Risk Of Knee Osteoarthritis Research Articles

Improved genetic prediction of the risk of knee osteoarthritis using the risk factor-based polygenic score

BackgroundPolygenic risk score (PRS) analysis is used to predict disease risk. Although PRS has been shown to have great potential in improving clinical care, PRS accuracy assessment has been mainly focused on European ancestry. This study aimed to develop an accurate genetic risk score for knee osteoarthritis (OA) using a multi-population PRS and leveraging a multi-trait PRS in the Japanese population.MethodsWe calculated PRS using PRS-CS-auto, derived from genome-wide association study (GWAS) summary statistics for knee OA in the Japanese population (same ancestry) and multi-population. We further identified risk factor traits for which PRS could predict knee OA and subsequently developed an integrated PRS based on multi-trait analysis of GWAS (MTAG), including genetically correlated risk traits. PRS performance was evaluated in participants of the Nagahama cohort study who underwent radiographic evaluation of the knees (n = 3,279). PRSs were incorporated into knee OA integrated risk models along with clinical risk factors.ResultsA total of 2,852 genotyped individuals were included in the PRS analysis. The PRS based on Japanese knee OA GWAS was not associated with knee OA (p = 0.228). In contrast, PRS based on multi-population knee OA GWAS showed a significant association with knee OA (p = 6.7 × 10−5, odds ratio (OR) per standard deviation = 1.19), whereas PRS based on MTAG of multi-population knee OA, along with risk factor traits such as body mass index GWAS, displayed an even stronger association with knee OA (p = 5.4 × 10−7, OR = 1.24). Incorporating this PRS into traditional risk factors improved the predictive ability of knee OA (area under the curve, 74.4% to 74.7%; p = 0.029).ConclusionsThis study showed that multi-trait PRS based on MTAG, combined with traditional risk factors, and using large sample size multi-population GWAS, significantly improved predictive accuracy for knee OA in the Japanese population, even when the sample size of GWAS of the same ancestry was small. To the best of our knowledge, this is the first study to show a statistically significant association between the PRS and knee OA in a non-European population.Trial registrationNo. C278.

Sitting may increase risk for radiographic incidence and progression of knee osteoarthritis over 2years: Data from alarge cohort study.

To examine the association of leisure-time sitting with radiographic incidence and progression of knee osteoarthritis (OA) over 2years, and to determine whether worktime sitting modifies this association. We included adults with or at high risk for knee OA who enroled in the Osteoarthritis Initiative (OAI). Participants reported leisure-time sitting (≤4 vs. >4h/day) and worktime sitting (frequent vs. infrequent) at enrolment, and had bilateral knee radiographs at enrolment and 2years later. Our outcome, radiographic knee OA incidence/progression (yes/no), was defined as any increase in Kellgren-Lawrence grade over 2years. We examined the association of leisure-time sitting (≤4 vs. >4h/day) with risk of radiographic knee OA incidence/progression using binary linear regression, adjusting for potential confounders. We stratified by worktime sitting (frequent vs. infrequent) and repeated our analysis. We included 4254 adults (mean age 61years; 58% women; mean body mass index 29kg/m2 ) who contributed a total of 8127 knees. Adults with >4h/day of leisure-time sitting had 25% higher risk (adjusted risk ratio [RR] 1.25, 95% confidence interval [95% CI] 1.08-1.50) for radiographic knee OA incidence/progression compared with adults with ≤4h/day of leisure-time sitting (referent group). Importantly, this association was intensified (RR 1.60, 95% CI 1.19-2.33) among adults with frequent worktime sitting, but was attenuated (RR 1.11, 95% CI 0.89-1.39) among adults with infrequent worktime sitting. Higher leisure-time sitting (>4h/day) may be associated with greater risk for radiographic knee OA incidence/progression over 2years. Furthermore, this association was intensified among adults who also reported frequent worktime sitting.

Evaluating the risk of knee osteoarthritis following unilateral ACL reconstruction based on an EMG-assisted method.

