hip disability and osteoarthritis outcome score (HOOS)--validity and responsiveness in total hip replacement

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Nilsdotter, Anna K; Lohmander, L Stefan; Klässbo, Maria

2003-01-01

The aim of the study was to evaluate if physical functions usually associated with a younger population were of importance for an older population, and to construct an outcome measure for hip osteoarthritis with improved responsiveness compared to the Western Ontario McMaster osteoarthritis score...

Prevalence of knee osteoarthritis, lumbar spondylosis, and osteoporosis in Japanese men and women: the research on osteoarthritis/osteoporosis against disability study.

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Yoshimura, Noriko; Muraki, Shigeyuki; Oka, Hiroyuki; Mabuchi, Akihiko; En-Yo, Yoshio; Yoshida, Munehito; Saika, Akihiko; Yoshida, Hideyo; Suzuki, Takao; Yamamoto, Seizo; Ishibashi, Hideaki; Kawaguchi, Hiroshi; Nakamura, Kozo; Akune, Toru

2009-01-01

Musculoskeletal diseases, especially osteoarthritis (OA) and osteoporosis (OP), impair activities of daily life (ADL) and quality of life (QOL) in the elderly. Although preventive strategies for these diseases are urgently required in an aging society, epidemiological data on these diseases are scant. To clarify the prevalence of knee osteoarthritis (KOA), lumbar spondylosis (LS), and osteoporosis (OP) in Japan, and estimate the number of people with these diseases, we started a large-scale population-based cohort study entitled research on osteoarthritis/osteoporosis against disability (ROAD) in 2005. This study involved the collection of clinical information from three cohorts composed of participants located in urban, mountainous, and coastal areas. KOA and LS were radiographically defined as a grade of > or =2 by the Kellgren-Lawrence scale; OP was defined by the criteria of the Japanese Society for Bone and Mineral Research. The 3,040 participants in total were divided into six groups based on their age: or =80 years. The prevalence of KOA in the age groups or =80 years 0, 9.1, 24.3, 35.2, 48.2, and 51.6%, respectively, in men, and the prevalence in women of the same age groups was 3.2, 11.4, 30.3, 57.1, 71.9, and 80.7%, respectively. With respect to the age groups, the prevalence of LS was 14.3, 45.5, 72.9, 74.6, 85.3, and 90.1% in men, and 9.7, 28.6, 41.7, 55.4, 75.1, and 78.2% in women, respectively. Data of the prevalence of OP at the lumbar spine and femoral neck were also obtained. The estimated number of patients with KOA, LS, and L2-L4 and femoral neck OP in Japan was approximately 25, 38, 6.4, and 11 million, respectively. In summary, we estimated the prevalence of OA and OP, and the number of people affected with these diseases in Japan. The ROAD study will elucidate epidemiological evidence concerning determinants of bone and joint disease.

Patellofemoral Osteoarthritis Progression and Alignment Changes after Open-Wedge High Tibial Osteotomy Do Not Affect Clinical Outcomes at Mid-term Follow-up.

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Goshima, Kenichi; Sawaguchi, Takeshi; Shigemoto, Kenji; Iwai, Shintaro; Nakanishi, Akira; Ueoka, Ken

2017-10-01

To evaluate the clinical and radiological outcomes of open-wedge high tibial osteotomy (OWHTO) with respect to the patellofemoral joint and to assess whether patellofemoral osteoarthritis (OA) progression and alignment changes after OWHTO affect clinical outcomes. Inclusion criteria were consecutive patients who underwent OWHTO from March 2005 to September 2013. Exclusion criteria were loss to follow-up within 2 years and absence of second-look arthroscopy findings at the time of plate removal. The clinical parameters, including anterior knee pain while climbing stairs, Japanese Orthopedic Association score, and Oxford Knee Score, were evaluated. Radiological outcomes, including weight-bearing line ratio, modified Blackburne-Peel ratio, posterior tibial slope, tilting angle, lateral shift ratio, and patellofemoral OA (Kellgren-Lawrence grade), were evaluated preoperatively and at the final follow-up. Cartilage status (International Cartilage Repair Society grade) was evaluated at the initial HTO and at plate removal. Fifty-three patients (60 knees) were included in this study. The mean follow-up was 58.2 ± 22.4 months. Two knees (3%) presented with mild anterior knee pain after OWHTO. The mean Japanese Orthopedic Association score (66.9 ± 11.2 to 91.2 ± 9.7) significantly improved (P patellofemoral OA had progressed in 15 knees (27%), and arthroscopically patellofemoral cartilage degeneration had progressed in 27 knees (45%). However, there was no significant correlation between changes in patellofemoral alignment and clinical outcomes. Changes in patellofemoral alignment and patellofemoral OA progression did not affect the clinical outcomes of OWHTO at mid-term follow-up. Level IV, therapeutic case series. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Incidence of total knee replacement subsequent to intra-articular injection of the anti-inflammatory compound LMWF-5A versus saline: a long-term follow-up study to a randomized controlled trial.

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Schwappach, John; Schultz, Joseph; Salottolo, Kristin; Bar-Or, David

2018-01-01

The disease modifying potential of osteoarthritis therapies are of increasing interest, including their effects on delaying total knee replacement (TKR). To date, there have been no studies to determine the effect of LMWF-5A, a novel anti-inflammatory compound derived from human serum albumin, on delaying TKR. We evaluated time to TKR three years after patients participated in a randomized trial of three intra-articular injections of LMWF-5A or saline. Patients were contacted via last known phone number and were asked to participate in a short nine item telephone questionnaire; verbal consent was obtained. The primary endpoint was incidence of TKR (%). In total, 39 of 45 patients responded (87% response rate). The overall incidence of TKR was 38.5% (15/39). TKR rates were higher in patients with more severe osteoarthritis defined by Kellgren-Lawrence grade 4, compared to patients with moderate osteoarthritis defined by Kellgren-Lawrence grade 3 (56% vs. 26%, p  = 0.06). Overall, there were no differences in TKR rates by treatment arm (39% LMWF-5A vs. 38% saline, p  = 0.92). In the severe osteoarthritis subset ( n  = 16), treatment with LMWF-5A resulted in a lower incidence of TKR compared to saline vehicle arm (40% vs. 83%, p  = 0.15). TKR rates were significantly lower with LMWF-5A in patients who responded to treatment (14% with LMWF-5A, vs. 100% with saline, p  = 0.03). This study demonstrates significant delays in TKR for patients with severe osteoarthritis treated with LMWF-5A, suggesting that LMWF-5A has the potential to provide structure modifying/preserving therapy in this population.

The relationship between the MRI features of mild osteoarthritis in the patellofemoral and tibiofemoral compartments of the knee

International Nuclear Information System (INIS)

Kornaat, Peter R.; Watt, Iain; Bloem, Johan L.; Riyazi, Naghmeh; Kloppenburg, Margreet

2005-01-01

The aim of this work was to demonstrate the relationship between osteoarthritic changes seen on magnetic resonance (MR) images of the patellofemoral (PF) or tibiofemoral (TF) compartments in patients with mild osteoarthritis (OA) of the knee. MR images of the knee were obtained in 105 sib pairs (210 patients) who had been diagnosed with OA at multiple joints. Entry criteria included that the degree of OA in the knee examined should be between a Kellgren and Lawrence score of 2 or 3. MR images were analyzed for the presence of cartilaginous lesions, bone marrow edema (BME) and meniscal tears. The relationship between findings in the medial and lateral aspects of the PF and TF compartments was examined. The number of cartilaginous defects on either side of the PF compartment correlated positively with number of cartilaginous defects in the ipsilateral TF compartment (odds ratio, OR, 55, confidence interval, CI, 7.8-382). The number of cartilaginous defects in the PF compartment correlated positively with ipsilateral meniscal tears (OR 3.7, CI 1.0-14) and ipsilateral PF BME (OR 17, CI 3.8-72). Cartilaginous defects in the TF compartment correlated positively with ipsilateral meniscal tears (OR 9.8, CI 2.5-38) and ipsilateral TF BME (OR 120, CI 6.5-2,221). Osteoarthritic defects lateralize or medialize in the PF and TF compartments of the knee in patients with mild OA. (orig.)

The relationship between the MRI features of mild osteoarthritis in the patellofemoral and tibiofemoral compartments of the knee

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Kornaat, Peter R.; Watt, Iain; Bloem, Johan L. [Leiden University Medical Center, Department of Radiology, Leiden (Netherlands); Riyazi, Naghmeh; Kloppenburg, Margreet [Leiden University Medical Center, Department of Rheumatology, Leiden (Netherlands)

2005-08-01

The aim of this work was to demonstrate the relationship between osteoarthritic changes seen on magnetic resonance (MR) images of the patellofemoral (PF) or tibiofemoral (TF) compartments in patients with mild osteoarthritis (OA) of the knee. MR images of the knee were obtained in 105 sib pairs (210 patients) who had been diagnosed with OA at multiple joints. Entry criteria included that the degree of OA in the knee examined should be between a Kellgren and Lawrence score of 2 or 3. MR images were analyzed for the presence of cartilaginous lesions, bone marrow edema (BME) and meniscal tears. The relationship between findings in the medial and lateral aspects of the PF and TF compartments was examined. The number of cartilaginous defects on either side of the PF compartment correlated positively with number of cartilaginous defects in the ipsilateral TF compartment (odds ratio, OR, 55, confidence interval, CI, 7.8-382). The number of cartilaginous defects in the PF compartment correlated positively with ipsilateral meniscal tears (OR 3.7, CI 1.0-14) and ipsilateral PF BME (OR 17, CI 3.8-72). Cartilaginous defects in the TF compartment correlated positively with ipsilateral meniscal tears (OR 9.8, CI 2.5-38) and ipsilateral TF BME (OR 120, CI 6.5-2,221). Osteoarthritic defects lateralize or medialize in the PF and TF compartments of the knee in patients with mild OA. (orig.)

Decreased synovial fluid ghrelin levels are linked with disease severity in primary knee osteoarthritis patients and are increased following laser therapy.

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Zou, Yu-Cong; Deng, Hong-Yu; Mao, Zheng; Zhao, Chang; Huang, Ju; Liu, Gang

2017-07-01

Ghrelin has been proved to inhibit inflammation and promote cartilage growth. So far, its role in patients with primary knee osteoarthritis has not been investigated. The current study was performed to explore the serum and synovial ghrelin levels as well as the relationship between ghrelin levels and disease severity in primary knee OA patients. 52 primary knee OA patients were recruited in the study. 52 sex and age-matched patients visiting our hospital for regular body check were selected as controls. The serum and synovial fluid ghrelin levels were examined by enzyme linked immunosorbent assay (ELISA) before treatment, one week and four weeks after laser therapy, respectively. The inflammation markers IL-6 and TNF-α were also investigated. The radiographic progression was assessed by Kellgren-Lawrence (K-L) grade scale and the symptomatic severity was evaluated by visual analog scale (VAS), Lequesne index and Lysholm scores. The Receiver Operating Characteristic (ROC) analysis curve was conducted to test the diagnostic value of ghrelin, IL-6 and TNF-α for radiographic progression. No significant difference of serum ghrelin levels was found between knee OA patients and healthy controls. Synovial fluid ghrelin concentrations were significantly negatively correlated with K-L grading (r=-0.591, Pghrelin levels were also related to clinical severity determined by Lequesne index (r=-0.308, P=0.025),VAS scores (r=-0.591, Pghrelin levels were also negatively associated with TNF-α (r=-0.424, P=0.002) and IL-6 concentrations (r=-0.428, P=0.002). ROC curve analysis demonstrated that ghrelin exhibited more diagnostic value than IL-6 and TNF-α for assessing radiographic progression in medium-late stage. Decreased synovial fluid ghrelin levels are related to disease severity in patients with primary osteoarthritis and are increased following laser therapy. Local application of ghrelin may serve as an adjunctive therapy for knee OA. Copyright © 2017. Published by

Women with knee osteoarthritis have more pain and poorer function than men, but similar physical activity prior to total knee replacement

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Tonelli Shalome M

2011-11-01

duration, pain catastrophizing, body mass index (BMI, and heat pain threshold; and (3 physical activity (average metabolic equivalent tasks (METS/day were BMI, age, Short-Form 36 (SF-36 Physical Function, Kellgren-Lawrence osteoarthritis grade, depression, and Knee Injury and Osteoarthritis Outcome Score (KOOS pain subscale. Conclusions Women continue to be as physically active as men prior to total knee replacement even though they have significantly more pain, greater pain sensitivity, poorer perceived function, and more impairment on specific functional tasks.

Rasch analysis of the Knee injury and Osteoarthritis Outcome Score (KOOS): a statistical re-evaluation

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Comins, J; Brodersen, J; Krogsgaard, M

2008-01-01

The knee injury and Osteoarthritis Outcome Score (KOOS), based on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), is widely used to evaluate subjective outcome in anterior cruciate ligament (ACL) reconstructed patients. However, the validity of KOOS has not been assessed...

Curcuma longa extract reduces inflammatory and oxidative stress biomarkers in osteoarthritis of knee: a four-month, double-blind, randomized, placebo-controlled trial.

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Srivastava, Shobhit; Saksena, Anil K; Khattri, Sanjay; Kumar, Santosh; Dagur, Raghubendra Singh

2016-12-01

Curcuma longa L. (CL), an Indian herb, has been used to treat many disorders because of its wide spectrum of pharmacological activities. It has been shown to exhibit anti-oxidant and anti-inflammatory properties, and is being used as herbal remedy since ancient times. Osteoarthritis of knee (KOA) is a chronic painful disorder in which prolong use of non-steroidal anti-inflammatory drugs (NSAIDs) or steroids may result into many serious side effects; hence, there is a need to develop herbal drugs, having good analgesia without side effects. Therefore, we planned to evaluate the efficacy of CL in KOA. The study was designed as a randomized, double-blind, placebo-controlled trial in patients of KOA. After obtaining ethical clearance and written informed consent, a total of 160 patients of KOA were randomly enrolled into two groups to receive either CL extract or placebo along with the standard drug regimen. The patients were assessed on day 0, day 60, and day 120. On the days of their visit, the clinical prognosis was assessed by visual analog scale (VAS) and Western Ontario and McMaster Universities (WOMAC) Osteoarthritis index. On these days, the radiographs were also taken for Kellgren and Lawrence grading and blood samples were collected for assessing the changes in levels of IL-1β and biomarkers of oxidative stress, such as reactive oxygen species and malondialdehyde (MDA). Over all significant improvement was observed in the patients of CL extract group as compared to placebo group. Clinically, the VAS and WOMAC scores became better, and simultaneously, the levels of biomarkers, viz., IL-1β, ROS, and MDA, were also significantly (p < 0.05) improved. It may be concluded that on chronic administration, CL suppresses inflammation and brings clinical improvement in patients of KOA, which may be observed by decreased level of IL-1β and VAS/WOMAC scores, respectively. At the same time, CL decreases the oxidative stress also.

The occurrence of osteoarthritis at a minimum of ten years after reconstruction of the anterior cruciate ligament

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Patt Thomas W

2008-06-01

Full Text Available Abstract Objective The objective of this study was to evaluate the incidence of radiographic osteoarthritis in the operated knee in comparison with the contralateral knee ten years after a bone-tendon bone patellar autograft ACL-reconstruction and to evaluate to which level patients regain activity ten years after reconstruction. Methods Fifty-three patients with ACL instability were operated arthroscopically using the central third of the patellar tendon as a bone-tendon-bone autograft. At a minimum of 10 year follow up 28/44 patients matched the inclusion criteria and could be reached for follow-up. Evaluation included a patient satisfaction evaluation using a Visual Analog Scale, physical examination (International Knee Documentation Committee score, Tegner score, Lysholm score, KT-1000 stabilometry and a radiological evaluation (Kellgren and Fairbanks classification. Results The patients' satisfaction, at a mean of 10,3 year follow-up, measured with a VAS score (0–10 was high with a mean of 8.5 (range 4 to 10. The KT 1000 arthrometer laxity measurements revealed in 55% of the patients an A rating (1–2 mm, in 29% a B rating (3–5 mm and in 16% a C rating (6–10 mm. According to the Tegner score 54% of the patients were able to perform at the same activity level as pre-operatively. The mean pre-operative Tegner score was 6.8 and the mean post-operative Tegner score was 6.0 at final follow up. The Lysholm score showed satisfactory results with a mean of 91 points (range 56 to 100. According to the Kellgren and Fairbank classifications, there is a significant difference (p Conclusion The patellar BTB ACL reconstruction does not prevent the occurrence of radiological OA after 10 years but does help the patient to regain the pre-operative level of activity.

Prevalence of pes anserine bursitis in symptomatic osteoarthritis patients: an ultrasonographic prospective study.

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Uysal, Fatma; Akbal, Ayla; Gökmen, Ferhat; Adam, Gürhan; Reşorlu, Mustafa

2015-03-01

The aim of this prospective study was to determine the prevalence of pes anserine bursitis (PAB) in patients with osteoarthritis. A total of 85 patients with primary knee osteoarthritis diagnosed according to the American College of Rheumatology (ACR) criteria were included in the study. The patients were divided into four groups using the Kellgren-Lawrence staging system. The knee X-rays evaluated according to this system indicated that 15.6% of patients were grade 1, 34.1% grade 2, 37.1% grade 3, and 13.5% grade 4. Ultrasonography (USG) was performed on both knees by a radiologist experienced in musculoskeletal system ultrasonography and unaware of the patients' physical examination or direct X-ray findings. The presence of PAB, longest diameter of bursitis, and area of bursitis were recorded. The average age of the 11 male and 74 female patients included in the study was 58.9 ± 9.0 years. A total of 170 knees of 85 patients were examined. The incidence of bursitis was significantly higher in females (p = 0.026). The incidence of bursitis on ultrasound was 20% (34/170). There was a statistical difference between the grades for bursitis incidence (p = 0.004). There was a significant positive correlation between both the longest length (p = 0.015, r = 0.187) and area (p = 0.003, r = 0.231) of PAB with osteoarthritis grade. The mean age of bursitis patients was higher than that of those without the condition (p = 0.038). In addition, the osteoarthritis (OA) grade and bursitis prevalence increased as the patients' age increased, and these increases were statistically significant (p bursitis was observed in one out of every five symptomatic OA patients and was more common in female patients and with advanced age. A positive correlation was found between OA grade and PAB size and area.

Effectiveness of a long-term use of a minimalist footwear versus habitual shoe on pain, function and mechanical loads in knee osteoarthritis: a randomized controlled trial.

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Trombini-Souza, Francis; Fuller, Ricardo; Matias, Alessandra; Yokota, Mariane; Butugan, Marco; Goldenstein-Schainberg, Claudia; Sacco, Isabel C N

2012-07-12

Recent studies have shown an important reduction of joint overload during locomotion in elderly women with knee osteoarthritis (OA) after short-term use of minimalist shoes. Our aim is to investigate the chronic effect of inexpensive and minimalist footwear on the clinical and functional aspects of OA and gait biomechanics of elderly women with knee OA. Fifty-six elderly women with knee OA grade 2 or 3 (Kellgren and Lawrence) are randomized into blocks and allocated to either the intervention group, which will use flexible, non-heeled shoes- Moleca®-for six months for at least six hours daily, or the control group, which could not use these shoes. Neither group is undergoing physical therapy treatment throughout the intervention period. Moleca® is a women's double canvas, flexible, flat walking shoe without heels, with a 5-mm anti-slip rubber sole and a 3-mm internal wedge of ethylene vinyl acetate. Both groups will be followed for six months and will be assessed at baseline condition, after three months, and after six months (end of intervention). All the assessments will be performed by a physiotherapist that is blind to the group allocation. The primary outcome is the pain Western Ontario and McMaster Universities Osteoarthritis (WOMAC) score. The secondary outcomes are global WOMAC score; joint stiffness and disability WOMAC scores; knee pain with a visual analogue scale; walking distance in the six-minute walk test; Lequesne score; amount and frequency (number of days) of paracetamol (500 mg) intake over six months; knee adduction moment during gait; global medical assessment score; and global patient auto-assessment score. At baseline, all patients receive a diary to record the hours of daily use of the footwear intervention; every two weeks, the same physiotherapist makes phone calls to all patients in order to verify adherence to treatment. The statistical analysis will be based on intention-to-treat analysis, as well as general linear models of

Effectiveness of a long-term use of a minimalist footwear versus habitual shoe on pain, function and mechanical loads in knee osteoarthritis: a randomized controlled trial

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Trombini-Souza Francis

2012-07-01

Full Text Available Abstract Background Recent studies have shown an important reduction of joint overload during locomotion in elderly women with knee osteoarthritis (OA after short-term use of minimalist shoes. Our aim is to investigate the chronic effect of inexpensive and minimalist footwear on the clinical and functional aspects of OA and gait biomechanics of elderly women with knee OA. Methods/Design Fifty-six elderly women with knee OA grade 2 or 3 (Kellgren and Lawrence are randomized into blocks and allocated to either the intervention group, which will use flexible, non-heeled shoes— Moleca®—for six months for at least six hours daily, or the control group, which could not use these shoes. Neither group is undergoing physical therapy treatment throughout the intervention period. Moleca® is a women’s double canvas, flexible, flat walking shoe without heels, with a 5-mm anti-slip rubber sole and a 3-mm internal wedge of ethylene vinyl acetate. Both groups will be followed for six months and will be assessed at baseline condition, after three months, and after six months (end of intervention. All the assessments will be performed by a physiotherapist that is blind to the group allocation. The primary outcome is the pain Western Ontario and McMaster Universities Osteoarthritis (WOMAC score. The secondary outcomes are global WOMAC score; joint stiffness and disability WOMAC scores; knee pain with a visual analogue scale; walking distance in the six-minute walk test; Lequesne score; amount and frequency (number of days of paracetamol (500 mg intake over six months; knee adduction moment during gait; global medical assessment score; and global patient auto-assessment score. At baseline, all patients receive a diary to record the hours of daily use of the footwear intervention; every two weeks, the same physiotherapist makes phone calls to all patients in order to verify adherence to treatment. The statistical analysis will be based on intention

Effect of biomagnetic therapy versus physiotherapy for treatment of knee osteoarthritis: a randomized controlled trial.

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Gremion, Gerald; Gaillard, David; Leyvraz, Pierre-Francois; Jolles, Brigitte M

2009-11-01

To assess the effectiveness of pulsed signal therapy in the treatment of knee osteoarthritis (Kellgren II or III). A randomized, double-blind controlled clinical trial. The first 95 patients sent to the clinic with knee osteo-arthritis were selected and randomized into treatment with pulsed signal therapy or conventional physiotherapy. Assessment included recording of usual demographic data, pertinent history, baseline medication and radiographs. Clinical evaluation was made at baseline, 6 weeks and 6 months after the end of treatment by the same blinded doctor. At each follow-up time, the patient was asked to complete a visual analogue pain scale and a Lequesne score. The doctor recorded the degree of pain on motion and the ability to move the affected knee. Both treatments resulted in significant improvements in pain and physical function. A statistical difference was observed only for activities of daily living, where the physiotherapy was more efficient (pphysiotherapy. Like physiotherapy, pulsed signal therapy has improved the clinical state of treated patients but with no significant statistical difference. Pulsed signal therapy is, however, more expensive.

Intra-articular hip injection: does pain relief correlate with radiographic severity of osteoarthritis?

International Nuclear Information System (INIS)

Deshmukh, Ajit J.; Rodriguez, Jose A.; Panagopoulos, Georgia; Alizadeh, Ahmadreza; Klein, Devon A.

2011-01-01

Intra-articular injection is being used widely for both diagnostic and therapeutic purposes in the hip. However, its efficacy is not always predictable in patients with hip osteoarthritis (OA). The purpose of this study was to determine whether the degree of radiographic severity of OA was predictive of the response to intra-articular injection of local anesthetic with corticosteroid and to determine the relationship between immediate pain relief resulting from the anesthetic and delayed pain relief resulting from corticosteroid administration. This retrospective study included 217 patients (220 injections) with diagnosis of hip OA who underwent a fluoroscopically guided therapeutic hip injection of local anesthetic and corticosteroid. Hip radiographs were scored using the Kellgren-Lawrence scale. Immediate and delayed pain relief was documented using a visual analog scale. Logistic regression analysis was performed to investigate whether age, gender or radiographic severity of OA were independent predictors of pain relief. Degree of agreement between immediate and delayed response was assessed with the kappa coefficient. Immediate pain relief was reported in 68.2% of hips and delayed relief in 71.4% of hips. A high level of agreement was observed between immediate and delayed pain relief (kappa = 0.80, p < 0.001). 94% of patients reporting immediate relief also reported relief 2 weeks later. Univariate and multivariate analysis revealed that neither gender nor age was related to immediate or delayed pain relief. Only severity of OA (based on radiographic analysis) was observed to be predictive of pain relief. Pain relief following intra-articular hip injection correlated with radiographic severity of OA. This intervention may be of therapeutic and prognostic value in patients awaiting hip arthroplasty. (orig.)

Synthesis of vibroarthrographic signals in knee osteoarthritis diagnosis training.

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Shieh, Chin-Shiuh; Tseng, Chin-Dar; Chang, Li-Yun; Lin, Wei-Chun; Wu, Li-Fu; Wang, Hung-Yu; Chao, Pei-Ju; Chiu, Chien-Liang; Lee, Tsair-Fwu

2016-07-19

Vibroarthrographic (VAG) signals are used as useful indicators of knee osteoarthritis (OA) status. The objective was to build a template database of knee crepitus sounds. Internships can practice in the template database to shorten the time of training for diagnosis of OA. A knee sound signal was obtained using an innovative stethoscope device with a goniometer. Each knee sound signal was recorded with a Kellgren-Lawrence (KL) grade. The sound signal was segmented according to the goniometer data. The signal was Fourier transformed on the correlated frequency segment. An inverse Fourier transform was performed to obtain the time-domain signal. Haar wavelet transform was then done. The median and mean of the wavelet coefficients were chosen to inverse transform the synthesized signal in each KL category. The quality of the synthesized signal was assessed by a clinician. The sample signals were evaluated using different algorithms (median and mean). The accuracy rate of the median coefficient algorithm (93 %) was better than the mean coefficient algorithm (88 %) for cross-validation by a clinician using synthesis of VAG. The artificial signal we synthesized has the potential to build a learning system for medical students, internships and para-medical personnel for the diagnosis of OA. Therefore, our method provides a feasible way to evaluate crepitus sounds that may assist in the diagnosis of knee OA.

Use of dimensionality reduction for structural mapping of hip joint osteoarthritis data

International Nuclear Information System (INIS)

Theoharatos, C; Fotopoulos, S; Boniatis, I; Panayiotakis, G; Panagiotopoulos, E

2009-01-01

A visualization-based, computer-oriented, classification scheme is proposed for assessing the severity of hip osteoarthritis (OA) using dimensionality reduction techniques. The introduced methodology tries to cope with the confined ability of physicians to structurally organize the entire available set of medical data into semantically similar categories and provide the capability to make visual observations among the ensemble of data using low-dimensional biplots. In this work, 18 pelvic radiographs of patients with verified unilateral hip OA are evaluated by experienced physicians and assessed into Normal, Mild and Severe following the Kellgren and Lawrence scale. Two regions of interest corresponding to radiographic hip joint spaces are determined and representative features are extracted using a typical texture analysis technique. The structural organization of all hip OA data is accomplished using distance and topology preservation-based dimensionality reduction techniques. The resulting map is a low-dimensional biplot that reflects the intrinsic organization of the ensemble of available data and which can be directly accessed by the physician. The conceivable visualization scheme can potentially reveal critical data similarities and help the operator to visually estimate their initial diagnosis. In addition, it can be used to detect putative clustering tendencies, examine the presence of data similarities and indicate the existence of possible false alarms in the initial perceptual evaluation

Quantitative measures of meniscus extrusion predict incident radiographic knee osteoarthritis – data from the Osteoarthritis Initiative

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Emmanuel, K.; Quinn, E.; Niu, J.; Guermazi, A.; Roemer, F.; Wirth, W.; Eckstein, F.; Felson, D.

2017-01-01

SUMMARY Objective To test the hypothesis that quantitative measures of meniscus extrusion predict incident radiographic knee osteoarthritis (KOA), prior to the advent of radiographic disease. Methods 206 knees with incident radiographic KOA (Kellgren Lawrence Grade (KLG) 0 or 1 at baseline, developing KLG 2 or greater with a definite osteophyte and joint space narrowing (JSN) grade ≥1 by year 4) were matched to 232 control knees not developing incident KOA. Manual segmentation of the central five slices of the medial and lateral meniscus was performed on coronal 3T DESS MRI and quantitative meniscus position was determined. Cases and controls were compared using conditional logistic regression adjusting for age, sex, BMI, race and clinical site. Sensitivity analyses of early (year [Y] 1/2) and late (Y3/4) incidence was performed. Results Mean medial extrusion distance was significantly greater for incident compared to non-incident knees (1.56 mean ± 1.12 mm SD vs 1.29 ± 0.99 mm; +21%, P meniscus (25.8 ± 15.8% vs 22.0 ± 13.5%; +17%, P meniscus in incident medial KOA, or for the tibial plateau coverage between incident and non-incident knees. Restricting the analysis to medial incident KOA at Y1/2 differences were attenuated, but reached significance for extrusion distance, whereas no significant differences were observed at incident KOA in Y3/4. Conclusion Greater medial meniscus extrusion predicts incident radiographic KOA. Early onset KOA showed greater differences for meniscus position between incident and non-incident knees than late onset KOA. PMID:26318658

Effect of a natural extract of chicken combs with a high content of hyaluronic acid (Hyal-Joint® on pain relief and quality of life in subjects with knee osteoarthritis: a pilot randomized double-blind placebo-controlled trial

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Schwartz Howard

2008-01-01

Full Text Available Abstract Background Intra-articular hyaluronic acid represents a substantive addition to the therapeutic armamentarium in knee osteoarthritis. We examined the effect of dietary supplementation with a natural extract of chicken combs with a high content of hyaluronic acid (60% (Hyal-Joint® (active test product, AP on pain and quality of life in subjects with osteoarthritis of the knee. Methods Twenty subjects aged ≥40 years with knee osteoarthritis (pain for at least 15 days in the previous month, symptoms present for ≥6 months, Kellgren/Lawrence score ≥2 participated in a randomized double-blind controlled trial. Ten subjects received AP (80 mg/day and 10 placebo for 8 weeks. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC and quality of life by the Short Form-36 (SF-36v2 were administered at baseline and after 4 and 8 weeks of treatment. Results WOMAC pain (primary efficacy variable was similar in both study groups (mean [SD] with 6.6 (4.0 points in the AP group and 6.4 (2.7 in the placebo group (P = 0.943. As compared with baseline, subjects in both groups showed statistically significant improvements in WOMAC pain, stiffness, physical function subscales, and in the aggregate score, but the magnitude of changes was higher in the AP group for WOMAC physical function (-13.1 [12.0] vs. -10.1 [8.6], P = 0.575 and total symptoms (-18.6 [16.8] vs. -15.8 [11.4], P = 0.694. At 4 weeks, statistically significant mean changes compared with baseline were observed in the SF-36v2 scales of role-physical, bodily pain, social functioning and role-emotional among subjects in the AP group, and in physical functioning, bodily pain, and social functioning in the placebo group. At 8 weeks, changes were significant for role-physical, bodily pain, and physical component summary in the AP group, and for physical functioning and role-emotional in the placebo arm. Changes in bodily pain and social functioning were of greater magnitude

Poor WOMAC scores in contralateral knee negatively impact TKA outcomes: data from the osteoarthritis initiative.

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Kahn, Timothy L; Soheili, Aydin C; Schwarzkopf, Ran

2014-08-01

While total knee arthroplasty (TKA) has been shown to have excellent outcomes, a significant proportion of patients experience relatively poor post-operative function. In this study, we test the hypothesis that the level of osteoarthritic symptoms in the contralateral knee at the time of TKA is associated with poorer post-operative outcomes in the operated knee. Using longitudinal cohort data from the Osteoarthritis Initiative (OAI), we included 171 patients who received a unilateral TKA. We compared pre-operative Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores in the contralateral knee to post-operative WOMAC scores in the index knee. Pre-operative contralateral knee WOMAC scores were associated with post-operative index knee WOMAC Total scores, indicating that the health of the pre-operative contralateral knee is a significant factor in TKA outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

[The prevalence of radiological osteoarthritis in relation to age, gender, birth-year cohort, and ethnic origins].

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Spahn, G; Schiele, R; Hofmann, G O; Schiltenwolf, M; Grifka, J; Vaitl, T; Schneider, S; Liebers, F; Klinger, H M

2011-04-01

This metaanalysis was performed to evaluate the prevalence of the radiological assessed knee osteoarthritis in the whole community. Medical databases (Medline, EMBASE, Cochrane) were searched for the strategy: ["Osteoarthritis" and "Knee" and "Prevalence"]. The deadline for the search was 31.12.2009. Two investigators (first and senior author) independently made the selection from 17 studies (from a total of 1428) according to the inclusion criteria: a cross-sectional study of the whole community, radiological investigation and definition of knee ROA by an established radiological score. Only studies in English or German language were evaluated. Effect sizes (event rate, odds ratio [OR] and confidence interval [CI]) were calculated by the software "Comprehensive Metaanalysis V2". Study heterogeneity (I2) was determined accordingly to Higgins. The kappa index for interobserver validity was k = 0.948. All studies judged the grade of osteoarthritis according to the Kellgren-Lawrence (KL) score. For calculation of knee ROA KL grades 2+ were estimated only. The total prevalence of knee ROA was 24.3 % (CI 23.4-25.2 %). The whole prevalence in male patients was 24.3 % (CI 23.4-25.2 %); I2 = 59.4 (p = 0.002) and in female patients 32.6 % (CI 31.8-33.4 %); I2 = 49,1 (p < 0.001). Younger male patients (age 50-) had a prevalence of 5.6 (CI 4.5-6.8). In older patients (80+) the male prevalence was 44.5 % (CI 39.6-49.5 %). In this age group female patients had a prevalence of 71.6 % (CI 67.6-75.3 %). The higher prevalence of knee ROA in female patients was significant (OR = 1.8 [1.7-1.9]; I2 = 46.0 [p < 0.001]). The prevalence of knee ROA was higher in male Asians compared with male Caucasians (OR = 1.1, CI 0.9-1.2; p = 0.080) in tendency. This difference was significant in female patients (OR = 2.2; CI 2.0-2.4; p < 0.001). Furthermore another trend was evaluated. Female patients (70-79 years) from the birth-year cohort 1920- had a prevalence of 37.8 % (CI 35.9-39.7)%. In

Compliance With the AAOS Guidelines for Treatment of Osteoarthritis of the Knee: A Survey of the American Association of Hip and Knee Surgeons.

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Carlson, Victor Rex; Ong, Alvin Chua; Orozco, Fabio Ramiro; Hernandez, Victor Hugo; Lutz, Rex William; Post, Zachary Douglas

2018-02-01

The American Academy of Orthopaedic Surgeons (AAOS) published a series of evidence-based guidelines for treatment of knee osteoarthritis (OA). We studied compliance with these guidelines among orthopaedic surgeons. We sent a survey to members of the American Association of Hip and Knee Surgeons. It included five clinical vignettes based on the Kellgren-Lawrence radiographic system for classification of knee OA. Respondents selected treatment currently supported or not supported by the AAOS guidelines. Of 345 responses, the frequency of use of recommended interventions was 80%, 82%, 21%, 50%, and 98% for OA at stages 0 through 4, respectively. For stage 2 and stage 3 OA, intra-articular hyaluronic acid was the most commonly selected intervention not recommended by the AAOS. Apparently, AAOS guidelines on the treatment of OA have not reached the orthopaedic community, resulting in lack of treatment consensus and continued use of modalities with no proven patient benefits. Management of moderate to severe knee OA does not align with AAOS guidelines. We encourage researchers to conduct clinical trials to identify the role of intra-articular corticosteroids in treating this condition.

Conservatively treated knee injury is associated with knee cartilage matrix degeneration measured with MRI-based T2 relaxation times. Data from the osteoarthritis initiative

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Hofmann, Felix C. [University of California San Francisco, Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Technical University of Munich, Department of Radiology, Munich (Germany); Neumann, Jan; Heilmeier, Ursula; Joseph, Gabby B.; Link, Thomas M. [University of California San Francisco, Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Nevitt, Michael C.; McCulloch, Charles E. [University of California San Francisco, Department of Epidemiology and Biostatistics, San Francisco, CA (United States)

2018-01-15

To investigate the association of cartilage degeneration with previous knee injuries not undergoing surgery, determined by morphologic and quantitative 3-T magnetic resonance imaging (MRI). We performed a nested cross-sectional study of right knee MRIs from participants in the Osteoarthritis Initiative (OAI) aged 45-79 with baseline Kellgren-Lawrence score of 0-2. Cases were 142 right knees of patients with self-reported history of injury limiting the ability to walk for at least 2 days. Controls were 426 right knees without history of injury, frequency-matched to cases on age, BMI, gender, KL scores and race (1:3 ratio). Cases and controls were compared using covariate-adjusted linear regression analysis, with the outcomes of region-specific T2 mean, laminar analysis and heterogeneity measured by texture analysis to investigate early cartilage matrix abnormalities and the Whole-Organ Magnetic Resonance Imaging Score (WORMS) to investigate morphologic knee lesions. Compared to control subjects, we found significantly higher mean T2 values in the injury [lateral tibia (28.10 ms vs. 29.11 ms, p = 0.001), medial tibia (29.70 ms vs. 30.40 ms, p = 0.014) and global knee cartilage (32.73 ms vs. 33.29 ms, p = 0.005)]. Injury subjects also had more heterogeneous cartilage as measured by GLCM texture contrast, variance and entropy (p < 0.05 in 14 out of 18 texture parameters). WORMS gradings were not significantly different between the two groups (p > 0.05). A history of knee injury not treated surgically is associated with higher and more heterogeneous T2 values, but not with morphologic knee abnormalities. Our findings suggest that significant, conservatively treated knee injuries are associated with permanent cartilage matrix abnormalities. (orig.)

Conservatively treated knee injury is associated with knee cartilage matrix degeneration measured with MRI-based T2 relaxation times. Data from the osteoarthritis initiative

International Nuclear Information System (INIS)

Hofmann, Felix C.; Neumann, Jan; Heilmeier, Ursula; Joseph, Gabby B.; Link, Thomas M.; Nevitt, Michael C.; McCulloch, Charles E.

2018-01-01

To investigate the association of cartilage degeneration with previous knee injuries not undergoing surgery, determined by morphologic and quantitative 3-T magnetic resonance imaging (MRI). We performed a nested cross-sectional study of right knee MRIs from participants in the Osteoarthritis Initiative (OAI) aged 45-79 with baseline Kellgren-Lawrence score of 0-2. Cases were 142 right knees of patients with self-reported history of injury limiting the ability to walk for at least 2 days. Controls were 426 right knees without history of injury, frequency-matched to cases on age, BMI, gender, KL scores and race (1:3 ratio). Cases and controls were compared using covariate-adjusted linear regression analysis, with the outcomes of region-specific T2 mean, laminar analysis and heterogeneity measured by texture analysis to investigate early cartilage matrix abnormalities and the Whole-Organ Magnetic Resonance Imaging Score (WORMS) to investigate morphologic knee lesions. Compared to control subjects, we found significantly higher mean T2 values in the injury [lateral tibia (28.10 ms vs. 29.11 ms, p = 0.001), medial tibia (29.70 ms vs. 30.40 ms, p = 0.014) and global knee cartilage (32.73 ms vs. 33.29 ms, p = 0.005)]. Injury subjects also had more heterogeneous cartilage as measured by GLCM texture contrast, variance and entropy (p < 0.05 in 14 out of 18 texture parameters). WORMS gradings were not significantly different between the two groups (p > 0.05). A history of knee injury not treated surgically is associated with higher and more heterogeneous T2 values, but not with morphologic knee abnormalities. Our findings suggest that significant, conservatively treated knee injuries are associated with permanent cartilage matrix abnormalities. (orig.)

Serum adipokines, adipose tissue measurements and metabolic parameters in patients with advanced radiographic knee osteoarthritis.

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Toussirot, Eric; Michel, Fabrice; Béreau, Matthieu; Dehecq, Barbara; Gaugler, Béatrice; Wendling, Daniel; Grandclément, Emilie; Saas, Philippe; Dumoulin, Gilles

2017-11-01

We conducted the present study to evaluate the serum levels of adipokines (leptin, total and high molecular adiponectin, resistin), a marker of cartilage breakdown (C2C), and ghrelin together with body composition in patients with knee osteoarthritis (OA). Fifty patients and 50 sex-matched healthy subjects (HS) were evaluated. Knee OA was scored according to the Kellgren-Lawrence (KL) grade. Body composition parameters including lean mass and measurements of fat mass (total fat, adiposity, fat in the android and gynoid regions, visceral fat and trunk/legs fat ratio) were obtained using dual energy X-ray absorptiometry. Most of the recruited patients (88%) had advanced knee OA with KL grade 3 or 4. The patients had higher body mass index than HS (p < 0.0001). Serum leptin, high molecular adiponectin, resistin and ghrelin levels did not differ between patients and HS. Total adiponectin was higher in women with OA compared to women from the HS group (p = 0.004). Total fat mass, adiposity and measurements of central adiposity (fat in the android region, trunk/lower limbs fat ratio and visceral fat) were increased in patients with knee OA (all p < 0.05). Total adiponectin was borderline associated with the severity of OA. Our results show that total adiponectin is significantly increased in women with advanced knee OA. Independently of gender, patients with severe knee OA were characterized by a significant excess of fat with a distribution toward the visceral region. This abnormal body composition may contribute to the cardiometabolic profile that is described in patients with knee OA.

Appendicular bone mass and knee and hand osteoarthritis in Japanese women: a cross-sectional study

Directory of Open Access Journals (Sweden)

Moji Kazuhiko

2002-10-01

Full Text Available Abstract Background It has been reported that there is an inverse association between osteoarthritis (OA and osteoporosis. However, the relationship of bone mass to OA in a Japanese population whose rates of OA are different from Caucasians remains uncertain. Methods We studied the association of appendicular bone mineral density (second metacarpal; mBMD and quantitative bone ultrasound (calcaneus; stiffness index with knee and hand OA among 567 Japanese community-dwelling women. Knee and hand radiographs were scored for OA using Kellgren-Lawrence (K/L scales. In addition, we evaluated the presence of osteophytes and of joint space narrowing. The hand joints were examined at the distal and proximal interphalangeal (DIP, PIP and first metacarpophalangeal/carpometacarpal (MCP/CMC joints. Results After adjusting for age and body mass index (BMI, stiffness index was significantly higher in women with K/L scale, grade 3 at CMC/MCP joint compared with those with no OA. Adjusted means of stiffness index and mBMD were significantly higher in women with definite osteophytes at the CMC/MCP joint compared to those without osteophytes, whereas there were no significant differences for knee, DIP and PIP joints. Stiffness index, but not mBMD, was higher in women with definite joint space narrowing at the CMC/MCP joint compared with those with no joint space narrowing. Conclusions Appendicular bone mass was increased with OA at the CMC/MCP joint, especially among women with osteophytes. Our findings suggest that the association of peripheral bone mass with OA for knee, DIP or PIP may be less clearcut in Japanese women than in other populations.

Adiponectin and Leptin Synovial Fluid Concentration as a Marker for the Severity of Knee Osteoarthritis in Obese Patients

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Eddy Mart Salim

2015-12-01

Full Text Available Purpose: Osteoarthritis (OA is a chronic degenerative joint disorder of the synovial joint characterized by loss of articular cartilage, osteophyte formation, and alterations of subchondral bone. An increase of weight bearing affect on knee joint biomechanically and alter concentration of adipokines, such as adiponectin and leptin. Herein we reported a correlation between adiponectin and leptin synovial fluid concentration with the severity of knee OA in obese patients. Material and Methods: Totally 45 patients were included in this research. ELISA was used to determine adiponectin and leptin concentrations of synovial fluid. The severity of knee OA was classified by Kellgren-Lawrence grading scale. Data analysis was conducted using SPSS for windows. Results: Based on the leptin measurement, it was shown that leptin concentrations were correlated positively with the severity of knee OA. Vice versa, adiponectin concentrations were correlated negative. Conclusion: Our study was support the biomarker function of adiponectin and leptin concentration on synovial fluids, in which those concentrations were related with the severity of OA. Those results also suggested the function of leptin and adiponectin on OA. [Cukurova Med J 2015; 40(4.000: 746-756

Clinical efficacy and safety of glucosamine, chondroitin sulphate, their combination, celecoxib or placebo taken to treat osteoarthritis of the knee: 2-year results from GAIT.

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Sawitzke, Allen D; Shi, Helen; Finco, Martha F; Dunlop, Dorothy D; Harris, Crystal L; Singer, Nora G; Bradley, John D; Silver, David; Jackson, Christopher G; Lane, Nancy E; Oddis, Chester V; Wolfe, Fred; Lisse, Jeffrey; Furst, Daniel E; Bingham, Clifton O; Reda, Domenic J; Moskowitz, Roland W; Williams, H James; Clegg, Daniel O

2010-08-01

Knee osteoarthritis (OA) is a major cause of pain and functional limitation in older adults, yet longer-term studies of medical treatment of OA are limited. To evaluate the efficacy and safety of glucosamine and chondroitin sulphate (CS), alone or in combination, as well as celecoxib and placebo on painful knee OA over 2 years. A 24-month, double-blind, placebo-controlled study, conducted at nine sites in the US ancillary to the Glucosamine/chondroitin Arthritis Intervention Trial, enrolled 662 patients with knee OA who satisfied radiographic criteria (Kellgren/Lawrence grade 2 or 3 changes and baseline joint space width of at least 2 mm). This subset continued to receive their randomised treatment: glucosamine 500 mg three times daily, CS 400 mg three times daily, the combination of glucosamine and CS, celecoxib 200 mg daily, or placebo over 24 months. The primary outcome was a 20% reduction in Western Ontario and McMaster University Osteoarthritis Index (WOMAC) pain over 24 months. Secondary outcomes included an Outcome Measures in Rheumatology/Osteoarthritis Research Society International response and change from baseline in WOMAC pain and function. Compared with placebo, the odds of achieving a 20% reduction in WOMAC pain were celecoxib: 1.21, glucosamine: 1.16, combination glucosamine/CS: 0.83 and CS alone: 0.69, and were not statistically significant. Over 2 years, no treatment achieved a clinically important difference in WOMAC pain or function as compared with placebo. However, glucosamine and celecoxib showed beneficial but not significant trends. Adverse reactions were similar among treatment groups and serious adverse events were rare for all treatments.

The longitudinal reliability and responsiveness of the OMERACT Hand Osteoarthritis Magnetic Resonance Imaging Scoring System (HOAMRIS)

DEFF Research Database (Denmark)

Haugen, Ida K.; Eshed, Iris; Gandjbakhch, Frederique

2015-01-01

Objective. To evaluate the interreader reliability of change scores and the responsiveness of the OMERACT Hand Osteoarthritis (OA) Magnetic Resonance Image (MRI) Scoring System (HOAMRIS). Methods. Paired MRI (baseline and 5-yr followup) from 20 patients with hand OA were scored with known time se...

Ultrasonographic assessment of pes anserinus tendon and pes anserinus tendinitis bursitis syndrome in patients with knee osteoarthritis.

Science.gov (United States)

Toktas, Hasan; Dundar, Umit; Adar, Sevda; Solak, Ozlem; Ulasli, Alper Murat

2015-01-01

The aim of this study was to assess the ultrasonographic (US) findings of pes anserinus tendon and bursa in patients with knee osteoarthritis (OA) with or without clinical pes anserinus tendinitis bursitis syndrome (PATBS). A total of 157 female patients with the diagnosis of knee OA on both knees (314 knees), and 30 age, and body mass index- matched healthy female controls without knee pain (60 knees), were included in the study. PATBS was clinically diagnosed. US evaluation parameters were the measurement of the thickness of pes anserinus tendon insertion region (PA) and examination of the morphologic intratendinous PA tissue characteristics and pes anserinus bursitis (PAB). Radiographic knee osteoarthritis graded I-IV according to Kellgren and Lawrence (KL) for each knee was recorded. Pain and functional status were assessed by the Visual Analog Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). There were 183 PATBS (58.3%) clinical diagnoses among the 314 knees with OA. The mean thickness of PA in the patients with knee OA graded 1,2,3,4 with/without PATBS was significantly greater than the controls (p = 0.001). The mean thickness of PA in knees with OA KL graded 3 and 4 with/without PATBS, was greater than knees with OA KL graded 1 and 2 with/without PATBS (p < 0,05) (except knee OA KL graded 2 with PATBS versus knee OA KL graded 4 without PATBS).The knee OA KL graded 1,2,3,4 with PATBS had significantly more PAB and less loss of normal fibrillar echotexture of PA compared to controls and knees with OA KL graded 1,2,3,4 without PATBS (p < 0.05). The VAS scores of knees with OA KL graded 3, 4 with PATBS were significantly greater than those of knees with OA KL graded 3,4 without PATBS (p < 0.05). PA thickness was significantly associated with the KL grade (r: 0.336, p:0.001) and PATBS (r: 0.371, p < 0.001). It is concluded that the mean thickness of PA in knees with OA with/without PATBS was significantly greater than the

Cross-cultural adaptation and validation of the French version of the Knee injury and Osteoarthritis Outcome Score (KOOS) in knee osteoarthritis patients

DEFF Research Database (Denmark)

Ornetti, P; Parratte, S; Gossec, L

2008-01-01

OBJECTIVE: To adapt the Knee injury and Osteoarthritis Outcome Score (KOOS) into French and to evaluate the psychometric properties of this new version. METHODS: The French version of the KOOS was developed according to cross-cultural guidelines by using the "translation-back translation" method...... to ensure content validity. KOOS data were then obtained in patients with symptomatic knee osteoarthritis (OA). The translated questionnaire was evaluated in two knee OA population groups, one with no indication for joint replacement (medicine), and the other waiting for joint replacement (surgery......). The psychometric properties evaluated were feasibility: percentage of responses, floor and ceiling effects; construct validity: internal consistency using Cronbach's alpha, correlations with osteoarthritis knee and hip quality of life domains using Spearman's rank test, and known group comparison between medicine...

Cross-cultural adaptation and validation of the French version of the Hip disability and Osteoarthritis Outcome Score (HOOS) in hip osteoarthritis patients

DEFF Research Database (Denmark)

Ornetti, P; Parratte, S; Gossec, L

2010-01-01

osteoarthritis (OA). METHODS: The French version of the HOOS was developed according to published international guidelines to ensure content validity. The new version was then evaluated in two symptomatic hip OA populations, one with no indication for joint replacement (medical group), and the other waiting......OBJECTIVE: To translate and adapt the Hip disability and Osteoarthritis Outcome Score (HOOS) into French and to evaluate the psychometric properties of this new version, by testing feasibility, internal consistency, construct validity, reliability and responsiveness, in patients with hip...

Knee Viscosupplementation: Cost-Effectiveness Analysis between Stabilized Hyaluronic Acid in a Single Injection versus Five Injections of Standard Hyaluronic Acid.

Science.gov (United States)

Estades-Rubio, Francisco J; Reyes-Martín, Alvaro; Morales-Marcos, Victor; García-Piriz, Mercedes; García-Vera, Juan J; Perán, Macarena; Marchal, Juan A; Montañez-Heredia, Elvira

2017-03-17

Given the wide difference in price per vial between various presentations of hyaluronic acid, this study seeks to compare the effectiveness and treatment cost of stabilized hyaluronic acid (NASHA) in a single injection with standard preparations of hyaluronic acid (HA) in five injections in osteoarthritis (OA) of the knee. Fifty-four patients with knee osteoarthritis (Kellgren-Lawrence Grade II and III) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain score greater than 7, with a homogeneous distribution of age, sex, BMI, and duration of disease, were included in this study. Patients were randomized into two groups: Group I was treated with NASHA (Durolane ® ) and Group II with HA (Go-ON ® ). Patient's evolution was followed up at the 1st, 2nd, 4th, 8th, 12th, and 26th week after treatment. A statistically significant improvement in WOMAC score was observed for patients treated with NASHA versus those who received HA at Week 26. In addition, the need for analgesia was significantly reduced at Week 26 in the NASHA-treated group. Finally, the economic analysis showed an increased cost of overall treatment with HA injections. Our data support the use of the NASHA class of products in the treatment of knee OA.

The development of a preliminary ultrasonographic scoring system for features of hand osteoarthritis.

LENUS (Irish Health Repository)

Keen, H I

2008-05-01

Painful osteoarthritis (OA) of the hand is common and a validated ultrasound (US) scoring system would be valuable for epidemiological and therapeutic outcome studies. US is increasingly used to assess peripheral joints, though most of the US focus in rheumatic diseases has been on rheumatoid arthritis. We aimed to develop a preliminary US hand OA scoring system, initially focusing on relevant pathological features with potentially high reliability.

Bone bruise in magnetic resonance imaging strongly correlates with the production of joint effusion and with knee osteoarthritis

International Nuclear Information System (INIS)

Oda, Hiromi; Igarashi, Mitsuo; Sase, Hiroshi; Sase, Takeshi; Yamamoto, Seizo

2008-01-01

The findings of magnetic resonance imaging (MRI) have not been studied systematically in patients with osteoarthritis (OA). The objective here was to compare MRI findings with radiological findings in patients with knee pain and to identify factors that influence the progression of OA of the knee. Of 212 patients with knee pain and MRI of the knee joint, 161 patients were selected for the study after exclusion of cases of trauma and other arthritides. MRI was used to evaluate the presence and degree of bone bruise, hydrarthrosis, and injuries to the cruciate ligament and meniscus. Bone bruise was classified into four types, and hydrarthrosis into four grades. Radiologically, OA progression in the femorotibial and patellofemoral joints was analyzed according to the Kellgren-Lawrence classification. Age was divided into four groups based on distribution quartiles. Logistic regression analysis and a generalized linear model with Poisson regression were used to analyze correlations among these factors. Bone bruise was present in 87 cases, hydrarthrosis in 100, cruciate ligament injury in 20, and meniscus injury in 98. The presence of bone bruise was not related to age, cruciate ligament injury, meniscus injury, nor to OA of the patellofemoral joint, but was related to hydrarthrosis and to OA of the femorotibial joint. Femorotibial OA was much more strongly associated with bone bruise than with hydrarthrosis. Furthermore, analyzing the relation between the types of bone bruise and the degree of hydrarthrosis using a generalized linear model with Poisson regression, there was a positive correlation between the grade of bone bruise and the amount of hydrarthrosis. A factor associated with the degree of osteoarthritis of the knee is bone bruise observed on MRI. The degree of hydrarthrosis is related to the grade of bone bruise, but is not linked to the degree of osteoarthritis. (author)

Longitudinal in vivo reproducibility of cartilage volume and surface in osteoarthritis of the knee

Energy Technology Data Exchange (ETDEWEB)

Brem, M.H. [Harvard Medical School, Brigham and Women' s Hospital, Musculoskeletal Division, Department of Radiology, ASB-1, L-1, Room 003E, Boston, MA (United States); University of Erlangen-Nuremberg, Division of Trauma Surgery and Orthopaedic Surgery, Department of Surgery, Erlangen (Germany); Pauser, J.; Yoshioka, H.; Stratmann, J.; Kikinis, R.; Duryea, J.; Lang, P. [Harvard Medical School, Brigham and Women' s Hospital, Musculoskeletal Division, Department of Radiology, ASB-1, L-1, Room 003E, Boston, MA (United States); Brenning, A. [University of Erlangen-Nuremberg, Department of Medical Informatics, Biometry and Epidemiology, Erlangen (Germany); Hennig, F.F. [University of Erlangen-Nuremberg, Division of Trauma Surgery and Orthopaedic Surgery, Department of Surgery, Erlangen (Germany); Winalski, C.S. [Harvard Medical School, Brigham and Women' s Hospital, Musculoskeletal Division, Department of Radiology, ASB-1, L-1, Room 003E, Boston, MA (United States); Cleveland Clinic Foundation, Division of Radiology, Cleveland, OH (United States)

2007-04-15

The aim of this study was to evaluate the longitudinal reproducibility of cartilage volume and surface area measurements in moderate osteoarthritis (OA) of the knee. We analysed 5 MRI (GE 1.5T, sagittal 3D SPGR) data sets of patients with osteoarthritis (OA) of the knee (Kellgren Lawrence grade I-II). Two scans were performed: one baseline scan and one follow-up scan 3 months later (96 {+-} 10 days). For segmentation, 3D Slicer 2.5 software was used. Two segmentations were performed by two readers independently who were blinded to the scan dates. Tibial and femoral cartilage volume and surface were determined. Longitudinal and cross-sectional precision errors were calculated using the standard deviation (SD) and coefficient of variation (CV%=100 x [SD/mean]) from the repeated measurements in each patient. The in vivo reproducibility was then calculated as the root mean square of these individual reproducibility errors. The cross-sectional root mean squared coefficient of variation (RMSE-CV) was 1.2, 2.2 and 2.4% for surface area measurements (femur, medial and lateral tibia respectively) and 1.4, 1.8 and 1.3% for the corresponding cartilage volumes. Longitudinal RMSE-CV was 3.3, 3.1 and 3.7% for the surface area measurements (femur, medial and lateral tibia respectively) and 2.3, 3.3 and 2.4% for femur, medial and lateral tibia cartilage volumes. The longitudinal in vivo reproducibility of cartilage surface and volume measurements in the knee using this segmentation method is excellent. To the best of our knowledge we measured, for the first time, the longitudinal reproducibility of cartilage volume and surface area in participants with mild to moderate OA. (orig.)

[Multiple linear regression analysis of X-ray measurement and WOMAC scores of knee osteoarthritis].

Science.gov (United States)

Ma, Yu-Feng; Wang, Qing-Fu; Chen, Zhao-Jun; Du, Chun-Lin; Li, Jun-Hai; Huang, Hu; Shi, Zong-Ting; Yin, Yue-Shan; Zhang, Lei; A-Di, Li-Jiang; Dong, Shi-Yu; Wu, Ji

2012-05-01

To perform Multiple Linear Regression analysis of X-ray measurement and WOMAC scores of knee osteoarthritis, and to analyze their relationship with clinical and biomechanical concepts. From March 2011 to July 2011, 140 patients (250 knees) were reviewed, including 132 knees in the left and 118 knees in the right; ranging in age from 40 to 71 years, with an average of 54.68 years. The MB-RULER measurement software was applied to measure femoral angle, tibial angle, femorotibial angle, joint gap angle from antero-posterir and lateral position of X-rays. The WOMAC scores were also collected. Then multiple regression equations was applied for the linear regression analysis of correlation between the X-ray measurement and WOMAC scores. There was statistical significance in the regression equation of AP X-rays value and WOMAC scores (Pregression equation of lateral X-ray value and WOMAC scores (P>0.05). 1) X-ray measurement of knee joint can reflect the WOMAC scores to a certain extent. 2) It is necessary to measure the X-ray mechanical axis of knee, which is important for diagnosis and treatment of osteoarthritis. 3) The correlation between tibial angle,joint gap angle on antero-posterior X-ray and WOMAC scores is significant, which can be used to assess the functional recovery of patients before and after treatment.

Correlation of serum cartilage oligomeric matrix protein (COMP) and interleukin-16 (IL-16) levels with disease severity in primary knee osteoarthritis: A pilot study in a Malaysian population.

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Das Gupta, Esha; Ng, Wei Ren; Wong, Shew Fung; Bhurhanudeen, Abdul Kareem; Yeap, Swan Sim

2017-01-01

The aim of this study was to investigate the correlations between serum cartilage oligomeric matrix protein (COMP), interleukin-16 (IL-16) and different grades of knee osteoarthritis (KOA) in Malaysian subjects. Ninety subjects were recruited comprising 30 with Kellgren-Lawrence (K-L) grade 2 KOA, 27 with K-L grade 3 KOA, 7 with grade 4 KOA, and 30 healthy controls. All subjects completed the Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire. Serum COMP and IL-16 levels were measured using ELISA and their values log transformed to ensure a normal distribution. There was no significant differences in levels of log serum COMP and IL-16 between healthy controls and KOA patients. There were no significant differences in the log serum COMP and IL-16 levels within the different K-L grades in the KOA patients. In KOA patients, log serum IL-16 levels significantly correlated with the WOMAC score (p = 0.001) and its subscales, pain (p = 0.005), stiffness (p = 0.019) and physical function (p<0.0001). Serum IL-16 levels were significantly higher in Malaysian Indians compared to Malays and Chinese (p = 0.024). In this multi-ethnic Malaysian population, there was no difference in serum COMP and IL-16 levels between healthy controls and patients with KOA, nor was there any difference in serum COMP or IL-16 levels across the various K-L grades of KOA. However, there were significant inter-racial differences in serum IL-16 levels.

Knee Injury and Osteoarthritis Outcome Score (KOOS)--development of a self-administered outcome measure

DEFF Research Database (Denmark)

Roos, Ewa M.; Roos, H P; Lohmander, L S

1998-01-01

There is broad consensus that good outcome measures are needed to distinguish interventions that are effective from those that are not. This task requires standardized, patient-centered measures that can be administered at a low cost. We developed a questionnaire to assess short- and long......-term patient-relevant outcomes following knee injury, based on the WOMAC Osteoarthritis Index, a literature review, an expert panel, and a pilot study. The Knee injury and Osteoarthritis Outcome Score (KOOS) is self-administered and assesses five outcomes: pain, symptoms, activities of daily living, sport...

Muscle strength, physical performance and physical activity as predictors of future knee replacement

DEFF Research Database (Denmark)

Skou, Søren T; Wise, Barton L; Lewis, Cora E

2016-01-01

Activity Scale for the Elderly score with incident KR between baseline and the 84-month follow-up. RESULTS: 1,252 (99.6%) participants (1,682 knees) completed the follow-up visits. 331 participants (394 knees) underwent a KR during the 84 months (229 women and 102 men). The crude analysis demonstrated......OBJECTIVE: To investigate associations between lower levels of muscle strength, physical performance and physical activity and the risk of knee replacement (KR) in older adults with frequent knee pain. METHOD: Participants from the Multicenter Osteoarthritis Study (MOST) with knee pain on most......% CI) 0.99 (0.99 to 1.00)), but not when adjusting for Kellgren-Lawrence grade (p = 0.97). CONCLUSION: Lower levels of chair stand performance and self-reported physical activity are not associated with an increased risk of KR within 7 years, while the independent effect of knee extensor strength...

Association of physical examination knee effusion with bone marrow lesions: cross-sectional and longitudinal analyses of a population-based cohort.

Science.gov (United States)

Cibere, Jolanda; Guermazi, Ali; Nicolaou, Savvas; Esdaile, John M; Thorne, Anona; Singer, Joel; Wong, Hubert; Kopec, Jacek A; Sayre, Eric C

2018-04-12

To determine the association of physical examination (PE) effusion with prevalence of bone marrow lesions (BML) on MRI, and incidence/progression of BML over 3 years in knee osteoarthritis (OA). A population-based cohort with knee pain (N=255) was assessed for PE effusion. On MRI, BML was graded 0-3 (none, mild, moderate, severe), incidence/progression defined as a worsening in the sum of BML scores over six surfaces by ≥1 grade. We analyzed the full cohort and mild disease subsample with Kellgren-Lawrence (KL) grade value (PPV) and negative predictive value (NPV) for PE effusion vs. BML (prevalence and incidence/progression). Weighted mean age was 56.7 years, mean BMI 26.5, 56.3% were female, 20.1% had PE effusion and 80.7% had KLrecruitment into clinical trials. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Clinical Outcomes of Knee Osteoarthritis Treated With an Autologous Protein Solution Injection: A 1-Year Pilot Double-Blinded Randomized Controlled Trial.

