Knee Osteoarthritis In Older Adults Research Articles

An overview of knee osteoarthritis severity in Pandanwangi, Malang

Introduction: The global prevalence of knee osteoarthritis in older adults is expected to continue to increase until 2050. This increase was consistent with the prevalence rates in Malang. This progression is simultaneously controlled by Sustainable Development Goals. This service is a measure to support the government in the early detection of severity and education of knee osteoarthritis patients. Methods: The method was adopted through Community-Based Participatory Research at Puskesmas Pandanwangi, Malang. The respondents included 58 elderly people with symptoms of knee osteoarthritis. According to the Indonesian Rheumatology Association, the symptoms often experienced in Indonesia are pain, crepitus when moved, joint stiffness for more than 30 min, indications of enlargement of the knee area, tenderness of the bone edge, and no warmth in the synovium area. Results: The results of the average mapping show that respondents experienced knee osteoarthritis severity in the mild category or had a Laquesne index score of more than 1-4. Conclusion: The severity of osteoarthritis in Pandanwangi is influenced by age and body mass index. These respondents were educated on sitting up and down, stair step up, knee flexion, heel slide knee extension, and tight booster exercises to prevent severity at the next level. Exercise parameters were adjusted according to the respondent's condition for 8-12 weeks, 2-3 sessions per week.

Effect of high plant protein/peptide nutrition supplementation on knee osteoarthritis in older adults with sarcopenia: A randomized, double-blind, placebo-controlled trial

Background & AimsSkeletal muscle is an important contributor to joint health. Previous studies have shown that age-related muscle mass and strength loss are closely associated with the development of knee osteoarthritis. The objective of this study is to investigate whether a high plant protein/peptide nutrition supplementation can alleviate knee osteoarthritis by improving muscle mass and strength. MethodsThis randomized, double-blind, placebo-controlled trial that included participants aged 50–70 years diagnosed with knee osteoarthritis and sarcopenia was conducted in China from February 2022 to September 2022 (ChiCTR2200056415). Participants were randomized to receive a 12-week high plant protein/peptide nutrition supplementation or a placebo twice daily, with one serving each after breakfast and lunch, respectively. The primary outcome analyzed using intention-to-treat analysis was difference in Short Physical Performance Battery (SPPB) from baseline to week 12 between the two groups. The secondary outcomes included changes in muscle mass, strength, symptom and imaging of knee osteoarthritis, body composition, biochemical parameters, and health quality scores. ResultsAfter 12 weeks, a total of 124 participants (38.7% male) completed the trial and were included in the final analysis. Over the 12-week follow-up, the experimental group showed a significant improvement in the SPPB total score (1.03, 95% CI, 0.69 to 1.38, P < 0.0001) compared with the placebo group. Grip strength (2.83 kg, 95% CI, 2.13–3.53, P < 0.0001) and skeletal muscle mass index (0.66 kg/m2, 95% CI, 0.45–0.86, P < 0.0001) were also significantly increased in the experimental group compared with the placebo group. The mean change in Western Ontario and McMaster Universities Osteoarthritis Index total score was −3.95 points (95% CI, −5.02 to −2.89, P < 0.0001) in the experimental group and 0.23 points (95% CI, −0.17 to 0.63, P = 0.253) in the placebo group. Additionally, within the experimental group, nine participants experienced an improvement in osteophyte magnetic resonance imaging results, while no improvement was observed in the placebo group. The experimental group also exhibited significant improvements in health quality compared with the placebo group as assessed by Short Form 36, the World Health Organization Quality of Life Brief Scale, and the Chalder Fatigue Scale. No serious adverse event was reported during the trial. ConclusionOral supplementation with high levels of plant protein/peptides can alleviate symptoms of osteoarthritis in elderly individuals with minor and mild knee osteoarthritis and sarcopenia. The improvement may be attributed to the enhancement of muscle mass, strength, and physical performance.