Objective: Anterior cruciate ligament reconstruction (ACLR) cannot decrease the risk of knee osteoarthritis after anterior cruciate ligament rupture, and tibial contact force is associated with the development of knee osteoarthritis. The purpose of this study was to compare the difference in bilateral tibial contact force for patients with unilateral ACLR during walking and jogging based on an EMG-assisted method in order to evaluate the risk of knee osteoarthritis following unilateral ACLR. Methods: Seven unilateral ACLR patients participated in experiments. The 14-camera motion capture system, 3-Dimension force plate, and wireless EMG test system were used to collect the participants' kinematics, kinetics, and EMG data during walking and jogging. A personalized neuromusculoskeletal model was established by combining scaling and calibration optimization. The inverse kinematics and inverse dynamics algorithms were used to calculate the joint angle and joint net moment. The EMG-assisted model was used to calculate the muscle force. On this basis, the contact force of the knee joint was analyzed, and the tibial contact force was obtained. The paired sample t-test was used to analyze the difference between the participants' healthy and surgical sides of the participants. Results: During jogging, the peak tibial compression force on the healthy side was higher than on the surgical side (p = 0.039). At the peak moment of tibial compression force, the muscle force of the rectus femoris (p = 0.035) and vastus medialis (p = 0.036) on the healthy side was significantly higher than that on the surgical side; the knee flexion (p = 0.042) and ankle dorsiflexion (p = 0.046) angle on the healthy side was higher than that on the surgical side. There was no significant difference in the first (p = 0.122) and second (p = 0.445) peak tibial compression forces during walking between the healthy and surgical sides. Conclusion: Patients with unilateral ACLR showed smaller tibial compression force on the surgical side than on the healthy side during jogging. The main reason for this may be the insufficient exertion of the rectus femoris and vastus medialis.

Levothyroxine use and longitudinal changes in thigh muscles in at-risk participants for knee osteoarthritis: preliminary analysis from Osteoarthritis Initiative cohort

BackgroundWe examined the association between levothyroxine use and longitudinal MRI biomarkers for thigh muscle mass and composition in at-risk participants for knee osteoarthritis (KOA) and their mediatory role in subsequent KOA incidence.MethodsUsing the Osteoarthritis Initiative (OAI) data, we included the thighs and corresponding knees of participants at risk but without established radiographic KOA (baseline Kellgren-Lawrence grade (KL) < 2). Levothyroxine users were defined as self-reported use at all annual follow-up visits until the 4th year and were matched with levothyroxine non-users for potential confounders (KOA risk factors, comorbidities, and relevant medications covariates) using 1:2/3 propensity score (PS) matching. Using a previously developed and validated deep learning method for thigh segmentation, we assessed the association between levothyroxine use and 4-year longitudinal changes in muscle mass, including cross-sectional area (CSA) and muscle composition biomarkers including intra-MAT (within-muscle fat), contractile percentage (non-fat muscle CSA/total muscle CSA), and specific force (force per CSA). We further assessed whether levothyroxine use is associated with an 8-year risk of standard KOA radiographic (KL ≥ 2) and symptomatic incidence (incidence of radiographic KOA and pain on most of the days in the past 12 months). Finally, using a mediation analysis, we assessed whether the association between levothyroxine use and KOA incidence is mediated via muscle changes.ResultsWe included 1043 matched thighs/knees (266:777 levothyroxine users:non-users; average ± SD age: 61 ± 9 years, female/male: 4). Levothyroxine use was associated with decreased quadriceps CSAs (mean difference, 95%CI: − 16.06 mm2/year, − 26.70 to − 5.41) but not thigh muscles’ composition (e.g., intra-MAT). Levothyroxine use was also associated with an increased 8-year risk of radiographic (hazard ratio (HR), 95%CI: 1.78, 1.15–2.75) and symptomatic KOA incidence (HR, 95%CI: 1.93, 1.19–3.13). Mediation analysis showed that a decrease in quadriceps mass (i.e., CSA) partially mediated the increased risk of KOA incidence associated with levothyroxine use.ConclusionsOur exploratory analyses suggest that levothyroxine use may be associated with loss of quadriceps muscle mass, which may also partially mediate the increased risk of subsequent KOA incidence. Study interpretation should consider underlying thyroid function as a potential confounder or effect modifier. Therefore, future studies are warranted to investigate the underlying thyroid function biomarkers for longitudinal changes in the thigh muscles.