Science.gov (United States)

Kon, Elizaveta; Engebretsen, Lars; Verdonk, Peter; Nehrer, Stefan; Filardo, Giuseppe

2018-01-01

Osteoarthritis (OA) is a debilitating disease resulting in substantial pain and functional limitations. A novel blood derivative has been developed to concentrate both growth factors and antagonists of inflammatory cytokines, with promising preliminary findings in terms of safety profile and clinical improvement. To investigate if one intra-articular injection of autologous protein solution (APS) can reduce pain and improve function in patients affected by knee OA in a multicenter, randomized, double-blind, saline-controlled study. Randomized controlled trial; Level of evidence, 2. Forty-six patients with unilateral knee OA (Kellgren-Lawrence 2 or 3) were randomized into the APS group (n = 31), which received a single ultrasound-guided injection of APS, and the saline (control) group (n = 15), which received a single saline injection. Patient-reported outcomes and adverse events were collected at 2 weeks and at 1, 3, 6, and 12 months through visual analog scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Knee injury and Osteoarthritis Outcome Score (KOOS), Short Form-36 (SF-36), Clinical Global Impression of Severity/Change (CGI-S/C), Patient Global Impression of Severity/Change (PGI-S/C), and Outcome Measures in Rheumatology-Osteoarthritis Research Society International (OMERACT-OARSI) responder rate. Imaging evaluation was also performed with radiograph and magnetic resonance imaging (MRI) before and after treatment (12 months and 3 and 12 months, respectively). The safety profile was positive, with no significant differences in frequency and severity of adverse events between groups. The improvement from baseline to 2 weeks and to 1, 3, and 6 months was similar between treatments. At 12 months, improvement in WOMAC pain score was 65% in the APS group and 41% in the saline group ( P = .02). There were no significant differences in VAS pain improvement between groups. At 12 months, APS group showed improved SF-36 Bodily Pain

Evidence that meniscus damage may be a component of osteoarthritis: the Framingham study.

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Englund, M; Haugen, I K; Guermazi, A; Roemer, F W; Niu, J; Neogi, T; Aliabadi, P; Felson, D T

2016-02-01

The etiology of degenerative meniscus tear is unclear but could be related to a generalized osteoarthritic disease process. We studied whether radiographic hand osteoarthritis (OA) is associated with meniscus damage. We examined 974 persons aged 50-90 years drawn via census tract data and random-digit dialing from Framingham, Massachusetts, United States. One reader assessed bilateral hand radiographs (30 joints) and another read frontal knee radiographs, all according to the Kellgren-Lawrence (KL) scale. A third reader assessed right knee 1.5-T magnetic resonance imaging (MRI) scans for meniscus damage. We calculated the prevalence of medial and/or lateral meniscus damage in those with one to two and three or more finger joints with radiographic OA (KL grade ≥2) compared to those without radiographic hand OA with adjustment for age, sex, and body mass index. We also evaluated the above association in persons without evidence of radiographic OA (KL grade 0) in their knee (n = 748). The prevalence of meniscus damage in the knee of subjects with no, one to two, and three or more finger joints with OA was 24.9%, 31.7%, and 47.2%, respectively. The adjusted prevalence ratio (PR) of having meniscus damage was significantly increased in those who had three or more finger joints with OA (1.40 [95% confidence interval (CI) 1.11-1.77]). The estimate remained similar in persons without evidence of radiographic OA in their knee (PR, 1.42 [95% CI 1.03-1.97]). The association was more robust for medial meniscus damage. Results suggest a common non-age related etiologic pathway for both radiographic hand OA and meniscus damage. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Sarcopenia and its relationship with osteoarthritis: risk factor or direct consequence?

Science.gov (United States)

Papalia, R; Zampogna, B; Torre, G; Lanotte, A; Vasta, S; Albo, E; Tecame, A; Denaro, V

2014-06-01

The aim of this review is to evaluate the clinical role of sarcopenia in patients affected by osteoarthritis (OA) of major joints. An online database research was performed, in order to retrieve all articles investigating the relationship between sarcopenia and OA. No peer-reviewed journal was excluded. Papers in English, French, Spanish and Italian language were considered. After consulting the full-text article, five studies have been included in the review. Of the five studies included, four are prospective studies and only one is a cross-sectional study which retrieved data retrospectively. A total of 4,231 patients, presenting a mean age of 62.0 years, were studied. Three studies evaluated only female subjects. Weight, height and body mass index were reported in all the articles. Knee OA has been assessed using the Kellgren-Lawrence grading system and the American college of rheumatology criteria. Alterations of the lean body mass on body weight ratio have been reported to be as a significant predictive parameter in two studies. Relationship between radiographic OA and an increase in the leg lean mass has been observed in one study. We cannot support neither the thesis of a direct effect of sarcopenia on OA development nor the opposite relation, because the up-to-date literature lacks basic science studies concerning these topics. The absence of clinical studies regarding measurements and tools to compare sarcopenia and OA do not allow to definitely clarify this relationship.

Longitudinal in vivo reproducibility of cartilage volume and surface in osteoarthritis of the knee

International Nuclear Information System (INIS)

Brem, M.H.; Pauser, J.; Yoshioka, H.; Stratmann, J.; Kikinis, R.; Duryea, J.; Lang, P.; Brenning, A.; Hennig, F.F.; Winalski, C.S.

2007-01-01

The aim of this study was to evaluate the longitudinal reproducibility of cartilage volume and surface area measurements in moderate osteoarthritis (OA) of the knee. We analysed 5 MRI (GE 1.5T, sagittal 3D SPGR) data sets of patients with osteoarthritis (OA) of the knee (Kellgren Lawrence grade I-II). Two scans were performed: one baseline scan and one follow-up scan 3 months later (96 ± 10 days). For segmentation, 3D Slicer 2.5 software was used. Two segmentations were performed by two readers independently who were blinded to the scan dates. Tibial and femoral cartilage volume and surface were determined. Longitudinal and cross-sectional precision errors were calculated using the standard deviation (SD) and coefficient of variation (CV%=100 x [SD/mean]) from the repeated measurements in each patient. The in vivo reproducibility was then calculated as the root mean square of these individual reproducibility errors. The cross-sectional root mean squared coefficient of variation (RMSE-CV) was 1.2, 2.2 and 2.4% for surface area measurements (femur, medial and lateral tibia respectively) and 1.4, 1.8 and 1.3% for the corresponding cartilage volumes. Longitudinal RMSE-CV was 3.3, 3.1 and 3.7% for the surface area measurements (femur, medial and lateral tibia respectively) and 2.3, 3.3 and 2.4% for femur, medial and lateral tibia cartilage volumes. The longitudinal in vivo reproducibility of cartilage surface and volume measurements in the knee using this segmentation method is excellent. To the best of our knowledge we measured, for the first time, the longitudinal reproducibility of cartilage volume and surface area in participants with mild to moderate OA. (orig.)

Meeting physical activity guidelines and the risk of incident knee osteoarthritis: a population-based prospective cohort study.

Science.gov (United States)

Barbour, K E; Hootman, J M; Helmick, C G; Murphy, L B; Theis, Kristina A; Schwartz, T A; Kalsbeek, W D; Renner, J B; Jordan, J M

2014-01-01

Knee osteoarthritis (OA) is a leading cause of disability and joint pain. Although other risk factors of knee OA have been identified, how physical activity affects incident knee OA remains unclear. Using data from the first (1999-2004) and second (2005-2010) followup periods of the Johnston County Osteoarthritis Project study, we tested the association between meeting physical activity guidelines and incident knee outcomes among 1,522 adults ages ≥45 years. The median followup time was 6.5 years (range 4.0-10.2 years). Physical activity at baseline (moderate-equivalent physical activity minutes/week) was calculated using the Minnesota Leisure Time Physical Activity questionnaire. Incident knee radiographic OA (ROA) was defined as the development of Kellgren/Lawrence grade ≥2 in a knee at followup. Incident knee symptomatic ROA (sROA) was defined as the development of ROA and symptoms in at least 1 knee at followup. Weibull regression modeling was used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for interval-censored data. In multivariable models, meeting the 2008 Department of Health and Human Services (HHS) physical activity guidelines (≥150 minutes/week) was not significantly associated with ROA (HR 1.20 [95% CI 0.92-1.56]) or sROA (HR 1.24 [95% CI 0.87-1.76]). Adults in the highest level (≥300 minutes/week) of physical activity had a higher risk of knee ROA and sROA compared with inactive (0 to guidelines was not associated with incident knee ROA or sROA in a cohort of middle-aged and older adults. Copyright © 2014 by the American College of Rheumatology.

Preoperative KOOS and SF-36 Scores Are Associated With the Development of Symptomatic Knee Osteoarthritis at 7 Years After Anterior Cruciate Ligament Reconstruction.

Science.gov (United States)

Ware, J Kristopher; Owens, Brett D; Akelman, Matthew R; Karamchedu, Naga Padmini; Fadale, Paul D; Hulstyn, Michael J; Shalvoy, Robert M; Badger, Gary J; Fleming, Braden C

2018-03-01

Anterior cruciate ligament (ACL) tears are associated with the development of knee osteoarthritis despite ACL reconstruction surgery. However, little evidence is available to determine which patients will develop symptomatic knee osteoarthritis. To determine if preoperative outcome measures-KOOS (Knee injury and Osteoarthritis Outcome Score) and SF-36 (36-item Short Form Health Survey)-were associated with the development of a symptomatic knee 7 years after ACL reconstruction. A secondary goal was to examine the relationship between imaging evidence of knee osteoarthritis and development of knee pain. Case-control study; Level of evidence, 3. Prospectively collected data from 72 patients were reviewed with 7-year follow-up after unilateral ACL reconstruction. Patients were divided into symptomatic and asymptomatic groups based on the previously defined KOOS pain ≤72. Demographic variables and preoperative KOOS and SF-36 scores were compared between groups. Radiographic and magnetic resonance imaging data were used to evaluate differences in joint space width, Osteoarthritis Research Society International radiographic score, and the Whole-Organ Magnetic Resonance Imaging Score between groups. Univariate and multivariate analyses were performed to identify potential predictors of pain at 7-year follow-up. Wilcoxon sum rank and t tests were used to compare imaging findings between the symptomatic and asymptomatic patients at 7 years. According to KOOS pain, 7 of the 72 patients available at 7-year follow-up formed the symptomatic group. No differences were found between groups in regard to demographic variables or intraoperative findings. In multivariate analysis, lower preoperative scores for KOOS sports/recreation ( P = .005) and SF-36 mental health ( P = .025) were associated with a painful knee at 7 years, with increased odds of 82% and 68% per 10-unit decrease, respectively. The Whole-Organ Magnetic Resonance Imaging Score at 7 years showed evidence of

Urinary C-terminal telopeptide of type II collagen, radiological severity, and functional assessment in knee osteoarthritis: are these related?

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Hayam M Abdel Ghany

2016-01-01

Conclusion This study further confirms that urinary CTX-II is an index of early cartilage degradation in knee OA even before radiological changes occurs. The functional assessment using the WOMAC is an easy inexpensive method in reflecting cartilage degradation. Moreover, this work supports the lack of association between the functional status of knee OA patients assessed using the WOMAC and their radiological severity measured using the Kellgren-Lawrence grading scale.

Baseline and longitudinal change in isometric muscle strength prior to radiographic progression in osteoarthritic and pre-osteoarthritic knees--data from the Osteoarthritis Initiative.

Science.gov (United States)

Eckstein, F; Hitzl, W; Duryea, J; Kent Kwoh, C; Wirth, W

2013-05-01

To test whether cross-sectional or longitudinal measures of thigh muscle isometric strength differ between knees with and without subsequent radiographic progression of knee osteoarthritis (KOA), with particular focus on pre-osteoarthritic female knees (knees with risk factors but without definite radiographic KOA). Of 4,796 Osteoarthritis Initiative participants, 2,835 knees with Kellgren Lawrence grade (KLG) 0-3 had central X-ray readings, annual quantitative joint space width (JSW) and isometric muscle strength measurements (Good strength chair). Separate slope analysis of covariance (ANCOVA) models were used to determine differences in strength between "progressor" and "non-progressor" knees, after adjusting for age, body mass index, and pain. 466 participant knees exceeded the smallest detectable JSW change during each of two observation intervals (year 2→4 and year 1→3) and were classified as progressors (213 women, 253 men; 128 KLG0/1, 330 KLG2/3); 946 participant knees did not exceed this threshold in either interval and were classified as non-progressors (588 women, 358 from men; 288KLG0/1, 658KLG2/3). Female progressor knees, including those with KLG0/1, tended to have lower extensor and flexor strength at year 2 and at baseline than those without progression, but the difference was not significant after adjusting for confounders. No significant difference was observed in longitudinal change of muscle strength (baseline→year 2) prior to radiographic progression. No significant differences were found for muscle strength in men, and none for change in strength concomitant with progression. This study provides no strong evidence that (changes in) isometric muscle strength precedes or is associated with structural (radiographic) progression of KOA. Copyright © 2013 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Relação entre intensidade de dor e capacidade funcional em indivíduos obesos com osteoartrite de joelho Relationship between pain intensity and functional capacity of obese individuals with knee osteoarthritis

Directory of Open Access Journals (Sweden)

KSS Vasconcelos

2006-01-01

Full Text Available CONTEXTUALIZAÇÃO: A osteoartrite (OA de joelho é uma doença crônica que acomete a cartilagem articular, provocando alterações ósseas, dor e rigidez à movimentação. A obesidade é um dos seus principais fatores de risco. As queixas de dificuldades funcionais são freqüentes, especialmente para a locomoção, que se torna mais lenta. Com os crescentes níveis de obesidade no Brasil, torna-se importante compreender como a OA de joelho afeta a capacidade funcional humana, a fim de se elaborar medidas de tratamento e prevenção. OBJETIVO: Analisar a influência da intensidade de dor, gravidade radiográfica, grau de obesidade e duração dos sintomas na capacidade funcional de indivíduos obesos com OA de joelho. MÉTODO: A intensidade de dor foi medida pelo questionário Western Ontario and McMaster Universities Index (WOMAC e durante os testes funcionais. A gravidade radiográfica foi analisada pela classificação Kellgren-Lawrence e o grau de obesidade pelo índice de massa corporal (IMC. Foram realizados quatro testes funcionais de velocidade: marcha usual e rápida, subir e descer escadas. RESULTADOS: A amostra foi constituída de 31 mulheres e 4 homens, com idade média de 51,65 ± 10,72 anos e IMC médio de 41,16 ± 8,37 kg/m². As atividades em escadas estavam associadas a níveis mais intensos de dor. Apenas a intensidade de dor apresentou correlações significativas com os resultados nos testes de velocidade. CONCLUSÃO: A intensidade de dor é um fator que influencia a realização de atividades funcionais em indivíduos obesos com OA de joelho, mas outros estudos são necessários para identificar os fatores determinantes de capacidade funcional nesta população.BACKGROUND: Knee osteoarthritis is a chronic disease that affects joint cartilage, causing bone structure alterations, pain and stiffness during movement. Obesity is one of its principal risk factors. Complaints about functional disability are frequent, especially

Efficacy and safety of single injection of cross-linked sodium hyaluronate vs. three injections of high molecular weight sodium hyaluronate for osteoarthritis of the knee: a double-blind, randomized, multi-center, non-inferiority study.

Science.gov (United States)

Ha, Chul-Won; Park, Yong-Beom; Choi, Chong-Hyuk; Kyung, Hee-Soo; Lee, Ju-Hong; Yoo, Jae Doo; Yoo, Ju-Hyung; Choi, Choong-Hyeok; Kim, Chang-Wan; Kim, Hee-Chun; Oh, Kwang-Jun; Bin, Seong-Il; Lee, Myung Chul

2017-05-26

This randomized, double-blind, multi-center, non-inferiority trial was conducted to assess the efficacy and safety of a cross-linked hyaluronate (XLHA, single injection form) compared with a linear high molecular hyaluronate (HMWHA, thrice injection form) in patients with symptomatic knee osteoarthritis. Two hundred eighty seven patients with osteoarthritis (Kellgren-Lawrence grade I to III) were randomized to each group. Three weekly injections were given in both groups but two times of saline injections preceded XLHA injection to maintain double-blindness. Primary endpoint was the change of weight-bearing pain (WBP) at 12 weeks after the last injection. Secondary endpoints included Western Ontario and McMaster Universities Osteoarthritis index; patient's and investigator's global assessment; pain at rest, at night, or in motion; OMERACT-OARSI responder rate; proportion of patients achieving at least 20 mm or 40% decrease in WBP; and rate of rescue medicine use and its total consumption. Mean changes of WBP at 12 weeks after the last injection were -33.3 mm with XLHA and -29.2 mm with HMWHA, proving non-inferiority of XLHA to HMWHA as the lower bound of 95% CI (-1.9 mm, 10.1 mm) was well above the predefined margin (-10 mm). There were no significant between-group differences in all secondary endpoints. Injection site pain was the most common adverse event and no remarkable safety issue was identified. This study demonstrated that a single injection of XLHA was non-inferior to three weekly injections of HMWHA in terms of WBP reduction, and supports XLHA as an effective and safe treatment for knee osteoarthritis. ClinicalTrials.gov ( NCT01510535 ). This trial was registered on January 6, 2012.

Large-scale meta-analysis of interleukin-1 beta and interleukin-1 receptor antagonist polymorphisms on risk of radiographic hip and knee osteoarthritis and severity of knee osteoarthritis.

Science.gov (United States)

Kerkhof, H J M; Doherty, M; Arden, N K; Abramson, S B; Attur, M; Bos, S D; Cooper, C; Dennison, E M; Doherty, S A; Evangelou, E; Hart, D J; Hofman, A; Javaid, K; Kerna, I; Kisand, K; Kloppenburg, M; Krasnokutsky, S; Maciewicz, R A; Meulenbelt, I; Muir, K R; Rivadeneira, F; Samuels, J; Sezgin, M; Slagboom, E; Smith, A J P; Spector, T D; Tamm, A; Tamm, A; Uitterlinden, A G; Wheeler, M; Zhai, G; Zhang, W; van Meurs, J B J; Valdes, A M

2011-03-01

To clarify the role of common genetic variation in the Interleukin-1β (IL1B) and Interleukin-1R antagonist (IL1RN) genes on risk of knee and hip osteoarthritis (OA) and severity of knee OA by means of large-scale meta-analyses. We searched PubMed for articles assessing the role of IL1B and IL1RN polymorphisms/haplotypes on the risk of hip and/or knee OA. Novel data were included from eight unpublished studies. Meta-analyses were performed using fixed- and random-effects models with a total of 3595 hip OA and 5013 knee OA cases, and 6559 and 9132 controls respectively. The role of ILRN haplotypes on radiographic severity of knee OA was tested in 1918 cases with Kellgren-Lawrence (K/L) 1 or 2 compared to 199 cases with K/L 3 or 4. The meta-analysis of six published studies retrieved from the literature search and eight unpublished studies showed no evidence of association between common genetic variation in the IL1B or IL1RN genes and risk of hip OA or knee OA (P>0.05 for rs16944, rs1143634, rs419598 and haplotype C-G-C (rs1143634, rs16944 and rs419598) previously implicated in risk of hip OA). The C-T-A haplotype formed by rs419598, rs315952 and rs9005, previously implicated in radiographic severity of knee OA, was associated with reduced severity of knee OA (odds ratio (OR)=0.71 95%CI 0.56-0.91; P=0.006, I(2)=74%), and achieved borderline statistical significance in a random-effects model (OR=0.61 95%CI 0.35-1.06 P=0.08). Common genetic variation in the Interleukin-1 region is not associated with prevalence of hip or knee OA but our data suggest that IL1RN might have a role in severity of knee OA. Copyright © 2010 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Variaciones en la estimación de la prevalencia de artrosis de rodilla según los criterios diagnósticos utilizados en los estudios poblacionales Impact of the distinct diagnostic criteria used in population-based studies on estimation of the prevalence of knee osteoarthritis

Directory of Open Access Journals (Sweden)

Mercè Comas

2010-01-01

Full Text Available Objetivo: Evaluar el impacto en la estimación de la prevalencia de artrosis de rodilla de las variaciones en los criterios diagnósticos utilizados en los estudios poblacionales. Métodos: Se realizó una búsqueda de estudios poblacionales sobre artrosis de rodilla realizados en población general no institucionalizada de Europa o Estados Unidos. Resultados: Se seleccionaron 8 artículos, 6 europeos y 2 de Estados Unidos. La definición de enfermedad se basó en criterios sintomáticos (dolor, criterios radiológicos (escala de Kellgren y Lawrence o la combinación de ambos, según el estudio. La prevalencia fue del 2,0 al 42,4% cuando se usaban criterios sintomáticos, del 16,3 al 33,0% cuando se usaban criterios radiológicos, y del 1,5 al 15,9% cuando se combinaban. La prevalencia era mayor en las mujeres y aumentaba con la edad, a excepción de algunas prevalencias estimadas a partir de síntomas, en las cuales se observa una disminución a partir de los 80 años de edad. Conclusiones: No hay consenso en los criterios utilizados para diagnosticar la artrosis de rodilla en los estudios poblacionales de prevalencia. Esto se refleja en una gran variabilidad en la prevalencia de artrosis de rodilla según el criterio diagnóstico, aparte de la edad y del sexo. Las prevalencias fueron mayores cuando se utilizó aisladamente la evidencia radiológica, seguida de los criterios sintomáticos y de la combinación de ambos.Objective: To assess the impact of the distinct diagnostic criteria used in population-based studies on estimation of the prevalence of knee osteoarthritis. Methods: We performed a search for population-based studies of the prevalence of knee osteoarthritis carried out in the general noninstitutionalized population in Europe or the USA. Results: Eight articles were selected, six from Europe and two from the USA. Depending on the study, definition of knee osteoarthritis was based on symptomatic criteria (pain, radiological criteria

How well do radiographic, clinical and self-reported diagnoses of knee osteoarthritis agree? Findings from the Hertfordshire cohort study.

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Parsons, Camille; Clynes, Michael; Syddall, Holly; Jagannath, Darshan; Litwic, Anna; van der Pas, Suzan; Cooper, Cyrus; Dennison, Elaine M; Edwards, Mark H

2015-01-01

Epidemiological studies of knee osteoarthritis (OA) have often used a radiographic definition. However, the clinical syndrome of OA is influenced by a broad range of factors in addition to the structural changes required for radiographic OA. Hence more recently several studies have adopted a clinical or self-reported approach to OA diagnosis rather than a radiographic approach. The aim of this study was to investigate agreement between radiographic OA and the clinical and self-reported diagnoses of OA. Data were available for 199 men and 196 women in the Hertfordshire Cohort Study (HCS), UK. Participants completed a questionnaire detailing self-reported OA. Clinical OA was defined based on American College of Rheumatology (ACR) criteria. Knee radiographs were taken and graded for overall Kellgren and Lawrence (K&L) score. The mean (standard deviation (SD)) age of study participants was 75.2 (2.6) years and almost identical proportions of men and women. The prevalence of knee OA differed depending on the method employed for diagnosis; 21% of the study participants self-reported knee OA, 18% of the participants had clinical knee OA and 42% of the participants had radiographic OA. Of those 72 study participants with a self-reported diagnosis of knee OA 52 (72%) had a radiographic diagnosis of knee OA, while 66% (39 out of 59) of study participants with clinical knee OA had a diagnosis of radiographic knee OA. However 58% of those participants diagnosed with radiographic OA did not have either self-reported knee OA or a diagnosis of clinical OA. Therefore in comparison with the radiographic definition of OA, both the clinical and self-report definitions had high specificity (91.5% & 91.5% respectively) and low sensitivity (24.5% and 32.7% respectively). There is modest agreement between the radiographic, clinical and self-report methods of diagnosis of knee OA.

Expedited CT-Based Methods for Evaluating Fracture Severity to Assess Risk of Post-Traumatic Osteoarthritis After Articular Fractures.

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Anderson, Donald D; Kilburg, Anthony T; Thomas, Thaddeus P; Marsh, J Lawrence

2016-01-01

Post-traumatic osteoarthritis (PTOA) is common after intra-articular fractures of the tibial plafond. An objective CT-based measure of fracture severity was previously found to reliably predict whether PTOA developed following surgical treatment of such fractures. However, the extended time required obtaining the fracture energy metric and its reliance upon an intact contralateral limb CT limited its clinical applicability. The objective of this study was to establish an expedited fracture severity metric that provided comparable PTOA predictive ability without the prior limitations. An expedited fracture severity metric was computed from the CT scans of 30 tibial plafond fractures using textural analysis to quantify disorder in CT images. The expedited method utilized an intact surrogate model to enable severity assessment without requiring a contralateral limb CT. Agreement between the expedited fracture severity metric and the Kellgren-Lawrence (KL) radiographic OA score at two-year follow-up was assessed using concordance. The ability of the metric to differentiate between patients that did or did not develop PTOA was assessed using the Wilcoxon Ranked Sum test. The expedited severity metric agreed well (75.2% concordance) with the KL scores. The initial fracture severity of cases that developed PTOA differed significantly (p = 0.004) from those that did not. Receiver operating characteristic analysis showed that the expedited severity metric could accurately predict PTOA outcome in 80% of the cases. The time required to obtain the expedited severity metric averaged 14.9 minutes/ case, and the metric was obtained without using an intact contralateral CT. The expedited CT-based methods for fracture severity assessment present a solution to issues limiting the utility of prior methods. In a relatively short amount of time, the expedited methodology provided a severity score capable of predicting PTOA risk, without needing to have the intact contralateral limb

The Effect of Glucosamine and/or Chondroitin Sulfate on the Progression of Knee Osteoarthritis: A GAIT Report

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Sawitzke, Allen D; Shi, Helen; Finco, Martha; Dunlop, Dorothy D; Bingham, Clifton O; Harris, Crystal L; Singer, Nora G; Bradley, John D; Silver, David; Jackson, Christopher G; Lane, Nancy E; Oddis, Chester V; Wolfe, Fred; Lisse, Jeffrey; Furst, Daniel E; Reda, Domenic J; Moskowitz, Roland W; Williams, H James; Clegg, Daniel O

2010-01-01

Objective Osteoarthritis of the knee causes significant morbidity and current medical treatment is limited to symptom relief, as therapies able to slow structural damage remain elusive. This study sought to evaluate the effect of glucosamine hydrochloride (glucosamine, G), sodium chondroitin sulfate (chondroitin sulfate, CS) (alone and in combination), celecoxib and placebo on progressive loss of joint space width (JSW). Methods A double-blind twenty-four month placebo-controlled study conducted at nine sites in the United States enrolled 572 participants from Glucosamine/chondroitin Arthritis Intervention Trial (GAIT) who satisfied radiographic criteria (Kellgren and Lawrence (K&L) Grade 2 or 3 changes and JSW of at least 2mm at baseline). Persons with primarily lateral compartment narrowing at any time point were excluded. Patients continued G 500mg three times daily, CS 400mg three times daily, the combination, celecoxib 200mg daily or placebo as randomized for GAIT. Minimum medial tibiofemoral JSW was measured at baseline, 12 and 24 months. The primary outcome measure was JSW change from baseline. Results The average JSW loss at 2 years for placebo, adjusted for design and clinical factors, was 0.16mm. No statistically significant difference for any treatment group compared to the placebo group was observed. Treatment effects for K&L Grade 2 knees, but not K&L Grade 3 knees showed a trend toward improvement relative to placebo. The study’s power was diminished by sample size, variance of JSW measurement and a smaller than expected loss in JSW. Conclusions At two years, no treatment achieved a predefined clinically important difference in JSW loss compared to placebo. However, patients with K&L Grade 2 osteoarthritis appear to have the greatest potential for modification by these treatments (ClinicalTrials.gov number, NCT00032890). PMID:18821708

Oxford Knee Score: cross-cultural adaptation and validation of the Turkish version in patients with osteoarthritis of the knee.

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Tuğay, Baki Umut; Tuğay, Nazan; Güney, Hande; Kınıklı, Gizem İrem; Yüksel, İnci; Atilla, Bülent

2016-01-01

The Oxford Knee Score (OKS) is a valid, short, self-administered, and site- specific outcome measure specifically developed for patients with knee arthroplasty. This study aimed to cross-culturally adapt and validate the OKS to be used in Turkish-speaking patients with osteoarthritis of the knee. The OKS was translated and culturally adapted according to the guidelines in the literature. Ninety-one patients (mean age: 55.89±7.85 years) with knee osteoarthritis participated in the study. Patients completed the Turkish version of the Oxford Knee Score (OKS-TR), Short-Form 36 Health Survey (SF-36), and Western Ontario and McMaster Universities Index (WOMAC) questionnaires. Internal consistency was tested using Cronbach's α coefficient. Patients completed the OKS-TR questionnaire twice in 7 days to determine the reproducibility. Correlation between the total results of both tests was determined by Spearman's correlation coefficient and intraclass correlation coefficients (ICC). Validity was assessed by calculating Spearman's correlation coefficient between the OKS, WOMAC, and SF-36 scores. Floor and ceiling effects were analyzed. Internal consistency was high (Cronbach's α: 0.90). The reproducibility tested by 2 different methods showed no significant difference (p>0.05). The construct validity analyses showed a significant correlation between the OKS and the other scores (p<0.05). There was no floor or ceiling effect in total OKS score. The OKS-TR is a reliable and valid measure for the self-assessment of pain and function in Turkish-speaking patients with osteoarthritis of the knee.

Reproducibility, validity, and responsiveness of the hip outcome score in patients with end-stage hip osteoarthritis.

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Naal, Florian D; Impellizzeri, Franco M; von Eisenhart-Rothe, Rüdiger; Mannion, Anne F; Leunig, Michael

2012-11-01

To evaluate reproducibility, validity, and responsiveness of the Hip Outcome Score (HOS) in patients with end-stage hip osteoarthritis. In a cohort of 157 consecutive patients (mean age 66 years; 79 women) undergoing total hip replacement, the HOS was tested for the following measurement properties: feasibility (percentage of evaluable questionnaires), reproducibility (intraclass correlation coefficient [ICC] and standard error of measurement [SEM]), construct validity (correlation with the Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC], Oxford Hip Score [OHS], Short Form 12 health survey, and University of California, Los Angeles activity scale), internal consistency (Cronbach's alpha), factorial validity (factor analysis), floor and ceiling effects, and internal and external responsiveness at 6 months after surgery (standardized response mean and change score correlations). Missing items occurred frequently. Five percent to 6% of the HOS activities of daily living (ADL) subscales and 20-32% of the sport subscales could not be scored. ICCs were 0.92 for both subscales. SEMs were 1.8 points (ADL subscale) and 2.3 points (sport subscale). Highest correlations were found with the OHS (r = 0.81 for ADL subscale and r = 0.58 for sport subscale) and the WOMAC physical function subscale (r = 0.83 for ADL subscale and r = 0.56 for sport subscale). Cronbach's alpha was 0.93 and 0.88 for the ADL and sport subscales, respectively. Neither unidimensionality of the subscales nor the 2-factor structure was supported by factor analysis. Both subscales showed good internal and external responsiveness. The HOS is reproducible and responsive when assessing patients with end-stage hip osteoarthritis in whom the items are relevant. However, based on the large proportion of missing data and the findings of the factor analysis, we cannot recommend this questionnaire for routine use in this target group. Copyright © 2012 by the American College of Rheumatology.

Knee injury and Osteoarthritis Outcome Score (KOOS – validation and comparison to the WOMAC in total knee replacement

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Roos Ewa M

2003-05-01

Full Text Available Abstract Background The Knee injury and Osteoarthritis Outcome Score (KOOS is an extension of the Western Ontario and McMaster Universities Osteoarthrtis Index (WOMAC, the most commonly used outcome instrument for assessment of patient-relevant treatment effects in osteoarthritis. KOOS was developed for younger and/or more active patients with knee injury and knee osteoarthritis and has in previous studies on these groups been the more responsive instrument compared to the WOMAC. Some patients eligible for total knee replacement have expectations of more demanding physical functions than required for daily living. This encouraged us to study the use of the Knee injury and Osteoarthritis Outcome Score (KOOS to assess the outcome of total knee replacement. Methods We studied the test-retest reliability, validity and responsiveness of the Swedish version LK 1.0 of the KOOS when used to prospectively evaluate the outcome of 105 patients (mean age 71.3, 66 women after total knee replacement. The follow-up rates at 6 and 12 months were 92% and 86%, respectively. Results The intraclass correlation coefficients were over 0.75 for all subscales indicating sufficient test-retest reliability. Bland-Altman plots confirmed this finding. Over 90% of the patients regarded improvement in the subscales Pain, Symptoms, Activities of Daily Living, and knee-related Quality of Life to be extremely or very important when deciding to have their knee operated on indicating good content validity. The correlations found in comparison to the SF-36 indicated the KOOS measured expected constructs. The most responsive subscale was knee-related Quality of Life. The effect sizes of the five KOOS subscales at 12 months ranged from 1.08 to 3.54 and for the WOMAC from 1.65 to 2.56. Conclusion The Knee injury and Osteoarthritis Outcome Score (KOOS is a valid, reliable, and responsive outcome measure in total joint replacement. In comparison to the WOMAC, the KOOS improved validity

MRI assessment of knee osteoarthritis: Knee Osteoarthritis Scoring System (KOSS) - inter-observer and intra-observer reproducibility of a compartment-based scoring system

International Nuclear Information System (INIS)

Kornaat, Peter R.; Ceulemans, Ruth Y.T.; Kroon, Herman M.; Bloem, Johan L.; Riyazi, Naghmeh; Kloppenburg, Margreet; Carter, Wayne O.; Woodworth, Thasia G.

2005-01-01

To develop a scoring system for quantifying osteoarthritic changes of the knee as identified by magnetic resonance (MR) imaging, and to determine its inter- and intra-observer reproducibility, in order to monitor medical therapy in research studies. Two independent observers evaluated 25 consecutive MR examinations of the knee in patients with previously defined clinical symptoms and radiological signs of osteoarthritis. We acquired on a 1.5 T system: coronal and sagittal proton density- and T2-weighted dual spin echo (SE) images, sagittal three-dimensional T1-weighted gradient echo (GE) images with fat suppression, and axial dual turbo SE images with fat suppression. Images were scored for the presence of cartilaginous lesions, osteophytes, subchondral cysts, bone marrow edema, and for meniscal abnormalities. Presence and size of effusion, synovitis and Baker's cyst were recorded. All parameters were ranked on a previously defined, semiquantitative scale, reflecting increasing severity of findings. Kappa, weighted kappa and intraclass correlation coefficient (ICC) were used to determine inter- and intra-observer variability. Inter-observer reproducibility was good (ICC value 0.77). Inter- and intra-observer reproducibility for individual parameters was good to very good (inter-observer ICC value 0.63-0.91; intra-observer ICC value 0.76-0.96). The presented comprehensive MR scoring system for osteoarthritic changes of the knee has a good to very good inter-observer and intra-observer reproducibility. Thus the score form with its definitions can be used for standardized assessment of osteoarthritic changes to monitor medical therapy in research studies. (orig.)

Factors Associated with the Use of Hyaluronic Acid and Corticosteroid Injections among Patients with Radiographically Confirmed Knee Osteoarthritis: A Retrospective Data Analysis.

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Lapane, Kate L; Liu, Shao-Hsien; Dubé, Catherine E; Driban, Jeffrey B; McAlindon, Timothy E; Eaton, Charles B

2017-02-01

Despite the rapid proliferation of hyaluronate (HA) and corticosteroid (CO) injections and clinical guidelines regarding their use in osteoarthritis (OA), information on the characteristics of people receiving these injections is scarce. We describe the use of injections among adults with radiographically confirmed knee OA and identify factors associated with injection use. We used publicly available data from the Osteoarthritis Initiative (OAI), an international collaboration sponsored by the National Institutes of Health, and included participants with ≥1 radiographically confirmed knee OA (Kellgren-Lawrence grade ≥2 [definite osteophytes and possible joint space narrowing (JSN) on anteroposterior weight-bearing radiograph]) at baseline. We matched 415 participants who received at least 1 HA and/or CO injection during the 6-month interval before 1 of the first 7 annual follow-up assessments to 1841 injection nonusers by randomly selecting a study visit to match the distribution observed in the injection users. Multinomial logistic regression models were used for identifying factors associated with injection use, including sociodemographic and clinical/functional factors. Eighteen percent of the 2256 patients identified as having knee OA had received at least 1 injection (years 1-7, 16.9%, 13.7%, 16.6%, 13.5%, 15.9%, 13.5%, and 9.9%, respectively), most commonly with CO (68.4%). HA and CO were more commonly injected in those with a higher annual household income (adjusted odds ratio [aOR] [95% CI] with HA, US ≥$50,000 vs injection may be associated with higher socioeconomic positioning and indicators of greater disease severity in patients with knee OA. Copyright © 2017. Published by Elsevier Inc.

Postural stability in patients with knee osteoarthritis: comparison with controls and evaluation of relationships between postural stability scores and International Classification of Functioning, Disability and Health components.

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Hsieh, Ru-Lan; Lee, Wen-Chung; Lo, Min-Tzu; Liao, Wei-Cheng

2013-02-01

To assess the differences in postural stability between patients with knee osteoarthritis and controls without knee osteoarthritis, and to evaluate possible relations between postural stability scores and International Classification of Functioning, Disability and Health (ICF) components. An age-matched, case-controlled trial with a cross-sectional design. A teaching hospital. Patients with knee osteoarthritis (n=73) and age-matched controls (n=60). Data on patients' postural stability and additional health-related variables were collected using various instruments. These included the Hospital Anxiety and Depression Scale, the Multidimensional Fatigue Inventory, the World Health Organization Quality of Life Brief Version, the physical function test (chair-rising time), the Chinese version of the Western Ontario and McMaster Universities Osteoarthritis Index, the Chinese version of the Knee Injury and Osteoarthritis Outcome Score, and the Biodex Stability System. A comparison of postural stability in patients with knee osteoarthritis versus that of controls was performed. The relation between postural stability scores for patients with knee osteoarthritis and ICF components was evaluated. Pearson correlation tests were used to determine the variables that correlated with postural stability among these patients. Patients with knee osteoarthritis displayed lower overall postural stability than controls (scores of 0.7 vs. 0.5, P=.006) and scored lower on the environmental domain of the World Health Organization Quality of Life Brief Version (62.2 vs 66.8, P=.014). For patients with knee osteoarthritis, postural stability was weakly associated with the ICF components of body functions and structures, including pain (r=.33-.34, P=.004), physical fatigue (r=.28, P=.016), and reduced motivation (r=.30, P=.011). Weak to moderate associations between postural stability and the ICF components of activities and participation were found; the relevant ICF variables included

Baseline and Longitudinal Change in Isometric Muscle Strength Prior to Radiographic Progression in Osteoarthritic and Pre-Osteoarthritic Knees- Data from the Osteoarthritis Initiative

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Eckstein, Felix; Hitzl, Wolfgang; Duryea, Jeff; Kwoh, C. Kent; Wirth, Wolfgang

2013-01-01

OBJECTIVE To test whether cross-sectional or longitudinal measures of thigh muscle isometric strength differ between knees with and without subsequent radiographic progression of knee osteoarthritis (KOA), with particular focus on pre-osteoarthritic female knees (knees with risk factors but without definite radiographic KOA). METHODS Of 4796 Osteoarthritis Initiative participants, 2835 knees with Kellgren Lawrence grade (KLG) 0–3 had central X-ray readings, annual quantitative joint space width (JSW) and isometric muscle strength measurements (Good strength chair). Separate slope ANCOVA models were used to determine differences in strength between “progressor” and “non- progressor” knees, after adjusting for age, body mass index, and pain. RESULTS 466 participant knees exceeded the smallest detectable JSW change during each of two observation intervals (year 2→4 and year 1→3) and were classified as progressors (213 women, 253 men; 128 KLG0/1, 330 KLG2/3); 946 participant knees did not exceed this threshold in either interval and were classified as non-progressors (588 women, 358 from men; 288KLG0/1, 658KLG2/3). Female progressor knees, including those with KLG0/1, tended to have lower extensor and flexor strength at year2 and at baseline than those without progression, but the difference was not significant after adjusting for confounders. No significant difference was observed in longitudinal change of muscle strength (baseline→year2) prior to radiographic progression. No significant differences were found for muscle strength in men, and none for change in strength concomitant with progression. CONCLUSION This study provides no strong evidence that (changes in) isometric muscle strength precedes or is associated with structural (radiographic) progression of KOA. PMID:23473978

Clinical and pathogenetic interrelation between molecular regulation of apoptosis and cell differentiation in osteoarthritis

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M A Kabalyk

2018-02-01

Full Text Available Aim. To determine clinical and pathogenetic relationship between the levels of apoptosis and growth and differentiation regulation (growth inhibitor 1 induced by oxidative stress, growth/differentiation factor 5 in osteoarthritis. Methods. In a rheumatology office of Vladivostok polyclinic №3 65 patients with knee osteoarthritis Kellgren grade 1-4 aged 66.5±8.0 years were examined. 25 healthy volunteers matched by sex and age without clinical and radiologic manifestations of osteoarthritis were included into control group. To measure concentration of the studied molecules in study patients’ blood, ELISA method was used. Results. Patients with osteoarthritis compared to control group had statistically significantly increased levels of Fas, growth/differentiation factor 5 and ratio of growth/differentiation factor 5/growth inhibitor 1 induced by oxidative stress. Fas levels were significantly lower in late stages 2-4 of osteoarthritis compared to stages 1 and 2. Growth/differentiation factor 5 level was lower in patients with stage 3-4 of osteoarthritis compared to stages 1 and 2. As radiologic signs of osteoarthritis progressed, decrease of the ratio of growth/differentiation factor 5/growth inhibitor 1 induced by oxidative stress, was registered which was significantly lower in stages 2 and 3 compared to stage 1. Conclusion. Extrinsic pathway of apoptosis plays a big role in forming pain syndrome in osteoarthritis, and its maintenance is provided by other mechanisms which include influence of oxidative stress via inhibition of cell cycle mediated by growth inhibitor 1 induced by oxidative stress, reduced involvement of growth/differentiation factor 5 in differentiation processes and regulation of protein synthesis of extracellular cartilaginous tissue matrix.

Presence of Gout is Associated With Increased Prevalence and Severity of Knee Osteoarthritis

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Howard, Rennie G.; Samuels, Jonathan; Gyftopoulos, Soterios; Krasnokutsky, Svetlana; Leung, Joseph; Swearingen, Christopher J.; Pillinger, Michael H.

2015-01-01

Background Gout and osteoarthritis (OA) are the most prevalent arthritides, but their relationship is neither well established nor well understood. Objectives We assessed whether a diagnosis of gout or asymptomatic hyperuricemia (AH) is associated with increased prevalence/severity of knee OA. Methods 119 male patients ages 55–85 were sequentially enrolled from the primary care clinics of an urban VA hospital, assessed and categorized into 3 groups: gout (ACR Classification Criteria), AH ([serum urate] ≥ 6.8 mg/dL, no gout), and control ([serum urate] gout). 25 patients from each group subsequently underwent formal assessment of knee OA presence and severity (ACR Clinical/Radiographic Criteria, Kellgren-Lawrence (KL) grade). Musculoskeletal ultrasound was used to detect monosodium urate (MSU) deposition at the knees and 1st metatarsophalangeal (MTP) joints. Results 68.0% of gout, 52.0% of AH, and 28.0% of age-matched control subjects had knee OA (gout vs. control, P=0.017). Odds ratio for knee OA in gout vs. controls was 5.46 prior to, and 3.80 after adjusting for BMI. Gout subjects also had higher KL grades than controls (P=0.001). Subjects with sonographically-detected MSU crystal deposition on cartilage were more likely to have OA than those without (60.0 vs 27.5%, P=0.037), with crystal deposition at the 1st MTP joints correlating most closely with OA knee involvement. Conclusion Knee OA was more prevalent in gout patients vs. controls, and intermediate in AH. Knee OA was more severe in gout patients vs. controls. PMID:25710856

Non-operative management of medial meniscus posterior horn root tears is associated with worsening arthritis and poor clinical outcome at 5-year follow-up.

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Krych, Aaron J; Reardon, Patrick J; Johnson, Nick R; Mohan, Rohith; Peter, Logan; Levy, Bruce A; Stuart, Michael J

2017-02-01

Medial meniscus posterior root tears (MMPRTs) are a significant source of pain and dysfunction, but little is known about the natural history and outcome and for non-operative management of these lesions. The purpose of this study was to evaluate (1) the mid-term clinical and radiographic outcomes of non-operative treatment of MMPRTs and (2) risk factors for worse outcomes. A retrospective review was performed for patients with symptomatic, unrepaired MMPRTs and a minimum 2-year follow-up for IKDC and Tegner outcome scores. Baseline and final radiographs were reviewed and graded according to Kellgren-Lawrence scores. Baseline MRIs were reviewed for the presence of meniscal extrusion, subchondral oedema, and insufficiency fractures. Failure was defined as conversion to arthroplasty or severely abnormal patient subjective IKDC score. Fifty-two patients (21M:31F) with a mean age of 58 ± 10 years were diagnosed with symptomatic MMPRTs clinically and confirmed by MRI and followed for a mean of 62 ± 30 months. Sixteen patients (31 %) underwent total knee arthroplasty at a mean of 30 ± 32 months after diagnosis with higher Kellgren-Lawrence grades associated with increased rates of arthroplasty (p = 0.01). Mean IKDC scores for the remaining patients were 61.2 ± 21 with significantly lower scores in females compared to males (75 ± 12 vs. 49 ± 20; p = 0.03). Mean Kellgren-Lawrence grades and rates of arthritis progressed over time on radiographs (1.5 ± 0.7 vs. 2.4 ± 1.0; p meniscus posterior horn root tears is associated with poor clinical outcome, worsening arthritis, and a relatively high rate of arthroplasty at 5-year follow-up. Female gender was associated with lower subjective scores and higher rate of arthroplasty. The current study provides a natural history benchmark for clinical outcomes that can be expected in patients with medial meniscus posterior horn root tears undergoing non-operative treatment and helps in counselling

Meaningful Change Scores in the Knee Injury and Osteoarthritis Outcome Score in Patients Undergoing Anterior Cruciate Ligament Reconstruction

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Ingelsrud, Lina Holm; Terwee, Caroline B; Terluin, Berend

2018-01-01

BACKGROUND: Meaningful change scores in the Knee injury and Osteoarthritis Outcome Score (KOOS) in patients undergoing anterior cruciate ligament (ACL) reconstruction have not yet been established. PURPOSE: To define the minimal important change (MIC) for the KOOS after ACL reconstruction. STUDY...... data for at least one of the KOOS subscales were obtained from 542 (45.3%) participants. Predictive modeling MIC values were 12.1 for the KOOS subscales of Sport and Recreational Function and 18.3 for Knee-Related Quality of Life. These values aid in interpreting within-group improvement over time...... and can be used as responder criteria when comparing groups. The corresponding and much lower values for the subscales of Pain (2.5), Symptoms (-1.2), and Activities of Daily Living (2.4) are the results from patients reporting, on average, only mild problems with these domains preoperatively. Although 4...

Values of functional indexes in assessment of efficacy of osteoarthritis treatment with Chondrolon and Zel T in polyclinic

Directory of Open Access Journals (Sweden)

O Y Maiko

2009-01-01

Full Text Available Objective. To study change of knee joints functional disability in pts with predominantly I-II stage of knee osteoarthritis (OA with clinical tests and WOMAC index for assessment of efficacy of treatment with Chondrolon and Zel T in polyclinic. Material and methods. 70 pts with I and II stage of OA according to Kellgren-Lawrence aged from 40 to 67 years were included. They were divided in 2 groups (30 pts in group I and40 pts in group II. Group I pts were treated with Chondrolon and group II pts – with Zel T. Treatment efficacy was assessed with WOMAC index, functional Lequesne index, pain on VAS at rest and at movement, knee mobility, time of walking for 30 m and walking stairs. Results. Positive changes of all parameters were revealed in both groups: significant improvement of pain on VAS, functional tests, Lequesne index, WOMAC scales was achieved. During treatment with Zel T improvement of the efficacy measures increased slower, mainly after 12 weeks of treatment (during treatment with Chondrolon – after8 weeks. Both drugs provided functional improvement assessed by WOMAC index butChondrolon was more effective. Conclusion. Chondrolon and Zel T can be used for treatment of OA at I or II stage with moderate knee joints functional disability. Course of treatment with Zel T should be continued not less than 3 months and with Chondrolon – 2 months.

Simple Scoring System and Artificial Neural Network for Knee Osteoarthritis Risk Prediction: A Cross-Sectional Study

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Yoo, Tae Keun; Kim, Deok Won; Choi, Soo Beom; Oh, Ein; Park, Jee Soo

2016-01-01

Background Knee osteoarthritis (OA) is the most common joint disease of adults worldwide. Since the treatments for advanced radiographic knee OA are limited, clinicians face a significant challenge of identifying patients who are at high risk of OA in a timely and appropriate way. Therefore, we developed a simple self-assessment scoring system and an improved artificial neural network (ANN) model for knee OA. Methods The Fifth Korea National Health and Nutrition Examination Surveys (KNHANES V-1) data were used to develop a scoring system and ANN for radiographic knee OA. A logistic regression analysis was used to determine the predictors of the scoring system. The ANN was constructed using 1777 participants and validated internally on 888 participants in the KNHANES V-1. The predictors of the scoring system were selected as the inputs of the ANN. External validation was performed using 4731 participants in the Osteoarthritis Initiative (OAI). Area under the curve (AUC) of the receiver operating characteristic was calculated to compare the prediction models. Results The scoring system and ANN were built using the independent predictors including sex, age, body mass index, educational status, hypertension, moderate physical activity, and knee pain. In the internal validation, both scoring system and ANN predicted radiographic knee OA (AUC 0.73 versus 0.81, p<0.001) and symptomatic knee OA (AUC 0.88 versus 0.94, p<0.001) with good discriminative ability. In the external validation, both scoring system and ANN showed lower discriminative ability in predicting radiographic knee OA (AUC 0.62 versus 0.67, p<0.001) and symptomatic knee OA (AUC 0.70 versus 0.76, p<0.001). Conclusions The self-assessment scoring system may be useful for identifying the adults at high risk for knee OA. The performance of the scoring system is improved significantly by the ANN. We provided an ANN calculator to simply predict the knee OA risk. PMID:26859664

Responsiveness of the OARSI-OMERACT osteoarthritis pain and function measures

DEFF Research Database (Denmark)

Bond, M; Davis, A; Lohmander, Stefan

2012-01-01

To assess the responsiveness of the Intermittent and Constant Osteoarthritis Pain (ICOAP) measure, Hip Disability and Osteoarthritis Outcome Score Physical Function Short Form (HOOS-PS), and the Knee Disability and Osteoarthritis Outcome Score Physical Function Short Form (KOOS-PS) in a pharmacol...

Gluteal tendinopathy and hip osteoarthritis: Different pathologies, different hip biomechanics.

Science.gov (United States)

Allison, Kim; Hall, Michelle; Hodges, Paul W; Wrigley, Tim V; Vicenzino, Bill; Pua, Yong-Hao; Metcalf, Ben; Grimaldi, Alison; Bennell, Kim L

2018-03-01

Gluteal tendinopathy (GT) and hip osteoarthritis (OA) are the most common causes of hip pain and associated disability in older adults. Pain and altered walking biomechanics are common to both conditions. This study aimed to compare three-dimensional walking biomechanics between individuals with unilateral, symptomatic GT and HOA. Sixty individuals with symptomatic unilateral GT confirmed by magnetic-resonance-imaging and 73 individuals with symptomatic unilateral HOA (Kellgren-Lawrence Grade ≥ 2) underwent three-dimensional gait analysis. Maximum and minimum values of the external sagittal hip moment, the first peak, second peak and mid-stance minimum of the hip adduction moment (HAM), sagittal plane hip excursion and hip joint angles, pelvic obliquity and trunk lean, at the three HAM time points during stance phase of walking were compared between groups. Compared to individuals with HOA, those with GT exhibited a greater hip peak extension moment (P < 0.001) and greater HAM throughout the stance phase of walking (P = 0.01-P < 0.001), greater hip adduction (P < 0.001) and internal rotation (P < 0.01-P < 0.001) angles and lower hip flexion angles and excursion (P = 0.02 - P < 0.001). Individuals with HOA exhibited a greater forward trunk lean (P ≤ 0.001) throughout stance, and greater ipsilateral trunk lean in the frontal plane (P < 0.001) than those with GT. Despite presence of pain in both conditions, hip kinematics and kinetics differ between individuals with symptomatic unilateral GT and those with symptomatic unilateral HOA. These condition-specific impairments may be targets for optimization of management of HOA and GT. Copyright © 2018 Elsevier B.V. All rights reserved.

Effect of 12 months treatment with chondroitin sulfate on cartilage volume in knee osteoarthritis patients: a randomized, double-blind, placebo-controlled pilot study using MRI.

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Railhac, J-J; Zaim, M; Saurel, A-S; Vial, J; Fournie, B

2012-09-01

This pilot study aimed to evaluate the correlation between clinical symptoms and cartilage volume through MRI in patients with knee osteoarthritis after 48 weeks of treatment with Structum®. Multicenter, double-blind, placebo-controlled, parallel-group study. Symptomatic knee osteoarthritis patients aged 50-75 years received either Structum® (500 mg twice daily; N = 22) or placebo (N = 21) during 48 weeks. Inclusion criteria were global pain in the target knee ≥30 mm (VAS 0-100) and radiological Kellgren-Lawrence grade 2 or 3. Clinical assessments included Lequesne index and VAS for pain on motion, at baseline, 24 and 48 weeks, and MRI at baseline and at 24 and 48 weeks. Global and compartments cartilage volume, joint cartilage abnormalities, meniscal lesions, ligaments abnormalities, synovitis, synovial effusion, osteophytes, subchondral cysts, popliteal cysts and subchondral oedema were quantified. The quantitative and qualitative reproducibility of MRI was tested by the Spearman correlation coefficient and kappa coefficients, respectively. Treatments were compared by an analysis of covariance with baseline value as covariate. Groups were comparable at baseline for demographics, disease characteristics, and cartilage volumes. A significant inter-readers correlation was seen for the assessment of cartilage volumes, number of cysts, and osteophytes (correlation coefficients from 0.951 to 0.980 within investigator and from 0.714 to 0.957). After 48 weeks, symptoms improved in both groups. The total cartilage volume increased in the Structum® group (+180 mm(3) + SD) which opposed to a loss in the placebo (-46 mm(3) + SD; NS). No statistically significant differences between groups were observed for the other MRI parameters. No correlations were evidenced between key MRI parameters changes and symptoms. The difference in the evolution of cartilage volume between the two groups could reflect a structure modifying effect of Structum

Cross-cultural adaptation and validation of the persian version of the oxford knee score in patients with knee osteoarthritis.

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Ebrahimzadeh, Mohammad Hosein; Makhmalbaf, Hadi; Birjandinejad, Ali; Soltani-Moghaddas, Seyed Hosein

2014-11-01

The Oxford Knee Score (OKS) is a short patient-reported outcome instrument that measures pain and physical activity related to knee osteoarthritis. The purpose of this study is to evaluate, construct validity and consistent reliability of the Persian version of the OKS. The case series consisted of 80 patients who were clinically diagnosed with having knee osteoarthritis. All patients were requested to fill-in the Persian OKS and Short-Form 36 Health Survey (SF-36). Correlation analysis between the Persian versions of these two instruments was then carried out. The scores of the Persian SF-36 were used to evaluate convergent and divergent validity of the 12-item Persian OKS. From a total of 80 patients, 63 were female (79%) and the remaining 17 were male (21%) with a mean age of 52.2 years. In the present study, high Cronbach's alpha of 0.95 confirms excellent internal consistency of the Persian OKS scale similar to previous investigations. The results confirm that the Persian version of this instrument is valid and reliable, similar to its English index and its subsequent translations in different languages. The Persian OKS is a reliable instrument to evaluate knee function in patients with knee osteoarthritis and is a useful tool for outcome measurement in clinical research.

Translation, Cross-cultural Adaptation, and Psychometric Properties of the German Version of the Hip Disability and Osteoarthritis Outcome Score

NARCIS (Netherlands)

Blasimann, A.; Dauphinee, S.W.; Staal, J.B.

2014-01-01

Study Design Clinical measurement. Objectives To translate and cross-culturally adapt the Hip disability and Osteoarthritis Outcome Score (HOOS) from English into German, and to study its psychometric properties in patients after hip surgery. Background There is no specific hip questionnaire in

New application of 18F-fluoride PET for the detection of bone remodeling in early-stage osteoarthritis of the hip.

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Kobayashi, Naomi; Inaba, Yutaka; Tateishi, Ukihide; Yukizawa, Yohei; Ike, Hiroyuki; Inoue, Tomio; Saito, Tomoyuki

2013-10-01

Recent studies have reported the acceleration of subchondral bone remodeling during the development of osteoarthritis (OA). However, it is not possible to evaluate such molecular abnormalities using conventional radiographic techniques. We have applied 18F-fluoride PET to the analysis of painful or dysplastic hips at various stages of OA and then compared this with radiographic findings and clinical findings. A consecutive series of 65 joints from 48 patients (average age, 40 years; range, 19-72 years) with a hip joint complaint or radiographic dysplastic hip were enrolled in this study. Twenty-five contralateral joints without any evidence of OA or clinical symptoms were assigned as a normal control group. Radiographic evaluations were performed on the basis of Kellgren and Lawrence grade and the minimum joint space. Clinical evaluations were performed using the grading scale for pain severity and the SUVmax was measured for each joint. The association between SUVmax and the radiographic or clinical findings was evaluated. 18F-fluoride PET shows a significantly higher uptake value for progressive-stage OA cases than for early-stage cases and also shows a significantly higher uptake value in cases with severe pain. Even in early-OA-stage patients who do not show joint space narrowing on a plain x-ray, cases with severe pain show a significantly higher uptake value. 18F-fluoride PET has great potential as an imaging method for diagnosing early-stage OA without any marked radiographic changes.

Race, sex, and risk factors in radiographic worsening of knee osteoarthritis.

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Vina, Ernest R; Ran, Di; Ashbeck, Erin L; Ratzlaff, Charles; Kwoh, C Kent

2018-02-01

Characterize radiographic worsening in knee osteoarthritis (KOA) by race and sex over 4 years and evaluate the role of established risk factors in observed race/sex differences. Whites (WHs) (694 males and 929 females) and African-Americans (AAs) (92 males and 167 females) at risk for radiographic KOA were eligible. Cox shared frailty models were used to estimate race and sex group differences in radiographic worsening, defined by Kellgren-Lawrence (K-L) and OARSI joint space narrowing (JSN). Mixed effect models for repeated measures were used to estimate race- and sex-specific mean medial and lateral fixed joint space width (fJSW) over 4 years of follow-up, as well as annual loss of fJSW. Risk of OARSI medial JSN grade worsening was higher among AA males than WH females [HR = 2.28, (95% CI: 1.14-4.57)], though adjustment for KOA risk factors attenuated the association. Compared to WH females, WH males had lower risk of K-L grade worsening [adjusted HR = 0.75 (95% CI: 0.58-0.96)]. Mean baseline medial fJSW (mm) was 6.49 in WH and AA males, 5.42 in WH females, and 5.41 in AA females. Annual change in mean medial fJSW was greater in AA males (-0.19mm/year) than in other subgroups (-0.09 WH males, -0.07 WH females, -0.10 AA females, p WHs, AAs had less lateral fJSW at baseline and throughout follow-up. Compared to WHs and AA females, AA males experienced higher risk of medial joint space loss. Controlling for established risk factors attenuated associations between race/sex and disease worsening, suggesting that risk factors such as obesity, history of knee injury, and bony finger joint enlargements largely explain race/sex variations in rates of KOA development and progression. Copyright © 2018 Elsevier Inc. All rights reserved.

Comparison of AIMS2-SF, WOMAC, x-ray and a global physician assessment in order to approach quality of life in patients suffering from osteoarthritis

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Szecsenyi Joachim

2006-01-01

Full Text Available Abstract Background Chronic diseases like osteoarthritis (OA substantially affect different dimensions of quality of life (QoL. The aim of the study was to reveal possible factors which mainly influence general practitioners (GPs assessment of patients' QoL. Methods 220 primary care patients with OA of the knee or the hip treated by their general practitioner for at least one year were included. All GPs were asked to assess patients' QoL based on the patients' history, actual examination and existing x-rays by means of a visual analog scale (VAS scale, resulting in values ranging from 0 to 10. Patients were asked to complete the McMaster Universities Osteoarthritis Index (WOMAC and the Arthritis Impact Measurement Scale2 Short Form (AIMS2-SF questionnaire. Results Significant correlations were revealed between "GP assessment" and the AIMS2-SF scales "physical" (rho = 0.495 and "symptom" (rho = 0.598 as well as to the "pain" scale of the WOMAC (rho = 0.557. A multivariate ordinal regression analysis revealed only the AIMS2-SF "symptom" scale (coefficient beta = 0.2588; p = 0.0267 and the x-ray grading according to Kellgren and Lawrence as significant influence variables (beta = 0.6395; p = 0.0004. Conclusion The results of the present study suggest that physicians' assessment of patients' QoL is mainly dominated by physical factors, namely pain and severity of x-ray findings. Our results suggest that socioeconomic and psychosocial factors, which are known to have substantial impact on QoL, are underestimated or missed. Moreover, the overestimation of x-ray findings, which are known to be less correlated to QoL, may cause over-treatment while important and promising targets to increase patients' QoL are missed.

Preliminary validation of 2 magnetic resonance image scoring systems for osteoarthritis of the hip according to the OMERACT filter.

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Maksymowych, Walter P; Cibere, Jolanda; Loeuille, Damien; Weber, Ulrich; Zubler, Veronika; Roemer, Frank W; Jaremko, Jacob L; Sayre, Eric C; Lambert, Robert G W

2014-02-01

Development of a validated magnetic resonance image (MRI) scoring system is essential in hip OA because radiographs are insensitive to change. We assessed the feasibility and reliability of 2 previously developed scoring methods: (1) the Hip Inflammation MRI Scoring System (HIMRISS) and (2) the Hip Osteoarthritis MRI Scoring System (HOAMS). Six readers (3 radiologists, 3 rheumatologists) participated in 2 reading exercises. In Reading Exercise 1, MRI of the hip of 20 subjects were read at a single time point followed by further standardization of methodology. In Reading Exercise 2, MRI of the hip of 18 subjects from a randomized controlled trial, assessed at 2 timepoints, and 27 subjects from a cross-sectional study were read for HIMRISS and HOAMS bone marrow lesions (BML) and synovitis. Reliability was assessed using intraclass correlation coefficient (ICC) and kappa statistics. Both methods were considered feasible. For Reading 1, HIMRISS ICC were 0.52, 0.61, 0.70, and 0.58 for femoral BML, acetabular BML, effusion, and total scores, respectively; and for HOAMS, summed BML and synovitis ICC were 0.52 and 0.46, respectively. For Reading 2, HIMRISS and HOAMS ICC for BML and synovitis-effusion improved substantially. Interobserver reliability for change scores was 0.81 and 0.71 for HIMRISS femoral and HOAMS summed BML, respectively. Responsiveness and discrimination was moderate to high for synovitis-effusion. Significant associations were noted between BML or synovitis scores and Western Ontario and McMaster Universities Osteoarthritis Index pain scores for baseline values (p ≤ 0.001). The BML and synovitis-effusion components of both HIMRISS and HOAMS scoring systems are feasible and reliable, and should be validated further.