Short-Term Impact of Low-Intensity Exercise with Blood Flow Restriction on Mild Knee Osteoarthritis in Older Adults: A Pilot Study

This pilot study aimed to investigate the immediate impact of low-intensity exercises with blood flow restriction (BFR) on older adults with knee osteoarthritis (KOA). Fifteen patients with KOA who were over 50 years old, participated and underwent low-intensity resistance knee exercises at 30% of their one-repetition maximum with BFR three times/week for two weeks. Pre- and post-exercise assessments included pain levels, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, isokinetic knee strength, lower extremity muscle volume (via leg circumference and muscle thickness), functional performance tests (timed up-and-go [TUG] and sit-to-stand [STS]), skeletal muscle index (SMI) using bioelectrical impedance analysis, and handgrip strength (HGS). Post-exercise, there was a significant reduction in pain. WOMAC scores showed significant improvements across all three domains: pain, stiffness, and physical function. In the TUG and STS tests, completion times were significantly reduced. Thigh and calf circumferences, as well as thigh muscle thickness significantly increased after exercise. Post-exercise SMI and HGS also significantly increased. However, isokinetic knee strength did not show significant changes. In conclusion, low-intensity BFR exercises provide immediate benefits in symptoms and physical performance for patients with KOA, potentially inducing local and systemic muscle mass increase, even after a short-term intervention.

The Influence of Weather Conditions on the Diurnal Variation in Range of Motion in Older Adults with Knee Osteoarthritis.

(1) Background: This study investigated the relationship between weather conditions, diurnal patterns, and total knee range of motion (ROM), as well as the severity of symptoms (pain and stiffness) in older adults with knee osteoarthritis. (2) Methods: An exploratory longitudinal study was conducted on 28 older adults with knee osteoarthritis (mean age 71.86 ± 4.49 years; 46.4% men, 53.6% women). We used as assessment tools the Visual Analog Scales (VAS) for self-reported local knee pain and stiffness, and goniometry for ROM. Measurements were taken twice, six months apart, in winter and summer, in the morning and evening of each selected day. Recorded weather factors comprised temperature, relative humidity, barometric pressure, and maximum wind speed. (3) Results: The study revealed significant effects of season and time of day on pain and stiffness, respectively (p < 0.001). Additionally, a significant interaction between season and time influenced total knee ROM (p < 0.001). Moreover, there was a statistically significant relationship between time and total knee ROM (p < 0.001). (4) Conclusions: This research underscores the complex link between seasonal fluctuations and daily variations in some symptomatic and functional aspects of knee osteoarthritis in older adults.

Quantitative evaluation of the infrapatellar fat pad in knee osteoarthritis: MRI-based radiomic signature

BackgroundThe infrapatellar fat pad (IFP) may have bilateral influence on knee osteoarthritis (KOA). IFP evaluation may be a key contributor to the diagnostic and clinical management of KOA. Few studies have evaluated KOA-related IFP alteration with radiomics. We investigated radiomic signature for the assessment of IFP for KOA progression in older adults.MethodsA total of 164 knees were enrolled and grouped based on Kellgren-Lawrence (KL) scoring. MRI-based radiomic features were calculated from IFP segmentation. The radiomic signature was developed using the most predictive subset of features and the machine-learning algorithm with minimum relative standard deviation. KOA severity and structure abnormality were assessed using a modified whole-organ magnetic resonance imaging score (WORMS). The performance of the radiomic signature was evaluated and the correlation with WORMS assessments was analyzed.ResultsThe area under the curve of the radiomic signature for diagnosing KOA was 0.83 and 0.78 in the training and test datasets, respectively. Rad-scores were 0.41 and 2.01 for the training dataset in the groups with and without KOA (P < 0.001) and 0.63 and 2.31 for the test dataset (P = 0.005), respectively. WORMS significantly and positively correlated with rad-scores.ConclusionsThe radiomic signature may be a reliable biomarker to detect IFP abnormality of KOA. Radiomic alterations in IFP were associated with severity and knee structural abnormalities of KOA in older adults.

Risk factors for the long-term incidence and progression of knee osteoarthritis in older adults: role of nonsurgical injury.