Longitudinal associations of body mass index and abdominal circumference with back pain among community-dwelling adults: data from the Osteoarthritis Initiative

BACKGROUND CONTEXTBack pain is the most common musculoskeletal problem in both developed and developing countries. The prevalence and burden of back pain increases with age, and the management of back pain becomes increasingly important in the context of global aging. There is increasing evidence that obesity is a modifiable risk factor for musculoskeletal pain in different locations. Understanding the role of obesity in back pain holds great potential for improving understanding of the mechanisms of back pain and for developing new preventive and therapeutic approaches. PURPOSETo evaluate the role of weight, body mass index (BMI) and abdominal circumference (AC) in risk of back pain over 96 months. DESIGNProspective cohort study. PATIENT SAMPLEThe sample was from 4,793 adults in the Osteoarthritis Initiative (OAI) database who had or were at increased risk for knee Osteoarthritis. OUTCOME MEASURESOutcome variables included the presence, severity, and frequency of back pain, using the past 30 days as the time frame. METHODSLongitudinal analysis of data from 4,793 participants enrolled in the Osteoarthritis Initiative, assessed every 12 or 24 months for weight, BMI (kg/m2), AC (cm), and presence, severity (none, mild, moderate, severe), and frequency (none, rarely, sometimes, often, always) of back pain. BMI and AC were decomposed into between-person and with-person components. Data analyses were performed using mixed-effects logistic (for presence of back pain) or ordered logistic regression (for severity and frequency of back pain) models. ResultsBack pain was reported in 58% of participants at baseline; 70% of those without back pain had incident back pain over 96 months. Both between-person (average value across a participant's all measurements) and within-person (deviations from the participant's average) effects of weight and BMI increased risk of presence, severity, and frequency of back pain (Odds radios (OR) per kg/m2: 1.010–1.046, p<.05) in females but not males, with statistically significant weight*sex and BMI*sex interactions. Similar findings were observed for between-person effects of AC on back pain, and the within-person effect of AC was only associated with back pain severity (OR per cm: 1.009, 95% confidence interval 1.002–1.017, p=.019) in females. CONCLUSIONSGreater average weight and BMI and increases in them increased odds of presence, severity, and frequency of back pain over 96 months in middle aged and older women but not men. Only average AC increased odds of back pain over time, in women. These findings suggest that preventing obesity and slowing weight gain is important for the management of back pain.

Prevalence and factors associated with knee osteoarthritis among middle-aged and elderly individuals in rural Tianjin: a population-based cross-sectional study

BackgroundThe prevalence of osteoarthritis has been investigated in many countries and regions. Considering the wide differences in ethnicity, socioeconomic status, environmental factors, and lifestyle patterns, our study aimed to report the prevalence of knee osteoarthritis (KOA) and its associated factors in rural areas of Tianjin.MethodsThis population-based cross-sectional study was conducted between June and August 2020. KOA was diagnosed according to the 1995 American College of Rheumatology criteria. Information on participants’ age, years of education, BMI, smoking and drinking status, sleep quality, and frequency of walking were collected. Multivariate logistic regression analysis was used to analyze factors influencing KOA.ResultsThis study included 3924 participants (1950 male and 1974 female); the mean age of all participants was 58.53 years. In total, 404 patients were diagnosed with KOA, and the overall prevalence of KOA was 10.3%. The prevalence of KOA was higher in women than in men (14.1% vs. 6.5%). The risk of KOA in women was 1.764 times higher than that in men. The risk of KOA increased following the increasement of age. There was higher risk of KOA in participants who walked frequently than in participants who walked infrequently (OR = 1.572); in participants with overweight than in participants with normal weight (OR = 1.509), in participants with average sleep quality (OR = 1.677) and those with perceived poor sleep quality (OR = 1.978), respectively, than participants with satisfactory sleep quality, and in postmenopausal women than in non-menopausal women (OR = 4.12). The risk of KOA in participants with an elementary level was lower (0.619 times) than participants with illiteracy. In addition, the results of gender subgroup analysis showed that in male, age, obesity, frequent walking and sleep quality were independent factors associated with KOA; while in female, age, BMI, education level, sleep quality, frequent walking and whether menopausal were independent factors associated with KOA (P < 0.05).ConclusionThe results of our population-based cross-sectional study showed that sex, age, educational level, BMI, sleep quality, and frequent walking were independent influencing factors for KOA, and the influencing factors for KOA differed between the sexes. In order to reduce the disease burden of KOA and the harm to the health of middle-aged and elderly people, the risk factors related to the control of KOA should be identified as much as possible.Trial registration: ChiCTR2100050140.