The role of thermal balneotherapy in the treatment of obese patient with knee osteoarthritis

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Masiero, Stefano; Vittadini, Filippo; Ferroni, Costanza; Bosco, Anna; Serra, Roberto; Frigo, Anna Chiara; Frizziero, Antonio

2018-02-01

Osteoarthritis (OA) is the most common form of arthritis clinically characterized by joint pain, functional limitation, and reduced quality of life. Several studies have shown a clear link between obesity and higher risk of knee OA. According to the multifactorial OA pathogenesis, the management of this condition requires a multidisciplinary approach. The objective of this study is to evaluate hydrokinesitherapy effects in thermal setting in obese patients with knee OA. Fifty-three patients were assessed for eligibility, of which 33 refused the treatment, while 10 patients dropped out after the enrollment for personal reasons or inability to adhere to the program. Ten patients (8 females, 2 males, mean age of 59.4 years) with obesity (range BMI 30-45 kg/m2) and knee OA (II-III grade of Kellgren-Lawrence scale) treated with hydrokinetic therapy in thermal water (two sessions per week for 8 consecutive weeks) completed the study. Primary outcome measure was pain (VAS). Secondary outcomes were clinical knee evaluation (range of motion—ROM, lower-limb muscle strength), WOMAC, and Lequesne Algofunctional Index. Patellar tendon and peri-articular soft tissue ultrasound evaluation and gait analysis at baseline (T0), at the end of treatment (T1), and at 6 months of follow-up (T2) were performed. Significant decrease on VAS pain during walking on a flat surface and going up/down stairs was reached from baseline at T1 ( p = 0.0039; p = 0.0098) and was maintained at T2 ( p = 0.00954) exclusively for VAS pain during walking on a flat surface. WOMAC score showed a significant reduction between T0 and T1 ( p = 0.0137) and between T0 and T2 ( p = 0.006438), as ROM evaluations. Kinematic path assessment did not show significant results in individual gait steps, except for the space-time variables of the average speed and the values of ground reaction force (GRF) obtained with force platforms. Hydrokinesitherapy in thermal environment in obese patients with knee OA may determine

Cross-Cultural Adaptation and Validation of the Persian Version of the Oxford Knee Score in Patients with Knee Osteoarthritis

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Mohammad Hosein Ebrahimzadeh

2014-11-01

Full Text Available Background: The Oxford Knee Score (OKS is a short patient-reported outcome instrument that measures pain and physical activity related to knee osteoarthritis. The purpose of this study is to evaluate, construct validity and consistent reliability of the Persian version of the OKS. Methods: The case series consisted of 80 patients who were clinically diagnosed with having knee osteoarthritis. All patients were requested to fill-in the Persian OKS and Short-Form 36 Health Survey (SF-36. Correlation analysis between the Persian versions of these two instruments was then carried out. The scores of the Persian SF-36 were used to evaluate convergent and divergent validity of the 12-item Persian OKS. Results: From a total of 80 patients, 63 were female (79% and the remaining 17 were male (21% with a mean age of 52.2 years. In the present study, high Cronbach’s alpha of 0.95 confirms excellent internal consistency of the Persian OKS scale similar to previous investigations. The results confirm that the Persian version of this instrument is valid and reliable, similar to its English index and its subsequent translations in different languages. Conclusion: The Persian OKS is a reliable instrument to evaluate knee function in patients with knee osteoarthritis and is a useful tool for outcome measurement in clinical research.

Pregabalin Improves Pain Scores in Patients with Fibromyalgia Irrespective of Comorbid Osteoarthritis.

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Argoff, Charles E; Emir, Birol; Whalen, Ed; Ortiz, Marie; Pauer, Lynne; Clair, Andrew

2016-11-01

Fibromyalgia (FM) is a chronic pain disorder with patients frequently suffering from comorbid conditions, including osteoarthritis (OA). Data on how FM patients with comorbid OA respond to recommended therapies (such as pregabalin) could help their treatment. This was a pooled exploratory analysis of three randomized placebo-controlled clinical trials of pregabalin in FM patients to assess the impact of comorbid OA on the response to pregabalin. Patients were divided into those with and without comorbid OA. Difference in change in least squares (LS) mean pain score at endpoint (assessed by 0-10 numeric rating scale, controlled for baseline pain score) with pregabalin (300 mg/day and 450 mg/day) vs placebo was assessed. Changes in Patient Global Impression of Change (PGIC) responders and Fibromyalgia Impact Questionnaire (FIQ) total score were also assessed. There were 1665 patients in the analysis set (558, placebo; 552, pregabalin 300 mg/day; 555, pregabalin 450 mg/day), including 296 with comorbid OA. Pregabalin 450 mg/day significantly improved the LS mean (95% confidence interval) difference in pain score vs placebo in patients with (0.99 [0.44, 1.55], P FIQ total score were observed in patients with and without comorbid OA. FM patients with or without comorbid OA respond to treatment with pregabalin 450mg/day with significant improvements in pain intensity scores. These data could provide guidance to healthcare professionals treating these patients. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Development and Reliability of a Preliminary Foot Osteoarthritis Magnetic Resonance Imaging Score.

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Halstead, Jill; Martín-Hervás, Carmen; Hensor, Elizabeth M A; McGonagle, Dennis; Keenan, Anne-Maree; Redmond, Anthony C; Conaghan, Philip G

2017-08-01

Foot osteoarthritis (OA) is very common but underinvestigated musculoskeletal condition and there is little consensus as to common magnetic resonance imaging (MRI) features. The aim of this study was to develop a preliminary foot OA MRI score (FOAMRIS) and evaluate its reliability. This preliminary semiquantitative score included the hindfoot, midfoot, and metatarsophalangeal joints. Joints were scored for joint space narrowing (JSN; 0-3), osteophytes (0-3), joint effusion/synovitis, and bone cysts (present/absent). Erosions and bone marrow lesions (BML) were scored (0-3) and BML were evaluated adjacent to entheses and at sub-tendon sites (present/absent). Additionally, tenosynovitis (0-3) and midfoot ligament pathology (present/absent) were scored. Reliability was evaluated in 15 people with foot pain and MRI-detected OA using 3.0T MRI multi-sequence protocols, and assessed using ICC as an overall score and per anatomical site. Intrareader agreement (ICC) was generally good to excellent across the foot in joint features (JSN 0.90, osteophytes 0.90, effusion/synovitis 0.46, cysts 0.87), bone features (BML 0.83, erosion 0.66, BML entheses 0.66, BML sub-tendon 0.60) and soft tissue features (tenosynovitis 0.83, ligaments 0.77). Interreader agreement was lower for joint features (JSN 0.43, osteophytes 0.27, effusion/synovitis 0.02, cysts 0.48), bone features (BML 0.68, erosion 0.00, BML entheses 0.34, BML sub-tendon 0.13), and soft tissue features (tenosynovitis 0.35, ligaments 0.33). This preliminary FOAMRIS demonstrated good intrareader reliability and fair interreader reliability when assessing the total feature scores. Further development is required in cohorts with a range of pathologies and to assess the psychometric measurement properties.

The Relationship Between Early-Stage Knee Osteoarthritis and Lower-Extremity Alignment, Joint Laxity, and Subjective Scores of Pain, Stiffness, and Function.

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Hicks-Little, Charlie A; Peindl, Richard D; Hubbard-Turner, Tricia J; Cordova, Mitchell L

2016-08-01

Knee osteoarthritis (OA) is a debilitating disease that affects an estimated 27 million Americans. Changes in lower-extremity alignment and joint laxity have been found to redistribute the medial and/or lateral loads at the joint. However, the effect that changes in anteroposterior knee-joint laxity have on lower-extremity alignment and function in individuals with knee OA remains unclear. To examine anteroposterior knee-joint laxity, lower-extremity alignment, and subjective pain, stiffness, and function scores in individuals with early-stage knee OA and matched controls and to determine if a relationship exists among these measures. Case control. Sports-medicine research laboratory. 18 participants with knee OA and 18 healthy matched controls. Participants completed the Western Ontario McMaster (WOMAC) osteoarthritis questionnaire and were tested for total anteroposterior knee-joint laxity (A-P) and knee-joint alignment (ALIGN). WOMAC scores, A-P (mm), and ALIGN (°). A significant multivariate main effect for group (Wilks' Λ = 0.30, F7,26 = 8.58, P Knee-OA participants differed in WOMAC scores (P knee OA had worse pain, stiffness, and functional outcome scores than the matched controls; however, ALIGN and A-P were no different. There was no association identified among participants' subjective scores, ALIGN, or A-P measures in this study.

Assessment of reliability, validity, responsiveness and minimally important change of the German Hip dysfunction and osteoarthritis outcome score (HOOS) in patients with osteoarthritis of the hip.

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Arbab, Dariusch; van Ochten, Johannes H M; Schnurr, Christoph; Bouillon, Bertil; König, Dietmar

2017-12-01

Patient-reported outcome measures are a critical tool in evaluating the efficacy of orthopedic procedures. The intention of this study was to evaluate reliability, validity, responsiveness and minimally important change of the German version of the Hip dysfunction and osteoarthritis outcome score (HOOS). The German HOOS was investigated in 251 consecutive patients before and 6 months after total hip arthroplasty. All patients completed HOOS, Oxford-Hip Score, Short-Form (SF-36) and numeric scales for pain and disability. Test-retest reliability, internal consistency, floor and ceiling effects, construct validity and minimal important change were analyzed. The German HOOS demonstrated excellent test-retest reliability with intraclass correlation coefficient values > 0.7. Cronbach´s alpha values demonstrated strong internal consistency. As hypothesized, HOOS subscales strongly correlated with corresponding OHS and SF-36 domains. All subscales showed excellent (effect size/standardized response means > 0.8) responsiveness between preoperative assessment and postoperative follow-up. The HOOS and all subdomains showed higher changes than the minimal detectable change which indicates true changes. The German version of the HOOS demonstrated good psychometric properties. It proved to be valid, reliable and responsive to the changes instrument for use in patients with hip osteoarthritis undergoing total hip replacement.

Knee Images Digital Analysis (KIDA): a novel method to quantify individual radiographic features of knee osteoarthritis in detail.

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Marijnissen, A C A; Vincken, K L; Vos, P A J M; Saris, D B F; Viergever, M A; Bijlsma, J W J; Bartels, L W; Lafeber, F P J G

2008-02-01

Radiography is still the golden standard for imaging features of osteoarthritis (OA), such as joint space narrowing, subchondral sclerosis, and osteophyte formation. Objective assessment, however, remains difficult. The goal of the present study was to evaluate a novel digital method to analyse standard knee radiographs. Standardized radiographs of 20 healthy and 55 OA knees were taken in general practise according to the semi-flexed method by Buckland-Wright. Joint Space Width (JSW), osteophyte area, subchondral bone density, joint angle, and tibial eminence height were measured as continuous variables using newly developed Knee Images Digital Analysis (KIDA) software on a standard PC. Two observers evaluated the radiographs twice, each on two different occasions. The observers were blinded to the source of the radiographs and to their previous measurements. Statistical analysis to compare measurements within and between observers was performed according to Bland and Altman. Correlations between KIDA data and Kellgren & Lawrence (K&L) grade were calculated and data of healthy knees were compared to those of OA knees. Intra- and inter-observer variations for measurement of JSW, subchondral bone density, osteophytes, tibial eminence, and joint angle were small. Significant correlations were found between KIDA parameters and K&L grade. Furthermore, significant differences were found between healthy and OA knees. In addition to JSW measurement, objective evaluation of osteophyte formation and subchondral bone density is possible on standard radiographs. The measured differences between OA and healthy individuals suggest that KIDA allows detection of changes in time, although sensitivity to change has to be demonstrated in long-term follow-up studies.

Association of Cross Linked C-Telopeptide II Collagen and Hyaluronic Acid with Knee Osteoarthritis Severity

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John Butar Butar

2013-12-01

Full Text Available BACKGROUND: This study was carried out to investigate the association of Cross Linked C-Telopeptide Type I & II Collagen (CTX-I and II and hyaluronic acid (HA with knee osteoarthritis (OA severity. METHODS: Sixty menopause women with primary knee OA were enrolled in this study during their visits to the Outpatient Department. Patients with knee pain during weight bearing, active or passive range of motion, or tenderness with Kellgren-Lawrence (KL grade of more than I were included. Patients with injury, inflammatory and metabolic diseases were excluded. Patients were put in a 10-hour fasting prior to withdrawal of morning blood samples for examinations of HA, CTX-I, interleukin 1 beta (IL-1β, and high sensitivity C reactive protein (hs-CRP level. Second void morning urine specimens were taken for CTXII assessment. HA, CTX-I and II levels were measured by enzyme-linked immunosorbent assay. RESULTS: Sixty menopausal female patients were included in this study, 35 with KL grade II, 17 grade III, and 8 grade IV. Means of CTX-II were significantly different between subjects KL grade IV and III (p=0.021. Correlation of KL grade was significant with CTX-II (p=0.001, r=0.412 and HA (p=0.0411, r=0.269. KL grades were not significantly associated with CTX-I (p=0.8364, r=-0.0272; IL-1β (p=0.5773, r=0.0853 and hs-CRP (p=0.2625, r=0.1470. CONCLUSIONS: CTX-II and HA were associated with severity of knee OA, suggesting that CTX-II and HA can be used as marker for knee OA severity. KEYWORDS: CTX-II, hyaluronic acid, otestoarthritis, knee.

[Definition, etiology, classification and presentation forms].

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Mas Garriga, Xavier

2014-01-01

Osteoarthritis is defined as a degenerative process affecting the joints as a result of mechanical and biological disorders that destabilize the balance between the synthesis and degradation of joint cartilage, stimulating the growth of subchondral bone; chronic synovitis is also present. Currently, the joint is considered as a functional unit that includes distinct tissues, mainly cartilage, the synovial membrane, and subchondral bone, all of which are involved in the pathogenesis of the disease. Distinct risk factors for the development of osteoarthritis have been described: general, unmodifiable risk factors (age, sex, and genetic makeup), general, modifiable risk factors (obesity and hormonal factors) and local risk factors (prior joint anomalies and joint overload). Notable among the main factors related to disease progression are joint alignment defects and generalized osteoarthritis. Several classifications of osteoarthritis have been proposed but none is particularly important for the primary care management of the disease. These classifications include etiological (primary or idiopathic forms and secondary forms) and topographical (typical and atypical localizations) classifications, the Kellgren and Lawrence classification (radiological repercussions) and that of the American College of Rheumatology for osteoarthritis of the hand, hip and knee. The prevalence of knee osteoarthritis is 10.2% in Spain and shows a marked discrepancy between clinical and radiological findings. Hand osteoarthritis, with a prevalence of symptomatic involvement of around 6.2%, has several forms of presentation (nodal osteoarthritis, generalized osteoarthritis, rhizarthrosis, and erosive osteoarthritis). Symptomatic osteoarthritis of the hip affects between 3.5% and 5.6% of persons older than 50 years and has different radiological patterns depending on femoral head migration. Copyright © 2014 Elsevier España, S.L. All rights reserved.

Biochemical comparison of osteoarthritic knees with and without effusion

Science.gov (United States)

2011-01-01

Background Several symptom-relieving interventions have been shown to be efficacious among osteoarthritis (OA) patients with knee effusion; however, not every symptomatic knee OA patient has clinical effusion. Results may be over-generalized since it is unclear if effused knees represent a unique pathological condition or subset compared to knees without effusion. The primary purpose of this study was to determine if biochemical differences existed between OA knees with and without effusion. Methods The present cross-sectional study consisted of 22 volunteers (11 with knee effusion, 11 without knee effusion) with confirmed late-stage radiographic knee OA (Kellgren-Lawrence score ≥ 3). Synovial fluid samples were collected and analyzed using a custom multiplex enzyme-linked immunosorbent assay to determine eight specific biomarker concentrations (e.g., catabolic, anabolic). Results Matrix metalloproteinase (MMP)-3, tissue inhibitor of MMPs (TIMP)-1, TIMP-2, and interleukin-10 were significantly higher in the knees with effusion than in the knees without effusion. Conclusions The biochemical differences that existed between knees with and without effusion provide support that OA subsets may exist, characterized by distinct biochemical characteristics and clinical findings (e.g., effusion). PMID:22122951

Patients With Knee Osteoarthritis Who Score Highly on the PainDETECT Questionnaire Present With Multimodality Hyperalgesia, Increased Pain, and Impaired Physical Function

OpenAIRE

Moss, Penny; Benson, Heather A.E.; Will, Rob; Wright, Anthony

2017-01-01

Objectives: PainDETECT is a self-report questionnaire that can be used to identify features of neuropathic pain. A proportion of patients with knee osteoarthritis (OA) score highly on the PainDETECT questionnaire. This study aimed to determine whether those with a higher “positive neuropathic” score on the PainDETECT questionnaire also had greater pain, hypersensitivity, and reduced function compared with individuals with knee OA with lower PainDETECT scores. Materials and Methods: In total, ...

Translation and Adaptation of Knee Injury and Osteoarthritis Outcome Score (KOOS in to Persian and Testing Persian Version Reliability Among Iranians with Osteoarthritis

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Solaleh Saraei-Pour

2007-04-01

Full Text Available Objective: To achieve a reliable tool for measuring health related quality of life among Iranians with knee osteoarthritis, by translating and culturally adapting the Knee injury and Osteoarthritis Outcome Score(KOOS to Persian and testing the reliability and internal consistency of the Iranian version. Materials & Methods: It was a non experimental methodology study. KOOS was translated and adapted culturally to Persian language and culture in three phases with respect to IQOLA project. For examining test-retest reliability Iranians version of KOOS was corresponded twice with in at least two days or at most one week interval, by 30 Iranian people with knee OA whom were referred to Municipality and 110 physiotherapy clinics of Tehran with PT order by physicians. It was a non experimental methodological research and we used sample of convenience and non probability design for sampling. Psychometric evaluation: the collected data from the questionnaires was rated and analyzed with SPSS software from the aspects of test-retest reliability, absolute reliability, subscale and item internal consistency. Results: Internal consistency which was calculated by Cronbach '&alpha was high for all the subscales (at least 0.76, except for "symptom" subscale which was moderate, and showed that items of each subscale measured the same construct. Item internal consistency after correction for overlap, was higher than optimal value (0.4, except for the items of" symptom" subscale , which demonstrated good item internal consistency. SEM and ICC which were used for evaluating the absolute and test-retest reliability in respect showed that all the subscales had good test-retest reliability (0.7 and the absolute reliability was also very good in such away that the highest calculated SEM for Persian version was 7.44 which was less than Minimal Perceptible Clinical Improvement (MPCI that is estimated 8 to 10 for the KOOS questionnaire. Conclusion: With the Persian

Comparison of the responsiveness of the Harris Hip Score with generic measures for hip function in osteoarthritis of the hip.

NARCIS (Netherlands)

Hoeksma, H.L.; Ende, C.H.M. van den; Ronday, H.K.; Heering, A.; Breedveld, F.C.; Dekker, J.

2003-01-01

OBJECTIVE: To compare responsiveness of the Harris Hip Score with generic measures (that is, the Short Form-36 (SF-36), and a test of walking speed and pain during walking) in patients with osteoarthritis (OA) of the hip. METHOD: The first 75 cases within the population of a randomised clinical

Prevalence of lumbar spondylosis and its association with low back pain among community-dwelling Japanese women

OpenAIRE

Tsujimoto, Ritsu; Abe, Yasuyo; Arima, Kazuhiko; Nishimura, Takayuki; Tomita, Masato; Yonekura, Akihiko; Miyamoto, Takashi; Matsubayashi, Shohei; Tanaka, Natsumi; Aoyagi, Kiyoshi; Osaki, Makoto

2016-01-01

Background: Lumbar spondylosis is more prevalent among the middle-aged and elderly, but few population-based studies have been conducted, especially in Japan. The purpose of this study was to explore the prevalence of lumbar spondylosis and its associations with low back pain among community-dwelling Japanese women. Methods: Lateral radiographs of the lumbar spine were obtained from 490 Japanese women ≥ 40 years old, and scored for lumbar spondylosis using the Kellgren-Lawrence (KL) grade at ...

Do MRI features at baseline predict radiographic joint space narrowing in the medial compartment of the osteoarthritic knee 2 years later?

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Madan-Sharma, Ruby; Kornaat, Peter R.; Bloem, Johannes L.; Watt, Iain [Leiden University Medical Center, Department of Radiology, Leiden (Netherlands); Kloppenburg, Margreet; Botha-Scheepers, Stella A. [Leiden University Medical Center, Department of Rheumatology, Leiden (Netherlands); Graverand, Marie-Pierre Hellio le [Pfizer Groton, Groton, CT (United States)

2008-09-15

The purpose of the study was to relate magnetic resonance imaging (MRI) features at baseline with radiographically determined joint space narrowing (JSN) in the medial compartment of the knee after 2 years in a group of patients with symptomatic osteoarthritis at multiple joint sites. MRI of the knee and standardized radiographs were obtained at baseline and after 2 years in 186 patients (81% female; aged 43-76 years; mean 60 years). MRI was analyzed for bone marrow lesions, cysts, osteophytes, hyaline cartilage defects, joint effusion, and meniscal pathology in the medial compartment. Radiographs were scored semiquantitatively for JSN in the medial tibiofemoral joint using the Osteoarthritis Research Society International (OARSI) atlas. Radiological progression was defined as {>=}1 grade increase. Associations between baseline magnetic resonance (MR) parameters and subsequent radiographic JSN changes were assessed using logistic regression. Relative risk (RR) was then calculated. Radiographic progression of JSN was observed in 17 (9.1%) of 186 patients. Eleven patients had a Kellgren and Lawrence (KL) score of {>=}2. A significant association was observed between all patients and meniscal tears (RR 3.57; confidence interval (CI) 1.08-10.0) and meniscal subluxation (RR 2.73; CI 1.20-5.41), between KL<2 and meniscal subluxation (RR 11.3; CI 2.49-29.49) and KL {>=} 2 and meniscus tears (RR 8.91; CI 1.13-22.84) and radiographic JSN 2 years later. Follow-up MR in 15 of 17 patients with progressive JSN showed only new meniscal abnormalities and no progression of cartilage loss. Meniscal pathology (tears and/or meniscal subluxation) was the only MRI parameter to be associated with subsequent radiographic progression of JSN in the medial tibiofemoral compartment on a radiograph 2 years later, as assessed by the OARSI score. (orig.)

Correlation between Family APGAR scores and health-related quality of life of Filipino elderly patients with knee osteoarthritis.

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Lim, Anne T C; Manching, James; Penserga, Ester G

2012-08-01

This study aims to describe the clinical profile of Filipino patients with knee osteoarthritis (OA) and correlate their health-related quality of life (HrQoL) with perceived family support. This is a cross-sectional, analytical study of patients seen at the Philippine General Hospital Arthritis Clinic diagnosed with knee OA using the American College of Rheumatology classification criteria. Questionnaires for the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) v.3.1 and Family APGAR (Adaptation, Partnership, Growth, Affection and Resolve) were self-administered. Pearson's correlation, analysis of variance and Bonferroni tests were applied. Ninety patients with 3 : 1 female-to-male ratio, mean age of 70.14 years qualified for the study. Mean body mass index was 23.3. Mean duration of symptoms was 5.9 years. Fifty-three considered their family to be highly functional, 28 moderately dysfunctional and nine severely dysfunctional. Analysis showed that Family APGAR is moderately and inversely correlated with pain (r = -0.3373; P = 0.0002), stiffness (r = -0.3642; P = 0.0004), function (r = -0.3646; P = 0.0004) and total WOMAC scores (r = -0.3880; P = 0.0002). Likewise, there were significant differences of total WOMAC scores in the pain, stiffness and function subscales (P = 0.0076, P = 0.0032, P = 0.0165 and P = 0.0159, respectively) between patients in highly functional and severely dysfunctional families, and between highly and moderately functional families. As Family APGAR scores increased, there was significant decrease in all WOMAC subscales. We described the clinical profile of 90 elderly patients with knee OA and the relationship of HrQoL to Family APGAR scores. This paper concludes that higher Family APGAR scores in this population correlated with better HrQoL. © 2012 The Authors International Journal of Rheumatic Diseases © 2012 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

Longitudinal study on osteoarthritis and bone metabolism

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L. Postiglione

2011-09-01

Full Text Available Objective: The relationship between Osteoarthritis (OA and Osteoporosis (OP is not well defined due to lacking in longitudinal data, mainly regarding correlations between biochemical factors and OA incidence. Aim of this paper was to investigate the predictive value for OA incidence of bone mass variations and of selected biochemical markers in healthy women participating in a population-based longitudinal study carried out in Naples (Italy. Subjects and Methods: High completion rate (85.2% and statistically adequate sample size were obtained: 139 women (45 to 79 years of age were examined and follow up visit was performed after two years (24±2 months, following the same protocol. Patients underwent medical examination, questionnaire, anthropometric measurements, blood sampling and urine collection. Bone mineral density (BMD measurement was performed by dual energy X-ray absorptiometry (DEXA at the lumbar spine (L1-L4 and femoral neck. Radiographs of dorsal and lumbar spine in lateral view were performed at basal and at 24 months visits; a team of three experts scored radiographs using Kellegren and Lawrence grading. Results: The score was calculated for two individual radiographic features (narrowing of the joint space, presence of osteophytes and as a global score. Results show a relevant percentage, 23% up, of subjects presenting both OA and OP. In the cross-sectional study the presence of osteophytosis correlates with anthropometric variables and PTH levels. In the longitudinal study results show a correlation between serum vitamin D and delta score for osteophytosis (β=0.02 p<0.05. Conclusions: Data obtained outline the importance of further studies on the pathogenetic link between OA and bone metabolism.

Prevalence of diffuse idiopathic skeletal hyperostosis (DISH) of the whole spine and its association with lumbar spondylosis and knee osteoarthritis: the ROAD study.

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Kagotani, Ryohei; Yoshida, Munehito; Muraki, Shigeyuki; Oka, Hiroyuki; Hashizume, Hiroshi; Yamada, Hiroshi; Enyo, Yoshio; Nagata, Keiji; Ishimoto, Yuyu; Teraguchi, Masatoshi; Tanaka, Sakae; Nakamura, Kozo; Kawaguchi, Hiroshi; Akune, Toru; Yoshimura, Noriko

2015-03-01

We aimed to assess the prevalence of diffuse idiopathic skeletal hyperostosis (DISH) and its association with lumbar spondylosis (LS) and knee osteoarthritis (KOA) using a population-based cohort study entitled Research on Osteoarthritis/osteoporosis Against Disability (ROAD). In the baseline ROAD study, which was performed between 2005 and 2007, 1,690 participants in mountainous and coastal areas underwent anthropometric measurements and radiographic examinations of the whole spine (cervical, thoracic, and lumbar) and both knees. They also completed an interviewer-administered questionnaire. Presence of DISH was diagnosed according to Resnick criteria, and LS and KOA were defined as Kellgren-Lawrence (KL) grade ≥3. Among the 1,690 participants, whole-spine radiographs of 1,647 individuals (97.5%; 573 men, 1,074 women; mean age, 65.3 years) were evaluated. Prevalence of DISH was 10.8% (men 22.0%, women 4.8%), and was significantly higher in older participants (presence of DISH 72.3 years, absence of DISH 64.4 years) and mainly distributed at the thoracic spine (88.7%). Logistic regression analysis revealed that presence of DISH was significantly associated with older age [+1 year, odds ratio (OR): 1.06, 95% confidence interval (CI): 1.03-1.14], male sex (OR: 5.55, 95% CI: 3.57-8.63), higher body mass index (+1 kg/m(2), OR: 1.08, 95% CI: 1.02-1.14), presence of LS (KL2 vs KL0: 1, OR: 5.50, 95% CI: 2.81-10.8) (KL ≥3 vs KL0: 1, OR: 4.09, 95% CI: 2.08-8.03), and presence of KOA (KL ≥3 vs KL0: 1, OR: 1.89, 95% CI: 1.14-3.10) after adjusting for smoking, alcohol consumption, and residential area (mountainous vs coastal). This cross-sectional population-based study clarified the prevalence of DISH in general inhabitants and its significant association with LS and severe KOA.

Hip Inflammation MRI Scoring System (HIMRISS) to predict response to hyaluronic acid injection in hip osteoarthritis

DEFF Research Database (Denmark)

Deseyne, Nicolas; Conrozier, Thierry; Lellouche, Henri

2018-01-01

OBJECTIVE: To assess predictors of response, according to hip MRI inflammatory scoring system (HIMRISS), in a sample of patients with hip osteoarthritis (OA) treated by hyaluronic acid (HA) injection. METHOD: Sixty patients with hip OA were included. Clinical outcomes were assessed at baseline...... SP=0.97, sensitivity SN=0.39, and positive and negative predictive values of 0.91 and 0.64, respectively. CONCLUSION: HIMRISS is reliable for total scores and sub-domains. It permits identification of responders to HA injection in hip OA patients........64, 0.83 and 0.78. Associations between MRI features and clinical data were assessed. Logistic regression (univariate and multivariate) was used to explore associations between MRI features and response to HA injection, according to WOMAC50 response at three months. RESULTS: In total, 45.5% of patients...

Psychometric Properties of the Malay Language Version of Knee Injury and Osteoarthritis Outcome Score (KOOS Questionnaire among Knee Osteoarthritis Patients: A Confirmatory Factor Analysis

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Zulkifli MM

2017-07-01

Full Text Available INTRODUCTION: This study aimed to cross-culturally adapt a Malay version of Knee Injury and Osteoarthritis Outcome Score (KOOS and to evaluate its psychometric properties in patients with knee osteoarthritis (OA. MATERIALS AND METHODS: The English version KOOS was translated into a Malay version using forward and backward translation process, followed by face validity and content validity. Two hundred and twenty-six knee OA patients attending the Outpatient and Orthopaedic Clinics, Universiti Sains Malaysia Hospital, completed the Malay version KOOS. Construct validity using confirmatory factor analysis and internal reliability assessment were performed. RESULTS: The results showed that the original five-factor model with 42 items failed to achieve acceptable values of the goodness of fit indices, indicating poor model fit. A new five-factor model of 26 items demonstrated acceptable level of goodness of fit (comparative fit index= 0.929, incremental fit index= 0.930, Tucker Lewis fit index= 0.920, root mean square error of approximation= 0.073 and Chisquared/ degree of freedom= 2.183 indices to signify a model fit. The Cronbach’s alpha value for the new model ranged from 0.776 to 0.946. The composite reliability values of each construct ranged between 0.819 and 0.921, indicating satisfactory to high level of convergent validity. CONCLUSION: The five-factor model with 26 items in the Malay version of KOOS questionnaire demonstrated a good degree of goodness of fit and was found to be valid, reliable and simple as an assessment tool for symptoms, pain, activity of daily living, sports and recreational activity and quality of life for Malaysian adults suffering from knee osteoarthritis.

Knee Injury and Osteoarthritis Outcome Score (KOOS): systematic review and meta-analysis of measurement properties.

Science.gov (United States)

Collins, N J; Prinsen, C A C; Christensen, R; Bartels, E M; Terwee, C B; Roos, E M

2016-08-01

To conduct a systematic review and meta-analysis to synthesize evidence regarding measurement properties of the Knee injury and Osteoarthritis Outcome Score (KOOS). A comprehensive literature search identified 37 eligible papers evaluating KOOS measurement properties in participants with knee injuries and/or osteoarthritis (OA). Methodological quality was evaluated using the COSMIN checklist. Where possible, meta-analysis of extracted data was conducted for all studies and stratified by age and knee condition; otherwise narrative synthesis was performed. KOOS has adequate internal consistency, test-retest reliability and construct validity in young and old adults with knee injuries and/or OA. The ADL subscale has better content validity for older patients and Sport/Rec for younger patients with knee injuries, while the Pain subscale is more relevant for painful knee conditions. The five-factor structure of the original KOOS is unclear. There is some evidence that the KOOS subscales demonstrate sufficient unidimensionality, but this requires confirmation. Although measurement error requires further evaluation, the minimal detectable change for KOOS subscales ranges from 14.3 to 19.6 for younger individuals, and ≥20 for older individuals. Evidence of responsiveness comes from larger effect sizes following surgical (especially total knee replacement) than non-surgical interventions. KOOS demonstrates adequate content validity, internal consistency, test-retest reliability, construct validity and responsiveness for age- and condition-relevant subscales. Structural validity, cross-cultural validity and measurement error require further evaluation, as well as construct validity of KOOS Physical function Short form. Suggested order of subscales for different knee conditions can be applied in hierarchical testing of endpoints in clinical trials. PROSPERO (CRD42011001603). Copyright © 2016 Osteoarthritis Research Society International. Published by Elsevier Ltd. All

Differences between opening versus closing high tibial osteotomy on clinical outcomes and gait analysis.

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Deie, Masataka; Hoso, Takayuki; Shimada, Noboru; Iwaki, Daisuke; Nakamae, Atsuo; Adachi, Nobuo; Ochi, Mitsuo

2014-12-01

High tibial osteotomy (HTO) for medial knee osteoarthritis (OA) is mainly performed via two procedures: closing wedge HTO (CW) and opening wedge HTO (OW). In this study, differences between these procedures were assessed by serial clinical evaluation and gait analysis before and after surgery. Twenty-one patients underwent HTO for medial knee OA in 2011 and 2012, with 12 patients undergoing CW and nine undergoing OW. The severity of OA was classified according to the Kellgren-Lawrence classification. The Japanese Orthopedic Association score for assessment of knee OA (JOA score), the Numeric Rating Scale (NRS), and the femoral tibial angle (FTA) on X-ray were evaluated. For gait analysis, gait speed, varus moment, varus angle and lateral thrust were calculated. The JOA score and NRS were improved significantly one year postoperatively in both groups. The FTA was maintained in both groups at one year. Varus angle and varus moment were significantly improved in both groups at each postoperative follow-up, when compared preoperatively. Lateral thrust was significantly improved at three months postoperatively in both groups. However, the significant improvement in lateral thrust had disappeared in the CW group six months postoperatively, whereas it was maintained for at least one year in the OW group. This study found that clinical outcomes were well maintained after HTO. OW reduced knee varus moment and lateral thrust, whereas CW had little effect on reducing lateral thrust. Level IV. Copyright © 2014 Elsevier B.V. All rights reserved.

Dextrose Prolotherapy for Knee Osteoarthritis: A Randomized Controlled Trial

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Rabago, David; Patterson, Jeffrey J.; Mundt, Marlon; Kijowski, Richard; Grettie, Jessica; Segal, Neil A.; Zgierska, Aleksandra

2013-01-01

PURPOSE Knee osteoarthritis is a common, debilitating chronic disease. Prolotherapy is an injection therapy for chronic musculoskeletal pain. We conducted a 3-arm, blinded (injector, assessor, injection group participants), randomized controlled trial to assess the efficacy of prolotherapy for knee osteoarthritis. METHODS Ninety adults with at least 3 months of painful knee osteoarthritis were randomized to blinded injection (dextrose prolotherapy or saline) or at-home exercise. Extra- and intra-articular injections were done at 1, 5, and 9 weeks with as-needed additional treatments at weeks 13 and 17. Exercise participants received an exercise manual and in-person instruction. Outcome measures included a composite score on the Western Ontario McMaster University Osteoarthritis Index (WOMAC; 100 points); knee pain scale (KPS; individual knee), post-procedure opioid medication use, and participant satisfaction. Intention-to-treat analysis using analysis of variance was used. RESULTS No baseline differences existed between groups. All groups reported improved composite WOMAC scores compared with baseline status (P dextrose prolotherapy improved more (P <.05) at 52 weeks than did scores for patients receiving saline and exercise (score change: 15.3 ± 3.5 vs 7.6 ± 3.4, and 8.2 ± 3.3 points, respectively) and exceeded the WOMAC-based minimal clinically important difference. Individual knee pain scores also improved more in the prolotherapy group (P = .05). Use of prescribed postprocedure opioid medication resulted in rapid diminution of injection-related pain. Satisfaction with prolotherapy was high. There were no adverse events. CONCLUSIONS Prolotherapy resulted in clinically meaningful sustained improvement of pain, function, and stiffness scores for knee osteoarthritis compared with blinded saline injections and at-home exercises. PMID:23690322

Cross-cultural adaptation and validation of the reliability of the Thai version of the Hip disability and Osteoarthritis Outcome Score (HOOS).

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Trathitiphan, Warayos; Paholpak, Permsak; Sirichativapee, Winai; Wisanuyotin, Taweechok; Laupattarakasem, Pat; Sukhonthamarn, Kamolsak; Jeeravipoolvarn, Polasak; Kosuwon, Weerachai

2016-10-01

HOOS was developed as an extension of the Western Ontario and McMaster Universities' Osteoarthritis Index questionnaire for measuring symptoms and functional limitations related to the hip(s) of patients with osteoarthritis. To determine the validity and reliability of the Thai version of the Hip disability and Osteoarthritis Outcome Score (HOOS) vis-à-vis hip osteoarthritis, the original HOOS was translated into a Thai version of HOOS, according to international recommendations. Patients with hip osteoarthritis (n = 57; 25 males) were asked to complete the Thai version of HOOS twice: once then again after a 3-week interval. The test-retest reliability was analyzed using the intraclass correlation coefficient (ICC). Internal consistencies were analyzed using Cronbach's alpha, while the construct validity was tested by comparing the Thai HOOS with the Thai modified SF-36 and calculating the Spearman's rank correlation coefficients. The Thai HOOS produced good reliability (i.e., the ICC was greater than 0.9 in all five subscales). All of the Cronbach's alpha showed that the Thai HOOS had high internal consistency (Cronbach's alpha greater than 0.8), especially for the pain and ADL subscales (0.89 and 0.90, respectively). The Spearman's rank correlation for all five subscales of the Thai HOOS had moderate correlation with the Bodily Pain subscale of the Thai SF-36. The pain subscale of the Thai HOOS had a high correlation with the Vitality and Social Function subscales of the Thai SF-36 (r = 0.55 and 0.54)-with which the symptom subscale had a moderate correlation. The Thai version of HOOS had excellent internal consistency, excellent test-retest reliability, and good construct validity. It can be used as a reliable tool for assessing quality of life for patients with hip osteoarthritis in Thailand.

An update on risk factors for cartilage loss in knee osteoarthritis assessed using MRI-based semiquantitative grading methods

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Alizai, Hamza [Boston University School of Medicine, Quantitative Imaging Center, Department of Radiology, Boston, MA (United States); Aspetar Orthopaedic and Sports Medicine Hospital, Doha (Qatar); University of Texas Health Science Center at San Antonio, Department of Radiology, San Antonio, TX (United States); Roemer, Frank W. [Boston University School of Medicine, Quantitative Imaging Center, Department of Radiology, Boston, MA (United States); Aspetar Orthopaedic and Sports Medicine Hospital, Doha (Qatar); University of Erlangen-Nuremberg, Department of Radiology, Erlangen (Germany); Hayashi, Daichi [Boston University School of Medicine, Quantitative Imaging Center, Department of Radiology, Boston, MA (United States); Aspetar Orthopaedic and Sports Medicine Hospital, Doha (Qatar); Yale University School of Medicine, Department of Radiology, Bridgeport Hospital, Bridgeport, CT (United States); Crema, Michel D. [Boston University School of Medicine, Quantitative Imaging Center, Department of Radiology, Boston, MA (United States); Aspetar Orthopaedic and Sports Medicine Hospital, Doha (Qatar); Hospital do Coracao and Teleimagem, Department of Radiology, Sao Paulo (Brazil); Felson, David T. [Boston University School of Medicine, Clinical Epidemiology Research and Training Unit, Boston, MA (United States); Guermazi, Ali [Boston University School of Medicine, Quantitative Imaging Center, Department of Radiology, Boston, MA (United States); Aspetar Orthopaedic and Sports Medicine Hospital, Doha (Qatar); Boston Medical Center, Boston, MA (United States)

2014-11-07

Arthroscopy-based semiquantitative scoring systems such as Outerbridge and Noyes' scores were the first to be developed for the purpose of grading cartilage defects. As magnetic resonance imaging (MRI) became available faor evaluation of the osteoarthritic knee joint, these systems were adapted for use with MRI. Later on, grading methods such as the Whole Organ Magnetic Resonance Score, the Boston-Leeds Osteoarthritis Knee Score and the MRI Osteoarthritis Knee Score were designed specifically for performing whole-organ assessment of the knee joint structures, including cartilage. Cartilage grades on MRI obtained with these scoring systems represent optimal outcome measures for longitudinal studies, and are designed to enhance understanding of the knee osteoarthritis disease process. The purpose of this narrative review is to describe cartilage assessment in knee osteoarthritis using currently available MRI-based semiquantitative whole-organ scoring systems, and to provide an update on the risk factors for cartilage loss in knee osteoarthritis as assessed with these scoring systems. (orig.)

An update on risk factors for cartilage loss in knee osteoarthritis assessed using MRI-based semiquantitative grading methods

International Nuclear Information System (INIS)

Alizai, Hamza; Roemer, Frank W.; Hayashi, Daichi; Crema, Michel D.; Felson, David T.; Guermazi, Ali

2015-01-01

Arthroscopy-based semiquantitative scoring systems such as Outerbridge and Noyes' scores were the first to be developed for the purpose of grading cartilage defects. As magnetic resonance imaging (MRI) became available faor evaluation of the osteoarthritic knee joint, these systems were adapted for use with MRI. Later on, grading methods such as the Whole Organ Magnetic Resonance Score, the Boston-Leeds Osteoarthritis Knee Score and the MRI Osteoarthritis Knee Score were designed specifically for performing whole-organ assessment of the knee joint structures, including cartilage. Cartilage grades on MRI obtained with these scoring systems represent optimal outcome measures for longitudinal studies, and are designed to enhance understanding of the knee osteoarthritis disease process. The purpose of this narrative review is to describe cartilage assessment in knee osteoarthritis using currently available MRI-based semiquantitative whole-organ scoring systems, and to provide an update on the risk factors for cartilage loss in knee osteoarthritis as assessed with these scoring systems. (orig.)

Prevalence of falls and the association with knee osteoarthritis and lumbar spondylosis as well as knee and lower back pain in Japanese men and women.

Science.gov (United States)

Muraki, Shigeyuki; Akune, Toru; Oka, Hiroyuki; En-Yo, Yoshio; Yoshida, Munehito; Nakamura, Kozo; Kawaguchi, Hiroshi; Yoshimura, Noriko

2011-10-01

There is little information on falls by sex and age strata in Japan, and few factors associated with falls have been established. However, the association between bone and joint diseases and falls remains unclear. We examined prevalence of falls by sex and age strata, determined its association with radiographic osteoarthritis (OA) of the knee and lumbar spine, and determined knee and lower back pain after single and multiple falls. A questionnaire assessed the number of falls during 12 months preceding baseline. Knee and lumbar spine radiographs were read by Kellgren/Lawrence (K/L) grade; radiographic knee OA and lumbar spondylosis were defined as a K/L grade of 3 or 4. Knee and lower back pain were estimated by an interview. A total of 587 men and 1,088 women (mean ± SD age 65.3 ± 12.0 years) were analyzed. During 1 year, 79 (13.5%) men and 207 (19.0%) women reported at least 1 fall. With increasing age, the prevalence of multiple falls was higher in women, but lower in elderly men age >60 years. In men, few factors were significantly associated with falls. In women, radiographic knee OA and lumbar spondylosis, as well as knee and lower back pain, were significantly associated with multiple falls without adjustment. Lower back pain and knee pain were independently associated with multiple falls in women after adjustment. Lower back pain and knee pain were significantly associated with multiple falls in women. Copyright © 2011 by the American College of Rheumatology.

Correlation between Gene Expression and Osteoarthritis Progression in Human

NARCIS (Netherlands)

Zhong, Leilei; Huang, Xiaobin; Karperien, Hermanus Bernardus Johannes; Post, Janine Nicole

2016-01-01

Osteoarthritis (OA) is a multifactorial disease characterized by gradual degradation of joint cartilage. This study aimed to quantify major pathogenetic factors during OA progression in human cartilage. Cartilage specimens were isolated from OA patients and scored 0–5 according to the Osteoarthritis

Good Life with osteoArthritis in Denmark (GLA:D™)

DEFF Research Database (Denmark)

Skou, Søren Thorgaard; Roos, Ewa M.

2017-01-01

BACKGROUND: The uptake of evidence-based guidelines in clinical practice is suboptimal in osteoarthritis (OA) and other chronic diseases. Good Life with osteoArthritis in Denmark (GLA:D) was launched in 2013 with the aim of implementing guidelines for the treatment of knee and hip OA in clinical...... disability and Osteoarthritis Outcome Score (HOOS) quality of life subscale, 0-100, worst to best), number of patients on painkillers and sick leave, and access to care according to guidelines. RESULTS: Data from 9,825 participants from the GLA:D registry were utilised in the analyses. It was demonstrated...... months are pain intensity (0 to 100, best to worst), objective physical function (30-s chair-stand test and 40-m fast-paced walk test), physical activity (number of days per week being physically active for at least 30 min), quality of life (Knee injury and Osteoarthritis Outcome Score (KOOS) and the Hip...

Dynamic weight-bearing assessment of pain in knee osteoarthritis

DEFF Research Database (Denmark)

Klokker, Louise; Christensen, Robin; Wæhrens, Eva Elisabet Ejlersen

2016-01-01

-minute-walk-test (6MWT), and 6-min-walk-test with subsequent pain rating (6MWTpain), and once with a transition questionnaire (TRANS-Q) for the patient-reported change in pain after 12 weeks of exercise. Construct validity (baseline-scores) and responsiveness (change-scores) were estimated by Spearman Correlation...... a standing position). The purpose of this study is to evaluate the construct validity, responsiveness, and interpretability of the DAP for knee osteoarthritis (OA). METHODS: One-hundred participants with knee OA were tested twice each with the DAP, the Knee injury and Osteoarthritis Outcome Score (KOOS), six...

Dynamic weight-bearing assessment of pain in knee osteoarthritis

DEFF Research Database (Denmark)

Klokker, Louise; Christensen, Robin; Osborne, Richard

2015-01-01

PURPOSE: To evaluate the reliability, agreement and smallest detectable change in a measurement instrument for pain and function in knee osteoarthritis; the Dynamic weight-bearing Assessment of Pain (DAP). METHODS: The sample size was set to 20 persons, recruited from the outpatient osteoarthritis...... for intra-rater test (1.95). The three knee bend scores all had ICC above 0.50, showing fair-to-good reliability. None of the knee bend scores showed acceptable SEM and SDC. CONCLUSIONS: The reproducibility of the DAP pain score meets the demands for use in clinical practice and research. The total knee...

Balsam “Mercana-Artrovit warming” — efficacy and tolerability in knee osteoarthritis

Directory of Open Access Journals (Sweden)

E S Tsvetkova

2007-01-01

Full Text Available Objective. To assess efficacy, local and systemic tolerability of balsam “Mercana-Artrovit warming” (BMAW containing methylnicotinat, mint and eucalyptus ethereal oils, propylene glycol extracts of eucalyptus, linden, nettle, elecampane, common wormwood, tansy, terpentine oil in knee osteoarthritis (KOA Material and methods. 60 pts were included in a two-week double blind placebo controlled randomized study. BMAW 5 ml was administered in 30 pts (the main group twice a day (in the morning and in the evening on the target knee joint. 30 pts of control group received placebo containing only components of stuff. Demographic and clinical parameters in the main and the control groups were comparable. Inclusion criteria: age from 40 to 70 years, pain intensity in the target joint at least 40 mm on VAS, I-III radiological stage according to Kellgren, Leqesne score 4-10, treatment with NSAIDs during the previous 3 months. Exclusion criteria: indications for intra-articular glucocorticoid injection, clinically significant disturbances of internal organs function and skin damages in the region of knee joint. Clinical efficacy was assessed by WOMAC index, pain at movement and at rest, time of 15 meters walking, general assessment of efficacy (separately by the pt and by the doctor. Frequency and character of adverse events was registered. Results. Local BMAW administration provided statistically significant decrease of WO MAC summated score (p=0,008, pain at movement (p<0,001 and at rest (p<0,005. So analgesic effect of the drug is sufficient for improvement of functional activity of pts with KOA. General efficacy assessment was significantly higher in the main group (Fisher exact test, p<0,005. Placebo did not significantly change efficacy measures. Adverse events were absent in both groups. Conclusion. The results of the study allows to recommend BMAW for local therapy of KOA

European validation of The Comprehensive International Classification of Functioning, Disability and Health Core Set for Osteoarthritis from the perspective of patients with osteoarthritis of the knee or hip.

Science.gov (United States)

Weigl, Martin; Wild, Heike

2017-09-15

To validate the International Classification of Functioning, Disability and Health Comprehensive Core Set for Osteoarthritis from the patient perspective in Europe. This multicenter cross-sectional study involved 375 patients with knee or hip osteoarthritis. Trained health professionals completed the Comprehensive Core Set, and patients completed the Short-Form 36 questionnaire. Content validity was evaluated by calculating prevalences of impairments in body function and structures, limitations in activities and participation and environmental factors, which were either barriers or facilitators. Convergent construct validity was evaluated by correlating the International Classification of Functioning, Disability and Health categories with the Short-Form 36 Physical Component Score and the SF-36 Mental Component Score in a subgroup of 259 patients. The prevalences of all body function, body structure and activities and participation categories were >40%, >32% and >20%, respectively, and all environmental factors were relevant for >16% of patients. Few categories showed relevant differences between knee and hip osteoarthritis. All body function categories and all but two activities and participation categories showed significant correlations with the Physical Component Score. Body functions from the ICF chapter Mental Functions showed higher correlations with the Mental Component Score than with the Physical Component Score. This study supports the validity of the International Classification of Functioning, Disability and Health Comprehensive Core Set for Osteoarthritis. Implications for Rehabilitation Comprehensive International Classification of Functioning, Disability and Health Core Sets were developed as practical tools for application in multidisciplinary assessments. The validity of the Comprehensive International Classification of Functioning, Disability and Health Core Set for Osteoarthritis in this study supports its application in European patients with

Resurfacing hemiarthroplasty compared to stemmed hemiarthroplasty for glenohumeral osteoarthritis

DEFF Research Database (Denmark)

Rasmussen, Jeppe V; Olsen, Bo S; Sorensen, Anne Kathrine

2015-01-01

PURPOSE: The aim of this study was to conduct a randomised, clinical trial comparing stemmed hemiarthroplasty and resurfacing hemiarthroplasty in the treatment of glenohumeral osteoarthritis. METHODS: A total of 40 shoulders (35 patients) were randomised to stemmed hemiarthroplasty or resurfacing...... hemiarthroplasty and evaluated three and 12 months postoperatively using the Constant-Murley score (CMS) and Western Ontario Osteoarthritis of the Shoulder (WOOS) index. RESULTS: There were no statistically significant differences in age, gender or pre-operative scores except for WOOS at baseline. Two patients...

Effectiveness of fluoroscopy-guided intra-articular steroid injection for hip osteoarthritis

International Nuclear Information System (INIS)

Subedi, N.; Chew, N.S.; Chandramohan, M.; Scally, A.J.; Groves, C.

2015-01-01

Aim: To demonstrate the benefits of fluoroscopy-guided intra-articular steroid injection in the hip with varying degrees of disease severity, and to investigate the financial aspects of the procedure and impact on waiting time. Materials and methods: A prospective study was undertaken of patients who underwent fluoroscopic intra-articular steroid injection over the 9-month study period. Comparative analysis of the Oxford hip pain score pre- and 6–8 weeks post-intra-articular injection was performed. Hip radiographs of all patients were categorised as normal, mild, moderate, or severe disease (four categories) based on the modified Kellgren–Lawrence severity scale, and improvement on the Oxford hip pain score on each of these four severity categories were assessed. Results: Within the study cohort of 100 patients, the mean increase in post-procedure hip score of 7.32 points confirms statistically significant benefits of the therapy (p<0.001, 95% confidence interval: 5.55–9.09). There was no significant difference in pre-injection hip score or change in score between the four severity categories (p=0.51). Significant improvement in hip score (p<0.05) was demonstrated in each of the four severity categories 6–8 weeks post-injection. No associated complications were observed. Conclusion: The present study confirms that fluoroscopy-guided intra-articular steroid injection is a highly effective therapeutic measure for hip osteoarthritis across all grades of disease severity with significant cost savings and the potential to reduce waiting times. - Highlights: • Comparable clinical effectiveness of fluoroscopy guided and theatre based therapeutic intra-articular hip injections. • Significant cost savings on fluoroscopy guided hip injection performed in a radiology department. • A potential reduction in patients' waiting time for the procedure.

Induction of osteoarthritis by injecting monosodium iodoacetate into the patellofemoral joint of an experimental rat model.

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Takahashi, Ikufumi; Matsuzaki, Taro; Kuroki, Hiroshi; Hoso, Masahiro

2018-01-01

This study aimed to investigate the histopathological changes in the patellofemoral joint using a rat model of osteoarthritis that was induced using monosodium iodoacetate, and to establish a novel model of patellofemoral osteoarthritis in a rat model using histopathological analysis. Sixty male rats were used. Osteoarthritis was induced through a single intra-articular injection of monosodium iodoacetate in both knee joints. Animals were equally divided into two experimental groups based on the monosodium iodoacetate dose: 0.2 mg and 1.0 mg. Histopathological changes in the articular cartilage of the patellofemoral joint and the infrapatellar fat pad were examined at 3 days, 1 week, 2 weeks, 4 weeks, 8 weeks, and 12 weeks after the monosodium iodoacetate injection. In the 1.0-mg group, the representative histopathological findings of osteoarthritis were observed in the articular cartilage of the patellofemoral joint over time. Additionally, the Osteoarthritis Research Society International scores of the patellofemoral joint increased over time. The synovitis scores of the infrapatellar fat pad in both groups were highest at 3 days, and then the values decreased over time. The fibrosis score of the infrapatellar fat pad in the 1.0-mg group increased with time, whereas the fibrosis score in the 0.2-mg group remained low. Representative histopathological findings of osteoarthritis were observed in the articular cartilage of the patellofemoral joint in a rat model of osteoarthritis induced using monosodium iodoacetate. With appropriate selection, this model may be regarded as an ideal patellofemoral osteoarthritis model.

Cross-cultural translation and measurement properties of the Polish version of the Knee injury and Osteoarthritis Outcome Score (KOOS) following anterior cruciate ligament reconstruction

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Paradowski, Przemysław T; Witoński, Dariusz; Kęska, Rafał

2013-01-01

Knee Injury and Osteoarthritis Outcome Score (KOOS) is available in over 30 languages and a commonly used Patient-Reported Outcome (PRO) for assessment of treatment effects following knee surgery. The aim of the study was to report the linguistic translational process and evaluate the psychometri...... properties of the Polish version of the KOOS questionnaire....

Translation, cross-cultural adaptation, and psychometric properties of the German version of the hip disability and osteoarthritis outcome score.

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Blasimann, Angela; Dauphinee, Sharon Wood; Staal, J Bart

2014-12-01

Clinical measurement. To translate and cross-culturally adapt the Hip disability and Osteoarthritis Outcome Score (HOOS) from English into German, and to study its psychometric properties in patients after hip surgery. There is no specific hip questionnaire in German that not only measures symptoms and function but also contains items about hip-related quality of life. The translation and cross-cultural adaptation involved forward translation, harmonization, cognitive debriefing, back translation, and comparison to the original HOOS following international guidelines. The German version was tested in 51 Swiss inpatients 8 weeks after different types of hip surgery, mainly total hip replacement. The mean age of the participants was 62.5 years, and the age range was from 27 to 87 years. Thirty (58.8%) of the participants were women. Internal consistency and test-retest reliability were estimated using Cronbach alpha and intraclass correlation coefficients for agreement. For construct validity, total scores of the German HOOS were correlated with those of the Western Ontario and McMaster Universities Osteoarthritis Index. The HOOS was also compared to the Medical Outcomes Study 36-Item Short-Form Health Survey. Cronbach alpha values for all German HOOS subscales were between .87 and .93. For test-retest reliability, the intraclass correlation coefficient for agreement was 0.85 for the total scores of the German HOOS. The Spearman rho for the Medical Outcomes Study 36-Item Short-Form Health Survey physical functioning subscale compared to the sum of all HOOS subscales was 0.71, and that for the Medical Outcomes Study 36-Item Short-Form Health Survey physical component summary was 0.97. The German HOOS has demonstrated adequate reliability and validity. Use of the German HOOS is recommended for assessment of patients after hip surgery, with the proviso that additional psychometric testing should be done in future research.

Development of an imaging mitigation strategy for patient enrolment in the tanezumab nerve growth factor inhibitor (NGF-ab) program with a focus on eligibility assessment.

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Roemer, Frank W; Miller, Colin G; West, Christine R; Brown, Mark T; Sherlock, Sarah P; Kompel, Andrew J; Diaz, Luis; Galante, Nicholas; Crema, Michel D; Guermazi, Ali

2017-12-01

Nerve growth factor antibodies (NGF-ab) have shown promising analgesic efficacy. Aim was to describe reader training efforts and present reliability data focusing on radiographic eligibility in the tanezumab program. A multi-step process was used for reader calibration and reliability testing. First, a reference standard set of cases was created and diagnostic performance was evaluated. A second exercise focused on agreement of ordinal assessment (Kellgren-Lawrence grading) of radiographic osteoarthritis. Subsequently, 11 readers were trained and read a test set of 100 cases focused on eligibility assessments. Additional reliability testing and calibration of five core readers assessing eligibility of 30 cases was performed 3 and 6 months after study start. Sensitivity for the reference standard readings ranged from 0.50 to 0.90 and specificity from 0.40 to 0.83. Overall agreement for Kellgren-Lawrence grading ranged from 71.4% to 82.9%. For the 11 reader exercise, in 76% of cases at least 8 of 11 readers agreed on eligibility status. For the reliability testing 3 months after study start, in 80.0% of cases at least 4 of 5 readers agreed on eligibility with a κ = 0.43 (95% CI: 0.32-0.54). For the reliability testing after 6 months, in 83.3% of cases at least 4 of 5 readers agreed on eligibility with a κ = 0.52 (95% CI: 0.41-0.63). After intense efforts spent in the development of an imaging program for an NGF-ab clinical program, the achieved reliability for eligibility assessment is substantial but not perfect. Ongoing efforts of calibration prior to including additional readers to the program and during study conduct between current readers will be needed to ensure agreement on potential adverse events and radiographic disease severity. Copyright © 2017 Elsevier Inc. All rights reserved.

Preliminary study of highly cross-linked hyaluronic acid-based combination therapy for management of knee osteoarthritis-related pain

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Palmieri B

2013-01-01

Full Text Available Beniamino Palmieri,1,2 Valentina Rottigni,1,2 Tommaso Iannitti2,31Department of General Surgery and Surgical Specialties, University of Modena and Reggio Emilia Medical School, Surgical Clinic, Modena, Italy; 2Poliambulatorio del Secondo Parere, Modena, Italy; 3Department of Physiology, School of Medicine, University of Kentucky Medical Center, Lexington, KY, USABackground: Hyaluronic acid has been extensively used for treatment of knee osteoarthritis due to its anti-inflammatory properties and its ability to act as a synovial lubricant. Furthermore, it has found application in combination with other drugs in the dermatological field and in pre-clinical studies in animal models of osteoarthritis. Experimental evidence suggests that a combination of this macromolecule with other drugs may act as a slow-release depot. However, to date, to the best of our knowledge, no one has tested local intra-articular delivery of highly cross-linked hyaluronic acid combined with bisphosphonate or nonsteroidal anti-inflammatory drugs for management of knee osteoarthritis pain in the clinical setting. The aim of the present randomized double-blind study was to investigate, for the first time, the effect of a highly cross-linked hyaluronic acid, Variofill®, alone or in combination with diclofenac sodium or sodium clodronate, for management of bilateral knee osteoarthritis-related pain.Methods: Sixty-two patients with symptomatic bilateral medial tibiofemoral knee osteoarthritis (Kellgren–Lawrence grade II and III and pain in both knees corresponding to a daily visual analog scale (VAS score ≥ 30 in the month before the beginning of the study were included in this investigation. Patients were divided into three groups: group 1, treated with an injection of hyaluronic acid alone (66 mg into each knee; group 2, treated with an injection of hyaluronic acid (49.5 mg plus diclofenac sodium (5 mg into each knee; group 3, treated with an injection of hyaluronic acid

Mitochondrial DNA (mtDNA haplogroups and serum levels of anti-oxidant enzymes in patients with osteoarthritis

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Fernandez-Moreno Mercedes

2011-11-01

Full Text Available Abstract Background Oxidative stress play a main role in the initiation and progression of the OA disease and leads to the degeneration of mitochondria. To prevent this, the chondrocytes possess a well-coordinated enzymatic antioxidant system. Besides, the mitochondrial DNA (mtDNA haplogroups are associated with the OA disease. Thus, the main goal of this work is to assess the incidence of the mtDNA haplogroups on serum levels of two of the main antioxidant enzymes, Manganese Superoxide Dismutase (Mn-SOD or SOD2 and catalase, and to test the suitability of these two proteins for potential OA-related biomarkers. Methods We analyzed the serum levels of SOD2 and catalase in 73 OA patients and 77 healthy controls carrying the haplogroups J, U and H, by ELISA assay. Knee and hip radiographs were classified according to Kellgren and Lawrence (K/L scoring from Grade 0 to Grade IV. Appropriate statistical analyses were performed to test the effects of clinical variables, including gender, body mass index (BMI, age, smoking status, diagnosis, haplogroups and radiologic K/L grade on serum levels of these enzymes. Results Serum levels of SOD2 appeared statistically increased in OA patients when compared with healthy controls (p Conclusions The increased levels of SOD2 in OA patients indicate an increased oxidative stress OA-related, therefore this antioxidant enzyme could be a suitable candidate biomarker for diagnosis of OA. Mitochondrial haplogroups significantly correlates with serum levels of catalase

Functional outcome measures in a surgical model of hip osteoarthritis in dogs.

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Little, Dianne; Johnson, Stephen; Hash, Jonathan; Olson, Steven A; Estes, Bradley T; Moutos, Franklin T; Lascelles, B Duncan X; Guilak, Farshid

2016-12-01

The hip is one of the most common sites of osteoarthritis in the body, second only to the knee in prevalence. However, current animal models of hip osteoarthritis have not been assessed using many of the functional outcome measures used in orthopaedics, a characteristic that could increase their utility in the evaluation of therapeutic interventions. The canine hip shares similarities with the human hip, and functional outcome measures are well documented in veterinary medicine, providing a baseline for pre-clinical evaluation of therapeutic strategies for the treatment of hip osteoarthritis. The purpose of this study was to evaluate a surgical model of hip osteoarthritis in a large laboratory animal model and to evaluate functional and end-point outcome measures. Seven dogs were subjected to partial surgical debridement of cartilage from one femoral head. Pre- and postoperative pain and functional scores, gait analysis, radiographs, accelerometry, goniometry and limb circumference were evaluated through a 20-week recovery period, followed by histological evaluation of cartilage and synovium. Animals developed histological and radiographic evidence of osteoarthritis, which was correlated with measurable functional impairment. For example, Mankin scores in operated limbs were positively correlated to radiographic scores but negatively correlated to range of motion, limb circumference and 20-week peak vertical force. This study demonstrates that multiple relevant functional outcome measures can be used successfully in a large laboratory animal model of hip osteoarthritis. These measures could be used to evaluate relative efficacy of therapeutic interventions relevant to human clinical care.