For one of the most chronic medical conditions, osteoarthritis, uncertainties remain on the impact of injury chronology, the role of repeat injury on the incidence/progression of this disease and the need for knee arthroplasty. To explore, in an older adult population, how nonsurgical knee injuries relate to osteoarthritis incidence/progression and the weight of independent risk factors for arthroplasty. A cohort study design evaluates the long-term impact of injuries on knee osteoarthritis outcomes. Knees with no prior injury (n = 6358) and with at least one injury (n = 819) ⩽20 years before study inclusion were from the Osteoarthritis Initiative cohort. Sociodemographic, clinical and structural [X-ray, magnetic resonance imaging (MRI)] data at study inclusion and changes within 96 months were analysed. Statistics included a mixed model for repeated measurements, generalized estimating equations and multivariable Cox regression with covariates. At inclusion, knees with prior injury demonstrated greater incidence and severity of osteoarthritis (p ⩽ 0.001). At 96 months, there was a greater increase in symptoms [Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, p = 0.002], joint space width (JSW, p = 0.039) loss, medial cartilage volume loss (CVL, p ⩽ 0.001) and bone marrow lesion size (BML, p ⩽ 0.049). Knees with/without injury at inclusion but with new ones over time had a pronounced increase in symptoms (all WOMAC scores, p ⩽ 0.001), JSW loss, lateral (without) and medial CVL, lateral (without) and medial meniscal extrusion and medial BML (without; all p ⩽ 0.030). Levels of lateral and medial meniscal extrusion (without) and symptoms (with/without; all WOMAC scores, p ⩽ 0.001) were all accentuated with a repeated new injury. Risk factors associated with the highest knee arthroplasty occurrence are new meniscal extrusion and new injury (p ⩽ 0.001). This study highlights the importance of nonsurgical knee injury in older adults as an independent risk factor for knee osteoarthritis and arthroplasty. These data will be beneficial in clinical practice as they will help identify individuals at greater risk of significant disease progression and worst disease outcomes for a customized therapeutic approach.

Biomonitoring the skeletal muscle metabolic dysfunction in knee osteoarthritis in older adults: Is Jumpstart Nutrition® Supplementation effective?

This study aimedto investigate the efficacy of Jumpstart Nutrition® dietary supplement (JNDS) for enhancing the skeletal muscle metabolism and function of older adults with knee osteoarthritis (KOA) by evaluating the biomarkers of aberrant levels of serum tumor necrosis factor-alpha (TNF-α), interleukin-10 (IL-10), C-reactive protein (CRP), creatine kinase-muscle (CK-MM), and aldolase-A (Aldo-A). This twelve-week registry included 54 patients treated with JNDS mainly comprised of calcium, phosphorus, vitamin-K2, coenzyme-Q10, boswellic acid, and curcumin mixed with soy and whey protein (experimental group) and 51 patients treated with symptomatic slow-acting drugs for osteoarthritis (SYSADOA) (control group) for KOA confirmed with radiological images. At week 0 and week 12 for both the groups evaluated, the non-fasting serum levels of TNF-α, IL-10, CRP, CK-MM, and Aldo-A by using appropriate kits. At week-twelve, the respective values of area under the ROC curves of the studied biomarkers for pooled experimental cohorts were 0.928, 0.907, 0.908, 0.927, and 0.988 having the significance of accuracy (R-square):66.28%, 47.25%, 70.39%, 65.13%, and 68.00%, indicating a satisfactory treatment policy, their mean± SD, and risk ratio, all exhibited highly significant differences (p<0.0001) and KOA-gradation was upgraded between≥2 and ≥3 from≥4 as per the Kellgren-Lawrence scale compared to the control. Fewer patients had to use emergency medications (p<0.05). Results suggest that JNDS may be effectively used to strengthen the skeletal muscle metabolismand function of elderly patients with KOA confirmed with the stabilization of studied biomarkers as an alternative to the treatment of SYSAD correlated with ROC curves and the Kellgren-Lawrence scale.

Effect of Heeled Shoes on Joint Symptoms and Knee Osteoarthritis in Older Adults: A 5-Year Follow-Up Study.