Relation of pain sensitization to self-reported and performance-based measures of physical functioning: the Multicenter Osteoarthritis (MOST) study

It is unclear if alterations in nociceptive signaling contribute to poor physical functioning in persons with knee osteoarthritis (OA). We aimed to characterize the relation of pain sensitization to physical functioning in persons with or at risk for knee OA, and determine if knee pain severity mediates these relationships. We used cross-sectional data from the Multicenter Osteoarthritis Study, a cohort study of persons with or at risk for knee OA. Pressure pain thresholds (PPTs) and temporal summation (TS) were assessed with quantitative sensory testing. Self-reported function was quantified with the Western Ontario and McMaster Universities Arthritis Index function subscale (WOMAC-F). Walking speed was determined during a 20-mwalk. Knee extension strength was assessed with dynamometry. Relations of PPTs and TS to functional outcomes were examined with linear regression. The mediating role of knee pain severity was assessed with mediation analyses. Among 1560 participants (60.5% female, mean age (SD) 67 (8), body mass index (BMI) 30.2 (5.5) kg/m2), lower PPTs and the presence of TS were associated with worse WOMAC-F scores, slower walking speeds, and weaker knee extension. The extent of mediation by knee pain severity was mixed, with the greatest mediation observed for self-report function and only minimally for performance-based function. Heightened pain sensitivity appears to be meaningfully associated with weaker knee extension in individuals with or at risk for knee OA. Relations to self-reported physical function and walking speed do not seem clinically meaningful. Knee pain severity differentially mediated these relationships.

Effect of transtibial prosthesis weight on the contralateral knee joint in relation to the risk of osteoarthritis.

Individuals with transtibial amputation place more load on the contralateral lower extremity. A higher adduction moment at the knee joint has been shown to have an effect on the risk of osteoarthritis. The aim of this study was to investigate the effect of weight-bearing of lower-limb prosthesis on the biomechanical parameters associated with the risk of contralateral knee osteoarthritis. Cross-sectional. The experimental group of 14 subjects with unilateral transtibial amputation (13 males). The mean age was 52.7 ± 14.2 years, height 175.6 ± 6.3 cm, weight 82.3 ± 12.5 kg, and duration of prosthesis use 16.5 ± 9.1 years. The control group consisted of 14 healthy subjects with identical anthropometric parameters. Dual emission X-ray absorptiometry was used to determine the weight of the amputated limb. For gait analysis, 10 Qualisys infrared cameras and a motion sensing system on 3 Kistler force platforms were used. Gait was analyzed with the original, lighter, commonly used prosthesis, as well as the prosthesis loaded to the original limb weight. The gait cycle and kinetic parameters of the amputated and healthy limbs were more similar to those of the control group when using the weighted prosthesis. We recommend further research to more accurately specify the weight of the lower-limb prosthesis with respect to the prosthesis design and duration of use of the heavier prosthesis during the day.

Investigate the situation of knee osteoarthristic and evaluate the results of treatment in Ha Dong general hospital in 2021

Objective: To investigate the situation of knee osteoarthritis and evaluate the results of treatment of primary knee osteoarthritis at Ha Dong General Hospital in 2021.Subjects and methods: A retrospective descriptive study on 93 medical records with a diagnosis of knee osteoarthritis according to the standards of the American College of Rheumatology ACR 1991, VAS scale &lt; 6 points, and Damp-Cold combined with Liver and Kidney deficiency according to TCM at Ha Dong General Hospital in 2021. Experimental group: Moxibustion-infrared lamp + Doc hoat ky sinh thang decoction + Electro- acupuncture for 20 days. Control group: Doc hoat ky sinh thang decoction + Electro-acupuncture for 20 days.Results: Physical workers and BMI ≥ 23 increase the risk of knee osteoarthritis. X-ray characteristics of the knee joint: mainly degeneration with 92.47% and inflammation with 60.81%. Features of knee joint ultrasound: Knee effusion accounted for 37.84%, Baker cyst accounted for 11.86%; 83.87% had osteophyte, 51.61% had endplate sclerosis and 39.78% had joint space narrowing. According to modern medicine: the number of patients with knee osteoarthritis and inflamed knee osteoarthritis has a similar incidence. According to traditional medicine: 81.72% were diagnosed with Damp-Cold combined with Liver and Kidney deficiency; 18.28% were Damp-Heat combined with Liver and Kidney deficiency, 9.68% were Damp-Cold standalone. The pain reduction efficiency according to VAS of the experimental group was 5.96 ± 1.09 points, higher than that of the control group which was 4.56 ± 0.77 points with statistical significance (p&lt;0.05). In the experimental group, 30% of patients had no pain, 70% of patients had mild pain. In the control group, 10% of patients had moderate pain, 86.7% had mild pain and only 3.3% of patients had no pain. The difference between the two groups was statistically significant (p&lt;0.05). The improvement effect of the experimental group was better than the control group, the difference was statistically significant (p &lt; 0.05). During 20 days of treatment, there were no unwanted clinical effects.