Incidence and risk factors for radiographic lumbar spondylosis and lower back pain in Japanese men and women: the ROAD study.

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Muraki, S; Akune, T; Oka, H; Ishimoto, Y; Nagata, K; Yoshida, M; Tokimura, F; Nakamura, K; Kawaguchi, H; Yoshimura, N

2012-07-01

To determine the incidence of radiographic lumbar spondylosis (LS)and lower back pain, and their risk factors in Japan using a large-scale population from the nationwide cohort Research on Osteoarthritis/osteoporosis Against Disability (ROAD) Study. Participants in the ROAD study who had been recruited between 2005 and 2007 were followed up with lumbar spine radiography for 3 years. A total of 2,282 paired radiographs (75% of the original sample) were scored using Kellgren and Lawrence (KL) grades, and the incidence and progression rate of radiographic LS was analyzed. The incidence of lower back pain was also examined. In addition, associations between risk factors and incident and progressive radiographic LS as well as incident lower back pain were tested. Given a 3.3-year follow-up, the incidence of KL≥2 radiographic LS was 50.0% and 34.4% (15.3% and 10.5% per year), while that of KL≥3 LS was 15.3% and 23.7% (4.6% and 7.2% per year) in men and women, respectively. The progression rate of LS was 20.5% and 27.4% (6.2% and 8.3% per year) in men and in women, respectively. In addition, the incidence of lower back pain was 28.3% and 31.2% (8.6% and 9.5% per year) in men and women. Lower back pain was not significantly associated with incident radiographic LS, while a more severe KL grade at baseline was associated with incident lower back pain. The present longitudinal study revealed a high incidence of radiographic LS in Japan. Copyright © 2012 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Correlations among measures of knee stiffness, gait performance and complaints in individuals with knee osteoarthritis.

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Oatis, Carol A; Wolff, Edward F; Lockard, Margery A; Michener, Lori A; Robbins, Steven J

2013-03-01

Stiffness is a common complaint in individuals with knee osteoarthritis and is a component of the osteoarthritis diagnosis. Yet the relationship between stiffness and function is poorly understood and methods to quantify stiffness are limited. Using a cross-sectional observational design with 66 subjects with knee osteoarthritis, stiffness and damping coefficients were calculated from a relaxed knee oscillation procedure. Gait parameters were measured using an electronic walkway. Self-reported pain, stiffness, and function were measured with the Western Ontario and McMaster Osteoarthritis Index. Correlation and Alexander's normalized-t approximation analyses were used to assess associations among the variables. Subset analysis was performed on subjects with and without tibiofemoral joint crepitus. Slight to moderate correlations existed between stiffness and damping coefficients and most gait parameters ((| r |=0.30-0.56; PMcMaster Osteoarthritis Index scores and all gait parameters (| r |=0.35-0.62; Pcoefficient was only slightly associated with patient-rated Western Ontario and McMaster Osteoarthritis Index stiffness subscale scores. Subset analysis revealed significant correlations that differed between those with and without crepitus. These findings suggest that laboratory measured stiffness and damping coefficients, Western Ontario and McMaster Osteoarthritis Index scores and gait-related measurements assess different aspects related to movement in individuals with knee osteoarthritis. Stiffness and damping coefficients may offer the ability to explain gait changes in the knee that are independent of a person's perceptions particularly in the early stages of the disease. Copyright © 2013 Elsevier Ltd. All rights reserved.

The type 2 cannabinoid receptor regulates susceptibility to osteoarthritis in mice.

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Sophocleous, A; Börjesson, A E; Salter, D M; Ralston, S H

2015-09-01

Cannabinoid receptors and their ligands have been implicated in the regulation of various physiological processes but their role in osteoarthritis has not been investigated. The aim of this study was to evaluate the role of the type 2 cannabinoid receptor (Cnr2) in regulating susceptibility to osteoarthritis in mice. We analysed the severity of knee osteoarthritis as assessed by the Osteoarthritis Research Society International (OARSI) scoring system in mice with targeted deletion of Cnr2 (Cnr2(-/-)) and wild type (WT) littermates. Studies were conducted in mice subjected to surgical destabilisation of the medial meniscus (DMM) and in those with spontaneous age-related osteoarthritis (OA). Osteoarthritis was more severe following DMM in the medial compartment of the knee in Cnr2(-/-) compared with WT mice (mean ± sem score = 4.9 ± 0.5 vs 3.6 ± 0.3; P = 0.017). Treatment of WT mice with the CB2-selective agonist HU308 following DMM reduced the severity of OA in the whole joint (HU308 = 8.4 ± 0.2 vs vehicle = 10.4 ± 0.6; P = 0.007). Spontaneous age related osteoarthritis was also more severe in the medial compartment of the knee in 12-month old Cnr2(-/-) mice compared with WT (5.6 ± 0.5 vs 3.5 ± 0.3, P = 0.008). Cultured articular chondrocytes from Cnr2(-/-) mice produced less proteoglycans in vitro than wild type chondrocytes. These studies demonstrate that the Cnr2 pathway plays a role in the pathophysiology of osteoarthritis in mice and shows that pharmacological activation of CB2 has a protective effect. Further studies of the role of cannabinoid receptors in the pathogenesis of osteoarthritis in man are warranted. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Reliability and validity of Persian version of Western Ontario and McMaster Universities Osteoarthritis index in knee osteoarthritis

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Bina Eftekhar-Sadat

2015-08-01

Full Text Available Introduction: This study aimed to test the reliability and validity of translated and adapted version of Western Ontario and McMaster (WOMAC questionnaire in Persian language speaking patients with symptomatic osteoarthritis (OA of the knee. Methods: 100 consecutive patients, attended 3 major referral rehabilitation centers at the northwest of Iran, were asked to answer two disease-specific questionnaires WOMAC and knee injury and osteoarthritis outcome score (KOOS. The same patients were readmitted for refilling the same questionnaire 24-48 hours after the first visit. Internal consistency, reliability, and validity were assessed. Results: There were statistically significant correlations between WOMAC and KOOS in case of the pain (P < 0.001 and stiffness (P = 0.004 scores subclass, the sum of difficulty with performing daily activity (DPDA score (P = 0.001 and also the total score (P < 0.001. Internal consistency with Cronbach’s alpha for the pain, stiffness, and physical function subscales were 0.96, 0.98, and 0.99, respectively. Internal consistency with Cronbach’s alpha for the total score of WOMAC was 0.99. Conclusion: We found that this Persian version of WOMAC questionnaire is a reliable and valid version for evaluating the knee OA.

Indian Hedgehog signaling pathway members are associated with magnetic resonance imaging manifestations and pathological scores in lumbar facet joint osteoarthritis

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Shuang, Feng; Zhou, Ying; Hou, Shu-Xun; Zhu, Jia-Liang; Liu, Yan; Zhang, Chun-Li; Tang, Jia-Guang

2015-05-01

Indian Hedgehog (HH) has been shown to be involved in osteoarthritis (OA) in articular joints, where there is evidence that Indian HH blockade could ameliorate OA. It seems to play a prominent role in development of the intervertebral disc (IVD) and in postnatal maintenance. There is little work on IHH in the IVD. Hence the aim of the current study was to investigate the role of Indian Hedgehog in the pathology of facet joint (FJ) OA. 24 patients diagnosed with lumbar intervertebral disk herniation or degenerative spinal stenosis were included. Preoperative magnetic resonance imaging (MRI) and Osteoarthritis Research Society International (OARSI) histopathology grading system was correlated to the mRNA levels of GLI1, PTCH1, and HHIP in the FJs. The Weishaupt grading and OARSI scores showed high positive correlation (r = 0.894) (P < 0.01). MRI Weishaupt grades showed positive correlation with GLI1 (r = 0.491), PTCH1 (r = 0.444), and HHIP (r = 0.654) mRNA levels (P < 0.05 in each case). OARSI scores were also positively correlated with GLI1 (r = 0. 646), PTCH1 (r = 0. 518), and HHIP (r = 0.762) mRNA levels (P < 0.01 in each case). Cumulatively our findings indicate that Indian HH signaling is increased in OA and is perhaps a key component in OA pathogenesis and progression.

Reduced knee joint loading with lateral and medial wedge insoles for management of knee osteoarthritis: a protocol for a randomized controlled trial.

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Lewinson, Ryan T; Collins, Kelsey H; Vallerand, Isabelle A; Wiley, J Preston; Woodhouse, Linda J; Reimer, Raylene A; Worobets, Jay T; Herzog, Walter; Stefanyshyn, Darren J

2014-12-03

Knee osteoarthritis (OA) progression has been linked to increased peak external knee adduction moments (KAMs). Although some trials have attempted to reduce pain and improve function in OA by reducing KAMs with a wedged footwear insole intervention, KAM reduction has not been specifically controlled for in trial designs, potentially explaining the mixed results seen in the literature. Therefore, the primary purpose of this trial is to identify the effects of reduced KAMs on knee OA pain and function. Forty-six patients with radiographically confirmed diagnosis medial knee OA will be recruited for this 3 month randomized controlled trial. Recruitment will be from Alberta and surrounding areas. Eligibility criteria include being between the ages of 40 and 85 years, have knee OA primarily localized to the medial tibiofemoral compartment, based on the American College of Rheumatology diagnostic criteria and be classified as having a Kellgren-Lawrence grade of 1 to 3. Patients will visit the laboratory at baseline for testing that includes dual x-ray absorptiometry, biomechanical testing, and surveys (KOOS, PASE activity scale, UCLA activity scale, comfort visual analog scale). At baseline, patients will be randomized to either a wedged insole group to reduce KAMs, or a waitlist control group where no intervention is provided. The survey tests will be repeated at 3 months, and response to wedged insoles over 3 months will be evaluated. This study represents the first step in systematically evaluating the effects of reduced KAMs on knee OA management by using a patient-specific wedged insole prescription procedure rather than providing the same insole to all patients. The results of this trial will provide indications as to whether reduced KAMs are an effective strategy for knee OA management, and whether a personalized approach to footwear insole prescription is warranted. NCT02067208.

Autologous Fat Transfer for Thumb Carpometacarpal Joint Osteoarthritis: A Prospective Study.

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Herold, Christian; Rennekampff, Hans-Oliver; Groddeck, Robert; Allert, Sixtus

2017-08-01

Most operations for carpometacarpal joint osteoarthritis of the thumb irreversibly alter or destroy the anatomy. There is a high demand for minimally invasive alternatives. The authors report the results of autologous fat transfer for treatment of thumb carpometacarpal joint osteoarthritis. In a prospective study, 50 patients with thumb carpometacarpal joint osteoarthritis were observed for 1 year after autologous fat transfer. Manual liposuction and centrifugation were performed. Pain rating according to visual analogue pain scale; objective force of pinch grip and fist closure; and Disabilities of the Arm, Shoulder, and Hand questionnaire scores before and after treatment were analyzed. The average pain in stage 2 patients preoperatively was 7.7 ± 1.3; it was 1.8 ± 1.9 after 6 months and 2.4 ± 3.1 after 12 months. Patients with stage 2 osteoarthritis demonstrated a superior benefit from this treatment compared with patients with either stage 3 or stage 4 thumb carpometacarpal joint osteoarthritis. There were similar improvements for the parameters strength and Disabilities of the Arm, Shoulder, and Hand questionnaire score. No serious adverse events were observed. Autologous fat transplantation is an appealing alternative, especially in early-stage basal joint osteoarthritis of the thumb. The low invasiveness of the procedure and early recovery of patients compared with classical procedures such as trapeziectomy, and the superior long-term results compared with classical injection therapy, make this approach feasible as a first-line therapy in early-stage basal joint osteoarthritis of the thumb. Therapeutic, IV.

The prevalence of radiological glenohumeral osteoarthritis in long-term type 1 diabetes: the Dialong shoulder study.

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Juel, N G; Brox, J I; Hellund, J C; Holte, K B; Berg, T J

2017-12-14

This study compares the prevalence of radiological osteoarthritis (OA) in patients with type 1 diabetes mellitus (DM1) for > 45 years and controls, and explores the association with shoulder pain and glycaemic burden in patients with DM1. The Dialong study is a cross-sectional, observational study with 30 years of historical data on long-term glycaemic control. We included 102 patients with DM1 and 73 diabetes-free controls. Demographic data, worst shoulder pain last week [numeric rating scale (NRS) 0-10], pain on abduction at examination (NRS 0-10), and current and historical glycosylated haemoglobin (HbA 1c ) levels were collected. Standardized shoulder X-rays were taken and interpreted for OA applying the Kellgren-Lawrence classification. In the diabetes group (49% women), the mean ± sd duration of DM1 was 50.6 ± 4.8 years, mean 30 year HbA 1c 7.4%, and age 61.9 ± 7.1 years. The mean age of controls (57% women) was 62.6 ± 7.0 years. Radiological glenohumeral OA was found in 36 diabetes patients (35%) and 10 controls (14%) [odds ratio (OR) 3.4, 95% confidence interval (CI) 1.6 to 7.5; p = 0.002]. Few persons had moderate and severe OA [6.9% vs 1.3%, OR 5.3 (95% Cl 0.6 to 44.1); p = 0.1]. Fifteen diabetes patients had painful OA versus two controls (adjusted OR 5.4, 95% CI 0.6 to 47.9; p = 0.13). There was no association between OA and long-term glycaemic burden (mean 30 year HbA 1c ) in the diabetes group (p > 0.2). Radiological glenohumeral OA was more common in patients with DM1 than in controls for mild, but not moderate and severe OA. The radiological findings were not associated with shoulder pain or long-term glycaemic burden.

Meniscal Allograft Transplantation Does Not Prevent or Delay Progression of Knee Osteoarthritis.

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Catherine Van Der Straeten

Full Text Available Meniscal tears are common knee injuries. Meniscal allograft transplantation (MAT has been advocated to alleviate symptoms and delay osteoarthritis (OA after meniscectomy. We investigated (1 the long-term outcome of MAT as a treatment of symptomatic meniscectomy, (2 most important factors affecting survivorship and (3 OA progression.From 1989 till 2013, 329 MAT were performed in 313 patients. Clinical and radiographic results and MAT survival were evaluated retrospectively. Failure was defined as conversion to knee arthroplasty (KA or total removal of the MAT.Mean age at surgery was 33 years (15-57; 60% were males. No-to-mild cartilage damage was found in 156 cases, moderate-to-severe damage in 130. Simultaneous procedures in 118 patients included cartilage procedures, osteotomy or ACL-reconstruction. At a mean follow-up of 6.8 years (0.2-24.3years, 5 patients were deceased and 48 lost (14.6%, 186 MAT were in situ (56.5% whilst 90 (27.4% had been removed, including 63 converted to a KA (19.2%. Cumulative allograft survivorship was 15.1% (95% CI:13.9-16.3 at 24.0 years. In patients <35 years at surgery, survival was significantly better (24.1% compared to ≥35 years (8.0% (p = 0.017. In knees with no-to-mild cartilage damage more allografts survived (43.0% compared to moderate-to-severe damage (6.6% (p = 0.003. Simultaneous osteotomy significantly deteriorated survival (0% at 24.0 years (p = 0.010. 61% of patients underwent at least one additional surgery (1-11 for clinical symptoms after MAT. Consecutive radiographs showed significant OA progression at a mean of 3.8 years (p<0.0001. Incremental Kellgren-Lawrence grade was +1,1 grade per 1000 days (2,7yrs.MAT did not delay or prevent tibiofemoral OA progression. 19.2% were converted to a knee prosthesis at a mean of 10.3 years. Patients younger than 35 with no-to-mild cartilage damage may benefit from MAT for relief of symptoms (survivorship 51.9% at 20.2 years, but patients and healthcare payers

Long-term clinical and radiographic outcome of patello-femoral realignment procedures: a minimum of 15-year follow-up.

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Vivod, Gregor; Verdonk, Peter; Drobnič, Matej

2014-11-01

A retrospective single-centre study was focused on the long-term outcome after different patello-femoral (PF) realignment procedures. Thirty-nine patients treated for recurrent PF instability were examined after a mean post-operative time of 22.5 years. Their 78 knees were divided into: non-operated knees (NON-OPERATED)-N = 24, isolated proximal procedures (PROXIMAL)-N = 22, isolated distal procedures (DISTAL)-N = 10, and combined procedures (COMBINED)-N = 22. PF-related medical history together with clinical, subjective (KOOS and Kujala scores), and radiographic (Caton-Deschamps PF height index, Kellgren-Lawrence scale for tibio-femoral OA, and Iwano classification for PF OA) evaluation was conducted. PF re-dislocation rate was comparable between PROXIMAL (36%), DISTAL (20%), and COMBINED (32%). Isolated proximal procedures revealed less central patella positions (PROXIMAL 64%; DISTAL 90%; COMBINED 95%) and more frequent PF apprehension test (PROXIMAL 82%; DISTAL 40%, COMBINED 50%). KOOS and Kujala scores were similar in all three surgical subgroups, but significantly lower than in NON-OPERATED. Patellas were positioned lower after DISTAL, 0.8 (0.5-1.0) or COMBINED, 0.9 (0.4-1.3). Kellgren-Lawrence scores ≥2 were found in 42% NON-OPERATED, 37% PROXIMAL, 70% DISTAL, and 59% COMBINED, whereas Iwano classification ≥2 was confirmed in 46% NON-OPERATED, 64% PROXIMAL, 80% DISTAL, and 86% COMBINED. High PF re-dislocation rates together with a very high incidence of PF OA indicate that PF realignment strategies used traditionally had failed to reach their long-term expectations. The transfer of tibial tuberosity resulted in more constrained PF joints than isolated proximal procedures which allowed for more residual PF instability. Distal procedures additionally increased the likelihood for tibio-femoral OA. III.

A novel method to assess subchondral bone formation using [18F]NaF-PET in the evaluation of knee degeneration.

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Jonnakuti, Venkata S; Raynor, William Y; Taratuta, Elena; Werner, Thomas J; Alavi, Abass; Baker, Joshua F

2018-05-01

Fluorine-18-sodium fluoride-PET ([F]NaF-PET) facilitates direct assessment of subchondral bone formation to evaluate degeneration in articulating joints. No standards exist for the quantification of joint activity using [F]NaF-PET, and many techniques rely on focal uptake to characterize an entire region of interest. This study proposes a novel method of quantitative global knee analysis to assess regions of expected bone remodeling in the evaluation of knee degeneration. The study population consisted of 18 patients with rheumatoid arthritis who underwent [F]NaF-PET/computed tomography imaging. The maximum standardized uptake value (knee SUVmax) in addition to a target-to-background ratio (TBR) that represents global knee activity adjusted for systemic bone formation measured at the lateral femoral neck (global knee TBR) were calculated. A radiologist scored standard radiographs of the knee in nine patients using the Kellgren-Lawrence grading system. Patients with greater [F]NaF uptake demonstrated greater knee deterioration, which was corroborated by the radiograph findings. Average Kellgren-Lawrence grading was strongly associated with both global knee TBR (Spearman ρ=0.69, P=0.04) and knee SUVmax scores (Spearman ρ=0.93, P=0.0003). Assessment of global activity within the joint is a feasible and clinically useful technique for characterizing disease activity with a single value. Furthermore, a ratio based on systemic bone turnover in a nonarticulating, weight-bearing site adjusts for differences in bone formation related to bodyweight or metabolic bone diseases. We hypothesize that a global knee TBR score may be more sensitive at detecting changes in disease progression, as new spatially distinct lesions with a lower SUV that develop within an region of interest would not be detected by the SUVmax methodology. Longitudinal studies assessing sensitivity with larger patient cohorts are needed to further validate this methodology.

The patellofemoral pain and osteoarthritis subscale of the KOOS (KOOS-PF)

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Crossley, Kay M; Macri, Erin M; Cowan, Sallie M

2018-01-01

with patellofemoral pain and/or osteoarthritis and 14 health and medical clinicians. Item reduction was performed using data from patellofemoral cohorts (n=138). We used the COnsesus-based Standards for the selection of health Measurements INstruments guidelines to evaluate reliability, validity, responsiveness......BACKGROUND: Patellofemoral pain and osteoarthritis are prevalent and associated with substantial pain and functional impairments. Patient-reported outcome measures (PROMs) are recommended for research and clinical use, but no PROMs are specific for patellofemoral osteoarthritis, and existing PROMs...... for patellofemoral pain have methodological limitations. This study aimed to develop a new subscale of the Knee injury and Osteoarthritis Outcome Score for patellofemoral pain and osteoarthritis (KOOS-PF), and evaluate its measurement properties. METHODS: Items were generated using input from 50 patients...

The challenge of the definition of early symptomatic knee osteoarthritis: a proposal of criteria and red flags from an international initiative promoted by the Italian Society for Rheumatology.

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Migliore, Alberto; Scirè, Carlo Alberto; Carmona, Loreto; Herrero-Beaumont, Gabriel; Bizzi, Emanuele; Branco, Jaime; Carrara, Greta; Chevalier, Xavier; Collaku, Ledio; Aslanidis, Spiros; Denisov, Lev; Di Matteo, Luigi; Bianchi, Gerolamo; Diracoglu, Demirhan; Frediani, Bruno; Maheu, Emmanuel; Martusevich, Natalia; Bagnato, Gian Filippo; Scarpellini, Magda; Minisola, Giovanni; Akkoc, Nurullah; Ramonda, Roberta; Barskova, Tatiana; Babic-Naglic, Durda; Muelas, Jose Vicente Moreno; Ionescu, Ruxandra; Rashkov, Rasho; Damjanov, Nemanja; Cerinic, Marco Matucci

2017-08-01

The aim of this study was to establish consensus for potential early symptomatic knee osteoarthritis (ESKOA) clinical definition and referral criteria from primary care to rheumatologists, based on available data from literature and a qualitative approach, in order to perform studies on patients fulfilling such criteria and to validate the obtained ESKOA definition. A complex methodological approach was followed including: (1) three focus groups (FG), including expert clinicians, researchers and patients; (2) a systematic literature review (SLR); (3) two discussion groups followed by a Delphi survey. FG and SLR were performed in parallel to inform discussion groups in order to identify relevant constructs to be included in the modified Delphi survey. ESKOA is defined in the presence of: (a) two mandatory symptoms (knee pain in the absence of any recent trauma or injury and very short joint stiffness, lasting for less than 10 min, when starting movement) even in the absence of risk factors, or (b) knee pain, and 1 or 2 risk factors or (c) three or more risk factors in the presence of at least one mandatory symptom, with symptoms lasting less than 6 months. These criteria are applicable in the absence of active inflammatory arthritis, generalized pain, Kellgren-Lawrence grade >0, any recent knee trauma or injury, and age lower than 40 years. Knee pain in the absence of any recent trauma lasting for less than 6 months was considered as the referral criterion to the rheumatologist for the suspicion of ESKOA. This consensus process has identified provisional clinical definition of ESKOA and defined potential referral criterion to rheumatologist, in order to test ESKOA obtained definition in prospective validation studies.

Arthritis self-efficacy scale scores in knee osteoarthritis: a systematic review and meta-analysis comparing arthritis self-management education with or without exercise.

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Brand, Emily; Nyland, John; Henzman, Cameron; McGinnis, Mark

2013-12-01

Systematic literature review and meta-analysis. To evaluate studies that used arthritis self-management education alone or with exercise to improve Arthritis Self-Efficacy Scale scores of patients with knee osteoarthritis. Increasing self-efficacy may improve patient knee osteoarthritis symptom management and function. MEDLINE (1946-March 2013), CINAHL (1981-March 2013), and PsycINFO (1967-March 2013) databases were searched. Twenty-four studies, including 3163 subjects (women, n = 2547 [80.5%]; mean ± SD age, 65.3 ± 6.5 years), met the inclusion criteria. A meta-analysis was performed to compare the standardized mean difference effect sizes (Cohen d) of randomized controlled studies that used the Arthritis Self-Efficacy Scale pain (13 studies, n = 1906), other symptoms (13 studies, n = 1957), and function (5 studies, n = 399) subscales. Cohen d effect sizes were also calculated for cohort studies that used the Arthritis Self-Efficacy Scale pain (10 studies, n = 1035), other symptoms (9 studies, n = 913), and function (3 studies, n = 141) subscales. Both randomized controlled studies and cohort studies were grouped by intervention type (intervention 1, arthritis self-management education alone; intervention 2, arthritis self-management education with exercise), and effect sizes were compared (Mann-Whitney U tests, Pmanagement education with exercise displayed higher methodological quality scale scores (76.8 ± 13.1 versus 61.6 ± 19.6, P = .03). Statistically significant standardized effect-size differences between intervention 1 and intervention 2 were not observed. Small to moderate effect sizes were observed regardless of whether the intervention included exercise. Exercise interventions used in conjunction with arthritis self-management education programs need to be developed to better enhance the self-efficacy of patients with knee osteoarthritis. Therapy, level 2b-.

Development and reliability of a multi-modality scoring system for evaluation of disease progression in pre-clinical models of osteoarthritis: celecoxib may possess disease-modifying properties.

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Panahifar, A; Jaremko, J L; Tessier, A G; Lambert, R G; Maksymowych, W P; Fallone, B G; Doschak, M R

2014-10-01

We sought to develop a comprehensive scoring system for evaluation of pre-clinical models of osteoarthritis (OA) progression, and use this to evaluate two different classes of drugs for management of OA. Post-traumatic OA (PTOA) was surgically induced in skeletally mature rats. Rats were randomly divided in three groups receiving either glucosamine (high dose of 192 mg/kg) or celecoxib (clinical dose) or no treatment. Disease progression was monitored utilizing micro-magnetic resonance imaging (MRI), micro-computed tomography (CT) and histology. Pertinent features such as osteophytes, subchondral sclerosis, joint effusion, bone marrow lesion (BML), cysts, loose bodies and cartilage abnormalities were included in designing a sensitive multi-modality based scoring system, termed the rat arthritis knee scoring system (RAKSS). Overall, an inter-observer correlation coefficient (ICC) of greater than 0.750 was achieved for each scored feature. None of the treatments prevented cartilage loss, synovitis, joint effusion, or sclerosis. However, celecoxib significantly reduced osteophyte development compared to placebo. Although signs of inflammation such as synovitis and joint effusion were readily identified at 4 weeks post-operation, we did not detect any BML. We report the development of a sensitive and reliable multi-modality scoring system, the RAKSS, for evaluation of OA severity in pre-clinical animal models. Using this scoring system, we found that celecoxib prevented enlargement of osteophytes in this animal model of PTOA, and thus it may be useful in preventing OA progression. However, it did not show any chondroprotective effect using the recommended dose. In contrast, high dose glucosamine had no measurable effects. Copyright © 2014 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Osteoarthritis after rotator cuff repair: A 10-year follow-up study.

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Flurin, P-H; Hardy, P; Valenti, P; Meyer, N; Collin, P; Kempf, J-F

2017-06-01

Joint surgery is often complicated by gradual bone and cartilage deterioration that eventually leads to secondary osteoarthritis. The primary objective of this study was to identify preoperative risk factors for gleno-humeral osteoarthritis after rotator cuff repair. The secondary objectives were to assess whether the risk of gleno-humeral osteoarthritis was influenced by the operative technique, occurrence of postoperative complications, cuff healing, and muscle degeneration and to determine whether gleno-humeral osteoarthritis affected the clinical outcome. The development of gleno-humeral osteoarthritis affects the postoperative clinical outcome. A retrospective multicentre study of patients who underwent rotator cuff repair in 2003 and were re-evaluated at least 10 years later was conducted under the aegis of the Société française de chirurgie orthopédique et traumatique (SOFCOT). Osteoarthritis severity was graded according to the Samilson-Prieto classification. Four hundred and one patients were included. At last follow-up, at least 10 years after surgery, the radiological Samilson-Prieto grades were distributed as follows: 0, n=181 (45%); 1, n=142 (n=35%); 2, n=57 (14%); 3, n=14 (4%); and 4, n=7 (2%). The mean Constant score was significantly higher in the patients without than with osteoarthritis at last follow-up (79/100 vs. 73/100, Posteoarthritis was significantly higher in the group with unhealed or re-torn cuffs (Sugaya type 4 or 5) than in the group with healed cuffs (Sugaya type 1, 2, or 3) (46% vs. 25%, P=0.012). Our study showed no associations linking the risk of gleno-humeral osteoarthritis to the patient activity profile, history of shoulder injury, or preoperative symptom duration. In contrast, statistically significant associations were identified between gleno-humeral osteoarthritis and age, male gender, initial tear severity, and the pain and mobility components of the preoperative Constant score. Decreased invasiveness of the

Comparison of continuous and intermittent treatment of patients with knee osteoarthritis with combined drug “Teraflex”

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L I Alexeeva

2008-01-01

Full Text Available Objective. To assess efficacy, safety and aftereffect duration of continuous and intermittent treatment of patients with knee osteoarthritis with “Teraflex”. Material and methods. 100 outpatients (2 groups 50 pts in each mainly women (99 pts with knee osteoarthritis 0I-III stage according to Kellgren-Lawrence fulfilling ACR criteria aged 45 to 73 years (mean age 57,8+7,39 years with pain at walking 40 mm and more on visual analog scale (VAS, regularly receiving NSAIDs for 30 days during previous 3 months were included. Follow up duration was 12 months (9 months — treatment and 3 months follow up to assess drug effect in both groups. Group 1 pts received continuous treatment with “Teraflex” during 9 months. Group 2 pts received the drug during 3 months, then treatment was interrupted for 3 months and after that 3-months course was repeated. Ibuprofen was given as a rescue medication 400 mg trice a day with possibility of subsequent decrease of dose. WOMAC index (assessment of pain, stiffness and functional disability, walking speed (15 m, efficacy assessment by doctor ant pt (improvement, absence of response, deterioration, status assessment by doctop and pt (very good, good, moderate, bad, veiy bad, daily requirement in NSAIDs, knee joint sonographic examination data were used as outcome measures. Results. Analgesic effect was achieved in both groups already after 1 month of therapy. At three months not only pain but also stiffness, joint function, WOMAC summated index and walking speed significantly improved in both groups. This improvement was maintained till the end of treatment in both groups. But group 2 pts at 6 months (before the beginning of the second course of treatment showed small increase of pain in damaged joint and summated WOMAC index which significantly differed from group 1 pts. At the end of treatment and in 3 months after the end of treatment these measures did not significantly differed in both groups. At the end

Body Mass Index and Western Ontario & McMaster Universities Osteoarthritis Index in Patients with Knee Osteoarthritis in Dr. Hasan Sadikin General Hospital, Bandung in November 2012

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Ainna Binti Mohamad Dat

2015-09-01

Full Text Available Background: Osteoarthritis is one of the major disabilities among elderly. One of its well-recognized potent risk factors is obesity. The aim of this study was to identify the body mass index and severity of knee osteoarthritis patients who were treated in Dr. Hasan Sadikin General Hospital Bandung. Methods: A descriptive study was carried out to 9 patients of the Medical Rehabilitation Policlinic at Dr. Hasan Sadikin General Hospital Bandung in November 2012. Patients were diagnosed as having knee Osteoarthritis based on American College of Rheumatology clinical classification. Exclusion criteria were patient having previous trauma in spine and lower limb, having bleeding disorder like hemophilia, incomplete data in medical records and incomplete data in questionnaire. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC was used to measure the intensity of pain, stiffness, and functional difficulty. The weight (kg and height (cm of the patients were measured and the Body Mass Index was calculated by Weight (kg/Height² (m. The data were analyzed using frequency distribution. Results: The patients who came to the Medical Rehabilitation Policlinic had ranged in age from 57 to78 years, mostly female with knee Osteoarthritis bilateral. Out of 9 patients, 5 patients were overweight, followed by normal BMI and obese type I. Patient with obese type 1 had the highest WOMAC score. Conclusions: Most of the patients with knee osteoarthritis bilateral are overweight and the patient with obese type 1 has the highest WOMAC score.

Adipokine hormones and hand osteoarthritis: radiographic severity and pain.

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Mei Massengale

Full Text Available Obesity's association with hand osteoarthritis cannot be fully explained by mechanical loading. We examined the relationship between adipokines and radiographic hand osteoarthritis severity and pain.In a pilot study of 44 hand osteoarthritis patients (39 women and 5 men, serum adipokine concentrations and hand x-ray Kallman-scores were analyzed using linear regression models. Secondary analyses examined correlates of hand pain.The cohort had a mean age of 63.5 years for women and 72.6 for men; mean (standard deviation Kallman-scores were 43.3(17.4 for women and 46.2(10.8 for men. Mean body-mass-index was 30 kg/m(2 for women and men. Mean leptin concentration was 32.2 ng/ml (women and 18.5 ng/ml (men; mean adiponectin-total was 7.9 ng/ml (women and 5.3 ng/ml (men; mean resistin was 7.3 ng/ml (women and 9.4 ng/ml (men. No association was found between Kallman-scores and adipokine concentrations (R(2 = 0.00-0.04 unadjusted analysis, all p-values>0.22. Secondary analyses showed mean visual-analog-scale pain of 4.8(2.4 for women and 6.6(0.9 for men. Leptin, BMI, and history of coronary artery disease were found to be associated with visual-analog-scale scores for chronic hand pain (R(2 = 0.36 unadjusted analysis, p-values≤0.04.In this pilot study, we found that adipokine serum concentrations were not associated with hand osteoarthritis radiographic severity; the most important correlates of joint damage were age and disease duration. Leptin serum concentration, BMI, and coronary artery disease were associated with the intensity of chronic hand OA pain.

Knee awareness and functionality after simultaneous bilateral vs unilateral total knee arthroplasty

DEFF Research Database (Denmark)

Latifi, Roshan; Thomsen, Morten Grove; Kallemose, Thomas

2016-01-01

AIM: To investigate knee awareness and functional outcomes in patients treated with simultaneous bilateral vs unilateral total knee arthroplasty (TKA). METHODS: Through a database search, we identified 210 patients who had undergone unilateral TKA (UTKA) and 65 patients who had undergone......-surgical treatments were failed, thus preoperatively the patients had poor functionality. All patients were asked to complete Forgotten Joint Score (FJS) and Oxford Knee Score (OKS) questionnaires. The patients were matched according to age, gender, year of surgery, Kellgren-Lawrence score and pre- and postoperative...... overall knee alignment. The FJS and OKS questionnaire results of the two groups were then compared. RESULTS: A mixed-effects model was used to analyze differences between SBTKA and UTKA. OKS: The mean difference in the OKS between the patients who had undergone SBTKA and those who had undergone UTKA was 1...

Decision quality instrument for treatment of hip and knee osteoarthritis: a psychometric evaluation

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Kearing Stephen A

2011-07-01

Full Text Available Abstract Background A high quality decision requires that patients who meet clinical criteria for surgery are informed about the options (including non-surgical alternatives and receive treatments that match their goals. The aim of this study was to evaluate the psychometric properties and clinical sensibility of a patient self report instrument, to measure the quality of decisions about total joint replacement for knee or hip osteoarthritis. Methods The performance of the Hip/Knee Osteoarthritis Decision Quality Instrument (HK-DQI was evaluated in two samples: (1 a cross-sectional mail survey with 489 patients and 77 providers (study 1; and (2 a randomized controlled trial of a patient decision aid with 138 osteoarthritis patients considering total joint replacement (study 2. The HK-DQI results in two scores. Knowledge items are summed to create a total knowledge score, and a set of goals and concerns are used in a logistic regression model to develop a concordance score. The concordance score measures the proportion of patients whose treatment matched their goals. Hypotheses related to acceptability, feasibility, reliability and validity of the knowledge and concordance scores were examined. Results In study 1, the HK-DQI was completed by 382 patients (79% and 45 providers (58%, and in study 2 by 127 patients (92%, with low rates of missing data. The DQI-knowledge score was reproducible (ICC = 0.81 and demonstrated discriminant validity (68% decision aid vs. 54% control, and 78% providers vs. 61% patients and content validity. The concordance score demonstrated predictive validity, as patients whose treatments were concordant with their goals had more confidence and less regret with their decision compared to those who did not. Conclusions The HK-DQI is feasible and acceptable to patients. It can be used to assess whether patients with osteoarthritis are making informed decisions about surgery that are concordant with their goals.

Lumbar spondylosis, lumbar spinal stenosis, knee pain, back muscle strength are associated with the locomotive syndrome: Rural population study in Japan.

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Chiba, Daisuke; Tsuda, Eiichi; Wada, Kanichiro; Kumagai, Gentaro; Sasaki, Eiji; Nawata, Atsushi; Nakagomi, Sho; Takahashi, Ippei; Nakaji, Shigeyuki; Ishibashi, Yasuyuki

2016-05-01

To comprehensively investigate the clinical and physical factors associating with locomotive syndrome (Loc-S); the locomotorium-disability for daily life. 647 volunteers participated (247 males, 400 females, Age: 58.4 ± 11.0, BMI: 22.5 ± 3.3). Three self-assessment questionnaires were administered: 1) "25-question Geriatric Locomotive Function Scale" (GFLS-25) for evaluating Loc-S (GLFS-25 ≥ 16 defined as Loc-S); 2) "diagnostic support tool for LSS" (LSS-DST) for evaluating the prevalence of lumbar spinal stenosis (LSS); 3) Knee injury and Osteoarthritis Outcome Score (KOOS). Plain radiographs of the bilateral knees and lumbar spine were evaluated, and the severity of lumbar spondylosis (LS) and knee osteoarthritis (KOA) defined by Kellgren-Lawrence grade. Bone status was evaluated by using the osteo-sono assessment index (OSI) at the calcaneus. Isometric muscle strength of trunk and leg (Nm/kg, both extension and flexion) were evaluated. Linear regression analysis was performed to elucidate the factors concerned with GFLS-25 including age, sex, and BMI. Thirty-nine subjects (6.0%, 13 males, 26 females) were defined as having Loc-S. Single regression model showed that age, height, BMI, skeletal muscle mass, OSI, LSS, KOOS, the severity of LS and KOA, and trunk- and leg-muscle strength were correlated with the degree of GLFS-25. Stepwise multiple regression model showed that sex, height, LSS, KOOS, the severity of LS, and back muscle strength were significantly correlated with that of GLFS-25. In this cross-sectional study, pain status associated with LSS and knee joint, structural severity for LS, and back muscle strength primarily affected the degree of GFLS-25. For managing Loc-S, we must pay more intensive attention to these factors. Copyright © 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

Clinical efficacy and safety over two years use of glucosamine, chondroitin sulfate, their combination, celecoxib or placebo taken to treat osteoarthritis of the knee: a GAIT report

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Shi, Helen; Finco, Martha F; Dunlop, Dorothy D; Harris, Crystal L; Singer, Nora G; Bradley, John D; Silver, David; Jackson, Christopher G; Lane, Nancy E; Oddis, Chester V; Wolfe, Fred; Lisse, Jeffrey; Furst, Daniel E; Bingham, Clifton O; Reda, Domenic J; Moskowitz, Roland W; Williams, H James; Clegg, Daniel O

2011-01-01

Objectives Osteoarthritis (OA) of the knee is a major cause of pain and limited function in older adults. Longer-term studies of medical therapy of OA are uncommon. This study was undertaken to evaluate the efficacy and safety of glucosamine and chondroitin sulfate (CS), alone or in combination, as well as celecoxib and placebo on painful knee OA over 24 months. Methods A 24-month, double-blind, placebo controlled study, conducted at 9 sites in the United States ancillary to the Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT), enrolled 662 patients with knee OA who satisfied radiographic criteria (Kellgren/ Lawrence [K/L] grade 2 or grade 3 changes and JSW of at least 2 mm at baseline). Patients who had been randomized to 1 of the 5 groups in GAIT continued to receive glucosamine 500 mg 3 times daily, CS 400 mg 3 times daily, the combination of glucosamine and CS, celecoxib 200 mg daily, or placebo over 24 months. The primary outcome measure was the number who reached a 20% reduction in WOMAC pain over 24 months. Secondary outcomes included reaching an OMERACT/OARSI response and change from baseline in WOMAC pain and function. Results The odds of achieving a 20%WOMAC were 1.21 for celecoxib, 1.16 for glucosamine, 0.83 for glucosamine and chondroitin sulfate and 0.69 for chondroitin sulfate alone with widely overlapping confidence intervals for all treatments. Conclusions Over 2 years, no treatment achieved a clinically important difference in WOMAC Pain or Function as compared with placebo. However, glucosamine and celecoxib showed beneficial trends. Adverse reactions were not meaningfully different among treatment groups and serious adverse events were rare for all therapies. PMID:20525840

Topical Ginger Treatment With a Compress or Patch for Osteoarthritis Symptoms.

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Therkleson, Tessa

2014-09-01

This article is a report of a study evaluating changes in health status before and after topical ginger treatment for adults with moderate to severe osteoarthritis. In 2011, 20 adults with chronic osteoarthritis were randomly assigned to one of two groups for 7 consecutive days of topical ginger treatment by trained nurses: Group 1 received a manually prepared ginger compress and Group 2 a standardized ginger patch. Participants had the option to continue self-treatment using the ginger patch for a further 24 weeks. A brief arthritis health questionnaire was completed weekly for 3 weeks and 4 weekly for 24 weeks. The mean scores for Group 1 and Group 2 show a notable decline following 1-week topical ginger treatment; scores in pain, fatigue, global effect, and functional status reduced by 48%, 49%, 40%, and 31%, respectively, whereas health satisfaction improved from 80% dissatisfied to 70% satisfied. Scores for all participants in all five domains progressively reduced over the following 24 weeks of self-treatment. Topical ginger treatment has the potential to relieve symptoms, improve the overall health, and increase independence of people with chronic osteoarthritis. © The Author(s) 2013.

CURRENT PHARMACOTHERAPY FOR KNEE OSTEOARTHRITIS: SPECIFIC FEATURES OF SYMPTOMATIC AND DISEASE MODIFYING EFFECTS. COMMUNICATION 1. SPECIFIC FEATURES OF THE SYMPTOMATIC EFFECTS OF CURRENT DRUGS TO TREAT KNEE OSTHEOARTHRITIS

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E. S. Tsvetkova

2015-01-01

Full Text Available Objective: to study the specific features of the symptomatic effect and tolerability of acetaminophen, glucosamine sulfate (GS, chondroitin sulfate (CS, and meloxicam in patents with knee osteoarthritis (OA. Subjects and methods. An 18-month open-label randomized prospective parallel-group trial enrolled 80 patients with knee OA who fulfilled the American College of Rheumatology criteria and signed the informed consent. They had Kellgren and Lawrence grades O-III OA with visual analogue scale pain intensity of ≥ 40 mm in the target knee, a body mass index of ≤ 35 kg/m2, and no clinical dysfunctions of vital organs and systems. The patients were randomized into 4 groups: 1 acetaminophen 2 g daily; 2 a standard GS regimen; 3 a standard CS regimen; 4 meloxicam 15 mg daily. The patients were followed up for 18 months. The effectiveness was evaluated by the WOMAC questionnaire, Leguesne index, and OMERACT-OARSI (D scenario during 8 visits. Laboratory and clinical examination as well as electrocardiography were performed. Adverse events were recorded during each visit.Results. After 4 weeks of treatment, symptomatic improvement was noted in all groups; however, the best effect was achieved by the use of meloxicam that ensured an obvious improvement in all patients. According to the OMERACT-OARSI criteria and changes in the WOMAC and Leguesne indices, the total efficacy of meloxicam was also highest. 20, 10, and 15% of the patients failed to respond to treatment in the acetaminophen, GS, and CS groups, respectively. Conclusion. The results of this trial suggest that it is expedient to use GS, CS, and meloxicam long, support the recent guidelines of the European Society for Clinical and Economic Aspects of Osteoporosis and OA (ESCEO, and can give proofs of the efficiency and safety of GS, CS, and meloxicam used in the treatment of knee OA.

Clinical efficacy of radiation synovectomy in digital joint osteoarthritis

International Nuclear Information System (INIS)

Kampen, Willm Uwe; Hellweg, Leif; Massoudi-Nickel, Schirin; Czech, Norbert; Henze, Eberhard; Brenner, Winfried

2005-01-01

Radiation synovectomy was developed for local treatment of rheumatoid arthritis. In this study, the long-term efficacy of radiation synovectomy was retrospectively evaluated in patients with osteoarthritis (activated arthrosis) of the digital joints using an algofunctional score. Fifty-three digital joints in 29 patients (mean age 64.8 years) were treated by intra-articular injection of 169 Er citrate. All joints were painful despite pharmacotherapy and showed an elevated blood pool pattern in a pretherapeutic three-phase bone scan, indicative for local synovitis. The patients were asked to classify their complaints with respect to different daily manual activities on a ten-step pain scale from 1 (total disability) to 10 (lack of any impairment) prior to and after treatment, with a mean follow-up of 41 months. Local signs of osteoarthritis such as joint swelling or pain were additionally evaluated and were scored from progression of complaints to excellent improvement based on patient self-evaluation. All patients reported a pronounced improvement in their manual activities. The mean total score of 4.73±0.58 for all activities prior to treatment increased significantly to 6.79±0.47 after radiation synovectomy (p<0.05). The best results were obtained in the thumb base joints, whereas distal interphalangeal joints were frequently resistant to therapy. Radiation synovectomy is highly effective in digital joint osteoarthritis with concomitant local synovitis. (orig.)

Clinical efficacy of radiation synovectomy in digital joint osteoarthritis

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Kampen, Willm Uwe; Hellweg, Leif; Massoudi-Nickel, Schirin; Czech, Norbert; Henze, Eberhard [University Hospital Schleswig-Holstein, Clinic of Nuclear Medicine, Kiel (Germany); Brenner, Winfried [University Hospital Hamburg-Eppendorf, Department of Nuclear Medicine (Germany)

2005-04-01

Radiation synovectomy was developed for local treatment of rheumatoid arthritis. In this study, the long-term efficacy of radiation synovectomy was retrospectively evaluated in patients with osteoarthritis (activated arthrosis) of the digital joints using an algofunctional score. Fifty-three digital joints in 29 patients (mean age 64.8 years) were treated by intra-articular injection of{sup 169}Er citrate. All joints were painful despite pharmacotherapy and showed an elevated blood pool pattern in a pretherapeutic three-phase bone scan, indicative for local synovitis. The patients were asked to classify their complaints with respect to different daily manual activities on a ten-step pain scale from 1 (total disability) to 10 (lack of any impairment) prior to and after treatment, with a mean follow-up of 41 months. Local signs of osteoarthritis such as joint swelling or pain were additionally evaluated and were scored from progression of complaints to excellent improvement based on patient self-evaluation. All patients reported a pronounced improvement in their manual activities. The mean total score of 4.73{+-}0.58 for all activities prior to treatment increased significantly to 6.79{+-}0.47 after radiation synovectomy (p<0.05). The best results were obtained in the thumb base joints, whereas distal interphalangeal joints were frequently resistant to therapy. Radiation synovectomy is highly effective in digital joint osteoarthritis with concomitant local synovitis. (orig.)

The effect of self-administered superficial local hot and cold application methods on pain, functional status and quality of life in primary knee osteoarthritis patients.

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Aciksoz, Semra; Akyuz, Aygul; Tunay, Servet

2017-12-01

To investigate the effect of the self-administered superficial local hot and cold applications on pain, and the functional status and the quality of life in primary knee osteoarthritis patients. Superficial local hot and cold application is used as a nonpharmacological method for the treatment of knee osteoarthritis. However, various guidelines for the management of knee osteoarthritis have conflicting recommendation for hot and cold therapy. A randomised clinical trial design. The sample consisted of patients (n = 96) who were diagnosed with primary knee osteoarthritis. During the application stage, patients were designated to the hot and cold application groups and administered hot and cold application twice a day for 3 weeks together with standard osteoarthritis treatment. The control group only used standard osteoarthritis treatment. The data were collected with a Descriptive Information Form, a Pain Scale, the WOMAC Osteoarthritis Index, the Nottingham Health Profile (NHP) and a Patient Satisfaction Evaluation Form. Outcome measures included pain intensity, functional status and quality of life. We found decreased primary measurement pain scores and improved functional status scores and quality of life scores after the application programme compared to the pre-application stage in both the hot and cold application groups. Once the application was completed, the pain scores, functional status scores and quality-of-life scores on the second measurements were found to be still statistically lower than the pre-application scores but higher than the first measurement ([p  .05). It was found that both hot and cold application resulted in a mild improvement in pain, functional status and quality of life, but this improvement was not sufficient to create a significant difference between the groups. This study contributes to the literature on hot and cold application methods as self-management strategies for patients with knee osteoarthritis. © 2017 John Wiley

The association between changes in synovial fluid levels of ARGS-aggrecan fragments, progression of radiographic osteoarthritis and self-reported outcomes: a cohort study

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Larsson, S; Englund, M; Struglics, A

2012-01-01

of tibiofemoral or patellofemoral OA according to the Osteoarthritis Research Society International (OARSI) atlas, and scored patient-reported outcomes using the Knee Injury and Osteoarthritis Outcome Score (KOOS). Using logistic regression (adjusted for age, gender, body mass index, time between examinations...

Association of Exercise Therapy and Reduction of Pain Sensitivity in Patients With Knee Osteoarthritis

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Henriksen, Marius; Klokker, Louise; Graven-Nielsen, Thomas

2014-01-01

OBJECTIVE: Exercise has beneficial effects on pain in knee osteoarthritis (OA), yet the underlying mechanisms are unclear. The purpose of this study was to investigate the effects of exercise on pressure-pain sensitivity in patients with knee OA. METHODS: In a randomized controlled trial...... visual analog scale pain scores during constant pressure for 6 minutes at 125% of the PPT as a measure of temporal summation (TS) of pressure-pain. Secondary outcomes included self-reported pain using the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire. Analyses were based on the "per...

Ability of the Canine Brief Pain Inventory to detect response to treatment in dogs with osteoarthritis

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Boston, Raymond C.; Coyne, James C.; Farrar, John T.

2010-01-01

Objective To determine whether the Canine Brief Pain Inventory (CBPI) can detect changes in dogs with osteoarthritis treated with an NSAID or a placebo. Design Double-blind, randomized, placebo-controlled clinical trial. Animals 70 dogs with osteoarthritis. Procedures Owners completed the CBPI on day 0. Dogs received carprofen or a placebo on days 1 through 14. Owners completed the CBPI again on day 14. Pain severity and pain interference scores from the CBPI were calculated, and the change from day 0 to day 14 was assessed within each group and between groups. Results No significant differences were detected in median scores for pain severity (3.50 and 3.25 on days 0 and 14, respectively) and pain interference (3.92 and 3.25 on days 0 and 14, respectively) in dogs receiving the placebo. Dogs receiving carprofen had significant changes in median scores for pain severity (4.25 to 2.25 on days 0 and 14, respectively) and pain interference (4.33 to 2.67 on days 0 and 14, respectively). There was a significantly greater improvement in pain severity and pain interference scores in dogs treated with carprofen, compared with improvement in scores for dogs receiving the placebo. Conclusions and Clinical Relevance The CBPI was able to detect improvements in pain scores in dogs with osteoarthritis treated with an NSAID or a placebo. These results, in combination with previous reliability and validity testing, support the use of the CBPI to obtain quantifiable assessments from owners regarding the severity and impact of chronic pain and treatment for dogs with osteoarthritis. PMID:19180716

Effectiveness of etofenamate for treatment of knee osteoarthritis: a randomized controlled trial

Directory of Open Access Journals (Sweden)

Güner S

2016-11-01

Full Text Available Savaş Güner,1 Mehmet Ata Gökalp,1 Abdurrahim Gözen,1 Seyyid Şerif Ünsal,1 Şükriye İlkay Güner2 1Department of Trauma and Orthopedic Surgery, Medical School, Yuzuncu Yil University, 2School of Health, Yuzuncu Yil University, Van, Turkey Abstract: The intramuscular application of etofenamate in the treatment of knee osteoarthritis was not observed in the existing English language literature. The objectives of this study were to compare the efficacy of etofenamate versus hyaluronic acid (HA in reducing joint pain and functional improvement for mild to moderate knee osteoarthritis. The patients were randomly divided into etofenamate (n=29 and HA (n=30 groups. Intramuscular etofenamate injection was administered as a series of seven intramuscular injections at intervals of 1 day. Intra-articular HA injection was administered as a series of three intra-articular injections at intervals of 1 week. Clinical evaluation was made before the first injection and again both 6 and 12 months after the last injection. The evaluation consisted of patient-assessed pain on a visual analog scale (VAS and on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC. Statistical significance was found for the etofenamate group when comparing preinjection with 12 months postinjection VAS scores (P<0.05. Statistical significance was also found for the HA group when comparing preinjection with 12 months postinjection VAS and WOMAC scores (P<0.05. However, there was no significant difference between the etofenamate and HA groups in terms of VAS or WOMAC scores measured at 12 months after injection (P>0.05. Results from this study indicated that, etofenamate treatment was not significantly more effective than HA treatment. However, both methods were effective and successful in treating knee osteoarthritis. Keywords: knee osteoarthritis, arthralgia, treatment, etofenamate, nonsteroidal anti-inflammatory drugs

[Efficacy of chondroitin sulphate in the treatment of elderly patients with gonarthrosis and coxarthrosis].

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Lazebnik, L B; Drozdov, V N

2005-01-01

To study chondroitin sulphate (CS) efficacy, tolerance and response duration in elderly patients with osteoarthrosis (OA) with consideration of OA duration and stage. A total of 97 patients aged 65-85 years with stage II-IV OA by Kellgren-Lawrence received CS treatment. The treatment efficacy was assessed by functional Lecken's index, pain intensity at walking and rest, general functional condition, need in nonsteroid anti-inflammatory (NSAI) drugs. Standardization was achieved with visual analogue scale (VAS). Positive effects (pain relief, better functional parameters, lower intake of NSAI drugs) were more pronounced and stable in patients with OA stage 1 and 2. In OA of stage 3 and 4, a beneficial effect of a 6-month CS course was unstable. Side effects were at the level of mean statistics. CS (structum) is recommended for treatment of OA stage 1-4 by Kellgren-Lawrence. Duration of the treatment depends on severity of x-ray symptoms of the disease.

The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) in Persian Speaking Patients with Knee Osteoarthritis.

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Ebrahimzadeh, Mohammad H; Makhmalbaf, Hadi; Birjandinejad, Ali; Keshtan, Farideh Golhasani; Hoseini, Hosein A; Mazloumi, Seyed Mahdi

2014-03-01

Osteoarthritis of the knee is the most common chronic joint disease that involves middle aged and elderly persons. There are different clinical instruments to quantify the health status of patients with knee osteoarthritis and one example is the WOMAC score that has been translated and adapted into different languages. The purpose of this study was cultural adaptation, validation and reliability testing of the Persian version of the WOMAC index in Iranians with knee osteoarthritis. We translated the original WOMAC questionnaire into Persian by the forward and backward technique, and then its psychometric study was done on 169 native Persian speaking patients with knee degenerative joint disease. Mean age of patients was 53.9 years. The SF-36 and KOOS were used to assess construct validity. Reliability testing resulted in a Cronbach's alpha of 0.917, showing the internal consistency of the questionnaire to be a reliable tool. Inter-correlation matrix among different scales of the Persian WOMAC index yielded a highly significant correlation between all subscales including stiffness, pain, and physical function. In terms of validity, Pearson`s correlation coefficient was significant between three domains of the WOMAC with PF, RP, BP, GH, VT, and PCS dimensions of the SF-36 health survey (P<0.005) and KOOS (P<0.0001) . The Persian WOMAC index is a valid and reliable patient- reported clinical instrument for knee osteoarthritis.

Osteoarthritis

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Osteoarthritis is the most common form of arthritis. It causes pain, swelling, and reduced motion in your ... it affects your hands, knees, hips or spine. Osteoarthritis breaks down the cartilage in your joints. Cartilage ...

The effect of glucosamine and/or chondroitin sulfate on the progression of knee osteoarthritis: a report from the glucosamine/chondroitin arthritis intervention trial.

Science.gov (United States)

Sawitzke, Allen D; Shi, Helen; Finco, Martha F; Dunlop, Dorothy D; Bingham, Clifton O; Harris, Crystal L; Singer, Nora G; Bradley, John D; Silver, David; Jackson, Christopher G; Lane, Nancy E; Oddis, Chester V; Wolfe, Fred; Lisse, Jeffrey; Furst, Daniel E; Reda, Domenic J; Moskowitz, Roland W; Williams, H James; Clegg, Daniel O

2008-10-01

Osteoarthritis (OA) of the knee causes significant morbidity and current medical treatment is limited to symptom relief, while therapies able to slow structural damage remain elusive. This study was undertaken to evaluate the effect of glucosamine and chondroitin sulfate (CS), alone or in combination, as well as celecoxib and placebo on progressive loss of joint space width (JSW) in patients with knee OA. A 24-month, double-blind, placebo-controlled study, conducted at 9 sites in the United States as part of the Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT), enrolled 572 patients with knee OA who satisfied radiographic criteria (Kellgren/Lawrence [K/L] grade 2 or grade 3 changes and JSW of at least 2 mm at baseline). Patients with primarily lateral compartment narrowing at any time point were excluded. Patients who had been randomized to 1 of the 5 groups in the GAIT continued to receive glucosamine 500 mg 3 times daily, CS 400 mg 3 times daily, the combination of glucosamine and CS, celecoxib 200 mg daily, or placebo over 24 months. The minimum medial tibiofemoral JSW was measured at baseline, 12 months, and 24 months. The primary outcome measure was the mean change in JSW from baseline. The mean JSW loss at 2 years in knees with OA in the placebo group, adjusted for design and clinical factors, was 0.166 mm. No statistically significant difference in mean JSW loss was observed in any treatment group compared with the placebo group. Treatment effects on K/L grade 2 knees, but not on K/L grade 3 knees, showed a trend toward improvement relative to the placebo group. The power of the study was diminished by the limited sample size, variance of JSW measurement, and a smaller than expected loss in JSW. At 2 years, no treatment achieved a predefined threshold of clinically important difference in JSW loss as compared with placebo. However, knees with K/L grade 2 radiographic OA appeared to have the greatest potential for modification by these treatments.

Patient, Provider, and Combined Interventions for Managing Osteoarthritis in Primary Care: A Cluster Randomized Trial.

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Allen, Kelli D; Oddone, Eugene Z; Coffman, Cynthia J; Jeffreys, Amy S; Bosworth, Hayden B; Chatterjee, Ranee; McDuffie, Jennifer; Strauss, Jennifer L; Yancy, William S; Datta, Santanu K; Corsino, Leonor; Dolor, Rowena J

2017-03-21

A single-site study showed that a combined patient and provider intervention improved outcomes for patients with knee osteoarthritis, but it did not assess separate effects of the interventions. To examine whether patient-based, provider-based, and patient-provider interventions improve osteoarthritis outcomes. Cluster randomized trial with assignment to patient, provider, and patient-provider interventions or usual care. (ClinicalTrials.gov: NCT01435109). 10 Duke University Health System community-based primary care clinics. 537 outpatients with symptomatic hip or knee osteoarthritis. The telephone-based patient intervention focused on weight management, physical activity, and cognitive behavioral pain management. The provider intervention involved electronic delivery of patient-specific osteoarthritis treatment recommendations to providers. The primary outcome was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total score at 12 months. Secondary outcomes were objective physical function (Short Physical Performance Battery) and depressive symptoms (Patient Health Questionnaire). Linear mixed models assessed the difference in improvement among groups. No difference was observed in WOMAC score changes from baseline to 12 months in the patient (-1.5 [95% CI, -5.1 to 2.0]; P = 0.40), provider (2.5 [CI, -0.9 to 5.9]; P = 0.152), or patient-provider (-0.7 [CI, -4.2 to 2.8]; P = 0.69) intervention groups compared with usual care. All groups had improvements in WOMAC scores at 12 months (range, -3.7 to -7.7). In addition, no differences were seen in objective physical function or depressive symptoms at 12 months in any of the intervention groups compared with usual care. The study involved 1 health care network. Data on provider referrals were not collected. Contrary to a previous study of a combined patient and provider intervention for osteoarthritis in a Department of Veterans Affairs medical center, this study found no statistically

Green tea (Camellia sinensis) for patients with knee osteoarthritis: A randomized open-label active-controlled clinical trial.

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Hashempur, Mohammad Hashem; Sadrneshin, Sara; Mosavat, Seyed Hamdollah; Ashraf, Alireza

2018-02-01

Green tea is known as a dietary supplement and a novel functional food worldwide. Since there are increasing preclinical evidence about efficacy of green tea for treating osteoarthritis, this study has aimed at assessing its efficacy and safety for patients with knee osteoarthritis. This is a randomized open-label active-controlled clinical trial. As many as fifty adults with osteoarthritis of knee were randomly allocated to receive the green tea extract (in dosage form of tablet) plus diclofenac tablet as "intervention group"; or: diclofenac tablet alone as "control group" for a period of four weeks. Patients were assessed at the beginning of intervention, and then 4 weeks later, in terms of pain score via visual analogue scale (VAS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire's total score in addition to its 3 sub-scores. Furthermore, they were asked about any adverse effects during intervention period. Mean differences of VAS pain, total WOMAC, and WOMAC physical function scores in green tea group showed a significant reduction, compared with the control group (P = 0.038, P = 0.006, and P = 0.004, respectively). However, No significant differences between the two groups were observed, regarding mean differences of WOMAC pain and stiffness scores of the enrolled patients (P = 0.163, and P = 0.150, respectively). Additionally, only 1 patient reported gastric upset [in control group]. It seems that green tea extract might well be considered as an adjunctive treatment both for control of pain and for the betterment of knee joint physical function in adults with osteoarthritis. However, further studies of longer duration and larger sample size are needed. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Patient-reported outcome and risk of revision after shoulder replacement for osteoarthritis

DEFF Research Database (Denmark)

Rasmussen, Jeppe V; Polk, Anne; Brorson, Stig

2014-01-01

PURPOSE: We used patient-reported outcome and risk of revision to compare hemiarthroplasty (HA) with total shoulder arthroplasty (TSA) and stemmed hemiarthroplasty (SHA) with resurfacing hemiarthroplasty (RHA) in patients with glenohumeral osteoarthritis. PATIENTS AND METHODS: We included all...... of presentation, the raw scores were converted to a percentage of the maximum score. Revision rates were calculated by checking reported revisions to the DSR until December 2011. WOOS and risk of revision were adjusted for age, sex, previous surgery, and type of osteoarthritis. RESULTS: There were 113 TSAs...... and 1096 HAs (837 RHAs and 259 SHAs). Patients treated with TSA generally had a better WOOS, exceeding the predefined minimal clinically important difference, at 1 year (mean difference 10, p

[Gluteal muscle contracture release for the treatment of gluteal muscle contracture induced knee osteoarthritis: a report of 52 cases].