ObjectiveOur aims were to examine the effects of heeled shoes on incident knee osteoarthritis (OA) and joint pain.MethodsWe used longitudinal data from the Chingford 1000 Women Study (Chingford Study), a prospective cohort of women aged 50 years or older. Participants with musculoskeletal disorders and/or a history of knee‐related injury/surgery were excluded. Participants were followed for up to 5 years for incident outcomes including 1) radiographic knee OA (RKOA) and 2) joint pain (feet, knees, hips, and back). Footwear data, including ever worn heels of 2 inches or more and daytime/evening hours (per week) spent wearing heeled shoes over five decades (ages <20 years, 20‐30 years, 30‐40 years, and >50 years), were available at Year 10 whereas knee radiographs and joint symptom data were also collected at Year 15. Cumulative time spent wearing heeled shoes was calculated for women reporting ever‐use of heeled shoes (≥2 inches). Multiple logistic regression was used to examine the relationship between exposures and outcomes (from Year 10 to Year 15).ResultsA total of 356 women were eligible at Year 10 with a median (interquartile range) age of 60 (56‐65) years. Compared with non‐use, ever‐use of heeled shoes (≥2 inches) was not associated with incident RKOA (1.35; 95% confidence interval: 0.56‐3.27). No associations were observed between increasing cumulative time spent wearing heels and incident outcomes.ConclusionCompared with the non‐use of heeled shoes, ever‐use of heels (≥2 inches) was not associated with incident RKOA and incident joint symptoms. Further, increasing cumulative time spent wearing heels was not associated with any of our outcomes.

The Effect of Theory-Led Intervention for Knee Osteoarthritis in Older Adults: A Cluster Randomized Trial

Knee osteoarthritis (KOA) is a common joint disease in people over 60 years old. Exercise therapy is one of the most effective non-pharmacological treatments for KOA, but low exercise adherence needs to be improved. This two-arm cluster randomized trial study was to evaluate the effect of the transtheoretical model-lead home exercise intervention (TTM-HEI) program on exercise adherence, KOA symptom (pain intensity and joint stiffness) and knee function (lower limb muscle strength and balance) in Chinese older adults diagnosed with KOA. A total of 189 community-dwelling older adults with KOA (intervention group: n = 103, control group: n = 86) were enrolled from 14 community centers in Beijing, China in 2018. The intervention was a two-stage and 24-week transtheoretical model-based exercise program, and the control group underwent a same length but non-theory-based exercise program. Exercise adherence was measured at weeks 4, 12, 24, 36, and 48 after the program started, KOA symptoms and knee function were measured at baseline, week 24, and week 48. Results showed that the growth rate of exercise adherence in the intervention group increased 2.175 units compared with the control group (unstandardized coefficient of slope on group B2 = 2.175, p < 0.001), and the intervention program maintained participants’ exercise adherence with 5.56 (SD = 1.00) compared with 3.16 (SD = 1.31) in the control group at week 48. In addition, TTM-HEI program showed significant effects on relieving KOA symptoms and improving knee function. This study provided an effective strategy for KOA intervention.

Electromoxibustion for knee osteoarthritis in older adults: A pilot randomized controlled trial

BackgroundElectromoxibustion devices are commercially available and can be self-administered by patients. Nevertheless, little is known about the effectiveness and potential burn injury of these devices as this topic is under-investigated. ObjectiveTo assess the preliminary effects and safety of an electromoxibustion (EM) device for improving knee pain and joint functions in older adults with knee osteoarthritis (KOA). Design, setting, participants and interventionThis was a pilot two-armed assessor-blinded randomized controlled trial to assess the effects of electromoxibustion (EM) on older adults with KOA. A total of 38 subjects aged 60 or above, with KOA for 3 months or above were recruited. Participants were randomized to the EM group or the knee health education group. The intervention group (n = 21) received 12 sessions of EM spanning across four weeks, while the control group (n = 17) received two sessions of knee health education. Main outcome measuresPrimary outcome included the pain severity Numerical Rating Scale (NRS) at baseline and week 4. Secondary outcomes included the Western Ontario and McMaster University Osteoarthritis Index (WOMAC), Short-Form Six-Dimension (SF6D), Timed Up & Go Test (TUG) and Fast Speed Gait (FSG). ResultsBoth groups showed a decreasing trend in knee pain intensity by NRS at post-intervention. There were also trends of improvement in the WOMAC score, TUG score, FGS test score and SF-6D score at week 4. Only a small between-group effect size (d = 0.13) was found, but medium between-group effects sizes were found in the WOMAC total score (d = 0.40) and WOMAC functional sub-score (d = 0.51). However, the differences were not statistically significant. ConclusionThis study suggested that EM may be beneficial for KOA in older adults, particularly in terms of improving knee function. Replication of similar studies in larger RCTs is warranted to confirm the effectiveness of EM on reducing pain and knee function of older adults with KOA. Trail registration numberNCT04034394.