Association of general and central obesity, and their changes with risk of knee osteoarthritis: a nationwide population-based cohort study

In this study, we aimed to evaluate the association between general and central obesity, and their changes with risk of knee osteoarthritis (OA) using retrospective cohort data collected from the Korean National Health Insurance Service. We studied 1,139,463 people aged 50 and over who received a health examination in 2009. To evaluate the association between general and/or central obesity and knee OA risk, a Cox proportional hazard models were used. Additionally, we investigate knee OA risk according to the change in obesity status over 2 years for subjects who had undergone health examinations for 2 consecutive years. General obesity without central obesity (HR 1.281, 95% CI 1.270–1.292) and central obesity without general obesity (HR 1.167, 95% CI 1.150–1.184) were associated with increased knee OA risk than the comparison group. Individuals with both general with central obesity had the highest risk (HR 1.418, 95% CI 1.406–1.429). This association was more pronounced in women and younger age group. Remarkably, the remission of general or central obesity over two years was associated with decreased knee OA risk (HR 0.884; 95% CI 0.867–0.902; HR 0.900; 95% CI 0.884–0.916, respectively). The present study found that both general and central obesity were associated with increased risk of knee OA and the risk was highest when the two types of obesity were accompanied. Changes in obesity status have been confirmed to alter the risk of knee OA.

Effects of Running on the Development of Knee Osteoarthritis: An Updated Systematic Review at Short-Term Follow-up.

Some studies have suggested that running increases the risk of knee osteoarthritis (OA), while others believe it serves a protective function. To perform an updated systematic review of the literature to determine the effects of running on the development of knee OA. Systematic review; Level of evidence, 4. A systematic review was performed by searching the PubMed, Cochrane Library, and Embase databases to identify studies evaluating the effect of cumulative running on the development of knee OA or chondral damage based on imaging and/or patient-reported outcomes (PROs). The search terms used were "knee AND osteoarthritis AND (run OR running OR runner)." Patients were evaluated based on plain radiographs, magnetic resonance imaging (MRI), and PROs (presence of knee pain, Health Assessment Questionnaire-Disability Index, and the Knee injury and Osteoarthritis Outcome Score). Seventeen studies (6 level 2 studies, 9 level 3 studies, and 2 level 4 studies), with 7194 runners and 6947 nonrunners, met the inclusion criteria. The mean follow-up time was 55.8 months in the runner group and 99.7 months in the nonrunner group. The mean age was 56.2 years in the runner group and 61.6 years in the nonrunner group. The overall percentage of men was 58.5%. There was a significantly higher prevalence of knee pain in the nonrunner group (P < .0001). Although 1 study found a significantly higher prevalence of osteophytes in the tibiofemoral (TF) and patellofemoral (PF) joints within the runner group, multiple studies found no significant differences in the prevalence of radiographic knee OA (based on TF/PF joint-space narrowing or Kellgren-Lawrence grade) or cartilage thickness on MRI between runners and nonrunners (P > .05). One study found a significantly higher risk of knee OA progressing to total knee replacement among nonrunners (4.6% vs 2.6%; P = .014). In the short term, running is not associated with worsening PROs or radiological signs of knee OA and may be protective against generalized knee pain.

Genetic polymorphisms of interleukin-16 in Egyptian patients with primary knee osteoarthritis