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Wang, Cheng-xiang; Gong, Yu-suo; Li, Sheng-hua; Liu, Hai-ping; Chai, Xi-ping

2011-07-01

To investigate clinical efficacy and significance of gluteal muscle contracture release for the treatment of gluteal muscle contracture induced knee osteoarthritis. From January 2008 to June 2010,52 patients with gluteal muscle contracture induced knee osteoarthritis were reviewed. Among the patients,15 patients were male and 37 patients were female, ranging in age from 15 to 45 years, with an average of 35 years. Eighteen patients had left knee osteoarthritis, 30 patients had right osteoarthritis, and 4 patients had double knee osteoarthritis. All the patients were treated with gluteal muscle contracture release. Lysholm knee score was used to evaluate therapeutic effects before and after operation. All the patients were followed up,and the duration ranged from 12 to 37 years,with a mean of 15 months. The Lysholm knee score improved from preoperative (68.12 +/- 0.78) points to postoperative (91.23 +/- 0.47) points at the last follow-up, the difference had statistical difference (t=31.269, Pmuscle contracture release is effective to relieve symptoms of gluteal muscles contracture and knee osteoarthritis. The patients with gluteal muscle contracture should be treated early so as to prevent effects of gluteal muscle contracture on knee joint, slow down degeneration of knee joint at early stage, and prevent occurrence of knee osteoarthritis.

T. E. Lawrence: Theorist and Campaign Planner

Science.gov (United States)

1992-05-12

honors in history, Lawrence’s curiosity lead him to the works of Carl von Clausewitz, Henri Jomini. Karl von Willisen, Rudolf von Caemmerer, Helmut von...113. M. J. Steiner . Inside Pan-Arabia. (Chicago: Herxiricks House, 1947), Chap 7. 114. T. E. Lawrence, "The Evolution of a Revolt," p65. 115. T. E...Unity. New York: Devin-Adair, 1958. Steiner . M. J. Inside Pan-Arabia. Chicago: Hendricks House. 1947. Thomas, Lowell. With Lawrence in Arabia. New York

Measurement of the bone mineral density of the os calcis as an indication of vertebral fracture in women with lumbar osteoarthritis

International Nuclear Information System (INIS)

Kotzki, P.-O.; Buyck, D.; Leroux, J.-L.; Thomas, E.; Rossi, M.

1993-01-01

In women with lumbar osteoarthritis, measurement of the os calcis bone mineral density (BMD) using dual-energy X-ray absorptiometry (DEXA) as an indication of vertebral fracture was evaluated. The in vivo precision of the method was 1.28%. Age-and sex-matched control curves were evaluated using a control of 193 females. Correlation between spine BMD and os calcis BMD was significant (r = 0.65, p<<0.001). For osteoporotic women without osteoarthritis (34), there was no significant difference in spine and the os calcis Z-score (-1.99SD and -1.83SD respectively). For osteoporotic women with osteoarthritis (30) the spine Z-score was -0.49SD; the os calcis Z-scores was -1.92SD. The difference was significant (p<0.001). Receiver operating characteristic (ROC) curves demonstrate the superiority of the os calcis as a measurement site over the lumbar spine, in correlation with existing crush fractures in the presence of osteoarthritis. (author)

Can the ICF osteoarthritis core set represent a future clinical tool in measuring functioning in persons with osteoarthritis undergoing hip and knee joint replacement?

Science.gov (United States)

Alviar, Maria Jenelyn; Olver, John; Pallant, Julie F; Brand, Caroline; de Steiger, Richard; Pirpiris, Marinis; Bucknill, Andrew; Khan, Fary

2012-11-01

To determine the dimensionality, reliability, model fit, adequacy of the qualifier levels, response patterns across different factors, and targeting of the International Classification of Functioning, Disability and Health (ICF) osteoarthritis core set categories in people with osteoarthritis undergoing hip and knee arthroplasty. The osteoarthritis core set was rated in 316 persons with osteoarthritis who were either in the pre-operative or within one year post-operative stage. Rasch analyses were performed using the RUMM 2030 program. Twelve of the 13 body functions categories and 13 of the 19 activity and participation categories had good model fit. The qualifiers displayed disordered thresholds necessitating rescoring. There was uneven spread of ICF categories across the full range of the patients' scores indicating off--targeting. Subtest analysis of the reduced ICF categories of body functions and activity and participation showed that the two components could be integrated to form one measure. The results suggest that it is possible to measure functioning using a unidimensional construct based on ICF osteoarthritis core set categories of body functions and activity and participation in this population. However, omission of some categories and reduction in qualifier levels are necessary. Further studies are needed to determine whether better targeting is achieved, particularly during the pre-operative and during the sub-acute care period.

Total knee replacement and non-surgical treatment of knee osteoarthritis

DEFF Research Database (Denmark)

Skou, Søren T; Roos, Ewa M; Laursen, Mogens B

2018-01-01

OBJECTIVES: To compare 2-year outcomes of total knee replacement (TKR) followed by non-surgical treatment to that of non-surgical treatment alone and outcomes of the same non-surgical treatment to that of written advice. DESIGN: In two randomized trials, 200 (mean age 66) adults with moderate...... to severe knee osteoarthritis (OA), 100 eligible for TKR and 100 not eligible for TKR, were randomized to TKR followed by non-surgical treatment, non-surgical treatment alone, or written advice. Non-surgical treatment consisted of 12 weeks of supervised exercise, education, dietary advice, use of insoles......, and pain medication. The primary outcome was the mean score of the Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales, covering pain, symptoms, activities of daily living (ADL), and quality of life (QOL). RESULTS: Patients randomized to TKR had greater improvements than patients randomized...

Construct validity and reliability of the Finnish version of the Knee Injury and Osteoarthritis Outcome Score.

Science.gov (United States)

Multanen, Juhani; Honkanen, Mikko; Häkkinen, Arja; Kiviranta, Ilkka

2018-05-22

The Knee Injury and Osteoarthritis Outcome Score (KOOS) is a commonly used knee assessment and outcome tool in both clinical work and research. However, it has not been formally translated and validated in Finnish. The purpose of this study was to translate and culturally adapt the KOOS questionnaire into Finnish and to determine its validity and reliability among Finnish middle-aged patients with knee injuries. KOOS was translated and culturally adapted from English into Finnish. Subsequently, 59 patients with knee injuries completed the Finnish version of KOOS, Western Ontario and McMaster Osteoarthritis Index (WOMAC), Short-Form 36 Health Survey (SF-36) and Numeric Pain Rating Scale (Pain-NRS). The same KOOS questionnaire was re-administered 2 weeks later. Psychometric assessment of the Finnish KOOS was performed by testing its construct validity and reliability by using internal consistency, test-retest reliability and measurement error. The floor and ceiling effects were also examined. The cross-cultural adaptation revealed only minor cultural differences and was well received by the patients. For construct validity, high to moderate Spearman's Correlation Coefficients were found between the KOOS subscales and the WOMAC, SF-36, and Pain-NRS subscales. The Cronbach's alpha was from 0.79 to 0.96 for all subscales indicating acceptable internal consistency. The test-retest reliability was good to excellent, with Intraclass Correlation Coefficients ranging from 0.73 to 0.86 for all KOOS subscales. The minimal detectable change ranged from 17 to 34 on an individual level and from 2 to 4 on a group level. No floor or ceiling effects were observed. This study yielded an appropriately translated and culturally adapted Finnish version of KOOS which demonstrated good validity and reliability. Our data indicate that the Finnish version of KOOS is suitable for assessment of the knee status of Finnish patients with different knee complaints. Further studies are needed to

Comparison of efficacy of intra-articular morphine and steroid in patients with knee osteoarthritis

Directory of Open Access Journals (Sweden)

Serbülent Gökhan Beyaz

2012-01-01

Full Text Available Introduction: Primary therapeutic aim in treatment of osteoarthritis of the knee is to relieve the pain of osteoarthritis. The aim of this study was to compare the efficacy of intra-articular triamcinolone with intra-articular morphine in pain relief due to osteoarthritis of the knee in the elderly population. Materials and Methods: Patients between 50 and 80 years of age were randomized into three groups. Group M received morphine plus bupivacaine intra-articularly, Group T received triamcinolone plus bupivacaine intra-articularly, and Group C received saline plus bupivacaine intra-articularly. Patients were evaluated before injection and in 2nd, 4th, 6th, and 12th weeks after injection. First-line supplementary analgesic was oral paracetamol 1500 mg/day. If analgesia was insufficient with paracetamol, oral dexketoprofen trometamol 50 mg/day was recommended to patients. Results: After the intra-articular injection, there was statistically significant decrease in visual analog scale (VAS scores in Groups M and T, when compared to Group C. The decrease of VAS scores seen at the first 2 weeks continued steadily up to the end of 12th week. There was a significant decrease in Groups M and T in the WOMAC scores, when compared to Group C. There was no significant difference in the WOMAC scores between morphine and steroid groups. Significantly less supplementary analgesics was used in the morphine and steroid groups. Conclusion: Intra-articular morphine was as effective as intra-articular triamcinolone for analgesia in patients with osteoarthritis knee. Intra-articular morphine is possibly a better option than intra-articular steroid as it has lesser side effects.

The Gait Deviation Index Is Associated with Hip Muscle Strength and Patient-Reported Outcome in Patients with Severe Hip Osteoarthritis

DEFF Research Database (Denmark)

Rosenlund, Signe; Holsgaard-Larsen, Anders; Overgaard, Søren

2016-01-01

) and with severe primary hip osteoarthritis underwent 3-dimensional gait analysis. Mean Gait Deviation Index, pain after walking and maximal isometric hip muscle strength (flexor, extensor, and abductor) were recorded. All patients completed the 'Physical Function Short-form of the Hip disability...... was to investigate associations between Gait Deviation Index as a measure of gait 'quality' and hip muscle strength and between Gait Deviation Index and patient-reported outcomes in patients with primary hip osteoarthritis. METHOD: Forty-seven patients (34 males), aged 61.1 ± 6.7 years, with BMI 27.3 ± 3.4 (kg/m2...... and Osteoarthritis Outcome Score (HOOS-Physical Function) and the Hip disability and Osteoarthritis Outcome Score subscales for pain (HOOS-Pain) and quality-of-life (HOOS-QOL). RESULTS: Mean Gait Deviation Index was positively associated with hip abduction strength (pstrength (p = 0...

Pulsed radiofrequency of the composite nerve supply to the knee joint as a new technique for relieving osteoarthritic pain: a preliminary report.

Science.gov (United States)

Vas, Lakshmi; Pai, Renuka; Khandagale, Nishigandha; Pattnaik, Manorama

2014-01-01

We report a new technique for pulsed radiofrequency (PRF) of the entire nerve supply of the knee as an option in treating osteoarthritis (OA) of knee. We targeted both sensory and motor nerves supplying all the structures around the knee: joint, muscles, and skin to address the entire nociception and stiffness leading to peripheral and central sensitization in osteoarthritis. Ten patients with pain, stiffness, and loss of function in both knees were treated with ultrasonography (USG) guided PRF of saphenous, tibial, and common peroneal nerves along with subsartorial, peripatellar, and popliteal plexuses. USG guided PRF of the femoral nerve was also done to address the innervation of the quadriceps muscle. Assessment of pain (Numerical Rating Scale [NRS], pain DETECT, knee function [Western Ontario and McMaster Universities Osteoarthritis Index- WOMAC]) were documented pre and post PRF at 3 and 6 months. Knee radiographs (Kellgren-Lawrence [K-L] grading) were done before PRF and one week later. All the patients showed a sustained improvement of NRS, pain DETECT, and WOMAC at 3 and 6 months. The significant improvement of patellar position and tibio-femoral joint space was concordant with the patient's reporting of improvement in stiffness and pain. The sustained pain relief and muscle relaxation enabled the patients to optimize physiotherapy thereby improving endurance training to include the daily activities of life. We conclude that OA knee pain is a product of neuromyopathy and that PRF of the sensory and motor nerves appeared to be a safe, effective, and minimally invasive technique. The reduction of pain and stiffness improved the knee function and probably reduced the peripheral and central sensitization.

Efficacy and safety of plasma rich in growth factors intra-articular infiltrations in the treatment of knee osteoarthritis.

Science.gov (United States)

Anitua, Eduardo; Sánchez, Mikel; Aguirre, José Javier; Prado, Roberto; Padilla, Sabino; Orive, Gorka

2014-08-01

The goal of this study was to systematically review the efficacy and safety of plasma rich in growth factors (PRGF) as a treatment for reducing symptoms in patients with knee osteoarthritis. A comprehensive and systematic literature search was conducted for PRGF treatment of knee osteoarthritis following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. All the studies had to include a PRGF group and a control group. Pre- and post-treatment measures of joint pain, reduced function, and stiffness were evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index, Knee Injury and Osteoarthritis Outcome Score, International Knee Documentation Committee score, Lequesne index, or number of Outcome Measures for Rheumatology Committee and Osteoarthritis Research Society International Standing Committee for Clinical Trials Response Criteria Initiative (OMERACT-OARSI) responders, with a follow-up period of at least 4 weeks. An assessment of both the quality and risk of bias of the studies was conducted. The literature search yielded 91 citations, but only 5 were eligible publications that met the inclusion criteria (2 randomized controlled trials, 2 prospective studies, and 1 retrospective analysis). Two studies were rated as having a low risk of bias whereas 3 had a high risk. In both randomized controlled trials, it was observed that after 6 months of treatment, the number of patients with a pain reduction of more than 50% was significantly higher in the PRGF group. In 2 other studies, the patients treated with PRGF showed a significant pain reduction compared with the control group. The remaining variables (Western Ontario and McMaster Universities Osteoarthritis Index scale for pain, function, and stiffness; Lequesne index; Knee Injury and Osteoarthritis Outcome Score scale; and number of OMERACT-OARSI responders) showed a statistically significant superiority of the group treated with PRGF. The current

Targeted deletion of Atg5 in chondrocytes promotes age-related osteoarthritis.

Science.gov (United States)

Bouderlique, Thibault; Vuppalapati, Karuna K; Newton, Phillip T; Li, Lei; Barenius, Björn; Chagin, Andrei S

2016-03-01

It has been suggested that the lysosomal recycling process called macro-autophagy plays a role in osteoarthritis development. We thus decided to genetically ablate the autophagy-indispensable Atg5 gene specifically in chondrocytes and analyse the development of osteoarthritis upon aging and in a post-traumatic model. Mice lacking the Atg5 gene in their chondrocytes (Atg5cKO) were generated by crossing Atg5-floxed mice with transgenic mice that expressed cre recombinase driven by the collagen type 2 promoter. Animals were analysed at the age of 2, 6 and 12 months for age-related osteoarthritis or underwent mini-open partial medial meniscectomy at 2 months of age and were analysed 1 or 2 months after surgery. We evaluated osteoarthritis using the Osteoarthritis Research Society International (OARSI) scoring on safranin-O-stained samples. Cell death was evaluated by terminal deoxy-nucleotidyl-transferase-mediated deoxy-UTP nick end labelling (TUNEL) and by immunostaining of cleaved caspases. We observed the development of osteoarthritis in Atg5cKO mice with aging including fibrillation and loss of proteoglycans, which was particularly severe in males. The ablation of Atg5 was associated with an increased cell death as assessed by TUNEL, cleaved caspase 3 and cleaved caspase 9. Surprisingly, no difference in the development of post-traumatic osteoarthritis was observed between Atg5cKO and control mice. Autophagy protects from age-related osteoarthritis by facilitating chondrocyte survival. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

A pilot study to evaluate the effects of floatation spa treatment on patients with osteoarthritis.

Science.gov (United States)

Hill, S; Eckett, M J; Paterson, C; Harkness, E F

1999-12-01

To conduct a preliminary investigation of the effects on floatation spa therapy on quality of life in patients with osteoarthritis to see if controlled trials are warranted. Uncontrolled clinical trial. Private floatation spa therapy centre. Fourteen patients with chronic osteoarthritis of the weight-bearing joints, of whom four dropped out. Six weekly sessions of floatation spa therapy. SF36, AIMS2 and MYMOP quality-of-life questionnaires. All patients improved. Differences between baseline and discharge scores showed statistically significant improvement for MYMOP, but not AIMS2 or SF-36. Controlled trials of floatation spa therapy for patients with osteoarthritis are warranted.

Transcatheter Arterial Embolization as a Treatment for Medial Knee Pain in Patients with Mild to Moderate Osteoarthritis

Energy Technology Data Exchange (ETDEWEB)

Okuno, Yuji, E-mail: how-lowlow@yahoo.co.jp [Edogawa Hospital, Department of Orthopedic Surgery (Japan); Korchi, Amine Mohamed, E-mail: amine.korchi@gmail.com [Geneva University Hospitals, Department of Diagnostic and Interventional Radiology (Switzerland); Shinjo, Takuma, E-mail: shin.takuma@a7.keio.jp [Keio University, Institute for Integrated Sports Medicine, School of Medicine (Japan); Kato, Shojiro, E-mail: shojiro7@yahoo.co.jp [Edogawa Hospital, Department of Orthopedic Surgery (Japan)

2015-04-15

PurposeOsteoarthritis is a common cause of pain and disability. Mild to moderate knee osteoarthritis that is resistant to nonsurgical options and not severe enough to warrant joint replacement represents a challenge in its management. On the basis of the hypothesis that neovessels and accompanying nerves are possible sources of pain, previous work demonstrated that transcatheter arterial embolization for chronic painful conditions resulted in excellent pain relief. We hypothesized that transcatheter arterial embolization can relieve pain associated with knee osteoarthritis.MethodsTranscatheter arterial embolization for mild to moderate knee osteoarthritis using imipenem/cilastatin sodium or 75 μm calibrated Embozene microspheres as an embolic agent has been performed in 11 and three patients, respectively. We assessed adverse events and changes in Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scores.ResultsAbnormal neovessels were identified within soft tissue surrounding knee joint in all cases by arteriography. No major adverse events were related to the procedures. Transcatheter arterial embolization rapidly improved WOMAC pain scores from 12.2 ± 1.9 to 3.3 ± 2.1 at 1 month after the procedure, with further improvement at 4 months (1.7 ± 2.2) and WOMAC total scores from 47.3 ± 5.8 to 11.6 ± 5.4 at 1 month, and to 6.3 ± 6.0 at 4 months. These improvements were maintained in most cases at the final follow-up examination at a mean of 12 ± 5 months (range 4–19 months).ConclusionTranscatheter arterial embolization for mild to moderate knee osteoarthritis was feasible, rapidly relieved resistant pain, and restored knee function.

Transcatheter Arterial Embolization as a Treatment for Medial Knee Pain in Patients with Mild to Moderate Osteoarthritis

International Nuclear Information System (INIS)

Okuno, Yuji; Korchi, Amine Mohamed; Shinjo, Takuma; Kato, Shojiro

2015-01-01

PurposeOsteoarthritis is a common cause of pain and disability. Mild to moderate knee osteoarthritis that is resistant to nonsurgical options and not severe enough to warrant joint replacement represents a challenge in its management. On the basis of the hypothesis that neovessels and accompanying nerves are possible sources of pain, previous work demonstrated that transcatheter arterial embolization for chronic painful conditions resulted in excellent pain relief. We hypothesized that transcatheter arterial embolization can relieve pain associated with knee osteoarthritis.MethodsTranscatheter arterial embolization for mild to moderate knee osteoarthritis using imipenem/cilastatin sodium or 75 μm calibrated Embozene microspheres as an embolic agent has been performed in 11 and three patients, respectively. We assessed adverse events and changes in Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scores.ResultsAbnormal neovessels were identified within soft tissue surrounding knee joint in all cases by arteriography. No major adverse events were related to the procedures. Transcatheter arterial embolization rapidly improved WOMAC pain scores from 12.2 ± 1.9 to 3.3 ± 2.1 at 1 month after the procedure, with further improvement at 4 months (1.7 ± 2.2) and WOMAC total scores from 47.3 ± 5.8 to 11.6 ± 5.4 at 1 month, and to 6.3 ± 6.0 at 4 months. These improvements were maintained in most cases at the final follow-up examination at a mean of 12 ± 5 months (range 4–19 months).ConclusionTranscatheter arterial embolization for mild to moderate knee osteoarthritis was feasible, rapidly relieved resistant pain, and restored knee function

Total elbow arthroplasty for primary osteoarthritis.

Science.gov (United States)

Schoch, Bradley S; Werthel, Jean-David; Sánchez-Sotelo, Joaquín; Morrey, Bernard F; Morrey, Mark

2017-08-01

Primary osteoarthritis of the elbow is a less common indication for total elbow arthroplasty (TEA). Higher complication rates in younger, active patients may offset short-term improvements in pain and function. The purpose of this study was to determine pain relief, functional outcomes, complications, and survival of TEA in this population. Between 1984 and 2011, 20 consecutive TEAs were performed for primary elbow osteoarthritis. Two patients died before the 2-year follow-up. Mean age at surgery was 68 years (range, 51-85 years). Outcome measures included pain, motion, Mayo Elbow Performance Score, satisfaction, complications, and reoperations. Mean follow-up was 8.9 years (range, 2-20 years). Three elbows sustained mechanical failures. Complications included intraoperative fracture (n = 2), wound irrigation and débridement (n = 1), bony ankylosis (n = 1), humeral loosening (n = 1), humeral component fracture (n = 1), and mechanical failure of a radial head component (n = 1). Fifteen elbows without mechanical failure were examined clinically. Pain improved from 3.6 to 1.5 (P  .05), with preoperative flexion contractures not improving. Mayo Elbow Performance Scores were available for 13 elbows without mechanical failure, averaging 81.5 points (range, 60-100 points); these were graded as excellent (n = 5), good (n = 2), and fair (n = 6). Subjectively, all patients without mechanical failure were satisfied. TEA represents a reliable surgical option for pain relief in patients with primary osteoarthritis. However, restoration of extension is not always obtained, indicating that more aggressive soft tissue releases or bony resection should be considered. Complications occurred in a large number of elbows, but mechanical failure was low considering the nature of this population and the length of follow-up. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC in Persian Speaking Patients with Knee Osteoarthritis

Directory of Open Access Journals (Sweden)

Mohammad H Ebrahimzadeh

2014-03-01

Full Text Available Background: Osteoarthritis of the knee is the most common chronic joint disease that involves middle aged and elderly persons. There are different clinical instruments to quantify the health status of patients with knee osteoarthritis and one example is the WOMAC score that has been translated and adapted into different languages. The purpose of this study was cultural adaptation, validation and reliability testing of the Persian version of the WOMAC index in Iranians with knee osteoarthritis.   Methods: We translated the original WOMAC questionnaire into Persian by the forward and backward technique, and then its psychometric study was done on 169 native Persian speaking patients with knee degenerative joint disease. Mean age of patients was 53.9 years. The SF-36 and KOOS were used to assess construct validity. Results: Reliability testing resulted in a Cronbach’s alpha of 0.917, showing the internal consistency of the questionnaire to be a reliable tool. Inter-correlation matrix among different scales of the Persian WOMAC index yielded a highly significant correlation between all subscales including stiffness, pain, and physical function. In terms of validity, Pearson`s correlation coefficient was significant between three domains of the WOMAC with PF, RP, BP, GH, VT, and PCS dimensions of the SF-36 health survey (P

The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC in Persian Speaking Patients with Knee Osteoarthritis

Directory of Open Access Journals (Sweden)

Mohammad H Ebrahimzadeh

2014-03-01

Full Text Available   Background: Osteoarthritis of the knee is the most common chronic joint disease that involves middle aged and elderly persons. There are different clinical instruments to quantify the health status of patients with knee osteoarthritis and one example is the WOMAC score that has been translated and adapted into different languages. The purpose of this study was cultural adaptation, validation and reliability testing of the Persian version of the WOMAC index in Iranians with knee osteoarthritis.   Methods: We translated the original WOMAC questionnaire into Persian by the forward and backward technique, and then its psychometric study was done on 169 native Persian speaking patients with knee degenerative joint disease. Mean age of patients was 53.9 years. The SF-36 and KOOS were used to assess construct validity. Results: Reliability testing resulted in a Cronbach’s alpha of 0.917, showing the internal consistency of the questionnaire to be a reliable tool. Inter-correlation matrix among different scales of the Persian WOMAC index yielded a highly significant correlation between all subscales including stiffness, pain, and physical function. In terms of validity, Pearson`s correlation coefficient was significant between three domains of the WOMAC with PF, RP, BP, GH, VT, and PCS dimensions of the SF-36 health survey (P

Epidemiology of Posttraumatic Osteoarthritis.

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Thomas, Abbey C; Hubbard-Turner, Tricia; Wikstrom, Erik A; Palmieri-Smith, Riann M

2017-06-02

Osteoarthritis is a leading cause of disability whose prevalence and incidence continue to increase. History of joint injury represents an important risk factor for posttraumatic osteoarthritis and is a significant contributor to the rapidly growing percentage of the population with osteoarthritis. This review will present the epidemiology associated with posttraumatic osteoarthritis, with particular emphasis on the knee and ankle joints. It is important to understand the effect of posttraumatic osteoarthritis on the population so that sufficient resources can be devoted to countering the disease and promoting optimal long-term health for patients after joint injury.

A COMPARATIVE STUDY BETWEEN JOINT MOBILIZATION AND CONVENTIONAL PHYSIOTHERAPY IN KNEE OSTEOARTHRITIS

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Aftab Ahmad

2016-04-01

Full Text Available Background: Osteoarthritis (O.A. is an active disease process involving articular cartilage destruction, subchondral bone thickening and new bone formation. Worldwide osteoarthritis is estimated to be the fourth leading cause of disability, in which 10% are males and 13% are females. Studies from china, Bangladesh and Pakistan have shown high prevalence of knee osteoarthritis. Pharmacological interventions, surgical procedures and Physiotherapy management play important role in knee Osteoarthritis. In Physiotherapy management of osteoarthritis, manual therapy along with thermotherapy and/or electrotherapy is used. Current study was to evaluate the effectiveness of joint mobilization in knee osteo-arthritis. Methods: Comparative study was undertaken on 50 patients with osteoarthritis of the knee who were randomly assigned to one of two groups that received Joint mobilization alone (n = 25; mean age, 53 years or Conventional Physiotherapy (n = 25; mean age, 50 years.Both groups were received their programs for 8 weeks; two sessions per week. Analysis of data within group and between groups of the pre and post treatment values of the function and pain was done using pair t test and independent t test. Results: Both groups showed significant improvement in ISOA score and VAS. There was statistical significant difference between the two groups (Group A and B i.e. p < 0.005. Conclusion: Manual joint mobilization improves the effectiveness of the treatment program in treating symptoms of knee OA and improves function in elderly people with knee OA.

THE RELIABILITY OF THE MANKIN SCORE FOR OSTEOARTHRITIS

NARCIS (Netherlands)

van der Sluijs, J.A.; GEESINK, RGT; van der Linden, A.J.; BULSTRA, SK; Kuijer, Roelof; DRUKKER, J

For the histopathological classification of the severity of osteoarthritic lesions of cartilage, the Mankin score is frequently used. A necessary constraint on the validity of this scoring system is the consistency with which cartilage lesions are classified. The intra- and interobserver agreement

Directional fractal signature methods for trabecular bone texture in hand radiographs: Data from the Osteoarthritis Initiative

International Nuclear Information System (INIS)

Wolski, M.; Podsiadlo, P.; Stachowiak, G. W.

2014-01-01

Purpose: To develop directional fractal signature methods for the analysis of trabecular bone (TB) texture in hand radiographs. Problems associated with the small size of hand bones and the orientation of fingers were addressed. Methods: An augmented variance orientation transform (AVOT) and a quadrant rotating grid (QRG) methods were developed. The methods calculate fractal signatures (FSs) in different directions. Unlike other methods they have the search region adjusted according to the size of bone region of interest (ROI) to be analyzed and they produce FSs defined with respect to any chosen reference direction, i.e., they work for arbitrary orientation of fingers. Five parameters at scales ranging from 2 to 14 pixels (depending on image size and method) were derived from rose plots of Hurst coefficients, i.e., FS in dominating roughness (FS Sta ), vertical (FS V ) and horizontal (FS H ) directions, aspect ratio (StrS), and direction signatures (StdS), respectively. The accuracy in measuring surface roughness and isotropy/anisotropy was evaluated using 3600 isotropic and 800 anisotropic fractal surface images of sizes between 20 × 20 and 64 × 64 pixels. The isotropic surfaces had FDs ranging from 2.1 to 2.9 in steps of 0.1, and the anisotropic surfaces had two dominating directions of 30° and 120°. The methods were used to find differences in hand TB textures between 20 matched pairs of subjects with (cases: approximate Kellgren-Lawrence (KL) grade ≥2) and without (controls: approximate KL grade <2) radiographic hand osteoarthritis (OA). The OA Initiative public database was used and 20 × 20 pixel bone ROIs were selected on 5th distal and middle phalanges. The performance of the AVOT and QRG methods was compared against a variance orientation transform (VOT) method developed earlier [M. Wolski, P. Podsiadlo, and G. W. Stachowiak, “Directional fractal signature analysis of trabecular bone: evaluation of different methods to detect early osteoarthritis

Isolated scaphotrapeziotrapezoid osteoarthritis: Prevalence, symptomatology and associated scapholunate ligament disruption in a population presenting to an accident and emergency department with acute wrist injuries

International Nuclear Information System (INIS)

Higginson, Antony P.; Braybrook, Jason; Williams, Stephen; Finlay, David

2001-01-01

AIM: To determine the prevalence of isolated scaphotrapeziotrapezoid osteoarthritis in a population presenting to an Accident and Emergency Department of Leicester Royal Infirmary with acute wrist injuries. Also to identify the presence of scapholunate ligament disruption in this patient group and quantify symptoms and loss of function in terms of the modified system of Green and O'Brien, a recognized clinical scoring system. MATERIALS AND METHODS: A total of 1711 radiographs of patients attending the Accident and Emergency Department were prospectively reviewed over a 5-month period. Those patients with isolated scaphotrapeziotrapezoid osteoarthritis were invited for clinical review. RESULTS: Sixteen patients were identified with isolated scaphotrapeziotrapezoid osteoarthritis. Two had a poor Green and O'Brien score and evidence of scapholunate ligament disruption (P < 0.05). CONCLUSION: Isolated scaphotrapeziotrapezoid osteoarthritis has a prevalence of 1% in a population presenting to an Accident and Emergency Department with acute wrist injuries over the age of 30 years. Isolated scaphotrapeziotrapezoid osteoarthritis may be asymptomatic even though the changes in the joint are severe. Scapholunate ligament disruption is associated with a poor Green and O'Brien score, but is not present in the majority of cases. Higginson, A.P. et al. (2001)

Curcumin slows osteoarthritis progression and relieves osteoarthritis-associated pain symptoms in a post-traumatic osteoarthritis mouse model.

Science.gov (United States)

Zhang, Zhuo; Leong, Daniel J; Xu, Lin; He, Zhiyong; Wang, Angela; Navati, Mahantesh; Kim, Sun J; Hirsh, David M; Hardin, John A; Cobelli, Neil J; Friedman, Joel M; Sun, Hui B

2016-06-03

Curcumin has been shown to have chondroprotective potential in vitro. However, its effect on disease and symptom modification in osteoarthritis (OA) is largely unknown. This study aimed to determine whether curcumin could slow progression of OA and relieve OA-related pain in a mouse model of destabilization of the medial meniscus (DMM). Expression of selected cartilage degradative-associated genes was evaluated in human primary chondrocytes treated with curcumin and curcumin nanoparticles and assayed by real-time PCR. The mice subjected to DMM surgery were orally administered curcumin or topically administered curcumin nanoparticles for 8 weeks. Cartilage integrity was evaluated by Safranin O staining and Osteoarthritis Research Society International (OARSI) score, and by immunohistochemical staining of cleaved aggrecan and type II collagen, and levels of matrix metalloproteinase (MMP)-13 and ADAMTS5. Synovitis and subchondral bone thickness were scored based on histologic images. OA-associated pain and symptoms were evaluated by von Frey assay, and locomotor behavior including distance traveled and rearing. Both curcumin and nanoparticles encapsulating curcumin suppressed mRNA expression of pro-inflammatory mediators IL-1β and TNF-α, MMPs 1, 3, and 13, and aggrecanase ADAMTS5, and upregulated the chondroprotective transcriptional regulator CITED2, in primary cultured chondrocytes in the absence or presence of IL-1β. Oral administration of curcumin significantly reduced OA disease progression, but showed no significant effect on OA pain relief. Curcumin was detected in the infrapatellar fat pad (IPFP) following topical administration of curcumin nanoparticles on the skin of the injured mouse knee. Compared to vehicle-treated controls, topical treatment led to: (1) reduced proteoglycan loss and cartilage erosion and lower OARSI scores, (2) reduced synovitis and subchondral plate thickness, (3) reduced immunochemical staining of type II collagen and aggrecan

Ernest Orlando Lawrence (1901-1958), Cyclotron and Medicine

Energy Technology Data Exchange (ETDEWEB)

Chu, William T.

2005-09-01

On August 8, 2001, Lawrence Berkeley National Laboratory celebrated the centennial of the birth of its founder (and namesake), Ernest Orlando Lawrence. For the occasion, many speeches were given and old speeches were remembered. We recall the words of the late Luis Alvarez, a Nobel Laureate and one of the Lawrence's closest colleagues: ''Lawrence will always be remembered as the inventor of the cyclotron, but more importantly, he should be remembered as the inventor of the modern way of doing science''. J. L. Heilbron and R. W. Seidel, in the introduction of their book, ''Lawrence and His Laboratory'' stated, ''The motives and mechanisms that shaped the growth of the Laboratory helped to force deep changes in the scientific estate and in the wider society. In the entrepreneurship of its founder, Ernest Orlando Lawrence, these motives, mechanisms, and changes came together in a tight focus. He mobilized great and small philanthropists, state and local governments, corporations, and plutocrats, volunteers and virtuosos. The work they supported, from astrophysics and atomic bombs, from radiochemistry to nuclear medicine, shaped the way we observe, control, and manipulate our environment.'' Indeed, all over the civilized world, the ways we do science changed forever after Lawrence built his famed Radiation Laboratory. In this editorial, we epitomize his legacy of changing the way we do medicine, thereby affecting the health and well being of all humanity. This year marks the 75th anniversary of the invention of the cyclotron by Ernest Orlando Lawrence at the University of California at Berkeley. Lawrence conceived the idea of the cyclotron early in 1929 after reading an article by Rolf Wideroe on high-energy accelerators. In the spring of 1930 one of his students, Nels Edlefsen, constructed two crude models of a cyclotron. Later in the fall of the same year, another student, M. Stanley Livingston

Patients With Knee Osteoarthritis Who Score Highly on the PainDETECT Questionnaire Present With Multimodality Hyperalgesia, Increased Pain, and Impaired Physical Function.

Science.gov (United States)

Moss, Penny; Benson, Heather A E; Will, Rob; Wright, Anthony

2018-01-01

PainDETECT is a self-report questionnaire that can be used to identify features of neuropathic pain. A proportion of patients with knee osteoarthritis (OA) score highly on the PainDETECT questionnaire. This study aimed to determine whether those with a higher "positive neuropathic" score on the PainDETECT questionnaire also had greater pain, hypersensitivity, and reduced function compared with individuals with knee OA with lower PainDETECT scores. In total, 130 participants with knee OA completed the PainDETECT, Western Ontario and McMaster Universities Arthritis Index (WOMAC), and Pain Quality Assessment Scale questionnaires. Quantitative sensory testing was carried out at 3 sites (both knees and elbow) using standard methods. Cold and heat pain thresholds were tested using a Peltier thermode and pressure pain thresholds using a digital algometer. Physical function was assessed using 3 timed locomotor function tests. In total, 22.3% of participants scored in the "positive neuropathic" category with a further 35.4% in the unclear category. Participants in the "positive neuropathic" category reported higher levels of pain and more impaired function based on the WOMAC questionnaire (Ppain thresholds at the OA knee. They were also slower to complete 2 of the locomotion tasks. This study identified a specific subgroup of people with knee OA who exhibited PainDETECT scores in the "positive neuropathic" category. These individuals experienced increased levels of pain, widespread, multimodality hyperalgesia, and greater functional impairment than the remaining cohort. Identification of OA patients with this pain phenotype may permit more targeted and effective pain management.

78 FR 56609 - Drawbridge Operation Regulations; Reynolds Channel, Lawrence, NY

Science.gov (United States)

2013-09-13

... Regulations; Reynolds Channel, Lawrence, NY AGENCY: Coast Guard, DHS. ACTION: Notice canceling temporary... Beach Bridge, mile 0.4, across Reynolds Channel, at Lawrence, New York. The owner of the bridge, Nassau... published a temporary deviation entitled ``Drawbridge Operation Regulations; Reynolds Channel, Lawrence, NY...

[Effects of education and strength training on functional tests among older people with osteoarthritis].

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Jiménez S, Christian Edgardo; Fernández G, Rubén; Zurita O, Félix; Linares G, Daniel; Farías M, Ariel

2014-04-01

Hip and knee osteoarthritis are important causes of pain and disability among older people. Education and strength training can alleviate symptoms and avoid functional deterioration. To assess muscle strength, fall risk and quality of life of older people with osteoarthritis and the effects of physiotherapy education and strength training on these variables. Thirty participants aged 78 ± 5 years (63% women) were randomly assigned to receive physiotherapy (Controls), physiotherapy plus education (Group 1) and physiotherapy plus strength training (group 2). At baseline and after 16 weeks of intervention, patients were evaluated with the Senior Fitness Test, Timed Up and Go and Quality of Life score short form (SF-36). During the intervention period, Senior Fitness Test and Timed Up and Go scores improved in all groups and SF-36 did not change. The improvement in Senior Fitness Test and Timed Up and Go was more marked in Groups 1 and 2 than in the control group. Education and strength training improve functional tests among older people with osteoarthritis.

Radiographic and magnetic resonance imaging of the stifle joint in experimental osteoarthritis of dogs

International Nuclear Information System (INIS)

Widmer, W.R.; Buckwalter, K.A.; Braunstein, E.M.; Hill, M.A.; O'Connor, B.L.; Visco, D.M.

1994-01-01

Radiography and magnetic resonance imaging were used to evaluate osteoarthritis at 2, 6, and 12 weeks following transection of the cranial cruciate ligament of the stifle (femorotibial) joint of 6 dogs. A quantitative radiographic scoring system was used to assess the progression of hard and soft tissue changes of osteoarthritis. Mediolateral (flexed joint) and oblique (extended joint) radiographic projections enabled identification of small osteophytes on the femoral trochlear ridges, which were detected at an earlier stage of development than was previously reported. Magnetic resonance imaging was useful in detecting changes in cartilage thickness, osteophytosis and intraarticular loose bodies. Radiography and magnetic resonance imaging were complementary in the assessment of pathologic changes of osteoarthritis

Comparison of oral robenacoxib and carprofen for the treatment of osteoarthritis in dogs: a randomized clinical trial.

Science.gov (United States)

Edamura, Kazuya; King, Jonathan N; Seewald, Wolfgang; Sakakibara, Nobuhiro; Okumura, Masahiro

2012-09-01

The efficacy and tolerability of robenacoxib for the treatment of osteoarthritis in dogs were evaluated in a prospective, multicenter, randomized, noninferiority design clinical trial. A total of 32 dogs presenting with osteoarthritis were allocated randomly to receive, orally once daily for 28 days, either 1-2 mg/kg robenacoxib (n=21) or 3.5-5 mg/kg carprofen (n=11). Dogs were assessed by clinicians and owners using numerical rating scale scores at baseline and days 14 and 28. The primary efficacy endpoint was the global functional disability score, which was the sum of clinician scores for standing posture, lameness at walk, lameness at trot, willingness to raise the contralateral limb and pain at palpation. There was a good to excellent level of efficacy in both treatment groups. Differences between days 14 and 28 compared to day 0 were significant for all 11 clinician and owner scores for robenacoxib, and for 6 of 11 scores for carprofen. The efficacy of robenacoxib was numerically superior to carprofen for all 13 endpoints, but differences were not statistically significant. For the global functional disability score, the estimated efficacy of robenacoxib was 1.244 (95% confidence interval 0.555-2.493) relative to carprofen. The tolerability of both treatments was good as assessed from adverse events, clinical signs, and hematology and serum biochemistry variables. In conclusion, once daily administration of robenacoxib tablets had noninferior efficacy and tolerability compared to carprofen for the treatment of the clinical signs of osteoarthritis in dogs.

Erosive osteoarthritis: a more severe form of radiographic hand osteoarthritis rather than a distinct entity?

Science.gov (United States)

Marshall, Michelle; Nicholls, Elaine; Kwok, Wing-Yee; Peat, George; Kloppenburg, Margreet; van der Windt, Danielle; Myers, Helen; Dziedzic, Krysia

2015-01-01

Objectives To determine whether erosive osteoarthritis shares the same pattern of joint involvement and risk profile as increasing grades of non-erosive hand osteoarthritis. Methods Participants were from two population-based cohorts, aged ≥50 years, reporting hand symptoms in the previous month. Interphalangeal joints were assessed for erosive osteoarthritis (Verbruggen–Veys erosive or remodelled phase) and radiographic osteoarthritis (sliding cut-offs of K&L≥2, K&L≥3 and K&L=4). At the joint level, similarities in the frequency and pattern of erosive and non-erosive osteoarthritis were assessed by Spearman's rank correlation coefficients and generalised estimating equations. At the person level, individuals with erosive osteoarthritis were compared to those with non-erosive osteoarthritis using logistic regression, adjusted for age and gender (aOR), for the following exposures: family history, previous injury, overuse and metabolic factors (BMI, dyslipidaemia, hypertension, diabetes). Results In 1076 symptomatic participants the ranked frequency of involvement for erosive joints was comparable to joints with K&L≥3 and K&L=4 (r>0.95). Patterns of joint involvement in erosive osteoarthritis were strongest for symmetry (aOR=6.5; 95% CI 3.0 to 14.1), followed by row (2.0; 0.8 to 5.0) and ray (0.3; 0.0 to 2.5), which was similar to joints with K&L≥3 and K&L=4. Individuals with erosive osteoarthritis (n=80) had an increased risk of metabolic syndrome (2.7; 1.0 to 7.1), notably dyslipidaemia (4.7; 2.1 to 10.6) compared with non-erosive osteoarthritis classed K&L≥3 (n=193). Conclusions The similar frequency of radiographic joint involvement and patterning in erosive osteoarthritis and more severe non-erosive osteoarthritis is consistent with prevalent erosive osteoarthritis being a severe form of hand osteoarthritis rather than a distinct entity. Metabolic exposures, dyslipidaemia in particular, may be implicated in erosive osteoarthritis. PMID:24095935

Prospective Evaluation of Intra-Articular Dextrose Prolotherapy for Treatment of Osteoarthritis in Dogs.

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Sherwood, J Matthew; Roush, James K; Armbrust, Laura J; Renberg, Walter C

The objective of this study was to evaluate intra-articular dextrose prolotherapy for osteoarthritis of the elbow or stifle in dogs in a randomized, double-blind, placebo-controlled, prospective pilot study. Seventeen dogs were evaluated with 10 meeting inclusion criteria for this study. Evaluations included orthopedic exam, visual lameness scoring, Canine Brief Pain Inventory (CBPI), goniometry, kinetic gait analysis, and radiography. Initial lameness score, age, body weight, duration of lameness, and CBPI scores did not differ between groups. Change in CBPI pain severity score in the prolotherapy group from wk 6-12 was significantly less improved than in the placebo group, with no other significant differences in pain severity or pain interference scores between groups. Range of motion and radiographic scores did not differ between groups at any time. Mean kinetic forces improved in prolotherapy dogs but were not significantly different between treatment groups at any time. Although easily performed and well-tolerated, there were no statistically significant benefits of dextrose prolotherapy for treatment of osteoarthritis of the elbow and stifle in dogs. Post hoc power analysis of these sample means and standard deviations found that 29-106 animals per group would be necessary to demonstrate significant differences in kinetic forces, providing useful guidance for future studies.

Matrix metalloproteinase activity and prostaglandin E2 are elevated in the synovial fluid of meniscus tear patients.

Science.gov (United States)

Liu, Betty; Goode, Adam P; Carter, Teralyn E; Utturkar, Gangadhar M; Huebner, Janet L; Taylor, Dean C; Moorman, Claude T; Garrett, William E; Kraus, Virginia B; Guilak, Farshid; DeFrate, Louis E; McNulty, Amy L

Meniscus tears are a common knee injury and are associated with the development of post-traumatic osteoarthritis (OA). The purpose of this study is to evaluate potential OA mediators in the synovial fluid and serum of meniscus tear subjects compared to those in the synovial fluid of radiographic non-OA control knees. Sixteen subjects with an isolated unilateral meniscus injury and six subjects who served as reference controls (knee Kellgren-Lawrence grade 0-1) were recruited. Twenty-one biomarkers were measured in serum from meniscus tear subjects and in synovial fluid from both groups. Meniscus tear subjects were further stratified by tear type to assess differences in biomarker levels. Synovial fluid total matrix metalloproteinase (MMP) activity and prostaglandin E2 (PGE2) were increased 25-fold and 290-fold, respectively, in meniscus tear subjects as compared to reference controls (p meniscus tear subjects (R = 0.83, p meniscus tear subjects, synovial fluid levels of MMP activity, MMP-2, MMP-3, sGAG, COMP, IL-6, and PGE2 were higher than serum levels (p meniscus tears had higher synovial fluid MMP-10 (p meniscus injury may be targets to promote meniscus repair and prevent OA development.

MRI of articular cartilaginous lesions. MRI findings in osteoarthritis of the knee joint

International Nuclear Information System (INIS)

Nozaki, Hiroyuki; Takezawa, Yuuichi; Suguro, Tohru; Igata, Atsuomi; Kudo, Yukihiko; Motegi, Mitsuo.

1995-01-01

An investigation was carried out to assess the usefulness of magnetic resonance imaging for imaging of the knee joint, especially for detecting articular cartilaginous lesions associated with osteoarthritis of the knee. A total of 141 patients with osteoarthritis were examined (23 males, 118 females). Their age range was 40-93 (mean age 66.2). Using radiotherapy examinations, patients were classified according to Hokkaido University Classification Criteria; 22, 49, 46, 16, and 8 patients were classified as Type I, II, III, IV and V, respectively. Articular cartilage defects were examined using MRI, and the number of such defects increased as the X-ray stage progressed. The appearance of a low signal intensity area in the bone marrow was examined using MRI, and the number of patients observed to have such areas increased as the x-ray stages progressed. JOA OA scores were significantly low for patients with meniscal tears. Patients were classified and results reviewed using MRI examinations. Classification by MRI of articular cartilage lesions correlated with the JOA OA scores. Low signal intensity areas in the bone marrow were frequently observed in advanced osteoarthritis cases, and there was correlation between FTA and MRI classifications of these areas. MRI is extremely valuable in detecting articular cartilage lesions in the knee joint, showing those lesions which cannot be detected by conventional radiography examinations. Thus, MRI is judged to be a clinically useful method for diagnosis of osteoarthritis. (author)

Military Service and Decision Quality in the Management of Knee Osteoarthritis.

Science.gov (United States)

Henderson, Eric R; Titus, Alexander J; Keeney, Benjamin J; Goodney, Philip P; Lurie, Jon D; Ibrahim, Said A

2018-05-18

Decision quality measures the degree to which care decisions are knowledge-based and value-aligned. Because military service emphasizes hierarchy, command, and mandates some healthcare decisions, military service may attenuate patient autonomy in healthcare decisions and lower decision quality. VA is the nation's largest provider of orthopedic care. We compared decision quality in a sample of VA and non-VA patients seeking care for knee osteoarthritis. Our study sample consisted of patients newly referred to our orthopedic clinic for the management of knee osteoarthritis. None of the study patients were exposed to a knee osteoarthritis decision aid. Consenting patients were administered the Hip/Knee Decision Quality Instrument (HK-DQI). In addition, they were surveyed about decision-making preferences and demographics. We compared results to a non-VA cohort from our academic institution's arthroplasty database. The HK-DQI Knowledge Score was lower in the VA cohort (45%, SD = 22, n = 25) compared with the non-VA cohort (53%, SD = 21, n = 177) (p = 0.04). The Concordance Score was lower in the VA cohort (36%, SD = 49%) compared with the control cohort (70%, SD 46%) (p = 0.003). Non-VA patients were more likely to make a high-quality decision (p = 0.05). Non-VA patients were more likely to favor a shared decision-making process (p = 0.002). Decision quality is lower in Veterans with knee osteoarthritis compared with civilians, placing them at risk for lower treatment satisfaction and possibly unwarranted surgical utilization. Our future work will examine if this difference is from conditioned military service behaviors or confounding demographic factors, and if conventional shared decision-making techniques will correct this deficiency.

Methodologies for semiquantitative evaluation of hip osteoarthritis by magnetic resonance imaging

DEFF Research Database (Denmark)

Jaremko, Jacob L; Lambert, Robert G W; Zubler, Veronika

2014-01-01

As a wider variety of therapeutic options for osteoarthritis (OA) becomes available, there is an increasing need to objectively evaluate disease severity on magnetic resonance imaging (MRI). This is more technically challenging at the hip than at the knee, and as a result, few systematic scoring...

Lawrence and his laboratory

International Nuclear Information System (INIS)

Hellbron, J.L.; Seidel, R.W.

1989-01-01

The birthplace of nuclear chemistry and nuclear medicine is the subject of this study of the Radiation Laboratory in Berkeley, California, where Ernest Lawrence used local and national technological, economic, and manpower resources to build the cyclotron

A MULTICENTER, BLIND, RANDOMIZED, PLACEBO-CONTROLLED STUDY OF THE SYMPTOM- AND STRUCTURE-MODIFYING EFFET OF ALFLUTOP IN PATIENTS WITH KNEE OSTEOARTHRITIS. REPORT 2: THE ASSESSMENT OF THE STRUCTURE-MODIFYING EFFECT OF THE DRUG

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L. I. Alekseeva

2014-01-01

Full Text Available Objective. To evaluate the symptom- and structure-modifying effect of Alflutop compared to placebo (PL in patients with knee osteoarthritis (OA. Material and methods. The study included 90 patients with knee OA (according to the criteria of the Russian Association of Rheumatologists at the stage 2–3 (according to the Kellgren-Lawrence scale; pain score when walk- ing ≥ 40 mm (assessed using the visual analog scale. All the patients provided an informed consent. The patients were randomly divided into two groups: group 1 (n=45 received an intramuscular injection of 1 mL Alflutop for 20 days with 6-month intervals for 2 years (a total of 4 courses for 2 years; group 2 (n=45 received an injection of PL (iso- tonic sodium chloride solution in the same way. Ibuprofen at a dose of 600–1200 mg/day was administered as concomitant therapy. To evaluate the structure-modifying effect of Alflutop, X-ray of the knee joint was performed at the beginning and end of the study; the level of biochemical markers (CTX-II and COMP was determined at the beginning, after 3 months, and at the end of the study. A statistical analysis was performed using the Statistica 10 software package.Results. After the 2-year follow-up, a statistically significant negative trend was detected less frequently in the group of patients treated with Alflutop compared to the PL group (6.1 and 38.4%, respectively. The statistically significant delay in joint space narrowing was observed in patients who received Alflutop in contrast to patients who received PL (the numerical score of the joint space, the Wilcoxon test; p=0.0003. An increase in osteo- phyte size was observed in 72% of the patients receiving PL, and only in 27% of the patients receiving Alflutop (medial and lateral osteophytes of the femoral bone, the Wilcoxon test; p=0.0078; medial and lateral osteophytes of the shin bone, the Wilcoxon test; p=0.0001 and p=0.0039, respective- ly. Augmentation of subchondral

[Quality of Outcome after Primary Total Hip Replacement at a Maximum Care Hospital in Relation to Preoperative Influencing Factors].

Science.gov (United States)

Osmanski-Zenk, K; Steinig, N S; Glass, Ä; Mittelmeier, W; Bader, R

2015-12-01

As the need for joint replacements will continue to rise, the outcome of primary total hip replacement (THR) must be improved and stabilised at a high level. In this study, we investigated whether pre-operative risk factors, such as gender, age and body weight at the time of the surgery or a restricted physical status (ASA-Status > 2 or Kellgren and Lawrence grade > 2) have a negative influence on the post-operative results or on patient satisfaction. Retrospective data collection and a prospective interview were performed with 486 patients who underwent primary total hip replacement between January 2007 and December 2010 in our hospital. The patients' satisfaction and quality of life were surveyed with the WOMAC-Score, SF-36 and EuroQol-5. Differences between more than two independent spot tests were tested with the non-parametric Kruskal-Wallis test. Differences between two independent spot tests were tested with the non-parametric Mann-Whitney U test. The frequencies were reported and odds ratios calculated. The confidence interval was set at 95 %. The level of significance was p total score of the SF-36 was 66.9 points. The patients declared an average EuroQol Index of 0.81. Our data show that the patients' gender did not influence the duration of surgery or the scores. However, female patients tended to exhibit more postoperative complications. However, increased patient age at the time of surgery was associated with an increased OR for duration of surgery, length of stay and risk of complications. Patients who had a normal body weight at time of the surgery showed better peri- and post-operative results. We showed that the preoperative estimated Kellgren and Lawrence grade had a significant influence on the duration of surgery. The ASA classification influenced the duration of surgery as well the length of stay and the rate of complications. The quality of results after primary THR depends on preoperative factors. Existing comorbidities have a

Osteoblast role in osteoarthritis pathogenesis.

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Maruotti, Nicola; Corrado, Addolorata; Cantatore, Francesco P

2017-11-01

Even if osteoarthritis pathogenesis is still poorly understood, numerous evidences suggest that osteoblasts dysregulation plays a key role in osteoarthritis pathogenesis. An abnormal expression of OPG and RANKL has been described in osteoarthritis osteoblasts, which is responsible for abnormal bone remodeling and decreased mineralization. Alterations in genes expression are involved in dysregulation of osteoblast function, bone remodeling, and mineralization, leading to osteoarthritis development. Moreover, osteoblasts produce numerous transcription factors, growth factors, and other proteic molecules which are involved in osteoarthritis pathogenesis. © 2017 The Authors. Journal of Cellular Physiology Published by Wiley Periodicals, Inc.

E.O. Lawrence

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period in his life when he thought that his discoveries in the field of high explosives would make war so pleasure of a visit to Sweden. I hope that we can in some measure compensate for that loss. I hope too disintegration. The picture has been sketchy; yet I hope it has indicated the versatility of his ideas. lawrence

Evaluation of construct and criterion validity for the 'Liverpool Osteoarthritis in Dogs' (LOAD clinical metrology instrument and comparison to two other instruments.

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Myles Benjamin Walton

Full Text Available To test the 'Liverpool Osteoarthritis in Dogs' (LOAD questionnaire for construct and criterion validity, and to similarly test the Helsinki Chronic Pain Index (HCPI and the Canine Brief Pain Inventory (CBPI.Prospective Study.222 dogs with osteoarthritis.Osteoarthritis was diagnosed in a cohort of dogs on the basis of clinical history and orthopedic examination. Force-platform analysis was performed and a "symmetry index" for peak vertical force (PVF was calculated. Owners completed LOAD, CBPI and HCPI instruments. As a test of construct validity, inter-instrument correlations were calculated. As a test of criterion validity, the correlations between instrument scores and PVF symmetry scores were calculated. Additionally, internal consistency of all instruments was calculated and compared to those previously reported. Factor analysis is reported for the first time for LOAD, and is compared to that previously reported for CBPI and HCPI.Significant moderate correlations were found between all instruments, implying construct validity for all instruments. Significant weak correlations were found between LOAD scores and PVF symmetry index, and between CBPI scores and PVF symmetry index.LOAD is an owner-completed clinical metrology instrument that can be recommended for the measurement of canine osteoarthritis. It is convenient to use, validated and, as demonstrated here for the first time, has a correlation with force-platform data.

Articular chondrocyte alignment in the rat after surgically induced osteoarthritis

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Takahashi, Hideaki; Tamaki, Hiroyuki; Yamamoto, Noriaki; Onishi, Hideaki

2017-01-01

[Purpose] Chondrocytes in articular cartilage are aligned as columns from the joint surface. Notably, loss of chondrocyte and abnormalities of differentiation factors give rise to osteoarthritis (OA). However, the relationship between chondrocyte alignment and OA progression remains unclear. This study was performed to investigate temporal alterations in surgically-induced OA rats. [Subjects and Methods] Thirteen-week-old Wistar rats (n=30) underwent destabilized medial meniscus surgery in their right knee and sham surgery in their left knee. Specimens (n=5) were collected at 0, 1, 2, 4 and 8 weeks after surgery. Histological analysis with Osteoarthritis Research Society International (OARSI) scores, cell density ratios, cell alignments and correlation between OARSI scores and cell density/alignment was performed. [Results] OARSI scores were significantly higher at 1, 2, 4 and 8 weeks in the DMM group than in the control. Cell density ratios were decreased significantly in the DMM group at 2, 4 and 8 weeks compared with the control. Chondrocyte alignment was decreased significantly in the DMM group at 4 and 8 weeks. There were negative correlations between OA severity and cell density / cell alignment. [Conclusion] The results suggest a relationship between chondrocyte alignment and cartilage homeostasis, which plays an important role in OA progression. PMID:28533592

Validation of a short form of the Western Ontario and McMaster Universities Osteoarthritis Index function subscale in hip and knee osteoarthritis.

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Baron, Gabriel; Tubach, Florence; Ravaud, Philippe; Logeart, Isabelle; Dougados, Maxime

2007-05-15

A short version of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) function scale has recently been developed to enhance the applicability of the scale in routine practice and clinical research for patients with hip and knee osteoarthritis. The goal of the present study was to validate this short form. We conducted a prospective 4-week cohort study of 1,036 outpatients. Performance on the WOMAC function long form (LF) and short form (SF) was compared. Agreement between responses on the 2 forms was examined according to a Bland-Altman plot. Responsiveness to change (by standardized response mean [SRM]), reproducibility (intraclass correlation coefficient [ICC]), and internal consistency (Cronbach's alpha) were computed for both forms. Construct validity was assessed based on functional impairment as measured on a numerical rating scale. At baseline, 24% of patients who completed the WOMAC LF had missing data for at least 1 item as compared with only 6% of patients who completed the WOMAC SF. The mean WOMAC SF score was greater than the mean WOMAC LF score (mean +/- SD difference -4.3 +/- 4.8 on a 0-100 scale). SRMs were 0.61 and 0.73, ICCs were 0.76 and 0.68, and Cronbach's alphas were 0.93 and 0.85 for the WOMAC LF and SF, respectively. The 2 forms had comparable correlation with functional impairment. The WOMAC function short form has a low rate of missing data and is a responsive, reproducible, and valid measure. The mean SF score was 4 points higher than the mean LF score.

Histopathological subgroups in knee osteoarthritis.

Science.gov (United States)

Wyatt, L A; Moreton, B J; Mapp, P I; Wilson, D; Hill, R; Ferguson, E; Scammell, B E; Walsh, D A

2017-01-01

Osteoarthritis (OA) is a heterogeneous, multi-tissue disease. We hypothesised that different histopathological features characterise different stages during knee OA progression, and that discrete subgroups can be defined based on validated measures of OA histopathological features. Medial tibial plateaux and synovium were from 343 post-mortem (PM) and 143 OA arthroplasty donations. A 'chondropathy/osteophyte' group (n = 217) was classified as PM cases with osteophytes or macroscopic medial tibiofemoral chondropathy lesions ≥grade 3 to represent pre-surgical (early) OA. 'Non-arthritic' controls (n = 48) were identified from the remaining PM cases. Mankin histopathological scores were subjected to Rasch analysis and supplemented with histopathological scores for subchondral bone marrow replacement and synovitis. Item weightings were derived by principle components analysis (PCA). Histopathological subgroups were sought using latent class analysis (LCA). Chondropathy, synovitis and osteochondral pathology were each associated with OA at arthroplasty, but each was also identified in some 'non-arthritic' controls. Tidemark breaching in the chondropathy/osteophyte group was greater than in non-arthritic controls. Three histopathological subgroups were identified, characterised as 'mild OA', or 'severe OA' with mild or moderate/severe synovitis. Presence and severity of synovitis helps define distinct histopathological OA subgroups. The absence of a discrete 'normal' subgroup indicates a pathological continuum between normality and OA status. Identifying specific pathological processes and their clinical correlates in OA subgroups has potential to accelerate the development of more effective therapies. Copyright © 2016 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

The Art of the Possible: T. E. Lawrence and Coalition Liaison

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2001-06-01

Letters of T. E. Lawrence and his Brothers ed. M. R . Lawrence (Oxford: Blackwell; New York: MacMillan, 1954), 284; quoted in Jeremy Wilson, Lawrence of...and dysentery and was bedridden in his tent for ten days. Up to this point in the fighting things had been moving quickly and Lawrence had been, by...determines that information is subject to special dissemination limitation specified by paragraph 4-505, DoD 5200.1- R . STATEMENT X: Distribution

A study to find out the immediate effect of macquarie injury management group (mimg protocol on pain and range of motion in primary osteoarthritis knee patients- an interventional study

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Dr. Shukla Yashasvi S.

2016-10-01

Full Text Available Osteoarthritis is a disorder of the diarthrodial joint, a slow degenerative disease clinically characterized by pain, loss of range of motion. On a radiograph seen as reduced joint space, formation of osteophytes, sclerosis of bone and deformity. Manual therapy has been proved to be an effective treatment method in knee osteoarthritis (OA, but there is a need to investigate effectiveness of MIMG manual therapy technique. There is limited evidence on effect of MIMG protocol in knee OA. To find the effectiveness of MIMG protocol on pain and range of motion in knee osteoarthritis. 30 subjects with the diagnosis of knee OA stage II and III on Kellegren Lawrence classification were recruited from Shree K.K.Sheth physiotherapy Centre, Rajkot, Gujarat. An interventional study was conducted on 30 subjects. The outcome measures were Pain and Range of Motion (ROM. The intra group comparison was statistically significant with p= <0.001. MIMG protocol is effective in treating OA knee. Hence it can be suggested as one of the treatment regime.

Balance and risk of fall in individuals with bilateral mild and moderate knee osteoarthritis.

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Khalaj, Nafiseh; Abu Osman, Noor Azuan; Mokhtar, Abdul Halim; Mehdikhani, Mahboobeh; Wan Abas, Wan Abu Bakar

2014-01-01

Balance is essential for mobility and performing activities of daily living. People with knee osteoarthritis display impairment in knee joint proprioception. Thus, the aim of this study was to evaluate balance and risk of fall in individuals with bilateral mild and moderate knee osteoarthritis. Sixty subjects aged between 50 and 70 years volunteered in this study. They were categorized into three groups which were healthy (n = 20), mild (n = 20) and moderate (n = 20) bilateral knee osteoarthritis groups. Dynamic and static balance and risk of fall were assessed using Biodex Stability System. In addition, Timed Up and Go test was used as a clinical test for balance. Results of this study illustrated that there were significant differences in balance (dynamic and static) and risk of fall between three groups. In addition, the main (most significant) difference was found to be between healthy group and moderate group. Furthermore, on clinical scoring of balance, the "Timed Up and Go" test, all three groups showed significant difference. In conclusion, bilateral knee osteoarthritis impaired the balance and increased the risk of fall, particularly in people with moderate knee osteoarthritis.