The effect of transtheoretical model-lead intervention for knee osteoarthritis in older adults: a cluster randomized trial

BackgroundKnee osteoarthritis (KOA) is a common joint disease in people over 60 years old. Exercise therapy is one of the most effective non-pharmacological treatments for KOA, but low exercise adherence needs to be improved. The present study aimed to evaluate the effect of the transtheoretical model-lead home exercise intervention (TTM-HEI) program on exercise adherence, KOA symptoms, and knee function in older adults with KOA.MethodsA two-arm, superiority, assessor-blinded, cluster randomized trial was conducted. Community-dwelling older adults with KOA were recruited from 14 community centers in Beijing, China, via print and social media advertisements from April to October 2018. The present study lasted 48 weeks, with an intervention duration of 0–24 weeks and follow-up time of 24–48 weeks. The intervention was a two-stage and 24-week TTM-based exercise program, and the control group underwent a same-length exercise program guidance without any exercise adherence interventions. The primary outcome was exercise adherence to the prescribed home exercise program and was measured using an 11-point numerical (0 = not at all through and 10 = completely as instructed) self-rating scale at weeks 4, 12, 24, 36, and 48 after the program started. KOA symptoms (pain intensity and joint stiffness) were measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and knee function (lower limb muscle strength and balance) was measured using the Five-Times-Sit-to-Stand Test (FTSST) and the Timed Up and Go Test (TUG) at baseline, week 24, and week 48. Latent growth model (GLM), repeated measures ANOVA, and independent t test were the main statistical tests used.ResultsA total of 189 older adults (intervention group: n = 103, control group: n = 86) were enrolled. Differences of any outcome measures at baseline were not significant between groups. The growth rate of exercise adherence in the intervention group increased 2.175 units compared with that in the control group (unstandardized coefficient of slope on group B2 = 2.175, p < 0.001), and the intervention program maintained participants’ exercise adherence with 5.56 (SD = 1.00) compared with 3.16 (SD = 1.31) in the control group at week 48. In addition, the TTM-HEI program showed significant effects on relieving KOA symptoms and improving knee function.ConclusionOver time, TTM-HEI could improve participants’ exercise adherence, KOA symptoms, and knee function.Trial registrationThis study was approved by the ethics committee (IRB00001052-17066) in July 2017 and was registered at the Chinese Clinical Trial Registry (website: www.chictr.org.cn, registry number: ChiCTR1800015458).

Electromoxibustion and Knee Health Education for Knee Osteoarthritis in Older Adults

Electromoxibustion and Knee Health Education for Knee Osteoarthritis in Older Adults

Effects of dry needling in an exercise program for older adults with knee osteoarthritis: A pilot clinical trial.

Background:Few studies have investigated the dry needling (DN) approach on knee osteoarthritis (KO) patients. The study's aim was to evaluate the short-term efficacy of adding DN to a therapeutic exercise protocol in the treatment of KO in older adults.Methods:A double-blind, pilot clinical trial with parallel groups [NCT02698072] was carried out for 12 weeks of treatment and follow-up. Twenty patients aged 65 years and older with myofascial trigger points (MTrPs) in the muscles of the thigh were recruited from older-adult care centers and randomly assigned to a DN + Exercise group or a Sham-DN + Exercise group. The Numeric Rating Scale (NRS; primary outcome) and Western Ontario and McMaster Universities Osteoarthritis Index questionnaire (WOMAC) were assessed before and after the intervention.Results:The NRS (analysis of variance, ANOVA) showed statistically significant differences in the time factor (F = 53.038; P < .0001; ηp2 = 0.747). However, it did not show a significant change in the group–time interaction (F = 0.082; P = .777; ηp2 = 0.005). The WOMAC scores (ANOVA) showed statistically significant differences in the time factor for total score WOMAC questionnaire (F = 84.826; P < .0001; ηp2 = 0.825), WOMAC pain (F = 90.478; P < .0001; ηp2 = 0.834), WOMAC stiffness (F = 14.556; P < .001; ηp2 = 0.447), and WOMAC function (F = 70.872; P < .0001; ηp2 = 0.797). However, it did not show a statistically significant change in the group–time interaction.Conclusion:Despite the pain intensity and disability clinically relevant improvement for both DN and Sham-DN combined with exercise, 6 sessions of DN added to a therapeutic exercise program for older adults with KO did not seem to improve pain intensity and functionality.