BackgroundThe pro-inflammatory cytokine, interleukin 16 (IL-16), has been shown to be secreted in low levels in knee osteoarthritis (KOA). The aim of the study was to examine the relationship between IL-16 polymorphisms and the risk of KOA in the Egyptian population, as well as the clinical and radiographic severity of KOA.ResultsIL16 rs11556218 thymidine triphosphate (T) T G (guanosine triphosphate), GG, TG + GG genotypes, and G allele (odd ratio (OR) = 0.315; 95% confidence interval (CI) = 0.191–0.518; P < 0.001; OR = 0.363; 95% CI = 0.162–0.815, P = 0.014; OR = 0.323; 95% CI = 0.202–0.519, P < 0.001; OR = 0.480; 95% CI = 0.338–0.683, P < 0.001 respectively); rs4778889 cytidine triphosphate (C) T,CC, TC + CC genotypes, and C allele (OR = 0.519, 95% CI = 0.319–0.844, P = 0.008; OR = 0.309, 95% CI = 0.105–0.916, P = 0.034; OR = 0.485, 95% CI = 0.304–0.775, P = 0.002; OR = 0.537, 95% CI = 0.365–0.791, P = 0.001 respectively); and rs4072111 CT, TT, CT + TT genotypes, and T allele (OR = 0.537, 95% CI = 0.323–0.893, P = 0.017, OR = 0.316, 95% CI = 0.096–0.843, P = 0.049, OR = 0.502, 95% CI = 0.309–0.816, P = 0.005; OR = 0.534, 95% CI = 0.353–0.809, P = 0.004 respectively) were associated with a decreased KOA risk, and they were significantly associated with decreased the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and the Kellgren-Lawrence (K/L) scores.Neither IL-16 serum levels nor IL-16 polymorphisms were associated with the susceptibility to KOA. Low KOA risk was associated with the haplotypes GTC and TCT.ConclusionThere was no correlation between serum IL-16 levels and KOA susceptibility or IL-16 polymorphisms. GTC and TCT haplotypes were associated with low KOA risk. The variant alleles rs11556218GG, TG + GG; rs4778889 CC, TC + CC; and rs4072111 TT, CT + TT were associated with a reduced risk of KOA.

Elucidating factors contributing todisparities in pain-related experiences among adults with or at risk for knee osteoarthritis.

We and others have reported ethnic/race group differences in clinical pain, physical function, and experimental pain sensitivity. However, recent research indicates that with consideration for socioenvironmental factors, ethnicity/race differences become less or non-significant. Understanding of factors contributing to pain inequities are needed. Guided by the NIA and NIMHD Health Disparities Research Frameworks, we evaluate the contributions of environmental and behavioral factors on previously reported ethnic/race group differences in: (1) clinical pain, (2) physical function, and (3) experimental pain in individuals with knee pain. Baseline data from Understanding of Pain and Limitations in Osteoarthritis Disease (UPLOAD) and UPLOAD-2 studies were analyzed. Participants were adults 45 to 85 years old who self-reported as non-Hispanic white (NHW) or black (NHB) with knee pain. A health assessment and quantitative sensory testing were completed. Sociodemographics, environmental, health, clinical and experimental pain, and physical functioning measures were included in nested regressions. Pooled data from 468 individuals, 57 ± 8 years of age, 63% women, and 53% NHB adults. As NHB adults were younger and reported greater socioenvironmental risk than the NHW adults, the term sociodemographic groups is used. With inclusion of recognized environmental and behavioral variables, sociodemographic groups remained a significant predictor accounting for <5% of the variance in clinical pain and physical function and <10% of variance in experimental pain. The incorporation of environmental and behavioral factors reduced relationships between sociodemographic groups and pain-related outcomes. Pain sites, BMI, and income were significant predictors across multiple models. The current study adds to a body of research on the complex array of factors contributing to disparities in pain-related outcomes.

Association of physical activity with loss of knee joint space width over two years: a compositional data analysis in the Osteoarthritis Initiative

There is continued debate as to how engaging in physical activity (PA), including moderate-to-vigorous PA (MVPA), light PA (LPA), and sedentary time (SED), affects one's risk for knee osteoarthritis (OA). Traditional regression methods do not account for the codependence of these categories of PA, whereby when one category increases, the others must decrease. Thus, we used compositional data analysis (CoDA) to examine time spent in each category of PA, or PA composition, and its association with loss of knee joint space width (JSW), a common indicator of knee OA progression. We performed a secondary analysis of data from a subset of participants in the Osteoarthritis Initiative. These participants had minute-by-minute activity data collected over 7 days at baseline; we then categorized each minute as MVPA, LPA, or SED. Our exposure, PA composition, represented min/day spent in each category. Our outcome, medial JSW loss, was the difference in medial tibiofemoral JSW from baseline to 2years later. We employed CoDA, using an isometric log-ratio transformation, to examine the association of PA composition with medial JSW loss over 2years, adjusting for potential confounders. We included 969 participants (age: 64.5 years, 56% female, body mass index [BMI]: 28.8kg/m2). Mean PA composition was: MVPA 9.1min/day, LPA 278min/day, SED 690min/day. Per adjusted regression models, higher MVPA was not associated with greater medial JSW loss (β=-0.0005, P=0.97), nor was LPA (β=0.06, P=0.27) or SED (β=-0.06, P=0.21). Using CoDA, PA composition was not associated with medial JSW loss over 2years.