T1rho MRI of menisci and cartilage in patients with osteoarthritis at 3T

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Wang, Ligong, E-mail: ligong.wang@nyumc.org [Quantitative Multinuclear Musculoskeletal Imaging Group (QMMIG), Center for Biomedical Imaging, Department of Radiology, New York University Langone Medical Center, New York, NY (United States); Chang, Gregory, E-mail: gregory.chang@nyumc.org [Quantitative Multinuclear Musculoskeletal Imaging Group (QMMIG), Center for Biomedical Imaging, Department of Radiology, New York University Langone Medical Center, New York, NY (United States); Xu, Jian, E-mail: jian.xu.sz@siemens.com [Siemens HealthCare, New York, NY (United States); Vieira, Renata L.R., E-mail: Renata.Vieira@nyumc.org [Quantitative Multinuclear Musculoskeletal Imaging Group (QMMIG), Center for Biomedical Imaging, Department of Radiology, New York University Langone Medical Center, New York, NY (United States); Krasnokutsky, Svetlana, E-mail: Svetlana.Krasnokutsky@nyumc.org [Division of Rheumatology, New York University Langone Medical Center, New York, NY (United States); Abramson, Steven, E-mail: StevenB.Abramson@nyumc.org [Division of Rheumatology, New York University Langone Medical Center, New York, NY (United States); Regatte, Ravinder R., E-mail: Ravinder.Regatte@nyumc.org [Quantitative Multinuclear Musculoskeletal Imaging Group (QMMIG), Center for Biomedical Imaging, Department of Radiology, New York University Langone Medical Center, New York, NY (United States)

2012-09-15

Objective: To assess and compare subregional and whole T1rho values (median ± interquartile range) of femorotibial cartilage and menisci in patients with doubtful (Kellgren–Lawrence (KL) grade 1) to severe (KL4) osteoarthritis (OA) at 3T. Materials and methods: 30 subjects with varying degrees of OA (KL1–4, 13 females, 17 males, mean age ± SD = 63.9 ± 13.1 years) were evaluated on a 3T MR scanner using a spin-lock-based 3D GRE sequence for T1rho mapping. Clinical proton density (PD)-weighted fast spin echo (FSE) images in sagittal (without fat saturation), axial, and coronal (fat-saturated) planes were acquired for cartilage and meniscus Whole-organ MR imaging score (WORMS) grading. Wilcoxon rank sum test was performed to determine whether there were any statistically significant differences between subregional and whole T1rho values of femorotibial cartilage and menisci in subjects with doubtful to severe OA. Results: Lateral (72 ± 10 ms, median ± interquartile range) and medial (65 ± 10 ms) femoral anterior cartilage subregions in moderate–severe OA subjects had significantly higher T1rho values (P < 0.05) than cartilage subregions and whole femorotibial cartilage in doubtful–minimal OA subjects. There were statistically significant differences in meniscus T1rho values of the medial posterior subregion of subjects with moderate–severe OA and T1rho values of all subregions and the whole meniscus in subjects with doubtful–minimal OA. When evaluated based on WORMS, statistically significant differences were identified in T1rho values between the lateral femoral anterior cartilage subregion in patients with WORMS5–6 (advanced degeneration) and whole femorotibial cartilage and all cartilage subregions in patients with WORMS0–1 (normal). Conclusion: T1rho values are higher in specific meniscus and femorotibial cartilage subregions. These findings suggest that regional damage of both femorotibial hyaline cartilage and menisci may be associated with

T1rho MRI of menisci and cartilage in patients with osteoarthritis at 3T

International Nuclear Information System (INIS)

Wang, Ligong; Chang, Gregory; Xu, Jian; Vieira, Renata L.R.; Krasnokutsky, Svetlana; Abramson, Steven; Regatte, Ravinder R.

2012-01-01

Objective: To assess and compare subregional and whole T1rho values (median ± interquartile range) of femorotibial cartilage and menisci in patients with doubtful (Kellgren–Lawrence (KL) grade 1) to severe (KL4) osteoarthritis (OA) at 3T. Materials and methods: 30 subjects with varying degrees of OA (KL1–4, 13 females, 17 males, mean age ± SD = 63.9 ± 13.1 years) were evaluated on a 3T MR scanner using a spin-lock-based 3D GRE sequence for T1rho mapping. Clinical proton density (PD)-weighted fast spin echo (FSE) images in sagittal (without fat saturation), axial, and coronal (fat-saturated) planes were acquired for cartilage and meniscus Whole-organ MR imaging score (WORMS) grading. Wilcoxon rank sum test was performed to determine whether there were any statistically significant differences between subregional and whole T1rho values of femorotibial cartilage and menisci in subjects with doubtful to severe OA. Results: Lateral (72 ± 10 ms, median ± interquartile range) and medial (65 ± 10 ms) femoral anterior cartilage subregions in moderate–severe OA subjects had significantly higher T1rho values (P < 0.05) than cartilage subregions and whole femorotibial cartilage in doubtful–minimal OA subjects. There were statistically significant differences in meniscus T1rho values of the medial posterior subregion of subjects with moderate–severe OA and T1rho values of all subregions and the whole meniscus in subjects with doubtful–minimal OA. When evaluated based on WORMS, statistically significant differences were identified in T1rho values between the lateral femoral anterior cartilage subregion in patients with WORMS5–6 (advanced degeneration) and whole femorotibial cartilage and all cartilage subregions in patients with WORMS0–1 (normal). Conclusion: T1rho values are higher in specific meniscus and femorotibial cartilage subregions. These findings suggest that regional damage of both femorotibial hyaline cartilage and menisci may be associated with

Knee Fat Pad Volumes in Patients with Hemophilia and Their Relationship with Osteoarthritis

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Annette von Drygalski

2017-01-01

Full Text Available Hemophilic arthropathy is a progressive, disabling condition with poorly understood pathobiology. Since there is an emerging interest to study the role of intra-articular fat pad size and biology in arthritic conditions, we explored fat pad volume changes in hemophilic arthropathy and to what extent they differed from osteoarthritis. We matched a cohort of 13 adult patients with hemophilic arthropathy of the knee with age- and gender-matched cohorts without osteoarthritis (“control cohort” and with the same degree of radiographic osteoarthritis (“OA cohort” in 1 : 2 fashion. Infrapatellar fat pad (IPFP and suprapatellar fat pad (SPFP volumes were calculated based on magnetic resonance imaging and differences in fat pad volumes, demographics, height, weight, and osteoarthritis scores were evaluated. Fat pad volumes were positively associated with body size parameters in all three cohorts but were unaffected by the degree of osteoarthritis. While IPFP volumes did not differ between cohorts, SPFP volumes expanded disproportionally with weight in hemophilia patients. Our observations indicate that IPFPs and SPFPs behave biologically differently in response to different arthritic stimuli. The exaggerated expansion of the SPFP in hemophilia patients highlights the importance of further studying the implications of fat pad biology for progression of hemophilic arthropathy.

ASCOT: Autologous Bone Marrow Stem Cell Use for Osteoarthritis of the Thumb—First Carpometacarpal Joint

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Buckley, Christina; Sugrue, Conor; Carr, Emma; O’Reilly, Aine; O’Neill, Shane; Carroll, Sean M.

2017-01-01

Background: The first carpometacarpal joint (CMCJ) in the hand is a commonly affected joint by osteoarthritis. It causes significant thumb base pain, limiting functional capacity. Microfracturing and application of autologous stem cells has been performed on large joints such as the knee but has never been evaluated for use in the smaller joints in the hand. Our aim was to determine the potential benefit of microfracturing and autologous bone marrow stem cells for treatment of osteoarthritis of the first CMCJ in the hand. Methods: All inclusion criteria were satisfied. Preoperative assessment by the surgeon, physiotherapist, and occupational therapist was performed. The first CMCJ was microfractured and the Bone Marrow Stem Cells were applied directly. Postoperatively, the patients were followed up for 1 year. Results: Fifteen patients met inclusion criteria; however, 2 patients were excluded due to postoperative cellulitis and diagnosis of De Quervain's tenosynovitis. The mean scores of the 13-patient preoperative and 1 year follow-up assessments are visual analog score at rest of 3.23–1.69 (P = 0.0292), visual analog score on activity of 7.92–4.23 (P = 0.0019), range of motion 45.77o–55.15o (P = 0.0195), thumb opposition score 7.62–9.23 (P = 0.0154), Disability of the Arm, Shoulder and Hand score of 51.67–23.08 (P = 0.0065). Strength improved insignificantly from 4.7 kg preoperatively to 5.53 kg at 12 months (P = 0.1257). All patients had a positive Grind test preoperatively and a negative test after 12 months. Conclusions: This innovative pilot study is a new approach to osteoarthritis of the thumb. PMID:29062653

Intermittent balneotherapy at the Dead Sea area for patients with knee osteoarthritis.

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Sherman, Gilad; Zeller, Lior; Avriel, Avital; Friger, Michael; Harari, Marco; Sukenik, Shaul

2009-02-01

Balneotherapy, traditionally administered during a continuous stay at the Dead Sea area, has been shown to be effective for patients suffering from knee osteoarthritis. To evaluate the effectiveness of an intermittent regimen of balneotherapy at the Dead Sea for patients with knee osteoarthritis. Forty-four patients with knee osteoarthritis were included in a prospective randomized single-blind controlled study. The patients were divided into two groups: a treatment group (n=24), which were treated twice weekly for 6 consecutive weeks in a sulfur pool heated to 35-36 degrees C, and a control group (n=20) treated in a Jacuzzi filled with tap water heated to 35-36 degrees C. Participants were assessed by the Lequesne index of osteoarthritis severity, the WOMAC index, the SF-36 quality of health questionnaire, VAS scales for pain (completed by patients and physicians), and physical examination. A statistically significant improvement, lasting up to 6 months, was observed in the treatment group for most of the clinical parameters. In the control group the only improvements were in the SF-36 bodily pain scale at 6 months, the Lequesne index at 1 month and the WOMAC pain score at the end of the treatment period. Although the patients in the control group had milder disease, the difference between the two groups was not statistically significant. Intermittent balneotherapy appears to be effective for patients with knee osteoarthritis.

Isolated patellofemoral osteoarthritis.

NARCIS (Netherlands)

Jonbergen, J.P.W. van; Poolman, R.W.; Kampen, A. van

2010-01-01

BACKGROUND AND PURPOSE: The optimal treatment for isolated patellofemoral osteoarthritis is unclear at present. We systematically reviewed the highest level of available evidence on the nonoperative and operative treatment of isolated patellofemoral osteoarthritis to develop an evidenced-based

Knee complaints vary with age and gender in the adult population. Population-based reference data for the Knee injury and Osteoarthritis Outcome Score (KOOS)

DEFF Research Database (Denmark)

Paradowski, Przemyslaw T; Bergman, Stefan; Sundén-Lundius, Anne

2006-01-01

Self-reported knee complaints may vary with age and gender. Reference data from the adult population would help to better interpret the outcome of interventions due to knee complaints. The objectives of the present study were to describe the variation of self-reported knee pain, function and qual......Self-reported knee complaints may vary with age and gender. Reference data from the adult population would help to better interpret the outcome of interventions due to knee complaints. The objectives of the present study were to describe the variation of self-reported knee pain, function...... and quality of life with age and gender in the adult population and to establish population-based reference data for the Knee injury and Osteoarthritis Outcome Score (KOOS)....

Bir Ahlak Eğitimcisi Olarak Lawrence Kohlberg

OpenAIRE

Çinemre, Arş. Gör. Semra

2013-01-01

Lawrence Kohlberg: As A Moral Educator Lawrence Kohlberg (1927-1987) is a scholar who has comprehensive knowledge of many fields especially philosophy, psychology, sociology, anthropology and education, and who is known clearly for cognitive moral development theory. Having looked at the works in national and international scale which are done on Kohlberg, it is seen generally that his moral development theory has been emphasized and that his moral educational works have been neglected. In fa...

Running and osteoarthritis.

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Willick, Stuart E; Hansen, Pamela A

2010-07-01

The overall health benefits of cardiovascular exercise, such as running, are well established. However, it is also well established that in certain circumstances running can lead to overload injuries of muscle, tendon, and bone. In contrast, it has not been established that running leads to degeneration of articular cartilage, which is the hallmark of osteoarthritis. This article reviews the available literature on the association between running and osteoarthritis, with a focus on clinical epidemiologic studies. The preponderance of clinical reports refutes an association between running and osteoarthritis. Copyright 2010 Elsevier Inc. All rights reserved.

ISOMETRIC EXERCISE VERSUS COMBINED CONCENTRIC-ECCENTRIC EXERCISE TRAINING IN PATIENTS WITH OSTEOARTHRITIS KNEE

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Nigombam Amit Kumar

2015-12-01

Full Text Available Background: Osteoarthritis is a slowly evolving articular disease, which appears to originate in the cartilage and affects the underlying bone and soft tissues. OA results in pain and functional disability. The purpose of this study was to determine the effect of isometric exercises and combined concentric-eccentric exercises in reducing pain and functional disability in patients with osteoarthritis of knee. Methods: Forty individuals who were diagnosed as osteoarthritis by qualified orthopaedics and orthopaedic surgeons were chosen and were randomly divided into 2 groups Group A (N=20 and Group B (N=20. Group A was treated with isometric exercises and Group B was treated with combined concentric-eccentric exercises. The intervention lasted eight weeks and the physical activity was carried out for 3 days a week. Both the groups were assessed for pain and functional disability of knee joint by using WOMAC osteoarthritis index and VAS. Results: Between group analysis of pre and post study data reveals that VAS and WOMAC osteoarthritis index revealed significant findings (P=0.00. Group B performs significantly better on both the scales after the treatment. Conclusion: Both the groups showed significant improvement in decreasing pain and functional disability. But mean scores of Group B showed greater improvement in reducing pain and functional disability as compared to Group A in patients with knee osteoarthritis. Thus the results suggest that a combined concentric-eccentric e

Physical Activity Predicts Higher Physical Function in Older Adults: The Osteoarthritis Initiative.

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Batsis, John A; Germain, Cassandra M; Vásquez, Elizabeth; Zbehlik, Alicia J; Bartels, Stephen J

2016-01-01

Physical activity reduces mobility impairments in elders. We examined the association of physical activity on risk of subjective and objective physical function in adults with and at risk for osteoarthritis (OA). Adults aged ≥ 60 years from the longitudinal Osteoarthritis Initiative, a prospective observational study of knee OA, were classified by sex-specific quartiles of Physical Activity Score for the Elderly scores. Using linear mixed models, we assessed 6-year data on self-reported health, gait speed, Late-Life Function and Disability Index (LLFDI) and chair stand. Of 2252 subjects, mean age ranged from 66 to 70 years. Within each quartile, physical component (PCS) of the Short Form-12 and gait speed decreased from baseline to follow-up in both sexes (all P physical activity is associated with maintained physical function and is mediated by muscle strength, highlighting the importance of encouraging physical activity in older adults with and at risk for OA.

Acupuncture as an Adjunct Therapy for Osteoarthritis in Chimpanzees (Pan troglodytes)

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Magden, Elizabeth R; Haller, Rachel L; Thiele, Erica J; Buchl, Stephanie J; Lambeth, Susan P; Schapiro, Steven J

2013-01-01

Acupuncture is an ancient practice that is currently used to treat disorders ranging from osteoarthritis to cardiomyopathy. Acupuncture involves the insertion of thin, sterile needles into defined acupuncture points that stimulate physiologic processes through neural signaling. Numerous scientific studies have proven the benefits of acupuncture, and given this scientific support, we hypothesized that acupuncture could benefit the nonhuman primates at our facility. As our chimpanzee colony ages, we are observing an increase in osteoarthritis and have focused our initial acupuncture treatments on this condition. We successfully trained 3 chimpanzees, by using positive-reinforcement training techniques, to voluntarily participate in acupuncture treatments for stifle osteoarthritis. We used 3 acupuncture points that correlate with alleviation of stifle pain and inflammation in humans. A mobility scoring system was used to assess improvements in mobility as a function of the acupuncture treatments. The 2 chimpanzees with the most severe osteoarthritis showed significant improvement in mobility after acupuncture treatments. Acupuncture therapy not only resulted in improved mobility, but the training sessions also served as enrichment for the animals, as demonstrated by their voluntary participation in the training and treatment sessions. Acupuncture is an innovative treatment technique that our data show to be safe, inexpensive, and, most importantly, effective for chimpanzees. PMID:23849446

Acupuncture as an adjunct therapy for osteoarthritis in chimpanzees (Pan troglodytes).

Science.gov (United States)

Magden, Elizabeth R; Haller, Rachel L; Thiele, Erica J; Buchl, Stephanie J; Lambeth, Susan P; Schapiro, Steven J

2013-07-01

Acupuncture is an ancient practice that is currently used to treat disorders ranging from osteoarthritis to cardiomyopathy. Acupuncture involves the insertion of thin, sterile needles into defined acupuncture points that stimulate physiologic processes through neural signaling. Numerous scientific studies have proven the benefits of acupuncture, and given this scientific support, we hypothesized that acupuncture could benefit the nonhuman primates at our facility. As our chimpanzee colony ages, we are observing an increase in osteoarthritis and have focused our initial acupuncture treatments on this condition. We successfully trained 3 chimpanzees, by using positive-reinforcement training techniques, to voluntarily participate in acupuncture treatments for stifle osteoarthritis. We used 3 acupuncture points that correlate with alleviation of stifle pain and inflammation in humans. A mobility scoring system was used to assess improvements in mobility as a function of the acupuncture treatments. The 2 chimpanzees with the most severe osteoarthritis showed significant improvement in mobility after acupuncture treatments. Acupuncture therapy not only resulted in improved mobility, but the training sessions also served as enrichment for the animals, as demonstrated by their voluntary participation in the training and treatment sessions. Acupuncture is an innovative treatment technique that our data show to be safe, inexpensive, and, most importantly, effective for chimpanzees.

[CLINICAL APPLICATION OF OXFORD MOBILE-BEARING BIPOLAR PROSTHESIS UNICOMPARTMENTAL KNEE ARTHROPLASTY FOR SINGLE COMPARTMENTAL KNEE OSTEOARTHRITIS].

Science.gov (United States)

Wang, Shangzeng; Cheng, Shao; Wang, Yisheng

2016-01-01

To evaluate the effectiveness of Oxford mobile-bearing bipolar prosthesis unicompartmental knee arthroplasty (UKA) in the treatment of single compartmental knee osteoarthritis. Between June 2011 and July 2013, 22 cases of single compartmental knee osteoarthritis were treated by Oxford mobile-bearing bipolar prosthesis UKA. Of 22 cases, 8 were male and 14 were female with an average age of 65 years (range, 45-80 years); the left knee was involved in 12 cases, and the right knee in 10 cases, with a mean disease duration of 32.5 months (range, 8-90 months). The mean weight was 55.2 kg (range, 50-65 kg), and the mean body mass index was 20.8 kg/m2 (range, 17-25 kg/m2). Osteoarthritis involved in the single knee medial compartment in all patients. Knee society score (KSS) and range of motion (ROM) were measured to evaluate the knee joint function. Primary healing of incision was obtained in all patients, and there was no complication of infection, bedsore, or deep venous thrombosis. Postoperative follow-up was 2-4 years (mean, 3.2 years). The X-ray films showed good position of prosthesis, no prosthesis dislocation, or periprosthetic infection during follow-up. Knee ROM, KSS function score, and KSS clinical score were significantly improved at 1 week after operation and at last follow-up when compared with preoperative ones (P 0.05). Oxford mobile-bearing bipolar prosthesis UKA is an effective method to treat single compartmental knee osteoarthritis, with the advantages of less trauma, earlier rehabilitation exercise, near physiological state in joint function, and less risk of complications.

Directional fractal signature methods for trabecular bone texture in hand radiographs: Data from the Osteoarthritis Initiative

Energy Technology Data Exchange (ETDEWEB)

Wolski, M., E-mail: marcin.wolski@curtin.edu.au; Podsiadlo, P.; Stachowiak, G. W. [Tribology Laboratory, School of Civil and Mechanical Engineering, Curtin University, Bentley, Western Australia 6102 (Australia)

2014-08-15

Purpose: To develop directional fractal signature methods for the analysis of trabecular bone (TB) texture in hand radiographs. Problems associated with the small size of hand bones and the orientation of fingers were addressed. Methods: An augmented variance orientation transform (AVOT) and a quadrant rotating grid (QRG) methods were developed. The methods calculate fractal signatures (FSs) in different directions. Unlike other methods they have the search region adjusted according to the size of bone region of interest (ROI) to be analyzed and they produce FSs defined with respect to any chosen reference direction, i.e., they work for arbitrary orientation of fingers. Five parameters at scales ranging from 2 to 14 pixels (depending on image size and method) were derived from rose plots of Hurst coefficients, i.e., FS in dominating roughness (FS{sub Sta}), vertical (FS{sub V}) and horizontal (FS{sub H}) directions, aspect ratio (StrS), and direction signatures (StdS), respectively. The accuracy in measuring surface roughness and isotropy/anisotropy was evaluated using 3600 isotropic and 800 anisotropic fractal surface images of sizes between 20 × 20 and 64 × 64 pixels. The isotropic surfaces had FDs ranging from 2.1 to 2.9 in steps of 0.1, and the anisotropic surfaces had two dominating directions of 30° and 120°. The methods were used to find differences in hand TB textures between 20 matched pairs of subjects with (cases: approximate Kellgren-Lawrence (KL) grade ≥2) and without (controls: approximate KL grade <2) radiographic hand osteoarthritis (OA). The OA Initiative public database was used and 20 × 20 pixel bone ROIs were selected on 5th distal and middle phalanges. The performance of the AVOT and QRG methods was compared against a variance orientation transform (VOT) method developed earlier [M. Wolski, P. Podsiadlo, and G. W. Stachowiak, “Directional fractal signature analysis of trabecular bone: evaluation of different methods to detect early

Cross-cultural adaptation and psychometric analysis of the Arabic version of the oxford knee score in adult male with knee osteoarthritis.

Science.gov (United States)

Alghadir, Ahmad H; Al-Eisa, Einas S; Anwer, Shahnawaz

2017-05-15

There are varieties of self-assessment questionnaire used for the evaluation of pain, functional disability, and health related quality of life in individuals with knee osteoarthritis (OA). The present study intended to adapt and translate the oxford knee score into the Arabic and investigated its psychometric properties in adult male with knee OA. Ninety-seven adult male (mean age 57.55 ± 11.49 years) with knee OA participated. Patients were requested to complete the adapted Arabic version of the Oxford knee score (OKS-Ar), reduced "Western Ontario and McMaster Universities Index (WOMAC)", and the Visual analogue scale (VAS). Patients were requested to complete 2 nd form of OKS-Ar at least 1 week apart to assess the reproducibility of the score. The OKS was adapted and translated into Arabic by two independent Arabic native speakers (one rehabilitation professional having experience of knee OA patients and another one a trained translator) according to the international guidelines. All the participants completed the 2 nd form of OKS-Ar (Response rate 100%). Reliability and internal consistency was high with an ICC of 0.97, and the Cronbach's alpha coefficient of 0.987, respectively. A significant relationship between the OKS-Ar and the WOMAC and VAS scores confirmed the construct validity (p < 0.001). The standard error of measurement (SEM) and the minimum detectable change (MDC) were 2.2 and 6.2, respectively. The adapted Arabic version of the OKS demonstrated acceptable psychometric properties, including reliability, internal consistency, and the validity. The present study indicates that the OKS-Ar is a suitable questionnaire to measure pain and physical function in the Arabic speaking adult male patients with knee OA.

Effect of a physiotherapy rehabilitation program on knee osteoarthritis in patients with different pain intensities.

Science.gov (United States)

Abdel-Aziem, Amr Almaz; Soliman, Elsadat Saad; Mosaad, Dalia Mohammed; Draz, Amira Hussin

2018-02-01

[Purpose] To examine the effect of physiotherapy rehabilitation program on moderate knee osteoarthritis in patients with different pain intensities. [Subjects and Methods] Sixty subjects (37 men and 23 women) with moderate knee osteoarthritis participated in the current study. Randomization software was used to select the participating subjects' numbers from the clinic records. They were classified into three groups according to pain intensity: mild, moderate, and severe pain groups. All groups underwent a standard set of pulsed electromagnetic field, ultrasound, stretching exercises, and strengthening exercises. Pain intensity, knee range of motion, knee function, and isometric quadriceps strength were evaluated using the visual analogue scale, universal goniometer, Western Ontario and McMaster Universities osteoarthritis index, and Jamar hydraulic dynamometer, respectively. The evaluation was performed before and after a 4-week rehabilitation program. [Results] All groups showed significant differences in pain intensity, knee range of motion, isometric quadriceps strength, and knee function. The score change in moderate pain group was significantly greater than those in mild and severe pain groups. [Conclusion] Pain intensity is one of the prominent factors that are responsible for the improvement of knee osteoarthritis. Consequently, pain intensity should be considered during rehabilitation of knee osteoarthritis.

One year effectiveness of neuromuscular exercise compared with instruction in analgesic use on knee function in patients with early knee osteoarthritis

DEFF Research Database (Denmark)

Holsgaard-Larsen, A; Christensen, R; Clausen, B

2018-01-01

of California Activity Score (UCLA) and the European Quality of Life-5 Dimensions. RESULTS: Ninety-three patients (57% women, 58 ± 8 years, body mass index 27 ± 4 kg/m(2)) were randomized to NEMEX (n = 47) or PHARMA group (n = 46) with data from 85% being available at 12-months follow-up. Good compliance......OBJECTIVE: To test long-term effectiveness of neuromuscular exercise (NEMEX) with instructions in optimized pharmacological treatment (PHARMA) on activities of daily living (ADL) in patients with early knee osteoarthritis. DESIGN: 12-months follow-up from a randomized controlled trial. Participants...... with mild-to-moderate medial tibiofemoral knee osteoarthritis were randomly allocated to 8 weeks NEMEX or PHARMA. The primary outcome measure was the ADL-subscale of the Knee Injury and Osteoarthritis Outcome Score (KOOS). Secondary outcome measures included the other four KOOS-subscales, the University...

Total Knee Arthroplasty for Knee Osteoarthritis: Support for a Foregone Conclusion?

Science.gov (United States)

Steinhaus, Michael E; Christ, Alexander B; Cross, Michael B

2017-07-01

Total knee arthroplasty (TKA) is generally accepted as the definitive treatment for advanced knee arthritis after patients fail nonoperative treatments; however, the safety and efficacy of TKA compared to continued nonoperative treatment has never been proven in high-quality, randomized controlled trials. Recently, a 2015 Danish study published a 12-month follow-up on a cohort of patients randomized to either a TKA or continued nonsurgical management for advanced knee osteoarthritis (OA). The authors reported significantly greater improvement in the TKA group in functional outcome scores such as the overall Knee Injury and Osteoarthritis Outcome Score (KOOS 4 score), the KOOS subscales, EQ-5D descriptive index, and timed get up-and-go and 20-m walk tests; however, patients in the TKA did suffer significantly more serious adverse events (SAE). The authors concluded that TKA combined with additional nonoperative care postoperatively is more efficacious than nonsurgical treatment alone in terms of improving pain, function, and quality of life at 12 months but is associated with more SAE. The purpose of this review is to identify the strengths and weaknesses of this trial, interpret its outcomes within the context of prior literature, and evaluate the validity of its conclusions.

Intra-articular therapies for osteoarthritis.

Science.gov (United States)

Yu, Shirley P; Hunter, David J

2016-10-01

Conventional medical therapies for osteoarthritis are mainly palliative in nature, aiming to control pain and symptoms. Traditional intra-articular therapies are not recommended in guidelines as first line therapy, but are potential alternatives, when conventional therapies have failed. Current and future intra-articular drug therapies for osteoarthritis are highlighted, including corticosteroids, hyaluronate, and more controversial treatments marketed commercially, namely platelet rich plasma and mesenchymal cell therapy. Intraarticular disease modifying osteoarthritis drugs are the future of osteoarthritis treatments, aiming at structural modification and altering the disease progression. Interleukin-1β inhibitor, bone morphogenic protein-7, fibroblast growth factor 18, bradykinin B2 receptor antagonist, human serum albumin, and gene therapy are discussed in this review. The evolution of drug development in osteoarthritis is limited by the ability to demonstrate effect. High quality trials are required to justify the use of existing intra-articular therapies and to advocate for newer, promising therapies. Challenges in osteoarthritis therapy research are fundamentally related to the complexity of the pathological mechanisms of osteoarthritis. Novel drugs offer hope in a disease with limited medical therapy options. Whether these future intra-articular therapies will provide clinically meaningful benefits, remains unknown.

the contribution made by te lawrence to the theory of revolutionary

African Journals Online (AJOL)

Lawrence was basically an academic thrown into the hurly-burly of leading an Arab revolt against. Turkish domination. It could be said that the war in the Middle East was a sideshow of the First. World War and Lawrence's part was a ' ... sideshow to the sideshow'l) Why then has Lawrence been remembered when greater ...

Does Participation in Sports Affect Osteoarthritic Progression After Periacetabular Osteotomy?

Science.gov (United States)

Hara, Daisuke; Hamai, Satoshi; Fukushi, Jun-Ichi; Kawaguchi, Ken-Ichi; Motomura, Goro; Ikemura, Satoshi; Komiyama, Keisuke; Nakashima, Yasuharu

2017-09-01

Periacetabular osteotomy (PAO) is an effective treatment for symptomatic acetabular dysplasia. However, whether postoperative participation in sports leads to progression of the Kellgren-Lawrence (KL) grade of osteoarthritis (OA) in these patients is unclear. To investigate (1) participation in sports before and after PAO and (2) whether postoperative participation in sports leads to progression of the KL grade. Case-control study; Level of evidence, 3. The authors retrospectively reviewed data on 161 patients (183 hips) who underwent PAO for symptomatic acetabular dysplasia with preoperative KL grade 1 or 2 between 1998 and 2011. The mean age at the time of surgery was 42.0 ± 10.9 years (range, 12-64 years), and the mean follow-up duration was 100 months (range, 13-180 months). Data included participation in sports, the University of California, Los Angeles (UCLA) activity scale score, age at the time of surgery, body mass index, follow-up duration, history of treatment for developmental hip dislocations, Merle d'Aubigné-Postel score, Oxford Hip Score, center-edge angle, and KL grade. Univariate and multivariate analyses were applied to determine which factors were associated with progression to KL grade 3 or 4 after PAO. The number of patients who participated in sports significantly increased from 50 (31.1%) preoperatively to 89 (55.3%) postoperatively. The mean UCLA score significantly increased from 4.7 ± 2.1 preoperatively to 5.5 ± 2.0 postoperatively. The KL grade progressed to grade 3 or 4 in 16 hips, including 4 hips that underwent conversion to total hip arthroplasty. No significant differences were found in postoperative participation in sports (89 hips [53.3%] vs 11 hips [68.8%], respectively; P = .24) and the UCLA score (5.6 ± 2.0 vs 5.1 ± 2.0, respectively; P = .30) between hips with KL grade 1 or 2 and KL grade 3 or 4. A multivariate analysis revealed that no factors, including postoperative participation in sports, were significantly

Associations of cigarette smoking, betel quid chewing and alcohol consumption with high-sensitivity C-reactive protein in early radiographic knee osteoarthritis: a cross-sectional study.

Science.gov (United States)

Zhang, Yi; Zeng, Chao; Wei, Jie; Li, Hui; Yang, Tuo; Yang, Ye; Deng, Zhen-han; Ding, Xiang; Lei, Guanghua

2016-03-11

High-sensitivity C-reactive protein (hsCRP) is possibly related to osteoarthritis (OA) progression and a variety of OA-related symptoms. This study aimed to examine associations between cigarette smoking, betel quid chewing and alcohol consumption and hsCRP in early radiographic knee OA. Cross-sectional health examination survey. This primary study was conducted in a health examination centre in China. 936 (656 men and 280 women) patients with early radiographic knee OA were included in this cross-sectional study. Smoking status was classified into four levels based on daily smoking habit: 0/day, 1-10/day, 11-20/day and >20/day. Betel quid chewing and alcohol consumption status was divided into 'Yes' or 'No'. Early radiographic knee OA was defined as Kellgren Lawrence (K-L) grade 1 or 2 in at least one leg, and elevated hsCRP was assessed as ≥ 3.0 mg/L. After adjustment for a number of potential confounding factors, a significant positive association between cigarette smoking and hsCRP was observed in the multivariable model. The multivariable-adjusted ORs (95% CI) of elevated hsCRP (≥ 3.0 mg/L) in the second (1-10/day, n=133), third (11-20/day, n=59) and highest (>20/day, n=104) cigarette smoking categories were 1.54 (95% CI 0.91 to 2.61), 1.27 (95% CI 0.57 to 2.79) and 2.09 (95% CI 1.20 to 3.64), respectively, compared with the non-smoker category (n=640). In addition, there was a positive dose-response relationship between cigarette smoking and elevated hsCRP (p for trend=0.01). No significant associations between betel quid chewing and alcohol consumption and hsCRP were observed in the multivariable model. This study indicated that cigarette smoking was positively associated with serum hsCRP level in patients with early radiographic knee OA. However, in view of the nature of cross-sectional designs, the results need to be confirmed by further prospective studies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted

St. Lawrence action plan meter

Energy Technology Data Exchange (ETDEWEB)

NONE

1992-12-31

The purpose of this bulletin is to report on the progress achieved under the St. Lawrence Action Plan. Under each of the Action Plan`s five objectives, it outlines environmental management indicators which identify actions taken and shows the results. This report presents the data collected in late August 1992 on the activities carried out by all partners of both governments involved in SLAP. The objectives examined in the bulletin are: to reduce by 90% the liquid toxic waste discharged by the 50 plants targeted for priority action; to prepare remediation plans for contaminated federal sites and restore wetlands; to conserve 5000 additional hectares of habitat and create a marine park; to develop and implement recovery plans for mammals, fish, birds, amphibians, reptiles, and plants; and to determine the state of the St. Lawrence River.

Osteoarthritis in the Knee Joints of Göttingen Minipigs after Resection of the Anterior Cruciate Ligament? Missing Correlation of MRI, Gene and Protein Expression with Histological Scoring.

Directory of Open Access Journals (Sweden)

Gregor Reisig

Full Text Available The Göttingen Minipig (GM is used as large animal model in articular cartilage research. The aim of the study was to introduce osteoarthritis (OA in the GM by resecting the anterior cruciate ligament (ACLR according to Pond and Nuki, verified by histological and magnetic resonance imaging (MRI scoring as well as analysis of gene and protein expression.The eight included skeletally mature female GM were assessed after ACLR in the left and a sham operation in the right knee, which served as control. 26 weeks after surgery the knee joints were scanned using a 3-Tesla high-field MR tomography unit with a 3 T CP Large Flex Coil. Standard proton-density weighted fat saturated sequences in coronal and sagittal direction with a slice thickness of 3 mm were used. The MRI scans were assessed by two radiologists according to a modified WORMS-score, the X-rays of the knee joints by two evaluators. Osteochondral plugs with a diameter of 4mm were taken for histological examination from either the main loading zone or the macroscopic most degenerated parts of the tibia plateau or condyle respectively. The histological sections were blinded and scored by three experts according to Little et al. Gene expression analysis was performed from surrounding cartilage. Expression of adamts4, adamts5, acan, col1A1, col2, il-1ß, mmp1, mmp3, mmp13, vegf was determined by qRT-PCR. Immunohistochemical staining (IH of Col I and II was performed. IH was scored using a 4 point grading (0-no staining; 3-intense staining.Similar signs of OA were evident both in ACLR and sham operated knee joints with the histological scoring result of the ACLR joints with 6.48 ± 5.67 points and the sham joints with 6.86 ± 5.84 points (p = 0.7953 The MRI scoring yielded 0.34 ± 0.89 points for the ACLR and 0.03 ± 0.17 for the sham knee joints. There was no correlation between the histological and MRI scores (r = 0.10021. The gene expression profiles as well as the immunohistochemical findings

The association between reduced knee joint proprioception and medial meniscal abnormalities using MRI in knee osteoarthritis: results from the Amsterdam osteoarthritis cohort.

Science.gov (United States)

van der Esch, M; Knoop, J; Hunter, D J; Klein, J-P; van der Leeden, M; Knol, D L; Reiding, D; Voorneman, R E; Gerritsen, M; Roorda, L D; Lems, W F; Dekker, J

2013-05-01

Osteoarthritis (OA) of the knee is characterized by pain and activity limitations. In knee OA, proprioceptive accuracy is reduced and might be associated with pain and activity limitations. Although causes of reduced proprioceptive accuracy are divergent, medial meniscal abnormalities, which are highly prevalent in knee OA, have been suggested to play an important role. No study has focussed on the association between proprioceptive accuracy and meniscal abnormalities in knee OA. To explore the association between reduced proprioceptive accuracy and medial meniscal abnormalities in a clinical sample of knee OA subjects. Cross-sectional study in 105 subjects with knee OA. Knee proprioceptive accuracy was assessed by determining the joint motion detection threshold in the knee extension direction. The knee was imaged with a 3.0 T magnetic resonance (MR) scanner. Number of regions with medial meniscal abnormalities and the extent of abnormality in the anterior and posterior horn and body were scored according to the Boston-Leeds Osteoarthritis Knee Score (BLOKS) method. Multiple regression analyzes were used to examine whether reduced proprioceptive accuracy was associated with medial meniscal abnormalities in knee OA subjects. Mean proprioceptive accuracy was 2.9° ± 1.9°. Magnetic resonance imaging (MRI)-detected medial meniscal abnormalities were found in the anterior horn (78%), body (80%) and posterior horn (90%). Reduced proprioceptive accuracy was associated with both the number of regions with meniscal abnormalities (P knee complaints. This is the first study showing that reduced proprioceptive accuracy is associated with medial meniscal abnormalities in knee OA. The study highlights the importance of meniscal abnormalities in understanding reduced proprioceptive accuracy in persons with knee OA. Copyright © 2013 Osteoarthritis Research Society International. All rights reserved.

Imaging findings predicting the outcome of cervical facet joint blocks

International Nuclear Information System (INIS)

Hechelhammer, Lukas; Pfirrmann, Christian W.A.; Zanetti, Marco; Hodler, Juerg; Schmid, Marius R.; Boos, Norbert

2007-01-01

To determine which cross-sectional imaging findings predict the short-term outcome of cervical facet joint blocks (FJB) and to evaluate the effect of combined intra-/periarticular versus periarticular injection on pain. Fifty facet joints in 37 patients were included in the study. Single, unilateral FJBs in 24 patients, and bilateral single level FJBs in 13 patients were performed, respectively. In all patients, pain relief was assessed using a visual analogue scale. All computed tomography (CT) examinations were blindly reviewed by two radiologists. Osteoarthritis was rated using the Kellgren classification. The presence of combined intra-/periarticular vs. sole periarticular injection of contrast was evaluated. Kellgren Grades 0 (n=23), 1 (n=5), 2 (n=3), 3 (n=9), and 4 (n=10) were found. Mean pain relief after injection was 35% (range: 0-100%). 40% of all injections were combined intra-/periarticular. There was neither a statistically significant difference between pain relief and combined intra-/periarticular versus sole periarticular injection (p=0.64) nor the grade of osteoarthritis (p=0.49). Pain relief after cervical FJBs does not correlate with morphologic alterations seen on CT. Periarticular FJBs are not less successful than combined intra-/periarticular FJBs. (orig.)

Lawrence, Prof. Ernest Orlando

Indian Academy of Sciences (India)

Home; Fellowship. Fellow Profile. Elected: 1954 Honorary. Lawrence, Prof. Ernest Orlando Nobel Laureate (Physics) - 1939. Date of birth: 8 August 1901. Date of death: 27 August 1958. YouTube; Twitter; Facebook; Blog. Academy News. IAS Logo. 29th Mid-year meeting. Posted on 19 January 2018. The 29th Mid-year ...

Osteoarthritis, obesity and weight loss

DEFF Research Database (Denmark)

Bliddal, Henning; Leeds, A R; Christensen, Robin Daniel Kjersgaard

2014-01-01

Obesity is widely acknowledged as a risk factor for both the incidence and progression of osteoarthritis, and has a negative influence on outcomes. Loss of at least 10% of body weight, coupled with exercise, is recognized as a cornerstone in the management of obese patients with osteoarthritis......, and can lead to significant improvement in symptoms, pain relief, physical function and health-related quality of life. However, questions still remain surrounding optimal management. Given the significant health, social and economic burden of osteoarthritis, especially in obese patients, it is imperative...... to advance our knowledge of osteoarthritis and obesity, and apply this to improving care and outcomes. This paper overviews what is already known about osteoarthritis and obesity, discusses current key challenges and ongoing hypotheses arising from research in these areas, and finally, postulates what...

Evaluation of histological scoring systems for tissue-engineered, repaired and osteoarthritic cartilage

NARCIS (Netherlands)

Rutgers, M.; van Pelt, M.J.; Dhert, W.J.A.; Creemers, L.B.; Saris, D.B.F.

2010-01-01

Osteoarthritis and Cartilage Volume 18, Issue 1, January 2010, Pages 12-23 -------------------------------------------------------------------------------- Review Evaluation of histological scoring systems for tissue-engineered, repaired and osteoarthritic cartilage M. Rutgers†, M.J.P. van Pelt†,

Immediate Efficacy of Neuromuscular Exercise in Patients with Severe Osteoarthritis of the Hip or Knee

DEFF Research Database (Denmark)

Villadsen, Allan; Overgaard, Søren; Holsgaard-Larsen, Anders

2014-01-01

and Osteoarthritis Outcome Score (HOOS) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire. The secondary outcomes were the HOOS/KOOS subscales Pain, Symptoms, Sport and Recreation, and Joint-related Quality of Life. Exploratory outcomes were functional performance measures and lower limb...... muscle power. RESULTS: Included were 165 patients, 56% female, average age 67 years (SD ± 8), and a body mass index of 30 (SD ± 5), who were scheduled for primary hip or knee replacement. The postintervention difference between mean changes in ADL was 7.2 points (95% CI 3.5 to 10.9, p = 0.0002) in favor...... and objective performance were improved and pain reduced immediately following 8 weeks of neuromuscular exercise. While the effects were moderate in hip OA, they were only small in knee OA. ClinicalTrials.gov Identifier: NCT01003756....

The patellofemoral pain and osteoarthritis subscale of the KOOS (KOOS-PF): development and validation using the COSMIN checklist.

Science.gov (United States)

Crossley, Kay M; Macri, Erin M; Cowan, Sallie M; Collins, Natalie J; Roos, Ewa M

2017-03-03

Patellofemoral pain and osteoarthritis are prevalent and associated with substantial pain and functional impairments. Patient-reported outcome measures (PROMs) are recommended for research and clinical use, but no PROMs are specific for patellofemoral osteoarthritis, and existing PROMs for patellofemoral pain have methodological limitations. This study aimed to develop a new subscale of the Knee injury and Osteoarthritis Outcome Score for patellofemoral pain and osteoarthritis (KOOS-PF), and evaluate its measurement properties. Items were generated using input from 50 patients with patellofemoral pain and/or osteoarthritis and 14 health and medical clinicians. Item reduction was performed using data from patellofemoral cohorts (n=138). We used the COnsesus-based Standards for the selection of health Measurements INstruments guidelines to evaluate reliability, validity, responsiveness and interpretability of the final version of KOOS-PF and other KOOS subscales. From an initial 80 generated items, the final subscale included 11 items. KOOS-PF items loaded predominantly on one factor, pain during activities that load the patellofemoral joint. KOOS-PF had good internal consistency (Cronbach's α 0.86) and adequate test-retest reliability (intraclass correlation coefficient 0.86). Hypothesis testing supported convergent, divergent and known-groups validity. Responsiveness was confirmed, with KOOS-PF demonstrating a moderate correlation with Global Rating of Change scores (r 0.52) and large effect size (Cohen's d 0.89). Minimal detectable change was 2.3 (groups) and 16 (individuals), while minimal important change was 16.4. There were no floor or ceiling effects. The 11-item KOOS-PF, developed in consultation with patients and clinicians, demonstrated adequate measurement properties, and is recommended for clinical and research use in patients with patellofemoral pain and osteoarthritis. © Article author(s) (or their employer(s) unless otherwise stated in the text of

Adaptation of the osteoarthritis-specific quality of life scale (the OAQoL) for use in Germany, Hungary, Italy, Spain and Turkey.

Science.gov (United States)

Wilburn, Jeanette; McKenna, Stephen P; Kutlay, Şehim; Bender, Tamas; Braun, Jürgen; Castillo-Gallego, Concepcion; Favero, Marta; Geher, Pal; Kiltz, Uta; Martin-Mola, Emilio; Ramonda, Roberta; Rouse, Matthew; Tennant, Alan; Küçükdeveci, Ayşe A

2017-05-01

The Osteoarthritis Quality of Life scale (OAQoL) is specific to individuals with osteoarthritis. The present study describes the adaptation of the OAQoL for use in the following five European languages: German, Hungarian, Italian, Spanish and Turkish. The study involved three stages in each language; translation, cognitive debriefing (face and content validity) and validation. The validation stage assessed internal consistency (Cronbach's alpha), reproducibility (test-retest reliability using Spearman's rank correlations), convergent and divergent validity (correlations with the Health Assessment Questionnaire, The Western Ontario and McMaster Universities Index of osteoarthritis and Nottingham Health Profile) and known group validity. The OAQoL was successfully translated into the target languages with minimal problems. Cognitive debriefing interviewees found the measures easy to complete and identified few problems with content. Internal consistency ranged from 0.94 to 0.97 and test-retest reliability (reproducibility) from 0.87 to 0.98. These values indicate that the new language versions produce very low levels of measurement error. Median OAQoL scores were higher for patients reporting a current flare of osteoarthritis in all countries. Scores were also related, as expected, to perceived severity of osteoarthritis. The OAQoL was successfully adapted for use in Germany, Hungary, Italy, Spain and Turkey. The addition of these new language versions will prove valuable to multinational clinical trials and to clinical practice in the respective countries.

Diclofenac Topical (osteoarthritis pain)

Science.gov (United States)

... gel (Voltaren) is used to relieve pain from osteoarthritis (arthritis caused by a breakdown of the lining ... Diclofenac topical liquid (Pennsaid) is used to relieve osteoarthritis pain in the knees. Diclofenac is in a ...

CIFKAS A Measurer of Functional Disability Status in Knee Osteoarthritis

Directory of Open Access Journals (Sweden)

Vijay K Singh

2012-01-01

Full Text Available Knee osteoarthritis (OA results in structural and functional abnormalities and reduced functional performance abilities. In developing countries majority of population lives in rural areas having limited resources and socio-cultural biodiversity. Their personal, socio-cultural and occupational habits vary and need to be addressed. So a culturally relevant and contextually appropriate, Composite Indian Functional Knee Assessment Scale (CIFKAS for measuring the functional status in knee osteoarthritis was formulated. 128 participants from various geographical regions of India of age range 40 to 60 years using convenient sampling were included and informed consent signed by the participants. Each participant was assigned to one of the two groups. 39 participants in group A reported no episode of knee pain while 89 participants in group B reported at least one episode of knee pain in the last two months. Each participant was assessed on Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC and CIFKAS and statistical analysis was done. The Pearson correlation coefficient calculated for all 128 subjects for pain, physical functional abilities and total functional disability score were 0.878, 0.925 and 0.945 respectively. Between group analysis was done using Independent t test and p value was found to be not significant for pain (<.178, highly significant for physical functional abilities (p<.0001 and very significant for total functional disability status score (p<.004. The results indicate that both WOMAC and CIFKAS are highly correlated and there is no difference between the two for measuring pain, but for functional ability and overall functional disability status within their functional context, CIFKAS is a better tool than WOMAC.

Life sciences: Lawrence Berkeley Laboratory, 1988

International Nuclear Information System (INIS)

1989-07-01

Life Sciences Research at LBL has both a long history and a new visibility. The physics technologies pioneered in the days of Ernest O. Lawrence found almost immediate application in the medical research conducted by Ernest's brother, John Lawrence. And the tradition of nuclear medicine continues today, largely uninterrupted for more than 50 years. Until recently, though, life sciences research has been a secondary force at the Lawrence Berkeley Laboratory (LBL). Today, a true multi-program laboratory has emerged, in which the life sciences participate as a full partner. The LBL Human Genome Center is a contribution to the growing international effort to map the human genome. Its achievements represent LBL divisions, including Engineering, Materials and Chemical Sciences, and Information and Computing Sciences, along with Cell and Molecular Biology and Chemical Biodynamics. The Advanced Light Source Life Sciences Center will comprise not only beamlines and experimental end stations, but also supporting laboratories and office space for scientists from across the US. This effort reflects a confluence of scientific disciplines --- this time represented by individuals from the life sciences divisions and by engineers and physicists associated with the Advanced Light Source project. And finally, this report itself, the first summarizing the efforts of all four life sciences divisions, suggests a new spirit of cooperation. 30 figs

Are radiographs needed when MR imaging is performed for non-acute knee symptoms in patients younger than 45 years of age?

International Nuclear Information System (INIS)

Braak, Bert P.M. ter; Vincken, Patrice W.J.; Erkel, Arian R. van; Bloem, Johan L.; Bloem, Rolf M.; Napoleon, L.J.; Coene, M.N.; Luijt, Peter A. van; Lange, Sam de

2007-01-01

The objective was to determine the value of radiographs in young adults with non-acute knee symptoms who are scheduled for magnetic resonance imaging (MRI). Nine hundred and sixty-one consecutive patients aged between 16 and 45 years with knee symptoms of at least 4 weeks' duration were prospectively included in three participating hospitals. After applying exclusion criteria, 798 patients remained. Exclusion criteria were previous knee surgery (including arthroscopy) or MRI, history of rheumatoid arthritis, clinical diagnosis of retropatellar chondromalacia, contra-indication for MRI and recent trauma. We identified two groups: group A with no history of trauma (n = 332), and group B with an old (>4 weeks) history of trauma (n = 466). Patients had a standardized history taken, and underwent a physical exam, antero-posterior (AP) and lateral radiographs and MRI. We evaluated the radiographs and MRI for osseous lesions, articular surface lesions, fractures, osteoarthritis, loose bodies, bone marrow edema and incidental findings. Subsequently, patients with osseous abnormalities (Kellgren grade 1 and 2 excluded) on radiographs and a matched control group was evaluated again using MRI without radiographs. Median duration of symptoms was 20 weeks. In group A, radiographs showed 36 osseous abnormalities in 332 patients (10.8%). Only 13 of these, all Kellgren grade 1 osteoarthritis, were not confirmed on MRI. MRI showed 72 (21.7%) additional abnormalities not confirmed on radiographs. In group B, radiographs showed 40 osseous abnormalities (8.6%) in 466 patients. Only 15 of these, all Kellgren grade 1 osteoarthritis, were not confirmed on MRI. MRI showed 194 (41.6%) additional abnormalities not confirmed on radiographs. The second evaluation of MRI without radiographs in 34 patients was identical to the first MRI evaluation. Common lesions were significantly more often diagnosed with MRI than with radiographs. Radiographs should not be obtained routinely when MRI is

Are radiographs needed when MR imaging is performed for non-acute knee symptoms in patients younger than 45 years of age?

Energy Technology Data Exchange (ETDEWEB)

Braak, Bert P.M. ter; Vincken, Patrice W.J.; Erkel, Arian R. van; Bloem, Johan L. [Leiden University Medical Center, Department of Radiology, P.O. Box 9600, Leiden (Netherlands); Bloem, Rolf M. [Leiden University Medical Center, Department of Orthopaedic Surgery, Leiden (Netherlands); Napoleon, L.J.; Coene, M.N. [HAGA Hospital, Department of Orthopaedic Surgery, The Hague (Netherlands); Luijt, Peter A. van [Leiden University Medical Center, Department of Traumatology, Leiden (Netherlands); Lange, Sam de [Medical Center Haaglanden, Department of Orthopaedic Surgery, The Hague (Netherlands); Department of Orthopaedic Surgery, Delft (Netherlands)

2007-12-15

The objective was to determine the value of radiographs in young adults with non-acute knee symptoms who are scheduled for magnetic resonance imaging (MRI). Nine hundred and sixty-one consecutive patients aged between 16 and 45 years with knee symptoms of at least 4 weeks' duration were prospectively included in three participating hospitals. After applying exclusion criteria, 798 patients remained. Exclusion criteria were previous knee surgery (including arthroscopy) or MRI, history of rheumatoid arthritis, clinical diagnosis of retropatellar chondromalacia, contra-indication for MRI and recent trauma. We identified two groups: group A with no history of trauma (n = 332), and group B with an old (>4 weeks) history of trauma (n = 466). Patients had a standardized history taken, and underwent a physical exam, antero-posterior (AP) and lateral radiographs and MRI. We evaluated the radiographs and MRI for osseous lesions, articular surface lesions, fractures, osteoarthritis, loose bodies, bone marrow edema and incidental findings. Subsequently, patients with osseous abnormalities (Kellgren grade 1 and 2 excluded) on radiographs and a matched control group was evaluated again using MRI without radiographs. Median duration of symptoms was 20 weeks. In group A, radiographs showed 36 osseous abnormalities in 332 patients (10.8%). Only 13 of these, all Kellgren grade 1 osteoarthritis, were not confirmed on MRI. MRI showed 72 (21.7%) additional abnormalities not confirmed on radiographs. In group B, radiographs showed 40 osseous abnormalities (8.6%) in 466 patients. Only 15 of these, all Kellgren grade 1 osteoarthritis, were not confirmed on MRI. MRI showed 194 (41.6%) additional abnormalities not confirmed on radiographs. The second evaluation of MRI without radiographs in 34 patients was identical to the first MRI evaluation. Common lesions were significantly more often diagnosed with MRI than with radiographs. Radiographs should not be obtained routinely when MRI is

A double-blind randomized placebo-controlled feasibility study evaluating individualized homeopathy in managing pain of knee osteoarthritis.

Science.gov (United States)

Koley, Munmun; Saha, Subhranil; Ghosh, Shubhamoy

2015-07-01

Few homeopathic complexes seemed to produce significant effects in osteoarthritis; still, individualized homeopathy remained untested. We evaluated the feasibility of conducting an efficacy trial of individualized homeopathy in osteoarthritis. A prospective, parallel-arm, double-blind, randomized, placebo-controlled pilot study was conducted from January to October 2014 involving 60 patients (homeopathy, n = 30; placebo, n = 30) who were suffering from acute painful episodes of knee osteoarthritis and visiting the outpatient clinic of Mahesh Bhattacharyya Homeopathic Medical College and Hospital, West Bengal, India. Statistically significant reduction was achieved in 3 visual analog scales (measuring pain, stiffness, and loss of function) and Osteoarthritis Research Society International scores in both groups over 2 weeks (P .05). Overall, homeopathy did not appear to be superior to placebo; still, further rigorous evaluation in this design involving a larger sample size seems feasible in future. Clinical Trials Registry, India (CTRI/2014/05/004589). © The Author(s) 2015.

Comparative, validity and responsiveness of the HOOS-PS and KOOS-PS to the WOMAC physical function subscale in total joint replacement for osteoarthritis

DEFF Research Database (Denmark)

Davis, A M; Perruccio, A V; Canizares, M

2009-01-01

OBJECTIVE: To evaluate the internal consistency of the Hip disability and Osteoarthritis Outcome Score-Physical Function Short-form (HOOS-PS) and the Knee injury and Osteoarthritis Outcome Score-Physical Function Short-form (KOOS-PS) in total hip replacement (THR) and total knee (TKR) replacement....... Construct validity and responsiveness were compared to the Western Ontario McMaster Universities' Osteoarthritis Index (WOMAC) Likert 3.0 physical function (PF) subscale and the PF excluding the items in the short measures (PF-exclusions). METHODS: Participants completed the full HOOS or KOOS, measures...... of fatigue, anxiety, depression and the Chronic Pain Grade (CPG) pre-surgery and the HOOS or KOOS 6 months post-surgery. Internal consistency for the HOOS-PS and KOOS-PS was calculated using Cronbach's alpha. For construct validity, it was hypothesized that correlations between the HOOS-PS or KOOS-PS and PF...

Total hip arthroplasty survival in femoral head avascular necrosis versus primary hip osteoarthritis: Case-control study with a mean 10-year follow-up after anatomical cementless metal-on-metal 28-mm replacement.

Science.gov (United States)

Ancelin, D; Reina, N; Cavaignac, E; Delclaux, S; Chiron, P

2016-12-01

Total hip arthroplasty is the most widely used procedure to treat avascular necrosis (AVN) of the femoral head. Few studies have compared the outcomes of THA in femoral head AVN and primary hip osteoarthritis. Therefore we performed a case-control study to compare THA for femoral head AVN vs. primary hip osteoarthritis in terms of: (1) prosthesis survival, (2) complication rates, (3) functional outcomes and radiographic outcomes, (4) and to determine whether specific risk factors for THA failure exist in femoral head AVN. THA survival is similar in femoral head AVN and primary hip osteoarthritis. We compared two prospective cohorts of patients who underwent THA before 65 years of age, one composed of cases with femoral head AVN and the other of controls with primary hip osteoarthritis. In both cohorts, a cementless metal-on-metal prosthesis with a 28-mm cup and an anatomical stem was used. Exclusion criteria were THA with other types of prosthesis, posttraumatic AVN, and secondary osteoarthritis. With α set at 5%, to obtain 80% power, 246 patients were required in all. Prosthesis survival was assessed based on time to major revision (defined as replacement of at least one implant fixed to bone) and time to aseptic loosening. The other evaluation criteria were complications, Postel-Merle d'Aubigné (PMA) score, and the Engh and Agora Radiographic Assessment (ARA) scores for implant osseointegration. The study included 282 patients, 149 with AVN and 133 with osteoarthritis. Mean age was 47.8±10.2 years (range, 18.5-65) and mean follow-up was 11.4±2.8 years (range, 4.5-18.3 years). The 10-year survival rates were similar in the two groups: for major revision, AVN group, 92.5% (95% confidence interval [95% CI], 90.2-94.8) and osteoarthritis group, 95.3% (95% CI, 92.9-97.7); for aseptic loosening, AVN group, 98.6% (95% CI, 97.6-98.6) and osteoarthritis, 99.2% (95% CI, 98.4-100). The AVN group had higher numbers of revision for any reason (19 vs. 6, P=0.018) and

The effect of balneotherapy on pain relief, stiffness, and physical function in patients with osteoarthritis of the knee: a meta-analysis.

Science.gov (United States)

Matsumoto, Hiromi; Hagino, Hiroshi; Hayashi, Kunihiko; Ideno, Yuki; Wada, Takashi; Ogata, Toru; Akai, Masami; Seichi, Atsushi; Iwaya, Tsutomu

2017-08-01

This meta-analysis was performed to determine the effect of balneotherapy on relieving pain and stiffness and improving physical function, compared to controls, among patients with knee osteoarthritis. We searched electronic databases for eligible studies published from 2004 to December 31, 2016, with language restrictions of English or Japanese. We screened publications in Medline, Embase, Cochrane library, and the Japan Medical Abstracts Society Database using two approaches, MeSH terms and free words. Studies that examined the effect of balneotherapy for treating knee osteoarthritis of a ≥2-week duration were included. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were used as the outcome measure. A total of 102 publications were assessed according to the exclusion criteria of the study; eight clinical trial studies, which comprised a total of 359 cases and 375 controls, were included in this meta-analysis. The meta-analysis analyzed improvement in WOMAC score at the final follow-up visit, which varied from 2 to 12 months post-intervention. Our meta-analysis indicates that balneotherapy was clinically effective in relieving pain and stiffness, and improving function, as assessed by WOMAC score, compared to controls. However, there was high heterogeneity (88 to 93%). It is possible that balneotherapy may reduce pain and stiffness, and improve function, in individuals with knee osteoarthritis, although the quality of current publications contributes to the heterogeneity observed in this meta-analysis.

Epidemiology of osteoarthritis: state of the evidence

Science.gov (United States)

Allen, Kelli D.; Golightly, Yvonne M.

2015-01-01

Purpose of review This review focuses on recent studies of osteoarthritis epidemiology, including research on prevalence, incidence, and a broad array of potential risk factors at the person level and joint level. Recent findings Studies continue to illustrate the high impact of osteoarthritis worldwide, with increasing incidence. Person-level risk factors with strong evidence regarding osteoarthritis incidence and/or progression include age, sex, socioeconomic status, family history, and obesity. Joint-level risk factors with strong evidence for incident osteoarthritis risk include injury and occupational joint loading; the associations of injury and joint alignment with osteoarthritis progression are compelling. Moderate levels of physical activity have not been linked to increased osteoarthritis risk. Some topics of high recent interest or emerging evidence for association with osteoarthritis include metabolic pathways, vitamins, joint shape, bone density, limb length inequality, muscle strength and mass, and early structural damage. Summary Osteoarthritis is a complex, multifactorial disease, and there is still much to learn regarding mechanisms underlying incidence and progression. However, there are several known modifiable and preventable risk factors, including obesity and joint injury; efforts to mitigate these risks can help to lessen the impact of osteoarthritis. PMID:25775186

Effect of balneotherapy on temporospatial gait characteristics of patients with osteoarthritis of the knee.

Science.gov (United States)

Kiliçoğlu, Onder; Dönmez, Arif; Karagülle, Zeki; Erdoğan, Nergis; Akalan, Ekin; Temelli, Yener

2010-04-01

Effects of balneotherapy on gait properties of patients with osteoarthritis of the knee were investigated prospectively. A total of 30 patients with knee osteoarthritis received balneotherapy consisting of two daily thermomineral water baths for 2 weeks. Patients were evaluated using gait analysis and clinical scores, both within 2 weeks, before and after spa treatment. Patients were walking faster in their control analyses (0.81 +/- 0.21 to 0.89 +/- 0.19 m/s; P = 0.017), with a shorter mean stance time (63.0 +/- 3.3 to 61.8 +/- 2.5% stride; P = 0.007), an increased cadence (96 +/- 13.1 to 100 +/- 11.9 steps/min; P = 0.094) and stride length (996 +/- 174 to 1,058 +/- 142 mm; P = 0.017). Balneotherapy also resulted in a significant decrease in Lequesne knee osteoarthritis index (12.1 +/- 3.7 to 10.0 +/- 3.3 points; P = 0.003), VAS for pain (58 +/- 25 to 33 +/- 15; P = 0.0001), VAS for patients' (56 +/- 24 to 29 +/- 19; P Balneotherapy has positive effects on gait properties and clinical health quality parameters of patients with knee osteoarthritis in short-term evaluations.

Relationship between weight loss in obese knee osteoarthritis patients and serum biomarkers of cartilage breakdown

DEFF Research Database (Denmark)

Bartels, E M; Henrotin, Y; Bliddal, H

2017-01-01

OBJECTIVE: To explore effects of weight loss and maintenance on serum cartilage biomarkers denaturation neoepitope for Collagen2 (Coll2-1) and Fibulin3 fragment (Fib3-2), as well as correlations between Coll2-1 and Fib3-2 and symptomatic improvement, in a knee osteoarthritis (KOA) population....... DESIGN: 192 obese KOA patients followed a 16 week weight loss intervention and 52 weeks weight maintenance (ClinicalTrials.gov identifier: NCT00655941). Assessments were at 0, 8, 16 and 68 weeks. Serum Coll2-1 and Fib3-2 were determined with ELISA, and symptoms by the Knee Osteoarthritis Outcome Score...

Delayed Gadolinium-Enhanced Magnetic Resonance Imaging (dGEMRIC) of Hip Joint Cartilage: Better Cartilage Delineation after Intra-Articular than Intravenous Gadolinium Injection

DEFF Research Database (Denmark)

Boesen, M.; Jensen, K.E.; Quistgaard, E.