A Narrative Review of the Prevalence and Risk Factors Associated With Development of Knee Osteoarthritis After Traumatic Unilateral Lower Limb Amputation.

Young military Service Members with traumatic unilateral lower limb amputations may be at a high risk for developing knee osteoarthritis (OA). There is growing evidence for potential influence and predictive value of nonsystemic risk factors on development and progression of primary knee OA in older adults. Proposed factors include chronic knee pain, obesity, abnormal knee joint mechanics, muscle weakness, previous knee trauma, and altered physical activity level. However, there is limited information available regarding whether such nonsystemic risk factors could also be responsible for the increased risk of knee OA after traumatic, unilateral lower limb amputation in young military Service Members. The purpose of this narrative review is to compile and present evidence regarding prevalence of nonsystemic and potentially modifiable knee OA risk factors in Service Members with traumatic, unilateral lower limb amputation, and to identify potential strategies for intervention. A comprehensive literature search was performed in July 2015 using structured search terms related to nonsystemic risk factors for knee OA. Current collective evidence does suggest an elevated prevalence of the nonsystemic knee OA risk factors in young military Service Members with unilateral lower limb amputation. In conclusion, the present state of the literature supports that young military Service Members with traumatic unilateral lower limb amputations may be at increased risk for developing knee OA compared to nonamputees. Military Service Members injured at a young age have a long life expectancy, and thus require comprehensive rehabilitation programs to prevent or delay progression of knee OA. Given the lack of strong evidence, further clinical research is needed to determine whether early identification and modification of nonsystemic risk factors for knee OA could optimize long-term function and quality of life in young Service Members after traumatic, unilateral, limb amputations.

Is yoga better than aerobic/strengthening exercises for managing knee osteoarthritis in older adults?

Is yoga better than aerobic/strengthening exercises for managing knee osteoarthritis in older adults?

The relationships between bone mineral density and radiographic features of hand or knee osteoarthritis in older adults: data from the Dong-gu Study.

The relationship between OA and osteoporosis has exhibited contradictory features over the past four decades. The aim of this study was to determine using separate analysis of the radiographic features of OA whether various radiographic features of OA were associated differently with BMD in the Korean elderly. Data were derived from the Dong-gu cohort; 2354 subjects were enrolled in the present cross-sectional study. Baseline characteristics, the BMDs of the lumbar spine and femoral neck measured by DXA, and X-rays of knees and hands were collected. A semi-quantitative grading system was used to estimate the severities of individual radiographic features. We adjusted for confounders using multiple linear regression modelling to analyse the relationships. After adjustment for confounders, hand and knee OA total scores were negatively associated with the BMDs of the lumbar spine and femoral neck, except for the total knee OA score and lumbar spine BMD. In detail, hand osteophytes and sclerosis exhibited positive relationships with the BMDs of the lumbar spine and femoral neck, except for hand osteophytes and femoral neck BMD. On the contrary, however, knee joint space narrowing (JSN), hand JSN, and hand subchondral cysts were negatively associated with the BMD of the lumbar spine and femoral neck. Knee JSN and hand subchondral cysts exerted the greatest effects on BMD. Separate analysis of the radiographic features of OA better reveals associations of OA with the BMD of the lumbar spine and femoral neck.