Degenerative changes through MR cartilage mapping in anterior cruciate ligament-reconstructed knees

BackgroundAnterior cruciate ligament (ACL) injury increases risk for post traumatic knee osteoarthritis. ACL injury causes lack of knee stability and frequently requires ACL-reconstruction (ACLR) in order to restore functional and anatomical joint stability. Magnetic resonance imaging with T2 mapping sequence is used to quantify the amount of water content in articular cartilage hence; it is considered a better tool and more beneficial than radiographic based assessment in early detection even before being symptomatic. The aim of work is to estimate the incidence of subclinical degenerative changes that happened early in patients who underwent ACL reconstruction and to identify the correlations of T2 mapping values with patients' BMI, meniscal state/operations, ACL graft assessment and presence of ACLR related complications.ResultsThe study was conducted upon 71 patients, divided into 61 anterior cruciate ligament reconstructed knees and 10 control cases using 1.5 T MRI. Assessment of cartilage sub-compartment T2 values and comparison with average normal cartilage T2 values obtained from the control group. Multiple correlations of the grade of articular cartilage degeneration within anterior cruciate ligament reconstructed knees with Body Mass Index (BMI), time of operation as well associated meniscal operations and anterior cruciate ligament graft complications.ConclusionsAdding the T2 cartilage mapping sequence improves the ability to detect subclinical early degenerative articular cartilage changes in patients who underwent anterior cruciate ligament reconstruction, taking into consideration the relation of the patients' BMI, previous meniscal injuries/operation, ACL graft status and related graft complications with the T2 cartilage mapping values.

Association between knee osteoarthritis and the risk of cardiovascular disease and the synergistic adverse effects of lack of exercise

We aimed to determine whether knee OA is associated with CVD risk and all-cause death and to evaluate whether the association differs by exercise behavior. We used Korea National Health Insurance Service (KNHIS) database and included 201,466 participants (7572 subjects diagnosed with knee OA) who underwent health screening between 2009 and 2015. Those who had been diagnosed with knee OA or CVD before the index year were excluded. Cox proportional hazard models were used after adjusting for sociodemographic and CVD risk factors to evaluate the association between knee OA and CVD risk and all-cause death. Stratification analysis was further performed to determine the effect of exercise behavior on this relationship. During a median follow-up of 7.06 ± 2.24 years, 8743 CVD (2510 MI and 6553 stroke) cases developed. Individuals with knee OA had increased risks of CVD [hazard ratio (HR) 1.26, 95% confidence interval (CI) 1.15–1.38], myocardial infarction (MI) (HR 1.20, 95% CI 1.00–1.44), and stroke (HR 1.29, 95% CI 1.16–1.43) compared with those without knee OA. Those with knee OA who did not exercise had an increased risk of CVD (HR 1.25, 95% CI 1.11–1.40), whereas no significant increased CVD risk was observed in those with knee OA who exercised at least once a week (HR 1.11, 95% CI 0.96–1.28). There was no association between knee osteoarthritis and all-cause death. Knee OA was independently associated with an increased risk of CVD. Lack of exercise might have a synergistic adverse effect on the association between knee OA and CVD.

The effect of ITLN1, XCL2 and DOT1L variants on knee osteoarthritis risk in the Han population.

Knee osteoarthritis (KOA) is a complex multifactorial disease, in which genetic factors account for 50% of the risk of osteoarthritis. This study investigated the association between ITLN1, XCL2 and DOT1L variants and KOA risk in the Han population. We applied Agena MassARRAY technology platform to genotype five single-nucleotide polymorphisms (SNPs) in 710 KOA patients and 709 controls. The correlation between ITLN1, XCL2 and DOT1L SNPs (rs2274908, rs4282797, rs4301615 and rs3815308) and KOA risk was calculated by logistic regression analysis, with odds ratio (OR) and 95% confidence intervals (CIs). Also, the relationship between genotypes at these different loci and clinical parameters (White blood cell, Eosinophil ratio, Neutrophil count, Eosinophil count, Monocyte ratio and Monocyte count) among patients and controls was analyzed. In the overall results, rs2274908, rs4301615 and rs3815308 were correlated with KOA susceptibility. After gender stratification analysis, ITLN1 rs2274908 and XCL2 rs4301615 were related to an increased risk of KOA in males, and ITLN1 rs2274908 and DOT1L rs3815308 were related to an increased risk of KOA in females. After age stratification analysis, ITLN1 rs2274908 and XCL2 rs4301615 were correlated with an increased risk of KOA in people aged > 65year old. After smoking stratification analysis and drinking stratification analysis, ITLN1 rs2274908, XCL2 rs4301615 and DOT1L rs3815308 were still associated with the risk of KOA. In short, ITLN1 rs2274908, XCL2 rs4301615 and DOT1L rs3815308 were related to KOA risk in the Han population, which was helpful to clarify the pathogenesis of these sites in KOA.