2006-01-01

years) with clinical and radiographic hip osteoarthritis (OA; Kellgren score II-III), MRI of the hip was performed twice on a clinical 1.5T MR scanner: On day 1, before and 90-180 min after 0.3 mmol/kg body weight i.v. Gd-DTPA and, on day 8, 90-180 min after ultrasound-guided i.a. injection of a 4 mmol......PURPOSE: To investigate and compare delayed gadolinium (Gd-DTPA)-enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC) in the hip joint using intravenous (i.v.) or ultrasound-guided intra-articular (i.a.) Gd-DTPA injection. MATERIAL AND METHODS: In 10 patients (50% males, mean age 58......) in the joint cartilage compared to the non-enhanced images (P I.a. Gd-DTPA provided significantly higher SNR and CNR compared to i.v. Gd-DTPA (P

Osteoarthritis after osteosynthesis of ankle injuries

International Nuclear Information System (INIS)

Lange, S.; Mechsner, K.; Langenscheidt, P.; Krankenhaus Spandau, Berlin

1984-01-01

98 patients were clinically and radiographically examined 2 to 9 years following the osteosynthesis of ankle fractures. The rate of secondary osteoarthritis was 70% including 40% of minor, 17% of medium and 13% of serious changes. Depending on the injured structures the frequency of posttraumatic osteoarthritis varies. Medium and serious radiology changes cause obvious dysfunction in 56% and 62% respectively. Joints free of Osteoarthritis one year after the injury will not develop secondary osteoarthritis later. (orig.) [de

Lawrence Livermore National Laboratory Environmental Report 2015

International Nuclear Information System (INIS)

Rosene, C. A.; Jones, H. E.

2016-01-01

The purposes of the Lawrence Livermore National Laboratory Environmental Report 2015 are to record Lawrence Livermore National Laboratory's (LLNL's) compliance with environmental standards and requirements, describe LLNL's environmental protection and remediation programs, and present the results of environmental monitoring at the two LLNL sites-the Livermore Site and Site 300. The report is prepared for the U.S. Department of Energy (DOE) by LLNL's Environmental Functional Area. Submittal of the report satisfies requirements under DOE Order 231.1B, ''Environment, Safety and Health Reporting,'' and DOE Order 458.1, ''Radiation Protection of the Public and Environment.''

Effect of joint traction on functional improvement and quality of life in patients with severe knee osteoarthritis

Directory of Open Access Journals (Sweden)

Sedigheh Sadat Naeimee

2012-07-01

Full Text Available Background and aim: Osteoarthritis (OA is the most prevalent joint disease in adults around the world and its incidence rises with age. Patients with severe knee osteoarthritis often complain of pain and severe functional disability. Most of conservative treatments used in this group of patients induce poor improvements. This study evaluated the effect of joint traction on quality of life of patients with severe knee osteoarthritis.Materials and Methods: In this clinical trial study, forty female patients with severe knee OA were randomly assigned to two following groups; common physiotherapy treatment and common physiotherapy treatment accompanied by knee distraction. Quality of life was evaluated pre- and post-treatment and also one month follow-up using the Knee injury and Osteoarthritis Outcome Score (KOOS questionnaire.Results: Common physiotherapy treatment accompanied by knee distraction resulted in significantly better quality of life post-treatment and at 1month follow-up, compared to common physiotherapy treatment alone (P<0.01.Conclusion: Common physiotherapy treatment accompanied by knee distraction induces significant improvement in quality of life in patients with severe knee osteoarthritis compared to common physiotherapy treatment alone.

78 FR 66265 - Drawbridge Operation Regulations; Reynolds Channel, Lawrence, NY

Science.gov (United States)

2013-11-05

... Regulations; Reynolds Channel, Lawrence, NY AGENCY: Coast Guard, DHS. ACTION: Notice of temporary deviation... from the regulations governing the operation of the Atlantic Beach Bridge, mile 0.4, across Reynolds.... SUPPLEMENTARY INFORMATION: The Atlantic Beach Bridge, across Reynolds Channel, mile 0.4, at Lawrence, New York...

78 FR 56610 - Drawbridge Operation Regulations; Reynolds Channel, Lawrence, NY

Science.gov (United States)

2013-09-13

... Regulations; Reynolds Channel, Lawrence, NY AGENCY: Coast Guard, DHS. ACTION: Notice of temporary deviation... from the regulations governing the operation of the Atlantic Beach Bridge, mile 0.4, across Reynolds.... SUPPLEMENTARY INFORMATION: The Atlantic Beach Bridge, across Reynolds Channel, mile 0.4, at Lawrence, New York...

Pathophysiology of osteoarthritis: perspectives

Directory of Open Access Journals (Sweden)

O. Viapiana

2011-09-01

Full Text Available Osteoarthritis is generally considered a degenerative disorder driven by mechanical alteration of joint cartilage, with the bone changes being reactive to cartilage changes. According to this pathogenetic mechanism the only strategy to prevent osteoarthritis should be based on the so-called “chondro-protective agents”. However, a number of recent finding suggests that both the initiation and the progression of the disease is driven by subchondral bone changes reactive to mechanical microdamages. These increase osteoblastic activity at the “tide-mark” with consequent enlargement of the epiphyses and osteophyte formation. The increased bone turnover is secondary to overproduction of cytokines that diffuse to cartilage tissue, where they suppress condrocyte activity and activate metallo-proteases. Preliminary observational finding and experimental data showed that inhibitors of bone turnover might slow osteoarthritis progression. The pathogenetic hypothesis for osteoarthritis illustrated here provides the rational for a new therapeutic approach to the disease.

Lower Quadriceps Rate of Force Development Is Associated With Worsening Physical Function in Adults With or at Risk for Knee Osteoarthritis: 36-Month Follow-Up Data From the Osteoarthritis Initiative.

Science.gov (United States)

Hu, Bo; Skou, Søren Thorgaard; Wise, Barton L; Williams, Glenn N; Nevitt, Michael C; Segal, Neil A

2018-01-31

To determine the association between quadriceps rate of force development (RFD) and decline in self-reported physical function and objective measures of physical performance. Longitudinal cohort study. Community-based sample from 4 urban areas. Osteoarthritis Initiative participants with or at risk for knee osteoarthritis, who had no history of knee/hip replacement, knee injury, or rheumatoid arthritis (N=2630). Not applicable. Quadriceps RFD (N/s) was measured during isometric strength testing. Worsening physical function was defined as the minimal clinically important difference for worsening self-reported Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function subscale score, 20-m walk time, and repeated chair stand time over 36 months. Compared with the slowest tertile of RFD, the fastest tertile had a lower risk for worsening of WOMAC physical function subscale score at 36-month follow-up, with an odds ratio (OR) of .68 (95% confidence interval [CI], .51-.92) after adjustment for age, sex, body mass index, depression, history of chronic diseases, and knee pain. In women, in comparison with the slowest tertile of RFD, the fastest tertile had a lower risk for worsening of WOMAC physical function subscale score at 36-month follow-up, with an adjusted OR of .57 (95% CI, .38-.86). This decreased risk did not reach statistical significance in men (OR, 0.81; 95% CI, 0.52-1.27). No statistically significant associations were detected between baseline RFD and walk or chair stand times. Our results indicate that higher RFD is associated with decreased risk for worsening self-reported physical function but not with decreased risk for worsening of physical performance. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Early days in the Lawrence Laboratory

International Nuclear Information System (INIS)

McMillan, E.M.

1976-10-01

Events at the Lawrence Radiation Laboratory at Berkeley to the end of 1940 are recalled. Radiation detection, discovery of new isotopes and elements, and accelerators are among the subjects included. 29 photographs

78 FR 34893 - Drawbridge Operation Regulations; Reynolds Channel, Lawrence, NY

Science.gov (United States)

2013-06-11

... Regulations; Reynolds Channel, Lawrence, NY AGENCY: Coast Guard, DHS. ACTION: Notice of temporary deviation... from the regulations governing the operation of the Atlantic Beach Bridge, mile 0.4, across Reynolds... Reynolds Channel, mile 0.4, at Lawrence, New York, has a vertical clearance in the closed position of 25...

Psychometric properties of the OARSI/OMERACT osteoarthritis pain and functional impairment scales: ICOAP, KOOS-PS and HOOS-PS.

Science.gov (United States)

Ruyssen-Witrand, A; Fernandez-Lopez, C J; Gossec, L; Anract, P; Courpied, J P; Dougados, M

2011-01-01

To evaluate the psychometric properties of the OARSI-OMERACT questionnaires in comparison to the existing validated scales. Consecutive hip or knee osteoarthritis patients consulting in an orthopedic department were enrolled in the study. Data collected were pain using the Intermittent and Constant Osteoarthritis Pain (ICOAP), a Numeric Rating Scale (NRS), the Western Ontario McMaster Universities' Osteoarthritis Index (WOMAC) pain subscale, the Lequesne pain subscale; functional impairment using the Knee disability and Osteoarthritis Outcome Score-Physical Function Shortform (KOOS-PS), the Hip disability and Osteoarthritis Outcome Score-Physical Function Shortform (HOOS-PS), a NRS, the WOMAC function sub-scale, the Lequesne function subscale. Validity was assessed by calculating the Spearman's correlation coefficient between all the scales. Reliability was assessed in out-patients with stable disease comparing the data collected within 2 weeks using the intra-class correlation coefficient (ICC). Responsiveness was assessed on the data from hospitalised patients prior to and 12 weeks after a total joint replacement (TJR) using the standardised response mean. Three hundred patients (mean age=68 years, females=62%, hip OA=57%) were included. There was a moderate to good correlation between ICOAP, KOOS-PS, HOOS-PS and the WOMAC, NRS and Lequesne scales. Reliability of the ICOAP hip OA HOOS-PS and KOOS-PS was good (ICC range 0.80-0.81) whereas it was moderate for knee ICOAP (ICC=0.65). Responsiveness of the ICOAP, KOOS-PS and HOOS-PS 12 weeks after TJR was comparable to responsiveness of other scales (SRM range: 0.54-1.82). The psychometric properties of the ICOAP, KOOS-PS and HOOS-PS were comparable to those of the WOMAC, Lequesne and NRS.

Prognostic biomarkers in osteoarthritis

Science.gov (United States)

Attur, Mukundan; Krasnokutsky-Samuels, Svetlana; Samuels, Jonathan; Abramson, Steven B.

2013-01-01

Purpose of review Identification of patients at risk for incident disease or disease progression in osteoarthritis remains challenging, as radiography is an insensitive reflection of molecular changes that presage cartilage and bone abnormalities. Thus there is a widely appreciated need for biochemical and imaging biomarkers. We describe recent developments with such biomarkers to identify osteoarthritis patients who are at risk for disease progression. Recent findings The biochemical markers currently under evaluation include anabolic, catabolic, and inflammatory molecules representing diverse biological pathways. A few promising cartilage and bone degradation and synthesis biomarkers are in various stages of development, awaiting further validation in larger populations. A number of studies have shown elevated expression levels of inflammatory biomarkers, both locally (synovial fluid) and systemically (serum and plasma). These chemical biomarkers are under evaluation in combination with imaging biomarkers to predict early onset and the burden of disease. Summary Prognostic biomarkers may be used in clinical knee osteoarthritis to identify subgroups in whom the disease progresses at different rates. This could facilitate our understanding of the pathogenesis and allow us to differentiate phenotypes within a heterogeneous knee osteoarthritis population. Ultimately, such findings may help facilitate the development of disease-modifying osteoarthritis drugs (DMOADs). PMID:23169101

Life sciences: Lawrence Berkeley Laboratory, 1988

Energy Technology Data Exchange (ETDEWEB)

1989-07-01

Life Sciences Research at LBL has both a long history and a new visibility. The physics technologies pioneered in the days of Ernest O. Lawrence found almost immediate application in the medical research conducted by Ernest's brother, John Lawrence. And the tradition of nuclear medicine continues today, largely uninterrupted for more than 50 years. Until recently, though, life sciences research has been a secondary force at the Lawrence Berkeley Laboratory (LBL). Today, a true multi-program laboratory has emerged, in which the life sciences participate as a full partner. The LBL Human Genome Center is a contribution to the growing international effort to map the human genome. Its achievements represent LBL divisions, including Engineering, Materials and Chemical Sciences, and Information and Computing Sciences, along with Cell and Molecular Biology and Chemical Biodynamics. The Advanced Light Source Life Sciences Center will comprise not only beamlines and experimental end stations, but also supporting laboratories and office space for scientists from across the US. This effort reflects a confluence of scientific disciplines --- this time represented by individuals from the life sciences divisions and by engineers and physicists associated with the Advanced Light Source project. And finally, this report itself, the first summarizing the efforts of all four life sciences divisions, suggests a new spirit of cooperation. 30 figs.

Association between MRI-defined osteoarthritis, pain, function and strength 3-10 years following knee joint injury in youth sport.

Science.gov (United States)

Whittaker, Jackie L; Toomey, Clodagh M; Woodhouse, Linda J; Jaremko, Jacob L; Nettel-Aguirre, Alberto; Emery, Carolyn A

2017-10-10

Youth and young adults who participate in sport have an increased risk of knee injury and subsequent osteoarthritis. Improved understanding of the relationship between structural and clinical outcomes postinjury could inform targeted osteoarthritis prevention interventions. This secondary analysis examines the association between MRI-defined osteoarthritis and self-reported and functional outcomes, 3-10 years following youth sport-related knee injury in comparison to healthy controls. Participants included a subsample (n=146) of the Alberta Youth Prevention of Early Osteoarthritis cohort: specifically, 73 individuals with 3-10 years history of sport-related intra-articular knee injury and 73 age-matched, sex-matched and sport-matched controls with completed MRI studies. Outcomes included: MRI-defined osteoarthritis, radiographic osteoarthritis, Knee Injury and Osteoarthritis Outcome Score, Intermittent and Constant Osteoarthritis Pain, knee extensor/flexor strength, triple-hop and Y-balance test. Descriptive statistics and univariate logistic regression were used to compare those with and without MRI-defined osteoarthritis. Associations between MRI-defined osteoarthritis and each outcome were assessed using multivariable linear regression considering the influence of injury history, sex, body mass index and time since injury. Participant median age was 23 years (range 15-27), and 63% were female. MRI-defined osteoarthritis varied by injury history, injury type and surgical history and was not isolated to participants with ACL and/or meniscal injuries. Those with a previous knee injury had 10-fold (95% CI 2.3 to 42.8) greater odds of MRI-defined osteoarthritis than uninjured participants. MRI-defined osteoarthritis was independently significantly associated with quality of life, but not symptoms, strength or function. MRI-detected structural changes 3-10 years following youth sport-related knee injury may not dictate clinical symptomatology, strength or function

Isolated scaphotrapeziotrapezoid osteoarthritis treatment using resurfacing arthroplasty with scaphoid anchorage.

Science.gov (United States)

Humada Álvarez, G; Simón Pérez, C; García Medrano, B; Faour Martín, O; Marcos Rodríguez, J J; Vega Castrillo, A; Martín Ferrero, M A

The aim of this study is to show the results of scaphotrapeziotrapezoid (STT) joint osteoarthritis treatment performing resurfacing arthroplasty with scaphoid anchorage. An observational, descriptive and retrospective study was performed. Ten patients with isolated STT joint osteoarthritis were studied between 2013 and 2015. The mean follow-up time was 26months. Clinical results, functional and subjective scores were reviewed. The patients were satisfied, achieving an average of 2.1 (0-3) on the VAS score and 16 (2 to 28) in the DASH questionnaire, and returning to work in the first three months post-surgery. Recovery of range of motion compared to the contralateral wrist was 96% in extension, 95% in flexion, 87% in ulnar deviation and 91% in radial deviation. The average handgrip strength of the wrist was 95% and pinch strength was 95% compared to the contralateral side. There were no intraoperative complications or alterations in postoperative carpal alignment. Resurfacing arthroplasty is proposed as a good and novel alternative in treating isolated SST joint arthritis. Achieving the correct balance between the strength and mobility of the wrist, without causing carpal destabilisation, is important to obtain satisfactory clinical and functional results. Copyright © 2017. Publicado por Elsevier España, S.L.U.

Intra-articular platelet-rich plasma (PRP) injections for treating knee pain associated with osteoarthritis of the knee in the Japanese population: a phase I and IIa clinical trial.

Science.gov (United States)

Taniguchi, Yu; Yoshioka, Tomokazu; Kanamori, Akihiro; Aoto, Katsuya; Sugaya, Hisashi; Yamazaki, Masashi

2018-02-01

Intra-articular platelet-rich plasma (PRP) injection has been found to be effective for treating osteoarthritis in patients from Western countries; however, the safety and efficacy of PRP have not been sufficiently investigated in Japanese patients. The present study aimed to evaluate the safety and feasibility of intra-articular PRP injection in Japanese patients with knee osteoarthritis. PRP without white blood cells was prepared using a single-spin centrifuge (PRGF-Endoret; BTI Biotechnology Institute, Vitoria, Spain). A 6-mL PRP volume was injected in the knee joint three times at 1 week intervals. All patients were prospectively evaluated before intervention and at 1, 3, and 6 months after the treatment. Adverse events, the Visual Analog Scale (VAS) pain score, Japanese Knee Osteoarthritis Measure (JKOM) score and Japanese Orthopedic Association score were evaluated. Ten patients (all women; average age, 60.6 years) were treated. Only minor adverse events after injection were noted, and symptoms resolved within 48 hours after the injection. The average VAS pain scores were 71.6 mm and 18.4 mm at baseline and the 6-month follow-up, respectively (P PRP injection likely represents a safe treatment option for Japanese patients with mild-to-moderate knee osteoarthritis, and has the potential to relieve pain for up to 6 months, but further study is needed to verify the efficacy.

Cross-cultural adaptation and validation of the Persian version of the Intermittent and Constant Osteoarthritis Pain Measure for the knee.

Science.gov (United States)

Panah, Sara Hojat; Baharlouie, Hamze; Rezaeian, Zahra Sadat; Hawker, Gilian

2016-01-01

The present study aimed to translate and evaluate the reliability and validity of the Persian version of the 11-item Intermittent and Constant Osteoarthritis Pain (ICOAP) measure in Iranian subjects with Knee Osteoarthritis (KOA). The ICOAP questionnaire was translated according to the Manufacturers Alliance for Productivity and Innovation (MAPI) protocol. The procedure consisted of forward and backward translation, as well as the assessment of the psychometric properties of the Persian version of the questionnaire. A sample of 230 subjects with KOA was asked to complete the Persian versions of ICOAP and Knee injury and Osteoarthritis Outcome Score (KOOS). The ICOAP was readministered to forty subjects five days after the first visit. Test-retest reliability was assessed using Intraclass Correlation Coefficient (ICC), and internal consistency was assessed by Cronbach's alpha and item-total correlation. The correlation between ICOAP and KOOS was determined using Spearman's correlation coefficient. Subjects found the Persian-version of the ICOAP to be clear, simple, and unambiguous, confirming its face validity. Spearman correlations between ICOAP total and subscale scores with KOOS scores were between 0.5 and 0.7, confirming construct validity. Cronbach's alpha, used to assess internal consistency, was 0.89, 0.93, and 0.92 for constant pain, intermittent pain, and total pain scores, respectively. The ICC was 0.90 for constant pain and 0.91 for the intermittent pain and total pain score. The Persian version of the ICOAP is a reliable and valid outcome measure that can be used in Iranian subjects with KOA.

Physiotherapy in hip and knee osteoarthritis: development of a practice guideline concerning initial assessment, treatment and evaluation.

Science.gov (United States)

Peter, W F; Jansen, M J; Hurkmans, E J; Bloo, H; Dekker, J; Dilling, R G; Hilberdink, W; Kersten-Smit, C; de Rooij, M; Veenhof, C; Vermeulen, H M; de Vos, R J; Schoones, J W; Vliet Vlieland, T P

2011-01-01

An update of a Dutch physiotherapy practice guideline in Hip and Knee Osteoarthritis (HKOA) was made, based on current evidence and best practice. A guideline steering committee, comprising 10 expert physiotherapists, selected topics concerning the guideline chapters: initial assessment, treatment and evaluation. With respect to treatment a systematic literature search was performed using various databases, and the evidence was graded (1-4). For the initial assessment and evaluation mainly review papers and textbooks were used. Based on evidence and expert opinion, recommendations were formulated. A first draft of the guideline was reviewed by 17 experts from different professional backgrounds. A second draft was field-tested by 45 physiotherapists. In total 11 topics were selected. For the initial assessment, three recommendations were formulated, pertaining to history taking, red flags, and formulating treatment goals. Concerning treatment, 7 recommendations were formulated; (supervised) exercise therapy, education and self management interventions, a combination of exercise and manual therapy, postoperative exercise therapy and taping of the patella were recommended. Balneotherapy and hydrotherapy in HKOA, and thermotherapy, TENS, and Continuous Passive Motion in knee OA were neither recommended nor discouraged. Massage therapy, ultrasound, electrotherapy, electromagnetic field, Low Level Laser Therapy, preoperative physiotherapy and education could not be recommended. For the evaluation of treatment goals the following measurement instruments were recommended: Lequesne index, Western Ontario and McMaster Universities osteoarthritis index, Hip disability and Osteoarthritis Outcome Score and Knee injury and Osteoarthritis Outcome Score, 6-minute walktest, Timed Up and Go test, Patient Specific Complaint list, Visual Analoge Scale for pain, Intermittent and Constant OsteoArthritis Pain Questionnaire, goniometry, Medical Research Council for strength, handheld

Lawrence Livermore National Laboratory Environmental Report 2014

Energy Technology Data Exchange (ETDEWEB)

Jones, H. E. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Bertoldo, N. A. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Blake, R. G. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Buscheck, W. M. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Byrne, J. G. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Cerruti, S. J. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Bish, C. B. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Fratanduono, M. E. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Grayson, A. R. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); MacQueen, D. H. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Montemayor, W. E. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Ottaway, H. L. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Paterson, L. E. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Revelli, M. A. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Rosene, C. A. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Swanson, K. A. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Terrill, A. A. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Wegrecki, A. M. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Wilson, K. R. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Woollett, J. S. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

2015-09-29

The purposes of the Lawrence Livermore National Laboratory Environmental Report 2014 are to record Lawrence Livermore National Laboratory’s (LLNL’s) compliance with environmental standards and requirements, describe LLNL’s environmental protection and remediation programs, and present the results of environmental monitoring at the two LLNL sites—the Livermore Site and Site 300. The report is prepared for the U.S. Department of Energy (DOE) by LLNL’s Environmental Functional Area. Submittal of the report satisfies requirements under DOE Order 231.1B, “Environment, Safety and Health Reporting,” and DOE Order 458.1, “Radiation Protection of the Public and Environment.”

Lawrence Livermore National Laboratory Environmental Report 2015

Energy Technology Data Exchange (ETDEWEB)

Rosene, C. A. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Jones, H. E. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

2016-09-22

The purposes of the Lawrence Livermore National Laboratory Environmental Report 2015 are to record Lawrence Livermore National Laboratory’s (LLNL’s) compliance with environmental standards and requirements, describe LLNL’s environmental protection and remediation programs, and present the results of environmental monitoring at the two LLNL sites—the Livermore Site and Site 300. The report is prepared for the U.S. Department of Energy (DOE) by LLNL’s Environmental Functional Area. Submittal of the report satisfies requirements under DOE Order 231.1B, “Environment, Safety and Health Reporting,” and DOE Order 458.1, “Radiation Protection of the Public and Environment.”

Obituary: Lawrence Hugh Aller, 1913-2003

Science.gov (United States)

Kaler, James B.

2003-12-01

The announcement still lies in my inbox: ``Lawrence Aller died last Sunday." On 16 March 2003, one of the world's fine astronomers passed away at the age of 89, leaving behind a legacy that will ripple as long as there are students of the celestial science, one that incorporated observation, theory, education, care, decency, and kindness. Lawrence was born in the humblest of conditions in Tacoma, Washington, on 24 September 1913. His mother, Lella (Belle) Allen, was a homemaker and his father Leslie Aller, was an occassional printer and gold prospector who thought that the use of the mind was a waste of time. With fierce persistence and dedication, Lawrence pulled off a feat that would probably not be possible now: getting into college without having finished high school, the result of being dragged to work in his father's primitive gold mining camp. His interest, sparked by leaflets from the Astronomical Society of the Pacific and by Russell, Dugan, and Stewart's venerable textbook, led him to a correspondence, and finally a meeting, with Donald Menzel of Harvard, who persuaded the admissions director of the University of California at Berkeley to admit him in 1932. From there, Lawrence went on to graduate school at Harvard and the Harvard Society of Fellows, where he studied with Menzel and developed his interest in stellar and nebular astronomy. After working in the War effort, he made his professorial debut at Indiana University, where he stayed until 1948 before leaving for the University of Michigan. Residing there for the next 14 years, he established his research reputation and helped develop the Michigan graduate program. In 1962, the opportunity arose to return to California, to UCLA, where he again was instrumental in founding a PhD program. There he stayed, through his retirement in 1984, doing research right up to the end. Eight other schools received him as visiting professor. Lawrence knew that to make inroads into astronomy, he needed to apply

Validation of the Chinese version 10-item Perceived Efficacy in Patient-Physician Interactions scale in patients with osteoarthritis

Directory of Open Access Journals (Sweden)

Zhao HW

2016-10-01

Full Text Available Huiwen Zhao,1 Wen Luo,1 Rose C Maly,2 Jun Liu,1 Junyi Lee,1 Yaning Cui1 1Joint Department, The 2nd Ward of Joint Surgery, Tianjin Hospital, Tianjin, the People’s Republic of China; 2Department of Family Medicine David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA Objectives: This study aimed to assess the reliability and validity of the Chinese version of the 10-item Perceived Efficacy in Patient–Physician Interaction (PEPPI-10 scale in hospitalized patients with severe knee osteoarthritis in the People’s Republic of China. Methods: Between January and March 2015, the Chinese versions of PEPPI, self-efficacy for exercise scale, osteoporosis self-efficacy scale, and modified fall efficacy scale were applied to assess 110 severe knee osteoarthritis patients who were hospitalized in the second ward of the department of arthroplasty surgery of Tianjin Hospital. Results: The Chinese version of the PEPPI-10 scale had a high coefficient of internal consistency (Cronbach’s α coefficient, 0.907. The score of the Chinese version of PEPPI was weakly correlated with the scores of the Chinese versions of self-efficacy for exercise scale, osteoporosis self-efficacy scale, and modified fall efficacy scale. Conclusion: The Chinese version of the PEPPI-10 scale exhibits sufficient internal consistency and convergent validity in hospitalized patients with severe knee osteoarthritis in the People’s Republic of China. Keywords: assessment of osteoarthritis, patient–physician communication, self-efficacy, instrument validation

Lawrence v. Texas

OpenAIRE

Kristan, Andrej

2014-01-01

Članek predstavlja nedavno rešeni ameriški primer Lawrence proti Texasu, ki bo v ustavnopravno kroniko zapisan s tremi poudarki. 1. je bilo na Vrhovnem sodišču ZDA v tem primeru izpostavljeno, da standard vrednot »zahodne civilizacije« postavlja Evropsko sodišče za človekove pravice. Ta standard se v ZDA prenaša s odločitvijo vrhovnega sodišča, da imajo homoseksualne osebe pravico do zasebnosti. 2. se s tem primerom postavljajo temelji inkorporacije mednarodnega prava človekovih pravic v amer...

Structural abnormalities and persistent complaints after an ankle sprain are not associated: an observational case control study in primary care.

Science.gov (United States)

van Ochten, John M; Mos, Marinka C E; van Putte-Katier, Nienke; Oei, Edwin H G; Bindels, Patrick J E; Bierma-Zeinstra, Sita M A; van Middelkoop, Marienke

2014-09-01

Persistent complaints are very common after a lateral ankle sprain. To investigate possible associations between structural abnormalities on radiography and MRI, and persistent complaints after a lateral ankle sprain. Observational case control study on primary care patients in general practice. Patients were selected who had visited their GP with an ankle sprain 6-12 months before the study; all received a standardised questionnaire, underwent a physical examination, and radiography and MRI of the ankle. Patients with and without persistent complaints were compared regarding structural abnormalities found on radiography and MRI; analyses were adjusted for age, sex, and body mass index. Of the 206 included patients, 98 had persistent complaints and 108 did not. No significant differences were found in structural abnormalities between patients with and without persistent complaints. In both groups, however, many structural abnormalities were found on radiography in the talocrural joint (47.2% osteophytes and 45.1% osteoarthritis) and the talonavicular joint (36.5% sclerosis). On MRI, a high prevalence was found of bone oedema (33.8%) and osteophytes (39.5) in the talocrural joint; osteophytes (54.4%), sclerosis (47.2%), and osteoarthritis (55.4%, Kellgren and Lawrence grade >1) in the talonavicular joint, as well as ligament damage (16.4%) in the anterior talofibular ligament. The prevalence of structural abnormalities is high on radiography and MRI in patients presenting in general practice with a previous ankle sprain. There is no difference in structural abnormalities, however, between patients with and without persistent complaints. Using imaging only will not lead to diagnosis of the explicit reason for the persistent complaint. © British Journal of General Practice 2014.

Presence, location, type and size of denuded areas of subchondral bone in the knee as a function of radiographic stage of OA - data from the OA initiative.

Science.gov (United States)

Frobell, R B; Wirth, W; Nevitt, M; Wyman, B T; Benichou, O; Dreher, D; Davies, R Y; Lee, J H; Baribaud, F; Gimona, A; Hudelmaier, M; Cotofana, S; Eckstein, F

2010-05-01

To assess the presence, location, type and size of denuded areas of subchondral bone (dAB) in the femorotibial joint, measured quantitatively with 3T MRI, in a large subset of OAI participants. One knee of 633 subjects (250 men, 383 women, aged 61.7+/-9.6 y) were studied, spanning all radiographic osteoarthritis (OA) stages. dABs were determined quantitatively using segmentations of coronal FLASHwe images, representing areas where the subchondral bone was not covered by cartilage. Post hoc visual examination of segmented images determined whether dABs represented full thickness cartilage loss or internal osteophyte. 7% Of the knees were Kellgren & Lawrence (KL) grade 0, 6% grade 1, 41% grade 2, 41% grade 3, and 5% grade 4. 39% Of the participants (48% of the men and 33% of the women) displayed dABs; 61% of the dABs represented internal osteophytes. 1/47 Participants with KL grade 0 displayed 'any' dAB whereas 29/32 of the KL grade 4 knees were affected. Even as early as KL grade 1, 29% of the participants showed dABs. There were significant relationships of dAB with increasing KL grades (Posteophytes were more frequent laterally (mainly posterior tibia and internal femur) whereas full thickness cartilage loss was more frequent medially (mainly external tibia and femur). dABs occur already at earliest stages of radiographic OA (KL grades 1 and 2) and become more common (and larger) with increasing disease severity. Almost all KL grade 4 knees exhibited dABs, with cartilage loss being more frequent than internal osteophytes. Copyright 2010 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Relationship between isometric thigh muscle strength and minimum clinically important differences in knee function in osteoarthritis: data from the osteoarthritis initiative.

Science.gov (United States)

Ruhdorfer, Anja; Wirth, Wolfgang; Eckstein, Felix

2015-04-01

To determine the relationship between thigh muscle strength and clinically relevant differences in self-assessed lower leg function. Isometric knee extensor and flexor strength of 4,553 Osteoarthritis Initiative participants (2,651 women and 1,902 men) was related to the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function scores by linear regression. Further, groups of male and female participant strata with minimum clinically important differences (MCIDs) in WOMAC function scores (6 of 68 units) were compared across the full range of observed values and to participants without functional deficits (WOMAC score 0). The effect of WOMAC knee pain and body mass index on the above relationships was explored using stepwise regression. Per regression equations, a 3.7% reduction in extensor strength and a 4.0% reduction in flexor strength were associated with an MCID in WOMAC function in women, and, respectively, a 3.6% and 4.8% reduction in men. For strength divided by body weight, reductions were 5.2% and 6.7%, respectively, in women and 5.8% and 6.7%, respectively, in men. Comparing MCID strata across the full observed range of WOMAC function confirmed the above estimates and did not suggest nonlinear relationships across the spectrum of observed values. WOMAC pain correlated strongly with WOMAC function, but extensor (and flexor) muscle strength contributed significant independent information. Reductions of approximately 4% in isometric muscle strength and of 6% in strength per body weight were related to a clinically relevant difference in WOMAC functional disability. Longitudinal studies will need to confirm these relationships within persons. Muscle extensor (and flexor) strength (per body weight) provided significant independent information in addition to pain in explaining variability in lower leg function. Copyright © 2015 by the American College of Rheumatology.

Perioperative plasmatic presepsin levels in patients undergoing total hip or knee replacement: a preliminary study.

Science.gov (United States)

Vicenti, G; Pesce, V; Bizzoca, D; Nappi, V; Palmiotto, F; Carrozzo, M; Moretti, B

2017-01-01

Presepsin (sCD14-ST) is an emerging biomarker in the diagnosis of sepsis. In the field of orthopaedics, it could be useful in the diagnosis and management of periprosthetic joint infections (PJI). The aim of this study is to define the normal perioperative plasmatic levels of presepsin in patients undergoing primary cementless total hip replacement (THR) or primary cemented total knee replacement (TKR). For this purpose, 50 patients (19 male, 31 female, mean age= 64.04±8.88) were recruited. The patients were divided into two groups: Group A patients underwent cementless THR, whereas Group B patients underwent cemented TKR. On recruitment, anthropometric data, smocking status, osteoarthritis stage according to Kellgren and Lawrence, Harris Hip Score (HHS) for Group A patients and Knee Society Score (KSS) for Group B patients, drugs assumption and comorbidities were recorded. All the patients underwent serial blood tests, including complete blood count, presepsin (PS), C-reactive protein (CRP) and procalcitonin (PCT) 24 hours before arthroplasty (T0) and at 24 (T1), 48 (T2), 72 (T3) and 96 (T4) hours postoperatively. Body temperature (θ) was recorded every six hours in the time lapse T0-T4. Presepsin plasmatic concentration was comparable at baseline in both groups. After surgery, however, a significant increase of presepsin was observed in Group A, whereas in Group B no significant changes of presepsin were recorded. A comparable trend of this biomarker was found in the two groups, i.e. presepsin increased from T0 to T3, when it reached its maximum value, and its decrease started at T4. Finally, presepsin resulted more accurate than CRP in the evaluation of perioperative inflammatory response in patients undergoing THR or TKR. These data will be helpful in defining a reference interval for presepsin in patients with prosthetic joint implants, and a cut-off of this biomarker for the diagnosis of PJI.

Beyond Lawrence v. Texas: crafting a fundamental right to sexual privacy.

Science.gov (United States)

Fasullo, Kristin

2009-05-01

After the watershed 2003 U.S. Supreme Court decision Lawrence v.Texas, courts are faced with the daunting task of navigating the bounds of sexual privacy in light of Lawrence's sweeping language and unconventional structure. This Note focuses on the specific issue of state governments regulating sexual device distribution. Evaluating the substantive due process rights of sexual device retailers and users, this Note ultimately argues that the privacy interest identified in Lawrence is sufficiently broad to protect intimate decisions to engage in adult consensual sexual behavior, including the liberty to sell, purchase, and use a sexual device.

Association of Beta-Blocker Use With Less Prevalent Joint Pain and Lower Opioid Requirement in People With Osteoarthritis.

Science.gov (United States)

Valdes, Ana M; Abhishek, Abhishek; Muir, Kenneth; Zhang, Weiya; Maciewicz, Rose A; Doherty, Michael

2017-07-01

Recent findings suggest that β-adrenergic blockers have antinociceptive properties. The aim of this study was to compare levels of large-joint pain between those taking adrenergic blockers and those taking other antihypertensive medications. Data from the Genetics of Osteoarthritis and Lifestyle (GOAL) study, a secondary-care cohort of osteoarthritis (OA) patients, were used. Joint pain was assessed using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain scores in 873 individuals with symptomatic hip and/or knee OA and hypertension, who were taking ≥1 prescription antihypertensive medications. The association between adrenergic blocker prescription and at least moderate joint pain (WOMAC score anxiety, and depression. The use of β-adrenergic blockers was associated with lower WOMAC pain scores and with a lower prevalence of joint pain after adjustment for demographic variables and comorbidity (adjusted odds ratio [OR adj ] for pain 0.68 [95% confidence interval (95% CI) 0.51, 0.92]; P blockers (OR adj for pain 0.94 [95% CI 0.55, 1.58]) or with any other class of antihypertensive medications. Prescription of beta-blockers was also associated negatively with opioid use (OR adj for opioids 0.73 [95% CI 0.54, 0.98]; P beta-blockers is associated with less joint pain and a lower use of opioids and other analgesics in individuals with symptomatic large-joint OA. This observation needs to be confirmed by other studies. © 2016, American College of Rheumatology.

Scientists in Gray Flannel Suits: Ernest Lawrence and the Development of Color Television

Science.gov (United States)

Roebke, Joshua

Physicists and historians typically remember Ernest Lawrence for one of two activities, his development of the cyclotron or his advocacy for atomic weapons. The two labs that he established in support of such endeavors are still named after him in California: Lawrence Berkeley and Lawrence Livermore. But there was a third accomplishment for which Lawrence believed he would always be remembered: the development of color television. In 1950, he sold a half stake of his company, Chromatic Television Laboratories, to Paramount Pictures for 1 million. That decade, Lawrence and his employees, especially Luis Alvarez and Edwin McMillan, designed cathode-ray tubes for color televisions while they championed hydrogen bombs. Although their commitment to the second was attributed to patriotism and their interest in the first was dismissed as a hobby, it is not so easy to disentangle their motives. Color screens were needed for more than variety shows and sitcoms; they displayed incoming missiles in vivid color. No company has ever been led by three future Nobel Laureates, yet Chromatic Television Laboratories was a failure. Even so, Lawrence had a profound influence on the development of color television, and I will tell this story for the first time.

Manufacturing of neutral beam sources at Lawrence Livermore Laboratory

International Nuclear Information System (INIS)

Baird, E.D.; Duffy, T.J.; Harter, G.A.; Holland, E.D.; Kloos, W.A.; Pastrone, J.A.

1979-01-01

Over 50 neutral beam sources (NBS) of the joint Lawrence Berkeley Laboratory (LBL)/Lawrence Livermore Laboratory (LLL) design have been manufactured, since 1973, in the LLL Neutral Beam Source Facility. These sources have been used to provide start-up and sustaining neutral beams for LLL mirror fusion experiments, including 2XIIB, TMX, and Beta II. Experimental prototype 20-kV and 80-kV NBS have also been designed, built, and tested for the Mirror Fusion Test Facility (MFTF)

Kinesio Taping does not improve the symptoms or function of older people with knee osteoarthritis: a randomised trial

Directory of Open Access Journals (Sweden)

Bruna Wageck

2016-07-01

Full Text Available Question: Does Kinesio Taping reduce pain and swelling, and increase muscle strength, function and knee-related health status in older people with knee osteoarthritis? Design: Randomised, controlled trial with concealed allocation, intention-to-treat analysis and blinded assessment. Participants: Seventy-six older people with knee osteoarthritis. Intervention: The experimental group received three simultaneous Kinesio Taping techniques to treat pain, strength and swelling. The control group received sham taping. All participants kept the taping on for 4 days. Outcome measures: The outcomes were: concentric muscle strength of knee extensors and flexors, measured by isokinetic dynamometry with an angular velocity of 60 deg/second normalised for body mass [(Nm/kg x 100 (%]; pressure pain threshold via digital pressure algometry (kgf/cm2; lower-limb swelling via volumetry (l and perimetry (cm; physical function via the Lysholm Knee Scoring Scale (0 = worst to 100 = best; and knee-related health status via the Western Ontario and McMaster (WOMAC osteoarthritis index (0 = best to 96 = worst. Outcomes were measured at Day 4 (end of the taping period and Day 19 (follow-up after the start of the treatment. Results: At Day 4, there were no significant between-group differences for knee extensor muscle strength (MD –1%, 95% CI –7 to 5, knee flexor muscle strength (MD 2%, 95% CI –3 to 7, the pressure pain threshold at any measured point, volumetry (MD 0.05 L, 95% CI –0.01 to 0.11, perimetry at any measured point, Lysholm score (MD –4 points, 95% CI –9 to 2, or WOMAC score (MD –2 points, 95% CI –8 to 4. The lack of significant between-group difference was also seen at the follow-up assessment on Day 19. Conclusion: The Kinesio Taping techniques investigated in this study provided no beneficial effects for older people with knee osteoarthritis on any of the assessed outcomes. Trial registration: Brazilian Registry of Clinical Trials, RBR

77 FR 42642 - Safety Zone; City of Ogdensburg Fireworks, St. Lawrence River, Ogdensburg, NY

Science.gov (United States)

2012-07-20

...-AA00 Safety Zone; City of Ogdensburg Fireworks, St. Lawrence River, Ogdensburg, NY AGENCY: Coast Guard... portion of the St. Lawrence River during the City of Ogdensburg Fireworks display. This temporary safety... as follows: Sec. 165.T09-0608 Safety Zone; City of Ogdensburg Fireworks, St. Lawrence River...

Biological knee reconstruction for combined malalignment, meniscal deficiency, and articular cartilage disease.

Science.gov (United States)

Harris, Joshua D; Hussey, Kristen; Wilson, Hillary; Pilz, Kyle; Gupta, Anil K; Gomoll, Andreas; Cole, Brian J

2015-02-01

The aim of this study was to analyze patient-reported outcomes in those undergoing the triad of simultaneous osteotomy, meniscal transplantation, and articular cartilage repair. Patients undergoing simultaneous meniscal transplantation, distal femoral or proximal tibial osteotomy, and articular cartilage surgery by a single surgeon (B.J.C.) were analyzed. Meniscal transplantation was performed using bone-in-slot techniques. Distal femoral and high tibial osteotomies were performed for valgus and varus malalignment, respectively. Microfracture, autologous chondrocyte implantation, and osteochondral autograft or allograft were performed for articular cartilage disease. Validated patient-reported and surgeon-measured outcomes were collected. Preoperative and postoperative outcomes and medial versus lateral disease were compared using Student t tests. Eighteen participants (mean age, 34 ± 7.8 years; symptomatic patients, 7.4 ± 5.6 years; 2.4 ± 1.0 surgical procedures before study enrollment; mean follow-up, 6.5 ± 3.2 years) were analyzed. Two thirds of participants had medial compartment pathologic conditions and one third had lateral compartment pathologic processes. At final follow-up, there were statistically significant clinically meaningful improvements in International Knee Documentation Committee (IKDC) subjective classification, Lysholm score, and 4 Knee Injury and Osteoarthritis Outcome Score (KOOS) subscores. Postoperative 12-item short form (SF-12) physical and mental component scores were not significantly different from preoperative scores. The Kellgren-Lawrence classification grade was 1.5 ± 1.1 at 2.5 ± 3.0 years after surgery. There was a significantly higher preoperative SF-12 physical composite score (PCS) in participants with lateral compartment pathologic conditions (v medial compartment conditions) (P = .011). Although there were 13 reoperations in 10 patients (55.5% reoperation rate), only one patient was converted to knee arthroplasty (5

Osteoarthritis 2012 year in review

DEFF Research Database (Denmark)

Roos, Ewa M.; Juhl, C B

2012-01-01

search was performed in Medline from July 2011 to 10 April 2012 using the terms 'osteoarthritis, knee', 'osteoarthritis, hip' rehabilitation, physical therapy, exercise therapy and preoperative intervention; both as text words and as MeSH terms where possible. Trials evaluating rehabilitation...

Osteoarthritis : the role of synovitis

NARCIS (Netherlands)

Kortekaas, Marion Catharina

2015-01-01

Osteoarthritis is a prevalent disease causing pain and disability. It’s aetiology is unknown and no curative treatment is available. Osteoarthritis research is complicated due to heterogeneity of the disease, slow progression and poor association of clinical features with radiographic

Glucosamine-containing supplement improves locomotor functions in subjects with knee pain: a randomized, double-blind, placebo-controlled study.

Science.gov (United States)

Kanzaki, Noriyuki; Ono, Yoshiko; Shibata, Hiroshi; Moritani, Toshio

2015-01-01

The aim of this study was to investigate the ability of a glucosamine-containing supplement to improve locomotor functions in subjects with knee pain. A randomized, double-blind, placebo-controlled, parallel-group comparative study was conducted for 16 weeks in 100 Japanese subjects (age, 51.8±0.8 years) with knee pain. Subjects were randomly assigned to one of the two supplements containing 1) 1,200 mg of glucosamine hydrochloride, 60 mg of chondroitin sulfate, 45 mg of type II collagen peptides, 90 mg of quercetin glycosides, 10 mg of imidazole peptides, and 5 μg of vitamin D per day (GCQID group, n=50) or 2) a placebo (placebo group, n=50). Japanese Knee Osteoarthritis Measure, visual analog scale score, normal walking speed, and knee-extensor strength were measured to evaluate the effects of the supplement on knee-joint functions and locomotor functions. In subjects eligible for efficacy assessment, there was no significant group × time interaction, and there were improvements in knee-joint functions and locomotor functions in both groups, but there was no significant difference between the groups. In subjects with mild-to-severe knee pain at baseline, knee-extensor strength at week 8 (104.6±5.0% body weight vs 92.3±5.5% body weight, P=0.030) and the change in normal walking speed at week 16 (0.11±0.03 m/s vs 0.05±0.02 m/s, P=0.038) were significantly greater in the GCQID group than in the placebo group. Further subgroup analysis based on Kellgren-Lawrence (K-L) grade showed that normal walking speed at week 16 (1.36±0.05 m/s vs 1.21±0.02 m/s, Pknee pain, GCQID supplementation was effective for relieving knee pain and improving locomotor functions.

Age and osteoarthritis: are AGEs the link?

NARCIS (Netherlands)

Vos, P.A.J.M.

2012-01-01

Osteoarthritis is a common joint disease in the elderly. By far the most important risk factor for osteoarthritis is aging. Age-related changes in the articular cartilage may be responsible for age-related increase in the number of people with osteoarthritis. One of the most striking changes in

Tibial tuberosity to trochlear groove distance and its association with patellofemoral osteoarthritis-related structural damage worsening: data from the osteoarthritis initiative.

Science.gov (United States)

Haj-Mirzaian, Arya; Guermazi, Ali; Hakky, Michael; Sereni, Christopher; Zikria, Bashir; Roemer, Frank W; Tanaka, Miho J; Cosgarea, Andrew J; Demehri, Shadpour

2018-04-30

To determine whether the tibial tuberosity-to-trochlear groove (TT-TG) distance is associated with concurrent patellofemoral joint osteoarthritis (OA)-related structural damage and its worsening on 24-month follow-up magnetic resonance imaging (MRI) in participants in the Osteoarthritis Initiative (OAI). Six hundred subjects (one index knee per participant) were assessed. To evaluate patellofemoral OA-related structural damage, baseline and 24-month semiquantitative MRI Osteoarthritis Knee Score (MOAKS) variables for cartilage defects, bone marrow lesions (BMLs), osteophytes, effusion, and synovitis were extracted from available readings. The TT-TG distance was measured in all subjects using baseline MRIs by two musculoskeletal radiologists. The associations between baseline TT-TG distance and concurrent baseline MOAKS variables and their worsening in follow-up MRI were investigated using regression analysis adjusted for variables associated with tibiofemoral and patellofemoral OA. At baseline, increased TT-TG distance was associated with concurrent lateral patellar and trochlear cartilage damages, BML, osteophytes, and knee joint effusion [cross-sectional evaluations; overall odds ratio 95% confidence interval (OR 95% CI): 1.098 (1.045-1.154), p patellofemoral OA-related structural damage and its worsening over 24 months. Abnormally lateralized tibial tuberosity may be considered as a risk factor for future patellofemoral OA worsening. • Excessive TT-TG distance on MRI is an indicator/predictor of lateral-patellofemoral-OA. • TT-TG is associated with simultaneous lateral-patellofemoral-OA (6-17% chance-increase for each millimeter increase). • TT-TG is associated with longitudinal (24-months) lateral-patellofemoral-OA (5-15% chance-increase for each millimeter).

SECONDARY OSTEOARTHRITIS IN RHEUMATOID ARTHRITIS

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I. A. Starodubtseva

2015-01-01

Full Text Available The paper considers the problems of comorbidities in patients with rheumatoid arthritis (RA. Two or more RA-related conditions were diagnosed according to the results of the QUEST-RA program implemented in 34 countries. Osteoarthritis along with hypertension, hyperlipidemia, and osteoporosis was detected among the most commonly diseases. Owing to expanded diagnostic capabilities, the recognition and treatment of the comorbidities have recently received much attention, as embodied in the draft Association of Rheumatologists of Russia Guidelines for RA management (2014; Part 1. The concept and major characteristics of secondary osteoarthritis in RA are analyzed. It is precisely the inflammatory process and underlying disease-related risk factors, including treatment, that have impact on the development of secondary osteoarthritis and patients’ quality of life as a whole. All this allows an inference about the mechanisms closely intertwined with the underlying disease for the development of secondary osteoarthritis, which initiates cartilage damage and further remodeling. Primary and secondary osteoarthritis was comparatively analyzed. Particular emphasis is placed on current cartilage biomarkers, their diagnostic value and role in monitoring the efficiency of treatment in clinical trials. The paper provides a comparative analysis of detectable serum and urine biomarkers according to the results of the complex analysis made by the National Institutes of Health. Particular attention is given to cartilage oligomeric matrix protein (COMP. Foreign authors’ investigations suggest that there is a relationship between serum COMP levels and disease severity and joint X-ray changes. There is evidence for the efficacy of hyaluronic acid used in the treatment of secondary osteoarthritis in patients with RA. 

Is increased joint loading detrimental to obese patients with knee osteoarthritis? A secondary data analysis from a randomized trial.

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Henriksen, M; Hunter, D J; Dam, E B; Messier, S P; Andriacchi, T P; Lohmander, L S; Aaboe, J; Boesen, M; Gudbergsen, H; Bliddal, H; Christensen, R

2013-12-01

To investigate whether increased knee joint loading due to improved ambulatory function and walking speed following weight loss achieved over 16 weeks accelerates symptomatic and structural disease progression over a subsequent 1 year weight maintenance period in an obese population with knee osteoarthritis (OA). Data from a prospective study of weight loss in obese patients with knee OA (the CARtilage in obese knee OsteoarThritis (CAROT) study) were used to determine changes in knee joint compressive loadings (model estimated) during walking after a successful 16 week weight loss intervention. The participants were divided into 'Unloaders' (participants that reduced joint loads) and 'Loaders' (participants that increased joint loads). The primary symptomatic outcome was changes in knee symptoms, measured with the Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire, during a subsequent 52 weeks weight maintenance period. The primary structural outcome was changes in tibiofemoral cartilage loss assessed semi-quantitatively (Boston Leeds Knee Osteoarthritis Score (BLOKS) from MRI after the 52 weight maintenance period. 157 participants (82% of the CAROT cohort) with medial and/or lateral knee OA were classified as Unloaders (n = 100) or Loaders (n = 57). The groups showed similar significant changes in symptoms (group difference: -2.4 KOOS points [95% CI -6.8:1.9]) and cartilage loss (group difference: -0.06 BLOKS points [95% CI -0.22:0.11) after 1 year, with no statistically significant differences between Loaders and Unloaders. For obese patients undergoing a significant weight loss, increased knee joint loading for 1 year was not associated with accelerated symptomatic and structural disease progression compared to a similar weight loss group that had reduced ambulatory compressive knee joint loads. NCT00655941. Copyright © 2013 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Osteoarthritis in the neonate

International Nuclear Information System (INIS)

Weigel, W.; Hayek, W.H.; Bens, G.

1979-01-01

A fatally ending index case of sepsis osteoarthritis that was diagnosed retrospectively initiated this report. This patient had severe, asymmetrically distributed metaphyseal growthdisturbances, many long bones. In order to determine the features of early radiologic diagnosis we report the findings of 7 further patients with neonatal septic osteoarthritis with clinical and radiological follow-up. The most important observation for early radiologic diagnosis of osteoarthritis is the displacement of fat layers along the metaphysis. Other findings of the soft tissues have the same diagnostic value as bone destruction and subperiosteal new bone formation found one to three weeks later on roentgenfilms. Detecting early signs of osteoarthritis helps in localizing the focus for bacteriologic diagnosis, which is to be more successful than blood cultures. Diagnosing a joint empyema initiates surgical intervention for pressure relief in order to avoid necrosis of the epiphysis as seen in the femoral bone in septic arthritis of the hip joint. Early diagnosis and treatment to destruction of growing cartilage is necessary to avoid gross disturbances and length discrepancies of long bones. In cases of sepsis called 'babygram' and a repeat examination 10 to 14 days later is mandatory. (orig.) [de

78 FR 71037 - St. Lawrence & Atlantic Railroad Company-Discontinuance of Service Exemption-in Cumberland County...

Science.gov (United States)

2013-11-27

... DEPARTMENT OF TRANSPORTATION Surface Transportation Board [Docket No. AB 1117X] St. Lawrence..., 2013, St. Lawrence & Atlantic Railroad Company (SLR) filed with the Surface Transportation Board (Board..., FD 35440 (STB served Dec. 29, 2010); Maine--Acquisition Exemption--Certain Assets of St. Lawrence...

MR Imaging-based Semi-quantitative Methods for Knee Osteoarthritis

Science.gov (United States)

JARRAYA, Mohamed; HAYASHI, Daichi; ROEMER, Frank Wolfgang; GUERMAZI, Ali

2016-01-01

Magnetic resonance imaging (MRI)-based semi-quantitative (SQ) methods applied to knee osteoarthritis (OA) have been introduced during the last decade and have fundamentally changed our understanding of knee OA pathology since then. Several epidemiological studies and clinical trials have used MRI-based SQ methods to evaluate different outcome measures. Interest in MRI-based SQ scoring system has led to continuous update and refinement. This article reviews the different SQ approaches for MRI-based whole organ assessment of knee OA and also discuss practical aspects of whole joint assessment. PMID:26632537

A natural mineral supplement provides relief from knee osteoarthritis symptoms: a randomized controlled pilot trial

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Kuskowski Michael A

2008-02-01

Full Text Available Abstract Background This small, pilot study evaluated the impact of treatment with a natural multi-mineral supplement from seaweed (Aquamin on walking distance, pain and joint mobility in subjects with moderate to severe osteoarthritis of the knee. Methods Subjects (n = 70 with moderate to severe osteoarthritis of the knee were randomized to four double-blinded treatments for 12 weeks: (a Glucosamine sulfate (1500 mg/d; (b Aquamin (2400 mg/d; (c Combined treatment composed of Glucosamine sulfate (1500 mg/d plus Aquamin (2400 mg/d and (d Placebo. Primary outcome measures were WOMAC scores and 6 Minute Walking Distances (6 MWD. Laboratory based blood tests were used as safety measures. Results Fifty subjects completed the study and analysis of the data showed significant differences between the groups for changes in WOMAC pain scores over time (p = 0.009 ANCOVA; however, these data must be reviewed with caution since significant differences were found between the groups at baseline for WOMAC pain and stiffness scores (p = 0.0039 and p = 0.013, respectively, ANOVA. Only the Aquamin and Glucosamine groups demonstrated significant improvements in symptoms over the course of the study. The combination group (like the placebo group did not show any significant improvements in OA symptoms in this trial. Within group analysis demonstrated significant improvements over time on treatment for the WOMAC pain, activity, composite and stiffness (Aquamin only scores as well as the 6 minute walking distances for subjects in the Aquamin and Glucosamine treatment groups. The Aquamin and Glucosamine groups walked 101 feet (+7% and 56 feet (+3.5% extra respectively. All treatments were well tolerated and the adverse events profiles were not significantly different between the groups. Conclusion This small preliminary study suggested that a multi mineral supplement (Aquamin may reduce the pain and stiffness of osteoarthritis of the knee over 12 weeks of treatment and

Risk factors of knee osteoarthritis, WHO-ILAR-COPCORD study

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Barghamdi M

2009-01-01

Full Text Available "nBackground: To evaluate the association between age, sex, BMI, waist/hip ratio, smoking, religion, ethnicity, education and knee osteoarthritis. "nMethods: Eligible subjects were randomly included from participants of Tehran COPCORD study, of whom 480 subjects with knee osteoarthritis were compared to 490 subjects without (case-control study. Using a questionnaire developed by COPCORD group (Asia & Oceania, we enquired about the risk factors of knee osteoarthritis i.e. age, sex, BMI, Waist/Hip ratio, religion, ethnicity, education and smoking. Knee osteoarthritis was defined using ACR criteria. Each knee was unit of analysis using GEE technique to evaluate these associations. "nResults: Age (OR; 1.096; CI95%: 1.091-1.1; P: 0.00 and sex (OR; 2.85; CI95%: 2.49-3.28; P: 0.00 showed significant association with knee osteoarthritis. Overweight (OR; 1.81; CI95%: 1.28-2.55; P: 0.00 and obesity (OR; 3.3; CI95%: 2.34-4.66; P: 0.00 both showed higher risk for knee osteoarthritis. The association between waist/hip ratio and knee osteoarthritis showed an OR of 5.28, CI95%: 0.89-31.44; P: 0.07. However, this association was only borderline significant. People with different religion or ethnicity and smokers had no extra risks for knee osteoarthritis. Higher education is a protective factor for knee osteoarthritis as people who had university education compared to people with no/primary education showed a lower risk for knee osteoarthritis (OR; 0.54; CI95%: 0.38-0.78; P: 0.00. "nConclusions: Our study confirmed that elderly, females, overweight and obese people are at higher risk to develop knee osteoarthritis as found in western societies. Higher education is a protective factor against knee osteoarthritis. Ethnicity, religion and smoking showed no extra risk of knee osteoarthritis.

Patellar resurfacing versus nonresurfacing in total knee arthroplasty for osteoarthritis: experience at a tertiary care institution in Pakistan

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Lakdawala RH

2012-02-01

Full Text Available Akil Fazal1, Riaz H Lakdawala21Clinical Fellow, NYU Hospital for Joint Disease, New York, US; 2Associate Professor and Chief, Section of Orthopedics, Department of Surgery, The Aga Khan University Hospital, Karachi, PakistanObjective: To determine the effect of patellar resurfacing in patients offered total knee arthroplasty for osteoarthritis.Design: Randomized control study.Place and duration of study: The Aga Khan University Hospital, Karachi, Pakistan from January 3, 2005 to January 9, 2010.Patients and methods: Patients undergoing primary total knee arthroplasty for osteoarthritis were assigned to either the patellar resurfacing or nonresurfacing arm using systematic sampling. This consisted of patients undergoing unilateral and bilateral knee arthroplasty. Preoperatively, Knee Society Knee and Function Scores were calculated. After a minimum of 3 years postoperatively Knee Society Knee and Function Scores as well as the Clinical Anterior Knee Pain Rating were calculated and analysis done to check for differences.Results: Seventy-five patients were recruited in each arm; 135 patients had bilateral and 15 had unilateral knee arthroplasty. The mean preoperative knee score was 40.4 for the resurfacing group and 40.60 for the nonresurfacing group (P = 0.45. This improved postoperatively to 93.67 and 94.23 respectively, with no difference between the two groups (P = 0.67. The mean preoperative function score was 45.50 for resurfaced patellae and 45.83 for nonresurfaced. This improved to 89.67 and 90.50, respectively, again with no difference (P = 0.51. Postoperative Clinical Anterior Knee Pain Rating was a mean of 0.1 for resurfaced and 0.13 for nonresurfaced patellas, with no difference on analysis (P = 0.06. However, patients who had bilateral knee arthroplasty had a slightly higher Clinical Anterior Knee Pain Rating than those who had single knee surgery (P = 0.046 irrespective of whether the patellar was resurfaced or not.Conclusion: In

OCCUPATIONAL RISK FACTORS IN KNEE OSTEOARTHRITIS

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Muralidhara

2015-12-01

Full Text Available INTRODUCTION Osteoarthritis (OA, also often called “osteoarthrosis” or “degenerative joint disease” is the most common form of arthritis. MATERIALS AND METHODS Present retrospective statistical study was conducted at the Department of orthopaedics in a tertiary care hospital (Catering to a largely agricultural population over a period of 2 years from January 2012 to December 2014. RESULTS Prevalence of osteoarthritis common in farmers accounting to 70%. Other occupations at risk of OA of knee were, Teachers 12%, Housewives 08%, Athletes 04%, Policemen 04% and Drivers 02%. It is in conformity with most previous studies reviewed. CONCLUSION Osteoarthritis of Knee is a major health issue and important cause of disability in elderly population. Occupational risk factors are important in development of osteoarthritis.

Topical Effects of Artemisia Absinthium Ointment and Liniment in Comparison with Piroxicam Gel in Patients with Knee Joint Osteoarthritis: A Randomized Double-Blind Controlled Trial.

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Basiri, Zahra; Zeraati, Fatemeh; Esna-Ashari, Farzaneh; Mohammadi, Farshid; Razzaghi, Keyvan; Araghchian, Malihe; Moradkhani, Shirin

2017-11-01

Pain alleviation and improvement of functional status are the main objectives in the treatment of osteoarthritis. Artemisia absinthium (AA) was used traditionally in reducing pain and inflammation. The aim of the present study was to compare the effects of topical formulations of AA and piroxicam gel (PG) among patients with knee osteoarthritis. In total, 90 outpatients aged 30-70 years with the diagnosis of primary osteoarthritis in at least one knee were enrolled in a randomized double-blind clinical trial. The patients referred to the Rheumatology Clinic at Shahid Beheshti Hospital in Hamadan province during 2012-2013. The patients were randomly assigned into three groups, 30 patients per group, and respectively received AA ointment (AAO) 3%, AA liniment (AAL) 3%, and PG; three times daily (TID) for 4 weeks. The patients were visited at baseline, week 4, and week 6. The effectiveness criteria were pain severity which was assessed with a 10-point visual analog scale (VAS), the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) for total pain score (WTPS), total physical function score (WTPFS), and total stiffness score (WTSS). Repeated measure ANOVA, paired t test and post hoc were used to compare variables. Statistical analysis was performed using the SPSS software, version 13.0 (SPSS Inc., Chicago, Illinois). All groups had similar patient demographics. The administration of PG significantly improved all tested criteria with no recurrence after discontinuing the treatment protocol. AAO alleviated all tested factors except for WTSS. Alleviation was comparable to PG. AAL only reduced pain factors (VAS, WTPS) in week 4 with recurrence in week 6. Administration of Artemisia ointment may have beneficial effects in the treatment of osteoarthritis. Trial Registration Number: IRCT201202123109N3.

Radiological imaging of osteoarthritis of the knee

International Nuclear Information System (INIS)

Wick, M.C.; Jaschke, W.; Klauser, A.S.