VITAMIN D SUPPLEMENTATION AND FUNCTIONAL KNEE OSTEOARTHRITIS PROGRESSION IN OLDER ADULTS WITH OBESITY: DATA FROM THE OSTEOARTHRITIS INITIATIVE

Objective: Older adults with obesity are at increased risk of knee osteoarthritis (KOA) and vitamin D deficiency, but data on the effect of vitamin D supplementation in this population are equivocal. This study evaluated the effect of vitamin D supplementation on functional progression of KOA in older adults with obesity. Participants with Body Mass Index ≥30 kg/m2 and aged ≥ 60 years from the Osteoarthritis Initiative progression cohort were stratified by baseline vitamin D use. The relationship between vitamin D supplementation and progression of KOA at 72 months was characterized. The Western Ontario McMaster University Osteoarthritis Index (WOMAC) pain scale was the primary outcome measure. Secondary measures included: WOMAC disability, Physical Activity Scale for the Elderly, gait speed and Knee injury and Osteoarthritis Outcome Score (KOOS) scales. In older adults with KOA and obesity, baseline supplemental vitamin D use did not predict functional progression of osteoarthritis at 72 months.

SAT0450 Efficacy of Hydroxychloroquine in the Treatment of Symptomatic Knee Osteoarthritis in Older Adults: A Randomized Placebo-Controlled Trial

BackgroundOsteoarthritis (OA), particularly knee OA, is one of the most common causes of pain and disability in older people. Inflammation has been implicated in the pathogenesis of OA. Antimalarial agents...

Physical activity and incident clinical knee osteoarthritis in older adults

To study the relationship between 4 components of physical activity and the 12-year incidence of clinical knee osteoarthritis (OA) among older adults. Longitudinal data from 1,678 men and women, ages 55-85 years, were collected in the Longitudinal Aging Study Amsterdam. Incident clinical knee OA was defined by an algorithm using self-report and general practitioner data. Physical activity was assessed by a validated questionnaire from which 4 physical activity component scores were created: muscle strength, intensity, mechanical strain, and turning actions. Cox proportional hazards models were conducted to examine the relationship between these scores and incident knee OA and reported as hazard ratios (HRs) with 95% confidence intervals (95% CIs). During 12 years of followup, 463 respondents (28%) developed clinical knee OA. A high mechanical strain score (HR 1.43, 95% CI 1.15-1.77) and a low muscle strength score (HR 1.30, 95% CI 1.01-1.68) were associated with an increased risk of knee OA after adjustment for age, sex, region of living, education, lifetime physical work demands, lifetime general physical activity, body mass index, current total physical activity level, and depression. No association was observed in the intensity and turning actions components. The results were similar for men and women, and for obese and nonobese respondents. Older adults who perform low muscle strength activities or activities causing high mechanical strain had an increased risk of clinical knee OA. These results suggest that specific components of physical activity may influence the development of knee OA.

Effect of recreational physical activities on the development of knee osteoarthritis in older adults of different weights: The Framingham Study

To evaluate the long-term effect of recreational exercise on the development of knee osteoarthritis (OA) in a community-based cohort of older adults, many of whom were overweight or obese. Subjects were asked about recreational activities including walking or jogging for exercise and working up a sweat, and were asked to compare their activity levels with others. Subjects were then asked about knee pain and weight-bearing anteroposterior and lateral knee radiographs were obtained. Approximately 9 years later, subjects were reexamined for OA. Radiographs were read for OA features in both tibiofemoral and patellofemoral compartments and were scored for tibiofemoral joint space narrowing. To evaluate incident OA, we excluded knees with OA at baseline for all analyses and focused on 3 knee-specific outcomes: incident radiographic OA, symptomatic OA, and tibiofemoral joint space loss. After adjusting for age, sex, body mass index (BMI), knee injury history, and correlation between knees, we evaluated the association of each recreational activity with OA development. A total of 1,279 subjects underwent both baseline and followup examinations (mean age at baseline 53.2 years). Neither recreational walking, jogging, frequent working up a sweat, nor high activity levels relative to peers were associated with a decrease or increase in risk of OA. Joint space loss was also unaffected by activity. Persons with BMI above the median (27.7 kg/m(2) for men and 25.7 kg/m(2) for women; mean BMI >30 kg/m(2) for both) had no increases in risk of OA by different type of activity. Among middle-aged and elderly persons without knee OA, many of whom were overweight, recreational exercise neither protects against nor increases risk of knee OA.