Bariatric surgery, osteoarthritis and arthroplasty of the hip and knee in Swedish Obese Subjects – up to 31 years follow-up of a controlled intervention study

To study the long-term effect of obesity and bariatric surgery on incidences of osteoarthritis and arthroplasty of hip and knee. Hazard ratios (HR) and incidence rates (IR) of osteoarthritis and arthroplasty of hip and knee were studied in the prospective, controlled, non-randomized Swedish Obese Subjects (SOS) study (bariatric surgery group, n=2007; matched controls given usual obesity care, n=2040) and the SOS reference cohort (n=1135, general population). Osteoarthritis diagnosis and arthroplasty for osteoarthritis were captured from the National Swedish Patient Register. Median follow-up time was 21.2 (IQR 16.4-24.8), 22.9 (IQR 19.1-25.7), and 20.1 years (IQR 18.7-20.9) for the control group, surgery group and reference cohort, respectively. The surgery group displayed lower incidence of hip osteoarthritis (IR 5.3, 95% CI 4.7-6.1) compared to controls (IR 6.6, 95% CI 5.9-7.5, adjHR 0.83, 95% CI 0.69-1.00) but similar incidence of hip arthroplasty. Similar incidence of knee osteoarthritis was observed in the surgery group and controls, but knee arthroplasty was more common in the surgery group (IR 7.4, 95% CI 6.6-8.2 and 5.6, 95% CI 4.9-6.4, adjHR 1.45, 95% CI 1.22-1.74). The reference cohort displayed lower incidences of osteoarthritis and arthroplasty of hip and knee compared with the surgery group and controls. Bariatric surgery did not normalize the increased risk of knee and hip osteoarthritis in patients with obesity but was associated with an increased incidence of knee arthroplasty compared to the control group. With the limitations inherent to the present data, additional studies are needed to confirm these results. clinicaltrials.gov Identifier: NCT01479452.

Research

The February 2023 Research Roundup360 looks at: Clinical and epidemiological features of scaphoid fracture nonunion; Routine sterile glove and instrument change at the time of abdominal wound closure to prevent surgical site infection (ChEETAh); Characterization of genetic risk of end-stage knee osteoarthritis treated with total knee arthroplasty; Platelet-rich plasma or autologous blood injection for plantar fasciitis; Volume and outcomes of joint arthroplasty; The hazards of absolute belief in the p-value laid bare.

Preoperative Loss of Knee Extension Affects Knee Extension Deficit in Patients After Anterior Cruciate Ligament Reconstruction.

Loss of knee extension (LOE) after anterior cruciate ligament reconstruction (ACLR) is associated with limited knee joint function and increased risk for knee osteoarthritis. Preoperative LOE will affect postoperative LOE for up to 12 months after ACLR. Cohort study; Level of evidence, 2. Included were patients who underwent anatomic ACLR between June 2014 and December 2018. In all patients, the postoperative rehabilitation protocol was the same. A heel height difference (HHD) ≥2 cm between the affected and the contralateral leg was used as a measure of LOE. Based on preoperative HHD, patients were divided into LOE and no-LOE groups. The HHD was reevaluated at 1, 3, 4, 6, 9, and 12 months postoperatively. Proportional hazards analysis was used, with the dependent variable being whether a postoperative HHD <2 cm was achieved; the independent variables being the presence or absence of preoperative LOE; and the adjusted variables being age, sex, time to surgery, and presence of meniscal sutures. A total of 389 patients (208 female, 181 male; median age, 21.0 years) were included in the study. There were 55 patients in the LOE group and 334 patients in the no-LOE group. The incidence of LOE at 12 months after ACLR was 13.8% in the no-LOE group and 38.2% in the LOE group (P < .001), with an absolute risk difference of 24.4%. The hazard ratio for achieving postoperative HHD <2 cm was 2.79 for the LOE group versus the no-LOE group (P < .001). Patients with preoperative LOE were nearly 3 times more likely than those without LOE to have LOE at 12 months after ACLR.