2012-01-01

Osteoarthritis is the most common degenerative age-related joint disease leading to typical degradation of articular cartilage with severe pain and limitation of joint motion. Although knee radiographs are widely considered as the gold standard for the assessment of knee osteoarthritis in clinical and scientific settings they increasingly have significant limitations in situations when resolution and assessment of cartilage is required. Analysis of osteoarthritis of the knee with conventional x-ray is associated with many technical limitations and is increasingly being replaced by high-quality assessment using magnetic resonance imaging (MRI) or sonography both in the clinical routine and scientific studies. Novel imaging modalities such as MRI or ultrasound enable in vivo visualization of the quality of the cartilaginous structure and bone as well as all articular and periarticular tissue. Therefore, the limitations of radiographs in assessment of knee osteoarthritis could be overcome by these techniques. This review article aims to provide insights into the most important radiological features of knee osteoarthritis and systematic visualization with different imaging approaches. The demographic development in western industrialized countries predicts an increase of ageing-related osteoarthritis of the knee for the next decades. A systematic radiological evaluation of patients with knee osteoarthritis includes the assessment of the periarticular soft tissue, cartilaginous thickness, cartilage volume, possible cartilage defects, the macromodular network of hyaline cartilage, bone marrow edema, menisci and articular ligaments. Modern imaging modalities, such as MRI and sonography allow the limitations of conventional radiography to be overcome and to visualize the knee structures in great detail to quantitatively assess the severity of knee osteoarthritis. (orig.) [de

A Double-Blind, Active-Controlled Clinical Trial of Sodium Bicarbonate and Calcium Gluconate in the Treatment of Bilateral Osteoarthritis of the Knee

Directory of Open Access Journals (Sweden)

María del Carmen Caamaño

2017-02-01

Full Text Available Objective: To evaluate the effect of intra-articular injections of sodium bicarbonate with a single (SBCG1 or double dose (SBCG2 of calcium gluconate administered monthly compared with methylprednisolone (MP for treatment of knee osteoarthritis. Methods: A 3-month, randomized, double-blind clinical trial with patients diagnosed with knee osteoarthritis (OA. The outcome variables were the Western Ontario-McMaster University Osteoarthritis Index (WOMAC and the Lequesne functional index. Results: After 3 months, all treatments significantly improved in overall WOMAC and Lequesne scores. Mean changes (95% confidence interval in WOMAC total score and the Lequesne index, respectively, for SBCG1 (−12.5 [−14.3, −10.7]; −9.0 [−11.4, −6.7] and SBCG2 (−12.3 [−14.3, −10.4]; −8.9 [−10.4, −7.4] were significantly greater than for MP (−5.0 [−7.2, −2.8]; −3.2 [−4.9, −1.5] ( P  < .001. Conclusions: Intra-articular injections of sodium bicarbonate and calcium gluconate are useful for short-term relief of OA symptoms in patients with bilateral knee osteoarthritis. Both treatments are more effective than MP injections in the reduction of knee OA symptoms. Trial Registration: Clinicaltrials.gov NCT00977444

Autogrammid, oma aja märk / Mike Lawrence

Index Scriptorium Estoniae

Lawrence, Mike

2004-01-01

Autogrammide kogumisest, nende ehtsusest, sportlastele kuulunud esemete kollektsioneerimisest. Lisatud: Kollektsionääride maiuspalu. Autor Mike Lawrence on oksjonifirma Bonhams/Brooks konsultant, ajakirjanik

Adherence to a Mediterranean diet is associated with lower prevalence of osteoarthritis: Data from the osteoarthritis initiative.

Science.gov (United States)

Veronese, Nicola; Stubbs, Brendon; Noale, Marianna; Solmi, Marco; Luchini, Claudio; Smith, Toby O; Cooper, Cyrus; Guglielmi, Giuseppe; Reginster, Jean-Yves; Rizzoli, Renè; Maggi, Stefania

2017-12-01

The Mediterranean diet appears to be beneficial for several medical conditions, but data regarding osteoarthritis (OA) are not available. The aim of this study was to investigate if adherence to the Mediterranean diet is associated with a lower prevalence of OA of the knee in a large cohort from North America. 4358 community-dwelling participants (2527 females; mean age: 61.2 years) from the Osteoarthritis Initiative were included. Adherence to the Mediterranean diet was evaluated through a validated Mediterranean diet score (aMED) categorized into quartiles (Q). Knee OA was diagnosed both clinically and radiologically. The strength of the association between aMED (divided in quartiles) and knee OA was investigated through a logistic regression analysis and reported as odds ratios (ORs) with 95% confidence intervals (CIs), adjusted for potential confounders. Participants with a higher adherence to Mediterranean diet had a significantly lower prevalence of knee OA compared to those with lower adherence (Q4: 25.2% vs. Q1: 33.8%; p Mediterranean diet, only higher use of cereals was associated with lower odds of having knee OA (OR: 0.76; 95%CI: 0.60-0.98; p = 0.03). Higher adherence to a Mediterranean diet is associated with lower prevalence of knee OA. This remained when adjusting for potential confounders. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Chicken collagen type II reduces articular cartilage destruction in a model of osteoarthritis in rats.

Science.gov (United States)

Xu, D; Shen, W

2007-06-01

To evaluate the therapeutic effects of domestic chicken collagen type II (CCII) on rat osteoarthritis (OA) and analyze concomitant changes in the level of Matrix metalloproteinase (MMP)-13, MMP-9, Cathepsin K and their mRNA as well as the tissue inhibitor of matrix metalloproteinase (TIMP)-1 mRNA in articular cartilage of osteoarthritic rats. Osteoarthritis models were surgically induced. Morphology of articular cartilage was done by haematoxylin and eosin staining and Mankin score was calculated, immunohistochemistry of MMP-13, MMP-9 and Cathepsin K was done by ABC method while the mRNA level for MMP-13, MMP-9, cathepsin K as well as TIMP-1 was evaluated by RT-PCR method. Oral administration of CCII reduced the morphological changes of osteoarthritic cartilage (shown by Mankin score), decreased levels of MMP-13, MMP-9, cathepsin K as well as their mRNA in articular cartilage from osteoarthritic rats while it exhibited no effect on TIMP-1 mRNA. Oral CCII reduced articular cartilage degradation of osteoarthritic rats and may probably be a potent drug candidate for OA treatment.

Marine geology of the St. Lawrence Estuary

Energy Technology Data Exchange (ETDEWEB)

St-Onge, Guillaume [Canada Research Chair in Marine Geology, Institut des sciences de la mer de Rimouski (ISMER) and GEOTOP Research Center, 310 allee des Ursulines, Rimouski, Quebec, G5L 3A1 (Canada); Duchesne, Mathieu J [Geological Survey of Canada, Quebec Division, 490 de la Couronne, Quebec City, Quebec, G1K 9A9 (Canada); Lajeunesse, Patrick, E-mail: guillaume_st-onge@uqar.qc.ca [Departement de geographie and Centre d' etudes nordiques, Universite Laval, Quebec City, Quebec, G1V 0A6 (Canada)

2011-05-15

The St. Lawrence Estuary, Eastern Canada, contains a very thick (>450 m) Quaternary sedimentary sequence. The results from recently conducted geophysical surveys in conjunction with piston coring indicate that these sediments were deposited under very high sedimentation rates, sometimes as high as {approx}30 m/ka during the last deglaciation. Results also reveal evidence of large submarine landslides during the Holocene, changes in sedimentation rates and the significant role of submarine canyons and channels to transfer sediments from the coast to the deeper marine environment. Finally, this paper highlights the presence of more than 1900 pockmarks on the seafloor of the St. Lawrence Estuary and discusses their possible origins: active hydrocarbon seeps in the Laurentian Channel and biogenic gas seepage on the northwestern shoulder of the Laurentian Channel.

Marine geology of the St. Lawrence Estuary

International Nuclear Information System (INIS)

St-Onge, Guillaume; Duchesne, Mathieu J; Lajeunesse, Patrick

2011-01-01

The St. Lawrence Estuary, Eastern Canada, contains a very thick (>450 m) Quaternary sedimentary sequence. The results from recently conducted geophysical surveys in conjunction with piston coring indicate that these sediments were deposited under very high sedimentation rates, sometimes as high as ∼30 m/ka during the last deglaciation. Results also reveal evidence of large submarine landslides during the Holocene, changes in sedimentation rates and the significant role of submarine canyons and channels to transfer sediments from the coast to the deeper marine environment. Finally, this paper highlights the presence of more than 1900 pockmarks on the seafloor of the St. Lawrence Estuary and discusses their possible origins: active hydrocarbon seeps in the Laurentian Channel and biogenic gas seepage on the northwestern shoulder of the Laurentian Channel.

The effect on knee-joint load of instruction in analgesic use compared with neuromuscular exercise in patients with knee osteoarthritis

DEFF Research Database (Denmark)

Clausen, Brian; Holsgaard-Larsen, Anders; Søndergaard, Jens

2014-01-01

, compared with optimized analgesics and antiinflammatory drug use, on the measures of knee-joint load in people with mild to moderate medial tibiofemoral knee osteoarthritis. METHOD/DESIGN: One hundred men and women with mild to moderate medial knee osteoarthritis will be recruited from general medical...... during walking (the Knee Index, a composite score of the first external peak total reaction moment on the knee joint from all three planes based on 3D movement analysis) after 8 weeks of intervention. Secondary outcomes include changes in the external peak knee-adduction moment and impulse and functional...

T2 Relaxation Time Mapping of Proximal Tibiofibular Cartilage by 3-Tesla Magnetic Resonance Imaging

International Nuclear Information System (INIS)

Kwack, Kyu-Sung; Cho, Jae Hyun; Kim, Jun Man; Kim, Sun Yong; Min, Byoung-Hyun; Yoon, Seung-Hyun

2009-01-01

Background: The proximal tibiofibular joint (PTFJ) can be considered the fourth compartment of the knee joint. However, there have been no studies of the T2 values (T2 relaxation time) of PTFJ cartilage. Purpose: To assess the T2 values of PTFJ cartilage at 3T magnetic resonance imaging (MRI), and to show the clinical utility of T2 values of PTFJ cartilage for the diagnosis of osteoarthritis (OA). Material and Methods: 118 patients who had knee MR imaging and knee radiography were enrolled. MRI was performed using a 3T MRI scanner, and T2 maps were calculated from a sagittal multi-echo acquisition. Two regions of interest (ROIs) were positioned within PTFJ cartilage and medial femoral condyle (MFC) cartilage. The average T2 value and standard deviation (SD) of each ROI were recorded. Using PTFJ cartilage as a standard reference, the T2 index ((MFC/PTFJ)x100) and T2SD index ((MFCSD/PTFJSD)x100) were calculated. A paired t test was performed to compare the mean and SD of ROIs within PTFJ and MFC cartilage. Correlation analyses were performed among the parameters age, Kellgren-Lawrence (KL) score, means and SDs of ROIs within PTFJ and MFC cartilage, T2 index, and T2SD index. Results: PTFJ cartilage had a significantly shorter T2 value than did MFC cartilage (P<0.0001). ROIs within PTFJ cartilage showed significantly smaller SDs than did those within MFC cartilage (P<0.0001). The average T2 value and SD of MFC and the T2SD index showed a positive correlation to the KL score (P<0.05). The correlation coefficients for the average T2 value, SD, and T2SD index of MFC were R=0.203, 0.254, and 0.268, respectively. However, there was no significant correlation between T2 values of PTFJ cartilage and KL score (P=0.643). Conclusion: PTFJ cartilage showed shorter and more homogeneous T2 values with a small SD than did MFC cartilage, regardless of the degree of OA at femorotibial compartments. PTFJ cartilage may be a useful internal standard reference to diagnose OA and would be

T2 Relaxation Time Mapping of Proximal Tibiofibular Cartilage by 3-Tesla Magnetic Resonance Imaging

Energy Technology Data Exchange (ETDEWEB)

Kwack, Kyu-Sung; Cho, Jae Hyun; Kim, Jun Man; Kim, Sun Yong (Dept. of Radiology, Ajou Univ. Medical Center, Suwon (Korea)); Min, Byoung-Hyun; Yoon, Seung-Hyun (Cartilage Regeneration Center, Ajou Univ. Medical Center, Suwon (Korea))

2009-11-15

Background: The proximal tibiofibular joint (PTFJ) can be considered the fourth compartment of the knee joint. However, there have been no studies of the T2 values (T2 relaxation time) of PTFJ cartilage. Purpose: To assess the T2 values of PTFJ cartilage at 3T magnetic resonance imaging (MRI), and to show the clinical utility of T2 values of PTFJ cartilage for the diagnosis of osteoarthritis (OA). Material and Methods: 118 patients who had knee MR imaging and knee radiography were enrolled. MRI was performed using a 3T MRI scanner, and T2 maps were calculated from a sagittal multi-echo acquisition. Two regions of interest (ROIs) were positioned within PTFJ cartilage and medial femoral condyle (MFC) cartilage. The average T2 value and standard deviation (SD) of each ROI were recorded. Using PTFJ cartilage as a standard reference, the T2 index ((MFC/PTFJ)x100) and T2SD index ((MFCSD/PTFJSD)x100) were calculated. A paired t test was performed to compare the mean and SD of ROIs within PTFJ and MFC cartilage. Correlation analyses were performed among the parameters age, Kellgren-Lawrence (KL) score, means and SDs of ROIs within PTFJ and MFC cartilage, T2 index, and T2SD index. Results: PTFJ cartilage had a significantly shorter T2 value than did MFC cartilage (P<0.0001). ROIs within PTFJ cartilage showed significantly smaller SDs than did those within MFC cartilage (P<0.0001). The average T2 value and SD of MFC and the T2SD index showed a positive correlation to the KL score (P<0.05). The correlation coefficients for the average T2 value, SD, and T2SD index of MFC were R=0.203, 0.254, and 0.268, respectively. However, there was no significant correlation between T2 values of PTFJ cartilage and KL score (P=0.643). Conclusion: PTFJ cartilage showed shorter and more homogeneous T2 values with a small SD than did MFC cartilage, regardless of the degree of OA at femorotibial compartments. PTFJ cartilage may be a useful internal standard reference to diagnose OA and would be

Clinical investigation compared with the effects of the bee-venom Acupuncture on knee joint with osteoarthritis

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Wang Wu-Hao

2001-12-01

Full Text Available Objective: This study is designed to find out the effects of the Bee-Venom Acupuncture on knee joint with osteoarthritis. Methods: We are investigated that outpatients suffer from knee joint pain deciphered at the division of Acupuncture in Jaseng oriental medicine hospital from the 13, July 1999 to unti111, November 2000. We make an estimated of the score from both before or after its treatment about 70 cases of diagnostic patient with the osteoarthritis of knee joints by biochemical method and X-RAY analysis, we observed in the progress of symptoms. Results: These results found that sex distinction with a disease caused much more female than male at the ratio of I to 5.36 in the proportion of males to females, jobs is mainly ranked with a housewife and approximately 82.9% of cases before our hospital have ever treated at the other clinics or hospitals. On the hand, the distribution interval of a case history is mainly followed by disease in below 6 month, interval of the period-treatment is mainly gone within 3 month and frequency of treatment is examined into II to 15 times, more than 16 times and below 10 times, respectively. We are estimated with the score of functional barrier from both before or after its treatment against osteoarthritis' patients and produced in the usefulness from the totally point of fields except the aid-device after its treatment In summary, these results demonstrated that Bee Venom, Acupuncture enhanced more than 82.9% to the improvement of treatment and p<0.05 considered to be statistically significant. Conclusion: These results suggest that Bee-venom Acupuncture may be playa role in the significant usefulness and have need of actively application for the clinical trials against osteoarthritis' patients.

Effects of administration of adipose-derived stromal vascular fraction and platelet-rich plasma to dogs with osteoarthritis of the hip joints.

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Upchurch, David A; Renberg, Walter C; Roush, James K; Milliken, George A; Weiss, Mark L

2016-09-01

OBJECTIVE To evaluate effects of simultaneous intra-articular and IV injection of autologous adipose-derived stromal vascular fraction (SVF) and platelet-rich plasma (PRP) to dogs with osteoarthritis of the hip joints. ANIMALS 22 client-owned dogs (12 placebo-treated [control] dogs and 10 treated dogs). PROCEDURES Dogs with osteoarthritis of the hip joints that caused signs of lameness or discomfort were characterized on the basis of results of orthopedic examination, goniometry, lameness score, the Canine Brief Pain Inventory (CBPI), a visual analogue scale, and results obtained by use of a pressure-sensing walkway at week 0 (baseline). Dogs received a simultaneous intraarticular and IV injection of SVF and PRP or a placebo. Dogs were examined again 4, 8, 12, and 24 weeks after injection. RESULTS CBPI scores were significantly lower for the treatment group at week 24, compared with scores for the control group. Mean visual analogue scale score for the treatment group was significantly higher at week 0 than at weeks 4, 8, or 24. Dogs with baseline peak vertical force (PVF) in the lowest 25th percentile were compared, and the treatment group had a significantly higher PVF than did the control group. After the SVF-PRP injection, fewer dogs in the treated group than in the control group had lameness confirmed during examination. CONCLUSIONS AND CLINICAL RELEVANCE For dogs with osteoarthritis of the hip joints treated with SVF and PRP, improvements in CBPI and PVF were evident at some time points, compared with results for the control group.

Osteoarthritis

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Allen, Kelli D.; Choong, Peter F.; Davis, Aileen M.

2016-01-01

Osteoarthritis (OA) is a leading cause of pain and disability worldwide. Despite the existence of evidence-based treatments and guidelines, substantial gaps remain in the quality of OA management. There is underutilization of behavioral and rehabilitative strategies to prevent and treat OA as well...

Efficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis: a multicenter study

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Kuptniratsaikul, Vilai; Dajpratham, Piyapat; Taechaarpornkul, Wirat; Buntragulpoontawee, Montana; Lukkanapichonchut, Pranee; Chootip, Chirawan; Saengsuwan, Jittima; Tantayakom, Kesthamrong; Laongpech, Supphalak

2014-01-01

Objective To determine the efficacy and safety of Curcuma domestica extracts in pain reduction and functional improvement. Methods 367 primary knee osteoarthritis patients with a pain score of 5 or higher were randomized to receive ibuprofen 1,200 mg/day or C. domestica extracts 1,500 mg/day for 4 weeks. The main outcomes were Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total, WOMAC pain, WOMAC stiffness, and WOMAC function scores. Adverse events (AEs) were also recorded. Results 185 and 182 patients were randomly assigned into C. domestica extracts and ibuprofen groups, respectively. The baseline characteristics were no different between groups. The mean of all WOMAC scores at weeks 0, 2, and 4 showed significant improvement when compared with the baseline in both groups. After using the noninferiority test, the mean difference (95% confidence interval) of WOMAC total, WOMAC pain, and WOMAC function scores at week 4 adjusted by values at week 0 of C. domestica extracts were noninferior to those for the ibuprofen group (P=0.010, P=0.018, and P=0.010, respectively), except for the WOMAC stiffness subscale, which showed a trend toward significance (P=0.060). The number of patients who developed AEs was no different between groups. However, the number of events of abdominal pain/discomfort was significantly higher in the ibuprofen group than that in the C. domestica extracts group (P=0.046). Most subjects (96%–97%) were satisfied with the treatment, and two-thirds rated themselves as improved in a global assessment. Conclusion C. domestica extracts are as effective as ibuprofen for the treatment of knee osteoarthritis. The side effect profile was similar but with fewer gastrointestinal AE reports in the C. domestica extracts group. PMID:24672232

Exploring differential item functioning in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC

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Pollard Beth

2012-12-01

Full Text Available Abstract Background The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC is a widely used patient reported outcome in osteoarthritis. An important, but frequently overlooked, aspect of validating health outcome measures is to establish if items exhibit differential item functioning (DIF. That is, if respondents have the same underlying level of an attribute, does the item give the same score in different subgroups or is it biased towards one subgroup or another. The aim of the study was to explore DIF in the Likert format WOMAC for the first time in a UK osteoarthritis population with respect to demographic, social, clinical and psychological factors. Methods The sample comprised a community sample of 763 people with osteoarthritis who participated in the Somerset and Avon Survey of Health. The WOMAC was explored for DIF by gender, age, social deprivation, social class, employment status, distress, body mass index and clinical factors. Ordinal regression models were used to identify DIF items. Results After adjusting for age, two items were identified for the physical functioning subscale as having DIF with age identified as the DIF factor for 2 items, gender for 1 item and body mass index for 1 item. For the WOMAC pain subscale, for people with hip osteoarthritis one item was identified with age-related DIF. The impact of the DIF items rarely had a significant effect on the conclusions of group comparisons. Conclusions Overall, the WOMAC performed well with only a small number of DIF items identified. However, as DIF items were identified in for the WOMAC physical functioning subscale it would be advisable to analyse data taking into account the possible impact of the DIF items when weight, gender or especially age effects, are the focus of interest in UK-based osteoarthritis studies. Similarly for the WOMAC pain subscale in people with hip osteoarthritis it would be worthwhile to analyse data taking into account the

β2‑adrenergic receptor functionality and genotype in two different models of chronic inflammatory disease: Liver cirrhosis and osteoarthritis.

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Roca, Reyes; Esteban, Pablo; Zapater, Pedro; Inda, María-Del-Mar; Conte, Anna Lucia; Gómez-Escolar, Laura; Martínez, Helena; Horga, José F; Palazon, José M; Peiró, Ana M

2018-06-01

The present study was designed to investigate the functional status of β2 adrenoceptors (β2AR) in two models of chronic inflammatory disease: liver cirrhosis (LC) and osteoarthritis (OA). The β2AR gene contains three single nucleotide polymorphisms at amino acid positions 16, 27 and 164. The aim of the present study was to investigate the potential influence of lymphocyte β2AR receptor functionality and genotype in LC and OA patients. Blood samples from cirrhotic patients (n=52, hepatic venous pressure gradient 13±4 mmHg, CHILD 7±2 and MELD 11±4 scores), OA patients (n=30, 84% Kellgren‑Lawrence severity 4 grade, 14% knee replacement joint) and healthy volunteers as control group (n=26) were analyzed. Peripheral blood mononuclear cells (PBMC) were isolated from whole blood and basal and isoproterenol induced adenylate cyclase activity (isoproterenol stimulus from 10‑9 to 10‑4 mM), and β2AR allelic variants (rs1042713, rs1042714, rs1800888) were determined. β2AR functionality was decreased in the two different models of chronic inflammatory disease studied, OA (50% vs. control) and LC (85% vs. control). In these patients, the strength of the β2AR response to adrenergic stimulation was very limited. Adrenergic modulation of PBMC function through the β2AR stimulus is decreased in chronic inflammatory processes including LC and OA, suggesting that the adrenergic system may be important in the development of these processes.

Hand osteoarthritis : natural course and determinants of outcome

NARCIS (Netherlands)

Bijsterbosch, Jessica

2013-01-01

We investigated the clinical and radiographic disease course of hand osteoarthritis as well as determinants of poor clinical outcome and radiographic progression over a period of six years in 289 patients with hand osteoarthritis. Because these patients had osteoarthritis at multiple joints this

Analysis of the reliability and validity of the Turkish version of the intermittent and constant osteoarthritis pain questionnaire.

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Erel, Suat; Şimşek, İbrahim Engin; Özkan, Hüseyin

2015-01-01

The aim of this study was to analyze the validity and reliability of the Turkish version (ICOAP-TR) of the intermittent and constant osteoarthritis pain (ICOAP) questionnaire in patients with knee osteoarthritis (OA). Thirty-eight volunteer patients diagnosed with knee OA answered the questionnaire twice with an interval of 2-4 days. The reliability of the measurement was assessed using Cronbach's alpha coefficient and intraclass correlation (ICC) for test-retest reliability. Criterion validity was tested against the Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain score and visual analog scale (VAS) designed to assess the perceived discomfort rated by the patient. Test-retest reliability was found to be ICC=0.942 for total score, 0.902 for constant pain subscale, and 0.945 for intermittent pain subscale. Internal consistency was tested using Cronbach's alpha and was found to be 0.970 for total score, 0.948 for constant pain subscale, and 0.972 for intermittent pain subscale. For criterion validity, the correlation between the total score of ICOAP-TR and WOMAC pain subscale was r=0.779 (p<0.05), and correlation between total score of ICOAP-TR and VAS was r=0.570 (p<0.05). The ICOAP-TR is a reliable and valid instrument to be used with patients with knee OA.

Association of Metabolic Syndrome and Its Components with Knee Osteoarthritis

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Shahpoor Maddah

2015-12-01

Full Text Available The association of obesity and other metabolic conditions with osteoarthritis is under debate; however, a strong link between metabolic disturbances is suggested to contribute to increased incidences and progression of osteoarthritis. We examined the association of metabolic syndrome and its components with the incidence of knee osteoarthritis in Iranian population. A community-based study was conducted on a total of 625 Iranian volunteers with the complaint of knee pain. Weight-bearing and anteroposterior plain radiographs of both knees were taken on the day of admission. Metabolic syndrome was diagnosed using the modified Adult Treatment Panel III of the National Cholesterol Education Program criteria. Prevalence rates of metabolic syndrome were 22.5% in males and 11.6% in females (P=0.002. The prevalence rate of knee osteoarthritis was 20.0% in males and 43.8% of females (P<0.001. In both genders, osteoarthritis group had higher serum levels of triglyceride and systolic blood pressure in comparison with non-osteoarthritis group. Women with osteoarthritis had higher Body Mass Index (BMI, however, this association was not observed in men. In females, the presence of osteoarthritis was significantly associated with the presence of metabolic syndrome, with the risk of metabolic syndrome in the osteoarthritis group at 2.187 fold the risk in the non-osteoarthritis group. But, the presence of osteoarthritis was not associated with metabolic syndrome in males. Metabolic syndrome mainly through high BMI is associated with knee osteoarthritis in the Iranian women, but neither metabolic syndrome nor any related components are associated with knee osteoarthritis in men.

Arthroscopic resection of the distal clavicle in osteoarthritis of the acromioclavicular joint

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Tae-Soo Park

2016-01-01

Full Text Available Background: Symptomatic acromioclavicular joint (ACJ lesions are a common cause of shoulder complaints that can be treated successfully with both conservative and surgical methods. There are several operative techniques, including both open and arthroscopic surgery, for excising the distal end of the clavicle. Here, we present a new modified arthroscopic technique for painful osteoarthritis of the ACJ and evaluate its clinical outcomes. Our hypothesis was that 4- to 7-mm resection of the distal clavicle in an en bloc fashion would have several advantages, including no bony remnants, maintenance of stability of the ACJ, and reduced prevalence of heterotopic ossification, in addition to elimination of the pathologic portion of the distal clavicle. Materials and Methods: 20 shoulders of 20 consecutive patients with painful and isolated osteoarthritis of the ACJ who were treated by arthroscopic en bloc resection of the distal clavicle were included in the study. There were 10 males and 10 females with an average age of 56 years (range 42-70 years. The mean duration of followup was 6 years and 2 months (range 4-8 years 10 months. The results were evaluated using the University of California Los Angeles (UCLA shoulder rating score. Results: The overall UCLA score was 13.7 preoperatively, which improved to 33.4 postoperatively. All subscores were improved significantly ( P < 0.001. There were no specific complications at the latest followup. Conclusion: It is critical in this procedure to resect the distal clavicle evenly from superior to inferior in an en bloc fashion without any small bony remnants and to preserve the capsule and acromioclavicular ligament superoposteriorly. This arthroscopic procedure is a reliable and reproducible technique for painful osteoarthritis of the ACJ lesions in active patients engaged in overhead throwing sports and heavy labor.

Prospective associations of C-reactive protein (CRP) levels and CRP genetic risk scores with risk of total knee and hip replacement for osteoarthritis in a diverse cohort.

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Shadyab, A H; Terkeltaub, R; Kooperberg, C; Reiner, A; Eaton, C B; Jackson, R D; Krok-Schoen, J L; Salem, R M; LaCroix, A Z

2018-05-22

To examine associations of high-sensitivity C-reactive protein (CRP) levels and polygenic CRP genetic risk scores (GRS) with risk of end-stage hip or knee osteoarthritis (OA), defined as incident total hip (THR) or knee replacement (TKR) for OA. This study included a cohort of postmenopausal white, African American, and Hispanic women from the Women's Health Initiative. Women were followed from baseline to date of THR or TKR, death, or December 31, 2014. Medicare claims data identified THR and TKR. Hs-CRP and genotyping data were collected at baseline. Three CRP GRS were constructed: 1) a 4-SNP GRS comprised of genetic variants representing variation in the CRP gene among European populations; 2) a multilocus 18-SNP GRS of genetic variants significantly associated with CRP levels in a meta-analysis of genome-wide association studies; and 3) a 5-SNP GRS of genetic variants significantly associated with CRP levels among African American women. In analyses conducted separately among each race and ethnic group, there were no significant associations of ln hs-CRP with risk of THR or TKR, after adjusting for age, body mass index, lifestyle characteristics, chronic diseases, hormone therapy use, and non-steroidal anti-inflammatory drug use. CRP GRS were not associated with risk of THR or TKR in any ethnic group. Serum levels of ln hs-CRP and genetically-predicted CRP levels were not associated with risk of THR or TKR for OA among a diverse cohort of women. Copyright © 2018 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Assessment of clinical practice guideline methodology for the treatment of knee osteoarthritis with intra-articular hyaluronic acid.

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Altman, Roy D; Schemitsch, Emil; Bedi, Asheesh

2015-10-01

Clinical practice guidelines are of increasing importance in the decision making for the treatment of knee osteoarthritis. Inconsistent recommendations regarding the use of intra-articular hyaluronic acid for the treatment of knee osteoarthritis have led to confusion among treating physicians. Literature search to identify clinical practice guidelines that provide recommendations regarding the use of intra-articular hyaluronic acid treatment for knee osteoarthritis was conducted. Included guidelines were appraised using the AGREE II instrument. Guideline development methodologies, how the results were assessed, the recommendation formation, and work group composition were summarized. Overall, 10 clinical practice guidelines were identified that met our inclusion criteria. AGREE II domain scores were variable across the included guidelines. The methodology utilized across the guidelines was heterogeneous regarding the evidence inclusion criteria, analysis of evidence results, formulation of clinical practice recommendations, and work group composition. The recommendations provided by the guidelines for intra-articular hyaluronic acid treatment for knee osteoarthritis are highly inconsistent as a result of the variability in guideline methodology. Overall, 30% of the included guidelines recommended against the use of intra-articular hyaluronic acid in the treatment of knee osteoarthritis, while 30% deemed the treatment an appropriate intervention under certain scenarios. The remaining 40% of the guidelines provided either an uncertain recommendation or no recommendation at all, based on the high variability in reviewed evidence regarding efficacy and trial quality. There is a need for a standard "appropriate methodology" that is agreed upon for osteoarthritis clinical practice guidelines in order to prevent the development of conflicting recommendations for intra-articular hyaluronic acid treatment for knee osteoarthritis, and to assure that treating physicians who

The impact of self-efficacy on physical activity maintenance in patients with hip osteoarthritis

DEFF Research Database (Denmark)

Hammer, Nanna Maria; Bieler, Theresa; Beyer, Nina Ann-Marie

2016-01-01

Purpose: Understanding motivational factors related to physical activity (PA) maintenance is essential in promoting long-term exercise benefits. This study explored the impact of self-efficacy (SE) on post-intervention PA maintenance in patients with hip osteoarthritis. Method: An SE-theory based...... mixed-methods sub-study of a trial investigating the effects of 4 months supervised exercise in patients with hip osteoarthritis. Questionnaire data (n = 52; baseline and 12 months) on PA and SE (Arthritis Self-Efficacy Scale, ASES, score-range 10–100) were analysed (Mann–Whitney test) for differences...... from incorporating the self-efficacy theory in the planning and execution of exercise interventions to promote post-intervention physical activity maintenance and long term health benefits. •Post-intervention physical activity maintenance may be increased by focussing on the patients’ exercise self-efficacy...

A hierarchy of patient-reported outcome measures for meta-analysis of knee osteoarthritis trials

DEFF Research Database (Denmark)

Juhl, Carsten Bogh; Lund, Hans; Guyatt, GH

2010-01-01

Title A hierarchy of patient-reported outcome measures for meta-analysis of knee osteoarthritis trials: empirical evidence from a survey of high impact journals Objective To develop a prioritized list for extracting patient-reported outcomes (PROs) measuring pain and disability for meta-analyses ......Title A hierarchy of patient-reported outcome measures for meta-analysis of knee osteoarthritis trials: empirical evidence from a survey of high impact journals Objective To develop a prioritized list for extracting patient-reported outcomes (PROs) measuring pain and disability for meta...... composite disability scores. Conclusions As choosing the most favorable PROs from individual trials can overestimate the effect compared to a systematic approach, using a prioritized list as presented in this study is recommended to reduce reviewer's likelihood of biased selection of PROs in meta-analyses....

Standing Stability in Knee Osteoarthritis Patients

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M.T. Karimi

2016-09-01

Full Text Available Aims: Being prevalent in the more than 40 years old persons, the knee osteoarthritis is one of the main factors in the function system failure mainly affecting their life. There is a type of instability in the persons with knee osteoarthritis, which is an increase in the domain and frequency of body pressure center. The aim of the present study was to compare the standing stability parameters in persons with knee osteoarthritis and healthy persons. Instrument & Methods: In this case-control, 15 patients with knee osteoarthritis referred to the physiotherapy clinic of the rehabilitation center and Al-Zahra hospital were studied in the muscle-skeletal research center of Isfahan University of Medical Sciences in 2015. The subjects were selected via stratified sampling method. As control group, 15 healthy persons were also studied in Isfahan. Total path length and the domain and frequency of pressure center in different directions were measured to assess the stability. Data was analyzed by SPSS 19 software using descriptive statistics and paired T test. Findings: There were increases in the mean movement domain and the frequency of pressure center in the anterior-posterior and the internal-external directions, as well as in the total path proceeded by the pressure center in the internal-external direction, in the persons with knee osteoarthritis than the healthy persons (p0.05. Conclusion: Standing stability and balance in persons with knee osteoarthritis decreases compared to healthy persons.

Complementary and Alternative Medicine and Osteoarthritis.

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Wang, Chenchen

2013-01-01

Patients with osteoarthritis experience high levels of pain, psychological distress and have limited therapeutic options. Emerging evidence from clinical trials suggests that both acupuncture and Tai Chi mind-body therapies are safe and effective treatments for osteoarthritis. Acupuncture has effects over and above those of 'sham acupuncture' and the most robust evidence to date demonstrates that acupuncture does have short-term benefits and is a reasonable referral option for patients with symptomatic osteoarthritis. Tai Chi is a mind-body exercise that enhances cardiovascular fitness, muscular strength, balance, and physical function. It also appears to be associated with reduced stress and anxiety and depression, as well as improved quality of life. Thus, Tai Chi may be safely recommended to patients with osteoarthritis as a complementary and alternative medical approach to affect patient well-being. Integrative approaches combine the best of conventional medicine and complementary and alternative medicine to ultimately improve patient care. These modalities may lead to the development of better disease modifying strategies that could improve symptoms and decrease the progression of osteoarthritis. This overview synthesizes the current body of knowledge about Chinese mind-body medicine to better inform clinical decision-making for our rheumatic patients.

LAWRENCE RADIATION LABORATORY COUNTING HANDBOOK

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Group, Nuclear Instrumentation

1966-10-01

The Counting Handbook is a compilation of operational techniques and performance specifications on counting equipment in use at the Lawrence Radiation Laboratory, Berkeley. Counting notes have been written from the viewpoint of the user rather than that of the designer or maintenance man. The only maintenance instructions that have been included are those that can easily be performed by the experimenter to assure that the equipment is operating properly.

EVALUATION OF FUNCTIONAL RESULTS OF MEDIAL OPENING WEDGE HIGH TIBIAL OSTEOTOMY FOR UNICOMPARTMENTAL OSTEOARTHRITIS VARUS KNEE

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Shyam Sundar Bakki

2017-01-01

Full Text Available BACKGROUND Osteoarthritis commonly affects the medial compartment of knee giving rise to varus deformity in majority of cases. Significant varus deformity further aggravates the pathology due to medialisation of the weight bearing line osteotomy of the proximal tibia realigns this weight bearing axis, thereby relieving pressure on the damaged medial compartment. OWHTO is a promising option in this scenario because it is associated with high accuracy in correcting the deformity and less number of complications when compared to lateral closing wedge HTO or UKA. In this study, we evaluate the functional outcome of HTO in patients with unicompartmental osteoarthritis. MATERIALS AND METHODS This is a prospective study of patients who attended the orthopaedic outpatient clinic in Government Hospital, Kakinada, between August 2013 to August 2015. The patients were evaluated by clinical examination and weight bearing radiographs. The patients who were found to have unicompartmental osteoarthritis with knee pain not relieved by conservative management and who satisfy the inclusion criteria were selected. RESULTS Excellent results can be achieved by appropriate selection criteria and planning with long limb weight bearing radiographs. There is an excellent relief of pain, which can be achieved within first few months postoperatively, which is assessed by VAS score. The KSS- knee score is excellent in 35%, good in 40%, fair in 20% and poor in 5%. The KSS- function score is excellent in 30%, good in 45%, fair in 20% and poor in 5%. There is significant improvement in the range of movement of the knee joint postoperatively. CONCLUSION In this study, we conclude that medial OWHTO is the preferred modality for unicompartmental OA in those aged <60 years and in developing nations like India where squatting is an important function, it has major role as it can restore near normal knee function without disturbing anatomy.

Development and Prevention of Running-Related Osteoarthritis.

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Ni, Guo-Xin

2016-01-01

Studies investigating the effect of running on risk for developing osteoarthritis at weight-bearing joints have reported with conflicting results. Generally, moderate-level running is not likely detrimental to joint health. However, many factors may be associated with the increased risk of developing osteoarthritis in runners. Factors often implicated in the development of osteoarthritis comprise those that increase joint vulnerability and those which increase joint loading. It is therefore suggested that running has different effects on different people. Efforts should be made to identify those with joint vulnerability and joint loading, and measures should be taken to have those factors and/or their running programs modified to run safely. Further investigations are needed to examine the effect of running on joint health under different conditions to confirm the association between exposure to risk factors and development of osteoarthritis, as well as to validate the effectiveness of measures for preventing running-related osteoarthritis.

Use of a 3-Telsa magnet to perform delayed gadolinium-enhanced magnetic resonance imaging of the distal interphalangeal joint of horses with and without naturally occurring osteoarthritis.

Science.gov (United States)

Bischofberger, Andrea S; Fürst, Anton E; Torgerson, Paul R; Carstens, Ann; Hilbe, Monika; Kircher, Patrick

2018-03-01

OBJECTIVE To characterize delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) features of healthy hyaline cartilage of the distal interphalangeal joint (DIPJ) of horses, to determine whether dGEMRIC can be used to differentiate various stages of naturally occurring osteoarthritis of the DIPJ, and to correlate relaxation times determined by dGEMRIC with the glycosaminoglycan concentration, water content, and macroscopic and histologic findings of hyaline cartilage of DIPJs with and without osteoarthritis. SAMPLE 1 cadaveric forelimb DIPJ from each of 12 adult warmblood horses. PROCEDURES T1-weighted cartilage relaxation times were obtained for predetermined sites of the DIPJ before (T1 preGd ) and after (T1 postGd ) intra-articular gadolinium administration. Corresponding cartilage sites underwent macroscopic, histologic, and immunohistochemical evaluation, and cartilage glycosaminoglycan concentration and water content were determined. Median T1 preGd and T1 postGd were correlated with macroscopic, histologic, and biochemical data. Mixed generalized linear models were created to evaluate the effects of cartilage site, articular surface, and macroscopic and histologic scores on relaxation times. RESULTS 122 cartilage specimens were analyzed. Median T1 postGd was lower than the median T1 preGd for normal and diseased cartilage. Both T1 preGd and T1 postGd were correlated with macroscopic and histologic scores, whereby T1 preGd increased and T1 postGd decreased as osteoarthritis progressed. There was topographic variation of T1 preGd and T1 postGd within the DIPJ. Cartilage glycosaminoglycan concentration and water content were significantly correlated with T1 preGd and macroscopic and histologic scores but were not correlated with T1 postGd . CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that dGEMRIC relaxation times varied for DIPJs with various degrees of osteoarthritis. These findings may help facilitate early detection of osteoarthritis.

77 FR 38488 - Safety Zone; Alexandria Bay Chamber of Commerce, St. Lawrence River, Alexandria Bay, NY

Science.gov (United States)

2012-06-28

... 1625-AA00 Safety Zone; Alexandria Bay Chamber of Commerce, St. Lawrence River, Alexandria Bay, NY... restrict vessels from a portion of the St. Lawrence River during the Alexandria Bay Chamber of Commerce... of proposed rulemaking (NPRM) entitled Safety Zone; Alexandria Bay Chamber of Commerce, St. Lawrence...

Intra-articular sodium hyaluronate 2 mL versus physiological saline 20 mL versus physiological saline 2 mL for painful knee osteoarthritis: a randomized clinical trial

DEFF Research Database (Denmark)

Lundsgaard, C.; Dufour, N.; Fallentin, E.

2008-01-01

, Knee Injury and Osteoarthritis Outcome Score (KOOS), Osteoarthritis Research Society International (OARSI) criteria, and global assessment of the patient's condition. Results: The mean age of the patients was 69.4 years; 55% were women. The effects of hyaluronate 2 mL, physiological saline 20 m......Objective: Methodological constraints weaken previous evidence on intra-articular viscosupplementation and physiological saline distention for osteoarthritis. We conducted a randomized, patient- and observer-blind trial to evaluate these interventions in patients with painful knee osteoarthritis....... Methods: We centrally randomized 251 patients with knee ostcoarthritis to four weekly intra-articular injections of sodium hyaluronate 2 mL (Hyalgan(R) 10.3 mg/mL) versus physiological saline 20 mL (distention) versus physiological saline 2 mL (placebo) and followed patients for 26 weeks. Inclusion...

MRI-guided focused ultrasound (MRgFUS) to treat facet joint osteoarthritis low back pain - case series of an innovative new technique

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Weeks, Evan M.; Platt, Michael W. [St Mary' s Hospital, Imperial College Healthcare NHS Trust, Department of Anaesthesia and Pain Medicine, London (United Kingdom); Gedroyc, Wladyslaw [St Mary' s Hospital, Imperial College Healthcare NHS Trust, Department of Radiology, London (United Kingdom)

2012-12-15

To evaluate the safety and efficacy of magnetic resonance-guided focused ultrasound (MRgFUS) to treat facet joint osteoarthritis pain. Patients with a positive response to facet joint interventions were recruited from Pain and Spinal Clinics. Treatments were performed at the levels of pain according to symptomatology, previous invasive treatment and MRI grading of facet joint osteoarthritis. Both safety and efficacy data were collected. Pain palliation was evaluated using a validated pain numerical rating scale (NRS), Oswestry disability questionnaire (ODQ), Brief Pain Inventory (BPI) and the EuroQol (EQ-5D) health state score Eighteen patients were treated. There were no major adverse events. At 6/12 we found a reduction in both the NRS (average/worst) pain scores (60.2 %/51.2 %). This was associated with 45.9 % improvement in the ODQ score and 61.9 % reduction in the BPI interference score. We observed an improvement in the EuroQol (EQ-5D) health state score based on UK coefficients of +0.379 (0.317 to 0.696). Our phase I observational pilot study has evaluated an innovative new technique that is both non-invasive and radiation free. It is the first description of this procedure in the literature. In all patients the technique was safe, free of complications, effective and well tolerated. (orig.)

MRI-guided focused ultrasound (MRgFUS) to treat facet joint osteoarthritis low back pain - case series of an innovative new technique

International Nuclear Information System (INIS)

Weeks, Evan M.; Platt, Michael W.; Gedroyc, Wladyslaw

2012-01-01

To evaluate the safety and efficacy of magnetic resonance-guided focused ultrasound (MRgFUS) to treat facet joint osteoarthritis pain. Patients with a positive response to facet joint interventions were recruited from Pain and Spinal Clinics. Treatments were performed at the levels of pain according to symptomatology, previous invasive treatment and MRI grading of facet joint osteoarthritis. Both safety and efficacy data were collected. Pain palliation was evaluated using a validated pain numerical rating scale (NRS), Oswestry disability questionnaire (ODQ), Brief Pain Inventory (BPI) and the EuroQol (EQ-5D) health state score Eighteen patients were treated. There were no major adverse events. At 6/12 we found a reduction in both the NRS (average/worst) pain scores (60.2 %/51.2 %). This was associated with 45.9 % improvement in the ODQ score and 61.9 % reduction in the BPI interference score. We observed an improvement in the EuroQol (EQ-5D) health state score based on UK coefficients of +0.379 (0.317 to 0.696). Our phase I observational pilot study has evaluated an innovative new technique that is both non-invasive and radiation free. It is the first description of this procedure in the literature. In all patients the technique was safe, free of complications, effective and well tolerated. (orig.)

Delayed Gadolinium-Enhanced Magnetic Resonance Imaging (dGEMRIC) of Hip Joint Cartilage: Better Cartilage Delineation after Intra-Articular than Intravenous Gadolinium Injection

DEFF Research Database (Denmark)

Boesen, M.; Jensen, K.E.; Quistgaard, E.

2006-01-01

PURPOSE: To investigate and compare delayed gadolinium (Gd-DTPA)-enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC) in the hip joint using intravenous (i.v.) or ultrasound-guided intra-articular (i.a.) Gd-DTPA injection. MATERIAL AND METHODS: In 10 patients (50% males, mean age 58...... years) with clinical and radiographic hip osteoarthritis (OA; Kellgren score II-III), MRI of the hip was performed twice on a clinical 1.5T MR scanner: On day 1, before and 90-180 min after 0.3 mmol/kg body weight i.v. Gd-DTPA and, on day 8, 90-180 min after ultrasound-guided i.a. injection of a 4 mmol....../l Gd-DTPA solution. Coronal STIR, coronal T1 fat-saturated spin-echo, and a cartilage-sensitive gradient-echo sequence (3D T1 SPGR) in the sagittal plane were applied. RESULTS Both the post-i.v. and post-i.a. Gd-DTPA images showed significantly higher signal-to-noise (SNR) and contrast-to-noise (CNR...

Resource intensification and osteoarthritis patterns: changes in activity in the prehistoric Sacramento-San Joaquin Delta region.

Science.gov (United States)

Cheverko, Colleen M; Bartelink, Eric J

2017-10-01

Ethnohistoric accounts and archaeological research from Central California document a shift from the use of lower-cost, high-ranked resources (e.g., large game) toward the greater use of higher-cost, low-ranked resources (e.g., acorns and small seeds) during the Late Holocene (4500-200 BP). The subsistence transition from higher consumption of large game toward an increased reliance on acorns was likely associated with increases in levels of logistical mobility and physical activity. This study predicts that mobility and overall workload patterns changed during this transition to accommodate new food procurement strategies and incorporate new dietary resources during the Late Holocene in Central California. Osteoarthritis prevalence was scored in the shoulder, elbow, hip, and knee of adult individuals (n = 256) from seven archaeological sites in the Sacramento-San Joaquin Delta region. Comparisons were made between osteoarthritis prevalence, sex, age-at-death, and time period using ANCOVAs. The results of this study indicate significant increases in osteoarthritis prevalence in the hip of adult males and females during the Late Period (1200-200 BP), even after correcting for the cumulative effects of age. No differences were observed between the sexes or between time periods for the shoulder, elbow, and knee joints. The temporal increase in hip osteoarthritis supports the hypothesis that there was an increasing need for greater logistical mobility over time to procure key resources away from the village sites. Additionally, the lack of sex differences in osteoarthritis prevalence may suggest that females and males likely performed similar levels of activity during these periods. © 2017 Wiley Periodicals, Inc.

Osteoarthritis year in review 2015: biology.

Science.gov (United States)

Malfait, A M

2016-01-01

This review highlights a selection of recently published literature in the area of osteoarthritis biology. Major themes transpiring from a PubMed search covering the year between the 2014 and the 2015 Osteoarthritis Research Society International (OARSI) World Congress are explored. Inflammation emerged as a significant theme, revealing complex pathways that drive dramatic changes in cartilage homeostasis and in the synovium. Highlights include a homeostatic role for CXC chemokines in cartilage, identification of the zinc-ZIP8-MTF1 axis as an essential regulator of cartilage catabolism, and the discovery that a small aggrecan fragment can have catabolic and pro-inflammatory effects through Toll-like receptor 2. Synovitis can promote joint damage, partly through alarmins such as S100A8. Synovitis and synovial expression of the pro-algesic neurotrophin, Nerve Growth Factor, are associated with pain. Increasingly, researchers are considering specific pathogenic pathways that may operate in distinct subsets of osteoarthritis associated with distinct risk factors, including obesity, age, and joint injury. In obesity, the contribution of metabolic factors and diet is under intense investigation. The role of autophagy and oxidative stress in age-related osteoarthritis has been further explored. This approach may open avenues for targeted treatment of distinct phenotypes of osteoarthritis. Finally, a small selection of novel analgesic targets in the periphery is briefly discussed, including calcitonin gene-related peptide and the neuronal sodium voltage-gated channels, Nav1.7 and Nav1.8. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

How to define responders in osteoarthritis

Science.gov (United States)

Cooper, Cyrus; Adachi, Jonathan D.; Bardin, Thomas; Berenbaum, Francis; Flamion, Bruno; Jonsson, Helgi; Kanis, John A.; Pelousse, Franz; Lems, Willem F.; Pelletier, Jean-Pierre; Martel-Pelletier, Johanne; Reiter, Susanne; Reginster, Jean-Yves; Rizzoli, René; Bruyère, Olivier

2013-01-01

Background Osteoarthritis is a clinical syndrome of failure of the joint accompanied by varying degrees of joint pain, functional limitation, and reduced quality of life due to deterioration of articular cartilage and involvement of other joint structures. Scope Regulatory agencies require relevant clinical benefit on symptoms and structure modification for registration of a new therapy as a disease-modifying osteoarthritis drug (DMOAD). An international Working Group of the European Society on Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) and International Osteoporosis Foundation was convened to explore the current burden of osteoarthritis, review current regulatory guidelines for the conduct of clinical trials, and examine the concept of responder analyses for improving drug evaluation in osteoarthritis. Findings The ESCEO considers that the major challenges in DMOAD development are the absence of a precise definition of the disease, particularly in the early stages, and the lack of consensus on how to detect structural changes and link them to clinically meaningful endpoints. Responder criteria should help identify progression of disease and be clinically meaningful. The ideal criterion should be sensitive to change over time and should predict disease progression and outcomes such as joint replacement. Conclusion The ESCEO considers that, for knee osteoarthritis, clinical trial data indicate that radiographic joint space narrowing >0.5 mm over 2 or 3 years might be a reliable surrogate measure for total joint replacement. On-going research using techniques such as magnetic resonance imaging and biochemical markers may allow the identification of these patients earlier in the disease process. PMID:23557069

Elektra prosthesis for trapeziometacarpal osteoarthritis

DEFF Research Database (Denmark)

Klahn, A; Nygaard, Mads; Gvozdenovic, R

2012-01-01

We present a prospective follow-up of 39 Elektra prostheses in 37 patients (32 women and five men), with a mean age of 56.5 (range 46-71) years; 34 patients had osteoarthritis and three had rheumatoid arthritis. Patients were followed using clinical examination, including measurement of pain...... be the key problem in treating trapeziometacarpal osteoarthritis using a total prosthesis....

Differences in characteristics and patient-reported questionnaire responses in patients who choose non-surgical versus surgical treatment for severe hip osteoarthritis

DEFF Research Database (Denmark)

Have, Mads; Overgaard, Søren; Jensen, Carsten

Background: Preoperative patient characteristics may influence patient choice for participating in RCT’s. Purpose / Aim of Study: This study aimed to compare patient characteristics, level of pain, physical function and joint space width in patients with severe hip osteoarthritis (OA) who accepted...... or refused to participate in a RCT. Materials and Methods: In this prospective cohort study a total of 137 patients with primary hip OA were asked to choose between surgical or non- surgical treatment. We then compared the characteristics of each patient cohort (demographics, pain level and duration......, analgesic use, exercise habits), the radiographic hip OA state and their responses to Hip dysfunction and Osteoarthritis Outcome Score (HOOS, 0-100) and European Quality of Life Scale (EQ-5D-5L) questionnaires. Findings / Results: The between-group HOOS scores were significantly different in three out...

Estonia's defence dollars spent wisely? / Tony Lawrence, Kaarel Kaas ; interv. Joel Alas

Index Scriptorium Estoniae

Lawrence, Tony

2007-01-01

Rahvusvahelise Kaitseuuringute Keskuse teadurid Tony Lawrence ja Kaarel Kaas kommenteerivad Eestis Suurbritannia kaitseatasheena töötanud kolonelleitnant Glen Granti kriitikat kaitsejõudude efektiivsuse osas, Eesti kaitsepoliitikat, küberrünnakut Eestile, kahe Eesti rahukaitseväelase surma missioonil Afganistanis ning üldsuse suhtumist Eesti osalemisele rahvusvahelistel missioonidel. Lisa: Tony Lawrence; Kaarel Kaas

Reconstructive surgery for patellofemoral joint incongruency.

Science.gov (United States)

Neumann, M V; Stalder, M; Schuster, A J

2016-03-01

A retrospective analysis of a heterogeneous patient cohort was performed to determine the outcome and eligibility of a combined trochleaplasty and soft tissue-balancing technique for repair of patellofemoral joint disorders. A strict surgical treatment algorithm including trochleaplasty and reconstruction of the medial patellofemoral ligament and vastus medialis oblique muscle was implemented to restore the patellofemoral joint. A heterogeneous patient cohort including 46 consecutively treated symptomatic knees was reviewed. The median follow-up period was 4.7 years (range 24-109 months). No patellar redislocation occurred post-operatively, and the median Kujala score improved from 62 (9-96) to 88 (47-100) points (p patellofemoral degenerative changes showed progression of osteoarthrosis according to the Kellgren and Lawrence classification. The surgical combination of trochleaplasty and reconstruction of the medial patellofemoral ligament and vastus medialis oblique muscle offers excellent clinical and radiological results. The overall results of the present study showed significant improvement of the Kujala score in patients with Dejour grades C and D dysplasia. These results outline the clinical relevance of trochleaplasty with additional soft tissue balancing as an effective joint-preserving method with satisfying results in patients with pre-existing degenerative changes. IV.

Prolotherapy for Osteoarthritis and Tendinopathy: a Descriptive Review.

Science.gov (United States)

Rabago, David; Nourani, Bobby

2017-06-01

Osteoarthritis and overuse tendinopathy are common chronic conditions of high societal and patient burden. The precise etiology of pain and disability in both conditions is multifactorial and not well understood. Patients are often refractory to conservative therapy. The development of new therapeutic options in both conditions is a public health priority. Prolotherapy is an injection-based outpatient regenerative therapy for chronic musculoskeletal conditions, including osteoarthritis and tendinopathy. The authors reviewed the basic science and clinical literature associated with prolotherapy for these conditions. Systematic review, including meta-analysis, and randomized controlled trials suggest that prolotherapy may be associated with symptom improvement in mild to moderate symptomatic knee osteoarthritis and overuse tendinopathy. Although the mechanism of action is not well understood and is likely multifactorial, a growing body of literature suggests that prolotherapy for knee osteoarthritis may be appropriate for the treatment of symptoms associated with knee osteoarthritis in carefully selected patients who are refractory to conservative therapy and deserves further basic and clinical science investigation for the treatment of osteoarthritis and tendinopathy.

Osteoarthritis among women in bahrain: a public health audit.

Science.gov (United States)

Asokan, Gv; Hussain, Muna S Hussain Abdullah; Ali, Eman Jm; Awate, Rajendra V; Khadem, Zahra Ka; Al-Safwan, Zainab Am

2011-11-01

This study aims to train students on public health survey; correlate risk factors of osteoarthritis and to identify modifiable risk factors. Osteoarthritis survey was carried out among 420 Bahraini women, above 40 years of age, diagnosed of osteoarthritis, attending ministry of health facilities. Most cases in the study were from the age group of 50-59 years with a mean age of 57. Osteoarthritis: of major joints alone was 74%; of generalized was 21% and of small joints of hands and feet alone was 5%. Within major osteoarthritis: 48% were knees alone; 51% were knee and hip and 2% were hip alone. Combinations of co-morbidities were found among 43%. History of diagnosed: diabetes in 10%, hypertension among 13% and hypercholesterolemia in 5% of cases. Half of the cases in the study were obese and 30% were overweight. Osteoarthritis of the Knee and the combination of the osteoarthritis of knee and hip was highest among obese followed by overweight cases. Menopause was found among 68%of patients. Patients on medication accounted for 85% and 75% were on Physiotherapy. Half of the sample had family history of osteoarthritis. While over 90% were less educated with odds ratio for being housewives at 3.085. The multivariate analysis of ordinal regression returned pseudo R(2) of 30% for the model with the following significant variables: age, BMI, menopause status, exercise, chronic morbidities and family history of osteoarthritis. Overall, the proportion of major osteoarthritis of the weight bearing joints is very high. The modifiable risk factors identified from this study are sedentary lifestyle, obesity and overweight, as well as chronic morbidities.

Magnetotherapy in hand osteoarthritis: a pilot trial.

Science.gov (United States)

Kanat, Elvan; Alp, Alev; Yurtkuran, Merih

2013-12-01

To evaluate the effectiveness of magnetotherapy in the treatment of hand osteoarthritis (HO). In this randomized controlled single-blind follow-up study, patients with HO were randomly assigned into 2 groups (G1 and G2). The subjects in G1 (n=25) received 25Hz, 450 pulse/s, 5-80G, magnetotherapy of totally 10 days and 20 min/day combined with active range of motion/strengthening exercises for the hand. G2 (n=25) received sham-magnetotherapy for 20 min/day for the same duration combined with the same hand exercises. Outcome measures were pain and joint stiffness evaluation, handgrip and pinchgrip strength (HPS), Duruöz and Auscan Hand Osteoarthritis Indexes (DAOI) and Short Form-36 Health Questionnaire (SF-36) administered at baseline, immediately after treatment and at the follow up. When the groups were compared with each other, improvement observed in SF-36 Pain (p<0.001), SF-36 Social Function (p=0.030), SF-36 Vitality (p=0.002), SF-36 General Health (p=0.001), Pain at rest (p<0.001), Pain at motion (p<0.001), Joint stiffness (p<0.001), DAOI (p<0.001) were in favor of G1. Changes in pain, function and quality of life scores showed significant advantage in favor of the applied electromagnetic intervention in patients with HO. Copyright © 2013 Elsevier Ltd. All rights reserved.

Cross-cultural adaptation and validation of the Turkish version of Oxford hip score.

Science.gov (United States)

Tuğay, Baki Umut; Tuğay, Nazan; Güney, Hande; Hazar, Zeynep; Yüksel, İnci; Atilla, Bülent

2015-06-01

The purpose of this study was to translate the Oxford hip score (OHS) into Turkish and to evaluate the psychometric properties by testing the internal consistency, reproducibility, construct validity, and responsiveness in patients with hip osteoarthritis (OA). Oxford hip score was translated and culturally adapted according to the guidelines in the literature. Seventy patients (mean age 61.45 ± 9.29 years) with hip osteoarthritis participated in the study. Patients completed the Turkish Oxford hip score (OHS-TR), the Short-Form 36 (SF-36), and Western Ontario and McMaster Universities Index (WOMAC). Internal consistency was tested using Cronbach's α coefficient. Patients completed OHS-TR questionnaire twice in 7 days for determining the reproducibility. Correlation between the total results of both tests was determined by the Pearson correlation coefficient and intraclass correlation coefficient (ICC). Validity was assessed by calculating the Pearson correlation coefficient between the OHS-TR and WOMAC and SF-36 scores. Floor and ceiling effects were analyzed. The internal consistency was high (Cronbach's α 0.93). The construct validity showed a significant correlation between the OHS-TR and WOMAC and related SF-36 domains (p < 0.001). The ICC's ranged between 0.80 and 0.99. There was no floor or ceiling effect in total OHS-TR score. The OHS-TR questionnaire is valid, reliable, and responsive for the Turkish-speaking patients with hip OA.

Osteoarthritis - histology and pathogenetic concepts

International Nuclear Information System (INIS)

Sulzbacher, I.

2000-01-01

Osteoarthitis is the most common joint disease affecting over 60% of the elderly population. It is characterized by the progressive erosion of articular cartilage leading to incapacity of movement. In the great majority of instances, osteoarthritis appears insidiously, without apparent initiating cause. This primary form is usually oligoarticular involving hip, knee, cervical vertebrae, interphalangeal joints of the fingers or tarsometatarsal joints of the feet. In case of an underlying systemic diasease or local injury the cartilage destruction is considered as secondary osteoarthritis. The pathogenesis of primary osteoarthritis suggests an intrinsic disease of cartilage in which biochemical and metabolic alterations result in its breakdown. Within the last decades different models were stablished which also concentrated on other joint structures such as bone or ligaments. Changes of the subchondral bone were found to precide cartilage damage suggesting a primary alteration of the subchondral region. Other studies concentrated on the metabolic activity of chondrocytes in healthy cartilage of osteoarthritis patients. The precise event that leads to these changes is still not clear. This review concentrates on the histological features in the course of the disease and tries to provide a summary on different pathogenetic concepts. (orig.) [de

The effect of mud therapy on pain relief in patients with knee osteoarthritis: a meta-analysis of randomized controlled trials.

Science.gov (United States)

Liu, Hua; Zeng, Chao; Gao, Shu-guang; Yang, Tuo; Luo, Wei; Li, Yu-sheng; Xiong, Yi-lin; Sun, Jin-peng; Lei, Guang-hua

2013-10-01

A meta-analysis was conducted to examine the effect of mud therapy on pain relief in patients with knee osteoarthritis (OA). A detailed search of PubMed®/MEDLINE® was undertaken to identify randomized controlled trials and prospective comparative studies published before 9 March 2013 that compared mud therapy with control group treatments in patients with knee OA. A quantitative meta-analysis of seven studies (410 patients) was performed. There was a significant difference between the groups in the visual analogue scale pain score (standardized mean difference [SMD] -0.73) and Western Ontario and McMaster Universities Osteoarthritis Index pain score (SMD -0.30), with differences in favour of mud therapy. Mud therapy is a favourable option for pain relief in patients with knee OA. Additional high-quality randomized controlled trials need to be conducted to explore this issue further and to confirm this conclusion.

Mindfulness Is Associated With Treatment Response From Nonpharmacologic Exercise Interventions in Knee Osteoarthritis.

Science.gov (United States)

Lee, Augustine C; Harvey, William F; Price, Lori Lyn; Han, Xingyi; Driban, Jeffrey B; Wong, John B; Chung, Mei; McAlindon, Timothy E; Wang, Chenchen

2017-11-01

To examine the association between baseline mindfulness and response from exercise interventions in knee osteoarthritis (OA). Cohort study; responder analysis of a clinical trial subset. Urban tertiary care academic hospital. Participants with symptomatic, radiographic knee OA (N=86; mean age, 60y; 74% female; 48% white). Twelve weeks (twice per week) of Tai Chi or physical therapy exercise. Treatment response was defined using Osteoarthritis Research Society International criteria indicating meaningful improvements in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, WOMAC function, or Patient Global Assessment scores. At baseline, participants completed the Five Facet Mindfulness Questionnaire (mean total score, 142±17) and were grouped into 3 categories of total mindfulness: higher, medium, or lower. Relative risk (RR) ratios were used to compare treatment response across groups. Participants with higher total mindfulness were 38% (95% confidence interval [CI], 1.05-1.83) more likely to meet responder criteria than those with lower mindfulness. We found no significant difference between medium and lower mindfulness groups (RR=1.0; 95% CI, 0.69-1.44). Among the 5 mindfulness facets, medium acting-with-awareness was 46% (95% CI, 1.09-1.96) more likely to respond than lower acting-with-awareness, and higher acting-with-awareness was 34% more likely to respond, but this did not reach significance (95% CI, 0.97-1.86). In this study, higher mindfulness, primarily driven by its acting-with-awareness facet, was significantly associated with a greater likelihood of response to nonpharmacologic exercise interventions in knee OA. This suggests that mindfulness-cultivating interventions may increase the likelihood of response from exercise. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Therapeutic Effectiveness and Safety of Mesotherapy in Patients with Osteoarthritis of the Knee.

Science.gov (United States)

Chen, Liang; Li, Dongqing; Zhong, Jun; Qiu, Bo; Wu, Xianglei